The Association Between Pelvic Discomfort and Erectile Dysfunction in Adult Male Bicyclists

BackgroundBicycle riding's impact on erectile function remains a topic of great interest given cycling's popularity as a mode of transportation and exercise.AimWe evaluated risk factors for sexual dysfunction in male cyclists with the primary intention of determining if genital/pelvic pain and numbness are associated with erectile dysfunction (ED).MethodsWe surveyed male cyclists using an online anonymous questionnaire. Cyclists were queried on their demographics, cycling experience, and sexual function using the Sexual Health Inventory for Men (SHIM). ED was diagnosed when a completed SHIM score was <22. Regression analysis was used to evaluate the risk of ED in men with genital/pelvic pain or numbness after riding. The survey was designed in the United States.OutcomesQuantitative characterization of cycling habits, onset and timing of genital pain and numbness, and SHIM score.ResultsA total of 1635 participants completed the survey. A majority of men were over the age of 50 (58%, 934/1,607), Caucasian (88%, 1,437/1,635), had been active cyclists for over 10 years (63%, 1,025/1,635) and used road bikes (97%, 1,578/1,635). Overall, 22%, 30%, and 57% of men reported ED, genital pain, and genital numbness, respectively. While controlling for cohort demographics, body mass index, cycling intensity and equipment, and medical comorbidities, no saddle characteristics were associated with the risk of developing genital numbness. However, men reporting penile numbness were at higher risk of reporting ED (odds ratio [OR] = 1.453, P = .048). In addition, quicker onset of numbness and resolution of numbness within a day was associated with impaired erectile function. For example, numbness occurring less than 1 hour after cycling had greater odds of leading to ED than numbness after 5 hours (OR = 2.002, P = .032). Similarly, genital pain occurring less than 1 hour (OR = 2.466, P = .031) after cycling was associated with higher ED risk.Strengths & LimitationsStrengths include a large sample size of high-intensity cyclists and validated questionnaire use. Limitations include reliance on anonymous self-reported survey data and minimal inquiry into the riding preferences and terrain traversed by cyclists.ConclusionsPelvic pain and numbness are common complaints among male riders in the United States. Men with such complaints are more likely to also report ED especially if it occurs earlier in the ride. Although direction of causality and temporality are uncertain, alleviation of factors resulting in pelvic discomfort may reduce cycling's impact on sexual function. Such interventions are critical given that cycling for both active travel and aerobic exercise confers numerous health benefits.Balasubramanian A, Yu J, Breyer BN, et al. The Association Between Pelvic Discomfort and Erectile Dysfunction in Adult Male Bicyclists. J Sex Med 2020;17:919–929.     

重症监护室患者不适体验及其与事实记忆的关系

目的探讨重症监护室（intensivecareunit，ICU）患者不适体验及其与事实记忆（factual recollection，FR）的相关性。方法对55例ICU患者及63例普通病房患者进行标准化FR问卷调查，并对结果进行分析。结果64％的ICU转出患者有ICU不适体验，其中以气管内导管、疼痛及幻觉所引起的不适较为常见；ICU患者FR评分平均为7．25分，普通病房患者FR评分平均为13．50分，二者比较差异有统计学意义（t=3．34，P〈0．01）；Logistic回归分析表明，FR评分与ICU患者不适体验，尤其是与气管内导管、疼痛及幻觉所引起的不适的发生显著相关，0R95％CI（1．2～2．1），P〈0．01。结论ICU患者的不适体验主要来自于气管内导管、疼痛和幻觉等；ICU患者相对于普通病房患者可能存在记忆减退；FR可能与ICU不适体验的发生具有相关性。     

Problematic alcohol and cannabis use among young adults: the roles of depression and discomfort and distress tolerance

