Angiomyxolipoma of the spermatic cord: A case report.

Lipomas are considered one of the most frequent benign mesenchymal tumors with copious variants. Among these variants is angiomyxolipoma (AML) which is considered an extremely rare entity. To the best of our knowledge, only 19 cases have been reported in the English medical literature, of which three of them involving the spermatic cord. Herein, we report the fourth case of a 37-year-old male patient with angiomyxolipoma (AML) of the spermatic cord discovered incidentally during elective hernia repair.

Crosstalk between Microglia and Neurons in Neurotrauma: An Overview of the Underlying Mechanisms.

Microglia are the resident immune cells of the brain and play a crucial role in housekeeping and maintaining homeostasis of the brain microenvironment. Upon injury or disease, microglial cells become activated, at least partly, via signals initiated by injured neurons. Activated microglia, thereby, contribute to both neuroprotection and neuroinflammation. However, sustained microglial activation initiates a chronic neuroinflammatory response which can disturb neuronal health and disrupt communications between neurons and microglia. Thus, microglia-neuron crosstalk is critical in a healthy brain as well as during states of injury or disease. As most studies focus on how neurons and microglia act in isolation during neurotrauma, there is a need to understand the interplay between these cells in brain pathophysiology. This review highlights how neurons and microglia reciprocally communicate under physiological conditions and during brain injury and disease. Furthermore, the modes of microglia-neuron communication are exposed, focusing on cell-contact dependent signaling and communication by the secretion of soluble factors like cytokines and growth factors. In addition, it has been discussed that how microglia-neuron interactions could exert either beneficial neurotrophic effects or pathologic proinflammatory responses. We further explore how aberrations in microglia-neuron crosstalk may be involved in central nervous system (CNS) anomalies, namely traumatic brain injury (TBI), neurodegeneration, and ischemic stroke. A clear understanding of how the microglia-neuron crosstalk contributes to the pathogenesis of brain pathologies may offer novel therapeutic avenues of brain trauma treatment.

The effectiveness of psychological interventions alone, or in combination with phosphodiesterase-5 inhibitors, for the treatment of erectile dysfunction:A systematic review.

Objectives: To highlight the efficacy of various psychological interventions (PI) when used in combination with, or in place of, phosphodiesterase-5 inhibitors (PDE-5i), as compared to the traditional treatment of men with erectile dysfunction (ED) with PDE-5i alone. Methods: A comprehensive literature review for the years 2005-2020 via MEDLINE and PubMed. We included randomised controlled trials that compared the use of either PDE-5i alone, PI alone or a combination of PDE-5i and PI in the treatment of psychogenic ED. All studies included were performed in adults aged 19-55 years and were written in English. Results: A total of 13 articles, with an overall sample of 597 men, were included in this systematic review. The results show that the combination of PI and PDE-5i was more effective than either PI or PDE-5i alone, on erectile function and long-term sexual satisfaction in men with psychogenic ED. Combined interventions were found to be significantly superior to medical treatment in seven studies and to PI alone in one study. In comparing PI to PDE-5i, two studies found PI to be significantly superior to PDE-5i use. In three other studies, PI was found significantly superior to no treatment at all, although some participants in the control group had taken PDE-5i. Conclusions: The combination of PDE-5i with PI shows real promise for the treatment of psychogenic ED. However, no conclusions could be made about what PI is more promising than the other and larger studies are needed to confirm these initial findings. Abbreviations: CBT: cognitive behavioural therapy; CBST: cognitive behavioural sex therapy; COVID-19: coronavirus disease 2019; ED: erectile dysfunction; EDITS: Erectile Dysfunction Inventory of Treatment Satisfaction; GPT, group psychotherapy: IIEF(-EF) (-OS) (-SD): International Index of Erectile Function (erectile functioning) (overall sexual satisfaction) (level of sexual desire); ITP: integrative treatment protocol; MHI: Mental Health Inventory; PDE-5i: phosphodiesterase-5 inhibitors; PI, psychological interventions; QoL: quality of life; RCT: randomised controlled trial; SHIM: Sexual Health Inventory for Men.