Evaluation of the Female Sexual Function Index in a Population Based Sample from Finland

The factor structure and reliability of the Female Sexual Function Index (FSFI) was evaluated in a Finnish population based sample of 2,081 women, age 33–43 years. In addition, associations between female sexual function and age, psychological distress, alcohol use, hormone based contraceptives, child sexual abuse (CSA), and adult sexual abuse were examined. The results supported a six factor solution for the FSFI with high internal consistencies, in line with earlier research in clinical populations. Psychological distress was positively associated with every dimension of the FSFI except desire problems. Age was associated with fewer pain problems. Alcohol use was associated with every dimension of the FSFI, but the direction of the association depended on if it was drinking in general or in connection to intercourse. More drinking in general was related to fewer sexual function problems while drinking in connection to intercourse was related to more sexual function problems. No significant correlation was found between adult sexual abuse and sexual function but between CSA and lubrication, satisfaction, and pain problems. Usage of oral contraceptive pill was not significantly associated with sexual function. The use of hormone based intrauterine systems was significantly associated with less pain and more desire, arousal, and satisfaction. In conclusion, the study supports use of the FSFI for assessing sexual function not only in clinical samples but also in population based samples. The associations found between sexual function and other important variables showed the complexity of sexual function.     

Resolution of primary acquired melanosis with atypia after minimal mitomycin C treatment

The most effective dose of mitomycin C (MMC) in the treatment of primary acquired melanosis (PAM) with atypia of the conjunctiva and cornea has yet to be established. This case report describes successful treatment of PAM with atypia with a single four day cycle of 0.02% MMC.     

Pafenolol in hypertension: a double-blind randomized trial of a new beta 1-selective adrenoceptor blocker

The antihypertensive effect of pafenolol, a new beta 1-selective adrenoceptor blocker without intrinsic sympathomimetic activity and three times more selective than metoprolol, was evaluated. Twenty-three patients with essential hypertension, mean age 49 years (range 21-62), were randomized after a 4-week placebo run-in period (double-blind) to 4 weeks of either placebo, pafenolol 50 mg or 100 mg once daily. A submaximal exercise test was performed before and at the end of the treatment period. Pafenolol 50 mg and 100 mg significantly reduced recumbent and standing blood pressure compared with baseline with a mean reduction of 17/14 and 10/12 mm Hg on pafenolol 50 mg and 15/10 and 14/10 mm Hg on pafenolol 100 mg, respectively. Heart rate, both at rest and during exercise, was significantly reduced (p less than 0.05) on pafenolol 100 mg compared with placebo. The reduction in exercise heart rate (percent) was dose dependent and significantly correlated to the log plasma concentration of pafenolol (r = 0.60; p less than 0.05). It can be concluded that pafenolol had a clinically relevant antihypertensive effect when given once daily. No difference between 50 and 100 mg could be demonstrated, thus suggesting that 50 mg may be the preferred dose for antihypertensive treatment.     

Fibrinolytic capacity increases with age in healthy humans,while endothelium-dependent vasodilation is unaffected

The capacity for stimulated endothelial release of tissue-type plasminogen activator (tPA) and endothelium-dependent vasodilation is diminished in patients with cardiovascular risk factors. We examined the effect of age on desmopressin-stimulated tPA release and endothelium-dependent vasodilation, using the perfused-forearm model. Thirty-two healthy subjects were divided into quartiles by age (mean age 24, 36, 54, and 72 years, respectively). Baseline fibrinolytic parameters, baseline forearm blood flow (FBF), and increase in stimulated FBF were all similar across age. By contrast, the capacity for desmopressin- stimulated release of tPA increased linearly by age. For tPA antigen, the total amount released (area-under-the-curve) was 1015, 1282, 2139, and 2845 ng/L tissue (p = 0.011) and the peak release rates were 62, 80, 113, and 163 ng/min/L tissue (p = 0.008) in the age-quartiles, respectively. A similar significant age-related response was observed for tPA activity. We conclude that in healthy individuals there is an up-regulation of the fibrinolytic response by age.     

