Category: Nevin Manimala

J Sex Med. 2022 May 1;19(5):729-737. doi: 10.1016/j.jsxm.2022.02.019.

ABSTRACT

BACKGROUND: Lower urinary tract Symptoms (LUTS) and Sexual dysfunction (SD) are common in women with MS and affect quality of life.

AIM: The aim of this study was to determine the relationship between sexual dysfunction (SD) and overactive bladder in women with Multiple Sclerosis (MS).

METHODS: From January 2019 to January 2021, we evaluated 89 female MS patients admitted for LUTS in a Neuro-Urology Department. SD was investigated using the Female Sexual Function Index (FSFI). All subjects completed the Urinary Symptom Profile scale (USP) and Hospital Anxiety and Depression Scale (HAD A/HAD D). Neurological impairment was assessed using the Expanded Disability Status Scale (EDSS). All patients underwent neurological examination and urodynamic studies. Univariate analysis and Multivariate logistic regression analysis were performed to identify predictors of SD in women with MS (FSFI <26.55).

OUTCOMES: Primary outcome was to determine the association between sexual dysfunction in women with MS and LUTS (overactive bladder, stress incontinence or voiding dysfunction).

RESULTS: Sexual dysfunction (FSFI<26,55) affected 74% of women with MS, even with low physical disabilities (EDSS<5). Univariate analysis showed that overactive bladder was more frequent in SD group, but no statistical difference was found (P < .12). No relationship was found between sexual dysfunction and stress incontinence (P = ,47), voiding dysfunction (P= 0.79) or urinary retention (P= .96). Multivariate logistic regression analysis identified overactive bladder to be an independent predictor of sexual dysfunction [aOR 0.03 (CI 0,0.98)]. Sexual dysfunction was not associated with detrusor overactivity on urodynamic studies or with impairment mobility but was strongly associated with the presence of depression (P < .01).

CLINICAL IMPLICATIONS: Sexual disorders in women with MS should be assessed as much as urinary disorder.

STRENGTHS AND LIMITATIONS: this study included the largest cohort of women with MS. But the sample was obtained in an outpatient setting with low neurological impairment.

CONCLUSION: In our study, SD was frequent affecting young women with no anticholinergic treatment and low physical impairment. Overactive bladder seemed to be independent predictor of sexual dysfunction. Conversely, SD was not associated with detrusor overactivity, neurological impairment, or duration of disease but was strongly associated with depression.

PMID:37057559 | DOI:10.1016/j.jsxm.2022.02.019

J Sex Med. 2022 Jul 1;19(7):1090-1097. doi: 10.1016/j.jsxm.2022.04.012.

ABSTRACT

BACKGROUND: Only a minority of men experiencing sexual problems will seek professional help and the proportion of gay or bisexual men can be even lower.

AIM: To investigate if sexual identity and minority stress are related to professional help-seeking in Polish gay and bisexual men.

METHODS: Sexual identity was measured with the standard question: “Do you consider yourself to be heterosexual, gay, or bisexual?” Men who provided a complete set of answers to the study tools and replied “yes” to the question: “Have you ever had a problem with sexual functioning that lasted at least several months?” were included (Ntotal =644, Nstraight = 203, Ngay = 324, Nbi = 117). A simple question on help-seeking was: “Did you seek professional assistance then?” Other data were gathered with the use of a self-constructed questionnaire. Minority stress processes, that is, internalized homophobia, expectations of rejection, and identity concealment, were measured with the subscales of the Sexual Minority Stress Scale.Bivariate analyses and multivariate logistic regressions were performed to test the statistical significance of sexual identity and minority stress processes as predictors of professional help-seeking.

OUTCOMES: Contacting a specialist when experiencing a sexual problem.

RESULTS: A total of 84.5% of all men did not seek professional help. Gay identity (OR = 0.58, P = .045), as opposed to bisexual identity, was significantly related to reduced odds of consulting a specialist. Age (OR = 1.03, P = .005), number of doctor’s visits per year (OR = 1.51, P < .001), and a psychiatric diagnosis (OR = 1.65, P = .043) were positively related to help-seeking behaviors. Identity concealment significantly decreased the likelihood of consulting a specialist (OR = 0.94, P = .017).

