UNASSIGNED: Erectile Dysfunction (ED) is a common challenge post Radical Prostatectomy (RALP), affecting men\'s sexual health after undergoing definitive cancer therapy. Despite employing nerve-sparing techniques, ED remains a prevalent issue in this population. Studies indicate that approximately 70%-85% of men experience varying degrees of ED following RALP. The existing treatment landscape for post-RALP-ED presents limitations, and a discernible knowledge gap persists. To address this, our study aims to investigate the efficacy of Shockwave Therapy (SWT) as a potential intervention for managing ED after RALP.
UNASSIGNED: This prospective, randomized, sham-controlled clinical trial aims to recruit 189 eligible patients post-RP and assess the effects of SWT. Comprehensive screening, including medical history, physical examinations, and biochemical evaluations, will be conducted to confirm eligibility. The intervention involves utilizing a device to administer focal shockwaves targeted at cavernosal tissue. Safety measures include continuous monitoring for adverse events and rigorous reporting protocols. The primary endpoint assesses changes in participants\' ability to engage in penetrative intercourse from baseline to study completion, while secondary endpoints encompass various measures of erectile function, including questionnaire-based assessments, ultrasound parameters, and clinical outcomes.
UNASSIGNED: Statistical analysis, encompassing ANOVA for continuous variables and Fisher\'s exact test for categorical ones, will evaluate demographic characteristics, baseline data, and primary as well as secondary outcomes for statistical significance. Detailed analysis of trends, subgroup comparisons, and treatment effects will provide a comprehensive understanding of the impact of SWT on post-RP ED.
UNASSIGNED: This study protocol represents a rigorous investigation into the potential therapeutic role of SWT in managing post-RP ED. The outcomes from this study aim to contribute valuable insights into the efficacy, safety, and potential improvements in erectile function following SWT, providing significant guidance for future interventions aimed at addressing this challenging condition affecting men\'s health and quality of life.

Female sexual dysfunction (FSD) is a complex issue affecting women of all ages; it involves several overlapping body systems and profoundly affects quality of life. The use of cell-based therapy, such as mesenchymal stem cells, has recently been investigated as a potential treatment for FSD.
This systematic review and meta-analysis aim to assess FSD outcomes following cell-based therapy.
We evaluated peer-reviewed articles from multiple online databases through November 2022 to identify studies that used cell-based therapy and reported sexual function outcomes in women. We performed a meta-analysis using data pooled from 3 clinical trials at our institution: CRATUS (NCT02065245), ACESO (NCT02886884), and CERES (NCT03059355). All 3 trials collected data from the Sexual Quality of Life-Female (SQOL-F) questionnaire as an exploratory outcome.
Existing literature on this topic is scarce. Five clinical studies and 1 animal study were included in the systematic review, and only 2 clinical studies were considered good quality: 1 reported significant SQOL-F improvement in women 6 months after cell therapy, and 1 reported posttherapy sexual satisfaction in all women. When individual patient data were pooled in a meta-analysis from 29 women across 3 trials at our institution, the SQOL-F was not significantly improved.
Despite growing interest in cell-based therapy for women\'s sexual health, this important issue is understudied in the literature. The optimal route, source, and dose of cell therapy to produce clinically meaningful change have yet to be determined, and further research is needed in larger randomized placebo-controlled clinical trials.

While phosphodiesterase type 5 inhibitors (PDE5is) and others are used to treat Erectile dysfunction (ED), many patients are either unresponsive or resistant to it. Stem cell therapy (SCT) is a promising alternative approach. Numerous preclinical trials have demonstrated improved erectile function in animal models using SCT, although the number of clinical trials investigating SCT for men with ED is limited. Nonetheless, findings from human clinical trials suggest that SCT may be a useful treatment option.
Biomedical literature, including PubMed, ClinicalTrials.gov, and European Union Clinical Trials Registry, were analyzed to summarize and synthesize information on stem cell therapy for ED in this narrative review. The achievements in preclinical and clinical evaluations are presented and critically analyzed.
SCT has demonstrated some benefits in improving erectile function, while further studies are urgently needed. Such studies would provide valuable insights into the optimal use of stem cell therapy and its potential as a therapeutic option for ED. Taking advantage of different mechanisms of action involved in various regenerative therapies, combination therapies such as SCT and low-energy shock waves or platelet-rich plasma may provide a more effective therapy and warrant further research.

