T. Wu., Tony
22 May 2004
Background and Purpose: The Massachusetts Male Aging Study found 52% of men aged 40 to 70 years suffered from erectile dysfunction (ED). Approximately two millions men in Taiwan were ED suffers, only 10% of them had taken Viagra®. The potential market is very attractive to pharmatheutical industry. By law, ED medicines are prescriptive drugs; in practice, more than 80% of ED drugs were sold without prescription in Taiwan. The launch of Levitra® and Cialis® has boosted the competition in the ED drug market. The purposes of this study are 1) to compare the marketing strategies of Viagra®, Levitra® and Cialis®, 2) to analyze factors influencing physicians¡¦ prescription, 3) to analyze factors affecting drug purchasers¡¦ decision, and 4) to survey the preference of drugstores owners on selling these drugs. Materials and Methods: The first step is face-to-face, in-depth interviews with product mangers to understand their marketing strategies. We will ask them to rate the significance of factors (e.g. efficacy, safety, price) affecting physicians¡¦ and patients¡¦ preference. Product mangers will be requested to rate the importance and relevance of the way product messages delivered to doctors¡¦ prescription behaviors. Questionnaires will be mailed to all urologists in Taiwan to survey factors they concerned when prescribing. We use mailing questionnaires and face-to-face interviews to assess the impact of drug efficacy, duration, safety, etc. on drug purchasers¡¦ decision. Drugstores owners will be interviewed to understand their favor in promoting certain drug. Comparative studies will be done to evaluate the difference between product mangers, physicians and patients. Results The marketing strategy of Pfizer is to emphasize the well-documented efficacy and long-term safety of Viagra® by seminars for physicians. Educational talks will be given to the public to explore the potential consumers. The goal of Bayer is to urge the silent ED suffers search for medical help, and to convince physicians that Levitra® is the drug of choice for ED patients. Eli-Lilly put almost all their marketing efforts and resources in drugstores. Drug efficacy and safety are most important factors influencing physicians¡¦ prescription. Approximately 85% of urologists surveyed favor Viagra®, 21% have safety concern on Cialis®. Most urologists considered Levitra® as alternative of Viagra® when failed. All product mangers overestimate the impact of key opinion leaders, literature, and seminars on physicians¡¦ prescription behaviors. Patients¡¦ survey disclosed that drug efficacy and safety are most important factors affecting drug purchasing. As compared to physicians, patients have more concern on the time of onset and duration. About 20% of drug purchasers are not ED suffers; 62% of purchasing is sporadic, one third of Viagra® users have the attempt to try other ED drugs. The drugstores owners have no specific preference for any drugs. Conclusions The extension of life expectancy and open discussion of male ED problem had resulted in tremendous growth of ED drug market. The launch of new drug may stimulate the selling amount in short run; the long-term market shares depend mainly on the drug efficacy and safety. In our study, we found that safety profile is the main concern for both physicians and drug purchasers. We believed that Viagra® may stay as the market leader, while Levitra® may have only small market share. Certain groups of drug purchasers, especially fake ED suffers and those who with multiple sex-partners will have high brand loyalty to Cialias®.
A research report submitted to the Faculty of Health Sciences at the University of the Witwatersrand in partial fulfillment of the requirements for the qualifications of MMed (Urology) 2017 / Background: Erectile dysfunction is one of the most important sequelae of pelvic fractures and may be transient or permanent. It can range from weak erections to severe sexual dysfunctions. Importantly, erectile dysfunction is more prevalent when the pelvic fracture is associated with urethral injury. Methods: This was a retrospective study of patient records, with a prospective questionnaire arm for patients admitted to the hospitals with a pelvic fracture between 01/07/2011 to 30/04/2015. The electronic databases of the Orthopedic Department at Helen Joseph Hospital and the Male Sexual Dysfunction Clinic at Charlotte Maxeke Johannesburg Academic Hospital were accessed for patients' contact details, by using the name and hospital number of each patient. Each patient was contacted telephonically with an open speaker in a presence of a witness/translator. The information sheet was read to the patient before the telephonic consent was obtained. After consent was obtained, patients were asked to verbally complete the International Index of Erectile Function score questionnaire. Results A total of 53 patients participated in the study, of which (43.4%) reported erectile dysfunction. The majority of patients indicated a recovery of erectile function between 2 8 | P a g e to 8 months after the injury. Most were found to still suffer from other forms of sexual impairment like orgasmic dysfunction and sexual satisfaction. However, sexual desire seemed to be preserved. Patients with sexual dysfunction were more likely to have had a urethral injury as well as a more severe fracture. Conclusions In our sample of 53 patients almost half reported sexual dysfunction after a pelvic fracture. Importantly, patients with urethral damage and a severe pelvic fracture should be followed up, as the risk of sexual dysfunction is high in these particular patients. / MT2017
The prevalence of the metabolic syndrome in men presenting with erectile dysfunction at a South African tertiary care centreWood, Bradley Ryan 22 October 2010 (has links)
