Impact of seminal trace element and glutathione levels on semen quality of Tunisian infertile men

<p>Abstract</p> <p>Background</p> <p>Growing evidence indicates that oxidative stress can be a primary cause of male infertility. Non-enzymatic antioxidants play an important protective role against oxidative damages and lipid peroxidation. Human seminal plasma is a natural reservoir of antioxidants. The aim of this study was to determine glutathione (GSH) concentrations, trace element levels (zinc and selenium) and the lipid peroxidation end product, malondialdehyde (MDA), in the seminal plasma of men with different fertility potentials.</p> <p>Methods</p> <p>Semen samples from 60 fertile men (normozoospermics) and 190 infertile patients (74 asthenozoospermics, 56 oligozoospermics, and 60 teratozoospermics) were analyzed for physical and biochemical parameters. Zinc (Zn) and selenium (Se) levels were estimated by atomic absorption spectrophotometry. Total GSH (GSHt), oxidized GSH (GSSG), reduced GSH (GSHr) and MDA concentrations were measured spectrophotometrically.</p> <p>Results</p> <p>Zn and Se concentrations in seminal plasma of normozoospermics were more elevated than the three abnormal groups. Nevertheless, only the Zn showed significant differences. On the other hand, Zn showed positive and significant correlations with sperm motility (P = 0.03, r = 0.29) and count (P < 0.01, r = 0.49); however Se was significantly correlated only with sperm motility (P < 0.01, r = 0.36). GSHt, GSSG and GSHr were significantly higher in normozoospermics than in abnormal groups. We noted a significant association between seminal GSHt and sperm motility (P = 0.03). GSSG was highly correlated to sperm motility (P < 0.001) and negatively associated to abnormal morphology (P < 0.001). GSHr was significantly associated to total sperm motility (P < 0.001) and sperm count (P = 0.01). MDA levels were significantly higher in the three abnormal groups than in normozoospermics. Rates of seminal MDA were negatively associated to sperm motility (P < 0.01; r = -0.24) and sperm concentration (P = 0.003; r = -0.35) Meanwhile, there is a positive correlation between seminal lipid peroxidation and the percentage of abnormal morphology (P = 0.008).</p> <p>Conclusions</p> <p>This report revealed that decreased seminal GSH and trace element deficiencies are implicated in low sperm quality and may be an important indirect biomarker of idiopathic male infertility. Our results sustain that the evaluation of seminal antioxidant status in infertile men is necessary and can be helpful in fertility assessment from early stages.</p

Towards a conceptual framework demonstrating the effectiveness of audiovisual patient descriptions (patient video cases): a review of the current literature

Background: Technological advances have enabled the widespread use of video cases via web-streaming and online download as an educational medium. The use of real subjects to demonstrate acute pathology should aid the education of health care professionals. However, the methodology by which this effect may be tested is not clear. Methods: We undertook a literature review of major databases, found relevant articles relevant to using patient video cases as educational interventions, extracted the methodologies used and assessed these methods for internal and construct validity. Results: A review of 2532 abstracts revealed 23 studies meeting the inclusion criteria and a final review of 18 of relevance. Medical students were the most commonly studied group (10 articles) with a spread of learner satisfaction, knowledge and behaviour tested. Only two of the studies fulfilled defined criteria on achieving internal and construct validity. The heterogeneity of articles meant it was not possible to perform any meta-analysis. Conclusions: Previous studies have not well classified which facet of training or educational outcome the study is aiming to explore and had poor internal and construct validity. Future research should aim to validate a particular outcome measure, preferably by reproducing previous work rather than adopting new methods. In particular cognitive processing enhancement, demonstrated in a number of the medical student studies, should be tested at a postgraduate level

Epistasis between COMT and MTHFR in Maternal-Fetal Dyads Increases Risk for Preeclampsia

Preeclampsia is a leading cause of perinatal morbidity and mortality. This disorder is thought to be multifactorial in origin, with multiple genes, environmental and social factors, contributing to disease. One proposed mechanism is placental hypoxia-driven imbalances in angiogenic and anti-angiogenic factors, causing endothelial cell dysfunction. Catechol-O-methyltransferase (Comt)-deficient pregnant mice have a preeclampsia phenotype that is reversed by exogenous 2-methoxyestradiol (2-ME), an estrogen metabolite generated by COMT. 2-ME inhibits Hypoxia Inducible Factor 1α, a transcription factor mediating hypoxic responses. COMT has been shown to interact with methylenetetrahydrofolate reductase (MTHFR), which modulates the availability of S-adenosylmethionine (SAM), a COMT cofactor. Variations in MTHFR have been associated with preeclampsia. By accounting for allelic variation in both genes, the role of COMT has been clarified. COMT allelic variation is linked to enzyme activity and four single nucleotide polymorphisms (SNPs) (rs6269, rs4633, rs4680, and rs4818) form haplotypes that characterize COMT activity. We tested for association between COMT haplotypes and the MTHFR 677 C→T polymorphism and preeclampsia risk in 1103 Chilean maternal-fetal dyads. The maternal ACCG COMT haplotype was associated with reduced risk for preeclampsia (P = 0.004), and that risk increased linearly from low to high activity haplotypes (P = 0.003). In fetal samples, we found that the fetal ATCA COMT haplotype and the fetal MTHFR minor “T” allele interact to increase preeclampsia risk (p = 0.022). We found a higher than expected number of patients with preeclampsia with both the fetal risk alleles alone (P = 0.052) and the fetal risk alleles in combination with a maternal balancing allele (P<0.001). This non-random distribution was not observed in controls (P = 0.341 and P = 0.219, respectively). Our findings demonstrate a role for both maternal and fetal COMT in preeclampsia and highlight the importance of including allelic variation in MTHFR

Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference

Pulmonary abnormalities after cardiac surgery are better explained by atelectasis than by increased permeability oedema

BACKGROUND: Cardiac surgery can be complicated by pulmonary abnormalities, but it is unclear how various manifestations interrelate. METHODS: A prospective study in the intensive care unit was performed on 26 mechanically ventilated patients without cardiac failure within 3 h after elective cardiac surgery involving cardiopulmonary bypass. Oedema (extravascular lung water, EVLW) was measured by the thermal-dye technique and permeability by a dual radionuclide technique, yielding a pulmonary leak index (PLI). Radiographic, mechanical and gas exchange features were used to calculate the lung injury score (LIS), ranging between 0 and 4. Evidence for left lower lobe atelectasis was obtained from plain radiographs. The plasma colloid osmotic pressure (COP) was measured by an oncometer. RESULTS: The EVLW (normal, 10 ml/kg. There was no difference in EVLW and PLI in patients with LIS 1 (31% of patients). In patients with radiographic evidence for atelectasis (46%), the positive end-expiratory pressure and inspiratory O2 fraction to maintain oxygenation were higher than in those without. CONCLUSIONS: After cardiac surgery, mild pulmonary oedema is relatively common, even in the absence of high filling pressures, and is mainly attributable to a low COP, irrespective of increased permeability in about one-half of patients. It may prolong mechanical ventilation at EVLW > 10 ml/kg. However, pulmonary radiographic and ventilatory abnormalities may result, at least in part, from atelectasis rather than increased permeability oedema

The association between homocysteine in the follicular fluid with embryo quality and pregnancy rate in assisted reproductive techniques

PURPOSE: To investigate the association between follicular fluid homocysteine levels and embryo quality and pregnancy rates in patients undergoing assisted reproduction. METHODS: Fifty infertile women who were admitted to our clinic were enrolled in the study. Ovulation induction was performed by using GnRH agonist and gonadotropins. For each patient, homocysteine level in the follicular fluid was measured by using nephelometric method after the oocyte pick-up. The association between the homocysteine concentration in the follicular fluid and the oocyte–embryo quality, pregnancy rates and hormone levels were investigated. RESULTS: Mean ± SD Hcy was 9.6 ± 2.02 μmol/L and 14.9 ± 2.93 μmol/L in pregnant and non-pregnant women, respectively (p < 0.0001). There were no statistically significant differences between pregnant and non-pregnant women in mean age, duration of infertility, body mass index, the oocyte–embryo quality parameters, and hormone levels. Homocystein did not have any correlation with M2, late M2, and total number of oocytes, number of fertilized oocytes and transferred embryos, and embryo quality grade. Area under curve (AUC) of hcy for prediction of pregnancy failure was 0.922 (p = 0.0001, 95% Confidence interval 0.85–0.99). A threshold of 11.9 μmol/L of hcy had a sensitivity of 82%, specificity of 100%, positive predictive value of 100% and negative predictive value of 91.6% for prediction of pregnancy failure. The subgroup analysis in male factor infertility group (n = 28), showed that mean homocystein was 9.9 ± 2.44 μmol/L and 14.1 ± 2.72 μmol/L in pregnant and non-pregnant women, respectively (p = 0.002). CONCLUSION: Low follicular fluid homocysteine level is associated with a better chance of clinical pregnancy

I Miti dell’Aldilà. Analisi strutturale e interpretazione per una ridefinizione del ruolo del racconto escatologico all’interno del corpus platonico

