Psychiatric symptoms during interferon treatment for hepatitis C: experiences from a tertiary care hepatology centre.

BACKGROUND: Most research on the psychiatric symptoms of peginterferon/ribavirin for the treatment of hepatitis C comes from VA centres and clinical trials with rigid entry criteria that often excluded patients with markers of mental health and substance use disturbance (MH/SUD). The findings from these lines of research may not be generalizable to patients treated under standard of care in a tertiary care setting. AIM: To investigate the incidence and outcomes of psychiatric symptoms in patients treated under standard of care protocol, not enrolled in clinical trials. METHODS: This is a retrospective analysis of 215 patients who underwent therapy from 2002 to 2006 at a university-based tertiary care centre. Survival curves explored the relationship between history of MH/SUD and the development of psychiatric symptoms on treatment. RESULTS: The cumulative history of MH/SUD was 67%. Of these, 39% had taken psychotropic medications previously, and 80% continued on them during therapy. On therapy, 46% developed depressive symptoms, 19% and 46% endorsed anxiety and irritability respectively. Cumulatively, 64% of patients indicated mood disturbance on therapy. Most symptoms developed between weeks 2 and 18, and rarely after week 20. Of those who developed mood symptoms, 66% required an intervention. Treatment discontinuation was infrequent. CONCLUSIONS: This large observational study provides important insights into the incidence and course of psychiatric symptoms in an unselected sample of patients treated in a tertiary care setting. Patients had higher rates of MH/SUD comorbidity, psychotropic medication use and exhibit higher rates of mood disturbance on therapy compared with previous reports, although a majority completed the prescribed treatment regimen.

Ultrasound and spermatogenesis in the rat.

Using exposure conditions comparable to those which have been associated by others with positive results, we tested for effects of ultrasound on sperm production over a period of 12 weeks following treatment. Continuous wave exposure with spatial average intensities of 1, 2 and 4 W/cm2 and exposure times up to 10 minutes were used. In some experiments, the exposures were repeated after an elapsed time of 48 h. No significant changes in spermatogenesis were related to any of the exposure conditions in spite of the fact that some of the treatments caused thermal tissue damage near bone. No effects of exposure were found in weights of the testis, prostate, seminal vesicle, or whole body.

Reduced training frequency effects on aerobic power and muscle adaptations in rats.

Female rats were exercised by swimming up to 4 h/day either 2, 4, or 6 days/wk. After 7 wk they continued to train at these frequencies or had their training reduced from 6 to 4, 2, or 0 days/wk for an additional 9 wk. Ventricular weights and maximum O2 uptake (VO2max) were increased by 5-10% after training 2 days/wk, 15-17% after 4 days/wk, and 25-30% after 6 days/wk. Following reduced training, VO2max was similar when the 4- or 2-day/wk reduced training groups are compared with their 4- or 2-day/wk continued training counterparts. In contrast, VO2max was greater in the 0-day reduced than in the sedentary control group. No differences in mitochondrial markers or myoglobin content in red or mixed skeletal muscles were found between training 2 or 4 days/wk vs. reduced training at comparable frequencies. O2 uptake capacity of plantaris muscles and myoglobin concentration in fast-twitch red vastus lateralis muscles were greater in the 0-day reduced group than in the sedentary controls. These data show that VO2max and certain markers of aerobic metabolism in skeletal muscles of rats are lost at a slower rate than their rate of increase from the untrained state. However, a reduction of swimming frequency from 6 to 4 or 2 days/wk is not a sufficient stimulus to maintain VO2max, cardiac enlargement, or the increased aerobic potential of skeletal muscle at the 6-day/wk levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Alteration of semen quality in dogs after creation of varicocele.

A left vein varicocele was created in male dogs by partially obstructing the left renal vein medial to the entrance of the left internal spermatic vein. Eight dogs had semen parameters determined preoperatively (2 times/week for five weeks) and postoperatively (2 times/week for twelve weeks). Semen quality was altered by the experimental varicocele. A significant decrease in sperm count, motility, per cent viable, and per cent oval sperm were noted. Semen volume was not affected. The possible chemical influence of serotonin is mentioned. Testosterone levels were unchanged by the varicocele. Histologic findings in the left and right testicles are mentioned before and after creation of the varicocele.

The varicocele and semen characteristics.

Our results indicate that the physical presence of a varicicele is not always associated with an alteration in sperm cell concentration and that a reduction of semen characteristics is more likely in men with reduced sperm counts. Our study also indicates that a higher pregnancy rate after varicocele ligation occurred in wives of patients in the lower sperm count groups. Other forms of therapy also were found to be associated with pregnancy in wives of men with varicoceles. The post-surgical pregnancy rate was 25 per cent compared to 12 per cent in the non-surgical group.