MMed (Urology), Faculty of Health Sciences, University of the Witwatersrand / The metabolic syndrome has recently become one of the major public health challenges and results from the increasing prevalence of obesity. Erectile dysfunction (ED) affects up to half of men over the age of forty. Men with co-morbid disease and risk factors including cardiovascular disease, hypertension, dyslipidaemia and depression all report a higher prevalence of ED. The current study investigated the prevalence of the metabolic syndrome in one hundred men with (ED) presenting to the Male Sexual Dysfunction Clinic at the Johannesburg Hospital. Participants underwent a thorough history taking and examination session which included the International Index of Erectile Function Score. Several fasting biochemistry and hormonal tests were performed. Participants were divided by race into three groups. Data was recorded in EXCEL and reported as mean±std or as a number (frequency). Where applicable, correlation between variables was determined. The prevalence of the metabolic syndrome was 39%, with the highest prevalence (54%) in the group comprising Asian, Coloured and Chinese participants. Eighty percent of participants had moderate-severe (ED), with a mean duration of 3,8 years. Glucose and HbA1c were strong predictors of ED duration. Severity of ED was not influenced by the presence of the metabolic syndrome. Men presenting with ED may represent an ideal patient group to screen for the metabolic syndrome, and therefore for cardiovascular disease, especially for those men within the asymptomatic period.
Harte, Christopher Brookes
07 November 2011
Cigarette smoking represents the most preventable cause of morbidity and mortality in the world today, and is responsible for enormous health-related economic burdens. Among other medical sequelae, erectile impairment has been shown to be associated with chronic tobacco use. The primary aim of the present study was to provide the first empirical investigation of the effects of smoking cessation on physiological and subjective indices of sexual health. Sixty-five long-term, heavy smoking men participated in a smoking cessation program and were assessed at baseline (while smoking regularly), at mid-treatment (while using a high dose nicotine transdermal patch), and at 4-week follow-up. Physiological and subjective sexual arousal indices, as well as self-reported sexual functioning (as measured by the International Index of Erectile Functioning (IIEF)) were assessed during each visit. Intent-to-treat analyses indicated that at followup successful quitters (n = 20), compared to those who relapsed (n = 45), showed significant improvements in physiological and subjective sexual arousal. Specifically, men demonstrated enhanced erectile responses, decreased latencies to reach maximum erectile capacity, and faster onset to reach maximum subjective sexual arousal. Although participants displayed across-session enhancements in self reported sexual function, successful quitters did not show a differential improvement compared to participants who relapsed. The results of the present investigation provide the first empirical evidence that smoking cessation significantly enhances both physiological and self-reported indices of sexual health in long-term male smokers, irrespective of baseline erectile impairment. It is hoped that these results may serve as a novel and enticing means to influence men to quit smoking. Increasing successful smoking cessation in men would significantly enhance quality of life, substantially reduce premature death, and alleviate enormous economic burdens caused by smoking-related diseases. / text
The experimental effects of pill attribution on sexual performance anxiety and subsequent erectile performancePujols, Yasisca 20 September 2013 (has links)
Erectile performance anxiety (EPA) is a subset of sexual anxiety characterized by a fear of erectile failure. EPA has been shown to play a pivotal role in male sexual problems including premature ejaculation and erectile dysfunction (Loudon, 1998; Perelman, 2006). EPA affects approximately 14% to 23% of U.S. men across age groups (Laumann, Paik, & Rosen, 1999), and is the most common proximal cause of psychogenic ED (Hale & Strassberg, 1990; Hedon, 2003; Perelman, 1994; Rosen, 2001). Phosphodiesterase type 5 (PDE5) inhibitors such as sildenafil citrate (brand-name Viagra) are the first line of pharmacological treatment for ED. Recreational use of PDE5 inhibitors -- defined as unprescribed use with the goal of sexual enhancement and prevention of erectile failure among men without clinically significant erectile difficulties. Approximately 13.4% of young men between the ages of 18 - 30 report using PDE5 inhibitors recreationally. The most commonly reported reason for off-prescription use is to enhance one's sexual performance, i.e., longer lasting erections or impress one's sexual partner (Bechara, Casabe, De Bonis, Helien, & Bertolino, 2010; Harte & Meston, 2011; Holt, 2009; Korkes, Costa-Matos, Gasperini, Reginato, & Perez, 2008; Musacchio, Hartrich, & Garofalo, 2006). Reducing anxiety -- specifically EPA is often given as a reason for recreational use, though to a lesser extent (Korkes et al., 2008; Schnetzler, Banks, Kirby, Zou, & Symonds, 2010). However, PDE5 inhibitors do not exert a significant increase in penile tumescence among men without erectile dysfunction (Mondaini et al., 2008). The actual sexual enhancement from recreational use of PDE5 inhibitors among this population would be limited in that blood flow to the healthy erectile tissue is already optimal. The proposed study aimed to examine the effects of an erection-enhancing pill description misattribution on anticipatory anxiety and subsequent subjective and physiological sexual response to an audiovisual erotic stimulus. Participants underwent two assessments of their subjective and physiological arousal response to an erotic film after randomization to one of three conditions (erection-enhancing pill description, memory-enhancing