Navegando por Palavras-chave "Erectile Dysfunction"
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- ItemSomente MetadadadosAdjunctive Treatment with Lodenafil Carbonate for Erectile Dysfunction in Outpatients with Schizophrenia and Spectrum: A Randomized, Double-Blind, Crossover, Placebo-Controlled Trial(Wiley-Blackwell, 2013-04-01) Alves Nunes, Luciana Vargas [UNIFESP]; Lacaz, Fernando Sargo [UNIFESP]; Bressan, Rodrigo Affonseca [UNIFESP]; Vargas Alves Nunes, Sandra Odebrecht; Mari, Jair de Jesus [UNIFESP]; Universidade Estadual de Londrina (UEL); Universidade Federal de São Paulo (UNIFESP)Introduction. Evidence is accumulating to support the presence of erectile dysfunction in patients with schizophrenia. This dysregulation may be amenable to therapeutic intervention to improve adherence and quality of life of patients who suffer from schizophrenia and schizoaffective disorders. Aim. We aimed to evaluate the use of adjunctive medication lodenafil for the treatment of erectile dysfunction in outpatients with schizophrenia and spectrum. Methods. the design was a randomized, double-blind, crossover, placebo-controlled trial with lodenafil and it was carried at the Schizophrenia Outpatients Program. Main Outcome Measures. the measures used to assess sexual dysfunction were Arizona Sexual Experiences Scale (ASEX) and International Index of Erectile Function (IIEF). the Positive and Negative Syndrome Scale (PANSS) and the Quality of Life Scale (QLS) were also used. the measures included the levels of prolactin, estradiol, luteinizing hormone, sex hormone-binding globulin, free testosterone, and total testosterone at baseline and end point. Lodenafil and placebo pills were used by the patients for 16 weeks. Results. Fifty male outpatients fulfilled the criteria and 94% of the participants completed the study. Lodenafil and placebo produced improvement in ASEX, IIEF scale, PANSS, and QLS, and there was no statistical difference between lodenafil and placebo groups in all sexual domains in the results of PANSS and QLS and in the results of hormone levels. Conclusion. These results indicate that both lodenafil and placebo were effective in the treatment of erectile dysfunction for schizophrenia. Placebo effect is very important in patients with schizophrenia and this study showed the importance of discussing sexuality and trying to treat these patients. Further studies designed to test treatments of erectile dysfunction in patients who suffer from schizophrenia are necessary. Nunes LVA, Lacaz FS, Bressan RA, Nunes SOVA, and Mari JJ. Adjunctive treatment with lodenafil carbonate for erectile dysfunction in outpatients with schizophrenia and spectrum: A randomized, double-blind, crossover, placebo-controlled trial. J Sex Med 2013; 10: 1136-1145.
- ItemSomente MetadadadosAngiotensin-Converting Enzyme Polymorphism and Erectile Dysfunction Complaints in the Brazilian Population(Wiley-Blackwell, 2010-08-01) Andersen, Monica L. [UNIFESP]; Guindalini, Camila [UNIFESP]; Santos-Silva, Rogerio [UNIFESP]; Bittencourt, Lia R. A. [UNIFESP]; Tufik, Sergio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction. Angiotensin-converting enzyme (ACE) is the major regulator of circulatory homeostasis. An insertion/deletion (I/D) polymorphism in the ACE gene has been associated with marked differences in serum ACE levels and with various cardiovascular diseases. Limited and conflicting data have been published on the influence of this genetic variant on the pathophysiology of erectile dysfunction (ED).Aim. To evaluate a potential association between ACE gene polymorphism and ED complaints in a population-based sample in So Paulo, Brazil.Main Outcome Measures. the prevalence of ED complaints was estimated according to previously validated 8 item questionnaire.Methods. A total of 449 men were enrolled in the Epidemiologic Sleep Study and answered an 8-item questionnaire to ascertain sexual performance/ED and satisfaction. ACE gene polymorphism were genotyped using a standard polymerase chain reaction method.Results. No significant case control difference was observed for the ACE gene I/D polymorphism either by genotype or allele-wise. Because age is a significant risk factor for ED complaints in our sample, we carried out analyses stratifying the sample by age group. the ID and II genotypes were significantly more frequent in ED complaint cases (88.9%) compared with controls (57.1%) in the men between 40 and 55 years of age. the frequency of the I allele NUS also significantly higher in individuals complaining of Ell (66.7%) compared with men with no complaints (39.0%) (odds ratio = 3.12; 95% confidence interval = 1.48-6.59). Correction for potential confounding variables, including genetic ancestry, did not affect the strength of the association.Conclusions. the findings of the present study suggest that the I/D polymorphism or another variant in close linkage disequilibrium with it may play a role in the development of ED in a specific age group and provides progress towards the understanding of the interaction between genetic factors and the risk of ED. Andersen ML, Guindalini C, Santos-Silva R, Bittencourt LRA, and Tufik S. Angiotensin converting enzyme polymorphism and erectile dysfunction complaints in the Brazilian population. J Sex Med 2010;7:2791-2797.
