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1.
Phytopathology ; 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38602688

RESUMO

The unculturable bacterium 'Candidatus Liberibacter solanacearum' (CLso) is responsible for a growing number of emerging crop diseases. However, we know little about the diversity and ecology of CLso and its psyllid vectors outside of agricultural systems, which limits our ability to manage crop disease and understand the impacts this pathogen may have on wild plants in natural ecosystems. In North America, CLso is transmitted to crops by the native potato psyllid (Bactericera cockerelli). But the geographic and host plant range of the potato psyllid and CLso beyond the borders of agriculture are not well understood. A recent study of historic herbarium specimens revealed that a unique haplotype of CLso was present infecting populations of the native perennial Solanum umbelliferum in California decades before CLso was first detected in crops. We hypothesized that this haplotype, and other potentially novel CLso variants, are still present in S. umbelliferum populations. To test this, we surveyed populations of S. umbelliferum in Southern California for CLso and potato psyllid vectors. We found multiple haplotypes of CLso and the potato psyllid associated with these populations, with none of these genetic variants having been previously reported in California crops. These results suggest that CLso and its psyllid vectors are much more widespread and diverse in North American natural plant communities than suggested by data collected solely from crops and weeds in agricultural fields. Further characterization of these apparently asymptomatic haplotypes will facilitate comparison with disease-causing variants and provide insights into the continued emergence and spread of CLso.

2.
Vet Rec ; 194(5): e3796, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38321362

RESUMO

BACKGROUND: Readability of client communications is a commonly overlooked topic in veterinary medical education. In human medicine, it has been advised that the readability of patient materials should be at USA schooling sixth-grade level or below. We hypothesised that student written discharge instructions would be of an inappropriate readability level, and discharges scored with higher reading grade levels would be associated with more complications. METHODS: The cohort comprised 149 dogs and cats presenting for sterilisation. The readability of discharge instructions was assessed using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) formulas. Records were examined for evidence of postoperative complications. RESULTS: The mean FRE score of the discharge instructions was 61.97, with 30.87% being classified as 'difficult' or 'fairly difficult', 60.4% as 'standard' and 8.72% as 'fairly easy'. The mean FKGL was 8.64, with 98% being above reading level 6. Overall, there was an association between FKGL and complication occurrence (p = 0.005). Stratification by species demonstrated FRE and FKGL to be associated with complication occurrence in dogs (FRE score, p = 0.038; FKGL, p = 0.002), but not cats (FRE score, p = 0.964; FKGL, p = 0.679). LIMITATIONS: Due to the retrospective nature of the study, there were difficulties associated with extracting relevant complication information from the medical records. CONCLUSION: Only 2% of owner-directed discharge instructions were written at readability levels aligning with the recommendations set forth in the human guidelines.


Assuntos
Doenças do Gato , Doenças do Cão , Humanos , Animais , Gatos , Cães , Doenças do Gato/cirurgia , Compreensão , Doenças do Cão/cirurgia , Alta do Paciente , Animais de Estimação , Estudos Retrospectivos , Esterilização
3.
JFMS Open Rep ; 10(1): 20551169231216405, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38304753

RESUMO

Case summary: A 4-year-old female spayed domestic shorthair cat with chronic anemia was evaluated for acute-onset lethargy, vomiting, abdominal distension, and a palpably enlarged and firm spleen. Abdominal ultrasound confirmed marked splenomegaly and concern for a splenic infarct, prompting exploratory abdominal surgery, where splenic torsion was diagnosed. A splenectomy was performed, and the cat recovered uneventfully. Splenitis was diagnosed on histopathology. Anemia improved postoperatively. The role of chronic anemia and other concurrent findings in the development of splenic torsion in this case remains unknown. Relevance and novel information: Splenic torsion has not been previously reported in cats, making this the first case of its kind. In cases of splenomegaly and abnormal splenic blood flow, splenic torsion should be considered a differential diagnosis in cats.

4.
Vet Sci ; 11(1)2024 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-38275934

RESUMO

FISH techniques have been applied for the visualization and identification of intracellular bacteria in companion animal species. Most frequently, these techniques have focused on the identification of adhesive-invasive Escherichia coli in gastrointestinal disease, although various other organisms have been identified in inflammatory or neoplastic gastrointestinal disease. Previous studies have investigated a potential role of Helicobacter spp. in inflammatory gastrointestinal and hepatic conditions. Other studies evaluating the role of infectious organisms in hepatopathies have received some attention with mixed results. FISH techniques using both eubacterial and species-specific probes have been applied in inflammatory cardiovascular, urinary, and cutaneous diseases to screen for intracellular bacteria. This review summarizes the results of these studies.

