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PubMedDate not supplied

Sexually transmitted infections among prison inmates in a rural district of Malawi.

As part of a comprehensive human immunodeficiency virus (HIV) prevention strategy targeting high-risk groups, sexually transmitted infection (STI) clinics are offered to all prisoners in Thyolo district, southern Malawi. Prison inmates are not, however, allowed access to condoms as it is felt that such an intervention might encourage homosexuality which is illegal in Malawi. A study was conducted between January 2000 and December 2001 in order to determine the prevalence, incidence, and patterns of STIs among male inmates of 2 prisons in this rural district. A total of 4229 inmates were entered into the study during a 2-year period. Of these, 178 (4.2%) were diagnosed with an STI. This included 83 (46%) inmates with urethral discharge, 60 (34%) with genital ulcer disease (GUD), and 35 (20%) inmates with epididymo-orchitis. Fifty (28%) STIs were considered incident cases acquired within the prisons (incidence risk 12 cases/1000 inmates/year). GUD was the most common STI in this group comprising 52% of all STI. This study shows that a considerable proportion of STIs among inmates are acquired within prison. In a setting of same-sex inmates, this suggests inter-prisoner same-sex sexual activity. The findings have implications for HIV transmission and might help in developing more rational policies on STI control and condom access within Malawi prisons.

Adult↗
PubMed1998

Inconclusive clinical and ultrasound evaluation of the scrotum: impact of magnetic resonance imaging on patient management and cost.

OBJECTIVES: To determine the diagnostic utility and net cost of magnetic resonance imaging (MRI) in the management of clinically and sonographically inconclusive scrotal lesions. METHODS: A multicenter retrospective review identified 34 patients diagnosed with scrotal MRI following inconclusive clinical and ultrasound (US) evaluation. Final diagnoses were based on surgery (n = 18) or clinical and US follow-up (n = 16). Final diagnoses of 29 testicular lesions were as follows: orchitis (n = 11), infarct (n = 6), neoplasm (n = 6), rupture (n = 3), torsion (n = 2), and radiation fibrosis (n = 1). Final diagnoses of five extratesticular lesions were as follows: epididymitis (n = 2), epididymal abscess (n = 2), and neoplasm (n = 1). Management plans prior to and following MRI findings were formulated by a general urologist and a urologic oncologist. The costs of the pre-MRI and post-MRI management plans were estimated using the Medicare reimbursement schedule. RESULTS: The leading US diagnosis was correct for 10 of 34 patients (29%) and the leading MRI diagnosis was correct for 31 of 34 patients (91%). MRI improved the management plan of the general urologist and urologic oncologist in 19 patients (56%) and 17 patients (50%), respectively. MRI worsened the management plan of both clinicians in 1 patient. Management was unchanged in all other patients. The overall net cost savings were $543 to $730 per patient for the urologic oncologist and the general urologist, respectively, and $3833 per patient originally scheduled for surgery. CONCLUSIONS: Use of MRI after inconclusive clinical and US evaluation of scrotal lesions may improve management, decrease the number of surgical procedures, and result in net cost savings.

Adolescent↗
PubMed1979

Steroid treatment of male subfertility caused by antisperm antibodies.

47 subfertile men with significant titres of antisperm antibodies were treated with one of two steroid regimens. The results were assessed by changes in sperm-counts and in serum antibody titres and by subsequent pregnancies. 15 oligozoospermic men were treated with prednisone 5 mg three times a day for 3--12 months. Sperm-counts became normal in 10 men and 4 of their wives became pregnant. 14 men with normal sperm-counts received the same treatment: antibody titres fell slightly and 3 of their wives became pregnant. 18 other men with normal sperm-counts were given one or more courses of methylprednisolone 96 mg/day for 7 days. There was a more pronounced fall in antibody titres in these men, and 7 of their wives became pregnant. Testicular biopsies in 3 men with high titres of antibodies and very low sperm-counts which became normal with prednisone showed adequate spermatogenesis; however, focal round-cell infiltration of seminiferous tubules was observed in 1 case. It is suggested that a steroid-responsive immune orchitis can occur spontaneously in man, and may contribute to the infertility of men with antisperm antibodies.

