High-frequency changes in single-trial visual evoked potentials for unattended stimuli in chronic schizophrenia.

BACKGROUND: Patients with schizophrenia reveal changes in information processing associated with external stimuli, which is reflected in the measurements of brain evoked potentials. We discuss actual knowledge on electro- (EEG) and magnetoencephalographic (MEG) changes in schizophrenia. NEW METHOD: The commonly used averaging technique entails the loss of information regarding the generation of evoked responses. We propose a methodology to describe single-trial (non-averaged) visual evoked potentials (VEP) using spectral and statistical analyses. We analysed EEG data registered in the O1-Cz and O2-Cz leads during unattended pattern-reversal stimulation, collected from a group of adult patients with chronic schizophrenia, and compared them to those of healthy individuals. Short-time single-trial VEP were transformed to the frequency domain using the FFT algorithm. Changes of the spectral power were visualized using spectrograms which were created by stacking single-trial spectra across all trials. Measures of the absolute and the relative spectral power were calculated and compared statistically. RESULTS: In schizophrenia, the energy density of VEP oscillations is shifted towards higher (gamma) frequencies, compared to healthy individuals. These differences are statistically significant in all analysed frequency bands for the relative power. This indicates distorted early processing of visual stimuli in schizophrenia. COMPARISON WITH EXISTING METHODS: The main advantage of the presented methodology is its simplicity and ease of interpretation of obtained results. The presented observations complement the knowledge on gamma oscillations acquired from computationally more complex methods of time-frequency analysis. CONCLUSIONS: High-frequency changes for single-trial VEPs are detected in chronic schizophrenia.

Efficacy of low energy shock-wave therapy generated using an electrohydraulic device in the treatment of ed: a systematic review and meta-analysis of randomized controlled trials / Eficacia de la terapia de ondas de choque de baja energía generada usando undispositivo electrohidráulico en el tratamiento de la disfunción eréctil: una revisión sistemáticay metanálisis de ensayos controlados aleatorios

Objectives: Over 50% of elderly menand 70% of male cardiac patients suffer from erectiledysfunction (ED). Although pharmacotherapy is effectiveand safe, it only brings a short-term improvement andmay cause side effects. Low energy shock-wave therapy(LESWT) is a promising causative modality for the treatment of ED. The evidence is still limited with differentresults obtained using different devices. The aim of thiswork was to evaluate evidence from randomized controlled trials regarding the efficacy of LESWT generatedby an electrohydraulic unit for the treatment of ED. Methods: A systematic review of the literature wasconducted in PubMed on May 20th, 2018 and supplemented by a Google search of grey literature, aswell as a hand search of the bibliographies of retrievedarticles. Out of 34 studies, 5 studies on 354 patientswere included in the quantitative synthesis.Results: The studies evaluated an abridged International Index of Erectile Function (IIEF-5), the Erectile Hardness Scale (EHS) and Flow-Mediated Dilatation (FMD).The meta-analysis revealed that LESWT improved theIIEF-5 score (mean difference: 5.16; 95% CI, 1.398.93; p=0.0073) and EHS score (risk difference:0.72; 95% CI, 0.73-0.80; p<0.001). Reporting ofFMD was inconsistent and not analyzed. The meta-anal-ysis of studies conducted with electrohydraulic devicesshowed greater benefits to patients in comparison to themeta-analyses of heterogeneous studies conducted usingvarious devices for generating shock waves.Conclusions: Evidence exists that LESWT generated with an electrohydraulic unit is effective. Further research is needed in order to evaluate this method indifferent patient populations and for the long-term