CLINICAL TRANSLATION: Specialists need to be aware that gay identity and identity concealment may prevent a proportion of men from seeking their help and thus should be publicly explicit about their inclusive and nonpathologizing approach to sexual diversity.

STRENGTHS AND LIMITATIONS: The major strengths of the study include the use of a relatively large sample size and data from the little recognized Polish context characterized by a predominantly hostile anti-LGBT social climate, and exploration of a neglected topic of substantial significance at the public and individual levels. The major limitations are the use of nonprobability sampling, cross-sectional self-report design, and a single question to capture the presence of sexual problems with no measurement of associated distress.

CONCLUSION: Gay men are at risk of avoiding help-seeking when experiencing sexual problems because of identity concealment.

PMID:37057549 | DOI:10.1016/j.jsxm.2022.04.012

J Sex Med. 2022 Apr 1;19(4):569-580. doi: 10.1016/j.jsxm.2022.01.516.

ABSTRACT

BACKGROUND: Despite the World Health Organization calling for sexuality to be recognized as an aspect of well-being, no studies have explored sexual activity and physical tenderness in older adults aged ≥ 75 years in Belgium or those aged ≥ 85 years worldwide.

AIM: To assess the prevalence and predictors of sexual activity and physical tenderness in a sample of older adults.

METHODS: Using data from a Belgian cross-sectional study on sexual violence (UN-MENAMAIS), information on sexual activity, physical tenderness, and associated characteristics was collected during structured face-to-face interviews with older adults living in the community, assisted living facilities, or nursing homes. Cluster random probability sampling with a random route-finding approach was used to select the participants.

OUTCOMES: Current sexual activity and physical tenderness in the previous 12 months, sociodemographic characteristics, chronological age, subjective age, number of sexual partners, sexual satisfaction, attitudes toward sexuality in later life, quality of life, and lifetime sexual victimisation.

RESULTS: Among the 511 participants included, 50.3% were in a relationship, mainly living with their partner; 31.3% indicated they were sexually active; and 47.3% of sexually inactive participants reported having experienced forms of physical tenderness in the previous 12 months. Sexual activity was associated with the presence of a partner, satisfaction with sexual life, permissive attitudes regarding sexuality in later life, a younger age, and a lack of disability. Physical tenderness was associated with the presence of a partner, community residency, and permissive attitudes regarding sexuality in later life.

CLINICAL IMPLICATIONS: Raising awareness among the general population, healthcare professionals, and older adults about sexuality in later life could contribute to ending this taboo and should therefore be a priority for society.

STRENGTHS AND LIMITATIONS: Our study fills a gap in the literature regarding sexual activity and physical tenderness in older adults aged ≥ 70 years, including respondents aged up to 99 years. Additionally, we explored different forms of sexual expression beyond intercourse, and face-to-face interviews contributed to the quality of the collected data. The main limitation of this study was the sample size, although the findings were similar to recent statistical indicators in Belgium.

CONCLUSION: One in 3 older adults aged ≥ 70 years living in Belgium are sexually active. These findings provide an opportunity to inform the general public and older adults about later life sexuality and to educate healthcare professionals about aging sexuality to increase discussions and avoid assumptions of asexuality in later life.

PMID:37057537 | DOI:10.1016/j.jsxm.2022.01.516

J Sex Med. 2022 Apr 1;19(4):590-593. doi: 10.1016/j.jsxm.2022.01.520.

ABSTRACT

BACKGROUND: Intracavernosal injections (ICI) are a well-established treatment option for men with erectile dysfunction (ED); however, the anticipation of pain with injection remains a significant barrier to the use of ICI.

AIM: To evaluate the patient-anticipated degree of pain versus the experienced degree of pain pre- and post-ICI in men undergoing their first injection with an erectile agent.

METHODS: We studied 51 patients who underwent their first ICI in our men’s health clinic. Anticipated needle-associated pain was judged with a pre-injection score, and pain experienced during the injection was judged with a post-injection score. All patients graded their pre- and post-ICI pain using a standard 10-point scale (0-10).

OUTCOMES: Pre- and post-ICI pain was defined with the visual analogue scale (0-10) in men undergoing their first penile injection.

