Combined treatment with myo-inositol, alpha-lipoic acid, folic acid and vitamins significantly improves sperm parameters of sub-fertile men: a multi-centric study.

OBJECTIVE: Reduction in motility and number of spermatozoa and change in their morphology are some of the most relevant causes of male infertility. Production of reactive oxygen species may affect motility, morphology and DNA stability of spermatozoa. This study aimed at evaluating the effect of combined treatment with myo-inositol, alpha-lipoic acid, folic acid, betaine and vitamins (namely, Sinopol®) on semen parameters of sub-fertile men. PATIENTS AND METHODS: We recruited 143 sub-fertile men, 26-53 years aged, no-smokers, without any testicular pathologies, with a normal endocrinological/metabolic profile, and no concomitant consumption of drugs. Out of them, 25 patients did not meet study inclusion criteria mainly due to the history of genital diseases that came to light after Sinopol® prescription. Among the 118 men that fulfilled inclusion criteria, 10 (8.4%) patients were lost at follow-up and in 8 (6.8%) cases the partner got pregnant spontaneously. Thus, 100 patients completed the study and semen analysis was performed before and after 90 days of treatment. RESULTS: Semen quality improved after 90 days of treatments, with a statistically significant increase of sperm concentration (p=0.0009), of number of spermatozoa (p=0.0017), of progressive motility (p=0.0047), of total motile sperm count (p=0.0010), and of normal sperm morphology (p<0.0001). CONCLUSIONS: For the first time we reported that a combination of nutraceuticals composed of myo-inositol, alpha-lipoic acid, folic acid, betaine and vitamins improves sperm parameters in sub-fertile men. We are aware that to clarify the clinical relevance of the data studies with larger sample sizes and longer durations are needed, as well as evaluation of myo-inositol and alpha-lipoic acid co-treatment effectiveness in improving the chances to obtain a pregnancy spontaneously or following assisted reproduction.

Assessing the formation of weak sodium complexes with negatively charged ligands.

The stability of sodium complexes with poly-carboxylic and polyamino-carboxylic acids is investigated with ion-selective electrode-Na(+) potentiometry, working at strictly constant ionic strength. It is observed that the formation constants of the Na(+) complexes with monoligand stoichiometry (ML) increase with the number of charges on the ligand. For example, in poly-carboxylic acids this dependency is linear and is well captured by an experimental equation. A different behaviour is observed for the poly-amino carboxylic acids, which show higher complexation capabilities reaching a plateau of the binding energy past a specific ligand size. The experimental results are discussed qualitatively using ab initio calculations based on DFT B3LYP, and the principal electronic characteristics of the ligands under investigation are identified. As a result of the flexibility imparted by the long chains of polyamino-carboxylic ligands, both experimental and theoretical models demonstrate that nitrogen atoms in proximity of Na(+) ions can participate in the metal coordination, thus providing further stabilization for the complexes. Moreover, by increasing the ligand size the stabilization gained in terms of ΔG reached a plateau for EDTA, in agreement with experimental observations.

HPV related diseases in males: a heavy vaccine-preventable burden.

Human Papillomavirus (HPV) has a significant impact in male's health, as cause of clinical manifestations ranging from genital warts to several cancers of the anogenital and aero-digestive tract. HPV types which most frequently affect men are 6, 11, 16 and 18, included in the HPV quadrivalent vaccine, recently approved for use in males by Food and Drug Administration (FDA) and European Medicines Agency (EMA). Although several data about the safety and efficacy of quadrivalent vaccine are available, the implementation of proper immunization plans dedicate to male's population cannot ignore the knowledge of the characteristics of the disease in men, which in some aspects should be clarify, in particular clearance of type-specific HPV infections and transmission dynamics. Purpose of this review is to summarise the main information about the burden and the natural history of the HPV related disease in males.

Impact of influenza during the post-pandemic season: epidemiological picture from syndromic and virological surveillance.

INTRODUCTION: Following the observation that 1 or 2 pandemic peak due to the circulation ofAHINlv had occurred in most countries and in most World Health Organization (WHO) Regions, WHO declared on August 10"h, 2010 that the world was moving into the post-pandemic period, whose surveillance presents considerable interest both from epidemiological and clinical point of view. We described the epidemiological picture emerged from syndromic and virological surveillance during the post-pandemic season in Liguria, Italy. MATERIALS AND METHODS: An Emergency Department Syndrome surveillance system, based on data collected at "San Martino" and IRCCS "G. Gaslini" Liguria Regional Reference University Hospitals for adults and children is active since July 2007. Monitored syndromes include "Influenza-Like Illness" (ILl) and "Low Respiratory Tract Infections" (LRTI). The Ligurian Regional Reference laboratory for Influenza virological surveillance and diagnosis offers rapid detection of influenza viruses by real-time and block RT-PCR, viral culture and genetic characterization by entire sequence analysis of haemagglutinin- and neuraminidase-coding regions in accordance with the international standards established by the global laboratory network. RESULTS AND DISCUSSION: The integration of syndromic surveillance system and laboratory surveillance for rapid detection and characterization of the disease responsible agent represented a specific and sensitive tool for influenza surveillance. The post-pandemic season was characterized by early onset and by the heaviest impacts for ILI and LRTI among the recent epidemic seasons. In contrast to the picture observed during the pandemic season, the 2010/11 winter was characterized by the intensive circulation of pandemic AH1N1v coupled with sustained activity due to influenza B and Respiratory Syncytial Virus (RSV). Antigenic and molecular characterization of influenza strains confirmed the good matching between circulating and 2010/11 vaccine viruses.

