Free testosterone and cardiometabolic parameters in men: comparison of algorithms.

OBJECTIVE: Calculating the free testosterone level has gained increasing interest and different indirect algorithms have been suggested. The objective was to compare free androgen index (FAI), free testosterone estimated using the linear binding model (Vermeulen: cFTV) and the binding framework accounting for allosterically coupled SHBG monomers (Zakharov: cFTZ) in relation to cardiometabolic conditions. DESIGN: A prospective cohort study including 5350 men, aged 30-70 years, participating in population-based surveys (MONICA I-III and Inter99) from 1982 to 2001 and followed until December 2012 with baseline and follow-up information on cardiometabolic parameters and vital status. RESULTS: Using age-standardized hormone levels, FAI was higher among men with baseline cardiometabolic conditions, whereas cFTV and cFTZ levels were lower compared to men without these conditions as also seen for total testosterone. Men in highest quartiles of cFTV or cFTZ had lower risk of developing type 2 diabetes (cFTV: HR = 0.74 (0.49-1.10), cFTZ: HR = 0.59 (0.39-0.91)) than men in lowest quartile. In contrast, men with highest levels of FAI had a 74% (1.17-2.59) increased risk of developing type 2 diabetes compared to men in lowest quartile. CONCLUSION: The association of estimated free testosterone and the studied outcomes differ depending on algorithm used. cFTV and cFTZ showed similar associations to baseline and long-term cardiometabolic parameters. In contrast, an empiric ratio, FAI, showed opposite associations to several of the examined parameters and may reflect limited clinical utility.

First flush analysis using a rainfall simulator on a micro catchment in an arid climate.

Urban runoff water from simulated rainfall for three different land uses (residential, industrial, commercial) at six different locations of Doha, Qatar was analysed for physico-chemical parameters such as, trace metals, pH, total suspended solids (TSS), total organic carbon (TOC), total phosphorus (TP), total kjeldahl nitrogen (TKN) and polyaromatic hydrocarbons (PAHs). Rainfall events with two different intensities (40 mm/h and 20 mm/h) were simulated in a micro catchment area (4.55 × 4.55 m2) using a specially designed portable rainfall simulator. Out of six sites, runoff samples were collected from five sites with paved surfaces. The study results demonstrated significant concentration of TSS, Cu, Fe, Mn and Zn in the urban runoff exceeding the Qatar Ministry of Municipality and Environment (MME) and Tropical Australian Standards. The first flush effect was also investigated during the experiment which exhibited first flush effect of selected pollutants (TSS, TKN, TP, TOC and heavy metals) at five study sites with impervious surfaces. The magnitude of the first flush varies across the study sites and was found to be affected by the surface texture of the sites. Analysis of variance revealed that, rainfall intensity has limited effect on the first flush in the studied scenarios, however, first flush effects showed relation with the event mean runoff concentration. Furthermore, strong positive correlations were observed between analysed water quality parameters, particularly between TSS, TOC and metals. This study is the first study investigating first flush in Qatar's capital, Doha which will provide a ground for future researcher to design appropriate stormwater treatment devices that will capture and treat the first flush for significant reduction of urban stormwater pollution.

Clinical, genetic, biochemical, and testicular biopsy findings among 1,213 men evaluated for infertility.

OBJECTIVE: To study the pathologic findings among men evaluated for infertility. DESIGN: A retrospective, single-center, cross-sectional study. SETTING: University hospital-based research center. PARTICIPANT(S): We included data from 1,213 medical records from infertile men referred for diagnostic work-up from 2005 to 2009. INTERVENTIONS(S): None. MAIN OUTCOME MEASURE(S): Health history, clinical findings, chromosome/genetic aberrations, semen quality, reproductive hormones. RESULT(S): In total, 64.4% of the infertile men had one or more reproductive disorders or factors influencing fertility, leaving 35.6% diagnosed as idiopathic infertile. In 244 patients (20%), including seven cases of testicular cancer and/or germ cell neoplasia in situ, a pathologic finding was first detected during diagnostic work-up. Two hundred four patients (16.8%) had a history of cryptorchidism and 154 (12.7%) of varicocele (grade 2 and 3). Thirty-three patients had chromosomal abnormalities, including 16 with sex chromosome abnormalities (11 with 47,XXY). Y-chromosome microdeletions were detected in 65 patients (5.4%). One hundred thirty-three had azoospermia, of which 58 had testicular biopsy findings (Sertoli cell-only syndrome: n = 23; spermatogenic arrest: n = 7; impaired spermatogenesis and atrophy: n = 28). Additionally, in idiopathic infertile men and infertile men with additional symptoms of testicular dysgenesis syndrome, 22.5% presented with a degree of Leydig cell insufficiency, with the highest frequency (33.1%) among patients with sperm concentration <5 million/mL. CONCLUSION(S): We report pathologic findings that could explain the male-factor infertility in two-thirds of infertile men referred to our center. Thus, male infertility may be a sign of an underlying disease that warrants attention.