Hypogonadism Research Articles

Utilisation patterns of radiotherapy among older patients: Insights from Portuguese National Cancer Registry data

IntroductionRadiation therapy (RT) will be required by millions of those aged 70 or older by 2040 based on European growth in cancer incidence among this age group. PurposeThis study evaluates the use of external radiotherapy (EBRT) using data from the Portuguese National Cancer Registry (RON), analysing various cancer locations and age groups. A comparative analysis was conducted between actual EBRT utilization and comorbidity-adjusted optimal rates. MethodsBased on RON’s data, cancer diagnoses from January to June 2018 were analysed. Optimal Utilization Proportions (OUP) of EBRT were obtained from European SocieTy for Radiotherapy and Oncology (ESTRO), Health Economics in Radiation Oncology (HERO) project. Actual utilization percentages (AUP) were calculated using national cancer registry data, and a comparative analysis adjusting for comorbidities was conducted. ResultsFor most cancer locations and age groups, the actual EBRT utilisation fell below the ESTRO-HERO recommendations, with potential untreated patients estimated at 22 % of all new cancer cases across all age groups. Disparities were observed for older patients, such as breast cancer EBRT actual utilisation declining from 68 % to 25 % for patients aged under 70 and 85 or older, respectively. Also, cervix cancer patients aged 75 or older exhibited nearly 100 % optimal EBRT utilisation. Conversely, older patients with bladder and colon cancer had significantly lower RT actual utilisation rates. Comorbidity-adjusted EBRT utilisation rates for lung, rectal, cervix, and breast cancers in patients aged 70–79 did not reached ESTRO-HERO task force recommended rates. The actual EBRT usage in Portugal failed to meet the comorbidity-adjusted optimal utilisation rate for all cancer locations and age groups. Nevertheless, Portuguese actual EBRT for rectal and prostate cancer, exceeded the actual rates in Australian cohort. ConclusionWhile EBRT is essential for older adults with cancer, disparities and suboptimal utilization highlight opportunities for improving cancer care provision.

Reconstructing the Stem Leydig Cell Niche via the Testicular Extracellular Matrix for the Treatment of Testicular Leydig Cell Dysfunction

AbstractTherapies involving the use of stem Leydig cells (SLCs), as testicular mesenchymal stromal cells, have shown great promise in the treatment of Leydig cell (LC) dysfunction in aging males. However, the outcomes of these therapies are not satisfactory. In this study, it is demonstrated that the aging microenvironment of the testicular interstitium impairs the function of SLCs, leading to poor regeneration of LCs and, consequently, inefficient functional restoration. The study develops a decellularized testicular extracellular matrix (dTECM) hydrogel from young pigs and evaluates its safety and feasibility as a supportive niche for the expansion and differentiation of SLCs. dTECM hydrogel facilitates the steroidogenic differentiation of SLCs into LCs, the primary producers of testosterone. The combination of SLCs with a dTECM hydrogel leads to a significant and sustained increase in testosterone levels, which promotes the restoration of spermatogenesis and fertility in an LC‐deficient and aged mouse model. Mechanistically, collagen 1 within the dTECM is identified as a key factor contributing to these effects. Notably, symptoms associated with testosterone deficiency syndrome are significantly alleviated in aged mice. These findings may aid the design of therapeutic interventions for patients with testosterone deficiency in the clinic.

Sexual dysfunction among long-term survivors of Hodgkin lymphoma.

Survival rates from childhood cancer continue to increase, with an ongoing interest in long-term survivorship. Although infertility and gonadal failure are well recognized in Hodgkin lymphoma (HL) survivors, sexual dysfunction is less studied. The objective of this study was to compare the prevalence of sexual dysfunction in HL survivors with that in matched community controls. Long-term survivors of HL (n=186; female, 51.61%; mean age at diagnosis. 14.41 years [range, 3.01-22.60 years]; current mean±standard deviation age, 36.73±7.93 years) and matched community controls (n=182; female, 50.55%; mean±standard deviation age, 36.41±9.02 years) completed a comprehensive, in-person clinical assessment, laboratory battery, and the International Index of Erectile Function or the Female Sexual Function Index questionnaire. Male survivors had increased levels of erectile dysfunction (18.89% vs. 6.67%; p=.0239) but indicated no difference in sexual desire. Female survivors had a higher prevalence of sexual dysfunction compared with female controls (46.88% vs. 15.22%; p<.0001) and an increased prevalence of moderate-to-severe loss of sexual desire (38.04% vs. 23.26%; p=.0361). Female survivors with sexual dysfunction indicated increased levels of anxiety (p=.0184), depression (p=.0153), and worse physical and mental health (p=.0141 and p=.0419, respectively). Male survivors with erectile dysfunction had higher rates of anxiety and impaired physical health (p=.0147 and p=.0266, respectively). Sexual dysfunction was prevalent in this childhood and adolescent Hodgkin lymphoma survivor cohort and was associated with effects on quality of life. Health care providers must recognize the need for screening and intervention in this group to hopefully contribute to improved overall quality of life.

