bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacodynamics of pentoxifylline and/or praziquantel in murine schistosomiasis mansoni
Authors: EL‐LAKKANY NAGLAA , NOSSEIR MONA
Published: March 2007

Pentoxifylline (PTX) was proved to exert both anti‐inflammatory and anti‐fibrotic effects, and was used therapeutically in this experimental model to investigate its role alone or with praziquantel (PZQ) in Schistosoma mansoni‐infected mice, and to explore its impact on the tissue expression of transforming growth factor‐β1 (TGF‐β1). S. mansoni‐infected mice were divided into seven groups: Control untreated (I), treated with curative dose of PZQ, 500 mg/kg/day for 2 consecutive days (II), or subcurative dose, 100 mg/kg/day for 2 consecutive days (III), treated with PTX (10 mg/kg/day for 5 days/wk) alone for 4 weeks (IV) or in addition to subcurative dose of PZQ (V), and treated with PTX alone for 8 weeks (VI) or in addition to subcurative dose of PZQ (VII). All animals were killed 10 weeks post infection. Parasitological assessment of worm burden, tissue egg load and oogram pattern was carried out. The degree of granulomatous fibrosis and eosinophilic cell population was quantified in Sirius‐red‐stained sections and tissue transforming growth factor beta‐1 expression was estimated immunohistochemically. Serum ALAT and GGT, as well as hepatic content of reduced GSH, were measured. The results revealed the highest percent of worm reduction and dead ova in groups (II) and (VII) accompanied by significant diminution in granulomatous parameters, collagen content and TGF‐β1 tissue expression. Moreover, treatments with PTX and/or PZQ ameliorated the liver functions. In conclusion, prolonged treatment with PTX has a potent anti‐fibrogenic role especially when used in the early stages of infection, with limited toxic effects on schistosome worms and eggs. Thus, PTX can be used as an adjuvant therapeutic tool with anti‐helminthic drugs in the treatment of human schistosomiasis.
T cell‐dependent and ‐independent expression of intestinal epithelial cell‐related molecules in rats infected with the nematode Nippostrongylus brasiliensis
Authors: KAWAI YUICHI , YAMAUCHI JUNKO , SOGA KOICHI , YAMADA MINORU , UCHIKAWA RYUICHI , TEGOSHI TATSUYA , ARIZONO NAOKI
Published: March 2007

To determine how T cells of thymic origin regulate the intestinal mucous response induced by nematode infection, mucin production and goblet cell‐specific secretory peptide expression were examined in euthymic rnu/+ and athymic rnu/rnu rats infected with the nematode Nippostrongylus brasiliensis. Euthymic rats showed transient goblet cell hyperplasia and upregulation of mucin production, which returned to preinfection levels by 21 days postinfection, when nematodes had been rejected from the intestine. In athymic rats, which failed to reject nematodes, goblet cell hyperplasia and accelerated mucin production continued at least until 21 days postinfection. Gene transcription of mucin‐core peptide (MUC)‐2 and ‐3 and trefoil factor (TFF)‐2 and ‐3 in the jejunal epithelium was upregulated parallel to the levels of goblet cell hyperplasia in both euthymic and athymic rats. On the other hand, resistin‐like molecule (Relm)β, sialyltransferase Siat4c and sulfotransferase 3ST1 showed significantly higher transcription levels in euthymic than in athymic rats at 7 and/or 10 days postinfection. These results suggest that the induction of intestinal mucin production occurs without the activation of thymus‐derived T cells, while the expression of Relmβ, Siat4c and 3ST1 in the intestinal epithelial cells seems to be regulated at least partly by thymus‐dependent mechanisms.
Trends in antimicrobial resistance in Campylobacter spp. causing traveler's diarrhea
Authors: RUIZ JOAQUIM , MARCO FRANCESC , OLIVEIRA INES , VILA JORDI , GASCÓN JOAQUIM
Published: March 2007

The aim of this study was to analyze the evolution of the levels of resistance to nine antimicrobial agents in clinical isolates of Campylobacter spp. causing traveler's diarrhea during the period from 1993 to 2003. The antimicrobial resistance levels to ampicillin, amoxicillin plus clavulanic acid, chloramphenicol, tetracycline, erythromycin, gentamicin, clindamicin, nalidixic acid and ciprofloxacin were established by the method of Kirby‐Bauer. Two subperiods (1993–1998 and 1999–2003) were chosen to compare the evolution of the levels of antimicrobial resistance. Mantel‐Haenszel or Fisher's exact test was performed to determine statistical significance. High levels of resistance to four out of nine antimicrobial agents tested were detected: ampicillin (66.3%), nalidixic acid (52.2%), ciprofloxacin (46.7%), and tetracycline (42.4%). In addition, resistance levels of 20.6% to amoxicillin plus clavulanic acid were detected. An increase in the resistance levels between the two subperiods analyzed for those five antimicrobial agents was observed. This increase was statistically significant for ampicillin, nalidixic acid, and ciprofloxacin. Two cases of therapeutic failure during treatment with ciprofloxacin were detected. The level of resistance to the most commonly used antibacterial agents in the developing world is increasing in Campylobacter spp., the increase in the resistance to quinolones being of special concern.
Gingival crevicular fluid levels of RANKL and OPG in periodontal diseases: implications of their relative ratio
Authors: Bostanci Nagihan , İlgenli Tunc , Emingil Gülnur , Afacan Beral , Han Buket , Töz Hüseyin , Atilla Gül , Hughes Francis J. , Belibasakis Georgios N.
Published: March 2007

Aim: Receptor activator of NF‐κB ligand (RANKL) and osteoprotegerin (OPG) are a system of molecules that regulate bone resorption. This study aims to compare the levels of RANKL, OPG and their relative ratio in gingival crevicular fluid (GCF) of healthy and periodontal disease subjects.

