Abstinence Time Research Articles

Recidiva da ingesta alcoólica em pacientes candidatos a transplante hepático: análise de fatores de risco

Alcohol relapse after transplantation is a serious concern in transplant centers and is a subject of controversy and debate. To evaluate the relapse of alcohol ingestion and the eventual associated factors in cirrhotic patients referred for liver transplantation. A retrospective study comprised of 90 adult patients with liver cirrhosis, listed for transplant. The exclusion criteria were: not having at least 6 months of abstinence and release not approved by the psychology team. The diagnosis of relapse (ingestion of any quantity of alcohol) was done based on the information in the patients histories and those provided by telephone contact. The rate of relapse was of 18.9%. This corresponded to 14.6% of the total number of men and 62.5% of the total number of women. Race, mean age, classification of hepatic dysfunction, time of alcoholism, quantity of alcohol ingested and the execution of transplant did not show significant correlation to alcohol relapse. The comparison between time of abstinence and relapse had an inversely proportional correlation. Relapse of alcohol consumption was low. Being of the female gender and having less than 1 year of abstinence has an influence upon alcohol relapse.

Influence of sexual abstinence length on sperm parameters and on IVF outcomes in ICSI assisted treatment cycles

There is no consensus in the literature for the optimal period of sexual abstinence required for patients undergoing assisted reproduction treatment (ART). Most IVF Clinics suggest a 3–5 days of abstinence. The aim of this study was to evaluate the influence of sexual abstinence on sperm parameters; fertilization; embryo quality and pregnancy rate on ICSI based ART. Retrospective analyses of 445 ICSI cycles. Sexual abstinence was recorded for patients with non-male factor infertiity on the day of oocyte collection. Semen samples were evaluated from all patients at least twice; first: 3 month before treatment and second on the day of ICSI using the WHO criteria. Groups of patients were divided according to the days of sexual abstinence: G1, G2, G3, G4, G5, G6 and G7 (1, 2, 3, 4, 5, 6–10 and ≥11 or more days of abstinence, respectively). Ovarian stimulation was performed by long protocol using Lupron and recombinant FSH. HCG was administered when at least 3 follicles reached 19 mm diameter. Collected oocytes were decumulated and all M2 eggs were injected. Fertilization and embryo development were assessed 20 h, 44 h and 68 h after insemination. Embryo transfer was performed on day 3. Pregnancy was recorded if two rising HCG values were measured; clinical pregnancy was determined by recording FCA. Statistical analyses was performed using the Chi-square test and the One-way ANOVA test; significance was established at P<0.05. Sperm concentration was lower in G1 and higher in G5 and G6 (18.9×106/mL, 27.4×106/mL and 26.3×106/mL respectively (P=0.02). There was no significant difference in sperm motility between the groups (P=0.757). Fertilization rate was higher in groups 1, 3, 5 and 6 (87%, 88%, 88% and 87%, respectively). The lowest fertilization rate was in G7 (81%). The best embryo quality was found in G1. The highest pregnancy rate was also observed in G1 (67.2%) while the lowest, in G5 (42.1%). The difference in pregnancy rate between G1 and G5, G6 and G7 showed to be significant (P=0.007). Shorter abstinence period is associated with lower sperm concentration higher embryo quality and higher pregnancy rate. Conversely, five or more days of abstinence was correlated with a considerable decrease in pregnancy rate. These findings suggest that there is an inverse correlation with the time of sexual abstinence and ICSI results. Hence, a short period of sexual abstinence is suggested whenever ICSI is performed.

Ethnic differences in alcohol treatment outcomes and the effect of concurrent smoking cessation treatment

The Timing of Alcohol and Smoking Cessation (TASC) Study tested the optimal timing of smoking cessation treatment in an alcohol-dependent population. Previously reported results suggest that providing concurrent smoking cessation treatment adversely affects alcohol outcomes. The purpose of this analysis was to investigate whether there are ethnic differences in alcohol and tobacco outcomes among a diverse sample of alcohol-dependent smokers using data from the TASC trial in which 499 participants were randomized to either concurrent (during alcohol treatment) or delayed (6 months later) smoking intervention. This analysis focused on smokers of Caucasian ( n = 381) and African American ( n = 78) ethnicity. Alcohol outcomes included 6 months sustained alcohol abstinence rates and time to first use of alcohol post-treatment. Tobacco outcomes included 7-day point prevalence smoking abstinence. Random effects logistic regression analysis was used to investigate intervention group and ethnic differences in the longitudinally assessed alcohol outcomes. Alcohol abstinence outcomes were consistently worse in the concurrent group than the delayed group among Caucasians, but this was not the case for African Americans. No significant ethnic differences were observed in smoking cessation outcomes. Findings from this analysis suggest that concurrent smoking cessation treatment adversely affects alcohol outcomes for Caucasians but not necessarily for African Americans.

