Female Assessment of Male Erectile Dysfunction Detection Scale (FAME): Development and Validation

IntroductionAlthough erectile dysfunction (ED) affects both members of the couple, no tools exist for the detection of ED by the female partner.AimThe aim of this study was to develop a scale for the detection of ED, as assessed by the female partner.MethodsDevelopment and validation of the Female Assessment of Male Erectile dysfunction detection scale (FAME) consisted of five stages: (i) two focus group discussions conducted among female partners of ED sufferers; (ii) item construction; (iii) initial content validation to document face validity and reduce number of items; (iv) final selection of items and investigation of concurrent validity and reliability, sensitivity and specificity of the scale in 83 Spanish-speaking couples; and (v) multicenter study conducted in a group of 106 English-speaking couples. Concurrent validity was assessed using Spearman's rho correlation coefficients between FAME and clinical diagnosis, the Sexual Health Inventory for Men (SHIM), and the erectile function domain of the International Index of Erectile Function (IIEF-EF). Reliability was tested using Cronbach's alpha, and sensitivity and specificity was investigated using clinical diagnosis as the gold standard criterion.Main Outcome MeasuresValidity, reliability, specificity, and sensitivity of the FAME scale when correlated with SHIM, IIEF-EF, and clinical diagnosis.ResultsQualitative analysis yielded 44 clues; 21 items demonstrated statistical significance as the best discriminating items using a t-test for independent samples. A final scale of six items was tested for validity, reliability, specificity, and sensitivity. FAME correlated significantly with clinical diagnosis (0.791, P < 0.001), the SHIM (0.788, P < 0.001), and the IIEF-EF (0.777, P < 0.001). Additional support for discriminant validity was obtained with receiver operating characteristics analysis. Cronbach's alpha was 0.941. Sensitivity was 96.1% and specificity 86.0%.ConclusionsAccurate detection of ED in men by the female partner is possible. In this study, FAME demonstrated concurrent validity and very good reliability, as well as excellent sensitivity and specificity. Rubio-Aurioles E, Sand M, Terrein-Roccatti N, Dean J, Longworth J, Eardley I, Brock G, Lee J, Arango de Montis I, and Rampazzo-Bonaldo C. Female assessment of male erectile dysfunction detection scale (FAME): Development and validation. J Sex Med 2009;6:2255–2270.     

Antiparkinsonian drug-induced sleepiness: a double-blind placebo-controlled study of L-dopa, bromocriptine and pramipexole in healthy subjects

AIMS

To assess the sleepiness induced by pramipexole, a D2/D3-dopamine receptor agonist commonly used in Parkinson''s disease and restless legs syndrome, without the problem of the confounding factors related to the disease.

METHODS

Placebo, bromocriptine (2.5 mg), L-dopa (100 mg) and pramipexole (0.5 mg) were administered in a single oral dose on four separate days, with at least a 2-week wash-out period in a randomized cross-over design. Induced somnolence was assessed using Multiple Sleep Latency Test (MSLT) and subjective scaling of vigilance. Twelve male subjects (26.3 ± 5.5 years old) without anxiety, mood, sleep or sedation disorders were enrolled.

RESULTS

Pramipexole significantly reduced mean sleep latency compared with placebo 3 h 30 min [−6.1 min (−9.8, −2.4), P = 0.002] and 5 h 30 min [−5.6 min (−7.7, −3.5), P = 0.003] after administration. In addition, the total duration of sleep during the tests was higher with pramipexole than with placebo [+6.0 min (2.3, 9.7), P < 0.001]. These differences were not observed with L-dopa and bromocriptine in comparison with placebo. The induced sleepiness was not associated with an increase in subjective somnolence scaling, indicating that this adverse event may occur without prior warning.

CONCLUSIONS

These results show that a single oral dose of pramipexole induces sleepiness as assessed by MSLT in healthy young subjects, independent of disease-related sleep dysfunction.     

Effect of subthalamic deep brain stimulation on non-motor fluctuations in Parkinson’s disease

The non-motor consequences of subthalamic stimulation are largely questioned. Cognition, motivation, anxiety, depression and even occurrence of suicides have been considered as a potential consequence of the surgical intervention. Non-motor fluctuations are present in all the patients with motor fluctuations and may sometimes be even more invalidating. Interestingly, subthalamic deep brain stimulation alleviates non-motor fluctuations allowing strikingly successful effects on sensory, dysautonomic and cognitive fluctuations while psychic fluctuations respond less consistently to this treatment. Nevertheless, severe mood fluctuations, oscillating from Off dysphoria to ON hypomania, are frequently associated with addictive behaviors and improve dramatically after subthalamic stimulation. This may be a further argument to support the indication of surgery for these patients.     

