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Sample records for velo-pharyngeal dysfunction evaluation

  1. Velo-pharyngeal dysfunction: Evaluation and management.

    Science.gov (United States)

    Marsh, Jeffrey L

    2009-10-01

    Separation of the nasal and oral cavities by dynamic closure of the velo-pharyngeal port is necessary for normal speech and swallowing. Velo-pharyngeal dysfunction (VPD) may either follow repair of a cleft palate or be independent of clefting. While the diagnosis of VPD is made by audiologic perceptual evaluation of speech, identification of the mechanism of the dysfunction requires instrumental visualization of the velo-pharyngeal port during specific speech tasks. Matching the specific intervention for management of VPD with the type of dysfunction, i.e. differential management for differential diagnosis, maximizes the result while minimizing the morbidity of the intervention.

  2. Velo-pharyngeal dysfunction: Evaluation and management

    Directory of Open Access Journals (Sweden)

    Marsh Jeffrey

    2009-10-01

    Full Text Available Separation of the nasal and oral cavities by dynamic closure of the velo-pharyngeal port is necessary for normal speech and swallowing. Velo-pharyngeal dysfunction (VPD may either follow repair of a cleft palate or be independent of clefting. While the diagnosis of VPD is made by audiologic perceptual evaluation of speech, identification of the mechanism of the dysfunction requires instrumental visualization of the velo-pharyngeal port during specific speech tasks. Matching the specific intervention for management of VPD with the type of dysfunction, i.e. differential management for differential diagnosis, maximizes the result while minimizing the morbidity of the intervention.

  3. Imaging for evaluation of erectile dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Hyup [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2001-03-15

    Penile erection is a complex phenomenon that includes coordinated intraaction of the nervous, arterial, venous, and sinusoidal systems. A defect in any of these systems may result in erectile dysfunction. Erectile dysfunction is defined as the consistent inability to generate or maintain an erection of sufficient rigidity for sexual intercourse. Although the introduction of sildenafil citrate made the information from imaging studies less critical in the management of the patients with erectile dysfunction, still the imaging studies such as Doppler US, penile arteriography, and cavemosonetry/cavemosography remain the major modalities in the evaluation of erectile dysfunction.

  4. Evaluation of Endothelial Dysfunction In Vivo.

    Science.gov (United States)

    Todiras, Mihail; Alenina, Natalia; Bader, Michael

    2017-01-01

    Vascular endothelial cells play a major role in maintaining cardiovascular homeostasis. Impairment of physiological properties of the endothelium, such as the promotion of vasodilation and anti-aggregation, leads to a condition called endothelial dysfunction. Endothelial dysfunction is an important early event in the pathogenesis of atherosclerosis and has been shown to have prognostic value in predicting vascular events including stroke and myocardial infarction.Endothelial-dependent vasodilation is one of the most widely used methods for assessment of endothelial function in rodents. It includes pharmacological stimulation (for example by acetylcholine) of endothelial release of NO and other vasoactive compounds in comparison with vascular response to endothelium-independent dilators such as sodium nitroprusside. However, usually this technique is performed in anesthetized animals. Here we describe a method which allows evaluation of endothelial dysfunction in conscious, freely moving mice and rats.

  5. PENILE DOPPLER IN THE EVALUATION OF ERECTILE DYSFUNCTION

    OpenAIRE

    Ajmal Shad; Ravichandra; Devdas; Vasu; De, Vivek

    2014-01-01

    Color doppler sonography can be useful in the evaluation of erectile dysfunction, which can result from psychogenic, endocrinologic, neurogenic, pharmacologic, and vasogenic causes. OBJECTIVE: To assess the role of Color doppler sonography in the evaluation of erectile dysfunction. MATERIAL AND METHODS: A cross-sectional study of twelve men with erectile dysfunction (between the age group of 45-60 years) underwent penile color doppler sonography. The hemodynamic function o...

  6. Automated Comprehensive Evaluation of mTBI Visual Dysfunction

    Science.gov (United States)

    2017-04-01

    AWARD NUMBER: W81XWH-15-2-0049 TITLE: Automated Comprehensive Evaluation of mTBI Visual Dysfunction PRINCIPAL INVESTIGATOR: LTC Jose E. Capo...Comprehensive Evaluation of mTBI Visual Dysfunction 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) LTC Jose E...order visual processing dysfunctions on a large population of Warfighters with acute mTBI as compared to healthy age-matched controls. This study also

  7. Evaluation of Helkimo anamnestic and dysfunction index in identical twins

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    Kučević Esad H.

    2016-01-01

    Full Text Available Introduction: In 1974 Marti Helkimo designed special questionnaires which were used for entering adequate contemporary data collected by medical history, analyzing the functions of the orofacial system and analyzing occlusion. Data were evaluated numerically with 0, 1 or 5, depending on the severity of the relevant findings and severity of clinical signs or symptoms of dysfunction. Objective: The aim of the research was to establish and evaluate specially designed Helkimos anamnestic and dysfunction index in monozygotic twins. Materials and Methods: A longitudinal prospective study was carried out on a randomized sample of 30 pairs of twins, 20 to 40 years old, and of both sexes. Dedicated design of the questionnaire made it possible to calculate the Helkimos anamnestic index (Ai, based on subjective feeling and positive or negative answers of subjects about the state of their masticatory apparatus. The clinical dysfunction index (Di represents objective functional analysis of structural and functional disorders of the orofacial complex, because it monitors multiple parameters. Kinematics of the lower jaw, conditions and limited function of the temporomandibular joints, the presence or absence of painful sensations during mandible movements during palpation of the joints and masticatory muscles, and the overall quantification of the incidence of craniomandibular dysfunction were all monitored and evaluated. The study was conducted in accordance with the local and international laws and ethical standards. Results: Medical records of 47 (78.3% twins did not present the signs and symptoms of craniomandibular dysfunction, i.e., Ai = 0. Twelve respondents were aware of the existence of mild signs of craniomandibular disorders (CMD. Acute and expressed craniomandibular disorder was identified in one of the twins Ai II 1 (1.7%. By evaluating and analyzing the results obtained using Helkimo analysis, positive dysfunction index (Di> 0, or certain signs

  8. Sexual dysfunction in infertile couples: evaluation and treatment of infertility.

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    Bayar, Ulku; Basaran, Mustafa; Atasoy, Nuray; Kokturk, Furuzan; Arikan, Ilker Inan; Barut, Aykut; Harma, Muge; Harma, Mehmet

    2014-02-01

    To evaluate the diagnostic and the predictive value of Arizona Sexual Experience Scale among primary infertile couples regarding sexual dysfunction. The cross-sectional and prospective pre, post study comprising primary infertile patients was carried out at Bulent Ecevit University Hospital, Zonguldak, Turkey. Fifty consecutive primary infertile couples not treated previously were investigated between 2003 and 2007 for the presence of sexual dysfunction by a psychiatrist. Arizona Sexual Experience Scale scoring was self-administered to determine sexual dysfunction among couples before treatment and also 3 months after the initiation of the treatment. Pretreatment mean values of the index parametres in both women and men were significantly increased after treatment. Statistically significant positive correlation was observed between pre- and post-treatment total scores in both women (r = 0.83; p treatment scores in women were were > 14 (Sensitivity: 57%; Specificity: 90%) and > 13 (Sensitivity: 83%; Specificity: 93%), respectively. Pre- and post-treatment scores in men were > 10 (Sensitivity: 65%; Specificity: 61%), > 11 (Sensitivity: 83%; Specificity: 62%), respectively. Binary logistic regression analyses revealed women's pre-treatment and post-treatment scores as a significant factor for prediction of sexual dysfunction independent of sociodemographic factors (p = 0.001 and p = 0.001, respectively). Evaluation and treatment of infertility is an important risk factor for sexual dyfunction. Pre- and posttreatment Arizona Sexual Experience Scale score could be used as a screening test for sexual dysfunction and might be used to decide pre/post-treatment consultation of couples with a specialist.

  9. Sexual Enhancement Groups for Dysfunctional Women: An Evaluation

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    Leiblum, Sandra R.; Ersner-Hershfield, Robin

    1977-01-01

    Three groups of women with sexual dysfunction were evaluated pretreatment and posttreatment. Two groups did not involve partner participation, while the third group included partners on two occasions. Results for all groups were similar. The question of whether orgasm through coitus alone is a reasonable goal is raised and challenged. (Author)

  10. Evaluation of erectile dysfunction among bicycle taxi (Boda boda ...

    African Journals Online (AJOL)

    Even stationary bikes can cause trauma to the blood supply to the penis, resulting in Erectile Dysfunction. Objective: To evaluate the effects of long term bicycle riding on erectile function among bicycle taxi (bodaboda) riders in Bungoma town. Design: A cross-sectional comparative study. Setting: Bungoma County, Kenya.

  11. Somatosensory evaluation in Dysfunctional Syndrome patients.

    Science.gov (United States)

    Hilgenberg-Sydney, P B; Kowacs, P A; Conti, P C R

    2016-02-01

    Many chronic pain patients are refractory to treatment, which leads to the suspicion that somehow they are not fully effective and probably some mechanism of pain generation and/or maintenance is still unknown. The aim of this cross-sectional study was to provide evidence-based data on pain mechanisms in different types of chronic pain conditions. Eighty women, with 18-65 years old, were included, divided into four groups: myofascial pain of the masticatory muscles (n = 20), fibromyalgia (n = 20), chronic daily headache and healthy volunteers (n = 20). All patients were submitted to quantitative sensory tests: pressure pain threshold, mechanical detection threshold, mechanical pain threshold, ischaemic pain tolerance, cold pain sensitivity, aftersensation, wind-up ratio and conditioned pain modulation. Current perception threshold was also determined (Neurometer CPT/C - Neurotron). Three different zones were evaluated: trigeminal (masseter muscle), cervical and extratrigeminal (thenar eminence). Data were recorded and subjected to statistical analysis (anova, Tukey and Student's t-tests). Masticatory myofascial pain, fibromyalgia and chronic daily headache individuals presented lower pressure pain thresholds than healthy volunteers (P = 0.00). Chronic daily headache individuals had a significantly higher mechanical detection threshold than healthy volunteers (P = 0.01). Individuals of the symptomatic groups showed lower values for mechanical pain threshold and for ischaemic pain tolerance (P = 0.00) than healthy volunteers. The ability to activate the mechanism of endogenous modulation is impaired in women with fibromyalgia and myofascial pain (P = 0.00). These results reinforce evidence of central sensitisation and impaired endogenous modulation system in individuals with myofascial pain, fibromyalgia and chronic daily headache. © 2015 John Wiley & Sons Ltd.

  12. Thyroid dysfunction during pregnancy and evaluation of its results

    OpenAIRE

    Bostancı, Mehmet Sühha; Taşkesen, Fatih

    2011-01-01

    S Objectives: In this study, we aim to evaluate obstetric outcomes of the women with thyroid dysfunction than the normal pregnant women. Materials and methods: In our study, 633 women between the ages of 18 to 35 who admitted to Kovancılar State Hospital Obstetrics and Gynecology Clinic for pregnancy follow-up between January 2010 and January 2011 were evaluated. Serum thyroid - stimulating hormones (TSH), free tri-iyodotironin (T3), free thyroxine (T4) levels for all patients were stud...

  13. Thyroid dysfunction during pregnancy and evaluation of its results

    OpenAIRE

    Fatih Taşkesen; Mehmet Sühha Bostancı

    2011-01-01

    In this study, we aim to evaluate obstetric outcomes of the women with thyroid dysfunction than the normal pregnant women.Materials and methos: In our study, 633 women between the ages of 18 to 35 who admitted to Kovancılar State Hospital Obstetrics and Gynecology Clinic for pregnancy follow-up between January 2010 and January 2011 were evaluated. Serum thyroid - stimulating hormones (TSH), free tri-iyodotironin (T3), free thyroxine (T4) levels for all patients were studied. Antithyroidal per...

  14. Current and future standards in evaluation of erectile dysfunction

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    Raymond W Pak

    2006-01-01

    Full Text Available Sexual dysfunction and more specifically erectile dysfunction (ED can be a harbinger of serious occult medical conditions. ED can be considered a clinical manifestation of generalized vascular disease and therefore shares similar risk factors: aging, hypertension, diabetes mellitus, hypercholesterolemia and smoking. The initial evaluation of men with ED should be thorough. Studies of normal and abnormal penile tumescence have led to the discovery of many important pathways. The greatest medical advance in the management of male sexual dysfunction since the identification of androgens have been the discoveries that nitric oxide (NO is the primary neuro-modulator of penile smooth muscle relaxation and that oral phosphodiesterase type 5 inhibitors enhance erection quality through the NO mechanism. As a consequence of oral pharmacotherapies, the role of invasive diagnostics has diminished. Most guidelines recommend only history, physical exam and limited laboratory testing prior to instituting oral therapies for ED. In 2006 we still have unanswered questions about ED and these will frame the role of future diagnosis and therapy: can lifestyle changes alone improve erectile function; is ED a marker for the development of atherosclerotic heart disease, do lower urinary tract symptoms of benign prostatic hypertrophy and ED share a common pathway?

  15. Thyroid dysfunction during pregnancy and evaluation of its results

    Directory of Open Access Journals (Sweden)

    Fatih Taşkesen

    2011-06-01

    Full Text Available In this study, we aim to evaluate obstetric outcomes of the women with thyroid dysfunction than the normal pregnant women.Materials and methos: In our study, 633 women between the ages of 18 to 35 who admitted to Kovancılar State Hospital Obstetrics and Gynecology Clinic for pregnancy follow-up between January 2010 and January 2011 were evaluated. Serum thyroid - stimulating hormones (TSH, free tri-iyodotironin (T3, free thyroxine (T4 levels for all patients were studied. Antithyroidal peroxidase (anti-TPO and Anti-thyroglobulin (anti-Tg parameters were measured if they were necessary. The relationship between thyroid functions and complications such as eclampsia, preeclampsia, maternal anemia, postpartum hemorrhage, fetal anomalies, shoulder dystocia, neonatal hypoglycemia was examined.Results: Hypothyroidism was found 18 of cases and hyperthyroidism was found 4 of them. The mean age of patients in the study was 26.42 (± 8.42. The mean values were 1.86 ± 0.19 μIU/mL for TSH, 1.15 ± 0.29 ng/mL for free T4 and 2.90 ± 0.31 pg/mL for free T3 respectively. Hashimoto’s thyroiditis (9 cases, 50 % was the most frequent etiology for patients with hypothyroidism. Other etiologic factors for hypothyroidism were found to be for 4 cases as (22.2%, iatrogenic (previously undergone thyroidectomy and 5 cases as (37.8% a lack of iodine. Maternal anemia was observed in 5 (27.78% cases with hypothyroidism. Preeclampsia was observed 16.67% in patients with hypothyroidism.Conclusion: Observed thyroid dysfunction in pregnant women may cause serious maternal and fetal complications. For disorders of thyroid function during pregnancy, to provide the necessary treatment at the appropriate time is important to prevent complications of mother and fetus. J Clin Exp Invest 2011;2(2:196-201

  16. Infrared thermography in the evaluation of meibomian gland dysfunction.

    Science.gov (United States)

    Su, Tai-Yuan; Ho, Wei-Ting; Chiang, Shu-Chiung; Lu, Chien-Yi; Chiang, Huihua Kenny; Chang, Shu-Wen

    2017-07-01

    To evaluate meibomian gland dysfunction (MGD) by infrared thermography. An observational study was conducted at the Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan. Participants included 89 MGD patients (30 in Grade 1, 49 in Grade 2, and 10 in Grade 3) and 65 controls. The close-eye thermographic images of the eyelid were obtained noninvasively by infrared thermography. Temperatures at 8 regions of interest (ROIs) of the eyelid margin and a reference temperature at the center of the upper eyelid were measured. The temperature ratio was defined as the temperature of ROI divided by the reference temperature. Eyelid margin temperature measured by infrared thermography increased from temporal side (ROI 1) to the nasal side (ROI 8) of the eye in both MGD patients and control groups. The temperature ratios were significantly higher in MGD participants than in controls, especially at ROI 8. The eyelid margin temperature measured by infrared thermography was higher in MGD participants. Further development of this infrared thermography system may become a rapid and non-invasive tool for MGD screening. Copyright © 2016. Published by Elsevier B.V.

  17. Evaluation and treatment of vestibular dysfunction in children.

    Science.gov (United States)

    Rine, Rose Marie; Wiener-Vacher, Sylvette

    2013-01-01

    The effect of vestibular dysfunction since birth is more debilitating than that attained later in life, and unlike adults, children with vestibular dysfunction since or shortly after birth do not recover function without intervention. The purpose of this report is to provide an overview of the etiology of vestibular dysfunction in children as well as the related impairments, and to describe testing methods and evidence based interventions to ameliorate the vestibular related impairments in children. In recent years, investigations have revealed that vestibular dysfunction is more common in children than previously thought, with consequent impairments in motor development, balance and reading abilities. The dysfunction may be due to central or peripheral lesions, each with distinct presentation of symptoms and test results. Common etiologies and clinical presentation of vestibular dysfunction in children are reviewed; appropriate screening and diagnostic techniques and efficacious medical and rehabilitation interventions are presented. Despite advances in clinical and diagnostic testing of vestibular function in children and infants, testing of vestibular function is not typically done. Comprehensive testing of signs and symptoms is critical for diagnosis and implementation of appropriate interventions.

  18. Therapeutic Evaluation of Cervical Dysfunction in Patients with Myofascial Pain Dysfunction Syndrome: A Prospective Study.

    Science.gov (United States)

    Jagdhari, B Smriti; Mukta, Motwani; Saket, A Golhar; Golhar, Anil V

    2017-07-01

    The aim of this study was to find out the therapeutic correlation between cervical dysfunction and myofascial pain dysfunction syndrome (MPDS). The study included 46 patients out of which 23 had MPDS with cervical pain (group I), and 23 patients had only MPDS (group II). Detailed history and examination of the patients were carried out, and the factors taken into consideration were pain and tenderness of muscles of mastication and neck muscles, maximum comfortable mouth opening, and cervical range of motion. All the patients were randomly divided and advised physical exercises, light amplification by stimulated emission of radiation (LASER) therapy, and the combination of both exercise and LASER. Patients were assessed for the relief of signs and symptoms of myofascial pain and cervical pain posttreatment, every month for 2 months. Both the groups showed a similar response to all the different treatment modalities. In group I, the patients also had relief in their cervical pain although the treatment was directed for MPDS. Patients from both the groups who were advised LASER and combination of both exercise and LASER showed better response in terms of reduction in visual analog scale, number of tender muscles, and increased maximum comfortable mouth opening posttreatment and during the follow-up, as compared with the patients who were advised only exercise. Patients having cervical pain showed significant improvement comparable with patients having no cervical pain. Hence, the conclusion drawn was that there is a positive interrelationship between MPDS and cervical (neck) pain; MPDS may act as a catalyst for precipitating cervical pain. Cervical pain showed significant improvement to physiotherapy in the form of exercise, LASER, and combination treatment, though the effective modality was LASER and combination of exercise and LASER therapy.

  19. Automated Comprehensive Evaluation of mTBI Visual Dysfunction

    Science.gov (United States)

    2016-10-01

    primarily because of the lack of objective assessment tools, overlap of symptoms in co- morbid conditions such as post-traumatic stress disorder...studies have identified oculomotor dysfunctions (OMDs) (i.e., version, vergence , and accommodation) to be the most common visual deficits associated

  20. Dynamic and morphologic evaluation of erectile dysfunction on ...

    African Journals Online (AJOL)

    Background: Penile erection is a complex phenomenon that involves coordinated interaction of the psychologic, hormonal, nervous, arterial, venous, and sinusoidal systems. Erectile dysfunction (ED) is the persistent inability to attain or maintain penile erection sufficient for sexual intercourse. This study aims to determine ...

  1. [EVALUATION OF DYSFUNCTION IN BLOOD COAGULATION IN CHILDREN WITH URTICARIA].

    Science.gov (United States)

    Nishimura, Koji; Kuzume, Kazuyo; Kagata, Yuki

    2016-03-01

    Recently, an association between coagulation dysfunction and the pathology of urticaria has been reported, but research in children is scarce. We measured levels of prothrombin fragments 1+2 (PTF1+2), fibrin degradation product (FDP), D-dimer, and mean platelet volume (MPV) in 32 children with urticaria. The study cohort comprised 18 cases of chronic and active urticaria, 7 cases of chronic and inactive urticaria, and 7 cases of acute urticaria. PTF1+2 levels in the chronic and active urticaria group were higher than those in the chronic and inactive urticaria group (purticaria group were higher than those in the chronic and inactive group (purticaria.

  2. A Classification System for Urodynamic Evaluation of Lower Urinary Tract System Dysfunction.

    Science.gov (United States)

    Athanasopoulos, Anastasios

    2017-04-14

    A classification system for lower urinary tract system (LUTS) dysfunction, based on urodynamics, could support the evaluation and management of this pathological condition. A new alphanumerical classification system is proposed for staging neurogenic and non-neurogenic LUTS dysfunction, according to the urodynamic evaluation. This is a proposal based on experience from everyday clinical practice and represents an opinion open to discussion. The purpose of this alphanumerical classification is the establishment of a simple, unified staging system describing all LUTS dysfunction situations, after a urodynamic evaluation, in a way that can help in diagnosis, treatment, health professionals' communication, education, and research. This alphanumerical classification for LUTS dysfunction could become a unified standard and a prerequisite for ensuring the quality of care in all resource settings. Moreover, it would be useful for the future to include a classification as part of LUTS dysfunction registration. A new alphanumerical classification system is presented. The purpose of this classification is the establishment of a simple, unified staging system describing entire lower urinary tract system dysfunction situations in a way that could help in diagnosis, treatment, health professionals' communication, education, and research. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

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

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    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.

  4. Improvement of quality of speech in patients with velo-pharyngeal insufficiency corrected using a buccinator myomucosal flap.

    Science.gov (United States)

    Dias, D K; Fernando, P D; Dissanayake, R D

    2016-01-01

    Oro-facial clefts involving the palate is the commonest structural defect causing velopharyngeal insufficiency (VPI) and poor intelli gibility of speech. Proper repair of the soft palateis a surgical challenge. Posterior-based buccinator myomucosal flap (BMF) is used to lengthen the soft palate of patients who undergo primary palatoplasty at Teaching Hospital, Karapitiya (THK). BMF is a good choice for the repair of medium sized mucosal defects in the oral cavity since it has appropriate thickness, contains mucous membrane with mucous glands and has a rich blood supply. Objectives To assess improvement in quality of speech after soft palate repair using BMF in patients with previously corrected cleft pate. Thirty four patients (M:F-1:1) who had undergone palatal lengthening using BMF procedure for correction of VPI for speech improvement at Teaching Hospital, Karapitiya from 2010 to 2012, were assessed before and one year after surgery for quality of speech. All patients below 8 years showed significant reduction of hypernasality (p<0.05), whereas only 60% of patients above 8 years showed reduction after the surgery. All patients showed reduction in nasal air emission and in consonant production error at least by one consonant. The group below 8 years showed more improvement in speech quality after surgery. Palatal lengthening using BMF procedure is a good treatment option for correction of VPI.

  5. TO STUDY AND EVALUATE DIASTOLIC DYSFUNCTION IN PATIENTS OF ALCOHOLIC AND NON-ALCOHOLIC CIRRHOSIS

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    Gaurav Sudhir

    2016-04-01

    Full Text Available BACKGROUND Cardiovascular dysfunction is the major component of morbidity in patients of liver cirrhosis and a cardinal prognostic indicator in patients undergoing liver transplantation. The constellation of hyperdynamic circulation, peripheral vasodilation and volume overload alters the systolic and diastolic dysfunction leading to cirrhotic cardiomyopathy (CCM. In this study, we evaluated and compared the diastolic dysfunction among alcoholic and non-alcoholic cirrhotic patients. AIMS 1 To Study the Prevalence of Diastolic Dysfunction in Alcoholic & Non-Alcoholic Cirrhotics and Controls. 2 To Compare the Diastolic functional status between alcoholic and non-alcoholic cirrhosis patients. MATERIALS AND METHODS A cross-sectional case control study was conducted in 100 male cirrhotic patients consisting of alcoholic and non-alcoholic cirrhotic subjects with age matched 50 controls in Pt. JNM Medical College & Dr. BRAM Hospital, Raipur. Left ventricular diastolic dysfunction was assessed using echocardiographic parameters. STATISTICAL ANALYSIS The range, median, standard deviation and statistical significance were calculated. Most of the data is analysed by Student Ttest, Mann Whitney U test, while the data with frequency distribution is analysed by Fisher’s exact. With p value 1. CONCLUSION Our study showed that patients with alcoholic and non-alcoholic cirrhosis have higher occurrence of DD (49% and 46% respectively than controls owing to alterations in the myocardial contractile and relaxation function. It also shows that although DD is a frequent event in cirrhosis, it is usually of mild degree and does not correlate with severity of liver dysfunction. There were no significant differences in diastolic parameters between alcoholic and non-alcoholic cirrhosis concluding that alcohol likely plays a non-significant role in cardiovascular dysfunction in cirrhotics.

  6. Nuclear medicine imaging technique in the erectile dysfunction evaluation: a mini-review

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, Camila Godinho; Moura, Regina; Neves, Rosane de Figueiredo [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes. Lab. de Radiofarmacia Experimental]. E-mail: cacagr@yahoo.com.br; Spinosa, Jean Pierre [Hopital de Zone, Morges (Switzerland). Dept. of Gynecology and Obstetrics; Bernardo-Filho, Mario [Instituto Nacional do Cancer, Rio de Janeiro, RJ (Brazil). Coordenadoria de Pesquisa

    2007-09-15

    Functional imaging with positron emission tomography and single photon emission computed tomography is capable of visualizing subtle changes in physiological function in vivo. Erectile dysfunction (ED) diminishes quality of life for affected men and their partners. Identification of neural substrates may provide information regarding the pathophysiology of types of sexual dysfunction originating in the brain. The aim of this work is to verify the approaches of the nuclear medicine techniques in the evaluation of the erectile function/dysfunction. A search using the words ED and nuclear medicine, ED and scintigraphy, ED and SPECT and ED and PET was done in the PubMed. The number of citations in each subject was determined. Neuroimaging techniques offer insight into brain regions involved in sexual arousal and inhibition. To tackle problems such as hyposexual disorders or ED caused by brain disorders, it is crucial to understand how the human brain controls sexual arousal and penile erection. (author)

  7. Evaluation of relationship between metacognition components and dysfunctional attitudes in outpatients with bipolar mood disorder II

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    H Kazemi

    2012-05-01

    Full Text Available Introduction: The aim of this study was to evaluate the relationship between metacognitive components and dysfunctional attitudes in outpatients with bipolar mood disorder II. Methods: Thirty-six young adult outpatients with current diagnoses of BMD II(20 females and 16 males were recruited from Esfahan Counseling Center. Diagnoses were based on the Structured Clinical Interview for DSM-IV Axis I Disorder-Clinical Version(SCID-CV. A battery of questionnaires including Metacognition Questionnaire and Dysfunctional Attitude Scale(DAS were self-assessed by patients before medical therapy. Results: Pearson's correlation analysis showed that the components of metacognition and its relationship with dysfunctional attitudes is positive and significant(r= 28/0, p<0/05. Multiple regression analysis showed that two of the metacognitive components emerged as potentially useful in prediction of dysfunctional attitudes(negative beliefs about uncontrollability, danger and thoughts control. Also, results indicated that those two components have a significant positive relationship with vulnerability, perfectionism and effectivenessR²= 0/29, 0/35; p<0/05. Components of positive beliefs about worry and beliefs about cognitive self-consciousness related to cognitive confidence in predicting the criterion variable and its components showed no significant contribution. Conclusion: Study findings suggest that DSM-IV BMD II outpatients with metacognitive distortions have shown higher levels of dysfunctional attitudes.

  8. Labelling, molecular modelling and biological evaluation of vardenafil: a potential agent for diagnostic evaluation of erectile dysfunction.

    Science.gov (United States)

    El-Kawy, O A; García-Horsman, J A; Tuominen, R K

    2016-12-01

    99mTc-tricarbonyl-vardenafil was specifically radiosynthesized for diagnostic evaluation of erectile dysfunction with a radiochemical yield ~97.2%. It was stable in saline up to 15h and in serum for more than 6h. The radiocomplex was lipophilic with a partition coefficient ~1.32 and plasma protein binding 72-76%. Its structure was determined using molecular mechanics and confirmed by NMR. In-silico docking to its target PDE5 enzyme was performed. The radiocomplex inhibitory activity was assessed and its IC50 was 0.7nM. Biodistribution in normal rats and biological evaluation in rat models of erectile dysfunction were performed. The results strongly suggested that 99mTc-tricarbonyl-vardenafil is a good candidate to image erectile dysfunction in humans. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Effects of olfactory dysfunction on sensory evaluation and preparation of foods.

    Science.gov (United States)

    Seo, Han-Seok; Hummel, Thomas

    2009-12-01

    Aim of this study was to investigate the impact of olfactory dysfunction on behavior during sensory evaluation and self-preparation, as well as on sensory perception and pleasantness of green tea and coffee. We compared the intensities of overall odor, flavor, and bitter taste, respectively, and the pleasantness ratings for three different concentrations of green teas and coffees between three groups: young (n=30) and elderly (n=30) with normal olfactory function and elderly (n=30) with olfactory dysfunction. In addition, we compared the subject groups' behavior during sensory testing and preparation of green tea or coffee. As expected, elderly subjects with olfactory dysfunction rated the overall odor intensity less intense than subjects with normal olfactory function. Also, elderly subjects with olfactory dysfunction rated the intensities of overall flavor and bitter taste significantly lower rather than subjects with normal olfactory function in green tea, whereas this result was not obtained in coffee. Compared to young subjects with normal olfactory function, elderly with olfactory dysfunction used more green tea powder to optimize their own green tea. Moreover, olfactory function scores assessed by the "Sniffin' Sticks" test were positively related with sniffing frequency for green tea and with sniffing time for coffee during sensory evaluation. During preparation of the green tea, compared to elderly subjects, young healthy subjects tried to adjust the green tea more frequently by adding green tea powder or water. Such behavioral differences were not present during coffee preparation. In conclusion, our findings demonstrate that olfactory dysfunction affects odor perception and sniffing behavior. However, under the current conditions, it appeared to have no effect on hedonic ratings and self-preparation behaviors.

  10. Guidelines for the evaluation and treatment of muscle dysfunction in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Barreiro, Esther; Bustamante, Víctor; Cejudo, Pilar; Gáldiz, Juan B; Gea, Joaquim; de Lucas, Pilar; Martínez-Llorens, Juana; Ortega, Francisco; Puente-Maestu, Luis; Roca, Josep; Rodríguez-González Moro, José Miguel

    2015-08-01

    In patients with chronic obstructive pulmonary disease (COPD), skeletal muscle dysfunction is a major comorbidity that negatively impacts their exercise capacity and quality of life. In the current guidelines, the most recent literature on the various aspects of COPD muscle dysfunction has been included. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) scale has been used to make evidence-based recommendations on the different features. Compared to a control population, one third of COPD patients exhibited a 25% decline in quadriceps muscle strength, even at early stages of their disease. Although both respiratory and limb muscles are altered, the latter are usually more severely affected. Numerous factors and biological mechanisms are involved in the etiology of COPD muscle dysfunction. Several tests are proposed in order to diagnose and evaluate the degree of muscle dysfunction of both respiratory and limb muscles (peripheral), as well as to identify the patients' exercise capacity (six-minute walking test and cycloergometry). Currently available therapeutic strategies including the different training modalities and pharmacological and nutritional support are also described. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  11. Evaluation of sexual dysfunction in female patients presenting with faecal incontinence or defecation disorder.

    Science.gov (United States)

    Pellino, Gianluca; Ramage, Lisa; Simillis, Constantinos; Warren, Oliver; Kontovounisios, Christos; Tan, Emile; Tekkis, Paris

    2017-05-01

    Female patients with pelvic floor diseases may suffer from several sexual disorders and sexual life impairments. The aim of this manuscript was to evaluate sexual dysfunction in female patients presenting with faecal incontinence (FI) and defecation disorder (DD). A retrospective review was performed of a prospectively collected database of sexually active women referred to the pelvic floor clinic, who completed the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-12 (PISQ-12) at first visit. Statistical analysis was performed to evaluate and compare sexual dysfunction between patients with FI and DD and with published data on the general population. Regression analysis was used to identify predictors of sexual dysfunction and surgery. Three hundred thirteen patients were included, 192 (61%) with FI and 121 (39%) with DD. The patients with DD received more non-gynaecological surgical procedures (p = 0.023). More patients with DD received surgery for their current pelvic floor disease (p orgasm perception (item 13, OR = 2.1) were the strongest predictors of worse sexual function in patients with FI. Patients with DD were almost 15 times more likely to receive subsequent surgery (OR = 14.6, p < 0.001), whereas fear of urine leakage almost doubled the risk. Sexual dysfunction is prevalent among patients suffering from FI and DD, and questionnaires are useful in recognizing these patients. Subsequent surgery is more common for patients with DD compared to those with FI.

  12. Osteopathic evaluation of somatic dysfunction and craniosacral strain pattern among preterm and term newborns.

    Science.gov (United States)

    Pizzolorusso, Gianfranco; Cerritelli, Francesco; D'Orazio, Marianna; Cozzolino, Vincenzo; Turi, Patrizia; Renzetti, Cinzia; Barlafante, Gina; D'Incecco, Carmine

    2013-06-01

    Palpatory skills are a central part of osteopathic manipulative treatment and palpatory diagnosis. The aim of osteopathic structural examination is to locate somatic dysfunction and cranial strain pattern, which are the hallmarks that form the basis for treatment decisions and strategy. In the osteopathic literature, there is a lack of studies evaluating preterm or term newborns during hospitalization. To determine the prevalence of somatic dysfunction and cranial strain pattern in a population of preterm and term newborns who were treated in a neonatal intensive care unit (NICU). During a period of 6 months--November 2009 through April 2010--the authors performed a retrospective review of data on consecutive preterm and term newborns who were admitted to the NICU of the Spirito Santo Public Hospital. Osteo pathic evaluation was performed once on each newborn, and somatic dysfunction and cranial strain pattern were identified. Descriptive analysis and test of association based on the χ(2) test were performed. One hundred fifty-five preterm and term newborns met the study's eligibility criteria. The highest rate of somatic dysfunction was found in the pelvic area of 63 newborns (40.7%). The sacroiliac joints were compressed unilaterally or bilaterally in 82 newborns (52.9%); the lumbosacral junction was restricted in 61 newborns (39.4%), and intraosseous lesions of the sacral bone were diagnosed in 57 newborns (36.8%). The spine accounted for somatic dysfunction in 38 newborns (24.5%), with the middle thoracic and lower thoracic areas restricted in 29 (18.7%) and 21 (16.8%) newborns, respectively. Sphenobasilar synchondrosis compression and lateral-vertical strain were diagnosed in 57 newborns (36.8%), with the sagittal and the coronal sutures found restricted in 35 (22.6%) and 30 (19.4%) newborns, respectively. The occipital bone presented the highest rate of intraosseous lesions, with the left condyle compressed in 48 newborns (31%), the right condyle in 46

  13. Efficacy of ultrasonography-guided renal biopsy for the evaluation of renal dysfunction following renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Jae; Choi, Chul Soon; Min, Seon Jeong; Lee, Gyung Kyu; Lee, Eil Seong; Kang, Ik Won; Bae, Sang Hoon [Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2003-12-15

    To evaluate the usefulness and complications of renal biopsy under ultrasonography-guidance in renal dysfunction after renal transplantation. Ultrasonography-guided renal biopsy was done in 47 patients with the transplanted kidney. The subjects consisted of 30 males and 17 females, age ranged from 16 to 66 years (average age=38 years). Biopsies were done once in 27 patients, twice in 17 patients, three times in 3 patients, a total of 70 biopsies. The success rate of renal biopsy for the accurate pathologic diagnosis and the incidence and types of complications following biopsy were evaluated. The success rate of renal biopsy for the accurate pathologic diagnosis was 96%(67/70). Pathologic diagnosis included 27 cases of acute rejection (39%), 8 cases of acute tubular necrosis (11%), 4 cases of acute rejection and acute tubular necrosis (6%), 4 cases of cyclosporin toxicity (6%), 4 cases of primary disease recurrence (6%), 4 cases of infection (6%) and others. Complications after renal biopsy included 15 cases of microscopic hematuria (21%), 1 case of gross hematuria with spontaneous cessation and 1 case of life threatening hemorrhage. Ultrasonography-guided renal biopsy is a safe and effective diagnostic method for the evaluation of renal dysfunction following renal transplantation.

  14. Value of MRI olfactory bulb evaluation in the assessment of olfactory dysfunction in Bardet-Biedl syndrome.

    Science.gov (United States)

    Braun, J J; Noblet, V; Kremer, S; Molière, S; Dollfus, H; Marion, V; Goetz, N; Muller, J; Riehm, S

    2016-07-01

    Olfactory bulb (OB) volume evaluation by magnetic resonance imaging (MRI) has been demonstrated to be related to olfactory dysfunction in many different diseases. Olfactory dysfunction is often overlooked in Bardet-Biedl syndrome (BBS) patients and is rarely objectively evaluated by MRI. We present a series of 20 BBS patients with olfactory dysfunction. The OB was evaluated separately and blindly by two radiologists (SR and SM) with 3 Tesla MRI imaging comparatively to 12 normal control subjects by global visual evaluation and by quantitative measurement of OB volume. In the 12 control cases OB visual evaluation was considered as normal in all cases for radiologist (SR) and in 10 cases for radiologist (SM). In the 20 BBS patients, OB visual evaluation was considered as abnormal in 18 cases for SR and in all cases for SM. OB volumetric evaluation for SR and SM in BBS patients was able to provide significant correlation between BBS and olfactory dysfunction. This study indicates that OB volume evaluation by MRI imaging like structural MRI scan for gray matter modifications demonstrates that olfactory dysfunction in BBS patients is a constant and cardinal symptom integrated in a genetical syndrome with peripheral and central olfactory structure alterations. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Venous or arterial endothelium evaluation for early cardiovascular dysfunction in hypertensive patients?

    Science.gov (United States)

    Rubira, Marcelo Custódio; Consolim-Colombo, Fernanda Marciano; Rabelo, Eneida Rejane; Yugar-Toledo, Juan Carlos; Casarini, Dulce; Coimbra, Silmara Regina; Martins, Luis Cláudio; Moreno, Heitor; Krieger, Eduardo Moacir; Irigoyen, Maria Claúdia

    2007-11-01

    Veins and arteries have active endothelium, producing vasoactive substances like nitric oxide. The aim of this study was to evaluate whether hypertensive patients exhibit venous endothelial dysfunction and to determine the relationship between endothelial-dependent and endothelial-independent vasodilation responses in venous and arterial systems. Sixteen unmedicated patients with stage I and II hypertension and without other risk factors and 15 matched normotensive volunteers had venous and arterial endothelial function evaluated with the dorsal hand vein technique and brachial artery ultrasonography. Hypertensive patients had a marked reduction of maximum dilation to acetylcholine (54.9% +/- 21.6%) compared with normotensive controls (85.2% +/- 27.0%). The flow-mediated dilation responses were reduced in hypertensive patients compared with controls (6.6% +/- 3.3%vs 12.4% +/- 2.6%, respectively). The responses to nitric oxide were similar in both groups, and the responses with the dorsal hand vein technique and flow-mediated dilation agreed in both groups. Hypertensive patients had an attenuated endothelial dependent response, indicating that endothelial dysfunction is also present in the venous system.

  16. Evaluation the effect of low-dose aspirin on endothelial dysfunction in preeclamptic patients

    Directory of Open Access Journals (Sweden)

    Mohammad Hashemi

    2016-01-01

    Full Text Available Background: Preeclampsia complicates up to 3% of pregnancies in developing countries. Endothelial dysfunction plays an important role in pathogenesis of preeclampsia. In this study, we aim to evaluate the effect of low-dose aspirin on endothelial dysfunction in preeclamptic patients. Materials and Methods: in this triple-blind randomized clinical trial, enrolled patients were divided randomly into two groups. Acetylsalicylic acid (ASA 80 mg or placebo will be taken daily by oral administration from the initiation of diagnosis until 2 months after delivery. Every patient's flow-mediated dilation (FMD were evaluated at the beginning of study and 2 months after delivery with the same experienced operator at a same period of the time (3–5 pm by high-resolution B-mode ultrasonographic. T-test or Mann–Whitney test was used in the comparison of means between the intervention and placebo groups. To compare FMD in each group, before and after the intervention, paired t-test was used. Results: Mean value of FMD in intervention (9.61 ± 5.58 and control group (9.40 ± 4.33 have no significant differences before drug consumption (P = 0.089. FMD in intervention group significantly increased after ASA consumption ([9.61 ± 5.58 vs. 13.65 ± 7.91] [P = 0.044]. Conclusion: Increase mean of FMD in intervention group shows that this supplement can improve endothelial function.

  17. Scintigraphy evaluation of the types of functional constipation in children with bowel bladder dysfunction.

    Science.gov (United States)

    Zivkovic, Vesna D; Lazovic, Milica; Stankovic, Ivona; Dimitrijevic, Lidija; Kocic, Mirjana; Vlajkovic, Marina; Stevic, Milos; Slavkovic, Andjelka; Djordjevic, Ivona; Hrkovic, Marija

    2014-12-01

    To evaluate the types of constipation according to colonic transit time in chronically constipated children with dysfunctional voiding (bowel bladder dysfunction, BBD group) and to compare the results with transit type in children with chronic functional constipation without urinary symptoms (constipation group) and children with normal bowel habits, but with lower urinary tract symptoms (control group). One-hundred and one children were included and their medical histories were obtained. The BBD group kept a voiding diary, and underwent urinalyses and urine culture, ultrasound examination of bladder and kidneys and uroflowmetry with pelvic floor electromyography. Radionuclear transit scintigraphy was performed in all children according to a standardized protocol. Patients were categorized as having either slow-transit (ST), functional fecal retention (FFR) or normal transit. FFR was diagnosed in 31 out of 38 children with BBD, and 34 out of 43 children in the constipation group. ST was found in seven children with BBD, compared with nine children in the constipation group. The control group children demonstrated normal colonic transit. Urgency, daily urinary incontinence and nocturnal enuresis were noted only in children with FFR. Both children with ST constipation and FFR complained of difficulties during voiding, voiding postponement and urinary tract infections. FFR is the most common form of constipation in children with dysfunctional voiding. However, some children might suffer from ST constipation. Differentiation between these two types of constipation is clinically significant because they require different treatment. Future studies with larger numbers of patients are needed to confirm the noted differences in urological symptoms in these two groups of constipated children.. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  18. Dysfunctional Patients with Temporomandibular Disorders: Evaluating the Efficacy of a Tailored Treatment Protocol.

    Science.gov (United States)

    Turk, Dennis C.; And Others

    1996-01-01

    Forty-eight dysfunctional patients with temporomandibular disorders (TMD) were randomly assigned to treatments consisting of an intraoral appliance, stress management, and either nondirective supportive counseling or cognitive therapy. Results support tailored treatment of dysfunctional TMD. (KW)

  19. The evaluation of diastolic dysfunction with tissue Doppler echocardiography in women with subclinical hypothyroidism and the effect of L-thyroxine treatment on diastolic dysfunction: a pilot study.

    Science.gov (United States)

    Erkan, Gulbanu; Erkan, Aycan Fahri; Cemri, Mustafa; Karaahmetoglu, Selma; Cesur, Mustafa; Cengel, Atiye

    2011-01-01

    Background. Subclinical hypothyroidism (SH) predominantly affects women. The necessity of treatment in SH is controversial. Objective. We aimed to investigate the response of diastolic dysfunction to thyroid hormone replacement therapy (THRT) in women. Methods and Results. Twenty-two female subjects with SH and 20 euthyroid female controls were enrolled. Baseline and follow-up biochemical, hormonal, and echocardiographic evaluations were performed. Repeat echocardiograms were performed three months after the achievement of a euthyroid status with THRT. Mean baseline myocardial performance index (MPI) was 0.27 ± 0.08 in the SH group, and 0.22 ± 0.06 in the control group (P = 0.03). MPI did not change significantly after THRT. Pulsed-wave Doppler findings were not different among the groups. However, tissue Doppler-derived mitral annular E' velocities were significantly lower in the SH group. A moderate but significant improvement was observed in E' velocities after THRT (13.2 ± 3.87 versus 14.53 ± 2.75, P = 0.04). We also observed left ventricular concentric remodeling in SH patients which was reversible with THRT. Conclusions. Tissue Doppler echocardiography may be a useful tool for monitoring the response of diastolic dysfunction to thyroid hormone replacement therapy in patients with SH. Our findings suggest that THRT may reverse diastolic dysfunction in women with SH.

  20. The Evaluation of Diastolic Dysfunction with Tissue Doppler Echocardiography in Women with Subclinical Hypothyroidism and the Effect of L-Thyroxine Treatment on Diastolic Dysfunction: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Gulbanu Erkan

    2011-01-01

    Full Text Available Background. Subclinical hypothyroidism (SH predominantly affects women. The necessity of treatment in SH is controversial. Objective. We aimed to investigate the response of diastolic dysfunction to thyroid hormone replacement therapy (THRT in women. Methods and Results. Twenty-two female subjects with SH and 20 euthyroid female controls were enrolled. Baseline and follow-up biochemical, hormonal, and echocardiographic evaluations were performed. Repeat echocardiograms were performed three months after the achievement of a euthyroid status with THRT. Mean baseline myocardial performance index (MPI was 0.27±0.08 in the SH group, and 0.22±0.06 in the control group (P=0.03. MPI did not change significantly after THRT. Pulsed-wave Doppler findings were not different among the groups. However, tissue Doppler-derived mitral annular E’ velocities were significantly lower in the SH group. A moderate but significant improvement was observed in E’ velocities after THRT (13.2±3.87 versus 14.53±2.75, P=0.04. We also observed left ventricular concentric remodeling in SH patients which was reversible with THRT. Conclusions. Tissue Doppler echocardiography may be a useful tool for monitoring the response of diastolic dysfunction to thyroid hormone replacement therapy in patients with SH. Our findings suggest that THRT may reverse diastolic dysfunction in women with SH.

  1. [Clinical evaluation of a thermodynamic treatment system for meibomian gland dysfunction].

    Science.gov (United States)

    Liang, Qingfeng; Liu, Hanruo; Guo, Yan; Cui, Rui; Li, Bin; Wang, Ningli; Labbe, Antoine

    2015-12-01

    To evaluate the effectiveness and safety of a single thermodynamic treatment system (LipiFlow) for meibomian gland dysfunction (MGD). Retrospective series case study. Forty-eight subjects with meibomian gland dysfunction were analyzed before and after 12 minutes LipiFlow system treatment. All subjects were examined before, 4 weeks and 12 weeks after this treatment. Subjective symptoms, lipid layer thickness (LLT), expressible meibomian gland, tear break-up time, meibomian gland assessment and ocular surface staining were measured. Statistical analysis was performed using SPSS 11.5 software. Analysis included those independent sample two-tailed t-tests for comparison of the mean change from baseline to 4 weeks and baseline to 12 weeks after Lipiflow treatment. Statistically significant difference was based on α=0.05 (PLipiFlow treatment had a significant reduction in the Ocular Surface Disease Index (OSDI) scores with 45.36±19.34 before treatment, 23.82±11.94 at 4 weeks (t=2.009, P=0.035) and 25.66±14.12 at 12 weeks (t=1.976 P=0.038). LipiFlow resulted in a higher number of expressible glands from 2.91±1.13 (baseline) to 6.27±2.37 (4 weeks, t=3.505, PLipiFlow system was a safety and effectiveness treatment of MGD in the 12-week study.

  2. EVALUATION OF RIGHT VENTRICULAR DYSFUNCTION AND PULMONARY ARTERY HYPERTENSION SECONDARY TO COPD SEVERITY BY ELECTROCARDIOGRAM AND ECHOCARDIOGRAPHY

    OpenAIRE

    Bhupendra Kumar; Nikhilesh; Ashok; Ashwin

    2015-01-01

    Patient with COPD carry increased risk of morbidity and mortality due to pulmonary artery hypertension, corpulmonale, cardiac arrhythmias, congestive heart fa ilure and pulmonary embolism. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate the cardiac changes secondary to severe COPD. AIM : To evaluate right ventricular dysfunction and pulmonary artery hypertension secondary to COPD severity as per GOLD gui...

  3. Optimising screening for cognitive dysfunction in bipolar disorder: Validation and evaluation of objective and subjective tools

    DEFF Research Database (Denmark)

    Jensen, Johan Høy; Støttrup, Mette Marie; Nayberg, Emilie

    2015-01-01

    and socio-occupational capacity. Methods Patients with bipolar disorder in partial or full remission (n=84) and healthy controls (n=68) were assessed with the Screen for Cognitive Impairment in Psychiatry (SCIP), Cognitive Complaints in Bipolar Disorder Rating Scale (COBRA), and established...... neuropsychological tests and subjective rating scales. Socio-occupational function and affective symptoms were evaluated with the Functional Assessment Short Test, and the Hamilton Depression Rating Scale 17-items and Young Mania Rating Scale, respectively. Concurrent validity of the SCIP and COBRA were assessed......, and socio-occupational difficulties. Results The SCIP and COBRA correlated strongly with established objective and subjective cognitive measures, respectively. The SCIP yielded higher sensitivity and specificity for detection of cognitive dysfunction than the COBRA or a combined SCIP-COBRA measure...

  4. Erectile dysfunction

    Science.gov (United States)

    Yafi, Faysal A.; Jenkins, Lawrence; Albersen, Maarten; Corona, Giovanni; Isidori, Andrea M.; Goldfarb, Shari; Maggi, Mario; Nelson, Christian J.; Parish, Sharon; Salonia, Andrea; Tan, Ronny; Mulhall, John P.; Hellstrom, Wayne J. G.

    2016-01-01

    Erectile dysfunction is a multidimensional but common male sexual dysfunction that involves an alteration in any of the components of the erectile response, including organic, relational and psychological. Roles for nonendocrine (neurogenic, vasculogenic and iatrogenic) and endocrine pathways have been proposed. Owing to its strong association with metabolic syndrome and cardiovascular disease, cardiac assessment may be warranted in men with symptoms of erectile dysfunction. Minimally invasive interventions to relieve the symptoms of erectile dysfunction include lifestyle modifications, oral drugs, injected vasodilator agents and vacuum erection devices. Surgical therapies are reserved for the subset of patients who have contraindications to these nonsurgical interventions, those who experience adverse effects from (or are refractory to) medical therapy and those who also have penile fibrosis or penile vascular insufficiency. Erectile dysfunction can have deleterious effects on a man’s quality of life; most patients have symptoms of depression and anxiety related to sexual performance. These symptoms, in turn, affect his partner’s sexual experience and the couple’s quality of life. This Primer highlights numerous aspects of erectile dysfunction, summarizes new treatment targets and ongoing preclinical studies that evaluate new pharmacotherapies, and covers the topic of regenerative medicine, which represents the future of sexual medicine. PMID:27188339

  5. Evaluation of Doppler-ultrasonography in the diagnosis of transjugular intrahepatic portosystemic shunt dysfunction: A prospective study.

    Science.gov (United States)

    Nicolas, Charlotte; Le Gouge, Amélie; d'Alteroche, Louis; Ayoub, Jean; Georgescu, Monica; Vidal, Vincent; Castaing, Denis; Cercueil, Jean-Pierre; Chevallier, Patrick; Roumy, Jérôme; Trillaud, Hervé; Boyer, Louis; Le Pennec, Vincent; Perret, Christophe; Giraudeau, Bruno; Perarnau, Jean-Marc; Stic-Tips Group

    2017-09-28

    To prospectively evaluate the performance of Doppler-ultrasonography (US) for the detection of transjugular intrahepatic portosystemic shunt (TIPS) dysfunction within a multicenter cohort of cirrhotic patients. This study was conducted in 10 french teaching hospitals. After TIPS insertion, angiography and liver Doppler-US were carried out every six months to detect dysfunction (defined by a portosystemic gradient ≥ 12 mmHg and/or a stent stenosis ≥ 50%). The association between ultrasonographic signs and dysfunction was studied by logistic random-effects models, and the diagnostic performance of each Doppler criterion was estimated by the bootstrap method. This study was approved by the ethics committee of Tours. Two hundred and eighteen pairs of examinations performed on 87 cirrhotic patients were analyzed. Variables significantly associated with dysfunction were: The speed of flow in the portal vein ( P = 0.008), the reversal of flow in the right ( P = 0.038) and left ( P = 0.049) portal branch, the loss of modulation of portal flow by the right atrium ( P = 0.0005), ascites ( P = 0.001) and the overall impression of the operator ( P = 0.0001). The diagnostic performances of these variables were low; sensitivity was Doppler-US. The performance of Doppler-US for the detection of TIPS dysfunction is poor compared to angiography. New tools are needed to improve diagnosis of TIPS dysfunction.

  6. Nuclear medicine imaging technique in the erectile dysfunction evaluation: a mini-review

    Directory of Open Access Journals (Sweden)

    Camila Godinho Ribeiro

    2007-09-01

    Full Text Available Functional imaging with positron emission tomography and single photon emission computed tomography is capable of visualizing subtle changes in physiological function in vivo. Erectile dysfunction(ED diminishes quality of life for affected men and their partners. Identification of neural substrates may provide information regarding the pathophysiology of types of sexual dysfunction originating in the brain. The aim of this work is to verify the approaches of the nuclear medicine techniques in the evaluation of the erectile function/disfunction. A search using the words ED and nuclear medicine, ED and scintigraphy, ED and spect and ED and pet was done in the PubMed. The number of citations in each subject was determined. Neuroimaging techniques offer insight into brain regions involved in sexual arousal and inhibition. To tackle problems such as hyposexual disorders or ED caused by brain disorders, it is crucial to understand how the human brain controls sexual arousal and penile erection.Imagens functionais, como o positron emission tomography e o single photon emission computed tomography são capazes de identificar súbitas alterações fisiológicas in vivo. A disfunção er��til diminui a qualidade de vida do casal. A identificação de substratos neurais pode esclarecer a fisiopatologia dos diferentes tipos de disfunções sexuais originadas no cérebro. O objetivo deste trabalho é verificar a abordagem das técnicas da medicina nuclear na avaliação da função/disfunção erétil. Uma pesquisa utilizando as palavras disfunção erétil e medicina nuclear, disfunção erétil e cintigrafia, disfunção erétil e SPECT e disfunção erétil e PET foi realizada no PubMed. O número de citações em cada palavra estudada foi determinado. Técnicas de neuroimagem permitem a avaliação das regiões cerebrais durante o estímulo ou inibição sexual. Para resolver alterações como disfunções hipossexuais ou disfunção erétil causada

  7. Role of imaging in the evaluation of renal dysfunction in heart failure patients.

    Science.gov (United States)

    Grande, Dario; Terlizzese, Paola; Iacoviello, Massimo

    2017-05-06

    Heart failure and kidney disease share common pathophysiological pathways which can lead to mutual dysfunction, known as cardiorenal syndrome. In heart failure patients, renal impairment is related to hemodynamic and non-hemodynamic factors. Both decreased renal blood flow and renal venous congestion due to heart failure could lead to impaired renal function. Kidney disease and worsening renal function are independently associated with poor prognosis in heart failure patients, both in acute and chronic clinical settings. The aim of this review is to assess the role of renal imaging modalities in the evaluation and management of heart failure patients. Renal imaging techniques could complete laboratory data, as estimated glomerular filtration rate, exploring different pathophysiological factors involved in kidney disease and adding valuable information about renal structure and function. In particular, Doppler examination of arterial and venous hemodynamics is a feasible and non invasive technique, which has proven to be a reliable method for prognostic stratification in patients with cardiorenal syndrome. The renal resistance index, a measure related to renal hemodynamics, can be calculated from the Doppler evaluation of arterial flow. Moreover, the analysis of Doppler venous flow patterns can integrate information from the arterial study and evaluate renal congestion. Other imaging modalities are promising, but still confined to research purposes.

  8. An electrophysiological approach to the evaluation of regional sympathetic dysfunction: a proposed classification.

    Science.gov (United States)

    Longmire, David R

    2006-01-01

    The importance to physicians of maintaining a level of understanding of illnesses and their treatment continues to reveal itself in a most striking fashion when it comes to the progressive interest recently directed to disorders of the autonomic nervous system (ANS). In particular, the relevance to pain practitioners of disease states which directly involve the sympathetic portion of the ANS has increased markedly following the international renaming of reflex sympathetic dystrophy (RSD) and causalgia to complex regional pain syndrome (CRPS) Type I and Type II respectively, as well as sympathetically maintained pain (SMP). Subsequently it has become better understood that many other forms of neuropathic pain also demonstrate local abnormalities of the sympathetic nervous supply to the skin within the painful territory, thereby increasing the diagnostic value of these (often subtle) cutaneous clinical signs. The objectives of this presentation include (a) a concise review of laboratory tests that are currently used in the evaluation of the autonomic nervous system, (b) a discussion of those procedures that were developed for the assessment of sympathetic sudomotor function, (c) a review of the anatomic pathways subserving those electrophysiological methods for sudomotor testing, and (d) the current diagnostic classification for regional abnormalities of sympathetic sudomotor dysfunction. Methods used in the preparation of this article have included a review of (a) historic clinical and laboratory articles (or translations thereof) regarding the medical importance of disorders of the autonomic nervous system, dating back to more than 155 years ago (b) anatomic and electrophysiological basis for electroneurodiagnostic sudomotor testing, and (c) the author's proposal for a diagnostic classification of regional sympathetic sudomotor dysfunction.

  9. Evaluation of Planning Dysfunction in Attention Deficit Hyperactivity Disorder and Autistic Spectrum Disorders Using the Zoo Map Task

    Science.gov (United States)

    Salcedo-Marin, M. D.; Moreno-Granados, J. M.; Ruiz-Veguilla, M.; Ferrin, M.

    2013-01-01

    Attention-Deficit-Hyperactivity-Disorders (ADHD) and Autistic-Spectrum-Disorders (ASD) share overlapping clinical and cognitive features that may confuse the diagnosis. Evaluation of executive problems and planning dysfunction may aid the clinical diagnostic process and help disentangle the neurobiological process underlying these conditions. This…

  10. Evaluation of a four month rehabilitation program for stroke patients with balance problems and binocular visual dysfunction

    DEFF Research Database (Denmark)

    Schow, Trine; Harris, Paul; Teasdale, Thomas William

    2016-01-01

    Trine Schow, Paul Harris, Thomas William Teasdale, Morten Arendt Rasmussen. Evaluation of a four month rehabilitation program for stroke patients with balance problems and binocular visual dysfunction. NeuroRehabilitation. 2016 Apr 6;38(4):331-41. doi: 10.3233/NRE-161324....

  11. Evaluating the Correlation between Serum NT-proBNP Level and Diastolic Dysfunction Severity in Beta-Thalassemia Major Patients

    Directory of Open Access Journals (Sweden)

    Behzad Alizadeh

    2016-10-01

    Full Text Available Background: N-terminal pro-brain natriuretic peptide (NT-proBNP is a sensitive biomarker for the detection of asymptomatic left ventricular (LV dysfunction. Since β-thalassemia major patients suffer from early diastolic dysfunction due to iron deposition of chronic blood transfusion, we tried to evaluate the correlation between the serum NT-proBNP level and the severity of LV diastolic dysfunction determined by echocardiography in these patients. Methods: Fifty β-thalassemia major patients with normal LV systolic function were studied by tissue Doppler echocardiography, and blood samples were taken at the same time to measure the serum NT-proBNP level. Using flow velocity through the mitral valve on the tissue velocity of the mitral annulus in early ventricular filling (E/E' as an LV diastolic function indicator, the patients were divided into 3 groups: group 1 no diastolic dysfunction (E/E' < 8, group 2 suspected diastolic dysfunction (E/E' = 8-15, and group 3 documented diastolic dysfunction (E/E' >15. Other variables assessed included sex, age, method of chelator therapy, and mean hemoglobin and ferritin levels for the past 2 years.Results: According to the echocardiographic findings of all the 50 patients (29 male and 21 female with an age range of 11-35 years (mean = 17.98 y, 46% were classified in group 1, 54% in group 2, and none in group 3. The NT-proBNP level was 1070 ± 566 ng/mL in group 1 and 974 ± 515 ng/mL in group 2. The t-test showed no significant difference between groups 1 and 2 in the NT-proBNP level (p value = 0.536. Conclusions: Due to specific conditions in thalassemia major patients, the correlation between the serum NT-proBNP level and the severity of diastolic dysfunction seems to be not meaningful.

  12. Evaluation of the effects of group psychotherapy on cognitive function in patients with multiple sclerosis with cognitive dysfunction and depression

    Directory of Open Access Journals (Sweden)

    Emine Bilgi

    2015-02-01

    Full Text Available Objective This study will evaluate how decreasing depression severity via group psychotherapy affects the cognitive function of patients with multiple sclerosis (MS who are also diagnosed with depression and cognitive dysfunction. Method MS patients completed the Brief Repeatable Battery of Neuropsychological Tests and Beck Depression Inventory (BDI. The group members diagnosed with depression and cognitive dysfunction underwent group psychotherapy for 3 months. Upon completion of psychotherapy, both tests were readministered. Results Depression and cognitive dysfunction were comorbid in 15 (13.9% of patients. Although improvement was detected at the end of the 3-month group psychotherapy intervention, it was limited to the BDI and the Paced Auditory Test. Conclusion Group psychotherapy might decrease cognitive impairment in MS patients.

  13. Evaluation of laser therapy and routine treatment modalities in the management of myofascial pain dysfunction syndrome

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    Smriti B Jagdhari

    2015-01-01

    Full Text Available Objective: To evaluate the efficacy of laser as a monotherapy and in combination with exercise therapy in comparison to only exercise in the treatment of Myofascial Pain Dysfunction Syndrome (MPDS or Temporomandibular Myofascial Pain. Materials and Methods: A total of 60 patients with MPDS were included in the study and were randomly divided into three groups: exercise, laser, and the combination of both (exercise and laser. Results: Significant reduction in pain at rest and pain on movement was observed with all three types of treatment modalities. Pain reduction was more in those patients who received combination of exercise and laser therapy. Similarly, decrease in the muscle tenderness was more when combination of exercise and laser therapy was used. Conclusion: The ideal therapy should be fast, cheap, and have a long-term effect. Laser (Helium Neon as monotherapy or in combination with exercise had shown promising results and can be used as an effective treatment modality for the treatment of MPDS.

  14. Evaluation of salivary cortisol and anxiety levels in myofascial pain dysfunction syndrome.

    Science.gov (United States)

    Nadendla, Lakshmi Kavitha; Meduri, Venkateswarlu; Paramkusam, Geetha; Pachava, Koteswara Rao

    2014-01-01

    Myofascial pain dysfunction syndrome (MPDS), otherwise called myofascial pain is one of the most common temporomandibular disorders, which in turn is the most common cause of orofacial pain of non-dental origin. Its etiology is multifactorial and still poorly understood. Psychological factors have been shown to play a role in the etiology. The aim of the study was to evaluate the association between anxiety and salivary cortisol levels in patients with myofascial pain. Twenty patients suffering from myofascial pain were recruited as the study group. The same number of age and sex matched healthy individuals were taken as the control group. The salivary samples collected between 9-9:15 am from both groups were analyzed for cortisol levels with the competitive enzyme-linked immunosorbent assay method. Anxiety levels of 40 patients were measured using Hamilton's anxiety scale. The mean serum cortisol level of the MPDS group showed a highly significant difference (p < 0.001) from the controls. The mean anxiety scores of the MPDS group showed a highly significant difference (p < 0.001) from the controls. A positive correlation was found between anxiety and the salivary cortisol levels in MPDS patients. These findings suggest that anxiety plays a vital role in the etio-pathogenesis of MPDS; thus, besides pharmacological treatment, psychological support is also needed.

  15. Evaluation of Left Ventricular Dyssynchrony after Coronary Artery Bypass Grafting in Patients with Ischemic Left Ventricular Dysfunction

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    MA Babaee Beigi

    2009-12-01

    Full Text Available Background: Ischemic left ventricular (LV dysfunction is one of the major causes of LV dyssynchrony. This is indicative of poor prognosis in patients with LV dysfunction and correction of ischemia by Coronary Artery Bypass Grafting (CABG may resynchronize LV contraction. The aim of this study was to evaluate the effect of CABG on LV dyssynchrony, systolic and diastolic function.Patients: The present study comprised 31 patients with ischemic LV dysfunction with Ejection Fraction (EF:25- 50%. Echocardiography with Tissue Doppler Imaging (TDI was performed to assess LV dyssynchrony (calculated by basal LV segment,to evaluate diastolic function by measurement of peak early diastolic mitral annular velocity (Em ,systolic function by measurement of peak early systolic mitral annular velocity (Sm and Ejection Fraction (EF by Simpson method.Results: Mean LV dyssychrony before CABG was 30±16 ms that decreased to 22±14 ms after operation (P=0.04.There was also improved diastolic and systolic function after CABG ( Em 0.04m/s versus 0.05 m/s , P=0.01 and Sm 0.06 m/s versus 0.08 m/s P=0.01.The mean ejection fraction rose from 40±8.6% to 42±8.2% (P=0.01.Conclusion: CABG is associated with improvement of LV dyssynchrony, systolic and diastolic function in patients with ischemic LV dysfunction.

  16. Evaluation of ventricular dysfunction using semi-automatic longitudinal strain analysis of four-chamber cine MR imaging.

    Science.gov (United States)

    Kawakubo, Masateru; Nagao, Michinobu; Kumazawa, Seiji; Yamasaki, Yuzo; Chishaki, Akiko S; Nakamura, Yasuhiko; Honda, Hiroshi; Morishita, Junji

    2016-02-01

    The aim of this study was to evaluate ventricular dysfunction using the longitudinal strain analysis in 4-chamber (4CH) cine MR imaging, and to investigate the agreement between the semi-automatic and manual measurements in the analysis. Fifty-two consecutive patients with ischemic, or non-ischemic cardiomyopathy and repaired tetralogy of Fallot who underwent cardiac MR examination incorporating cine MR imaging were retrospectively enrolled. The LV and RV longitudinal strain values were obtained by semi-automatically and manually. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cutoff of the minimum longitudinal strain value for the detection of patients with cardiac dysfunction. The correlations between manual and semi-automatic measurements for LV and RV walls were analyzed by Pearson coefficient analysis. ROC analysis demonstrated the optimal cut-off of the minimum longitudinal strain values (εL_min) for diagnoses the LV and RV dysfunction at a high accuracy (LV εL_min = -7.8 %: area under the curve, 0.89; sensitivity, 83 %; specificity, 91 %, RV εL_min = -15.7 %: area under the curve, 0.82; sensitivity, 92 %; specificity, 68 %). Excellent correlations between manual and semi-automatic measurements for LV and RV free wall were observed (LV, r = 0.97, p cine MR imaging can evaluate LV and RV dysfunction with simply and easy measurements. The strain analysis could have extensive application in cardiac imaging for various clinical cases.

  17. Pituitary dysfunction in traumatic brain injury: Is evaluation in the acute phase worthwhile?

    Directory of Open Access Journals (Sweden)

    Pradip P Dalwadi

    2017-01-01

    Full Text Available Introduction: Traumatic brain injury (TBI is an under-recognized cause of hypopituitarism. According to recent data, it could be more frequent than previously known. However, there is a scarcity of data in Indian population. Aims: The main aim of the study was to determine the prevalence of pituitary hormone deficiencies in the acute phase of TBI. The secondary objectives were to correlate the severity of trauma with basal hormone levels and to determine whether initial hormone deficiencies predict mortality. Subjects and Methods: Forty-nine TBI patients (41 men and 8 women were included in this study. Pituitary functions were evaluated within 24 h of admission. Results: Gonadotropin deficiency was found in 65.3% patient while 46.9% had low insulin-like growth factor-1, 12.24% had cortisol level <7 mcg/dl. Cortisol and prolactin level were positively correlated with the severity of TBI suggestive of stress response. Free triiodothyronine (fT3 and free thyroxine were significantly lower in patients with increasing severity of tuberculosis. Logistic regression analysis revealed that mortality after TBI was unrelated to the basal pituitary hormone levels except low T3 level, which was found to be positively related to mortality. Conclusions: Pituitary dysfunction is common after TBI and the most commonly affected axes are growth hormone and gonadotropin axis. Low fT3 correlates best with mortality. During the acute phase of TBI, at least an assessment of cortisol is vital as undetected cortisol deficiency can be life-threatening

  18. A qualitative evaluation of online chat groups for women completing a psychological intervention for female sexual dysfunction.

    Science.gov (United States)

    Hucker, Alice; McCabe, Marita P

    2014-01-01

    Because of the embarrassment that can surround female sexual dysfunctions, online interventions offer an anonymous and private treatment alternative. Recently, an online cognitive-behavioral treatment for female sexual dysfunctions was evaluated. Although significant improvements were observed in sexual functioning, the treatment was primarily a behavioral intervention because of difficulties with engaging participants in cognitive therapy over e-mail. To address this limitation, the use of chat groups was incorporated into a new online treatment for female sexual dysfunctions-the PursuingPleasure program. Thirty-eight women participated in the PursuingPleasure chat groups. The goals of the chat groups were to address and overcome challenges as women progressed through PursuingPleasure and to create a social support network where group therapy processes could be used. The chat groups aimed to address misunderstandings, monitor changes, and receive feedback. A qualitative analysis of the chat groups revealed that they helped to facilitate the cognitive-affective aspects of the program, as well as fulfill their other intended functions. This study demonstrates how the use of chat groups in the online treatment of female sexual dysfunctions is a useful addition to Internet-based treatment. Feedback suggests that the chat groups were one of the most helpful aspects of the program, although a small group of women reported finding the groups unhelpful.

  19. Erectile dysfunction.

    Science.gov (United States)

    Khera, Mohit; Goldstein, Irwin

    2011-06-29

    Erectile dysfunction may affect 30% to 50% of men aged 40 to 70 years, with age, smoking, and obesity being the main risk factors, although 20% of cases have psychological causes. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of phosphodiesterase inhibitors in men with erectile dysfunction of any cause? What are the effects of phosphodiesterase inhibitors on erectile dysfunction in men with diabetes, with cardiovascular disease, with spinal cord injury, and with prostate cancer or undergoing prostatectomy? What are the effects of drug treatments other than phosphodiesterase inhibitors in men with erectile dysfunction of any cause? What are the effects of devices, psychological/behavioural treatments, and alternative treatments in men with erectile dysfunction of any cause? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 81 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: alprostadil (intracavernosal, intraurethral, topical), cognitive behavioural therapy, ginseng, papaverine, papaverine plus phentolamine (bimix), papaverine plus phentolamine plus alprostadil (trimix), penile prostheses, phosphodiesterase inhibitors (sildenafil, tadalafil, vardenafil), psychosexual counselling, vacuum devices, and yohimbine.

  20. The Evaluation of Relationship between Sexual Self-concept and Sexual Dysfunction in Individuals Undergoing Methadone Maintenance Treatment.

    Science.gov (United States)

    Rajabizadeh, Ghodratolah; Yazdanpanah, Fatemeh; Ramezani, Mohammad Arash

    2017-04-01

    The present study was conducted with the aim of designing a causal model for the evaluation of sexual dysfunctions based on the variables of methadone dosage and sexual self-concept among individuals undergoing methadone maintenance treatment (MMT). The study population of the present study consisted of married men of 20 to 45 years of age with sexual ýrelations and undergoing MMT for a minimum of 8 weeks referring to all MMT clinics of Kerman, Iran, in ýý2015-2016. ýThe subjects were selected through multi-stage cluster sampling (n = 250). Data were collected using the General Health Questionnaire (GHQ-28), Multi-Dimensional Sexual Self-concept Questionnaire (MSSQ), and Internal Index for Erectile Function (IIEF). Data were analyzed using path analysis method and Pearson correlation coefficient. The suggested model was evaluated using structural equation model (SEM), and indirect relationships were assessed using Bootstrap method. The suggested model showed acceptable fitness with the data, and all routes, except methadone use route, to sexual function were significant. The result of the multiple ýindirect route showed that sexual function had a significant relationship with methadone use through ýsexual self-concept. In total, 60% of variance in sexual dysfunction was explained using the variables of the suggested model. Further studies are suggested to be conducted regarding psychological factors effective on the sexual dysfunctions among individuals undergoing MMT, such as sexual self-concept. Moreover, more detailed evaluation of each subscale of positive and negative sexual self-concept is recommended to assess the psychological causes of sexual dysfunctions in these individuals and design psychological, behavioral, and cognitive-behavioral treatment interventions for them.

