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Investigating the microbial pathogens of sexually transmitted infections among heterosexual Vietnamese men with symptomatic urethritis 调查越南异性恋男性症状性尿道炎性传播感染的微生物病原体
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2022-04-13 DOI: 10.1080/13685538.2022.2063272
Bac Hoai Nguyen, Q. Pham, Long Hoang, A. Sansone, E. Jannini, C. Tran
Abstract Objective To explore the microbial etiology of urethritis in Vietnamese men and the association with patients’ characteristics, especially their sexual behaviors. Methods This study was conducted on 349 men who presented with symptomatic urethritis and evidence of STIs (determined by multiplex PCR tests) at the Department of Andrology and Sexual Medicine—Hanoi Medical University Hospital. All information regarding medical history, sexual activities, and symptoms of urethritis was documented. Results C. trachomatis and N. gonorrhoea remained the two most common causative pathogens, followed by an unexpectedly high prevalence of Mycoplasma and Ureaplasma species. Coinfection was significant with a rate of 40.7%. Men who had sex with female sex workers (FSWs) were more likely to be positive with N. gonorrhoea but less likely to be positive with C. trachomatis and M. genitalium than those having sex with only one romantic partner. Conclusions Our findings suggested the important role of other microorganisms, especially M. genitalium, in the etiology of urethritis in men besides the previously well-known causes of STIs. Since the coinfection rate is quite high, targeted treatment with clear microbial evidence should be considered rather than empiric antimicrobial therapy.
摘要目的探讨越南男性尿道炎的微生物病因及其与患者特征,特别是性行为的关系。方法本研究在河内医科大学医院男科和性医学科对349名有症状性尿道炎和性传播感染(通过多重PCR检测确定)证据的男性进行。所有关于尿道炎病史、性活动和症状的信息都记录在案。结果沙眼衣原体和淋病奈瑟菌仍是两种最常见的致病菌,其次是支原体和解脲原体。共感染率为40.7%。与仅与一名浪漫伴侣发生性关系的男性相比,与女性性工作者发生性行为的男性更有可能对淋病奈瑟菌呈阳性,但对沙眼衣原体和生殖器支原体呈阳性的可能性较小。结论我们的研究结果表明,除了先前已知的性传播感染病因外,其他微生物,特别是生殖支原体,在男性尿道炎病因中也发挥着重要作用。由于合并感染率相当高,应考虑有明确微生物证据的靶向治疗,而不是经验性的抗菌治疗。
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引用次数: 1
Androgen deprivation therapy and depression in the prostate cancer patients: review of risk and pharmacological management 癌症前列腺患者的雄激素缺乏治疗与抑郁症:风险和药物管理综述
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2022-03-28 DOI: 10.1080/13685538.2022.2053954
Abdulrahman M Alwhaibi, Sary Alsanea, Bana Almadi, Jawza Al-sabhan, F. Alosaimi
Abstract Purpose: Despite the effectiveness of androgen deprivation therapy in advanced prostate cancer, serious neuropsychiatric consequences in androgen deprivation therapy (ADT)-treated patients, mainly depression, have been concerning and gained more attention recently. This narrative review aims to shed light on the risk and pharmacological management of ADT-induced depression in PCa patients. Methods: We searched PubMed, Scopus and Google Scholar databases using MESH keywords “Prostate cancer OR prostate neoplasm” AND “Depression” AND “Androgen Deprivation Therapy” AND “antidepressants”. Search was limited to English and studies conducted on humans. Studies’ titles and abstracts were screened, and further information were obtained from the text, if necessary, to decide whether studies are to be included in this review. Results: Our review revealed 23 studies confirming the occurrence and worsening of depressive symptoms in ADT-treated patients, which frequently require pharmacological interventions; whereas 10 studies indicated otherwise. All studies were prospective, retrospective, cross-sectional or case reports. Based on the incidence of depression provided by the observational studies, the