Understanding the Male Perspective: Evaluating Quality of Life and Psychological Distress in Serbian Men Undergoing Infertility Treatment.

The experience of an infertility diagnosis and treatment imposes a profound burden on affected individuals, encompassing not only physical and medical aspects but also a plethora of psychological, social, and emotional factors. By employing a multimodal assessment featuring validated self-report questionnaires, physical measurements, and clinical records, the present study aimed to explore the quality of life and psycho-emotional distress of men undergoing infertility treatment in Serbia, thereby addressing the dearth of research on the underrepresented male perspective in this domain. Findings revealed diverse semen abnormalities among participants (n = 96, average age 37.69 ± 5.72), with significant associations between longer treatment durations and reduced sperm motility. The observed rates of men surpassing predetermined DASS-42 questionnaire thresholds for depression, anxiety, and stress in the analyzed cohort were 13.54%, 11.46%, and 22.92%, respectively. Summary scores in conceptual areas comprised in the SF-36 questionnaire ranged from 49.00 ± 6.25 for the mental health dimension to 90.16 ± 17.75 obtained in the physical functioning subscale. Patients with a longer treatment duration demonstrated lower scores in the role emotional domain, indicative of a less favorable emotional state. Expectedly, inverse correlations were found between the SF-36 mental health score and DASS-42 subscales. By addressing the existing knowledge gap and highlighting the unique needs of infertile men, the finding of this study may contribute to a more inclusive and holistic approach to infertility research and management.

Cadmium and lead implication in testis cancer; is there a connection?

Testis cancer (TC) is the most common malignancy of young men. Current evidence from studies, alongside genetics and hormonal status, suggests a significant role of toxic metals, cadmium (Cd) and lead (Pb), in the origin and development of TC. Besides oxidative stress and endocrine disruption, interaction with bioelements is one of the critical mechanisms of Cd and Pb toxicity and malign transformation. This study aimed to investigate metal levels in blood, healthy, and tumor testis tissue and to reveal hormone, oxidative status, and bioelements levels in patients with TC. The study enrolled 52 patients with TC and 61 healthy volunteers. Toxic metals and bioelements levels were analyzed by atomic absorption spectrophotometry (AAS) while electrochemiluminescence immunoassay (ECLIA) and spectrophotometry methods were used for hormone and oxidative parameters evaluation. Significantly higher blood Cd levels were depicted in TC cohort. Furthermore, blood Cd elevation was associated with a 1.98 higher probability of TC developing. However, a metal concentration between healthy and tumor testis tissue did not differ significantly. Lower levels of estradiol and testosterone, established in a cohort of TC patients, followed the significant role of hormones in TC development. At the same time, ischemia-modified albumin (IMA) has been recognized as a parameter with very good accuracy as a potential diagnostic marker for TC. The study revealed different distribution patterns of copper (Cu) and zinc (Zn) in the three compartments of the patients, as well significant correlation between essential metals Cu/Zn and toxic metals Cd/Pb indicating metal-metal interactions as pivotal mechanisms of metals toxicity.

Neurological and electroneurography findings in patients with systemic sclerosis and symptoms of neuropathic pain in extremities.

OBJECTIVE: To analyze neurological and electroneurography (ENG) findings in patients with systemic sclerosis (SSc) and symptoms of neuropathic pain in upper and lower extremities. PATIENTS AND METHODS: Using the PainDetect questionnaire, 42 consecutive patients with SSc (38 women and 4 men) were screened for the presence of neuropathic pain in upper and/or lower extremities. Patients with previously diagnosed diabetes or other metabolic diseases, malignancy, other autoimmune disorders, or any neurological or psychiatric disease, were not included. Neurological examination, ENG, and laboratory analyses (glycated hemoglobin-HbA1C, and vitamin B12) were performed in SSc patients with neuropathic pain in extremities. Methods of descriptive statistics were used to summarize the data. RESULTS: Eleven patients (26.2%) had significant symptoms of neuropathic pain in extremities. Neurological examination indicated polyneuropathy in 10/11 (90.9%) of patients. Symmetrical hyperesthesia in the lower and/or upper extremities was found in ten patients. Symmetrical hyporeflexia was found in 7/11 (63.6%) of patients in the arms, and 6/11 (54.4%) of patients in the legs. Proprioception was diminished in 3/11 (27.3%), whilst pallhypesthesia was present in all patients. However, polyneuropathy could be confirmed by ENG only in four out of ten SSc patients, who had typical neurological findings for polyneuropathy. Hypoesthesia in a specific lumbar root dermatome, suggesting radiculopathy, was found in 6/11 (54.5%) of patients. Asymmetrical hyporeflexia was noticed in 2/11 (18.1%) of patients in the lower limbs. Seven patients (63.6%) had signs of radiculopathy in at least one root dermatome on ENG. CONCLUSION: A significant number of SSc patients with neuropathic pain in the upper and/or lower extremities have symptoms and signs of polyneuropathy undetectable by ENG, which indirectly suggests the presence of small-fiber polyneuropathy in these patients. In some patients, radiculopathy cannot be excluded as possible co-morbid non-scleroderma condition associated with neuropathic pain.

