EMAS position statement: Testosterone replacement therapy in the aging male‏.

INTRODUCTION Late-onset hypogonadism (LOH) represents a common clinical entity in aging males, characterized by the presence of symptoms (most usually of a sexual nature, such as decreased libido, decreased spontaneous erections and erectile dysfunction) and signs, in combination with low serum testosterone concentrations. Whether testosterone replacement therapy (TRT) should be offered to those individuals is still under extensive debate. AIMS The aim of this position statement is to provide and critically appraise evidence on TRT in the aging male, focusing on pathophysiology and characteristics of LOH, indications for TRT, available therapeutic agents, monitoring and treatment-associated risks. MATERIALS AND METHODS Literature review and consensus of expert opinion. RESULTS AND CONCLUSIONS Diagnosis and treatment of LOH is justified, if a combination of symptoms of testosterone deficiency and low testosterone is present. Patients receiving TRT could profit with regard to obesity, metabolic syndrome, type 2 diabetes mellitus, sexual function and osteoporosis and should undergo scheduled testing for adverse events regularly. Potential adverse effects of TRT on cardiovascular disease, prostate cancer and sleep apnea are as yet unclear and remain to be investigated in large-scale prospective studies. Management of aging men with LOH should include individual evaluation of co-morbidities and careful risk versus benefit assessment.

Thrombotic thrombocytopenic purpura during pregnancy versus imitator of preeclampsia.

BACKGROUND Thrombotic thrombocytopenic purpura (TTP) is a severe disorder affecting the microcirculation of multiple organs due to a systemic endothelial cell injury secondary to a deficiency in ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 motif, member 13) activity. TTP is a rare complication of pregnancy with a poor prognosis and high fetal mortality, especially when it occurs during the first trimester. Recent data have supported that effective treatment of TTP is plasma therapy. Unfortunately a major problem remains in the delay in diagnosis due to confounding factors between other "imitators of preeclampsia." Rapid and readily available laboratory testing to quickly diagnose TTP is desperately needed to improve care and to save mother and future child life. CASE REPORT We describe a rare case of successful pregnancy after TTP manifestations occurring in the first trimester; most importantly, our experience represents the first case of atypical manifestation due to neurologic and kidney manifestations preceding laboratory assay alterations. RESULTS We treated a patient with plasma replacement of 30 mL/kg/day and daily plasmapheresis in combination with continuous infusion of fresh-frozen plasma 10 mL/kg/day. The response of clinical manifestation immediately improved. At 30 weeks, the patient had multiple episodes of high blood pressure and concomitant decrease of hemoglobin and platelet count, so a cesarean section was immediately performed. She delivered a healthy female baby. CONCLUSION Early diagnosis by ADAMTS13 activity, occasionally occurring before clinical manifestations, aided us in promptly administering commended and life-saving treatments.

The TREAT-NMD DMD Global Database: analysis of more than 7,000 Duchenne muscular dystrophy mutations.

Analyzing the type and frequency of patient-specific mutations that give rise to Duchenne muscular dystrophy (DMD) is an invaluable tool for diagnostics, basic scientific research, trial planning, and improved clinical care. Locus-specific databases allow for the collection, organization, storage, and analysis of genetic variants of disease. Here, we describe the development and analysis of the TREAT-NMD DMD Global database (http://umd.be/TREAT_DMD/). We analyzed genetic data for 7,149 DMD mutations held within the database. A total of 5,682 large mutations were observed (80% of total mutations), of which 4,894 (86%) were deletions (1 exon or larger) and 784 (14%) were duplications (1 exon or larger). There were 1,445 small mutations (smaller than 1 exon, 20% of all mutations), of which 358 (25%) were small deletions and 132 (9%) small insertions and 199 (14%) affected the splice sites. Point mutations totalled 756 (52% of small mutations) with 726 (50%) nonsense mutations and 30 (2%) missense mutations. Finally, 22 (0.3%) mid-intronic mutations were observed. In addition, mutations were identified within the database that would potentially benefit from novel genetic therapies for DMD including stop codon read-through therapies (10% of total mutations) and exon skipping therapy (80% of deletions and 55% of total mutations).

Oral-facial-digital syndrome type VI: is C5orf42 really the major gene?

Oral-facial-digital type VI syndrome (OFDVI) is a rare phenotype of Joubert syndrome (JS). Recently, C5orf42 was suggested as the major OFDVI gene, being mutated in 9 of 11 families (82 %). We sequenced C5orf42 in 313 JS probands and identified mutations in 28 (8.9 %), most with a phenotype of pure JS. Only 2 out of 17 OFDVI patients (11.7 %) were mutated. A comparison of mutated vs. non-mutated OFDVI patients showed that preaxial and mesoaxial polydactyly, hypothalamic hamartoma and other congenital defects may predict C5orf42 mutations, while tongue hamartomas are more common in negative patients.

Report of the Second European Zebrafish Principal Investigator Meeting in Karlsruhe, Germany, March 21-24, 2012.

The second European Zebrafish Principal Investigator (PI) Meeting was held in March, 2012, in Karlsruhe, Germany. It brought together PIs from all over Europe who work with fish models such as zebrafish and medaka to discuss their latest results, as well as to resolve strategic issues faced by this research community. Scientific discussion ranged from the development of new technologies for working with fish models to progress in various fields of research such as injury and repair, disease models, and cell polarity and dynamics. This meeting also marked the establishment of the European Zebrafish Resource Centre (EZRC) at Karlsruhe that in the future will serve as an important focus and community resource for zebrafish- and medaka-based research.

