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This article examines Nietzsche’s evaluations of silence and laughter as Pyrrho’s two responses to the dilemma caused by doubts about truth in aphorism 213 of ‘The Wanderer and His Shadow’ (WS 213). Contrary to the common belief that speechlessness leads Pyrrho to tranquillity (ataraxia), in WS 213, it is a symptom of his intellectual impotence caused by logical impasse. Silence proves to be subject to the same traps as speeches. In his later period, Nietzsche deems Pyrrho’s impotent will to truth and pursuit of tranquility nihilism. He contends that Pyrrho’s impotence triggers his ressentiment of dogmatists and labels Pyrrho as a Greek Buddhist in unpublished sections writtenin 1888. For Nietzsche, the only antidote to dogmatism and even nihilism is laughter, a way of overcoming Pyrrho’s obstinate will to truth embodied in the form of logical argumentation. Nietzsche seems to attribute the Democritean cheerfulness (euthumia) to Pyrrho, a manifestation of healthy skepticism and a dynamicconstellation of drives that embrace and overcome suffering. In Thus Spoke Zarathustra, Nietzsche claims that laughter is a sign of recovery from a spirit of excessive seriousness, which is embodied by the free-spirited Zarathustra, an antipode to Pyrrho ‘the fanatic of mistrust.’ [ABSTRACT FROM AUTHOR]

\nHIGHLIGHTSInfertility affects 8–12% of couples globally, with male factors contributing to around 40% of cases. Common male infertility issues include erectile dysfunction (ED) and low sperm count or quality, which account for over 90% of cases. These problems often result from anatomical, hormonal, or genetic abnormalities. This review focuses on natural aphrodisiac herbs commonly used to address ED, providing detailed information on their botanical characteristics, metabolic pathways, recommended dosages, phytochemical properties, side effects, origins, and traditional uses. It also reviews recent studies on medicinal herbs that boost sexual desire and treat urological conditions. By compiling reliable findings from the past decade, the study aims to serve as a comprehensive resource for individuals dealing with sexual health issues. Through careful evaluation of each herb, it offers insights into their effectiveness and limitations, emphasizing the potential of natural treatments as complementary alternatives to conventional therapies for male infertility and related conditions.Anatomy, hormone abnormalities and genetic flaws may contribute to male infertility.The most popular natural aphrodisiac herbs used in the treatment of infertility were revised.Unique and reliable references to sexual desire and urological problems were provided.Safe aphrodisiac herbs including phytochemical products were emphasized.Plants were investigated for their potential as aphrodisiacs and fertility enhancersAnatomy, hormone abnormalities and genetic flaws may contribute to male infertility.The most popular natural aphrodisiac herbs used in the treatment of infertility were revised.Unique and reliable references to sexual desire and urological problems were provided.Safe aphrodisiac herbs including phytochemical products were emphasized.Plants were investigated for their potential as aphrodisiacs and fertility enhancers [ABSTRACT FROM AUTHOR]

Introduction: Erectile dysfunction (ED) is common in men who are in their sixth decade of life and older, particularly those with diabetes. This study aimed to determine whether long-term glycaemic control affects the severity of ED in diabetic male patients attending the diabetic clinic at Kalafong Provincial Tertiary Hospital (KPTH). Methods: This cross-sectional study used data collected at the KPTH Diabetic Clinic, Gauteng, South Africa. Eighty-one male patients aged over 55 years who attended the diabetic clinic in 2017 were selected to participate in this study. The Sexual Health Inventory for Men (SHIM) questionnaire was used to determine the severity of ED, and the mean glycated haemoglobin A1c (HbA1c) over the preceding two years was used to assess glycaemic control. Results: The SHIM distinguished between ED categories among the participants (Cronbach's alpha: 0.964). The HbA1c did not differ significantly between SHIM ED categories (p = 0.867). No significant difference was detected between the mean HbA1c in those with ED (8.26%, IQR: 7.2 to 9.4) and those without ED (7.6%, IQR: 6.7 to 8.9) (p = 0.494). Multivariate analyses revealed that a longer duration of diabetes, moderate albuminuria, the presence of any peripheral neuropathy, the number of antihypertensive agents used, and smoking history were associated with ED. However, the mean HbA1c of the preceding two years did not significantly contribute to ED (p = 0.133). Conclusion: The SHIM reliably distinguished between ED categories in this population, with high internal consistency; however, glycaemic control, as measured by HbA1c over the preceding two years, did not play a significant role in predicting the presence or severity of ED. [ABSTRACT FROM AUTHOR]

AbstractObjectives: To evaluate whether the presence of sexual problems in men (i.e., erectile dysfunction, premature ejaculation, or delayed ejaculation) is associated with differential sexual behavior during masturbation and partnered sex. Methods: Cisgender participants (n = 2,807) completed an internet-based, cross-sectional questionnaire about sexual interest, behavior, and functioning. Results: Men with premature ejaculation were less likely to engage in foreplay-type behaviors, whereas men with erectile dysfunction or delayed ejaculation were more likely to include self-stimulation and/or other stimulation strategies during partnered sex. Conclusions: Different behavioral patterns among dysfunctional men represent potential strategies for modulating sexual arousal levels. [ABSTRACT FROM AUTHOR]

Relationship obsessive compulsive disorder (ROCD) is a disabling presentation of obsessive compulsive disorder (OCD) that has recently received increased research attention. ROCD refers to obsessive preoccupation, doubts, and compulsive behaviors focusing on one's relationship and relationship partner's qualities and attributes). In this paper, we present ROCD through a case study, describe its phenomenology and evaluate the impact of ROCD symptoms on sexual functioning. We then describe processes that may underlie dysfunctional sexual behavior in ROCD drawing on cognitive-behavioral models of ROCD and contemporary theories of sexual response. Conceptual links between ROCD and related constructs to various propensities of sexual behavior are discussed and treatment suggestions are outlined. This paper describes the phenomenon of relationship obsessive compulsive disorder (ROCD), via a case description that presents the reader with the possible effect of ROCD on sexual functioning. We them suggest possible cognitive-behavioral mechanisms that might explain the association between ROCD and sexual dysfunction, and finally, outline several treatment implications. [ABSTRACT FROM AUTHOR]

Sexual minority individuals are at higher risk of mental health concerns than heterosexual individuals due to the impacts of minority stress. Previous counseling interventions for sexual minority individuals have focused on pathology and reducing negative symptoms. However, there is a need for more empirical counseling interventions that address these disparities from a positive psychology perspective. Utilizing a multiple probe single case research design, the current study examined the impact of a well-being therapy protocol for improving the psychological well-being for four sexual minority individuals. There was no functional relation observed for the Well-Being Therapy protocol on psychological well-being. Discussion of the findings and implications for future research are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Testosterone deficiency (TD) is relatively common in aging men, affecting around 2% of the general population. Testosterone replacement therapy (TRT) represents the most common medical approach for subjects who are not interested in fathering. Areas covered: This review summarizes advances in TRT, including approved or non-approved pharmacological options to overcome TD. When possible, a meta-analytic approach was applied to minimize subjective and biased interpretations of the available data. Expert opinion: During the last decade, several new TRT formulations have been introduced on the market, including oral, transdermal, and parenteral formulations. Possible advantages and limitations have been discussed appropriately. Anti-estrogens, including selective estrogen modulators or aromatase inhibitors still represent further possible off-label options. However, long-term side effects on sexual function and bone parameters constitute major limitations. Glucagon-like peptide 1 analogues can be an alternative option in particular for massive obesity-associated TD. Weight loss obtained through lifestyle modifications including diet and physical exercise should be encouraged in all overweight and obese patients. A combination of TRT and lifestyle changes can be considered in those subjects in whom a reversal of the condition cannot be expected in a reasonable time frame. [ABSTRACT FROM AUTHOR]