average among ADT-treated patients was 18.23% (range: 2.1–46.9%), while it was 8.42% (range: 1.4–23.3%) in the non-ADT patients. Although several treatments have been used for depression in cancer patients, current knowledge lacks observational and controlled studies as well as clinical guidelines that demonstrate efficacy and safety of antidepressants and guide clinicians to the appropriate treatment in these patients, respectively. On the other side, a few clinical studies have been published regarding the efficacy of selective serotonin reuptake inhibitors, selective serotonin and norepinephrine reuptake inhibitors and/or saftey on other ADT associated adverse effects. Conclusions: Our work supports the recent attention towards mood issues as an adverse effect of ADT, and that greater awareness of this is warranted among clinicians. Clinical studies published regarding the use of antidepressants for other ADT associated adverse effects established the foundation that can be adopted to examine these therapies on ADT-induced depression.
摘要目的:尽管雄激素剥夺治疗对晚期前列腺癌有效,但近年来,雄激素剥夺治疗(ADT)患者严重的神经精神后果(主要是抑郁症)引起了人们的关注和关注。这篇叙述性综述旨在阐明前列腺癌患者adt诱导抑郁的风险和药物管理。方法:使用MESH关键词“前列腺癌或前列腺肿瘤”、“抑郁症”、“雄激素剥夺疗法”和“抗抑郁药”检索PubMed、Scopus和谷歌Scholar数据库。搜索仅限于英语和对人类的研究。对研究的标题和摘要进行筛选,并在必要时从文本中获得进一步的信息,以决定是否将研究纳入本综述。结果:我们回顾了23项研究,证实了adt治疗患者抑郁症状的发生和恶化,这往往需要药物干预;然而,有10项研究表明并非如此。所有研究均为前瞻性、回顾性、横断面或病例报告。根据观察性研究提供的抑郁发生率,adt治疗患者的平均抑郁发生率为18.23%(范围:2.1-46.9%),而非adt患者的平均抑郁发生率为8.42%(范围:1.4-23.3%)。虽然已经有几种治疗方法用于治疗癌症患者的抑郁症,但目前的知识缺乏观察性和对照研究,以及临床指南来证明抗抑郁药的有效性和安全性,并指导临床医生分别对这些患者进行适当的治疗。另一方面,关于选择性5 -羟色胺再摄取抑制剂、选择性5 -羟色胺和去甲肾上腺素再摄取抑制剂的疗效和/或其他ADT相关不良反应的安全性的临床研究已经发表。结论:我们的工作支持了最近对情绪问题作为ADT副作用的关注,并且临床医生有必要对此有更多的认识。发表的关于使用抗抑郁药治疗其他ADT相关不良反应的临床研究,为检验这些治疗ADT诱发抑郁症的方法奠定了基础。
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引用次数: 4
Male subclinical hypogonadism and late-onset hypergonadotrophic hypogonadism: mechanisms, endothelial function, and interplay between reproductive hormones, undercarboxylated osteocalcin, and endothelial dysfunction 男性亚临床性腺功能减退和迟发性促性腺功能亢进:机制、内皮功能和生殖激素、低羧化骨钙素和内皮功能障碍之间的相互作用
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2022-03-15 DOI: 10.1080/13685538.2022.2049744
R. Matta, Hazem Mohamed Farrage, Ahmed Abdelfadel Saedii, M. Abdelrahman
Abstract Background Pathogenesis and endothelial function in subclinical hypogonadism (SCH) remain unclear. Undercarboxylated osteocalcin (ucOC) participates in atherosclerosis and reproduction. We explored the underlying mechanisms and interplay of endothelial dysfunction, unOC and reproductive hormones in SCH and primary late-onset hypogonadism (LOH). Methods In the SCH, LOH, and healthy eugonadal male groups, we measured serum unOC, calculated luteinizing hormone/testosterone (LH/T), LH.T product, and estradiol/T (E/T) as indicators of impaired Leydig cells, androgen sensitivity index (ASI), and aromatase activity, respectively (LH set-point regulators), and assessed flow-mediated dilation of the brachial artery (FMD%), carotid-intima media thickness (CIMT), and aortic stiffness (AS). Results ↑LH/T, ↑ASI, ↓aromatase activity, normal T, follicle-stimulating hormone (FSH) and sex hormone-binding globulin (SHBG) levels, ↑unOC, and enhanced atherosclerotic markers (↓FMD%, ↑CIMT, ↑AS) are characteristics of SCH. Testosterone was positively correlated with FMD% in SCH. The independent predictors were: SHBG and LH for FMD% and CIMT, respectively, and LH/T, ucOC, FSH, estradiol, and E/T ratio for AS in the LOH group; and LH for FMD% & AS and LH and LH/T for CIMT in all study subjects. Conclusions SCH is a distinct clinical entity characterized by impaired androgen sensitivity and aromatase activity, compensatory elevated unOC, endothelial dysfunction, and anti-atherogenic role of testosterone.
