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Emotions appeared very early in phylogenetic and ontogenetic development. The word emotion originates from the Latin verb movere. However, attempts to distinguish and name the concept represented by the phrase emotion reach back to the beginnings of human language. The compound and subjective nature of emotions stress an essential aspect of this phenomenon, which leads to changes in physiological, psychological, and behavioral issues. World literature dedicates significant attention to the mutual associations between the cognitive and adaptive processes and emotions. Emotions help to estimate the adaptational meaning of stimuli. Its cognitive aspect is, however, just as significant. The review of the literature presented herein is an attempt to classify and evaluate particular emotions, both positive and negative, and the influence they have on physical and mental health. Paul Ekman, the author of one of the more esteemed classification attempts, has distinguished six basic emotions: anger, disgust, fear, happiness, sadness, and surprise. These universal emotions are recognized based on emotional facial expressions, the automatic reactions that unfold within microseconds. Robert Plutchik, on the other hand, devised his „emotion wheel“ upon which he organized eight basic emotions by grouping them in pairs comprising a combination of positive and negative emotions. He is also the author of one of the best framed emotional combination theories. In this respect, emotions play a crucial role as compound model reactions to everyday situations such as a long-lasting effort ensuring survival and individual development. [ABSTRACT FROM AUTHOR]

This technique-focused observational study explores the impact of a 6-week Nordic Walking (NW) program on physiological and biomechanical aspects in ischemic heart disease (IHD) patients. Twelve male IHD patients (66.2 ± 5.2 years, 12.2 ± 7.5 years of disease duration) were evaluated pre- and post-training for (i) gait parameters, (ii) exercise tolerance using electrocardiographic (ECG) stress test, (iii) a 6-min walk test (6MWT). The NW training, adhering to IHD patient guidelines, involved a 100-m walk at a self-selected, preferred speed without sticks, with classic NW sticks and mechatronic sticks. A mechatronic measuring system, specifically engineered for measuring, diagnosing and monitoring the patient's gait, was integrated into mechatronic sticks. Post-training, significant enhancements were observed in ECG stress test duration, metabolic equivalency, and 6MWT distance, irrespective of the stick type. However, no significant changes were noted in spatiotemporal parameters concerning the measured side, stick utilisation, or type. The results suggest that NW training boosts exercise capacity and refines gait mechanics in male IHD patients. However, the improvement in exercise capacity was not linked to changes in gait mechanics from NW training but rather to the movement during NW gait. Hence, the key to enhancing exercise capacity in IHD patients is the movement during NW gait, not the quality of gait mechanics., (© 2024. The Author(s).)

Background : This cross-sectional study aimed to investigate the prevalence of erectile dysfunction (ED) in elderly men with overweight or obesity and coronary artery disease. Methods : Patients recruited in cardiac rehabilitation centers post-myocardial infarction provided demographic and anthropomorphic data. ED was assessed using the abbreviated International Index of Erectile Function 5 (IIEF-5) Questionnaire. Results : The study included 661 men with a mean age of 67.3 ± 5.57 years, a mean BMI of 27.9 ± 3.6 m/kg 2 , and a mean waist circumference of 98.9 ± 10.23 cm. Over 90% of men experienced ED, with similar proportions across BMI categories. The development of ED in men with a waist circumference of ≥100 cm had 3.74 times higher odds (OR 3.74; 95% CI: 1.0-13.7; p = 0.04) than in men with a waist circumference of <100 cm. Men with obesity and moderate-to-severe and severe ED were older compared to those without these disorders (67.1 ± 5.29 vs. 65.3 ± 4.35; p = 0.23). Conclusions : The prevalence of ED in men with coronary artery disease surpasses 90%. An increased body weight raises the risk of ED, with waist circumference proving to be a more reliable predictor of this risk compared to BMI. Physicians are encouraged to screen elderly patients with cardiovascular disease for ED and address obesity to enhance overall health.

