International Index Research Articles

Association between improved erectile function and dietary patterns: a systematic review and meta-analysis.

Erectile dysfunction (ED) is prevalent among men, but its relationship with dietary habits is uncertain. The aim of our study was to assess whether dietary patterns enhance erectile function by reviewing the literature published before August 1, 2022, via PubMed, Web of Science, and EMBASE databases. The data compiled included author details; publication dates, countries, treatments, patient numbers, ages, follow-ups, and clinical trial outcomes, such as ED cases, odds ratios (ORs), confidence intervals (CIs), and International Index of Erectile Function-5 (IIEF-5) scores with means and standard deviations. An analysis of 14 studies with 27 389 participants revealed that plant-based diets (OR = 0.71, 95% CI: 0.66-0.75; P < 0.00001), low-fat diets (OR = 0.27, 95% CI: 0.13-0.53; P = 0.0002), and alternative diets such as intermittent fasting and organic diets (OR = 0.54, 95% CI: 0.36-0.80; P = 0.002) significantly reduced ED risk. High-protein low-fat diets (hazard ratio [HR] = 1.38, 95% CI: 1.12-1.64; P < 0.00001) and high-carb low-fat diets (HR = 0.79, 95% CI: 0.55-1.04; P < 0.00001) improved IIEF-5 scores. Combined diet and exercise interventions decreased the likelihood of ED (OR = 0.49, 95% CI: 0.28-0.85; P = 0.01) and increased the IIEF-5 score (OR = 3.40, 95% CI: 1.69-5.11; P < 0.0001). Diets abundant in fruits and vegetables (OR = 0.97, 95% CI: 0.96-0.98; P < 0.00001) and nuts (OR = 0.54, 95% CI: 0.37-0.80; P = 0.002) were also correlated with lower ED risk. Our meta-analysis underscores a strong dietary-ED association, suggesting that low-fat/Mediterranean diets rich in produce and nuts could benefit ED management.

Scoping Review of Pre-Exposure Prophylaxis and Post-Exposure Prophylaxis in HIV Prevention in Türkiye

Abstract Background Pre-Exposure Prophylaxis (PrEP) is a medical -antiretroviral- prevention method that reduces the risk of HIV transmission during sexual intercourse or injection drug use. Post-exposure prophylaxis (PEP) refers to taking medicine after risky exposure. The European Centre for Disease Prevention and Control (ECDC) has recommended the integration of PrEP into the existing HIV prevention packages since 2015. In Türkiye, first PrEP Guideline was published in 2022. The aim of this study is to evaluate the literature gap on the PrEP and PEP for HIV prevention research in Türkiye. Methods This study was conducted in October 2023. Searches were performed using the keywords ‘HIV, AIDS’ and ‘Pre-exposure prophylaxis, PrEP, Post-exposure prophylaxis, PEP’ in PubMed, Web of Science, Scopus, TRDizin, and Dergipark for all years. ‘Türkiye, Turkey, Turkish’ were added into the keywords in international indexes, without using country filters. Inclusion criteria were research on PrEP or PEP for HIV, research conducted in or using data from Türkiye, publications in English/Turkish. Exclusion criteria were non-HIV topics, non-Turkish data, non-English/Turkish publications. Lists were merged, duplicates were removed. Inclusion-exclusion criteria were conducted at title and abstract level. Full texts of the included articles examined for bibliometric characteristics, study types, and key results. Results 1014 publications yielded, 993 evaluated, and 17 fully reviewed. Four discussed Türkiye’s PrEP practices (2018-2023); three analyzed PEP regimens; three were reviews on PrEP/PEP in Türkiye (2016-2022). Two original research articles explored PrEP awareness among Türkiye’s men having sex with men (2022) and infectious disease physicians’ attitudes toward PrEP (2020). Studies showed gaps in PrEP information and service access. Conclusions There are limited studies published on PrEP and PEP in HIV prevention in Türkiye. This study highlights the need for local research on the topic. Key messages • Evaluation of Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) publications highlights gaps in HIV prevention research. • Limited literature on PrEP and PEP in HIV prevention emphasizing the need for further studies and improved access to PrEP information.

Pain associated with prostaglandin E1-containing intracavernosal injection medication is associated with poor erectile function recovery after radical prostatectomy.

