OBJECTIVE: To investigate the effect of psychological intervention based on the extension and expansion of positive psychology (PERMA) model on sexual psychological resilience (PR) and erectile function in patients with psychogenic erectile dysfunction (pED). METHODS: This prospective, single-blind, randomized controlled trial included 122 cases of pED diagnosed in our hospital from September 2023 to August 2024, which were equally divided into a trial and a control group, the former treated by PERMA-based psychological intervention in addition to drug therapy, while the latter by drug therapy only. After 2, 4 and 8 weeks of treatment, we obtained the scores of the patients on IIEF-5, Connor-DavidsonResilience Scale (CD-RISC), Self-Esteem and Sexual Relationship Satisfaction Scale (SESRS) and the quality of sexual life, and compared them between the two groups before and after intervention. RESULTS: At 2, 4 and 8 weeks after treatment, the IIEF-5 scores were significantly lower in the trial than in the control group (P<0.05). There were no statistically significant differences in the baseline scores on any dimensions of CD-RISC between the two groups, while after 8 weeks of treatment, the scores on personal abilities, stress resistance, control, mental influence and total CD-RISC scores were all remarkably higher in the trial group than in the control (P<0.05). No statistically significant differences were observed between the two groups before treatment either in the SESRS scores, or in the average number of effective erections, average duration of each erection and average erection hardness. After 8 weeks of treatment, the patients in the trial group, compared with the controls, showed marked increases in self-esteem, sexual relationship satisfaction and total SESRS scores, as well as in the average number of effective erections, average duration of each erection and average erection hardness (P<0.05). CONCLUSION For the treatment of pED, PERMA-based psychological intervention in addition to active medication contributes to elevating the psychological resilience and improving the erectile function of the patients.
Humans ; Male ; Erectile Dysfunction/therapy* ; Prospective Studies ; Single-Blind Method ; Quality of Life ; Psychology, Positive ; Self Concept ; Resilience, Psychological ; Adult ; Middle Aged ; Sexual Behavior ; Penile Erection

Poor retention in care (RIC) is associated with higher antiretroviral therapy (ART) failure and worse survival. Identifying high risk patients for poor RIC is important for targeted intervention. A retrospective cohort study was conducted at a tertiary care hospital in Korea. HIV-infected patients initiating ART during 2002-2008 were included. 5 year-RIC was measured by hospital visit constancy (HVC) at 5 years after initiating ART. Among 247 enrolled patients, 179 (72.5%) remained in care, 20 (8.1%) were transferred to other hospitals, 9 (3.6%) died and 39 (15.8%) were lost to follow-up. We compared the demographic, psychosocial, and clinical characteristics between the groups with 100% HVC (n = 166, 67.2%) and < or = 50% HVC (n = 33, 13.4%). In multivariable analysis, ART-starting age < or = 30 years (odds ratio [OR] 4.08 vs. > 50; 95% confidence interval [CI] 1.10-15.15, P = 0.036), no non-HIV related comorbidity (OR 2.94 vs. comorbidity > or = 1; 95% CI 1.02-8.49, P = 0.046), baseline CD4 cell count > 300 cells/muL (OR 3.58 vs. < or = 200; 95% CI 1.33-9.65, P = 0.012) were significant predictable factors of poor RIC. HIV/AIDS care-givers should pay attention to young patients with higher baseline CD4 cell counts and no non-HIV related comorbidity.
Adult ; Anti-HIV Agents/*therapeutic use ; CD4 Lymphocyte Count ; CD4-Positive T-Lymphocytes/cytology ; Cohort Studies ; Comorbidity ; Demography ; Female ; HIV Infections/*drug therapy/mortality/psychology ; Hospitals ; Humans ; Male ; *Medication Adherence/psychology ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Republic of Korea ; Retrospective Studies

BACKGROUNDThis meta-analysis evaluated the effect of noninvasive, positive pressure ventilation on severe, stable chronic obstructive pulmonary disease (COPD).

METHODSPUBMED, CNKI, Wanfang, EMBASE and the Cochrane trials databases were searched. Randomized controlled trials of patients with severe, stable COPD and receiving noninvasive positive pressure ventilation, compared with sham ventilation or no ventilation, were reviewed. The mortality, physiological and health related parameters were pooled to yield odds ratio (OR), weighted mean differences or standardized mean differences (SMD), with 95% confidence interval (CI).

RESULTSEight parallel and three crossover randomized controlled trials met the inclusion criteria. Pooled analysis for parallel, randomized controlled trials showed noninvasive positive pressure ventilation: (1) Did not affect the 12- or 24-month mortality (OR 0.82, 95%CI: 0.48 to 1.41); (2) Improved the arterial carbon dioxide tension (SMD -0.88, 95%CI: -1.43 to -0.34); (3) Did not improve forced expiratory volume in one second (SMD 0.20, 95%CI: -0.06 to 0.46), maximal inspiratory pressure (SMD 0.01, 95%CI: -0.28 to 0.29) or 6-minute walk distance (SMD 0.17, 95%CI: -0.16 to 0.50); (4) Subgroup analysis showed noninvasive positive pressure ventilation improved the arterial carbon dioxide tension in hypercapnic patients. Pooled analysis for crossover randomized controlled trials did not show improvement in arterial blood gas or forced expiratory volume in one second with noninvasive positive pressure ventilation.