Over recent decades, the use of the Internet has dramatically increased, both for professional purposes and entertainment. We investigated the link between social media use, video games, dating apps, and pornography on men's sexual health, which makes life easier, but also carries potential threats. Online surveys including The International Index of Erectile Function (IIEF) and Bergen Social Media Addiction Scale questionnaires were spread to young, sexually active men. We asked about demographics, sexual activity, and the use of social media, video games, dating apps, and pornography. We enrolled 702 men aged 18 to 60 years (mean 24.06 ± 5.70). In general, 1.6% of men were exposed to social media addiction. Social media addiction had a negative impact on IIEF scores, while pornography in general had no impact on men's sexual health. However, more extensive use of pornography was correlated with lower IIEF scores. A negative impact of dating apps use on the IIEF score was also found but the correlation was weak ( p = 0.049). No correlation was found between playing games and IIEF. We conclude that social media addiction negatively affected men's sexual functioning during the COVID-19 pandemic. The development of strategies for the safe use of the Internet and dissemination of this knowledge through social media campaigns can help young people to recognize the first symptoms of social media addiction.

Nociplastic pain is a recently distinguished type of pain, distinct from neuropathic and nociceptive pain, and is well described in the literature. It is often mistaken for central sensitization. Pathophysiology has not been clearly established with regard to alteration of the concentration of spinal fluid elements, the structure of the white and gray matter of the brain, and psychological aspects. Many different diagnostic tools, i.e., the painDETECT and Douleur Neuropathique 4 questionnaires, have been developed to diagnose neuropathic pain, but they can also be applied for nociplastic pain; however, more standardized instruments are still needed in order to assess its occurrence and clinical presentation. Numerous studies have shown that nociplastic pain is present in many different diseases such as fibromyalgia, complex regional pain syndrome type 1, and irritable bowel syndrome. Current pharmacological and nonpharmacological treatments for nociceptive and neuropathic pain are not entirely suitable for treating nociplastic pain. There is an ongoing effort to establish the most efficient way to manage it. The significance of this field has led to several clinical trials being carried out in a short time. The aim of this narrative review was to discuss the currently available evidence on pathophysiology, associated diseases, treatment possibilities, and clinical trials. It is important that physicians widely discuss and acknowledge this relatively new concept in order to provide optimized pain control for patients.

The study aimed to compare the technique of normal gait with the Nordic walking (NW) gait with classical and mechatronic poles in patients with ischemic heart disease. It was assumed that equipping classical NW poles with sensors enabling biomechanical gait analysis would not cause a change in the gait pattern. The study involved 12 men suffering from ischemic heart disease (age: 66.2 ± 5.2 years, body height: 173.8 ± 6.74 cm; body mass: 87.3 ± 10.89 kg; disease duration: 12.2 ± 7.5 years). The MyoMOTION 3D inertial motion capture system (Noraxon Inc., Scottsdale, AZ, USA) was used to collect biomechanical variables of gait (spatiotemporal and kinematic parameters). The subject's task was to cover the 100 m distance with three types of gait-walking without poles (normal gait), walking with classical poles to NW, and walking with mechatronic poles from the so-called preferred velocity. Parameters were measured on the right and left sides of the body. The data were analyzed using two-way repeated measures analysis of variance with the between-subject factor "body side." Friedman's test was used when necessary. For most kinematic parameters, with the exception of knee flexion-extension ( p = 0.474) and shoulder flexion-extension ( p = 0.094), significant differences were found between normal and walking with poles for both the left and right side of the body and no differences due to the type of pole. Differences between the left and right movement ranges were identified only for the ankle inversion-eversion parameter (gait without poles p = 0.047; gait with classical poles p = 0.013). In the case of spatiotemporal parameters, a reduction in the cadence step value using mechatronic poles and the stance phase using classical poles compared to normal walking was observed. There was also an increase in the values for step length and step time regardless of the type of poles, stride length, and swing phase when using classical poles and stride time when using mechatronic poles. The differences between the right and left sides of the measurement occurred when walking with both types of poles for single support (gait with classical poles p = 0.003; gait with mechatronic poles p = 0.030), stance phase (gait with classical poles p = 0.028; gait with mechatronic poles p = 0.017) and swing phase (gait with classical poles p = 0.028; gait with mechatronic poles p = 0.017). Mechatronic poles can be used in the study of the biomechanics of gait in real-time with feedback on its regularity because no statistically significant differences were found between the NW gait with classical and mechatronic poles in the studied men with ischemic heart disease., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Agnieszka Szpala et al.)

