An unresolved discussion: presence of premature ejaculation and erectile dysfunction in lumbar disc hernia

Purpose

Premature ejaculation (PE) and erectile dysfunction (ED) are both frequent diseases with several questions about the aetiological factors for these disorders. Lumbar disc herniation (LDH), which can cause both neurological and physiological impairments, may be a causative reason. We prospectively tried to evaluate the presence of PE and ED in patients with LDH and identify the effect of both surgical and physical therapy treatments for LDH on PE and ED.

Methods

A total of 50 patients with LDH and a corresponding control group without LDH at an age of 18–50 years were included in the study. Both PE and ED were evaluated with premature ejaculation diagnostic tool (PEDT) and International Index of Erectile Function. Mean intravaginal ejaculatory latency time (IELT) was calculated at their 5 consecutive intercourse. Physical therapy or microdiscectomy was performed according to indication. After 6 months of follow-up, patients in treatment group were re-evaluated for PE and ED.

Results

Mean age of study and control group was 34.1 ± 3.3 and 34.2 ± 4.0 years, respectively (p = 0.979). In LDH group, IELT was <1 min in 12 (24 %), 1–2 (16 %) min in 8, 2–3 min in 7 (14 %), 3–4 min in 7 (14 %) and 4 or more minutes in 16 (32 %) patients. These numbers were 11 (22 %), 8 (16 %), 5 (10 %), 9 (18 %) and 17 (34 %) in control group, respectively. Mean PEDT score of patients who had IELT < 1 min was 11.9 ± 2.1 and 10.7 ± 2.1 in study and control group, whereas it decreased to 1.0 ± 2.8 and 0.5 ± 1.8 as IELT increased over 4 min, respectively. There were 11 (22 %) patients with ED in LDH group, whereas there were only 2 (4 %) in control group (p = 0.017). Twenty patients with LDH underwent surgery while 30 had been taken into physical therapy. After 6 months, patients with PE significantly decreased in both surgery and physical therapy group (p = 0.025 and p = 0.046). Patients with ED also decreased after treatment, but the numbers were so limited for statistical evaluation.

Conclusion

Although ED was more frequent in patients with LDH, PE was similar in both study and control groups, but the treatment of LDH had positive effects on PE and ED.     

Clinical and cognitive profiles of patients with both Parkinson’s disease and essential tremor

Although Parkinson’s disease (PD) and essential tremor (ET) are distinct clinical disorders, their coexistence can sometimes cause diagnostic problems. In this study, we conducted detailed investigations of patients with both ET and PD (ET–PD) and compared their clinical and cognitive profiles with those of patients with only ET or only PD. This study examined three groups of patients: the first group had ET–PD concomitantly (n = 9); the second group had only ET (n = 9); the third group had only PD (n = 10). The groups were compared in terms of demographic characteristics, clinical features, and cognitive functions. With the exception of positive family histories, which were more common in ET–PD than in PD patients, we found no differences among the groups with respect to demographic characteristics (p = 0.044). PD-only patients had more akinetic-rigid type Parkinsonism (p = 0.016), and their levodopa response was better than that of ET–PD patients (p = 0.017). Patients with ET–PD obtained significantly lower scores than those with pure ET on several cognitive tests, suggesting a prominent frontal-type cognitive dysfunction. In conclusion ET–PD patients differed from PD patients, showing more frequent familial tremor histories and lower levodopa responsiveness. This patient population also demonstrated more severe cognitive impairments than pure-ET patients. This result suggests that ET–PD patients are a subset of ET patients with more widespread neurodegeneration, which may indicate the presence of a syndrome that includes overlap between ET and PD.     

The effects of polycystic ovary syndrome on gestational diabetes mellitus

The aim of this study was to explore the inter-relationship between polycystic ovary syndrome and gestational diabetes mellitus, and demonstrate maternal and fetal outcomes. This was a case-control study in 1360 pregnant women who received a diagnosis of gestational diabetes mellitus between 24 and 28 weeks of gestational age. Among all diagnosed with gestational diabetes mellitus, 150 pregnant women had received a polycystic ovary syndrome, and 160 women who did not have polycystic ovary syndrome were designated as controls. The incidence of pregnancy-induced hypertension was 26.3% and 12% in the case and control groups, respectively. Preeclampsia was seen at an incidence of 12% and 6% in case and in control groups, respectively. The difference in neonatal hypoglycemia between the two groups was statistically significant, with an incidence of 17% and 5% in the case and in control groups, respectively. This study demonstrated that the presence of polycystic ovary syndrome along with gestational diabetes mellitus increases the risk of pregnancy induced hypertension by 2.4 fold, preeclampsia by 2 fold and neonatal hypoglycemia by 3.2 fold, compared to gestational diabetes mellitus alone.     

Simultaneous determination of equivalent dose to organs and tissues of the patient and of the physician in interventional radiology using the Monte Carlo method

This study presents the results of computations of organ equivalent doses and effective doses for the patient and the primary physician during an interventional cardiological examination. The simulations were carried out for seven x-ray spectra (between 60 kVp and 120 kVp) using the Monte Carlo code MCNP. The voxel-based whole-body model VIP-Man was employed to represent both the patient and the physician, the former lying on the operation table while the latter standing 15 cm from the patient at about waist level behind a lead apron. The x-rays, which were generated by a point source positioned around the table and were directed with a conical distribution, irradiated the patient's heart under five major projections used in a coronary angiography examination. The mean effective doses under LAO45, PA, RAO30, LAO45/CAUD30 and LLAT irradiation conditions were calculated as 0.092, 0.163, 0.161, 0.133 and 0.118 mSv/(Gy cm2) for the patient and 1.153, 0.159, 0.145, 0.164 and 0.027 microSv/(Gy cm2) for the shielded physician. The effective doses for the patient determined in this study were usually lower than the literature data obtained through measurements and/or calculations and the discrepancies could be attributed to the fact that this study computes the effective doses specific to the VIP-Man body model, which lacks an ovarian contribution to the gonadal equivalent dose. The effective doses for the physician agreed reasonably well with the literature data.     

Tridimensional evaluation of maxillary and mandibular movements in orthognathic surgery

For better evaluation of long-term results of orthognathic surgery, movements of osteotomized maxillary and mandibular segments should be documented both in x-, y-, and z-axes and in terms of kind of movement (either linear or rotational movements). Lateral cephalometric, anteroposterior cephalometric, and submentovertex radiographs of 14 patients, treated with combined orthodontic and surgical treatment for skeletal class III malocclusion, were reevaluated retrospectively to demonstrate the applicability and usefulness of defined parameters in four maxillary and five mandibular movements. There was no clinically significant relapse in the follow-up period of 6 months in any of the patients. Differences between preoperative and postoperative measurements to demonstrate the linear movement in the z-axis, rotational movements in the x-axis and y-axis of the maxilla, and the linear movement in the z-axis of the mandibula were found to be statistically significant. Differences between early postoperative and late postoperative measurements to demonstrate rotational movement in the y-axis of the maxilla and rotational movement in the y-axis of the mandibula were found to be statistically significant. In this article, the possible tridimensional movements and cephalometric measurements of osteotomized bony segments after LeFort I and sagittal split osteotomy surgery were defined for better evaluation and follow up of the postoperative results.