Sexual dysfunction in subjects treated with inhibitors of 5a-reductase for benign prostatic hyperplasia: a comprehensive review and meta-analysis

Sexual dysfunction in subjects treated with inhibitors of 5a-reductase for benign prostatic hyperplasia: a comprehensive review and meta-analysi

Short-term vertical velocity field in the Appennines (Italy) revealed by geodetic levelling data

We estimate current vertical movements along the Apennines (Italy) through repeatedly measured high precision levelling routes. In order to highlight regional crustal deformation the analysis of a geodetic database, with a minimum benchmark density of 0.7 bm/km (1943–2003 time period), is carried out. We evaluate systematic and random error and their propagation along the levelling routes. Tests on original raw height data have been carried out to define error propagation. The computed relative vertical rates stand significantly above error propagation. A series of traverses along and across the Apennines and a map of relative vertical velocities reveal a geodetic signal characterised by values up to 2.5–3.0 mm/a and by wavelengths up to 100 km. © 2006 Elsevier B.V. All rights reserved

Coseismic and post-seismic slip of the 2009 L'Aquila (central Italy) MW 6.3 earthquake and implications for seismic potential along the Campotosto fault from joint inversion of high-precision levelling, InSAR and GPS data

After the April 6th 2009 MW 6.3 (ML 5.9) L'Aquila earthquake (central Italy), we re-measured more than 100 km of high-precision levelling lines in the epicentral area. The joint inversion of the levelling measurements with InSAR and GPS measurements, allowed us to derive new coseismic and post-seismic slip distributions and to de- scribe, with high resolution details on surface displacements, the activation and the slip distribution of a second- ary fault during the aftershock sequence that struck the Campotosto area (major event MW 5.2). Coseismic slip on the Paganica fault occurred on one main asperity, while the afterslip distribution shows a more complex pattern, occurring on three main patches, including both slips on the shallow portions and on the deeper parts of the rup- ture plane. The comparison between coseismic and post-seismic slip distributions strongly suggests that afterslip was triggered at the edges of the coseismic asperity. The activation of a segment of the Campotosto fault during the aftershock sequence, with a good correlation between the estimated slipping area, moment release and distribution of aftershocks, raises the opportunity to discuss the local seismic hazard following the occurrence of the 2009 L'Aquila mainshock. The Campotosto fault appears capable of generating earthquakes as large as his- torical events in the region (M N 6.5) or as small as the ones associated with the 2009 sequence. In the case that the Campotosto fault is accumulating a significant portion of the current interseismic deformation, the 2009 MW N 5 events will have released only a small amount of the accumulated elastic strain, and then a significant hazard still remains in the area. Continuing geodetic monitoring and a densification of the GPS networks in the region are therefore needed to estimate the tectonic loading across the different recognized active fault systems in this part of the Apennines.Published168-1852T. Tettonica attivaJCR Journalrestricte

Erectile dysfunction is common among men with acromegaly and is associated with morbidities related to the disease

Background: The prevalence of erectile dysfunction (ED) and its correlates in men with acromegaly has never been investigated. Aim: To evaluate sexual function in men with acromegaly. Methods: Multicenter-based, retrospective analysis of a non-selected series of 57 acromegalic subjects (mean age: 52.7 14.2 years) was performed. Acromegalic subjects reporting ED (n = 24) were compared with matched ED- patients without acromegaly or pituitary disease (con- trols), selected from a cohort of more than 4000 subjects enrolled in the Flrence Sexual Medicine and Andrology Unit. Patients were interviewed using SIEDY structured interview, a 13-item tool for the assessment of ED-related morbidities. Several clinical and biochemical parameters were taken. Penile colour-Doppler ultrasound (PCDU) was performed in a subgroup of 37 acromegalic subjects. Results: ED was reported by 42.1% of acromegalic sub- jects. After adjusting for age and testosterone, acromegalic subjects with ED had a higher prevalence of hypertension, and more often reported an impairment of sleep-related erections and a longer smoking habit. Accordingly, acro- megaly-associated ED was characterized by a higher organic component and worse PCDU parameters. No rela- tionship between ED and testosterone levels or other acro- megaly-related parameters was found. However, acromegalic subjects with severe ED reported a longer dis- ease duration. In a case-control analysis, comparing acromegalic subjects with ED-matched-controls free from acromegaly (1:5 ratio), acromegalic men had a worse ED problem and a higher organic component of ED, as derived from SIEDY score. In line with these data, acrome- galic patients with ED had a higher prevalence of major adverse cardiovascular events (MACE) history at enrol- ment and lower PCDU parameters. Conclusions: Subjects with complicated acromegaly are at an increased risk of developing ED, especially those with cardiovascular morbidities. Our data suggest including a sexual function evaluation in routine acromegaly follow- up

Testosterone positively regulates vagina NO-induced relaxation: an experimental study in rats

