bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency and Focus of Sexual History Taking in Male Patients—A Pilot Study Conducted among Swiss General Practitioners and Urologists
Authors: Platano Giacomo , Margraf Jürgen , Alder Judith , Bitzer Johannes 
Published: October 2007

ABSTRACT

Introduction
General practitioners (GPs) and urologists are the first medical contacts for men with sexual dysfunction. Previous studies have shown that many GPs hesitate to address sexual issues and little is known about the sexological skills of urologists.

Aim
To analyze sexual history taking (SHT) by Swiss GPs and urologists, in terms of active exploration, focus, and competence in discussing and treating sexual dysfunction.

Methods
A semi-structured interview was developed and used in face-to-face encounters with 25 GPs and 25 urologists.

Main Outcome Measures
Content and frequency of interview responses.

Results
Urologists reported a significantly higher frequency of actively asking male patients about sexual dysfunction (22.80% vs. 10.42%, P =0.01). GPs and urologists avoided actively asking certain patient groups about sexual dysfunction (e.g., “immigrants,”“macho men”). GPs reported a significantly lower percentage of male patients who spontaneously address sexual problems (6.35% vs. 18.40%, P &lt;0.001). Both physician groups emphasized erectile dysfunction in SHT. Eight percent of GPs and 28% of urologists considered their competence in discussing sexual dysfunction as very good. No GP and 20% of urologists considered their competence in treating sexual dysfunction as very good. Urologists reported having significantly greater competence in discussing (P =0.02) and treating (P &lt;0.001) sexual dysfunction than the GPs. Competence in discussing correlated positively with competence in treating sexual dysfunction for GPs (P =0.01) and urologists (P &lt;0.001). The majority of GPs (92%) and urologists (76%) reported a need for continuing education in sexual issues.

Conclusions
Our results justify establishing guidelines for SHT in Switzerland to better meet the sexual health needs of male patients. Physicians should be encouraged to routinely inquire about sexual issues, overcome their discomfort with the subject, and regard male sexuality as more than erectile function. A clear need exists for relevant continuing education for Swiss GPs and urologists.
Plexiform Neurofibroma of the Penis Associated with Erectile Dysfunction due to Arterial Steeling
Authors: Garaffa Giulio , Bettocchi Carlo , Christopher Nim , Ralph David 
Published: October 2007

ABSTRACT

Introduction
Solitary involvement of the genitourinary tract by Von Recklinghousen disease (VRD) is extremely rare.

Aims
This report documents the management of a case of a plexiform neurofibroma on the penile shaft associated with erectile dysfunction. The literature surrounding VRD and its effects on the genital area was also investigated.

Methods
After a complete preoperative investigation of the nature of the mass and of the erectile dysfunction, the neurofibroma was completely excised with preservation of the neurovascular bundle.

Results
At 6-months postoperative follow-up, there was no sign of tumor recurrence and the glans sensation was maintained. The erectile dysfunction persisted postoperatively and failed to respond to medical treatment.

Conclusions
A complete excision of penile neurofibromas is mandatory to prevent recurrence or malignant degeneration and can be safely performed preserving the neurovascular bundle.
Glucose-6-Phosphate Dehydrogenase Deficiency: An Etiology for Idiopathic Priapism?
Authors: Burnett Arthur L. , Bivalacqua Trinity J. 
Published: October 2007

ABSTRACT

Introduction
Efforts to identify the health risk associations for priapism may reveal pathophysiologic mechanisms for the disorder and suggest a scientifically rational approach for correcting it.

Aim
We describe a clinical presentation of idiopathic recurrent priapism in a patient with glucose-6-phosphate dehydrogenase (G6PD) deficiency and consider a possible nitric oxide (NO)-dependent mechanistic basis from which the medical condition causes priapism.

Methods
The case report profiled a 35-year-old African-American man with G6PD deficiency who presented with a rapid progression of recurrent priapism episodes. He was outwardly healthy and did not have sickle cell disease or trait by hematologic screening. His management featured use of a long-term, continuous phosphodiesterase type 5 (PDE5) inhibitor therapeutic regimen.

