Efficiency of antibiotic treatment of premature ejaculation in patients with type III prostatic inflammation

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Teoman Cem Kadioglu

2011-03-01

Full Text Available The most common male sexual disorder is premature ejaculation as it affects 30-40% of sexually active men. Various studies showed that the correlation of prostatic inflammation and chronic bacterial prostatitis with premature ejaculation is present in more than half of the sufferers. These studies also show that more than 85% of prostatic inflammation cases was shown to be caused by chronic prostatitis in the premature ejaculation patient group. Even though this relation is evident, the effect of antibiotic treatment of premature ejaculation in patients with chronic prostatitis has only recently being investigated extensively. In this study, 36 men suffering from secondary premature ejaculation who were included the study. These patients had no erectile dysfunction problems and were included in the study after they timed intravaginal ejaculatory latency in their last 3 intercourses to see that time was less than 2 minutes in each trial. To evaluate the prostatic inflammation, diagnosis was made by identifying 10 or more white blood cells per high power field in expressed prostatic secretions. 22 of 36 premature ejaculation patients in our study had more than 10 white blood cells in thier expressed prostatic secretions and were diagnosed to have prostatic inflammation. The other 14 patients were included in the study as the control group. Following one month antibiotic treatment 78% patients in the study group returned with the information that all 3 of their last intercourses ended with more than 2 minutes of intravaginal ejaculatory latency time while none of the control group reported similarly. No side effects were reported by any of the patients due to antibiotic usage. Our study shows that patients with PE that may benefit from month-long quinolone antibiotic therapy can be screened for by checking their expressed prostatic secretions under a microscope in the office. A more accurate definition of premature ejaculation, a scale for

Premature ejaculation and serotonergic antidepressants-induced delayed ejaculation : the involvement of the serotonergic system

NARCIS (Netherlands)

Waldinger, MD; Berendsen, HHG; Blok, BFM; Olivier, B; Holstege, G

Premature ejaculation has generally been considered a psychosexual disorder with psychogenic aetiology. Although still mainly treated by behavioural therapy, in recent years double-blind studies have indicated the beneficial effects of some of the serotonergic antidepressants (SSRIs) in delaying

Current pharmacological agents for the treatment of premature ejaculation

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Onur Dede

2014-06-01

Full Text Available This study was aimed to review and assess the update studies regarding medical treatment for premature ejaculation (PE. It is the most common sexual problem affecting men. It can affect men at all ages and has a serious impact on the quality of life for men and their partners. A wide variety of therapeutic modalities have been tried for treatment of premature ejaculation. Psychological therapies may be helpful for patients with complaint PE. Several topical therapies have been used including lidocaine cream, lidocaine-prilocaine cream. There has been recent interest in the selective serotonin reuptake inhibitors (SSRI for the treatment of PE, due to the fact that one of their common side effects is delayed ejaculation. Currently used SSRIs have several non-sexual side effects and long half lives, therefore there has been interest in developing a short acting, and efficacious SSRI that can be used on-demand for PE. Dapoxetine has been recently evaluated for the treatment of PE by several groups, and results so far appear promising.

An evidence-based unified definition of lifelong and acquired premature ejaculation

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Serefoglu, Ege Can; McMahon, Chris G; Waldinger, Marcel D

2014-01-01

INTRODUCTION: The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data...... appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have...... as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less...

On-Demand Treatment of Premature Ejaculation with Citalopram: A Randomized Double-Blind Study

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Ghafuri Zahra

2009-10-01

Full Text Available "nAs the most common male sexual disorder premature ejaculation (PE, also referred to as early ejaculation (EE or rapid ejaculation (RE, affects 30%-40% of sexually active men. Despite the limited number of available studies comparing the efficacy of selective serotonin re-uptake inhibitors (SSRI they have been thought to have beneficial effects for the treatment of patients with PE. In the present study, we assessed the efficacy of on-demand use of citalopram, in the treatment of premature ejaculation. A randomized double blind study of fixed dose on-demand use of citalopram was performed in Roozbeh Psychiatry Hospital, Tehran University of Medical Sciences. The sample was consisted of 80 married patients diagnosed with PE according to Diagnostic and Statistical Manual of Mental Disorders. The patients were randomly assigned to two groups: group 1 consisting of 42 patients received 20mg citalopram, and group 2 consisting of 38 patients received placebo four hours before intercourse for a 4-week treatment course. The effects of drug on the ejaculatory function in each group were assessed by the intravaginal ejaculation latency time (IELT, and the Chinese Index of Premature Ejaculation (CIPE before and at the end of treatment course. The mean IELT increased from 66.78±36.94 to 80.85±43.05 seconds in group 1 and from 63.44±33.16 to 65.71±34.26 seconds in group 2 (P = 0.000. Mean CIPE score increased 1.14±1.04 and 0.52±0.50 in group 1 and 2 respectively (P = 0.002. The patients treated with on demand citalopram showed significantly greater improvement in IELT and CIPE score compared to the patients receiving placebo. It seems that citalopram may be an effective treatment of premature ejaculation with on-demand usage. However further studies are warranted.

Recent advances in the treatment of premature ejaculation

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Kate D Linton

2010-01-01

Full Text Available Kate D Linton, Kevan R WylieSheffield Teaching Hospitals, Sheffield, UKAbstract: Premature ejaculation (PE is the most common sexual problem affecting men. It can affect men at all ages and has a serious impact on the quality of life for men and their partners. Currently there are no pharmaceutical agents approved for use in the UK, and so all drugs used for this condition are off label. Behavioral therapy has been used to treat PE, but the results are not durable once therapy has been concluded. Several topical therapies have been used including severance-secret (SS cream, lignocaine spray, lidocaine-prilocaine cream and lidocaine-prilocaine spray (TEMPE. There has been recent interest in the selective serotonin reuptake inhibitors (SSRIs for the treatment of PE, due to the fact that one of their common side effects is delayed ejaculation. Currently used SSRIs have several non-sexual side effects and long half lives, therefore there has been interest in developing a short acting, efficacious SSRI that can be used on-demand for PE. Dapoxetine has been recently evaluated for the treatment of PE by several groups, and results so far appear promising.Keywords: premature ejaculation, topical therapies, selective serotonin re-uptake inhibitor, dapoxetine

The 5-HT₁A receptor CG polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation

NARCIS (Netherlands)

Janssen, Paddy K C; van Schaik, R; Zwinderman, Aeilko H; Olivier, Berend|info:eu-repo/dai/nl/073067199; Waldinger, Marcel D|info:eu-repo/dai/nl/163958564

INTRODUCTION: Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 min, and has been postulated as a neurobiological dysfunction related to diminished serotonergic neurotransmission with 5-HT₁A receptor hyperfunction and

Premature ejaculation

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Chris G McMahon

2007-01-01

Full Text Available Premature ejaculation (PE is a common male sexual disorder. Recent normative data suggests that men with an intravaginal ejaculatory latency time (IELT of less than 1 minute have "definite" PE, while men with IELTs between 1 and 1.5 minutes have "probable" PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (5-hydroxytryptamine, serotonin receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors is well tolerated and offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains. Investigational drugs such as the ejaculo-selective serotonin transport inhibitor, dapoxetine represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control and sexual satisfaction with minimal adverse effects.

Premature ejaculation.

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McMahon, Chris G

2007-04-01

Premature ejaculation (PE) is a common male sexual disorder. Recent normative data suggests that men with an intravaginal ejaculatory latency time (IELT) of less than 1 minute have "definite" PE, while men with IELTs between 1 and 1.5 minutes have "probable" PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (5-hydroxytryptamine, serotonin) receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors is well tolerated and offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains. Investigational drugs such as the ejaculo-selective serotonin transport inhibitor, dapoxetine represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control and sexual satisfaction with minimal adverse effects.

Thyroid-stimulating hormone assessments in a Dutch cohort of 620 men with lifelong premature ejaculation without erectile dysfunction

NARCIS (Netherlands)

Waldinger, Marcel D.; Zwinderman, Aeilko H.; Olivier, Berend; Schweitzer, Dave H.

2005-01-01

Introduction. Apart from the involvement of central serotonergic neurotransmission on lifelong premature ejaculation, interference of thyroid function has been speculated. Aim. To study thyroid function in a large group of men with lifelong premature ejaculation (LPE). Methods. Lifelong premature

The 5-HT₁A receptor CG polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation

NARCIS (Netherlands)

Janssen, Paddy K. C.; van Schaik, R.; Zwinderman, Aeilko H.; Olivier, Berend; Waldinger, Marcel D.

2014-01-01

Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 min, and has been postulated as a neurobiological dysfunction related to diminished serotonergic neurotransmission with 5-HT₁A receptor hyperfunction and 5-HT₂C

An Evidence-Based Unified Definition of Lifelong and Acquired Premature Ejaculation: Report of the Second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation

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Serefoglu, Ege Can; McMahon, Chris G; Waldinger, Marcel D; Althof, Stanley E; Shindel, Alan; Adaikan, Ganesh; Becher, Edgardo F; Dean, John; Giuliano, Francois; Hellstrom, Wayne JG; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

2014-01-01

Introduction The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE. Aim The aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE. Methods In April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted. Results The committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the

An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation.

Science.gov (United States)

Serefoglu, Ege Can; McMahon, Chris G; Waldinger, Marcel D; Althof, Stanley E; Shindel, Alan; Adaikan, Ganesh; Becher, Edgardo F; Dean, John; Giuliano, Francois; Hellstrom, Wayne Jg; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

2014-06-01

The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE. The aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE. In April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted. The committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. The

Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach.

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Pastore, Antonio L; Palleschi, Giovanni; Fuschi, Andrea; Maggioni, Cristina; Rago, Rocco; Zucchi, Alessandro; Costantini, Elisabetta; Carbone, Antonio

2014-06-01

Premature ejaculation is the most common male sexual disorder. The aim of the study was to evaluate the possible therapeutic role of pelvic floor muscle rehabilitation in patients affected by lifelong premature ejaculation. We treated 40 men with lifelong premature ejaculation, reporting, a baseline intravaginal ejaculatory latency time (IELT) ≤ 1 min, with 12-week pelvic floor muscle rehabilitation. At the end of the rehabilitation, mean IELTs were calculated to evaluate the effectiveness of the therapy. At the end of the treatment, 33 (82.5%) of the 40 patients gained control of their ejaculatory reflex, with a mean IELT of 146.2 s (range: 123.6-152.4 s). A total of 13 out of 33 (39%) patients were evaluated at 6 months follow up, and they maintained a significant IELT (112.6 s) compared with their initial IELT (mean 39.8 s). The results obtained in our subjects treated with pelvic floor rehabilitation are promising. This therapy represents an important cost reduction compared with the standard treatment (selective serotonin reuptake inhibitors). Based on the present data, we propose pelvic floor muscle rehabilitation as a new, viable therapeutic option for the treatment of premature ejaculation.

Serotonin Transporter Promoter Region (5-HTTLPR) Polymorphism is Associated with the Intravaginal Ejaculation Latency Time in Dutch Men with Lifelong Premature Ejaculation

NARCIS (Netherlands)

Janssen, Paddy K. C.; Bakker, Steven C.; Réthelyi, Janos; Zwinderman, Aeilko H.; Touw, Daan J.; Olivier, Berend; Waldinger, Marcel D.

2009-01-01

Introduction. Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 minute, and has been postulated as a neurobiological dysfunction with genetic vulnerability for the short IELTs, related to disturbances of central

Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation

NARCIS (Netherlands)

Janssen, Paddy K C; Bakker, Steven C; Réthelyi, Janos; Zwinderman, Aeilko H; Touw, Daan J; Olivier, Berend; Waldinger, Marcel D

INTRODUCTION: Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 minute, and has been postulated as a neurobiological dysfunction with genetic vulnerability for the short IELTs, related to disturbances of central

Premature ejaculation. 3. Therapy.

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Piediferro, Guido; Colpi, Elisabetta M; Castiglioni, Fabrizio; Scroppo, Fabrizio I

2004-12-01

Serotonergic drugs (SSRIs) are the most commonly used, but they are characterized by relapse some time after medication interruption as well as by sexual side effects. The efficacy of phosphodiesterase-5 inhibitors seems excellent, but the risk of tachyphylaxis has been reported. The former (fluoxetine, paroxetine, sertraline, clomipramine) should be used in young patients with hyper-orgasmic forms, while the latter (sildenafil, tadalafil, vardenafil) should be used in hypo-orgasmic forms, in old age or when PE is associated with erectile dysfunction. Topical anesthetics provide satisfactory results in premature ejaculation due to hypersensitivity of the glans, and physiotherapy of the pelvic floor muscles proves successful in cases associated with pelvic floor dysfunction. Therapeutic associations and psycho-sexual therapy techniques may improve results, particularly in the long term.

Removal of foreskin remnants in circumcised adults for treatment of premature ejaculation

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Mohammad Reza Namavar

2011-01-01

Full Text Available Background and Aim : Premature ejaculation (PE is the most prevalent sexual dysfunction in every country. There are many types of treatment, but the main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medicine. The prepuce is a specific erogenous zone that contains a rich and complex network of nerves. Circumcision radically desensitizes the penis, but incomplete circumcision may cause premature ejaculation. We evaluate the effect of removal of foreskin remnants in adults on PE. Materials and Methods : The sensitive area of penile skin and the remaining parts of foreskin in adult men were recognized in 47 selective patients. Under local anesthesia, the remnant parts of foreskin were incised and removed. They were asked to fill the investigating questionnaire about the changes of intravaginal latency ejaculatory time (IVELT, patients and their sexual partners′ satisfaction with sexual life, control over ejaculation, and penile sensitivity, before and after treatment. Results : There were no signs of inflammation and no serious adverse reactions in all cases after operation. IVELT significantly increased from 64.25 before surgery to 731.49 sec after surgery (P<0.001. The percentage of postoperative satisfaction in both the patient and his partner significantly increased (P<0.001. After surgery, 95.7% of men had better control over their ejaculation. This surgery significantly decreased sensitivity of penis (P<0.001, but it did not change glans penis insensitivity. Conclusions : These results indicate that removal of foreskin remnants in adults is an effective modality in selective patients of PE.

Serotonin Transporter Promoter Region (5-HTTLPR) Polymorphism Is Not Associated With Paroxetine-Induced Ejaculation Delay in Dutch Men With Lifelong Premature Ejaculation

NARCIS (Netherlands)

Janssen, Paddy K C; Zwinderman, Aeilko H; Olivier, Berend; Waldinger, Marcel D

PURPOSE: To investigate the association between the 5-HT-transporter-gene-linked promoter region (5-HTTLPR) polymorphism and 20-mg paroxetine-induced ejaculation delay in men with lifelong premature ejaculation (LPE). MATERIALS AND METHODS: This was a prospective study of 10 weeks of paroxetine

Premature ejaculation: challenging new and the old concepts [version 1; referees: 2 approved

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Odunayo Kalejaiye

2017-12-01

Full Text Available Premature ejaculation remains a difficult condition to manage for patients, their partners, and the clinician. Whilst prevalence rates are estimated to be 20–40%, determining a diagnosis of premature ejaculation is difficult, as the definition remains both subjective and ill-defined in the clinical context. As our understanding of the ejaculatory pathway has improved, new opportunities to treat the condition have evolved with mixed results. In this review, we explore some of these controversies surrounding the aetiology, diagnosis, and treatment of this condition and discuss potential novel therapeutic options.

Serotonin Transporter Promoter Region (5-HTTLPR) Polymorphism Is Not Associated With Paroxetine-Induced Ejaculation Delay in Dutch Men With Lifelong Premature Ejaculation

NARCIS (Netherlands)

Janssen, Paddy K. C.; Zwinderman, Aeilko H.; Olivier, Berend; Waldinger, Marcel D.

2014-01-01

To investigate the association between the 5-HT-transporter-gene-linked promoter region (5-HTTLPR) polymorphism and 20-mg paroxetine-induced ejaculation delay in men with lifelong premature ejaculation (LPE). This was a prospective study of 10 weeks of paroxetine treatment in 54 men with LPE.

Emerging treatments for premature ejaculation: focus on dapoxetine

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Wayne JG Hellstrom

2008-12-01

Full Text Available Wayne JG HellstromChief, Section of Andrology, Department of Urology, Tulane University School of Medicine, New Orleans, LA, USAAbstract: Premature ejaculation (PE is a common problem in men worldwide. It has a significant impact on affected men and their partners in terms of self-esteem, dissatisfaction with their sexual relationships, personal distress, and interpersonal difficulty. Psychological therapies may achieve short-term improvements, but there are limited data on the long-term success of these methods. Oral therapy with long-acting selective serotonin reuptake inhibitors (SSRIs improves intravaginal ejaculatory latency time (IELT, but these agents are designed to be administered daily and may be associated with unwanted sexual side effects and withdrawal symptoms upon abrupt discontinuation. Dapoxetine is a short-acting SSRI that can be taken as needed (prn by men with PE. It has been studied in five separate multicenter, randomized, double-blind, placebo-controlled trials involving more than 6000 men with PE. In four studies that evaluated IELT as an endpoint (N = 4843, dapoxetine 30 and 60 mg prn achieved statistically significant increases in IELT versus placebo. Dapoxetine also showed statistically significant improvements in perceived control over ejaculation, PE-related personal distress, and other patient-reported outcomes in all five trials. Dapoxetine treatment is generally well-tolerated, with low incidences of discontinuation syndrome, sexual dysfunction, and treatment-emergent mood symptoms. The most common adverse events with dapoxetine included nausea, diarrhea, headache, dizziness, and somnolence.Keywords: dapoxetine, discontinuation syndrome, premature ejaculation, selective serotonin reuptake inhibitor

An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation

NARCIS (Netherlands)

McMahon, Chris G.; Althof, Stanley; Waldinger, Marcel D.; Porst, Hartmut; Dean, John; Sharlip, Ira; Adaikan, P. G.; Becher, Edgardo; Broderick, Gregory A.; Buvat, Jacques; Dabees, Khalid; Giraldi, Annamaria; Giuliano, François; Hellstrom, Wayne J. G.; Incrocci, Luca; Laan, Ellen; Meuleman, Eric; Perelman, Michael A.; Rosen, Raymond; Rowland, David; Segraves, Robert

2008-01-01

To develop a contemporary, evidence-based definition of premature ejaculation (PE). There are several definitions of PE; the most commonly quoted, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders - 4th Edition - Text Revision, and other definitions of PE,

Erectile dysfunction and premature ejaculation: interrelationships and psychosexual factors.

Science.gov (United States)

Brody, Stuart; Weiss, Petr

2015-02-01

Both erectile dysfunction (ED) and premature ejaculation (PE) impair the quality of sexual intercourse for both men and their female partners. This study aims to examine with a large representative sample the interrelationships of measures of ED, PE, typical intravaginal ejaculatory latency time (IELT), men's perceived relationship quality with their mother, and age of first being in love. In this cross-sectional study, a nationally representative sample of 960 Czech coitally experienced men (aged 15-84), provided age, International Index of Erectile Function 5-item (IIEF-5), Index of Premature Ejaculation (IPE) scores, IELT, rating of relationship with their mother, and age at first being in love. Correlations, partial correlations adjusting for age, analysis of covariance (ANCOVA), and multiple regression statistical methods were used. IIEF-5, IPE, and IELT were significantly intercorrelated (IIEF-5 and IPE: r=0.64). Better IIEF-5 scores were associated with younger age at first (and ever) being in love. Poorer IPE score, shorter IELT, and mild-moderate ED were associated with poorer perceived mother relationship (which was also associated with first being in love at an older age). Multiple regression analyses revealed that: (i) greater IELT was associated with better erectile function and better mother relationship, but not with age; and (ii) IELT of mother relationship and poorer IIEF-5, but marginally with age. History of homosexual activity was unrelated to IIEF-5, IPE, IELT, and perceived mother relationship scores. The findings suggest that degrees of ED and PE are often comorbid, and both ED and PE are associated with less favorable early experiences with women. Brody S and Weiss P. Erectile dysfunction and premature ejaculation: Interrelationships and psychosexual factors. J Sex Med 2015;12:398-404. © 2014 International Society for Sexual Medicine.

An Evidence-Based Unified Definition of Lifelong and Acquired Premature Ejaculation: Report of the Second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation

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Ege Can Serefoglu, MD

2014-06-01

Conclusion: The ISSM unified definition of lifelong and acquired PE represents the first evidence-based definition for these conditions. This definition will enable researchers to design methodologically rigorous studies to improve our understanding of acquired PE. Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, Becher EF, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An evidence-based unified definition of lifelong and acquired premature ejaculation: Report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. Sex Med 2014;2:41–59.

An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) ad hoc committee for the definition of premature ejaculation

NARCIS (Netherlands)

McMahon, Chris G.; Althof, Stanley E.; Waldinger, Marcel D.; Porst, Hartmut; Dean, John; Sharlip, Ira D.; Adaikan, P. G.; Becher, Edgardo; Broderick, Gregory A.; Buvat, Jacques; Dabees, Khalid; Giraldi, Annamaria; Giuliano, François; Hellstrom, Wayne J. G.; Incrocci, Luca; Laan, Ellen; Meuleman, Eric; Perelman, Michael A.; Rosen, Raymond C.; Rowland, David L.; Segraves, Robert

2008-01-01

The medical literature contains several definitions of premature ejaculation (PE). The most commonly quoted definition, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision, and other definitions of PE are all authority based

An evidence-based definition of lifelong premature ejaculation: Report of the International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation

DEFF Research Database (Denmark)

McMahon, C.G.; Althof, S.E.; Waldinger, M.D.

2008-01-01

Introduction. The medical literature contains several definitions of premature ejaculation (PE). The most commonly quoted definition, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision, and other definitions of PE are all auth...

Acquired premature ejaculation and male accessory gland infection: relevance of ultrasound examination

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Sandro La Vignera

2016-01-01

Full Text Available We have previously demonstrated a high frequency of premature ejaculation (PE among patients with male accessory gland infection (MAGI. The aim of this study was to evaluate the ultrasound (US features of patients with MAGI and acquired premature ejaculation (APE associated (MAGI-APEpos. US evaluation of 50 MAGI-APEpos patients compared to 50 patients with MAGI without PE (MAGI-PEneg which represent the control group. The diagnosis of APE was made through the evaluation of Intravaginal ejaculation latency time (IELT and confirmed with the questionnaire PEDT (Premature Ejaculation Diagnostic Tool. The main outcome measure was represented by the frequency of US criteria suggestive of P (prostatitis, V (vesiculitis, and E (epididymitis in MAGI-APEpos and MAGI-PEneg patients. MAGI-APEpos patients showed a total number of US criteria significantly higher compared to MAGI-PEneg patients. MAGI-APEpos showed a higher frequency of US criteria of V and E (complicated forms of MAGI. Finally, in MAGI-APEpos group, it was found a positive relationship between the anteroposterior diameter (APD of the caudal tract of the epididymis and the APD of the seminal vesicles, as well as between both diameters and the PEDT score. MAGI-APEpos patients have a peculiar US characterization compared to MAGI-PEneg patients. According to these results, US evaluation of the epididymal and of the prostato vesicular tract should be considered in the practical clinical approach of patients with MAGI and APE. In particular, it could be a support for a possible pathophysiological interpretation of this clinical problem in these patients.

Premature Ejaculation, Selective Serotonin Reuptake Inhibitor (ssri) Induced Delayed Ejaculation In The Framework Of The Emotional Motor System

NARCIS (Netherlands)

Waldinger, Marcel D; Berendsen, Hemmie H.G.; Blok, Bertil F.M.; Olivier, Berend; Holstege, Gert

1998-01-01

Premature ejaculation has generally been considered a psychosexual disorder with psychogenic aetiology. Although still mainly treated by behavioural therapy, in recent years double-blind studies have indicated the beneficial effects of some of the serotonergic anti depressants (SSRIs) in delaying

Premature ejaculation and its associated factors among men attending a primary healthcare clinic in Kelantan, Malaysia

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Mohd Roslan Ahmad Zamree, MMed.

2018-04-01

�لاحتمالات المعدلة (٩٥٪ فاصل ثقة: ٦.٠ (١.١٥، ٣١.٢٣] كانت مرتبطة ارتباطا ذا قيمة مع سرعة القذف.الاستنتاجات: سيتسبب تعزيز الوعي بسرعة القذف في المجتمع وبين مقدمي الرعاية الصحية، في زيادة معدل الكشف عن هذا الاضطراب. كما ستساعد هذه البيانات أيضا على تقديم خدمات صحية جنسية أفضل. ويوصى بإجراء البحوث على الأمراض المصاحبة لدى الرجال الذين يعانون من سرعة القذف بسبب تأثيرها السلبي على الصحة النفسية والاجتماعية وجودة الحياة. Abstract: Objectives: This study aimed to determine the prevalence of premature ejaculation and its associated factors among men attending a primary healthcare clinic in Kota Bharu, Kelantan, Malaysia. Methods: A cross-sectional study was conducted on 18- to 60-year-old sexually active men during at least the past 6 months. Patients with unstable psychiatric illnesses, mental retardation, and illiteracy were excluded. A questionnaire on sociodemographic factors, Malay version Premature Ejaculation Diagnostic Tool, and Malay version International Index Erectile Function-5 were distributed. Premature ejaculation was defined as a Premature Ejaculation Diagnostic Tool score of 9 and above. Descriptive analysis and simple and multiple logistic regression analyses were performed using SPSS version 22. Results: A total of 294 of 313 eligible men responded, with a response rate of 93.9%. The prevalence of premature ejaculation was 21.4% (n = 63. The multiple logistic regression analysis showed that mild [adj. OR (95% CI: 5.6 (1.89, 16.91; P = 0.002], mild-moderate [adj. OR (95% CI: 8.2 (2.72, 24.46; P < 0.001], and moderate-severe [adj. OR (95% CI: 6.0 (1.15, 31.23; P = 0.03] erectile dysfunctions were significantly associated with premature

The role of diallyl thiosulfinate associated with nuciferine and diosgenin in the treatment of premature ejaculation: A pilot study

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Tommaso Cai

2018-03-01

Full Text Available Objective: To assess the efficacy and safety of an association of diallyl thiosulfinate with nuciferine and diosgenin in the treatment of a group of patients suffering from premature ejaculation (PE, primary or secondary to erectile dysfunction (ED. Materials and methods: From July 2015 to October 2016, 143 patients (mean age 25.3; range 18-39 affected by PE completed the study and were finally analyzed in this phase I study. All patients, after clinical assessment and laboratory evaluation were asked to take an association of diallyl thiosulfinate with nuciferine and diosgenin as oral tablet, once a day, on alternate days, for three months. At the baseline and after three months of treatment, each patient was asked to complete the following questionnaires: International Index of Erectile Function (IIEF-5, Premature Ejaculation Diagnostic Tool (PEDT, Male Sexual Health Questionnaire (MSHQ. Results: A statistical significant improvement in terms of erectile function, comparing the IIEF-5 value at baseline and follow- up visit was found (respectively IIEF-5: 8.7 vs 14.01; p < 0.001. Moreover, at follow-up visit, 97/143 men (67.8% referred a subjective improvement of the erection quality and a better control of the ejaculation (PROs. The IELT improved too between the baseline evaluation and the follow-up visit (p < 0.001. Conclusion: In conclusion, our study, even if supported by preliminary results, showed how Diallyl Thiosulfinate, Nuciferine and Diosgenin is able to improve the control of ejaculation in patients suffering from PE, primary or secondary to ED without any significant adverse effects.

The 5-HT2C receptor gene Cys23Ser polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation

NARCIS (Netherlands)

Janssen, Paddy Kc; Schaik, Ron van; Olivier, Berend|info:eu-repo/dai/nl/073067199; Waldinger, Marcel D|info:eu-repo/dai/nl/163958564

2014-01-01

It has been postulated that the persistent short intravaginal ejaculation latency time (IELT) of men with lifelong premature ejaculation (LPE) is related to 5-hydroxytryptamine (HT)2C receptor functioning. The aim of this study was to investigate the relationship of Cys23Ser 5-HT2C receptor gene

Relation of size of seminal vesicles on ultrasound to premature ejaculation

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Zhi-Wei Hong

2017-01-01

Full Text Available Myriad biological factors have been proposed to explain premature ejaculation (PE. However, data correlating PE with seminal vesicles (SVs are sparse. The study aimed to evaluate the relationship between the size of SV and PE. The cross-sectional study included 44 outpatients with PE and 44 volunteers without PE, and the size of SV was compared. Self-estimated intravaginal ejaculatory latency time, the Premature Ejaculation Diagnostic Tool (PEDT, the International Index of Erectile Function-15, and the National Institutes of Health-Chronic Prostatitis Symptom Index were used for assessment of symptoms. Compared to the control group, the PE group had significantly higher mean anterior-posterior diameter (APD of SV (P < 0.001. The optimal mean APD of SV cutoff level was 9.25 mm for PE. In the PE group, PEDT was also higher with a mean APD of SV ≥9.25 mm compared with mean APD of SV <9.25 mm. PEDT was significantly correlated with the mean APD of SV (r = 0.326, P = 0.031. The seminal plasma proteins were compared between six PE and six matched control cases by mass spectrometry and it was shown that 102 proteins were at least 1.5-fold up- or down-regulated. Among them, GGT1, LAMC1, and APP were significantly higher in the PE group. These results indicated that men with a larger mean APD of SV might have a higher PEDT score. Transrectal ultrasound of SV should be considered in the evaluation of patients with premature ejaculation. SV might be a potential target for the treatment of patients with PE and ultrasound change in SV.

An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) ad hoc committee for the definition of premature ejaculation.

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McMahon, Chris G; Althof, Stanley E; Waldinger, Marcel D; Porst, Hartmut; Dean, John; Sharlip, Ira D; Adaikan, P G; Becher, Edgardo; Broderick, Gregory A; Buvat, Jacques; Dabees, Khalid; Giraldi, Annamaria; Giuliano, François; Hellstrom, Wayne J G; Incrocci, Luca; Laan, Ellen; Meuleman, Eric; Perelman, Michael A; Rosen, Raymond C; Rowland, David L; Segraves, Robert

2008-07-01

The medical literature contains several definitions of premature ejaculation (PE). The most commonly quoted definition, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision, and other definitions of PE are all authority based rather than evidence based, and have no support from controlled clinical and/or epidemiological studies. The aim of this article is to develop a contemporary, evidence-based definition of PE. In August 2007, the International Society for Sexual Medicine (ISSM) appointed several international experts in PE to an Ad Hoc Committee for the Definition of Premature Ejaculation. The committee met in Amsterdam in October 2007 to evaluate the strengths and weaknesses of current definitions of PE, to critique the evidence in support of the constructs of ejaculatory latency, ejaculatory control, sexual satisfaction, and personal/interpersonal distress, and to propose a new evidence-based definition of PE. The committee unanimously agreed that the constructs that are necessary to define PE are rapidity of ejaculation, perceived self-efficacy and control, and negative personal consequences from PE. The committee proposed that lifelong PE be defined as ". . . a male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration, and the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy." This definition is limited to men with lifelong PE who engage in vaginal intercourse. The panel concluded that there are insufficient published objective data to propose an evidence-based definition of acquired PE. The ISSM definition of lifelong PE represents the first evidence-based definition of PE. This definition will hopefully lead to the development of new tools and Patient Reported

Development and validation of a premature ejaculation diagnostic tool.

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Symonds, Tara; Perelman, Michael A; Althof, Stanley; Giuliano, François; Martin, Mona; May, Kathryn; Abraham, Lucy; Crossland, Anna; Morris, Mark

2007-08-01

Diagnosis of premature ejaculation (PE) for clinical trial purposes has typically relied on intravaginal ejaculation latency time (IELT) for entry, but this parameter does not capture the multidimensional nature of PE. Therefore, the aim was to develop a brief, multidimensional, psychometrically validated instrument for diagnosing PE status. The questionnaire development involved three stages: (1) Five focus groups and six individual interviews were conducted to develop the content; (2) psychometric validation using three different groups of men; and (3) generation of a scoring system. For psychometric validation/scoring system development, data was collected from (1) men with PE based on clinician diagnosis, using DSM-IV-TR, who also had IELTs or =11 PE. The development and validation of this new PE diagnostic tool has resulted in a new, user-friendly, and brief self-report questionnaire for use in clinical trials to diagnose PE.

On-demand Modafinil Improves Ejaculation Time and Patient-reported Outcomes in Men With Lifelong Premature Ejaculation.

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Tuken, Murat; Kiremit, Murat Can; Serefoglu, Ege Can

2016-08-01

To evaluate the effects of modafinil on the intravaginal ejaculatory latency time (IELT) and patient-reported outcomes in patients with lifelong premature ejaculation (PE). Treatment-naïve lifelong PE patients were included in this proof-of-concept study. Self-estimated IELTs of the patients were recorded and the Premature Ejaculation Profile (PEP) questionnaire was administered before the initiation of on-demand modafinil 100 mg treatment. At the end of 1 month of treatment, self-estimated IELTs were recorded again, along with posttreatment PEP outcomes. Overall, 55 lifelong PE patients with a mean age of 35.07 ± 7.80 (range: 22-58) years were enrolled. Modafinil treatment modestly increased the mean IELT at the end of 1 month (24.82 ± 16.10 seconds vs 49.82 ± 31.46 seconds, P = .0001). Moreover, at the end of 1 month, patients reported in the PEP questionnaire better control over ejaculation (0.75 ± 0.67 vs 1.35 ± 0.91, P = .0001), improved satisfaction with sexual intercourse (0.98 ± 0.78 vs 1.40 ± 0.85, P = .0001), lesser personal distress (0.42 ± 0.69 vs 0.89 ± 1.01, P = .0001), and reduced interpersonal difficulty (1.69 ± 1.48 vs 1.95 ± 1.47, P = .0001). In an uncontrolled proof-of-concept study of men with treatment-naïve lifelong PE where IELT was self-reported without a stopwatch, modest improvements of both IELT and patient-reported outcome measures were observed. Future controlled clinical trials are necessary to confirm these findings. Copyright © 2016 Elsevier Inc. All rights reserved.

Pharmacological/dynamic rehabilitative behavioural therapy for premature ejaculation: Results of a pilot study

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Franco Mantovani

2017-06-01

Full Text Available Objectives: Premature ejaculation (PE is a sexual disorder characterised by excessive rapidity of orgasm. It is defined as either primary (60%, present since the onset of sexual activity, or secondary (40%, manifesting later in life. To date, dapoxetine is the only preparation approved for the on-demand treatment of PE. However, side effects, costs associated with the treatment of chronic PE, drug dependence and its variable effectiveness leads to a not insignificant drop-out rate. Dynamic rehabilitative/behavioural therapy may be a viable therapeutic option, working alongside pharmacological treatment, as long as the participation and involvement of both the individual and the couple is optimal. Materials and methods: 18 patients were enrolled, aged between 25 and 55 (mean: 40, all with primary PE, free of comorbidities and with their partners involved. Six patients were prescribed 30 mg dapoxetine two hours before sexual relations for 3 months (group A; 6 patients began the dynamic rehabilitative treatment (group B; 6 other couples were assigned to pharmacological treatment in association with dynamic rehabilitative behavioural treatment for 3 months (group C. Division of subjects was carried out by simple randomisation, excluding patients with a short frenulum, phimosis, ED, chronic prostatitis or experiencing results from previous treatment. Results: Outcomes of treatment were evaluated at the end of the 3 months of treatment and 3 months after discontinuing treatment. In Group A 75% of patients were cured at 3 months and 25% at 6 months. In Group B 25% patients were cured at 3 months and 25% at 6 months. In Group C 75% of patients were cured 3 months and 50% at 6 months. "Cured" means a Premature Ejaculation Diagnostic Tool (PEDT score reduced from an average of 12 to an average of 6 and Intravaginal Ejaculation Latency Time (IELT values from < 1 to > 6 minutes. Conclusions: the integration of pharmacological treatment with dynamic

Effect of DA-8031, a novel oral compound for premature ejaculation, on male rat sexual behavior.

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Kang, Kyung Koo; Sung, Ji Hyun; Kim, Soon Hoe; Lee, Sukhyang

2014-03-01

DA-8031 is a potent and selective serotonin transporter inhibitor developed for the treatment of premature ejaculation. The aim of the present study was to investigate the effects of DA-8031 on male sexual behavior in a rat model. Sexual behavior was examined after an acute oral administration of 10, 30 or 100 mg/kg of DA-8031 in copulation studies with female rats. Pharmacokinetic parameters were calculated after oral administration of DA-8031 at a dose level of 30 mg/kg. DA-8031 treatment produced a dose-dependent increase in ejaculation latency time and showed statistical significance at 30 and 100 mg/kg dosage levels compared with the vehicle (P DA-8031 treatment reduced the mean number of ejaculations in a dose-dependent manner. No changes in post-ejaculatory interval, numbers of mounts, intromissions or ejaculations were observed at any dose. In pharmacokinetic study, the blood concentration of DA-8031 peaked at 0.38 ± 0.14 h after oral administration, and then rapidly declined with a half-life of 1.79 ± 0.32 h. Treatment with DA-8031 delays the ejaculation latency time without affecting the initiation of mounting behavior or post-ejaculatory interval in rats. Furthermore, DA-8031 is rapidly absorbed and eliminated after oral administration in rats. These preclinical findings provide a clue for the clinical testing of DA-8031 as an "on-demand" agent for premature ejaculation. © 2013 The Japanese Urological Association.

Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review

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Katy Cooper, PhD

2015-09-01

Conclusions: There is limited evidence that physical behavioral techniques for PE improve IELT and other outcomes over waitlist and that behavioral therapies combined with drug treatments give better outcomes than drug treatments alone. Further RCTs are required to assess psychotherapeutic approaches to PE. Cooper K, Martyn‐St James M, Kaltenthaler E, Dickinson K, Cantrell A, Wylie K, Frodsham L, and Hood C. Behavioral therapies for management of premature ejaculation: A systematic review. Sex Med 2015;3:174–188.

Toward Evidence-Based Genetic Research on Lifelong Premature Ejaculation: A Critical Evaluation of Methodology

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2011-01-01

Recently, four premature ejaculation (PE) subtypes have been distinguished on the basis of the duration of the intravaginal ejaculation latency time (IELT). These four PE subtypes have different etiologies and pathogeneses. Genetic research on PE should consider the existence of these PE subtypes and the accurate measurement of the IELT with a stopwatch. Currently, three methods of genetic research on PE have been used. They differ in the investigated population, tool of measurement, study design, and variables of PE. From animal and human research, it is derived that the central serotonergic system "modulates" ejaculation, whereas the ejaculation (reflex) itself is probably not under direct influence of the serotonergic system, but rather under the influence of other neurotransmitter systems in the spinal cord. For genetic research on PE, it is important to take into account that the (serotonergic) modulation of the IELT is variable among men and may even be absent. This means that serotonergic genetic polymorphisms may only be found in men with PE who respond with an ejaculation delay treatment with a selective serotonin reuptake inhibitor. PMID:21344023

Penile Traumatic Neuroma: A Late Complication of Penile Dorsal Neurotomy to Treat Premature Ejaculation

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Hyun Jun Park

2016-09-01

Conclusion: The main complications of SDN are recurrence of premature ejaculation, pain or paresthesia on the glans penis, and erectile dysfunction. However, no traumatic neuroma has been reported as a complication. We report that a traumatic neuroma can occur after SDN.

The epidemiology of premature ejaculation.

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Saitz, Theodore Robert; Serefoglu, Ege Can

2016-08-01

Vast advances have occurred over the past decade with regards to understanding the epidemiology, pathophysiology and management of premature ejaculation (PE); however, we still have much to learn about this common sexual problem. As a standardized evidence-based definition of PE has only recently been established, the reported prevalence rates of PE prior to this definition have been difficult to interpret. As a result, a large range of conflicting prevalence rates have been reported. In addition to the lack of a standardized definition and operational criteria, the method of recruitment for study participation and method of data collection have obviously contributed to the broad range of reported prevalence rates. The new criteria and classification of PE will allow for continued research into the diverse phenomenology, etiology and pathogenesis of the disease to be conducted. While the absolute pathophysiology and true prevalence of PE remains unclear, developing a better understanding of the true prevalence of the disease will allow for the completion of more accurate analysis and treatment of the disease.

Interventions to treat premature ejaculation: a systematic review short report.

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Cooper, Katy; Martyn-St James, Marrissa; Kaltenthaler, Eva; Dickinson, Kath; Cantrell, Anna

2015-03-01

Premature ejaculation (PE) is commonly defined as ejaculation with minimal sexual stimulation before, on or shortly after penetration and before the person wishes it. PE can be either lifelong and present since first sexual experiences (primary), or acquired (secondary), beginning later (Godpodinoff ML. Premature ejaculation: clinical subgroups and etiology. J Sex Marital Ther 1989;15:130-4). Treatments include behavioural and pharmacological interventions. To systematically review evidence for clinical effectiveness of behavioural, topical and systemic treatments for PE. The following databases were searched from inception to 6 August 2013 for published and unpublished research evidence: MEDLINE; EMBASE; Cumulative Index to Nursing and Allied Health Literature; The Cochrane Library including the Cochrane Systematic Reviews Database, Cochrane Controlled Trials Register, Database of Abstracts of Reviews of Effects and the Health Technology Assessment database; ISI Web of Science, including Science Citation Index, and the Conference Proceedings Citation Index-Science. The US Food and Drug Administration website and the European Medicines Agency (EMA) website were also searched. Randomised controlled trials (RCTs) in adult men with PE were eligible (or non-RCTs in the absence of RCTs). RCT data were extrapolated from review articles when available. The primary outcome was intravaginal ejaculatory latency time (IELT). Data were meta-analysed when possible. Other outcomes included sexual satisfaction, control over ejaculation, relationship satisfaction, self-esteem, quality of life, treatment acceptability and adverse events (AEs). A total of 103 studies (102 RCTs, 65 from reviews) were included. RCTs were available for all interventions except yoga. The following interventions demonstrated significant improvements (p < 0.05) in arithmetic mean difference in IELT compared with placebo: topical anaesthetics - eutectic mixture of local anaesthetics (EMLA(®), Astra

Psychometric Properties of the Iranian Version of the Premature Ejaculation Diagnostic Tool

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Amir H. Pakpour, PhD

2014-04-01

Conclusion: The results provide evidence for good reliability and validity of the Iranian version of the PEDT. The questionnaire therefore represents a suitable tool for screening PE in Iranian men. Pakpour AH, Yekaninejad MS, Nikoobakht MR, Burri A, and Fridlund B. Psychometric properties of the Iranian version of the Premature Ejaculation Diagnostic Tool. Sex Med 2014;2:31–40.

Black stone - a natural remedy for premature ejaculation and performance enhancement, or maybe not?

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Bush, Carly; O'Farrell, Nigel

2014-08-01

We describe the use of a non-prescribed aid (Black stone) for premature ejaculation that resulted in a chemical burn on the penis with an appearance similar to severe balanitis. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Prevalence and Associated Factors of Premature Ejaculation in the Anhui Male Population in China: Evidence-Based Unified Definition of Lifelong and Acquired Premature Ejaculation.

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Gao, Jingjing; Peng, Dangwei; Zhang, Xiansheng; Hao, Zongyao; Zhou, Jun; Fan, Song; Zhang, Yao; Mao, Jun; Dou, Xianming; Liang, Chaozhao

2017-03-01

In 2014, new evidence-based definitions of lifelong premature ejaculation (LPE) and acquired premature ejaculation (APE) were proposed by the International Society for Sexual Medicine. Based on the new PE definitions, the prevalence of and factors associated with LPE and APE have not been investigated in China. To evaluate the prevalence of and factors associated with LPE and APE in men with the complaint of PE in China. From December 2011 to December 2015, a cross-sectional field survey was conducted in five cities in the Anhui province of China. Questionnaire data of 3,579 men were collected in our database. The questionnaire included subjects' demographic information and medical and sexual histories. Men who were not satisfied with their time to ejaculate were accepted as having the complaint of PE. Men with the complaint of PE who met the new definition of PE were diagnosed as having LPE or APE. New definition of LPE and APE. Of 3,579 men who completed the questionnaire, 34.62% complained of PE. Mean age, body mass index, and self-estimated intravaginal ejaculatory latency time for all subjects were 34.97 ± 9.02 years, 23.33 ± 3.56 kg/m 2 , and 3.09 ± 1.36 minutes, respectively. The prevalences of LPE and APE in men with the complaint of PE were 10.98% and 21.39%, respectively. LPE and APE were associated with age, body mass index, and smoking and exercise rates (P hypertension, diabetes mellitus, and heart disease (P < .001 for all comparisons). In this study, the prevalences of LPE and APE in men with the complaint of PE were 10.98% and 21.39%, respectively. Patients with APE were older and more likely to smoke, had more comorbidities, and had a higher body mass index than patients with LPE. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

The relationship between self-estimated intravaginal ejaculatory latency time and International Prostate Symptom Score in middle-aged men complaining of ejaculating prematurely in China.

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Zhang, Xiansheng; Tang, Dongdong; Xu, Chuan; Gao, Pan; Hao, Zongyao; Zhou, Jun; Liang, Chaozhao

2015-03-01

Some factors associated with the four premature ejaculation (PE) syndromes have been studied, but the association between International Prostate Symptom Score (IPSS) and the four PE syndromes has not been investigated. We performed this study to evaluate the association between IPSS and intravaginal ejaculatory latency time (IELT) in men with the four PE syndromes. From June 2012 to January 2014, a total of 690 men aged 40-59 years complaining of ejaculating prematurely and another 452 male healthy subjects of the same age without these complaints were included in this study. Men with the complaints of ejaculating prematurely were classified as one of the four PE syndromes: lifelong PE, acquired PE (APE), variable PE, and subjective PE. Each of them completed a detailed questionnaire including information on demographics, medical and sexual history (e.g., self-estimated IELT), IPSS, and International Index of Erectile Function-5. Associations between IPSS and self-estimated IELT in middle-aged men with the four PE syndromes. Men complaining of ejaculating prematurely reported higher IPSS (11.2 ± 6.0 vs. 5.5 ± 3.3 ) and shorter self-estimated IELT (2.1 ± 1.6 minutes vs. 4.8 ± 3.3) than men without complaints (P men with the four PE syndromes showed significant correlations with IPSS (P men with PE complaints (adjusted r = -0.378, P men with APE (adjusted r = -0.502, P Men complaining of ejaculating prematurely reported worse IPSS than men without these complaints. Self-estimated IELT was negatively associated with IPSS in men complaining of ejaculating prematurely, and the correlation was the strongest in men with APE. © 2015 International Society for Sexual Medicine.

Awareness and timing of pelvic floor muscle contraction, pelvic exercises and rehabilitation of pelvic floor in lifelong premature ejaculation: 5 years experience

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Giuseppe La Pera

2014-06-01

Full Text Available Objectives: To assess the cure rate of patients with premature ejaculation who underwent a treatment involving: 1 awareness of the pelvic floor muscles 2 learning the timing of execution and maintenance of contraction of the pelvic floor muscles during the sensation of the pre-orgasmic phase 3 pelvic floor rehabilitation (bio feed back, pelvic exercises and electrostimulation. Materials and methods: We recruited 78 patients with lifelong premature ejaculation who completed the training. The patients were informed of the role of the pelvic floor. They were taught to carry out the execution and maintenance of contraction of the pelvic floor muscles during the sensation of the pre-orgasmic phase to control the ejaculatory reflex. In order to improve the awareness, the tone and the endurance of the pelvic floor muscles, patients were treated with the rehabilitation of pelvic floor (RPF consisting mainly in biofeedback, pelvic exercises and in some cases also in electro-stimulation (ES. The training was carried out for a period of about 2-6 months with an average of 2-5 visits per cycle. Results: 54% of patients who completed the training were cured of premature ejaculation and learned over time to be able to postpone the ejaculation reflex. In a subgroup of 26 patients was also measured the IELT which on the average increased from < 2 minutes to >10 minutes. The best results occurred mainly in patients aged less than 35 where the cure rate was 65%. There were no side effects. Conclusions: In this study, approximately half of patients with premature ejaculation were cured after applying the above treatment.This therapy, necessitates a fairly long period of time (2-6 months and a great commitment on the part of the patient, nevertheless it can be a valid and effective treatment for patients with premature ejaculation. This treatment makes the patient independent in that he is not bound to specific times for taking medication. Furthermore there are no

An overview of pharmacotherapy in premature ejaculation.

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Porst, Hartmut

2011-10-01

With increasing interest and clinical research in male sexual disorders, it has become clear that not only psychological but also organic, neurobiological, and genetic factors may play an important role in premature ejaculation (PE). This article provides an overview of the different treatment options both for lifelong (primary, "congenital") and acquired (secondary) PE. Review of the literature. Currently used treatment options for PE. Treatments reviewed include psychological/behavioral/sexual counseling therapy, topical anesthetics, dapoxetine, and other selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and phosphodiesterase-5 (PDE-5) inhibitors. Before starting any therapy for PE, correct diagnosis has to be made considering the patient's reported intravaginal ejaculatory latency time (IELT) and the duration and type of PE. Concomitant erectile dysfunction (ED) should be either ruled out or proven by appropriate means. In uncomplicated cases of PE with stable partnerships, medical treatment represents the first-choice option with a high likelihood of success. Dapoxetine, where available, or other SSRIs provide suitable therapeutic options with a good risk/benefit profile for patients. In complicated ("difficult-to-treat") PE patients, a combination of medication and sexual counseling should be considered the first treatment option. Combination therapies of PDE-5 inhibitors and PE-related medications should be offered to patients suffering from comorbid PE and ED, with ED treatment starting first. In those patients with severe PE-IELTs of IELT, compared with either monotherapy. 2011 International Society for Sexual Medicine.

Relationship between premature ejaculation and depression in Korean males.

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Son, Hwancheol; Song, Sang Hoon; Lee, Jun-Young; Paick, Jae-Seung

2011-07-01

The psychological impacts of premature ejaculation (PE), which include guilt, anxiety, and distress, have been well established in Western countries. However, in Asia, although a substantial number of epidemiological studies have surveyed the prevalence of PE, researchers have not thoroughly investigated the relationship between PE and depression, or have defined PE properly. We studied the association between PE and depression and other psychological disturbances, in a Korean cohort by applying an appropriate definition for PE and validated outcome measures of depression. METHODS.  A total of 956 males (≥20 years) were initially approached via an Internet survey company. Participants were asked to complete a questionnaire requesting detailed medical and sexual histories, which included questions from the Erectile Function Domain score in the International Index of Erectile Function (IIEF-EF) and the Beck Depression Inventory (BDI). The prevalence of PE was evaluated using two different definitions-self-assessed PE and presumed PE. Presumed PE was defined as a short ejaculation time (an estimated intravaginal ejaculatory latency time ≤5 minutes), an inability to control ejaculation, and the presence of distress resulting from PE. Ejaculation-related questionnaire, the IIEF-EF, and BDI. A total of 334 men were evaluated. The prevalence of PE was 10.5% according to the Presumed PE definition, whereas by self-assessment, it was 25.4%. Self-assessed PE patients suffered from various psychological problems, such as depression, low self-esteem, bother, and low sexual satisfaction. Even after excluding erectile dysfunction (ED) subjects, a significant relationship was found between self-assessed PE and depression. Moreover, after further classification of the Self-assessed PE group, we found that subjects included in this group, but not in the Presumed PE group, suffered more from psychological burden than any other members of the cohort. Korean men with subjective

Visceral adiposity index is associated with premature ejaculation inversely: a cross-sectional study.

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Cakir, Suleyman Sami; Ozcan, Levent; Besiroglu, Huseyin; Dursun, Murat; Polat, Emre Can; Otunctemur, Alper; Ozbek, Emin

2018-01-16

Visceral adiposity index (VAI) is a novel indicator for the assessment of visceral obesity. In this study, we aimed to evaluate the relationship between VAI and premature ejaculation (PE). A total of 300 men were included in the study. Hundred and fifty men with PE and 150 men without PE (control). All men were evaluated for PE by premature ejaculation diagnostic tool (PEDT). VAI levels were calculated using body mass index (BMI), high density lipoprotein and triglyceride (TG) levels. Mean age of the study groups was 34.3 ± 5.2 (30-60) years and the mean age of the controls were 35.9 ± 5.3 (30-60) years. The men with PE had lower BMI, TG levels, waist circumference (WC) and higher high-density lipoprotein-cholesterol (HDL-C) levels. Mean VAI level was 4.13 ± 0.7 in study group and 5.72 ± 1.6 in control group, respectively. VAI levels were statistically higher in men without PE (p correlation between VAI and PE. VAI is superior index for the evaluation and calculation the relationship between obesity and PE.

Selective resection of dorsal nerves of penis for premature ejaculation.

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Zhang, G-X; Yu, L-P; Bai, W-J; Wang, X-F

2012-12-01

Premature ejaculation (PE) is one of the most prevalent male sexual dysfunctions. Selective resection of the dorsal nerve (SRDN) of penis has recently been used for the treatment of PE and has shown some efficacy. To further clarify the efficacy and safety of SRDN on PE, we performed a preliminary, randomized, placebo-controlled clinical observational study. Persons with the complaints of rapid ejaculation, asking for circumcision because of redundant foreskin, intravaginal ejaculation latency time (IELT) within 2 min, not responding to antidepressant medication or disliking oral medication were randomly enrolled in two groups. From April 2007 to August 2010, a total of 101 eligible persons were enrolled, 40 of them received SRDN which dorsal nerves of the penis were selectively resected, and those (n = 61) enrolled in the control group were circumcised only. IELT and the Brief Male Sexual Function Inventory (BMSFI) questionnaire were implemented pre- and post-operatively for the evaluation of the effect and safety of the surgery. There are no statistically significant differences in the baseline data including mean ages, mean IELTs, perceived control abilities and the BMSFI mean scores between the two groups. With regard to the post-operative data of the surgery, both IELTs and perceived control abilities were significantly increased after SRDN (1.1 ± 0.9 min vs. 3.8 ± 3.1 min for pre- and post-operative IELT, respectively, p 0.05). Also, there were no statistically significant differences both in BMSFI composite and subscale scores between the two groups after surgery. Hence, we conclude that SRDN is effective in delaying ejaculation and improving ejaculatory control, whereas erectile function is not affected. The results imply that SRDN may be an alternative method for the treatment of PE for some patients. © 2012 The Authors. International Journal of Andrology © 2012 European Academy of Andrology.

Nonresponders to Daily Paroxetine and Another SSRI in Men With Lifelong Premature Ejaculation : A Pharmacokinetic Dose-Escalation Study for a Rare Phenomenon

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Janssen, Paddy Kc; Touw, Daan; Schweitzer, Dave H; Waldinger, Marcel D

PURPOSE: Nonresponse to any selective serotonin reuptake inhibitor (SSRI) treatment is rare. In this study, we aimed to investigate ejaculation delay nonresponse to paroxetine treatment in men with lifelong premature ejaculation (PE) who were also known to be nonresponders to other SSRIs. MATERIALS

The Efficacy and Safety of On-demand Tramadol and Paroxetine Use in Treatment of Life Long Premature Ejaculation: A Randomized Double-blind Placebo-controlled Clinical Trial

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Hamidi-Madani, Ali; Motiee, Reza; Mokhtari, Gholamreza; Nasseh, Hamidreza; Esmaeili, Samaneh; Kazemnezhad, Ehsan

2018-01-01

Background: Several medical therapies have been proposed for the treatment of premature ejaculation (PE). Paroxetine and tramadol were both reported to be effective in treatment of PE. In this study, the therapeutic effects of tramadol, paroxetine and placebo were compared in treatment of primary PE. Methods: In this randomized, double-blind, placebo-controlled clinical trial, 150 patients were divided into 3 groups. One group was treated with tramadol 50 mg ondemand, the other group took paroxetine 20 mg on-demand and the third group was treated with placebo. Before starting treatment and after 12 weeks, patients were asked to measure their average intravaginal ejaculation latency time (IELT) and fill the PEP (Premature Ejaculation Profile) questionnaire. Results: At the end of the 12th week, the mean IELT and average of PEP scores improved in all 3 groups. The increase in tramadol group was significantly higher than the paroxetine and placebo groups (pIELT and PEP scores in all 3 groups, the rate of improvement in tramadol group was significantly more than the others. Thus, tramadol may be considered as an appropriate alternative therapeutic option for lifelong PE. PMID:29850442

The majority of men with lifelong premature ejaculation prefer daily drug treatment: an observation study in a consecutive group of Dutch men

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Waldinger, Marcel D.; Zwinderman, Aeilko H.; Olivier, Berend; Schweitzer, Dave H.

2007-01-01

INTRODUCTION: Whether men with lifelong premature ejaculation (PE) prefer on-demand drug treatment to delay ejaculation time to daily drug treatment, has never been studied as a separate study question. AIM: To study how men with lifelong PE feel about the use of serotonergic antidepressants, and

Possible role of serum testosterone, gonadotropins and prolactin in patients with premature ejaculation.

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Abu El-Hamd, M; Farah, A

2018-02-01

Premature ejaculation (PE) is the most common male sexual dysfunction. This study aimed to investigate the role of serum testosterone, gonadotropins and prolactin in patients with PE. In a prospective a case-controlled study, it was conducted on 90 male patients with PE and 90 male healthy participants as controls. Patients were evaluated by Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculatory latency time (IELT). Patients with mean IELT values ≤60 s and PEDT total scores ≥11 were considered to have PE. Serum levels of total testosterone (TT), free testosterone (FT), follicle-stimulating hormone (FSH), luteinising hormone (LH) and prolactin (PL) were investigated in patients with PE and controls. There was no statistically significant difference between patients with PE and controls regarding the serum levels of TT, FT, FSH, LH and PL (p value ˃.05). There was no significant correlation between the sex hormones levels (TT, FT, FSH, LH and PL) and (age, body mass index (BMI), IELTS and total PEDT scores of the patients; p value ˃.05). This study concluded that there was no disturbance in serum levels of testosterone, gonadotropins and prolactin in patients with PE and controls. These hormones could not relate to pathogenesis of PE. © 2017 Blackwell Verlag GmbH.

The Premature Ejaculation Profile: validation of self-reported outcome measures for research and practice.

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Patrick, Donald L; Giuliano, François; Ho, Kai Fai; Gagnon, Dennis D; McNulty, Pauline; Rothman, Margaret

2009-02-01

To evaluate the reliability and validity of the Premature Ejaculation Profile (PEP), a self-reported outcome instrument for evaluating domains of PE and its treatment, comprised of four single-item measures, a profile, and an index score. Data were from men participating in observational studies in the USA (PE, 207 men; non-PE, 1380) and Europe (PE, 201; non-PE, 914) and from men with PE (1238) participating in a phase III randomized, placebo-controlled clinical trial of dapoxetine. The PEP contains four measures: perceived control over ejaculation, personal distress related to ejaculation, satisfaction with sexual intercourse, and interpersonal difficulty related to ejaculation, each assessed on five-point response scales. Test-retest reliability, known-groups validity, and ability to detect a patient-reported global impression of change (PGI) in condition were evaluated for the individual PEP measures and a PEP index score (the mean of all four measures). Profile analysis was conducted using multivariate analysis of variance. All PEP measures showed acceptable reliability (intraclass correlation coefficients ranged from 0.66 to 0.83) and mean scores for all measures differed significantly between PE and non-PE groups (P measures. The PEP profiles of men with and without PE differed significantly (P measure for use in monitoring outcomes of men with PE.

Clinical Characteristics of the Premature Ejaculation Sufferers in Aegean Region of the Turkey: A Multicentre, Observational Study

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Ahmet Cihan

2014-11-01

Full Text Available Demonstration of the intra-vaginal ejaculation latency time (IELT distribution in male subjects and its clinical expressions among couples in the Aegean region of the Turkey. Materials and Methods Subjects were recruited to the study from six different urologic centers in the Aegean region. During the enrollment period subjects were recruited in to two group according to presence of premature ejaculation (PE. PE diagnosis was made according to DSM-4 definition. Subjects and their partners were evaluated with patient reported outcome measures (PRO related to the ejaculation-based questionnaire (Premature ejaculation patient profile questionnaire -PEPQ. Stopwatch measurements were also asked from each couple to record intravaginal ejaculation latency time (IELT. Couples who completed two clinical visits with 4 wk interval were recruited to the data analysis. Results Among 141 eligible subjects, mean age was 36.5±9.7 years and mean partner age was 32.9±9.8 years. Following the initial evaluation 80 subjects recruited to group 1(PE and 41 subjects recruited to the group 2 (non-PE. Geometric mean IELT of the subjects was significantly differed between PE and non- PE group (64.7±66.8 vs. 521.5±414.7 seconds, p<0.001. All of the PEPQ domain scores were also differed between groups. Subjects in the PE group gave poor ratings than non-PE subjects. Partner responses were similar pattern. Correlation analyses of the PEPQ scores demonstrated significant positive correlations between “perceived control over ejaculation” and “satisfaction with sexual intercourse” domains of the PEPQ and with IELT. Conclusion Geographic distribution of IELT and its impacts among couples by the several subjective aspects of PRO measures should be assessed during PE investigation

An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation.

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McMahon, Chris G; Althof, Stanley; Waldinger, Marcel D; Porst, Hartmut; Dean, John; Sharlip, Ira; Adaikan, P G; Becher, Edgardo; Broderick, Gregory A; Buvat, Jacques; Dabees, Khalid; Giraldi, Annamaria; Giuliano, François; Hellstrom, Wayne J G; Incrocci, Luca; Laan, Ellen; Meuleman, Eric; Perelman, Michael A; Rosen, Raymond; Rowland, David; Segraves, Robert

2008-08-01

To develop a contemporary, evidence-based definition of premature ejaculation (PE). There are several definitions of PE; the most commonly quoted, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders - 4th Edition - Text Revision, and other definitions of PE, are all authority-based rather than evidence-based, and have no support from controlled clinical and/or epidemiological studies. Thus in August 2007, the International Society for Sexual Medicine (ISSM) appointed several international experts in PE to an Ad Hoc Committee for the Definition of PE. The committee met in Amsterdam in October 2007 to evaluate the strengths and weaknesses of current definitions of PE, to critically assess the evidence in support of the constructs of ejaculatory latency, ejaculatory control, sexual satisfaction and personal/interpersonal distress, and to propose a new evidence-based definition of PE. The Committee unanimously agreed that the constructs which are necessary to define PE are rapidity of ejaculation, perceived self-efficacy, and control and negative personal consequences from PE. The Committee proposed that lifelong PE be defined as a male sexual dysfunction characterized by ejaculation which always or nearly always occurs before or within about one minute of vaginal penetration, and the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy. This definition is limited to men with lifelong PE who engage in vaginal intercourse. The panel concluded that there are insufficient published objective data to propose an evidence-based definition of acquired PE. The ISSM definition of lifelong PE represents the first evidence-based definition of PE. This definition will hopefully lead to the development of new tools and patient-reported outcome measures for diagnosing and assessing the efficacy of treatment

Efficacy of Dapoxetine in the Treatment of Premature Ejaculation

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McMahon, Chris G.

2011-01-01

Introduction Premature ejaculation (PE) is a common male sexual disorder which is associated with substantial personal and interpersonal negative psychological factors. Pharmacotherapy of PE with off-label antidepressant SSRI drugs is common. Development and regulatory approval of drugs specifically for the treatment of PE will reduce reliance on off-label treatments and serve to fill a unmet treatment need. Aim To review evidence supporting the efficacy and safety of dapoxetine in the treatment of PE. Methods MEDLINE and the proceedings of major international and regional scientific meetings during the period 1994–2010 were searched for publications or abstracts using the word dapoxetine in the title, abstract or keywords. This search was then manually cross-referenced for all papers. This review encompasses studies of dapoxetine pharmacokinetics, animal studies, human phase 1, 2 and 3 efficacy and safety studies and drug-interaction studies. Results Dapoxetine is a potent selective serotonin re-uptake inhibitor, which is administered on-demand 1–3 hours prior to planned sexual contact. Dapoxetine is rapidly absorbed and eliminated, resulting in minimal accumulation and has dose-proportional pharmacokinetics, which are unaffected by multiple dosing. Dapoxetine 30 mg and 60 mg has been evaluated in 5 randomized, double-blind, placebo-controlled studies in 6081 men aged ≥18 years. Outcome measures included stopwatch-measured intravaginal ejaculatory latency time (IELT), Premature Ejaculation Profile (PEP) inventory items, clinical global impression of change (CGIC) in PE, and adverse events. Mean IELT, all PEP items and CGIC improved significantly with both doses of dapoxetine vs. placebo (P < 0.001 for all). The most common treatment related adverse effects included nausea (11.0% for 30 mg, 22.2% for 60 mg), dizziness (586% for 30 mg, 10.9% for 60 mg), and headache (5.6% for 30 mg, 8.8% for 60 mg), and evaluation of validated rated scales demonstrated no SSRI

Efficacy of Dapoxetine in the Treatment of Premature Ejaculation

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Chris G. McMahon

2011-01-01

Full Text Available Introduction Premature ejaculation (PE is a common male sexual disorder which is associated with substantial personal and interpersonal negative psychological factors. Pharmacotherapy of PE with off-label antidepressant SSRI drugs is common. Development and regulatory approval of drugs specifically for the treatment of PE will reduce reliance on off-label treatments and serve to fill a unmet treatment need. Aimml To review evidence supporting the efficacy and safety of dapoxetine in the treatment of PE. Methods MEDLINE and the proceedings of major international and regional scientific meetings during the period 1994-2010 were searched for publications or abstracts using the word dapoxetine in the title, abstract or keywords. This search was then manually cross-referenced for all papers. This review encompasses studies of dapoxetine pharmacokinetics, animal studies, human phase 1, 2 and 3 efficacy and safety studies and drug-interaction studies. Results Dapoxetine is a potent selective serotonin re-uptake inhibitor, which is administered on-demand 1-3 hours prior to planned sexual contact. Dapoxetine is rapidly absorbed and eliminated, resulting in minimal accumulation and has dose-proportional pharmacokinetics, which are unaffected by multiple dosing. Dapoxetine 30 mg and 60 mg has been evaluated in 5 randomized, double-blind, placebo-controlled studies in 6081 men aged > 18 years. Outcome measures included stopwatch-measured intravaginal ejaculatory latency time (IELT, Premature Ejaculation Profile (PEP inventory items, clinical global impression of change (CGIC in PE, and adverse events. Mean IELT, all PEP items and CGIC improved significantly with both doses of dapoxetine vs. placebo (P < 0.001 for all. The most common treatment related adverse effects included nausea (11.0% for 30 mg, 22.2% for 60 mg, dizziness (586% for 30 mg, 10.9% for 60 mg, and headache (5.6% for 30 mg, 8.8% for 60 mg, and evaluation of validated rated scales

Validity of premature ejaculation diagnostic tool and its association with International Index of Erectile Function-15 in Chinese men with evidence-based-defined premature ejaculation

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Dong-Dong Tang

2018-01-01

Full Text Available The premature ejaculation diagnostic tool (PEDT is a brief diagnostic measure to assess premature ejaculation (PE. However, there is insufficient evidence regarding its validity in the new evidence-based-defined PE. This study was performed to evaluate the validity of PEDT and its association with IIEF-15 in different types of evidence-based-defined PE. From June 2015 to January 2016, a total of 260 men complaining of PE and defined as lifelong PE (LPE/acquired PE (APE according to the evidence-based definition from Andrology Clinic of the First Affiliated Hospital of Anhui Medical University, along with 104 male healthy controls without PE from a medical examination center, were enrolled in this study. All individuals completed questionnaires including demographics, medical and sexual history, as well as PEDT and IIEF-15. After statistical analysis, it was found that men with PE reported higher PEDT scores (14.28 ± 3.05 and lower IIEF-15 (41.26 ± 8.20 than men without PE (PEDT: 5.32 ± 3.42, IIEF-15: 52.66 ± 6.86, P < 0.001 for both. It was suggested that a score of ≥9 indicated PE in both LPE and APE by sensitivity and specificity analyses (sensitivity: 0.875, 0.913; specificity: 0.865, 0.865, respectively. In addition, IIEF-15 were higher in men with LPE (42.64 ± 8.11 than APE (39.43 ± 7.84, P < 0.001. After adjusting for age, IIEF-15 was negatively related to PEDT in men with LPE (adjust r = −0.225, P < 0.001 and APE (adjust r = −0.378, P < 0.001. In this study, we concluded that PEDT was valid in the diagnosis of evidenced-based-defined PE. Furthermore, IIEF-15 was negatively related to PEDT in men with different types of PE.

