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International Journal of Molecular... Nov 2023Polyarteritis nodosa (PAN), also known as panarteritis nodosa, represents a form of necrotizing vasculitis that predominantly affects medium-sized vessels, although it... (Review)
Review
Polyarteritis nodosa (PAN), also known as panarteritis nodosa, represents a form of necrotizing vasculitis that predominantly affects medium-sized vessels, although it is not restricted to them and can also involve smaller vessels. The clinical presentation is heterogeneous and characterized by a significant number of patients exhibiting general symptoms, including asthenia, fever, and unintended weight loss. Although PAN can involve virtually any organ, it preferentially affects the skin, nervous system, and the gastrointestinal tract. Orchitis is a rare but specific manifestation of PAN. The absence of granulomas, glomerulonephritis, and anti-neutrophil cytoplasmic antibodies serves to distinguish PAN from other types of vasculitis. Major complications consist of hemorrhagic and thrombotic events occurring in mesenteric, cardiac, cerebral, and renal systems. Historically, PAN was frequently linked to hepatitis B virus (HBV) infection, but this association has dramatically changed in recent years due to declining HBV prevalence. Current epidemiological research often identifies a connection between PAN and genetic syndromes as well as neoplasia. This article provides a comprehensive review of PAN, specifically focusing on the progression of its clinical manifestations over time.
Topics: Male; Humans; Polyarteritis Nodosa; Vasculitis; Hepatitis B; Hepatitis B virus; Gastrointestinal Tract
PubMed: 38068989
DOI: 10.3390/ijms242316668 -
Seminars in Nuclear Medicine Nov 2023This article discusses the current clinical role and scope of functional radionuclide imaging using testicular perfusion scintigraphy with Tc-pertechnetate in patients... (Review)
Review
This article discusses the current clinical role and scope of functional radionuclide imaging using testicular perfusion scintigraphy with Tc-pertechnetate in patients presenting with an acute hemiscrotum for an early and reliable diagnosis of testicular torsion. The technique of testicular perfusion scintigraphy is described, and the characteristic findings are detailed with examples. The imaging characteristics of the various phases of testicular torsion and its differentiation from epididymitis and/or epididymo-orchitis and the other related conditions presenting as an acute hemiscrotum are detailed. In some cases, further evaluation by SPECT imaging increases the clarity and accuracy of diagnosis and, on occasion, hybrid SPECT/CT in selected complicated cases improves the diagnostic yield of the perfusion scintigraphy. Ultrasonographic and color Doppler findings are described concurrently with the scintigraphic findings. The several case examples presented demonstrate the additional clinical benefit of complementing functional and structural imaging for improving the sensitivity, specificity and accuracy of testicular imaging in the diagnosis.
Topics: Male; Humans; Spermatic Cord Torsion; Diagnosis, Differential; Orchitis; Epididymitis; Radionuclide Imaging
PubMed: 37210316
DOI: 10.1053/j.semnuclmed.2023.04.005 -
Clinical Endocrinology Jan 2024Men have more severe Coronavirus disease 2019 (Covid-19) outcomes and higher mortality rates than women, and it was suggested that testosterone levels might promote... (Review)
Review
Men have more severe Coronavirus disease 2019 (Covid-19) outcomes and higher mortality rates than women, and it was suggested that testosterone levels might promote severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and Covid-19 severity. However, clinical studies have not supported this theory. Studies have consistently shown that serum testosterone concentrations during acute Covid-19 in men are inversely proportional to the inflammatory cytokines and severity of illness. It is likely that lower testosterone concentrations in this setting are a result of acute Covid-19 illness on the hypothalamic-pituitary-testicular axis. Clinical trials that attempted to lower testosterone concentrations further or block androgen signaling acutely during Covid-19 in men did not result in improved Covid-19 outcomes. Additionally, pre-existing male hypogonadism, diagnosed before Covid-19 pandemic, was found to be a risk factor for hospitalization from Covid-19. In this review, we also discuss the preclinical and mechanistic studies that have evaluated the role of androgens in SARS-CoV-2 infection and illness. Finally, long-term consequences of Covid-19 on male reproductive health are reviewed. SARS-CoV-2 virus is known to infiltrate testis and induce orchitis in men, but it is unclear if Covid-19 leads to an increase in incidence of male hypogonadism.
Topics: Humans; Male; Female; Testosterone; COVID-19; SARS-CoV-2; Pandemics; Androgens; Hypogonadism
PubMed: 37501254
DOI: 10.1111/cen.14952 -
Urologie (Heidelberg, Germany) Jun 2024Acute genital diseases can occur at any age and are characterized by complaints of various kinds of the external genitalia. Pain, swelling, and redness of the scrotum,...