AbstractWhen men root manhood in sexual performance, their inability to get and maintain an erection (i.e. erectile dysfunction) may pose a threat to ageing men’s ability to enact masculinity. Using data from the 2015–2016 National Social Life, Health and Aging Project (NSHAP) – a nationally representative survey of the USA – this study finds that age and erectile dysfunction interact: men who report ‘trouble getting or maintaining an erection’ have a higher odds of reporting anxiety before sex. However, this effect gradually declines as the sample of men with erectile dysfunction ages (from ages 49 to 95). Additionally, men who do not report erectile dysfunction have the same odds of sex-anxiety throughout the sample, regardless of their age. The change in sexual performance may cause distress for men, as they feel unable to maintain their dominant masculinity in old age. While previous studies have shown that age and gender interact to affect men’s sexual health in mid-life and later-life, this study adds to the feminist gerontology literature by providing indirect evidence that changes in sexual response may become gradually less anxiety-inducing, and thereby, less threatening for men as they age. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM) is a global health issue in the twenty-first century, and there are numerous challenges in preventing and alleviating its chronic complications. The herb Epimedium has beneficial therapeutic effects on various human diseases, including DM. Its major flavonoid component, icariin, has significant anti-DM activity and may help improve pancreatic β-cell dysfunction and insulin resistance. Furthermore, preclinical evidence has shown that icariin and its in vivo bioactive form, icariside II, have preventive and therapeutic effects on several diabetic complications, including diabetic cardiomyopathy, diabetic vascular endothelial disorder, diabetic nephropathy, and diabetic erectile dysfunction. In this review, we present the general and toxicological information concerning icariin and icariside II and review the anti-DM effects of icariin from a molecular perspective. Additionally, we discuss the potential benefits of icariin and icariside II on the important pathological mechanisms of various diabetic complications. Despite positive preclinical evidence, additional investigations are needed before relevant clinical studies can be conducted. Therefore, we conclude with suggestions for future research. Hopefully, this review will provide a comprehensive molecular perspective for future research and product development related to icariin and icariside II in treating DM and diabetic complications. [ABSTRACT FROM AUTHOR]

After the 1989–1992 collapse of the Soviet bloc, Eastern European countries underwent rapid socioeconomic changes from state socialism to neoliberal capitalism. Yet, research from these countries has been only scarcely used to study the neoliberalization of sexuality. To fill this gap, this article examines heterosexual masculinity in Poland at the turn of the 1980s and 1990s. Using Foucauldian approaches to discourse, I analyze how sexual problems were discussed in Pan, the first Polish lifestyle magazine for men (1987–1993). I demonstrate that, in contrast to the neoliberal models of heterosexuality, the state-socialist masculinity of Pan did not advocate discipline, control, and sexual mastery, but it repudiated egalitarianism and reciprocity of pleasure. Heterosexual dynamics in Pan prioritized men's interests at the expense of women, whom various sexual experts silenced, admonished, and blamed for sexual difficulties. As a result, Pan constructed a deeply patriarchal masculinity of unaccountability and entitlement to women's submissiveness. These findings add novel insights that help understand the ideologies of sexuality under state socialism. [ABSTRACT FROM AUTHOR]

To explore men's views on the causes and consequences of two common sexual dysfunctions – erectile dysfunction and premature ejaculation – and how this affects physical and mental health as well as social life and intimate or close relations. A qualitative design with semi-structured interviews using open-ended questions was employed. Individual interviews were conducted, audio recorded and transcribed, and a qualitative content analysis of the text was performed. Informants were recruited from an outpatient primary care clinic in Sweden that offers consultation about sexual health to primarily younger men, age 20 years and above. A total of 18 participants were included in the study, ten with erectile dysfunction and eight with premature ejaculation or both. Using the content analysis, different views and strategies of erectile dysfunction and premature ejaculation were presented to illustrate a range of perceptions. The main theme emerged as 'Striving to understand and deal with the problem', which was divided into four categories: 'Reasons for seeking healthcare', 'Own perceptions/images about the problem and its cause', 'Experienced consequences on sex life' and 'Relationship qualities'. Participants experienced their problems in relation to a partner. Feelings of shame and fear of not being fit for desired sexual practices were common. They thought that underlying physical illness or previous sexual activities could have caused their problems. Decreased sexual desire and low self-esteem were seen as consequences, and participants wished for both medical treatment and counselling as support. Sexual dysfunction impairs general health and relationships with partners. While counselling is the basic treatment, those who are offered pharmaceutical treatment need follow-up concerning effectiveness and potential concerns. People with sexual dysfunction may have decreased quality of life and poorer somatic and mental health in general. People with sexual dysfunction may have few places to turn to in a traditional primary health care setting. The participants expressed concerns about their physical health, their relationships with partners and motivation for treatment. Men's visits to primary care for sexual dysfunction provides opportunities to talk about lifestyle and relationships and discover other illnesses. [ABSTRACT FROM AUTHOR]

Narrating illness experiences in a culturally acceptable manner is essential for retaining quality of life after the disruptive event of being diagnosed for prostate cancer. Psychological pressures caused by treatment side-effects such as erectile dysfunction require reinterpretation of the meanings and impacts of these side-effects on masculinity. This helps maintain coherence in men's lives. We studied how men employ culturally available discursive strategies (compensation, redefinition, recontextualisation, and normalisation) in reconstructing masculinity and sexuality. Our data consists of 22 interviews of heterosexual Finnish prostate cancer patients who had undergone surgery. The aim was to analyse the ways in which various life situations and social relations shaped and limited the use of these strategies. Discourse analysis revealed that older age, a supportive spouse, children, supportive male friends, and good health – were key elements men used in reconstructing a coherent new self-image and conception of life following cancer treatment. Men with sexually active male friends, men without families, younger men and men with new intimate relationships struggled to develop a new version of their masculinity. Being able to effectively utilise certain aspects of one's life situation in re-constructing masculinity is important in maintaining quality of life despite troublesome treatment side-effects. [ABSTRACT FROM AUTHOR]

The association between alcohol use and erectile dysfunction (ED) has not been explored adequately. The aim of this study is (i) to determine the prevalence of ED in patients with Alcohol use disorder (AUD), (ii) the association of ED with sociodemographic and clinical variables, (iii) the association between severity of drinking and sociodemographic and clinical variables, and (iv) the assess the change in ED after one month of abstinence from alcohol. 203 consecutive patients were recruited into the study after taking written informed consent. Sociodemographic data was collected using a proforma and ED was assessed using International Index of Erectile Function-5 (IIEF-5). The patients were also followed up after 1 month of abstinence to assess the change in erectile function. The prevalence of ED was 68.5%. Out of the 203 subjects, 28.1% had mild ED, 24.1% had mild to moderate ED, 9.9% had moderate ED and 6.4% had severe ED. Significant association were seen between ED and age, marital status, diabetes mellitus, hypertension, total duration, and severity of drinking. A significant association was seen between severity of drinking and age, diabetes mellitus, hypertension, alcoholic liver disease, tobacco use and duration of drinking. The improvement in ED after 1 month abstinence was found to be significant. ED is a common problem in patients with AUD. Routine assessment of sexual functioning is warranted in patients with AUD and the information that ED improves with abstinence can provide an impetus to change. [ABSTRACT FROM AUTHOR]

