bluuebunny/crossref_metadata_2025_split huggingface dataset:
Matrix metalloproteinase‐9 and tissue inhibitor of matrix metalloproteinase‐1 in blood as markers for early atherosclerosis in subjects with chronic periodontitis
Authors: Söder P‐Ö. , Meurman J. H. , Jogestrand T. , Nowak J. , Söder B. 
Published: January 2009

Background and Objectives:  An association has been found between periodontal disease and the development of atherosclerosis. We investigated the hypothesis that periodontal disease triggers the expression of matrix metalloproteinase‐9 (MMP‐9) and tissue inhibitor of matrix metalloproteinase‐1 (TIMP‐1) in blood. Increased levels of these parameters might then indicate early atherosclerosis.Material and Methods:  In this cross‐sectional study, the material comprised 80 subjects with chronic periodontitis and 31 subjects with no periodontal disease. Sixteen years after diagnosis of periodontal disease ultrasonography revealed a statistically significant difference (p < 0.001) of carotid intima–media thickness between the subjects with chronic periodontitis and the periodontally healthy subjects. Matrix metalloproteinase‐9 and TIMP‐1 were analyzed from blood as periodontal and systemic inflammatory markers. The relationship between MMP‐9, TIMP‐1 and MMP‐9/TIMP‐1 as dependent variables and several independent variables (age, sex, smoking, education, body mass index, hypertension, periodontal disease and cholesterol) were analyzed in multiple logistic regression models to assess the value of the inflammatory markers in predicting carotid atherosclerosis.Results:  Matrix metalloproteinase‐9 and TIMP‐1 were significantly higher in plasma from subjects with periodontal disease and atherosclerosis. Periodontal disease was identified as the principal independent predictor both for atherosclerosis (odds ratio 3.89 for increase in bilateral carotid intima–media thickness) and for increased MMP‐9, TIMP‐1 and MMP‐9/TIMP‐1 (odds ratio 2.58, 5.53 and 3.41, respectively). Classical atherosclerosis risk factors, such as increased total cholesterol, age and sex (women), were significant predictors in the model.Conclusion:  Matrix metalloproteinase‐9, TIMP‐1 and MMP‐9/TIMP‐1 in blood from subjects with periodontal disease could be useful laboratory markers for increased carotid artery intima–media thickness.
Procyanidins Produce Significant Attenuation of Doxorubicin‐Induced Cardiotoxicity via Suppression of Oxidative Stress
Authors: Li Wei , Xu Bin , Xu Jian , Wu Xiao‐Li 
Published: January 2009

Abstract:  Doxorubicin is widely prescribed in the chemotherapy of haematological malignancies and solid tumours. The major side effect of doxorubicin is oxidative injury‐related cardiotoxicity, which has dramatically hindered its usage. Procyanidins from grape seeds are potent free radical scavengers that have been shown to protect against anthracycline‐induced cardiotoxicity. In the present study, we tested whether procyanidins would prevent the doxorubicin‐induced cardiotoxicity in rats. Rats were intraperitoneally treated with doxorubicin at a cumulative dose of 15 mg/kg with and without pre‐administration of procyanidins. Our data showed that doxorubicin led to cardiac function deterioration, myocardial injury and increased oxidative stress in cardiac tissues. The cardiac function deterioration by doxorubicin included increased QT‐interval and ST‐interval in electrocardiograph (ECG) and decreased left ventricular developed pressure. Doxorubicin‐induced myocardial injury was shown by the increased creatine kinase, alanine aminotransferase and aspartate aminotransferase in serum as well as in myocardial lesions. Pretreatment with procyanidin (150 mg/kg daily) effectively hindered the adverse effects of doxorubicin, such as myocardial injury and impaired heart function. Procyanidin pretreatment attenuated cytoplasmic vacuolization, increased left ventricular developed pressure and improved the ECG. The cardioprotective effect of procyanidin corresponded to the decrease of lipid peroxidation and the increase of cardiac antioxidant potency in doxorubicin‐treated rats that were also given procyanidin. An in vitro cytotoxic study showed that procyanidins did not attenuate the antineoplastic activity of doxorubicin to A549 adenocarcinoma cells. All the above lines of evidence suggest that procyanidins protect cardiomyocytes from doxorubicin‐induced cardiotoxicity via suppression of oxidative stress.
Self-Esteem, Confidence, and Relationships in Brazilian Men with Erectile Dysfunction Receiving Sildenafil Citrate: A Randomized, Parallel-Group, Double-Blind, Placebo-Controlled Study in Brazil
Authors: Glina Sidney , Damião Ronaldo , Abdo Carmita , Afif-Abdo João , Tseng Li-Jung , Stecher Vera 
Published: January 2009