Main Outcome Measures
Clinical history data and response to PDE5 inhibitor therapy.

Results
After a 3-month duration of PDE5 inhibitor therapy, priapism recurrences were sufficiently resolved and the patient discontinued therapy. At 18-month clinical follow-up, he experienced only minor priapism recurrences and retention of full erectile ability.

Conclusions
G6PD deficiency offers an explanation for idiopathic priapism. The medical condition generates a pathophysiologic milieu consistent with aberrant NO signaling and heightened oxidative stress in the penis.
Comparison of the Effects of Hormone Therapy Regimens, Oral and Vaginal Estradiol, Estradiol+Drospirenone and Tibolone, on Sexual Function in Healthy Postmenopausal Women
Authors: Çayan Filiz , Dilek Umut , Pata Özlem , Dilek Saffet 
Published: October 2007

ABSTRACT

Introduction
Sexual dysfunction is more prevalent in postmenopausal women.

Aims
To prospectively evaluate and compare the effects of hormone therapy (HT) regimens, oral and vaginal estradiol, estradiol+drospirenone and tibolone, on sexual function in healthy postmenopausal women.

Methods
The study included 169 consecutive healthy postmenopausal women, and the women were divided into two groups: 111 women received HT, and 58 women received no treatment and served as a control group. As an HT, 23 women with surgically induced menopause received oral 17-β estradiol. The rest of the women with natural menopause were prospectively randomized: 22 received oral 17-β estradiol+drospirenone daily, 42 received oral tibolone, and 24 received vaginal 17-β estradiol. Sexual function was evaluated with a detailed 19-item questionnaire, the female sexual function index, including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain.

Main Outcome Measures
The differences in sexual function were compared before and 6 months after the treatment in all women.

Results
Total sexual function score increased from 19.81 ± 7.15 to 22.9 ± 6.44 in the HT group and decreased from 21.6 ± 8.69 to 17.6 ± 5.7 in the control group, revealing a significant difference from baseline to post-treatment between the two groups (P =0.000). The highest improvement in total score and arousal was achieved with the oral 17-β estradiol (P =0.000 and P =0.000, respectively). The highest improvement in lubrication was achieved with the oral and vaginal 17-β estradiol groups (P =0.000). The highest improvement in orgasm was achieved with the tibolone group (P =0.000). The highest improvement in pain was achieved with the oral and vaginal 17-β estradiol groups (P =0.000).

Conclusions
HT provided significant improvement in sexual function compared to women receiving no treatment, and therefore, HT regimens should be suggested for improvement in sexual functioning of postmenopausal women.
A Passion for Castration: Characterizing Men Who Are Fascinated with Castration, but Have Not Been Castrated
Authors: Roberts Lesley F. , Brett Michelle A. , Johnson Thomas W. , Wassersug Richard J. 
Published: October 2007

ABSTRACT

Introduction
A number of men have extreme castration ideations. Many only fantasize about castration; others actualize their fantasies.

Aims
We wish to identify factors that distinguish those who merely fantasize about being castrated from those who are at the greatest risk of genital mutilation.

Methods
Seven hundred thirty-one individuals, who were not castrated, responded to a survey posted on http://www.eunuch.org. We compared the responses of these “wannabes” to those of 92 men who were voluntarily castrated and responded to a companion survey.

Main Outcome Measures
Respondents answered the questionnaire items relating to demographics, origin of interest in castration, and ambition toward eunuchdom.

Results
Two categories of wannabes emerged. A large proportion (∼40%) of wannabes' interest in castration was singularly of a fetishistic nature, and these men appeared to be at a relatively low risk of irreversible genital mutilation. Approximately 20% of the men, however, appeared to be at great risk of genital mutilation. They showed a greater desire to reduce libido, change their genital appearance, transition out of male, and prevent sexually offensive behavior. Nineteen percent of all wannabes have attempted self-castration, yet only 10% have sought medical assistance.

