1,721,082 research outputs found
Ruolo dell'HPV nell'infertilità maschile
Full text linkIntroduzione: Le malattie sessualmente trasmesse (MST) rappresentano una nota
causa di infertilità maschile. È stata dimostrata l’associazione tra l’infezione da
papillomavirus (HPV) ed una significativa alterazione dei parametri seminali, in
particolare una riduzione della motilità. Nonostante l’HPV sia stato e sia tutt’ora
oggetto di molti studi, è stato considerato prevalentemente il genere femminile e
ad oggi restano da chiarire molti aspetti in ambito andrologico, su tutti il ruolo
clinico e laboratoristico di questo virus nel liquido seminale, la possibilità di una
diffusione nel circolo ematico e le strategie possibili per contrastare ed accelerare
la clearance dell’infezione.
Scopo: Gli scopi della ricerca sono stati quelli di valutare l'efficacia di una tecnica
di swim-up modificata per la rimozione dell’HPV da campioni di liquido seminale
infettati, di indagare la possibile associazione tra la presenza dell’HPV e di
anticorpi anti-spermatozoo e determinarne la clearance dell’infezione dal liquido
seminale, caratterizzare le cellule rotonde infette nel liquido seminale e valutare la
presenza del virus in cellule circolanti e valutare il ruolo del counseling nel
decorso clinico dell’infezione nelle coppie eterosessuali positive.
Materiali e metodi: Per raggiungere gli scopi prefissati, le metodiche utilizzate
nelle varie categorie di pazienti arruolati nelle diverse fasi della ricerca sono:
analisi del liquido seminale, TUNEL test, FISH per HPV e FISH per la
valutazione di aneuploidie, citofluorimetria, swim-up e swim-up con eparinasi III,
spermMar test, immunofluorescenza, PCR per HPV e INNO-LiPA.
Risultati: Il trattamento enzimatico dei campioni infetti si è dimostrato efficace
nella rimozione completa del virus e non ha comportato danni significativi alla
qualità degli spermatozoi trattati. Nei soggetti infetti, la presenza dell’HPV non
solo si associa ad una riduzione della motilità ma anche ad un incremento degli
anticorpi antispermatozoo (ASA) che si riducono e scompaiono al progredire della
clearance virale. Nel liquido seminale il virus è presente oltre che negli
spermatozoi e nelle cellule di sfaldamento anche nei linfociti B e nelle natural
killer (NK), cellule queste osservate positive anche in circolo in un piccolo gruppo di pazienti. Nel follow-up di coppie positive all’HPV si è osservato inoltre che un counseling mirato è efficace nel velocizzare il tempo di risoluzione dell’infezione che appare doppio nell’uomo rispetto alla donna.
Conclusioni: È sempre più evidente il ruolo dell’HPV nell’infertilità maschile e
la necessità di avere linee guida efficaci per prendersi cura dei soggetti e delle
coppie HPV positive. I risultati di questa ricerca, nonostante necessitino di
ulteriori conferme ci forniscono utili risultati e spunti di riflessione interessanti per sviluppi futuri. Innanzitutto il trattamento enzimatico dei campioni infetti si è rivelato efficace e sicuro nel rimuovere l’infezione e dovrebbe essere tenuto in considerazione soprattutto per i soggetti che si sottopongono a tecniche di fecondazione assistita. La forte associazione tra HPV e ASA suggerisce inoltre di valutare la presenza dell’infezione in soggetti affetti da infertilità idiopatica che
risultino positivi allo spermMar test. Inoltre nei soggetti e nelle coppie positive è consigliato un counseling mirato e un follow-up preciso che valuti non solo i siti
genitali ma anche il cavo orale per permettere e velocizzare l’eradicazione
dell’infezione. Futuri sviluppi di ricerca sono inoltre stimolati dal riscontro di
cellule circolanti positive all’HPV che rendono d’obbligo il chiarire quale sia il
significato clinico e laboratoristico di questo dato, e se e quali implicazioni possa
avere per il paziente
Adolescents and web porn: a new era of sexuality
Full text linkBackground: Pornography can affect the lifestyles of adolescents, especially in terms of their sexual habits and porn consumption, and may have a significant influence on their sexual attitudes and behaviors. Objective: The aim of this study was to understand and analyze the frequency, duration, and perception of web porn utilization by young Italians attending high school. Materials and methods: A total of 1565 students attending the final year of high school were involved in the study, and 1492 have agreed to fill out an anonymous survey. The questions representing the content of this study were: 1) How often do you access the web? 2) How much time do you remain connected? 3) Do you connect to pornographic sites? 4) How often do you access pornographic sites? 