ABSTRACT
Random controlled trials on the efficacy of naltrexone and acamprosate in the treatment of alcohol dependence were reviewed, using a Relative Benefit (RB) analysis approach. A total of 42 studies were included, showing acamprosate use demonstrated a modest improvement, with a RB of 1.76 at three month follow-up. Short-term administration of naltrexone significantly reduced the relapse rate, but was not associated with modification in the abstinence rate. There was insufficient data available to ascertain the efficacy of naltrexone and acamprosate over prolonged periods of time, or the effectiveness of the medications relative to each other.
Subject(s)
Alcohol Deterrents/therapeutic use , Alcoholism/drug therapy , Naltrexone/therapeutic use , Narcotic Antagonists/therapeutic use , Taurine/analogs & derivatives , Acamprosate , Adolescent , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Randomized Controlled Trials as Topic , Single-Blind Method , Taurine/therapeutic useABSTRACT
OBJECTIVE: To map the fine-touch pressure thresholds of the adult penis in circumcised and uncircumcised men, and to compare the two populations. SUBJECTS AND METHODS: Adult male volunteers with no history of penile pathology or diabetes were evaluated with a Semmes-Weinstein monofilament touch-test to map the fine-touch pressure thresholds of the penis. Circumcised and uncircumcised men were compared using mixed models for repeated data, controlling for age, type of underwear worn, time since last ejaculation, ethnicity, country of birth, and level of education. RESULTS: The glans of the uncircumcised men had significantly lower mean (sem) pressure thresholds than that of the circumcised men, at 0.161 (0.078) g (P = 0.040) when controlled for age, location of measurement, type of underwear worn, and ethnicity. There were significant differences in pressure thresholds by location on the penis (P < 0.001). The most sensitive location on the circumcised penis was the circumcision scar on the ventral surface. Five locations on the uncircumcised penis that are routinely removed at circumcision had lower pressure thresholds than the ventral scar of the circumcised penis. CONCLUSIONS: The glans of the circumcised penis is less sensitive to fine touch than the glans of the uncircumcised penis. The transitional region from the external to the internal prepuce is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. Circumcision ablates the most sensitive parts of the penis.