CONCLUSIONSNoninvasive positive pressure ventilation improves the arterial carbon dioxide tension but does not improve the mortality, pulmonary function, or exercise tolerance and should be cautiously used in severe stable chronic obstructive pulmonary disease.

Carbon Dioxide ; blood ; Forced Expiratory Volume ; Humans ; Positive-Pressure Respiration ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; psychology ; therapy ; Quality of Life ; Randomized Controlled Trials as Topic

Nocardiosis is an uncommon Gram-positive bacterial infection caused by aerobic actinomycetes in the genus Nocardia. Nocardia spp. have the ability to cause localized or systemic suppurative disease in humans and animals. Nocardiosis is typically regarded as an opportunistic infection, but approximately one-third of infected patients are immunocompetent. We report a rare case of pulmonary nocardiosis and a brain abscess caused by Nocardia asteroides in an elderly woman with a history of Crohn's disease. Radiographic imaging revealed a contrast-enhancing lesion with perilesional parenchymal edema that was preoperatively thought to be a neoplasm. The patient experienced aggressive disease progression simulating a metastatic brain tumor. Early diagnosis of norcadiosis, the absence of underlying disease, and the administration of appropriate antibiotics has a positive impact on prognosis. Familiarity with the magnetic resonance and computed tomography findings associated with CNS nocardiosis, such as those presented here, is essential for making an early diagnosis.
Actinobacteria ; Aged ; Animals ; Anti-Bacterial Agents ; Brain ; Brain Abscess ; Brain Neoplasms ; Crohn Disease ; Disease Progression ; Early Diagnosis ; Edema ; Female ; Gram-Positive Bacterial Infections ; Humans ; Magnetic Resonance Spectroscopy ; Nocardia ; Nocardia asteroides ; Nocardia Infections ; Opportunistic Infections ; Prognosis ; Recognition (Psychology)

BACKGROUND: Increased intra-abdominal pressure during laparoscopic surgery causes cephalad displacement of the diaphragm, resulting in the formation of atelectasis, which can be overcome by positive end-expiratory pressure (PEEP). The aim of this prospective study was to investigate the level of optimal PEEP to maintain adequate arterial oxygenation and hemodynamics during robot-assisted laparoscopic radical prostatectomy (RLRP). METHODS: One hundred patients undergoing RLRP were randomly allocated to one of five groups (n = 20) (0, 3, 5, 7 and 10 cmH2O of PEEP). Hemodynamic variables and respiratory parameters were measured at baseline with the patient in the supine position; at 30 min, 1, 2, 3 and 4 h during CO2 insufflation with the patient in the post-Trendelenburg position; and after deflation in the supine position with increasing PEEP. RESULTS: The PaO2 levels and alveolar-arterial difference in oxygen tension (AaDO2) were improved in patients with PEEPs compared with patients in whom PEEP was not used. The application of PEEP (10 cmH2O) resulted in higher PaO2 levels compared to those with lower PEEP levels, but excessive peak airway pressure (PAP) was sometimes observed. The application of a PEEP of 7 cmH2O resulted in similar PaO2 levels without causing excessive PAP. There was a significant difference in central venous pressure between the groups, but there were no significant differences in heart rate, mean arterial pressure or minute ventilation between the groups. CONCLUSIONS: A PEEP of 7 cmH2O is associated with the greater improvement of PaO2 and AaDO2 without causing excessive PAP during RLRP.
Arterial Pressure ; Central Venous Pressure ; Diaphragm ; Displacement (Psychology) ; Heart Rate ; Hemodynamics ; Humans ; Insufflation ; Laparoscopy ; Oxygen ; Positive-Pressure Respiration ; Prospective Studies ; Prostatectomy ; Pulmonary Atelectasis ; Robotics ; Supine Position ; Ventilation

PURPOSE: We examined the respiratory morbidities in late-preterm infants compared to those of the early-preterm infants and term infants throughout the first year of life. METHODS: Data were retrospectively collected for 87 late-preterm, 72 early-preterm, and 608 term infants who were admitted to NICU and the nursery of Busan St. Mary's Medical Center from Jan 2007 to Oct 2009. RESULTS: There were significant differences in the proportions of the out-born infants, twin pregnancy, small for gestational age, and Caesarean section in the three groups (P<0.05). Late-preterm and early-preterm infants had longer duration of hospitalization, larger proportions of respiratory distress syndrome, mechanical ventilation at birth, oxygen therapy after 48 hours of birth, oxygen dependency at 28 days, and continuous positive airway pressure support at 28 days compared to term infants during the neonatal period (P=0.000). Late-preterm infants and early-preterm infants were re-admitted more often than term infants during the first year of life (P=0.000). Also Late-preterm and early-preterm infants had increased chance of respiratory tract illness than term infants (P=0.001). CONCLUSION: In this study, we demonstrated that there are higher chances of respiratory morbidities in the late-preterm infants than the term infants either during the neonatal period or throughout the first year of life, although early-preterm infants showed greatest respiratory morbidities.
Cesarean Section ; Continuous Positive Airway Pressure ; Dependency (Psychology) ; Female ; Gestational Age ; Hospitalization ; Humans ; Infant ; Nurseries ; Oxygen ; Parturition ; Pregnancy ; Pregnancy, Twin ; Respiration, Artificial ; Respiratory System ; Retrospective Studies