Growth factors (GF), with the activity of stimulating cell growth, play a significant role in biology, medicine, and exercise physiology. In the process of exercise, human tissues are impacted, making cells suffer damage. Growth factor can accelerate the repair of damaged cells and regulate the synthesis of protein, so biological preparations of growth factors can be added to traditional therapies. A combination of growth factor biologics and conventional therapies may improve the efficiency of injury repair, but growth factor biologics may not produce any results. The feasibility of growth factor biologics in the treatment of motor injury was discussed. The research have shown that: 1) GF biological agent therapy is a very promising treatment for motor injury, which is based on the power of autologous growth factor (GFs) to accelerate tissue healing, promote muscle regeneration, increase angiogenesis, reduce fibrosis, and make the muscle injury rapid recovery. 2) There are various methods for delivering the higher dose of GF to the injured tissue, but most of them depend on the platelet release of GF. At the site of injury, there are several ways to deliver higher doses of GF to the injured tissue. 3) At present, the inhibition of GF is mainly through signal transduction inhibitors and inhibition of transcription factor production. 4) Pattern of GF during wound repair: GF directly regulates many key steps of normal wound repair, including inflammatory cell chemotaxis, division and proliferation of fibroblasts, keratinocytes and vascular endothelial cells, formation of new blood vessels, and synthesis and degradation of intercellular substances. 5) When GF promotes chronic wound healing, in most cases, certain GF can be used targeted only when in vivo regulation still cannot meet the need for repair.

Energy-based therapies are novel treatments for erectile dysfunction that are thought to work by stimulation of tissue vasodilation, neoangiogenesis, and so forth. Low-intensity extracorporeal shock wave therapy (Li-ESWT) is the energy-based therapy with the most robust evidence basis demonstrating efficacy and safety. Among this evidence, randomized controlled trials (RCTs) evaluating Li-ESWT have largely been focused on responders to phosphodiesterase-5 inhibitors. Many of these RCTs have limitations including short follow-up durations, inconsistent protocols, and small sample sizes. Until more diverse patient populations are studied and these limitations are addressed, the use of Li-ESWT should remain limited to IRB-approved clinical research trials.

Dental amalgam has been successfully used for the restoration of carious lesions for more than 180 years. It is clinically characterized by high longevity and low technique sensitivity. For decades, dental amalgam has been discussed in the public, especially due to its roughly 50% mercury content. Since the Minamata Convention was published in 2013 with the primary goal of reducing the anthropogenic mercury release into the environment, the previously muted amalgam discussion has received fresh impetus. Another considerable disadvantage of amalgam is its silver/greyish color, which simply no longer matches patients\' esthetic demands.The present paper describes the basic problems with amalgam against the background of multiple biological, clinical, and health policy factors. Possible consequences of the Minamata Convention concerning legal regulations as well as the use of dental biomaterials and therefore also relating to the future national healthcare system are discussed. Finally, possible amalgam alternatives and the urgent need for biomedical research towards restorative dentistry are presented, embedded into the crucial question of whether we are actually conducting the correct debate.
UNASSIGNED: Dentales Amalgam wird seit über 180 Jahren erfolgreich in der zahnärztlichen Füllungstherapie kariöser Läsionen eingesetzt. Es ist langlebig, in der Verarbeitung wenig techniksensitiv und damit fehlertolerant. Seit vielen Jahren befindet sich das dentale Amalgam jedoch in der öffentlichen Diskussion, v. a. wegen seines Quecksilberanteils von ca. 50 %. Seit Veröffentlichung des „Minamata-Übereinkommens“ im Jahr 2013 mit dem primären Ziel, die Ausleitung anthropogenen Quecksilbers in die Umwelt zu reduzieren, ist die zwischenzeitlich fast verstummte Amalgamkritik wieder deutlich lauter geworden. Ein weiterer nicht unerheblicher Nachteil des Amalgams ist die silbrig-schwärzliche Farbe, die heute den ästhetischen Erfordernissen der Patienten oft nicht mehr entspricht.Der vorliegende Beitrag skizziert die Grundproblematik von Amalgam vor dem Hintergrund multipler biologischer, klinischer und gesundheitspolitischer Aspekte. Es wird Bezug genommen zu möglichen Auswirkungen, insbesondere des Minamata-Übereinkommens, auf gesetzliche Regelungen sowie auf die Verwendung von Werkstoffen und damit auch auf das Versorgungssystem der Zukunft. Außerdem werden mögliche Materialalternativen sowie biomedizinischer Forschungsbedarf auf dem Gebiet der restaurativen Zahnerhaltung dargestellt und abschließend die Frage gestellt, ob wir überhaupt die richtige Diskussion führen.

