RESUMO
OBJECTIVES: Evidence regarding demand trends for erectile dysfunction (ED) treatments are scarce in South America. This study aims to evaluate trends in ED treatments in Chile over a 10-year period (2010- 2020) and estimate the potential number of candidates for penile prosthesis. MATERIALS AND METHODS: Sales trends of pharmacological treatments and penile prosthesis were obtained from market studies. The potential number of candidates for penile prosthesis implantation was calculated by crossing epidemiological data with previously reported ED prevalence, proportion of sexually active men, percentage of men seeking medical assistance for ED, and the proportion of patients who are non-responders to ED oral drug therapies Results: In the 10-year studied period, the Chilean male population older than 50 years increased 34.7%, with an average annual variation (AAV) of 3.4%. For the same period, the sales of oral drug therapies for ED increased by 71.3% (AAV 6.2%), the sales of intracavernosal vasoactive agents (ICVA) decreased by 0.4% (AAV -0.2%), and penile prosthesis sales increased by 113% (AAV 6.7%). We estimated that only 0.05% of sexually active men older than 50 years old with ED who sought medical assistance finally had a penile prosthesis implanted to manage their condition. CONCLUSIONS: Demand for ED oral drug therapies significantly increased in Chile during the last decade, while ICVA remained stable. The annual rate of penile prosthesis implantation increased. However, the gap between the potential penile prosthesis candidates and the actual number of devices implanted is suspected to remain extremely high.
Assuntos
Disfunção Erétil , Implante Peniano , Prótese de Pênis , Administração Oral , Chile/epidemiologia , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Implante Peniano/efeitos adversosRESUMO
Las Enfermedades cardiovasculares (ECV) son la principal causa de fallecimientos en el mundo, la Cardiopatía Coronaria Isquémica (CCI) es la más frecuente, tiene alta morbi-mortalidad. El riesgo de desarrollarla en varones es de 40 a 49 por ciento y en mujeres de 32 por ciento, según el estudio de Framinghan. La angina estable es la manifestación inicial de la enfermedad arterial coronaría crónica en aproximadamente la mitad de los pacientes. Se han diseñado Técnicas de revascularización miocárdica: Angioplastia Percutánea con Stent (ICP) y Revascularización Quirúrgica con Puentes arteriales y venosos (CABG) los que han experimentado importantes avances tecnológicos, se cuestiona su papel en el tratamiento de los pacientes con enfermedad coronaria crónica estable. Objetivos: Se compararon las tasa de Mortalidad y de eventos adversos mayores así como la función sistólica (Fracción de Eyección) del ventrículo izquierdo entre dos grupos de pacientes CABG vs. ICP a los 36 meses de realizado el procedimiento. Métodos: Estudio de tipo investigación documental, de diseño analítico, observacional, retrospectivo y transversal. Luego de aplicar criterios de inclusión, exclusión entre pacientes con enfermedad coronaria crónica estable sometidos a revascularización miocárdica por angioplastia percutánea con Stent (ICP) o revascularización quirúrgica de miocardio (CABG) en el Centro Médico Naval entre el periodo 2006-2008, a los 36 meses de realizado el procedimiento. Análisis estadístico (Programa informático SPSS), Chi cuadrado, se utilizó para comparación de proporciones y el Test de Student para las variables continuas. Se aceptaron como significación estadística todos los valores p<0,05. Resultados: En el periodo de estudio se evaluaron 94 pacientes con enfermedad coronaria crónica isquémica estable (CCI), 45 sometidos a revascularización quirúrgica (CABG) y 49 a revascularización vía percutánea (ICP). La edad media fue 68 años, predominando el sexo masculino...
Assuntos
Masculino , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Angioplastia , Doença das Coronárias/terapia , Isquemia Miocárdica , Revascularização Miocárdica , Estudos Observacionais como Assunto , Estudos Retrospectivos , Estudos TransversaisRESUMO
BACKGROUND: Outcome of Extracorporeal Shockwave Lithotripsy (SWL) is determined by physical factors that affect stone fragmentation and clearance. PURPOSE: To evaluate the predictive value of the Lithotripsy Table Height (LTH) in SWL outcome. Lithotripsy Table Height (LTH) is a variable that represents skin to therapy head distance, and it is proportional to the energy that reaches the stone. MATERIALS AND METHODS: A prospective study enrolled patients undergoing SWL for radiopaque urinary stones. All procedures were performed using a Modulith SLX (Karl Storz, Germany) Lithotripter. Patient weight, height and age; stone location and size; number of shock waves delivered, and LTH were recorded. One month post-procedure a KUB was obtained. Logistic regression analysis was used to evaluate the effects of these variables on stone-free outcome. A ROC curve was plotted. RESULTS: Fifty-six patients were enrolled. After one month follow-up, overall success rate (Stone Free) was 83.9% (n = 47). LTH was the only independent predictor of outcome in both univariate and multivariate analysis (p = 0.029). Stone size (p = 0.45) and BMI (p = 0.32) were not significant. In the ROC curve, LTH showed an Area under the Curve = 0.791. Patients with LTH < 218 (n = 8) had relative risk of residual stones = 7.5, odds Ratio: 6.6 (Stone free rate 37.5% vs. 91.5%). CONCLUSION: LTH appears to be an independent predictor of SWL outcome. High success rates can be expected if LTH > 218. Patients with lower LTH had a less effective therapy, therefore, worse stone fragmentation and clearance. These findings may help improve patient selection for SWL therapy.
Assuntos
Litotripsia/instrumentação , Mesas Cirúrgicas/normas , Cálculos Urinários/terapia , Adulto , Estatura , Peso Corporal , Chile , Desenho de Equipamento/normas , Feminino , Humanos , Litotripsia/métodos , Masculino , Pessoa de Meia-Idade , Posicionamento do Paciente/instrumentação , Posicionamento do Paciente/métodos , Estudos Prospectivos , Curva ROC , Análise de Regressão , Cálculos Urinários/patologiaRESUMO
BACKGROUND: Outcome of Extracorporeal Shockwave Lithotripsy (SWL) is determined by physical factors that affect stone fragmentation and clearance. PURPOSE: To evaluate the predictive value of the Lithotripsy Table Height (LTH) in SWL outcome. Lithotripsy Table Height (LTH) is a variable that represents skin to therapy head distance, and it is proportional to the energy that reaches the stone. MATERIALS AND METHODS: A prospective study enrolled patients undergoing SWL for radiopaque urinary stones. All procedures were performed using a Modulith SLX (Karl Storz, Germany) Lithotripter. Patient weight, height and age; stone location and size; number of shock waves delivered, and LTH were recorded. One month post-procedure a KUB was obtained. Logistic regression analysis was used to evaluate the effects of these variables on stone-free outcome. A ROC curve was plotted. RESULTS: Fifty-six patients were enrolled. After one month follow-up, overall success rate (Stone Free) was 83.9 percent (n = 47). LTH was the only independent predictor of outcome in both univariate and multivariate analysis (p = 0.029). Stone size (p = 0.45) and BMI (p = 0.32) were not significant. In the ROC curve, LTH showed an Area under the Curve = 0.791. Patients with LTH < 218 (n = 8) had relative risk of residual stones = 7.5, odds Ratio: 6.6 (Stone free rate 37.5 percent vs. 91.5 percent). CONCLUSION: LTH appears to be an independent predictor of SWL outcome. High success rates can be expected if LTH > 218. Patients with lower LTH had a less effective therapy, therefore, worse stone fragmentation and clearance. These findings may help improve patient selection for SWL therapy.