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Medicines, Volume 9, Issue 9 (September 2022) – 3 articles

Cover Story (view full-size image): Post-SSRI syndrome (PSSD) is an iatrogenic disease that occurs when taking selective serotonin reuptake inhibitors (SSRIs), drugs commonly used to treat anxiety–depressive disorders. This complex syndrome is characterized by changes in libido, genital anesthesia, anorgasmia, delayed orgasms, ejaculatory dysfunctions, and difficulty in maintaining an erection, often accompanied by emotional concerns. Although sexual dysfunctions are common side effects of SSRIs, their pathophysiology and treatment remain largely unknown. Our study retrospectively evaluated the potential efficacy of different treatments to improve male PSSD. Neuropharmacological modulation, using vortioxetine or bupropion, may improve erectile function and related concerns. View this paper
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8 pages, 303 KiB  
Communication
The Effectiveness of GLP-1 Receptor Agonist Semaglutide on Body Composition in Elderly Obese Diabetic Patients: A Pilot Study
by Yoshinori Ozeki, Takayuki Masaki, Akari Kamata, Shotaro Miyamoto, Yuichi Yoshida, Mitsuhiro Okamoto, Koro Gotoh and Hirotaka Shibata
Medicines 2022, 9(9), 47; https://doi.org/10.3390/medicines9090047 - 16 Sep 2022
Cited by 8 | Viewed by 3519
Abstract
Background and Objectives: This study aimed to investigate the changes in obesity severity, glucose metabolism, and body composition in patients with obesity and type 2 diabetes mellitus treated with glucagon-like peptide 1 receptor agonist (GLP1-RA) semaglutide. Materials and Methods: Body weight (BW), metabolic [...] Read more.
Background and Objectives: This study aimed to investigate the changes in obesity severity, glucose metabolism, and body composition in patients with obesity and type 2 diabetes mellitus treated with glucagon-like peptide 1 receptor agonist (GLP1-RA) semaglutide. Materials and Methods: Body weight (BW), metabolic parameters, and body composition were examined before and 3 months after semaglutide administration. The mass of body fat (FM), fat weight percentage (%FM), mass of skeletal muscle (MM), skeletal MM percentage (%MM), and limb muscles were measured using the bioelectrical impedance method. Results: Semaglutide dramatically reduced the weight, the body mass index (BMI), and the levels of the glucose metabolic markers, including fasting blood glucose and hemoglobin A1c, and accelerated the loss of excess BW. FM, MM, and %FM after semaglutide treatment also decreased. Conversely, semaglutide had no effect on the %MM after 3 months. In limb muscle analyses, right upper and lower leg muscle percentages, left upper and lower leg muscles, and the ratios of the lower/upper muscles were maintained by semaglutide treatment. Conclusions: These results suggest that the GLP1-RA semaglutide effectively reduces body adiposity while maintaining the MM in obese type 2 diabetic patients. Full article
12 pages, 5666 KiB  
Article
Chest X-ray Features in Drug-Resistant Tuberculosis Patients in Nigeria; a Retrospective Record Review
by Olanrewaju Oladimeji, Adenike Temitope Adeniji-Sofoluwe, Yasir Othman, Victor Abiola Adepoju, Kelechi Elizabeth Oladimeji, Bamidele Paul Atiba, Felix Emeka Anyiam, Babatunde A. Odugbemi, Tolulope Afolaranmi and Ayuba Ibrahim Zoakah
Medicines 2022, 9(9), 46; https://doi.org/10.3390/medicines9090046 - 06 Sep 2022
Cited by 2 | Viewed by 2575
Abstract
Chest X-ray (CXR) characteristics of patients with drug-resistant tuberculosis (DR-TB) depend on a variety of factors, and therefore, identifying the influence of these factors on the appearance of DR-TB in chest X-rays can help physicians improve diagnosis and clinical suspicion. Our aim was [...] Read more.
