The experience of using the UltraFertile Plus micronutrient complex for correction of idiopathic forms of secretory infertility in men

The study objective is to evaluate the effect of the UltraFertile Plus micronutrient complex on parameters of the ejaculate in men with idiopathic infertility.Materials and methods. The study included 45 men aged between 24 and 48 years (median 31 years) suffering infertility in marriage. All patients took 2 capsules of UltraFertile Plus once a day in the morning at breakfast for 3 months. The patients didn’t receive any other therapy during the study. Hormonal status, spermogram parameters, MAR test, number of sperm with fragmented DNA using flow cytofluorometry with monoclonal antibodies were analyzed prior to treatment and after it.Results. After a course of UltraFertile Plus therapy, significant improvement of spermogram parameters was observed in the majority of patients. Sperm count increased from 43.5 to 62.0 million/ml (p < 0.001), percent of progressive motile sperm (categories А and В) increased from 29.3 to 44.4 % (p <0.001), normal morphology sperm count increased from 3.0 to 4.0 % (p <0.001). Administration of UltraFertile Plus promoted a decrease in the number of sperm with fragmented DNA from 14.7 to 10.1 % (p = 0.001) and was effective for patients with this parameter below 22 %. No significant effect of UltraFertile Plus was observed in MAR test. Plasma total and free testosterone levels significantly increased as a result of administration of UltraFertile Plus.Conclusion. Administration of the UltraFertile Plus micronutrient complex promotes a decrease in sperm DNA fragmentation, an increase in sperm count, percentage of progressive motile sperm and normal morphology sperm, testosterone level.The authors declare no conflict of interest.All patients gave written informed consent to participate in the study

EFFECT OF PROSTATILEN® AC ON SPERM DNA FRAGMENTATION DURING TREATMENT OF PATIENTS WITH CHRONIC NONBACTERIAL PROSTATITIS AND CONCOMITANT DISORDERS OF THE REPRODUCTIVE FUNCTION

The study objective is to analyze the effect of Prostatilen® AC on sperm DNA fragmentation during treatment of patients with chronic nonbacterial prostatitis and concomitant disorders of the reproductive function.Materials and methods. The study is based on the results of treatment of 25 men aged 24 to 45 years (mean age 35.3 ± 4.4 years) with a verified diagnosis of chronic nonbacterial prostatitis and complaints of early-stage missed miscarriage in a spouse/sexual partner. All patients received Prostatilen® AC daily in rectal suppositories formulation. The duration of treatment was 10 days with retreatment after 20 days. In all patients before treatment and 20 days after it, spermiogram parameters (5th ed., WHO, 2010) and sperm DNA fragmentation level using SCSA (sperm chromatin structure assay) by FACSCantoll with monoclonal antibodies (Roche, Germany) were determined, and all patients underwent the MAR (mixed antiglobulin reaction) test with normal value considered to be 10 % or less. The normal value of sperm DNA fragmentation was considered to be 15 % or less (low risk of fertility impairment). The analysis of the obtained data was carried out using the IBM SPSS Statistics program 22.Results. Before the treatment, pathologic level of sperm DNA fragmentation was observed in 6 (43 %) of 14 patients with normozoospermia and in 7 (63 %) of 11 patients with pathozoospermia (χ² = 1.06; p <0.3). Thus, there weren’t any significant difference between the rates of occurrence of increased sperm DNA fragmentation in patients with normo- and pathozoospermia. A correlation was found between the level of sperm DNA fragmentation and the results of MAR test before treatment (r = 0.8, p <0.05), which varied between 0 and 99 % (mean 16.48 ± 31.64 %). Meanwhile, increased sperm DNA fragmentation was observed in 7 (53 %) of 13 patients with pathological MAR test results, and in 2 (40 %) of 5 patients with normal MAR test results (χ² = 0.67; p <0.01). The level of sperm DNA fragmentation prior to treatment varied between 1 and 55 % (mean 18.99 ± 6.87 %), and after treatment it varied between 1 and 26 % (mean 9.76 ± 4.32 %). Increased level of sperm DNA fragmentation was observed in 13 (52 %) of 25 patients before treatment with Prostatilen® AC and only in 3 (12 %) patients after the treatment (χ² = 0.86; p < 0.001).Conclusion. Prostatilen® AC as treatment of chronic nonbacterial prostatitis promotes a decrease in the level of sperm DNA fragmentation

Does Computed Tomography or Positron Emission Tomography/Computed Tomography Contribute to Detection of Small Focal Cancers in the Prostate?