Sequential outbreaks of multidrug-resistant Acinetobacter baumannii in intensive care units of a tertiary referral hospital in Italy: combined molecular approach for epidemiological investigation.

A laboratory-based surveillance study was conducted from January 2007 to May 2010 in San Martino Tertiary Referral Hospital in Genoa, Italy in which the molecular epidemiology of multidrug-resistant Acinetobacter baumannii was investigated in the five intensive care units (ICUs). A total of 53 A. baumannii strains were isolated from patients admitted to ICUs (69.8%) and to other epidemiologically linked hospital wards (30.2%) and were genotyped by repetitive extragenic palindromic polymerase chain reaction (REP-PCR), multilocus sequence typing (MLST) and adeB sequence typing. REP-PCR fingerprinting analysis, MLST and adeB typing results were well correlated and allowed us to classify strains causing epidemic events into three major epidemic clones: A (REP-I/ST4, adeB-STII genotype) isolated for the first time in May 2007, B (REP-IV/ST95, adeB-STI genotype) from November 2007 to May 2009 and C (REP-VII/ST118, adeB-STII genotype) from July 2008 to May 2010. MLST results demonstrated that epidemic clones A and C were related as they were members of the widespread clonal complex CC92. The genetic determinants of carbapenem resistance were investigated and resistance associated with the presence of the bla(OxA-58-like) gene with ISAba2 and ISAba3 elements flanking it in clone A, and with the bla(OxA-23-like) gene flanked by ISAba1 in clones B and C. A molecular approach allowed the prompt introduction of infection control measures and the evaluation of data in a global epidemiological context.

Role of congenital rubella reference laboratory: 21-months-surveillance in Liguria, Italy.

INTRODUCTION: Rubella is generally a mild rush fever disease when acquired in childhood, but when infection occurs during the first months of pregnancy, high risk of trans-placental transmission to the foetus and of congenital anomalies exists. In November 2003, a National Plan for measles and congenital rubella elimination was approved in Italy. The aim was to reduce and maintain Congenital Rubella Syndrome incidence lower than 1 case per 100,000 live births/year by 2007. Since June 2006, Liguria Administrative Region recognized U.O. Hygiene, "San Martino" University Hospital, Genoa, as regional reference laboratory for diagnosis of rubella infection during pregnancy and post-partum. METHODS: Twenty-one-month virological-surveillance results between April 2007 and December 2008 were reported in terms of demographic data, risk factors, access reasons, clinical picture, vaccination, previous rubella disease, laboratory results of pregnant women and newborns. RESULTS AND CONCLUSION: Since the beginning of surveillance, 65 pregnant women with suspected virus infection and 18 newborns with suspected congenital rubella were followed up. The results of laboratory surveillance highlighted (i) the importance of an early screening, (ii) the suboptimal specificity of chemiluminescent assays, that often yield false positive IgM results and (iii) the fundamental role of second-level laboratory to confirm the serological diagnosis and to detect the virus by molecular techniques.

The enzymatic synthesis of glucosylmyristate as a reaction model for general considerations on 'sugar esters' production.

'Sugar esters' are non-ionic biodegradable surfactant which are potentially attractive for the cosmetic and food market. Unfortunately, the formation of by-products by chemical synthesis affects the quality of the surfactant. Enzymatic synthesis is a promising and environmentally friendly approach preventing this problem but requiring a proper setting up of the reaction system (membrane reactor, azeotropic mixture, pervaporation system, etc.) for the control of the water activity so that the enzyme efficiency is often negatively affected. In this paper, the synthesis of glucosylmyristate by Novozym 435 is taken as a model to illustrate the general features of the 'sugar esters' synthesis, with particularly regard to the influence on the synthesis of the pre-reaction treatment of the enzyme and reaction mixture, water adsorbents, reaction solvents, products and reagents. The aim is reached by placing the water adsorbents in contact with the enzyme preparation, so that high dehydration efficiency is achieved and the other factors affecting the kinetic of the synthesis are better highlighted.

[A duodenal trichophytobezoar]. / Tricofitobezoar duodenal.

A case of intestinal obstruction with surgical diagnosis of duodenal trichophytobezoar occurs in a 20 years old man, undergoing Military Service, with alterations in his behavior labelled as "border-line" schizophrenia, and hysteroschizoid characteristics (oral anxiety). It couldn't be determined neither trichophagy nor ingestion of any of nutrients involved by literature in bezoars formation. Etiological and physiopathological data offered by literature are compared. Without the existence of organic causes of remora in our case the presence of alterations in his behavior determined by the anxiety caused by his military duties might be the catalyst of the atypical ingestion.

Tricofitobezoar duodenal. / [A duodenal trichophytobezoar]

A case of intestinal obstruction with surgical diagnosis of duodenal trichophytobezoar occurs in a 20 years old man, undergoing Military Service, with alterations in his behavior labelled as [quot ]border-line[quot ] schizophrenia, and hysteroschizoid characteristics (oral anxiety). It couldnt be determined neither trichophagy nor ingestion of any of nutrients involved by literature in bezoars formation. Etiological and physiopathological data offered by literature are compared. Without the existence of organic causes of remora in our case the presence of alterations in his behavior determined by the anxiety caused by his military duties might be the catalyst of the atypical ingestion.