- ItemSomente MetadadadosAssociation Analysis of Endothelial Nitric Oxide Synthase G894T Gene Polymorphism and Erectile Dysfunction Complaints in a Population-Based Survey(Wiley-Blackwell, 2010-03-01) Andersen, Monica L. [UNIFESP]; Guindalini, Camila [UNIFESP]; Santos-Silva, Rogerio [UNIFESP]; Bittencourt, Lia Rita A. [UNIFESP]; Tufik, Sergio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction.Erectile dysfunction (ED) is a common disorder leading to a serious, negative impact on the quality of the patient's life. the gene encoding endothelial nitric oxide synthase (eNOS) is an interesting candidate gene for understanding the physiopathology of ED, as it is involved in the catalytic production of nitric oxide (NO), the neurotransmitter that plays a critical role in penile tumescence and erection.Aim.To evaluate a potential association between the G894T polymorphism in the eNOS gene and ED complaints in a population-based sample in São Paulo, Brazil.Main Outcome Measures.The prevalence of ED complaints was estimated according to the answer to the question How would you describe your ability to get and keep an erection that is adequate for satisfactory intercourse? ED was considered to be present if the response was sometimes or never.Methods.A total of 449 men were enrolled in the study and answered an eight-item questionnaire to ascertain sexual performance/ED and satisfaction. the eNOS G894T polymorphism was genotyped using a standard polymerase chain reaction method.Results.Univariate analysis demonstrated that ED was associated with diabetes, hypertension, sleep apnea severity, increasing age and body mass index, as well as testosterone levels (P < 0.05). Forward multiple regression models indicated that age was the only independent factor associated with ED in this population (odds ratio = 1.09; 95% CI 1.06-1.11; P < 0.0001). Genotypic and allelic analyses provided no evidence for an association between this polymorphism and the risk for ED complaints in this sample. Population stratification did not affect the association test results.Conclusions.This is the first study to examine the effect of polymorphisms in the eNOS gene and the risk for ED utilizing a case-control approach in the Brazilian population. Our results do not support a major role for eNOS gene polymorphisms in ED in this population. Andersen ML, Guindalini C, Santos-Silva R, Bittencourt LRA, and Tufik S. Association analysis of endothelial nitric oxide synthase G894T gene polymorphism and erectile dysfunction complaints in a population-based survey. J Sex Med 2010;7:1229-1236.
- ItemSomente MetadadadosThe Effectiveness of Psychological Interventions for the Treatment of Erectile Dysfunction: Systematic Review and Meta-Analysis, Including Comparisons to Sildenafil Treatment, Intracavernosal Injection, and Vacuum Devices(Blackwell Publishing, 2008-11-01) Melnik, Tamara; Soares, Bernardo G. O. [UNIFESP]; Nasello, Antonia Gladys; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)In contrast to the impressive advances in somatic research of erectile dysfunction (ED), scientific literature shows contradictory reports on the results of psychotherapy for the treatment of ED.Authors conducted a meta-analysis to evaluate the effectiveness of psychological interventions for the treatment of ED compared to oral drugs, local injection, vacuum devices, or other psychological intervention.Distinct sources of randomized controlled trials (RCTs) were searched: electronic databases (between 1966 and 2007), cross checking of references, and contact with scientific societies.For dichotomous outcomes the pooled relative risks were calculated and for continuous outcomes mean differences between interventions. Statistical heterogeneity was addressed.Eleven RCTs involving 398 men met the inclusion criteria.There is evidence that group therapy improves ED. Focused sex group therapy showed greater efficacy than control group. Men randomized to receive psychotherapy plus sildenafil showed significant improvement of ED and were less likely than those receiving only sildenafil to drop out. Regarding to the effectiveness of psychological interventions for the treatment of ED compared to local injection and vacuum devices no difference was found. Melnik T, Soares BGO, and Nasello AG. the effectiveness of psychological interventions for the treatment of erectile dysfunction: Systematic review and meta-analysis, including comparisons to sildenafil treatment, intracavernosal injection, and vacuum devices. J Sex Med 2008;5:2562-2574.
