Males Mean Age Research Articles

Comparing the Effects of 8-week Exercise Programs in the Sagittal and Frontal Planes on the Postural Sway of Elderly Men

Background and Aims Exercises are mostly used to control balance and reduce the risk of falling in the elderly. However, the effect of exercise in the frontal plane has been less studied. Therefore, this study aims to compare the effect of 8 week exercises in the sagittal and frontal planes on the postural sway of elderly men. Methods In this quasi-experimental study, 24 elderly males (Mean age: 67.21±1.56 years) were divided into two intervention groups of sagittal-plane and frontal-plane exercises. The exercises were performed for 8 weeks. The center of pressure (CoP) parameters in two groups before and after the intervention were evaluated using a foot scanner system. Finally, the ANCOVA was used for data analysis. P≤0.05 was considered statistically significant. Results The results showed a significant decrease in CoP perturbations in the Y-axis at the medial-lateral, anterior-posterior, and lateral-medial directions in the frontal plane group compared to the sagittal group (P<0.05). Moreover, there was a significant decrease in the CoP area after perturbations at the medial-lateral, anterior-posterior, and lateral-medial directions in the frontal group compared to the sagittal group (P<0.05). Conclusion It seems that exercises in the frontal plane can reduce postural sway in elderly men compared to sagittal-plane exercises. Therefore, it is recommended to emphasize the exercises of the hip abductor and adductor muscles in the frontal plane in designing exercise protocols for elderly men.

Angiographic Anatomy of the Prostatic Artery in the Korean Population: A Bicentric Retrospective Study.

The aim of this study was to analyze the origins of prostatic arteries (PAs) in the Korean population and compare them with those reported in the literature. From April 2018 to February 2024, 108 male (mean age ± standard deviation: 71.6 ± 9.7 years) with lower urinary tract symptoms (n = 102) or refractory hematuria (n = 6) underwent prostatic artery embolization (PAE). Computed tomography and angiography images were retrospectively reviewed. The branching pattern of the internal iliac artery (IIA) was classified according to the Yamaki system. The origin of the PA was categorized using the de Assis definition, and the incidence of each type was recorded. A systematic literature review was conducted and the most common types of PA were investigated. PAE was successfully implemented on 211 of the 216 pelvic sidewalls. PA cannulation failed in five sidewalls due to a steno-occlusive state. The most common IIA type was type A, in which the IIA was divided into the superior gluteal artery and gluteal-pudendal trunk (77%). Of 226 PAs analyzed, including 15 in 211 sidewalls exhibiting dual PAs, the most common PA origin was the internal pudendal artery (type IV, 35%), followed by the superior vesical (type I, 25%) and obturator (type III, 21%) arteries. Anterior division of IIA (type II) was less common (10%). Type V (uncommon origins) occurred in 8% of cases, including five distal internal pudendal arteries, four quadfurcations, three inferior gluteal arteries, three trifurcations, two medial femoral circumflex arteries, and two rectal arteries. Two of the five patients with surgically or endovascularly altered anatomy were successfully treated via PAs originating from the medial femoral circumflex arteries. Globally, type I is the most common PA type. In the Korean population, the most common IIA pattern and PA origin were types A and IV, respectively.

Multivariable reference centiles for maximum grip strength in childhood to young adults

ObjectivesMaximum grip strength (mGS) is a useful predictor of health-related outcomes in children and adults. The aim of the study was to generate sex- and age-adjusted reference centiles for mGS for children, adolescents and young adults, while adjusting for body height and body mass index (BMI).MethodsA retrospective analysis of longitudinal data from children and young adults participating in the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study (single center, open cohort study) from 2004 to 2022 was conducted. To generate sex-, age-, height- and BMI-adjusted reference centiles, a new algorithm combining multiple linear regression and the LMS method was conducted.ResultsOverall, 3325 measurements of mGS of 465 females and 511 males were eligible. The mean age at measurement of females was 12.6 ± 3.9 years, mean age of males was 12.4 ± 4.7 years. The median of number of repeated measurements per individual was 3 (range 1–8). The mGS was significantly (p < 0.001) correlated to body height and BMI (r = 0.303–0.432). Additional reference centiles for the change of z-scores of mGS were generated for children and young adults from 8 to 20 years.ConclusionsWe proposed to evaluate mGS in children, adolescents and young adults with the presented reference centiles adjusted to sex, age, height and BMI. The method presented may also be applicable to other biological variables that depend more than just on sex and age. For the first time, also reference centiles to assess the change of mGS in repeated measurements were presented.

The Risk of Mortality in Elderly Patients with Acute Vascular Insufficiency of the Intestine is 2.5-Fold Greater than that in Adult Patients: An Analysis of 36,864 Patients.

