BACKGROUND & AIMS: :Cognitive and learning styles research is limited by the lack of evidence supporting valid interpretations of style assessment scores. We sought evidence to support the validity of scores from 4 instruments: the Index of Learning Styles (ILS); the Learning Style Inventory (LSI); the Cognitive Styles Analysis (CSA), and the Learning Style Type Indicator (LSTI). The ILS assesses 4 domains: sensing-intuitive (SensInt), active-reflective (ActRefl), sequential-global (SeqGlob) and visual-verbal (VisVerb), each of which parallel a similar domain in at least 1 of the other instruments. We administered the ILS, LSI and CSA to family medicine and internal medicine residents and Year 1 and 3 medical students and applied the multitrait-multimethod matrix to evaluate convergence and discrimination. After 3 months participants repeated the ILS and completed the LSTI. A total of 89 residents and medical students participated. Multitrait-multimethod analysis showed evidence of both convergence and discrimination for ActRefl (ILS, LSI and LSTI) and SensInt (ILS and LSTI) scores. ILS SeqGlob and SensInt scores showed unanticipated correlation. No other domains met the criteria for convergence or discrimination. Test-retest reliabilities for ILS scores were 0.856 for SensInt, 0.809 for ActRefl, 0.703 for SeqGlob and 0.684 for VisVerb. Cronbach's alpha values were > or = 0.810 for LSI and 0.237-0.758 for LSTI. At least 9 participants misinterpreted the LSI instructions. These data support the validity of ILS active-reflective and sensing-intuitive scores, LSI active-reflective scores and LSTI sensing-intuitive scores for determining learning styles in this population. Cognitive style and learning style scores may not be interchangeable, even for constructs with similar definitions.

背景与目标： : 认知和学习风格研究受到缺乏支持风格评估分数有效解释的证据的限制。我们从4种工具中寻找证据来支持分数的有效性: 学习风格指数 (ILS); 学习风格清单 (LSI); 认知风格分析 (CSA) 和学习风格类型指标 (LSTI)。ILS评估4个域: 感知-直觉 (SensInt)，主动-反射 (ActRefl)，顺序-全局 (SeqGlob) 和视觉-言语 (VisVerb)，每个域在至少1个其他工具中都平行于一个相似的域。我们对家庭医学和内科住院医师以及1年级和3年级的医学生进行了ILS，LSI和CSA的管理，并应用了多性状-多方法矩阵来评估收敛和歧视。3个月后，参与者重复ILS并完成LSTI。共有89名居民和医学生参加。多性状-多方法分析显示了ActRefl (ILS，LSI和LSTI) 和SensInt (ILS和LSTI) 得分的收敛性和区分性。ILS SeqGlob和SensInt评分显示出意想不到的相关性。没有其他领域符合趋同或歧视的标准。对SensInt，ActRefl，SeqGlob，0.703和VisVerb，对0.809 0.856 ILS分数的重测可靠性。LSI的Cronbach α 值> 或 = 0.810，LSTI的0.237-0.758。至少有9名参与者误解了LSI指令。这些数据支持ILS主动反射和感知直觉分数，LSI主动反射分数和LSTI感知直觉分数用于确定该人群的学习方式的有效性。认知风格和学习风格得分可能不可互换，即使对于具有相似定义的结构也是如此。

BACKGROUND & AIMS: :Adolescents who are changing residence, as well as their social and economic circumstances may experience lifestyle changes that have an effect on body composition outcomes such as undernutrition, overweight or obesity. This paper uses data from Birth to Twenty, a birth cohort of South African urban children, to determine the relationship between residential mobility and body mass index (BMI) amongst Black adolescents aged 15 (n=1613), and to examine the role of changes in household socioeconomic status (SES). The prevalence of overweight and obesity in the sample was 25% in females and 8% in males. Amongst the females, a strong positive association between residential mobility and BMI was observed for those who also experienced an increase in household SES between birth and 15 years (β=0.42, SE=0.13), while no effect was identified for males. The study shows the potential for environmental change and increased resources to influence the risk for obesity. It also highlights the value in considering the range of social environmental factors and changes across the early life course that might play a part in evolving nutritional patterns in urban transitioning environments.

