scholarly journals PDE-5 inhibitors in monotherapy versus combination therapy in a sample of 1200 patients with erectile dysfunction

2015 ◽  
Vol 87 (3) ◽  
pp. 204 ◽  
Author(s):  
Luis Labairu-Huerta ◽  
Bárbara Padilla-Fernández ◽  
José Luis Arrondo-Arrondo ◽  
Lauro Sebastián Valverde-Martínez ◽  
Agustín Martín-Rodríguez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Erectile Dysfunction ◽  
Combination Therapy ◽  
Medical History ◽  
Penile Prosthesis ◽  
Free Testosterone ◽  
Homogeneous Distribution ◽  
Therapeutic Success ◽  
Exact Test

Objectives: To compare the effectiveness in the treatment of erectile dysfunction when using PDE-5 inhibitors (PDE5i), alprostadil (PG-E1) and testosterone (TES) in monotherapy or combination therapy. Material and Methods: Observational multicentre retrospective study of men diagnosed and treated for ED between January 2008 and January 2014. Age, social and employment situation, pathological medical history, risk factors, usual treatments, IIEF-5 at the first consultation and at first and each 6 months follow-ups, physical examination, calculated total and free testosterone and received treatment were analysed. Descriptive statistics, one-way ANOVA analysis, Chi2 for qualitative data, t-test, Fisher's exact test and Pearson's correlation coefficient were used; p < 0.05 is considered significant. Results: Average age was 58.61 years, SD5.02, average follow- up time 48.21 months, SD 6.21, range 6-174 months. Out of the patients 76.12% were married, 9.81% divorced/separated, 10.04% single, 4.03% widowed; 85.14% of the total in stable partnership but 66.16% were not accompanied by their partners. In total 844 patients received monotherapy (597 PDE5i; 62 PG-E1; 36 TES; 27 penile prosthesis; 121 psychotherapy/alternative therapies) and 357 combination therapy (167 PDE5i+TES; 124 PDE5i+PGE1; 66 PG-E1+TES). There was a homogeneous distribution between risk factors and medical history groups. Satisfactory response according to IIEF-5 was achieved for 72.33% of patients on PDE5i monotherapy, 46.65% of patients on PDE5i+PG-E1 combination therapy and 83.41% of patients on PDE5i+TES. Conclusions: The best therapeutic success for ED in this series was achieved through a combination of testosterone+PDE-5 inhibitors without increasing morbidity and maintaining the response over time. Larger studies with longer follow-up will corroborate these findings.

scholarly journals Endogenous sex hormone levels in men are not associated with risk of venous thromboembolism: the Tromsø study

2009 ◽  
Vol 160 (5) ◽  
pp. 833-838 ◽  
Author(s):  
Johan Svartberg ◽  
Sigrid K Brækkan ◽  
Gail A Laughlin ◽  
John-Bjarne Hansen
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Free Testosterone ◽  
Population Based ◽  
Sex Hormone ◽  
Population Based Study ◽  
Hormone Levels ◽  
Increased Risk ◽  
The Impact

ObjectivesLow testosterone levels in men have been associated with cardiovascular risk factors and atherosclerosis and lately also an increased risk of both cardiovascular disease (CVD) and all-cause mortality. As arterial CVDs and venous thromboembolism (VTE) have been shown to share common risk factors, the purpose of the present study was to determine the impact of endogenous sex hormone levels on the incidence of VTE in a cohort of men.DesignA prospective, population-based study.MethodsSex hormone measurements were available in 1350 men, aged 50–84, participating in the Tromsø study in 1994–1995. First, lifetime VTE-events during the follow-up were registered up to September 1 2007.ResultsThere were 63 incident VTE-events (4.5 per 1000 person-years) during a mean of 10.4 years of follow-up. Age was significantly associated with increased risk of VTE; men 70 years or older had a 2.5-fold higher risk of VTE (HR 2.47, 95% CI 1.19–5.12), compared with those between 50 and 60 years of age. In age-adjusted analyses, endogenous sex hormones levels were not associated with risk of VTE; for each s.d. increase, hazards ratios (95% CI) were 1.06 (0.83–1.35) for total testosterone, 1.02 (0.79–1.33) for free testosterone, and 1.27 (0.94–1.71) for ln-estradiol. In dichotomized analyses comparing men in the lowest total and free testosterone quartile with men in the higher quartiles, hypoandrogenemia was not associated with risk of VTE.ConclusionsIn this population-based study of middle-aged and older men, endogenous sex hormone levels were not associated with 10-year risk of VTE.

