(c) Published by Elsevier Ireland Ltd “
“Erectile dysfunctio

(c) Published by Elsevier Ireland Ltd.”
“Erectile dysfunction (ED), metabolic syndrome (MetS), and hypogonadism are closely related, often coexisting in the aging male. Obesity was shown to raise the risk of ED and hypogonadism, as well as other endocrinological disturbances with impact on erectile function. We selected 179 patients referred for ED to our andrology unit, aiming to evaluate gonadotropins and estradiol interplay in context of ED, MetS, and hypogonadism. Patients were stratified into groups in accordance with the presence (or not) of MetS and/or

hypogonadism. Noticeable differences in total testosterone (TT) and free testosterone (FT) levels were found between patients with and without MetS. YM155 in vivo Men with MetS evidenced lower TT circulating levels with an increasing number of MetS parameters, for which hypertriglyceridemia and waist circumference strongly contributed. Regarding the hypothalamic-pituitary-gonadal axis, patients with hypogonadism did not exhibit raised LH levels. Interestingly, among those with higher LH levels, estradiol values were also increased. Possible explanations for

this unexpected profile of estradiol may be the age-related adiposity, other estrogen-raising pathways, or even unknown mechanisms. Estradiol is possibly a molecule with further interactions beyond the currently described. Our results further enlighten this still unclear multidisciplinary and complex subject, raising new investigational opportunities.”

Defects of the scalp

often pose a reconstructive challenge https://www.selleckchem.com/products/acalabrutinib.html in dermatologic surgery.


We report our experience with the H-plasty type of bilateral advancement flap for the closure of small to ABT-263 inhibitor medium-sized scalp defects that cannot be closed primarily.


In this case series study, 69 scalp defects 1.5 to 3.0 cm in diameter that could not be closed primarily were repaired using the H-plasty type of bilateral advancement flap.


Sixty-nine 1.5- to 3.0-cm-diameter scalp defects resulting from Mohs micrographic surgery that could not be closed primarily were identified over the 2-year study period. All 69 defects were closed entirely with the bilateral advancement flap, and there were no significant complications.


The H-plasty type of bilateral advancement flap allows appropriately selected scalp defects that might not be readily closed primarily to be repaired easily using local skin, providing an attractive alternative to other flap techniques, skin grafting, and healing via secondary intention. The limitations of this study are that the results are based on a retrospective single-surgeon experience and that there was no long-term follow-up scheduled to evaluate the final cosmetic outcome of the repair.

The authors have indicated no significant interest with commercial supporters.

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