RESULTS: Medians and interquartile ranges (IQRs) of the patients’ age [65 years (54.5-68.0)], pre-injection pain [5 (4-7)], and post-injection pain [1 (1-2)] were recorded. Most men in the study had erectile dysfunction (68.6%) and/or Peyronie’s Disease (64.7%). The average pre-injection prediction pain score was 5.45 ± 2.15; the average post-injection perceived pain score was 1.20 ± 0.73. Thus, there was an average discrepancy of over 4 points in predicted pain vs perceived pain. A paired t-test was performed which showed a statistically significant difference between pre- and post-injection scores (P < .05). A Wilcoxson Signed Rank Test showed statistical significance in the difference between pre- and post-injection pain scores (P < .05).

CLINICAL IMPLICATIONS: ICI is a safe, effective treatment for patients with ED and is associated with significantly less pain than is anticipated by patients.

STRENGTHS & LIMITATIONS: This is the first report to describe the discrepancy between pre-ICI anticipated pain and post-ICI experienced pain. Limitations include an overall small sample size.

CONCLUSION: Patients experience significantly less pain with ICI than they anticipate having. This represents an important factor to consider when counseling patients about available ED treatments.

PMID:37057531 | DOI:10.1016/j.jsxm.2022.01.520

J Sex Med. 2022 Apr 1;19(4):620-628. doi: 10.1016/j.jsxm.2022.01.005.

ABSTRACT

BACKGROUND: Pleasure-seeking reasons are the main drivers of pornography use (PU), but the regulation of unpleasant states, namely distraction from or suppression of negative emotions and stress relief, are other potential predictors of this behavior.

AIM: Our main objective is to develop an explanatory model of problematic PU, assessing difficulties in emotion regulation, loneliness, perceived stress, as well as age and gender as predictors.

METHODS: A cross-sectional study was conducted that included a total of 340 participants (M = 28.50 years, SD = 10.32). Self-report inventories were administered that measured problematic PU (PPCS), difficulties in emotion regulation (DERS-SF), loneliness (UCLALS-3), and perceived stress (PSS-10).

RESULTS: The findings were indicative of recreational PU, with only a small number of participants (4.6%) reporting a possible problematic PU. There were statistically significant gender differences (F(1,337) = 33.306, P ≤ .001), namely that men were more likely to report problematic PU (M = 36.03, SD = 21.30) than women (M = 25.32, SD = 9.24). Problematic PU was significantly and positively correlated either with difficulties in emotion regulation, loneliness, perceived stress and age. Stepwise multiple linear regression analysis showed that difficulties in emotion regulation (β = 0.259, P ≤ .001), loneliness (β = 0.209, P = .001), and gender (β = -0.377, P ≤ .001) define the best subset of predictors of problematic PU. Age and perceived stress were not selected as predictors in this subset.

CLINICAL TRANSLATION: The promotion of better emotion regulation abilities and strategies for adaptive coping with loneliness must be taken into consideration, namely in cases of problematic PU or compulsive sexual behavior disorder.

STRENGTHS & LIMITATIONS: Being a cross-sectional study with a convenience sample and the fact that these variables explain only a part of the explained variance of the problematic PU are the main limitations. Despite the limitations, the principal contribution of this study is the understanding that gender, difficulties in emotion regulation, and loneliness remain as main predictors of problematic PU, even when combined in the explanatory model.

CONCLUSION: The current study provides a better understanding of the predictors of problematic PU related with the reduction or avoidance of unpleasant states. Emotion regulation, loneliness, and perceived stress, studied simultaneously, provide a better understanding of the complex relationships between these factors and problematic PU. Difficulties in emotion regulation and loneliness are predictors of higher problematic PU, as well as the expected gender effect.

PMID:37057530 | DOI:10.1016/j.jsxm.2022.01.005

Clin Implant Dent Relat Res. 2023 Apr 14. doi: 10.1111/cid.13205. Online ahead of print.

ABSTRACT

BACKGROUND: Customized computer-aided-design/computer-aided-manufacturing (CAD/CAM) titanium meshes have been adopted for alveolar bone augmentation. But the inaccuracies between planned and created bone volume/contour are quite common, and the surgical placement of the customized mesh was considered as the first critical factor. However, the evaluation of surgical placement accuracy of customized mesh is currently lacking.

