Assessing tumor response to neoadjuvant chemoradiation in rectal cancer with rectoscopy and 18F-FDG PET/CT: results from a prospective series.

INTRODUCTION: rectoscopy and 18F-FDG PET/CT as a diagnostic algorithm for the assessment of tumor response in rectal cancer after neoadjuvant chemoradiation therapy (CRT) is very useful. MATERIAL AND METHODS: this was a prospective longitudinal study in patients with locally advanced rectal cancer treated with neoadjuvant CRT. Patients were assessed after CRT completion with a digital rectal examination, proctoscopy and 18F-FDG PET/CT. Patients were subdivided as clinical (cCR) or radiologic (rCR) responders and non-responders according to tumor response. Clinical and radiological re-assessment was compared with the surgical specimen. Pathological tumor regression (pCR) grade was determined according to Mandard's classification. Of the 68 patients included, 15 (22 %) presented pCR in the surgical specimen and tumor persistence (non-PCR) was detected in the remaining 53 (78 %). Clinical assessment (DRE+ rectoscopy) identified 15 patients as cCR and 53 as non-cCR, two were false positives and two were false negatives. The overall accuracy was 94 %. 18F-FDG PET/CT identified 18 patients as rCR and 50 as non-rCR, one was a false positive and four were false negatives. The overall accuracy was 92 %. A combination of clinical findings and 18F-FDG PET/CT resulted in an accuracy of 96 %. The combination of clinical findings + 18F-FDG PET/CT was able to correctly identify all cases of pCR, with the exception of one case that presented a tumor regression of 80 %. In this series, 18F-PET-CT and clinical assessment had excellent accuracies in differentiating PCR from non-PCR after CRT completion. PET-CT combined with clinical assessment had a better accuracy than both modalities independently. 18F-FDG PET/CT is a valid tool that complements the clinical assessment of tumor response.

Estimating Simultaneous Equation Models through an Entropy-Based Incremental Variational Bayes Learning Algorithm.

The presence of unaccounted heterogeneity in simultaneous equation models (SEMs) is frequently problematic in many real-life applications. Under the usual assumption of homogeneity, the model can be seriously misspecified, and it can potentially induce an important bias in the parameter estimates. This paper focuses on SEMs in which data are heterogeneous and tend to form clustering structures in the endogenous-variable dataset. Because the identification of different clusters is not straightforward, a two-step strategy that first forms groups among the endogenous observations and then uses the standard simultaneous equation scheme is provided. Methodologically, the proposed approach is based on a variational Bayes learning algorithm and does not need to be executed for varying numbers of groups in order to identify the one that adequately fits the data. We describe the statistical theory, evaluate the performance of the suggested algorithm by using simulated data, and apply the two-step method to a macroeconomic problem.

Long-Term Outcome After Conventional Two-Stage Hepatectomy Versus Tourniquet-ALPPS in Colorectal Liver Metastases: A Propensity Score Matching Analysis.

BACKGROUND: To compare the overall survival (OS) and disease-free survival (DFS) of Tourniquet-ALPPS (T-ALPPS) and conventional two-stage hepatectomy (TSH) in patients with colorectal liver metastases (CRLM). METHODS: A retrospective study from a prospectively collected database was performed between October 2000 and July 2016. TSH was performed before September 2011, after which time T-ALPPS became the technique of choice. A propensity score matching (PSM) was performed based on a 1:1 ratio with consideration of the following variables: number and size of metastases, bilobar disease presence, and chemotherapy received. RESULTS: Thirty-four patients received T-ALPPS; 41 patients received TSH. After PSM, 21 patients remained in each group, with 100% resectability in the T-ALPPS group and 90.5% resectability in the TSH group. The median OS for TSH was 41 months; for T-ALPPS, the median OS was 36 months (P = 0.925). The median DFS was 16 months in the TSH group; the median DFS was 9 months in the T-ALPPS group (P = 0.930). The 1-, 3-, and 5-year OS for TSH was 81%, 66.7%, and 23.8% vs. 76.2%, 57.1%, and 22.9% for T-ALPPS, respectively. The 1-, 3-, and 5-year DFS for TSH was 66.7%, 9.5%, and 5% vs. 44.6%, 11.1%, and 11.1% for T-ALPPS, respectively. The volume increase with T-ALPPS was superior to that with TSH (68% vs. 39%; P = 0.018). There were no differences in morbidity and mortality after stages 1 and 2. CONCLUSIONS: T-ALPPS produces a similar outcome to TSH, indicating that it could be a safe and effective alternative for curative hepatectomy for all patients.