Acute genital diseases can occur at any age and are characterized by complaints of various kinds of the external genitalia. Pain, swelling, and redness of the scrotum, adjacent groin region, and immediate surroundings are the leading symptoms, the severity of which may vary. In addition, peritonitic symptoms such as nausea, vomiting, and circulatory sensations may be present and are comparable to symptoms of an acute abdomen. The term "acute scrotum" encompasses various clinical entities, where scrotal symptoms are predominant and represent a urological emergency situation. Immediate and comprehensive diagnostics are necessary to ensure timely management in case of necessary surgical intervention.
Topics: Humans; Male; Acute Disease; Diagnosis, Differential; Genital Diseases, Male; Scrotum
PubMed: 38689028
DOI: 10.1007/s00120-024-02335-1 -
Progres En Urologie : Journal de... Nov 2023The role of urogenital infections in male infertility has long been the subject of debate. (Review)
Review
BACKGROUND
The role of urogenital infections in male infertility has long been the subject of debate.
METHODS
A bibliographic search limited to English-language literature on human subjects published before 5/2023 resulted in the selection of 189 articles.
RESULTS
Male infertility is often of multifactorial aetiology, and to optimise the prognosis it is important to manage all the factors that can be corrected, including infectious causes, which represent one of the most frequent aetiologies. The infectious agents involved in urogenital infections are most often bacterial or viral, and more rarely parasitic. They can infect the seminal tract, male accessory glands and/or testicles, and usually result in inflammation and increased oxidative stress. These infections reduce male fertility, in particular by altering spermogram parameters and increasing sperm DNA fragmentation. For these reasons, the search for a urogenital infection should be systematic, involving a careful history and clinical examination, ultrasound and systematic bacteriological tests guided by clinical findings. Aetiological treatment may be proposed depending on the picture and the germ involved.
CONCLUSION
This review should help the urologist to establish an accurate diagnosis of the form and extent of the infection, and enable him to define an appropriate therapeutic strategy, tailored to the patient, in order to obtain the best chances of improving male fertility.
Topics: Humans; Male; Semen; Infertility, Male; Inflammation; Spermatozoa; Testis; Urinary Tract Infections; Bacterial Infections
PubMed: 38012909
DOI: 10.1016/j.purol.2023.09.015 -
Clinical Imaging Dec 2023Various infectious and inflammatory diseases affect the genitourinary system. This paper provides a review of multiple common and uncommon infectious and inflammatory... (Review)
Review
Various infectious and inflammatory diseases affect the genitourinary system. This paper provides a review of multiple common and uncommon infectious and inflammatory conditions affecting the genitourinary system and some associated complications. These include acute infectious cystitis, emphysematous cystitis, acute pyelonephritis, emphysematous pyelonephritis, renal and perinephric abscesses, pyonephrosis, xanthogranulomatous pyelonephritis, epididymo-orchitis, vasitis, prostatitis, pelvic inflammatory disease, renal hydatid infection, renal tuberculosis, actinomycosis, Erdheim-Chester Disease, IgG4-Related Kidney Disease, urethritis and urethral strictures, ureteritis cystica, and genitourinary fistulas. Radiologists should be aware of these diseases' complications and management. Uncommon conditions must be considered when evaluating the genitourinary system.
Topics: Male; Humans; Inflammation; Urogenital System; Pyelonephritis; Urinary Tract Infections; Kidney Diseases; Cystitis
PubMed: 37918136
DOI: 10.1016/j.clinimag.2023.110013 -
Proceedings of the National Academy of... Sep 2023Regulatory T cells (Tregs) modulate tissue homeostatic processes and immune responses. Understanding tissue-Treg biology will contribute to developing...
Regulatory T cells (Tregs) modulate tissue homeostatic processes and immune responses. Understanding tissue-Treg biology will contribute to developing precision-targeting treatment strategies. Here, we show that Tregs maintain the tolerogenic state of the testis and epididymis, where sperm are produced and mature. We found that Treg depletion induces severe autoimmune orchitis and epididymitis, manifested by an exacerbated immune cell infiltration [CD4 T cells, monocytes, and mononuclear phagocytes (MPs)] and the development of antisperm antibodies (ASA). In Treg-depleted mice, MPs increased projections toward the epididymal lumen as well as invading the lumen. ASA-bound sperm enhance sperm agglutination and might facilitate sperm phagocytosis. Tolerance breakdown impaired epididymal epithelial function and altered extracellular vesicle cargo, both of which play crucial roles in the acquisition of sperm fertilizing ability and subsequent embryo development. The affected mice had reduced sperm number and motility and severe fertility defects. Deciphering these immunoregulatory mechanisms may help to design new strategies to treat male infertility, as well as to identify potential targets for immunocontraception.
Topics: Male; Animals; Mice; Humans; T-Lymphocytes, Regulatory; Semen; Spermatozoa; Immune Tolerance; Antibodies; Fertility
PubMed: 37676910
DOI: 10.1073/pnas.2306797120