The Efficacy and Safety of On-demand Tramadol and Paroxetine Use in Treatment of Life Long Premature Ejaculation: A Randomized Double-blind Placebo-controlled Clinical Trial.

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Hamidi-Madani, Ali; Motiee, Reza; Mokhtari, Gholamreza; Nasseh, Hamidreza; Esmaeili, Samaneh; Kazemnezhad, Ehsan

2018-01-01

Several medical therapies have been proposed for the treatment of premature ejaculation (PE). Paroxetine and tramadol were both reported to be effective in treatment of PE. In this study, the therapeutic effects of tramadol, paroxetine and placebo were compared in treatment of primary PE. In this randomized, double-blind, placebo-controlled clinical trial, 150 patients were divided into 3 groups. One group was treated with tramadol 50 mg ondemand, the other group took paroxetine 20 mg on-demand and the third group was treated with placebo. Before starting treatment and after 12 weeks, patients were asked to measure their average intravaginal ejaculation latency time (IELT) and fill the PEP (Premature Ejaculation Profile) questionnaire. At the end of the 12th week, the mean IELT and average of PEP scores improved in all 3 groups. The increase in tramadol group was significantly higher than the paroxetine and placebo groups (p<0.0001). There were no significant differences in terms of side effects between the 3 groups. The results showed that despite an increase in mean IELT and PEP scores in all 3 groups, the rate of improvement in tramadol group was significantly more than the others. Thus, tramadol may be considered as an appropriate alternative therapeutic option for lifelong PE.

Acupuncture versus paroxetine for the treatment of premature ejaculation: a randomized, placebo-controlled clinical trial.

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Sunay, Didem; Sunay, Melih; Aydoğmuş, Yasin; Bağbancı, Sahin; Arslan, Hüseyin; Karabulut, Ayhan; Emir, Levent

2011-05-01

Acupuncture therapy has been used by many researchers in both male and female sexual dysfunction studies. To determine whether acupuncture is effective as a premature ejaculation (PE) treatment compared with paroxetine and placebo. The study was conducted with methodologic rigor based on Consolidated Standards of Reporting Trials (CONSORT) criteria. Ninety patients referred to the urology clinic at a tertiary training and research hospital with PE were included in this randomized controlled trial and randomly assigned into paroxetine, acupuncture, and placebo groups. Heterosexual, sexually active men aged between 28 and 50 yr were included. Men with other sexual disorders, including erectile dysfunction; with chronic psychiatric or systemic diseases; with alcohol or substance abuse; or who used any medications were excluded. The medicated group received paroxetine 20 mg/d; the acupuncture or sham-acupuncture (placebo) groups were treated twice a week for 4 wk. Intravaginal ejaculation latency times (IELTs) and the Premature Ejaculation Diagnostic Tool (PEDT) were used to assess PE. IELTs were calculated by using a partner-held stopwatch. Data were analyzed statistically. Median PEDT scores of paroxetine, acupuncture, and placebo groups were 17.0, 16.0, and 15.5 before treatment, and 10.5, 11.0, and 16.0 after treatment, respectively (p=0.001, p=0.001, and p=0.314, respectively). Subscores after treatment were significantly lower than subscores before treatment in the paroxetine and acupuncture groups but remained the same in the placebo group. Significant differences were found between mean-rank IELTs of the paroxetine and placebo groups (p=0.001) and the acupuncture and placebo groups (p=0.001) after treatment. Increases of IELTs with paroxetine, acupuncture, and placebo acupuncture were 82.7, 65.7, and 33.1 s, respectively. Extent of ejaculation delay induced by paroxetine was significantly higher than that of acupuncture (p=0.001). The most important limitation

A new potential risk factor in patients with erectile dysfunction and premature ejaculation: folate deficiency

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Wen-Jie Yan

2014-12-01

Full Text Available We investigated serum folic acid (FA levels in patients with erectile dysfunction (ED and/or premature ejaculation (PE. Fasting serum samples were obtained from 42 patients with ED, 36 with PE, 25 ED patients with PE, and 30 healthy men; the mean intravaginal ejaculation latency time (IELT was measured during a 4 weeks baseline period. Levels of sex hormones (follicle-stimulating hormone, luteinizing hormone, total testosterone, homocysteine (Hcys, and FA were measured using chemiluminescent immunoassays. The sexual functions of PE patients and normal control men were evaluated using the Chinese Index of Premature Ejaculation (CIPE. The abridged International Index of Erectile Function-5 (IIEF-5 questionnaire was used to gauge erectile quality for ED patients and for normal controls. Serum FA concentrations were lower in ED (7.61 ± 3.97 ng ml -1, PE (9.37 ± 3.40 ng ml -1, and ED/PE (8.84 ± 4.28 ng ml -1 patients than in healthy men (12.23 ± 5.76 ng ml -1 , P 0.05. There were positive correlations between serum FA concentrations and CIPE scores (r = 0.530, P < 0.01, IIEF-5 scores (r = 0.589, P < 0.01, and IELT (r = 0.445, P < 0.01; negative correlations with Hcys concentrations (r = −0.487, P < 0.01 were found in all participants. These findings showed a strong relationship between serum FA levels and sexual dysfunction, possibly due to an effect of FA on the metabolism of nitric oxide, Hcys, and 5-hydroxytryptamine.

Escitalopram treatment for premature ejaculation has a negative effect on semen parameters.

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Koyuncu, H; Serefoglu, E C; Yencilek, E; Atalay, H; Akbas, N B; Sarıca, K

2011-01-01

The aim of this study was to determine the impact of long-term escitalopram treatment on semen parameters of patients with lifelong premature ejaculation (PE). Between November 2008 and January 2010, patients admitted to urology outpatient clinic with a self-reported complaint of PE were evaluated. Medical and sexual history of patients were recorded and patients with lifelong PE (a total of 25 patients) who met the International Society of Sexual Medicine definition were asked to record their intravaginal ejaculatory latency time (IELT) for 1 month, complete Premature Ejaculation Diagnostic Tool (PEDT) questionnaire and give semen samples. Afterwards, patients received 10 mg escitalopram daily for 12 weeks and were invited for control visits at first and third month of treatment. During control visits, PEDT was administered again whereas IELTs were recorded and semen samples were re-examined. PEDT scores, arithmetic means of IELTs and results of semen analyses, which were recorded at baseline, first and third month were compared. At the third month of treatment, a significant increase in mean IELTs and a significant decrease in PEDT scores were detected. However there was a significant decrease in sperm concentration, motility and morphology when compared with the baseline semen measures. Daily escitalopram treatment effects the semen parameters of patients with lifelong PE. Further investigations with larger series are needed to see whether other serotonin reuptake inhibitors have similar side effects and to expose the exact mechanism underlying it. Different treatment modalities should be suggested to patients who desire fertility.

Serotonin Transporter Promoter Region (5-HTTLPR) Polymorphism Is Not Associated With Paroxetine-Induced Ejaculation Delay in Dutch Men With Lifelong Premature Ejaculation

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Janssen, Paddy K.C.; Zwinderman, Aeilko H.; Olivier, Berend

2014-01-01

Purpose To investigate the association between the 5-HT-transporter-gene-linked promoter region (5-HTTLPR) polymorphism and 20-mg paroxetine-induced ejaculation delay in men with lifelong premature ejaculation (LPE). Materials and Methods This was a prospective study of 10 weeks of paroxetine treatment in 54 men with LPE. Intravaginal ejaculation latency time (IELT) was measured by stopwatch. Controls consisted of 92 Caucasian men. All men with LPE were genotyped for the 5-HTTLPR polymorphism. Allele frequencies and genotypes of short (S) and long (L) variants of the polymorphism were compared between patients and controls. Associations between the LL, SL, and SS genotypes and fold increase of mean IELT were investigated. Results Of the 54 patients, 43 (79.6%) responded to 20-mg paroxetine treatment with an ejaculation delay, whereas 11 patients (20.4%) did not respond; 44%, 18%, and 18% of the patients showed a fold increase in mean IELT of 2-10, 10-20, and more than 20, respectively. Of the 54 men, 14 (25.9%) had the LL genotype, 29 (53.7%) had the SL genotype, and 11 (20.4%) had the SS genotype. In the 92 controls, the LL, SL, and SS genotypes were present in 27 (29.3%), 41 (44.6%), and 24 (26.1%), respectively. No statistically significant differences were found in 5-HTTLPR allelic variations or in 5-HTTLPR gene variations. In all men treated with 20 mg paroxetine, analysis of variance of the natural logarithm of fold increase in the IELT showed no statistically significant difference according to genotype (p=0.83). Conclusions The 5-HTTLPR polymorphism is not associated with daily 20-mg paroxetine treatment-induced ejaculation delay in men with LPE. PMID:24578810

Relationship between premature ejaculation and chronic prostatitis/chronic pelvic pain syndrome.

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Lee, Jun Ho; Lee, Sung Won

2015-03-01

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common etiology of premature ejaculation (PE). However, the current data are insufficient to explain this relationship and to support routine screening of men with PE. This study aims to evaluate the relationship between PE and CP/CPPS. A cross-sectional study was conducted that included 8,261 men who had participated in a health examination. The Premature Ejaculation Diagnostic Tool (PEDT), the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), and the International Index of Erectile Function-5 (IIEF) were used for assessment of symptoms. A full metabolic work-up and serum testosterone level checks were also performed. We then investigated the relationship using the Spearman correlation test, multiple linear regression, and logistic regression analyses. Associations of PEDT with NIH-CPSI. The mean age was 50.4 ± 5.5 years. In total, 2,205 (24.9%) men had prostatitis-like symptoms (NIH-CPSI pain score of ≥4 and perineal or ejaculatory pain), and 618 (7.0%) men had moderate to severe symptoms (NIH-CPSI pain score of ≥8). Additionally, 2,144 men (24.2%) were classified as demonstrating PE (PEDT > 10). The PEDT score was found to have a significant positive correlation with the NIH-CPSI pain domain score (correlation coefficient = 0.206; P prostatitis-like symptoms, OR for PE: 1.269, 95% confidence interval: 1.113-1.447; moderate to severe symptoms, OR for PE: 2.134: 95% confidence interval: 1.782-2.557). Our data showed a significant correlation between the PEDT score and the NIH-CPSI score. We suggest routine screening for CP/CPPS in men with PE and PE in men with CP/CPPS. © 2014 International Society for Sexual Medicine.

Effects of Herbal vigRX on Premature Ejaculation: A randomized, double-blind study

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Z Ghafuri

2010-05-01

Full Text Available Objective :   "nWe conducted a double-blind, placebo-controlled study todetermine the efficacy of an herbal sexual supplement (vigRX on premature ejaculation (PE. Method: "nA randomized double blind study was conducted on a fixed dose of herbal vigRX at Roozbeh Psychiatry Hospital, Tehran University of Medical Sciences. The sample consisted of 85 married patients diagnosed withprimary PE according to Diagnostic and Statistical Manual of Mental Disorders. Each patient underwent diagnostic evaluation by one trained psychiatrist, using Structured Clinical Interview for DSM-IV-TR. Each patient was evaluated by researchers to exclude the organic sexual dysfunctions. The patients were randomly assigned in to two groups: group 1 consisting of 42 patients receiving placebo, and group 2 consisting of 43 patients receiving 540 mg herbal vigRX for a 4-week treatment course. The effects of the drug on the ejaculatory function in each group were assessed by the intravaginal ejaculation latency time (IELT, and the Chinese Index of Premature Ejaculation (CIPE before and at the end of the treatment course. Statistical analysis was performed using SPSS software (15th version.      Results: "nThe mean IELT increased 22.4 and 32.0 seconds in the placebo and the vigRX group respectively after the treatment course. The mean IELT differences between the two groups was not significant. The mean CIPE score increased 2.40 and 4.37 in the placebo and the vigRX group respectively .The mean CIPE score differences between the two groups was not significant.No side effect was reported by the subjects in neither groups during the treatment course. "nConclusion: Although the improvement in IELT and CIPE scores in the herbal vigRX group was more than the placebo group, this difference was not statistically significant. The increasing of IELT and CIPE score in the placebo group may be due to the placebo effects. Further studies with higher vigRX doses, greater sample size

An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE)

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Althof, Stanley E; McMahon, Chris G; Waldinger, Marcel D|info:eu-repo/dai/nl/163958564; Serefoglu, Ege Can; Shindel, Alan W; Adaikan, P Ganesan; Becher, Edgardo; Dean, John; Giuliano, Francois; Hellstrom, Wayne J G; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

INTRODUCTION: In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient and

Sexual function improvement in association with serum leptin level elevation in patients with premature ejaculation following sertraline treatment: a preliminary observation

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Kun-Long Tang

2014-11-01

Full Text Available The objective of our work was to evaluate the effect of sertraline hydrochloride on serum levels of leptin and sexual function in patients with premature ejaculation (PE. A total of 124 patients with a history of PE at least 6 months, aged 20-50 years, were treated with sertraline hydrochloride. One hundred and four age-matched normal males without a history of PE were included control subjects and were untreated. Before and after the 8 week experiment, sexual performance parameters including the intravaginal ejaculation latency time (IELT and the Chinese premature ejaculation index (CIPE were collected from both PE patients and control subjects through a questionnaire survey and analyzed. Serum levels of leptin were measured. Correlations of serum leptin with Body Mass Index (BMI were analyzed. Before sertraline treatment, serum levels of leptin were significantly higher (32.9 vs 8.8μg/L, p<0.001 but IELT and CIPE score were significantly lower (54 vs 590, p <0.001; 8.7 vs 22.3, p <0.0001 in PE patients than control subjects. After 8 weeks of treatment with sertraline, serum levels of leptinl in PE patients were decreased markedly to 8.0 μg/L, which was not significantly different from the levels in control subjects (p >0.05; and IELT and CIPE score in PE patients were increased to the values similar to those in control subjects. The sensitivity and specificity values were 87.5% and 96.3% for leptin as a diagnosis target. These observations suggest sertraline as a selective serotonin reuptake inhibitor may offer an effective option for treating premature ejaculation.

New agents in the treatment of premature ejaculation.

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McMahon, Chris G; McMahon, Chelsea N; Leow, Liang Joo

2006-12-01

Premature ejaculation (PE) is a common male sexual disorder. Recent normative data suggest that men with an intravaginal ejaculatory latency time (IELT) of less than 1 minute have "definite" PE, while men with IELTs between 1 and 1.5 minutes have "probable" PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (serotonin) receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors (SSRIs) offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains and is well tolerated. Investigational drugs such as the ejaculo-selective serotonin transport inhibitors (ESSTIs) such as dapoxetine and UK-390,957 represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control, and sexual satisfaction with minimal adverse effects.

Effects of Adult Male Circumcision on Premature Ejaculation: Results from a Prospective Study in China

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Jingjing Gao

2015-01-01

Full Text Available The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE. Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group were evaluated. Detailed evaluations (including circumcision and control groups on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT, Patient-Reported Outcome measures, and 5-item version of the International Index of Erectile Function were used to measure the ejaculatory and erectile function for all subjects. The results showed that, during the one-year follow-up, men after circumcision experienced higher IELT and better scores of control over ejaculation, satisfaction with sexual intercourse, and severity of PE than men before circumcision (P<0.001 for all. Similarly, when compared with the control group, the circumcised men reported significantly improved IELT, control over ejaculation, and satisfaction with sexual intercourse (P<0.001 for all. These findings suggested that circumcision might have positive effects on IELT, ejaculatory control, sexual satisfaction, and PE severity. In addition, circumcision was significantly associated with the development of PE.

Somatosensory evoked potentials assess the efficacy of circumcision for premature ejaculation.

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Xia, J-D; Jiang, H-S; Zhu, L-L; Zhang, Z; Chen, H; Dai, Y-T

2016-07-01

To assess the efficacy and mechanism of circumcision in the treatment of premature ejaculation (PE) with redundant prepuce, we enrolled a total of 81 PE patients who received circumcision. The patients' ejaculatory ability and sexual performances were evaluated before and after circumcision by using questionnaires (Intravaginal ejaculation latency time (IELT), Chinese Index of PE with 5 questions (CIPE-5) and International Index of Erectile function- 5 (IIEF-5)). Furthermore, somatosensory evoked potentials (SEPs) including dorsal nerve (DNSEP) and glans penis (GPSEP) of the patients were also measured. The mean IELTs of preoperation and post operation were 1.10±0.55 and 2.48±2.03 min, respectively (PIELT after operation was 2.16 min, compared with the baseline 1.07 min before the operation, the fold increase of the IELT was 2.02. Compared with the uncircumcised status, scores of CIPE-5 showed a significant increase after circumcision (P<0.001). The mean latencies (and amplitudes) of GPSEP and DNSEP were 38.1±4.0 ms (3.0±1.9 uV) and 40.5±3.4 ms (2.8±1.6 uV) before circumcision, respectively; and 42.8±3.3 ms (2.8±1.6 uV) and 40.5±4.1 ms (2.4±1.2 uV) in the follow-up end point after circumcision. Only the latencies of GPSEP showed significant prolongation before and after circumcision (P<0.001). The ejaculation time improvement after circumcision is so small, and equal to placebo response, therefore it could not be interpreted as a therapeutic method in men with PE.

Premature ejaculation results from partners' mismatch: development and validation of index of intra-vaginal ejaculation latency time.

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Cai, L; Wen, Y; Jiang, M; Zeng, M; Zhang, B

2016-05-01

Mismatch of partners in premature ejaculation (PE) regarding intra-vaginal ejaculation latency time (IELT) is usually neglected. Here we proposed the concept and evaluated the use of index of IELT (IIELT) as an objective diagnostic tool for PE. Data from 103 self-reporting PE patients and 59 normal controls were collected. The expected IELTs of both the male and female partners were provided by each participating couple in two questionnaires. IIELT=stopwatch IELT/(1/2 the male's expected IELT+1/2 the female's expected IELT). The stopwatch IELTs were 1.74±1.4 min (PE group) and 14.45±11.0 min (control group), PIELTs were 15.65±8.7 min (men) and 14.16±6.9 min (women) in the PE group, and 21.3±16.1 min (men) and 20.04±13.47 min (women) in the control group, P<0.05. The calculated IIELTs were 0.14±0.12 (PE group) and 0.83±0.60 (control group), P<0.05. The best cut-off point was 0.658, the Youden index was 0.652, sensitivity was 0.991, specificity was 0.661, positive predictive probability was 83.46% and negative predictive probability was 97.6%. We concluded that IIELT was an integrated measurement of the couples' sexual equilibrium and demonstrated that it provided a simple and objective screening indicator for diagnosing self-reported PE.

Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation.

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Janssen, Paddy K C; Bakker, Steven C; Réthelyi, Janos; Zwinderman, Aeilko H; Touw, Daan J; Olivier, Berend; Waldinger, Marcel D

2009-01-01

Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 minute, and has been postulated as a neurobiological dysfunction with genetic vulnerability for the short IELTs, related to disturbances of central serotonin (5-hydroxytryptamine [5-HT]) neurotransmission and 5-HT receptor functioning. To investigate the relationship between 5-HT transporter gene-linked polymorphism (5-HTTLPR) and short IELTs in men with lifelong PE. A prospective study was conducted in 89 Dutch Caucasian men with lifelong PE. IELT during coitus was assessed by stopwatch over a 1-month period. Controls consisted of 92 Dutch Caucasian men. All men with LPE were genotyped for a 5-HTT-promoter polymorphism. Allele frequencies and genotypes of short (S) and long (L) variants of 5-HTTLPR polymorphism were compared between patients and controls. Association between LL, SL, and SS genotypes, and the natural logarithm of the IELT in men with LPE was investigated. IELT measured by stopwatch, 5-HTTLPR polymorphism. In men with lifelong PE, the geometric mean, median, and natural mean IELTs were 21, 26, and 32 seconds, respectively. There were no significant differences in the 5-HTT polymorphism alleles and genotypes between 89 Dutch Caucasian men with LPE (S 47%, L 53%/LL 29%, SL 48%, SS 22%) and 92 Dutch Caucasian controls (S 48%, L 52%/LL 29%, SL 45%, SS 26%). In men with lifelong PE there was a statistically significant difference between LL, SL, and SS genotypes in their geometric mean IELT (P IELTs than the SS and SL genotypes. The 5-HTTLPR polymorphism is associated with significant effects on the latency to ejaculate in men with lifelong PE. Men with SS and SL genotypes have 100% and 90% longer ejaculation time, respectively than men with LL genotypes.

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis

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Waldinger, M. D.; Zwinderman, A. H.; Schweitzer, D. H.; Olivier, B.

2004-01-01

The aim of this systematic review and meta-analysis is to evaluate whether the design and methodology of drug-treatment studies of premature ejaculation affect the efficacy outcome differently. Therefore, methodological, design and efficacy data from 79 studies ( 3034 males), published between 1943

Functional and psychological characteristics of belgian men with premature ejaculation and their partners.

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Kempeneers, Philippe; Andrianne, Robert; Bauwens, Sabrina; Georis, Isabelle; Pairoux, Jean-François; Blairy, Sylvie

2013-01-01

Physiological, behavioral, cognitive, and emotional factors are generally acknowledged to play a role in premature ejaculation (PE). However, the nature and the extent of their etiological impact remain largely imprecise. The present study examined functional and psychometric dynamics at work in a PE population. A total of 461 men with PE and 80 partners completed an online questionnaire. The main outcome measures were self-reported ejaculatory latency time, the feeling of control upon ejaculation, sexual satisfaction, distress related to PE, trait anxiety (STAI-B), sexual cognitions (Sexual Irrationality Questionnaire [SIQ]), social anxiety (Liebowitz's Social Anxiety Scale [LSAS] and Social Interaction Self-Statement Test [SISST]), and personality traits (Temperament and Character Inventory-Revised [TCI-R]). In our sample, the median latency time to ejaculation was between 1 and 2 min. Sexual satisfaction and distress correlated more strongly with the feeling of control than with the self-reported latency time. Men experienced more distress and dissatisfaction related to PE than did their partners, while overestimating their partners' distress and dissatisfaction. PE participants' scores differed significantly, albeit slightly, from STAI-B, SIQ, LSAS, and SISST norms. The differences were negligible on TCI-R. Some differences became stronger when subtypes were considered. Participants combining generalized and lifelong PE with self-reported latency times of sexual satisfaction and control, higher distress, higher social anxiety, and harm avoidance (TCI-R/HA) scores. By contrast, the situational subtype of PE was found to be characterized by a higher level of satisfaction, a greater feeling of control, less distress, and higher trait anxiety scores. However, the trends remained statistically discrete.

Phosphodiesterase 5 inhibitors in the treatment of premature ejaculation.

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Wang, W F; Minhas, S; Ralph, D J

2006-10-01

To date, there is no FDA-approved therapy for premature ejaculation (PE). Recently, phosphodiesterase 5 inhibitors (PDE5-Is) have been demonstrated to have encouraging results in the treatment of PE by a few studies. The aim of this review was to assess the updated manuscripts and thereafter present the practical recommendations and possible mechanisms concerning PDE5-Is for treating PE. Using MEDLINE, we searched and assessed the peer manuscripts published from 1 January 1996 to 1 September 2005 about PDE5-Is for treating PE. The results show that the number of patients in all the reports is very few and most of the studies do not employ double-blinded and placebo-controlled tests, though they are prospective and randomized. Therefore, the results and conclusions might be biased. PDE5-Is are suggested to be used in PE with old age or associated with erectile dysfunction (ED), or to be employed alone or in combination with selective-serotonin reuptake inhibitors (SSRIs) when SSRIs fail to treat PE; behavioural therapy is proposed to be used for preventing the recurrence of PE following withdrawal of PDE5-Is. In addition, for the PE patient with a definite aetiological cause, the aetiology should be cured first, if PE still exists, followed by PDE-Is prescription. Possible mechanisms that are involved include relaxing the smooth muscles of vas deferens, seminal vesicle, prostate and urethra; decreasing the central sympathetic output; inducing peripheral analgesia; prolonging the duration of erection; and increasing confidence, the perception of ejaculatory control, overall sexual satisfaction, and decreasing the post-orgasmic refractory time to achieve a second erection after ejaculation. Well-designed multicentre studies are urgently warranted to further elucidate the efficacies and safety as well as mechanisms of PDE5-Is in the treatment of PE.

The diagnostic value of the premature ejaculation diagnostic tool and its association with intravaginal ejaculatory latency time.

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Kam, Sung Chul; Han, Deok Hyun; Lee, Sung Won

2011-03-01

Premature ejaculation (PE) is the most prevalent male ejaculation disorder. The premature ejaculation diagnostic tool (PEDT) was developed to systematically apply the DSM-IV-TR criteria in diagnostic PE. To evaluate the diagnostic value of the PEDT and its association with intravaginal ejaculatory latency time (IELT). (i) Korean validation of PEDT: data was collected from men interviewed by one of the two clinical experts, who made a diagnostic of present or absence of PE, using DSM-IV-TR criteria. A total of 103 patients with PE and 100 men without PE were enrolled into the study and requested to complete the PEDT; and (ii) The correlation between IELT and PEDT: 200 participants were enrolled and each participant was asked to make out PEDT. All participants were requested to measure IELT. Validity and reliability of the PEDT and its association with IELT. The geometric mean IELT of the PE group was 115.37 ± 78.14 seconds. The number of men reporting IELTs of 2 minutes were 28 (28.6%), 29 (29.6%), and 41 (41.8%), respectively. The Cronbach's alpha score was calculated as 0.93, showing adequate internal consistency. The test-retest correlation coefficients of each item were higher than 0.72 and the correlation coefficients of the total score was 0.88. (P IELT showed an adequate negative correlation. (ρ = -0.77, P IELT ≤ 2 minutes) and IELT showed a negative correlation. (ρ = -0.6, P < 0.0001) The PEDT was highly effective in detecting the presence of PE. The result of our study supports its validity as a diagnostic tool in the clinical setting. © 2010 International Society for Sexual Medicine.

Contemporary Management of Disorders of Male Orgasm and Ejaculation.

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Althof, Stanley E; McMahon, Chris G

2016-07-01

Ejaculatory disorders lie along a conceptual continuum with premature ejaculation anchoring one end, normal ejaculation in the center, and difficulties with delayed or anejaculation at the opposite end. Retrograde ejaculation, painful ejaculation, and postorgasmic illness syndrome can occur at any point on the continuum. This manuscript defines the ejaculatory dysfunctions, reviews the anatomy and physiology of orgasm and ejaculation, and summarizes the pharmacological, psychological, and combined treatment approaches to ejaculatory dysfunctions. Copyright © 2016 Elsevier Inc. All rights reserved.

Male masturbation device for the treatment of premature ejaculation

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J.E. Rodríguez

2016-03-01

Conclusions: The patients who used the device Flip Hole increased of significant form the control grade on the ejaculation, and its interpersonal ejaculation distress and they reduced difficulties. To further evaluate the validity of these claims, randomized controlled trials should occur.

Dapoxetine: a new option in the medical management of premature ejaculation

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2012-01-01

Premature ejaculation (PE) is a common male sexual disorder which is associated with substantial personal and interpersonal negative psychological consequences. Pharmacotherapy of PE with off-label antidepressant selective serotonin reuptake inhibitors (SSRIs) is common, effective and safe. Development and regulatory approval of drugs specifically for the treatment of PE will reduce reliance on off-label treatments and serve to fill an unmet treatment need. The objective of this article is to review evidence supporting the efficacy and safety of dapoxetine in the treatment of PE. MEDLINE, Web of Science, PICA, EMBASE and the proceedings of major international and regional scientific meetings were searched for publications or abstracts published during the period 1993–2012 that used the word ‘dapoxetine’ in the title, abstract or keywords. This search was then manually cross referenced for all papers. This review encompasses studies of dapoxetine pharmacokinetics, animal studies, human phase I, II and III studies, independent postmarketing and pharmacovigilance efficacy and safety studies and drug-interaction studies. Dapoxetine is a potent SSRI which is administered on demand 1–3 h prior to planned sexual contact. It is rapidly absorbed and eliminated, resulting in minimal accumulation, and has dose-proportional pharmacokinetics which are unaffected by multiple dosing. Dapoxetine 30 mg and 60 mg has been evaluated in five industry-sponsored randomized, double-blind, placebo-controlled studies in 6081 men aged at least 18 years. Outcome measures included stopwatch-measured intravaginal ejaculatory latency time (IELT), Premature Ejaculation Profile (PEP) inventory items, Clinical Global Impression of Change (CGIC) in PE, and adverse events. Mean IELT, all PEP items and CGIC improved significantly with both doses of dapoxetine versus placebo (all p <0.001). The most common treatment-related adverse effects included nausea (11.0% for 30 mg, 22.2% for 60 mg

Time Will Tell : Genetic Influences on Ejaculation Time

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Janssen, P.K.C.

2014-01-01

Lifelong premature ejaculation (PE) is a male sexual disorder characterized by persistent short ejaculation times of less than about 1 minute, in more than 90% of intercourses, with nearly every female partner, since the first sexual activities of a man in puberty or adolescence (Waldinger 2007). In

Diagnosis and Treatment of Premature Ejaculation by Urologists in South Korea

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Deok Ha Seo

2016-12-01

Full Text Available Purpose: This study discusses the treatment of premature ejaculation (PE using various approaches with the goal of evaluating the methods of diagnosis and treatment of PE in clinical practice in 2014 in South Korea. Materials and Methods: We surveyed 200 urologists and andrologists who treated patients with PE from July 1, 2014 to July 29, 2014 using an online questionnaire. The questionnaire was composed of 4 parts: disease, comorbidities, diagnosis, and treatment. Using the answers to this survey, current trends in the diagnosis and treatment of PE were investigated using weighted averages. Results: The median number per month of patients who were diagnosed with PE was 14 patients (interquartile range, 7∼24. The time to ejaculation necessary for a diagnosis of PE was considered to be ＜1 minute by 12% of respondents, ＜2 minutes by 27%, ＜3 minutes by 28%, ＜5 minutes by 13%, and 20% stated that diagnosis was based on a patient’s subjective complaint. The treatment methods preferred by PE patients were reported to be pharmacological treatment (87%, surgical treatment (9.5%, and behavioral management (3.5%. The treatment methods used by respondents were pharmacological treatment (77%, surgical treatment (15%, and behavioral management (14%. The most commonly used pharmacological treatment was the oral administration of dapoxetine (97%. Conclusions: In 2014 in South Korea, various methods were used to diagnose and treat PE. The most commonly used treatment for PE was the oral administration of dapoxetine. It was also found that surgical treatment was applied in some cases.

Practical tips for sexual counseling and psychotherapy in premature ejaculation.

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Rowland, David; Cooper, Stewart

2011-10-01

A number of milestones in the treatment of premature ejaculation (PE) have occurred over the past five decades, including the development of various behavioral and cognitive techniques as well as pharmacotherapies that modify neurophysiological processes involved in ejaculation. Nevertheless, the notion that sexual responses such as PE are influenced by physiological, psychobehavioral, cultural, and relationship factors is as valid now as it was 50 years ago, and therefore, interventions should consider all such domains in the development of effective treatment strategies. Provide an overview of which patients with PE are suitable to receive psychosexual treatment and the psychological approaches for managing this disorder. Review of the literature. Psychosexual treatments that integrate behavioral, psychological, and relationship functioning. PE is typically a couple's problem and, therefore, psychotherapy is best when the partner is involved. Before embarking on psychotherapy, the clinician should obtain a medical history pertaining to sexual-, psychological-, and relationship-related factors, so that the treatment strategy can be tailored to the needs of the individual. General strategies underpinning integrative, "process-oriented" elements of psychotherapy most relevant to PE are: developing the therapist-patient relationship; expressing empathy, genuineness, and positive regard; motivational interviewing, i.e., developing motivation to change; developing discrepancy; working through resistance; identifying PE-related affect, cognitions, and behaviors (including interaction with partners); and supporting self-efficacy. The four main domains that encompass psychotherapy techniques specific to the treatment of PE are: behavioral; cognitive; affective; and relational. Sustained positive outcomes in PE may be obtained using a combination treatment strategy that addresses all elements of PE, including psychological and biological factors. Psychosexual treatments

Complementary and Alternative Medicine for Management of Premature Ejaculation: A Systematic Review.

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Cooper, Katy; Martyn-St James, Marrissa; Kaltenthaler, Eva; Dickinson, Kath; Cantrell, Anna; Ren, Shijie; Wylie, Kevan; Frodsham, Leila; Hood, Catherine

2017-03-01

Premature ejaculation (PE) is defined as ejaculation within 1 minute (lifelong PE) or 3 minutes (acquired PE), inability to delay ejaculation, and negative personal consequences. Management includes behavioral and pharmacologic approaches. To systematically review effectiveness, safety, and robustness of evidence for complementary and alternative medicine in managing PE. Nine databases including Medline were searched through September 2015. Randomized controlled trials evaluating complementary and alternative medicine for PE were included. Studies were included if they reported on intravaginal ejaculatory latency time (IELT) and/or another validated PE measurement. Adverse effects were summarized. Ten randomized controlled trials were included. Two assessed acupuncture, five assessed Chinese herbal medicine, one assessed Ayurvedic herbal medicine, and two assessed topical "severance secret" cream. Risk of bias was unclear in all studies because of unclear allocation concealment or blinding, and only five studies reported stopwatch-measured IELT. Acupuncture slightly increased IELT over placebo in one study (mean difference [MD] = 0.55 minute, P = .001). In another study, Ayurvedic herbal medicine slightly increased IELT over placebo (MD = 0.80 minute, P = .001). Topical severance secret cream increased IELT over placebo in two studies (MD = 8.60 minutes, P medicine with selective serotonin reuptake inhibitors (SSRIs) favored SSRIs (MD = 1.01 minutes, P = .02). However, combination treatment with Chinese medicine plus SSRIs improved IELT over SSRIs alone (two studies; MD = 1.92 minutes, P medicine alone (two studies; MD = 2.52 minutes, P effects were not consistently assessed but where reported were generally mild. There is preliminary evidence for the effectiveness of acupuncture, Chinese herbal medicine, Ayurvedic herbal medicine, and topical severance secret cream in improving IELT and other outcomes. However, results are based on clinically

The 5-HT₁A receptor C(1019)G polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation.

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Janssen, Paddy K C; van Schaik, R; Zwinderman, Aeilko H; Olivier, Berend; Waldinger, Marcel D

2014-06-01

Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 min, and has been postulated as a neurobiological dysfunction related to diminished serotonergic neurotransmission with 5-HT₁A receptor hyperfunction and 5-HT₂C hypofunction. To investigate the relationship between 5-HT₁A receptor gene (HTR₁A)-C(1019)G promoter polymorphism and IELT in men with LPE. This polymorphism is known to increase 5-HT1A receptor expression. A prospective study was conducted in 54 Dutch Caucasian men with LPE. Baseline IELT during coitus was assessed by stopwatch over a 1-month period. All men were genotyped for HTR₁A gene polymorphism. Allele frequencies and genotypes of C and G variants of HTR₁A polymorphism were determined. Association between CC, CG, and GG genotypes and the IELT in men with LPE were investigated. IELT measured by stopwatch, HTR₁A polymorphism. In this cohort of men with LPE, the geometric mean IELT was 23.8 s. Of the 54 men, the CC, CG and GG genotype frequency for the C(1019)G polymorphism of the 5-HT₁A gene was 33%, 43% and 24%, respectively. The geometric mean IELT for the CC, CG and GG genotypes were 14.5, 27.7 and 36.0 s, respectively (p=0.019). Compared to GG and CG genotypes, men with CC genotype had a 250% and 190% shorter ejaculation time, respectively. HTR₁A gene polymorphism is associated with the IELT in men with LPE. Men with CC genotype have shorter IELTs than men with GG and CG genotypes. Copyright © 2014 Elsevier Inc. All rights reserved.

A combination of tryptophan, Satureja montana, Tribulus terrestris, Phyllanthus emblica extracts is able to improve sexual quality of life in patient with premature ejaculation

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Salvatore Sansalone

2016-10-01

Full Text Available Objective: The management of patient affected by premature ejaculation (PE is nowadays not highly satisfactory. Here, we aimed to evaluate the tolerability and efficacy of a combination of tryptophan, Satureja montana, Tribulus terrestris, Phyllanthus emblica extracts in order to improve sexual quality of life in patients with premature ejaculation. Materials and methods: All patients attending to 5 urological centers from January 2015 to March 2015, due to premature ejaculation were enrolled in this study. At the enrolment visit, all subjects underwent self-administered IIEF-5, Male Sexual Health Questionnaire-Ejaculation Disorder (MSHQEjD, PEDT and IELTS (calculated as mean from that perceived by partner and that perceived by patient and underwent urological visit and laboratory examinations. All patients received one tablet per day of a combination of tryptophan, Satureja montana, Tribulus terrestris, Phyllanthus emblica extracts for 3 months (Group A. After 3 months all patients underwent follow-up visit with the same investigations that have been carried out in the enrolment visit. The results were compared with a cohort of patients enrolled in the same period in another urological center and considered as a control group (Group B. All patients in the control group underwent counseling and sexual behavioral treatment without any pharmacological compound. Results: At the follow-up analysis, significant changes in terms of IELT in the Group A (mean difference: 31.90; p < 0.05 at 3 months and versus Group B at the intergroup analysis (mean difference: 30.30; p < 0.05 were reported. In the group A, significant differences from baseline to last follow- up were observed relative to IIEF-5 (mean difference: 1.04; p < 0.05, PEDT (mean difference: -2.57; p < 0.05 and FSH (mean difference: -16.46; p < 0.05. Conclusion: In conclusion, patients affected by PE may significantly benefit from oral therapy with a combination of tryptophan, Satureja montana

A combination of tryptophan, Satureja montana, Tribulus terrestris, Phyllanthus emblica extracts is able to improve sexual quality of life in patient with premature ejaculation.

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Sansalone, Salvatore; Russo, Giorgio Ivan; Mondaini, Nicola; Cantiello, Francesco; Antonini, Gabriele; Cai, Tommaso

2016-10-05

The management of patient affected by premature ejaculation (PE) is nowadays not highly satisfactory. Here, we aimed to evaluate the tolerability and efficacy of a combination of tryptophan, Satureja montana, Tribulus terrestris, Phyllanthus emblica extracts in order to improve sexual quality of life in patients with premature ejaculation. All patients attending to 5 urological centers from January 2015 to March 2015, due to premature ejaculation were enrolled in this study. At the enrolment visit, all subjects underwent self-administered IIEF-5, Male Sexual Health Questionnaire-Ejaculation Disorder (MSHQEjD), PEDT and IELTS (calculated as mean from that perceived by partner and that perceived by patient) and underwent urological visit and laboratory examinations. All patients received one tablet per day of a combination of tryptophan, Satureja montana, Tribulus terrestris, Phyllanthus emblica extracts for 3 months (Group A). After 3 months all patients underwent follow-up visit with the same investigations that have been carried out in the enrolment visit. The results were compared with a cohort of patients enrolled in the same period in another urological center and considered as a control group (Group B). All patients in the control group underwent counseling and sexual behavioral treatment without any pharmacological compound. At the follow-up analysis, significant changes in terms of IELT in the Group A (mean difference: 31.90; p < 0.05) at 3 months and versus Group B at the intergroup analysis (mean difference: 30.30; p < 0.05) were reported. In the group A, significant differences from baseline to last follow- up were observed relative to IIEF-5 (mean difference: 1.04; p < 0.05), PEDT (mean difference: -2.57; p < 0.05) and FSH (mean difference: -16.46; p < 0.05). In conclusion, patients affected by PE may significantly benefit from oral therapy with a combination of tryptophan, Satureja montana, Tribulus terrestris, Phyllanthus emblica extracts in terms of

Premature ejaculation: do we have effective therapy?

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Serefoglu, Ege Can; Saitz, Theodore R; Trost, Landon; Hellstrom, Wayne J G

2013-03-01

Premature ejaculation (PE) is the most common sexual dysfunction, with the majority of PE patients remaining undiagnosed and undertreated. Despite its prevalence, there is a current paucity of data regarding available treatment options and mechanisms. The objective of the current investigation is to review and summarize pertinent literature on therapeutic options for the treatment of PE, including behavioral/psychologic, oral pharmacotherapy, and surgery. A pubmed search was conducted on articles reporting data on available treatment options for PE. Articles describing potential mechanisms of action were additionally included for review. Preference was given towards randomized, controlled trials, when available. PE remains an underdiagnosed and undertreated disease process, with limited data available regarding potential underlying mechanisms and long-term outcomes of treatment options. Psychological/behavioral therapies, including the stop-start, squeeze, and pelvic floor rehabilitation techniques have demonstrated improvements in short-term series, with decreased efficacy with additional follow-up. Topical therapies, which are commonly utilized result in prolonged intravaginal ejaculatory latency time (IELT) at the expense of potential penile/vaginal Hypothesia. Oral therapies similarly demonstrate improved IELTs with variable side effect profiles and include selective serotonin reuptake inhibitors (daily or on demand), phosphodiesterase-5 inhibitors, alpha-1 adrenergic antagonists, and tramadol. Alternative therapies such as acupuncture have shown benefits in limited studies. Surgery is not commonly performed and is not recommended by available guidelines. PE is a common condition, with limited data available regarding its underlying pathophysiology and treatment. Available therapies include topical, oral, behavioral/psychologic modification, or a combination thereof. Additional research is required to assess the optimal treatment strategies and algorithms as

Level of Sexual Myths Level in Premature Ejaculation Cases

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Mehmet Gunes

2016-06-01

Full Text Available Objective: The aim of this study is to determine level of belief in sexual myths in the cases of premature ejacula­tion (PE which is the most common sexual dysfunction in men. Methods: This study included 100 cases who applied Di­cle University Faculty of Medicine hospitals meet prema­ture ejaculation criteria of DSM-5 and 70 healthy controls. Sociodemographic data form, Hamilton Depression Rat­ing Scale (HDS, Hamilton Anxiety Rating Scale (HAS, Arizona Sexual Experience Scale (ASES-Men form and Sexual Myths Evaluation Form were applied to partici­pants. Results: In the study, rate of belief in sexual myths in PE cases was found significantly higher than healthy controls. In the PE cases, education time less than 10 years, the presence of comorbid sexual dysfunction were found to be statistically significant factors that increase the level of belief in sexual myths in the PE cases, HDS (p=0.0002, HAS (p=0.0001, ASES (p=0.0004 scores were statisti­cally significantly higher than the control group. In the loss of sexual desire in men with comorbid ASES (p=0.0001, with ED, ASES (p=0.001 and HDS (p=0.040 scores were found statistically significantly higher. Conclusions: Sexual information should be given in the appropriate age by educated person in educational insti­tutions.

Biallelic and Triallelic 5-Hydroxytyramine Transporter Gene-Linked Polymorphic Region (5-HTTLPR) Polymorphisms and Their Relationship with Lifelong Premature Ejaculation: A Case-Control Study in a Chinese Population

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Huang, Yuanyuan; Zhang, Xiansheng; Gao, Jingjing; Tang, Dongdong; Gao, Pan; Li, Chao; Liu, Weiqun; Liang, Chaozhao

2016-01-01

Background This study aimed to explore the relationship between premature ejaculation (PE) and the serotonin transporter gene-linked polymorphic region (5-HTTLPR) with respect to the biallelic and triallelic classifications. Material/Methods A total of 115 outpatients who complained of ejaculating prematurely and who were diagnosed as having lifelong premature ejaculation (LPE) and 101 controls without PE complaint were recruited. All subjects completed a detailed questionnaire and were genotyped for 5-HTTLPR polymorphism using PCR-based technology. We evaluated the associations between 5-HTTLPR allelic and genotypic frequencies and their association with LPE, as well as the intravaginal ejaculation latency time (IELT) of different 5-HTTLPR genotypes among LPE patients. Results The patients and controls did not differ significantly in terms of any characteristic except age. The results showed no significant difference regarding biallelic 5-HTTLPR. According to the triallelic classification, no significant difference was found when comparing the genotypic distribution (P=0.091). However, the distribution of the S, LG, and LA alleles in the cases was significantly different from the controls (P=0.018). We found a significantly lower frequency of LA allele and higher frequency of LG allele in patients. Based on another classification by expression, we found a significantly lower frequency of the L’L’ genotype (OR=0.37; 95%CI=0.15–0.91, P=0.025) in patients with LPE. No significant association was detected between IELT of LPE and different genotypes. Conclusions Contrary to the general classification based on S/L alleles, triallelic 5-HTTLPR was associated with LPE. Triallelic 5-HTTLPR may be a promising field for genetic research in PE to avoid false-negative results in future studies. PMID:27311544

A meta-analysis of the effects of the 5-hydroxytryptamine transporter gene-linked promoter region polymorphism on susceptibility to lifelong premature ejaculation.

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Lijie Zhu

Full Text Available OBJECTIVE: Premature ejaculation (PE has been reported as the most common male sexual dysfunction with global prevalence rates estimated at approximately 30%. The neurobiogenesis of ejaculation is very complex and involves the serotoninergic (5-hydroxytryptamine, 5-HT system. Recently, genetic polymorphisms located on SLC6A4 gene codifying for 5-HT transporter (5-HTT, the major regulator of serotonic neurotransmission, have been linked with the pathogenesis and risk of PE. Apparently studies of this type of polymorphism in PE have show conflicting results. METHODS: A meta-analysis was performed that are available in relation with 5-HTT gene-linked promoter region (5-HTTLPR polymorphism and the risk of lifelong PE (LPE in men to clarify this relationship. We searched Pubmed and Embase (last search updated on Aug 2012 using 'premature ejaculation', 'polymorphism or variant', 'genotype', 'ejaculatory function', and 'rapid ejaculation' as keywords and reference lists of studies corresponded to the inclusion criteria for meta-analysis. These studies involved the total number of 481 LPE men and 466 health control men subjects. Odds ratio (OR and 95% confidence intervals (CIs were used to evaluate this relationship. RESULTS: In the overall analysis, significant associations between LPE risk and 5-HTTLPR polymorphism were found (L-allele vs. S-allele OR = 0.86, 95% CI = 0.79-0.95, P = 0.002; LL vs. SS: OR = 0.80, 95% CI = 0.68-0.95, P = 0.009; LS vs. SS: OR = 0.85, 95% CI = 0.76-0.97, P = 0.012 and LL+LS vs. SS: OR = 0.88, 95% CI = 0.81-0.95, P = 0.002. Moreover, in subgroup analysis based on ethnicity, similar significant associations were detected. The Egger's test did not reveal presence of a publication bias. CONCLUSIONS: Our investigations demonstrate that 5-HTTLPR (L>S polymorphism might protect men against LPE risk. Further studies based on larger sample size and gene-environment interactions should

The 5-HT2C receptor gene Cys23Ser polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation

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Paddy KC Janssen

2014-08-01

Full Text Available It has been postulated that the persistent short intravaginal ejaculation latency time (IELT of men with lifelong premature ejaculation (LPE is related to 5-hydroxytryptamine (HT2C receptor functioning. The aim of this study was to investigate the relationship of Cys23Ser 5-HT2C receptor gene polymorphism and the duration of IELT in men with LPE. Therefore, a prospective study was conducted in 64 Dutch Caucasian men with LPE. Baseline IELT during coitus was assessed by stopwatch over a 1-month period. All men were genotyped for Cys23Ser 5-HT2C receptor gene polymorphism. Allele frequencies and genotypes of Cys and Ser variants of 5-HT2C receptor gene polymorphism were determined. Association between Cys/Cys and Ser/Ser genotypes and the natural logarithm of the IELT in men with LPE were investigated. As a result, the geometric mean, median and natural mean IELT were 25.2, 27.0, 33.9 s, respectively. Of all men, 20.0%, 10.8%, 23.1% and 41.5% ejaculated within 10, 10-20, 20-30 and 30-60 s after vaginal penetration. Of the 64 men, the Cys/Cys and Ser/Ser genotype frequency for the Cys23Ser polymorphism of the 5-HT2C receptor gene was 81% and 19%, respectively. The geometric mean IELT of the wildtypes (Cys/Cys is significantly lower (22.6 s; 95% CI 18.3-27.8 s than in male homozygous mutants (Ser/Ser (40.4 s; 95% CI 20.3-80.4 s (P = 0.03. It is concluded that Cys23Ser 5-HT2C receptor gene polymorphism is associated with the IELT in men with LPE. Men with Cys/Cys genotype have shorter IELTs than men with Ser/Ser genotypes.

The 5-HT2C receptor gene Cys23Ser polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation.

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Janssen, Paddy Kc; Schaik, Ron van; Olivier, Berend; Waldinger, Marcel D

2014-01-01

It has been postulated that the persistent short intravaginal ejaculation latency time (IELT) of men with lifelong premature ejaculation (LPE) is related to 5-hydroxytryptamine (HT)2C receptor functioning. The aim of this study was to investigate the relationship of Cys23Ser 5-HT2C receptor gene polymorphism and the duration of IELT in men with LPE. Therefore, a prospective study was conducted in 64 Dutch Caucasian men with LPE. Baseline IELT during coitus was assessed by stopwatch over a 1-month period. All men were genotyped for Cys23Ser 5-HT2C receptor gene polymorphism. Allele frequencies and genotypes of Cys and Ser variants of 5-HT2C receptor gene polymorphism were determined. Association between Cys/Cys and Ser/Ser genotypes and the natural logarithm of the IELT in men with LPE were investigated. As a result, the geometric mean, median and natural mean IELT were 25.2, 27.0, 33.9 s, respectively. Of all men, 20.0%, 10.8%, 23.1% and 41.5% ejaculated within 10, 10-20, 20-30 and 30-60 s after vaginal penetration. Of the 64 men, the Cys/Cys and Ser/Ser genotype frequency for the Cys23Ser polymorphism of the 5-HT2C receptor gene was 81% and 19%, respectively. The geometric mean IELT of the wildtypes (Cys/Cys) is significantly lower (22.6 s; 95% CI 18.3-27.8 s) than in male homozygous mutants (Ser/Ser) (40.4 s; 95% CI 20.3-80.4 s) (P = 0.03). It is concluded that Cys23Ser 5-HT2C receptor gene polymorphism is associated with the IELT in men with LPE. Men with Cys/Cys genotype have shorter IELTs than men with Ser/Ser genotypes.

Association of STin2 VNTR Polymorphism of Serotonin Transporter Gene with Lifelong Premature Ejaculation: A Case-Control Study in Han Chinese Subjects.

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Huang, Yuanyuan; Zhang, Xiansheng; Gao, Jingjing; Tang, Dongdong; Gao, Pan; Peng, Dangwei; Liang, Chaozhao

2016-10-07

BACKGROUND The STin2 VNTR polymorphism has a variable number of tandem repeats in intron 2 of the serotonin transporter gene. We aimed to explore the relationship between STin2 VNTR polymorphism and lifelong premature ejaculation (LPE). MATERIAL AND METHODS We recruited a total of 115 outpatients who complained of ejaculating prematurely and who were diagnosed as LPE, and 101 controls without PE complaint. Allelic variations of STin2 VNTR were genotyped using PCR-based technology. We evaluated the associations between STin2 VNTR allelic and genotypic frequencies and LPE, as well as the intravaginal ejaculation latency time (IELT) of different STin2 VNTR genotypes among LPE patients. RESULTS The patients and controls did not differ significantly in terms of any characteristic except age. A significantly higher frequency of STin2.12/12 genotype was found among LPE patients versus controls (P=0.026). Frequency of patients carrying at least 1 copy of the 10-repeat allele was significantly lower compared to the control group (28.3% vs. 41.8%, OR=0.55; 95%CI=0.31-0.97, P=0.040). In the LPE group, the mean IELT showed significant difference in STin2.12/12 genotype when compared to those with STin2.12/10 and STin2.10/10 genotypes. The mean IELT in10-repeat allele carriers was 50% longer compared to homozygous carriers of the STin2.12 allele. CONCLUSIONS Our results indicate the presence of STin2.10 allele is a protective factor for LPE. Men carrying the higher expression genotype STin2. 12/12 have shorter IELT than 10-repeat allele carriers.

The mathematical formula of the intravaginal ejaculation latency time (IELT distribution of lifelong premature ejaculation differs from the IELT distribution formula of men in the general male population

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Paddy K.C. Janssen

2016-03-01

Full Text Available Purpose: To find the most accurate mathematical description of the intravaginal ejaculation latency time (IELT distribution in the general male population. Materials and Methods: We compared the fitness of various well-known mathematical distributions with the IELT distribution of two previously published stopwatch studies of the Caucasian general male population and a stopwatch study of Dutch Caucasian men with lifelong premature ejaculation (PE. The accuracy of fitness is expressed by the Goodness of Fit (GOF. The smaller the GOF, the more accurate is the fitness. Results: The 3 IELT distributions are gamma distributions, but the IELT distribution of lifelong PE is another gamma distribution than the IELT distribution of men in the general male population. The Lognormal distribution of the gamma distributions most accurately fits the IELT distribution of 965 men in the general population, with a GOF of 0.057. The Gumbel Max distribution most accurately fits the IELT distribution of 110 men with lifelong PE with a GOF of 0.179. There are more men with lifelong PE ejaculating within 30 and 60 seconds than can be extrapolated from the probability density curve of the Lognormal IELT distribution of men in the general population. Conclusions: Men with lifelong PE have a distinct IELT distribution, e.g., a Gumbel Max IELT distribution, that can only be retrieved from the general male population Lognormal IELT distribution when thousands of men would participate in a IELT stopwatch study. The mathematical formula of the Lognormal IELT distribution is useful for epidemiological research of the IELT.

The mathematical formula of the intravaginal ejaculation latency time (IELT) distribution of lifelong premature ejaculation differs from the IELT distribution formula of men in the general male population

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Janssen, Paddy K.C.

2016-01-01

Purpose To find the most accurate mathematical description of the intravaginal ejaculation latency time (IELT) distribution in the general male population. Materials and Methods We compared the fitness of various well-known mathematical distributions with the IELT distribution of two previously published stopwatch studies of the Caucasian general male population and a stopwatch study of Dutch Caucasian men with lifelong premature ejaculation (PE). The accuracy of fitness is expressed by the Goodness of Fit (GOF). The smaller the GOF, the more accurate is the fitness. Results The 3 IELT distributions are gamma distributions, but the IELT distribution of lifelong PE is another gamma distribution than the IELT distribution of men in the general male population. The Lognormal distribution of the gamma distributions most accurately fits the IELT distribution of 965 men in the general population, with a GOF of 0.057. The Gumbel Max distribution most accurately fits the IELT distribution of 110 men with lifelong PE with a GOF of 0.179. There are more men with lifelong PE ejaculating within 30 and 60 seconds than can be extrapolated from the probability density curve of the Lognormal IELT distribution of men in the general population. Conclusions Men with lifelong PE have a distinct IELT distribution, e.g., a Gumbel Max IELT distribution, that can only be retrieved from the general male population Lognormal IELT distribution when thousands of men would participate in a IELT stopwatch study. The mathematical formula of the Lognormal IELT distribution is useful for epidemiological research of the IELT. PMID:26981594

Delayed Ejaculation and Associated Complaints: Relationship to Ejaculation Times and Serum Testosterone Levels.

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Morgentaler, Abraham; Polzer, Paula; Althof, Stanley; Bolyakov, Alexander; Donatucci, Craig; Ni, Xiao; Patel, Ankur B; Basaria, Shehzad

2017-09-01

Although delayed ejaculation (DE) is typically characterized as a persistently longer than anticipated or desired time to ejaculation (or orgasm) during sexual activity, a timing-based definition of DE and its association with serum testosterone has not been established in a large cohort. To examine in an observational study estimated intravaginal ejaculatory latency time (IELT) and masturbatory ejaculation latency time (MELT) in men self-reporting DE, assess the association of IELT and MELT with serum testosterone levels, and determine whether correlation with demographic and sexual parameters exist. Men who resided in the United States, Canada, and Mexico were enrolled from 2011 to 2013. Self-estimated IELT and MELT were captured using an Ejaculatory Function Screening Questionnaire in a sample of 988 men screened for possible inclusion in a randomized clinical trial assessing testosterone replacement therapy for ejaculatory dysfunction (EjD) and who self-reported the presence or absence of DE and symptoms of hypogonadism. Additional comorbid EjDs (ie, anejaculation, perceived decrease in ejaculate volume, and decreased force of ejaculation) were recorded. Men with premature ejaculation were excluded from this analysis. IELT and MELT were compared between men self-reporting DE and men without DE. The associations of IELT and MELT with serum testosterone were measured. IELT, MELT, and total testosterone levels. Sixty-two percent of screened men self-reported DE with or without comorbid EjDs; 38% did not report DE but did report at least one of the other EjDs. Estimated median IELTs were 20.0 minutes for DE vs 15 minutes for no DE (P IELTs and MELTs. Estimated ejaculation times during vaginal intercourse and/or masturbation were not associated with serum testosterone levels in this study; thus, routine androgen evaluation is not indicated in these men. This large systematic analysis attempted to objectively assess the ejaculation latency in men with self

Ancient Chinese Fangzhongshu (Sexual Skills and Methods Therapy for Premature Ejaculation

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Yong Zhu

2016-12-01

Full Text Available Premature ejaculation (PE is a common male sexual dysfunction that can have significant effects on a couple’s relationship. Behavioral therapy and psychotherapy are both safe and effective methods of treating PE. Ancient Chinese fangzhongshu (sexual skills and methods, which reflects a summary of expert experiences in sexology, contains many therapies for sexual dysfunction that are similar to those used in behavioral therapy or psychotherapy. A brief introduction dealing with the latest definitions of PE and treatment strategies drawn from behavioral therapy and psychotherapy is provided. Typical therapies for PE from ancient Chinese fangzhongshu are listed and briefly analyzed in order to define their domain of applicability and instructions for use. Ancient Chinese fangzhongshu contains many effective and safe therapies for PE. It should be incorporated into modern medical practice after critical analysis, and its scientific aspects should be promoted as a way of improving reproductive health, both to benefit individuals affected by PE and to promote traditional Chinese culture. Based on an analysis of the condition of the individual patient, one or multiple therapies guided by fangzhongshu can be expected to have an effect on the patient. Ancient Chinese fangzhongshu is of great value and should to be popularized and applied as a remedy for PE.

A case report of over-the-counter codeine dependence as consequence of self-medication for premature ejaculation

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Sethulakshmi Sreevalsam Anil

2017-01-01

Full Text Available Over-the-counter (OTC opioid abuse, including codeine, has been a growing problem around the world. Although the majority of the abusers use it for recreational purposes, many become dependent on it after having used it a medication for pain or cough. We present a case of codeine dependence where the initial prescribed use had been as a cough medication, but the subsequent abuse of it occurred the following self-medication for premature ejaculation. There is growing need for awareness among doctors and pharmacists of OTC abuse of opioids and for preventive interventions such as restricting supply, audit of pharmacies, training pharmacists, and counter staff and dispensing knowledge about proper use of opioid-containing medications to patients.

Neyrodoz in the treatment of secondary premature ejaculation in patients with chronic prostatitis

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I. V. Vinogradov

2015-01-01

Full Text Available Premature ejaculation (PE is the type of sexual dysfunction, which is characterized by constant or nearly constant uncontrolled ejaculation before vaginal penentration or within minutes of the start of sexual intercourse, that causing a feeling of sexual dissatisfaction and leading to sexual frustration among the partners. It has been shown that the antimicrobial and antiinflammatory therapy of chronic prostatitis (CP increases the duration of sexual intercourse and improves the control over the ejaculation. PE in the patients with CP may be an independent sexual disorder that may require a specific correction. Antidepressants are the first line of drugs in the treatment of PE according to the recommendations of the European Association of Urology. However, some patients refuse to intake this medicine. The aim of our study was to evaluate the clinical efficacy and safety of Neyrodoz in the treatment of PE in patients with CP.Materials and methods. The study included 32 patients (mean age 37.5 years who have had complains on PE after the treatment of CP. All the patients were randomly selected into two groups. 1st – basic group (n = 15 and 2nd – control group (n = 17.The first group patients intook Neyrodoz 2 capsules twice a day. The second group got placebo in the same dose during 30 days.Results. The time of intravaginal latency increased from 40,8 ± 9,9 (25–56 to180,1± 41,2 (120–240 seconds in patients of the 1st group after the therapy. The score of tool-PEDT decreased from 15,8 ± 3,1 (11–20 to 3,9 ± 2,9 (0–8. The visual analogue scale (VAS symptoms improved from 8,6 ± 1,4 (6–10 to 2,5 ± 2,1 (0–5. The time of intravaginal latency increased from 38,4 ± 10,0 (25–59 to 40,7 ± 7,4 (35–59 seconds in 14 of 17 men in the second group of patients. The score of tool-PEDT decreased from 15,6 ± 2,8 (11–20 to 14,3 ± 2,7 (12–19. The VAS symptoms improved from 8,9 ± 1,3 (6–10 to 8,5 ± 1,7 (6–10.Conclusions

The global online sexuality survey (GOSS): The United States of America in 2011 Chapter III--Premature ejaculation among English-speaking male Internet users.

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Shaeer, Osama

2013-07-01

The Global Online Sexuality Survey (GOSS) is a worldwide epidemiologic study of sexuality and sexual disorders. In 2010, the first report of GOSS came from the Middle East. This report studies the prevalence rate of premature ejaculation (PE) in the U.S. as of 2011-2012 and evaluates risk factors for PE. GOSS was randomly deployed to English-speaking male web surfers in the USA via paid advertising on Facebook®, comprising 146 questions. Prevalence of PE as per the International Society of Sexual Medicine's (ISSM) definition. With a mean age of 52.38 years ± 14.5, 1,133 participants reported on sexual function. As per the ISSM definition of PE, the prevalence rate of PE in the USA as of 2011 was 6.3%. This is in contrast to 49.6% as per the Premature Ejaculation Diagnostic Tool (PEDT), 77.6% as per unfiltered subjective reports, and 14.4% as per subjective reporting on more consistent basis. 56.3% of the latter reported lifelong PE. 63.2% could be classified as having natural variable PE. Erectile dysfunction is a possible predisposing factor for acquired PE, while genital size concerns may predispose to lifelong PE. Age, irregular coitus, circumcision, and the practice of masturbation did not pose a risk for PE, among other risk factors. Oral treatment for PE was more frequently used and reported to be more effective than local anesthetics, particularly in those with lifelong PE. Applying the ISSM definition, prevalence of PE is far less than diagnosed by other methods, 6.3% among Internet users in USA as of the year 2011. PEDT measures both lifelong and acquired PE, in addition to 35% men with premature-like ejaculatory dysfunction, making it inaccurate for isolating lifelong and acquired PE cases. © 2013 International Society for Sexual Medicine.

Safety and efficacy of vardenafil versus sertraline in the treatment of premature ejaculation: a randomised, prospective and crossover study.