Seminal thrombin-activatable fibrinolysis inhibitor: a regulator of liquefaction

Several active components of the haemostatic system have been identified in human semen. Here we investigated the presence of thrombin-activatable fibrinolysis inhibitor (TAFI) in seminal plasma. Using an enzyme-linked immunosorbent assay, TAFI levels were measured in 36 semen specimens obtained from subfertile, normally fertile, fertile sperm donor and vasectomized individuals. TAFI was detectable in human semen. Its levels were highest in vasectomized individuals compared with the other groups, including a pooled normal semen parameter stratification group (by World Health Organization criteria). This elevation in the vasectomy group was found to be statistically significant in comparison with the normally fertile (P < 0.01) and the pooled normal semen parameter groups (P < 0.05). Seminal TAFI levels showed a significant positive correlation with total sperm count and sperm density. In contrast, a negative association was observed with semen volume, days of sexual abstinence and liquefaction time. The highly motile sperm group showed low TAFI levels. Our results establish the presence of TAFI in seminal plasma with a probable role in the protection of the seminal clot against lysis. It also suggests a downstream (post-testicular) source for its production. This reinforces the involvement of the conventional haemostatic system in the coagulation and liquefaction properties of human semen.

Cannabis induces different cognitive changes in schizophrenic patients and in healthy controls

It is known that 60 to 80% of schizophrenic patients show deficits in cognition. There may be an increase in these deficits as a result of additional regular use of cannabis. The aim of the study was to evaluate the effect of chronic cannabis consumption on the cognitive functions of schizophrenic patients and healthy control subjects after a minimum abstinence time of 28 days. The study sample consisted of 39 schizophrenics (19 cannabis-abusers and 20 non-abusers) and 39 healthy controls (18 cannabis-abusers, 21 non-abusers). In a 2 × 2-factorial design (Diagnostic Groups [healthy controls, schizophrenic patients] × Cannabis abuse [without, with]) with diagnostic group and cannabis consumption considered between-subject factors) we tested the hypothesis that dually diagnosed patients (i.e. suffering both from schizophrenia and cannabis abuse) perform worse in neuropsychological tests than schizophrenic patients without cannabis abuse. On the whole, schizophrenic patients performed worse than healthy control subjects. Surprisingly, rather than deteriorating neuropsychological performance, regular cannabis abuse prior to the first psychotic episode improved cognition in some tests. This was even more pronounced when regular consumption started before the age of 17. On the other hand, cannabis use deteriorated test performance in healthy controls, especially in cases when regular consumption started before the age of 17. To sum up, regular cannabis abuse has a different effect on cognitive function in schizophrenic patients and healthy controls.

Effects of multiple drug abuse on attentional functioning - the impact of substance abuse, psychiatric disorder and time of abstinence

Effects of multiple drug abuse on attentional functioning - the impact of substance abuse, psychiatric disorder and time of abstinence

Fertility Parameters and Urine Concentrations of Phthalate Metabolites in German Men Visiting an Outpatient Clinic for Fertility Workup