Evidence has grown recently on the correlation between lifestyle and physical activity, and their impact on the functioning of the entire organism. In addition, a decrease in physical efficiency may be an indicator of the early diagnosis of systemic diseases. The aim of this study was to determine whether there is a relationship between exercise tolerance and possible erectile dysfunction or mental disorders. A cross-sectional study was conducted among 254 men in 4 cardiac rehabilitation centers in Poland using the standardized International Index of Erectile Function 5 (IIEF-5) and Beck Depression Inventory (BDI) questionnaires. Erectile dysfunction was directly proportional to the metabolic equivalent of the task (MET) variable. An increase in exercise tolerance by 1 point was associated with an increase in the IIEF-5 score by 1.62 points, indicating a reduction in the severity of erectile dysfunction. The 1-point increase in MET was associated with a 1.8-point decrease in BDI, indicating that an increase in exercise tolerance is associated with a decrease in the severity of depressive disorders. Increasing the tolerance of physical effort has a beneficial effect not only on the general well-being, but also on the sexual and mental health of men. An increase in exercise tolerance is associated with a reduction in the incidence of erectile dysfunction. On the other hand, in patients with depressive disorders, the improvement of exercise tolerance reduces the intensity of depression symptoms. Exercise tolerance can be an early and simple marker at the onset of erectile dysfunction or mood disorders.

Due to the worldwide spread of COVID-19, some restrictions were introduced which could lead to the development of distress and somatic symptoms. This survey aimed to study the mental and sexual health of men during the COVID-19 outbreak. An online questionnaire was conducted to collect data on contact with people suspected of infection/infected with the SARS-CoV-2 virus, use of stimulants, and perceived mental and sexual health during isolation among Polish men. They were also asked to answer the Beck Depression Inventory (BDI) and the International Index of Erectile Function (IIEF-15) questionnaire. In total, 606 men with a mean age of 28.46 ± 9.17 years took part in the survey. Fear of contracting the COVID-19 infection had a negative impact on the mental health of 132 men (21.8%). Fear of the health condition of loved ones caused stress and a depressed mood in 253 men (41.7%), and media reports worsened the mental health of 185 men (30.2%). In the BDI, 71.95% of the respondents did not suffer from depressive symptoms, 17.33% were diagnosed with mild depression, 6.11% with moderate depression, and 4.62% had severe depression. The mean score in the IIEF-15 questionnaire in the erectile function domain was 22.27, orgasm-7.63, desire-8.25, satisfaction-10.17, and general satisfaction-6.84. Depressive symptoms indicated more severe sexual functioning disorders ( p < 0.001). Fear, following the media, and loneliness were associated with more severe depressive and sexual disorders ( p < 0.001). The libido level ( p = 0.002) and frequency of sexual activity ( p < 0.001) were also lower during the pandemic than before the lockdown. These data showed that the COVID-19 pandemic had a significant impact on male mental and sexual health.

In this study, we investigated the relationship between social media use and women's sexual functioning during the COVID-19 pandemic. Data were collected between April and November 2021. Online surveys including the Female Sexual Functioning Index (FSFI) and Bergen Social Media Addiction Scale (BSMAS) questionnaires were distributed to young, sexually active women. Information was collected on their demographics, sexual life, and use of social media. We enrolled 546 women (mean age 23.07 ± 4.69). In general, 5.68% of the women were at high risk of social media addiction. Social media addiction had a negative impact on FSFI scores, while pornography use had a positive effect on women's sexual functioning. Users of dating apps also obtained lower FSFI scores than non-users. No differences in FSFI scores were observed between gamers and non-gamers. The impact of time spent on social media on FSFI scores was not significant. We conclude that social media addiction negatively affected women's sexual functioning during the COVID-19 pandemic.