- ItemSomente MetadadadosEfficacy and Tolerability of Lodenafil Carbonate for Oral Therapy in Erectile Dysfunction: A Phase II Clinical Trial(Wiley-Blackwell, 2009-02-01) Glina, Sidney; Toscano, Iderpol; Gomatzky, Celso [UNIFESP]; Goes, Plinio Moreira de [UNIFESP]; Nardozza Junior, Archimedes; Claro, Joaquim Francisco de Almeida [UNIFESP]; Pagani, Eduardo; Hosp Ipiranga; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Cristalia LTDAOral treatment with phosphodiesterase type 5 inhibitor (PDE5) is considered the first-line treatment for patients with erectile dysfunction (ED). Lodenafil carbonate (LC) is a novel PDE5.This is a phase II, prospective, randomized, double-blind, and placebo controlled clinical trial of LC.Efficacy end points were International Index of Sexual Function (IIEF) erectile domain, IIEF questions 3 and 4, and Sexual Encounter Profile (SEP) questions 2 and 3, before and after the use of LC or placebo.Seventy-two men older than 18 years, with ED for at least 6 months with stable sexual relationship were enrolled. Patients were randomized to placebo or LC 80 mg, 40 mg, or 20 mg and followed for 4 weeks.IIEF erectile domain scores before and after the use of medications were (mean +/- standard deviation [SD]): placebo: 11.9 +/- 3.4 and 12.6 +/- 5.5; LC 20 mg: 15.8 +/- 4.1 and 18.9 +/- 6.6; LC 40 mg: 11.9 +/- 4.4 and 15.4 +/- 8.1; LC 80 mg: 14.2 +/- 4.7 and 22.8 +/- 6.0 (anova P < 0.01). the SEP-2 scores before and after the use of medications were (Mean +/- SD): placebo: 71.0 +/- 33.1 and 51.2 +/- 43.1; LC 20 mg 70.3 +/- 34.2 and 75.5 +/- 31.5; LC 40 mg: 48.4 +/- 42.1 and 60.8 +/- 42.5; LC 80 mg: 68.6 +/- 33.5 and 89.6 +/- 26.0. the SEP-3 scores were: placebo 23.3 +/- 27.6 and 33.6 +/- 42.3; LC 20 mg: 32.3 +/- 38.9 and 51.2 +/- 41.7; LC 40 mg: 39.7 +/- 44.7 and 46.7 +/- 41.1; LC 80 mg* 17.2 +/- 29.5 and 74.3 +/- 36.4 (*P < 0.05 for difference to placebo).The drug was well tolerated. Adverse reactions were mild and self-limited and included headache, rhinitis, flushing, color visual disorders, and dyspepsia. This study showed that the dosage of 80 mg of LC was significantly more efficacious than placebo and well tolerated. Glina S, Toscano I, Gomatzky C, de Goes PM, Junior AN, de Almeida Claro JF, and Pagani E. Efficacy and tolerability of lodenafil carbonate for oral therapy in erectile dysfunction: A phase II clinical trial. J Sex Med 2009;6:553-557.
- ItemSomente MetadadadosGenetics of Erectile Dysfunction: A Review of the Interface between Sex and Molecular Biomarkers(Wiley-Blackwell, 2011-11-01) Andersen, Monica L. [UNIFESP]; Guindalini, Camila [UNIFESP]; Tufik, Sergio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction. in recent years, new tools for the study of molecular biology and genetics have resulted in significant contributions to the scientific community. the potential use of genetic variations as biomarkers in the management of current and future conditions is generating considerable excitement in health care for disorders such as erectile dysfunction (ED).Aim. This review briefly describes the molecular and genetic mechanisms involved in ED and provides an overall view of the literature relevant to possible relationships between genetic factors and ED.Methods. This is a narrative review of studies on the potential influence of polymorphisms on the risk of developing ED.Main Outcome Measure. We reviewed genetic association studies involving polymorphisms and the ED phenotype.Results. There is growing evidence for the influence of genetic polymorphisms on the risk of ED and on the interindividual variability in sildenafil treatment.Conclusions. Although this field is still in its infancy, genetic association studies aimed at defining a molecular basis for ED have provided some important evidence that a patient's genotype may be used in the future to assess risk, as well as to plan treatment and prevention programs in the clinic. Andersen ML, Guindalini C, and Tufik S. Genetics of erectile dysfunction: A review of the interface between sex and molecular biomarkers. J Sex Med 2011;8:3030-3039.