Objetivo: Más del 50% de los hombresancianos y más del 70% de hombres con enfermedades cardiacas sufren de disfunción eréctil (DE). Aunquela farmacoterapia es efectiva y segura, solo conllevauna mejoría temporal y puede causar efectos secundarios. La terapia con ondas de choque de baja energía(OCBE) es una técnica prometedora para el tratamientode la DE. La evidencia es aún limitada con resultadosdiferentes obtenidos con aparatos diferentes. El objetivo de este trabajo es evaluar la evidencia de ensayosrandomizados en relación a OCBE generado con unidades electrohidráulicas para el tratamiento de la DE. Materiales y métodos: Una revisión sistemática de la literatura fueconducida en PubMed el 20 mayo 2018 y suplementada por la búsqueda de Google en literatura gris. También se hicieron búsquedas individuales de artículos.De 34 estudios, 5 estudios en 354 pacientes fueronincluidos para la síntesis cuantitativa. Resultados: Los estudios evaluaron abridged International Index of Erectile Function (IIEF-5), Erectile Hardness Scale (EHS) y Flow-Mediated Dilatation (FMD).El metanálisis reveló que OCBE mejoró el score deIIEF-5 (diferencia media: 5,16; 95% CI, 1,39-8,93;p=0,0073) y EHS score (diferencia de riesgo: 0,72;95% CI, 0,73-0,80; p<0,001). Los reportes de FMDfueron inadecuados y no se analizaron. El metanálisisde estudios conducidos con aparatos electrohidráulicosdemostró mayores beneficios a pacientes en comparación con el metanálisis de estudios heterogéneos conducido utilizando varios aparatos generadores de ondas. Conclusiones: La evidencia demuestra que OCBEgenerado por una unidad electrohidráulica es efectiva.Es necesaria más investigación para poder evaluar estemétodo en diferentes poblaciones de pacientes y parael largo plazo.(AU)

Efficacy of low energy shock-wave therapy generated using an electrohydraulic device in the treatment of ED: A systematic review and meta-analysis of randomized controlled trials. / Eficacia de el tratamiento con ondas de choque de baja energía utilizando un aparato electrohidráulico en el tratamiento de la difunción eréctil: revisión sistemática y metanálisis de ensayos randomizados.

OBJECTIVES: Over 50% of elderly men and 70% of male cardiac patients suffer from erectile dysfunction (ED). Although pharmacotherapy is effective and safe, it only brings a short-term improvement and may cause side effects. Low energy shock-wave therapy (LESWT) is a promising causative modality for the treatment of ED. The evidence is still limited with different results obtained using different devices. The aim of this work was to evaluate evidence from randomized controlled trials regarding the efficacy of LESWT generated by an electrohydraulic unit for the treatment of ED. METHODS: A systematic review of the literature was conducted in PubMed on May 20th, 2018 and supplemented by a Google search of grey literature, as well as a hand search of the bibliographies of retrieved articles. Out of 34 studies, 5 studies on 354 patients were included in the quantitative synthesis. RESULTS: The studies evaluated an abridged International Index of Erectile Function (IIEF-5), the Erectile Hardness Scale (EHS) and Flow-Mediated Dilatation (FMD). The meta-analysis revealed that LESWT improved the IIEF-5 score (mean difference: 5.16; 95% CI, 1.39-8.93; p=0.0073) and EHS score (risk difference:0.72; 95% CI, 0.73-0.80; p<0.001). Reporting of FMD was inconsistent and not analyzed. The meta-analysis of studies conducted with electrohydraulic devices showed greater benefits to patients in comparison to the meta-analyses of heterogeneous studies conducted using various devices for generating shock waves. CONCLUSIONS: Evidence exists that LESWT generated with an electrohydraulic unit is effective. Further research is needed in order to evaluate this method in different patient populations and for the long-term.

OBJETIVOS:  Más del 50% de los hombres ancianos y más del 70% de hombres con enfermedades cardiacas sufren de disfunción eréctil (DE). Aunque la farmacoterapia es efectiva y segura, solo conlleva una mejoría temporal y puede causar efectos secundarios. La terapia con ondas de choque de baja energía (OCBE) es una técnica prometedora para el tratamiento de la DE. La evidencia es aún limitada con resultados diferentes obtenidos con aparatos diferentes. El objetivo de este trabajo es evaluar la evidencia de ensayos randomizados en relación a OCBE generado con unidades electrohidráulicas para el tratamiento de la DE.MÉTODOS: Una revisión sistemática de la literatura fue conducida en PubMed el 20 mayo 2018 y suplementada por la búsqueda de Google en literatura gris. También se hicieron búsquedas individuales de artículos. De 34 estudios, 5 estudios en 354 pacientes fueron incluidos para la síntesis cuantitativa. RESULTADOS: Los estudios evaluaron abridged International Index of Erectile Function (IIEF-5), Erectile Hardness Scale (EHS) y Flow-Mediated Dilatation (FMD). El metanálisis reveló que OCBE mejoró el score de IIEF-5 (diferencia media: 5,16; 95% CI, 1,39-8,93;p=0,0073) y EHS score (diferencia de riesgo: 0,72;95% CI, 0,73-0,80; p<0,001). Los reportes de FMD fueron inadecuados y no se analizaron. El metanálisis de estudios conducidos con aparatos electrohidráulicos demostró mayores beneficios a pacientes en comparación con el metanálisis de estudios heterogéneos conducido utilizando varios aparatos generadores de ondas. CONCLUSIONES: La evidencia demuestra que OCBE generado por una unidad electrohidráulica es efectiva. Es necesaria más investigación para poder evaluar este método en diferentes poblaciones de pacientes y para el largo plazo.

