bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosis of fetal parvovirus B19 infection: value of virological assays in fetal specimens
Authors: Bonvicini F , Manaresi E , Gallinella G , Gentilomi GA , Musiani M , Zerbini M
Published: April 2009

Objective  The purpose of our work was to examine the most reliable laboratory diagnosis of fetal parvovirus B19 infection in hydropic fetuses by evaluating the most appropriate clinical sample and laboratory test.

Design  B19 DNA detection in fetal samples and serological signs of B19 infection in the respective mothers. Samples collected between January 2000 and July 2008.

Setting  Microbiology, University of Bologna, Bologna, Italy.

Samples One hundred thirty‐five fetal samples (58 fetal cord blood and 77 amniotic fluid samples) and 109 serum samples collected from 109 pregnant women.

Methods  Validated and certified in situ hybridisation assay (ISH) and polymerase chain reaction–enzyme‐linked immunosorbent assay (PCR‐ELISA) were performed on fetal samples to detect B19 DNA. B19‐specific antibodies were investigated in maternal serum samples by a commercial enzyme immunoassay.

Main outcome measures  Parvovirus B19 DNA detection in fetal specimens was analysed in relation to maternal serological signs of infection.

Results  Parvovirus B19 DNA was detected in 22.41% of fetal cord blood and 36.36% of amniotic fluid samples. A statistically significant difference was found between DNA detection by ISH (23.70%) and PCR‐ELISA (14.81%) (P= 0.004). Only 11.76% of fetuses with virological diagnosis of B19 infection were from women with serological signs of acute/recent B19 infection.

Conclusions  Diagnosis of fetal parvovirus B19 infection cannot always rely on maternal serological investigations but rather on the virological analysis of fetal samples. Both fetal cord blood and amniotic fluid samples are suitable for diagnosis, but the detection of B19 DNA in the cells of amniotic fluid samples by ISH proved to be the most reliable diagnostic system.
Cell salvage at caesarean section: the need for an evidence‐based approach
Authors: Geoghegan J , Daniels JP , Moore PAS , Thompson PJ , Khan KS , Gülmezoglu AM
Published: April 2009

Haemorrhage, a leading cause of maternal morbidity and mortality, is frequently associated with caesarean section. Allogeneic blood is an increasingly rare and scare resource. Intraoperative Cell Salvage (IOCS) offers the possibility of improving outcome and reducing allogeneic blood transfusion in cases of haemorrhage at caesarean section. The available literature on the use of IOCS in obstetrics demonstrates that there is limited evidence to support or refute the use of IOCS at caesarean section. However, this procedure has been introduced into obstetric practice. Before opinions about its use become solidified, there is a window of opportunity to launch a large multicentre randomised controlled trial to address the current equipoise.
Fetal fibronectin as a predictor of spontaneous preterm labour in asymptomatic women with a cervical cerclage
Authors: Duhig KE , Chandiramani M , Seed PT , Briley AL , Kenyon AP , Shennan AH
Published: April 2009

Objective  To assess the accuracy of fetal fibronectin (fFN) testing for prediction of preterm labour in asymptomatic high‐risk women with a cervical cerclage.

Design  Retrospective observational study.

Setting  United Kingdom.

Population  Nine hundred and ten asymptomatic women at high‐risk of Preterm birth referred to specialist antenatal clinics and undergoing fFN testing between November 1997 and December 2007.

Methods  Women had fFN tests taken between 23+0 and 27+6 weeks’ gestation, on one or more occasions.

Main outcome measures  Sensitivity, specificity, positive predictive values and negative predictive values of fFN testing for predicting delivery <30 and <37 weeks were compared in those with and without cerclage.

Results  For delivery <30 weeks’ gestation, the specificity of fFN testing was significantly lower in women with cervical cerclage (77% vs 90%; P ≤ 0.00001). The sensitivity of the test was similar between the groups (78.6 (no‐cerclage) vs 60% (cerclage); P > 0.4). The negative predictive value of the fFN test for delivery <30 weeks was high in both groups (>98%).

Conclusions  Asymptomatic high‐risk women with cerclage in situ are more likely to have a false positive fFN test. The negative predictive value is similar.
Automatic Relationship-Harm Associations and Interpersonal Trauma Involving Close Others
Authors: DePrince Anne P. , Combs Melody D. , Shanahan Michelle
Published: April 2009

Women exposed to violence early in life are at risk of revictimization. The interpersonal schema hypothesis of revictimization proposes that revictimized women will be more likely to hold negative expectations about intimate relationships, including expectations that relationships involve harm, relative to singly or nonvictimized women. To test the interpersonal schema hypothesis, we used the implicit lexical decision task to examine automatic associations between relationship and harm concepts among college women who reported histories of no, single, or multiple types of interpersonal trauma involving close others (e.g., family member, partner). Women exposed to multiple types of interpersonal trauma involving close others showed stronger relationship–harm associations than singly or nonexposed women. Relationship–harm associations predicted the number of interpersonal trauma types (e.g., sexual, physical trauma) involving close others reported by participants, but were unrelated to posttraumatic stress disorder (PTSD) symptoms. Findings suggest that relational schemata held by women exposed to multiple types of interpersonal trauma involving close others include concepts of harm, which may have implications for how multiply victimized women behave in and think about intimate relationships.
Perceiving Pervasive Discrimination Over Time: Implications for Coping
Authors: Foster Mindi D.
Published: April 2009

