Health care workers’ perceptions and reported use of respiratory protective equipment: A qualitative analysis

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Treatment Satisfaction of Men and Partners Following Switch from On‐Demand Phosphodiesterase Type 5 Inhibitor Therapy to Tadalafil 5 mg Once Daily

IntroductionTreatment satisfaction of men receiving phosphodiesterase 5 inhibitors (PDE5) for erectile dysfunction (ED) and their partners is essential to successful long‐term therapy.AimThis study aims to assess treatment satisfaction, in men with a partial response to on‐demand (PRN) PDE5 and their female partners, following tadalafil 5 mg once daily or placebo.MethodsThe study was randomized, double‐blind, parallel, and placebo‐controlled in men primarily with mild to moderate ED. Treatment satisfaction was assessed following a 4‐week maximum dose PRN lead‐in, 4‐week nondrug washout, and treatment through 12 weeks. Men were ≥18 years old with ED for ≥3 months and International Index of Erectile Function Erectile Function score of ≥17 and <26 at screening and <26 following PRN lead‐in.Main Outcome MeasuresTreatment satisfaction was assessed using the Treatment Satisfaction Scale (TSS) for patients and partners. TSS domain scores range from 0 to 100, with higher values indicating greater satisfaction. Statistical comparisons were made using analysis of covariance.ResultsTreatment satisfaction was significantly greater with tadalafil once daily vs. placebo across all TSS domains for both patients and their partners (all P < 0.001). For patients, mean scores for the TSS domains Confidence to Complete Sexual Activity and Satisfaction with Orgasm ranged from 53.7 to 57.8 after the PRN lead‐in and 26.7 to 31.9 following the nondrug washout. Following randomized treatment, scores for tadalafil and placebo were 55.4 and 32.6, respectively, for Confidence to Complete Sexual Activity and 57.5 and 37.9, respectively, for Satisfaction with Orgasm. Results were comparable for other TSS domains and between men and their partners.ConclusionsTreatment satisfaction was comparable for tadalafil 5 mg once daily and PRN PDE5 for both patients and female partners, suggesting that tadalafil once daily is a viable therapy option for men with ED who had a partial response to PRN PDE5 therapy. Burns PR, Rosen RC, Dunn M, Baygani SK, and Perelman MA. Treatment satisfaction of men and partners following switch from on‐demand phosphodiesterase type 5 inhibitor therapy to tadalafil 5 mg once daily. J Sex Med 2015;12:720–727.     

Efficacy of Once-Daily Administration of Udenafil for 24 Weeks on Erectile Dysfunction: Results from a Randomized Multicenter Placebo-Controlled Clinical Trial

IntroductionThe method of administration of oral phosphodiesterase-5 inhibitors has been expanded to once-daily repeated administration with lower initial dosage than on-demand administration.AimThe aim of this study was to evaluate the efficacy and safety of once-daily udenafil as a treatment for erectile dysfunction (ED) for intermediate-term period.MethodsThis multicenter, randomized, double-blind clinical trial included 346 ED patients (placebo, udenafil 50 mg, udenafil 75 mg). Subjects were treated with each medication once daily for 24 weeks.Main Outcome MeasuresSubjects were asked to complete the International Index of Erectile Function (IIEF)-erectile function (EF) domain at baseline, 12 weeks, and 24 weeks and the development of adverse drug reactions (ADRs) was inspected.ResultsBoth dosages of udenafil induced a significant increase in IIEF-EF compared with placebo at both 12 and 24 weeks. When patients were divided according to the severity of baseline EF score, significant improvement was observed only with udenafil 75 mg regardless of the degree of ED. At 24 weeks, the proportions of patients who reported a return to normal EF (IIEF-EF over 26) were 39.1% for udenafil 50 mg and 47.0% for udenafil 75 mg. In terms of safety, ADRs were observed in 6.1%, 12.9%, and 17.9% for placebo, udenafil 50 mg, and 75 mg, respectively. Although a statistically higher rate of ADRs was observed in the udenafil 75 mg group (P = 0.024), the majority were mild and recovered without treatment.ConclusionsOnce-daily administration of udenafil 50 mg and 75 mg for 24 weeks resulted in improvement of EF. In particular, udenafil 75 mg improves EF regardless of the baseline degree of ED. Moon KH, Ko YH, Kim SW, Moon DG, Kim JJ, Park NC, Lee SW, Paick J-S, Ahn TY, Chung WS, Min KS, Park JK, Yang DY, and Park K. Efficacy of once-daily administration of udenafil for 24 weeks on erectile dysfunction: Results from a randomized multicenter placebo-controlled clinical trial. J Sex Med 2015;12:1194–1201.     

