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As with other aspects of men’s health it is the most vulnerable men and those that lead the most risky lifestyles that are creating the conditions for the spread of the diseases and adding to their level of premature death. Though this section deals with the major causes of infection for men it is not to be forgotten that there are opportunities to influence the health of women directly through programmes aimed at men. Making this available for boys as well as girls will help prevent the spread of this virus and further reduce the risk of cancer. Despite the higher absolute number of deaths among women, men have a higher standardised death rate: more deaths in women occur among those over age 80 years (77% compared to 55% for men). It can result from external causes which have specific importance to men’s increased vulnerability. The risk of developing pneumonia is greater in people with general ill-health or with pre-existing lung disease. It is also greater in smokers, users of immunosuppressant drugs, and users of intravenous drugs. A further significant factor is alcohol abuse, which results in a diminished immune response and increases the risk of developing the disease and of its severity (de Roux et al. There has been an overall steady decline in the age-standardised death rate for Pneumonia, with the rate of decline similar for both men and women (Fig. The majority of the deaths occur over the age of 80 years 345 with some 55% of male deaths and 77% of female deaths as a result of Pneumonia occurring over this age (Fig. Although the number of deaths among people aged 85+ years is greater in women, the rate for men is higher given the smaller number of men who live to 85+ years of age. The peak 3-fold higher rate of death in men aged 50-54 again reinforces the challenges men face in these middle years. The success stories of the past were a result of a sustained programme of immunisation, surveillance, contact tracing and screening for infected individuals, and treatment coupled with improving social conditions. These actions cut the route of transmission for the contagious Mycobacterium tuberculosis bacillus and prevented the disease from taking a hold within communities. However, this requires sophisticated health care systems staffed by capable practitioners. A second is the development of drug-resistant strains as a result of poor patient management, non-adherence to prescribed medicine, and poor national programmes (Davies, 2001). It is usually contained by the body’s natural defences into a fibrous capsule following a mild illness. The European Region has the highest number of drug resistant cases in the world and though many of these are not within the countries included in this study the rate of inward migration from these neighbouring countries is a very local threat and the greatest number of cases within Europe are to be seen in foreign nationals who have emigrated or are seeking asylum from countries where the disease is rife. The problem of non- adherance to drug regimes is a factor related to this ignorance of the disease and its treatment. A further factor is the risk of affected individuals avoiding health services due to the fear of being repatriated. These figures represent a reduction of nearly 3500 cases for both men and women since 2004 (see Fig. However the low number of deaths and the overall downward trend have to be treated cautiously, because there are some very concerning figures in some parts of Europe. Exploration of the data from the countries for this age range shows that the Eastern European countries are carrying the majority of that burden, with Lithuania having a death rate of 48. Although surveys of representative samples have been conducted in many European countries, it is often difficult to make comparisons because of variations in sampling, data collection and measurement. Although less than half (45%) of all diagnoses 354 of Chlamydia occur in men, in four of the 13 countries with valid data (Latvia, Malta, Portugal, Slovenia) men comprise the majority of Chlamydia diagnoses. Furthermore, the age distribution among men is different to than for women, with a greater proportion of diagnoses in men occurring in those aged over 25 than is the case for women. Across the 18 countries with valid comparable data, 71% of all diagnoses of gonorrhoea infection occurred in men: in only two countries (Estonia and Turkey) was gonorrhoea more likely to be diagnosed in women. Although direct comparisons are confounded by differences in definitions, men are also more likely than women to have been diagnosed with syphilis: in 14 of the 18 countries, the majority of syphilis diagnoses occurred in men, and in 8 countries over 80% of diagnoses occurred in men. The male to female ratios do not appear to be affected by the stage of infection used in different countries’ surveillance data. The age distributions among men and women differ: a greater proportion of gonorrhoea and syphilis diagnoses in men occur in those aged over 25 than is the case for women. Among men, the proportion of diagnoses of gonorrhoea and syphilis are markedly higher than the population proportions of homosexually active men. The proportion of gonorrhoea attributed to homosexual transmission ranged from 19% to 69%, and in 7 of the 10 countries with data on presumed transmission 355 mode, the majority of infections among men were attributed to homosexual activity. This can happen in various ways: sexual intercourse without a condom; contact with blood or blood products; injection drug use; and mother-to-child transmission during pregnancy, birth, or breastfeeding. However, the predominant modes of transmission in Europe have been sexual activity between men and injection drug use. The relative importance of male homosexual activity, injection drug use, and other modes of transmission varies between countries within Europe, and has varied over the course of the epidemic. All other decreasing trends are due to underreporting and under diagnosis or reporting delay. For several countries there was a change in surveillance system, which may have contributed to the change (e. One exception to this pattern appear to be Estonia, where younger adults account for the largest proportion of new diagnoses. It is important to consider the size of the population in which the incident cases are found, the stage of epidemic and the link between diagnosis and deaths. Viral hepatitis has three main forms: Hepatitis A, Hepatitis