Revealing the Hidden Diagnostic Clues of Male Infertility from Human Seminal Plasma by Dispersive Solid Phase Extraction and MALDI-TOF MS.

Seminal plasma (SP) mirrors the local pathophysiology of the male reproductive system and represents a non-invasive fluid for the study of infertility. Matrix-Assisted Laser Desorption/Ionization-Time-of-Flight Mass Spectrometry (MALDI-TOF-MS) provides a high-throughput platform to rapidly extrapolate the diagnostic profiles of information-rich patterns. In this study, dispersive solid phase extraction (d-SPE) combined with MALDI-TOF-MS was applied for the first time to the human SP, with the aim of revealing a diagnostic signature for male infertility. Commercially available octadecyl (C18)-, octyl (C8)-bonded silica sorbents and hexagonal mesoporous silica (HMS) were tested and the robustness of MALDI-TOF peptide profiling was evaluated. Best performances were obtained for C18-bonded silica with the highest detection of peaks and the lowest variation of spectral features. To assess the diagnostic potential of the method, C18-bonded silica d-SPE and MALDI-TOF-MS were used to generate enriched endogenous peptide profiles of SP from 15 fertile and 15 non-fertile donors. Principal component analysis (PCA) successfully separated fertile from non-fertile men into two different clusters. An array of seven semenogelin-derived peptides was found to distinguish the two groups, with high statistical significance. These findings, while providing a rapid and convenient route to selectively enrich native components of SP peptidome, strongly reinforce the prominent role of semenogelins in male infertility.

The Risky Health Behaviours of Male Adolescents in the Southern Italian Region: Implications for Sexual and Reproductive Disease.

Recent epidemiological studies suggest an increase of sexual and reproductive chronic diseases caused by problematic behaviours acquired during peri-pubertal age. The aims of our study were: (i) to investigate awareness of sexual transmitted infections (STIs) among adolescents; (ii) to describe the close relationship between possibly incorrect lifestyles during adolescence and reproductive and sexual disturbances during adulthood. The "Amico-Andrologo" survey is a permanent nationwide surveillance program supported by the Italian Ministry of Health. We administered a validated structured interview to investigate the lifestyle of adolescents and their knowledge of STIs. We selected a cohort of 360 male high-school students aged ≥18 years old. In this cohort, 150 (41.5%) were smokers while 59 (19.7%) smoked more than 10 cigarettes/day; 25 (9.3%) declared a consumption ≥6 drinks/weekend; and 65 (19.7%) were habitual cannabis consumers (at least twice/week). Among the sample of students selected, the main sources of sexual disease information were the internet and friends. The perceived level of knowledge on STIs was the same between students that used contraceptive methods and students that did not. The present results demonstrate that adolescents in Calabria do not receive appropriate information about risky health behaviours. Therefore, there is a necessity for specific educational programs to increase awareness of dangerous behaviours during the transitional age that is relevant for a safe sexual and reproductive adult life.

[Questionnaire based evaluation of prostate biopsy complication comparing different bioptic schemes]. / Questionnaire based evaluation of prostate biopsy complication comparing different bioptic schemes.

OBJECTIVES: The systematic parasagittal sextant biopsy technique under transrectal ultrasound guidance, routinely performed to diagnose and stage prostate cancer, has been shown to outperform directed or random biopsies, revolutioning our ability to detect carcinoma of the prostate. Different biopsy schemes have been proposed with similar positive percentage of cancer detection. The present study evaluate from the patient's perspective the complications with the use of two different systematic biopsy protocols with 14 and 8 cores. MATERIAL AND METHODS: Between January 1999 and February 2000, 177 consecutive patients, mean age 64.1 +/- 7.7 years, referred for normal screening digital rectal examination (DRE) and prostate specific antigen (PSA) level 4-10 ng/ml, were submitted to a transrectal US examination followed by lesion directed and 14 scheme systematic biopsies to detect prostate cancer. Biopsies were obtained from conventional sextant biopsies (6 core) and 3 alternate sites which included: the right and left extreme lateral peripheral zone between anterior tissue and posterior gland base (2 core); the right and left transition zone, immediately adjacent to the urethra anterior and posterior (4 core) and the right and left central gland in the mid zone typical of benign prostatic hyperplasia (BPH) (2 core). All specimens were separated for specific location identification. Cancer was identified in 61 patients (34.46%). Traditional sextant biopsies showed 23 patients (37.7%) with positive core to detect cancer, while a sextant regimen incorporating lateral peripheral zone biopsies and transitional zone detected 19 cancer (31.1%). The combination of lateral peripheral and transitional zone alone detected cancer in 59 patients. No cancer was detected in central gland. The lateral peripheral zone was the most frequently positive site biopsy followed by the transitional zone. According the results of our study from April 2000 we started to consider a novel scheme to reduce number of biopsies maintaining the same sensitivity. A subsequent group of 121 patients, mean age 61 +/- 4.6 years, enrolled from April 2000 to May 2001, underwent a transrectal US examination followed by lesion directed and 8 scheme systematic biopsies. None of the patients had previously undergone prostate biopsy. In all patients a visual analog score (VAS) questionnaire about pain and complications was obtained 7 days after the procedure. RESULTS: Of the 149 patients who completed the questionnaire 9.9% found the procedure moderately to extremely painful afterwards, with a VAS > 5, the commonest of these complications being pain and voiding difficulties with a mean value of 15.8%, systemic symptoms as fever or sweats with a mean value of 7.65% of cases. Between the two groups submitted to 14 or 8 scheme biopsies, we detect a statistically significant difference for urethral bleeding (7.3% vs 4.9% p value 0.05) and rectal bleeding (10.3% vs 3.7% p value 0.04), systemic symptoms 10.3% vs 5.0% p value 0.05) and painful voiding afterwards (5.8% vs 2.4% p value 0.02). CONCLUSIONS: Ultrasound guided transrectal biopsy of the prostate is a well tolerated and effective method for obtaining multiple biopsy specimens from the prostate with low incidence of serious complications. The absolute value of referred complications with VAS < 5 results high, but the rate of major complications results low. The 8 biopsy scheme, including sampling in peripherial zone at midgland and transition zone periuretrally toward the base, should be considered in a initial biopsy scheme to reduce number of biopsy and enhancing sensitivity, with a significant less degree of complication rate compared to a extensive 14 biopsy scheme.