Salvage Reirradiation with Proton Beam Therapy for Locoregionally Recurrent Non-Small Cell Lung Cancer.

This retrospective study evaluates outcomes of 66 patients who underwent reirradiation (re-RT) with proton beam therapy (PBT) for recurrent non-small cell lung cancer. Toxicity was scored via the CTCAE v5.0, and outcomes estimated using the Kaplan-Meier method, with associations evaluated via Cox proportional hazards and logistic regression analyses. Patients were treated to a median re-RT prescription of 66 Gy/33 fxs (BED10 = 79 Gy; IQR: 71-84 Gy) at an interval of 1.4 years from prior RT. Half (50%) received concurrent chemotherapy. At 14 months follow-up, the median OS and PFS were 5 months (95%CI: 13-17) and 12.5 months (95%CI: 10-15), respectively. On multivariable analysis, a higher RT dose (BED10 > 70 Gy) [HR0.37; 95%CI: 0.20-0.68, p = 0.001] and concurrent chemotherapy (HR0.48; 95%CI: 0.28-0.81, p = 0.007) were associated with improved PFS, while treatment site overlap was adversely associated (HR1.78; 95%CI: 1.05-3.02, p = 0.031). The median PFS for definitive RT with concurrent chemotherapy (n = 28), definitive RT alone (BED10 > 70 Gy) [n = 22], and lower prescription RT (BED10 < 70 Gy) [n = 16] was 15.5 months (95%CI: 7.3-23.7), 14.1 months (95%CI: 10.9-17.3), and 3.3 months (95%CI: 0-12.3), respectively (log-rank, p = 0.006), with corresponding 2-year estimates of 37% (±9), 18% (±8), and 12.5% (±8), respectively. The incidence of Grade 3+ toxicity was 10.5% (6% pulmonary; 3% esophageal; and 1.5% skin), including one Grade 4 bronchopulmonary hemorrhage but no Grade 5 events. Cases with central site overlap had higher composite Dmax to the esophagus (median 87 Gy [IQR:77-90]), great vessels (median 120 Gy [IQR:110-138]), and proximal bronchial tree (median 120 Gy [IQR:110-138]) as compared to other cases (p ≤ 0.001 for all). However, no significant associations were identified with Grade 3+ events. Thoracic re-RT with PBT is an option for recurrent NSCLC with acceptable outcomes and toxicity for select patients. When feasible, higher prescription doses (BED10 > 70 Gy) should be delivered for definitive intent, and concurrent chemotherapy may benefit individual cases.

Experience in the treatment of patients with androgenic deficiency and comorbidity pathology

Background. Age-related involution of the male reproductive system, known as testosterone deficiency syndrome, andropause, androgen deficiency in the aging male, or partial androgen deficiency in the aging male, causes clinical manifestations that impair quality of life and increase the risk of mortality, especially from cardiovascular disease. In Russia, the problem of hypodiagnosis of androgen deficiency remains up-to-date, with a low frequency of prescription of replacement therapy. Aim. At assessing the effectiveness of testosterone in the rehabilitation of patients with hypogonadism and cardiovascular pathology. Materials and methods. It involved 36 men aged 25–75 years with various cardiological pathologies. Results. As a result of the study, testosterone as a form of a transdermal gel is effective at doses of 50 mg/day. Three-month use of testosterone gel increases the level of testosterone to 2.9 nmol/l (p0.05). Conclusion. Thus, testosterone may play a key role in the treatment of hypogonadism and related cardiovascular diseases, although its safety and feasibility remain a matter of debate.