We investigated whether long-term social restrictions and COVID-19 exposure have different impacts on the mental and sexual health of Polish women compared to the effects experienced at the beginning of the pandemic. An online survey was conducted among Polish women via Facebook groups. The Beck Depression Inventory (BDI) and Female Sexual Function Index (FSFI) scores were compared for the first wave (April-May 2020) and the second wave (November 2020 to February 2021) of the pandemic. We enrolled 1644 participants (mean age 25.11 ± 7.09 years) during the first wave and 720 participants (mean age 23.23 ± 5.34 years) during the second wave of COVID-19 pandemic. Significant differences were observed in libido levels and frequency of sexual activity before and during the first and second wave of the COVID-19 pandemic (both p < 0.001). The percentage of participants under psychiatric or psychological care increased from 6.5% to 14.44% and those who were anxious about the health conditions of loved ones increased from 57.5% to 65.14%. BDI scores increased significantly from 11 (IQR 5-18) to 12 (IQR 7-20). The change in the FSFI score was not significant (27.01 ± 7.61 vs. 26.38 ± 7.76). The COVID-19 pandemic affected various aspects of human life, including sexual life. The data obtained during the first and the second wave of the COVID-19 pandemic in Poland showed that female sexual dysfunction did not differ, but depressive symptoms and fear intensified.

The impact of social media on the eagerness to undergo aesthetic breast surgery is unknown. We aimed to evaluate the association between Instagram engagement and the willingness to undergo breast augmentation. Women aged between 19-34 years old participated in an online survey. Of the 1560 respondents, 1226 (78.59%) met the inclusion criteria. BMI, bra type, bra cup size, education, and level of activity on Instagram increased the willingness to undergo breast augmentation (OR = 1.520, p = 0.020). Moreover, concurrent Snapchat use (OR = 1.348, p = 0.024) and the number of published posts on a respondent's Instagram accounts (reference, n > 26; 0 < n ≤ 26; OR = 0.708, p = 0.009; lack of posts ( n = 0): OR = 0.702, p = 0.155) were significant drivers of the respondents' willingness. Fashion (OR = 0.730, p = 0.021), design/architecture (OR = 0.730, p = 0.022), and models (OR = 0.623, p = 0.004) were the searched content categories that increased the desire for breast augmentation. Positive and negative feeling scores that were triggered by Instagram content were correlated with BREAST-Q scores. We concluded that Instagram is a commonly used social network service among young women, and it may drive a desire for breast augmentation. Further analyses of Instagram preferences may help assess the willingness to undergo breast surgery, and in turn assist in tailoring marketing campaigns.

Erectile dysfunction (ED) and coronary artery disease (CAD) share common risk factors, some of which have genetic backgrounds, while others may be stimulated by family lifestyle. We investigated the impact of the familial occurrence of CAD on the presence of ED and the presence of classic risk factors for ED in men with CAD. This cross-sectional observational study involved 751 men with CAD who were subjected to cardiac rehabilitation. Overall, 75.63% of the men had ED. CAD was diagnosed in 39.28% of the studied men's relatives. ED was less frequent in the men with familial CAD than in those without (71.53% vs. 78.29%). Similar relations were observed for the presence of CAD in parents (70.43% vs. 78.34%) and the father (69.95% vs. 77.46%). The International Index of Erectile Function 5 score was significantly higher in patients with familial CAD (median (interquartile range); 17 (12-22) vs. 16 (10-21); p = 0.0118), in parents (18 (12-22) vs. 16 (10-20); p = 0.021), and in the father (18 (12-22) vs. 16 (10-21); p = 0.0499). Age and education minimized the effect of familial CAD. Familial CAD increased the incidence of hypertension, dyslipidemia, and smoking but not sedentary lifestyle. Despite the higher prevalence of selected risk factors for ED in men with familial CAD, a higher incidence of ED was not observed.

