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Dai GX, Tan W, Shen Y, Lin D, Xu RA, Lin Q, Wei Z. Differential inhibition of sildenafil and macitentan on saxagliptin metabolism. Toxicol Appl Pharmacol 2024; 486:116934. [PMID: 38663673 DOI: 10.1016/j.taap.2024.116934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/16/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024]
Abstract
The development of diabetes mellitus (DM) is generally accompanied by erectile dysfunction (ED) and pulmonary arterial hypertension (PAH), which increases the use of combination drug therapy and the risk of drug-drug interactions. Saxagliptin for the treatment of DM, sildenafil for the treatment of ED and PAH, and macitentan for the treatment of PAH are all substrates of CYP3A4, which indicates their potential involvement in drug-drug interactions. Therefore, we investigated potential pharmacokinetic interactions between saxagliptin and sildenafil/macitentan. We investigated this speculation both in vitro and in vivo, and explored the underlying mechanism using in vitro hepatic metabolic models and molecular docking assays. The results showed that sildenafil substantially inhibited the metabolism of saxagliptin by occupying the catalytic site of CYP3A4 in a competitive manner, leading to the alterations in the pharmacokinetic properties of saxagliptin in terms of increased maximum plasma concentration (Cmax), area under the plasma concentration-time curve from time 0 to 24 h (AUC(0-t)), area under the plasma concentration-time curve from time 0 extrapolated to infinite time (AUC(0-∞)), decreased clearance rate (CLz/F), and prolonged terminal half-life (t1/2). In contrast, a slight inhibition was observed in saxagliptin metabolism when concomitantly used with macitentan, as no pharmacokinetic parameters were altered, except for CLz/F. Thus, dosage adjustment of saxagliptin may be required in combination with sildenafil to achieve safe therapeutic plasma concentrations and reduce the risk of potential toxicity, but it is not necessary for co-administration with macitentan.
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Affiliation(s)
- Ge-Xin Dai
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Wei Tan
- The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), Chongqing 401120, China
| | - Yuxin Shen
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Dongdong Lin
- School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Ren-Ai Xu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
| | - Qianmeng Lin
- Department of Oncology, Department of Pathology, NHC Key Laboratory of Cancer Proteomics & State Local Joint Engineering Laboratory for Anticancer Drugs, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
| | - Zhen Wei
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325035, China.
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Echeverría F, Gonzalez-Sanabria N, Alvarado-Sanchez R, Fernández M, Castillo K, Latorre R. Large conductance voltage-and calcium-activated K + (BK) channel in health and disease. Front Pharmacol 2024; 15:1373507. [PMID: 38584598 PMCID: PMC10995336 DOI: 10.3389/fphar.2024.1373507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/12/2024] [Indexed: 04/09/2024] Open
Abstract
Large Conductance Voltage- and Calcium-activated K+ (BK) channels are transmembrane pore-forming proteins that regulate cell excitability and are also expressed in non-excitable cells. They play a role in regulating vascular tone, neuronal excitability, neurotransmitter release, and muscle contraction. Dysfunction of the BK channel can lead to arterial hypertension, hearing disorders, epilepsy, and ataxia. Here, we provide an overview of BK channel functioning and the implications of its abnormal functioning in various diseases. Understanding the function of BK channels is crucial for comprehending the mechanisms involved in regulating vital physiological processes, both in normal and pathological conditions, controlled by BK. This understanding may lead to the development of therapeutic interventions to address BK channelopathies.
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Affiliation(s)
- Felipe Echeverría
- Centro Interdisciplinario de Neurociencia de Valparaíso, Instituto de Neurociencia, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Naileth Gonzalez-Sanabria
- Centro Interdisciplinario de Neurociencia de Valparaíso, Instituto de Neurociencia, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Rosangelina Alvarado-Sanchez
- Centro Interdisciplinario de Neurociencia de Valparaíso, Instituto de Neurociencia, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Miguel Fernández
- Centro Interdisciplinario de Neurociencia de Valparaíso, Instituto de Neurociencia, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Karen Castillo
- Centro Interdisciplinario de Neurociencia de Valparaíso, Instituto de Neurociencia, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
- Centro de Investigación de Estudios Avanzados del Maule, Vicerrectoría de Investigación y Postgrado, Universidad Católica del Maule, Talca, Chile
| | - Ramon Latorre
- Centro Interdisciplinario de Neurociencia de Valparaíso, Instituto de Neurociencia, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
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Merrill RM, Song D, Ashton MK. Comparing the Strength of Associations Between Male Genital Problems and Mental Illnesses and Sleep Disorders. Am J Mens Health 2024; 18:15579883241228243. [PMID: 38279822 PMCID: PMC10822091 DOI: 10.1177/15579883241228243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/29/2024] Open
Abstract
This study compares the rate of selected types of mental illnesses (stress, anxiety, depression) and sleep disorders (insomnia, sleep apnea) according to the status of eight male genital problems. Analyses utilize medical claims data for male employees aged 18 to 64 years of a large corporation, 2017 to 2021. Approximately 1,076 (7.3%) men per year have one or more genital problems. The most common being benign prostatic hyperplasia (BPH; 3.8%) and then erectile dysfunction (ED; 1.7%). For BPH patients, the rate experiencing stress, anxiety, depression, or a combination of these is 0.96%, 6.2%, 5.3%, and 5.1%, respectively. Corresponding rates for ED are 1.5%, 7.2%, 5.9%, and 7.5%. For BPH patients, the rate experiencing insomnia, sleep apnea, or both is 3.1%, 22.7%, and 2.0%, respectively. Corresponding rates for ED are 1.2%, 20.6%, and 2.2%. Male genital problems positively associate with having one or more mental illnesses (stress, anxiety, depression), except for hydrocele, with ED and penis disorder having the strongest associations. Male genital problems also positively associate with having insomnia and/or sleep apnea, except for infertility and orchitis, with BPH and ED having the strongest associations. The positive associations involving BPH and ED with mental illnesses are each more pronounced in the younger age group (18-49 vs. 50-64). Similar results are seen in the models involving sleep disorders. Thus, comorbid male genital problems, mental illnesses, and sleep disorders exist, with the strength of associations unique to the male genital problem and sometimes modified by age.
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Affiliation(s)
- Ray M. Merrill
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - Dajeong Song
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - McKay K. Ashton
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT, USA
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Hudson J, Cruickshank M, Quinton R, Aucott L, Wu F, Grossmann M, Bhasin S, Snyder PJ, Ellenberg SS, Travison TG, Brock GB, Gianatti EJ, van der Schouw YT, Emmelot-Vonk MH, Giltay EJ, Hackett G, Ramachandran S, Svartberg J, Hildreth KL, Antonic KG, Tenover JL, Tan HM, Ho Chee Kong C, Tan WS, Marks LS, Ross RJ, Schwartz RS, Manson P, Roberts SA, Skovsager Andersen M, Velling Magnussen L, Aceves-Martins M, Gillies K, Hernández R, Oliver N, Dhillo WS, Bhattacharya S, Brazzelli M, Jayasena CN. Symptomatic benefits of testosterone treatment in patient subgroups: a systematic review, individual participant data meta-analysis, and aggregate data meta-analysis. THE LANCET. HEALTHY LONGEVITY 2023; 4:e561-e572. [PMID: 37804846 DOI: 10.1016/s2666-7568(23)00169-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Testosterone replacement therapy is known to improve sexual function in men younger than 40 years with pathological hypogonadism. However, the extent to which testosterone alleviates sexual dysfunction in older men and men with obesity is unclear, despite the fact that testosterone is being increasingly prescribed to these patient populations. We aimed to evaluate whether subgroups of men with low testosterone derive any symptomatic benefit from testosterone treatment. METHODS We did a systematic review and meta-analysis to evaluate characteristics associated with symptomatic benefit of testosterone treatment versus placebo in men aged 18 years and older with a baseline serum total testosterone concentration of less than 12 nmol/L. We searched major electronic databases (MEDLINE, Embase, Science Citation Index, and the Cochrane Central Register of Controlled Trials) and clinical trial registries for reports published in English between Jan 1, 1992, and Aug 27, 2018. Anonymised individual participant data were requested from the investigators of all identified trials. Primary (cardiovascular) outcomes from this analysis have been published previously. In this report, we present the secondary outcomes of sexual function, quality of life, and psychological outcomes at 12 months. We did a one-stage individual participant data meta-analysis with a random-effects linear regression model, and a two-stage meta-analysis integrating individual participant data with aggregated data from studies that did not provide individual participant data. This study is registered with PROSPERO, CRD42018111005. FINDINGS 9871 citations were identified through database searches. After exclusion of duplicates and publications not meeting inclusion criteria, 225 full texts were assessed for inclusion, of which 109 publications reporting 35 primary studies (with a total 5601 participants) were included. Of these, 17 trials provided individual participant data (3431 participants; median age 67 years [IQR 60-72]; 3281 [97%] of 3380 aged ≥40 years) Compared with placebo, testosterone treatment increased 15-item International Index of Erectile Function (IIEF-15) total score (mean difference 5·52 [95% CI 3·95-7·10]; τ2=1·17; n=1412) and IIEF-15 erectile function subscore (2·14 [1·40-2·89]; τ2=0·64; n=1436), reaching the minimal clinically important difference for mild erectile dysfunction. These effects were not found to be dependent on participant age, obesity, presence of diabetes, or baseline serum total testosterone. However, absolute IIEF-15 scores reached during testosterone treatment were subject to thresholds in patient age and baseline serum total testosterone. Testosterone significantly improved Aging Males' Symptoms score, and some 12-item or 36-item Short Form Survey quality of life subscores compared with placebo, but it did not significantly improve psychological symptoms (measured by Beck Depression Inventory). INTERPRETATION In men aged 40 years or older with baseline serum testosterone of less than 12 nmol/L, short-to-medium-term testosterone treatment could provide clinically meaningful treatment for mild erectile dysfunction, irrespective of patient age, obesity, or degree of low testosterone. However, due to more severe baseline symptoms, the absolute level of sexual function reached during testosterone treatment might be lower in older men and men with obesity. FUNDING National Institute for Health and Care Research Health Technology Assessment Programme.
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Affiliation(s)
- Jemma Hudson
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Richard Quinton
- Translational & Clinical Research Institute, University of Newcastle, Newcastle upon Tyne, UK
| | - Lorna Aucott
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Frederick Wu
- Division of Diabetes, Endocrinology & Gastroenterology, University of Manchester, Manchester, UK
| | - Mathis Grossmann
- University of Melbourne Austin Health, Heidelberg, VIC, Australia
| | | | - Peter J Snyder
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan S Ellenberg
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Gerald B Brock
- Department of Surgery, Western University and Omega Fertility Center, London, ON, Canada
| | - Emily J Gianatti
- Department of Endocrinology, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Marielle H Emmelot-Vonk
- Department of Geriatrics, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Centre, Leiden, Netherlands
| | - Geoff Hackett
- School of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Johan Svartberg
- Division of Internal Medicine, Section of Endocrinology, University Hospital of North Norway, Tromsø, Norway; Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kerry L Hildreth
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kristina Groti Antonic
- Department of Endocrinology, University Medical Centre, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Joyce Lisa Tenover
- Geriatric Medicine, VA Palo Alto Health Care System, Palo Alto, CA, USA; School of Medicine, Stanford University, Stanford, CA, USA
| | - Hui Meng Tan
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Wei Shen Tan
- MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Leonard S Marks
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Richard J Ross
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Robert S Schwartz
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Paul Manson
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | | | | | | | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Rodolfo Hernández
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Nick Oliver
- Faculty of Medicine, Imperial College London, London, UK
| | | | - Siladitya Bhattacharya
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Miriam Brazzelli
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Kilic M, Erkan A, Zengin S, Dundar G, Boyaci C. Inflammatory biomarkers may predict response to phosphodiesterase type 5 inhibitor treatment in patients with erectile dysfunction. Investig Clin Urol 2023; 64:404-411. [PMID: 37417566 DOI: 10.4111/icu.20230013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/27/2023] [Accepted: 05/22/2023] [Indexed: 07/08/2023] Open
Abstract
PURPOSE In this study, we aimed to evaluate the clinical utility of the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and monocyte/high-density lipoprotein cholesterol ratio (MHR) in predicting response to a phosphodiesterase type 5 inhibitor (PDE5i) when used as the first-line medical treatment of erectile dysfunction (ED). MATERIALS AND METHODS This study prospectively included 185 patients who were diagnosed with ED and started PDE5i treatment. After PDE5i treatment, 107 (57.8%) patients with an International Index of Erectile Function-5 (IIEF-5) score below 22 were assigned to Group 1, and 78 (42.2%) patients with an IIEF-5 score of 22 or above were assigned to Group 2. The outcome measures of the study were demographic characteristics and inflammation markers between the groups. RESULTS The mean IIEF-5 change after PDE5i treatment was 6.1±4.2 points in Group 1 and 11.5±3.2 points in Group 2 (p=0.001). The mean age was 54.6±9.2 years in Group 1 and 47.8±10.3 years in Group 2 (p<0.001), and the median fasting blood glucose values of Groups 1 and 2 were 105 (36) mg/dL and 97 (23) mg/dL, respectively (p=0.010). The LMR and MHR values were 2.39±0.23 and 13.8±7, respectively, for Group 1, and 2.03±0.22 and 17±6.6, respectively, for Group 2 (p=0.044 and p=0.002, respectively). On multivariable analysis, younger age and increased MHR were independent predictors of benefit from PDE5i treatment. CONCLUSIONS This study showed that only MHR as an inflammatory biomarker was an independent predictor for response to PDE5i in the treatment of ED. Also, several factors were predictive of treatment failure.