  1. A Comparative Evaluation of Minimal Therapist Contact and 15-Session Treatment for Female Orgasmic Dysfunction.

    Science.gov (United States)

    Morokoff, Patricia J.; LoPiccolo, Joseph

    1986-01-01

    Compared a four-session minimal therapist contact (MTC) program for treatment of lifelong global orgasmic dysfunction in women to a 15-session full therapist contact (FTC) program. Both programs were effective in producing female orgasm and in improving satisfaction with the sexual relationship and, for women in MTC treatment, happiness in…

  2. Symptomatic Arnold-Chiari malformation and cranial nerve dysfunction: a case study of applied kinesiology cranial evaluation and treatment.

    Science.gov (United States)

    Cuthbert, Scott; Blum, Charles

    2005-05-01

    To present an overview of possible effects of Arnold-Chiari malformation (ACM) and to offer chiropractic approaches and theories for treatment of a patient with severe visual dysfunction complicated by ACM. A young woman had complex optic nerve neuritis exacerbated by an ACM type I of the brain. Applied kinesiology chiropractic treatment was used for treatment of loss of vision and nystagmus. After treatment, the patient's ability to see, read, and perform smooth eye tracking showed improvement. Further studies into applied kinesiology and cranial treatments for visual dysfunctions associated with ACM may be helpful to evaluate whether this single case study can be representative of a group of patients who might benefit from this care.

  3. In vivo Confocal Microscopy Evaluation of Meibomian Gland Dysfunction in Dry Eye Patients with Different Symptoms

    Directory of Open Access Journals (Sweden)

    Hui Zhao

    2016-01-01

    Conclusions: IVCM application provides a strong support to differentiate dry eye patients with different symptoms: meibomian gland dysfunction (MGD plays a pivotal role in dry eye aggravation, and using IVCM to observe MG fibrosis, changes in size and density of MG as well as status of inflammation cells can help not only correctly diagnose the type and severity of dry eye, but also possibly prognosticate in routine eye examination in the occurrence of MGD.

  4. Anatomical evaluation of penile venous system by CT cavernosography in patients with erectile dysfunction and venous leakage

    Directory of Open Access Journals (Sweden)

    P Famili

    2012-11-01

    Full Text Available Background: Erectile dysfunction is an important problem in men and an organic cause is found in about 50% of cases. When a vasculogenic etiology is suspected, imaging assessments are of great help. Cavernosography is traditionally recognized as an imaging modality for evaluation of venous leakage in men with impotency. We employed CT cavernosography as a novel technique for demonstrating penile venous anatomy and leaking veins.Methods: In the present case series study, we recruited 45 patients with erectile dysfunction by convenient sampling at Hazrat Rasoul Akram Hospital in Tehran, Iran, during one year (1390. The patients had previously been diagnosed with venous incompetency by Doppler study. After intracavernosal injection of prostaglandin E1, we injected sterile normal saline into the corpora cavernosa to achieve penile erection. Later, we injected contrast media into the corpus cavernosum, which was followed by CT scan of the penis and pelvic area to show the venous anatomy and leakage sites.Results: The mean age of the patients was 35.8±8.9 years. 36 (80% patients had venous leakage in crural veins, 27 (60% in cavernosal veins, 27 (60% in circumflex veins, 24 (52.3% in urethral veins, 21 (46.7% in deep dorsal vein, 3 (6.7% in para-arterial veins and 3 (6.7% in corpus spongiosum. Conclusion: The results of this study show the high prevalence of venous leakage in patients referring for erectile dysfunction. Moreover, CT cavernosography was shown to be a useful method for evaluating penile venous system and its related leakage sites which are important for surgical planning.

  5. Evaluation of remission of temporomandibular joints pain as a result of treatment of dysfunction using intraarticular injection.

    Science.gov (United States)

    Pihut, Małgorzata; Górecka, Małgorzata; Ceranowicz, Piotr

    2017-01-01

    The temporomandibular joint pain, which occurs in the course of temporomandibular joint dysfunction, is one of the main clinical problems in the treatment of joint disc displacement. The aim of the study was to evaluate changes in temporomandibular joints pain in treatment supporting disc displacement without reduction using intra-articular injection of hyaluronic acid and platelet-rich plasma. The study consisted of a group of 60 patients, aged 35-49, who reported for treatment, because of pain in the preauricural area. The functional examination stated disk dicplacement without reduction, along with the accompanying pain of temporomandibular joints. Patients were treated between January 2015 and February 2017. They were divided into two groups of 30 persons. The intraarticular injection of hyaluronic acid was administered in the I-test group, and the injection of platelet-rich plasma in the control group. This treatment was carried out parallel to the use of repositioning splits. Analysis of regression of symptoms other than intensity of pain during the treatment, evaluated in this study shows a decrease of individual symptoms, but the results of the regression of pain between two groups did not differ statistically significantly, because "p" is bigger than 0.05. The results of the research show the clinical benefits of application of hyaluronic acid and plate rich plasma in the treatment of temporomandibular joint dysfunction.

  6. Evaluation of constipation after parasacral transcutaneous electrical nerve stimulation in children with lower urinary tract dysfunction--a pilot study.

    Science.gov (United States)

    Veiga, Maria Luiza; Lordêlo, Patrícia; Farias, Tiago; Barroso, Ubirajara

    2013-10-01

    To evaluate the efficacy of parasacral transcutaneous electrical nerve stimulation (TENS) for the treatment of constipation in children with lower urinary tract dysfunction (LUTD). We treated 9 boys and 5 girls with a mean age of 8.07 ± 2.72 years. 10 (71.4%) had overactive bladder and 4 (28.6%) had voiding dysfunction. A total of 20 parasacral TENS sessions, 20 min each (10 Hz), were performed 3 times per week. The criteria used to assess constipation were the Rome III criteria for children, the Bristol Stool Chart, and a visual analog scale (pain from 0 to 10). The children were reassessed immediately after treatment. No specific treatment of constipation was performed. After treatment, 85.7% (p children's constipation symptoms had improved following the Rome III criteria. Parasacral TENS significantly impacted the following symptoms: "the presence of at least one episode of fecal incontinence per week", "history of stool retention", and "the presence of a large fecal mass in the rectum." There was no significant change in the Bristol Stool Chart evaluation (p constipation in children with LUTD, satisfactory results were obtained for both complaints. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  7. Evaluation of Crocus sativus L. (saffron) on male erectile dysfunction: a pilot study.

    Science.gov (United States)

    Shamsa, Ali; Hosseinzadeh, Hossein; Molaei, Mahmood; Shakeri, Mohammad Taghi; Rajabi, Omid

    2009-08-01

    In this study, the effect of Crocus sativus (saffron) was studied on male erectile dysfunction (ED). Twenty male patients with ED were followed for ten days in which each morning they took a tablet containing 200mg of saffron. Patients underwent the nocturnal penile tumescence (NPT) test and the international index of erectile function questionnaire (IIEF-15) at the start of the treatment and at the end of the ten days. After the ten days of taking saffron there was a statistically significant improvement in tip rigidity and tip tumescence as well as base rigidity and base tumescence. ILEF-15 total scores were significantly higher in patients after saffron treatment (before treatment 22.15+/-1.44; after treatment 39.20+/-1.90, pSaffron showed a positive effect on sexual function with increased number and duration of erectile events seen in patients with ED even only after taking it for ten days.

  8. Role of PET to evaluate coronary microvascular dysfunction in non-ischemic cardiomyopathies.

    Science.gov (United States)

    Bravo, Paco E; Di Carli, Marcelo F; Dorbala, Sharmila

    2017-07-01

    Coronary microvascular dysfunction (CMD) can result from structural and functional abnormalities at the intramural and small coronary vessel level affecting coronary blood flow autoregulation and consequently leading to impaired coronary flow reserve. CMD often co-exists with epicardial coronary artery disease but is also commonly seen in patients with various forms of heart disease, including dilated, hypertrophic, and infiltrative cardiomyopathies. CMD can go unnoticed without any symptoms, or manifest as angina, and/or dyspnea, and contribute to the development of heart failure, and even sudden death especially when co-existing with myocardial fibrosis. However, whether CMD in non-ischemic cardiomyopathy is a cause or an effect of the underlying cardiomyopathic process, or whether it can be potentially modifiable with specific therapies, remains incompletely understood.

  9. Evaluation of early cardiac dysfunction in patients with systemic lupus erythematosus with or without anticardiolipin antibodies.

    Science.gov (United States)

    Barutcu, A; Aksu, F; Ozcelik, F; Barutcu, C A E; Umit, G E; Pamuk, O N; Altun, A

    2015-09-01

    The aim of this study was to use transthoracic Doppler echocardiographic (TTE) imaging methods to identify cardiac dysfunction, an indicator of subclinical atherosclerosis in asymptomatic systemic lupus erythematosus (SLE) patients in terms of cardiac effects. This study involved 80 patients: a study group (n = 50) and control group (n = 30). They were categorized into four subgroups: anticardiolipin antibodies (aCL) (+) (n = 14) and aCL (-) (n = 36); systemic lupus erythematosus disease activity index (SLEDAI) ≥ 6 (n = 15) and SLEDAI 5 years group compared with the disease period <5 years group (p < 0.01, p < 0.05, respectively). Carrying out regular scans with TTE image of SLE patients is important in order to identify early cardiac involvement during monitoring and treatment. Identifying early cardiac involvement in SLE may lead to a reduction in mortality and morbidity rates. © The Author(s) 2015.

  10. Primary graft dysfunction; possible evaluation by high resolution computed tomography, and suggestions for a scoring system

    DEFF Research Database (Denmark)

    Belmaati, Esther; Jensen, Claus; Kofoed, Klaus F

    2009-01-01

    We have reviewed and discussed current knowledge on existing scoring systems regarding high resolution computed tomography (HRCT) images for the assessment of primary graft dysfunction (PGD) after lung transplantation. Adult respiratory distress syndrome (ARDS) has been more widely studied...... performed on patients with cystic fibrosis (CF). Sensitivity of HRCT for the detection of parenchymal changes is superior to other imaging methods. High levels of reproducibility are achievable amongst observers who score HRCT lung images. Development of standardized criteria that specify the inclusion......, and reproducibility of these systems were discussed. Lastly, the future perspectives for 64-multi-slice computed tomography (MSCT) in relation to PGD were discussed. Few studies on scoring systems of lung tissue by HRCT in ARDS patients and idiopathic pulmonary fibrosis (IPF) patients were found. Most studies were...

  11. Estimation of right ventricular dysfunction by computed tomography pulmonary angiography: a valuable adjunct for evaluating the severity of acute pulmonary embolism.

    Science.gov (United States)

    Jia, Dong; Zhou, Xiao-Ming; Hou, Gang

    2017-02-01

    To evaluate the feasibility and the efficacy of computed tomography pulmonary angiography (CTPA) in differentiating acute pulmonary embolism (PE) patients with or without right ventricular dysfunction and to evaluate the severity of right ventricular dysfunction in acute PE patients with CPTA. We retrospectively collected and measured the following parameters: right ventricular diameter by short axis in the axial plane (RVDaxial), left ventricular diameter by short axis in the axial plane (LVDaxial), right ventricular diameter by level on the reconstructed four-chamber views (RVD4-CH), left ventricular diameter by level on the reconstructed four-chamber views (LVD4-CH), main pulmonary artery diameter (MPAD), ascending aorta diameter (AOD), coronary sinus diameter (CSD), superior vena cava diameter (SVCD), inferior vena cava (IVC) reflux and interventricular septum deviation by CTPA, and we calculated the RVDaxial/LVDaxial, RVD4-CH/LVD4-CH and MPAD/AOD ratios in acute PE patients. We assessed right ventricular function and pulmonary artery systolic pressure (PASP) by echocardiography (ECHO) and then divided the patients into two groups: group A had right ventricular dysfunction, and group B did not have right ventricular dysfunction. We utilized a logistic regression model to analyse the relationship between right ventricular dysfunction and the measurement parameters obtained from CTPA, and we constructed the ROC curve to confirm the optimal cut-off value of the statistically significant parameter in the logistic regression model. After an initial screening, 113 acute PE patients were enrolled in our study. Among them, 42 patients showed right ventricular dysfunction (37.2 %), and 71 patients showed no right ventricular dysfunction (62.8 %). The difference between the patients with right ventricular dysfunction and patients without right ventricular dysfunction was statistical significant in RVD4-CH/LVD4-CH ratio. Logistic regression model analysis revealed

  12. [THE NEW APPROACH TO EVALUATION OF ENDOTHELIUM DYSFUNCTION: DETECTION OF NUMBER OF CIRCULATING ENDOTHELIUM CELLS USING FLOW CYTOMETRY TECHNIQUE].

    Science.gov (United States)

    Feoktistova, V S; Vavilkova, T V; Sirotkina, O V; Boldueva, S A; Gaikovaia, L B; Leonova, I A; Laskovets, A B; Ermakov, A I

    2015-04-01

    The endothelium dysfunction takes leading place in pathogenesis of development of cardiovascular diseases. The circulating endothelium cells of peripheral blood can act as a direct cell marker of damage and remodeling of endothelium. The study was carried out to develop a new approach to diagnose of endothelium dysfunction by force of determination of number of circulating endothelium cells using flow cytometry technique and to apply determination of circulating endothelium cells for evaluation of risk of development of ischemic heart disease in women of young and middle age. The study embraced 62 female patients with angiography confirmed ischemic heart disease, exertional angina pectoris at the level of functional class I-II (mean age 51 ± 6 years) and 49 women without anamnesis of ischemic heart disease (mean age 52 ± 9 years). The occurrence of more than three circulating endothelium cells by 3 x 105 leukocytes in peripheral blood increases relative risk of development of ischemic heart disease up to 4 times in women of young and middle age and risk of development of acute myocardial infarction up to 8 times in women with ischemic heart disease. The study demonstrated possibility to apply flow cytometry technique to quantitatively specify circulating endothelium cells in peripheral blood and forecast risk of development of ischemic heart disease in women of young and middle age depending on level of circulating endothelium cells.

  13. Evaluation of radioprotective effect of aloe vera and zinc/copper compounds against salivary dysfunction in irradiated rats.

    Science.gov (United States)

    Nejaim, Yuri; I V Silva, Amaro; V Vasconcelos, Taruska; J N L Silva, Emmanuel; M de Almeida, Solange

    2014-09-01

    The aim of this study was to evaluate the radioprotective and reparative effects of compounds based on aloe vera, zinc, and copper against salivary gland dysfunction in Wistar rats. A total of 150 Wistar rats were randomly divided into 12 groups, in which the animals received aloe vera and/or zinc and copper. In eight of these groups the animals were also subjected to irradiation before or after administration of the substances. After 27 days, sialometry tests were performed. Data were analyzed using ANOVA and the Tukey test (P aloe vera before or after irradiation showed a significantly higher salivary flow rate than rats that had been simply irradiated. When both substances were administered, a statistically significant difference in the salivary flow rate was observed in comparison with the irradiation alone group seven days after irradiation. The present results suggest that aloe vera exerts positive protective and reparative effects, and can be considered a potential radioprotective substance.

  14. Automatic evaluation of speech rhythm instability and acceleration in dysarthrias associated with basal ganglia dysfunction

    Directory of Open Access Journals (Sweden)

    Jan eRusz

    2015-07-01

    Full Text Available Speech rhythm abnormalities are commonly present in patients with different neurodegenerative disorders. These alterations are hypothesized to be a consequence of disruption to the basal ganglia circuitry involving dysfunction of motor planning, programming and execution, which can be detected by a syllable repetition paradigm. Therefore, the aim of the present study was to design a robust signal processing technique that allows the automatic detection of spectrally-distinctive nuclei of syllable vocalizations and to determine speech features that represent rhythm instability and acceleration. A further aim was to elucidate specific patterns of dysrhythmia across various neurodegenerative disorders that share disruption of basal ganglia function. Speech samples based on repetition of the syllable /pa/ at a self-determined steady pace were acquired from 109 subjects, including 22 with Parkinson's disease (PD, 11 progressive supranuclear palsy (PSP, 9 multiple system atrophy (MSA, 24 ephedrone-induced parkinsonism (EP, 20 Huntington's disease (HD, and 23 healthy controls. Subsequently, an algorithm for the automatic detection of syllables as well as features representing rhythm instability and rhythm acceleration were designed. The proposed detection algorithm was able to correctly identify syllables and remove erroneous detections due to excessive inspiration and nonspeech sounds with a very high accuracy of 99.6%. Instability of vocal pace performance was observed in PSP, MSA, EP and HD groups. Significantly increased pace acceleration was observed only in the PD group. Although not significant, a tendency for pace acceleration was observed also in the PSP and MSA groups. Our findings underline the crucial role of the basal ganglia in the execution and maintenance of automatic speech motor sequences. We envisage the current approach to become the first step towards the development of acoustic technologies allowing automated assessment of rhythm

  15. The usefulness of MR imaging of the temporal bone in the evaluation of patients with facial and audiovestibular dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Uk; Kim, Hyung Jin; Cho, Young Kuk; Lim, Myung Kwan; Kim, Won Hong; Suh, Chang Hae; Lee, Seung Chul [Inha University College of Medicine, Incheon (Korea, Republic of)

    2002-01-01

    To evaluate the clinical utility of MR imaging of the temporal bone in patients with facial and audiovestibular dysfunction with particular emphasis on the importance of contrast enhancement. We retrospectively reviewed the MR images of 179 patients [72 men, 107 women; average age, 44 (range, 1-77) years] who presented with peripheral facial palsy (n=15), audiometrically proven sensorineural hearing loss (n=104), vertigo (n=109), or tinnitus (n=92). Positive MR imaging findings possibly responsible for the patients' clinical manifestations were categorized according to the anatomic sites and presumed etiologies of the lesions. We also assessed the utility of contrast-enhanced MR imaging by analyzing its contribution to the demonstration of lesions which would otherwise not have been apparent. All MR images were interpreted by two neuroradiologists, who reached their conclusions by consensus. MR images demonstrated positive findings, thought to account for the presenting symptoms, in 78 (44%) of 179 patients, including 15 (100%) of 15 with peripheral facial palsy, 43 (41%) of 104 with sensorineural hearing loss, 40 (37%) of 109 with vertigo, and 39 (42%) of 92 with tinnitus. Thirty (38%) of those 78 patients had lesions that could be confidently recognized only at contrast-enhanced MR imaging. Even though its use led to positive findings in less than half of these patients, MR imaging of the temporal bone is a useful diagnostic procedure in the evaluation of those with facial and audiovestibular dysfunction. Because it was only at contrast-enhanced MR imaging that a significant number of patients showed positive imaging findings which explained their clinical manifestations, the use of contrast material is highly recommended.

  16. Discrepancy between myocardial perfusion and fatty acid metabolism following acute myocardial infarction for evaluating the dysfunctional viable myocardium.

    Science.gov (United States)

    Biswas, Shankar K; Sarai, Masayoshi; Toyama, Hiroshi; Hishida, Hitoshi; Ozaki, Yukio

    2012-01-01

    Following acute myocardial infarction (AMI) the area of myocardial perfusion and metabolism mismatch is designated as dysfunctional viable myocardium. (123)I-beta-methyl iodophenyl pentadecanoic acid (BMIPP) is clinically very useful for evaluating myocardial fatty acid metabolism, and (99)mTc-Tetrofosmin (TF) is a widely used tracer for myocardial perfusion. This study was designed to evaluate the degree of discrepancy between BMIPP and TF at the subacute state of AMI. Fifty-two patients (aged 59 ± 10 years; mean 46 years) with AMI were enrolled, and all of them underwent percutaneous coronary intervention (PCI). Patients were classified according to ST-T change and PCI timing. (123)I-beta-methyl iodophenyl pentadecanoic acid and TF cardiac scintigraphy were performed on 7 ± 3.5 days of admission using a dual headed gamma camera. Perfusion and fatty acid metabolism defect were scored on a 17 segments model. The mean BMIPP defect score on early and delayed images were 16.67 ± 10.19 and 16.25 ± 10.40, respectively. The mean TF defect score was 10 ± 7.69. Defect score of BMIPP was significantly higher than that of the TF (P TF), and 5 (10%) patients showed matched defect (BMIPP = TF). Mismatched defect score (MMDS) was significantly higher in patients with ST-segment elevation myocardial infarction (STEMI) than that of non-ST-segment elevation myocardial infarction (NSTEMI) (P < 0.041; 95% CI 0.11-5.19). At the subacute state of AMI, most of the patients showed perfusion-metabolism mismatch, which represents the dysfunctional viable myocardium, and patients with STEMI showed higher mismatch. Copyright © 2012 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  17. On the Physiology of Normal Swallowing as Revealed by Magnetic Resonance Imaging in Real Time

    Directory of Open Access Journals (Sweden)

    Arno Olthoff

    2014-01-01

    Full Text Available The aim of this study was to assess the physiology of normal swallowing using recent advances in real-time magnetic resonance imaging (MRI. Therefore ten young healthy subjects underwent real-time MRI and flexible endoscopic evaluations of swallowing (FEES with thickened pineapple juice as oral contrast bolus. MRI movies were recorded in sagittal, coronal, and axial orientations during successive swallows at about 25 frames per second. Intermeasurement variation was analyzed and comparisons between real-time MRI and FEES were performed. Twelve distinct swallowing events could be quantified by real-time MRI (start time, end time, and duration. These included five valve functions: oro-velar opening, velo-pharyngeal closure, glottal closure, epiglottic retroflexion, and esophageal opening; three bolus transports: oro-velar transit, pharyngeal delay, pharyngeal transit; and four additional events: laryngeal ascent, laryngeal descent, vallecular, and piriform sinus filling and pharyngeal constriction. Repetitive measurements confirmed the general reliability of the MRI method with only two significant differences for the start times of the velo-pharyngeal closure (t(8=-2.4, P≤0.046 and laryngeal ascent (t(8=-2.6, P≤0.031. The duration of the velo-pharyngeal closure was significantly longer in real-time MRI compared to FEES (t(8=-3.3, P≤0.011. Real-time MRI emerges as a simple, robust, and reliable tool for obtaining comprehensive functional and anatomical information about the swallowing process.

  18. Evaluation of shear stress accumulation on blood components in normal and dysfunctional bileaflet mechanical heart valves using smoothed particle hydrodynamics.

    Science.gov (United States)

    Shahriari, S; Maleki, H; Hassan, I; Kadem, L

    2012-10-11

    Evaluating shear induced hemodynamic complications is one of the major concerns in design of the mechanical heart valves (MHVs). The monitoring of these events relies on both numerical simulations and experimental measurements. Currently, numerical approaches are mainly based on a combined Eulerian-Lagrangian approach. A more straightforward evaluation can be based on the Lagrangian analysis of the whole blood. As a consequence, Lagrangian meshfree methods are more adapted to such evaluation. In this study, smoothed particle hydrodynamics (SPH), a fully meshfree particle method originated to simulate compressible astrophysical flows, is applied to study the flow through a normal and a dysfunctional bileaflet mechanical heart valves (BMHVs). The SPH results are compared with the reference data. The accumulation of shear stress patterns on blood components illustrates the important role played by non-physiological flow patterns and mainly vortical structures in this issue. The statistical distribution of particles with respect to shear stress loading history provides important information regarding the relative number of blood components that can be damaged. This can be used as a measure of the response of blood components to the presence of the valve implant or any implantable medical device. This work presents the first attempt to simulate pulsatile flow through BMHVs using SPH method. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Why a combined intracavernosal injection with trimix and oral sildenafil is reliable therapy in the ultrasonographic evaluation of erectile dysfunction

    National Research Council Canada - National Science Library

    Park, Jong Kwan; Park, Jung Sun; Jeon, Sang Bong; Cui, Wan Shou; Kim, Sung Zoo; Kang, Kyung Koo; Lee, Sung Won

    2008-01-01

    ... correlating with haemodynamic changes in the cavernosal arteries after an intracavernosal injection (ICI) with vasoactive agents with or without oral sildenafil in men with erectile dysfunction...

  20. Teaching Effectiveness, Impression Management, and Dysfunctional Behavior: Student Evaluation of Teaching Control Data

    Science.gov (United States)

    Crumbley, D. Larry; Reichelt, Kenneth J.

    2009-01-01

    Purpose: Student evaluation of teaching (SET) questionnaires are used in many countries, although much current research questions the validity of these surveys. US research indicates that more than 90 percent of academic accounting departments use this performance measurement. This paper aims to focus on the validity of SET data.…

  1. A randomized, double-masked study to evaluate the effect of omega-3 fatty acids supplementation in meibomian gland dysfunction

    Directory of Open Access Journals (Sweden)

    Oleñik A

    2013-08-01

    Full Text Available Andrea Oleñik,1 Ignacio Jiménez-Alfaro,1 Nicolás Alejandre-Alba,1 Ignacio Mahillo-Fernández2 1Department of Ophthalmology, Jiménez Díaz Foundation, Madrid, Spain; 2Department of Statistics, Jiménez Díaz Foundation, Madrid, Spain Background: Dysfunction of the meibomian gland (MG is among the most frequent causes of ophthalmological symptoms. The inflammation seen in meibomian gland dysfunction (MGD is part of its pathogenesis, and evidence of the antioxidant-inflammatory properties of omega-3 fatty acids suggests this to be an appropriate treatment for MGD. Objective: We aimed to assess the effectiveness of omega-3 fatty acids versus placebo, in improving the symptoms and signs of MGD. Methods: We conducted a randomized and double-mask trial of 3 months duration. We enrolled 61 patients who presented with symptomatic MGD and no tear instability (defined as tear breakup time [TBUT] <10 seconds. Participants were randomly assigned to two homogeneous subgroups. For patients in group A, the study treatment included cleaning the lid margins with neutral baby shampoo and use of artificial tears without preservatives, plus a placebo oral agent. For patients in group B, the study treatment included cleaning the lid margins with neutral baby shampoo and use of artificial tears without preservatives, plus oral supplementation with omega-3 fatty acids. We performed the following tests: (1 TBUT; (2 Schirmer I test; (3 Ocular Surface Disease Index© (OSDI©; Allergan, Inc., Irvine, CA, USA; (4 MG expression; (5 evaluation of lid margin inflammation; and (6 interpalpebral and corneal dye staining. Results: After 3 months of evaluation, the mean OSDI, TBUT, lid margin inflammation, and MG expression presented improvement from the baseline values, in group B (P < 0.01, P < 0.001, P < 0.0001, P < 0.0001, respectively. The Schirmer test results were also improved and statistically significant (P < 0.01. Conclusion: Oral omega-3 fatty acids, 1.5 grams per

  2. Evaluating sexual nursing care intervention for reducing sexual dysfunction in Indonesian cervical cancer survivors

    Directory of Open Access Journals (Sweden)

    Yati Afiyanti

    2016-01-01

    Full Text Available Objective: This study aims to describe the factors affecting successful nursing care intervention on sexuality. Methods: A one-group pre- and post-test design was used. Fifty-three cervical cancer survivors and their spouses were administered with nursing care intervention on sexuality in three sessions and evaluated after 6 weeks. Results: Sexual intervention reduced dyspareunia symptoms, improved vaginal lubrication, improved sexual satisfaction, and enhanced sexual arousal, sexual desire, and orgasm among cancer survivors and their spouses. The other influencing factors also simultaneously contributed to the success of nursing care intervention. Conclusions: Nursing care intervention on sexuality could be a part of supportive nursing care and an important aspect in standard nursing care for cancer patients in Indonesia.

  3. Neuropsychological dysfunction in patients with end-stage pulmonary disease: lung transplant evaluation

    Science.gov (United States)

    Crews, W. David; Jefferson, Angela L.; Broshek, Donna K.; Rhodes, Robert D.; Williamson, John; Brazil, Amy M.; Barth, Jeffrey T.; Robbins, Mark K.

    2011-01-01

    There has been a relative absence of studies that have examined the neuropsychological profiles of potential lung transplant candidates. Neuropsychological data are presented for 134 patients with end-stage pulmonary disease who were being evaluated as potential candidates for lung transplantation. Neuropsychological test results indicated that a significantly greater proportion of the patients exhibited impaired performances on a number of Selective Reminding Test (SRT) tasks as compared to the expected population frequency distributions for these measures. The highest frequencies of impairment were observed on the SRT’s Immediate Free Recall (46.43%), Long-term Retrieval (41.67%), and Consistent Long-term Retrieval (51.19%) variables. On the Minnesota Multiphasic Personality Inventory-2 (MMPI-2)/Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A), patients’ mean clinical profile revealed elevations on Scales 1 (Hypochondriasis) and 3 (Conversion Hysteria). This profile indicated that they were experiencing an array of symptomatology ranging from somatic complaints to lethargy and fatigue, and that they may have been functioning at a reduced level of efficiency. Findings are discussed in light of patients’ end-stage pulmonary disease and factors possibly contributing to their neuropsychological test performances. Implications for clinical practice and future research are also provided. PMID:14591451

  4. The Buccinator Mucomuscular Flap: An In-Depth Analysis and Evaluation of Its Role in the Management of Velopharyngeal Dysfunction.

    Science.gov (United States)

    Ahl, Rebecka; Harding-Bell, Anne; Wharton, Laura; Jordan, Adam; Hall, Per

    2016-09-01

    A significant proportion of patients with cleft palate experience persisting velopharyngeal dysfunction (VPD) after primary surgery. Pharyngoplasty is the most common procedure to correct inadequate velopharyngeal closure. Although it is often effective, it poses a risk for postoperative airway obstruction. The mucomuscular buccinator flap is a more recent alternative: In the largest case series to date, we outline its use and evaluate its effectiveness in managing persistent VPD. Over 9 years, 103 buccinator flap procedures were performed by the Cambridge group to improve velar function. Clinical records were retrospectively assessed: 60 patients were analyzed by two expert speech and language therapists external to the group using the Cleft Audit Protocol for Speech-Augmented. In a subset of patients, the buccinator flap was interpolated between the limbs of a large mucosal Z-plasty. Consensus listening was undertaken, and interrater reliability was calculated for 24.17% of the cohort. The remaining samples were assessed by a single listener following calibrated consensus listening. There was a significant reduction in VPD (P cleft speech characteristics, and audible nasal emission. Overall, 13.5% of patients required further corrective speech surgery. The buccinator mucomuscular flap reliably and effectively improves velar function in the management of VPD and has low complication rates. We therefore recommend the use of the buccinator flap in primary surgical management of persisting VPD.

  5. Erectile Dysfunction

    Science.gov (United States)

    ... of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include: Depression, anxiety or other mental health conditions Stress Relationship problems due to stress, poor communication or other concerns ...

  6. Erectile Dysfunction

    Science.gov (United States)

    ... Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/men/erectile-dysfunction.html. Accessed Nov. ... medicine and a synthesis of the main available therapies. Diabetes & Metabolism. 2012;38:1. Nippoldt TB (expert opinion). ...

  7. Orgasmic dysfunction

    Science.gov (United States)

    ... dysfunction is when a woman either cannot reach orgasm, or has trouble reaching orgasm when she is sexually excited. When sex is ... to 15% of women have never had an orgasm. Surveys suggest that up to one half of ...

  8. Erectile dysfunction

    National Research Council Canada - National Science Library

    Giuliano, F; Droupy, S

    2013-01-01

    Erectile dysfunction (ED) is the most commonly studied sexual disorder. ED is defined by a consistent or recurrent inability to attain and/or maintain penile erection sufficient for sexual activity...

  9. Erectile Dysfunction

    Science.gov (United States)

    ... rigid. Medications The oral medications for erectile dysfunction, sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), relax the muscles ... to begin working; the erection helping effects of sildenafil and vardenafil last for about 8 hours and ...

  10. Why a combined intracavernosal injection with trimix and oral sildenafil is reliable therapy in the ultrasonographic evaluation of erectile dysfunction.

    Science.gov (United States)

    Park, Jong Kwan; Park, Jung Sun; Jeon, Sang Bong; Cui, Wan Shou; Kim, Sung Zoo; Kang, Kyung Koo; Lee, Sung Won

    2008-09-01

    To evaluate prospectively and compare the clinical response and the change in nucleotides correlating with haemodynamic changes in the cavernosal arteries after an intracavernosal injection (ICI) with vasoactive agents with or without oral sildenafil in men with erectile dysfunction (ED). In all, 80 patients with ED were prospectively evaluated by clinical assessments, measuring nucleotides in blood plasma and haemodynamics in cavernosal arteries. All patients had colour Doppler ultrasonography (CDU) twice with an interval of 5 h. First, each patient had CDU after ICI with trimix (0.25 mL) or prostaglandin E1 (PGE1, 5 microg), and the second CDU was after ICI trimix given 1 h after oral placebo (group I), sildenafil 25 mg (group II) or 100 mg (group III) and after ICI with PGE1 at 1 h after oral placebo (group IV) or 100 mg sildenafil (group V). Levels of cGMP and cAMP in peripheral venous and penile cavernosal blood plasma were measured at 15 min after ICI. The mean peak systolic velocity (PSV) at 5, 10, 15 min, and resistive index at 10 min in the second CDU after ICI with trimix, were significantly increased in group III. The mean (sem) levels of cavernosal cGMP were significantly increased in group III and V, from 1130.1 (313.5) to 2056.7 (580.4) and 1017.0 (214.2) to 1905.2 (915.0) fmol/mL, respectively. cAMP was significantly increased in group V, from 9533.1 (2068.4) to 12150 (3684.2) fmol/mL. The haemodynamic changes and cGMP and cAMP production in the cavernosum were improved by trimix plus sildenafil more than with than PGE1 plus sildenafil or one ICI with trimix or PGE1. The results suggest that ICI with trimix and sildenafil is the best combination for a pharmacological erection test.

  11. Renal dysfunction in cirrhosis.

    Science.gov (United States)

    Urrunaga, Nathalie H; Mindikoglu, Ayse L; Rockey, Don C

    2015-05-01

    Renal dysfunction causes significant morbidity in cirrhotic patients. Diagnosis is challenging because it is based on serum creatinine, which is used to calculate estimated glomerular filtration rate, which itself is not an ideal measure of renal function in patients with cirrhosis. Finding the exact cause of renal injury in patients with cirrhosis remains problematic due to the limitations of the current diagnostic tests. The purpose of this review is to highlight studies used to diagnose renal dysfunction in patients with renal dysfunction and review current treatments. New diagnostic criteria and classification of renal dysfunction, especially for acute kidney injury (AKI), have been proposed in hopes of optimizing treatment and improving outcomes. New biomarkers that help to differentiate structural from functional AKI in cirrhotic patients have been developed, but require further investigation. Vasoconstrictors are the most commonly recommended treatment of hepatorenal syndrome (HRS). Given the high mortality in patients with type 1 HRS, all patients with HRS should be evaluated for liver transplantation. When renal dysfunction is considered irreversible, combined liver-kidney transplantation is advised. Development of new biomarkers to differentiate the different types of AKI in cirrhosis holds promise. Early intervention in cirrhotic patients with renal dysfunction offers the best hope of improving outcomes.

  12. Morphometric evaluation of nitric oxide synthase isoforms and their cytokine regulators predict pulmonary dysfunction and survival in systemic sclerosis

    Directory of Open Access Journals (Sweden)

    E.R. Parra

    2013-01-01

    Full Text Available Because histopathological changes in the lungs of patients with systemic sclerosis (SSc are consistent with alveolar and vessel cell damage, we presume that this interaction can be characterized by analyzing the expression of proteins regulating nitric oxide (NO and plasminogen activator inhibitor-1 (PAI-1 synthesis. To validate the importance of alveolar-vascular interactions and to explore the quantitative relationship between these factors and other clinical data, we studied these markers in 23 cases of SSc nonspecific interstitial pneumonia (SSc-NSIP. We used immunohistochemistry and morphometry to evaluate the amount of cells in alveolar septa and vessels staining for NO synthase (NOS and PAI-1, and the outcomes of our study were cellular and fibrotic NSIP, pulmonary function tests, and survival time until death. General linear model analysis demonstrated that staining for septal inducible NOS (iNOS related significantly to staining of septal cells for interleukin (IL-4 and to septal IL-13. In univariate analysis, higher levels of septal and vascular cells staining for iNOS were associated with a smaller percentage of septal and vascular cells expressing fibroblast growth factor and myofibroblast proliferation, respectively. Multivariate Cox model analysis demonstrated that, after controlling for SSc-NSIP histological patterns, just three variables were significantly associated with survival time: septal iNOS (P=0.04, septal IL-13 (P=0.03, and septal basic fibroblast growth factor (bFGF; P=0.02. Augmented NOS, IL-13, and bFGF in SSc-NSIP histological patterns suggest a possible functional role for iNOS in SSc. In addition, the extent of iNOS, PAI-1, and IL-4 staining in alveolar septa and vessels provides a possible independent diagnostic measure for the degree of pulmonary dysfunction and fibrosis with an impact on the survival of patients with SSc.

  13. Evaluation of pain regression in patients with temporomandibular dysfunction treated by intra-articular platelet-rich plasma injections: a preliminary report.

    Science.gov (United States)

    Pihut, M; Szuta, M; Ferendiuk, E; Zeńczak-Więckiewicz, D

    2014-01-01

    The objective of this study was to evaluate the regression of temporomandibular pain as a result of intra-articular injections of platelet-rich plasma (PRP) to patients with temporomandibular joint dysfunction previously subjected to prosthetic treatment. The baseline study material consisted of 10 patients, both males and females, aged 28 to 53 years, previously treated due to painful temporomandibular joint dysfunction using occlusal splints. All patients were carried out to a specialist functional assessment of the dysfunction using the Polish version of the RDC/TMD questionnaire axis I and II. Intra-articular injections were preceded by a preparation of PRP. The injection sites were determined by the method used during arthroscopic surgical procedures. Following aspiration, 0.5 mL of plasma was injected into each temporomandibular joint. The comparison of the intensity of pain during all examinations suggests a beneficial effect of the procedure being performed as the mean VAS score was 6.5 at examination I, 2.8 at examination II, and 0.6 at examination III. Application of the intra-articular injections of platelet-rich plasma into the temporomandibular joints has a positive impact on the reduction of the intensity of pain experienced by patients treated for temporomandibular joint dysfunction.

  14. Laryngeal Dysfunction

    DEFF Research Database (Denmark)

    Hull, James H; Backer, Vibeke; Gibson, Peter G

    2016-01-01

    The larynx is one of the most highly innervated organs in humans and serves a number of vitally important, complex, and highly evolved biological functions. On a day-to-day basis, the larynx functions autonomously, addressing several roles including airway protection, swallowing, and phonation....... In some situations the larynx appears to adopt a functional state that could be considered maladaptive or "dysfunctional." This laryngeal dysfunction can underpin and account for a number of respiratory symptoms that otherwise appear incongruous with a clinical disease state and/or contribute...

  15. Evaluation of Metabolic and Synaptic Dysfunction Hypotheses of Alzheimer's Disease (AD): A Meta-Analysis of CSF Markers.

    Science.gov (United States)

    Manyevitch, Roni; Protas, Matthew; Scarpiello, Sean; Deliso, Marisa; Bass, Brittany; Nanajian, Anthony; Chang, Matthew; Thompson, Stefani M; Khoury, Neil; Gonnella, Rachel; Trotz, Margit; Moore, D Blaine; Harms, Emily; Perry, George; Clunes, Lucy; Ortiz, Angelica; Friedrich, Jan O; Murray, Ian V J

    2018-01-01

    Alzheimer's disease (AD) is currently incurable and a majority of investigational drugs have failed clinical trials. One explanation for this failure may be the invalidity of hypotheses focusing on amyloid to explain AD pathogenesis. Recently, hypotheses which are centered on synaptic and metabolic dysfunction are increasingly implicated in AD. Evaluate AD hypotheses by comparing neurotransmitter and metabolite marker concentrations in normal versus AD CSF. Meta-analysis allows for statistical comparison of pooled, existing cerebrospinal fluid (CSF) marker data extracted from multiple publications, to obtain a more reliable estimate of concentrations. This method also provides a unique opportunity to rapidly validate AD hypotheses using the resulting CSF concentration data. Hubmed, Pubmed and Google Scholar were comprehensively searched for published English articles, without date restrictions, for the keywords "AD", "CSF", and "human" plus markers selected for synaptic and metabolic pathways. Synaptic markers were acetylcholine, gamma-aminobutyric acid (GABA), glutamine, and glycine. Metabolic markers were glutathione, glucose, lactate, pyruvate, and 8 other amino acids. Only studies that measured markers in AD and controls (Ctl), provided means, standard errors/deviation, and subject numbers were included. Data were extracted by six authors and reviewed by two others for accuracy. Data were pooled using ratio of means (RoM of AD/Ctl) and random effects meta-analysis using Cochrane Collaboration's Review Manager software. Of the 435 identified publications, after exclusion and removal of duplicates, 35 articles were included comprising a total of 605 AD patients and 585 controls. The following markers of synaptic and metabolic pathways were significantly changed in AD/controls: acetylcholine (RoM 0.36, 95% CI 0.24-0.53, pproof of concept for the use of meta-analysis validation of AD hypotheses, specifically via robust evidence for the cholinergic hypothesis of AD

  16. Use of Optical Mapping to Evaluate Mechanisms and New Therapies for Bladder Dysfunction Due to Spinal Cord Injury

    Science.gov (United States)

    2014-12-01

    JP, Bemelmans BL. Current opinion on the working mechanisms of neuromodulation in the treatment of lower urinary tract dysfunction. Curr Opin Urol...41. Low JA. Urethral behavior during the involuntary detrusor contraction. Am J Obstet Gynecol 1977;128:32–42. 42. Groenendikjk PM, Heesakkers JP...development. Curr Urol Rep 2005;6:146–51. 17. Hashimoto Y, Ushiki T, Uchida T, et al. Scanning electron microscopic observation of apical sites of open

  17. Left Ventricular Diastolic Dysfunction in Asymptomatic Type 2 Diabetic Patients: Detection and Evaluation by Tissue Doppler Imaging

    OpenAIRE

    Zahiti, Bedri Faik; Gorani, Daut Rashit; Gashi, Fitim Bejtullah; Gjoka, Sami Bajram; Zahiti, Lorita Bedri; Haxhiu, Bekim Syl?; Kamberi, Lulzim Selim

    2013-01-01

    CONFLICT OF INTEREST: NONE DECLARED The aim of the study was detection of diastolic dysfunction of myocardium with Tissue Doppler Imaging (TDI) in asymptomatic type 2 diabetic patients, in five years duration of disease, and normal cardiac function on conventional echocardiography (CE), according to the performance showed on exercise stress test. Material and Methods We studied 300 patients, of them 150 patients with non-obese, normotensive, uncomplicated type 2 diabetes, in five years durati...

  18. Serelaxin as a potential treatment for renal dysfunction in cirrhosis: Preclinical evaluation and results of a randomized phase 2 trial.

    Directory of Open Access Journals (Sweden)

    Victoria K Snowdon

    2017-02-01

    Full Text Available Chronic liver scarring from any cause leads to cirrhosis, portal hypertension, and a progressive decline in renal blood flow and renal function. Extreme renal vasoconstriction characterizes hepatorenal syndrome, a functional and potentially reversible form of acute kidney injury in patients with advanced cirrhosis, but current therapy with systemic vasoconstrictors is ineffective in a substantial proportion of patients and is limited by ischemic adverse events. Serelaxin (recombinant human relaxin-2 is a peptide molecule with anti-fibrotic and vasoprotective properties that binds to relaxin family peptide receptor-1 (RXFP1 and has been shown to increase renal perfusion in healthy human volunteers. We hypothesized that serelaxin could ameliorate renal vasoconstriction and renal dysfunction in patients with cirrhosis and portal hypertension.To establish preclinical proof of concept, we developed two independent rat models of cirrhosis that were characterized by progressive reduction in renal blood flow and glomerular filtration rate and showed evidence of renal endothelial dysfunction. We then set out to further explore and validate our hypothesis in a phase 2 randomized open-label parallel-group study in male and female patients with alcohol-related cirrhosis and portal hypertension. Forty patients were randomized 1:1 to treatment with serelaxin intravenous (i.v. infusion (for 60 min at 80 μg/kg/d and then 60 min at 30 μg/kg/d or terlipressin (single 2-mg i.v. bolus, and the regional hemodynamic effects were quantified by phase contrast magnetic resonance angiography at baseline and after 120 min. The primary endpoint was the change from baseline in total renal artery blood flow. Therapeutic targeting of renal vasoconstriction with serelaxin in the rat models increased kidney perfusion, oxygenation, and function through reduction in renal vascular resistance, reversal of endothelial dysfunction, and increased activation of the AKT

  19. Erectile dysfunction among men attending surgical outpatients ...

    African Journals Online (AJOL)

    Background: Erectile dysfunction is becoming a public health issue with high incidences reported in community studies. Objective: To evaluate the characteristics and outcome of treatment in men with erectile dysfunction in a tertiary center in Ibadan southwestern Nigeria. Methods: Data of men with erectile dysfunction was ...

  20. Vesicoureteral reflux and bladder dysfunction.

    Science.gov (United States)

    Lee, Hyeyoung; Lee, Yong Seung; Im, Young Jae; Han, Sang Won

    2012-09-01

    , dysfunctional voiding seems to be more closely related to renal damage in association with VUR than overactive bladder. However, studies show that UTI can induce renal scarring even without VUR present and urodynamic abnormalities are quite often detected in these cases. Whether reflux of sterile urine in bladder dysfunction can cause significant renal scarring, especially when intrarenal reflux is present remains controversial. Another issue that warrants further research is the direct relationship between bladder dysfunction and renal scarring, since some reports suggest that these two conditions share a common genotype. Recently some studies have suggest VUR as a causal factor of bladder dysfunction, supported by the fact that bladder dysfunction resolves after injection therapy of VUR. Further study with more objective evaluation of bladder dysfunction may be needed.

  1. Evaluating the Effect of Cognitive Dysfunction on Mental Imagery in Patients with Stroke Using Temporal Congruence and the Imagined 'Timed Up and Go' Test (iTUG.

    Directory of Open Access Journals (Sweden)

    Maxime Geiger

    Full Text Available Motor imagery (MI capacity may be altered following stroke. MI is evaluated by measuring temporal congruence between the timed performance of an imagined and an executed task. Temporal congruence between imagined and physical gait-related activities has not been evaluated following stroke. Moreover, the effect of cognitive dysfunction on temporal congruence is not known.To assess temporal congruence between the Timed Up and Go test (TUG and the imagined TUG (iTUG tests in patients with stroke and to investigate the role played by cognitive dysfunctions in changes in temporal congruence.TUG and iTUG performance were recorded and compared in twenty patients with chronic stroke and 20 controls. Cognitive function was measured using the Montreal Cognitive Assessment (MOCA, the Frontal Assessment Battery at Bedside (FAB and the Bells Test.The temporal congruence of the patients with stroke was significantly altered compared to the controls, indicating a loss of MI capacity (respectively 45.11 ±35.11 vs 24.36 ±17.91, p = 0.02. Furthermore, iTUG test results were positively correlated with pathological scores on the Bells Test (r = 0.085, p = 0.013, likely suggesting that impairment of attention was a contributing factor.These results highlight the importance of evaluating potential attention disorder in patients with stroke to optimise the use of MI for rehabilitation and recovery. However further study is needed to determine how MI should be used in the case of cognitive dysfunction.

  2. The application of color Doppler flow imaging in the diagnosis and therapeutic effect evaluation of erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Xu-Jun Xuan

    2016-01-01

    Full Text Available We aim to investigate the correlations between hemodynamic parameters, penile rigidity grading, and the therapeutic effects of phosphodiesterase type 5 inhibitors using color Doppler flow imaging after intracavernosal injection in patients with erectile dysfunction. This study involved 164 patients. After intracavernosal injection with a mixture of papaverine (60 mg, prostaglandin E 1 (10 mg, and lidocaine (2%, 0.5-1 ml, the penile vessels were assessed using color Doppler flow imaging. Penile rigidity was classified based on the Erection Hardness Score system as Grades 4, 3, 2 or 1 (corresponding to Schramek Grades V to II. Then, the patients were given oral sildenafil (50-100 mg and scored according to the International Index of Erectile Function (IIEF-5 questionnaire. The number of patients with penile rigidities of Schramek Grades II to V was 14, 18, 21, and 111, respectively. The IIEF-5 score was positively correlated with the refilling index of the penile cavernosal artery (r = 0.79, P< 0.05, the peak systolic velocity (r = 0.45, P< 0.05, and penile rigidity (r = 0.75, P< 0.05, and was negatively correlated with the end diastolic velocity (r = −0.74, P< 0.05. For patients with erectile dysfunction, both the IIEF-5 score after sildenafil administration, which is correlated with penile rigidity, and the hemodynamic parameters detected using color Doppler flow imaging may predict the effects of phosphodiesterase type 5 inhibitor treatment and could provide a reasonable model for the targeted-treatment of erectile dysfunction.

  3. The application of color Doppler flow imaging in the diagnosis and therapeutic effect evaluation of erectile dysfunction.

    Science.gov (United States)

    Xuan, Xu-Jun; Bai, Gang; Zhang, Cai-Xia; Xu, Chao; Lu, Fu-Ding; Peng, Yang; Ma, Gang; Han, Cong-Hui; Chen, Jun

    2016-01-01

    We aim to investigate the correlations between hemodynamic parameters, penile rigidity grading, and the therapeutic effects of phosphodiesterase type 5 inhibitors using color Doppler flow imaging after intracavernosal injection in patients with erectile dysfunction. This study involved 164 patients. After intracavernosal injection with a mixture of papaverine (60 mg), prostaglandin E 1 (10 mg), and lidocaine (2%, 0.5-1 ml), the penile vessels were assessed using color Doppler flow imaging. Penile rigidity was classified based on the Erection Hardness Score system as Grades 4, 3, 2 or 1 (corresponding to Schramek Grades V to II). Then, the patients were given oral sildenafil (50-100 mg) and scored according to the International Index of Erectile Function (IIEF-5) questionnaire. The number of patients with penile rigidities of Schramek Grades II to V was 14, 18, 21, and 111, respectively. The IIEF-5 score was positively correlated with the refilling index of the penile cavernosal artery (r = 0.79, PDoppler flow imaging may predict the effects of phosphodiesterase type 5 inhibitor treatment and could provide a reasonable model for the targeted-treatment of erectile dysfunction.

  4. Evaluation of penile cavernosal artery intima-media thickness in patients with erectile dysfunction. A new parameter in the diagnosis of vascular erectile dysfunction. Our experience on 59 cases

    Directory of Open Access Journals (Sweden)

    Domenico Prezioso

    2014-03-01

    Full Text Available Objective: A precise characterization of erectile dysfunction (ED of vascular origin has not yet been achieved, although cavernous peak systolic velocity (PSV is generally considered a major parameter. Nevertheless the penile dynamic color Doppler is invasive and linked to several complications. The intima-media thicknesses (IMT of cavernosal artery would add to the predictive value of vasculogenic ED risk and outcomes. We also hypothesized the existence of a correlation between IMT cavernosal artery and IMT carotid arteries. This study seeks to evaluate these hypotheses with our experience, investigating the predictive accuracy of carotid and cavernosal Doppler ultrasound findings for discriminating patients with vasculogenic ED. Material and methods: A total of 59 subjects (32 vasculogenic ED patients - group A - and 27 no vasculogenic ED patients - group B were evaluated in our andrological center from September 2012 to June 2013 and enrolled in the study. All subjects underwent medical history, erectile function domain of the International Index of Erectile Function, physical examination, routine and sex hormone blood tests, and high resolution dynamic color Doppler ultrasound evaluation of carotid and penile districts and valutation of IMT in both districts. Results: The values of cavernosal artery IMT in group A were higher than in group B (0,28 ± 0,06 mm vs 0,17 ± 0,07 mm. Even the values of carotid artery IMT in vasculogenic ED group were higher than in no vasculogenic ED group (0,74 ± 0,14 mm vs 0,59 ± 0,11 mm. The cavernosal IMT showed a moderate (r = 0.61 positive linear correlation (p < 0.001 with the carotid artery IMT. Conclusions: An increased cavernous IMT might predict ED of vascular origin with more accuracy than PSV and could be a sensitive predictor also for systemic atherosclerosis at an earlier phase.

  5. Evaluation of global and regional left ventricular function obtained by quantitative gated SPECT using {sup 99m}Tc-tetrofosmin for left ventricular dysfunction

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    Ban, Kazunobu; Nakajima, Tohru; Iseki, Harukazu; Abe, Sumihisa; Handa, Shunnosuke; Suzuki, Yutaka [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine

    2000-08-01

    The quantitative gated SPECT (QGS) software is able to calculate LV volumes and visualize LV wall motion and perfusion throughout the cardiac cycle using an automatic edge detection algorithm of the left ventricle. We evaluated the reliability of global and regional LV function assessment derived from QGS by comparing it with the results from left ventriculo-cineangiography (LVG). In 20 patients with left ventricular dysfunction who underwent ECG gated {sup 99m}Tc-tetrofosmin SPECT, the end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) were calculated. The QGS-assessed regional wall motion was determined using the cinematic display. QGS-derived EDV, ESV and LVEF correlated well with those by LVG (p<0.001 for each). There was a good correlation between wall motion score (WMS) derived from the QGS and the LVG (r=0.40, p<0.05). In some patients with extensive myocardial infarction, there was a discrepancy in the regional wall motion results between QGS and LVG. The ECG-gated SPECT using QGS is useful to evaluate global and regional LV functions in left ventricular dysfunction. (author)

  6. Left ventricular diastolic dysfunction in asymptomatic type 2 diabetic patients: detection and evaluation by tissue Doppler imaging.

    Science.gov (United States)

    Zahiti, Bedri Faik; Gorani, Daut Rashit; Gashi, Fitim Bejtullah; Gjoka, Sami Bajram; Zahiti, Lorita Bedri; Haxhiu, Bekim Sylë; Kamberi, Lulzim Selim

    2013-01-01

    NONE DECLARED The aim of the study was detection of diastolic dysfunction of myocardium with Tissue Doppler Imaging (TDI) in asymptomatic type 2 diabetic patients, in five years duration of disease, and normal cardiac function on conventional echocardiography (CE), according to the performance showed on exercise stress test. We studied 300 patients, of them 150 patients with non-obese, normotensive, uncomplicated type 2 diabetes, in five years duration of disease and 150 healthy control subjects. Of all patients, 100 with type 2 diabetes, and 100 patients from the control group underwent exercise test on a treadmill. All participants underwent both CE and TDI echocardiography. With TDI, lateral E' peak velocity, atrial velocity (A'), their ratio (E'/A') and systolic velocity (S') were measured. Diastolic dysfunction was diagnosed by tissue Doppler imaging, and the following criterion was met: E'/A' ratio <1. Cardiac function with CE was without significant features in the two groups. Using TDI interrogation, diabetic subjects showed a lower E' velocity (10,75±1,2 vs. 14±3 cm/s, p<0,001), an increased A' velocity (10,65±1,8 vs. 11±3 cm/s, p<0,02), and a reduced E/A ratio (0,82±0,04 vs. 1,17±1,4, p<0,001), S (8.92±3,80 vs. 9,30±3.30 cm/sec); E/A (1,17±0.55, p<0,01). In diabetic patients, after the exercise stress test performance, the myocardial velocity increase is registered for wave E'=1,27 cm/sec (12,01%), for wave A'=1,7 cm/sec (15,9%), reduced ratio E'/A' (0.89±0,1 cm/sec 9,0%) and S'=1,3 cm/sec (14,77%). Whereas, mean myocardial velocity values in examined control group after the exercise stress test were higher as follows: E'=2,7 cm/sec (19%), A'=2,1 cm/sec (14%), E'/A'=0,8 cm/sec (12%), and S'=2,7 cm/sec (18%). Myocardial diastolic dysfunction due to reduced exercise tolerance can be evidenced by TDI in type 2 diabetic subjects, even in the presence of a normal cardiac function with CE and symptom free diabetic patients in rest. Therefore, our

  7. Left Ventricular Diastolic Dysfunction in Asymptomatic Type 2 Diabetic Patients: Detection and Evaluation by Tissue Doppler Imaging

    Science.gov (United States)

    Zahiti, Bedri Faik; Gashi, Fitim Bejtullah; Gjoka, Sami Bajram; Zahiti, Lorita Bedri; Haxhiu, Bekim Sylë; Kamberi, Lulzim Selim

    2013-01-01

    CONFLICT OF INTEREST: NONE DECLARED The aim of the study was detection of diastolic dysfunction of myocardium with Tissue Doppler Imaging (TDI) in asymptomatic type 2 diabetic patients, in five years duration of disease, and normal cardiac function on conventional echocardiography (CE), according to the performance showed on exercise stress test. Material and Methods We studied 300 patients, of them 150 patients with non-obese, normotensive, uncomplicated type 2 diabetes, in five years duration of disease and 150 healthy control subjects. Of all patients, 100 with type 2 diabetes, and 100 patients from the control group underwent exercise test on a treadmill. All participants underwent both CE and TDI echocardiography. With TDI, lateral E’ peak velocity, atrial velocity (A’), their ratio (E’/A’) and systolic velocity (S’) were measured. Diastolic dysfunction was diagnosed by tissue Doppler imaging, and the following criterion was met: E’/A’ ratio <1. Cardiac function with CE was without significant features in the two groups. Results and Discussion Using TDI interrogation, diabetic subjects showed a lower E’ velocity (10,75±1,2 vs. 14±3 cm/s, p<0,001), an increased A’ velocity (10,65±1,8 vs. 11±3 cm/s, p<0,02), and a reduced E/A ratio (0,82±0,04 vs. 1,17±1,4, p<0,001), S (8.92±3,80 vs. 9,30±3.30 cm/sec); E/A (1,17±0.55, p<0,01). In diabetic patients, after the exercise stress test performance, the myocardial velocity increase is registered for wave E’=1,27 cm/sec (12,01%), for wave A’=1,7 cm/sec (15,9%), reduced ratio E’/A’ (0.89±0,1 cm/sec 9,0%) and S’=1,3 cm/sec (14,77%). Whereas, mean myocardial velocity values in examined control group after the exercise stress test were higher as follows: E’=2,7 cm/sec (19%), A’=2,1 cm/sec (14%), E’/A’=0,8 cm/sec (12%), and S’=2,7 cm/sec (18%). Myocardial diastolic dysfunction due to reduced exercise tolerance can be evidenced by TDI in type 2 diabetic subjects, even in the

  8. Disease, dysfunction, and synthetic biology.

    Science.gov (United States)

    Holm, Sune

    2014-08-01

    Theorists analyzing the concept of disease on the basis of the notion of dysfunction consider disease to be dysfunction requiring. More specifically, dysfunction-requiring theories of disease claim that for an individual to be diseased certain biological facts about it must be the case. Disease is not wholly a matter of evaluative attitudes. In this paper, I consider the dysfunction-requiring component of Wakefield's hybrid account of disease in light of the artifactual organisms envisioned by current research in synthetic biology. In particular, I argue that the possibility of artifactual organisms and the case of oncomice and other bred or genetically modified strains of organism constitute a significant objection to Wakefield's etiological account of the dysfunction requirement. I then develop a new alternative understanding of the dysfunction requirement that builds on the organizational theory of function. I conclude that my suggestion is superior to Wakefield's theory because it (a) can accommodate both artifactual and naturally evolved organisms, (b) avoids the possibility of there being a conflict between what an organismic part is supposed to do and the health of the organism, and (c) provides a nonarbitrary and practical way of determining whether dysfunction occurs. © The Author 2014. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Sexual dysfunction in diabetes.

    Science.gov (United States)

    Tamás, Várkonyi; Kempler, Peter

    2014-01-01

    We aimed to summarize the etiology, clinical characteristics, diagnosis, and possible treatment options of sexual dysfunction in diabetic patients of both sexes. Details of dysfunction in diabetic women are less conclusive than in men due to the lack of standardized evaluation of sexual function in women. Male sexual dysfunction is a common complication of diabetes, including abnormalities of orgasmic/ejaculatory function and desire/libido in addition to penile erection. The prevalence of erectile dysfunction (ED) among diabetic men varies from 35% to 75%. Diabetes-induced ED has a multifactorial etiology including metabolic, neurologic, vascular, hormonal, and psychological components. ED should be regarded as the first sign of cardiovascular disease because it can be present before development of symptomatic coronary artery disease, as larger coronary vessels better tolerate the same amount of plaque compared to smaller penile arteries. The diagnosis of ED is based on validated questionnaires and determination of functional and organic abnormalities. First-, second- and third-line therapy may be applied. Phosphodiesterase-5 (PDE-5) inhibitor treatment from the first-line options leads to smooth muscle relaxation in the corpus cavernosum and enhancement in blood flow, resulting in erection during sexual stimulus. The use of PDE-5 inhibitors in the presence of oral nitrates is strictly contraindicated in diabetic men, as in nondiabetic subjects. All PDE-5 inhibitors have been evaluated for ED in diabetic patients with convincing efficacy data. Second-line therapy includes intracavernosal, trans- or intraurethral administration of vasoactive drugs or application of a vacuum device. Third-line therapies are the implantation of penile prosthesis and penile revascularization.

  10. Evaluation of the efficacy, safety, and acceptability of an eyelid warming device for the treatment of meibomian gland dysfunction.

    Science.gov (United States)

    Benitez Del Castillo, José Manuel; Kaercher, Thomas; Mansour, Khaled; Wylegala, Edward; Dua, Harminder

    2014-01-01

    Meibomian gland dysfunction (MGD) is widespread and has significant impact on patients' quality of life. Eyelid hygiene is the mainstay of treatment but is unstandardized and requires commitment from the patient and encouragement from the ophthalmologist. Blephasteam(®) is an eyelid warming device designed to be an easy-to-use and standardized treatment for MGD. In the present study, 73 patients were treated for 21 days with twice daily Blephasteam(®) sessions. The primary efficacy variable, a symptomatology visual analog scale score, declined from 63.07±21.23 (mean ± standard deviation) on day 0 to 41.90±25.49 on day 21. There were also improvements in a number of secondary efficacy variables including subjective ocular symptoms and clinical signs and symptoms of MGD and dry eye, though tear film breakup time and tear osmolarity were not improved. Global efficacy was assessed as satisfactory or very satisfactory in 83.8% of cases. Patient-reported subjective ocular symptoms declined during the study, and a majority of patients rated the efficacy of Blephasteam(®) as satisfactory or very satisfactory. Most patients found the device comfortable and were able to continue with normal activities (reading, watching TV, using a computer) during the Blephasteam(®) session. No safety or tolerability issues were identified.

  11. Head stabilization measurements as a potential evaluation tool for comparison of persons with TBI and vestibular dysfunction with healthy controls.

    Science.gov (United States)

    Sessoms, Pinata H; Gottshall, Kim R; Sturdy, Jordan; Viirre, Erik

    2015-03-01

    A large percentage of persons with traumatic brain injury incur some type of vestibular dysfunction requiring vestibular physical therapy. These injuries may affect the natural ability to stabilize the head while walking. A simple method of utilizing motion capture equipment to measure head movement while walking was used to assess improvements in head stabilization of persons undergoing computerized vestibular physical therapy and virtual reality training for treatment of their vestibular problems. Movement data from the head and sacrum during gait were obtained over several visits and then analyzed to determine improved oscillatory head movement relative to the sacrum. The data suggest that, over time with treatment, head stabilization improves and moves toward a pattern similar to that of a healthy control population. This simple analysis of measuring head stability could be transferred to smaller, portable systems that are easily utilized to measure head stability during gait for use in gait assessment and physical therapy training. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  12. Quantitative circumferential strain analysis using adenosine triphosphate-stress/rest 3-T tagged magnetic resonance to evaluate regional contractile dysfunction in ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Masashi, E-mail: m.nakamura1230@gmail.com [Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295 (Japan); Kido, Tomoyuki [Department of Radiology, Saiseikai Matsuyama Hospital, Ehime 791-0295 (Japan); Kido, Teruhito; Tanabe, Yuki; Matsuda, Takuya; Nishiyama, Yoshiko; Miyagawa, Masao; Mochizuki, Teruhito [Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295 (Japan)

    2015-08-15

    Highlights: • Infarcted segments could be differentiated from non-ischemic and ischemic segments with high sensitivity and specificity under at rest conditions. • The time-to-peak circumferential strain values in infarcted segments were more significantly delayed than those in non-ischemic and ischemic segments. • Both circumferential strain and circumferential systolic strain rate values under ATP-stress conditions were significantly lower in ischemic segments than in non-ischemic segments. • Subtracting stress and rest circumferential strain had a higher diagnostic capability for ischemia relative to only utilizing rest or ATP-stress circumferential strain values. • A circumferential strain analysis using tagged MR can quantitatively assess contractile dysfunction in ischemic and infarcted myocardium. - Abstract: Purpose: We evaluated whether a quantitative circumferential strain (CS) analysis using adenosine triphosphate (ATP)-stress/rest 3-T tagged magnetic resonance (MR) imaging can depict myocardial ischemia as contractile dysfunction during stress in patients with suspected coronary artery disease (CAD). We evaluated whether it can differentiate between non-ischemia, myocardial ischemia, and infarction. We assessed its diagnostic performance in comparison with ATP-stress myocardial perfusion MR and late gadolinium enhancement (LGE)-MR imaging. Methods: In 38 patients suspected of having CAD, myocardial segments were categorized as non-ischemic (n = 485), ischemic (n = 74), or infarcted (n = 49) from the results of perfusion MR and LGE-MR. The peak negative CS value, peak circumferential systolic strain rate (CSR), and time-to-peak CS were measured in 16 segments. Results: A cutoff value of −12.0% for CS at rest allowed differentiation between infarcted and other segments with a sensitivity of 79%, specificity of 76%, accuracy of 76%, and an area under the curve (AUC) of 0.81. Additionally, a cutoff value of 477.3 ms for time-to-peak CS at rest

  13. Evaluation of the efficacy, safety, and acceptability of an eyelid warming device for the treatment of meibomian gland dysfunction

    Directory of Open Access Journals (Sweden)

    Benitez del Castillo JM

    2014-10-01

    Full Text Available José Manuel Benitez del Castillo,1 Thomas Kaercher,2 Khaled Mansour,3 Edward Wylegala,4 Harminder Dua5 1Universidad Complutense, Madrid, Spain; 2Augenarztpraxis, Heidelberg, Germany; 3Department of Ophthalmology, Tjongerschans Hospital, Heerenveen, the Netherlands; 4Department of Ophthalmology, Medical University of Silesia, District Railway Hospital, Katowice, Poland; 5Division of Ophthalmology and Visual Sciences, Eye ENT Centre, Queens Medical Centre, Nottingham, UKAbstract: Meibomian gland dysfunction (MGD is widespread and has significant impact on patients’ quality of life. Eyelid hygiene is the mainstay of treatment but is unstandardized and requires commitment from the patient and encouragement from the ophthalmologist. Blephasteam® is an eyelid warming device designed to be an easy-to-use and standardized treatment for MGD. In the present study, 73 patients were treated for 21 days with twice daily Blephasteam® sessions. The primary efficacy variable, a symptomatology visual analog scale score, declined from 63.07±21.23 (mean ± standard deviation on day 0 to 41.90±25.49 on day 21. There were also improvements in a number of secondary efficacy variables including subjective ocular symptoms and clinical signs and symptoms of MGD and dry eye, though tear film breakup time and tear osmolarity were not improved. Global efficacy was assessed as satisfactory or very satisfactory in 83.8% of cases. Patient-reported subjective ocular symptoms declined during the study, and a majority of patients rated the efficacy of Blephasteam® as satisfactory or very satisfactory. Most patients found the device comfortable and were able to continue with normal activities (reading, watching TV, using a computer during the Blephasteam® session. No safety or tolerability issues were identified.Keywords: dry eye, Blephasteam®

  14. Combined Expansion Pharyngoplasty and Anterior Palatoplasty for the Treatment of OSA.

    Science.gov (United States)

    Pang, Kenny P; Piccin, Ottavio; Pang, Edward B; Pang, Kathleen A; Chan, Yiong Huak; Rotenberg, Brian W

    2016-12-01

    To evaluate the success rates of combined Expansion Sphincter Pharyngoplasty and the Anterior Palatoplasty in the treatment of OSA. A two center prospective series of 73 patients with OSA. All patients were >18 years old, retro-palatal obstruction, concentric velo-pharyngeal collapse, BMI OSA, 33 moderate OSA and 20 severe OSA patients. Twenty-three patients had pre-operative DISE, and 61 patients had nose/palate surgery, while only 12 had palate surgery alone. The overall success rate (50 % reduction and AHI OSA patients. Level of evidence IV.

  15. Optimization of flow reserve measurement using SPECT technology to evaluate the determinants of coronary microvascular dysfunction in diabetes

    Energy Technology Data Exchange (ETDEWEB)

    Marini, Cecilia [CNR Institute of Bioimages and Molecular Physiology, Milan, Section of Genoa (Italy); Bezante, GianPaolo; Modonesi, Elisa; Rollando, Daniela; Balbi, Manrico; Brunelli, Claudio [University of Genoa, Department of Internal Medicine, Cardiology, Genoa (Italy); Gandolfo, Patrizia; Morbelli, Silvia D.; Armonino, Riccardo [University of Genoa, Department of Internal Medicine, Nuclear Medicine, Genoa (Italy); DePascale, Angelo; Maggi, Davide; Albertelli, Manuela; Cordera, Renzo [University of Genoa, Department of Endocrinological Metabolic Sciences, Diabetology, Genoa (Italy); Sambuceti, Gianmario [University of Genoa, Department of Internal Medicine, Nuclear Medicine, Genoa (Italy); Advanced Biotechnology Center, Genoa (Italy)

    2010-02-15

    The aim of this study was to validate a new method to measure regional myocardial perfusion reserve (MPR) with technetium-labelled tracers in patients with type 2 diabetes mellitus (DM2). A total of 40 consecutive DM2 patients without history of coronary artery disease (CAD) and 7 control subjects were recruited. Dipyridamole myocardial blood flow index (MBF) was assessed by measuring first transit counts in the pulmonary artery and myocardial count rate from gated SPECT images using {sup 99m}Tc-labelled tracers. The corresponding MBF index was estimated 2 h later according to the same procedure. Regional myocardial perfusion reserve (MPR) was defined as the ratio between dipyridamole and baseline MBF using a 17-segment left ventricular (LV) model. Coronary flow reserve (CFR) was estimated by transthoracic contrast echo Doppler monitoring of flow velocity in the left anterior descending coronary artery (LAD) during the same session. Estimated MPR was higher in control subjects than in patients (3.36 {+-} 0.66 vs 1.91 {+-} 0.61, respectively, p < 0.01). In patients, LAD CFR and LAD MPR were 2.01 {+-} 0.78 vs 1.93 {+-} 0.63, respectively (p = ns). The agreement between the two techniques was documented by their close correlation (r = 0.92, p < 0.001) and confirmed by the Bland-Altman analysis. Reversible perfusion defects occurred in 13 patients (32%) who showed similar MPR values as the remaining 27 (2.10 {+-} 0.71 vs 1.83 {+-} 0.71, respectively, p = ns). Finally, MPR was closely correlated with age (r = -0.50, p < 0.01) and time elapsed from the diagnosis of DM2 (r = -0.51, p < 0.01). LV regional MPR can be accurately estimated with the broadly available single photon technology. Application of this method to DM2 patients documents the presence of a microvascular dysfunction homogeneously distributed throughout the LV walls and most frequently not associated with reversible perfusion defects. (orig.)