5) How much time you spend on them? 6) How often do you masturbate? and 7) How do you rate the attendance of these sites? Statistical analysis was performed by Fischer's test. Results: All young people, on an almost daily basis, have access to Internet. Among those surveyed, 1163 (77.9%) of Internet users admit to the consumption of pornographic material, and of these, 93 (8%) access pornographic websites daily, 686 (59%) boys accessing these sites perceive the consumption of pornography as always stimulating, 255 (21.9%) define it as habitual, 116 (10%) report that it reduces sexual interest towards potential real-life partners, and the remaining 106 (9.1%) report a kind of addiction. In addition, 19% of overall pornography consumers report an abnormal sexual response, while the percentage rose to 25.1% among regular consumers. Conclusion: It is necessary to educate web users, especially young users, to a safe and responsible use of the Internet and of its contents. Moreover, public education campaigns should be increased in number and frequency to help improve knowledge of Internet-related sexual issues both by adolescents and by parents
Successful management of giant hydrocolpos in a limited-resource setting
No full textAbdominal distention and urinary retention are rare manifestations in newborns. The differential diagnosis of a female neonate presenting these signs, especially when combined, should include hydrocolpos due to imperforate hymen. The prognosis of imperforate hymen is generally good, although it can be associated with serious nephro-urologic and infectious complications. Early diagnosis and drainage of hydrocolpos allow prevention and/or improvement of these possible complications. In limited-resource settings, diagnostic imaging is more difficult to obtain, and, therefore, increased caution and an accurate physical exam with perineal inspection are essential. We report the case of a 8-day-old female neonate showing abdominal distention and urinary retention. She had a final diagnosis of imperforate hymen with giant hydrocolpos, complicated by obstructive uropathy and following urosepsis and bladder perforation
Gastroschisis Spiral-like Closure with Umbilical Cord in a Limited-resource Setting: A Case Report
Full text linkGastroschisis is one of the most frequent congenital surgical problems in fetuses and neonates, with a continuously increasing incidence worldwide. In limited-resource settings, the management of this condition is difficult, and the mortality rates are much higher than those observed in high-income countries. We report the case of a newborn with gastroschisis and viscero-abdominal disproportion, submitted to abdominal wall closure through utilization of umbilical cord tissue. This technique has not already been applied in low-resource countries, where it can show advantages such as lower risk of abdominal compartment syndrome and local infection, high availability, and low cost.</jats:p
Spontaneous fertility and in vitro fertilization outcome: New evidence of human papillomavirus sperm infection
Full text linkObjective To evaluate the reproductive outcome of infertile couples undergoing assisted reproduction techniques (ART) with or without human papillomavirus (HPV) semen infection. Design Cross-sectional clinical study. Setting Units of andrology, reproductive medicine, and gynecology. Patient(s) A total of 226 infertile couples. Intervention(s) Male partners were evaluated by means of fluorescence in situ hybridization (FISH) for HPV on semen. After a diagnostic period, female partners underwent intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI). Main Outcome Measure(s) Seminal parameters and FISH analysis for HPV in sperm head. Spontaneous or assisted pregnancies, live births, and miscarriages were recorded. Statistical analysis included unpaired Student t test and chi-square test. Result(s) Fifty-four male partners (23.9%) had HPV semen infection confined to sperm, confined to exfoliated cells, or in both cells. During the diagnostic period, noninfected couples showed spontaneous pregnancies. IUI and ICSI treatments were performed in, respectively, 60 and 98 noninfected and in 21 and 33 infected couples, with 38.4% and 14.2% cumulative pregnancy rates, respectively. The follow-up of pregnancies showed a higher miscarriage rate in infected couples (62.5% vs. 16.7%). Ongoing pregnancies of the latter group were characterized by HPV infection confined to exfoliated cells. Conclusion(s) A reduction in natural and assisted cumulative pregnancy rate and an increase in miscarriage rate are related to the presence of HPV at sperm level. Although the exact mechanism by which sperm infection is able to impair fertility remains unclear, this aspect is worthy of further investigations. If confirmed, these results could change the clinical and diagnostic approach to infertile couples
Twenty-four-hour monitoring of scrotal temperature in obese men and men with a varicocele as a mirror of spermatogenic function.