The Impact of Temporary Stay at High Altitude on the Circulatory System.

In recent times many people stay temporarily at high altitudes. It is mainly associated with the growing popularity of regular air travel, as well as temporary trips to mountain regions. Variable environmental conditions, including pressure and temperature changes, have an impact on the human body. This paper analyses the physiological changes that may occur while staying at high altitude in healthy people and in people with cardiovascular diseases, such as arterial hypertension, pulmonary hypertension, heart failure, ischemic heart disease, or arrhythmias. Possible unfavourable changes were underlined. Currently recognized treatment recommendations or possible treatment modifications for patients planning to stay at high altitudes were also discussed.

Sexual health in Polish elderly men with coronary artery disease: importance, expectations, and reality.

Deterioration in overall health, hormonal disturbances, and erectile dysfunction (ED) contributes to limitations in sexual activity in the elderly, which is further limited by incorrect beliefs about the hazards of sexual activity in cardiac patients. We aimed to analyze the occurrence of ED in elderly men, their perception of the relevance of good sexual function, and their expectations of physicians. A cross-sectional study encompassed 731 patients with coronary artery disease (CAD) subjected to cardiac rehabilitation. Demographic data and data on modifiable risk factors and patient expectations were collected. ED was assessed using the IIEF-5 questionnaire. Relationships among the risk factors for ED, occurrence of ED, and patient expectations, as well as the changes in the indicators between 2012 and 2016, were analyzed. The mean age of men was 70.7 ± 5.1 years. The prevalence of ED was 93.0%. The IIEF-5 score was significantly associated with age, tobacco smoking, exercise tolerance, time to diagnosis of CAD, and treatment with calcium channel blockers and diuretics. Patients declared that sexual activity was overall important (47.9%) or very important (25.6%). Three hundred and sixty (49.3%) patients expected their physician to show interest in their sexual health, but the topic was addressed in only 12.5%. Over the past few years, we have observed an increase in the awareness and importance of sexual health as well as a significant increase in patients' expectations of physicians to show interest in their sexual health. Patients' expectations of discussing and receiving treatment for ED remain an unmet medical need.

Diagnosis of hypogonadism in patients treated with low energy shock wave therapy for erectile dysfunction: a narrative review.

Several methods of treatment of erectile dysfunction (ED) are offered with low energy shock-wave therapy (LESWT) gaining increasing attention. Reports have documented that LESWT stimulates tissue neovascularization, proliferation and differentiation of endothelial cells, and production of nitric oxide - all can improve the condition of erectile tissue. However, the overall and sexual condition of men deteriorates with age which is linked with a constant decrease in testosterone concentration. A higher risk of sexual health disorders and reduced physical fitness correlates with a testosterone concentration of <12 nmol/L. Such patients may require testosterone replacement therapy. We conducted a target literature review to investigate whether testosterone concentration is taken into account in studies on the use of LESWT in the treatment of ED. We found that most studies did not provide any information on testosterone status. Only 8 of 25 studies examined showed values of testosterone concentrations. Only one of these analyses checked the relationship between the efficacy of LESWT and testosterone concentration. As a result, meta-analyses published to date may not show the full value of LESWT in the treatment of ED. We conclude that in the light of the significant role testosterone plays in the process of an erection and the mechanism of LESWT action, it can be recommended to examine testosterone concentration and to diagnose hypogonadism during the qualification of patients to studies on LESWT efficacy. Moreover, the effectiveness of LESWT in relation to the current testosterone concentration should also be further investigated.

Evaluation of the impact of treatment with hematopoietic stem cells transplantation (HSCT) on biochemical markers of heart function and novel electrocardiographic markers of repolarization in patients with hematological malignancies.