背景与目标： : 改变居住地以及他们的社会和经济环境的青少年可能会经历生活方式的改变，这些改变会影响身体成分的结果，例如营养不足，超重或肥胖。本文使用从出生到20岁的数据 (南非城市儿童的出生队列) 来确定居住流动性与15岁黑人青少年 (n = 1613) 的体重指数 (BMI) 之间的关系，并研究其作用在家庭社会经济地位 (SES) 中的变化。样本中超重和肥胖的患病率在女性中25%，在男性中8%。在女性中，对于那些在出生至15岁之间家庭SES增加的人 (β = 0.42，SE = 0.13)，观察到居住流动性与BMI之间存在很强的正相关关系，而对男性则没有发现影响。这项研究显示了环境变化的潜力和增加的资源来影响肥胖的风险。它还强调了在考虑社会环境因素的范围以及整个早期生活过程中可能在城市转型环境中不断变化的营养模式中发挥作用的价值。

BACKGROUND & AIMS: OBJECTIVE:To explore the prognostic value of the postsurgical half-life (HL) of serum alpha-fetoprotein (AFP). BACKGROUND:There is still a paucity of early surrogate indicators of clinical endpoints after liver resection of hepatocellular carcinoma (HCC). METHODS:The analysis was based on cohorts of 225 (exploration set) and 117 (validation set) treatment-naïve HCC patients undergoing curative liver resection. We defined 3 categories of AFP HL: early complete resolution of AFP, normal HL, and prolonged HL if the HL exceeded 7 days. Overall, probabilities of recurrence and survival were estimated and compared across the AFP HL categories. RESULTS:In the exploration cohort, 48 patients (21.3%) achieved early AFP complete resolution, 116 (51.6%) had normal HL, and 61 (27.1%) had prolonged HL. Long AFP HL was significantly associated with early postoperative recurrence (P < 0.001), as was microvascular invasion. Early recurrence within 2 years of resection was observed in 59% of the patients with prolonged AFP HL compared with only 29.3% of those with normal AFP HL (P < 0.001). A log-rank test followed by multivariate Cox analysis identified an independent function of prolonged AFP HL in predicting shorter recurrence-free survival and overall survival time after HCC resection (hazard ratios, 2.81 and 3.58; P < 0.001). When AFP HL analysis was applied to the validation cohort, the association between prolonged AFP HL and survival endpoints (hazard ratio, 11.63 and 16.39; P < 0.001) was confirmed.

背景与目标：

BACKGROUND & AIMS: :Chondrolipoma is an extremely rare variant of lipoma with cartilaginous metaplasia. The presence of nonlipomatous components can lead to a variety of entities in the differential diagnosis from the radiologic findings. We describe an unusual case of a chondrolipoma occurring in the right ankle of a 9-year-old female. Physical examination showed a 3.5-cm, elastic-hard, poorly mobile, nontender mass adherent to the Achilles tendon. Plain radiographs revealed a faintly calcified soft tissue mass without bone involvement. Magnetic resonance imaging showed a well-defined mass with 2 components with heterogeneous signal intensity, suggesting the coexistence of a fatty area and another nonlipomatous component. Marginal excision of the tumor was performed. Histologically, the tumor was composed of mature adipose tissue studded with islands of mature hyaline cartilage. Based on these findings, the tumor was diagnosed as a chondrolipoma. The patient had no evidence of local recurrence within 9 months of follow-up. To the best of our knowledge, this is the first case of chondrolipoma originating from the ankle in a child.