Introduction: The COVID-19 pandemic can cause emotional distress, which can in turn lead to the development of mental and physical symptoms., Aim: We examined the association of the COVID-19 outbreak and the mental, physical and sexual health of the female Polish population., Methods: Data were collected in an online survey distributed on social media from April 22, 2020 through to May 7, 2020. The data collection began one month after the start of lockdown in Poland., Main Outcome Measure: Women were asked to complete the Beck Depression Inventory (BDI) and the Female Sexual Function Index (FSFI) questionnaires., Results: Overall, 1644 women (median age 23 years) took part in the survey. They reported a lower frequency of sexual activity (P < .001) and a lower libido level (P < .001) during the pandemic then before it. 57.5% of the study group (n = 944) strongly agreed or agreed that fear of the health condition of loved ones was a source of stress and depressed mood. The average BDI-II total score was 11 (range 0-51; IQR 5-18), which corresponds to minimal depression. The average FSFI total score was 27.01 ± 7.61 (range 2-36). The FSFI and BDI scores were significantly correlated (P < .001). The FSFI score was significantly correlated with the presence of any comorbid chronic disease, the intensity of the fear of infection and fear of health conditions, perceived loneliness, and the being up to date with media news. The BDI score was significantly correlated with age, the intensity of the fear of infection and fear of health conditions, perceived loneliness, being up to date with media news, and the more frequent use of stimulants., Conclusions: The COVID-19 lockdown setting was associated with a high occurrence of depressive symptoms and increased risk of sexual dysfunction with decreased libido and lower sexual frequency the most commonly reported issues. Szuster E, Kostrzewska P, Pawlikowska A, et al. Mental and Sexual Health of Polish Women of Reproductive Age During the COVID-19 Pandemic - An Online Survey. Sex Med 2021;9:100367., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: Over 50% of elderly men and 70% of male cardiac patients suffer from erectile dysfunction (ED). Although pharmacotherapy is effective and safe, it only brings a short-term improvement and may cause side effects. Low energy shock-wave therapy (LESWT) is a promising causative modality for the treatment of ED. The evidence is still limited with different results obtained using different devices. The aim of this work was to evaluate evidence from randomized controlled trials regarding the efficacy of LESWT generated by an electrohydraulic unit for the treatment of ED., Methods: A systematic review of the literature was conducted in PubMed on May 20th, 2018 and supplemented by a Google search of grey literature, as well as a hand search of the bibliographies of retrieved articles. Out of 34 studies, 5 studies on 354 patients were included in the quantitative synthesis., Results: The studies evaluated an abridged International Index of Erectile Function (IIEF-5), the Erectile Hardness Scale (EHS) and Flow-Mediated Dilatation (FMD). The meta-analysis revealed that LESWT improved the IIEF-5 score (mean difference: 5.16; 95% CI, 1.39-8.93; p=0.0073) and EHS score (risk difference:0.72; 95% CI, 0.73-0.80; p<0.001). Reporting of FMD was inconsistent and not analyzed. The meta-analysis of studies conducted with electrohydraulic devices showed greater benefits to patients in comparison to the meta-analyses of heterogeneous studies conducted using various devices for generating shock waves., Conclusions: Evidence exists that LESWT generated with an electrohydraulic unit is effective. Further research is needed in order to evaluate this method in different patient populations and for the long-term.

Several methods of treatment of erectile dysfunction (ED) are offered with low energy shock-wave therapy (LESWT) gaining increasing attention. Reports have documented that LESWT stimulates tissue neovascularization, proliferation and differentiation of endothelial cells, and production of nitric oxide - all can improve the condition of erectile tissue. However, the overall and sexual condition of men deteriorates with age which is linked with a constant decrease in testosterone concentration. A higher risk of sexual health disorders and reduced physical fitness correlates with a testosterone concentration of <12 nmol/L. Such patients may require testosterone replacement therapy. We conducted a target literature review to investigate whether testosterone concentration is taken into account in studies on the use of LESWT in the treatment of ED. We found that most studies did not provide any information on testosterone status. Only 8 of 25 studies examined showed values of testosterone concentrations. Only one of these analyses checked the relationship between the efficacy of LESWT and testosterone concentration. As a result, meta-analyses published to date may not show the full value of LESWT in the treatment of ED. We conclude that in the light of the significant role testosterone plays in the process of an erection and the mechanism of LESWT action, it can be recommended to examine testosterone concentration and to diagnose hypogonadism during the qualification of patients to studies on LESWT efficacy. Moreover, the effectiveness of LESWT in relation to the current testosterone concentration should also be further investigated., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tau-20-796). The authors have no conflicts of interest to declare., (2020 Translational Andrology and Urology. All rights reserved.)

