scholarly journals COVID-19 and male fertility: Taking stock of one year after the outbreak began

2021 ◽  
Vol 93 (1) ◽  
pp. 115-119
Author(s):  
Rocco Francesco Delle Fave ◽  
Giordano Polisini ◽  
Gianluca Giglioni ◽  
Arnaldo Parlavecchio ◽  
Lucio Dell'Atti ◽  
...  

Objectives: The aim of this review is to summarize, following a timeline, the current knowledge regarding the effects of the Sars-cov2 virus on male fertility, researching the pathological and clinical results of the studies published in the last year. Methods: A systematic research was performed on the major international online databases; Thirty-five articles were selected. Results: A statistically significant reduction in testosterone levels and sperm quality in subjects with COVID-19 has been highlighted in several papers; however, in many cases the tests have been conducted in patients with active disease and long-term consequences are still not known. Some studies have confirmed the presence of the virus in the testis in a low percentage of patients; viral presence in sperm has only been found in one study. Testicular discomfort, which could indicate viral orchitis, was highlighted in several works, with an incidence of up to 19% percent of patients. The presence of inflammatory lymphocytic infiltrates, IgG and inflammatory cytokines have been documented in several works; pathological signs of inflammation were found in 60.9% of testicular biopsies performed in one study. The entry of the virus into the testis cells, both stromal and seminal cells appeared to be Angiotensin Converting Enzyme-2 (ACE2) mediated, as it also occurs in other tissues. DNA fragmentation, reactive oxygen species (ROS) formation, autoantibody production and ACE2 mediated effect have all been hypothesized as cause of cellular damage. Conclusions: The results on effects of COVID-19 infection on the male reproductive system are currently insufficient as they are based on a small number of patients and therefore are often contradictory.Certain mechanisms of testicular damage are still to be assessed, as any risk categories like age, ethnicity, or others. As for the transmission of the virus through sperm, there is insufficient evidence to ensure that this cannot happen.

Antioxidants ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1283
Author(s):  
Maria Nunzia De Luca ◽  
Marisa Colone ◽  
Riccardo Gambioli ◽  
Annarita Stringaro ◽  
Vittorio Unfer

Infertility is defined as a couple’s inability to conceive after at least one year of regular unprotected intercourse. This condition has become a global health problem affecting approximately 187 million couples worldwide and about half of the cases are attributable to male factors. Oxidative stress is a common reason for several conditions associated with male infertility. High levels of reactive oxygen species (ROS) impair sperm quality by decreasing motility and increasing the oxidation of DNA, of protein and of lipids. Multi-antioxidant supplementation is considered effective for male fertility parameters due to the synergistic effects of antioxidants. Most of them act by decreasing ROS concentration, thus improving sperm quality. In addition, other natural molecules, myo-inositol (MI) and d-chiro–inositol (DCI), ameliorate sperm quality. In sperm cells, MI is involved in many transduction mechanisms that regulate cytoplasmic calcium levels, capacitation and mitochondrial function. On the other hand, DCI is involved in the downregulation of steroidogenic enzyme aromatase, which produces testosterone. In this review, we analyze the processes involving oxidative stress in male fertility and the mechanisms of action of different molecules.


2011 ◽  
Vol 7 (2) ◽  
pp. 97 ◽  
Author(s):  
Niels Voigt ◽  
Dobromir Dobrev ◽  
◽  

Atrial fibrillation (AF) is the most common arrhythmia and is associated with substantial cardiovascular morbidity and mortality, with stroke being the most critical complication. Present drugs used for the therapy of AF (antiarrhythmics and anticoagulants) have major limitations, including incomplete efficacy, risks of life-threatening proarrhythmic events and bleeding complications. Non-pharmacological ablation procedures are efficient and apparently safe, but the very large size of the patient population allows ablation treatment of only a small number of patients. These limitations largely result from limited knowledge about the underlying mechanisms of AF and there is a hope that a better understanding of the molecular basis of AF may lead to the discovery of safer and more effective therapeutic targets. This article reviews the current knowledge about AF-related ion-channel remodelling and discusses how these alterations might affect the efficacy of antiarrhythmic drugs.