- ItemSomente MetadadadosImpairment of Sexual Function in Rats with Epilepsy(Wiley-Blackwell, 2012-09-01) Andersen, Monica L. [UNIFESP]; Alvarenga, Tathiana A. [UNIFESP]; Scorza, Fulvio A. [UNIFESP]; Matos, Gabriela [UNIFESP]; Sonoda, Eliza Y. [UNIFESP]; Hirotsu, Camila [UNIFESP]; Cavalheiro, Esper A. [UNIFESP]; Tufik, Sergio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction. Epilepsy is a chronic disease that affects men and women of all ages, with different levels of severity. Many individuals with epilepsy also suffer from impairments in sexual function. However, it is difficult to differentiate between the impact of the disease and the impact of antiepileptic drugs on sexual function in human subjects. Aims. To evaluate sexual behavior in adult male rats submitted to chronic pilocarpine-induced epilepsy. Methods. First, non-epileptic rats were exposed to nine training sessions to acquire sexual experience, and their baseline sexual performance was evaluated. Then, the same rats were given pilocarpine to induce status epilepticus followed by chronic epilepsy. Once the animals had developed spontaneous recurrent seizures, their sexual behavior was evaluated during three sessions. Main Outcome Measures. Examine changes in latencies to first mount, intromission, and ejaculation, and the total number of mounts, intromissions, and ejaculations. Results. All outcome measures related to sexual motivation and sexual performance were markedly impaired during chronic epilepsy compared with the baseline and the control group. Conclusion. These findings will aid in understanding the interaction between sexual behavior and epilepsy, as well as encouraging further experimental studies in human patients with epilepsy suffering from sexual dysfunction. Andersen ML, Alvarenga TA, Scorza FA, Matos G, Sonoda EY, Hirotsu C, Cavalheiro EA, and Tufik S. Impairment of sexual function in rats with epilepsy. J Sex Med 2012;9:22662272.
- ItemSomente MetadadadosPDEI-5 for Erectile Dysfunction: A Potential Role in Seizure Susceptibility(Wiley-Blackwell, 2012-08-01) Matos, Gabriela [UNIFESP]; Scorza, Fulvio A. [UNIFESP]; Cavalheiro, Esper A. [UNIFESP]; Tufik, Sergio [UNIFESP]; Andersen, Monica L. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction. There is a high prevalence of erectile dysfunction (ED) in men with epilepsy; however, few studies have been conducted concerning the treatment of ED in this neurological group. Aim. the main purpose of this review is to highlight the influence of phosphodiesterase type 5 inhibitor (PDEI-5) for ED on seizure susceptibility. Methods. All available online articles with information pertaining to PDEI-5 and seizure susceptibility were included in this review. Main Outcome Measures. the main outcome assessed demonstrated the intriguing role of PDEI-5 and its metabolites on seizure susceptibility. Results. Case reports in men without epilepsy described seizure occurrence and electrophysiological changes following sildenafil, tadalafil, or vardenafil treatment. Consistent with these findings, preclinical studies suggested a proconvulsant effect of PDEI-5 on models of seizure induction. Conclusions. Evidence suggests an influence of PDEI-5 on seizure susceptibility in humans. in addition, preclinical studies have demonstrated the role of nitric oxide metabolites in the facilitation of paroxysmal phenomenon. Although there are many causes of seizures, medical professionals should be aware of the possible influence of PDEI-5 on seizure susceptibility. Further investigation by physicians and scientists is required to improve our understanding of this important topic. Matos G, Scorza FA, Cavalheiro EA, Tufik S, and Andersen ML. PDEI-5 for erectile dysfunction: A potential role in seizure susceptibility. J Sex Med 2012;9:21112121.