Intracavernosal injection therapy is often used as second-line therapy for erectile dysfunction associated with radical prostatectomy when therapy with phosphodiesterase-5 inhibitors has failed, but prostaglandin E1-containing vasoactive agents are associated with penile pain in some men. To define the incidence of pain with prostaglandin E1-containing intracavernosal injectionmixtures for erectile dysfunction associated with radical prostatectomy when therapy with phosphodiesterase-5 inhibitors has failed, and whether painwasa predictor of erectile function recovery. Men who underwent radical prostatectomy andwerecommencedonintracavernosal injection within 12 months of radical prostatectomy were included. A pain visual analog scale (0-10) was used to assess the degree of pain. Erectile function recovery was defined asthe International Index of Erectile Function domain score ≥24using phosphodiesterase-5 inhibitors at 24months. The study included 566 patients, mean age was 58±14 (42-74) years. Duration post-radical prostatectomy at intracavernosal injection training was 3.5±3.5m. Nerve sparing status: bilateral 76%, unilateral 13%, and non-nerve sparing 11%. Incidence of pain with intracavernosal injection per nerve sparing status: bilateral 10% of patients, unilateral 32%, non-nerve sparing 92% (p<0.001). Median visual analog scale in those experiencing pain: bilateral 4 (interquartile range 3, 5), unilateral 5.5 (interquartile range 3, 6), non-nerve sparing 7 (interquartile range 3, 9) (p<0.001). Phosphodiesterase-5 inhibitors success at 24months (no pain vs. pain): bilateral 70%vs. 40% (p<0.001), unilateral 50%vs. 28% (p<0.001), non-nerve sparing 10%vs. 0% (p<0.001). On multivariate analysis, predictors of failure to respond to phosphodiesterase-5 inhibitors at 24months post-radical prostatectomy included baseline erectile function, increasing age, incomplete nerve-sparing surgery, and presence of pain. The presence of penile pain with intracavernosal injection is associated with poorer erectile function recovery post-radical prostatectomy. Incidence of pain is high in men with non-nerve sparing radical prostatectomy; older patient age, poorer nerve sparing, poor baseline erectile function, and the presence of penile pain with prostaglandin E1-containing intracavernosal injection medication, were predictive of poor erectile function recovery using phosphodiesterase-5 inhibitors at 24months.

Analysis of the Competitiveness of Digital Service Trade Between China and RCEP Partner Countries

Abstract: Based on the digital service trade data from China and RCEP partner countries from 2008 to 2022, this study analyzes the current status of digital service trade, including export scale, structure, and policies. It calculates the international market share and trade competitiveness index, and provides an in-depth analysis of the overall competitiveness of digital service trade and the competitiveness levels by industry within RCEP countries. The study finds that while the international competitiveness of digital service trade between China and RCEP partner countries is relatively weak, the development speed is relatively fast. In response, China should increase efforts in digital infrastructure construction with RCEP partners, promote digital technology research and innovation; enhance digital security and privacy protection, and improve relevant laws and policies; reduce barriers to digital service trade, and increase the influence in formulating digital trade rules; strengthen political mutual trust among RCEP countries, and deepen cooperation in digital service trade.

Relationship between erectile dysfunction and alexithymia in male patients with implantable cardioverter defibrillators: a cross-sectional study

BackgroundImplantable Cardioverter-Defibrillator (ICD) implantation is a life-saving intervention for individuals at risk of life-threatening arrhythmias. However, the psychosocial impact of ICD implantation extends beyond its cardiovascular benefits, potentially influencing emotional well-being and sexual health. This can lead to erectile dysfunction, which, is often associated with alexithymia. Both erectile dysfunction and alexithymia can significantly affect the psychological well-being of both patients and their partners.AimsThis study examines the association of erectile dysfunction with alexithymia in patients after ICD implantation. Additionally, we investigate potential moderators of this association.MethodPatients (N=165) completed self-rating questionnaires: Toronto Alexithymia scale (TAS-20), International Index of Erectile Function (IIEF-5), Adjustment disorder – new module (ADNM-20). Descriptive statistics, correlations, multivariate linear regressions, and moderation analysis were conducted.ResultsThe determinants of erectile dysfunction in ICD patients were explored in a regression model explaining 22% of the total variance. The ADNM-20 subscale preoccupation was found to significantly moderate the relationship between the alexithymia subscale externally oriented thinking and erectile dysfunction (R2 = 0.02, p=0.03).ConclusionWe did not find evidence for a relationship between externally oriented thinking and erectile dysfunction at low to average levels of preoccupation. However, evidence for such a relationship was found at high levels of preoccupation, where more externally oriented thinking was related to more erectile dysfunction. The intersection of alexithymia and erectile dysfunction represents a promising avenue for future research, offering opportunities to unravel the intricate connections between emotional processing and sexual health. Enhancing insights into this relationship could lead to innovative interventions that address the needs of individuals struggling with both conditions, fostering improved emotional expression, intimate relationships, and sexual satisfaction.