This study provides evidence that the effects of perceived pervasive discrimination may be dynamic over time. It was expected that participants who perceived discrimination to be highly pervasive would initially be more likely to engage in inactive coping strategies than those who perceived low pervasiveness; however, those who continued to perceive high pervasiveness over time were expected ultimately to engage in more active strategies than those perceiving low pervasiveness. Using a 28-day diary, women and ethnic minorities described their daily experiences of discrimination and indicated their appraisals of its pervasiveness as well as their coping strategies. Results showed that participants who initially perceived low pervasiveness reported more active coping and religion use as well as less behavioral disengagement than those initially perceiving high pervasiveness. However, this pattern was reversed by the end of the study. Implications for integrating time into the assessment of coping with discrimination are discussed.
A Meta-Analysis on the Malleability of Automatic Gender Stereotypes
Authors: Lenton Alison P. , Bruder Martin , Sedikides Constantine
Published: April 2009

This meta-analytic review examined the efficacy of interventions aimed at reducing automatic gender stereotypes. Such interventions included attentional distraction, salience of within-category heterogeneity, and stereotype suppression. A small but significant main effect (g = .32) suggests that these interventions are successful but that their scope is limited. The intervention main effect was moderated by publication status, sample nationality, and intervention type. The meta-analytic findings suggest several issues worthy of further investigation, such as whether (a) other categories of intervention not yet identified or tested could be more effective, (b) suppression necessarily produces ironic effects in automatic stereotyping, (c) various indirect measures are differentially sensitive to stereotype change, and (d) automatic stereotypes about men differ in their malleability from those about women.
Group-Level Coping as a Moderator Between Heterosexism and Sexism and Psychological Distress in Sexual Minority Women
Authors: Szymanski Dawn M. , Owens Gina P.
Published: April 2009

The purpose of this study was: (1) to examine concurrently the relationship between heterosexist events and sexist events and psychological distress and (2) to investigate sexual orientation–based and gender-based group-level coping as potential moderators of the heterosexism–distress and sexism–distress links among 282 lesbian and bisexual women. Findings from the Internet survey revealed that, when examined together, both heterosexism and sexism were unique and additive predictors of psychological distress. Results also supported a moderating role of feminist group-level coping in the link between number of sexist events and psychological distress, with the difference between the high–and low–feminist-activity groups occurring at the lower levels of sexism. Thus, it appears that high involvement in feminist activities may provide a buffer against the negative effects of sexism, but only when sexist events are relatively low in number.
What's in a Label? Judgments of Feminist Men and Feminist Women
Authors: Anderson Veanne N.
Published: April 2009

Although significant progress has been made on research concerning stereotypes of feminist women, very little is known about the stereotypes of feminist men. College students rated one of four terms—“feminist man,” “feminist woman,” “man,” or “woman.” Compared to “feminist woman,” “feminist man” was evaluated more positively, but as less potent (i.e., lower in stereotypically masculine characteristics) and less heterosexual. Although feminist man had the highest evaluative ratings of the four terms and was rated similarly in confidence to woman and man, compared to the other terms it was rated low in attractiveness and potency. These results suggest that at least on some dimensions a feminist man's masculinity may be questioned, which in turn may be a hindrance to men in adopting the feminist label.
On Motivated Role Selection: Gender Beliefs, Distant Goals, and Career Interest
Authors: Evans Clifford D. , Diekman Amanda B.
Published: April 2009

Despite widespread changes in occupational opportunities, men and women continue to show divergent preferences for careers. This research invoked a motivational framework to explain sex-differentiated career interest. From a role congruity perspective ( Diekman & Eagly, 2008 ), the internalization of gender roles leads people to endorse gender-stereotypic goals, which then lead to interest in occupations that afford the pursuit of those goals. Three studies provided evidence for the hypotheses. Study 1 found that male-and female-stereotypic careers were perceived to afford different goals. Studies 2 and 3 found that men and women endorsed different goals and that this gender-normative goal endorsement predicted gender-stereotypic career interest. In addition, structural equation modeling (Study 3) indicated that internalization of gender roles fully accounted for sex-differentiated goal endorsement. These findings thus extend the social role theory framework to consider processes related to self-selection into specific social roles.
Breathing patterns during progressive incremental cycle and treadmill exercise are different
Authors: Kalsås Knud , Thorsen Einar
Published: April 2009

Perceived breathlessness at comparable minute ventilation (VE) is higher with cycling than with running. Different use of the upper extremities and chest wall may influence the breathing pattern. It was hypothetized that the relationship between tidal volume (VT) and VE throughout progressive incremental exercise is different with the two modes of exercise. Twelve well trained subjects (seven men) 20–25 years had incremental maximal exercise tests on a treadmill and a cycle ergometer on different days in random order. Heart rate, respiratory gases, VE and VT were measured on a computerized exercise testing system, and data were averaged over 20 s periods. The VE−VT relationship was characterized by maximum VT, VT at a VE of 30 l min−1 (VT30), the Hey plot and by a least squares quadratic regression model. The increase in VT by VE was steeper and VT30 was higher with cycling compared to running. VTmax was not different, but was achieved at a lower VE with cycling. Breathing strategies are different with running and cycling in young well trained subjects, and exercise mode must be accounted for in normative studies of breathing pattern.
Adolescents with Learning Disabilities as Writers: Are We Selling Them Short?
Authors: Schumaker Jean B. , Deshler Donald D.
Published: April 2009