OBJECTIVE: To evaluate safety and clinical response of Low-intensity Shockwave Therapy (Li-SWT) for the treatment of erectile dysfunction.
METHODS: A single-institution, 2 arm, phase II randomized clinical trial was conducted between February 2017 and April 2019. Patients were randomized into 2 groups, with Li-SWT delivering a total of 3,600 shocks over 5 days (720 once a day, Group A) or over 2 weeks (600 once a day, 3 times a week, Group B). Patients were evaluated for the safety of therapy and completed the International Index of Erectile Function-Erectile Function domain and the Erectile Hardness Scale assessment at baseline, and at 1, 3, and 6 months visits.
RESULTS: Among 87 evaluable patients, 45 and 42 were allocated to Groups A and B treatment schedules, respectively, and 80 patients (40 per group) completed the 6-month evaluation. No adverse events were reported during treatment or during follow-up. There were statistically significant (P < .05) improvements in International Index of Erectile Function-Erectile Function score (mean increase of 2.7 [95% CI = 1.2, 4.2] and 2.7 points [95% CI = 1.4, 4.1] for Groups A and B, respectively) and in Erectile Hardness Scale (mean increase of 0.6 points (95% CI = 0.3, 0.8) and 0.5 (95% CI = 0.2, 0.8) for Groups A and B, respectively) at 6 months, with no differences between groups.
CONCLUSIONS: No difference in outcomes was found when Li-SWT 3,600 shocks were delivered over 1 or 2 weeks at 6 months follow-up and both schedules were safe with no adverse events during or after treatment. Further trials with longer follow-up and sham arm will provide valuable information regarding treatment efficacy and durability. Patel P, Katz J, Lokeshwar SD, et al. Phase II Randomized, Clinical Trial Evaluating 2 Schedules of Low-Intensity Shockwave Therapy for the Treatment of Erectile Dysfunction. Sex Med 2020;8:214-222.

Novel therapeutic modalities have been proposed for the treatment and management of erectile dysfunction (ED). Stem cell therapy (SCT) is the injection of mesenchymal stem cells or stromal vascular fractions from adipose and other tissue sources. Although SCT has been studied and reported in multiple rodent trials, few human clinical trials exist.
The aim of this study was to provide a systematic review of SCT for the treatment of ED with an emphasis on data from peer-reviewed human studies.
A systematic review was performed evaluating SCT for ED in human studies using PubMed-Medline and Scopus databases. Literature search was conducted using key words such as \"Clinical Trials of SCT for ED,\" \"Stromal Vascular Fraction Treatment for ED,\" and \"SCT for ED.\" Systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
The main outcomes measure was the safety and efficacy of SCT for ED in humans.
5 studies specific to SCT for ED treatment were included. A total of 61 patients were included in these phase I and II clinical trials and follow-up periods ranged from 6-62 months. End points of the studies included safety, tolerability, and efficacy of SCT for ED. The majority of the studies demonstrated improvement in erectile function due to SCT in patients, including improvements in penile vascular flow, International Index of Erectile Function-15 items, and Erectile Hardness Scale scores. All of the studies reported that there were no serious adverse events for patients. Limitations of the studies included small cohort sizes, and only 1 contained a sham arm.
The 5 completed human clinical trials show promise for SCT as a restorative therapy for the treatment of ED. However, although promising, there still exists very limited data for the use of SCT for ED in humans. With the expansion of clinics offering SCT for ED, it is imperative that SCT is investigated further for safety, efficacy, and standardization. Lokeshwar SD, Patel P, Shah SM, et al. A Systematic Review of Human Trials using Stem Cell Therapy for Erectile Dysfunction. Sex Med Rev 2020;8:122-130.