Material and Methods: GCF was obtained from healthy (n=21), gingivitis (n=22), chronic periodontitis (n=28), generalized aggressive periodontitis (n=25) and chronic periodontitis subjects under immunosuppressant therapy (n=11). RANKL and OPG concentrations in GCF were measured by enzyme‐linked immunosorbent assays.

Results: RANKL levels were low in health and gingivitis groups, but increased in all three forms of periodontitis. OPG levels were higher in health than all three periodontitis, or gingivitis groups. There were no differences in RANKL and OPG levels between chronic and generalized aggressive periodontitis groups, whereas these were lower in the immunosuppressed chronic periodontitis group. The RANKL/OPG ratio was significantly elevated in all three periodontitis forms, compared with health or gingivitis, and positively correlated to probing pocket depth and clinical attachment level.

Conclusion: GCF RANKL and OPG levels were oppositely regulated in periodontitis, but not gingivitis, resulting in an enhanced RANKL/OPG ratio. This ratio was similar in all three periodontitis groups and may therefore predict disease occurrence.
Possible Roles of KIR2DL4 Expression on uNK Cells in Human Pregnancy
Authors: Yan Wei‐hua , Lin Aifen , Chen Bao‐guo , Zhou Mei‐ying , Dai Mei‐zhen , Chen Xue‐jiao , Gan Ling‐hong , Zhu Min , Shi Wei‐wu , Li Bo‐li
Published: March 2007

Problem

To investigate possible roles of the natural killer (NK) cell receptor killer immunoglobulin‐like receptor (KIR)2DL4 expressed on uterine NK (uNK) cells during pregnancy, we investigated KIR2DL4 expression on uNK cells isolated from patients with early recurrent spontaneous abortion (RSA) and normal early pregnancy women, and functions of KIR2DL4 was analyzed in vitro.

Methods of the study

Semi‐quantitative RT‐PCR analysis was introduced to detect KIR2DL4 messenger RNA (mRNA) expression on uNK cells. Cytotoxicity and cytokine production as the result of interaction of KIR2DL4 and its ligand human leukocyte antigen (HLA)‐G were analyzed in vitro with lactic dehydrogenase releasing method and enzyme‐linked immunosorbent assay, respectively.

Results

No significant difference in KIR2DL4 mRNA expression was observed, while the KIR2DL4 protein level in isolated uNK cells is much higher in normal controls than that in RSA patients. Data showed that HLA‐G transfection could not reverse the lysis of uNK against HLA‐G transfected K562 cells but induced cytokine production. Furthermore, we demonstrated that, via KIR2DL4, membrane‐bound HLA‐G could induce high cytotoxicity and cytokine production in a high cytotoxic, IL‐2 dependent human NK cell line NK‐92 cells.

Conclusion

Our data suggest that KIR2DL4 might play a crucial implication for human pregnancy.
Establishment of the Porcine Epitheliochorial Placenta Is Associated with Endometrial T‐Cell Recruitment
Authors: Dimova Tanya , Mihaylova Anastassia , Spassova Petia , Georgieva Rayna
Published: March 2007

Problem

We assessed implantation‐associated quantitative changes in peripheral blood and endometrial T lymphocytes throughout epitheliochorial placenta formation.

Method of study

T‐cell subsets were investigated in 10‐, 15‐, 20‐, 30‐, and 40‐day pregnant and non‐pregnant sows by flow cytometry and immunohistochemistry.

Results

Endometrial total T, T cytotoxic (Tc), and T helper (Th) cells were in peak numbers at the attachment phase of implantation and Tc cells persisted in high proportions up to placental establishment. The number of γδ T lymphocytes was relatively small and implantation‐independent. In situ, T cells increased in number with the advancement of implantation and formed T‐cell clusters with implantation phase‐dependent location. Percentages of peripheral blood T cells were not significantly changed throughout the implantation.

Conclusion

Superficial and adeciduate implantation of pigs has a profound effect on the number of total T, Tc, and Th cells and pattern of distribution of endometrial T cells in situ.
Natural Killer Cell Functional Activity Suppression By Intravenous Immunoglobulin, Intralipid and Soluble Human Leukocyte Antigen‐G
Authors: Roussev Roumen G. , Ng Siu Chui , Coulam Carolyn B.
Published: March 2007

Problem

The purpose of this study was to compare the ability of intravenous immunoglobulin (IVIg), intralipid and soluble human leukocyte antigen (sHLA)‐G to suppress natural killer (NK) cell cytotoxicity in an in vitro assay.

Method of study

Blood samples taken from 275 women experiencing reproductive failure were analyzed for NK cytotoxicity and the suppression of NK cytotoxicity by IVIg 4 and 2 mg/mL (n = 275), intralipid 18 and 9 mg/mL (n = 275) and sHLA‐G 70 and 35 ng/mL (n = 50) using immunofluorescent labeled K562 cells as targets and flow cytometry.

