Investigating the basis of sexual dysfunction during late-onset hypogonadism

Late-onset hypogonadism (LOH) is the term used to describe the decline in serum testosterone levels associated with increasing age in men above 40 years. A number of symptoms are attributed to LOH, but the most common association is that of sexual dysfunction. LOH has recently come under greater scrutiny with the widespread use of testosterone therapy, and concerns regarding the efficacy and safety of testosterone replacement therapy have been raised. In particular, the cardiovascular safety and the beneficial effects of testosterone replacement therapy on general health have been questioned. This review will give an overview of the current evidence for the relationship of LOH and male sexual dysfunction

6-Formyl-2-meth­oxy-3-nitro­phenyl 4-toluene­sulfonate

In the title compound, C15H13NO7S, the inter­planar angle between the two aromatic rings is 26.04 (3)°. The crystal structure is stabilized by C—H⋯O interactions

Roux-en-Y Gastric Bypass Increases Glycemic Variability and Time in Hypoglycemia in Patients With Obesity and Prediabetes or Type 2 Diabetes: A Prospective Cohort Study

OBJECTIVE: Roux-en-Y gastric bypass (RYGB) is an established treatment for type 2 diabetes and obesity. The study objective was to establish RYGB's effects on glycemic variability (GV) and hypoglycemia. RESEARCH DESIGN AND METHODS: This was a prospective observational study of 10 participants with obesity and prediabetes or type 2 diabetes who underwent RYGB. Patients were studied before RYGB (Pre) and 1 month, 1 year, and 2 years postsurgery with continuous glucose measurement (CGM). A mixed-meal test (MMT) was conducted at Pre, 1 month, and 1 year. RESULTS: After RYGB, mean CGM decreased (at 1 month, 1 year, and 2 years), and GV increased (at 1 year and 2 years). Five of the 10 participants had a percent time in range (%TIR) <3.0 mmol/L (54 mg/dL) greater than the international consensus target of 1% at 1 or 2 years. Peak glucagon-like peptide-1 (GLP-1) and glucagon area under the curve during MMT were positively and negatively associated, respectively, with contemporaneous %TIR <3.0 mmol/L. CONCLUSIONS: Patients undergoing RYGB are at risk for development of postbariatric hypoglycemia due to a combination of reduced mean glucose, increased GV, and increased GLP-1 response

Surgical and minimally invasive treatment of ischaemic and non-ischaemic priapism : A systematic review by the EAU Sexual and Reproductive Health Guidelines panel

Peer reviewedPostprin

Dynamics of Vibrio cholerae in a Typical Tropical Lake and Estuarine System: Potential of Remote Sensing for Risk Mapping

Vibrio cholerae, the bacterium responsible for the disease cholera, is a naturally-occurring bacterium, commonly found in many natural tropical water bodies. In the context of the U.N. Sus�tainable Development Goals (SDG) targets on health (Goal 3), water quality (Goal 6), life under water (Goal 14), and clean water and sanitation (Goal 6), which aim to “ensure availability and sustain�able management of water and sanitation for all”, we investigated the environmental reservoirs of V. cholerae in Vembanad Lake, the largest lake in Kerala (India), where cholera is endemic. The response of environmental reservoirs of V. cholerae to variability in essential climate variables may play a pivotal role in determining the quality of natural water resources, and whether they might be safe for human consumption or not. The hydrodynamics of Vembanad Lake, and the man-made barrier that divides the lake, resulted in spatial and temporal variability in salinity (1–32 psu) and temperature (23 to 36 ◦C). The higher ends of this salinity and temperature ranges fall outside the preferred growth conditions for V. cholerae reported in the literature. The bacteria were associated with filtered water as well as with phyto- and zooplankton in the lake. Their association with benthic organisms and sediments was poor to nil. The prevalence of high laminarinase and chitinase enzyme expression (more than 50 µgmL−1 min−1 ) among V. cholerae could underlie their high association with phyto- and zooplankton. Furthermore, the diversity in the phytoplankton community in the lake, with dominance of genera such as Skeletonema sp., Microcystis sp., Aulacoseira sp., and Anabaena sp., which changed with location and season, and associated changes in the zooplankton community, could also have affected the dynamics of the bacteria in the lake. The probability of presence or absence of V. cholerae could be expressed as a function of chlorophyll concentration in the water, which suggests that risk maps for the entire lake can be generated using satellite-derived chlorophyll data. In situ observations and satellite-based extrapolations suggest that the risks from environmental V. cholerae in the lake can be quite high (with probability in the range of 0.5 to 1) everywhere in the lake, but higher values are encountered more frequently in the southern part of the lake. Remote sensing has an important role to play in meeting SDG goals related to health, water quality and life under water, as demonstrated in this example related to cholera

Type 2 diabetes remission 2 years post Roux‐en‐Y gastric bypass and sleeve gastrectomy: the role of the weight loss and comparison of DiaRem and DiaBetter scores

AIMS: The comparative efficacy of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy on Type 2 diabetes remission and the role of weight loss are unclear. The DiaRem Type 2 diabetes remission prediction score uses HbA1c , age and Type 2 diabetes medications but not Type 2 diabetes duration. The aim of this study was to compare the predictive value of the DiaRem score with the DiaBetter score that includes Type 2 diabetes duration, upon combined (complete plus partial) 2-year post-surgery Type 2 diabetes remission in people following RYGB and sleeve gastrectomy, and to investigate the relationship between weight loss and Type 2 diabetes remission. METHODS: A retrospective single-centre cohort study of obese people with Type 2 diabetes who underwent RYGB (107) or sleeve gastrectomy (103) and a separate validation cohort study (173) were undertaken. Type 2 diabetes remission, per cent weight loss, DiaRem, DiaBetter scores and areas under receiving operator characteristic (ROC) curves were calculated. The relationship between per cent weight loss and Type 2 diabetes remission was investigated using logistic regression with multivariate adjustments. RESULTS: The proportion of people achieving Type 2 diabetes remission was highest for those with the lowest DiaBetter and DiaRem scores, and lowest in those with the highest scores. Areas under the ROC curves were comparable [DiaBetter: 0.867 (95% CI: 0.817-0.916); DiaRem: 0.865 (95% CI: 0.814-0.915), P = 0.856]. Two-year per cent weight loss was higher post RYGB [26.6 (95% CI: 24.8-28.4)] vs post-sleeve gastrectomy [20.6 (95% CI: 18.3-22.8), P < 0.001]. RYGB had 151% higher odds of Type 2 diabetes CR compared with sleeve gastrectomy [OR 2.51 (95% CI: 1.12-5.60), P = 0.025]. This association became non-significant when adjusted for per cent weight loss. CONCLUSION: DiaBetter and DiaRem scores predict Type 2 diabetes remission following RYGB and sleeve gastrectomy. Two-year per cent weight loss plays a key role in determining Type 2 diabetes remission. This article is protected by copyright. All rights reserved