TM1-O-08 Introduction: Phthalates are thought to be hormonally active in humans and exert reproductive toxicity. The general population is exposed to phthalates through nutrition, consumer products, and medical devices. The present study explored whether internal phthalate exposure can be related to parameters of semen quality (ie, concentration, motility, and morphology) and hormone status. Methods: We recruited 335 men who were part of subfertile couples and were referred to the Outpatients Department Centre of Dermatology and Andrology of the University of Giessen, Germany, for fertility workup between April 2004 and October 2005. Semen analysis was performed according to guidelines of the World Health Organization (WHO) using the revised Duesseldorf classification of sperm morphology. If necessary, parameters were dichotomized based on 1999 WHO reference values for sperm concentration (<20 million/mL) and motility (<50% motile), as well as Tygerberg strict criteria for morphology (<4% normal). In single spot urine secondary metabolites of DEHP, 5OH-MEHP, and 5oxo-MEHP next to the monoester metabolite MEHP and depending on volume of urine sample, other phthalate metabolites were analyzed (eg, MnBP, MBzBP, MBzP). Results: Concentrations of phthalate metabolites of n = 296 men (median age, 34 years; median body mass index, 25.99 kg/m2) entered analysis. Median concentrations (μg/L) were as follows: MEHP (n = 287), 4.91; MnBP (n = 249), 32.76; MBzBP (n = 137), 5.14; and MBzP (n = 111), 5.03. Semen parameters of n = 253 men entered analysis. Semen concentration (<20 million/mL (n = 279): 33.0%) or sperm motility (WHO A+B <50% [n = 266]: 24.8%) were not found to be associated neither with the secondary metabolites nor with MEHP (adjusted logistic and linear regression). Adjustment was performed for: age, time of abstinence, and smoking status. Tendencies found in preliminary evaluations for sperm morphology (<4% normal [n = 259]: 62.2%) did not turn to significant values in this larger sample. Semen concentrations and motility as well as hormone levels (n = 276) (median for FSH, 5.0 mU/mL; LH, 3.5 mU/mL; and testosterone, 3.5 ng/mL) were not related to concentrations of any metabolites. Conclusions: Metabolites of DEHP and other phthalates analyzed in the scope of this study are considered to be very specific for determining internal phthalate exposure. According to this evaluation fertility parameters, ie, hormones and semen analyses do not show significant associations with concentrations of phthalate metabolites determined in spot urine sampled at the day of fertility workup, ie, no indication of acute effects. Further analyses, aimed at studying middle-term effects will address associations between the phthalate concentrations presented here and fertility parameters assessed in the same men during a second consultation several weeks later.

Altered Semen Quality in Relation to Urinary Concentrations of Phthalate Monoester and Oxidative Metabolites

Phthalates are multifunctional chemicals used in a variety of consumer, medical, and personal care products. Previously, we reported dose-response associations of decreased semen quality with urinary concentrations of monobutyl phthalate (MBP) and monobenzyl (MBzP) phthalate, which are metabolites of dibutyl phthalate and butylbenzyl phthalate, respectively. The present study extends our work in a larger sample of men and includes measurements of di(2-ethylhexyl) phthalate (DEHP) oxidative metabolites. Between January 2000 and May 2004, we recruited 463 male partners of subfertile couples who presented for semen analysis to the Massachusetts General Hospital. Semen parameters were dichotomized based on World Health Organization reference values for sperm concentration (<20 million/mL) and motility (<50% motile) and the Tygerberg Kruger Strict criteria for morphology (<4% normal). The comparison group was men with all 3 semen parameters above the reference values. In a single spot urine sample from each man, phthalate metabolites were measured using solid-phase extraction coupled to high-performance liquid chromatography isotope-dilution tandem mass spectrometry. There were dose-response relationships of MBP with low sperm concentration (odds ratio per quartile adjusted for age, abstinence time, and smoking status = 1.00, 3.1, 2.5, 3.3; P for trend = 0.04) and motility (1.0, 1.5, 1.5, 1.8; P for trend = 0.04). There was suggestive evidence of an association between the highest MBzP quartile and low sperm concentration (1.00, 1.1, 1.1, 1.9; P for trend = 0.13). There were no relationships of monoethyl phthalate, monomethyl phthalate, and the DEHP metabolites with these semen parameters. The present study confirms previous results on the relationship of altered semen quality with exposure to MBP at general population levels. We did not find associations between semen parameters and 3 DEHP metabolites.

Cost-effectiveness of prize-based incentives for stimulant abusers in outpatient psychosocial treatment programs

Objective To evaluate the cost-effectiveness of a prize-based intervention as an addition to usual care for stimulant abusers. Methods This cost-effectiveness analysis is based on a randomized clinical trial implemented within the National Drug Abuse Treatment Clinical Trials Network. The trial was conducted at eight community-based outpatient psychosocial drug abuse treatment clinics. Four hundred and fifteen stimulant abusers were assigned to usual care ( N = 206) or usual care plus abstinence-based incentives ( N = 209) for 12 weeks. Participants randomized to the incentive condition earned the chance to draw for prizes for submitting substance negative samples; the number of draws earned increased with continuous abstinence time. Incremental cost-effectiveness ratios were estimated to compare prize-based incentives relative to usual care. The primary patient outcome was longest duration of confirmed stimulant abstinence (LDA). Unit costs were obtained via surveys administered at the eight participating clinics. Resource utilizations and patient outcomes were obtained from the clinical trial. Acceptability curves are presented to illustrate the uncertainty due to the sample and to provide policy relevant information. Results The incremental cost to lengthen the LDA by 1 week was US$ 258 (95% confidence interval, US$ 191–401). Sensitivity analyses on several key parameters show that this value ranges from US$ 163 to 269. Conclusions Compared with the usual care group, the incentive group had significantly longer LDAs and significantly higher costs.