Vascular insufficiency of the intestine is difficult to diagnose and it has high mortality rates. Our study aimed to identify risk factors for in-hospital mortality of patients emergently admitted with the primary diagnosis of vascular insufficiency of the intestine. Adult (18-64 years) and elderly (>64 years) patients emergently admitted with the primary diagnosis of vascular insufficiency of the small and large intestine were analyzed using the National Inpatient Sample database from 2005-2014. Using stratified analysis and backward multivariable logistic regression analysis, the relationship between mortality and several risk factors were evaluated. There were 36,864 patients analyzed of which 4,994 died in hospital. Most patients were elderly, making up 23,052 of the total patients (63.4%). The mean (SD) age for adult males, adult females, elderly males, and elderly females were 50.51 (11.18), 52.12 (10.06), 77.00 (7.50), and 78.44 (7.88) years, respectively. When the data was stratified according to outcome, deceased adult patients accounted for 6.9% of all adult patients, while elderly deceased patients accounted for 17.5% of all elderly patients. Elderly patients had a 2.5 times increase in mortality compared to adult patients. When the data was stratified according to operation status, non-operation patients had 58.6% use of gastrointestinal invasive diagnostic procedures, as opposed to the operative patients with 30.3% use. In the final regression model, age (OR=1.03, 95%CI: 1.02-1.04), male sex (OR=1.12, 95%CI: 1.04-1.21), operation (OR=2.73, 95%CI: 2.50-2.97), bacterial infections (OR=3.12, 95%CI: 2.82-3.44), respiratory diseases, (OR=1.84, 95%CI: 1.71-1.99), cardiac diseases (OR=2.78, 95%CI: 2.09-2.48), liver diseases (OR=2.24, 95%CI: 1.99-2.53), genitourinary system diseases (OR=1.40, 95%CI: 1.30-1.51), fluid and electrolyte disorders (OR=1.48, 95%CI: 1.37-1.60), neurological diseases (OR=1.23, 95%CI: 1.13-1.33), and trauma, burns, and poisons (OR=1.57, 95%CI: 1.43-1.73) were the risk factors for mortality. Gastrointestinal invasive diagnostic procedures (OR=0.31, 95%CI: 0.28-0.34) and hospital length of stay (OR=0.91, 95%CI: 0.90-0.92) were protective factors for mortality in all patients. For elderly patients emergently admitted for intestinal vascular insufficiency, the odds of mortality were 2.5 times greater than in adult patients. Age, male sex, operation, and several comorbidities were risk factors for mortality; whereas, invasive diagnostic procedures and longer hospital stay were the protective factors against mortality.

Gender Based Comparison of Mean Arterial Pressure and Pulse Pressure after Stress Induction in Healthy Adults

Abstract: Background: Mean Arterial Pressure (MAP) and Pulse Pressure (PP) are both key parameters to diagnose and manage cardiovascular diseases and hypertension, a leading cause of mortality and morbidity globally. Men and women are physically different from each other. Objective: Is to evaluate gender-based comparison of MAP and PP of healthy adults after stress induction. Material and Methods: This cross-sectional study was designed and conducted in the Institute of Basic Medical Sciences (IBMS) at Khyber Medical University (KMU) from January 2022 to April 2022. A total of fifty-two participants including twenty-six males and twenty-six females were selected using convenience sampling. Sample size estimation was carried out using G*Power. Healthy adults between the age of 18-40 years were included in the study. Blood Pressure (BP) and Heart Rate (HR) were checked both before and after the stress induction. MAP and PP were calculated using the formulas obtained from the literature i.e., MAP = DP + 1/3 (PP) and PP = SBP-DBP. Result: The mean age of males was 27.16 ± 4.28 years and that of females was 23.15 ± 2.86 years. Both pre and post stress comparison of mean difference between healthy adult males and females, revealed no significant difference between MAP (Post-Stress p=0.97 and Pre-Stress p=0.61), PP (Post-Stress p=0.18 and Pre-Stress p=0.05) and HR (Post-Stress p=0.11 and Pre-Stress p=0.57). Males had a higher PP than females in both pre and post stress phase. Females had a slightly higher MAP than males in the pre stress phase. In the post stress phase, MAP showed a positive correlation with HR and PP. While in the pre stress phase, all the variables (MAP, PP and HR) showed no correlation with each other. Conclusion: MAP and PP show no significant difference between healthy adult males and females, after stress induction.

Carotid Intima-Media Thickness and Metabolic Complications in Children with HIV on Antiretroviral Therapy: A Cross-Sectional Study.