PURPOSE: The aim of this study was to evaluate the accuracy of the surgical placement of customized meshes.

METHODS: A total of 30 cases, 20 without the screws-position-guided template and 10 with the screws-position-guided template, were included in this study. The cone beam CT (CBCT) data sets of pre- and postoperative were converted into 3D models and digitally aligned. Then the actual placement of customized mesh and retainer titanium screws was compared to the virtual one to assess the surgical placement accuracy of customized mesh. At least 6 months after surgery, a new CBCT was taken and converted into 3D models. Planned bone volume, created bone volume, vertical bone augmentation, healing complications rate, pseudo-periosteum rate, exposure rate, and infection rate were all evaluated.

RESULTS: The 3D digital reconstruction/registration analysis showed that the average difference between actual placement and planned one of customized mesh in positive and negative directions was 2.69 ± 0.70 mm and -1.41 ± 0.90 mm, respectively, without the screws-position-guided template. And the mean difference values between the actual and planned placement of the screws on the X and Y axes were 0.74 ± 0.85 mm and 0.89 ± 0.84 mm. In contrast, with the screws-position-guided template, the results were 2.38 ± 0.69 mm and -1.30 ± 1.13 mm. Accordingly, the mean difference values of screws were 0.76 ± 0.84 mm and 0.94 ± 0.72 mm. There was no statistical difference between the two groups, and the noninferiority of the control group compared to the test group was also confirmed by the comparative analysis.

CONCLUSION: It can be concluded that there is a certain deviation between the planned surgical placement and actual one of customized mesh, and using screws-position-guided template is of limited help for its accurate placement. Further research is needed to achieve precise surgical placement of the customized mesh to achieve precise alveolar bone augmentation.

PMID:37057478 | DOI:10.1111/cid.13205

Phys Chem Chem Phys. 2023 Apr 14. doi: 10.1039/d2cp05082j. Online ahead of print.

ABSTRACT

The site-specific hydrogen-atom elimination mechanism previously reported for photoexcited ethyl radicals (CH₃CH₂) [D. V. Chicharro et al., Chem. Sci., 2019, 10, 6494] is interrogated in the photodissociation of the ethyl isotopologues CD₃CD₂, CH₃CD₂ and CD₃CH₂ through the velocity map imaging (VMI) detection of the produced hydrogen- and deuterium-atoms. The radicals, generated in situ from photolysis of a precursor using the same laser pulse employed in their excitation to Rydberg states, decompose along the C_α-H/D and C_β-H/D reaction coordinates through coexisting statistical and site-specific mechanisms. The experiments are carried out at two excitation wavelengths, 201 and 193 nm. The comparison between both sets of results provides accurate information regarding the primary role in the site-specific mechanism of the radical internal reservoir. Importantly, at 193 nm excitation, higher energy dissociation channels (not observed at 201 nm) producing low-recoil H/D-atoms become accessible. High-level ab initio calculations of potential energy curves and the corresponding non-adiabatic interactions allow us to rationalize the experimental results in terms of competitive non-adiabatic decomposition paths. Finally, the adiabatic behavior of the conical intersections in the face of several vibrational modes – the so-called vibrational promoting modes – is discussed.

PMID:37057377 | DOI:10.1039/d2cp05082j

J Periodontol. 2023 Apr 14. doi: 10.1002/JPER.22-0721. Online ahead of print.

ABSTRACT

BACKGROUND: This study evaluated the systemic (intestine and adipose tissue) and local (periodontal tissues) impact of probiotic therapy in rats with metabolic syndrome (MS) associated or not with periodontitis (PE).

METHODS: Forty-eight rats received a high-fat diet for induction of MS for 16 weeks. They were subdivided into groups with (+) and without (-) PE, receiving (*) or not (**) probiotic (PROB): MS-, MSP-*, MSPE+**, and MSPEP+*. PROB administration (Bifidobacterium animalis subsp. lactis HN019) started on the eighth week of the study and PE was induced on the 14th week by placing ligature on the animals’ lower first molars. Euthanasia occurred in the 16th week. Biomolecular, immunoenzymatic assays, and histomorphometric analyses were performed. The data obtained were statistically analyzed (ANOVA, Tukey, p<0.05).