Previous machine learning approaches fail to consider race and ethnicity and social determinants of health (SDOH) to predict childhood asthma exacerbations. A predictive model for asthma exacerbations in children is developed to explore the importance of race and ethnicity, rural-urban commuting area (RUCA) codes, the Child Opportunity Index (COI), and other ICD-10 SDOH in predicting asthma outcomes. Insurance and coverage claims data from the Arkansas All-Payer Claims Database were used to capture risk factors. We identified a cohort of 22,631 children with asthma aged 5–18 years with 2 years of continuous Medicaid enrollment and at least one asthma diagnosis in 2018. The goal was to predict asthma-related hospitalizations and asthma-related emergency department (ED) visits in 2019. The analytic sample was 59% age 5–11 years, 39% White, 33% Black, and 6% Hispanic. Conditional random forest models were used to train the model. The model yielded an area under the curve (AUC) of 72%, sensitivity of 55% and specificity of 78% in the OOB samples and AUC of 73%, sensitivity of 58% and specificity of 77% in the training samples. Consistent with previous literature, asthma-related hospitalization or ED visits in the previous year (2018) were the two most important variables in predicting hospital or ED use in the following year (2019), followed by the total number of reliever and controller medications. Predictive models for asthma-related exacerbation achieved moderate accuracy, but race and ethnicity, ICD-10 SDOH, RUCA codes, and COI measures were not important in improving model accuracy. [ABSTRACT FROM AUTHOR]

Body mass index (BMI) and serum albumin (ALB) level are long-established markers that reflect the nutritional status and eventually the prognosis of cancer patients. The objective of the study was to determine the clinical significance of these factors and specify their roles in outcomes compared with performance status (PS) and weight loss (WL), which are considered the most significant patient-related prognostic factors in small cell lung cancer (SCLC) treated with platinum-etoposide-based chemotherapy. A total of 378 patients with SCLC were enrolled in the study and analyzed retrospectively. BMI values were similar by clinical stage, whereas the percentages of the patients with WL, low serum ALB, and particularly poor (≥2) PS were significantly higher in patients with extended disease SCLC (ED-SCLC) compared to those with limited disease SCLC (LD-SCLC). In LD-SCLC, patients with poor PS lived for a significantly shorter time than patients with good PS (HR: 7.791, p = 0.0001); however, BMI (HR: 1.035, p = 0.8), WL (HR: 0.857, p = 0.5), and ALB (HR: 0.743, p = 0.3) had no significant effect on the outcome. In ED-SCLC, PS (HR: 4.257, p = 0.0001), WL (HR: 1.677, p = 0.001), and ALB (HR: 0.680, p = 0.007) had an impact on survival, but BMI did not (HR: 0.791, p = 0.08). In LD-SCLC, the univariate analysis showed that only poor PS was correlated with increased mortality (HR: 7.791, p = 0.0001); yet it lost significance in multivariate analysis. In ED-SCLC, poor PS (HR: 4.257, p = 0.0001), WL (HR: 1.667, p = 0.001), and a low ALB level (HR: 0.680, p = 0.007) were shown to be factors for poor prognosis in the univariate analysis; yet only PS remained significant in multivariate analysis (HR: 2.286, p = 0.001). Even though BMI and serum albumin showed no prognostic value in SCLC patients treated with chemotherapy, PS was found to be the most significant prognostic factor in both LD- and ED-SCLC stages. [ABSTRACT FROM AUTHOR]

Sexual aversion disorder (SAD) is a chronic condition that impacts sexual and psychological well-being. However, the relevance of SAD as a discrete disorder remains highly debated. This study aimed to clarify the status of SAD as either a distinct disorder or a trans-diagnostic symptom shared among sexual dysfunctions. This cross-sectional study used a latent class analysis approach among a Canadian community sample (n = 1,363) to identify how patterns of SAD symptoms (i.e., sexual fear, disgust, and avoidance) emerge across different spheres of sexual functioning (i.e., desire and arousal, erection or lubrication, genito-pelvic pain, and orgasm) and examine sociodemographic and psychosexual correlates of the identified classes. Examination of fit indices suggested four classes: Sexually functional, Impaired desire and responsiveness, Sexual aversion, and Comorbid sexual dysfunctions. Sexual aversion class members were more likely to be single, had experienced sexual assault in adulthood, and report lower levels of sexual satisfaction and psychological well-being, compared to Sexually functional class members. Results suggest that SAD is a distinct clinical syndrome, while its symptoms may co-occur with other sexual dysfunctions. To ensure that the needs of people with SAD are met with tailored treatment options, future nosography might consider reclassifying SAD as a specific disorder. [ABSTRACT FROM AUTHOR]

We aim to evaluate the effect of testicular trauma on male reproductive outcomes. The electronic medical record was retrospectively searched using diagnosis codes for testicular trauma and procedure codes for testicular trauma repairs, at Los Angeles County and Parkland Hospitals, for males aged 18–55 years. Charts were reviewed for trauma details, reproductive hormones, and semen analyses. Men were contacted by phone for a fertility and sexual performance survey. Fifty-six patients were identified as having testicular trauma. Twelve were reached by telephone, of which 33.3% had blunt and 66.7% had penetrating traumas. The mean duration since trauma was 41 months. One quarter reported new-onset erectile dysfunction post-trauma, 16.7% endorsed new-onset dysuria, 8.3% endorsed long-term testicular pain. Only two males (16.7%) attempted paternity post-trauma, both with primary infertility. One patient (8.3%) was attempting paternity post-trauma and experiencing primary infertility for 42 months. Two patients (16.7%) had undergone semen analysis testing, both patient-reported as 'normal'. None of the 12 patients we reached were under the care of a urologist. Both short and long-term urologic follow-up is crucial for testicular trauma patients. Despite some experiencing lasting consequences, none of these men were under the care of a urologist. [ABSTRACT FROM AUTHOR]

Objective: To investigate sexual function stratified according to four clinical phenotypes of polycystic ovary syndrome (PCOS) and its association with clinical and quality of life parameters, and to compare these with healthy controls in Chinese women with PCOS. Methods: A cross-sectional study was designed in 1000 PCOS women and 500 control women aged 18–45 years. PCOS women were grouped into four clinical phenotypes according to the Rotterdam Criteria. FSFI (Female Sexual Function Index), SF-12 (the 12-item short form health survey) and clinical and hormonal characteristics likely to affect sexual function were determined. Results: 809 PCOS women and 385 control women with complete parameters were evaluated after screening. Phenotype A had a lower total FSFI mean score (23.14 ± 3.22) compared with phenotype D and control group (p < 0.05). The control group had the highest total FSFI mean score (24.98 ± 3.78). For the percentage at risk of sexual dysfunction, phenotype A (87.5%) and phenotype B (82.46%) had a higher risk of female sexual dysfunction (FSD) than that in phenotype C (75.34%), phenotype D (70.56%) and control group (61.30%) (p < 0.05). SF-12 mental domain scores were significantly lower in phenotypes A and B compared with phenotypes C and control group (p < 0.05). Infertility treatment, bioavailable testosterone, psychological factors, age and waist circumference presented negative correlation with female sexual function. Conclusions: The risk of FSD in PCOS women seemed to be associated with PCOS clinical phenotypes. The classical PCOS phenotype with oligo-ovulation and hyperandrogenism had a higher risk of sexual dysfunction. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in females in the reproductive period with estimated prevalence of 5% to 18% [1]. It contributes to the mortality and morbidity in patients with PCOS due to the increased risk of different metabolic and cardiovascular (CV) complications [2]. Despite the presence of obesity in 40-60% of cases [3], the disease may occur in non-obese women. The occurrence of metabolic disorders in non-obese PCOS patients, suggests that the syndrome itself may play a role in the development of metabolic and CV co-morbidities [4]. The identification of early stages of atherosclerosis in patients with PCOS might be useful in the development of new strategies to control modifiable CV risk factors [5]. Assessment of vascular endothelial function (ED) as an initial reversible step in atherosclerosis development, may serve as an integral index for CV risk factor burden [6]. In addition, carotid intima media thickness (CIMT) is a helpful marker for atherosclerosis and for the identification of increased risk of CV disease [7]. Our study assessed the early vascular changes in Egyptian women with PCOS both physically and functionally by looking at the CIMT using high resolution Doppler ultrasound and by measuring ED using brachial artery flow–mediated vasodilatation (FMD). Our results indicate that patients with PCOS have significant ED and premature atherosclerosis which is, to a great extent, independent of obesity and IR. This suggests that PCOS patients are at increased risk for premature CVD and may benefit from early detection and management. [ABSTRACT FROM AUTHOR]