Trans fatty acid intake is inversely related to total sperm count in young healthy men.

STUDY QUESTION: Is intake of fatty acids related to semen quality among young men? SUMMARY ANSWER: The intake of trans fatty acids is inversely related to total sperm count in healthy young men. WHAT IS KNOWN ALREADY: Spain has seen an increase in the proportion of calories consumed as fat over the same period that a downward trend in semen quality has been observed. In addition, rodent models suggest that trans fat intake may severely affect testicular function. STUDY DESIGN, SIZE, DURATION: Cross-sectional study of 209 men recruited between October 2010 and November 2011. PARTICIPANTS/MATERIALS, SETTING, METHODS: A group of 209 healthy young university students 18-23 years of age provided a semen sample and completed a previously validated food frequency questionnaire. The association between intake of fatty acids with semen quality parameters (sperm concentration, motility, morphology and total count) was assessed using multivariate linear regression. MAIN RESULTS AND THE ROLE OF THE CHANCE: Trans fatty acid intake was inversely related to total sperm count after adjusting for potential confounders (P, trend = 0.03). The multivariate adjusted mean (95% confidence interval) total sperm count in increasing quartiles of trans fat intake was 144 (110-190), 113 (87-148), 100 (18-130) and 89 (69-117). There also was an inverse association between cholesterol intake and ejaculate volume (P, trend = 0.04). No other statistically significant relations were observed. LIMITATIONS, REASONS FOR CAUTION: The cross-sectional design of the study limits causal inference, we cannot exclude the possibility of unmeasured confounding and there was insufficient statistical power to identify modest associations. WIDER IMPLICATIONS OF THE FINDINGS: The results of this study, together with previous experimental work in rodents and biomarker studies among infertility patients, suggest that intake of trans fatty acids may be related to lower semen quality. Although the data provide further evidence that diet is a modifiable factor that could impact male fertility, it is not known whether the observed differences in sperm count translate into differences in fertility. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by The Seneca Foundation, Regional Agency of Science and Technology, grant no 00694/PI/04, Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III (FIS), grant no PI10/00985, and grant P30 DK46200 from the National Institutes of Health. The authors have no competing interests to declare.

Anogenital distance of women in relation to their mother's gynaecological characteristics before or during pregnancy.

Animal models suggest that anogenital distance (AGD) at birth reflects androgen concentrations during in-utero development and predicts adult AGD. Several human observational studies show an association between menstrual cycle irregularities and a hyperandrogenic environment and that may result in a potential alteration of the female reproductive tract during in-utero development. This study examined associations between AGD of young women and their mother's gynaecological characteristics before or during pregnancy. This is cross-sectional study of 100 college-age volunteers in southern Spain. Physical and gynaecological examinations were conducted on the young women and they and their mothers completed epidemiological questionnaires on lifestyles and gynaecological history. Linear regression analysis was used to examine the association between AGD measurements (anus-fourchette (AGDAF) and anus-clitoris (AGDAC)) of women and their mother's gynaecological characteristics. Longer AGDAF was associated with the presence of mother's menstrual cycle irregularities before pregnancy (P=0.03). Longer female AGD has been related to excess androgen exposure in utero in toxicological studies. The current findings may be consistent with studies in which an association between menstrual cycle irregularities and an hyperandrogenic environment has been reported, which therefore may result in a potential modification of the female offspring's reproductive tract during in-utero development, including AGD. Rodent models suggest that perineal length at birth reflects male hormone concentrations (androgens) during in-utero development and predicts adult perineal length. Several human studies show a relationship between menstrual cycle irregularities and an excessive androgen environment. We hypothesize that androgen excess may result in a potential alteration of the female reproductive tract during in-utero development. Our aim was to examine associations between perineal length of young women and their mother's gynaecological characteristics before or during pregnancy. This is a study of 100 college-age volunteers in Southern Spain. Physical and gynaecological examinations were conducted on the young women and they and their mothers completed epidemiological questionnaires on lifestyles and gynaecological history. We used multivariate analyses to assess the association between perineal length of women and their mother's gynaecological characteristics. Longer perineal length was associated with the presence of mother's menstrual cycle irregularities before pregnancy. Longer female perineal length has been related to excess androgen exposure in utero in rodent studies. Our findings may be consistent with previous studies in which an association between menstrual cycle irregularities and an excess of androgen has been reported, which therefore may result in a potential modification of the female offspring's reproductive tract during in-utero development, including perineal length.