5.
Microbiol Spectr ; 12(1): e0116723, 2024 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-38038456

RESUMO

IMPORTANCE: Antilisterial LAB strains have been proposed as biological control agents for application in food processing environments. However, the effect of resident food processing environment microbiota on the performance on antilisterial LAB strains is poorly understood. Our study shows that the presence of microbiota collected from ice cream processing facilities' environmental surfaces can affect the attachment and inhibitory effect of LAB strains against L. monocytogenes. Further studies are therefore needed to assess whether individual microbial taxa affect antilisterial properties of LAB strains and to characterize the underlying mechanisms.


Assuntos
Sorvetes , Lactobacillales , Listeria monocytogenes , Microbiota , Manipulação de Alimentos , Microbiologia de Alimentos
7.
Annu Rev Entomol ; 69: 277-302, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-37738463

RESUMO

Psyllids constitute a diverse group of sap-feeding Sternorrhyncha that were relatively obscure until it was discovered that a handful of species transmit bacterial plant pathogens. Yet the superfamily Psylloidea is much richer than the sum of its crop-associated vectors, with over 4,000 described species exhibiting diverse life histories and host exploitation strategies. A growing body of research is uncovering fascinating insights into psyllid evolution, biology, behavior, and species interactions. This work has revealed commonalities and differences with better-studied Sternorrhyncha, as well as unique evolutionary patterns of lineage divergence and host use. We are also learning how psyllid evolution and foraging ecology underlie life history traits and the roles of psyllids in communities. At finer scales, we are untangling the web of symbionts across the psyllid family tree, linking symbiont and psyllid lineages, and revealing mechanisms underlying reciprocal exchange between symbiont and host. In this review, we synthesize and summarize key advances within these areas with a focus on free-living (nongalling) Psylloidea.


Assuntos
Hemípteros , Traços de História de Vida , Animais , Hemípteros/microbiologia , Filogenia , Bactérias , Biologia
8.
Phytopathology ; 113(9): 1620-1621, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37924846

RESUMO

Plant viruses are an ever-present threat to agricultural production and provide a wide array of symptoms resulting in economic losses throughout the world. Diseases can be transmitted by insect vectors, as well as through pollen, seed, and other means. With the increased globalization of agriculture, the introduction of new viruses from exotic locations and their establishment in new production regions and even new crops is a growing concern. Advancing knowledge of the epidemiology of plant viruses including development of new diagnostic methods, virus surveillance, and modeling, virus ecology and evolution, virus interactions with insect vectors, and other factors are important toward reducing the spread of plant viruses and managing virus diseases.


Assuntos
Doenças das Plantas , Vírus de Plantas , Produtos Agrícolas , Clima , Mudança Climática
9.
APL Bioeng ; 7(4): 046108, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37915752

RESUMO

Stiffened arteries are a pathology of atherosclerosis, hypertension, and coronary artery disease and a key risk factor for cardiovascular disease events. The increased stiffness of arteries triggers a phenotypic switch, hypermigration, and hyperproliferation of vascular smooth muscle cells (VSMCs), leading to neointimal hyperplasia and accelerated neointima formation. However, the mechanism underlying this trigger remains unknown. Our analyses of whole-transcriptome microarray data from mouse VSMCs cultured on stiff hydrogels simulating arterial pathology identified 623 genes that were significantly and differentially expressed (360 upregulated and 263 downregulated) relative to expression in VSMCs cultured on soft hydrogels. Functional enrichment and gene network analyses revealed that these stiffness-sensitive genes are linked to cell cycle progression and proliferation. Importantly, we found that survivin, an inhibitor of apoptosis protein, mediates stiffness-dependent cell cycle progression and proliferation as determined by gene network and pathway analyses, RT-qPCR, immunoblotting, and cell proliferation assays. Furthermore, we found that inhibition of cell cycle progression did not reduce survivin expression, suggesting that survivin functions as an upstream regulator of cell cycle progression and proliferation in response to ECM stiffness. Mechanistically, we found that the stiffness signal is mechanotransduced via the FAK-E2F1 signaling axis to regulate survivin expression, establishing a regulatory pathway for how the stiffness of the cellular microenvironment affects VSMC behaviors. Overall, our findings indicate that survivin is necessary for VSMC cycling and proliferation and plays a role in regulating stiffness-responsive phenotypes.

