bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity, Dyslipidemias and Erectile Dysfunction: A Report of a Subcommittee of the Sexual Medicine Society of North America
Authors: Mulhall John , Teloken Patrick , Brock Gerald , Kim Edward 
Published: August 2006

ABSTRACT
Because of increasingly sedentary lifestyles and diets higher in saturated fats, obesity and dyslipidemias are common and increasing in prevalence in Westernized countries. Longitudinal population-based studies clearly demonstrate that dyslipidemias and obesity, as well as factors such as hypertension, diabetes, and smoking, are major risk factors for atherosclerosis. Both clinical and animal models of endothelial dysfunction confirm that atherosclerosis leads to increased cerebrovascular and cardiovascular morbidity. Clinical studies with hypolipidemic agents demonstrate that hydroxy-3-methylglutaryl coenzyme A reductase inhibitors can decrease the risk of vascular morbidity. An increasing body of evidence from animal models demonstrates that hypercholesterolemia and atherosclerosis are risk factors for the development of erectile dysfunction (ED). This causal relationship between obesity and dyslipidemias with the development of ED in humans still needs further definition with convincing peer-reviewed scientific studies. The challenge for the future will be to define the benefit of controlling obesity and dyslipidemias on the development of ED and improvement of erectile function.
Subclinical Erectile Dysfunction: Proposal for a Novel Taxonomic Category in Sexual Medicine
Authors: Jannini Emmanuele A. , Lenzi Andrea , Isidori Andrea , Fabbri Andrea 
Published: August 2006

ABSTRACT
The definition of erectile dysfunction currently used and accepted worldwide does not encompass all possible changes to male erection. Partial, temporary, or episodic absence of erection is not considered as true erectile dysfunction. This leads to a lack of diagnosis and therapy and perhaps even the risk of the subsequent development of overt impotence. The lack of an evidence-based diagnosis of such a condition may be due to the widespread, pernicious self-prescription of erection drugs, obtained from the illegal market. To define the pathological condition of men experiencing a lack of erection who are unaffected by erectile dysfunction, we propose herein a new taxonomic category, based on new sexological criteria. In addition, we suggest research into biochemical markers to define this condition, which we have named subclinical erectile dysfunction.
Sexual Problems Among a Specific Population of Minority Women Aged 40–80 Years Attending a Primary Care Practice
Authors: Sadovsky Richard , Alam Wahila , Enecilla Mignon , Cosiquien Reginald , Tipu Omar , Etheridge-Otey Jennifer 
Published: August 2006

ABSTRACT

Introduction
Clinicians are embarrassed about discussing sex with patients and do not know how to ask about sexual problems in a way that will optimize honest and open responses. Learning about inquiry responses and the prevalence of sexual problems among specific groups of women, including minority women, can help identify appropriate inquiry and management pathways.

Aim
To better understand useful inquiry techniques as well as to describe the prevalence of sexual problems among a specific group of minority women aged 40–80 years.

Main Outcome Measures
Responses to two styles of sexual problem inquiry, direct vs. ubiquity, were compared among sexually active subjects. Prevalence of sexual problems and interest in discussing problems with personal clinician were determined.

Methods
Minority women aged 40–80 years receiving care at one of two Family Health Centers in Brooklyn, New York who could speak English met inclusion criteria. A cross-sectional survey of 212 subjects, the majority being Afro-Caribbean, identified those who were sexually active and then randomly asked about sexual problems using one of two inquiry types: (i) a direct question, such as “Do you have a problem during sex,” or (ii) a ubiquity-style question, such as “Many women with diabetes have sexual problems, how about you?” Sexual problems were characterized by recognized phases of female sexual activity. Interest in discussing sexual problems with a personal clinician was determined.

Results
Of the 212 women surveyed, 108 (50.9%) were sexually active with 37 (34.3%) of these women responding “yes” when asked about sexual problems using one of the two inquiry techniques. Stratified analysis by age group showed significantly higher reporting of sexual problems when a ubiquity-style inquiry was used among older women aged 61–80 years (P = 0.028) but not among younger ones. The prevalence of sexual problems was 14.8% reporting pain, 12.0% lack of interest, 9.2% lack of excitation, 5.5% lack of orgasm, and 6.5%“other.” Forty-three percent of women with problems said they would like to discuss their problem(s) with their clinician.

