DOCSLIB.ORG

University of Southampton Research Repository

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
University of Southampton Research Repository University of Southampton Research Repository Copyright © and Moral Rights for this thesis and, where applicable, any accompanying data are retained by the author and/or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This thesis and the accompanying data cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder/s. The content of the thesis and accompanying research data (where applicable) must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holder/s. When referring to this thesis and any accompanying data, full bibliographic details must be given, e.g. Thesis: Author (Year of Submission) "Full thesis title", University of Southampton, name of the University Faculty or School or Department, PhD Thesis, pagination. Data: Author (Year) Title. URI [dataset] University of Southampton Faculty of Medicine Sexual functioning in patients with anxiety disorders: an investigation of the potential influence of neuroinflammatory and endocrine factors by Hesham Yousry Elnazer MBBCh MRCPsych ORCID ID https://orcid.org/0000-0002-3508-684X Thesis for the degree of Doctor of Medicine September 2019 Abstract University of Southampton Abstract Faculty of Medicine School of Clinical and Experimental Sciences Thesis for the degree of Doctorate of Medicine Sexual functioning in patients with anxiety disorders: an investigation of the potential influence of neuroinflammatory and endocrine factors By Hesham Yousry Elnazer Previous studies have revealed complex associations between sexual dysfunction, depressive symptoms, and treatment with antidepressant drugs, and provide evidence linking depression, neuroinflammation and hypothalamo-pituitary-axis (HPA) dysregulation. However, little is known about the prevalence of sexual dysfunction or incidence of treatment-emergent sexual dysfunction in patients with anxiety disorders. Published studies have found contrasting evidence of the association between anxiety symptoms and disrupted levels of inflammatory markers, and investigations of HPA function in anxiety disorders have produced inconsistent findings. Augmentation with COX-2 inhibitors in patients with depression can reduce depressive symptoms and improve quality of life, but the potential therapeutic benefit of COX-2 inhibitors in patients with anxiety disorders is uncertain. This thesis includes a systematic review of the utility of the Arizona Sexual Experiences scale (ASEX) and a series of investigations in patients with anxiety disorders (n=35), with exploration of sexual function, anxiety symptoms, neuroinflammation and HPA dysregulation, at baseline, after six weeks of treatment, and after six weeks of augmentation with the COX-2 inhibitor celecoxib. The ASEX appears reliable, valid, and sensitive to change, and acceptable in a broad range of clinical settings. Cross-sectional findings indicate a point prevalence of sexual dysfunction of 57.1% at Baseline, 75.1% at Week 6 and 39.3% at Week 12. Sexual dysfunction was significantly positively correlated with the severity of anxiety symptoms, and significantly negatively correlated with mental wellbeing at Baseline, Week 6 and Week 12. There were low levels of IL-12p70 and low IL-2 but a high level of TNF-α at Week 6. At Week 12, there were low levels of IL-1β, low IL-12p70 and IL-13, a high level of TNF-α (regardless of augmentation with celecoxib) but low IL-2 levels in the non- augmentation group. At Baseline, patients with panic disorders with agoraphobia had a high hair cortisol concentration (HCC). Longitudinal analysis found worsening of sexual function at Week 6, but significant improvement in anxiety symptoms, wellbeing and sexual function at Week 12 in the celecoxib augmentation group. There was a significant reduction in IL-2 level from Week 6 to Week 12 in the augmentation group, a reduction of HCC from Baseline to Week 6, and a slight elevation at Week 12, although changes in HCC were not statistically significant. Investigating sexual dysfunction as part of the clinical assessment of patients with anxiety disorders, is important to facilitate better management and well-being. Augmentation with celecoxib can improve clinical outcomes, yet further research is needed to retest this. More research is needed to explore HCC in anxiety disorders in larger clinical samples. i Table of Contents Table of Contents Table of Contents .......................................................................................................... i Table of Tables ............................................................................................................ vii Table of Figures ............................................................................................................ix List of Accompanying Materials ....................................................................................xi Research Thesis: Declaration of Authorship ................................................................ xiii Acknowledgements ..................................................................................................... xv Definitions and Abbreviations .................................................................................... xvii Chapter 1 Introduction ............................................................................................... 1 1.1 General Introduction .................................................................................................. 1 1.2 Anxiety Disorders ....................................................................................................... 