Persistent dysfunctional frontal lobe activation in former smokers

Chronic smoking and nicotine exposure are accompanied by impaired cognitive task performance, modulated cerebral activity in brain imaging studies, and neuritic damage in experimental animals. The profile of the described dysfunctions matches frontal lobe circuits which also play a role in reward processing and reinforcement behavior. However, it is largely unknown if cerebral dysfunctions are reversible or persist during long term abstinence. Cortical activation during auditory target processing (oddball task, P300 component) was recorded with 32-channel EEG in 247 healthy subjects consisting of 84 smokers, 53 former smokers (mean time of abstinence 11.9 years), and 110 never smokers. Both current smokers and former smokers exhibited significantly diminished P300 amplitudes (Cz, Pz) relative to never smokers. Neuroelectric source analysis (low resolution brain electromagnetic tomography) revealed a hypoactivation of the anterior cingulate, orbitofrontal, and prefrontal cortex in smokers compared to never smokers. A similar profile of hypoactivation was observed in former smokers. For the first time, evidence is provided that dysfunctional activation of frontal lobe networks in smokers is also present in long term abstainers.

Lower Sperm Counts Following Prenatal Tobacco Exposure

BACKGROUND: Recent findings have indicated that prenatal exposure to tobacco smoke may cause lower sperm concentration in ejaculates of adult men. To extend the research on this hypothesis we investigated the dose-dependency of the association, controlling for other prenatal exposures. METHODS: From 1987 to 1996, four separate occupational semen studies were conducted at three centres in Denmark. A total of 945 men provided semen and blood samples, and information on reproductive and lifestyle factors. In 2004, we collected data on the maternal smoking habits during pregnancy from 522 mothers of the participating men. RESULTS: Adjusting for study subgroup, abstinence time and other factors, we found statistically non-significant differences in mean sperm concentrations: 65.0 x 10(6)/ml [95% confidence interval (CI) 51, 81] among sons of non-smokers; 59.1 x 10(6)/ml (95% CI 46, 75) among sons of mothers who had smoked 1-10 cigarettes/day; and 57.7 x 10(6)/ml (95% CI 40, 81) among those whose mothers had smoked >10 cigarettes/day. The former group had a higher odds ratio (OR) for oligozoospermia (sperm concentration < or =20 x 10(6)/ml) of 1.5 (95% CI 0.9, 2.8), the latter group an OR of 2.6 (95% CI 1.2, 5.8). CONCLUSION: We observed a dose-dependent association between prenatal tobacco exposure, lower sperm concentration and higher risk of oligozoospermia.

Semen quality in fertile US men in relation to geographical area and pesticide exposure

We conducted the first US study to compare semen quality among study centres using standardized methods and strict quality control. We present data on semen quality in partners of 493 pregnant women recruited through prenatal clinics in four US cities during 1999-2001. Sperm concentration, semen volume and motility were determined at the centres and morphology was assessed at a central laboratory. While between-centre differences in sperm morphology and sample volume were small, sperm concentration and motility were significantly reduced in Columbia, MO (MO) relative to men in New York, NY, Minneapolis, MN and Los Angeles, CA; total number of motile sperm was 113 x 10(6) in MO and 162, 201 and 196 x 10(6) in CA, MN and NY respectively. Differences among centres remained significant in multivariate models that controlled for abstinence time, semen analysis time, age, race, smoking, history of sexually transmitted disease and recent fever (all p-values <0.01). We hypothesized that poorer sperm concentration and motility in MO men relative to other centres might be related to agricultural pesticides that are commonly used in the mid-west. We investigated this hypothesis by conducting a nested case-control study within the MO cohort. We selected 25 men in this cohort for whom all semen parameters (concentration, % normal morphology and % motile) were low as cases and an equal number of men for whom all semen parameters were within normal limits as controls. We measured metabolites of eight non-persistent, current-use pesticides in urine samples the men had provided at the time of semen collection. Pesticide metabolite levels were elevated in cases compared with controls for the herbicides alachlor and atrazine, and for the insecticide diazinon (2-isopropoxy-4-methyl-pyrimidinol) (p-values for Wilcoxon rank test = 0.0007, 0.012, and 0.0004 for alachlor, atrazine and diazinon respectively). Men with higher levels of alachlor or diazinon were significantly more likely to be cases than men with low levels [odds ratios (OR) = 30.0, 16.7 for alachlor and diazinon respectively], as were men with atrazine over the limit of detection (OR = 11.3). These associations between current-use pesticides and reduced semen quality suggest that agricultural chemicals may have contributed to the reduced semen quality seen in fertile men from mid-Missouri.

