Bonakdarhashemi, Milad

Abstract Background Erectile dysfunction (ED) is a known precursor and sequela of cardiovascular disease (CVD), with ED severity predicting CVD severity. Aim This study aimed to evaluate the utility of ceramide levels in patients with ED. Methods We initiated ceramide testing in all patients with ED. We retrospectively analyzed ceramide levels from electronic records and stratified by severity of symptoms using the erectile function domain of the International Index of Erectile Function (IIEF). Outcomes The study aimed to determine whether abnormal ceramide levels were associated with ED severity and increased cardiovascular risk. Results Three hundred and fifty-four patients were reviewed, of whom 253 (71.5%) had moderate or higher ED. A statistically significant difference in abnormal ceramide values was found in patients with moderate to severe symptoms, and the odds of getting an abnormal ceramide test were increased based on the IIEF scoring alone (odds ratio [OR] 2.3 [1.04-5.12]; P-value = .034). Clinical Implications Serum ceramide testing could be beneficial in identifying cardiovascular risk in men with ED, potentially prompting cardiac referrals and lifestyle modifications. Strengths and Limitations The strengths of this study include a large sample size and the use of a well-established scale, while the limitations include the retrospective nature of the study and the need for further research to validate the findings. Conclusion Patients undergoing management for ED may benefit from serum ceramide testing and subsequent cardiac referral.

e17168 Background: Prostate cancer is the most prevalent cancer and the second leading cancer related death in men in the USA. Radical prostatectomy represents the mainstay treatment for patients with localized prostate cancer. Management of metastatic disease requires multidisciplinary practice and innovative approach for individualized favorable outcomes. Treatment sequencing in patients with advanced prostate cancer has been reported to impact patient’s response to subsequent treatment as well as overall survival outcomes. Here in, we thought to investigate the impact of prior chemotherapy treatment on PSA response rates to 177Lut PSMA. Methods: We conduct a single center retrospective study including 164 patients diagnosed with advanced prostate cancer and treated with 177Lut PSMA for metastatic hormone resistant prostate cancer. 92 patients received 177Lut PSMA as a salvage treatment late after chemotherapy (group A), and we compared them with 70 patients received 177Lut PSMA early in an adjuvant fashion within 3 months after chemotherapy (group B). Favorable PSA response was defined by 50% or more reduction in PSA value after complete treatment with 177Lut PSMA. Results: Approximately 43 % of patients in (group B) received their 177Lut PSMA within six months. The average number of chemo cycles received by patients of (group B) is between 3 to 6 cycles. Median patients’ age (IQR) 63 years (57.75 - 68), median (IQR) number of cycles of 177Lut PSMA 5 (5 - 6). Statistical analyses were performed to determine any differences in post lut PSA response in both groups of patients. Approximately 49 % of patients in (group A) had favorable PSA response versus 44 % of patients in (group B) (p-value 0.3853). Conclusions: The use of 177Lut-PSMA in the post-chemotherapy setting demonstrated similar outcomes whether administered early or late. These findings suggest that the timing of treatment may not significantly impact its effectiveness, but further research is needed to confirm these results and explore potential optimizations for patient care.