RESUMEN
Tramadol, one of the most commonly abused drugs in Middle East, impacts spermatogenesis and disturbs reproductive hormones in animal studies. We aimed to investigate tramadol impact on sperm quality and on levels of testosterone, prolactin and gonadotropins, in tramadol abusers (n = 30) to age-matched control (n = 30). Abusers had significantly low percentages of sperm motility, normal forms and vitality compared with control (95% CI -40.7 to -19.3, -13.5 to -9.3 and -31.9 to -9.7 respectively). Hypoandrogenism (95% CI -4.5 to -2.8), hyperprolactinaemia (CI (95%) 4.9 to 9.4) and hypergonadotropinaemia (95% CI 2.9 to 7.2 for FSH and 2.0 to 7.8 for LH) were observed in tramadol abusers vs controls. Smokers (26 of 30), concurrently abusing other drugs (11 of 30) and asymptomatic leucocytospermic (15 of 30) patients subgroups significantly abused tramadol beyond 3 years (p = .02, <.001, = .03 respectively) and in excess >450 mg/day (p = .02, = .01, = .005 respectively). Progressive motility (a + b%) was significantly low in young men <25 years old (p = .03) subgroup. Tramadol abuse is associated with poor sperm quality, hyperprolactinaemia and hypergonadotropic hypogonadism. We recommend semen analysis for tramadol long-intakes, question sperm donors and follow-up studies to prevent and reverse tramadol-induced testicular damage.
Asunto(s)
Analgésicos Opioides/efectos adversos , Hiperprolactinemia/etiología , Hipogonadismo/etiología , Trastornos Relacionados con Opioides/complicaciones , Motilidad Espermática/efectos de los fármacos , Espermatogénesis/efectos de los fármacos , Testículo/efectos de los fármacos , Tramadol/efectos adversos , Adolescente , Adulto , Gonadotropinas/metabolismo , Humanos , Masculino , Medio Oriente , Prolactina/metabolismo , Análisis de Semen , Fumar/epidemiología , Testosterona/metabolismoRESUMEN
Apreviously reported two-reflection, undeviating-beam total internal reflection (TIR) quarter-wave phase retarder is optimized. The specifications and characteristics of the device are sensitive to the refractive index n of the rhomb material. In particular, the size of the rhomb can be reduced by a factor of 11 for the same aperture size if a glass with n = 1.70 is used instead of one with n = 1.53. Optimal conditions are in the refractive-index interval n = 1.68-1.71. Coated rhombs of this type are mentioned.