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Almsaoud NA, Safar O, Alshahrani ST, Alwadai R, Alkhaldi SM, Almurayyi M, Alrweili HH, Assiri HM, Al Jubran A, Hakami B, Alzahrani MA. The effect of penile traction device in men with Peyronie's disease on penile curvature, penile length, and erectile dysfunction: a systematic review and meta-analysis. Transl Androl Urol 2023; 12:1673-1685. [PMID: 38106680 PMCID: PMC10719764 DOI: 10.21037/tau-23-310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 10/20/2023] [Indexed: 12/19/2023] Open
Abstract
Background Peyronie's disease (PD) results in curvature, pain, and erectile dysfunction (ED). Penile traction devices (PTDs) are a non-invasive treatment option for PD by applying mechanical forces to elicit biochemical responses that reduce curvature and improve penile function. In the present study, we systematically reviewed and analyzed the literature investigating the use of PTD to treat PD. Methods We have conducted electronic and manual search strategies within the databases and included articles to find relevant studies. A total of Five studies met all the predefined inclusion criteria and were selected for inclusion in the review. Outcomes assessed are penile length, penile curvature, and erectile function (EF). The study population consisted of patients with PD, the intervention was penile traction therapy (PTT), the comparison was matched placebo or follow-up, and the study design was randomized controlled trials (RCTs) or cohort studies. The Cochrane risk of bias assessed the studies' quality for randomized studies and the Newcastle-Ottawa scale (NOS) for non-randomized observational studies. All statistical analyses were performed using R software. Results were considered statistically significant for P<0.05. Results Only five studies met inclusion and exclusion criteria and were published between 2014 and 2021. The sample sizes range [51-110], totaling 419, with a mean of 83.8 patients-the follow-up with a mean of 6.75 months. This meta-analysis evaluated the efficacy of PTD on curvature degree, penile length, and EF in patients. There is a significant positive effect on the curvature degree (P=0.0373), while there is no significant effect on penile length and EF (P=0.5315 and 0.1010), respectively. They are Indicating low heterogeneity with an estimated total heterogeneity of 0. Overall, the available evidence does not support the efficacy of the intervention for penile length or EF. Conclusions The current evidence suggests that PTDs can be a safe and effective treatment option for men with PD to reduce penile curvature. However, further research, including more RCTs with extended follow-up periods, is needed to fully understand their efficacy and determine the ideal timing and patient subtypes that would benefit from PTD.
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Affiliation(s)
- Nazal A. Almsaoud
- Urology Department, Prince Mutaib Bin Abdulaziz Hospital, Sakaka, Al-Jouf Region, Saudi Arabia
| | - Omar Safar
- Urology Department, Armed Forces Hospital Southern Region, Khamis Mushayt, Saudi Arabia
| | | | - Raed Alwadai
- Urology Department, King Abdullah Hospital, Bishah, Assir, Saudi Arabia
| | - Sulaiman M. Alkhaldi
- Urology Department, Prince Mutaib Bin Abdulaziz Hospital, Sakaka, Al-Jouf Region, Saudi Arabia
| | - Muath Almurayyi
- Urology Department, King Khaled University Medical city-Abha, Assir, Saudi Arabia
| | - Hana Hazi Alrweili
- Urology Department, Prince Mutaib Bin Abdulaziz Hospital, Sakaka, Al-Jouf Region, Saudi Arabia
| | - Hassan M. Assiri
- Urology Department, Armed Forces Hospital Southern Region, Khamis Mushayt, Saudi Arabia
| | - Abdulkareem Al Jubran
- Urology Department, Armed Forces Hospital Southern Region, Khamis Mushayt, Saudi Arabia
| | - Basel Hakami
- Urology Department, King Faisal Medical City for Southern Region (KFMCity), Abha, Saudi Arabia
- Urology Department, King Fahad Central Hospital, Jazan, Saudi Arabia
| | - Meshari A. Alzahrani
- Urology Department, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