Dieffenbachia standleyi Croat is a plant belonging to Araceae and is native to Central America, and South America. While there have been studies on the Dieffenbachia species, Dieffenbachia standleyi Croat has yet to be studied in depth. Dieffenbachia was used as a folk remedy to prevent inflammation and treat gout, erectile dysfunction, and coldness. Thus, this study investigates the pharmacological function of Dieffenbachia standleyi Croat's methanol extract (DSE). When RAW 264.7 macrophages were treated with DSE and stimulated with lipopolysaccharide, DSE reduced the expression of inducible nitric oxide (NO) synthase and cyclooxygenase-2, thereby decreasing NO and prostaglandin E2 production and pro-inflammatory cytokines including IL-1ß, IL-18, IL-6, and TNF-a. By confirming DSE's anti-inflammatory mechanisms, we determined that DSE inhibits IκBa phosphorylation in the nuclear factor κappa B pathway, and inflammasome formation, without affecting MAPK pathways. This study suggests that Dieffenbachia standleyi Croat is a potential anti-inflammatory agent for inflammatory diseases. [ABSTRACT FROM AUTHOR]

Background: Erectile dysfunction (ED) is a common diabetes-related complication. Materials and methods: This study examined the effect of daily low-dose tadalafil (5mg) on patients' quality of life (including that of sex life) and blood circulation. Erectile dysfunction questionnaires were administered to 20 patients with type 2 diabetes (T2DM) and ED. The safety and efficacy of tadalafil were evaluated using laboratory tests, and the effect on blood circulation was measured through nail fold capillaroscopy. Results: Daily tadalafil use by patients with T2DM and ED showed a statistically significant increase in the erectile reliability score from of 1.15 to 3.20 (p < .00012). Capillary blood circulation improvement tests showed a statistically significant increase in apical limb width from 13.1 to 14.64 mm (p = .04829) and flow from 9035 to 11946 µm³/s (p = .04405). Although not significant, increased capillary width and speed (rate of blood flow) confirmed improved blood circulation. There were no significant changes in the cardiac indicators (troponin, prostate-specific antigen, or electrocardiogram tests) before and after tadalafil administration, supporting the safety of its low-dose daily administration. Conclusions: A small dose of daily tadalafil was shown to safely improve erectile dysfunction and peripheral blood flow in patients with T2DM, in which peripheral arterial diseases should not be considered separately but rather as complex entities. [ABSTRACT FROM AUTHOR]

The present study evaluated the effect of lead exposure with and without zinc therapy on male sexual and erectile function. Twenty male Wistar rats were randomly assigned into four groups; the control, zinc-treated, lead-exposed, lead + zinc-treated groups. Administrations were per os daily for 28 days. Zinc co-administration significantly improved absolute and relative penile weights and the latencies and frequencies of mount, intromission, and ejaculation in lead-exposed rats. Also, zinc ameliorated lead-induced reductions in motivation to mate and penile reflex/erection. These findings were accompanied by attenuation of lead-induced suppression of circulating nitric oxide (NO), penile cyclic guanosine monophosphate (cGMP), dopamine, serum luteinizing hormone, follicle-stimulating hormone, and testosterone. In addition, zinc alleviated lead-induced upregulation of penile activities of acetylcholinesterase and xanthine oxidase (XO), and uric acid (UA) and malondialdehyde (MDA) levels. Furthermore, zinc ameliorated the lead-induced decline in penile nuclear factor erythroid 2-related factor 2 (Nrf2) and reduced glutathione (GSH) levels, and catalase, superoxide dismutase (SOD), glutathione peroxidase (GPx), and glutathione-S-transferase (GST) activities. This study revealed that co-administration of zinc improves lead-induced sexual and erectile dysfunction by suppressing XO/UA-driven oxidative stress and upregulating testosterone via Nrf2-mediated signaling. [ABSTRACT FROM AUTHOR]

The study aims to determine whether body mass index (BMI), metabolic syndrome (MS) or its individual components (primary hypertension, type 2 diabetes mellitus and dyslipidemias) are risk factors for common urological diseases. Cross-sectional study with data collected on February 28, 2022 from the TriNetX Research Network. Patients were divided in cohorts according to their BMI, presence of MS (BMI > 30 kg/m2, type 2 diabetes mellitus, primary hypertension and disorders of lipoprotein metabolism) and its individual components and its association with common urological conditions was determined. For each analysis, odds ratio (OR) with 95% confidence intervals were calculated. Statistical significance was assessed at p <.05. BMI > 30 kg/m2 was associated with increased risk of lithiasis, kidney cancer, overactive bladder, male hypogonadism, benign prostatic hyperplasia, and erectile dysfunction (p <.05). On the contrary, BMI was inversely associated with ureteral, bladder and prostate cancer (p <.05). In all urological diseases, MS was the strongest risk factor, with prostate cancer (OR = 2.53) showing the weakest and male hypogonadism the strongest (OR = 13.00) associations. MS and its individual components were significant risk factors for common urological conditions. Hence holistic approaches with lifestyle modification might prevent common urological disease. Overall, metabolic syndrome is the strongest risk factor for all the analysed urological diseases. Abnormally high body mass index can be a risk or protective factor depending on the threshold and urological disease that are being evaluated. Metabolic syndrome and increased BMI should be considered important factors associated to the prevalence of common urological diseases. [ABSTRACT FROM AUTHOR]

Assessing the extent to which COVID-19 impacted hospitals can provide important learnings for future pandemics. This study aims to determine the impact of the 7-month duration COVID-19 pandemic-related lockdown orders on ophthalmology-related hospital admissions and emergency department (ED) presentations, during 2020 in Victoria, Australia. Analysis was performed on Victorian statewide data from the Victorian Emergency Minimum Dataset (VEMD) and Victorian Admitted Episodes Dataset (VAED), between 1 January 2018 and 31 October 2020. Numbers of presentations and admissions for key ophthalmic conditions were stratified by age, socioeconomic status, location (metropolitan versus rural), and triage category. From the observations occurring in the pre-pandemic period (January 2018 to March 2020), a linear regression prediction model was built for each diagnosis which predicted what the presentation number in the COVID-19 period would have been if the pandemic had not occurred. Based on pre-COVID-19 trends, the largest decreases in expected admissions were for glaucoma (32.9%) and retinal breaks and detachments (21.2%). For the ED data, the most apparent changes were: an increase in presentations for foreign bodies (22.6%); a decrease in retinal detachments (35.5%); and a decrease in keratitis (18.4%) relative to predictions. Hospital admissions decreased and patterns of ED attendances changed during lockdown. The findings suggest the need for the following: increased safety messaging to avoid eye injuries around the home; improved pathways for safe and rapid triaging of eye conditions in the community to ensure effective use of ED resources; and messaging to ensure that people do not delay care when they notice signs of sight-threatening conditions such as retinal detachment. [ABSTRACT FROM AUTHOR]