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Mathers, M J; Klotz, T; Roth, S; Lümmen, G; Sommer, F

2009-06-01

We investigated safety and efficacy of vardenafil and sertraline in premature ejaculation (PE). Seventy-two men graded their primary PE on a scale of 0-8 (0 = almost never, 8 = almost always). Intravaginal ejaculatory latency time (IELT) was measured. Patients were included if they scored their PE as 4 or greater and their IELTs were less than 1.30 min. After 6 weeks of behavioural psychosexual therapy, 49 patients still had a PE of 4 or greater and an IELT less than 1.30 min and they were randomised: 6 weeks vardenafil (10 mg) or sertraline (50 mg). After a wash-out phase for 1 week, medication was changed in a cross-over design. Initially, all 72 men with PE received behavioural therapy. Twenty-three men were satisfied with treatment and excluded. The remaining 49 men graded their PE as 5.94 +/- 1.6 and IELT was 0.59 min and patients were randomised. Four men discontinued the study. Vardenafil improved PE grading: 2.7 +/- 2.1 (P IELT increased to 5.01 +/- 3.69 (P IELT 3.12 +/- 1.89 (P < 0.001) with sertraline. It is concluded that vardenafil and sertraline are useful agents in the pharmacological treatment of PE.

Geometric mean IELT and premature ejaculation: appropriate statistics to avoid overestimation of treatment efficacy.

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Waldinger, Marcel D; Zwinderman, Aeilko H; Olivier, Berend; Schweitzer, Dave H

2008-02-01

The intravaginal ejaculation latency time (IELT) behaves in a skewed manner and needs the appropriate statistics for correct interpretation of treatment results. To explain the rightful use of geometrical mean IELT values and the fold increase of the geometric mean IELT because of the positively skewed IELT distribution. Linking theoretical arguments to the outcome of several selective serotonin reuptake inhibitor and modern antidepressant study results. Geometric mean IELT and fold increase of geometrical mean IELT. Log-transforming each separate IELT measurement of each individual man is the basis for the calculation of the geometric mean IELT. A drug-induced positively skewed IELT distribution necessitates the calculation of the geometric mean IELTs at baseline and during drug treatment. In a positively skewed IELT distribution, the use of the "arithmetic" mean IELT risks an overestimation of the drug-induced ejaculation delay as the mean IELT is always higher than the geometric mean IELT. Strong ejaculation-delaying drugs give rise to a strong positively skewed IELT distribution, whereas weak ejaculation-delaying drugs give rise to (much) less skewed IELT distributions. Ejaculation delay is expressed in fold increase of the geometric mean IELT. Drug-induced ejaculatory performance discloses a positively skewed IELT distribution, requiring the use of the geometric mean IELT and the fold increase of the geometric mean IELT.

Association of STin2 Variable Number of Tandem Repeat (VNTR) Polymorphism of Serotonin Transporter Gene with Lifelong Premature Ejaculation: A Case-Control Study in Han Chinese Subjects

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Huang, Yuanyuan; Zhang, Xiansheng; Gao, Jingjing; Tang, Dongdong; Gao, Pan; Peng, Dangwei; Liang, Chaozhao

2016-01-01

Background The STin2 VNTR polymorphism has a variable number of tandem repeats in intron 2 of the serotonin transporter gene. We aimed to explore the relationship between STin2 VNTR polymorphism and lifelong premature ejaculation (LPE). Material/Methods We recruited a total of 115 outpatients who complained of ejaculating prematurely and who were diagnosed as LPE, and 101 controls without PE complaint. Allelic variations of STin2 VNTR were genotyped using PCR-based technology. We evaluated the associations between STin2 VNTR allelic and genotypic frequencies and LPE, as well as the intravaginal ejaculation latency time (IELT) of different STin2 VNTR genotypes among LPE patients. Results The patients and controls did not differ significantly in terms of any characteristic except age. A significantly higher frequency of STin2.12/12 genotype was found among LPE patients versus controls (P=0.026). Frequency of patients carrying at least 1 copy of the 10-repeat allele was significantly lower compared to the control group (28.3% vs. 41.8%, OR=0.55; 95%CI=0.31–0.97, P=0.040). In the LPE group, the mean IELT showed significant difference in STin2.12/12 genotype when compared to those with STin2.12/10 and STin2.10/10 genotypes. The mean IELT in10-repeat allele carriers was 50% longer compared to homozygous carriers of the STin2.12 allele. Conclusions Our results indicate the presence of STin2.10 allele is a protective factor for LPE. Men carrying the higher expression genotype STin2. 12/12 have shorter IELT than 10-repeat allele carriers. PMID:27713390

Tradução e adaptação cultural do Index of Premature Ejaculation (IPE para o português do Brasil Traducción y adaptación cultural del Index of Premature Ejaculation (IPE al portugués de Brasil Translation and cultural adaptation of the Index of Premature Ejaculation (IPE to Brazilian Portuguese

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Ítor Finotelli Júnior

2012-12-01

Full Text Available O presente estudo traduziu e adaptou o Index of Premature Ejaculation (IPE para o português do Brasil, por método de equivalência semântica. O IPE é uma escala em autorrelato composta por 10 itens que avaliam critérios como senso de controle, satisfação sexual e sofrimento. Compuseram esse processo 11 profissionais qualificados para tal método e uma amostra de 50 participantes para avaliação quanto à inteligibilidade. As etapas foram: tradução, retrotradução, avaliação da equivalência semântica, crítica final por especialistas e pré-teste da versão. Os resultados para avaliação da equivalência apresentaram concordância significativa entre os juízes. Essa avaliação classificou os itens como inalterados ou pouco alterados. A crítica final por especialista avaliou qualitativamente as divergências e consolidou a versão aplicada na amostra. Após essa aplicação, algumas sugestões foram incorporadas e constituíram a versão final. Os resultados foram satisfatórios na compreensão da linguagem empregada. Para essa versão, conservou-se o nome em inglês, acrescido ao final de "adaptação brasileira".El presente estudio tradujo y adaptó el Index of Premature Ejaculation (IPE para el portugués de Brasil, por método de equivalencia semántica. El IPE es una escala de autoinforme compuesta por 10 ítems que evalúan criterios como sentido de control, satisfacción sexual y sufrimiento. Participaron de ese proceso 11 profesionales calificados para tal método y una muestra de 50 participantes para evaluación con referencia a la inteligibilidad. Las etapas fueron traducción, retrotraducción, evaluación de la equivalencia semántica, crítica final por expertos y pretest de la versión. Los resultados para la evaluación de la equivalencia presentaron concordancia significativa entre los jueces. Esa evaluación clasificó los ítems como inalterados o poco alterados. La crítica final por expertos evalu

Effects of Tadalafil 5 mg Dosed Once Daily in Men with Premature Ejaculation.

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Ozcan, Levent; Polat, Emre Can; Onen, Efe; Kocaaslan, Ramazan; Otunctemur, Alper; Cekmen, Mustafa; Eraldemir, Ceyla; Ozbek, Emin

2017-01-01

In this study, we evaluated the effect of 5 mg tadalafil once daily in men with premature ejaculation (PE). Thirty married men with lifelong PE and 30 healthy men as control group were included in this study. All the patients received 5 mg tadalafil once a day for a month. The international index of erectile function questionnaire and intravaginal ejaculatory latency times (IELTs) and PE profile were recorded before and after treatment. Plasma samples were collected before and after treatment. The mean baseline IELTs was 40.8 ± 8.1 s in the PE group and 196.5 ± 26.2 s in the control group. After treatment in the PE group, the mean IELTs values showed a statistically significant improvement from the baseline values. At the end of 4 weeks, in the PE group, the mean IELT values showed a statistically significant improvement from the baseline values. Baseline serum nitric oxide (NO) levels were 27.3 ± 1.7 in the PE group and in the 31.1 ± 1.4 healthy control groups. After treatment, NO levels were increased from baseline. We consider that 5 mg tadalafil once daily is safety and effective for the treatment of PE. © 2016 S. Karger AG, Basel.

Role of Frenular Web Preservation on Ejaculation Latency Time

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Alborz Salavati

2012-10-01

Full Text Available Premature ejaculation (PE is one of prevalent male sexual dysfunctions worldwide. Despite many psychiatric backgrounds, yet there are speculations about organic etiologies considering both anatomic and physiologic points of view. This survey assesses effect of frenular web preservation on premature ejaculation. One thousand and forty otherwise healthy men being visited for urolithiasis (asymptomatic patients were asked for PE according to the International Society of Sexual Medicine definition criteria as intravaginal ejaculation latency time (IELT less than a minute according to stop watch checked by patients' partner and were examined for presence of frenular web. Frenular web defined as a residual of frenulum after a circumcision. Overall prevalence of PE was 18.2% (n=102. We found the presence of frenulum at physical examination in 255 out of 560 (45.5%. Prevalence of PE was 20.7% (n=53 and 16% (n=49 in patients with frenular web preserved and without it, respectively. PE was higher among the men with frenulum preserved; but no statistically significant differences were seen (P=0.70. We did not find any relationship between frenular web and PE, and concerns about this, during circumcision, may not be justified. PE is a not only a problem of local anatomical condition but many psychological and neurological factors could interact with it.

Turkish validation of the premature ejaculation diagnostic tool and its association with intravaginal ejaculatory latency time.

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Serefoglu, E C; Cimen, H I; Ozdemir, A T; Symonds, T; Berktas, M; Balbay, M D

2009-01-01

There are uncertain issues on the diagnostic methods of premature ejaculation (PE). The premature ejaculation diagnostic tool (PEDT) was developed to systematically apply the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria in diagnosing PE and the aim of this study is to carry out the Turkish validation of the PEDT and to evaluate its association with intravaginal ejaculatory latency time (IELT). A total of 94 patients with a self-reported complaint of PE and 88 men without PE were enrolled into the study and requested to complete the nine-item PEDT, which was translated into Turkish. The patients were also requested to measure IELT. All participants were requested to come for a second visit to assess the PEDT's retest reliability; data from 78 men in the PE group and 69 men in the control group were collected. The IELT data of 35 patients were also recorded. The mean age of the PE group and the control group were 39.4+/-9.7 (24-65) and 30.1+/-5.7 (20-56), respectively, (P=0.068). Among the patients in the PE group, 24 (68.5%) reported life-long PE, whereas 11 (31.5%) reported acquired PE. The geometric mean IELT of the PE group was 59.7+/-46.2 (6.5-197.7) s. The number of men reporting IELTs of 2 min were 20 (57.1%), 11 (31.5) and 4 (11.4%), respectively. The factor analysis assessment showed that the five-item combination (questions 1, 2, 3, 4 and 8) explained 74.4% of the variance, there were no other combinations that explained the variance more effectively. Cronbach's alpha score of five-item combination was calculated as 0.77, showing adequate internal consistency. The overall Cronbach's alpha score did not increase if any item combination was deleted. The test-retest correlation coefficients of each item were higher than 0.80 and the correlation coefficient of the total score was 0.90. The PEDT and IELT showed an adequate correlation (rho=0.44). As a conclusion, the validated five-item Turkish version of PEDT is a

Dapoxetine for the treatment of premature ejaculation: results from a randomized, double-blind, placebo-controlled phase 3 trial in 22 countries.

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Buvat, Jacques; Tesfaye, Fisseha; Rothman, Margaret; Rivas, David A; Giuliano, François

2009-04-01

Dapoxetine is being developed for the on-demand treatment of premature ejaculation (PE). Previous clinical trials have demonstrated its safety and efficacy. To evaluate the long-term efficacy and safety of dapoxetine in men with PE. This randomized, double-blind, parallel-group, placebo-controlled, phase 3 trial, conducted in 22 countries, enrolled men (N=1162) > or = 18 yr of age who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision criteria for PE for > or = 6 mo, with an intravaginal ejaculatory latency time (IELT) or = 75% of intercourse episodes at baseline. Dapoxetine 30 mg or dapoxetine 60 mg or placebo on demand (1-3 h before intercourse) for 24 wk. Stopwatch-measured IELT, Premature Ejaculation Profile (PEP), Clinical Global Impression (CGI) of change, adverse events (AEs). The study was completed by 618 men. Mean average IELT increased from 0.9 min at baseline (all groups) to 1.9 min, 3.2 min, and 3.5 min with placebo and dapoxetine 30 mg and dapoxetine 60 mg, respectively, at study end point; geometric mean IELT increased from 0.7 min at baseline to 1.1 min, 1.8 min, and 2.3 min, respectively, at study end point. All PEP measures and IELTs improved significantly with dapoxetine versus placebo at week 12 and week 24 (p<0.001 for all). The most common AEs were nausea, dizziness, diarrhea, and headache. AEs led to discontinuation in 1.3%, 3.9%, and 8.2% of subjects with placebo and dapoxetine 30 mg and dapoxetine 60 mg, respectively. Limitations of this study included the exclusion of men who were not in long-term monogamous relationships. Dapoxetine significantly improved all aspects of PE and was generally well tolerated in this broad population.

An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE

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Stanley E. Althof, PhD

2014-06-01

Conclusion: Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual dysfunction. We again recommend that these guidelines be reevaluated and updated by the ISSM in 4 years. Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, Becher E, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE. Sex Med 2014;2:60–90.

The use of old and recent DSM definitions of premature ejaculation in observational studies: a contribution to the present debate for a new classification of PE in the DSM-V.

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Waldinger, Marcel D; Schweitzer, Dave H

2008-05-01

The DSM-III definition of premature ejaculation (PE) contains the criterion "control" but not that of "ejaculation time." In contrast, the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) (DSM-IV-TR) contains the criterion "short ejaculation time," while it lacks "control." To review the adequacy and consequent use of all criteria of the DSM-IV-TR definition in previously published PE Internet surveys. Reviewing all published cohort studies on PE from 2004 to 2007. MEDLINE and EMBASE computer bibliographies were used. Definitions of DSM-III, DSM-IV-TR, and International Classification of Diseases. Five papers, of which three are original studies, reported inclusion of men with PE according to DSM-IV-TR definition but omitted to apply the required "short ejaculation time" criterion. These studies, which have defined PE according to subjective criteria such as control, actually referred to the DSM-III definition. Using DSM-III-like definitions in three different studies revealed a highly variable prevalence of PE (32.5%, 27.6%, and 13.0%). In contrast, based on studies using a 1-minute cutoff point, being the time that is required to call ejaculation time "short" or using the criterion "persistent occurrence," PE revealed to be far less prevalent (5-6%). Unacceptable discrepancies of PE definitions according to DSM-III (abandoned but still used) and DSM-IV-TR argue strongly in favor of a multidimensional new classification of PE for the DSM-V.

An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE)

DEFF Research Database (Denmark)

Althof, Stanley E; McMahon, Chris G; Waldinger, Marcel D

2014-01-01

INTRODUCTION: In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient...... for the diagnosis and treatment of PE for family practice clinicians as well as sexual medicine experts. METHOD: A comprehensive literature review was performed. RESULTS: This article contains the report of the second ISSM PE Guidelines Committee. It offers a new unified definition of PE and updates the previous...... of their patients. CONCLUSION: Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual...

Standard operating procedures in the disorders of orgasm and ejaculation.

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McMahon, Chris G; Jannini, Emmanuele; Waldinger, Marcel; Rowland, David

2013-01-01

Ejaculatory/orgasmic disorders are common male sexual dysfunctions and include premature ejaculation (PE), inhibited ejaculation, anejaculation, retrograde ejaculation, and anorgasmia. To provide recommendations and guidelines of the current state-of-the-art knowledge for management of ejaculation/orgasmic disorders in men as standard operating procedures (SOPs) for the treating health care professional. The International Society of Sexual Medicine Standards Committee assembled over 30 multidisciplinary experts to establish SOPs for various male and female sexual medicine topics. The SOP for the management of disorders of orgasm and ejaculation represents the opinion of four experts from four countries developed in a process over a 2-year period. Expert opinion was based on grading of evidence-based medical literature, limited expert opinion, widespread internal committee discussion, public presentation, and debate. PE management is largely dependent upon etiology. Lifelong PE is best managed with PE pharmacotherapy (selective serotonin reuptake inhibitors and/or topical anesthetics). The management of acquired PE is etiology specific and may include erectile dysfunction (ED) pharmacotherapy in men with comorbid ED. All men seeking treatment for PE should receive basic psychosexual education. Graded behavioral therapy is indicated when psychogenic or relationship factors are present and is often best combined with PE pharmacotherapy in an integrated treatment program. Delayed ejaculation, anejaculation, and/or anorgasmia may have a biogenic and/or psychogenic etiology. Men with age-related penile hypoanesthesia should be educated, reassured, and instructed in revised sexual techniques which maximize arousal. Retrograde ejaculation is managed by education, patient reassurance, and pharmacotherapy. Additional research is required to further the understanding of the disorders of ejaculation and orgasm. © 2012 International Society for Sexual Medicine.

Cross-cultural differences in women's sexuality and their perception and impact of premature ejaculation.

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Burri, Andrea; Graziottin, Alessandra

2015-01-01

To assess the cross-cultural differences in women's perception of premature ejaculation (PE). A total of 1463 sexually active women from 3 different countries—Mexico, South Korea, and Italy—reporting being or having been in a relationship with a man who suffers from PE were included in the study. A mix of self-constructed questions and questions taken from validated instruments were used, including the Female Sexual Function Index, the Female Sexual Distress Scale, and the Relationship Assessment Scale. Significant differences in importance of ejaculatory control and the degree of distress caused by PE were detected between the 3 countries (P < .001 for both). Lack of control was the most commonly reported reason for distress for Mexico, short latency for Italy, and lack of control for South Korea. Mexico reported the highest rates of previous relationship breakups due to PE (28.9%), whereas Italian women reported the lowest relationship satisfaction and South Korean women the highest. It is important to get a better understanding of which sexual issues are important for individuals across different cultures, and whether the same aspects of the problem are considered distressing. This can have implications on nosology, on types of treatments offered, and hence, the likelihood of their efficiency when a couple's sexual perspective is carefully considered. Copyright © 2015 Elsevier Inc. All rights reserved.

The premature ejaculation diagnostic tool (PEDT): linguistic validity of the Chinese version.

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Huang, Yan-Ping; Chen, Bin; Ping, Ping; Wang, Hong-Xiang; Hu, Kai; Zhang, Tao; Yang, Hao; Jin, Yan; Yang, Qi; Huang, Yi-Ran

2014-09-01

The premature ejaculation diagnostic tool (PEDT) was developed to standardize the diagnosis of PE and has been applied in many countries. However, a linguistic validation of the Chinese version of PEDT does not exist. This study aims to undertake the Chinese validation of the PEDT and to evaluate its association with self-estimated intravaginal ejaculatory latency time (IELT) and clinical expert diagnosis of PE. A Chinese version of PEDT was confirmed by andrologist and bilingual linguist. Participants were recruited among seven different communities of Shanghai from 2011 to 2012, and their information regarding self-reported PE, self-estimated IELT, expert diagnosis of PE, and PEDT scores were collected. Validity of the PEDT and its association with clinical expert diagnosis of PE and self-estimated IELT were analyzed. A total of 143 patients without PE (mean age 55.11 ± 7.65 years) and 100 men with PE (mean age 53.07 ± 8.08 years) were enrolled for validation. Of the patients in PE group, the number of men reporting self-estimated IELTs of ≤1, 1-2, and >2 minutes were 34 (34.0%), 22 (22.0%), and 44 (44.0%), respectively. The Cronbach's alpha score (α = 0.77) showed adequate internal consistency, and the test-retest correlation coefficients of each item (r ≥ 0.70, P IELT (ρ = -0.396, P IELT ≤1 minute). The Chinese version of PEDT is valid in screening the presence of PE among Chinese men. The PEDT showed an adequate negative correlation with self-estimated IELT and an excellent concordance with clinician diagnosis of PE. © 2014 International Society for Sexual Medicine.

Self-reported premature ejaculation prevalence and characteristics in Korean young males: community-based data from an internet survey.

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Son, Hwancheol; Song, Sang Hoon; Kim, Soo Woong; Paick, Jae-Seung

2010-01-01

Premature ejaculation (PE) is suspected to be the most prevalent male sexual complaint, and the prevalence of PE is considerably high also in the younger generation. We investigated the PE prevalence based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed text revision; DSM-IV-TR) definition and the risk factors of PE in Korean young men via Internet survey. Subjects (n = 3980) aged from 20 to 59, who performed sexual intercourse more than once a month during the past 6 months were asked to participate in this study. Participants were asked to complete a questionnaire that consisted of questions on general, medical, and sexual history related to ejaculation. A total of 600 subjects were included in this study. PE prevalence was found to be 18.3%. Prevalences were not significantly different across age groups, after excluding subjects with erectile dysfunction (ED). Educational level, marital status and duration, average income, sexual orientation, smoking, alcohol consumption, and circumcision status showed no difference in the PE and non-PE groups. Partners perceived satisfaction rates were 45.0% in the PE group and 63.9% in the non-PE group. Significant differences were found between the PE and non-PE groups in terms of ED, obesity, and depression prevalence. However, multiple logistic regression analysis revealed that the significant risk factors of PE were age and the frequency of conversations with partners about sexual intercourse. This Internet-based study is limited because participants probably represent a selected population of Internet users with non-representative educational and socioeconomic profiles. This study is the first to report the prevalence of both self-reported PE and PE on the basis of the DSM-IV-TR definition in the Korean population. This study demonstrates that PE in Korea is as prevalent as it is in European countries and the United States.

Validity of the patient-reported Clinical Global Impression of Change as a measure of treatment response in men with premature ejaculation.

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Althof, Stanley E; Brock, Gerald B; Rosen, Raymond C; Rowland, David L; Aquilina, Joseph W; Rothman, Margaret; Tesfaye, Fisseha; Bull, Scott

2010-06-01

The Clinical Global Impression of Change (CGIC) measures have high utility in clinical practice. However, it is unknown whether the CGIC is valued for assessing premature ejaculation (PE) symptoms and/or the relationship between CGIC and other validated PE patient-reported measures. The study aims to assess the validity of the patient-reported CGIC measure in men with PE and to examine the relationship between CGIC ratings and assessments of control, satisfaction, personal distress, and interpersonal difficulty. Data from a randomized, double-blind, 24-week phase 3 trial in 1,162 men with PE who received dapoxetine (30 mg or 60 mg) or placebo on demand provided the basis for the analysis. Patients were ≥18 years, in a stable monogamous relationship for ≥6 months, met the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision criteria for PE for ≥6 months, and had an intravaginal ejaculatory latency time (IELT) ≤2 minutes in ≥75% of intercourse episodes. The CGIC asked patients to rate improvement or worsening of their PE compared with the start of the study using a 7-point response scale; other patient-reported measures were control over ejaculation, satisfaction with sexual intercourse, interpersonal difficulty, and personal distress related to ejaculation. Stopwatch-measured IELT was recorded. Associations between CGIC and change in other measures at study end point were assessed. The magnitude of IELT increased for each category of improvement on the CGIC: 1.63, 4.03, and 7.15 minutes for slightly better, better, and much better, respectively. Higher CGIC ratings were correlated with greater improvement in control (r = 0.73), satisfaction (r = 0.62), greater reduction in distress (r = -0.52), and interpersonal difficulty (r = -0.39). Total variance accounted for was 57.4%: control (48.7%), satisfaction (4.5%), IELT (2.8%), and distress (1.15%). The analyses support the validity of the CGIC measure in men with PE. The CGIC

A Randomized Double-blind Placebo-controlled Trial to Assess the Effect of Tamarind seed in Premature Ejaculation

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Abdulla Homayuonfar

2018-01-01

Full Text Available Background: This randomized clinical trial was aimed to evaluate the effect of oral use of tamarind seed powder as an herbal product in patients affected by premature ejaculation (PE. Materials and Methods: In this study, 75 patients randomized in tamarind group (25 patients received daily 130 mg tamarind seed powder, paroxetine group (25 patients received daily 20 mg paroxetine, and placebo group (25 patients. Patients received the treatment regimen for 4 weeks. The primary outcome was intravaginal ejaculatory latency time (IELT. The secondary outcomes were PE diagnostic tool score, sexual function using International Index of Erectile Function (IIEF, and complications. Studied sexual functions include erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. Results: The mean of IELT in tamarind, paroxetine, and placebo groups at baseline was 35.2 ± 26.5, 38 ± 27.6, and 44 ± 34.9 s and at the end of study was 49.5 ± 48.2, 147.4 ± 209.6, and 46.9 ± 37.6 s, respectively, which in paroxetine group significantly increased compared to other groups. IIEF scores for orgasmic function and intercourse satisfaction for paroxetine after treatment significantly increased than that of other groups. The differences between tamarind and placebo groups for studied variables were not statistically significant. The mean of increases in IELT for tamarind, paroxetine, and placebo groups was 14.35 ± 34.3, 109.4 ± 213.4, and 2.9 ± 9.3 s, respectively, which in paroxetine group was significantly higher than other groups and in tamarind group was significantly higher than placebo. Conclusions: Paroxetine was significantly better than tamarind seed powder and placebo although side effect in paroxetine was more frequent. IELT significantly more increased in tamarind group compared to placebo.

Pharmacokinetics and tolerability of DA-8031, a novel selective serotonin reuptake inhibitor for premature ejaculation in healthy male subjects

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Shin D

2017-03-01

Full Text Available Dongseong Shin,1 SeungHwan Lee,2 Sojeong Yi,2 Seo Hyun Yoon,2 Joo-Youn Cho,2 Mi Young Bahng,3 In-Jin Jang,2 Kyung-Sang Yu2 1Clinical Trials Center, Gachon University Gil Medical Center, Incheon, 2Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, 3Department of Product Development, Dong-A ST, Seoul, Korea Objective: DA-8031 is a selective serotonin reuptake inhibitor under development for the treatment of premature ejaculation. This is the first-in-human study aimed at evaluating the pharmacokinetics and tolerability of DA-8031 and its metabolites (M1, M2, M4, and M5 in the plasma and urine after administration of a single oral dose in healthy male subjects.Methods: A dose block-randomized, double-blind, placebo-controlled, single ascending dose study was conducted. Subjects received either placebo or a single dose of DA-8031 at 5, 10, 20, 40, 60, 80, or 120 mg. DA-8031 and its four metabolites were analyzed in the plasma and urine for pharmacokinetic evaluation. The effect of genetic polymorphisms of cytochrome-P450 (CYP enzymes on the pharmacokinetics of DA-8031 was evaluated.Results: After a single dose, plasma DA-8031 reached the maximum concentration at a median of 2–3 h and was eliminated with terminal elimination half-life of 17.9–28.7 h. The mean renal clearance was 3.7–5.6 L/h. Dose-proportional pharmacokinetics was observed over the dose range of 20–80 mg. Among the metabolites, M4 had the greatest plasma concentration, followed by M5 and M1. Subjects with CYP2D6 intermediate metabolizer had significantly greater dose-normalized Cmax and AUC0–t of DA-8031 as well as smaller metabolic ratios than those subjects with CYP2D6 extensive metabolizer. The most common adverse events were nausea, dizziness, and headache, and no serious adverse events were reported.Conclusion: In conclusion, the systemic exposure of DA-8031 was increased proportionally to the dose within 20

Comparison of paroxetine and dapoxetine, a novel selective serotonin reuptake inhibitor in the treatment of premature ejaculation

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Abdulmuttalip Simsek

2014-10-01

Full Text Available Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor and the first drug approved for the on-demand treatment of premature ejaculation (PE. Our objective in this study was to characterize the efficacy of on-demand dapoxetine (30 and 60 mg and daily paroxetine (20 mg usage in treating PE. We conducted a 1 month study involving a total of 150 patients. Patients were divided into three groups of 50. Group 1 were treated with on-demand dapoxetine (30 mg, Group 2 with on-demand dapoxetine (60 mg and Group 3 with daily paroxetine (20 mg. Our outcome measurement was increased from baseline intravaginal ejaculatory latency time (IELT after treatment. The IELT increased from baseline to posttreatment by 117%, 117% and 170% in the paroxetine group (P 0.05, while the 60 mg dapoxetine group had a larger posttreatment IELT increase compared with the 30 mg dapoxetine (P < 0.05 and paroxetine (P < 0.01 groups. Dapoxetine (60 mg 1-3 h before planned intercourse is a very effective treatment modality for PE. However, an on-demand dose of 30 mg dapoxetine is no more effective than the currently prescribed paroxetine treatment.

Long-term space changes after premature loss of a primary maxillary first molar

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Lin, Yng-Tzer J.; Lin, Yai-Tin

2016-01-01

Background/purpose: The consequence of premature loss of primary teeth resulting in the need for space maintainers has been controversial for many years. There is no longitudinal long-term report in literature regarding the premature loss of a primary maxillary first molar. The aim of this study was to continue observing the long-term space changes of 19 cases following premature loss of a primary maxillary first molar during the transition from primary to permanent dentition. Materials an...

Screening for erectile dysfunction in men with lifelong premature ejaculation--Is the Sexual Health Inventory for Men (SHIM) reliable?

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McMahon, Chris G

2009-02-01

Some men with premature ejaculation (PE) and normal erectile function record contradictory response/s to The Sexual Health Inventory for Men (SHIM) and may be incorrectly categorized as suffering from erectile dysfunction (ED). The aim of this study was to evaluate the frequency of false positive SHIM diagnosis of ED in men with lifelong PE. SHIM, stopwatch intravaginal ejaculation latency time (IELT). A prospective observational study of men with normal erectile function and lifelong PE, diagnosed using the ISSM definition of lifelong PE, was conducted. The SHIM was self-administered at Visit 1. Mean per subject stopwatch IELT was determined from four subsequent intercourse attempts. Seventy-eight subjects with a mean age of 33.2 +/- 8.3 years and a geometric mean IELT of 15.9 +/- 2.3 seconds were enrolled. The mean SHIM score for all subjects was 20.4 +/- 6.0. Fifty-two subjects (66.7%) have SHIM scores of >21 (mean 24.3 +/- 1.1), consistent with normal erectile function, and a geometric mean IELT of 18.3 +/- 2.2 seconds. Twenty-six subjects (33.3%) had SHIM scores IELT of 10.5 +/- 2.3 seconds. The incidence of false positive SHIM diagnosis of ED (SHIM IELT. Although the geometric mean IELT for subjects with SHIM scores 21, there were no significant differences between the geometric mean IELT or the IELT distribution of all subjects vs. the normal erectile function IELT (SHIM > 21) cohort. This study demonstrates a 33.3% false positive SHIM diagnosis of ED in men with PE. This is likely to limit subject recruitment in clinical trials by exclusion of subjects with low-range IELTs but is unlikely to result in significantly different baseline IELTs or IELT distributions.

Safety and efficacy of dapoxetine in the treatment of premature ejaculation: a double-blind, placebo-controlled, fixed-dose, randomized study.

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Safarinejad, Mohammad R

2008-05-01

The aim of the study was to evaluate the efficacy and safety of a selective serotonin reuptake inhibitor (SSRI) drug dapoxetine in delaying ejaculation in patients with premature ejaculation (PE). A total of 212 potent men with PE were randomly assigned to receive 30 mg orally dapoxetine (group 1, N=106) twice daily or similar regimen of placebo (group 2, N=106) during a 12-week period for each agent. Pretreatment evaluation included history and physical examination, geometric mean intravaginal ejaculatory latency time (IELT, primary outcome measure), and International Index of Erectile Function (IIEF). The efficacy of two treatments was assessed every 2 weeks during treatment, at the end of study, and in 3-month follow-up after cessation of treatment. We measured geometric mean IELT. Thus, the IELT values were logarithmically transformed before statistical analysis, and the results are reported as fold increases from baseline with associated 95% confidence intervals (CI). The independent sample two-tailed t-test was used to compare the IELTs. At the end of 12-week treatment, the dapoxetine group had a 2.9- (95% CI, 1.84-4.16) fold increase of the geometric mean IELT, while after placebo the geometric mean IELT did not increase significantly (1.4-fold increase; 95% CI, 0.84-1.63) (p=0.001). The mean weekly intercourse episodes increased from pretreatment values of 1.16 and 1.14 to 2.2 and 1.4, for dapoxetine and placebo, respectively (p=0.04). Baseline mean intercourse satisfaction domain values of IIEF, 12 and 11, reached to 16 and 10 at the 12-week treatment in groups 1 and 2, respectively (p=0.04). At the end of 3-month follow-up period, the geometric mean IELT in dapoxetine and placebo group demonstrated 1.4- (95% CI, 0.66-1.46) and 1.3- (95% CI, 0.77-1.63) fold increase, respectively (p=0.1). Three-month intercourse satisfaction domain value of IIEF was 11 in group 1 and 10 in group 2 (p=0.1). Mean number of adverse events was 19 for dapoxetine and 7 for

Percutaneous CT-guided cryoablation of the dorsal penile nerve for treatment of symptomatic premature ejaculation.

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David Prologo, J; Snyder, Laura L; Cherullo, Edward; Passalacqua, Matthew; Pirasteh, Ali; Corn, David

2013-02-01

To evaluate expansion of image-guided interventional cryoablation techniques usually employed for pain management to address the feasibility, safety, and efficacy of treatment for a urologic condition with otherwise limited treatment options, premature ejaculation (PE). Prospective institutional review board approval was obtained, and 24 subjects with PE were enrolled. All patients underwent unilateral percutaneous computed tomography-guided cryoablation of the dorsal penile nerve (DPN). Postprocedural intravaginal ejaculatory latency times (IELTs) and PE Profile (PEP) results served as outcome variables. In addition, subjects were asked whether they would have the procedure done again based on their experience at the 180- and 360-day marks. The technical success rate was 100%. Baseline average IELT was 54.7 seconds ± 7.8 (n = 24), which increased to a maximum of 256 seconds ± 104 (n = 11; P = .241) by day 7 and decreased to 182.5 seconds ± 87.8 (n = 6; P = .0342) by day 90. The mean IELT remained at 182.5 seconds ± 27.6 at day 180 (n = 23; PIELTs significantly improved at 180 and 360 days, and 83% of subjects reported that they would undergo the procedure again if given the same opportunity. There were no procedure-related complications. CT-guided percutaneous unilateral cryoablation of the DPN is a feasible, safe, single-day outpatient procedure for the treatment of symptomatic PE. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

Retrograde ejaculation

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Symptoms include: Cloudy urine after orgasm Little or no semen is released during ejaculation ... 2016:chap 141. McMahon CG. Disorders of male orgasm and ejaculation. In: Wein AJ, Kavoussi LR, Partin ...

Changes of cerebral current source by audiovisual erotic stimuli in premature ejaculation patients.

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Hyun, Jae-Seog; Kam, Sung-Chul; Kwon, Oh-Young

2008-06-01

Premature ejaculation (PE) is one of the most common forms of male sexual dysfunction. The mechanisms of PE remain poorly understood, despite its high prevalence. To investigate the pathophysiology and causes of PE in the central nervous system, we tried to observe the changes in brain current source distribution by audiovisual induction of sexual arousal. Electroencephalograpies were recorded in patients with PE (45.0 +/- 10.3 years old, N = 18) and in controls (45.6 +/- 9.8 years old, N = 18) during four 10-minute segments of resting, watching a music video excerpt, resting, and watching an erotic video excerpt. Five artifact-free 5-second segments were used to obtain cross-spectral low-resolution brain electromagnetic tomography (LORETA) images. Statistical nonparametric maps (SnPM) were obtained to detect the current density changes of six frequency bands between the erotic video session and the music video session in each group. Comparisons were also made between the two groups in the erotic video session. In the SnPM of each spectrum in patients with PE, the current source density of the alpha band was significantly reduced in the right precentral gyrus, the right insula, and both superior parietal lobules (P erotic video session, the current densities of the beta-2 and -3 bands in the PE group were significantly decreased in the right parahippocampal gyrus and left middle temporal gyrus (P < 0.01). Neuronal activity in the right precental gyrus, the right insula, both the superior parietal lobule, the right parahippocampal gyrus, and the left middle temporal gyrus may be decreased in PE patients upon sexual arousal. Further studies are needed to evaluate the meaning of decreased neuronal activities in PE patients.

Geometric mean IELT and premature ejaculation: appropriate statistics to avoid overestimation of treatment efficacy

NARCIS (Netherlands)

Waldinger, Marcel D.; Zwinderman, Aeilko H.; Olivier, Berend; Schweitzer, Dave H.

2008-01-01

INTRODUCTION: The intravaginal ejaculation latency time (IELT) behaves in a skewed manner and needs the appropriate statistics for correct interpretation of treatment results. AIMS: To explain the rightful use of geometrical mean IELT values and the fold increase of the geometric mean IELT because

Rasch Analysis of the Premature Ejaculation Diagnostic Tool (PEDT and the International Index of Erectile Function (IIEF in an Iranian Sample of Prostate Cancer Patients.

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Chung-Ying Lin

Full Text Available Male sexual dysfunction is an increasing problem across a variety of general and clinical populations, such as cancer populations; especially among prostate cancer patients who tend to receive treatments that often result in erectile dysfunction (ED and/or premature ejaculation (PE. Therefore, in order to diagnose ED and PE in these populations, adequate and efficient instruments such as the International Index of Erectile Function 5-item version (IIEF-5 and the Premature Ejaculation Diagnostic Tool (PEDT are needed. However, since this is an important topic additional evidence of psychometric properties of the IIEF-5 and the PEDT in such samples are required. Thus the aim of the present study was to use Rasch models to investigate the construct validity, local dependency, score order, and differential item functioning (DIF of both questionnaires in a sample of prostate cancer patients.Prostate cancer patients (n = 1058, mean±SD age = 64.07±6.84 years who visited urology clinics were invited to fill out the IIEF-5 and the PEDT. Construct validity was examined using infit and outfit mean square (MnSq and local dependency using correlations between each two residual Rasch scores. Score order was investigated using step and average measures of difficulty and DIF using DIF contrast.All IIEF-5 and PEDT items had acceptable infit and outfit MnSq. Step measures revealed that all but two items had disordered categories in terms of scores 1 to 3. Only one local dependency was found, and no items displayed DIF across age, educational level, and help seeking.The results showed that both the IIEF-5 and the PEDT had sound psychometric properties in the Rasch analyses, although some score disordering could be detected in both instruments. The results of no DIF items in both instruments suggest using them to compare ED and PE across age and educational level is adequate.

Concept and understanding of premature discharge in Indian patients

Directory of Open Access Journals (Sweden)

B S Chavan

2014-01-01

Full Text Available Introduction: Due to lack of formal sex education in India, the unpleasant past sexual experiences and at times normal physiological activities can lead to various myths and sexual beliefs. Base on their beliefs, individuals seeking treatment for early ejaculation have their set of expectations. Premature ejaculation (PME in Indian population thus, has personal meaning and there is no common agreement on it. Materials and Methods: With the help of semi-structured questionnaire, we surveyed the sexual activity, sexual beliefs and past sexual experiences of those seeking treatment for early ejaculation (n = 62 and compared them with an age-matched control (n = 50. Results: Those seeking treatment for early ejaculation expected more number of strokes (39.1 vs. 32.6 in lesser time (11.5 min vs. 16.3 during sexual encounters i.e. more rapid thrusting. Significantly more of those seeking treatment for early ejaculation felt that masturbation was not a normal activity and that both male and female partners must climax simultaneously for satisfactory sexual experience. Also, significantly more of those seeking treatment for early ejaculation reported their first sexual experience to be unsatisfactory. Conclusion: In the cultural context of India, those seeking treatment for early ejaculation may be distressed due to their inability to meet their own expectations in addition to distress of inability to hold ejaculation as desired. It is essential to re-educate such individuals before considering the diagnosis of PME. Various diagnostic criteria for PME have not emphasized the exclusion of cultural factors as contributors to distress of PME.

Twelve-month space changes after premature loss of a primary maxillary first molar.

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Lin, Yai-Tin; Lin, Wen-Hsien; Lin, Yng-Tzer J

2011-05-01

Many early investigations concerning space changes following premature extraction of primary molars had a cross-sectional design, a small sample size, and a somewhat crude methodology, which may have led to misunderstandings. The aim of this study was to use established longitudinal data to investigate ongoing (12-month) dental-arch space problems arising as a result of premature loss of a primary maxillary first molar. Thirteen children (mean ± SD age at time of tooth extraction, 6.0 ± 0.74 years) with unilateral premature loss of a primary maxillary first molar were selected for this study. Maxillary dental study casts were obtained from participants 2 or 3 days after the tooth was removed, as well as at a follow-up appointment 12 months later. Six reference lines were measured on the study cast: D + E space, arch width, arch length, intercanine width, intercanine length, and arch perimeter. For each participant, the D + E space of the contralateral intact primary molar served as a control. A paired t-test was used to compare the cast measurements between initial examination and 12-month follow-up. A t-test was used to compare D + E space changes with those of the control group. The D + E space of the extraction side after 12 months was significantly smaller than that of the control side (P 0.05). The 12-month space changes in the maxillary dental arch after premature loss of a primary maxillary first molar consist mainly of distal drift of the primary canine toward the extraction site. Mesial movement of permanent molars or tilting of the primary molars did not occur. An increased arch dimension was found especially in the anterior segment (intercanine width and length). There is no need for the use of space maintainers from the results in this study in cases of premature loss of a primary first molar. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

THE PHYSIOLOGY AND ECOPHYSIOLOGY OF EJACULATION

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Rosa Angélica Lucio

2011-12-01

Full Text Available Different studies dealing with ejaculation view this process as a part of the male copulatory behavior. Some of them explain ejaculation as the consequence of a neuroendocrine feedback loops or from a purely anatomical perspective. The goal of the present review is to discuss the traditional and novel themes related to the biology of ejaculation. The text begins with the description of the behavioral motor patterns that lead to ejaculation. The anatomo-physiological mechanisms are explained under the notion that ejaculation is more than genitals and an excurrent duct system; thus it is also included the participation of the striated perineal musculature. Although ejaculation is a sexual spinal reflex, it is inhibited tonically by supraspinal structures. Such supraspinal modulation may explain the prudent sperm allocation, by which males adjust the number of sperm per ejaculate while copulating under distinct competitive scenarios. In some mammals, ejaculate components facilitate seminal coagulation, an adaptation that may increase the male reproductive fitness. Finally, there is a reflection of the so-called human ejaculatory disturbances, which from an ecophysiolgical perspective could represent advantages instead of sexual malfunction as are recognize under the medical view.

[Efficacy of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation].

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Li, Jian-xin; Lu, Qing-ge

2015-05-01

To observe the clinical effectiveness of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation (PE). A total of 120 patients with secondary non-consolidated kidney qi PE were randomly assigned to groups A (aged [35.5 ± 5.4] yr), B (aged [36.2 ± 5.7] yr), and C (aged [35.2 ± 5.3] yr) in the ratio of 1:1:1 to receive Qilin Pills (once 6 g, bid), sertraline (once 50 mg, qd), and Qilin Pills plus sertraline, respectively, all for 4 weeks. The intravaginal ejaculatory latency time (IELT) and PE diagnostic tool (PEDT) scores were obtained before and after medication and at 1 month after drug withdrawal, and comparative analyses were made among the three groups of patients. The IELT was dramatically prolonged in groups A, B, and C after treatment ([3.23 ± 1.84], [3.87 ± 2.43], and [5.92 ± 3.11] min) and at 1 month after drug withdrawal ([1.85 ± 1.27], [1.52 ± 1.06], and [ 4.26 ± 1.88 ] min) as compared with the baseline ([0.88 ± 0.45], [0.84 ± 0.47], and [0.85 ± 0.50] min) (P Pills combined with sertraline has a definite efficacy in the treatment of secondary non-consolidated kidney qi PE and therefore deserves wide clinical application.

The effect of sperm concentration in the ejaculate on morphological traits of bull spermatozoa.

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Kondracki, Stanisław; Banaszewska, Dorota; Wysokńjska, Anna; Iwanina, Maria

2012-01-01

Experiments were performed on 75 ejaculates obtained from 19 bulls representing different cattle breeds used at the Masovian Centre for Animal Breeding and Reproduction in Łowicz. Fresh ejaculates were measured in respect to their volume and sperm count in the ejaculates was determined. The ejaculates were classified based on the criterion of sperm concentration and divided into five groups. Sperm morphometric measurements were taken from each bull and assessment of semen morphology was done on the basis of examination under a microscope using preparations made from fresh ejaculates. For each slide, morphometric measurements were taken of 15 randomly selected spermatozoa characterised by normal morphology and well visible under the microscope. Additionally, in each preparation morphometry of 500 spermatozoa was evaluated, numbers of spermatozoa with normal morphology and morphological abnormalities were recorded and these were categorized into spermatozoa with major and minor defects. An insignificant correlation was observed between the sperm concentration in the ejaculate and morphological traits, dimensions and shapes of bull spermatozoa. The less concentrated ejaculates contained spermatozoa with a slightly larger head circumference and a more elongated head shape in comparison with the spermatozoa in the more concentrated ejaculates. The highest frequency of morphologically malformed spermatozoa, both in the case of primary and secondary alterations, was observed in ejaculates with sperm concentration of no more than 1000 x 10(3)/mm3.

Three-dimensional space changes after premature loss of a maxillary primary first molar.

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Park, Kitae; Jung, Da-Woon; Kim, Ji-Yeon

2009-11-01

A space maintainer is generally preferred when a primary first molar is lost before or during active eruption of the first permanent molars in order to prevent space loss. However, controversy prevails regarding the space loss after eruption of the permanent first molars. The purpose of this study was to examine spatial changes subsequent to premature loss of a maxillary primary first molar after the eruption of the permanent first molars. Thirteen children, five girls and eight boys, expecting premature extraction of a maxillary primary first molar because of caries and/or failed pulp therapy, were selected. Spatial changes were investigated using a three-dimensional laser scanner by comparing the primary molar space, arch width, arch length, and arch perimeter before and after the extraction of a maxillary primary first molar. Also, the inclination and angulation changes in the maxillary primary canines, primary second molars, and permanent first molars adjacent to the extraction site were investigated before and after the extraction of the maxillary primary first molar in order to examine the source of space loss. There was no statistically significant space loss on the extraction side compared to the control side (P = 0.33). No consistent findings were seen on the inclination and angulation changes on the extraction side. The premature loss of a maxillary primary first molar, in cases with class I molar relationship, has limited influence on the space in permanent dentition.

Space changes after premature loss of the mandibular primary first molar: a longitudinal study.

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Lin, Y T; Chang, L C

1998-01-01

The purpose of this study was to evaluate the space changes after premature loss of the primary mandibular first molar. Twenty-one children (12 boys and 9 girls), with premature loss of the primary mandibular first molar, were selected from the children's dental clinic for this study. The age ranged from 5.1 to 7.2 years with an average of 6 years and 11 months. Mandibular study casts were made from alginate impression for each initial examination and a follow-up examination eight months later. Four measurements including D+E (first and second primary molars) space, arch width, arch length and arch perimeter were tested for comparisons between the initial examination and the follow-up examination eight months later. The D+E space of intact primary molars served as a control. The results showed that the D+E space on the extraction side after the follow-up examination eight months later was significantly shorter than the control side (p = 0.025) and less than the initial D+E space (p 0.05). It is concluded that the space change after the eruption of the first permanent molar in the mandible is mostly distal movement of the primary cuspid during the early stage of premature loss of the primary first molar.

Immediate and six-month space changes after premature loss of a primary maxillary first molar.

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Lin, Yai-Tin; Lin, Wen-Hsien; Lin, Yng-Tzer J

2007-03-01

Premature loss of primary maxillary first molars has been associated with a number of consequences (such as tipping of the first permanent molar). The aim of the authors' study was to investigate dental-arch space problems arising as a result of premature loss of a primary maxillary first molar. This study was composed of 19 children who experienced unilateral premature loss of a primary maxillary first molar. The authors used each patient's intact contralateral arch segment as a control. The authors obtained maxillary dental study casts two or three days after the tooth was extracted, as well as six months later. The D + E space from the extraction side six months after removal of the tooth (mean +/- standard deviation, 15.62 +/- 1.13 millimeters) was significantly smaller than the space on the control side (16.88 +/- 1.12 mm) and the initial D + E space (16.70 +/- 0.69 mm). The authors found a significantly shorter arch length (25.47 +/- 1.58 mm) and larger intercanine width (31.29 +/- 2.49 mm) six months after the tooth was extracted compared with the initial arch length (25.66 +/- 1.64 mm) and intercanine width (30.42 +/- 2.64 mm). The early space changes to the maxillary arch subsequent to premature loss of a primary maxillary first molar are primarily distal drift of the primary canines toward the extraction space and palatal migration of the maxillary incisors. Although 1 mm of space was lost, which is statistically significant, this is not likely to be of sufficient clinical significance to warrant use of a space maintainer. If palatal movement appears to be needed, the dentist should consider use of a palatal arch rather than a band-and-loop maintainer. The effects of space maintainers need to be re-evaluated in cases of unilateral premature loss of a primary maxillary first molar.

Effects of sertraline on brain current source of the high beta frequency band: analysis of electroencephalography during audiovisual erotic stimulation in males with premature ejaculation.

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Kwon, O Y; Kam, S C; Choi, J H; Do, J M; Hyun, J S

2011-01-01

To identify the effects of sertraline, a selective serotonin reuptake inhibitor, for the treatment of premature ejaculation (PE), changes in brain current-source density (CSD) of the high beta frequency band (22-30 Hz) induced by sertraline administration were investigated during audiovisual erotic stimulation. Eleven patients with PE (36.9±7.8 yrs) and 11 male volunteers (24.2±1.9 years) were enrolled. Scalp electroencephalography (EEG) was conducted twice: once before sertraline administration and then again 4 h after the administration of 50 mg sertraline. Statistical non-parametric maps were obtained using the EEG segments to detect the current-density differences in the high beta frequency bands (beta-3, 22-30 Hz) between the EEGs before and after sertraline administration in the patient group and between the patient group and controls after the administration of sertraline during the erotic video sessions. Comparing between before and after sertraline administration in the patients with PE, the CSD of the high beta frequency band at 4 h after sertraline administration increased significantly in both superior frontal gyri and the right medial frontal gyrus (P<0.01). The CSD of the beta-3 band of the patients with PE were less activated significantly in the middle and superior temporal gyrus, lingual and fusiform gyrus, inferior occipital gyrus and cuneus of the right cerebral hemisphere compared with the normal volunteers 4 h after sertraline administration (P<0.01). In conclusion, sertraline administration increased the CSD in both the superior frontal and right middle temporal gyrus in patients with PE. The results suggest that the increased neural activity in these particular cerebral regions after sertraline administration may be associated with inhibitory effects on ejaculation in patients with PE.

Identification of Chromosomes Alterations in Primary Breast Cancer Using Premature Chromosome Condensation

National Research Council Canada - National Science Library

Griffin, Constance

2000-01-01

.... We are developing a new method, premature chromosome condensation (PCC),using mitotic Xenopus extracts that will allow us to obtain G-banded karyotypes from primary, uncultured breast cancer specimens...

A multinational population survey of intravaginal ejaculation latency time.

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Waldinger, Marcel D; Quinn, Paul; Dilleen, Maria; Mundayat, Rajiv; Schweitzer, Dave H; Boolell, Mitradev

2005-07-01

Intravaginal ejaculation latency time (IELT), defined as the time between the start of vaginal intromission and the start of intravaginal ejaculation, is increasingly used in clinical trials to assess the amount of selective serotonin reuptake inhibitor-induced ejaculation delay in men with premature ejaculation. Prospectively, stopwatch assessment of IELTs has superior accuracy compared with retrospective questionnaire and spontaneous reported latency. However, the IELT distribution in the general male population has not been previously assessed. To determine the stopwatch assessed-IELT distribution in large random male cohorts of different countries. A total of 500 couples were recruited from five countries: the Netherlands, United Kingdom, Spain, Turkey, and the United States. Enrolled men were aged 18 years or older, had a stable heterosexual relationship for at least 6 months, with regular sexual intercourse. The surveyed population were not included or excluded by their ejaculatory status and comorbidities. This survey was performed on a "normal" general population. Sexual events and stopwatch-timed IELTs during a 4-week period were recorded, as well as circumcision status and condom use. The IELT, circumcision status, and condom use. The distribution of the IELT in all the five countries was positively skewed, with a median IELT of 5.4 minutes (range, 0.55-44.1 minutes). The median IELT decreased significantly with age, from 6.5 minutes in the 18-30 years group, to 4.3 minutes in the group older than 51 years (PIELT varied between countries, with the median value for Turkey being the lowest, i.e., 3.7 minutes (0.9-30.4 minutes), which was significantly different from each of the other countries. Comparison of circumcised (N=98) and not-circumcised (N=261) men in countries excluding Turkey resulted in median IELT values of 6.7 minutes (0.7-44.1 minutes) in circumcised compared with 6.0 minutes (0.5-37.4 minutes) in not-circumcised men (not significant). The

[Retroperitoneal lymphadenectomy and disorders of ejaculation].

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Deiana, G; Ranieri, A; Micheli, E; Peracchia, G; Canclini, L P; Sironi, D; Levorato, C A; Lembo, A

1999-09-01

Retrograde ejaculation is a frequent and permanent complication after bilateral retroperitoneal lymphadenectomy (RPLND). Seminal emission and ejaculation are primarily under sympathetic control. Several studies after RPLND in patients with nonseminomatous testis cancer proved the role of preservation of the efferent fibers originating from the lumbar sympathetic ganglia. Based on the results of anatomical studies, a modified unilateral operative technique and nerve-sparing approach permit to preserve normal anterograde ejaculation without reduction of long-term survival.

Delayed Ejaculation

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... cases, it is due to a combination of physical and psychological concerns. Psychological causes of delayed ejaculation include: Depression, anxiety or other mental health conditions Relationship problems due to stress, poor communication ...

Cerebral Damage May Be the Primary Risk Factor for Visual Impairment in Preschool Children Born Extremely Premature

DEFF Research Database (Denmark)

Slidsborg, Carina; Bangsgaard, Regitze; Fledelius, Hans Callø

2012-01-01

OBJECTIVES To investigate the importance of cerebral damage and retinopathy of prematurity (ROP) for visual impairment in preschool children born extremely premature and to determine the primary risk factor of the two. METHODS A clinical follow-up study of a Danish national cohort of children born......, 3.0-25.2; P visual impairment in children born extremely premature, and cerebral damage may be the primary risk...... participants were identified through the National Birth Register and invited to participate in a clinical examination. The children were evaluated with regard to visual acuity, foveal sequelae, and maximum ROP stage and the presence of global developmental deficits (an indicator for cerebral damage...

Long-term space changes after premature loss of a primary maxillary first molar

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Yng-Tzer J. Lin

2017-03-01

Conclusion: The anterior and posterior arch dimensions significantly increased 81 months after premature loss of a primary maxillary first molar, which suggested that space maintainers were not needed in these cases.

Brain activation during human male ejaculation

NARCIS (Netherlands)

Holstege, Ger; Georgiadis, Janniko R.; Paans, Anne M.J.; Meiners, Linda C.; Graaf, Ferdinand H.C.E. van der; Reinders, A.A.T.Simone

2003-01-01

Brain mechanisms that control human sexual behavior in general, and ejaculation in particular, are poorly understood. We used positron emission tomography to measure increases in regional cerebral blood flow (rCBF) during ejaculation compared with sexual stimulation in heterosexual male volunteers.

Pontine control of ejaculation and female orgasm.

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Huynh, Hieu K; Willemsen, Antoon T M; Lovick, Thelma A; Holstege, Gert

2013-12-01

The physiological component of ejaculation shows parallels with that of micturition, as both are essentially voiding activities. Both depend on supraspinal influences to orchestrate the characteristic pattern of activity in the pelvic organs. Unlike micturition, little is known about the supraspinal pathways involved in ejaculation and female orgasm. To identify brainstem regions activated during ejaculation and female orgasm and to compare them with those activated during micturition. Ejaculation in men and orgasm in women were induced by manual stimulation of the penis or clitoris by the participants' partners. Positron emission tomography (PET) with correction for head movements was used to capture the pattern of brain activation at the time of sexual climax. PET scans showing areas of activation during sexual climax. Ejaculation in men and orgasm in women resulted in activation in a localized region within the dorsolateral pontine tegmentum on the left side and in another region in the ventrolateral pontine tegmentum on the right side. The dorsolateral pontine area was also active in women who attempted but failed to have an orgasm and in women who imitated orgasm. The ventrolateral pontine area was only activated during ejaculation and physical orgasm in women. Activation of a localized region on the left side in the dorsolateral pontine tegmentum, which we termed the pelvic organ-stimulating center, occurs during ejaculation in men and physical orgasm in women. This same region has previously been shown to be activated during micturition, but on the right side. The pelvic organ-stimulating center, via projections to the sacral parasympathetic motoneurons, controls pelvic organs involved in voiding functions. In contrast, the ventrolateral pontine area, which we term the pelvic floor-stimulating center, produces the pelvic floor contractions during ejaculation in men and physical orgasm in women via direct projections to pelvic floor motoneurons. © 2013

Urethral anatomy and semen flow during ejaculation

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Kelly, Diane

2016-11-01

Ejaculation is critical for reproductive success in many animals, but little is known about its hydrodynamics. In mammals, ejaculation pushes semen along the length of the penis through the urethra. Although the urethra also carries urine during micturition, the flow dynamics of micturition and ejaculation differ: semen is more viscous than urine, and the pressure that drives its flow is derived primarily from the rhythmic contractions of muscles at the base of the penis, which produce pulsatile rather than steady flow. In contrast, Johnston et al. (2014) describe a steady flow of semen through the crocodilian urethral groove during ejaculation. Anatomical differences of tissues associated with mammalian and crocodilian urethral structures may underlie these differences in flow behavior.

Normal male sexual function: emphasis on orgasm and ejaculation.

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Alwaal, Amjad; Breyer, Benjamin N; Lue, Tom F

2015-11-01

Orgasm and ejaculation are two separate physiological processes that are sometimes difficult to distinguish. Orgasm is an intense transient peak sensation of intense pleasure creating an altered state of consciousness associated with reported physical changes. Antegrade ejaculation is a complex physiological process that is composed of two phases (emission and expulsion), and is influenced by intricate neurological and hormonal pathways. Despite the many published research projects dealing with the physiology of orgasm and ejaculation, much about this topic is still unknown. Ejaculatory dysfunction is a common disorder, and currently has no definitive cure. Understanding the complex physiology of orgasm and ejaculation allows the development of therapeutic targets for ejaculatory dysfunction. In this article, we summarize the current literature on the physiology of orgasm and ejaculation, starting with a brief description of the anatomy of sex organs and the physiology of erection. Then, we describe the physiology of orgasm and ejaculation detailing the neuronal, neurochemical, and hormonal control of the ejaculation process. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

A novel treatment modality in patients with premature ejaculation resistant to conventional methods: the neuromodulation of dorsal penile nerves by pulsed radiofrequency.

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Basal, Seref; Goktas, Serdar; Ergin, Atilla; Yildirim, Ibrahim; Atim, Abdulkadir; Tahmaz, Lutfi; Dayanc, Murat

2010-01-01

Premature ejaculation (PE) is the most common sexual problem experienced by men, and it affects 20%-30% of them. Pulsed radiofrequency (PRF) neuromodulation has been shown to be an effective treatment for a wide range of pain conditions. We used PRF to treat PE by desensitizing dorsal penile nerves in patients resistant to conventional treatments. Fifteen patients with a lifelong history of PE, defined as an intravaginal ejaculatory latency time (IELT) of IELT and sexual satisfaction score (SSS; for patients and their partners) were obtained. The mean IELTs before and 3 weeks after procedure were 18.5 +/- 17.9 and 139.9 +/- 55.1 seconds, respectively. Side effects did not occur. Mean SSSs of patients before and after treatment were 1.3 +/- 0.3 and 4.6 +/- 0.5, and mean SSSs of partners before and after treatment were 1.3 +/- 0.4 and 4.4 +/- 0.5, respectively. In all cases, IELT and SSS were significantly increased (P < .05). None of the patients or their wives reported any treatment failure during the follow-up period. The mean follow-up time was 8.3 +/- 1.9 months. It is early to conclude that this new treatment modality might be used widely for the treatment of PE; however, because it is an innovative modality, placebo-controlled studies (eg, sham procedure), with larger numbers of patients and including assessment of penile sensitivity (eg, biothesiometry), are needed.

[Laser treatment for retinopathy of prematurity in neonatal intensive care units. Premature Eye Rescue Program].

Science.gov (United States)

Maka, Erika; Imre, László; Somogyvári, Zsolt; Németh, János

2015-02-01

Retinopathy of prematurity is a leading cause of childhood blindness around the world. The Department of Ophthalmology at the Semmelweis University and the Peter Cerny Neonatal Emergency and Ambulance Service started an innovative Premature Eye Rescue Program to reduce the non-essential transport of premature babies suffering from retinopathy of prematurity. During the first 5 years 186 eyes of 93 premature babies were treated at the bedside with stage 3 retinopathy of prematurity in the primary hospitals. In this first 5-years period the authors reduced the number of transports of premature babies for laser treatment; 93 children avoided the unnecessary transport, saving altogether a distance of 21,930 kilometers for children, as well as the ambulance service. The Premature Eye Rescue Program offers a good and effective alternative for treatment of retinopathy in the primary hospitals. The authors propose the national extension of this program.

Frequency of temporomandibular joint dysfunction with clicking symptom due to primary molar premature loss in children aged 6-12 years old

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Riana Hestu Laksitowati

2009-03-01

Full Text Available Temporomandibular joint dysfunction with clicking symptom is sound “click” when open and close the mouth. The purpose of this study was to obtain the description of the frequency of temporomandibular joint dysfunction with clicking symptom caused by premature loss of primary molar teeth in children aged 6-12 years old at SDIT Imam Bukhari. The study was a descriptive survey, 136 students as samples were taken by purposive sampling technique. Premature loss of primary molar teeth examined by checking up the first and second primary molars upper and lower jaw using the hand mirror and explorer. Temporomandibular joint dysfunction examined by palpation and using a stethoscope. The result of this study showed that from 136 students having premature loss there are 49 students (36,03% had temporomandibular joint dysfunction with clicking symptom. The conclusion of this study indicates that more than one-fourth students at SDIT Imam Bukhari with premature loss of primary molar teeth had temporomandibular joint dysfunction with clicking symptom.

Prevalence of prematurely lost primary teeth in 5-10-year-old children in Thamar city, Yemen: A cross-sectional study.

Science.gov (United States)

Murshid, Sakhr A; Al-Labani, Mohammed A; Aldhorae, Khalid A; Rodis, Omar M M

2016-08-01

The premature loss of primary teeth is a potential risk factor for poor arch length development. Adequate arch length is important to the progression of the permanent teeth. Poor arch length can lead to crowding, ectopic eruption, or impaction of these teeth. This study is designed to assess the prevalence of premature loss of primary teeth in the 5-10-year-old age group. The study group included 185 children, that is, 91 boys and 94 girls. The dental examination was conducted by an experienced examiner under sufficient artificial light. Data including patient age and missing teeth were collected. Descriptive statistics were applied for data analysis, and from the results, Chi-square tests were used at a level of significance of 5% (P premature loss of primary teeth with no statistically significant difference between genders. The lower left primary second molar was the most commonly absent tooth in the dental arch (13.5%). The status of premature loss of primary teeth was high in the study group. Implementation of efficient educational and preventive programs to promote oral health would help children maintain a healthy primary dentition and eventually prevent the disturbances in the future development of normal occlusion. Early detection and management of the space problems associated with the early loss of primary teeth would help in reducing malocclusion problems.

On-demand treatment of premature ejaculation with clomipramine and paroxetine: A randomized, double-blind fixed-dose study with stopwatch assessment

NARCIS (Netherlands)

Waldinger, Marcel D.; Zwinderman, Aeilko H.; Olivier, Berend

2004-01-01

Objective: To investigate the degree of ejaculation delay induced by on-demand treatment with 20 mg paroxetine and 25 mg clomipramine and to assess the type and severity of non-sexual side-effects of treatment at the day of and the day after treatment with these drugs. Method: A randomized,

Prevalence of prematurely lost primary teeth in 5–10-year-old children in Thamar city, Yemen: A cross-sectional study

Science.gov (United States)

Murshid, Sakhr A.; Al-Labani, Mohammed A.; Aldhorae, Khalid A.; Rodis, Omar M. M.

2016-01-01

Objectives: The premature loss of primary teeth is a potential risk factor for poor arch length development. Adequate arch length is important to the progression of the permanent teeth. Poor arch length can lead to crowding, ectopic eruption, or impaction of these teeth. This study is designed to assess the prevalence of premature loss of primary teeth in the 5-10-year-old age group. Materials and Methods: The study group included 185 children, that is, 91 boys and 94 girls. The dental examination was conducted by an experienced examiner under sufficient artificial light. Data including patient age and missing teeth were collected. Descriptive statistics were applied for data analysis, and from the results, Chi-square tests were used at a level of significance of 5% (P premature loss of primary teeth with no statistically significant difference between genders. The lower left primary second molar was the most commonly absent tooth in the dental arch (13.5%). Conclusion: The status of premature loss of primary teeth was high in the study group. Implementation of efficient educational and preventive programs to promote oral health would help children maintain a healthy primary dentition and eventually prevent the disturbances in the future development of normal occlusion. Early detection and management of the space problems associated with the early loss of primary teeth would help in reducing malocclusion problems. PMID:27652244

Premature ovarian failure

Directory of Open Access Journals (Sweden)

Persani Luca

2006-04-01

Full Text Available Abstract Premature ovarian failure (POF is a primary ovarian defect characterized by absent menarche (primary amenorrhea or premature depletion of ovarian follicles before the age of 40 years (secondary amenorrhea. It is a heterogeneous disorder affecting approximately 1% of women e.g. Turner syndrome represent the major cause of primary amenorrhea associated with ovarian dysgenesis. Despite the description of several candidate genes, the cause of POF remains undetermined in the vast majority of the cases. Management includes substitution of the hormone defect by estrogen/progestin preparations. The only solution presently available for the fertility defect in women with absent follicular reserve is ovum donation.

Space loss following premature loss of primary second molars.