P2644Coronary atherosclerotic burden and risk of major adverse cardiac events in hypertensive patients with erectile dysfunction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Ioakeimidis ◽  
C Vlachopoulos ◽  
D Terentes-Printzios ◽  
C Georgakopoulos ◽  
E Oikonomou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Erectile Dysfunction ◽  
Coronary Artery ◽  
Comprehensive Evaluation ◽  
Bypass Graft ◽  
Peak Systolic Velocity ◽  
Sexual Life ◽  
Total Testosterone ◽  
Risk Category

Abstract Purpose Aim of the study is to assess the prevalence of angiographically coronary artery disease (CAD) and the incidence of future cardiovascular (CV) events among hypertensive males with erectile dysfunction (ED) on the basis of calculated total CV risk at first presentation. Methods A total of 392 hypertensive ED patients without diabetes or known cardiovascular disease underwent a comprehensive evaluation for presence of target organ damage (TOD) and stratified into three total CV risk categories based on blood pressure (BP) category, CV risk factors, TOD and presence of chronic kidney disease. Total testosterone (TT) and peak systolic velocity (PSV) at penile arteries were measured as markers of ED severity and predictors of CV risk. All patients underwent exercise treadmill test and stress echocardiography to reveal myocardial ischemia. Men with positive one or both of the two tests were referred for coronary angiography in order to document CAD. Our primary outcome was a composite measure which included acute myocardial infarction (AMI), stroke, congestive heart failure, revascularization with either percutaneous coronary intervention or coronary artery bypass graft surgery. All patients were followed from cohort entry until major CV event, or end of study period (December 2018), whichever occurred first. Results The whole population was divided into high (n=176), intermediate (n=120) and low (n=96) total CV risk groups. The three groups had similar mean age (57 yrs). The prevalence of angiographically documented CAD was significantly higher among patients in the high risk group (n=32, 18%), compared to intermediate (n=15, 12.5%) and low risk (n=4, 4.1%) (overall P<0.05). Furthermore, there was a progressive decrease in penile PSV and TT levels from low to moderate and high total CV risk (35 vs 31 vs 28 cm/s and 5.1 vs 4.3 vs 3.8 ng/ml, respectively, overall P<0.001), indicating significant microvascular damage and androgen deficiency in men with a higher CV risk category. Interestingly, Kaplan-Meier analysis revealed a comparable incidence of major CV events in patients who were at high and intermediate total CV risk at entry (12.5% vs. 11%, respectively, log-rank =0.57) and a greater incidence of major CV events compared to that of low CV risk patients (3.2%), (log-rank P=0.004, for all comparisons) during a 9-year follow-up period (figure). CV events during a 9-year follow-up Conclusion The incidence of future CV events is considerably high among hypertensive ED patients with a intermediate total CV risk at first evaluation. Such patients may require a comprehensive evaluation to reveal occult CAD and they need an aggressive management of BP and concomitant risk factors to reduce their CV risk and improve their sexual life.

Clinicopathologic Characterization of Early Onset Endoscopically Unresectable Adenomas (EOEUAs)

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S55-S55
Author(s):  
Rayan Saade ◽  
Zhiyan Fu ◽  
Hwajeong Lee
Keyword(s):  
Risk Factors ◽  
Alcohol Consumption ◽  
Early Onset ◽  
Age Group ◽  
Exact Test ◽  
Pathologic Features ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Pathology Reports

Abstract Objectives Early onset colorectal carcinoma (CRC), defined as CRC detected in patients ≤50 years old, are frequently located in the distal colorectum and are associated with risk factors that are common to adenoma. We examined the risk factors, pathologic features, and clinical implications associated with EOEUA. Methods A retrospective cohort of 154 patients with EOEUA was retrieved. Clinical data were obtained from electronic medical records. A minimum of 12 months follow-up was considered valid follow-up data. Archived pathology slides were evaluated for the presence of high-grade dysplasia (HGD) and Paneth cells (PCs) in adenomatous crypts. Additional pathologic data were retrieved from pathology reports. The patients were stratified into age >50 vs ≤50 years. Fisher’s exact test and Student t test were performed when indicated (P < .05 was considered statistically significant). Results In the ≤50-year group, EOEUAs were common in the rectosigmoid colon compared to >50-year group (41.2% vs 16.8%; P = .025). The association with diabetes, obesity, and alcohol consumption was similar in the two groups, whereas the incidences of hypertension, hyperlipidemia, and smoking were significantly lower in the ≤50-year group. No significant differences in gender distribution, adenoma size, HGD, PC presence, and future adenoma burden were observed between the two groups. Conclusion The association with established risk factors of adenoma to include diabetes, obesity, and alcohol consumption in EOEUA is comparable to that of older patients. In contrast, hypertension, hyperlipidemia, and smoking do not appear to be associated with an increased risk of endoscopically unresectable adenoma in this age group. Similar to early onset CRC, EOEUAs are common in the rectosigmoid, supporting the premise that flexible sigmoidoscopy may be a viable screening alternative in this age group, especially for patients with diabetes, obesity, or alcohol history.

