Charles University Faculty of Pharmacy in Hradec Králové Department of Pharmacology and Toxicology Candidate: Tereza Klapková Supervisor: Assoc. Prof. PharmDr. František Trejtnar, CSc. Title of diploma thesis: Recent knowledge on drug effect on male fertility Among the various types of side effects presented in clinically used drugs, negative effects on male reproductive functions can be find. This issue seems to be important and current especially due to the general trend of the decrease in fertility in men and the increasing drug use in younger age groups. The aim of this diploma thesis was to create an overview summarizing current expert knowledge on the effect of drugs on male fertility. For this purpose, we selected relevant publications in the PubMed database, perform their analysis and create the text ofthe thesis. The review focuses mainly on groups of drugs that are often clinically used and discussed in relation to male fertility, such as drugs acting on the cardiovascular system, antimicrobial drugs, drugs used in pain therapy, antidepressants, antiepileptics, antipsychotics, immunosuppressants and some other drugs. In addition to standard drugs, the review also includes several important natural substances, which are used as adjunctive therapy of various diseases or are important from a...

Aluminium is an element of increasing clinical importance. It not only has uses as a medicinal substance but also in recent years it has been shown to be the cause of considerable toxicity, particularly in the setting of chronic renal failure. Diseases that have been shown to be associated with aluminium, or in which it has been implicated, include dialysis dementia, renal osteodystrophy and Alzheimer's disease. This thesis has studied aspects of the interaction between aluminium and the kidney. The work has addressed two major issues. Firstly, a study is described where Malvin's stop-flow technique was used to determine any excretory/absorptive tubular site for Al in the pig kidney. Al was found to be excreted in the distal nephron of the pig kidney. Secondly, the toxic effects of Al in vitro on the DNA of pig kidney cell line LLC-PKl were investigated, in an attempt to elucidate some of the mechanisms of toxic action. DNA synthesis was measured using ³H-TdR incorporation. Over increases of both time (9-72 h) and Al concentration (0.01-8.0 mM), ³H-TdR incorporation was diminished. Effects were evident at concentrations as low as 0.05 mM Al. The production of DNA strand breaks was assessed by the increase in size of cell nucleoids (ie DNA in supercoiled form). Nucleoid size was analyzed in a Epics 753 Fluorescence Activated Cell Sorter interfaced with an MDADSII data acquisition and analysis system. After 90 min incubation with Al (over the concentration range 0.001-32 mM), an increase in nucleoid size was noted at concentrations above 0.05 mM. The data demonstrate that Al exerts an effect on kidney cells in vitro which is expressed as diminished DNA synthesis and production of DNA strand breaks. These effects on DNA may have important long-term implications on various disease states associated with Al toxicity.

Background and Purpose: The adverse effects of drugs may influence results on tests of mobility and balance, but the drug-specific impact is not identified when using these tests. We propose that a quantitative drug index (QDI) will assist in assessing fall risk based on these tests, when combined with other fall risk variables. Methods: Fifty-seven community-dwelling older adults who could walk independently on a treadmill and had Mini-Mental State Examination (MMSE) scores equal to or greater than 24 participated. Mobility and balance outcome measures included the Balance Evaluation Systems Test (BESTest), Berg Balance Scale (BBS), Timed Up and Go (TUG) and cognitive dual task TUG (TUGc). Fall history, current drug list, and Activity-Specific Balance Confidence (ABC) scale scores were also collected. Body mass index (BMI) was calculated. The QDI was derived from the drug list for each individual, and based on fall-related drug adverse effects. Multiple linear regression analyses were conducted using age, BMI, and QDI as predictor variables for determining mobility and balance test scores, and ABC scale scores. Subsequently, participants were divided into (QDI = 0) low-impact drug group (LIDG) and (QDI > 0) high-impact drug group (HIDG) for Mann-Whitney 2-group comparisons. Results: Age, BMI, and QDI were all significant (P <.001) independent variables in multiple regression analyses for mobility and balance test scores, but not for the ABC scale. Separately, the 2 group comparisons for the BESTest, BBS, TUG, and TUGc demonstrated that HIDG scored significantly (P <.05) worse on these tests compared with the LIDG. Drug counts were also significantly higher for the HIDG than for the LIDG. In contrast, age, BMI, MMSE, and reported falls in the last 12 months were not significantly different between groups. Conclusion: Age, BMI, and QDI - all contributed independently to the mobility and balance test scores examined, and may provide health care professionals a screening tool to determine whether additional mobility and balance testing is required. In addition, the QDI is a more precise marker of adverse effects of drugs compared with drug counts, as the latter does not quantitate the influence of drugs on physiologic function.

The aims of the research were to establish whether diphenylhydantoin and phenobarbitone are teratogenic in mice both in vivo and in an in vitro whole embryo culture system, to investigate possible mechanisms of teratogenicity and to examine whether the methods used in this study, may form a basis for developing systems of more extensive drug teratogenicity screening.

Silicosis continues to be an important occupational disease in South Africa, particularly in small, poorly regulated industries. A case series is described of six workers who developed silicosis whilst involved in the processing of semi-precious gem stones. They had been employed as stone sculptors in lapidaries where they processed tigers' eye, rose quartz, amethyst, quartz crystal and a variety of other locally occurring semi-precious stones. In five of the cases exposure was in small and poorly regulated lapidaries without specific dust control measures. The sixth was detected during the course of a health and hygiene survey (including dust sampling) that I conducted in one of two lapidaries still operating in the Western Cape. These workers developed serious disease. Progressive massive fibrosis (PMF) was noted in 4 of the 6 cases, three of whom had progression of their disease after cessation of exposure. With the development of PMF the initial restrictive pulmonary function abnormalities were followed by steadily worsening airflow obstruction. Lung biopsies confirmed silicosis in one case and were suggestive in a further two. Tuberculosis was confirmed in two cases and suspected and treated in a third. Workmen's' Compensation was awarded in five cases. The survey confirmed that in semiprecious gem stone processing, the risk of silicosis appears to be confined to stone sculptors. Tried and proven techniques of general and local exhaust ventilation combined with water or oil to control dust at source were capable of effectively reducing dust emission to acceptable levels.