Science.gov (United States)

Alnahwi, Hassan H; Donly, Kevin J; Contreras, Claudia I

2015-01-01

This study was designed to evaluate the amount of space loss (SL) caused by premature loss of primary second molars, determine whether the eruption status of permanent first molars is an important factor in the amount of SL, and evaluate the effectiveness of space maintainers (SMs) in SL prevention. SL associated with 100 prematurely extracted primary second molars was evaluated in 87 healthy patients. Teeth were divided into groups based on the use of SMs (36 with SM and 64 without SM). Bitewing and periapical radiographs taken before extraction and 6, 12, 24, 36, and 48 months after extraction were used to determine the amount of SL. Not every patient attended every recall appointment, so the sample size varied at different evaluation times. The most significant amount of SL occurred in the first 12 months after extraction. In patients who did not use an SM, at 6 months there was a mean SL of 2.12 mm (SD, 1.65 mm) and at 12 months there was a mean of 4.02 mm (SD, 1.65), with significantly more SL in the first 6 months (P 0.05). When patients without an SM were grouped by the eruption status of the permanent first molar, there was significantly more SL in the groups with unerupted first molars than there was in the groups with erupted first molars at both 6 months (P < 0.001) and 12 months (P < 0.05). At both 6 and 12 months, the amount of SL in patients who had an SM (n = 13 and n = 14, respectively) was not significantly different from the amount of SL in those who did not have an SM (n = 33 and n = 23, respectively). SMs should be placed as soon as possible following tooth extraction to prevent undue SL. Placement of an SM a year or more after extraction has minimal benefit, since most SL takes place within the first year. SL does occur even when SMs are used.

Complex patterns of multivariate selection on the ejaculate of a broadcast spawning marine invertebrate.

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Fitzpatrick, John L; Simmons, Leigh W; Evans, Jonathan P

2012-08-01

Assessing how selection operates on several, potentially interacting, components of the ejaculate is a challenging endeavor. Ejaculates can be subject to natural and/or sexual selection, which can impose both linear (directional) and nonlinear (stabilizing, disruptive, and correlational) selection on different ejaculate components. Most previous studies have examined linear selection of ejaculate components and, consequently, we know very little about patterns of nonlinear selection on the ejaculate. Even less is known about how selection acts on the ejaculate as a functionally integrated unit, despite evidence of covariance among ejaculate components. Here, we assess how selection acts on multiple ejaculate components simultaneously in the broadcast spawning sessile invertebrate Mytilus galloprovincialis using the statistical tools of multivariate selection analyses. Our analyses of relative fertilization rates revealed complex patterns of selection on sperm velocity, motility, and morphology. Interestingly, the most successful ejaculates were made up of slower swimming sperm with relatively low percentages of motile cells, and sperm with smaller head volumes that swam in highly pronounced curved swimming trajectories. These results are consistent with an emerging body of literature on fertilization kinetics in broadcast spawners, and shed light on the fundamental nature of selection acting on the ejaculate as a functionally integrated unit. © 2012 The Author(s). Evolution© 2012 The Society for the Study of Evolution.

Spontaneous ejaculation in a wild Indo-Pacific bottlenose dolphin (Tursiops aduncus.

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Tadamichi Morisaka

Full Text Available Spontaneous ejaculation, which is defined as the release of seminal fluids without apparent sexual stimulation, has been documented in boreoeutherian mammals. Here we report spontaneous ejaculation in a wild Indo-Pacific bottlenose dolphin (Tursiops aduncus, and present a video of this rare behavior. This is the first report of spontaneous ejaculation by an aquatic mammal, and the first video of this behavior in animals to be published in a scientific journal.

Do Men Produce Higher Quality Ejaculates When Primed With Thoughts of Partner Infidelity?

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Pham, Michael N; Barbaro, Nicole; Holub, Andrew M; Holden, Christopher J; Mogilski, Justin K; Lopes, Guilherme S; Nicolas, Sylis C A; Sela, Yael; Shackelford, Todd K; Zeigler-Hill, Virgil; Welling, Lisa L M

2018-01-01

Sperm competition theory can be used to generate the hypothesis that men alter the quality of their ejaculates as a function of sperm competition risk. Using a repeated measures experimental design, we investigated whether men produce a higher quality ejaculate when primed with cues to sperm competition (i.e., imagined partner infidelity) relative to a control prime. Men ( n = 45) submitted two masturbatory ejaculates-one ejaculate sample for each condition (i.e., sperm competition and control conditions). Ejaculates were assessed on 17 clinical parameters. The results did not support the hypothesis: Men did not produce higher quality ejaculates in the sperm competition condition relative to the control condition. Despite the null results of the current research, there is evidence for psychological and physiological adaptations to sperm competition in humans. We discuss methodological limitations that may have produced the null results and present methodological suggestions for research on human sperm competition.

The premature loss of primary first molars: space loss to molar occlusal relationships and facial patterns.

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Alexander, Stanley A; Askari, Marjan; Lewis, Patricia

2015-03-01

To investigate space changes with the premature loss of primary first molars and their relationship to permanent molar occlusion and facial forms. Two hundred twenty-six participants (ranging in age from 7 years 8 months to 8 years 2 months; 135 female, 91 male) met all inclusion criteria designed to study space loss as a result of the premature loss of the primary first molar. After 9 months, space loss was evaluated in relationship to molar occlusion and facial form. Statistical evaluation was performed with the paired t-test and with a two-way analysis of variance for independent groups. Patients with leptoprosopic facial form and end-on molar occlusions all exhibited a statistically significant difference when compared to controls in terms of space loss (P molar occlusion displayed space loss as well (P molar occlusion displayed space loss in the maxilla (P molar occlusions showed no significant difference in space loss. The relationship between the first permanent molar occlusion and facial form of the child has an influence on the loss of space at the primary first molar site.

Prostatic urethra malformation associated with retrograde ejaculation: a case report.

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Zhao, Kai; Zhang, Jianzhong; Xu, Aiming; Zhang, Cheng; Wang, Zengjun

2016-12-21

Retrograde ejaculation can have anatomical, neurogenic, or pharmacological causes. Among these factors, malformation of the prostatic urethra is an uncommon cause. We describe a 29-year-old Han Chinese man with absence of his verumontanum combined with ejaculatory duct cysts, and no other cause for ejaculatory dysfunction. His verumontanum was replaced by a deep groove adjacent to his bladder neck, which could significantly influence bladder neck contraction. In addition, the large cysts in the ejaculatory duct could obstruct the anterior outlet of his prostatic urethra and prevent seminal fluid flow in an anterograde direction. There are few reports of retrograde ejaculation associated with congenital malformations of the posterior urethra. Malformations associated with bladder neck laxity and increased tone of the prostatic urethral outlet can contribute to retrograde ejaculation. Malformation of the prostatic urethra is an uncommon cause of retrograde ejaculation, and can be difficult to treat.

Time-to-ejaculation and the quality of semen produced by masturbation at a clinic.

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Elzanaty, Saad

2008-05-01

To investigate the association between the length of time-to-ejaculation and semen parameters. Ejaculates from 142 men under infertility assessment were analyzed according to the World Health Organization guidelines. Seminal neutral alpha-glucosidase (NAG), prostate-specific antigen (PSA), zinc, and fructose were also measured. Three groups according to the length of the time-to-ejaculation were defined: G(15) (greater than 15 minutes). Time to ejaculation showed negative significant correlation with sperm concentration (rho = -0.20, P = 0.02), total sperm count (rho = -0.20, P = 0.04), NAG (rho = -0.20, P = 0.01), and fructose (rho = -0.30, P = 0.02), respectively. No significant correlations existed among the time-to-ejaculation and age, sexual abstinence, semen volume, sperm motility, PSA, and zinc. There were negative significant associations among time-to-ejaculation and sperm concentration (beta = -3.0; P = 0.004), total sperm count (beta = -10; P = 0.02), total count of progressive motility (beta = -7.0; P = 0.02), and fructose (beta = -0.30; P = 0.02), respectively. No significant associations existed among the time-to-ejaculation and semen volume, motility grades, NAG, PSA, and zinc. G(15) (mean difference = 50 x 10(6)/mL; P = 0.01), (mean difference = 176 x 10(6)/ejaculate; P = 0.02), (mean difference = 110 x 10(6)/ejaculate; P = 0.03), respectively. Fructose was significantly higher in G(15) (mean difference = 5.0 mmol/L; P = 0.03). The time-to-ejaculation length was associated with semen parameters. These results might reflect the negative effect of acute stress during semen collection via masturbation at a clinic on semen parameters.

Salvaging urospermic ejaculates from brown bear (Ursus arctos).

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Gomes-Alves, S; Alvarez, M; Nicolas, M; Martínez-Rodríguez, C; Borragán, S; Chamorro, C A; Anel, L; de Paz, P

2014-11-30

The objective of this study was to reverse the osmotic stress of sperm in urine contaminated bear ejaculates that were obtained by electroejaculation using pre-freezing washing or density gradient centrifugation isolation. In Experiment 1, ejaculates were divided into six aliquots, five were diluted in each washing extender: 200, 300, 400, 500 and 700 mOsm/kg (prepared from a Tes-Tris-Fructose base, adding water or fructose as corresponds), at a 1:2 ratio (raw semen: washing solution, v/v); and the other aliquot was handled without washing (Control group). Samples were centrifuged at 600 × g for 6 min prior to freezing. In Experiment 2, ejaculates were divided into two aliquots: one was diluted 1:1 with TCG (Tris-Citric acid-Glucose) and centrifuged at 600 × g for 6 min (Centrifugation Control; C-Control); the other was treated with PureSperm density gradient column. After treatments, samples were cryopreserved. Sperm motility, viability (SYBR-14/propidium iodide (PI)) and acrosomal status (peanut agglutinin-fluorescein isothiocyanate (PNA-FITC)/PI) were analyzed before and after freezing. Ejaculates with an initial osmolality of less than 120 mOsm/kg treated with pre-freezing washing, and the Control sample had greater pre-freezing sperm motility than the raw ejaculate, but sperm viability was not different among these groups. The samples washed with 700 mOsm/kg solutions had the least pre-freezing viability. In the post-thawing evaluation, pre-freezing washing treatments did not provide any improvement in comparison with the Control sample, and treatment with 700 mOsm/kg extender had deleterious effects in all urospermic samples. PureSperm density gradient centrifugation applied to urospermic raw semen was suitable for improving sperm motility and viability of pre-freezing samples and the selected spermatozoa had greater freezing capacity. Copyright © 2014 Elsevier B.V. All rights reserved.

A Healthy Live Birth Following ICSI with Retrograde Ejaculated Sperm

African Journals Online (AJOL)

AJRH Managing Editor

Retrograde ejaculation, sometimes called dry orgasm, refers to the medical condition when semen enters the urinary bladder. (retrograde) instead of emerging through the penis after orgasm (antegrade). In some instances, a very minute quantity of antegrade semen appears in the ejaculate and may or may not be devoid of ...

Quality and freezing qualities of first and second ejaculates collected from endangered Gulf Coast Native rams.

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Nel-Themaat, L; Harding, G D; Chandler, J E; Chenevert, J F; Damiani, P; Fernandez, J M; Humes, P E; Pope, C E; Godke, R A

2006-10-01

The Gulf Coast Native sheep, or Louisiana Native sheep, is an endangered previously feral domestic sheep population of European origin that has been under natural selection pressure for reproductive survival in their transplanted range while roaming in the southern Gulf Coast Region of the United States. This sheep population has an increased natural resistance to internal parasites, breeds year-around and has a greater percentage of live lambs as compared with other breeds of sheep raised in similar environments. To preserve the genetic diversity of this important feral sheep population, semen was collected by electro-ejaculation and subjected to cryopreservation for subsequent storage in a genome resource bank. Unrelated rams (n=5) were collected 3 days-a-week, allowing at least 2 days of rest between collections. Two ejaculates were obtained from each ram per collection day, with the second collection conducted 10min after the first ejaculation. Semen was processed using the standard Salamon cryopreservation procedure in a Tris-yolk-glycerol extender, frozen in 0.5ml plastic straws using liquid nitrogen (LN(2)) vapor and stored in LN(2). Each ejaculate was evaluated for volume, sperm concentration/ml (x10(9)/ml), number of spermatozoa/ejaculate (x10(9)), sperm progressive motility (%) for pre-cooled semen, cooled semen and semen after thawing. For the five rams, each semen variable for the first ejaculate was compared with that of the second ejaculate collected 10min later. The mean semen volume, sperm concentration and number of spermatozoa per ejaculate obtained from the first ejaculate were significantly greater (P< or =0.01) than those of the second ejaculate (comparisons being 1.62 and 1.06; 3.2 and 1.5; 5.4 and 1.8, respectively). Overall, the mean motility of pre-cooled (22 degrees Celsius), cooled (5 degrees Celsius) and frozen (-196 degrees Celsius) post-thawed spermatozoa was less (P< or =0.01) in the first ejaculate (71.5, 64.8 and 34.1%, respectively

Clove

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... ingredient product used to keep men from reaching orgasm too early (premature ejaculation). In foods and beverages, ... THE SKIN: In men, to keep from reaching orgasm too early (premature ejaculation): A multi-ingredient cream ...

Dong Quai

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... who had a stroke. Allergies. Anemia. Constipation. Early orgasm in men (premature ejaculation). High blood pressure. Joint ... 3 months. APPLIED TO THE SKIN: For early orgasm in men (premature ejaculation): A specific cream containing ...

Male crickets adjust ejaculate quality with both risk and intensity of sperm competition.

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Simmons, Leigh W; Denholm, Amy; Jackson, Chantelle; Levy, Esther; Madon, Ewa

2007-10-22

Sperm competition theory predicts that males should increase their expenditure on the ejaculate with increasing risk of sperm competition, but decrease their expenditure with increasing intensity. There is accumulating evidence for sperm competition theory, based on examinations of testes size and/or the numbers of sperm ejaculated. However, recent studies suggest that ejaculate quality can also be subject to selection by sperm competition. We used experimental manipulations of the risk and intensity of sperm competition in the cricket, Teleogryllus oceanicus. We found that males produced ejaculates with a greater percentage of live sperm when they had encountered a rival male prior to mating. However, when mating with a female that presented a high intensity of sperm competition, males did not respond to risk, but produced ejaculates with a reduced percentage of live sperm. Our data suggest that males exhibit a fine-tuned hierarchy of responses to these cues of sperm competition.

Multiple effects of sibutramine on ejaculation and on vas deferens and seminal vesicle contractility.

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Nojimoto, Fernanda D; Piffer, Renata C; Kiguti, Luiz Ricardo de A; Lameu, Claudiana; de Camargo, Antônio C M; Pereira, Oduvaldo C M; Pupo, André S

2009-09-15

Sibutramine is an inhibitor of norepinephrine and 5-HT reuptake largely used in the management of obesity. Although a fairly safe drug, postmarketing adverse effects of sibutramine were reported including abnormal ejaculation in men. This study investigates the effects of sibutramine on ejaculation and vas deferens and seminal vesicle contractility. Adult male rats received sibutramine (5; 20; or 50 mg kg(-1), ip) and after 60 min were exposed to receptive females for determination of ejaculation parameters. The vasa deferentia and seminal vesicles of untreated rats were mounted in isolated organ baths for recording of isometric contractions and HEK293 cells loaded with fluorescent calcium indicator were used to measure intracellular Ca(2+) transients. Sibutramine 5 and 20 mg kg(-1) reduced ejaculation latency whereas 50 mg kg(-1) increased ejaculation latency. Sibutramine 3 to 30 microM greatly increased the sensitivity of the seminal vesicle and vas deferens to norepinephrine, but at concentrations higher than 10 microM there were striking depressions of maximal contractions induced by norepinephrine, carbachol and CaCl(2). In HEK293 cells, sibutramine 10 to 100 microM inhibited intracellular Ca(2+) transients induced by carbachol. Depending on the doses, sibutramine either facilitates or inhibits ejaculation. Apart from its actions in the central nervous system, facilitation of ejaculation may result from augmented sensitivity of smooth muscles to norepinephrine while reductions of intracellular Ca(2+) may be involved in the delayed ejaculation observed with high doses of sibutramine.

Multiple effects of sibutramine on ejaculation and on vas deferens and seminal vesicle contractility

International Nuclear Information System (INIS)

Nojimoto, Fernanda D.; Piffer, Renata C.; Kiguti, Luiz Ricardo de A.; Lameu, Claudiana; Camargo, Antonio C.M. de; Pereira, Oduvaldo C.M.; Pupo, Andre S.

2009-01-01

Sibutramine is an inhibitor of norepinephrine and 5-HT reuptake largely used in the management of obesity. Although a fairly safe drug, postmarketing adverse effects of sibutramine were reported including abnormal ejaculation in men. This study investigates the effects of sibutramine on ejaculation and vas deferens and seminal vesicle contractility. Adult male rats received sibutramine (5; 20; or 50 mg kg -1 , ip) and after 60 min were exposed to receptive females for determination of ejaculation parameters. The vasa deferentia and seminal vesicles of untreated rats were mounted in isolated organ baths for recording of isometric contractions and HEK293 cells loaded with fluorescent calcium indicator were used to measure intracellular Ca 2+ transients. Sibutramine 5 and 20 mg kg -1 reduced ejaculation latency whereas 50 mg kg -1 increased ejaculation latency. Sibutramine 3 to 30 μM greatly increased the sensitivity of the seminal vesicle and vas deferens to norepinephrine, but at concentrations higher than 10 μM there were striking depressions of maximal contractions induced by norepinephrine, carbachol and CaCl 2 . In HEK293 cells, sibutramine 10 to 100 μM inhibited intracellular Ca 2+ transients induced by carbachol. Depending on the doses, sibutramine either facilitates or inhibits ejaculation. Apart from its actions in the central nervous system, facilitation of ejaculation may result from augmented sensitivity of smooth muscles to norepinephrine while reductions of intracellular Ca 2+ may be involved in the delayed ejaculation observed with high doses of sibutramine.

SSRIs and ejaculation: a double-blind, randomized, fixed-dose study with paroxetine and citalopram.

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Waldinger, M D; Zwinderman, A H; Olivier, B

2001-12-01

Selective serotonin reuptake inhibitors (SSRIs) are known to induce delayed orgasm and ejaculation. However, different SSRIs may differentially delay ejaculation. A double-blind, fixed-dose study in healthy men with lifelong rapid ejaculation was performed to evaluate potential differences between clinically relevant doses of two selective serotonin reuptake inhibitors, paroxetine and citalopram, in their effects on ejaculation. Thirty men with an intravaginal ejaculation latency time (IELT) less than 1 minute were randomly assigned to receive paroxetine (20 mg/day) and citalopram (20 mg/day) for 5 weeks, after taking half the dosage in the first week. During the 1-month baseline and 6-week treatment period, IELTs were measured at home by using a stopwatch procedure. The trial was completed by 23 men. Analysis of variance revealed a between-group difference in the evolution of IELT delay over time (p = 0.0004); the IELT after paroxetine and citalopram gradually increased from 18 and 21 seconds to approximately 170 and 44 seconds, respectively. Paroxetine 20 mg/day exerted a strong delay (8.9-fold increase), whereas citalopram 20 mg/day mildly delayed ejaculation (1.8-fold increase). These results indicate that paroxetine leads to a significant delay in orgasm and ejaculation, whereas citalopram seems to have less of an effect on it.

Ejaculate traits in the Namibian cheetah (Acinonyx jubatus): influence of age, season and captivity.

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Crosier, Adrienne E; Marker, Laurie; Howard, JoGayle; Pukazhenthi, Budhan S; Henghali, Josephine N; Wildt, David E

2007-01-01

The objective was to examine the influence of animal age, season and captivity status on seminal quality in wild-born cheetahs (Acinonyx jubatus) in Namibia, Africa. Animals were divided into three age categories: juvenile (14-24 months; n = 16 males, 23 ejaculates); adult (25-120 months; n = 76 males, 172 ejaculates); and aged (>120 months; n = 5 males, 5 ejaculates). Seasons were categorised into hot-wet (January-April), cold-dry (May-August) and hot-dry (September-December). A comparison between freshly wild-caught (n = 29 males, 41 ejaculates) and captive-held cheetahs (n = 68 males, 159 ejaculates) was also conducted. Raw ejaculates contained 69.0 +/- 1.1% motile spermatozoa (mean +/- s.e.m.) with 73.6 +/- 1.5% of these cells containing an intact acrosome. Overall, 18.4 +/- 0.9% of spermatozoa were morphologically normal, with midpiece anomalies being the most prevalent (approximately 39%) defect. Juvenile cheetahs produced ejaculates with poorer sperm motility, forward progressive status, lower seminal volume and fewer total motile spermatozoa than adult and aged animals. Spermatogenesis continued unabated throughout the year and was minimally influenced by season. Proportions of sperm malformations were also not affected by season. Ejaculates from captive cheetahs had increased volume and intact acrosomes, but lower sperm density than wild-caught counterparts. In summary, Namibian cheetahs produce an extraordinarily high proportion of pleiomorphic spermatozoa regardless of age, season or living (captive versus free-ranging) status. Young males less than 2 years of age produce poorer ejaculate quality than adult and aged males. Because (1) all study animals were wild born and (2) there was little difference between freshly caught males and those maintained in captivity for protracted periods, our results affirm that teratospermia in the cheetah is mostly genetically derived. It also appears that an ex situ environment for the Namibian cheetah can ensure sperm

Ejaculate quality and constraints in relation to sperm competition levels among eutherian mammals.

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Lüpold, Stefan

2013-10-01

The outcome of sperm competition is influenced by the relative quantity and quality of sperm among competing ejaculates. Whereas it is well established that individual ejaculate traits evolve rapidly under postcopulatory sexual selection, little is known about other factors that might influence the evolution of ejaculates. For example, the metabolic rate is likely to affect the sperm production rate and the cellular activity or metabolism of sperm, and it has recently been suggested to constrain the evolution of sperm length in large but not small mammals. I thus examined in eutherian mammals how ejaculate quality traits vary with one another and with testis mass, body size, and metabolism. I found all ejaculate traits to covary positively with one another and to increase with relative testis mass. When controlling for testis mass, small-bodied species showed superior sperm quality (but not sperm number). Furthermore, sperm motility and viability were positively associated with the mass-corrected metabolic rate, but the percentage of morphologically normal and acrosome-intact sperm were not. These results indicate that body size and the energy budget may also influence the evolution of ejaculate quality, although these influences appear to vary among traits. © 2013 The Author(s). Evolution © 2013 The Society for the Study of Evolution.

Ejaculate parameters in patients with abdominal obesity

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E. A. Epanchintseva

2015-01-01

Full Text Available Objective: the definition of association of levels of sex steroid hormones and ejaculate parameters with different types of fat distribution in infertile men with overweight and obesity. Materials and methods. A total of 119 somatically healthy Russian men who contacted Novosibirsk Center of Reproductive Medicine in 2012–2014 with the problem of infertility have been examined. Based on the results of anthropometric surveys all the men were divided into 3 groups. The 1st group included men with overweight, obesity, and upper type of fat distribution (the ratio of waist circumference (WC to the hip circumference (HC ≥ 0.95; the 2nd group – men with overweight, obesity and lower type of fat distribution (WC/HC < 0.95; the 3rd group – men with normal body weight. Questionnaires have been completed; determination in serum of concentrations of total testosterone, estradiol, sex hormones binding globulin (SHBG; free testosterone calculated. Special study of ejaculate included semen analysis, sperm morphology assessment by strict criteria of Kruger MAP test, NCA-test, analysis of DNA fragmentation of sperm. Results. In all 3 groups frequency of medical and social risk factors occurrence for infertility were analyzed: sexually transmitted infections, 88 chronic prostatitis, the systematic consumption of alcohol and smoking. It was revealed that these factors occurred with a high, but not significantly different frequency in men of 3 groups: the frequency of sexually transmitted infections in the 1st, 2nd and 3rd groups was 65.8; 61.0 and 63.2 %; systematic consumption of alcohol – 85.4; 78.1 and 63.2 %; systematic smoking – 36.6; 53.7 and 34.21 %; chronic prostatitis – 68.3; 56.1 and 50.0 % respectively. The average concentrations of sex steroid hormones and SHBG in the serum of men of all groups did not go beyond the reference range. Patients of the 1st and 2nd groups had significantly lower concentration of total testosterone in serum

Human milk for the premature infant

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Underwood, Mark A.

2012-01-01

Synopsis Premature infants are a heterogeneous group with widely differing needs for nutrition and immune protection with risk of growth failure, developmental delays, necrotizing enterocolitis, and late-onset sepsis increasing with decreasing gestational age and birth weight. Human milk from women delivering prematurely has more protein and higher levels of many bioactive molecules compared to milk from women delivering at term. Human milk must be fortified for small premature infants to achieve adequate growth. Mother’s own milk improves growth and neurodevelopment and decreases the risk of necrotizing enterocolitis and late-onset sepsis and should therefore be the primary enteral diet of premature infants. Donor milk is a valuable resource for premature infants whose mothers are unable to provide an adequate supply of milk, but presents significant challenges including the need for pasteurization, nutritional and biochemical deficiencies and a limited supply. PMID:23178065

Relationship between premature loss of primary teeth with oral hygiene, consumption of soft drinks, dental care, and previous caries experience.

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López-Gómez, Sandra Aremy; Villalobos-Rodelo, Juan José; Ávila-Burgos, Leticia; Casanova-Rosado, Juan Fernando; Vallejos-Sánchez, Ana Alicia; Lucas-Rincón, Salvador Eduardo; Patiño-Marín, Nuria; Medina-Solís, Carlo Eduardo

2016-02-26

We determine the relationship between premature loss of primary teeth and oral hygiene, consumption of soft drinks, dental care and previous caries experience. This study focused on 833 Mexican schoolchildren aged 6-7. We performed an oral examination to determine caries experience and the simplified oral hygiene index. The dependent variable was the prevalence of at least one missing tooth (or indicated for extraction) of the primary dentition; this variable was coded as 0 = no loss of teeth and 1 = at least one lost primary tooth. The prevalence of at least one missing tooth was 24.7% (n = 206) (95% CI = 21.8-27.7). The variables that were associated with the prevalence of tooth loss (p oral hygiene (OR = 3.24), a lower frequency of brushing (OR = 1.60), an increased consumption of soda (OR = 1.89) and use of dental care (curative: OR = 2.83, preventive: OR = 1.93). This study suggests that the premature loss of teeth in the primary dentition is associated with oral hygiene, consumption of soft drinks, dental care and previous caries experience in Mexican schoolchildren. These data provide relevant information for the design of preventive dentistry programs.

Ejaculate of sneaker males is pheromonally inconspicuous in the black goby, Gobius niger (Teleostei, Gobiidae).

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Locatello, L; Mazzoldi, C; Rasotto, M B

2002-11-01

The black goby, Gobius niger, shows alternative male mating tactics, i.e., parental and sneaker males. Males release a sexual pheromone that attracts females and stimulates aggressive displays in males. This pheromone is produced by the mesorchial gland, a structure well developed in parental males but markedly undeveloped in sneakers. We measured the behavioral response of parental males to the ejaculates of males performing different reproductive tactics. Parental males reacted to the ejaculate of other parental males, with stereotypic aggressive behaviors, but not to the ejaculate of sneakers; consequently sneaker male ejaculate appears to be pheromonally inconspicuous. Copyright 2002 Wiley-Liss, Inc.

Diversity of extracellular vesicles in human ejaculates revealed by cryo-electron microscopy

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Johanna L. Höög

2015-11-01

Full Text Available Human ejaculates contain extracellular vesicles (EVs, that to a large extent are considered to originate from the prostate gland, and are often denominated “prostasomes.” These EVs are important for human fertility, for example by promoting sperm motility and by inducing immune tolerance of the female immune system to the spermatozoa. So far, the EVs present in human ejaculate have not been studied in their native state, inside the seminal fluid without prior purification and isolation procedures. Using cryo-electron microscopy and tomography, we performed a comprehensive inventory of human ejaculate EVs. The sample was neither centrifuged, fixed, filtered or sectioned, nor were heavy metals added. Approximately 1,500 extracellular structures were imaged and categorized. The extracellular environment of human ejaculate was found to be diverse, with 5 major subcategories of EVs and 6 subcategories of extracellular membrane compartments, including lamellar bodies. Furthermore, 3 morphological features, including electron density, double membrane bilayers and coated surface, are described in all subcategories. This study reveals that the extracellular environment in human ejaculate is multifaceted. Several novel morphological EV subcategories are identified and clues to their cellular origin may be found in their morphology. This inventory is therefore important for developing future experimental approaches, and to interpret previously published data to understand the role of EVs for human male fertility.

Within-population variation in ejaculate characteristics in a prolonged breeder, Peron's tree frog, Litoria peronii

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Sherman, Craig D. H.; Uller, Tobias; Wapstra, Erik; Olsson, Mats

2008-11-01

Sperm number is often a good predictor of success in sperm competition; however, it has become increasingly clear that, for some species, variation in probability of paternity cannot be explained by sperm number alone. Intraspecific variation in ejaculate characteristics, such as the number of viable sperm and sperm longevity, may play an equally important role in determining fertilization success. Here, we assess variation among ejaculates in three factors that may contribute to fertilization success (number of sperm per ejaculate, viability, and longevity), in a population of Peron’s tree frog ( Litoria peronii). We detected large variation among males in the number of sperm per ejaculate and the proportion of viable sperm within ejaculates, which could not be explained by variation in either male size or body condition. However, the proportion of viable sperm released by males increased over the season. Finally, we assessed sperm longevity (proportion viable sperm determined using a dual-fluorochrome vital dye) at two different temperatures. At 23°C, on average, 75% of sperm remained viable after 2 h, but there were significant differences amongst males with the percentage of viable sperm ranging from 43% to 95%. For sperm incubated at 4°C, ejaculates varied fivefold in sperm longevity with some males having 50% viable sperm after 5 days. Our data suggest that ejaculate characteristics (sperm number, viability, and longevity) vary widely in Peron’s tree frog and may therefore play an important role in determining siring success both in the presence and absence of sperm competition. We discuss the results in relation to selection on ejaculate traits via natural and sexual selection in this and other amphibians.

Significant changes of T2 value in the peripheral zone and seminal vesicles after ejaculation

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Shin, Takeshi [Dokkyo Medical University, Department of Radiology, Tochigi (Japan); Dokkyo Medical University Koshigaya Hospital, Department of Urology, Saitama (Japan); Kaji, Yasushi [Dokkyo Medical University, Department of Radiology, Tochigi (Japan); Shukuya, Toshiro; Nozaki, Miwako [Dokkyo Medical University Koshigaya Hospital, Department of Radiology, Saitama (Japan); Soh, Shigehiro; Okada, Hiroshi [Dokkyo Medical University Koshigaya Hospital, Department of Urology, Saitama (Japan)

2018-03-15

To analyse the quantitative changes of the prostate and seminal vesicles (SV) on magnetic resonance imaging (MRI) after ejaculation. Ten healthy young males were enrolled for T2-weighted and T2 mapping MRI before and after two consecutive ejaculations. T2 values of the peripheral zone (PZ) and the central gland (CG) at the midgland of the prostate were compared before and after ejaculation, respectively. T2 values of the PZ at the apex and base were also compared before and after, respectively. Pre- and post-ejaculation SV volumes were compared. The Wilcoxon's signed rank test with Bonferroni adjustment was used for comparison. After ejaculation, T2 values of the PZ significantly decreased (mean, 119±20 vs. 105±21, p=0.002) while those of the CG did not significantly change at the midgland. At the apex, T2 values of the PZ also decreased significantly (mean, 114±9 vs. 94±7, p=0.002). On the other hand, T2 values of the PZ did not change at the base. SV volumes were significantly reduced after ejaculation (mean, 11.1±7.7mL vs. 7.2±6.7mL, p=0.002). Ejaculation decreases T2 values of the PZ at the midgland and apex, and reduces SV volumes. Abstinence periods should be considered in evaluating the prostate and SV on MRI. (orig.)

Sexual Problems in Men: MedlinePlus Health Topic

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... Spanish Retrograde ejaculation (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Sexual Problems in ... Premature ejaculation Reifenstein syndrome Retrograde ejaculation Related Health Topics Erectile Dysfunction Penis Disorders Prostate Diseases Testicular Disorders ...

Premature loss of primary teeth: part I, its overall effect on occlusion and space in the permanent dentition.

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Hoffding, J; Kisling, E

1978-01-01

Premature loss of primary molars causes, without doubt, permanent changes in regard to space and sagittal molar relations, in the permanent dentition. The changes are due to drifting of teeth and lack of growth, and such changes should, whenever possible, be prevented. In part two of this series of papers, a further analysis of the data will be presented.

Diagnostic and treatment of retrograde ejaculation as a manifestation of urogenital form of autonomic diabetic polyneuropathy

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Dmitry Gennadyevich Kurbatov

2015-07-01

Full Text Available Background. Retrograde ejaculation in patients with type 1 diabetes mellitus is a complication of autonomic neuropathy that causes excretory infertility. It can be partial (reduction of ejaculate or total (absence of ejaculate and occurs in 10%–20% of men with type 1 diabetes mellitus.Aim. The aim of the study was to assess the effectiveness of a new endoscopic method for retrograde ejaculation correction and antegrade ejaculation restoration.Materials and methods. We included 30 patients with type 1 diabetes mellitus who had spermatozoa present in their post-orgasmic urine and ultrasonographic evidence of impaired or absent bladder neck closure. The mean age of participants was 32 (30–35 years, mean duration of diabetes was 17 (12–22 years and mean preoperative glycated haemoglobin level was 7.4% (6.9%–8.0%. All participants had total retrograde ejaculation. We used conventional irrigated urethrocystoscopy under local anaesthesia. During urethroscopy, bladder neck gaping was observed in all cases. Biocompatible material was injected at three points under the mucous layer of the posterior urethra, reaching the closing of the opposite edges of the urethra. A spermiogram was examined 1 week after the operation.Results. Restoration of antegrade ejaculation was achieved for 22 patients (73%, and the effects persisted for a mean of 7 (2–12 months. The spouses of four men became pregnant after surgery. In one case, the pregnancy resulted in a spontaneous abortion at gestational week 8, but the other three cases continued normally.Conclusion.This new method provides a highly effective means of restoring the physiological passage of the ejaculate. The operation is a low-invasive endoscopic procedure that does not disrupt urination, and it is possible to receive ejaculate of sufficient.

Autoimmune premature ovarian failure

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Beata Komorowska

2017-02-01

Full Text Available Premature ovarian failure (POF, also termed as primary ovarian insufficiency (POI, is a highly heterogenous condition affecting 0.5-3.0% of women in childbearing age. These young women comprise quite a formidable group with unique physical and psychological needs that require special attention. Premature ovarian senescence (POS in all of its forms evolves insidiously as a basically asymptomatic process, leading to complete loss of ovarian function, and POI/POF diagnoses are currently made at relatively late stages. Well-known and well-documented risk factors exist, and the presence or suspicion of autoimmune disorder should be regarded as an important one. Premature ovarian failure is to some degree predictable in its occurrence and should be considered while encountering young women with loss of menstrual regularity, especially when there is a concomitant dysfunction in the immune system.

Ejaculates are not used as nuptial gifts in simultaneously hermaphroditic snails.

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Lodi, Monica; Meijer, Fedde W; Koene, Joris M

2017-08-01

Promoted by sexual selection, males usually adopt different ways to increase their fertilization chances. In many insect taxa males donate nuptial gifts, together with sperm, which represent a valuable additional nutrient source that females can use to provision eggs. This has also been suggested to occur in simultaneous hermaphrodites, organisms with both sex functions. In theory, donation of nuptial gifts or extra nutrients might work in hermaphrodites that mate unilaterally (one-way donation of ejaculates), but will not be effective when these organisms mate reciprocally (mutual exchange of ejaculates), since on average each partner would receive the amount it also transfers. Hence, for the latter the net amount gained would be zero, and when considering the non-trivial costs of metabolic conversion the energy balance of this exchange ends up negative. To test this prediction, we measured the material (dry weight) and resource (carbon and nitrogen content) investment into ejaculates of the unilaterally mating freshwater snail Lymnaea stagnalis and spermatophores of the reciprocally mating land snail Cornu aspersum. When compared to eggs, our measurements indicate that the investment is low for ejaculates and spermatophores, neither of which represent a significant contribution to egg production. Importantly, during reciprocal matings, couples exchanged similar amounts of material and resources, thus a gain of extra substances seems irrelevant. Hence, caution is needed when generalizing functions of male reproductive strategies across mating systems. Although digestion of ejaculates does not provide extra material and resources in simultaneous hermaphrodites, their absorption could still be important to eliminate an excess of received sperm and to select sperm via cryptic female choice. Copyright © 2017 Elsevier GmbH. All rights reserved.

The influence of premature loss of temporary upper molars on permanent molars.

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Cernei, E R; Maxim, Dana Cristiana; Zetu, Irina Nicoleta

2015-01-01

Premature loss of primary molars due to dental caries and their complications has been associated with space loss and eruptive difficulties, especially when the loss occurs early. The aim of our study was to determine the impact of premature loss of temporary upper molars upon the longitudinal axis of the first and second upper permanent molar. The study group included 64 patients 6-9 years old with premature loss of primary molars and a control group of 48 patients with intact temporary teeth. It was evaluated the angle between longitudinal axis of first and second upper permanent molars and occlusal plane. The sofware used is Easy Dent 4 Viewer®.The data were analyzed by using the Statistical Package for the Social Sciences (version 20.0; SPSS, Chicago, III). It was observed that premature loss of upper second deciduous molars modifies greater the vertical axis of the permanent molars than the premature loss of first upper primary molar. First upper primary molar loss cause an acceleration eruption of first premolar, which will produce a distal inclintion of the both permanent molars. The use of space maintainers after premature loss of the second upper temporary molar is a last solution in preventing tridimensional lesions in the dental arch and occlusion.

Pontine Control of Ejaculation and Female Orgasm

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Huynh, Hieu K.; Willemsen, Antoon T. M.; Lovick, Thelma A.; Holstege, Gert

2013-01-01

IntroductionThe physiological component of ejaculation shows parallels with that of micturition, as both are essentially voiding activities. Both depend on supraspinal influences to orchestrate the characteristic pattern of activity in the pelvic organs. Unlike micturition, little is known about the

Premature dental eruption: report of case.

LENUS (Irish Health Repository)

McNamara, C M

2011-08-05

This case report reviews the variability of dental eruption and the possible sequelae. Dental eruption of the permanent teeth in cleft palate children may be variable, with delayed eruption the most common phenomenon. A case of premature dental eruption of a maxillary left first premolar is demonstrated, however, in a five-year-old male. This localized premature dental eruption anomaly was attributed to early extraction of the primary dentition, due to caries.

Sperm competition in humans: mate guarding behavior negatively correlates with ejaculate quality.

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Leivers, Samantha; Rhodes, Gillian; Simmons, Leigh W

2014-01-01

In species where females mate with multiple males, the sperm from these males must compete to fertilise available ova. Sexual selection from sperm competition is expected to favor opposing adaptations in males that function either in the avoidance of sperm competition (by guarding females from rival males) or in the engagement in sperm competition (by increased expenditure on the ejaculate). The extent to which males may adjust the relative use of these opposing tactics has been relatively neglected. Where males can successfully avoid sperm competition from rivals, one might expect a decrease in their expenditure on tactics for the engagement in sperm competition and vice versa. In this study, we examine the relationship between mate guarding and ejaculate quality using humans as an empirical model. We found that men who performed fewer mate guarding behaviors produced higher quality ejaculates, having a greater concentration of sperm, a higher percentage of motile sperm and sperm that swam faster and less erratically. These effects were found independent of lifestyle factors or factors related to male quality. Our findings suggest that male expenditure on mate guarding and on the ejaculate may represent alternative routes to paternity assurance in humans.

AXIAL MODIFICATIONS OF PERMANENT LOWER MOLARS AFTER PREMATURE LOSSES OF TEMPORARY MOLARS.

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Cernei, E R; Mavru, R B; Zetu, Irina Nicoleta

2016-01-01

The aim of our study was to determine the impact of premature loss of temporary lower molars upon the longitudinal axis of the first and second permanent molars. The study groups included 61 patients, 6-9 year olds with premature loss of primary molars and a control group of 24 patients with intact temporary teeth. We evaluated the angle between longitudinal axis of first and second lower permanent molars and occlusal plane. It was observed that premature loss of lower second deciduous molar modifies more the vertical axis of first and second permanent molars than the premature loss of first lower primary molar. Reducing space occurs mainly through mesial inclination of molars that separates the edentulous breach. Temporary loss of both lower first molars on the same quadrant causes an accelerated eruption of both premolars increasing the prevalence of eruption sequence: "4-5-3-7". The preservation of the occlusal morpho-functional complex using space maintainers mainly when the premature loss of the second primary molars occurs is the best interceptive treatment option.

The office management of ejaculatory disorders.

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Jiann, Bang-Ping

2016-08-01

Premature ejaculation (PE), delayed ejaculation (DE), anejaculation (AE) and retrograde ejaculation (RE) are four main ejaculatory disorders (EjDs) observed in clinical practice. Despite their high prevalence, EjDs remain underdiagnosed and undertreated. Primary care physicians should incorporate the discussion of sexual health topics into routine visits to facilitate EjD diagnosis and treatment. Because the causes of EjDs are multifactorial, the management of EjDs is etiology-specific and may require a holistic approach. Dapoxetine, a selective serotonin reuptake inhibitor, is the only drug approved for on-demand treatment of lifelong and acquired PE. In clinical practice, scheduled follow-up visits, risk factor treatment, appropriate dose escalation, adequate sexual attempts, patient education, and partner involvement are critical factors responsible for optimal overall management of PE and dapoxetine treatment outcomes.

[Ineffective sexuality pattern in an adolescent: nursing approach in primary health care].

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Martín-García, Angel; Oter-Quintana, Cristina; Brito-Brito, Pedro Ruymán; Martín-Iglesias, Susana; Alcolea-Cosín, M Teresa

2013-01-01

Adolescent is a phase of continual physiological, psychological and social adaptation. It is during this time that young people tend to have their first sexual experiences. Sexual dysfunctions are characterized by important clinical changes in sexual desire and/or by psycho-physiological changes in the sexual response cycle. Premature ejaculation is one of the most frequent sexual dysfunction amongst men, with a higher prevalence in the younger population compared to other populations. The clinical case is presented of a 17 year-old male who experienced difficulties during his sexual relations. It is discussed whether his condition was a sexual dysfunction or ineffective sexual pattern. The care plan which was developed in nursing consultation was described for ineffective sexual pattern; the pending nursing treatment incorporated activities recommended by scientific evidence. Finally, the role of primary health care nursing professionals is pointed out in the detection and approach of sexual problems in adolescents. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Effect of Prostatilene® AC and Prostatilene® on the ejaculate level of antisperm antibodies in the treatment of patients with chronic abacterial prostatitis and concomitant reproductive dysfunctions

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S. Kh. Al’-Shukri

2016-01-01

Full Text Available Objective: to evaluate the comparative effects of Prostatilene® AC (rectal suppositories and Prostatilene® (rectal suppositories 30 mg on the ejaculate level of antisperm antibodies in the treatment of patients with chronic abacterial prostatitis and concomitant reproductive dysfunctions.Subjects and methods. A total of 98 men aged 25–45 years with a verified diagnosis of chronic abacterial prostatitis and related reproductive functions were examined. The patients were treated and examined in an outpatient setting at 2 specialized research centers. A study group (n = 49 received therapy with Prostatilene® AC, a control group (n = 49 had Prostatilene®. A direct mixed antiglobulin reaction (MAR test was used to determine antisperm antibody levels in all the patients before and after a cycle of therapy. The findings were compared.Results. Primary examination revealed the presence of ejaculate antisperm antibodies in 43 (87.8 % and 40 (81.6 % cases in the study and control groups, respectively. After treatment, Prostatilene® was found to affect ejaculate antisperm antibody levels. The latter were reduced by Prostatilene® AC treatment. Final examination showed that 17 (34.6 % patients had antisperm antibodies in the ejaculate.Conclusion. Prostatilene® AC, unlike and Prostatilene®, is able to lower the ejaculate level of antisperm antibodies in patients with chronic abacterial prostatitis and concomitant reproductive dysfunctions.

Identification, RNAi knockdown, and functional analysis of an ejaculate protein that mediates a postmating, prezygotic phenotype in a cricket.

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Jeremy L Marshall

2009-10-01

Full Text Available Postmating, prezygotic phenotypes, especially those that underlie reproductive isolation between closely related species, have been a central focus of evolutionary biologists over the past two decades. Such phenotypes are thought to evolve rapidly and be nearly ubiquitous among sexually reproducing eukaryotes where females mate with multiple partners. Because these phenotypes represent interplay between the male ejaculate and female reproductive tract, they are fertile ground for reproductive senescence--as ejaculate composition and female physiology typically change over an individual's life span. Although these phenotypes and their resulting dynamics are important, we have little understanding of the proteins that mediate these phenotypes, particularly for species groups where postmating, prezygotic traits are the primary mechanism of reproductive isolation. Here, we utilize proteomics, RNAi, mating experiments, and the Allonemobius socius complex of crickets, whose members are primarily isolated from one another by postmating, prezygotic phenotypes (including the ability of a male to induce a female to lay eggs, to demonstrate that one of the most abundant ejaculate proteins (a male accessory gland-biased protein similar to a trypsin-like serine protease decreases in abundance over a male's reproductive lifetime and mediates the induction of egg-laying in females. These findings represent one of the first studies to identify a protein that plays a role in mediating both a postmating, prezygotic isolation pathway and reproductive senescence.

QUALITY OF NATIVE EJACULATE IN DOG OUT AND DURING SEXUAL SEASON

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Kenan Podžo

2013-09-01

Full Text Available The seasonal influence, i.e. the influence of climatic changes on the dog semen was investigated. Dog age varied between 2-4. German-shepard-type dog body weight was about 25 kg, and the other mixed breed dogs about 9 kg. All were kept in good zoo-hygienic conditions (sunny, ventilated and dry rooms. Dogs were served ready-made pellet food with the daily meals adjusted to their body mass. Experimental researches were mainly performed before and during the sexual season. Sperm from the dogs was taken manually every 5-6 days. After obtaining the ejaculate, the sperm-sampler was inserted in pre-heated cotton, and brought to the andrologic laboratory. Tools and instruments used for ejaculate sampling were heated to +35°C before use. Quality control was performed with the devices and instruments heated to  +38°C in order to avoid detrimental effect of rapid cooling to sperm movement, metabolism, etc. Sampled native ejaculates were anylized for the volume, motility, concentration, etc.Key words: dog, sperm, sexual season

Socially cued seminal fluid gene expression mediates responses in ejaculate quality to sperm competition risk.

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Simmons, Leigh W; Lovegrove, Maxine

2017-08-30

There is considerable evidence that males will increase the number of sperm ejaculated in response to sperm competition risk. However, whether they have the capacity to adjust seminal fluid components of the ejaculate has received less attention. Male crickets ( Teleogryllus oceanicus ) have been shown to adjust the viability of sperm in their ejaculate in response to sperm competition risk. Here we show that socially mediated plasticity in sperm viability is probably due, at least in part, to male adjustments in the protein composition of the seminal fluid. Seven seminal fluid protein genes were found to have an increased expression in males exposed to rival calls. Increased expression of these genes was correlated with increased sperm viability in whole ejaculates, and gene knockdown confirmed that at least one of these proteins promotes sperm viability. Our results lend support for recent theoretical models that predict complex responses in male allocation to seminal fluid composition in response to sperm competition risk. © 2017 The Author(s).

Diagnostic and treatment of retrograde ejaculation as a manifestation of urogenital form of autonomic diabetic polyneuropathy

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Dmitry Gennadyevich Kurbatov

2015-07-01

This new method provides a highly effective means of restoring the physiological passage of the ejaculate. The operation is a low-invasive endoscopic procedure that does not disrupt urination, and it is possible to receive ejaculate of sufficient.

Ejaculate traits and sperm cryopreservation in the endangered Baird's tapir (Tapirus bairdii).

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Pukazhenthi, Budhan S; Togna, Gina Della; Padilla, Luis; Smith, Diorene; Sanchez, Carlos; Pelican, Katey; Sanjur, Oris I

2011-01-01

There is little information on the reproductive biology of the male Baird's tapir (Tapirus bairdii). In this study, we characterized the ejaculate traits and evaluated the efficacy of 2 cryodiluents on sperm cryosurvival. Ejaculates were assessed for volume, pH, sperm motility, forward progression, osmolality, sperm concentration, sperm morphology, and acrosomal integrity. For cryopreservation, ejaculates with >50% total sperm motility were washed, and sperm pellets were resuspended in either Botu-Crio (CryoVital, Grandau, Germany) or INRA 96 containing 2% egg yolk and 2.5% each of methyl- and dimethylformamide (INRA 96), and they were cryopreserved over liquid nitrogen vapor. Thawed samples were incubated in vitro (25 °C) and evaluated for percent total sperm motility, forward progression, and acrosomal integrity at hourly intervals for 4 hours. Spermic ejaculates were obtained from all males, and the mean seminal volume, sperm concentration per milliliter, percent sperm motility, progressive status, and percent morphologically normal cells were 20.4 ± 4.3 mL, 101.2 ± 24.0 × 10(6)/mL, 46.1% ± 5.0%, 2.9 ± 0.1, and 6.9% ± 1.4%, respectively. There was a positive significant correlation between percent normal sperm and animal age (r = 0.66; P tapir; demonstrate that tapir spermatozoa can be cryopreserved in diluents containing amides alone or in combination with glycerol; and provide fundamental information critical for development of assisted reproductive technologies for the Baird's tapir.

Excessive Premature Atrial Complexes and the Risk of Recurrent Stroke or Death in an Ischemic Stroke Population.

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Vinther, Kristina H; Tveskov, Claus; Möller, Sören; Auscher, Soren; Osmanagic, Armin; Egstrup, Kenneth

2017-06-01

Our aim was to investigate the association of premature atrial complexes and the risk of recurrent stroke or death in patients with ischemic stroke in sinus rhythm. In a prospective cohort study, we used 24-hour Holter recordings to evaluate premature atrial complexes in patients consecutively admitted with ischemic strokes. Excessive premature atrial complexes were defined as >14 premature atrial complexes per hour and 3 or more runs of premature atrial complexes per 24 hours. During follow-up, 48-hour Holter recordings were performed after 6 and 12 months. Among patients in sinus rhythm, the association of excessive premature atrial complexes and the primary end point of recurrent stroke or death were estimated in both crude and adjusted Cox proportional hazards models. We further evaluated excessive premature atrial complexes contra atrial fibrillation in relation to the primary end point. Of the 256 patients included, 89 had atrial fibrillation. Of the patients in sinus rhythm (n = 167), 31 had excessive premature atrial complexes. During a median follow-up of 32 months, 50 patients (30% of patients in sinus rhythm) had recurrent strokes (n = 20) or died (n = 30). In both crude and adjusted models, excessive premature atrial complexes were associated with the primary end point, but not with newly diagnosed atrial fibrillation. Compared with patients in atrial fibrillation, those with excessive premature atrial complexes had similarly high risks of the primary end point. In patients with ischemic stroke and sinus rhythm, excessive premature atrial complexes were associated with a higher risk of recurrent stroke or death. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Premature menopause.

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Okeke, Tc; Anyaehie, Ub; Ezenyeaku, Cc

2013-01-01

Premature menopause affects 1% of women under the age of 40 years. The women are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. There is need to use simplified protocols and improved techniques in oocyte donation to achieve pregnancy and mother a baby in those women at risk. Review of the pertinent literature on premature menopause, selected references, internet services using the PubMed and Medline databases were included in this review. In the past, pregnancy in women with premature menopause was rare but with recent advancement in oocyte donation, women with premature menopause now have hoped to mother a child. Hormone replacement therapy is beneficial to adverse consequences of premature menopause. Women with premature menopause are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. Public enlightenment and education is important tool to save those at risk.

Dilution of boar ejaculates with BTS containing HEPES in place of bicarbonate immediately after ejaculation can reduce the increased inducibility of the acrosome reaction by treatment with calcium and calcium ionophore A23187, which is potentially associated with boar subfertility.

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Murase, Tetsuma; Imaeda, Noriaki; Yamada, Hiroto; Takasu, Masaki; Taguchi, Kazuo; Katoh, Tsutomu

2010-06-01

The present study investigated whether substitution of HEPES for bicarbonate in BTS (BTS-H) used to dilute boar ejaculates immediately after ejaculation could reduce the increased inducibility of the acrosome reaction by calcium and calcium ionophore A23187. When an ejaculate was split, diluted 5-fold with regular BTS (BTS-B) and BTS-H and stored at 17 C for 12 h or 60 h, the extender or storage time had no significant influence on sperm motility or viability measured by the eosin-nigrosin method. When spermatozoa diluted serially with BTS-B and stored (36 h) were stimulated with Ca2+ (3 mM) and A23187 (0.3 microM), the proportion of spermatozoa that underwent the acrosome reaction (% acrosome reactions) significantly increased as the magnifications of dilution increased (bicarbonate content almost unchanged by dilution). By contrast, the % acrosome reactions in spermatozoa similarly diluted and stored with BTS-H decreased with the increasing magnifications of dilution (bicarbonate decreased). Sperm motility immediately after the end of incubation without A23178 tended to be lower for BTS-H than BTS-B, and the ejaculates for BTS-H had a tendency to have a lower total protein in seminal plasma than those for BTS-B. These results implied that the samples for BTS-H could be used as a model for ejaculates possibly collected during summer and showing subfertility. When an ejaculate was split, diluted serially with BTS-B and BTS-H and stored, viability measured by staining with propidium iodide was extremely similar between the 2 extenders and among the different dilution magnifications, regardless of whether spermatozoa were washed (stored for 36-66 h) or not (stored for 66-72 h). These results suggest that boar ejaculate can be stored with BTS-H at least according to the results for sperm motility and viability and that hypersensitivity of spermatozoa to Ca2+ and A23187 potentially associated with boar subfertility could be lessened by diluting ejaculates with BTS-H.

Efficacy of Intravitreal Bevacizumab for Stage 3+ Retinopathy of Prematurity

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Mintz-Hittner, Helen A.; Kennedy, Kathleen A.; Chuang, Alice Z.

2011-01-01

BACKGROUND Retinopathy of prematurity is a leading cause of childhood blindness worldwide. Peripheral retinal ablation with conventional (confluent) laser therapy is destructive, causes complications, and does not prevent all vision loss, especially in cases of retinopathy of prematurity affecting zone I of the eye. Case series in which patients were treated with vascular endothelial growth factor inhibitors suggest that these agents may be useful in treating retinopathy of prematurity. METHODS We conducted a prospective, controlled, randomized, stratified, multicenter trial to assess intravitreal bevacizumab monotherapy for zone I or zone II posterior stage 3+ (i.e., stage 3 with plus disease) retinopathy of prematurity. Infants were randomly assigned to receive intravitreal bevacizumab (0.625 mg in 0.025 ml of solution) or conventional laser therapy, bilaterally. The primary ocular outcome was recurrence of retinopathy of prematurity in one or both eyes requiring retreatment before 54 weeks’ postmenstrual age. RESULTS We enrolled 150 infants (total sample of 300 eyes); 143 infants survived to 54 weeks’ postmenstrual age, and the 7 infants who died were not included in the primary-outcome analyses. Retinopathy of prematurity recurred in 4 infants in the bevacizumab group (6 of 140 eyes [4%]) and 19 infants in the laser-therapy group (32 of 146 eyes [22%], P = 0.002). A significant treatment effect was found for zone I retinopathy of prematurity (P = 0.003) but not for zone II disease (P = 0.27). CONCLUSIONS Intravitreal bevacizumab monotherapy, as compared with conventional laser therapy, in infants with stage 3+ retinopathy of prematurity showed a significant benefit for zone I but not zone II disease. Development of peripheral retinal vessels continued after treatment with intravitreal bevacizumab, but conventional laser therapy led to permanent destruction of the peripheral retina. This trial was too small to assess safety. PMID:21323540

Prematurity, atopy, and childhood asthma in Puerto Ricans.

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Rosas-Salazar, Christian; Ramratnam, Sima K; Brehm, John M; Han, Yueh-Ying; Boutaoui, Nadia; Forno, Erick; Acosta-Pérez, Edna; Alvarez, María; Colón-Semidey, Angel; Canino, Glorisa; Celedón, Juan C

2014-02-01

Puerto Rican children share a disproportionate burden of prematurity and asthma in the United States. Little is known about prematurity and childhood asthma in Puerto Rican subjects. We sought to examine whether prematurity is associated with asthma in Puerto Rican children. We performed a case-control study of 678 children aged 6 to 14 years with (n = 351) and without (n = 327) asthma living in San Juan, Puerto Rico. Prematurity was defined by parental report for our primary analysis. In a secondary analysis, we only included children whose parents reported prematurity that required admission to the neonatal intensive care unit. Asthma was defined as physician-diagnosed asthma and wheeze in the prior year. We used logistic regression for analysis. All multivariate models were adjusted for age, sex, household income, atopy (≥1 positive IgE level to common allergens), maternal history of asthma, and early-life exposure to environmental tobacco smoke. In a multivariate analysis there was a significant interaction between prematurity and atopy on asthma (P = .006). In an analysis stratified by atopy, prematurity was associated with a nearly 5-fold increased odds of asthma in atopic children (adjusted odds ratio, 4.7; 95% CI, 1.5-14.3; P = .007). In contrast, there was no significant association between prematurity and asthma in nonatopic children. Similar results were obtained in our analysis of prematurity requiring admission to the neonatal intensive care unit and asthma. Our results suggest that atopy modifies the estimated effect of prematurity on asthma in Puerto Rican children. Prematurity might explain, in part, the high prevalence of atopic asthma in this ethnic group. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Fisioterapia pélvica no tratamento da ejaculação precoce: uma revisão integrativa / Pelvic physiotherapy in the treatment of premature ejaculation: an integrative review

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Fernanda Santos Fontana

2018-04-01

Full Text Available A ejaculação precoce (EP é prevalente, apresentando diversos tipos de tratamento, evidenciando a falta de uma modalidade definitiva. A fisioterapia pélvica emerge como modalidade terapêutica e necessita de maior esclarecimento. Assim, buscou-se descrever a eficácia das técnicas de fisioterapia utilizadas no tratamento da EP. Para tanto, foi realizada uma revisão integrativa de ensaios clínicos nas bases de dados PubMed, LILACS e SciELO. Os resultados retornaram ensaios passíveis de inclusão, num total de cinco artigos utilizados. A fisioterapia pélvica mostrou sucesso de 54% a 83% de cura. O treino da musculatura do assoalho pélvico, auxiliado ou não por eletroestimulação e biofeedback, foi a técnica descrita. Conclui-se que a fisioterapia pélvica é eficaz na cura da maior parte das vítimas de EP. No entanto, mais estudos se fazem necessário nesta área, particularmente ensaios clínicos testando as diferentes técnicas. Premature ejaculation (PE is the most prevalent sexual dysfunction in men, and today there are several different types of treatment, indicating the lack of a definite mode for that. Physiotherapy emerges as a therapeutic, but needs further clarification. To describe the physiotherapy techniques currently used in the treatment of PE, discussing their effectiveness. Having this in mind, we performed a systematic review on PubMed, LILACS and SciELO, including clinical trials of physiotherapy techniques treating PE. Two databases returned files amenable to inclusion so, a total of five articles was used. Pelvic physiotherapy showed 54% to 83% cure rate and training of the pelvic floor muscles, aided or not by electrical stimulation and biofeedback, was the most frequent modality. Pelvic physiotherapy is effective in curing the majority of victims of PE, but further study in this area is a necessity, mainly clinical trials which test different techniques.

Do male secondary sexual characters signal ejaculate quality? A meta-analysis.

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Mautz, Brian S; Møller, Anders P; Jennions, Michael D

2013-08-01

There are two reasons why researchers are interested in the phenotypic relationship between the expression of male secondary sexual characters (SSCs) and 'ejaculate quality' (defined as sperm/ejaculate traits that are widely assumed to increase female fertility and/or sperm competitiveness). First, if the relationship is positive then females could gain a direct benefit by choosing more attractive males for fertility assurance reasons ('the phenotype-linked fertility' hypothesis). Second, there is much interest in the direction of the correlation between traits favoured by pre-copulatory sexual selection (i.e. affecting mating success) and those favoured by post-copulatory sexual selection (i.e. increasing sperm competitiveness). If the relationship is negative this could lead to the two forms of selection counteracting each other. Theory predicts that the direction of the relationship could be either positive or negative depending on the underlying genetic variance and covariance in each trait, the extent of variation among males in condition (resources available to allocate to reproductive traits), and variation among males in the cost or rate of mating. We conducted a meta-analysis to determine the average relationship between the expression of behavioural and morphological male secondary sexual characters and four assays of ejaculate quality (sperm number, viability, swimming speed and size). Regardless of how the data were partitioned the mean relationship was consistently positive, but always statistically non-significant. The only exception was that secondary sexual character expression was weakly but significantly positively correlated with sperm viability (r = 0.07, P < 0.05). There was no significant difference in the strength or direction of the relationship between behavioural and morphological SSCs, nor among relationships using the four ejaculate quality assays. The implications of our findings are discussed. © 2013 The Authors. Biological Reviews �

Modified Distal Shoe Appliance for Premature Loss of Multiple Deciduous Molars: A Case Report

OpenAIRE

Bhat, Prasanna Kumar; K., Navin H.; Idris, Mohammed; Christopher, Pradeep; Rai, Niharika

2014-01-01

Preservation of the primary dentition until the normal time of exfoliation is one of the most important factor involved in preventive and interceptive dentistry. The premature loss of second primary molar before the eruption of permanent first molar can create a significant arch space/tooth size discrepancy. Distal shoe space maintainer is a valuable part of the Paediatric Dentist’s armamentarium in those cases where the second primary molar is prematurely lost and it helps to guide the first...

Myopia in premature babies with and without retinopathy of prematurity.

OpenAIRE

Nissenkorn, I; Yassur, Y; Mashkowski, D; Sherf, I; Ben-Sira, I

1983-01-01

One hundred and fifty-five premature infants weighing 600-2000 g were followed up during 1974-80 for the presence of retinopathy of prematurity (ROP) and for the existence of myopia. 50% of the premature infants who had ROP were myopic, while only 16% myopic premature infants were found among those who did not have ROP. There was a positive correlation between the degree of myopia and the severity of cicatricial ROP. No difference existed in the frequency and degree of myopia between prematur...

Complications and the effect of varicocelectomy on semen analysis, fertility, early ejaculation and spontaneous abortion

Directory of Open Access Journals (Sweden)

Shamsa Ali

2010-01-01

Full Text Available Varicocele is still an enigma. Its effects on semen analysis, fertility and, more re-cently, early ejaculation and spontaneous abortion in spouses are not yet fully understood. In this retrospective study, we evaluated these four parameters (semen analysis, fertility, early ejacu-lation and spontaneous abortion among spouses in relation to varicocele and varicocelectomy during a 13-year period. A total of 1,711 patients with varicocele underwent varicocelectomy by high inguinal method (251 cases, subinguinal method (1,375 cases, scrotal method (34 cases, and subinguinal method with local anesthesia (38 cases. Our complication rate was acceptable. Sperm count, motility and morphology increased three months post operation in 55, 51, and 46%, respectively (P value 0.000, 0.000, and 0.015, respectively. Paternity was 56% after one year of post varicocelectomy follow-up. Only 7 out of 82 azoospermic men had sperm in their semen after varicocelectomy and only one of them with mild spermatogenic hypoplasia became a father. The spontaneous abortion rate in the spouses of respondents was 59%. Early ejaculation improved in 75% of the respondents. In conclusion, varicocelectomy does not improve sperm parameters in all men, but it improves pregnancy rate, early ejaculation, and scrotal pain.

Retinopathy of prematurity and neurodevelopmental disabilities in premature infants.

Science.gov (United States)

Beligere, Nagamani; Perumalswamy, Vijayalaksmi; Tandon, Manish; Mittal, Amit; Floora, Jayasheele; Vijayakumar, B; Miller, Marilyn T

2015-10-01

Prematurity is a major global health issue leading to high mortality and morbidity among the survivors. Neurodevelopmental disability (NDD) and retinopathy of prematurity (ROP) are the most common complications of prematurity. In fact, ROP is the second leading cause of childhood blindness in the world. Although there is much information regarding the occurrence of ROP and of NDD in premature infants, there have been few studies on ROP and its association with NDD. The objectives of this article are to review the current literature on the subject and to publish our own findings concerning the association between ROP and NDD in premature infants. The review suggests that although NDDs are related to degree of prematurity, NDD could also be the result of visual impairments resulting from ROP. Our own study shows a close association between NDD and zonal involvement of ROP: higher NDD if zone 1 is involved and less if zone 3 is involved. Copyright © 2015 Elsevier Ltd. All rights reserved.

Modified distal shoe appliance for premature loss of multiple deciduous molars: a case report.

Science.gov (United States)

Bhat, Prasanna Kumar; K, Navin H; Idris, Mohammed; Christopher, Pradeep; Rai, Niharika

2014-08-01

Preservation of the primary dentition until the normal time of exfoliation is one of the most important factor involved in preventive and interceptive dentistry. The premature loss of second primary molar before the eruption of permanent first molar can create a significant arch space/tooth size discrepancy. Distal shoe space maintainer is a valuable part of the Paediatric Dentist's armamentarium in those cases where the second primary molar is prematurely lost and it helps to guide the first permanent molar into place. Conventional design poses various limitations in cases of premature loss of multiple deciduous molars. Thus, it is required to modify the conventional designs according to the needs of the patient. This case report describes an innovative modification of distal shoe appliance in cases of premature loss of multiple deciduous molars. In the present case, modification of distal shoe space maintainer was advocated because of inadequate abutments caused due to multiple loss of deciduous molars. Bilateral design of distal shoe was planned for unilateral loss of deciduous molars.

Finely Resolved On-Road PM2.5 and Estimated Premature Mortality in Central North Carolina.