Dietary intake of antioxidant nutrients is associated with semen quality in young university students.

STUDY QUESTION: What are the associations between the dietary intake of antioxidant nutrients and semen parameters in young men? SUMMARY ANSWER: Our study suggests that some sperm parameters are sensitive to dietary intake of antioxidant nutrients. WHAT IS KNOWN ALREADY: A few reports have suggested that some dietary factors might be related to semen quality. However, the relationship between the intake of antioxidant nutrients and semen quality in young men remains unexplored. STUDY DESIGN, SIZE, DURATION: In this cross-sectional study, 215 young men were included between October 2010 and November 2011. PARTICIPANTS/MATERIALS, SETTING, METHODS: Healthy university students with complete dietary and semen quality data were analyzed. Dietary intake was recorded using a validated food frequency questionnaire. The associations between the energy-adjusted nutrient intake of antioxidants in quartiles and the semen volume, sperm concentration, sperm motility, sperm morphology, total sperm count and total motile sperm count were assessed using multivariate linear regression. MAIN RESULTS AND THE ROLE OF CHANCE: Out of 240 students who contacted us, 223 (92.9%) were eligible to participate in this study, and 215 attended the clinical appointment. In the multivariate adjusted linear regression models, there was a positive association between dietary intakes of cryptoxanthin (P(trend) = 0.03), vitamin C (P(trend) = 0.04), lycopene (P(trend) = 0.03) and ß-carotene (P(trend) = 0.04) and total motile sperm count. The semen volume increased with higher intakes of vitamin C (P(trend) = 0.04). LIMITATIONS, REASONS FOR CAUTION: Only one sample of semen was taken for each subject. However, there are indications that one semen sample may be sufficient to characterize the semen quality of the individuals in epidemiological studies. Bias due to measurement errors may also occur since there is no perfect method to assess diet. However, any bias due to measurement error would be non-differential and would reduce, not increase, the strength of the associations. Although selection bias in cross-sectional studies might not always be ruled out, our subjects were university student volunteers who were rewarded for their participation and the study was not advertised as a fertility study. WIDER IMPLICATIONS OF THE FINDINGS: Previous articles in this area have focused mainly on men attending fertility clinics, thus our study brings generalizability to young men of the general population with unknown or untested fertility. Some of our results are in agreement with the previously reported papers.

Anogenital distance is related to ovarian follicular number in young Spanish women: a cross-sectional study.

BACKGROUND: In animals, anogenital distance (AGD) at birth reflects androgen levels during pregnancy and predicts adult AGD. Little is known about AGD in relation to female reproductive characteristics in humans, a question this study was designed to explore. METHODS: We used multiple linear and logistic regression analyses to model the relationships between adult female reproductive system characteristics (e.g. ovarian morphology, menstrual cycle) and two measures of AGD [anus-fourchette (AGD(AF)) and anus-clitoris (AGD(AC))] in 100 college-age volunteers in Spain. Ovarian morphology was classified as having < 6 or ≥ 6 follicles per ovary. RESULTS: Both AGD measures were positively associated with ovarian follicle number, with AGD(AF) being more strongly associated. Women in the upper tertile of the AGD(AF) and AGD(AC) distributions were more likely to have ≥ 6 ovarian follicles [OR: 6.0 (95% CI 2.0, 17.6) and 3.0 (95% CI 1.1, 8.6), respectively] compared to women in the lowest tertile. CONCLUSIONS: Increased follicular recruitment has been related to excess androgen exposure in utero in toxicological studies. Our results suggest that the androgenic environment during early fetal life may influence reproductive system development, including AGD, in human females.

The management of missed miscarriage in an outpatient setting: 800 versus 600 µg of vaginal misoprostol.

