Significance of antinuclear antibodies and rheumatoid factor in patients with advanced peripheral arterial disease

To determine whether or not elevated titers of antinuclear antibodies [ANA] and/or rheumatoid factor [RF] are associated with patients with advanced peripheral arterial disease [PAD]. A cross-sectional study was done between September 2005 and December 2006. Fifty-eight patients with clinical and angiographic evidence of PAD and 41 controls were studied. Controls had no documented history of peripheral, coronary or cerebral vascular disease. All subjects were screened for metabolic syndrome and C-reactive protein [CRP] as riskfactors for peripheral vascular disease. Additionally, all were tested for anti-mitochondrial,anti-neutrophilcytoplasmicand anti-smooth muscle antibodies; those with positive results were excluded. ANA and RF were measured in sera from cases and controls. One case and 3 controls had positive anti-smooth muscle antibodies and were therefore excluded from statistical analysis. Metabolic syndrome was significantly more prevalent in patients than controls [p < 0.05]. Mean CRP level was 4.78 +/- 7.70 and 2.65 +/- 3.86 mg/dl in cases and controls, respectively [p = 0.021]. ANA were detected at a titer of >/= 1:40 in 6 [10.5%] of the advanced PAD patients but none of the controls; the difference was not statistically significant. RF was less prevalent in cases than controls [p < 0.05]. RF and ANA do not appear to be associated with PAD in a Kuwaiti population

Male infertility in Kuwait. Etiologic and therapeutic aspects

To evaluate the pathological patterns associated with male infertility in Kuwait and to characterize treatment outcome after varicocele repair using percutaneous varicocele embolization. We carried out a prospective study of 64 infertile men in Kuwait between 2001 and 2005. All patients included had proven non-obstructive azoospermia or oligospermia [sperm count <20 million/ml]. All patients underwent ultrasonographic evaluation of the scrotum. Fine needle aspiration of the testes was performed on all azoospermic patients. A total of 24 [38%] patients were azoospermic while 40 [62%] were oligospermic. Sertoli- cell-only pattern was the most common cytopathology associated with primary testicular failure. Among the oligospermic patients, 50% had small to moderate varicocele. Spermatic vein embolization resulted in a significant rise in the mean sperm count from 10.6 +/- 3.8 million/ml to 30.2 +/- 6.8 million/ml [p<0.05] in 5 treated oligospermic patients, followed by spontaneous pregnancy in 2 couples. No effect was seen on azoospermic patients. From an etiological point of view, we believe that the high incidence of Sertoli cell-only-syndrome among nationals and residents of a country that underwent a major environmental insult strengthens the chances of an environmental role in the development of this syndrome. From a management point of view, in cultures where in vitro fertilization is either still not widely acceptable or is unaffordable, oligospermia with clinical or subclinical varicocele deserves a trial of a low risk, out patient procedure, namely, spermatic vein embolization that could improve fertility