To evaluate carotid intima media thickness (CIMT) in children with Human immunodeficiency virus (HIV) on anti-retroviral therapy (ART) and in controls. Also, to compare body mass index (BMI), body fat percentage, skin-fold thickness (SFT), waist-to-height ratio (WHtR), lipid profile, blood pressure, lipodystrophy syndrome (LDS), non-alcoholic fatty liver disease (NAFLD) in children with HIV and in controls and to determine association between lipid profile, LDS, liver amino-transferases, NAFLD, BMI, body fat percentage, SFT, WHtR and CIMT. This cross-sectional study was done in 7 to 12 y old children attending the ART clinic and receiving ART for ≥6 mo according to 2018 National Aids Control Organization (NACO) guidelines. Thirty age and gender matched controls were enrolled from the pediatrics OPD. Weight, height, BMI, waist circumference, skin fold thickness and blood pressure were recorded. Lipid profile,liver amino-transferases, USG abdomen and CIMT were done with prior appointment. The present study had 43% females and 57% males (mean age of 9.33 ± 1.65 y). All cases were on combination ART (mean treatment duration: 59.1 mo). CIMT was significantly increased in cases as compared to controls 0.481 ± 0.087mm vs. 0.418 ± 0.072mm (p = 0.003). However, CIMT did not correlate with any other parameter. Cases had significantly higher body fat percentage (17% vs. 13.15%), systolic blood pressure (SBP), SFT, total cholesterol (TC) and low density lipoprotein- cholesterol (LDL-C) as compared to controls. NAFLD was seen in 3 cases (1%), lipohypertrophy in 7 (23%) cases and 5 (16%) controls. Children with HIV on ART have significantly higher CIMT and increased metabolic abnormalities.

Evaluation of psychosocial aspects in patients with juvenile idiopathic arthritis

The relationship between psychological factors and the overall health of patients with Juvenile Idiopathic Arthritis (JIA) is evident, yet the specific impact of the presence of Temporomandibular Joint (TMJ) signs or symptoms is not fully understood. This article seeks to elucidate the current knowledge of the relationship between TMJ signs and symptoms, psychosocial factors, and broader clinical manifestations in JIA patients. To investigate this relationship further, the present article will also present the results of a study including a total of 73 JIA patients, consisting of 56 females and 17 males (mean age 12.2 ± 2.8 years old; range 6–16). These patients were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). Self-reported questionnaires were used to investigate the psychosocial aspects of stress, anxiety, depression, and catastrophizing. General quality of life and disease activity were assessed with the JAMAR questionnaire (Juvenile Arthritis Multidimensional Assessment Report). For inferential statistics, the Pearson r coefficient, linear regression models and T test for unpaired data were used. The level of significance was P<0.05. Increased general disease activity and significant impacts on quality of life were associated with increased psychological distress. The four psychosocial factors examined, including anxiety, stress, catastrophizing, and depression, all had a negative impact on the quality of life, symptomatology, and disease activity. Specifically, anxiety and catastrophizing influenced the relationship between the presence of symptoms and the reported quality of life where higher levels of anxiety and catastrophizing increased the impact of the symptoms on the quality of life. Finally, the presence of TMJ signs and/or symptoms did not exacerbate the psychosocial domains but affected the functional aspect of the patient.

Predictors of Non-invasive Ventilation Failure and Associated Factors Among the COVID-19 Patients Admitted to Intensive Care Unit.

Non-invasive ventilation (NIV) is a method of oxygenation supply that eliminates the need for an endotracheal airway. Non-invasive ventilation failure is defined as the necessity for endotracheal intubation or death during the NIV trial. This study aimed to identify the predictors and associated factors of NIV failure in coronavirus disease 2019 (COVID-19) patients admitted to an intensive care unit (ICU). This retrospective, longitudinal cohort study utilized electronic medical records of COVID-19 patients admitted to the ICU. A total of 150 patients were included in the study. Patient demographics, medical history, laboratory tests, partial pressure of carbon dioxide (PCO2), oxygen saturation (SpO2), heart rate, acidosis, consciousness, oxygenation, and respiratory rate (HACOR score), and the ratio of oxygen saturation (ROX) index (the SpO2/fraction of inspired oxygen [FIO2] to respiratory rate [SF] ratio) were recorded. Non-invasive ventilation failure was determined based on the need for endotracheal intubation or cardiac-respiratory arrest while on NIV. Of 150 patients, 55.3% were male (mean age: 55.9 years), with an NIV failure rate of 67.3%, a mortality rate of 66.7%, and 3.3% of patients requiring tracheostomy after NIV failure. The ROX index consistently decreased over time, and an increase in the HACOR score and PCO2 after 6 hours of commencing NIV were the predictors of NIV failure. Additionally, higher levels of lactate dehydrogenase, lower SF ratios, and higher APACHE scores upon ICU admission were significantly associated with NIV failure. Notably, the erythrocyte sedimentation rate (ESR) as an inflammatory index, SF ratio upon ICU admission, HACOR score, ROX index, and PCO2 after 12 hours were significant predictors of in-hospital mortality in patients receiving NIV. The ROX index, HACOR scale, and PCO2 are significant predictors of both NIV failure and in-hospital mortality.