[cat] Aquest treball té per objecte l'estudi dels tres “mites del més enllà” inclosos en els tres diàlegs de Plató: Gòrgies, Fedó, República. El mateix té com objectiu la redefinició de la funció desenvolupada per les narracions escatològiques dins el corpus platònic, a través d'un estudi de tipus analític dels tres fragments considerats, adreçat a reconstruir -tot i mantenint les especificitats de cadascun dels mateixos i dels diàlegs en els quals s'inclouen - un quadre de conjunt de l'ús, els significats i les finalitats que Plató pretenia atribuïr-los. Aquí, els tres fragments del Gòrgies, del Fedó i de la República no són considerats des de l'únic - per molt evident que sigui - valor ètic i protrètic, però també i especialment, des del punt de vista de les remissions actuades per les imatges de les que estan constituïts respecte de qüestions de notable importància teòrica, desenvolupades dins dels diàlegs als que es refereixen. L'estudi preveu, en la doble via de l'anàlisi estructural i conceptual, que no constitueixen, des de l'òptica d'aquesta investigació, dues vies diferents, sinó dues formes obligatòriament complementàries d'afrontar els “mythoi” considerats. En tot cas, l'estudi es presenta no pas com exclusiu respecte dels fragments específicament analitzats, donat que s'associa al mateix, a efectes de completesa, l'anàlisi conceptual i estructural dels diàlegs dels que formen part, assumint, en un cert sentit, un "caire holístic": els mites escatològics ens recondueixen, de fet, a alguns pilars del pensament platònic, presents no només al Gòrgies, al Fedó i a la República, sinó en el conjunt de la producció filosòfica atenenca. La investigació s'articula en tres parts, una per cada mite considerat: I- El Gòrgies. El mite del judici; II – El Fedó. Els destins de les ànimes; III- La República. La tria. En cada part, hi trobem: un “status quaestionis” que, breument, recapitula els principals filons hermenèutics que s'han desenvolupat al voltant de l'específica narració mítica; l'anàlisi del contingut del fragment, amb un ampli aprofundiment corresponent a les fonts que subministraren a Plató els materials per la construcció de la imatge mítica; l'anàlisi de l'estructura formal dels tres fragments objecte d'anàlisi; la definició dels nuclis i l'estructura conjunta de cada diàleg. Els anàlisi s'alternen regularment amb recapitulacions i reflexions que tenen la finalitat de no deixar que perdem la visió de conjunt que ha de seguir a l'estudi dels detalls. L'anàlisi estructural, que és complementari a la consideració dels nuclis conceptuals, il.lumina la funció dels mites del més enllà que poden ser considerats, de ple dret, part integrant dels diàlegs en els que s'inclouen i "parts serioses" del discurs, ja que es presenten com a narracions capaces d'incloure i sintetitzar, d'un sol cop, els principals nusos teòrics plantejats per cadascun dels diàlegs als que pertanyen oferint, d'aquesta forma, una visió del conjunt de les temàtiques tractades. “Mythos” i “logos”, en el fons, diuen les mateixes coses.[eng] The purpose of the present work is the analysis of the three “myths oft he underworld journey” which are included in Plato’s three dialogues: namely Gorgias, Phaedo and The Republic. The main goal is to re-define the role of eschatological myths within the platonic corpus, through an analytical study of the three passages in which these myths are included, whose aim is to reconstruct a comprehensive framework of their use, meanings and finalities, following Plato’s intents, while keeping the specific features of each passage and of each of the three dialogues in which the passages are included. Here the three passages are not only considered for their unique, even if evident, ethical and protreptic value, but also and above all they look at the recall that images can suggest in respect to important theoretical elements. The study follows the double path of the structural and conceptual analysis which do not constitute two different ways, but rather two complementary ways of dealing with the mythoi. However the present research is not to be thought as exclusively devoted to the analysis of the aforementioned specific passages, since, for completeness, it is correlated to the conceptual and structural analysis of the entire dialogues of which each passage is part of. In this way a “holistic cut” is given: the myths of the underworld journey bring back some of the cornerstones of Plato’s thinking, which are present not only in Gorgias, Phaedo and The Republic, but also in the entire work of the Athenian Philosopher. This work is structured into three main sections, one for each dialogue: I- The Gorgias. The Myth of Judgment; II- The Phaedo. The Fate of Souls; III-The Republic. The Choice. In each part there is: a status quaestionis through which the main hermeneutical key points which are developed around the myth are summarized; the analysis of the content of the passage, with a wide study of the sources that gave Plato the inspiration for the construction of the mythical image; the analysis of the formal structure of the three passages themselves; the definitions of the theoretical cores and of the overall structure of each dialogue. Each analysis is punctually interspersed with recaps and reflections whose purpose is that to keep the global view, this being necessary in order to follow the studies particulars. The structural analysis, which is complementary to that of the conceptual cores, enlightens the role played by the myths of the underworld journey, which can be fully considered integral parts of the dialogues to which they belong and “serious parts” of the speech. Since they are to be seen as narrations capable to encompass and synthesize, at a glance, the principal theoretical issues present in each dialogue, give in this way a full overview of the covered topics. Mythos and logos, after all, say the same things