BACKGROUND: Many misoprostol regimens have been used to treat early pregnancy loss as an alternative to surgical evacuation, with differing adverse event and success rates. AIMS: This study sought to compare the effectiveness and adverse effects of 800 and 600 µg of misoprostol administered vaginally for the treatment of early pregnancy failure in an outpatient setting. METHODS: A retrospective, observational study of 946 women with a missed miscarriage <12 weeks' gestation was performed: 487 women received 800 µg (group 1) and 459 women received 600 µg (group 2) of vaginal misoprostol every 24 h for two days. The first follow-up was seven days after treatment. Women were asked about symptoms, and a transvaginal ultrasound was performed. If an incomplete miscarriage or gestational sac was still found, then an additional dose of intravaginal misoprostol was prescribed, and a second follow-up visit was arranged for seven days later. Surgical evacuation was scheduled for women who did not wish to continue medical treatment after the first or second follow-up visit. RESULTS: The total rate of complete miscarriage was 90.6% after 800 µg and 87.8% after 600 µg of intravaginal misoprostol. The percentage of women who underwent surgical evacuation after medical treatment was 9.4% for group 1 and 12.2% for group 2. CONCLUSIONS: Complete uterine evacuation after a missed miscarriage was effectively induced by both 600 and 800 µg of misoprostol. The overall success of medical treatment with intravaginal misoprostol demonstrates that the treatment is safe in an outpatient setting.

A hyper-matheuristic approach for solving mixed integer linear optimization models in the context of data envelopment analysis.

Mixed Integer Linear Programs (MILPs) are usually NP-hard mathematical programming problems, which present difficulties to obtain optimal solutions in a reasonable time for large scale models. Nowadays, metaheuristics are one of the potential tools for solving this type of problems in any context. In this paper, we focus our attention on MILPs in the specific framework of Data Envelopment Analysis (DEA), where the determination of a score of technical efficiency of a set of Decision Making Units (DMUs) is one of the main objectives. In particular, we propose a new hyper-matheuristic grounded on a MILP-based decomposition in which the optimization problem is divided into two hierarchical subproblems. The new approach decomposes the model into discrete and continuous variables, treating each subproblem through different optimization methods. In particular, metaheuristics are used for dealing with the discrete variables, whereas exact methods are used for the set of continuous variables. The metaheuristics use an indirect representation that encodes an incomplete solution for the problem, whereas the exact method is applied to decode the solution and generate a complete solution. The experimental results, based on simulated data in the context of Data Envelopment Analysis, show that the solutions obtained through the new approach outperform those found by solving the problem globally using a metaheuristic method. Finally, regarding the new hyper-matheuristic scheme, the best algorithm selection is found for a set of cooperative metaheuristics ans exact optimization algorithms.

Relationships between heavy metal concentrations in three different body fluids and male reproductive parameters: a pilot study.

BACKGROUND: Animal studies have shown the reproductive toxicity of a number of heavy metals. Very few human observational studies have analyzed the relationship between male reproductive function and heavy metal concentrations in diverse biological fluids. METHODS: The current study assessed the associations between seminal and hormonal parameters and the concentration of the 3 most frequent heavy metal toxicants (lead, cadmium and mercury) in three different body fluids. Sixty one men attending infertility clinics that participated in a case-control study to explore the role of environmental toxins and lifestyles on male infertility were analyzed. Concentration of lead, cadmium and mercury were measured in blood and seminal plasma and whole blood using anodic stripping voltammetry and atomic absorption spectrophotometry. Serum samples were analyzed for follicle-stimulating hormone, luteinizing hormone and testosterone. Semen analyses were performed according to World Health Organization criteria. Mann-Whitney test and Spearman's rank correlations were used for unadjusted analyses. Multiple linear regression models were performed controlling for age, body mass index and number of cigarettes per day. RESULTS: There were no significant differences between cases and controls in the concentrations of heavy metals in any of the three body fluids. In multivariate analyses using all subjects no significant associations were found between serum hormone levels and metal concentrations. However there was a significant positive association between the percentage of immotile sperms and seminal plasma levels of lead and cadmium. CONCLUSIONS: Our results suggest that the presence of lead and cadmium in the reproductive tract of men may be related to a moderate alteration of their seminal parameters.

Improving prediction of COVID-19 evolution by fusing epidemiological and mobility data.

We are witnessing the dramatic consequences of the COVID-19 pandemic which, unfortunately, go beyond the impact on the health system. Until herd immunity is achieved with vaccines, the only available mechanisms for controlling the pandemic are quarantines, perimeter closures and social distancing with the aim of reducing mobility. Governments only apply these measures for a reduced period, since they involve the closure of economic activities such as tourism, cultural activities, or nightlife. The main criterion for establishing these measures and planning socioeconomic subsidies is the evolution of infections. However, the collapse of the health system and the unpredictability of human behavior, among others, make it difficult to predict this evolution in the short to medium term. This article evaluates different models for the early prediction of the evolution of the COVID-19 pandemic to create a decision support system for policy-makers. We consider a wide branch of models including artificial neural networks such as LSTM and GRU and statistically based models such as autoregressive (AR) or ARIMA. Moreover, several consensus strategies to ensemble all models into one system are proposed to obtain better results in this uncertain environment. Finally, a multivariate model that includes mobility data provided by Google is proposed to better forecast trend changes in the 14-day CI. A real case study in Spain is evaluated, providing very accurate results for the prediction of 14-day CI in scenarios with and without trend changes, reaching 0.93 [Formula: see text], 4.16 RMSE and 1.08 MAE.