Adverse reactions to the antiarrhythmic medication amiodarone are severe, potentially life-threatening, and not rare. One in three patients on long-term therapy experience elevated liver enzymes, and clinically apparent liver toxicity occurs in 1% of patients treated. We report the case of a 76-year-old patient with amiodarone-induced intrahepatic cholestasis and prolonged hyperbilirubinemia despite the discontinuation of the offending agent. Current research hypothesizes that amiodarone leads to hepatic injury both by direct hepatotoxicity and by increasing the likelihood of hepatocytes to create abnormal, toxic metabolites. Increased awareness of such an adverse effect can guide clinicians toward the possible underlying etiologies of prolonged jaundice.

Delusions of parasitosis are a rare psychiatric disorder in which the patient has a fixed, false belief of being infested with parasites. The disorder is classified as primary if no cause is identified or secondary if associated with general organic conditions, psychiatric illnesses, and drugs (substance induced). Several medications have been reported in association with delusions of parasitosis, including anti-parkinsonian medications, ciprofloxacin, cetirizine, doxepin, and others. Delusions of parasitosis have not been previously reported to be associated with gabapentin use. We present the case of a patient who developed delusions of parasitosis after been initiated on gabapentin treatment for neuropathic pain and complete disappearance of symptoms after the medication was discontinued.

Indiana University-Purdue University Indianapolis (IUPUI) / Understanding the factors that increase patients susceptibility to orthodontically induced root resorption is of the utmost importance to the practicing clinician. Numerous studies have been conducted that investigated contributing and etiological factors that tend to increase the amount of external apical root resorption a patient may incur during orthodontic treatment. However, there has been little research that has attempted to determine if patients treated with different slot size orthodontic brackets exhibit the same amount of external apical root resorption. The purpose of this research was to determine if patients treated with the 0.018 x 0.025 slot size bracket and patients treated with the 0.022 x 0.028 exhibited similar amounts of external apical root resorption during orthodontic treatment. Pre and Post treatment panoramic films from 91 consecutively treated orthodontic patients from a private orthodontic practice were used for this study. Each case that was included in the study had been treated with standard edgewise brackets using the Tweed-Merrifield philosophy of treatment. Forty-three cases from the 0.018 group and 48 from the 0.022 group were obtained. Each film that was analyzed was blinded prior to measuring to minimize observer bias. Mitutoyo Digimatic® calipers accurate to the nearest tenth of a millimeter were used for obtaining tooth measurements. Measurements were made from the Cemento-enamel junction and from incisal/occlusal to most apical portion of each incisor and all first molars. Statistical analysis was performed and the results showed no significant correlation between the size of the bracket and the amount of root resorption. No significant correlations existed between the groups for patient age, time in treatment, gender, and angle classification. Statistically significant differences were noted for cases in which extraction of four bicuspids was performed. Subjects belonging to the extraction group demonstrated significantly more external apical root resorption than those in which extractions were not done. This study demonstrated that the incidence of EARR that a patient may incur during treatment is independent of the size of the slot of the orthodontic bracket.

Background: The causes of childhood brain tumors (CBT) are essentially unknown. Exposure to extremely low frequency magnetic fields (ELF-MF) (3-3000Hz) is an ubiquitous part of modern life. However, very few studies have investigated the possible effect of maternal occupational ELF-MF exposure on CBT and the available findings are inconsistent across studies. / Methods: We examined the role of maternal occupational exposure to ELF-MF shortly before and during pregnancy on the incidence of childhood brain tumors. A total of 548 incident cases and 760 healthy controls recruited between 1980 and 2002 from two Canadian provinces (Quebec and Ontario) were included and their mothers were interviewed. Tumors were classified as astroglial tumors, primitive neuroectodermal tumors (PNET), and other gliomas. Quantitative occupational ELF-MF exposure in microtesla units was estimated using individual exposure estimations or a job exposure matrix. We used three metrics to analyze exposure: cumulative, average, and maximum level attained. / Results: Using the average exposure metric measured before conception, an increased risk was observed for astroglial tumors (OR=1.5, and 95% CI=1.0-2.4). During the entire pregnancy period, a significantly increased risk was observed for astroglial tumors as well as for all childhood brain tumors with the average metric (OR=1.6, 95% CI=1.1-2.5 and OR=1.5; 95% CI=1.1-2.2, respectively). Based on job titles, a two-fold risk increase was observed for astroglial tumors (OR=2.3, 95% CI=0.8-6.3) and for all childhood brain tumors (OR=2.3, 95% CI=1.0-5.4) among sewing machine operators. / Conclusion: Results are suggestive of a possible association between maternal occupational ELF-MF exposure and certain brain tumors in their offspring. / Keywords: brain tumors, occupational exposures, maternal exposures, magnetic fields, childhood cancer, job exposure matrix

Thesis (M.S.)--University of South Florida, 2007. / Title from PDF of title page. Document formatted into pages; contains 80 pages. Includes bibliographical references.