RESULTS: The MSPEP group exhibited reduced alveolar bone loss when compared with the MSPE group, as well as lower levels of hepatic steatosis and proteinuria (p<0.05). In the intestinal environment, the MSPE group exhibited significantly lower villus height and crypt depth, as well as a greater increase in Bacillota when compared with the MSPEP group (p<0.05). The MSPEP group showed lower adipokine gene expression (FABP4, NAMPT and LEPR) in adipose tissue than the MSPE group (p<0.05).

CONCLUSION: The probiotic B. lactis HN019 reduced the severity of experimental periodontitis and modulated the expression of lipogenic genes and intestinal morphological and microbiological parameters in rats with MS. This article is protected by copyright. All rights reserved.

PMID:37057371 | DOI:10.1002/JPER.22-0721

Eur J Paediatr Dent. 2023 Mar 1:1. doi: 10.23804/ejpd.2023.1846. Online ahead of print.

ABSTRACT

BACKGROUND: The presence of the parent could influence the behaviour of the child during the dental visit. The objective of this study was to assess the effect of the Parental Presence- Absence Technique (PPAT) on the behaviour of anxious children receiving dental restoration under local anaesthesia.

METHODS: A cohort prospective observational study of a statistically calculated sample size with 80% power, recruited 84 anxious children ages 6-9-year-old who scored ≥26 on the Abeer Children Dental Anxiety Scale (ACDAS) over two visits. Forty-two children were allocated to either the Parental Presence (PP) or the Parental Absence (PA) group to have one composite restoration under local anaesthesia.

STATISTICAL ANALYSIS: A two-sample t-test was used to compare differences in the mean of ACDAS between the PP and the PA groups, and between boys and girls. The P-value of ≤0.05 was set for a statistically significant result.

CONCLUSION: The use of the PPAT in children aged 6-9- year appears to be an effective method to improve children’s behaviour when having dental restorations under local anaesthesia.

PMID:37057363 | DOI:10.23804/ejpd.2023.1846

J Prim Care Community Health. 2023 Jan-Dec;14:21501319231164545. doi: 10.1177/21501319231164545.

ABSTRACT

The objective of the CONTINUE (conversations in routine OB care) pilot study was to gather preliminary data on the benefits of integrating a well-designed pregnancy support tool (“CONTINUE Tool”) in low-income prenatal care. A total of 184 tools were distributed by 21 OB providers during the study implementation period. Follow-up data were collected from 71 (38.5%) prenatal patients across three community-based midwestern OB clinics serving a diverse prenatal patient population. Early-gestation prenatal patients received the strategically designed CONTINUE Tool during routine prenatal care and later completed a semi-structured interview or electronic survey to report pre-determined individual benefit items experienced due to tool usage. Factor analysis used individual benefit items to identify factors representing common underlying benefits (“factor benefits”). Logistic regression analyses were performed to describe the relative odds of participants with low income (public insurance) experiencing individual and factor benefits of tool use compared to participants of higher income (private insurance). Chi square tests (or Fisher’s exact tests) were performed to generate P values reflecting statistically significant differences by income group. More low-income prenatal participants reported experiencing individual benefits as compared to higher-income participants. Among factor benefits, low-income participants were statistically more likely to report experiencing a time-related logistics benefit (OR = 4.00; 95% CI 1.02-15.73; P = .045). Low-income participants reported experiencing an overall logistics factor benefit (OR = 4.29; 95% CI 0.47-38.75), including a cost-related logistics benefit (OR = 3.08; CI 0.59-16.00), as well as an understanding benefit (OR = 1.90; 95% CI 0.72-5.04) and a self-efficacy benefit (OR = 1.30; 95% CI 0.44-3.87). While this study is limited by sample size due to being a pilot study, the findings suggest there may be tangible benefits to introducing the CONTINUE Tool among low-income prenatal patients. Given the staggering inequity in OB care and subsequent health outcomes, any preliminary findings on ways to help combat this are necessary and should lay the groundwork for subsequent randomized trials. Our preliminary findings show that supplementing routine OB care with the CONTINUE Tool can confer benefits to both providers and patients, but particularly for low-income prenatal patients who tend to have more structural barriers to adequate care in the first place.

PMID:37057337 | DOI:10.1177/21501319231164545