[Dietary intake of trace elements and semen quality and reproductive hormone levels in young men: relationship with fertility]. / Oligoelementos en la dieta y calidad seminal y niveles de hormonas reproductivas en varones jóvenes: relación con la fertilidad.

OBJECTIVE: The aim of this study was to study the associations between dietary intake of trace elements and semen quality and reproductive hormones levels in young men. MATERIAL AND METHOD: This is a cross-sectional study in healthy male university students (n=209) recruited in Murcia Region (Spain) between 2010 and 2011. Dietary intake of trace elements (iron, iodine and cinc) was assessed using a validated food frequency questionnaire. Semen analysis (sperm concentration, motility and morphology) was carried out according to World Health Organization guidelines. Serum concentrations of follicle-stimulating and luteinizing hormones and testosterone were also determined. Kruskal-Wallis and Chi-squared tests were used in bivariate analysis and multiple lineal regression was used to adjust for significant covariates. RESULTS: A statistically significant inverse association between dietary intake of iron and sperm concentration (P, trend=0.01) and the percentage of progressive motile sperm (P, trend=0.004) were observed. No other significant associations for the remaining sperm parameters or reproductive hormones were detected. CONCLUSIONS: Our results show that high levels of iron may be associated with reduced sperm concentration and motility in young men. However, further studies are needed, particularly in other male populations consulting for infertility problems.

[Associations between dietary inflammatory index and male reproductive parameters]. / Asociaciones entre el índice inflamatorio de la dieta y parámetros reproductivos masculinos.

OBJECTIVE: The aim of this work was to assess the associations between the dietary inflammatory index (DII) and male reproductive parameters. MATERIAL AND METHOD: Cross-sectional study of 209 healthy male university students (18-23 years old) recruited from October 2010 to November 2011 in Murcia Region (Southern Spain). Semen analyses (sperm concentration, motility and morphology) were carried out according to World Health Organization guidelines. Serum concentrations of follicle-stimulating and luteinizing hormones, estradiol, inhibin b and testosterone were also determined. Diet intake was assessed using a validated food frequency questionnaire. The DII assessed the inflammatory potential of one's diet. Negative or positive values of DII reflected anti-inflammatory or pro-inflammatory dietary status, respectively. Linear regression was used to analyze the relation between the DII score and semen quality parameters and reproductive hormone levels adjusting for potential important covariates. RESULTS: We found statistically significant positive associations between the DII and progressive sperm motility (PR) (P, trend=0.03] and total sperm motility (PR+NP) (P, trend=0.04]. No significant associations were observed for other semen parameters or male reproductive hormones. CONCLUSIONS: Our results suggest that a pro-inflammatory dietary status may be associated with increased sperm motility in young men, but will not impact sperm count, morphology or reproductive hormones. However, further research is needed to confirm these findings and extend these results to other male populations.

Anogenital distance and variability in semen parameters.

The purpose of this study was to analyze whether the anogenital distance (AGD) was associated with variability in semen parameters. Semen parameters analyzed following the WHO guidelines and sperm DNA fragmentation were evaluated in 160 semen samples obtained over a period of a year from 16 healthy male volunteers. Two types of AGD measurements from the anus to the rear base of the scrotum (AGDAS) and to the cephalic insertion of the penis (AGDAP) were taken in each individual. The association between AGDs and semen parameters were studied using three statistical tools: a) general coefficient of variation (CV) and intra-individual coefficient of variation (CVi), b) general linear models for repeated measures, and c) mixed model fixed effects panel data. Men with shortened AGDAP have significantly greater intra-individual variability in sperm concentration, total sperm count, and normal sperm morphology. Conversely, greater total sperm motility was observed in men with long AGDAS. Shortened AGDAS was associated with less intra-individual variability of total sperm motility (progressive and non-progressive). AGD measurements were associated with the variability in semen parameters. AGD may be useful to determine intra-individual variability in semen parameters. ABBREVIATIONS: AGD: anogenital distance; AGDAP: anogenital distance from the anus to the cephalic insertion of the penis; AGDAS: anogenital distance from the anus to the rear base of the scrotum; AIC: Akaike information criteria; BMI: body mass index; CV: general coefficient of variation; CVi: intra-individual coefficient of variation; GLM: generalized linear model; PR+NP: total sperm motility.