Semen Parameters in Norwegian Fertile Men

The World Health Organization (WHO) provides guidelines for assessing the various semen variables. A set of reference ranges is given in the WHO Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction, but several studies indicate that the values should be revised. Furthermore, semen parameters obtained at different laboratories are not directly comparable even if the same methods are used. Thus, it is recommended that each laboratory establish its own reference ranges. In this study, semen from 99 men who had recently achieved a pregnancy were analyzed to establish reference ranges for semen variables. The reference values were based on the group with time to pregnancy (TTP) 12 cycles or less (92%) and abstinence time from 2 to 7 days. The 5th and 10th percentiles for sperm concentration were 10.6 and 16.9 x 10(6)/mL, respectively, and 33% (5th percentile) and 43% (10th percentile) for spermatozoa with progressive motility. These values were below the WHO lower limit. The percentages of ideal spermatozoa (percentage with normal morphology according to WHO strict criteria) were 3 (5th percentile) and 4 (10th percentile). Thirty-nine percent reported that their partners became pregnant during the first cycle after they had stopped using contraception. The semen parameters in this group were compared with the others. Overall, the semen parameters were more favorable in the group with TTP = 1 cycle than in the group with TTP > 1. Sperm concentration, progressive motility, and percentage of ideal spermatozoa according to WHO strict criteria were significantly different in the 2 groups. However, when analyzed by multiple logistic regression, only "total numbers of sperm with progressive motility" remained in the model (P = .002). This is in accordance with previous studies indicating that a combination of semen characteristics provides a better predictor of male fertility potential than the single parameters. In conclusion, new reference ranges for semen variables deviating from the WHO values are established for our laboratory.

STANDARDIZATION AND QUALITY CONTROL FOR THE DETERMINATION OF ALPHA-GLUCOSIDASE IN SEMINAL PLASMA

We attempted to provide an instruction for the standardization of alpha-glucosidase level determination and quality controls within the same laboratory and among different laboratories. Each of 51 semen samples was divided into two aliquots, centrifuging at 1000 g for 10 min or 3000 g for 15 min. The alpha-glucosidase level and sperm concentration of each sample were assayed. The alpha-glucosidase level in seminal plasma obtained at 3000 g for 15 min centrifugation was significantly lower than that at 1000 g for 10 min (p = 0.001). An additional 6 samples of seminal plasma with or without phenylmethylsulfonyl fluoride (PMSF), obtained at 3000 g for 15 min centrifugation, were frozen for 20 days, and each of 6 samples was determined for their alpha-glucosidase levels after thawing every other day. There was no significant difference between alpha-glucosidase levels in seminal plasma regardless of the presence of PMSF. The alpha-glucosidase level increased with the length of abstinence period. In conclusion, centrifugal velocity and abstinence time should be standardized in the alpha-glucosidase determination. Frozen seminal plasma may serve as the sample for quality control among clinical laboratories.