Conclusions
In a specific minority group of women aged 40 years and older, especially those over age 60 years, ubiquity-style inquiries may encourage more open and honest responses about sexual problems. The most common sexual problem among this group of women was pain. There is willingness and even interest in talking with clinicians about sexual issues. Recognition of sexual problem prevalences helps clarify the high number of women who could be potentially helped with current and future pharmacologic and psychosocial treatments.
Differential Regulation of the Expression of Estrogen, Progesterone, and Androgen Receptors by Sex Steroid Hormones in the Vagina: Immunohistochemical Studies
Authors: Pessina Monica A. , Hoyt Richard F. , Goldstein Irwin , Traish Abdulmaged M. 
Published: August 2006

ABSTRACT

Objective
Significant structural changes occur in the rat vagina in response to sex steroid hormone deprivation and replacement. However, the mechanism by which these changes occur is not clearly understood and our current hypothesis is that these effects are mediated, at least in part, by the expression of sex steroid hormone receptors. The goal of this study was to assess changes in steroid hormone receptor expression and distribution in response to sex steroid hormone deprivation and administration.

Methods
Female rats were either kept intact (controls) or ovariectomized. Ovariectomized animals were treated with vehicle, estradiol, testosterone, progesterone, or hormone combinations. Using immunohistochemistry, hormone receptor distribution was assessed in all layers of the vaginal wall.

Results
After ovariectomy, estrogen receptor alpha (ERα) was up-regulated and progesterone receptor (PR) was down-regulated. Estradiol replacement restored these ovariectomy-induced changes, and this effect was dose-dependent. Androgen receptor (AR) expression was unaffected by ovariectomy or estradiol replacement. However, testosterone treatment resulted in increased AR density in the muscularis. Addition of either testosterone or progesterone to estradiol mitigated but did not abolish the effects of estradiol alone.

Conclusion
Estradiol down-regulated ERα and up-regulated PR expression in the vagina, suggesting this may be a mechanism to prevent continued proliferation of the epithelium by surges of estradiol during the estrous cycle.
Brain-Derived Neurotrophic Factor (BDNF) Acts Primarily via the JAK/STAT Pathway to Promote Neurite Growth in the Major Pelvic Ganglion of the Rat: Part I
Authors: Bella Anthony J. , Lin Guiting , Tantiwongse Kavirach , Garcia Maurice , Lin Ching-Schwun , Brant William , Lue Tom F. 
Published: August 2006

ABSTRACT

Introduction
Identification of the molecular mechanism of cavernous nerve regeneration is essential for future development of neuroprotective and regenerative strategies.

Aim
To identify specific signal transduction pathway(s) associated with brain-derived neurotrophic factor (BDNF) enhanced cavernous nerve regeneration in an in vitro model.

Materials and Methods
Using 6-month-old male Fisher rats, inhibitors of four candidate signaling pathways were added to BDNF-treated explant cultures of major pelvic ganglia with attached cavernous nerve fragments. Study groups comprised of controls, BDNF alone at 50 ng/mL, or BDNF 50 ng/mL and inhibitors against MEK, PI3-K, PKA, and JAK/STAT pathways at increasing concentrations.

Main Outcome Measure
The maximal neurite length for each tissue culture was measured and the mean maximal length ± standard deviation was determined for all groups at 24, 36, and 48 hours.

Results
The JAK/STAT specific inhibitor AG490 significantly reduced BDNF-enhanced neurite growth. Maximum neurite lengths at 24, 36, and 48 hours for BDNF 50 ng/mL treated groups were 182.3, 348.1, and 528.1 µm, compared with AG490 at 25 µM (86.4, 165.1, 278.3 µm), 50 µM (78.8, 151.7, 235.3 µm), and 100 µM (71.83, 107.0, 219.6 µm) (P &lt; 0.05). Neurite measures for BDNF with 25 and 50 µM U0126 (MEK pathway) were reduced to 402.0 and 424.3 µm at 48 hours, respectively (P &lt; 0.05), likely reflecting an accessory molecular pathway. A similar observation was made for 100 uM LY294002 (PI3-K). No difference was observed for PKA inhibition.