Autoantibodies↗
PubMed2003

Pathological and serological evidence of Brucella-infection in baleen whales (Mysticeti) in the western North Pacific.

Abnormal testes and uterus were observed in 13 males (33%) and one female (3%) out of 40 common minke whales (Balaenoptera acutorostrata) in the western North Pacific. Similar lesions were found in testis and ovary, respectively, in one male (2%) and female (2%) out of 43 Bryde's whales (Balaenoptera edeni) in the western North Pacific. Grossly, granular lesions with caseation and calcification were main pathological signs, and they were restricted to reproductive organs of mature whales. Chronic purulent or granulomatous orchitis was observed by microscopic analysis. Antibodies to Brucella species were detected in the serum samples of 15/40 (38%) of common minke whales and 4/43 (9%) of Bryde's whales. Neither pathological nor serological change was found in the examined sperm whales (Physeter macrocephalus) in the western North Pacific and Antarctic minke whales (Balaenoptera bonaerensis). These results strongly suggest that Brucella infection was involved in two species of baleen whales (Mysticeti) in the North Pacific.

Agglutination Tests↗
PubMedDate not supplied

Uptake of porcine rubulavirus (LPMV) by PK-15 cells.

BACKGROUND: The porcine virus denominated La Piedad Michoacan Virus (LPMV) is a member of the family Paramyxoviridae and is the cause of a disease in pigs present only in Mexico. The disease is characterized by meningoencephalitis and respiratory distress in young pigs, epididymitis and orchitis in boars, and reproductive failure and abortion in sows. METHODS: The cytopathology, morphology, and distribution of the hemagglutination neuraminidase (HN) and nucleoprotein (NP) proteins of LPMV were investigated following inoculation into PK-15 cells. The cytopathic effect was characterized by cytoplasmic vacuolation and the formation of syncytia and cytoplasmic inclusion bodies. RESULTS: In immunofluorescence assays using a monoclonal antibody (MAb) against the HN protein at 5-60 min post-infection (early infection), a diffuse immunofluorescence was observed near the cell membrane and adjacent to the nuclear membrane. At 24 h post-infection (late infection), a dust-like immunofluorescence was observed throughout the cytoplasm. LPMV-infected cells incubated with the MAb against the NP protein showed punctate cytoplasmic fluorescence during the early stages of infection. At the late infection stage, these fluorescent particles became larger and were seen predominantly in the cytoplasm of syncytia. This pattern was also apparent by immunohistochemical labeling and immunogold electron microscopy. The latter technique revealed that HN protein was diffusely distributed throughout the cytoplasm. When using the MAb against the NP protein, nucleocapsid organization was the most prominent feature and resulted in the formation of cytoplasmic inclusion bodies visible by light and electron microscopy. Immunogold labeling of purified nucleocapsids was shown by electron microscopy. Virus particles and nucleocapsids were morphologically similar to members of the Paramyxoviridae family. CONCLUSIONS: The morphologic characteristics of the virions and the distribution patterns of the HN and NP proteins in PK-15 infected cells indicate that the mechanisms of LPMV replication are generally similar to those of the members of the Paramyxoviridae family.

Animals↗
PubMed1999

An MRSA outbreak in a urology ward and its association with Nd:YAG coagulation laser treatment of the prostate.

An outbreak of methicillin resistant Staphylococcus aureus (MRSA) involving 88 patients in a general urology ward is described. Symptomatic bacteraemia and epididymo-orchitis occurred in 10 and 8% of patients respectively. Patients had a particularly high risk of acquiring serious MRSA infection after endoscopic neodymium yttrium aluminium garnet (Nd:YAG) laser treatment of the prostate. Appreciation of the mode of transmission of MRSA, a programme of continuing education for all medical and nursing staff, simple changes in ward protocol and advances in surgical laser technique contributed to the control of the outbreak.