Conclusions
We identify several motivating factors for extreme castration ideations and provide a classification for reasons why some males desire orchiectomies. Castration ideations fall under several categories of the Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. (DSM-IV), most notably a Gender Identity Disorder other than male-to-female (MtF) transsexual (i.e., male-to-eunuch) and a Body Identity Integrity Disorder. Physicians need to be aware of males who have strong desires for emasculation without a traditional MtF transsexual identity.
Acute Effects of Nicotine on Physiological and Subjective Sexual Arousal in Nonsmoking Men: A Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Harte Christopher B. , Meston Cindy M. 
Published: October 2007

ABSTRACT

Introduction
Chronic nicotine treatment has deleterious effects on vascular functioning and catecholamine modulation, which may compromise erectile functioning. Evidence that long-term cigarette smoking is an independent risk factor for introducing impotence is robust. However, limited studies have focused on the acute effects of smoking on physiological sexual response, and none have investigated the deleterious effects of isolated nicotine on human sexual arousal. Consequently, pathophysiological underpinnings of tobacco-induced—and particularly, nicotine-induced—erectile dysfunction are not well understood.

Aim
To provide the first empirical examination of the acute effects of isolated nicotine on sexual arousal in nonsmoking men.

Methods
Twenty-eight sexually functional heterosexual men (mean age 21 years), each with less than 100 direct exposures to nicotine, participated in a double-blind, randomized, placebo-controlled, crossover trial. Participants received either Nicorette polacrilex gum (SmithKline Beecham Consumer Healthcare, Pittsburgh, PA, USA) (6 mg; approximately equivalent to smoking one high-yield cigarette) or placebo gum, matched for appearance, taste, and consistency, approximately 40 minutes prior to viewing an erotic film.

Main Outcome Measures
Physiological (circumferential change via penile plethysmography) and subjective (continuous self-report) sexual responses to erotic stimuli were examined, as well as changes in mood.

Results
Nicotine significantly reduced erectile responses to the erotic films (P =0.02), corresponding to a 23% reduction in physiological sexual arousal. This occurred in 16 of 20 men with valid physiological recordings. Nicotine had no significant effect on continuous subjective ratings of sexual arousal (P =0.70) or on mood (all Ps &gt; 0.05).

Conclusions
Isolated nicotine can significantly attenuate physiological sexual arousal in healthy nonsmoking men. These findings have implications for elucidating physiological mechanisms responsible for the effects of nicotine on sexual dysfunction, and for assisting public health policy in considering the deleterious effects of nicotine on sexual health.
Urologist Practice Patterns in the Management of Premature Ejaculation: A Nationwide Survey
Authors: Shindel Alan , Nelson Christian , Brandes Steven 
Published: October 2007

ABSTRACT

Introduction
Contemporary U.S. urologist's “real world” practice patterns in treating premature ejaculation (PE) are unknown.

Aim
To ascertain contemporary urologist practice patterns in the management of PE.

Method
A randomly generated mailing list of 1,009 practicing urologists was generated from the American Urologic Association (AUA) member directory. A custom-designed survey was mailed to these urologists with a cover letter and a return-address envelope. Responses were compared with the AUA 2004 guidelines for the treatment of PE.

Main Outcome Measures
The survey assessed several practice-related factors and asked questions of how the subject would handle various presentations of PE in their practice.

Results
Responses from practicing urologists totaled 207 (21%). Eighty-four percent of the respondents were in private practice and 11% were in academics. Most urologists (73%) saw less than one PE patient per week. On-demand selective serotonin reuptake inhibitor (SSRI) therapy was the most commonly selected first line treatment (26%), with daily dosing a close second (22%). Combination SSRI therapy, the “stop/start” technique, the “squeeze” technique, and topical anesthetics were favored by 13, 18, 18, and 11% of the respondents, respectively. If primary treatment failed, changing dosing of SSRIs, topical anesthetics, and referral to psychiatry were increasingly popular options. Ten percent of urologists would treat PE before erectile dysfunction (ED) in a patient with both conditions, with the remainder of the respondents treating ED first, typically with a phosphodiesterase type 5 inhibitor (78% of total). Fifty-one percent of urologists report that they would inquire about the sexual partner, but only 8, 7, and 4% would evaluate, refer, or treat the partner, respectively.

