Evaluation of temporal changes in the sexual function among Japanese women using the female sexual function index: An Internet survey.

OBJECTIVES: Female sexual dysfunction is an underestimated problem that negatively affects women's quality of life. Although the overall prevalence of sexual dysfunction in women is high, only a few studies have focused on this problem. In Japan, an index of female sexual function has not been clearly defined. Hence, this study aimed to investigate the sexual function of normal Japanese women and the temporal changes they experienced using the Female Sexual Function Index administered online in 2012 and 2019. METHODS: The subjects were Japanese women aged 20-79 years registered in an Internet research company. We collected data of 1034 and 2031 women in 2012 and 2019, respectively, based on Japan's population distribution according to age. Subsequently, we analyzed the collected data using a Japanese version of the Female Sexual Function Index. We investigated the temporal changes in the Female Sexual Function Index total score, the ratio of women who did not engage in sexual activities and women having "no sexual activity" with their partners, and the total Female Sexual Function Index scores according to age. RESULTS: The average Female Sexual Function Index total score decreased from 14.6 in 2012 to 12.5 in 2019 (p < 0.001). No significant difference was observed in the average Female Sexual Function Index score of the group with sexual activity between 2012 (22.2) and 2019 (22.4). The ratio of women not engaging in sexual activities increased from 42.2% in 2012 to 54.0% in 2019. The ratio of women having "no sexual activity" with their partners increased by 10%. CONCLUSION: Comparison of data between 2012 and 2019 indicated that Japanese women have become less sexually active. The average Female Sexual Function Index total score of 22 may be useful as a reference value for diagnosing female sexual dysfunction in Japan.

Comparison of the clinical effect of dutasteride therapy for benign prostatic hyperplasia when initiated at different time points: A multicentre, observational, retrospective chart review study.

AIM: To evaluate the effects of early (≤6 months after starting any medical treatment [baseline] for benign prostatic hyperplasia [BPH]), intermediate (between >6 months and 2 years from baseline) and late (2 years after baseline) initiation of add-on dutasteride therapy on the incidence of acute urinary retention (AUR) and BPH-related surgery in Japanese patients with moderate-to-severe BPH. METHODS: This multicentre, observational, retrospective chart review study used anonymised data from Japanese medical records. Eligible patients (≥50 years) were followed from baseline until first AUR, BPH-related surgery or Year 4. RESULTS: Overall, 1206 patients were included (early initiation: n = 793; intermediate: n = 233; late: n = 180). Early dutasteride initiation was not superior to late initiation in reducing the risk of first AUR or BPH-related surgery from baseline (hazard ratio [HR] 0.733; 95% confidence interval [CI] 0.468-1.150) but was superior in reducing the risk of first AUR alone (HR 3.449; 95% CI 1.796-6.623). One year after initiation, the cumulative incidence of first AUR rose rapidly in the late vs early and intermediate initiation groups. Incidences of all parameters (first AUR/BPH-related surgery, first AUR alone and BPH-related surgery alone) in patients undergoing BPH-related surgery in low incidence sites (ie clinical sites with ≤ 16% incidence of first AUR or BPH-related surgery) were significantly lower in the early vs late initiation groups. CONCLUSION: Early dutasteride initiation reduced the risk of AUR in a Japanese real-world setting. A randomised controlled trial is warranted to evaluate the benefit of early initiation in preventing BPH-related surgery in Japanese patients.

Effectiveness of pharmaceutical support by pharmacists in urinary care teams.

To facilitate timely removal of urinary catheters and promote self-voiding among inpatients, urinary care teams have been established in some Japanese medical institutions. However, direct evidence of the effectiveness of pharmacist intervention in urinary care teams is limited. We evaluated the efficacy of pharmaceutical support by a pharmacist in a urinary care team. Between September 2017 and August 2018, 84 patients met the criteria for initiating continuous intervention. Patients with (20 cases) and without (8 cases) adoption of pharmaceutical support (initiation or discontinuation of treatment for dysuria) were scored for urinary function (including degree of independence of urination and score of lower urinary tract disorder) and for urinary situation. Comparative analysis results showed that pharmacist intervention in the adoption cases resulted in significantly improved scores for urinary function than in non-adoption cases. Similarly, pharmaceutical support resulted in improved overall urinary situation in the patients (85.0% of adoption cases compared to 37.5% of the non-adoption cases). The most common pharmaceutical support was a recommendation to discontinue drugs that induce dysuria (65.0% of the cases). Taken together, our findings suggested that pharmacists are important members of urinary care teams.