2012 ◽  
Vol 153 (45) ◽  
pp. 1787-1792 ◽  
Author(s):  
Mária Horváth ◽  
Endre Czeizel

Introduction: There is a decline in male fertility thus new treatments are needed. Aims: To test the efficacy of a new dietary supplement developed in the USA and registered as a curing drug in Hungary (OGYI). Methods: In a clinical trial 100 men with low sperm quality (spermium count 5–20 M/ml, good motility 10–40%, and adverse shape 30–50%) were examined. Results: Sperm parameters were measured before and after a 3-month treatment and after another 3-month without treatment. This dietary supplement statistically and clinically significantly improved sperm count and motility. In 74 cases this dietary supplement demonstrated a beneficial effect on sperm quality (more than 10% increase in sperm count, or quality of motility, or shape); in 16 cases the improvement exceeded 30%. No adverse effect could be accounted for this treatment. Conclusions: This new dietary supplement may contribute to the treatment of male infertility. Orv. Hetil., 2012, 153, 1787–1792.


2000 ◽  
Vol 35 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Robert A. Quercia ◽  
Ronald Abrahams ◽  
C. Michael White ◽  
John D'Avella ◽  
Mary Campbell

A pharmacy-managed anemia program included distribution and clinical components, with the goal of making epoetin alpha therapy for hemodialysis patients more cost-effective. The Pharmacy Department prepared epoetin alpha doses for patients in unit-dose syringes, utilizing and documenting vial overfill. Pharmacists dosed epoetin alpha and iron (oral and intravenous) per protocol for new and established patients. Baseline data were obtained in 1994, one year prior to implementation of the program, and were re-evaluated in 1995 and 1998. Cost avoidance from utilization of epoetin alpha vial overfill in 1995 and 1998 was $83,560 and $91,148 respectively. In 1995 and 1998, cost avoidance from pharmacy management of anemia was $191,159 and $203,985 respectively. The total cost avoidance from 1995 through 1998 was estimated at $1,018,638. The number of patients with hematocrits under 31% decreased from 32% in 1994 to 21% and 14% in 1995 and 1998 respectively. We conclude that a pharmacy-managed anemia program for hemodialysis patients results in significant cost savings and better achievement of target hematocrits.


2010 ◽  
Vol 24 (8) ◽  
pp. 481-488 ◽  
Author(s):  
Bogdan Superceanu ◽  
Sander Veldhuyzen van Zanten ◽  
Chris Skedgel ◽  
Michael Shepherd ◽  
Ingrid Sketris

BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used agents that can cause serious gastrointestinal (GI) side effects. For patients at increased risk of NSAID-related GI complications, prophylaxis with either a nonselective NSAID plus gastroprotective agent (GPA) or, alternatively, therapy with a cyclooxygenase-2 selective inhibitor with or without a GPA such as a proton pump inhibitor (PPI), is recommended.AIM: To describe the rate, timing and duration of GI prophylaxis in Nova Scotia seniors receiving nonselective NSAIDs.METHODS: The Nova Scotia Seniors’ Pharmacare Program beneficiaries for the years 1998 to 2002 were studied. A cohort of incident NSAID and GPA users was selected from all nonselective NSAID users (no prescribed NSAID dispensed 12 months before the index month and no GPA dispensed two months before the index prescription). Monthly coprescribing rates were calculated by dividing the number of patients in the cohort using GPAs by the number of NSAID users. GI prophylactic coprescribing was defined as the coprescribing rate present at the first month (index month) of prescribing an NSAID.RESULTS: The cohort consisted of 12,906 patients. Seventy-five per cent of the nonselective NSAID prescriptions dispensed were for up to two months duration, with only 2.3% longer than one year. GI prophylaxis was given to only 3.8% of patients starting NSAIDs who were not on a GPA in the two months before starting NSAIDs. Of this 3.8%, 92.7% of the patients received H2-receptor antagonists (H2RAs), and 7% received PPIs. The rate of H2RA coprescribing increased with the number of consecutive months on an NSAID from 3.5% in the first month to 24.1% at 48 months. For PPIs, the coprescribing rate increased from 0.3% to 1.9% of all NSAID users in the cohort. The rate of gastroprophylaxis coprescribing for patients receiving NSAIDs did not rise with increasing age.CONCLUSION: In Nova Scotian seniors using nonselective NSAIDs, the rate of GI prophylaxis was low. Most patients received H2RAs as GPAs despite evidence that they offer insufficient protection.