背景亚临床性腺功能减退症(SCH)的发病机制和内皮功能尚不清楚。低羧化骨钙素(ucOC)参与动脉粥样硬化和生殖。我们探讨了内皮功能障碍、unOC和生殖激素在SCH和原发性迟发性性腺功能减退(LOH)中的潜在机制和相互作用。方法测定SCH组、LOH组和健康性腺正常男性血清unOC,计算黄体生成素/睾酮(LH/T)、LH。T产物、雌二醇/T (E/T)分别作为受损间质细胞、雄激素敏感性指数(ASI)和芳香化酶活性(LH设值调节剂)的指标,并评估肱动脉血流介导的扩张(FMD%)、颈动脉内膜中厚(CIMT)和主动脉硬度(as)。结果↑LH/T、↑ASI、↓芳香化酶活性、正常T、促卵泡激素(FSH)和性激素结合球蛋白(SHBG)水平、↑unOC和动脉粥样硬化标志物(↓FMD%、↑CIMT、↑AS)是SCH的特征。SCH中睾酮与FMD%呈正相关。独立预测因子为:LOH组FMD%和CIMT分别为SHBG和LH, AS为LH/T、ucOC、FSH、雌二醇和E/T比值;所有研究对象FMD% & AS的LH和CIMT的LH和LH/T。结论SCH是一种独特的临床实体,其特征是雄激素敏感性和芳香酶活性受损、代偿性unOC升高、内皮功能障碍和睾酮的抗动脉粥样硬化作用。
{"title":"Male subclinical hypogonadism and late-onset hypergonadotrophic hypogonadism: mechanisms, endothelial function, and interplay between reproductive hormones, undercarboxylated osteocalcin, and endothelial dysfunction","authors":"R. Matta, Hazem Mohamed Farrage, Ahmed Abdelfadel Saedii, M. Abdelrahman","doi":"10.1080/13685538.2022.2049744","DOIUrl":"https://doi.org/10.1080/13685538.2022.2049744","url":null,"abstract":"Abstract Background Pathogenesis and endothelial function in subclinical hypogonadism (SCH) remain unclear. Undercarboxylated osteocalcin (ucOC) participates in atherosclerosis and reproduction. We explored the underlying mechanisms and interplay of endothelial dysfunction, unOC and reproductive hormones in SCH and primary late-onset hypogonadism (LOH). Methods In the SCH, LOH, and healthy eugonadal male groups, we measured serum unOC, calculated luteinizing hormone/testosterone (LH/T), LH.T product, and estradiol/T (E/T) as indicators of impaired Leydig cells, androgen sensitivity index (ASI), and aromatase activity, respectively (LH set-point regulators), and assessed flow-mediated dilation of the brachial artery (FMD%), carotid-intima media thickness (CIMT), and aortic stiffness (AS). Results ↑LH/T, ↑ASI, ↓aromatase activity, normal T, follicle-stimulating hormone (FSH) and sex hormone-binding globulin (SHBG) levels, ↑unOC, and enhanced atherosclerotic markers (↓FMD%, ↑CIMT, ↑AS) are characteristics of SCH. Testosterone was positively correlated with FMD% in SCH. The independent predictors were: SHBG and LH for FMD% and CIMT, respectively, and LH/T, ucOC, FSH, estradiol, and E/T ratio for AS in the LOH group; and LH for FMD% & AS and LH and LH/T for CIMT in all study subjects. Conclusions SCH is a distinct clinical entity characterized by impaired androgen sensitivity and aromatase activity, compensatory elevated unOC, endothelial dysfunction, and anti-atherogenic role of testosterone.","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47474894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The association between histological prostatitis and benign prostatic hyperplasia: a single-center retrospective study 组织学前列腺炎与良性前列腺增生的关系:一项单中心回顾性研究
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2022-03-15 DOI: 10.1080/13685538.2022.2050360
Jinze Li, Yunxiang Li, D. Cao, Yin Huang, Lei Peng, Chunyang Meng, Qiang Wei
Abstract Objective To investigate the relationship between histological prostatitis (HP) and clinical parameters related to benign prostatic hyperplasia (BPH) in male. Method The clinical data of 196 BPH patients who underwent transurethral resection of the prostate were collected. According to the results of hematoxylin-eosin (H&E) staining of prostate tissue, patients were divided into two groups: BPH with HP group and BPH without HP group. Differences in acute urinary retention (AUR), prostate volume (PV), serum sex hormones, lower urinary tract symptoms (LUTS) related parameters, and