scholarly journals 955Risk of drowning: the Japan Collaborative Cohort (JACC) Study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Takashi Kimura ◽  
Satoyo Ikehara ◽  
Akiko Tamakoshi
Keyword(s):  
Risk Factors ◽  
Medical History ◽  
Heavy Drinking ◽  
The Elderly ◽  
Drinking Habits ◽  
Hazard Ratios ◽  
History Of ◽  
Current Drinker ◽  
Self Administered Questionnaire

Abstract Background In Japan, the unintentional drowning mortality rate among the elderly is exceptionally high. However, the risk factors for drowning in Japan are not fully understood. This study aims to explore the risk factors of drowning in Japan. Methods This study used data from the Japan Collaborative Cohort Study, a prospective cohort aged 40–79 years initiated 1988-1990. A total of 86,298 individuals (35,984 men and 50,314 women) completed a self-administered questionnaire and were mainly followed up by the end of 2009. We calculated hazard ratios (HRs) and 95% confidence intervals (95%CIs) for drowning according to age, body mass index, drinking habits, medical history, marital status, and years of education. Results A total of 194 drownings occurred during a median follow-up period of 18.9 years. The multivariable HRs (95%CIs) of drowning were 0.21 (0.10–0.45) for aged &lt;50 years, 0.37 (0.21-0.65) for 50–59 years compared with 60–69 years, 3.08 (1.39–6.85) for bereaved compared with married, 3.39 (1.19-9.66) for with medical history of stroke compared without, and 3.18 (1.39–7.30) for current drinker with ≥69.0g ethanol/day compared with never drinker in men, 0.20 (0.09-0.43) for aged &lt;50 years and 3.39 (1.19-9.66) for 50-59 years in women. Conclusions Younger people were found to have a lower risk of drowning. For men, bereavement, history of stroke, and current heavy drinking were found to have higher risk of drowning. Key messages In Japan, bereavement, a history of stroke, and heavy drinking among men found to have higher risk of drowning

scholarly journals A prospective study of erectile dysfunction in men after pelvic surgical procedures and its association with non - modifiable risk factors

2019 ◽  
Author(s):  
Sofia Artemi ◽  
Panteleimon Vassiliu ◽  
Nikolaos Arkadopoulos ◽  
Maria - Eleni Smyrnioti ◽  
Pavlos Sarafis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Erectile Dysfunction ◽  
Erectile Function ◽  
Pelvic Surgery ◽  
Modifiable Risk Factors ◽  
Analysis Model ◽  
History Of ◽  
Male Patients ◽  
A Prospective Study

Abstract Objective: Erectile dysfunction can be caused iatrogenically, due to pelvic surgery. The purpose of this study was to evaluate sexual function at various times after pelvic surgery in male patients and to investigate the non-modifiable risk factors associated with the presence and intensity of sexuality in these patients. Results: The mean age of the participants was 66.16 ± 13.07 years old. Regarding comorbidity, 47.2% reported various cardiovascular problems, 20.8% hypertension, 9.4% diabetes mellitus and 5.7% depression. A history of colectomy was present in 36.8%, 18.9% had undergone sigmoidectomy, and 33% inguinal hernia repair. The percentage of severe erectile function increased from 38.7% before surgery to 48.1% (25% increase) after surgery, at the end of the follow-up period (p <0.05). In the multivariate analysis model, age emerged as an independent predictor of erectile function ( p <0.001). Age was the most important determinant of the IIEF score, which was aggravated by 25% from the first to the last assessment of patients.