Results

Natural killer cytotoxicity was suppressed in all samples. Among patients with normal NK cell activity, IVIg suppressed NK cytotoxicity by 44.9 ± 8.1%, intralipid suppressed NK killing by 45.2 ± 8.3% and sHLA‐G suppressed by 49.0 ± 9.2%. When specimens with abnormal NK activity were observed for suppression of cytotoxicity, IVIg suppressed by 38.9 ± 5.4%, intralipid suppressed by 39.8 ± 6.2% and sHLA‐G suppressed by 39.9 ± 5.0%.

Conclusion

Intravenous immunoglobulin, intralipid and sHLA‐G suppressed NK cell cytotoxicity with equal efficacy in an in vitro assay.
Theoretical Basis for Herbal Medicines, Tokishakuyaku‐San and Sairei‐To, in the Treatment of Recurrent Abortion: Enhancing the Production of Granulocyte–Macrophage Colony‐Stimulating Factor in Decidual Stromal Cells
Authors: Nagamatsu Takeshi , Fujii Tomoyuki , Matsumoto Junko , Kanai Takao , Hyodo Hironobu , Yamashita Takahiro , Kozuma Shiro , Taketani Yuji
Published: March 2007

Problem

To get insight into the basis for the empirical usage of herbal medicines, such as Tokishakuyaku‐san (Toki) and Sairei‐to (Sai) in the treatment of recurrent abortion and intrauterine growth restriction, we examined whether these medicines modulate the production of granulocyte–macrophage colony‐stimulating factor (GM‐CSF), a cytokine working as an important mediator for intercellular communication in the embryonic development, in decidual stromal cells (DSCs).

Method of study

Human DSCs were cultured with either Toki or Sai at several different concentrations. The effect on cell proliferation was assessed by WST‐8 assay. GM‐CSF released into culture medium was analyzed using enzyme‐linked immunosorbent assay, and semi‐quantitative polymerase chain reaction was carried out to see GM‐CSF mRNA expression in DSCs.

Results

Sai inhibited the proliferation of cultured DSCs, while no interference was observed in the presence of Toki. Both Toki and Sai enhanced the release of GM‐CSF into culture medium. The amount of GM‐CSF mRNA in cultured DSCs was as well increased by either Toki or Sai.

Conclusion

Considering the significance of GM‐CSF in embryonic development, clinical benefit of these herbal medicines in the treatment of recurrent abortion might be based on the shown pharmacological reaction related to GM‐CSF.
Dento‐alveolar and maxillofacial injuries – a retrospective study from a level 1 trauma center in Israel
Authors: Lin Shaul , Levin Liran , Goldman Sharon , Peled Micha
Published: March 2007

Abstract –  To evaluate the frequency and causes of dental and maxillofacial trauma in hospitalized patients. From January 1, 2000 to December 31, 2003, data from hospitalized trauma patients in a level 1 trauma center in Israel were analyzed according to age, gender, time, place, and cause of injury. Maxillofacial and tooth injuries were separated and further analyzed according to the above parameters. The analysis was based on data from the Israel Trauma Registry (ITR). Of all 14 040 trauma patients, 1038 (7.4%) involved maxillofacial or dental injuries. Common causes of injury were motor vehicle crashes (41%), falls (27%) and intentional injuries (23%). Fifty percent occurred on the street/road, 17% at home and 14% in public buildings. Surgery was required in 55.5% of all maxillofacial injuries. Males were hospitalized three times more than females, and young people, ages 19–28, were at greatest risk (30.2%). Oral and maxillofacial trauma is common, requiring dental health training for primary caregivers.
A novel trehalase from Mycobacterium smegmatis − purification, properties, requirements
Authors: Carroll J. David , Pastuszak Irena , Edavana Vineetha K. , Pan Yuan T. , Elbein Alan D.
Published: March 2007

Trehalose is a nonreducing disaccharide of glucose (α,α‐1,1‐glucosyl‐glucose) that is essential for growth and survival of mycobacteria. These organisms have three different biosynthetic pathways to produce trehalose, and mutants devoid of all three pathways require exogenous trehalose in the medium in order to grow. Mycobacterium smegmatis and Mycobacterium tuberculosis also have a trehalase that may be important in controlling the levels of intracellular trehalose. In this study, we report on the purification and characterization of the trehalase from M. smegmatis, and its comparison to the trehalase from M. tuberculosis. Although these two enzymes have over 85% identity throughout their amino acid sequences, and both show an absolute requirement for inorganic phosphate for activity, the enzyme from M. smegmatis also requires Mg2+ for activity, whereas the M. tuberculosis trehalase does not require Mg2+. The requirement for phosphate is unusual among glycosyl hydrolases, but we could find no evidence for a phosphorolytic cleavage, or for any phosphorylated intermediates in the reaction. However, as inorganic phosphate appears to bind to, and also to greatly increase the heat stability of, the trehalase, the function of the phosphate may involve stabilizing the protein conformation and/or initiating protein aggregation. Sodium arsenate was able to substitute to some extent for the sodium phosphate requirement, whereas inorganic pyrophosphate and polyphosphates were inhibitory. The purified trehalase showed a single 71 kDa band on SDS gels, but active enzyme eluted in the void volume of a Sephracryl S‐300 column, suggesting a molecular mass of about 1500 kDa or a multimer of 20 or more subunits. The trehalase is highly specific for α,α‐trehalose and did not hydrolyze α,β‐trelalose or β,β‐trehalose, trehalose dimycolate, or any other α‐glucoside or β‐glucoside. Attempts to obtain a trehalase‐negative mutant of M. smegmatis have been unsuccessful, although deletions of other trehalose metabolic enzymes have yielded viable mutants. This suggests that trehalase is an essential enzyme for these organisms. The enzyme has a pH optimum of 7.1, and is active in various buffers, as long as inorganic phosphate and Mg2+ are present. Glucose was the only product produced by the trehalase in the presence of either phosphate or arsenate.
Physiological Changes in Female Genital Sensation During Sexual Stimulation
Authors: Gruenwald Ilan , Lowenstein Lior , Gartman Irena , Vardi Yoram
Published: March 2007

Introduction

A normal sexual response in the female depends on the integrity of afferent sensory input from the genital region. So far genital sensation has been investigated only during a non-excitatory state, and the sensory physiological changes, which occur during the sexual cycle in this region, are still obscured.

