Sperm DNA damage in patients with chronic viral C hepatitis

Introduction

The aim of this study was to evaluate the conventional and biofunctional parameters of sperm in young infertile patients with Hepatitis C (HCV) infection.

Methods

Forty HCV patients with primary infertility, aged 27 to 42 years (mean 36.4 years) and twenty HCV patients with secondary infertility aged 28 to 45 years (mean 35.0 ± 2.8 years), underwent hormonal and sperm analysis in addition to the determination of reactive oxygen species (ROS) concentrations in the sperm and flow-cytometric evaluation. The following biofunctional sperm parameters were evaluated by flow cytometry: DNA fragmentation, mitochondrial membrane potential, chromatin condensation, and the rate of early apoptosis.

Results

Overall, patients with HCV showed significantly worse median values of conventional and biofunctional sperm parameters than control subjects, including sperm density (31.7 vs. 80.4 million/ml), forward motility (9.4 vs. 25%), normal forms (15.4 vs. 24.8%), DNA fragmentation (6.6 vs. 2.2%), low MMP (45.5 vs. 8%), an early apoptosis rate (5 vs. 2.7%), and abnormal chromatin (18.9 vs. 13.9%). Finally, HCV patients had significantly higher basal (250 vs. 75 × 10³/cpm) and stimulated (550 vs. 120 × 10³/cpm) ROS levels in semen compared to control subjects. None of the examined parameters (sperm, hormonal, biofunctional and assessment of oxidative status in the semen) was significantly different between HCV patients with primary and secondary infertilities.

Discussion

These results confirm that HCV infection has a negative impact on sperm parameters. The overlap of the results observed in the two groups of HCV patients supports the hypothesis that HCV infection may cause to alterations in sperm parameters.     

Mental health and social participation skills of wheelchair basketball players: A controlled study

The aim of this study was to assess differences in psychological well-being, symptomatic psychological disorders and social participation, between competitive wheelchair basketball participants and those non-participants. Forty-six wheelchair participants, 24 Basketball players (aged 35.60 ± 7.56) and 22 non-players (aged 36.20 ± 6.23), completed three validated self-report questionnaires: Participation Scale (PS), Psychological Well-Being Scale [PWBS] and Symptom Checklist 90 R [SCL-90-R]. ANOVA showed significant overall differences between the two groups. The social restriction score, evaluated by PS, was significantly higher in the non-basketball participants (p = 0.00001) than the basketball participants. The PWB Scale showed significant differences in all 6 dimensions: positive relations with others, environmental mastery, personal growth, purpose in life and self-acceptance (p < 0.01), and autonomy (p < 0.05), with better scores in the basketball participants. The SCL-90-R scores were significantly lower for the basketball group in the following 6 symptomatic dimensions: depression, phobic anxiety, and sleep disorder (p < 0.01), somatization, interpersonal sensitivity and psychoticism (with p < 0.05). It was concluded that competitive wheelchair basketball participants showed better psychological well-being and social skills than those non-participants.     

Using Protamine Can Significantly Reduce the Incidence of Bleeding Complications after Carotid Endarterectomy without Increasing the Risk of Ischemic Cerebral Events

Background

Controversy persists regarding the use of protamine sulfate (PS) during carotid endarterectomy (CEA), chiefly because of conflicting experiences reporting both less bleeding and a higher stroke risk. The goal of the present study was to test the hypothesis that reversing heparin with PS after CEA significantly reduces the incidence of bleeding complications without increasing the risk of postoperative stroke.

Methods

From January 2010 to December 2012 all consecutive patients undergoing CEA under general anesthesia at our institution received 5,000 U of heparin prior to carotid clamping, which was partially (half-dose) reversed with PS 25 mg immediately after declamping (group I). Heparinization had never been reversed with PS in earlier CEAs performed from 1998 to 2009 at the same institution (group II). All patients were assessed preoperatively and postoperatively by a neurologist, and cerebral magnetic resonance imaging was performed in all group I patients to exclude any silent cerebral infarction. End points of the study were bleeding complications, perioperative (30-day) stroke, and death.

Results

Overall, 219 CEAs (201 patients) were performed in group I, and 1,458 CEAs (1,294 patients) in group II. Demographics, risk factors, and preoperative antiplatelet medication were comparable in the two groups. The incidence of adverse events (group I vs group II) was as follows: stroke (0 vs 0.5 % [8/1,458], p = 0.27); death (0 vs 0 %); neck bleeding (0 vs 8.2 % [120/1,458], p < 0.001).

Conclusions

The results of the present study demonstrate that (1) partially neutralizing heparin with PS after CEA can significantly reduce the risk of bleeding complications, and (2) there is no association between the administration of PS and the incidence of postoperative stroke.