Holocene vegetation and fire history of the mountains of Northern Sicily (Italy)

Knowledge about vegetation and fire history of the mountains of Northern Sicily is scanty. We analysed five sites to fill this gap and used terrestrial plant macrofossils to establish robust radiocarbon chronologies. Palynological records from Gorgo Tondo, Gorgo Lungo, Marcato Cixé, Urgo Pietra Giordano and Gorgo Pollicino show that under natural or near natural conditions, deciduous forests (Quercus pubescens, Q. cerris, Fraxinus ornus, Ulmus), that included a substantial portion of evergreen broadleaved species (Q. suber, Q. ilex, Hedera helix), prevailed in the upper meso-mediterranean belt. Mesophilous deciduous and evergreen broadleaved trees (Fagus sylvatica, Ilex aquifolium) dominated in the natural or quasi-natural forests of the oro-mediterranean belt. Forests were repeatedly opened for agricultural purposes. Fire activity was closely associated with farming, providing evidence that burning was a primary land use tool since Neolithic times. Land use and fire activity intensified during the Early Neolithic at 5000 bc, at the onset of the Bronze Age at 2500 bc and at the onset of the Iron Age at 800 bc. Our data and previous studies suggest that the large majority of open land communities in Sicily, from the coastal lowlands to the mountain areas below the thorny-cushion Astragalus belt (ca. 1,800 m a.s.l.), would rapidly develop into forests if land use ceased. Mesophilous Fagus-Ilex forests developed under warm mid Holocene conditions and were resilient to the combined impacts of humans and climate. The past ecology suggests a resilience of these summer-drought adapted communities to climate warming of about 2 °C. Hence, they may be particularly suited to provide heat and drought-adapted Fagus sylvatica ecotypes for maintaining drought-sensitive Central European beech forests under global warming conditions.

Opferung Isaks [Illustration]

Filippo Brunellesco

Ms. lat. oct. 108 - Privilegia Ordinis Eremitarum Sancti Augustini

Vorbesitzer: Augustinereremitenkloster Como; F.P.; de Nigris; Osvaldo Calvi; D. Filippo Nodari; Arnulf Kogler

Ms. lat. oct. 276 - Enarrationes in C. Suetonium Tranquillum de vita duodecim Caesarum, libri IV-VII

Vorbesitzer: Freiherren von Holzhausen

Ildegonda : novella

del Tommaso Grossi

Su la pietosa morte di Giulia Cappelletti e Romeo Montecchi : lettere critiche

di Filippo Scolari ; aggiuntovi un poemetto inedito in ottave rime di Teresa Albarelli Vordoni

Ms. Ff. Mus. 980 - Domin. XIV post Trinit. : Es ist das Hertz ein trotzig und verzagt Ding p. ; a. 2 Violini, 2 Oböe, 1 Viola, Canto, Alto, Tenore, Basso con i ripieni + Violoncello, Violono in ripieno + Organo

di Georgio Filippo Telemann

Ms. lat. oct. 5 - Monarchia di Spagna

Vorbesitzer: Johann Maximilian Zum Jungen

Influencia de seis portainjertos de vid sobre el comportamiento vitícola de la cv. Malbec y estudio de las relaciones hídricas que se establecen

El uso de portainjertos en la vid se ha difundido por su resistencia a filoxera y nemátodos, pero también por su tolerancia a condiciones adversas del suelo. Por otro lado, los portainjertos modifican las relaciones fuente-destino, influyendo en el comportamiento vegetativo y reproductivo de las plantas y en la composición de la uva, lo cuál puede ser utilizado como una herramienta de manejo agronómico. A fin de evaluar si existe un comportamiento diferencial de los portainjertos en cuanto a expresión vegetativa, vigor, rendimiento y composición de la uva, y explicar dichas diferencias en términos de exploración radical, relaciones hídricas, asimilación de carbono, eficiencia en el uso del agua y partición de asimilados se realizó un ensa-yo a campo de cv. Malbec sobre seis portainjertos (3309 C, 1103 P, 140 Ru, SO4, Harmony y Cereza) y a pie franco. Los portainjertos 140 Ru, 1103 P y SO4 tuvieron una mayor tendencia a la producción de uva (mayor Índice de Ravaz), y Franco, Cereza y 3309 C a vegetar, mostrando Harmony una situación intermedia. Las ba-yas sobre el pie Cereza tuvieron un mayor peso (1,96 g) que sobre Harmony (1,75 g). No se encontraron diferencias en los polifenoles de las bayas entre portainjertos. La fotosíntesis de la planta entera (Amax) de Franco, 1103 P y SO4 fue mayor que la de Harmony. La conductancia hidráulica foliar específica (kL) de Harmony fue me-nor que la de Cereza, y su conductancia hidráulica (kH) fue menor que la de Franco, Cereza y SO4. El número de raíces totales de 140 Ru fue mayor que el de 1103 P, SO4 y Harmony. El portainjerto 140 Ru se destacó por privilegiar el desarrollo radi-cal y reproductivo sobre el vegetativo, y por su mayor eficiencia en el uso del agua (EUA). Las diferencias entre portainjertos pueden ser explicadas en parte por dife-rencias en la kL que a su vez incide en el estado hídrico de las plantas (ΨL). De ma-nera que cuando la kL es más baja, el ΨL es menor (i.e., Harmony), y cuando la kL es más alta, el ΨL es mayor (i.e., Franco y Cereza). Mayores ΨL se asocian con mayores superficies foliares.