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Medscape
3 days ago
- Business
- Medscape
Intestinal Ultrasound Wins in Early Crohn's Prognosis
Findings on intestinal ultrasound (IUS) are useful for predicting remission in recent-onset Crohn's disease (CD), a prospective, population-based cohort of newly diagnosed patients in Denmark reported. Adding to the growing body of evidence on the utility of this noninvasive imaging tool in monitoring disease activity in the newly diagnosed, the multicenter study published in Clinical Gastroenterology and Hepatology characterized ultrasonographic features at diagnosis and evaluated IUS's prognostic value. Existing literature has focused on patients with long-standing disease. Investigators led by first author Gorm R. Madsen, MD, PhD, of the Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults at Copenhagen University Hospital, observed continued improvement in most IUS parameters throughout the first year. 'Our findings thereby emphasize the role of IUS in improving patient management, and its use in patient risk stratification already at diagnosis,' the investigators wrote. Some 38% of patients reached ultrasonic transmural remission within 3 months of diagnosis, an achievement associated with higher rates of sustained steroid-free clinical remission and reduced need for treatment escalation. 'Ultrasonic transmural remission is achievable early in Crohn's disease and is associated with favorable outcomes, underscoring the value of intestinal ultrasound in early disease management,' the researchers wrote. Study Details While IUS is increasingly recognized for monitoring CD, little was known about its prognostic value early in the disease course. 'We aimed to determine whether sonographic inflammation at diagnosis — and particularly the achievement pftransmural remission after 3 months — could predict future outcomes,' Madsen told Medscape Medical News . 'This is important, as early identification of patients at risk of surgery or treatment escalation may help guide therapy decisions more effectively.' From May 2021 to April 2023, 201 patients (mean age, 35 years; 54.2% men) with new adult-onset CD were followed by IUS and monitored with symptomatic, biochemical, and endoscopic evaluations. After 3 months, transmural remission was achieved more often by patients with colonic disease, and no associations were found between sonographic inflammation at diagnosis and diagnostic delay. 'We were positively surprised. Nearly 40% of newly diagnosed Crohn's patients achieved transmural remission within 3 months — a higher proportion than seen in earlier studies, which mostly focused on long-standing or trial-selected populations,' Madsen said. 'It was also striking how strongly early IUS findings predicted the need for surgery, outperforming endoscopy and biomarkers.' In other findings, transmural remission at 3 months was significantly associated with steroid-free clinical remission at both 3 months and all subsequent follow-ups within the first year. It was also linked to a lower risk for treatment escalation during the follow-up through to 12 months: 26% vs 53% ( P =.003). At 12 months, 41% had achieved transmural remission. Higher baseline body mass index significantly reduced the likelihood of 12-month transmural remission. For overweight, the odds ratio (OR) was 0.34 (95% CI, 0.12-0.94), while for obesity, the OR was 0.16 (95% CI, 0.04-0.73). The International Bowel Ultrasound Segmental Activity Score in the terminal ileum at diagnosis emerged as the best predictor of ileocecal resection during the first year, with an optimal threshold of 63 (area under the curve, 0.92; sensitivity, 100%; specificity, 73%). The use of IUS has expanded considerably in the past 3 years, and in 2024, the American Gastroenterological Association updated its clinical practice guidance on the role of this modality in inflammatory bowel disease. IUS is noninvasive, radiation-free, inexpensive, and doable at the bedside with immediate results, Madsen said. 'For patients, this means less anxiety and discomfort. For healthcare systems, it enables faster clinical decisions, reduced need for endoscopy or MRI, and closer disease monitoring, particularly valuable in treat-to-target strategies.' In terms of limitations, however, IUS is operator-dependent and consistent training is crucial, he added. 'Certain anatomical regions, particularly the proximal small bowel, can be more challenging to evaluate. Additionally, while IUS is highly effective for assessing inflammatory activity, it becomes more difficult to accurately assess disease involvement when inflammation extends beyond approximately 20 cm of the small bowel.' Key Insights Commenting on the Danish study from a US perspective, Anna L. Silverman, MD, a gastroenterology fellow at Icahn School of Medicine at Mount Sinai in New York City, agreed the findings in adult patients with newly diagnosed, rather than long-standing, CD contribute to the growing body of evidence supporting IUS's applicability for both treatment monitoring and prognosis. 