Is erectile dysfunction an early clinical symptom of chronic kidney disease?

OBJECTIVES: Erectile dysfunction (ED) is the persistent inability to attain and/or maintain erection sufficient for satisfactory sexual performance. Chronic kidney disease (CKD) is a problem with increasing incidence every day which disrupts quality of life significantly. We aimed to research whether ED is a warning symptom for the early stages of CKD or not. MATERIALS AND METHODS: The records of 639 patients attending Ordu University due to ED were retrospectively investigated. According to International Index of Erectile Function (IIEF) scores and degree of ED, patients were compared in terms of GFR values. RESULTS: In 92.8% of patients, serum creatinine values were within normal limits (<1 mg/dL), while 30.5% of patients were observed to have GFR below 80. While stage 2 CKD was identified in 1% of the control group, this rate was calculated as 8% in the group with severe ED. In stage 1 and stage 2 CKD, IIEF scores were identified to be low by clear degree. CONCLUSIONS: Results confirm that it was identified that the incidence of stage 1 and stage 2 CKD was higher among patients attending with ED compared to the control group. Just as ED may be an early clinical marker of coronary artery disease, it may be early warning symptom for CKD.

Thyroid function among women with gestational trophoblastic diseases. A cross-sectional study.

BACKGROUND: Gestational trophoblastic diseases (GTDs) are treatable rare tumors with wide distribution. The estimated incidence of GTDs varies dramatically between different regions globally. In early pregnancy, there may be high human chorionic gonadotropin (HCG) concentrations, normal or slightly increased free T4 (fT4) and subnormal thyroid-stimulating hormone (TSH), causing hyperthyroidism ranging from subclinical to severe. Beta-HCG causes thyrotoxicosis through thyroid stimulation in patients with trophoblastic tumors. OBJECTIVE: To assess thyroid function among patients diagnosed with complete or partial hydatidiform mole, within the GTD spectrum. DESIGN AND SETTING: Cross-sectional study based on patients' medical records at Van University Hospital, Van, Turkey. METHODS: 50 patients monitored due to diagnoses of hydatidiform mole were included and were examined regarding thyroid function. Thyroid gland size and volume were measured using thyroid ultrasonography. Beta-HCG, TSH, fT4, free T3 (fT3), total T4 (TT4), total T3 (TT3), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG) and thyroglobulin levels were measured. RESULTS: Among these patients, 15 (30%) were diagnosed with complete hydatidiform mole and 35 (70%) with partial hydatidiform mole, according to pathology results. Those with complete hydatidiform mole were older (P = 0.003), with higher number of pregnancies (P = 0.032), lower TSH level (P = 0.011) and higher fT4 and TT4 levels (P = 0.04; P = 0.028), compared with partial hydatidiform mole patients. CONCLUSION: In hydatidiform mole patients, thyroid disease severity increases with age, parity, beta-HCG level and mole size. However, prospective multicenter studies on this topic are needed, with larger numbers of patients and closer monitoring.

Thyroid function among women with gestational trophoblastic diseases. A cross-sectional study

ABSTRACT BACKGROUND: Gestational trophoblastic diseases (GTDs) are treatable rare tumors with wide distribution. The estimated incidence of GTDs varies dramatically between different regions globally. In early pregnancy, there may be high human chorionic gonadotropin (HCG) concentrations, normal or slightly increased free T4 (fT4) and subnormal thyroid-stimulating hormone (TSH), causing hyperthyroidism ranging from subclinical to severe. Beta-HCG causes thyrotoxicosis through thyroid stimulation in patients with trophoblastic tumors. OBJECTIVE: To assess thyroid function among patients diagnosed with complete or partial hydatidiform mole, within the GTD spectrum. DESIGN AND SETTING: Cross-sectional study based on patients' medical records at Van University Hospital, Van, Turkey. METHODS: 50 patients monitored due to diagnoses of hydatidiform mole were included and were examined regarding thyroid function. Thyroid gland size and volume were measured using thyroid ultrasonography. Beta-HCG, TSH, fT4, free T3 (fT3), total T4 (TT4), total T3 (TT3), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG) and thyroglobulin levels were measured. RESULTS: Among these patients, 15 (30%) were diagnosed with complete hydatidiform mole and 35 (70%) with partial hydatidiform mole, according to pathology results. Those with complete hydatidiform mole were older (P = 0.003), with higher number of pregnancies (P = 0.032), lower TSH level (P = 0.011) and higher fT4 and TT4 levels (P = 0.04; P = 0.028), compared with partial hydatidiform mole patients. CONCLUSION: In hydatidiform mole patients, thyroid disease severity increases with age, parity, beta-HCG level and mole size. However, prospective multicenter studies on this topic are needed, with larger numbers of patients and closer monitoring.

