Objective
To investigate the influence of Lamotrigine (LTG) on sex hormone, seminal fluid and sexual function in male epilepsy patients.
Methods
The blood sex hormone levels and sperm quality were detected in 20 normal controls and 16 male epilepsy patients in Epilepsy Center of Sichuan Province People's Hospital from April 2015 to November 2016. All participants were detected before taking medicine and after being treated with LTG monotherapy for 1 year. The international index of erectile function-5 (IIEF-5) was employed to assess the sexual function in the groups above, and the results were compared.
Results
Compared with the control group, the total number of sperm, the rate of forward movement, survival, normal sperm and the score of IIEF-5 in the untreated group were less (P<0.05). LTG treatment group's sperm parameters and the score of IIEF-5 seemed improve, but there was no statistically significant difference (P>0.05). There was no significant difference in sexual hormones between the groups above (P>0.05).
Conclusions
Semen quality and the score of IIEF-5 in epileptic male decline more easily; LTG might improve the semen quality and sexual function, but no significant difference has being found.
Mitral regurgitation is one of the most common valvular heart diseases, with functional mitral regurgitation being the predominant type. Ventricular functional mitral regurgitation (VFMR) occurs due to impaired left ventricular systolic function combined with left ventricular dilation, leading to mitral annular enlargement and papillary muscle displacement, which cause relative tethering of the mitral leaflets despite structurally normal valve apparatus. Patients with VFMR often present with severe heart failure, face high surgical risks, and have a poor prognosis. In recent years, mitral valve transcatheter edge-to-edge repair (TEER) has emerged as a well-established interventional technique, offering a new treatment option for VFMR patients and significantly improving clinical outcomes. This review focuses on the advances in the pathogenesis, epidemiological characteristics, diagnosis, and management of VFMR, particularly the application and efficacy-influencing factors of TEER.
ObjectiveTo analyse baseline information, semen, sex hormones and sexual function to understand the differences between male patient with epilepsy(MPWE) and healthy men. At the same time, we preliminarily evaluated the risk factors related to reproductive function in MPWE to provide clinical method for reducing the risk of infertility.MethodsWe collected data of 112 MPWE in the Department of Neurology, First Affiliated Hospital of Dali University from February 2019 to February 2020. Sixty-seven healthy male volunteers matching the age of the survey group were selected. All men completed semen and sex hormone test. Men with sexual life experience completed the International index of erectile function scale (IIEF-5) and the Premature ejaculation diagnostic tool (PEDT). MPWE completed the Quality of life in epilepsy-1(QOLIE-31). The baseline data, semen quality, sex hormone level and sexual function questionnaire scores of MPWE and healthy controls were compared. In addition, according to the diagnostic criteria of abnormal male reproductive function, MPWE were divided into abnormal group and normal group. Single factor analysis and binary logistic regression analysis were used to preliminarily explore the related risk factors of reproductive function in MPWE.ResultsCompared with the healthy control group, the proportion of married and childbearing, testosterone level, sperm concentration, sperm survival rate and IIEF-5 score in MPWE were significantly reduced (P<0.05). Compared with the normal group, age, body mass index, seizure frequency and drug type in the abnormal group were significant differences statistically (P<0.05). The total score and energy score of QOLIE-31 in the abnormal group were significantly lower than that in the normal group (P<0.05). Binary Logistic regression analysis indicated that energy score [B=?0.033, OR=0.967, 95%CI(0.937, 0.999)], age [B=0.879, OR=2.408, 95%CI (1.070, 5.416)], seizure frequency [B=1.788, OR=5.976, 95% CI (2.031, 17.589)].ConclusionThe reproductive function of MPWE is lower than that in healthy men. The total score, energy score, age, body mass index, seizure frequency and type of drugs will significantly affect the reproductive function of MPWE. Energy score, age and seizure frequency are independent risk factors that affect the reproductive function of MPWE. Abnormal reproductive function of MPWE was positively correlated with age and seizure frequency, but negatively correlated with energy score.
ObjectiveTo systematically review the association between 5α-reductase inhibitors (5ARIs) and risk of sexual dysfunction in subjects with benign prostatic hyperplasia (BPH).MethodsPubMed, Web of Science, The Cochrane Library, EMbase, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on the association between 5ARIs and risk of sexual dysfunction in subjects with BPH from inception to October 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Stata 12.0 software.ResultsA total of 15 studies involving 17 774 subjects were included. The results of the meta-analysis showed that compared with the placebo group, 5ARIs could significantly increase risk of erectile dysfunction (RR=1.52, 95%CI 1.36 to 1.69, P<0.000 1), while decrease libido (RR=1.79, 95%CI 1.37 to 2.32, P<0.000 1) and ejaculation disorder (RR=2.97, 95%CI 1.82 to 4.83, P<0.000 1) in subjects with BPH. Subgroup analysis of the type of 5ARIs, intervention period, publication year and sample size showed that the 5ARIs had a higher risk of sexual dysfunction than the placebo group.ConclusionsCurrent evidence shows that 5ARIs can increase risk of erectile dysfunction, decrease libido and ejaculation disorder in subjects with BPH. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
Atrial functional mitral regurgitation (AFMR) is characterized by left atrial enlargement, without left ventricular dilation or systolic dysfunction, and with structurally normal leaflet tissue. It predominantly occurs in patients with atrial fibrillation and heart failure with preserved ejection fraction. The complex pathophysiological mechanisms involve mitral annular dilation, atriogenic leaflet tethering, and inadequate leaflet adaptation. Currently, standardized management protocols for AFMR remain lacking. Common approaches include pharmacotherapy, rhythm control, and surgical or percutaneous interventions, all requiring individualized therapeutic strategy based on etiology and clinical characteristics. This review discusses recent advances in the pathogenesis and treatment of AFMR, aiming to provide valuable insights for clinical practice and future research.