Conclusion
The JAK/STAT pathway is the major signal-transduction pathway of BDNF-enhanced cavernous nerve growth in an in vitro rat model.
Brain-Derived Neurotrophic Factor (BDNF) Acts Primarily via the JAK/STAT Pathway to Promote Neurite Growth in the Major Pelvic Ganglion of the Rat: Part 2
Authors: Lin Guiting , Bella Anthony J. , Lue Tom F. , Lin Ching-Shwun 
Published: August 2006

ABSTRACT

Introduction
Surgical and radiation therapies of bladder and prostate cancers may damage cavernous nerves and cause erectile dysfunction (ED). We previously showed that brain-derived neurotrophic factor (BDNF) could restore erectile function in a neurogenic ED rat model. We now investigated the signaling mechanism of BDNF in major pelvic ganglia (MPG) explants.

Aim
To identify the signaling mechanism that mediates the neurotrophic effect of BDNF in cultured MPG.

Methods
Major pelvic ganglia was isolated from male rats for immunohistochemistry and immunofluorescence staining to locate BDNF receptors, pan-neurotrophin 75 (p75), tropomyosin-related kinase B (TrkB), and tropomyosin-related kinase C (TrkC). The dorso-caudal region of MPG was treated with BDNF to determine the optimal dosage for promoting neurite growth. Specific kinase inhibitors AG490, KT5720, LY294002, and U0126 were then used to treat MPG either alone or prior to BDNF treatment. The treated MPG was examined for neurite growth and for expression and phosphorylation of JAK2, STAT1, and STAT3 by Western blot analysis.

Main Outcome Measures
Lengths of neurite growth from MPG were measured to quantify the effects of BDNF and to identify specific signaling pathways. Ratios of phosphorylated vs. unphosphoryated proteins of JAK2, STAT1, and STAT2 in control and treated MPG were determined to confirm JAK/STAT as the principal signaling pathway.

Results
Tropomyosin-related kinase B and TrkC were localized to neurons whereas p75 to perineuronal satellite glial cells (SGC). The optimal dosage of BDNF for promoting MPG neurite growth was between 25 and 50 ng/mL. Among the four specific kinase inhibitors, AG490 was the strongest in suppressing MPG neurite growth as well as BDNF-induced phosphorylation of JAK2, STAT1, and STAT3.

Conclusions
In rat MPG, TrkB and TrkC were expressed in neurons, whereas p75 in SGC. Optimal BDNF dosage for promoting MPG neurite growth was between 25 and 50 ng/mL. BDNF promotes MPG neurite growth primarily by activating the JAK/STAT pathway.
Efficacy and Safety of Flexible-Dose Vardenafil in Men with Type 1 Diabetes and Erectile Dysfunction
Authors: Ziegler Dan , Merfort Frank , Van Ahlen Hermann , Yassin Aksam , Reblin Tjark , Neureither Marcus 
Published: August 2006

ABSTRACT

Introduction
Erectile dysfunction (ED) affects up to 70% of men with diabetes, occurring with a higher prevalence in those with type 1 diabetes than with type 2 diabetes. Studies investigating treatment of ED in men with diabetes have largely been conducted in a total male population with diabetes. Limited data are available on the efficacy and safety of the potent oral phosphodiesterase-5 inhibitor vardenafil in men with ED and type 1 diabetes.

Aims
To evaluate the safety and efficacy of flexible-dose vardenafil therapy in a prospective randomized study in phosphodiesterase 5 inhibitor-naïve subjects with type 1 diabetes and ED.

Methods
In this multicenter, double-blind, placebo-controlled clinical trial, phosphodiesterase-5 inhibitor-naïve patients were randomized to receive placebo (N = 149) or flexible-dose (5–20 mg) (N = 153) vardenafil.

Main Outcome Measure
Sexual Encounter Profile diary questions 2 and 3, concerning success rates of vaginal insertion and maintenance of erection to allow successful intercourse, respectively.

Results
Vardenafil significantly improved mean success rates for Sexual Encounter Profile 2 and 3 compared with baseline and placebo at 4, 8, and 12 weeks (P &lt; 0.0001, intention to treat and last observation carried forward). These rates were unaffected by stratification into distinct subsets according to the level of HbA1c (HbA1c &lt; 7%, good glycemic control; HbA1c &gt;7–≤8%, moderate glycemic control; and HbA1c &gt; 8%, poor glycemic control). Vardenafil treatment also significantly improved the Erectile Function domain score (P &lt; 0.0001) of the International Index of Erectile Function compared with placebo, in addition to scores for the other individual domains of the International Index of Erectile Function. The most commonly reported treatment-emergent adverse events were headache (3.1%) and flushing (2.5%), which were mild to moderate and transient in nature.