2 1.3 Hypothalamic-pituitary-adrenal (HPA) axis................................................................ 3 1.4 Cortisol Levels in Patients with Anxiety Disorders ..................................................... 5 1.4.1 Method for the Literature Review ..................................................................... 5 1.4.2 Panic Disorder and Agoraphobia ........................................................................ 5 1.4.3 Generalised Anxiety Disorder (GAD) ................................................................ 20 1.4.4 Specific (Simple) Phobia ................................................................................... 25 1.4.5 Obsessive Compulsive Disorder (OCD) ............................................................. 29 1.4.6 Social Anxiety Disorder (Social Phobia) ............................................................ 32 1.4.7 Pharmacological challenge and cortisol in anxiety disorders .......................... 44 1.4.8 Summary .......................................................................................................... 45 1.5 Human sexual response ........................................................................................... 47 1.5.1 Background ....................................................................................................... 47 1.5.2 Physiological and molecular mechanisms in erection ..................................... 47 1.5.3 Physiological and molecular mechanisms in detumescence ........................... 49 1.5.4 Renin angiotensin system ................................................................................ 51 1.5.5 Tumour Necrosis Factor (TNF) ......................................................................... 52 1.5.6 Endothelin-1 (ET-1)........................................................................................... 53 1.5.7 Interleukins ....................................................................................................... 53 1.5.8 Prostaglandins .................................................................................................. 54 1.5.9 Damage-associated molecular patterns (DAMPs) ........................................... 54 i Table of Contents 1.5.10 Modulators and potential therapeutic targets ................................................ 54 1.5.11 Summary .......................................................................................................... 57 1.6 Sexual function and anxiety ..................................................................................... 59 1.6.1 Background ...................................................................................................... 59 1.6.2 Influence of treatment with psychotropic medications on sexual function ... 60 1.6.3 Management of sexual dysfunction in mood disorders .................................. 64 1.7 Neuro-inflammation and anxiety disorders ............................................................ 67 1.7.1 Background ...................................................................................................... 67 1.7.2 Method for the Literature Review ................................................................... 71 1.7.3 Panic disorder and Agoraphobia...................................................................... 71 1.7.4 Generalised anxiety disorder (GAD) ................................................................ 74 1.7.5 Other anxiety disorders ................................................................................... 82 1.7.6 Anti-inflammatory treatment and anxiety disorders ...................................... 82 1.7.7 Summary .......................................................................................................... 83 1.8 Hypotheses
Load more

Recommended publications
  • Are Supplements Supplemented? Evaluating the Composition of Complementary and Alternative Medicines Using Mass Spectrometry and Metabolomics
    Are supplements supplemented? Evaluating the composition of complementary and alternative medicines using mass spectrometry and metabolomics By Elly Gwyn Crighton BForensics in Forensic Biology & Toxicology (First Class Honours) BSc in Molecular Biology & Biomedical Science This thesis is presented for the degree of Doctor of Philosophy Perth, Western Australia at Murdoch University 2020 Declaration I declare that: i. The thesis is my own account of my research, except where other sources are acknowledged. ii. The extent to which the work of others has been used is clearly stated in each chapter and certified by my supervisors. iii. The thesis contains as its main content, work that has not been previously submitted for a degree at any other university. i Abstract The complementary and alternative medicines (CAM) industry is worth over US$110 billion globally. Products are available to consumers with little medical advice; with many assuming that such products are ‘natural’ and therefore safe. However, with adulterated, contaminated and fraudulent products reported on overseas markets, consumers may be placing their health at risk. Previous studies into product content have reported undeclared plant materials, ingredient substitution, adulteration and contamination. However, no large-scale, independent audit of CAM has been undertaken to demonstrate these problems in Australia. This study aimed to investigate the content and quality of CAM products on the Australian market. 135 products were analysed using a combination of next-generation DNA sequencing and liquid chromatography-mass spectrometry. Nearly 50% of products tested had contamination issues, in terms of DNA, chemical composition or both. 5% of the samples contained undeclared pharmaceuticals.