Conclusions
The majority of our respondents diagnose PE by patient complaint, and treat ED before PE, as per the 2004 PE guidelines. Very few urologists offer referral or treatment to sexual partners of men suffering from PE. Additional randomized studies in the treatment of PE are needed.
Lack of Interspecific Plant Competition With a Dominant Grass in the Understory of a Lowland Forest in Colombia
Authors: Stevenson Pablo R. 
Published: October 2007

ABSTRACTI analyzed a natural experiment of competition involving a dominant herb in Tinigua Park, Colombia. Pharus virescens is a dominant monocarpic grass that synchronously produces seeds once every 5 yr, after which all individuals die. I found no difference in species richness, density, or diversity comparing plots with and without the grass in 381 quadrats (4 m2) and there was no negative relationship between the abundance of the grass and that of other plants.
Diet and Dietary Preferences of the Southern Cassowary (Casuarius casuarius) in North Queensland, Australia
Authors: Bradford Matt G. , Dennis Andrew J. , Westcott David A. 
Published: October 2007

ABSTRACTWe investigated the diet of the southern cassowary (Casuarius casuarius) by identifying the seeds and fruits in fecal droppings encountered on a set of transects over 2 yr in upland rain forest in the wet tropics of North Queensland. A total of 198 droppings containing 56 plant species were found. We surveyed fleshy fruit availability over the subsequent 68 mo on transects in the same area to ascertain fruiting patterns in the study area. The number of droppings found each month did not correspond to the pattern of available fruit biomass. There was no relationship between the fruit traits of moisture content, flesh to seed mass ratio, color, or crop size to contribution of a species to the diet. During the lean fruiting season (May–July) cassowaries relied more on species that fruited continuously throughout the year as they were significantly over‐represented in droppings, while annual fruiting species were under‐represented. During months of high fruit availability (October–December), continuously fruiting species were still over‐represented in the diet but became less important while annual and biennial species became more important. Significantly more species with large fruit and large seeds appeared in the diet than expected and we confirm that the cassowary contributes to the continued dispersal of these species over long distances and in large quantities.
Photosynthesis and Leaf Structure in Domesticated Cassava (Euphorbiaceae) and a Close Wild Relative: Have Leaf Photosynthetic Parameters Evolved Under Domestication?
Authors: Pujol Benoît , Salager Jean‐Louis , Beltran Michèle , Bousquet Sandie , McKey Doyle 
Published: October 2007

ABSTRACTBroad patterns across wild plant species show that leaf composition and morphology vary predictably among habitats, richer habitats favoring resource‐acquisition strategies and poorer habitats favoring resource‐conservation strategies. Domestication is often accompanied by a shift to richer habitats, and might thus be expected to lead to a shift in leaf composition and morphology and hence in photosynthetic parameters. We compared leaf photosynthetic parameters in domesticated cassava (Manihot esculenta) and a close wild relative, using greenhouse‐grown plants. In domesticated cassava, CO2 exchange rate expressed per unit mass and specific leaf area (SLA, m2/kg dry mass) were greater than in the wild relative, whereas leaf dry matter content (LDMC, dry mass/fresh mass) was lower in the domesticate. These results suggest that SLA and net photosynthetic rates may both have increased in the evolution of cassava under domestication, enabling more rapid growth in relatively resource‐rich and protected agricultural habitats. Previous comparisons of photosynthetic rates in domesticated plants and wild relatives have usually considered only leaf area‐based measures. Here, we discuss the interest of using mass‐based rates to study the evolution of ecological strategies under domestication.
Risk and Crisis Management in the Reformed European Agricultural Policy
Authors: Cafiero Carlo , Capitanio Fabian , Cioffi Antonio , Coppola Adele 
Published: October 2007