Cross Infection↗
PubMed1999

Reversible bilateral hydronephrosis without obstruction in hepatitis B-associated polyarteritis nodosa.

The manifestations of polyarteritis nodosa (PAN) are varied, but urological abnormalities other than ureteric stenosis and orchitis have not been described. We report a case of hepatitis B-associated PAN with bilateral hydronephrosis without obstruction. Retrograde urography conclusively demonstrated the absence of obstruction. Vasculitis-related myopathy, or neuropathy of the ureter, is the most likely cause of this finding. The patient was treated with high-dose steroids, cyclophosphamide, and plasmapheresis with resolution of hydronephrosis. Although the patient required dialysis at initiation of therapy, she went on to recover sufficient renal function to discontinue dialysis. We review the literature on the treatment of hepatitis B-associated PAN and discuss the pitfalls in diagnosis of this condition.

Adult↗
PubMed2003

Analysis of 508 infertile male patients in south-western Finland in 1980-2000: hormonal status and factors predisposing to immunological infertility.

OBJECTIVE: To analyse the factors predisposing to male immunological infertility from the hospital records of 508 patients that had been treated for infertility in the Turku University Central Hospital from 1980 to 2000. In addition, the hormonal status was investigated at the beginning of treatment. RESULTS: Patients with a history of mumps, or either a fresh varicocele or a history of varicocele had statistically significant lower levels of MAR antisperm antibodies (ASAs) than patients with no such conditions. Repair of varicocele (either surgical or embolisation), showed a statistically significant enhancement of the total sperm cell counts in ejaculates, but it appeared not to have any influence on other parameters of the semen analysis (mobility and morphology). Of all male infertility patients, 66.3% had normal hormonal status at the beginning of treatment, 12.6% of patients had hypotestosteronemia and 22.1% had subclinical hypogonadism. Patients with subclinical hypogonadism had lower total sperm cell count in ejaculates than patients with normal hormonal status although they had statistically significant more offspring. In addition, it appeared that mumps orchitis as well as smoking and alcohol abuse are risk factors for subclinical hypogonadism. CONCLUSION: No clear predisposing factor for male immunological infertility could be found. However, patients with subclinical hypogonadism differed from other male infertility patients and thus may form a special group among the male infertility patients.

Alcoholism↗
PubMed1997

Common causes of infertility in the bull.

Fertility is a fragile parameter that may vary temporarily or be permanently depressed. The bull's ability to maintain body condition and the existence of conformational abnormalities may alter fertility. Abnormalities of the external genitalia may directly affect the bull's ability to copulate or may alter the quality of his semen. Testicular disease alters semen quality, sometimes transiently and other times permanently. In many cases, the fertility prognosis for testicular problems cannot be judged on the basis of one examination. Epididymitis and seminal vesiculitis are the two most common diseases of the secondary sex organs of the bull. They are often associated with each other or orchitis and are difficult to treat.

Animals↗
PubMed1995

Animal models of autoimmune endocrine disease and their uses in developing new methods of intervention.

This review provides basic information concerning the major animal models in use for the study of autoimmune endocrine diseases (AEDs). Although several other models exist which parallel human AEDs such as autoimmune orchitis, most research in this area has centred on animal models of insulin-dependent diabetes mellitus (IDDM) and thyroiditis. These models, between them, appear to exhibit most of the disease manifestations of their human counterparts and thereby permit the study of possible methods of intervention in the disease process. While no one model represents a perfect correlation with the human disease it represents, common characteristics are recognizable between them. For instance, the central role of activated T cells in controlling the disease process. The chapter continues by examining the various ways in which models of autoimmunity, specifically IDDM and experimental allergic thyroiditis (EAT), have been used to investigate the possibility of preventing or arresting autoimmune destruction. Several different approaches are described that illustrate the variety of techniques that have proven both potentially, or in reality, effective and those that have proven less efficacious than first hoped.