Hipogonadismo masculino

Male hypogonadism (HG) is defined as the functional incompetence of the gonads with suboptimal or altered production of hormones and germ cells. The prevalence between 30 and 70 years of age is 10% and increases with age. It is classified according to the origin, as primary hypergonadotropic HG, secondary hypothalamic-pituitary hypogonadotropic HG and HG due to peripheral resistance to the androgenic effect. The diagnosis requires clinical suspicion and hormonal determinations that confirm it. The main treatment is the administration of testosterone by transdermal or injectable route, with the option of using GnRH or gonadotropins.

Comprehensive fertility preservation can be offered in a timely manner around gonadotoxic therapy in children and adolescents.

Treatment for certain childhood cancers and nonmalignant conditions can lead to future infertility and gonadal failure. The risk of treatment delay must be considered when offering fertility preservation (FP) options. We examined the timeline from FP referral to return to treatment (RTT) in pediatric patients who underwent FP due to iatrogenic risk for infertility. A retrospective review was performed of patients with FP consultation due to an increased risk of iatrogenic infertility at Ann & Robert H. Lurie Children's Hospital of Chicago from 2018 to 2022. Data on diagnosis, age, treatment characteristics, and procedure were collected. A total of 337 patients (n=149 with ovaries, n=188 with testes) had an FP consultation. Of patients with ovaries, 106 (71.1%) underwent ovarian tissue cryopreservation (OTC), 10 (6.7%) completed ovarian stimulation/egg retrieval (OSER), and 33 (22.1%) declined FP. Of the patients with testes, 98 (52.1%) underwent testicular tissue cryopreservation (TTC), 48 (25.5%) completed sperm banking (SB), and 42 (22.3%) declined FP. Median time from referral to FP consultation was short (ovaries: 2days, range: 0-6; testes: 1day, range: 0-5). OSER had a significantly longer RTT versus OTC and no FP (52.5 vs.19.5 vs. 12days, p=.01). SB had a significantly quicker RTT compared to TTC or no FP (9.0 vs. 21.0 vs. 13.5days; p=.008). For patients who underwent OTC/TTC and those who declined FP, there was no significant difference in time from consultation to treatment. It is feasible to promptly offer and complete FP with minimal delay to disease-directed treatment.

Cytogenetic spectrum and clinical presentation of Klinefelter syndrome: A comprehensive study from South India

BackgroundKlinefelter syndrome (KS) is a common sex chromosome abnormality that mostly presents as testicular failure and a myriad of other clinical features. The phenotypic features and their severity vary between individuals, age groups and cytogenetic subtypes. Karyotyping remains the method of choice for the diagnosis of KS despite advanced molecular testing in this modern era. The objective of this study was to determine the cytogenetic subtypes, clinical presentation and hormonal profile of patients with KS. MethodsRetrospective observational study comprised patients with KS determined by cytogenetic analysis at the tertiary care centre in south India from 2001 to 2019. Clinical details including testicular size, hormone levels and semen analysis were obtained from the medical records. ResultsThere were 147 KS (145 post-natal and 2 pre-natal) patients ranging in age from two days to 51 years, 116 (74.8%) patients being ≥18 years. Classic (cKS), mosaic (mKS) and variant KS (vKS) accounted for 126 (85.7%), 9 (6.1%) and 12 (8.2%) cases and their mean ages were 26.6, 29.6 and 12.8 years, respectively. cKS and mKS had diverse clinical presentations including several co-morbidities of which small testes were most common (94.8%). vKS presented with behavioural problems (58.3%) without any comorbidities. Testosterone (p < 0.05), FSH and LH levels were abnormal in >90% of patients. ConclusionAll three cytogenetic subtypes of KS were seen in our patients. cKS was seen in all ages, mKS was common in adults and vKS was seen predominantly in children. Early diagnosis of KS and timely medical intervention may alter the clinical outcomes and improve the quality of life.

Effects of acute stress on biological motion perception.