systemic inflammation indicators were compared between the two groups. SPSS software v.25 was used for statistical analysis. Results Compared with the BPH without HP group, the BPH with HP group had greater AUR rate, PV, total IPSS, and IPSS-storage in BPH with HP group (p < 0.05). However, there were no significant differences in IPSS-voiding, post-void residual volume, maximum urinary flow rate, serum sex hormones, and systemic inflammation indicators between the two groups (p > 0.05). Conclusions This study suggests that patients with HP have larger PV, more severe LUTS, and a higher risk of AUR. HP is closely related to BPH and may be a key factor in the occurrence and clinical progress of BPH.
摘要目的探讨男性组织学前列腺炎(HP)与良性前列腺增生(BPH)相关临床参数的关系。方法收集经尿道前列腺电切术治疗前列腺增生196例的临床资料。根据前列腺组织苏木精-伊红(H&E)染色结果,将患者分为两组:BPH伴HP组和BPH不伴HP组。比较两组之间急性尿潴留(AUR)、前列腺体积(PV)、血清性激素、下尿路症状(LUTS)相关参数和全身炎症指标的差异。采用SPSS软件v.25进行统计分析。结果与无HP组相比,有HP组BPH患者的AUR率、PV、IPSS总量和IPSS存储量均高于无HP组(p  0.05)。结论本研究表明,HP患者PV更大,LUTS更严重,AUR风险更高。HP与BPH密切相关,可能是BPH发生和临床进展的关键因素。
{"title":"The association between histological prostatitis and benign prostatic hyperplasia: a single-center retrospective study","authors":"Jinze Li, Yunxiang Li, D. Cao, Yin Huang, Lei Peng, Chunyang Meng, Qiang Wei","doi":"10.1080/13685538.2022.2050360","DOIUrl":"https://doi.org/10.1080/13685538.2022.2050360","url":null,"abstract":"Abstract Objective To investigate the relationship between histological prostatitis (HP) and clinical parameters related to benign prostatic hyperplasia (BPH) in male. Method The clinical data of 196 BPH patients who underwent transurethral resection of the prostate were collected. According to the results of hematoxylin-eosin (H&E) staining of prostate tissue, patients were divided into two groups: BPH with HP group and BPH without HP group. Differences in acute urinary retention (AUR), prostate volume (PV), serum sex hormones, lower urinary tract symptoms (LUTS) related parameters, and systemic inflammation indicators were compared between the two groups. SPSS software v.25 was used for statistical analysis. Results Compared with the BPH without HP group, the BPH with HP group had greater AUR rate, PV, total IPSS, and IPSS-storage in BPH with HP group (p < 0.05). However, there were no significant differences in IPSS-voiding, post-void residual volume, maximum urinary flow rate, serum sex hormones, and systemic inflammation indicators between the two groups (p > 0.05). Conclusions This study suggests that patients with HP have larger PV, more severe LUTS, and a higher risk of AUR. HP is closely related to BPH and may be a key factor in the occurrence and clinical progress of BPH.","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45842460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Usefulness of routine assessment of free testosterone for the diagnosis of functional male hypogonadism 游离睾酮常规检测对功能性男性性腺功能减退的诊断价值
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2022-03-04 DOI: 10.1080/13685538.2022.2046727
P. Facondo, Elena Di Lodovico, L. Pezzaioli, C. Cappelli, A. Ferlin, A. Delbarba