10.
Ophthalmol Sci ; 3(4): 100391, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38025162

RESUMO

Purpose: Evaluate the degree of concept coverage of the general eye examination in one widely used electronic health record (EHR) system using the Observational Health Data Sciences and Informatics Observational Medical Outcomes Partnership (OMOP) common data model (CDM). Design: Study of data elements. Participants: Not applicable. Methods: Data elements (field names and predefined entry values) from the general eye examination in the Epic foundation system were mapped to OMOP concepts and analyzed. Each mapping was given a Health Level 7 equivalence designation-equal when the OMOP concept had the same meaning as the source EHR concept, wider when it was missing information, narrower when it was overly specific, and unmatched when there was no match. Initial mappings were reviewed by 2 graders. Intergrader agreement for equivalence designation was calculated using Cohen's kappa. Agreement on the mapped OMOP concept was calculated as a percentage of total mappable concepts. Discrepancies were discussed and a final consensus created. Quantitative analysis was performed on wider and unmatched concepts. Main Outcome Measures: Gaps in OMOP concept coverage of EHR elements and intergrader agreement of mapped OMOP concepts. Results: A total of 698 data elements (210 fields, 488 values) from the EHR were analyzed. The intergrader kappa on the equivalence designation was 0.88 (standard error 0.03, P < 0.001). There was a 96% agreement on the mapped OMOP concept. In the final consensus mapping, 25% (1% fields, 31% values) of the EHR to OMOP concept mappings were considered equal, 50% (27% fields, 60% values) wider, 4% (8% fields, 2% values) narrower, and 21% (52% fields, 8% values) unmatched. Of the wider mapped elements, 46% were missing the laterality specification, 24% had other missing attributes, and 30% had both issues. Wider and unmatched EHR elements could be found in all areas of the general eye examination. Conclusions: Most data elements in the general eye examination could not be represented precisely using the OMOP CDM. Our work suggests multiple ways to improve the incorporation of important ophthalmology concepts in OMOP, including adding laterality to existing concepts. There exists a strong need to improve the coverage of ophthalmic concepts in source vocabularies so that the OMOP CDM can better accommodate vision research. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

11.
Waste Manag ; 171: 411-420, 2023 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-37783136

RESUMO

Digestion of waste feedstocks by larvae of the black soldier fly Hermetia illucens (Diptera: Stratiomyidae) (BSF) results in proteins for animal feed and organic fertilizer with a reduced environmental footprint, but it can still have negative environmental effects through greenhouse gas (GHG) and ammonia (NH3) emissions. Both biomass conversion by BSF larvae and associated GHG and NH3 emissions can depend on substrate properties that may be optimized through microbial inoculation pre-treatments, such as bokashi fermentation. Here, we quantified the effects of bokashi fermentation of brewery's spent grains on BSF rearing metrics and associated GHG and NH3 emissions at benchtop scale. We found that bokashi fermentation increased larval biomass by 40% and shortened development time by over two days on average, compared with unfermented spent grains. In line with increased larval growth, CO2 emissions in BSF larvae treatments were 31.0 and 79.0% higher in the bokashi fermented spent grains and Gainesville substrates, respectively, compared to the unfermented spent grains. Adding BSF larvae to the spent grains increased cumulative N2O emissions up to 64.0 mg N2O kg substratedry-1 but there were essentially no N2O emissions when larvae were added to fermented spent grains. Bokashi fermentation also reduced NH3 fluxes from the volatilization of substrate nitrogen in the BSF larvae treatment by 83.7-85.8% during days 7 and 9, possibly by increasing N assimilation by larvae or by reducing the transformation of substrate NH4+ to NH3. Therefore, bokashi fermentation may be applied to improve performance of BSF larvae on a common industrial waste stream and reduce associated emissions.