High-dose chemotherapy (HDC) followed by stem cell transplantation (HSCT) is a well-established method in patients with hematological malignancies, and for last few years, many efforts have been made to estimate short- and long-term efficacy of this method, as well as early and late complications. The present study concentrates on cardiotoxic effects, mainly early changes using biochemical markers such as N-terminal natriuretic peptide type B (NT-proBNP) and cardiac troponins (cTn). Simultaneously, the analysis of 12-lead ECG was done before and after the procedure in which the novel repolarization markers: Tp-e and Tp-e/QT ratio were measured, together with standard markers: QT, QTc. It was found that NT-pro BNP was significantly increased after HSCT in comparison to results before it, and no significant changes were present in Troponin levels. Simultaneously, Tp-e interval and Tp-e/QT ratio were significantly higher after HSCT. The use of cyclophosphamide, advanced age, and higher level of blood cholesterol concentration were risk factors for the increase in NT-proBNP and treatment with cyclophosphamide as well as fludarabine and higher creatinine levels were risk factors for the increase in Tp-e/QT ratio. In conclusion, in the early term evaluation after HSCT in patients with no previously diagnosed heart disease, the mild changes in markers of heart overload and repolarization were noted. The observations suggest that in all patients undergoing HSCT, even the ones without pre-existing cardiovascular disease, the evaluation, and monitoring of heart function should be considered.

Relation of Postexercise Reduction of Arterial Blood Pressure and Erectile Dysfunction in Patients with Coronary Heart Disease.

Penile erection is a hemodynamic process consisting of 2 synchronized components in which the first (active) requires proper vascular endothelium functioning, whereas the second one (passive) is based on a veno-occlusive mechanism. Antihypertensive treatment reduces the passive component, often leading to the development of erectile dysfunction (ED), but lifestyle modifications can improve the sexual functioning. The study aimed to evaluate the association between blood pressure (BP) reduction caused by cardiovascular training and the intensity of ED in men with coronary heart disease. A total of 101 men (mean age 59.50 ± 7.93) with ED treated invasively for coronary heart disease and subjected to cardiac rehabilitation were enrolled. Patient characteristics, the International Index of Erectile Function 5 (IIEF-5) questionnaire (IIEF-5), and BP values were collected at baseline and after 6 months of cardiac rehabilitation and were analyzed. Cardiac rehabilitation led to a significant reduction of 5.08 mm Hg in systolic BP (p <0.001) and of 1.60 mm Hg in diastolic BP (p <0.001). The IIEF-5 score (EQ) significantly increased (median 15, interquartile range 11 to 19 vs median 18, interquartile range 12 to 21, p <0.001). Greater improvement in sexual performance was significantly negatively correlated with age, concentration of triglycerides, and high-density lipoprotein, whereas it was positively correlated with the presence of diabetes and baseline IIEF-5 score. After excluding patients with diabetes, a greater decrease in systolic BP was found to be significantly associated with greater improvement in erectile performance. In conclusion, a reduction of arterial BP caused by cardiac training is accompanied by improvement in erectile performance. This effect is the strongest in patients with hypertension and those with dyslipidemia.

Should information about sexual health be included in education directed toward men with cardiovascular diseases?

BACKGROUND: Modifiable risk factors contribute to the pathogenesis of cardiovascular disease (CVD) and erectile dysfunction (ED). We aimed to compare the knowledge about the contribution of modifiable risk factors to the pathogenesis of CVD and ED. The impact of patients' having modifiable risk factors on the awareness of their negative influence on the development of CVD and ED was examined. METHODS: To this multicenter cohort study, we included 417 patients with CHD who had been hospitalized in the cardiology or cardiac surgery department during the previous six weeks and underwent cardiac rehabilitation in one of the five centers. Knowledge about modifiable risk factors was collected. ED was assessed by an abridged IIEF-5 questionnaire. Comparisons between groups were conducted using the Student's t-test, Mann-Whitney U test, and Kruskal-Wallis test. Relationships were analyzed with Spearman's rank correlation coefficient. RESULTS: The mean number of correctly identified risk factors for CVD was significantly higher than those for ED (3.71 ± 1.87 vs. 2.00 ± 1.94; p < .0001). Smoking was the most recognized risk factor both for CVD and ED. Dyslipidemia was least frequently identified as a risk factor for CVD. Sedentary lifestyle was the only risk factor whose incidence did not affect the level of patient knowledge. CONCLUSIONS: Cardiac patients with ED know more about risk factors for CVD than ED. It is necessary to include information about the negative impact of modifiable risk factors on sexual health into education programs promoting healthy lifestyles in men with cardiovascular diseases.