Abnormal percent amplitude of fluctuation in patients with lifelong premature ejaculation is associated with neurotransmitter profiles.

Identifying additional imaging biomarkers of lifelong premature ejaculation (LPE) may provide valuable insights into understanding the underlying neural mechanisms of this disorder. Forty-six LPE patients and thirty-five healthy controls (HCs) were enrolled in this study. The Percent Amplitude of Fluctuation (PerAF) method was used to assess differences in brain function in LPE patients compared to HCs during the resting-state. Receiver operating characteristic (ROC) analysis was used to investigate the potential biomarkers based on the imaging findings. Correlation analysis was then applied to examine the relationships between the neuroimaging findings and clinical symptoms. We also investigated whether PerAF alterations in LPE patients were associated with specific neurotransmitter systems. Compared to HCs, LPE patients showed increased PerAF in the middle cingulate cortex (MCC), supramarginal gyrus, Rolandic operculum, parahippocampus/hippocampus (ParaHIPP/HIPP) as well as insula; and decreased PerAF in the precuneus, inferior temporal cortex plus occipital cortex. The MCC and ParaHIPP/HIPP exhibited higher classification performance on ROC analysis. Positive correlations were found between the Premature Ejaculation Diagnostic Tool score and PerAF in the insula, and the International Index of Erectile Function score and PerAF in the precuneus. Additionally, altered PerAF in LPE patients correlated significantly with the spatial distribution of dopamine, acetylcholine and epinephrine pathways. Our findings indicate that LPE patients have PerAF-related changes in certain brain regions associated with visual, sensory and/or emotional processing, and reveal that the abnormal control of ejaculatory function may be related to the combined dysregulation of neurotransmitter systems in LPE patients.

Market timing with moving average distance: International evidence

We explore the ability of the distance between short- and long-run moving averages, called MAD, to predict future returns of international market-wide indices. MAD portfolios yield abnormal profits after transaction costs, which do not reverse in the long run. This suggests that anchoring to long-run moving averages is a global phenomenon that applies also to market-wide indices. The annualized MAD portfolios’ alpha values are double-digit, with Sharpe ratios significantly higher than the global benchmarks. Similar results for developed economies and developed markets indicate that international diversification is still effective and offers significant economic benefits even among developed countries.

A Study of the Relationship Between Objective Tests to Diagnose Erectile Dysfunction and Markers of Cardiovascular Disease

Background: Erectile dysfunction (ED) can stem from various organic and functional causes but is often linked to vascular health and cardiovascular disease. Limited data exist on how cardiovascular disease markers correlate with objective ED tests like the Nocturnal Penile Tumescence and Rigidity (NPTR) test and Penile Color Doppler Ultrasound (PCDU). Methods: A prospective observational study was performed, and 58 men with ED were assessed using the International Index of Erectile Function-15 (IIEF-15), NPTR test, and PCDU. Peripheral vascular health was evaluated through carotid intima-media thickness (cIMT) and brachial flow-mediated dilation (FMD). Results: Out of the participants, 44 had normal NPTR results, while 14 had abnormal results. The group with abnormal NPTR results was significantly older and had higher rates of hypertension and diabetes. Although the IIEF-15 scores were similar between the two groups, those with abnormal NPTR results had a lower peak systolic velocity (PSV) and a higher prevalence of impaired PSV. Correlations between the IIEF, NPTR, PCDU, and peripheral vascular markers lost significance after the age adjustment. Conclusions: This study suggests that abnormal NPTR results, combined with cardiovascular risk factors, may signal vascular ED and generalized vasculopathy, highlighting the need for cardiovascular assessment. An accurate ED diagnosis should integrate clinical evaluation with multiple tests while considering aging as a key risk factor.