'By focusing on early-stage CD, the study provides clearer insights into initial disease activity and response to therapy, reinforcing the value of this noninvasive, point-of-care modality,' she told Medscape Medical News . 'These findings enhance our understanding of IUS as a tool to help guide early management decisions in CD.' Ashwin Ananthakrishnan, MBBS, MPH, director of the Crohn's and Colitis Center at Massachusetts General Hospital and an associate professor at Harvard Medical School, both in Boston, concurred that this is an important study. 'It includes newly diagnosed patients — so a very 'clean' cohort in terms of not being influenced by confounders,' he told Medscape Medical News . 'We don't fully know yet the best treatment target in CD, and this study highlights the importance of early transmural healing in determining outcomes at 1 year,' he noted. In addition, the study highlighted a convenient tool that can increasingly be applied at point of care in the United States. 'Colonoscopy at 3 months is not practical and has low patient acceptability, so using IUS in this circumstance would have value and impact.' Ananthakrishnan pointed to several unanswered questions, however. 'Are there patients who may not have healing early but may take some extra time to achieve transmural remission, and if so, what are their outcomes? What is the best timepoint for transmural healing assessment? What is the incremental value of measuring it at 3 vs 6 months?' In addition, he wondered, how much is the added value of IUS over clinical symptoms and/or markers such as calprotectin and C-reactive protein? 'In the subset of patients with clinical and transmural remission, there was no difference in endoscopic outcomes at 1 year, so this is an unanswered question,' Ananthakrishnan said. This study was funded by an unrestricted grant from the Novo Nordisk Foundation.
Euronews
08-03-2025
- Health
- Euronews
Men with better quality sperm may live longer, study finds
The quality of semen could be an indicator of overall health for men, experts told Euronews Health. ADVERTISEMENT Men with better sperm quality may live longer lives, according to a new study. Researchers analysed data from nearly 80,000 Danish men with a follow-up of up to 50 years. The men had had their semen quality assessed in the laboratory due to couple infertility. The analysis looked at semen volume, sperm concentration, and the proportion of motile sperm - meaning sperm that moved efficiently - and had a normal shape. Those with a higher number of motile sperm had a life expectancy that was two to three years longer than men with the lowest number of motile sperm, according to the findings published in the journal Human Reproduction. 'In absolute terms, men with a total motile count of more than 120 million lived 2.7 years longer than men with a total motile count of between zero and five million,' Dr Lærke Priskorn, a senior researcher at Copenhagen University Hospital in Denmark and the study's lead author, said in a statement. 'The lower the semen quality, the lower the life expectancy. This association was not explained by any diseases in the ten years before semen quality assessment or the men's educational level,' she added. A potential health indicator for men One hypothesis to explain the link is that semen quality could work as an indicator of men's overall health. Previous research cited by the team found that men with a lower sperm concentration were also hospitalised seven years earlier on average, 'underlining that men with impaired semen quality as a group not only can expect to die earlier but also to live fewer healthy years'. 'The current findings corroborate and add to the limited albeit growing body of research showing that semen quality is an important marker of current health and likely predictive of future health across the lifespan,' Dr Germaine Buck Louis, dean of the College of Health at George Mason University in the US, told Euronews Health in an email. 'Greater clinical awareness is evolving and has prompted some authors to call for semen quality being considered the 6th vital sign,' the expert, who was not involved in the study, added. The typical vital signs measuring the body's basic functions are temperature, heart rate, respiratory rate, blood pressure, and oxygen saturation. The study does not identify the underlying causes of the difference in life expectancy, but Louis said that 'environmental exposures may be responsible, possibly through oxidative stress pathways, as they affect both reproductive health and health, more globally'. 'Without knowing the exact causes of the infertility and the cell functions affected, it is difficult to develop medical interventions or new drugs to treat the problem(s),' Dolores Lamb, co-director of the research learning centre at Children's Mercy Kansas City, a hospital in the US, told Euronews Health. 'The common link between infertility and the increased health risks of men with infertility is currently under active research investigation,' Lamb added.