Background/Objective: Using two different high-risk samples, the present study compared and contrasted two different strategies/questionnaire types for assessing a history of sexual violence: a general trauma screening vs. specialised behaviourally-specific questionnaires. Methods: Sample 1 included 91 men and women seeking detoxification treatment services in a publicly funded, urban clinic who completed a trauma and substance use questionnaire battery during treatment. Sample 2 included 310 women at a rural college who completed a trauma and religious coping questionnaire battery for course credit. All participants completed both types of questionnaires: One general trauma screening questionnaire (i.e. the Life Events Checklist [LEC]) and two behaviourally-specific specialised questionnaires (i.e. the 2007 Sexual Experiences Survey [SES] and the Childhood Trauma Questionnaire [CTQ]). Results: There were large differences in the cases identified by the behaviourally-specific questionnaires (SES and CTQ) compared to the general trauma screening questionnaire (the LEC) in both samples but few differences in the prevalence rates of sexual violence detected by each questionnaire type. In the detoxification sample, the differences were especially notable for men. Follow-up analyses indicated that degree of traumatisation impacted results likely by increasing participant's willingness to endorse face-valid items on the LEC. Conclusions: For men, the behaviourally-specific questionnaires (SES/CTQ) were necessary to identify cases. For those with more severe trauma histories, the LEC was equivalent to the SES/CTQ in identifying a similar number of sexual violence cases. Thus, clinicians and researchers should consider the population when selecting assessments to identify sexual violence history. For men and rural college women, general trauma questionnaires are not as accurate as specialised sexual violence measures in detecting cases. While prevalence rates were often similar, which cases were detected by general trauma and specialised questionnaires were different. Individuals with greater trauma exposure were more likely to endorse face-valid sexual violence items on the general trauma questionnaires. [ABSTRACT FROM AUTHOR]

This review aims to summarize the findings from recent literature (2010–2022) reporting on complications that resulted from the surgical use of SURGICEL for intraoperative hemostasis. A literature search was conducted using the MEDLINE (OVID), Embase, and Cochrane Central Register of Controlled Trials – CENTRAL (OVID) databases. The studies were sorted into case reports and other study types for data extraction. Covidence was used for data extraction and statistics were descriptive. Of the total 560 articles screened, 73 papers were selected for a full-text review and 70 studies were included in this review. A total of 7,242 participants were included in the studies (case studies n = 93, others n = 7149). 67/70 of the included studies reported complications when SURGICEL was used intraoperatively. Reported complications included: SURGICEL induced masses (granulomas, abscesses, hematomas, cysts) (n = 25), hemorrhagic complications (n = 12), masses misdiagnosed as tumors, cardiovascular, nervous system, and hepatobiliary complications, pain, and infections. Other complications included: fistulas, erectile dysfunction, chorioamnionitis, swelling, urinary leak, renal failure, and anaphylaxis. Publications reporting on complications associated with the use of SURGICEL intraoperatively have continued to emerge. Future studies should compare how the types and rates of complications compare between SURGICEL and alternative hemostatic agents. [ABSTRACT FROM AUTHOR]

Refugee and asylum seeker women face a variety of health challenges. However, little is known globally about health problems in these women at midlife and beyond, including menopausal symptoms, sexual dysfunctions and pelvic floor disorders. This scoping review aimed to understand these neglected health issues with respect to prevalence and risk factors. Eight databases were searched in August 2022 without the limit of publication year. Data were analyzed narratively. A total of 10 reports from seven studies were included with 945 women living in Australia, Canada, the USA and Pakistan. Three reports were addressing menopause, seven addressed sexual dysfunctions and one addressed pelvic floor disorders. There were no data regarding menopause symptoms; however, perceptions of menopause varied widely across studies. Few studies reported a high prevalence of sexual dysfunctions and pelvic organ prolapses, but none of them used a validated questionnaire. Taboos and cultural factors, lack of knowledge and education, lack of family support, language insufficiency and financial problems were common barriers to not seeking care for these health issues. This review demonstrates lack of evidence of these neglected health issues in refugee and asylum seeker women at midlife, and further studies with validated questionnaires and larger samples are warranted. [ABSTRACT FROM AUTHOR]

The famous discussion of Scythian cross-dressers in Hippocrates' Airs Waters Places (Aer.) 22 puzzled perhaps most medieval and Renaissance medical authorities. The text wrestled with a pre-Hippocratic, encephalocentric theory of spermatogenesis. Modern reception of the convoluted hypothesis put forward here gradually distilled three etiologies of failing virility: impotence, subfertility, and unmanliness. A gradual shift is discernable from increasingly Galenic neuro-andrological theories (sixteenth century) to neuropsychiatric (late-seventeenth through eighteenth century), phrenological and psychopathological (early- and late-nineteenth century), and finally early psycho-endocrinological (early-twentieth century) ideas about masculinity. Aer. 22 was a ubiquitously recurring reference across all of these episodes, indeed well beyond medicine, rendering it a highly sensitive index of change in neurodevelopmental and neuropsychiatric thinking. The pre-Enlightenment, neurology-centric onset of this extended modern history of sexual/gender medicine is briefly discussed, as well as its phrenological afterlife. [ABSTRACT FROM AUTHOR]

Erectile dysfunction (ED) is one of the most common sexual health diagnoses in men. Previous studies demonstrated that ED can be even more prevalent among sexual minority men. This study investigated whether sexual identity is related to erectile function (EF) and explored variables possibly contributing to the differences between Polish straight and sexual minority men. The study sample included 1,246 gay, 838 straight, and 535 bisexual men who participated in an online survey. First, the psychometric qualities of the IIEF-2-EF scale used in the study were examined through confirmatory and exploratory factor analysis; a correction to account for potential bias in the questionnaire was also applied. Next, a series of univariate and multivariable models accounting for predictors possibly contributing to the observed differences between the groups of men were conducted. It was demonstrated that gay and bisexual men were more likely to show poorer EF. However, as demonstrated in the subgroup of men who were in relationships, sexual identity lost its significance when the unique characteristics of minority men's sexuality (i.e., less focus on insertive penetrative sex in gay men and more frequent relational non-exclusivity in bisexual men) were controlled for. Erectile problems in minority men may benefit from clinical consideration in the unique context of their sexuality. [ABSTRACT FROM AUTHOR]

We analyzed data from the 2018 Sex in Canada survey (n = 1,015 cisgender men) to examine the association between feminist identification and reported use of prescription ED medication (EDM) during men's last sexual encounter. Feminist-identified men were substantially more likely to report EDM use than non-feminist men, even after controlling for alcohol use before sex, erection difficulties, sexual arousal, sexual health, mental health, and physical health. One explanation is that feminist men may use EDM to bolster their masculinity when it is otherwise threatened by their identification as feminist. Another is that non-feminist men may be less likely to use prescription EDM because they view accessing healthcare services as a threat to their masculinity. It is also possible that feminist men are more likely to use EDM because they wish to maintain an erection to better please their partner. Lastly, feminist men may be more honest about EDM use than non-feminist men, even though rates are similar. Regardless of the exact reason, therapists can use these results to tailor sexual health messages to clients based on feminist identification. Future work could employ qualitative methods to understand why feminist men report higher rates of EDM use than non-feminist men. [ABSTRACT FROM AUTHOR]