This article chronicles the evolution of a programmatic line of research on strategic writing instruction for adolescents with learning disabilities (LD) conducted by staff and affiliates of the University of Kansas Center for Research on Learning. The goal associated with this research is that students with LD learn the writing skills that they need to succeed in high school and beyond and that their skills are comparable to the skills of their peers. Individual studies have shown that adolescents with LD can master a given writing strategy and can apply that strategy to novel prompts and in general education classes. Moreover, they can learn simple writing strategies from computerized programs. They can also maintain use of a writing strategy over time. When students learn several writing strategies, their scores on standardized tests improve, and their writing competency is comparable to that of peers. Studies have also shown that teachers can teach the writing strategies and achieve successful results. Care must be taken, however, to ensure that students with LD receive the instruction under conditions where they have multiple opportunities to reach mastery on each skill and receive individualized feedback on practice attempts. Overall, the research has shown that adolescents with LD can learn complex writing skills such as planning, writing, and editing multiparagraph themes; can apply these skills to tasks that are assigned in required general education courses; and can be successful in those courses.
Reflections on Research on Writing and Technology for Struggling Writers
Authors: MacArthur Charles A.
Published: April 2009

In this article, I discuss research on the use of technology to support the writing of students with learning disabilities. Struggling writers can benefit from a wide range of computer applications for writing. Word processing, spelling checkers, word prediction, and speech recognition offer support for transcription and revision. Word processing also opens up opportunities for more meaningful publication of writing. Outlining programs and concept mapping software can help with planning. New forms of writing, including Internet chat, blogs, multimedia, and wikis, have not been studied extensively, but they may offer both opportunities and challenges to struggling writers. In addition to describing the research, I try to articulate some general themes and principles that I hope will be helpful to both teachers and researchers.
An Improvised Oxygen Supply System for Pandemic and Disaster Use
Authors: Little Charles M. , Merritt Mark , Wentworth Allen
Published: April 2009

Background:  Current disaster planning for pandemic influenza anticipates overwhelming numbers of patients in need of hospitalization. The anticipated use of extra, or “surge,” beds is common in both hospital and community disaster response planning. In a pandemic of respiratory illness, supplemental oxygen will be a life‐saving intervention. There are currently few options to provide these proposed surge beds with the necessary oxygen.

Objectives:  A method of providing an improvised oxygen delivery system for use in a disaster was developed and tested. This system was designed to use readily available commercial materials to assemble an oxygen delivery system.

Methods:  The study consisted of a laboratory design, assembly, and testing of an improvised oxygen system.

Results:  A liquid oxygen (LOX) Dewar container was used to supply oxygen systems built from inexpensive commercially available plastic tubing and fittings. The system will drive ventilators without significant pressure drop or ventilator malfunction. The final developed system will supply 30 patients with up to 6 L/min (l pm) oxygen each by nasal cannula from a single oxygen Dewar.

Conclusions:  An improvised system to deliver oxygen for patient beds or ventilator use can be easily assembled in the event of a disaster. This could be life‐saving in the event of a pandemic of respiratory illness.
Angiotensin II activates connective tissue growth factor and induces extracellular matrix changes involving Smad/activation and p38 mitogen‐activated protein kinase signalling pathways in human dermal fibroblasts
Authors: Zhang Guo‐You , Li Xuan , Yi Cheng‐Gang , Pan Hua , He Guo‐Dong , Yu Qing , Jiang Liang‐Fu , Xu Wei‐Hua , Li Zhi‐Jie , Ding Jian , Lin Ding‐Sheng , Gao Wei‐Yang
Published: April 2009

Abstract:  Angiotensin II (Ang II) stimulation has been shown to regulate proliferation of skin fibroblasts and the production of extracellular matrix, which are very important processes in skin wound healing and fibrosis; however, there is little knowledge about the mechanisms involved in this process. We investigated the molecular aspects of this system with regards to Ang II in human dermal fibroblasts (HDF) and its potential role in fibrosis. Fibroblasts derived from human skin were subjected to examine differential relative gene and protein expression after transfection with specific reporter expression vectors and Ang II in vitro. In growth‐arrested HDFs, Ang II treatment for 20 min caused acute activation of Smad2 phosphorylation, Smad overexpression and Smad‐dependent gene transcription. The angiotensin type 1 (AT1) antagonist losartan diminished Ang II‐induced Smad activation. The blockade of endogenous transforming growth factor‐β1 did modify the activation of Smad caused by Ang II. The p38 mitogen‐activated protein kinase (MAPK) inhibitor SB203580 diminished Ang II‐induced Smad2 phosphorylation. Transient transfection with Smad7, which interferes with receptor‐mediated activation of Smad2, diminished Ang II‐induced connective tissue growth factor promoter activation, gene and protein expression and fibronectin, type I procollagen and type III procollagen overexpression, showing that Smad activation is involved in Ang II‐induced dermal fibrosis. Our results show that Ang II activation of Smad2 occurs via the AT1 receptor, but not the AT2 receptor. Activation of Smad2 required p38 MAPK but not p42/p44 MAPK or the epidermal growth factor receptor.
Keratinocytes: a source of the transmitter l‐glutamate in the epidermis
Authors: Fischer Matthias , Glanz Dagobert , Urbatzka Maximilian , Brzoska Thomas , Abels Christoph
Published: April 2009