pill description, or a no pill control). It was hypothesized that compared to those in the memory-enhancing pill group and the no pill control group, participants in the erection-enhancing pill group would respond with greater anticipatory anxiety and dampened penile tumescence in response to a subsequent no-pill erotic film presentation. Results of the study provided partial support for the hypothesized negative effects of the pill attribution manipulation. In the subset of subjects with complete pre and post-manipulation physiological data, those led to believe they ingested an erectile-enhancing herb showed a dampening of erectile tumescence to a subsequent erotic film presentation. Also, consistent with prediction, erectile performance anxiety was associated with decreased tumescence after the bogus "average" erectile performance feedback compared to baseline. These findings suggest that pill attribution may influence sexual arousal to some extent, despite methodological issues such as partial physiological data loss and believability of the pill instructional set manipulation. / text
Mannens sexualitet efter genomgången prostatacancerbehandling : En litteraturbaserad studie / Male sexuality after treatment for prostatecancer : A litterature reviewJansson, Anna, Olsson, Linda January 2012 (has links)
No description available.
Carrillo-Larco, Rodrigo M., Luza-Dueñas, Anais Casandra, Urdániga-Hung, Mónica, Bernabe-Ortiz, Antonio
Aims: To assess the diagnostic accuracy of four undiagnosed Type 2 diabetes mellitus risk scores accounting for erectile dysfunction status. Methods: This was a population-based cross-sectional study. Type 2 diabetes was defined according to a oral glucose tolerance test and self-reported physician diagnosis. Erectile dysfunction was defined according to the answer to the question, ‘Have you had difficulties obtaining an erection in the last 6 months?’ (yes/no). The risk scores used were the FINDRISC, LA-FINDRISC, American Diabetes Association score and the Peruvian Risk Score. A Poisson regression model was fitted to assess the association between Type 2 diabetes and erectile dysfunction. The area under the receiver-operating characteristic curve was estimated overall and by erectile dysfunction status. Results: A total of 799 men with a mean (sd) age of 48.6 (10.7) years were included in the study. The overall prevalence of Type 2 diabetes was 9.3%. Compared with healthy men, men with Type 2 diabetes had 2.71 (95% CI 1.57–4.66) higher chances of having erectile dysfunction. Having excluded men aware of Type 2 diabetes status (N=38), the area under the receiver-operating characteristic curve of three of the risk scores (not the American Diabetes Association score) improved among those who had erectile dysfunction in comparison with those who did not; for example, the area under the receiver-operating characteristic curve of the LA-FINDRISC score was 89.6 (95% CI 78.7–99.9) in men with erectile dysfunction and 76.5 (95% CI 68.5–84.4) overall. Conclusions: In a population-based study, erectile dysfunction was more common in men with Type 2 diabetes than in the otherwise healthy men. Screening for erectile dysfunction before screening for Type 2 diabetes seems to improve the accuracy of well-known risk scores for undiagnosed Type 2 diabetes. / Antonio Bernabe-Ortiz is a Research Training Fellow in Public Health and Tropical Medicine (103994/Z/14/Z), funded by the Wellcome Trust. / Revisión por pares
Erectile dysfunction: heritability and cognitive and physiological correlates of the subclinical vascular disorderMoore, Caitlin 28 November 2015 (has links)
The broad goals of this dissertation were to explore possible causes of erectile dysfunction (ED), and examine outcomes associated with the condition. To address these objectives, data from the Vietnam Era Twin Study of Aging (VETSA), a longitudinal study of cognitive aging, were utilized. Previous research demonstrated moderate heritability of ED in middle-aged men, but questions remain about the replicability of these findings given that only one study exists on the topic and it utilized an unvalidated ED measure. Additionally, it is unknown to what extent genetic factors account for stability and change of ED symptomatology over time. In the first study, we conducted a longitudinal assessment of ED using the Sexual Health Inventory for Men (SHIM) administered to 668 male twins. Results revealed that the heritability (proportion of variance explained by genetic factors) of ED at both time points is moderate (0.3 –0.6). Over the past two decades ED has been recognized as primarily a disorder of vascular dysfunction. Inflammation is an important correlate of vascular dysfunction. Chapter 2 examined the association of ED with four inflammatory serum protein indices [albumin, globulin, albumin/globulin ratio (AGR), and the albumin*globulin interaction (AGI)] in 388 men free from cardiovascular disease (CVD). Results indicated that the AGR, albumin, and globulin protein levels are significantly associated with ED, even after accounting for other risk factors. Intriguingly, AGR and globulin levels were found to be more strongly associated with ED than conventional vascular risk factors, such as hypertension, high cholesterol, obesity, and smoking. As such, globulin and AGR may be useful biomarkers when diagnosing and managing ED. The simplicity and affordability of these assays make these markers particularly valuable. Given the negative impact that vascular disease has on cognition, Chapter 3 explored whether men with ED are at greater risk for experiencing cognitive decline compared to healthy peers. In total, 485 men free from CVD were administered cognitive tests across 13 domains. Tests were readministered 5 years later. Results revealed that men with ED were more likely to show significant decline on tasks of set-shifting, tool/mechanical knowledge, vocabulary, and verbal fluency.