Prospective Multicenter Comprehensive Survey on Male Sexual Dysfunction following Laparoscopic, Robotic, and Transanal Approaches for Rectal Cancer (the LANDMARC Study).

To investigate the incidence of male sexual dysfunction (SD) including erectile dysfunction (ErD) and ejaculatory dysfunction (EjD) after minimally invasive rectal cancer surgery. Male SD significantly affects post-rectal cancer surgery quality of life (QOL). Current assessments using the International Index of Erectile Function-5 are unsuitable for patients with reduced postoperative sexual activity, because it assumes sexual intercourse. This study addresses this gap using the Erection Hardness Score (EHS) and custom ejaculatory questionnaires. This prospective multicenter open-label phase II trial enrolled 399 patients who underwent laparoscopic (Lap), robotic (Ro), or transanal (Ta) rectal cancer surgery. EHS and custom ejaculatory questionnaires assessed ErD, EjD, and potency impairment at 3, 6, and 12 months postoperatively. The rates were assessed in the full analysis set and compared between the Lap and Ro groups after propensity score matching. At 12 months, the overall incidences of ErD and EjD were 34.7% and 29.8%, respectively. The Ro group showed a significantly lower EjD rate (25.0%) than the Lap group (40.9%), with no significant difference in ErD. Potency impairment was lower in the Ro group at 6 months (32.7% vs. 22.3%) and 12 months (29.0% vs. 17.8%) postoperatively. The Ta group showed relatively high ErD and EjD at 3 months, with some recovery at 12 months. Minimally invasive rectal cancer surgery commonly results in ErD, EjD, and potency impairment. Robotic surgery provides lower EjD rates and less potency impairment. Comprehensive sexual function assessments are essential to inform patients and improve QOL outcomes.

Assessing the achievement of sustainable development in the Maghreb countries

Aim. Comparative analysis of the progress of achieving sustainable development by Maghreb countries (among them Libya, Tunisia, Algeria, Morocco, Mauritania) according to the indices developed by international organizations and scientific institutions, as well as ranking the countries according to the level of sustainable development in the region.Objectives. To analyze the regulatory framework governing sustainable development in the Maghreb countries; to assess the level of sustainable development of the countries under consideration according to international environmental, social and economic indices in 2018–2023; to apply a universal methodology for assessing sustainable development based on basic statistical data of each country; to identify common achievements and unique challenges faced by countries in the process of implementing sustainable development programs.Methods. The analysis is based on the comparison of statistical data, publications and reports of international organizations on the success of the implementation of sustainable development programs in the Maghreb countries. Comparative and analytical approaches to assessing the level of sustainable development were applied, and attention was paid to factors affecting successes and obstacles to achieving sustainable development.Results. Maghreb countries are at different levels of sustainable development. The article traces the differences in the countries’ strategies for implementing national sustainable development programs. The analysis of the level of sustainable development in Maghreb countries showed that Morocco has the highest position. Libya has the lowest level of sustainable development. The poverty rate in the region is decreasing, although in Libya, it remains high. Countries are showing progress in renewable energy development, with Morocco in particular implementing solar energy programs. Despite the successes, the countries face significant challenges. Inequality in access to resources and income, along with high unemployment, especially among youth, remains a pressing problem in the region. Political instability in Libya, non-cooperation between Morocco and Algeria hinder economic development and the realization of the Sustainable Development Goals.Conclusions. Regular monitoring of the level of sustainable development in the Maghreb countries, as well as timely adjustment of actions, serves as a necessary step to achieve prosperity and well-being in the region. Despite many challenges, Libya, Tunisia, Algeria, Morocco and Mauritania have great potential for sustainable development. However, realizing the Aim. requires considerable effort, political will and effective cooperation, both within the region and internationally. It is necessary to continue to invest in development, strengthen regional cooperation and utilize innovative technologies to achieve a sustainable future.