Accommodating resistance is more effective than free weight resistance to induce post-activation performance enhancement in squat jump performance after a short rest interval

Background/objectivesPrior work regarding post-activation performance enhancement (PAPE) has shown that various resistance training methods and conditioning activities may induce a PAPE effect such as free weight resistance, accommodating resistance or isoinertial resistance. However, the accommodating resistance and other types of resistance have rarely been directly compared. Thus, the aim of this study was to compare the effects of two different conditioning activities (CA) - a trap bar deadlift with (FW + AR condition) or without (FW condition) accommodating resistance - on subsequent squat jump (SJ) performance after a short rest interval of 90s. MethodsThe study had a cross-over design and fifteen strength trained males (mean age: 22.9 ± 2.1 years; mean relative strength level 2.01 ± 0.27 kg/body mass) participated in one familiarization, two experimental and one control session (CNTR condition). Two CAs were implemented throughout the study - a single set of 3 repetitions of a trap bar deadlift at 80 % of 1RM using solely free weight resistance or with the addition of approximately 15 % of 1RM elastic band tension. The SJ measurements were performed at the baseline and 90s after CAs. ResultsThe FW + AR condition significantly improved subsequent SJ performance (p < 0.05, effect size 0.34) whereas the FW and CNTR conditions were found to be ineffective to acutely enhance performance. ConclusionsOur results suggest that the addition of accommodating resistance is superior to free weight resistance in order to acutely improve jump performance after a 90s rest interval. To observe the performance enhancement effect with solely free weight resistance it should be considered to introduce alteration in loading strategies or possibly lengthening the rest interval.

Exploring food safety knowledge, attitudes, and practices of nursing and medical students: Insights from a cross‐sectional study in Bangladesh

AbstractThis study focuses on nursing and medical students, assessing their knowledge, attitudes, and practices (KAP) regarding food safety. This non‐random cross‐sectional study was conducted between October and December 2022, with 1100 students (721 nursing and 379 medical) completing self‐administered questionnaires. 949 (86.3%) of the respondents were female and 151 (13.7%) were male (mean age 20.90 ± 1.74). Nursing students outperformed medical students in food safety KAP scores (19.45 ± 3.19 vs. 19.13 ± 3.36), (10.61 ± 1.52 vs. 10.27 ± 1.80), and (46.96 ± 6.48 vs. 42.87 ± 6.49), with significant differences in food safety attitudes and practices (p &lt; 0.05), as well as knowledge regarding personal hygiene, food preparation, cooking, foodborne pathogens, and cross‐contamination (p &lt; 0.05). Multivariate stepwise linear regression analysis revealed predictors of food safety knowledge, including age, residence, academic year, personal food poisoning experience, and familiarity with food safety authority (p &lt; 0.05). Similarly, institutional context, gender, income, residential status, academic year, personal cooking habit, father's education level, and mother's education level had a substantial impact on the attitudes of students. Predictors of safe food handling practices encompassed institutional context, age, gender, family monthly income, residential status, academic year, father's education level, personal food poisoning experience, and familiarity with food safety authority (p &lt; 0.05). These findings highlighted the need for targeted educational interventions to improve food safety KAP among nursing and medical students considering their forthcoming responsibilities as carers.

Mortality patterns and risk factors in burn patients: A cross-sectional study from Pakistan

According to WHO, a burn is a type of tissue injury that may be caused by thermal, electric, radioactive, or chemical agents. Burns represent a critical public health concern worldwide, particularly in developing countries that experience a disproportionately high incidence of burn injuries and mortality rates. Accurate and comprehensive statistics regarding the causes of mortality and their associated factors are crucial for informed healthcare decision-making. Unfortunately, there is a notable scarcity of studies that specifically address these issues, and a significant disparity exists between clinically diagnosed causes of death and postmortem findings. This study aims to determine the causes of mortality among patients admitted to the Burns Center to improve healthcare provision and reduce the mortality rate of burn patients. This retrospective cohort study involved 262 patients, comprising 58 % (n = 152) males and 42 % (n = 110) females. The mean age of males was 34.5 years (std = 13.9) while for males was 31.9 years (std = 13.2). The data was retrieved from patients' files and autopsy reports collected from the burns centre. The chi-square test and T-test were used to identify any correlation between the variables. The causes of mortality included sepsis (48.9, n = 128), hypovolemic shock (27.5, n = 72), renal failure (22.9, n = 60), and cardiac failure (0.8, n = 2). Significant associations were observed between the causes of mortality and factors such as age, total body surface area affected (TBSA), inhalational injury, and etiology of burns (p-value < 0.05. However, no significant associations were found with gender or the degree of burns (p-value > 0.05). Our study illustrates sepsis/multiple organ failure (MOF) as the most common cause of death in burn patients, along with highlighting the risk factors having a strong correlation with the causes of mortality in individuals with burn injuries.