    [Show full text]
  • Phosphodiesterase (PDE)
    Phosphodiesterase (PDE) Phosphodiesterase (PDE) is any enzyme that breaks a phosphodiester bond. Usually, people speaking of phosphodiesterase are referring to cyclic nucleotide phosphodiesterases, which have great clinical significance and are described below. However, there are many other families of phosphodiesterases, including phospholipases C and D, autotaxin, sphingomyelin phosphodiesterase, DNases, RNases, and restriction endonucleases, as well as numerous less-well-characterized small-molecule phosphodiesterases. The cyclic nucleotide phosphodiesterases comprise a group of enzymes that degrade the phosphodiester bond in the second messenger molecules cAMP and cGMP. They regulate the localization, duration, and amplitude of cyclic nucleotide signaling within subcellular domains. PDEs are therefore important regulators ofsignal transduction mediated by these second messenger molecules. www.MedChemExpress.com 1 Phosphodiesterase (PDE) Inhibitors, Activators & Modulators (+)-Medioresinol Di-O-β-D-glucopyranoside (R)-(-)-Rolipram Cat. No.: HY-N8209 ((R)-Rolipram; (-)-Rolipram) Cat. No.: HY-16900A (+)-Medioresinol Di-O-β-D-glucopyranoside is a (R)-(-)-Rolipram is the R-enantiomer of Rolipram. lignan glucoside with strong inhibitory activity Rolipram is a selective inhibitor of of 3', 5'-cyclic monophosphate (cyclic AMP) phosphodiesterases PDE4 with IC50 of 3 nM, 130 nM phosphodiesterase. and 240 nM for PDE4A, PDE4B, and PDE4D, respectively. Purity: >98% Purity: 99.91% Clinical Data: No Development Reported Clinical Data: No Development Reported Size: 1 mg, 5 mg Size: 10 mM × 1 mL, 10 mg, 50 mg (R)-DNMDP (S)-(+)-Rolipram Cat. No.: HY-122751 ((+)-Rolipram; (S)-Rolipram) Cat. No.: HY-B0392 (R)-DNMDP is a potent and selective cancer cell (S)-(+)-Rolipram ((+)-Rolipram) is a cyclic cytotoxic agent. (R)-DNMDP, the R-form of DNMDP, AMP(cAMP)-specific phosphodiesterase (PDE) binds PDE3A directly.
    [Show full text]
  • General Pharmacology
    GENERAL PHARMACOLOGY Winners of “Nobel” prize for their contribution to pharmacology Year Name Contribution 1923 Frederick Banting Discovery of insulin John McLeod 1939 Gerhard Domagk Discovery of antibacterial effects of prontosil 1945 Sir Alexander Fleming Discovery of penicillin & its purification Ernst Boris Chain Sir Howard Walter Florey 1952 Selman Abraham Waksman Discovery of streptomycin 1982 Sir John R.Vane Discovery of prostaglandins 1999 Alfred G.Gilman Discovery of G proteins & their role in signal transduction in cells Martin Rodbell 1999 Arvid Carlson Discovery that dopamine is neurotransmitter in the brain whose depletion leads to symptoms of Parkinson’s disease Drug nomenclature: i. Chemical name ii. Non-proprietary name iii. Proprietary (Brand) name Source of drugs: Natural – plant /animal derivatives Synthetic/semisynthetic Plant Part Drug obtained Pilocarpus microphyllus Leaflets Pilocarpine Atropa belladonna Atropine Datura stramonium Physostigma venenosum dried, ripe seed Physostigmine Ephedra vulgaris Ephedrine Digitalis lanata Digoxin Strychnos toxifera Curare group of drugs Chondrodendron tomentosum Cannabis indica (Marijuana) Various parts are used ∆9Tetrahydrocannabinol (THC) Bhang - the dried leaves Ganja - the dried female inflorescence Charas- is the dried resinous extract from the flowering tops & leaves Papaver somniferum, P album Poppy seed pod/ Capsule Natural opiates such as morphine, codeine, thebaine Cinchona bark Quinine Vinca rosea periwinkle plant Vinca alkaloids Podophyllum peltatum the mayapple
    [Show full text]