12.
Clin Biomech (Bristol, Avon) ; 110: 106105, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37778085

RESUMO

BACKGROUND: People with knee osteoarthritis walk with excessive muscle co-contraction that can accelerate disease progression. Central pain sensitization is common in people with knee osteoarthritis and may be related to walking patterns. The objective of this study was to examine the relation of central pain sensitization with muscle co-contraction during walking in people with knee osteoarthritis. METHODS: This study reports secondary analysis from baseline data of two clinical trials (n = 90 participants with knee osteoarthritis). The presence of central pain sensitization was measured by mechanical temporal summation at the patella and the wrist. Quadriceps and hamstrings activation was assessed using surface electromyography during walking at self-selected and fast paces. Muscle co-contraction indices for vastus medialis-medial hamstrings and vastus lateralis-lateral hamstrings muscle pairs were calculated during stance phases. Co-contraction outcomes were compared between people with and without mechanical temporal summation at each site, adjusting for age, sex, and body mass index. FINDINGS: People with mechanical temporal summation at the knee had greater vastus lateralis-lateral hamstrings co-contraction while walking at a fast pace (P = 0.04). None of the other differences was statistically significant, but the overall trends and effect sizes indicated greater co-contraction in people with temporal summation at the knee irrespective of gait phase, walking speed, or muscle pairs. INTERPRETATION: Central pain sensitization, assessed as mechanical temporal summation at the knee, is related to greater knee muscle co-contraction during fast walking in people with knee osteoarthritis. Thus, mitigating central sensitization may be an interventional target to reduce muscle co-contraction for people with knee osteoarthritis.


Assuntos
Osteoartrite do Joelho , Humanos , Fenômenos Biomecânicos , Eletromiografia , Marcha/fisiologia , Articulação do Joelho/fisiologia , Músculo Esquelético/fisiologia , Osteoartrite do Joelho/complicações , Dor , Caminhada/fisiologia , Masculino , Feminino
13.
JFMS Open Rep ; 9(2): 20551169231199451, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37841898

RESUMO

Case summary: A 6-year-old female Siamese cat presented with an 8-week history of vomiting and progressive hyporexia. On presentation, the cat was found to have a hypochloremic alkalosis. Imaging demonstrated hiatal hernia and megaesophagus. Exploratory laparotomy demonstrated a paraesophageal hiatal hernia. The hernia was reduced, phrenoplasty and esophagopexy were performed, and a gastrotomy tube was placed. Treatment of the hernia led to resolution of the megaesophagus. Relevance and novel information: Megaesophagus can occur secondarily to paraesophageal hernia in the cat. In this case, correction of the paraesophageal hernia led to complete resolution of the esophageal dilation and all associated clinical signs.

14.
JCO Oncol Pract ; 19(11): 1069-1079, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37733980

RESUMO

PURPOSE: Germline genetic testing (GT) is recommended for men with prostate cancer (PC), but testing through traditional models is limited. The ProGen study examined a novel model aimed at providing access to GT while promoting education and informed consent. METHODS: Men with potentially lethal PC (metastatic, localized with a Gleason score of ≥8, persistent prostate-specific antigen after local therapy), diagnosis age ≤55 years, previous malignancy, and family history suggestive of a pathogenic variant (PV) and/or at oncologist's discretion were randomly assigned 3:1 to video education (VE) or in-person genetic counseling (GC). Participants had 67 genes analyzed (Ambry), with results disclosed via telephone by a genetic counselor. Outcomes included GT consent, GT completion, PV prevalence, and survey measures of satisfaction, psychological impact, genetics knowledge, and family communication. Two-sided Fisher's exact tests were used for between-arm comparisons. RESULTS: Over a 2-year period, 662 participants at three sites were randomly assigned and pretest VE (n = 498) or GC (n = 164) was completed by 604 participants (VE, 93.1%; GC, 88.8%), of whom 596 participants (VE, 98.9%; GC, 97.9%) consented to GT and 591 participants completed GT (VE, 99.3%; GC, 98.6%). These differences were not statistically significant although subtle differences in satisfaction and psychological impact were. Notably, 84 PVs were identified in 78 participants (13.2%), with BRCA1/2 PV comprising 32% of participants with a positive result (BRCA2 n = 21, BRCA1 n = 4). CONCLUSION: Both VE and traditional GC yielded high GT uptake without significant differences in outcome measures of completion, GT uptake, genetics knowledge, and family communication. The increased demand for GT with limited genetics resources supports consideration of pretest VE for patients with PC.


Assuntos
Aconselhamento Genético , Neoplasias da Próstata , Humanos , Masculino , Pessoa de Meia-Idade , Proteína BRCA1/genética , Proteína BRCA2/genética , Estrogênios Conjugados (USP) , Aconselhamento Genético/métodos , Aconselhamento Genético/psicologia , Neoplasias da Próstata/genética , Neoplasias da Próstata/terapia
15.
Environ Entomol ; 52(5): 900-906, 2023 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-37656634