Aim

To investigate the sensory status of the female genital region during sexual arousal and orgasm.

Main Outcome Measures

Genital sensory thresholds measured by Quantitative Sensory Testing (vibratory and thermal) were compared in a non-excitatory vs. excitatory state in normal sexually functioning females.

Methods

Eleven healthy female volunteers were recruited and attended three separate visits. During each session only one anatomical site, either clitoris or vagina was tested for either vibratory or thermal stimuli. A psychophysical method of limits was employed for threshold determination of warm or vibratory stimuli. In each session, all women were tested at baseline, immediately after arousal, after orgasm and three more measurements – 5, 10, and 20 minutes during the recovery state.

Results

A significant decrease in clitoral vibratory sensation threshold was observed between the baseline and the arousal phases (P = 0.003). Comparison of vibratory sensation between baseline and following orgasm at the clitoral and vaginal region showed a significant difference (P < 0.001) for both regions. These changes were not significant for thermal threshold sensation at the clitoral region (P = 0.6).

Conclusion

This is the first time that genital sensation has been measured during the excitatory phase of the female sexual cycle. This normative data may serve as a baseline for further investigations of the sensory input of the genital organs during intercourse in pathological states.
Loss of Sexual Desire in the Postmenopausal Woman
Authors: Wylie Kevan , Daines Brian , Jannini Emmanuele A. , Hallam-Jones Ruth , Boul Lori , Wilson Llynwen , Athanasiadis Loukas , Brewster Marnie , Kristensen Ellids
Published: March 2007

Introduction

Hypoactive sexual desire disorder (HSDD) is a common clinical problem that may bother women.

Aim

To provide a clear clinical pathway for the assessment and management of women presenting with symptoms of loss of sexual interest and desire (HSDD).

Main Outcome Measures

Patient self-report of sexual satisfaction and quality of life.

Methods

A multidisciplinary team of experts reviewed a clinical case summary. The contribution of physical, pharmacological, psychological, and psychiatric as well as interrelational factors as potential contributors to the condition are described.

Results

A multifactorial assessment with a combination of psychosocial, physical, and hormonal interventions may be a useful model in offering treatment pathways for symptoms of HSDD. A favorable outcome was reported.

Conclusion

Multidisciplinary teamworking that allows a thorough assessment and package of interventions is often necessary to support women with HSDD.
Erectile Dysfunction Severity Might Be Associated with Poor Cardiovascular Prognosis in Diabetic Men
Authors: Heruti Rafi J. , Uri Inbal , Arbel Yaron , Swartzon Michael , Galor Shay , Justo Dan
Published: March 2007

Introduction

Although erectile dysfunction (ED) might be associated with coronary heart disease (CHD), there is no evidence it predicts poor cardiovascular prognosis. On the other hand, an abnormal heart rate profile during exercise stress testing predicts poor cardiovascular prognosis in high-risk patients, such as diabetic men, even in the absence of CHD.

Aim

In order to study if ED predicts poor cardiovascular prognosis in high-risk patients, we examined the association between ED and heart rate profile during exercise stress testing in diabetic men with no CHD.

Main Outcome Measures

Erectile dysfunction severity, exercise capacity during exercise stress testing, and heart rate decrease after exercise stress testing.

Methods

A retrospective study. The medical charts of diabetic men with vascular ED from a single-sex clinic were reviewed, as well as the medical charts of body mass index (BMI)- and age-matched diabetic men without ED going through routine check-ups. All men underwent routine treadmill stress testing according to the Bruce protocol in order to characterize heart rate profile during exercise. The Sexual Health Inventory for Men (SHIM) questionnaire was used to characterize ED.

Results

Included were 18 diabetic men with ED (SHIM questionnaire scores 5–21) and 18 diabetic men without ED (SHIM questionnaire scores 22–25), 40 years of age or older. None of the men had signs of coronary insufficiency during exercise treadmill stress testing. Although the two groups did not statistically differ with respect to the mean age, the mean BMI, the prevalence of cardiovascular risk factors, and the mean exercise treadmill stress testing findings, the SHIM questionnaire scores were significantly associated with low metabolic equivalents (r = 0.51, P = 0.03) and delayed heart rate recovery during the first 2 minutes after exercise (r = 0.55, P = 0.018) only among diabetic men with ED.

Conclusion

Erectile dysfunction severity might be associated with poor cardiovascular prognosis in adult diabetic men with no CHD.
Differences Between Pre- and Postmenopausal Women in Cues for Sexual Desire
Authors: McCall Katie , Meston Cindy
Published: March 2007

Introduction

Recently, McCall and Meston presented an assessment tool for empirically categorizing stimuli associated with sexual desire in women. Significant differences in cues resulting in sexual desire were found between women with and without hypoactive sexual desire disorder (HSDD).