Animals↗
PubMed2003

Scrotal abscess originating from appendicitis: a case report.

There are numerous reports concerning the presentation of appendicitis as a urologic problem. However, scrotal abscess originating from appendicitis has rarely been described. We report a right scrotal abscess due to a preceding retroperitoneal abscess originating from retrocecal appendicitis. The scrotal abscess developed progressively following appendectomy. Scrotal exploration was carried out under the presumptive diagnosis of abscessed epididymo-orchitis. However, the patient remained febrile and had productive pus drained from the scrotum after exploration. Abdominal computerized tomography demonstrated that a large retroperitoneal abscess had accumulated at the appendectomy site. Percutaneous drainage of the retroperitoneal abscess resulted in resolution of the scrotal abscess. In cases of scrotal abscess following previous abdominal events (e.g. appendectomy), we recommend that abdominal origins should be carefully surveyed before scrotal exploration.

Abscess↗
PubMed1987

The epidemiology of mumps in the UK: a preliminary study of virus transmission, herd immunity and the potential impact of immunization.

Mathematical models and statistical analyses of epidemiological data are employed to assess the potential impact of mass vaccination on the incidences of cases of mumps infection and cases of mumps related complications. The analyses reveal that in the United Kingdom the average age at infection with the mumps virus is currently between 6-7 years and that the inter-epidemic period of the infection is approximately 3 years. The critical level of vaccine uptake to eliminate mumps virus transmission is predicted to be approximately 85% of each cohort of boys and girls by the age of 2 years. Analyses of published data show that the risk of complication arising from mumps infection is markedly age- and sex-related. Model predictions suggest that the incidence of orchitis will be increased, over the level pertaining prior to mass vaccination, by levels of vaccine uptake (by 2 years of age) that are less than 70% of each yearly cohort of boys and girls. Moderate (over 60%) to high (75%) levels of vaccine uptake, however, are predicted to reduce the overall incidence of cases of mumps related complications (especially those with CNS involvement).

Adolescent↗
PubMed2004

Epidemiological features and clinical manifestations in 469 adult patients with brucellosis in Babol, Northern Iran.

The epidemiological features and clinical manifestations of adult cases of brucellosis admitted to the Department of Infectious Diseases, Babol Medical University, Iran from 1997 to 2002 were investigated. Of 469 cases, 267 (56.9%) were males. The mean age of cases was 36.9 +/- 15 years. Most (60.8%) were from rural areas. Two thirds of cases (306, 66.3%) presented during spring or summer. Fresh cheese (22.4%), animal husbandry (11.3%), laboratory worker (8.1%) and veterinary profession (1.5%) were the main risk factors. Forty-five families (9.6%) had two cases. Sweating, fever, and arthralgia were the most frequent clinical symptoms. Complications were documented in 105 males (39.5%) and 41 females (20.3%, P=0.0001). Peripheral arthritis was seen in 24 (9%) males and 19 (9.4%) females, with knees and hips being the most common sites of infection. Sacroiliitis and spondylitis were seen in 28 (6%) and 32 (6.8%) cases respectively with spondylitis more common in males (P=0.023). Epididymo-orchitis was seen in 29 (10.9%) males. There were three cases each of endocarditis (0.6%) and neurological complications (0.6%). Most patients with brucellosis did not have any of the known risk factors for brucellosis. Thus consumption of unsafe dairy products could be the main route of infection. The disease manifested with a diversity of clinical manifestations and complications. Complications were more frequent in males than females.

Adolescent↗
PubMed2001

Genital disorders, linear and testicular characteristics in Menz rams.