Biological motion perception is an essential part of the cognitive process. Stress can affect the cognitive process. The present study explored the intrinsic ERP features of the effects of acute psychological stress on biological motion perception. The results contributed scientific evidence for the adaptive behavior changes under acute stress. After a mental arithmetic task was used to induce stress, the paradigm of point-light displays was used to evaluate biological motion perception. Longer reaction time and lower accuracy were found in the inverted walking condition than in the upright walking condition, which was called the "inversion effect". The P2 peak amplitude and the LPP mean amplitude were significantly higher in the local inverted perception than in the local upright walking condition. Compared to the control condition, the stress condition induced lower RT, shorter P1 peak latency of biological motion perception, lower P2 peak amplitude and LPP mean amplitude, and higher N330 peak amplitude. There was an "inversion effect" in biological motion perception. This effect was related to the structural characteristics of biological motion perception but unrelated to the state of acute psychological stress. Acute psychological stress accelerated the reaction time and enhanced attention control of biological motion perception. Attention resources were used earlier, and less attentional investment was made in the early stage of biological motion perception processing. In the late stage, a continuous weakening of inhibition was shown in the parieto-occipital area.

Professional football training and recovery: A longitudinal study on the effects of weekly conditioning session and workload variables.

The main purpose of this longitudinal study was to investigate football players' recovery status, through hormonal response, in relation to accumulated workload at two comparable time points of the first (T1) and second half (T2) of the competitive season. Moreover, this study investigated athletes' hormonal response to a typical weekly conditioning session (5 days before match: MD-5), at T1 and T2, to detect changes in players' recovery capability over time. Salivary cortisol (sC) and testosterone (sT) of 24 professional players (27.8 ± 4.1 years of age) were collected before, after, and 24 hours following MD-5 in two comparable microcycles of T1 and T2. GPS training data (total and high-intensity distance) of the 7 and 28 days before sampling were used to obtain athletes' acute and chronic workloads. Results showed a pre-training significant decrease of sT and an increase of sC (p<0.05) in T2, compared to T1. Moreover, athletes showed high sC and low sT levels before, after and 24 hours following MD-5 in T2. Workload analysis revealed significant correlations of chronic load with sC (r = 0.45, p = 0.056) and T/C ratio (r = -0.59; p = 0.007). These results suggested that, in professional football, chronic workload has a greater impact on players' recovery time than acute workload over the sport season. Moreover, athletes' hormonal response to the weekly conditioning session at T2 revealed an altered anabolic/catabolic balance, highlighting the key role of continuous internal and external workload monitoring during the season.

Neuropsychiatric involvement in systemic lupus erythematosus contributes to organ damage beyond the nervous system: a post-hoc analysis of 5 phase III randomized clinical trials

ObjectiveTo investigate the association between neuropsychiatric systemic lupus erythematosus (NPSLE) and SLICC/ACR damage index (SDI) items, especially non-neuropsychiatric items.MethodsBaseline data from five phase III trials (BLISS-52, BLISS-76, BLISS-SC, BLISS-NEA, EMBRACE) were analysed. NPSLE involvement was defined as NP BILAG A/B/C/D (n = 272); NP BILAG E denoted non-neuropsychiatric SLE (n = 3273). We employed multivariable logistic regression analysis adjusting for age, sex, disease duration, and ethnicity.ResultsThe median (IQR) and mean ± SD SDI scores were 0 (0–1) and 0.62 ± 1.09. Compared with the non-neuropsychiatric SLE group, NPSLE patients were more likely to develop damage (adjusted (a)OR = 2.86; 95% CI = 2.28–3.59). This held true also after suppression of the NP SDI items (aOR = 1.70; 95% CI = 1.36–2.12). Beyond the neuropsychiatric domain, NPSLE was associated with damage in the cardiovascular (aOR = 2.63; 95% CI = 1.75–3.95), musculoskeletal (aOR = 1.90; 95% CI = 1.43–2.52), and skin (aOR = 1.54; 95% CI = 1.06–2.22) SDI domains. Dissecting domains into items, NPSLE was associated with coronary artery disease (aOR = 3.08; 95% CI = 1.44–6.58), myocardial infraction (aOR = 3.11; 95% CI = 1.54–6.27), muscle atrophy (aOR = 3.34; 2.16–5.16), scarring alopecia (aOR = 1.79; 95% CI = 1.19–2.70), bowel infarction (aOR = 1.98; 95% CI = 1.20–3.26), retinopathy (aOR = 2.23; 95% CI = 1.15–4.32), and premature gonadal failure (aOR = 2.10; 95% CI = 1.11–3.90).ConclusionThe intricate association between NPSLE and damage accrual extends beyond the nervous system to also comprise the musculoskeletal, skin, and cardiovascular organ systems.

