bluuebunny/crossref_metadata_2025 huggingface dataset:
A brief history of brain iron accumulation in Parkinson disease and related disorders
Authors: Foley Paul B. , Hare Dominic J. , Double Kay L.
Published: May 2022

Iron has a long and storied history in Parkinson disease and related disorders. This essential micronutrient is critical for normal brain function, but abnormal brain iron accumulation has been associated with extrapyramidal disease for a century. Precisely why, how, and when iron is implicated in neuronal death remains the subject of investigation. In this article, we review the history of iron in movement disorders, from the first observations in the early twentieth century to recent efforts that view extrapyramidal iron as a novel therapeutic target and diagnostic indicator.
Geometrization vs. unification: the Reichenbach–Einstein quarrel about the Fernparallelismus field theory
Authors: Giovanelli Marco
Published: May 2022

This study reconstructs the 1928–1929 correspondence between Reichenbach and Einstein about the latter’s latest distant parallelism-unified field theory, which attracted considerable public attention at the end of the 1920s. Reichenbach, who had recently become a Professor in Berlin, had the opportunity to discuss the theory with Einstein and therefore sent him a manuscript with some comments for feedback. The document has been preserved among Einstein’s papers. However, the subsequent correspondence took an unpleasant turn after Reichenbach published a popular article on distant parallelism in a newspaper. Einstein directly wrote to the Editorial Board complaining about Reichenbach’s unfair use of off-the-record information. While Reichenbach’s reply demonstrates a sense of personal betrayal at Einstein’s behavior, his published writings of that period point to a sense of intellectual betrayal of their shared philosophical ideals. In his attempts to unify both electricity and gravitation, Einstein had abandoned the physical heuristic that guided him to the relativity theory, to embrace a more speculative, mathematical heuristic that he and Reichenbach had both previously condemned. A decade-long personal and intellectual friendship grew fainter and then never recovered. This study, relying on archival material, aims to revisit the Reichenbach–Einstein relationship in the late 1920s in light of Reichenbach’s neglected contributions to the epistemology of the unified field theory program. Thereby, it hopes to provide a richer account of Reichenbach’s philosophy of space and time.
Re-Strukturierung des Berufseinstiegs
Authors: Janssen Inka
Published: May 2022

Das Berufsanerkennungsjahr steht unter dem Schutzmantel der Anleitung und hat eine gesonderte Stellung innerhalb einer Kolleg_innenschaft. Die im Studium erworbenen Qualifikationen bedürfen eines angemessenen Transfers in der Praxis. Doch dieser muss, dem abgeschlossenen Studium entsprechend, adäquat entlohnt und anerkannt werden.
Morphometric deterministic model for prediction of sediment yield index for selected watersheds in upper Narmada Basin
Authors: Meshram Sarita Gajbhiye , Meshram Chandrashekhar , Hasan Mohd Abul , Khan Muhammad Arshad , Islam Saiful
Published: May 2022

Soil erosion is common and has a wide range of spatiotemporal variability. It is crucial in determining sediment output, which is essential for proper watershed management. In this research, we propose morphometric deterministic models (MDM) for prediction of sediment yield index using morphometric parameters of 49 watersheds from Upper Narmada Basin of Madhya Pradesh state, India. For this purpose, Shuttle Radar Topography Mission generated Digital Elevation Model was used to extract and analyze 12 morphometric parameters including linear, aerial, and relief parameters. Principle Component Analysis has been applied for the most effective parameter estimation. The linear and nonlinear MDM were discovered to be suitable for the field of sediment research due to the high value of R2 (over 70%). The sediment yield forecasting is critical for taking the appropriate management measures in the watershed to reduce the sediment load in the reservoir and extend the life of the structure.
Impact of dose reducing software on patient and staff temple dose during fluoroscopically guided pacemaker insertion, closure devices implantation and coronary angiography procedures
Authors: Wilson-Stewart Kelly S. , Fontanarosa Davide , Malacova Eva , Trapp Jamie V.
Published: May 2022

The aim of this study is to investigate the effectiveness of dose reducing software (ClarityIQ) on patient and staff dose during fluoroscopically guided cardiac procedures. Dose measurements were collected in a room without dose reducing software (n = 157) and compared with similar procedures performed in two rooms with the software (n = 1141). Procedures included diagnostic coronary angiography, percutaneous coronary intervention, deployment of cardiac closure devices (for occlusion of atrial septal defect, patent foramen ovale, and atrial appendage) and insertion of permanent pacemakers. The dose reducing software was found to be effective in reducing patient and staff dose by approximately 50%. This study has added to the limited literature reporting on the capability of dose reducing software to decrease radiation exposure during the implantation of cardiac closure devices, as well as demonstrating a reduction in dose to the cardiologist and nursing staff. Administrators should ensure timely upgrades to angiographic equipment to safeguard patients and staff against the potentially adverse effects of radiation exposure. Regardless of the use of dose reducing software, the mean occupational dose during closure devices was in descending order scout > scrub > cardiologist. Scrub nurse dose was found to be higher than the cardiologist during closure devices (0.98/0.26 μSv) and diagnostic coronary angiograms (1.51/0.82 μSv). Nursing staff should be aware that their levels of radiation dose during some cardiac procedures may come close to or even exceed that of the cardiologist.
Principles of Model Specification in ANOVA Designs
Authors: Rouder Jeffrey N. , Schnuerch Martin , Haaf Julia M. , Morey Richard D.
Published: May 2022

