Acute graft-versus-host disease, interstitial pneumonitis, endothelial leakage syndrome, and veno-occlusive disease are major complications of bone marrow transplantation. Though several new regimens for prophylaxis and treatment of these syndromes have been introduced, the overall incidence has been only slightly reduced over the last few years. We retrospectively analyzed tumor necrosis factor alpha (TNF alpha) serum levels between day -8 and day 100 after bone marrow transplantation in 56 patients transplanted in our unit for a variety of hematological diseases. In 34 patients with uneventful courses, mean TNF alpha levels rose to a maximum of 76 +/- 29 pg/mL. In contrast, 22 patients with major transplant related complications showed mean increases of TNF alpha of 492 +/- 235 pg/mL (P less than .0001). Increases of TNF alpha occurred before interstitial pneumonitis and severe acute graft-versus-host disease with a latency of 25 to 54 days. Early complications such as endothelial leakage syndrome and veno- occlusive disease were closely associated with increases of TNF alpha serum levels. Our study suggests two pathways of TNF alpha release: activation of host macrophages and stimulation of donor cells in the course of acute graft-versus-host disease. Cytokine monitoring should be helpful for prediction and earlier treatment of major transplant related complications.

This study suggests that central obesity, assessed by several anthropometric indicators, is associated to the presence of erectile dysfunction in men older than 60 years. Sagittal abdominal diameter, sagittal abdominal diameter-height index, maximum abdominal circumference, waist circumference and waist-hip index were useful indicators to predict the presence of erectile dysfunction.

Introduction Although Peyronie’s Disease (PD) was first described over 250 years ago, its precise etiology remains obscure. Aim Analyze a variety of potential associated factors with PD, including erectile dysfunction. Materials and Methods This cross-sectional study included 83 consecutive men with PD and 252 age-matched controls. All men completed the International Index of Erectile Function (IIEF) and were evaluated regarding their clinical and demographic characteristics, comorbidities, and used medications. Anthropometric measures included body mass index and waist circumference (WC). Fasting blood glucose, lipid profile, total testosterone, and dehydroepiandrosterone-sulfate were determined. Main Outcome Measures Clinical and laboratory characteristics associated to PD. Results The mean age was 59.2 ± 10 years in the cases and 59.7 ± 12 years in the controls. Marital status, current smoking, and excessive consumption of alcoholic beverages were similar between groups (P > 0.05). PD was more common among white skin color males (P = 0.001). The mean score for each IIEF domain and the androgen levels were similar in the two groups. Thiazides were the only medication associated to PD (P = 0.03). Dupuytren’s disease was more frequent among individuals with PD (P = 0.001). The distribution of all other comorbidities investigated was similar between groups (P > 0.05). The characteristics WC > 102 cm and levels of low-density lipoprotein (LDL) > 130 mg/dL were more prevalent in the controls (P <0.05). After multivariate analysis, white skin color (OR: 8.47, 95%CI: 1.98–36.24) and thiazide use (OR: 2.29, 95%CI: 1.07–4.90) were associated to PD, and LDL > 130 mg/dL (OR: 0.55, 95%CI: 0.32–0.92) and WC > 102 cm (OR: 0.53, 95%CI: 0.29–0.96) were inversely associated to PD. Conclusions In this study, PD was more common among white skin colored males. An inverse relationship with the presence of elevated serum levels of LDL and WC was observed. We found no association with medications other than thiazides and comorbidities other than Dupuytren’s disease. Androgen serum levels and sexual dysfunction had also no association to PD.

A low ratio of testosterone to prostate specific antigen is an independent predictor of prostate cancer in hypogonadal men with prostate specific antigen 4.0 ng/ml or less. Ratios less than 1.8 were associated with a greater than 3-fold increase in prostate cancer risk.

measured. The relationship between the severity of ED and serum HbA 1c levels was assessed. RESULTSOf men with HbA 1c levels of < 8%, half had mild, and 18% and 32% had moderate and severe ED, respectively ( P = 0.038); of men with HbA 1c levels of ≥ 8%, 25%, 29%, and 46% had mild, moderate and severe ED, respectively ( P = 0.008). In addition, men with HbA 1c levels of ≥ 11% had a statistically higher prevalence of severe ED ( P = 0.002). There was no difference in severity of ED in the HbA 1c subgroups when the duration of DM was £ 5 years ( P = 0.87), but most men with HbA 1c levels of ≥ 8% and a history of DM of 6-10 or > 10 years had severe ED ( P < 0.03). CONCLUSIONThis study suggests that the severity of ED is associated with increasing HbA 1c levels in diabetic men.