BACKGROUND AND OBJECTIVES: The use of oral appliances has recently risen as an effective alternative treatment methods for patients with simple snoring or mild to moderate obstructive sleep apnea, who prefer oral appliances to continuous positive airway pressure (CPAP) or who are unable to tolerate CPAP therapy. The objective of this study was to identify which polysomnographic parameters are related to the successful use of oral appliances in patients with sleep-disordered breathing. SUBJECTS AND METHOD: We performed a retrospective study of 29 subjects with sleep-disordered breathing and prescribed the use of an oral appliance. To determine which polysomnographic parameters were related to responsiveness to oral appliances, differences in responder rates were assessed according to apnea severity, sleep position, rapid eye movement-stage dependency, body mass index (BMI) and nasal surgery history. RESULTS: Twenty-one of 29 patients showed improved respiratory disturbance index after oral-appliance treatment. Responder rates of patients with mild, moderate, and severe sleep-disordered breathing were 72.3%, 80%, and 62.5%, respectively. Responder rates among position-dependent and non-position dependent groups were 85% and 44.4%, respectively. When grouping into overweight and normal weight groups according to BMI, responder rates were 69.57% and 83.3%, respectively. The responder rate for 24 patients who had undergone septoturbinoplasty was 75%, whereas it was 60% for the non-surgery group. CONCLUSION: Oral appliance therapy is confirmed to be useful for patients with simple snoring or mild to moderate sleep apnea, or position dependent sleep apnea, and those who have normal weight and low nasal resistance.Oral appliance therapy is confirmed to be useful for patients with simple snoring or mild to moderate sleep apnea, or position dependent sleep apnea, and those who have normal weight and low nasal resistance.
Apnea ; Body Mass Index ; Continuous Positive Airway Pressure ; Dependency (Psychology) ; Eye ; Humans ; Mandibular Advancement ; Nasal Surgical Procedures ; Orthodontic Appliances ; Overweight ; Retrospective Studies ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring

Fenazaquin (4-[[4 (1,1-dimethylethyl) pheynyl]ethoxy]quinazoline) is an insecticide that inhibits NADH ubiquinone oxidoreductase of the mitochondria, which is also known as complex I. An 83 year old female was brought to our emergency department (ED) having been found collapsed and unconscious at home by her family. She had ingested up to 100 ml from a bottle of 20% fenazaquin solution. In the ED, she showed severe persistent lactic acidosis despite a seemingly stable hemodynamic condition. Despite intensive supportive management, including positive pressure ventilation, packed red cell transfusion, hemodialysis, and intravenous N-acetylcysteine administration, the lactic acidosis did not respond. To our knowledge, this is the first report of fenazaquin poisoning in humans. No antidote for fenazaquin is known. In this case report, we discuss clinical characteristics and possible pathophysiologic mechanism of fenazaquin poisoning with a literature review.
Acetylcysteine ; Acidosis, Lactic ; Electron Transport Complex I ; Emergencies ; Female ; Hemodynamics ; Humans ; Mitochondria ; Positive-Pressure Respiration ; Quinazolines ; Renal Dialysis ; Unconscious (Psychology)

Continuous Positive Airway Pressure ; methods ; Depression ; physiopathology ; Humans ; Sleep Apnea, Obstructive ; psychology ; therapy

BACKGROUND: Staphylococcus aureus is most frequently isolated Gram-positive cocci from clinical specimens. The accurate identification of S. aureus is required. Lipovitellin-salt-mannitol (LSM) agar is medium for differentiating S. aureus and coagulase-negative staphylococci (CNS) by mannitol acidification and lipovitellin lipase reaction. In this study, we compare LSM agar with the other conventional methods for differentiating S. aureus and CNS in clinical laboratories, coagulase test, mannitol-salt agar (MSA), and DNase agar. METHODS: One hundred and forty-five isolates of staphylococci from clinical specimens are used. S. aureus and CNS were identified by coagulase test, MSA, DNase agar, and LSM agar. RESULTS: Eighty-nine isolates were identified as S. aureus and 59 isolates were revealed CNS. Compared ability of methods to differntiate S. aureus from CNS, sensitivity and specificity were 98.7% and 96.6% with LSM agar, 92.1% and 96.6% with coagulase test, 96.6% and 93.2% with MSA, 93.3% and 98.3% with DNase agar, respectively. CONCLUSIONS: LSM agar show good discrimination between S. aureus and CNS. LSM agar may be used for identification of S. aureus in clinical laboratories.
Agar* ; Coagulase ; Deoxyribonucleases ; Discrimination (Psychology) ; Gram-Positive Cocci ; Lipase ; Mannitol ; Sensitivity and Specificity ; Staphylococcus aureus* ; Staphylococcus*