2010 ◽  
Vol 26 (4) ◽  
pp. 445-452 ◽  
Author(s):  
Solveiga Kelbauskiene ◽  
Nomeda Baseviciene ◽  
Kawe Goharkhay ◽  
Andreas Moritz ◽  
Vita Machiulskiene

PEDIATRICS ◽  
1949 ◽  
Vol 3 (2) ◽  
pp. 181-194
Author(s):  
PAUL A. DI SANT'AGNESE

Additional serologic studies are presented of a group of newborn infants whose antibody production following combined prophylactic inoculation against tetanus, diphtheria and pertussis was reported in a previous paper. Duration of Antibody Titers: In the 10 months following the last injection of triple combined antigen a steady decline in diphtheria antitoxin titers was observed which was more marked in patients who had achieved high antibody levels. A similar decrease was found in the percentage of infants with high titers of tetanus antitoxin, but there were no cases whose tetanus antitoxin level dropped to less than the "protective" titer (0.1 unit/cc.). Progressive decrease in diphtheria and tetanus antitoxin titers with passage of time is in agreement with findings of others. After the third and last immunizing injection, a rapid initial decrease was noted in the number of patients with "protective" pertussis agglutinin titers (1:400 or higher); then a levelling off took place and no further change was noted in the next six months. On the other hand, a steady decline was found in the percentage of infants with "high" agglutinin levels (1:3200). To our knowledge this has not been observed before. The young age of our patients at the time of the basic injections may have been responsible for the findings. Antibody Titers After Booster Dose: One group of infants was reinjected at the age of six months (four months after the third and last immunizing injection), another group at one year of age (10 months after the last injection). All booster doses consisted of 0.5 cc. of the same triple combined antigen used in basic immunization. After booster a marked increase was noted in diphtheria antitoxin titers to a level higher than that observed following the basic immunizing injections. Tetanus antitoxin response was considered to have been equally good, although more difficult to evaluate because of the high antitoxin levels present before reinjection. In the case of pertussis agglutinins, it appeared as if there were a "ceiling" of about 60% of infants who could, even after reinjection, develop a "protective" agglutinin titer (1:400 or higher). A striking difference was observed in both pertussis agglutinin levels and diphtheria antitoxin titers achieved by infants reinjected at six months and one year of age. This was thought to be due to immaturity of the immune mechanisms in the younger age group. An added factor in the case of diphtheria antitoxin in some patients may have been the persistence of passive antibodies acquired transplacentally. Antibody titers also were determined six months after booster dose in the infants who had been reinjected at the age of six months. A marked decrease was observed in the percentage of patients with "protective" pertussis agglutinin titers and "high" (1.0 unit/cc.) diphtheria antitoxin levels. No reduction was noted in tetanus antitoxin titers. Effects of Passive immunity to Diphtheria on Active immunization with Diphtheria Toxoid: With only one exception, all infants tested after a booster dose had been administered between 6 and 12 months of age had "protective" diphtheria antitoxin titers (0.03 units/cc. or more). Active immunization against diphtheria was therefore considered to have been achieved in all cases (with one exception) despite the passively transmitted antitoxin present at birth in over half the cases. While passive diphtheria antitoxin present at birth did not prevent "sensitization" of the antibody-forming tissues to the diphtheria antigen, it did decrease significantly the amounts of antitoxin actively produced in response to basic inoculation. Reasons for the success of active diphtheria immunization in this series are discussed. Arguments against active immunization of mothers in pregnancy for protection of their offspring are considered.