Deterioration in overall health, hormonal disturbances, and erectile dysfunction (ED) contributes to limitations in sexual activity in the elderly, which is further limited by incorrect beliefs about the hazards of sexual activity in cardiac patients. We aimed to analyze the occurrence of ED in elderly men, their perception of the relevance of good sexual function, and their expectations of physicians. A cross-sectional study encompassed 731 patients with coronary artery disease (CAD) subjected to cardiac rehabilitation. Demographic data and data on modifiable risk factors and patient expectations were collected. ED was assessed using the IIEF-5 questionnaire. Relationships among the risk factors for ED, occurrence of ED, and patient expectations, as well as the changes in the indicators between 2012 and 2016, were analyzed. The mean age of men was 70.7 ± 5.1 years. The prevalence of ED was 93.0%. The IIEF-5 score was significantly associated with age, tobacco smoking, exercise tolerance, time to diagnosis of CAD, and treatment with calcium channel blockers and diuretics. Patients declared that sexual activity was overall important (47.9%) or very important (25.6%). Three hundred and sixty (49.3%) patients expected their physician to show interest in their sexual health, but the topic was addressed in only 12.5%. Over the past few years, we have observed an increase in the awareness and importance of sexual health as well as a significant increase in patients' expectations of physicians to show interest in their sexual health. Patients' expectations of discussing and receiving treatment for ED remain an unmet medical need., Competing Interests: None

Background: Modifiable risk factors contribute to the pathogenesis of cardiovascular disease (CVD) and erectile dysfunction (ED). We aimed to compare the knowledge about the contribution of modifiable risk factors to the pathogenesis of CVD and ED. The impact of patients' having modifiable risk factors on the awareness of their negative influence on the development of CVD and ED was examined., Methods: To this multicenter cohort study, we included 417 patients with CHD who had been hospitalized in the cardiology or cardiac surgery department during the previous six weeks and underwent cardiac rehabilitation in one of the five centers. Knowledge about modifiable risk factors was collected. ED was assessed by an abridged IIEF-5 questionnaire. Comparisons between groups were conducted using the Student's t-test, Mann-Whitney U test, and Kruskal-Wallis test. Relationships were analyzed with Spearman's rank correlation coefficient., Results: The mean number of correctly identified risk factors for CVD was significantly higher than those for ED (3.71 ± 1.87 vs. 2.00 ± 1.94; p < .0001). Smoking was the most recognized risk factor both for CVD and ED. Dyslipidemia was least frequently identified as a risk factor for CVD. Sedentary lifestyle was the only risk factor whose incidence did not affect the level of patient knowledge., Conclusions: Cardiac patients with ED know more about risk factors for CVD than ED. It is necessary to include information about the negative impact of modifiable risk factors on sexual health into education programs promoting healthy lifestyles in men with cardiovascular diseases.

Introduction: A typical symptom of chronic lower-limb ischaemia is lower-limb pain, which occurs during walking forcing the patient to stop, intermittent claudication (IC). Exercise rehabilitation is the basic form of treatment for these patients., Aim: The aim of this study was to compare the effectiveness of three types of physical training programmes conducted over a 12-week period in patients with chronic lower-limb arterial insufficiency., Materials and Methods: Ninety-five people qualified for the 3-month supervised motor rehabilitation programme, conducted three times a week. The respondents were assigned to three types of rehabilitation programmes using a pseudo-randomization method: Group I (TW), subjects undertaking treadmill walking training; Group II (NW), subjects undertaking Nordic walking training; Group III (RES+NW), subjects undertaking resistance and Nordic walking training. Treadmill test, 6 Minute Walk Test (6MWT), and isokinetic test were repeated after 3 months of rehabilitation, which 80 people completed., Results: Combined training (RES+NW) is more effective than Nordic walking alone and supervised treadmill training alone for improving ankle force-velocity parameters (p<0.05) in patients with intermittent claudication. Each of the proposed exercise rehabilitation programmes increased walking distance of patients with intermittent claudication (p<0.05), especially in 6MWT (p=0.001). Significant relationships of force-velocity parameters are observed in the maximum distance obtained in 6MWT, both in Group III (RES + NW) and in Group II (NW) at the level of moderate and strong correlation strength, which indicates that if the lower limbs are stronger the walking distance achieved in 6MWT is longer., Conclusions: Given both the force-velocity parameters and the covered distance, the training RES + NW gives the most beneficial changes compared to training TW alone and NW alone. All types of training increased walking distance, which is an important aspect of the everyday functioning of people with IC.