Problematic substance use is associated with depression. Clarifying the relationship between substance use and depression remains an important research goal, with implications for prevention and treatment. Individual differences in the ability to tolerate negative physical and emotional sensations were hypothesized to play a role in substance use behaviors among depressed individuals. The present study investigated the roles of discomfort and distress tolerance in the relationship between alcohol and cannabis problems and depression among undergraduates (N=265). Consistent with other reports, depression was correlated with alcohol and cannabis problems. As predicated, distress tolerance mediated the relationships between depression and alcohol and cannabis problems. Interestingly, discomfort intolerance moderated the relationship between depression and cannabis problems such that depressed individuals with high discomfort tolerance were most vulnerable to cannabis problems. These data suggest that distress intolerance may at least partially account for alcohol and cannabis problems among depressed young adults whereas discomfort intolerance may actually serve a protective role in the development of cannabis problems.     

The evaluation of ergonomic risk factors among meat cutters working in Jabalpur,India

Abstract

Background:

Manual meat cutters in India are at high risk of work-related musculoskeletal disorders (WMSDs) for a variety of reasons including holding awkward postures, repetitive forceful exertions, and inadequate rest. This is the first study of its kind to investigate the nature and magnitude of WMSDs among manual meat cutters in India.

Objective:

The aim of this study was to measure the ergonomic risk factors for WMSDs among adult male manual meat cutters working in Jabalpur, India.

Methods:

We used direct observation, activity analysis, questionnaires, interviews, photography, and video to measure the quantitative ergonomic risk factors.

Results:

Ovako working posture analysis indicated high scores (four for the back in peeling, six for the arms in cutting, and six for the arms during mincing tasks). Rapid entire body assessment method (REBA) scores were also high at 10/10 for deboning and mincing tasks, all associated with repetitive movements of the arms and awkward posture of the upper part of the body.

Conclusions:

The study indicates that most tasks for meat cutters fall in the high-risk category for occupational injury. Results suggest that ergonomic interventions that address retooling and workstation and process redesign would be useful in reducing the number of injuries.     

Discomfort and the cortical haemodynamic response to coloured gratings

In five experiments we measured the amplitude of the haemodynamic response to visual patterns using near infrared spectroscopy of the visual cortex. The patterns were gratings with bars that differed in chromaticity but not in luminance. In all experiments, with a wide range of chromaticities of the grating bars, the amplitude of the haemodynamic response increased with the separation of the chromaticities in the CIE 1976 UCS diagram. The amplitude did not vary consistently with the cone activation, or with the signal in colour difference channels. In four further experiments, again with a wide range of chromaticities, the gratings were rated for visual comfort. Discomfort increased consistently with the separation of the chromaticities. Given that a large haemodynamic response to patterns is generally associated with headache, we suggest that the discomfort may be a homeostatic signal to reduce sustained metabolic load on the visual cortex.     

Effects of Nasopore Packing on Dacryocystorhinostomy

Purpose

To investigate the effects of placement of the absorbable packing material Nasopore at the anastomosis site of newly formed mucosal flaps on postoperative re-bleeding, discomfort, and on the success rate of dacryocystorhinostomy (DCR).

Methods

A review of the medical records of patients with primary acquired nasolacrimal duct obstruction that underwent external or endonasal DCR by a single surgeon was performed. The degree of re-bleeding, discomfort, and postoperative results, including anatomical success, functional success and postoperative nasal findings such as granulation, synechiae, and membrane formation were compared in patients whose anastomosis site was packed with either Nasopore or Merocel, a non-absorbable packing material.

Results

A total of 77 patients (101 eyes) were included. Of the 101 eyes, 30 were packed with Nasopore, while 71 were packed with Merocel. The Nasopore group showed significantly better results than the Merocel group in the degree of re-bleeding and the level of patient discomfort (p = 0.000, 0.039, respectively; Pearson''s chi-square test), whereas there were no statistically significant differences between the two groups in postoperative anatomical and functional success (p > 0.05).

Conclusions

Nasopore significantly reduced postoperative nasal re-bleeding and patient discomfort during the early post-surgical period, but failed to show an effect on the postoperative anatomical and functional success of DCR.