RESUMO

Aphids (Hemiptera: Aphididae) extract nutrients from host plant phloem via stylets that facilitate salivation and sap uptake. When navigating to the phloem, aphids periodically puncture nonvascular cells and sample cell contents, but rarely cause significant cell damage. As a result, aphids are considered "stealthy" feeders. In contrast, insects that do cause damage, such as chewing herbivores, will take up host cell contents-including DNA-into their guts. Researchers can use molecular barcoding methods to identify recent host use patterns of chewing herbivores. This information is valuable for both pest management and basic ecological studies. Because of their stealthy feeding style, it was assumed that host plant DNA could not be recovered from aphids and other Sternorrhyncha. However, several recent studies document host plant DNA uptake by psyllids, which feed in a similar manner to aphids. Therefore, we hypothesized that aphids may also acquire DNA from host plants. Since aphids puncture and sample cytosol contents from cells, we predicted that aphids would be most likely to acquire DNA from chloroplasts. To test this, we performed host feeding and host transfer experiments with Myzus persicae (Sulzer), then used PCR to recover and sequence a region between the trnT and trnF genes from acquired chloroplast DNA. We found that M. persicae readily acquires chloroplast DNA, even prior to phloem contact, and that fragment sizes sufficient for host plant identification can be recovered. Our work suggests that molecular gut content analysis is a viable tool for studying aphid-host interactions.

16.
Sensors (Basel) ; 23(17)2023 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-37687899

RESUMO

Formaldehyde is a known human carcinogen and an important indoor and outdoor air pollutant. However, current strategies for formaldehyde measurement, such as chromatographic and optical techniques, are expensive and labor intensive. Low-cost gas sensors have been emerging to provide effective measurement of air pollutants. In this study, we evaluated eight low-cost electrochemical formaldehyde sensors (SFA30, Sensirion®, Staefa, Switzerland) in the laboratory with a broadband cavity-enhanced absorption spectroscopy as the reference instrument. As a group, the sensors exhibited good linearity of response (R2 > 0.95), low limit of detection (11.3 ± 2.07 ppb), good accuracy (3.96 ± 0.33 ppb and 6.2 ± 0.3% N), acceptable repeatability (3.46% averaged coefficient of variation), reasonably fast response (131-439 s) and moderate inter-sensor variability (0.551 intraclass correlation coefficient) over the formaldehyde concentration range of 0-76 ppb. We also systematically investigated the effects of temperature and relative humidity on sensor response, and the results showed that formaldehyde concentration was the most important contributor to sensor response, followed by temperature, and relative humidity. The results suggest the feasibility of using this low-cost electrochemical sensor to measure formaldehyde concentrations at relevant concentration ranges in indoor and outdoor environments.

18.
J Air Waste Manag Assoc ; 73(10): 760-776, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37602777

RESUMO

Poor air quality is linked to numerous adverse health effects including strokes, heart attacks, and premature death. Improving energy efficiency in the industrial sector reduces air emissions and yields health benefits. One of these strategies, replacing an existing grid boiler (GB) with a combined heat and power (CHP) system, can improve a facility's energy efficiency but can also increase local air emissions, which in turn can affect health outcomes. Previous studies have considered air-emissions and health outcomes of CHP system installation at a single location, but few studies have investigated the regional air quality and health impacts of replacing an existing GB with new CHP system. This study estimates the emission changes and associated health impacts of this shift in 14 regions in the US, representing different electricity generation profiles. It assumes that one manufacturing facility in each region switches from an existing GB to a CHP system. The monetized annual US health benefits of shifting a single GB to a CHP in each of the 14 regions range from $-5.3 to 0.55 million (2022 USD), while including CHP emission control increases the benefits by 100-170% ($9,000 to 1.15 million (2022 USD)). This study also includes a sensitivity analysis, which suggests that the facility location (region, state, and county), boiler efficiency, and emission control of the CHP are key factors that would determine whether shifting from a GB to CHP system would result in health benefits or burdens.Implications: Combined heat and power (CHP) systems offer industrial facilities the opportunity to improve their energy efficiency and reduce greenhouse gas emissions. However, CHP systems also combust more fuel on site and can also increase local air emissions. This study evaluates how converting an existing grid boiler (GB) system to a CHP system (with or without emission control) affects local (from combustion) and regional emissions (from electricity consumption) and the associated health burdens in different US regions. A facility can use this study's analysis as an example for estimating the tradeoffs between local emission changes, regional emission changes, and health effects. It also provides a comparison between the incremental cost of adding SCR (compared to uncontrolled CHPs) and the NPV of the monetized health benefits associated with adding the SCR.