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Affiliation(s)
- Metin Kilic
- Department of Urology, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Türkiye.
| | - Anil Erkan
- Department of Urology, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Türkiye
| | - Salim Zengin
- Department of Urology, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Türkiye
| | - Gokce Dundar
- Department of Urology, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Türkiye
| | - Caglar Boyaci
- Department of Urology, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Türkiye
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Abdi F, Alimoradi Z, Roozbeh N, Amjadi MA, Robatjazi M. Does acupuncture improve sexual dysfunction? A systematic review. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:1-16. [PMID: 34704431 DOI: 10.1515/jcim-2021-0194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Sexual dysfunction can adversely affect the quality of life and interpersonal relationships. nowadays, a lot of attention is paid to traditional Chinese medicine with better curative effects and less adverse events. Recent studies have implied the promising effect of acupuncture on sexual function. This systematic review evaluate the effectiveness and safety of acupuncture in treating female and male sexual dysfunction. CONTENT PubMed, Cochrane Central of Controlled Trials (CENTRAL), EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Scopus, and Google Scholar were searched up to 2021. No limitation to language and date. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). SUMMARY Among 160 initially assessed papers, 13 articles were included. The findings showed that acupuncture improve sexual dysfunction in domains of desire, libido, erectile dysfunction and impotency. Most studies did not report any serious side effects from acupuncture, and only three studies reported minor adverse events. OUTLOOK The available evidence indicate that acupuncture has positive on improvement of sexual dysfunction with no serious side effects. Although acupuncture has gained increasing popularity for the management of sexual dysfunction, high methodological quality evidence regarding its efficacy is lacking.
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Affiliation(s)
- Fatemeh Abdi
- School of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran
| | - Zainab Alimoradi
- Social Determinants of Health Research Center, Q Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Nasibeh Roozbeh
- Mother and Child Welfare Research Center, Hormozgan University of Medical Science, Bander Abbas, Iran
| | - Marjan Akhavan Amjadi
- Department of Midwifery, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mehri Robatjazi
- Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran
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Mansour RY, ElBorolossy R, Shaheen SM, Sabri NA. Evaluation of drug interactions of saxagliptin with sildenafil in healthy volunteers. Eur J Clin Pharmacol 2022; 78:1935-1944. [PMID: 36214883 PMCID: PMC9549831 DOI: 10.1007/s00228-022-03397-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/27/2022] [Indexed: 11/29/2022]
Abstract
Purpose The purpose of this study is to investigate the effect of sildenafil a CYP3A4 substrate and inhibitor on the pharmacokinetics and safety of saxagliptin.
Methods Eighteen healthy volunteers were recruited in sequential; single-center study to determine pharmacokinetic parameters of saxagliptin and sildenafil, and (AUC0-∞), (AUC0-t); Cmax; tmax; t½, ke; ka were measured using validated LC–MS/MS method. Therapeutic doses were given as follows: Sildenafil 50 mg single dose on day one, then washout period from day two till day eight. Saxagliptin 5 mg once/day was given from day 9 till day 12; then on day 13, the two drugs were co-administered. Blood samples for pharmacokinetic analysis were collected on days 1 and 13 for sildenafil and on days 12 and 13 for saxagliptin. Results Saxagliptin ratios of T/R and 90% CI were 132.1% (122.7–142.3) for AUC0–t, and 167.6% (154.6–181.8) for Cmax. On the other hand, sildenafil pharmacokinetics were not affected. Gmax changed from 93.7 mg/dl to 95.6 mg/dl (P > 0.001) and AUCg0-t from 512.8 ng.h/ml to 532.75 ng.h/ml (P > 0.001) after co-administration of both drugs. Conclusion Sildenafil significantly affected the pharmacokinetic parameters of saxagliptin when co-administered. Registration This trial was registered at clinicaltrials.gov under identifier number: [NCT04170790] in November 2019.
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Affiliation(s)
- Rania Y Mansour
- MScs. Of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Radwa ElBorolossy
- Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
| | - Sara M Shaheen
- Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Nagwa A Sabri
- Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
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Patnaik N, Mishra KG, Pradhan NR. Evaluation of Serum Testosterone Levels Following Three Months of SA3X (Spilanthes acmella) Supplementation. Cureus 2022; 14:e26236. [PMID: 35898380 PMCID: PMC9308386 DOI: 10.7759/cureus.26236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: Low testosterone is usually associated with erectile dysfunction (ED). SA3X (Spilanthes acmella) has proven to be effective in alleviating symptoms of ED, which could be due to an alteration in serum testosterone levels. This study was carried out to evaluate the change in testosterone levels in participants with ED supplemented with SA3X for three months. Materials and Methods: A group of 326 sexually active men aged 25-60 years was investigated from November 2021 to May 2022 in Hyderabad. The participants were subjected to supplementation with SA3X capsules for three months, and a follow-up was done at the end of six months with serum testosterone assessment in each visit. The change in testosterone level was assessed using a mixed model repeated measures analysis. Results: A significant increase was observed in the mean serum testosterone levels by the end of the second month (323.91 ± 13.76 ng/dL vs. 309.84 ± 14.11 ng/dL; p=0.03) and third month (332.27 ± 12.85 ng/dL vs. 309.84 ± 14.11 ng/dL; p<0.01) of SA3X therapy. The adjusted mean change in testosterone levels was found to be 22.43 ng/dL at the end of the three-month therapy. It was also observed that the change in testosterone levels was significantly lower in participants having diabetes mellitus, hypercholesterolemia, and a history of substance abuse. However, participants on phosphodiesterase-5 inhibitors had an increased change in testosterone levels. Conclusion: Supplementation with SA3X capsules for three months increases the serum testosterone levels. However, causality cannot be ascertained owing to the longitudinal nature of the study, and further controlled trials are required for the same.
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Bott A, Nicol G, Odutola A, Halliday R, Acharya MR, Ward A, Chesser TJS. Long-term patient reported sexual and urological dysfunction in males after operatively treated pelvic ring injuries Do generic outcome measures identify genitourinary health problems? Injury 2022; 53:2139-2144. [PMID: 35246326 DOI: 10.1016/j.injury.2022.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 01/03/2022] [Accepted: 01/29/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND A consecutive series of 177 male patients, with high energy pelvic ring injuries, were treated operatively in our institution. The purpose of this study was to evaluate long-term sexual and urological dysfunction in these patients using validated disease specific patient reported outcome measures (PROMs), and identify if sexual and urological dysfunction is detectable from generic outcome scores used in the assessment of pelvic ring injury at a minimum of 10 years follow-up (range 10-22). METHODS Surviving patients were contacted to complete validated PROMs to examine genitourinary and global functional outcome. Fifty-two male participants, had a mean age of 44-years-old (range,16-69) and ISS of 17 at time of injury. Mean duration follow-up of 15 years. The primary outcome measures were the Sexual Health Inventory for Men (SHIM) and the Modular Questionnaire for Male Lower Urinary Tract Symptoms (MLUTS). Secondary outcomes were the EQ-5D and Short Form 36. Responses were tested for correlation between generic and disease-specific PROMs and analyzed for association with genitourinary injury and age as risk factors of poor outcome. RESULTS Genitourinary injuries occurred in 7 patients (13%), and ten patients (19%) had documented neurological dysfunction following injury. Satisfactory general functional outcome was reported with EQ-5D-3L VAS score of 71. However, 80% report some level of sexual dysfunction with 37% reporting it as severe. MLUTS mean symptom score was 9 (range, 0 - 26) and bothersomeness score was 21 (range, 0-90). There was poor correlation between urological and sexual dysfunction scores and between the disease specific and generic scores. CONCLUSION In operatively treated pelvic ring injuries, validated disease specific PROMs, (SHIM and MLUTs) identified a significant impact to both sexual and urological patient health, with 37% reporting severe sexual dysfunction. Longstanding sexual and/or urological dysfunction can be a source of significant psychological impact that this study has shown is not identifiable using generic PROMs; EQ-5D-3L and SF-36. To gain a holistic understanding of the functional outcome of patients following a pelvic injury, urological and sexual dysfunction must not be overlooked.
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Affiliation(s)
- Alasdair Bott
- Southmead Hospital, Bristol, BS10 6NB, United Kingdom.
| | - Graeme Nicol
- Ninewells Hospital, Dundee, DD2 1SG, United Kingdom
| | - Adekoyejo Odutola
- Weston General Hospital, Weston-Super-Mare, BS23 4TQ, United Kingdom
| | - Ruth Halliday
- North Bristol NHS Trust, Southmead Hospital, Bristol, BS10 6NB, United Kingdom
| | - Mehool R Acharya
- Department of Pelvic and Acetabular Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, United Kingdom
| | - Anthony Ward
- Department of Pelvic and Acetabular Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, United Kingdom
| | - Timothy J S Chesser
- Department of Pelvic and Acetabular Surgery, Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, United Kingdom
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Das J, Yadav S. Comorbidities of male patients with sexual dysfunction in a psychiatry clinic: A study on industrial employees. Ind Psychiatry J 2022; 31:81-88. [PMID: 35800853 PMCID: PMC9255625 DOI: 10.4103/ipj.ipj_116_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/27/2020] [Accepted: 07/21/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Previous studies assessed the association of sexual dysfunction (SD) in cases of specific organic and psychiatric disorders separately as risk factors of SD, but the extent of association of various disorders in cases of SD was rarely evaluated. This study was conducted to assess almost all types of comorbidities to find out their effects on SD in male patients and to make complete diagnoses. MATERIALS AND METHODS All male patients aged between 18 and 60 years reporting with sexual problems to the psychiatry outpatient department were evaluated with Arizona sexual experiences scale (ASEX) for males. Their assessment included detailed medical and psychiatric history including medicine intake, physical and mental status examination. Relevant biochemical investigations were done including sex hormone assessment. RESULTS Among 104 males diagnosed as cases of SD according to the ASEX scale in 1 year period only 75 patients completed all the biochemical and hormonal assessments. It was observed that 38.67% were diagnosed as SD without any comorbidity, 25.33% had biochemical or hormonal or physical comorbidities, 21.33% had psychiatric comorbidities and 14.67% had psychiatric as well as biochemical or hormonal or physical comorbidities (n = 75). The severity of SD was higher in the patients with comorbidity and the age of the patients predicted its severity. CONCLUSION All cases of SD should be assessed in detail for physical, biochemical, hormonal, and psychiatric comorbidities to treat them holistically. Psychiatrists should play a key role in assessing, diagnosing, treating, and referring them to the appropriate treatment provider.