Conclusion
These data suggest that vardenafil significantly improves erectile function in men with type 1 diabetes and is well tolerated, regardless of the level of glycemic control.
Vardenafil Improved Erectile Function in a “Real-Life” Broad Population Study of Men with Moderate to Severe Erectile Dysfunction in Australia and New Zealand
Authors: McMahon Chris , Lording Douglas , Stuckey Bronwyn , Tan Ven , Gillman Michael , White Warwick , Di Natale Sebastian , Bramwell Pauline 
Published: August 2006

ABSTRACT

Introduction
Phosphodiesterase type 5 inhibitor drugs produce vasodilatation by inhibiting the breakdown of cyclic guanosine monophosphate and have proven efficacy in treating erectile dysfunction (ED).

Aim
To evaluate the efficacy, safety, and tolerability of vardenafil in men with moderate to severe ED of broad etiology.

Main Outcome Measures
The erectile function (EF) domain score, the response to Questions 13 and 14 of the International Index of Erectile Function (IIEF) questionnaire, and the proportion of “yes” responses to questions 2 and 3 of the Sexual Encounter Profile (SEP), a Global Assessment (GAQ), and Global Satisfaction Questions (GSQ) were compared at baseline and at 12 weeks of treatment with as-needed vardenafil.

Methods
A total of 326 subjects with a mean age of 57.6 years and moderate to severe erectile dysfunction of various etiologies received vardenafil (5–20 mg) for 12 weeks in a prospective multicenter, open-label flexible-dose study.

Results
Compared with baseline, vardenafil was superior in all efficacy outcomes. A significant mean improvement of 13.4 (P &lt; 0.001) in the EF domain from baseline was obtained at week 12. Subjects who received 5, 10, and 20 mg vardenafil at week 12 experienced improvements of 11.9, 15.1, and 12.9 respectively in the EF domain score. Sexual intercourse was successfully completed (SEP3) in 76.3%, 80.1%, and 74.3% of subjects receiving 5, 10, and 20 mg vardenafil compared with 25.9%, 17.9%, and 19.2% at baseline, respectively. For all doses combined at week 12, the change in SEP3 from baseline was 56.7% (P &lt; 0.001). Treatment with vardenafil was well tolerated, and headaches, flushing, nasal congestion, and dyspepsia were the most frequently observed adverse events.

Conclusions
Vardenafil was effective and well tolerated in men with moderate to severe erectile dysfunction. Treatment with vardenafil was associated with a significantly higher IIEF erectile function domain score and completion of successful intercourse rate compared with baseline.
Prospective, Randomized, Open-Label, Fixed-Dose, Crossover Study to Establish Preference of Patients with Erectile Dysfunction After Taking the Three PDE-5 Inhibitors
Authors: Tolrà Josep Rodríguez , Campaña José María Cuadrado , Ciutat Lluis Fumadó , Miranda Eladio Franco 
Published: August 2006

ABSTRACT

Introduction
We conducted a prospective, randomized, open-label, fixed-dose preference study, with a crossover design, using sildenafil, vardenafil, and tadalafil.

Aim
To assess patient preference for sildenafil (100 mg), vardenafil (20 mg), and tadalafil (20 mg) for the treatment of erectile dysfunction. Secondary objectives included finding out whether patients would follow treatment with a second or third option, in the event that the preferred drug was not available, and to assess side effects.

Main Outcome Measures
Patient preference for any treatment, and evaluation of the elements that patients would assess when choosing one of these drugs.

Material and Methods
Sildenafil (100 mg), vardenafil (20 mg), and tadalafil (20 mg) were taken at least six times over a period of 45–60 days with a washout period of 7 days. A total of 132 patients were enrolled to achieve a valid sample of 90 cases (15 per randomized group, total of six groups). Enrolled patients had mild to moderate erectile function.

