A multicenter randomized clinical trial investigating the cost-effectiveness of treatment strategies with or without antibiotics for uncomplicated acute diverticulitis (DIABOLO trial)

Background. Conservative treatment of uncomplicated or mild diverticulitis usually includes antibiotic therapy. It is, however, uncertain whether patients with acute diverticulitis indeed benefit from antibiotics. In most guidelines issued by professional organizations antibiotics are considered mandatory in the treatment of mild diverticulitis. This advice lacks evidence and is merely based on experts' opinion. Adverse effects of the use of antibiotics are well known, including allergic reactions, development of bacterial resistance to antibiotics and other side-effects. Methods. A randomized multicenter pragmatic clinical trial comparin

Does varicocele repair improve conventional semen parameters? A meta-analytic study of before-after data

Purpose The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles. Materials and Methods The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies). Results Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129–0.278; p<0.001; I2=83.62%, Egger’s p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474–1.706; p<0.001; I2=97.86%, Egger’s p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526–2.121; p<0.001; I2=97.88%, Egger’s p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318–1.968; p<0.001; I2=98.65%, Egger’s p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%–2.153%; p<0.001; I2=98.97%, Egger’s p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%–1.759%; p<0.001; l2=97.98%, Egger’s p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%–1.211%; p<0.001; I2=97.87%, Egger’s p=0.1864. Conclusions The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele. Keywords Controlled before-after studies; Infertility, male; Meta-analysis; Varicocel

Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data

Purpose: The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles. Materials and methods: The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies). Results: Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129-0.278; p&lt;0.001; I²=83.62%, Egger's p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474-1.706; p&lt;0.001; I²=97.86%, Egger's p&lt;0.0001; total sperm count: SMD 1.824, 95% CI: 1.526-2.121; p&lt;0.001; I²=97.88%, Egger's p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318-1.968; p&lt;0.001; I²=98.65%, Egger's p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%-2.153%; p&lt;0.001; I²=98.97%, Egger's p&lt;0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%-1.759%; p&lt;0.001; l2=97.98%, Egger's p&lt;0.001; sperm morphology: SMD 1.066, 95% CI 0.992%-1.211%; p&lt;0.001; I²=97.87%, Egger's p=0.1864. Conclusions: The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele

Role of Mineral Nutrients in Plant Growth Under Extreme Temperatures

Food productivity is decreasing with the drastic increase in population, while it is expected that the global population will be nine to ten billion in 2050. Growth, production, and development on whole plant, cell, and subcellular levels are extremely affected by environmental factors particularly with the extreme temperature events (high- or low-temperature stress). Increase in the fluidity of lipid membrane, protein accumulation, and denaturation are the direct effects of high temperature on a plant. Membrane integrity loss, protein deprivation, protein synthesis inhabitation, and inactivation of mitochondrial and chloroplast enzymes are the indirect effects of high temperature. Similarly, the oval abortion, alteration of the pollen tube, reduction in fruit set, pollen sterility, and flower abscission are the consequences of low temperature at the time of product development, which in turn lowers the yield. The judicious nutrient management is essential for improving the plant nutrition status to mitigate the drastic effects of temperature stress as well as for sustainable plant yield under extreme temperature events, because nutrient deficiency results in growth and development problems in 60% cultivars worldwide. Additionally, effective nutrient management increases the temperature stress tolerance in plants. Therefore, the appropriate nutrient application rates and timings are imperative for alleviating the heat stress in plants and can serve as an effective and decent strategy. To minimize the contrasting effects of the environmental stresses, particularly heat stress, several examples of the supplemental applications of N, P, K, Ca, Mg, Se, and Zn are given in detail in this study, to observe how these nutrients reduce the effects of temperature stress in plants. This study concluded that judicious nutrient management minimizes the heat stress and increases the growth and yield of plants