背景与目标： : 软骨脂肪瘤是脂肪瘤的一种极其罕见的变异型软骨化生。非脂肪瘤性成分的存在可导致放射学发现的鉴别诊断疾病中的各种实体。我们描述了一个9岁女性右脚踝发生软骨脂肪瘤的不寻常病例。体格检查显示跟腱附着有3.5厘米，弹性坚硬，移动不良，不柔软的肿块。X线平片显示微弱的钙化软组织肿块，没有骨受累。磁共振成像显示出一个明确的质量，其中有2个成分，信号强度不均匀，表明脂肪区域和另一种非脂肪瘤成分并存。进行了肿瘤的边缘切除术。从组织学上讲，肿瘤由成熟的脂肪组织组成，这些脂肪组织散布着成熟的透明软骨岛。根据这些发现，该肿瘤被诊断为软骨脂肪瘤。在随访的9个月内，患者没有局部复发的证据。据我们所知，这是第一例起源于儿童脚踝的软骨脂肪瘤。

BACKGROUND & AIMS: INTRODUCTION:Abnormal ankle-brachial index (ABI) is associated with increased morbidity and mortality in hemodialysis patients. However, whether the decrease in ABI over time carries the prognostic value is unknown. The aim of this study was to assess whether the decrease in ABI over time was a good predictor of poor cardiovascular (CV) prognosis in hemodialysis patients. METHODS:This study enrolled 234 routine hemodialysis patients and 173 patients completed the follow-up. The ABI was measured by an ABI-form device at baseline and at the first year follow-up. The ΔABI was defined as ABI measured at the first year follow-up minus ABI measured at baseline. Progressors of ABI were defined as patients with ΔABI < -0.3. CV events were defined as CV death, hospitalization for unstable angina, nonfatal myocardial infarction, hospitalization for arrhythmia, hospitalization for congestive heart failure and stroke. RESULTS:The follow-up period was 37.8 ± 11.1 months. In the multivariate analysis, progressors of ABI (hazard ratio, 2.71; 95% confidence interval, 1.10-6.68, P = 0.03), decreased albumin and increased high-sensitivity C-reactive protein were associated with increased CV events. CONCLUSIONS:This longitudinal study showed ΔABI < -0.3 was independently associated with an increase in CV events. Hence, a great decrease in ABI over time might be a useful indicator of poor CV prognosis in hemodialysis patients.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Individuals with HIV disease often must adhere to complex medication regimens. To date, regimen complexity has not been examined in the literature using standardized procedures incorporating all important elements of antiretroviral (ARV) regimens. OBJECTIVE:This article presents a novel method of quantifying regimen complexity using objective criteria addressing the factors that may complicate adherence to ARV regimens. METHODS:Part 1 of this article describes the development of the Antiretroviral Regimen Complexity (ARC) Index scoring system. Based on input from pediatric and adult patients, caregivers of pediatric patients, and health care professionals, this comprehensive system includes the number of medications, dosing schedules, administration methods, special instructions, and required preparations associated with ARV regimens. Weights are applied for each of these factors to produce an overall score representing the regimen's level of complexity. Part 2 of this article presents reliability and validity data for the system. RESULTS:The ARC Index demonstrates excellent test-retest and interrater reliability as well as strong construct and discriminant validity. An on-line version of this system minimizes computation errors. CONCLUSIONS:Although modifications may be necessary for patients requiring nonstandard dosing instructions, preliminary evidence supports the utility of this measure as a reliable and valid indicator of the complexity of antiretroviral treatment regimens.

背景与目标：

BACKGROUND & AIMS: :It is unclear whether overweight but otherwise healthy boys with delayed puberty have a variation of constitutional delay of growth and maturation (CDGM) or a different etiology for their pubertal delay. To characterize better this group of boys and investigate whether their growth pattern distinguishes them from boys with typical CDGM, growth data were analyzed in eight overweight (BMI SDS > or = 85th percentile) and 37 non-overweight (BMI SDS <85th percentile) boys with delayed puberty. Primary outcome measures included predicted height (PH) and adult height (AH). At diagnosis of delayed puberty, the overweight boys had less delayed bone ages (chronological age [CA] - bone age [BA] = 1.2 +/- 1.0 vs 2.5 +/- 1.1 years, p <0.01), greater height SDS for CA (-0.5 +/- 0.7 vs -2.4 +/- 0.8, p <0.001), and greater height SDS for BA (0.6 +/- 0.9 vs -0.4 +/- 1.1, p <0.05). PH for the overweight boys exceeded their mid-parental height (MPH) by 5.0 +/- 7.2 cm while non-overweight boys were predicted to fall below their MPH by 2.8 +/- 6.3 cm (p <0.01). Available AH data corroborated the differences in PH, with a trend for overweight boys to have greater height relative to their MPH than the non-overweight boys. These observations suggest that in the context of delayed puberty, being overweight may modulate adult height and/or that the etiology of delayed puberty in overweight boys may differ from typical CDGM.

