User:R. Salonga UCSF/sandbox

Pudendal Nerve Entrapment
A few recommendations to decrease nerve compression while cycling include having soft, wide seat in a horizontal position and setting the handlebar height lower than the seat. Additionally, other recommendations include wearing padded bike shorts, standing on pedals periodically, shifting to higher gears, and taking frequent breaks.

Pudendal Nerve Stimulation (PNS) was found to significantly decrease subjective pain levels in people with pudendal neuralgia. A majority of people who underwent PNS reported "significant" or "remarkable" pain relief at 2 weeks after treatment.

Although there are no specific clinical signs or test results for diagnosing PN secondary to PNE, there is a set of criteria called Nantes' criteria that can help guide diagnoses. The criteria include:

A systematic review analyzed PN due to pudendal entrapment and PN without pudendal entrapment in women with chronic pelvic-perianal pain. The review classified the Nantes' criteria a a gold standard for diagnosing PN secondary to PNE. Because of this, the authors of the systematic review additionally suggest that the criteria may be useful in assessing the efficacy and effectiveness of pudendal nerve entrapment treatments.
 * 1) Pain in the anatomical territory of the pudendal nerve.
 * 2) Worsened by sitting.
 * 3) The patient is not woken at night by the pain.
 * 4) No objective sensory loss on clinical examination.
 * 5) Positive anesthetic pudendal nerve block

Although there has been no evidence for a direct functional connection between the pudendal nerve and sacrotuberous ligament, many clinical studies have pointed at the sacrotuberous ligament as a potential cause of PNE. Around the ischial level of the spine, pudendal nerve runs between the sacrotuberous ligament and the sacrospinous ligament (posteriorly and anteriorly, respectively), giving way for potential compression of the pudendal nerve.

Another review that looked at cycling-related sexual dysfunction suggested that cycling may indirectly cause sexual dysfunction by disturbing the testosterone signaling aspect of the hypothalamic-pituitary-gonadal axis of the body.

People may also experience a burning pain in perianal or genital areas.

Group 8 Peer Review
Group 8's edits substantially improved the article. Their lead section describes the topic in a straightforward, understandable manner given that their topic is a paradox, even explicitly explaining why the topic is paradoxical in lay language. Their article is structured in a logical order, beginning with the early accounts of the Health Survival Paradox in literature dating as early as the 18th century. The article then goes into certain factors that are thought to contribute to the paradox, then into the certain advantages women and men have in survival and morbidity, respectively. At the end, the article highlights some and potential biases of the paradox that can be taken into final consideration when formulating subjective viewpoints on the topic.

Group 8's goals were to rearrange the components of the article for clarity, to add content to a few of the subsections to better define and connect concepts, and to add citations to the article. I believe that they were successful in completing these goals to better improve the Health Survival Paradox article. The article was quite easy to follow and the data included were clearly presented; I also felt that the information included by Group 8 was relevant to understanding the topic.

Group 8 presented their many reliable sources in a neutral way, giving readers a good picture of the data regarding the Health Survival Paradox. Not only did they present the information they found in studies, but they also addressed limitations of the studies. For example, under Social and Biological Factors, it was stated that "women tend to have better prognosis due to the presence of estrogen receptor beta," and they further went on to say, "However, this is a continued study that may be due to biological factors—such as..." This is just one of many examples throughout the article of the neutral tone that Group 8 presents in their work.

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