ObjectiveTo evaluate the effect of antisperm antibodies (ASAs), hormonal levels, intratesticular haemodynamics and the surgical approach on the outcomes of varicocelectomy in infertile men, as assessed by seminal variables.Patients and methodsIn a prospective case-series study, 82 infertile men with varicocele (35 left and 47 bilateral) were evaluated. The preoperative assessment included a physical examination, semen analysis, assessment of ASAs in seminal plasma, hormonal levels (follicle-stimulating hormone (FSH), luteinising hormone and testosterone), and scrotal colour Doppler ultrasonography (CDUS) to measure the peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI) and pulsatility index. Patients were scheduled for varicocelectomy, with high ligation (Palomo) used in 40 patients (18, 45%, with left and 22, 55%, with bilateral varicocele), or an inguinal approach (Ivanissivich) with loupe magnification used in 42 (17, 40%, with left and 25, 60%, with bilateral varicocele). The men were reassessed at ⩾3 months after surgery and according to the improvement in seminal variables (expressed as a ⩾50% increase in total motile sperm count, TMSC), patients were further categorised into ‘improved’ or ‘unimproved’. Binary logistic regression analysis was used to investigate the predictors of improvement.ResultsBefore surgery the ASAs were positive in 17 men (21%). There was no significant difference between the right and left sides in intratesticular haemodynamics. The TMSC was improved in 52 (63%) patients who had a significant improvement in the haemodynamic variables. Intratesticular haemodynamics, serum FSH and testosterone levels differed significantly between the improved and unimproved patients. Positivity for ASAs, the surgical approach and laterality of the varicocele were not significantly different, although the ASA-positive cases were characterised by a significant decrease in motility. Logistic regression analysis showed that the EDV, PSV, FSH, testosterone level and bilateral testicular volume (BTV) were significant predictors of improvement.ConclusionPositivity for ASAs is not a predictor of the outcome after varicocelectomy but affects only the motile fraction in positive cases, despite the improvement in other seminal variables and testicular haemodynamics, and regardless of the surgical approach. The EDV, PSV, FSH, testosterone and BTV were significant predictors of a successful outcome.

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Background: Growth Differentiation Factor 15 (GDF 15) is one of the transforming growth factor-β (TGF-β) family, which is released from different cells under conditions of stress. Increased levels of GDF-15 are associated with cardiovascular diseases and are related to the progression and prognosis of the disease. Aim: the aim of the present study was to determine the correlation between serum GDF15 level and cardiovascular risk in patients with type2 DM using Framingham risk score (FRS). Subjects and methods: this study included three groups: control group (n=20), prediabetic group (n=30) and diabetic group (n=30). The participants have been subjected to laboratory investigations including serum levels of GDF15, measured by enzyme linked immunosorbent assay (ELISA). FRS was calculated through using the 10-year CHD Risk Framingham Tables. Results: there was a statistically significant increase in serum GDF 15 in diabetic and prediabetic groups in comparison to the control group (p= 0.006, p= 0.025) sequentially and serum GDF15 was significantly positively correlated with FRS in both the diabetic and prediabetic groups (r= 0.44, p=0.015and r= 0.38, p=0.04) sequentially. Conclusion: Serum GDF15 level may be a useful clinical biomarker for predicting cardiovascular risk in patients with type2 DM.

To determine the association of plasma copeptin, a surrogate of vasopressin, with the incidence of Diabetic Nephropathy in Type 2 diabetes mellitus. Early detection of individuals having the highest risk could help avoid this complication. 60 patients with type 2 diabetes mellitus and 20 apparently healthy subjects serving as control were included. Plasma levels of Copeptin and other biochemical parameters were determined. The correlation between copeptin and estimated glomerular filtration rate (eGFR) was investigated. There was a significant association between elevated copeptin concentrations and eGFR decline ( P= 0.001). High plasma levels of copeptin were associated with lower ACR (P < 0.001). As copeptin is emerging biomarker in diagnosis of many diseases ,our results suggest that copeptin could be a useful prognostic marker for kidney function decline in type 2 diabetic patients and by this eventually help prevent kidney complications.