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Alqahtani BA, Alenazi AM. Cognitive Frailty among Older Adults in Rural Areas: Prevalence and Risk Factors. J Clin Med 2023; 12:7019. [PMID: 38002633 PMCID: PMC10672463 DOI: 10.3390/jcm12227019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Cognitive frailty (CF), which is a combination of physical frailty and cognitive impairment, has been associated with functional deterioration in the elderly. However, information about the prevalence of CF and associated factors among Saudi older adults is lacking. OBJECTIVES To assess the prevalence of CF and its associated factors in Saudi community-dwelling older adults. DESIGN Cross-sectional. SETTING Community-based. SUBJECTS AND METHODS Thise study included community-dwelling elderly adults aged 60 years and over living in the Riyadh region. This study took place from August 2019 to June 2020. CF was defined as the co-existence of physical frailty and mild cognitive impairment (MCI) without dementia. The association between sociodemographic and clinical factors and CF was estimated using the relative risk ratio and confidence intervals (RRR; CIs 95%) using a multivariable binary logistic regression. MAIN OUTCOME MEASURES Fried's frailty phenotype index; and the Mini-Mental State Examination. SAMPLE SIZE A total of 421 community-dwelling older adults (63% male; mean [SD] age 70 [7.1] years). RESULTS The overall prevalence of CF was 6.1%. The following factors were associated with CF: age (RRR 16.3; 95% CI 4.91-54.4), being single (RRR = 3.76 95% CI 1.70-8.31), and number of chronic conditions (RRR 3.1; 95% CI 1.74-5.49). CONCLUSIONS This study indicated the high prevalence of CF among Saudi community-dwelling older individuals compared to other populations. Screening for early diagnosis should be incorporated during examination for older adults. LIMITATIONS The cross-sectional design limits the causality inference with associated risk factors.
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Affiliation(s)
- Bader A. Alqahtani
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia;
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Bettelli G. Geriatric anesthesia: Demographics, epidemiology, state of the art at international level, educational needs, and future perspectives. Saudi J Anaesth 2023; 17:467-473. [PMID: 37779572 PMCID: PMC10540985 DOI: 10.4103/sja.sja_411_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 10/03/2023] Open
Abstract
Population aging has induced in the last year a corresponding aging inside the surgical population, currently accounting for 45%.50% of the total surgical population in the majority of the advanced countries. This has induced a number of new challenges in the daily anesthesia practice, ranging from the need of implementing specific education in the field of geriatric medicine, organizational adjustments aimed to adapt our preoperative evaluation methodology to the needs older patients present, and a careful redesign of the whole perioperative course for these patients. Today's anesthesiologists are called to became familiar with the aging processes and their impact on the patho.physiological perioperative course, with the concept of functional impairment and frailty and with the dimensions of polypathology, polymedication, and reduced functional reserves. The introduction of new trends such as the team-based approach and interdisciplinary culture are essential to overcome these emerging criticalities.
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Affiliation(s)
- Gabriella Bettelli
- Specialist in Anaesthesia and Intensive Care, Specialist in Cardiology, MSc in Geriatric Medicine, Scientific Director, 2 Level Master in Perioperative Geriatric Medicine, San Marino University, Past Director Dpt. of Anesthesia, Intensive Care, Day Surgery and Pain Treatment, Past Director Geriatric Surgery Area, IRCCS INRCA – Italian National Research Centre on Aging, Ancona, Italy
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Alshanberi AM. Frailty in Kingdom of Saudi Arabia-Prevalence and Management, Where Are We? Healthcare (Basel) 2023; 11:1715. [PMID: 37372833 DOI: 10.3390/healthcare11121715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
A recent report from the United Nations state that the percentage of elderly individuals in the Kingdom of Saudi Arabia (KSA) will witness a sharp increase in the next three decades (5.6% in 2017 to 23% by 2050). This situation will lead to an increased prevalence of comorbidities and hence, will require close monitoring and constant care of such individuals who are prone to suffer from complications such as arthritis, cardiovascular disorders, diabetes, neurological disorders, etc. Frailty is one such age-related phenomenon which enhances the risk of falling, functional restrictions and greater vulnerability to adverse consequences, which tend to lead to institutionalization. Such factors highlight the importance of the urgent awareness for circumventing the progression of frailty toward a compromised health status. This concise report is an attempt to sum up the relevant research articles published with regard to frailty and concomitant diseases in the last 5 years. It also sums up the research on frailty in the KSA elderly population, till date. This article reflects the opinions of an author on tackling such issues through a well-directed mechanism involving interdisciplinary transitional care and geriatric co-management.