Black women experience persistent sexual pain that may often last longer than White women. Despite the value of sexual communication to alleviate sexual pain concerns, many women do not disclose sexual pain to their partners. Limited research explores barriers to disclosing sexual pain to partners among Black women. This study seeks to fill this gap. Relying on an integration of Sexual Script theory and Superwoman Schema, the study explored the barriers that premenopausal, cisgender Black women from the Southern USA perceived when disclosing sexual pain to their primary partners. We identified five common themes from women's open-ended responses to an online survey: (a) distressing emotions associated with disclosure; (b) limited knowledge and communication skills; (c) protecting partner's feelings and ego; (d) invading privacy; and (e) taking sole responsibility for managing sexual pain. Findings suggest a combination of intrapsychic, interpersonal and cultural factors influence Black women's perceived ability to have direct and open dyadic communication about sexual pain with their partners. Implications for Black women's sexual health and relationship outcomes are discussed. [ABSTRACT FROM AUTHOR]

A noticeable tendency in the first generation of scholarship on sexual orientation and gender identity/expression (SOGIE) in Africa has been the focus on urban or modern institutional settings. A dominant theme is to document people's struggles against stigma, fear and violence to better inform interventions to strengthen human rights and sexual health for all. In some cases, unintentionally, the impression conveyed of Africa is of a continent with cultures that are uniformly, hostile to SOGIE rights. The present study arises from a large survey among boys and men in KwaZulu-Natal, South Africa that problematises that impression. The study revealed unexpectedly high levels of same-sex sexual experience among boys and men in a mostly rural, culturally conservative setting. Following from that revelation, we conducted in-depth interviews to gain insight into their lives. Informants did indeed recount many incidents of discrimination and violence and admitted to sometimes severe emotional health problems. Yet they also spoke of finding love, acceptance, allies, resources, humour and hope for the future. In this paper, we tease out key themes from the interviews in relation to trends in the scholarship. [ABSTRACT FROM AUTHOR]

Conflict-related sexual violence (CRSV) is one of the most severe and stigmatizing human rights violations. The recognition of men and boys as targets of sexual violence is a rather recent development. In the present study data on experiences of sexual violence as well as mental health outcomes were analysed in recently arrived male refugees (N = 392) in Germany. More than one third of the men interviewed (n = 128; 36.6%) reported having experienced sexual violence. Compared to male refugees without experiences of sexual violence, male refugee survivors showed higher prevalence rates of PTSD. Moreover, some differences were found between the subgroups on the single symptoms level, indicating higher severity in those affected by sexual violence, including negative alterations in cognition/mood, suicidal ideation, and nervousness or shakiness inside. The findings provide initial data on prevalence of sexual violence and related mental health outcomes in male refugees newly arrived in Germany and emphasize the significance of sexual violence as a risk factor for different mental health outcomes. This provides clear implications for health care professionals that could aid them in better identifying those affected. Finally, further research is urgently needed that takes a closer, more differentiated look at sexual violence in male refugee populations. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the existing mobile applications focused on sexual health and analyze the included content and therapeutic techniques. Three databases with mobile applications were searched and 47 applications met the criteria. More applications have been developed for men, most of them included content for erectile dysfunction, and only one for vaginismus. Most apps included sexuality tips and Kegel exercises, and only one technique for working on thoughts and emotions. In conclusion, a number of mobile applications have been developed to enhance sexual functioning, but scientific verification of their effectiveness has been completely lacking. [ABSTRACT FROM AUTHOR]

There are a variety of conditions under which religiosity may be positively or negatively associated with sexual and relationship satisfaction. To better understand these conditions, we conducted two studies using two separate samples: one with individuals (1,695 individuals), and one with couples (481 dyads), to test how sexual sanctification and sexual mindfulness moderate these associations. Across studies sexual mindfulness was positively associated with sexual and relationship satisfaction for the individual and partner, but there was no evidence for moderation; sexual sanctification was consistently associated with higher sexual and relationship satisfaction, and in some cases moderated the association between religiosity and both sexual and relationship satisfaction for women and men. In Study 1, religiosity was associated with lower sexual and relationship satisfaction for both men and women when sexual sanctification was low, but not with either type of satisfaction when sexual sanctification was high. In Study 2, religiosity was positively associated with sexual satisfaction for men but only when sexual sanctification was high. The combined evidence indicates that sexual sanctification may be one factor that distinguishes whether religion helps or hinders sexual and relationship satisfaction. [ABSTRACT FROM AUTHOR]

Emotion regulation is a transdiagnostic process strongly related with emotional difficulties, which may interfere with sexual functioning. Little is known about this association in athletes. The current study examined differences in difficulties in emotion regulation in sports practitioners with and without sexual difficulties. A total of 174 athletes (64 women and 110 men) completed a web-survey, answering a sociodemographic information questionnaire, the Difficulties in Emotion Regulation Scale – Short Form, and the Female Sexual Functioning Index/the International Index of Erectile Function. Results suggested that 34 women (53.1%) experienced sexual difficulties and 40 men (35.1%) reported erectile difficulties. Women with sexual difficulties revealed greater difficulties in goal-directed behavior. Men with erectile difficulties revealed greater lack of emotional awareness and clarity, more difficulties in goal-directed behavior (focusing on relevant information and ignoring distractors) and impulse control, and higher nonacceptance of emotions. Overall, current findings enhance the role of difficulties in emotional regulation in sexual functioning in male and female sports practitioners. [ABSTRACT FROM AUTHOR]

This study examined the associations among erectile difficulties, sexual satisfaction, and relationship satisfaction, and whether there is a buffering effect of non-penetrative partnered sex on relationship satisfaction in men aged 50+ who report erectile difficulties. An analysis of survey data from 431 Czech men (aged 50–96, Mdn = 64). Engagement in non-penetrative partnered sex did not moderate the relationship between erectile difficulties and sexual and relationship satisfaction, but it was linked to higher sexual and relationship satisfaction. The buffering effect of non-penetrative practices for the link between erectile difficulties and relationship satisfaction has not been supported. [ABSTRACT FROM AUTHOR]

Men convicted of rape are a heterogenous group among individuals with sexual offending history. This may contribute to the difficulty of establishing adequate treatment during institutionalization and preventing recidivism after release. Therefore, we aimed to identify an empirical typology of individuals convicted of rape based on (a) common criminological variables (age at first offense, number of prior convictions, relation to the victim), (b) offense behavior (alcoholization during the offense) and (c) clinical diagnoses (substance abuse and dependence, psychopathy, sexual sadism, Cluster B personality disorders, paraphilias, paraphilia-related disorders) associated with the risk of sexual offending. Data of N = 575 adult males with raping history were analyzed. We found four types with different profiles in the described variables: an antisocial impulsive, a sexualized, a highly violent and a non-criminal situational type. The types significantly varied in prognostic validity for violent, but not sexual, recidivism. Also, the typology exhibited a slightly higher predictive validity for violent recidivism than Static-99 scores. In contrast to Static-99, the typology failed to significantly predict sexual recidivism. Although the types explained more variance of violent recidivism than Static-99 scores, the value of applying a broad set of risk factors in contrast to combining only few are discussed. [ABSTRACT FROM AUTHOR]