  16. Sexual dysfunction in Obsessive-Compulsive disorder

    Directory of Open Access Journals (Sweden)

    Firoozeh Raisi

    2015-05-01

    Conclusion: High prevalence of sexual dysfunction in OCD women and significant correlation between male sexual dysfunction and OCD (r= -481.0 between total score of OCI-R with erectile dysfunction and r= -458.0 between total score of OCI-R and sexual satisfaction could confirm a relation between OCD and sexual disorders. So, evaluation of sexual function in all patients with OCD is recommended.

  17. Evaluation of Functional Lower Urinary Tract Dysfunction in Children: Are the Physicians Complying with the Current Guidelines?

    Directory of Open Access Journals (Sweden)

    Mesrur Selcuk Silay

    2013-01-01

    were used for statistical analyses. Results. Of the 117 departments a total of 93 have completed the survey (n: 58 urology; n: 35 paediatric nephrology. Routine use of a questionnaire with validated symptom scoring system was found to be 13.9%. Of the participants, only 38.7% were asking all of the patients to fill the bladder diary. During treatment, only 24.7% were applying standard urotherapy for every patient. Almost half of the clinicians (45.1% believed that they were personally insufficient during the evaluation of those children. Finally, 86% reported that children with LUTD were not adequately approached. Conclusions. Evaluation of LUTD in children is not complying with the current guidelines. General approach for those children needs to be revisited by the clinicians.

  18. Avaliação vestibular em mulheres com disfunção temporomandibular Vestibular evaluation in women with temporomandibular dysfunction

    Directory of Open Access Journals (Sweden)

    Bianca Simone Zeigelboim

    2007-06-01

    Full Text Available OBJETIVO: avaliar o comportamento vestibular em pacientes com disfunção temporomandibular. MÉTODOS: avaliaram-se 27 pacientes do sexo feminino, na faixa etária de 30 a 53 anos, encaminhadas do Centro de Diagnóstico e Tratamento da Articulação Temporomandibular para o Laboratório de Otoneurologia da Universidade Tuiuti do Paraná. Realizaram-se os seguintes procedimentos: anamnese, inspeção otológica e avaliação vestibular por meio da vectoeletronistagmografia. RESULTADOS: as queixas mais freqüentes foram: dificuldade ou dor ao movimento do pescoço (77,7%, dor irradiada para ombro/braço (77,7%, zumbido e formigamento de extremidade superior (77,7%, tontura e dor de cabeça (66,6%, ansiedade (55,5%, sensação de cabeça oca (51,8%, agitação durante o sono (51,8% e depressão (51,8%. O exame vestibular esteve alterado em 20 pacientes (74,0% na prova calórica. Houve freqüência de alteração no sistema vestibular periférico. Houve predomínio das síndromes vestibulares periféricas deficitárias. CONCLUSÃO: ressalta-se a importância de se estudar a relação do sistema vestibular com a disfunção temporomandibular uma vez que observamos, na presente pesquisa, um número elevado de alteração no exame labiríntico.PURPOSE: to evaluate the vestibular functioning in patients with temporomandibular joint dysfunction. METHODS: 27 female patients were evaluated, with age varying from 30 to 53-year-old, referred from the Centre of Diagnosis and Treatment of Temporomandibular Joint Dysfunction to the Otoneurological Laboratory of Tuiuti University of Paraná. The following exams were carried out: anamnesis, otoscopy and vestibular evaluations through vectoelectronystagmography. RESULTS: the most frequent complaints were: difficulty or pain with movement of the neck (77.7%, pain irradiated to the shoulder/arm (77.7%, tinnitus and paresthesia of superior extremities (77.7% in each one, dizziness and headaches (66,6%, anxiety (55

  19. Autonomic Dysfunctions in Parkinsonian Disorders

    Directory of Open Access Journals (Sweden)

    Hyo-Jin Bae

    2009-10-01

    Full Text Available Background and Purpose: Symptoms of autonomic dysfunctions are common in the patients with parkinsonian disorders. Because clinical features of autonomic dysfunctions are diverse, the comprehensive evaluation is essential for the appropriate management. For the appreciation of autonomic dysfunctions and the identification of differences, patients with degenerative parkinsonisms are evaluated using structured questionnaire for autonomic dysfunction (ADQ. Methods: Total 259 patients, including 192 patients with [idiopathic Parkinson’s disease (IPD, age 64.6 ± 9.6 years], 37 with [multiple system atrophy (MSA, 62.8 ± 9.1], 9 with [dementia with Lewy body (DLB, 73.9 ± 4.3], and 21 with [progressive supranuclear palsy (PSP, 69.4 ± 9.6]. The ADQ was structured for evaluation of the presence of symptoms and its severity due to autonomic dysfunction, covering gastrointestinal, urinary, sexual, cardiovascular and thermoregulatory domains. Patients were also evaluated for the orthostatic hypotension. Results: Although dementia with Lewy body (DLB patients were oldest and duration of disease was longest in IPD, total ADQ scores of MSA and PSP (23.9 ± 12.6 and 21.1 ± 7.8 were significantly increased than that of IPD (15.1 ± 10.6. Urinary and cardiovascular symptom scores of MSA and gastrointestinal symptom score of PSP were significantly worse than those of IPD. The ratio of patient with orthostatic hypotension in IPD was 31.2% and not differed between groups (35.1% in MSA, 33.3% in DLB and 33.3% in PSP. But the systolic blood pressure dropped drastically after standing in patients with MSA and DLB than in patients with IPD and PSP. Conclusions: Patients with degenerative parkinsonism showed widespread symptoms of autonomic dysfunctions. The severity of those symptoms in patients with PSP were comparing to that of MSA patients and worse than that of IPD.

  20. Posterior Tibial Tendon Dysfunction

    Science.gov (United States)

    .org Posterior Tibial Tendon Dysfunction Page ( 1 ) Posterior tibial tendon dysfunction is one of the most common problems of the foot and ankle. It occurs when the posterior tibial tendon becomes inflamed or torn. As a result, the ...

  1. Female Sexual Dysfunction

    Science.gov (United States)

    ... medically as female sexual dysfunction. Many women experience problems with sexual function at some point. Female sexual dysfunction can occur at any stage of life. It can be lifelong or be acquired later in life. It can ...

  2. Cardiac autonomic dysfunction in chronic stroke women is attenuated after submaximal exercise test, as evaluated by linear and nonlinear analysis.

    Science.gov (United States)

    Francica, Juliana Valente; Bigongiari, Aline; Mochizuki, Luís; Scapini, Kátia Bilhar; Moraes, Oscar Albuquerque; Mostarda, Cristiano; Caperuto, Erico Chagas; Irigoyen, Maria Cláudia; De Angelis, Katia; Rodrigues, Bruno

    2015-09-29

    We evaluated cardiac autonomic modulation in women with chronic ischemic stroke (at least 4 years post-stroke) at rest and in response to submaximal exercise test. Fourteen post-stroke women (S group) and 10 healthy women (C group) participated in this study. Autonomic modulation (using linear and nonlinear analysis), blood pressure and metabolic variables at rest were evaluated immediately after the exercise test and during the recovery period (20 min). All participants underwent submaximal exercise test on cycle ergometer with gas analysis. At rest, the S group displayed higher lactate concentration, systolic (SBP) and diastolic blood pressure (DBP) values when compared to C group. Furthermore, the S group had lower heart rate variability (HRV) in time domain (SDNN: S = 30 ± 5 vs. 40 ± 8 ms; rMSSD: S = 14 ± 2 vs. C = 34 ± 3 ms), decreased high frequency band of pulse interval (S = 8.4 ± 2 vs. 33.1 ± 9 %) and 2V pattern of symbolic analysis (S = 17.3 ± 1 vs. 30 ± 3 %) (both indicators of cardiac vagal modulation) when compared to C group. Immediately after exercise, S group presented higher values of lactate, SBP, DBP and double product when compared to C group, as well as decreased heart rate recovery (HRR) measured at the first, second and third minutes. At recovery time, all HRV parameters in time and frequency domains improved in the S group; however, HF band remained lower when compared to C group. After the exercise test, women with chronic stroke presented reduced heart rate variability, reduced cardiac vagal modulation, as well as reduced HRR, while displayed an improvement of heart rate variability and cardiac vagal modulation when compared to their baseline. These results reinforce the importance of a physically active lifestyle for cardiovascular autonomic disorders observed in chronic stroke women.

  3. The evaluation of pelvic floor muscle strength in women with pelvic floor dysfunction: A reliability and correlation study.

    Science.gov (United States)

    Navarro Brazález, Beatriz; Torres Lacomba, María; de la Villa, Pedro; Sánchez Sánchez, Beatriz; Prieto Gómez, Virginia; Asúnsolo Del Barco, Ángel; McLean, Linda

    2017-04-28

    The purposes of this study were: (i) to evaluate the reliability of vaginal palpation, vaginal manometry, vaginal dynamometry; and surface (transperineal) electromyography (sEMG), when evaluating pelvic floor muscle (PFM) strength and/or activation; and (ii) to determine the associations among PFM strength measured using these assessments. One hundred and fifty women with pelvic floor disorders participated on one occasion, and 20 women returned for the same investigations by two different raters on 3 different days. At each session, PFM strength was assessed using palpation (both the modified Oxford Grading Scale and the Levator ani testing), manometry, and dynamometry; and PFM activation was assessed using sEMG. The interrater reliability of manometry, dynamometry, and sEMG (both root-mean-square [RMS] and integral average) was high (Lin's Concordance Correlation Coefficient [CCC] = 0.95, 0.93, 0.91, 0.86, respectively), whereas the interrater reliability of both palpation grading scales was low (Cohen's Kappa [k] = 0.27-0.38). The intrarater reliability of manometry (CCC = 0.96), and dynamometry (CCC = 0.96) were high, whereas intrarater reliability of both palpation scales (k = 0.78 for both), and of sEMG (CCC = 0.79 vs 0.80 for RMS vs integral average) was moderate. The Bland-Altman plot showed good inter and intrarater agreement, with little random variability for all instruments. The correlations among palpation, manometry, and dynamometry were moderate (coefficient of determination [r(2) ] ranged from 0.52 to 0.75), however, transperineal sEMG amplitude was only weakly correlated with all measures of strength (r(2)  = 0.23-0.30). Manometry and dynamometry are more reliable tools than vaginal palpation for the assessment of PFM strength in women with pelvic floor disorders, especially when different raters are involved. The different PFM strength measures used clinically are moderately correlated; whereas, PFM activation recorded

  4. Evaluation of the Safety and Effectiveness of Intense Pulsed Light in the Treatment of Meibomian Gland Dysfunction

    Directory of Open Access Journals (Sweden)

    Xiaodan Jiang

    2016-01-01

    Full Text Available Purpose. This study aims to explore the safety and efficacy of a novel treatment-intense pulsed light (IPL in MGD eyes. Methods. This study is a prospective and open label study. Forty eyes of 40 MGD patients were recruited in the study and received 4 consecutive IPL treatments on day 1, day 15, day 45, and day 75. Ten ocular surface symptoms were evaluated with a subjective face score at every visit. Best spectacle corrected visual acuity, intraocular pressure (IOP, conjunctival injection, upper and lower tear meniscus height (TMH, tear break-up time (TBUT, corneal staining, lid margin and meibomian gland assessments, and meibography were also recorded at every visit, as well as the adverse effects on the eye and ocular surface. Results. Significant improvements were observed in single and total ocular surface symptom scores, TBUT, and conjunctival injection at all the visits after the initial IPL treatment (P<0.05. Compared to baseline, the signs of eyelid margin, meibomian gland secretion quality, and expressibility were significantly improved at every visit after treatments. There was no regional and systemic threat observed in any patient. Conclusion. Intense pulsed light (IPL therapy is a safe and efficient treatment in relieving symptoms and signs of MGD eyes.

  5. Written information material and availability of sexual health care for men experiencing sexual dysfunction after prostate cancer treatment: An evaluation of Dutch urology and radiotherapy departments.

    Science.gov (United States)

    Grondhuis Palacios, L A; Krouwel, E M; Duijn, M; den Oudsten, B L; den Ouden, M E M; Putter, H; Pelger, R C M; Elzevier, H W

    2017-03-01

    Objective was to investigate content of written information material and availability of sexual health care for men experiencing sexual dysfunction (SD) after prostate cancer treatment. A cross-sectional survey was conducted among Dutch urology and radiotherapy departments to evaluate information materials and availability of sexual health care. Out of 71 eligible departments, 34 urology and 15 radiotherapy departments participated in the survey (response rate 69.0%). Fifty-nine brochures corresponding to 31 urology and 11 radiotherapy departments were analysed. In 88.1% of collected information material, sexual health was mentioned. Regarding extensiveness, 20.4% of the brochures contained extensive information, 50.8% moderate amount of information and 28.8% contained little or no information. Urology departments provided pre-treatment nurse consultations more often than radiotherapy departments. Sexual counselling was more frequently provided by urology departments. Urology departments were more aware of adequate referral possibilities. Information material provided by Dutch urology and radiotherapy departments does not address treatment-related SD routinely. Sexual health care is not available everywhere for men experiencing SD. Applying a standard regarding content of sexual health in information material is recommended as well as improved awareness of referral possibilities and enhanced provision of pre-treatment nurse consultations for men experiencing SD after prostate cancer treatment. © 2016 John Wiley & Sons Ltd.

  6. Correlation between peak systolic velocity and diameter of cavernosal arteries in flaccid versus dynamic state for the evaluation of erectile dysfunction.

    Science.gov (United States)

    Souper, R; Hartmann, J; Alvarez, M; Fuentes, I; Astroza, G; Marconi, M

    2017-07-01

    Previous studies have suggested that parameters measured in the flaccid state (FS) by penile duplex Doppler ultrasound (PDDU) may predict the outcome after intracavernosal injection (ICI). The aim of this study was to evaluate the association between peak systolic velocity (PSV) and cavernosal artery diameter (CAD) in the FS with PSV and clinical assessment of erection hardness (CAEH) after ICI. Fifty patients who underwent PDDU for erectile dysfunction were prospectively enrolled. PSV and CAD were measured in FS and then correlated with PSV and CAEH after ICI of 20 μg of e1 prostaglandin (PGe1). Even though PSV in FS demonstrated a significant correlation with PSV after ICI (P=0.04, r=0.21), none of the cutoff values tested (10, 13 and 15 cm s(-1) in FS) had a combined sensitivity and specificity >80% to predict a PSV after ICI ⩾30 cm s(-1). No correlation was observed between CAD in FS and PSV after ICI. Also, no association was observed between PSV in FS and development of a complete full rigid erection after ICI. Although PSV in FS statistically correlates with PSV after ICI, predictive values are low, making it non-reliable to predict accurately the response to ICI of 20 μg PGe1.

  7. Point-of-care gastrointestinal and urinary tract sonography in daily evaluation of gastrointestinal dysfunction in critically ill patients (GUTS Protocol).

    Science.gov (United States)

    Perez-Calatayud, Angel Augusto; Carrillo-Esper, Raul; Anica-Malagon, Eduardo Daniel; Briones-Garduño, Jesus Carlos; Arch-Tirado, Emilio; Wise, Robert; Malbrain, Manu L N G

    2018-01-05

    There is currently a lack of universally accepted criteria for gastrointestinal (GI) failure or dysfunction in critical care. Also, the clinical assessment of intestinal function is notoriously difficult and thus often goes unrecognized, contributing to poor outcomes. A recent grading system has been proposed to define acute gastrointestinal injury (AGI) in conjunction with other organ function scores (e.g., SOFA). Ultrasonography has become widely accepted as a diagnostic tool for GI problems and pathology. We propose a sonographic examination of the abdomen, using the GUTS protocol (gastrointestinal and urinary tract sonography) in critically ill patients as part of the point-of-care ultrasound evaluation in patients with AGI. This article reviews possible applications of ultrasonography that may be relevant to monitor the GI function in critically ill patients. The GI ultrasound protocol (GUTS) focuses on four gastrointestinal endpoints: gastrointestinal diameter, mucosal thickness, peristalsis, and blood flow. Also, it is possible to examine the urinary tract and kidney function. Real-time ultrasound with the GUTS protocol is a simple, inexpensive, bedside imaging technique that can provide anatomical and functional information of the GI tract. Further studies are needed to investigate the utility of GUTS with other parameters, such as GI biomarkers, AGI class, and clinical outcomes.

  8. Importance of axial penile rigidity in objective evaluation of erection quality in patients with erectile dysfunction--comparison with radial rigidity.

    Science.gov (United States)

    Mizuno, Ichiro; Komiya, Akira; Watanabe, Akihiko; Fuse, Hideki

    2010-01-01

    The aim of this prospective study was to evaluate the usefulness of measurement of axial penile rigidity, compared with radial penile rigidity. Twenty-two patients, aged 21-75 years old (a mean of 50), with erectile dysfunction underwent axial penile rigidity measurements by the digital inflection rigidometer (DIR) as well as radial penile rigidity measurements by the RigiScan Plus during intracavernous pharmacological erection testing. A significant correlation was recognized between axial rigidity, and radial rigidity at the tip (p = 0.0024) and base (p = 0.0098) of the penis. In 10 patients, the DIR revealed axial rigidity of 550 g or more, and they also had radial rigidity of 60% or more at the tip and base. In 14 and 17 subjects, radial rigidity of 60% or more was observed at the tip and base, respectively. Four of the former 14 and 7 of the latter 17 had axial rigidity <550 g. A RigiScan results of radial rigidity of 60% or more should be interpreted cautiously and not necessarily regarded as normal. Copyright (c) 2010 S. Karger AG, Basel.

  9. Prospective evaluation of intense pulsed light and meibomian gland expression efficacy on relieving signs and symptoms of dry eye disease due to meibomian gland dysfunction

    Directory of Open Access Journals (Sweden)

    Dell SJ

    2017-05-01

    Full Text Available Steven J Dell,1 Ronald N Gaster,2 Sheila C Barbarino,1 Derek N Cunningham1 1Dell Laser Consultants, Austin, TX, 2Gaster Eye Center, Beverly Hills, CA, USA Purpose: The aim of this study was to estimate the efficacy of intense pulsed light (IPL, followed by meibomian gland expression (MGX, for reducing the number and severity of signs and symptoms of dry eye disease (DED secondary to meibomian gland dysfunction (MGD. Patients and methods: In a prospective study conducted in two sites, 40 subjects (80 eyes with moderate to severe MGD were enrolled. Major inclusion criteria consisted of at least two of the following measures being compatible with DED in both eyes: tear breakup time (TBUT, meibomian gland score (MGS, corneal fluorescein staining (CFS, Standard Patient Evaluation of Eye Dryness (SPEED questionnaire, and tear film osmolarity (TFO. Enrolled patients underwent four treatment sessions, 3 weeks apart. Each treatment included the administration of 10–15 pulses of IPL on the cheeks and nose, followed by MGX of the upper and lower eyelids. TBUT, MGS, CFS, SPEED, TFO, and lipid layer thickness (LLT were measured at baseline (BL and at 9, 12, and 15 weeks after BL. Results: Due to different staining methods used for TBUT measurements, TBUT and CFS were analyzed separately for each site. From BL to the final follow-up, the number of signs compatible with DED decreased from 3.3±0.1 to 1.4±0.1. TBUT improved by +93% (n=38; P<0.0001 and +425% (n=42; P<0.0001 for sites 1 and 2, respectively. SPEED, MGS, and CFS improved by -55% (n=80; P<0.0001, -36% (n=80; P<0.0001, and -58% (n=38; P<0.0001, respectively. In 20 eyes with abnormally elevated TFO at BL, TFO improved by -7% (n=20; P<0.005. LLT did not change (n=38; P=0.88. Conclusion: In subjects with moderate to severe MGD, IPL combined with MGX reduced the number and severity of symptoms and signs of DED. Except for LLT, all examined outcome measures significantly improved after 15

  10. Myocardial dysfunction in pediatric septic shock.

    Science.gov (United States)

    Raj, Shashi; Killinger, James S; Gonzalez, Jennifer A; Lopez, Leo

    2014-01-01

    To evaluate the prevalence and significance of myocardial dysfunction in children with septic shock. Thirty patients with septic shock were evaluated by transthoracic echocardiography within 24 hours of admission to a pediatric critical care unit. Transthoracic echocardiography evaluation included left ventricular (LV) size and function, mitral valve inflow velocities in early and late diastole, mitral valve annular velocities in systole and early and late diastole, and LV myocardial performance index. LV systolic dysfunction was defined as an ejection fraction or shortening fraction z-score 2. Secondary outcomes included troponin I concentration, acute kidney injury, and 28-day mechanical ventilation-free duration. Mortality for the 30 patients (mean age, 9.5 ± 7 years) was 7%. The prevalence of LV systolic and/or diastolic dysfunction was 53% (16 of 30). Eleven patients (37%) had systolic dysfunction, 10 (33%) had diastolic dysfunction, and 5 (17%) had both. Systolic and/or diastolic dysfunction was significantly associated with troponin I level (P = .007) and acute kidney injury (P = .02), but not with ventilation-free duration (P = .12). Kaplan-Meier analyses for pediatric critical care unit and hospital length of stay identified no differences between patients with and those without myocardial dysfunction. Myocardial dysfunction occurs frequently in children with septic shock but might not affect hospital length of stay. Copyright © 2014 Mosby, Inc. All rights reserved.

  11. Lack of awareness of erectile dysfunction in many men with risk factors for erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Magee Michelle

    2010-11-01

    Full Text Available Abstract Background Men with erectile dysfunction often have concurrent medical conditions. Conversely, men with these conditions may also have underlying erectile dysfunction. The prevalence of unrecognized erectile dysfunction in men with comorbidities commonly associated with erectile dysfunction was determined in men invited to participate in a double-blind, randomized, placebo-controlled trial of sildenafil citrate. Methods Men ≥30 years old presenting with ≥1 erectile dysfunction risk factor (controlled hypertension, hypercholesterolemia, smoking, metabolic syndrome, stable coronary artery disease, diabetes, depression, lower urinary tract symptoms, obesity [body mass index ≥30 kg/m2] or waist circumference ≥40 inches, and not previously diagnosed with erectile dysfunction were evaluated. The screening question, "Do you have erectile dysfunction?," with responses of "no," "yes," and "unsure," and the Erectile Function domain of the International Index of Erectile Function (IIEF-EF were administered. Results Of 1084 men screened, 1053 answered the screening question and also had IIEF-EF scores. IIEF-EF scores indicating erectile dysfunction occurred in 71% (744/1053, of whom 54% (399/744 had moderate or severe erectile dysfunction. Of 139 answering "yes," 526 answering "unsure," and 388 answering "no," 96%, 90%, and 36%, respectively, had some degree of erectile dysfunction. The mean±SD (range number of risk factors was 2.9 ± 1.7 (3-8 in the "yes" group, 3.2 ± 1.7 (3-9 in the "unsure" group, and 2.6 ± 1.5 (2-8 in the "no" group. Conclusion Although awareness of having erectile dysfunction was low, most men with risk factors had IIEF-EF scores indicating erectile dysfunction. Erectile dysfunction should be suspected and assessed in men with risk factors, regardless of their apparent level of awareness of erectile dysfunction. Trial registration ClinicalTrials.gov Identifier NCT00343200.

  12. Hyperemesis gravidarum and placental dysfunction disorders

    NARCIS (Netherlands)

    Koudijs, Heleen M; Savitri, Ary I; Browne, Joyce L|info:eu-repo/dai/nl/413640671; Amelia, Dwirani; Baharuddin, Mohammad; Grobbee, Diederick E|info:eu-repo/dai/nl/071889256; Uiterwaal, Cuno S P M|info:eu-repo/dai/nl/136603947

    2016-01-01

    BACKGROUND: Evidence about the consequence of hyperemesis gravidarum (HG) on pregnancy outcomes is still inconclusive. In this study, we evaluated if occurrence of hyperemesis gravidarum is associated with placental dysfunction disorders and neonatal outcomes. METHODS: A prospective cohort study was

  13. Questionnaires for assessment of female sexual dysfunction

    DEFF Research Database (Denmark)

    Giraldi, Annamaria; Rellini, Alessandra; Pfaus, James G

    2011-01-01

    There are many methods to evaluate female sexual function and dysfunction (FSD) in clinical and research settings, including questionnaires, structured interviews, and detailed case histories. Of these, questionnaires have become an easy first choice to screen individuals into different categories...

  14. Evaluation of a potential parathyroid dysfunction under treatment with radioactive iodine of benign thyroid diseases; Pruefung einer potentiellen strahleninduzierten Nebenschilddruesenfunktionsstoerung waehrend einer Radioiodtherapie benigner Schilddruesenerkrankung

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, Serena Christine

    2011-09-28

    The intention of the present thesis was the evaluation of a potential parathyroid dysfunction under treatment with radioactive iodine of benign thyroid diseases. It was to be examined whether a change in the parathyroid function would arise within the first week on treatment. So far there are some minor studies existing describing significant changes in the parathyroid hormone serum level within the first months after radioactive iodine therapy of benign and malignant thyroid diseases. Moreover, it is a fact that external beam-radiotherapy can induce neoplasia and that the risk for the subsequent development of primary hyperparathyroidism doubles or triples after external beam-radiotherapy of the head and neck. Up to now, however, an increased incidence for primary hyperparathyroidism following treatment with radioactive iodine ({sup 131}I) could not be proved. At the department of nuclear medicine of the university hospital Giessen-Marburg GmbH, location Marburg, a prospective cohort study was executed on radioactive iodine therapy of benign thyroid diseases with 105 probands (75 women / 30 men, mean age 60.62 ± 14.3 years). According to their thyroid diseases these 105 probands were classified into following subgroups: thyroid adenoma with 23 patients, multifocal thyroid autonomy with 8 patients, disseminated thyroid autonomy with 37 patients as well as the subgroup Graves' hyperthyroidism (without Graves' ophtalmopathy) and accordingly Graves' disease (with Graves' ophtalmopathy) with 37 patients. The serum level of the intact parathyroid hormone was determined directly before starting the radioactive iodine therapy on the admission day and on day 1, 3 and 5 of the radioactive iodine therapy as well as at the ambulant follow-up examination one month after the start of the therapy. In case of 99 of 105 probands the serum level of parathyroid hormone declined on treatment with {sup 131}I with its nadir on day 3 of therapy (decline by 15.71 ng

  15. Pilot randomized controlled trial to evaluate the effect of aquatic and land physical therapy on musculoskeletal dysfunction of sickle cell disease patients

    Directory of Open Access Journals (Sweden)

    Camila Tatiana Zanoni

    2015-04-01

    Full Text Available Objective: To compare the effect of aquatic and land-based physiotherapy in reducing musculoskeletal hip and lower back pain and increasing overall physical capabilities of sickle cell disease patients. Methods: Informed written consent was obtained from all volunteers who were submitted to evaluations using different functional scales: Lequesne's Algofunctional Questionnaire and Oswestry Disability Index, trunk and hip range of motion, goniometry, trunk and hip muscle strength assessment using load cell, and surface electromyography of the iliocostalis, long dorsal (longissimus, gluteus maximus, gluteus medius and tensor fasciae latae muscles. Ten patients were randomized into two groups: aquatic physiotherapy with a mean age of 42 years (range: 25-67 and conventional physiotherapy with a mean age of 49 years (range: 43-59. Both groups were submitted to a twelve-week program of two sessions weekly. Results: After the intervention, significant improvements were observed regarding the Lequesne index (p-value = 0.0217, Oswestry Disability Index (p-value = 0.0112, range of motion of trunk extension (p-value = 0.0320, trunk flexion muscle strength (p-value = 0.0459, hip extension and abduction muscle strength (p-value = 0.0062 and p-value = 0.0257, respec- tively. Range of motion of trunk and hip flexion, extension, adduction and abduction, trunk extensor muscle strength and all surface electromyography variables showed no significant statistical difference. Conclusion: Physical therapy is efficient to treat musculoskeletal dysfunctions in sickle cell disease patients, irrespective of the technique; however, aquatic therapy showed a trend toward improvement in muscle strength. Further studies with a larger patient sample and longer periods of therapy are necessary to confirm these results.

  16. [Evaluation of self-esteem in males with erectile dysfunction treated with viagra. Analysis of a Spanish patients group selected from a multicenter, international study].

    Science.gov (United States)

    Martínez-Jabaloyas, J M; Moncada, I; Rodríguez-Vela, L; Gutiérrez, P R; Chaves, J

    2010-09-01

    Erectile dysfunction (ED) leads to psychological disturbances, especially anxiety and loss of self-esteem. We try to understand the emotional changes, based on self-esteem and relationships in a group of Spanish men with ED after sildenafil treatment, with the use of the the SEAR questionnaire (Self-Esteem And Relationship). The patients recruited in Spain, where selected from an international, multicenter, randomized, parallel-group, double-blind, placebo-controlled, sildenafil study designed to assess self-esteem and relationships in men with ED. We compared the changes in the different domains of the SEAR questionnaire (Self-steem, sexual activity, self-confidence and general relationships) that was administered before and after treatment; the different domains of the IIEF was evaluated as well. We also calculated the correlation between changes in self-esteem domain of the SEAR questionnaire. The statistical study was based on an analysis of covariance of change in scores and a correlation analysis. The Spanish group of researchers included 119 patients. The erectile function domain score showed significantly greater improvement for the group of sildenafil. The difference in change in total mean score of the SEAR after treatment was 16.9 (95% CI 8.9, 24.8) for sildenafil over placebo (p=0.0001), with a significantly higher score improvement in all the domains of the SEAR for Sildenafil. There was a significant correlation between the changes in the domain of self-esteem of the SEAR and the IIEF erectile function domain for both treatment groups. Emotional improvement was confirmed in patients treated with sildenafil based on improved self-esteem, self-confidence and relationships. Changes in the IIEF erectile function domain correlate with the SEAR self-esteem domain.

  17. [Higher Brain Dysfunction].

    Science.gov (United States)

    Kashima, Haruo

    2015-01-01

    The technical term "higher brain dysfunction" is used widely in Japan. However, it is not always clear what "higher" means. The author thinks that the term "higher" is understood as being associated with a meaning. In this article, the differences between higher brain dysfunctions and elementary brain dysfunctions are discussed from the point of view of lesion localization and the consistency of symptoms. The psychiatric approach is indispensable for the assessment of higher brain dysfunction. A simple test for mild Alzheimer-type dementia is also introduced.

  18. [Evaluation of short-term effect of intense pulsed light combined with meibomian gland expression in the treatment of meibomian gland dysfunction].

    Science.gov (United States)

    Rong, B; Tu, P; Tang, Y; Liu, R X; Song, W J; Yan, X M

    2017-09-11

    Objective: To explore short-term effect of intense pulsed light (IPL) combined with meibomian gland expression in treating meibomian gland dysfunction (MGD). Methods: This study was a prospective, randomized, double-masked, controlled study. Forty-four MGD patients were enrolled in the study and received three consecutive IPL treatments with an interval of 4 weeks. One eye of each patient was randomly assigned as the study eye receiving the IPL therapy with an energy of 14-16 J/cm(2), and the fellow eye was as the control eye receiving a placebo therapy with 0 J/cm(2). Meibomian gland expression was immediately performed after the IPL treatment in both eyes. Efficacy was evaluated through assessment of the meibomian gland yielding secretion score (MGYSS) , SPEED questionnaire, tear film break-up time (TBUT), cornea fluorescein staining and infrared meibography. Safety was evaluated through best spectacle corrected visual acuity, intraocular pressure, slit lamp examination and fundus examination. These examinations were performed before and after each treatment. Results: Significant improvements were observed in the MGYSS and TBUT after IPL treatments (P<0.05). The improvements compared to the baseline of MGYSS at the upper eyelid in the treatment eyes were significantly higher than those in the control eyes after the first treatment (Z=-2.036, P=0.003). The improvements compared to baseline of MGYSS at the lower eyelid and the TBUT in the treatment eyes were significantly higher than those in the control eyes after the second treatment (Z=-2.999 and -2.036, respectively P=0.007 and 0.042, respectively). SPEED and cornea fluorescein staining were decreased in both eyes after IPL treatments, but there was no statistical difference between the two eyes. No obvious complication was observed in the study. Conclusions: IPL treatment combined with meibomian gland expression is an efficient and safe therapy, and can increase meibomian gland yielding secretion, increase the

  19. Sexual dysfunction within an adult developmental perspective.

    Science.gov (United States)

    Fagan, P J; Meyer, J K; Schmidt, C W

    1986-01-01

    The focus of this paper is on the adult who has adequately mastered the oedipal stage of psychosexual development and who presents with a sexual dysfunction. Drawing on the developmental sequence of Erik Erikson, the authors suggest that failure to address adequately an adult psychosocial crisis may result in sexual dysfunction. There may be both adult developmental deficits and regression to adolescent and adult stages previously negotiated. Both may be symptomatically represented by sexual dysfunction. The authors urge that the sexual and marital problems be evaluated within an adult developmental framework and that the therapy address the psychosocial issues which are appropriate to the developmental stage of the patient.

  20. Cognitive dysfunction and hepatitis C virus infection

    OpenAIRE

    Solinas, Antonio; Piras, Maria Rita; Deplano, Angelo

    2015-01-01

    Cognitive dysfunction in patients with chronic hepatitis C virus (HCV) infection is a distinct form of minimal hepatic encephalopathy (MHE). In fact, the majority of HCV-positive patients, irrespective of the grading of liver fibrosis, display alterations of verbal learning, attention, executive function, and memory when they are evaluated by suitable neuropsychological tests. Similarities between the cognitive dysfunction of HCV patients and MHE of patients with different etiologies are uncl...

  1. Evaluation of Monocular Treatment for Meibomian Gland Dysfunction with an Automated Thermodynamic System in Elderly Chinese Patients: A Contralateral Eye Study

    OpenAIRE

    Yinying Zhao; Jialu Xie; Junhua Li; Yana Fu; Xiaolei Lin; Shangrong Wang; Jiling Ma; Yune Zhao

    2016-01-01

    Purpose. To investigate the safety and efficacy of monocular treatment for elderly Chinese patients with meibomian gland dysfunction (MGD) with an automated thermodynamic system. Methods. This study was a prospective, examiner-masked, contralateral eye clinical trial. The eye perceived by the patient to be worse (test eye) received a 12-minute LipiFlow treatment, while the other eye served as control. All patients were examined before treatment and one week, one month, and three months after ...

  2. USEFULNESS OF SEQUENTIAL ORGAN FAILURE ASSESSMENT (SOFA) AND ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION II (APACHE II) SCORE IN ANALYSING PATIENTS WITH MULTIPLE ORGAN DYSFUNCTION SYNDROME IN SEPSIS

    OpenAIRE

    Abhinandan; Vedavathi

    2013-01-01

    Sepsis with multiple organ dysfunction syndrome (MODS) is a common cause of Intensive Care Unit (ICU) mortality and morbidity. Early initiation of appro priate effective antimicrobial therapy is essential for a favorable outcome in the patient with sepsis. Cultures and serology are available only after 24 to 48 hours. In the crucial hours which determine the prognosis of the patient the physician has to de pend on clinical symptoms and demographic data to aid in diagnosis...

  3. Single-blinded, randomized, and controlled clinical trial evaluating the effects of Omega-3 fatty acids among septic patients with intestinal dysfunction: A pilot study.

    Science.gov (United States)

    Chen, Huaisheng; Wang, Wei; Hong, Yingcai; Zhang, Huadong; Hong, Chengying; Liu, Xueyan

    2017-08-01

    Sepsis is a systemic inflammatory reaction, which is aggravated by aspects of the immune response that are thought to be inhibited by Omega-3 fatty acids. The aim of the present study was to determine if Omega-3 fatty acid could modulate immunological function and improve survival rate among septic patients with intestinal dysfunction. A total of 48 mechanically ventilated patients with intestinal dysfunction were included in this prospective, randomized and single-blind clinical study. Patients were randomly divided into control (group A) and treatment groups (group B). The treatment protocol for all the participants followed the Sepsis Survival Campaign guidelines, and group B received total parenteral nutrition containing 100 ml of Omega-3 fatty acids (containing 10 g refined fish oil) per day in addition to the standard treatment applied in group A. Group B had a significantly lower mortality rate compared with group A (12.5 vs. 41.7%, POmega-3 fatty acids improved T helper/inducer and CD4/CD8 ratios, and may have reduced mortality, among septic patients with intestinal dysfunction.

  4. Prospective evaluation of Peristeen® transanal irrigation system with the validated neurogenic bowel dysfunction score sheet in the pediatric population.

    Science.gov (United States)

    Kelly, Maryellen S; Dorgalli, Crystal; McLorie, Gordon; Khoury, Antoine E

    2017-03-01

    To determine the ability of Peristeen® transanal irrigation system to reduce symptoms of neurogenic bowel dysfunction (NBD) in patients using the validated neurogenic bowel dysfunction scoring system for the pediatric population. Patients 3-21 years with NBD whose current bowel program was unsuccessful were given the Neurogenic Bowel Dysfunction (NBoDS) score sheet before initiating Peristeen®, and at 2 weeks, 2 months, and 6 months after. All patients were started on Peristeen® with tap water (20 ml/kg) per daily irrigation. Mean and paired t-tests were completed. 24 patients were enrolled and had follow-up. Mean age was 10.5 years (range 3-21 years), 25%, 50%, 25% had thoracic, lumbar and sacral level lesions respectively. Mean NBoDS score at initiation of Peristeen® was 20.21 (±5.56), n = 24. The mean score after two weeks of use was 12.75 (±4.40), n = 24. There was a statistically significant decrease of 7.46 (95%CI, 5.07-9.84) points, t(23) = 6.47, P irrigation system provides a significant reduction in NBoDS scores in pediatric patients with NBD. Peristeen® should be considered when other conservative bowel management options have been unsuccessful. Neurourol. Urodynam. 36:632-635, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. Auditory Dysfunction in Patients with Cerebrovascular Disease

    Directory of Open Access Journals (Sweden)

    Sadaharu Tabuchi

    2014-01-01

    Full Text Available Auditory dysfunction is a common clinical symptom that can induce profound effects on the quality of life of those affected. Cerebrovascular disease (CVD is the most prevalent neurological disorder today, but it has generally been considered a rare cause of auditory dysfunction. However, a substantial proportion of patients with stroke might have auditory dysfunction that has been underestimated due to difficulties with evaluation. The present study reviews relationships between auditory dysfunction and types of CVD including cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, cerebrovascular malformation, moyamoya disease, and superficial siderosis. Recent advances in the etiology, anatomy, and strategies to diagnose and treat these conditions are described. The numbers of patients with CVD accompanied by auditory dysfunction will increase as the population ages. Cerebrovascular diseases often include the auditory system, resulting in various types of auditory dysfunctions, such as unilateral or bilateral deafness, cortical deafness, pure word deafness, auditory agnosia, and auditory hallucinations, some of which are subtle and can only be detected by precise psychoacoustic and electrophysiological testing. The contribution of CVD to auditory dysfunction needs to be understood because CVD can be fatal if overlooked.

  6. Taste and smell function in chronic disease: a review of clinical and biochemical evaluations of taste and smell dysfunction in over 5000 patients at The Taste and Smell Clinic in Washington, DC.

    Science.gov (United States)

    Henkin, Robert I; Levy, Lucien M; Fordyce, April

    2013-01-01

    To describe systematic methods developed over 40 years among over 5000 patients at The Taste and Smell Clinic in Washington, DC to evaluate taste and smell dysfunction. A tripartite methodology was developed. First, methods to determine clinical pathology underlying the multiple disease processes responsible for taste and smell dysfunction were developed. Second, methods to determine biochemical parameters responsible for these pathologies were developed. Third, methods to implement these techniques were developed to form a unified basis upon which treatment strategies can be developed to treat these patients. Studies were performed in 5183 patients. Taste loss was present in 62% of patients, smell loss in 87%. Most patients with taste loss (52%) exhibited Type II hypogeusia; most patients with smell loss (56%) exhibited Type II hyposmia. Sensory distortions were present in 60%. Four common diagnostic entities were found: post influenza-type hyposmia and hypogeusia (27% of patients), idiopathic causes (16%), allergic rhinitis (15%) and post head injury (14%). Regardless of clinical diagnosis the major biochemical abnormality found in most patients (~70%) was diminished parotid salivary and nasal mucus secretion of cAMP and cGMP. Taste and smell dysfunctions are common clinical problems associated with chronic disease processes. These symptoms require a systematic, integrated approach to understand their multiple and complex components. The approach presented here can and has led to effective treatment. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Chronic pelvic floor dysfunction.

    Science.gov (United States)

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Spinal Cord Dysfunction (SCD)

    Data.gov (United States)

    Department of Veterans Affairs — The Spinal Cord Dysfunction (SCD) module supports the maintenance of local and national registries for the tracking of patients with spinal cord injury and disease...

  9. Diastolic dysfunction in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiese, Signe Skovgaard; Halgreen, Hanne

    2016-01-01

    Development of esophageal varices, ascites, and hepatic nephropathy is among the major complications of cirrhosis. The presence of cirrhotic cardiomyopathy, which includes a left ventricular diastolic dysfunction (DD), seems to deteriorate the course of the disease and the prognosis. Increased...

  10. Gut dysfunction in Parkinson's disease.

    Science.gov (United States)

    Mukherjee, Adreesh; Biswas, Atanu; Das, Shyamal Kumar

    2016-07-07

    Early involvement of gut is observed in Parkinson's disease (PD) and symptoms such as constipation may precede motor symptoms. α-Synuclein pathology is extensively evident in the gut and appears to follow a rostrocaudal gradient. The gut may act as the starting point of PD pathology with spread toward the central nervous system. This spread of the synuclein pathology raises the possibility of prion-like propagation in PD pathogenesis. Recently, the role of gut microbiota in PD pathogenesis has received attention and some phenotypic correlation has also been shown. The extensive involvement of the gut in PD even in its early stages has led to the evaluation of enteric α-synuclein as a possible biomarker of early PD. The clinical manifestations of gastrointestinal dysfunction in PD include malnutrition, oral and dental disorders, sialorrhea, dysphagia, gastroparesis, constipation, and defecatory dysfunction. These conditions are quite distressing for the patients and require relevant investigations and adequate management. Treatment usually involves both pharmacological and non-pharmacological measures. One important aspect of gut dysfunction is its contribution to the clinical fluctuations in PD. Dysphagia and gastroparesis lead to inadequate absorption of oral anti-PD medications. These lead to response fluctuations, particularly delayed-on and no-on, and there is significant relationship between levodopa pharmacokinetics and gastric emptying in patients with PD. Therefore, in such cases, alternative routes of administration or drug delivery systems may be required.

  11. 3.0 T magnetic resonance myocardial perfusion imaging for semi-quantitative evaluation of coronary microvascular dysfunction in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Yin, Liang; Xu, Hai-Yan; Zheng, Sui-Sheng; Zhu, Ying; Xiao, Jiang-Xi; Zhou, Wei; Yu, Si-Si; Gong, Liang-Geng

    2017-12-01

    This study aimed to assess coronary microvascular dysfunction (CMD) differences in hypertrophic cardiomyopathy (HCM) patients using cardiac magnetic resonance (CMR) first-pass perfusion and late gadolinium enhancement imaging. Forty-seven patients with HCM and twenty-one healthy volunteers underwent CMR at rest. Imaging protocols included short axis cine, first-pass myocardial perfusion, and late gadolinium enhancement (LGE). Left ventricular end-diastolic wall thickness (EDTH), LGE, time to peak (T peak ), maximal up-slope (Slope max ), and peak signal intensity (SI peak ) were assessed for each myocardial segment. The HCM myocardial segments were grouped by the degree of LGE and hypertrophy. T peak , SI peak , Slope max and EDTH in multiple groups were assessed and compared by ANOVA test/Kruskal-Wallis test. The Spearman correlation test was used to determine the relationships between EDTH, LGE and perfusion parameters (T peak , Slope max and SI peak ). Compared to control group segments, T peak increased while Slope max and SI peak decreased in non-LGE/non-hypertrophic segments and LGE/hypertrophic segments in the HCM group, while T peak increased more significantly in LGE/hypertrophic segments (all p hypertrophic segments of HCM patients, and it may be helpful in the early diagnosis of coronary microvascular dysfunction in HCM. This abnormal perfusion is associated with the severity of myocardial fibrosis and the degree of hypertrophy.

  12. Voiding dysfunction - A review

    Directory of Open Access Journals (Sweden)

    Sripathi V

    2005-01-01

    Full Text Available In a child who is toilet trained the sudden onset of daytime wetting with frequency or urgency is alarming to the parents. Initially this subject was subdivided into a number of descriptive clinical conditions which led to a lot of confusion in recognition and management. Subsequently, the term elimination dysfunction was coined by Stephen Koff to emphasise the association between recurrent urinary infection, wetting, constipation and bladder overactivity. From a urodynamic point of view, in voiding dysfunction, there is either detrusor overactivity during bladder filling or dyssynergic action between the detrusor and the external sphincter during voiding. Identifying a given condition as a ′filling phase dysfunction′ or ′voiding phase dysfunction′ helps to provide appropriate therapy. Objective clinical criteria should be used to define voiding dysfunction. These include bladder wall thickening, large capacity bladder and infrequent voiding, bladder trabeculation and spinning top deformity of the urethra and a clinically demonstrated Vincent′s curtsy. The recognition and treatment of constipation is central to the adequate treatment of voiding dysfunction. Transcutaneous electric nerve stimuation for the treatment of detrusor overactivity, biofeedback with uroflow EMG to correct dyssynergic voiding, and behavioral therapy all serve to correct voiding dysfunction in its early stages. In established neurogenic bladder disease the use of Botulinum Toxin A injections into the detrusor or the external sphincter may help in restoring continence especially in those refractory to drug therapy. However in those children in whom the upper tracts are threatened, augmentation of the bladder may still be needed.

  13. Biology of Sexual Dysfunction

    Directory of Open Access Journals (Sweden)

    Anil Kumar Mysore Nagaraj

    2009-05-01

    Full Text Available Sexual activity is a multifaceted activity, involving complex interactions between the nervous system, the endocrine system, the vascular system and a variety of structures that are instrumental in sexual excitement, intercourse and satisfaction. Sexual function has three components i.e., desire, arousal and orgasm. Many sexual dysfunctions can be categorized according to the phase of sexual response that is affected. In actual clinical practice however, sexual desire, arousal and orgasmic difficulties more often than not coexist, suggesting an integration of phases. Sexual dysfunction can result from a wide variety of psychological and physiological causes including derangements in the levels of sex hormones and neurotrensmitters. This review deals with the biology of different phases of sexual function as well as implications of hormones and neurotransmitters in sexual dysfunction

  14. Endothelial dysfunction: a comprehensive appraisal

    Directory of Open Access Journals (Sweden)

    Vilariño Jorge O

    2006-02-01

    Full Text Available Abstract The endothelium is a thin monocelular layer that covers all the inner surface of the blood vessels, separating the circulating blood from the tissues. It is not an inactive organ, quite the opposite. It works as a receptor-efector organ and responds to each physical or chemical stimulus with the release of the correct substance with which it may maintain vasomotor balance and vascular-tissue homeostasis. It has the property of producing, independently, both agonistic and antagonistic substances that help to keep homeostasis and its function is not only autocrine, but also paracrine and endocrine. In this way it modulates the vascular smooth muscle cells producing relaxation or contraction, and therefore vasodilatation or vasoconstriction. The endothelium regulating homeostasis by controlling the production of prothrombotic and antithrombotic components, and fibrynolitics and antifibrynolitics. Also intervenes in cell proliferation and migration, in leukocyte adhesion and activation and in immunological and inflammatory processes. Cardiovascular risk factors cause oxidative stress that alters the endothelial cells capacity and leads to the so called endothelial "dysfunction" reducing its capacity to maintain homeostasis and leads to the development of pathological inflammatory processes and vascular disease. There are different techniques to evaluate the endothelium functional capacity, that depend on the amount of NO produced and the vasodilatation effect. The percentage of vasodilatation with respect to the basal value represents the endothelial functional capacity. Taking into account that shear stress is one of the most important stimulants for the synthesis and release of NO, the non-invasive technique most often used is the transient flow-modulate "endothelium-dependent" post-ischemic vasodilatation, performed on conductance arteries such as the brachial, radial or femoral arteries. This vasodilatation is compared with the

  15. Evaluation of the short-term executive plus intervention for executive dysfunction after traumatic brain injury: a randomized controlled trial with minimization.

    Science.gov (United States)

    Cantor, Joshua; Ashman, Teresa; Dams-O'Connor, Kristen; Dijkers, Marcel P; Gordon, Wayne; Spielman, Lisa; Tsaousides, Theodore; Allen, Hafina; Nguyen, Michael; Oswald, Jennifer

    2014-01-01

    To determine whether the Short-Term Executive Plus (STEP) cognitive rehabilitation program improves executive dysfunction after traumatic brain injury (TBI). Randomized, waitlist controlled trial with minimization and blinded outcome assessment. Community. Participants with TBI and executive dysfunction (N=98; TBI severity 50% moderate/severe; mean time since injury ± SD, 12±14y; mean age ± SD, 45±14y; 62% women; 76% white). STEP program: 12 weeks (9h/wk) of group training in problem solving and emotional regulation and individual sessions of attention and compensatory strategies training. Factor analysis was used to create a composite executive function measure using the Problem Solving Inventory, Frontal Systems Behavior Scale, Behavioral Assessment of the Dysexecutive Syndrome, and Self-Awareness of Deficits Interview. Emotional regulation was assessed with the Difficulties in Emotion Regulation Scale. The primary attention measure was the Attention Rating and Monitoring Scale. Secondary measures included neuropsychological measures of executive function, attention, and memory and measures of affective distress, self-efficacy, social participation, and quality of life. Intention-to-treat mixed-effects analyses revealed significant treatment effects for the composite executive function measure (P=.008) and the Frontal Systems Behavior Scale (P=.049) and Problem Solving Inventory (P=.016). We found no between-group differences on the neuropsychological measures or on measures of attention, emotional regulation, self-awareness, affective distress, self-efficacy, participation, or quality of life. The STEP program is efficacious in improving self-reported post-TBI executive function and problem solving. Further research is needed to identify the roles of the different components of the intervention and its effectiveness with different TBI populations. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  16. Stent graft placement for dysfunctional arteriovenous grafts

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Gyeong Sik [Dept. of Radiology, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam (Korea, Republic of); Shin, Byung Seok; Ohm, Joon Young; Ahn, Moon Sang [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2015-07-15

    This study aimed to evaluate the usefulness and outcomes of stent graft use in dysfunctional arteriovenous grafts. Eleven patients who underwent stent graft placement for a dysfunctional hemodialysis graft were included in this retrospective study. Expanded polytetrafluoroethylene covered stent grafts were placed at the venous anastomosis site in case of pseudoaneurysm, venous laceration, elastic recoil or residual restenosis despite the repeated angioplasty. The patency of the arteriovenous graft was evaluated using Kaplan-Meier analysis. Primary and secondary mean patency was 363 days and 741 days. Primary patency at 3, 6, and 12 months was 82%, 73%, and 32%, respectively. Secondary patency at the 3, 6, 12, 24, and 36 months was improved to 91%, 82%, 82%, 50%, and 25%, respectively. Fractures of the stent graft were observed in 2 patients, but had no effect on the patency. Stent graft placement in dysfunctional arteriovenous graft is useful and effective in prolonging graft patency.

  17. Female sexual dysfunction

    DEFF Research Database (Denmark)

    Giraldi, Annamaria; Wåhlin-Jacobsen, Sarah

    2016-01-01

    Female sexual dysfunction (FSD) is a controversial condition, which has prompted much debate regarding its aetiology, components, and even its existence. Our inability to work together as clinicians, psychologists, patients, and advocates hinders our understanding of FSD, and we will only improve...

  18. Mitochondrial Dysfunction in Gliomas

    Czech Academy of Sciences Publication Activity Database

    Katsetos, C.D.; Anni, H.; Dráber, Pavel

    2013-01-01

    Roč. 20, č. 3 (2013), s. 216-227 ISSN 1071-9091 R&D Projects: GA MŠk LH12050 Institutional support: RVO:68378050 Keywords : gliomas * mitochondrial dysfunction * microtubule proteins Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.883, year: 2013

  19. Report of the international consensus development conference on female sexual dysfunction: definitions and classifications

    NARCIS (Netherlands)

    Basson, R.; Berman, J.; Burnett, A.; Derogatis, L.; Ferguson, D.; Fourcroy, J.; Goldstein, I.; Graziottin, A.; Heiman, J.; Laan, E.; Leiblum, S.; Padma-Nathan, H.; Rosen, R.; Segraves, K.; Segraves, R. T.; Shabsigh, R.; Sipski, M.; Wagner, G.; Whipple, B.

    2000-01-01

    PURPOSE: Female sexual dysfunction is highly prevalent but not well defined or understood. We evaluated and revised existing definitions and classifications of female sexual dysfunction. MATERIALS AND METHODS: An interdisciplinary consensus conference panel consisting of 19 experts in female sexual

  20. Associations of low grade inflammation and endothelial dysfunction with depression : The Maastricht study

    NARCIS (Netherlands)

    van Dooren, F.E.P.; Schram, M.T.; Schalkwijk, C.G.; Stehouwer, C.D.; Henry, R.M.; Dagnelie, P.C.; Schaper, N.C.; van der Kallen, C. J.; Koster, A.; Sep, S. J.; Denollet, J.; Verhey, F.R.J.; Pouwer, F.

    2016-01-01

    Background The pathogenesis of depression may involve low-grade inflammation and endothelial dysfunction. We aimed to evaluate the independent associations of inflammation and endothelial dysfunction with depressive symptoms and depressive disorder, and the role of lifestyle factors in this

  1. Longitudinal Association Between Endothelial Dysfunction, Inflammation, and Clotting Biomarkers With Subclinical Atherosclerosis in Type 1 Diabetes: An Evaluation of the DCCT/EDIC Cohort.

    Science.gov (United States)

    Hunt, Kelly J; Baker, Nathaniel L; Cleary, Patricia A; Klein, Richard; Virella, Gabriel; Lopes-Virella, Maria F

    2015-07-01

    There is considerable interest in identifying biomarkers that predict high risk for the development of macrovascular complications in patients with diabetes. Therefore, the longitudinal association between subclinical atherosclerosis as measured by internal carotid artery intima-media thickness (IMT) and acute-phase reactants, cytokines/adipokines, thrombosis, and adhesion molecules was examined. Biomarkers were measured at four time points over 20 years in 886 DCCT/EDIC participants with type 1 diabetes. Four composite scores were created by combining z scores generated from within the data set of individual biomarkers: acute-phase reactants (fibrinogen, C-reactive protein), thrombosis (fibrinogen, active and total plasminogen activator inhibitor [PAI]-1), cytokines/adipokines (tumor necrosis factor receptor-1 and -2, active and total PAI-1, IL-6), and endothelial dysfunction (soluble intracellular adhesion molecule-1, soluble vascular cell adhesion molecule-1, and soluble E-selectin). Internal carotid IMT was measured at EDIC years 1, 6, and 12, with elevated IMT defined at each time point as being in the upper quintile of its distribution. Logistic regression models indicate that while individual biomarkers were not predictive of or associated with subclinical atherosclerosis, composite scores of acute-phase reactants (odds ratio [OR] 2.78 [95% CI 1.42, 5.42]), thrombolytic factors (OR 2.83 [95% CI 1.45, 5.52]), and cytokines/adipokines (OR 2.83 [95% CI 1.48, 5.41]) measured at our final time point EDIC years 8-11 were associated with higher levels of atherosclerosis at EDIC year 12, but findings were not consistent at early time points. The endothelial dysfunction score was not appreciably predictive of or associated with subclinical atherosclerosis at any of the time points measured. The pathophysiologic relationship between higher biomarker levels and progression of subclinical atherosclerosis remains unclear. © 2015 by the American Diabetes Association

  2. Psychosocial dysfunction associated with skin picking disorder and trichotillomania

    DEFF Research Database (Denmark)

    Grant, Jon E.; Redden, Sarah A.; Leppink, Eric W.

    2016-01-01

    Skin picking disorder (SPD) and trichotillomania (TTM) are common and oftentimes disabling disorders. 125 Participants with SPD and 152 with TTM undertook clinical and neurocognitive evaluation, and were grouped according to mild, moderate, or severe levels of psychosocial dysfunction...... that levels of self-reported psychosocial dysfunction have a strong association with specific clinical aspects of SPD and TTM....

  3. Improvement effect of green tea on hepatic dysfunction, lipid ...

    African Journals Online (AJOL)

    We have evaluated the antioxidant effect of green tea on cadmium-induced hepatic dysfunction and stress oxidant in rats. Adult male Wistar rats were administered cadmium by injection with 20 μmoles/Kg bw/3 days for six months. Results revealed a significant (p < 0.05) liver dysfunction, lipid peroxidation and a decline in ...

  4. Endothelial dysfunction after non-cardiac surgery

    DEFF Research Database (Denmark)

    Søndergaard, E S; Fonnes, S; Gögenur, I

    2015-01-01

    was to systematically review the literature to evaluate the association between non-cardiac surgery and non-invasive markers of endothelial function. METHODS: A systematic search was conducted in MEDLINE, EMBASE and Cochrane Library Database according to the PRISMA guidelines. Endothelial dysfunction was described only...

  5. Cognitive dysfunction and hepatitis C virus infection.

    Science.gov (United States)

    Solinas, Antonio; Piras, Maria Rita; Deplano, Angelo

    2015-05-08

    Cognitive dysfunction in patients with chronic hepatitis C virus (HCV) infection is a distinct form of minimal hepatic encephalopathy (MHE). In fact, the majority of HCV-positive patients, irrespective of the grading of liver fibrosis, display alterations of verbal learning, attention, executive function, and memory when they are evaluated by suitable neuropsychological tests. Similarities between the cognitive dysfunction of HCV patients and MHE of patients with different etiologies are unclear. It is also unknown how the metabolic alterations of advanced liver diseases interact with the HCV-induced cognitive dysfunction, and whether these alterations are reversed by antiviral therapies. HCV replication in the brain may play a role in the pathogenesis of neuroinflammation. HCV-related brain dysfunction may be associated with white matter neuronal loss, alterations of association tracts and perfusion. It is unclear to what extent, in patients with cirrhosis, HCV triggers an irreversible neurodegenerative brain damage. New insights on this issue will be provided by longitudinal studies using the protocols established by the diagnostic and statistical manual of mental disorders fifth edition for cognitive disorders. The domains to be evaluated are complex attention; executive functions; learning and memory; perceptual motor functions; social cognition. These evaluations should be associated with fluorodeoxyglucose positron emission tomography and magnetic resonance imaging (MRI) protocols for major cognitive disorders including magnetic resonance spectroscopy, diffusion tensor imaging, magnetic resonance perfusion, and functional MRI. Also, the characteristics of portal hypertension, including the extent of liver blood flow and the type of portal shunts, should be evaluated.

  6. Evaluation of Monocular Treatment for Meibomian Gland Dysfunction with an Automated Thermodynamic System in Elderly Chinese Patients: A Contralateral Eye Study

    Directory of Open Access Journals (Sweden)

    Yinying Zhao

    2016-01-01

    Full Text Available Purpose. To investigate the safety and efficacy of monocular treatment for elderly Chinese patients with meibomian gland dysfunction (MGD with an automated thermodynamic system. Methods. This study was a prospective, examiner-masked, contralateral eye clinical trial. The eye perceived by the patient to be worse (test eye received a 12-minute LipiFlow treatment, while the other eye served as control. All patients were examined before treatment and one week, one month, and three months after treatment. Clinical parameters included dry eye symptoms, lipid layer thickness (LLT, partial blink (PB ratio, invasive tear breakup time (ITBUT and cornea staining, Schirmer I test, meibomian glands yielding liquid secretion (MGYLS, and meibomian gland dropout. Results. A total of 29 patients were examined during the three-month follow-up. At each posttreatment visit, they had a significant reduction in dry eye symptoms accompanied by an increase of ITBUT and MGYLS and a reduction in corneal staining compared with the baseline parameters. There was a significant improvement in MGYLS and ITBUT in the test eye compared with the control eye. Other clinical parameters were not statistically significant. Conclusion. LipiFlow is an effective treatment for patients with MGD. Monocular treatment with LipiFlow may be a cost-effective treatment option to those afflicted with MGD in the developing world.

  7. Evaluation of Monocular Treatment for Meibomian Gland Dysfunction with an Automated Thermodynamic System in Elderly Chinese Patients: A Contralateral Eye Study.

    Science.gov (United States)

    Zhao, Yinying; Xie, Jialu; Li, Junhua; Fu, Yana; Lin, Xiaolei; Wang, Shangrong; Ma, Jiling; Zhao, Yune

    2016-01-01

    Purpose. To investigate the safety and efficacy of monocular treatment for elderly Chinese patients with meibomian gland dysfunction (MGD) with an automated thermodynamic system. Methods. This study was a prospective, examiner-masked, contralateral eye clinical trial. The eye perceived by the patient to be worse (test eye) received a 12-minute LipiFlow treatment, while the other eye served as control. All patients were examined before treatment and one week, one month, and three months after treatment. Clinical parameters included dry eye symptoms, lipid layer thickness (LLT), partial blink (PB) ratio, invasive tear breakup time (ITBUT) and cornea staining, Schirmer I test, meibomian glands yielding liquid secretion (MGYLS), and meibomian gland dropout. Results. A total of 29 patients were examined during the three-month follow-up. At each posttreatment visit, they had a significant reduction in dry eye symptoms accompanied by an increase of ITBUT and MGYLS and a reduction in corneal staining compared with the baseline parameters. There was a significant improvement in MGYLS and ITBUT in the test eye compared with the control eye. Other clinical parameters were not statistically significant. Conclusion. LipiFlow is an effective treatment for patients with MGD. Monocular treatment with LipiFlow may be a cost-effective treatment option to those afflicted with MGD in the developing world.

  8. Dysfunctions in public psychiatric bureaucracies.

    Science.gov (United States)

    Marcos, L R

    1988-03-01

    The author describes common dysfunctions in public psychiatric organizations according to the model of bureaucracy articulated by Max Weber. Dysfunctions are divided into the categories of goal displacement, outside interference, unclear authority structure and hierarchy, and informal relations in the work place. The author emphasizes the bureaucratic nature of public psychiatry and the need for mental health professionals to understand the dysfunctions of the organizations in which they work, including the impact of these dysfunctions on the provision of quality care.

  9. A clinicopathological study of dysfunctional uterine bleeding

    Directory of Open Access Journals (Sweden)

    N Katuwal

    2014-09-01

    Full Text Available Background: Dysfunctional uterine bleeding is a form of abnormal uterine bleeding when there is absence of organic disease of the genital tract. The objective of this study was to find out the clinical and pathological aspect of women presenting with dysfunctional uterine bleeding.Materials and Methods: A descriptive study was conducted over a period of one year from April 14th 2010 to April 13th 2011 in the Department of Obstetrics and Gynaecology and Department of Pathology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A complete history, clinical examination, pelvic scan, hormonal status if required and endometrial biopsy were done to diagnose dysfunctional uterine bleeding.Results: A total of 120 cases were included. The age of the patients diagnosed dysfunctional uterine bleeding were ranging from 24 -63 years. Dysfunctional uterine bleeding was most common in the age group 40-44 yrs (30% followed by 45-49 yrs (27.5%. Menorrhagia (41.7% was the most common presenting sign. Majority histopathology of endometrium revealed anovulatory pattern (61.7% followed by ovulatory (38.3%. Of the cases with an anovulatory pattern 48.6% was proliferative endometrium, 33.8% disordered proliferative endometrium, 6.8%atrophic, 5.4% weakly proliferative and 2.7% each of simple hyperplasia without atypia and complex hyperplasia with atypia. All cases with ovulatory pattern showed secretory endometrium.Conclusion: Dysfunctional uterine bleeding was the most common in the perimenopausal age group and chiefly in the form of an anovulatory endometrium. . Histopathological evaluation of endometrium helps exclude the local causes and establishes the diagnosis of dysfunctional uterine bleeding, its types, and clinical correlation to histopathological findings and finally helps to determine the mode of management.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11500 Journal of Pathology of Nepal; Vol.4,No. 8 (2014 635-638

  10. What Is a Dysfunctional School?

    Science.gov (United States)

    Bergman, M. M.

    2013-01-01

    Whether or not a school is dysfunctional depends largely on how dysfunctionality in schools is defined and measured. Dysfunctionality, as any construct, is subject to definition and interpretation, and it is thus always marked by perspectivism. But regardless of the definition games occasionally played by academics, some form of reality takes…

  11. Diabetic cardiac autonomic dysfunction. Parasympathetic versus sympathetic

    Energy Technology Data Exchange (ETDEWEB)

    Uehara, Akihiko; Kurata, Chinori; Sugi, Toshihiko; Mikami, Tadashi; Shouda, Sakae [Hamamatsu Univ. School of Medicine, Shizuoka (Japan)

    1999-04-01

    Diabetic cardiac autonomic dysfunction often causes lethal arrhythmia and sudden cardiac death. {sup 123}I-Metaiodobenzylguanidine (MIBG) can evaluate cardiac sympathetic dysfunction, and analysis of heart rate variability (HRV) can reflect cardiac parasympathetic activity. We examined whether cardiac parasympathetic dysfunction assessed by HRV may correlate with sympathetic dysfunction assessed by MIBG in diabetic patients. In 24-hour electrocardiography, we analyzed 4 HRV parameters: high-frequency power (HF), HF in the early morning (EMHF), rMSSD and pNN50. MIBG planar images and SPECT were obtained 15 minutes (early) and 150 minutes (late) after injection and the heart washout rate was calculated. The defect score in 9 left ventricular regions was scored on a 4 point scale (0=normal - 3=severe defect). In 20 selected diabetic patients without congestive heart failure, coronary artery disease and renal failure, parasympathetic HRV parameters had a negative correlation with the sum of defect scores (DS) in the late images (R=-0.47 to -0.59, p<0.05) and some parameters had a negative correlation with the washout rate (R=-0.50 to -0.55, p<0.05). In a total of 64 diabetic patients also, these parameters had a negative correlation with late DS (R=-0.28 to -0.35, p<0.05) and early DS (R=-0.27 to -0.32, p<0.05). The progress of diabetic cardiac parasympathetic dysfunction may parallel the sympathetic one. (author)

  12. Sex therapy for female sexual dysfunction

    Science.gov (United States)

    2013-01-01

    Introduction About 45% of women suffer from some form of sexual dysfunction. Despite its high prevalence, there are few studies that have systematically evaluated sex therapy in comparison with other interventions. Objective Review randomized clinical trials that present psychotherapeutic interventions for female sexual dysfunctions. Method Through a search in three databases (Medline, Web of Science and PsycInfo), 1419 references were found. After an analysis of the abstracts, twenty-seven articles met the inclusion criteria and composed this review. Results Sex therapy, as proposed by Masters and Johnson and Heiman and LoPiccolo, is still the most commonly used form of therapy for sexual dysfunctions; although it has shown results, the results do not consistently support that this is the best alternative in the treatment of sexual dysfunctions. Conclusion There is a lack of systematic study of many female sexual dysfunctions. Orgasmic disorder and sexual pain (vaginismus and dyspaurenia) are the most extensively studied disorders and those in which sex therapy seems to have better outcomes. PMID:24066697

  13. Evaluation of an automated thermodynamic treatment (LipiFlow®) system for meibomian gland dysfunction: a prospective, randomized, observer-masked trial.

    Science.gov (United States)

    Finis, David; Hayajneh, Jasmin; König, Claudia; Borrelli, Maria; Schrader, Stefan; Geerling, Gerd

    2014-04-01

    To compare the effectiveness of a single LipiFlow(®) treatment with combined lid warming and massage in patients with meibomian gland dysfunction (MGD). In this prospective, randomized, crossover, observer-masked clinical trial, subjects were randomized to receive either a single 12-min LipiFlow-LipiFlow Thermal Pulsation (LTP) system treatment or to perform combined twice-daily lid warming and massage for 3 months. All subjects were examined before, and 1 and 3 months after initiation of treatments. Investigated parameters included subjective symptoms, lipid layer thickness, meibomian gland assessment, tear break-up time, tear osmolarity, corneal and conjunctival staining, Schirmer test values, and tear meniscus height. A total of 31 subjects completed the 3-month follow-up. At 1 and 3 months, patients in the LipiFlow treatment group had a significant reduction in Ocular Surface Disease Index (OSDI) scores compared with those in the lid-margin hygiene group. Both treatments produced a significant improvement in expressible meibomian glands compared to the baseline parameters, but no significant difference was noted between the two groups. The other investigated objective parameters did not show a significant difference. Results of our study show that a single LipiFlow treatment is as least as effective as a 3-month, twice-daily lid margin hygiene regimen for MGD. However, the present study was observer-masked only, and therefore a placebo effect may have confounded any improvements in subjective symptoms and other parameters in both groups. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. A meta-regression evaluating the effectiveness and prognostic factors of oral phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction

    Science.gov (United States)

    Yuan, Jin-Qiu; Mao, Chen; Yang, Zu-Yao; Fu, Xiao-Hong; Wong, Samuel Y; Tang, Jin-Ling

    2016-01-01

    The effectiveness of phosphodiesterase type 5 inhibitors (PDE5-Is) for erectile dysfunction (ED) varies considerably among trials, but available studies investigating the factors that affect the effectiveness are few and findings are not consistent. A systematic search was performed in PubMed, Cochrane Library, and EMBASE to identify randomized controlled trials comparing PDE5-Is with placebo for the treatment of ED. The methodological quality of included studies was assessed by the Cochrane Collaboration's tool for assessing risk of bias. The associations between prespecified study-level factors and effectiveness were tested by a random effects meta-regression model. This study included 93 trials with 26 139 patients. When all PDE5-Is were grouped together, Caucasian ethnicity was associated with 15.636% (95% confidence interval [CI]: 0.858% to 32.579%) increase in risk ratio (RR) for Global Assessment Questionnaire question-1 (GAQ-1), and 1.473 (95% CI: 0.406 to 2.338) score increase in mean difference (MD) for posttreatment International Index of Erectile Function-Erectile Function domain score (IIEF-EF), compared to Asian ethnicity. A one-score increase in baseline IIEF-EF was associated with −5.635% (95% CI: −9.120% to −2.017%) reduction in RR for GAQ-1, and −0.229 (95% CI: −0.425 to −0.042) score decrease in MD for posttreatment IIEF-EF. In conclusion, PDE5-Is are more effective in Caucasians than Asians, and in patients with more severe ED. PMID:25966626

  15. A meta-regression evaluating the effectiveness and prognostic factors of oral phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Jin-Qiu Yuan

    2016-01-01

    Full Text Available The effectiveness of phosphodiesterase type 5 inhibitors (PDE5-Is for erectile dysfunction (ED varies considerably among trials, but available studies investigating the factors that affect the effectiveness are few and findings are not consistent. A systematic search was performed in PubMed, Cochrane Library, and EMBASE to identify randomized controlled trials comparing PDE5-Is with placebo for the treatment of ED. The methodological quality of included studies was assessed by the Cochrane Collaboration′s tool for assessing risk of bias. The associations between prespecified study-level factors and effectiveness were tested by a random effects meta-regression model. This study included 93 trials with 26 139 patients. When all PDE5-Is were grouped together, Caucasian ethnicity was associated with 15.636% (95% confidence interval [CI]: 0.858% to 32.579% increase in risk ratio (RR for Global Assessment Questionnaire question-1 (GAQ-1, and 1.473 (95% CI: 0.406 to 2.338 score increase in mean difference (MD for posttreatment International Index of Erectile Function-Erectile Function domain score (IIEF-EF, compared to Asian ethnicity. A one-score increase in baseline IIEF-EF was associated with −5.635% (95% CI: −9.120% to −2.017% reduction in RR for GAQ-1, and −0.229 (95% CI: −0.425 to −0.042 score decrease in MD for posttreatment IIEF-EF. In conclusion, PDE5-Is are more effective in Caucasians than Asians, and in patients with more severe ED.

