The socio-cultural aspects of sexual medicine: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).

Introduction: The intersection of culture, history, religion, traditions, laws, political trends, and evolving attitudes affects sexual expression and acceptance or rejection of sexual practices. Clinicians and clinical care are affected by these factors as well, although clinicians are not always aware of the way in which their training, their own experiences and attitudes influence the way in which they approach patients. In this paper, we contextualize and then describe 2 areas of sexual practices and 1 area of sexual difficulty that sexual medicine clinicians encounter in their practice, namely, the practice of female genital mutilation/cutting, penile circumcision, and the experience of unconsummated marriages.

The ethical and economic aspects of sexual medicine: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).

Introduction: In recent years, the field of sexual medicine has undergone major transformations brought about by the internet and concern with genital performance and aesthetics. On the other hand, economic transformations have increased barriers to better care and sexual education.

Methods: Given the emerging knowledge of this topic, we conducted a narrative review of the extant literature through wide searches in PubMed and Google and on global websites relevant to this topic, such as the World Health Organization, the United Nations, and others.

The Role of a C-Terminal Seven-Amino Acid Motif in TbCSV C3 Protein and Its Interaction With NbPOLA2 in Enhancing Viral Replication.

The C3 protein of tobacco curly shoot virus (TbCSV), a possible evolutionary intermediate between truly monopartite begomoviruses and those requiring satellite molecules for infectivity, has been identified as a viral replication enhancer (REn). However, the mechanisms underlying this enhancement are largely unknown. In this study, we generated two mutant infectious clones of TbCSV: one with a deletion of the 3' end region of the C3 gene that does not overlap with C2 (TbCSV) and another in which this region was replaced by a phylogenetically unrelated iLOV gene sequence (TbCSV).

Interplay between tobacco curly shoot virus vsiRNA24 and triosephosphate isomerase: implications for Nicotiana benthamiana viral defense.

Virus-derived small interfering RNAs (vsiRNAs) play an important role in viral infection by regulating the expression of host genes. At present, research on the regulation of plant primary metabolic pathways by vsiRNAs is very limited. TvsiRNA24 derived from tobacco curly shoot virus (TbCSV) was amplified by reverse transcription polymerase chain reaction, and its target gene NbTPI (triosephosphate isomerase) was verified using reverse transcription quantitative polymerase chain reaction and GFP fluorescence observation.

Ethylene response transcription factor 5 (ERF5) enhances defense against tobacco curly shoot virus and associated betasatellite (TbCSV/TbCSB) in Nicotiana benthamiana.

Begomovirus/betasatellite disease complex significantly threatens global crop production. Identifying potential plant antiviral genes is crucial for disease control. Nicotiana benthamiana is susceptible to viruses and contains 266 ethylene response transcription factors (ERFs).

Molecular Identification and Genetic Diversity Analysis of Papaya Leaf Curl China Virus Infecting Ageratum conyzoides.

Papaya leaf curl China virus (PaLCuCNV) is a damaging plant pathogen causing substantial losses to crop. The complete genomes of three PaLCuCNV isolates from Ageratum conyzoides were obtained and combined with the 68 reference isolates in GenBank for comprehensive genetic diversity analyses using specialized computational tools. Sequence alignment revealed nucleotide sequence similarity ranging from 85.

The TATA-box binding protein-associated factor TAF12b facilitates the degradation of type B response regulators to negatively regulate cytokinin signaling.

Cytokinins (CKs) are one of the important classes of plant hormones essential for plant growth and development. TATA-box binding protein-associated factor 12b (TAF12b) is involved in CK signaling, but its molecular and biochemical mechanisms are not fully understood. In this study, TAF12b of Nicotiana benthamiana (NbTAF12b) was found to mediate the CK response by directly interacting with type B response regulators (B-RRs), positive regulators of CK signaling, and inhibiting their transcriptional activities.

Safety and efficacy of botulinum neurotoxin in the treatment of erectile dysfunction refractory to phosphodiesterase inhibitors: Results of a randomized controlled trial.