Immune Reactivity Is More Suppressed in Patients with Alcoholic Liver Disease than in Patients with Virus‐Induced Cirrhosis after CRH Stimulation

The most frequent diagnoses for liver transplantation are virus-induced cirrhosis (VIC) and alcoholic liver disease (ALD), after an abstinence period of at least 6 months. Chronic ethanol consumption has been linked to an abnormal neuroendocrine-immune axis and to an altered surgical stress response inducing an increased infection rate. Preoperative stress testing might be relevant to detect stress-induced immune alteration. The aim of this study was to investigate the preoperative stress-like response to corticotrophin-releasing-hormone challenge (CRH) of patients with ALD compared with patients with VIC and their immune sequelae. Nine patients with ALD and 8 patients with VIC were included in this clinical study prior to transplantation. All patients received CRH in the morning. Blood samples were drawn before and after stress testing. In response to CRH, the ALD patients showed a significant decrease in the plasma interleukin (IL)-6/IL-10 ratio. After lipopolysaccharide stimulation of whole blood from CRH-challenged ALD patients, IL-10 increased significantly. The cytotoxic T1-(Tc1) to cytotoxic T2 (Tc2) ratio was significantly decreased in ALD patients after the stress test. Infections occurred significantly more often in ALD patients within the past year before study inclusion. ALD patients showed a stronger anti-inflammatory immune status and response than VIC patients. This difference was associated with a higher infection rate despite a median alcohol abstinence time of 3.5 years. Although an altered immune response is well known among patients with actual alcohol-use disorders, to the best of our knowledge, it is not described in patients after such a long abstinence time.

COMORBID PHOBIC DISORDERS DO NOT INFLUENCE OUTCOME OF ALCOHOL DEPENDENCE TREATMENT. RESULTS OF A NATURALISTIC FOLLOW-UP STUDY

Despite claims that comorbid anxiety disorders tend to lead to a poor outcome in the treatment of alcohol dependence, the few studies on this topic show conflicting results. To test whether the outcome of treatment-seeking alcohol-dependent patients with a comorbid phobic disorder is worse than that of similar patients without a comorbid phobic disorder. The probabilities of starting to drink again and of relapsing into regular heavy drinking in (i) a group of 81 alcohol-dependent patients with comorbid social phobia or agoraphobia were compared with those in (ii) a group of 88 alcohol-dependent patients without anxiety disorders in a naturalistic follow-up using Cox regression analysis. Adjusted for initial group differences, the hazard ratio for the association of phobic disorders with resumption of drinking was 1.05 (95% CI, 0.85-1.30, P = 0.66) and the adjusted hazard ratio for the association of phobic disorders with a relapse into regular heavy drinking was 1.02 (95% CI, 0.78-1.33, P = 0.89). The findings of this study do not confirm the idea that alcohol-dependent patients who have undergone alcohol-dependence treatment are at greater risk of a relapse if they have a comorbid anxiety disorder. No differences were found in abstinence duration or time to relapse into regular heavy drinking between patients with and without comorbid phobic disorders.

SPERM CELL MOTILITY AND MORPHOLOGY IN RELATION TO ORGANOCHLORINE EXPOSURE IN INUIT AND EUROPEAN POPULATIONS

ISEE-196 Introduction: Inconsistent results have been found in previous studies of sperm cell motility and morphology in relation to exposure to persistent organochlorine pollutants (POPs). the majority of these studies have been conducted among selected populations of infertility clients or occupational cohorts with a limited number of participants. Methods: We conducted a cross sectional study of semen quality and POP exposure by means of semen and blood samples from a total of 798 men from all regions in Greenland (n=201), fishermen from the east and west coasts of Sweden (n=191), inhabitants of the city of Warsaw, Poland (n=198) and inhabitants of the city of Kharkov, Ukraine (n=208). Blood samples were analyzed for CB-153 and p,p’-DDE using GC-MS. Sperm cell motility and morphology was measured according to the WHO (1999) guidelines and quality control was conducted to assess inter-observer variability. Multivariate statistics were used to analyze the association of the proportion of progressive motile sperm cells (WHO grade A+B) and proportion of sperm cells with normal morphology in relation to POP exposure controlled for population, abstinence time and age for both outcome variables and in addition time to analysis for sperm cell motility. Results: The lipid adjusted cb-153 serum concentrations varied greatly, with the highest exposure levels found in Greenland, followed by Sweden, Kharkov and Warsaw. p,p´-dde showed a different pattern with the highest exposure levels in Kharkov, followed by Greenland, Warsaw and Sweden. CB-153 and p,p´-DDE exposure levels were highly correlated in Greenland (r=0.92) and in Sweden (r=0.72), but less in Warsaw (r=0.40) and Kharkov (r=0.05). the sperm cell motility and morphology varied between populations, however, with no indication of any country being superior or inferior for both semen quality endpoints. Sperm cell motility was inversely related to log CB-153 exposure (β= −3.4; p=0.002) while the serum level of p,p’-DDE was not related to sperm cell motility independently of CB-153 exposure. the proportion of normal sperm cells did not reveal any significant association to either CB-153 or p,p’-DDE exposure. Conclusion: With the largest study performed to date on sperm cell motility and morphology, we observed that serum levels of CB-153 were negatively associated with sperm cell motility, but not with sperm morphology. As for p,p’-DDE concentrations, no association with the studied semen quality outcomes were seen.