Sperm counts may have declined in young university students in Southern Spain.

Several studies have investigated temporal trends in semen quality in Northern Europe, but none has examined this question in Southern Europe. A prior study conducted in Almeria Province (Southern Spain) reported higher sperm count and concentration among Spanish young men recruited from 2001 to 2002 compared with young men from Northern Europe. The aim of this new study was to examine whether semen quality has changed among Spanish young men in the last decade. In this cross-sectional study, questionnaires and semen samples were collected from 215 healthy young university students from Murcia Region between 2010 and 2011. The 273 men from the Almeria study previously studied were included in a trend analysis of the two populations from Southern Spain. Descriptive statistics were calculated for the Murcia study population and these and semen variables for the Murcia and Almeria study populations were compared. Study methods and population characteristics were similar across the two studies. Therefore, we used multiple linear regression analyses on the combined population (controlling for study centre, age, ejaculation abstinence time, season, smoking, medication during the last 3 months, Body mass index (BMI), presence of varicocoele and prenatal exposure to tobacco) to look for a birth-cohort effect over the combined study period (2001-2011). Sperm concentration and total sperm count declined significantly with year of birth in the pooled analysis (ß = -0.04 and ß = -0.06, respectively, both p < 0.01). Sperm counts were significantly lower in Murcia study subjects than in the Almeria participants; sperm concentration median (5th-95th) = 44.0 (8.9-129) million/mL vs. 51.0 (5.0-206) million/mL; p < 0.01 and total sperm count = 121 (17.8-400) million vs. 149 (8.0-599) million; p < 0.01. Other semen variables did not differ significantly between the two studies. Our study suggests that total sperm count and sperm concentration may have declined in young Spanish men over the last decade.

Correlations between Different Heavy Metals in Diverse Body Fluids: Studies of Human Semen Quality.

It has been hypothesized that exposure to heavy metals may impair male reproduction. To measure the effect produced by low doses of heavy metals on semen parameters, it is necessary to clarify in which body fluids those measurements must be performed. Sixty-one men attending infertility clinics participated in our study. Concentrations of lead, cadmium, and mercury were measured in whole blood, blood plasma, and seminal plasma using spectroanalytical and electrochemical methods. Semen analyses were performed according to World Health Organization criteria. For statistical analysis, Spearman's rank correlations, mean comparison tests, and discriminant analysis were calculated. Significant correlations between the measured concentrations of the three heavy metals in the same biological fluids were observed. However, no similar relationship was seen when comparing the concentrations in different body fluids of the same metal. According to our results and previous publications, seminal plasma might be the best body fluid for assessing impairment of human semen parameters.

Oligoelementos en la dieta y calidad seminal y niveles de hormonas reproductivas en varones jóvenes: relación con la fertilidad / Dietary intake of trace elements and semen quality and reproductive hormone levels in young men: relationship with fertility

Objetivo: El objetivo de este trabajo fue analizar las asociaciones entre la ingesta dietaria de oligoelementos y la calidad seminal y los niveles de hormonas reproductivas en varones jóvenes. Material y método: Se trata de un estudio transversal realizado en jóvenes universitarios sanos (n = 209) de la Región de Murcia entre 2010 y 2011. Los valores de ingesta dietaria de oligoelementos (hierro, yodo y cinc) se obtuvieron mediante un cuestionario de frecuencia alimentaria validado. Los análisis seminales (concentración, movilidad y morfología espermática) se llevaron a cabo siguiendo los criterios y guía de la Organización Mundial de la Salud. Se analizaron los niveles séricos de las hormonas folículo-estimulante, luteinizante y testosterona. Se utilizaron pruebas no paramétricas (Kruskal-Wallis) y la χ2 para los análisis bivariantes, y modelos de regresión lineal múltiple para ajustar por covariables significativas. Resultados: Se mostró una asociación inversa estadísticamente significativa entre la ingesta dietaria de hierro y la concentración espermática (P, tendencia = 0,01) y el porcentaje de espermatozoides móviles progresivos (P, tendencia = 0,004). No se encontraron asociaciones significativas con el resto de parámetros espermáticos, ni con las hormonas reproductivas. Conclusiones: Nuestros resultados muestran que niveles altos de ingesta dietaria de hierro estarían asociados con una disminución de la concentración y movilidad espermática en jóvenes varones. No obstante, son necesarios más estudios para confirmar estos hallazgos, en particular, en otras poblaciones de varones que consultan por problemas de infertilidad

