Prevalence of Ureaplasma urealyticum and Mycoplasma hominis infection in unselected infertile men.

In this study, we investigated the prevalence of Ureaplasma urealyticum and Mycoplasma hominis infection among 250 unselected infertile men, the presence of urogenital symptoms in infected men and the effects of these microorganisms on the conventional sperm parameters. Urethral samples were obtained using a swab inserted 3-4 cm into the urethral meatus. Ureaplasma urealyticum and Mycoplasma hominis were detected by the kit Mycofast R evolution 3 Elitech Microbiology (Elitech Microbiology, Signes, France). Ureaplasma urealyticum was detected in 15.6% of the cases and Mycoplasma hominis in 3.6%. One patients had a co-infection with both pathogens. About 41% of the infertile patients with mycoplasma infection had urogenital symptoms. A lower number of patients with mycoplasma infection had normal sperm parameters compared with non-infected infertile men, but this frequency showed only a trend compared to non-infected patients (Chi-square=3.61; P=0.057), and a significantly higher percentage of patients with oligo-astheno-teratozoospermia (Chi-square=127.3; P<0.0001), or asthenozoospermia alone (Chi-square=5.74; P<0.05) compared to non-infected infertile patients. In conclusion, this study showed an elevated prevalence of Ureaplasma urealyticum and Mycoplasma hominis infection in unselected men attending an infertility outpatient clinic and that the presence of these microorganisms is associated with a higher percentage of patients with abnormal sperm parameters.

Involvement of PKCα-MAPK/ERK-phospholipase A(2) pathway in the Escherichia coli invasion of brain microvascular endothelial cells.

Escherichia coli K1 is the most common Gram-negative organism that causes neonatal meningitis following penetration of the blood-brain barrier. In the present study we demonstrated the involvement of cytosolic (cPLA(2)) and calcium-independent phospholipase A(2) (iPLA(2)) and the contribution of cyclooxygenase-2 products in E. coli invasion of microvascular endothelial cells. The traversal of bacteria did not determine trans-endothelial electrical resistance (TEER) and ZO-1 expression changes and was reduced by PLA(2)s siRNA. cPLA(2) and iPLA(2) enzyme activities and cPLA(2) phosphorylation were stimulated after E. coli incubation and were attenuated by PLA(2), PI3-K, ERK 1/2 inhibitors. Our results demonstrate the role of PKCα/ERK/MAPK signaling pathways in governing the E. coli penetration into the brain.

Self-terminated ventricular fibrillation and recurrent syncope.

Ventricular fibrillation (VF) is a lethal arrhythmia that requires immediate cardioversion and is rarely self-terminating. Spontaneous termination is typically associated with more organized activation than sustained VF terminated by shock, but the precise mechanism is unclear. In the present case, we describe a patient with recurrent syncope and documented self-terminating VF, who ultimately underwent implantable cardioverter defibrillator insertion. Assessment of the rhythm strip revealed organization of a chaotic rhythm into monomorphic ventricular tachycardia before termination, in supportive of previous reports. In conclusion, self-terminating VF is a very rare condition that can cause syncope.

Chlamydia trachomatis prevalence in unselected infertile couples.

Chlamydia (C.) trachomatis, an obligate intracellular bacterium, is responsible for the most common sexual transmitted disease and infertility. The purpose of this study was to evaluate: a) the frequency of chlamydial infection in unselected infertile couples and b) whether chlamydial infection could be identified in the semen sample as effectively as in the urethral swab of infertile patients. To accomplish this, 73 unselected, consecutive infertile couples were enrolled. Both male and female partners underwent a complete work-up to identify the cause of their infertility. A PCR method was used to detect C. trachomatis in urethral swabs and the semen samples of the male partners and in the cervical swabs of the female partners. C. trachomatis infection was found in 6 couples (8.2%). Three couples had both partners infected, 2 couples had only the male partner infected, and 1 only the female partner. C. trachomatis infection was found in the urethral swab of all 5 men infected, whereas the bacterial DNA was found in the semen sample of 2 of them. These findings suggest that C. trachomatis infection is present in about 8% of unselected infertile couples and that the bacterium should be searched in the male partner urethral swab which has a higher sensitivity.

Cardiovascular magnetic resonance imaging for valvular heart disease.