The diagnostic accuracy of carbohydrate-deficient transferrin, sialic acid and commonly used markers of alcohol abuse during abstinence

Background The normalization of alcohol abuse markers during the abstinence depends on the time since the last drinking. The aim of this study was to evaluate the diagnostic accuracy (area under the curve—AUC, sensitivity and specificity) of CDT, sialic acid and others biochemical and hematological markers of chronic alcohol abuse during abstinence. Methods We studied 75 patients admitted to the treatment of alcohol dependence. The blood samples were collected upon admission to the hospital. CDT was estimated using an immunoturbidimetric assay after anion-exchange chromatography and sialic acid by enzymatic colorimetric method. Results Mean values of all markers were significantly higher. All tests, except SA, negatively correlated with time of abstinence but not with age, duration of dependence and amounts of weekly alcohol consumption. The area under the curve (AUC) for all tested markers decreased progressively during the abstinence. The highest AUC was obtained for CDT (0.98) and the lowest for ALT (0.78) when alcohol was consumed in the last week. AUC for sialic acid was lower than of CDT but higher than of ALT. Conclusions We conclude that the diagnostic accuracy for tested laboratory markers depends on the self-reported time of abstinence being the highest for CDT in the first week of abstinence. The accuracy of sialic acid was observed between GGT and ALT.

Lower sperm counts following prenatal tobacco exposure

Recent findings have indicated that prenatal exposure to tobacco smoke may cause lower sperm concentration in ejaculates of adult men. To extend the research on this hypothesis we investigated the dose-dependency of the association, controlling for other prenatal exposures. From 1987 to 1996, four separate occupational semen studies were conducted at three centres in Denmark. A total of 945 men provided semen and blood samples, and information on reproductive and lifestyle factors. In 2004, we collected data on the maternal smoking habits during pregnancy from 522 mothers of the participating men. Adjusting for study subgroup, abstinence time and other factors, we found statistically non-significant differences in mean sperm concentrations: 65.0 x 10(6)/ml [95% confidence interval (CI) 51, 81] among sons of non-smokers; 59.1 x 10(6)/ml (95% CI 46, 75) among sons of mothers who had smoked 1-10 cigarettes/day; and 57.7 x 10(6)/ml (95% CI 40, 81) among those whose mothers had smoked >10 cigarettes/day. The former group had a higher odds ratio (OR) for oligozoospermia (sperm concentration < or =20 x 10(6)/ml) of 1.5 (95% CI 0.9, 2.8), the latter group an OR of 2.6 (95% CI 1.2, 5.8). We observed a dose-dependent association between prenatal tobacco exposure, lower sperm concentration and higher risk of oligozoospermia.

Longitudinal changes in semen parameters in young Danish men from the Copenhagen area

Several recent studies have reported low sperm concentration in young men recruited from the general population, but it is unknown whether the semen quality of these young men reflects that of more mature men or is reduced due to relative immaturity. We conducted a longitudinal follow-up study to address this question. We followed 158 young men (median age = 19.1 years at entry) for up to 4 years and requested quarterly semen samples (total 1838 semen samples) and yearly genital examinations. We examined longitudinal changes in sperm concentration, semen volume, percentage of immotile sperm and percentage of morphologically normal sperm. We used general linear models in which each man served as his own control which also controlled for age, smoking, urogenital infections or disorders, fever and abstinence time. We found no evidence that sperm concentration, total sperm count or percentage of morphologically normal sperm changed appreciably during the 4 years of follow-up. Semen volume appeared to increase slightly with age, perhaps due to greater acceptance of the study protocol by participants. Sperm motility also improved somewhat, although this may, at least in part, reflect a trend in motility measurement. In this analysis of 1838 semen samples from 158 young men from the Copenhagen area, sperm concentration, total sperm count and sperm morphology did not change significantly during 4 years of follow-up, suggesting that previously reported low sperm concentration and poor sperm morphology among young Danish men are unlikely to be the result of immaturity.