Perceptions and opinions of men and women on a man's sexual confidence and its relationship to ED: results of the European Sexual Confidence Survey.

The European Sexual Confidence Survey examined the opinions of men and women on the link between a man's sexual confidence and functional (erectile and orgasmic) and emotional (satisfaction and self-confidence) aspects of sex and life in general. The online survey of sexually active adults (25-64 years of age) was conducted in 12 European countries using multiple-choice questions and predefined statements on sexual confidence. Erectile function was assessed by erection hardness score (EHS). Of 8576 respondents (4246 men, 4330 women), 23.9% reported non-optimal erectile hardness (EHS3) for themselves or their partners. 79.0% believed that an ability to sexually satisfy their partner is most closely linked to a man's sexual confidence. One in three linked a man's sexual confidence to erection hardness and ability to reach orgasm. The majority (∼94.0%) believed that it is important for a man to be sexually confident for good sex and that being able to have good sex enables men to have greater satisfaction with life overall. Lack of sexual confidence due to insufficient erection rigidity was considered by most respondents (∼65.0%) to reduce a man's confidence about the next sexual encounter and also his self-confidence and self-esteem overall.

Prevalence and detection rate of underlying disease in men with erectile dysfunction receiving phosphodiesterase type 5 inhibitors in the United Kingdom: a retrospective database study.

AIM: To determine the rate of newly detected underlying disease in men receiving their first (index) phosphodiesterase type 5 inhibitor (PDE5i) prescription. METHODS: This non-interventional, retrospective study used anonymised patient records from UK general practices identified from the THIN database. Records of men aged ≥ 18 years, who received an index PDE5i prescription between January 1999 and June 2008 and with a continuous medical history (≥ 60 months) before the index prescription were included. Primary end-points were the prevalence of underlying disease prior to the index prescription and to establish the detection rate, defined as cumulative incidence of such a diagnosis in the 3 months following the index prescription. Assessments included comparison with age-matched controls, comparison with identical time periods immediately before and 1 year after, index prescription, and changes over time during the study period. Descriptive statistics, analysis of proportions and multivariate logistic regression analysis were used. RESULTS: Among the 24,708 patients receiving a PDE5i, the prevalence of any underlying diagnosis before the index prescription was 70.23%; prevalence of vasculogenic disease was highest (48.20%). The detection rate of any underlying disease was 11.53%, and again highest for vasculogenic disease (4.07%). Compared with an age-matched control population, the additional detection rate of an unknown underlying disease at PDE5i prescription was 45 for hypertension, 61 for hypercholesterolaemia, 38 for diabetes and 5 for hypogonadism per 10,000 men. CONCLUSION: Only a minority of men with erectile dysfunction have a previously undiagnosed important underlying disease that is uncovered at the time of an initial PDE5i prescription by a GP.

Induction of the IL-10 gene via the fas receptor in monocytes--an anti-inflammatory mechanism in the absence of apoptosis.

Death receptors play an important role in controlling cell numbers and immune responses. In contrast to TNF receptors, little is known about non-apoptosis functions of the Fas receptor (CD95, APO-1). Here we demonstrate that Fas receptor engagement results in the induction of the IL-10 gene in monocytes, but not in lymphocytes or dendritic cells. In contrast, TNF-alpha stimulated IL-10 production in dendritic cells but not monocytes. Fas receptor-mediated transcriptional activation of the IL-10 gene was followed by the release of large amounts of the cytokine in cell cultures and occurred in the absence of apoptosis induction. Since caspase activation did not occur in monocytes following Fas receptor engagement, it is unlikely that caspases are involved in IL-10 gene activation. Monocyte-derived IL-10 suppressed T cell proliferation induced by anti-CD3 monoclonal antibody without affecting CD3-mediated transmembrane signal transduction. In conclusion, we report about a novel pathway initiated via the Fas receptor leading to transcriptional activation of at least one cytokine gene. Fas ligand-induced IL-10 production in monocytes might represent an important anti-inflammatory mechanism in secondary immune responses.