No full textSperm viral infection and male infertility: focus on HBV, HCV, HIV, HPV, HSV, HCMV, and AAV
No full textChronic viral infections can infect sperm and are considered a risk factor in male infertility. Recent studies have shown that the presence of HIV, HBV or HCV in semen impairs sperm parameters, DNA integrity, and in particular reduces forward motility. In contrast, very little is known about semen infection with human papillomaviruses (HPV), herpesviruses (HSV), cytomegalovirus (HCMV), and adeno-associated virus (AAV). At present, EU directives for the viral screening of couples undergoing assisted reproduction techniques require only the evaluation of HIV, HBV, and HCV. However, growing evidence suggests that HPV, HSV, and HCMV might play a major role in male infertility and it has been demonstrated that HPV semen infection has a negative influence on sperm parameters, fertilization, and the abortion rate. Besides the risk of horizontal or vertical transmission, the negative impact of any viral sperm infection on male reproductive function seems to be dramatic. In addition, treatment with antiviral and antiretroviral therapies may further affect sperm parameters. In this review we attempted to focus on the interactions between defined sperm viral infections and their association with male fertility disorders. All viruses considered in this article have a potentially negative effect on male reproductive function and dangerous infections can be transmitted to partners and newborns. In light of this evidence, we suggest performing targeted sperm washing procedures for each sperm infection and to strongly consider screening male patients seeking fertility for HPV, HSV, and HCMV, both to avoid viral transmission and to improve assisted or even spontaneous fertility outcome
Association, prevalence, and clearance of human papillomavirus and antisperm antibodies in infected semen samples from infertile patients
No full textOBJECTIVE:
To evaluate prevalence, association, and clearance of human papillomavirus (HPV) and antisperm antibodies (ASAs) in infected semen samples from infertile patients.
DESIGN:
Cross-sectional clinical study.
SETTING:
Andrology and microbiology sections at a university hospital.
PATIENT(S):
Three groups of subjects: 61 infertile patients with HPV semen infection, 104 noninfected infertile subjects, and 92 control subjects.
INTERVENTION(S):
Semen analysis, spermMar test, fluorescence in situ hybridization for sperm aneuploidy and for HPV, and immunofluorescence for HPV 16-L1 and immunoglobulins (IgA, IgG, and IgM) determination.
MAIN OUTCOME MEASURE(S):
Association of sperm procedures, HPV sperm infection, sperm aneuploidies, and sperm ASAs.
RESULT(S):
Infertile patients with HPV semen infection showed high percentages of ASAs. In these patients HPV sperm infection was associated with lower sperm motility, which was worse in subjects with ASAs. No alterations of sperm chromosomes were observed. To obtain a significant clearance of both HPV sperm infection and ASAs at least 24 months of follow-up were needed.
CONCLUSION(S):
Human papillomavirus has been recently suggested to have an important role in male infertility. This study demonstrated that HPV sperm infection can be long lasting and frequently associated with ASAs that may further reduce male fertility. Infertile patients with positive spermMar test results should be considered for investigation for HPV, especially if they are candidates for assisted reproduction
Reduced neonatal mortality in a regional hospital in Mozambique linked to a Quality Improvement intervention
Full text linkBACKGROUND:
Neonatal mortality remains a serious health issue especially in low resource countries, where 99% of neonatal deaths occur. Doctors with Africa CUAMM is an Italian non-governmental organization in the field of healthcare that has been working in Africa since 1955. In Mozambique, at the Central Beira Hospital (CBH), it has a project with the aim of supporting the neonatal intensive care unit (NICU) and the Obstetrical Department of the CBH through a multi-level intervention. Our aim was to evaluate the effectiveness of CUAMM continuous Quality Improvement intervention in terms of reduction of the overall neonatal mortality rate in the NICU of CBH.
METHODS:
A baseline analysis was performed in order to assess the actual standard of neonatal care. Subsequently, the intervention was focused on three main areas: infrastructure, equipment and clinical protocols improvement. A retrospective pre- (2013)/post- (2014) implementation analysis of clinical outcomes was performed.
RESULTS:
Total population included 4,276 newborns, 2,118 (50%) born in 2013 and 2158 (50%) born after implementation. Baseline characteristics of the two groups were similar apart from a higher incidence of outborn neonates (33% vs 30%, p = 0.02) and a lower incidence of Apgar score < 7 at 5 min (37% vs 43%, p < 0.01). The rates of admissions for asphyxia (22% vs 30%), sepsis (4% vs 7%) and prematurity (18% vs 28%) increased between the two study period. Mortality rate for each of these causes decreased from before to after the implementation: asphyxia (34% vs 19%, p < 0.01), sepsis (39% vs 28%, p = 0.06) and prematurity (43% vs 33%, p < 0.01).
CONCLUSION:
We found a reduction in mortality rate among newborns admitted to CBH's NICU after the first year of CUAMM intervention. Most of this reduction can be attributed to the decrease in deaths for asphyxia, sepsis and prematurity. A Quality Improvement intervention based on infrastructural, equipment and clinical objectives was associated with a reduction of neonatal mortality rate in a low-resource NIC
Molecular karyotyping of single sperm with nuclear vacuoles identifies more chromosomal abnormalities in patients with testiculopathy than fertile controls: Implications for ICSI
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