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La relazione tra malattie andrologiche e genitourinarie maschili e disturbi del sonno è stata precedentemente segnalata solo in studi a singola istituzione con piccole coorti. È stato recentemente svolto uno studio dal titolo Sleep disorders are associated with testosterone deficiency and erectile dysfunction, il cui obiettivo era valutare l'associazione tra disfunzione erettile (DE) e carenza di testosterone con vari disturbi del sonno utilizzando un ampio database. Cosa dice lo studio? Il database TriNetX Diamond è stato analizzato nel giugno 2022. Negli uomini di età compresa tra 40 e 70 anni, l'insonnia, l'apnea notturna e il disturbo del ritmo circadiano del sonno sono stati valutati ciascuno in modo indipendente per determinare l'associazione con disfunzione erettile e carenza di testosterone e quindi seguiti dalla corrispondenza del punteggio di propensione eseguita per età, ipertensione, iperlipidemia, diabete mellito, cardiopatia ischemica, consumo di tabacco e obesità. La carenza di testosterone era più probabile negli uomini con diagnosi di apnea notturna (odds ratio (OR) 1,66 [95% intervallo di confidenza (CI) 1,65-1,67]), insonnia (OR 1,74 [95% CI 1,73-1,76]) e disfunzione del ritmo circadiano (OR 2,63 [95% CI 2,54-2,73]) rispetto ai controlli. La disfunzione erettile era più probabile negli uomini con diagnosi di apnea notturna (OR 1,02 [95% CI 1,01-1,03]), insonnia (OR 1,30 [95% CI 1,30-1,31]) e disfunzione del ritmo circadiano (OR 1,54 [95% CI 1,30-1,31]) CI 1,49-1,59]) rispetto ai controlli. I nostri sottolineano l'impatto negativo della scarsa qualità e quantità del sonno sulle malattie del sistema genito-urinario e andrologiche maschile identificando queste relazioni nella più grande coorte negli Stati Uniti studiata fino ad oggi. Fonte: Sleep disorders are associated with testosterone deficiency and erectile dysfunction-a U.S. claims database analysis AUTORE andrea.militello Dr. Andrea Militello Urologo, Andrologo, Sessuologo, Patologo della riproduzione Laureato in Medicina e Chirurgia nel 1991 presso Università La Sapienza di Roma. Iscritto all'Ordine dei Medici di Roma tesserino n° 43740. Premiato quale miglior andrologo d'Italia ai Top doctors Award 2022. Laurea in “Medicina e Chirurgia" conseguita nel luglio 1991 con votazione di 110/110 e lode presso l’Universita’ degli Studi di Roma “La Sapienza”, discutendo la tesi sperimentale: ”Chemioterapia endocavitaria con epidoxorubicina e interferone per via sistemica nella profilassi dei tumori superficiali della vescica”. Nel novembre 1996 ha conseguito la specializzazione in Urologia con votazione di 70/70 e lode presso il Dipartimento di Urologia “U. Bracci” del Policlinico “Umberto I” di Roma discutendo la tesi sperimentale: ”L’ecografia trans rettale, il PSA ed il PSAD. Tre metodiche a confronto nella diagnostica del carcinoma della prostata”. Nel 2014 conseguimento di Master di II livello in Andrologia ,implantologia e chirurgia protesica. Nel 2016 conseguimento Master di secondo livello in Seminologia e Fisiopatologia della Riproduzione Umana. Dal 2018 revisore delle riviste scientifiche Central European Journal of Urology , Hormone and Metabolic Research Journal. Dal 2018 libero docente presso l’Università Federiciana di Cosenza. Nel 2014 vincitore del Doctoralia Awards quale miglior Urologo Andrologo d’Italia , nel 2018 Vincitore del Mio Dottore Awards quale miglior Urologo Andrologo d’Italia. #andrologia #informazione #medicina #myyearonyoutube #testosterone

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The team was also moving very fast, and its speed was even faster than that of the Yu Tang Iron Cavalry and the Dong Xuan Black Cavalry. When the team got closer, Fu Baoguo saw the other side clearly, but he was even more surprised.

I saw that this group of people, none of them had armor, all wearing only leather robes, which was very strange. Some people were even ragged and naked; however, it was such a team that joined the battle in an unexpected manner, yelling and shouting!

Moreover, the target was the Dong Xuan Black Cavalry!

“What the hell is going on?” Marshal Fu really couldn’t figure it out.

