Purpose: Erectile dysfunction (ED) is associated with several vascular disorders, but the associations between ED and vascular
parameters are still unclear.
Materials and Methods: We analyzed and synthesized a comprehensive range of studies from PubMed, Web of Science, and
Scopus regarding the associations between ED and the following measures: ankle-brachial index (ABI), pulse wave velocity
(PWV), intima-media thickness (IMT), nitrate-mediated dilation (NMD), flow-mediated dilation (FMD), augmentation index
(AI), endothelial progenitor cells (EPCs) and other vascular parameters. Subgroup analysis was conducted according to specific
types of parameters. Study quality was assessed by using the Newcastle–Ottawa Scale. Sensitivity analysis was conducted
to confirm the robustness of the pooled results.
Results: Fifty-seven studies with 7,312 individuals were included. Twenty-eight studies were considered to be high-quality.
ED patients had a 0.11 mm higher IMT (95% confidence interval [CI]: 0.07, 0.15), a 2.86% lower FMD (95% CI: -3.56,
-2.17), a 2.34% lower NMD (95% CI: -3.37, -1.31), a 2.83% higher AI (95% CI: 0.02, 5.63), a 1.11 m/s higher PWV (95%
CI: 0.01, 2.21), and a 0.72% lower percentage of EPCs (95% CI: -1.19, -0.24) compared to those without ED. However, ABI
was similar between ED patients and non-ED individuals. According to sensitivity analysis, the pooled results were robust.
Conclusions: Our study confirmed the associations between ED and several vascular parameters and highlighted the importance
of prevention and management of vascular and endothelial dysfunction in ED patients.
Medicine, Diseases of the genitourinary system. Urology
Diangienda Kuntima Diasiama Pablo, Joseph Mbuyi, Dieudonné Moningo Molamba
et al.
The authors report the case of tuberculous spondylodiscitis with unusual clinical and paraclinical features, in a healthy young boy of 16 year old with persistent and complicated left orchiepididymitis despite a well-conducted treatment. The diagnosis was delayed for several months and the evolution was favorable after etiological treatment.
Maria L. Bageta, Michelle Wood, Pablo Lopez Balboa
et al.
Abstract Background Epidermolysis bullosa (EB) is an inherited genodermatosis of variable severity characterised by skin and mucosal fragility commonly associated with altered gait patterns and hypermobility. Objectives To define the altered gait pattern and identify possible causes in patients with EB. Methods Retrospective review of the EB database to identify children with EB with at least one physiotherapy assessment between 2009 and 2022. Results Forty‐eight children out of 59 referrals to physiotherapy with an altered gait pattern were identified (81.3%); 23 (48%) had recessive dystrophic EB (RDEB), 17 (36%) EB simplex, five (10%) Junctional EB (JEB) and three (6%) dominant dystrophic EB (DDEB). The patho‐mechanical altered gait patterns were characterised by altered load‐bearing surface in contact with the floor (63%), short shuffling pattern with high cadence and decreased single support (42%) and equinovarus (toe walking) (6%). Hypermobility (as defined by the Beighton score) was present in 67% of patients: 43% in RDEB, 88% in EBS, 100% in JEB and 67% in DDEB. Conclusions In this study, we provide the first accurate data for the causes of altered gait patterns in children with EB. Healthcare professionals should be aware of joint hypermobility and its effect on gait in this patient cohort.
Dermatology, Diseases of the genitourinary system. Urology
Faustine Kyungu Nkulu-Kalengayi, Anna-Karin Hurtig, Ida Linander
Around 40% of people living with human immunodeficiency virus (HIV) in Sweden are women. However, little is known about their experiences, particularly those related to sexual and reproductive health and rights (SRHR). This study aims to explore perceptions and experiences of SRHR among women living with HIV (LWH). Twelve interviews were conducted with women LWH from September to October 2019 and analysed using thematic analysis. The central theme describing participants’ experiences of social relationships, intimate encounters and reproductive life, “Discrimination is harder to live with than the disease itself”, is based on three themes that contain subthemes. Theme 1 describes how participants reconsider and reorient their sexual and reproductive life after diagnosis. Theme 2 highlights how (mis)perceptions of HIV affect sexual and reproductive life and lead to abusive treatment and internalisation. Theme 3 describes a paradoxical shift of responsibilities where participants experience being compelled to take greater responsibility in some situations and stripped of the right to decide in others. This study suggests that despite notable progress in HIV treatment, stigma and discrimination stemming from outdated beliefs and (mis)conceptions, ambiguous policies and guidelines, and unequal access to information affect SRHR experiences of women LWH more than the virus itself. The results emphasise the need to: update knowledge within healthcare settings and among the public; clarify ambiguous legislations and guidelines; ensure equal access to information to enable all women LWH to take informed decisions, make fully informed choices and realise their SRHR; and consider the diversity of women LWH and enable shared decision-making.