Partial oesophageal perforation associated with cold carbonated beverage ingestion

We present a rare case of spontaneous intramural oesophageal perforation after the rapid ingestion of a cold carbonated beverage. A previously well patient presented with sudden onset of severe retrosternal pain associated with pain on swallowing. A contrast computed tomography scan and gastroscopy confirmed the diagnosis. With the widespread popular practice of drinking cold carbonated beverages, especially during the summer season, clinicians should be aware of this possible serious complication.     

Regional haemodynamic effects of endothelin-1 in rat and man: unexpected adverse reaction

Endothelin-1 was infused into the non-dominant brachial artery in two male subjects. We then monitored intra-arterial mean blood pressure, right atrial pressure, the heart rate and forearm blood flow (by plethysmography). Endothelin-1 at a dose of 5 x 10(-14) to 5 x 10(-9) mol, infused over 5 min periods, elicited no major changes in mean arterial pressure, heart rate and right atrial pressure. We observed an initial increase in forearm blood flow, followed by dose-dependent decreases of 25, 34 and 42% at 5 x 10(-11) to 5 x 10(-9) mol. A higher dose of endothelin-1, 5 x 10(-8) mol, given to only one of the subjects, elicited sweating and vomiting. In this subject, mean arterial pressure, right atrial pressure and the heart rate did not change, while forearm blood flow increased transiently. A deep muscular pain developed in the forearm receiving the endothelin-1 infusion after 30 min (maximum 2 h, duration 10 h), and this pain was intensified by touch and muscle contractions. The force of muscle contractions in the forearm was markedly reduced and a visible oedema developed. In order to investigate the mechanisms of oedema formation, endothelin-1 (10(-10) to 5 x 10(-8) mol/l) was given intra-arterially in a rat hindquarter preparation which was perfused at a constant flow rate. In the rat, endothelin-1 increased both pre- and postcapillary resistance, leading to an increase in capillary hydrostatic pressure and a marked net transcapillary fluid transfer from the perfusate to tissue. There was no sign of increased vascular permeability.(ABSTRACT TRUNCATED AT 250 WORDS)     

Contractions in human coronary bypass vessels stimulated by extracellular nucleotides

BACKGROUND: The present study was designed to evaluate the relative contribution of different contractile P2 receptors in human saphenous vein compared with internal mammary artery obtained during coronary artery surgery. METHODS: The isometric tension in endothelium-denuded isolated vessel segments was recorded in vitro. The P2 receptor mRNA expression was quantified by real-time polymerase chain reaction. RESULTS: The P2X(1) receptor agonist, alphabeta-MeATP (alphabeta-methylene-adenosine triphosphate), was the most potent vasoconstrictor, with more efficacious contractions in the saphenous vein than in the internal mammary artery. The selective P2Y(6) receptor agonist, UDPbetaS (uridine 5'-O-thiodiphosphate), stimulated more potent contractions in saphenous vein compared with internal mammary artery. Furthermore, UDPbetaS induced long-lasting contractions for more than 2 hours, explained by the low desensitization rate of the P2Y(6) receptor. The ATP-induced vasoconstriction could not be abolished by desensitization of P2X(1) receptors with alphabeta-MeATP, or P2Y(2/4) receptors with UTPgammaS (uridine 5'-O-3-thiotriphosphate), indicating the presence of yet another contractile ATP receptor. Based on quantification with real-time polymerase chain reaction, the P2Y(11) receptor could be responsible for this ATP contraction. CONCLUSIONS: The P2X(1) and P2Y(6) receptors elicit more prominent contractions in the saphenous vein as compared with the internal mammary artery. These results may present one explanation for the differences in the two conduits. It is possible that selective antagonists of P2X(1) and P2Y(6) receptors could be used to prevent vasospasm and restenosis in the saphenous vein during and after revascularization surgery.