Abstract:  Various glutamate receptors have been described in both keratinocytes and melanocytes. l‐Glutamate is the physiological agonist of the glutamate receptor family. The source of this transmitter had not yet been identified. In normal human epidermal keratinocytes (NHEK) and HaCaT‐keratinocytes, cell supernatants were sampled in various stages of cell density and the l‐glutamate content photometrically determined. The following examination time‐points were defined: non‐confluent (ca. 33%), subconfluent (ca. 70%) and confluent (90–100%). The l‐glutamate concentration originally in the culture medium was 14.7 mg/l (0.1 mm/l). The l‐glutamate concentration in the cell supernatant increased in NHEK with increasing cell density: non‐confluent 39.9 ± 4 mg/l, subconfluent 60.6 ± 15.8 mg/l, confluent 100.7 ± 33.2 mg/l. A linear increase of l‐glutamate concentration was also found for HaCaT cells. The investigations show that keratinocytes are capable of producing and releasing l‐glutamate. Thus they are a source of l‐glutamate which acts as a transmitter on epidermal glutamate receptors.
Big snake, small snake: which wound is worse when bitten?
Authors: Hon Kam‐Lun Ellis , Lee Ka‐Wah Tony , Cheung Kam‐Lau , Ng Pak‐Cheung
Published: April 2009

Snakebites in children and teenagers are relatively uncommon in the metropolitan city of Hong Kong. They are rarely fatal but may cause significant morbidity and fear. We report two cases of snakebites to illustrate that the spectrum of morbidity is independent of the size of the snakes. A 7‐year‐old boy was bitten in successions by a green snake. Envenomation occurred at the second bite site. He developed local and systemic signs that were promptly relieved with anti‐venom therapy at the intensive care unit. An 18‐year‐old girl was bitten by a large python but only sustained minor local soft tissue injuries. This report serves to alert the public that snake may bite in successions and envenomation may occur with the subsequent bite.

Conclusion: A small snake may be venomous and a large snake may not be. Avoidable risk factors associated with snakebites (such as avoiding areas known to harbour snakes in the evening in summer and autumn and wearing protective footwear) are highlighted.
Oocyte membrane localization of vitellogenin receptor coincides with queen flying age, and receptor silencing by RNAi disrupts egg formation in fire ant virgin queens
Authors: Lu Hsiao‐Ling , Vinson S. B. , Pietrantonio Patricia V.
Published: April 2009

In ant species in which mating flights are a strategic life‐history trait for dispersal and reproduction, maturation of virgin queens occurs. However, the specific molecular mechanisms that mark this transition and the effectors that control premating ovarian growth are unknown. The vitellogenin receptor (VgR) is responsible for vitellogenin uptake during egg formation in insects. In the red imported fire ant, Solenopsis invicta Buren (Hymenoptera: Formicidae), virgin queens have more abundant VgR transcripts than newly mated queens, but limited egg formation. To elucidate whether the transition to egg production involved changes in VgR expression, we investigated both virgin and mated queens. In both queens, western blot analysis showed an ovary‐specific VgR band (∼ 202 kDa), and immunofluorescence analysis of ovaries detected differential VgR localization in early‐ and late‐stage oocytes. However, the VgR signal was much lower in virgin queens ready to fly than in mated queens 8 h post mating flight. In virgin queens, the receptor signal was first observed at the oocyte membrane beginning at day 12 post emergence, coinciding with the 2 weeks of maturation required before a mating flight. Thus, the membrane localization of VgR appears to be a potential marker for queen mating readiness. Silencing of the receptor in virgin queens through RNA interference abolished egg formation, demonstrating that VgR is involved in fire ant ovary development pre mating. To our knowledge, this is the first report of RNA interference in any ant species and the first report of silencing of a hymenopteran VgR.
Phosphorylation‐dependent binding of human transcription factor MOK2 to lamin A/C
Authors: Harper Maryannick , Tillit Jeanne , Kress Michel , Ernoult‐Lange Michèle
Published: April 2009

Human MOK2 is a DNA‐binding transcriptional repressor. Previously, we identified nuclear lamin A/C proteins as protein partners of hsMOK2. Furthermore, we found that a fraction of hsMOK2 protein was associated with the nuclear matrix. We therefore suggested that hsMOK2 interactions with lamin A/C and the nuclear matrix may be important for its ability to repress transcription. In this study, we identify JNK‐associated leucine zipper and JSAP1 scaffold proteins, two members of c‐Jun N‐terminal kinase (JNK)‐interacting proteins family as partners of hsMOK2. Because these results suggested that hsMOK2 could be phosphorylated, we investigated the phosphorylation status of hsMOK2. We identified Ser38 and Ser129 of hsMOK2 as phosphorylation sites of JNK3 kinase, and Ser46 as a phosphorylation site of Aurora A and protein kinase A. These three serine residues are located in the lamin A/C‐binding domain. Interestingly, we were able to demonstrate that the phosphorylation of hsMOK2 interfered with its ability to bind lamin A/C.
Efficacy and Safety of Omega-3 for Treatment of Early-Stage Peyronie’s Disease: A Prospective, Randomized, Double-Blind Placebo-Controlled Study
Authors: Safarinejad Mohammad Reza
Published: April 2009

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal).