Background: There has been recent interest in the use of botulinum neurotoxin (BoNT) in the field of Andrology, whereby it has been investigated in the treatment of penile retraction and premature ejaculation.

Objectives: To evaluate the safety and efficacy of intracavernosal BoNT-A injection in the treatment of patients with erectile dysfunction (ED) refractory to oral phosphodiesterase inhibitors (PDE5Is).

Patients And Methods: A double-blind randomized placebo-controlled prospective comparative study conducted at one center and involved 70 patients with ED refractory to PDE5Is.

Intra-cavernous injection of BOTOX (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial.

Background: Erectile dysfunction (ED) is a socioeconomic problem.There are several options for its management including intra-cavernosal injection (ICI).

Objective: To compare the safety, efficacy, and durability of ICI of onabotulinum toxin-A (BTX) in different doses (50 and 100 U) against placebo (saline) in the management of vasculogenic ED non-responding to pharmacological therapy (phosphodiesterase type 5 inhibitors or/and ICI of trimix).

Analysis of Pathogenicity and Virulence Factors of .

(ALCScV) is a novel monopartite begomovirus, which was identified from plants in Sichuan Province, China. In this study, we showed that ALCScV can induce typical dwarf and downward leaf-curling symptoms in , , and plants and that the noncognate betasatellite can enhance disease symptoms and increase viral accumulation. Expression of the ALCScV-encoded V2, C1, and C4 proteins through a (PVX) vector caused severe symptoms in .

Suppression of nbe-miR1919c-5p Expression in Enhances Tobacco Curly Shoot Virus and Its Betasatellite Co-Infection.

MicroRNAs (miRNAs) are non-coding but functional RNA molecules of 21-25 nucleotides in length. MiRNAs play significant regulatory roles in diverse plant biological processes. In order to decipher the relationship between nbe-miR1919c-5p and the accumulations of tobacco curly shoot virus (TbCSV) and its betasatellite (TbCSB) DNAs, as well as viral symptom development, we investigated the function of nbe-miR1919c-5p during TbCSV and TbCSB co-infection in plants using a PVX-and a TRV-based short tandem target mimic (STTM) technology.

Tobacco curly shoot virus C3 protein enhances viral replication and gene expression in Nicotiana benthamiana plants.

Geminiviruses are single-stranded DNA viruses that cause devastating diseases in many crops worldwide. The replication enhancer proteins (REn), encoded by the C3 (AC3, and AL3) ORFs of geminiviruses, have critical roles in viral DNA accumulation and symptom development in infected plants. In the current study, we have constructed an infectious clone of the Tobacco curly shoot virus (TbCSV) C3 mutant, TbCSV, that contains two start codon mutations that abrogated C3 ORF expression, but did not alter the amino acid sequence of the C2 ORF.

Botulinum Neurotoxin and Its Potential Role in the Treatment of Erectile Dysfunction.

Introduction: Botulinum toxin type A (BoNT-A) has been used to treat several striated and smooth muscle disorders. During the past year, human and animal studies conducted in Egypt and Canada by two different groups of investigators have suggested a possible role for the intracavernosal injection of BoNT-A in the treatment of erectile dysfunction (ED).

Aim: To discuss BoNT-A and its current medical uses, the rationale for its new potential use in the treatment of ED, and the available evidence and concerns.

Infrapubic Liposuction for Penile Length Augmentation in Patients with Infrapubic Adiposities.

Introduction: Hidden penis, inconspicuous and concealed penis are synonyms for the same entity "buried penis" where the penile shaft is hidden below the surface of the prepubic fat to an extent that gives an impression of a short penis, despite corporeal length being normal.

Aim: The aim of our work is the reduction in the amount of the suprapubic fat by liposuction to reveal the buried penis and assess the results, patient satisfaction and possible complications.

Methods: The procedure of suprapubic liposuction was carried out on ten men who were attending the outpatient clinic of Andrology complaining of small-sized penis.

SOP conservative (medical and mechanical) treatment of erectile dysfunction.