Aim

The present study examined differences in cues resulting in sexual desire between pre- and postmenopausal women with and without sexual desire concerns using the Cues for Sexual Desire Scale (CSDS) which assesses four distinct aspects of desire motivators: (i) Love/Emotional Bonding Cues; (ii) Erotic/Explicit Cues; (iii) Visual/Proximity Cues; and (iv) Implicit/Romantic Cues.

Main Outcome Measures

The Female Sexual Function Index and the CSDS.

Methods

Women included premenopausal women with no sexual concerns (N = 35), premenopausal women with low sexual desire (N = 30), postmenopausal women with no sexual concerns (N = 21), and postmenopausal women with low sexual desire (N = 39).

Results

Consistent with prior findings, women with low sexual desire reported significantly less Love/Emotional Bonding Cues, Erotic/Explicit Cues, Implicit/Romantic Cues, and had significantly lower CSDS total scores as compared with women with no sexual difficulties. Postmenopausal women were more likely to report cues associated with Love/Emotional Bonding as compared with premenopausal women.

Conclusion

There were significant differences between women with and without sexual desire concerns in Love/Emotional Bonding Cues, Erotic/Explicit Cues, Implicit/Romantic Cues, and CSDS total scores. There were no significant differences between pre- and postmenopausal women in Erotic/Explicit Cues, Visual/Proximity Cues, or Implicit/Romantic Cues. Interestingly, postmenopausal women with and without HSDD endorsed more Love/Emotional Bonding Cues resulting in feelings of sexual desire as compared with premenopausal women.
Development and Validation of the Quality of Erection Questionnaire
Authors: Porst Hartmut , Gilbert Claire , Collins Suzanne , Huang Xiangning , Symonds Tara , Stecher Vera , Hvidsten Kyle
Published: March 2007

Introduction

There are no psychometrically validated assessment tools designed to solely and specifically evaluate satisfaction with the quality of erections.

Aim

To develop and psychometrically analyze the Quality of Erection Questionnaire (QEQ), a new patient-reported measure developed to evaluate men’s satisfaction with the quality of their erections.

Methods

The questionnaire was developed through in-depth qualitative interviews of men with erectile dysfunction (ED) in the United States and Australia. An exploratory methodology study was conducted on 65 men with ED. Subsequently, the psychometric properties were confirmed in a larger dataset of 558 men with ED from two combined clinical trials.

Main Outcome Measures

Identification of potential redundancy or outliers in items (Pearson inter-item correlations); exploratory factor analysis (unrotated and varimax rotated); internal consistency (Cronbach’s alpha); convergent validity (Pearson correlation coefficients between the QEQ total score and domain scores of the International Index of Erectile Function); known-groups validity (ability of the QEQ scores to differentiate between ED severity groups); test–retest reliability (Pearson correlation coefficient).

Results

The QEQ demonstrated excellent convergent and known-groups validity. Additional analysis demonstrated high internal consistency (Cronbach’s alpha, 0.92). Item analysis demonstrated a unidimensional structure and suggested that satisfaction with hardness may be the key driver for satisfaction with overall quality of erections (r = 0.8). The smaller exploratory study demonstrated good test–retest reliability (r = 0.82).

Conclusion

The QEQ is a six-item, patient-reported measure with a unidimensional structure, which produces a total score that may be transformed to a 0–100 scale. Psychometric analysis confirmed reliability and validity of the QEQ, which solely and specifically evaluates satisfaction of men with the quality of their erections. The QEQ is a potentially useful measure for monitoring and evaluating treatment in those who are bothered by, or concerned about, their erectile function.
Effectiveness of Hypnosis for the Treatment of Vulvar Vestibulitis Syndrome: A Preliminary Investigation
Authors: Pukall Caroline , Kandyba Kristina , Amsel Rhonda , Khalifé Samir , Binik Yitzchak
Published: March 2007

Introduction

Vulvar vestibulitis syndrome (VVS) is a common cause of vulvar pain. Therapeutic options target different pain systems believed to be involved in its development and maintenance. Most treatments target the pain component with the assumption that sexual function will increase once the pain has decreased, yet this is not necessarily the case.

Aims

Research has supported the effectiveness of hypnosis for many chronic pain disorders, and a case report demonstrated pain reduction and an increase in intercourse pleasure in a woman with VVS. This preliminary study examined the effectiveness of hypnosis on pain and psychosexual function in VVS.

Methods

Eight women suffering from VVS completed a hypnosis screening assessment, an interview, pain and psychosexual questionnaires, a gynecologic examination, vestibular pain threshold measurement, a psychosexual assessment, and six hypnotherapy sessions. The physical examinations, interview, and questionnaires were repeated at 1 and 6 months posttreatment.

Main Outcome Measures

These included pain ratings during the gynecologic examination, vestibular pain thresholds, scores on the McGill Pain Questionnaire and Pain Catastrophizing Scale, and responses to questions on intercourse-related and nonintercourse-related pain. Measures of psychosexual function included the Female Sexual Function Index, State-Trait Anxiety Scale, Beck Depression Inventory-II, and the Brief Symptom Inventory.

Results

Results indicated significant decreases in gynecologic examination pain and in several measures assessing intercourse pain, and nonsignificant increases in threshold. Some indices of noncoital vulvar pain decreased. Overall sexual function, particularly sexual satisfaction, increased at posttreatment. There were no differences on any psychological measure. Participants reported satisfaction with the treatment and rated their VVS pain reduction as average.

