The Association Between Erectile Dysfunction and Sleep Parameters: Data from a Prospective,Controlled Cohort

BackgroundMany studies have reported a possible strong relationship between poor sleep quality, sleep disruption, sleep disorders, and erectile dysfunction (ED).AimThis study aimed to investigate the relationship between sleep quality and ED.MethodsPatients diagnosed with ED by the International Index of Erectile Function-5 (IIEF-5) questionnaire and 72 healthy adult men were included. Participants completed the questionnaire, underwent a detailed physical examination, and provided blood samples. All enrolled subjects then wore the Fitbit Charge 2 that monitored sleep throughout the night.OutcomesPrimary outcome measures included scores on the IIEF-5, General Anxiety Disorder-7 (GAD-7) scale, Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and sleep monitoring parameters obtained from Fitbit Charge 2.ResultsFinally, a total of 107 ED patients and 72 healthy adult men were enrolled in this study. Univariate analysis indicated that the GAD-7 (P < .001), PHQ-9 (P < .001), and PSQI scores (P < .001) significantly differed according to the presence/absence of ED. Further multiple logistic regression analysis showed that the PHQ-9 (odds ratio [OR]: 1.227, 95% confidence interval [CI]: 1.070-1.407; P = .003) and PSQI scores (OR: 1.220, 95%CI: 1.116-1.334; P < .001) were independent risk factors for ED. Analysis of objective sleep monitoring parameters showed that total sleep time (TST) (P = .001), sleep onset latency (SOL) (P = .026), deep sleep (N3) duration (P = .011) and rapid eye movement (REM) sleep duration (P < .001) were significantly differed between the 2 groups, with durations in the ED group significantly lower than those in the non-ED group. In addition, receiver operating characteristic (ROC) curve analysis indicated that the REM sleep duration had the highest area under the curve (AUC: 0.728) of all sleep parameters, with a P value < .001, a sensitivity of 72.2% and a specificity of 73.8%.Clinical ImplicationsUrologists and andrologists should be aware of impacted sleep quality and depression in ED patients.Strengths & LimitationsThe strength of this study is that the relationship between sleep quality and ED was assessed with both a subjective scale and an objective sleep monitoring tool. However, our study only described an association between sleep quality and ED and did not establish a causal relationship.ConclusionSleep parameters are strongly associated with ED, indicating that poor sleep quality may increase the likelihood of ED.Wu X, Zhang Y, Zhang W, et al. The Association Between Erectile Dysfunction and Sleep Parameters: Data from a Prospective, Controlled Cohort. J Sex Med 2022;19:1387–1396.     

Complications of decompressive craniectomy for head injury

There is much interest in the use of decompressive craniectomy for intracranial hypertension. Whilst technically straightforward, the procedure is not without significant complications. A retrospective analysis was undertaken of 41 patients who had had a decompressive craniectomy for severe head injury in the years 2006 and 2007 at the two major hospitals in Western Australia, Sir Charles Gairdner Hospital and Royal Perth Hospital. Complications attributable to the decompressive surgery were: herniation of the cortex through the bone defect, 18 patients (51%); subdural effusion, 22 patients (62%); seizures, five patients (14%) and hydrocephalus, four patients (11%). Complications attributable to the subsequent cranioplasty were: infection, four patients (11%) and bone flap resorption, six patients (17%). Syndrome of the trephined occurred in three (7%) of those patients whose bone flap had significantly resorbed. Two deaths (5.5%) occurred as a direct complication of the craniectomy or cranioplasty procedure. I attempted to define what may be regarded as a complication of the decompressive procedure rather than what may be a consequence of the primary pathological process of traumatic brain injury.     

Preoperative depressive symptoms predict postoperative seizure outcome in temporal and frontal lobe epilepsy

ObjectiveRecent research has pointed to the possibility of a bidirectional relationship between seizure frequency in epilepsy and depressive symptoms. The study described here investigated the relationship between preoperative depressive symptomatology and postoperative seizure outcome in a sample of patients with temporal (TLE) and frontal (FLE) lobe epilepsy.MethodsA retrospective analysis was conducted on the data from 115 eligible patients with TLE (N = 97) and FLE (N = 18) and resections limited to one cortical lobe who were evaluated preoperatively and 1 year after epilepsy surgery with respect to depressive symptoms (Beck Depression Inventory, BDI) and seizure outcome. The latter was assessed in terms of actual total seizure frequency as well as a dichotomous variable (seizure free vs. not seizure free) for the 1-year outcome. Repeated-measures analyses of variance and regression analyses were applied.ResultsSeizure-free patients had significantly lower BDI scores preoperatively as well as postoperatively than patients who were not seizure free. In the regression analyses, the preoperative BDI score was a significant predictor of postoperative seizure frequency as well as seizure freedom. When only patients with TLE were analyzed, the results for the association between preoperative BDI and postoperative seizure frequency and seizure freedom remained consistent.ConclusionThe present results provide evidence for a statistical bidirectionality of the relationship between depressive symptoms and postoperative seizure status in a mixed sample of patients with TLE and FLE. Possible reasons for this bidirectional association include an underlying common pathology in both depression and epilepsy, for example, structural changes or functional alterations in neurotransmitter systems.     