The effectiveness of low-level laser therapy in the treatment of patients with post-COVID-19 erectile dysfunction

BACKGROUND: Non-drug therapy has proven to be the most effective and convenient method in the treatment of patients with post-Covid erectile dysfunction. One of these treatments is low-level laser therapy. The advantage of this method is the high therapeutic effect of a low-intensity laser on the function of the pudendal nerve and on the endothelium of the vessels of the cavernous body. AIM: To study the effectiveness of low-level laser therapy in the treatment of patients with post-Covid erectile dysfunction. MATERIALS AND METHODS: Under our supervision from 2021 to 2023. At the medical center Medical Dental Institute there were 40 patients diagnosed with post-Covid erectile dysfunction. The control group (n=20) of patients underwent a 2-month course of standard drug therapy, and the main group, in addition to drug therapy, underwent a course of low-intensity laser therapy. Erectile function was assessed using the International Index of Erectile Function (IIEF) and quality of life was assessed using the Life Satisfaction Index (LSIA). RESULTS: After treatment erectile function improved in the control group by 11.7% (p 0.05) and in the main group by 33.1% (p 0.05). The quality of life satisfaction in the control group increased by 28.7% (p 0.05) in the control group and by 87% (p 0.05) in the main group. CONCLUSION: The use of a contact red laser with a wavelength of 635 nm was 1.8 times more effective than standard drug therapy in restoring erectile function. In addition, the improvement in life satisfaction during low-intensity laser therapy exceeded these indicators in the control group by 2 times.

External validation and calibration of the HoLISTIC Consortium's advanced-stage Hodgkin lymphoma international prognostic index (A-HIPI) in the Brazilian Hodgkin lymphoma registry.

The Hodgkin lymphoma International Study for Individual Care (HoLISTIC) Consortium's A-HIPI model, developed in 2022 for advanced-stage classical Hodgkin lymphoma (cHL), predicts survival within 5 years amongst newly diagnosed patients. This study validates its performance in the Brazilian Hodgkin lymphoma registry. By 2022, the Brazilian HL registry included 1357 cHL patients, with a median 5-year follow-up. Probabilities for 5-year progression-free survival (PFS) and overall survival (OS) were calculated using A-HIPI-model equations. Discrimination (Harrell C-statistic/Uno C-statistic) and calibration measures assessed external validation and calibration. Lab values beyond the allowed range were excluded, mirroring the initial A-HIPI analysis. A total of 694 advanced-stage cHL patients met the original inclusion criteria (age 18-65 years, Stage IIB-IV). Median age was 31 years; 46.3% were females. Stage distribution was IIB (33.1%), III (27.4%), IV (39.5%). Bulky disease in 32.6%. Five-year PFS and OS were 68.4% and 86.0%, respectively. Harrell C-statistics were 0.60 for PFS and 0.69 for OS, and Uno C-statistics were 0.63 for PFS and 0.72 for OS. Calibration plots demonstrated well-calibrated predictions with calibration slopes of 0.91 and 1.03 for 5-year OS and PFS, respectively. Despite differing patient, clinical characteristics, and socioeconomic factors, the baseline prediction tool performed well in the Brazilian cohort, demonstrating adequate discrimination and calibration. This supports its reliability in diverse settings.

Regenerative therapies for erectile dysfunction: a systematic review, Bayesian network meta-analysis, and meta-regression.