Effect of amylase on sperm motility and viability.

The effect of increasing concentrations of amylase on the percentage of active spermatozoa, the quality of their motility and the percentage of viable cells was studied in semen samples in vitro. The amount of amylase needed to liquefy viscous semen samples in vitro also was determined. The percentage of active spermatozoa and viable cells, and the quality of sperm motility were altered in relationship to the amylase levels. Significant decreases in these parameters compared to control values were seen at the higher concentrations of amylase. The lowest level of amylase did not alter these parameters significantly and was sufficient to liquefy 80 per cent of the viscous semen samples. Amylase appears to be effective at low concentrations for use in liquefying viscous semen samples, thus making them easier to analyze during routine semen examination. The level of amylase used and the interval between addition and analysis must be controlled carefully.

Simultaneous determination of human sperm morphology and viability: simple office technique.

Determinations of sperm morphology and viability are useful techniques for assessment of semen quality. In this report eosin-nigrosin is compared with hematoxylin-eosin for effectiveness in characterizing spermatozoa. The results indicate that eosin-nigrosin and hematoxylineosin give comparable results in differentiating spermatozoa. In addition, eosin-nigrosin allows the determination of the per cent of viable cells in each morphologic category. The eosin-nigrosin staining technique is a simple, rapid method which may give additional information in the assessment of male infertility.

Supravital staining of spermatozoa: relationship of eosin concentration to the percentage of cells staining live.

Supravital staining of human spermatozoa is a useful technique to assess semen quality. We compared 3 concentrations of eosin (1, 2.5 and 5 per cent) for their effectiveness to differentiate viable and non-viable spermatozoa. The percentage of viable cells determined by each concentration was compared as well as the percentage of cells estimated to be active. The results indicate that the percentage of spermatozoa determined to be viable with the supravital stains can be altered by changing the percentage of eosin in the stains. Use of 1 per cent eosin gave values that were significantly higher than the percentage of cells determined to be viable with 5 per cent eosin and the percentage of cells estimated to be active. Better quality slides were produced with 5 per cent eosin, which provided values that correlated favorably with motility estimations.

Age-related changes in male rat reproductive organ weights and plasma testosterone concentrations after administration of a monoamine oxidase inhibitor.

Experiments were conducted to determine the effects of pargyline, a monoamine oxidase inhibitor, onmale rat reproductive organ weights, testicular histology, and plasma testosterone levels. Pargyline was administered to various groups of rats by implanting it, either dissolved or in a powder form, in Silastic tubing capsules. Additional rats were injected with pargyline solutions. The effects of pargyline.appeared to be age-related with younger animals, weighing under 400 gm (less than 100 days of age), showing a decrease in testicular and accessory organ weights and plasma testosterone. Older animals did not show a decrease in organ weights. Testicular histology in the pargyline-treated groups showed sloughage of cellular material into the tubular lumina, decreases in the number of cell layers, and a reduction of the number of mature spermatocytes. Other areas in the same testis were normal, however, and resembled control histology. The results suggest that pargyline can have detrimental effects on testicular function and that the effects may be age-related.

Correlation between follicle stimulating hormone, luteinizing hormone, testosterone and 5-hydroxyindole acetic acid with sperm cell concentration.

Plasma follicle stimulating hormone, luteinizing hormone, testosterone, urinary 5-hydroxyindole acetic acid and 17-ketosteroids were measured in patients seen at an infertility clinic. Plasma follicle stimulating hormone and luteinizing hormone levels, and urinary 5-hydroxyindole acetic acid levels were increased in patients with sperm concentrations less than 10 times 10(6) per ml. The results suggest that in patients with sperm counts less than 10 times 10(6) per ml. there is not only impaired spermatogenesis but also decreased Leydig cell function. Urinary 17-ketosteroid levels were not related to sperm cell concentration.

Vasectomy and vasovasostomy. I. Timing of histologic changes in immature and mature dog testis after vasectomy.

The effects of vasectomy on the development and maintenance of spermatogenesis was studied using immature and mature dog testes. Bilateral vasectomy in immature dogs delayed the development of advanced spermatocytes, spermatids, and spermatozoa for about 3 months postsurgery. Spermatogenesis appeared to be recovered to control levels by 4 months postvasectomy. Spermatogenesis in mature dogs was also altered after bilateral vasectomy. Decreased numbers of advanced spermatocytes as well as maturation arrest was observed by 3 weeks postvasectomy. Seminiferous tubule cell layers quickly decreased to one to three layers as the lumina became occluded with sloughed cells by 3 to 6 weeks postvasectomy. Recovery in terms of the numbers of spermatocytes, spermatids, and spermatozoa was evident by 13 weeks postvasectomy, although occasional dog testes did not recover and appeared to be more sensitive to vasectomy-induced damage. It thus appears that vasectomy temporarily inhibits both the development and maintenance of spermatogenesis in immature as well as mature dog testes. Spermatogenesis does recover but may be maintained at somewhat lower levels after vasectomy. Changes are rapid in onset and take several weeks to be reversed. Some dog testes appear to be more sensitive to the damage and it may be irreversible in these testes.