Abstract Objective To investigate whether routine assessment of free testosterone improves the diagnostic accuracy of functional hypogonadism. Methods Total and free testosterone (calculated on SHBG levels) were determined in 188 patients with sexual symptoms and 184 with infertility. Results Hypogonadism (calculated free testosterone <63 pg/ml) was found in 47/188 (25.0%) patients with sexual symptoms and in 21/184 (11.4%) with infertility. Total testosterone determination misdiagnosed hypogonadism in 8.4% (12/143) of men with sexual symptoms and in 2% (3/152) with infertility. In subjects with borderline total testosterone, only 24.7% (19/77) had hypogonadism confirmed by free testosterone levels. Free testosterone levels significantly correlated with age, haematocrit, gonadotropins, gynecomastia, BMI, and number of co-morbidities, whereas total testosterone associated only with the latter two. Furthermore, age, haematocrit, BMI, and the presence of erectile dysfunction and of low libido were significantly different between men with normal and low free testosterone, whereas only BMI and low libido were significantly different between patients with normal and low total testosterone. Conclusion Routine assessment of free testosterone allows a more accurate diagnosis of functional hypogonadism, especially in men with sexual symptoms. Free testosterone levels associate with clinical and biochemical parameters of androgen deficiency better than total testosterone levels.
摘要目的探讨游离睾酮的常规评估是否能提高功能性性腺功能减退症的诊断准确性。方法测定188例性症状患者和184例不孕患者的总睾酮和游离睾酮水平。结果性腺功能减退(计算的游离睾酮<63 pg/ml)在性症状患者中为47/188(25.0%),在不孕患者中为21/184(11.4%)。8.4%(12/143)有性症状的男性和2%(3/152)有不孕的男性中,总睾酮测定被误诊为性腺功能减退症。在总睾酮处于临界水平的受试者中,只有24.7%(19/77)的人患有经游离睾酮水平证实的性腺功能减退症。游离睾酮水平与年龄、红细胞压积、促性腺激素、女性乳房发育症、BMI和合并症数量显著相关,而总睾酮仅与后两者相关。此外,年龄、红细胞压积、BMI以及勃起功能障碍和性欲低下的存在在游离睾酮正常和低的男性之间存在显著差异,而只有BMI和性欲低下在总睾酮正常和较低的患者之间存在显著不同。结论常规检测游离睾酮可更准确地诊断功能性性腺功能减退症,尤其是有性症状的男性。游离睾酮水平与雄激素缺乏症的临床和生化参数的相关性好于总睾酮水平。
{"title":"Usefulness of routine assessment of free testosterone for the diagnosis of functional male hypogonadism","authors":"P. Facondo, Elena Di Lodovico, L. Pezzaioli, C. Cappelli, A. Ferlin, A. Delbarba","doi":"10.1080/13685538.2022.2046727","DOIUrl":"https://doi.org/10.1080/13685538.2022.2046727","url":null,"abstract":"Abstract Objective To investigate whether routine assessment of free testosterone improves the diagnostic accuracy of functional hypogonadism. Methods Total and free testosterone (calculated on SHBG levels) were determined in 188 patients with sexual symptoms and 184 with infertility. Results Hypogonadism (calculated free testosterone <63 pg/ml) was found in 47/188 (25.0%) patients with sexual symptoms and in 21/184 (11.4%) with infertility. Total testosterone determination misdiagnosed hypogonadism in 8.4% (12/143) of men with sexual symptoms and in 2% (3/152) with infertility. In subjects with borderline total testosterone, only 24.7% (19/77) had hypogonadism confirmed by free testosterone levels. Free testosterone levels significantly correlated with age, haematocrit, gonadotropins, gynecomastia, BMI, and number of co-morbidities, whereas total testosterone associated only with the latter two. Furthermore, age, haematocrit, BMI, and the presence of erectile dysfunction and of low libido were significantly different between men with normal and low free testosterone, whereas only BMI and low libido were significantly different between patients with normal and low total testosterone. Conclusion Routine assessment of free testosterone allows a more accurate diagnosis of functional hypogonadism, especially in men with sexual symptoms. Free testosterone levels associate with clinical and biochemical parameters of androgen deficiency better than total testosterone levels.","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46453971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Is erectile dysfunction an early clinical symptom of chronic kidney disease? 勃起功能障碍是慢性肾病的早期临床症状吗?
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2021-12-01 DOI: 10.1080/13685538.2021.1936483
Abdullah Cirakoglu, Ahmet Yuce, Erdal Benli, Yeliz Kasko Arici, Harun Dugeroglu, Ercan Ogreden