Standard Operational Procedures for Low Sexual Desire in Men

IntroductionLow sexual desire in men is a condition that has received little attention; nevertheless it occurs with high frequency. Clinicians are in need of clear guidelines to address this problem.AimTo develop standardized operational procedures to be implemented with men presenting low sexual desire/interest (LSD/I).MethodsReview of relevant evidence-based literature and published guidelines, integrated with expert opinion.Main OutcomeOperational procedures for LSD/I that are recommended for clinical practice with various degrees of support from published evidence.ResultsA new classification scheme is proposed; LSD/I is proposed as an umbrella term for which hypoactive sexual desire disorder (HSDD) is only a subtype. The following standard operational procedures are described: (i) Detection of LSD/I: screening for LSD/I, screening for LSD/I in patients with other sexual dysfunctions; (ii) Diagnosis and assessment of etiology: diagnostic criteria for LSD/I, assessment of depression status, assessment of relationship status, assessment of endocrinologic status, diagnostic criteria for HSDD in men; (iii) Treatment: treatment of LSD/I secondary to low testosterone, treatment of LSD/I secondary to elevated prolactin, treatment of LSD/I secondary to other endocrinologic disorders, treatment of LSD/I secondary to depressive illness and or anxiety disorders, treatment of LSD/I secondary to relationship conflict and treatment of HSDD. A diagnostic and treatment algorithm is presented.ConclusionsLSD/I is a common condition that should be identified in patients; it is recommended that this condition be actively investigated by the clinician. Once the diagnosis of LSD/I in men is confirmed, a thorough search for possible causes needs to include both biological and psychological causes. Treatment should be etiologically oriented. Rubio-Aurioles E and Bivalacqua TJ. Standard operational procedures for low sexual desire in men. J Sex Med **;**:**–**.     

Introduction of the American/Asian genotype of dengue 2 virus into the Yucatan State of Mexico

A dengue (DEN) outbreak occurred in the Yucatan State of Mexico in 2002. Three isolates were obtained from patients presenting with DEN-like symptoms, and examined by partial nucleotide sequencing and phylogenetic analysis. The isolates were identified as DEN-2 viruses of the American-Asian genotype; this is the first report of this genotype in the Yucatan State. The DEN-2 viruses of the American-Asian genotype have been associated with more severe disease outcomes. Thus, its introduction into the Yucatan State presents a serious problem to public health authorities. During this outbreak, DEN virus infection was confirmed in 18% (282 of 1,560) of the patients who presented with DEN-like symptoms. Of these, 87 (31%) patients met the World Health Organization criteria for dengue hemorrhagic fever, including two patients who died. The majority (77%) of the patients experienced secondary infections in this epidemic.     

Pathways from Parental Knowledge and Warmth to Adolescent Marijuana Use: An Extension to the Theory of Planned Behavior

Despite research indicating that effective parenting plays an important protective role in adolescent risk behaviors, few studies have applied theory to examine this link with marijuana use, especially with national data. In the current study (N = 2,141), we hypothesized that parental knowledge (of adolescent activities and whereabouts) and parental warmth are antecedents of adolescents’ marijuana beliefs—attitudes, subjective norms, and perceived behavioral control—as posited by the Theory of Planned Behavior (TPB; Ajzen 1991). These three types of beliefs were hypothesized to predict marijuana intention, which in turn was hypothesized to predict marijuana consumption. Results of confirmatory factor analyses corroborated the psychometric properties of the two-factor parenting structure as well as the five-factor structure of the TPB. Further, the proposed integrative predictive framework, estimated with a latent structural equation model, was largely supported. Parental knowledge inversely predicted pro-marijuana attitudes, subjective norms, and perceived behavioral control; parental warmth inversely predicted pro-marijuana attitudes and subjective norms, ps < .001. Marijuana intention (p < .001), but not perceived behavioral control, predicted marijuana use 1 year later. In households with high parental knowledge, parental warmth also was perceived to be high (r = .54, p < .001). Owing to the analysis of nationally representative data, results are generalizable to the United States population of adolescents 12–18 years of age.     

Effect of renal function on risedronate pharmacokinetics after a single oral dose

AIMS: To determine the relationship between risedronate pharmacokinetics and renal function. METHODS: Risedronate was administered to adult men and women (n=21) with various degrees of renal function (creatinine clearance 15-126 ml min-1 ) as a single oral dose of 30 mg. Serum samples were obtained for 72 h after dosing, and urine samples were collected for 72 h after dosing and then periodically for 6 weeks. Risedronate concentrations were determined using an enzyme-linked immunosorbent assay (ELISA). Risedronate serum concentration-time and urinary excretion rate-time profiles were analysed simultaneously using nonlinear regression. RESULTS: Renal clearance and volume of distribution were linearly related to creatinine clearance (r2=0.854, P<0.001; and r2=0.317, P<0.01, respectively). Decreases in predicted renal clearance and volume of distribution of 82 and 69%, respectively, were observed when creatinine clearance decreased from 120 to 20 ml min-1. A 64% decrease in predicted oral clearance was observed when creatinine clearance decreased from 120 to 20 ml min-1 (P=0.064). Iohexol clearance, a predictor of renal function, produced similar results to those observed with creatinine clearance. Risedronate was well tolerated by the study population. CONCLUSIONS: Risedronate renal clearance was significantly related to a decrease in renal function. There was a consistent reduction in oral clearance with a decrease in creatinine clearance. However, based on the regression analysis, generally no dosage adjustment appears to be necessary for most patients with mild or moderate renal impairment (creatinine clearance >20 ml min-1 ).