Patient and partner satisfaction with Viagra (sildenafil citrate) treatment as determined by the Erectile Dysfunction Inventory of Treatment Satisfaction Questionnaire.

OBJECTIVES: To assess the efficacy and safety of Viagra (sildenafil citrate) in male outpatients with erectile dysfunction and patient and partner satisfaction with treatment using the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). METHODS: A total of 247 patients with erectile dysfunction of broad-spectrum etiology were treated in a randomized, double-blind, parallel-group, multicenter study conducted at outpatient clinics. Patients receiving oral sildenafil (25, 50, and 100 mg) were compared with patients receiving placebo during a 12-week period. The principal efficacy measures were responses to question 3 (ability to achieve an erection) and question 4 (ability to maintain an erection) on the International Index of Erectile Function and three global efficacy questions. Patient and partner satisfaction with treatment were assessed, for the first time, using the EDITS questionnaire. RESULTS: Efficacy scores for the International Index of Erectile Function questions and the global efficacy questions were significantly higher for patients receiving sildenafil than for those receiving placebo (P <0.001). Both patients and partners receiving sildenafil also had significantly higher EDITS scores than those receiving placebo (P <0.001). Adverse events were chiefly mild or moderate. Two patients receiving sildenafil and none receiving placebo discontinued treatment because of adverse events. CONCLUSIONS: Sildenafil was an effective, well-tolerated treatment for erectile dysfunction in an outpatient setting. Partner evaluations corroborated patient assessments. The results from the EDITS questionnaire indicated that after 12 weeks of receiving sildenafil both patients and partners reported higher levels of treatment satisfaction relative to placebo.

Renal tumors in young adults.

Primary renal malignancies are relatively rare in young adults. Eighteen patients between the ages of twenty and forty years underwent nephrectomy for renal tumors at our institution between 1947 and 1989. Data were reviewed in this group regarding method of presentation, duration of symptoms, tumor histology, pathologic stage, and survival. Tumor histology parallels that of older patients, the majority being adenocarcinoma (78%). The duration of symptoms prior to seeking medical attention was long, averaging eighty-four weeks. The overall survival rate, excluding nontumor deaths, was 50 percent. No patient with nodal or distant metastases survived, regardless of histology.

Experimental evidence of a strategy for a beat swing prior to a kip.

Throughout a beat swinging motion prior to a kip the gymnast changes the relative orientation of his legs and head-torso with respect to his arms. It was observed that if these changes occurred in a correct order he could rapidly increase his swing with his limited strength. If changes in orientation of the body parts did not take place in a correct phase, the person would immediately begin to lose any height gained. Previous measurements of the filmed motion of a gymnast performing this motion and his anthropometric dimension and were used to compute from the Dempster-Hanavan model the gymnast's center-of-mass (CM) and polar moment-of-inertia (I) at each instant throughout the maneuver. A simple mechanical model should be able to reproduce the time history of the CM. This model provides some insight into what might be required to increase one's swing. From filmed motion of "good" and "bad" beat swings leading to a kip and this simple model a simple strategy was devised. Graphs are presented which show that the simple strategy is related to the gymnast's radius-of-gyration. The simple strategy is only for the swinging motion. It was concluded that the strategy of the final, small segment of the kip was not the same as that during the swinging segment but a complex one of largely utilizing the accumulated angular momentum.

Personalized, electro-kinematic, neuromuscular model of a human forearm.

Electromyography, the recording of muscular activity, is of importance in industrial, biomechanical, and sports research as well as in medical diagnoses. When a muscle is activated, an electric potential in the order of microvolts (muV) is generated. This potential can be picked up, amplified, and displayed on an oscilloscope or strip chart recorder. Researchers have developed ways of analyzing these signals in terms of their characteristics. A numerical index, which reflects the basic characteristics of the electromyogram, mainly amplitude, frequency, and duration, can be used to provide quantitative information. The method used in this work for EMG processing consisted of filtering, rectification, and integration over very small intervals of time. Both analog and digital filtering proved necessary. Angular accelerometer and rotational potentiometer data were used in conjunction with limb inertia parameters obtained from existing biochemical models for the individual tested for obtaining the torques as a function of time. A system parameter identification method was used to determine the muscle parameters, such as occur in the single muscle Hill model, of four muscle groups for a human arm. The main results consist of personalized arm muscle group models. It was concluded that the method provided excellent (fit) personalized arm muscle group models under dynamic conditions. This method could lead to fundamental scientific information about a living muscle group from experiments in vivo.