PIP: Histologic changes in immature and mature dog testis after vasectomy were studied. 8 pairs of male puppies were used in the 1st experiment; 8 had bilateral vasectomies and 8 had sham operations. The development of advanced spermatocytes, spermatids, and spermatozoa was delayed for about 3 months postsurgery. By 4 months postsurgery spermatogenesis appeared to be recovered to control levels. In the 2nd series of experiments 14 adult male dogs were used; 12 had a bilateral vasectomy and 2 were controls. Spermatogenesis was altered after vasectomy; by 3 weeks postvasectomy decreased numbers of advanced spermatocytes as well as maturation arrest were observed. Seminiferous tubule cell layers decreased to 1-3 layers as the lumina were occluded with sloughed cells by 3-6 weeks postvasectomy. By 13 weeks postvasectomy recovery in terms of numbers of spermatocytes, spermatides, and spermatozoa was evident. Some dog testes seemed more sensitive to the damage and did not recover.

Caffeine, theophylline, and human sperm motility.

Concentrations of 10(-2), 10(-3), 10(-4), 10(-5), or 10(-6) M caffeine and theophylline were added to semen samples to determine the effects of these compounds on several parameters of semen quality. Semen samples were incubated at 37 degrees C and observed 0.5,1,2,4, and 6 hours after addition of the respective compounds. Semen quality was determined by estimating the percentage of active spermatozoa, by estimating sperm motility, and by counting the number of viable sperm at each time interval. Neither of the compounds, at any of the dose levels tested, had any significantly different effects on the quality of sperm motility or the percentage of active or viable spermatozoa, although a few samples responded favorably to these compounds. Noted improvements in semen quality did not appear to be dependent on the initial semen quality. The data contradict previous reports and suggest that methyl xanthines do not have beneficial effects on the majority of semen samples obtained from men seen at a fertility evaluation clinic.

Semen analysis: a review of samples from 225 men seen at an infertility clinic.

The results from 225 men attending an infertility clinic are presented. The percentage of oval, viable and active sperm cells, and the motility scores were lower in samples with counts less than 10 times 10(6) per ml., increased in counts or 10 to 40 times 10(6) per ml. and again increased in counts more than 40 times 10(6) per ml. The percentage of semen samples with abnormalities in measured parameters dramatically increased as the sperm count decreased. The percentage of samples with significant numbers of white blood cells was higher in samples with sperm counts less than 10 times 10(6) per ml. and in the azoospermic patients, while viscosity problems seemed to be associated with counts less than 10 times 10(6) per ml. Agglutination was more of a problem in samples with counts more than 40 times 10(6) per ml.

A comparison of subjective measurements of human sperm motility and viability with two live-dead staining techniques.

Two commonly used live-dead stains (eosin-nigrosin (EN) and eosin-opal blue (EOB)) were compared with the estimated active spermatozoa in semen samples from patients attending an infertility service. Twenty-eight semen samples were analyzed throughout the day of their collection by estimating the number of active spermatozoa and by staining a portion of the incubated sample (37 degrees C) with each stain. The samples were analyzed 30, 60, 120, 240, and 360 minutes after the initial collection. At 30 minutes there were no significant differences between the estimated values and those of either stain. The slope of the EN stain closely paralleled that of the estimated measurements throughout the remainder of the time periods, while the EOB slope was somewhat steeper. Repeatability of values for semen samples obtained on different days was generally good for each stain. A comparison of semen samples from 85 patients, 30 minutes after collection, showed no significant differences between the numbers of estimated active sperm and the percentage live using the EN stain. Studies of 132 semen samples using the EN stain showed a positive correlation with the over-all quality of sperm motility. The results indicate that there is a role for live-dead staining in assessing semen quality.

Inhibition of rat spermatogenesis and seminiferous tubule growth after short-term and long-term administration of a monoamine oxidase inhibitor.

Seminiferous tubules from rats killed 24 hours after injection of pargyline, a monoamine oxidase inhibitor, did not grow well in tissue culture when compared to control tubules. Treated tubules showed severe tubular degeneration and loss of cellular detail after nine days in culture. Animals injected with pargyline for ten days had varying degrees of semi-niferous tubule degeneration with depletion of the spermatogenic elements. It is suggested that pargyline has a detrimental effect on spermatogenesis. Pargyline possibly acts by decreasing MAO levels which, in turn, may increase potentially damaging amines which may be responsible for the testicular damage.