ANOVA—the workhorse of experimental psychology—seems well understood in that behavioral sciences have agreed-upon contrasts and reporting conventions. Yet, we argue this consensus hides considerable flaws in common ANOVA procedures, and these flaws become especially salient in the within-subject and mixed-model cases. The main thesis is that these flaws are in model specification. The specifications underlying common use are deficient from a substantive perspective, that is, they do not match reality in behavioral experiments. The problem, in particular, is that specifications rely on coincidental rather than robust statements about reality. We provide specifications that avoid making arguments based on coincidences, and note these Bayes factor model comparisons among these specifications are already convenient in the BayesFactor package. Finally, we argue that model specification necessarily and critically reflects substantive concerns, and, consequently, is ultimately the responsibility of substantive researchers. Source code for this project is at github/PerceptionAndCognitionLab/stat_aov2.
084 Short-Term Stretched Penile Length Analysis for Subsequent Erectile Dysfunction after Robotic-Assisted Radical Prostatectomy with Bilateral Neurovascular Bundle Preservation
Authors: Yang CH , Lin YS , Ou YC , Weng WC , Huang LH , Lu CH , Hsu CY , Tung MC
Published: May 2022

Introduction

Stretched Penile Length (SPL) is observed to shrink after radical prostatectomy (RP) and has chances resuming the length as long as 12 months.

Objective

To assess the short-term SPL change from patients after robotic-assisted radical prostatectomy (RARP) with bilateral neurovascular bundle (NVB) preservation and experiencing subsequent erectile dysfunction (ED). Effects from tadalafil, post-operative androgen deprivation therapy (ADT), and no medication or intervention are compared.

Methods

From April to December 2018, patients developing ED (IIEF-5<22) after RARP with bilateral NVB preservation were included. SPL was measured as length from pubic symphysis to external urethral opening. Tadalafil 5 mg once daily (Group 1), postoperative ADT (Group 2) and control group (Group 3) were classified. Postoperative ADT was prescribed during the whole periods of 6 months for surgical adverse effects in group 2. Follow-ups were arranged 2 weeks after operation in the first time, and then every month up to 6 months. Student t test, chi-square test and SAS 9.4 were utilized to see if significant difference when p<0.05.

Results

With 64 men, 1 was excluded for preoperative ADT use. SPL-related comparisons were listed at Table 1. Preoperative SPL was measured without differences. Generally, in 6-month span, more men were with increased SPL in group 1 than in group 3, and also more with deterioration compared to group 3 (p=0.048). Same trend was observed in group 2 compared to group 3 (p=0.036). Men in group 1 (at the time deciding to take tadalafil) experienced a worse shortening SPL than group 3 (the 30–day change after operation) (p< 0.0001). Significantly improvement on SPL between before (7.93±1.89 (median: 7.5) cm) and after (8.59±2.17 (median:9) cm) tadalafil in group 1 (p=0.037) and also significantly improved against the SPL change from post-operative 30-day to 5-month of group 3 (p=0.004).

Conclusions

In our analysis, 63.7% of subsequent ED after RARP with bilateral NVB preservation would experience SPL shortening around 3 cm (around 30% of preoperative SPL) if only observation in 6 months after operation. Postoperative ADT for 6 months would contribute to approximately additional 15% shortening rates with the same degree. Significant improvement around 1 cm (around 10% of the preoperative SPL) on SPL was observed after tadalafil 5 mg once daily with median 4-month prescription.

Disclosure

Work supported by industry: no.
092 Characteristics and Frequency of Fibrosis in Men with Erectile Dysfunction Treated with Intracavernous Drugs
Authors: Corredor H , Jimenez J , Rodríguez S , Chapa B , Chavez S , Sandoval C
Published: May 2022

Introduction

Fibrosis of the corpora cavernosa is a complication related to the use of intracavernous medication (FIC) for erectile dysfunction (ED), which can produce sequelae that affect the quality of sexual intercourse.

Objective

The objective of this study is to determine the frequency of fibrosis in a group of ED patients treated with intracavernous medication with a magisterial combination of papaverine, phentolamine, atropine, and alprostadil and to characterize this event.

Methods

The clinical records of men with ED and use of FIC treated in an institution in the city of Monterrey in Mexico during 2018 were reviewed. Those with reports of complications after the use of treatment were identified and the search was complemented with the report of adverse events of the same year. The sociodemographic and clinical data of the patients were extracted, and a descriptive analysis of the information was made.

Results

252 patients were treated with FIC in the period of interest. Five of them (0.019%) had fibrosis in the penis. Age ranged from 47 to 74 years, none had diabetes or other fibrosis-associated comorbidities, and no previous episodes of priapism were reported. The dose of the FIC varied with application between 2 and 3 times a week. The time from treatment to plaque formation varied between 3 and 10 months, the largest size of the lesion was 0.6 × 0.4 cm. Three patients reported failures with the technique of application of the intracavernous medication; four reported curvature between 10 and 40 degrees. Regarding the consequences of fibrosis, two patients reported pain, one patient informed inability to penetrate during intercourse, and another patient reported shortening of his penis.

Conclusions

The frequency of fibrosis in patients with ED after the use of intracavernous medication is low, however, those affected may present pain and inability to penetrate and have satisfactory sexual relations.