Observational Cross-Sectional Study on Mediterranean Diet and Sperm Parameters

Infertility, affecting 15 to 25% of couples in the most developed countries, is recognized by the World Health Organization as a public health issue at a global level. Different causes are acknowledged to reduce fertility in both sexes. In particular, about 40–50% of cases recognize a male factor. Dietary habits and lifestyle are acknowledged to influence sperm quality and are therefore important modifiable factors in male reproductive health. Conditions such as overweight/obesity, impaired glucose metabolism and determinants of metabolic syndrome, together with unhealthy lifestyle behavior, i.e., smoking cigarettes and physical inactivity, are suggested to have a negative impact on male fertility. While individual elements and characteristics of the Western diet and habits are considered risk factors for male infertility, the Mediterranean diet (MD) seems to promote reproductive potential for improving sperm quality. It is also interesting to note that previous observational studies reported a positive correlation between the consumption of the single food classes of the MD pattern (i.e., vegetables and fruits, poultry, fish and seafood, whole grains, low-fat dairy products) and the quality of several sperm parameters. To evaluate the relationship between sperm parameters and MD adherence, we performed a cross-sectional study on the seminal data of 300 males (mean age 34.6 ± 9.1 years) who spontaneously referred to our center of reproductive medicine. The evaluation of adherence to MD was performed with a validated 14-point Mediterranean Diet Adherence Screener (MEDAS) questionnaire. Our findings showed that sperm parameters such as sperm count, motility, viability and normal morphology are significantly and positively correlated with MEDAS, independently of BMI and age. In addition, the application of an ROC curve on MEDAS value vs. seminal alterations identified 6.25 as the score threshold value below which altered sperm parameters were more likely to occur [AUC = 0.096 (CI: 0.059–0.133; p &lt; 0.00)]. Therefore, adhering to the MD with at least a MEDAS score of 6.26 increases the probability of normozoospermia. Moreover, subjects who had a MEDAS value lower than 6.25 had an Odds Ratio of 6.28 (CI = 3.967–9.945) for having at least one altered sperm parameter compared to those who were more adherent to the MD. In conclusion, our findings show that a higher adherence to the MD is associated with better semen parameters, in particular in relation to sperm count, sperm concentration, typical sperm morphology, and sperm progressive motility.

Anticipatory Heart Rate Before Moderate- and Vigorous-Intensity Exercise Among Sedentary and Physically Active Young Adult Males.

Background Anticipatory heart rate (HR) refers to an increase in HR that occurs in anticipation of a future event or activity. The anticipatory heart rate (HR) response before exercise is an important physiological indicator of exercise readiness. This study aimed to compare the anticipatory HR changes between sedentary and physically active young adult males during moderate- and vigorous-intensity exercise. Understanding these anticipatory heart rate patterns can provide insights into the physiological adaptations and cardiovascular health of individuals with varying physical activity levels. Materials and methods A total of 60 young adult males, comprising sedentary (n = 30) and physically active individuals (n = 30), participated in this study. A brisk walking for a distance of 50 m was considered moderate intensity and one minute of spot jogging at maximum effort with verbal encouragement was considered vigorous intensity exercise. The HR was recorded at baseline, just before the exercise, and on each minute up to 5 minutes after the exercise. Results The study involved 30 physically active young adult males (mean age 20.23 ± 1.43 years) and 30 sedentary adult males (mean age 20.07 ± 1.17 years). In physically active young adults, the resting HR was 76.4±10.89 bpm and just before starting moderate-intensity exercise, it was 78.83±12.98 bpm, paired t-test P = 0.22. The HR just before vigorous-intensity exercise was 80.83±11.18 bpm (paired t-test P = 0.03). In sedentary young adults, the resting HR was 82.23±12.69 bpm and just before starting moderate-intensity exercise, it was 90.13±18.69 bpm, paired t-test P = 0.0008. The HR just before vigorous-intensity exercise was 91.7±15.04 bpm (paired t-test P <0.0001). Conclusion Physically active young adults did not exhibit a significant increase in anticipatory HR before moderate-intensity exercise. However, sedentary individuals exhibit a significant anticipatory HR response. Before vigorous-intensity exercise, both exhibited significant increments in HR. The result highlights the importance of considering the anticipatory HR response as a potential marker of cardiovascular health and exercise readiness.

Prevalence and Correlation of Concha Bullosa and Nasal Septal Deviation with Maxillary Sinus Mucosal Thickening Using Cone-Beam Computed Tomography

Background: This study aimed to assess the prevalence and correlation of Concha Bullosa (CB) and Nasal Septal Deviation (NSD) with maxillary sinus Mucosal Thickening (MT) using Cone-Beam Computed Tomography (CBCT).&#x0D; Methods: This descriptive, cross-sectional study was conducted on CBCT scans of 228 females and 157 males (mean age of 44.82±15.10 years) retrieved from the archives of the Radiology Department of Shahid Beheshti Dental School. The images were evaluated by one oral and maxillofacial radiologist for presence/absence of NSD, CB, and maxillary sinus MT, and their correlations. Statistical analyses were performed by independent t-test, Chi-square test, and binomial test (alpha=0.05).&#x0D; Results: The prevalence of CB, NSD, and MT was 61.6, 80, and 70.6%, respectively. NSD (p=0.131) and CB (p=0.211) had no significant correlation with MT. However, CB and NSD were significantly correlated (p=0.006). NSD had a significant correlation with contralateral presence of CB as well (p=0.000). The prevalence of CB was significantly higher in females (p&lt;0.05), while the prevalence of NSD and MT was significantly higher in males (p&lt;0.05).&#x0D; Conclusion: The present study revealed no significant correlation between CB and NSD with maxillary sinus MT. Thus, in absence of clinical symptoms, patients with CB or NSD should not be necessarily referred for treatment of sinus abnormalities. However, considering the significant correlation of CB and NSD, in case of presence of one entity, the other one should be suspected.