The two top cavalry in the world were fighting each other, and there were actually a thousand horse thieves who forced their way into the battle?

Where did these guys get such courage?

That action was clearly seeking death! ?

“The people coming are wolf bandits!” A deputy general next to him was also surprised: “Wolf bandits never ask right or wrong, regardless of their identities and origins, they rob anyone they see, without exception, and are the targets that both the enemy and us want to eliminate… Why this time, they are helping us fight? And they just rushed into the black cavalry formation, this… this is simply seeking death!?”

“Wolf bandits? They are wolf bandits?” Fu Baoguo opened his mouth wide.

For a moment, he didn’t know what to say.

Fu Baoguo had heard of this banditry that only circulated in legends, but in Fu Baoguo’s opinion, it was just a minor problem, not worth sending a large army to encircle and suppress, so he just let it go. With so few people, even if they commit more sins, they can’t cause much trouble!

When the war is over, just send an army and suppress it.

But now, even if their actions are to help the Yu Tang Iron Cavalry, they are also… but they are too weird, right? What’s going on? Who can help me sort it out?

“Even if he was born in Yu Tang, it is understandable that he has the heart to serve his country, but… this is too impulsive, too careless, too stupid, isn’t it?”

Fu Baoguo murmured: “Is the leader of this wolf bandit just a reckless man?”

Fu Baoguo’s guess was not wrong at all, He Dachui is really a reckless man!

He can’t read a single word, and the most thing he has done in his life is to be brave and fierce; in the past, he would listen to the wolf bandit military advisor; however, this time, he believed what he saw with his own eyes more, and was sure that his own combat power was enough to lock the situation, so he entered the battle forcefully!

If you must say it’s strange, it’s the wolf bandit military advisor who didn’t stop him from committing suicide throughout the whole process, but rushed into the army with him!

It is also because of this that He Dachui is sure that the decision he made is really wise and incomparable!

However, at this moment, He Dachui, who entered the battle, regretted it in just a few dozen breaths. He regretted it so much that his intestines turned green!

It turns out that watching from a distance is completely different from joining the battlefield in person, and it is not the same thing at all!

The cultivation of each of his brothers is indeed higher than that of any black cavalry or iron cavalry.

Even the speed of individual movement is also superior to that of the wolf bandits, and even the explosive power of the horses is not inferior to that of the wolf bandits!

All of the above are correct, He Dachui really did not see it wrong, and did not make a wrong judgment!

The only misjudgment is actually that after they entered the battle formation, they suddenly found that what they thought was all what they thought, and it was all unreliable. The cultivation is better… at most it can only be counted as fart!

One-on-one, the wolf bandits are invincible against the black cavalry and iron cavalry, without any dispute!

Three to three, the wolf bandits can still win, and the black cavalry and iron cavalry can try their luck and join forces to target one person, or they can take the life of one person.

If it is ten to ten, the battle is still dominated by the wolf bandits, and there is a high probability that the wolf bandits will lose half of their lives and the cavalry will be wiped out!

However, when it comes to a battle of a hundred people, the Wolf Bandits will definitely lose. The only chance of survival is to use their faster movement speed than the two cavalrymen to escape, or there may be a chance of survival.

As for the battle of a thousand people that He Dachui had imagined before, there will indeed be a big victory, or even a complete victory. Yes, the one who won the complete victory is one of the two cavalrymen, and the thousand Wolf Bandits will not be able to escape the tragedy of complete destruction!

As for the large-scale military confrontation in front of him… the Wolf Bandits have no room to fight back, and they can only be slaughtered!

Yes, they can only be slaughtered!

He Dachui’s imagination that he can cause an imbalance in the battle formation with one move, and thus make achievements, did not appear at all! The only thing he saw was… the eight hundred brothers who joined the battle, and only in the moment of rushing into the battle formation, less than ten breaths, one third of them were gone!

He blinked in disbelief, and when he looked again, he found that there were less than two hundred people left on the Blue Island!

This… this is too fast!

The team didn’t even have the chance to attack. The moment they entered the battle, the enemy’s weapons attacked from all directions, and there were also gusts of arrows pouring down like a rainstorm.

The wolf bandits fell off their horses one after another, and all those who fell off their horses were trampled into meat paste in the first place!

The black cavalry suffered almost no losses!

He Dachui felt as if he had been hit hard by a big hammer, and felt dizzy for a while!

At this time, a wolf bandit dressed as a scholar rode on a horse with a thin body, waving a long sword and rushing towards this side. There were three people guarding him and rushing towards him together.