This article argues that the works of Ludwig Tieck—specifically the fairy tales collected in Phantasus—and the poems of Friedrich Hölderlin operate according to an aesthetics of impotentiation. Impotentiation designates the coexistence of seemingly opposed operations: on the one hand, the generation of forms that can be developed further in unexpected directions; and on the other hand, impotence, a condition whereby processes of emergence are brought to a standstill. The works of Tieck and Hölderlin draw on these operations to imbue sites of deviant emergence with uncertainty, albeit directed toward different ends. Tieck dramatizes the shifting of states in which everyday forms of intelligibility are briefly suspended, thereby allowing individuals to explore alternative forms of being, some of which are transgressive, some of which are redemptive, if but for a short while; his tales gesture at impotent forms not capable of development, but nevertheless invested with a critical force over and against problematic reality. Hölderlin situates his poetic voice on the cusp of an emergent order that would entail a revolutionary suspension of cultural norms; poised between the possibility of renewal and the danger of annihilation, his poetry invests such inflection points with an increased sense of urgency. [ABSTRACT FROM AUTHOR]

Eurycoma longifolia Jack (EL) has been used for treating erectile dysfunction, in which inflammation plays a major role. EL tissue cultures can overcome the shortage of material; however, the anti-inflammatory property of such cultures has not been investigated. Herein, we evaluated the anti-inflammatory effects of root and callus cultures of EL and of a related species, Eurycoma harmandiana Pierre (EH), on lipopolysaccharide-activated RAW 264.7 cells. Eurycomalactone and 9-methoxycanthin-6-one were the predominant compounds in EL calli. Eurycomanone content was 0.283 mg/g in EL root culture and 0.348 mg/g in intact roots. The extracts of the root and callus cultures significantly inhibited nitric oxide production, and inhibited the expression of iNOS, IL-6, and COX-2 genes. Overall, the tissue cultures of EH and EL produced eurycomanone, chaparinone, eurycomalactone, 9-hydroxycanthin-6-one, canthin-6-one, and 9-methoxycanthin-6-one, which exhibited anti-inflammatory effects. These tissue cultures may be a valuable and sustainable source of active ingredients effective against inflammatory conditions. [ABSTRACT FROM AUTHOR]

Introduction: Phytochemicals have garnered much attention because they are useful in managing several human diseases. Yohimbine is one such phytochemical with significant pharmacological potential and could be exploited for research by medicinal chemists. It is an indole alkaloid obtained from various natural/synthetic sources. Aims and Results: The research on yohimbine started early, and its use as a stimulant and aphrodisiac by humans has been reported for a long time. The pharmacological activity of yohimbine is mediated by the combined action of the central and peripheral nervous systems. It selectively blocks the pre and postsynaptic α2-adrenergic receptors and has a moderate affinity for α1 and α2 subtypes. Yohimbine also binds to other behaviourally relevant monoaminergic receptors in the following order: α-2 NE > 5HT-1A>, 5HT-1B > 1-D > D3 > D2 receptors. Conclusion: The current review highlights some significant findings that contribute to developing yohimbine-based drugs. It also highlights the therapeutic potential of yohimbine against selected human diseases. However, further research is recommended on the pharmacokinetics, molecular mechanisms, and drug safety requirements using well-designed randomized clinical trials to produce yohimbine as a pharmaceutical agent for human use. Yohimbine is a natural indole alkaloid with significant pharmacological potential. Humans have used it as a stimulant and aphrodisiac from a relatively early time. It blocks the pre- and postsynaptic α2-adrenergic receptors that could be exploited for managing erectile dysfunction, myocardial dysfunction, inflammatory disorders, and cancer. [ABSTRACT FROM AUTHOR]

Endometriosis is one of the most common chronic diseases of women. This study aimed to investigate the effect of sensate focus technique and sexual position changing on sexual function of women who used medical treatment for endometriosis. This clinical trial study was performed on 80 women who used medical treatment for endometriosis. Women were randomly assigned to two groups: in the intervention group, 2 h of verbal educational session were held and at the end of the session, an instruction booklet about sensate focus technique was given to them, the control group received routine treatment. The sexual function and the dyspareunia of the participants were evaluated after 4 and 8 weeks. Eight weeks after the intervention, the mean total score of sexual function in the intervention group was significantly improved compared to before the intervention (p < 0.001). The mean score of sexual pain in the follow-up periods in the intervention group was significantly different compared to before the intervention and control groups (p < 0.001). The sensate focus technique and sexual position change simultaneously improve sexual function in women with endometriosis who used medication. Trial registration: Approval number from Iranian Registry of Clinical Trials: IRCT2200617047812N1 (Registration date: 2020-11-05). What is already known on this subject? The role of endometriosis in the genesis of sexual dysfunction in women has been mentioned in several articles. Researches have shown that some sexual positions put less pressure on parts of the pelvis that contain endometrial tissue. The sensate focus technique can improve sexual dysfunction, including hypoactive sexual desire disorder (HSDD) and female sexual arousal disorder (FSAD), orgasm, dyspareunia, and vaginismus. What do the results of this study add? Have a positive effect on sexual function and dyspareunia in women with endometriosis undergoing medical treatment and improve their sexual function. What are the implications of these findings for clinical practice and/or further research? Medical staff recommended becoming familiar with these techniques to teach sensate focus and sexual position changing to women with endometriosis to improve their sexual function. [ABSTRACT FROM AUTHOR]

Van der Toorn's 2018 edition of Papyrus Amherst 63 paved the way for a fresh examination of this difficult Demotic–Aramaic text. This article first examines the literary structure of the text and suggests a revised internal arrangement of its constituents, in particular those of Section IV. The revised arrangement serves as the basis for the ensuing discussion. The article discusses the designation 'Rash', a term that is key for an understanding of the many episodes related in the papyrus, and suggests that it designated the heavenly abode of the gods, from where they operated in heaven and earth. It then examines the few references to the earthly seats of the gods, and in particular passage viii 1–7a, which relates the heavenly or earthly realms of the gods and their seats in the sanctuaries. The final part of the article examines the way the author of Section II tried to resolve the theological problem of the impotence of god in the face of defeats, destructions and deportations. The author explains god's silence by his slumber in his heavenly abode. Surprisingly, the theological solution of sin and punishment is absent from the papyrus, in contrast to its frequent appearance in many ancient Near Eastern texts and, above all, in the biblical literature. [ABSTRACT FROM AUTHOR]

Men with premature ejaculation (PE) during partnered sex (as defined by poor ejaculatory control) show significantly reduced PE symptomology during masturbation, but the reasons for this disparity are not clear. This study investigated the other two PE-related diagnostic criteria, namely ejaculatory latency (EL) and bother/distress, in order to explore possible explanations for this disparity between types of sexual activity. Specifically, 1,447 men with either normal or poor ejaculatory control were compared on EL parameters, bother/distress, and sexual satisfaction/pleasure during both partnered sex and masturbation. Results indicated that men with PE reported longer ELs during masturbation than partnered sex, in contrast with men without PE who reported shorter ELs during masturbation. Bother/distress was lower for both groups during masturbation, but bother/distress in men with PE during masturbation was comparable to that of men without PE during partnered sex. Minimal difference in these patterns was found across lifelong and acquired PE subtypes, whereas men with PE with comorbid erectile dysfunction appeared to represent a distinct group. These findings have implications for PE management or treatment as well as for the overall conceptualization of PE as a pathophysiological condition. [ABSTRACT FROM AUTHOR]