The analysis of the parameters of 24-hr ECG Holter monitoring in patients with blood neoplasms undergoing high-dose chemotherapy and stem cell transplantation.

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a widely used procedure in the treatment of malignant diseases, including blood neoplasms and has increased survival in hematological diseases. The aim of the study was to analyze parameters of 24-hr ECG monitoring in patients with selected blood neoplasms in whom the procedure of hematopoietic stem cell transplantation was performed. METHODS: The study group consisted of 64 adults diagnosed with hematologic cancer qualified for HSCT with the previous high dose chemotherapy (HDC). In all patients 24-hr Holter monitoring was carried out twice. First examination took place prior to the HSCT procedure, and the second after finishing the procedure of HSCT. RESULTS: The minimal and mean heart rate (HR min and HR max) from 24-hr ECG recording was statistically significantly higher after the transplantation in comparison with the first test. The number of premature ventricular complexes (PVCs) was higher in the test after HSCT. In the second examination there was significantly higher percentage of premature ventricular complexes, incidents of tachycardia, and Mobitz type 1 second degree atrioventricular block. In regression analysis, in a group of patients with blood neoplasms after HSCT and HDC, administration of cyclophosphamide, fludarabine and total body irradiation were independent risk factors for electrocardiographic abnormalities in 24-hr Holter monitoring, that is, the increase in HR min, HR mean and PVCs. CONCLUSION: In patients with blood neoplasms undergoing HSCT more electrocardiographic abnormalities may be found after this procedure in comparison with the 24-hr Holter monitoring before transplantation.

Low-energy Shock Wave Therapy-A Novel Treatment Option for Erectile Dysfunction in Men With Cardiovascular Disease.

Patients with cardiovascular disease (CVD) are prone to developing erectile dysfunction (ED) owing to the common risk factors and pathogenesis underlying ED and CVD. As a result, ED affects nearly 80% of male patients with CVD. The efficacy of phosphodiesterase type 5 inhibitors, vacuum erection devices, or intracavernosal injection of vasodilating agents is well established in the treatment of ED; however, their use is limited. Low-energy shock wave therapy is a novel modality that may become a causative treatment for ED. This review aims to assess the efficacy and safety of low-energy shock wave therapy in the treatment of ED in men with CVD.

Sexual health of male cardiac patients - present status and expectations of patients with coronary heart disease.

INTRODUCTION: Due to the pathogenetic association between erectile disorders and cardiovascular diseases, cardiologists consult many patients with erectile dysfunction (ED). The aim of the study was to evaluate sexual function in patients with coronary heart disease (CHD) and the use of sexual knowledge in cardiology practice, both current use and that expected by patients. MATERIAL AND METHODS: One thousand one hundred and thirty-six patients (average age: 60.73 ±9.20) underwent a dedicated survey which encompassed demographic data and the presence of modifiable ED risk factors. The presence of ED was assessed using the International Index of Erectile Function (IIEF-5) Questionnaire. RESULTS: Sexual problems were discussed by cardiologists with 45 (3.96%) patients. The frequency of initiating the topic was significantly associated with the respondents' education level (p = 0.0031); however, it was not associated with the patients' age, duration of CHD, presence of ED, or modifiable risk factors. Four hundred and sixteen (36.62%) respondents indicated that they expect their cardiologist to take an interest in their ED. Nine hundred and twenty-six (81.51%) patients claimed good sexual function to be important or very important to them. Attitude to sexual function was significantly associated with age (p < 0.0001), duration of CHD (p = 0.0018), education (p = 0.0011), presence of ED (p = 0.0041), diabetes (p = 0.0283) and hyperlipidaemia (p = 0.0014). CONCLUSIONS: The low frequency with which cardiologists initiate the topic of ED is in contrast to the expectations of patients with CHD. The majority of these patients regard good sexual maintenance as an important part of their life.

Assessment of body surface potential mapping in diabetic patients with recognized depression.

