Books helpful to patients with sexual and marital problems: a bibliography.

The aim of this project was to develop a current, problem-focused list of books helpful to patients with sexual and/or marital problems. Survey forms requesting respondents to list books helpful to patients with specific marital/sexual problems were sent to all members of the Society for Sex Therapy and Research (SSTAR) and the clinical members of the Society for the Scientific Study of Sex (SSSS). Of 933 forms, 170 (18%) were returned. Responses were verified for accuracy and a full citation was developed for each. Tabulations of responses were calculated and a bibliography developed.     

Injection therapy for impotence

Injection of vasoactive drugs is an effective form of treatment for selected patients with impotence from virtually all causes. The two most commonly employed drugs in the United States are either papaverine alone or various combinations of papaverine and phentolamine. Patients with organic and mixed impotence are best suited for injection treatment, but selected patients with psychogenic impotence also benefit from therapy. After the patient is selected for injection therapy, he undergoes a series of trial injections in the physician's office. The incidence of priapism will be minimized if the initially administered doses are low and the patient is titrated to an appropriate dose level. Uncontrolled trials have revealed that injection treatment produces a satisfactory erection in 65 to 100 per cent of patients for a follow-up period of as long as 2 years with minimal side effects, but the dropout rate is high. If priapism does occur, it almost always responds readily to treatment with aspiration, low doses of an alpha-adrenergic agent, or both. The other common side effects are bruising or ecchymosis and nodule formation at the injection site. This latter complication has not been noted to cause significant abnormal penile curavature necessitating cessation of the program.     

Das Hepatitis-E-Virus – ein zoonotisches Virus: Verbreitung, Übertragungswege und Bedeutung für die Lebensmittelsicherheit

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Das Hepatitis-E-Virus (HEV) ist ein Erreger einer akuten Hepatitis beim Menschen. Darüber hinaus treten zunehmend auch...     

Breast Cancer and Non‐Hodgkin Lymphoma in a Young Male with Cowden Syndrome

Male breast cancer (MBC) is unusual, especially in young adults. Most cases of MBC as a secondary malignancy relate to the previous treatment with ionizing radiation. MBC can be associated with mutations in hereditary cancer predisposition syndrome genes (i.e., BRCA2); however, no such association has been reported in patients with Cowden syndrome (involving the phosphatase and tensin homolog [PTEN] gene). We describe a patient with Cowden syndrome who was initially diagnosed with B‐cell lymphoblastic lymphoma at the age of 7 years, then MBC at the age of 31 years, and never received radiation therapy.     

High‐risk cytogenetics in multiple myeloma: Further scrutiny of deletions within the IGH gene region enhances risk stratification

Multiple myeloma is a clonal malignancy of plasma cells in the bone marrow. Risk stratification is partly based on cytogenetic findings that include abnormalities of the IGH locus as determined by fluorescence in situ hybridization (FISH), such as rearrangements that result in either standard‐risk or high‐risk gene fusions. IGH deletions have been evaluated as a group in multiple myeloma patients with respect to cumulative outcomes but have provided limited guidance. Whether these deletions have the potential to result in gene fusions and thus further stratify patients is unknown. We identified 229 IGH deletions in patients referred for plasma cell dyscrasia genetic testing over 5.5 years. Follow‐up was conducted on 208 of the deletions with dual fusion FISH probes for standard‐risk (IGH‐CCND1) and high‐risk IGH gene fusions (IGH‐FGFR3, IGH‐MAF, IGH‐MAFB). Of all deletions identified with follow‐up, 44 (21%) resulted in a gene fusion as detected by FISH, 15 (7%) of which were fusion partners associated with high‐risk multiple myeloma. All fusion‐positive 3′‐IGH deletions (6 fusions) resulted in high‐risk IGH‐FGFR3 fusions. Of the 15 high‐risk fusion‐positive cases, eight were without other high‐risk cytogenetic findings. This study is the first to evaluate the presence of IGH gene fusions upon identification of IGH deletions and to characterize the deletion locus. Importantly, these findings indicate that follow‐up FISH studies with dual fusion probes should be standard of care when IGH deletions are identified in multiple myeloma.     

Rapid ejaculation

Rapid ejaculation, or premature ejaculatory dysfunction, is the most frequently encountered sexual complaint of men and couples. It is most common in adolescents, young adults, and other sexually naive males. Increased risk is associated with lack of sexual experience, lack of knowledge regarding normal male and female sexual responses, and with those individuals who highly associate psychological factors (such as fear, guilt, and anxiety) with sexual activity. This article provides a basic review of the pathophysiology of ejaculatory dysfunction and discusses the current treatment options for rapid ejaculation.     

Nocturnal penile tumescence activity unchanged after long-term intracavernous injection therapy

PURPOSE: Anecdotal evidence suggests that some men have restored erectile function after long-term intracavernous injection therapy for erectile dysfunction. We objectively assessed this phenomenon using nocturnal penile tumescence testing. MATERIALS AND METHODS: In our retrospective study 19 men with a mean age of 53.5 years who had organic erectile dysfunction underwent nocturnal penile tumescence testing before and after prostaglandin E1 based intracavernous injection at least 6 months in duration. The nocturnal penile tumescence parameters measured included the number of erectile episodes, base and tip tumescence, and percent of time with rigidity greater than 70% at the penile base and tip. A 5-item questionnaire was given to all patients after the intracavernous injection period to assess subjective changes in erectile quality. RESULTS: Mean time on intracavernous injection was 2.42 years and mean injection frequency was 3.74 times monthly. Prostaglandin E1 only, and combined prostaglandin E1, phentolamine and papaverine were used in 7 and 9 cases, respectively. Nine patients believed that unaided erection improved after intracavernous injection and 6 achieved intercourse without injection who were unable to do so before injection. No statistically significant changes were noted in any of the 5 objectively measured nocturnal penile tumescence parameters. CONCLUSIONS: Long-term prostaglandin E1 based intracavernous injection may provide subjective improvement in erectile function in some men. However, as measured by nocturnal penile tumescence testing, no objective improvement in spontaneous erectile function occurs.     

Psychological treatment strategies for rapid ejaculation: rationale, practical aspects, and outcome

The landscape has dramatically changed for patients seeking treatment for rapid ejaculation. Previously, psychotherapy or behavioral treatment was considered to be the treatment of choice for this troubling sexual dysfunction. Since the early 1990s, an efficacious alternative treatment has emerged—the off-label administration of SSRI medications. Currently, several short-acting SSRI compounds are in phase III clinical trials and are likely to receive approval as the first medical treatment for rapid ejaculation. Given the presumed efficacy of these new compounds and the off-label use of the current SSRIs, one might conclude that psychotherapy\behavior therapy for rapid ejaculation is an obsolete and antiquated intervention. On the contrary, psychotherapy is now more relevant than ever. The two aims of this paper are to review psychological/behavioral therapies for rapid ejaculation and to discuss the important role of combined psychological and medical treatment. In the new age of SSRI treatment for rapid ejaculation, some form of psychological/behavioral intervention is essential to help patients/couples make better use of medical therapies, to learn skills to delay ejaculation once off medication, to bolster sexual confidence, and to enhance patient and partner sexual satisfaction.