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Affiliation(s)
- Jnanamay Das
- Department of Psychiatry, ESIC Model Hospital, Noida, Uttar Pradesh, India
| | - Shailly Yadav
- Department of Psychiatry, ESIC Model Hospital, Gurugram, Haryana, India
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Surmeli DM, Karpuzcu HC, Atmis V, Cosarderelioglu C, Yalcin A, Varli M, Aras S. Association between sarcopenia and erectile dysfunction in older males. Arch Gerontol Geriatr 2021; 99:104619. [PMID: 34998130 DOI: 10.1016/j.archger.2021.104619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/14/2021] [Accepted: 12/28/2021] [Indexed: 11/02/2022]
Abstract
INTRODUCTION In advanced age, both sarcopenia and erectile dysfunction (ED) occur with similar underlying causes through different mechanisms. In our study we investigated the association between sarcopenia and ED in older men. METHODS A total of 193 male patients aged 60 years and older were included in the study. The presence of sarcopenia was investigated in accordance with EWGSOP2 diagnostic criteria. For evaluation of ED, we used the 5-question International Index of Erectile Dysfunction questionnaire with categories of no ED, mild-moderate ED, and moderate-severe ED. Total testosterone levels were measured. RESULTS The median age of the patients was 71.9 (range 60-93 years). The prevalence of sarcopenia was 24.9%, and moderate-severe ED was 49.2%. Moderate-severe ED was more common in patients with sarcopenia than those without (70.8% vs 42.1%, p < 0.001). After adjustment for age and Charlson Comorbidity Index, the presence of sarcopenia was significantly associated with moderate-severe ED with odds ratio (OR) of 2.71 (95% Confidence Interval [CI] 1.29-5.73, p = 0.009). The components of sarcopenia were assessed separately in multivariate analysis. Muscle strength and muscle mass were significantly associated with moderate-severe ED with OR of 0.93 (95%CI 0.89-0.98) and 0.68 (95%CI 0.54-0.86), respectively, whereas gait speed was not associated with moderate-severe ED. CONCLUSION The presence of sarcopenia in older men is associated with an increased risk of moderate-severe ED. In addition, decreased muscle strength and decreased muscle mass are associated with an increased risk of moderate-severe ED. Prospective studies are needed to reveal the causality between sarcopenia and ED.
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Affiliation(s)
- Deniz Mut Surmeli
- Department of Geriatrics, Ankara University Faculty of Medicine, Ibn-i Sina Hospital, Ankara 06230, Turkey.
| | - Hulusi Can Karpuzcu
- Department of Internal Medicine, Ankara University Faculty of Medicine, Ibn-i Sina Hospital, Ankara, Turkey; Department of Internal Medicine, Republic of Turkey Ministry of Health Ankara Provincial Health Directorate, Kizilcahamam State Hospital, Ankara, Turkey
| | - Volkan Atmis
- Department of Geriatrics, Ankara University Faculty of Medicine, Ibn-i Sina Hospital, Ankara 06230, Turkey
| | - Caglar Cosarderelioglu
- Department of Geriatrics, Ankara University Faculty of Medicine, Ibn-i Sina Hospital, Ankara 06230, Turkey
| | - Ahmet Yalcin
- Department of Geriatrics, Ankara University Faculty of Medicine, Ibn-i Sina Hospital, Ankara 06230, Turkey
| | - Murat Varli
- Department of Geriatrics, Ankara University Faculty of Medicine, Ibn-i Sina Hospital, Ankara 06230, Turkey
| | - Sevgi Aras
- Department of Geriatrics, Ankara University Faculty of Medicine, Ibn-i Sina Hospital, Ankara 06230, Turkey
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Aiyekomogbon JO, Itanyi DU, Atim T, Igashi JB. Evaluation of erectile dysfunction in the ageing men using colour Doppler sonography. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00158-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Erectile dysfunction (ED) is common among ageing men because of associated underlying risk factors which are peculiar to this category of patients. Endothelial dysfunction and replacement of cavernosal smooth muscles by collagen fibres are common in older men, making them prone to ED. It is either vasogenic, neurogenic, hormonal, cavernosal or psychogenic in origin, but vasogenic causes are the commonest. This study was aimed at establishing vasogenic causes among patients being evaluated for ED using Doppler ultrasound as this category of ED is amenable to either medical and/or surgical treatment.
Methods
The study was conducted from July 2015 to January, 2017 at Federal Medical Centre Abuja. Nineteen consecutive patients with clinical diagnosis of erectile dysfunction were evaluated with Doppler ultrasound scan using a high-frequency linear array transducer. The penile scan was done before and after intracavernosal injection of 20 µg of Prostaglandin E1 (PGE1). B-mode scan of the penis was done prior to intracavernosal injection of PGE1, and the spectral waveforms as well as peak systolic velocity (PSV) of the CA were recorded at 5 min interval, from 5 to 50 min post-intracavernosal injection of PGE1, using angle of insoation ≤ 60°.
Results
The age range of the patients was fifty to sixty-six years (mean: 57.4 ± 4.3 years), while the PSV of CA varied between 21.4 and 104.4 cm/s (mean: 46.2 ± 19.2) among the entire patients, between 21.4 and 22.3 cm/s (mean: 21.9 ± 0.7) among patients with arteriogenic ED, and between 25.0 and 74.9 cm/s (mean: 45.0 ± 15.5) among those with venogenic ED. Arteriogenic ED was found in two patients (10.6%), while venogenic ED was observed in seven patients, which constituted 36.8% of the entire research participants. None had Peyronie’s disease, penile fracture, penile tumour or mixed arteriogenic and venogenic ED.
Conclusion
47.4% of the patients had vasogenic ED and venogenic ED was more common than arterioegenic ED in the age range considered. This categorization of ED with Doppler study is imperative before initiating therapy as treatment protocol for vasogenic ED is aetiologic specific.
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Gore-Gorszewska G. "What Do You Mean by Sex?" A Qualitative Analysis of Traditional versus Evolved Meanings of Sexual Activity among Older Women and Men. JOURNAL OF SEX RESEARCH 2021; 58:1035-1049. [PMID: 32779942 DOI: 10.1080/00224499.2020.1798333] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
ABSTRACTOlder adults remain sexually active well into later life; yet, there is no consistency in the literature about what sex means to them. The study described in this paper investigated the understanding of sexual activity as reported by 30 women and men from Poland, aged 65 to 82 (M = 71, SD = 5,24). Semi-structured interviews were thematically analyzed in relation to sexual scripts theory and the participants' specific sociocultural background. The results demonstrate the diversity of opinions on what sex is: from penetrative intercourse, through various expressions of physical intimacy, to emotional intimacy as a central concept. The dominant perception of sex as intercourse among some study participants evolved into an intimacy-oriented and partner-focused activity, with the discovery of fondling and female sexual pleasure as components of sex. Certain life events - such as ending a long-term marriage or engaging in a new romantic relationship - were identified as facilitating this change. Notable similarities in older women's and men's perceptions of satisfying sex in later life were observed. Acknowledging the nuanced meaning of sex for this population can contribute to a better understanding of the specificity of older adults' sexuality.
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Kerie S, Workineh Y, Kasa AS, Ayalew E, Menberu M. Erectile dysfunction among testicular cancer survivors: A systematic review and meta-analysis. Heliyon 2021; 7:e07479. [PMID: 34286139 PMCID: PMC8278428 DOI: 10.1016/j.heliyon.2021.e07479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/10/2021] [Accepted: 07/01/2021] [Indexed: 11/29/2022] Open
Abstract
Background Erectile dysfunction is one of the common complications of testicular cancer with a prevalence of 11.3%–84%. It has devastating effects on men and their partner's quality of life, sexual satisfaction, and sexual experience. The findings of the previous studies on this matter were uneven and inconsistent. Therefore, this systematic review and meta-analysis is conducted to acquire a more recent and comprehensive result. Methods and materials PubMed, Scopus, Goggle scholar, Science Direct, African Index Medicus, African Journal online, EMBASE, and Cochrane Library databases were searched. All necessary data were extracted using a standardized data extraction format. Data were analyzed using STATA 14 statistical software. A heterogeneity of studies was assessed using the I2 statistics. Publication bias was checked by using a funnel plot and Egger's regression test. A random-effects model was computed to estimate the pooled prevalence of erectile dysfunction. Result Fourteen full-text studies were included in this systematic review and meta-analysis. The pooled prevalence of erectile dysfunction among testicular cancer survivors was found to be 34.60% (95% CI: 25.89, 43.30 [I2 = 95.9% p = 0.000]). Study design subgroup analysis indicated that the pooled prevalence of erectile dysfunction was 50.02% (95% CI: 22.78, 77.28% [I2 = 96.1 p = 0.000]), and 27.36% (95% CI: 19.23, 34.48% [I2 = 91.6, P = 0.000]) in the case-control and cohort studies, respectively. Likewise, the level of erectile dysfunction was varied based on ED erectile dysfunction measuring tools and testicular cancer treatment modalities. Conclusion In this study erectile dysfunction was found to be a highly prevalent complication in testicular cancer survivors. It had also causes of heterogeneity in terms of treatment modalities, study designs, and measuring tools. Therefore prevention of this complication should be the concern of the responsible bodies.
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Affiliation(s)
- Sitotaw Kerie
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yinager Workineh
- Department of Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ayele Semachew Kasa
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Emiru Ayalew
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melak Menberu
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Mirone V, Napolitano L, D'Emmanuele di Villa Bianca R, Mitidieri E, Sorrentino R, Vanelli A, Vanacore D, Turnaturi C, La Rocca R, Celentano G, Arcaniolo D, Cirino G. A new original nutraceutical formulation ameliorates the effect of Tadalafil on clinical score and cGMP accumulation. ACTA ACUST UNITED AC 2021; 93:221-226. [PMID: 34286560 DOI: 10.4081/aiua.2021.2.221] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/05/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the efficacy of the combination of Tadalafil 5 mg and nutritional supplements composed by Panax ginseng, Moringa Oleifera and Rutin on erectile function in men with mild and moderate vasculogenic ED. METHODS we prospectively enrolled 86 patients divided into two groups A (45), B (33) in this multicenter randomized, doubleblind, placebo-controlled trial . Drop out was 8 patients (3 patients in group A and 5 in Group B). At screening visit patients underwent clinical examination, blood test (hormonal and metabolic profile) and filled out the IIEF-5 questionnaire and the SEP-2, SEP-3. Patients were randomized by a computergenerated list to receive either Tadalafil 5 mg once daily plus nutritional supplement once daily (group A) or Tadalafil 5 mg plus placebo with the same administration schedule (group B) for 3 months. Blood samples, IIEF-5, SEP-2 and SEP-3 have been collected again after 3 months. cGMP was measured in platelets of 38 patients at baseline and after one months. RESULTS Mean age was 59.98 ± 6.90 (range 38-69), mean IIEF-5 score at baseline was 13.59 ± 3.90. After three months of treatment, IIEF-5 score significantly improved in both groups compared to baseline (13.18 ± 3.75 vs 20.48 ± 2.24, p < 0.0001; 14.15 ± 4.09 vs 19.06 ± 4.36, p < 0.0001, in group A and group B respectively). Patients treated with Tadalafil plus nutritional supplement showed a significantly higher increase in IIEF-5 score compared to those who received placebo (7.27 ± 2.20 and 4.9 ± 2.79, respectively; p < 0.0001;). No hormonal differences and metabolic effects were found. According cGMP result, nutritional supplements ameliorates and extends the activity of the chronic treatment. CONCLUSIONS IIEF-5 significant increase in group B, can be ascribed to the nutritional supplement properties and antioxidant effects of moringa oleifera, ginseng and rutin and this can enhance the endothelial NO and cGMP production.
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Affiliation(s)
- Vincenzo Mirone
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples Federico II, Naples.
| | - Luigi Napolitano
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples Federico II, Naples.
| | | | - Emma Mitidieri
- Department of Pharmacy, School of Medicine and Surgery, University of Naples, Federico II, Naples.
| | - Raffaella Sorrentino
- Department of Pharmacy, School of Medicine and Surgery, University of Naples, Federico II, Naples.
| | | | - Domenico Vanacore
- Department of Pharmacy, School of Medicine and Surgery, University of Naples, Federico II, Naples.
| | - Carlotta Turnaturi
- Department of Pharmacy, School of Medicine and Surgery, University of Naples, Federico II, Naples.
| | - Roberto La Rocca
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples Federico II, Naples.
| | - Giuseppe Celentano
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples Federico II, Naples.
| | - Davide Arcaniolo
- Urology Unit, Department of Woman Child and of General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples.
| | - Giuseppe Cirino
- Department of Pharmacy, School of Medicine and Surgery, University of Naples, Federico II, Naples.