Euronews
08-03-2025
- Health
- Euronews
Men with higher quality sperm may have longer lifespan, new study finds
The quality of semen could be an indicator of overall health for men, experts told Euronews Health. ADVERTISEMENT Men with better sperm quality may live longer lives, according to a new study. Researchers analysed data from nearly 80,000 Danish men with a follow-up of up to 50 years. The men had had their semen quality assessed in the laboratory due to couple infertility. The analysis looked at semen volume, sperm concentration, and the proportion of motile sperm - meaning sperm that moved efficiently - and had a normal shape. Those with a higher number of motile sperm had a life expectancy that was two to three years longer than men with the lowest number of motile sperm, according to the findings published in the journal Human Reproduction. 'In absolute terms, men with a total motile count of more than 120 million lived 2.7 years longer than men with a total motile count of between zero and five million,' Dr Lærke Priskorn, a senior researcher at Copenhagen University Hospital in Denmark and the study's lead author, said in a statement. 'The lower the semen quality, the lower the life expectancy. This association was not explained by any diseases in the ten years before semen quality assessment or the men's educational level,' she added. Related Scientists link male infertility to air pollution and female infertility to noise pollution A potential health indicator for men One hypothesis to explain the link is that semen quality could work as an indicator of men's overall health. Previous research cited by the team found that men with a lower sperm concentration were also hospitalised seven years earlier on average, 'underlining that men with impaired semen quality as a group not only can expect to die earlier but also to live fewer healthy years'. 'The current findings corroborate and add to the limited albeit growing body of research showing that semen quality is an important marker of current health and likely predictive of future health across the lifespan,' Dr Germaine Buck Louis, dean of the College of Health at George Mason University in the US, told Euronews Health in an email. 'Greater clinical awareness is evolving and has prompted some authors to call for semen quality being considered the 6th vital sign,' the expert, who was not involved in the study, added. The typical vital signs measuring the body's basic functions are temperature, heart rate, respiratory rate, blood pressure, and oxygen saturation. Related AI could be used to improve success of IVF as many struggle with infertility The study does not identify the underlying causes of the difference in life expectancy, but Louis said that 'environmental exposures may be responsible, possibly through oxidative stress pathways, as they affect both reproductive health and health, more globally'. 'Without knowing the exact causes of the infertility and the cell functions affected, it is difficult to develop medical interventions or new drugs to treat the problem(s),' Dolores Lamb, co-director of the research learning centre at Children's Mercy Kansas City, a hospital in the US, told Euronews Health. 'The common link between infertility and the increased health risks of men with infertility is currently under active research investigation,' Lamb added.
Telegraph
05-03-2025
- Health
- Telegraph
Men with better sperm live longer
Men with better sperm live nearly three years longer, a study by Danish researchers suggests. In the first study to link semen quality with lifespan, scientists discovered a correlation between the shape, movement and number of sperm that men have and their longevity. Men with more than 120 million swimming sperm could expect to live 2.7 years longer than men with a total active sperm count of between 0 and 5 million. Experts believe hidden health problems such as genetic defects on the sex chromosomes or a compromised immune system may be driving infertility, and that checking sperm counts might be an early indicator that disease is brewing. 'We need to better understand the association between semen quality and men's general health,' said Dr Niels Jorgensen, the chief andrologist at Copenhagen University Hospital. 'However, this study suggests that we can identify subgroups of men with impaired semen quality who are apparently healthy when their semen quality is assessed, but who are at increased risk of developing certain diseases later in life. 'Thus, fertility evaluations, which are typically conducted when the men are relatively young, would serve as an opportunity for detecting and mitigating the risks of other health problems in the longer term.'