Science.gov (United States)

Chang, Shih Ying; Vizuete, William; Serre, Marc; Vennam, Lakshmi Pradeepa; Omary, Mohammad; Isakov, Vlad; Breen, Michael; Arunachalam, Saravanan

2017-12-01

To quantify the on-road PM 2.5 -related premature mortality at a national scale, previous approaches to estimate concentrations at a 12-km × 12-km or larger grid cell resolution may not fully characterize concentration hotspots that occur near roadways and thus the areas of highest risk. Spatially resolved concentration estimates from on-road emissions to capture these hotspots may improve characterization of the associated risk, but are rarely used for estimating premature mortality. In this study, we compared the on-road PM 2.5 -related premature mortality in central North Carolina with two different concentration estimation approaches-(i) using the Community Multiscale Air Quality (CMAQ) model to model concentration at a coarser resolution of a 36-km × 36-km grid resolution, and (ii) using a hybrid of a Gaussian dispersion model, CMAQ, and a space-time interpolation technique to provide annual average PM 2.5 concentrations at a Census-block level (∼105,000 Census blocks). The hybrid modeling approach estimated 24% more on-road PM 2.5 -related premature mortality than CMAQ. The major difference is from the primary on-road PM 2.5 where the hybrid approach estimated 2.5 times more primary on-road PM 2.5 -related premature mortality than CMAQ due to predicted exposure hotspots near roadways that coincide with high population areas. The results show that 72% of primary on-road PM 2.5 premature mortality occurs within 1,000 m from roadways where 50% of the total population resides, highlighting the importance to characterize near-road primary PM 2.5 and suggesting that previous studies may have underestimated premature mortality due to PM 2.5 from traffic-related emissions. © 2017 Society for Risk Analysis.

Antidepressants and ejaculation: a double-blind, randomized, placebo-controlled, fixed-dose study with paroxetine, sertraline, and nefazodone.

Science.gov (United States)

Waldinger, M D; Zwinderman, A H; Olivier, B

2001-06-01

Antidepressant medication is often associated with sexual side effects. A double-blind, placebo-controlled study in men with lifelong rapid ejaculation was performed to assess the effects of two selective serotonin (5-HT) reuptake inhibitors--paroxetine and sertraline--and the 5-HT2 antagonist and 5-HT/noradrenaline reuptake inhibitor nefazodone on the latency to ejaculate. Forty-eight men with an intravaginal ejaculation latency time (IELT) of a maximum of 1 minute were randomly assigned to receive paroxetine (20 mg/day), sertraline (50 mg/day), nefazodone (400 mg/day), or placebo for 6 weeks. During the 1-month baseline and 6-week treatment period, IELTs were measured at home with a stopwatch. The trial was completed by 40 men. During the 6-week treatment period, the geometric mean IELT in the placebo group was stable at approximately 20 seconds. Analysis of variance revealed a between-group difference in the evolution of IELT delay over time (p = 0.002); the IELT after paroxetine and sertraline gradually increased to approximately 146 and 58 seconds, respectively, compared with 28 seconds in the nefazodone group. The paroxetine and sertraline groups differed significantly (p < 0.001 and p = 0.024, respectively) from placebo, but the nefazodone group did not (p = 0.85). Compared with baseline, paroxetine exerted the strongest delay in ejaculation, whereas sertraline delayed it only moderately. There was no clinically relevant delay in ejaculation with nefazodone.

The improving effect of reduced glutathione on boar sperm cryotolerance is related with the intrinsic ejaculate freezability.

Science.gov (United States)

Yeste, Marc; Estrada, Efrén; Pinart, Elisabeth; Bonet, Sergi; Miró, Jordi; Rodríguez-Gil, Joan E

2014-04-01

Reduced glutathione (GSH) improves boar sperm cryosurvival and fertilising ability when added to freezing extenders. Poor freezability ejaculates (PFE) are known to present lower resistance than good freezability ejaculates (GFE) to cryopreservation procedures. So far, no study has evaluated whether the ability of GSH to counteract the cryopreservation-induced injuries depends on ejaculate freezability (i.e. GFE vs. PFE). For this reason, thirty boar ejaculates were divided into three equal volume fractions and cryopreserved with or without GSH at a final concentration of either 2 or 5mM in freezing media. Before and after freeze-thawing, sperm quality was evaluated through analysis of viability, motility, integrity of outer acrosome membrane, ROS levels, integrity of nucleoprotein structure, and DNA fragmentation. Ejaculates were classified into two groups (GFE or PFE) according to their post-thaw sperm motility and viability assessments in negative control (GSH 0mM), after running cluster analyses. Values of each sperm parameter were then compared between treatments (GSH 0mM, GSH 2mM, GSH 5mM) and freezability groups (GFE, PFE). In the case of GFE, GSH significantly improved boar sperm cryotolerance, without differences between 2 and 5mM. In contrast, PFE freezability was significantly increased when supplemented with 5mM GSH, but not when supplemented with 2mM GSH. In conclusion, PFE need a higher concentration of GSH than GFE to improve their cryotolerance. Copyright © 2014 Elsevier Inc. All rights reserved.

Retrograde ejaculation and sexual dysfunction in men with diabetes mellitus

DEFF Research Database (Denmark)

Fedder, J; Kaspersen, Maja Døvling; Brandslund, I

2013-01-01

Retrograde ejaculation (RE) and erectile dysfunction may be caused by diabetes mellitus (DM), but the prevalence of RE among DM patients is unknown. A prospective, blinded case-control study comparing men with DM with matched controls according to RE and erectile dysfunction was performed. Twenty...

Female ejaculation orgasm vs. coital incontinence: a systematic review.

Science.gov (United States)

Pastor, Zlatko

2013-07-01

Women may expel various kinds of fluids during sexual arousal and at orgasm. Their origins, quantity, compositions, and expulsion mechanisms depend on anatomical and pathophysiological dispositions and the degree of sexual arousal. These are natural sexual responses but may also represent symptoms of urinary incontinence. The study aims to clarify the etiology of fluid leakage at orgasm, distinguish between associated physiological sexual responses, and differentiate these phenomena from symptoms of illness. A systematic literature review was performed. EMBASE (OvidSP) and Web of Science databases were searched for the articles on various phenomena of fluid expulsions in women during sexual arousal and at orgasm. Articles included focused on female ejaculation and its variations, coital incontinence (CI), and vaginal lubrication. Female ejaculation orgasm manifests as either a female ejaculation (FE) of a smaller quantity of whitish secretions from the female prostate or a squirting of a larger amount of diluted and changed urine. Both phenomena may occur simultaneously. The prevalence of FE is 10-54%. CI is divided into penetration and orgasmic forms. The prevalence of CI is 0.2-66%. Penetration incontinence occurs more frequently and is usually caused by stress urinary incontinence (SUI). Urodynamic diagnoses of detrusor overactivity (DOA) and SUI are observed in orgasmic incontinence. Fluid expulsions are not typically a part of female orgasm. FE and squirting are two different physiological components of female sexuality. FE was objectively evidenced only in tens of cases but its reported high prevalence is based mostly on subjective questionnaire research. Pathophysiology of squirting is rarely documented. CI is a pathological sign caused by urethral disorder, DOA, or a combination of both, and requires treatment. An in-depth appreciation of these similar but pathophysiologically distinct phenomena is essential for distinguishing normal, physiological sexual

LOSS OF SPACE ACCORDING TO THE TIME AND THE TYPE OF THE PREMATURE EXTRACTED DECIDUOUS TEETH

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Radosveta S. Andreeva

2016-06-01

Full Text Available There is a difference of space loss depending on the time of premature extraction and the type of the prematurely extracted teeth. The aim of the study is to determine the space loss according to the time and the type of the extracted teeth. Material and methods: We studied 90 children 6 to 9 years old with premature loss of one or more primary teeth divided into three groups according to the severity of the orthodontic deformation. We used two biometric methods – the Moyers method and measured the mesial and distal movement of the adjustment teeth by drawing perpendicular lines towards the middle line. Results: The average amount of space lost is 0,033 mm for the first group, 2,2 for the second and 3,16 for the third group. The lack of space when the first primary molars are extracted is 0,37 mm in the upper jaw and is due to medicalization of the second primary molar. In the lower jaw the loss of space is – 1,12mm. The lack of space when the second primary molars are prematurely extracted is 1,2 for the upper and 1,45 for the lower jaw. Conclusion: The time is a significant factor for the loss of space. The reduction of space increases when the premature extraction is done before more than two months and when second primary molars are extracted.

Your Premature Baby

Science.gov (United States)

... volunteer leader Partner Spotlight Become a partner World Prematurity Day What's happening in your area Find out ... 3 weeks after a premature birth. Retinopathy of prematurity (ROP) . This is an abnormal growth of blood ...

[Correlation between the lower first permanent molar axis and the premature loss of temporary molars].

Science.gov (United States)

Petcu, Ana; Maxim, A; Haba, Danisia

2009-01-01

The aim of our study was to determine the impact of premature loss of temporary molars upon the longitudinal axis of the first permanent molar. The study sample was formed by 94 orthopanthomografies of child patients with premature loss of lower temporary molars (first or second) after clinical eruption of the first permanent molar. All panoramic radiographs have been realized with the same panoramic unit with 1.4% magnification coefficient and were analyzed using a standardized technique of tracing the images of teeth and bone on matte acetate paper. It was evaluated the angle between longitudinal axis of first permanent lower molar and occlusal plane. It was observed that premature loss of lower second deciduous molar modifies greater the vertical axis of first permanent molar (between 61 degrees and 79 degrees) then premature loss of first lower primary molar. This is perhaps because the loss of space in the case of premature exfoliation of first primary molar is due more to distal drift of canine then mesial drift of molars. The drift to mesial of first permanent molar is more accentuated proportional with the age at which appeared premature loss and so it is loss of leeway space.

Dimorphic ejaculates and sperm release strategies associated with alternative mating behaviors in the squid.

Science.gov (United States)

Apostólico, Lígia H; Marian, José E A R

2017-11-01

Sperm competition is a powerful postcopulatory selective force influencing male adaptations associated with increasing fertilization success, and it is usually related to the evolution of different strategies of ejaculate expenditure between individuals. Ejaculates may also be influenced by additional selective pressures associated with sperm competition, such as timing between insemination and fertilization, female reproductive tract morphology, and fertilization environment. Also, males that adopt alternative mating tactics may face distinct sperm competition pressures, which may lead to the evolution of intraspecific diversity in ejaculates. In loliginid squids, males with alternative reproductive tactics (sneakers and consorts) differ not only in mating behavior, but also transfer spermatophores into two distinct sites within the female. Here, we compared structure and functioning of spermatophores between sneakers and consorts in the squid Doryteuthis plei applying microscopy techniques and in vitro experiments. Sneakers and consorts exhibit differences in spermatophore structure that lead to distinct spermatophoric reactions and spermatangium morphologies. Moreover, in sneakers, sperm release lasts longer and their sperm show an aggregative behavior not detected in consorts. Slow sperm release may be a strategy to guarantee longer sperm provision, given the wide interval between sneaker mating and egg release. For consorts, in turn, intense and quick sperm discharge may be advantageous, as timing between mating and egg-laying is relatively short. Within the complex squid mating system, factors such as (i) different fertilization sites and (ii) interval between mating and egg release may also influence sperm competition, and ultimately shape the evolution of divergent ejaculates between dimorphic males. © 2017 Wiley Periodicals, Inc.

Guest editorial: Pharmacology of male sexual behavior

NARCIS (Netherlands)

Waldinger, Marcel D; Olivier, Berend

The introduction of the selective serotonin reuptake inhibitors (SSRIs) in the mid 1980s has led not only to an increased attention to antidepressant-induced sexual side effects, but also to a paradigm shift in the theory of premature ejaculation (PE). Because of their ejaculation delaying effects,

[Knowledge of the "Gräfenberg zone" and female ejaculation in ancient Indian sexual science. A medical history contribution].

Science.gov (United States)

Syed, R

1999-01-01

Ancient Indian texts in sexology (kamaśastra) from the 11th century onwards prove that their authors knew about the area later termed the "Gräfenberg zone" in Europe, as well as about the female ejaculation connected with the stimulation of this area. The Gräfenberg zone is a sexually arousable zone in the front part of the vagina, stimulation of which can lead to the discharge of liquid from the urethra, a phenomenon which is described as female ejaculation. The german gynaecologist Ernst Gräfenberg, who worked in America, described this zone, situated beneath the clitoris, for the first time (at least in this century) in Western medicine in an article published in 1950. (There are, however, evidences, that the 17th-century anatomist Regnier de Graaf had knowledge about the mentioned erogenous zone as well as female ejaculation.) Since the 1980s the so-called Gräfenberg zone, popularly termed "G-spot", and female ejaculation have been controversially discussed medically as well as in popular science, first in the United States, then in Europe; both phenomena have meanwhile been accepted as facts in medical manuals and reference books (e.g. the "Pschyrembel"). Whereas the oldest and most well-known sexological-erotological work of Ancient India, the Kamasutra, dating probably from the third century A.D., apparently did not know the Gräfenberg zone and female ejaculation, texts such as the Pañcasayaka (11th century), Jayamangala (Yaśodhara's commentary on the Kamasutra from the 13th century), the Ratirahasya (13th century), as well as the late kamaśastra-works Smaradipika and Anangaranga (16th century?) demonstrably describe both, the Gräfenberg zone and female ejaculation, in great detail. The female ejaculation is described already in the 7th century in a non-kamaśastra-text, in a work of the poet Amaru called the Amaruśataka.

Increased count, motility, and total motile sperm cells collected across three consecutive ejaculations within 24 h of oocyte retrieval: implications for management of men presenting with low numbers of motile sperm for assisted reproduction.

Science.gov (United States)

Said, Al-Hasen; Reed, Michael L

2015-07-01

The purpose of this study was to quantitate changes in seminal volume, sperm count, motility, qualitative forward progression, and total motile sperm cells per ejaculate, across three consecutive ejaculates collected from individuals within 24 h preceding an IVF cycle. Men presenting with oligoasthenozoospermia or asthenozoospemia attempted three ejaculates within 24 h preceding IVF. Ejaculate 1 was produced the afternoon prior to oocyte retrieval, and ejaculates 2 and 3 were produced the morning of oocyte retrieval with 2-3 h between collections. Ejaculates 1 and 2 were extended 1:1 v/v with room temperature rTYBS. Test tubes were placed into a beaker of room temperature water, then placed at 4 °C for gradual cooling. Ejaculate 3 was not extended, but pooled with ejaculates 1 and 2 and processed for intracytoplasmic sperm injection (ICSI). Out of 109 oocyte retrievals, 28 men were asked to attempt multiple consecutive ejaculations. Among this population, 25/28 (89.3 %) were successful, and 3/28 men (10.7 %) could only produce two ejaculates. Mean volumes for ejaculates 1, 2, and 3 were significantly different from each other (p sperm counts, motility, qualitative forward progression, and total motile cells per ejaculate for the ejaculates1, 2, and 3 demonstrated the following: ejaculates 2 and 3 were not significantly different, but counts, motility, and total motile sperm were improved over ejaculate 1 (p sperm in this population by 8-fold compared to the first ejaculate alone, facilitating avoidance of sperm cryopreservation and additional centrifugation steps that could affect sperm viability and/or function.

Effect of SSRI antidepressants on ejaculation: a double-blind, randomized, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine, and sertraline.

Science.gov (United States)

Waldinger, M D; Hengeveld, M W; Zwinderman, A H; Olivier, B

1998-08-01

Depression is a common cause of sexual dysfunction, but also antidepressant medication is often associated with sexual side effects. This article includes two related studies. The first double-blind, placebo-controlled study was conducted in men with lifelong rapid ejaculation and aimed to assess putative differences between the major selective serotonin reuptake inhibitors (SSRIs) (fluoxetine, fluvoxamine, paroxetine, and sertraline) with regard to their ejaculation-delaying effect. Sixty men with an intravaginal ejaculation latency time (IELT) of 1 minute or less were randomly assigned to receive fluoxetine 20 mg/day, fluvoxamine 100 mg/day, paroxetine 20 mg/day, sertraline 50 mg/day, or placebo for 6 weeks. During the 1-month baseline and 6-week treatment periods, the men measured their IELT at home using a stopwatch. The trial was completed by 51 men. During the 6-week treatment period, the geometric mean IELT in the placebo group was constant at approximately 20 seconds. Analysis of variance revealed a between-groups difference in the evolution of IELT delay (p = 0.0004); in the paroxetine, fluoxetine, and sertraline groups there was a gradual increase to about 110 seconds, whereas in the fluvoxamine group, IELT was increased to only approximately 40 seconds. The paroxetine, fluoxetine, and sertraline groups differed significantly (p IELT IELT > 1 minute) to investigate whether data about SSRI-induced delayed ejaculation in men with rapid ejaculation may be extrapolated to men with less-rapid ejaculation. After measurement of IELT at home (using a stopwatch) during a 1-month baseline assessment, 32 men with an IELT of 1 minute or less (group 1) or more than 1 minute (group 2) were randomly assigned to receive paroxetine 20 mg/day or placebo for 6 weeks in a double-blind manner. Patients continued to measure their IELTs at home during the 6 weeks of the study. At baseline, 24 patients consistently had IELTs of one minute or less (group 1), and eight patients

Sperm competition risk drives rapid ejaculate adjustments mediated by seminal fluid.

Science.gov (United States)

Bartlett, Michael J; Steeves, Tammy E; Gemmell, Neil J; Rosengrave, Patrice C

2017-10-31

In many species, males can make rapid adjustments to ejaculate performance in response to sperm competition risk; however, the mechanisms behind these changes are not understood. Here, we manipulate male social status in an externally fertilising fish, chinook salmon ( Oncorhynchus tshawytscha ), and find that in less than 48 hr, males can upregulate sperm velocity when faced with an increased risk of sperm competition. Using a series of in vitro sperm manipulation and competition experiments, we show that rapid changes in sperm velocity are mediated by seminal fluid and the effect of seminal fluid on sperm velocity directly impacts paternity share and therefore reproductive success. These combined findings, completely consistent with sperm competition theory, provide unequivocal evidence that sperm competition risk drives plastic adjustment of ejaculate quality, that seminal fluid harbours the mechanism for the rapid adjustment of sperm velocity and that fitness benefits accrue to males from such adjustment.

Size dependence in non-sperm ejaculate production is reflected in daily energy expenditure and resting metabolic rate.

Science.gov (United States)

Friesen, Christopher R; Powers, Donald R; Copenhaver, Paige E; Mason, Robert T

2015-05-01

The non-sperm components of an ejaculate, such as copulatory plugs, can be essential to male reproductive success. But the costs of these ejaculate components are often considered trivial. In polyandrous species, males are predicted to increase energy allocation to the production of non-sperm components, but this allocation is often condition dependent and the energetic costs of their production have never been quantified. Red-sided garter snakes (Thamnophis sirtalis parietalis) are an excellent model with which to quantify the energetic costs of non-sperm components of the ejaculate as they exhibit a dissociated reproductive pattern in which sperm production is temporally disjunct from copulatory plug production, mating and plug deposition. We estimated the daily energy expenditure and resting metabolic rate of males after courtship and mating, and used bomb calorimetry to estimate the energy content of copulatory plugs. We found that both daily energy expenditure and resting metabolic rate were significantly higher in small mating males than in courting males, and a single copulatory plug without sperm constitutes 5-18% of daily energy expenditure. To our knowledge, this is the first study to quantify the energetic expense of size-dependent ejaculate strategies in any species. © 2015. Published by The Company of Biologists Ltd.

Retinopathy of Prematurity

Science.gov (United States)

Steinweg, Sue Byrd; Griffin, Harold C.; Griffin, Linda W.; Gingras, Happy

2005-01-01

The eyes of premature infants are especially vulnerable to injury after birth. A serious complication is called retinopathy of prematurity (ROP), which is abnormal growth of the blood vessels in an infant's eye. Retinopathy of prematurity develops when abnormal blood vessels grow and spread throughout the retina, which is the nerve tissue at the…

Does immunity regulate ejaculate quality and fertility in humans?

OpenAIRE

Philip A. Skau; Ivar Folstad

2005-01-01

The production of high-quality ejaculates may represent significant costs during male reproduction. Spermatozoa are perceived as nonself by the immune system and are exposed to immunological attacks in the male reproductive tract. Autoimmunity to spermatozoa results in the production of antisperm antibodies that reduce sperm quality and hence fertility. Thus, males are dependent on the testis being an immunoprivileged site to reduce immunological reactions against their own sperm, and immunop...

Testicular prosthesis: Patient satisfaction and sexual dysfunctions in testis cancer survivors.

Science.gov (United States)

Catanzariti, Francesco; Polito, Benedetta; Polito, Massimo

2016-10-05

We studied patient satisfaction about sexual activity after prosthesis implantation using validated questionnaires with the aim to discover if testicular prosthesis could be responsible of sexual dysfunctions (erectile dysfunction or premature ejaculation). We evaluated a total of 67 men who underwent radical orchiectomy for testicular cancer and a silicon testicular prosthesis implantation from January 2008 to June 2014 at our Hospital. These patients completed 5 validated questionnaires the day before orchiectomy and 6 months after surgery: the International Index of Erectile Function 5 (IIEF5), the Premature Ejaculation Diagnostic Tool (PEDT), the Body Exposure during Sexual Activities Questionnaire (BESAQ), the Body-Esteem Scale and the Rosenberg Self- Esteem Scale. We also evaluated 6 months after surgery any defects of the prosthesis complained by the patients. The questionnaires completed by patients didn't show statistically significant changes for erectile dysfunction (p > 0.05) and premature ejaculation (p > 0.05). On the contrary the psychological questionnaires showed statistically significant change for the BESAQ (p < 0.001) and the Body Esteem Scale (p < 0.001), but not for the Rosenberg Self-Esteem Scale (p > 0,05). A total of 15 patients (22.37%) were dissatisfied about the prosthesis: the most frequent complaint (8 patients; 11.94%) was that the prosthesis was firmer than the normal testis. Testicular prosthesis implantation is a safe surgical procedure that should be always proposed before orchiectomy for cancer of the testis. The defects complained by patients with testicular prosthesis are few, they don't influence sexual activity and they aren't able to cause erectile dysfunction or premature ejaculation.

Semen quality in ejaculates produced by masturbation in men with spinal cord injury.

Science.gov (United States)

Kathiresan, A S Q; Ibrahim, E; Modh, R; Aballa, T C; Lynne, C M; Brackett, N L

2012-12-01

Retrospective study. Most men with spinal cord injury are anejaculatory. Much has been reported about their semen quality collected by penile vibratory stimulation and electroejaculation (EEJ). What is not well-described is the nature of semen quality in SCI patients who can ejaculate by masturbation. This study was performed to understand the degree to which their semen quality differed from that of anejaculatory SCI patients versus that of healthy non-SCI control subjects. University of Miami. Retrospective chart review of Male Fertility Research Program participants from 1991 to 2011. Of 528 SCI subjects, 444 met inclusion criteria of completing an algorithm in which ejaculation occurred by masturbation (n=43), PVS (n=243), or EEJ (n=158). Sperm motility was higher in the SCI-masturbation group (36.9%) than the PVS group (25.9%, Pmasturbation (58.0%, Pmasturbation group had similar antegrade sperm concentration (83.3×10(6) cc(-1)) as the PVS group (77.4×10(6) cc(-1)) and control group (82.0×10(6) cc(-1)), but higher than the EEJ group (49.8×10(6) cc(-1), Pmasturbation group had significantly more men with incomplete injuries (84%) than the PVS group (54%, Pmasturbation in men with SCI. Sperm motility was higher in men with SCI who could, versus could not, ejaculate by masturbation. Completeness of injury may contribute to this difference.

Calculation of organ doses in x-ray examinations of premature babies

International Nuclear Information System (INIS)

Smans, Kristien; Tapiovaara, Markku; Cannie, Mieke; Struelens, Lara; Vanhavere, Filip; Smet, Marleen; Bosmans, Hilde

2008-01-01

Lung disease represents one of the most life-threatening conditions in prematurely born children. In the evaluation of the neonatal chest, the primary and most important diagnostic study is the chest radiograph. Since prematurely born children are very sensitive to radiation, those radiographs may lead to a significant radiation detriment. Knowledge of the radiation dose is therefore necessary to justify the exposures. To calculate doses in the entire body and in specific organs, computational models of the human anatomy are needed. Using medical imaging techniques, voxel phantoms have been developed to achieve a representation as close as possible to the anatomical properties. In this study two voxel phantoms, representing prematurely born babies, were created from computed tomography- and magnetic resonance images: Phantom 1 (1910 g) and Phantom 2 (590 g). The two voxel phantoms were used in Monte Carlo calculations (MCNPX) to assess organ doses. The results were compared with the commercially available software package PCXMC in which the available mathematical phantoms can be downsized toward the prematurely born baby. The simple phantom-scaling method used in PCXMC seems to be sufficient to calculate doses for organs within the radiation field. However, one should be careful in specifying the irradiation geometry. Doses in organs that are wholly or partially outside the primary radiation field depend critically on the irradiation conditions and the phantom model

Early or Premature Menopause

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... email updates Enter email Submit Early or premature menopause Menopause that happens before age 40 is called ... What is the difference between early and premature menopause? Early or premature menopause happens when ovaries stop ...

Guidelines on the use of space maintainers following premature loss of primary teeth.

Science.gov (United States)

Brothwell, D J

1997-11-01

To formulate evidence-based guidelines on the appropriate use of space maintaining appliances to prevent or reduce the severity of malocclusion in the permanent dentition following the premature loss of primary teeth. Placement of lingual arch, palatal arch, band-loop, crown-loop, and intra-alveolar space maintainers. Reduced prevalence or severity of space loss in the primary or mixed dentition, reduced prevalence or severity of malocclusion in the permanent dentition measured as significant changes in: crowding, ectopic eruption, impacted teeth, Angle's class II or III occlusion, crossbite, deep overbite, deep overjet, or midline shift. Articles published from 1966 to 1996, located though Medline searches. Only clinical trials, cohort studies, case-control studies, or large case series were considered. Relevant clinical findings were evaluated and categorized using evidence-based methods and values established by the Canadian Task Force on the Periodic Health Examination. A recommendation was developed for the use of space maintainers. The potential benefits of using space maintaining appliances include reduced prevalence or severity of: crowding, ectopic eruption, tooth impaction, crossbite, excessive overbite and overjet, and poor molar relationship. Other advantages include the potential for considerable cost savings by reducing the need for future orthodontic treatment. The potential disadvantages of using space maintaining appliances include soft tissue impingement, interference with eruption of adjacent teeth, pain, plaque accumulation, caries, and broken, dislodged or lost appliances. There is poor evidence to recommend for or against the use of space maintainers to prevent or reduce the severity of malocclusion in the permanent dentition (see Table 1, Recommendation C) Decisions regarding the use of space maintainers must therefore be guided by factors other than scientific evidence.

Congenital adrenal hyperplasia: a case report with premature teeth exfoliation and bone resorption.

Science.gov (United States)

Angelopoulou, Matina V; Kontogiorgos, Elias; Emmanouil, Dimitris

2015-06-01

Congenital adrenal hyperplasia (CAH) is an inherited autosomal recessive disorder characterized by insufficient production of cortisol. The aim of this case report was to present a child with CAH, premature exfoliation of primary teeth and accelerated eruption of his permanent teeth related to bone resorption. A 4.5-year-old Caucasian boy with CAH and long-term administration of glucocorticoids was referred for dental restoration. Clinical examination revealed primary molars with worn stainless steel crowns, severe attrition of the upper canines, and absence of the upper incisors. Before the completion of treatment, abnormal mobility of the first upper primary molars and the lower incisors was detected, and a few days later the teeth exfoliated prematurely. Histologic examination revealed normal tooth structure. Alkaline phosphatase and blood cells values were normal. Eruption of the permanent dentition was also accelerated. Tooth mobility was noticed in the permanent teeth as soon as they erupted, along with bone destruction. Examination revealed an elevated level of receptor activator of nuclear factor-κB ligand and lower-than-normal osteoprotegerin and vitamin D levels. The patient was treated with vitamin D supplements, and his teeth have been stable ever since. CAH is a serious chronic disorder appearing in children with accelerated dental development and possibly premature loss of primary teeth. Copyright © 2015 by the American Academy of Pediatrics.

Safety Analysis for Pentavaccine Used in Premature Infants: Family Vaccination Centre’s Experiment

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D. А. Novikova

2015-01-01

Full Text Available Combined vaccines containing non-cellular pertussis component and having low reactogenicity, increase vaccination coverage against controllable infections. However, the safety of vaccination in children dealing with health issues, as well as those having a history of premature infancy, requires additional research. The article presents reactogenicity analysis for the DTP-IPV/HIB pentavaccine during primary vaccination and revaccination of premature infants (n = 85, as well as vaccination of mature newborns (n = 1433 inoculated in accordance with the national Vaccination Calendar behind the schedule. The occurrence of post-vaccinal reactions in the premature infant group was the same as in the mature infant group and amounted to 41.2% and 45.0%; the occurrence of common reactions was 18.8% and 22.4%; local effects measured 25.8% and 27.9% respectively. Post-vaccinal reactions were either weak or moderate, not requiring treatment, and they would completely disappear by the end of the third post-vaccinal day. Simultaneous injection of pentavaccine and Hepatitis B vaccine and pneumococcal conjugate vaccine in children with a history of premature infancy, showed no influence during the post-vaccinal period. The reactogenicity of pentavaccine increased along with the vaccination ratio during the primary series of vaccinations. 

Male Sexual Quality Of Life Is Maintained Satisfactorily Throughout Life In The Amazon Rainforest

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Thiago Teixeira, MD, MSc

2018-06-01

Full Text Available Introduction: The Amazon Rainforest is a cradle of biodiversity, where different ethnic groups have specific sexual habits. Aims: To define the average sexual quality of life of Amazonian men 18 to 69 years old, evaluate the influence of aging on their sexual function, and calculate the prevalence of premature ejaculation, delayed ejaculation, and hypoactive sexual desire disorder. Methods: A cross-sectional quantitative probability sample study was performed with a demographically representative population (N = 385, with data collected privately at participants’ houses, including men who had been sexually active for a minimum of 6 months. The Male Sexual Quotient (MSQ was used to measure sexual satisfaction and function. Statistical analysis was performed with SPSS 21.0 using the Kruskal-Wallis test (P < .05, and a multiple linear regression analysis was performed to investigate which factors could predict participants’ quality of sexual life. Main Outcome Measures: MSQ scores. Results: The response rate was 81.69%. The mean age was 36.00 ± 12.95 years, and most men had mixed ethnicity (63.11%, were self-employed (42.07%, had a monthly earned income of US$0 to US$460 (46.75%, and were single (36.10%. The mean MSQ score was 80.39 ± 12.14 (highly satisfied. None of the demographic characteristics showed a statistically significant influence on sexual satisfaction. The difference in quality of sexual life was statistically significant compared with age (P < .01. The domains of desire (P < .01, partner satisfaction (P = .04, and erection quality (P < .01, P = .03, P = .02 were statistically significant. Prevalences of sexual dysfunctions were 36.54% for premature ejaculation, 6.5% for delayed ejaculation, and 11.69% for hypoactive sexual desire disorder. Conclusions: Independent of age, these men have an excellent quality of sexual life. Sexual domains such as desire, partner satisfaction, and erection quality are related to the

Apnea of prematurity

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... medlineplus.gov/ency/article/007227.htm Apnea of prematurity To use the sharing features on this page, ... down or stops from any cause. Apnea of prematurity refers to short episodes of stopped breathing in ...

Testicular prosthesis: Patient satisfaction and sexual dysfunctions in testis cancer survivors

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Francesco Catanzariti

2016-10-01

Full Text Available Purpose: We studied patient satisfaction about sexual activity after prosthesis implantation using validated questionnaires with the aim to discover if testicular prosthesis could be responsible of sexual dysfunctions (erectile dysfunction or premature ejaculation. Materials and Methods: We evaluated a total of 67 men who underwent radical orchiectomy for testicular cancer and a silicon testicular prosthesis implantation from January 2008 to June 2014 at our Hospital. These patients completed 5 validated questionnaires the day before orchiectomy and 6 months after surgery: the International Index of Erectile Function 5 (IIEF5, the Premature Ejaculation Diagnostic Tool (PEDT, the Body Exposure during Sexual Activities Questionnaire (BESAQ, the Body-Esteem Scale and the Rosenberg Self- Esteem Scale. We also evaluated 6 months after surgery any defects of the prosthesis complained by the patients. Results: The questionnaires completed by patients didn’t show statistically significant changes for erectile dysfunction (p > 0.05 and premature ejaculation (p > 0.05. On the contrary the psychological questionnaires showed statistically significant change for the BESAQ (p < 0.001 and the Body Esteem Scale (p < 0.001, but not for the Rosenberg Self-Esteem Scale (p > 0,05. A total of 15 patients (22.37% were dissatisfied about the prosthesis: the most frequent complaint (8 patients; 11.94% was that the prosthesis was firmer than the normal testis. Conclusions: Testicular prosthesis implantation is a safe surgical procedure that should be always proposed before orchiectomy for cancer of the testis. The defects complained by patients with testicular prosthesis are few, they don’t influence sexual activity and they aren’t able to cause erectile dysfunction or premature ejaculation.

Bystander-induced apoptosis and premature differentiation in primary urothelial explants after charged particle microbeam irradiation

International Nuclear Information System (INIS)

Belyakov, O.V.; Folkard, M.; Mothersill, C.; Prise, K.M.; Michael, B.D.

2002-01-01

The ureter primary explant technique was developed to study bystander effects under in vivo like conditions where stem and differentiated cells are present. Irradiation was performed with a 3 He 2+ charged particle microbeam available at the Gray Cancer Institute, with high (∼2 μm) precision. Tissue sections from porcine ureters were pre-irradiated with the microbeam at a single location with 10 3 He 2+ particles (5 MeV; LET 70 keV.μm -1 ). After irradiation, the tissue section was incubated for 7 days, thus allowing the explant outgrowth to form. Total cellular damage (total fraction of micronucleated and apoptotic cells) was measured according to morphological criteria. Apoptosis was also assessed using a 3'-OH DNA end-labelling technique. Premature differentiation was estimated using antibodies to uroplakin III, a specific marker of terminal urothelial differentiation. Results of our experiments demonstrated a significant bystander-induced differentiation and a less significant increase in apoptotic and micronucleated cells. A hypothesis based on the protective nature of the bystander effect is proposed. (author)

CLINICAL AND PHARMACOECONOMIC REASONABILITY OF USING PROBIOTIC ENTEROCOCCUS STRAIN FOR THE COMPLEX DEVELOPMENTAL CARE PROGRAM FOR PREMATURE INFANTS

Directory of Open Access Journals (Sweden)

N. V. Gonchar

2015-01-01

Full Text Available Introduction. Possibilities of using probiotic enterococci in premature neonates undergoing inpatient antibacterial therapy remains understudied. The article is aimed at analyzing clinical and pharmacoeconomic reasonability of using probiotic Enterococcus faecium L3 strain in premature infants with very low body weight in the framework of complex inpatient developmental care. Patients and methods. 55 children randomized into 2 groups were observed: the control group (n = 26 was undergoing standard developmental care program, the primary group (n = 29 was introduced liquid probiotic Enterococcus faecium L3 strain (titer — 108 CFU/ml or more (0.5 ml TID for 14 days after attaining the enteral feeding volume of 5.0 ml. Results. Analysis of the clinical symptoms characteristic of non-smooth course of developmental care over premature infants helped to reveal higher frequency of infectious complications in the control group children than in the primary group (14 [53.8%] vs. 6 [20.7%]; p < 0.05. Acute food intolerance was observed less frequently in the primary group than in the control group (6 [20.7%] vs. 10 [38.5%], p > 0.05. The primary group's children featured significant decrease in the frequency of monocytosis, positive changes of intestinal microbiotic composition (increase in the amount of bifidum bacteria, lactobacilli, enterococci, decrease in the amount of Clostridium difficile and antibiotic-resistant clinical Klebsiella pneumoniae strains. Conclusion. Favorable outcome of developmental care over premature infants (absence of infectious complications was less expensive in the primary group's children.

Progress on study of the risk factors of retinopathy of prematurity

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Hong-Cheng Gao

2018-01-01

Full Text Available Retinopathy of prematurity(ROPis an ocular disease caused by retinal ophthalmic dysplasia in premature infants, leads to strabismus, amblyopia, cataract, glaucoma, and even blindness, which seriously affects the quality of life of preterm infants. The infant blindness ratio has climbed to 6%-18%, according to figures released by the World Health Organisation. ROP is the primary cause of blindness in children of the world in recent years. But the pathogenesis of ROP is not yet clear. Gestational age, birth weight, oxygen intake, delivery mode, multiple newborns, neonatal respiratory distress syndrome, anemia, blood transfusion, sepsis, infection, hypercapnia, hyperbilirubinemia, maternal prenatal use of a drug are all the risk factors. We reviewed the risk factors and possible mechanism of ROP, in order to offer theoretical support for the study and prevention of ROP in premature infants.

Screening of subfertile men for testicular carcinoma in situ by an automated image analysis-based cytological test of the ejaculate

DEFF Research Database (Denmark)

Almstrup, K; Lippert, Marianne; Mogensen, Hanne O

2011-01-01

a slightly lower sensitivity (0.51), possibly because of obstruction. We conclude that this novel non-invasive test combining automated immunocytochemistry and advanced image analysis allows identification of TC at the CIS stage with a high specificity, but a negative test does not completely exclude CIS...... and detected in ejaculates with specific CIS markers. We have built a high throughput framework involving automated immunocytochemical staining, scanning microscopy and in silico image analysis allowing automated detection and grading of CIS-like stained objects in semen samples. In this study, 1175 ejaculates...... from 765 subfertile men were tested using this framework. In 5/765 (0.65%) cases, CIS-like cells were identified in the ejaculate. Three of these had bilateral testicular biopsies performed and CIS was histologically confirmed in two. In total, 63 bilateral testicular biopsy were performed...

Primary ovarian insufficiency: an update

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Cox L

2014-02-01

Full Text Available Leticia Cox, James H LiuUH Case Medical Center, MacDonald Women's Hospital, Department of Obstetrics and Gynecology, Case Western Reserve University School of Medicine, Department of Reproductive Biology, Cleveland, OH, USAAbstract: Primary ovarian insufficiency is a condition that represents impaired ovarian function on a continuum with intermittent ovulation. This condition commonly leads to premature menopause, defined as cessation of ovulation prior to the age of 40 years. Because there are potential immediate and long-term consequences of hypoestrogenism, a timely diagnosis is invaluable. This comprehensive review will discuss identifiable causes for primary ovarian insufficiency, including genetic disorders and metabolic abnormalities, as well as review current strategies for diagnosis, evaluation, and management of women with this condition.Keywords: premature ovarian failure, premature menopause, ovarian dysfunction

Stress induced by premature chromatin condensation triggers chromosome shattering and chromothripsis at DNA sites still replicating in micronuclei or multinucleate cells when primary nuclei enter mitosis.

Science.gov (United States)

Terzoudi, Georgia I; Karakosta, Maria; Pantelias, Antonio; Hatzi, Vasiliki I; Karachristou, Ioanna; Pantelias, Gabriel

2015-11-01

Combination of next-generation DNA sequencing, single nucleotide polymorphism array analyses and bioinformatics has revealed the striking phenomenon of chromothripsis, described as complex genomic rearrangements acquired in a single catastrophic event affecting one or a few chromosomes. Via an unproven mechanism, it is postulated that mechanical stress causes chromosome shattering into small lengths of DNA, which are then randomly reassembled by DNA repair machinery. Chromothripsis is currently examined as an alternative mechanism of oncogenesis, in contrast to the present paradigm that considers a stepwise development of cancer. While evidence for the mechanism(s) underlying chromosome shattering during cancer development remains elusive, a number of hypotheses have been proposed to explain chromothripsis, including ionizing radiation, DNA replication stress, breakage-fusion-bridge cycles, micronuclei formation and premature chromosome compaction. In the present work, we provide experimental evidence on the mechanistic basis of chromothripsis and on how chromosomes can get locally shattered in a single catastrophic event. Considering the dynamic nature of chromatin nucleoprotein complex, capable of rapid unfolding, disassembling, assembling and refolding, we first show that chromatin condensation at repairing or replicating DNA sites induces the mechanical stress needed for chromosome shattering to ensue. Premature chromosome condensation is then used to visualize the dynamic nature of interphase chromatin and demonstrate that such mechanical stress and chromosome shattering can also occur in chromosomes within micronuclei or asynchronous multinucleate cells when primary nuclei enter mitosis. Following an aberrant mitosis, chromosomes could find themselves in the wrong place at the wrong time so that they may undergo massive DNA breakage and rearrangement in a single catastrophic event. Specifically, our results support the hypothesis that premature chromosome

Differential distribution of sperm subpopulations and incidence of pleiomorphisms in ejaculates of captive howling monkeys ( Alouatta caraya)

Science.gov (United States)

Valle, R. R.; Carvalho, F. M.; Muniz, J. A. P. C.; Leal, C. L. V.; García-Herreros, M.

2013-10-01

The aim of this study was to develop an objective method to determine the incidence of pleiomorphisms and its influence on the distribution of sperm morphometric subpopulations in ejaculates of howling monkeys ( Alouatta caraya) by using a combination of computerized analysis system (ASMA) and principal component analysis (PCA) methods. Ejaculates were collected by electroejaculation methods on a regular basis from five individuals maintained under identical captive environmental, nutritional, and management conditions. Each sperm head was measured for dimensional parameters (Area [ A, (square micrometers)], Perimeter [ P, (micrometers)], Length [ L, (micrometers)], and Width [ W, (micrometers)]) and shape-derived parameters (Ellipticity [( L/ W)], Elongation [( L - W)/( L + W)], and Rugosity [(4л A/ P 2)]). PCA revealed two principal components explaining more than the 96 % of the variance. Clustering methods and discriminant analyzes were performed and seven separate subpopulations were identified. There were differences ( P ASMA and PCA is a useful clinical diagnostic resource for detecting deficiencies in sperm morphology and sperm subpopulations in A. caraya ejaculates that could be used in ex situ conservation programs of threatened species in Alouatta genus or even other endangered neotropical primate species.

Effects of alpha1-adrenoceptor antagonist (tamsulosin) on incident of ejaculation and semen quality in the goat.

Science.gov (United States)

Kimsakulvech, S; Suttiyotin, P; Pinyopummin, A

2015-04-01

Male temporary contraception is occasionally required in some animals. Alpha1-adrenoceptor antagonist (tamsulosin) can cause ejaculation disorder. Two sets of Latin square were applied to six male goats to received either normal saline, dimethylsulphoxide or tamsulosin (179.8 nmol kg(-1) ) at 1-week interval. Semen collection and libido scoring were undertaken at 3, 6 and 24 h post-injection. For ejaculated semen, its quality was evaluated. Physiological measurements including body temperature, respiration and heart rates were measured before injection and at 30 min before semen collection. The results showed that libido score and physiological changes were not affected by treatments and time periods. Anejaculation was observed in 11 (91.7%), 5 (41.7%) and 1 (8.3%) males at 3, 6 and 24 h post-tamsulosin injection respectively. The incidence returned to normal when compared with control groups at 24 h. The percentages of motile and live spermatozoa at 6 h post-tamsulosin injection were significantly lower (P tamsulosin had temporary effects on ejaculation and semen quality without reducing sex desire and physiological functions in male goats. © 2014 Blackwell Verlag GmbH.

Follow-up study on premature infants with and without retinopathy of prematurity.

OpenAIRE

Robinson, R; O'Keefe, M

1993-01-01

The ocular complications in population of 131 premature infants, with and without retinopathy of prematurity (ROP) are reported. An increased incidence of strabismus (20% with ROP and 25% without ROP) and myopia (27.5% with ROP and 8.8% without ROP) was shown. Significant visual loss occurred in 10.7% overall, increasing to 35% with stage 3 disease and 100% with stage 4. With the increased survival rate of premature infants, the relevance to future management of this expanding group of young ...

Measurement errors in polymerase chain reaction are a confounding factor for a correct interpretation of 5-HTTLPR polymorphism effects on lifelong premature ejaculation: a critical analysis of a previously published meta-analysis of six studies.

Science.gov (United States)

Janssen, Paddy K C; Olivier, Berend; Zwinderman, Aeilko H; Waldinger, Marcel D

2014-01-01

To analyze a recently published meta-analysis of six studies on 5-HTTLPR polymorphism and lifelong premature ejaculation (PE). Calculation of fraction observed and expected genotype frequencies and Hardy Weinberg equilibrium (HWE) of cases and controls. LL,SL and SS genotype frequencies of patients were subtracted from genotype frequencies of an ideal population (LL25%, SL50%, SS25%, p = 1 for HWE). Analysis of PCRs of six studies and re-analysis of the analysis and Odds ratios (ORs) reported in the recently published meta-analysis. Three studies deviated from HWE in patients and one study deviated from HWE in controls. In three studies in-HWE the mean deviation of genotype frequencies from a theoretical population not-deviating from HWE was small: LL(1.7%), SL(-2.3%), SS(0.6%). In three studies not-in-HWE the mean deviation of genotype frequencies was high: LL(-3.3%), SL(-18.5%) and SS(21.8%) with very low percentage SL genotype concurrent with very high percentage SS genotype. The most serious PCR deviations were reported in the three not-in-HWE studies. The three in-HWE studies had normal OR. In contrast, the three not-in-HWE studies had a low OR. In three studies not-in-HWE and with very low OR, inadequate PCR analysis and/or inadequate interpretation of its gel electrophoresis resulted in very low SL and a resulting shift to very high SS genotype frequency outcome. Consequently, PCRs of these three studies are not reliable. Failure to note the inadequacy of PCR tests makes such PCRs a confounding factor in clinical interpretation of genetic studies. Currently, a meta-analysis can only be performed on three studies-in-HWE. However, based on the three studies-in-HWE with OR of about 1 there is not any indication that in men with lifelong PE the frequency of LL,SL and SS genotype deviates from the general male population and/or that the SL or SS genotype is in any way associated with lifelong PE.

The not-so-harmless maxillary primary first molar extraction.

Science.gov (United States)

Northway, W M

2000-12-01

Premature loss of primary molars has been associated with space loss and eruptive difficulties, especially when the loss occurs to the primary second molars and when it occurs early. This has not been thought to be the case for primary first molars. The author revisited 13 cases from an earlier study on the effects of premature loss of maxillary primary molars. These longitudinal cases were scrutinized, using serial panoramic radiographs, to explain the irregular response in terms of dental migration. The author presents two case reports. In the earlier study, the author used digitized study casts and the concept of D + E space--the space occupied by the primary first and second molars--to describe the dental migration that occurred after premature tooth loss. Using analysis of variance on data generated using an instrument capable of measuring in tenths of millimeters, the author produced findings regarding the amount of space loss, rate of space loss, effect of age at loss, amount of space regained at the time of replacement by the permanent tooth and effect on Angle's classification. Finally, the author created a simulation describing directional change; this revealed that the maxillary primary first molar loss resulted in a mesial displacement of the permanent canine during eruption. When the maxillary primary first molar is lost prematurely, the first premolar erupts in a more mesial direction than normal, as a result of the mesial incline of the primary second molar, and consumes the space of the permanent canine, which becomes blocked out. Rather than use a space maintainer after the premature loss of the maxillary primary first molar, the author suggests, clinicians can choose from a number of other options for preventing the first premolar from erupting too far in a mesial direction.

Ejaculation Induced by the Activation of Crz Neurons Is Rewarding to Drosophila Males.

Science.gov (United States)

Zer-Krispil, Shir; Zak, Hila; Shao, Lisha; Ben-Shaanan, Shir; Tordjman, Lea; Bentzur, Assa; Shmueli, Anat; Shohat-Ophir, Galit

2018-05-07

The reward system is a collection of circuits that reinforce behaviors necessary for survival [1, 2]. Given the importance of reproduction for survival, actions that promote successful mating induce pleasurable feeling and are positively reinforced [3, 4]. This principle is conserved in Drosophila, where successful copulation is naturally rewarding to male flies, induces long-term appetitive memories [5], increases brain levels of neuropeptide F (NPF, the fly homolog of neuropeptide Y), and prevents ethanol, known otherwise as rewarding to flies [6, 7], from being rewarding [5]. It is not clear which of the multiple sensory and motor responses performed during mating induces perception of reward. Sexual interactions with female flies that do not reach copulation are not sufficient to reduce ethanol consumption [5], suggesting that only successful mating encounters are rewarding. Here, we uncoupled the initial steps of mating from its final steps and tested the ability of ejaculation to mimic the rewarding value of full copulation. We induced ejaculation by activating neurons that express the neuropeptide corazonin (CRZ) [8] and subsequently measured different aspects of reward. We show that activating Crz-expressing neurons is rewarding to male flies, as they choose to reside in a zone that triggers optogenetic stimulation of Crz neurons and display conditioned preference for an odor paired with the activation. Reminiscent of successful mating, repeated activation of Crz neurons increases npf levels and reduces ethanol consumption. Our results demonstrate that ejaculation stimulated by Crz/Crz-receptor signaling serves as an essential part of the mating reward mechanism in Drosophila. VIDEO ABSTRACT. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Premature pubarche is niet altijd onschuldig

NARCIS (Netherlands)

Backes, Manouk; Zwaveling-Soonawala, Nitash; Kamp, Gerdine A.

2012-01-01

Premature pubarche is defined as growth of pubic hair before the age of 8 years in girls and 9 years in boys. In most cases, it is caused by premature adrenarche, which is a premature increased synthesis of androgens in the adrenal gland and is considered to be relatively harmless. Premature

Prematures with and without Regressed Retinopathy of Prematurity: Comparison of Long-Term (6-10 Years) Ophthalmological Morbidity.

Science.gov (United States)

Cats, Bernard P.; Tan, Karel E. W. P.

Reporting long-term ophthalmologic sequelae among ex-prematures at 6 to 10 years of age, this study compares 42 ex-premature infants who had had regressed forms of retinopathy of prematurity (ROP) during the neonatal period with 42 matched non-ROP ex-premature controls at 6 to 10 years of age. Subjects were subdivided into four groups: (1) ROP…

Deceptive female oviposition behaviour elicits male ejaculation in the European bitterling

Czech Academy of Sciences Publication Activity Database

Smith, C.; Zhu, Y.; Liu, H.; Reichard, Martin

2007-01-01

Roč. 71, č. 6 (2007), s. 1841-1846 ISSN 0022-1112 R&D Projects: GA AV ČR KJB600930501 Grant - others:The Leverhulme Trust(GB) NSFC 30470237 Institutional research plan: CEZ:AV0Z60930519 Keywords : mating tactics * pre-oviposition ejaculation * signal evolution * sneaking sperm competition Subject RIV: EH - Ecology, Behaviour Impact factor: 1.404, year: 2007 http://www.blackwell-synergy.com/doi/pdf/10.1111/j.1095-8649.2007.01624.x

Which are the male factors associated with female sexual dysfunction (FSD)?

Science.gov (United States)

Maseroli, E; Fanni, E; Mannucci, E; Fambrini, M; Jannini, E A; Maggi, M; Vignozzi, L

2016-09-01

It has been generally assumed that partner's erectile dysfunction, premature, and delayed ejaculation play a significant role in determining female sexual dysfunction (FSD). This study aimed to evaluate the role of the male partner's sexual function, as perceived by women, in determining FSD. A consecutive series of 156 heterosexual women consulting our clinic for FSD was retrospectively studied. All patients underwent a structured interview and completed the Female Sexual Function Index (FSFI). FSFI total score decreased as a function of partner's age, conflicts within the couple, relationship without cohabitation and the habit of engaging in intercourse to please the partner; FSFI total score increased as a function of frequency of intercourse, attempts to conceive and fertility-focused intercourse. FSFI total score showed a negative, stepwise correlation with partner's perceived hypoactive sexual desire (HSD) (r = -0.327; p dysfunction, premature and delayed ejaculation. In an age-adjusted model, partner's HSD was negatively related to FSFI total score (Wald = 9.196, p = 0.002), arousal (Wald = 7.893, p = 0.005), lubrication (Wald = 5.042, p = 0.025), orgasm (Wald = 9.293, p = 0.002), satisfaction (Wald = 12.764, p sexual pleasure, and with a higher frequency of masturbation, even after adjusting for age. In patients not reporting any reduction in libido, FSFI total score was significantly lower when their partner's libido was low (p = 0.041); the correlation disappeared if the patient also experienced HSD. In conclusion, the presence of erectile dysfunction, premature, and delayed ejaculation of the partner may not act as a primary contributing factor to FSD, as determined by FSFI scores; conversely, women's sexuality seems to be mostly impaired by the perceived reduction in their partner's sexual interest. © 2016 American Society of Andrology and European Academy of Andrology.

Premature ovarian failure

OpenAIRE

Pacheco, José

2011-01-01

Premature ovarian failure is characterized by secondary amenorrhea affecting a woman before the age of 40, leading to hypoestrogenism, infertility, and consequences of premature menopause, such as osteoporosis, cardiovascular disease, neurovegetative alterations, and others. Follicular exhaustion is due to either follicles shortage or oocytes accelerated destruction. Main causes are genetic, autoimmune and iatrogenic. Among genetic causes Xq and Xp deletions, translocations, numeric aberratio...

The longitudinal effect of ejaculation on seminal vesicle fluid volume and whole-prostate ADC as measured on prostate MRI

Energy Technology Data Exchange (ETDEWEB)

Barrett, Tristan; Gallagher, Ferdia A. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospital and University of Cambridge, CamPARI Clinic, Cambridge (United Kingdom); Tanner, James; Gill, Andrew B.; Slough, Rhys A. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Wason, James [University of Cambridge, MRC Biostatistics Unit, Cambridge (United Kingdom)

2017-12-15

To prospectively investigate the longitudinal effect of ejaculatory abstinence on MRI-measured seminal vesicle (SV) volume and whole-prostate ADC over consecutive days. 15 healthy male volunteers (mean 35.9 years, range 27-53) underwent 3-T MRI at baseline and 1, 2 and 3 days post-ejaculation. Prostate and SV volumes were derived by volume segmentation and whole-gland apparent diffusion coefficient (ADC) values calculated. A mixed-effects linear regression compared ADC values and prostate/seminal vesicle volumes in each volunteer between studies in a pairwise manner. All subjects completed the four MRIs. Mean prostate volume was 22.45 cm{sup 3} (range 13.04-31.21 cm{sup 3}), with no change between the four studies (p = 0.89-0.99). 13/15 subjects showed SV volume reduction from baseline to day 1, with group-mean decreasing from 6.45 to 4.80 cm{sup 3} (-25.6%, p < 0.001), and a significant reduction from baseline to day 2 (-18.1%, p = 0.002). There was a significant volume increase from both day 1 (+21.3%, p = 0.006) and day 2 (+10.2%, p = 0.022) to day 3 post-ejaculation. There was a significant reduction in ADC from 1.105 at baseline to 1.056 x 10{sup -3} mm{sup 2}/s at day 1 (mean -4.3%, p = 0.009). The longitudinal effect of ejaculation on SV volume was demonstrated. Significant reductions in SV volume and whole-gland ADC were observed post-ejaculation, supporting a 3-day period of abstinence before prostate MRI. (orig.)

Premature menopause linked to CVD and osteoporosis.

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Park, Claire; Overton, Caroline

2010-03-01

Premature menopause affects 1% of women under the age of 40, the usual age of the menopause is 51. Most women will present with irregular periods or no periods at all with or without climacteric symptoms. Around 10% of women present with primary amenorrhoea. A careful history and examination are required. It is important to ask specifically about previous chemotherapy or radiotherapy and to look for signs of androgen excess e.g. polycystic ovarian syndrome, adrenal problems e.g. galactorrhoea and thyroid goitres. Once pregnancy has been excluded, a progestagen challenge test can be performed in primary care. Norethisterone 5 mg tds po for ten days or alternatively medroxyprogesterone acetate 10 mg daily for ten days is prescribed. A withdrawal bleed within a few days of stopping the norethisterone indicates the presence of oestrogen and bleeding more than a few drops is considered a positive withdrawal bleed. The absence of a bleed indicates low levels of oestrogen, putting the woman at risk of CVD and osteoporosis. FSH levels above 30 IU/l are an indicator that the ovaries are failing and the menopause is approaching or has occurred. It should be remembered that FSH levels fluctuate during the month and from one month to the next, so a minimum of two measurements should be made at least four to six weeks apart. The presence of a bleed should not exclude premature menopause as part of the differential diagnosis as there can be varying and unpredictable ovarian function remaining. The progestagen challenge test should not be used alone, but in conjunction with FSH, LH and oestradiol. There is no treatment for premature menopause. Women desiring pregnancy should be referred to a fertility clinic and discussion of egg donation. Women not wishing to become pregnant should be prescribed HRT until the age of 50 to control symptoms of oestrogen deficiency and reduce the risks of osteoporosis and CVD.

Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

Science.gov (United States)

2016-01-01

The Sexual Tipping Point® (STP) model is an integrated approach to the etiology, diagnosis and treatment of men with delayed ejaculation (DE), including all subtypes manifesting ejaculatory delay or absence [registered trademark owned by the MAP Educational Fund, a 501(c)(3) public charity]. A single pathogenetic pathway does not exist for sexual disorders generally and that is also true for DE specifically. Men with DE have various bio-psychosocial-behavioral & cultural predisposing, precipitating, maintaining, and contextual factors which trigger, reinforce, or worsen the probability of DE occurring. Regardless of the degree of organic etiology present, DE is exacerbated by insufficient stimulation: an inadequate combination of “friction and fantasy”. High frequency negative thoughts may neutralize erotic cognitions (fantasy) and subsequently delay, ameliorate, or inhibit ejaculation, while partner stimulation (friction) may prove unsatisfying. Assessment requires a thorough sexual history including inquiry into masturbatory methods. Many men with DE engage in an idiosyncratic masturbatory style, defined as a masturbation technique not easily duplicated by the partner’s hand, mouth, or vagina. The clinician’s most valuable diagnostic tool is a focused sex history (sex status). Differentiate DE from other sexual problems and review the conditions under which the man can ejaculate. Perceived partner attractiveness, the use of fantasy during sex, anxiety-surrounding coitus and masturbatory patterns require meticulous exploration. Identify important DE causes by juxtaposing an awareness of his cognitions and the sexual stimulation experienced during masturbation, versus a partnered experience. Assist the man in identifying behaviors that enhance immersion in excitation and minimize inhibiting thoughts, in order to reach ejaculation in his preferred manner. Discontinuing, reducing or altering masturbation is often required, which evokes patient resistance

Treatment of premature ejaculation: a new combined approach

Directory of Open Access Journals (Sweden)

Adel Kurkar

2015-01-01

Causes of PE differ considerably. In this paper, we compared the outcomes of two single treatment lines together with a combination of both. The combination therapy was more effective than either line alone.

Feeding premature neonate

DEFF Research Database (Denmark)

Dam, Mie S.; Juhl, Sandra M.; Sangild, Per T.

2017-01-01

Kinship, understood as biogenetic proximity, between a chosen animal model and a human patient counterpart, is considered essential to the process of ‘translating’ research from the experimental animal laboratory to the human clinic. In the Danish research centre, NEOMUNE, premature piglets are fed...... a novel milk diet (bovine colostrum) to model the effects of this new diet in premature infants. Our ethnographic fieldwork in an experimental pig laboratory and a neonatal intensive care unit (NICU) in 2013–2014 shows that regardless of biogenetics, daily practices of feeding, housing, and clinical care...... the researchers refer to as the ‘translatability’ of the results. In the NICU, parents of premature infants likewise imagine a kind of interspecies kinship when presented with the option to supplement mother's own milk with bovine colostrum for the first weeks after birth. However, in this setting the NICU...

Family Perspectives on Prematurity

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Zero to Three (J), 2003

2003-01-01

In this article, seven families describe their experiences giving birth to and raising a premature baby. Their perspectives vary, one from another, and shift over time, depending on each family's circumstances and the baby's developmental course. Experiences discussed include premature labor, medical interventions and the NICU, bringing the baby…

Prenatal stress, prematurity and asthma

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Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C.

2016-01-01

Asthma is the most common chronic disease of childhood, affecting millions of children in the U.S. and worldwide. Prematurity is a risk factor for asthma, and certain ethnic or racial minorities such as Puerto Ricans and non-Hispanic Blacks are disproportionately affected by both prematurity and asthma. In this review, we examine current evidence to support maternal psychosocial stress as a putative link between prematurity and asthma, while also focusing on disruption of the hypothalamic-pituitary-adrenal (HPA) axis and immune responses as potential underlying mechanisms for stress-induced “premature asthma”. Prenatal stress may not only cause abnormalities in the HPA axis but also epigenetic changes in the fetal glucocorticoid receptor gene (NR3C1), leading to impaired glucocorticoid metabolism. Moreover, maternal stress can alter fetal cytokine balance, favoring Th2 (allergic) immune responses characteristic of atopic asthma: IL-6, which has been associated with premature labor, can promote Th2 responses by stimulating production of IL-4 and IL-13. Given a link among stress, prematurity, and asthma, future research should include birth cohorts aimed at confirming and better characterizing “premature asthma”. If confirmed, clinical trials of prenatal maternal stress reduction would be warranted to reduce the burden of these common co-morbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (e.g. from firearms) are justified, not only by public safety but also by growing evidence of detrimental effects of violence-induced stress on psychiatric and somatic health. PMID:26676148

Screening of subfertile men for testicular carcinoma in situ by an automated image analysis-based cytological test of the ejaculate

DEFF Research Database (Denmark)

Almstrup, K; Lippert, Marianne; Mogensen, Hanne O

2011-01-01

in conjunction with analysis of the ejaculates because of infertility work-up. Histological analysis of the biopsies for the presence of CIS yielded a test sensitivity of 0.67 and a specificity of 0.98. In addition, ejaculates from 45 patients with clinical signs of an overt TC were investigated and yielded...... a slightly lower sensitivity (0.51), possibly because of obstruction. We conclude that this novel non-invasive test combining automated immunocytochemistry and advanced image analysis allows identification of TC at the CIS stage with a high specificity, but a negative test does not completely exclude CIS...

Why do premature newborn infants display elevated blood adenosine levels?

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Panfoli, Isabella; Cassanello, Michela; Bruschettini, Matteo; Colella, Marina; Cerone, Roberto; Ravera, Silvia; Calzia, Daniela; Candiano, Giovanni; Ramenghi, Luca

2016-05-01

Our preliminary data show high levels of adenosine in the blood of very low birth weight (VLBW) infants, positively correlating to their prematurity (i.e. body weight class). This prompted us to look for a mechanism promoting such impressive adenosine increase. We hypothesized a correlation with oxygen challenge. In fact, it is recognized that either oxygen lack or its excess contribute to the pathogenesis of the injuries of prematurity, such as retinopathy (ROP) and periventricular white matter lesions (PWMI). The optimal concentration of oxygen for resuscitation of VLBW infants is currently under revision. We propose that the elevated adenosine blood concentrations of VLBW infants recognizes two sources. The first could be its activity-dependent release from unmyelinated brain axons. Adenosine in this respect would be an end-product of the hypometabolic VLBW newborn unmyelinated axon intensely firing in response to the environmental stimuli consequent to premature birth. Adenosine would be eventually found in the blood due to blood-brain barrier immaturity. In fact, adenosine is the primary activity-dependent signal promoting differentiation of premyelinating oligodendrocyte progenitor cells (OPC) into myelinating cells in the Central Nervous System, while inhibiting their proliferation and inhibiting synaptic function. The second, would be the ecto-cellular ATP synthesized by the endothelial cell plasmalemma exposed to ambient oxygen concentrations due to premature breathing, especially in lung. ATP would be rapidly transformed into adenosine by the ectonucleotidase activities such as NTPDase I (CD39), and NT5E (CD73). An ectopic extra-mitochondrial aerobic ATP synthetic ability was reported in many cell plasma-membranes, among which endothelial cells. The potential implications of the cited hypotheses for the neonatology area would be great. The amount of oxygen administration for reviving of newborns would find a molecular basis for its assessment. VLBW

Space maintenance in the primary and mixed dentitions.

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Simon, Thomas; Nwabueze, Ifechide; Oueis, Hassan; Stenger, James

2012-01-01

Loss of space in the primary dentition is considered one of the main causes of malocclusion in the permanent dentition. The purpose of this paper is to review ond summarize the indications and use of space maintainers in primary and mixed dentitions as preventive measures of future malocclusion. Two main types of space maintainers are used to maintain the space in primary ond mixed dentitions: fixed and removable appliances. Band and loop is the appliance of choice when a primary maxillary or mandibular first molar is prematurely lost. With the premature loss of a second primary molar, Nance or transpalatal (TPA) appliances can be used on the maxillary arch and the lower lingual holding arch (LLHA) for the mandibular arch.

Long-term health consequences of premature or early menopause and considerations for management

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Faubion, Stephanie S.; Kuhle, Carol L.; Shuster, Lynne T.; Rocca, Walter A.

2015-01-01

Aim To review the current evidence concerning the long-term harmful effects of premature or early menopause, and to discuss some of the clinical implications. Material and methods Narrative review of the literature. Results Women undergoing premature or early menopause, either following bilateral salpingo-oophorectomy or because of primary ovarian insufficiency, experience the early loss of estrogen and other ovarian hormones. The long-term consequences of premature or early menopause include adverse effects on cognition, mood, cardiovascular, bone, and sexual health, as well as an increased risk of early mortality. The use of hormone therapy has been shown to lessen some, although not all of these risks. Therefore, multiple medical societies recommend providing hormone therapy at least until the natural age of menopause. It is important to individualize hormone therapy for women with early estrogen deficiency, and higher dosages may be needed to approximate physiological concentrations found in premenopausal women. It is also important to address the psychological impact of early menopause and to review the options for fertility and the potential need for contraception, if the ovaries are intact. Conclusions Women who undergo premature or early menopause should receive individualized hormone therapy and counseling. PMID:25845383

Measurement errors in polymerase chain reaction are a confounding factor for a correct interpretation of 5-HTTLPR polymorphism effects on lifelong premature ejaculation: a critical analysis of a previously published meta-analysis of six studies.