Objective: The aim of this study was to study the associations between dietary intake of trace elements and semen quality and reproductive hormones levels in young men. Material and method: This is a cross-sectional study in healthy male university students (n = 209) recruited in Murcia Region (Spain) between 2010 and 2011. Dietary intake of trace elements (iron, iodine and cinc) was assessed using a validated food frequency questionnaire. Semen analysis (sperm concentration, motility and morphology) was carried out according to World Health Organization guidelines. Serum concentrations of follicle-stimulating and luteinizing hormones and testosterone were also determined. Kruskal-Wallis and Chi-squared tests were used in bivariate analysis and multiple lineal regression was used to adjust for significant covariates. Results: A statistically significant inverse association between dietary intake of iron and sperm concentration (P, trend = 0.01) and the percentage of progressive motile sperm (P, trend = 0.004) were observed. No other significant associations for the remaining sperm parameters or reproductive hormones were detected. Conclusions: Our results show that high levels of iron may be associated with reduced sperm concentration and motility in young men. However, further studies are needed, particularly in other male populations consulting for infertility problems

Asociaciones entre el índice inflamatorio de la dieta y parámetros reproductivos masculinos / Associations between dietary inflammatory index and male reproductive parameters

Objetivo: El objetivo de este trabajo fue analizar las asociaciones entre el índice inflamatorio de la dieta (IID) y los parámetros reproductivos masculinos. Material y método: Estudio transversal realizado en 209 jóvenes universitarios sanos (18-23 años) de la Región de Murcia entre octubre 2010 y noviembre 2011. Los análisis seminales (concentración, movilidad y morfología espermática) se realizaron siguiendo los criterios de la Organización Mundial de la Salud. Se analizaron las concentraciones séricas de las hormonas folículo-estimulante, luteinizante, testosterona, inhibina B y estradiol. La ingesta dietaria fue valorada mediante un cuestionario de frecuencia alimentaria validado. El potencial inflamatorio de la dieta se valoró mediante el IID. Unos valores negativos o positivos de IID reflejaron una mayor propiedad antiinflamatoria o proinflamatoria, respectivamente. Se utilizaron modelos de regresión lineal para analizar la relación entre el IID y la calidad seminal y niveles de hormonas reproductivas tras ajustar por posibles covariables importantes. Resultados: Se mostró una asociación positiva estadísticamente significativa entre el IID y el porcentaje de espermatozoides móviles progresivos (PR) (P, tendencia = 0,03) y la movilidad espermática total (PR + NP) (P, tendencia = 0,04). No se encontraron asociaciones significativas con el resto de parámetros espermáticos, ni con las hormonas reproductivas. Conclusiones: Nuestros resultados indican que una mayor propiedad proinflamatoria de la dieta podría estar asociada con un aumento de la movilidad espermática en varones jóvenes, pero no afectaría a la concentración o morfología espermática o a las hormonas reproductivas. Sin embargo, se necesitan más estudios para confirmar estos hallazgos y extender estos resultados a otras poblaciones de varones

Objective: The aim of this work was to assess the associations between the dietary inflammatory index (DII) and male reproductive parameters. Material and method: Cross-sectional study of 209 healthy male university students (18-23 years old) recruited from October 2010 to November 2011 in Murcia Region (Southern Spain). Semen analyses (sperm concentration, motility and morphology) were carried out according to World Health Organization guidelines. Serum concentrations of follicle-stimulating and luteinizing hormones, estradiol, inhibin b and testosterone were also determined. Diet intake was assessed using a validated food frequency questionnaire. The DII assessed the inflammatory potential of one's diet. Negative or positive values of DII reflected anti-inflammatory or pro-inflammatory dietary status, respectively. Linear regression was used to analyze the relation between the DII score and semen quality parameters and reproductive hormone levels adjusting for potential important covariates. Results: We found statistically significant positive associations between the DII and progressive sperm motility (PR) (P, trend = 0.03] and total sperm motility (PR + NP) (P, trend = 0.04]. No significant associations were observed for other semen parameters or male reproductive hormones. Conclusions: Our results suggest that a pro-inflammatory dietary status may be associated with increased sperm motility in young men, but will not impact sperm count, morphology or reproductive hormones. However, further research is needed to confirm these findings and extend these results to other male populations