Diseases of the genitourinary system. Urology, The family. Marriage. Woman
Background End-stage renal disease (ESRD) is the final stage during the development of renal failure. Depression is the most common psychiatric disorder in patients with ESRD, which in turn aggravates the progression of renal failure, however, its underlying mechanism remains unclear. This study aimed to reveal the pathogenesis and to discover novel peripheral biomarkers for ESRD patients with depression through metabolomic analysis. Methods Ultra-high-performance liquid chromatography coupled with mass spectrometry (UPLC-MS) was used to explore changes of serum metabolites among healthy controls, ESRD patients with or without depression. The differential metabolites between groups were subjected to clustering analysis, pathway analysis, receiver operating characteristic (ROC) curve analysis. Results A total of 57 significant serum differential metabolites were identified between ESRD patients with or without depression, which were involved in 19 metabolic pathways, such as energy metabolism, glycerolipid metabolism, and glutamate-centered metabolism. Moreover, the area under the ROC curve of gentisic acid, uric acid, 5-hydroxytryptamine, 2-phosphoglyceric acid, leucyl-phenylalanine, propenyl carnitine, naloxone, pregnenolone, 6-thioxanthene 5'-monophosphate, hydroxyl ansoprazole, zileuton O-glucuronide, cabergoline, PA(34:2), PG(36:1), probucol and their combination was greater than 0.90. Conclusions Inflammation, oxidative stress and energy metabolism abnormalities, glycerolipid metabolism, and glutamate-centered metabolism are associated with the pathogenesis of ESRD with depression, which may be promising targets for therapy. Furthermore, the identified differential metabolites may serve as biomarkers for the diagnosis of ESRD patients with depression.
Urogenital Myiasis is rarely documented in developed countries, so epidemiological data are limited and often associated with travel to endemic regions. We report a Case of urogenital myiasis, unassociated with travel, in a 31 year old male. The patient presented to the emergency department after passing a larval fly during micturition. Pathologic examination of the initial urine sample confirmed the presence of living fly larvae and further evaluation was arranged with the urology department. The patient had no further episodes, and resolution was confirmed via urinalysis and cystoscopy. Several common risk factors were identified, including poor sanitation and hygiene.
Omar Karray, Ndiamoi Akassimadou, Stéphane Bart
et al.
Among extramedullary manifestations of multiple myeloma, testicular localization is exceptional. A scrotal mass in this context poses diagnostic and therapeutic challenges given the aesthetic, psychological and reproductive impact of surgery.Authors report a case of testicular plasmocytoma seven years after remission from multiple myeloma. The treatment consisted of left inguinal orchidectomy. Diagnosis needed the recourse to immunohistochemistry.Diagnostic modalities, therapeutic options and evolutive eventualities will be discussed.Extra-medullar localization is exceptionally reported in extramedullary multiple melanoma. Management depends on the concomitant or distant character of hemopathy diagnosis and the disease evolutive history.
Christopher Thiam Seong Lim, Nurul Zaynah Nordin, N. Z. Fadhlina
et al.
Abstract Background Although there is a large volume of literature regarding the definition and epidemiology of. Type 2 diabetes nephropathy (T2DN). There has been a paucity of data focused on the rate of transition of T2 DN. Based on our personal observation a certain percentage of our incident end stage renal disease (ESRD) patients from T2DN experienced a rapid decline of renal function. Their rapid decline nature of glomerular filtration rate (GFR) of 46 to 60 mL/min per 1.73m2 per year have far exceeded the KDIGO definitions of acute kidney injury (abrupt decrease in kidney function occurring over 7 days or less), acute kidney disease (acute or subacute damage and/or loss of kidney function for a duration of between 7 and 90 days after exposure to an acute kidney injury initiating event (Chawla et al Nat Rev Nephrol 241–57 2017) or even rapid decliner (eGFR declines > 5 mL/min per 1.73m2 per year) (Chawla et al Nat Rev Nephrol 241–57 2017; Andrassy Kidney Int 622–623 2013). Case presentation We describe here three cases of type 2 diabetic patients that have rapid renal deterioration with rate of decline 46 - 60 mL/min per 1.73m2 per year. All the patients are heavily nephrotic. All of the renal biopsies done showed the classical diabetic changes, hypertensive changes, diffuse tubulointerstitial damage, and interstitial nephritis. All of the patients admitted to taking various form of traditional medications in hope of curing their renal disease. Conclusion We wish to highlight that type 2 diabetics with massive nephrotic range proteinuria have enhanced risk of rapid renal function deterioration. The patients should be educated about the risks of rapid renal function deterioration when there is presence of heavy proteinuria. High grade proteinuria is likely to inflict the diffuse tubulointerstitial inflammation. The interstitial nephritis could be further worsened by traditional supplements consumption. Timely health education and advice must be undertaken to retard this unwanted rapid renal disease progression.
Abstract Background Although triptorelin is increasingly used in China for biochemical castration, its effects on primary prostate cancer symptoms remain unclear. This study aimed to assess the prevalence of lower urinary tract symptoms (LUTS) in Chinese prostate cancer patients and the effectiveness of triptorelin on LUTS. Methods In this 48-week multicenter, non-interventional, prospective study, we enrolled patients with locally advanced or metastatic prostate cancer. Patients received triptorelin (15 mg) intramuscularly at baseline and at weeks 12, 24, and 36 with symptom assessment using the International Prostate Symptoms Score (IPSS). The primary endpoints were the prevalence of LUTS at baseline per IPSS categories and the percentage of patients with moderate to severe LUTS (IPSS > 7) at baseline, having at least a 3-point reduction of IPSS score at week 48. Results A total of 398 patients were included; 211 (53.0%) and 160 (40.2%) among them had severe and moderate LUTS, respectively. Of the patients with IPSS scores available at baseline and at week 48 (n = 213), 81.2% achieved a reduction in IPSS of at least 3 points. Of the patients with moderate to severe LUTS at baseline and IPSS scores available at baseline and at week 48 (n = 194), 86.6% achieved a total IPSS reduction of at least 3 points. Conclusions The vast majority of Chinese patients with locally advanced or metastatic prostate cancer scheduled to receive triptorelin as part of their standard treatment have severe or moderate LUTS. Triptorelin therapy resulted in sustained improvement of LUTS in these patients.