背景与目标： : 尚不清楚青春期延迟的超重但健康的男孩是否存在生长和成熟的体质延迟 (CDGM) 或青春期延迟的不同病因。为了更好地描述这一组男孩，并调查他们的生长模式是否将他们与典型CDGM男孩区分开，对8名超重 (BMI SDS> 或 = 85百分位) 和37名非超重 (BMI SDS <85百分位) 青春期延迟男孩的生长数据进行了分析。主要结局指标包括预测身高 (PH) 和成人身高 (AH)。在诊断青春期延迟时，超重男孩的骨龄延迟较少 (按时间顺序年龄 [CA] -骨龄 [BA] = 1.2/- 1.0 vs 2.5/- 1.1岁，p <0.01)，CA的更高高度SDS (-0.5 +/- 0.7 vs -2.4 +/- 0.8，p <0.001)，BA的更高高度SDS (0.6 +/- 0.9 vs -0.4 +/- 1.1，p <0.05)。超重男孩的ph值超过其父母中等身高 (MPH) 5.0 +/-7.2厘米，而非超重男孩预计将低于其MPH 2.8 +/-6.3厘米 (p <0.01)。可用的AH数据证实了PH的差异，超重男孩的身高相对于其MPH的趋势比非超重男孩更大。这些观察结果表明，在青春期延迟的情况下，超重可能会调节成人身高和/或超重男孩青春期延迟的病因可能与典型的CDGM不同。

BACKGROUND & AIMS: :The effect of body mass index (BMI) and obesity on apolipoprotein (apo) A-I levels and kinetics was examined by gender. Apo A-I kinetics were determined with a primed, constant infusion of deuterated leucine in the fed state in 19 men and 13 postmenopausal women. Compared with nonobese men, nonobese women had a higher level of high-density lipoprotein cholesterol (HDL-C) and apo A-I due to a 48% higher apo A-I production rate (PR) (P = .05). Obesity had no significant effects on apo A-I kinetics in women. In contrast, compared with nonobese men, obese men had a 9% lower apo A-I level due to a 64% higher fractional catabolic rate (FCR) partially offset by a 47% higher PR. Obese women had a 52% higher HDL-C than obese men (50 vs 33 mg/dL, respectively; P = .012), a finding related to the faster apo A-I FCR in obese men. BMI was directly correlated with apo A-I FCR (r = 0.84, P < .001) and PR (r = 0.79, P < .001) in men but not in women. Sixty-two percent of the variability in PR and 71% of the variability in FCR were due to BMI in men and only 3% and 23%, respectively, in women. In conclusion, BMI has a significant effect on apo A-I PR and FCR in men but not in women.

背景与目标： : 通过性别检查了体重指数 (BMI) 和肥胖对载脂蛋白 (apo) A-I水平和动力学的影响。在19名男性和13名绝经后女性中，通过在进食状态下持续不断地输注氘代亮氨酸来确定Apo A-I动力学。与非肥胖男性相比，非肥胖女性的高密度脂蛋白胆固醇 (hdl-c) 和apo a-I水平较高，原因是apo A-I的生产率 (PR) 48% 较高 (P = .05)。肥胖对女性的apo A-I动力学没有显着影响。相反，与非肥胖男性相比，肥胖男性的apo a-I水平9% 较低，这是由于64% 较高的分解代谢率 (FCR) 部分被47% 较高的PR抵消。肥胖女性的hdl-c比肥胖男性高52% (分别为50 vs 33 mg/dL; P = .012)，这一发现与肥胖男性的apo a-I FCR更快有关。BMI与男性的apo A-I FCR (r = 0.84，P <.001) 和PR (r = 0.79，P <.001) 直接相关，而女性则不相关。PR变异性的60 2% 和FCR变异性的71% 是由于男性的BMI，而女性分别只有3% 和23%。总之，BMI对男性的apo a-I PR和FCR有显着影响，而女性则没有。

