Erectile dysfunction might be associated with chronic periodontal disease: two ends of the cardiovascular spectrum.

INTRODUCTION: Both chronic periodontal disease (CPD) and erectile dysfunction (ED) are associated with cardiovascular disease and its risk factors, including smoking and diabetes mellitus. However, the association between ED and CPD has never been studied. AIM: To study the association between ED and CPD. MAIN OUTCOME MEASURES. Prevalence of ED, prevalence of CPD, ED severity. METHODS: The study population consisted of 305 men who filled the Sexual Health Inventory for Men (SHIM) questionnaire in order to detect ED and assess its severity, and underwent a pair of standardized posterior dental bitewing radiographs in order to detect CPD. SHIM questionnaire scores 21 or less represented ED. Alveolar bone loss of >or=6 mm represented CPD. RESULTS: The mean age of included men was 39.5 +/- 6.7 years. Overall, 70 (22.9%) men had ED and 13 (4.3%) had CPD. CPD was significantly more prevalent among men with mild ED (P = 0.004) and moderate to severe ED (P = 0.007) in comparison to men without ED. CONCLUSIONS: ED might be associated with CPD. These preliminary findings are consistent with theories that associate these conditions with systemic inflammation, endothelial dysfunction, and atherosclerosis.

Dental attendance and self-assessment of dental status by Israeli military personnel according to gender, education, and smoking status, 1998-2006.

OBJECTIVE: The goal of the study was to analyze dental attendance and self-assessment of dental status among Israeli military personnel, according to gender, education, and smoking status. METHODS: Data were analyzed from a computerized questionnaire on dental attendance and dental status, completed by military personnel who attended one medical clinic for the required periodic medical examination between 1998 and 2006. RESULTS: For 60% of the respondents, the last dental visit was within the previous 12 months. The last dental visit was for scheduled treatment for 49.8%, a dental examination for 21.5%, and emergency dental treatment for 12.2%. College graduates rated their dental self-care higher than non-college graduates, and nonsmokers rated their self-care higher than smokers. Of the participants, 50.9% considered their own dental status good or excellent and 7.2% considered their oral health status poor. No significant differences were found according to gender. CONCLUSIONS: The findings indicated high dental attendance but low self-perception of dental status in Israeli military personnel in comparison with the Israeli general population and low attendance in comparison with U.S. Army personnel. A compulsory periodic dental examination among Israeli military personnel, similar to the required periodic medical examination, is recommended.

[General physicians' knowledge of dental operation prophylaxis for infective endocarditis].

OBJECTIVES: To evaluate the knowledge of young primary health care physicians in relation to the 1997 AHA guidelines for the prevention of bacterial endocarditis in relation to dental treatment in patients at risk. STUDY DESIGN: Forty-three physicians, with a median time of 2 years from medical school graduation, filled out a questionnaire that presented 8 medical conditions and 10 dental operations. The participants were asked whether or not antibiotic prophylaxis for infective endocarditis is required for each condition or operation. Later, the participants were asked to prescribe a regimen of prophylaxis for a non-allergic patient. RESULTS: The overall correct answer rates for the 8 medical conditions and 10 dental operations were 78% and 75%, respectively. The most conspicuous lack of knowledge was with regard to hypertrophic cardiomyopathy and dental scaling. Eighty-one percent of the physicians prescribed the correct pre-operative antibiotic dose, but a third of the participants prescribed an unnecessary postoperative dose. CONCLUSIONS: Although the present results are better than previous reports, there is still a need to foster the implementation of the guidelines among health care workers. Undergraduate and post-graduate education programs are needed in order to enhance the knowledge and eliminate the overuse and under-use of antibiotics, with the accompanying potential risks.

The minority of young adult men with sexual disorders seek medical treatment.

INTRODUCTION: The Israel Defense Force (IDF) conducts screening examinations of military personnel aimed at early detection of morbidities, including erectile dysfunction (ED) and other sexual disorders (SDs). Men with SDs are referred to the IDF's sex clinic for consultation. AIM: We present the long-term compliance of military men with SDs to the screening program. MAIN OUTCOME MEASURES: We investigated how many men screened for ED and other SDs turned to the IDF's sex clinic for consultation. METHODS: Subjects 25-50 years old performed screening examinations at the Staff Periodic Examination Center. The Sexual Health Inventory for Men (SHIM) questionnaire was used to categorize ED. The IDF's sex clinic records were investigated. RESULTS: During 2001-2003, 5,836 men completed the SHIM questionnaire. Overall, 1,570 (26.9%) men had low SHIM scores suggesting ED and other SDs. Although only 76 (4.8%) of these men turned to the IDF's sex clinic over these years, more men conferred with the IDF's sexologist every year, and more men were referred by their primary-care physicians to the IDF's sex clinic regardless of their SHIM score. CONCLUSIONS: Screening for SDs in young adult men is not enough; encouraging young adult men screened for SDs to turn to a sex clinic for evaluation is the true challenge. Nevertheless, adding a sexual questionnaire to screening examinations may raise the awareness of sexual issues in both the patients and their primary-care physicians.

Erectile dysfunction severity might be associated with poor cardiovascular prognosis in diabetic men.

INTRODUCTION: Although erectile dysfunction (ED) might be associated with coronary heart disease (CHD), there is no evidence it predicts poor cardiovascular prognosis. On the other hand, an abnormal heart rate profile during exercise stress testing predicts poor cardiovascular prognosis in high-risk patients, such as diabetic men, even in the absence of CHD. AIM: In order to study if ED predicts poor cardiovascular prognosis in high-risk patients, we examined the association between ED and heart rate profile during exercise stress testing in diabetic men with no CHD. MAIN OUTCOME MEASURES: Erectile dysfunction severity, exercise capacity during exercise stress testing, and heart rate decrease after exercise stress testing. METHODS: A retrospective study. The medical charts of diabetic men with vascular ED from a single-sex clinic were reviewed, as well as the medical charts of body mass index (BMI)- and age-matched diabetic men without ED going through routine check-ups. All men underwent routine treadmill stress testing according to the Bruce protocol in order to characterize heart rate profile during exercise. The Sexual Health Inventory for Men (SHIM) questionnaire was used to characterize ED. RESULTS: Included were 18 diabetic men with ED (SHIM questionnaire scores 5-21) and 18 diabetic men without ED (SHIM questionnaire scores 22-25), 40 years of age or older. None of the men had signs of coronary insufficiency during exercise treadmill stress testing. Although the two groups did not statistically differ with respect to the mean age, the mean BMI, the prevalence of cardiovascular risk factors, and the mean exercise treadmill stress testing findings, the SHIM questionnaire scores were significantly associated with low metabolic equivalents (r = 0.51, P = 0.03) and delayed heart rate recovery during the first 2 minutes after exercise (r = 0.55, P = 0.018) only among diabetic men with ED. CONCLUSIONS: Erectile dysfunction severity might be associated with poor cardiovascular prognosis in adult diabetic men with no CHD.