Chronic Low back pain (CLBP) is a common health concern with various consequences in particular on different aspects of sexual function. This study aimed to assess sexual function in men with chronic degenerative CLBP and to identify factors associated with erectile dysfunction (ED). We conducted a cross-sectional study over a 12-month period. Adult male patients with degenerative CLBP (≥ 3 months duration) of degenerative or disc-related origin were consecutively enrolled. Sociodemographic characteristics and CLBP characteristics (intensity with Visual Analogic Scale (VAS), radicular pain and its pattern…) were collected. Patients with inflammatory rheumatic diseases, prior spinal surgery, or medical conditions known to cause sexual dysfunction were excluded. Sexual function was evaluated using the International Index of Erectile Function (IIEF) and the Sexual Assessment Questionnaire (SAQ). Psychological status, disability, and sleep quality were also evaluated. Multivariate logistic regression was performed to identify factors associated with ED. We included 101 male patients with a mean age of 52.14 ± 12.89 years. Erectile dysfunction (IIEF erectile function domain ≤ 25) was present in 83
Introduction:Transient gestational thyrotoxicosis (TGT) occurs when human chorionic gonadotropin (hCG) directly stimulates the maternal thyroid gland during the first trimester of pregnancy. We report a case of complicated TGT in a young woman who required treatment with Lugol's solution. Case Presentation:A 29-year-old pregnant woman, at 10 weeks gestation and with no significant medical history, was referred to the endocrinology department for evaluation of hyperthyroidism. She had been experiencing persistent vomiting, anorexia, fatigue, palpitations, abdominal pain, and unintentional weight loss for 2 weeks. On examination, her heart rate was at 120 bpm, and she exhibited resting tremors, but there were no signs of exophthalmos or goiter. Laboratory results revealed a free T4 level 2.2 times above the upper limit of the normal range, with a thyroid-stimulating hormone (TSH) level of 0.01 mUI/L. Tests for thyroid receptor antibodies, thyroid peroxidase antibodies, and anti-thyroglobulin antibodies were negative. A cervical ultrasound with Doppler showed a normal-sized thyroid gland without hypervascularity or nodules, confirming the diagnosis of TGT.Additionally, liver enzyme abnormalities were observed, with ASAT elevated 4.84 times and ALAT 3.42 times the normal limit. Also, acute pancreatitis was diagnosed, as evidenced by a lipase level three times above the upper limit of normal. Given the contraindications for antithyroid drugs (ATDs) and glucocorticoids, treatment was initiated with Lugol's iodine 5% (five drops three times daily) and propranolol (60 mg/day) for 2 weeks. Symptoms of thyrotoxicosis resolved, free T4 returned to normal levels, and liver enzymes normalized. Conclusion:This case highlights the interesting role of Lugol's iodine as a short-term and effective therapeutic option in selected cases of TGT.
INTRODUCTION:Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome (ACS) but remains insufficiently characterized. This study aimed to evaluate early and long-term outcomes of patients with SCAD. METHODS:A national wide, 25-year (since 2000), study with prospective (since 2017) inclusions of patients presenting for ACS with documented SCAD. Primary endpoint was in-hospital and long term major adverse cardiac and cerebrovascular events (MACCE). RESULTS:87 patients. Mean age 47.5±11 years, 71% female, 84% had no or only one conventional cardiovascular risk factor. Pregnancy-associated (P-SCAD) accounted for 9%. ST-segment elevation myocardial infarction and cardiogenic shock were described in 51% and 7%. 101 SCAD lesions (60% type 1, 37% type 2 and 3% type 3) were noted. Left anterior descending was the most affected vessel (72%), multivessel involvement was observed in 26% and severe tortuosities were reported in 38%. Conservative strategy was possible in 84% of patients; among them 15% required subsequent urgent clinically driven revascularization. Coronary angiography and percutaneous interventions were associated with five major complications of which one was fatal. Six in-hospital deaths were reported (7%), 4 of them were P-SCAD. After 16-month median follow-up, overall major events and mortality rates were 17% and 9% respectively. Two SCAD recurrences were reported. CONCLUSIONS:SCAD affected a middle-aged, predominantly female population, with no or few conventional risk factors. In-hospital mortality was high especially in P-SCAD. Coronary angiography and interventions for SCAD were associated with frequent complications, and a conservative management should be preferred when possible.
The Alberta Stroke Program Early CT Score (ASPECTS) is a standardized method to assess early ischemic changes in the middle cerebral artery (MCA) territory on Non-contrast computed tomography (NCCT) scans. It plays a critical role in acute stroke management by guiding clinicians identify candidates for intravenous thrombolysis or mechanical thrombectomy based on the extent of ischemic damage. However, manual ASPECTS evaluation suffers from inter-observer variability and depends heavily on clinician experience. This study proposes a machine learning-based approach using two complementary models : the first classifies patients according to their eligibility for revascularization treatments, while the second identifies affected and unaffected ASPECTS regions and automatically estimates the ASPECTS score. Both models were trained and evaluated on a dataset of 40 patients, with annotated CT slices from the publicly available AISD dataset (Acute Ischemic Stroke Dataset, N=397). The approach achieved promising performance, with 93,33% accuracy in patient classification, and 93% accuracy for detecting affected and unaffected regions of interest (ROIs). However, the small sample size (40 patients) and lack of external validation limit the generalizability of the findings. Future work will focus on automating region of interest segmentation using deep learning and improving the models’ generalizability across diverse datasets and clinical environments.
Neuro-Behçet’s disease (NBD) is a severe neurological manifestation of Behçet’s disease (BD), a multisystemic inflammatory vasculitis affecting multiple organs. NBD presents complex immunopathological features involving both innate and adaptive immune responses. CD39 (ectonucleoside triphosphate diphosphohydrolase-1, ENTPD1), an ectoenzyme expressed on various immune cells, has emerged as a critical regulator of inflammation through its role in hydrolyzing extracellular ATP to immunosuppressive adenosine. This mini-review explores the role of CD39 in modulating neuroinflammation in NBD, focusing on its function in immune cell subsets, its dual role in inflammation and regulation, and its potential as a therapeutic target. It synthesizes the role of CD39 in neuroinflammatory disorders, with a specific focus on Neuro-Behçet’s Disease (NBD). We examine the dual role of CD39 expression in driving inflammation and immune regulation, and highlighting its potential as a therapeutic target.