Valvular heart disease (VHD) is a clinically important diagnosis, with significant associated morbidity and mortality. Multiple imaging modalities exist to characterize valvular and associated cardiac anatomy. Cardiovascular magnetic resonance (CMR) has emerged as a comprehensive noninvasive imaging modality for VHD. With use of well-established, standardized imaging sequences, CMR can accurately and precisely diagnose valvular structural abnormalities, assess severity of regurgitant and stenotic lesions, and potentially define patient prognosis. This article reviews the clinical applications of CMR in assessment of VHD.

Association of atrial fibrillation and amino-terminal pro-brain natriuretic peptide concentrations in dyspneic subjects with and without acute heart failure: results from the ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) study.

BACKGROUND: Amino-terminal pro-brain natriuretic peptide (NT-proBNP) testing is useful for diagnosis or exclusion of heart failure (HF) in dyspneic patients. Atrial fibrillation (AF) may cause dyspnea in the absence of acute HF and may also affect plasma levels of NT-proBNP. METHODS: We prospectively enrolled 599 patients presenting with dyspnea to the emergency department and obtained a blood sample for NT-proBNP measurement. The diagnosis of AF was identified via presentation electrocardiogram. A final diagnosis of HF was determined by blinded study physicians using all available hospital records for each subject through 60 days of follow-up. We assessed the association between the presence of AF and level of NT-proBNP in subsets of patients with and without HF. RESULTS: Of 599 dyspneic patients, 75 (13%) were in AF at presentation; these patients had significantly higher median NT-proBNP levels when compared with those without AF (2934 vs 294 pg/mL, P < .0001). Among patients with acute HF, AF was present in 28%; NT-proBNP levels were lower in those with AF versus those without (3488 vs 4492 pg/mL, P < .001), but AF was not independently associated with NT-proBNP after multivariable adjustment. In patients without acute HF, median NT-proBNP concentrations were significantly higher in those with AF than in those without (932 vs 121 pg/mL, P = .02); in these subjects, AF was the strongest predictor of an NT-proBNP concentration in a range consistent with acute HF (odds ratio 9.94, 95% CI 2.97-33.3, P < .001). CONCLUSION: Atrial fibrillation is associated with higher NT-proBNP concentrations in dyspneic patients, particularly in those without acute HF.

Amino-terminal pro-brain natriuretic peptide: a biomarker for diagnosis, prognosis and management of heart failure.

There is a substantial need for a diagnostic tool to aid in the early diagnosis of heart failure and in the recognition of those at risk for its development, as well as in guidance of therapy. Testing for amino-terminal pro-brain natriuretic peptide (NT-proBNP) has been recognized to have utility in the diagnosis, prognosis and management of heart failure. In addition, numerous other applications for NT-proBNP testing are now recognized, such as evaluation of patients with heart disease in the absence of heart failure, as well as the diagnostic and prognostic evaluation of patients with acute coronary syndromes or pulmonary thromboembolism.

Experimental Chlamydia trachomatis infection causes apoptosis in human sperm.

BACKGROUND: Chlamydia trachomatis is responsible for a widespread sexually transmitted infection. In men, it is associated with a wide clinical spectrum causing infertility. Furthermore, C. trachomatis serovar E infection decreases motility and increases the number of non-viable sperm. No other effects of C. trachomatis have been reported on sperm despite the crucial role of DNA integrity for sperm function. The aim of this study was to investigate the effects of C. trachomatis on sperm apoptosis. METHODS: Sperm from eight normozoospermic men were incubated with increasing concentrations of C. trachomatis serovar E elementary bodies (EB) for 6 and 24 h. Sperm were then collected to evaluate phosphatidylserine (PS) membrane translocation and DNA fragmentation by Annexin V-propidium iodide staining, TUNEL assay and flow cytometry. RESULTS: After 6 h of incubation, C. trachomatis had no effect on the percentage of sperm showing PS externalization. However, a significant effect on this parameter was observed after 24 h. C. trachomatis also significantly increased the number of sperm with DNA fragmentation both after 6 and 24 h of incubation. CONCLUSIONS: C. trachomatis causes sperm PS externalization and DNA fragmentation. These effects may explain the negative direct impact of C. trachomatis infection on sperm fertilizing ability.