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16
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Molina-Vega M, Asenjo-Plaza M, Banderas-Donaire MJ, Hernández-Ollero MD, Rodríguez-Moreno S, Álvarez-Millán JJ, Cabezas-Sanchez P, Cardona-Díaz F, Alcaide-Torres J, Garrido-Sánchez L, Castellano-Castillo D, Tinahones FJ, Fernández-García JC. Prevalence of and risk factors for erectile dysfunction in young nondiabetic obese men: results from a regional study. Asian J Androl 2021; 22:372-378. [PMID: 31603141 PMCID: PMC7406095 DOI: 10.4103/aja.aja_106_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Erectile dysfunction (ED), a condition closely related to cardiovascular morbidity and mortality, is frequently associated with obesity. In this study, we aimed to determine the prevalence of ED and evaluate the associated risk factors in a cohort of 254 young (18-49 years) nondiabetic obese (body mass index [BMI] ≥ 30 kg m-2) men from primary care. Erectile function (International Index of Erectile Function [IIEF-5] questionnaire), quality of life (Aging Males' Symptoms [AMS scale]), and body composition analysis (Tanita MC-180MA) were determined. Total testosterone was determined using high-performance liquid chromatography-mass spectrometry. Multivariate logistic regression analysis was used to study the factors associated with ED. ED prevalence was 42.1%. Subjects with ED presented higher BMI, waist circumference, number of components of the metabolic syndrome, AMS score, insulin resistance, and a more unfavorable body composition than those without ED. Multivariate logistic regression analysis showed that a pathological AMS score (odds ratio [OR]: 4.238, P < 0.001), degree of obesity (BMI ≥ 40 kg m-2, OR: 2.602, P = 0.005, compared with BMI 30-34.9 kg m-2), high-density lipoprotein (HDL)-cholesterol levels (OR: 0.956, P = 0.004), and age (OR: 1.047, P = 0.016) were factors independently associated with ED. In conclusion, we demonstrate that, in a primary care-based cohort of nondiabetic young obese men, ED affected >40% of subjects. A pathological AMS score, the degree of obesity, and age were positively associated with ED, while elevated HDL-cholesterol levels were inversely associated with the odds of presenting ED. Further prospective studies are needed to evaluate the long-term consequences of ED in this population.
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Affiliation(s)
- MarIa Molina-Vega
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital (IBIMA), Málaga University, Málaga 29010, Spain.,Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain
| | | | | | | | | | | | | | - Fernando Cardona-Díaz
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital (IBIMA), Málaga University, Málaga 29010, Spain.,Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Juan Alcaide-Torres
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital (IBIMA), Málaga University, Málaga 29010, Spain
| | - Lourdes Garrido-Sánchez
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital (IBIMA), Málaga University, Málaga 29010, Spain.,Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Daniel Castellano-Castillo
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital (IBIMA), Málaga University, Málaga 29010, Spain.,Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Francisco J Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital (IBIMA), Málaga University, Málaga 29010, Spain.,Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - José C Fernández-García
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital (IBIMA), Málaga University, Málaga 29010, Spain.,Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain
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Abstract
BACKGROUND Dietary supplements with ginseng, or ginseng alone, are widely used for a broad range of conditions, including erectile dysfunction. Ginseng is particularly popular in Asian countries. Individual studies assessing its effects are mostly small, of uneven methodological quality and have unclear results. OBJECTIVES To assess the effects of ginseng on erectile dysfunction. SEARCH METHODS We conducted systematic searches on multiple electronic databases, including CENTRAL, MEDLINE, Embase, CINAHL, AMED, and loco-regional databases of east Asia, from their inceptions to 30 January 2021 without restrictions on language and publication status. Handsearches included conference proceedings. SELECTION CRITERIA We included randomized or quasi-randomized controlled trials that evaluated the use of any type of ginseng as a treatment for erectile dysfunction compared to placebo or conventional treatment. DATA COLLECTION AND ANALYSIS Two authors independently classified studies and three authors independently extracted data and assessed risk of bias in the included studies. We rated the certainty of evidence according to the GRADE approach. MAIN RESULTS We included nine studies with 587 men with mild to moderate erectile dysfunction, aged from 20 to 70 years old. The studies all compared ginseng to placebo. We found only short-term follow-up data (up to 12 weeks). Primary outcomes Ginseng appears to have a trivial effect on erectile dysfunction when compared to placebo based on the Erectile Function Domain of the International Index of Erectile Function (IIEF)-15 instrument (scale: 1 to 30, higher scores imply better function; mean difference [MD] 3.52, 95% confidence interval [CI] 1.79 to 5.25; I² = 0%; 3 studies; low certainty evidence) assuming a minimal clinically important difference (MCID) of 4. Ginseng probably also has a trivial effect on erectile function when compared to placebo based on the IIEF-5 instrument (scale: 1 to 25, higher scores imply better function; MD 2.39, 95% CI 0.89 to 3.88; I² = 0%; 3 studies; moderate certainty evidence) assuming a MCID of 5. Ginseng may have little to no effect on adverse events compared to placebo (risk ratio [RR] 1.45, 95% CI 0.69 to 3.03; I² = 0%; 7 studies; low certainty evidence). Based on 86 adverse events per 1000 men in the placebo group, this would correspond to 39 more adverse events per 1000 (95% CI 27 fewer to 174 more). Secondary outcomes Ginseng may improve men's self-reported ability to have intercourse (RR 2.55, 95% CI 1.76 to 3.69; I² = 23%; 6 studies; low certainty evidence). Based on 207 per 1000 men self-reporting the ability to have intercourse in the placebo group, this would correspond to 321 more men (95% CI 158 more to 558 more) per 1000 self-reporting the ability to have intercourse. Ginseng may have a trivial effect on men's satisfaction with intercourse based on the Intercourse Satisfaction Domain of the IIEF-15 (scale: 0 to 15, higher scores imply greater satisfaction; MD 1.19, 95% CI 0.41 to 1.97; I²=0%; 3 studies; low certainty evidence) based on a MCID of 25% improvement from baseline. It may also have a trivial effect on men's satisfaction with intercourse based on item 5 of the IIEF-5 (scale: 0 to 5, higher scores imply more satisfaction; MD 0.60, 95% CI 0.02 to 1.18; 1 study; low certainty evidence) based on a MCID of 25% improvement from baseline. No study reported quality of life as an outcome. We found no trial evidence to inform comparisons to other treatments for erectile dysfunction, such as phosphodiesterase-5 inhibitors. We were unable to conduct any predefined subgroup analyses. AUTHORS' CONCLUSIONS Based on mostly low certainty evidence, ginseng may only have trivial effects on erectile function or satisfaction with intercourse compared to placebo when assessed using validated instruments. Ginseng may improve men's self-reported ability to have intercourse. It may have little to no effect on adverse events. We found no trial evidence comparing ginseng to other agents with a more established role in treating erectile dysfunction, such as phosphodiesterase-5 inhibitors.
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Affiliation(s)
- Hye Won Lee
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea, South
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea, South
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Korea, South
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea, South
| | - Terje Alraek
- Institute of Health Sciences, Kristiania University College, Oslo, Norway
- NAFKAM, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Chris Zaslawski
- College of Traditional Chinese Medicine, University of Technology, Sydney, Australia
| | - Jong Wook Kim
- Department of Urology, Korea University Guro Hospital, Seoul, Korea, South
| | - Du Geon Moon
- Department of Urology, Korea University Guro Hospital, Seoul, Korea, South
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18
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The past, present and future: bespoke surgery for older patients with prostate cancer. Nat Rev Urol 2021; 18:257-258. [PMID: 33782582 DOI: 10.1038/s41585-021-00458-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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19
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Zhang W, Wei Y, Cao X, Guo K, Wang Q, Xiao X, Zhai X, Wang D, Huang Z. Enzymatic preparation of Crassostrea oyster peptides and their promoting effect on male hormone production. JOURNAL OF ETHNOPHARMACOLOGY 2021; 264:113382. [PMID: 32918991 DOI: 10.1016/j.jep.2020.113382] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 08/12/2020] [Accepted: 09/06/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Crassostrea gigas Thunberg and other oysters have been traditionally used in China as folk remedies to invigorate the kidney and as natural aphrodisiacs to combat male impotence. AIM OF THE STUDY Erectile dysfunction (ED) has become a major health problem for the global ageing population. The aim of this study is therefore to evaluate the effect of peptide-rich preparations from C. gigas oysters on ED and related conditions as increasing evidence suggests that peptides are important bioactive components of marine remedies and seafood. MATERIALS AND METHODS Crassostrea oyster peptide (COP) preparations COP1, COP2 and COP3 were obtained from C. gigas oysters by trypsin, papain or sequential trypsin-papain digestion, respectively. The contents of testosterone, cyclic adenosine monophosphate (cAMP) and nitric oxide (NO) and the activity of nitric oxide synthase (NOS) in mice and/or cells were measured by enzyme-linked immunosorbent assays. Real-time PCR was used to assess the expression of genes associated with sex hormone secretion pathways. The model animal Caenorhabditis elegans was also used to analyze the gene expression of a conserved steroidogenic enzyme. In silico analysis of constituent peptides was performed using bioinformatic tools based on public databases. RESULTS The peptide-rich preparation COP3, in which >95% peptides were <3000 Da, was found to increase the contents of male mouse serum testosterone and cAMP, both of which are known to play important roles in erectile function, and to increase the activity of mouse penile NOS, which is closely associated with ED. Further investigation using mouse Leydig-derived TM3 cells demonstrates that COP3 was able to stimulate the production of testosterone as well as NO, a pivotal mediator of penile erection. Real-time PCR analysis reveals that COP3 up-regulated the expression of Areg and Acvr2b, the genes known to promote sex hormone secretion, but not Fst, a gene involved in suppressing follicle-stimulating hormone release. Furthermore, COP3 was also shown to up-regulate the expression of let-767, a well-conserved C. elegans gene encoding a protein homologous to human 17-β-hydroxysteroid dehydrogenases. Preliminary bioinformatic analysis using the peptide sequences in COP3 cryptome identified 19 prospective motifs, each of which occurred in more than 10 peptides. CONCLUSIONS In this paper, Crassostrea oyster peptides were prepared by enzymatic hydrolysis and were found for the first time to increase ED-associated biochemical as well as molecular biology parameters. These results may help to explain the ethnopharmacological use of oysters and provide an important insight into the potentials of oyster peptides in overcoming ED-related health issues.
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Affiliation(s)
- Wanwan Zhang
- Institute for Food Nutrition and Human Health, School of Food Science and Engineering, South China University of Technology, Guangzhou, 510641, China; Center for Bioresources and Drug Discovery, School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Yifang Wei
- Institute for Food Nutrition and Human Health, School of Food Science and Engineering, South China University of Technology, Guangzhou, 510641, China; Center for Bioresources and Drug Discovery, School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Xiaoxiao Cao
- Center for Bioresources and Drug Discovery, School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Kaixin Guo
- Institute for Food Nutrition and Human Health, School of Food Science and Engineering, South China University of Technology, Guangzhou, 510641, China; Center for Bioresources and Drug Discovery, School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, 510006, China
| | - Qiangqiang Wang
- Institute for Food Nutrition and Human Health, School of Food Science and Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Xiaochun Xiao
- Research and Development Center, Infinitus (China) Company Ltd, Guangzhou, 510665, China
| | - Xufeng Zhai
- Research and Development Center, Infinitus (China) Company Ltd, Guangzhou, 510665, China
| | - Dingding Wang
- Center for Bioresources and Drug Discovery, School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, 510006, China.
| | - Zebo Huang
- Institute for Food Nutrition and Human Health, School of Food Science and Engineering, South China University of Technology, Guangzhou, 510641, China; Center for Bioresources and Drug Discovery, School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, 510006, China.