Assuntos
Gases de Efeito Estufa , Temperatura Alta , Indústrias , Eletricidade , Instalações Industriais e de Manufatura
19.
J Am Vet Med Assoc ; 261(9): 1-5, 2023 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-37217175

RESUMO

OBJECTIVE: To assess and compare the quality of smartphone ECG tracings to standard (base-apex) ECG tracings and assess agreement of ECG parameters between smartphone-based ECG and standard ECG. ANIMALS: 25 rams. PROCEDURES: The rams were consecutively examined with standard ECG and smartphone-based ECG (KardiaMobile; AliveCor Inc) after physical examination. ECGs were compared for quality score, heart rate, and ECG waves, complexes, and intervals. Quality scores were based on the presence or absence of baseline undulation and tremor artifacts using a 3-point scoring system (lowest possible = 0; highest possible = 3). A lower score was indicative of a better-quality ECG. RESULTS: Smartphone-based ECGs were interpretable in 65% of cases, while 100% of standard ECGs were interpretable. Standard ECG quality was superior to smartphone-based ECG quality, with no agreement in the quality between devices (κ coefficient, -0.0062). There was good agreement for heart rate with mean difference 2.86 beats/min (CI, -3.44 to 9.16) between the standard and smartphone ECGs. Good agreement was observed for P wave amplitude with mean difference 0.02 mV (CI, -0.01 to 0.05), QRS duration with mean difference -10.5 ms (CI, -20.96 to -0.04), QT interval with mean difference -27.14 ms (CI, -59.36 to 5.08), T wave duration with mean difference -30.00 ms (CI, -66.727 to 6.727), and T wave amplitude with mean difference -0.07 mV (CI, -0.22 to 0.08) between the 2 devices. CLINICAL RELEVANCE: Our findings indicate good agreement between standard and smartphone ECG for most parameters, although 35% of smartphone ECGs were uninterpretable.


Assuntos
Doenças dos Ovinos , Smartphone , Masculino , Ovinos , Animais , Eletrocardiografia/veterinária , Arritmias Cardíacas/veterinária , Frequência Cardíaca
20.
Drugs ; 83(6): 531-546, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36943634

RESUMO

BACKGROUND: Nutritional therapies are effective alternative treatments for male infertility or subfertility. These are cost-effective and easily implementable, unlike other advanced invasive treatments. Even moderate improvements in sperm quality could improve spontaneous pregnancy. OBJECTIVE: We aimed to compare the effectiveness of all nutritional therapies in male infertility/subfertility treatment and ranked their efficacy based on type and etiology. We intend to aid clinicians with an evidence-based approach to affordable and safer initial infertility treatment for those who mainly do not wish to have other advanced invasive treatments or could not afford or have access to them. METHODS: We included 69 studies with 94 individual study arms identified from bibliographic databases and registries. We included studies in adult men with proven infertility or subfertility that investigated nutritional or dietary supplement therapies compared with control or placebo and at least reported on a sperm parameter. We undertook a network meta-analysis and performed a pairwise meta-analysis on all sperm parameter outcomes and meta-regression. No language or date restriction was imposed. A systematic article search was concluded on August 29, 2022. RESULTS: Our network meta-analysis is the first to compare all dietary interventions in a single analysis, sub-grouped by intervention type and type of infertility. L-Carnitine with micronutrients, antioxidants, and several traditional herbal supplements showed statistically and clinically significant improvement in sperm quality. Meta-regression identified that improvement in the sperm count, motility and morphology translated into increased pregnancy rates (p < 0.001; p < 0.001; p < 0.002, respectively). In particular, L-carnitine with micronutrient therapy (risk ratio [RR]: 3.60, 95% CI 1.86, 6.98, p = 0.0002), followed by zinc (RR 5.39, 95% CI 1.26, 23.04, p = 0.02), significantly improved pregnancy rates. Men with oligozoospermia (RR 4.89), followed by oligoasthenozoospermia (RR 4.20) and asthenoteratozoospermia (RR 3.53), showed a significant increase in pregnancy rates. CONCLUSION: We ranked nutritional therapies for their ability to improve sperm quality in men with infertility. Nutritional therapies, particularly L-carnitine alone or combined with micronutrients, significantly improved sperm parameters and pregnancy rates even under severe conditions. We believe these affordable solutions may be valuable for people without access to or who do not wish to undergo more invasive and costly fertility treatments.


Assuntos
Infertilidade Masculina , Sêmen , Gravidez , Adulto , Feminino , Masculino , Humanos , Metanálise em Rede , Infertilidade Masculina/tratamento farmacológico , Infertilidade Masculina/etiologia , Micronutrientes/uso terapêutico , Carnitina/uso terapêutico
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