Assessing the influence of cardiovascular risk factors on the severity of erectile dysfunction: a multivariate statistical analysis

Introduction. The American Heart Association identifies 7 major factors that affect the condition of the vascular wall: smoking, blood pressure, total cholesterol, glucose, body mass index, physical activity, and diet. The vascular wall lesions most often manifest clinically as vasculogenic erectile dysfunction (ED). Consequently, evaluating patients for the presence of the above risk factors can not only help in the treatment of ED, but can also significantly increase the chances of early detection of cardiac pathology.Purpose of the study. To assess cardiovascular disorder markers’ role in prognosing of the presence or absence of ED and its severity.Materials and methods. The study included 40 patients aged 33 – 60 years. Erectile function was assessed using the device «Androscan – MIT» ("Minimally invasive technologies" LLC, Moscow, Russian Federation) and the IIEF-15 questionnaire. Statistical data processing was carried out using Statistica 12 («StatSoft Inc.», Tusla, CA, USA) и IBMÒ SPSS Statistics 26 («SPSS: An IBM Company», IBM SPSS Corp., Armonk, NY, USA).Results. For patients with more severe ED, a greater deviation of the parameters studied from normal is typical. The most significant impact on the detection of different ED degrees using the device «Androscan – MIT» had TC, HDL, LDL, RP, BMI, triglycerides и HbA1c levels. Based on the androscanning data, a classification tree with two branches (branching conditions — the level of TC and LDL) and four terminal vertices (depending on the degree of ED) was obtained. There were no classification errors predicting ED degrees, which in this case indicates the good significance of the mathematical prediction. Only IIEF-15 scores had the greatest impact on ED detection using IIEF-15. The only condition for branching when constructing classification trees was the number of IIEF-15 points (two branches with three terminal vertices were obtained).Conclusion. Cardiovascular risk factors are predictors of vascular ED, detected by androscanning, while the widespread IIEF-15 questionnaire remains completely dependent on subjective feelings of patients without relying on laboratory and instrumental research methods

Selection criteria for minimally invasive endoscopic treatment of urolithiasis depending on stone characteristics

Introduction. According to the guidelines, the stone maximum diameter is one of the main criteria for choosing the method of nephrolithotripsy. When planning an operation, the surgeon focuses not only on the diameter, but also on the renal pelvis anatomy, stone density and number of it, the presence of hydronephrosis, a history of surgery, etc. The maximum diameter is not an exhaustive characteristic that allows you to choose the optimal treatment.Objective. To evaluate the effect of stone volume (compared to its maximum diameter) on the duration of minimally invasive endoscopic nephrolithotripsy.Materials & methods. The study was retrospective. The study included 55 patients (22 women, 33 men), the average age was 47.0 ± 1.9 years. All patients underwent minimally invasive thulium fiber laser nephrolithotripsy for stones up to 20 mm (mean maximum diameter — 13.3 ± 0.6 mm, mean density — 1041.0 ± 48.0 HU). Minimally invasive endoscopic interventions such as retrograde intrarenal surgery (RIRS, n = 30), minipercutaneous and micropercutaneous nephrolithotripsy (miniPNL, n = 16 and microPNL, n = 9, respectively) were performed. Patients with urinary system abnormalities, acute urinary tract infections and patients without stone-free status were excluded from the study. In addition to evaluating standard indicators, the stone volume was calculated in all patients using the formula of a scalene ellipsoid (median volume — 287 [144; 538] mm3). Spearman's rank correlation coefficient (r) with an assessment of the significance level was calculated for the stone maximum diameter and volume for the total sample of patients and for each surgical intervention method separately.Results. The analysis of the total sample of patients reliably revealed a weak correlation (r = 0.39) between the stone maximum diameter and surgery time. And a moderate correlation was found between the stone volume and surgery time (r = 0.53). A similar relationship with the linear distribution was also observed in the analysis in all groups.Conclusion. When choosing minimally invasive laser nephrolithotripsy, it is advisable to focus not only on the stone maximum diameter, density, and localisation, but also on the stone volume, which has a great correlation with the surgery time

Non-invasive electromagnetic detection of prostate cancer: efficiency analysis

Introduction. Early diagnosis of cancer is one of the most important international strategies. Malignant and healthy tissues differ in the interaction with electromagnetic waves. Pilot studies show a potential perspective for non-invasive analysis of electromagnetic anisotropy in biological tissues.Objective. To assess the diagnostic importance of the electromagnetic detection of prostate cancer (PCa) within the prospective study.Materials & methods. One hundred and twenty-four patients were included to undergo a prostate biopsy, transurethral prostate resection, or radical prostatectomy. The investigators did not have information on their clinical details. Research technique: the probe was applied to the perineal region, turning it in three planes. A reduction of the 465 MHz band below a threshold was fixed and was considered suspect for PCa. The results of electromagnetic evaluation were compared with the findings of a pathomorphological study after biopsy or surgery.Results. Fourty-seven true-positive and 21 true-negative results were detected, 20 false-negative and 46 false-positive (follow-up group as potentially true-positive group). The overall sensitivity was 82%, specificity – 31%. The positive and negative predictive values were 73% and 62%, respectively. The accuracy of the method was 54%.Conclusion. Early PCa stage could be a reason for many false-positive results and low specificity, as a result. PCa detection is significantly reduced with lesions less than 3 mm, therefore patients with false-positive results were placed in the follow-up group. Patients’ examination with the TRIMprob TM («Galileo Avionica» SpA, Torino, Italy) could increase the early PCa detection at the screening. The research is currently ongoing

Energy market wars as a factor of military-political escalation in Eastern Mediterranean region : A Russian perspective

Regional multipolarity has increased the complexity of geopolitical interests along with the worsening of international relations. Geopolitics is a means of not only interpreting the state of the political environment, but also in projecting the desired geo-economic end state for an actor. A much more pragmatic approach to securing perceived national interests is observed among newly emerging non-Western international actors in the Mediterranean region. This article analyses the energy factor which influences military-political situation in Eastern Mediterranean region with an emphasis upon Turkey and Russia’s sometimes cooperation and sometimes competition. The decision by Greece, Republic of Cyprus and Israel on commencement of construction of EastMed gas pipeline has been analysed. This decision was considered to be one of the key causes of the escalation in Libya. The conclusion is that Turkey strives to complicate the laying of any gas pipelines stretching from south-eastern direction to Europe bypassing its territory. The Russian escalation factor was also analysed. Finally, strategic risks for Turkey relating to its build-up of a military presence in Libya have been identified. These factors form the basis for consequences of possible escalation of conflict for the entire region