ABSTRACT

Introduction
Psychosocial manifestations of erectile dysfunction (ED) differ across cultures. Understanding the treatment response to ED medications within cultural groups can aid in resource allocation and in developing treatment strategies.

Aim
Evaluate the effect of sildenafil treatment on self-esteem, confidence, and sexual relationship satisfaction in Brazilian men with ED.

Main Outcome Measure
The Self-Esteem and Relationship (SEAR) questionnaire, a validated, 14-question instrument developed to specifically address self-esteem and relationship issues within the context of ED.

Methods
Men aged 18 years or older with a clinical diagnosis of ED (≤21 on the Sexual Health Inventory for Men) and in a stable relationship with a partner during the study were eligible. The primary end point was a change from baseline in the self-esteem subscale of the SEAR questionnaire. Thirteen Brazilian sites participated in a randomized, double-blind, placebo-controlled trial of sildenafil treatment for ED. Patients were randomized to receive either 50 mg of sildenafil (adjustable to 25 mg or 100 mg based on patient response) or matching placebo approximately 1 hour before anticipated sexual activity but not more than once a day.

Results
At the end of double-blind treatment, 63 and 66 patients in the placebo and sildenafil groups, respectively, from 13 Brazilian sites were assessed for efficacy. Brazilian patients receiving sildenafil had significantly greater improvements in their scores on the SEAR self-esteem subscale (42.9 [95% confidence interval 35.7–50.0]) compared with placebo (21.1 [95% confidence interval 13.7–28.6]; P &lt; 0.0001). Effect sizes ranged from 0.91 to 1.25 for individual SEAR components.

Conclusions
The psychosocial parameters in Brazilian men with ED assessed by the SEAR questionnaire showed significant improvements in self-esteem, confidence, and relationships after treatment with sildenafil.
Pain, Psychosocial, Sexual, and Psychophysical Characteristics of Women with Primary vs. Secondary Provoked Vestibulodynia
Authors: Sutton Katherine S. , Pukall Caroline F. , Chamberlain Susan 
Published: January 2009

ABSTRACT

Introduction
Women with provoked vestibulodynia (PVD), a common cause of dyspareunia, are typically considered a homogeneous group. However, research suggests that differences on some factors (e.g., medical history, pain characteristics, psychological functioning, treatment response) exist based upon whether the pain was present at first intercourse (primary PVD: PVD1) or developed at some later point (secondary PVD: PVD2).

Aims
The purpose of this study was to examine differences in demographic variables, pain characteristics, psychosocial and psychosexual adjustment, and pain sensitivity between women with PVD1 and PVD2.

Methods
Twenty-six women suffering from PVD (13 with PVD1 and 13 with PVD2) completed a screening assessment, a standardized gynecological examination, an interview, questionnaires, and a quantitative sensory testing session.

Main Outcome Measures
These included pain ratings during the gynecological examination and interview, scores on measures of psychosocial/sexual functioning (e.g., Short Form-36 [SF-36] Health Survey, Female Sexual Function Index), and thresholds and pain ratings during thermal sensory testing over the dominant forearm and vulvar vestibule.

Results
The women with PVD1 were more likely to be nulliparous, but they were not significantly different from the women with PVD2 on other demographic variables or in their pain ratings during the gynecological examination. The women with PVD1 reported lower levels of social and emotional functioning and heightened anxiety surrounding body exposure during sexual activity, and they also displayed lower heat pain tolerance over the forearm and lower heat detection and pain thresholds at the vulvar vestibule than the women with PVD2.

