Men with anxiety disorders have been identified as high risk of developing erectile dysfunction (ED). The aim of this review is to define the prevalence and severity of ED in the male anxiety disorder population. A literature search of three electronic databases (PubMed, Embase and PsychINFO) and a grey literature registry was conducted. Inclusion criteria were studies that investigated adult males, documented diagnosis of anxiety disorders made by a qualified psychiatrist and use of a validated tool to diagnose ED such as International Index of Erectile Function or ICD-10/DSM-IV. The search yielded 1220 articles and 12 studies were selected. The anxiety disorders investigated were post-traumatic stress disorder, obsessive–compulsive disorder, social phobia/social anxiety disorder and panic disorder. We found that the median [IQR] prevalence of ED was 20.0 [5.1–41.2]% and the median [IQR] International Index of Erectile Function-5 scores were 17.62 [13.88–20.88], indicating a mild to moderate severity. Our review suggests a high prevalence of ED in the anxiety disorder population and ED may be more severe in this cohort, therefore advocating this is an important clinical topic. However, the evidence is limited due to the high heterogeneity between the studies and more research is required in this field.
We read with interest the study by Vatier et al. (1) on educational continuity. As final year medical students, we concurred with many of the findings highlighted by the authors. However, we noted that preference for face-to-face learning by teachers was not explored to a similar depth, and we would like to add to this discussion.In our experience, although video-teaching and recorded material allowed continuity during the pandemic, it predominantly helped to progress theoretical skills and expand knowledge base. While this may be an excellent tool for preclinical teaching, it is insufficient for practical learning.At our university, interactive workshops on cultural diversity, minority inclusion, and basic clinical skills are organized in the early years: many of these are run by experienced patient educators and senior students. Holding these remotely could minimize their impact and subsequently the importance of these themes in students' future practice. Also, direct learner-to-learner interaction is key for development of interpersonal skills such as communication, team-work and leadership. In particular, nonverbal communication is known to play a significant role in good practice (2). Absence of in-person sessions may result in the underdevelopment of these skills.An article by Zis et al.(3) showed that extended periods of remote education reduced enthusiasm in all year groups, and increased self-doubt in senior medical students. There was also an associated increase in burnout of the latter group, although interestingly the reverse was seen for preclinical students. These findings emphasize the importance of clinical exposure and in-person teaching, as ultimately, passionate students will become safe doctors.Nevertheless, the benefits of virtual teaching cannot be negated. The concerns of teachers in this paper alongside its findings and those of Zis et al. highlight the benefits of introducing virtual teaching early in the medical curriculum. This could improve students' mental well-being, while ensuring educational goals are met. Thus we agree with the authors' suggestion of combining virtual and face-to-face education, as a good compromise for teachers and students without risking the loss of crucial aspects in clinical medical education.
Background: The current study reports the clinical outcomes of the efficacy of computerized tomography (CT) guided cryoablation (CA) in the treatment of patients with small renal masses.Methods: This retrospective single institution study analyses the clinical outcomes of 36 renal tumours that were managed with cryoablation. Patient age, sex, tumour size, complications and recurrences were recorded. These patients were followed up at 3,6- and 12-months interval, they underwent biopsy and abdominal contrast enhanced ultrasound (CEUS) depending upon indications.Results: 36 patients (63.9% male, 19.4% female) each with a single small renal mass had CA with a follow-up at 3, 6 and 12 months. The mean tumour size was 606.9±31.8 mm2. Eleven complications occurred in 36 patients, for an overall complication rate of 30.6%. One (2.7%) patient had enhancement at the surgical bed on initial imaging and were considered incomplete ablations. None of the patients showed signs of distant metastases at the 3, 6 and 12-month follow-ups.Conclusions: Cryoablation of renal masses results in acceptable oncologic efficacy with an acceptable number of complications. Therefore, it remains a viable treatment for renal masses.
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