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Affiliation(s)
- Asim Muhammed Alshanberi
- Department of Community Medicine and Pilgrims Health Care, Umm Alqura University, Makkah 24382, Saudi Arabia
- Medicine Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia
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Potentially Inappropriate Medications among Elderly with Frailty in a Tertiary Care Academic Medical Centre in Saudi Arabia. Healthcare (Basel) 2022; 10:healthcare10081440. [PMID: 36011096 PMCID: PMC9408046 DOI: 10.3390/healthcare10081440] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/23/2022] [Accepted: 07/28/2022] [Indexed: 11/17/2022] Open
Abstract
This study aims to assess the prevalence of potentially inappropriate medications (PIMs) and to analyze the relationship between the PIMs and frailty among inpatient older adults aged 65 and above in Saudi Arabia. A retrospective cross-sectional study design was utilized during the period between April 2021 and April 2022 of all patients aged 65 years and above admitted in a public tertiary hospital in Saudi Arabia. Data on the number of medications and the use of PIMs were assessed using Beers’ criteria while the frailty status was assessed using the “FRAIL Scale”. Of the 358 patient files that were reviewed, 52.2% were males, 60.9% were aged 65−74 years, and 82% were married. The prevalence of robust, prefrail, and frail patients was 5%, 36.9%, and 58.1%, respectively. According to the 2019 Beers criteria, a total of 45.8% (n = 164) participants identified as using PIMs. Compared to the non-PIMs group, the PIMs group demonstrated significant differences in the number of medications (p < 0.001), the number of comorbidities (p < 0.05), and the frailty score (p < 0.001). The strongest predictor of PIM use was a number of comorbidities, recording an odds ratio of 2.86, (95% CI 1.21−6.77, p < 0.05). Our results show that the use of PIM was significantly associated with frail older adults with multiple comorbidities and in patients with polypharmacy. A clear assessment and evaluation tool may improve the quality of drug treatment in the older adult population, particularly in frail patients.
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Fang J, Ren J, Ren L, Qiu X, Yuan S, Wang W, Wang J. Perceived Social Support and Associated Factors Among Community-Dwelling Older Adults With Frailty and Pre-frailty in Hangzhou, China. Front Psychiatry 2022; 13:944293. [PMID: 35911254 PMCID: PMC9329702 DOI: 10.3389/fpsyt.2022.944293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/20/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES The present study aimed to explore the social support among community-dwelling older adults with frailty and pre-frailty and to ascertain associated factors. METHODS The frailty status of the participant was assessed via the Chinese FRAIL Scale. The dependent variable, level of social support, was evaluated using the Social Support Rating Scale (range: 12-66). This study explored the influencing factors from three aspects containing sociodemographic characteristics, family environment, and community environment. Independent-sample t-test, Analysis of Variance, and multiple linear regression analyses were conducted to examine determinants of social support. RESULTS There were significant differences in overall social support between non-frail, pre-frail, and frail participants [38.01 (SD = 6.48) vs. 33.62 (SD = 6.25) vs. 30.50 (SD = 6.68), F = 62.157, p < 0.001]. Older adults with frailty and pre-frailty who were single would have lower levels of overall social support. In the pre-frail group, living alone was associated with lower overall social support. In contrast, the relationship with children and the availability of recreational activities were associated factors for the frail group. CONCLUSIONS The level of social support among frail and pre-frail community-dwelling older adults was lower than the robust older adults and influenced by different factors according to the frailty category, which suggests taking targeted measures for social support improvement.
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Affiliation(s)
- Juan Fang
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Jianping Ren
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Lixian Ren
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xiantao Qiu
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Shuang Yuan
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Wenting Wang
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Jinjing Wang
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
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