Disclosure

Work supported by industry: no. A consultant, employee (part time or full time) or shareholder is among the authors (Boston Medical Group).
095 The Brachial-Ankle Pulse Wave Velocity is a Predictive Factor for Erectile Dysfunction in Patients with Benign Prostate Hyperplasia
Authors: Amano T , Takasawa T , Shizukuda Y , Imao T
Published: May 2022

Introduction

Phosphodiesterase (PDE) 5 inhibitors induce relaxation of endothelial cells. Tadalafil, one of PDE 5 inhibitors, has been applied for the treatments of erectile dysfunction (ED) and benign prostate hyperplasia (BPH). Under continuous treatments with PDE 5 inhibitor for BPH, it is significant to investigate the relationship between endothelial and sexual functions by comparing the brachial-ankle pulse wave velocity (baPWV).and the sexual health inventory for men (SHIM) score.

Objectives

Total 89 BPH patients who consulted our clinic with a complaint of urinary symptoms were enrolled in this prospective study. They were treated with a daily dose of 5mg tadalafil.

Methods

The Institutional Review Board (IRB) approved this clinical study and informed consents had been obtained from 89 BPH patients. Their vessels endothelial function was assessed by baPWV and erectile function was evaluated by SHIM score. International prostate symptom score (IPSS) was obtained as male lower urinary symptoms (LUTS) parameters. However, we focused on the relationship between vessels endothelial and erectile function in this sub-analysis report. Therefore, the SHIM scores were compared with baPWV and IPSS at 0, 3, 6, 12, 24, 36, 48, 60, 72 and 84 months after PDE5 inhibitor treatment.

Results

The mean age of 89 patients was 66.7 +/- 11.1 years old. Their prostate size was 29.8 +/- 21.2 ml. Initial SHIM, baPWV and IPSS score were 7.4 +/- 5.6, 1742.5 +/- 393.0 cm/sec and 17.5+/- 7.5, respectively. Before tadalafil treatment, baPWV and SHIM were significantly correlated (p=0.0025) which indicated patients with low vessels endothelial function vessels endothelial function suffered from erectile dysfunction. F4rthere06re, all the data of baPWV and SHIM including after tadalafil treatment from 3 to 84 months (n=472) were significantly co-related each other (p<0.0001). On the other hand, baPWV were significantly improved from 3 to12 months after tadalafil administration, however baPWV levels returned to the baseline levels after 24 to 84 months. SHIM score was significantly improved from 3 to24 months after tadalafil administration, however SHIM levels returned to the baseline levels after 36 to 84 months.

Conclusions

Our previous paper (Aging Male 21, 2018) reported that PDE5 inhibitors improved ED, male LUTS and baPWV from 3 to 12 months. The present data also suggested that endothelial function and male LUTS strongly related to ED in BPH patients. However, baPWV and SHM score levels returned to the baseline levels after 24 and 36 months, respectively. Thus, tadalafil can delay vessels endothelial and erectile dysfunction in BPH patients. In addition, erectile dysfunction seems to be occurred after vessels endothelial dysfunction. Hence, baPWV might be a predictive factor for ED in BPH patients with tadalafil treatments.

Disclosure

Work supported by industry: no.
099 Increased Risk of Subsequent Cardiovascular Disease Among Men Aged 31-60 Years with Erectile Dysfunction
Authors: Huang I , Chen W , Huang EY , Chung H , Huang WJ
Published: May 2022

Background

Men presenting with erectile dysfunction (ED) or coronary artery disease (CAD) can be regarded as two different manifestation of vascular occlusion incident. ED has been proven to be an independent predictor of CAD, especially young men aged 40-49 years. Although psychogenic ED is more prevalent in younger patients less than 40 years of age, but the ED presentation can also be related to vasculogenic etiology. The purpose of this study is to evaluate the subsequent CAD risk in young ED patients and also determine the relative CAD risk in ED men stratified by age.

Methods

A total of 3091 ED patients and 9273 randomly-selected controls without ED were selected from the National research database and studied retrospectively from January 1,1997 to December 31, 2007. The comparison cohort without ED was matched for age and comorbidities (diabetes, hypertension, hyperlipidemia and ischemic stroke). All subjects were followed up by the end of 2009. Cox proportional hazards regression models were used to explore the connection between ED and the development of CAD.

Results

The ED patients have a greater chance of developing cardiovascular disease compared to controls (460/3091, 14.9% vs. 1021/9273, 11.0%, p-values < 0.0001). Cox proportional hazards regression suggested ED increases the risk of CAD development (HR 1.37, 95% CI [1.22-1.53], p<0.0001). Results stratified by 10-year age decades demonstrate ED men aged 31-40 years, 41-50 years, and 51-60 years pose greater risk of developing CAD comparing to the controls (HR 1.61, 95% CI [1.04-2.52], p=0.03; HR 1.79, 95% CI [1.38-2.32], p< 0.0001; HR 1.68, 95% CI [1.35-2.09], p< 0.0001, respectively). On the contrary, the incident cardiac events were not increased in ED men aged 21-30 years, 61-70 years and 71-80 years comparing to the controls (HR 1.77, 95% CI [0.50-6.29], p=0.38; HR 1.17, 95% CI [0.95-1.44], p=0.15; HR 0.88, 95% CI [0.65-1.19], p=0.40, respectively).

Conclusion

Erectile dysfunction is a harbinger of cardiovascular clinical events in men aged 31-60 years. Erectile dysfunction should prompt investigation and close follow up for further cardiac events.