Objectives: Erectile dysfunction (ED) is the persistent inability to attain and/or maintain erection sufficient for satisfactory sexual performance. Chronic kidney disease (CKD) is a problem with increasing incidence every day which disrupts quality of life significantly. We aimed to research whether ED is a warning symptom for the early stages of CKD or not.

Materials and methods: The records of 639 patients attending Ordu University due to ED were retrospectively investigated. According to International Index of Erectile Function (IIEF) scores and degree of ED, patients were compared in terms of GFR values.

Results: In 92.8% of patients, serum creatinine values were within normal limits (<1 mg/dL), while 30.5% of patients were observed to have GFR below 80. While stage 2 CKD was identified in 1% of the control group, this rate was calculated as 8% in the group with severe ED. In stage 1 and stage 2 CKD, IIEF scores were identified to be low by clear degree.

Conclusions: Results confirm that it was identified that the incidence of stage 1 and stage 2 CKD was higher among patients attending with ED compared to the control group. Just as ED may be an early clinical marker of coronary artery disease, it may be early warning symptom for CKD.

目的:勃起功能障碍(ED)是指持续无法达到和/或维持足以满足性行为的勃起。慢性肾脏疾病(CKD)是一个发病率日益增加的问题,严重影响了生活质量。我们的目的是研究ED是否是CKD早期的预警症状。材料与方法:回顾性分析奥尔都大学639例ED患者的临床资料。根据国际勃起功能指数(IIEF)评分和ED程度,比较患者的GFR值。结果:92.8%的患者血清肌酐值在正常范围内(结论:结果证实,与对照组相比,ED患者的1期和2期CKD发病率更高。正如ED可能是冠状动脉疾病的早期临床标志,它也可能是CKD的早期预警症状。
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引用次数: 2
Secondary spinal cord changes and spinal deformity following traumatic spinal cord injury. 外伤性脊髓损伤后继发性脊髓改变和脊柱畸形。
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2021-12-01 DOI: 10.1080/13685538.2020.1800631
Mohammad Ahmad Jamous, Raed Awni Jaradat, Mustafa Mohamed Alwani

Secondary spinal cord changes can follow spinal cord injuries (SCIs). This retrospective study was to uncover the chronic secondary changes that affect the spinal cord following severe injuries and to evaluate the influence of residual spinal deformity in the development of posttraumatic spinal cord changes. Fifty-eight patients (39 male, 19 female) with complete traumatic SCI and recent Magnetic resonance imaging (MRI) follow-up were reviewed retrospectively. A minimum of 2 years duration between trauma and MRI study was required (mean 2.9 years [2.1-4.7]). Two groups of patients were formed: with spinal deformity (and or spinal canal compromise) and without spinal deformity (and or spinal canal compromise). MRI of the injured spine demonstrated four major types of spinal cord changes; these are spinal cord atrophy, myelomalacia, syrinx, and focal cyst formation. The correlation of these changes to the presence of spinal deformity and or spinal canal compromise was also studied. Twenty-three patients (40%) of the studied population had more than 30° kyphosis and or 50% compromise of the spinal canal. Chronic spinal cord changes occurred in 25 patients (43%), 17 of these changes occurred in patients with spinal deformity and the remaining 8 occurred in patients without spinal deformity or canal compromise (p ≤ .05). The prevalence of spinal cord atrophy and focal cysts was significantly higher in patients with residual deformity and or spinal canal compromise (p ≤ .05). The authors recommend proper spinal cord decompression and fixation for patients with complete SCI to reduce the chance of secondary SCI.

脊髓损伤(SCIs)后可发生继发性脊髓改变。本回顾性研究旨在揭示严重损伤后影响脊髓的慢性继发性变化,并评估脊髓残留畸形对创伤后脊髓变化发展的影响。回顾性分析58例完全性外伤性脊髓损伤患者(男39例,女19例)近期MRI随访情况。创伤和MRI研究之间至少需要2年的时间(平均2.9年[2.1-4.7])。将患者分为两组:有脊柱畸形(和/或椎管受损)和无脊柱畸形(和/或椎管受损)。损伤脊柱的MRI显示了四种主要类型的脊髓改变;脊髓萎缩、骨髓瘤软化、鼻塞和局灶性囊肿形成。这些变化与脊柱畸形和/或椎管受损的相关性也被研究。研究人群中有23名患者(40%)有超过30°的后凸和或50%的椎管受损。25例(43%)发生慢性脊髓改变,其中17例发生在脊柱畸形患者中,其余8例发生在无脊柱畸形或椎管受损的患者中(p≤0.05)。脊髓萎缩和局灶性囊肿的患病率在残余畸形和/或椎管受损的患者中明显更高(p≤0.05)。作者建议对完全性脊髓损伤患者进行适当的脊髓减压和固定,以减少继发性脊髓损伤的机会。
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引用次数: 1
Physiological testosterone replacement effects on male aged rats with orchiectomy-induced osteoporosis in advanced stage: a tomographic and biomechanical pilot study. 生理睾酮替代对老龄雄性大鼠晚期睾丸切除所致骨质疏松的影响:一项断层扫描和生物力学的初步研究。
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2021-12-01 DOI: 10.1080/13685538.2021.1990256
Vinícius de Paiva Gonçalves, Adriana Alicia Cabrera-Ortega, Jhonatan de Souza Carvalho, Dania Ramadan, Luís Carlos Spolidorio