P-069 The expression patterns of ALOX15 and GPX4 in the seminiferous epithelium of men with non-obstructive azoospermia (NOA) due to primary testicular failure

Abstract Study question Does the expression of ALOX15 and GPX4 differ in NOA men with a history of cryptozoospermia from NOA who never had sperm in their ejaculate? Summary answer There was no significant difference between these 2 groups of patients. What is known already Oxidative stress (OS) has been investigated as a prime suspect for many unexplained pathologies, including primary testicular failure (PTF). The fact that male germ cells are rich in polyunsaturated fatty acids (PUFAs) but have a limited amount of cytoplasmic scavenging enzymes, is the reason behind their extreme vulnerability to OS. The accumulation of lipid peroxidation markers leads to the inactivation of glutathione peroxidase 4 (GPX4), the lipid repair enzyme, and the exacerbation of arachidonate 15-lipoxygenase (ALOX15), a lipoxygenase enzyme that promotes lipid degradation. This study investigates the activity of these antagonizing enzymes in the testicular tissue of NOA patients. Study design, size, duration This observational study was conducted in the period from May 2020, following the Ethics Committee of the University of Split School of Medicine approval, to October 2023. The testicular tissue from 57 patients diagnosed with NOA (according to WHO criteria) and referred to their first microTESE as a part of fertility treatment was collected and processed. Participants/materials, setting, methods Samples were prepared for histological evaluation and immunodetection (fixation; embedding in paraffin; H&amp;E staining; and staining with anti-ALOX15 and anti-GPX4 antibodies). Two groups of NOA patients were observed: Crypto-NOA and NOA group. The main outcome measure was the number of ALOX15 positive germ cells per 1 mm² of the seminiferous tubule surface (N/ mm²) and the percentage (%) of GPX4 positive surface per surface of the tubule measured by the ImageJ program. Main results and the role of chance Spermatozoa were retrieved in 37 of 57 (64,91 %) men; samples of 4 patients had to be excluded due to poor fixation. There were 18 patients in the Crypto-NOA group, and 10 in the NOA group, while 5 patients were diagnosed with obstructive azoospermia (OA) and were used as controls. For comparison of the baseline data of Crypto-NOA and NOA patients, we used the Mann-Whitney test, and with statistical significance set at the level of P &amp;lt; 0.05, we found that there were significantly more patients with cryptorchism in the NOA group. As a tool for histological evaluation, we used the diagnostic code designed by McLachlan et al. and found similar spermatogenic phenotypes between Crypto NOA and NOA patients. The most represented phenotype was hypospermatogenesis with a moderate reduction in late spermatid number mixed with normal tubules (38,8 % in Crypto-NOA; 40% in NOA), following the phenotype where late spermatids are present in some tubules but mixed with tubules showing no progression past the spermatocyte stage. Using the Mann-Whitney test, we did not find a significant difference in the expression of ALOX15 and GPX4 in the seminiferous epithelium of Crypto-NOA and NOA patients. Limitations, reasons for caution The testicular tissue of NOA patients is characterized by focal or patchy spermatogenesis which led to the exclusion of several samples due to the fixation of tissue with a homogenous pattern of Sertoli cell-only or germ-cell arrest. Wider implications of the findings This study will provide additional information regarding the cause of impaired spermatogenesis and help to determine if the patient is a potential candidate for antioxidant therapy. Our next step is to associate the expression patterns of ALOX15 and GPX4 with the success rates of in vitro fertilization procedure outcomes. Trial registration number not applicable

Probing Dust and Gas Properties Using Ringed Disks

How rapidly a planet grows in mass and how far it may park from the host star depend sensitively on two nondimensional parameters: Stokes number St and turbulent α. Yet these parameters remain highly uncertain, being difficult or impossible to measure directly. Here, we demonstrate how the ringed disks can be leveraged to obtain St and α separately by constructing a simple toy model that combines the dust radial equation of motion under aerodynamic drag and coupling to gas motion with the measured distribution of dust masses in Class 0/I disks. Focusing on known systems with well-resolved dust rings, we find that the ranges of St and α that are consistent with the measured properties of the rings are small: 10−4 ≲ St ≲ 10−2 and 10−5 ≲ α ≲ 10−3. These low St and α ensure the observed rings are stable against clumping. Even in one marginal case where the formation of bound clumps is possible, further mass growth by pebble accretion is inhibited. Furthermore, the derived low α is consistent with the nearly inviscid regime where type I migration can be prematurely halted. Our analysis predicts a minimal planet population beyond ∼tens of au, where we observe dust rings and significantly more vigorous planet formation inside ∼10 au, consistent with current exo-giant statistics. We close with discussions on the implications of our results on small planet statistics at large orbital distances.