Directory of Open Access Journals (Sweden)

Paddy K C Janssen

Full Text Available OBJECTIVE: To analyze a recently published meta-analysis of six studies on 5-HTTLPR polymorphism and lifelong premature ejaculation (PE. METHODS: Calculation of fraction observed and expected genotype frequencies and Hardy Weinberg equilibrium (HWE of cases and controls. LL,SL and SS genotype frequencies of patients were subtracted from genotype frequencies of an ideal population (LL25%, SL50%, SS25%, p = 1 for HWE. Analysis of PCRs of six studies and re-analysis of the analysis and Odds ratios (ORs reported in the recently published meta-analysis. RESULTS: Three studies deviated from HWE in patients and one study deviated from HWE in controls. In three studies in-HWE the mean deviation of genotype frequencies from a theoretical population not-deviating from HWE was small: LL(1.7%, SL(-2.3%, SS(0.6%. In three studies not-in-HWE the mean deviation of genotype frequencies was high: LL(-3.3%, SL(-18.5% and SS(21.8% with very low percentage SL genotype concurrent with very high percentage SS genotype. The most serious PCR deviations were reported in the three not-in-HWE studies. The three in-HWE studies had normal OR. In contrast, the three not-in-HWE studies had a low OR. CONCLUSIONS: In three studies not-in-HWE and with very low OR, inadequate PCR analysis and/or inadequate interpretation of its gel electrophoresis resulted in very low SL and a resulting shift to very high SS genotype frequency outcome. Consequently, PCRs of these three studies are not reliable. Failure to note the inadequacy of PCR tests makes such PCRs a confounding factor in clinical interpretation of genetic studies. Currently, a meta-analysis can only be performed on three studies-in-HWE. However, based on the three studies-in-HWE with OR of about 1 there is not any indication that in men with lifelong PE the frequency of LL,SL and SS genotype deviates from the general male population and/or that the SL or SS genotype is in any way associated with lifelong PE.

Premature ovarian insufficiency in young girls: repercussions on uterine volume and bone mineral density.

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Bakhsh, Hanadi; Dei, Metella; Bucciantini, Sandra; Balzi, Daniela; Bruni, Vincenzina

2015-01-01

To evaluate biological differences among young subjects with premature ovarian insufficiency (POI) commencing at different stages of life. Retrospective observational study. Careggi University Hospital Participants: One hundred sixty-two females aged between 15 and 29 years with premature ovarian insufficiency. Data were collected as a retrospective chart review of baseline evaluation at diagnosis of premature ovarian insufficiency (POI). About 162 participants were divided into four groups based on gynecological age. Two primary outcome variables (uterine development and bone mineral density (BMD)) were analyzed in terms of differences among groups and in a multivariate logistic regression analysis. Uterine development was clearly jeopardized when estrogen insufficiency started at a very young age. Total body BMD showed significant differences among the four groups studied, clearly corresponding to the duration of ovarian function. Data were discussed in relation to the choice of hormone replacement therapy regimens.

Your Premature Baby: Low Birthweight

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... volunteer leader Partner Spotlight Become a partner World Prematurity Day What's happening in your area Find out ... to remove damaged parts of intestine. Retinopathy of prematurity (also called ROP) . ROP affects blood vessels in ...

Health Issues of Premature Babies

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... they leave the hospital for home. Retinopathy of Prematurity (ROP) What It Is: ROP is an eye ... sometimes seen in preterm babies include anemia of prematurity (a low red blood cell count) and heart ...

Retinal vascular speed prematurity requiring treatment.

Science.gov (United States)

Solans Pérez de Larraya, Ana M; Ortega Molina, José M; Fernández, José Uberos; Escudero Gómez, Júlia; Salgado Miranda, Andrés D; Chaves Samaniego, Maria J; García Serrano, José L

2018-03-01

To analyse the speed of temporal retinal vascularisation in preterm infants included in the screening programme for retinopathy of prematurity. A total of 185 premature infants were studied retrospectively between 2000 and 2017 in San Cecilio University Hospital of Granada, Spain. The method of binocular indirect ophthalmoscopy with indentation was used for the examination. The horizontal disc diameter was used as a unit of length. Speed of temporal retinal vascularisation (disc diameter/week) was calculated as the ratio between the extent of temporal retinal vascularisation (disc diameter) and the time in weeks. The weekly temporal retinal vascularisation (0-1.25 disc diameter/week, confidence interval) was significantly higher in no retinopathy of prematurity (0.73 ± 0.22 disc diameter/week) than in stage 1 retinopathy of prematurity (0.58 ± 0.22 disc diameter/week). It was also higher in stage 1 than in stages 2 (0.46 ± 0.14 disc diameter/week) and 3 of retinopathy of prematurity (0.36 ± 0.18 disc diameter/week). The rate of temporal retinal vascularisation (disc diameter/week) decreases when retinopathy of prematurity stage increases. The area under the receiver operating characteristic curve was 0.85 (95% confidence interval: 0.79-0.91) for retinopathy of prematurity requiring treatment versus not requiring treatment. The best discriminative cut-off point was a speed of retinal vascularisation prematurity may be required. However, before becoming a new standard of care for treatment, it requires careful documentation, with agreement between several ophthalmologists.

Synergy and interactions among biological pathways leading to preterm premature rupture of membranes.

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Lannon, Sophia M R; Vanderhoeven, Jeroen P; Eschenbach, David A; Gravett, Michael G; Adams Waldorf, Kristina M

2014-10-01

Preterm premature rupture of membranes (PPROM) occurs in 1% to 2% of births. Impact of PPROM is greatest in low- and middle-income countries where prematurity-related deaths are most common. Recent investigations identify cytokine and matrix metalloproteinase activation, oxidative stress, and apoptosis as primary pathways to PPROM. These biological processes are initiated by heterogeneous etiologies including infection/inflammation, placental bleeding, uterine overdistention, and genetic polymorphisms. We hypothesize that pathways to PPROM overlap and act synergistically to weaken membranes. We focus our discussion on membrane composition and strength, pathways linking risk factors to membrane weakening, and future research directions to reduce the global burden of PPROM. © The Author(s) 2014.

Altered PIWI-LIKE 1 and PIWI-LIKE 2 mRNA expression in ejaculated spermatozoa of men with impaired sperm characteristics.

Science.gov (United States)

Giebler, Maria; Greither, Thomas; Müller, Lisa; Mösinger, Carina; Behre, Hermann M

2018-01-01

In about half the cases of involuntary childlessness, a male infertility factor is involved. The PIWI-LIKE genes, a subclade of the Argonaute protein family, are involved in RNA silencing and transposon control in the germline. Knockout of murine Piwi-like 1 and 2 homologs results in complete infertility in males. The aim of this study was to analyze whether the mRNA expression of human PIWI-LIKE 1-4 genes is altered in ejaculated spermatozoa of men with impaired sperm characteristics. Ninety male participants were included in the study, among which 47 were with normozoospermia, 36 with impaired semen characteristics according to the World Health Organization (WHO) manual, 5 th edition, and 7 with azoospermia serving as negative control for the PIWI-LIKE 1-4 mRNA expression in somatic cells in the ejaculate. PIWI-LIKE 1-4 mRNA expression in the ejaculated spermatozoa of the participants was measured by quantitative real-time PCR. In nonazoospermic men, PIWI-LIKE 1-4 mRNA was measurable in ejaculated spermatozoa in different proportions. PIWI-LIKE 1 (100.0%) and PIWI-LIKE 2 (49.4%) were more frequently expressed than PIWI-LIKE 3 (9.6%) and PIWI-LIKE 4 (15.7%). Furthermore, a decreased PIWI-LIKE 2 mRNA expression showed a significant correlation with a decreased sperm count (P = 0.022) and an increased PIWI-LIKE 1 mRNA expression with a decreased progressive motility (P = 0.048). PIWI-LIKE 1 and PIWI-LIKE 2 mRNA expression exhibited a significant association with impaired sperm characteristics and may be a useful candidate for the evaluation of the impact of PIWI-LIKE 1-4 mRNA expression on male infertility.

Comparison of sperm subpopulation structures in first and second ejaculated semen from Japanese black bulls by a cluster analysis of sperm motility evaluated by a CASA system.

Science.gov (United States)

Kanno, Chihiro; Sakamoto, Kentaro Q; Yanagawa, Yojiro; Takahashi, Yoshiyuki; Katagiri, Seiji; Nagano, Masashi

2017-08-04

In the present study, bull sperm in the first and second ejaculates were divided into subpopulations based on their motility characteristics using a cluster analysis of data from computer-assisted sperm motility analysis (CASA). Semen samples were collected from 4 Japanese black bulls. Data from 9,228 motile sperm were classified into 4 clusters; 1) very rapid and progressively motile sperm, 2) rapid and circularly motile sperm with widely moving heads, 3) moderately motile sperm with heads moving frequently in a short length, and 4) poorly motile sperm. The percentage of cluster 1 varied between bulls. The first ejaculates had a higher proportion of cluster 2 and lower proportion of cluster 3 than the second ejaculates.

Effects of correcting for prematurity on cognitive test scores in childhood.

Science.gov (United States)

Wilson-Ching, Michelle; Pascoe, Leona; Doyle, Lex W; Anderson, Peter J

2014-03-01

The American Academy of Pediatrics recommends that test scores should be corrected for prematurity up to 3 years of age, but this practice varies greatly in both clinical and research settings. The aim of this study was to contrast the effects of using chronological age and those of using corrected age on measures of cognitive outcome across childhood. A theoretical model was constructed using norms from the Bayley Scales of Infant and Toddler Development, Third Edition; the Wechsler Preschool and Primary Scale of Intelligence, Third Edition Australian; and the Wechsler Intelligence Scales for Children, Fourth Edition Australian. Baseline scores representing different levels of functioning (70, below average; 85, borderline; and 100, average) were recalculated using the normative data for ages 6 months to 16 years to account for 1, 2, 3 and 4 months of prematurity. The model created depicted the difference in standardised scores between chronological and corrected age. Compared with scores corrected for prematurity, the absolute reduction in scores using chronological age was greater for increasing degree of prematurity, younger ages at assessment and higher baseline scores and was substantial even beyond 3 years of age. However, the pattern was erratic, with considerable fluctuation evident across different ages and baseline scores. Chronological age results in a lowering of scores at all ages for preterm-born subjects that is greater in the first few years and in those born at earlier gestational ages. Whether or not to correct for prematurity depends upon the context of the assessment. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Viable acrosome-intact human spermatozoa in the ejaculate as a marker of semen quality and fertility status

DEFF Research Database (Denmark)

Egeberg Palme, Dorte Louise; Rehfeld, Anders; Bang, Anne Kirstine

2018-01-01

STUDY QUESTION: Is it possible, in an unbiased and clinical relevant way, to determine the number of viable acrosome-intact human spermatozoa in ejaculates and to use this as a measure of fertility chances? SUMMARY ANSWER: Image cytometry enables easy and unbiased quantification of viable acrosome......-intact spermatozoa and it correlates with semen quality and fertility status. WHAT IS KNOWN ALREADY: The presence of the acrosome and its ability to respond to physiological inducers (e.g. progesterone) in the female reproductive tract at the appropriate time and place is required for fertilization. However......, the available assays are labor intensive and therefore not used clinically. STUDY DESIGN, SIZE, DURATION: Washed semen samples and capacitated swim-up fractions from volunteers were used to develop the assay. Subsequently washed ejaculates from patients in fertility treatment (n = 156), proven fertile men (n...

Premature ovarian failure risk factors in an Iranian population

Directory of Open Access Journals (Sweden)

Ghassemzadeh A

2012-04-01

Full Text Available Alieh Ghassemzadeh1,2, Laya Farzadi1,2, Elaheh Beyhaghi1,21Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2Alzahra University Hospital, Department of Obstetrics and Gynecology, Tabriz University of Medical Sciences, Tabriz, IranBackground: The aim of this study was to determine possible correlates of premature ovarian failure (POF in an Iranian population.Methods: In a case-control study, 80 patients with POF were compared with 80 controls enrolled from the same setting during 2007–2008. A food diary was used to assess food consumption habits.Results: Mean age of starting ovarian failure symptoms was 19.3 ± 5.7 years and mean age of menopause was 22.6 ± 6.3 years. Familial coincidence was observed in 16 POF patients versus no one in the control group (P < 0.05. POF patients had lower frequency of both eating red meat and fish when compared with controls (P < 0.001. POF and control subjects consumed similar amounts of dairy products, being 5.3 ± 3.2 times per week in POF and 5.6 ± 2.1 times in the control groups.Conclusion: In this study, an association between POF and lower red meat or fish consumption was found.Keywords: POF, etiology, case-control, nutrition, premature menopause, premature ovarian dysfunction, primary ovarian insufficiency

Premature infants' health at multiple induced pregnancy.

Directory of Open Access Journals (Sweden)

Chernenkov Yu.V.

2015-09-01

Full Text Available Objective: to define the risk factors adversely influencing prenatal development at premature birth at use of methods of assisted reproductive technology (ART; to estimate premature' infants health from multiple induced pregnancy according to Perinatal Center of Saratov for last 3 years. Material and Methods. Under supervision there were 139 pregnant women with application ART. 202 children (51 twins were born and 5 triplet babies, from them 83 premature infants born from multiple induced pregnancy have been analyzed. Results. The newborns examined by method ART, were distributed as follows: 22-28 weeks — 19 children; 29-32 weeks — 23; 33-36 weeks — 41. Asphyxia at birth was marked at all premature infants. Respiratory insufficiency at birth is revealed in 87,3% of cases. The most frequent pathologies in premature infants are revealed: neurologic infringements and bronchopulmonary pathology occured at all children, developmental anomaly — 33, 8%, retinopathies in premature infants — 26,5%. The mortality causes include: extreme immaturity, cerebral leukomalacia, IVN 3 degrees. Conclusion. The risk factors, premature birth at application of methods ART are revealed: aged primiparas, pharmacological influence, absence of physiological conditions of prenatal development; multifetation. The high percent of birth of children with ELBW and ULBW is revealed. RDCN with further BPD development, retinopathies in premature infants and CNS defeat is more often occured.

7 CFR 29.1050 - Prematurity.

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Prematurity. 29.1050 Section 29.1050 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Type 92) § 29.1050 Prematurity. A condition of growth and development characteristic of the lower...

xidative Stress and Retinopathy of Prematurity

OpenAIRE

Ümeyye Taka Aydın; Hatip Aydın; Osman Çekiç

2014-01-01

Oxidative stress plays an important role in the etiology of retinopathy of prematurity. Insufficient antioxidant system and increased oxidative stress in premature infants lead to the development of the disease. Understanding the mechanism of oxidative stress and antioxidant system and the related signaling pathways contribute to the development of novel options for diagnosis and treatment of retinopathy of prematurity. The current review aimed to evaluate the relationship between ox...

Educational paper: Retinopathy of prematurity.

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Casteels, Ingele; Cassiman, Catherine; Van Calster, Joachim; Allegaert, Karel

2012-06-01

Retinopathy of prematurity (ROP) is a proliferative retinal vascular disease affecting the premature infant with an incompletely vascularized retina. The spectrum of ophthalmological findings in ROP exists from minimal sequelae, which do not affect vision, to bilateral retinal detachment and total blindness. With the increased survival of very small infants, retinopathy of prematurity has become one of the leading causes of childhood blindness. Over the past two decades, major advances have been made in understanding the pathogenesis of ROP, to a large extent as a result of changes in clinical risk factors (oxygen and non-oxygen related) and characteristics observed in ROP cases. This article provides a literature review on the evolution in clinical characteristics, classification and treatment modalities and indications of ROP. Special attention is hereby paid to the neonatal factors influencing the development of ROP and to the necessity for everyone caring for premature babies to have a well-defined screening and treatment protocol for ROP. Such screening protocol needs to be based on a unit-specific ROP risk profile and, consequently, may vary between different European regions. Retinopathy of prematurity is an important cause of ocular morbidity and blindness in children. With better understanding of the pathogenesis, screening and treatment guidelines have changed over time and are unit specific.

Refractive status and optical components of premature babies with or without retinopathy of prematurity at 3-4 years old.

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Ouyang, Li-Juan; Yin, Zheng-Qin; Ke, Ning; Chen, Xin-Ke; Liu, Qin; Fang, Jing; Chen, Lin; Chen, Xiu-Rong; Shi, Hui; Tang, Ling; Pi, Lian-Hong

2015-01-01

To investigate the refractive status and optical components of premature babies with or without retinopathy of prematurity (ROP) at 3-4 years old, and to explore the influence of prematurity and ROP on the refractive status and optical components. Premature babies receiving fundus examination were recruited into ROP group and non-ROP group, with age-matched full-term babies as controls. The incidence of myopia was the highest in ROP (3/59, 5.08%). The incidence of astigmatism was significantly different between ROP (37.29%, 22/59) and controls (17.86%, 15/84). The corneal refractive power in ROP and non-ROP was more potent compared with controls (PPremature babies with or without ROP are susceptible to myopia and astigmatism. ROP, prematurity and low birth-weight synergistically influence the development of refractive status and optical components, of which the prematurity and low birth-weight are more important.

Evaluation the Frequency of Sexual Dysfunction in Infertile Men, Fatemieh Hospital, Hamadan

Directory of Open Access Journals (Sweden)

H. Babolhavaeji

2008-07-01

Full Text Available Introduction & Objective: Sexual dysfunction is called to inability to get or keep a successful sexual intercourse. The term “sexual dysfunction” may also be used to describe other problems that interfere with sexual intercourse, such as inability to achieve erection and problems with ejaculation or orgasm. Damage to nerves, arteries, smooth muscles and fibrous tissues, often as a result of a disease, are the most common cause of erectile dysfunction. The aim of the present study was to evaluate the frequency of sexual dysfunction in patients referred to Fatemieh infertility clinic, Hamadan.Materials & Methods: In this cross-sectional study all males referred to Fatemieh infertility center in 2005, were entered the study. All patients were clinically examined and their medical histories were obtained. Data such as age, accusation, education, history of smoking and opioid abusing, sexual dysfunction, inability to achieve orgasm, premature ejaculation and the frequency of intercourse were entered in the questionnaires. Data was analyzed using SPSS 13 and 2 statistical test.Results: The mean age of patients studied was 32.37.4 years (20-65 years. From 245 cases, 135 (55.1% had sexual dysfunction. The most common sexual dysfunction was premature ejaculation(38.8%. Other sexual dysfunctions were impotence with 16.3% , lack of sexual desire with 12.2% and orgasm disorder with 10.6% respectively. 65.9% patients were uneducated or had elementary education , 27.4% had diploma , and 6.7% had academic education. 23.7% of patients had addiction and 34.1% were smoker.Conclusion : This study showed that most common etiology of sexual dysfunction was premature ejaculation. Other sexual dysfunctions were: impotence, sexual desire disorder and orgasm disorder respectively.

Premature infant

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... matter Infection or neonatal sepsis Low blood sugar (hypoglycemia) Neonatal respiratory distress syndrome, extra air in the tissue ... Outlook (Prognosis) Prematurity used to be a major cause of infant deaths. Improved medical and nursing techniques ...

Prematurity Affects Age of Presentation of Pyloric Stenosis.

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Costanzo, Caitlyn M; Vinocur, Charles; Berman, Loren

2017-02-01

Term infants with hypertrophic pyloric stenosis (HPS) typically present between 4 and 6 weeks. There is limited consensus, however, regarding age of presentation of premature infants. We aim to determine if there is an association between the degree of prematurity and chronological age of presentation of HPS. A total of 2988 infants who had undergone a pyloromyotomy for HPS were identified from the 2012 and 2013 NSQIP-P Participant Use Files. Two hundred seventeen infants (7.3%) were born prematurely. A greater degree of prematurity was associated with an older chronological age of presentation ( P Prematurity was significantly associated with an increase in overall postoperative morbidity, reintubation, readmission, and postoperative length of stay. When clinicians evaluate an infant with nonbilious emesis with a history of prematurity, they should consider pyloric stenosis if the calculated postconceptional age is between 44 and 50 weeks. When counseling families of premature infants, surgeons should discuss the increased incidence of postpyloromyotomy morbidity.

FOETOMATERNAL AND NEONATAL OUTCOME OF PRETERM PREMATURE RUPTURE OF MEMBRANES

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Kusumam Vilangot Nhalil

2017-10-01

Full Text Available BACKGROUND Preterm premature rupture of membrane is defined as rupture of foetal membrane before onset of labour at less than 37 completed weeks of gestation. Incidence of PPROM is around 3-10% of all deliveries. Primary complication for mother is infection and for foetus and neonate is prematurity, foetal distress, cord compression, deformation, pulmonary hypoplasia, necrotising enterocolitis and neurologic disorders. Most likely outcome is preterm delivery within 1 week. The aim of the study is to study the foetomaternal and neonatal outcome in PPROM patients and the common prevalent organism in PPROM. MATERIALS AND METHODS This is a cohort study of pregnant women from 24-37 weeks with PPROM admitted to IMCH for a period of 1 year, January 2016 to December 2016. 100 patients with PPROM were taken up for the study. The data was collected using the following inclusion and exclusion criteria. Inclusion criteria are gestational age 24-37 weeks confirmed by dates, clinical examination and ultrasound with lack of uterine contractions for at least 1 hour from PPROM; single live pregnancy in vertex presentation; PPROM confirmed by direct visualisation, neonates admitted in NICU soon after delivery. RESULTS 49% of patients with preterm premature rupture of membranes were from 18-24 years.68% of patients had a latency period of 3 weeks.15% of patients had maternal tachycardia, 4% had tenderness of uterus and 4% had leucocytosis and 14% had an elevated CRP. Thus, clinical chorioamnionitis was seen in 14% of patients, 38% of babies born had prematurity and 2% had sepsis and 19% had respiratory distress syndrome and hyperbilirubinaemia, 2% had perinatal asphyxia, 2% had anomalies, 1% had necrotising enterocolitis and 5% were NND. Common organisms were normal flora, E. coli, Streptococci and Enterococci. CONCLUSION PPROM increases the incidence of maternal morbidity with longer hospital stay due to chorioamnionitis. Neonatal morbidity is increased due to

Conceptualizing pathways linking women's empowerment and prematurity in developing countries.

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Afulani, Patience A; Altman, Molly; Musana, Joseph; Sudhinaraset, May

2017-11-08

Globally, prematurity is the leading cause of death in children under the age of 5. Many efforts have focused on clinical approaches to improve the survival of premature babies. There is a need, however, to explore psychosocial, sociocultural, economic, and other factors as potential mechanisms to reduce the burden of prematurity. Women's empowerment may be a catalyst for moving the needle in this direction. The goal of this paper is to examine links between women's empowerment and prematurity in developing settings. We propose a conceptual model that shows pathways by which women's empowerment can affect prematurity and review and summarize the literature supporting the relationships we posit. We also suggest future directions for research on women's empowerment and prematurity. The key words we used for empowerment in the search were "empowerment," "women's status," "autonomy," and "decision-making," and for prematurity we used "preterm," "premature," and "prematurity." We did not use date, language, and regional restrictions. The search was done in PubMed, Population Information Online (POPLINE), and Web of Science. We selected intervening factors-factors that could potentially mediate the relationship between empowerment and prematurity-based on reviews of the risk factors and interventions to address prematurity and the determinants of those factors. There is limited evidence supporting a direct link between women's empowerment and prematurity. However, there is evidence linking several dimensions of empowerment to factors known to be associated with prematurity and outcomes for premature babies. Our review of the literature shows that women's empowerment may reduce prematurity by (1) preventing early marriage and promoting family planning, which will delay age at first pregnancy and increase interpregnancy intervals; (2) improving women's nutritional status; (3) reducing domestic violence and other stressors to improve psychological health; and (4) improving

Chlamydiae in the ejaculate: their influence on the quality and morphology of sperm.

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Veznik, Zdenek; Pospisil, Leopold; Svecova, Drahomira; Zajicova, Atanaska; Unzeitig, Vit

2004-07-01

Given the lack of information concerning the role of Chlamydia trachomatis in male fertility, the aim of this study was to ascertain and analyze the quality of Chlamydiae-positive and -negative semen. Sperm count was performed according to the 1999 World Health Organization (WHO) laboratory manual for examination of human semen and sperm-cervical mucus interaction, and sperm survival was assessed by a 120-min test. The evaluation of the morphological examination of ejaculates was carried out using the sasmo (strict morphological analysis of ejaculates) computer program. Chlamydiae were detected by immunofluorescent reaction using the Progen Biotechnik GmbH diagnostic set. Fisher's exact test and the chi-quadrate test were used for statistical analysis. Of the total of 627 sperm samples examined, Chlamydiae were detected in 136 cases (21.7%). Sperm analysis showed significant differences between Chlamydiae-positive and -negative samples. The Chlamydiae-contaminated group showed normal sperm morphology 14.4% lower, volume 6.4% lower, concentration 8.3% lower, motility 7.8% and velocity 9.3% lower than in Chlamydiae-negative samples. The average values for normal spermatozoa and motility in the Chlamydiae-positive group were also significantly reduced. Chlamydia trachomatis was found to be a possible factor in sperm pathology. These results could help to elucidate the role of Chlamydia trachomatis in male infertility.

Female orgasm but not male ejaculation activates the pituitary. A PET-neuro-imaging study.

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Huynh, Hieu Kim; Willemsen, Antoon T M; Holstege, Gert

2013-08-01

The pituitary gland plays an important role in basic survival mechanisms by releasing fluctuating amounts of hormones into the bloodstream, depending on the circumstances the individual finds itself. However, despite these changes in pituitary hormonal production, neuroimaging studies have never been able to demonstrate changes in the activation level of the pituitary. The most apparent reason is the much higher blood flow rate in the pituitary than in the brain. However, the present PET-scanning study demonstrates for the first time that neuroimaging techniques can identify increased pituitary activity. In a study with 11 healthy women sexual orgasm compared to rest caused an increased blood supply to the pituitary. We assume that this increase signifies elevated pituitary activation in order to produce higher plasma concentrations of oxytocin and prolactin. These hormones induce vaginal and uterus movements, ovulation and enhancement of sperm and egg transport. No increased blood supply was observed comparing clitoral stimulation, orgasm attempt, and faked orgasm with rest. In a study with 11 healthy men comparing ejaculation with rest did not reveal increased pituitary activation, probably because ejaculation causes a much lower increase of oxytocin and prolactin plasma concentration than female orgasm. Copyright © 2013 Elsevier Inc. All rights reserved.

Acute appendicitis in a premature baby

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Beluffi, Giampiero; Alberici, Elisa

2002-01-01

A case of acute appendicitis in a premature baby in whom diagnosis was suggested on plain films of the abdomen is presented. In this baby air in a hollow viscus suspected of being an enlarged appendix was the clue to diagnosis. The diagnostic dilemma of this rare and life-threatening condition in premature babies and newborns is underlined. The relevance of different imaging modalities and of different findings in this age group is discussed. Awareness of this rare condition and possible differential diagnosis in newborns and premature babies is stressed. (orig.)

Relationship between premature mortality and socioeconomic factors in black and white populations of US metropolitan areas.

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Cooper, R S; Kennelly, J F; Durazo-Arvizu, R; Oh, H J; Kaplan, G; Lynch, J

2001-01-01

examined the association of mortality with selected socioeconomic indicators of inequality and segregation among blacks and whites younger than age 65 in 267 US metropolitan areas. The primary aim of the analysis was to operationalize the concept of institutional racism in public health. Socioeconomic indicators were drawn from Census and vital statistics data for 1989-1991 and included median household income; two measures of income inequality; percentage of the population that was black; and a measure of residential segregation. Age-adjusted premature mortality was 81% higher in blacks than in whites, and median household income was 40% lower. Income inequality, as measured by the Gini coefficient, was greater within the black population (0.45) than within the white population (0.40; p inequality for the total population was significantly correlated with premature mortality (r = 0.33). Black (r = 0.26) and white (r = 0.20) population-specific correlations between income inequality and premature mortality, while still significant, were smaller. Residential segregation was significantly related to premature mortality and income inequality for blacks (r = 0.38 for both); among whites, however, segregation was modestly correlated with premature mortality (r = 0.19) and uncorrelated with income inequality. Regional analyses demonstrated that the association of segregation with premature mortality was much more pronounced in the South and in areas with larger black populations. Social factors such as income inequality and segregation strongly influence premature mortality in the US. Ecologic studies of the relationships among social factors and population health can measure attributes of the social context that may be relevant for population health, providing the basis for imputing macro-level relationships.

Comparative study of visual functions in premature pre-school children with and without retinopathy of prematurity

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Lígia Beatriz Bonotto

2014-01-01

Full Text Available Purpose: Observe whether there are differences in visual functions among premature infants with treated retinopathy of prematurity (ROP in relation to preterm infants with ROP and spontaneous regression; and among these two groups with ROP and the control group without ROP. Methods: Crosssectional observational no blind study. Premature infants were born between 06/199206/2006 and were exam between 06/200912/2010; registered in data of Hospital de Olhos Sandalla Amin Ghanem; with gestational age less than or equal to 32 weeks and 1,599 g born weigh; without ROP and ROP stages II or III, in one of the eyes, with spontaneous regression or with treatment; at least three visits during the selection period at maximum 6 months in the first exam and minimum 4 years of age in reassessment (chronological age were include. Premature that did not respond or were not located for reassessment and those that did not have conditions to do the exams were exclude. Study's groups: G1 ROP posttreatment; G2ROP postspontaneous regression; G3 without ROP (control. Visual function evaluated with visual acuity (VA, contrast sensitivity test (CST, color test (CT, eye movement, stereopsis. Results: Overall, there were 24 premature infants and 48 eyes. Normal VA: 64.28% (G1, 87.5% (G2 and 100% (G3; Normal CST: 66.67% (G1, 100% (G2 and 55.56% (G3; Normal Ishihara CT: 100% (G1 and G2 and 86% (G3; Normal Farnsworth CT: 20% (G1, 75% (G2 and 50% (G3. Normal stereoacuity: 0.00% (G1; 25% (G2 and 3.5% (G3. Strabismus: 37% (G2, 0.00% (G1 and G3. The prevalent tendency for lower response in CST and CT between the premature children in group G3 and Farnsworth color test in G1 is a curious result of this work and more study is necessary about these visual functions in older premature children. Conclusion: The visual functions showed no statistically significant difference among the groups studied.

Future premature mortality due to O3, secondary inorganic aerosols and primary PM in Europe--sensitivity to changes in climate, anthropogenic emissions, population and building stock.

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Geels, Camilla; Andersson, Camilla; Hänninen, Otto; Lansø, Anne Sofie; Schwarze, Per E; Skjøth, Carsten Ambelas; Brandt, Jørgen

2015-03-04

Air pollution is an important environmental factor associated with health impacts in Europe and considerable resources are used to reduce exposure to air pollution through emission reductions. These reductions will have non-linear effects on exposure due, e.g., to interactions between climate and atmospheric chemistry. By using an integrated assessment model, we quantify the effect of changes in climate, emissions and population demography on exposure and health impacts in Europe. The sensitivity to the changes is assessed by investigating the differences between the decades 2000-2009, 2050-2059 and 2080-2089. We focus on the number of premature deaths related to atmospheric ozone, Secondary Inorganic Aerosols and primary PM. For the Nordic region we furthermore include a projection on how population exposure might develop due to changes in building stock with increased energy efficiency. Reductions in emissions cause a large significant decrease in mortality, while climate effects on chemistry and emissions only affects premature mortality by a few percent. Changes in population demography lead to a larger relative increase in chronic mortality than the relative increase in population. Finally, the projected changes in building stock and infiltration rates in the Nordic indicate that this factor may be very important for assessments of population exposure in the future.

Association between human breast milk and retinopathy of prematurity.

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Fonseca, Luciana Teixeira; Senna, Denise C; Eckert, Gabriela Unchalo; Silveira, Rita de Cássia; Procianoy, Renato Soibelmann

2018-04-01

To evaluate the possible protective effect of breast milk against retinopathy of prematurity by comparing the amount of breast milk received by patients who developed retinopathy of prematurity and those who did not and to determine both the required minimum amount of breast milk and the time of life during which neonates need to receive breast milk for this effect to be significant. Cohort study of newborns with a birth weight of prematurity of any degree was 31% (100 of 323 patients) and that of severe retinopathy of prematurity was of 9% (29 of 323 patients). The median amounts of breast milk received daily by patients with and without retinopathy of prematurity were 4.9 mL/kg (interquartile range, 0.3-15.4) and 10.2 mL/kg (1.5-25.5), respectively. The amount of breast milk received in the first 6 weeks of life was inversely associated with the incidence of both retinopathy of prematurity of any degree and severe retinopathy of prematurity in the univariate analyses. However, the statistical significance was maintained only during the sixth week of life in a per-period multivariate analysis controlling for confounding factors. Small amounts of breast milk are inadequate to prevent retinopathy of prematurity in premature newborns at risk for the disease.

A new way of thinking about complications of prematurity.

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Moore, Tiffany A; Berger, Ann M; Wilson, Margaret E

2014-01-01

The morbidity and mortality of preterm infants are impacted by their ability to maintain physiologic homeostasis using metabolic, endocrine, and immunologic mechanisms independent of the mother's placenta. Exploring McEwen's allostatic load model in preterm infants provides a new way to understand the altered physiologic processes associated with frequently occurring complications of prematurity such as bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity. The purpose of this article is to present a new model to enhance understanding of the altered physiologic processes associated with complications of prematurity. The model of allostatic load and complications of prematurity was derived to explore the relationship between general stress of prematurity and complications of prematurity. The proposed model uses the concepts of general stress of prematurity, allostasis, physiologic response patterns (adaptive-maladaptive), allostatic load, and complications of prematurity. These concepts are defined and theoretical relationships in the proposed model are interpreted using the four maladaptive response patterns of repeated hits, lack of adaptation, prolonged response, and inadequate response. Empirical evidence for cortisol, inflammation, and oxidative stress responses are used to support the theoretical relationships. The proposed model provides a new way of thinking about physiologic dysregulation in preterm infants. The ability to describe and understand complex physiologic mechanisms involved in complications of prematurity is essential for research. Advancing the knowledge of complications of prematurity will advance clinical practice and research and lead to testing of interventions to reduce negative outcomes in preterm infants.

Innate Immunity and Human Milk MicroRNAs Content: A New Perspective for Premature Newborns

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Erika Cione

2017-02-01

Full Text Available Context The premature newborns are prone to develop both early onset and late onset neonatal sepsis. The major causes of this phenomenon rely on the immaturity of the immune system, which has reduced capability to respond adequately to pathogens. Evidence Acquisition Titles and abstracts of previous papers were scanned before reading the full-text, in order to retrieve appropriate information. The databases used for searching were PubMed, Cochrane, and Embase for articles published before 1st of July, 2016. Secondary search for articles cited in reference lists were identified by the primary search. This review focused on neonatal sepsis incidence and the associated immune response with regards to microRNAs of human milk as a new microelement that enables regulation of innate immunity functions. Results Since human milk is a valuable source of microRNAs, a better understanding of its content will open a new therapeutic avenue for the clinical management of infectious diseases affecting premature newborns. The variation in miRNAs quantity in human milk needs to be considered. Mother’s milk can have different amounts of miRNAs and the identification of a microMilk batch richer of miRNAs can be a nutrition intervention method for modulating innate immunity in clinical management of premature newborns. Conclusions Routine translation of the microMilk concept for neonatal intensive care unit (NICU, in the management of premature newborns could be a way of defending premature newborns and Very Low Birth Weight (VLBW infants from both early and late sepsis.

Short-term outcome after intravitreal ranibizumab injections for the treatment of retinopathy of prematurity.

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Castellanos, María Ana Martínez; Schwartz, Shulamit; García-Aguirre, Gerardo; Quiroz-Mercado, Hugo

2013-07-01

To evaluate ocular outcome in premature infants treated with intravitreal ranibizumab injections for retinopathy of prematurity (ROP) over a period of 3 years. An interventional case series. Premature infants with high-risk prethreshold or threshold ROP with plus disease received an off label monotherapy with intravitreal injections of ranibizumab. The primary outcome was treatment success defined as regression of neovascularisation (NV) and absence of recurrence. The secondary outcomes were ocular and systemic adverse events and visual acuity. Six eyes were included in the study and treated with intravitreal injections of ranibizumab. All showed complete resolution of NV after a single injection. The anti-angiogenic intravitreal injections allowed for continued normal vessel growth into the peripheral retina, without any signs of disease recurrence or progression during the follow up period. No ocular or systemic adverse effects were observed. Three years of follow up in a small series suggest that intravitreal ranibizumab injections for ROP result in apparently preserved ocular outcome. Further large scale studies are needed to address the long-term safety and efficacy.

Retinopathy of prematurity

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Benavides Vargas, Ana Maria

2013-01-01

Retinopathy of prematurity has been the leading cause of childhood blindness. Early and effective screening has helped to diagnose the visual target of an infant by the difference between growing up with a disability or not. A joint effort between ophthalmologists and neonatologists is proposed to control this disease, ensuring success. An appropriate, early, effective and timely treatment has been the laser and cryotherapy like good choices for the neonate to prevent disease progression. Evaluation of screening program, to determine the incidence, compare statistics variables have been measures as other medical pathologies should be encouraged as research topics. A decrease in the incidence of retinopathy of prematurity is expected, controlling the risk factors during the child's stay in intrahospital neonatal unit [es

Effects of Cardiac Rehabilitation on Sexual Dysfunction of Post Myocardial Infarction Patients

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Jamshid Najafian

2001-01-01

Full Text Available Objective: The common sexual complains in patients with coronary heart disease and post myocardial infarction are decrease in libido, impotence, and premature or delay ejaculation. Cardiac rehabilitation could decrease many of the psychological features of myocardial infarction and also increase exercise capacity of patients. Rehabilitation may also improve sexual disturbances in these patients directly or indirectly. This study is a clinical trial that evaluate the effect of rehabilitation on sexual problem of post MI patients. Materials & Methods: 60 patients took part in this study. All of them were men aged between 35 and 65. All patients had myocardial infarction one month ago. 30 patients were referred for cardiac rehabilitation (Case, and 30 people were patients who were not recommended to take part in rehabilitation because their physician did not believe on rehabilitation. Questioner for anxiety, depression, impotency, libido and premature ejaculation were evaluated by before and after study period. The cardiac rehabilitation composed of 24 sessions. Each session consisted of one hour of aerobic exercise (10 min warm up, 10 min cool down and 40 min isotonic exercise. Results: After cardiac rehabilitation the scores for anxiety, depression, premature ejaculation and impotency were decreased and the scores of libido were increased. In both case and control groups, the changes were significant by paired t test P<0.05. The differences between case and control were significant for depression, libido and impotency by independent t test. Conclusion: Cardiac rehabilitation could improve sexual problems in post myocardial infarction patients directly and indirectly by effect on psychological characteristics.

Prematurely terminated slug tests

International Nuclear Information System (INIS)

Karasaki, K.

1990-07-01

A solution of the well response to a prematurely terminated slug test (PTST) is presented. The advantages of a PTST over conventional slug tests are discussed. A systematized procedure of a PTST is proposed, where a slug test is terminated in the midpoint of the flow point, and the subsequent shut-in data is recorded and analyzed. This method requires a downhole shut-in device and a pressure transducer, which is no more than the conventional deep-well slug testing. As opposed to slug tests, which are ineffective when a skin is present, more accurate estimate of formation permeability can be made using a PTST. Premature termination also shortens the test duration considerably. Because in most cases no more information is gained by completing a slug test to the end, the author recommends that conventional slug tests be replaced by the premature termination technique. This study is part of an investigation of the feasibility of geologic isolation of nuclear wastes being carried out by the US Department of Energy and the National Cooperative for the Storage of Radioactive Waste of Switzerland

Risk Factors for premature birth in a hospital

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Margarita E. Ahumada-Barrios

Full Text Available Abstract Objective: to determine the risk factors for premature birth. Methods: retrospective case-control study of 600 pregnant women assisted in a hospital, with 298 pregnant women in the case group (who gave birth prematurely <37 weeks and 302 pregnant women who gave birth to a full-term newborn in the control group. Stata software version 12.2 was used. The Chi-square test was used in bivariate analysis and logistic regression was used in multivariate analysis, from which Odds Ratios (OR and Confidence Intervals (CI of 95% were derived. Results: risk factors associated with premature birth were current twin pregnancy (adjusted OR= 2.4; p= 0.02, inadequate prenatal care (< 6 controls (adjusted OR= 3.2; p <0.001, absent prenatal care (adjusted OR= 3.0; p <0.001, history of premature birth (adjusted OR= 3.7; p <0.001 and preeclampsia (adjusted OR= 1.9; p= 0.005. Conclusion: history of premature birth, preeclampsia, not receiving prenatal care and receiving inadequate prenatal care were risk factors for premature birth.

Voice related quality of life in pediatric patients with a history of prematurity.

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Walz, Patrick C; Hubbell, Michael P; Elmaraghy, Charles A

2014-07-01

To determine incidence of dysphonia in patients with history of prematurity and evaluate the correlation between dysphonia and risk factors unique to premature infants. The aim of this study is to determine parent-perceived vocal quality in patients with history of prematurity and whether duration of intubation, number of intubations, and incidence of patent ductus arteriosus repair were correlated with these perceptions. Cohort study of premature patients presenting to outpatient clinics from January 2010 to January 2013 in tertiary care center. Patients gestational age ≤37 weeks at birth without history of tracheostomy or known vocal fold pathology were eligible. A volunteer sample was obtained from patients presenting in Otolaryngology clinics from January 2010 to January 2013 whose parents agreed to complete surveys. Outcomes were assessed via parental completion of pediatric voice outcomes score (pVOS) and pediatric voice-related quality of life (pVRQOL) instruments. The primary outcome assessed was the incidence of dysphonia in infants with a history of prematurity without known vocal pathology. Additionally, patient factors associated with dysphonia were evaluated. The hypothesis tested was formulated prior to data collection. Sixty-nine participants were included. Mean age at follow-up was 28 (3-197) months. Mean gestational age was 29 (23-37) weeks. Mean intubation duration was 3 (0-22) weeks and median number of intubations was 1 (range 0-5). Voice outcome scores varied widely with pVRQOL scores demonstrating a mean of 89.2±18.1 (25-100) and pVOS with a mean of 11.4±2.2 (0-13). Univariate analysis utilized Spearman correlation coefficients for continuous variables and Wilcoxon Two-sample test for categorical groups. Significance was set at pquality in premature patients. Further study is required to correlate parent perceptions with objective vocal quality data and physical findings of vocal pathology. These data may increase the clinician's suspicion

Frequency of neonatal complications after premature delivery

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Gordana Grgić

2013-04-01

Full Text Available Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. The incidence of preterm birth ranges from 5 to 15%. Aims of the study were to determine the average body weight, Apgar score after one and five minutes, and the frequency of the most common complications in preterminfants.Methods: The study involved a total of 631 newborns, of whom 331 were born prematurely Aims of this study were to (24th-37th gestational weeks-experimental group, while 300 infants were born in time (37-42 weeks of gestation-control group.Results: Average body weight of prematurely born infants was 2382 grams, while the average Apgar score in this group after the fi rst minute was 7.32 and 7.79 after the fifth minute. The incidence of respiratory distress syndrome was 50%, intracranial hemorrhage, 28.1% and 4.8% of sepsis. Respiratory distresssyndrome was more common in infants born before 32 weeks of gestation. Mortality of premature infants is present in 9.1% and is higher than that of infants born at term.Conclusions: Birth body weight and Apgar scores was lower in preterm infants. Respiratory distress syndrome is the most common fetal complication of prematurity. Intracranial hemorrhage is the second most common complication of prematurity. Mortality of premature infants is higher than the mortality of infants born at term birth.

Future Premature Mortality Due to O3, Secondary Inorganic Aerosols and Primary PM in Europe — Sensitivity to Changes in Climate, Anthropogenic Emissions, Population and Building Stock

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Geels, Camilla; Andersson, Camilla; Hänninen, Otto; Lansø, Anne Sofie; Schwarze, Per E.; Ambelas Skjøth, Carsten; Brandt, Jørgen

2015-01-01

Air pollution is an important environmental factor associated with health impacts in Europe and considerable resources are used to reduce exposure to air pollution through emission reductions. These reductions will have non-linear effects on exposure due, e.g., to interactions between climate and atmospheric chemistry. By using an integrated assessment model, we quantify the effect of changes in climate, emissions and population demography on exposure and health impacts in Europe. The sensitivity to the changes is assessed by investigating the differences between the decades 2000–2009, 2050–2059 and 2080–2089. We focus on the number of premature deaths related to atmospheric ozone, Secondary Inorganic Aerosols and primary PM. For the Nordic region we furthermore include a projection on how population exposure might develop due to changes in building stock with increased energy efficiency. Reductions in emissions cause a large significant decrease in mortality, while climate effects on chemistry and emissions only affects premature mortality by a few percent. Changes in population demography lead to a larger relative increase in chronic mortality than the relative increase in population. Finally, the projected changes in building stock and infiltration rates in the Nordic indicate that this factor may be very important for assessments of population exposure in the future. PMID:25749320

Future Premature Mortality Due to O3, Secondary Inorganic Aerosols and Primary PM in Europe — Sensitivity to Changes in Climate, Anthropogenic Emissions, Population and Building Stock

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Camilla Geels

2015-03-01

Full Text Available Air pollution is an important environmental factor associated with health impacts in Europe and considerable resources are used to reduce exposure to air pollution through emission reductions. These reductions will have non-linear effects on exposure due, e.g., to interactions between climate and atmospheric chemistry. By using an integrated assessment model, we quantify the effect of changes in climate, emissions and population demography on exposure and health impacts in Europe. The sensitivity to the changes is assessed by investigating the differences between the decades 2000–2009, 2050–2059 and 2080–2089. We focus on the number of premature deaths related to atmospheric ozone, Secondary Inorganic Aerosols and primary PM. For the Nordic region we furthermore include a projection on how population exposure might develop due to changes in building stock with increased energy efficiency. Reductions in emissions cause a large significant decrease in mortality, while climate effects on chemistry and emissions only affects premature mortality by a few percent. Changes in population demography lead to a larger relative increase in chronic mortality than the relative increase in population. Finally, the projected changes in building stock and infiltration rates in the Nordic indicate that this factor may be very important for assessments of population exposure in the future.

Path analysis of risk factors leading to premature birth.

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Fields, S J; Livshits, G; Sirotta, L; Merlob, P

1996-01-01

The present study tested whether various sociodemographic, anthropometric, behavioral, and medical/physiological factors act in a direct or indirect manner on the risk of prematurity using path analysis on a sample of Israeli births. The path model shows that medical complications, primarily toxemia, chorioammionitis, and a previous low birth weight delivery directly and significantly act on the risk of prematurity as do low maternal pregnancy weight gain and ethnicity. Other medical complications, including chronic hypertension, preclampsia, and placental abruption, although significantly correlated with prematurity, act indirectly on prematurity through toxemia. The model further shows that the commonly accepted sociodemographic, anthropometric, and behavioral risk factors act by modifying the development of medical complications that lead to prematurity as opposed to having a direct effect on premature delivery. © 1996 Wiley-Liss, Inc. Copyright © 1996 Wiley-Liss, Inc.

Radiation-induced premature menopause: a misconception

International Nuclear Information System (INIS)

Madsen, Berit L.; Giudice, Linda; Donaldson, Sarah S.

1995-01-01

Purpose: To disprove the common view that women who have undergone irradiation to fields excluding the pelvis are at risk for radiation-induced premature menopause, we reviewed menstrual function and fertility among women treated with subtotal lymphoid irradiation for Hodgkin's Disease. Methods and Materials: Treatment and follow-up records of all women less than age 50 at the time of diagnosis of Stage I or II supradiaphragmatic Hodgkin's Disease, treated with subtotal lymphoid irradiation alone and enrolled in radiotherapy trials from 1967 to 1985, were reviewed. In addition, patients were surveyed regarding their menstrual status and fertility history. Results: Thirty-six women, aged 10 to 40 years, with normal menstrual function at the time of Hodgkin's diagnosis, were identified. Mean follow-up was 14 years, with a range of 1.25-22.75 years. The average radiation dose to mantle and paraaortic fields was 40-44 Gy; the calculated scatter radiation dose to the pelvis at the ovaries was 3.2 Gy. There were 38 pregnancies in 18 women; all offspring are normal. One of 36 women (2.7%) experienced premature menopause. The reported rate of premature menopause in women who have not undergone irradiation is 1-3%; not significantly different than the rate in our study. There is a syndrome whereby antibodies to several endocrine organs occur (including the ovary), which is associated with premature ovarian failure. This syndrome may be associated with prior radiation to the thyroid, such as that given by mantle-irradiation for Hodgkin's Disease. We report such a case. Conclusion: There is little risk of premature menopause in women treated with radiation fields that exclude the pelvis. Women with presumed radiation-induced premature menopause warrant an evaluation to exclude other causes of ovarian failure, such as autoimmune disorders

Outcomes for Extremely Premature Infants

Science.gov (United States)

Glass, Hannah C.; Costarino, Andrew T.; Stayer, Stephen A.; Brett, Claire; Cladis, Franklyn; Davis, Peter J.

2015-01-01

Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for four years and is now approximately 11.5%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23–24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal EDC. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (ELBW) (CPAP, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91–95% (compared to 85–89%) avoids excess mortality. However, final analyses of data from these trials have not been published, so definitive recommendations are still pending The development of neonatal neurocognitive care visits may improve neurocognitive outcomes in this high-risk group. Long-term follow up to detect and address developmental, learning, behavioral, and social problems is critical for children born at these early gestational ages. The striking similarities in response to extreme prematurity in the lung and brain imply that agents and

Morphological characterisation of vesicular structures in the canine ejaculate

DEFF Research Database (Denmark)

Goericke-Pesch, Sandra Kathrin; Hauck, S; Bergmann, M

2015-01-01

different MV types were identified based on diameter, structure, contents and electron density of contents as well as presence, number and size of smaller MV inside the MV itself. In normospermic males, secondary vesicles (type i, H, K1/2) included smaller vesicles and had a weighted mean diameter of 409...... is missing by now. This is, however, needed to provide a basis for detailed biochemical and functional studies as it is generally assumed that different MV populations are responsible for distinct tasks. MV were prepared for light (LM) and transmission electron microscopy (TEM) analysis using samples from...... normospermic dogs (n=15), hypokinozoospermic dogs (n=2, h) and one castrated azoospermic dog (a). For TEM, a new preparation protocol was used resulting in a higher MV retrieval rate. Using fractionated semen samples, most MV were identified in the second (sperm-rich) fraction in LM. Using pooled ejaculates...

Maternal assessment of pain in premature infants

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Maria Carolina Correia dos Santos

2015-12-01

Full Text Available Objective: to identify mothers' perceptions about the pain in their premature babies in the Neonatal Intensive Care Unit. Methods: evaluative, quantitative study with investigative nature conducted with 19 mothers of hospitalized premature newborns. Data were obtained from closed questions, answered by mothers. Results: from the participants, two (10.5% reported that newborns are unable to feel pain. From the 17 mothers who said that premature babies can feel pain, the majority (94.1% identified crying as a characteristic of pain sensation. Eleven (64.7% stated that uneasiness is a sign of pain in newborns. Conclusion: for the proper management of neonatal pain it is essential that mothers know the signs of pain in premature newborns, and that health professionals instruct this recognition, through the enhancement of the maternal presence and practice of effective communication between professionals and newborns’ families.

RESEARCHES RELATED TO THE REDUCTION OF PREMATURITY THROUGH PREMATURE RUPTURE OF MEMBRANES IN 2017

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Maria BOLOTA

2017-06-01

Full Text Available Data from literature, especially from the US, has provided data on prediction, prevention and treatment of premature membrane rupture (RPM. RPM is a significant cause of premature birth and can cause complications of a term task. Considerable research on RPM has led to a better understanding of the mechanism of spontaneous breakage of membranes, risk factors, and good results for newborns resulting from such obstetrical events. Spontaneous rupture of the membranes increases the risk of intrauterine infection and umbilical cord compression as well as the risk of premature detachment of placenta. Newborn babies resulting from RPM have an increased risk of morbidity compared to gestational age, and the risk of infection is increased compared with other premature babies due to ancillary causes. If RPM occurs in the second trimester, there is an additional risk of pulmonary hypoplasia and hip dysplasia. Pre-term conservative treatment prolongs latency to birth. Antibiotics reduce the risk of infection while corticosteroid treatment (dexamethasone reduces respiratory complications and interventricular haemorrhage without increasing the risk of infection. Birth is necessary or unavoidable in many cases by RPMs and because conservative treatment often results in no results; That is why studies are needed to identify all risk factors and the need to treat pregnant women at risk of RPM; 17-hydroxy-progesterone is a specific treatment for preventing recurrent membrane rupture. (http://www.ginecologultau.ro/ruptura-prematura-a-membranelor, 2013.

Symbolic transfer entropy-based premature signal analysis

International Nuclear Information System (INIS)

Wang Jun; Yu Zheng-Feng

2012-01-01

In this paper, we use symbolic transfer entropy to study the coupling strength between premature signals. Numerical experiments show that three types of signal couplings are in the same direction. Among them, normal signal coupling is the strongest, followed by that of premature ventricular contractions, and that of atrial premature beats is the weakest. The T test shows that the entropies of the three signals are distinct. Symbolic transfer entropy requires less data, can distinguish the three types of signals and has very good computational efficiency. (interdisciplinary physics and related areas of science and technology)

Social support for parents of premature infants

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Agnieszka Skurzak

2018-03-01

Full Text Available Prematurity is still an actual medical problem. Significant increase in the survival rate of premature babies is observed due to the progress in perinatal care .Usually, parents are not prepared for a premature birth, for the majority of them the hospitalization of a child in neonatal intensive care unit is a source of fear,  moreover parents often blame themselves for the situation. Appearing emotions and questions require a compatible response from the therapeutic team. The most important activity in the practice of the team is emotional, informative, evaluative support.

Noninvasive Ventilation in Premature Neonates.

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Flanagan, Keri Ann

2016-04-01

The use of noninvasive ventilation is a constantly evolving treatment option for respiratory disease in the premature infant. The goals of these noninvasive ventilation techniques are to improve gas exchange in the premature infant's lungs and to minimize the need for intubation and invasive mechanical ventilation. The goals of this article are to consider various uses of nasal interfaces, discuss skin care and developmental positioning concerns faced by the bedside nurse, and discuss the medical management aimed to reduce morbidity and mortality. This article explores the nursing role, the advances in medical strategies for noninvasive ventilation, and the team approach to noninvasive ventilation use in this population. Search strategy included a literature review on medical databases, such as EBSCOhost, CINAHL, PubMed, and NeoReviews. Innovative products, nursing research on developmental positioning and skin care, and advanced medical management have led to better and safer outcomes for premature infants requiring noninvasive ventilation. The medical focus of avoiding long-term mechanical ventilation would not be possible without the technology to provide noninvasive ventilation to these premature infants and the watchful eye of the nurse in terms of careful positioning, preventing skin breakdown and facial scarring, and a proper seal to maximize ventilation accuracy. This article encourages nursing-based research to quantify some of the knowledge about skin care and positioning as well as research into most appropriate uses for noninvasive ventilation devices.

Review of the mechanisms and therapeutic avenues for retinal and choroidal vascular dysfunctions in retinopathy of prematurity.

Science.gov (United States)

Rivera, José Carlos; Madaan, Ankush; Zhou, Tianwei Ellen; Chemtob, Sylvain

2016-12-01

Retinopathy of prematurity (ROP) is a multifactorial disease and the main cause of visual impairment and blindness in premature neonates. The inner retina has been considered the primary region affected in ROP, but choroidal vascular degeneration and progressive outer retinal dysfunctions have also been observed. This review focuses on observations regarding neurovascular dysfunctions in both the inner and outer immature retina, the mechanisms and the neuronal-derived factors implicated in the development of ROP, as well potential therapeutic avenues for this disorder. Alterations in the neurovascular integrity of the inner and outer retina contribute to the development of ROP. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

In vivo test of bitter (andrographis paniculata nees.) extract to ejaculated sperm quality

Science.gov (United States)

Sumarmin, R.; Huda, NK; Yuniarti, E.; Violita

2018-03-01

Sambiloto or Bitter (Andrographis paniculata Nees.), are often used to treat various diseases, such as influenza, cancer, anti-inflammation, anti-HIV, anti-mitotic and anti-fertility. This study aimed to determine the effects of the bitter (Andrographis paniculata Nees.) extract to ejaculated sperm mice quality (Mus musculus L. Swiss Webster). This research was conducted using Completely Randomized Design with 4 treatments, which are 0.0 g/b.w., (P0), 0.2 g/b.w., (P1), 0,4 g/b.w., (P3), or 0.6 g/b.w., (P4) bitter extract orally for 36 days. After treatment, the mice decapitated, dissected and collected the sperm from vas deferens. Then, the number of sperm counted by used the improved Neubauer and then stained by Eosin to count the abnormal sperm. Data analyzed by ANOVA (Analysis of Variance) then DNMRT. The results showed that the average numbers of sperm are 28.80 x 105 (P0), 19.50 x 105 (P1), 12.50 x105 (P2) and 9.50 x 105 (P3). The average abnormal sperm numbers are 18.33 x 105 (P0), 22.50 x 105 (P1), 31.50 x105 (P2) and 39.33 x 105 (P3). It showed that the effective treatment to decrease sperm number was 0.2 g/b.w., of bitter extract. It can conclude that the bitter (Andrographis paniculata Nees.) extract decreases the quality of the ejaculated sperm of mice (Mus musculus L.)

Aggressive Posterior Retinopathy of Prematurity in a Premature Male Infant

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Jun Zhou

2017-07-01

Full Text Available A premature male infant was born at 30 weeks’ gestation with a birth weight of 1,700 g in a rural hospital. He was diagnosed with respiratory distress syndrome and received continuous positive airway pressure treatment for 26 days. At 26 days after birth, the patient was transferred to our hospital for further evaluation and management. A comprehensive eye examination revealed a stage 3 retinopathy of prematurity (ROP involving zone 2 in both eyes. The patient was recommended to a provincial-level eye hospital for emergency laser therapy. Five months after birth, the feedback from the eye hospital showed that the patient had a high risk of blindness in both eyes. Our case report shows that delaying first screening examination increases the possibility of developing aggressive posterior ROP in infants with ROP. Doctors in rural hospitals should be aware of this possibility and trained for early screening and treatment in high-risk infants.

Optimal oxygen saturation in premature infants

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Meayoung Chang

2011-09-01

Full Text Available There is a delicate balance between too little and too much supplemental oxygen exposure in premature infants. Since underuse and overuse of supplemental oxygen can harm premature infants, oxygen saturation levels must be monitored and kept at less than 95% to prevent reactive oxygen species-related diseases, such as retinopathy of prematurity and bronchopulmonary dysplasia. At the same time, desaturation below 80 to 85% must be avoided to prevent adverse consequences, such as cerebral palsy. It is still unclear what range of oxygen saturation is appropriate for premature infants; however, until the results of further studies are available, a reasonable target for pulse oxygen saturation (SpO2 is 90 to 93% with an intermittent review of the correlation between SpO2 and the partial pressure of arterial oxygen tension (PaO2. Because optimal oxygenation depends on individuals at the bedside making ongoing adjustments, each unit must define an optimal target range and set alarm limits according to their own equipment or conditions. All staff must be aware of these values and adjust the concentration of supplemental oxygen frequently.

Prevalence and Associated Factors of Premature Ejaculation in the Anhui Male Population in China: Evidence-Based Unified Definition of Lifelong and Acquired Premature Ejaculation

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Jingjing Gao, MM

2017-03-01

Conclusion: In this study, the prevalences of LPE and APE in men with the complaint of PE were 10.98% and 21.39%, respectively. Patients with APE were older and more likely to smoke, had more comorbidities, and had a higher body mass index than patients with LPE.

Loss of space and dental arch length after the loss of the lower first primary molar: a longitudinal study.

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Cuoghi, O A; Bertoz, F A; de Mendonca, M R; Santos, E C

1998-01-01

The premature loss of primary teeth may harm the normal occlusal development, although there are debates relating to the necessity of using space maintainer appliances. The aim of the study is to evaluate the changes in the dental arch perimeter and the space reduction after the premature loss of the lower first primary molar in the mixed dentition stage. The sample consists of 4 lower arch plaster models of 31 patients, within the period of pre-extraction, 6, 12 and 18 months after the lower first primary molar extraction. A reduction of space was of noted with the cuspid dislocation and the permanent incisors moving toward the space of the extraction site. It was concluded that the lower first molar primary premature loss, during the mixed dentition, implicates an immediate placement of a space maintainer.

Rival male relatedness does not affect ejaculate allocation as predicted by sperm competition theory.

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Melissa L Thomas

Full Text Available When females are sexually promiscuous, the intensity of sperm competition for males depends on how many partners females mate with. To maximize fitness, males should adjust their copulatory investment in relation to this intensity. However, fitness costs associated with sperm competition may not only depend on how many males a female has mated with, but also how related rival males are. According to theoretical predictions, males should adjust their copulatory investment in response to the relatedness of their male rival, and transfer more sperm to females that have first mated with a non-sibling male than females that have mated to a related male. Here, for the first time, we empirically test this theory using the Australian field cricket Teleogryllus oceanicus. We expose male crickets to sperm competition from either a full sibling or non-sibling male, by using both the presence of a rival male and the rival male's actual competing ejaculate as cues. Contrary to predictions, we find that males do not adjust ejaculates in response to the relatedness of their male rival. Instead, males with both full-sibling and non-sibling rivals allocate sperm of similar quality to females. This lack of kin biased behaviour is independent of any potentially confounding effect of strong competition between close relatives; kin biased behaviour was absent irrespective of whether males were raised in full sibling or mixed relatedness groups.

[Family participation in premature care in neonatal ICU].

Science.gov (United States)

Gaíva, Maria Aparecida Munhoz; Scochi, Carmen Gracinda Silvan

2005-01-01

This study aimed at analyzing the family participation in the premature assistance in a university hospital neonatal ICU. Data were collected from the participant observation. Results showed that despite of the mother's presence in the daily life of their premature children placed in a hospital, family isn't inserted in the work process and mothers are the only ones who take part of the cares. This participation basically happens in the execution of maternity care, especially at the medium risk unity, the mother and premature family are less welcomed and there isn't any partnership between the care team and the family, there aren't team interventions in order to turn premature family in autonomous subject to promote health and life quality to baby's life.

Risk Factors for premature birth in a hospital 1

Science.gov (United States)

Ahumada-Barrios, Margarita E.; Alvarado, German F.

2016-01-01

Abstract Objective: to determine the risk factors for premature birth. Methods: retrospective case-control study of 600 pregnant women assisted in a hospital, with 298 pregnant women in the case group (who gave birth prematurely <37 weeks) and 302 pregnant women who gave birth to a full-term newborn in the control group. Stata software version 12.2 was used. The Chi-square test was used in bivariate analysis and logistic regression was used in multivariate analysis, from which Odds Ratios (OR) and Confidence Intervals (CI) of 95% were derived. Results: risk factors associated with premature birth were current twin pregnancy (adjusted OR= 2.4; p= 0.02), inadequate prenatal care (< 6 controls) (adjusted OR= 3.2; p <0.001), absent prenatal care (adjusted OR= 3.0; p <0.001), history of premature birth (adjusted OR= 3.7; p <0.001) and preeclampsia (adjusted OR= 1.9; p= 0.005). Conclusion: history of premature birth, preeclampsia, not receiving prenatal care and receiving inadequate prenatal care were risk factors for premature birth. PMID:27463110

Time trends and risk factor associated with premature birth and infants deaths due to prematurity in Hubei Province, China from 2001 to 2012.

Science.gov (United States)

Xu, Haiqing; Dai, Qiong; Xu, Yusong; Gong, Zhengtao; Dai, Guohong; Ding, Ming; Duggan, Christopher; Hu, Zubin; Hu, Frank B

2015-12-10

The nutrition and epidemiologic transition has been associated with an increasing incidence of preterm birth in developing countries, but data from large observational studies in China have been limited. Our study was to describe the trends and factors associated with the incidence of preterm birth and infant mortality due to prematurity in Hubei Province, China. We conducted a population-based survey through the Maternal and Child Health Care Network in Hubei Province from January 2001 to December 2012. We used data from 16 monitoring sites to examine the trend and risk factors for premature birth as well as infant mortality associated with prematurity. A total of 818,481 live births were documented, including 76,923 preterm infants (94 preterm infants per 1,000 live births) and 2,248 deaths due to prematurity (2.75 preterm deaths per 1,000 live births). From 2001 to 2012, the incidence of preterm birth increased from 56.7 to 105.2 per 1,000 live births (P for trend prematurity declined from 95.0 to 13.4 per 1,000 live births (P for trend prematurity were observed in Hubei Province from 2001 to 2012. Our results provide important information for areas of improvements in reducing incidence and mortality of premature birth.

Comparative investigations in microradiography and micromorphometry in bones of premature and young infants

International Nuclear Information System (INIS)

Mueller, K.H.G.

1988-01-01

Using comparative investigations in micromorphometry and microradiograms of cross sections of the bone we got new results about the mineralisation of residual bridges of the cartilage and the neogenesis of the osteoid. In contrast to the current interpretation investigations in primary- or micro osteons as well in cross sections as in longitudinal sections of the bone show a periodic and inhomogeneous mineralisation during bone development in premature and young infants. (orig.) [de

Human cytomegalovirus infections in premature infants by ...