Conclusion

Hypnotherapy appears to be a promising treatment for reducing intercourse pain and some aspects of noncoital vulvar pain, and for restoring sexual function in women with VVS. These results suggest that a large controlled trial should be considered.
Efficacy of Vardenafil and Influence on Self-Esteem and Self-Confidence in Patients with Severe Erectile Dysfunction
Authors: Martin-Morales Antonio , Meijide Fernando , García Nicolás , Artes Maite , Muñoz Ana
Published: March 2007

Aim

To assess the efficacy of vardenafil in a population of Spanish men with erectile dysfunction (ED), its influence on patients’ self-esteem and self-confidence, and its effect on their quality of life.

Main Outcome Measures

Efficacy was assessed by the International Index of Erectile Function-Erectile Function (IIEF-EF) domain, the Rosenberg Self-Esteem scale, the Johnson and McCoy Self-Confidence scale, the Medical Outcome Short Form (SF-36) scale, items 2 and 3 of the Sexual Encounter Profile questionnaire, and the Global Assessment Question (GAQ). Safety assessments included laboratory tests, physical exam, electrocardiogram, vital signs, and adverse events.

Methods

This was a randomized, double-blind, multicenter, placebo-controlled study. After a 4-week treatment-free period, patients received flexible-dose vardenafil or placebo for 12 weeks. The initial dose was 10 mg, which could be titrated up to 20 mg or down to 5 mg at weeks 4 and 8.

Results

A total of 121 patients were included in the intention-to-treat analysis (61 on vardenafil and 60 on placebo). Of these, 16 in the vardenafil group and 14 in the placebo group had severe ED. There was a greater improvement in IIEF-EF domain score with vardenafil vs. placebo for all patients (score change of 10.9 vs. 1.6, respectively, P < 0.001) and for patients with severe ED (score change of 13.4 vs. 2.2, respectively, P = 0.011). A significant difference in favor of vardenafil was also observed for positive responses to the GAQ (73.8% vs. 25.0%, P < 0.001). After 12 weeks, vardenafil-treated patients with severe ED showed a significant improvement in their self-esteem compared with patients receiving placebo (change from baseline −1.51 vs. 3.54, respectively, P = 0.036). Vardenafil treatment was well tolerated.

Conclusion

Vardenafil was highly effective for improving EF in all patients with ED, and resulted in significant improvements in self-esteem in patients with severe ED.
Continuing Medical Education: Sexual Medicine Education: Review and Commentary (CME)
Authors: Parish Sharon J. , Clayton Anita H.
Published: March 2007

Introduction

Sexual medicine education is an important and fundamental topic not adequately represented in most undergraduate and residency training programs.

Aim

The purpose of this article is to better enable the participant to understand the importance of sexual medicine education, and to review existing models and innovations in undergraduate and graduate medical education. This activity is designed for the practicing physician.

Methods

A literature review of the topic was performed.

Main Outcome Measure

Current state of, and new developments in, sexual medicine education.

Results

In all countries, medical students, house staff, and practicing physicians currently receive variable, nonstandardized, or inadequate training in sexual history taking and sexual medicine assessment and treatment. There remain significant physician–patient barriers to discussing sexual issues; and patients feel that their physicians are reluctant, disinterested, or unskilled in sexual problem management. There is a knowledge gap between developments in sexual medicine and the clinical skills of practicing physicians.

Conclusion

The challenge is to create uniform, widely available programs that provide practicing physicians across specialties with the needed skills to meet modern patients' needs in sexual medicine healthcare delivery.
Effect of the Destruction of Cells Containing the Serotonin Reuptake Transporter on Urethrogenital Reflexes
Authors: Gravitt Karla , Marson Lesley
Published: March 2007

Introduction

The urethrogenital (UG) reflex is an autonomic and somatic response that mimics some of the physiological changes seen during ejaculation. The UG reflex is tonically inhibited by neurons in the ventral medulla, an area containing serotonin neurons.

Aim

To examine the effect of lesions of brain neurons containing the serotonin reuptake transporter (SERT) on ejaculatory-like reflexes.

Methods

Anti-SERT saporin (80 nL, 1 mM) or saline was injected bilaterally into the ventrolateral medulla of male Sprague–Dawley rats. Ten to 18 days later, animals were deeply anesthetized and the presence of the UG reflex was examined before and after acute spinal cord transection (T9–10). Following the experiment the presence and number of serotonin and norepinephrine containing neurons (using tryptophan hydroxylase and dopamine beta-hydroxylase, respectively) was performed.

Main Outcome Measures

The UG reflex and cell counts.

Results

In saline-injected controls the UG reflex was not evoked in the anesthetized, intact preparation, indicating the presence of the supraspinal inhibition, as previously reported. Injection of anti-SERT saporin into the ventrolateral medulla allowed the UG reflex to be activated in the intact preparation, thus removed the inhibition. This was associated with a decrease in the number of serotonin neurons in the ventrolateral medulla and raphe. No change in the number of noradrenergic neurons was observed.

Conclusion

These studies suggest that ventral medullary neurons containing SERT are involved in the tonic inhibition of the UG reflex.
Altered Penile Vascular Reactivity and Erection in the Zucker Obese-Diabetic Rat
Authors: Wingard Christopher , Fulton David , Husain Shahid
Published: March 2007

Introduction

The combination of the independent risk factors for erectile dysfunction, obesity, hypertension, and diabetes are manifested collectively in a condition known as metabolic syndrome X. However, the exact mechanism(s) by which the combination of these factors contributes to erectile dysfunction have yet to be elucidated.