The level of sex and fertility hormones in the serum of male patients recovered from COVID-19

The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that generated the COVID­-19 pandemic is a broad-spectrum infection that besides the respiratory tract, can attack multiple organs, including­ the digestive, circulatory, and urinary systems. However, the negative consequences of SARS-CoV-2 on the male reproductive system have been largely ignored. The aim of this research was to see how SARS-CoV-2 affects the production of hormones, which are the markers of male reproductive function and fertility. The 350 Iraqi male participants were classified into two groups consisting of 150 COVID-19 recovered patients with a mean age of (32 ± 7.9) years and COVID-19 diagnosis confirmed by RT-PCR, and 200 apparently healthy male volunteers of similar age. The patients’ group was further divided into three groups depending on the recovery period of 3, 5 and 7 months. Serum levels of testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin were measured using the Mindray CL-1000i automated chemiluminescence analyzer provided with matching kits. When comparing the indices of COVID-19 recovered participants to the control group, the results revealed a decrease in testosterone level that was positively associated with the recovery period and an increase in the LH, FSH and prolactin levels that were negatively associated with the recovery period. It is supposed that infection with SARS-CoV-2 may be followed by a temporary condition of testicular failure. Keywords: male fertility, SARS-COV-2, sex hormones

Unexpected gonadal failure in a well male patient: case report

Unexpected gonadal failure in a well male patient: case report

Hypogonadism in men with inflammatory joint diseases: Frequency and clinical characteristics

To study the frequency of hypogonadism (HG) in men with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) and to evaluate the impact of HG on the course of RA and and concomitant diseases. A single-stage continuous study included 170 men with RA, 57 men with AS and 85 men with PsA, who were hospitalized at the Nasonova Research Institute of Rheumatology. Patients were assessed for total testosterone (ТS) levels and subsequently divided into subgroups with normal (>12 nmol/l) and reduced levels. An intergroup comparison was carried out on the main indicators used in clinical rheumatological practice to assess the stage, activity and other medical and demographic characteristics of rheumatic disease, as well as on concomitant conditions. The second stage of the study involved a pairwise intergroup comparison among patients with HG with RA, AS and PsA. The incidence of ТS deficiency among patients with RA was 24.1%, among patients with AS - 17.5%, and with PsA - 31.8%. In patients with RA, HG was associated with a significantly higher mean body mass index, higher fasting blood glucose and uric acid, higher erythrocyte sedimentation rate and anemia. Patients with AS with HG had significantly lower hemoglobin levels and more frequent anemia, as well as higher levels of C-reactive protein and erythrocyte sedimentation rate. In PsA, older age was observed in the androgen deficiency group, as well as higher body mass index and fasting glucose levels; obesity was more common. An intergroup comparison of quantitative and qualitative indicators between patients with androgen deficiency in all three rheumatic diseases (RDs) did not reveal significant differences in the average concentrations of ТS, luteinizing hormone, sex hormone binding globulin, experience of RD, laboratory markers of inflammatory activity, as well as glucose and uric acid. A similar incidence of diabetes mellitus, obesity and anemia was noted for all three nosologies. ТS levels and the presence of HG were not associated with the stage and activity of RD, but ТS deficiency was accompanied by higher laboratory indicators of inflammatory activity, lower hemoglobin values, and metabolic disorders. Patients with HG, regardless of nosology, had similar levels of sex hormones and indicators reflecting RD and concomitant conditions.

Protective roles of some natural and synthetic aromatase inhibitors in testicular insufficiency caused by Bisphenol A exposure

ABSTRACT In our study, the protective role of synthetic aromatase inhibitors anastrozole (ANS), letrozole (LTZ) and exemestane (EXM) and natural aromatase inhibitors resveratrol (RSV) and apigenin (APG) against testicular failure caused by exposure to Bisphenol A (BPA) was investigated. The epididymal sperm concentration, sperm motility and sperm morphology were determined. Oxidative stress and inflammatory response parameters were examined and histological examinations were performed in testicular tissues. Our results revealed that BPA exposure decreased serum testosterone and estrogen levels, increased FSH and LH levels (p < 0.05). BPA has been found to increase oxidative stress and inflammatory response and disrupt the histological structure. Also, BPA exposure decreased testicular weight, epididymal sperm concentration and motility, and increased abnormal sperm rate (p < 0.05). These results show that ANS, LTZ and RSV treatments reduce the BPA-induced testicular damage.