This article has been retracted at the request of the Editor-in-Chief. Following the retraction of Dr. Safarinejad’s work by other journals, The Journal of Sexual Medicine has undertaken an extensive re-review of all papers Dr. Safarinejad published with the journal. Following an intensive re-evaluation and close scrutiny of the manuscripts, our expert reviewers raised multiple concerning questions about the methodology, results, and statistical interpretation as presented in this article. Dr. Safarinejad was contacted to provide his original data and offer explanations to address the concerns expressed by the reviewers. Dr Safarinejad chose not to respond. Consequently, we can no longer verify the results or methods as presented and therefore retract the article.
Depression Resulting from Olfactory Dysfunction is Associated with Reduced Sexual Appetite—A Cross-Sectional Cohort Study
Authors: Gudziol Volker , Wolff-Stephan Silvia , Aschenbrenner Katja , Joraschky Peter , Hummel Thomas
Published: April 2009

Introduction

Anecdotal reports from patients with smell loss provided the basic motivation for the present study on sexual dysfunction among patients with olfactory dysfunction. The aim of the present study was to investigate the sexual appetite and the subject’s depression in regard to olfactory function.

Methods

Eighty-six patients referred to our smell and taste clinic with olfactory dysfunction were investigated. Olfactory function was assessed by means of the “Sniffin’ Sticks” test battery consisting of tests for odor threshold (T), odor discrimination (D), and odor identification (I). Their results were summed up to a composite score, the so-called “TDI score.” All participants completed a questionnaire including the Beck Depression Inventory (BDI) and 11 questions for evaluation of the sexual appetite in regard to the time before the onset of olfactory dysfunction and since the olfactory dysfunction. The points received for the latter questions were summed up to the so called Sexual Appetite Index (SAI).

Results

Olfactory testing revealed that 38 patients were functionally anosmic, 39 patients were hyposmic, and nine patients were normosmic. The average BDI score was 11.0 ± 8.4 points. Evaluation of the SAI questionnaire revealed a significant decrease (P = 0.003) of the score from 22.7 ± 4.5 points from the time before to 21.4 ± 4.9 points since the onset of olfactory loss. No significant correlation was found between olfactory function and the SAI since the onset of olfactory dysfunction. However, the BDI score correlated negatively with the SAI since the onset of olfactory dysfunction (r85 = −0.36; P = 0.001).

Conclusion

The present study does not confirm the hypothesis that loss of olfactory function directly impacts on sexual appetite. It seems that depression caused by olfactory loss is the main cause for the self-reported decrease in sexual appetite as the onset of olfactory dysfunction.
Post-Radical Prostatectomy Pharmacological Penile Rehabilitation: Practice Patterns Among the International Society for Sexual Medicine Practitioners
Authors: Teloken Patrick , Mesquita Guilherme , Montorsi Francesco , Mulhall John
Published: April 2009

Introduction

Despite the fact that there is minimal evidence-based data supporting it, the concept of pharmacological penile rehabilitation following radical prostatectomy (RP) is receiving great attention.

Aim

To define attitudes and practice patterns of clinicians who were members of the International Society for Sexual Medicine (ISSM) and/or its affiliated societies.

Methods

Members of the ISSM and its regional affiliates were invited to participate in a web-based survey.

Main Outcome Measures

Demographic factors, current practice status, and opinions regarding post-RP erectile dysfunction and penile rehabilitation. The statistical methods used included chi-square, Student’s t-tests, and logistic regression analysis.

Results

Three hundred-one physicians from 41 countries completed the questionnaire (82% were urologists). Sixty-five percent of the responders had formal sexual medicine specialty training, 44% had uro-oncology specialty training, and 60% performed RPs. Eighty-seven percent performed some form of rehabilitation. As part of the primary rehabilitation strategy, 95% used phosphodiesterase type 5 inhibitors (PDE5), 30% used vacuum device, 75% used intracavernosal injections, and 9.9% used intraurethral prostaglandin. Fifty-four percent commenced rehabilitation immediately/just after urethral catheter removal, and 37% within the first 4 months after RP. Neither the number of years in medical practice, clinician age, nor country/region of practice differed between rehabilitation performers and nonperformers. With regard to the primary reason for avoiding rehabilitation: 50% responded said it is the cost; 25% said the fact that it is not evidence-based; and 25% said they were not familiar with the concept. Performing rehabilitation was positively associated with urologic oncology training (P = 0.03), performing RP (P < 0.001), and seeing over 50 post-RP patients per year (P = 0.011).

Conclusions

Among ISSM members post-RP penile rehabilitation is widely practiced, commenced early, and based predominantly on PDE5 inhibitors and intracavernosal injections. Clinicians who perform RP or see over 50 such patients per year are the most likely to perform rehabilitation. Cost represents the most common reason for rehabilitation neglect.
New Electroencephalogram (EEG) Neuroimaging Methods of Analyzing Brain Activity Applicable to the Study of Human Sexual Response
Authors: Ortigue Stephanie , Patel Nisa , Bianchi-Demicheli Francesco
Published: April 2009

Introduction

Electroencephalogram (EEG) combined with brain source localization algorithms is becoming a powerful tool in the neuroimaging study of human cerebral functions.

Aim

The present article provides a tutorial on the various EEG methods currently used to study the human brain activity, notably during sexual response.

Main Outcome Measures

Review of published literature on standard EEG waveform analyses and most recent electrical neuroimaging techniques (microstate approach and two methods of brain source localization).