Clinical examination, bodily condition score (BCS), heart girth (HG), body length (BL), wither height (WH), and scrotal circumference (SC) were assessed on 486 mature Ethiopian Menz rams, on small farms, in local markets, and at the main abattoir in Addis Ababa from December 1994 to April 1995. Almost 27% of the rams were found to be unfit for breeding. Poor general condition, mainly in the form of respiratory disorders, was seen in 1.2% of the rams. Balanoposthitis, epididymitis and orchitis were the most common pathological conditions, affecting the external reproductive organs in 14.6%, 4.5% and 4.1% of the rams, respectively. Testicular calcification, cysts and testicular haemorrhagic lesions were detected in 4, 6 and 8, respectively, of the 60 rams examined at necropsy. The BCS, HG, BL and WH averaged 2.1 +/- 0.5, 67.7 +/- 5.0 cm, 60.1 +/- 4.5 cm and 60.1 +/- 4.3 cm, respectively. The mean SC was 25.5 +/- 3.9 cm and did not vary significantly with age (p > 0.05). Among the linear body measurements, the highest correlation was between BL and WH (r = 0.66). SC was found to be most closely correlated to HG (r = 0.46). More investigations into the relationship between the present findings and actual fertility, and on their practical application in the selection of rams for breeding is recommended.

Animals↗
PubMed2001

Effects of endocrine disruptors on prosobranch snails (Mollusca: Gastropoda) in the laboratory. Part III: Cyproterone acetate and vinclozolin as antiandrogens.

The effects of suspected endocrine disrupting chemicals on freshwater and marine prosobranch species were analysed in laboratory experiments. In this last of three publications, the responses of the fresh water snail Marisa cornuarietis and of two marine prosobranchs (Nucella lapillus, Nassarius (Hinia) reticulatus) to the antiandrogenic model compounds cyproterone acetate (CPA) and vinclozolin (VZ) are presented. The snails were exposed to nominal CPA concentrations of 1.25 mg/L alone and simultaneously to a potent synthetic estrogen (ethinylestradiol), androgen (methyltestosterone) or an indirectly acting xeno-androgen (tributyltin) in experiments with adult specimens and in a life cycle test for 12 months. Marisa and Nucella were furthermore exposed to nominal concentrations of 0.03-1.0 microgram VZ/L for up to 5 months. The antiandrogens induced a number of biological responses in all three species. The length of the penis and of accessory male sex organs (e.g., penis sheath, prostate) were significantly reduced. For Marisa, this effect occurred only in sexually immature specimens and was reversible as the males attained puberty. Typical androgen-mediated responses (imposex development, delayed spermatogenesis, tubulus necrosis of the testis with orchitis and Leydig cell hyperplasia) were partially or totally suppressed by a simultaneous administration of CPA. In the two marine species even adult, sexually mature males responded to antiandrogens with a reduction of the male sex organs and an advancement of the sexual repose phase. The results for CPA and VZ are compared with the effects of an exposure to xeno-estrogens (bisphenol A, octylphenol) and xeno-androgens (triphenyltin, tributyltin) in the same species. Each group of endocrine disruptors induces a characteristic set of toxicological effects in prosobranch snails which can be used as endpoints in an organismic invertebrate test for the identification of endocrine mimetic test compounds. Estrogens cause primarily an induction of superfemales resulting in an increased female mortality by the enhancement of spawning mass and egg production. The main effects of androgens are a virilization of females by imposex development and a marked decrease of the fecundity. Compared with estrogens and androgens, the antiandrogen responses seem to be less drastic and might have--in contrast to the two other disruptor classes--no biologically significant effects at the population level.

Androgen Antagonists↗
PubMed2002

Management of the acute scrotum in children.

BACKGROUND: The study investigates the hypothesis that testicular torsion is over-diagnosed by emergency department (ED) doctors. Diagnoses made by ED doctors are compared with those made by a surgical registrar or specialist and the review outcome by a surgical registrar or specialist on diagnosis and management is evaluated. METHODS: Medical records of all boys up to the age of 14 years who presented with an acute scrotum to the ED at The Canberra Hospital between October 1995 and October 2000 were retrospectively reviewed. RESULTS: A total of 182 boys presented to the ED on 190 occasions; mean age of presentation was 10.1 years and mean time from onset of pain to presentation was 27.6 h. Ninety (47.4%) patients had a torted testicular appendage, 23 (12.1%) had testicular torsion and 12 (6.3%) had epididymitis or orchitis. Eighty-one patients underwent surgery, in whom 61 were excluded from having testicular torsion. Testicular torsion was suspected by ED doctors in 57.5% of patients, by registrars in 35.4% and by specialists in 17.7%. Overall, the correct diagnosis was made by ED doctors in 39% of patients, by registrars in 53% and by specialists in 76%. CONCLUSIONS: Less experienced examiners suspect testicular torsion more frequently than surgical registrars or specialists. Review of the patient by an experienced examiner should allow for more accurate initial diagnoses and spare some children unnecessary surgical procedures.