Sexual dysfunction:the roles of yohimbine hydrochloride and intracavernosal vasoactive drugs in the treatment of erectile dysfunction, the effect of transurethral resection of prostate on sexual functions and the impact of dihydrotestosterone on andropausal symptomsKunelius, P. (Pekka) 06 October 1999 (has links)
Abstract Altogether 406 patients were included in five studies, and all patients were examined and controlled in the Oulu University Hospital during the years 1991–1998. Twenty-nine patients with mixed-type erectile dysfunction (ED) were recruited into a randomized, controlled, double-blind crossover comparison of placebo and high-dose yohimbine hydrochloride (36 mg per day orally). Positive clinical responses were obtained in 44% of the patients during yohimbine treatment and in 48% during placebo treatment. Thirty patients with ED underwent an intracavernosal injection test (ICI) using three different active agents (prostaglandin E1(PGE1), papaverine hydrochloride (PV), moxisylyte (MS)) and physiological saline. PGE1 produced significantly better rigidity than either PV or MS. Sixty-nine patients with ED who had started ICI therapy with PGE1 at least three years previously were invited to a control examination to find out the long-term outcome of this treatment and to evaluate the patients' overall satisfaction with their sexual life. 46.4% of the patients had discontinued PGE1 therapy, the mean time of using PGE1 having been 23.3 months (range 0–48 months). 34.8% of the patients reported that their own spontaneous erections had improved during the PGE1 therapy. The sexual functions of 155 patients with benign prostatic hyperplasia (BPH) were evaluated before TURP and 6 and 12 months afterwards with questionnaires. Only 26% of the patients had completely satisfactory erections before TURP, while 22% had satisfactory erections 6 months later and 24% 12 months later. The majority of patients (about 70%) were satisfied with their sexual life both before and after the procedure. 123 men with symptoms of andropause participated in a randomized, placebo-controlled study to assess the effects of dihydrotestosterone (DHT) gel in men with andropausal symptoms. The drug was administered transdermally once a day during six months. Early morning erections improved significantly (p < 0.003) in the DHT group by the three-month control, the ability to maintain erections was better, and there was also a positive effect on libido. In the patients with a elevated (> 12) international index of the prostatic symptoms score (I-PSS) before DHT treatment, I-PSS decreased from 17.7 to 12.3 points. As a conclusion yohimbine hydrochloride is no better than placebo in the treatment of patients with mixed-type ED. PGE1, PV and MS are well tolerated, and PGE1 was shown to be the most effective drug of the three. ICI therapy with PGE1 in long-term use is safe and effective. Sexual functions in men did not change after TURP, and this group of aging men were fairly satisfied with their sexual life despite of the fact that they had some ED and one third of the patients had not had intercourse during the previous year. Transdermal administration of DHT in aging men improves sexual function.
Regionální analýza při tvorbě prodejních plánů / The Use of Regional Analysis in Sales Plan CreationPeřinová, Pavlína January 2010 (has links)
Clearly defined sales plans are crucial for any business nowadays. Particular market situation, main competitors and key factors all of these should be taken into consideration when creating a relevant sales plan. In today`s global society the cooperation of marketing and sales department is unavoidable. Knowing the exact market situation and regional differences to create a relevant plan is important not just for sales in general but also as one of the key motivating factors for people in sales force. This diploma thesis should analyze how relevant are the key factors that are being followed on a way to reach the sales target in ED market in the Czech Republic considering the demographic data and economic strength of the regions.
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