Conclusions
The findings from this study support previous research indicating that women with PVD1 and PVD2 differ in a number of domains. Further research is needed to confirm and elaborate on these findings.
Sexual Function: A Comparison Between Male Renal Transplant Recipients and Hemodialysis Patients
Authors: Tavallaii Seyed Abbass , Mirzamani Mahmood , Heshmatzade Behzadi Ashkan , Assari Shervin , Khoddami Vishteh Hamid Reza , Hajarizadeh Behzad , Einollahi Behzad 
Published: January 2009

ABSTRACT

Introduction
For all the studies into the sexual health of kidney transplant recipients, there is a paucity of controlled studies regarding the difference in the sexual relationship of kidney transplant recipients and end-stage renal disease (ESRD) patients under hemodialysis.

Aim
We compared the sexual function of kidney transplant recipients and ESRD patients under hemodialysis in male patients.

Main Outcome Measures
The patients’ sexual function was assessed using the Relationship and Sexuality Scale.

Method
In this case-controlled study, 89 male renal transplant recipients and 25 male hemodialysis patients were randomly selected from the outpatient clinic of Baqiyatallah Hospital, Tehran, Iran, in 2006. The two groups were not significantly different in terms of age, living place, level of education, duration of ESRD (months), ESRD cause, and somatic comorbidities (Ifudu index).

Results
The renal transplant patients in comparison with the hemodialysis group reported a better overall sexual relationship (17.3 ± 0.6 vs. 21.6 ± 1.4; P = 0.001), and all subscales including sexual function (9.9 ± 0.3 vs. 11.4 ± 0.6; P = 0.03), sexual frequency (6.3 ± 0.3 vs. 7.4 ± 0.6; P = 0.04), and sexual fear (1.1 ± 0.2 vs. 2.8 ± 0.5; P = 0.001). In addition, kidney recipients had significantly more sexual intercourse in a 2-week period prior to the study (P = 0.008).

Conclusions
In our male population, kidney transplant recipients, in comparison with the ESRD patients under hemodialysis, reported a better sexual relationship.
The Effects of Hypoestrogenism on the Vaginal Wall: Interference with the Normal Sexual Response
Authors: Da Silva Lara Lucia Alves , Useche Bernardo , Ferriani Rui Alberto , Reis Rosana Maria , De Sá Marcos Felipe Silva , De Freitas Mauricio Mesquita Sabino , E Silva Julio César Rosa , De Sá Rosa e Silva Ana Carolina Japur 
Published: January 2009

ABSTRACT

Introduction
The sexual response depends on the adequate function of all systems related to the genital and extra-genital organs. Physiological conditions such as menopause can interfere with sexual expression because of central and peripheral changes. Genital effects of estrogen include vaginal trophism, lubrication, and local pleasure sensation in the sexual arousal phase. Hypoestrogenism causes changes in the four layers of the vaginal wall that may result in dyspareunia and a loss in the quality of the genital arousal response.

Aim
The purpose of this review is to highlight the changes in the vaginal wall caused by hypoestrogenism, its possible relationship with dyspareunia, and its repercussions for genital arousal. Treatments for hypoestrogenism are also discussed.

Methods
We evaluated the data available in PubMed (1982–2008) and surveyed the reference list for relevant studies. Two reviewers analyzed the data independently. A study was considered to be of high quality if it had all three of the following characteristics: (i) prospective design; (ii) valid data; and (iii) adequate sample size. Reviews and experimental animal studies were also considered.

Main Outcome Measures
Normal genital morphology, hypoestrogenism and hormone replacement therapy were the focus of the studies reviewed in this paper.

Results
Atrophy of the vaginal wall may be associated with dyspareunia and genital sexual arousal disorder, but psychological and sociocultural aspects must also be considered. Regardless, however, local estrogen therapy is useful in improving vaginal wall trophism and, thus, in improving the sexual response.

Conclusions
There are many possible alterations in the structure of the vaginal wall that are related to estrogen deficiency that may require medical intervention beyond the usual strategies used to attain adequate sexual function. Physicians should attempt to treat these alterations, and more research is needed to elucidate the physiopathology of dyspareunia and genital sexual arousal physiology.
Female Urinary Incontinence During Intercourse: A Review on an Understudied Problem for Women’s Sexuality
Authors: Serati Maurizio , Salvatore Stefano , Uccella Stefano , Nappi Rossella E. , Bolis Pierfrancesco 
Published: January 2009

ABSTRACT

Introduction
Coital urinary incontinence is a frequently underreported symptom, with a relevant impact on women’s sexuality and quality of life.