CNN
05-03-2025
- Health
- CNN
Sperm quality linked to living longer, new study finds
People who have higher levels of strong, agile sperm may live nearly three years longer than those with poor swimmers incapable of making it to their destination, according to new research. The large-scale study followed more than 78,000 men for 50 years. The ability of sperm to properly swim through the female reproductive tract to reach and fertilize an egg is called motility. 'In absolute terms, men with a total motile count of more than 120 million (per milliliter of semen) lived 2.7 years longer than men with a total motile count of between 0 and 5 million,' said lead study author Lærke Priskorn, a researcher and doctoral candidate at Copenhagen University Hospital — Rigshospitalet in Denmark, in a statement. To translate that into ages, a man with extremely poor sperm motility might be expected to live up to 77.6 years, while a man with extremely high motility might survive to 80.3 years, according to the study published Tuesday in the journal Human Reproduction. 'The fact that there is an association between semen quality and longevity is an important finding,' said Dr. Michael Eisenberg, professor of urology and director of male reproductive medicine and surgery at Stanford University School of Medicine. He was not involved in the new research. 'There have been prior studies that suggest this link between reproductive health and overall health,' Eisenberg said in an email. Could sperm count be a 'canary in the mine'? In the new report, researchers compared the quality of sperm samples taken between 1965 and 2015 from men undergoing infertility testing in Copenhagen. The quality of the men's sperm was then compared with national medical records gathered by the Danish national health service. 'The lower the semen quality, the lower the life expectancy,' Priskorn said. 'This association was not explained by any diseases in the ten years before semen quality assessment or the men's educational level.' Motility counts are typically provided in percentages, not total numbers. The World Health Organization considers a man's sperm normal if about 42% of the sperm in each sample of ejaculate is capable of swimming to their destination. However, a motility count of less than 5 million per milliliter of semen is associated with a severe case of oligospermia, or low sperm count, which often leads to male infertility, the study said. A sperm motility of about 125 million per milliliter of semen is normal for a fertile male, Eisenberg said. However, that doesn't guarantee male fertility, experts say. If not for fertility, why would testing semen be a benefit? Because it could also be a marker for male health problems at younger ages, said John Aitken, a distinguished professor emeritus from the School of Environmental and Life Sciences at the University of Newcastle, Australia, who was not connected to the study. 'In men, it appears to be their semen profile that is providing the most significant information concerning their future health and wellbeing,' Aitken wrote in an editorial published alongside the study. 'If spermatozoa really are the canaries in the coal mine of male health, the obvious question to ask is, why?' Aitken posited. 'What possible factors could link the ultimate life expectancy of males with the quality of their semen profile in early adulthood?' Oxidative stress is one possibility According to Aitken, one answer explaining the association might be oxidative stress, caused when free radicals run rampant. Free radicals are unstable molecules that can damage DNA and cellular function and lead to cell death throughout the body, including the testes and sperm. 'Any factor (genetic, immunological, metabolic, environmental or lifestyle) that enhances overall levels of oxidative stress, could reasonably be expected to drive changes in the semen profile and subsequent patterns of mortality,' Aitken posited. Smoking, excessive alcohol, sun exposure, pesticides, industrial chemicals and air pollutants are just a few of the ways free radicals are activated, according to the National Cancer Institute. The body does have a way to fight back — with antioxidants. Nicknamed 'free radical scavengers,' antioxidants can prevent and repair damage caused by some types of free radicals, experts say. While supplements have failed to show promise against free radicals, fruits, vegetables, nuts and grains with key vitamins and minerals are excellent sources of antioxidants, according to the Cleveland Clinic. Citrus fruits, red and green peppers, and broccoli are full of the antioxidant vitamin C, while nuts, sunflower seeds, spinach and broccoli are good sources of vitamin E, another antioxidant, the clinic states on its website. Salmon and tuna contain selenium, as does brown rice, eggs and whole wheat bread. Beta carotene, another antioxidant, can be found in carrots, apricots, kale, mangos and sweet potatoes.