Aim: This study aimed to evaluate the effect of physiological testosterone replacement on male aged rats with orchiectomy-induced osteoporosis in advanced stage.Methods: Thirty male rats (Rattus norvegicus albinus, Holtzman lineage) were randomly distributed into 3 groups (n = 10): 1-sham, 2-orchiectomy (OCX), 3-OCX + testosterone replacement (OCX + T). On day 0, a sham or orchiectomy surgery was performed according to the groups. Thirty and sixty days after surgeries, the animals from OCX + T group received testosterone intramuscularly, and the rats in all groups were euthanized on day 77. The femurs were removed for micro-CT scanning and biomechanical test.Results: Orchiectomy resulted in a marked trabecular bone damage (p < 0.05), which was not reversed with testosterone treatment (OCX + T group). The femoral strength was lower in orchiectomized animals (p < 0.05), while the bone strength in OCX + T group was similar to that observed in the sham animals (p > 0.05) and correlated to this parameter the deformation of rupture was smaller in OCX + T group.Conclusion: In conclusion, testosterone depletion induced by orchiectomy established an osteoporotic environment, mainly affecting the trabecular bone. Moreover, even though testosterone treatment did not enhance these variables, the hormonal replacement improved the femoral fracture strength and promoted beneficial effects on the biomechanical parameters compromised by castration in femoral bone.

目的:探讨生理性睾酮替代对老龄雄性大鼠晚期睾丸切除所致骨质疏松症的影响。方法:雄性褐家鼠(Rattus norvegicus albinus, Holtzman) 30只,随机分为3组(n = 10): 1-sham, 2- orchectomy (OCX), 3-OCX +睾酮替代(OCX + T)。第0天,各组分别行假手术或睾丸切除术。术后30、60 d, OCX + T组大鼠肌注睾酮,各组大鼠于第77天安乐死。取下股骨进行微ct扫描和生物力学试验。结果:睾丸切除术导致明显的骨小梁损伤(p 0.05),睾酮治疗组(OCX + T组)无逆转。去睾丸动物股骨强度较低(p 0.05),而OCX + T组骨强度与假手术动物相似(p > 0.05),且与此参数相关,OCX + T组骨折变形较小。结论:睾丸切除术引起的睾酮水平下降建立了骨质疏松环境,主要影响骨小梁。此外,尽管睾酮治疗并没有增强这些变量,但激素替代提高了股骨骨折强度,并促进了对股骨去势损害的生物力学参数的有益影响。
{"title":"Physiological testosterone replacement effects on male aged rats with orchiectomy-induced osteoporosis in advanced stage: a tomographic and biomechanical pilot study.","authors":"Vinícius de Paiva Gonçalves,&nbsp;Adriana Alicia Cabrera-Ortega,&nbsp;Jhonatan de Souza Carvalho,&nbsp;Dania Ramadan,&nbsp;Luís Carlos Spolidorio","doi":"10.1080/13685538.2021.1990256","DOIUrl":"https://doi.org/10.1080/13685538.2021.1990256","url":null,"abstract":"<p><p><b>Aim:</b> This study aimed to evaluate the effect of physiological testosterone replacement on male aged rats with orchiectomy-induced osteoporosis in advanced stage.<b>Methods:</b> Thirty male rats (<i>Rattus norvegicus albinus</i>, Holtzman lineage) were randomly distributed into 3 groups (<i>n</i> = 10): 1-sham, 2-orchiectomy (OCX), 3-OCX + testosterone replacement (OCX + T). On day 0, a sham or orchiectomy surgery was performed according to the groups. Thirty and sixty days after surgeries, the animals from OCX + T group received testosterone intramuscularly, and the rats in all groups were euthanized on day 77. The femurs were removed for micro-CT scanning and biomechanical test.<b>Results:</b> Orchiectomy resulted in a marked trabecular bone damage (<i>p <</i> 0.05), which was not reversed with testosterone treatment (OCX + T group). The femoral strength was lower in orchiectomized animals (<i>p <</i> 0.05), while the bone strength in OCX + T group was similar to that observed in the sham animals (<i>p</i> > 0.05) and correlated to this parameter the deformation of rupture was smaller in OCX + T group.<b>Conclusion:</b> In conclusion, testosterone depletion induced by orchiectomy established an osteoporotic environment, mainly affecting the trabecular bone. Moreover, even though testosterone treatment did not enhance these variables, the hormonal replacement improved the femoral fracture strength and promoted beneficial effects on the biomechanical parameters compromised by castration in femoral bone.</p>","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39516558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Recommendations on the diagnosis, treatment and monitoring of testosterone deficiency in men. 男性睾酮缺乏的诊断、治疗和监测建议。
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2021-12-01 DOI: 10.1080/13685538.2021.1962840
Bruno Lunenfeld, George Mskhalaya, Michael Zitzmann, Giovanni Corona, Stefan Arver, Svetlana Kalinchenko, Yuliya Tishova, Abraham Morgentaler

