ABSTRACT
PURPOSE: In a systematic data analysis, we evaluated the influence of a digital health app on erection scores as well as life quality and patient activation in a group of patients with erectile dysfunction. METHODS: In all, 44 participants took part in an evidence-based program for patients with erectile dysfunction. The in app 12-week program included pelvic floor exercises and physiotherapeutic and cardiovascular training. In addition, there where sessions on mindfulness and sexual therapy as well as useful information about erectile dysfunction and its causes, nutrition, and risk factors. The median age was 46 years (19-75 years). All patients answered IIEF5, PAM-13 and QoL-Med questionnaires at the beginning and the end of the program. A total of 27 questionnaires could be evaluated at both times. RESULTS: The average improvement in IIEF5 score was 4.5 points (pâ¯< 0.0001). 96% of patients showed overall improvement of erection scores. Improvement in life quality was shown in 93% of participants. Moreover, there was a significant increase in patient activation scores. CONCLUSION: We were able to show that a multimodal digital app for self-management of erectile dysfunction improved not only erection scores but also life quality and patient activation. We concluded that it is possible to reproduce results of analog studies in a digital setting. Digital solutions can help to include patients in their treatment and to put guideline suggestions into practice.
Subject(s)
Erectile Dysfunction , Mobile Applications , Erectile Dysfunction/therapy , Humans , Male , Middle Aged , Penile Erection/physiology , Quality of Life , Treatment OutcomeABSTRACT
OBJECTIVES: National and international guidelines recommend empiric first-line treatments of individuals infected with Helicobacter pylori without prior antimicrobial susceptibility testing. For this reason, knowledge of primary resistance to first-line antibiotics such as clarithromycin is essential. We assessed the primary resistance of H. pylori in Germany to key antibiotics by molecular genetic methods and evaluated risk factors for the development of resistance. METHODS: Gastric tissue samples of 1851 yet treatment-naïve H. pylori-positive patients were examined with real-time PCR or PCR and Sanger sequencing for mutations conferring resistance to clarithromycin, levofloxacin and tetracycline. Clinical and epidemiological data were documented and univariable and multivariable logistic regression analyses were conducted. RESULTS: Overall primary resistances were 11.3% (210/1851) to clarithromycin, and 13.4% (201/1497) to levofloxacin; resistance to tetracycline (2.5%, 38/1497) was as low as combined resistance to clarithromycin/levofloxacin (2.6%, 39/1497). Female sex and prior antimicrobial therapies owing to unrelated bacterial infections were risk factors for clarithromycin resistance (adjusted OR (aOR) 2.3, 95% CI 1.6-3.4; and 2.6, 95% CI 1.5-4.5, respectively); older age was associated with levofloxacin resistance (aOR for those ≥65 years compared with those 18-35 years: 6.6, 95% CI 3.1-14.2). CONCLUSIONS: Clarithromycin might still be recommended in first-line eradication therapies in yet untreated patients, but as nearly every tenth patient may carry clarithromycin-resistant H. pylori it may be advisable to rule out resistance ahead of treatment by carrying out susceptibility testing or prescribing an alternative therapy.