Abstract 17132: Risk Factors for Anthracycline And/or Herceptin-induced Left Ventricular Systolic Dysfunction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yasmin S Hamirani ◽  
Ali El Sayed ◽  
Patrick Dillon ◽  
Andrew Wong ◽  
Pooja Mehra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Lv Function ◽  
Fisher Exact Test ◽  
Ventricular Systolic Dysfunction ◽  
Exact Test ◽  
The Difference

Introduction: Anthracyclines (ANT) and Herceptin (HER) are known to cause left ventricular (LV) systolic dysfunction and congestive heart failure (CHF). We aimed to identify the clinical risk factors associated with reduced LV function caused by one or both agents. Methods: We retrospectively examined our electronic records for patients that received ANT and/or HER from 2000-2013 and identified 3253 patients. 2704 were excluded for lack of a follow-up EF assessment (2699) or development of CAD (5) after the start of chemotherapy. Of the remaining 216 patients, 27 (12.5%) had a drop in EF after chemotherapy of >10% to below 50% and 185 (86.6%) did not. Kruskal Wallis test and Fisher exact test were utilized to estimate the difference between groups, and logistic regression model was used to predict a fall in EF. Results: More patients with a fall in EF had hypertension (HTN), hyperlipidemia (HL) and CAD (Table). A higher % of patients with a fall in EF received both HER and ANT as compared to ANT alone (36% vs 9.5% p=0.001). Higher use of liposomal doxorubicin was seen in the group with no reduction in EF. The median (IQR) time difference (days) between start of chemotherapy and reduced EF was 213 (76-761) and the doxorubicin dose in this group was 240 (128.5-254) mg/m2. On multivariate analysis hypertension and use of Herceptin remained independent predictors of EF fall. Conclusion: HTN, HL, CAD and concomitant HER use were univariate predictors of EF decline, while only HTN and HER were independent multivariate predictors. Given the prevalence of reduced EF at follow-up, late assessment of EF is indicated to avoid missing chemotherapy-induced cardiotoxicity.

scholarly journals Physical activity trajectories and mortality: population based cohort study

BMJ ◽  
2019 ◽  
pp. l2323 ◽  
Author(s):  
Alexander Mok ◽  
Kay-Tee Khaw ◽  
Robert Luben ◽  
Nick Wareham ◽  
Soren Brage
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Medical History ◽  
Population Based ◽  
Moderate Intensity ◽  
Hazard Ratios

AbstractObjectiveTo assess the prospective associations of baseline and long term trajectories of physical activity on mortality from all causes, cardiovascular disease, and cancer.DesignPopulation based cohort study.SettingAdults from the general population in the UK.Participants14 599 men and women (aged 40 to 79) from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort, assessed at baseline (1993 to 1997) up to 2004 for lifestyle and other risk factors; then followed to 2016 for mortality (median of 12.5 years of follow-up, after the last exposure assessment).Main exposurePhysical activity energy expenditure (PAEE) derived from questionnaires, calibrated against combined movement and heart rate monitoring.Main outcome measuresMortality from all causes, cardiovascular disease, and cancer. Multivariable proportional hazards regression models were adjusted for age, sex, sociodemographics, and changes in medical history, overall diet quality, body mass index, blood pressure, triglycerides, and cholesterol levels.ResultsDuring 171 277 person years of follow-up, 3148 deaths occurred. Long term increases in PAEE were inversely associated with mortality, independent of baseline PAEE. For each 1 kJ/kg/day per year increase in PAEE (equivalent to a trajectory of being inactive at baseline and gradually, over five years, meeting the World Health Organization minimum physical activity guidelines of 150 minutes/week of moderate-intensity physical activity), hazard ratios were: 0.76 (95% confidence interval 0.71 to 0.82) for all cause mortality, 0.71 (0.62 to 0.82) for cardiovascular disease mortality, and 0.89 (0.79 to 0.99) for cancer mortality, adjusted for baseline PAEE, and established risk factors. Similar results were observed when analyses were stratified by medical history of cardiovascular disease and cancer. Joint analyses with baseline and trajectories of physical activity show that, compared with consistently inactive individuals, those with increasing physical activity trajectories over time experienced lower risks of mortality from all causes, with hazard ratios of 0.76 (0.65 to 0.88), 0.62 (0.53 to 0.72), and 0.58 (0.43 to 0.78) at low, medium, and high baseline physical activity, respectively. At the population level, meeting and maintaining at least the minimum physical activity recommendations would potentially prevent 46% of deaths associated with physical inactivity.ConclusionsMiddle aged and older adults, including those with cardiovascular disease and cancer, can gain substantial longevity benefits by becoming more physically active, irrespective of past physical activity levels and established risk factors. Considerable population health impacts can be attained with consistent engagement in physical activity during mid to late life.