The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age globally. One in four persons living in Europe and Northern America will be aged 65 or over. One of the goals of ISSAM is to raise awareness of the special health needs of older men. Since a significant number of aging men will eventually become testosterone deficient, the Hypogonadism panel of ISSAM updates its guidelines.

许多国家内老年人口的相对比例增长将成为二十一世纪最重要的社会变化之一,65岁或以上的人在历史上第一次超过全球五岁以下儿童的数量。生活在欧洲和北美的四分之一的人将达到或超过65岁。该方案的目标之一是提高对老年男子特殊保健需要的认识。由于相当数量的老年男性最终会出现睾酮缺乏,ISSAM性腺功能减退小组更新了指南。
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引用次数: 22
Epicardial fat tissue can predict subclinical left ventricular dysfunction in patients with erectile dysfunction. 心外膜脂肪组织可预测勃起功能障碍患者的亚临床左心室功能障碍。
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2021-12-01 DOI: 10.1080/13685538.2021.1945572
Hayati Eren, Muhammed Bahadır Omar, Ülker Kaya, Ertuğrul Gazi Özbey, Lütfi Öcal

Background: Erectile dysfunction (ED) is an early form of atherosclerosis and subclinical myocardial dysfunction. Epicardial fat tissue (EFT) is associated with impaired left ventricular (LV) function, even in the absence of cardiovascular disease. The aim of this study was to investigate the association between EFT and LV systolic function in patients with erectile ED by speckle tracking echocardiography (2D-STE) method.

Methods: A total of 129 consecutive patients with ED were compared with 145 age- and sex-matched control subjects. ED was evaluated using the International Index of Erectile Function questionnaire. Thickness of EFT was measured by TTE. Global LV longitudinal strain (LV-GLS) and global LV circumferential strain (LV-GCS) were measured by 2D-STE method.

Results: The EFT thickness was significantly higher in the patients with ED (p <.01). LV-GLS and LV-GCS were revealed to be more deterioration in the ED group compared to controls (-18.2 ± 2.7 vs. (-21.1 ± 3.9, p<.001; -19.5 ± 4.1 vs. -21.9 ± 3.9, p<.001, respectively). It has been shown that EFT thickness is an independent predictor of LV dysfunction.

Conclusions: These results indicate that EFT thickness is associated with subclinical LV systolic dysfunction in patients with ED.

背景:勃起功能障碍(ED)是动脉粥样硬化和亚临床心肌功能障碍的早期形式。心外膜脂肪组织(EFT)与左心室(LV)功能受损相关,即使在没有心血管疾病的情况下。本研究的目的是通过斑点跟踪超声心动图(2D-STE)方法研究勃起性ED患者的EFT与左室收缩功能之间的关系。方法:将129例连续ED患者与145例年龄和性别匹配的对照组进行比较。使用国际勃起功能指数问卷对ED进行评估。用TTE法测定EFT厚度。采用2D-STE法测量左室纵向应变(LV- gls)和左室周向应变(LV- gcs)。结果:ED患者的EFT厚度显著高于ED患者(p vs.(-21.1±3.9,pv);结论:EFT厚度与ED患者亚临床左室收缩功能障碍相关。
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引用次数: 3
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Aging Male
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