The purpose of this prospective longitudinal study was to determine the prevalence of sexual dysfunction (SD) in women in the third trimester of pregnancy and at 8 week and 6 months in the postpartum period, as well as to identify the factors affecting sexual function in the postpartum period. 110 pregnant women were included in the study. The results showed significant differences in the scores between pregnancy and 6 months after delivery and between 8 weeks and 6 months after delivery. The scores in desire, sexual arousal, lubrication, orgasm, and satisfaction subdimensions were significantly higher and the score in pain subdimension was significantly lower at 6 months than during pregnancy and at eight weeks after delivery. Sexual dysfunction is a common problem in women in the last trimester of pregnancy and at eight weeks after delivery. However, this problem substantially resolves at postpartum 6 months. What is already known on this subject? Physiological, psychological, and hormonal changes, especially during pregnancy and postpartum period, have a considerable impact on sexual function. Therefore, identifying various aspects of sexual problems during pregnancy and postpartum period and improving the body of knowledge about sexual function would contribute to the health of women and couples. What the results of this study add? Sexual dysfunction is a common problem in women in the last trimester of pregnancy and at 8 weeks after delivery. However, this problem substantially resolves at postpartum 6 months. What the implications are of these findings for clinical practice and/or further research? A striking finding in the study is the increase of SD risk in the sixth month of postpartum with women's starting to work. This problem, which has been addressed sparsely in the current literature, can be considered a condition requiring an in-depth research. [ABSTRACT FROM AUTHOR]

To determine the impact of Penile Mondor's disease (PMD) in patients with erectile dysfunction (ED). Forty-seven patients diagnosed with PMD were included in the study and analyzed prospectively. The patients were divided into two groups according to the presence of ED at admission. The patients with ED were named Group 1, and those without ED were named Group 2. The International Index of Erectile Function (IIEF-5) and Beck Anxiety Inventory (BAI) forms at admission, 3rd, and 6th months were compared. There were 21 (44.6%) patients in Group 1 and 26 (55.4%) patients in Group 2. The mean patient ages in Group 1 and Group 2 were 38.1 ± 7.5 and 26.9 ± 10.3 years, respectively (p < 0.001). The mean admission IIEF-5 score was 19.52 ± 1.21 in Group 1 and 22.92 ± 1.23 in Group 2. After treatment, the mean IIEF-5 scores in Group 1 were 19.24 ± 1.14 and 19.09 ± 1.09 at the 3rd and 6th months, respectively. The mean IIEF-5 scores in Group 2 was 22.77 ± 0.99 and 22.96 ± 1.08 at 3rd and 6th months, respectively. In Group 1, the 6th-month IIEF-5 score was lower than the initial score (p = 0.026). In Group 1, the mean BAI score at 6 months increased compared to admission (6.0 ± 1.27 vs 5.43 ± 1.43,p = 0.015). PMD can worsen symptoms in men with ED who have a low IIEF5 score. The anxiety of recurrence of PMD during sexual intercourse may have caused this situation, or this may also be due to the natural progression of ED. [ABSTRACT FROM AUTHOR]

Couples undergoing assisted reproductive technologies (ART) are prone to sexual dysfunction and lower quality of life (QoL), but whether the incidence of these problems differs with the type of ART is unknown. As such, we conducted this cross-sectional survey to compare the sexual function and QoL of 75 couples undergoing intrauterine insemination (IUI), and 160 couples undergoing in vitro fertilization (IVF). They completed an anonymous questionnaire which included: (i) demographic characteristics; (ii) female sexual function index (FSFI) or (iii) international index of erectile function-5 (IIEF-5); and (iv) fertility QoL questionnaire (FertiQoL). Overall, 22.6% of wives and 39.1% of husbands were at risk for sexual dysfunction, and the risk was similar in IUI and IVF groups. Mean core/treatment/total FertiQoL scores of husbands were higher than wives: 74.98 vs. 68.24/70.02 vs. 65.87/73.52 vs. 67.54 (all p < 0.001). FertiQoL scores were similar in IUI and IVF groups except wives' treatment FertiQoL score was significantly higher in the IUI group (68.93 vs. 64.44; p = 0.009). This study confirms that risks for sexual dysfunction were similar in IUI and IVF couples. Wives undergoing IVF had significantly lower treatment FertiQoL score. In both IUI and IVF groups, husbands' QoL was better than wives' QoL. [ABSTRACT FROM AUTHOR]

Examine prospective relationships between erectile dysfunction (ED) drugs and CD4 and CD8 T-cells, and immune markers among men who have sex with men (MSM). Data from Multicenter AIDS Cohort Study, an observational prospective cohort study, with semiannual follow-ups conducted in four U.S. centers from 1998 onwards was used. Marginal structural models using g-computation were fitted to estimate the mean differences for the effects of self-reported ED drug use on CD4 and CD8 T-cell outcomes and immune biomarkers. Total of 1,391 men with HIV (MWH) and 307 men without HIV (MWOH) was included. Baseline mean CD4 cell count among MWH and MWOH was 499.9 and 966.7 cells/μL, respectively. At baseline, 41.8% of MWH were virally suppressed. ED drug users reported a mean of 44.4 months of exposure to ED drugs. ED drug use was associated with increased CD4 cell outcomes among MWH but not MWOH. Mean differences in CD4 cell counts after 1 year of ED drug use was 57.6 cells/μL and increased to 117.7 after 10 years among MWH. CD8 counts were higher in ED drug users among MWH over 10 years than non-users; no consistent differences were found among MWOH. ED drug use appeared to reduce immune marker levels, such as IL-6 and increase markers, such as IL-10. We observed similar effects of ED drug use on biomarker levels among MWOH. Long-term use of ED drugs do not adversely affect immune function among MWH or MWOH. Future studies on the relationships between different types of ED drugs and effects on T-cell subtypes are warranted. [ABSTRACT FROM AUTHOR]

Background: Erectile dysfunction is the most common sexual disorder in type 2 diabetes. Its pathogenesis may involve various disturbances including endothelial dysfunction and dysautonomia. The involvement of a low testosterone level is still debated. The aim of this study was to evaluate the contribution of total testosterone during erectile dysfunction in patients living with type 2 diabetes. Method: A cross-sectional study was conducted in a population of male with type 2 diabetes, aged 30–60 years, and enrolled at the National Obesity Centre of the Yaoundé Central Hospital. Non-diabetic conditions that could affect testosterone level were excluded. Erectile dysfunction was assessed using the IIEF-5 questionnaire. Total testosterone was measured by ELISA. The relationship between erectile dysfunction and total testosterone has been explored through correlation using Pearson's coefficient. The significance threshold was set at 0.05. Results: A total of 83 participants were included, with an average age of 47.9 ± 7.8 years. The median duration of diabetes was 24 (5; 72) months. The frequency of ED was 65.1%, severe for 50% of cases and significantly associated with the duration of diabetes (OR = 7.5 [2.4; 22.8]). The mean testosterone level was 14.3 ± 5.1 nmol/l. A low level of testosterone was found in 8.4% (7/83) of participants, and sedentary lifestyle was significantly associated with low testosterone level (OR = 4.1 [1; 15.4]). There was no difference between the mean total testosterone level of patients with ED (14.1 ± 4.7 nmol/l) and those without (14.3 ± 5.9 nmol/l) (p = 0.8). No association was found between total testosterone level and IIEF-5 score (r = −0.05; p = 0.5). Conclusion: Erectile dysfunction occurs in two out of three people living with type 2 diabetes and is severe for half of the cases. Total testosterone level does not seem to have an influence on the onset or severity of ED in male under 60 years with type 2 diabetes, but it is associated with a sedentary lifestyle. [ABSTRACT FROM AUTHOR]