Unconsummated marriage: a systematic review of etiological factors and clinical management.

Unconsummated marriage (UCM) is the inability of the heterosexual married couple to have penovaginal sexual intercourse. The study sought to systematically review current evidence regarding the etiological factors and clinical management of UCM. A comprehensive bibliographic search on the MEDLINE, Scopus, Web of Science, and Cochrane Library databases was performed in June 2023. Studies were selected if they described married couples who never had sexual intercourse in case report or case series evaluating the related causes and/or management and reporting data with qualitative, quantitative, or mixed methods. The review was reported according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-analyses) statement and registered in PROSPERO with ID CRD42023433040. A total of 27 studies including 1638 males and 1587 females were selected. Eight (29.6%) articles were case reports involving a single couple and 19 (70.4%) studies were case series. Mean Murad score was 4.1 (range, 1-8) showing low-intermediate overall study quality. All articles had a level of evidence of 4. Most of studies were conducted in Egypt (n = 5 [18.4%]), Israel (n = 4 [14.9%]), and the United States (n = 4 [14.9%]). The mean age of males and females varied between 24.2 and 37.6years and from 21 to 27.4years, respectively. The reasons for the medical visit that led to the diagnosis of UCM were inability to consummate in 23 (85.2%) studies, inability to conceive in 1 (3.7%) article, and mixed in 3 (11.1%) articles. The mean duration of UCM varied from 7days to 3.5years. Eight studies involving both men and women showed that vaginismus (8.4%-81%) and erectile dysfunction (10.5%-61%) were the most common causes of UCM. Three articles reported that 16.6% to 26% of all UCM cases were due to both male and female factors. Sildenafil, tadalafil, intracavernosal injection, penile plication, female genital reconstructive surgery, vaginal dilators, lubricants, psychosexual therapy, and sex education were the various treatment modalities in 27 studies to achieve consummation rate of 66.6% to 100%. A strength is that this is the first systematic review covering the entire spectrum of UCM. Limitations comprised the low quality of most of the included articles and the large percentage of UCM cases probably not published. Erectile dysfunction and vaginismus are the most reported causes of UCM; however, a strong psychological component certainly underlies a significant number of cases. A multidisciplinary approach based on strategic integration of sex education, medical therapy, psychosexual support, and surgical treatment would seem the most suitable option to manage couples with UCM.

Adult survivors of childhood cancer have significant levels of impaired cardiorespiratory fitness, inflammatory markers and poor quality of life outcomes

Abstract Anthracycline chemotherapy is used in approximately two thirds of the 35,000 European children diagnosed with cancer each year. Unfortunately 1 in 10 will develop symptomatic heart failure at 40 years after therapy. Emerging evidence suggests that anthracyclines exert a significant cardiovascular insult that expands beyond an impaired ejection fraction. Impaired cardiac reserve has been demonstrated in patients treated as adults however the impact of cancer treatment in childhood during cardiac development, is less widely described, particularly the long-term effects, several decades post treatment. Purpose This study explores quality of life (QOL), cardiorespiratory fitness and imaging outcomes in adult childhood cancer survivors (CCS) treated with &amp;gt;100mg/m2 of anthracycline. Methods Adult CCS (&amp;gt;18 years) were recruited from our regional cardio-oncology surveillance programme. Anthracycline equivalence dose was calculated according to ESC 2022 guidance. Questionnaires were completed describing exercise habits and QOL (SF36). Outcomes in each domain were assessed against population age/gender matched normative values. A 6-minute walk test was performed and % predicted values adjusted for height/weight/age/gender (6MWT%). CCS with abnormal 6MWT% were referred for CPEX. Cardiac biomarker analysis (wrCRP, NTproBNP and TnT) and cardiac imaging were performed. Results Consent was gained from 86 CCS (55% male) mean age 28 (18-53 years). Mean dose was 270mg/m2 (108-705). 70% met NHS exercise targets. 49% were overweight or obese. 13% had an ejection fraction (EF) of &amp;lt;50% and 26% had an abnormal global longitudinal strain (GLS). 34 (40%) of patients had 6MWT% below the lower limit of normal (LLN). CCS scored below the LLN in every QOL domain, with marked abnormalities in general health (20% abnormal), mental health (16%) and physical functioning (13%). Symptoms were similar in sedentary and non-sedentary patients. Sedentary CCS had abnormal wrCRP (p = 0.002), 6MWT% (p = 0.002) and lower indexed stroke volumes on MRI (p = 0.015). Exercise duration (mins/week) correlated with improved 6MWT%, fractional shortening, septal E/e’ (all P&amp;lt;0.05). Vigorous exercise compared to sedentary habits were associated with better 6MWT%, wrCRP, reduced frailty and improved QOL as well as NTproBNP, GLS and EF. At 20 years post anthracycline, EF was impaired in 7/35 (20%), GLS impaired in 36% and 22% met criteria for frailty/prefrailty. Conclusion Childhood cancer survivors display significant impairment in cardiorespiratory fitness and score lower in all quality of life domains. Sedentary behaviour is associated with worse QOL, impaired cardiorespiratory fitness, inflammation and abnormal imaging. Interestingly, reported symptoms did not differ regardless of activity level. Whether sedentary behaviour is secondary to cardiotoxicity or exercise mitigates the effect of cardiotoxicity is still unclear and further research is anticipated in this field.