Disclosure

Work supported by industry: no.
104 The Relationship Between Site-Specific Prostate Surface Dose in Cases of Iodine-125 Prostate Brachytherapy and Erectile Dysfunction
Authors: Ishii S , Takata R , Kikuchi K , Itoh A , Tsuyukubo T , Tamura D , Ikarashi D , Maekawa S , Matsuura T , Kato R , Kato Y , Kanehira M , Sugimura J , Abe T , Nakamura R , Obara W
Published: May 2022

Objective

To conduct detailed measurements of site-specific radiation doses in 36 sections plotted on the surface of the prostate after brachytherapy (BT), to conduct a comprehensive analysis of the regions associated with erectile dysfunction (ED).

Subjects and methods

The subjects were 81 patients selected from among patients who underwent BT between 2004 and 2016 because they were able to complete the International Index of Erectile Function (IIEF)-6 questionnaire pre-treatment and 12 months post-treatment. Post-planning was done by inputting CT images made over a four-week period after treatment into a radiotherapy planning system, dividing the surface of the prostate into 36 equal sections, and measuring the D90 radiation dose (Gy) at each site. The soft tissue surrounding the corpus cavernosum was set as the ROI for the uretheral bulb spongy tissue, and the radiation dose to this region was similarly calculated.

Results

We selected 56 of the 81 patients who did not have ED or who had mild ED prior to treatment. 23 patients who scored 22 or higher on the IIEF-6 at 12 months post-treatment were assigned to the non-ED group, and 11 patients who scored under 11 were assigned to the ED group. Statistical inter-group comparison of the site-specific radiation doses indicated that the doses were significantly higher in the ED group in the following sections: Center of right lobe at 3 o'clock, center of left lobe at 2-4 o'clock, apex of left lobe at 2-4 o'clock. No significant difference in radiation dose was found for the corpus cavernosum.

Conclusion

In the group of patients with high radiation doses to the middle and apex at 2 – 4 o'clock the IIEF-6 score was significantly lower at 12 months post-treatment. This suggests that excessive radiation exposure to these sections may have an effect on post-BT ED.

Disclosure

Work supported by industry: no.
105 Combine Treatment of Veno-Occlusive ED Withveno-Occlusive Surgery, Injections of Stem Cells and VEGF
Authors: Knigavko O , Gramatiuk S
Published: May 2022

Introduction

The venous leakage is one of the most often reason of erectile dysfunction (ED) in young and middle age men. The main reason of veno-occlusive ED (VOED) is the insufficiency venous obstruction in corpora cavernosa under tunica albuginea that is why all types of veno-occlusive operations have particular and short term effect up to renovation of venous leakage in half year. Conservative treatment of VOED with PDE-5 has a low effectiveness. Evermore young patients deny Penile prosthesis implantation for psychological reason.

Objective

We want to stimulate growth of endothelial valves under tunica albuginea with injections autological mesenchymal stem cells and autological VEGF (Vascular endothelial growth factor) and combine it with veno-occlusive surgery.

Materials and Methods

On the basis of the Kharkiv Regional Clinical Centre of Urology and Nephrology, Andrology deratment in 2012-2021 we carried out comprehensive examination and treatment of 174 patients with VOED. Most of them 142 (81.6%) have left side or bilateral varicocele. The average patient age is 36.5 +4.1 years. Patients with prostatitis or depression/anxiety were excluded from the investigation or treated previously. We provided embolization of deep dorsal and Santorini plexus veins for patients with distal form of VOED throw deep dorsal vein –46 patients -Group 1.We performed ligation of deep dorsal and penile veins with Marmar surgery from peno-pubical incision for proximal form of VOED – 68 patients – Group 2, And we made both methods together for 62 patients –Group 3 with combination of proximal and distal leak. Patients with only surgical methods created subgroup A – 105 men. For improving of veno-occlusive mechanism for 69 patients (subgroup B) we injected to each corpus cavernosa 1 mln of autological endothelial stem cells 5 times (2 times before and 3 times after surgery) each 1.5-2 months and we performed 15 microinjections of VEGF each 10 days. During occlusive operations we injected to ligated veins (deep dorsal and big penile veins) 2 mln of autological fibroblastic stem cells in retrograde direction. Then we compared short (2 months) and long term (10 months) result.

Results

The efficacy of surgical treatment according to subjective data (questionnaires on IIEF-5) in 2 months was almost equal (16.7±3.1 and 16.9±3.0), but in 10 months significantly higher in SubGroup B(14.3±3.2 and 19.6±3.4). According to objective data in 10 months adding microinjections of autological stem cells and VEGF to surgery significantly improves Erectile function (absence of venous leakage on Doppler Penile US with bemix) 56.4% - subgroup A and 91.4% - subgroup B.

Conclusions

Half year injections of autological stem cells and VEGF improve of veno-occlusive mechanism and increases effectiveness and long term result of veno-occlusive operations for treatment of VOED.

Cavernosografy of combine form of VOED

Disclosure

Work supported by industry: no.
124 Prognostic Value of High-Sensitivity Modified Glasgow Prognostic Score in Castration-Resistant Prostate Cancer Patients Who Received Docetaxel
Authors: Sakamoto S , Ando K , Imamura Y , Kato M , Komiya A , Ichikawa T
Published: May 2022

Introduction

The Glasgow prognostic score, a marker of systemic inflammation, is associated with clinical outcomes in different cancers including prostate cancer. However, there is no evidence for the relationship between the high-sensitivity modified Glasgow prognostic score (Hs-mGPS) in prostate cancer and its prognosis.

Objective

This study aimed to investigate the prognostic significance of Hs-mGPS in castration-resistant prostate cancer (CRPC) treated with docetaxel.

