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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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Risk Factors for Mechanical Ventilation in Patients with Guillain-Barré Syndrome. Neurocrit Care 2022; 37:121-128. [PMID: 35338435 DOI: 10.1007/s12028-022-01457-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/24/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Respiratory support is required in 20-30% of patients with Guillain-Barré syndrome (GBS). We investigated clinical and biological risk factors for mechanical ventilation (MV) in northeast China through a retrospective GBS study. The Erasmus GBS Respiratory Insufficiency Score (EGRIS) is a prognostic model for MV in patients with GBS, and its usefulness has been validated in several countries but not in China. Therefore, we intended to validate the EGRIS model in our GBS cohort. METHODS A total of 252 patients with GBS were included in this study from January 2013 to October 2017. Risk factors for MV were identified via multivariate logistic regression analysis. The prognostic value of the EGRIS was validated via receiver operating characteristic curve analysis. RESULTS Thirty-one patients (12.3%) required MV (mean age 54.19 years), with a majority being male (77.4%). The risk factors for MV were male sex [odds ratio (OR) 3.720, 95% confidence interval (CI) 1.155-11.985, p < 0.05], shorter interval from onset to admission (OR 0.830, 95% CI 0.711-0.970, p < 0.05), lower Medical Research Council sum score at admission (OR 0.942, 95% CI 0.911-0.973, p < 0.001), neutrophil-to-lymphocyte ratio at admission (OR 1.174, 95% CI 1.049-1.315, p < 0.01), and cranial nerve deficit (OR 3.805, 95% CI 1.373-10.541, p < 0.05). The EGRIS had a good predictive ability for MV (area under the receiver operating curve 0.861) in patients with GBS, and a high EGRIS was a predictor for MV (OR 8.778, 95% CI 3.432-22.448, p < 0.001). However, there was no significant difference in ganglioside administration between ventilated and nonventilated patients. CONCLUSIONS An elevated neutrophil-to-lymphocyte ratio at admission and a high EGRIS could serve as predictors for MV in our GBS cohort.
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Zhang Y, Feng X, Wu X, Zhang W, Dai Y, Jiang H, Zhang X. A systematic review and meta-analysis of the relationship between erectile dysfunction and the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios. Andrologia 2021; 54:e14337. [PMID: 34879439 DOI: 10.1111/and.14337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/15/2021] [Accepted: 11/21/2021] [Indexed: 01/10/2023] Open
Abstract
Several studies were conducted to explore the association between haematological parameters and erectile dysfunction (ED), but the conclusions were contradictory with small sample size. The extensively search was conducted in PubMed, Cochrane Library and Web of science from inception to August 2021. Studies comparing the haematological parameter (at least NLR, PLR) between ED patients and healthy controls were eligible for the present meta-analysis. The differences in NLR and PLR between ED patients and healthy controls were assessed by calculating the standardised mean difference (SMD) and 95% confidence interval (95% CI). Eventually, 7 studies were remained for our meta-analysis, with a total of 929 ED patients and 737 healthy controls. For the methodological quality based on NOS, 5 studies were of high quality, scored 7, and 8. 2 studies were of moderate quality, scored 6. There were statistically significant differences in NLR values between ED patients and healthy controls, based on the pooled results (SMD: 0.53, 95% CI: 0.24-0.82). Pooled results from the 6 studies revealed that ED patients had higher PLR values than healthy controls (SMD: 0.70, 95%CI: 0.12-1.28). Our meta-analysis solidly confirmed the association between NLR, PLR and ED. Increased NLR and PLR should be independent risk factors for ED.
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Affiliation(s)
- Yuyang Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Xingliang Feng
- Department of Surgical Urology, the Third Affiliated Hospital of Soochow University, Changzhou, China.,Department of Surgical Urology, the First People's Hospital of Changzhou, Changzhou, China
| | - Xu Wu
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Wei Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Yutian Dai
- Department of Andrology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hui Jiang
- The Department of Urology, Peking University Third Hospital, Beijing, China
| | - Xiansheng Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
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