Cigarette smoking abolishes the mediterranean diet benefit on exercise capacity, coronary physiology and target organ damage in hypertensive males with erectile dysfunction

Abstract Background Erectile dysfunction (ED) often coexists impairing quality of life in the hypertensive aging male population. The Mediterranean diet (Med-diet) benefits cardiovascular health. Coronary flow reserve (CFR) displays the ability of the coronary circulation to increase flow. Central vascular stiffness and microalbuminuria (UMALb) represent hypertension-related target organ damage (TOD). Purpose To investigate cigarette smoking adverse effects on the Med-diet benefit in exercise capacity, coronary physiology and TOD in hypertensive males with ED. Methods We enrolled 290 hypertensive ED males (mean age: 57 yo) with no history of diabetes mellitus or overt cardiovascular disease. 121 (42%) were current cigarette smokers. Intensity of smoking referred in packs/year. All underwent a treadmill stress test (Bruce protocol), exercise capacity was validated as metabolic equivalents (METs). We measured the CFR of the LAD artery (2D echo) by performing an adenosine protocol (max dose 140μg/Kg/min over 6 min). PW Doppler measurements were achieved at the middle/distal LAD (color Doppler flow mapping). CFR was validated as ratio between peak diastolic flow velocity following drug infusion and rest. Ratios ≥ 2 indicate macro and microvascular coronary integrity. Participants were screened for the presence of UMALb (urinary albumin loss 30 – 300 mg /24 h urine volume collection). Finally a non-invasive evaluation of the carotid – femoral pulse wave velocity (PWV), estimation of central pressures and augmentation index (AIx) a parameter of wave reflection amplification were performed (Sphygmocor device). ED severity and the Med-diet adherence were assessed by the SHIM-5 (range:0-25) and the Med-diet (range:0-55) scores. Higher values indicate a better erectile ability and Med-diet compliance respectively. Results In bivariate analysis the Med-diet score was positively associated with METs, CFR and the SHIM-5 score and negatively with PWV, AIx and UMALb (p&amp;lt; 0,05). CFR, METs and the SHIM-5 score were also positively related (p&amp;lt; 0,03). In linear regression analysis the Med-diet relation remained significant after correction for age, BMI, LDL, total cholesterol and systolic blood pressure. However introducing cigarette smoking as a cofounder abolished the above relations. Packs/year were positively related to AIx, UMALb and negatively to the SHIM-5 score (p&amp;lt; 0,05). We also divided our population according to the mean Med-diet score (27) in high and low Med-diet groups .The high score group had higher METs and SHIM-5 score and lower PWV. Smokers had higher AIx and lower SHIM-5 score (pictures). Conclusion Cigarette smoking influences microvascular physiology and peripheral wave reflection and so abolishes Med-diet benefit on exercise capacity, coronary physiology, target organ damage and erectile ability in hypertensive males with ED. It is of vital importance consult this population avoiding smoking to restore cardiovascular health and quality of life.

Efficacy of azilsartan medoxomil in patients with hypertension and stable coronary artery disease in combination with type 2 diabetes