Currently there is ample discussion among EU Institutions (European Commission, European Parliament, and Member States' governments) on the opportunity for setting up a comprehensive EU‐wide framework on risk and crises in agriculture. In the meantime, within the limits of the WTO rules on agriculture, national governments are allowed to intervene through direct compensation to farmers in case of exceptional events that cause damages to farming operations and through subsidies to crop insurance programs. Such schemes are quite expensive for domestic budgets and some Member States are trying to switch some of their cost to the Community's budget, although an expansion of financial resources devoted to agriculture in Europe is rather unlikely. Moving from the recently emanated proposal of the European Commission, this paper discusses the main issues related to public intervention for risk and crises management in agriculture. Actuellement, les institutions européennes (Commission européenne, Parlement européen et gouvernements des pays membres) discutent intensément de l'opportunité d'élaborer un cadre général pour l'ensemble de l'Union européenne sur les crises et les risques dans le secteur agricole. Entre‐temps, selon les règles de l'OMC sur l'agriculture, les gouvernements nationaux peuvent intervenir en accordant des compensations financières directes aux agriculteurs en cas de circonstances exceptionnelles causant des dommages aux exploitations agricoles ainsi que des subventions aux programmes d'assurance récolte. Ces interventions amputent considérablement les budgets nationaux, et certains pays membres tentent de transférer une partie de leurs coûts au budget de l'Union européenne, bien qu'il soit peu probable que les ressources financières consacrées à l'agriculture en Europe augmentent. A la lumière de la récente proposition de la Commission européenne, le présent article traite des principaux thèmes liés à l'intervention publique dans la gestion des risques et des crises dans le secteur agricole.
Does a Crisis Matter? Forest Policy Responses to the Mountain Pine Beetle Epidemic in British Columbia
Authors: Nelson Harry 
Published: October 2007

“[a]n epidemic of catastrophic proportions”⋖Larry Pedersen, Chief Forester in 2003, in describing the impact of the outbreak.What factors are responsible for the introduction of new policies (especially those involving substantive change) is a phenomenon that is still poorly understood. Researchers have identified policy windows where a confluence of events, such as a change in government, the emergence of a new issue, and ongoing policy processes, come together to create the opportunity for new policy development. Natural disasters can open such policy windows by drawing attention to an issue and mobilizing political will. Yet at the same time, even if policy windows do open, they may not result in effective policy development. The institutional setting in which such policies are developed also plays a key role. In the case of the Canadian forest sector, the combination of public resources and private capital make policy development especially challenging. Although the scale of the Mountain Pine Beetle epidemic in British Columbia is unprecedented, and will change the nature of the forest resource (and by extension the industry and communities that rely upon it), the policy response has been limited to short‐term measures. Although some policy reform was introduced, policy makers have yet to address the question of whether more fundamental changes are required in order to address the full consequences of the epidemic.La détermination des facteurs responsables de l’introduction de nouvelles politiques (particulièrement celles qui comportent des changements substantiels) demeurent un phénomène mal compris. Des chercheurs ont déterminé des fenêtres d’opportunité politique où divers événements, tels qu’un changement de gouvernement, l’émergence d’une nouvelle préoccupation et des processus politiques continus, convergent pour créer l’occasion d’élaborer de nouvelles politiques. Les catastrophes naturelles peuvent créer ces fenêtres d’opportunité politique en attirant l’attention sur une préoccupation et en mobilisant la volonté politique. Pourtant, même si des fenêtres d’opportunité politique s’ouvrent, elles peuvent ne pas se solder par l’élaboration de politiques efficaces. Le cadre institutionnel dans lequel ces politiques sont élaborées joue aussi un rôle important. Dans le cas du secteur forestier canadien, la combinaison de ressources publiques et de capitaux privés rend l’élaboration de politiques particulièrement délicate. Bien que l’étendue de l’épidémie de dendroctone du pin ponderosa en Colombie‐Britannique soit sans précédent et modifiera la nature de la ressource forestière (et par extension, l’industrie et les collectivités qui en dépendent), la réaction politique s’est limitée à des mesures à court terme. Malgré une certaine réforme des politiques, les décideurs doivent s’interroger sur la nécessité d’apporter ou non des changements fondamentaux supplémentaires pour surmonter les conséquences de l’épidémie.