Methods

Retrospective overview of pertinent literature.

Results

Although the standard EEG waveform analyses enable millisecond time-resolution information about the human sexual responses in the brain, less is clear about their related spatial information. Nowadays, the improvement of EEG techniques and statistical approaches allows the visualization of the dynamics of the human sexual response with a higher spatiotemporal resolution. Here, we describe these enhanced techniques and summarize along with an overview of what we have learned from them in terms of chronoarchitecture of sexual response in the human brain. Finally, the speculation on how we may be able to use other enhanced approaches, such as independent component analysis, are also presented.

Conclusions

EEG neuroimaging has already been proven as a strong worthwhile research tool. Combining this approach with standard EEG waveform analyses in sexual medicine may provide a better understanding of the neural activity underlying the human sexual response in both healthy and clinical populations.
Attitudes Toward and Frequency of Partner Interactions Among Women Reporting Decreased Sexual Desire
Authors: Dennerstein Lorraine , Hayes Richard , Sand Michael , Lehert Philippe
Published: April 2009

Introduction

Limited published data address the impact of low sexual desire and interest on multiple domains of women’s partnered relationships.

Aim

To investigate associations between sexual interest and attitudes toward and frequency of partner interactions in women with reduced sexual desire.

Methods

A cross-sectional study was conducted using market research databases to recruit women from the general community in the United States, Germany, and Italy. Telephone interviews screened women to obtain a sample aged 18–65 years, in a relationship, and upset/bothered by decreased sexual desire. A 60-minute face-to-face questionnaire was conducted in participants’ homes.

Main Outcome Measures

Attitudes Toward Partner Interactions (ATPI) index measured sexual and nonsexual partner interactions. Higher scores indicated more positive attitudes and a higher frequency of partner interactions. Sexual interest was assessed on a 6-point scale.

Results

One thousand four hundred two of the 8,000 women screened met the inclusion criteria and agreed to participate (USA N = 600, Germany N = 402, Italy N = 400). A high percentage of participants reported that their sexual interest was absent to very weak (45%) or somewhat weak (43%). Mean ATPI scores increased significantly across sexual interest categories, from absent to very weak (3.7, 95% confidence interval [CI] 3.4 to 4.0) to somewhat weak (5.3, 95% CI 5.0 to 5.6) to somewhat strong or greater sexual interest (7.8, 95% CI 7.3 to 8.4) (one-way analysis of variance, effect size = 0.129, P = 0.001). Higher reported sexual interest was significantly associated with comparatively positive ATPI scores (above the median) (Phi-Kraemer, K = 0.194 P < 0.001).

Conclusion

Clinicians need to be aware that women suffering from characteristics of hypoactive sexual desire disorder have more negative patterns of partner interactions.
Derangements in Endothelial Cell-to-Cell Junctions Involved in the Pathogenesis of Hypercholesterolemia-Induced Erectile Dysfunction
Authors: Ryu Ji-Kan , Zhang Lu Wei , Jin Hai-Rong , Piao Shuguang , Choi Min Ji , Tuvshintur Buyankhuu , Tumurbaatar Munkhbayar , Shin Sun Hwa , Han Jee-Young , Kim Woo Jean , Suh Jun-Kyu
Published: April 2009

Introduction

Endothelial cell-to-cell junctions are crucial for vascular formation, networking, and remodeling of blood vessels as well as for inducing and integrating intracellular signals.

Aim

We investigated the differential expression and distribution of endothelial cell-to-cell junction proteins in the penis of mice with hypercholesterolemia-induced erectile dysfunction.

Methods

Two-month-old C57BL/6J mice were fed a diet containing 4% cholesterol and 1% cholic acid, and age-matched control animals were fed a normal diet, for 3 months. We performed dual priming oligonucleotide (DPO)-based multiplex polymerase chain reaction (PCR) (Seegene, Seoul, Korea) to screen the differential gene expression of 21 endothelial cell-to-cell junctions.

Main Outcome Measures

At 5 months, erectile function was measured by electrical stimulation of the cavernous nerve, and the penis was harvested and stained with antibody to claudin-5, vascular endothelial (VE)-cadherin, and platelet/endothelial cell adhesion molecule (PECAM)-1 (N = 8 per group). Cavernous specimens from a separate group of animals were used for claudin-5, VE-cadherin, and PECAM-1 reverse transcriptase-PCR and Western blot analysis.

Results

Erectile function was significantly lower in hypercholesterolemic mice than in controls. DPO-based multiplex PCR revealed a profound decrease in the gene expression of endothelium-specific cell-to-cell junction proteins, including claudin-5, VE-cadherin, and PECAM-1, in hypercholesterolemic mice compared with that in controls. The expression of claudin-5, VE-cadherin, and PECAM-1 protein evaluated by Western blot or immunohistochemistry was significantly lower in hypercholesterolemic mice than in controls. These endothelial cell-to-cell junction proteins were more sparsely distributed in the endothelium of cavernous sinusoids than in the endothelium of cavernous artery and dorsal blood vessels.