Aim. To study the effect of azilsartan medoxomil (AZL-M) on the 24-hour blood pressure (BP) profile in patients with hypertension (HTN), type 2 diabetes (T2D) and stable coronary artery disease (CAD).Material and methods. A total of 183 patients with CAD in combination with HTN and T2D took part in the study (100 men (54,64%), 83 women (45,36%)). All patients were previously prescribed a statin, antiplatelet therapy, a beta-blocker, and an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB). At baseline, the proportion of people taking ARBs and ACEIs was 30% and 70%, respectively. All study participants were discontinued from a previously prescribed ARBs or ACE inhibitors and were prescribed 6-month AZL-M (Edarbi®) therapy. During this period, according to the study plan, patients visited the medical center to assess the effectiveness and safety of therapy and blood pressure changes.Results. The mean age of the patients was 65,0 years (60-69 years), while the mean body mass index (BMI) — 31,24 kg/m2. The mean age of female participants was higher than the mean age of males: 66,35±6,59 vs 62,72±8,82 years (p=0,002). The mean BMI in women was higher and was 33.08 kg/m2, while in men it was 30,74 kg/m2 (p=0,001). Six-month AZL-M therapy decreased 24-hour BP values. Thus, the time index of systolic blood pressure (SBP) hypertension in the daytime decreased from 63% to 12%, while at night from 70% to 10%, and the time index of diastolic blood pressure (DBP) hypertension in the daytime from 18% to 10%, and at night from 44% to 8%. The main result is confirmation of AZL-M effectiveness in relation to BP control, as well as good drug tolerability. At the visit after 1-month AZL-M therapy, target BP values were recorded in 45,4% of participants, and after six months — the proportion of people with normal 24-hour BP values was 69,9%.Conclusion. Edarbi® therapy in patients with HTN in combination with T2D and stable CAD leads to 24-hour BP normalization. At the same time, the drug has a good safety profile, since the reported adverse events were not related to the drug.

Abstract 14654: Contemporary Gender Differences in Clinical Outcomes of Patients With Takotsubo Cardiomyopathy - A United States National Inpatient Sample Database Analysis

Introduction: Takotsubo cardiomyopathy (TCM) is classically more prevalent in females, however whether gender differences exist in clinical outcomes of patients with TCM need further clarification. Given the lower prevalence of TCM in males, limitations of previous research included small sample size and demographic disproportion between groups. The purpose of our study is to analyze gender differences in clinical outcomes of TCM hospitalizations using national inpatient sample (NIS). Methods: We searched the 2020 NIS for TCM hospitalizations using ICD 10 code I51.81. Multivariable logistic regression model adjusted for patient and hospital level confounders was used to compare the clinical outcomes between genders. Results: We identified 41,290 TCM hospitalizations in 2020. Of these 19.9% were males (mean age = 63 years, mean charlson comorbidity index = 3.2) and 80.1% were females (mean age = 68 years, mean charlson comorbidity index = 2.7). Females had a lower risk of inpatient mortality (OR: 0.49, 95% CI 0.41-0.58, p &lt; 0.001), cardiac arrest (OR: 0.58, 95% CI 0.43-0.79, p = 0.001) and cardiogenic shock (OR: 0.67, 95% CI 0.55-0.82, p &lt; 0.001). There was no gender difference in the use of intra-aortic balloon pump (IABP), Impella assist system, or extra-corporeal membrane oxygenation (ECMO) Figure 1. Conclusion: Our findings indicate that despite a higher prevalence of TCM in females, clinical outcomes were worse in males. In our analysis, there was no gender difference in the use of IABP, Impella or ECMO. Future research is needed to better understand clinical predictors of adverse cardiac events in male patients hospitalized with TCM to improve outcomes.

Abstract 11799: Sex Disparities in Characteristics and Outcomes in Patients Admitted With Takayasu Arteritis

Introduction: Takayasu Arteritis (TA) is a rare form of chronic and progressive granulomatous vasculitis, mainly affecting the aorta and its branches. It is known to be more prevalent in young females of childbearing age. Our study compares potential disparities between Males and Females with TA. Methods: Our study focused on patients diagnosed with TA admitted between 2016-2020 via the National Inpatient Sample. We compared the prevalence of different comorbidities between Males and Females . Logistic models allowed us to evaluate any differences between outcomes between the two groups. Results: We found 7210 patients with TA in the United States, comprising 1575 (21.8%) males and 5635(78.2%) females. Females were older (mean age 45.67 years) than Males( mean age 43.29 years, p&lt;0.01), but with a lower mean Charlson Comorbidity Index (CCI) score (2.45 in females and 2.75 in males, p&lt;0.01). Considerable differences in patient characteristics were also observed, as described in Table 1. Overall Males were also more likely than females to report events of aortic aneurysms (aOR 1.959, 95% CI 1.607-2.389, p&lt;0.01), aortic dissections (aOR 3.147, 95% CI 2.337-4.238, p&lt;0.01), acute kidney injury (AKI) (aOR 1.589, 95% CI 1.344-1.879, p&lt;0.01), acute limb ischemia (aOR 1.896, 95% CI 1.138-3.160, p=0.014), and death (aOR 1.381, 95% CI 1.012-1.883, p=0.042). However, no differences were noted in events of major adverse cardiac events (MACE) (aOR 1.028, 95% CI 0.838-1.257, p=0.807). Conclusions: Males had less prevalence of TA than Females but still reported a higher likelihood of complications of aortitis, i.e., Aortic aneurysms as well as dissection. The greater incidence of AKI in males may be linked to direct insult to the vessels or secondary to their comorbidities. Even though no differences in MACE were seen between the two sexes, male patients had higher mortality.