Aim

We hypothesized that protein kinase C (PKC) and Rho-kinase enhanced vascular tone and thus contributed to erectile dysfunction in this condition.

Methods

Erectile function was evaluated by recording voltage-dependent increases in intracavernosal pressure following stimulation of the cavernosal nerve in 16- to 20-week-old lean and obese-diabetic Zucker rats. Cavernosal tissue contractile and relaxation responses were evaluated in vitro when contracted with phenylephrine, endothelin-1 and relaxed by Rho-kinase, PKC inhibitors or sodium nitroprusside. Additionally, cavernosal tissue Rho-kinase, protein kinase, and nitric oxide synthase isoform expression were evaluated by Western blot.

Results

The voltage-dependent erectile responses were suppressed by >30% in the obese-diabetic Zucker rat. The maximal stress generated by cavernosal tissue from the obese-diabetic was significantly greater than the lean response by greater than 0.8 mN/mm2 for both phenylephrine and endothelin stimulation. The PKC inhibitor, chelerythrine, inhibited more than 30% of the phenylephrine-induced and 70% of the endothelin-1-induced contractions. Rho-kinase inhibition, with either Y-27632 or HA-1077, revealed impaired relaxations of nearly 30% in tissue from obese-diabetic animals. Western blot analysis revealed increased protein expression of PKC α and δ and Rho-kinase α and β but no loss for endothelial or neuronal nitric oxide synthase.

Conclusion

In this rodent model both PKC and Rho-kinase signaling elements may contribute to an enhanced vasoconstriction state of the penile smooth muscle that was differentially dependent on the agonist used. The enhanced vasoconstrictive state of the tissue could contribute to the reduced voltage-dependent erectile response in the obese-diabetic Zucker rat.
Improvement of Sexual Function in Men with Late-Onset Hypogonadism Treated with Testosterone Only
Authors: Yassin Aksam A. , Saad Farid
Published: March 2007

Aim

Late-onset hypogonadism is associated with relatively mild testosterone deficiencies. This study investigated the effects of restoring testosterone levels to normal in men with complaints of low sexual desire and erectile dysfunction.

Main Outcome Measures

Sexual function was assessed with the International Index of Erectile Function (IIEF) at baseline and after 24 weeks of testosterone administration.

Methods

Twenty-two hypogonadal men (mean age 58 years) with erectile dysfunction were studied. Fifteen patients had serum testosterone below 6.9 nmol/L, and seven between 7.2 and 11.7 nmol/L (reference values in our laboratory ≥12.0 nmol/L); there were considerable comorbidities. The duration of sexual complaints was on average 3.8 years. Patients received intramuscular long-acting testosterone undecanoate.

Results

In all patients, serum testosterone levels were restored to normal within 6–8 weeks. Twelve patients reported a significant improvement in the sexual desire domain (from 4.5 to 8.4) and experienced an improvement in the erectile function domain (from 12 to 25 [Questions 1–5 plus 15)], following treatment with this long-acting testosterone; in 9 of 12 patients, this occurred only after at least 12–24 weeks. The remaining 10 patients reported an improvement of sexual desire (from 4.5 to 7.5), but no significant improvement in the erectile function domain (from 12 to 14). No changes in serum prostate-specific antigen or prostate volume were noticed while receiving this long-acting testosterone preparation.

Conclusion

Restoring testosterone levels to normal in men with proven subnormal testosterone levels improves libido in most subjects, and erectile function in more than 50% of these men. It may take 12–24 weeks before the effects of testosterone become manifest.
Letrozole Versus Testosterone. A Single-Center Pilot Study of HIV-Infected Men Who Have Sex with Men on Highly Active Anti-Retroviral Therapy (HAART) with Hypoactive Sexual Desire Disorder and Raised Estradiol Levels
Authors: Richardson Daniel , Goldmeier David , Frize Graham , Lamba Harpal , De Souza Carl , Kocsis Agnes , Scullard George
Published: March 2007

Introduction

Since the advent of Highly Active Anti-Retroviral Therapy (HAART), men with HIV experience good quality of life and expect to have normal sexual function. However, it appears that men infected with HIV commonly complain of sexual problems. There is evidence that men on HAART develop low sexual desire that is associated with raised estradiol levels. It has been postulated that abnormal metabolism seen in this group of men increases the aromatization of testosterone to estradiol. We hypothesized that letrozole, an aromatase inhibitor that inhibits the conversion of testosterone to estradiol, would be beneficial in these men.

Aim

The aim of this study was to compare the effects of testosterone vs. an aromatase inhibitor, letrazole, in HIV-infected men with raised estradiol and low sexual desire.

Methods

Thirteen men who have sex with men on HAART with low sexual desire as well as raised estradiol levels (>120 pmol/L) were randomly allocated to receive either parenteral testosterone (Sustanon 250 intramuscular injection) (N = 6) or letrozole 2.5 mg orally daily (N = 7) for 6 weeks.

Main Outcome Measures

Sex steroid hormone assays, sex hormone-binding globulin, virological, hematological, and biochemical parameters were measured before and after treatment. Each subject was given the Spector Sexual Desire Inventory and the Depression/Anxiety Stress Scale before and immediately after treatment. Subjects were also asked to estimate the number of actual sexual acts before and after treatment.

Results

Inventory data showed a rise in dyadic desire in both treatment arms. Mean actual sexual acts rose from 0.33 to 1.5 in the testosterone group and from 0.43 to 1.29 for the letrozole group. Luteinizing hormone increased in seven of seven men on letrozole. Serum testosterone increased in seven of seven men on letrozole. There were no adverse events from either medication.