  16. Mitochondrial dysfunction in obesity.

    Science.gov (United States)

    de Mello, Aline Haas; Costa, Ana Beatriz; Engel, Jéssica Della Giustina; Rezin, Gislaine Tezza

    2018-01-01

    Obesity leads to various changes in the body. Among them, the existing inflammatory process may lead to an increase in the production of reactive oxygen species (ROS) and cause oxidative stress. Oxidative stress, in turn, can trigger mitochondrial changes, which is called mitochondrial dysfunction. Moreover, excess nutrients supply (as it commonly is the case with obesity) can overwhelm the Krebs cycle and the mitochondrial respiratory chain, causing a mitochondrial dysfunction, and lead to a higher ROS formation. This increase in ROS production by the respiratory chain may also cause oxidative stress, which may exacerbate the inflammatory process in obesity. All these intracellular changes can lead to cellular apoptosis. These processes have been described in obesity as occurring mainly in peripheral tissues. However, some studies have already shown that obesity is also associated with changes in the central nervous system (CNS), with alterations in the blood-brain barrier (BBB) and in cerebral structures such as hypothalamus and hippocampus. In this sense, this review presents a general view about mitochondrial dysfunction in obesity, including related alterations, such as inflammation, oxidative stress, and apoptosis, and focusing on the whole organism, covering alterations in peripheral tissues, BBB, and CNS. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Erection hardness score for the evaluation of erectile dysfunction: further psychometric assessment in patients treated by intracavernous prostaglandins injections after radical prostatectomy.

    Science.gov (United States)

    Parisot, Juliette; Yiou, René; Salomon, Laurent; de la Taille, Alexandre; Lingombet, Odile; Audureau, Etienne

    2014-08-01

    Erectile dysfunction (ED) affects quality of life in patients treated by radical prostatectomy (RP). The Erection Hardness Score (EHS) is a single-item scale that has demonstrated good psychometric properties for assessing erectile function (EF) in patients treated by sildenafil, but its applicability to other treatment contexts has not yet been tested. This study aims to test the validity and time and treatment responsiveness of the EHS to assess ED in men with post-RP ED treated with alprostadil injections. This is a 1-year follow-up cohort study of 75 patients treated by RP for localized prostate cancer in a urology department setting between January 2007 and December 2008. Data were prospectively collected at 6 and 12 months post-RP. The EHS, the International Index of Erectile Function (IIEF) reference questionnaire, the Global Assessment Questionnaire (GAQ), and Numeric Pain Scale (NPS) were collected. Convergent validity (Spearman correlation coefficients with IIEF domains), known-groups validity (comparing EHS scores across ED severity groups), time and treatment responsiveness (effect size with/without treatment and over the follow-up period), and predictive ability (area under the receiver operating characteristics curve [AUC-ROC]) were analyzed for this study. The EHS showed good convergent validity (all Spearman coefficients significant at the P<0.05 level), adequate known-groups validity (global differentiation between IIEF-EF severity groups; P<0.001), and treatment responsiveness (effect size: +1.8 [6 months], +2.1 [12 months]), but limited time responsiveness and predictive ability of the EHS for a normal EF at 12 months follow-up when compared with the IIEF-EF domain (AUC-ROC: 0.72 vs. 0.85; P<0.01). Our findings support the overall good psychometric properties of the EHS in patients with post-RP ED treated with alprostadil injections. However, evidence for limited predictive validity and responsiveness to change over time should be considered for

  18. Prevalence of sexual dysfunction during pregnancy.

    Science.gov (United States)

    Leite, Alessandra Plácido Lima; Campos, Ana Aurélia Salles; Dias, Antonio Roberto Cardoso; Amed, Abes Mahmed; De Souza, Eduardo; Camano, Luis

    2009-01-01

    This study aims to evaluate the sexual function and to determine the prevalence of sexual dysfunction among teenagers and adult women during pregnancy using the Female Sexual Function Index (FSFI). A cohort study was conducted with 271 healthy pregnant women presenting a stable relationship with their partners. These women contributed to the survey since the laboratory diagnosis of their present pregnancy. Anonymous questionnaires evaluated aspects of sexual activity and female sexual function. This last item was assessed through the FSFI questionnaire. The women sexual function showed a similar pattern during the first and second trimesters; however, it presented a significantly clear decrease in the third trimester. There was a significant difference in the scores of all FSFI domains when comparing the second and third trimesters. The sexual dysfunction among pregnant teenagers was rated 40.8% in the first trimester, 31.2% in the second and 63.2% in the third. For pregnant adults, the dysfunction was rated, respectively, 46.6%, 34.2% and 73.3%. The sexual function is affected during pregnancy with a significant decrease in all FSFI domains in the third trimester considering both pregnant teenagers and adults. Prevalence of sexual dysfunction is high during pregnancy and reaches higher levels in the third trimester in both age groups; however, teenagers presented better sexual function ratings.

  19. Assessment of pelvic floor dysfunctions using dynamic magnetic resonance imaging

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    Hoda Salah Darwish

    2014-03-01

    Conclusion: Dynamic MRI is an ideal, non invasive technique which does not require patient preparation for evaluation of pelvic floor. It acts as one stop shop for diagnosing single or multiple pelvic compartment involvement in patients with pelvic floor dysfunction.

  20. Aging and Erectile Dysfunction.

    Science.gov (United States)

    Echeverri Tirado, Laura C; Ferrer, Julio E; Herrera, Ana M

    2016-01-01

    Erectile dysfunction (ED) has been identified as the most common sexual problem that affects mainly men older than 40 years. According to this, there is a strong evidence linking ED with a number of medical conditions and related risk factors that had been described in the literature, yet there is limited information about the specific mechanism involved in the establishment of ED among healthy older men. The purpose of this study is to review the literature and mainly focus on the basic physiologic and vascular alterations and morphologic changes related to aging and its related risk factors, summarizing the main and the latest findings in basic research of tissue remodeling process involved in ED pathophysiology. Data from the pertinent literature were examined to inform our conclusions. This article defines the morphologic and physiologic mechanisms involved in the process of aging, which play a key role in the development of sexual dysfunction. ED has been considered as a nonlife-threatening condition, but the recognition of its multiple comorbid conditions, the importance of aging process over the male sexual performance among them its relation with vascular and nitric oxide content alteration, as well as penile morphologic changes, and the fact that it is a widespread under-reported disease, have established the need of an early diagnosis and treatment of this common sexual problem within the general male population. In this case, morphologic and physiologic mechanisms that are involved in the aging process play a key role in the development of sexual dysfunction in the absence of any other clinical or medical condition. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  1. Olfactory Dysfunction in Nasal Bone Fracture.

    Science.gov (United States)

    Kim, Sug Won; Park, Beom; Lee, Tae Geun; Kim, Ji Ye

    2017-06-01

    All nasal bone fractures have the potential for worsening of olfactory function. However, few studies have studied the olfactory outcomes following reduction of nasal bone fractures. This study evaluates posttraumatic olfactory dysfunction in patients with nasal bone fracture before and after closed reduction. A prospective study was conducted for all patients presenting with nasal bone fracture (n=97). Each patient consenting to the study underwent the Korean version of Sniffin' Sticks test (KVSS II) before operation and at 6 month after closed reduction. The nasal fractures were divided according to the nasal bone fracture classification by Haug and Prather (Types I-IV). The olfactory scores were compared across fracture types and between preoperative and postoperative settings. Olfactory dysfunction was frequent after nasal fracture (45/97, 46.4%). Our olfactory assessment using the KVSS II test revealed that fracture reduction was not associated with improvements in the mean test score in Type I or Type II fractures. More specifically, the mean posttraumatic Threshold, discrimination and identification score decreased from 28.8 points prior to operation to 23.1 point at 6 months for Type II fracture with septal fracture. Our study has revealed two alarming trends regarding post-nasal fracture olfactory dysfunction. First, our study demonstrated that almost half (46.4%) of nasal fracture patients experience posttraumatic olfactory dysfunction. Second, closed reduction of these fractures does not lead to improvements olfaction at 6 months, which suggest that olfactory dysfunction is probably due to factors other than the fracture itself. The association should be further explored between injuries that lead to nasal fracture and the mechanism behind posttraumatic olfactory dysfunction.

  2. Managing female sexual dysfunction.

    Science.gov (United States)

    Buster, John E

    2013-10-01

    Female sexual dysfunctions (FSDs) range from short-term aggravations to major emotional disturbances adversely affecting family and workplace. This review highlights diagnosis and management of the four most widely diagnosed FSDs. It initially focuses on hypoactive sexual desire disorder (HSDD) as a driving force at the heart of all other FSDs; nothing happens without sexual desire. Successful resolution of HSDD frequently facilitates resolution of other disorders. Central to understanding HSDD is the impact of aging female sexual endocrinology and its effect on both prevalence and expression patterns of FSD. Advances in this field have enabled introduction of some the most effective treatments yet described for HSDD. Sexual arousal disorder, though commonly affected by the same factors as HSDD, is heavily associated with psychotropic drugs and mood elevators. Orgasmic disorder is frequently the downstream result of other sexual dysfunctions, particularly HSDD, or the result of a major psychosexual trauma. Successful management of the underlying disorder often resolves orgasmic disorder. Sexual pain disorder is frequently the result of a gynecologic disorder, such as endometriosis, that can be substantially managed through successful treatment of that disorder. This article ends with the article's most important note: how to initiate the conversation. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Risk factors for swallowing dysfunction in stroke patients

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    Anna Flávia Ferraz Barros Baroni

    2012-06-01

    Full Text Available CONTEXT: Stroke is a frequent cause of dysphagia. OBJECTIVE: To evaluate in a tertiary care hospital the prevalence of swallowing dysfunction in stroke patients, to analyze factors associated with the dysfunction and to relate swallowing dysfunction to mortality 3 months after the stroke. METHODS: Clinical evaluation of deglutition was performed in 212 consecutive patients with a medical and radiologic diagnosis of stroke. The occurrence of death was determined 3 months after the stroke. RESULTS: It was observed that 63% of the patients had swallowing dysfunction. The variables gender and specific location of the lesion were not associated with the presence or absence of swallowing dysfunction. The patients with swallowing dysfunction had more frequently a previous stroke, had a stroke in the left hemisphere, motor and/or sensitivity alterations, difficulty in oral comprehension, alteration of oral expression, alteration of the level of consciousness, complications such as fever and pneumonia, high indexes on the Rankin scale, and low indexes on the Barthel scale. These patients had a higher mortality rate. CONCLUSIONS: Swallowing evaluation should be done in all patients with stroke, since swallowing dysfunction is associated with complications and an increased risk of death.

  4. Myofascial Pain Dysfunction Syndrome (MPDS

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    Hamed Mortazavi

    2010-10-01

    Full Text Available Introduction: Myofascial Pain Dysfunction Syndrome (MPDS is one of the most important causes of the orofacial pain. The main purpose of this study was to evaluate 40 related variables in this regard. Materials and Methods: Thirty nine patients with MPDS were evaluated in this study. Different factors including age, gender, occupation, marital status, sensitivity of masticatory muscles, maximum opening of the mouth, deviation, deflection, involvement of temporomandibular joint, habit, parafunction, malocclusion, neck pain, headache, earache and history of jaw involvement, etc were analyzed in this  evaluation. Results: In our study, 39 patients (32 females and 7 males, 20-40 years old, with the average age of 35 ± 13.32 years were studied. 51% were housewives and 74.4% were married. The most common involvements were Clicking (74.4%, pain in temporomandibular joint (54%, headache (46.2%, earache (41%, neck-pain (35.9%, trouble in the mouth opening (71.8%, malocclusion Class I (74.4%, cross bite and deep bite (25%, clenching (64.1% and involvement of masseter and lateral pterygoid muscle (84%. Conclusion: Since MPDS consists of variable symptoms, it might be very difficult to provide any definite diagnosis and treatment. Therefore the more the specialists extend their knowledge and information about this disorder, the more they will make the best decision in this regard.

  5. Thyroid dysfunction in infertile women

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    S G Perminova

    2011-12-01

    Full Text Available Objective. To study the rate and structure of thyroid diseases in infertile women and to asses their reproductive system depending upon the thyroid pathology. Subjects and methods. The study was based on the results of screening of T status of 496 women with infertility (main group and 80 fertile women (control group. Traditional methods of diagnosis of infertility were used along with special methods of investigation including assessment of function and structure of T (TTH, fT4, fT3, AT-TPO, AT-rTTH, ultrasound examination of T, thin-niddle aspirational biopsy, scintigraphy of T. A complex evaluation of the reproductive system status in infertile women was done depending on the type of T pathology. Results. Infertile women were found to suffer from thyroid dysfunction 3.8 times as more often as fertile ones (48% and 12.5%, p <0.05. Its structure included mainly AT-TPO carrier phenomenon in combination with ultrasound markers of thyroid autoimmunity (24%, hypothyroidism following thyroid autoimmunity (9.4% demonstrating itself as clinical (0.8%, subclinical (8.6%, and euthyroid (7.8% goiters. The portion of women with infertility and hyperthyroidism was small (0.6%. An association of thyroid autoimmunity with idiopathic infertility, endometriosis, endocrine infertility was found. Conclusion. It is necessary to perform a screening assessment of the function and structure of T in infertile women within diagnostic search for the reasons of infertility and in-time correction of the revealed thyroid dysfunction.

  6. Avaliação da microbiota ocular em pacientes com disfunção do filme lacrimal Evaluation of conjunctival flora in patients with tear film dysfunction

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    Melissa Megumi Tomimatsu

    2009-12-01

    Full Text Available OBJETIVO: Avaliar a microbiota conjuntival em olhos com disfunção do filme lacrimal, e a modificação desta microbiota após a colocação de plug de silicone no canalículo inferior. MÉTODOS: Série de casos intervencionais não comparativos para avaliar 68 olhos de 41 pacientes com disfunção do filme lacrimal, durante o período de 2002 a 2007, na Universidade Federal de São Paulo. Todos os pacientes foram submetidos à colheita de amostras de raspado conjuntival de fundo-de-saco inferior para cultivo em Brain heart infusion broth. Os vinte e dois pacientes submetidos à colocação de plug de silicone repetiram a colheita de raspado conjuntival um mês após o procedimento. RESULTADOS: Dos 68 olhos avaliados, 47 apresentaram crescimento bacteriano nas amostras colhidas. Nove diferentes espécies de bactérias foram identificadas: Staphylococcus coagulase negativa em 66,66%, Staphylococcus aureus em 13,72%, Corynebacterium sp em 5,86%, Enterobacter aerogenes em 3,92%, Streptococcus hemolítico do grupo viridans em 1,96%, Serratia sp em 1,96%, Alcaligenes xylosoxidans spp em 1,96%, Corynebacterium xerosis em 1,96%, e Proteus mirabilis em 1,96%. Staphylococcus coagulase negativa (SCN foi o microrganismo mais frequentemente isolado tanto antes quanto após o plug de silicone. A sensibilidade do SCN à Oxacilina antes da colocação do plug era de 87,50%, e, após, de 73,68%. CONCLUSÃO: A microbiota em olhos com disfunção do filme lacrimal é bastante semelhante à encontrada em olhos normais. A resistência de SCN à Oxacilina foi um pouco maior após o implante do plug de silicone.PURPOSE: To evaluate conjunctival microbiota in eyes with tear film dysfunction and its modification after punctal occlusion with silicone plug. METHODS: Non comparative interventional case series study to evaluate 68 eyes of 41 patients with tear film dysfunction, from 2002 to 2007, followed in Federal University of Sao Paulo. Samples for culture were all

  7. Cardiac sympathetic innervation assessed with (123)I-MIBG retains prognostic utility in diabetic patients with severe left ventricular dysfunction evaluated for primary prevention implantable cardioverter-defibrillator.

    Science.gov (United States)

    García-González, P; Fabregat-Andrés, Ó; Cozar-Santiago, P; Sánchez-Jurado, R; Estornell-Erill, J; Valle-Muñoz, A; Quesada-Dorador, A; Payá-Serrano, R; Ferrer-Rebolleda, J; Ridocci-Soriano, F

    2016-01-01

    Scintigraphy with iodine-123-metaiodobenzylguanidine ((123)I-MIBG) is a non-invasive tool for the assessment of cardiac sympathetic innervation (CSI) that has proven to be an independent predictor of survival. Recent studies have shown that diabetic patients with heart failure (HF) have a higher deterioration in CSI. It is unknown if (123)I-MIBG has the same predictive value for diabetic and non-diabetic patients with advanced HF. An analysis is performed to determine whether CSI with (123)I-MIBG retains prognostic utility in diabetic patients with HF, evaluated for a primary prevention implantable cardioverter-defibrillator (ICD). Seventy-eight consecutive HF patients (48 diabetic) evaluated for primary prevention ICD implantation were prospectively enrolled and underwent (123)I-MIBG to assess CSI (heart-to-mediastinum ratio - HMR). A Cox proportional hazards multivariate analysis was used to determine the influence of (123)I-MIBG images for prediction of cardiac events in both diabetic and non-diabetic patients. The primary end-point was a composite of arrhythmic event, cardiac death, or admission due to HF. During a mean follow-up of 19.5 [9.3-29.3] months, the primary end-point occurred in 24 (31%) patients. Late HMR was significantly lower in diabetic patients (1.30 vs. 1.41, p=0.014). Late HMR≤1.30 was an independent predictor of cardiac events in diabetic (hazard ratio 4.53; p=0.012) and non-diabetic patients (hazard ratio 12.31; p=0.023). Diabetic patients with HF evaluated for primary prevention ICD show a higher deterioration in CSI than non-diabetics; nevertheless (123)I-MIBG imaging retained prognostic utility for both diabetic and non-diabetic patients. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  8. Investigating a patient with erectile dysfunction: Is it really necessary?

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    Vincenzo Mirone

    2006-01-01

    Full Text Available The National Institute of Health defined erectile dysfunction as the persistent inability to achieve and/or to maintain an erection for a satisfactory sexual performance. Erectile dysfunction must be considered a public health problem for its high prevalence worldwide. Aetiology of erectile dysfunction can be classified as organic, psychogenic or mixed. Erectile dysfunction must be considered the first sign of many diseases. Thus, a correct diagnostic approach is essential before starting an effective therapeutic regimen. Current guidelines concerning management of erectile dysfunction agree on the great importance of anamnesis as being the basis of a correct diagnosis of erectile deficit. First level diagnostic tests, including anamnesis, validated questionnaire, routine laboratory tests and hormonal profile seem enough to make an aetiological diagnosis of erectile dysfunction and to identify and remove any erectile dysfunction (ED risk factors in most cases. First level tests should be performed, so than urologists can accurately diagnose ED and prescribe relevant treatment. Second level diagnostic evaluation includes specialistic instrumental exams that can be helpful for accurate aetiological diagnosis of erectile dysfunction. These exams, including Penile dynamic colour-duplex. Doppler ultrasonography, nocturnal penile tumescence recording, cavernosometry/cavernosography and neurological investigation, should be performed when first level diagnostic assessment is not clear, when the presence of an underlying organic pathology should be excluded in young patients with persistent ED, when veno-occlusive or neurogenic ED is suspected and when a better definition of the disease is needed.

  9. Pathogenetic Evaluation of Dysfunction in the Erythron System of Experimental Animals during Modeling of Iron Deficiency Anemia in the Gestation Period.

    Science.gov (United States)

    Zhdanov, V V; Udut, E V; Sotnikova, L S; Burmina, Ya V; Miroshnichenko, L A; Simanina, E V; Polyakova, T Yu; Zyuz'kov, G N; Chaikovskii, A V; Stavrova, L A; Fedorova, E P; Dygai, A M

    2016-02-01

    We studied the dynamics of erythropoiesis in CBA mice during gestation against the background of treatment with iron-binding drug. The mechanisms of suppression of the bone marrow erythroid stem were evaluated. Administration of deferoxamine in a dose of 1 g/kg induced hypoplasia of the erythroid hemopoietic lineage. Suppression of bone marrow erythropoiesis manifested in a decrease of hemoglobin concentration and counts of reticulocytes, erythrocytes, and erythrokaryocytes. These changes were accompanied by a decrease in functional activity of erythropoietic precursors and secretion of erythropoietically active humoral factors by bone marrow myelokaryocytes. These data indicate that deferoxamine can be used for modeling of iron defi ciency anemia in pregnancy.

  10. Hyperemesis gravidarum and placental dysfunction disorders.

    Science.gov (United States)

    Koudijs, Heleen M; Savitri, Ary I; Browne, Joyce L; Amelia, Dwirani; Baharuddin, Mohammad; Grobbee, Diederick E; Uiterwaal, Cuno S P M

    2016-11-25

    Evidence about the consequence of hyperemesis gravidarum (HG) on pregnancy outcomes is still inconclusive. In this study, we evaluated if occurrence of hyperemesis gravidarum is associated with placental dysfunction disorders and neonatal outcomes. A prospective cohort study was conducted in a maternal and child health primary care referral center, Budi Kemuliaan Hospital and its branch, in Jakarta, Indonesia. 2252 pregnant women visiting the hospital for regular antenatal care visits from July 2012 until October 2014 were included at their first clinic visit. For women without, with mild and with severe hyperemesis, placental dysfunction disorders (gestational hypertension, preeclampsia (PE), stillbirth, miscarriage), neonatal outcomes (birth weight, small for gestational age (SGA), low birth weight (LBW), Apgar score at 5 min, gestational age at delivery) and placental outcomes (placental weight and placental-weight-to-birth-weight ratio (PW/BW ratio)) were studied. Compared to newborns of women without hyperemesis, newborns of women with severe hyperemesis had a 172 g lower birth weight in adjusted analysis (95%CI -333.26; -10.18; p = 0.04). There were no statistically significant effects on placental dysfunction disorders or other neonatal outcome measures. The results of our study suggest that hyperemesis gravidarum does not seem to induce placental dysfunction disorders, but does, if severe lead to lower birth weight.

  11. The need for standardisation of cardiac FDG PET imaging in the evaluation of myocardial viability in patients with chronic ischaemic left ventricular dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Kuuti, J. [Turku Univ. (Finland). Turku PET Centre; Schelbert, H.R. [UCLA School of Medicine, Los Angeles, CA (United States). Dept. of Molecular and Medical Pharmacology; Bax, J.J. [Leiden University Medical Center (Netherlands). Dept. of Cardilogy

    2002-09-01

    The evaluation of myocardial glucose utilisation with fluorine-18 fluorodeoxyglucose (FDG) and positron emission tomography is currently considered the most reliable tool for the identification of myocardial viability. However, the investigations using FDG imaging to predict improvement in left ventricular (LV) function after revascularisation have reported wide ranges for sensitivity (71%-100%) and, in particular, for specificity (33%-91%). The variable results may be related to differences in study populations but also to differences in the imaging protocols employed. Detailed analysis of the published studies has revealed differences in study populations, patient selection criteria, the methods for assessing changes in LV function post revascularisation and the timing of these assessments. Even more importantly, protocols have varied substantially with regard to imaging equipment, perfusion tracers, metabolic conditions, data analysis and interpretation of results. In addition, evaluation of patients with insulin resistance appears to represent a specific challenge. This review examines the different study protocols and methodologies used for myocardial FDG imaging in order to draw conclusions concerning optimal imaging protocols. It appears that the optimisation and standardisation of study protocols and analysis of FDG images for the assessment of myocardial viability are critical. In addition, multi-centre trials seem warranted on prediction of long-term function, congestive heart failure symptoms, survival and quality of life.

  12. Investigation of erectile dysfunction

    Science.gov (United States)

    Patel, D V; Halls, J; Patel, U

    2012-01-01

    Erectile dysfunction (ED) represents a common and debilitating condition with a wide range of organic and non-organic causes. Physical aetiologies can be divided into disorders affecting arterial inflow, the venous occlusion mechanism or the penile structure itself. Various imaging modalities can be utilised to investigate the physical causes of ED, but penile Doppler sonography (PDS) is the most informative technique, indicated in those patients with ED who do not respond to oral pharmacological agents (e.g. phosphodiesterase type 5 inhibitors). This review will examine the anatomical and physiological basis of penile erection, the method for performing PDS and features of specific causes of ED, and will also consider the alternative imaging modalities available. PMID:23118101

  13. Depression and erectile dysfunction.

    Science.gov (United States)

    Seagraves, R T

    2000-05-01

    The association of depression and erectile dysfunction (ED) has been firmly established, but it may be difficult to distinguish between cause and effect--whether ED causes the depression or the depression causes ED--in an individual patient. In most patients who have major depression, successful reversal of the depressive syndrome results in a return of erectile capacity. In other patients--those who suffer from minor depression--restoration of erectile capacity can lead to an improvement in mood. In either case, knowing how to diagnose depression in ED patients is important, not only because depressed patients are more likely to drop out of treatment for ED, but also because untreated depression can be life-threatening.

  14. Progressive posterior cortical dysfunction

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    Fábio Henrique de Gobbi Porto

    Full Text Available Abstract Progressive posterior cortical dysfunction (PPCD is an insidious syndrome characterized by prominent disorders of higher visual processing. It affects both dorsal (occipito-parietal and ventral (occipito-temporal pathways, disturbing visuospatial processing and visual recognition, respectively. We report a case of a 67-year-old woman presenting with progressive impairment of visual functions. Neurologic examination showed agraphia, alexia, hemispatial neglect (left side visual extinction, complete Balint's syndrome and visual agnosia. Magnetic resonance imaging showed circumscribed atrophy involving the bilateral parieto-occipital regions, slightly more predominant to the right . Our aim was to describe a case of this syndrome, to present a video showing the main abnormalities, and to discuss this unusual presentation of dementia. We believe this article can contribute by improving the recognition of PPCD.

  15. Epilepsy and Mitochondrial Dysfunction

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    Russell P. Saneto DO, PhD

    2017-10-01

    Full Text Available Epilepsy is a common manifestation of mitochondrial disease. In a large cohort of children and adolescents with mitochondrial disease (n = 180, over 48% of patients developed seizures. The majority (68% of patients were younger than 3 years and medically intractable (90%. The electroencephalographic pattern of multiregional epileptiform discharges over the left and right hemisphere with background slowing occurred in 62%. The epilepsy syndrome, infantile spasms, was seen in 17%. Polymerase γ mutations were the most common genetic etiology of seizures, representing Alpers-Huttenlocher syndrome (14%. The severity of disease in those patients with epilepsy was significant, as 13% of patients experienced early death. Simply the loss of energy production cannot explain the development of seizures or all patients with mitochondrial dysfunction would have epilepsy. Until the various aspects of mitochondrial physiology that are involved in proper brain development are understood, epilepsy and its treatment will remain unsatisfactory.

  16. Cycling and erectile dysfunction

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    Ina Šibli

    2015-01-01

    Full Text Available Abstract: For many years medical studies have implicated bicycle riding is causing erectile dysfunction (ED in association with higher perineal pressure. This review focuses upon epidemiological studies assesing the impact of cycling on ED, pathogenesis of ED in cyclists  as well as on research considering changes of perineal pressure, hemodynamics, and nerve conduction when cycling. Investigestors were also interested in different saddle sizes, materials and geometry and also in the impact of saddle and riders position on changes to the perineum. Research on female cyclists is very limited but indicates similar genitourinary disorders as in male cyclists. We also review  research on preventative and therapeutic options regarding bicycle riding and ED.

  17. Endothelins & erectile dysfunction.

    Science.gov (United States)

    Ritchie, Robert; Sullivan, Mark

    2011-06-01

    Erectile dysfunction (ED) is common and a significant contributor to poor quality of life and psychosocial morbidity in men. Normal erectile function requires effective co-ordination between a number of complex neural pathways. Penile tumescence occurs in response to rapid arterial inflow to the corpora cavernosa with simultaneous venous outflow restriction due to expansion of the lacunar spaces. This process is under both central and local neuromediation. Endothelins are potent vasoconstrictor peptides that cause strong, slowly developing but sustained contraction of trabecular smooth muscles cells of the corpora cavernosa. Multiple mechanisms of action are proposed, including transmembrane calcium flux, mobilisation of inositol triphosphate sensitive intracellular calcium stores and calcium sensitisation through the Rho-Rho kinase pathway. The exact role of endothelins in the pathogenesis of ED currently remains unclear. Elevated endothelin-1 levels are found in patients with diabetes mellitus and this alone may be sufficient to cause ED. However, this is not borne out in clinical studies. The resultant elevated intracellular calcium may, however, modulate gene expression sufficiently to cause smooth muscle proliferation. Alternatively, alterations in endothelin receptor sensitivity in conditions such as diabetes and hypertension may enhance vasoconstrictor processes. Currently there is contradictory evidence for the role of endothelin receptor antagonists in ED. Animals studies suggest they inhibit corporal vasoconstriction, improve erectile function and protect against diabetes-induced smooth muscle apoptosis. However, the results of clinical studies in ED have been less promising. Uncertainty regarding the exact role of endothelin in penile erection hampers progress in this area. It is possible that the endothelin system may only be relevant to ED in certain conditions where global endothelial dysfunction exists (e.g. diabetes mellitus, systemic sclerosis) and

  18. Hyperemesis gravidarum and placental dysfunction disorders

    OpenAIRE

    Koudijs, Heleen M.; Savitri, Ary I.; Browne, Joyce L.; Amelia, Dwirani; Baharuddin, Mohammad; Grobbee, Diederick E.; Uiterwaal, Cuno S. P. M.

    2016-01-01

    BACKGROUND: Evidence about the consequence of hyperemesis gravidarum (HG) on pregnancy outcomes is still inconclusive. In this study, we evaluated if occurrence of hyperemesis gravidarum is associated with placental dysfunction disorders and neonatal outcomes. METHODS: A prospective cohort study was conducted in a maternal and child health primary care referral center, Budi Kemuliaan Hospital and its branch, in Jakarta, Indonesia. 2252 pregnant women visiting the hospital for regular antenata...

  19. Bladder Dysfunction and Vesicoureteral Reflux

    Directory of Open Access Journals (Sweden)

    Ulla Sillén

    2008-01-01

    Full Text Available In this overview the influence of functional bladder disturbances and of its treatment on the resolution of vesicoureteral reflux (VUR in children is discussed. Historically both bladder dysfunction entities, the overactive bladder (OAB and the dysfunctional voiding (DV, have been described in conjunction with VUR. Treatment of the dysfunction was also considered to influence spontaneous resolution in a positive way. During the last decades, however, papers have been published which could not support these results. Regarding the OAB, a prospective study with treatment of the bladder overactivity with anticholinergics, did not influence spontaneous resolution rate in children with a dysfunction including also the voiding phase, DV and DES (dysfunctional elimination syndrome, most studies indicate a negative influence on the resolution rate of VUR in children, both before and after the age for bladder control, both with and without treatment. However, a couple of uncontrolled studies indicate that there is a high short-term resolution rate after treatment with flow biofeedback. It should be emphasized that the voiding phase dysfunctions (DV and DES are more severe than the genuine filling phase dysfunction (OAB, with an increased frequency of UTI and renal damage in the former groups. To be able to answer the question if treatment of bladder dysfunction influence the resolution rate of VUR in children, randomized controlled studies must be performed.

  20. Thyroid dysfunction in the elderly

    African Journals Online (AJOL)

    1997-09-09

    Sep 9, 1997 ... hyperthyroidism and 7 of hypothyroidism. Subclinical disease was diagnosed in 40 subjects. The overall prevalence of thyroid dysfunction in this population was. 11.2%. In 22 (3.4%) this had previously been recognised, while in 50 (7.8%) the dysfunction was newly diagnosed by the current survey.

  1. Endotoxemia accelerates diaphragm dysfunction in ventilated rabbits.

    Science.gov (United States)

    Yang, Yi; Yu, Tao; Pan, Chun; Longhini, Federico; Liu, Ling; Huang, Yingzi; Guo, Fengmei; Qiu, Haibo

    2016-12-01

    Ventilators may induce diaphragm dysfunction, and most of the septic population who are admitted to the intensive care unit require mechanical ventilation. However, there is no evidence that sepsis accelerates the onset of ventilator-induced diaphragm dysfunction or affects the microcirculation. Our study investigated whether lipopolysaccharide (LPS)-induced endotoxemia accelerated diaphragm dysfunction in ventilated rabbits by evaluating microcirculation, lipid accumulation, and diaphragm contractility. After anesthesia and tracheostomy, 25 invasively monitored and mechanically ventilated New Zealand white rabbits were randomized to control (n = 5), controlled mechanical ventilation (CMV) (n = 5), pressure support ventilation (PSV; n = 5), CMV or PSV with LPS-induced endotoxemia (CMV-LPS and PSV-LPS, respectively; n = 5 for each). Rabbits were anesthetized and ventilated for 24 h, except the control rabbits (30 min). Diaphragmatic contractility was evaluated using neuromechanical and neuroventilatory efficiency. We evaluated the following at the end of the protocol: (1) diaphragm microcirculation; (2) lipid accumulation; and (3) diaphragm muscular fibers structure. Diaphragm contractility, microcirculation, lipid accumulation, and fiber structures were severely compromised in endotoxemic animals after 24 h compared to nonendotoxemic rabbits. Moreover, a slight but significant increase in lipid accumulation was observed in CMV and PSV groups compared with controls (P rabbits, affects the microcirculation, and results in diaphragmatic lipid accumulation and contractility impairment. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. What's New in Cleft Palate and Velopharyngeal Dysfunction Management?

    Science.gov (United States)

    Naran, Sanjay; Ford, Matthew; Losee, Joseph E

    2017-06-01

    After studying this article, the participant should be able to: 1. Have a clear understanding of the evolution of concepts of velopharyngeal dysfunction, especially as it relates to patients with a cleft palate. 2. Explain the subjective and objective evaluation of speech in children with velopharyngeal dysfunction. 3. On the basis of these diagnostic findings, be able to classify types of velopharyngeal dysfunction. 4. Develop a safe, evidence-based, patient-customized treatment plan for velopharyngeal dysfunction founded on objective considerations. Velopharyngeal dysfunction is improper function of the dynamic structures that work to control the velopharyngeal sphincter. Approximately 30 percent of patients having undergone cleft palate repair require secondary surgery for velopharyngeal dysfunction. A multidisciplinary team using multimodal instruments to evaluate velopharyngeal function and speech should manage these patients. Instruments may include perceptual speech analysis, video nasopharyngeal endoscopy, multiview speech videofluoroscopy, nasometry, pressure-flow, and magnetic resonance imaging. Velopharyngeal dysfunction may be amenable to surgical or nonsurgical treatment methods or a combination of each. Nonsurgical management may include speech therapy or prosthetic devices. Surgical interventions could include palatal re-repair with repositioning of levator veli palatini muscles, posterior pharyngeal flap, sphincter pharyngoplasty, or soft palate or posterior wall augmentation. Treatment interventions should be based on objective assessment and rating of the movement of lateral and posterior pharyngeal walls and the palate to optimize speech outcomes. Treatment should be tailored to specific anatomical and physiologic findings and the overall needs of the patient.

  3. Predictive Value of Hepatic and Renal Dysfunction Based on the Models for End-Stage Liver Disease in Patients With Heart Failure Evaluated for Heart Transplant.

    Science.gov (United States)

    Szyguła-Jurkiewicz, B; Nadziakiewicz, P; Zakliczynski, M; Szczurek, W; Chraponski, J; Zembala, M; Gasior, M

    2016-06-01

    The evaluation of prognosis and determination of a long-term treatment strategy is an important element of management in patients with heart failure (HF). The aim of the study was to determine the prognostic value of the Model for End-Stage Liver Disease (MELD) and its modifications, MELD and serum sodium (MELD-Na) and MELD excluding the international normalized ratio (MELD-XI), as well as other independent risk factors for death during a 4-year follow-up. We analyzed retrospectively 143 patients with advanced HF, evaluated for heart transplant between 2009 and 2011. Patients using warfarin were excluded from the study. The long-term follow-up data were obtained during follow-up visits and/or phone contact with the patients or their families. The age of the patients was 54 (48-59) years and 88.1% of patients were male. Mortality rate during the follow-up period was 49%. The MELD scores (hazard ratio [HR], 1.12; P < .001), as well as serum high-sensitivity C-reactive protein (hs-CRP; HR, 1.01; P < .01) and N-terminal pro-brain natriuretic peptide (NT-proBNP; HR, 1.01; P < .05) levels, were independent risk factors for death. Receiver operator characteristic analysis indicated that a MELD cutoff of 10 (area under the curve [AUC], 0.756; P < .0001], MELD-XI cutoff of 13.0 (AUC, 0.720; P < .0001), MELD-Na cutoff of 13.0 (AUC, 0.813; P < .0001), hs-CRP cutoff of 4.02 (AUC, 0.686; P < .001), and NT-proBNP cutoff of 1055 (AUC, 0.722; P < .001) were the best predictive values as predictors of death. MELD, MELD-Na, and MELD-XI scores are prognostic factors for death during a 4-year follow-up. A high MELD score is an independent prognostic factor for death. NT-proBNP and hs-CRP serum concentrations are other independent factors influencing death. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Evaluating the Influence of Motor Control on Selective Attention through a Stochastic Model: The Paradigm of Motor Control Dysfunction in Cerebellar Patient

    Directory of Open Access Journals (Sweden)

    Giacomo Veneri

    2014-01-01

    Full Text Available Attention allows us to selectively process the vast amount of information with which we are confronted, prioritizing some aspects of information and ignoring others by focusing on a certain location or aspect of the visual scene. Selective attention is guided by two cognitive mechanisms: saliency of the image (bottom up and endogenous mechanisms (top down. These two mechanisms interact to direct attention and plan eye movements; then, the movement profile is sent to the motor system, which must constantly update the command needed to produce the desired eye movement. A new approach is described here to study how the eye motor control could influence this selection mechanism in clinical behavior: two groups of patients (SCA2 and late onset cerebellar ataxia LOCA with well-known problems of motor control were studied; patients performed a cognitively demanding task; the results were compared to a stochastic model based on Monte Carlo simulations and a group of healthy subjects. The analytical procedure evaluated some energy functions for understanding the process. The implemented model suggested that patients performed an optimal visual search, reducing intrinsic noise sources. Our findings theorize a strict correlation between the “optimal motor system” and the “optimal stimulus encoders.”

  5. Muscle dysfunction in cancer patients

    DEFF Research Database (Denmark)

    Christensen, Jesper Frank; Jones, L W; Andersen, J L

    2014-01-01

    implications of muscle dysfunction in cancer patients. The efficacy of exercise training to prevent and/or mitigate cancer-related muscle dysfunction is also discussed. DESIGN: We identified 194 studies examining muscular outcomes in cancer patients by searching PubMed and EMBASE databases. RESULTS: Muscle...... in oncology practice. Significant progress has been made over the last decade in the field of exercise oncology, indicating that exercise training constitutes a potent modulator of skeletal muscle function in patients with cancer. CONCLUSION: There are clear associations between muscle dysfunction...... dysfunction is evident across all stages of the cancer trajectory. The causes of cancer-related muscle dysfunction are complex, but may involve a wide range of tumor-, therapy- and/or lifestyle-related factors, depending on the clinical setting of the individual patient. The main importance of muscle...

  6. Respiratory dysfunction in Parkinson's disease.

    Science.gov (United States)

    Torsney, K M; Forsyth, D

    2017-03-01

    Respiratory dysfunction has been associated with Parkinson's disease since it was first described in 1817. The respiratory symptoms observed in Parkinson's disease patients vary greatly. Most patients remain asymptomatic, whereas others present with acute shortness of breath and even stridor. In August 2016, an electronic literature search was conducted using PubMed and Google Scholar. Results were screened and studies reporting on respiratory dysfunction associated with Parkinson's disease were included. Respiratory dysfunction is due to a combination of factors including restrictive changes, upper airway obstruction, abnormal ventilatory drive and response to medications. Much debate surrounds the mechanism underlying respiratory dysfunction in Parkinson's disease, its prevalence and the effect of levodopa on respiration. It is clear from this review that larger studies, comparing patients of similar disease duration and severity using the same pulmonary function parameters, are required to provide a better understanding of the pathophysiology underlying respiratory dysfunction in Parkinson's disease.

  7. Pulmonary dysfunction in obese early adolescents

    Directory of Open Access Journals (Sweden)

    Bambang Supriyatno

    2010-08-01

    Full Text Available Aim Obesity leads to various complications, including pulmonary dysfunction. Studies on pulmonary function of obese children are limited and the results are controversial. This study was aimed to determine proportion of pulmonary dysfunction on early adolescents with obesity and to evaluate correlation between obesity degree with pulmonary dysfunction degree.Methods A cross-sectional study was conducted at the Department of Child Health, Medical School, University of Indonesia, from November 2007 to December 2008. Subjects were 10 to 12 year-old adolescents with obesity. Subjects underwent pulmonary function test (PFT to assess FEV1/FVC, FEV1, FVC, V50, and V25.Results 110 subjects fulfilled study criteria, 83 (75.5% were male and 27 (24.5% were female with median BMI 26.7 (22.6-54.7 kg/m2; 92 subjects (83.6% were superobese. History of asthma and allergic rhinitis were found in 32 (29.1% and 46 (41.8% subjects, respectively. 64 (58.2% subjects had abnormal PFT results consisting of restrictive type in 28 (25.5% subjects, obstructive in 3 (2.7%, and combined type in 33 (30%. Mean FEV1, FVC, V50, and V25 values were below normal, while mean FEV1/FVC ratio was normal. There was no statistically significant correlation between BMI and PFT parameters. No significant correlation was found between degree of obesity and the severity of pulmonary dysfunction.Conclusions Pulmonary dysfunction occurs in 58.2% obese early adolescents. The most common abnormality was combined type (30%, followed by restrictive (25.5%, and obstructive type (2.7%. There was no correlation between BMI and pulmonary function test parameters. (Med J Indones 2010;19:179-84Key words: early adolescents, obesity, pulmonary function test

  8. Urinary Incontinence and Associated Female Sexual Dysfunction.

    Science.gov (United States)

    Duralde, Erin R; Rowen, Tami S

    2017-10-01

    Urinary incontinence (UI) and sexual dysfunction are common conditions often undiagnosed and untreated in women and are associated with decreased quality of life. To evaluate the relation between UI and female sexual dysfunction (FSD), considering incontinence type and the psychosocial and physiologic aspects of sexual function. PubMed search of terms related to UI and FSD from 1979 to 2016 generated 603 published references, of which 26 were included. Nine additional studies came from bibliographic review. Rates and types of sexual dysfunction. In cross-sectional and case-control studies, UI was associated with increased rates and severity of FSD. Coital UI occurred in 24% to 66% of women with UI. Impaired body image, fear of coital UI, avoidance of sex, and complete abstinence were more common in women with UI. Deficits in desire, lubrication, satisfaction, and increased pain were found across numerous studies. Mixed UI was associated with more FSD than urgency UI and stress UI. Multiple studies suggest urgent UI is more bothersome than stress UI. Coital UI was associated with a urodynamic diagnosis other than genuine stress incontinence in 25% to 50%. Leakage at penetration was associated with stress UI; leakage at orgasm was associated more often with detrusor overactivity. Women's UI is associated with increased rates of sexual dysfunction, suggesting concurrent screening is warranted. Clarifying timing of coital leakage would facilitate targeted treatment. Standardization of FSD measurements could better elucidate the relation between UI and FSD. Duralde ER, Rowen TS. Urinary Incontinence and Associated Female Sexual Dysfunction. Sex Med Rev 2017;5:470-485. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  9. Cardiac magnetic resonance myocardial perfusion reserve index is reduced in women with coronary microvascular dysfunction. A National Heart, Lung, and Blood Institute-sponsored study from the Women's Ischemia Syndrome Evaluation.

    Science.gov (United States)

    Thomson, Louise E J; Wei, Janet; Agarwal, Megha; Haft-Baradaran, Afsaneh; Shufelt, Chrisandra; Mehta, Puja K; Gill, Edward B; Johnson, B Delia; Kenkre, Tanya; Handberg, Eileen M; Li, Debiao; Sharif, Behzad; Berman, Daniel S; Petersen, John W; Pepine, Carl J; Bairey Merz, C Noel

    2015-04-01

    Women with signs and symptoms of ischemia and no obstructive coronary artery disease often have coronary microvascular dysfunction (CMD), diagnosed by invasive coronary reactivity testing (CRT). Although traditional noninvasive stress imaging is often normal in CMD, cardiac MRI may be able to detect CMD in this population. Vasodilator stress cardiac MRI was performed in 118 women with suspected CMD who had undergone CRT and 21 asymptomatic reference subjects. Semi-quantitative evaluation of the first-pass perfusion images was completed to determine myocardial perfusion reserve index (MPRI). The relationship between CRT findings and MPRI was examined by Pearson correlations, logistic regression, and sensitivity/specificity. Symptomatic women had lower mean pharmacological stress MPRI compared with reference subjects (1.71±0.43 versus 2.23±0.37; P<0.0001). Lower MPRI was predictive of ≥1 abnormal CRT variables (odds ratio =0.78 [0.70, 0.88], P<0.0001, c-statistic 0.78 [0.68, 0.88]). An MPRI threshold of 1.84 predicted CRT abnormality with sensitivity 73% and specificity 74%. Noninvasive cardiac MRI MPRI can detect CMD defined by invasive CRT. Further work is aimed to optimize the noninvasive identification and management of CMD patients. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00832702. © 2015 American Heart Association, Inc.

  10. Avaliação clínica de sinais e sintomas da disfunção temporomandibular em crianças Clinical evaluation of signs and symptoms of children’s temporomandibular dysfunction

    Directory of Open Access Journals (Sweden)

    Eduardo César Almada Santos

    2006-04-01

    Full Text Available OBJETIVO: avaliar a freqüência dos sinais e sintomas, dos hábitos parafuncionais e das características oclusais de 80 crianças, pacientes da clínica de Ortodontia Preventiva da Faculdade de Odontologia de Araçatuba - UNESP. METODOLOGIA: o exame clínico constituiu-se de avaliação das características oclusais do paciente e observação da presença de hábitos parafuncionais. As crianças foram submetidas a uma entrevista, supervisionadas pelos pais, cujas perguntas relacionavam-se com os sinais e sintomas da disfunção. RESULTADOS E CONCLUSÕES: concluiu-se que os sinais e sintomas mais freqüentes foram o hábito de ranger os dentes, dores de cabeça e ruídos na ATM. A onicofagia e o bruxismo foram os hábitos parafuncionais mais prevalentes. A freqüência de sinais e sintomas da disfunção temporomandibular pode ser verificada em crianças por meio da entrevista e exame clínico minucioso.AIM: to assess the frequency of signs and symptoms of the parafunctional habits and of the occlusal characteristics of 80 children, patients of the Preventive Orthodontics Clinic at Araçatuba’s Faculty of Dentistry - UNESP. METHODS: the clinical test comprised evaluation of the patient’s occlusal characteristics and observation of the presence of parafunctional habits. The children were submitted to a parent-supervised interview, whose questions were related to the signs and symptoms of the dysfunction. RESULTS AND CONCLUSION: we concluded that the most frequent signs and symptoms were teeth-grinding, headache and ATM noises. The most prevalent parafunctional habits were onicophagy and bruxism. The frequency of signs and symptoms of temporomandibular dysfunction can be noticed in children through interview and a detailed clinical test.

  11. [Thyroid dysfunction during pregnancy].

    Science.gov (United States)

    Díez, Juan J; Iglesias, Pedro; Donnay, Sergio

    2015-10-21

    Recent clinical practice guidelines on thyroid dysfunction and pregnancy have changed health care provided to pregnant women, although their recommendations are under constant revision. Trimester- and area-specific reference ranges for serum thyroid-stimulating hormone are required for proper diagnosis of hypothyroidism and hyperthyroidism. There is no doubt on the need of therapy for overt hypothyroidism, while therapy for subclinical hypothyroidism is controversial. Further research is needed to settle adverse effects of isolated hypothyroxinemia and thyroid autoimmunity. Differentiation between hyperthyroidism due to Graves' disease and the usually self-limited gestational transient thyrotoxicosis is critical. It is also important to recognize risk factors for postpartum thyroiditis. Supplementation with iodine is recommended to maintain adequate iodine nutrition during pregnancy and avoid serious consequences in offspring. Controversy remains about universal screening for thyroid disease during pregnancy or case-finding in high-risk women. Opinions of some scientific societies and recent cost-benefit studies favour universal screening. Randomized controlled studies currently under development should reduce the uncertainties that still remain in this area. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  12. [Hypothalamic dysfunction in obesity].

    Science.gov (United States)

    van de Sande-Lee, Simone; Velloso, Licio A

    2012-08-01

    Obesity, defined as abnormal or excessive fat accumulation that may impair life quality, is one of the major public health problems worldwide. It results from an imbalance between food intake and energy expenditure. The control of energy balance in animals and humans is performed by the central nervous system (CNS) by means of neuroendocrine connections, in which circulating peripheral hormones, such as leptin and insulin, provide signals to specialized neurons of the hypothalamus reflecting body fat stores, and induce appropriate responses to maintain the stability of these stores. The majority of obesity cases are associated with central resistance to both leptin and insulin actions. In experimental animals, high-fat diets can induce an inflammatory process in the hypothalamus, which impairs leptin and insulin intracellular signaling pathways, and results in hyperphagia, decreased energy expenditure and, ultimately, obesity. Recent evidence obtained from neuroimaging studies and assessment of inflammatory markers in the cerebrospinal fluid of obese subjects suggests that similar alterations may be also present in humans. In this review, we briefly present the mechanisms involved with the loss of homeostatic control of energy balance in animal models of obesity, and the current evidence of hypothalamic dysfunction in obese humans.

  13. Pelvic floor dysfunction and sensory impairment: Current evidence.

    Science.gov (United States)

    Mahoney, Charlotte; Smith, Anthony; Marshall, Andy; Reid, Fiona

    2017-03-01

    To explore the role of sensory nerve impairment in women with pelvic organ prolapse, painful bladder syndrome, urinary and fecal incontinence, and sexual dysfunction. Medline and Embase were searched for articles in which sensory testing, either quantitative sensory testing or current perception thresholds, had been used to evaluate women with pelvic organ prolapse, stress and urge urinary incontinence, fecal incontinence and female sexual dysfunction. All search terms were expanded within each database prior to searching. Research to date has included small numbers of participants, used poorly matched controls, lacked a systemic sensory examination and applied non-standardized sensory testing techniques. However, the evidence suggests women with pelvic organ prolapse demonstrate sensory dysfunction. The role of sensory impairment in stress urinary incontinence is inconclusive. In women with urge urinary incontinence there is some evidence to suggest it may be urethrally mediated. Women with painful bladder syndrome may have more sensitive nerve endings which are unable to ignore repeated stimuli. Sensory impairment is common in women with sexual dysfunction, typically involving larger nerve fibres. There were no studies evaluating sensory function in women with fecal incontinence. Current evidence suggests women with pelvic floor dysfunction demonstrate sensory impairment though the causes remain unclear. Further studies are needed to investigate the different conditions of pelvic floor dysfunction using standardized sensory testing techniques, as well as evaluate the timing and mechanism by which any sensory impairment develops. Neurourol. Urodynam. 36:550-556, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. Erectile dysfunction in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Imen Gorsane

    2016-01-01

    Full Text Available Erectile dysfunction (ED is a common problem seen among patients on hemodialysis (HD, but it is still a taboo subject in our country. The attention given to this sexual problem remained low, and the prevalence of ED among these patients has not been well characterized. We carried out this study in order to determine the prevalence and severity of ED in HD patients. We conducted a descriptive cross-sectional study in our HD unit in March 2013. ED was evaluated using the International Index Erection Function. Thirty patients with a mean age of 49.1 years were eligible for this study. The main causes of chronic kidney disease were hypertension (62.5% and diabetes (41.6%. The prevalence of ED was 80%, including 33.3% severe ED. Plasma levels of gonadotropins: luteinizing hormone (LH, follicule-stimulating hormone were in the standards except for one patient who had an elevated level of LH. Prolactin was elevated in four cases. ED was present in 8.4% of patients before the discovery of renal failure and in 91.6% of patients at the beginning of dialysis. For 19 patients (79.1%, the ED had increased during the dialysis sessions. A significant number of our HD patients presented with ED of varying degrees. Nephrologists should pay attention to the problem of ED in order to improve the quality of their life.

  15. Adenosine dysfunction in epilepsy

    Science.gov (United States)

    Boison, Detlev

    2011-01-01

    Extracellular levels of the brain’s endogenous anticonvulsant and neuroprotectant adenosine largely depend on an astrocyte-based adenosine cycle, comprised of ATP release, rapid degradation of ATP into adenosine, and metabolic reuptake of adenosine through equilibrative nucleoside transporters and phosphorylation by adenosine kinase (ADK). Changes in ADK expression and activity therefore rapidly translate into changes of extracellular adenosine, which exerts its potent anticonvulsive and neuroprotective effects by activation of pre- and postsynaptic adenosine A1 receptors. Increases in ADK increase neuronal excitability, whereas decreases in ADK render the brain resistant to seizures and injury. Importantly, ADK was found to be overexpressed and associated with astrogliosis and spontaneous seizures in rodent models of epilepsy, as well as in human specimen resected from patients with hippocampal sclerosis and temporal lobe epilepsy. Several lines of evidence indicate that overexpression of astroglial ADK and adenosine deficiency are pathological hallmarks of the epileptic brain. Consequently, adenosine augmentation therapies constitute a powerful approach for seizure prevention, which is effective in models of epilepsy that are resistant to conventional antiepileptic drugs. The adenosine kinase hypothesis of epileptogenesis suggests that adenosine dysfunction in epilepsy undergoes a biphasic response: An acute surge of adenosine that can be triggered by any type of injury might contribute to the development of astrogliosis via adenosine receptor –dependent and –independent mechanisms. Astrogliosis in turn is associated with overexpression of ADK, which was shown to be sufficient to trigger spontaneous recurrent electrographic seizures. Thus, ADK emerges as a promising target for the prediction and prevention of epilepsy. PMID:22700220

  16. Cognitive dysfunction after cardiovascular surgery

    DEFF Research Database (Denmark)

    Funder, K S; Steinmetz, J; Rasmussen, L S

    2009-01-01

    This review describes the incidence, risk factors, and long-term consequences of cognitive dysfunction after cardiovascular surgery. Postoperative cognitive dysfunction (POCD) is increasingly being recognized as an important complication, especially in the elderly. A highly sensitive neuropsychol......This review describes the incidence, risk factors, and long-term consequences of cognitive dysfunction after cardiovascular surgery. Postoperative cognitive dysfunction (POCD) is increasingly being recognized as an important complication, especially in the elderly. A highly sensitive...... neuropsychological test battery must be used to detect POCD and a well-matched control group is very useful for the analysis and interpretation of the test RESULTS: Cardiovascular surgery is associated with a high incidence of POCD. Cardiopulmonary bypass was thought to explain this difference, but randomized...

  17. Causes of sexual dysfunction (image)

    Science.gov (United States)

    Female sexual dysfunction describes women who are indifferent or hostile to sexual intercourse, who have no response to sexual advances or stimulation, or who are unable to have an orgasm during sexual intercourse.

  18. Orgasmic Dysfunction after Radical Prostatectomy

    OpenAIRE

    Capogrosso, Paolo; Ventimiglia, Eugenio; Cazzaniga, Walter; Montorsi, Francesco; Salonia, Andrea

    2017-01-01

    In addition to urinary incontinence and erectile dysfunction, several other impairments of sexual function potentially occurring after radical prostatectomy (RP) have been described; as a whole, these less frequently assessed disorders are referred to as neglected side effects. In particular, orgasmic dysfunctions (ODs) have been reported in a non-negligible number of cases, with detrimental impacts on patients' overall sexual life. This review aimed to comprehensively discuss the prevalence ...

  19. Thyroid dysfunction and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Sima Nazarpour

    2015-07-01

    Full Text Available Background: Pregnancy has a huge impact on the thyroid function in both healthy women and those that have thyroid dysfunction. The prevalence of thyroid dysfunction in pregnant women is relatively high. Objective: The objective of this review was to increase awareness and to provide a review on adverse effect of thyroid dysfunction including hyperthyroidism, hypothyroidism and thyroid autoimmune positivity on pregnancy outcomes. Materials and Methods: In this review, Medline, Embase and the Cochrane Library were searched with appropriate keywords for relevant English manuscript. We used a variety of studies, including randomized clinical trials, cohort (prospective and retrospective, case-control and case reports. Those studies on thyroid disorders among non-pregnant women and articles without adequate quality were excluded. Results: Overt hyperthyroidism and hypothyroidism has several adverse effects on pregnancy outcomes. Overt hyperthyroidism was associated with miscarriage, stillbirth, preterm delivery, intrauterine growth retardation, low birth weight, preeclampsia and fetal thyroid dysfunction. Overt hypothyroidism was associated with abortion, anemia, pregnancy-induced hypertension, preeclampsia, placental abruption, postpartum hemorrhage, premature birth, low birth weight, intrauterine fetal death, increased neonatal respiratory distress and infant neuro developmental dysfunction. However the adverse effect of subclinical hypothyroidism, and thyroid antibody positivity on pregnancy outcomes was not clear. While some studies demonstrated higher chance of placental abruption, preterm birth, miscarriage, gestational hypertension, fetal distress, severe preeclampsia and neonatal distress and diabetes in pregnant women with subclinical hypothyroidism or thyroid autoimmunity; the other ones have not reported these adverse effects. Conclusion: While the impacts of overt thyroid dysfunction on feto-maternal morbidities have been clearly

  20. Thyroid dysfunction and pregnancy outcomes

    Science.gov (United States)

    Nazarpour, Sima; Ramezani Tehrani, Fahimeh; Simbar, Masoumeh; Azizi, Fereidoun

    2015-01-01

    Background: Pregnancy has a huge impact on the thyroid function in both healthy women and those that have thyroid dysfunction. The prevalence of thyroid dysfunction in pregnant women is relatively high. Objective: The objective of this review was to increase awareness and to provide a review on adverse effect of thyroid dysfunction including hyperthyroidism, hypothyroidism and thyroid autoimmune positivity on pregnancy outcomes. Materials and Methods: In this review, Medline, Embase and the Cochrane Library were searched with appropriate keywords for relevant English manuscript. We used a variety of studies, including randomized clinical trials, cohort (prospective and retrospective), case-control and case reports. Those studies on thyroid disorders among non-pregnant women and articles without adequate quality were excluded. Results: Overt hyperthyroidism and hypothyroidism has several adverse effects on pregnancy outcomes. Overt hyperthyroidism was associated with miscarriage, stillbirth, preterm delivery, intrauterine growth retardation, low birth weight, preeclampsia and fetal thyroid dysfunction. Overt hypothyroidism was associated with abortion, anemia, pregnancy-induced hypertension, preeclampsia, placental abruption, postpartum hemorrhage, premature birth, low birth weight, intrauterine fetal death, increased neonatal respiratory distress and infant neuro developmental dysfunction. However the adverse effect of subclinical hypothyroidism, and thyroid antibody positivity on pregnancy outcomes was not clear. While some studies demonstrated higher chance of placental abruption, preterm birth, miscarriage, gestational hypertension, fetal distress, severe preeclampsia and neonatal distress and diabetes in pregnant women with subclinical hypothyroidism or thyroid autoimmunity; the other ones have not reported these adverse effects. Conclusion: While the impacts of overt thyroid dysfunction on feto-maternal morbidities have been clearly identified and its long

  1. Prostatic Disease and Sexual Dysfunction

    OpenAIRE

    Kim, Sae Woong

    2011-01-01

    Prostatitis and benign prostatic hyperplasia (BPH) are common prostatic diseases. Furthermore, the incidence of prostate cancer has recently shown a rapid increase, even in Korea. Pain caused by prostatitis may induce sexual dysfunction, including erectile dysfunction and ejaculatory disturbance. And BPH itself, or treatments for BPH, may affect sexual function. In addition, with increased detection of localized prostate cancer, surgical treatments and radiation therapy have also increased, a...

  2. Delirium is associated with early postoperative cognitive dysfunction

    DEFF Research Database (Denmark)

    Rudolph, J.L.; Marcantonio, E.R.; Culley, D.J.

    2008-01-01

    The purpose of this analysis was to determine if postoperative delirium was associated with early postoperative cognitive dysfunction (at 7 days) and long-term postoperative cognitive dysfunction (at 3 months). The International Study of Postoperative Cognitive Dysfunction recruited 1218 subjects...... >or= 60 years old undergoing elective, non-cardiac surgery. Postoperatively, subjects were evaluated for delirium using the criteria of the Diagnostic and Statistical Manual. Subjects underwent neuropsychological testing pre-operatively and postoperatively at 7 days (n = 1018) and 3 months (n = 946......). Postoperative cognitive dysfunction was defined as a composite Z-score > 2 across tests or at least two individual test Z-scores > 2. Subjects with delirium were significantly less likely to participate in postoperative testing. Delirium was associated with an increased incidence of early postoperative...

  3. An open-label, multicenter, flexible dose study to evaluate the efficacy and safety of Viagra (sildenafil citrate) in Korean men with erectile dysfunction and arterial hypertension who are taking antihypertensive agents.

    Science.gov (United States)

    Park, Hyun Jun; Park, Nam Cheol; Shim, Hong Bang; Park, Jong Kwan; Lee, Sung Won; Park, Kwangsung; Kim, Sae Woong; Moon, Ki Hak; Lee, Dong Hyeon; Yoon, Sang Jin

    2008-10-01

    Erectile dysfunction (ED) is common among men taking antihypertensive agents to control blood pressure. We evaluated the efficacy and safety of sildenafil citrate in men with ED taking antihypertensive agents. A total of 198 male subjects, aged 20 years and older were enrolled. This study was conducted for 10 weeks as an open-label, multicenter and flexible dose trial with a 2-week screening period and an 8-week treatment phase. Subjects were asked to complete Event Log Worksheets, as well as the International Index of Erectile Function (IIEF) and the Global Efficacy Assessment Questions (GEAQ) questionnaires during the study period. The average age among the 167 subjects who completed the study was 55.8 (31.7 to 77.1). The scores for questions 3 and 4 of IIEF improved from 2.3 and 1.8 at baseline to 3.7 and 3.4 at week 4 and 3.8 and 3.4 at week 8, respectively. There were 86.3% of the patients reported improved erectile function at week 8; 88.3% of the patients reported improved ability to achieve sexual intercourse at week 8. There were no significant differences observed in the responses to questions 3 and 4 of IIEF and GEAQ by the number of antihypertensive agents taken. The adverse events were facial flushing (20.1%), headache (11.7%), palpitation (5.0%), rhinitis (2.8%), URI (2.8%), dizziness (2.2%), dyspnea (2.2%), and nausea (1.7%). Sildenafil citrate is an effective treatment for ED; it is safe and well tolerated by patients with ED taking multiple antihypertensive agents for arterial hypertension.

  4. Psychosocial interventions for erectile dysfunction.

    Science.gov (United States)

    Melnik, T; Soares, B G O; Nasselo, A G

    2007-07-18

    Normal sexual function is a biopsychosocial process and relies on the coordination of psychological, endocrine, vascular, and neurological factors. Recent data show that psychological factors are involved in a substantial number of cases of erectile dysfunction (ED) alone or in combination with organic causes. However, in contrast to the advances in somatic research of erectile dysfunction, scientific literature shows contradictory reports on the results of psychotherapy for the treatment of ED. To evaluate the effectiveness of psychosocial interventions for the treatment of ED compared to oral drugs, local injection, vacuum devices and other psychosocial interventions, that may include any psycho-educative methods and psychotherapy, or both, of any kind. The following databases were searched to identify randomised or quasi-randomised controlled trials: MEDLINE (1966 to 2007), EMBASE (1980 to 2007), psycINFO (1974 to 2007), LILACS (1980 to 2007), DISSERTATION ABSTRACTS (2007) and the Cochrane Central Register of Controlled Trials (CENTRAL) (2007). Besides this electronic search cross checking the references of all identified trials, contact with the first author of all included trials was performed in order to obtain data on other published or unpublished trials. Handsearch of the International Journal of Impotence Research and Journal of Sex and Marital Therapy since its first issue and contact with scientific societies for ED completed the search strategy. All relevant randomised and quasi-randomised controlled trials evaluating psychosocial interventions for ED. Authors of the review independently selected trials found with the search strategy, extracted data, assessed trial quality, and analysed results. For categorical outcomes the pooled relative risks (RR) were calculated, and for continuous outcomes mean differences between interventions were calculated as well. Statistical heterogeneity was addressed. Nine randomised (Banner 2000; Baum 2000; Goldman 1990

  5. Prevalence of Concomitant Sacroiliac joint Dysfunction in Patients With Image Proven Herniated Lumbar Discs

    Directory of Open Access Journals (Sweden)

    Salah Alalawi

    2009-05-01

    Full Text Available Background:Sacroiliac joint (SIJ dysfunction is a widely known but poorly defined cause of low back pain. To our knowledge, few published studies have been conducted to evaluate systematically the prevalence and significance of concomitant sacroiliac joint dysfunction in patients with herniated lumbar discs. As concomitant SIJ dysfunction in low back pain patients is likely to respond to particular noninvasive interventions such as manipulation,improved understanding of the relationship between these two diagnoses would improve clinical decision making and research.Methods:This study was designated to estimate the prevalence of concomitant sacroiliac joint dysfunction in sub acute low back pain patients with image proven discopathy and evaluate the theory that sacroiliac joint dysfunction can be a source of pain and functional disability in discopathy. A total of 202 patients with sub acute radicular back pain and MRI proven herniated lumbar discs underwent standardized   physiatrist history and physical examination, specified for detection of concomitant sacroiliac joint dysfunction.Results: Sacroiliac joint dysfunction is a concomitant finding in 72.3% of evaluated patients.There was significantly higher SIJ dysfunction prevalence in female patients (p <0.0001. Conclusion: SIJ dysfunction is a significant pathogenic factor with high possibility of occurrence in low back pain. Thus, in the presence of radicular and sacroiliac joint symptoms, SIJ dysfunction, regardless of intervertebral disc pathology, must be considered in clinical decisiomaking.

  6. Role of Nanotechnology in Erectile Dysfunction Treatment.

    Science.gov (United States)

    Wang, Alice Y; Podlasek, Carol A

    2017-01-01

    The biological importance of nanotechnology-based delivery vehicles for in vivo tissue regeneration is gaining acceptance by the medical community; however, its relevance and incorporation into the treatment of sexual dysfunction are evolving and have not been well evaluated. To provide scientific evidence examining the use of state-of-the-art nanotechnology-based delivery methodology in the treatment of erectile dysfunction (ED) in animal models and in patients. This review assessed the current basic science literature examining the role of nanotechnology-based delivery vehicles in the development of potential ED therapies. There are four primary areas where nanotechnology has been applied for ED treatment: (i) topical delivery of drugs for on-demand erectile function, (ii) injectable gels into the penis to prevent morphologic changes after prostatectomy, (iii) hydrogels to promote cavernous nerve regeneration or neuroprotection, and (iv) encapsulation of drugs to increase erectile function (primarily of phosphodiesterase type 5 inhibitors). Basic science studies provide evidence for a significant and evolving role for nanotechnology in the development of therapies for ED and suggest that properly administered nano-based therapies might be advantageous for treating male sexual dysfunction. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  7. Microvascular endothelial dysfunction predicts the development of erectile dysfunction in men with coronary atherosclerosis without critical stenoses.

    Science.gov (United States)

    Reriani, Martin; Flammer, Andreas J; Li, Jing; Prasad, Megha; Rihal, Charanjit; Prasad, Abhiram; Lennon, Ryan; Lerman, Lilach O; Lerman, Amir

    2014-11-01

    Erectile dysfunction (ED) is associated with an increased risk for cardiovascular disease, stroke, and all-cause mortality, independent of conventional cardiovascular risk factors. Coronary endothelial dysfunction is independently associated with ED in men with early coronary atherosclerosis. We aimed to investigate whether coronary microvascular dysfunction predicts development of ED in patients presenting with coronary atherosclerosis without critical stenoses. Coronary microvascular function was evaluated in 130 men with coronary atherosclerosis without critical stenoses by administration of intracoronary acetylcholine at the time of diagnostic study. After a mean follow-up of 8.4 years, patients were assessed for the development of ED by administration of a questionnaire. In all, 68 (50%) men had microvascular endothelial dysfunction at baseline; 35 (51%) men with microvascular endothelial dysfunction developed ED on follow-up compared with 19 (31%) men without microvascular endothelial dysfunction. Men who developed ED had a lower coronary blood flow response (% [INCREMENT]CBF) compared with men who did not develop ED, with mean±SD of 25.4±71.3 versus 81.7±120 (P=0.003). In univariate analysis, microvascular endothelial dysfunction was a predictor for the development of ED, with relative risk of 2.4 (1.2-4.9) (P=0.016). In multivariate logistic regression adjusting for traditional cardiovascular risk factors (age, hypertension, hyperlipidemia, diabetes, vascular disease, and family history of coronary artery disease), only microvascular endothelial dysfunction (P=0.027) and age (P=0.044) remained significant predictors of development of ED. Coronary microvascular dysfunction is a predictor of the development of ED in men with coronary atherosclerosis without critical stenoses. This study underscores the systemic involvement of the endothelial function in vascular disease.

  8. Bulbar dysfunction in normal pressure hydrocephalus: a prospective study.

    Science.gov (United States)

    Chankaew, Ekawut; Srirabheebhat, Prajak; Manochiopinig, Sriwimon; Witthiwej, Theerapol; Benjamin, Itsara

    2016-09-01

    OBJECTIVE Normal pressure hydrocephalus (NPH) is clinically characterized by gait disturbance, cognitive impairment, and urinary incontinence, as well as enlargement of the ventricles. To the best of the authors' knowledge, there have been no previous publications regarding the correlation between bulbar dysfunction and NPH. The primary objective of this study was to compare preoperative and postoperative prevalence of bulbar dysfunction in patients with NPH. Secondary objectives included assessing the results of surgery for swallowing, speech, gait, cognition, and urination, and evaluating the correlation between bulbar dysfunction and triad symptoms. METHODS Fifty-three patients with NPH who underwent shunt placement surgery at Siriraj Hospital were included in the study. Patients were evaluated for gait, cognition, urination, swallowing, and speech before and 6 months after shunt placement. Triad symptoms were assessed using standard methods. Bulbar dysfunctions were assessed using the Swallowing Problem Questionnaire, Thai Articulation Test, Resonation Screening Test (RST), and Thai Nasality Test. The Thai Speech Assessment Program and nasometer were used for objective speech measurement. RESULTS Preoperatively, 86% (43/50) of patients had swallowing problems and 75% (37/49) had speech problems, as measured by the RST. Postoperatively, there was significant improvement in swallowing (p nasometer test. All triad symptoms were improved. There were significant correlations between swallowing impairment and gait disturbance (r = 0.358, p = 0.009), and RST and cognitive impairment (r = -0.502, p < 0.001). CONCLUSIONS This is the first study of bulbar dysfunction in patients with NPH. The results showed that the prevalence of bulbar dysfunction is very high. The correlation between bulbar dysfunction and the classic NPH triad has been documented and published. These bulbar symptoms also significantly improved after surgery. As such, bulbar dysfunction should be

  9. Voiding dysfunctions in children with mental retardation.

    Science.gov (United States)

    Yang, Pei-Yu; Meng, Nai-Hsin; Chou, Eric Chieh-lung

    2010-09-01

    This study aims to evaluate the voiding disorder and lower urinary tract symptoms in mentally retarded children. Fifty-one mentally retarded children (age 7.7 years) was assessed. A volunteer sample comprised of 36 typically developing children (age 6.4 years) served as the comparative group. All participants underwent uroflometric investigation, and residual urine was detected by sonography. Urological history including history of urinary tract infection, incontinence, frequency, and dysurea was collected. In addition, the mentally retarded group was classified according to IQ: severe mentally retarded group (IQ below 40) (n = 11), moderate mentally retarded group (IQ: 41 to 55) (n = 19), mild mentally retarded group (IQ: 56 to 70) (n = 21). Group comparisons were analyzed using Chi-square and Student's t-test. Of the 51 mentally retarded children, 18(35.2%) were found to have voiding dysfunction, which is significantly higher than the control group (8.3%). The incidence of urine incontinence and frequency is also significantly higher in the mentally retarded group. The comparison of the three mentally retarded subgroups showed that the severe mentally retarded group had the highest incidence of voiding dysfunction and urinary incontinence. Overall, the mentally retarded group had higher percentage of small bladder capacity. We concluded that mentally retarded children have a higher incidence of voiding dysfunction and incontinence than the control group. Early detection of voiding dysfunction in an objective, non-invasive manner is important in mentally retarded children, particularly those with severe cognitive impairment. © 2009 Wiley-Liss, Inc.