They were the wolf bandit military advisor and the other three leaders. They were the ones with the highest cultivation among the wolf bandits except He Dachui. It was also because of this that these people could survive until now.

But when they rushed to He Dachui, there were only the last two people left, and one of them had his left shoulder cut off, and it seemed that he would most likely not survive.

“Brother, hurry up…” The military advisor waved his sword, the sword light was sharp, and he showed extraordinary power. The surrounding black riders could not control it for a while, but his face was abnormally flushed. It was obvious that he had used some secret method to stimulate the potential of life. Even if he showed his power for a while, it would be difficult to last. When his life force was exhausted, it would be the moment of his death!

“Brother, hurry up and enter the pass!”

The military advisor shouted: “With today’s incident, the wolf bandits will be destroyed. Brother, you can expect to have a wife and children in the future, but don’t forget to burn incense for your brothers in the future!”

He Dachui was struck by lightning when he heard the words, and his eyes widened: “You…how do you know?”

His heart was trembling.

The plan in my heart…

The military advisor smiled bitterly: “Brother, we all know what you think… But the war between the two countries has begun, and the Wolf Bandits will be destroyed sooner or later… Even if they are not killed, they will all starve to death… If we can use our lives to exchange for a golden road for you… Everyone is happy!”

He Dachui’s body shook again, and he almost fell off his horse. He shouted frantically: “You know this is the case, but you still want to die…” Before he finished speaking, he was so confused that he couldn’t say anything anymore.

At the same time, a rain of arrows fell down, and the landing point was exactly where He Dachui was.

At this moment, He Dachui lost his mind and was full of confusion. He didn’t even try to resist, and he was about to be stabbed like a hedgehog.

He Dachui, who was in a trance, suddenly felt his eyes go dark. It turned out that the leader with one arm broken flew over to him and blocked the incoming arrows for him. He was immediately pricked like a hedgehog, and his eyes were still looking at He Dachui: “Brother… hurry up… brothers are fighting for their lives… just for your future… we will die anyway… don’t let the brothers down…”

The voice stopped here, and the leader’s body suddenly shook and fell off the horse. Only his eyes were still anxiously staring at He Dachui, but he gradually lost his spirit.

However, countless cavalrymen rumbled in, drowning his anxious eyes. He Dachui fought desperately, fought back desperately, and fought as hard as he could, just wanting to see his brothers again. However, after enduring the charge of this team of cavalry, all he could see was a pile of rotten meat…

Countless swords, spears and arrows still greeted He Dachui without stopping.

The Black Cavalry hated this group of horse thieves!

He Dachui’s plan that day was a mistake, but there was one thing that was not wrong, that is, their entry into the battle eventually affected the overall situation. Although the horse thieves were completely wiped out, they played the role of a straw as He Dachui imagined, and successfully disrupted the Black Cavalry’s charge formation. The Iron Cavalry took advantage of this opportunity and this omission to slaughter them wantonly, and they already had a great advantage, and they were about to turn the advantage into a winning advantage and win a great victory!

And this situation, both the Iron Cavalry and the Black Cavalry knew in their hearts, it was a foregone conclusion and irreversible, it was just a matter of time!

So the Black Cavalry naturally hated these intrusive horse thieves, and they must kill all the horse thieves before their army was completely wiped out, otherwise, how could they rest in peace? !

Especially the horse thief leader in front of them, if he is not dead, everyone will never stop!

The bandit strategist was still swinging his sword desperately, and continued to use the remaining vitality to protect He Dachui and rush out. He Dachui was waving his two hammers and crying.

That’s what I planned… But I didn’t expect everyone to die so miserably, all perishing in this battle…

I thought that at least 80% of my brothers would follow me into the pass and turn from bandits to soldiers…

Now, there are only two people left! ?

After a roar, the strategist’s eyes showed a look of despair, and a black spear pierced into the strategist’s stomach fiercely, and then pierced out from the back.

The military advisor grabbed the spear with one hand and chopped off the black spear soldier’s head with a sword. Then he thrust the sword into the buttocks of the warhorse under He Dachui’s crotch, and hissed, “Go~~~”

“Remember, don’t act on your own in the future, and follow orders in everything…” The military advisor hadn’t finished his last sentence when a knife chopped his right hand, and then three more spears stabbed into his body.

With a whoosh, a sharp knife swept past, and the horse thief military advisor’s head flew up before he finished his last sentence.

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