African Journals Online (AJOL)

Freezing breast milk may be protective for the preterm infant until the titer of CMV antibody increases. However clinical importance of CMV infection in premature infants by breast-feeding is still unclear. This minireview focuses on recent advances in the study of CMV infection in premature infants by breastfeeding.

History of cryptorchidism and ejaculate volume as simple predictors for the presence of testicular sperm

DEFF Research Database (Denmark)

Fedder, Jens

2011-01-01

Testicular volume, hormones, and growth factors are used as predictors of finding motile testicular sperm in azoospermic men. In this study, the possible predictive value of very simple parameters such as systematic history, clinical examination, and determination of ejaculate volume have been...... evaluated. Two-hundred and sixty-two consecutive non-vasectomized men with azoospermia/aspermia were evaluated by systematic history, clinical examination, ultrasonography of the scrotal content, and hormonal and genetic analyses. Hormonal analyses included, as a minimum, determination of follicular...

A NANOS3 mutation linked to protein degradation causes premature ovarian insufficiency

OpenAIRE

Wu, X; Wang, B; Dong, Z; Zhou, S; Liu, Z; Shi, G; Cao, Y; Xu, Y

2013-01-01

Primary ovarian insufficiency (POI), or premature ovarian failure, is defined as the cessation of ovarian function before the age of 40. An insufficient ovarian follicle pool derived from primordial germ cells (PGCs) is an important cause of POI. Although the Nanos gene family is known to be required for PGC development and maintenance in diverse model organisms, the relevance of this information to human biology is not yet clear. In this study, we screened the coding regions of the NANOS1, N...

Retinopathy of prematurity: an epidemic in the making.

Science.gov (United States)

Quinn, Graham E; Gilbert, Clare; Darlow, Brian A; Zin, Andrea

2010-10-01

To explore the etiology, incidence and methods to prevent and treat severe retinopathy of prematurity (ROP), which is rapidly becoming a threat to the vision of babies in areas of the world where increasing numbers of premature babies are surviving. The data used in this review were mainly from Medline and PubMed published in English. The search term was "retinopathy of prematurity and premature birth". We discuss the historical perspectives, prevalence and incidence, classification and treatment methods of ROP in premature babies. Peripheral retinal ablation for eyes with severe ROP can help prevent progression to blindness and several large clinical trials have shown the effectiveness of this treatment in high risk eyes. As a greater proportion of VLBW and ELBW babies survive, the population of babies at risk increases. In various regions of the world, different identification criteria are used to determine which babies are at risk of blindness in order to provide timely diagnostic examinations and treatment as needed. Methods for preventing ROP include better ante-natal and obstetric care leading to a reduction in the rate of prematurity, the use of ante-natal corticosteroids, and better neonatal care practices. Recent developments have indicated that management of oxygen supplementation is important for the prevention of severe ROP; however, there is not yet known what oxygen saturation target should be adopted. Sepsis increases severe ROP in very preterm infants. Genetic associations and a telemedicine approach may be explored to detect ROP. Treatment of anti-VEGF therapy are potentially useful in eyes with severe ROP, but long term effects are not yet known and such treatment should be used with great caution. ROP is a potentially binding disease for premature babies which is becoming more prevalent with the development improving neonatal services in many countries in recent years. High priority should be placed on developing approaches to prevent ROP

Relationship between serum 25-hydroxy vitamin D levels and retinopathy of prematurity.

Science.gov (United States)

Kabataş, Emrah Utku; Dinlen, Nurdan Fettah; Zenciroğlu, Ayşegül; Dilli, Dilek; Beken, Serdar; Okumuş, Nurullah

2017-11-01

Aim To evaluate the relationship between serum 25-hydroxy vitamin D, 25 (OH) D, levels and retinopathy of prematurity. Methods and Results Serum 25 (OH) D levels were measured in 97 very low birth weight infants, prior to vitamin D supplementation. The development of retinopathy of prematurity and its treatment requirement were evaluated. At follow-up, retinopathy of prematurity developed in 71 (73.2%) infants. Serum 25 (OH) D levels were significantly lower in infants with retinopathy of prematurity than ones without retinopathy of prematurity ( P prematurity development [OR: 1.14, 95% CI (1.02-1.27), P = 0.02]. Conclusion Lower 25 (OH) D levels in the first days of life may be related to retinopathy of prematurity development and treatment requirement in premature infants.

Premature ovarian failure

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Vujović Svetlana

2012-01-01

Full Text Available Premature ovarian failure (POF is the occurrence of hypergonadotropic hypoestrogenic amenorrhea in women under the age of forty years. It is idiopathic in 74-90% patients. Known cases can be divided into primary and secondary POF. In primary POF genetic aberrations can involve the X chromosome (monosomy, trisomy, translocations, deletions or autosomes. Genetic mechanisms include reduced gene dosage and non-specific chromosome effects impairing meiosis, decreasing the pool of primordial follicles and increasing atresia due to apoptosis or failure of follicle maturation. Autoimmune ovarian damage is caused by alteration of T-cell subsets and T-cell mediated injury, increase of autoantibody producing B-cells, a low number of effector/cytotoxic lymphocyte, which decreases the number and activity of natural killer cells. Bilateral oophorectomy, chemotherapy, radiotherapy and infections cause the secondary POF. Symptoms of POF include irritability, nervousness, loss of libido, depression, lack of concentration, hot flushes, weight gaining, dry skin, vaginal dryness, frequent infections etc. The diagnosis is confirmed by the level of FSH of over 40 IU/L and estradiol below 50 pmol/L in women aged below 40 years. Biochemical and other hormonal analysis (free thyroxin, TSH, prolactin, testosterone, karyotype (<30 years of age, ultrasound of the breasts and pelvis are advisable. Optimal therapy is combined estrogen progestagen therapy given in a sequential rhythm, after excluding absolute contraindications. Testosterone can be added to adnexectomized women and those with a low libido. Sequential estrogen progestagen replacement therapy is the first line therapy for ovulation induction in those looking for pregnancy and after that oocyte donation will be advised. Appropriate estro-progestagen therapy improves the quality of life and prevents complications such as cardiovascular diseases, osteoporosis, stroke etc.

[Birth weight distribution among premature infants and related social factors].

Science.gov (United States)

Guo, Li-jun; Ye, Rong-wei; Wang, Gui-xia; Wang, Juan; Li, Zhi-wen; Ren, Ai-guo

2009-12-01

To understand the distribution of birth weight among premature infants and the associated social factors. The study population consisted of 97 537 women who delivered singleton live birth of 20 to 41 gestational weeks in 4 counties/cities, Jiangsu and Zhejiang provinces, China from 1995 to 2000. Chi-square test was employed to test the difference of proportions between respective groups. One- way ANOVA was used to test the differences regarding the mean of gestational weeks at the first prenatal visit and the mean of prenatal visits between the two groups. Multivariate logistic regression was conducted to examine the factors associated with premature birth. Women aged 35 years had higher (8.8%) premature incidence than those aged less than 24 years (5.6%), 25 - 29 years (4.6%), or 30 - 34 years (4.5%, P premature incidence than those with height taller than 150 cm (5.0%). Women whose BMI were at least 28 and 24 - 28 had higher (5.5%, 5.5%) premature incidences than those whose BMI were 18.5 - 24.0 (5.0%), premature birth was 6.0% among women without previous pregnancy, higher than that among those women with 4 times of pregnancies (5.7%), 2 times of pregnancies (4.3%), and 3 times of pregnancies (4.0%). Parous women with at least two deliveries had higher (9.3%) premature incidence than the primiparous women (5.2%) and whose women with only one delivery (4.5%, P premature incidence than those who did not receive the service (6.1%). The mean times of prenatal visits among women with premature births was 8.53, less than that of those with full term delivery (10.97). Women with less than four times of prenatal visit had higher (18.9%) premature incidence than those with at least five prenatal visits (4.9%). Multivariate logistic regression showed that premature delivery risk was associated with age, height, BMI, gravidity, parity, early prenatal care, the mean of gestational weeks at first prenatal visit and the mean number of prenatal visits etc. Premature delivery

Adequacy of published screening criteria for retinopathy of prematurity.

Science.gov (United States)

Taranath, Deepa A; Oh, Dickson D-S; Keane, Miriam C; Fabel, Helen; Marshall, Peter

2016-03-01

Criteria for screening preterm infants for retinopathy of prematurity vary around the world. We aimed to analyse the efficacy of alternative screening criteria. We collected retrospective data at a tertiary level neonatal nursery. Our participants were 1007 babies, born between 1997 and 2011, at prematurity. We determined whether disease would be detected using an alternative Australian screening model (gestational age prematurity is our main outcome. Using several of the alternative criteria, two neonates with clinically significant retinopathy of prematurity, one of whom required laser treatment to preserve sight, would not have been screened, and their disease may have gone undetected. Use of prematurity may risk clinically significant cases being missed and others may screen babies unnecessarily. Alternative criteria should be considered and '<30 weeks gestational age and/or <1500 g birth weight' appears a viable option. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

Confocal Microscopy and Image Analysis Indicates a Region-Specific Relation between Active Caspases and Cytoplasm in Ejaculated and Epididymal Sperm

Science.gov (United States)

García Vazquez, Susana; Aragón Martínez, Andrés; Flores-Alonso, Juan Carlos

2012-01-01

Previously, it was suggested a relation between the presence of apoptosis markers with cytoplasm in mammalian sperm. In this work, flow cytometry, confocal microscopy and image analysis were used to analyze the relationship between active caspase-3 and -7 and intracellular esterases expression in ejaculated or epididymal ram sperm. Sperm obtained from ejaculates from the caput, corpus, or cauda of the epididymis were treated with an inhibitor of active caspase-3 and -7 and a marker of cytoplasmic esterases. Additionally, ejaculated sperm were incubated for one, two, or three hours before evaluation for active caspases. Sperm subpopulations positive for active caspases and/or intracellular esterases were detected by flow cytometry and confocal microscopy; however, image analysis of confocal images showed that the correlation between active caspases and cytoplasmic esterases in sperm is region-specific. Lower values of Spearman correlation coefficients were found when whole sperm or head sperm was analyzed; however, a high correlation was observed for midpiece sperm. Incubation of sperm for two or three hours promoted the autoactivation of caspases. It has been suggested that the presence of apoptotic markers in sperm are related with a process of abortive apoptosis and with errors during spermiogenesis. Our results permit us suggest that the origin of the relationship between active caspases and cytoplasmic esterases is due to differentiation errors occurring during spermiogenesis because the percentages of sperm with active caspases are not different in the caput, corpus, or cauda of the epididymis. In this study we demonstrate that existing sperm subpopulations can express active caspases and intracellular esterases and that the correlation between these molecules is high in midpiece sperm. PMID:22530029

Pulpectomy procedures in primary molar teeth

OpenAIRE

Hany Mohamed Aly Ahmed

2014-01-01

Premature loss of primary molars can cause a number of undesirable consequences including loss of arch length, insufficient space for erupting premolars and mesial tipping of the permanent molars. Pulpectomy of primary molar teeth is considered as a reasonable treatment approach to ensure either normal shedding or a long-term survival in instances of retention. Despite being a more conservative treatment option than extraction, efficient pulpectomy of bizarre and tortuous root canals encased ...

Impact of enteral protein supplementation in premature infants

Directory of Open Access Journals (Sweden)

Barrus DM

2012-06-01

Full Text Available David M Barrus1, Joann Romano-Keeler2, Christopher Carr3, Kira Segebarth4, Betty Claxton2, William F Walsh2, Paul J Flakoll51Department of Neonatology, Saint Francis Hospital–Bartlett, Memphis, TN, 2Department of Pediatrics, Vanderbilt Medical Center, Nashville, TN, 3Department of Surgery, Naval Hospital Bremerton, Bremerton, WA, 4Pediatric and Diabetes Specialists, Carolinas Medical Center, Charlotte, NC, 5Department of Surgery, Vanderbilt Medical Center, Nashville, TN, USAObjective: The quantity of enteral protein supplementation required by premature infants to optimize growth has not been determined. This study compares the growth of premature infants fed the current standard intake of protein (3.5 g/kg/day with the growth of those fed a higher amount (4.0 g/kg/day.Study design: Fifty-two infants <1500 g and <33 weeks gestational age participated in a blinded, single-center, prospective randomized control trial to compare growth between two groups of different protein-intake levels. Primary outcomes were average daily weight gain (g/kg/day, head-circumference (cm/kg/week and linear growth velocity (cm/kg/week. Secondary outcomes were serum indices of protein tolerance and plasma amino acid concentrations.Results: Infants receiving higher amounts of protein had higher rates of growth for body weight (18.2 ± 0.7 versus 16.2 ± 1.0 g/kg/day; P < 0.05 and head circumference (0.87 ± 0.08 versus 0.62 ± 0.07 cm/kg/week; P < 0.05, with no differences in blood protein or plasma amino acid concentrations. Length of hospital stay was 14 days shorter for the higher-protein group (51.4 ± 4.0 versus 65.9 ± 6.3 days.Conclusion: Increasing premature infant enteral protein supplementation from a calculated intake of 3.5–4.0 g/kg/day improved growth in a safe manner.Keywords: human milk, human milk fortifier, growth, low birth weight

Long-term impact of prematurity on postnatal neurohormonal regulation

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M. I. Ziborova

2016-01-01

Full Text Available This article considers the psychophysiological and neuroendocrine differences characteristic of premature children, which are as a result of long-term perinatal consequences. Particular emphasis is laid on the effects of the hypothalamic-pituitary-adrenocortical stress system, the performance of which is reprogramed during complicated pregnancy, labor, and postnatal period under pain stress due to medical manipulations. Being extremely sensitive to all these exposures, the brain of a premature infant develops during activation of the stress system and takes on a few distinctive properties in addition to independent neuroanatomical distinctions due to premature birth. The altered neurohormonal patterns revealed in very prematurely born children and adolescents involve the regulation of mental processes, behavior, metabolism, and circadian rhythms (sleep-wake regulation, which differ from those in their maturely born peers. These cases allow learning and behavior problems and lower cognitive estimates to be considered in normally developing children born extremely prematurely who have also hormonal dysregulation.

Communication during copulation in the sex-role reversed wolf spider Allocosa brasiliensis: Female shakes for soliciting new ejaculations?

Science.gov (United States)

Garcia Diaz, Virginia; Aisenberg, Anita; Peretti, Alfredo V

2015-07-01

Traditional studies on sexual communication have focused on the exchange of signals during courtship. However, communication between the sexes can also occur during or after copulation. Allocosa brasiliensis is a wolf spider that shows a reversal in typical sex roles and of the usual sexual size dimorphism expected for spiders. Females are smaller than males and they are the roving sex that initiates courtship. Occasional previous observations suggested that females performed body shaking behaviors during copulation. Our objective was to analyze if female body shaking is associated with male copulatory behavior in A. brasiliensis, and determine if this female behavior has a communicatory function in this species. For that purpose, we performed fine-scaled analysis of fifteen copulations under laboratory conditions. We video-recorded all the trials and looked for associations between female and male copulatory behaviors. The significant difference between the time before and after female shaking, in favor of the subsequent ejaculation is analyzed. We discuss if shaking could be acting as a signal to accelerate and motivate palpal insertion and ejaculation, and/or inhibiting male cannibalistic tendencies in this species. Copyright © 2015 Elsevier B.V. All rights reserved.

'Rush' type retinopathy of prematurity: report of three cases.

OpenAIRE

Nissenkorn, I; Kremer, I; Gilad, E; Cohen, S; Ben-Sira, I

1987-01-01

Three premature infants observed to develop severe stage III retinopathy of prematurity (ROP) at 3 to 5 weeks of age received immediate treatment by cryoablation and photocoagulation, with good results. The critical importance of the ophthalmic examination of premature babies from the age of 2 weeks, so as not to overlook such cases of 'rush' type ROP is stressed and the difficulty involved in treating such small neonates is discussed.

Ichthyosis prematurity syndrome: a well-defined congenital ichthyosis subtype

DEFF Research Database (Denmark)

Bygum, Anette; Westermark, Per; Brandrup, Flemming

2008-01-01

Ichthyosis prematurity syndrome is a rare syndrome characterized by the clinical triad of premature birth, thick caseous desquamating epidermis, and neonatal asphyxia. We describe two siblings with ichthyosis prematurity syndrome. The index patient was born at gestational week 34. Immediately aft...... in the stratum corneum and stratum granulosum. Diagnosing this syndrome is important to reassure parents, obstetricians, and pediatricians about its benign course after complications in the perinatal period....

Retinopathy of Prematurity: Clinical Features, Classification, Natural History, Management and Outcome.

Science.gov (United States)

Shah, Parag K; Prabhu, Vishma; Ranjan, Ratnesh; Narendran, Venkatapathy; Kalpana, Narendran

2016-11-07

Retinopathy of prematurity is an avoidable cause of childhood blindness. Proper understanding of the classification and treatment methods is a must in tackling this disease. Literature search with PubMed was conducted covering the period 1940-2015 with regards to retinopathy of prematurity, retrolental fibroplasia, its natural history, classification and treatment. The clinical features, screening and staging of retinopathy of prematurity according to International classification of retinopathy of prematurity (ICROP) has been included with illustrations. The standard current treatment indications, modalities and outcomes from landmark randomized controlled trials on retinopathy of prematurity have been mentioned. This review would help pediatricians to update their current knowledge on classification and treatment of retinopathy of prematurity. Screening for retinopathy of prematurity, in India, should be performed in all preterm neonates who are born <34 weeks gestation and/or <1750 grams birthweight; as well as in babies 34-36 weeks gestation or 1750-2000 grams birthweight if they have risk factors for ROP. Screening should start by one month after birth.

Premature rupture of membranes

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... gov/ency/patientinstructions/000512.htm Premature rupture of membranes To use the sharing features on this page, ... water that surrounds your baby in the womb. Membranes or layers of tissue hold in this fluid. ...

Test of Fruit Extract Pare (Momordica charantia L.) to Quality of Ejaculated Spermatozoa Mice (Mus musculus L.)

Science.gov (United States)

Fifendy, M.; Indriati, G.

2018-04-01

Pare (Momordica charantia L.) can be used in the treatment of various diseases, such as influenza, cancer, anti-inflammatory, anti-HIV, antimitotic and antifertilitas. This study aimed to determine the effect of the herbal bitter (Momordica charantia L.) to ejaculated sperm quality mice (Mus musculus L.). This research was conducted using Completely Randomized Design (CRD) with 4 treatments and 6 replications, water and fed adlibitum. First treatment is given solvent extract. Second treatments extract were given 0.2 gram, third treatment were given 0.4 gram of extracts and fourth treatment were treated exstrac 0.6 gram were orally for 30 days. After the mice decapitated, dissected and take sperm from vas deferens. Then, the sperm preparation determined using the improved Neubauer. Data were analyzed by ANOVA (Analysis of Varians). The results shoured at doses of 0,2 gram, the average sperm count was 19.89. decrease significant when compared with the control in which the average number of sperm 29.13. So with this research the effective doses to decrease sperm count and can be used as a contraception medication dosage was 0,2 gram. It can be conclude that the extract of bitter (Momordica charantia L.) can decrease the quality of the ejaculated sperm of mice (Mus musculus L.)

The relationship of the subtypes of preterm birth with retinopathy of prematurity.

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Lynch, Anne M; Wagner, Brandie D; Hodges, Jennifer K; Thevarajah, Tamara S; McCourt, Emily A; Cerda, Ashlee M; Mandava, Naresh; Gibbs, Ronald S; Palestine, Alan G

2017-09-01

Retinopathy of prematurity is an adverse outcome of preterm birth and is a leading cause of childhood blindness. The relationship between the subtypes of preterm birth with retinopathy of prematurity is understudied. To investigate whether there is a difference in the incidence of type 1 or type 2 retinopathy of prematurity in infants with preterm birth resulting from spontaneous preterm labor, a medical indication of preterm birth, or preterm premature rupture of the membranes. A retrospective cohort study was conducted of 827 infants screened for retinopathy of prematurity who were delivered at a single tertiary care center in Colorado. All infants fulfilled the American Academy of Pediatrics 2013 screening criteria for retinopathy of prematurity defined as "infants with a birth weight of ≤1500 g or gestational age of 30 weeks or less (as defined by the attending neonatologist) and selected infants with a birth weight between 1500 and 2000 g or gestational age of >30 weeks with an unstable clinical course, including those requiring cardiorespiratory support and who are believed by their attending pediatrician or neonatologist to be at high risk for retinopathy of prematurity." Two independent reviewers masked to retinopathy of prematurity outcomes determined whether preterm birth resulted from spontaneous preterm labor, medical indication of preterm birth, or preterm premature rupture of the membranes. Discrepancies were resolved by a third reviewer. Data were analyzed with univariate and multivariable logistic regression. In our cohort, the frequency of preterm birth resulting from spontaneous preterm labor, medical indication of preterm birth, or preterm premature rupture of the membranes was 34%, 40%, and 26%, respectively. The mean gestational age (weeks, days) ± SD (range) in the cohort and across the preterm birth subtypes was as follows: entire cohort, 28 weeks, 6 days ± 2 weeks, 3 days (23 weeks, 3 days - 36 weeks, 4 days); spontaneous preterm labor

Retinopathy of prematurity - from recognition of risk factors to treatment recommendations.

Science.gov (United States)

Fagerholm, Reija; Vesti, Eija

Retinopathy of prematurity is a proliferative retinal disorder diagnosed exclusively in prematurely born infants. In retinopathy of prematurity, growth of the retinal vasculature is disturbed, leading to hypoxia-induced pathological changes typical of retinopathy of prematurity, in the worst case resulting in retinal detachment. The most typical risk factors predisposing to the disease include hyperoxemia, low levels of insulin-like growth factor 1 (IGF-I), and low birth weight in relation to weeks of pregnancy. Laser therapy of peripheral retina is the currently established form of treatment. Screening is applied in order to recognize the pathological changes in retinopathy of prematurity early enough.

Premature graying of hair: An independent risk marker for coronary ...

African Journals Online (AJOL)

The presence of premature graying of hair was associated with 3.24 times the risk of CAD on multiple logistic regression analysis. CONCLUSION: The presence of premature graying of hair was associated with an increased risk of CAD in young smokers. Premature graying of hair can be used as preliminary evidence by ...

Neighborhood Environmental Health and Premature Death From Cardiovascular Disease.

Science.gov (United States)

Gaglioti, Anne H; Xu, Junjun; Rollins, Latrice; Baltrus, Peter; O'Connell, Laura Kathryn; Cooper, Dexter L; Hopkins, Jammie; Botchwey, Nisha D; Akintobi, Tabia Henry

2018-02-01

Cardiovascular disease (CVD) is the leading cause of death in the United States and disproportionately affects racial/ethnic minority groups. Healthy neighborhood conditions are associated with increased uptake of health behaviors that reduce CVD risk, but minority neighborhoods often have poor food access and poor walkability. This study tested the community-driven hypothesis that poor access to food at the neighborhood level and poor neighborhood walkability are associated with racial disparities in premature deaths from CVD. We examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates at the census tract level for the city of Atlanta using multivariable logistic regression models. We produced maps to illustrate premature CVD mortality, food access, and walkability by census tract for the city. We found significant racial differences in premature CVD mortality rates and geographic disparities in food access and walkability among census tracts in Atlanta. Improved food access and walkability were associated with reduced overall premature CVD mortality in unadjusted models, but this association did not persist in models adjusted for census tract population composition and poverty. Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality. This study highlights disparities in premature CVD mortality and neighborhood food access and walkability at the census tract level in the city of Atlanta. Improving food access may have differential effects for subpopulations living in the same area. These results can be used to calibrate neighborhood-level interventions, and they highlight the need to examine race-specific health outcomes.

Surgical Ligation of Patent Ductus Arteriosus in Very-low-birth-weight Premature Infants in the Neonatal Intensive Care Unit

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Yu-Chen Ko

2009-01-01

Full Text Available This study reported our experience of bedside patent ductus arteriosus (PDA ligation for prematurity in the neonatal intensive care unit (NICU. Between April 1992 and March 2006, 41 very-low-birth-weight premature infants underwent PDA ligation in the NICU. There were 18 male and 23 female infants. The mean gestational age and birth weight were 26.9 weeks and 900.9 g, respectively. Preoperatively, 25 infants were ventilator-dependent. After operation, there were five deaths caused by complications of prematurity. Surgical complications occurred in four and all recovered well after treatment. Twenty preoperatively intubated babies survived and were extubated at 21.6 ± 12.7 days postoperatively. In conclusion, bedside PDA ligation in the NICU is safe and effective. It can avoid transportation of critically ill, very small infants. We suggest surgical closure as the primary treatment in very-low-birth-weight infants who are ventilator-dependent to avoid the possible complications of indomethacin and prolonged intubation.

Acetaminophen developmental pharmacokinetics in premature neonates and infants

DEFF Research Database (Denmark)

Anderson, Brian J; van Lingen, Richard A; Hansen, Tom G

2002-01-01

The aim of this study was to describe acetaminophen developmental pharmacokinetics in premature neonates through infancy to suggest age-appropriate dosing regimens.......The aim of this study was to describe acetaminophen developmental pharmacokinetics in premature neonates through infancy to suggest age-appropriate dosing regimens....

Associations between Salivary Testosterone Levels, Androgen‐Related Genetic Polymorphisms, and Self‐Estimated Ejaculation Latency Time

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Patrick Jern, PhD

2014-08-01

Conclusions: We were unable to find support for the hypothesis suggesting an association between T levels and ELT, possibly because of the low number of phenotypically extreme cases (the sample used in the present study was population based. Our results concerning genetic associations should be interpreted with caution until replication studies have been conducted. Jern P, Westberg L, Ankarberg‐Lindgren C, Johansson A, Gunst A, Sandnabba NK, and Santtila P. Associations between salivary testosterone levels, androgen‐related genetic polymorphisms, and self‐estimated ejaculation latency time. Sex Med 2014;2:107–114.

Adolescent Premature Ovarian Insufficiency Following Human Papillomavirus Vaccination

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Deirdre Therese Little MBBS, DRANZCOG, FACRRM

2014-10-01

Full Text Available Three young women who developed premature ovarian insufficiency following quadrivalent human papillomavirus (HPV vaccination presented to a general practitioner in rural New South Wales, Australia. The unrelated girls were aged 16, 16, and 18 years at diagnosis. Each had received HPV vaccinations prior to the onset of ovarian decline. Vaccinations had been administered in different regions of the state of New South Wales and the 3 girls lived in different towns in that state. Each had been prescribed the oral contraceptive pill to treat menstrual cycle abnormalities prior to investigation and diagnosis. Vaccine research does not present an ovary histology report of tested rats but does present a testicular histology report. Enduring ovarian capacity and duration of function following vaccination is unresearched in preclinical studies, clinical and postlicensure studies. Postmarketing surveillance does not accurately represent diagnoses in adverse event notifications and can neither represent unnotified cases nor compare incident statistics with vaccine course administration rates. The potential significance of a case series of adolescents with idiopathic premature ovarian insufficiency following HPV vaccination presenting to a general practice warrants further research. Preservation of reproductive health is a primary concern in the recipient target group. Since this group includes all prepubertal and pubertal young women, demonstration of ongoing, uncompromised safety for the ovary is urgently required. This matter needs to be resolved for the purposes of population health and public vaccine confidence.

Retinopathy of Prematurity (ROP)

Science.gov (United States)

... developing severe ROP, especially those in underserved or remote areas. Currently in the U.S., evaluation of premature ... files require the free Adobe® Reader® software for viewing. This website is maintained by the NEI Office ...

Retinopathy of prematurity in a cohort of neonates at Groote Schuur ...

African Journals Online (AJOL)

Retinopathy of prematurity (ROP) is a preventable cause of visual impairment in premature ... and extremely low-birth-weight (ELBW) premature infants from the West Metro ...... Arch Ophthalmol 2000;118(5):645-649. http://dx.doi.org/10.1001/.

Computed tomography of the head of new born premature infants

International Nuclear Information System (INIS)

Ohno, Tsutomu; Mizobe, Naoki; Takehiro, Hideo

1983-01-01

Evaluation of the extracerebral space on CT resulted as follows: The existence of the etracerebral space in the parieto-occipital region (PO-ECS) was physiological findings characteristic to premature infants. Its incidence was higher and the width of the space was greater, in those of premature infants. Generally PO-ECS disappeared around 40 weeks of gestation, while it tended to remaine beyond 40 weeks in premature infants born after less than 30 weeks of pregnancy. The appearance and disappearance of the PO-ECS may present some approach to learning the development of the brain in premature infants. (Ueda, J.)

The economic impact of prematurity and bronchopulmonary dysplasia.

Science.gov (United States)

Álvarez-Fuente, María; Arruza, Luis; Muro, Marta; Zozaya, Carlos; Avila, Alejandro; López-Ortego, Paloma; González-Armengod, Carmen; Torrent, Alba; Gavilán, Jose Luis; Del Cerro, María Jesús

2017-12-01

Bronchopulmonary dysplasia (BPD) is one of the most serious chronic lung diseases in infancy and one of the most important sequels of premature birth (prevalence of 15-50%). Our objective was to estimate the cost of BPD of one preterm baby, with no other major prematurity-related complications, during the first 2 years of life in Spain. Data from the Spanish Ministry of Health regarding costs of diagnosis-related group of preterm birth, hospital admissions and visits, palivizumab administration, and oxygen therapy in the year 2013 were analyzed. In 2013, 2628 preterm babies were born with a weight under 1500 g; 50.9% were males. The need for respiratory support was 2.5% needed only oxygen therapy, 39.5% required conventional mechanical ventilation, and 14.9% required high-frequency ventilation. The incidence of BPD was of 34.9%. The cost of the first 2 years of life of a preterm baby with BPD and no other major prematurity-related complications ranged between 45,049.81 € and 118,760.43 €, in Spain, depending on birth weight and gestational age. If the baby required home oxygen therapy or developed pulmonary hypertension, this cost could add up to 181,742.43 €. Prematurity and BPD have an elevated cost, even for public health care systems. This cost will probably increase in the coming years if the incidence and survival of preterm babies keeps rising. The development of new therapies and preventive strategies to decrease the incidence of BPD and other morbidities associated with prematurity should be a priority. What is known: • Bronchopulmonary dysplasia (BPD) is a serious chronic lung disease related with premature birth. • BPD is an increasing disease due to the up-rise in the number of premature births. What is new: • The economic cost of preterm birth and BPD has never before been estimated in Spain nor published with European data. • Preterm babies with BPD and a good clinical outcome carry also an important economic and social burden.

Improved sperm kinematics in semen samples collected after 2 h versus 4-7 days of ejaculation abstinence.

Science.gov (United States)

Alipour, H; Van Der Horst, G; Christiansen, O B; Dardmeh, F; Jørgensen, N; Nielsen, H I; Hnida, C

2017-07-01

Does a short abstinence period of only 2 h yield spermatozoa with better motility characteristics than samples collected after 4-7 days? Despite lower semen volume, sperm concentration, total sperm counts and total motile counts, higher percentages of motile spermatozoa with higher velocity and progressiveness were detected in samples obtained after 2 h. Most studies that have assessed the effect of abstinence periods on sperm motility parameters in men with a sperm concentration below 15 million/ml have detected a higher percentage of motile spermatozoa in samples obtained after short abstinence periods. Studies of men with sperm concentrations above 15 million/ml have reported significantly decreased motile sperm counts after 24 h of abstinence compared with longer abstinence periods. This study had a controlled repeated-measures design based on semen samples from 43 male partners, in couples attending for IVF treatment, who had a sperm concentration above 15 million/ml. Data were collected between June 2014 and December 2015 in the Fertility Unit of Aalborg University Hospital (Aalborg, Denmark). Participants provided a semen sample after 4-7 days of abstinence followed by another sample after only 2 h. For both ejaculates, sperm concentration, total sperm counts, motility groups and detailed kinematic parameters were assessed and compared by using the Sperm Class Analyzer (SCA) computer-aided sperm analysis system before and after density gradient selection. The laboratory's local manual method (Makler chamber) was used for comparison. The second raw ejaculate demonstrated lower semen volume (P sperm concentration (P = 0.003) and sperm counts in all motility sub-groups (P sperm concentration and total sperm counts in all motility sub-groups, the significantly higher percentage of spermatozoa with better motility characteristics (velocity, progressiveness and hyperactivation) in the second ejaculate, may provide and allow for a simpler and more effective

RESEARCH ON REDUCING PREMATURITY RUPTURE OF MEMBRANE

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Maria URSACHI (BOLOTA

2016-12-01

Full Text Available The membranes surrounding the amniotic cavity are composed from amnion and chorion, tightly adherent layers which are composed of several cell types, including epithelial cells, trophoblasts cells and mesenchyme cells, embedded in a collagenous matrix. They retain amniotic fluid, secret substances into the amniotic fluid, as well as to the uterus and protect the fetus against upward infections from urogenital tract. Normally, the membranes it breaks during labor. Premature rupture of the amniotic sac (PRAS is defined as rupture of membranes before the onset of labor. Premature rupture of the fetal membrane, which occurs before 37 weeks of gestation, usually, refers to preterm premature rupture of membranes. Despite advances in the care period, premature rupture of membranes and premature rupture of membranes preterm continue to be regarded as serious obstetric complications. On the term 8% - 10% of pregnant women have premature rupture of membranes; these women are at increased risk of intrauterine infections, where the interval between membrane rupture and expulsion is rolled-over. Premature rupture of membranes preterm occurs in approximately 1% of all pregnancies and is associated with 30% -40% of preterm births. Thus, it is important to identify the cause of pre-term birth (after less than 37 completed weeks of "gestation" and its complications, including respiratory distress syndrome, neonatal infection and intraventricular hemorrhage. Objectives: the development of the protocol of the clinical trial on patients with impending preterm birth, study clinical and statistical on the socio-demographic characteristics of patients with imminent preterm birth; clinical condition of patients and selection of cases that could benefit from the application of interventional therapy; preclinical investigation (biological and imaging of patients with imminent preterm birth; the modality therapy; clinical investigation of the effectiveness of short

Age-Related Effect of Viral-Induced Wheezing in Severe Prematurity

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Geovanny F. Perez

2016-10-01

Full Text Available Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear. Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years. Results: The study comprised of a total of 630 hospitalizations (n = 580 children. Sixty-seven percent of these hospitalizations occurred in children born full-term (>37 weeks, 12% in preterm (32–37 weeks and 21% in severely premature children (<32 weeks. The most common viruses identified were rhinovirus (RV; 60% and respiratory syncytial virus (RSV; 17%. Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old. Conclusions: Our results indicate that the vulnerability to viral infections in children born severely premature is more specific for RV and RSV and persists during the first three years of age. Further studies are needed to elucidate the age-dependent molecular mechanisms that underlie why premature infants develop RV- and RSV-induced wheezing in early life.

Neighborhood Environmental Health and Premature Death From Cardiovascular Disease

Science.gov (United States)

Xu, Junjun; Rollins, Latrice; Baltrus, Peter; O’Connell, Laura Kathryn; Cooper, Dexter L.; Hopkins, Jammie; Botchwey, Nisha D.; Akintobi, Tabia Henry

2018-01-01

Introduction Cardiovascular disease (CVD) is the leading cause of death in the United States and disproportionately affects racial/ethnic minority groups. Healthy neighborhood conditions are associated with increased uptake of health behaviors that reduce CVD risk, but minority neighborhoods often have poor food access and poor walkability. This study tested the community-driven hypothesis that poor access to food at the neighborhood level and poor neighborhood walkability are associated with racial disparities in premature deaths from CVD. Methods We examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates at the census tract level for the city of Atlanta using multivariable logistic regression models. We produced maps to illustrate premature CVD mortality, food access, and walkability by census tract for the city. Results We found significant racial differences in premature CVD mortality rates and geographic disparities in food access and walkability among census tracts in Atlanta. Improved food access and walkability were associated with reduced overall premature CVD mortality in unadjusted models, but this association did not persist in models adjusted for census tract population composition and poverty. Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality. Conclusion This study highlights disparities in premature CVD mortality and neighborhood food access and walkability at the census tract level in the city of Atlanta. Improving food access may have differential effects for subpopulations living in the same area. These results can be used to calibrate neighborhood-level interventions, and they highlight the need to examine race-specific health outcomes. PMID:29389312

Primary antiphospholipid syndrome: absence of premature atherosclerosis in patients without traditional coronary artery disease risk factors.

Science.gov (United States)

Andrade, D; Bortolotto, L; Bonfá, E; Borba, E

2016-04-01

To investigate if patients with Primary Antiphospholipid Syndrome (PAPS) with venous and/or arterial thrombosis without traditional coronary artery disease (CAD) risk factors develop early atherosclerotic vascular damage. 27 female patients with PAPS (Sidney criteria) and 27 age, body mass index (BMI), and sex matched controls were consecutively selected. Exclusion criteria were: black race, age ≥55 years, traditional cardiovascular risk factors, other thrombophilias or connective tissue diseases, corticosteroids use and pregnancy. All subjects underwent Pulse Wave Velocity (PWV) and Echo-Tracking (ET), both in carotidal bed, to analyse vascular functional properties. Age (p = 0.92) and BMI (p = 0.91) were comparable in both groups. PAPS patients and controls had similar PWV (9.07 ± 1.08 m/s vs 9.42 ± 1.47 m/s, p = 0.34) as well as echo tracking parameters such as intima-media thickness (683 ± 171 µm vs 636 ± 140 µm, p = 0.52), carotideal diameter (p = 0.26), distensibility (p = 0.92), compliance coefficients (p = 0.36) and elastic modulus (p = 0.78). Patients with exclusively venous thrombosis showed lower PWV than patients with arterial thrombosis (8.55 ± 0.70 m/s vs 9.56 ± 0.94 m/s, p = 0.01), but no difference regarding intima-media thickness (683 ± 171 µm vs 636 ± 140 µm, p = 0.52) was observed. Patients with PAPS do not seem to be at higher risk of developing premature atherosclerosis. Patients who suffered exclusively venous thrombosis seem to be at lower risk than those with exclusively arterial events. Other studies need to confirm our findings. © The Author(s) 2015.

[Development and evaluation of an e-learning program for mothers of premature infants].

Science.gov (United States)

Lee, Nae-Young; Kim, Young-Hae

2008-02-01

It has been attempted to support mother of premature infants by providing information of premature infant care using e-learning because premature infants need continuous care from birth to after discharge. The e-Learning Program for mother of premature was developed with Xpert, Namo web editor, Adobe Photoshop, and PowerPoint and applied for 4 weeks from 4 to 30 September 2006. 1) We found that the contents of information which premature infants' need when being in the hospital and after discharge were the definition of a premature infant, orientation of NICU, care of premature infants, care of premature infants' common diseases, the connection of healthcare resources, exchange of information, and the management of rearing stress. 2) The program content consisted of cause of premature birth, comparison to full-term baby, physiology character, orientation of NICU, common health problems, follow up care, infection control, feeding, normal development physically and mentally, weaning method, and vaccination. Considering the results, this program for mother of premature is a useful means to provide premature-care information to mothers. This information can be readily accessible and can be varied and complex enough to be able to help mothers to the information and assistance they require.

[Evaluation of maternal parameters as risk factors for premature birth (individual and combined effects)].

Science.gov (United States)

Voigt, M; Briese, V; Pietzner, V; Kirchengast, S; Schneider, K T M; Straube, S; Jorch, G

2009-08-01

We aimed to examine the individual and combined effects of nine maternal parameters (biological, medical, and social) on rates of prematurity. Our objective was to provide obstetricians with a way of screening women for likely premature deliveries. We conducted a retrospective analysis on the data of about 2.3 million pregnancies taken from the German perinatal statistics of 1995-2000. Rates of prematurity were calculated with single and multi-dimensional analyses on the basis of nine maternal parameters (age, weight, height, number of previous live births, stillbirths, miscarriages and terminations of pregnancy, smoking status, previous premature delivery). The following combinations of parameters were investigated in particular: rates of prematurity according to the number of previous stillbirths, miscarriages, and terminations; rates of prematurity according to the number of previous live births and maternal age, height and weight. We also included daily cigarette consumption and previous premature deliveries in our analyses. The rate of prematurity (premature deliveries (32-36 weeks) was 5.9%, and the rate of very early premature deliveries (prematurity (prematurity of 27.5% in women with the following combination of parameters: > or =1 stillbirth, > or =2 terminations of pregnancy and > or =2 miscarriages. A rather high risk of premature delivery (>11%) was also found for elderly (> or =40 years) grand multiparous women as well as small (premature deliveries (>10%). The risk table that we present here may assist in predicting premature delivery. Georg Thieme Verlag KG Stuttgart.New York.

Birth of healthy twins after intracytoplasmic sperm injection using ejaculated immotile spermatozoa from a patient with Kartagener's syndrome.

Science.gov (United States)

Geber, S; Lemgruber, M; Taitson, P F; Valle, M; Sampaio, M

2012-05-01

This case report demonstrates a successful pregnancy after ICSI combined with hypo-osmotic swelling test in a couple with Kartagener's syndrome with complete immotile ejaculated spermatozoa. Our result suggests that even for complete immotile spermatozoa, the use of hypo-osmotic swelling test is a good alternative to identify viable spermatozoa. When associated with ICSI, it can be a valuable tool to get fertilisation and pregnancy. © 2011 Blackwell Verlag GmbH.

Risk Factors for premature birth in a hospital 1

OpenAIRE

Ahumada-Barrios, Margarita E.; Alvarado, German F.

2016-01-01

Abstract Objective: to determine the risk factors for premature birth. Methods: retrospective case-control study of 600 pregnant women assisted in a hospital, with 298 pregnant women in the case group (who gave birth prematurely

Faktor Ibu yang Mempengaruhi Persalinan Prematur di RSUD Arifin Achmad Pekanbar

Directory of Open Access Journals (Sweden)

Liva Maita

2012-11-01

Full Text Available Persalinan prematur atau Partus Prematurus adalah persalinan yang terjadi pada usia kehamilan kurang dari 37 minggu dihitung dari hari pertama haid terakhir. Data di RSUD Arifin Achmad Pekanbaru didapatkan data pada tahun 2010 didapatkan data jumlah persalinan sebanyak 2400 kasus, dengan persalinan prematur 190 kasus (7,91%, tahun 2011 jumlah persalinan sebanyak 2287 kasus dengan persalinan prematur 279 kasus (12% dan pada periode Januari-April 2012 jumlah persalinan prematur 780 kasus (11,5%. Tujuan penelitian adalah diketahuinya hubungan dari komplikasi kehamilan, riwayat persalinan prematur, anemia, umur dan paritas dengan persalinan prematur. Jenis penelitian yang digunakan adalah studi kasus kontrol. Populasi dalam penelitian ini adalah seluruh ibu bersalin di RSUD Arifin achmad Pekanbaru. Besarnya sampel terdiri dari 245 kasus dan 245 kontrol. Analisis data dilakukan secara univariat, bivariat dan multivariat dengan metode Regresi Logistic Ganda. Hasil penelitian adalah komplikasi kehamilan (95% CI: 4,09-9,21, umur (CI 95%: 1,58-3,69, dan paritas (95% CI: 1,05-2,36 berhubungan dengan persalinan prematur. Kesimpulan yaitu variabel dominan yang berhubungan dengan kejadian persalinan prematur adalah komplikasi kehamilan dan tidak ada variabel counfounding. Saran kepada ibu hamil yang mengalami komplikasi kehamilan untuk memeriksakan kehamilan secara teratur minimal 4 kali selama kehamilan; pada ibu paritas tinggi disarankan menggunakan kontrasepsi mantap; dan Kepada tenaga kesehatan dapat mengelompokkan status pasien yang berisiko untuk mempermudah pemberian KIE

Acute Associations Between Outdoor Temperature and Premature Rupture of Membranes.

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Ha, Sandie; Liu, Danping; Zhu, Yeyi; Sherman, Seth; Mendola, Pauline

2018-03-01

Extreme ambient temperatures have been linked to preterm birth. Preterm premature rupture of membranes is a common precursor to preterm birth but is rarely studied in relation to temperature. We linked 15,381 singleton pregnancies with premature rupture of membranes from a nationwide US obstetrics cohort (2002-2008) to local temperature. Case-crossover analyses compared daily temperature during the week preceding delivery and the day of delivery to 2 control periods, before and after the case period. Conditional logistic regression models calculated the odds ratio (OR) and 95% confidence intervals (CIs) of preterm and term premature rupture of membranes for a 1°C increase in temperature during the warm (May-September) and cold (October-April) season separately after adjusting for humidity, barometric pressure, ozone, and particulate matter. During the warm season, 1°C increase during the week before delivery was associated with a 5% (95% CI, 3%, 6%) increased preterm premature rupture of membranes risk, and a 4% (95% CI, 3%, 5%) increased term premature rupture of membranes risk. During the cold season, 1°C increase was associated with a 2% decreased risk for both preterm (95% CI, 1%, 3%) and term premature rupture of membranes (95% CI, 1%, 3%). The day-specific associations for the week before delivery were similar, but somewhat stronger for days closer to delivery. Relatively small ambient temperature changes were associated with the risk of both preterm and term premature of membranes. Given the adverse consequences of premature rupture of membranes and concerns over global climate change, these findings merit further investigation. See video abstract at, http://links.lww.com/EDE/B312.

[Macronutrients and energy in milk from mothers of premature infants].

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He, Bi-Zi; Sun, Xiu-Jing; Quan, Mei-Ying; Wang, Dan-Hua

2014-07-01

To study the dynamic changes in macronutrients and energy in human milk from mothers of premature infants. A total of 339 human milk samples were collected from 170 women who delivered preterm or full-term infants in the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital between November 2012 and January 2014. Macronutrients (proteins, fats and carbohydrates and energy were measured using a MIRIS human milk analyzer and compared between groups. In milk samples from premature infants' mothers, the protein levels were the highest in colostrum (2.22±0.49 g/dL), less in transitional milk (1.83±0.39 g/dL), and the least in mature milk (1.40±0.28 g/dL) (Pmacronutrients and energy in milk from mothers of premature infants vary significantly between colostrum, transitional milk, and mature milk. Protein levels are significantly higher in colostrum from premature infants' mothers than in colostrum from term infants' mothers, but the significant difference is not seen for mature milk. Macronutrient and energy levels show significant differences between milk samples from mothers of premature infants with different gestational ages, so as to meet different needs of premature infants.

Premature aging

International Nuclear Information System (INIS)

Sassaki, Hideo

1992-01-01

The hypothesis that radiation may accelerate aging phenomenon has been studied extensively, using the population of A-bomb survivors. In this paper, non-specific radiation-induced premature aging is discussed with a review of the literature. Cardiac lipofuscin, papillary fibrosis, aortic extensibility, hexamine/collagen ratio in the skin and aorta, testicular changes, giant hepatic cell nucleus, and neurofibril changes have so far been studied pathologically in the context of A-bomb radiation. Only testicular sclerosis has been found to correlate with distance from the hypocenter. Suggestive correlation was found to exist between the hexamine/collagen ratio in the skin and aorta and A-bomb radiation. Grip strength and hearing ability were decreased in the group of 100 rad and the group of 50-99 rad, respectively. The other physiological data did not definitely correlate with A-bomb radiation. Laboratory data, including erythrocyte sedimentation rate, α and β globulin levels, phytohemagglutinin reaction, T cell counts, erythrocyte glycophorin-A, the incidence of cerebral stroke, ischemic heart disease, and cataract were age-dependent and correlated with A-bomb radiation. These findings indicated that the occurrence of arteriosclerosis-related diseases, changes in immunological competence, and some pathological and physiological findings altered with advancing age, suggesting the correlation with A-bomb radiation. In general, it cannot be concluded that there is a positive correlation between A-bomb radiation and the premature aging. (N.K.) 51 refs

The Mediterranean diet adherence by pregnant women delivering prematurely: association with size at birth and complications of prematurity.

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Parlapani, Elisavet; Agakidis, Charalampos; Karagiozoglou-Lampoudi, Thomais; Sarafidis, Kosmas; Agakidou, Eleni; Athanasiadis, Apostolos; Diamanti, Elisavet

2017-11-13

The Mediterranean diet (MD) is associated with decreased risk of metabolic syndrome and gestational diabetes due to the anti-inflammatory and antioxidative properties of its components. The aim was to investigate the potential association of MD adherence (MDA) during pregnancy by mothers delivering prematurely, with intrauterine growth as expressed by neonates' anthropometry at birth and complications of prematurity. This is a single-center, prospective, observational cohort study of 82 women who delivered preterm singletons at post conceptional age (PCA) ≤ 34 weeks and their live-born neonates. Maternal and neonatal demographic and clinical data were recorded. All mothers filled in a food frequency questionnaire, and the MDA score was calculated. Based on 50th centile of MD score, participants were classified into high-MDA and low-MDA groups. The low-MDA mothers had significantly higher pregestational BMI and rates of overweight/obesity (odd ratios (OR) 3.5) and gestational hypertension/preeclampsia (OR 3.8). Neonates in the low-MDA group had significantly higher incidence of intrauterine growth restriction (IUGR) (OR 3.3) and lower z-scores of birth weight and BMI. Regarding prematurity-related complications, the low MDA-group was more likely to develop necrotizing enterocolitis, bronchopulmonary dysplasia, and retinopathy of prematurity (OR 3.2, 1.3, and 1.6, respectively), while they were less likely to develop respiratory distress syndrome (OR 0.49), although the differences were not statistically significant. However, adjustment for confounders revealed MDA as a significant independent predictor of hypertension/preeclampsia, IUGR, birth weight z-score, necrotizing enterocolitis, and bronchopulmonary dysplasia. High MDA during pregnancy may favorably affect intrauterine growth and certain acute and chronic complications of prematurity as well as maternal hypertension/preeclampsia.

Association of Maternal Preeclampsia With Infant Risk of Premature Birth and Retinopathy of Prematurity.

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Shulman, Julia P; Weng, Cindy; Wilkes, Jacob; Greene, Tom; Hartnett, M Elizabeth

2017-09-01

Studies report conflicting associations between preeclampsia and retinopathy of prematurity (ROP). This study provides explanations for the discrepancies to clarify the relationship between preeclampsia and ROP. To evaluate the association of maternal preeclampsia and risk of ROP among infants in an unrestricted birth cohort and a restricted subcohort of preterm, very low birth weight (P-VLBW) infants. A retrospective review of 290 992 live births within the Intermountain Healthcare System in Utah from January 1, 2001, through December 31, 2010, was performed. Generalized estimating equations for logistic regressions with covariate adjustment were applied to relate ROP to preeclampsia among the full cohort and in a subcohort of P-VLBW infants born at younger than 31 weeks' gestation and weighing less than 1500 g. The occurrence of ROP was related to maternal preeclampsia in the full cohort and in a subcohort of P-VLBW infants. In the full cohort, 51% of the infants were male and the mean (SD) gestational age was 38.38 (1.87) weeks. In the P-VLBW cohort, 55% were male and the mean (SD) gestational age was 26.87 (2.40) weeks. In the full cohort, preeclampsia was associated with an increased risk of all ROP (adjusted odds ratio [aOR], 2.46; 95% CI, 2.17-2.79; P prematurity, because prematurity is an outcome of preeclampsia.

Effects of pre-pregnancy obesity, race/ethnicity and prematurity.

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de Jongh, B E; Paul, D A; Hoffman, M; Locke, R

2014-04-01

To investigate the association between maternal pre-pregnancy obesity, race/ethnicity and prematurity. Retrospective cohort study of maternal deliveries at a single regional center from 2009 to 2010 time period (n = 11,711). Generalized linear models were used for the analysis to estimate an adjusted odds ratio with 95% confidence interval of the association between maternal pre-pregnancy obesity, race/ethnicity and prematurity. Analysis controlled for diabetes, chronic hypertension, previous preterm birth, smoking and insurance status. The demographics of the study population were as follows, race/ethnicity had predominance in the White/Non-Hispanic population with 60.1%, followed by the Black/Non-Hispanic population 24.2%, the Hispanic population with 10.3% and the Asian population with 5.4%. Maternal pre-pregnancy weight showed that the population with a normal body mass index (BMI) was 49.4%, followed by the population being overweight with 26.2%, and last, the population which was obese with 24.4%. Maternal obesity increased the odds of prematurity in the White/Non-Hispanic, Hispanic and Asian population (aOR 1.40, CI 1.12-1.75; aOR 2.20, CI 1.23-3.95; aOR 3.07, CI 1.16-8.13, respectively). Although the Black/Non-Hispanic population prematurity rate remains higher than the other race/ethnicity populations, the Black/Non-Hispanic population did not have an increased odds of prematurity in obese mothers (OR 0.87; CI 0.68-1.19). Unlike White/Non-Hispanic, Asian and Hispanic mothers, normal pre-pregnancy BMI in Black/Non-Hispanic mothers was not associated with lower odds for prematurity. The odds for mothers of the White/Non-Hispanic, Hispanic and Asian populations, for delivering a premature infant, were significantly increased when obese. Analysis controlled for chronic hypertension, diabetes, insurance status, prior preterm birth and smoking. Obesity is a risk factor for prematurity in the White/Non-Hispanic, Asian and Hispanic population, but not for the

Balance in children born prematurely currently aged 6–7

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Dziuba Ewa

2017-12-01

Full Text Available Study aim: Premature birth is one of the major problems of obstetrics, leading to numerous complications that are associated with prematurity, for instance balance disorders. The aim of the study was to assess the impact of premature birth on the ability to maintain balance in children commencing their school education. Material and methods: The study included children aged 6-7 years. The study group consisted of 59 children (31 girls and 28 boys, mean age 6.38 ± SD 0.73 born prematurely between 24 and 35 weeks of gestation. The control group consisted of 61 children (28 girls and 33 boys, mean age 6.42 ± 0.58 born at term. The research utilized standardized test tools - one-leg open-eyed and closed-eyed standing test, one-leg jumping test - and an original questionnaire survey. Results: The children born at term achieved better results in the majority of tests. The comparison of girls and boys born pre­maturely and at term showed no statistically significant difference between them in terms of dynamic balance, static balance or total balance control. The comparison of the tests performed on the right and left lower limb in prematurely born children showed no statistically significant differences. Conclusion: Premature birth affects the ability to maintain body balance. The results of the study indicate the need to develop coordination skills that shape body balance in prematurely born children.

EVALUATING THE EFFECTIVENESS OF ELKAR (L-CARNITINE IN PREMATURE INFANTS

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Svetlana V. Garina

2016-06-01

Full Text Available Introduction. Recently in Russia there is a tendency to increase the proportion of premature infants, prolonged postnatal adaptation which may be associated with carnitine deficiency Early diagnosis and correction of carnitine deficiency in premature infants is possible to reserve the prevention of pathological conditions of the prenatal period in these patients. Materials and Methods. 98 newborn infants have been examined with the help of clinical laboratory methods. Results. It has been stated that the overwhelming majority of newborn infants irrespective of their gestational age and body mass at the moment of birth had reference ranges of crude carnitine and higher degree of floating carnitine in their peripheral blood within the first days of their lives. These changes are particularly characteristic for small pre-mature infants. Statistically significant differences between the levels of crude carnitine and floating carnitine depended on the gender of newborn infants have been revealed. Directly correlated dependence of the level of crude carnitine on the body mass at the moment of birth of small premature infants has been stated. Discussion and Conclusions. It has been proved that implementing L-carnitine into the development care plan for premature infants facilitates quick body weight gain, significantly cuts down the period of tube feeding, lowers frequency of anemia development of premature infants and duration of neonatal jaundice. The ability of Elkar to correct functional diseases of cardio vascular system of premature infants has been shown.

Testicular sperm is superior to ejaculated sperm for ICSI in cryptozoospermia: An update systematic review and meta-analysis.

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Kang, Yi-No; Hsiao, Ya-Wen; Chen, Chien-Yu; Wu, Chien-Chih

2018-05-18

Intracytoplasmic sperm injection (ICSI) is well established and provides patients with severely impaired sperm quality with an opportunity to father a child. However, previous studies do not clearly indicate whether male with cryptozoospermia should use testicular sperm or ejaculated sperm for ICSI. The newest systematic review of this topic also gave a controversial conclusion that was based on incorrect pooling result. Moreover, two clinical studies published after the systematic review. In the present update systematic review and meta-analysis, a comprehensive citation search for relevant studies was performed using the Cochrane library databases, Embase, Ovid MEDLINE, PubMed, ScienceDirect, Scopus, and Web of Science up to September 2017. The search returned 313 records, in which six studies were included in quantitative synthesis. These studies involved 578 male infertility patients who had undergone 761 ICSI cycles. The risk ratios favour fresh testicular sperm for good quality embryo rate (1.17, 95% CI 1.05-1.30, P = 0.005), implantation rate (95% CI 1.02-2.26, P = 0.04), and pregnancy rate (RR = 1.74, 95% CI 1.20-2.52, P = 0.004). In conclusion, the existing evidence suggests that testicular sperm is better than ejaculated sperm for ICSI in male with cryptozoospermia.

Premature hair greying may predict reduced bone mineral density in Graves' disease.

LENUS (Irish Health Repository)

Leary, A C

2012-02-03

BACKGROUND: Premature hair greying has been associated with low bone mineral density (BMD), and it may be more frequent in Graves\\' disease. AIMS: To determine whether premature greying is associated with reduced BMD in women with Graves\\' disease and in control women, and to examine whether premature greying is more common in Graves\\' disease. METHODS: Premature greying (> 50% grey by 40 years) and BMD were determined in 44 women with a history of Graves\\' disease and 133 female controls referred for routine BMD measurement. Exclusion criteria included diseases or drugs known to affect BMD. RESULTS: Mean Z and T scores at the lumbar spine were significantly lower (P < 0.04) in subjects with premature greying than in those not prematurely grey among women with Graves\\' disease, but not among control women. Multiple regression confirmed this difference between Graves\\' and control women (P = 0.041). There were no differences at other measurement sites. Of Graves\\' patients, 36% were prematurely grey compared with 25% of control women (P = 0.14). CONCLUSION: Premature greying may be a weak marker for reduced BMD in women with a history of Graves\\' disease, but it is not a marker in normal women.

Bartter syndrome: presentation in an extremely premature neonate.

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Flores, F X; Ojeda, F J; Calhoun, D A

2013-08-01

Reports of Bartter syndrome in premature neonates are rare. We describe the presentation and clinical course of a neonate born at 25.6 weeks estimated gestational age with polyuria, hyponatremia, hypokalemia and hypercalciuria ,who was diagnosed with neonatal Bartter syndrome. The evaluation, diagnosis and management of neonatal Bartter syndrome in this premature neonate are discussed.

Is "Delayed Umbilical Cord Clamping" Beneficial for Premature Newborns?

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Amir-Mohammad Armanian

2017-05-01

Full Text Available Background: The appropriate moment for clamping the umbilical cord is controversial. Immediate cord clamping (ICC is an item of active management of the third stage of labor (AMTSL. Unclamped umbilical cord may cause inconvenience in preterm neonates because they commonly need some levels of emergent services. Some studies revealed delayed cord clamping (DCC of preterm neonates results in better health conditions like lower rates of respiratory distress syndrome (RDS, less morbidities in labor room and lower risk of postpartum hemorrhage. The aim of the present study was to determine the effect of delayed umbilical cord clamping on premature neonatal outcomes. Materials and Methods: In this single‑center randomized control trial study, sixty premature neonates (gestational age ≤ 34 weeks were randomly assigned to ICC (cord clamped at 5–10 seconds or DCC (30–45 seconds groups and followed up in neonatal intensive care unit (NICU. Primary outcomes were 1st and 5th minute Apgar score, average of level of hematocrit after birth, intra ventricle hemorrhage and need some levels of resuscitation. Results: Differences in demographic characteristics were not statistically significant. After birth, neonates who had delayed clamping had significantly higher mean hematocrit after at 4-hour of birth (49.58+5.15gr/dl vs. 46.58+5.40gr/dlin DCC vs. ICC groups, respectively (P=0.031. Delayed cord clamping reduced the duration of need to nasal continues positive airway pressure (NCPAP (86.7% and 60.0% in ICC and DCC groups, respectively, P= 0.039. Attractively, the results showed lower incidence of clinical sepsis in delayed cord clamping neonates (53.3% vs. 23.3% in ICC and DCC groups, respectively, P=0.033. Conclusion: Prematurity complications might decrease by delay umbilical cord clamping which improve the hematocrit, duration of need to NCPAP and incidence of clinical sepsis. Furthermore, DCC may have no negative impact on neonatal resuscitation.

Primary Ovarian Insufficiency: X chromosome defects and autoimmunity.

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Persani, Luca; Rossetti, Raffaella; Cacciatore, Chiara; Bonomi, Marco

2009-08-01

Premature ovarian failure (POF) is a primary ovarian defect characterized by absent menarche or premature depletion of ovarian follicles before the age of 40 years. However, in several instances the distinction between definitive or intermittent POF may be difficult on clinical bases, therefore the more appropriate term Primary Ovarian Insufficiency (POI) has been recently proposed and will be used in this review. POI is a heterogeneous disorder affecting approximately 1% of women disappearance of menstrual cycles (secondary amenorrhea) associated with a defective folliculogenesis. POI is generally characterized by low levels of gonadal hormones (estrogens and inhibins) and high levels of gonadotropins (LH and FSH) (hypergonadotropic amenorrhea). Heterogeneity of POI is reflected by the variety of possible causes, including autoimmunity, toxics, drugs, as well as genetic defects. Several data indicate that POI has a strong genetic component. In this manuscript we discuss the X chromosome abnormalities that are associated with POI.

Zone 1 retinopathy of prematurity in a transitional economy: a cautionary note.

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Carden, Susan M; Lan, Luu Ngoc; Huynh, Tess

2006-06-01

To describe three low risk infants in whom severe retinopathy of prematurity developed. A prospective, observational case series. setting: National Hospital of Pediatrics, Hanoi, Vietnam. study population: Premature infants in the neonatal ward. observation procedure: Eye examinations. Severe retinopathy of prematurity occurred in three infants. All had zone 1 disease and other unusually severe findings, such as neovascularization of the disk. These infants would not be at risk for the development of such severe retinopathy of prematurity in countries with a developed economy. Unusual characteristics of retinopathy of prematurity may be occurring in countries with transitional economies. Screening programs should be implemented and should take into consideration the possibility that retinopathy of prematurity may occur in infants who fall outside the screening guidelines that are used in the developed world.

Premature Calcifications of Costal Cartilages: A New Perspective Premature Calcifications of Costal Cartilages: A New Perspective

International Nuclear Information System (INIS)

Rhomberg, W.; Schuster, A.

2014-01-01

Calcifications of the costal cartilages occur, as a rule, not until the age of 30 years. The knowledge of the clinical significance of early and extensive calcifications is still incomplete. Materials and Methods. A search was made to find patients below the age of 30 years who showed distinct calcifications of their lower costal cartilages by viewing 360 random samples of intravenous pyelograms and abdominal plain films. The histories, and clinical and laboratory findings of these patients were analyzed. Results. Nineteen patients fulfilled the criteria of premature calcifications of costal cartilages (CCCs). The patients had in common that they were frequently referred to a hospital and were treated by several medical disciplines. Nevertheless many complaints of the patients remained unsolved. Premature CCCs were often associated with rare endocrine disorders, inborn errors of metabolism, and abnormal hematologic findings. Among the metabolic disorders there were 2 proven porphyrias and 7 patients with a suspected porphyria but with inconclusive laboratory findings. Conclusion. Premature CCCs are unlikely to be a normal variant in skeletal radiology. The findings in this small group of patients call for more intensive studies, especially in regard to the putative role of a porphyria

Unilateral testicular torsion following ejaculation by manual sexual stimulation in an adolescent: A case report

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Omer Faruk Yagli

2018-05-01

Full Text Available Testicular torsion is one of the most common causes of acute scrotum in children and adolescents. The bell-clapper deformity, which detected in 12% of males, is the most important reason that leads to testicular torsion. In our case, a 14 years old male admitted to our clinic due to testicular torsion developed after ejaculation with manual sexual stimulation of the penis. The most important criteria in determining the loss of testis is the degree and duration of torsion. Here, we discussed the rare cause of testicular torsion along with diagnostic and therapeutic characteristics.

Antibiotics after preterm premature rupture of the membranes.

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Singh, Katherine; Mercer, Brian

2011-06-01

Preterm premature rupture of the membranes remains a common cause of preterm deliveries and neonatal morbidities. The goal of this study is to review the evidence with regard to the antibiotic treatment after preterm premature rupture of the membranes, long-term outcomes related to antibiotic treatment, and possible complications with treatment. Future research goals are also discussed.

System of the ophthalmologic help premature children with retinopathy of prematurity in the Central region of Russia

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A. V. Tereshchenko

2012-01-01

Full Text Available Purpose: Functional results analysis of ophthalmologic help system for premature infants, which includes the full cycle of early revelation, treatment and regular medical check-up activities for patients with ROP in Central region of Russia.Methods: Fields for ROP screening were performed in premature infants medical care units by clinic specialists. Infants with re- vealed ROP were directed to Kaluga Branch of IRtC «Eye Microsurgery» for detailed diagnostic examination and subsequent treatment and monitoring.Results: In 2003-2011 454 fields in Kaluga, tula, Bryansk, and Orel regions were made. 8861 infants were examined. ROP was found in 1834 infants (20.7%. 823 different interventions for infants with active ROP were performed: 737 retinal lasercoagulations, 3-ports vitrectomy — 72, lensvitrectomy — 14. the total efficacy of the treatment was 92.9%.Conclusion: the ophthalmologic help system for premature infants in Central region of Russia combines all directions from de-tailed diagnostic to hich-technology treatment. It allows to reproduce one all over the Russian Federation territory.