PURPOSE: Female sexual response involves a complex interplay between neurophysiological mechanisms and the nitric oxide (NO)-mediated relaxation of clitoris and vagina. The aim of this study was to evaluate sex steroids regulation of the relaxant pathway in vagina, using a validated animal model. METHODS: Subgroups of OVX Sprague–Dawley rats were treated with 17β-estradiol, testosterone, or testosterone and letrozole, and compared with a group of intact animals. Masson’s trichrome staining was performed for morphological evaluation of the distal vaginal wall, in vitro contractility studies investigated the effect of OVX and in vivo treatments on vaginal smooth muscle activity. RNA from vaginal tissue was analyzed by semi-quantitative RT-PCR. RESULTS: Immunohistochemical analysis showed that OVX induced epithelial and smooth muscle structural atrophy, testosterone and testo + letrozole increased the muscle bundles content and organization without affecting the epithelium while 17β-estradiol mediated the opposite effects. In vitro contractility studies were performed on noradrenaline pre-contracted vaginal strips from each experimental group. Acetylcholine (0.001–10 µM) stimulation induced a concentration-dependent relaxation, significantly reduced by NO-synthase inhibitor L-NAME and by guanylate cyclase inhibitor ODQ. OVX resulted in a decreased responsiveness to acetylcholine, restored by testosterone, with or without letrozole, but not by 17β-estradiol. OVX sensitivity to the NO-donor SNP was higher than in the control. Vardenafil, a PDE5 inhibitor, enhanced SNP effect in OVX + testosterone as well as in control, as supported by RNA expression analysis. CONCLUSIONS: Our study demonstrates that testosterone improves the NO-mediated smooth muscle vaginal cells relaxation confirming its role in maintaining the integrity of muscular relaxant machinery

Cardiometabolic risk is unraveled by color Doppler ultrasound of the clitoral and uterine arteries in women consulting for sexual symptoms

Female sexual dysfunction (FSD) may be a mirror of a poor cardiometabolic state. In a small pilot study enrolling 71 women with FSD, we previously demonstrated that clitoral Pulsatility Index (PI) evaluated by using color Doppler ultrasound (CDU), reflecting vascular resistance, was associated with cardiometabolic risk factors. Data on uterine CDU in this context are lacking. First, to confirm previously reported data on the direct association between clitoral PI and cardiometabolic risk factors on a larger study population of women consulting for sexual symptoms; second, to investigate eventual similar correlations between cardiometabolic risk factors and CDU parameters of the uterine artery. We also ascertained whether uterine artery PI, similarly to what had previously been observed for clitoral artery PI, was directly related to body image uneasiness and psychopathological symptoms, assessed by validated questionnaires. N = 230 women consulting our clinic for sexual symptoms were examined with clitoral CDU and blood sampling and were asked to fill out the Female Sexual Function Index, the Middlesex Hospital Questionnaire (MHQ) and the Body Uneasiness Test (BUT). In a subgroup of women (n = 164), we also performed transvaginal CDU with measurement of uterine artery parameters. At multivariate analysis, we found a direct association between clitoral PI and body mass index (BMI) (p = 0.004), waist circumference (WC) (p = 0.004), triglycerides (p = 0.006), insulin (p = 0.029) and HOMA-IR (p = 0.009). Furthermore, a correlation between obesity and Metabolic Syndrome (MetS) and a higher clitoral PI was observed (p = 0.003 and p = 0.012, respectively). Clitoral PI was also correlated with MHQ-S (p = 0.010), a scale exploring somatized anxiety symptoms, and BUT-B Positive Symptom Distress Index (p = 0.010), a measure of body image concerns. Similarly, when investigating the uterine artery, we were able to demonstrate an association between its PI and BMI (p < 0.0001), WC (p = 0.001), insulin (p = 0.006), glycated haemoglobin (p =  < 0.0001), and HOMA-IR (p = 0.009). Women diagnosed with obesity and MetS showed significantly higher uterine PI values vs. those without obesity or MetS (p = 0.001 and p = 0.004, respectively). Finally, uterine PI was associated with BUT-A Global Severity Index (p < 0.0001) and with several other BUT-A subdomains. Vascular resistance of clitoral and uterine arteries is associated with cardiometabolic risk factors and body image concerns in women consulting for sexual symptoms. If further confirmed in different populations, our data could suggest CDU, a common examination method, as a useful tool for an identification—and possible correction—of cardiometabolic risk factors

Low Testosterone Levels Predict Clinical Adverse Outcomes in SARS-CoV-2 Pneumonia Patients

Background: The pandemic of new severe acute respiratory syndrome (SARS) due to coronavirus (CoV) 2 (SARS-CoV-2) has stressed the importance of effective diagnostic and prognostic biomarkers of clinical worsening and mortality. Epidemiological data showing a differential impact of SARS-CoV-2 infection on women and men have suggested a potential role for testosterone (T) in determining gender disparity in the SARS-CoV-2 clinical outcomes. Objectives: To estimate the association between T level and SARS-CoV-2 clinical outcomes (defined as conditions requiring transfer to higher or lower intensity of care or death) in a cohort of patients admitted in the respiratory intensive care unit (RICU). Materials and methods: A consecutive series of 31 male patients affected by SARS-CoV-2 pneumonia and recovered in the respiratory intensive care unit (RICU) of the “Carlo Poma” Hospital in Mantua were analyzed. Several biochemical risk factors (ie, blood count and leukocyte formula, C-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), ferritin, D-dimer, fibrinogen, interleukin 6 (IL-6)) as well as total testosterone (TT), calculated free T (cFT), sex hormone–binding globulin (SHBG), and luteinizing hormone (LH) were determined. Results: Lower TT and cFT were found in the transferred to ICU/deceased in RICU group vs groups of patients transferred to IM or maintained in the RICU in stable condition. Both TT and cFT showed a negative significant correlation with biochemical risk factors (ie, the neutrophil count, LDH, and PCT) but a positive association with the lymphocyte count. Likewise, TT was also negatively associated with CRP and ferritin levels. A steep increase in both ICU transfer and mortality risk was observed in men with TT&nbsp;&lt;&nbsp;5&nbsp;nmol/L or cFT&nbsp;&lt;&nbsp;100&nbsp;pmol/L. Discussion and conclusion: Our study demonstrates for the first time that lower baseline levels of TT and cFT levels predict poor prognosis and mortality in SARS-CoV-2-infected men admitted to RICU