Current guidelines advocate a shared decision-making process approach to erectile dysfunction management, and while there is growing interest in regenerative therapies such as stem cell therapy, platelet-rich plasma injections, and low-intensity shockwave therapy for erectile dysfunction, comparative data on the efficacy of these modalities are limited. This systematic review and network meta-analysis aims to compare stem cell therapy, platelet-rich plasma injections, and low-intensity shockwave therapy for managing erectile dysfunction and quantify their impact on the International Index of Erectile Function (IIEF). In January 2024, a systematic search of online databases was performed to identify randomized clinical trials related to stem cell therapy, platelet-rich plasma injections, and low-intensity shockwave therapy in erectile dysfunction. Eligible articles reported outcomes using the IIEF score. Data were inputted into Review Manager 5.4 for pairwise meta-analysis. Data were then used to build a network in R Studio. These networks were used to model 200 000 Markov Chains via MonteCarlo sampling. The results are expressed as standardized mean difference (SMD) with 95% credible intervals (CrI). Meta-regression was used to adjust for PDE5is use. Impact on the International Index of Erectile Function. A total of 16 studies involving 907 patients were analyzed. The standardized mean difference (SMD) vs control for stem cell therapy was 0.92 [95% CrI -0.49, 2.3]. For platelet-rich plasma, the SMD vs control was 0.83 [95% CrI 0.15, 1.5], and for low-intensity shockwave therapy, the SMD vs control was 0.84 [95% CrI 0.49, 1.2]. When stratifying low-intensity shockwave therapy by dose, the SMD vs control at 0.15mJ/mm2 was 1.1 [95% CrI 0.36, 1.9], while at 0.09mJ/mm2, it was 0.75 [95% CrI 0.26, 1.2]. Meta-regression adjusting for the administration of PDE5 inhibitors yielded non-significant results. The findings suggest that stem cells, platelet-rich plasma, and low intensity shockwave therapy, particularly at 0.15 and 0.09mJ/mm2, may offer improvements in erectile function. The strength is the robust statistical methods. Limitations are in heterogeneity in control groups and follow-up durations among included studies. Shockwave therapy and platelet-rich plasma demonstrated statistically significant improvements, though the clinical relevance and extent of their impact remain questionable. Further research is necessary to determine the efficacy of stem cell therapies for erectile function.

Sexual dysfunction and its associated factors among patients with heart failure in public hospitals in Gondar town, North and West Gondar, 2024

IntroductionSexual dysfunction is characterized by difficulties that interfere with achieving satisfying sexual activity, affecting desire, arousal, orgasm, and overall satisfaction. A recent study in Ethiopia identified heart failure as one of the most common cardiovascular diseases in the country. Sexual dysfunction significantly affects the quality of life in individuals with heart failure, yet it often goes underdiagnosed and underreported. Understanding the prevalence of sexual dysfunction and the factors influencing sexuality in these patients is essential. Therefore, the primary objective of this study was to determine the prevalence of sexual dysfunction among patients with heart failure in Gondar City and the northern and western zones of Gondar public hospitals.MethodThis study included 423 participants diagnosed with heart failure, selected through simple random sampling from January 3 to February 30, 2024. Data were collected using an interviewer-administered questionnaire covering socio-demographic, behavioral, and clinical information. Sexual dysfunction in males was assessed using the International Index of Erectile Function-5, while the Female Sexual Function Index-6 was used for females. Data were entered into Epidata version 3.6 and later exported to SPSS version 25 for analysis. Binary logistic regression was employed to identify factors associated with sexual dysfunction, with a significance level set at p ≤ 0.05.ResultA total of 423 heart failure patients participated in the study, achieving a 100% response rate. The results indicated a significant prevalence of sexual dysfunction, affecting 57.92% of participants (95% CI 54.76%–63.76%). Female participants reported a higher prevalence of sexual dysfunction, with 63% of the 138 female heart failure patients affected. Among the 285 male participants, 55.4% (158 patients) were identified as having erectile dysfunction. Multivariable logistic regression analysis revealed that factors such as body mass index, age, insufficient physical activity, and smoking were significantly associated with sexual dysfunction in females. In males, erectile dysfunction was significantly linked to diabetes mellitus, heart failure classification, age, and insufficient physical activity.Conclusion and recommendationThis study identified a high prevalence of sexual dysfunction, with females being more affected than males. Additionally, the research identified several factors influencing sexual dysfunction among patients with heart failure, including BMI, age, cigarette smoking, diabetes mellitus, and the classification of heart failure. The study recommends that healthcare providers and other stakeholders take proactive measures to alleviate the burden of sexual dysfunction in patients with heart failure. Strategies should focus on controlling the severity of heart failure symptoms, effectively managing comorbidities, and addressing factors such as body weight, psychological well-being, and behavioral patterns. By targeting these areas, healthcare providers can work toward minimizing the risk of sexual dysfunction and improving the overall quality of life for patients with heart failure.

The Relationship between Erectile Dysfunction, Self-Esteem, and Depression in Post-Myocardial Infarction Patients.