Acute Disease↗
PubMed2002

Antegrade scrotal sclerotherapy in the treatment of varicocele: a prospective study.

OBJECTIVE: To assess the results of our experience in correcting primary varicocele using a modified technique of antegrade scrotal sclerotherapy. PATIENTS AND METHODS: From December 1997 to February 2000, 201 patients with primary varicocele underwent antegrade scrotal sclerotherapy. Before treatment all patients were evaluated by a physical examination, colour Doppler ultrasonography of the spermatic cord, and abdominal and scrotal ultrasonography. Sperm samples were analysed only in patients aged > 18 years. The treatment was administered using a special venous catheter system with a Y-adapter. Complications after treatment and the rate of persistence of reflux were assessed 3 and 6 months after the antegrade scrotal treatment, by clinical examination and colour-Doppler ultrasonography of the spermatic cord. RESULTS: The mean operative duration was 15 min; there were no significant complications during treatment and all patients were discharged within 4 h. Complications after treatment occurred in 10 of the 201 patients (5%); four patients had epididymo-orchitis, three a scrotal haematoma, one a surgical wound infection, one persistent scrotal pain and one persistent flank pain on the same side as the surgery. Reflux was persistent in 12 patients (6%). CONCLUSIONS: Antegrade scrotal sclerotherapy is a simple, minimally invasive and highly effective technique for blocking spermatic vein reflux, with a low rate of complications. The technical changes simplified the cannulation of the spermatic vein and facilitated antegrade phlebography and sclerotherapy using the air-block technique.

Adolescent↗
PubMed1997

The use of the detrusorrhaphy for vesico-ureteric reflux: the way forward?

OBJECTIVE: To assess the outcome of all detrusorrhaphies carried out for simple single-system vesico-ureteric reflux (VUR) in children at one institution over a 4-year period. PATIENTS AND METHODS: Twenty-nine patients (11 boys, 18 girls, 43 renal units; mean age at presentation 23 months; range, antenatal to 72 months) were analysed in two groups. Group 1 comprised those undergoing asynchronous bilateral procedures (two patients, four units) and unilateral procedures (15 patients, 15 units), and group 2, those undergoing synchronous bilateral procedures (12 patients, 24 units). The mean (range) follow-up was 17 months (6-39) and 15 months (7-24), respectively. RESULTS: Three patients had antenatal hydronephrosis related to VUR post-natally and 26 had urinary tract infections (13 recurrent, one with haematuria, seven 'breakthrough', one with calculi and four with enuresis). The mean age at operation was 54 months (range 14-167). The mean (range) duration of anaesthesia was 69 min (40-120) in group 1 and 80 min (65-120) in group 2. All patients were catheterized urethrally for a mean (range) duration of 3 days (2-4) in group 1 and 5 days (2-15) in group 2 and the mean hospital stay was 3 days (2-6) and 6 days (4-16), respectively. Post-operative complications occurred in 14 patients including one bladder spasm, five urinary tract infections, two with urinary retention, three with haematuria and one each of pneumonia, epididymo-orchitis, anuria, failure to stent and conversion to Cohen reimplantation. Operative success and clinical success were similar within groups but differed between groups, although not significantly (15 of 17 in group 1 and eight of 12 in group 2). CONCLUSION: Unilateral but not synchronous bilateral detrusorrhaphy seems an appropriate surgical treatment for VUR.

Child↗