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Compared to efficient and secure female contraception, a vasectomy and condoms are the only options for men. The choice of male contraceptive methods is limited, so contraception mainly rests on the shoulders of women. Several concepts are considered: testosterone administration -inhibiting pituitary secretion of lutropin (LH) and follicle stimulating hormone (FSH), progestogen -affecting the secretion of gonadotropin and gonadoliberin (GnRH) antagonists. New potential targets for non-hormonal male contraception were discovered: glyceraldehyde-3-phosphate-dehydrogenase (GAPDHS) -specific to male germ cells and voltage-gated cation channel (CatSper). Both are responsible for sperm motility. Drugs such as thioridazine used in schizophrenia treatment and phenoxybenzamine (antihypertensive activity) exhibit a contraceptive effect. Similar action exhibits an analogue of lonidamine -adjudin and an antagonist of retinoic acid receptors (BMS-189453). Researchers are working on a contraceptive vaccine, whose active ingredient is epididymal protease inhibitor (Eppin). Another promising method acts by blocking Bromodomain testis-specific proteins (Brdt) involved in the process of spermatogenesis. JQ1-the Brdt inhibitor causes reversible infertility without affecting the endocrine signaling pathways. A recent discovery of Juno as the binding partner for Izumo1 identifies these proteins as the cell-surface receptor pair, essential for gamete recognition and this interaction can be inhibited by an anti-Juno monoclonal antibody. Our review shows that the situation of men can change and investigators are close to the optimal solution. In the near future men will be able to choose the best contraceptive suited to their needs (Adv Clin Exp Med 2015, 24, 4, 705-714).

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Autorzy przedstawili opis przypadku 55-letniego mężczyzny z prawostronnym niedowładem połowiczym o nagłym początku, u którego wysunięto podejrzenie udaru niedokrwiennego mózgu oraz zastosowano leczenie trombolityczne zgodnie z aktualnymi kryteriami kwalifikacji, natomiast ostatecznie, na podstawie wyników badań pomocniczych, rozpoznano u niego wyściółczaka rdzenia kręgowego.

Background. The mortality rate for spontaneous intracerebral haemorrhage (ICH) has remained high and stable for many years. The unfavourable prognostic factors include age, bleeding volume, location of the haematoma, high blood pressure, and disturbed consciousness on admission. Other risk factors associated with medical care also deserve attention. The study aimed to analyse the relationship between day of admission, concerning other prognostic factors, and short-term mortality in ICH, in a Polish specialist stroke unit. Methods. Medical records of 156 patients (74 males, 82 females, mean age 68.7 years) diagnosed with spontaneous ICH and admitted to a specialist stroke center were retrospectively analysed. Demographics, location, volume of bleeding, blood pressure values, and the Glasgow Coma Scale (GCS), as well as the day of admission, were determined. The relationships were analysed between these factors and 30-day mortality in the patients with ICH. Results. A total of 83 patients were admitted to the hospital during weekdays (Monday 8 am to Friday 3 pm) and 73 during weekends or holidays. Of these, 65 patients died within 30 days. Patients admitted at weekends initially presented with lower GCS scores. Admission on Saturday was associated with an increased risk of death (OR 3.38, 95% CI 1.2–9.48, p < 0.05 ), but after correction for clinical state measured with the GCS and ICH score, the association was no longer significant. Conclusions. The time and mode of admission were not associated with increased risk of short-term mortality in ICH patients. Prehospital care issues should be additionally considered as prognostic factors of the outcome.

STRESZCZENIEChoroba Fabry'ego jest rzadkim lizosomalnym schorzeniem spichrzeniowym, dziedziczonym w sposób recesywny sprzężony z chromosomem X, spowodowanym przez mutacje w genie kodującym a-galaktozydazę A. Niedobór tego enzymu skutkuje postępującym gromadzeniem glikosfingolipidów w komórkach różnych tkanek i narządów, zaburzając ich czynność. U kobiet, w zależności od wzoru inaktywacji chromosomu X, przebieg choroby może być bardzo zróżnicowany -od postaci bezobjawowych do ciężkich, zagrażających życiu.Autorzy przedstawili przypadek kobiety z niedowładem czterokończynowym o nagłym początku, u której na podstawie złożonego obrazu klinicznego oraz badań pomocniczych rozpoznano chorobę Fabry'ego.