scholarly journals Persistent cough and asthma-like symptoms post COVID-19 hospitalization in children

2021 ◽  
Author(s):  
hossein esmaeilzadeh ◽  
Anahita Sanaei Dashti ◽  
Negar Mortazavi ◽  
Fatemian Fatemian ◽  
Mohebat Vali
Keyword(s):  
Risk Factors ◽  
Allergic Rhinitis ◽  
Medical History ◽  
Laboratory Data ◽  
Previous History ◽  
Hospitalized Children ◽  
Past Medical History ◽  
Persistent Cough ◽  
History Of

Abstract Backgrounds: Respiratory viruses are the main triggers of asthma. Coronavirus is shown to contribute to infections of the respiratory tract that can lead to prolong cough and asthma. Objectives: Present study aimed to determine the risk of developing Persistent cough and asthma-like symptoms in hospitalized children due to COVID-19. Methods: This prospective study was carried out in a tertiary referral center. During the COVID-19 pandemic, 69 hospitalized pediatric patients admitted with COVID-19 were observed from February2020 to January 2021. Clinical and laboratory data were recorded, and after discharge, patients were followed and visited for cough and asthma evaluation in one, 2 and 6 months later. Patients with asthma-like diagnosis in follow up define as asthma-like group and patients without any sign of asthma categorized as the non-asthma group. Asthma-like co-morbids and risk factors were evaluated and compared between two groups. Results: Most of the COVID-19 hospitalized patients (N=42) (58.5%) were not affected by asthma-like symptoms in follow-up. 60.9% of the COVID-19 patients were male. The asthma-like group cases had a significantly familial history of asthma (63.0%), past medical history of asthma (33.3%), and Allergic rhinitis (85.2%). Rates of signs and symptoms during hospitalization were significantly higher in patients with COVID-19 and past medical history of asthma. Conclusions: We found an asthma-like prevalence of 41.5% in the cohort of COVID-19 hospitalized children. Family history of asthma and previous history of asthma and allergic rhinitis are risk factors for asthma-like after COVID-19 hospitalization. COVID-19 presentations are more severe in the asthma-like group.

scholarly journals 500 penile prostheses implanted by a surgeon in Italy in the last 30 years

2015 ◽  
Vol 87 (3) ◽  
pp. 216 ◽  
Author(s):  
Diego Pozza ◽  
Mariangela Pozza ◽  
Marco Musy ◽  
Carlotta Pozza
Keyword(s):  
Erectile Dysfunction ◽  
Penile Prosthesis ◽  
Great Majority ◽  
Public Hospitals ◽  
Single Center ◽  
Experienced Surgeon ◽  
Penile Prostheses ◽  
Lost To Follow Up ◽  
Prosthetic Surgery

Objectives: The aim of our study was to report our experience with patients affected by Erectile Dysfunction (ED) and undergoing penile prosthetic implantation (PPI) in a single center by a single surgeon. Material and Methods: We retrospectively evaluated the clinical outcome of 500 patients (mean age: 51.5 years, range: 20-86 years) affected by ED and referred to our private andrological center from January 1984 to December 2013 who underwent penile prosthesis implantation, including the reported level of patient satisfaction. Results: 182 silicone, 180 malleable, 18 monocomponent hydraulic and 120 multicomponents hydraulic prostheses were implanted by the same experienced surgeon. All patients were hospitalized for the procedure. All patients were evaluated immediately, 1 month (496 patients) and, for the great majority, every year after implantation. One hundred twenty five patients were lost to follow-up. Twenty two patients underwent revision surgery for complications in the postoperative period. The most serious postoperative complications were mechanical problems (45 patients, 9.0%) and infection (15 patients, 3%). Forty two (8.4%) prostheses were explanted. Overall, 80% (400/500) of patients were able to have sexual intercourse and were fully satisfied with the results. Conclusions: In our experience prosthetic surgery should be considered a good solution for men affected by ED and not responsive to other therapeutic solutions. Prosthetic surgery can be performed not only in large public hospitals but also in smaller private facilities.

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