无明显视力下降的糖尿病患者黄斑区视网膜厚度的研究

目的:分析无明显视力下降的糖尿病患者与正常人黄斑区视网膜厚度的差异。方法:选取2018-04/2019-06在我院确诊为2型糖尿病且无明显视力下降(最佳矫正视力≥0.8)的患者40例79眼为观察组,同期选取健康志愿者64例119眼为对照组。采用3D OCT获得两组受检者黄斑区9个区域平均视网膜厚度和黄斑区中心凹视网膜厚度(CRT)、平均视网膜厚度(ART)及视网膜体积(TV),并分析两组受检者之间的差异。结果:观察组患者CRT、ART、TV(193.99±14.58μm、291.07±12.24μm、8.22±0.35mm 3)均明显高于对照组受检者(187.38±12.24μm、280.54±8.71μm、7.92±0.25mm 3),且观察组患者黄斑区9个区域平均视网膜厚度均明显高于对照组受检者,差异均有统计学意义(P<0.05)。结论:无明显视力下降的2型糖尿病患者早期黄斑区视网膜厚度和体积较正常人增加。     

布洛伪麻那敏片与氨酚伪麻那敏片治疗上呼吸道症状的对照研究

目的：评价布洛伪麻那敏片治疗由普通感冒或感冒所致的上呼吸道症状的有效性和安全性。方法：采用多中心、随机双盲、阳性药物平行对照研究。共完成的病例数为226例。其中A组112例,B组114例,分别予以布洛伪麻那敏片和氨酚伪麻那敏片治疗,药物用法为每日3次,每次1片,疗程3～5d。结果：A组的总有效率为100.00%,总显效率为98.21%;B组的总有效率为99.12%,总显效率为97.37%。表明A组和B组总疗效差异无统计学意义（P〉0.05）。两组总有效率和总显效率非劣效性检验显示,A组非劣效于B组（P〈0.05）。不良反应发生率,A组和B组分别为20.18%和24.79%（P〉0.05）。结论：布洛伪麻那敏片和氨酚伪麻那敏片均系对症治疗感冒所致上呼吸道症状的安全有效药物。     

多普勒超声检查甲状腺癌患者的血流动力学指标及其与淋巴结转移的关系研究

目的探讨彩色多普勒超声检查甲状腺癌患者的血流动力学指标,以及血流动力学指标与颈部淋巴结转移的关系。方法将60例甲状腺癌患者根据颈部淋巴结是否转移分为淋巴结转移组和无淋巴结转移组,同时选取60名健康体检者作为对照组。使用多普勒超声进行血流成像,观察肿瘤的血流分布,并进行Adler血流分级,同时测算肿瘤血流速度(PSV)、搏动指数(PI)及阻力指数(RI)。结果淋巴结转移组和非淋巴结转移组甲状腺癌患者的PSV、PI和RI均明显高于对照组,差异均有统计学意义(P﹤0.01);同时淋巴结转移组甲状腺癌患者的PSV、PI明显高于无淋巴结转移组,RI明显低于无淋巴结转移组,差异均有统计学意义(P﹤0.01)。淋巴结转移组和无淋巴结转移组甲状腺癌患者Adler血流分级均主要集中在2级、3级,两组Adler血流分级,血流检出率和2、3级血流检出率比较,差异均无统计学意义(P﹥0.05)。结论多普勒超声检查能对甲状腺癌患者血流动力学指标进行有效评估,同时为术前评估患者是否伴有颈部淋巴结转移提供参考。     

Coexistence of Primary Sarcomatoid Carcinoma of the Right Ventricle and Absence of Right Pulmonary Artery

We describe the imaging features of a 48‐year‐old woman with primary sarcomatoid carcinoma originating from right ventricular outflow tract (RVOT) and isolated absence of right pulmonary artery (RPA). Computed tomography pulmonary angiography (CTPA) demonstrated the absence of RPA. Both transthoracic echocardiography (TTE) and CTPA revealed multiple masses filling and obstructing the RVOT. A palliative operation was performed on the patient, and the postoperative histopathology and immunohistochemical examination confirmed primary sarcomatoid carcinoma originating from the RVOT. The operation also confirmed the absence of RPA.