Results
The International Index of Erectile Function (IIEF) score improved from baseline and was statistically significant in all cases (P &lt; 0.0001). When we compared the IIEF scores, we found a statistically significant difference between tadalafil and vardenafil (P = 0.0002) favoring the former; similar results were obtained with the Erectile Dysfunction Inventory for Treatment Satisfaction (EDITS) Questionnaire (P = 0.000075). We also found a significant difference (P = 0.012) between tadalafil and sildenafil, again in favor of the former. In assessing drug preference, 25 patients (27.77%) chose sildenafil, 18 (20%) vardenafil, and 47 (52.22%) tadalafil. A total of 94% of patients would be willing to take another drug if the preferred choice was not available. All drugs were well tolerated.

Conclusions
Although this is a preference study based on subjective elements, statistically significant differences comparing the IIEF score and the EDITS Questionnaire lead us to believe that beyond patients’ subjective preference per se, said preference is probably also based on a genuinely superior response to one drug over another.
Cues Resulting in Desire for Sexual Activity in Women
Authors: McCall Katie , Meston Cindy 
Published: August 2006

ABSTRACT

Introduction
A number of questionnaires have been created to assess levels of sexual desire in women, but to our knowledge, there are currently no validated measures for assessing cues that result in sexual desire. A questionnaire of this nature could be useful for both clinicians and researchers, because it considers the contextual nature of sexual desire and it draws attention to individual differences in factors that can contribute to sexual desire.

Aim
The aim of the present study was to create a multidimensional assessment tool of cues for sexual desire in women that is validated in women with and without hypoactive sexual desire disorder (HSDD).

Methods
Factor analyses conducted on both an initial sample (N = 874) and a community sample (N = 138) resulted in the Cues for Sexual Desire Scale (CSDS) which included four factors: (i) Emotional Bonding Cues; (ii) Erotic/Explicit Cues; (iii) Visual/Proximity Cues; and (iv) Implicit/Romantic Cues.

Main Outcome Measures
Scale construction of cues associated with sexual desire and differences between women with and without sexual dysfunction.

Results
The CSDS demonstrated good reliability and validity and was able to detect significant differences between women with and without HSDD. Results from regression analyses indicated that both marital status and level of sexual functioning predicted scores on the CSDS. The CSDS provided predictive validity for the Female Sexual Function Index desire and arousal domain scores, and increased cues were related to a higher reported frequency of sexual activity in women.

Conclusions
The findings from the present study provide valuable information regarding both internal and external triggers that can result in sexual desire for women. We believe that the CSDS could be beneficial in therapeutic settings to help identify cues that do and do not facilitate sexual desire in women with clinically diagnosed desire difficulties.
Surgical Treatment of Vulvar Vestibulitis Syndrome: Outcome Assessment Derived from a Postoperative Questionnaire
Authors: Goldstein Andrew T. , Klingman Daisy , Christopher Kurt , Johnson Crista , Marinoff Stanley C. 
Published: August 2006

ABSTRACT

Introduction
Vulvar vestibulitis syndrome (VVS) is the most common pathology in women with sexual pain. Surgery for VVS was first described in 1981. Despite apparently high surgical success rates, most review articles suggest that surgery should be used only “as a last resort.” Risks of complications such as bleeding, scarring, and recurrence of symptoms are often used to justify these cautionary statements. However, there are little data in the peer-reviewed literature to justify this cautionary statement.

Aims
To determine patient satisfaction with vulvar vestibulectomy for VVS and the rate of complications with this procedure.

Methods
Women who underwent a complete vulvar vestibulectomy with vaginal advancement by one of three different surgeons were contacted via telephone by an independent researcher between 12 and 72 months after surgery.

Main Outcome Measures
The primary outcome measurement of surgical success was overall patient satisfaction with surgery. Additional secondary outcome measurements included improvement in dyspareunia, changes in coital frequency, and occurrence of surgical complications.

Results
In total, 134 women underwent surgery in a 5-year period. An independent research assistant was able to contact 106 women, and 104 agreed to participate in the study. Mean duration since surgery was 26 months. A total of 97 women (93%) were satisfied, or very satisfied, with the outcome of their surgery. Only three patients (3%) reported persistently worse symptoms after surgery and only seven (7%) reported permanent recurrence of any symptoms after surgery. Prior to surgery, 72% of the women were completely apareunic; however, after surgery, only 11% were unable to have intercourse.

Discussion
In this cohort of patients, there was a high degree of satisfaction with surgery for VVS. In addition, the risks of complications with this procedure were low, and most complications were transient and the risk of recurrence after surgery was also found to be low.