Common Causes of Pain in Systemic Sclerosis: Frequency, Severity, and Relationship to Disease Status, Depression, and Quality of Life.

BACKGROUND: In routine clinical practice, healthcare professionals draw little attention to pain in patients with systemic sclerosis (SSc). Pain has adverse effects on functional ability, social and emotional wellbeing. AIMS: This study aims to assess the frequency and severity of different types of pain in patients with SSc, and the relationship of pain with disease status, depression and quality of life. DESIGN: Consecutive patients with SSc were included in this cross-sectional study. Patients with previously diagnosed painful diseases or conditions (other rheumatic diseases, angina pectoris, neurological disorders, etc.) were excluded. SETTINGS: Patients, who visited our rheumatology outpatient clinic from February to November 2016, participated in this study. PARTICIPANTS/SUBJECTS: 42 consecutive patients with SSc (38 women and 4 men), mean age 56.5 years, mean disease duration 9.5 years, were included. METHODS: All patients filled in a questionnaire, to indicate the presence or absence of some predefined pain syndromes. Disease status was assessed using the Scleroderma Assessment Questionnaire (SAQ), symptoms of depression by the Beck's Depression Inventory (BDI), whilst the quality of life was evaluated using the EuroQol questionnaire. RESULTS: It was found that 92.9% of SSc patients suffer from different types of pain, and 45.2% of patients have pain every day. Joint pain was the most common type of pain, present in 78.6% of patients, followed by pain associated with Raynaud's phenomenon (69%), back pain (47.6%), headache (31%), chest pain (23.8%), odynophagia (21.4%) and painful digital ulcers (19%). Symptoms of neuropathic pain were noticed in 26.2% of patients. Severe joint pain, everyday pain and symptoms of neuropathic pain in SSc were associated with more severe disease and poorer quality of life. Pain related to Raynaud's phenomenon, digital ulcers, odynophagia and joint pain were associated with significant symptoms of depression. CONCLUSION: The majority of patients with SSc suffer from different types of pain. Pain is associated with more severe disease, depression and poor quality of life.

Procalcitonin and Other Biomarkers of Sepsis in Newborns in the Intensive Care Unit.

Neonatal sepsis is one of the most significant causes of mortality and morbidity in infants. Among numerous parameters available to confirm the presence of sepsis in newborns procalcitonin (PCT) has been chosen. The aim of this study was the determination of PCT, C-reactive protein (CRP) serum amyloid A (SAA), plasminogen, protein C, antithrombin III (AT III) and white blood cell count (WBC) in blood sample obtained by puncture of the umbilical vein. Sixty two newborn infants were included in the study: 31 with suspected bacterial infection and 31 healthy babies Serum procalcitonin was measured using Kryptor analyzer (Brahms Aktiengesellschaft, Germany); serum hsCRP and SAA on the Behring Nephelometer II (Dade Behring Diagnostics GmbH, Marburg, Germany); plasma plasminogen, protein C and AT III on BCT Coagulation system, (Dade Behring Diagnostics GmbH, Marburg, Germany); and WBC count was determined in the whole blood using hematological analyzer ADVIA 120 Hematology System (Bayer, Germany). The obtained mean values of PCT, hsCRP, SAA, WBC, plasminogen, AT III, protein C in newborn's samples with suspected bacterial infection/healthy newborns were: 0.188 ng/L / 0.121 ng/L; 1.20 mg/L / 1.30 mg/L, 1.28% / 1.70%; 16.0 x 10(9)/L/12.0 x 10(9) / L, 61.0% / 59.0%, 52.0% / 64.5%, 39.0% / 41.0%, respectively. Neonates with bacterial infection had significantly higher values of PCT (p <0.001), WBC (p <0.001) and CRP (p <0.05) compared to healthy babies. Based on these results, it may be concluded that procalcitonin is useful for early diagnosis of sepsis in newborns.