Coenzyme Q10 and male infertility: a meta-analysis

Objective

To evaluate the effect of coenzyme Q10 treatments in male infertility, specifically in these parameters: live birth and pregnancy rates, CoQ10 seminal concentration, sperm concentration, and sperm motility.

Materials and methods

Systematic review and meta-analysis in male infertility patients with CoQ10 oral treatments. Three trials were included: 149 males in CoQ10 group and 147 males in placebo group.

Results

None of the included trials provided any data regarding live births. The results of this meta-analysis show that supplementing infertile men with CoQ10 does not increase pregnancy rates. The analysis showed, among patients receiving CoQ10 treatment, a statistically significant increase in: CoQ10 seminal concentration (RR 49.55, 95 % CI 46.44 to 52.66, I² = 17 %), sperm concentration (RR 5.33, 95 % CI 4.18 to 6.47, I² = 58 %), and sperm motility (RR 4.50, 95 % CI 3.92 to 5.08, I² = 0 %)

Conclusion

There is no evidence in the literature that CoQ10 increases either live birth or pregnancy rates, but there is a global improvement in sperm parameters. Adequately powered, robust trials of individual and combination antioxidant therapies are required to guide clinical practice.     

A randomised controlled trial comparing two popliteal nerve catheter tip positions for postoperative analgesia after day‐case hallux valgus repair

We compared the effect of two different positions of a sciatic nerve catheter within the popliteal fossa on local anaesthetic consumption and postoperative analgesia in patients undergoing day‐case hallux valgus repair. Eighty‐four patients were randomly allocated to receive a sciatic nerve catheter either between the tibial and peroneal components (sciatic group) or medial to the tibial nerve (tibial group). The primary endpoint was postoperative local anaesthetic consumption, while secondary endpoints were pain scores, number of occasions where sleep was disturbed by pain and incidence of insensate limb and foot drop at 24 h and 48 h postoperatively. Postoperative median (IQR [range]) local anaesthetic consumption was 126 (106–146 [98–180]) ml in the sciatic group versus 125 (114–158 [98–200]) ml in the tibial group (p = 0.103). Insensate limb occurred in 14 patients in the sciatic group versus one patient in the tibial group (p < 0.001), while foot drop was reported by six patients in the sciatic group and none in the tibial group (p = 0.012). Sciatic nerve catheter placement medial to the tibial nerve may be a superior analgesic technique for day‐case foot surgery.     

Interassay reproducibility of myocardial perfusion gated SPECT in patients with atrial fibrillation

Aim  

The aim of this study was to assess interassay reproducibility of myocardial perfusion gated-SPECT for calculation of end-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF) in patients with atrial fibrillation (AF).     

Effect of the glycaemic index of a pre-exercise meal on metabolism and cycling time trial performance

This study investigated the effects of low or high glycaemic index (GI) foods consumed prior to a 40 km time trial (TT) on metabolism and subsequent endurance performance. Ten male cyclists consumed high GI or low GI meals, providing 1 g kg^?1 body mass of carbohydrate, 45 min prior to the TT. The TT performance was significantly (p = 0.009) improved in the low (93 ± 8 min) compared to the high GI trial (96 ± 7 min). Low GI carbohydrate oxidation rate (2.51 ± 1.71 g min^?1) was higher (p = 0.003) than the HGI carbohydrate oxidation rate (2.14 ± 1.5 g min^?1). Fat oxidation rate was significantly higher (p = 0.002) for the high (0.27 ± 0.17 g min^?1) than the low GI trial (0.16 ± 0.14 g min^?1). Insulin rose significantly following the high compared to the low GI meal (p = 0.008) but dropped significantly to similar values throughout the TT. No significant differences in either TGA or FFA concentration were observed between the trials. The low GI meal led to an increase in the availability of carbohydrate and a greater carbohydrate oxidation throughout the exercise period, which may have sustained energy production towards the end of exercise and led to the improved TT performance observed.     

Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC): Standardisation of the principal subscale to assess awareness in patients with disorders of consciousness

Establishing valid and reliable measures for use with patients with disorders of consciousness (DOC) following profound brain injury is challenging due to a number of factors including the complex presentation of such patients and assessor variability. The auditory modality has been demonstrated to have greater sensitivity for detecting awareness in DOC patients. However, there are no measures developed to assess auditory responsiveness specifically. The objective of this study was to examine the psychometric properties of the principal subscale of a music therapy assessment tool (MATADOC) developed for use with adult DOC patients. The subscale assesses behavioural domains essential for diagnosis of awareness. Twenty-one adult patients were recruited from a specialist rehabilitation unit. In a prospective study with repeated measures, internal consistency, inter-rater and test–retest reliability and dimensionality were examined. The five-item scale showed satisfactory internal reliability (α = .76) and a strong first principal component. Corrected item-total correlations were all > .45. Inter-rater intra-class correlations (ICCs) ranged from 0.65–1.00 and intra-rater ICCs from 0.77–0.90. Rasch analysis confirmed these impressions of a reliable, unidimensional and homogenous scale. Diagnostic outcomes had 100% agreement with a validated external reference standard. The results indicate that the MATADOC principal subscale provides a new behavioural measure that can contribute to interdisciplinary assessment of awareness with DOC patients.     

Clinical and molecular biologic characteristics of early-onset versus late-onset colorectal carcinoma in Filipinos

A case-control study of Filipino patients who underwent surgical resection for colorectal cancer (CRC) during a 1-year period was undertaken. Thirty-five patients under age 40 years were identified. Paraffin blocks of these and 35 randomly selected patients over age 40 underwent histologic and immunohistochemical evaluation. Markers chosen for evaluation included the apoptosis-associated gene products (p53 and bcl-2), a tumor proliferation activity-related factor (Ki-67), and the markers (MLH1 and MSH2) of DNA microsatellite instability (MSI). Results were correlated with age and the stage and location of the tumor. The average age of the early-onset group was 30.7 years compared to the late-onset group at 67.0 years; and the male/female ratio was equivalent. The younger patients had a significantly higher Dukes stage, the tumors were more poorly differentiated, and they were more frequently of the mucinous and signet ring cell histopathologic type. Expression of p53 was higher in the younger patients (p < 0.001) and was independent of the degree of differentiation or the stage of the tumor. No differences of expression were noted for the other markers measured. The increased frequency of CRC in Filipino patients less than 40 years of age offers a unique opportunity to gain a better understanding of carcinogenesis, which might be exploited during diagnosis and management. The differences noted between the early- and late-onset CRC are provocative and provide an impetus for increased screening in Filipinos.     

Clinical and sociodemographic variables associated with the onset of posttraumatic stress disorder in road traffic accidents

Our objective was to identify variables related to the onset of acute posttraumatic stress disorder (PTSD) after a road traffic accident. We evaluated 60 victims of a motor vehicle accident (MVA) in 2004 at 2 months postaccident. Thirty of them had developed PTSD; the other 30 had not developed PTSD. Clinical data, physical injuries, and sociodemographic characteristics were determined in 60 victims. The Davidson Trauma Scale (DTS) and a Structured Clinical Interview for DSM-IV (SCID) were used to evaluate PTSD occurrence. PTSD scores assessed by DTS and SCID at 2 months were significantly and positively associated with female sex, severe physical injuries, perceived social deprivation, and loss of job activity due to the accident. Female sex, severe physical injury, perceived social deprivation, and sick leave were related to the diagnosis of PTSD 2 months after the accident.     

“Bouveret's syndrome” presenting with acute pancreatitis a very rare and challenging variant of gallstone ileus

INTRODUCTIONBouveret's syndrome is a rare variant of gallstone ileus and describes gastric outlet obstruction secondary to an impacted stone in the duodenum. Its presentation is vague and clinical diagnosis is often difficult resulting in a delay in diagnosis.PRESENTATION OF CASEWe report a patient who presented initially with non-specific symptoms and subsequently with features in keeping with acute pancreatitis, but eventually was found to have Bouveret's syndrome.DISCUSSIONDifferent treatment strategies are discussed. Although endoscopic treatment combined with many newer modalities like lithotripsy have been tried, surgery remains the definitive management in the vast majority of cases.CONCLUSIONBouveret's syndrome is a rare condition, can also present as pancreatitis and often difficult to diagnose initially, but with appropriate treatment has a good outcome.