Conclusion

Letrozole may be useful in the management of men on HAART who have low sexual desire.
Micronised and non‐micronised sulphur applications control peach scab equally well with negligible differences in fruit quality
Authors: Schnabel G. , Layne D.R. , Holb I.J.
Published: March 2007

In a 2‐year study, micronised (finely ground) and non‐micronised sulphur spray programmes were investigated for peach scab control and influence on peach fruit quality variables including fruit colouration, soluble solids content and flesh firmness. Both sulphur programmes, applied six or 11 times at 15 kg ha−1, controlled scab equally well in both years on cultivars (cvs) Contender and Cresthaven. Six applications of a half dosage of both micronised and non‐micronised sulphur programmes were significantly less effective (P < 0.05) compared with all other programmes when scab incidence was >90% on cv. Contender. None of the sulphur programmes influenced significantly (P < 0.05) colouration and flesh firmness of harvested fruits compared with the industry standard (a chlorothalonil–captan programme). Only soluble solids concentrations showed significant differences among fungicide programmes (P < 0.05), but these differences were not consistent with either particle sizes of sulphur fungicide or reduced application fungicide programmes. In conclusion, our study showed that (a) micronised sulphur did not control peach scab more effectively compared to non‐micronised sulphur; (b) six applications of sulphur were sufficient to control peach scab when disease pressure was low to medium; and (c) neither six nor 11 applications of sulphur‐based products applied at 15 kg ha−1 had commercially relevant negative impacts on important peach fruit quality variables.
THE CONTEXT OF MARRIAGE AND CRIME: GENDER, THE PROPENSITY TO MARRY, AND OFFENDING IN EARLY ADULTHOOD*
Authors: KING RYAN D. , MASSOGLIA MICHAEL , MACMILLAN ROSS
Published: March 2007

Marriage is central to theoretical debates over stability and change in criminal offending over the life course. Yet, unlike other social ties such as employment, marriage is distinct in that it cannot be randomly assigned in survey research to more definitively assess causal effects of marriage on offending. As a result, key questions remain as to whether different individual propensities toward marriage shape its salience as a deterrent institution. Building on these issues, the current research has three objectives. First, we use a propensity score matching approach to estimate causal effects of marriage on crime in early adulthood. Second, we assess sex differences in the effects of marriage on offending. Although both marriage and offending are highly gendered phenomena, prior work typically focuses on males. Third, we examine whether one's propensity to marry conditions the deterrent capacity of marriage. Results show that marriage suppresses offending for males, even when accounting for their likelihood to marry. Furthermore, males who are least likely to marry seem to benefit most from this institution. The influence of marriage on crime is less robust for females, where marriage reduces crime only for those with moderate propensities to marry. We discuss these findings in the context of recent debates concerning gender, criminal offending, and the life course.
DELINQUENT BEHAVIOR, OFFICIAL DELINQUENCY, AND GENDER: CONSEQUENCES FOR ADULTHOOD FUNCTIONING AND WELL‐BEING*
Authors: LANCTÔT NADINE , CERNKOVICH STEPHEN A. , GIORDANO PEGGY C.
Published: March 2007

The general aim of this article is to evaluate the consequences of both delinquent behavior and institutionalization as a juvenile delinquent on the quality of adult functioning and well‐being, with a specific focus on gender differences. Data were gathered from two related data sources: a sample of previously institutionalized offenders (n=210) and a sample of individuals living in private households (n=721). Males and females in both samples were interviewed initially in 1982 when they were adolescents and re‐interviewed in their late twenties. Results showed that having been institutionalized as an adolescent seriously compromises multiple life domains in adulthood, especially for females. The data also show that an official delinquent status and a high level of involvement in delinquency during adolescence each has independent consequences for male and female adult functioning and well‐being. Institutionalization is strongly predictive of precarious, premature, unstable, and unsatisfied conditions in multiple life domains but much less predictive of behavioral outcomes. On the other hand, a high level of delinquency involvement in adolescence is predictive of antisocial behavior in adulthood, but it tends to have no direct effects on adversity in other life domains. These results are mostly invariant across gender.
DRUG USE AND DESISTANCE PROCESSES
Authors: SCHROEDER RYAN D. , GIORDANO PEGGY C. , CERNKOVICH STEPHEN A.
Published: March 2007

Sampson and Laub's age‐graded theory of informal social control emphasizes the importance of adult social bonds such as marriage and stable employment in redirecting behavior in a more prosocial direction. Heavy alcohol use has also been shown to influence persistent patterns of offending as well as more episodic offending across the life course. Sampson and Laub's life‐course theory emphasizes the negative impact of alcohol use on marital and employment bonds. Although alcohol has indeed been shown to have significant effects on criminal offending, we argue that drug use and the drug culture in which many contemporary offenders are enmeshed have consequences that often complicate desistance processes in ways that alcohol does not. Drug use and its lifestyle concomitants bring together a host of distinctive social dynamics that compromise multiple life domains. The current project investigates the role of drug use on desistance processes relying on a contemporary sample of previously institutionalized youth. We draw on three waves of data from the Ohio life‐course study, a project that spans some 21 years. The results support the assertion that drug use exerts unique effects on desistance processes, once levels of alcohol use are taken into account. We investigate possible mechanisms that help to explain the differential impact of drug use on offending and find that social network effects, particularly partner criminality, explain some but not all of the negative impact of drug use on life‐course patterns of criminal offending.