Prostate cancer is considered to be a multifocal tumor in the majority of patients. Based on histologic data after prostatectomy, there is a growing insight that a considerable number of men who receive a diagnosis in the contemporary setting of prostate-specific antigen screening have unilateral or unifocal disease. With this, the current concept of whole-gland therapy has come into discussion. The need for improvement of intraprostatic tumor characterization is clear. Molecular imaging is one of the areas of research on this aspect. The clinical indications for positron emission tomography (PET)/CT have increased rapidly in the field of oncology and are largely based on fluorodeoxyglucose (FDG) PET. Both conventional CT and FDG PET, however, cannot detect prostate cancer foc

LONG-TERM RESULTS OF TREATMENT OF PATIENTS WITH CHRONIC NONBACTERIAL PROSTATITIS AND INCREASED LEVEL OF SPERM DNA FRAGMENTATION WITH THE PROSTATILEN® AC DRUG

The study objective is to evaluate the results of treatment of patients with chronic nonbacterial prostatitis, increased level of sperm DNA fragmentation, and concomitant reproductive function disorders with the Prostatilen® AC drug 1, 2, and 3 months after the end of therapy.Materials and methods. Thirty five men aged 21–46 years (mean age 31.3 ± 4.3 years) with a verified diagnosis of “chronic nonbacterial prostatitis, associated reproductive function disorders, history of early-stage missed miscarriage in a wife/sex partner” were examined. All patients received Prostatilen® AC as rectal suppositories daily for 10 days with a repeat course 20 days later. Before and after the treatment, as well as after 1, 2, and 3 months after its end, the fraction of spermatozoa with fragmented DNA was measured in all patients using sperm chromatin structure assay with flow cytofluorometry. The risk of decreased fertility was considered low if the number of spermatozoa with fragmented DNA was 15 % or lower (this value is considered the norm). If DNA fragmentation was 16 % or higher, it was considered increased.Results. The fraction of spermatozoa with fragmented DNA significantly decreased during the treatment, and 1 month after the end of the therapy it was 7.5 ± 4.2 % (prior to treatment it was 17.8 ± 6.7 %) (p <0.005). Prior to Prostatilen® AC treatment, enhanced DNA fragmentation was observed in 18 (51 %) patients, 1 month after treatment – only in 6 (17 %); the difference is statistically significant (p <0.001). Two months after the end of treatment, increased level of DNA fragmentation was detected in 7 (20 %) patients, 3 months after – in 15 (42 %) patients. Aside from that, if the fraction of spermatozoa with fragmented DNA was more than 30 % before treatment, then a decrease in this value during treatment wasn’t statistically significant.Conclusion. Prostatilen® AC promotes a reduction in the level of sperm DNA fragmentation in patients with chronic nonbacterial prostatitis. A steady positive effect persists for 2 months with a tendency to weaken at the end of month 3 which indicates advisability of repeated courses of Prostatilen® AC treatment 2 months after the end of therapy

