We failed to demonstrate an association between testosterone levels and ED, thus we believe that testosterone does not play an important role in patients with ED when MS is present [10, 26�C28]. We also believe that vascular endothelial changes Pacritinib phase 3 are a common cause of ED [1].In conclusion, the results obtained show that patients with ED have a higher prevalence of MS and higher mean values of acute phase parameters (CRP). Binary logistic regression analysis showed a strong association between ED and metabolic syndrome after controlling for multiple confounding variables. In addition, multiple linear regression analysis showed that systolic BP and CRP predicted a high percentage of IIEF changes.

Cardiovascular screening by MS criteria assessment in patients with ED may be useful to detect individuals who are at risk and start preventive treatment against the development of cardiovascular disease.Conflict of InterestsThe authors declare that there is no conflict of interests.DisclosureThe study was approved by the Ethics Committee of San Cecilio University Hospital.Authors’ ContributionAll authors have participated and contributed in this paper.Acknowledgment The authors acknowledge Urology Department, San Cecilio University Hospital.
Ehrlichiosis and anaplasmosis are important, emerging zoonotic tick-borne diseases caused by gram-negative, obligate intracellular bacteria from the Anaplasmataceae family. In the host cells, the bacteria reside in inclusion bodies (morulae), which provide a hospitable environment for survival [1, 2].

Canidae can be infected by several Anaplasmataceae agents: Ehrlichia canis, E. ewingii, E. chaffeensis, Anaplasma platys, A. phagocytophilum, Neorickettsia risticii, and N. helminthoeca. Ehrlichia and Anaplasma infections are transmitted through the salivary secretions of attached ticks. Ehrlichia canis is usually transmitted by brown dog tick (Rhipicephalus sanguineus) bites, which can also transmit E. ewingii and most likely Anaplasma platys [1]. The occurrence of the tick R. sanguineus parasitizing humans in Brazil [3] serves to warn the risk of transmission of such pathogens Brefeldin_A (A. platys and E. canis) to humans [4, 5].E. canis species mainly infect monocytes, which causes canine monocytic ehrlichiosis, and A. platys species infect platelets, which causes canine cyclic thrombocytopenia. The A. platys platelet tropism is unique among ehrlichial-related organisms, even though all of these infections may result in thrombocytopenia [2]. E. canis is the main pathogen implicated in cases of canine ehrlichiosis in Brazil, but A. platys has recently been identified by PCR in samples from the South region with a prevalence ranging from 25.