Introduction: Erectile dysfunction (ED) is the most frequently treated male sexual dysfunction worldwide. ED is a chronic condition that exerts a negative impact on male self-esteem and nearly all life domains including interpersonal, family, and business relationships.

Aim: The aim of this study is to provide an updated overview on currently used and available conservative treatment options for ED with a special focus on their efficacy, tolerability, safety, merits, and limitations including the role of combination therapies for monotherapy failures.

Erectile dysfunction.

Erectile dysfunction is a common clinical entity that affects mainly men older than 40 years. In addition to the classical causes of erectile dysfunction, such as diabetes mellitus and hypertension, several common lifestyle factors, such as obesity, limited or an absence of physical exercise, and lower urinary tract symptoms, have been linked to the development of erectile dysfunction. Substantial steps have been taken in the study of the association between erectile dysfunction and cardiovascular disease.

SOP: corpus cavernosum assessment (cavernosography/cavernosometry).

Introduction: There is no universal gold standard diagnostic test to differentiate psychogenic from organic erectile dysfunction (ED). Cavernosography/cavernosometry has been used to evaluate veno-occlusive dysfunction (VOD) in men with a proposed organic ED.

Aim: To develop evidence-based guidelines for the performance and interpretation of cavernosography/cavernosometry.

SOP: physical examination and laboratory testing for men with erectile dysfunction.

Introduction: Physical examination and laboratory evaluation of men with erectile dysfunction (ED) are opportunities to identify potentially life-threatening etiologies and comorbid conditions.

Aim: To review genital anatomy, identify any physical abnormalities, assess for comorbid conditions, and reveal significant risk factors for ED.

Methods: Expert opinion was based on evidence-based medical literature and consensus discussions between members of this International Society for Sexual Medicine (ISSM) standards committee.

Position paper: Management of men complaining of a small penis despite an actually normal size.

Introduction: With the worldwide increase in penile augmentation procedures and claims of devices designed to elongate the penis, it becomes crucial to study the scientific basis of such procedures or devices, as well as the management of a complaint of a small penis in men with a normal penile size.

Aim: The aim of this work is to study the scientific basis of opting to penile augmentation procedures and to develop guidelines based on the best available evidence for the management of men complaining of a small penis despite an actually normal size.

Methods: We reviewed the literature and evaluated the evidence about what the normal penile size is, what patients complaining of a small penis usually suffer from, benefits vs.

Priapism: pathogenesis, epidemiology, and management.

Introduction: Priapism describes a persistent erection arising from dysfunction of mechanisms regulating penile tumescence, rigidity, and flaccidity. A correct diagnosis of priapism is a matter of urgency requiring identification of underlying hemodynamics.

Aims: To define the types of priapism, address its pathogenesis and epidemiology, and develop an evidence-based guideline for effective management.

Comparing penile measurements in normal and erectile dysfunction subjects.

Introduction: With the increase in penile augmentation procedures it becomes important to assess what is the normal erect penile size in both potent men and men with erectile dysfunction (ED).

Aim: The aim of this work is to define the average stretched penile size in normal men and ED patients.

Main Outcome Measures: Penile length and girth.

An evidence-based perspective to the medical treatment of male infertility: a short review.

Introduction: Evidence-based medicine (EBM) is the integration of best research evidence with clinical expertise and patient preferences and values.

Aim: This narrative review aims to assist the physicians to make informed decisions based on the best available evidence in the area of male infertility and the patients' own preferences and values.

Methods: In this review we present the current state of knowledge and uncertainties about the medical management of male infertility.

Combination clomiphene citrate and antioxidant therapy for idiopathic male infertility: a randomized controlled trial.

Objective: To assess the effect of treatment with a combination of clomiphene citrate as an antiestrogen and vitamin E as an antioxidant on the incidence of pregnancy and sperm variables in men with idiopathic oligozoospermia and infertility.

Design: Prospective, randomized, placebo-controlled trial.

Setting: The outpatient andrology clinic at a university hospital.