  • Patent Application Publication ( 10 ) Pub . No . : US 2019 / 0192440 A1
    US 20190192440A1 (19 ) United States (12 ) Patent Application Publication ( 10) Pub . No. : US 2019 /0192440 A1 LI (43 ) Pub . Date : Jun . 27 , 2019 ( 54 ) ORAL DRUG DOSAGE FORM COMPRISING Publication Classification DRUG IN THE FORM OF NANOPARTICLES (51 ) Int . CI. A61K 9 / 20 (2006 .01 ) ( 71 ) Applicant: Triastek , Inc. , Nanjing ( CN ) A61K 9 /00 ( 2006 . 01) A61K 31/ 192 ( 2006 .01 ) (72 ) Inventor : Xiaoling LI , Dublin , CA (US ) A61K 9 / 24 ( 2006 .01 ) ( 52 ) U . S . CI. ( 21 ) Appl. No. : 16 /289 ,499 CPC . .. .. A61K 9 /2031 (2013 . 01 ) ; A61K 9 /0065 ( 22 ) Filed : Feb . 28 , 2019 (2013 .01 ) ; A61K 9 / 209 ( 2013 .01 ) ; A61K 9 /2027 ( 2013 .01 ) ; A61K 31/ 192 ( 2013. 01 ) ; Related U . S . Application Data A61K 9 /2072 ( 2013 .01 ) (63 ) Continuation of application No. 16 /028 ,305 , filed on Jul. 5 , 2018 , now Pat . No . 10 , 258 ,575 , which is a (57 ) ABSTRACT continuation of application No . 15 / 173 ,596 , filed on The present disclosure provides a stable solid pharmaceuti Jun . 3 , 2016 . cal dosage form for oral administration . The dosage form (60 ) Provisional application No . 62 /313 ,092 , filed on Mar. includes a substrate that forms at least one compartment and 24 , 2016 , provisional application No . 62 / 296 , 087 , a drug content loaded into the compartment. The dosage filed on Feb . 17 , 2016 , provisional application No . form is so designed that the active pharmaceutical ingredient 62 / 170, 645 , filed on Jun . 3 , 2015 . of the drug content is released in a controlled manner. Patent Application Publication Jun . 27 , 2019 Sheet 1 of 20 US 2019 /0192440 A1 FIG .
    [Show full text]
  • Illicit Erectile Dysfunction Products in the Netherlands Dysfunction a Decade of Trends and a 2007-2010 Product Update Products
    Illicit erectile Illicit erectile dysfunction products in the Netherlands dysfunction A decade of trends and a 2007-2010 product update products Illicit erectile dysfunction products in the Netherlands A decade of trends and a 2007-2010 product update RIVM Report 370030003/2010 RIVM Report 370030003 Colophon © RIVM 2010 Parts of this publication may be reproduced, provided acknowledgement is given to the 'National Institute for Public Health and the Environment', along with the title and year of publication. B.J. Venhuis, National Institute for Public Health and the Environment M.E. Zwaagstra, Dutch Customs Laboratory J.D.J. van den Berg, Netherlands Forensic Institute A.J.H.P. van Riel, National Poisons Information Center H.W.G. Wagenaar, Royal Dutch Association for the Advancement of Pharmacy K. van Grootheest, National Pharmacovigilance Centre Lareb D.M. Barends, National Institute for Public Health and the Environment D. de Kaste, National Institute for Public Health and the Environment Contact: Dries de Kaste Centre for Quality of Chemical Pharmaceutical Products [email protected] This investigation was commissioned by The Netherlands Health Care Inspectorate (IGZ), and carried out within the framework of V/370030/10/PC Page 2 of 73 RIVM Report 370030003 Abstract Illicit erectile dysfunction products in the Netherlands A decade of trends and a 2007-2010 product update Illicit erectile dysfunction (ED) products often contain experimental medicines. The acute health risks of using such illicit ED products, however, appear to be relatively low – at least to date. Less health damage has been reported than expected based on the presumed use of these products, although their long-term effects on human health are unknown.