OBJECTIVES: Parameters of body surface potential mapping (BSPM) in DM II patients are significantly different comparing with healthy non-diabetic subjects. Hypothesis that these changes are more pronounced in DM II patients with depression was tested in the present study. For this purpose, analysis of the relationship between the Int-QRST (isointegral) maps distribution and the depressive symptoms intensification, as well interrelation between depressive and diabetic symptoms were performed. MATERIAL AND METHODS: BSPM registrations were obtained from the three study groups (aged 37-52 years), namely 40 diabetic patients with clinically documented depression, 30 depressive patient without DM and 90 normal subjects. BSPM recordings were displayed in a form of the Int-QRST maps. Examination with BDI and HbA1c test were also performed in all investigated subjects. RESULTS: Isointegral QRST maps turned out to display abnormal, i.e. non-dipolar distribution. Moreover, extent of Int-QRST maps multipolarity increased in the examined diabetic patients along with DM II duration, BDI scores and HbA1c level. CONCLUSIONS: Non-dipolar distribution of Int-QRST maps, more pronounced in diabetic patients with depression, can be a specific indicator of the increased risk of severe ventricular arrhythmias occurring prior to abnormalities detectable on the standard 12-lead ECG recordings, which is of great importance especially in prevention of life-threatening arrhythmias.

Cardiovascular Risk Factors Among Lower Silesian Students of the Faculty of Medicine: Knowledge and Distribution.

BACKGROUND: Cardiovascular disease is a major contributor to the global burden of disease. Further reduction of cardiovascular mortality will require multidirectional prevention. Popularizing prevention measures requires the involvement of qualified and well-educated personnel. Before any modifications of educational programs it is necessary to assess the level of knowledge of future physicians. OBJECTIVES: The aim of the study was to evaluate medical students' knowledge of cardiovascular (CV) risk factors. The paper presents the outcomes of a study investigating the knowledge of CV risk factors and the prevalence of those risk factors in the study population. MATERIAL AND METHODS: The study was conducted between 2007 and 2012 and the study population was comprised of 1406 students (497 men and 909 women) from South and South Western Poland. A survey designed by the authors, based on the Framingham survey, was used for the interviews. RESULTS: The students correctly identified 4.38 ± 0.91 CV risk factors. The most frequently listed risk factors for cardiovascular diseases were a lack of physical activity and a fat-rich diet. The study participants who identified CV risk factors more or less accurately do not follow the recommendations aimed at prevention. Awareness, even relatively high awareness, does not correlate with a healthy lifestyle. Extreme examples of this are people who are aware of the negative effects of cigarette smoking but continue to smoke. CONCLUSIONS: The study revealed an insufficient level of awareness of CV risk factors among medical students.

Echocardiographic evaluation of the early cardiotoxic effect of hematopoietic stem cell transplantation in patients with hematologic malignancies.

The purpose was to evaluate the early cardiotoxic effects of the treatment in the course of hematopoietic stem cell transplantation (HSCT) in patients with hematologic malignancies. The studies were conducted on 47 patients qualified for the HSCT. Echocardiography was carried out prior to the HSCT and after the HSCT. It was shown that higher age, administration of cyclophosphamide and higher glucose concentrations represented independent risk factors for the worsening of left ventricular diastolic function. Higher cumulative dose of anthracyclines in the previous cytostatic treatment, higher age and administration of cyclophosphamide represented independent risk factors for worsening of left ventricular systolic function. Peri-transplant therapy in the course of HSCT in patients with hematologic malignancies gives the negative effect on the diastolic and systolic left ventricular function, however, previous treatment is of importance, as higher cumulative dose of anthracyclines represents an independent risk factor for the worsening of left ventricular systolic function.

Heart rate recovery, cardiac rehabilitation and erectile dysfunction in males with ischaemic heart disease.

OBJECTIVE: Heart rate recovery (HRR) is a recognised marker used in clinical practice for assessing the risk of sudden cardiac death. Physical exercise leads to an improvement in HRR and has a proven beneficial effect on erection quality (EQ) related to the activity of the autonomic nervous system in men with ischaemic heart disease (IHD). This paper evaluates the relationship between HRR and EQ in patients with IHD and erectile dysfunction (ED) who underwent cardiac rehabilitation. METHODS: The main analysis was based on the Mann-Whitney U test, Wilcoxon signed-rank test, Spearman correlation coefficient, Pearson's chi-square test, chi-square test, with the Yates correction and (if possible) parametric tests were used. This prospective, non-randomised intervention study included 124 men with IHD and ED [International Index of Erectile Function (IIEF-5) scores of ≤21]. Of these, 89 patients underwent a 6-month cardiac rehabilitation phase III programme, whereas 35 did not. The results of the participants' total IIEF-5 scores and their HRR, demographic and clinical data were analysed. RESULTS: The results of the 89 rehabilitated patients (mean age: 60.44±9.29 years) and 35 controls (mean age: 61.43±8.81 years) were analysed. In the rehabilitated patients, the mean baseline IIEF-5 score was 13.15±5.76 (95% CI: 11.93-14.36) and HRR was 16.49±7.68/min (95% CI: 14.88-18.11). After cardiac rehabilitation, the parameters of ED and HRR improved significantly and were significantly higher than those of the controls; the mean IIEF-5 score of the rehabilitated group increased to 15.36±6.51 (95% CI: 13.99-16.73), while HRR increased to 21.40±7.25/min (95% CI: 19.88-22.93). A significant correlation was found between ∆HRR and ∆EQ (r=0.409791) as a result of the 6-month cardiac training programme. CONCLUSION: Cardiac rehabilitation assessed by HRR has a sizable effect on autonomic balance in patients with IHD and ED, which plays a significant role in the mechanism of erection improvement.