Factores asociados a la variabilidad de la calidad seminal: un estudio de seguimiento / Factors associated with the variability of semen quality: a follow-up study

Objetivo. El objetivo de este estudio es analizar si el tiempo de abstinencia sexual y la frecuencia de eyaculación, así como determinados hábitos de vida, contribuyen a la variabilidad de la calidad seminal. Material y método. Se trata de un estudio prospectivo y de seguimiento que se llevó a cabo durante un año evaluando múltiples muestras seminales procedentes de 19 varones voluntarios sanos. La obtención de muestras seminales fue aproximadamente cada 4-6 semanas. Además, los sujetos cumplimentaron encuestas de seguimiento epidemiológicas sobre hábitos de vida. Se calculó el porcentaje de coeficiente de variación (CV) intraindividual (%CVi) y el CV interindividual (%CVe). Resultados. El mayor CVi fue del 74,5% en el recuento total y del 65,6% en la concentración espermática, seguidos del 41,2% en la morfología y del 30,1% en el volumen. El menor CVi fue del 14,6% para la movilidad espermática. Los coeficientes de CVe fueron superiores y siguieron un patrón similar. Se obtuvieron resultados comparables al considerar los hábitos de vida. En general, los CVi y los CVe fueron más bajos en sujetos que practicaban habitualmente ejercicio ligero o moderado, o en consumidores no habituales de vino, cerveza o café. Conclusiones. La recomendación de analizar una única muestra seminal nos podría comprometer a un diagnóstico erróneo del potencial fértil de un varón. No obstante, los resultados de un único análisis seminal podrían considerarse más fiables o consistentes si están presentes ciertos hábitos de vida (AU)

Objective. The aim of this study is to analyze whether abstinence time or the frequency of ejaculation and selected lifestyles could be related to variability of semen quality. Material and methods. This is a prospective, follow-up study over 1 year evaluating several semen samples from 19 healthy male volunteers. Semen samples were obtained approximately every 4-6 weeks. Besides, follow-up epidemiological questionnaires on lifestyles were filled out by the participants. Intra- (%CVi) and inter-individual (%CVe) coefficients of variation were calculated. Results. The highest CVi was 74.5% for sperm count and 65.6% for sperm concentration, followed by 41.2% form sperm morphology and 30.1% for volume. The lowest CVi was 14.6% for sperm motility. The CVe were higher and presented a similar pattern. With regard to lifestyles, comparable results were obtained. Generally, CVi and CVe were lower in subjects practicing regular, light or moderate exercise, and having irregular intake of wine, beer or coffee. Conclusions. The recommendation of analyzing only one semen sample could lead to a mistaken diagnosis of the men's fertility potential. However, the results of a single semen analysis could be more reliable or consistent if some lifestyles are present (AU)

Tamaño de la fratría y victimización escolar / Number of siblings and school victimization

El presente estudio analiza la relación entre el número de hermanos y la victimización escolar. Para lograr este objetivo se realizó un estudio transversal en 28 centros escolares de educación secundaria obligatoria (ESO) elegidos por muestreo aleatorio en la Región de Murcia. El total de estudiantes incluidos en la investigación fue de 2552 con edades comprendidas entre 11 y 18 años. Los estudiantes cumplimentaron un cuestionario anónimo que incluía preguntas sobre aspectos sociodemográficos y familiares, y situaciones de violencia y victimización escolar. La victimización se midió por la frecuencia referida por los estudiantes de haber sufrido durante la semana precedente las acciones agresivas presentadas en el cuestionario. Los resultados obtenidos destacan que tanto los hijos únicos como los estudiantes que tienen 4 o más hermanos sufren niveles más graves de victimización escolar. Nuestro estudio sugiere que el número de hermanos es una variable que debe ser considerada en los estudios sobre victimización escolar (AU)

This work studies the association between number of siblings and victimization at school. A cross-sectional study was carried out with 28 secondary schools in Murcia (Spain). Sample of 2552 children aged 11 to 18 completed an anonymous self-administered questionnaire, that included socio-demographic information, quality family relationships and school victimization. Victimization was measured by asking children to recall specific acts they had suffered during the previous week. Only children and those with 4 or more brothers or sisters referred the highest levels of school victimization. Our study suggests that the number of brothers and sisters are related to the level of victimization at school (AU)