    [Show full text]
  • Phosphodiesterase Type 5 Inhibitors - a Priority Direction for the Treatment of Erectile Dysfunction of Various Origins
    Turkish Journal of Physiotherapy and Rehabilitation; 32(3) ISSN 2651-4451 | e-ISSN 2651-446X PHOSPHODIESTERASE TYPE 5 INHIBITORS - A PRIORITY DIRECTION FOR THE TREATMENT OF ERECTILE DYSFUNCTION OF VARIOUS ORIGINS Gafarov R.R.1, Bobokulov N.A.1, Batirov B.A.1, Muradov S.S.2 1 Samarkand State Medical Institute, 2 Sogda Medical Centre Erectile dysfunction (ED) is a condition in which a man is unable to achieve and maintain an erection to a degree sufficient for successful intercourse. ED is a serious problem affecting both the psychosocial state of the man and his partner [1]. In the ED development, the role of bad habits is great, for example, among smoking men it occurs 20% more often than among nonsmokers [2,3]. ED is associated with various comorbid conditions such as hypertension, hyperlipidemia, metabolic syndrome, lower urinary tract symptoms (LUTS) or benign prostatic hyperplasia (BPH), cardiovascular disease, psychological factors, diabetes mellitus, post-radical prostatectomy, antidepressant medication and antihypertensive drugs, etc. (Table 1). Table 1. Pathophysiology of ED [4]. Vasculogenic Recreational habits (i.e., cigarette smoking) Lack of regular physical exercise Obesity Cardiovascular diseases (e.g. hypertension, coronary artery disease, peripheral vasculopathy) Type 1 and 2 diabetes mellitus; hyperlipidaemia; metabolic syndrome; hyperhomocysteinemia Major pelvic surgery (e.g., radical prostatectomy) or radiotherapy (pelvis or retroperitoneum) Neurogenic Central causes Degenerative disorders (e.g., multiple sclerosis,
    [Show full text]
  • The Potential Role of Sildenafil in Cancer Management Through EPR Augmentation
    Journal of Personalized Medicine Review The Potential Role of Sildenafil in Cancer Management through EPR Augmentation Mohamed Haider 1,2,* , Amr Elsherbeny 3 , Valeria Pittalà 4 , Antonino N. Fallica 4 , Maha Ali Alghamdi 5,6 and Khaled Greish 6,* 1 Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates 2 Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates 3 Division of Molecular Therapeutics and Formulation, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK; [email protected] 4 Department of Drug and Health Science, University of Catania, 95125 Catania, Italy; [email protected] (V.P.); [email protected] (A.N.F.) 5 Department of Biotechnology, College of Science, Taif University, Taif 21974, Saudi Arabia; [email protected] 6 Department of Molecular Medicine, Princess Al-Jawhara Centre for Molecular Medicine, School of Medicine and Medical Sciences Arabian Gulf University, Manama 329, Bahrain * Correspondence: [email protected] (M.H.); [email protected] (K.G.); Tel.: +97-156-761-5401 (M.H.); +973-1723-7393 (K.G.) Abstract: Enhanced permeation retention (EPR) was a significant milestone discovery by Maeda et al. paving the path for the emerging field of nanomedicine to become a powerful tool in the fight against cancer. Sildenafil is a potent inhibitor of phosphodiesterase 5 (PDE-5) used for the treatment of erectile dysfunction (ED) through the relaxation of smooth muscles and the modulation of vascular endothelial permeability. Overexpression of PDE-5 has been reported in lung, colon, metastatic Citation: Haider, M.; Elsherbeny, A.; breast cancers, and bladder squamous carcinoma.