Aim
This article will review the available evidence on incidence, pathophysiology, and treatment of coital urinary incontinence with the attempt to present the current state of the art.

Methods
PubMed was searched for reports about coital urinary incontinence that were published from 1970 to 2008, and the most relevant articles were reviewed.

Main Outcome Measures
Review on epidemiology, pathophysiology, diagnosis, and treatment of coital incontinence.

Results
The incidence of coital incontinence in incontinent women has been reported to range between 10% and 27%. At present, some evidence suggests an association between urinary leakage at penetration and urodynamic stress (USI) incontinence as well as urinary leakage during orgasm and detrusor overactivity (DO). When treatment for these conditions are based upon urodynamic findings, pelvic floor muscle training, surgery, and pharmacotherapy show satisfactory cure rates.

Conclusions
Coital urinary incontinence deserves much more attention in clinical practice: women should be specifically interviewed for this disturbance because it has a very negative impact on their sexuality. If a reliable urodynamic diagnosis is made, coital urinary incontinence at penetration can be cured in more than 80% of cases by surgery in the presence of USI. The form of coital incontinence during orgasm is curable by antimuscarinic treatment in about 60% of cases when associated with DO.
Atorvastatin Ameliorates Sildenafil-Induced Penile Erections in Experimental Diabetes by Inhibiting Diabetes-Induced RhoA/Rho-Kinase Signaling Hyperactivation
Authors: Morelli Annamaria , Chavalmane Aravinda Krishnappa , Filippi Sandra , Fibbi Benedetta , Silvestrini Enrico , Sarchielli Erica , Zhang Xin-Hua , Vignozzi Linda , Vannelli Gabriella Barbara , Forti Gianni , Maggi Mario 
Published: January 2009

ABSTRACT

Introduction
One of the proposed mechanisms responsible for diabetes-related erectile dysfunction (ED) is overactivity of RhoA/ROCK signaling, as seen in experimental models of chemical diabetes.

Aim
Because statins may interfere with RhoA/Rho-kinase (ROCK) signaling through the reduction of geranyl-geranyl pyrophosphate (GGPP), required for RhoA activation, we investigated whether atorvastatin ameliorated diabetes-related ED.

Methods
Streptozotocin-induced (8 weeks) diabetic rats and alloxan-induced (8 weeks) diabetic rabbits received atorvastatin (5 mg/kg daily) for the last 2 weeks. In vitro contractility studies were conducted in the rabbit model. In the rat model, sildenafil effect on electrical stimulation (ES)-induced erection was investigated. Atorvastatin action was also analyzed using human fetal penile smooth muscle cells (hfPSMCs) exposed to low (5 mM), high (22 mM), and very high (40 mM) glucose.

Main Outcome Measures
Atorvastatin effect on hyperglicemia-induced RhoA/ROCK signaling was evaluated using the ROCK inhibitor Y-27632 in both animal models and by analyzing functional effects downstream to RhoA activation in hfPSMCs.

Results
In both diabetic models, atorvastatin did not affect glycemia, lipid plasma levels, and the hypogonadal state. In diabetic rats, atorvastatin ameliorated the erectile response to the ES of the cavernous nerve and normalized sildenafil effect on erectile function, strongly decreased by diabetes. In penile tissue from diabetic animals, atorvastatin completely restored the diabetes-induced hypersensitivity to Y-27632 and prevented RhoA membrane translocation/activation. In hfPSMCs, high glucose significantly increased not only membrane RhoA expression, but also ROCK activity (increased phosphorylation of the ROCK substrate myosin phosphatase target subunit 1) and several RhoA-dependent functions such as proliferation, migration, and smooth muscle-related gene expression. Atorvastatin restored all the high-glucose-induced effects, an action specifically reverted by GGPP.