A New and Simple Risk Predictor of Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention: TIMI Risk Index.

BACKGROUND: The thrombolysis in myocardial infarction risk index (TRI) was developed to estimate prognosis at the initial contact of the healthcare provider in coronary artery disease patients without laboratory parameters. In this study, we aimed to investigate the relationship of the baseline TRI and contrast-induced nephropathy (CIN) in patients with ST-elevation myocardial infarction (STEMI). METHODS: A total of 963 consecutive STEMI diagnosed patients who underwent primary percutaneous intervention were included in the study. TRI was calculated using the formula "heart rate × (age/10) 2/SBP" on admission. CIN was defined as an increase in serum creatinine concentration ≥25%, 48 hours later over the baseline. RESULTS: Of the total of 963 patients, CIN was observed in 13% (n=128). TRI was significantly higher in the CIN (+) group compared with the CIN (-) group (32.9 ± 18.8 vs 19.9 ± 9.9, P < 0.001). There was a stronger correlation between CIN and age, diastolic blood pressure, heart rate, Killip class, left ventricular ejection fraction, amount of contrast media, and diabetes mellitus. The amount of contrast media (OR 1.010, 95% CI 1.007-1.012, P < 0.001) and TRI (OR 1.047, 95% CI 1.020-1.075, P=001) were independent predictors of CIN. The best threshold TRI for predicting CIN was ≥25.8, with a 67.1% sensitivity and 80.4% specificity (area under the curve (AUC): 0.740, 95% CI: 0.711-0.768, P < 0.001). CONCLUSION: TRI is an independent predictor of CIN, and it may be used as a simple and reliable risk assessment of CIN in STEMI patients without the need for laboratory parameters.

Monocyte to high-density lipoprotein cholesterol ratio in patients with diabetes mellitus and diabetic nephropathy.

AIM: We investigated the relationship of monocyte to high-density lipoprotein cholesterol ratio (MHR) with diabetes mellitus and diabetic nephropathy. METHODS & RESULTS: A total of 220 diabetes mellitus patients and 70 healthy controls were enrolled. There was no difference in an MHR between normoalbuminuric diabetic patients and the healthy controls. The MHR in patients with diabetic nephropathy was significantly higher than that of both the normoalbuminuric diabetic patients and the healthy controls. There was a significant positive correlation between urine albumin to creatinine ratio and the MHR. In multivariate linear regression analysis, the MHR was independently correlated with urine albumin to creatinine ratio.  Conclusion: An increased MHR may be a biomarker for diabetic nephropathy.

Mesterolone treatment of aging male syndrome improves lower urinary tract symptoms.

OBJECTIVE: To investigate the effects of mesterolone on prostate in patients treated for aging male syndrome. METHODS: The cross-sectional study was conducted from June to September, 2009, at endocrinology and metabolism department of Yuzuncu Yil University, Van, Turkey, andcomprised patients with symptoms of aging male syndrome and/or low testosterone. They were given mesterolone 50 mg/day per oral for two months. Aging Male Symptoms and International Prostate Symptom Score questionaires and prostate-related quality of life scores were completed and prostate ultrasonography (USG) was performed before and after the treatment. Total testosterone, free testosterone, gonadotropins, estradiol, prolactin, sex-hormone binding globulin, as well as total and free prostate-specific antigen were also studied. RESULTS: Of the 34 patients in the study, 22(64.70%) had their prostate volume increased, while 12(35.29%) had it decreased. The change, however, was not statistically significant (p<0.098). Mesterolone significantly improved Aging Male Symptoms, International Prostate Symptom and prostate-related quality of life scores (p<0.001). These improvements though significant were independent of the changes in prostate volume. Total testosterone, sex-hormone binding globulin andestradiol decreased, while free testosterone showed no change (p<0.002, p<0.001, p<0.024, p<0.337). The fraction of free testosterone increased (p<0.001), while total and free prostate-specific antigen did not change (p<0.368 and p<0.841) CONCLUSION: Mesterolone proved to be a safe alternative in the treatment of Aging Male Syndrome. It also improved lower urinary tract symptoms and prostate-related quality of life.