    [Show full text]
  • Pharmaceutical Formulations Comprising Dapoxetine and a PDE5 Inhibitor
    (19) TZZ __T (11) EP 2 698 145 A1 (12) EUROPEAN PATENT APPLICATION (43) Date of publication: (51) Int Cl.: 19.02.2014 Bulletin 2014/08 A61K 9/00 (2006.01) A61K 31/138 (2006.01) A61K 31/4985 (2006.01) (21) Application number: 13180676.2 (22) Date of filing: 16.08.2013 (84) Designated Contracting States: • Türkyilmaz, Ali AL AT BE BG CH CY CZ DE DK EE ES FI FR GB 34460 Istanbul (TR) GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO • Mutlu, Onur PL PT RO RS SE SI SK SM TR 34460 Istanbul (TR) Designated Extension States: BA ME (74) Representative: Sevinç, Erkan Istanbul Patent & Trademark (30) Priority: 17.08.2012 TR 201209599 Consultancy Ltd. Plaza 33, Buyukdere Cad. No: 33/16 (71) Applicant: Sanovel Ilac Sanayi ve Ticaret A.S. Sisli 34460 Istanbul (TR) 34381 Istanbul (TR) (72) Inventors: • Cifter, Ümit 34460 Istanbul (TR) (54) Pharmaceutical Formulations comprising dapoxetine and a PDE5 inhibitor (57) The present invention is related to formulations thereof. The invention is also related to a process for containing a combination of dapoxetine or a pharmaceu- preparing a similar formulation and its use in treatment tically acceptable salt thereof with a phosphodiesterase of erectile dysfunction. Type 5 inhibitor or a pharmaceutically acceptable salt EP 2 698 145 A1 Printed by Jouve, 75001 PARIS (FR) EP 2 698 145 A1 Description Technical field of the invention 5 [0001] The present invention is related to formulations containing a combination of dapoxetine or a pharmaceutically acceptable salt thereof with a phosphodiesterase Type 5 inhibitor or a pharmaceutically acceptable salt thereof.
    [Show full text]
  • Analysis of Herbal Dietary Supplements for Sexual Performance Enhancement
    Journal of Pharmaceutical and Biomedical Analysis 63 (2012) 135–150 Contents lists available at SciVerse ScienceDirect Journal of Pharmaceutical and Biomedical Analysis jou rnal homepage: www.elsevier.com/locate/jpba Analysis of herbal dietary supplements for sexual performance enhancement: First characterization of propoxyphenyl-thiohydroxyhomosildenafil and identification of sildenafil, thiosildenafil, phentolamine and tetrahydropalmatine as adulterants ∗ Stéphane Balayssac, Véronique Gilard, Chantal Zedde, Robert Martino, Myriam Malet-Martino Groupe de RMN Biomédicale, Laboratoire SPCMIB (UMR CNRS 5068), Université Paul Sabatier, 118 route de Narbonne, 31062 Toulouse cedex, France a r t i c l e i n f o a b s t r a c t Article history: Nine herbal dietary supplements intended to be beverages for enhancing sexual performance were ana- Received 8 December 2011 lyzed before their possible launch on the market. Four of them contained a sildenafil analog reported for Received in revised form 24 January 2012 the first time as an adulterant. After isolation and characterization using NMR, MS, IR and UV, this analog Accepted 26 January 2012 was named propoxyphenyl-thiohydroxyhomosildenafil as the ethoxy chain on the phenyl ring of the Available online 4 February 2012 already known analog thiohydroxyhomosildenafil was replaced by a propoxy moiety. One formulation was tainted with thiosildenafil, another unapproved PDE-5 inhibitor. Sildenafil along with the natural Keywords: alkaloid tetrahydropalmatine that has no documented effect for enhancing erectile dysfunction were Dietary supplements Adulterants identified in two formulations. Another formulation was adulterated with phentolamine, a drug that is Propoxyphenyl-thiohydroxyhomosildenafil not approved for boosting male sexual performance when taken orally. The last formulation containing NMR osthole, a bioactive natural coumarine improving sexual dysfunction, is most probably truly natural.