BACKGROUND & AIMS: :Hepatocellular carcinoma (HCC) is a common malignancy and the main cause of mortality in patients with chronic liver diseases. This study reports the inhibitory effect of boron on HCC induced in rats by administering thioacetamide (TAA) (0.03%) in drinking water for 400days. Boron (4mg/kg body weight) was administered orally after induction of carcinoma. Treatment was continued for 122days, and cell proliferation, histology and biochemistry of treated and control group of rats were studied. Proliferating cell nuclear antigen (PCNA), and [(3)H]-thymidine incorporation, which increased in rats exposed to carcinogen, significantly decreased after boron treatment. PCNA index decreased from 80 in HCC rats to 32 after boron treatment. In the control group, it was 20. Boron caused a dose-dependent decrease in carcinogen-induced [(3)H]-thymidine uptake by the rat hepatocyte. It could partially reverse the activity of selected biochemical indicators of hepatic damage, oxidative stress, selenium and serum retinol, which are depleted in liver cancer, and improved overall health of animal. The study implicates the elevated levels of mammalian molybdenum Fe-S containing flavin hydroxylases, which increase the free radical production and oxidative stress, consequently causing increased hepatic cell proliferation in HCC, and reports boron to ameliorate these changes in liver cancer.

背景与目标： 肝细胞癌 (HCC) 是一种常见的恶性肿瘤，是慢性肝病患者死亡的主要原因。这项研究报告了硼通过在饮用水中施用硫代乙酰胺 (TAA) (0.03%) 400天对大鼠诱导的HCC的抑制作用。诱导癌后口服硼 (4mg/kg体重)。持续治疗122天，并研究了治疗组和对照组大鼠的细胞增殖，组织学和生物化学。在暴露于致癌物的大鼠中，增殖细胞核抗原 (PCNA) 和 [(3)H]-胸苷掺入增加，在硼处理后显着减少。硼处理后，PCNA指数从肝癌大鼠的80下降到32。对照组为20。硼导致大鼠肝细胞对致癌物诱导的 [(3)H]-胸苷摄取的剂量依赖性降低。它可以部分逆转肝癌中肝损伤，氧化应激，硒和血清视黄醇的某些生化指标的活性，并改善动物的整体健康状况。该研究暗示了含有黄素羟化酶的哺乳动物钼Fe-S水平升高，这会增加自由基的产生和氧化应激，从而导致HCC中肝细胞增殖增加，并报道硼可以改善肝癌中的这些变化。

BACKGROUND & AIMS: :Inflammation affects the reliability of ferritin. The serum level of transferrin receptor protein (sTfR) represents true demand of iron in the body. This study attempts to identify levels of sTfR and correlate the trends of sTfR/ferritin index with BMI in the population of Karachi. 132 gender matched volunteers between the ages of 20-60 years were recruited for this cross-sectional study. BMI was calculated using the formula: (weight in kg / height in m2). Following groups were made according to South Asian criteria of BMI; Group A: normal weight (18.0-22.9 kg/m2), Group B: overweight (23.0-24.9 kg/m2), Group C: obese (>25.0 kg/m2). Serum ferritin, sTfR and CRP levels were determined using ELISA kits. Statistical comparisons were performed using Mann Whitney U and Spearman's rank correlation, where p<0.05 was considered significant. The results identified increased in TIBC, sTfR, ferritin and CRP in obese as compared to normal weight individuals (p<0.001). sTfR/ferritin ratio was 0.822 which signifies increased risk of acute myocardial infarction in group C. Serum iron (r=-0.359,p=0.004) showed negative correlation with BMI while serum ferritin (r=0.237,p< 0.001) and sTfR (r=0.263,p= 0.036) levels were positively associated to BMI. This study highlights a novel finding that sTfR is most likely a better clinical measure of iron status in inflammatory conditions as its expression is effected by erythropoiesis and not by inflammation. Risk of Acute myocardial infarction can also be predicted by increased sTfR/ferritin ratio.