2021 ◽  
Vol 23 (2) ◽  
pp. 155-164
Author(s):  
Vladislav E. Moiseenko ◽  
Alexander V. Pavlovsky ◽  
Dmitry A. Granov ◽  
Larisa V. Kochorova ◽  
Inna V. Dodonova ◽  
...  

Morbidity and mortality from pancreatic cancer is an urgent medical and social problem. Evaluation of statistical indicators in dynamics makes it possible to identify organizational and clinical problems in providing care to patients with malignant neoplasms of the pancreas. Medical and statistical indicators of incidence of malignant pancreatic neoplasms in St. Petersburg residents are evaluated. The assessment of medical and statistical indicators of the incidence of malignant neoplasms of the pancreas in residents of St. Petersburg. Statistical data were studied for the period from 2014 to 2019. The increase in the "rough" indicator of primary morbidity changed from 417.99 per 100 thousand population in 2014 to 505.6 in 2019. In the structure of primary cancer incidence, the indicator of active detection of pancreatic cancer glands in 2014 amounted to 3.6%, in 2019 3.8%. The proportion of patients with diagnoses confirmed morphologically increased from 48.9% to 61.4%. The proportion of patients with newly diagnosed stage IV of the disease changed from 39.5% in 2014 to 51.4% in 2019, and in patients with stage III in 2019 it was 33.3% (a decrease in comparison with 2014 15.3%). In 2019, the disease was diagnosed at stage II in 15.2% of patients. The proportion of patients with stage I in 2019 was 6.6%, this indicator in 2014 was registered at the level of 19.2%. From 2014 to 2019, the one-year mortality rate did not change and amounted to 67.9 and 67.4%, respectively (the decrease was 0.7%). Over the past 5 years, there has been no significant downward trend in the "rough" incidence and mortality rates from pancreatic cancer. However, in the dynamics, there was an increase in the number of patients registered for 5 or more years, and an increase in the accumulation index of the contingent of patients with pancreatic cancer.


2021 ◽  
pp. 13
Author(s):  
Kalpesh Hathi

Introduction: This study was aimed at comparing outcomes of minimally invasive (MIS) versus OPEN surgery for lumbar spinal stenosis (LSS) in patients with diabetes. Methodology: This retrospective cohort study included patients with diabetes who underwent spinal decompression alone or with fusion for LSS within the Canadian Spine Outcomes and Research Network (CSORN) database. Outcomes of MIS and OPEN approaches were compared for two cohorts: (i) patients with diabetes who underwent decompression alone (N = 116; MIS, n = 58, OPEN, n = 58) and (ii) patients with diabetes who underwent decompression with fusion (N = 108; MIS, n = 54, OPEN, n = 54). Mixed measures analyses of covariance compared modified Oswestry Disability Index (mODI) and back and leg pain at one-year post operation. The number of patients meeting minimum clinically important difference (MCID) or minimum pain/disability at one year were compared. Result: MIS approaches had less blood loss (decompression alone difference 99.66 mL, p = 0.002; with fusion difference 244.23, p < 0.001) and shorter LOS (decompression alone difference 1.15 days, p = 0.008; with fusion difference 1.23 days, p = 0.026). MIS compared to OPEN decompression with fusion had less patients experience an adverse event (difference, 13 patients, p = 0.007). The MIS decompression with fusion group had lower one-year mODI (difference, 14.25, p < 0.001) and back pain (difference, 1.64, p = 0.002) compared to OPEN. More patients in the MIS decompression with fusion group exceeded MCID at one year for mODI (MIS 75.9% vs OPEN 53.7%, p = 0.028) and back pain (MIS 85.2% vs OPEN 70.4%, p = 0.017). Conclusion: MIS approaches were associated with more favorable outcomes for patients with diabetes undergoing decompression with fusion for LSS.


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