Tooth Erosions Associated with Gastroesophageal Reflux: Cause, Prevention and Restorative Therapy Abstract. Dental erosions are caused by the recurring contact of solutions which are unsaturated in tooth minerals,ith hard tooth substances. This initially leads to softening and later to an irreversible loss of hard tooth substance. Erosion is observed particularly with excessive consumption of acidic foods (e.g. soft drinks or citrus fruits) but also in connection with gastrointestinal (gastroesophageal reflux disease) or psychosomatic diseases (anorexia nervosa or bulimia nervosa). The aim of this article is to define dental erosions, their causes, prevalence and consequences as well as possible preventive measures. Based on a clinical example of a patient with reflux-related erosions, a therapy option with direct composite tooth build-up is presented.
Zusammenfassung. Dentale Erosionen entstehen durch den wiederkehrenden Kontakt von Lösungen, die an Zahnmineralien ungesättigt sind, mit den Zahnhartsubstanzen. Dieses führt initial zu einer Erweichung und später zu einem irreversiblen Verlust an Zahnhartsubstanzen. Erosionen werden insbesondere beim übermässigen Konsum saurer Lebensmittel (z.B. Softdrinks oder Zitrusfrüchte) aber auch im Zusammenhang mit gastrointestinalen Erkrankungen (gastroösophageale Reflux-Erkrankung) oder psychosomatischen Erkrankung (Anorexia nervosa oder Bulimia nervosa) beobachtet. Ziel des vorliegenden Artikels ist es, dentale Erosionen zu definieren und ihre Ursachen, Prävalenz und Folgen sowie mögliche präventive Massnahmen aufzuzeigen. Anhand eines klinischen Beispiels eines Patienten mit Reflux-bedingten Erosionen wird eine Therapiemöglichkeit mit direktem Kompositaufbauten der Zähne dargestellt.

Despite the fact that almost one-third of patients suffer from visual deficits following brain damage; neuro-visual rehabilitation to compensate for visual field deficits is relatively neglected in the clinical setting. This is in contrast to physio and speech therapies, which are the bread and butter of rehabilitative programs. Likewise, programs that address coping with dementia usually concentrate on language, memory and cognitive skills, but often fail to address the deficits experienced by the subset of patients suffering from progressive cortico-visual dysfunction. Herein, we will review the different approaches to neuro-visual rehabilitation, mainly concentrating on restorative and compensatory treatments. While the first claims to restore vision in the blind visual field, the latter attempts to improve the use of the remaining intact field. These approaches differ in their premise regarding the ability of the adult human brain to adapt following damage, reflecting different attitudes toward the presumed treatment target organ. While restorative therapies claim to reactivate inactive neurons within or around the damaged cortices, compensatory approaches aim to improve voluntary eye movements to compensate the visual loss. We will also briefly discuss the use of optical devices for bypassing the visual deficit as well as the use of the blind-sight phenomena to convert non-conscious visual abilities in the blind visual field into awareness. The various therapeutic approaches will be discussed in the context of patients suffering from hemianopsia and in patients suffering from posterior cortical atrophy. We will argue that of all, the compensatory strategies have shown the most promising results.