    [Show full text]
  • Phosphodiesterase 5 Inhibitors for the Treatment of Erectile Dysfunction: a Trade-Off Network Meta-Analysis
    EURURO-6137; No. of Pages 7 E U R O P E A N U R O L O G Y X X X ( 2 0 1 5 ) X X X – X X X ava ilable at www.sciencedirect.com journa l homepage: www.europeanurology.com Platinum Priority – Review – Sexual Medicine Editorial by XXX on pp. x–y of this issue Phosphodiesterase 5 Inhibitors for the Treatment of Erectile Dysfunction: A Trade-off Network Meta-analysis a,y a,y a,b,c d e Liang Chen , Sergej E.L. Staubli , Marc P. Schneider , Alfons G. Kessels , Sandra Ivic , e a, Lucas M. Bachmann , Thomas M. Kessler * a b Neuro-Urology, Spinal Cord Injury Center & Research, University of Zu¨rich, Balgrist University Hospital, Zu¨rich, Switzerland; Brain Research Institute, c University of Zu¨rich, Zu¨rich, Switzerland; Department of Health Sciences and Technology, Swiss Federal Institute of Technology Zu¨rich, Zu¨rich, Switzerland; d e Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht, The Netherlands; Medignition Research Consultants, Zu¨rich, Switzerland Article info Abstract Article history: Context: Erectile dysfunction (ED) is a major health care problem worldwide and phosphodiesterase 5 inhibitors (PDE5Is) are the pharmacological treatment of choice. Accepted March 15, 2015 However, the optimal PDE5I for ED treatment is not known. Objective: To investigate trade-offs between efficacy and adverse events for various Keywords: PDE5Is in treating ED. Phosphodiesterase 5 inhibitors Evidence acquisition: A review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. Medline, Scopus, reference Erectile dysfunction lists of relevant articles, and systematic reviews were searched.
    [Show full text]
  • Stembook 2018.Pdf
    The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances FORMER DOCUMENT NUMBER: WHO/PHARM S/NOM 15 WHO/EMP/RHT/TSN/2018.1 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances. Geneva: World Health Organization; 2018 (WHO/EMP/RHT/TSN/2018.1). Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data.
    [Show full text]
  • A Abacavir Abacavirum Abakaviiri Abagovomab Abagovomabum
    A abacavir abacavirum abakaviiri abagovomab abagovomabum abagovomabi abamectin abamectinum abamektiini abametapir abametapirum abametapiiri abanoquil abanoquilum abanokiili abaperidone abaperidonum abaperidoni abarelix abarelixum abareliksi abatacept abataceptum abatasepti abciximab abciximabum absiksimabi abecarnil abecarnilum abekarniili abediterol abediterolum abediteroli abetimus abetimusum abetimuusi abexinostat abexinostatum abeksinostaatti abicipar pegol abiciparum pegolum abisipaaripegoli abiraterone abirateronum abirateroni abitesartan abitesartanum abitesartaani ablukast ablukastum ablukasti abrilumab abrilumabum abrilumabi abrineurin abrineurinum abrineuriini abunidazol abunidazolum abunidatsoli acadesine acadesinum akadesiini acamprosate acamprosatum akamprosaatti acarbose acarbosum akarboosi acebrochol acebrocholum asebrokoli aceburic acid acidum aceburicum asebuurihappo acebutolol acebutololum asebutololi acecainide acecainidum asekainidi acecarbromal acecarbromalum asekarbromaali aceclidine aceclidinum aseklidiini aceclofenac aceclofenacum aseklofenaakki acedapsone acedapsonum asedapsoni acediasulfone sodium acediasulfonum natricum asediasulfoninatrium acefluranol acefluranolum asefluranoli acefurtiamine acefurtiaminum asefurtiamiini acefylline clofibrol acefyllinum clofibrolum asefylliiniklofibroli acefylline piperazine acefyllinum piperazinum asefylliinipiperatsiini aceglatone aceglatonum aseglatoni aceglutamide aceglutamidum aseglutamidi acemannan acemannanum asemannaani acemetacin acemetacinum asemetasiini aceneuramic
    [Show full text]