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Abstract
INTRODUCTION Andropause is a complicated process in men's life which can negatively affect their quality of life in both physical and psychological dimensions. OBJECTIVES The aim of this study was to determine the prevalence of andropause among Iranian men age 40-85 years and its relationship with quality of life. MATERIALS AND METHODS This was a cross-sectional study among 393 men attending ten urban healthcare centers in Ilam province in southwestern Iran. Study participants were recruited using proportional random sampling. The Male andropause symptoms self-assessment questionnaire (MASSQ) and SF-12 were used for data collection. Data were analyzed using SPSS version 22 (Chicago, IL). RESULTS The mean (SD) of participants scores in MASSQ was 57.46 (17.56). Only 61 (15.5%) men were classified at "don't need testosterone" category based on MASSQ. There were significant associations between the eight aspects of HRQoL and the andropause severity (p < .001). Older age, lower education, having depression, coronary heart disease, and incontinence were associated with increased odds of andropause (p < .05). CONCLUSION This study confirmed findings of previous studies regarding andropause and its relationship with men's quality of life. Future studies in this topic are needed to discover all the factors that may influence men andropause.
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Affiliation(s)
- Nazanin Rezaei
- Department of Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Arman Azadi
- Department of Nursing, Ilam University of Medical Sciences, Ilam, Iran
| | - Reza Pakzad
- Department of Epidemiology, Tehran University of Medical Sciences, Tehran, Iran
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
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Sharma R, Bansal P, Arora M. Pitfalls in AGS Beers Criteria® Reflect Communication Gap Between Top Healthcare Organizations: Beware or Be Aware. J Am Geriatr Soc 2020; 68:2969-2971. [PMID: 33000469 DOI: 10.1111/jgs.16859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Rishabh Sharma
- Department of Pharmacy Practice, Indo-Soviet Friendship College of Pharmacy, Moga, India
| | - Parveen Bansal
- University Centre of Excellence in Research, Baba Farid University of Health Sciences, Faridkot, India
| | - Malika Arora
- Multidisciplinary Research Unit, Department of Health Research, Ministry of Family and Welfare, Government of India, Guru Gobind Singh Medical College and Hospital, Faridkot, India
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Zewdie KA, Ayza MA, Tesfaye BA, Wondafrash DZ, Berhe DF. A Systematic Review on Rho-Kinase as a Potential Therapeutic Target for the Treatment of Erectile Dysfunction. Res Rep Urol 2020; 12:261-272. [PMID: 32766173 PMCID: PMC7373493 DOI: 10.2147/rru.s255743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/22/2020] [Indexed: 01/22/2023] Open
Abstract
Background Erectile dysfunction (ED) is a common clinical condition with limited treatment options. The main aim of the present systematic review was to synthesize information on Rho-kinase as a novel therapeutic approach for the treatment of ED. Methods We performed a systematic literature study in PubMed, Google Scholar and Scopus. Included studies were original articles studied the role of Rho-kinase in the pathogenesis and/or new treatment approach for ED in animal models and clinical studies, published between 2014 and 2019. Data derived from each study were study design used, interventions applied and main treatment outcomes. The quality of the selected articles was assessed by CAMARADES criteria and data were analyzed using descriptive statistics. Results A total of 1067 original articles were retrieved in the given period and eighteen papers met our inclusion criteria. Five articles explain the role of Rho-kinase in ED pathogenesis using different models such as cavernous nerve crush injury, heart failure-induced ED, vasculogenic and post-radical prostatectomy ED, diabetes-induced ED and age-related ED. Other ten papers explain the role of novel drugs evaluated for ED treatment by targeting Rho-kinase as a new approach for ED therapy. The rest three papers discuss the role of plant extracts used by traditional society for the treatment of ED and assess their potential function in targeting Rho-kinase in animal models. The penile erectile functional index has shown that the ratio of intracavernosal pressure to mean arterial pressure (ICP/MAP) was decreased due to age and various chronic diseases. Whilst, ROCK I and ROCK II expression were increased. Western blot findings have also shown that ROCK II and MYPT-1 phosphorylation rates increased in cavernous tissue after ED induction. Besides, compounds which can inhibit the action of Rho-kinase activity showed relaxation of the corpus cavernosum, decrease in corporal fibrosis, and alleviate increased apoptosis and caspase-3 activity in an NO-independent manner. Moreover, histological and molecular dysregulation have been improved by inhibition of Rho-kinase. Conclusion Targeting Rho-kinase may be a possible target for the treatment of ED secondary to specific causes, and Rho-kinase inhibitors may be a new drug family for the treatment of ED. However, this requires further studies for in-depth understanding.
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Affiliation(s)
- Kaleab Alemayehu Zewdie
- Department of Pharmacology and Toxicology, School of Pharmacy, Mekelle University, Mekelle, Ethiopia
| | - Muluken Altaye Ayza
- Department of Pharmacology and Toxicology, School of Pharmacy, Mekelle University, Mekelle, Ethiopia
| | - Bekalu Amare Tesfaye
- Department of Pharmacology and Toxicology, School of Pharmacy, Mekelle University, Mekelle, Ethiopia
| | - Dawit Zewdu Wondafrash
- Department of Pharmacology and Toxicology, School of Pharmacy, Mekelle University, Mekelle, Ethiopia
| | - Derbew Fikadu Berhe
- Department of Pharmacology and Toxicology, School of Pharmacy, Mekelle University, Mekelle, Ethiopia
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Prieto-Castro R, Puigvert-Martínez AM, Artigas-Feliu R, Illán-Mateo P, Cruz-Culebra N, Artés-Ferragud M. Opinions, Attitudes, and Perceptions in Relation to Erectile Dysfunction and Premature Ejaculation in the Undiagnosed Spanish Male Population. Results of the PANDORA Project. J Sex Med 2020; 17:1495-1508. [PMID: 32622766 DOI: 10.1016/j.jsxm.2020.04.381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Approximately 43% of Spanish men report experiencing premature ejaculation (PE) at some point in their lives and 12.1% suffer from erectile dysfunction (ED), of whom only 16.5% have seen a doctor. Despite this, ED and PE remain undiagnosed among a supposedly healthy segment of the population. AIM To assess the general knowledge of a representative population of healthy Spanish males of the symptoms, treatment, and expectations related to ED and PE. METHODS This was a descriptive study based on an online questionnaire in which 2,515 males aged 25-75 years with no history of ED and/or PE presented their perception of aspects related to symptoms, diagnosis, treatment, and expectations in ED and PE. MAIN OUTCOME MEASURES The study provided an evaluation of the knowledge, attitude, and underdiagnosis of ED and/or PE in healthy males and the approach taken by urology specialists and other disciplines. RESULTS The survey was completed by 2,515 healthy males, including over 80% of those who had completed secondary or higher education. 60% of the sample had never seen a urologist and 59% and 62% of the participating men responded correctly to the statements about PE and ED, respectively. Their lack of knowledge of the therapeutic alternatives was clear (74% and 76% of the panel were unaware of the existence of effective treatments for ED and PE, respectively). Despite the initiative shown by some participants in seeking information about each condition (10.3% for ED; 16.7% for PE), only 4.7% of them had been questioned about ED by a medical practitioner (1.9% for PE). The underdiagnosis rate stood at 3.5% for ED (5.6% participants >65 years) and at about 10% for PE. CLINICAL IMPLICATIONS These results will represent a point of departure for establishing some recommendations to improve the detection and treatment of these disorders. STRENGTHS & LIMITATIONS This is the first study of its kind in Spain to analyze the underdiagnosis of ED and/or PE inferred from data reported by a population of healthy males. Screening for ED was performed with a validated questionnaire. However, the rest of the research was conducted using adaptations of validated questionnaires or a self-designed questionnaire based on and in consultation with a group of experienced andrologists. CONCLUSION People need to have greater knowledge of both the conditions and the related false myths to make sure that they are familiar with the existence of drug treatments and socio-sanitary interventions. Primary care physicians and urologists should also be more proactive in routine visits in order to achieve better management of ED and PE. Prieto-Castro R, Puigvert-Martínez AM, Artigas-Feliu R, et al. Opinions, Attitudes, and Perceptions in Relation to Erectile Dysfunction and Premature Ejaculation in the Undiagnosed Spanish Male Population. Results of the PANDORA Project. J Sex Med 2020;17:1495-1508.
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Affiliation(s)
- R Prieto-Castro
- Andrology Unit, Sexual and Reproductive Medicine, Reina Sofía Regional University Hospital of Cordoba, Córdoba, Spain.
| | | | | | - P Illán-Mateo
- Menarini Group Spain, Medical Department, Barcelona, Spain
| | - N Cruz-Culebra
- Menarini Group Spain, Medical Department, Barcelona, Spain
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Najimi A, Veisani Y, Azami S, Azadi A. Investigating the sexual quality of life and its relationship with general health in older men in Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:150. [PMID: 32766335 PMCID: PMC7377141 DOI: 10.4103/jehp.jehp_748_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/24/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Sexual problems in elder people are considered as a public health concern and can affect their overall health and quality of life. This study aimed to investigate the sexual quality of life and its relationship with general health in older men in the west of Iran. METHODS This was a cross-sectional study among 362 older men aged 60 years or older attending Comprehensive Health Care Centers in Ilam, Iran. Samples selected through Quota sampling method and simple random sampling. Data were collected using the Sexual Quality of Life Questionnaire-Male and General Health Questionnaire-28. RESULTS The mean ± standard deviation (SD) of age was 69.9 ± 8.1 years. The mean ± SD score of sexual quality of life and general health of older men was 46.6 ± 14.6 and 19.2 ± 9.7, respectively. A positive and significant association was found between sexual quality of life and general health (P < 0.001, r = -0.41). Moreover, general health, age, sleep problems, and the level of education were the important predictors for sexual quality of life in elder men (P < 0.05). CONCLUSION According to the results, the sexual quality of life of participants was at a moderate level. Since only some factors influencing the sexual quality of life were ascertained, further studies are required to investigate all factors influencing older men's sexual quality of life.
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Affiliation(s)
- Alireza Najimi
- Student Research Committee, Department of Nursing, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Yousef Veisani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Sanaz Azami
- Student Research Committee, Department of Nursing, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Arman Azadi
- Student Research Committee, Department of Nursing, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
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RELATIONSHIP BETWEEN MASKED ARTERIAL HYPERTENSION AND ERECTILE DYSFUNCTION. JOURNAL OF MEN'S HEALTH 2020. [DOI: 10.15586/jomh.v16isp1.184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Sleep restriction and testosterone concentrations in young healthy males: randomized controlled studies of acute and chronic short sleep. Sleep Health 2019; 5:580-586. [PMID: 31416797 DOI: 10.1016/j.sleh.2019.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 06/17/2019] [Accepted: 07/04/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Low testosterone in men increases the risk for various disorders. Severe sleep restriction (SR) may reduce testosterone, but the effects of long-term short sleep are unknown. This study tested the effects of SR on circulating testosterone in healthy young men. DESIGN Randomized controlled studies of SR vs habitual sleep (HS) in inpatient (study 1, n=14) and outpatient (study 2, n=13) settings. METHODS Study 1 involved severe, acute SR (4 hours time in bed [TIB]) vs HS (9 hours TIB) for 5 nights; study 2 consisted of mild, long-term SR (HS 1.5 hours of sleep/night) vs HS for 6 weeks. Plasma testosterone levels were measured at baseline and end point (study 1) or baseline, week 3, and week 6 (study 2) of each phase. Linear model analyses to assess the effects of SR on testosterone were performed separately for each study. RESULTS Study 1: There were no significant sleep-time interaction on testosterone concentrations (change in testosterone levels during HS = 22.86 ± 163.79 ng/dL; SR = 43.73 ± 159.96 ng/dL, P = .41) and no main effect of sleep duration (P = .13). Study 2: There were a trend for a sleep-time interaction (P = .067) and a main effect of sleep on testosterone concentrations from 6 weeks of SR (P = .0046). Testosterone concentrations were slightly lower but increased over time with SR relative to HS. CONCLUSIONS Sleep restriction does not adversely affect plasma testosterone levels in healthy young men. Given prior contradicting evidence, confirmatory studies should be done to ascertain the influence of sleep duration and quality on testosterone concentrations in men throughout life.