Background: The interplay between the physical and mental health of patients recovering from myocardial infarction (MI) is crucial. Erectile dysfunction (ED) is a common sexual issue, particularly among patients who have had a myocardial infarction and arterial diseases, and it significantly affects self-esteem and overall psychological well-being. Despite significant advances in cardiac rehabilitation, the psychosocial aspects, especially those related to sexual health, remain underexplored. Objectives: The objective of this study was to examine the relationship between ED, self-esteem, and depression in male patients post-MI, and to assess how ED treatment affects patients' psychological health. Methods: This cross-sectional study involved 80 male patients with a confirmed MI within the last six months, aged between 35 and 77 years. The Beck Depression Inventory-II (BDI-II) and Rosenberg Self-Esteem Scale (SES) were used to assess psychological well-being, while the International Index of Erectile Function-5 (IIEF-5) was employed specifically to evaluate ED. Results: This study demonstrates a strong interdependence between mental and physical health in post-myocardial infarction (MI) patients, with ED being a key factor affecting self-esteem. There is a significant negative correlation between self-esteem and depression, highlighting the importance of psychological resilience in post-MI rehabilitation. Elevated self-esteem helps mitigate depressive symptoms, contributing to improved mental health and rehabilitation outcomes. Conclusions: Older patients tend to have lower self-esteem, likely due to the presence of multiple comorbidities and a longer, more challenging recovery period post-MI. Age was a significant factor in predicting lower self-esteem, but other demographic characteristics did not have a strong influence on self-esteem, depression, or ED.

Effects of gender-affirming hormone therapy on lower urinary tract symptoms and sexual function among transgender individuals.

Gender-affirming hormone therapy (GAHT) includes estrogen preparations and androgen inhibitors for transgender women, and testosterone preparations for transgender men. The aim of the study was to investigate possible effects of GAHT on lower urinary tract symptoms (LUTS) and sexual function among transgender individuals. Fifty-one transgender men and 47 transgender women were prospectively recruited. Four validated female questionnaires (Bristol Female Lower Urinary Tract Symptoms [BFLUTS] questionnaire, the Medical, Epidemiologic, and Social aspects of Aging [MESA] questionnaire, Urgency, the Severity and Impact Questionnaire [USIQ], and the Female Sexual Function Index [FSFI]) and two validated male questionnaires (International Prostate Symptom Score [IPSS], and the International Index of Erectile Function [IIEF]) were used to assess LUTS and sexual function among transgender men and women, respectively, before and during GAHT. Follow-up was performed over a period of 3-12 months. Thirty-four transgender men (mean age 24.4 ± 7.6 years) and 31 transgender women (mean age 29 ± 8.7 years) completed all questionnaires, before and during GAHT. Testosterone treatment was associated with a statistically significant improvement in sexual desire among transgender men, as reflected in the FSFI questionnaire (4.5 ± 1.2 vs. 3.6 ± 1.3, P = 0.002). None of the three LUTS questionnaires showed statistically significant changes during the treatment with testosterone preparations. Estrogen treatment was associated with a statistically significant decrease in erectile function among transgender women, as reflected by the IIEF questionnaire (9.0 ± 7.2 vs. 14.1 ± 11.1, P = 0.012). No significant changes were found in LUTS during the treatment with estrogen preparations, except for a slight worsening of nocturia (2.1 ± 1.8 vs. 1.1 ± 1.4, P = 0.009). GAHT was not found to be associated with significant LUTS in both transgender men and women. Nevertheless, some effects on sexual function were observed, mainly a decrease in erectile function among transgender women and an increase in sexual desire among transgender men.

The Effect of Physiotherapy on Erectile Dysfunction Secondary to Prostatic Adenectomy: A Randomized Control Trial Study.

The objective of this randomized controlled trial was to investigate the impact of manual therapy (friction massage) and pelvic floor muscle (PFM) training on erectile dysfunction (ED), pelvic floor muscle thickness, and blood flow in the penile arteries and veins in men who have undergone prostatic adenectomy (PA). This study employed a randomized, double-blinded, controlled trial design. Forty patients participated and were divided into two groups: intervention and control (n=20 per group). The intervention group received 10 sessions of pelvic floor muscle training and manual therapy, while the control group solely underwent pelvic floor muscle training. The recovery rate was measured using the International Index of Erectile Function 15 (IIEF-15) questionnaire and Erection Hardness Score (EHS). Sonographic factors were assessed using simple and Doppler ultrasound. The intervention group exhibited significantly higher erectile function scores (F(1,37)=158.04, P < 0.001, η2 P = 0.810) and a higher average total (IIEF-15) score (20.52) (F(1,37)=136.76, P < 0.001, η2 P = 0.787) compared to the control group in the post-test assessment. Comparison between the two groups revealed an increase in ultrasonic parameters such as the thickness of the ischiocavernosus and bulbospongiosus muscles, maximum systolic velocity, and minimum diastolic velocity of the cavernosal artery in the intervention group. However, the maximum blood flow velocity in the posterior vein decreased. PFM training and friction massage play a significant role in managing ED following PA, positioning them as the primary treatment approach for men experiencing ED post-prostatectomy.