Conclusion

Down-regulation of the endothelial cell-to-cell junctions and decreased endothelial content in the corpus cavernosum might play a major role in the deterioration of erectile function in hypercholesterolemic mice.
Quantitative Sensory Testing of Peripheral Thresholds in Patients with Lifelong Premature Ejaculation: A Case-Controlled Study
Authors: Salonia Andrea , Saccà Antonino , Briganti Alberto , Del Carro Ubaldo , Dehò Federico , Zanni Giuseppe , Rocchini Lorenzo , Raber Marco , Guazzoni Giorgio , Rigatti Patrizio , Montorsi Francesco
Published: April 2009

Introduction

The main functional factors related to lifelong premature ejaculation (PE) etiology have been suggested to be penile hypersensitivity, greater cortical penile representation, and disturbance of central serotoninergic neurotransmission.

Aims

To quantitatively assess penile sensory thresholds in European Caucasian patients with lifelong PE using the Genito-Sensory Analyzer (GSA, Medoc, Ramat Yishai, Israel) as compared with those of an age-comparable sample of volunteers without any ejaculatory compliant.

Methods

Forty-two consecutive right-handed, fully potent patients with lifelong PE and 41 right-handed, fully potent, age-comparable volunteers with normal ejaculatory function were enrolled. Each man was assessed via comprehensive medical and sexual history; detailed physical examination; subjective scoring of sexual symptoms with the International Index of Erectile Function; and four consecutive measurements of intravaginal ejaculatory latency time with the stopwatch method. All men completed a detailed genital sensory evaluation using the GSA; thermal and vibratory sensation thresholds were computed at the pulp of the right index finger, and lateral aspect of penile shaft and glans, bilaterally.

Main Outcome Measures

Comparing quantitatively assessed penile thermal and vibratory sensory thresholds between men with lifelong PE and controls without any ejaculatory compliant.

Results

Patients showed significantly higher (P < 0.001) thresholds at the right index finger but similar penile and glans thresholds for warm sensation as compared with controls. Cold sensation thresholds were not significantly different between groups at the right index finger or penile shaft, but glans thresholds for cold sensation were bilaterally significantly lower (P = 0.01) in patients. Patients showed significantly higher (all P ≤ 0.04) vibratory sensation thresholds for right index finger, penile shaft, and glans, bilaterally, as compared with controls.

Conclusions

Quantitative sensory testing analysis suggests that patients with lifelong PE might have a hypo- rather than hypersensitivity profile in terms of peripheral sensory thresholds. The peripheral neuropathophysiology of lifelong PE remains to be clarified.
Peripheral Vascular Disease and Erectile Dysfunction as Predictors of Mortality in Heart Failure Patients
Authors: Hebert Kathy , Lopez Barbara , Macedo Francisco Yuri Bulcao , Gomes Conrado Rios , Urena Johan , Arcement Lee M.
Published: April 2009

Introduction

Seventy percent to 90% of patients with heart failure (HF) report erectile problems. There are no published data on whether erectile dysfunction (ED) and peripheral vascular disease (PVD) correlate with mortality in HF patients. Also, little is known regarding the impact of HF etiology on mortality in patients with ED.

Aims

Our aim was to investigate the relationship between ED and mortality in HF patients, to evaluate whether the etiology of HF carries a prognostic measure in patients with ED, and to assess the impact of PVD on mortality in optimally treated HF patients with ED.

Main Outcome Measures

The measures are: (i) mortality by presence or absence of ED; (ii) mortality by HF etiology and presence or absence of ED; and (iii) PVD and mortality in HF patients on optimal medical therapy with ED.

Methods

This is a single-center, prospective cohort study of 328 male HF patients (ejection fraction ≤ 40%) followed while being treated with optimal doses of beta blockers and angiotensin-converting enzyme inhibitors. The Sexual Health Inventory for Men survey was used to assess ED (no ED ≥ 22 and ED ≤ 21). Ankle brachial index (ABI) was used to assess PVD (normal ABI ≥ 0.9 and abnormal ABI < 0.9).

Results

Kaplan–Meier curves were constructed to examine the relationship between the presence or absence of ED and PVD, and mortality in a HF population. Although not statistically significant, a trend for increased risk of death was demonstrated in the ischemic cardiomyopathy cohort with ED.

Conclusions

ED, highly prevalent in this cohort, did not identify HF patients on optimal medical therapy at increased risk for mortality. Among the HF patients with ED, HF type was not associated with increased risk for mortality whereas PVD was independently associated with a statistically significant increase in mortality.
The Impact of the Mid-Urethral Slings for the Treatment of Stress Urinary Incontinence on Female Sexuality
Authors: Serati Maurizio , Salvatore Stefano , Uccella Stefano , Zanirato Mara , Cattoni Elena , Nappi Rossella E. , Bolis Pierfrancesco
Published: April 2009

Introduction

No available review has been specifically designed to analyze the relationship between mid-urethral slings for stress urinary incontinence (SUI) and female sexual function.

Aim

The aim of our review has been to go through the available evidence and define the present state of the art about the effects of this specific type of surgery for SUI on female sexuality.

Methods

PubMed was searched for reports about the impact of mid-urethral slings on female sexual function that were published from 1995 to 2008, and the most relevant papers were reviewed.

Main Outcome Measures

Review on the effect of mid-urethral slings on sexuality.

Results

A total of 14 papers including 904 women have been published about the relationship between mid-urethral slings and female sexual function. The main mechanism accounting for improved sexuality is the cure of coital incontinence, while the most common symptom related to worsened sexual life is dyspareunia.

