Sexual Dysfunction Among Young Men: Overview of Dietary Components Associated With Erectile Dysfunction.

BACKGROUND: Sexual dysfunction is relatively common in young men, presenting in diverse manifestations, including erectile dysfunction (ED), for which dietary modifications, including increased intake of dietary antioxidants, have been suggested as promising and cost-efficient approaches. AIM: To assess the consumption of selected dietary antioxidants, in particular flavonoids, in relation to ED symptoms in young men. METHODS: Men 18 to 40 years old were invited to complete an anonymous web-based questionnaire for this case-control study. ED was diagnosed with the International Index of Erectile Function (IIEF) and flavonoid intake was recorded using food-frequency questionnaires, with an emphasis on flavonoid-rich foods such as coffee, fruits, etc. Participants without ED (IIEF score ≥ 26; n = 264) formed the control group and those with ED (IIEF score < 26; n = 86) formed the case group. OUTCOMES: Dietary flavonoid intake. RESULTS: Men with ED reported a lower median monthly intake of total flavonoids (-2.18 g, 95% CI = -3.15 to -1.21, P < .001) and all flavonoid subclasses (P < .001) compared with controls. Adjustment of intake for age and body mass index showed that consumption of flavonoids 50 mg/day lowered the risk for ED by 32% (odds ratio = 0.68, 95% CI = 0.55-0.85, P < .001). Of all recorded flavonoids, flavones appeared to contribute the most to healthy erectile function. Controls reported a greater consumption of vegetables and fruits, a lower intake of dairy and alcoholic beverages, and a less intense smoking habit compared with cases (P < .001). CLINICAL IMPLICATIONS: Increased intake of fruits, vegetables, and flavonoids decreases the risk of ED in young men. STRENGTH AND LIMITATIONS: The strength of this study stems from the innovative hypothesis, the young age of participants, and the suggested therapeutic effects of cheap dietary components against ED. Limitations include the relatively small sample and cross-sectional design. CONCLUSION: Low flavonoid-in particular flavone-intake is associated with ED in young adult men. Mykoniatis I, Grammatikopoulou MG, Bouras E, et al. Sexual Dysfunction Among Young Men: Overview of Dietary Components Associated With Erectile Dysfunction. J Sex Med 2018;15:176-182.

Suprascapular glomus tumor: an unusual cause of chronic shoulder pain.

Glomus tumors (GT) are rare mesenchymal tumors that develop in the subungual digital region. Extradigital GTs are very rare, with atypical clinical features. We report the case of a 63-year-old male with a five-year history of intermittent shoulder pain, where an excisional biopsy confirmed the diagnosis of a glomus tumor.

Hypoxia-Inducible Factor 2a Expression Is Positively Correlated With Gleason Score in Prostate Cancer.

BACKGROUND: One of the main factors in response to hypoxia in the tumor microenvironment is the hypoxia-inducible factor (HIF) pathway. Although its role in other solid tumors, particularly renal cell carcinoma, has been sufficiently elucidated, it remains elusive in prostate cancer. The aim of the present study was to investigate the expression of main proteins involved in this pathway and determine the correlation of the results with clinicopathological outcomes of patients with prostate cancer. METHODS: The immunohistochemical expression of HIF-1a, HIF-2a and their regulators, prolyl hydroxylase domain (PHD)1, PHD2 and PHD3 and factor inhibiting HIF (FIH), was assessed on a tissue microarray. This was constructed from radical prostatectomy specimens, involving both tumor and corresponding adjacent non-tumoral prostate tissues from 50 patients with localized or locally advanced prostate cancer. RESULTS: In comparison with non-tumoral adjacent tissue, HIF-1a exhibited an equal or lower expression in 86% of the specimens (P = 0.017), while HIF-2a was overexpressed in 52% (P = 0.032) of the cases. HIF-1a protein expression was correlated with HIF-2a (P < 0.001), FIH (P = 0.004), PHD1 (P < 0.001), PHD2 (P < 0.001) and PHD3 (P = 0.035). HIF-2a expression was positively correlated with Gleason score (P = 0.017) and International Society of Urological Pathologists (ISUP) grade group (P = 0.022). CONCLUSIONS: The findings of the present study suggest a key role for HIF-2a in prostate cancer, as HIF-2a expression was found to be correlated with Gleason score and ISUP grade of the patients. However, further studies are required to validate these results and investigate the potential value of HIF-2a as a therapeutic target in prostate cancer.

Ureteral Guidewire Looping and Entrapment above an Impacted Ureter Stone.

We present a rare case of a hydrophilic guidewire looping and entrapment in the ureter of a patient with an impacted stone in the proximal ureter during a simple double-J stent insertion. Looping of guidewire is a rare complication in urology and only few cases have been described. In that case, release and removal of the entrapped guidewire was possible only after one step fragmentation of the stone with laser lithotripsy.