Autoimmune bullous diseases in skin of color

Dermatologic health care disparities disproportionately affect patients with skin of color (SoC), defined as Fitzpatrick skin phototypes IV-VI (light brown, brown, and black skin tones), resulting in delayed treatment and increased morbidity and mortality.¹ Numerous studies predict that by 2060 the White race will be a minority in the United States. Despite the rising SoC population, there remains a scarcity of peer-reviewed literature depicting skin conditions in SoC. In 2006, autoimmune

Bullous pemphigoid

Bullous pemphigoid (BP) is the most common AIBD, with a reported incidence of 2.4 to 23 cases/1,000,000.⁵ BP prevalence is an estimated 12/100,000.⁶ It affects patients 60 to 80 years old with a 1-year mortality of 20%.⁷BP is characterized by tissue-bound and circulating IgG autoantibodies against hemi-desmosomal anchoring proteins, BP180 and BP230.⁸ Diagnosis is confirmed via lesional biopsy, showing a subepidermal bulla with eosinophils in the infiltrate, and perilesional direct

Conclusions

AIBD in SoC patients have heterogeneous clinical presentations with features that may not be readily recognized. These can range from the color of erythema on darker skin types to postinflammatory hyperpigmentation, sometimes being confused for other disorders, as commonly observed with BP and PV. In DH, erythema may not be as pronounced in darker skin types, but even when it is, varied histologic features may create confusion about the clinical diagnosis. There may be some genetic associations

     

Ganglioside or sialic acid attenuates ethanol-induced decrements in locomotion, nose-poke exploration, and anxiety, but not body temperature.

1. This laboratory has previously reported that pretreatment with ganglioside, or even with its constituent, sialic acid (SA), can attenuate certain intoxicating effects of ethanol. It was important to see if these findings could be replicated, particularly by using other measures of ethanol effects. Herein we report that pretreatment with either gangliosides or SA attenuated ethanol-induced decrements in locomotion, nose-poke exploration, and anxiety, but not body temperature. 2. An ethanol dose of 4 gm/kg caused a temperature drop of about 3 degrees C, which was unaffected by any pretreatment. The onset to sleep, however, was delayed an average of 18 or 36 secs in mice pretreated with ganglioside or SA, respectively. Ethanol-only (4 gm/kg) depressed mean cumulative locomotor activity to 31% of normal, whereas the depression was 83% of normal with beef brain ganglioside pretreatment. At 2 gm/kg ethanol alone decreased nose poking in a hole-board test to 29% of normal, but the depression was only 55-63% of normal with SA or ganglioside pretreatment. In a staircase climbing anxiety test, this dose of ethanol had no effect by itself, but both ganglioside and SA pre-treatment increased climbing by 22%. Ethanol did depress rearing to only 11% of normal, whereas rearing was 51 and 99% of normal with SA and ganglioside pretreatment, respectively. In a dark-preference test, ethanol-only caused mice to spend 64% of the time in the light, compared to 31% for controls. Time in the light was only 39 and 46% with ganglioside and SA pretreatment, respectively. 3. Blood levels of ethanol were not significantly affected by pretreatment. 4. When given alone, gangliosides significantly stimulated locomotion and staircase climbing. SA significantly decreased rearing in the staircase test. Both gangliosides and SA tended to increase nose poking, number of crossings in the dark-preference test, and time in a lighted compartment. Thus, it is possible that some of the attenuation of intoxication is attributable to non-specific stimulant properties of gangliosides and SA.