背景与目标： : 炎症影响铁蛋白的可靠性。血清转铁蛋白受体蛋白 (sTfR) 水平代表体内铁的真正需求。这项研究试图确定sTfR的水平，并将sTfR/铁蛋白指数的趋势与卡拉奇人口的BMI相关联。这项横断面研究招募了132名年龄在20-60岁之间的性别匹配志愿者。BMI的计算公式为 :( 体重kg/身高m2)。根据南亚BMI标准分为以下组; A组: 正常体重 (18.0-22.9千克/m2)，B组: 超重 (23.0-24.9千克/m2)，C组: 肥胖 (> 25.0千克/m2)。使用ELISA试剂盒测定血清铁蛋白，sTfR和CRP水平。使用Mann Whitney U和Spearman秩相关进行统计比较，其中p<0.05被认为是显著的。结果表明，与正常体重个体相比，肥胖者的TIBC，sTfR，铁蛋白和CRP升高 (p<0.001)。0.822了sTfR/铁蛋白比值，这表明C组发生急性心肌梗死的风险增加。血清铁 (r =-0.359，p = 0.004) 与BMI呈负相关，而血清铁蛋白 (r = 0.237，p< 0.001) 和sTfR (r = 0.263，p = 0.036) 与BMI呈正相关。这项研究强调了一项新发现，即sTfR最有可能是炎症条件下铁状态的更好的临床指标，因为其表达受红细胞生成而不是炎症影响。急性心肌梗死的风险也可以通过增加sTfR/铁蛋白比率来预测。

BACKGROUND & AIMS: PURPOSE:To investigate the effect of the glycemic index (GI) of pre-exercise snack bars on substrate utilization during subsequent moderate intensity exercise. METHODS:Fourteen male participants (Age: 27 ± 5 yr; BMI: 22.5 ± 2.7 kg m(-2); [Formula: see text]: 48.7 ± 6.1 mL kg(-1 )min(-1)) completed two trials in a randomized and counterbalanced crossover design. Two iso-caloric snack bars with different GI values (20, LGI versus 68, HGI) were provided to the participants. Ninety minutes later, all participants completed 45 minutes of ergometer cycling at 65% [Formula: see text]. Substrate utilization was measured using indirect calorimetry. RESULTS:During exercise, higher fat oxidation and lower carbohydrate (CHO) oxidation were observed in the LGI trial (LGI versus HGI: CHO, 87.3 ± 20.1 versus 99.2 ± 19.0 g, p < 0.05; Fat, 15.0 ± 5.8 versus 9.7 ± 7.0 g, p < 0.05). CONCLUSION:Compared with an iso-caloric HGI snack bar, pre-exercise LGI snack bar consumption may facilitate a shift of substrate utilization from CHO to fat during subsequent moderate intensity exercise.

背景与目标：

BACKGROUND & AIMS: :We have studied the effects of ankle arthrodesis on the gait of three subjects with special attention to the time and sagittal plane kinematic and kinetic characteristics. Each subject had a painless arthrodesis and no other gait limitation. To compensate for this disability they showed an increased range of movement at the ipsilateral mid-tarsal, knee and hip joints, and required greater than normal resuftan joint moments to be generated at the ipsilateral knee and hip joints. The subjects exhibited stride-to-stride kinetic compensation at the knee and hip joints, with associated variability in resultant joint moments and power patterns. However, they achieved a symmetric gait by mimicking ipsilateral movements with the opposite limb.

背景与目标： : 我们研究了踝关节固定术对三名受试者步态的影响，特别注意时间和矢状面运动学和动力学特征。每个受试者都有无痛性关节固定术，没有其他步态限制。为了弥补这种残疾，他们显示同侧中，膝和髋关节的运动范围增加，并且需要在同侧膝关节和髋关节处产生比正常的resuftan关节力矩更大的运动。受试者在膝关节和髋关节表现出步幅运动补偿，并在关节力矩和动力模式上产生相关的变异性。但是，他们通过模仿与相反肢体的同侧运动来实现对称步态。