Conclusion
Atorvastatin improves diabetes-related ED and restores sildenafil responsiveness, most probably by inhibiting RhoA/ROCK signaling, which underlies several high-glucose-induced derangements in penile smooth muscle cell commitment.
Clinically Relevant Changes in Sexual Desire, Satisfying Sexual Activity and Personal Distress as Measured by the Profile of Female Sexual Function, Sexual Activity Log, and Personal Distress Scale in Postmenopausal Women with Hypoactive Sexual Desire Disorder
Authors: DeRogatis Leonard R. , Graziottin Alessandra , Bitzer Johannes , Schmitt Sonja , Koochaki Patricia E. , Rodenberg Cynthia 
Published: January 2009

ABSTRACT

Introduction
Transdermal testosterone patch (TTP) treatment produced statistically significant improvements in a satisfying sexual activity (SSA), sexual desire, and personal distress in postmenopausal women suffering from hypoactive sexual desire disorder (HSDD), but clinical significance of these changes was not determined.

Aim
To quantify the magnitude of change in three principal outcomes measures determined by HSDD patients as associated with the perception of meaningful benefit with TTP therapy.

Methods
The criteria for defining responders were determined using anchoring methodology and receiver operating characteristics analysis to establish minimum important differences (MIDs) in a representative subsample of 132 patients in two randomized, controlled trials in surgically menopausal women with HSDD (N = 1,094). Perceived benefit was established based upon the question “Overall, would you say that you experienced a meaningful benefit from the study patches?”. These data defined responders and established MIDs for changes in sexual desire, SSA, and personal distress. The MIDs were applied to the two trials to establish responder rates in each treatment group.

Main Outcome Measures
Changes in score that correspond to the MID for sexual desire, SSA, and personal distress, and responder rates in each treatment group based upon these values.

Results
Increases in frequency of SSA of greater than 1 activity/4 weeks, increases in sexual desire score of ≥8.9, and decreases in the personal distress score of ≥20.0 were identified as threshold improvements best able to differentiate responders and nonresponders. The responder rate was significantly higher (P &lt; 0.001) in the testosterone group vs. placebo for all three outcomes measures (sexual desire, 50% vs. 34%; SSA, 44% vs. 30%; personal distress, 51% vs. 39%).

Conclusions
Changes in sexual desire, SSA, and personal distress observed with TTP treatment in surgically menopausal women with HSDD were clinically significant and were associated with a meaningful treatment benefit.
Pulse Pressure, an Index of Arterial Stiffness, is Associated with Androgen Deficiency and Impaired Penile Blood Flow in Men with ED
Authors: Corona Giovanni , Mannucci Edoardo , Lotti Francesco , Fisher Alessandra D. , Bandini Elisa , Balercia Giancarlo , Forti Gianni , Maggi Mario 
Published: January 2009

ABSTRACT

Introduction
Pulse pressure (PP; i.e., the arithmetic difference between systolic and diastolic blood pressure) reflects arterial stiffness and has been suggested to be an independent cardiovascular risk factor.

Aim
The aim of the present study is to asses the possible contribution of PP to arteriogenic erectile dysfunction (ED) and ED-associated hypogonadism.

Methods
A consecutive series of 1,093 (mean age 52.1 ± 13.0 years) male patients with ED and without a previous history of hypertension or not taking any antihypertensive drugs were investigated.

Main Outcome Measures
Several hormonal and biochemical parameters were studied, along with structured interview on erectile dysfunction (SIEDY), ANDROTEST structured interviews, and penile Doppler ultrasound.

Results
Subjects with higher PP quartiles showed worse erectile function and higher prevalence of arteriogenic ED even after adjustment for confounding factors. Furthermore, sex hormone binding globulin-unbound testosterone levels declined as a function of PP quartiles. Accordingly, the prevalence of overt hypogonadism (calculated free testosterone &lt; 180 pmol/L or free testosterone &lt; 37 pmol/L) increased as a function of PP quartiles (17.% vs. 39.7%, and 30.8% vs. 58.6% for the first vs. fourth quartile, respectively, for calculated free testosterone and free testosterone; all P &lt; 0.0001 for trend). This association was confirmed even after adjustment for confounders (Adjusted [Adj]) r = 0.090 and 0.095 for calculated free testosterone &lt; 180 pmol/L and free testosterone &lt; 37 pmol/L, respectively; all P &lt; 0.05).

Conclusions
PP is an easy method to estimate and quantify patient arterial stiffness. We demonstrated here for the first time that elevated PP is associated with arteriogenic ED and male hypogonadism. The calculation of PP should became more and more familiar in the clinical practice of health care professionals involved in sexual medicine.