System of the ophthalmologic help premature children with retinopathy of prematurity in the Central region of Russia

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A. V. Tereshchenko

2014-07-01

Full Text Available Purpose: Functional results analysis of ophthalmologic help system for premature infants, which includes the full cycle of early revelation, treatment and regular medical check-up activities for patients with ROP in Central region of Russia.Methods: Fields for ROP screening were performed in premature infants medical care units by clinic specialists. Infants with re- vealed ROP were directed to Kaluga Branch of IRtC «Eye Microsurgery» for detailed diagnostic examination and subsequent treatment and monitoring.Results: In 2003-2011 454 fields in Kaluga, tula, Bryansk, and Orel regions were made. 8861 infants were examined. ROP was found in 1834 infants (20.7%. 823 different interventions for infants with active ROP were performed: 737 retinal lasercoagulations, 3-ports vitrectomy — 72, lensvitrectomy — 14. the total efficacy of the treatment was 92.9%.Conclusion: the ophthalmologic help system for premature infants in Central region of Russia combines all directions from de-tailed diagnostic to hich-technology treatment. It allows to reproduce one all over the Russian Federation territory.

Maternal Smoking during Pregnancy, Prematurity and Recurrent Wheezing in Early Childhood

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Robison, Rachel G; Kumar, Rajesh; Arguelles, Lester M; Hong, Xiumei; Wang, Guoying; Apollon, Stephanie; Bonzagni, Anthony; Ortiz, Kathryn; Pearson, Colleen; Pongracic, Jacqueline A; Wang, Xiaobin

2013-01-01

Summary Background Prenatal maternal smoking and prematurity independently affect wheezing and asthma in childhood. Objective We sought to evaluate the interactive effects of maternal smoking and prematurity upon the development of early childhood wheezing. Methods We evaluated 1448 children with smoke exposure data from a prospective urban birth cohort in Boston. Maternal antenatal and postnatal exposure was determined from standardized questionnaires. Gestational age was assessed by the first day of the last menstrual period and early prenatal ultrasound (pretermprematurity and maternal antenatal smoking on recurrent wheeze, controlling for relevant covariates. Results In the cohort, 90 (6%) children had recurrent wheezing, 147 (10%) were exposed to in utero maternal smoke and 419 (29%) were premature. Prematurity (odds ratio [OR] 2.0; 95% CI, 1.3-3.1) was associated with an increased risk of recurrent wheezing, but in utero maternal smoking was not (OR 1.1, 95% CI 0.5-2.4). Jointly, maternal smoke exposure and prematurity caused an increased risk of recurrent wheezing (OR 3.8, 95% CI 1.8-8.0). There was an interaction between prematurity and maternal smoking upon episodes of wheezing (p=0.049). Conclusions We demonstrated an interaction between maternal smoking during pregnancy and prematurity on childhood wheezing in this urban, multiethnic birth cohort. PMID:22290763

Prenatal Diagnosis of a Segmental Small Bowel Volvulus with Threatened Premature Labor

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Barbara Monard

2017-01-01

Full Text Available Fetal primary small bowel volvulus is extremely rare but represents a serious life-threatening condition needing emergency neonatal surgical management to avoid severe digestive consequences. We report a case of primary small bowel volvulus with meconium peritonitis prenatally diagnosed at 27 weeks and 4 days of gestation during threatened premature labor with reduced fetal movements. Ultrasound showed a small bowel mildly dilated with thickened and hyperechogenic intestinal wall, with a typical whirlpool configuration. Normal fetal development allowed continuation of pregnancy with ultrasound follow-up. Induction of labor was decided at 37 weeks and 2 days of gestation because of a significant aggravation of intestinal dilatation appearing more extensive with peritoneal calcifications leading to the suspicion of meconium peritonitis, associated with reduced fetal movements and reduced fetal heart rate variability, for neonatal surgical management with a good outcome.

Prenatal Diagnosis of a Segmental Small Bowel Volvulus with Threatened Premature Labor

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Mottet, Nicolas; Ramanah, Rajeev; Riethmuller, Didier

2017-01-01

Fetal primary small bowel volvulus is extremely rare but represents a serious life-threatening condition needing emergency neonatal surgical management to avoid severe digestive consequences. We report a case of primary small bowel volvulus with meconium peritonitis prenatally diagnosed at 27 weeks and 4 days of gestation during threatened premature labor with reduced fetal movements. Ultrasound showed a small bowel mildly dilated with thickened and hyperechogenic intestinal wall, with a typical whirlpool configuration. Normal fetal development allowed continuation of pregnancy with ultrasound follow-up. Induction of labor was decided at 37 weeks and 2 days of gestation because of a significant aggravation of intestinal dilatation appearing more extensive with peritoneal calcifications leading to the suspicion of meconium peritonitis, associated with reduced fetal movements and reduced fetal heart rate variability, for neonatal surgical management with a good outcome. PMID:29230337

Apnea of Prematurity (For Parents)

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... mature enough to allow nonstop breathing. This causes large bursts of breath followed by periods of shallow breathing or stopped breathing. Apnea of prematurity usually ends on its own after a few ...

Sildenafil and retinopathy of prematurity risk in very low birth weight infants

NARCIS (Netherlands)

S. Samiee-Zafarghandy; J.N. van den Anker (John); M. Laughon (Matthew); R.H. Clark; P.B. Smith; C.P. Hornik

2016-01-01

textabstractObjective: To examine the effect of sildenafil therapy on development of severe retinopathy of prematurity (ROP) requiring surgical intervention in premature infants. Study Design: We identified premature infants who were discharged from Pediatrix Medical Group neonatal intensive care

Trends of premature mortality in Swietokrzyskie Province (Poland), years 2002-2010.

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Gózdz, Stanislaw; Krzyzak, Michalina; Maślach, Dominik; Wróbel, Monika; Bielska-Lasota, Magdalena

2013-01-01

of death causes were responsible for an average 76.0% PYLL. The analysis of the causes of premature mortality in Swietokrzyskie Province shows that in the majority of cases it is due to preventable deaths, which calls for the necessity of more intensive measures in primary and secondary prevention as well as the improvement in treatment standards, mainly of cardiovascular diseases, cancers, injuries and accidents.

Premature delivery

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Bernardita Donoso Bernales

2012-09-01

Full Text Available Preterm delivery is the single most important cause of perinatal morbidity and mortality. In Chile, preterm births have increased in the past decade, although neonatal morbidity and mortality attributable to it shows a downward trend, thanks to improvements in neonatal care of premature babies, rather than the success of obstetric preventive and therapeutic strategies. This article describes clinical entities, disease processes and conditions that constitute predisposing factors of preterm birth, as well as an outline for the prevention and clinical management of women at risk of preterm birth.

Analysis on screening results of 2 203 premature infants with retinopathy

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Qian Wang

2018-06-01

Full Text Available AIM: To investigate the incidence and risk factors of retinopathy of prematurity(ROPin preterm infants. METHODS: The wide-field digital pediatric Retinal imaging system was used to screen 2 203 preterm infants with gestational age RESULTS: Totally 367 infants(621 eyeswere diagnosed as retinopathy among 2 203 premature infants and the incidence of ROP was 16.66%; 236 cases(399 eyesof ROP(26.61%were detected in 887 cases of premature infants in accord with screening standard of the Chinese Premature Retinopathy Screening Guidelines(2014, and 131 cases(222 eyesof ROP(9.95%was detected in 1 316 cases of premature infants outside the screening standard. In our research, the incidence of ROP was related with gestational age, birth weight, oxygen duration and mechanical ventilation. However, the relationship had not been found with artificial insemination, caesarean birth, gender, polyembryony, acute respiratory distress syndrome(ARDS, hypertensive disorders in pregnancy, gestational diabetes mellitus, intrauterine infection, intrauterine distress, premature rupture of membrane. The incidence of ROP was statistically significant between different gestational age groups, different birth weight groups and different oxygen groups(PCONCLUSION: The incidence of ROP is 16.66% in this study, and there is still a certain proportion outside the screening standard of the Chinese Premature Retinopathy Screening Guidelines(2014. Gestational age, birth weight, oxygen duration and mechanical ventilation are high risk factors for ROP.

Hepatic Insulin Resistance and Altered Gluconeogenic Pathway in Premature Baboons.

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McGill-Vargas, Lisa; Gastaldelli, Amalia; Liang, Hanyu; Anzueto Guerra, Diana; Johnson-Pais, Teresa; Seidner, Steven; McCurnin, Donald; Muscogiuri, Giovanna; DeFronzo, Ralph; Musi, Nicolas; Blanco, Cynthia

2017-05-01

Premature infants have altered glucose regulation early in life and increased risk for diabetes in adulthood. Although prematurity leads to an increased risk of diabetes and metabolic syndrome in adult life, the role of hepatic glucose regulation and adaptation to an early extrauterine environment in preterm infants remain unknown. The purpose of this study was to investigate developmental differences in glucose metabolism, hepatic protein content, and gene expression of key insulin-signaling/gluconeogenic molecules. Fetal baboons were delivered at 67%, 75%, and term gestational age and euthanized at birth. Neonatal baboons were delivered prematurely (67% gestation), survived for two weeks, and compared with similar postnatal term animals and underwent serial hyperinsulinemic-euglycemic clamp studies. Premature baboons had decreased endogenous glucose production (EGP) compared with term animals. Consistent with these results, the gluconeogenic molecule, phosphoenolpyruvate carboxykinase messenger RNA, was decreased in preterm baboons compared with terms. Hepatic insulin signaling was altered by preterm birth as evidenced by decreased insulin receptor-β, p85 subunit of phosphoinositide 3-kinase, phosphorylated insulin receptor substrate 1, and Akt-1 under insulin-stimulated conditions. Furthermore, preterm baboons failed to have the normal increase in glycogen synthase kinase-α from fetal to postnatal life. The blunted responses in hepatic insulin signaling may contribute to the hyperglycemia of prematurity, while impaired EGP leads to hypoglycemia of prematurity. Copyright © 2017 Endocrine Society.

Adverse respiratory outcome after premature rupture of membranes before viability.

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Verspyck, Eric; Bisson, Violene; Roman, Horace; Marret, Stéphane

2014-03-01

To determine whether preterm premature rupture of membranes (PPROM) before 24 weeks is an independent risk factor for poor outcome in preterm neonates. A retrospective comparative cohort study was conducted, including viable premature infants born between 25 and 34-weeks gestation. Each preterm case with early PPROM was matched with two preterm controls of the same gestational age at birth, sex and birth date and who were born spontaneously with intact membranes. Logistic regression was performed to identify independent risk factors associated with composite respiratory and perinatal adverse outcomes for the overall population of preterm infants. Thirty-five PPROM cases were matched with 70 controls. Extreme prematurity (26-28 weeks) was an independent risk factor for composite perinatal adverse outcomes [odds ratio (OR) 43.9; p = 0.001]. Extreme prematurity (OR 42.9; p = 0.001), PPROM (OR 7.1; p = 0.01), male infant (OR 5.2; p = 0.02) and intrauterine growth restriction (IUGR, OR 4.8; p = 0.04) were factors for composite respiratory adverse outcomes. Preterm premature rupture of membranes before viability represents an independent risk factor for composite respiratory adverse outcomes in preterm neonates. Extreme prematurity may represent the main risk factor for both composite respiratory and perinatal adverse outcomes. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

[Outcomes of surgical management of retinopathy of prematurity--an overview].

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Kuprjanowicz, Leszek; Kubasik-Kładna, Katarzyna; Modrzejewska, Monika

2014-01-01

According to the guidelines by the ETROP (Early Treatment for Retinopathy of Prematurity) study group, laser therapy is the gold standard in the treatment of retinopathy of prematurity. However, progression of the disease is seen in 12% of eyes despite the treatment. Since there is no causal treatment, new therapies of retinopathy of prematurity, are continually sought, such as anti-VEGF agents, beta-blockers, or insulin-like growth factor gene therapy. In cases with concomitant retinal detachment, surgery is performed. The standard therapy for retinopathy of prematurity stages 4-5 involves pars plicata vitrectomy and lensectomy (stage 5), ab externo surgery (scleral buckling) and lens-sparing vitrectomy (some cases of stage 4). Classic vitrectomy with lensectomy is reserved only for cases with advanced retinal tractions, retina-lens apposition or for cases of intraoperative lens damage during the lens-sparing vitrectomy. The ab externo surgery does not eliminate vitreous tractions, but it stabilises the neovascular membrane activity (transforming it into a scar). The indication for this type of operation is stage 4 retinopathy of prematurity with peripheral proliferations, except for the posterior--aggressive form of retinopathy of prematurity. Many papers have been published on combined therapy involving vitrectomy and conservative treatment. In conclusion, optimal timing of surgical intervention is difficult to determine in stages 4 and 5, because the anatomical and functional outcomes in stage 5 are unfavourable. Both, ab externo surgery and vitrectomy tend to produce poor macular vision in eyes with advanced retinopathy of prematurity, therefore surgical intervention at stage 4 just before the local macular retinal detachment provides better anatomical and functional outcomes.

Biomarkers of brain injury in the premature infant

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Martha V. Douglas-Escobar

2013-01-01

Full Text Available The term encephalopathy of prematurity encompasses not only the acute brain injury (such as intraventricular hemorrhage but also complex disturbance on the infant’s subsequent brain development. In premature infants, the most frequent recognized source of brain injury is intraventricular hemorrhage (IVH and periventricular leukomalacia (PVL. Furthermore 20-25% infants with birth weigh less than 1,500 g will have IVH and that proportion increases to 45% if the birth weight is less than 500-750 g. In addition, nearly 60% of very low birth weight newborns will have hypoxic-ischemic injury. Therefore permanent lifetime neurodevelopmental disabilities are frequent in premature infants. Innovative approach to prevent or decrease brain injury in preterm infants requires discovery of biomarkers able to discriminate infants at risk for injury, monitor the progression of the injury and assess efficacy of neuroprotective clinical trials. In this article, we will review biomarkers studied in premature infants with IVH, Post-hemorrhagic ventricular dilation (PHVD and PVL including: S100b, Activin A, erythropoietin, chemokine CCL 18, GFAP and NFL will also be examined. Some of the most promising biomarkers for IVH are S100β and Activin. The concentrations of TGF-β1, MMP-9 and PAI-1 in cerebrospinal fluid could be used to discriminate patients that will require shunt after post-hemorrhagic ventricular dilation. Neonatal brain injury is frequent in premature infants admitted to the neonatal intensive care and we hope to contribute to the awareness and interest in clinical validation of established as well as novel neonatal brain injury biomarkers.

Impact of Prematurity on Language Skills at School Age

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Smith, Jamie Mahurin; DeThorne, Laura Segebart; Logan, Jessica A. R.; Channell, Ron W.; Petrill, Stephen A.

2014-01-01

Purpose: The existing literature on language outcomes in children born prematurely focuses almost exclusively on standardized test scores rather than discourse-level abilities. The authors of this study looked longitudinally at school-age language outcomes and potential moderating variables for a group of twins born prematurely versus a control…

Advances in understanding and management of retinopathy of prematurity.

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Hartnett, Mary Elizabeth

The understanding, diagnosis, and treatment of retinopathy of prematurity have changed in the 70 years since the original description of retrolental fibroplasia associated with high oxygenation. It is now recognized that retinopathy of prematurity differs in appearance worldwide and as ever smaller and younger premature infants survive. New methods are being evaluated to image the retina, diagnose severe retinopathy of prematurity, and determine windows of time for treatment to save eyes and improve visual and neural outcomes. New treatments to promote physiologic retinal vascular development, vascular repair, and inhibit vasoproliferation by regulating proteins involved in vascular endothelial growth factor, insulin-like growth factor, or erythropoietin signaling. Reducing excessive oxidative/nitrosative stress and understanding progenitor cells and neurovascular and glial vascular interactions are being studied. Copyright © 2016 Elsevier Inc. All rights reserved.

HEARING FUNCTION IN PREMATURE CHILDREN WITH INTRAUTERINE GROWTH RESTRICTION

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I. V. Rakhmanova

2012-01-01

Full Text Available Initial audiological test was performed in 136 premature children with various gestational age born from single fetation. The children were divided into 2 groups: prematures with intrauterine growth restriction (IUGR and prematures with normal weight for their gestational age (normotrophy. The study showed that the rate of passing the initial audiological test using the method of DPOAE was lower in both ears in children with IUGR, than in children with normotrophy. The correlation between the results of initial audiological test and birth weight was found: the lower was weight, the higher was risk of absence of acoustic response registration on initial examination.

Hospitalized Premature Infants Are Colonized by Related Bacterial Strains with Distinct Proteomic Profiles

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Christopher T. Brown

2018-04-01

Full Text Available During the first weeks of life, microbial colonization of the gut impacts human immune system maturation and other developmental processes. In premature infants, aberrant colonization has been implicated in the onset of necrotizing enterocolitis (NEC, a life-threatening intestinal disease. To study the premature infant gut colonization process, genome-resolved metagenomics was conducted on 343 fecal samples collected during the first 3 months of life from 35 premature infants housed in a neonatal intensive care unit, 14 of whom developed NEC, and metaproteomic measurements were made on 87 samples. Microbial community composition and proteomic profiles remained relatively stable on the time scale of a week, but the proteome was more variable. Although genetically similar organisms colonized many infants, most infants were colonized by distinct strains with metabolic profiles that could be distinguished using metaproteomics. Microbiome composition correlated with infant, antibiotics administration, and NEC diagnosis. Communities were found to cluster into seven primary types, and community type switched within infants, sometimes multiple times. Interestingly, some communities sampled from the same infant at subsequent time points clustered with those of other infants. In some cases, switches preceded onset of NEC; however, no species or community type could account for NEC across the majority of infants. In addition to a correlation of protein abundances with organism replication rates, we found that organism proteomes correlated with overall community composition. Thus, this genome-resolved proteomics study demonstrated that the contributions of individual organisms to microbiome development depend on microbial community context.

Hospitalized Premature Infants Are Colonized by Related Bacterial Strains with Distinct Proteomic Profiles

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Xiong, Weili; Olm, Matthew R.; Thomas, Brian C.; Baker, Robyn; Firek, Brian; Morowitz, Michael J.; Hettich, Robert L.

2018-01-01

ABSTRACT During the first weeks of life, microbial colonization of the gut impacts human immune system maturation and other developmental processes. In premature infants, aberrant colonization has been implicated in the onset of necrotizing enterocolitis (NEC), a life-threatening intestinal disease. To study the premature infant gut colonization process, genome-resolved metagenomics was conducted on 343 fecal samples collected during the first 3 months of life from 35 premature infants housed in a neonatal intensive care unit, 14 of whom developed NEC, and metaproteomic measurements were made on 87 samples. Microbial community composition and proteomic profiles remained relatively stable on the time scale of a week, but the proteome was more variable. Although genetically similar organisms colonized many infants, most infants were colonized by distinct strains with metabolic profiles that could be distinguished using metaproteomics. Microbiome composition correlated with infant, antibiotics administration, and NEC diagnosis. Communities were found to cluster into seven primary types, and community type switched within infants, sometimes multiple times. Interestingly, some communities sampled from the same infant at subsequent time points clustered with those of other infants. In some cases, switches preceded onset of NEC; however, no species or community type could account for NEC across the majority of infants. In addition to a correlation of protein abundances with organism replication rates, we found that organism proteomes correlated with overall community composition. Thus, this genome-resolved proteomics study demonstrated that the contributions of individual organisms to microbiome development depend on microbial community context. PMID:29636439

Histological Chorioamnionitis: Effects on Premature Delivery and Neonatal Prognosis

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Gulin Erdemir

2013-08-01

Conclusion: Chorioamnionitis not only causes premature deliveries, but is also associated with neonatal complications and increased mortality. Clinical findings and infectious markers in mother or infant do not predict the diagnosis of histological chorioamnionitis. Therefore, placental histopathology may have a role in predicting neonatal outcome in premature deliveries, especially those below 30 weeks.

Erytromycine bij prematuur gebroken vliezen gunstig voor de gezondheid van het kind [Erythromycin for premature rupture of membranes is beneficial for infant

NARCIS (Netherlands)

Buitendijk, S.E.

2001-01-01

In the 'Overview of the role of antibiotics in curtailing labour and early delivery'(ORACLE I)-trial in women with premature rupture of membranes, the use of erythromycin was found to be associated with a decrease in the primary composite outcome (neonatal death, chronic lung disease or major

Social representations of mothers about gestational hypertension and premature birth.

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de Souza, Nilba Lima; de Araújo, Ana Cristina Pinheiro Fernandes; Costa, Iris do Ceu Clara

2013-01-01

To identify the meanings attributed by mothers to hypertensive disorders of pregnancy (HDPs) and their consequences, such as premature birth and hospitalization of the infant in the neonatal intensive care unit (NICU). A qualitative study, based on the Central Nucleus Theory, with 70 women who had hypertensive disorders of pregnancy and preterm delivery. We used the technique of free word association (FWAT) with three stimuli: high blood pressure during pregnancy, prematurity and NICU. We obtained 1007 evocations, distributed as follows: high blood pressure during pregnancy (335) prematurity (333) and NICU (339). These constituted three thematic units: representation of HDPs, prematurity and the NICU. The categories death and negative aspects were inherent to the three units analyzed, followed by coping strategies and needs for care present in HDPs and prematurity. The study had death as its central nucleus, and highlighted the subjective aspects present in the high risk pregnancy and postpartum cycle. It is hoped that this research will contribute to qualifying nursing care for women confronting the problem of HDPs, so that they can cope with less impacts from the adverse effects of high risk pregnancy and birth.

Radiation-induced life-shortening and premature aging

International Nuclear Information System (INIS)

Walburg, H.E. Jr.

1975-01-01

Data from a number of studies on irradiated laboratory animals showed that almost none of the characteristic lesions associated with senescence that were studied adequately reflects a radiation effect analogous to premature aging. In fact, most of the age-related changes showed no effect of radiation at all, and many of those that did (for example, graying of hair, sterility, cataract formation) did not appear to be due to similar mechanisms. It is concluded that, in the light of more recent information, the hypothesis of radiation-induced premature aging requires reassessment. (80 references) (CH)

Primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a prematurely terminated randomized controlled trial.

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Binda, G A; Karas, J R; Serventi, A; Sokmen, S; Amato, A; Hydo, L; Bergamaschi, R

2012-11-01

This randomized controlled trial (RCT) was performed to test the hypothesis that adverse event rates following primary anastomosis (PRA) are not inferior to those following nonrestorative colon resection for perforated diverticulitis with peritonitis. Patients admitted for perforated diverticulitis with peritonitis were randomly assigned to PRA (left colon resection with PRA and loop ileostomy) or nonrestorative colon resection (left colon resection with end colostomy). The endpoint was adverse events defined as mortality and morbidity following PRA or nonrestorative colon resection and stoma reversal. The estimated sample size was 300 patients in each study arm (alpha 0.10; 90% power). During a 9-year period, 90 patients were randomly assigned to undergo PRA or nonrestorative colon resection in 14 centres in eight countries. Thirty-four PRA patients were comparable to 56 nonrestorative colon resection patients for age (P = 0.481), gender (P = 0.190), APACHE III (P = 0.281), Hinchey stage III vs IV (P = 0.394) and Mannheim Peritonitis Index (P = 0.145). There were no differences in operating time (P = 0.231), surgeries performed at night (P = 0.083), open vs laparoscopic approach (P = 0.419) and litres of peritoneal irrigation (P = 0.096). There was no significant difference in mortality (2.9 vs 10.7%; P = 0.247) and morbidity (35.3 vs 46.4%; P = 0.38) following PRA or nonrestorative colon resection. After a similar lag time (P = 0.43), 64.7% of PRA patients and 60% of nonrestorative colon resection patients underwent stoma reversal (P = 0.659). Adverse event rates following stoma reversal differed significantly after PRA and reversal of nonrestorative resection (4.5 vs 23.5%; P = 0.0589). No conclusions may be drawn on preference of one treatment over another from this RCT because it was prematurely terminated following accrual of 15% of its sample size. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

Features of retinopathy of prematurity in a tertiary care hospital in Lahore.

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Jamil, Ahmad Zeeshan; Tahir, Muhammad Younis; Ayub, Muhammad Hammad; Mirza, Khurram Azam

2015-02-01

To study the demographic and clinical features of Retinopathy of Prematurity in urban Punjab. The cross-sectional study was performed at Hameed Latif Hospital, Lahore, from April 2010 to October 2013 and comprised neonates born with birth weight less than 2000 g, gestational age less than 37 weeks, or those who were considered high risk for Retinopathy of Prematurity. Variables recorded included history, birth weight, gestational age, oxygen supplementation, development of Retinopathy of Prematurity, and laser treatment. Data was analysed using SPSS 17. There were 285 neonates in the study with a mean birth weight of 1280.34 ± 350.43 g and mean gestational age being 29.38 ± 3.14 weeks. Overall, 167 (58.6%) received supplemental oxygen, 86(30.2%) were anaemic and 44 (15.4%) received blood transfusion. Besides, 47 (16.5%) premature babies were product of multiple gestation, 34 (11.9%) were having respiratory distress, 25 (8.8%) had sepsis and received intravenous antibiotics, 70(24.6%) developed Retinopathy of Prematurity, and 22 (7.7%) developed threshold disease and received laser treatment at mean gestational age of 32.11 ± 2.53 weeks. Screening is key to preventing childhood blindness caused by Retinopathy of Prematurity. Prematurity, low birth weight and supplemental oxygen therapy are significant risk factors for the condition.

Risk factors of intracranial hemorrhage in premature neonates.

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Nasrin Khalessi

2014-09-01

Full Text Available Intraventricular hemorrhage (IVH is an important cause of brain injury in premature neonates. Current study tries to define associated risk factors of IVH in preterm neonates in Aliasghar Children Hospital during 2008 to 2011. In this study, the risk factors have been evaluated in premature neonates with IVH, who had at least one brain sonography since their admission in NICU. A total of 63 premature neonates with IVH were assessed. Mean gestational age was 29.81 (24-34 weeks and mean birth weight was 1290.83±382.96 gr. Other risk factors such as sex, mode of delivery, history of using infertility drugs, maternal disease, maternal hypertension and preeclampsia, lumbar puncture, ventilator therapy and pneumothorax were considered. Because no absolute treatment for IVH is available, identifying risk factors is important in prevention and management of IVH.

Neurological consequences of systemic inflammation in the premature neonate.

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Patra, Aparna; Huang, Hong; Bauer, John A; Giannone, Peter J

2017-06-01

Despite substantial progress in neonatal care over the past two decades leading to improved survival of extremely premature infants, extreme prematurity continues to be associated with long term neurodevelopmental impairments. Cerebral white matter injury is the predominant form of insult in preterm brain leading to adverse neurological consequences. Such brain injury pattern and unfavorable neurologic sequelae is commonly encountered in premature infants exposed to systemic inflammatory states such as clinical or culture proven sepsis with or without evidence of meningitis, prolonged mechanical ventilation, bronchopulmonary dysplasia, necrotizing enterocolitis and chorioamnionitis. Underlying mechanisms may include cytokine mediated processes without direct entry of pathogens into the brain, developmental differences in immune response and complex neurovascular barrier system that play a critical role in regulating the cerebral response to various systemic inflammatory insults in premature infants. Understanding of these pathologic mechanisms and clinical correlates of such injury based on serum biomarkers or brain imaging findings on magnetic resonance imaging will pave way for future research and translational therapeutic opportunities for the developing brain.

Neurological consequences of systemic inflammation in the premature neonate

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Aparna Patra

2017-01-01

Full Text Available Despite substantial progress in neonatal care over the past two decades leading to improved survival of extremely premature infants, extreme prematurity continues to be associated with long term neurodevelopmental impairments. Cerebral white matter injury is the predominant form of insult in preterm brain leading to adverse neurological consequences. Such brain injury pattern and unfavorable neurologic sequelae is commonly encountered in premature infants exposed to systemic inflammatory states such as clinical or culture proven sepsis with or without evidence of meningitis, prolonged mechanical ventilation, bronchopulmonary dysplasia, necrotizing enterocolitis and chorioamnionitis. Underlying mechanisms may include cytokine mediated processes without direct entry of pathogens into the brain, developmental differences in immune response and complex neurovascular barrier system that play a critical role in regulating the cerebral response to various systemic inflammatory insults in premature infants. Understanding of these pathologic mechanisms and clinical correlates of such injury based on serum biomarkers or brain imaging findings on magnetic resonance imaging will pave way for future research and translational therapeutic opportunities for the developing brain.

Nutritional factors and visual function in premature infants.

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Jewell, V C; Northrop-Clewes, C A; Tubman, R; Thurnham, D I

2001-05-01

Approximately 5-7% of all infants are born prematurely, and birth before 37 weeks is the most common cause of neonatal mortality, morbidity and long-term disability. Premature infants are poorly equipped for life outside the womb, and oxidant stress has been implicated in the aetiology of visual impairment in these infants, who are often exposed to increased O2 concentrations and high light intensity in neonatal units. The carotenoids lutein and zeaxanthin, which give the macular area of the eye its yellow colour, are located in the retinal pigment epithelium of the eye, and are believed to play a role in protecting it against oxidative and light damage. The macular pigments are of dietary origin, and green leafy vegetables are the primary source of lutein and zeaxanthin. Lutein is one of the five most common carotenoids found in the diet. There is current interest in the macular pigment in relation to age-related macular degeneration, but these pigments may also have a protective role in the retinal pigment epithelium of the newborn infant. Little information is available on blood lutein and zeaxanthin levels in neonates. Levels of lutein in human milk are two to three times higher than those of beta-carotene, whereas their concentrations in the mothers' blood are approximately the same. Human milk is the main dietary source of lutein and zeaxanthin for infants until weaning occurs. The biochemical mechanisms which mediate the transport of the macular carotenoids into the eye are not known, but tubulin has been identified as the major carotenoid-binding protein, and may play a role in the physiology of the macula.

Pathophysiology of gastroesophageal reflux disease in premature infants using a radionuclide method

International Nuclear Information System (INIS)

Ishihara, Michiomi

2001-01-01

The cases of 36 very low birthweight infants (premature group) and 52 mature infants with birth weights as low as 1500 g (mature group) with gastro-esephageal reflux disease (GERD) were reviewed. These infants received 24 hour pH monitoring, reflux scintigraphy, gastric emptying, and antrum motility measurement. The results of 24-hour pH monitoring of the premature group are not different from these of the mature group. Time required for reflux scintigraphy of the premature group is higher than that of the mature group. Emptying time of premature group is slower than that of the mature group. Dietary management in premature infants with GERD is important. Using a nasoduodenal feeding tube is quite effective. Radionuclide method, in addition to 24-hour pH monitoring, should be used to evaluate total gastroesophageal function. (author)

Pathophysiology of gastroesophageal reflux disease in premature infants using a radionuclide method

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Ishihara, Michiomi [Tokyo Metropolitan Hospital of Ohkubo (Japan)

2001-12-01

The cases of 36 very low birthweight infants (premature group) and 52 mature infants with birth weights as low as 1500 g (mature group) with gastro-esephageal reflux disease (GERD) were reviewed. These infants received 24 hour pH monitoring, reflux scintigraphy, gastric emptying, and antrum motility measurement. The results of 24-hour pH monitoring of the premature group are not different from these of the mature group. Time required for reflux scintigraphy of the premature group is higher than that of the mature group. Emptying time of premature group is slower than that of the mature group. Dietary management in premature infants with GERD is important. Using a nasoduodenal feeding tube is quite effective. Radionuclide method, in addition to 24-hour pH monitoring, should be used to evaluate total gastroesophageal function. (author)

Perspectives and attitudes of pediatricians concerning post-discharge care practice of premature infants.

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Gad, A; Parkinson, E; Khawar, N; Elmeki, A; Narula, P; Hoang, D

2017-01-01

Survival rates of premature infants are at a historical high and increasingly more pediatricians are caring for former premature infants. The goal of this study was to describe the perspectives and attitudes of pediatricians, as well as, the challenges of rendering post-neonatal intensive care unit (NICU) discharge care for premature infants. An anonymous 22-question web-based survey was emailed to pediatricians who are current members of the American Academy of Pediatrics (AAP) and practicing in Kings County, New York. There were 148 completed surveys with 79% being general pediatricians. Of all respondents, 63% believed that premature infants should have a neonatal high risk follow-up visit within days after discharge and 64% were satisfied with the NICU discharge summary acquisition. While 74% of pediatricians felt comfortable following up with former extremely premature infants, 65% referred to specialists, most often to child development, neurology, and physical and/or occupational therapy. The majority (85%) were more likely to refer premature infants to early intervention. Participating pediatricians varied in their knowledge of immunization and breastfeeding guidelines. Finally, 88% of respondents acknowledged that caregivers of premature infants experience increased stress, with 53% stating that the stress should be addressed. Understanding the perceptions and challenges of pediatricians who care for premature infants may help improve post NICU quality of care. Transition to the outpatient setting is a crucial step in the management of premature infants and a focus on improved hand-off procedures between hospital and physicians may prove beneficial. Also, pediatricians must stay abreast of current recommendations for breastfeeding and vaccinations. Furthermore, emphasis should be given to stress reduction and management for caregivers of former premature infants.

Influence of the blood glucose level on the development of retinopathy of prematurity in extremely premature children.

Science.gov (United States)

Nicolaeva, Galina V; Sidorenko, Evgenyj I; Iosifovna, Amkhanitskaya Lyubov

2015-01-01

To investigate the influence of the blood glucose level on the development of retinopathy of prematurity (ROP) in extremely premature infants. Sixty-four premature infants with a gestational age of less than 30 weeks and a birth weight of less than 1500 g were included in the study. Children without ROP were allocated to Group 1 (n=14, gestational age 28.6 ± 1.4 weeks, birth weight 1162 ± 322 g), and children with spontaneous regression of ROP were allocated to Group 2 (n=32, gestational age 26.5 ± 1.2 weeks, birth weight 905 ± 224 g). Children with progressive ROP who underwent laser treatment were included in Group 3 (n=18, gestational age 25.4 ± 0.7 weeks, birth weight 763 ± 138 g). The glucose level in the capillary blood of the premature infants was monitored daily during the first 3 weeks of life. A complete ophthalmological screening was performed from the age of 1 month. The nonparametric signed-rank Wilcoxon-Mann-Whitney test was used for statistical analysis. The mean blood glucose level was 7.43 ± 2.6 mmol/L in Group 1, 7.8 ± 2.7 mmol/L in Group 2, and 6.7 ± 2.6 mmol/L in Group 3. There were no significant differences in the blood glucose levels between children with and without ROP, and also between children with spontaneously regressing ROP and progressive ROP (p>0.05). Additionally, there were no significant differences in the blood glucose levels measured at the first, second, and third weeks of life (p>0.05). The blood glucose level is not related to the development of ROP nor with its progression or regression. The glycemic level cannot be considered as a risk factor for ROP, but reflects the severity of newborns' somatic condition and morphofunctional immaturity.

Patent Ductus Arteriosus in Premature Neonates

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Mezu-Ndubuisi, Olachi J.; Agarwal, Ghanshyam; Raghavan, Aarti; Pham, Jennifer T.; Ohler, Kirsten H.; Maheshwari, Akhil

2015-01-01

Persistent patency of the ductus arteriosus is a major cause of morbidity and mortality in premature infants. In infants born prior to 28 weeks of gestation, a hemodynamically-significant patent ductus arteriosus (PDA) can cause cardiovascular instability, exacerbate respiratory distress syndrome, prolong the need for assisted ventilation, and increase the risk of bronchopulmonary dysplasia, intraventricular hemorrhage, renal dysfunction, intraventricular hemorrhage, cerebral palsy, and mortality. In this article, we review the pathophysiology, clinical features, and assessment of hemodynamic significance, and provide a rigorous appraisal of the quality of evidence to support current medical and surgical management of PDA of prematurity. Cyclo-oxygenase inhibitors such as indomethacin and ibuprofen remain the mainstay of medical therapy for PDA, and can be used both for prophylaxis as well as rescue therapy to achieve PDA closure. Surgical ligation is also effective and is used in infants who do not respond to medical management. Although both medical and surgical treatment have proven efficacy in closing the ductus, both modalities are associated with significant adverse effects. Because the ductus does undergo spontaneous closure in some premature infants, improved and early identification of infants most likely to develop a symptomatic PDA could help in directing treatment to the at-risk infants and allow others to receive expectant management. PMID:22564132

[Initial results of the Erfurt Prevention of Prematurity Campaign].

Science.gov (United States)

Hoyme, U B; Grosch, A; Roemer, V M; Saling, E

1998-01-01

Genital infection particularly bacterial vaginosis (BV) increases the relative risk of prematurity. Detection of disturbances of vaginal milieu at an early stage and the use of suitable countermeasures such as intervention with antimicrobial substances, e.g. clindamycin, can reduce the preterm birth rate, provided the diagnosis is made early enough. Since October 1996 pregnant women being given prenatal care in 16 of the 29 outpatient offices in Erfurt, have been informed about the Prematurity Prevention Programme and have been offered to take part and to perform self-measurements of their vaginal pH twice a week in order to screen for any disturbances in the vaginal milieu. Special CarePlan-VpH gloves (Selfcare, Oberhaching) were used to identify patients a risk (pH > 4.7). The pregnant women taking part in the programme were instructed to see their physician immediately, if abnormal values were present, in order to get them confirmed and to start lactobacillus acidophilus therapy (Gynoflor, Nourypharma, Oberschleissheim) or, in case of BV, to treat with clindamycin cream (Sobelin, Upjohn, Erlangen) i.vag. Patients being given prenatal care in the 13 outpatient offices not participating and other pregnant women in Erfurt who were not interested in the programme served as control group. Up to now 59 out of 314 women in the intervention group have been identified as risk cases (p > or = 4.7). 52 of them were treated with a lactobacillus preparation, and 19 additionally with clindamycin cream, 3 patients refused to have any therapy. In this ongoing study the prematurity rate was 8.3% in the self-measurement/intervention group vs. 13.0% in the control group (n = 1,842); 0.3% vs. 3.3% of the neonates belonged to the group of very early prematures with a gestational age of < 32 + 0 weeks (p < 0.01). PROM was registered in 22.3% vs. 32.1% (p < 0.001) respectively. Self-measurement of vaginal pH at close intervals, as recommended by Saling, leads to the early

Lung function and exercise capacity in young adults born prematurely

NARCIS (Netherlands)

Vrijlandt, EJLE; Gerritsen, J; Boezen, HM; Grevink, RG; Duiverman, EJ

2006-01-01

Rationale: Limited information is available about the long-term outcome of lung function and exercise capacity in young adults born prematurely. Objective: To determine long-term effects of prematurity on lung function (volumes, diffusing capacity) and exercise capacity in expreterms compared with

Anemia of prematurity : time for a change in transfusion management?

NARCIS (Netherlands)

Khodabux, Chantal Muriel

2013-01-01

In this thesis we investigated clinical effects of allogeneic red blood cell (RBC) transfusions in premature infants, different transfusion volumes in relation to neonatal outcome in premature infants and the use of autologous cord blood (CB) as an alternative for allogeneic transfusions. Despite

Economic analysis of the costs associated with prematurity from a literature review.

Science.gov (United States)

Soilly, A L; Lejeune, C; Quantin, C; Bejean, S; Gouyon, J B

2014-01-01

To analyse published cost-of-illness studies that had assessed the cost of prematurity according to gestational age at birth. A review of the literature was carried out in March 2011 using the following databases: Medline, ScienceDirect, The Cochrane Library, Econlit and Business Source Premier, and a French Public-Health database. Key-word sequences related to 'prematurity' and 'costs' were considered. Studies that assessed costs according to the gestational age (GA) at the premature birth (prematurity (extreme, early, moderate and late). Results showed that whatever the follow-up period, costs correlated inversely with GA. They also showed considerable variability in costs within the same GA group. Differences between studies could be explained by the choices made, concerning i/the study populations, ii/contextual information, iii/and various economic criteria. Despite these variations, a global trend of costs was estimated in the short-term period using mean costs from four American studies that presented similar methodologies. Costs stand at over US$ 100,000 for extreme prematurity, between US$ 40,000 and US$ 100,000 for early prematurity, between US$ 10,000 and US$ 30,000 for moderate prematurity and below US$ 4500 for late prematurity. This review underlined not only the clear inverse relationship between costs and GA at birth, but also the difficulty to transfer the results to the French context. It suggests that studies specific to the French health system need to be carried out. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Persistent hyperplastic primary vitreous: imaging evaluation

International Nuclear Information System (INIS)

Jacob, Beatriz Mahmud; Teixeira, Kim-Ir-Sen Santos; Figueiredo, Sizenildo da Silva; Nobrega, Bruno Barcelos da

2003-01-01

Persistent hyperplastic primary vitreous (PHPV) is a congenital developmental anomaly of the eye that primarily affects premature infants. PHPV results from failure of regression of the embryogenic primary vitreous and hyaloid vasculature, and proliferation of connective tissue. Three types of PHPV may be found: anterior, posterior and a combination of anterior and posterior. The clinical findings include leukocoria (white pupillary reflex) and microphthalmic eye. This anomaly is usually unilateral and unassociated with other systemic findings. The differential diagnosis between PHPV and other ocular diseases may be difficult due to similar features such as leukocoria, detached retina, retinal folds and cataract. Other diseases with similar features include retinoblastoma, isolated congenital cataract, retinopathy of prematurity and pseudo gliomas or leukocorias. Direct visualization of the remnants of the fetal hyaloid vascular system offers the best evidence of PHPV. However, diagnosis using the ophthalmoscope is sometimes impossible because of opaque tissues. In this circumstance an indirect visualization by ultrasound, computed tomography or magnetic resonance imaging may be useful. These imaging methods provide valuable information for the differentiation from other diseases, particularly retinoblastoma. The authors present a review of the literature and an iconographic study of the imaging findings in patients with PHPV. (author)

Maternal Iron Deficiency Anemia as a Risk Factor for the Development of Retinopathy of Prematurity.

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Dai, Alper I; Demiryürek, Seniz; Aksoy, Sefika Nur; Perk, Peren; Saygili, Oguzhan; Güngör, Kivanc

2015-08-01

Retinopathy of prematurity is a proliferative vascular disease affecting premature newborns and occurs during vessel development and maturation. The aim of this study was to evaluate the maternal iron deficiency anemia as possible risk factors associated with the development of retinopathy of prematurity among premature or very low birth weight infants. In this study, mothers of 254 infants with retinopathy of prematurity were analyzed retrospectively, and their laboratory results of medical records during pregnancy were reviewed for possible iron deficiency anemia. In a cohort of 254 mothers of premature infants with retinopathy of prematurity, 187 (73.6%) had iron deficiency, while the remaining 67 (26.4%) mothers had no deficiency. Babies born to mothers with iron deficiency anemia with markedly decreased hemoglobin, hematocrit, mean corpuscular volume, serum iron, and ferritin levels were more likely to develop retinopathy of prematurity. Our results are the first to suggest that maternal iron deficiency is a risk factor for the development of retinopathy of prematurity. Our data suggest that maternal iron supplementation therapy during pregnancy might lower the risk of retinopathy of prematurity. Copyright © 2015 Elsevier Inc. All rights reserved.

Validation of the Children's Hospital of Philadelphia Retinopathy of Prematurity (CHOP ROP) Model.

Science.gov (United States)

Binenbaum, Gil; Ying, Gui-Shuang; Tomlinson, Lauren A

2017-08-01

The Children's Hospital of Philadelphia Retinopathy of Prematurity (CHOP ROP) model uses birth weight (BW), gestational age at birth (GA), and weight gain rate to predict the risk of severe retinopathy of prematurity (ROP). In a model development study, it predicted all infants requiring treatment, while greatly reducing the number of examinations compared with current screening guidelines. To validate the CHOP ROP model in a multicenter cohort that is large enough to obtain a precise estimate of the model's sensitivity for treatment-requiring ROP. This investigation was a secondary analysis of data from the Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study. The setting was 30 hospitals in the United States and Canada between January 1, 2006, and June 30, 2012. The dates of analysis were September 28 to October 5, 2015. Participants were premature infants at risk for ROP with a known ROP outcome. Sensitivity for Early Treatment of Retinopathy of Prematurity type 1 ROP and potential reduction in the number of infants requiring examinations. In the primary analysis, the CHOP ROP model was applied weekly to predict the risk of ROP. If the risk was above a cut-point level (high risk), examinations were indicated, while low-risk infants received no examinations. In a secondary analysis, low-risk infants received fewer examinations rather than no examinations. Participants included 7483 premature infants at risk for ROP with a known ROP outcome. Their median BW was 1070 g (range, 310-3000 g), and their median GA was 28 weeks (range, 22-35 weeks). Among them, 3575 (47.8%) were female, and their race/ethnicity was 3615 white (48.3%), 2310 black (30.9%), 233 Asian (3.1%), 93 Pacific Islander (1.2%), and 40 American Indian/Alaskan native (0.5%). The original CHOP ROP model correctly predicted 452 of 459 infants who developed type 1 ROP (sensitivity, 98.5%; 95% CI, 96.9%-99.3%), reducing the number of infants requiring examinations by 34.3% if only high

Blood cell mitochondrial DNA content and premature ovarian aging.

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Marco Bonomi

Full Text Available Primary ovarian insufficiency (POI is a critical fertility defect characterized by an anticipated and silent impairment of the follicular reserve, but its pathogenesis is largely unexplained. The frequent maternal inheritance of POI together with a remarkable dependence of ovarian folliculogenesis upon mitochondrial biogenesis and bioenergetics suggested the possible involvement of a generalized mitochondrial defect. Here, we verified the existence of a significant correlation between blood and ovarian mitochondrial DNA (mtDNA content in a group of women undergoing ovarian hyperstimulation (OH, and then aimed to verify whether mtDNA content was significantly altered in the blood cells of POI women. We recruited 101 women with an impaired ovarian reserve: 59 women with premature ovarian failure (POF and 42 poor responders (PR to OH. A Taqman copy number assay revealed a significant mtDNA depletion (P<0.001 in both POF and PR women in comparison with 43 women of similar age and intact ovarian reserve, or 53 very old women with a previous physiological menopause. No pathogenic variations in the mitochondrial DNA polymerase γ (POLG gene were detected in 57 POF or PR women with low blood mtDNA content. In conclusion, blood cell mtDNA depletion is a frequent finding among women with premature ovarian aging, suggesting that a still undetermined but generalized mitochondrial defect may frequently predispose to POI which could then be considered a form of anticipated aging in which the ovarian defect may represent the first manifestation. The determination of mtDNA content in blood may become an useful tool for the POI risk prediction.

The next generation: poor compliance with risk factor guidelines in the children of parents with premature coronary heart disease.

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Langner, N R; Rowe, P C; Davies, R

1994-01-01

The offspring of individuals with premature coronary heart disease are themselves at increased risk for myocardial infarction before the age of 55. Consensus panels have recommended that all such offspring undergo an evaluation of cardiovascular risk, including cholesterol testing. To examine self-reported rates of cardiovascular risk factor assessment in this population, we conducted a telephone survey of 318 Canadian adults with premature coronary heart disease and of one offspring from 298 (94%) of the 318 families. The median age of the offspring was 20 years (range 2 to 39 y). Among the 219 late adolescent and young adult offspring, only 97 (44%) reported having had a blood cholesterol measurement during the preceding 3 years. Thirty-seven percent reported being current smokers, 31% were overweight, and 30% exercised fewer than three times per week. Men were less likely than women to report having had their blood pressure measured in the preceding year (57% vs 80%). These low rates of cardiac risk factor assessment families of patients with premature coronary heart disease represent missed opportunities for primary prevention. More effective strategies to prevent atherosclerosis in this population are needed.

Benefits & risks of statin therapy for primary prevention of cardiovascular disease in Asian Indians – A population with the highest risk of premature coronary artery disease & diabetes

Science.gov (United States)

Enas, Enas A.; Kuruvila, Arun; Khanna, Pravien; Pitchumoni, C.S.; Mohan, Viswanathan

2013-01-01

Several reviews and meta-analyses have demonstrated the incontrovertible benefits of statin therapy in patients with cardiovascular disease (CVD). But the role for statins in primary prevention remained unclear. The updated 2013 Cochrane review has put to rest all lingering doubts about the overwhelming benefits of long-term statin therapy in primary prevention by conclusively demonstrating highly significant reductions in all-cause mortality, major adverse cardiovascular events (MACE) and the need for coronary artery revascularization procedures (CARPs). More importantly, these benefits of statin therapy are similar at all levels of CVD risk, including subjects at low (statins is also highly effective in delaying and avoiding expensive CARPs such as angioplasties, stents, and bypass surgeries. There is no evidence of any serious harm or threat to life caused by statin therapy, though several adverse effects that affect the quality of life, especially diabetes mellitus (DM) have been reported. Asian Indians have the highest risk of premature coronary artery disease (CAD) and diabetes. When compared with Whites, Asian Indians have double the risk of CAD and triple the risk of DM, when adjusted for traditional risk factors for these diseases. Available evidence supports the use of statin therapy for primary prevention in Asian Indians at a younger age and with lower targets for low-density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein (non-HDL-C), than those currently recommended for Americans and Europeans. Early and aggressive statin therapy offers the greatest potential for reducing the continuing epidemic of CAD among Indians. PMID:24434254

Effects of prematurity on language acquisition and auditory maturation: a systematic review.

Science.gov (United States)

Rechia, Inaê Costa; Oliveira, Luciéle Dias; Crestani, Anelise Henrich; Biaggio, Eliara Pinto Vieira; Souza, Ana Paula Ramos de

2016-01-01

To verify which damages prematurity causes to hearing and language. We used the decriptors language/linguagem, hearing/audição, prematurity/prematuridade in databases LILACS, MEDLINE, Cochrane Library and Scielo. randomized controlled trials, non-randomized intervention studies and descriptive studies (cross-sectional, cohort, case-control projects). The articles were assessed independently by two authors according to the selection criteria. Twenty-six studies were selected, of which seven were published in Brazil and 19 in international literature. Nineteen studies comparing full-term and preterm infants. Two of the studies made comparisons between premature infants small for gestational age and appropriate for gestational age. In four studies, the sample consisted of children with extreme prematurity, while other studies have been conducted in children with severe and moderate prematurity. To assess hearing, these studies used otoacoustic emissions, brainstem evoked potentials, tympanometry, auditory steady-state response and visual reinforcement audiometry. For language assessment, most of the articles used the Bayley Scale of Infant and Toddler Development. Most studies reviewed observed that prematurity is directly or indirectly related to the acquisition of auditory and language abilities early in life. Thus, it could be seen that prematurity, as well as aspects related to it (gestational age, low weight at birth and complications at birth), affect maturation of the central auditory pathway and may cause negative effects on language acquisition.

The role of domoic acid in abortion and premature parturition of California sea lions (Zalophus californianus) on San Miguel Island, California.

Science.gov (United States)

Goldstein, Tracey; Zabka, Tanja S; Delong, Robert L; Wheeler, Elizabeth A; Ylitalo, Gina; Bargu, Sibel; Silver, Mary; Leighfield, Tod; Van Dolah, Frances; Langlois, Gregg; Sidor, Inga; Dunn, J Lawrence; Gulland, Frances M D

2009-01-01

Domoic acid is a glutaminergic neurotoxin produced by marine algae such as Pseudo-nitzschia australis. California sea lions (Zalophus californianus) ingest the toxin when foraging on planktivorous fish. Adult females comprise 60% of stranded animals admitted for rehabilitation due to acute domoic acid toxicosis and commonly suffer from reproductive failure, including abortions and premature live births. Domoic acid has been shown to cross the placenta exposing the fetus to the toxin. To determine whether domoic acid was playing a role in reproductive failure in sea lion rookeries, 67 aborted and live-born premature pups were sampled on San Miguel Island in 2005 and 2006 to investigate the causes for reproductive failure. Analyses included domoic acid, contaminant and infectious disease testing, and histologic examination. Pseudo-nitzschia spp. were present both in the environment and in sea lion feces, and domoic acid was detected in the sea lion feces and in 17% of pup samples tested. Histopathologic findings included systemic and localized inflammation and bacterial infections of amniotic origin, placental abruption, and brain edema. The primary lesion in five animals with measurable domoic acid concentrations was brain edema, a common finding and, in some cases, the only lesion observed in aborted premature pups born to domoic acid-intoxicated females in rehabilitation. Blubber organochlorine concentrations were lower than those measured previously in premature sea lion pups collected in the 1970s. While the etiology of abortion and premature parturition was varied in this study, these results suggest that domoic acid contributes to reproductive failure on California sea lion rookeries.

Major determinants of survival and length of stay in the neonatal intensive care unit of newborns from women with premature preterm rupture of membranes.

Science.gov (United States)

Kurek Eken, Meryem; Tüten, Abdülhamit; Özkaya, Enis; Karatekin, Güner; Karateke, Ateş

2017-08-01

To assess the predictors of outcome in terms of length of stay in the neonatal intensive care unit (NICU) and survival of neonates from women with preterm premature rupture of membranes (PPROM). A population-based retrospective study including 331 singleton pregnant women with PPROM at 24-34 gestational weeks between January 2013 and December 2015 was conducted. Gestational age at delivery, birth weight, route of delivery, newborn gender, maternal age, oligohydramnios, premature retinopathy (ROP), necrotising enterocolitis (NEC), sepsis, fetal growth retardation (FGR), intracranial hemorrhagia (ICH), bronchopulmonary dysplasia (BPD), respiratory distress syndrome (RDS), primary pulmonary hypertension (PPH), congenital cardiac disease (CCD), patent ductus arteriosus (PDA), use of cortisol (betamethasone) and maternal complications including gestational diabetes, preeclampsia and chorioamnionitis were used to predict neonatal outcomes in terms of length of stay in the NICU and survival. In linear regression analyses, birth weight, ROP, CCD, BPD, PDA, NEC and preeclampsia were significant confounders for length of stay in the NICU. Among them, birth weight was the most powerful confounder for prolongation of the NICU stay (t: -6.43; p Prematurity-related complications are the most important problems for which precautions should be taken. Therefore, premature deliveries should be avoided to prevent infection and to prolong the latent period in cases of PPROM in order to decrease prematurity-related outcomes.

Mondia whitei (Periplocaceae prevents and Guibourtia tessmannii (Caesalpiniaceae facilitates fictive ejaculation in spinal male rats

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Watcho Pierre

2013-01-01

Full Text Available Abstract Background Mondia whitei and Guibourtia tessmannii are used in Cameroon traditional medicine as aphrodisiacs. The present study was undertaken to evaluate the pro-ejaculatory effects of the aqueous and organic solvent extracts of these plants in spinal male rats. Methods In spinal cord transected and urethane-anesthetized rats, two electrodes where inserted into the bulbospongiosus muscles and the ejaculatory motor pattern was recorded on a polygraph after urethral and penile stimulations, intravenous injection of saline (0.1 ml/100 g, dopamine (0.1 μM/kg, aqueous and organic solvent plant extracts (20 mg/kg. Results In all spinal rats, urethral and penile stimulations always induced the ejaculatory motor pattern. Aqueous or hexane extract of Mondia whitei (20 mg/kg prevented the expression of the ejaculatory motor pattern. The pro-ejaculatory effects of dopamine (0.1 μM/kg were not abolished in spinal rats pre-treated with Mondia whitei extracts. Aqueous and methanolic stem bark extracts of Guibourtia tessmannii (20 mg/kg induced fictive ejaculation characterized by rhythmic contractions of the bulbospongiosus muscles followed sometimes with expulsion of seminal plugs. In rats pre-treated with haloperidol (0.26 μM/kg, no ejaculatory motor pattern was recorded after intravenous injection of Guibourtia tessmannii extracts (20 mg/kg. Conclusion These results show that Mondia whitei possesses preventive effects on the expression of fictive ejaculation in spinal male rats, which is not mediated through dopaminergic pathway; on the contrary, the pro-ejaculatory activities of Guibourtia tessmannii require the integrity of dopaminergic system to exert its effects. The present findings further justify the ethno-medicinal claims of Mondia whitei and Guibourtia tessmannii.

The circadian variation of premature atrial contractions

DEFF Research Database (Denmark)

Larsen, Bjørn Strøier; Kumarathurai, Preman; Nielsen, Olav W

2016-01-01

AIMS: The aim of the study was to assess a possible circadian variation of premature atrial contractions (PACs) in a community-based population and to determine if the daily variation could be used to assess a more vulnerable period of PACs in predicting later incidence of atrial fibrillation (AF...... variation in heart rate. After adjusting for relevant risk factors, the risk of AF was equal in all time intervals throughout the day. CONCLUSION: Premature atrial contractions showed a circadian variation in subjects with frequent PACs. No specific time interval of the day was more predictive of AF than...

PREMATURE BIRTH AS A MEDICAL AND SOCIAL HEALTHCARE PROBLEM. PART 2

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E. S. Sakharova

2017-01-01

Full Text Available Morbidity and mortality, like a frequency of long-term unfavourable psychomotor developmental outcomes is in inverse relationship with gestational age and birth weight. Now scientists give attention to the risk factors — the infection, preeclampsia, smoking, etc., to look for prevention of premature birth. The outcome of premature baby depends on the birth weight; the methodof labor and the hospital technical support also have an influence. The frequency of neurological impairments — infantile cerebral palsy, visual and hearing disorders, and probability of severe bronchopulmonary dysplasia are also in inverse relationship with gestational age and birth weight. Last decade there are many scientists give attention to the cognitive deficit and behavior disorders in adolescents, born premature. Premature infants with extremely low birth weight have developmental disorders at 8-13%. Not all of cognitive and behavioral problems have symptoms in the first years of life, but have delayed unfavourable effects. The severity of cognitive deficit not always corresponds with structural impairments of brain, detected in functional studies of premature baby in the first year of life.  

Maternal experiences with premature children in a neonatal intensive care unit

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Raphael Colares de Sá

2012-06-01

Full Text Available Objective: Understand the maternal experience with premature children in neonatal intensive care unit. Methods: This is a qualitative and descriptive study. A questionnaire was used with semi-structured interview type, analyzed by the technique of content analysis and discussed, using the theoretical framework. The sample consisted of 11 mothers who accompanied their babies every day in the Neonatal Intensive Care Unit. Results: After discourse analysis emerged the following categories: experiencing maternal feelings in relation to the baby at risk; the meaning of the neonatal unit for mothers of premature infants, maternal perceptions about prematurity and experiencing the formation of the maternal-filial bond. Conclusions:The mother of premature experiences difficult times in the face of risk and instability of the baby, causing ambivalent feelings in relation to prematurity. Nevertheless, it was found thatfeelings of happiness, love and desire to see your baby being discharged form hospital and live with his family, were significant in relation to feelings of sadness and fear of losing her child.

Presentation of Aural Stimuli to Newborns and Premature Infants: An Audiological Perspective.

Science.gov (United States)

Cassidy

1999-01-01

The purpose of this study was twofold: (a) to examine extant research in the field of music with premature and full term infants in order to identify protocols being used in the presentation of musical stimuli to neonates and (b) to use knowledge gleaned from audiology as a basis for suggesting a standardized protocol for use of musical stimuli with infants. Articles considered appropriate for inclusion in the analysis met the following criteria: (a) presented data for the effects of music on a dependent measure, (b) had subjects who were identified as either premature or term newborns receiving treatment after birth and prior to discharge from the hospital, and (c) used music for some or all of the aural stimuli. Articles (N = 20) were categorized by demographic information, types of aural stimuli, independent variables, dependent measures, and protocol used to present the musical stimuli. Of primary importance to this study was the protocol used in each study to present musical stimuli. Data regarding total duration of stimuli per day, longest duration of stimuli per day, method of stimuli presentation, placement of speakers, decibel level of stimuli, and where;he decibel level was measured reveal that there is no standard protocol being followed with regard to the presentation of aural stimuli. Recommendations include future research on (a) determining a minimum gestational age where music therapy may be appropriate, (b) determining the frequency spectrum perceived by a premature infant, (c) determining the decibel levels reaching the ear drum and assessing appropriate levels for minimum stimulation with maximum results, and (d) carefully considering the method of stimulus presentation as it will have an impact on the decibel level reaching the ear drum of these infants.

Screening for retinopathy of prematurity and treatment outcome in a tertiary hospital in Hong Kong.

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Iu, L Pl; Lai, C Hy; Fan, M Cy; Wong, I Yh; Lai, J Sm

2017-02-01

Studies on the prevalence and severity of retinopathy of prematurity in the local population are scarce. This study aimed to evaluate the prevalence, screening, and treatment outcome of retinopathy of prematurity in a tertiary hospital in Hong Kong. This cross-sectional study with internal comparison was conducted at Queen Mary Hospital, Hong Kong. The study evaluated 89 premature infants who were born at the hospital and were screened for retinopathy of prematurity, in accordance with the 2008 British Guidelines, between January 2013 and December 2013. The prevalences of retinopathy of prematurity and severe retinopathy requiring treatment were studied. The mean (± standard deviation) gestational age at birth was 30 +2 weeks ± 16.5 days (range, 24 +1 to 35 +5 weeks). The mean birth weight was 1285 g ± 328 g (range, 580 g to 2030 g). A total of 15 (16.9%) infants developed retinopathy of prematurity and three (3.4%) required treatment. In a subgroup analysis of extremely-low-birth-weight infants of prematurity and 17.6% required treatment. Multivariate logistic regression analysis suggested low birth weight and patent ductus arteriosus were significantly associated with development of retinopathy of prematurity (Pprematurity, all regressed successfully after one laser treatment. Retinopathy of prematurity is a significant problem among premature infants in Hong Kong, especially those with extremely low birth weight. Our screening service for retinopathy of prematurity was satisfactory and treatment results were good. Strict adherence to international screening guidelines and vigilance in infants at risk are key to successful management of retinopathy of prematurity.

Mitochondrial dysfunction in alveolar and white matter developmental failure in premature infants.

Science.gov (United States)

Ten, Vadim S

2017-02-01

At birth, some organs in premature infants are not developed enough to meet challenges of the extra-uterine life. Although growth and maturation continues after premature birth, postnatal organ development may become sluggish or even arrested, leading to organ dysfunction. There is no clear mechanistic concept of this postnatal organ developmental failure in premature neonates. This review introduces a concept-forming hypothesis: Mitochondrial bioenergetic dysfunction is a fundamental mechanism of organs maturation failure in premature infants. Data collected in support of this hypothesis are relevant to two major diseases of prematurity: white matter injury and broncho-pulmonary dysplasia. In these diseases, totally different clinical manifestations are defined by the same biological process, developmental failure of the main functional units-alveoli in the lungs and axonal myelination in the brain. Although molecular pathways regulating alveolar and white matter maturation differ, proper bioenergetic support of growth and maturation remains critical biological requirement for any actively developing organ. Literature analysis suggests that successful postnatal pulmonary and white matter development highly depends on mitochondrial function which can be inhibited by sublethal postnatal stress. In premature infants, sublethal stress results mostly in organ maturation failure without excessive cellular demise.

Level of anxiety in parents of high-risk premature twins.

Science.gov (United States)

Zanardo, V; Freato, F; Cereda, C

1998-01-01

We attempted to define parental anxiety in a population of parents of high-risk premature twins (mean birth weight 1,493 +/- 227 kg; mean gestational age 33 +/- 3.5 weeks), admitted to III level NICU. We specifically examined the following factors; gestational age of the twins, whether or not the twins had ventilatory support, pulmonary sequelae, major malformations or intra-ventricular hemorrhage, parental gender and highest level of education obtained by the parent. In the immediate pre-discharge period and a month later, a questionnaire (State-Trait Anxiety Inventory) was given to all parents of premature twins presenting for the discharge. The parents of 30 twins entered the study twice, at the discharge of their first twin (mean postnatal age 40 +/- 32 days), and one month later. They included 15 mothers and 11 fathers, aged 33 +/- 5.5 and 33 +/- 4.2 years, and at the second evaluation 11 mothers and 10 fathers, respectively. As case-controls we examined parental anxiety of fifteen consecutive singleton high-risk prematures, with equal gestational age, discharged immediately after. Our results indicate that the parents of high-risk twin and singleton prematures present an elevated, lasting state-trait anxiety level. Pre- and post-discharge parental anxiety is more elevated (not significant) in twinning with respect to the prematurity alone. When assessed separately by parental gender, in both these groups an increased (not significant) anxiety was persistently found in the mothers. We recommend that, although neonatologists generally define the discharge of the high-risk premature based upon the acquired stabilization of vital parameters, they pay special attention to the twin group we have identified which is at increased risk for predischarge parental anxiety.

Sleep deprivation, pain and prematurity: a review study

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Kelly Cristina Santos de Carvalho Bonan

2015-02-01

Full Text Available The aim was to describe current reports in the scientific literature on sleep in the intensive care environment and sleep deprivation associated with painful experiences in premature infant. A systematic search was conducted for studies on sleep, pain, premature birth and care of the newborn. Web of Knowledge, MEDLINE, LILACS, Cochrane Library, PubMed, EMBASE, Scopus, VHL and SciELO databases were consulted. The association between sleep deprivation and pain generates effects that are observed in the brain and the behavioral and physiological activity of preterm infants. Polysomnography in intensive care units and pain management in neonates allow comparison with the first year of life and term infants. We have found few references and evidence that neonatal care programs can influence sleep development and reduce the negative impact of the environment. This evidence is discussed from the perspective of how hospital intervention can improve the development of premature infants.

Prematurity as a factor of damaged child development

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Chukhutova G.L.

2015-03-01

Full Text Available At present time prematurity is the main reason for disability in children, which can be exemplified by the fact that 2/3 of educatees of children' homes for blind and deaf are preterm children. The most drastic consequences of prematurity is cerebral palsy with spastic diplegia; blindness or poor vision as a result of retina detachment; auditory inefficiency connected with the nerve deafness, decline in general cognitive and speech development; difficulties in coordination and planning serial operations; psycho-emotional impairments like autism. The distinctive features of appearance (failure to thrive, microcephalism with deformation of the shape of the head and behavior (stereotyped movements, lack in initiative purposeful activity make these children recognizable and let us talk about naturally determined set of impairments connected with the main reason — prematurity. The article regards the influence of preterm birth on child's nervous system and it's remote effect on his/her psychic development.