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Levkovich I, Gewirtz-Meydan A, Karkabi K, Ayalon L. When sex meets age: Family physicians' perspectives about sexual dysfunction among older men and women: A qualitative study from Israel. Eur J Gen Pract 2019; 25:85-90. [PMID: 30848972 PMCID: PMC6493318 DOI: 10.1080/13814788.2019.1580263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Gender differences in relation to sexual functioning among older adults have received very little research attention, although the ageing process is likely to be characterized by difficulties in sexual functioning among both women and men. OBJECTIVES The purpose of this qualitative research is to examine and understand the perceptions of family physicians, and the differences in their attitudes regarding male and female patients. METHOD Qualitative interviews with family physicians were conducted between August 2017 and December 2017. Sixteen family physicians participated in the study, aged 36-64; most were born in Israel and half of them were women. Twelve physicians were Jewish, two were Christian and two were Muslim. Nine work in rural practices and seven work in urban practices. We used in-depth, semi-structured, face-to-face interviews. The interviews were recorded, transcribed and analysed by three researchers using content analysis. RESULTS The analysis of the interviews revealed two main themes: (1) Differences as perceived by family physicians: men are perceived as being interested in engaging in full sexual relations, including penetration, while among women, the main need is focused on the relationship and intimacy. (2) Gender differences regarding seeking a solution through the family physician. Family physicians reported that most of the patients who seek solutions regarding sexual dysfunction in old age are men with impotence problems. Family physicians perceived that women seek out solutions less frequently, some because they are afraid their relationship will suffer if they do not continue having sex with their partners. CONCLUSION Men and women were seen as having different motivations for engaging in sex and different needs from physicians.
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Affiliation(s)
- Inbar Levkovich
- a The Division of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine , Technion-Israel Institute of Technology , Haifa , Israel
| | - Ateret Gewirtz-Meydan
- b The Louis and Gaby Weisfeld School of Social Work , Bar-Ilan University , Ramat Gan , Israel.,c Sex and Couple Therapy Unit , Meir Medical Center , Kfar Saba , Israel
| | - Khaled Karkabi
- d Department of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine, Clalit Health Services, Haifa and Western Galilee District , Technion-Israel Institute of Technology , Haifa , Israel
| | - Liat Ayalon
- b The Louis and Gaby Weisfeld School of Social Work , Bar-Ilan University , Ramat Gan , Israel
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28
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Chen YF, Lin CS, Hong CF, Lee DJ, Sun C, Lin HH. Design of a Clinical Decision Support System for Predicting Erectile Dysfunction in Men Using NHIRD Dataset. IEEE J Biomed Health Inform 2018; 23:2127-2137. [PMID: 30369456 DOI: 10.1109/jbhi.2018.2877595] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Erectile dysfunction (ED) affects millions of men worldwide. Men with ED generally complain failure to attain or maintain an adequate erection during sexual activity. The prevalence of ED is strongly correlated with age, affecting about 40% of men at age 40 and nearly 70% at age 70. A variety of chronic diseases, including diabetes, ischemic heart disease, congestive heart failure, hypertension, depression, chronic renal failure, obstructive sleep apnea, prostate disease, gout, and sleep disorder, were reported to be associated with ED. In this study, data retrieved from a subset of the National Health Insurance Research Database of Taiwan were used for designing the clinical decision support system (CDSS) for predicting ED incidences in men. The positive cases were male patients aged 20-65 who were diagnosed with ED between January 2000 and December 2010 confirmed by at least three outpatient visits or at least one inpatient visit, while the negative cases were randomly selected from the database without a history of ED and were frequency (1:1), age, and index year matched with the ED patients. Data of a total of 2832 ED patients and 2832 non-ED patients, each consisting of 41 features including index age, 10 comorbidities, and 30 other comorbidity-related variables, were retrieved for designing the predictive models. Integrated genetic algorithm and support vector machine was adopted to design the CDSSs with two experiments of independent training and testing (ITT) conducted to verify their effectiveness. In the 1st ITT experiment, data extracted from January 2000 till December 2005 (61.51%, 1742 positive cases and 1742 negative cases) were used for training and validating and the data retrieved from January 2006 till December 2010 were used for testing (38.49%), whereas in the 2nd ITT experiment, data in the training set (77.78%) were extracted from January 2000 till Deceber 2007 and those in the testing set (22.22%) were retrieved afterward. Tenfold cross validation and three different objective functions were adopted for obtaining the optimal models with best predictive performance in the training phase. The testing results show that the CDSSs achieved a predictive performance with accuracy, sensitivity, specificity, g-mean, and area under ROC curve of 74.72%-76.65%, 72.33%-83.76%, 69.54%-77.10%, 0.7468-0.7632, and 0.766-0.817, respectively. In conclusion, the CDSSs designed based on cost-sensitive objective functions as well as salient comorbidity-related features achieve satisfactory predictive performance for predicting ED incidences.
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Aldawsari HM, Hosny KM. Solid lipid nanoparticles of Vancomycin loaded with Ellagic acid as a tool for overcoming nephrotoxic side effects: Preparation, characterization, and nephrotoxicity evaluation. J Drug Deliv Sci Technol 2018. [DOI: 10.1016/j.jddst.2018.02.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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MAT, a Novel Polyherbal Aphrodisiac Formulation, Enhances Sexual Function and Nrf2/HO-1 Pathway While Reducing Oxidative Damage in Male Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:8521782. [PMID: 29853975 PMCID: PMC5949178 DOI: 10.1155/2018/8521782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/26/2018] [Indexed: 01/08/2023]
Abstract
Mucuna pruriens, Ashwagandha, and Tribulus terrestris are known as the enhancers for sexual health, functional activities, vitality, and longevity. These herbs had been widely used in the Ayurveda medicine as aphrodisiacs through the ages, and their efficacy was also verified separately in our previous publication. Therefore, the aim of this study was to determine the effects of Mucuna, Ashwagandha, and Tribulus complexes on sexual function in rats. Twenty-eight male rats allocated to four groups as follows: (i) negative control (C); (ii) positive control or sildenafil citrate treated group (5 mg/kg) (S); (iii) MAT1 (combination of 10 mg Mucuna (M) + 10 mg Ashwagandha (A) + 10 mg Tribulus (T)/kg BW); (iv) MAT 2 (20 mg Mucuna + 20 mg Ashwagandha + 20 mg Tribulus/kg BW). There was no significant difference found between the MAT1 and MAT2 groups while they showed significantly increased testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) levels when compared to the negative control. Significant increases in Nrf2/HO1 levels and decreases in NF-κB were detected in MAT groups similar to the decrease in serum and testis malondialdehyde (MDA) levels as compared to both controls. The sperm motility, count, and rate also significantly improved in both MAT groups, while ALT, AST, creatinine, ALP, and urea levels did not change in any of the groups. Oral consumption of MATs combination in male rats resulted in inhibition of NF-κB and MDA and also increased sex hormones with Nrf2-mediated HO-1 induction. MAT combinations may improve sexual functions by increasing levels of sexual hormones and regulation of NF-κB and Nrf2/HO-1 signaling pathways.
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Xybilun ® , actualité 2018 de la dysfonction érectile. SEXOLOGIES 2018. [DOI: 10.1016/j.sexol.2018.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Colson M, Cuzin B, Faix A, Grellet L, Huyghes E. Les traitements oraux de la dysfonction érectile aujourd’hui, pour quel patient ? SEXOLOGIES 2018. [DOI: 10.1016/j.sexol.2018.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Gebregeorgise DT, Belay YM, Kälvemark Sporrong S. Sildenafil citrate use in Addis Ababa: characteristics of users and pharmacists' dispensing practices. Int J Clin Pharm 2017; 40:67-73. [PMID: 29134487 DOI: 10.1007/s11096-017-0558-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 11/02/2017] [Indexed: 12/17/2022]
Abstract
Background Studies have reported misuse of sildenafil citrate for recreational purpose, not least by healthy young men. This is becoming a major concern, for medical and other reasons. Objective The aim of this study was to document the characteristics of sildenafil citrate users and to explore the dispensing practices of the medicine in selected community pharmacies in Addis Ababa, Ethiopia. Setting Data was collected in community pharmacies in Addis Ababa, Ethiopia. Method A survey, using a self-administrated questionnaire, was conducted among customers who purchased sildenafil citrate from community pharmacies. Simple descriptive statistics were used to analyse data. Also, semi-structured interviews were conducted with community pharmacists. These were analysed thematically. Main outcome measures Socio-demographic characteristics (survey), themes (interviews). Results All survey respondents (n = 197) were men, 57.9% were below 40 years old, 53.8% had never been married and 58.4% had used sildenafil citrate before. A minority (16.2%) were diagnosed with erectile dysfunction. The main reason for buying sildenafil citrate was experimentation (45.7%). Pharmacists reported that sildenafil citrate was often dispensed without a prescription. The reason for this was, according to the interviewees, competition in the market. Also, the medicine was often dispensed without adequate information or counselling. Conclusions Selling and buying sildenafil citrate without a prescription seems to be common practice in pharmacies in Addis Ababa. It is crucial to strengthen the regulatory activity to protect customers from health risks. In addition pharmacy professionals should be supported to work in accordance with professional and legal standards.
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Affiliation(s)
- Dawit Teshome Gebregeorgise
- University of Copenhagen, Copenhagen, Denmark.,Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yajeb Melesse Belay
- University of Copenhagen, Copenhagen, Denmark.,Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Abstract
Erectile dysfunction (ED) is one of the most common disorders in male and is often associated with other age-related comorbidities. The aging process affects the structural organization and function of penile erectile components such as smooth muscle cell and vascular architecture. These modifications affect penile hemodynamics by impairing cavernosal smooth muscle cell relaxation, reducing penile elasticity, compliance and promoting fibrosis. This review aims to identify the mechanisms of ED in the penile aging process in experimental and clinical data. It also highlights areas that are in need of more research. The search strategies yielded total records screened from PubMed. Clarification of the molecular mechanisms that accompanies corpus cavernosum aging and aging-associated ED will aid new perspectives in the development of novel mechanism-based therapeutic approaches. Age is not a limiting factor for ED medical management, and it is never too late to treat. Hypogonadism should be managed regardless of age, and synergistic effects have been found during testosterone (T) replacement therapy when used along with oral phosphodiesterase-5 (PDE-5) inhibitors. Therefore, the clinical management of ED related to aging can be done by therapeutic interventions that include PDE-5 inhibitors, and other pharmacological treatments.
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Affiliation(s)
- Ecem Kaya
- a Department of Biochemistry and Pharmacology , Faculty of Pharmacy, Ankara University , Ankara , Turkey and
| | - Suresh C Sikka
- b Department of Urology and Pharmacology , Tulane University Health Sciences Center , New Orleans , LA , USA
| | - Philip J Kadowitz
- b Department of Urology and Pharmacology , Tulane University Health Sciences Center , New Orleans , LA , USA
| | - Serap Gur
- a Department of Biochemistry and Pharmacology , Faculty of Pharmacy, Ankara University , Ankara , Turkey and
- b Department of Urology and Pharmacology , Tulane University Health Sciences Center , New Orleans , LA , USA
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Khanzada U, Khan SA, Hussain M, Adel H, Masood K, Adil SO, Manohar M. Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan. World J Mens Health 2017; 35:22-27. [PMID: 28459144 PMCID: PMC5419116 DOI: 10.5534/wjmh.2017.35.1.22] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 02/13/2017] [Accepted: 02/28/2017] [Indexed: 01/12/2023] Open
Abstract
PURPOSE In patients with erectile dysfunction, it is important to differentiate psychogenic from organic causes. Penile Doppler ultrasonography is a relatively inexpensive and minimally invasive tool for this purpose. This study was conducted to evaluate the causes of erectile dysfunction in an adult male population, using penile Doppler ultrasonography. MATERIALS AND METHODS A retrospective study was conducted in a single center. All patients who presented with complaints of erectile dysfunction and underwent penile Doppler ultrasonography between July 2014 and June 2016 were included in this study. All examinations were performed using GE Voluson S6 and GE Logiq P5 devices. Following baseline scans, an intracavernosal injection of 20 μg of prostaglandin E1 was given. Peak systolic and end diastolic velocities were measured in each cavernosal artery. Patients with a peak systolic velocity of <25 cm/s were considered to have arterial insufficiency, while an end diastolic velocity of >5 cm/s was considered to indicate venous incompetence. RESULTS Out of 97 patients (mean age, 37.09±11.59 years; range, 19~69 years), 50 patients (51.5%) had normal findings, 24 patients (24.7%) had arterial insufficiency, 15 patients (15.5%) had a venous leak, and 8 patients (8.2%) patients had arterial insufficiency with a venous leak. Psychogenic erectile dysfunction was significantly higher among patients aged ≤40 years, while arterial insufficiency with or without a venous leak was significantly higher among patients aged >40 years (p=0.022). CONCLUSIONS A majority of the studied individuals demonstrated no organic cause of erectile dysfunction, thus confirming a high prevalence of the psychogenic etiology, particularly in relatively young individuals.