  10. Biochemical Pattern Of Erectile Dysfunction in Nigerians Living in ...

    African Journals Online (AJOL)

    Erectile dysfunction (ED) is a global disease which may not be lethal, but has a negative impact on the quality of life and self esteem of the patients. There are conflicting reports on the need or otherwise for endocrine evaluation of patients with this disease. The objective of the study was to evaluate testosterone, luteinizing ...

  11. Association of perfectionistic and dependent dysfunctional attitudes with subthreshold depression

    Directory of Open Access Journals (Sweden)

    Horiuchi S

    2017-08-01

    Full Text Available Satoshi Horiuchi,1 Shuntaro Aoki,2,3 Koki Takagaki,4 Fumihito Shoji5 1Faculty of Social Welfare, Iwate Prefectural University, Iwate, Japan; 2Graduate School of Psychological Science, Health Sciences University of Hokkaido, Hokkaido, Japan; 3Japan Society for the Promotion of Science, Tokyo, Japan; 4Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan; 5Graduate School of Social Welfare, Iwate Prefectural University, Iwate, Japan Background: Dysfunctional attitudes are beliefs and attitudes that induce negative thoughts about the self, others, and the future, leading to depression. Perfectionistic dysfunctional attitudes are beliefs and attitudes about achievement and excessive fear of failure, while dependent dysfunctional attitudes are beliefs and attitudes about dependency on, and approval from, others. Subthreshold depression refers to a depressive state that does not meet the diagnostic criteria for a major depressive episode. This study examined whether the difference in perfectionistic dysfunctional attitudes between college students with subthreshold depression and those with no depression would be greater than that of dependent dysfunctional attitudes.Methods: Participants were defined as having subthreshold depression if they scored 16 or higher on the Japanese version of the Center for Epidemiologic Studies Depression Scale but did not meet the diagnostic criteria for a major depressive episode, as assessed by the major depressive episode module of the Mini-International Neuropsychiatric Interview. The participants included 21 male and 87 female college students, with a mean age of 20.3 years. Dysfunctional attitudes were evaluated with the Japanese version of the 24-item Dysfunctional Attitude Scale.Results: Of the 108 students, 34 had subthreshold depression while 74 had no depression. The magnitudes of the differences in perfectionistic and dependent dysfunctional attitudes between the students with

  12. Postprostatectomy Erectile Dysfunction: A Review

    Science.gov (United States)

    Salonia, Andrea; Briganti, Alberto; Montorsi, Francesco

    2016-01-01

    In the current era of the early diagnosis of prostate cancer (PCa) and the development of minimally invasive surgical techniques, erectile dysfunction (ED) represents an important issue, with up to 68% of patients who undergo radical prostatectomy (RP) complaining of postoperative erectile function (EF) impairment. In this context, it is crucial to comprehensively consider all factors possibly associated with the prevention of post-RP ED throughout the entire clinical management of PCa patients. A careful assessment of both oncological and functional baseline characteristics should be carried out for each patient preoperatively. Baseline EF, together with age and the overall burden of comorbidities, has been strongly associated with the chance of post-RP EF recovery. With this goal in mind, internationally validated psychometric instruments are preferable for ensuring proper baseline EF evaluations, and questionnaires should be administered at the proper time before surgery. Careful preoperative counselling is also required, both to respect the patient's wishes and to avoid false expectations regarding eventual recovery of baseline EF. The advent of robotic surgery has led to improvements in the knowledge of prostate surgical anatomy, as reflected by the formal redefinition of nerve-sparing techniques. Overall, comparative studies have shown significantly better EF outcomes for robotic RP than for open techniques, although data from prospective trials have not always been consistent. Preclinical data and several prospective randomized trials have demonstrated the value of treating patients with oral phosphodiesterase 5 inhibitors (PDE5is) after surgery, with the concomitant potential benefit of early re-oxygenation of the erectile tissue, which appears to be crucial for avoiding the eventual penile structural changes that are associated with postoperative neuropraxia and ultimately result in severe ED. For patients who do not properly respond to PDE5is, proper

  13. Prostatic disease and sexual dysfunction.

    Science.gov (United States)

    Kim, Sae Woong

    2011-06-01

    Prostatitis and benign prostatic hyperplasia (BPH) are common prostatic diseases. Furthermore, the incidence of prostate cancer has recently shown a rapid increase, even in Korea. Pain caused by prostatitis may induce sexual dysfunction, including erectile dysfunction and ejaculatory disturbance. And BPH itself, or treatments for BPH, may affect sexual function. In addition, with increased detection of localized prostate cancer, surgical treatments and radiation therapy have also increased, and the treatments may cause sexual dysfunction. Aging is also an important factor in the deterioration of the quality of life of men. Deterioration of quality of life caused by prostate diseases may be affected not only by the prostate diseases themselves but also by the sexual dysfunction caused by the prostate diseases secondarily. Thus, consideration of these points at the time of treatment of prostate disease is required. Therapies suitable to each condition should be selected with an understanding of the close association of prostate diseases and associated sexual dysfunction with the quality of life of males.

  14. Anatomy of pelvic floor dysfunction.

    Science.gov (United States)

    Corton, Marlene M

    2009-09-01

    Normal physiologic function of the pelvic organs depends on the anatomic integrity and proper interaction among the pelvic structures, the pelvic floor support components, and the nervous system. Pelvic floor dysfunction includes urinary and anal incontinence; pelvic organ prolapse; and sexual, voiding, and defecatory dysfunction. Understanding the anatomy and proper interaction among the support components is essential to diagnose and treat pelvic floor dysfunction. The primary aim of this article is to provide an updated review of pelvic support anatomy with clinical correlations. In addition, surgical spaces of interest to the gynecologic surgeon and the course of the pelvic ureter are described. Several concepts reviewed in this article are derived and modified from a previous review of pelvic support anatomy.

  15. Mitochondrial Dysfunction in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    P. C. Keane

    2011-01-01

    Full Text Available Parkinson's disease (PD is a progressive, neurodegenerative condition that has increasingly been linked with mitochondrial dysfunction and inhibition of the electron transport chain. This inhibition leads to the generation of reactive oxygen species and depletion of cellular energy levels, which can consequently cause cellular damage and death mediated by oxidative stress and excitotoxicity. A number of genes that have been shown to have links with inherited forms of PD encode mitochondrial proteins or proteins implicated in mitochondrial dysfunction, supporting the central involvement of mitochondria in PD. This involvement is corroborated by reports that environmental toxins that inhibit the mitochondrial respiratory chain have been shown to be associated with PD. This paper aims to illustrate the considerable body of evidence linking mitochondrial dysfunction with neuronal cell death in the substantia nigra pars compacta (SNpc of PD patients and to highlight the important need for further research in this area.

  16. Sexual dysfunctions in psoriatic patients

    Directory of Open Access Journals (Sweden)

    Maria Isabela Sarbu

    2015-04-01

    Full Text Available Psoriasis is a chronic, immune-mediated disorder with a worldwide occurrence characterized by well-defined infiltrated erythematous papules and plaques, covered by silvery white or yellowish scales. It is a physically, socially and emotionally invalidating disorder that affects 1-2% of the population. Sexual health is an important part of general health and sexual dysfunctions can negatively affect self-esteem, confidence, interpersonal relationships and the quality of life. Dermatology Life Quality Index (DLQI, Psoriasis Disability Index (PDI and the Impact of Psoriasis on Quality of Life (IPSO questionnaire are all questionnaires used to assess the quality of life of patients with psoriasis and each has one question regarding sexual dysfunction. Several scales were also designed to particularly assess sexual satisfaction in men and women. The aim of this paper is to perform an overview of the existing studies on sexual dysfunction in psoriatic patients.

  17. Respiratory diseases and muscle dysfunction.

    Science.gov (United States)

    Gea, Joaquim; Casadevall, Carme; Pascual, Sergi; Orozco-Levi, Mauricio; Barreiro, Esther

    2012-02-01

    Many respiratory diseases lead to impaired function of skeletal muscles, influencing quality of life and patient survival. Dysfunction of both respiratory and limb muscles in chronic obstructive pulmonary disease has been studied in depth, and seems to be caused by the complex interaction of general (inflammation, impaired gas exchange, malnutrition, comorbidity, drugs) and local factors (changes in respiratory mechanics and muscle activity, and molecular events). Some of these factors are also present in cystic fibrosis and asthma. In obstructive sleep apnea syndrome, repeated exposure to hypoxia and the absence of reparative rest are believed to be the main causes of muscle dysfunction. Deconditioning appears to be crucial for the functional impairment observed in scoliosis. Finally, cachexia seems to be the main mechanism of muscle dysfunction in advanced lung cancer. A multidimensional therapeutic approach is recommended, including pulmonary rehabilitation, an adequate level of physical activity, ventilatory support and nutritional interventions.

  18. Erectile dysfunction among diabetic patients in Saudi Arabia: A hospital-based primary care study

    Directory of Open Access Journals (Sweden)

    Yousef A Al-Turki

    2007-01-01

    Conclusions: Complete (severe and partial erectile dysfunction was quite common among adult diabetic patients in a hospital-based primary care setting in Saudi Arabia. It is important for primary care physicians to diagnose erectile dysfunction in diabetic patients, and to counsel them early, as most patients are hesitant to discuss their concern during a consultation. Further studies are recommended to evaluate the effect of other risk factors on erectile dysfunction in diabetic patients.

  19. GASTROINTESTINAL MANIFESTATIONS OF MITOCHONDRIAL DYSFUNCTION

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    A. A. Ziganshina

    2016-01-01

    Full Text Available Objective: to highlight the current concepts of gastrointestinal manifestations of mitochondrial dysfunction. The data available in Russian and foreign literature on the gastrointestinal manifestations of mitochondrial dysfunction were analyzed. Functional digestive diseases are common in pediatric practice; however, their etiopathogenesis has not been adequately explored today. According to the literature, impaired cellular energy metabolism may underlie gastrointestinal motility disorders in cyclic vomiting syndrome, gastroesophageal reflux, gastric stasis, chronic diarrhea, constipation, intestinal pseudoobstruction, malabsorption syndrome, irritable bowel syndrome, as well as diseases of the liver and pancreas.

  20. Lysosomal dysfunction in neurodegenerative diseases

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    Klaudia Tomala

    2017-05-01

    Full Text Available Recent data advocate for the implication of lysosomes in the development of programmed cell death. Lysosomal dysfunction decreased the efficiency of autophagosome/lysosome fusion that leads to vacuolation of cells. Autophagic vacuoles containing damaged organelles and altered proteins are hallmarks in most neurodegenerative disorders. These aggregates consequently disrupt cellular homeostasis causing neuronal cell death due apoptosis or necrosis. Moreover calpain mediated or mutation inducted lysosomal rupture result in release of lysosomal cathepsins into the cytoplasm and inducing neuronal cell death. In this review we emphasize the pathophysiological mechanism connecting disrupting autophagy – lysosomal pathway and lysosomal dysfunction in neuronal cell death called lysosomal cell death.

  1. Exercício resistido na avaliação da disfunção endotelial na insuficiência cardíaca Resistive exercise in the evaluation of endothelial dysfunction in heart failure

    Directory of Open Access Journals (Sweden)

    Ricardo Tavares de Carvalho

    2006-06-01

    Full Text Available OBJETIVO: Avaliar o uso de exercício físico resistido no estudo da disfunção endotelial na insuficiência cardíaca comparativamente à hiperemia reativa (HR. MÉTODOS: Dezoito portadores de insuficiência cardíaca (IC e 15 voluntários realizaram esforço físico manual de preensão intermitente em bolsa pneumática com intensidade correspondente a 75% da carga máxima previamente avaliada. Foram avaliados por ultra-sonografia vascular de alta resolução para análise dos diâmetros da artéria braquial e fluxos bem como determinação do débito cardíaco em repouso, após HR e após exercício. Foram calculados o índice de fluxo sistólico na artéria braquial e o índice cardíaco. RESULTADOS: Houve aumento do índice de fluxo sistólico na artéria braquial nas condições HR e exercício físico sendo maior nessa última. Houve aumento do índice cardíaco nas condições de estudo comparativamente ao repouso. CONCLUSÃO: O exercício físico resistido, na carga avaliada, aumenta o fluxo sanguíneo local de forma mais intensa que a HR, constituindo-se numa opção fisiológica à avaliação da disfunção endotelial na IC .OBJECTIVE: To evaluate the use of resistive exercise in the study of endothelial dysfunction in heart failure (HF comparatively to reactive hyperemia (RH. METHODS: Eighteen patients with heart failure and 15 normal volunteers were submitted to intermittent handgrip exercise in a pneumatic bag, at an intensity that corresponds to 75% of the previously assessed maximum load. Patients underwent high-resolution vascular ultrasonography for brachial artery diameter and flow evaluation as well as cardiac output determination at rest, RH and after exercise. The systolic flow index in the brachial artery and cardiac index were calculated. RESULTS: Systolic flow index increase in the brachial artery was observed after RH and physical exercise, with the latter presenting the highest increase. There was an increase in the

  2. Pure Obstructive Sleep Apnea Syndrome and Erectile Dysfunction

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    Cenk Gürbüz

    2011-11-01

    Full Text Available Objective: The aim of this study is to investigate the existence of erectile dysfunction in patients with obstructive sleep apnea syndrome (OSAS in which the other possible causes of erectile dysfunction were eliminated.Material and Methods: The study group consisted of 24 patients diagnosed as OSAS with polysomnographic evaluation, and 15 non-apneic controls (mean age; 41.0±8.8 and 42.3±7.9 year respectively whose comorbidities which might be associated with erectile dysfunction were excluded. Daytime sleepiness was evaluated by Epworth Sleepiness Scale (ESS and measurement of erectile function was performed by International Index of Erectile Function.Results: The rate of erectile dysfunction in OSAS and control groups were 54.2% and 33.3% respectively (p=0.204. The difference between mean erectile function scores of patient and control groups was non-significant (26.1±4.5 and 26.3±4.3 respectively, p=0.900. There was no correlation between erectile function scores and apnea hypnoea index (r=-0.140; p=0.395.Conclusion: Findings obtained from this study suggest that the high incidence of erectile dysfunction reported in OSAS patients seems to be related with concomitant comorbidities such as diabetes, atherosclerosis and neuroendocrine disorders rather than sleep apnea.

  3. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, J.E.; Brennan, M.T.; Verdonck- de Leeuw, I.M.; Gibson, R.J.; Eilers, J.G.; Waltimo, T.; Bots, C.P.; Michelet, M.; Sollecito, T.P.; Rouleau, T.S.; Sewnaik, A.; Bensadoun, R.J.; Fliedner, M.C.; Silverman, S.; Spijkervet, F.K.L.

    2012-01-01

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  4. Markers of primary graft dysfunction

    DEFF Research Database (Denmark)

    2012-01-01

    The present invention relates to methods for diagnosing transplant rejection, or a condition associated with transplant rejection, such as, primary graft dysfunction in a subject, to antigen probe arrays for performing such a diagnosis, and to antigen probe sets for generating such arrays....

  5. Photobiomodulation on alcohol induced dysfunction

    Science.gov (United States)

    Yang, Zheng-Ping; Liu, Timon C.; Zhang, Yan; Wang, Yan-Fang

    2007-05-01

    Alcohol, which is ubiquitous today, is a major health concern. Its use was already relatively high among the youngest respondents, peaked among young adults, and declined in older age groups. Alcohol is causally related to more than 60 different medical conditions. Overall, 4% of the global burden of disease is attributable to alcohol, which accounts for about as much death and disability globally as tobacco and hypertension. Alcohol also promotes the generation of reactive oxygen species (ROS) and/or interferes with the body's normal defense mechanisms against these compounds through numerous processes, particularly in the liver. Photobiomodulation (PBM) is a cell-specific effect of low intensity monochromatic light or low intensity laser irradiation (LIL) on biological systems. The cellular effects of both alcohol and LIL are ligand-independent so that PBM might rehabilitate alcohol induced dysfunction. The PBM on alcohol induced human neutrophil dysfunction and rat chronic atrophic gastritis, the laser acupuncture on alcohol addiction, and intravascular PBM on alcoholic coma of patients and rats have been observed. The endonasal PBM (EPBM) mediated by Yangming channel, autonomic nervous systems and blood cells is suggested to treat alcohol induced dysfunction in terms of EPBM phenomena, the mechanism of alcohol induced dysfunction and our biological information model of PBM. In our opinion, the therapeutic effects of PBM might also be achieved on alcoholic myopathy.

  6. Current Concepts in Ejaculatory Dysfunction

    Science.gov (United States)

    Wolters, Jeffrey P; Hellstrom, Wayne J. G

    2006-01-01

    Although erectile dysfunction has recently become the most well-known aspect of male sexual dysfunction, the most prevalent male sexual disorders are ejaculatory dysfunctions. Ejaculatory disorders are divided into 4 categories: premature ejaculation (PE), delayed ejaculation, retrograde ejaculation, and anejaculation/anorgasmia. Pharmacologic treatment for certain ejaculatory disorders exists, for example the off-label use of selective serotonin reuptake inhibitors for PE. Unfortunately, the other ejaculatory disorders are less studied and not as well understood. This review revisits the physiology of the normal ejaculatory response, specifically explores the mechanisms of anejaculation, and presents emerging data. The neurophysiology of the ejaculatory reflex is complex, making classification of the role of individual neurotransmitters extremely difficult. However, recent research has elucidated more about the role of serotonin and dopamine at the central level in the physiology of both arousal and orgasm. Other recent studies that look at differing pharmacokinetic profiles and binding affinities of the α1-antagonists serve as an indication of the centrally mediated role of ejaculation and orgasm. As our understanding of the interaction between central and peripheral modulations and regulation of the process of ejaculation increases, the probability of developing centrally acting pharmaceutical agents for the treatment of sexual dysfunction approaches reality. PMID:17215997

  7. Sweating dysfunction in Parkinson's disease

    NARCIS (Netherlands)

    Swinn, L; Schrag, A; Viswanathan, R; Lees, A; Quinn, N; Bloem, Bastiaan R.

    2003-01-01

    We sought to determine the prevalence and nature of sweating disturbances in patients with Parkinson's disease (PD), and investigated their correlation with other clinical features and with Quality of Life (QoL) measures. A questionnaire on symptoms and consequences of sweating dysfunction was

  8. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, Judith E.; Brennan, Mike T.; Leeuw, Irma M. Verdonck-de; Gibson, Rachel J.; Eilers, June G.; Waltimo, Tuomas; Bots, Casper P.; Michelet, Marisol; Sollecito, Thomas P.; Rouleau, Tanya S.; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C.; Silverman, Sol; Spijkervet, Fred K. L.

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  9. Endocrine dysfunction in patients of leprosy

    Directory of Open Access Journals (Sweden)

    Rohit Kumar Singh

    2015-01-01

    Full Text Available Background: Leprosy is a chronic granulomatous disease and affects many internal organs in addition to the skin and peripheral nerves. Endocrine dysfunction is often silent and is often missed in patients of leprosy leading to significant morbidity. We studied the presence of occult endocrine disorders in leprosy patients and compared the same with disease parameters. Materials and Methods: We evaluated 40 patients of leprosy (aged 18-70 years, any duration in this cross-sectional, observational study. All subjects were assessed for pituitary, thyroid, adrenal, gonadal function, and dynamic testing was done when deemed necessary. The participants were divided into two groups: Group 1 (Leprosy, n = 40 and Group 2 (Controls, n = 20 and the data were analyzed with appropriate statistical tests. Results: The study participants (35 males, 5 females had a mean age of 36.4 ± 11.3 years, and duration of the disease was 2.5 ± 5.5 years. Eleven out of 40 patients showed results consistent with an endocrine disorder, including subclinical hypothyroidism (n = 4, sick euthyroid syndrome (n = 3, growth hormone (GH deficiency (n = 2, primary hypogonadism (n = 2 and secondary hypogonadism in one patient. One patient had partial hypopituitarism (GH deficiency and secondary hypogonadism and none of the controls showed any hormonal dysfunction. Testosterone levels showed inverse correlation with the number of skin patches (P = 0.0006. Conclusion: Occult endocrine dysfunction is seen in a quarter of patients with leprosy. Thyroid and gonadal axes abnormalities are common, and the severity is more in lepromatous forms of the disease. Further large studies are required to confirm the findings observed in our study.

  10. Erectile Dysfunction in Individuals with Neurologic Disability: A Hospital-based Cross-sectional Study

    OpenAIRE

    Salvatore Calabrò, Rocco; Gervasi, Giuseppe; Naro, Antonino; De Luca, Rosaria; Marullo, Michelangelo; Bramanti, Placido

    2016-01-01

    Objective: Neurogenic erectile dysfunction can be broadly defined as an inability to sustain or maintain a penile erection due to neurologic impairment. Sexual problems can occur due to any lesion affecting the central and peripheral nervous system. The aim of this study was to evaluate the prevalence and causes of erectile dysfunction in a group of hospital inpatients suffering from neurologic disorders.

  11. Erectile dysfunction and pcsychoemotional state in ischemic heart disease patients undergone coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Ye. V. Pomeshkin

    2012-01-01

    Full Text Available The impact of erectile dysfunction on psychoemotional state of patients undergone coronary artery bypass graft surgery was evaluated. The International Index of Erectile Function, postcompression cavernous artery dilation test, nocturnal penile tumescence recording and psychophysiological exam were used. It was found that ischemic heart disease patients have higher incidence of associated psychoemotional and erectile dysfunctions.

  12. Eye Movements as Indicators of Vestibular Dysfunction.

    Science.gov (United States)

    Menshikova, Galina Ya; Kovalev, Artem I; Klimova, Oxana A; Chernorizov, Alexander M

    2015-01-01

    Virtual reality technologies are in wide use in sport psychology. An advantage of this kind of technology is the possibility to assess sportspeople's readiness to perform complex movements. This study is aimed at developing a method for the evaluation of vestibular function disturbances in young skaters. Such disturbances may occur while skaters are performing rotation movements. To achieve this goal, we induced a vection illusion, accompanied by virtual environment rotation in a CAVE virtual reality system. Vestibular disturbances were tested for two groups-professional skaters and people who had very little or no skating experience. The quantitative evaluation of vestibular dysfunction was based on eye movement characteristics, which were recorded in subjects experiencing a vection illusion. © The Author(s) 2015.

  13. Improvement effect of green tea on hepatic dysfunction, lipid ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-09-01

    Sep 1, 2009 ... effects against cancers. The present study was designed to assess the pro- tective effect of green tea infusion by evaluating the free radicals scavenging capacity using the DPPH and NBT / riboflavin in vitro. In vivo, the liver dysfunction paramet- ers rate, lipid peroxidation, and antioxidant enzymes acti-.

  14. Transient left atrial dysfunction is a feature of Takotsubo syndrome

    DEFF Research Database (Denmark)

    Stiermaier, Thomas; Graf, Tobias; Möller, Christian

    2017-01-01

    BACKGROUND: Takotsubo syndrome (TTS) is characterized by a transient left and/or right ventricular dysfunction as a consequence of a distinctive pattern of regional wall motion abnormalities. However, a systematic evaluation of the left atrial (LA) function in patients with TTS is lacking. The ai...

  15. Obstructive sleep apnea syndrome and erectile dysfunction: does ...

    African Journals Online (AJOL)

    Objectives: The aim of this age-matched, controlled, prospective clinical study was to investigate frequency and degree of erectile dysfunction (ED) in patients with obstructive sleep apnea syndrome (OSAS) and to evaluate the results of only continuous positive airway pressure (CPAP) therapy on ED in patients with OSAS.

  16. A review of the interrelationship between vestibular dysfunction ...

    African Journals Online (AJOL)

    problems and dyslexia were also associated with dysfunction of the vestibular system. Different tests evaluating vestibular loss were identified of which some can be used successfully by practitionars. Various programmes and activities were identified to successfully rehabilitate vestibular function. For better understanding ...

  17. Heart Rate Variability in Male Sexual Arousal and Erectile Dysfunction

    Science.gov (United States)

    2007-01-22

    psychiatric disorders (First, Spitzer, Gibbon, & Williams, 1994). Current contact with a psychotherapist for behavioral and/or emotional disturbance...Psychologic factors in the multidisciplinary evaluation and treatment of erectile dysfunction. Urol Clin North Am, 15(1), 41-51. Stein, P. K

  18. Long-term smoking results in haemostatic dysfunction in chronic ...

    African Journals Online (AJOL)

    Background: Smoking has been known to cause endothelial dysfunction and bronchial carcinoma and duration of smoking has been implicated in the effects of smoking on regular smokers. This study evaluated the effects of long-term smoking on some coagulation markers in chronic smokers. Materials and Methods: A ...

  19. Correlation between prevalence of erectile dysfunction and length of ...

    African Journals Online (AJOL)

    Even stationary bikes can cause trauma to the blood supply to the penis, resulting in erectile dysfunction (22). Objective: To evaluate the effects of long hours of bicycle riding/week on erectile function among bicycle taxi (boda boda) riders in Bungoma town. Design: A Cross-sectional survey. Setting: Bungoma town, part of ...

  20. Preorchiectomy Leydig Cell Dysfunction in Patients With Testicular Cancer

    DEFF Research Database (Denmark)

    Bandak, Mikkel; Jørgensen, Niels; Juul, Anders

    2017-01-01

    AND METHODS: We evaluated luteinizing hormone (LH), total testosterone (TT), calculated free T (cFT), estradiol, and sex hormone-binding globulin (SHBG) preorchiectomy in 561 patients with TGCC and compared with 561 healthy controls. We calculated TT/LH and cFT/LH ratios and constructed bivariate charts of TT...... before orchiectomy. Contralateral GCNIS, increasing age, and increasing tumor size are associated with Leydig cell dysfunction. We hypothesize that patients with preexisting Leydig cell dysfunction are at increased risk of testosterone deficiency following treatment....

  1. Mechanistic link between erectile dysfunction and systemic endothelial dysfunction in type 2 diabetic rats.

    Science.gov (United States)

    Musicki, B; Hannan, J L; Lagoda, G; Bivalacqua, T J; Burnett, A L

    2016-09-01

    Men with type 2 diabetes mellitus (T2DM) and erectile dysfunction (ED) have greater risk of cardiovascular events than T2DM men without ED, suggesting ED as a predictor of cardiovascular events in diabetic men. However, molecular mechanisms underlying endothelial dysfunction in the diabetic penis explaining these clinical observations are not known. We evaluated whether the temporal relationship between ED and endothelial dysfunction in the systemic vasculature in T2DM involves earlier redox imbalance and endothelial nitric oxidase synthase (eNOS) dysfunction in the penis than in the systemic vasculature, such as the carotid artery. Rats were rendered T2DM by high-fat diet for 2 weeks, followed by an injection with low-dose streptozotocin. After 3 weeks, erectile function (intracavernosal pressure) was measured and penes and carotid arteries were collected for molecular analyses of eNOS uncoupling, protein S-glutathionylation, oxidative stress (4-hydroxy-2-nonenal, 4-HNE), protein expression of NADPH oxidase subunit gp91(phox) , endothelium-dependent vasodilation in the carotid artery, and non-adrenergic, non-cholinergic (NANC)-mediated cavernosal relaxation. Erectile response to electrical stimulation of the cavernous nerve and NANC-mediated cavernosal relaxation was decreased (p penis, but not in the carotid artery, of T2DM compared to non-diabetic rats. In conclusion, redox imbalance, increased oxidative stress by NADPH oxidase, and eNOS uncoupling, occur early in T2DM in the penis, but not in the carotid artery. These molecular changes contribute to T2DM ED, while vascular function in the systemic vasculature remains preserved. © 2016 American Society of Andrology and European Academy of Andrology.

  2. Masticatory function in temporomandibular dysfunction patients: electromyographic evaluation Função mastigatória em pacientes com disfunção temporomandibular: avaliação eletromiográfica

    Directory of Open Access Journals (Sweden)

    Giédre Berretin-Felix

    2005-12-01

    Full Text Available Temporomandibular dysfunction (TMD is a complex disturbance that involves the masticatory muscles and/or temporomandibular joint, causing damage to the masticatory function. This study evaluated the electromyographic activity of the masseter muscle during habitual mastication of bread, apple, banana, cashew nut and paraffin film (Parafilm M in 25 adult subjects, of both gender, with TMD. The results were compared to those of a control group, composed of 15 adult subjects, of both sexes, free of signs and/or symptoms of TMD. The MYO-TRONICS Inc., K6-I computer software was used for electromyographic processing and analyzed the following parameters: duration of the act, duration of the masticatory cycle and number of cycles. No significant differences were found between subjects in the control group and individuals with TMD as to duration of the masticatory act and of the masticatory cycle, considering all materials used for mastication. The duration of the masticatory act and cycle was longer during mastication of paraffin film in both groups. The number of masticatory cycles was higher for mastication of apple in comparison to mastication of banana, in both groups. It can be concluded that the consistency of foods influences the duration parameters of the act, duration of the cycle and the number of masticatory cycles, and the behavior of the masticatory muscles in individuals with TMD during habitual mastication is similar to that verified in individuals without TMD.A disfunção temporomandibular (DTM representa um quadro complexo que envolve os músculos mastigatórios e/ou a articulação temporomandibular, causando prejuízos à função mastigatória. Este estudo avaliou a atividade eletromiográfica do músculo masseter durante a mastigação habitual de pão, maçã, banana, castanha de caju e folha de parafilme (Parafilm M em 25 indivíduos adultos, de ambos os gêneros, com DTM. Os resultados foram comparados com os obtidos para o

  3. Recognizing and treating pelvic pain and pelvic floor dysfunction.

    Science.gov (United States)

    Prather, Heidi; Spitznagle, Theresa Monaco; Dugan, Sheila A

    2007-08-01

    The reported prevalence rates of pain within the pelvis range from 3.8% to 24% in women aged 15 to 73 years. Despite the significant number of women affected, pelvic floor pain and dysfunction are commonly overlooked in women seeking medical care. Physiatrists are uniquely qualified to manage these patients because of their knowledge of the musculoskeletal and nervous systems and their awareness of the relationships among pain, physiology, and function. When evaluating women who have pelvic pain, practitioners must ask questions about history of urinary or fecal incontinence, dyspareunia, or pelvic pain with certain activities or associated with menses, surgery, or trauma. If left unidentified, pelvic floor dysfunction can deter individuals from normal bowel and bladder function, intimacy, and even engagement in work and social functions. This article introduces pelvic floor anatomy, neurophysiology, and function and provides an overview of pelvic pain and pelvic floor dysfunctions and their recognition and treatment.

  4. Cardiovascular drugs and erectile dysfunction - a symmetry analysis

    DEFF Research Database (Denmark)

    Rasmussen, Lotte; Hallas, Jesper; Madsen, Kenneth Grønkjaer

    2015-01-01

    AIM: Erectile dysfunction is a common problem among patients with cardiovascular diseases and the influence of cardiovascular drugs is much debated. The aim of this study was to evaluate the short term potential for different cardiovascular drugs to affect the risk of being prescribed a drug...... against erectile dysfunction. METHODS: We employed a symmetry analysis design and included all Danish male individuals born before 1950 who filled their first ever prescription for a cardiovascular drug and a 5-phosphodiesterase inhibitor within a 6 month interval during 2002-2012. If the cardiovascular...... drug induces erectile dysfunction, this would manifest as a non-symmetrical distribution of subjects being prescribed the cardiovascular drug first vs. persons following the opposite pattern. Furthermore, we calculated the number of patients needed to treat for one additional patient to be treated...

  5. Effects of liraglutide on ovarian dysfunction in polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Nylander, Malin; Frøssing, Signe; Clausen, Helle V.

    2017-01-01

    -blind, randomized trial, 72 women with PCOS were allocated to intervention with the GLP-1 analogue liraglutide or placebo (1.8 mg/day), in a 2:1 ratio. At baseline and 26-week follow-up, bleeding pattern, levels of AMH, sex hormones and gonadotrophins were assessed and ovarian morphology evaluated. Liraglutide......Polycystic ovary syndrome (PCOS) encompasses an ovarian and a metabolic dysfunction. Glucagon-like peptide-1 (GLP-1) analogues facilitate weight loss and ameliorate metabolic dysfunction in overweight women with PCOS, but their effect on ovarian dysfunction is scarcely reported. In a double...... caused 5.2 kg (95% CI 3.0 to 7.5, P Bleeding ratio improved with liraglutide: 0.28 (95% CI 0.20 to 0.36, P

  6. Clinical Manifestations and Myositis-Specific Autoantibodies Associated with Physical Dysfunction after Treatment in Polymyositis and Dermatomyositis: An Observational Study of Physical Dysfunction with Myositis in Japan

    Directory of Open Access Journals (Sweden)

    Hidenaga Kawasumi

    2016-01-01

    Full Text Available Objective. The physical function of PM/DM patients after remission induction therapy remains unknown adequately. The aim of our study was to evaluate the present status of physical dysfunction and to clarify the clinical manifestations and myositis-specific autoantibodies (MSAs associated with physical dysfunction after treatment in PM/DM. Methods. We obtained clinical data including the age at disease onset, gender, disease duration, laboratory data prior to initial treatment, and the specific treatment administered. We evaluated disease activity and physical dysfunction after treatment using the core set provided by the International Myositis Assessment and Clinical Studies Group. Results. 57% of the 77 enrolled patients with PM/DM had troubles in daily living after treatment. At the enrolment, disease activity evaluated by physicians was only revealed in 20% of patients. In a multivariate analysis, the age at disease onset, female gender, and CK levels before treatment were significantly associated with the severity of physical dysfunction after treatment. Anti-SRP positivity was associated with more severe physical dysfunction after treatment than anti-ARS or anti-MDA5. Conclusions. Half of the PM/DM patients showed physical dysfunction after treatment. Age at disease onset, gender, CK level before treatment, and anti-SRP were significant predictors associated with physical dysfunction after treatment in PM/DM.

  7. Endothelial dysfunction in idiopathic sudden sensorineural hearing loss: a review

    Directory of Open Access Journals (Sweden)

    Nicola Quaranta

    2016-07-01

    Full Text Available An endothelial dysfunction has been described in idiopathic sudden sensorineural hearing loss (ISSHL patients. The purpose of our review was to: i identify, evaluate and review recent research about cardiovascular risk factors involvement and signs of endothelial dysfunction in ISSHL; ii implication of these discovering in clinical practice and future research. A Medline literature search was conducted to identify any study on the involvement of endothelial dysfunction in ISSHL, published in the English language in the last decade. The following MEDLINE search terms were used: sudden sensorineural hearing loss (SSHL and endothelial dysfunction (text words. Additional studies were identified by hand searching the references of original articles and review articles. Studies were not excluded on the basis of the qualitative or quantitative definitions of SSHL, treatment regimens, or outcome measures. Data were extracted from included papers by a reviewer. Information on the patients, investigations, methods, interventions, and outcomes were systematically analyzed. Characteristics and results of all included studies were reviewed systematically. High levels of adhesion molecules, hyperhomocysteinemia and lower folate levels, unbalanced oxidative status, a lower value of flow-mediated dilatation of brachial artery and a reduced percentage of circulating endothelial progenitor cells in patients affected by ISSHL support the hypothesis that this syndrome should be considered as a microcirculation disorder based on endothelial dysfunction and drive clinicians to implement all the traditional strategies used for preventing cardiovascular events, to also reduce the likelihood of ISSHL occurrence.

  8. Incontinence and Erectile Dysfunction Following Radical Prostatectomy: A Review

    Directory of Open Access Journals (Sweden)

    Gerasimos Alivizatos

    2005-01-01

    Full Text Available Radical prostatectomy remains the treatment of choice for localized prostate cancer in age-appropriate and health-appropriate men. Although cancer control is the most important aspect of a radical prostatectomy, minimization of postoperative morbidity, especially urinary incontinence and erectile dysfunction, is becoming a greater concern. We reviewed recent data available on Medline regarding the incidence, pathophysiology, evaluation, and treatment of incontinence and sexual dysfunction after radical prostatectomy. Health-related quality of life issues have been specifically addressed. Although low incidences of incontinence and erectile dysfunction after radical prostatectomy have been reported in the hands of experienced surgeons, the literature review revealed a great variety, with incontinence rates ranging from 0.3–65.6% and potency rates ranging from 11–87%. Several factors contribute to this wide difference, the most important being the application of a meticulous surgical technique. General and cancer-specific health-related quality of life is not being affected after radical prostatectomy. The incidence of incontinence and erectile dysfunction is higher after radical prostatectomy when compared to the incidence observed when other therapies for localized prostate cancer are applied. However, the majority of the patients undergoing radical prostatectomy would vote for the operation again. Today, avoidance of major complications after radical prostatectomy depends mostly on a high-quality surgical technique. When incontinence or erectile dysfunction persists after radical prostatectomy, the majority of the treated patients can be managed effectively by various methods.

  9. Endothelial Dysfunction in Idiopathic Sudden Sensorineural Hearing Loss: A Review.

    Science.gov (United States)

    Quaranta, Nicola; De Ceglie, Vincenzo; D'Elia, Alessandra

    2016-04-20

    An endothelial dysfunction has been described in idiopathic sudden sensorineural hearing loss (ISSHL) patients. The purpose of our review was to: i) identify, evaluate and review recent research about cardiovascular risk factors involvement and signs of endothelial dysfunction in ISSHL; ii) implication of these discovering in clinical practice and future research. A Medline literature search was conducted to identify any study on the involvement of endothelial dysfunction in ISSHL, published in the English language in the last decade. The following MEDLINE search terms were used: sudden sensorineural hearing loss (SSHL) and endothelial dysfunction (text words). Additional studies were identified by hand searching the references of original articles and review articles. Studies were not excluded on the basis of the qualitative or quantitative definitions of SSHL, treatment regimens, or outcome measures. Data were extracted from included papers by a reviewer. Information on the patients, investigations, methods, interventions, and outcomes were systematically analyzed. Characteristics and results of all included studies were reviewed systematically. High levels of adhesion molecules, hyperhomocysteinemia and lower folate levels, unbalanced oxidative status, a lower value of flow-mediated dilatation of brachial artery and a reduced percentage of circulating endothelial progenitor cells in patients affected by ISSHL support the hypothesis that this syndrome should be considered as a microcirculation disorder based on endothelial dysfunction and drive clinicians to implement all the traditional strategies used for preventing cardiovascular events, to also reduce the likelihood of ISSHL occurrence.

  10. The CNS and bladder dysfunction

    Science.gov (United States)

    Holstege, Gert; Griffiths, Derek J.

    2012-01-01

    The brain's role in the development and maintenance of bladder control is critical, although its precise role in patient-reported complaints such as urgency and urine leakage is unknown. Functional brain imaging studies have advanced our knowledge of brain activity during the micturition cycle, showing multiple neuronal circuits involved as parts of a ‘brain-bladder control network.’ Yet, new advances need to be made in order to incorporate this knowledge into existing models of neuroanatomy and of clinical syndromes of bladder dysfunction and related clinical practice. This short article explains why and how brain imaging methods are poised to achieve that goal and decode the role of the brain in widely prevalent clinical conditions related to bladder dysfunction. PMID:23091564

  11. COGNITIVE DYSFUNCTIONS IN DIABETIC POLYNEUROPATHY

    Directory of Open Access Journals (Sweden)

    Mirena Valkova

    2011-12-01

    Full Text Available Introduction: The objective of our study was to examine cognitive status, short – term memory, delayed recall and the retention of visual information in diabetics with polyneuropathy and to establish the impacts of some risk factors on cognitive performance.Contingent and methods: We assessed 47 diabetic patients with polyneuropathy, using the Mini Mental State Examination, 10 words test, the Benton visual retention test and the Hamilton scale.Results: Global cognitive dysfunction, decline in verbal memory and visual retention and tendency for depressive mood were observed. We found statistically significant interaction of ageing, sex, severity of pain, duration and late onset of diabetes mellitus (DM on cognitive functioning. Therapy association on cognition was not found.Conclusions: Our study confirms the hypothesis of global cognitive dysfunction, associated with diabetic polyneuropathy. The interactions of sex and pain severity require further study. We arise a hypothesis of asymmetrical brain injury in diabetics.

  12. Microvascular Dysfunction and Cognitive Impairment

    Science.gov (United States)

    De Silva, T. Michael; Faraci, Frank M.

    2016-01-01

    The impact of vascular risk factors on cognitive function has garnered much interest in recent years. The appropriate distribution of oxygen, glucose and other nutrients by the cerebral vasculature is critical for proper cognitive performance. The cerebral microvasculature is a key site of vascular resistance and a preferential target for small vessel disease. While deleterious effects of vascular risk factors on microvascular function are known, the contribution of this dysfunction to cognitive deficits is less clear. In this review, we summarize current evidence for microvascular dysfunction in brain. We highlight effects of select vascular risk factors (hypertension, diabetes and hyperhomocysteinemia) on the pial and parenchymal circulation. Lastly, we discuss potential links between microvascular disease and cognitive function, highlighting current gaps in our understanding. PMID:26988697

  13. Oral health and erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Vijendra P Singh

    2017-01-01

    Full Text Available Ample evidence strongly supports the fact that periodontal disease is a major risk factor for various systemic diseases namely cardio-vascular disease, diabetes mellitus, etc. Recently, investigators focussed on exploring the link between chronic periodontitis (CP and erectile dysfunction (ED by contributing to the endothelial dysfunction. Both the diseases share common risk factors. Various studies conducted in different parts of the world in recent years reported the evidence linking this relationship as well as improvement in ED with periodontal treatment. Systemic exposure to the periodontal pathogen and periodontal infection-induced systemic inflammation was thought to associate with these conditions. The objective of this review was to highlight the evidence of the link between CP and ED and the importance of oral health in preventing the systemic conditions.

  14. Mitochondrial dysfunction and organophosphorus compounds

    Energy Technology Data Exchange (ETDEWEB)

    Karami-Mohajeri, Somayyeh [Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Kerman University of Medical Sciences, Kerman (Iran, Islamic Republic of); Abdollahi, Mohammad, E-mail: Mohammad.Abdollahi@UToronto.Ca [Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of)

    2013-07-01

    Organophosphorous (OPs) pesticides are the most widely used pesticides in the agriculture and home. However, many acute or chronic poisoning reports about OPs have been published in the recent years. Mitochondria as a site of cellular oxygen consumption and energy production can be a target for OPs poisoning as a non-cholinergic mechanism of toxicity of OPs. In the present review, we have reviewed and criticized all the evidences about the mitochondrial dysfunctions as a mechanism of toxicity of OPs. For this purpose, all biochemical, molecular, and morphological data were retrieved from various studies. Some toxicities of OPs are arisen from dysfunction of mitochondrial oxidative phosphorylation through alteration of complexes I, II, III, IV and V activities and disruption of mitochondrial membrane. Reductions of adenosine triphosphate (ATP) synthesis or induction of its hydrolysis can impair the cellular energy. The OPs disrupt cellular and mitochondrial antioxidant defense, reactive oxygen species generation, and calcium uptake and promote oxidative and genotoxic damage triggering cell death via cytochrome C released from mitochondria and consequent activation of caspases. The mitochondrial dysfunction induced by OPs can be restored by use of antioxidants such as vitamin E and C, alpha-tocopherol, electron donors, and through increasing the cytosolic ATP level. However, to elucidate many aspect of mitochondrial toxicity of Ops, further studies should be performed. - Highlights: • As a non-cholinergic mechanism of toxicity, mitochondria is a target for OPs. • OPs affect action of complexes I, II, III, IV and V in the mitochondria. • OPs reduce mitochondrial ATP. • OPs promote oxidative and genotoxic damage via release of cytochrome C from mitochondria. • OP-induced mitochondrial dysfunction can be restored by increasing the cytosolic ATP.

  15. Insulin dysfunction and Tau pathology

    Directory of Open Access Journals (Sweden)

    Noura eEl Khoury

    2014-02-01

    Full Text Available The neuropathological hallmarks of Alzheimer's disease (AD include senile plaques of β-amyloid (Aβ peptides (a cleavage product of the Amyloid Precursor Protein, or APP and neurofibrillary tangles (NFT of hyperphosphorylated Tau protein assembled in paired helical filaments (PHF. NFT pathology is important since it correlates with the degree of cognitive impairment in AD.Only a small proportion of AD is due to genetic variants, whereas the large majority of cases (~99% is late onset and sporadic in origin. The cause of sporadic AD is likely to be multifactorial, with external factors interacting with biological or genetic susceptibilities to accelerate the manifestation of the disease.Insulin dysfunction, manifested by diabetes mellitus (DM might be such factor, as there is extensive data from epidemiological studies suggesting that DM is associated with an increased relative risk for AD. Type 1 diabetes (T1DM and type 2 diabetes (T2DM are known to affect multiple cognitive functions in patients. In this context, understanding the effects of diabetes on Tau pathogenesis is important since tau pathology show a strong relationship to dementia in AD, and to memory loss in normal aging and mild cognitive impairment.Here, we reviewed preclinical studies that link insulin dysfunction to Tau protein pathogenesis, one of the major pathological hallmarks of AD. We found more than 30 studies reporting on Tau phosphorylation in a mouse or rat model of insulin dysfunction. We also payed attention to potential sources of artifacts, such as hypothermia and anesthesia, that were demonstrated to results in Tau hyperphosphorylation and could major confounding experimental factors. We found that very few studies reported the temperature of the animals, and only a handful did not use anesthesia. Overall, most published studies showed that insulin dysfunction can promote Tau hyperphosphorylation and pathology, both directly and indirectly, through hypothermia.

  16. Postprostatectomy Erectile Dysfunction: A Review

    OpenAIRE

    Capogrosso, Paolo; Salonia, Andrea; Briganti, Alberto; Montorsi, Francesco

    2016-01-01

    In the current era of the early diagnosis of prostate cancer (PCa) and the development of minimally invasive surgical techniques, erectile dysfunction (ED) represents an important issue, with up to 68% of patients who undergo radical prostatectomy (RP) complaining of postoperative erectile function (EF) impairment. In this context, it is crucial to comprehensively consider all factors possibly associated with the prevention of post-RP ED throughout the entire clinical management of PCa patien...

  17. Ambulatory anaesthesia and cognitive dysfunction

    DEFF Research Database (Denmark)

    Rasmussen, Lars S; Steinmetz, Jacob

    2015-01-01

    , sleep deprivation, unfamiliar surroundings, and medication errors. Enhanced recovery programmes (fast-track regimens) may allow earlier discharge which is probably beneficial for the elderly. Frailty is becoming an increasingly important concept that needs to be clinically considered in elderly patients...... anaesthesia in the outpatient setting. Cognitive complications such as delirium and postoperative cognitive dysfunction are less frequent in ambulatory surgery than with hospitalization. SUMMARY: The elderly are especially susceptible to adverse effects of the hospital environment such as immobilisation...

  18. Amiodarone-induced thyroid dysfunction.

    Science.gov (United States)

    Danzi, Sara; Klein, Irwin

    2015-05-01

    Amiodarone is an effective medication for the treatment of cardiac arrhythmias. Originally developed for the treatment of angina, it is now the most frequently prescribed antiarrhythmia drug despite the fact that its use is limited because of potential serious side effects including adverse effects on the thyroid gland and thyroid hormones. Although the mechanisms of action of amiodarone on the thyroid gland and thyroid hormone metabolism are poorly understood, the structural similarity of amiodarone to thyroid hormones, including the presence of iodine moieties on the inner benzene ring, may play a role in causing thyroid dysfunction. Amiodarone-induced thyroid dysfunction includes amiodarone-induced thyrotoxicosis (AIT) and amiodarone-induced hypothyroidism (AIH). The AIT develops more commonly in iodine-deficient areas and AIH in iodine-sufficient areas. The AIT type 1 usually occurs in patients with known or previously undiagnosed thyroid dysfunction or goiter. The AIT type 2 usually occurs in normal thyroid glands and results in destruction of thyroid tissue caused by thyroiditis. This is the result of an intrinsic drug effect from the amiodarone itself. Mixed types are not uncommon. Patients with cardiac disease receiving amiodarone treatment should be monitored for signs of thyroid dysfunction, which often manifest as a reappearance of the underlying cardiac disease state. When monitoring patients, initial tests should include the full battery of thyroid function tests, thyroid-stimulating hormone, thyroxine, triiodothyronine, and antithyroid antibodies. Mixed types of AIT can be challenging both to diagnose and treat and therapy differs depending on the type of AIT. Treatment can include thionamides and/or glucocorticoids. The AIH responds favorably to thyroid hormone replacement therapy. Amiodarone is lipophilic and has a long half-life in the body. Therefore, stopping the amiodarone therapy usually has little short-term benefit. © The Author(s) 2013.

  19. Erectile dysfunction and amatorial cycling.

    Science.gov (United States)

    Colpi, Giovanni Maria; Contalbi, Gianfranco; Ciociola, E; Mihalca, Radu

    2008-09-01

    Today cycling is considered a useful form of exercise for reducing cardiovascular risk, but it may also represent a risk factor for erectile dysfunction and perineal-genital paresthesia. These disorders are attributed to the local reduction of oxygen in the perineal-genital area, secondary to the perineal compression. Numerous studies have been carried out measuring the penile oxygen pressure or penile blood flow by echo-colour-Doppler: a reduced inflow of blood and oxygen to the cavernous tissue was demonstrated. The attention of the specialist is therefore concentrated on the compression of the perineum on the bicycle saddle and how to reduce this through the position of the cyclist on the bicycle (i.e. height and tilt of the saddle), the different shapes of saddle available (i.e. noseless, grooved, wide, etc.) and the padding materials of the saddle. In order to reduce perineal compression, the posterior part of the saddle should be as wide as the distance between the two ischiatic tuberosities. In addition, the saddle should be studied on the basis of the biotype of the cyclist: ectomorphic, mesomorphic or endomorphic. However, in the genesis of the erectile dysfunction of the cyclist, apart from the above-mentioned factors, an "individual predisposition to developing erectile dysfunction" linked to the perineal-genital anatomy (i.e. type of insertion of the perineum into the root of the penis, number of layers of the tunica albuginea of the corpus cavernosum) cannot be excluded.

  20. Endovascular therapy for vasculogenic erectile dysfunction.

    Science.gov (United States)

    Rogers, Jason H; Rocha-Singh, Krishna J

    2012-04-01

    Erectile dysfunction (ED) is an important clinical condition that affects a significant proportion of men. Although there are many etiologies for ED, many cases have a vascular basis that is related to inadequate arterial inflow, veno-occlusive dysfunction, or abnormalities in smooth muscle (cavernosal tissue) relaxation. These vascular abnormalities can exist in isolation or combination. Since the advent of phosphodiesterase-5 inhibitor (PDE5i) therapy, the initial management of ED in most cases consists of a brief medical evaluation followed by a trial of PDE5i therapy. However, up to 50% of men have an inadequate response to PDE5i therapy and discontinue therapy. Subsequent therapies for ED are increasingly invasive, including penile injection of vasodilators, vacuum pumps, and penile implants. With increased awareness of ED among clinicians and the growing mechanistic link between ED and atherosclerotic vascular disease, there has been renewed interest in the diagnosis and management of arteriogenic ED. Prior reports in the 1980s described the existence of arterial inflow lesions in patients with ED, and there are a modest number of reports describing the feasibility of revascularization with balloon angioplasty. Despite initial clinical success, enthusiasm for this technique waned, presumably because ED frequently recurred due to restenosis and lack of small vessel endovascular therapies. Recent investigation and the availability of newer tools such as drug-eluting stents have renewed interest in this field. Although conceptually attractive, endovascular therapy for ED presents significant challenges related to unanswered questions such as the prevalence and appropriate diagnostic evaluation of arteriogenic ED, and the safety and feasibility of stent-based therapies in this population. In addition, the evaluation, management, and follow-up of patients with vascular ED require a multi-disciplinary team with specialists in urology, sexual medicine, and vascular

  1. Pelvic Floor Dysfunction in Aging Women

    Directory of Open Access Journals (Sweden)

    Gin-Den Chen

    2007-12-01

    Full Text Available The occurrence of pelvic floor dysfunction may increase steadily during the aging process in women. Pelvic floor dysfunction may be associated with dysfunctions of micturition, defecation, prolapse, and sex. The natural history and mechanism of pelvic floor dysfunction in aged women are not well understood or explored. In this article, we review the effect of age on the prevalence of pelvic floor dysfunction and on the structural and functional changes of the lower urinary tract, anorectum and pelvic floor. Altogether, the aging process has a negative impact on either the function or structure of the lower urinary tract, anorectum and pelvic floor in women.

  2. dysfunction

    African Journals Online (AJOL)

    flow diminishes. Decreased coronary blood flow results in myocardial ischaemia, tissue infarction, mitral insufficiency and dilated ischaemic cardiomyopathy. Approximately 10–15% of ... placed at the level of T12 on the patient's back lateral to the vertebrae to ... cardiopulmonary bypass and achieve haemodynamic stability.

  3. Antipsychotics and Sexual Dysfunction: Sexual Dysfunction - Part III

    Directory of Open Access Journals (Sweden)

    Anil Kumar Mysore Nagaraj

    2009-11-01

    Full Text Available Satisfying sexual experience is an essential part of a healthy and enjoyable life for most people. Antipsychotic drugs are among the various factors that affect optimal sexual functioning. Both conventional and novel antipsychotics are associated with significant sexual side effects. This review has presented various studies comparing different antipsychotic drugs. Dopamine antagonism, increased serum prolactin, serotonergic, adrenergic and cholinergic mechanisms are all proposed to be the mechanisms for sexual dysfunction. Drug treatment for this has not given satisfactory long-term results. Knowledge of the receptor pharmacology of an individual antipsychotic will help to determine whether it is more or less likely to cause sexual side effects and its management.

  4. Relation between sexual dysfunctions and epilepsy, type of epilepsy, type of antiepileptic drugs: a prospective study.

    Science.gov (United States)

    Pavone, Carlo; Giacalone, Ninfa; Vella, Marco; Urso, Lidia; Zummo, Leila; Fierro, Brigida

    2017-04-28

    The aim of this study was to evaluate the incidence of sexual dysfunctions in males with epilepsy, the type of epilepsy, the frequency of seizures, the type of antiepileptic drugs (AEDs), the serum hormonal profile and the presence of psychiatric comorbidity. Sixty-one patients focused on type of epilepsy, frequency of seizures, AEDs, hormonal profile and presence of mood disorders. We excluded all patients with severe neurologic and psychiatric impairment and patient who were not able to fill questionnaires. Mean age was 31.2 years (range 18-50 years); 31 patients (50.8%) had an idiopathic generalised epilepsy and 30 (49.2%) a focal epilepsy; among them, latter 18 (60%) had probably symptomatic type and 12 (40%) symptomatic type. Sexual functions were evaluated by "International Inventory of Erectile Function" questionnaire. Out of 61 enrolled patients, 22 (36.7%) showed sexual dysfunctions: erectile dysfunctions in 14 (23%), orgasmic dysfunctions in (11.5%) and sexual drive dysfunctions in 12 (19.7%). Out of 61 patients, 36 were subjected to blood measurement of sexual hormones and 21 (58.3%) showed hormonal modifications. Sexual dysfunction are present in 36.7% of enrolled males with epilepsy; there is any association between sexual dysfunctions and various AEDs in the treatment, except for carbamazepine (CBZ); there is not any association between sexual dysfunctions and frequency of seizures; hormonal changes are associated with sexual dysfunction in males with epilepsy treated with AEDs but not with the orgasmic dysfunction; there is not any association between hormonal changes and type of AEDs, except for CBZ; depression is associated with sexual dysfunctions.

  5. Practical management: vocal cord dysfunction in athletes.

    Science.gov (United States)

    Wilson, John J; Wilson, Erin M

    2006-07-01

    Vocal cord dysfunction (VCD) is characterized by paradoxical adduction of the vocal folds during inhalation, and occasionally upon exhalation, resulting in extrathoracic airflow obstruction. Sports medicine professionals must have a high index of suspicion for VCD when acute respiratory symptoms occur so that prompt evaluation and use of appropriate specialists results in an accurate and timely diagnosis. Many factors have been implicated in the pathophysiology of VCD, including laryngeal irritants, psychogenic and neurogenic causes. The diagnosis and management of VCD involves a variety of specialties including pulmonology, otolaryngology, speech-language pathology, allergy and immunology, and psychologic management as appropriate. The mainstay of treatment remains behavioral management guided by a medical speech-language pathologist, as well as pharmacologic management for VCD triggers.

  6. Specific aspects of erectile dysfunction in sexology.

    Science.gov (United States)

    Borrás-Valls, J J; Gonzalez-Correales, R

    2004-10-01

    The sexology of erectile dysfunction (ED) is approached from a perspective that integrates medical, psychological, and social aspects. This article reviews the clinical intervention in sexology beginning with the diagnostic evaluation, where the organic and psychological factors (predisposing, precipitating, and perpetuating) contributing to ED are determined. A description of the differential diagnosis process follows, which establishes the relevance of organic factors in order to organize therapeutic strategies. There are three possible treatment processes: psychological intervention with the patient, intervention on the partner relationship, or intervention with the partner. Referral criteria are also described, such as when patients with ED should be referred to a sexologist, and to whom sexologists should refer patients with ED.

  7. Temporomandibular joint dysfunction in Parkinson's Disease: an integrative literature review

    Directory of Open Access Journals (Sweden)

    Taysa Vannoska de Almeida Silva

    Full Text Available ABSTRACT Temporomandibular joint dysfunction is a set of disorders involving the masticatory muscles, temporomandibular joint and associated structures. It is known that the progression of motor symptoms in Parkinson's disease is an indication that these people are more prone to the development of this dysfunction. Thus, this study aims to investigate the signs and symptoms of temporomandibular dysfunction in people with Parkinson's disease. The search was performed in the databases: MEDLINE/ PubMed, LILACs, CINAHL, SCOPUS, Web of Science and PEDro, without timing or language restriction. Specific descriptors were used for each database and keywords, evaluated by the instruments: Critical Appraisal Skill Program and Agency for Health care and Research and Quality. A total of 4,209 articles were found but only 5 were included. After critical analysis of the methodology of the articles, one did not reach the minimum score required by the evaluation instruments, thus, it was excluded. The selected articles addressed, as signs and symptoms of temporomandibular joint dysfunction, the following: myofascial pain, bruxism, limitation of mouth opening, dislocation of the articular disc and asymmetry in the distribution of occlusal contacts. Further studies are needed in order to determine the relationship between cause and effect of the analyzed variables, so as to contribute to more specific and effective therapeutic interventions.

  8. Saccharomyces boulardii CNCM I-745 supplementation reduces gastrointestinal dysfunction in an animal model of IBS

    National Research Council Canada - National Science Library

    Paola Brun; Melania Scarpa; Chiara Marchiori; Gloria Sarasin; Valentina Caputi; Andrea Porzionato; Maria Cecilia Giron; Giorgio Palù; Ignazio Castagliuolo

    We evaluated the effect of Saccharomyces boulardii CNCM I-745 on intestinal neuromuscular anomalies in an IBS-type mouse model of gastrointestinal motor dysfunctions elicited by Herpes Simplex Virus type 1 (HSV-1...

  9. Saccharomyces boulardii CNCM I-745 supplementation reduces gastrointestinal dysfunction in an animal model of IBS

    National Research Council Canada - National Science Library

    Paola Brun; Melania Scarpa; Chiara Marchiori; Gloria Sarasin; Valentina Caputi; Andrea Porzionato; Maria Cecilia Giron; Giorgio Palù; Ignazio Castagliuolo

    2017-01-01

    Background We evaluated the effect of Saccharomyces boulardii CNCM I-745 on intestinal neuromuscular anomalies in an IBS-type mouse model of gastrointestinal motor dysfunctions elicited by Herpes Simplex Virus type 1 (HSV-1) exposure...

  10. ECHO parameters of diastolic dysfunction.

    Science.gov (United States)

    Schumacher, A; Khojeini, Ev; Larson, Df

    2008-09-01

    Most patients with cardiac disease have diastolic dysfunction which is characterized by impaired diastolic filling and/or abnormal diastolic relaxation. The trans-esophageal echocardiography (TEE) used routinely during open-heart surgical procedures has exceptional resolution that may permit the identification and grading of diastolic dysfunction. The goal of this study was to determine which echocardiography (ECHO) parameters can best describe diastolic dysfunction due to myocardial remodeling and fibrosis. Baseline transthoracic ECHO was performed on 3-month-old C57BL/6J female mice followed by administration of isoproterenol (2 microg/g/d) for 6 days. On day 7, transthoracic ECHO was performed to determine the change of left ventricular (LV) inflow parameters due to isoproterenol-mediated cardiac remodeling. The mid-LV region was stained with picrosirius red to quantify myocardial fibrosis and demonstrated a 5-fold increase in cardiac fibrosis (p = 0.002). LV mass was increased by 36% (p = 0.0016). Mitral valve flow Doppler peak velocities E and A were measured from a 4-chamber view. The E/A ratio did not change, but the E deceleration time, velocity time integral of the E-A complex (E-A VTI), E/E-A VTI ratio, isovolumic relaxation time (IVRT), and diastolic time all significantly increased. The corresponding tissue Doppler parameter, Ea/Aa ratio, decreased by 25% (p = 0.035). The left atrial dimension and the ECHO index of left atrial pressure (E/Ea) significantly increased (p < 0.02). These data suggest that, with a long-axis and a 4-chamber view, the clinician can adequately determine diastolic function in the open-heart surgical patient.

  11. Pseudotumor Cerebri and Glymphatic Dysfunction

    Directory of Open Access Journals (Sweden)

    Marcio Luciano de Souza Bezerra

    2018-01-01

    Full Text Available In contrast to virtually all organ systems of the body, the central nervous system was until recently believed to be devoid of a lymphatic system. The demonstration of a complex system of paravascular channels formed by the endfeet of astroglial cells ultimately draining into the venous sinuses has radically changed this idea. The system is subsidized by the recirculation of cerebrospinal fluid (CSF through the brain parenchyma along paravascular spaces (PVSs and by exchanges with the interstitial fluid (IF. Aquaporin-4 channels are the chief transporters of water through these compartments. This article hypothesizes that glymphatic dysfunction is a major pathogenetic mechanism underpinning idiopathic intracranial hypertension (IIH. The rationale for the hypothesis springs from MRI studies, which have shown many signs related to IIH without evidence of overproduction of CSF. We propose that diffuse retention of IF is a direct consequence of an imbalance of glymphatic flow. This imbalance, in turn, may result from an augmented flow from the arterial PVS into the IF, by impaired outflow of the IF into the paravenous spaces, or both. Our hypothesis is supported by the facts that (i visual loss, one of the main complications of IIH, is secondary to the impaired drainage of the optic nerve, a nerve richly surrounded by water channels and with a long extracranial course in its meningeal sheath; (ii there is a high association between IIH and obesity, a condition related to paravascular inflammation and lymphatic disturbance, and (iii glymphatic dysfunction has been related to the deposition of β-amyloid in Alzheimer’s disease. We conclude that the concept of glymphatic dysfunction provides a new perspective for understanding the pathophysiology of IIH; it may likewise entice the development of novel therapeutic approaches aiming at enhancing the flow between the CSF, the glymphatic system, and the dural sinuses.

  12. Dementia risk in renal dysfunction

    Science.gov (United States)

    Camerino, Ileana; van Boxtel, Martin P.J.; Verhey, Frans R.J.; Irving, Kate; Brayne, Carol; Kivipelto, Miia; Starr, John M.; Yaffe, Kristine; de Leeuw, Peter W.; Köhler, Sebastian

    2017-01-01

    Objective: Renal dysfunction has been linked with increased risk for cognitive impairment and dementia, but studies are conflicting. For that reason, the aim of the present systematic review and meta-analysis is to summarize the best available evidence on the prospective association between potential markers of renal dysfunction and development of cognitive impairment or dementia. Methods: Medline, Embase, and Cochrane Database of Systematic Reviews were searched for potential publications until August 1, 2016. Studies were eligible if they fulfilled the following criteria: population-based study, prospective design, ≥100 participants, aged ≥45 years, ≥1 year follow-up, and cognition/dementia outcomes. Where appropriate, random effects meta-analyses were conducted yielding pooled odds ratios (OR) and 95% confidence intervals (CI). Results: Twenty-two out of 8,494 abstracts fulfilled the eligibility criteria. Sufficient evidence was found for albuminuria, mixed results for estimated glomerular filtration rate (eGFR), insufficient support for cystatin C, and tentative evidence for serum creatinine and creatinine clearance. Meta-analyses of 5 studies representing 27,805 persons showed a 35% increased risk of cognitive impairment or dementia in those with albuminuria (OR 1.35, 95% CI 1.06–1.73, p = 0.015), whereas eGFR <60 mL/min/1.73 m2 showed no significant association (OR 1.28, 95% CI 0.99–1.65, p = 0.063). No meta-analyses could be done for serum creatinine, creatinine clearance, or cystatin C. Conclusions: The overall evidence for an association between renal dysfunction and cognitive impairment or dementia is modest. Evidence suggests that albuminuria is associated with higher odds of developing cognitive impairment or dementia. PMID:27974647

  13. Sexual Dysfunction in Patients with Polycystic Ovary Syndrome in Malaysia.

    Science.gov (United States)

    Dashti, Sareh; Latiff, Latiffah A; Hamid, Habibah Abdul; Sani, Suriani Mohamad; Akhtari-Zavare, Mehrnoosh; Abu Bakar, Azrin Shah; Binti Sabri, Nur Amirah Inani; Ismail, Maimunah; Esfehani, Ali Jafarzadeh

    2016-01-01

    Polycystic ovary syndrome (PCOS) is a combination of chronic anovulation, obesity, and hyperandrogenism and can affect sexual function in women of reproductive age. It is also associated with endometrial cancer. Our aim was to evaluate the frequency and predisposing factors of sexual dysfunction in PCOS patients. In this cross-sectional study, 16 married women with a definite diagnosis of PCOS were recruited. Sexual function was assessed in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain using the female sexual function index (FSFI) questionnaire. Patients were also assessed for mental health using the depression, anxiety and stress (DASS-21) questionnaire. Presence of hirsutism was assessed using the Ferriman-Gallwey (FG) scoring system. Demographic data were obtained from patients during in-person interview. Sexual dysfunction was present in 62.5% of patients with the domains of arousal and lubrication particularly affected (93.8% and 87.5%, respectively). Patients with symptoms of depression and anxiety were significantly more likely to suffer sexual dysfunction than those without these symptoms (p=0.04 and p=0.03 respectively). Patients with stress symptoms reported higher orgasm dysfunction than those without (p=0.02). No significant difference in any of the FSFI score domains was observed between patients with and without hirsutism. PCOS patients markedly suffer from sexual dysfunction and therefore it seems appropriate to be screened for intervention. Poor mental health conditions that may be the result of infertility or other complications of PCOS should also be considered as curable causes of sexual dysfunction in these patients.

  14. Vaginismus and accompanying sexual dysfunctions in a Turkish clinical sample.

    Science.gov (United States)

    Dogan, Sultan

    2009-01-01

    Although vaginismus is a common sexual dysfunction in Turkey, there are only limited data about sexual behavior characteristics and comorbidity with other sexual dysfunctions in vaginismic patients. To investigate the frequency of female sexual dysfunctions (FSDs) in a Turkish clinical sample and to determine the comorbidity of other FSDs in women diagnosed with lifelong vaginismus. The study included 54 female patients who presented to a psychiatry department with sexual problems/complaints. The subjects were evaluated using a semi-structured questionnaire. The questionnaire was developed by the researchers in order to assess sexually dysfunctional patients and included detailed questions about socio-demographic variables, and general medical and sexual history. All participants were also assessed using the Golombok Rust Inventory of Sexual Satisfaction. The most common primary FSD in our sample was vaginismus (75.9%), followed by hypoactive sexual desire (9.2%). Regarding comorbidity, in 36 female patients with lifelong vaginismus, we found dyspareunia in 17 women (47.2%), orgasmic disorder in eight women (22.2%), and sexual desire disorder in six women (16.6%) as a second sexual dysfunction, based on the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, Text Revision criteria. With respect to FSDs within the Turkish clinical population, vaginismic patients constitute the largest group and cultural factors may play a role in the occurrence of this condition. Additionally, our data indicated that there was a strong correlation between vaginismus and dyspareunia. There was also a high frequency of hypoactive desire and orgasm disorder in vaginismic patients. These results suggest that multidimensional assessment of sexual dysfunction in female patients is of great importance.

  15. Drug addiction and sexual dysfunction.

    Science.gov (United States)

    Zaazaa, Adham; Bella, Anthony J; Shamloul, Rany

    2013-09-01

    This article attempts to review the most current and the well-established facts concerning drug addiction and sexual dysfunction. Surprisingly, even though alcohol is prevalent in many societies with many myths surrounding its sexual-enhancing effects, current scientific research cannot provide a solid conclusion on its effect on sexual function. Unfortunately, the same concept applies to tobacco smoking; however, most of the current knowledge tends to support the notion that it, indeed, can negatively affect sexual function. Similar ambiguities also prevail with substances of abuse. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Ageing with neurogenic bowel dysfunction

    DEFF Research Database (Denmark)

    Nielsen, S D; Faaborg, Pia Møller; Finnerup, Nanna Brix

    2017-01-01

    at 18% in 1996 and 19% in 2015. During the 19-year period, there had been no significant change in the methods for bowel care, but 22 (20%) had undergone surgery for bowel dysfunction, including 11 (10%) who had some form of stoma. Conclusion: Self-assessed severity of constipation increased but quality...... of life remained stable in a cohort of people with SCI followed prospectively for 19 years. Methods for bowel care remained surprisingly stable but a large proportion had undergone stoma surgery....

  17. Increased leukocyte rho kinase (ROCK) activity and endothelial dysfunction in cigarette smokers

    OpenAIRE

    Hidaka, Takayuki; Hata, Takaki; Soga, Junko; Fujii, Yuichi; Idei, Naomi; Fujimura, Noritaka; Kihara, Yasuki; Noma, Kensuke; Liao, James K.; Higashi, Yukihito

    2010-01-01

    Rho-associated kinases (ROCKs) have been shown to be involved in the pathogenesis of atherosclerosis. Although smoking is associated with endothelial dysfunction and ROCK inhibitors improve endothelial function in smokers, it is not known whether ROCK activity is increased in smokers and whether this correlates with endothelial dysfunction. The purpose of this study was to evaluate the relationship between ROCK activity and endothelial function in smokers. We evaluated flow-mediated vasodilat...

  18. Dynamic imaging of posterior compartment pelvic floor dysfunction by evacuation proctography: Techniques, indications, results and limitations

    Energy Technology Data Exchange (ETDEWEB)

    Maglinte, Dean D.T. [Department of Radiology, Indiana University Medical Center, University Hospital and Outpatient Center, 550 N. University Blvd. UH 0279, Indianapolis, IN 46202 (United States)]. E-mail: dmaglint@iupui.edu; Bartram, Clive [Imperial College Faculty of Medicine, Consulting Radiology, St. Mark' s Hospital, Northwick Park, Harrow HA1 3UJ (United Kingdom)

    2007-03-15

    The clinical management of patients with anorectal and pelvic floor dysfunction is often difficult. Evacuation proctography has evolved from a method to evaluate the anorectum for functional disorders to its current status as a practical method for evaluating anorectal dysfunction and pelvic floor prolapse. It has a high observer accuracy and yield of positive diagnosis. Clinicians find it of major benefit and has altered management from surgical to medical and vice versa in a significant number of cases.