Endothelial Function in Patients with Hematologic Malignancies Undergoing High-Dose Chemotherapy Followed by Hematopoietic Stem Cell Transplantation.

The aim of the study was to examine endothelial function in patients with hematological malignancies treated with high-dose chemotherapy followed by hematopoietic stem cell transplantation. The studies were conducted on 43 consecutive patients qualified for HSCT following high-dose chemotherapy based on the current standards. Then, due to exclusion criteria, a group of 38 patients were chosen for further investigations. Evaluation of endothelial function by means of flow-mediated dilatation (FMD) was conducted in patients with hematological malignancies before HSCT (test A) and after HSCT (test B). Brachial artery diameter (BAD) after occlusion, change in BAD and FMD were significantly lower after HSCT as compared to the results obtained before the transplantation (p < 0.05). The regression analysis indicated that administration of fludarabine and cytarabine, and also higher blood concentrations of creatinine represented risk factors for the impairment of endothelial function expressed as decreased FMD value. In patients with hematopoietic malignancies treated with HSCT, endothelial function assessed by the flow-mediated dilatation was impaired after chemotherapy and stem cell administration.

Effect of Endurance Cardiovascular Training Intensity on Erectile Dysfunction Severity in Men With Ischemic Heart Disease.

The protective effect of physical activity on arteries is not limited to coronary vessels, but extends to the whole arterial system, including arteries, in which endothelial dysfunction and atherosclerotic changes are one of the key factors affecting erectile dysfunction development. The objective of this study was to report whether the endurance training intensity and training-induced chronotropic response are linked with a change in erectile dysfunction intensity in men with ischemic heart disease. A total of 150 men treated for ischemic heart disease, who suffered from erectile dysfunction, were analyzed. The study group consisted of 115 patients who were subjected to a cardiac rehabilitation program. The control group consisted of 35 patients who were not subjected to any cardiac rehabilitation. An IIEF-5 (International Index of Erectile Function) questionnaire was used for determining erectile dysfunction before and after cardiac rehabilitation. Cardiac training intensity was objectified by parameters describing work of endurance training. The mean initial intensity of erectile dysfunction in the study group was 12.46 ± 6.01 (95% confidence interval [CI] = 11.35-13.57). Final erectile dysfunction intensity (EDI) assessed after the cardiac rehabilitation program in the study group was 14.35 ± 6.88 (95% CI = 13.08-15.62), and it was statistically significantly greater from initial EDI. Mean final training work was statistically significantly greater than mean initial training work. From among the parameters describing training work, none were related significantly to reduction of EDI. In conclusion, cardiac rehabilitation program-induced improvement in erection severity is not correlated with endurance training intensity. Chronotropic response during exercise may be used for initial assessment of change in cardiac rehabilitation program-induced erection severity.

Nature of interstitial cells of Cajal of the upper urinary tract.

Interstitial cells of Cajal (ICCs) were discovered in the gastrointestinal tract over 100 years ago and since then numerous digestive tract pathologies involving ICCs have been described. Many researchers explored ICCs presence and function in the upper urinary tract. Currently, we know that ICCs have potential plasticity, their own spontaneous activity and that they are responsible for Ca2+ waves generation and neuromuscular transmission. ICCs are also involved in the conjugation, propagation and modulation of peristaltic waves in the upper urinary tract. Despite everything we know about ICCs, their role in the pathogenesis of the upper urinary tract abnormalities remains still unclear and results of published studies are confusing. The authors' intention was to review the scientific literature regarding ICCs and to summarise the current knowledge about their nature in the upper urinary tract.