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Affiliation(s)
- Usman Khanzada
- Department of Radiology, Dow Institute of Radiology, Karachi, Pakistan
| | - Sohail Ahmed Khan
- Department of Radiology, Dow Institute of Radiology, Karachi, Pakistan
| | - Munawar Hussain
- Department of Radiology, Dow Institute of Radiology, Karachi, Pakistan
| | - Hatem Adel
- Department of Radiology, Dow Institute of Radiology, Karachi, Pakistan
| | - Kamran Masood
- Department of Radiology, Dow Institute of Radiology, Karachi, Pakistan
| | - Syed Omair Adil
- Department of Research, Dow University of Health Sciences, Karachi, Pakistan.
| | - Murli Manohar
- Department of Radiology, Dow Institute of Radiology, Karachi, Pakistan
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Huri HZ, Ling CF, Razack AHA. Drug-related problems in patients with erectile dysfunctions and multiple comorbidities. Ther Clin Risk Manag 2017; 13:407-419. [PMID: 28408836 PMCID: PMC5384729 DOI: 10.2147/tcrm.s118010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This study was conducted in a tertiary medical center in Kuala Lumpur, Malaysia. A total of 200 erectile dysfunction (ED) patients with 499 cases who had received pharmacological treatments for their ED participated in this study. Types, causes and factors associated with drug-related problems (DRPs) in ED patients with multiple comorbidities were assessed. A total of 244 DRPs with an average of 1.2±2.1 DRPs per patient were identified. Drug interaction contributed the most to DRPs occurrence. There was a significant higher risk of DRPs in patients with benign prostatic hyperplasia, lower urinary tract infection and elderly and end-stage renal disease. Early identification of types of DRPs and factors associated may enhance their prevention and management.
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Affiliation(s)
- Hasniza Zaman Huri
- Department of Pharmacy, Faculty of Medicine, University of Malaya.,Clinical Investigation Centre, University Malaya Medical Centre
| | - Chui Fang Ling
- Department of Pharmacy, Faculty of Medicine, University of Malaya
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Toprak O, Sarı Y, Koç A, Sarı E, Kırık A. The impact of hypomagnesemia on erectile dysfunction in elderly, non-diabetic, stage 3 and 4 chronic kidney disease patients: a prospective cross-sectional study. Clin Interv Aging 2017; 12:437-444. [PMID: 28280316 PMCID: PMC5340248 DOI: 10.2147/cia.s129377] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Erectile dysfunction (ED) is common in older men with chronic kidney disease. Magnesium is essential for metabolism of nitric oxide which helps in penile erection. There is little information available about the influence of serum magnesium on ED. The aim of the study was to assess the influence of hypomagnesemia on ED in elderly chronic kidney disease patients. SUBJECTS AND METHODS A total of 372 patients aged 65-85 years, with an estimated glomerular filtration rate of 60-15 mL/min/1.73 m2, were divided into two groups according to serum magnesium levels: hypomagnesemia, n=180; and normomagnesemia, n=192. ED was assessed through the International Index of Erectile Function-5. Hypomagnesemia is defined as serum magnesium <1.8 mg/dL. RESULTS The prevalence of ED was higher among hypomagnesemic subjects compared to that among normomagnesemics (93.3% vs 70.8%, P<0.001). Severe ED (62.8% vs 43.8%, P=0.037), mild-to-moderate ED (12.2% vs 5.2%, P=0.016), abdominal obesity (37.2% vs 22.9%, P=0.003), metabolic syndrome (38.4% vs 19.2%, P=0.026), proteinuria (0.83±0.68 vs 0.69±0.48 mg/dL, P=0.023), and C-reactive protein (6.1±4.9 vs 4.1±3.6 mg/L, P<0.001) were high; high-density lipoprotein cholesterol (48.8±14.0 vs 52.6±13.5 mg/dL, P=0.009), and albumin (4.02±0.53 vs 4.18±0.38 g/dL, P=0.001) were low in the hypomagnesemia group. Serum magnesium ≤1.85 mg/dL was the best cutoff point for prediction of ED. Hypomagnesemia (relative risk [RR] 2.27), age ≥70 (RR 1.74), proteinuria (RR 1.80), smoking (RR 21.12), C-reactive protein (RR 1.34), abdominal obesity (RR 3.92), and hypertension (RR 2.14) were predictors of ED. CONCLUSION Our data support that ED is related to hypomagnesemia in elderly patients with moderately to severely reduced kidney function.
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Affiliation(s)
| | | | - Akif Koç
- Division of Urology, Department of Medicine, Balikesir University School of Medicine, Balikesir, Turkey
| | - Erhan Sarı
- Division of Urology, Department of Medicine, Balikesir University School of Medicine, Balikesir, Turkey
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Son YJ, Jang M, Jun EY. Prevalence of Erectile Dysfunction and Associated Factors in Korean Older Adults With Coronary Artery Disease. J Gerontol Nurs 2016; 42:32-41. [PMID: 27379456 DOI: 10.3928/00989134-20160701-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 06/10/2016] [Indexed: 12/21/2022]
Abstract
The current study aimed to identify the prevalence and associated factors of erectile dysfunction (ED) among 161 Korean adults 60 and older with coronary artery disease (CAD). ED was diagnosed in 72.2% of patients-the prevalence of which was significantly associated with age, education, employment, monthly income, frequency of sexual intercourse, body mass index, and low-density lipoprotein. Health-related quality of life (HRQoL) was lower in patients with ED than in those without ED (p < 0.001). Hierarchical multiple regression analysis revealed that ED significantly influenced HRQoL in patients with CAD after adjusting for sociodemographic and disease-related characteristic variables (p < 0.001). Interventions and training courses for health care providers should focus on improving caregivers' knowledge and communication skills with patients and spouses regarding sexual health. Furthermore, guidelines to improve HRQoL in patients with CAD should consider incorporating sexual counseling. [Journal of Gerontological Nursing, 42(10), 32-41.].
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40
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Somes J, Donatelli NS. Nitroglycerin? Yes or No? That Is the Question! Risk of Administering Sublingual Nitroglycerin When the Patient Is Using Phosphodiesterase-5 Inhibitors. J Emerg Nurs 2016; 42:434-7. [PMID: 27594077 DOI: 10.1016/j.jen.2016.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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41
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Erectile dysfunction as a predictor of asymptomatic coronary artery disease in elderly men with type 2 diabetes. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2016; 13:552-6. [PMID: 27582774 PMCID: PMC4987428 DOI: 10.11909/j.issn.1671-5411.2016.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Voznesensky M, Annam K, Kreder KJ. Understanding and Managing Erectile Dysfunction in Patients Treated for Cancer. J Oncol Pract 2016; 12:297-304. [PMID: 27072383 PMCID: PMC5015452 DOI: 10.1200/jop.2016.010678] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Cancer can cause sexual adverse effects by direct and indirect pathways. It can involve sexual organs, indirectly affect body image, or cause fatigue or depression with subsequent effects on libido. Erectile dysfunction (ED), the inability to obtain or maintain an erection firm enough for sexual intercourse, can also result from adverse effects of cancer treatment, such as fatigue, pain, or anxiety about therapy. In addition, depressed feelings about having cancer can affect sexuality, causing a range of signs and symptoms that can lead to ED. Chemotherapy, hormone therapy, surgery, and radiation can all cause sexual adverse effects. Additional factors that play a role include patient age and degree of ED before starting cancer treatment. In this article, we discuss how chemotherapy, hormone therapy, surgery, and radiation affect erectile function as well as possible treatment options for ED.
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Choi HK, Jung JA, Shon J, Bahng MY, Cho DY, Yeo CW, Kim EY, Shin JG. The Effect of Age on the Pharmacokinetics of Udenafil in Healthy Subjects. J Clin Pharmacol 2016; 56:1372-1377. [PMID: 27006150 DOI: 10.1002/jcph.739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/17/2016] [Indexed: 11/07/2022]
Abstract
Udenafil, a cyclic guanosine monophosphate-specific phosphodiesterase type 5 inhibitor, has been developed to treat erectile dysfunction. We evaluated the effect of age on the pharmacokinetics and tolerability of udenafil. A single-center, open-label, parallel-group phase 1 study was conducted in healthy adult subjects who took a single oral dose of udenafil (100 mg). The pharmacokinetics and tolerability of udenafil were compared between 12 healthy young men (21-27 years) and 12 healthy elderly men (65-78 years). Serial blood and urine samples were collected for up to 60 and 48 hours after dosing. The plasma concentrations of udenafil and its major metabolite, DA-8164, were analyzed using a validated liquid chromatography-tandem mass spectrometry method. The mean Cmax of udenafil tended to be slightly less (214.0 vs 292.8 μg/L) in the elderly compared with the young (GMR, 68.9; 95% CI, 48.9-97.1); however, the AUC did not differ between the groups (1858.8 vs 2100.6 μg·h/L; GMR, 84.6; 95% CI, 66.1-108.4). The mean t1/2 was prolonged by approximately 5 hours in the elderly (P < .05). The clearance and metabolic AUC ratio did not differ between the elderly and young. In terms of tolerability, all adverse events were mild, and all subjects recovered without additional therapy. The systemic exposure of elderly subjects to udenafil appears to be comparable to or slightly less than that of young healthy subjects. Based on our pharmacokinetic comparisons, udenafil dose adjustment is unlikely to be required in the elderly population.
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Affiliation(s)
- Hyang-Ki Choi
- Department of Pharmacology, Inje University College of Medicine, Busan Jin-gu, Busan, Republic of Korea
| | - Jin Ah Jung
- Department of Pharmacology, Inje University College of Medicine, Busan Jin-gu, Busan, Republic of Korea.,Department of Clinical Pharmacology, Inje University Busan Paik Hospital, Busan Jin-gu, Busan, Republic of Korea
| | - Jihong Shon
- Department of Pharmacology, Inje University College of Medicine, Busan Jin-gu, Busan, Republic of Korea.,Department of Clinical Pharmacology, Inje University Busan Paik Hospital, Busan Jin-gu, Busan, Republic of Korea
| | - Mi Young Bahng
- Dong-A ST Co., Ltd, Dong Dae Moon-gu, Seoul, Republic of Korea
| | - Doo-Yeoun Cho
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University, Bundang-gu, Seongnam, Republic of Korea
| | - Chang Woo Yeo
- Department of Pharmacology, Inje University College of Medicine, Busan Jin-gu, Busan, Republic of Korea.,Department of Clinical Pharmacology, Inje University Busan Paik Hospital, Busan Jin-gu, Busan, Republic of Korea
| | - Eun-Young Kim
- Department of Pharmacology, Inje University College of Medicine, Busan Jin-gu, Busan, Republic of Korea.,Department of Clinical Pharmacology, Inje University Busan Paik Hospital, Busan Jin-gu, Busan, Republic of Korea
| | - Jae-Gook Shin
- Department of Pharmacology, Inje University College of Medicine, Busan Jin-gu, Busan, Republic of Korea. .,Department of Clinical Pharmacology, Inje University Busan Paik Hospital, Busan Jin-gu, Busan, Republic of Korea.