Methods

We retrospectively analyzed clinical datasets from 131 CRPC patients who received docetaxel treatment at Chiba University Hospital and a related hospital. Clinical factors including Hs-mGPS before docetaxel treatment were evaluated according to overall survival.

Results

The numbers of patients with Hs-mGPS of 0, 1, and 2 were 88, 30, and 13, respectively. The median prostate-specific antigen (PSA) level was 28.9 ng/mL. The median testosterone level was 13.0 ng/dL. The percentages of bone and visceral metastases were 80.8% and 10.2%, respectively. For overall survival, Hs-mGPS ≥ 1 (hazard ratio of 2.41; p = 0.0048), testosterone ≥ 13.0 ng/dL (hazard ratio of 2.23; p = 0.0117), and PSA ≥ 28.9 ng/mL (hazard ratio of 2.36; p = 0.0097) were significant poor prognostic factors in the multivariate analysis. The results of the two-group analysis showed that a higher Hs-mGPS was associated with high PSA, alkaline phosphatase, and testosterone levels. The median testosterone levels for Hs-mGPS of 0, 1, and 2 were 9.0, 16.5, and 23.0, respectively. Based on the multivariate analysis, we created a combined score with three prognostic factors: Hs-mGPS, testosterone, and PSA. The low-risk group (score of 0-1) showed a significantly longer overall survival compared to the intermediate-risk (score of 2-3) and high-risk (score of 4) groups (p < 0.0001).

Conclusion

Our results demonstrated that an elevated Hs-mGPS was an independent prognostic factor in CRPC patients treated with docetaxel therapy. Risk classification based on Hs-mGPS, testosterone, and PSA may be useful in predicting the prognosis of CRPC patients.

Disclosure

Work supported by industry: no.
133 Outcomes of Treatment for LOH Syndrome Assessed by Free Testosterone
Authors: Kaku Y , Sato K , Ooishi A , Ishida T , Okada K , Chiba K , Fujisawa M
Published: May 2022

Objective

Late-onset hypogonadism (LOH) is defined by reduced serum testosterone levels, and androgen replacement therapy (ART) is widely used. While serum total testosterone (TT) is used as an indicator for diagnosis and treatment for LOH in the United States and Europe, serum free testosterone (FT) is used in Japan. Patients with low FT levels (less than 8.5 pg/mL) are to be indicated for ART as LOH, and patients with moderate FT levels (between 8.5 pg/mL and 11.8 pg/mL) are also to be considered for ART as LOH borderline. In this study, we examined the outcomes of LOH and LOH borderline patients who were treated by ART.

Methods

We examined Aging Male Symptom (AMS) scale scores of LOH (n=76) and LOH borderline patients (n=16) who were treated with ART for at least 6 months at our hospital.

Results

In LOH patients, AMS score decreased from 52.1±12.3 to 41.5±12.2 (p<0.05). On the other hand, in borderline cases AMS score also decreased from 55.8±10.2 to 36.5±8.45 (p<0.05). There was no significant difference between two groups.

Conclusion

ART improves AMS score both in LOH and LOH borderline patients, but there were no significant differences between two groups in this study.

Disclosure

Work supported by industry: no.
138 Aging Exacerbates Hypertension Related Testicular Injury in Rats
Authors: Shimizu S , Nagao Y , Shimizu T , Higashi Y , Aratake T , Zou S , Yamamoto M , Saito M
Published: May 2022

Introduction

The average age of paternity is rising in developed world. Hypertension is the most common chronic disease among adult males, affecting male fertility. Aging is an important risk factor for the development of atherosclerosis and hypertension. However, involvements of aging on hypertension related testicular injury are not fully clarified.

Objective

In this study, we investigated the involvements of aging on testes in spontaneously hypertensive rats (SHRs).

Methods

Male SHRs and Wistar Kyoto rats (WKYs; normotensive control) at the age of 36, 54 or 72 weeks (wk) were used (n=6, each age). At each age, body weight, testicular weight and blood pressure were measured. Serum testosterone and testicular tissue levels of malondialdehyde (MDA: a maker of lipid peroxide) were also measured by colorimetric assay and ELISA assay. Morphological changes in the testis were evaluated by hematoxylin and eosin staining. TUNEL staining was performed to quantify the apoptosis in testis.

Results

SHRs at 36, 54 o 72 wk showed a significant increase in mean blood pressure compared to WKYs at each age. SHRs at 54 or 72 but not 36 wk demonstrated a significant decrease in body weight and increase in testicular weight/body weight ratio compared to WKYs at each age. Testicular tissue levels of MDA in SHRs at all ages were significantly higher than those in WKYs at all ages. Serum testosterone in SHRs at 54 or 72 but not 36 wk was lower than that in WKYs at each age. SHRs at 54 or 72 but not 36 wk demonstrated obvious morphological changes such as thickening of blood vessel wall in testis, and seminiferous tubules with degeneration compared to the WKYs at each age. Number of TUNEL positive cells in testicular seminiferous tubules in SHRs at 36 wk was significantly greater than those in WKYs at 36 wk. While number of TUNEL positive cells in testicular seminiferous tubules in SHRs at 72 wk was significantly lower than those in WKYs at 72 wk.

Conclusion

Aged SHRs showed significant increases in oxidative damage and vacuolation in testes, and decrease in serum testosterone compared to age matched WKYs. Aging could exacerbate hypertension related testicular injury in rats.

