RESUMO
BACKGROUND: Erectile dysfunction is a preoccupying issue, just like motor and bladder disability, in spinal cord injured (SCI) patients. This is particularly so because of the increasing prevalence of paraplegic and tetraplegic subjects and the fact that these patients are younger, and sexually active. OBJECTIVE: To determine the effects of Sildenafil (Viagra((R))) on erectile dysfunction in SCI patients. METHODS: After medical ethics committee approval and informed patient consent, we conducted a prospective inquiry between January and March 2007 in 16 SCI patients who were under Sildenafil treatment for erectile dysfunction. An abridged version of the International Index of Erectile Function (IIEF-5) questionnaire was completed the patients. RESULTS: The mean age (range) of the patients was 32.75 yrs (21-53 yrs). The mean duration of their disability was 47.75 months (4 yr). Trauma was the etiology in 87.5% of the cases (44% were road accidents). 12/16 patients were paraplegics (10 above T10) and 4 were tetraplegics (1 above C4 and 3 below C5). The mean duration of sildenafil treatment was 18.75 months (17 days-7 yr). 70% of the patients were satisfied with their erection after treatment. However, 10/16 patients had concomitant treatment with alprostadil. CONCLUSION: Sildenafil is a vasoactive drug which can be used as a simple, discrete and effective treatment for erectile dysfunction in SCI patients. This approach is compatible with the efforts to improve the quality of life and rehabilitation of these patients.
RESUMO
OBJECTIVE: To evaluate the quality of life of handicapped students integrated into the ordinary higher education system. MATERIALS AND METHODS: Over a seven-month period in the academic year 2000-2001, we performed a descriptive, cross-sectional, analytical survey of 203 handicapped students registered in universities and high schools in Abidjan, Ivory Coast. The first part of the survey questionnaire concerned the students' social-demographic and clinical characteristics and the second part consisted of a quality of life assessment in terms of building and teaching accessibility and socioeconomic aspects. Quality of life was evaluated on a six-step scale, as per the life satisfaction questionnaire of Bränholm and Fugl-Meyer. RESULTS: A number of the handicapped students (60.6%) received financial support from their families. Several students (89.2 and 10.8%) presented motor and sensory handicaps, respectively. A number of respondents (63.5%) considered that building accessibility was dissatisfactory. A number of the surveyed students (73.89%) were at university. Teaching accessibility was judged to be satisfactory by motor-handicapped subjects and dissatisfactory by sensory handicapped persons. A number of the surveyed students (26.6%) spent between 25 to 50% of their monthly income on handicap-related expenses and 19.7% of the survey population even spent more than 50% of their income in this respect. The surveyed students' considered their overall quality of life to be dissatisfactory. CONCLUSION: Improving handicapped students' quality of life requires an appropriate legislative environment and adequate financial support in order to incite educational institutions to accept these students' needs and their specific characteristics.