Chest X-ray (CXR) characteristics of patients with drug-resistant tuberculosis (DR-TB) depend on a variety of factors, and therefore, identifying the influence of these factors on the appearance of DR-TB in chest X-rays can help physicians improve diagnosis and clinical suspicion. Our aim was to describe the CXR presentation of patients with DR-TB and its association with clinical and demographic factors. A retrospective analysis of the CXRs of DR-TB patients in Nigeria between 2010 and 2016 was performed, reviewing features of chest radiographs, such as cavitation, opacity and effusion, infiltration and lung destruction. The association of these abnormal CXR findings with clinical and demographic characteristics was evaluated using bivariate and multivariate models, and a p-value < 0.05 was considered statistically significant with a 95% confidence interval. A total of 2555 DR-TB patients were studied, the majority (66.9%) were male, aged 29–38 years (36.8%), previously treated (77%), from the South West treatment zone (43.5%), HIV negative (76.7%) and bacteriologically diagnosed (89%). X-ray findings were abnormal in 97% of the participants, with cavitation being the most common (41.5%). Cavitation, effusion, fibrosis, and infiltration were higher in patients presenting in the South West zone and in those previously treated for DR-TB, while lung destruction was significantly higher in patients who are from the South South zone, and in those previously treated for DR-TB. Patients from the South East zone (AOR: 6.667, 95% CI: 1.383–32.138, p = 0.018), the North East zone (AOR: 6.667, 95% CI: 1.179–37.682, p = 0.032) and the North West zone (AOR: 6.30, 95% CI: 1.332–29.787, p = 0.020) had a significantly increased likelihood of abnormal chest X-ray findings, and prior TB treatment predisposed the patient to an increased likelihood of abnormal chest X-ray findings compared to new patients (AOR: 8.256, 95% CI: 3.718–18.330, p = 0.001). The finding of a significantly higher incidence of cavities, effusions and fibrosis in DR-TB patients previously treated could indicate late detection or presentation with advanced DR-TB disease, which may require a more individualized regimen or surgical intervention. Full article
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11 pages, 326 KiB  
Article
Cutting the First Turf to Heal Post-SSRI Sexual Dysfunction: A Male Retrospective Cohort Study
by Rosaria De Luca, Mirjam Bonanno, Alfredo Manuli and Rocco Salvatore Calabrò
Medicines 2022, 9(9), 45; https://doi.org/10.3390/medicines9090045 - 01 Sep 2022
Cited by 4 | Viewed by 9788
Abstract
Post-SSRI sexual dysfunction (PSSD) is a set of heterogeneous sexual problems, which may arise during the administration of selective serotonin reuptake inhibitors (SSRIs) and persist after their discontinuation. PSSD is a rare clinical entity, and it is commonly associated with non-sexual concerns, including [...] Read more.
Post-SSRI sexual dysfunction (PSSD) is a set of heterogeneous sexual problems, which may arise during the administration of selective serotonin reuptake inhibitors (SSRIs) and persist after their discontinuation. PSSD is a rare clinical entity, and it is commonly associated with non-sexual concerns, including emotional and cognitive problems and poor quality of life. To date, however, no effective treatment is available. The aim of this study was to retrospectively evaluate the potential efficacy of the different treatments used in clinical practice in improving male PSSD. Of the 30 patients referred to our neurobehavioral outpatient clinic from January 2020 to December 2021, 13 Caucasian male patients (mean age 29.53 ± 4.57 years), previously treated with SSRIs, were included in the study. Patients with major depressive disorder and/or psychotic symptoms were excluded a priori to avoid overlapping symptomatology, and potentially reduce the misdiagnosis rate. To treat PSSD, we decided to use drugs positively affecting the brain dopamine/serotonin ratio, such as bupropion and vortioxetine, as well as other compounds. This latter drug is known not to cause or reverse iatrogenic SD. Most patients, after treatment with vortioxetine and/or nutraceuticals, reported a significant improvement in all International Index of Erectile Function-(IIEF-5) domains (p < 0.05) from baseline (T0) to 12-month follow-up (T1). Moreover, the only patient treated with pelvic muscle vibration reached very positive results. Although our data come from a retrospective open-label study with a small sample size, drugs positively modulating the central nervous system serotonin/dopamine ratio, such as vortioxetine, could be used to potentially improve PSSD. Large-sample prospective cohort studies and randomized clinical trials are needed to investigate the real prevalence of this clinical entity and confirm such a promising approach to a potentially debilitating illness. Full article
(This article belongs to the Section Neurology and Neurologic Diseases)
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