Disclosure

Work supported by industry: no.
154 The Effect of Combination Treatment with Low-Intensity Shockwave Therapy and Tadalafil on Mild and Mild-to-Moderate Erectile Dysfunction A Double-Blind, Randomized, Placebo-Controlled Clinical Trial
Authors: Mykoniatis I. , Pyrgidis N. , Zilotis F. , Fournaraki A. , Kapoteli V. , Kalyvianakis D. , Hatzichristou D.
Published: May 2022

Introduction

Combination of different first-line treatments for erectile dysfunction (ED) has emerged as a promising therapeutic approach.

Objectives

To conduct the first double-blind, randomized, placebo-controlled clinical trial to evaluate the efficacy and safety of combination therapy with low-intensity shockwave therapy (LiST) and tadalafil versus LiST and placebo in patients with mild or mild-to-moderate vasculogenic ED.

Methods

Fifty sexually active patients fulfilling the eligibility criteria were randomly assigned to six sessions of LiST twice weekly for three weeks and tadalafil once daily (n=25) or placebo (n=25) for four weeks. Patients were evaluated at one, three and six months after completion of the treatment protocol. An intension-to-treat analysis was performed. Erectile function was assessed at all time points based on the International Index of Erectile Function – Erectile Domain (IIEF-EF) and the Sexual Encounter Profile (SEP) diaries. The number of patients attaining a minimal clinically important difference (MCID) in the IIEF-EF, as well as the safety of combination therapy were also evaluated.

Results

Adjusting for the baseline values, IIEF-EF improved by 0.8 points (95%CI: -0.2-1.9, p=0.12) at one month, 1 point (95%CI: 0.1-1.9, p=0.02) at three months and 1.7 (95%CI: 0.8-2.7, p =<0.001) at six months in patients treated with combination of LiST and tadalafil compared to LiST and placebo. Between the two groups, the proportion of “yes” responses to question 3 of SEP diaries improved significantly only at the 6-month evaluation, while the number of patients attaining a MCID in the IIEF-EF only at the 3-month evaluation. No adverse events were reported during the whole study period.

Conclusions

Combination of LiST twice weekly for three weeks and tadalafil 5mg once daily for four weeks may further ameliorate mild or mild-to-moderate vasculogenic ED compared to LiST monotherapy and is considered a safe treatment modality. Still, further high-quality studies are warranted to corroborate our findings.

Disclosure

Work supported by industry: no.
169 Impact of Low-Intensity Extracorporeal Shock Wave Therapy on Sexual Function after Non-Nerve-Sparing Robot-Assisted Laparoscopic Radical Prostatectomy
Authors: Inoue S. , Hayashi T. , Teishima J.
Published: May 2022

Objective

Considering the natural course of cavernous nerve recovery following robot-assisted laparoscopic radical prostatectomy (RARP), early intervention of low-intensity extracorporeal shockwave therapy (LIESWT) would be more effective for enhancing overall recovery of potency. We analyzed longitudinally alterations in sexual function in patients after RARP, with focus on the effect of early and delayed intervention with LIESWT.

Method

This study was open-label prospective study. Four patients after RARP were enrolled into this study's protocol over a period between January and June 2017. This early intervention was performed three times a week for two weeks in admission and one time per week in our out patient clinic for six weeks. For the purpose of setting a control group, the same surgeon performed RARP on 4 patients over a period between June 2012 and December 2014. These patients received LIESWT and this delayed protocol was same as that by Vardi et al. The same surgeon performed RARP on 100 patients over a period between April 2012 and February 2015. These patients were assigned to the non-LIESWT group for setting another control group. Sexual function (SF) was assessed with the Expanded Prostate Cancer Index Composite (EPIC). A validated form of self-reported questionnaire was administered to the inpatients before RARP, and mailed to all patients receiving RARP at 3, 6, 9, and 12 months after RARP.

Results

There was no significant inter-group difference in the baseline patient characteristics and surgical outcomes. The mean duration from RARP to the start of penile rehabilitation was 6 months for patients of the delayed LIESWT group. The SF score was significantly higher at preoperative, postoperative 6 and 9 months (p=0.0024, 0.0001, and 0.0004) in the early-LIESWT group. The SF score of early-LIESWT was significantly higher than that of delayed-LIESWT at postoperative 6 and 9 months (19.7 vs. 7.4; p = 0.0153, 26.2 vs. 6.1; p = 0.0154). On the other hand, there was no significant difference in the SF score between delayed and non-LIESWT groups at all time points.

Conclusions

Our findings show that penile rehabilitation with LIESWT immediately before urethral catheter removal improved sexual function scores. Our preliminary results suggest that LIESWT could be used as a treatment option in penile rehabilitation.

Disclosure

Work supported by industry: no.
190 Straining to Void is Associated with Dyspareunia in Japanese Women
Authors: Aoki Y. , Yokohama O.
Published: May 2022

Introduction

Female lower urinary tract symptoms (LUTS) affect quality of life and sexual activity.

Objectives

This study aimed to evaluate the influences of LUTS on female dyspareunia (pain during vaginal penetration), as little is known on this topic.

Methods

The study population comprised 369 women who participated in 2-day health examinations at a single institution in Japan, from April 2010 to March 2011. All participants were asked to complete a standardized self-reported questionnaire. Using the International Prostate Symptom Score (IPSS), IPSS-QOL score, and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), we evaluated urinary symptoms, including urinary incontinence, urgency, daytime frequency, straining, and nocturia. To assess dyspareunia, we asked the question "Over the past 4 weeks, how often did you experience discomfort or pain during vaginal penetration?", with answer choices of "Did not attempt intercourse", "Almost always or always", "Most times", "Sometimes", “A few times”, and "Almost never or never", from part of a questionnaire from the Japanese translation of the Female Sexual Function Index (Question 17 of FSFI-J) [Rosen. J Sex Marital Ther, 2000]. We analyzed relationships between dyspareunia and LUTS. The Mann-Whitney U test and logistic regression models were used for statistical analyses. Values of P<0.05 were considered statistically significant.