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Kim M, Kim SY, Rou WS, Hwang SW, Lee BS. Erectile dysfunction in patients with liver disease related to chronic hepatitis B. Clin Mol Hepatol 2015; 21:352-7. [PMID: 26770923 PMCID: PMC4712162 DOI: 10.3350/cmh.2015.21.4.352] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 10/21/2015] [Accepted: 11/09/2015] [Indexed: 02/06/2023] Open
Abstract
Background/Aims Despite sexual function making an important contribution to the quality of life, data on erectile function are relatively scant in patients with chronic liver disease. We evaluated the prevalence of and risk factors for erectile dysfunction (ED) in patients with liver disease related to hepatitis B, especially among those with chronic hepatitis B (CHB) or early-stage cirrhosis. Methods In total, 69 patients (35 with CHB and 34 with hepatitis-B-related liver cirrhosis [HBV-LC]) aged 40-59 years were analyzed. Child-Pugh classes of A and B were present in 30 (88.2%) and 4 (11.8%) of the patients with HBV-LC, respectively. The erectile function of the patients was evaluated using the Korean version of IIEF-5. Results The prevalence of any ED was 24.6% for all patients, and 8.6% and 41.2% for those with CHB and HBV-LC, respectively (P=0.002). While there was only one (2.9%) CHB patient for each stage of ED, mild, moderate, and severe ED stages were seen in three (8.8%), one (2.9%), and ten (29.4%) of the HBV-LC patients, respectively. Multiple regression analysis identified the type of liver disease (P=0.010), hypertension (P=0.022), score on the Beck Depression Inventory (P =0.044), and the serum albumin level (P=0.014) as significant independent factors for the presence of ED. Conclusions The prevalence of ED was significantly higher in patients with early-stage HBV-LC than in those with CHB. Therefore, screening male patients with early viral cirrhosis for ED and providing appropriate support are needed, especially when the cirrhosis is accompanied by hypertension, depression, or a depressed level of serum albumin.
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Affiliation(s)
- Min Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Seul Young Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Woo Sun Rou
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Se Woong Hwang
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Byung Seok Lee
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
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46
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Li H, Bai G, Zhang X, Shi B, Liu D, Jiang H, Ji Z, Davis MR, Zhu Z, Fang Y. Effects of Two Different Dosages of Sildenafil on Patients With Erectile Dysfunction. Am J Mens Health 2015; 11:525-530. [PMID: 26634859 DOI: 10.1177/1557988315620467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
To investigate the effects of two different dosages of sildenafil on patients with erectile dysfunction (ED), a total of 3,674 patients with ED were recruited to answer questionnaires designed specifically for this study. There were 977 patients in the 50 mg group and there were 2,697 patients in the 100 mg group. Both 50 mg and 100 mg of sildenafil therapy increased the ED patients' average monthly frequency of sexual intercourse, improved erectile function state in self-assessment, and elevated sexual satisfaction and enjoyment. Despite a higher rate of concomitant diseases, patients in the higher dosage of sildenafil group had a better outcome in the average monthly frequency of sexual intercourse and sexual enjoyment compared with those in the lower dosage. Such a study might be helpful for health care providers to choose sildenafil dosage for patients with ED.
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Affiliation(s)
- Hongjun Li
- 1 Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Gang Bai
- 1 Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Xinyu Zhang
- 1 Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Bingbing Shi
- 1 Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Defeng Liu
- 2 Peking University Third Hospital, Beijing, China
| | - Hui Jiang
- 2 Peking University Third Hospital, Beijing, China
| | - Zhigang Ji
- 1 Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | | | - Ziwen Zhu
- 4 University of Missouri, Columbia, MO, USA
| | - Yujiang Fang
- 3 Des Moines University, Des Moines, IA, USA.,4 University of Missouri, Columbia, MO, USA
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Artom N, Pinna G, Musso NR, Orlandini F, Malasoma P, Uccelli M, Artom A, Rabbia F, Pascale C, Lantieri F, Pende A. Prevalence of erectile dysfunction in a cohort of Italian hypertensive subjects. Clin Exp Hypertens 2015; 38:143-9. [PMID: 26418513 DOI: 10.3109/10641963.2015.1060994] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to evaluate the prevalence of erectile dysfunction (ED) in a cohort of Italian hypertensive men and the association with clinical and biochemical data. The study involved 270 consecutive hypertensive subjects aged 40-70 years evaluated in Italian Hypertension Centers of six hospitals from Liguria and Piedmont. ED was assessed through the self-administered questionnaire of the International Index of Erectile Function. Clinical history with ongoing drug treatment, various clinical parameters, biochemical data and evidence about the presence of subclinical target organ damage was collected. Twenty-seven subjects refused to answer the questionnaire (10%). Among the 243 remained subjects, 123 presented ED (50.6%). ED was highly related to age, systolic blood pressure, pulse pressure, smoking status, statin therapy and kidney function. The addition of a thiazide diuretic to an inhibitor of the renin-angiotensin system significantly increased the prevalence of ED. The prevalence of ED increased in relation with the number of hypotensive drug classes taken by the patients. ED was highly prevalent in this cohort of Italian hypertensive subjects and was associated with other cardiovascular risk factors, such as age, smoking status and kidney function. The role of ED as an early marker of cardiovascular disease is discussed.
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Affiliation(s)
- Nathan Artom
- a Clinic of Internal Medicine 1, University of Genoa , Genoa , Italy
| | - Giuliano Pinna
- b Division of Internal Medicine , Cottolengo Hospital , Turin , Italy .,c Division of Internal Medicine , Cardinal Massaia Hospital , Asti , Italy
| | - Natale R Musso
- a Clinic of Internal Medicine 1, University of Genoa , Genoa , Italy
| | | | - Paolo Malasoma
- d Division of Internal Medicine , Sant' Andrea Hospital , La Spezia , Italy
| | | | - Alberto Artom
- e Division of Internal Medicine , Santa Corona Hospital , Pietra Ligure , Italy
| | - Franco Rabbia
- f Division of Internal Medicine and Hypertension Unit , University of Turin , Turin , Italy , and
| | - Claudio Pascale
- b Division of Internal Medicine , Cottolengo Hospital , Turin , Italy
| | - Francesca Lantieri
- g Biostatistics Unit, Health Science Department, University of Genoa , Genoa , Italy
| | - Aldo Pende
- a Clinic of Internal Medicine 1, University of Genoa , Genoa , Italy
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Yang Y, Liu R, Jiang H, Hong K, Zhao L, Tang W, Mao J. Association Between Dosage Frequency and the Treatment Outcomes of Sildenafil in Young and Middle-aged Men With Erectile Dysfunction: A Chinese, Multicenter, Observational Study. Urology 2015; 86:62-7. [PMID: 26142584 DOI: 10.1016/j.urology.2015.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/09/2015] [Accepted: 03/13/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the correlation between the dosage frequency of sildenafil and its treatment outcomes in men with erectile dysfunction (ED). METHODS Data were from a 4-week, multicenter, observational study of men (1699), between 18 and 60 years of age, with a clinical diagnosis of ED defined as the Sexual Health Inventory for Men (SHIM) score ≤21. The erectile function and quality of sexual life were evaluated at the baseline and the endpoint of sildenafil treatment (after 4 weeks) by using SHIM, Self-Esteem and Relationship Questionnaire, 36-Item Short Form Health Survey, Erection Hardness Score, and the global efficacy question. RESULTS Nine hundred thirty-five patients were enrolled in the ≤1 weekly, 573 in the 2-3 weekly, and 158 in the 4-7 weekly dosage frequency cohorts. After 4 weeks of treatment, a higher dosage frequency of sildenafil was associated with a better SHIM, Self-Esteem and Relationship Questionnaire, and 36-Item Short Form Health Survey score improvement (all P <.0001). Hyperlipidemia is a poor prognostic factor (odds ratio, 3.59; P = .04), whereas hypertension (odds ratio, 0.25; P <.01) and coronary heart disease (odds ratio, 0.56; P = .05) are sensitive to sildenafil treatment. CONCLUSION Higher dosage frequency of sildenafil is associated with a better improvement of sexual function and quality of life of men with ED, and the concomitant treatment of hyperlipidemia is recommended.
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Affiliation(s)
- Yi Yang
- Reproductive Medical Center, First Hospital of Jilin University, Changchun, China
| | - Ruizhi Liu
- Reproductive Medical Center, First Hospital of Jilin University, Changchun, China
| | - Hui Jiang
- Department of Urology, Peking University Third Hospital, Beijing, China.
| | - Kai Hong
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Lianming Zhao
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Wenhao Tang
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Jiaming Mao
- Department of Urology, Peking University Third Hospital, Beijing, China
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Chen YF, Lin HH, Lu CC, Hung CT, Lee MH, Hsu CY, Chung WS. Gout and a Subsequent Increased Risk of Erectile Dysfunction in Men Aged 64 and Under: A Nationwide Cohort Study in Taiwan. J Rheumatol 2015; 42:1898-905. [DOI: 10.3899/jrheum.141105] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 02/07/2023]
Abstract
Objective.Few studies have examined the relationship between gout and erectile dysfunction (ED). We investigated whether patients with gout exhibited an increased risk of ED.Methods.This longitudinal nationwide cohort study investigated the incidence and risk of ED in 19,368 men with gout who were newly diagnosed between January 2002 and December 2008. A total of 77,472 controls without gout were randomly selected from the general population and frequency-matched according to age and sex. The patients were followed up from the date on which they were included in the study cohort to the date of an ED event, censoring, or December 31, 2010. We conducted the Cox proportional hazard model to estimate the effects of gout on ED risk including age and comorbidities.Results.The gout cohort exhibited a 1.21-fold adjusted HR of subsequent ED development compared with the non-gout cohort (95% CI 1.03–1.44). The incidence of ED increased with age in both cohorts and was higher among the patients in the gout cohort than among those in the non-gout cohort. Compared to the patients without gout and comorbidities, the patients with both gout and any type of comorbidity exhibited a 2.04-fold risk of developing ED (95% CI 1.63–2.57). Further, the patients with gout who had numerous comorbidities exhibited the dose-response effect in developing ED.Conclusion.This nationwide cohort study revealed that ED risk is significantly higher in patients with gout than in the general population.
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Hoffmann LS, Etzrodt J, Willkomm L, Sanyal A, Scheja L, Fischer AWC, Stasch JP, Bloch W, Friebe A, Heeren J, Pfeifer A. Stimulation of soluble guanylyl cyclase protects against obesity by recruiting brown adipose tissue. Nat Commun 2015; 6:7235. [PMID: 26011238 PMCID: PMC4455111 DOI: 10.1038/ncomms8235] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 04/21/2015] [Indexed: 12/31/2022] Open
Abstract
Obesity is characterized by a positive energy balance and expansion of white adipose tissue (WAT). In contrast, brown adipose tissue (BAT) combusts energy to produce heat. Here we show that a small molecule stimulator (BAY 41-8543) of soluble guanylyl cyclase (sGC), which produces the second messenger cyclic GMP (cGMP), protects against diet-induced weight gain, induces weight loss in established obesity, and also improves the diabetic phenotype. Mechanistically, the haeme-dependent sGC stimulator BAY 41-8543 enhances lipid uptake into BAT and increases whole-body energy expenditure, whereas ablation of the haeme-containing β1-subunit of sGC severely impairs BAT function. Notably, the sGC stimulator enhances differentiation of human brown adipocytes as well as induces 'browning' of primary white adipocytes. Taken together, our data suggest that sGC is a potential pharmacological target for the treatment of obesity and its comorbidities.
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Affiliation(s)
- Linda S Hoffmann
- Institute of Pharmacology and Toxicology, University Hospital Bonn, University of Bonn, Bonn D-53105, Germany
| | - Jennifer Etzrodt
- Institute of Pharmacology and Toxicology, University Hospital Bonn, University of Bonn, Bonn D-53105, Germany
| | - Lena Willkomm
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Institute of Cardiovascular Research and Sports Medicine, Cologne D-50735, Germany
| | - Abhishek Sanyal
- Institute of Pharmacology and Toxicology, University Hospital Bonn, University of Bonn, Bonn D-53105, Germany.,Research Training Group 1873, University of Bonn, Bonn D-53127, Germany
| | - Ludger Scheja
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Alexander W C Fischer
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Johannes-Peter Stasch
- Bayer Pharma AG, Wuppertal D-42113, Germany.,Institute of Pharmacy, Martin Luther University Halle-Wittenberg, Halle an der Saale D-06120, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Institute of Cardiovascular Research and Sports Medicine, Cologne D-50735, Germany
| | - Andreas Friebe
- Institute of Physiology, Martin Luther University Würzburg, Würzburg D-97070, Germany
| | - Joerg Heeren
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Alexander Pfeifer
- Institute of Pharmacology and Toxicology, University Hospital Bonn, University of Bonn, Bonn D-53105, Germany.,Research Training Group 1873, University of Bonn, Bonn D-53127, Germany.,PharmaCenter, University of Bonn, Bonn D-53119, Germany
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