  19. Cardiovascular drugs and erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Terzić Branka M.

    2014-01-01

    Full Text Available Erectile dysfunction (ED is a disorder, which basically can have organic nature, psychological or mixed. ED is not a rarity, and data on its prevalence vary, depending on the areas in which the survey was conducted, followed by a period of research and the definition of the disorder. Most of the men associate ED problem with using drugs, especially cardiac. Even though there is some truth in it, mainly the real causes of ED are not well known even to professionals. Contemporary studies of risk factors for cardiovascular disease, particularly coronary heart disease, have shown the clear link between erectile dysfunction and coronary heart disease, wherein ED first manifests. While, ED precedes the onset of symptoms of coronary heart disease and show to the patient and the physician a clear signal of the direction for conducting diagnostic tests and further treatment in the interest of the health of patients. Endocrine, and neurological disorders, as well as bad habits in addition to the cardiac and kidney disease, lead to ED. It is known also, that the use of cardiac medicines may contribute to ED occurrence. Better knowledge of adverse reactions to medicines, a better understanding of the nature of the disease and the implementation of necessary diagnostic procedures, with a good choice of medication, contribute to solving problems related to ED. If all mentioned do not help, there is the possibility of using new drugs to correct ED.

  20. [Male sexual dysfunctions and homosexuality].

    Science.gov (United States)

    Leuillet, P; Cour, F; Droupy, S

    2013-07-01

    The homosexuality, which expresses itself through a varied and complex behavior that those whom are shared by the heterosexual majority, is not that a simple sexual behavior, obvious or not, but a whole set of attitudes, affects, preferences, values, lifestyle which concern profoundly the individual, as the heterosexuality. A review of the literature using PubMed database has been performed to select 38 articles. Among sexual difficulties met by the gays, erectile dysfunction and hypoactive sexual desire are the more frequent. Concerning the ejaculation disorders observed in the gay population, premature ejaculation is rather rare in comparison with heterosexual men; however delayed ejaculation or anejaculation are more frequent. Painful sexual disorders in particular anodyspareunia are also reported. Sexual disorder management must follows the classic rules but it is necessary to be aware how to approach the specific questions affecting the homosexual persons. Still the homosexual person has to find a competent therapist, "opened" to the sexual problem of the homosexuals, with the aim of a care privileging the efficiency to efficacy in the respect for the truth of the homosexual person. The homosexuality is the only one of the "unusual" sexual conducts to possibly concern the daily medical practice due to is prevalence. The management of sexual dysfunctions must privilege the "meeting" in a quest of sense in front of any sexual symptom, whatever the individual sexual orientation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. Insulin Resistance and Mitochondrial Dysfunction.

    Science.gov (United States)

    Gonzalez-Franquesa, Alba; Patti, Mary-Elizabeth

    2017-01-01

    Insulin resistance precedes and predicts the onset of type 2 diabetes (T2D) in susceptible humans, underscoring its important role in the complex pathogenesis of this disease. Insulin resistance contributes to multiple tissue defects characteristic of T2D, including reduced insulin-stimulated glucose uptake in insulin-sensitive tissues, increased hepatic glucose production, increased lipolysis in adipose tissue, and altered insulin secretion. Studies of individuals with insulin resistance, both with established T2D and high-risk individuals, have consistently demonstrated a diverse array of defects in mitochondrial function (i.e., bioenergetics, biogenesis and dynamics). However, it remains uncertain whether mitochondrial dysfunction is primary (critical initiating defect) or secondary to the subtle derangements in glucose metabolism, insulin resistance, and defective insulin secretion present early in the course of disease development. In this chapter, we will present the evidence linking mitochondrial dysfunction and insulin resistance, and review the potential for mitochondrial targets as a therapeutic approach for T2D.

  2. Orgasmic Dysfunction after Radical Prostatectomy

    Science.gov (United States)

    Ventimiglia, Eugenio; Cazzaniga, Walter; Montorsi, Francesco; Salonia, Andrea

    2017-01-01

    In addition to urinary incontinence and erectile dysfunction, several other impairments of sexual function potentially occurring after radical prostatectomy (RP) have been described; as a whole, these less frequently assessed disorders are referred to as neglected side effects. In particular, orgasmic dysfunctions (ODs) have been reported in a non-negligible number of cases, with detrimental impacts on patients' overall sexual life. This review aimed to comprehensively discuss the prevalence and physiopathology of post-RP ODs, as well as potential treatment options. Orgasm-associated incontinence (climacturia) has been reported to occur in between 20% and 93% of patients after RP. Similarly, up to 19% of patients complain of postoperative orgasm-associated pain, mainly referred pain at the level of the penis. Moreover, impairment in the sensation of orgasm or even complete anorgasmia has been reported in 33% to 77% of patients after surgery. Clinical and surgical factors including age, the use of a nerve-sparing technique, and robotic surgery have been variably associated with the risk of ODs after RP, although robust and reliable data allowing for a proper estimation of the risk of postoperative orgasmic function impairment are still lacking. Likewise, little evidence regarding the management of postoperative ODs is currently available. In general, physicians should be aware of the prevalence of ODs after RP, in order to properly counsel all patients both preoperatively and immediately post-RP about the potential occurrence of bothersome and distressful changes in their overall sexual function. PMID:28459142

  3. Insulin Resistance and Mitochondrial Dysfunction

    DEFF Research Database (Denmark)

    Gonzalez-Franquesa, Alba; Patti, Mary-Elizabeth

    2017-01-01

    Insulin resistance precedes and predicts the onset of type 2 diabetes (T2D) in susceptible humans, underscoring its important role in the complex pathogenesis of this disease. Insulin resistance contributes to multiple tissue defects characteristic of T2D, including reduced insulin-stimulated glu......Insulin resistance precedes and predicts the onset of type 2 diabetes (T2D) in susceptible humans, underscoring its important role in the complex pathogenesis of this disease. Insulin resistance contributes to multiple tissue defects characteristic of T2D, including reduced insulin...... of defects in mitochondrial function (i.e., bioenergetics, biogenesis and dynamics). However, it remains uncertain whether mitochondrial dysfunction is primary (critical initiating defect) or secondary to the subtle derangements in glucose metabolism, insulin resistance, and defective insulin secretion...... present early in the course of disease development. In this chapter, we will present the evidence linking mitochondrial dysfunction and insulin resistance, and review the potential for mitochondrial targets as a therapeutic approach for T2D....

  4. Reflex sympathetic dystrophy: misdiagnosis in patients with dysfunctional postures of the upper extremity.

    Science.gov (United States)

    Stutts, J T; Kasdan, M L; Hickey, S E; Bruner, A

    2000-11-01

    The purpose of this case-control study was to assess the frequency of the inappropriate diagnosis of reflex sympathetic dystrophy (RSD) in patients who presented with dysfunctional postures of the upper extremity (n = 43). This group of patients with a dysfunctional posture was compared with a randomly selected control group of patients who presented with pain but no dysfunctional posture (n = 88). The patients underwent radiographic evaluation after review of previous medical records and history and physical examination. Patients with dysfunctional postures had a significantly higher frequency (63%) of a previous inappropriate diagnosis of RSD compared with the control group (6%). None of the patients in either group had objective findings consistent with a diagnosis of RSD. Patients presenting with dysfunctional postures of the upper extremity may be misdiagnosed as having RSD and rarely meet the criteria for this diagnosis.

  5. Sexual dysfunctions after prostate cancer radiation therapy; Dysfonctions sexuelles apres irradiation pour cancer de la prostate

    Energy Technology Data Exchange (ETDEWEB)

    Droupy, S. [Service d' urologie-andrologie, CHU Caremeau, 30 - Nimes (France)

    2010-10-15

    Sexual dysfunctions are a quality of life main concern following prostate cancer treatment. After both radiotherapy and brachytherapy, sexual function declines progressively, the onset of occurrence of erectile dysfunction being 12-18 months after both treatments. The pathophysiological pathways by which radiotherapy and brachytherapy cause erectile dysfunction are multi-factorial, as patient co-morbidities, arterial damage, exposure of neurovascular bundle to high levels of radiation, and radiation dose received by the corpora cavernosa at the crurae of the penis may be important in the aetiology of erectile dysfunction. Diagnosis and treatment of postradiation sexual dysfunctions must integrate pre-therapeutic evaluation and information to provide to the patient and his partner a multidisciplinary sexual medicine management. (authors)

  6. The treatment of autonomic dysfunction in tetanus

    Directory of Open Access Journals (Sweden)

    T van den Heever

    2017-07-01

    Full Text Available We report a case of generalised tetanus in a 50-year-old female patient after sustaining a wound to her right lower leg. She developed autonomic dysfunction, which included labile hypertension alternating with hypotension and sweating. The autonomic dysfunction was treated successfully with a combination of morphine sulphate infusion, magnesium sulphate, and clonidine. She also received adrenaline and phenylephrine infusions as needed for hypotension. We then discuss the pathophysiology, clinical features and treatment options of autonomic dysfunction.

  7. Role of Lipotoxicity in Endothelial Dysfunction

    OpenAIRE

    Kim, Jeong-a; Montagnani, Monica; Chandrasekran, Sruti; Quon, Michael J.

    2012-01-01

    Lipotoxicity, caused in large part by overnutrition, directly leads to endothelial dysfunction. Excess lipids in both the circulation and at the tissue level contribute to endothelial dysfunction that underlies much of the pathophysiology of both metabolic disease, including obesity and diabetes and their CV complications. Direct lipotoxic effects on other organs as well as secondary insults from endothelial dysfunction synergize to cause substantial morbidity and mortality. Lifestyle interve...

  8. Treatment of peripheral vestibular dysfunction using photobiomodulation

    Science.gov (United States)

    Lee, Min Young; Hyun, Jai-Hwan; Suh, Myung-Whan; Ahn, Jin-Chul; Chung, Phil-Sang; Jung, Jae Yun; Rhee, Chung Ku

    2017-08-01

    Gentamicin, which is still used in modern medicine, is a known vestibular toxic agent, and various degrees of balance problems have been observed after exposure to this pharmacologic agent. Photobiomodulation is a candidate therapy for vertigo due to its ability to reach deep inner ear organs such as the cochlea. Previous reports have suggested that photobiomodulation can improve hearing and cochlea function. However, few studies have examined the effect of photobiomodulation on balance dysfunction. We used a rat model to mimic human vestibulopathy resulting from gentamicin treatment and evaluated the effect of photobiomodulation on vestibular toxicity. Slow harmonic acceleration (SHA) rotating platform testing was used for functional evaluation and both qualitative and quantitative epifluorescence analyses of cupula histopathology were performed. Animals were divided into gentamicin only and gentamicin plus laser treatment groups. Laser treatment was applied to one ear, and function and histopathology were evaluated in both ears. Decreased function was observed in both ears after gentamicin treatment, demonstrated by low gain and no SHA asymmetry. Laser treatment minimized the damage resulting from gentamicin treatment as shown by SHA asymmetry and recovered gain in the treated ear. Histology results reflected the functional results, showing increased hair cell density and epifluorescence intensity in laser-treated cupulae.

  9. Cardiovascular dysfunction in infants with neonatal encephalopathy.

    LENUS (Irish Health Repository)

    Armstrong, Katey

    2012-04-01

    Severe perinatal asphyxia with hypoxic ischaemic encephalopathy occurs in approximately 1-2\\/1000 live births and is an important cause of cerebral palsy and associated neurological disabilities in children. Multiorgan dysfunction commonly occurs as part of the asphyxial episode, with cardiovascular dysfunction occurring in up to a third of infants. This narrative paper attempts to review the literature on the importance of early recognition of cardiac dysfunction using echocardiography and biomarkers such as troponin and brain type natriuretic peptide. These tools may allow accurate assessment of cardiac dysfunction and guide therapy to improve outcome.

  10. Dysfunctional gaze processing in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Cristina Berchio

    2017-01-01

    The present study provides neurophysiological evidence for abnormal gaze processing in BP and suggests dysfunctional processing of direct eye contact as a prominent characteristic of bipolar disorder.

  11. Differentiating vocal cord dysfunction from asthma

    Directory of Open Access Journals (Sweden)

    Fretzayas A

    2017-10-01

    Full Text Available Andrew Fretzayas,1,2 Maria Moustaki,3 Ioanna Loukou,3 Konstantinos Douros4 1Third Department of Pediatrics, Athens University Medical School, “Attikon” University Hospital, Haidari, Greece; 2Athens Medical Center, Department of Pediatrics, Marousi, Greece; 3Department of Cystic Fibrosis, “Aghia Sofia”, Children’s Hospital, Athens, Greece; 4Respiratory Unit, Third Department of Pediatrics, Athens University Medical School, “Attikon” University Hospital, Haidari, Greece Abstract: Vocal cord dysfunction (VCD-associated symptoms are not rare in pediatric patients. Dyspnea, wheezing, stridor, chest pain or tightness and throat discomfort are the most commonly encountered symptoms. They may occur either at rest or more commonly during exercise in patients with VCD, as well as in asthmatic subjects. The phase of respiration (inspiration rather than expiration, the location of the wheezing origin, the rapid resolution of symptoms, and the timing occurring in relation to exercise, when VCD is exercise induced, raise the suspicion of VCD in patients who may have been characterized as merely asthmatics and, most importantly, had not responded to the appropriate treatment. The gold standard method for the diagnosis of VCD is fiberoptic laryngoscopy, which may also identify concomitant laryngeal abnormalities other than VCD. However, as VCD is an intermittent phenomenon, the procedure should be performed while the patient is symptomatic. For this reason, challenges that induce VCD symptoms should be performed, such as exercise tests. Recently, for the evaluation of patients with exercise-induced VCD, continuous laryngoscopy during exercise (such as treadmill, bicycle ergometer, swimming was used. A definite diagnosis of VCD is of importance, especially for those patients who have been erroneously characterized as asthmatics, without adequate response to treatment. In these cases, another therapeutic approach is necessary, which will depend on

  12. AB162. Is it feasible to apply a new concept of erectile dysfunction syndrome (EDS) in clinical practice?

    OpenAIRE

    Chen, Jun; Zhang, Bin; Wen, Jiaming

    2014-01-01

    How to understand the erectile function? How to define erectile dysfunction? In general, erectile function is evaluated by the quality of penile erection. If penis shows good erection, we think erectile function is normal. Otherwise, erectile dysfunction occurs. This concept is reflected in the definition of erectile dysfunction (ED). ED is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. From the definition of ED, it...

  13. [Rehabilitation for intravaginal ejaculatory dysfunction with using a masturbation aid].

    Science.gov (United States)

    Kobori, Yoshitomo; Aoki, Hiroaki; Nishio, Koujiro; Sato, Ryo; Ashizawa, Yoshio; Yagi, Hiroshi; So, Shigehiro; Arai, Gaku; Okada, Hiroshi

    2012-05-01

    Recently the incidence of intravaginal ejaculatory dysfunction is increasing among infertile couples in Japan. Some unusual ways of masturbation and psychogenic issues were reported to cause this disorder. Patients, who had done masturbation in an unusual way for long time since their adolescence, were difficult to gain normal intravaginal ejaculation by the behavior therapy which was used for erectile dysfunction. We, therefore, used a masturbation aid (TENGA) for rehabilitation of ejaculation to overcome this condition. From January, 2010 through March, 2011, a total of 16 patients with intravaginal ejaculatory dysfunction underwent rehabilitation of ejaculation using TENGA. Patients' satisfaction and achievement of intravaginal ejaculation were evaluated by the questionnaire. Twelve patients (75%) could ejaculate in the masturbation aid (TENGA). Five patients (31%) succeeded to ejaculate in the partner's vagina after rehabilitation. A masturbation aid (TENGA) was a useful tool to correct the way of masturbation and achieve normal intravaginal ejaculation. This masturbation aid can be one of the effective options for the treatment of intravaginal ejaculatory dysfunction.

  14. Late renal dysfunction in adult survivors of bone marrow transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Lawton, C.A.; Cohen, E.P.; Barber-Derus, S.W.; Murray, K.J.; Ash, R.C.; Casper, J.T.; Moulder, J.E. (Medical College of Wisconsin Affiliated Hospitals, Milwaukee (USA))

    1991-06-01

    Until recently long-term renal toxicity has not been considered a major late complication of bone marrow transplantation (BMT). Late renal dysfunction has been described in a pediatric population status post-BMT which was attributable to the radiation in the preparatory regimen. A thorough review of adults with this type of late renal dysfunction has not previously been described. Fourteen of 103 evaluable adult patients undergoing allogeneic (96) or autologous (7) bone marrow transplantation, predominantly for leukemia and lymphomas, at the Medical College of Wisconsin (Milwaukee, WI) have had a syndrome of renal insufficiency characterized by increased serum creatinine, decreased glomerular filtration rate, anemia, and hypertension. This syndrome developed at a median of 9 months (range, 4.5 to 26 months) posttransplantation in the absence of specific identifiable causes. The cumulative probability of having this renal dysfunction is 20% at 1 year. Renal biopsies performed on seven of these cases showed the endothelium widely separated from the basement membrane, extreme thickening of the glomerular basement membrane, and microthrombi. Previous chemotherapy, antibiotics, and antifungals as well as cyclosporin may add to and possibly potentiate a primary chemoradiation marrow transplant renal injury, but this clinical syndrome is most analogous to clinical and experimental models of radiation nephritis. This late marrow transplant-associated nephritis should be recognized as a potentially limiting factor in the use of some intensive chemoradiation conditioning regimens used for BMT. Some selective attenuation of the radiation to the kidneys may decrease the incidence of this renal dysfunction.

  15. Incidence of sexual dysfunction in patients with obesity and overweight.

    Science.gov (United States)

    Martins e Silva, Benedito; Rêgo, Lerika Moreira; Galvão, Márcio Almeida; Florêncio, Telma Maria de Menezes Toledo; Cavalcante, Jairo Calado

    2013-01-01

    To assess the prevalence of sexual dysfunction in obese and overweight patients treated at the Professor Alberto Antunes University Hospital (HUPAA - UFAL). This is a descriptive study. The sample consisted of overweight or obese females. Anthropometric data were collected for assessment of body mass index (BMI) and waist circumference (WC). In all subjects we measured the levels of blood glucose, total cholesterol and triglycerides. We applied a Portuguese-validated version of the Female Sexual Function Index (FSDI), which assesses sexual response as for desire, arousal, vaginal lubrication, orgasm, sexual satisfaction and pain. The total score is the sum of scores for each domain multiplied by the corresponding factor and can vary from '2 'to '36', a total score less than or equal to '26 ' being considered risky for sexual dysfunction. We evaluated 23 women with a mean age of 44, where 73.9% were obese and 82.6% had a highly increased risk for metabolic complications (WC e" 88 cm). The increased risk for sexual dysfunction was present in 78.3% of the interviewees, causing biopsychosocial impairment. Hypertension, diabetes and dyslipidemia were present in 33.3%, 22.2% and 61.1%, respectively, of patients at risk for sexual dysfunction. The analysis of the results demonstrates the need for better research and attention of physicians to patients with obesity or overweight.

  16. Vestibular dysfunction in a child with embryonic exposure to accutane.

    Science.gov (United States)

    Westerman, S T; Gilbert, L M; Schondel, L

    1994-05-01

    Children with a history of embryonic exposure to Accutane (isotretinoin) are at great risk for major physical malformations, brain malformations, and decreased intelligence. A case is presented of a 4-year 7-month-old black male with a history of embryonic exposure to Accutane who was born with embryopathy that includes bilateral major ear deformities. The child has a significant bilateral conductive hearing loss, and, in addition, a left sided sensorineural loss. Vestibular function testing revealed evidence of peripheral and central vestibular dysfunction. A course of diphenhydramine hydrochloride and Donnatal (phenobarbital, hyoscyamine sulfate, atropine sulfate, and scopolamine hydrobromide) significantly alleviated the symptoms of vestibular dysfunction. Otologic management of these children should include clinical documentation of the external deformities, evaluation of cochlear function, and early auditory habilitation. Vestibular function should also be evaluated in all children with a history of embryonic exposure to isotretinoin.

  17. Diabetes and sexual dysfunction: current perspectives

    Directory of Open Access Journals (Sweden)

    Maiorino MI

    2014-03-01

    Full Text Available Maria Ida Maiorino,1 Giuseppe Bellastella,1 Katherine Esposito2 1Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Naples, Italy; 2Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy Abstract: Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress – all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes. Keywords: diabetes mellitus, diabetes complications, erectile dysfunction, female sexual dysfunction, lifestyle changes

  18. Inside the Spiral of Dysfunction: The Personal Consequences of Working for a Dysfunctional Leader

    Science.gov (United States)

    Shuck, Brad; Rose, Kevin; Bergman, Matt

    2015-01-01

    Dysfunctional leaders suffocate others with coercive power and ego, are unpredictable, and often lack self-awareness about their dysfunction. Dysfunctional leaders are incredibly difficult to work with and can cause a series of cascading personal consequences for employees who work with them. This Perspectives in Human Resource Development essay…

  19. Diabetes and Retinal Vascular Dysfunction

    Directory of Open Access Journals (Sweden)

    Eui Seok Shin

    2014-01-01

    Full Text Available Diabetes predominantly affects the microvascular circulation of the retina resulting in a range of structural changes unique to this tissue. These changes ultimately lead to altered permeability, hyperproliferation of endothelial cells and edema, and abnormal vascularization of the retina with resulting loss of vision. Enhanced production of inflammatory mediators and oxidative stress are primary insults with significant contribution to the pathogenesis of diabetic retinopathy (DR. We have determined the identity of the retinal vascular cells affected by hyperglycemia, and have delineated the cell autonomous impact of high glucose on function of these cells. We discuss some of the high glucose specific changes in retinal vascular cells and their contribution to retinal vascular dysfunction. This knowledge provides novel insight into the molecular and cellular defects contributing to the development and progression of diabetic retinopathy, and will aid in the development of innovative, as well as target specific therapeutic approaches for prevention and treatment of DR.

  20. Psychopathy: cognitive and neural dysfunction

    Science.gov (United States)

    R. Blair, R. James

    2013-01-01

    Psychopathy is a developmental disorder marked by emotional deficits and an increased risk for antisocial behavior. It is not equivalent to the diagnosis Antisocial Personality Disorder, which concentrates only on the increased risk for antisocial behavior and not a specific cause—ie, the reduced empathy and guilt that constitutes the emotional deficit. The current review considers data from adults with psychopathy with respect to the main cognitive accounts of the disorder that stress either a primary attention deficit or a primary emotion deficit. In addition, the current review considers data regarding the neurobiology of this disorder. Dysfunction within the amygdala's role in reinforcement learning and the role of ventromedial frontal cortex in the representation of reinforcement value is stressed. Data is also presented indicating potential difficulties within parts of temporal and posterior cingulate cortex. Suggestions are made with respect to why these deficits lead to the development of the disorder. PMID:24174892

  1. Animal models of erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Snehlata V Gajbhiye

    2015-01-01

    Full Text Available Animal models have contributed to a great extent to understanding and advancement in the field of sexual medicine. Many current medical and surgical therapies in sexual medicine have been tried based on these animal models. Extensive literature search revealed that the compiled information is limited. In this review, we describe various experimental models of erectile dysfunction (ED encompassing their procedures, variables of assessment, advantages and disadvantages. The search strategy consisted of review of PubMed based articles. We included original research work and certain review articles available in PubMed database. The search terms used were "ED and experimental models," "ED and nervous stimulation," "ED and cavernous nerve stimulation," "ED and central stimulation," "ED and diabetes mellitus," "ED and ageing," "ED and hypercholesteremia," "ED and Peyronie′s disease," "radiation induced ED," "telemetric recording," "ED and mating test" and "ED and non-contact erection test."

  2. Orgasmic Dysfunction after Radical Prostatectomy.

    Science.gov (United States)

    Capogrosso, Paolo; Ventimiglia, Eugenio; Cazzaniga, Walter; Montorsi, Francesco; Salonia, Andrea

    2017-04-01

    In addition to urinary incontinence and erectile dysfunction, several other impairments of sexual function potentially occurring after radical prostatectomy (RP) have been described; as a whole, these less frequently assessed disorders are referred to as neglected side effects. In particular, orgasmic dysfunctions (ODs) have been reported in a non-negligible number of cases, with detrimental impacts on patients' overall sexual life. This review aimed to comprehensively discuss the prevalence and physiopathology of post-RP ODs, as well as potential treatment options. Orgasm-associated incontinence (climacturia) has been reported to occur in between 20% and 93% of patients after RP. Similarly, up to 19% of patients complain of postoperative orgasm-associated pain, mainly referred pain at the level of the penis. Moreover, impairment in the sensation of orgasm or even complete anorgasmia has been reported in 33% to 77% of patients after surgery. Clinical and surgical factors including age, the use of a nerve-sparing technique, and robotic surgery have been variably associated with the risk of ODs after RP, although robust and reliable data allowing for a proper estimation of the risk of postoperative orgasmic function impairment are still lacking. Likewise, little evidence regarding the management of postoperative ODs is currently available. In general, physicians should be aware of the prevalence of ODs after RP, in order to properly counsel all patients both preoperatively and immediately post-RP about the potential occurrence of bothersome and distressful changes in their overall sexual function. Copyright © 2017 Korean Society for Sexual Medicine and Andrology.

  3. Test Performance Related Dysfunctional Beliefs

    Directory of Open Access Journals (Sweden)

    Recep TÜTÜNCÜ

    2012-11-01

    Full Text Available Objective: Examinations by using tests are very frequently used in educational settings and successful studying before the examinations is a complex matter to deal with. In order to understand the determinants of success in exams better, we need to take into account not only emotional and motivational, but also cognitive aspects of the participants such as dysfunctional beliefs. Our aim is to present the relationship between candidates’ characteristics and distorted beliefs/schemata just before an examination. Method: The subjects of the study were 30 female and 30 male physicians who were about to take the medical specialization exam (MSE in Turkey. Dysfunctional Attitude Scale (DAS and Young Schema Questionnaire Short Form (YSQ-SF were applied to the subjects. The statistical analysis was done using the F test, Mann-Whitney, Kruskal-Wallis, chi-square test and spearman’s correlation test. Results: It was shown that some of the DAS and YSQ-SF scores were significantly higher in female gender, in the group who could not pass the exam, who had repetitive examinations, who had their first try taking an examination and who were unemployed at the time of the examination. Conclusion: Our findings indicate that candidates seeking help before MSE examination could be referred for cognitive therapy or counseling even they do not have any psychiatric diagnosis due to clinically significant cognitive distortion. Measurement and treatment of cognitive distortions that have negative impact on MSE performance may improve the cost-effectiveness and mental well being of the young doctors.

  4. TEMPOROMANDIBULAR DYSFUNCTION, STRESS AND COMMON MENTAL DISORDER IN UNIVERSITY STUDENTS

    OpenAIRE

    Augusto, Viviane Gontijo; Perina, Keity Cristina Bueno; Penha,Daniel Silva Gontijo; dos Santos, Daiane Carolina Alves; Oliveira, Val?ria Aparecida Souza

    2016-01-01

    ABSTRACT Objective: To evaluate the prevalence of temporomandibular dysfunction (TMD) and its association with perceived stress and common mental disorder (CMD) in academic students. Methods: This is s transversal observational study conducted at Universidade de Minas Gerais, Divinópolis Unit, in health science courses. To investigate the prevalence of TMD, the anamnestic index by Fonseca was used. Stress was assessed by the perceived stress scale, translated and adapted for the Brazilian...

  5. Erectile dysfunction is not a mirror of endothelial dysfunction in HIV-infected patients.

    Science.gov (United States)

    Guaraldi, Giovanni; Beggi, Mattia; Zona, Stefano; Luzi, Kety; Orlando, Gabriella; Carli, Federica; Ligabue, Guido; Rochira, Vincenzo; Rossi, Rosario; Modena, Maria Grazia; Bouloux, Pierre

    2012-04-01

    The penis has been compared to a barometer of endothelial health, erectile dysfunction (ED) being an early sign of endothelial dysfunction. The aim of the study was to investigate the extent of the association between ED and endothelial dysfunction in patients with human immunodeficiency virus (HIV) infection on antiretroviral therapy. In this observational cross-sectional study, we evaluated the prevalence and factors associated with ED in a cohort of 133 HIV-infected men. The International Index of Erectile Function, ultrasound assessment of brachial artery flow mediated dilatation (FMD), and multi-slice computed tomography for coronary artery calcifications (CAC) as surrogates of endothelial dysfunction, the Adult Treatment Panel III criteria to diagnose metabolic syndrome (MS), plasma total testosterone (hypogonadism), and a visual analogue scale (VAS) of aesthetic satisfaction of the face and of the body (psychological distress associated with lipodystrophy). Thirty-nine (29.32%) patients had mild ED, 14 (10.52%) patients had moderate ED, and 26 (19.55%) patients had severe ED. Prevalence of ED ranged from 45% to 65%, respectively, in patients less than 40 and more than 60 years old. MS was present in 20 (25%) patients with ED and 13 (24%) patients without ED (P value = 0.87). Prevalence of ED neither appeared to be associated with MS as a single clinical pathological entity nor with the numbers of its diagnostic components. FMD  100 was present in 8 (10%) patients with ED and 5 (9%) patients without ED (P value = 0.87). A stepwise multivariable logistic regression analysis was used to find predictors of ED. Independent predictors were VAS face (odds ratio [OR] = 0.85, 95% confidence interval [CI] 0.73-0.99, P = 0.049) and age per 10 years of increase (OR = 1.73, 95% CI 1.02-2.94, P = 0.04). Age constituted the most important risk factor for ED, which was related to aesthetic dissatisfaction of the face leading to negative body

  6. Sociodemographic and clinical correlates of sexual dysfunction ...

    African Journals Online (AJOL)

    Background: Sexual dysfunction is common in patients receiving psychotropic medications and may reduce their quality of life and medication adherence with resultant negative impact on treatment outcomes. Objectives: In this study, we described the various types of sexual dysfunction among psychiatric outpatients ...

  7. Peri-operative cognitive dysfunction and protection

    DEFF Research Database (Denmark)

    Steinmetz, J; Rasmussen, L S

    2016-01-01

    factors, the predominant one being age. Ignorance of the causes for postoperative cognitive dysfunction contributes to the difficulty of conducting interventional studies. Postoperative cognitive disorders are associated with increased mortality and permanent disability. Peri-operative interventions can...... reduce the rate of delirium in the elderly, but in spite of promising findings in animal experiments, no intervention reduces postoperative cognitive dysfunction in humans....

  8. Suspecting Neurological Dysfunction From E Mail Messages ...

    African Journals Online (AJOL)

    A non medical person suspected and confirmed neurological dysfunction in an individual, based only on e mail messages sent by the individual. With email communication becoming rampant “peculiar” email messages may raise the suspicion of neurological dysfunction. Organic pathology explaining the abnormal email ...

  9. Psychosocial dysfunction among adolescents who abuse ...

    African Journals Online (AJOL)

    Background: Substance abuse has been associated with psychosocial dysfunction from previous reports; however, the prevalence and pattern of such morbidity is unknown in our environment. Aims: The aim of the study was to determine the prevalence and pattern of psychosocial dysfunction among adolescents who ...

  10. Erectile Dysfunction Among Men Attending Surgical Outpatients ...

    African Journals Online (AJOL)

    2016-04-05

    Sildenafil citrate (Viagra) for the treatment of erectile dysfunction in Nigerian men. Int J Impot Res. 2003;15 Suppl 1:S15‑8. 19. Heidelbaugh JJ. Management of erectile dysfunction. Am Fam. Physician 2010;81:305‑12. [Downloaded free from http://www.nigerianjsurg.com on Tuesday, April 05, 2016, IP: 41.132.79.253

  11. Symptoms of Nerve Dysfunction After Hip Arthroscopy

    DEFF Research Database (Denmark)

    Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto

    2014-01-01

    PURPOSE: The primary purpose of this study was to analyze the rate, pattern, and severity of symptoms of nerve dysfunction after hip arthroscopy (HA) by reviewing prospectively collected data. The secondary purpose was to study whether symptoms of nerve dysfunction were related to traction time. ...

  12. Cleft palate repair and velopharyngeal dysfunction.

    Science.gov (United States)

    Hopper, Richard A; Tse, Raymond; Smartt, James; Swanson, Jordan; Kinter, Sara

    2014-06-01

    After studying this article, the participant should be able to: (1) Describe the technical details common to all cleft palate repairs that optimize outcomes and minimize complications. (2) Explain the subjective and objective evaluation of speech in children with cleft palate. (3) Practice with an increased awareness of the management of complications associated with cleft palate repair. (4) Design a treatment plan for velopharyngeal dysfunction. Goals of a successful cleft palate repair include separation of the oral and nasal components without fistula, achieving sufficient velar length, and creating functional transverse orientation of the levator muscle sling. A number of techniques have been described to achieve these goals, but they all have the following technical details in common: elevation of oral mucosal flaps based on the greater palatine arteries, tension free nasal lining mobilization, and functional intervelar muscle dissection. After palate repair, speech evaluation needs to be performed by an objective interdisciplinary team following a standardized protocol. Identification of velopharyngeal insufficiency secondary to an incompetent nasopharyngeal port will necessitate secondary speech surgery. These secondary techniques include pharyngeal flaps, soft palate lengthening, or pharyngeal sphincters, which should be tailored to optimize speech, while minimizing the risk of obstructive sleep apnea.

  13. Current Diagnosis and Management of Erectile Dysfunction

    Science.gov (United States)

    Pastuszak, Alexander W.

    2015-01-01

    Erectile dysfunction (ED) affects a growing number of men in the USA and abroad, with significant impacts on sexual function and overall quality of life. The risk factors for ED are numerous and include a strong link to cardiovascular disease, such that men with ED should be screened for cardiovascular disease. The evaluation of men presenting with ED includes a comprehensive history and physical exam to aid in the identification of comorbidities as well as laboratory testing to evaluate hormone and lipid levels and sugar metabolism. Adjunct studies are also available, though their utility is often limited to specific subtypes of ED. Once the etiology of ED is established, treatment can be initiated using appropriate medical therapies, including phosphodiesterase type 5 (PDE5) inhibitors, and transurethral or intracavernosal therapies, with surgical intervention via revascularization or penile prosthesis placement in men demonstrating a lack of response to medical therapy. In all cases of ED, a psychogenic component is present and referral for psychological intervention with or without medical therapy should be considered. PMID:25878565

  14. Autonomic dysfunction in cirrhosis and portal hypertension

    DEFF Research Database (Denmark)

    Dümcke, Christine Winkler; Møller, Søren

    2008-01-01

    Liver cirrhosis and portal hypertension are frequently associated with signs of circulatory dysfunction and peripheral polyneuropathy, which includes defects of the autonomic nervous system. Autonomic dysfunction, which is seen in both alcoholic and non-alcoholic liver cirrhosis and increases wit...... liver disease. A description is given of its aetiology and the typical circulatory dysfunction with characteristic hyperdynamic and hyporeactive circulation and heart failure, and the most important tests of the autonomic nervous system.......Liver cirrhosis and portal hypertension are frequently associated with signs of circulatory dysfunction and peripheral polyneuropathy, which includes defects of the autonomic nervous system. Autonomic dysfunction, which is seen in both alcoholic and non-alcoholic liver cirrhosis and increases...

  15. Nanomedicines for dysfunctional macrophage-associated diseases.

    Science.gov (United States)

    He, Hongliang; Ghosh, Shobha; Yang, Hu

    2017-02-10

    Macrophages play vital functions in host inflammatory reaction, tissue repair, homeostasis and immunity. Dysfunctional macrophages have significant pathophysiological impacts on diseases such as cancer, inflammatory diseases (rheumatoid arthritis and inflammatory bowel disease), metabolic diseases (atherosclerosis, diabetes and obesity) and major infections like human immunodeficiency virus infection. In view of this common etiology in these diseases, targeting the recruitment, activation and regulation of dysfunctional macrophages represents a promising therapeutic strategy. With the advancement of nanotechnology, development of nanomedicines to efficiently target dysfunctional macrophages can strengthen the effectiveness of therapeutics and improve clinical outcomes. This review discusses the specific roles of dysfunctional macrophages in various diseases and summarizes the latest advances in nanomedicine-based therapeutics and theranostics for treating diseases associated with dysfunctional macrophages. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Effects of percutaneous posterior tibial nerve stimulation on voiding dysfunctions in cerebral palsy: A case report

    Directory of Open Access Journals (Sweden)

    Farshideh Alishahi

    2017-01-01

    Full Text Available The present study, conducted on three children with cerebral palsy who had voiding dysfunction. After collecting demographic information, symptoms of voiding dysfunctions were recorded. Then; we did an ultrasonographic evaluation of the bladder to measure residual urine volume. Physiotherapy treatment through percutaneous electrical stimulation of the posterior tibial nerve was performed in 12 sessions. Bladder ultrasonography was repeated after treatment. Abnormal residual urine volume became normal in patients with urinary retention. Percutaneous posterior tibial nerve stimulation reduces symptoms of voiding dysfunctions in children with cerebral palsy

  17. Pupillary Light Reflexes are Associated with Autonomic Dysfunction in Bolivian Diabetics But Not Chagas Disease Patients.

    Science.gov (United States)

    Halperin, Anthony; Pajuelo, Monica; Tornheim, Jeffrey A; Vu, Nancy; Carnero, Andrés M; Galdos-Cardenas, Gerson; Ferrufino, Lisbeth; Camacho, Marilyn; Justiniano, Juan; Colanzi, Rony; Bowman, Natalie M; Morris, Tiffany; MacDougall, Hamish; Bern, Caryn; Moore, Steven T; Gilman, Robert H

    2016-06-01

    Autonomic dysfunction is common in Chagas disease and diabetes. Patients with either condition complicated by cardiac autonomic dysfunction face increased mortality, but no clinical predictors of autonomic dysfunction exist. Pupillary light reflexes (PLRs) may identify such patients early, allowing for intensified treatment. To evaluate the significance of PLRs, adults were recruited from the outpatient endocrine, cardiology, and surgical clinics at a Bolivian teaching hospital. After testing for Chagas disease and diabetes, participants completed conventional autonomic testing (CAT) evaluating their cardiovascular responses to Valsalva, deep breathing, and orthostatic changes. PLRs were measured using specially designed goggles, then CAT and PLRs were compared as measures of autonomic dysfunction. This study analyzed 163 adults, including 96 with Chagas disease, 35 patients with diabetes, and 32 controls. PLRs were not significantly different between Chagas disease patients and controls. Patients with diabetes had longer latency to onset of pupil constriction, slower maximum constriction velocities, and smaller orthostatic ratios than nonpatients with diabetes. PLRs correlated poorly with CAT results. A PLR-based clinical risk score demonstrated a 2.27-fold increased likelihood of diabetes complicated by autonomic dysfunction compared with the combination of blood tests, CAT, and PLRs (sensitivity 87.9%, specificity 61.3%). PLRs represent a promising tool for evaluating subclinical neuropathy in patients with diabetes without symptomatic autonomic dysfunction. Pupillometry does not have a role in the evaluation of Chagas disease patients. © The American Society of Tropical Medicine and Hygiene.

  18. Impact of aging and comorbidity on the efficacy of low-intensity shock wave therapy for erectile dysfunction.

    Science.gov (United States)

    Hisasue, Shin-ichi; China, Toshiyuki; Horiuchi, Akira; Kimura, Masaki; Saito, Keisuke; Isotani, Shuji; Ide, Hisamitsu; Muto, Satoru; Yamaguchi, Raizo; Horie, Shigeo

    2016-01-01

    To evaluate the efficacy of low-intensity shock wave therapy and to identify the predictive factors of its efficacy in Japanese patients with erectile dysfunction. The present study included 57 patients with erectile dysfunction who satisfied all the following conditions: more than 6-months history of erectile dysfunction, sexual health inventory for men score of ≤ 12 without phosphodiesterase type-5 inhibitor, erection hardness score grade 1 or 2, mean penile circumferential change by erectometer assessing sleep related erection of erectile dysfunction. Age and comorbidities are negative predictive factors of therapeutic response. © 2015 The Japanese Urological Association.

  19. Vancouver Symptom Score for Dysfunctional Elimination Syndrome: Reliability and Validity of the Dutch Version.

    Science.gov (United States)

    't Hoen, Lisette A; Korfage, Ida J; Verhallen, Jacintha T C M; van Ledden-Klok, Marjan J; van den Hoek, Joop; Blok, Bertil F M; Scheepe, Jeroen R

    2016-08-01

    We sought to establish the reliability and validity of the Dutch version of the Vancouver Symptom Score for Dysfunctional Elimination Syndrome for children with dysfunctional voiding and their parents. For this cross-sectional multicenter study the Vancouver Symptom Score for Dysfunctional Elimination Syndrome was translated and cross-culturally adapted to Dutch following a standardized process. Patients 16 years or younger with dysfunctional voiding and their parents were recruited at pediatric, pediatric urology and pelvic floor physical therapy outpatient clinics. The reference group consisted of children 6 to 16 years old without dysfunctional voiding and their parents. All groups completed questionnaires. The evaluated measurement properties included discriminative ability, internal consistency, test-retest reliability, interrater agreement, criterion validity using the Pediatric Incontinence Questionnaire and construct validity. A cutoff value for diagnosis of dysfunctional voiding was determined. A total of 50 patients and 60 references and their parents were included in the study. The Vancouver Symptom Score for Dysfunctional Elimination Syndrome showed good discriminative ability. A moderate internal consistency was found (Cronbach alpha 0.37-0.55). Test-retest reliability was moderate to good, and interrater agreement demonstrated good correlation between children and parents (ICC 0.85, 95% CI 0.79-0.89). A weak correlation with the Pediatric Incontinence Questionnaire was found in patients and construct validity was confirmed. Cutoff scores for dysfunctional voiding were 11 and 9 for patients and parents, respectively. The Dutch Vancouver Symptom Score for Dysfunctional Elimination Syndrome displayed moderate to good reliability and validity properties for the patient and parent versions. Use of this instrument in clinical practice will support the assessment of dysfunctional voiding and facilitate international reporting of research results. Copyright

  20. Role of mitochondrial dysfunction in hyperglycaemia-induced coronary microvascular dysfunction: Protective role of resveratrol.

    Science.gov (United States)

    Joshi, Mandar S; Williams, David; Horlock, Duncan; Samarasinghe, Thilini; Andrews, Karen L; Jefferis, Ann-Maree; Berger, Philip J; Chin-Dusting, Jaye P; Kaye, David M

    2015-05-01

    Microvascular complications are now recognized to play a major role in diabetic complications, and understanding the mechanisms is critical. Endothelial dysfunction occurs early in the course of the development of complications; the precise mechanisms remain poorly understood. Mitochondrial dysfunction may occur in a diabetic rat heart and may act as a source of the oxidative stress. However, the role of endothelial cell-specific mitochondrial dysfunction in diabetic vascular complications is poorly studied. Here, we studied the role of diabetes-induced abnormal endothelial mitochondrial function and the resultant endothelial dysfunction. Understanding the role of endothelial mitochondrial dysfunction in diabetic vasculature is critical in order to develop new therapies. We demonstrate that hyperglycaemia leads to mitochondrial dysfunction in microvascular endothelial cells, and that mitochondrial inhibition induces endothelial dysfunction. Additionally, we show that resveratrol acts as a protective agent; resveratrol-mediated mitochondrial protection may be used to prevent long-term diabetic cardiovascular complications. © The Author(s) 2015.

  1. Dysfunctional assumptions in bipolar disorder.

    Science.gov (United States)

    Lam, Dominic; Wright, Kim; Smith, Neil

    2004-04-01

    Despite the initial encouraging outcome in developing CBT for bipolar affective disorder [Arch. Gen. Psychiatry 2002 (in press); Psychol. Med. 31 (2001) 459-467], very little is known about whether there are any differences in dysfunctional attitudes between unipolar and bipolar patients. Both the behavioural activation system theory [J. Pers. Soc. Psychol. 67 (1994) 488-498; Major Theories of Personality Disorder, Guilford Press, New York, 1996; Psychol. Bull. 117 (1995) 434-449] and the cognitive model for bipolar affective disorder [Cognitive Therapy for Bipolar Disorder: A Therapist's Guide to Concepts, Methods and Practise, Wiley, New York, 1999] postulate high goal striving as a risk factor for bipolar disorder. However, the existing subscales in the dysfunctional attitude scale (DAS) were derived from patients and relatives of patients suffering from unipolar depression, patients with a mixed psychiatric diagnosis or normal controls. None of the existing subscales reflects high goal striving beliefs. Using a sample of bipolar patients may yield different factors. A total of 143 bipolar 1 patients filled in the short version of DAS 24. Principal component analysis was carried out to derive factors. The scores of these factors were compared with those of 109 unipolar patients to investigate if these factors distinguish bipolar patients from unipolar patients. Three factors were derived: factor 1 'Goal-attainment' accounted for 25.0% of the total variance. Factor 2 'Dependency' accounted for 11.0% of the total variance. Factor 3 'Achievement' accounted for 8.2% of the total variance. However, factor 1 appeared to consist of items that made a coherent theoretical construct. No significant differences were found when the validation sample was compared with 109 patients suffering from unipolar depression in any of the three factors. When subjects who were likely to be in a major depressive episode were excluded, the scores of bipolar patients (n=49) were

  2. Evaluation of endothelial dysfunction in patients with familial Mediterranean fever: the relationship between the levels of asymmetric dimethylarginine and endocan with carotid intima-media thickness and endothelium-dependent vasodilation.

    Science.gov (United States)

    Ozalper, Veysel; Kara, Muammer; Tanoglu, Alpaslan; Cetındaglı, Ibrahim; Ozturker, Coskun; Hancerlı, Yusuf; Hıra, Serdar; Kara, Kemal; Beyazıt, Yavuz; Yazgan, Yusuf

    2017-09-01

    It has been suggested that there is an ongoing subclinical inflammation in familial Mediterranean fever (FMF) patients also in attack-free periods as well. Due to this ongoing inflammation, endothelial dysfunction (ED) may develop. Previously, ED has been suggested to increase the risk of the atherosclerosis and cardiovascular disease (CVD). Endocan is recognized as a specific molecule of the endothelium and has been shown to increase in some cases associated with inflammation. However, there is not sufficient data whether those with FMF could develop ED in the early period of life. In this study, we aimed to investigate ED and its relation with endocan in young FMF patients. A total of 57 male patients diagnosed with FMF according to the Tel Hashomer criteria and a total of 33 healthy males with similar characteristics to the patient group were included in this research. Complete blood count, erythrocyte sedimentation rate (ESR), fibrinogen, serum glucose, serum LDL cholesterol (LDL-C) and triglyceride (TG), asymmetric dimethylarginine (ADMA), and endocan levels were tested from fasting blood samples. Moreover, carotid intima-media thickness (CIMT) and flow-mediated dilatation (FMD) were measured. The endocan levels of the FMF patients during an attack-free period were significantly higher than those of the control group (p  0.05). CIMT values were similar among FMF patients and healthy controls (p > 0.05). These results have suggested that ED may develop in the patients with FMF who have no additional CVD risk, even during young adulthood, and endocan may be a favorable biomarker at demonstration of ED than ADMA among FMF patients.

  3. Erectile Dysfunction Herbs: A Natural Treatment for ED?

    Science.gov (United States)

    ... erectile dysfunction: A natural treatment for ED? Some herbs claim to help erectile dysfunction. Find out the ... You've likely seen advertisements for erectile dysfunction herbs or supplements to "increase your sexual performance." Could ...

  4. Duration of Thyroid Dysfunction Correlates with All-Cause Mortality

    DEFF Research Database (Denmark)

    Laulund, Anne Sofie; Nybo, Mads; Brix, Thomas Heiberg

    2014-01-01

    INTRODUCTION AND AIM: The association between thyroid dysfunction and mortality is controversial. Moreover, the impact of duration of thyroid dysfunction is unclarified. Our aim was to investigate the correlation between biochemically assessed thyroid function as well as dysfunction duration...

  5. Psychological impact and sexual dysfunction in men with and without spinal cord injury.

    Science.gov (United States)

    Cobo Cuenca, Ana I; Sampietro-Crespo, Antonio; Virseda-Chamorro, Miguel; Martín-Espinosa, Noelia

    2015-02-01

    The World Health Organization recognizes sexual health as a fundamental right that should be guaranteed to all individuals. Sexual dysfunction affects various aspects in the lives (physical, psychic, and social) of affected persons. To assess the different types of sexual dysfunction, the quality of life (QOL), depression, anxiety, and levels of self-esteem observed in 165 men with sexual dysfunction, both with and without spinal cord injury (SCI). Case control study of 85 men with SCI and sexual dysfunction, and 80 men without SCI that have sexual dysfunction. The Sexual Health Evaluation Scale, the Fugl-Meyer Life Satisfaction Questionnaire scale, the Hospital Anxiety and Depression Scale, the Evaluation of the Sexual Health Scale, and Rosenberg's Self-esteem Scale were all used for data collection. Of the members in group A (with SCI), 89.4% (76) showed erectile dysfunction, and 75.2% (64) reported anejaculation. In group B (without SCI), 75 (96.8%) showed erectile dysfunction, and 58.7% (47) had disorders of sexual desire. In group A, 16.47 % (14) showed signs of depression, and 35.3% (30) had signs of anxiety. In group B, 30% (24) had elevated scores regarding depression, and 48.75% (39) had high scores for anxiety. All of the participants reported a high general QOL and a high satisfaction with their QOL but reported that their satisfaction with their sexual lives was only at the acceptable level. Social QOL is significantly higher in the SCI group (t Student P=0.031). The QOL, self-esteem, and anxiety and depression levels are significantly correlated. Men with sexual dysfunction strive to adapt to their situations, with the relationship between the type of sexual dysfunction and the QOL, mood (depression), and self-esteem all being important considerations. Sexuality and employment status are the areas where men with spinal cord injuries report less satisfaction. © 2014 International Society for Sexual Medicine.

  6. Effects of percutaneous posterior tibial nerve stimulation on voiding dysfunctions in cerebral palsy: A case report

    OpenAIRE

    Farshideh Alishahi; Reza Farjad; Farideh Dehghan Manshadi

    2016-01-01

    The present study, conducted on three children with cerebral palsy who had voiding dysfunction. After collecting demographic information, symptoms of voiding dysfunctions were recorded. Then; we did an ultrasonographic evaluation of the bladder to measure residual urine volume. Physiotherapy treatment through percutaneous electrical stimulation of the posterior tibial nerve was performed in 12 sessions. Bladder ultrasonography was repeated after treatment. Abnormal residual urine volume becam...

  7. Neonatal goiter with congenital thyroid dysfunction in two infants diagnosed by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kondoh, Mutsuko [Department of Radiology, St. Marianna University, Seibu Hospital, Kanagawa (Japan); Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa-ken 216-8511 (Japan); Miyazaki, Osamu; Imanishi, Yoshimasa; Hayakawa, Minako [Department of Radiology, St. Marianna University, Seibu Hospital, Kanagawa (Japan); Aikyou, Miho; Doi, Hiromi [Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa (Japan)

    2004-07-01

    It is essential to diagnose thyroid dysfunction at an early stage because congenital hypothyroidism (CH) represents one of the most common preventable causes of delayed physical and psychological development, including mental retardation. US evaluates the shape of the thyroid gland. CT and scintigraphic examinations demonstrate iodine metabolism of the thyroid, but there is associated radiation exposure. We encountered two cases of congenital goiter, in which MRI was very helpful in confirming thyroid dysfunction and was very useful in making an accurate diagnosis. (orig.)

  8. Breathing exercises for dysfunctional breathing/hyperventilation syndrome in children.

    Science.gov (United States)

    Barker, Nicola J; Jones, Mandy; O'Connell, Neil E; Everard, Mark L

    2013-12-18

    -over design. The cross-over design was considered inappropriate due to the purported long-lasting effects of breathing retraining. Children up to the age of 18 years with a clinical diagnosis of dysfunctional breathing were eligible for inclusion. We planned to include children with a primary diagnosis of asthma with the intention of undertaking a subgroup analysis. Children with symptoms secondary to cardiac or metabolic disease were excluded.We considered any type of breathing retraining exercise for inclusion in this review, such as breathing control, diaphragmatic breathing, yoga breathing, Buteyko breathing, biofeedback-guided breathing modification and yawn/sigh suppression. We considered programmes where exercises were either supervised (by parents or a health professional, or both) or unsupervised. We also considered relaxation techniques and acute episode management as long as it was clear that breathing exercises were a component of the intervention.Any intervention without breathing exercises or where breathing exercises were not key to the intervention were excluded. We planned that two authors (NJB and MJ) would extract data independently using a standardised form. Any discrepancies would be resolved by consensus. Where agreement could not be reached a third review author (MLE) would have considered the paper. We identified 264 potential trials and reviews from the search. Following removal of duplicates, we screened 224 papers based on title and abstract. We retrieved six full-text papers and further evaluated them but they did not meet the inclusion criteria. There were, therefore, no studies suitable for inclusion in this review. The results of this systematic review cannot inform clinical practice as no suitable trials were identified for inclusion. Therefore, it is currently unknown whether these interventions offer any added value in this patient group or whether specific types of breathing exercise demonstrate superiority over others. Given that breathing

  9. Myocardial Dysfunction and Shock after Cardiac Arrest

    Science.gov (United States)

    Jentzer, Jacob C.; Chonde, Meshe D.; Dezfulian, Cameron

    2015-01-01

    Postarrest myocardial dysfunction includes the development of low cardiac output or ventricular systolic or diastolic dysfunction after cardiac arrest. Impaired left ventricular systolic function is reported in nearly two-thirds of patients resuscitated after cardiac arrest. Hypotension and shock requiring vasopressor support are similarly common after cardiac arrest. Whereas shock requiring vasopressor support is consistently associated with an adverse outcome after cardiac arrest, the association between myocardial dysfunction and outcomes is less clear. Myocardial dysfunction and shock after cardiac arrest develop as the result of preexisting cardiac pathology with multiple superimposed insults from resuscitation. The pathophysiology involves cardiovascular ischemia/reperfusion injury and cardiovascular toxicity from excessive levels of inflammatory cytokine activation and catecholamines, among other contributing factors. Similar mechanisms occur in myocardial dysfunction after cardiopulmonary bypass, in sepsis, and in stress-induced cardiomyopathy. Hemodynamic stabilization after resuscitation from cardiac arrest involves restoration of preload, vasopressors to support arterial pressure, and inotropic support if needed to reverse the effects of myocardial dysfunction and improve systemic perfusion. Further research is needed to define the role of postarrest myocardial dysfunction on cardiac arrest outcomes and identify therapeutic strategies. PMID:26421284

  10. Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction

    Directory of Open Access Journals (Sweden)

    Rodrigo Pedraza

    2014-01-01

    Full Text Available Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR is a noninvasive modality involving cognitive reeducation, modification, and retraining of the pelvic floor and associated musculature. We describe our standardized PMR protocol for the management of pelvic floor dysfunction syndromes. Pelvic Muscle Rehabilitation Program. The diagnostic assessment includes electromyography and manometry analyzed in 4 phases: (1 initial baseline phase; (2 rapid contraction phase; (3 tonic contraction and endurance phase; and (4 late baseline phase. This evaluation is performed at the onset of every session. PMR management consists of 6 possible therapeutic modalities, employed depending on the diagnostic evaluation: (1 down-training; (2 accessory muscle isolation; (3 discrimination training; (4 muscle strengthening; (5 endurance training; and (6 electrical stimulation. Eight to ten sessions are performed at one-week intervals with integration of home exercises and lifestyle modifications. Conclusions. The PMR protocol offers a standardized approach to diagnose and manage pelvic floor dysfunction syndromes with potential advantages over traditional biofeedback, involving additional interventions and a continuous pelvic floor assessment with management modifications over the clinical course.

  11. Small fiber dysfunction in patients with Wilson's disease

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    Francisco de Assis A. Gondim

    2014-08-01

    Full Text Available Objective: Patients with Wilson’s disease (WD may develop a wide variety of neuropsychiatric symptoms, but there are few reports of autonomic dysfunction. Here, we described evidence of small fiber and/or autonomic dysfunction in 4 patients with WD and levodopa-responsive parkinsonism. Method: We reviewed the charts of 4 patients with WD who underwent evaluation for the presence of neuromuscular dysfunction and water-induced skin wrinkling test (SWT. Results: Two men and 2 women (33±3.5 years with WD were evaluated. They all had parkinsonism at some point during their disease course. Parkinsonism on patient 4 almost completely subsided with treatment of WD. Two patients had significant sensory and 2 significant autonomic complaints, including syncopal spells. NCS/EMG was normal in all but SWT was abnormal in half of them (mean 4-digit wrinkling of 0.25 and 1. Discussion: A subset of patients with WD exhibit evidence of abnormal skin wrinkling test (small fiber neuropathy.

  12. Diastolic Dysfunction and Severity of Cirrhosis in Nonalcoholic Cirrhotic Patients

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    A. Salari

    2013-01-01

    Full Text Available Background. In this study, we evaluated the association between diastolic dysfunction severity and severity of cirrhosis in nonalcoholic cirrhotic patients. Methods. This cross-sectional study was conducted on all nonalcoholic cirrhotic patients who were admitted in Rasht Razi hospital the Cancer of Guilan Province, north of Iran, from January 2011 to March 2012. Severity of cirrhosis was evaluated by Child-Pugh score. A 12-lead surface ECG and echocardiographic studies were performed. We used a HDI 3000 (Philips ATL, Bothell, WA, USA equipped with 2 to 4 MHz probes. Diastolic function was determined by an expert cardiac sonographer. Data were analyzed by SPSS for win (version16. A P value less than 0.05 was considered significant. Results. Sixty-tree percent of patients were male. The mean age of patients was 52.78±15.2 years. 22%, 38%, and 40% of patients were considered as child class A, B, and C, respectively. There was a significant relation between diastolic dysfunction and disease duration (P=0.001, female gender (P=0.004, age > 60 years (P=0.045, and severity of cirrhosis (P=0.048. On multivariate analysis, decreased E/A ratio (P=0.03 and disease duration (P=0.02 showed an independent significant relation. Conclusion. According to the relation between severity of cirrhosis and diastolic dysfunction, we recommend cardiac assessment in all child B and C cirrhotic patients.

  13. Dysfunctional Attitudes in Alcohol Dependents: A Comparative Study

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    Görkem Karakaþ Uðurlu

    2012-08-01

    Full Text Available Objective: Cognitive behavioral theory provides a theoretical framework for understanding the etiology and persistence of pathological drinking, and a conceptual basis for developing clinical techniques to treat the disorder. In line with this scope, we aimed to investigate the cognitive properties of alcohol dependence. Method: Two groups composed of seventy-nine inpatients with a diagnosis of alcohol dependence and thirty one healthy controls who were using alcohol, but not filling the requirements of alcohol dependence diagnosis were included in this study. Dysfunctional attitudes scale (DAS was given to both groups for detection of dysfunctional cognition. At the same time, alcohol dependent group was evaluated using Structured Clinical Interview for DSM-III-R-Axis-I and Axis-II (SCID I and II. The data was evaluated using SPSS 17. Results: DAS total scores and perfectionist attitudes, need for approval and independent attitudes subscores were significantly higher in patients than healthy controls. In addition, a significant correlation was detected between DAS total scores, and the age of emergence of alcohol dependence. Conclusion: As a result of the study, it can be concluded that concluded with literature, alcohol dependent patients have dysfunctional beliefs. In particular, a relation was detected between alcohol dependence and perfectionist attitude, need for approval and independent attitudes. [JCBPR 2012; 1(2.000: 113-120

  14. The anatomy of group dysfunction.

    Science.gov (United States)

    Hayes, David F

    2014-04-01

    The dysfunction of the radiology group has 2 components: (1) the thinking component-the governance structure of the radiology group; how we manage the group; and (2) the structural component-the group's business model and its conflict with the partner's personal business model. Of the 2 components, governance is more important. Governance must be structured on classic, immutable business management principles. The structural component, the business model, is not immutable. In fact, it must continually change in response to the marketplace. Changes in the business model should occur only if demanded or permitted by the marketplace; instituting changes for other reasons, including personal interests or deficient knowledge of the deciders, is fundamentally contrary to the long-term interests of the group and its owners. First, we must learn basic business management concepts to appreciate the function and necessity of standard business models and standard business governance. Peter Drucker's The Effective Executive is an excellent primer on the subjects of standard business practices and the importance of a functional, authorized, and fully accountable chief executive officer. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  15. Neurostimulation for Neurogenic Bowel Dysfunction

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    J. Worsøe

    2013-01-01

    Full Text Available Background. Loss of normal bowel function caused by nerve injury, neurological disease or congenital defects of the nervous system is termed neurogenic bowel dysfunction (NBD. It usually includes combinations of fecal incontinence, constipation, abdominal pain and bloating. When standard treatment of NBD fails surgical procedures are often needed. Neurostimulation has also been investigated, but no consensus exists about efficacy or clinical use. Methods. A systematic literature search of NBD treated by sacral anterior root stimulation (SARS, sacral nerve stimulation (SNS, peripheral nerve stimulation, magnetic stimulation, and nerve re-routing was made in Pubmed, Embase, Scopus, and the Cochrane Library. Results. SARS improves bowel function in some patients with complete spinal cord injury (SCI. Nerve re-routing is claimed to facilitate defecation through mechanical stimulation of dermatomes in patients with complete or incomplete SCI or myelomeningocele. SNS can reduce NBD in selected patients with a variety of incomplete neurological lesions. Peripheral stimulation using electrical stimulation or magnetic stimulation may represent non-invasive alternatives. Conclusion. Numerous methods of neurostimulation to treat NBD have been investigated in pilot studies or retrospective studies. Therefore, larger controlled trials with well-defined inclusion criteria and endpoints are recommended before widespread clinical use of neurostimulation against NBD.

  16. Swallowing dysfunction in cancer patients.

    Science.gov (United States)

    Raber-Durlacher, Judith E; Brennan, Mike T; Verdonck-de Leeuw, Irma M; Gibson, Rachel J; Eilers, June G; Waltimo, Tuomas; Bots, Casper P; Michelet, Marisol; Sollecito, Thomas P; Rouleau, Tanya S; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C; Silverman, Sol; Spijkervet, Fred K L

    2012-03-01

    Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools, prevalence, complications, and impact on quality of life in patients with a variety of different cancers, particularly in those treated with curative chemoradiation for head and neck cancer. The literature search was limited to the English language and included both MEDLINE/PubMed and EMBASE. The search focused on papers reporting dysphagia as a side effect of cancer and cancer therapy. We identified relevant literature through the primary literature search and by articles identified in references. A wide range of assessment tools for dysphagia was identified. Dysphagia is related to a number of factors such as direct impact of the tumor, cancer resection, chemotherapy, and radiotherapy and to newer therapies such as epidermal growth factor receptor inhibitors. Concomitant oral complications such as xerostomia may exacerbate subjective dysphagia. Most literature focuses on head and neck cancer, but dysphagia is also common in other types of cancer. Swallowing impairment is a clinically relevant acute and long-term complication in patients with a wide variety of cancers. More prospective studies on the course of dysphagia and impact on quality of life from baseline to long-term follow-up after various treatment modalities, including targeted therapies, are needed.

  17. Sleep apnoea and metabolic dysfunction

    Directory of Open Access Journals (Sweden)

    Maria R. Bonsignore

    2013-09-01

    Full Text Available Obstructive sleep apnoea (OSA is a highly prevalent condition often associated with central obesity. In the past few years, several studies have analysed the potential independent contribution of OSA to the pathogenesis of metabolic abnormalities, including type 2 diabetes, the metabolic syndrome and non-alcoholic fatty liver disease. New perspectives in OSA patient care have been opened by the promotion of lifestyle interventions, such as diet and exercise programmes that could improve both OSA and the metabolic profile. The rich clinical literature on this subject, together with the growing amount of data on pathophysiological mechanisms provided by animal studies using the chronic intermittent hypoxia model, urged the organising Committee of the Sleep and Breathing meeting to organise a session on sleep apnoea and metabolic dysfunction, in collaboration with the European Association for the Study of Diabetes. This review summarises the state-of-the-art lectures presented in the session, more specifically the relationship between OSA and diabetes, the role of OSA in the metabolic consequences of obesity, and the effects of lifestyle interventions on nocturnal respiratory disturbances and the metabolic profile in OSA patients.

  18. Polyphenols in preventing endothelial dysfunction

    Directory of Open Access Journals (Sweden)

    Sylwia Biegańska-Hensoldt

    2017-03-01

    Full Text Available One of the main causes of mortality in developed countries is atherosclerosis. The pathogenesis of atherosclerosis is associated with endothelial dysfunction. Consumption of food rich in natural antioxidants including polyphenols significantly improves endothelial cells functions.Polyphenols have a beneficial effect on the human body and play an important part in protecting the cardiovascular system. Polyphenols present in food have antioxidant, anti-inflammatory, antihypertensive, antithrombotic and antiproliferative properties. Catechins cause an increase in the activity of endothelial nitric oxide synthase (eNOS and increased production of nitric oxide (NO and decrease in blood pressure. Catechins also reduce platelet adhesion, lower the concentration of C-reactive protein and tumor necrosis factor alpha and interleukin-6. Resveratrol inhibits NADPH oxidase expression, increases the expression of eNOS and NO production as well as decreases the expression of proinflammatory cytokines, and also lowers the concentration of the soluble forms of adhesion molecules – sICAM-1 and sVCAM-1 in blood. Quercetin reduces the blood level of low density lipoprotein cholesterol, lowers blood pressure, reduces the concentration of C-reactive protein and F2-isoprostane level. Curcumin has antagonistic activity to homocysteine. Curcumin increases the expression of eNOS and reduces oxidative DNA damage in rat cardiomyocytes. Numerous attempts are taken for improving the bioavailability of polyphenols in order to increase their use in the body.

  19. TREM-1 Promotes Pancreatitis-Associated Intestinal Barrier Dysfunction

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    Shengchun Dang

    2012-01-01

    Full Text Available Severe acute pancreatitis (SAP can cause intestinal barrier dysfunction (IBD, which significantly increases the disease severity and risk of mortality. We hypothesized that the innate immunity- and inflammatory-related protein-triggering receptor expressed on myeloid cells-1 (TREM-1 contributes to this complication of SAP. Thus, we investigated the effect of TREM-1 pathway modulation on a rat model of pancreatitis-associated IBD. In this study we sought to clarify the role of TREM-1 in the pathophysiology of intestinal barrier dysfunction in SAP. Specifically, we evaluated levels of serum TREM-1 and membrane-bound TREM-1 in the intestine and pancreas from an animal model of experimentally induced SAP. TREM-1 pathway blockade by LP17 treatment may suppress pancreatitis-associated IBD and ameliorate the damage to the intestinal mucosa barrier.

  20. Impact of thyroid hormone dysfunction on periodontal disease

    Directory of Open Access Journals (Sweden)

    Shaila Kothiwale

    2016-01-01

    Full Text Available Thyroid hormones play an important role in the regulation of physiologic processes. Thyroid dysfunction is the second most common glandular disorder of the endocrine system and is increasing predominantly among women. Thyroid disease can lead to imbalance in the homeostasis of the body and affect the healing capacity of tissues. However, limited data are available regarding the relationship between thyroid hormone imbalance and periodontal health. This case report presents the influence of thyroid hormone dysfunction and its impact on periodontal disease progression, systemic health of the patient, and the management of periodontal disease. The report emphasizes the need for frequent professional evaluations, patient education, and consistent educational reinforcement by health care providers in patients with hypothyroidism.

  1. ISCHEMIC HEART DISEASE AND RENAL DYSFUNCTION

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    F. I. Belyalov

    2017-01-01

    Full Text Available The ischemic heart disease (IHD with comorbid kidney dysfunction has more severe course and worse prognosis, regardless of the chosen therapeutic strategy for the treatment of coronary disease. Traits of diagnosis and treatment of IHD in patients with renal dysfunction, including end-stage kidney disease, are discussed. The analysis of the studies showed increasing difficulties in the diagnosis of IHD, and decrease in the effectiveness of drug and invasive treatment.Results of large randomized and observational studies can help to treat patients with IHD and comorbid renal dysfunction more effectively and safe. 

  2. Etiology and Management of Sexual Dysfunction

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    Narendra Kumar Muthugaduru Shivarudrappa

    2009-09-01

    Full Text Available Sexual dysfunction is the impairment or disruption of any of the three phases of normal sexual functioning, including loss of libido, impairment of physiological arousal and loss, delay or alteration of orgasm. Each one of these can be affected by an orchestra of factors like senility, medical and surgical illnesses, medications and drugs of abuse. Non-pharmacological therapy is the main stay in the treatment of sexual dysfunction and drugs are used as adjuncts for a quicker and better result. Management in many of the cases depends on the primary cause. Here is a review of the major etiological factors of sexual dysfunction and its management

  3. Physical therapy in the management of myofacial pain dysfunction syndrome.

    Science.gov (United States)

    Talaat, A M; el-Dibany, M M; el-Garf, A

    1986-01-01

    A study of the effectiveness of physical therapy for patients with myofacial pain dysfunction syndrome was performed. Clinical evaluation of 120 patients revealed marked male preponderance, distribution according to age showed a great prevalence of the third decade, and most common chief complaints were pain and muscle tenderness. Patients were classified randomly into three equal groups treated by muscle relaxant drugs, shortwave diathermy, and ultrasonic therapy, respectively. Regular follow-up was carried out for 6 to 12 months to assess patients' responses to different forms of treatment. Evaluation revealed marked relief of symptoms by the use of physical therapy, and the best results were obtained by the use of ultrasonic therapy.

  4. Management of sexual dysfunction due to central nervous system disorders: a systematic review.

    Science.gov (United States)

    Lombardi, Giuseppe; Musco, Stefania; Kessler, Thomas M; Li Marzi, Vincenzo; Lanciotti, Michele; Del Popolo, Giulio

    2015-04-01

    To systematically review the management of sexual dysfunction due to central nervous system (CNS) disorders. The review was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were identified independently by two reviewers using electronic searches of MEDLINE and OVID (from January 2004 to August 2014) and hand searches of reference lists and review articles. In patients with CNS disorders, neuro-urological assessment is recommended for both genders before starting any treatment for sexual dysfunction. For men, blood sexual hormones evaluation is the main investigation performed before phosphodiesterase type 5 inhibitors (PDE5Is) treatment, whereas there is no consensus on routine laboratory tests for women. PDE5Is are the first-line medical treatment for men, with the most robust data derived from patients with spinal cord injury assessed by validated questionnaires, mainly the International Index of Erectile Function-15. There is no effective medical treatment for sexual dysfunction in women. Sacral neuromodulation for lower urinary tract dysfunction may improve sexual dysfunction in both genders. Although sexual dysfunction is a major burden for patients with CNS disorders, high-evidence level studies are rare and only available for PDE5Is treating erectile dysfunction. Well-designed prospective studies are urgently needed for both genders. © 2015 The Authors. BJU International © 2015 BJU International.

  5. Erectile dysfunction in methadone maintenance patients: a cross sectional study in northern iran.

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    Seyed Hamzeh Hosseini

    2013-12-01

    Full Text Available Erectile dysfunction affects quality of life and is a common dysfunction in drug abusers. The aim of this study was to evaluate the frequency of erectile dysfunction in drug abusers on methadone maintenance therapy to reduce this drug side effect in the future studies.This cross-sectional study was conducted with two hundred addicted individuals on methadone maintenance therapy. Erectile dysfunction was surveyed using the International Index of Erectile Function (IIEF. Finally, all data were collected and analyzed by descriptive statistics such as measures of variability and central tendency and Chi-squared (χ(2 test using SPSS Version18.0 software.The amount of the total frequency of erectile dysfunction was pointed 30 or less among the two hundred patients and included the moderate and severe cases. In this study, the number of patients with erectile dysfunction was fifty three (26.5%.The frequency of erectile dysfunction in our study was approximately 1.5 times of prevalence of the public (16.1%. In this study, all the factors related to sexual function such as erectile function, libido, orgasm, and sexual pleasure showed a decline among drug abusers.