Results

A total of 315 individuals completed the questionnaire (response rate, 84%). The mean age of respondents was 47.2 years (range, 31-69 years). Our analysis included 125 women (40%), and excluded 190 women (60%) who reported that they had not attempted intercourse over the past 4 weeks. Among sexually active women, 44% had experienced dyspareunia. Straining to void and IPSS-QOL score were significantly higher in women reporting dyspareunia. In multivariate analysis, significant correlations were found between dyspareunia and both straining to void and IPSS-QOL score (Odds ratio, 16.9 (1.38-205)).

Conclusion

Straining to void and IPSS-QOL score correlated significantly with dyspareunia among Japanese women in this study. The underlying mechanism remains unclear, and little data have been accumulated on the association between straining to void and dyspareunia, although a previous study reported LUTS as a predictor of sexual pain for women in the United States (odds ratio = 7.61) [Laumann. JAMA, 1999]. Our study confirmed straining to void and IPSS-QOL score as factors independently associated with dyspareunia. These results suggest that straining to void can offer a predictor of female dyspareunia.

Disclosure

Work supported by industry: no.
195 Sexuality of the Woman During Pregnancy: Experience of the Tunisian Woman
Authors: Boufarguine R. , Bettaieb H. , Mbarki W. , Halouani S. , Abidi I. , Makni A. , Frikha M. , Souayah N. , Mbarki C. , Oueslati H.
Published: May 2022

Introduction

During various life transitions, sexuality can be disturbed and must be adjusted accordingly. This is particularly the case during pregnancy. This period is full of simultaneous multidimensional upheavals of a biological, physiological, psychological, emotional, social and sexual nature for the future parents.

Objective

To determine the factors associated with sexual dysfunction in a population of Tunisian women during pregnancy.

Methods

Multicentric prospective analytic study including 300 pregnant Tunisian women using the Arabic version of the Female Sexual Function Index (FSFI).

Results

We found a significant decrease in sexual frequency in rural versus urban settings (p=0.002). All sexual function items were significantly impaired in rural settings, except for orgasm and satisfaction. The FSFI score was lower for rural women (p=0.001). The type of marriage also proved to be a determining factor in the sexual life of pregnant women. In fact, in couples where the marriage was traditional, we noted a greater decrease in sexual relations (p < 0.01). All sexual function items were significantly impaired compared to couples where the marriage was for love. The item most affected was arousal (p<0.001). Nevertheless, pain was less during sexual intercourse for couples who had a love marriage (p<0.001). The decrease in frequency of intercourse was estimated at 78.33% when the agreement was poor, compared to only 49.68% when the marital agreement was good. The items most affected were orgasm, desire and arousal for couples with poor agreement. The FSFI score was also significantly impaired for this category (p <0.01). Similarly, women who frequently or always talked with their husbands about sexuality showed more desire, arousal, lubrication, orgasm and satisfaction with better overall sexual function on the FSFI. Another factor that appeared to negatively influence sexual function in pregnant women was a history of instrumental forceps delivery. Indeed, it was responsible for a significant impairment of arousal, orgasm and lubrication. It was also responsible for a more marked sexual dysfunction (FSFI score at 12.21 vs 22.76 in the absence of previous forceps delivery; p=0.01).

Conclusion

Pregnancy is certainly a period of vulnerability for the woman and her partner, but this is not a reason for it to be a desert of several months for the intimacy of the couple. Sexuality should no longer be considered as a tool for procreation only, but rather as a source of pleasure and relaxation and a privileged moment of complicity between the partners. Adapting to the events of pregnancy and the changes that are inherent to it requires the support of the family and the medical profession.

Disclosure

Work supported by industry: no.
197 Women Who Practice Commercial Sex and Chemsex in St. Petersburg (Russia)
Authors: Vykhodtcev S. , Tregubenko I. , Fedorova A.
Published: May 2022

Introduction & objective

Evaluation of psychological defenses (i.e. psychological mechanisms that support the self-conception) and personal identity explain the reasons why female sex workers practiced chemsex. It also helps to identify targets for psychotherapy, including prevention of problems such as chemsex and risky sexual behavior.

Methods

In our study, 65 women aged 18-33 years (mean age 25.4 years) who practiced commercial sex in Saint Petersburg (Russia) were interviewed. Among them, 30 (46%) also practiced chemsex. They were compared with 35 (54%) women who did not practice chemsex. With each of participating woman we had a structured interview. We also analyzed their free self-descriptions and descriptions based on the Life Style Index (LSI) method.

Results

Women practicing chemsex identified themselves as unique and special, i.e. outstanding as well as more risky, seeking new experiences and open to unusual experiences. They also pointed out that chemsex allowed them practice sex with any client without experiencing negative emotions. Women practicing chemsex demonstrated a high level of psychological defenses. Later, this can lead to various problems such as drug addiction, commercial sex as the only possible model of sex, the risk of HIV infection, hepatitis, syphilis, etc., mental disorders, aggression towards women. Among the psychological defenses, the most non-constructive ones (such as negation, displacement, and projection) prevailed. This means that such women ignore anxiety information and repression psycho-traumatic experience. Simple recommendations such as “to be cautious because of danger” will not be effective for these women.