Downsizing a thrombus of advanced renal cell carcinoma in a presurgical setting with sorafenib.

A 53-year-old man presented with fever, 15 kg weight loss, ECOG performance status 0, and 12 × 9.5 cm renal tumor with an associated level II (near level III) tumor thrombus extending into the vena cava. We offered a presurgical targeted therapy to downsize the thrombus and primary tumor, which may reduce the extent of the surgery and operative risk. The patient accepted this approach with administration of sorafenib, resulting in a marked reduction of the primary renal tumor and 43% regression in tumor thrombus. Tumor shrinkage and regression of the thrombus allowed resection of the left kidney. Pathological findings revealed that part of the tumor was necrotic tissue. Two years after initiation of presurgical sorafenib therapy, the patient remains alive without evidence of disease progression.

[A report of two cases of priapism with metastatic penile tumor].

We report two cases of priapism with metastases to the penis. The first case was a 52-year old man, diagnosed as suffering from gastric cancer by endoscopic biopsy five years previously, but for whom no treatment was performed. He visited our office due to priapism with a duration of 11 days. Physical examination showed two palpable mass lesions on the glans. A glansocavernosum shunt (Winter shunt) was performed, but this was not effective. Radiotherapy was also ineffective. Pathological analysis revealed gastric cancer metastasis to the penis and this was diagnosed as the cause of the priapism. He died of respiratory failure on postoperation day 28. The second case was a 64-year old man with kidney cancer. Hemodialysis had been performed due to chronic renal failure for 20 years and visited our office due to priapism from which he had suffered for 30 days. Computed tomography (CT) demonstrated a left renal cell cancer and metastasized to the retroperitoneal lymph nodes. A Winter shunt was performed on the penis and then a cavernosospongiosum anastomosis was done. The priapism improved about 40%. Pathological analysis confirmed that the renal cell cancer had metastasized to the penis and this was concluded to be responsible for the priapism.

Synthesis of Vinylene-Co,N-Linked Multi(porphyrin)s by the Addition of Free-Base Porphyrins to a C(2)H(2) Complex of Cobalt(III) Porphyrin and Their Oxidative Rearrangement to Vinylene-N,N'-Linked Multi(porphyrin)s.

The nucleophilic addition reaction of a pyrrole nitrogen of free-base porphyrins to a pi-complexed acetylene ligand in a cationic Co(III) porphyrin intermediate afforded good yields of vinylene-Co,N'-linked bis(porphyrin)s, (Por)Co(III)-CH=CH-(N-Por)H(2). N-substituted porphyrin free bases are N-vinylated regioselectively at the pyrrole adjacent to the original N-substituted pyrrole in this reaction. Tris- and tetrakis(porphyrin)s have been prepared by reacting a vinylene-N,N'-linked bis(meso-tetraarylporphyrin) with (OEP)Co(III)(H(2)O)(2)ClO(4) (OEP: octaethylporphyrin dianion) and acetylene. The tetrakis(porphyrin) proved to be a 1:1 mixture of C(i)()- and C(2)-symmetric regioisomers. These organometallic Co(III) complexes underwent facile oxidative migration of the Co-bound vinyl group to a porphyrin pyrrole nitrogen when treated with Fe(III) salts or HClO(4) to provide moderate to good yields of Co(II) vinylene-N,N'-linked multi(porphyrin) complexes. (Vinylene-N,N')bis(porphyrin) free bases with combinations of different porphyrins have been obtained by this procedure. The homobinuclear (2Co(II), 2Cu(II), and 2Zn(II)) and heterobinuclear (Co(II)Cu(II) and Co(II)Zn(II)) complexes have been prepared and characterized spectroscopically. The single-crystal X-ray analysis of (CH=CH-N,N')[(OEP)Co(II)Cl][(TPP)Zn(II)Cl] (TPP: meso-tetraphenylporphyrin dianion) showed a face-to-face structure with an average inter-ring separation of 4.39 Å (triclinic P&onemacr;; Z = 2; a = 14.806(4), b = 18.703(10), c = 13.796(3) Å, alpha = 97.69(3), beta = 99.57(2), gamma = 96.74(3) degrees ).