  6. Executive dysfunction in late-onset depression.

    Science.gov (United States)

    Pisljar, Marko; Pirtosek, Z; Repovs, G; Grgic, M

    2008-06-01

    Depression in the elderly is frequently accompanied by cognitive impairment. Executive dysfunction, including disturbances in planning, sequencing, organizing and abstracting has been reported in late-onset depression. They were found to be associated with relapse and recurrence of geriatric major depression and with residual depressive symptoms. A group of patients with late-onset depression, compared with age matched healthy volunteers, were assessed for deficits in executive functioning. We used the computer version of Stroop Color-Word test enabling more detailed reaction time analysis. Severity of depression was evaluated with Hamilton depression rating scale and Geriatric depression scale. The preliminary results of a study show that patients with late-onset depression have increased absolute reaction times in Stroop colour-word test. Significant differences in the magnitude of individual interference effects pointing towards a characteristic change in attentional processes in depressed patients. The preliminary results of a study comparing a group of elderly depressed patients with a control group of older healthy volunteers confirm changes in executive functions.

  7. Adenosine prevents isoprenaline-induced cardiac contractile and electrophysiological dysfunction.

    Science.gov (United States)

    Shao, Yangzhen; Redfors, Björn; Mattson-Hultén, Lillemor; Scharing Täng, Margareta; Daryoni, Elma; Said, Mohammed; Omerovic, Elmir

    2013-10-15

    Excessive levels of catecholamines are believed to contribute to cardiac dysfunction in a variety of disease states, including myocardial infarction and heart failure, and are particularly implicated in stress-induced cardiomyopathy, an increasingly recognized cardiomyopathy associated with significant morbidity and mortality. We have previously shown that a high dose of isoprenaline induces reversible regional dysfunction of the left ventricle in mice. We now hypothesize that adenosine can prevent cardiac dysfunction in this mouse model of stress-induced cardiomyopathy. Hundred male C57BL/6 mice were injected with 400mg/kg isoprenaline and then randomized to either 400mg/kg adenosine or saline. Cardiac function was evaluated by echocardiography at baseline and 2, 24, 48, 72, 96 and 120 min post isoprenaline. Myocardial fibrosis was quantified after 10 days. Intracellular lipid accumulation was quantified after 2 and 24h. Electrophysiological parameters and degree of lipid accumulation were evaluated in cultured HL1 cardiomyocytes. Two hours post isoprenaline treatment, echocardiographic parameters of global and posterior wall regional function were significantly better in adenosine-treated mice (P<0.05). This difference persisted at 24h, but saline-treated mice gradually recovered over the next 96 h. Intracellular lipid accumulation was also significantly lower in adenosine mice. We found no sign of fibrosis in the adenosine mice, whereas the extent of fibrosis in isoprenaline mice was 1.3% (P<0.05). Furthermore, adenosine-treated HL1 cells showed preserved electrophysiological function and displayed less severe intracellular lipid accumulation in response to isoprenaline. In conclusion, adenosine attenuates isoprenaline-induced cardiac dysfunction in mice and cells. © 2013 Elsevier B.V. All rights reserved.

  8. Performance Evaluations in Audit Firms

    DEFF Research Database (Denmark)

    Riise Johansen, Thomas; Christoffersen, Jeppe

    2017-01-01

    Previous research has only minimally examined the association between the behaviour and performance evaluations of individual auditors beyond the use of efficiency-focused evaluations. We examine the association between dysfunctional auditor behaviour and three evaluation foci: an efficiency focu...

  9. Animal models of brain dysfunction in phenylketonuria

    NARCIS (Netherlands)

    Martynyuk, A. E.; van Spronsen, F. J.; Van der Zee, E. A.

    2010-01-01

    Phenylketonuria (PKU) is a metabolic disorder that results in significant brain dysfunction if untreated. Although phenylalanine restricted diets instituted at birth have clearly improved PKU outcomes, neuropsychological deficits and neurological changes still represent substantial problems. The

  10. [Urological dysfunction after sexual abuse and violence].

    Science.gov (United States)

    Berberich, H J; Neubauer, H

    2004-03-01

    Criminal statistics say that 300,000 children are sexually abused in the Federal Republic of Germany every year: 70-75% are abused by their own fathers or another psychological parent. Most victims are girls aged 7-12 years. Sexual abuse during childhood can lead to severe psychosomatic dysfunctions both in children and adults. Possible long-term results are depression, anxiety, emotional and cognitive problems, personal dysfunction, eating and sleeping disorders, alcohol or drug abuse, relationship problems, social maladaptation, and somatizations. Many urological dysfunctions without organic findings can be caused by sexual abuse. Among others, chronic pelvic pain (CPPS), enuresis, incontinence, and sexual dysfunction can occur. When children or adults see the urologist because of their symptoms there is always the danger of reproducing the abusive event by invasive diagnostic methods.Sometimes harming themselves the patients bring this situation about unconsciously. With the following article we want to heighten the awareness among urologists.

  11. Udenafil for the treatment of erectile dysfunction

    National Research Council Canada - National Science Library

    Cho, Min Chul; Paick, Jae-Seung

    2014-01-01

    Erectile dysfunction (ED) is often perceived by both patients and sexual partners as a serious problem that can jeopardize quality of life, psychosocial or emotional well-being, and the partnership in the long term...

  12. Mitochondrial dysfunction underlying outer retinal diseases

    DEFF Research Database (Denmark)

    Lefevere, Evy; Toft-Kehler, Anne Katrine; Vohra, Rupali

    2017-01-01

    Dysfunction of photoreceptors, retinal pigment epithelium (RPE) or both contribute to the initiation and progression of several outer retinal disorders. Disrupted Müller glia function might additionally subsidize to these diseases. Mitochondrial malfunctioning is importantly associated with outer...

  13. Olfactory dysfunction in Iranian diabetic patients.

    Directory of Open Access Journals (Sweden)

    Jalal Mehdizadeh Seraj

    2015-04-01

    Full Text Available Olfactory dysfunction is a known complication of diabetes and, despite its importance in the quality of life, is usually neglected due to its gradual progression. In this study, we aim to determine the prevalence and severity of olfactory dysfunction in diabetics and its association with microangiopathic complications of the disease (neuropathy, nephropathy, and retinopathy. Excluding the confounding factors, a case-control study of 60 eligible subjects, divided into a group of 30 diabetic patients and a group of 30 control subjects was performed. We used "absorbent perfumer's paper strips" method to test the olfactory threshold. In our study, 60% of diabetics were found to have some degree of olfactory dysfunction and a significant difference (P<0.01 between the olfactory threshold of the case and control groups was observed. There were no significant associations between the olfactory dysfunction and age, sex, treatment duration and microangiopathic complications.

  14. Erectile Dysfunction: A Sign of Heart Disease?

    Science.gov (United States)

    ... cause erectile dysfunction. Alcohol Use. Drinking too much alcohol can cause heart disease and might contribute to other causes of heart disease, such as high blood pressure or abnormal cholesterol. Alcohol also impairs erections. High blood pressure. Over time, ...

  15. Screening for cognitive dysfunction in unipolar depression

    DEFF Research Database (Denmark)

    Ott, Caroline Vintergaard; Bjertrup, Anne Juul; Jensen, Johan Høy

    2016-01-01

    with the executive skills domain only (r =-0.3, p=0.05). LIMITATIONS: A modest sample size. CONCLUSIONS: The SCIP-D and COBRA are valid measures of objective and subjective cognitive impairment, respectively, and should ideally be implemented together in the screening for cognitive dysfunction in UD.......BACKGROUND: Persistent cognitive dysfunction in unipolar depression (UD) contributes to socio-occupational impairment, but there are no feasible methods to screen for and monitor cognitive dysfunction in this patient group. The present study investigated the validity of two new instruments...... to screen for cognitive dysfunction in UD, and their associations with socio-occupational capacity. METHOD: Participants (n=53) with UD in partial or full remission and healthy control persons (n=103) were assessed with two new screening instruments, the Danish translations of the Screen for Cognitive...

  16. Study of pulmonary dysfunctions in liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Amr M. Helmy

    2014-10-01

    Conclusion: Liver cirrhosis is associated with unique pulmonary complications. The early identification of pulmonary dysfunctions in cirrhotic patients is crucial as it affects the prognosis and guides the future management by speeding up orthotopic liver transplantation (OLT recommendations.

  17. Erectile dysfunction in the cardiovascular patient

    National Research Council Canada - National Science Library

    Vlachopoulos, Charalambos; Jackson, Graham; Stefanadis, Christodoulos; Montorsi, Piero

    2013-01-01

    Erectile dysfunction is common in the patient with cardiovascular disease. It is an important component of the quality of life and it also confers an independent risk for future cardiovascular events...

  18. Erectile Dysfunction: Viagra and Other Oral Medications

    Science.gov (United States)

    Erectile dysfunction: Viagra and other oral medications By Mayo Clinic Staff Oral medications are often the first line of treatment for ... medications work well and cause few side effects. Sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) and avanafil ( ...

  19. The relationship between temporomandibular dysfunction and head and cervical posture.

    Science.gov (United States)

    Matheus, Ricardo Alves; Ramos-Perez, Flávia Maria de Moraes; Menezes, Alynne Vieira; Ambrosano, Gláucia Maria Bovi; Haiter-Neto, Francisco; Bóscolo, Frab Norberto; de Almeida, Solange Maria

    2009-01-01

    This study aimed to evaluate the possibility of any correlation between disc displacement and parameters used for evaluation of skull positioning in relation to the cervical spine: craniocervical angle, suboccipital space between C0-C1, cervical curvature and position of the hyoid bone in individuals with and without symptoms of temporomandibular dysfunction. The patients were evaluated following the guidelines set forth by RDC/TMD. Evaluation was performed by magnetic resonance imaging for establishment of disc positioning in the temporomandibular joints (TMJs) of 30 volunteer patients without temporomandibular dysfunction symptoms and 30 patients with symptoms. Evaluation of skull positioning in relation to the cervical spine was performed on lateral cephalograms achieved with the individual in natural head position. Data were submitted to statistical analysis by Fisher's exact test at 5% significance level. To measure the degree of reproducibility/agreements between surveys, the kappa (K) statistics was used. Significant differences were observed between C0-C1 measurement for both symptomatic (p=0.04) and asymptomatic (p=0.02). No statistical differences were observed regarding craniocervical angle, C1-C2 and hyoid bone position in relation to the TMJs with and without disc displacement. Although statistically significant difference was found in the C0-C1 space, no association between these and internal temporomandibular joint disorder can be considered. Based on the results observed in this study, no direct relationship could be determined between the presence of disc displacement and the variables assessed.

  20. Towards an analysis of dysfunctional grammar.

    Science.gov (United States)

    Rigaudeau-McKenna, B

    2005-01-01

    This article applies Systemic Functional Linguistics (SFL) to the study of language dysfunction. It demonstrates the potential that Systemic Functional analysis can offer to one aspect of the analysis of language dysfunction--the failure to realise complexes of clauses. For the purpose of analysis, new concepts and new measures have been created. The newly defined concepts and measures are illustrated in the discourse data of normally developing children and adolescents with brain injury.

  1. The role of dysfunctional HDL in atherosclerosis.

    Science.gov (United States)

    Navab, Mohamad; Reddy, Srinivasa T; Van Lenten, Brian J; Anantharamaiah, G M; Fogelman, Alan M

    2009-04-01

    This review focuses on HDL function in modulating LDL oxidation and LDL-induced inflammation. Dysfunctional HDL has been identified in animal models and humans with chronic inflammatory diseases including atherosclerosis. The loss of antiinflammatory function correlated with a loss of function in reverse cholesterol transport. In animal models and perhaps in humans, dysfunctional HDL can be improved by apoA-I mimetic peptides that bind oxidized lipids with high affinity.

  2. The role of dysfunctional HDL in atherosclerosis

    OpenAIRE

    Navab, Mohamad; Reddy, Srinivasa T.; Van Lenten, Brian J.; Anantharamaiah, G. M.; Fogelman, Alan M.

    2009-01-01

    This review focuses on HDL function in modulating LDL oxidation and LDL-induced inflammation. Dysfunctional HDL has been identified in animal models and humans with chronic inflammatory diseases including atherosclerosis. The loss of antiinflammatory function correlated with a loss of function in reverse cholesterol transport. In animal models and perhaps in humans, dysfunctional HDL can be improved by apoA-I mimetic peptides that bind oxidized lipids with high affinity.

  3. [Endothelial dysfunction in pathogenesis of duodenal ulcer].

    Science.gov (United States)

    Oparin, A G; Oparin, A A

    2002-01-01

    It is shown that in patients with ulcer associated with Helicobacter pylori (HP) there is a close correlation between the severity of the lesion of gastroduodenal protective mucous barrier and that of endothelial dysfunction manifesting in elevated level of endothelin-1, serum levels of TBK-active products, inhibition of blood flow and narrowing of the celiac trunk. The correlation becomes stronger with expanding contamination of gastroduodenal mucosa with HP. Thus, HP may participate in breaking the protective mucous barrier in endothelial dysfunction.

  4. Trichotillomania In A Patient With Sexual Dysfunction

    Directory of Open Access Journals (Sweden)

    Aswathi Krishna

    2016-10-01

    Full Text Available Trichotillomania is a chronic psychiatric disorder characterized by pulling out one's own hair, which results in an obvious loss of hair. Hair pulling was first described in Henri Allopeau in 1889. The term "trichotillomania" comes from the Greek words "thrix" - hair, "tillein" - to pull and "Mania" madness or frenzy. 30 year old man presented with complaints of hairpulling behavior and associated erectile dysfunction. His hairpulling behavior improved on treating his sexual dysfunction.

  5. Amiodarone-induced thyroid dysfunction: brand-name versus generic formulations

    Science.gov (United States)

    Tsadok, Meytal A.; Jackevicius, Cynthia A.; Rahme, Elham; Essebag, Vidal; Eisenberg, Mark J.; Humphries, Karin H.; Tu, Jack V.; Behlouli, Hassan; Joo, Jennifer; Pilote, Louise

    2011-01-01

    Background: Amiodarone is associated with dysfunction of the thyroid. Concerns have arisen regarding the potential for adverse effects with generic formulations of amiodarone. We evaluated and compared the risk of thyroid dysfunction between patients using brand-name versus generic formulations of amiodarone and identified risk factors for thyroid dysfunction. Methods: We conducted a retrospective cohort study of patients with atrial fibrillation aged 66 years and older. We used administrative databases that linked information on demographics and clinical characteristics, claims for prescription drugs and discharges from hospital. We estimated thyroid dysfunction using person-year incidence. Results: Of the 60 220 patients in the cohort, 2804 (4.7%) used the brand-name formulation of amiodarone and 6278 (10.4%) used the generic formulation. Baseline characteristics between these two groups were comparable. The median maintenance dose of amiodarone was 200 mg/d for both groups. The total incidence rate for thyroid dysfunction was 14.1 per 100 person-years for both formulations. The mean time to clinical dysfunction of the thyroid was 4.32 years for the brand-name formulation and 4.09 years for the generic formulation. In a multivariate analysis, there was no significant difference in the incidence rates of thyroid dysfunction between the generic and brand formulations (hazard ratio 0.97, 95% confidence interval 0.87–1.08). Factors associated with an increased risk of thyroid dysfunction were being a woman, increasing age and having chronic obstructive pulmonary disease. Interpretation: In this population-based study, we saw no difference between brand-name and generic formulations of amiodarone in terms of incidence of thyroid dysfunction. PMID:21746822

  6. High Triglycerides Predicts Arteriogenic Erectile Dysfunction and Major Adverse Cardiovascular Events in Subjects With Sexual Dysfunction.

    Science.gov (United States)

    Corona, Giovanni; Cipriani, Sarah; Rastrelli, Giulia; Sforza, Alessandra; Mannucci, Edoardo; Maggi, Mario

    2016-09-01

    The atherogenic role of triglycerides (TG) remains controversial. The aim of the present study is to analyze the contribution of TG in the pathogenesis of erectile dysfunction (ED) and to verify the value of elevated TG in predicting major adverse cardiovascular events (MACE). An unselected series of 3,990 men attending our outpatient clinic for sexual dysfunction was retrospectively studied. A subset of this sample (n = 1,687) was enrolled in a longitudinal study. Several clinical, biochemical, and instrumental (penile color Doppler ultrasound; PCDU) factors were evaluated. Among the patients studied, after adjustment for confounders, higher TG levels were associated with arteriogenic ED and a higher risk of clinical and biochemical hypogonadism. Conversely, no association between TG and other sexual dysfunctions was observed. When pathological PCDU parameters-including flaccid acceleration (<1.17 m/sec(2)) or dynamic peak systolic velocity (PSV <35 cm/sec)-were considered, the negative association between impaired penile flow and higher TG levels was confirmed, even when subjects taking lipid-lowering drugs or those with diabetes were excluded from the analysis (OR = 6.343 [1.243;32.362], P = .026 and 3.576 [1.104;11.578]; P = .34 for impaired acceleration and PSV, respectively). Similarly, when the same adjusted models were applied, TG levels were associated with a higher risk of hypogonadism, independently of the definition criteria (OR = 2.892 [1.643;5.410], P < .0001 and 4.853 [1.965;11.990]; P = .001 for total T <12 and 8 nM, respectively). In the longitudinal study, after adjusting for confounders, elevated TG levels (upper quartile: 162-1686 mg/dL) were independently associated with a higher incidence of MACE (HR = 2.469 [1.019;5.981]; P = .045), when compared to the rest of the sample. Our data suggest an association between elevated TG and arteriogenic ED and its cardiovascular (CV) risk stratification. Whether the use of TG lowering drugs

  7. Analysis of kidney dysfunction in orthopaedic patients

    Directory of Open Access Journals (Sweden)

    Kateros Konstantinos

    2012-09-01

    Full Text Available Abstract Backround This retrospective study was undertaken to determine the incidence of kidney dysfunction (KD and to identify potential risk factors contributing to development of KD in orthopaedic population following an elective or emergency surgery. Methods A total of 1025 patients were admitted in our institution over a period of one year with various indications. Eight hundred and ninety-three patients (87.1% had a surgical procedure. There were 42 (52.5% male and 38 (47.5% female with a mean age of 72 years (range: 47 to 87 years. We evaluated the following potential risk factors: age, comorbidities, shock, hypotension, heart failure, medications (antibiotics, NSAIDs, opiates, rhabdomyolysis, imaging contrast agents and pre-existing KD. Results The overall incidence of KD was 8.9%. Sixty-eight patients developed acute renal injury (AKI and 12 patients developed acute on chronic kidney disease (CKD. In sixty-six (82.5% patients renal function was reversed to initial preoperative status. Perioperative dehydration (p = 0.002, history of diabetes mellitus (p = 0.003, pre-existing KD (p = 0.004, perioperative shock (p = 0.021 and administration of non-steroid anti-inflammatory drugs (NSAIDs (p = 0.028 or nephrotoxic antibiotics (p = 0.037 were statistically significantly correlated with the development of postoperative KD and failure to gain the preoperative renal function. Conclusion We conclude that every patient with risk factor for postoperative KD should be under closed evaluation and monitoring.

  8. Kidney dysfunction and cerebral microbleeds in neurologically healthy adults.

    Directory of Open Access Journals (Sweden)

    Sang Hyuck Kim

    Full Text Available Cerebral microbleed (CMB is a potent risk factor for overt cerebrovascular disease. Although some studies indicated the possible role of renal dysfunction as a risk factor of CMB, the findings could not be generalized. This study aimed to investigate the association between renal dysfunction and cerebral microbleed (CMB in neurologically healthy adults.A total of 2,518 subjects who underwent brain MRI as part of health screening were involved in the study. CMBs were defined as well-demarcated focal areas of low signal intensity with associated blooming on the T2-weighted MRI measuring less than 5mm in diameter. The glomerular filtration rate (GFR was estimated using the Modification of Diet in Renal Disease formula. Kidney function was classified as normal (≥90, mild (60 to 89.9, moderate (30 to 59.9, and severe (<30 mL/min/1.73 m2 renal dysfunction according to the GFR.The mean age of the participants was 57.5 ± 8.3 years (ranged 40 to 79, and 1,367 subjects (54.3% were male. The mean GFR level was 81.5 ± 15.5, and the prevalence of CMB was 4.1% (n = 103. Subjects with CMB demonstrated a higher proportion of moderate-to-severe renal dysfunction than those without CMB (15.5% vs. 5.0%, p < 0.001. In the multivariate logistic regression analysis, moderate-to-severe renal dysfunction showed a significant association with CMB (adjusted odd ratio = 2.63; p = 0.008. Furthermore, a decrease in the GFR level was associated with an increasing trend of the presence of CMB (p for trend = 0.031 and number of CMB lesions (p for trend = 0.003.Renal dysfunction was significantly associated with the presence of CMB in neurologically healthy adults. More studies are needed to evaluate if treatment of kidney disease and risk factor modification may prevent further progress of CMB.

  9. Prognostic impact of isolated right ventricular dysfunction in sepsis and septic shock: an 8-year historical cohort study.

    Science.gov (United States)

    Vallabhajosyula, Saraschandra; Kumar, Mukesh; Pandompatam, Govind; Sakhuja, Ankit; Kashyap, Rahul; Kashani, Kianoush; Gajic, Ognjen; Geske, Jeffrey B; Jentzer, Jacob C

    2017-09-07

    Echocardiographic myocardial dysfunction is reported commonly in sepsis and septic shock, but there are limited data on sepsis-related right ventricular dysfunction. This study sought to evaluate the association of right ventricular dysfunction with clinical outcomes in patients with severe sepsis and septic shock. Historical cohort study of adult patients admitted to all intensive care units at the Mayo Clinic from January 1, 2007 through December 31, 2014 for severe sepsis and septic shock, who had an echocardiogram performed within 72 h of admission. Patients with prior heart failure, cor-pulmonale, pulmonary hypertension and valvular disease were excluded. Right ventricular dysfunction was defined by the American Society of Echocardiography criteria. Outcomes included 1-year survival, in-hospital mortality and length of stay. Right ventricular dysfunction was present in 214 (55%) of 388 patients who met the inclusion criteria-isolated right ventricular dysfunction was seen in 100 (47%) and combined right and left ventricular dysfunction in 114 (53%). The baseline characteristics were similar between cohorts except for the higher mechanical ventilation use in patients with isolated right ventricular dysfunction. Echocardiographic findings demonstrated lower right ventricular and tricuspid valve velocities in patients with right ventricular dysfunction and lower left ventricular ejection fraction and increased mitral E/e' ratios in patients with combined right and left ventricular dysfunction. After adjustment for age, comorbidity, illness severity, septic shock and use of mechanical ventilation, isolated right ventricular dysfunction was independently associated with worse 1-year survival-hazard ratio 1.6 [95% confidence interval 1.2-2.1; p = 0.002) in patients with sepsis and septic shock. Isolated right ventricular dysfunction is seen commonly in sepsis and septic shock and is associated with worse long-term survival.

  10. Mitochondrial Dysfunction in Lysosomal Storage Disorders.

    Science.gov (United States)

    de la Mata, Mario; Cotán, David; Villanueva-Paz, Marina; de Lavera, Isabel; Álvarez-Córdoba, Mónica; Luzón-Hidalgo, Raquel; Suárez-Rivero, Juan M; Tiscornia, Gustavo; Oropesa-Ávila, Manuel

    2016-10-11

    Lysosomal storage diseases (LSDs) describe a heterogeneous group of rare inherited metabolic disorders that result from the absence or loss of function of lysosomal hydrolases or transporters, resulting in the progressive accumulation of undigested material in lysosomes. The accumulation of substances affects the function of lysosomes and other organelles, resulting in secondary alterations such as impairment of autophagy, mitochondrial dysfunction, inflammation and apoptosis. LSDs frequently involve the central nervous system (CNS), where neuronal dysfunction or loss results in progressive neurodegeneration and premature death. Many LSDs exhibit signs of mitochondrial dysfunction, which include mitochondrial morphological changes, decreased mitochondrial membrane potential (ΔΨm), diminished ATP production and increased generation of reactive oxygen species (ROS). Furthermore, reduced autophagic flux may lead to the persistence of dysfunctional mitochondria. Gaucher disease (GD), the LSD with the highest prevalence, is caused by mutations in the GBA1 gene that results in defective and insufficient activity of the enzyme β-glucocerebrosidase (GCase). Decreased catalytic activity and/or instability of GCase leads to accumulation of glucosylceramide (GlcCer) and glucosylsphingosine (GlcSph) in the lysosomes of macrophage cells and visceral organs. Mitochondrial dysfunction has been reported to occur in numerous cellular and mouse models of GD. The aim of this manuscript is to review the current knowledge and implications of mitochondrial dysfunction in LSDs.

  11. Mitochondrial Dysfunction in Lysosomal Storage Disorders

    Directory of Open Access Journals (Sweden)

    Mario de la Mata

    2016-10-01

    Full Text Available Lysosomal storage diseases (LSDs describe a heterogeneous group of rare inherited metabolic disorders that result from the absence or loss of function of lysosomal hydrolases or transporters, resulting in the progressive accumulation of undigested material in lysosomes. The accumulation of substances affects the function of lysosomes and other organelles, resulting in secondary alterations such as impairment of autophagy, mitochondrial dysfunction, inflammation and apoptosis. LSDs frequently involve the central nervous system (CNS, where neuronal dysfunction or loss results in progressive neurodegeneration and premature death. Many LSDs exhibit signs of mitochondrial dysfunction, which include mitochondrial morphological changes, decreased mitochondrial membrane potential (ΔΨm, diminished ATP production and increased generation of reactive oxygen species (ROS. Furthermore, reduced autophagic flux may lead to the persistence of dysfunctional mitochondria. Gaucher disease (GD, the LSD with the highest prevalence, is caused by mutations in the GBA1 gene that results in defective and insufficient activity of the enzyme β-glucocerebrosidase (GCase. Decreased catalytic activity and/or instability of GCase leads to accumulation of glucosylceramide (GlcCer and glucosylsphingosine (GlcSph in the lysosomes of macrophage cells and visceral organs. Mitochondrial dysfunction has been reported to occur in numerous cellular and mouse models of GD. The aim of this manuscript is to review the current knowledge and implications of mitochondrial dysfunction in LSDs.

  12. No effect of oral testosterone treatment on sexual dysfunction in alcoholic cirrhotic men

    DEFF Research Database (Denmark)

    Gluud, C; Wantzin, P; Eriksen, J

    1988-01-01

    The prevalence and course of sexual dysfunction was evaluated in 221 alcoholic cirrhotic men participating in a double-blind, placebo-controlled study on the effect of oral testosterone treatment on liver disease. At entry, 67% (95% confidence limits, 61%-74%) complained of sexual dysfunction....... In conclusion, oral testosterone treatment does not significantly influence the type or course of sexual dysfunction in alcoholic cirrhotic men. However, sexual function improved after reduction of ethanol consumption in these patients.......-binding globulin-bound testosterone concentrations disappeared, however, when age, ethanol consumption, and severity of liver disease were included as covariates in the analysis. During follow-up (median 30 mo, range 1-48 mo) sexual dysfunction improved significantly (p less than 0.05) at 6, 12, and 24 mo...

  13. Cognitive Dysfunctions in Patients with Alcohol Dependence Syndrome in a Tertiary Hospital in Kathmandu.

    Science.gov (United States)

    Adhikari, S; Rana, M; Shakya, S; Ojha, S P

    2016-01-01

    Alcohol dependence is a chronic disorder, accompanied by neuropsychological deficits. Patients with alcohol dependence were evaluated to identify the cognitive dysfunctions. The study followed descriptive design and recruited participants (N=62) from inpatient services of the Department of Psychiatry and Mental Health by convenient sampling. Participants were evaluated with the Severity of Alcohol Dependence Questionnaire, Frontal Assessment Battery and PGI Memory Scale for the severity of alcohol dependence, executive impairments and memory dysfunctions respectively once they had completed alcohol detoxification. Total duration of alcohol consumption was 13.93 ± 8.74 years, period of dependence was 2.97 ± 2.23 years and 56.5% had moderate level of dependence. 33.9% of the participants had executive impairments particularly in conceptualization, programming and mental flexibility. 38% of variance in executive dysfunction was explained by illness variables, where period of alcohol dependence and education were significant predictors. 54.8% had significant memory dysfunction particularly in visual retention, remote memory, verbal retention of dissimilar pairs and delayed recall. Memory dysfunction differed significantly among the age groups (F=10.22, pmemory dysfunction was explained by illness variables, where duration of alcohol consumption was a significant predictor (β = .485, palcohol dependence. Hence, routine neuropsychological assessment is of particular importance for early detection and remediation of underlying deficits, which completes the treatment of alcohol dependence.

  14. Geriatric oral and maxillofacial dysfunctions in the context of geriatric syndrome.

    Science.gov (United States)

    Nam, Y; Kim, N-H; Kho, H-S

    2017-01-31

    To propose the application of the concept of geriatric syndrome for common geriatric oral and maxillofacial dysfunctions and to suggest the necessity of developing effective evaluation methods for oral and maxillofacial frailty. The concepts of frailty and geriatric syndrome based on multi-morbidity and polypharmacy were applied to five common geriatric oral medicinal dysfunctional problems: salivary gland hypofunction (dry mouth), chronic oral mucosal pain disorders (burning mouth symptoms), taste disorders (taste disturbances), swallowing disorders (dysphagia), and oral and maxillofacial movement disorders (oromandibular dyskinesia and dystonia). Each of the dysfunctions is caused by various kinds of diseases and/or conditions and medications, thus the concept of geriatric syndrome could be applied. These dysfunctions, suggested as components of oral and maxillofacial geriatric syndrome, are associated and interacted with each other in a complexity of vicious cycle. The resulting functional impairments caused by this syndrome can cause oral and maxillofacial frailty. Geriatric oral and maxillofacial dysfunctions could be better appreciated in the context of geriatric syndrome. The development of effective methods for evaluating the severity of these dysfunctions and the resulting frailty is essential. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Can simvastatin improve erectile function and health-related quality of life in men aged >40 years with erectile dysfunction? Rationale and design of the Erectile Dysfunction and Statins (EDS) Trial [ISRCTN66772971]1

    National Research Council Canada - National Science Library

    Daksha Trivedi; Michael Kirby; Felicity Norman; Izabela Przybytniak; Shehzad Ali; David M. Wellsted

    2011-01-01

    ... *To describe the rationale and design of the Erectile Dysfunction and Statins (EDS) Trial which aims to evaluate the effectiveness of simvastatin on erectile function and health-related quality of life in men aged...

  16. Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence

    Directory of Open Access Journals (Sweden)

    Elisabete Rodrigues Nascimento

    2013-11-01

    Full Text Available The aim of this study was to conduct a systematic review of the literature regarding the prevalence of sexual dysfunction in patients with cardiovascular diseases. An article search of the ISI Web of Science and PubMed databases using the search terms "sexual dysfunction”, “cardiovascular diseases”, “coronary artery disease", “myocardial infarct" and “prevalence” was performed. In total, 893 references were found. Non-English-language and repeated references were excluded. After an abstract analysis, 91 references were included for full-text reading, and 24 articles that evaluated sexual function using validated instruments were selected for this review. This research was conducted in October 2012, and no time restrictions were placed on any of the database searches. Reviews and theoretical articles were excluded; only clinical trials and epidemiological studies were selected for this review. The studies were mostly cross-sectional, observational and case-control in nature; other studies used prospective cohort or randomized clinical designs. In women, all domains of sexual function (desire, arousal, vaginal lubrication, orgasm, sexual dissatisfaction and pain were affected. The domains prevalent in men included erectile dysfunction and premature ejaculation and orgasm. Sexual dysfunction was related to the severity of cardiovascular disease. When they resumed sexual activity, patients with heart disease reported significant difficulty, including a lack of interest in sex, sexual dissatisfaction and a decrease in the frequency of sexual activity.

  17. Dysfunctional parenting styles increase interpersonal sensitivity in healthy subjects.

    Science.gov (United States)

    Otani, Koichi; Suzuki, Akihito; Shibuya, Naoshi; Matsumoto, Yoshihiko; Kamata, Mitsuhiro

    2009-12-01

    The effects of dysfunctional parenting styles on interpersonal sensitivity were studied in 640 Japanese volunteers. Interpersonal sensitivity was assessed by the Interpersonal Sensitivity Measure (IPSM), and perceived parental rearing was evaluated by the Parental Bonding Instrument (PBI), which is consisted of care and protection factors. Parental rearing was classified into 4 types, i.e., optimal parenting (high care/low protection), affectionate constraint (high care/high protection), neglectful parenting (low care/low protection), and affectionless control (low care/high protection). Males with paternal affectionless control showed higher total IPSM scores than those with paternal optimal parenting (p = 0.022). Females with maternal affectionate constraint (p = 0.001), neglectful parenting (p = 0.022), and affectionless control (p = 0.003) showed higher total IPSM scores than those with maternal optimal parenting. In males and females, dysfunctional parenting styles by the opposite-sex parents did not affected total IPSM scores. The present study suggests that in both males and females interpersonal sensitivity is increased by dysfunctional parenting styles by the same-sex parents.

  18. Investigation of auditory dysfunction in Leber hereditary optic neuropathy.

    Science.gov (United States)

    Yu-Wai-Man, Patrick; Elliott, Clive; Griffiths, Philip G; Johnson, Ian J; Chinnery, Patrick F

    2008-09-01

    To investigate the possibility of auditory dysfunction in patients with Leber hereditary optic neuropathy (LHON). We prospectively recruited 10 affected patients from the north-east of England harbouring one of the three primary mitochondrial LHON mutations (3460G>A n = 3, 11778G>A n = 5 and 14484T>C n = 2). A detailed auditory history was taken and they were asked to complete a validated hearing questionnaire. Each patient then underwent a comprehensive topographic neuroauditory assessment to evaluate both middle- and inner-ear functions and the integrity of the brainstem auditory pathways. We found no evidence of cochlear nerve dysfunction or abnormalities of the central brainstem auditory pathways in our LHON cohort and five patients had completely normal hearing tests. The remainder had mild conductive hearing loss from childhood ear infections and/or high-frequency sensorineural hearing loss from previous noise injury. Although further studies are required to confirm our findings, auditory dysfunction as a result of a primary LHON mutation is probably uncommon.

  19. Plasma Osteoprotegerin Levels Before and After Treatment of Thyroid Dysfunctions

    Directory of Open Access Journals (Sweden)

    Didem Özdemir

    2013-12-01

    Full Text Available Purpose: Osteoprotegerin (OPG is a soluble decoy receptor for the receptor activator of nuclear factor kappaB ligand, thereby inhibiting bone resorption. In this study, we aimed to evaluate plasma OPG levels in patients with thyroid dysfunctions and determine whether its levels change after restoration of euthyroidism. Material and Method: OPG levels were studied at the time of diagnosis and after the restoration of euthyroidism at least for 8 weeks in patients diagnosed with overt thyrotoxicosis and hypothyroidism. Results: Seventeen hypothyroid, 17 thyrotoxic patients and 17 age-, sex- and body mass index-matched healthy controls were analyzed. Mean basal plasma OPG levels were 5.42±2.66, 5.04±1.62 and 5.24±0.93 pmol/l in thyrotoxic, hypothyroid and healthy controls, respectively (p=0.844. After restoration of euthyroidism, OPG was 5.52±2.37 pmol/l in thyrotoxic and 4.33±1.37 pmol/l in hypothyroid patients, indicating no significant difference compared to baseline values (p=0.846 and p=0.109, respectively. We also did not observe any correlation between basal OPG levels and basal thyrotropin and thyroid hormone levels. Discussion: Thyroid dysfunctions seem to affect bone functions by mechanisms other than OPG, however, more clinical studies with larger sample sizes are needed to clarify the underlying mechanisms of thyroid dysfunction-related changes in bone metabolism. Turk Jem 2013; 17: 102-7

  20. Cognitive Dysfunctions in Patients with Alcohol Dependence Syndrome in a Tertiary Hospital in Kathmandu

    Directory of Open Access Journals (Sweden)

    Sirjana Adhikari

    2016-03-01

    Full Text Available Introduction: Alcohol dependence is a chronic disorder, accompanied by neuropsychological deficits. Patients with alcohol dependence were evaluated to identify the cognitive dysfunctions. Method: The study followed descriptive design and recruited participants (N=62 from inpatient services of the Department of Psychiatry and Mental Health by convenient sampling. Participants were evaluated with the Severity of Alcohol Dependence Questionnaire, Frontal Assessment Battery and PGI Memory Scale for the severity of alcohol dependence, executive impairments and memory dysfunctions respectively once they had completed alcohol detoxification. Results: Total duration of alcohol consumption was 13.93±8.74 years, period of dependence was 2.97±2.23 years and 56.5% had moderate level of dependence. 33.9% of the participants had executive impairments particularly in conceptualization, programming and mental flexibility. 38% of variance in executive dysfunction was explained by illness variables, where period of alcohol dependence and education were significant predictors. 54.8% had significant memory dysfunction particularly in visual retention, remote memory, verbal retention of dissimilar pairs and delayed recall. Memory dysfunction differed significantly among the age groups (F=10.22, p<0.01 and age was a significant predictor (β=.542, p<0.001. 19% variance in memory dysfunction was explained by illness variables, where duration of alcohol consumption was a significant predictor (β = .485, p<0.01. Conclusion: Findings indicate that cognitive dysfunctions are prevalent among patients with alcohol dependence. Hence, routine neuropsychological assessment is of particular importance for early detection and remediation of underlying deficits, which completes the treatment of alcohol dependence. Keywords: alcohol dependence: cognitive dysfunctions; executive functions; memory. | PubMed

  1. Simvastatin improves the sexual health-related quality of life in men aged 40 years and over with erectile dysfunction: additional data from the erectile dysfunction and statin trial

    OpenAIRE

    Trivedi, Daksha; Wellsted, David M.; Collard, Jade B; Kirby, Michael

    2014-01-01

    Background Erectile dysfunction is prevalent in men over 40 years, affecting their quality of life and that of their partners. The aims of this study were: a) To evaluate the internal reliability of the male erectile dysfunction specific quality of life (MED-QoL) scale and explore its factor structure. b) To evaluate the effect of simvastatin on subscales of the MED-QoL in men over forty years with erectile dysfunction. Methods This is a double blind randomised controlled trial of 40 mg simva...

  2. Cardiac dysfunction in cancer survivors unmasked during exercise.

    Science.gov (United States)

    Kearney, Maria C; Gallop-Evans, Eve; Cockcroft, John R; Stöhr, Eric J; Lee, Eveline; Backx, Karianne; Haykowsky, Mark; Yousef, Zaheer; Shave, Rob

    2017-03-01

    The cardiac dysfunction associated with anthracycline-based chemotherapy cancer treatment can exist subclinically for decades before overt presentation. Stress echocardiography, the measurement of left ventricular (LV) deformation and arterial haemodynamic evaluation, has separately been used to identify subclinical cardiovascular (CV) dysfunction in several patient groups including those with hypertension and diabetes. The purpose of the present cross-sectional study was to determine whether the combination of these techniques could be used to improve the characterisation of subclinical CV dysfunction in long-term cancer survivors previously treated with anthracyclines. Thirteen long-term cancer survivors (36 ± 10 years) with prior anthracycline exposure (11 ± 8 years posttreatment) and 13 age-matched controls were recruited. Left ventricular structure, function and deformation were assessed using echocardiography. Augmentation index was used to quantify arterial haemodynamic load and was measured using applanation tonometry. Measurements were taken at rest and during two stages of low-intensity incremental cycling. At rest, both groups had comparable global LV systolic, diastolic and arterial function (all P > 0·05); however, longitudinal deformation was significantly lower in cancer survivors (-18 ± 2 vs. -20 ± 2, P exercise, this difference between groups persisted and further differences were uncovered with significantly lower apical circumferential deformation in the cancer survivors (-24 ± 5 vs. -29 ± 5, -29 ± 5 vs. 35 ± 8 for first and second stage of exercise respectively, both P exercise provides a more comprehensive characterisation of subclinical LV dysfunction. Larger studies are required to determine the clinical relevance of these preliminary findings. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

  3. Transanal irrigation for the treatment of neuropathic bowel dysfunction.

    Science.gov (United States)

    López Pereira, Pedro; Salvador, Obdulia Perez; Arcas, Julia Alonso; Martínez Urrutia, M A Jose; Romera, Roberto Lobato; Monereo, Enrique Jaureguízar

    2010-04-01

    Children with spinal cord lesions very often experience bowel dysfunction, with a significant impact on their social activities and quality of life. Our aim was to evaluate the efficacy of the Peristeen transanal irrigation (TI) system in patients with neuropathic bowel dysfunction (NBD). We prospectively reviewed 40 children with spina bifida and NBD who did not respond satisfactorily to conventional bowel management and were treated with the Peristeen TI system. Dysfunctional bowel symptoms, patient opinion and level of satisfaction were analysed before and during TI treatment using a specific questionnaire. Thirty-five children completed the study. Mean patient age and follow up were 12.5 years (6-25) and 12 months (4-18), respectively. Average irrigation frequency and instillation volume were once every 3 days and 616ml (200-1000), respectively. Bowel dysfunction symptoms including faecal incontinence improved significantly in all children. Patient opinion of intestinal functionality improved from 2.3±1.4 to 8.2±1.5 (P<0.0001) and mean grade of satisfaction with the Peristeen system was 7.3. Patient independence also improved from 28 to 46% and no adverse events were recorded. TI should be used as a first therapeutic approach in those children with NBD who do not respond to conservative or medical bowel management before other more invasive treatment modalities are considered. The Peristeen system is as effective as other TI methods, but it is easy to learn, safe and increases the patient's independence. Copyright © 2009 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  4. External Mechanical Devices and Vascular Surgery for Erectile Dysfunction.

    Science.gov (United States)

    Trost, Landon W; Munarriz, Ricardo; Wang, Run; Morey, Allen; Levine, Laurence

    2016-11-01

    The field of sexual medicine is continuously advancing, with novel outcomes reported on a regular basis. Given the rapid evolution, updated guidelines are essential to inform practicing clinicians on best practices. To summarize the current literature and provide clinical guidelines on penile traction therapy, vacuum erection devices, and penile revascularization. A consensus panel was held with leading sexual medicine experts during the 2015 International Consultation on Sexual Medicine (ICSM). Relevant literature was reviewed and graded based on Oxford criteria to develop evidence-based guideline and consensus statements. The development of clinically relevant guidelines. Penile traction therapy is a viable therapy to modestly improve penile length as a primary therapy, before penile prosthesis placement in men with decreased penile length or after surgery for Peyronie's disease. It also might have a role in the acute phase of Peyronie's disease but has inconsistent outcomes in the long-term phase. Vacuum erection devices are effective in creating an erection satisfactory for intercourse, even in difficult-to-treat populations. They also might be used in the post-prostatectomy setting to maintain penile length but have insufficient evidence as a penile rehabilitation therapy. For vasculogenic erectile dysfunction, men with suspected arterial insufficiency can be evaluated with penile Duplex Doppler ultrasonography and confirmatory angiography. Penile revascularization procedures have consistently demonstrated benefits in very select patient populations; however, inadequate data exists to suggest the superiority of one technique. Men with vascular risk factors are likely poor candidates for penile revascularization, although veno-occlusive dysfunction and age are less significant. Therapies for treating primary veno-occlusive dysfunction are not recommended and should be reserved for clinical trials. Since the prior ICSM meeting, multiple developments have

  5. Cardiovascular Autonomic Dysfunction in Children and Adolescents With Rett Syndrome.

    Science.gov (United States)

    Kumar, Ajay; Jaryal, Ashok; Gulati, Sheffali; Chakrabarty, Biswaroop; Singh, Akanksha; Deepak, K K; Pandey, R M; Gupta, Neerja; Sapra, Savita; Kabra, Madhulika; Khajuria, Rajni

    2017-05-01

    Autonomic dysfunction is common in children with Rett syndrome. They usually manifest with agitation, persistent screaming, constipation, gastroesophageal reflux, aerophagia, hyperventilation, and breath-holding episodes. Cardiovascular autonomic dysfunction may result in fatal a arrhythmia. Many of these events are mistaken for seizures and treated with antiepileptics. The present study was conducted in a tertiary care teaching hospital in north India for more than a six month period. MeCP2 mutation positive, 24 cases with Rett syndrome and 24 age-matched healthy girls were evaluated for cardiovascular autonomic dysfunction (heart rate variability, head-up tilt test, and cold pressor test). The mean age was 9.06 years (±3.4) and 9.75 years (±3.13) for patients and control subjects, respectively. The heart rate variability contributed independently by parasympathetic and sympathetic nervous system was significantly reduced in cases compared with control subjects (P = 0.033 and P = 0.001, respectively). There was significant sympathovagal imbalance with sympathetic overactivity in cases compared with control subjects (P = 0.001). The mean longest QT c interval was significantly prolonged in cases compared with control subjects (P = 0.001). Cold pressor test and head-up tilt test could be done in 16 Rett syndrome patients (because of poor cooperation) and in all 24 control subjects. The change in blood pressure during cold pressor test and head-up tilt test was not significantly different in cases and control subjects. Children with Rett syndrome exhibited significant cardiovascular autonomic dysfunction in the form of sympathetic overactivity, parasympathetic underactivity, and sympathovagal imbalance. These findings have potentially important therapeutic- and outcome-related implications. Copyright © 2017. Published by Elsevier Inc.

  6. Cognitive Dysfunctions in Patients with Alcohol Dependence Syndrome in a Tertiary Hospital in Kathmandu

    OpenAIRE

    Sirjana Adhikari; Mita Rana; Suraj Shakya; Saroj Prasad Ojha

    2016-01-01

    Introduction: Alcohol dependence is a chronic disorder, accompanied by neuropsychological deficits. Patients with alcohol dependence were evaluated to identify the cognitive dysfunctions. Method: The study followed descriptive design and recruited participants (N=62) from inpatient services of the Department of Psychiatry and Mental Health by convenient sampling. Participants were evaluated with the Severity of Alcohol Dependence Questionnaire, Frontal Assessment Battery and PGI Memory Sc...

  7. Early detection of left ventricular dysfunction in asymptomatic diabetic patient using strain and strain rate echocardiographic imaging

    Directory of Open Access Journals (Sweden)

    Rania Gaber

    2014-03-01

    Conclusion: Type 2 diabetes mellitus deteriorate both LV systolic and diastolic performance. Strain and strain rate by tissue Doppler Imaging is superior to conventional Doppler in early detection and evaluation of systolic and diastolic dysfunction in type 2 diabetic patients.

  8. Long-term results of bulking agent injection for persistent incontinence in cases of neurogenic bladder dysfunction

    NARCIS (Netherlands)

    de Vocht, T. F.; Chrzan, R.; Dik, P.; Klijn, A. J.; de Jong, T. P. V. M.

    2010-01-01

    PURPOSE: We evaluated the effectiveness of bladder neck injection as a supplementary treatment for persistent low pressure incontinence after unsatisfactory fascial sling procedures in patients with neurogenic lower urinary tract dysfunction. MATERIALS AND METHODS: A total of 89 patients with

  9. Arterial stiffness and endothelial dysfunction independently and synergistically predict cardiovascular and renal outcome in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Theilade, S; Lajer, Maria Stenkil; Jorsal, Anders

    2012-01-01

    To evaluate whether pulse pressure alone or with placental growth factor as estimates of arterial stiffness and endothelial dysfunction, predicts mortality, cardiovascular disease and progression to end-stage renal disease in patients with Type 1 diabetes.......To evaluate whether pulse pressure alone or with placental growth factor as estimates of arterial stiffness and endothelial dysfunction, predicts mortality, cardiovascular disease and progression to end-stage renal disease in patients with Type 1 diabetes....

  10. Avaliação da mecânica ventilatória em indivíduos com disfunção têmporo-mandibular e assintomáticos Evaluation of ventilatory mechanics in individuals with temporomandibular dysfunction and in asymptomatic individuals

    Directory of Open Access Journals (Sweden)

    F Pasinato

    2006-09-01

    Full Text Available CONTEXTO: A relação entre disfunções respiratórias e têmporo-mandibulares tem sido recentemente constatada pela incidência de dor orofacial entre indivíduos com história de doenças respiratórias obstrutivas tanto de vias aéreas superiores como nas inferiores. OBJETIVO: Avaliar comparativamente a mecânica ventilatória em indivíduos com disfunção têmporo-mandibular (DTM e em indivíduos assintomáticos. MÉTODO: Participaram do estudo 35 voluntários, sendo 20 indivíduos com DTM e 15 assintomáticos. Os participantes foram avaliados para verificação da presença e grau de disfunção têmporo-mandibular. Realizou-se avaliação respiratória, por meio de inspeção do padrão e tipo ventilatório, medida dos perímetros torácicos, teste de força dos músculos respiratórios e histórico de enfermidade respiratória. RESULTADOS: Nos indivíduos com DTM, o modo respiratório bucal (30% e misto (15%, bem como o padrão ventilatório apical (45% foram predominantes. Observou-se uma menor expansibilidade torácica e uma redução estatisticamente significante no índice de amplitude abdominal nos indivíduos com DTM. Estes indivíduos também apresentaram maior incidência de patologias respiratórias obstrutivas tanto de vias aéreas superiores (70% como inferiores (45% em relação aos assintomáticos. CONCLUSÃO: Os resultados indicam que existe uma influência da mecânica ventilatória sobre a ocorrência de disfunção têmporo-mandibular.BACKGROUND: The relationship between respiratory and temporomandibular dysfunctions has recently been brought to light through the incidence of orofacial pain among individuals with a history of obstructive respiratory diseases in the upper and lower airways. OBJECTIVE: To comparatively evaluate the ventilatory mechanics in individuals with temporomandibular dysfunction (TMD and in asymptomatic individuals. METHOD: Thirty-five volunteers took part in the study: 20 individuals with TMD and

  11. Erectile dysfunction in liver transplant patients.

    Science.gov (United States)

    Huyghe, E; Kamar, N; Wagner, F; Yeung, S J; Capietto, A H; El-Kahwaji, L; Muscari, F; Plante, P; Rostaing, L

    2008-12-01

    The objectives of the study were to determine the frequency of erectile dysfunction (ED) after liver transplantation (LT) and discuss potential risk factors. Of 123 eligible LT men, 98 (79.7%) responded to a questionnaire about sexual function at a mean time posttransplant of 5.4 +/- 4.0 years (1.0-21). Erection was evaluated using the five-question international index for erectile function score, and sexual satisfaction by the patient-baseline treatment-satisfaction status (TSS) score. Questions also focused on patient perception of changes overtime. We found that after LT, the proportion of sexually inactive men decreased from 29% to 15% (p = 0.01), but the proportion of men with ED remained unchanged. The absence of sexual activity was associated with pretransplant sexual inactivity (p = 0.001), age (p = 0.008), cardiovascular disease (p = 0.03), use of diuretics (p = 0.04), anticoagulants (p = 0.001), statins (p = 0.01) and treatment for diabetes (p = 0.03). Cardiovascular disease (p = 0.05), posttransplantation diabetes (p = 0.04), alcohol abuse (p = 0.03), antidepressants (p = 0.05) and angiotensin II receptor blockers (p = 0.05) were associated with having ED after LT. Having a low TSS score was associated with a history of endocrine disease (p = 0.03), antidepressants (p = 0.04) and diuretics (p = 0.03). In conclusion, LT improves sexual activity, but ED is multifactorial and remains a long-term condition in the majority of patients.

  12. Transcutaneous temperature controlled radiofrequency for orgasmic dysfunction

    Science.gov (United States)

    2016-01-01

    Background and Objectives To evaluate the safety, tolerability, and clinical efficacy of transcutaneous temperature controlled radiofrequency (TTCRF) on vulvovaginal tissue for orgasmic dysfunction. Study Design/Materials and Methods Subjects included 25 sexually active women, ages 21–65, with self‐reported difficulty in achieving orgasms during sex (anorgasmic or slow‐to‐orgasm). Each patient received three sessions at intervals of about 1 month. Treatment was performed using a slim S‐shaped probe with a stamp‐sized metal radiofrequency emitter on one surface of the tip (25 minutes total time on average). External treatments covered the labia majora and minora, lower mons pubis, perineal body, clitoral hood, and clitoris. Full length treatment of the vagina with concentration on the anterior wall was performed. Tissue temperature during therapy was elevated to and maintained between 40°C and 45°C. No anesthesia was required. After treatment, patients immediately resumed normal activities, including sex. Results Twenty‐three of 25 patients reported an average reduction in time to orgasm of 50%. Patients also noted significant vaginal tightening effects, increased vaginal moisture, and improved vulvar and clitoral sensitivity. All anorgasmic patients reported the ability to achieve orgasms. Two patients had minimal response. Conclusion TTCRF is an effective non‐hormonal, non‐surgical option for women having difficulty achieving orgasm. Treatment also has visible tightening effects on feminine tissues and appears to increase local blood flow, resulting in increased vaginal tightness and moisture. Improved appearance and friction resulted in improved confidence and reduced performance anxiety. Lasers Surg. Med. 48:641–645, 2016. © 2016 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc. PMID:27197701

  13. Hypercholesterolemia and microvascular dysfunction: interventional strategies

    Directory of Open Access Journals (Sweden)

    James Milinda E

    2010-11-01

    Full Text Available Abstract Hypercholesterolemia is defined as excessively high plasma cholesterol levels, and is a strong risk factor for many negative cardiovascular events. Total cholesterol levels above 200 mg/dl have repeatedly been correlated as an independent risk factor for development of peripheral vascular (PVD and coronary artery disease (CAD, and considerable attention has been directed toward evaluating mechanisms by which hypercholesterolemia may impact vascular outcomes; these include both results of direct cholesterol lowering therapies and alternative interventions for improving vascular function. With specific relevance to the microcirculation, it has been clearly demonstrated that evolution of hypercholesterolemia is associated with endothelial cell dysfunction, a near-complete abrogation in vascular nitric oxide bioavailability, elevated oxidant stress, and the creation of a strongly pro-inflammatory condition; symptoms which can culminate in profound impairments/alterations to vascular reactivity. Effective interventional treatments can be challenging as certain genetic risk factors simply cannot be ignored. However, some hypercholesterolemia treatment options that have become widely used, including pharmaceutical therapies which can decrease circulating cholesterol by preventing either its formation in the liver or its absorption in the intestine, also have pleiotropic effects with can directly improve peripheral vascular outcomes. While physical activity is known to decrease PVD/CAD risk factors, including obesity, psychological stress, impaired glycemic control, and hypertension, this will also increase circulating levels of high density lipoprotein and improving both cardiac and vascular function. This review will provide an overview of the mechanistic consequences of the predominant pharmaceutical interventions and chronic exercise to treat hypercholesterolemia through their impacts on chronic sub-acute inflammation, oxidative stress, and

  14. [Effectiveness of treating periodontitis in patients with thyroid dysfunction].

    Science.gov (United States)

    Moskvina, T S

    2001-01-01

    Efficiency of some drugs in the treatment of periodontitis in combination with corrective treatment of thyroid function was evaluated in 70 patients with hypo- and hyperthyrosis with different initial level of nonspecific resistance. The therapeutic complex including drugs commonly used in the treatment of periodontitis and irrigation of the periodontium with lithium chloride and chlorohexidine solutions was highly effective in patients with thyroid dysfunction and relatively favorable status of nonspecific resistance of the organism. In patients with hypo- and hyperthyrosis with poor nonspecific resistance the best effect in the treatment of periodontitis was attained with potassium orotate as an immunomodulator and lithium chloride.

  15. Molecular and biological pathways of skeletal muscle dysfunction in chronic obstructive pulmonary disease

    Science.gov (United States)

    Gea, Joaquim

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) will be a major leading cause of death worldwide in the near future. Weakness and atrophy of the quadriceps are associated with a significantly poorer prognosis and increased mortality in COPD. Despite that skeletal muscle dysfunction may affect both respiratory and limb muscle groups in COPD, the latter are frequently more severely affected. Therefore, muscle dysfunction in COPD is a common systemic manifestation that should be evaluated on routine basis in clinical settings. In the present review, several aspects of COPD muscle dysfunction are being reviewed, with special emphasis on the underlying biological mechanisms. Figures on the prevalence of COPD muscle dysfunction and the most relevant etiologic contributors are also provided. Despite that ongoing research will shed light into the contribution of additional mechanisms to COPD muscle dysfunction, current knowledge points toward the involvement of a wide spectrum of cellular and molecular events that are differentially expressed in respiratory and limb muscles. Such mechanisms are thoroughly described in the article. The contribution of epigenetic events on COPD muscle dysfunction is also reviewed. We conclude that in view of the latest discoveries, from now, on new avenues of research should be designed to specifically target cellular mechanisms and pathways that impair muscle mass and function in COPD using pharmacological strategies and/or exercise training modalities. PMID:27056059

  16. Dysfunctional cognitions of depressive inpatients and their relationship with treatment outcome.

    Science.gov (United States)

    Köhler, Stephan; Unger, Theresa; Hoffmann, Sabine; Mackert, Arthur; Ross, Barbara; Fydrich, Thomas

    2015-04-01

    Dysfunctional cognitions can contribute to depression and its maintenance. They may be related to a higher relapse rate and a longer duration of the depressive episode. The relevance of dysfunctional cognitions for acute inpatient treatment of unipolar depression is examined in this study and its variability by cognitive behavioural therapy (CBT). 222 patients suffering from Major Depressive Disorder (MDD) were evaluated during their inpatient treatment by assessing admission and discharge depression scores and their relationship to dysfunctional cognitions, using the Dysfunctional Attitude Scale (DAS). The relationship between dysfunctional cognitions and treatment outcome was examined. Primary outcome measures were the Hamilton-Rating-Scale (HRSD) and the Beck Depression Inventory (BDI). Higher age, depression severity at admission, comorbid personality disorders and recurrent depressive disorders are related with higher DAS-scores at admission. DAS-Scores declined during treatment but to a lower extend than depressive symptom scales (effect size dDAS-G t1-t2 = .31; dHRSD t1-t2 = 2.88; dBDI t1-t2 = 1.38). Higher DAS-scores at admission correlated negatively with the improvement of depressive symptoms during treatment (HRSD: r = -.62; p depressive symptoms and are associated with poorer treatment outcome even in combined treatment of antidepressant medication and CBT during inpatient treatment. Changes of dysfunctional cognitions seem to be a long-term treatment goal, especially because of their association with comorbid personality disorders and recurrent depressive disorders. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Automatic Measurements of Mitral Annular Plane Systolic Excursion and Velocities to Detect Left Ventricular Dysfunction.

    Science.gov (United States)

    Grue, Jahn Frederik; Storve, Sigurd; Dalen, Håvard; Salvesen, Øyvind; Mjølstad, Ole Christian; Samstad, Stein O; Torp, Hans; Haugen, Bjørn Olav

    2018-01-01

    The purpose of the study described here was to evaluate an automatic algorithm for detection of left ventricular dysfunction, based on measurements of mitral annular motion indices from color tissue Doppler apical four-chamber recordings. Two hundred twenty-one patients, among whom 49 had systolic and 11 had diastolic dysfunction, were included. Echocardiographic evaluation by cardiologists was the reference. Twenty patients were also examined by medical students. The ability of the indices to detect systolic and diastolic dysfunction were compared in receiver operating characteristic analyses, and the agreement between automatic and reference measurements was evaluated. Mitral annular plane systolic excursion ≤10 mm detected left ventricular dysfunction with 82% specificity, 76% specificity, 56% positive predictive value and 92% negative predictive value. The automatic measurements acquired from expert recordings better agreed better with the reference than those acquired from student recordings. We conclude that automatic measurements of systolic mitral annular motion indices can be helpful in detection of left ventricular dysfunction. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Assessment of autonomic nervous system dysfunction in multiple sclerosis and association with clinical disability

    Science.gov (United States)

    Kale, Nilufer; Magana, Setty; Agaoglu, Jale; Tanik, Osman

    2009-01-01

    Recent studies have reported autonomic dysfunction (AD) in multiple sclerosis (MS), and bladder and/or bowel dysfunction, orthostatic hypotension, and cardiac adaptation disorders have been observed in a wide range of patients (15–80%). The primary aim of this study is to investigate the frequency and association of AD in MS patients, assessed by sympathetic skin response (SSR) and a symptoms questionnaire. The secondary aims are to study the association of AD and disease disability assessed by expanded disability status scale (EDSS), as well as disease duration. One hundred clinically definite MS (CDMS) patients were evaluated for autonomic nervous system (ANS) dysfunction by use of an autonomic symptoms questionnaire and SSR testing. The relationship between these methods, AD and disease-related parameters, such as the expanded disability status scale (EDSS) and disease duration were all evaluated. Sixty-five per cent of the patients presented with AD and 29% of these patients had abnormal SSR results. MS patients with high EDSS values (EDSS>4) and longer disease duration were more likely to have ANS dysfunction (p<0.0001). ANS dysfunction is not uncommon in CDMS patients and thus non-invasive investigations of AD are warranted to optimize AD evaluation and disease management. PMID:21577363

  19. Assessment of autonomic nervous system dysfunction in multiple sclerosis and the association with clinical disability

    Directory of Open Access Journals (Sweden)

    Nilufer Kale

    2009-06-01

    Full Text Available Background: Recent studies have reported autonomic dysfunction (AD in multiple sclerosis (MS, bladder and/or bowel dysfunction, orthostatic hypotension, and cardiac adaptation disorders have been observed in a wide range (15-80%. The primary aim of this study is to investigate the frequency and association of AD in MS patients, assessed by sympathetic skin reaction (SSR and a symptoms questionnaire. The secondary aims of this study are to study the association of AD and disease disability assessed by expanded disability status scale (EDSS, as well as disease duration. Design and Methods: 100 clinically definite MS patients were evaluated for ANS dysfunction by use of an autonomic symptoms questionnaire and SSR testing. The relationship between these methods, AD and disease-related parameters, such as the expanded disability status scale (EDSS and disease duration were all evaluated. Results: 65% of the patients presented with AD and 29% of these patients had abnormal SSR results. MS patients with high EDSS values (EDSS >4 and longer disease duration were more likely to have ANS dysfunction (p less than 0.0001. Conclusions. ANS dysfunction is not uncommon in CDMS patients and thus noninvasive investigations of AD are warranted to optimize AD evaluation and disease management.

  20. Sex Offenders Seeking Treatment for Sexual Dysfunction--Ethics, Medicine, and the Law.

    Science.gov (United States)

    Phillips, Elizabeth A; Rajender, Archana; Douglas, Thomas; Brandon, Ashley F; Munarriz, Ricardo

    2015-07-01

    The treatment of sexual dysfunction in patients with prior sexual offenses poses ethical and legal dilemmas. Sex offenders are not obligated by law to disclose this history to medical professionals. Over 20% of sex offenders experience sexual dysfunction; however, the number of sex offenders seeking evaluation for sexual dysfunction is unknown. The aims of this study were to determine the incidence and characteristics of sex offenders seeking treatment in our clinic; and to review data regarding sex offender recidivism and ethics pertaining to the issue as it relates to treating physicians. Sex offenders were identified via three methods: new patient screening in a dedicated sexual medicine clinic, chart review of those on intracavernosal injection (ICI) therapy for erectile dysfunction (ED), and review of patient's status-post placement of penile prosthesis. Charts were cross-referenced with the U.S. Department of Justice National Sex Offender Public Website. Patient characteristics and details of offenses were collected. The main outcome measures used were a self-reported sexual offense and national registry data. Eighteen male sex offenders were identified: 13 via new patient screening; 3 by review of ICI patients; 1 by review of penile prosthesis data; and 1 prior to penile prosthesis placement. All were primarily referred for ED. Of those with known offenses, 64% were level 3 offenders (most likely to re-offend). The same number had committed crimes against children. All those with complete data had multiple counts of misconduct (average 3.6). Ninety-four percent (17/18) had publicly funded health care. Twelve (67%) were previously treated for sexual dysfunction. Registered sex offenders are seeking and receiving treatment for sexual dysfunction. It is unknown whether treatment of sexual dysfunction increases the risk of recidivism of sexual offenses. Physicians currently face a difficult choice in deciding whether to treat sexual dysfunction in sex

  1. Diaphragmatic Dysfunction Is Characterized by Increased Duration of Mechanical Ventilation in Subjects With Prolonged Weaning.

    Science.gov (United States)

    Lu, Zhihua; Xu, Qiuping; Yuan, Yuehua; Zhang, Ge; Guo, Feng; Ge, Huiqing

    2016-10-01

    Diaphragmatic dysfunction is often underdiagnosed and is among the risk factors for failed weaning. The purpose of this study was to determine the prevalence of diaphragmatic dysfunction diagnosed by B-mode ultrasonography and to determine whether prolonged weaning subjects with diaphragmatic dysfunction have increased duration of mechanical ventilation compared with those without diaphragmatic dysfunction. This was a prospective observational study in mechanically ventilated subjects who failed ≥3 spontaneous breathing trials or required >7 d of weaning after the first spontaneous breathing trial. Diaphragm thickness was measured in the zone of apposition using a 6-13-MHz ultrasound transducer during a spontaneous breathing trial. The diaphragmatic thickening fraction was calculated as a percentage from the formula: (Thickness at peak inspiration - thickness at end expiration)/thickness at end expiration. Intra-observer and inter-observer reliability were also evaluated. Forty-one subjects (24 males; 62.2 ± 15.9 y old) were included in the study. Of these, the prevalence of ultrasonographic diaphragmatic dysfunction (defined as diaphragmatic thickening fraction of ventilation time after inclusion (293.4 ± 194.8 vs 145.1 ± 101.3 h, P = .02) and ICU stay (29.2 ± 11.4 vs 22.4 ± 7.7 d, P = .03) than subjects without diaphragmatic dysfunction. Diaphragmatic dysfunction as assessed by B-mode ultrasonography is common in subjects with prolonged weaning. Subjects with such diaphragmatic dysfunction show longer mechanical ventilation durations and ICU stays. Copyright © 2016 by Daedalus Enterprises.

  2. Sexual dysfunction improved in heroin-dependent men after methadone maintenance treatment in Tianjin, China.

    Directory of Open Access Journals (Sweden)

    Minying Zhang

    Full Text Available OBJECTIVE: To investigate whether methadone maintenance treatment (MMT is correlated with sexual dysfunction in heroin-dependent men and to determine the prevalence and risk factors of sexual dysfunction among men on MMT. METHODS: The study included a retrospective survey and a cross-sectional survey which contained interviews of 293 men who are currently engaged in MMT. The results of the two surveys were compared. For a subset of 43 participants, radioimmunoassay was additionally conducted using retrospective and prospective blood samples to test the levels of plasma testosterone and luteinizing hormone. Other study evaluations were the International Index of Erectile Function (IIEF-15, and Self-rating Depression Scale. RESULTS: Sexual dysfunction in all five IIEF-15 domains (erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction was strongly associated with long-term use of heroin. A decrease in the severity of sexual dysfunction was associated with MMT initiation. Erectile dysfunction, lack of sexual desire, inability to orgasm, and lack of intercourse satisfaction were significantly correlated with increasing age of the participants. Methadone dose and duration of methadone treatment were not found to be associated with sexual dysfunction. The level of plasma testosterone significantly declined during methadone treatment, but results from multivariate analysis indicated low levels of testosterone were not the main cause of sexual dysfunction. No correlation between reported depression status and sexual function was found. CONCLUSIONS: While high levels of sexual dysfunction were reported by heroin-dependent men in our study before and after MMT initiation, MMT appears to be correlated with improved sexual function in the population of the study.

  3. [Primary and secondary prevention of erectile dysfunction].

    Science.gov (United States)

    Kaminsky, A; Sperling, H; Popken, G

    2011-10-01

    Erectile dysfunction has an incidence of up to 75% in men aged 80, thus making primary prevention really important. Aetiologically multiple reasons are responsible for erectile dysfunction; therefore, recommendations for primary prevention contain different parts. The first one is to maintain a healthy arterial system and prevent atherosclerosis. Besides that diabetes, neurogenic disturbances or mental distress should be avoided. Physical activity, balanced nutrition, nonsmoking, unsaturated fatty acids and moderate alcohol consumption are preventive. Regular erections cause oxygenation of the cavernous body and prevent fibrosis which could lead to an insufficient occlusion of the cavernous veins. If the patient already suffers from coronary heart disease or diabetes, blood pressure, pulse, blood lipids and blood sugar should be as normal as possible. Erectile dysfunction might be the primary symptom of coronary heart disease; therefore, consideration should be given to a cardiac examination in the diagnostic setting.

  4. [Female sexual dysfunction: Drug treatment options].

    Science.gov (United States)

    Alcántara Montero, A; Sánchez Carnerero, C I

    2016-01-01

    Many women will likely experience a sexual problem in their lifetime. Female sexual dysfunction is a broad term used to describe 3 categories of disorders of a multifactorial nature. Effective, but limited pharmacotherapeutic options exist to address female sexual dysfunction. The FDA recently approved the first agent for treatment of hypoactive sexual desire disorder in pre-menopausal women. Off-label use of hormonal therapies, particularly oestrogen and testosterone, are the most widely employed for female sexual dysfunction, particularly in post-menopausal women. Other drugs currently under investigation include phosphodiesterase inhibitors and agents that modulate dopamine or melanocortin receptors. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Female Sexual Dysfunctions and Urogynecological Disorders

    Directory of Open Access Journals (Sweden)

    Emillio Sacco

    2013-12-01

    Full Text Available Female sexual dysfunctions are a highly prevalent and often-underestimated health problem and include disorders of sexual desire, arousal, orgasm and sexual pain, associated with self-distress. Pathophysiology of female sexual dysfunctions is complex and still poorly understood, although it has been related to several biological, medical and psychological factors. Amongst women, urogynecological disorders such as urinary incontinence, overactive bladder syndrome, bladder pain syndrome and pelvic organ prolapse, have been found to be associated with sexual dysfunctions, although the biological and psychological bases of these associations are poorly investigated. Data on sexual function impact of these conditions come from several cross-sectional or community-based, epidemiological studies based on self-administered validated psychometric tools. This review focuses on the most relevant available evidence on the impact of urogynecological disorders and related surgical treatments on female sexual function.

  6. Taxonomy of segmental myocardial systolic dysfunction

    Science.gov (United States)

    McDiarmid, Adam K.; Pellicori, Pierpaolo; Cleland, John G.

    2017-01-01

    The terms used to describe different states of myocardial health and disease are poorly defined. Imprecision and inconsistency in nomenclature can lead to difficulty in interpreting and applying trial outcomes to clinical practice. In particular, the terms ‘viable’ and ‘hibernating’ are commonly applied interchangeably and incorrectly to myocardium that exhibits chronic contractile dysfunction in patients with ischaemic heart disease. The range of inherent differences amongst imaging modalities used to define myocardial health and disease add further challenges to consistent definitions. The results of several large trials have led to renewed discussion about the classification of dysfunctional myocardial segments. This article aims to describe the diverse myocardial pathologies that may affect the myocardium in ischaemic heart disease and cardiomyopathy, and how they may be assessed with non-invasive imaging techniques in order to provide a taxonomy of myocardial dysfunction. PMID:27147609

  7. Pain related sexual dysfunction after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Aasvang, Eske Kvanner; Møhl, Bo; Bay-Nielsen, Morten

    2006-01-01

    To determine the incidence of pain related sexual dysfunction 1 year after inguinal herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal herniorrhaphy, chronic genital pain, dysejaculation......, and sexual dysfunction have only been described sporadically. The aim was therefore to describe these symptoms in a questionnaire study. A nationwide detailed questionnaire study in September 2004 of pain related sexual dysfunction in all men aged 18-40 years undergoing inguinal herniorrhaphy between October...... 2002 and June 2003 (n=1015) based upon the nationwide Danish Hernia Database collaboration. The response rate was 68.4%. Combined frequent and moderate or severe pain from the previous hernia site during activity was reported by 187 patients (18.4%). Pain during sexual activity was reported by 224...

  8. DELINQUENT BEHAVIOUR OF CHILDREN FROM DYSFUNCTIONAL FAMILIES

    Directory of Open Access Journals (Sweden)

    Sandra Bateva

    2014-12-01

    Full Text Available The subject of my research in the paper are the children from dysfunctional families, primarily their delinquent behavior, education and moral, actually, who takes care of them and who undertakes the family roles and whether this care is sufficient for building these personalities.This research approaches towards the study of the delinquent behavior of children from dysfunctional families. It examines to what extent the educational level of parents, the material condition, the health condition, the leisure time, the average monthly income of the family, the available permanent goods, the educational resources, the social communications within the very family, all affect the delinquent behavior of children from dysfunctional families. 