DIAGNOSTIC VALUE OF DEFINITION OF FRACTIONS OF PROSTATIC SPECIFIC ANTIGEN AND PROSTATE HEALTH INDEX

OBJECTIVE. The authors investigated the value of comprehensive assessment of clinical and laboratory factors including prostate specific antigen (PSA) fractions and prostate health index (PHI) in diagnostics of prostate cancer. MATERIALS AND METHODS. The study numbered 148 patients who were examined for suspected prostate cancer. Clinicians made the measurement of total PSA and fractions, PHI, multifocal transrectal biopsy of prostate. The statistical data were analyzed. RESULTS. The formulas obtained used the discriminant analysis of all clinical and laboratory factors (PSA fractions and PHI). These formulas showed the high possibility (77-80 %) to predict the presence of prostate cancer with sensitivity 70-78 % and specificity 77-83 %. Percentage of [-2]proPSA depended on PHI value and had the significant influence on the possibility of prostate cancer detection

ROLE OF KINETIC PERFORMANCE OF PSA IN SELECTION OF THE PATIENTS FOR CONDUCTION OF ¹¹C-CHOLINE PET/CT AIMED TO REVEAL LOCAL RECURRENCES OF PROSTATE CANCER

Given study was aimed to research a role of kinetic performance of PSA in selection of the patients for conduction ¹¹C-choline PET/CT in order to reveal local recurrences in patient with prostate cancer after radiation therapy (RT) and radical prostatectomy (RP). The study included 185 patients with histologically distinctive prostate cancer and biochemical signs of tumor recurrence after RP (61 patients) or RT (124 patients). All the patients were examined using ¹¹C-choline PET/ CT in order to detect local relapses. Calculation of growth rate of the PSA level and PSA doubling time were made. According to results of ¹¹C-choline PET/CT, recurrences of prostate cancer were detected in 124 out of 185 (65%). There were 22 patients out of 61 (36%) after RP and there were 102 patients out of 124 (82%) after RT. It was stated a correlation between PSA rates, growth rate of PSA level and presence or absence of relapse according to PET/CT results. PSA level and growth rate of PSA were indicated as the most significant predictive signs, which could influence on the selection of the patients for conduction of ¹¹C-choline PET/CT in relation to detection of local recurrence after RT and RP

Mechanisms of leukocyte accumulation and activation in chorioamnionitis: interleukin 1 beta and tumor necrosis factor alpha enhance colony stimulating factor 2 expression in term decidua.

Chorioamnionitis is a major cause of prematurity as well as perinatal morbidity and mortality. The present study observed a marked increase in immunohistochemical staining for Colony Stimulating Factor 2 (CSF2; also known as granulocyte macrophage-colony stimulating factor), a potent neutrophil and macrophage chemoattractant and activator, in the decidua of patients with CAM compared with controls (n = 8; P = .001). To examine the regulation of this CSF2, cultured decidual cells primed with estradiol (E2) or E2 plus medroxyprogesterone acetate, were exposed to tumor necrosis factor-α or interleukin-1β and secreted CSF2 measured by ELISA. Levels of CSF2 in E2 plus MPA-treated cultures increased 18- and 245-fold following treatment with TNF or IL1B (n = 7, P < .05). Quantitative RT-PCR demonstrated parallel changes in mRNA levels. This study reveals that CSF2 is strongly expressed in decidua from patients with CAM and indicates TNF or IL1B as important regulators of CAM-related decidual leukocyte infiltration and activation

[11C]choline PET for the intraprostatic tumor characterization and localization in recurrent prostate cancer after EBRT

Aim. This study focuses on the potential role of [C-11] choline positron emission tomography (PET) for the intraprostatic tumor characterization and localization in recurrent prostate cancer after EBRT. Methods. This retrospective study was conducted in patients who were being followed up after EBRT for histological proven prostate cancer. We selected the patients with a local recurrence by [C-11]choline PET/CT fusion. The results of PET were compared with the results of histology and with clinical follow-up. Results. Forty-two patients with a local recurrence suggested by PET were included in this study. According to PET results: of the 42 patients, 15 (36%) had a focal recurrence, 27 (64%) showed a diffuse recurrence. The overall concordance of PET with histology concerning detection of recurrence was 76% (32 patients had positive PET results and positive biopsies). We confirmed the local recurrence as visualized by PET in 37/42(88%) patients using a composite reference with histology and clinical follow up after local salvage treatment. The concordance of the intraprostatic distribution of the tumor with PET with histology from transrectal prostate biopsies (median biopsies 7, range 4-12) was 47% (7/15) in unilateral cases and 41% (11/27) in bilateral cases. No significant differences were seen between the 2 groups in serum PSA at time of PET (P=0.509) and SUV (P=0.739) using Student's t-test. Conclusion. Intraprostatic characterization of recurrent prostate cancer after EBRT with C-11-choline PET is feasible at present but shows a moderate concordance with routine transrectal prostate biopsies. The accuracy is too low for the routine use of this modality in the present scenario