Conclusions

The psychotherapy of women practicing commercial sex and chemsex should be oriented towards personal identity and awareness of the risky nature of their sexual behavior. To be unique and special means to choose the path of self-defenses, and not self-destruction.

Disclosure

Work supported by industry: no.
205 Therapeutic Groups of Men with Penile or Testicular Cancer
Authors: Silva I. , Naccarato A. , Denardi F. , Ferreira U. , Matheus W.
Published: May 2022

Testicular cancer (TC) primarily affects men aged 15 to 40 years, and the incidence is around 5/100,000. Tumors are usually aggressive and have a great psychological impact on patients.

Penile cancer (PC) represents 2% of all types of tumors that affect men in Brazil. Most of the affected population are elderly men. Usually, the tumor is identified at an advanced stage, when the only treatment available is total or partial penectomy, causing a great emotional impact.

This work aims to evaluate the impact of psychotherapy, in an open group, on Health-Related Quality of Life (HRQOL) and Sexuality in patients with TC and PC who have been diagnosed, are undergoing treatment - surgery, radiotherapy, chemotherapy or hormone therapy - or who are being followed up after treatment. Data will be collected through an initial interview (Identification, Anamnesis, Health Anamnesis, Degree of Satisfaction with Life and Sexuality, Affective-Emotional Assessment and Treatment Data), SF-36 and IIEF-5 short form questionnaire, in patients who are diagnosed, who have undergone treatment - surgery, radiotherapy, chemotherapy or hormone therapy - or who are being monitored at the clinic, and reapplication at the end of 12 sessions of group psychotherapy. Each session will be answered 5 questions related to the perception of the previous session.

The group is available for 2 years, once a week, and the patient will attend 12 sessions. The sessions last 90 minutes, conducted by the same psychologist.

The research is been developed considering the ethical principles of secrecy, privacy, confidentiality and non-identification of the interviewees' data.

The study does not pose risks to the subjects and invasive techniques of the body or psychological suffering will not be used. Before starting the process, the Informed Consent Form (TCLE) is delivered, as well as the provision of all details regarding the research. It is also explained that participation is voluntary and that the participant can leave the research at any time, without prejudice to their treatment and monitoring.

Only patients who meet all these criteria will be included, after signing the informed consent.

Disclosure

Work supported by industry: no.
213 Effect of Clomiphene Citrate Therapy for Male Infertility
Authors: Okada K , Sato K , Ohnishi A , Kaku Y , Ishida T , Chiba K , Fujisawa M
Published: May 2022

Introduction & Objectives

To assess the efficacy and safety of clomiphene citrate (CC) for idiopathic male infertility.

Methods

We identified low testosterone (T) and male infertility patients treated with CC at our institution in the period September 2017 to May 2020. Data were gathered on patient characteristics and laboratory values at baseline. We retrospectively evaluated patients whose sperm concentration < 15*106/mL and/or sperm motility < 40%. FSH, LH and total T were measured before and 6-8 weeks after CC therapy. Sperm concentration, sperm motility were evaluated 3 month after CC therapy. Side effects were also recorded. In this series, 25 mg of CC was added every morning in all patients.

Results

A total of 37 men were included, with a mean age of 36.7 years. After 3month of CC therapy, sperm concentration was significantly increased from 14.07±16.21*106/ml to 30.52±38.10*106/ml. Sperm motility was also increased from 22.61±17.32% to 29.01±17.11%, but not significantly. Total T, FSH, and LH levels all significantly increased. 2 couples (5.4%) got pregnant. 2 patients experienced side effects: acne, n = 1; increased hepatic enzymes, n = 1. There were 5 patients who complained low libido and/or ED, but no improvement by T elevation.

Conclusions

According to our data, CC therapy increased sperm concentration significantly. CC therapy may be an effective and safe alternative for patients with low T and low sperm concentration. We have to evaluate more cases to know the CC therapy effect for low libido and ED.

Disclosure

Work supported by industry: no.
228 Efficacy of Combined Treatment of Intramuscular Testosterone Injection and Testosterone Ointment Application for Late-Onset Hypogonadism: an Open-Labeled, Randomized, Crossover Study
Authors: Narukawa T , Soh J , Kanemitsu N , Harikai S , Ukimura O
Published: May 2022

Introduction

The best method for administering testosterone replacement therapy (TRT) for late-onset hypogonadism (LOH) remains controversial. This study aimed to compare the efficacy and safety of a combined treatment (CT) involving intramuscular testosterone injection and testosterone ointment application [Glowmin® (GL)] with intramuscular injection monotherapy (IMIM).

Materials and methods

Patients were randomly assigned as follows: Group 1 received IMIM for 12 weeks and CT for 12 weeks and Group 2 received CT for 12 weeks and IMIM for 12 weeks. Patients were then asked about their treatment preferences: (A) IMIM, (B) a combination of IMIM and ointment, or (C) either A or B.

Results

Patients (n = 43) completed the study without any adverse effects. No significant differences between each treatment period were found. In Group 1, most patients chose B (n = 13) while in Group 2, most chose A (n = 10). In each group, patients preferred the second treatment phase; however, statistical significance was not reached between A and B (Group 1, p = 0.11 and Group 2, p = 0.47, respectively).

Conclusions

TRT by CT is compatible with TRT by IMIM. Patients who cannot continue TRT because of polycythemia from IMIM may be suited to CT.

Disclosure

Work supported by industry: yes, by Daito pharmaceutical company.