BACKGROUND & AIMS: OBJECTIVE:To assess the use of the International Index of Erectile Function (IIEF), routinely used in patients being treated for localized prostate cancer, including potency-preserving, nerve-sparing radical prostatectomy (RP), as many patients complain that the results of the IIEF over 4 weeks before RP are not representative. PATIENTS AND METHODS:The study included 123 consecutive patients (mean age 64.6 years, range 52-78) who had endoscopic-extraperitoneal RP and who completed the IIEF. The interval between the diagnosis of the disease and surgery was >4 weeks in all. The patients completed the same questionnaire referring to the last 4 weeks before their prostate biopsy, as a modified index of their sexual status (IIEFm and EFm). RESULTS:The clinical stage of disease was cT1c (34.9%), cT2a (49.5%), cT2b (5.7%) and cT2c (9.9%) before RP. The mean IIEF score was 42.8 and the mean EF domain score was 16.9; the mean IIEFm was 54.9 and the EFm domain score was 23.7. All the differences were statistically significant (P < 0.001). CONCLUSION:The IIEF questionnaire scores are influenced by many factors. Depression after a diagnosis of cancer, and the prostate biopsy-related symptoms, e.g. prostatitis, perineal pain and haemospermia, might compromise the patients' well-being and libido, and thus affect the IIEF scores before RP. We therefore suggest using the IIEFm and EFm scores before prostate biopsy to assess the patients' sexual status before any treatment for localized prostate cancer.

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BACKGROUND & AIMS: :A brachial loop is a rare anatomic variation and can result in the failure of transradial coronary procedures. We report a brachial loop encountered in a patient undergoing a coronary angiogram. During this angiogram, a 0.035'' J-tipped Teflon-coated guidewire met with resistance in the brachial artery because of this rare vascular loop. In this case report, we discuss the technique we used to manage this rare condition. Interventional cardiologists should keep in mind that resistance of the guidewire can result in major vessel complications during the transradial approach.

背景与目标： 肱动脉环是一种罕见的解剖变异，可导致经桡动脉冠状动脉手术失败。我们报告了在接受冠状动脉造影的患者中遇到的臂环。在此血管造影中，由于这种罕见的血管回路，0.035的J形尖头聚四氟乙烯涂层的导丝在肱动脉中遇到阻力。在本案例报告中，我们讨论了用于管理这种罕见情况的技术。介入心脏病学家应记住，导丝的阻力可能会导致经radial入路时的主要血管并发症。

BACKGROUND & AIMS: OBJECTIVE:Cross-sectional data suggest that obesity, particularly central obesity, may be associated with decreased production of sex steroid hormones in men. However, longitudinal hormone data on men in relation to obesity status are limited. Previous studies have not consistently demonstrated whether sex steroids are associated specifically to body mass index or to measures of central obesity. Our objective was to examine the relation of obesity (body mass index > 30 kg/m2), and of central obesity (waist circumference > 100 cm or waist to hip ratio > 0.95) to longitudinal change in sex steroid hormones in men. DESIGN:Prospective follow-up of a population-based sample of men in Boston. PATIENTS:Nine hundred forty-two (942) men in the Massachusetts Male Ageing Study with complete anthropometry and hormone data at baseline (1987-1989, ages 40-70) and follow-up (1995-1997). MEASUREMENTS:Free and total testosterone (FT and TT), dehydroepiandrosterone sulphate (DHEAS), and sex hormone-binding globulin (SHBG) were assessed using standardized methods. Health behaviours and medical history were obtained by structured interview. Repeated measures regression was used to describe trends in steroid hormones and SHBG in relation to obesity status, adjusting for age, smoking, alcohol, comorbidities, and physical activity. RESULTS:Obesity was associated with decreased levels of total and free testosterone, and of SHBG at follow-up relative to baseline. For any given baseline concentration of TT, FT or SHBG, follow-up levels were lowest among men who remained obese or who became obese during follow-up. This was true for all three indices of obesity. Central adiposity was associated with lower DHEAS levels at follow-up, while elevated body mass index was not. CONCLUSIONS:Obesity may predict greater decline in testosterone and SHBG levels with age. Central adiposity may be a more important predictor of decline in DHEAS than is body mass index.

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