Conclusions

In the majority of cases, women undergoing mid-urethral sling procedures for SUI report that their sexual function is improved or unchanged by this type of surgery, although a not negligible risk of developing dyspareunia (<15%) exists. There are no sufficient data to draw definitive conclusions about possible differences between retropubic vs. transobturator procedures.
Hyperlipidemia and Sexual Function in Premenopausal Women
Authors: Esposito Katherine , Ciotola Miryam , Maiorino Maria Ida , Giugliano Francesco , Autorino Riccardo , De Sio Marco , Cozzolino Domenico , Saccomanno Franco , Giugliano Dario
Published: April 2009

Introduction

No reported studies exist assessing the relationship between sexual function and hyperlipidemia in women.

Aim

In this study, we assessed the domains of sexual function in a representative sample of sexually active premenopausal women with hyperlipidemia, but without cardiovascular disease, as compared with an age-matched female population without hyperlipidemia.

Methods

To be enrolled in the study, women had to meet at least one of the following criteria for the diagnosis of hyperlipidemia: low-density lipoprotein (LDL) cholesterol levels >160 mg/dL; high-density lipoprotein (HDL) cholesterol levels <50 mg/dL; or triglyceride levels >150 mg/dL. Lipid parameters were assessed and verified on blood taken at least twice in the hospital during the screening phase. Four hundred forty-one premenopausal women with hyperlipidemia were compared with 115 age-matched premenopausal women without hyperlipidemia.

Main Outcome Measures

We used the Female Sexual Function Index (FSFI) for assessing the key dimensions of female sexual function.

Results

The two groups were well matched for age and smoking prevalence. Compared with women of the control group, women with hyperlipidemia had reduced mean global FSFI score (22.8 ± 6.8 vs. 29.4 ± 4.9, P < 0.001). Individual analysis of the different domains showed that women with hyperlipidemia reported significantly lower arousal, orgasm, lubrication, and satisfaction scores than control women. Based on the total FSFI score, 51% of women with hyperlipidemia had scores of 26 or less, indicating sexual dysfunction, as compared with 21% of women without hyperlipidemia (P < 0.001). Based on a more conservative analysis including women under the lower quartile of the distribution of FSFI score, 32% of women with hyperlipidemia had scores of 23 or less, as compared with 9% of women without hyperlipidemia (P < 0.001). Multiple regression analysis identified age, body mass index, HDL-cholesterol and triglycerides as independent predictors of FSFI score.

Conclusions

Women with hyperlipidemia have significantly lower FSFI-domain scores as compared with age-matched women without hyperlipidemia. HDL cholesterol and triglyceride levels were independently associated with the FSFI score.
Oral Phosphodiesterase Type 5 Inhibitors Alleviate Recurrent Priapism Complicating Thalassemia Intermedia: A Case Report
Authors: Tzortzis Vassilios , Mitrakas Lampros , Gravas Stavros , Mamoulakis Charalampos , Meissner Andreas , Kyriakou Despina , Melekos Michael D.
Published: April 2009

Introduction

Recurrent ischemic priapism still remains a serious and difficult to treat complication of certain hematological disorders. Elucidation of the underlying pathophysiologic mechanisms and application of new effective prophylactic treatments are needed.

Aim

To present the efficacy of phosphodiesterase type 5 inhibitors (PDE5is) as a preventive measure against ischemic priapism recurrences complicating thalassemia intermedia.

Methods

We report on the case of a 19-year-old Caucasian man with thalassemia intermedia complicated by recurrent episodes of priapism following therapeutic splenectomy. After failure of conventional measures to control recurrences, a trial of long-term PDE5is use was initiated.

Main Outcome Measures

PDE5is efficacy based on clinical patient history.

Results

Within 2 months of PDE5i preventive strategy, priapism recurrences nearly resolved. At 6 months, prophylaxis was discontinued. At 12 months, the patient reported clear improvement and satisfaction, experiencing rare episodes of priapism and a physiologic erectile function.

Conclusions

PDE5 dysregulation seems to be an underline pathogenetic mechanism of thalassemia intermedia-associated priapism. It appears that PDE5is might have a role in the clinical management of such patients and their preventive efficacy warrants further testing in clinical trials.
Urethral Corpus Spongiosum Amyloidosis Presenting with Urethrorrhagia During Erection
Authors: Cormio Luigi , Sanguedolce Francesca , Pentimone Salvatore , Perrone Antonia , Annese Pasquale , Turri Francesco Paolo , Bufo Pantaleo , Carrieri Giuseppe
Published: April 2009

Introduction

Urethral amyloidosis is a rare, probably inflammatory condition usually presenting with hematuria and obstructive urinary symptoms, thus mimicking urethral malignancy. After histological confirmation of the diagnosis, treatment can be expectant or symptomatic.

Aim

To report an unusual cause of urethrorrhagia occurring only during erection in an otherwise healthy man.

Methods

A 30-year-old man presented with a 5-month history of urethrorrhagia occurring only during erection, and with a painless palpable nodule in his penile urethra clearly visible on urethral US and magnetic resonance imaging, but not on urethroscopy.

Results

The patient underwent wide surgical excision of the urethral nodule and grafting of the urethral defect with a pedicled preputial flap. Histological examination revealed isolated amyloid of urethral corpus spongiosum.

Conclusions

Isolated urethrorrhagia during erection and without urinary symptoms can be the presenting sign of urethral amyloidosis involving corpus spongiosum rather than the urethral lumen; in such cases, surgical exploration, wide urethral excision and grafting are mandatory.