Penile erection is a hemodynamic process consisting of 2 synchronized components in which the first (active) requires proper vascular endothelium functioning, whereas the second one (passive) is based on a veno-occlusive mechanism. Antihypertensive treatment reduces the passive component, often leading to the development of erectile dysfunction (ED), but lifestyle modifications can improve the sexual functioning. The study aimed to evaluate the association between blood pressure (BP) reduction caused by cardiovascular training and the intensity of ED in men with coronary heart disease. A total of 101 men (mean age 59.50 ± 7.93) with ED treated invasively for coronary heart disease and subjected to cardiac rehabilitation were enrolled. Patient characteristics, the International Index of Erectile Function 5 (IIEF-5) questionnaire (IIEF-5), and BP values were collected at baseline and after 6 months of cardiac rehabilitation and were analyzed. Cardiac rehabilitation led to a significant reduction of 5.08 mm Hg in systolic BP (p <0.001) and of 1.60 mm Hg in diastolic BP (p <0.001). The IIEF-5 score (EQ) significantly increased (median 15, interquartile range 11 to 19 vs median 18, interquartile range 12 to 21, p <0.001). Greater improvement in sexual performance was significantly negatively correlated with age, concentration of triglycerides, and high-density lipoprotein, whereas it was positively correlated with the presence of diabetes and baseline IIEF-5 score. After excluding patients with diabetes, a greater decrease in systolic BP was found to be significantly associated with greater improvement in erectile performance. In conclusion, a reduction of arterial BP caused by cardiac training is accompanied by improvement in erectile performance. This effect is the strongest in patients with hypertension and those with dyslipidemia., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Patients with cardiovascular disease (CVD) are prone to developing erectile dysfunction (ED) owing to the common risk factors and pathogenesis underlying ED and CVD. As a result, ED affects nearly 80% of male patients with CVD. The efficacy of phosphodiesterase type 5 inhibitors, vacuum erection devices, or intracavernosal injection of vasodilating agents is well established in the treatment of ED; however, their use is limited. Low-energy shock wave therapy is a novel modality that may become a causative treatment for ED. This review aims to assess the efficacy and safety of low-energy shock wave therapy in the treatment of ED in men with CVD., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Introduction: Due to the pathogenetic association between erectile disorders and cardiovascular diseases, cardiologists consult many patients with erectile dysfunction (ED). The aim of the study was to evaluate sexual function in patients with coronary heart disease (CHD) and the use of sexual knowledge in cardiology practice, both current use and that expected by patients., Material and Methods: One thousand one hundred and thirty-six patients (average age: 60.73 ±9.20) underwent a dedicated survey which encompassed demographic data and the presence of modifiable ED risk factors. The presence of ED was assessed using the International Index of Erectile Function (IIEF-5) Questionnaire., Results: Sexual problems were discussed by cardiologists with 45 (3.96%) patients. The frequency of initiating the topic was significantly associated with the respondents' education level ( p = 0.0031); however, it was not associated with the patients' age, duration of CHD, presence of ED, or modifiable risk factors. Four hundred and sixteen (36.62%) respondents indicated that they expect their cardiologist to take an interest in their ED. Nine hundred and twenty-six (81.51%) patients claimed good sexual function to be important or very important to them. Attitude to sexual function was significantly associated with age ( p < 0.0001), duration of CHD ( p = 0.0018), education ( p = 0.0011), presence of ED ( p = 0.0041), diabetes ( p = 0.0283) and hyperlipidaemia ( p = 0.0014)., Conclusions: The low frequency with which cardiologists initiate the topic of ED is in contrast to the expectations of patients with CHD. The majority of these patients regard good sexual maintenance as an important part of their life., Competing Interests: The authors declare no conflict of interest.