Impact of varicocelectomy on sperm parameters and hormone levels in infertile patients with sickle cell disease

Purpose: This study analyzes the semen parameters and gonadal hormone levels in infertile patients with sickle cell disease (SCD) and palpable varicoceles who underwent varicocelectomy for impaired semen parameters. Patients and methods: Improvements in the semen parameters—serum levels of total testosterone, follicle-stimulating hormone (FSH), and inhibin B—and testicular volume (TV) in 18 infertile patients with SCD were evaluated before and at 6 months after varicocelectomy. Results: Before varicocelectomy, all sperm parameters were affected, with high rates of low sperm concentration (83.3%), poor motility (88.9%), and abnormal morphology (77.8%). All sperm parameters were altered in 61.1%. On follow-up at 55.5 months after varicocelectomy, improvement in all the semen parameters was successful and complete in 22.2% but was not significant in 77.8%. The median follow-up period for sperm recovery was relatively long at 60.3 months. Total testosterone, FSH, and inhibin B were not significantly different before and after treatment (P &gt; 0.05). However, testosterone, FSH, and TV significantly correlated with the semen parameters (P &lt; 0.05). Moreover, a significant positive correlation was found between TV and inhibin B (P &lt; 0.05), and the improvement in the semen parameters was significantly correlated with primary hypogonadism (P &lt; 0.05). Conclusion: In adult men with SCD, varicocelectomy had a positive impact on the impaired seminal parameters and may be an option before sperm cryopreservation to improve future male fertility. Furthermore, primary testicular failure may be a feature of reversible spermatogenesis recovery in these patients.

Good Handling Practices Have Positive Impacts on Dairy Calf Welfare

The objective was to evaluate the effects of good handling practices on dairy calf welfare. Forty-eight crossbred dairy calves were assigned to two treatments: conventional handling (CH): calves kept in individual pens, fed milk replacer in buckets without nipples and abruptly weaned; or good handling practices (GHP): calves kept in group pens, fed milk replacer in buckets with nipples, given daily tactile stimulation during feeding, and progressive weaning. Calf welfare was assessed from birth to 120 days of age, based on: health (plasma concentrations of glucose and IgG, and occurrences of diarrhea, pneumonia, tick-borne disease, or death); physiology (heart rate [HR], respiratory rate [RR], and rectal temperature [RT]); behavior (flight distance [FD], latencies for first movement [LM] and to hold the calf in a pen corner [LH], and total time a calf allowed touching [TTT]); and performance indicators (body weight, average daily gain, and weaning success at 70 days of age). Calves in the GHP treatment had a lower HR at 30 days of age, shorter FD and LH, longer TTT, and lower RR and RT than CH (p &lt; 0.05). However, health, deaths and performance indicators did not differ (p &gt; 0.05) between treatments. Based on various indicators, GHP improved dairy calf welfare.

SARS-CoV-2 Transmission in Alberta, British Columbia, and Ontario, Canada, January 2020-January 2022.

We estimated COVID-19 transmission potential and case burden by variant type in Alberta, British Columbia, and Ontario, Canada, during January 23, 2020-January 27, 2022; we also estimated the effectiveness of public health interventions to reduce transmission. We estimated time-varying reproduction number (Rt) over 7-day sliding windows and nonoverlapping time-windows determined by timing of policy changes. We calculated incidence rate ratios (IRRs) for each variant and compared rates to determine differences in burden among provinces. Rt corresponding with emergence of the Delta variant increased in all 3 provinces; British Columbia had the largest increase, 43.85% (95% credible interval [CrI] 40.71%-46.84%). Across the study period, IRR was highest for Omicron (8.74 [95% CrI 8.71-8.77]) and burden highest in Alberta (IRR1.80 [95% CrI 1.79-1.81]). Initiating public health interventions was associated with lower Rt and relaxing restrictions and emergence of new variants associated with increases in Rt.