Assessment of Sexual Dysfunction in Male Patients with Young-Onset Parkinson’s Disease: A Case-Control Study

Introduction: There is a need for a comprehensive assessment of sexual dysfunction in patients with young-onset Parkinson’s disease (PD) to better understand its impact on this population. This study aimed to assess sexual dysfunction in patients with young-onset PD. Methods: This case-control study was conducted using a self-administered International Index of Erectile Function Scale (IIEF) questionnaire. The questionnaire included questions related to sexual function, including the ability to achieve and maintain erection and sexual desire. The participants included 30 individuals with young-onset PD and 30 controls without PD who were matched for age and gender. Results: The study enrolled 30 patients with an average age of 37.2 ± 5.29 years and PD symptom duration ranging from less than two years to over two years. Most patients were classified as having stage 2 or 3 PD and exhibited a range of symptoms, such as bradykinesia, tremors, rigidity, and postural instability. The findings revealed that 40% of the PD group experienced moderate erectile dysfunction, while 23.33% reported severe dysfunction, in contrast to the absence of dysfunction observed in the control group. The analysis indicated that patients with a disease duration of less than two years had higher scores across all five components of the IIEF questionnaire. Furthermore, anxiety, depression, increased medication use, and disease severity significantly affected sexual function. Conclusion: This study highlights the impact of young-onset PD on sexual function and underscores the importance of the early recognition and management of sexual dysfunction in patients with PD.

Low magnesium levels and prognosis in newly diagnosed diffuse large B-cell lymphoma.

Magnesium (Mg) is an essential element involved in cellular metabolism. We demonstrated that in patients with diffuse large B-cell lymphoma (DLBCL) undergoing autologous stem cell transplant (SCT), those with a serum Mg < 2.0mg/dL at the time of transplant had worse outcomes. In this study, we aimed to learn the prognostic value of low serum Mg in patients with untreated DLBCL. We analyzed serum from 408 patients and tested 2 Mg cutpoints-low (<1.7mg/dL) and low normal (<2.0mg/dL), a range we found associated with lower survival in the SCT group. We found 3% of patients with low levels and 23% with low normal levels. Low normal serum Mg levels were associated with a higher stage at diagnosis, more extranodal involvement, higher international prognostic index score, lower overall survival (OS), and event-free survival. These data warrant testing Mg replacement to a target of >2.0mg/dL to learn if survival can be improved.

Safety and efficacy of platelet-rich plasma injection for treatment of erectile dysfunction: a prospective randomized controlled study

BackgroundAffected sexual relationships affect both the quality of life of men and women. Platelet-derived therapies are becoming increasingly popular in various medical and surgical fields because of their ability to aid in tissue healing and vascular remodeling. This study aimed to assess the safety and effectiveness of platelet-rich plasma (PRP) injections in treating patients with erectile dysfunction (ED).ResultsFifty-two participants with mild to moderate ED were divided into two groups: group A, who received three PRP penile injections, and group B, who received three saline injections (5 ml for each injection site). The International Index of Erectile Function (IIEF) was used to evaluate all participants. A month after the last injection, the PRP group's IIEF was 16.12 ± 1.25, while the placebo group's was 15.99 ± 1.21 (p = 0.683). Following a 3-month period, the IIEF for the PRP group was 16.44 ± 1.17, while the placebo group's was 16.31 ± 1.06 (p value = 0.653). Following a 6-month period, the IIEF for the PRP group was 16.35 ± 1.45, while that for the placebo group's was 16.23 ± 1.19 (p = 0.727). In terms of IIEF, there was no significant difference between the two groups after one, three, and six months of treatment.ConclusionIn brief, our research revealed no data to support the application of PRP injections in the management of mild-to-moderate ED.