  9. Menstrual dysfunction in swimmers: a distinct entity.

    Science.gov (United States)

    Constantini, N W; Warren, M P

    1995-09-01

    Menstrual dysfunction is common among athletes with very low body mass, such as long distance runners and dancers, and is usually associated with hypothalamic dysfunction. The purpose of this study was to investigate the menstrual status of swimmers, in whom exercise is nonweight bearing and thinness is, thus, not essential. Questionnaires recording the menstrual history of 69 young competitive swimmers (aged 16.4 +/- 0.5) were compared to those of 279 age-matched controls. Age of menarche (M) was significantly (P runners. We, therefore, suggest a different mechanism for reproductive dysfunction in swimmers that is associated not with hypoestrogenism, but, rather, with mild hyperandrogenism. A distinction among the various types of athletic amenorrhea should be made based on hormonal profiles with attention to their weight and somatotype.

  10. Beta cell dysfunction and insulin resistance

    Directory of Open Access Journals (Sweden)

    Marlon E Cerf

    2013-03-01

    Full Text Available Beta cell dysfunction and insulin resistance are inherently complex with their interrelation for triggering the pathogenesis of diabetes also somewhat undefined. Both pathogenic states induce hyperglycemia and therefore increase insulin demand. Beta cell dysfunction results from inadequate glucose sensing to stimulate insulin secretion therefore elevated glucose concentrations prevail. Persistently elevated glucose concentrations above the physiological range result in the manifestation of hyperglycemia. With systemic insulin resistance, insulin signaling within glucose recipient tissues is defective therefore hyperglycemia perseveres. Beta cell dysfunction supersedes insulin resistance in inducing diabetes. Both pathological states influence each other and presumably synergistically exacerbate diabetes. Preserving beta cell function and insulin signaling in beta cells and insulin signaling in the glucose recipient tissues will maintain glucose homeostasis.

  11. Laparoscopic correction of peritoneal catheter dysfunction.

    Science.gov (United States)

    Kazemzadeh, Gholamhossein; Modaghegh, Mohammad-Hadi Saeed; Tavassoli, Alireza

    2008-10-01

    To present our experiences with laparoscopic repair of peritoneal catheter dysfunction Total of 24 patients with peritoneal catheter malfunction were considered for two-port laparoscopic manipulation. Two patients with unsuccessful result in the first trial and 3 patients with successful peritoneal dialysis results were reoperated because of catheter dysfunction. The success rates at the first and second manipulation was 79% and 80%. The most frequent cause of catheters dysfunction was migration of catheters out of the true pelvis. During the follow up, 8 patients were referred for renal transplantation, 8 underwent hemodialysis and 5 continued with normal catheter function. The mean longevity of the catheters after laparoscopic correction was 42 months. One year longevity rate as measured as 79%. Laparoscopy is the procedure of choice even in recurrent cases, for correction of malfunctioning continuous ambulatory peritoneal catheters, because this procedure is the only technique that can detects pathologic causes of catheters malfunction and can resolve those problems at the same time.

  12. [Urinary tract dysfunction in older patients].

    Science.gov (United States)

    Verdejo, Carlos; Méndez, Santiago; Salinas, Jesús

    2016-11-18

    Urinary tract dysfunction in older patients has a multifactorial aetiology and is not a uniform clinical condition. Changes due to physiological ageing as well as comorbidity and polypharmacy, can produce several dynamic conditions such as urinary incontinence and urinary retention. Lower urinary tract symptoms increase with age in both sexes and are a major problem in older patients due to their medical and psychosocial consequences. For these reasons, in assessing urinary dysfunction in older patients, we should consider external circumstances such as polypharmacy, poor mobility, affective and cognitive disorders and also accessibility to housing. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  13. Pharmacological approaches to coronary microvascular dysfunction.

    Science.gov (United States)

    Guarini, Giacinta; Huqi, Alda; Morrone, Doralisa; Capozza, Paola; Todiere, Giancarlo; Marzilli, Mario

    2014-12-01

    In recent decades coronary microvascular dysfunction has been increasingly identified as a relevant contributor to several cardiovascular conditions. Indeed, coronary microvascular abnormalities have been recognized in patients suffering acute myocardial infarction, chronic stable angina and cardiomyopathies, and also in patients with hypertension, obesity and diabetes. In this review, we will examine pathophysiological information needed to understand pharmacological approaches to coronary microvascular dysfunction in these different clinical contexts. Well-established drugs and new pharmacological agents, including those for which only preclinical data are available, will be covered in detail. Copyright © 2014. Published by Elsevier Inc.

  14. Subclinical Thyroid Dysfunction and Fracture Risk

    DEFF Research Database (Denmark)

    Blum, Manuel R; Bauer, Douglas C; Collet, Tinh-Hai

    2015-01-01

    IMPORTANCE: Associations between subclinical thyroid dysfunction and fractures are unclear and clinical trials are lacking. OBJECTIVE: To assess the association of subclinical thyroid dysfunction with hip, nonspine, spine, or any fractures. DATA SOURCES AND STUDY SELECTION: The databases of MEDLINE...... and EMBASE (inception to March 26, 2015) were searched without language restrictions for prospective cohort studies with thyroid function data and subsequent fractures. DATA EXTRACTION: Individual participant data were obtained from 13 prospective cohorts in the United States, Europe, Australia, and Japan....... Levels of thyroid function were defined as euthyroidism (thyroid-stimulating hormone [TSH], 0.45-4.49 mIU/L), subclinical hyperthyroidism (TSH

  15. Liver dysfunction and anti-thyroid therapy

    Directory of Open Access Journals (Sweden)

    Danae A Papachristos

    2015-01-01

    Full Text Available Thioamides have been used in the management of hyperthyroidism for over 50 years. Liver dysfunction is a rare but important side effect associated with their use. Recently, cases of liver failure associated with propylthiouracil have prompted the Federal Drug Administration to issue a Boxed Warning to the label of propylthiouracil regarding its risk of potentially fatal liver injury and acute liver failure in adults and children. Herein, we present a case to underline the importance of recognising the similar potential for severe hepatic dysfunction with the use of other thioamides.

  16. Hepatic mitochondrial dysfunction in Friedreich Ataxia

    Directory of Open Access Journals (Sweden)

    Stüwe Sven H

    2011-11-01

    Full Text Available Abstract Background Mitochondrial dysfunction due to respiratory chain impairment is a key feature in pathogenesis of Friedreich ataxia. Friedreich ataxia affects the nervous system, heart and pancreas. Methods We assessed hepatic mitochondrial function by 13C-methionine-breath-test in 16 Friedreich ataxia patients and matched healthy controls. Results Patients exhaled significantly smaller amounts of 13CO2 over 90 minutes. Maximal exhaled percentage dose of 13CO2 recovery was reduced compared to controls. Conclusions 13C-methionine-breath-test indicates subclinical hepatic mitochondrial dysfunction in Friedreich ataxia but did not correlate with GAA repeat lengths, disease duration or disease severity.

  17. Psychosocial pathways to sexual dysfunction among female inmates.

    Science.gov (United States)

    Baltieri, Danilo Antonio

    2014-08-01

    Although health surveys on sexual issues during incarceration have shown that women report having engaged in sexual activities while in prison, studies on sexual functioning in female inmates have been largely dismissed. This study aimed to assess sexual functioning among incarcerated women and determine the psychometric and sociodemographic features that are possibly related to the risk of sexual dysfunction. This was a cross-sectional study conducted inside a penitentiary for women in São Paulo, Brazil. From June 2006 to June 2010, 315 inmates convicted of robbery or homicide were recruited. High risk of female sexual dysfunction (HRFSD) was measured using the Female Sexual Function Index and participants were also evaluated for alcohol and drug misuse, impulsiveness, depressive symptoms, and psychosocial features. Descriptive statistics and multivariate logistic regression were utilized to analyze the data. Among the participants, 253 (80.32 %) met the criteria for HRFSD. Older age, total time of imprisonment, and depressive symptoms were related to a higher risk, while the status of being married, being Black, having sexual relations with other inmates, and receiving conjugal visits were associated with a lower risk. As only 110 (34.92 %) inmates admitted to having sexual relationships inside prison, we evaluated this sub-sample separately. For this sub-sample, 61 (55.45 %) women met the criteria for HRFSD and the main factors associated with this risk were total time of imprisonment and depressive symptoms. Incarcerated women are uniquely vulnerable because they often have histories of deprivation and violence stemming from multiple sources and experience considerable psychological symptoms as a consequence of imprisonment. With the affected population rarely receiving psychosocial management for sexual dysfunction, service delivery efforts should be intensified to target this high-risk population.

  18. [Clinical procedure in amiodarone-induced thyroid dysfunction].

    Science.gov (United States)

    Różycka-Kosmalska, Monika; Michalak, Renata; Kosmalski, Marcin; Ptaszyński, Paweł; Wranicz, Jerzy Krzysztof; Zieleniewski, Wojciech; Cygankiewicz, Iwona

    2016-01-01

    Amiodarone is an antiarrhythmic drug frequently used in everyday clinical practice. Its mechanism of action involves the interaction with many receptors, including those in the cardiac conduction system. Amiodarone usefulness is protect in the treatment of a variety of tachyarrhythmias, both benign and life-threatening. In contrast to other antiarrhythmic drugs, amiodarone is characterized by high therapeutic efficacy, both in patients with normal and impaired left ventricular systolic function. A significant limitation of its is associated with side effects including thyroid gland dysfunction. Disturbances of this organ associated with amiodarone are an important diagnostic and therapeutic problem. They may contribute to the occurrence of both Amiodarone- Induced Thyrotoxicosis (AIT) and Amiodarone-Induced Hypothyroidism (AIH). The risk of such complications should be considered for each patient individually, taking into account thyroid function at the beginning of pharmacotherapy. Appropriate procedure, both before and after treatment allows a rapid diagnosis and treatment of thyroid disturbances. It seems that the best parameter used to assess the hormonal imbalance during amiodarone therapy is the concentration of the free triiodothyronine (fT3). The evaluation of thyroid function should be performed before starting pharmacotherapy, and then repeated every six months. In the case of a thyroid dysfunction, assessment must be performed immediately according to standard diagnostic and therapeutic regimens. Despite abnormal thyroid function, high efficiency of amiodarone and relatively small risk of thyroid damage allows continuation therapy. Amiodarone therapy requires a care from both cardiologist and endocrinologist. The aim of this paper is to present the state of art of evaluation of the thyroid function and procedures implemented in care of thyroid dysfunction before and during treatment with amiodarone. © 2016 MEDPRESS.

  19. Cardiovascular disease and cognitive dysfunction in systemic lupus erythematosus.

    Science.gov (United States)

    Murray, Sara G; Yazdany, Jinoos; Kaiser, Rachel; Criswell, Lindsey A; Trupin, Laura; Yelin, Edward H; Katz, Patricia P; Julian, Laura J

    2012-09-01

    Cognitive dysfunction and cardiovascular disease are common and debilitating manifestations of systemic lupus erythematosus (SLE). In this study, we evaluated the relationship between cardiovascular events, traditional cardiovascular risk factors, and SLE-specific risk factors as predictors of cognitive dysfunction in a large cohort of participants with SLE. Subjects included 694 participants from the Lupus Outcomes Study (LOS), a longitudinal study of SLE outcomes based on an annual telephone survey querying demographic and clinical variables. The Hopkins Verbal Learning Test-Revised and the Controlled Oral Word Association Test were administered to assess cognitive function. Multiple logistic regression was used to identify cardiovascular events (myocardial infarction, stroke), traditional cardiovascular risk factors (hypertension, hyperlipidemia, diabetes mellitus, obesity, smoking), and SLE-specific risk factors (antiphospholipid antibodies [aPL], disease activity, disease duration) associated with cognitive impairment in year 7 of the LOS. The prevalence of cognitive impairment as measured by verbal memory and verbal fluency metrics was 15%. In adjusted multiple logistic regression analyses, aPL (odds ratio [OR] 2.10, 95% confidence interval [95% CI] 1.3-3.41), hypertension (OR 2.06, 95% CI 1.19-3.56), and a history of stroke (OR 2.27, 95% CI 1.16-4.43) were significantly associated with cognitive dysfunction. In additional analyses evaluating the association between these predictors and severity of cognitive impairment, stroke was significantly more prevalent in participants with severe impairment when compared to those with mild or moderate impairment (P = 0.036). These results suggest that the presence of aPL, hypertension, and stroke are key variables associated with cognitive impairment, which may aid in identification of patients at greatest risk. Copyright © 2012 by the American College of Rheumatology.

  20. A importância da avaliação postural no paciente com disfunção da articulação temporomandibular The importance of the postural evaluation in patients with temporomandibular joint dysfunction

    Directory of Open Access Journals (Sweden)

    Daniela Vieira Amantéa

    2004-09-01

    Full Text Available O equilíbrio do corpo bem como os movimentos da cabeça são originados pelo posicionamento do crânio sobre a região cervical determinando assim a postura do indivíduo. Estando a articulação temporomandibular (ATM diretamente relacionada com a região cervical e escapular através de um sistema neuromuscular comum, alterações posturais da coluna cervical podem acarretar em distúrbios na ATM e vice-versa. O número crescente de pacientes com disfunção da articulação temporomandibular (DTM que apresentavam alterações posturais levou ao desenvolvimento de estudos que procuram demonstrar suas relações. Este trabalho propôs-se realizar uma revisão de literatura que demonstre a relação entre má postura e DTM. Salienta ainda a necessidade de uma equipe multidisciplinar, formada pelo médico ortopedista, o cirurgião dentista e o fisioterapeuta, para realizarem juntos o diagnóstico e o tratamento de tais alterações.The position of the head over the neck determines the posture of the body and is responsible for the body balance and head movements. The temporomandibular joint (TMA is directly related to the cervical and the scapular region by a common neuromuscular system. Changes in the cervical spine can cause lead to TMA disorders and contra wise. The increasing number of patients with TMA disorders who also had postural disorders led to the development of studies to evaluate their interactions. The present study aimed to review the papers that have shown a relationship between wrong posture and TMA disorders. It emphasizes the importance of a multidisciplinary team formed by an orthopedist, dental surgeon, and physiotherapist in the diagnosis and treatment of TMA disorders and wrong posture.

  1. Linear shock wave therapy in the treatment of erectile dysfunction.

    Science.gov (United States)

    Pelayo-Nieto, M; Linden-Castro, E; Alias-Melgar, A; Espinosa-Pérez Grovas, D; Carreño-de la Rosa, F; Bertrand-Noriega, F; Cortez-Betancourt, R

    2015-09-01

    Linear Shock Wave Therapy (LSWT) is a new noninvasive therapy that uses low-intensity shock waves to induce local angiogenesis promising modality in the treatment of erectile dysfunction (ED). To evaluate the effectiveness of LSWT in men with vasculogenic erectile dysfunction (ED), in a Tertiary Care Center. Included 15 men aged 45-70 years, sexually active with mild and moderate vascular ED evaluated with the International Index of Erectile Function (IIEF). The study was conducted in three stage: screening, treatment and results. Treatment stage: 4 weekly sessions LSWT (RENOVA ®) 5000 waves (.09mJ/mm(2)). Erectile function was assessed with IIEFF-EF, SEP (Sexual Encounter Profile) and GAQ (Global Assessment Questions) at one and six months after treatment. The rate of success was 80% (12/15). Patients with mild ED (6/15) 40% and moderate ED (9/15) 60%. We found a positive association between IIEF-Basal (average 14.23 pts) and IIEF at one month and six months after therapy (19.69 pts) a difference of 5.46 pts. (P<.013). The feasibility and tolerability of this treatment, and rehabilitation potential features, make it this an attractive new treatment option for patients with ED. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Explaining dysfunctional effects of lexicographical communication

    African Journals Online (AJOL)

    user

    Explaining Dysfunctional Effects of Lexicographical Communication. 61 part of the aim.El propositions relate directly to the observability and measur- ability of aim.El. They can be taken from education theory, for instance Bloom's revised taxonomy of educational objectives (cf. Anderson and Krathwohl. 2001).21. It is now ...

  3. Spotlight on olfactory dysfunction in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Rodríguez-Violante M

    2017-06-01

    Full Text Available Mayela Rodríguez-Violante,1,2 Natalia Ospina-García,1,2 Christian Pérez-Lohman,1,2 Amin Cervantes-Arriaga1,2 1Movement Disorders Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; 2Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico Abstract: Olfactory dysfunction is frequent in Parkinson’s disease (PD. A correlation between olfactory dysfunction and the pathophysiological process of the disease has been confirmed. On the other hand, olfaction disturbances are also prevalent in other neurodegenerative diseases, and may be related to other factors such as gender, age, smoking, and trauma. Clinically, hyposmia is commonly assessed by smell identification testing. Good diagnostic accuracy has been widely reported, but differences in sensitivity and specificity due to sociocultural factors have also been reported. Since hyposmia may be present before the onset of motor symptoms, it has the potential to serve as a biomarker for the identification of subjects at risk of developing PD. Several studies have been conducted to assess the utility of smell testing as an isolated or combined biomarker for this end. Finally, severe olfactory dysfunction has been associated with faster disease progression and higher risk of cognitive decline in patients with PD. Olfactory dysfunction assessment in PD will continue to be relevant in research and clinical practice. Keywords: Parkinson’s disease, olfaction, smell identification test, biomarker 

  4. Prevalence of anxiety and depressive erectile dysfunction

    African Journals Online (AJOL)

    Although prevalence rates of ED and depression increase with age, they may be co-morbid in age groups other than the elderly. However, sexual dysfunction is a common side-effect of antidepressant treatment, and may also explain the relationship between depression and ED. Serotonin re- uptake inhibitors (SRIs) ...

  5. Acute Right Ventricular Dysfunction Complicating Prolonged ...

    African Journals Online (AJOL)

    We report a case of transient right ventricular dysfunction associated with prolonged cardiac tamponade, an unusual complication of uncertain etiology. We believe that in this case dynamic coronary flow restriction resulted in ischemic injury and stunning of the right ventricle. Other possible causes are briefly reviewed. Right ...

  6. Dimensions of working memory dysfunction in schizophrenia.

    NARCIS (Netherlands)

    Pukrop, R.; Matuschek, E.; Ruhrmann, S.; Brockhaus, A.; Tendolkar, I.; Bertsch, A.; Klosterkötter, J.

    2003-01-01

    The aim of this study was to investigate the underlying structure of eight working memory tests used to assess prefrontal dysfunction in schizophrenia research [Letter-Number Span (LNS), Digit-Symbol Test (DST), Trail-Making Test B (TMT-B), Delayed Response Task (DRT) for spatial working memory,

  7. Cerebral energy metabolism during induced mitochondrial dysfunction

    DEFF Research Database (Denmark)

    Nielsen, T H; Bindslev, TT; Pedersen, S M

    2013-01-01

    In patients with traumatic brain injury as well as stroke, impaired cerebral oxidative energy metabolism may be an important factor contributing to the ultimate degree of tissue damage. We hypothesize that mitochondrial dysfunction can be diagnosed bedside by comparing the simultaneous changes in...

  8. Erectile dysfunction | Smith | South African Family Practice

    African Journals Online (AJOL)

    Erectile dysfunction (ED) is a medical term that describes the inability to achieve and/or maintain an erect penis adequate for sexual function. This condition is one of the most common sexual problems for men and increases with age, but it's not a natural part of ageing. Approximately one half of men aged 40 years and ...

  9. Lower urinary tract dysfunction in children

    NARCIS (Netherlands)

    Klijn, AJ

    2016-01-01

    Lower urinary tract dysfunction in children can have many faces. It can present with incontinenece for urine, urinary tract infections or even constipation or loosing stools. All kinds of factors influencing the function of the pelvic floor muscle tension can have an impact on the lower urinary

  10. Explaining dysfunctional effects of lexicographical communication

    African Journals Online (AJOL)

    user

    atically and formally analysed to identify functional, non-functional and dysfunctional effects of lexicographical communication. ... of noise at soccer matches]. In a comment during question and discussion time .... the effect of the communication process, when the user applies the meaning of the lexicographic message to the ...

  11. Hepatitis C Virus-Induced Mitochondrial Dysfunctions

    Directory of Open Access Journals (Sweden)

    Birke Bartosch

    2013-03-01

    Full Text Available Chronic hepatitis C is characterized by metabolic disorders and a microenvironment in the liver dominated by oxidative stress, inflammation and regeneration processes that lead in the long term to hepatocellular carcinoma. Many lines of evidence suggest that mitochondrial dysfunctions, including modification of metabolic fluxes, generation and elimination of oxidative stress, Ca2+ signaling and apoptosis, play a central role in these processes. However, how these dysfunctions are induced by the virus and whether they play a role in disease progression and neoplastic transformation remains to be determined. Most in vitro studies performed so far have shown that several of the hepatitis C virus (HCV proteins localize to mitochondria, but the consequences of these interactions on mitochondrial functions remain contradictory, probably due to the use of artificial expression and replication systems. In vivo studies are hampered by the fact that innate and adaptive immune responses will overlay mitochondrial dysfunctions induced directly in the hepatocyte by HCV. Thus, the molecular aspects underlying HCV-induced mitochondrial dysfunctions and their roles in viral replication and the associated pathology need yet to be confirmed in the context of productively replicating virus and physiologically relevant in vitro and in vivo model systems.

  12. Left atrial myxoma with biventricular dysfunction.

    Science.gov (United States)

    Raut, Monish S; Shad, Sujay; Maheshwari, Arun

    2016-09-01

    Occurrence of left atrial myxoma with severe ventricular dysfunction without any obstructive coronary artery disease, as presented in our case, is very rare. It may be due to undiagnosed concomitant dilated cardiomyopathy or unknown cardiodepressant effect of myxoma which warrants further research. Copyright © 2016 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  13. The treatment of autonomic dysfunction in tetanus

    African Journals Online (AJOL)

    Opiates. In 1972, Rie and Wilson[25] reported the successful use of morphine to control autonomic dysfunction in a case of tetanus. It does not appear to act as a peripheral α-adrenergic antagonist but rather attenuates sympathetic efferent discharge within the central nervous system. Buchanan et al.[26] reported in 1979 ...

  14. Women's health implications of ovulatory dysfunction

    NARCIS (Netherlands)

    Daan, NMP

    2016-01-01

    The association between ovulatory dysfunction and the occurrence of future CVD events remains largely unsettled.The association between PCOS and cardiometabolic abnormalities (e.g. obesity, dyslipidemia, insulin resistance) has indeed been clearly established, and was reaffirmed in the current

  15. Melatonin in Mitochondrial Dysfunction and Related Disorders

    OpenAIRE

    Venkatramanujam Srinivasan; D Warren Spence; Pandi-Perumal, Seithikurippu R; Brown, Gregory M.; Cardinali, Daniel P.

    2011-01-01

    Mitochondrial dysfunction is considered one of the major causative factors in the aging process, ischemia/reperfusion (I/R), septic shock, and neurodegenerative disorders like Parkinson's disease (PD), Alzheimer's disease (AD), and Huntington's disease (HD). Increased free radical generation, enhanced mitochondrial inducible nitric oxide (NO) synthase activity, enhanced NO production, decreased respiratory complex activity, impaired electron transport system, and opening of mitochondrial per...

  16. Lysyl oxidase and adipose tissue dysfunction

    DEFF Research Database (Denmark)

    Pastel, Emilie; Price, Emily; Sjöholm, Kajsa

    2018-01-01

    BACKGROUND/OBJECTIVES: Lysyl oxidase (LOX) is an enzyme crucial for collagen fibre crosslinking and thus for fibrosis development. Fibrosis is characterised by a surplus of collagen fibre accumulation and is amongst others also a feature of obesity-associated dysfunctional adipose tissue (AT) which...

  17. Sexual dysfunction in Nigerian stroke survivors

    African Journals Online (AJOL)

    EB

    2013-09-03

    Sep 3, 2013 ... Objectives: This survey reports sexual dysfunction in Nigerian stroke survivors, and determines the influence of socio- ... Participants completed the Beck Depression Inventory, Stroke Specific Quality of Life Scale and post-stroke sexual function ..... Medical. Aspects of Human Sexuality 1979; 13: 16-30. 25.

  18. Family Roles, Alcoholism, and Family Dysfunction.

    Science.gov (United States)

    Alford, Karola M.

    1998-01-01

    Examines family roles in college undergraduates (N=748). Comparing role identification found no differences between children of alcoholics (ACOA) and non-ACOAs. Differences were found in participants from dysfunctional families. Results suggest a need for clinicians to re-think the use of role conceptualization in therapeutic work with ACOAs, with…

  19. Endothelial Dysfunction in Chronic Inflammatory Diseases

    Directory of Open Access Journals (Sweden)

    Curtis M. Steyers

    2014-06-01

    Full Text Available Chronic inflammatory diseases are associated with accelerated atherosclerosis and increased risk of cardiovascular diseases (CVD. As the pathogenesis of atherosclerosis is increasingly recognized as an inflammatory process, similarities between atherosclerosis and systemic inflammatory diseases such as rheumatoid arthritis, inflammatory bowel diseases, lupus, psoriasis, spondyloarthritis and others have become a topic of interest. Endothelial dysfunction represents a key step in the initiation and maintenance of atherosclerosis and may serve as a marker for future risk of cardiovascular events. Patients with chronic inflammatory diseases manifest endothelial dysfunction, often early in the course of the disease. Therefore, mechanisms linking systemic inflammatory diseases and atherosclerosis may be best understood at the level of the endothelium. Multiple factors, including circulating inflammatory cytokines, TNF-α (tumor necrosis factor-α, reactive oxygen species, oxidized LDL (low density lipoprotein, autoantibodies and traditional risk factors directly and indirectly activate endothelial cells, leading to impaired vascular relaxation, increased leukocyte adhesion, increased endothelial permeability and generation of a pro-thrombotic state. Pharmacologic agents directed against TNF-α-mediated inflammation may decrease the risk of endothelial dysfunction and cardiovascular disease in these patients. Understanding the precise mechanisms driving endothelial dysfunction in patients with systemic inflammatory diseases may help elucidate the pathogenesis of atherosclerosis in the general population.

  20. Sociodemographic and clinical correlates of sexual dysfunction ...

    African Journals Online (AJOL)

    2016-02-09

    Feb 9, 2016 ... quality of life and medication adherence with resultant negative impact on treatment outcomes. Objectives: In this study, we described the various types of sexual dysfunction among psychiatric outpatients receiving psychotropic ..... role reversal within a relationship, bringing about feelings of inadequacy in ...

  1. Neuromuscular dysfunction associated with delayed weaning from ...

    African Journals Online (AJOL)

    Yehia Khalil

    2012-03-21

    Mar 21, 2012 ... Neuromuscular dysfunction associated with delayed weaning from mechanical ventilation in patients with respiratory failure. Yehia Khalil a. , Emad El Din Mustafa a. , Ahmed Youssef a. ,. Mohamed Hassan Imam b,. *, Amni Fathy El Behiry a a Department of Chest, Faculty of Medicine, Alexandria University, ...

  2. Diaphragm Dysfunction in Mechanically Ventilated Patients.

    Science.gov (United States)

    Dot, Irene; Pérez-Teran, Purificación; Samper, Manuel-Andrés; Masclans, Joan-Ramon

    2017-03-01

    Muscle involvement is found in most critical patients admitted to the intensive care unit (ICU). Diaphragmatic muscle alteration, initially included in this category, has been differentiated in recent years, and a specific type of muscular dysfunction has been shown to occur in patients undergoing mechanical ventilation. We found this muscle dysfunction to appear in this subgroup of patients shortly after the start of mechanical ventilation, observing it to be mainly associated with certain control modes, and also with sepsis and/or multi-organ failure. Although the specific etiology of process is unknown, the muscle presents oxidative stress and mitochondrial changes. These cause changes in protein turnover, resulting in atrophy and impaired contractility, and leading to impaired functionality. The term 'ventilator-induced diaphragm dysfunction' was first coined by Vassilakopoulos et al. in 2004, and this phenomenon, along with injury cause by over-distention of the lung and barotrauma, represents a challenge in the daily life of ventilated patients. Diaphragmatic dysfunction affects prognosis by delaying extubation, prolonging hospital stay, and impairing the quality of life of these patients in the years following hospital discharge. Ultrasound, a non-invasive technique that is readily available in most ICUs, could be used to diagnose this condition promptly, thus preventing delays in starting rehabilitation and positively influencing prognosis in these patients. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Effect of Common Visual Dysfunctions on Reading.

    Science.gov (United States)

    McPartland, Brian P.

    1985-01-01

    Six common visual dysfunctions are briefly explained and their relationships to reading noted: (1) ametropia, refractive error; (2) inaccurate saccades, the small jumping eye movements used in reading; (3) inefficient binocularity/fusion; (4) insufficient convergence/divergence; (5) heterophoria, imbalance in extra-ocular muscles; and (6)…

  4. Minor neurological dysfunction in children with dyslexia

    NARCIS (Netherlands)

    Punt, Marja; De Jong, Marianne; De Groot, Erik; Hadders-Algra, Mijna

    2010-01-01

    AIM To improve understanding of brain function in children with severe dyslexia in terms of minor neurological dysfunctions (MNDs). METHOD One hundred and four children (81 males, 23 females; age range 7-12y; mean age 9y 7mo, SD 1y 2mo;) with severe dyslexia (the presence of a Full-scale IQ score of

  5. Sexual dysfunction during primiparous and multiparous women ...

    African Journals Online (AJOL)

    Normal sexual functioning comprises of sexual activity together with transition through the phases from arousal to relaxation with no problem. Delivery has different effects on body organs, especially, on genitalia the disorder of which can cause sexual dysfunctions. In this study, an attempt is made to compare postpartum ...

  6. Kidney dysfunction after allogeneic stem cell transplantation

    NARCIS (Netherlands)

    Kersting, S.

    2008-01-01

    Allogeneic stem cell transplantation (SCT) is a widely accepted approach for malignant and nonmalignant hematopoietic diseases. Unfortunately complications can occur because of the treatment, leading to treatment-related mortality. We studied kidney dysfunction after allogeneic SCT in 2 cohorts of

  7. Olfactory dysfunction in neuromyelitis optica spectrum disorders

    NARCIS (Netherlands)

    Zhang, L.J.; Zhao, N.; Fu, Y.; Zhang, D.Q.; Wang, J.; Qin, W.; Zhang, N.N.N.; Wood, K.; Liu, Y.; Yu, C.S.; Shi, F.D.; Yang, L.

    2015-01-01

    Few data were available for the understanding of olfactory function in neuromyelitis optica spectrum disorders (NMOSDs). The aims of our study were to investigate the incidence of olfactory dysfunction and characterize olfactory structures, using MRI, in patients with NMOSDs. Olfactory function was

  8. Italian cross-cultural adaptation and validation of three different scales for the evaluation of shoulder pain and dysfunction after neck dissection: University of California - Los Angeles (UCLA) Shoulder Scale, Shoulder Pain and Disability Index (SPADI) and Simple Shoulder Test (SST).

    Science.gov (United States)

    Marchese, C; Cristalli, G; Pichi, B; Manciocco, V; Mercante, G; Pellini, R; Marchesi, P; Sperduti, I; Ruscito, P; Spriano, G

    2012-02-01

    Shoulder syndrome after neck dissection is a well known entity, but its incidence and prognostic factors influencing recovery have not been clearly assessed due to the heterogeneity of possible evaluations. The University of California - Los Angeles (UCLA) Shoulder Scale, the Shoulder Pain and Disability Index (SPADI) and the Simple Shoulder Test (SST) are three English-language questionnaires commonly used to test shoulder impairment. An Italian version of these scales is not available. The aim of the present study was to translate, culturally adapt and validate an Italian version of UCLA Shoulder Scale, SPADI and SST. Translation and cross-cultural adaptation of the SPADI, the UCLA shoulder scale and the SST was performed according to the international guidelines. Sixty-six patients treated with neck dissection for head and neck cancer were called to draw up these scales. Forty patients completed the same questionnaires a second time one week after the first to test the reproducibility of the Italian versions. All the English-speaking Italian patients (n = 11) were asked to complete both the English and the Italian versions of the three questionnaires to validate the scales. No major problems regarding the content or the language were found during the translation of the 3 questionnaires. For all three scales, Cronbach's α was > 0.89. The Pearson correlation coefficient was r > 0.91. With respect to validity, there was a significant correlation between the Italian and the English versions of all three scales. This study shows that the Italian versions of UCLA Shoulder Scale, SPADI and SST are valid instruments for the evaluation of shoulder dysfunction after neck dissection in Italian patients.

  9. Vascular Dysfunction in Horses with Endocrinopathic Laminitis.

    Directory of Open Access Journals (Sweden)

    Ruth A Morgan

    Full Text Available Endocrinopathic laminitis (EL is a vascular condition of the equine hoof resulting in severe lameness with both welfare and economic implications. EL occurs in association with equine metabolic syndrome and equine Cushing's disease. Vascular dysfunction, most commonly due to endothelial dysfunction, is associated with cardiovascular risk in people with metabolic syndrome and Cushing's syndrome. We tested the hypothesis that horses with EL have vascular, specifically endothelial, dysfunction. Healthy horses (n = 6 and horses with EL (n = 6 destined for euthanasia were recruited. We studied vessels from the hooves (laminar artery, laminar vein and the facial skin (facial skin arteries by small vessel wire myography. The response to vasoconstrictors phenylephrine (10-9-10-5M and 5-hydroxytryptamine (5HT; 10-9-10-5M and the vasodilator acetylcholine (10-9-10-5M was determined. In comparison with healthy controls, acetylcholine-induced relaxation was dramatically reduced in all intact vessels from horses with EL (% relaxation of healthy laminar arteries 323.5 ± 94.1% v EL 90.8 ± 4.4%, P = 0.01, laminar veins 129.4 ± 14.8% v EL 71.2 ± 4.1%, P = 0.005 and facial skin arteries 182.0 ± 40.7% v EL 91.4 ± 4.5%, P = 0.01. In addition, contractile responses to phenylephrine and 5HT were increased in intact laminar veins from horses with EL compared with healthy horses; these differences were endothelium-independent. Sensitivity to phenylephrine was reduced in intact laminar arteries (P = 0.006 and veins (P = 0.009 from horses with EL. Horses with EL exhibit significant vascular dysfunction in laminar vessels and in facial skin arteries. The systemic nature of the abnormalities suggest this dysfunction is associated with the underlying endocrinopathy and not local changes to the hoof.

  10. [The therapy of masticatory organ dysfunctions (CMD)].

    Science.gov (United States)

    Kiss, Géza; Pácz, Miklós; Kiss, Péter

    2013-12-01

    The authors have been dealing with disorders of the masticatory organ (CMD) for several decades and they published their experience and summarized findings that they have gained from over 2,000 cases. They gave a summary of masticatory organ dysfunction diagnostics in 3rd issue of Fogorvosi Szemle in 2011. In their current paper they discuss the treatment of masticatory organ dysfunctions (CMD) according to the logic of diagnostic algorythm and they present it to the practising dentist. They would like to emphasize that it is not allowed to indicate any treatment especially an irreversible one, without a diagnosis. The cause of the disease can very often be identified or specified after the symptom relieving treatment. After summarizing the general treatment principles depending on the functional condition of the masticatory organ, they give a detailed explanation of systematic functional therapy, i.e., symptomatic treatment or medical treatment, physiotherapy, occlusal splint therapy and the definitive treatment that follows (such as occlusal adjustment, prosthetic rehabilitation, orthodontics and surgical intervention). They classify the occlusal instruments (splint), which are often misinterpreted or not used in the proper way in practice (and bibliography), according to indications. They outline some orthodontic anomalies in connection with the masticatory organ: on the one hand when the patient who undergoes an orthodontic treatment has a latent or manifest masticatory organ dysfunction (CMD), on the other hand when the dysfunction appears during the orthodontic treatment. Among the definitive treatment principles they emphasize the gnathological aspects of prosthetic rehabilitation. They draw attention to the maintenance therapy of patients suffering from masticatory organ dysfunction.

  11. [Predictors of Family Dysfunction among Adolescent Students].

    Science.gov (United States)

    Gómez-Bustamante, Edna Margarita; Castillo-Ávila, Irma; Cogollo, Zuleima

    2013-03-01

    Determination of family dysfunction predictors in adolescent students of Cartagena, Colombia. A cross-sectional analytical research was conducted by means of a probabilistic sample per conglomerate of high-school students. Participation of students between 13 and 17 years was requested. Family dysfunction was identified through the family APGAR scale. Predictors were adjusted by binary logistic regression. A total of 1,730 students agreed to participate, mean age was 14.7 years (SD=1.2), and 52.7% were girls. The family APGAR scale showed a Cronbach alpha of 0.78. A group of 896 students (51.8%) reported family dysfunction. Predictors of family dysfunction were: clinically significant depressive symptoms (OR=3.61; IC 95%: 2.31-5.63), low religiosity (OR=1.73; CI 95%: 1.41-2.13), non-nuclear family (OR=1.71, CI 95% 1.71-2.09) (OR=1.73, 95% CI 1.41-2.13), non-nuclear family (OR=1.71, 95%: CI 1.41-2.09), consumption of any illegal substance in their lives (OR=1.67, CI 95%: 1.15-2.13), residents of depressed neighborhoods (OR = 1.49; CI 95%: 1.19-1.87), and poor academic performance (OR=1.43; CI 95%: 1.15-1.76). Clinically significant depressive symptoms, low religiosity and non-nuclear family are the main predictors of family dysfunction among adolescent students in Cartagena, Colombia. The association is possibly bidirectional. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  12. Endothelial dysfunction in rheumatic autoimmune diseases.

    Science.gov (United States)

    Murdaca, Giuseppe; Colombo, Barbara Maria; Cagnati, Paola; Gulli, Rossella; Spanò, Francesca; Puppo, Francesco

    2012-10-01

    Rheumatic autoimmune diseases have been associated with accelerated atherosclerosis and various types of vasculopathies. Atherosclerosis is an inflammatory condition which starts as a "response to injury" favoring endothelial dysfunction which is associated with increased expression of adhesion molecules, pro-inflammatory cytokines, pro-thrombotic factors, oxidative stress upregulation and abnormal vascular tone modulation. Endothelial dysfunction in rheumatic autoimmune diseases involves innate immune responses, including macrophages and dendritic cells expression of scavenger and toll-like receptors for modified or native LDL as well as neutrophil and complement activation, and dysregulation of adaptive immune responses, including proliferation of autoreactive T-helper-1 lymphocytes and defective function of dendritic and regulatory T cells. Specific differences for endothelial function among different disorders include: a) increased amounts of pro-atherogenic hormones, decreased amounts of anti-atherogenic hormones and increased insulin resistance in rheumatoid arthritis; b) autoantibodies production in systemic lupus erythematosus and antiphospholipid syndrome; c) smooth muscle cells proliferation, destruction of internal elastic lamina, fibrosis and coagulation and fibrinolytic system dysfunction in systemic sclerosis. Several self-antigens (i.e. high density lipoproteins, heat shock proteins, β2-glycoprotein1) and self-molecules modified by oxidative events (i.e. low density lipoproteins and oxidized hemoglobin) have been identified as targets of autoimmune responses. Endothelial dysfunction leads to accelerated atherosclerosis in rheumatoid arthritis, systemic lupus erythematosus and spondyloarthropaties whereas obliterative vasculopathy is associated with systemic sclerosis. In this paper, we will briefly review the most relevant information upon endothelial dysfunction and inflammatory mechanisms in atherosclerosis and we will summarize the similarities

  13. Dysfunctional eating behaviour, psychological well-being and adaptation to pregnancy: A study with women in the third trimester of pregnancy.

    Science.gov (United States)

    Gonçalves, Sónia; Freitas, Flávia; Freitas-Rosa, Marta Alexandre; Machado, Bárbara César

    2015-05-01

    This study evaluated the prevalence and predictors of dysfunctional eating. Women in the third trimester of pregnancy participated in this study (N = 105). Dysfunctional eating was associated with a higher body mass index, enhanced negative body image, more somatic symptoms, poorer marital relationships, more negative attitudes regarding pregnancy and the baby and more emotional problems. A higher body mass index prior to the pregnancy, higher weight gain during pregnancy and a more negative perception of body image predicted dysfunctional eating. Clinicians must be aware of the presence of dysfunctional eating during pregnancy to prevent relevant physiological and psychosocial consequences during this stage. © The Author(s) 2015.

  14. Influence of sexual performance anxiety on Erectile Dysfunction%性操作焦虑对阴茎勃起障碍的影响研究

    Institute of Scientific and Technical Information of China (English)

    刘明矾

    2002-01-01

    Objective: To understand psychological factors involved in erectile dysfunction. Methods: The erectile dysfunction rating scale (EDRS), State-trait anxiety inventory (STAI), and sexual psychological questionnaire (self-designed) were administered to 74 cases (30 psychogenic ED patients and 44 normal control objects).Results: High levels of sexual performance anxiety were found to affect patients' self-evaluation and coping responses. Sexual performance anxiety, deficient sexual sensitivity and poor communication techniques were the major contributing factors of psychogenic erectile dysfunction.Conclusion: Sexual performance anxiety constitutes a significant factor of erective dysfunction.

  15. Myocardial dysfunction in malnourished children

    Directory of Open Access Journals (Sweden)

    Faddan Nagla Hassan

    2010-01-01

    Full Text Available Background : Malnourished children suffer several alterations in body composition that could produce cardiac abnormalities. Aim : The aim of the present study was to detect the frequency of myocardial damage in malnourished children as shown by echocardiography and cardiac troponin T (cTnT level. Methods : Forty-five malnourished infants and young children (mean±SD of age was 11.24 ±7.88 months were matched with 25 apparently healthy controls (mean±SD of age was 10.78±6.29 months. Blood sample was taken for complete blood picture, liver and kidney function tests, serum sodium, potassium, calcium levels and cTnT. All the malnourished children were subjected to echocardiographic evaluation. Results : Malnourished children showed a significantly lower left ventricular (LV mass than the control group. The LV systolic functions were significantly impaired in patients with severe malnutrition. The cTnT level was higher than the upper reference limits in 11 (24.44% of the studied malnourished children and all of them had a severe degree of malnutrition. The cTnT level was significantly higher in patients with anemia, sepsis and electrolyte abnormalities and it correlated negatively with LV ejection fraction (EF. Six of the studied children with high cTnT levels (54.5% died within 21 days of treatment while only one case (2.9% with normal level of cTnT died within the same period. Conclusions: LV mass is reduced in malnourished children. Children with severe malnutrition have a significant decrease in LV systolic functions. Elevated cTnT levels in malnourished children has both diagnostic and prognostic significance for cardiomyocyte damage.

  16. Metformin attenuates ER stress-induced mitochondrial dysfunction.

    Science.gov (United States)

    Chen, Qun; Thompson, Jeremy; Hu, Ying; Das, Anindita; Lesnefsky, Edward J

    2017-12-01

    Endoplasmic reticulum (ER) stress, a disturbance of the ER function, contributes to cardiac injury. ER and mitochondria are closely connected organelles within cells. ER stress contributes to mitochondrial dysfunction, which is a key factor to increase cardiac injury. Metformin, a traditional anti-diabetic drug, decreases cardiac injury during ischemia-reperfusion. Metformin also inhibits ER stress in cultured cells. We hypothesized that metformin can attenuate the ER stress-induced mitochondrial dysfunction and subsequent cardiac injury. Thapsigargin (THAP, 3 mg/kg) was used to induce ER stress in C57BL/6 mice. Cell injury and mitochondrial function were evaluated in the mouse heart 48 hours after 1-time THAP treatment. Metformin was dissolved in drinking water (0.5 g/250 ml) and fed to mice for 7 days before THAP injection. Metformin feeding continued after THAP treatment. THAP treatment increased apoptosis in mouse myocardium compared to control. THAP also led to decreased oxidative phosphorylation in heart mitochondria-oxidizing complex I substrates. THAP decreased the calcium retention capacity, indicating that ER stress sensitizes mitochondria to mitochondrial permeability transition pore opening. The cytosolic C/EBP homologous protein (CHOP) content was markedly increased in THAP-treated hearts compared to control, particularly in the nucleus. Metformin prevented the THAP-induced mitochondrial dysfunction and reduced CHOP content in cytosol and nucleus. Thus, metformin reduces cardiac injury during ER stress through the protection of cardiac mitochondria and attenuation of CHOP expression. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Breast cancer treatment and sexual dysfunction: Moroccan women's perception

    Directory of Open Access Journals (Sweden)

    Ismaili Nabil

    2011-06-01

    Full Text Available Abstract Background This exploratory prospective study evaluated women's responses to questions that asked them to describe how their body image and sexual functioning had changed since their breast cancer diagnosis to treatment. Methods A questionnaire concerning body image scale and various sexual problems experienced after diagnosis and treatment was anonymously completed by 120 women in the outpatient clinic of our hospital's Division of medical Oncology. To be eligible, subjects had to be sexually active and had histology proven breast cancer. They also had to have received treatment for breast cancer. Results 100% of participants have never spoken with their doctor about this subject. 84% of the participants continued sexual activity after treatment, but there was an increase in the incidence of sexual functioning problems which resulted in a slight reduction in the quality of their sex lives. 65% of the women experienced dyspareunia followed by lubrication difficulties (54% and the absence or reduction of sexual desire (48% and 64%, respectively while, 37% had lack of satisfaction (37%. Female orgasmic disorder and brief intercourse and arousal were reported respectively by 40% and 38% of the subjects. The sexual dysfunctions were absent before diagnosis and management of breast cancer in 91.5% subjects and of these 100% subjects complained of a deterioration of the symptomatology after the various treatments. 90% of the dysfunctions were observed after chemotherapy, 9% after surgery and 3% after radiotherapy; none of the subjects indicated the onset of dysfunctions to have been associated with hormonotherapy. 100% expressed not having received sufficient information about how the disease and treatment (including surgery might affect their sexual life. Conclusion Breast cancer and its treatment may result in significant difficulties with sexual functioning and sexual life. Addressing these problems is essential to improve the quality of

  18. Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes

    Directory of Open Access Journals (Sweden)

    Tasso Julio Lobo

    2015-01-01

    Full Text Available Background: Heart failure and atrial fibrillation (AF often coexist in a deleterious cycle. Objective: To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF ablation. Methods: Patients with ventricular systolic dysfunction [ejection fraction (EF <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia". Clinical (NYHA functional class and echocardiographic (EF, left atrial diameter data were compared (McNemar test and t test before and after ablation. Results: 31 patients (6 women, 25 men, aged 37 to 77 years (mean, 59.8±10.6, underwent RF ablation. The etiology was mainly idiopathic (19 p, 61%. During a mean follow-up of 20.3±17 months, 24 patients (77% were in sinus rhythm, 11 (35% being on amiodarone. Eight patients (26% underwent more than one procedure (6 underwent 2 procedures, and 2 underwent 3 procedures. Significant NYHA functional class improvement was observed (pre-ablation: 2.23±0.56; postablation: 1.13±0.35; p<0.0001. The echocardiographic outcome also showed significant ventricular function improvement (EF pre: 44.68%±6.02%, post: 59%±13.2%, p=0.0005 and a significant left atrial diameter reduction (pre: 46.61±7.3 mm; post: 43.59±6.6 mm; p=0.026. No major complications occurred. Conclusion: Our findings suggest that AF ablation in patients with ventricular systolic dysfunction is a safe and highly effective procedure. Arrhythmia control has a great impact on ventricular function recovery and functional class improvement.

  19. Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes

    Science.gov (United States)

    Lobo, Tasso Julio; Pachon, Carlos Thiene; Pachon, Jose Carlos; Pachon, Enrique Indalecio; Pachon, Maria Zelia; Pachon, Juan Carlos; Santillana, Tomas Guillermo; Zerpa, Juan Carlos; Albornoz, Remy Nelson; Jatene, Adib Domingos

    2015-01-01

    Background Heart failure and atrial fibrillation (AF) often coexist in a deleterious cycle. Objective To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF) ablation. Methods Patients with ventricular systolic dysfunction [ejection fraction (EF) <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia". Clinical (NYHA functional class) and echocardiographic (EF, left atrial diameter) data were compared (McNemar test and t test) before and after ablation. Results 31 patients (6 women, 25 men), aged 37 to 77 years (mean, 59.8±10.6), underwent RF ablation. The etiology was mainly idiopathic (19 p, 61%). During a mean follow-up of 20.3±17 months, 24 patients (77%) were in sinus rhythm, 11 (35%) being on amiodarone. Eight patients (26%) underwent more than one procedure (6 underwent 2 procedures, and 2 underwent 3 procedures). Significant NYHA functional class improvement was observed (pre-ablation: 2.23±0.56; postablation: 1.13±0.35; p<0.0001). The echocardiographic outcome also showed significant ventricular function improvement (EF pre: 44.68%±6.02%, post: 59%±13.2%, p=0.0005) and a significant left atrial diameter reduction (pre: 46.61±7.3 mm; post: 43.59±6.6 mm; p=0.026). No major complications occurred. Conclusion Our findings suggest that AF ablation in patients with ventricular systolic dysfunction is a safe and highly effective procedure. Arrhythmia control has a great impact on ventricular function recovery and functional class improvement. PMID:25387404

  20. Levels of uric acid in erectile dysfunction of different aetiology.

    Science.gov (United States)

    Barassi, Alessandra; Corsi Romanelli, Massimiliano Marco; Pezzilli, Raffaele; Dozio, Elena; Damele, Clara Anna Linda; Vaccalluzzo, Liborio; Di Dario, Marco; Goi, Giancarlo; Papini, Nadia; Massaccesi, Luca; Colpi, Giovanni Maria; Melzi d'Eril, Gian Vico

    2018-01-12

    Erectile dysfunction is a common disease characterized by endothelial dysfunction. The aetiology of ED is often multifactorial but evidence is being accumulated in favor of the proper function of the vascular endothelium that is essential to achieving and maintaining penile erection. Uric acid itself causes endothelial dysfunction via decreased nitric oxide production. This study aims to evaluate the serum uric acid (SUA) levels in 180 ED patients, diagnosed with the International Index of Erectile Function-5 (IIEF-5) and 30 non-ED control. Serum uric acid was analyzed with a commercially available kit using ModularEVO (Roche, Monza, Italy). Within-assay and between-assay variations were 3.0% and 6.0%, respectively. Out of the ED patients, 85 were classified as arteriogenic (A-ED) and 95 as non-arteriogenic (NA-ED) with penile-echo-color-Doppler. Uric acid levels (median and range in mg/dL) in A-ED patients (5.8, 4.3-7.5) were significantly higher (p uric acid levels in patients with mild A-ED (IIEF-5 16-20) and severe/complete A-ED (IIEF-5 ≤ 10) that were 5.4 (range 4.3-6.5) mg/dL and 6.8 (range 6.4-7.2) mg/dL, respectively. There was no difference between the levels of uric acid in patients with different degree of NA-ED. Our findings reveal that SUA is a marker of ED but only of ED of arteriogenic aetiology.

  1. Animal Models for the Study of Female Sexual Dysfunction

    Science.gov (United States)

    Marson, Lesley; Giamberardino, Maria Adele; Costantini, Raffaele; Czakanski, Peter; Wesselmann, Ursula

    2017-01-01

    Introduction Significant progress has been made in elucidating the physiological and pharmacological mechanisms of female sexual function through preclinical animal research. The continued development of animal models is vital for the understanding and treatment of the many diverse disorders that occur in women. Aim To provide an updated review of the experimental models evaluating female sexual function that may be useful for clinical translation. Methods Review of English written, peer-reviewed literature, primarily from 2000 to 2012, that described studies on female sexual behavior related to motivation, arousal, physiological monitoring of genital function and urogenital pain. Main Outcomes Measures Analysis of supporting evidence for the suitability of the animal model to provide measurable indices related to desire, arousal, reward, orgasm, and pelvic pain. Results The development of female animal models has provided important insights in the peripheral and central processes regulating sexual function. Behavioral models of sexual desire, motivation, and reward are well developed. Central arousal and orgasmic responses are less well understood, compared with the physiological changes associated with genital arousal. Models of nociception are useful for replicating symptoms and identifying the neurobiological pathways involved. While in some cases translation to women correlates with the findings in animals, the requirement of circulating hormones for sexual receptivity in rodents and the multifactorial nature of women’s sexual function requires better designed studies and careful analysis. The current models have studied sexual dysfunction or pelvic pain in isolation; combining these aspects would help to elucidate interactions of the pathophysiology of pain and sexual dysfunction. Conclusions Basic research in animals has been vital for understanding the anatomy, neurobiology, and physiological mechanisms underlying sexual function and urogenital pain

  2. Occult endocrine dysfunction in patients of cerebrovascular accident

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    K. V. S. Hari Kumar

    2016-01-01

    Full Text Available Background: Cerebrovascular disorders are common conditions leading to significant morbidity and mortality in the population. Occult endocrine disorders also contribute to the morbidity and we studied the prevalence of endocrine dysfunction in patients of cerebrovascular accident (CVA. Materials and Methods: We evaluated 30 patients of CVA (aged 18-75, admission within 72 h of symptoms and positive neuroimaging in this prospective, observational study. All subjects were assessed clinically and biochemically for hormonal dysfunction at admission and for mortality at the end of 1 month. The patients were divided into two groups: Group 1 (infarct, n = 20 and Group 2 (hemorrhage, n = 10 and the data were analyzed with appropriate statistical tests using GraphPad Prism Software, version 6. Results: The study participants (24M:6F had a mean age of 60.7 ± 11.4 years and body weight of 67.2 ± 11.4 kg. Fourteen out of 30 patients showed results consistent with an endocrine disorder, including sick euthyroid syndrome (SES and central hypothyroidism (n = 10, secondary hypogonadism (n = 3, subclinical hypothyroidism (n = 1, and growth hormone (GH deficiency in two patients. The endocrine conditions did not differ significantly between both the groups and nine out of 30 patients succumbed to their illness within 1 month. None of the hormonal parameters studied, could predict the 30 day mortality. Conclusion: Endocrine disorders are common in acute stage of CVA and commonest finding is a SES. Hormonal dysfunction did not differ based on the etiology of the CVA. Long-term follow-up is essential to understand the morbidity contributed by the hormonal alterations.

  3. Assessment of Sexual Dysfunction in Patients with Fibromyalgia Syndrome

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    Rahime Nur Ülker

    2013-12-01

    Full Text Available Objectives: The aim of our study is to determine the presence, quality of sexual dysfunction in patients with fibromyalgia syndrome and to compare with normal population. Material and Methods: A total of 55 sexually active women who were admitted to Department of Physical Therapy and Rehabilitation of Antalya Research and Training Hospital and diagnosed with fibromyalgia syndrome according to 1990 and 2010 American College of Rheumatology (ACR criteria. A control group composed of 50 sexually active women who were admitted to our clinic with various musculoskeletal system complaints were also included in the study in order to compare the parameters used for clinical assessment of patients and to determine whether the patients differ from normal population. Patients and controls who met inclusion criteria were applied Female Sexual Function Index (FSFI for assessment of sexual function. This test was developed by Rosen and colleagues in 2000, it is composed of 19 questions and inquires six different dimensions including desire, arousal, lubrication, orgasm, sexual satisfaction and pain. Turkish validation test was done by Turkish Society Of Andrology in 2003, answers are multiplied with a coefficient and each section is evaluated on six scores. Minimum score is 2.4 and maximum is 36 and standardly used for assessment of female sexual dysfunction in Turkey. Results: Subscale and total score of Female Sexual Function Index of Fibromyalgia syndrome patients were found statistically significantly lower than those of control group (p<0.05. Conclusion: Disorders of sexual function or its quality are one of the problems seen in fibromyalgia syndrome patients. It should be noticed that sexual function assessment must be a part of treatment of fibromyalgia syndrome. It is quite difficult to determine the mechanism between sexual dysfunction and fibromyalgia syndrome and new and larger studies are needed to determine this mechanism. (Turkish Journal of

  4. Post-resuscitation myocardial microcirculatory dysfunction is ameliorated with eptifibatide.

    Science.gov (United States)

    Kern, Karl B; Sasaoka, Taro; Higashi, Haruhiko; Hilwig, Ronald W; Berg, Robert A; Zuercher, Mathias

    2011-01-01

    The post-cardiac arrest syndrome includes a decline in myocardial microcirculation function. Inhibition of the platelet IIb/IIIa glycoprotein receptor has improved myocardial microvascular function post-percutaneous coronary intervention. Therefore, we evaluated such inhibition with eptifibatide for its effect on myocardial microcirculation function post-cardiac arrest and resuscitation. Four groups of swine were studied in a prospective, randomized, blinded, placebo-controlled protocol including; eptifibatide administered during CPR (Group 1, n=5), after resuscitation (Group 2, n=4), during and after resuscitation (Group 3, n=5), or placebo (Group 4, n=10). CPR was initiated following 12min of untreated VF. Those successfully resuscitated were studied during a 4-h post-resuscitation period. Coronary flow reserve, a measure of microcirculation function (in the absence of coronary obstruction), as well as parameters of left ventricular systolic and diastolic function, were measured pre-arrest and serially post-resuscitation. Coronary flow reserve was preserved during the post-resuscitation period, indicating normal microcirculatory function in the eptifibatide-treated animals, but not in the placebo-treated group. However, LV function declined equally in both groups during the first 4h after cardiac arrest. Inhibition of platelet IIb/IIIa glycoprotein receptors with eptifibatide post-resuscitation prevented myocardial microcirculation dysfunction. Left ventricular dysfunction post-resuscitation was not improved with eptifibatide, and perhaps transiently worse at 30min post-resuscitation. Post-cardiac arrest ventricular dysfunction may require a multi-modality treatment strategy for successful prevention or amelioration. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Reversal of thienopyridine-induced platelet dysfunction following desmopressin administration.

    Science.gov (United States)

    Levine, Michael; Swenson, Steve; McCormick, Taylor; Henderson, Sean O; Thomas, Stephen H; Markland, Francis S

    2013-06-01

    Adenosine diphosphate (ADP)-receptor antagonists are widely used for thrombus prevention, although reversing their platelet dysfunction is difficult. This study evaluated the ability of desmopressin to reverse clopidogrel-induced platelet dysfunction. Sprague-Dawley rats received either clopidogrel (30 mg/kg) or placebo, followed 4 h later by saline or desmopressin (0.15, 0.3, or 0.6 μg/kg). Bleeding times and platelet aggregation studies were subsequently performed. A bleeding time >25 min was considered "prolonged." The median bleeding time for clopidogrel-exposed rats was 21 min, vs. 6 min for controls (p < 0.01). Progressively higher doses of 1-deamino-8-D-arginine vasopressin (DDAVP) were associated with a reduced number of rats with prolonged bleeding time (p = 0.001). Higher doses of DDAVP were also associated with a reduction in the median (IQR) bleeding time; 29 (13.5-30) min in rats receiving clopidogrel without DDAVP vs. 19 (12-28) min in rats receiving clopidogrel and 0.6 μg/kg DDAVP. The step-wise dosing of DDAVP resulted in a 54 % reduction in meeting the endpoint of prolonged bleeding time (OR 0.46; p = 0.025; 95 % CI 0.23-0.91). Platelet aggregation was observed in all control rats, but only some of those clopidogrel-treated rats who received 0.6 μg/kg DDAVP. In this model of an ADP-receptor antagonist, DDAVP results in partial reversal of clopidogrel-induced platelet dysfunction.

  6. Leydig cell dysfunction, systemic inflammation and metabolic syndrome in long-term testicular cancer survivors.

    Science.gov (United States)

    Bandak, M; Jørgensen, N; Juul, A; Lauritsen, J; Oturai, P S; Mortensen, J; Hojman, P; Helge, J W; Daugaard, G

    2017-10-01

    Twenty to thirty percent of testicular cancer (TC) survivors have elevated serum levels of luteinising hormone (LH) with or without corresponding low testosterone levels (Leydig cell dysfunction) during clinical follow-up for TC. However, it remains to be clarified if this subgroup of TC survivors has an increased long-term risk of systemic inflammation and metabolic syndrome (MetS) when compared with TC survivors with normal Leydig cell function during follow-up. TC survivors with Leydig cell dysfunction and a control group of TC survivors with normal Leydig cell function during follow-up were eligible for participation in the study. Markers of systemic inflammation and prevalence of MetS were compared between TC survivors with Leydig cell dysfunction and the control group. Of 158 included TC survivors, 28 (18%) had uncompensated Leydig cell dysfunction, 59 (37%) had compensated Leydig cell dysfunction and 71 (45%) had normal Leydig cell function during follow-up. MetS and markers of systemic inflammation were evaluated at a median follow-up of 9.7 years (interquartile range 4.1-17.1) after TC treatment. The prevalence of MetS was significantly lower among patients with compensated Leydig cell dysfunction during follow-up (12% versus 27%, p = 0.04), whereas there was no difference between TC survivors with uncompensated Leydig cell dysfunction and controls (33% versus 27%, p = 0.5). Apart from high-sensitivity C-reactive protein which was higher in TC survivors with uncompensated Leydig cell dysfunction during follow-up, there was no evidence of increased systemic inflammation in patients with Leydig cell dysfunction during clinical follow-up. Total testosterone at follow-up was significantly associated with MetS, whereas there was no association between LH and MetS. We did not find evidence that TC survivors with Leydig cell dysfunction during clinical follow-up had increased long-term risk of MetS. Total testosterone at follow-up was significantly associated

  7. Renal dysfunction in African patients with acute heart failure

    NARCIS (Netherlands)

    Sani, Mahmoud U.; Davison, Beth A.; Cotter, Gad; Sliwa, Karen; Edwards, Christopher; Liu, Licette; Damasceno, Albertino; Mayosi, Bongani M.; Ogah, Okechukwu S.; Mondo, Charles; Dzudie, Anastase; Ojji, Dike B.; Voors, Adrian A.

    Aims In Western countries with typically elderly ischaemic acute heart failure patients, predictors and clinical outcome of renal dysfunction and worsening renal function are well described. However, the prevalence, predictors and clinical outcome of renal dysfunction in younger, mainly hypertensive

  8. Cognitive dysfunction after fast-track hip and knee replacement

    DEFF Research Database (Denmark)

    Krenk, Lene; Kehlet, Henrik; Bæk Hansen, Torben

    2014-01-01

    BACKGROUND: Postoperative cognitive dysfunction (POCD) is reported to occur after major surgery in as many as 20% of patients, elderly patients may especially experience problems in the weeks and months after surgery. Recent studies vary greatly in methods of evaluation and diagnosis of POCD......, and the pathogenic mechanisms are still unclear. We evaluated a large uniform cohort of elderly patients in a standardized approach, after major joint replacement surgery (total hip and knee replacement). Patients were in an optimized perioperative approach (fast track) with multimodal opioid-sparing analgesia...... to 2 weeks and 3 months postoperatively. LOS, pain, opioid use, inflammatory response, and sleep quality were recorded. The practice effect of repeated cognitive testing was gauged using data from a healthy community-dwelling control group (n = 161). RESULTS: Median LOS was 2 days (interquartile range...

  9. Evaluering

    DEFF Research Database (Denmark)

    Wahlgren, Bjarne; Andersen, Michael; Wandall, Jakob

    Idéen til denne bog opstod i forbindelse med undervisningen i evaluering af uddannelse på Århus Universitet. Vi oplevede, at der nok fandtes megen litteratur om evaluering, både på dansk og især engelsk, men ikke meget litteratur, der på en overskuelig og dækkende måde kunne bruges som indføring i...... det brede felt, som bogen dækker. En del dansksproget evalueringslitteratur drejer sig om programevaluering på et mere generelt niveau. Meget af denne litteratur har fokus på offentlig virksomhed, men kun i mindre grad på uddannelse. En del litteratur omhandler evaluering af undervisning, en del har...... fokus på elevers læring. Vi har villet skrive en bog, der dækker hele feltet: Evaluering af læring, undervisning og uddannelse. Vi har med bogen villet skabe overblik over dette omfattende felt, som udvikler sig i mange retninger. Dette ud fra den opfattelse, at evaluering får stadig større betydning...

  10. Peyronie′s disease and erectile dysfunction: Current understanding and future direction

    Directory of Open Access Journals (Sweden)

    Laurence A Levine

    2006-01-01

    This article briefly reviews what is currently understood about the etiology and presentation of the patient with Peyronie′s disease and tries to clarify several of the widely held misconceptions. In addition, there are recommendations for evaluation and a more detailed discussion of the erectile dysfunction associated with Peyronie′s disease, as well as appropriate treatment options.

  11. Do endocrines play an etiological role in diabetic and nondiabetic sexual dysfunctions?

    Science.gov (United States)

    Ficher, M; Zuckerman, M; Fishkin, R E; Goldman, A; Neeb, M; Fink, P J; Cohen, S N; Jacobs, J A; Weisberg, M

    1984-01-01

    Sexually dysfunctional diabetic and nondiabetic males were compared with a group of normal controls using different endocrinological, psychophysiological, and psychological parameters. One hundred male subjects participated in this study: 47 diabetics with sexual dysfunction (DD), 31 nondiabetics with sexual dysfunction (NDD), and 22 normal controls (C). They were evaluated by an internist (physical examination and medical history), a psychologist (psychological and sexual functioning tests), a psychiatrist (psychiatric history and mental status examination), a urologist (genitourinary physical examination), and an endocrine biochemist (evaluation of endocrine factors). Additionally, subjects were evaluated for nocturnal penile tumescence (NPT) during three nights in the sleep laboratory to obtain a differential diagnosis of impotence, that is, psychogenic vs. organic. Both sexually dysfunctional groups showed significant differences on several measures in the psychological and psychophysiological evaluations. There were also significant differences between these two groups and the control group. Plasma levels of total testosterone and serum levels of prolactin, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) showed no significant differences among the three groups, but there were some significant correlations between the endocrine and psychological measures. No significant correlations were found between the endocrine and psychophysiological measures.

  12. Development of a sexual function questionnaire for clinical trials of female sexual dysfunction

    NARCIS (Netherlands)

    Quirk, Frances H.; Heiman, Julia R.; Rosen, Raymond C.; Laan, Ellen; Smith, Michael D.; Boolell, Mitra

    2002-01-01

    OBJECTIVE: To better evaluate efficacy in clinical trials of drugs as potential treatments for female sexual dysfunctions (FSD), a brief, multidimensional measure of female sexual function was developed. METHODS: Data from semistructured interviews with 82 women with or without FSD, aged 19-65

  13. Specific postural support promotes variation in motor behaviour of infants with minor neurological dysfunction

    NARCIS (Netherlands)

    de Graaf-Peters, Victorine B.; De Groot-Hornstra, Agnes H.; Dirks, Tineke; Hadders-Algra, Mijna

    2006-01-01

    This study evaluated the effect of specific postural support on motor behaviour of infants with and without minor neurological dysfunction (MND). The following questions were addressed: (1) Does application of supportive pillows affect the time during which the infant exhibits general movements

  14. Measuring right-hemisphere dysfunction in children: validity of two new computer tests

    NARCIS (Netherlands)

    Sips, H.J.W.A.; C.E. Catsman-Berrevoets (Coriene); H.R. van Dongen (Huug); van der Werff, P.J.J.; Brooke, L.J.

    1994-01-01

    textabstractThe validity of two new computer‐mediated tests for the detection of right‐cerebral hemisphere lesions in children–the Right‐hemisphere Dysfunction Test and the Visual Perception Test–was evaluated. Normative data were drawn from a group of 91 children (aged five to 14 years) and 14

  15. Cardiac magnetic resonance markers of progressive RV dilation and dysfunction after tetralogy of Fallot repair

    NARCIS (Netherlands)

    Wald, Rachel M.; Valente, Anne Marie; Gauvreau, Kimberlee; Babu-Narayan, Sonya V.; Assenza, Gabriele Egidy; Schreier, Jenna; Gatzoulis, Michael A.; Kilner, Philip J.; Koyak, Zeliha; Mulder, Barbara; Powell, Andrew J.; Geva, Tal

    2015-01-01

    Patients with repaired tetralogy of Fallot (TOF) are followed serially by cardiac magnetic resonance (CMR) for surveillance of RV dilation and dysfunction. We sought to define the prevalence of progressive RV disease and the optimal time interval between CMR evaluations. Candidates were selected

  16. Intracavernosal alprostadil is effective for the treatment of erectile dysfunction in diabetic men

    NARCIS (Netherlands)

    Heaton, JPW; Lording, D; Liu, SN; Litonjua, AD; Guangwei, L; Kim, SC; Kim, JJ; Zhi-Zhou, S; Israr, D; Niazi, D; Rajatanavin, R; Suyono, S; Benard, F; Casey, R; Brock, G; Belanger, A

    2001-01-01

    The efficacy and safety of intracavernosal alprostadil was evaluated for the treatment of erectile dysfunction in men with type I or type II diabetes mellitus. This was an open-label, flexible dose-escalating study involving 336 men (77% of whom were Asian/Oriental) enrolled by 15 centres in

  17. Psychology's Role in the Assessment of Erectile Dysfunction: Historical Precedents, Current Knowledge, and Methods.

    Science.gov (United States)

    Ackerman, Mark D.; Carey, Michael P.

    1995-01-01

    Describes the role of the psychologist in the evaluation of erectile dysfunction. Reviews current diagnostic criteria and provides a historical overview of the topic. Summarizes current epidemiologic knowledge, including data on prevalence and research on cognitive, affective, dydactic, and lifestyle etiologic risk factors. Discusses assessment…

  18. Urinary dysfunction after rectal cancer treatment is mainly caused by surgery

    NARCIS (Netherlands)

    Lange, M. M.; Maas, C. P.; Marijnen, C. A. M.; Wiggers, T.; Rutten, H. J.; Kranenbarg, E. Klein; van de Velde, C. J. H.

    Background. Urinary dysfunction (UD) is common after rectal cancer treatment, but the contribution of each treatment component (surgery and radiotherapy) to its development remains unclear. This study aimed to evaluate UD during 5 years after total mesorectal excision (TME) and to investigate the

  19. Occupational cycling is a risk factor for erectile dysfunction in east ...

    African Journals Online (AJOL)

    Background: The association between bicycle riding and erectile dysfunction is controversial and hypothesised to be caused by pressure from the bicycle seat on the pudendal nerve. Objectives: To evaluate erectile function in East African occupational cyclists (OC) using International Index of Erectile Function ...

  20. Vestibular Dysfunction and Difficulty with Driving: Data from the 2001–2004 National Health and Nutrition Examination Surveys

    Directory of Open Access Journals (Sweden)

    Eric X. Wei

    2017-10-01

    Full Text Available Background and objectiveThere is growing understanding of the role of vestibular function in spatial navigation and orientation. Individuals with vestibular dysfunction demonstrate impaired performance on static and dynamic tests of spatial cognition, but there is sparse literature characterizing how these impairments might affect individuals in the real-world. Given the important role of visuospatial ability in driving a motor vehicle, we sought to evaluate whether individuals with vestibular dysfunction might have increased driving difficulty.Materials and methodsWe used data from the 2001–2004 National Health and Nutrition Examination Surveys to evaluate the influence of vestibular dysfunction in driving difficulty in a nationally representative sample of U.S. adults aged ≥50 years (n = 3,071. Vestibular function was measured with the modified Romberg test. Furthermore, since vestibular dysfunction is a known contributor to falls risk, we assessed whether individuals with vestibular dysfunction and concomitant driving difficulty were at an increased risk of falls.ResultsIn multivariate analyses, vestibular dysfunction was associated with a twofold increased odd of driving difficulty (odds ratio 2.16, 95% CI 1.57, 2.98. Among participants with vestibular dysfunction, concomitant driving difficulty predicted an increased risk of falls that was significantly higher than in participants with vestibular dysfunction only (odds ratio 13.01 vs. 2.91, p < 0.0001.ConclusionThis study suggests that difficulty driving may be a real-world manifestation of impaired spatial cognition associated with vestibular loss. Moreover, driving difficulty may be a marker of more severe vestibular dysfunction.