Impact of total PSA, PSA doubling time and PSA velocity on detection rates of 11C-Choline positron emission tomography in recurrent prostate cancer

<p>To evaluate the effect of total PSA (tPSA) and PSA kinetics on the detection rates of C-11-Choline PET in patients with biochemical recurrence (BCR) after radical prostatectomy (RP) or external beam radiotherapy (EBRT).</p><p>We included 185 patients with BCR after RP (PSA > 0.2 ng/ml) or after EBRT (ASTRO definition). After injection of 400 MBq C-11-Choline i.v., a scan was made using the ECAT HR + PET camera with CT fusion images or Siemens mCT PET/CT. Biopsy-proven histology, confirmative imaging (CT or bone scan) and/or clinical follow-up (PSA) were used as composite reference. Statistical analysis was performed using PASW Statistics 18.</p><p>C-11-Choline PET was positive in 124/185 cases (65 %) (in 22/61 (36 %) after RP, 102/124 (82 %) after EBRT). In 79 patients a local recurrence was identified, and 45 patients showed locoregional metastases on PET/CT. In 20 cases a proven false-negative PET scan was observed. Positive PET scans were confirmed by histology in 87/124 (70 %) cases, by confirmatory imaging in 34/124 (28 %) and by clinical follow-up after salvage treatment in 3 (2 %) cases. The ROC analysis to detect a recurrence showed significant difference in area under the curve (AUC) of tPSA 0.721(p <0.001) and PSA velocity 0.730 (p <0.001). PSA doubling time showed no significant difference with an AUC of 0.542 (p = 0.354). Detection rates are <50 % in tPSA <2 ng/ml and/or PSA velocity <1 ng/ml/year.</p><p>Total serum PSA and PSA velocity have significant effect on the detection rates of C-11-Choline PET/CT in men with a BCR after RP or EBRT.</p>

Effect of Prostatilene® AC and Prostatilene® on the ejaculate level of antisperm antibodies in the treatment of patients with chronic abacterial prostatitis and concomitant reproductive dysfunctions

Objective: to evaluate the comparative effects of Prostatilene® AC (rectal suppositories) and Prostatilene® (rectal suppositories 30 mg) on the ejaculate level of antisperm antibodies in the treatment of patients with chronic abacterial prostatitis and concomitant reproductive dysfunctions.Subjects and methods. A total of 98 men aged 25–45 years with a verified diagnosis of chronic abacterial prostatitis and related reproductive functions were examined. The patients were treated and examined in an outpatient setting at 2 specialized research centers. A study group (n = 49) received therapy with Prostatilene® AC, a control group (n = 49) had Prostatilene®. A direct mixed antiglobulin reaction (MAR) test was used to determine antisperm antibody levels in all the patients before and after a cycle of therapy. The findings were compared.Results. Primary examination revealed the presence of ejaculate antisperm antibodies in 43 (87.8 %) and 40 (81.6 %) cases in the study and control groups, respectively. After treatment, Prostatilene® was found to affect ejaculate antisperm antibody levels. The latter were reduced by Prostatilene® AC treatment. Final examination showed that 17 (34.6 %) patients had antisperm antibodies in the ejaculate.Conclusion. Prostatilene® AC, unlike and Prostatilene®, is able to lower the ejaculate level of antisperm antibodies in patients with chronic abacterial prostatitis and concomitant reproductive dysfunctions