B and Hepatitis C, which when combined comprise one of Eurostat’s 65 causes of death (or external causes) classification groups (Viral hepatitis B15-B19). These diseases cause inflammation of the liver and have varying degrees of impact on the health of the individual, from acute to chronic and from mild to life threatening. Hepatitis A is transmitted through infected stools or contaminated food, Hepatitis B is transmitted through contact with an infected individual’s blood or through direct contact with an infectious person and is common in migrants from countries where the condition is more commonplace (such as Asia and South East Asia), men who have sex with men, and drug users. Recent trends in the epidemiology of sexually transmitted infections in the European Union. Women tend to have more problems with regards to dentition but men have the greatest need with regard to poor periodontal health, which, apart from being a cause of considerable pain and discomfort, is associated with cardiovascular disease and increasingly with metabolic syndrome in men. It is ironic that although men are less likely to use preventative dental services women have a higher incidence of dental caries. The causes of periodontal disease are closely associated with risky male health behaviour but though this was once seen mainly as a problem of the older men it is now being increasingly seen in the young, especially those who are obese. Improved oral care is a precursor to reducing the incidence of systemic diseases across the world and early health promoting strategies aimed at men would seem to hold great worth. Careful and regular oral hygiene can make significant differences in oral health and consequent systemic health, but evidence suggest that men are less effective in this regard than women and are less likely to use preventative dental services. The World Health Organisation has a specific programme dedicated to oral 51 health and the World Oral Health Report (2003) was an important statement as to the need to take this area seriously. This database is hosted by the Niigata University in Japan and holds useful information on the extent of disease within collaborating countries, but unfortunately this data is not broken down by sex. This limits its usefulness in determining the gendered implications of this important condition. This has been demonstrated in a number of other studies, including a national survey of Hungary (Madlena et al. A detailed analysis of the sex and gender differences concluded that this was a multifactoral issue with no one definitive answer but it is possible that different salivary composition and flow rate, hormonal fluctuations, dietary habits, genetic variations, and particular social roles among their family were associated with the increased risk for women (Ferraro & Vieira, 2010). Due to this increased risk women are more likely to wear a removable denture and to have lost more natural teeth (Eurobarometer, 2009). Most often oral diseases are related to infections, with many factors influencing their ability to take hold and progress to advanced chronic conditions. These risk factors include both the local environment within the mouth and with the rapid rate of renewal needed for healthy gums any disease which compromises the bodies immune system (i. In addition there are a number of other important associated conditions that also have relevance to the higher prevalence this disease has in men. The recent fourth German Dental Health Survey comprising a national cross-sectional survey conducted in 2005 included 925 adults (35–44 years) and 1040 seniors (65–74 years).
Tea contains, group of cat- echins that includes catechin, epicatechin, gallocatechin, Carrot epigallocatechin, catechin gallate, epicatechin gallate, gallocatechin gallate, and epigallocatechin gallate and Daucus carota commonly known as "Carrot" belongs vitamins, minerals polyphenols, favonols (theafavins, to the family of Apiaceaeis, a useful vegetable being used thearubigens) , adenine, theobromine, theophylline, xan- worldwide. Many studies have been done on chemical thine, gallotannin, small amounts of aminophylline and composition of this plant and a large number of active a yellow volatile oil which is solid at room temperatures ingredients such as volatile oils, steroids, tannins, favo- and has strong aromatic smell and favor [9]. It has been re- rent researches have shown that both green and black ported that carrot can increase the potency in men, while tea contain favenoids such as quercetin, kaempferol and in women it stimulates menstruation, and seeds are more myricetin, which have strong anti-toxic and anti-carci- effective than other parts of the plant [19]. Both antioxidative and androgenic Garlic (Allium sativum) has been used as a medicine activity of Z. Ginger has been shown that decreases lipid phide is the bioactive organosulphur component of gar- peroxidation and increases glutathione content in blood lic, which have antioxidant effects [23]. Some studies have reported that garlic nale have a benefcial effect on male reproductive func- harmsthe function of testes and has spermicidal effects tions in rats, which are confrmed by other studies on the on spermatozoa but some others demonstrated the op- increased sperm counts, motility,testosterone, and de- posite effect [25]. It increase in the number of empty seminiferous tubules in was also observed that the administration of ginger can testes and a decrease in the level of testosterone. Also,a decreased prostate productive organ which might be due to the androgenic weight was associated with a reduction in citric acid con- activity of ginger [31]. Rats fed with a clearly increased level of testosterone in the rats even garlic water extract over 3 months showed an increase in in spite of receiving 5 mg/kg/day gentamicin comparing epididymis spermatozoa [27]. It has spermatogenesis stop at the primary spermatocyte stage been demonstrated that, ginger have an antioxidant and with 50 mg of oral administration of garlic powder for androgenic activity in dose of 50 mg/kg/rat, which have 70 days [28]. Some of these different results In another study, administration of 50 mg/kg/cock and might be due to the type of preparations used like garlic 100 mg/kg/cock ginger to 28, 32, 36, 40 and 44 week- powder [26, 28] , water extract [27] , aged garlic, raw age rats, signifcantly increased the concentration and garlic juice and heated garlic juice [30] or the doses and motility of sperms in ejaculation volume. Zingiber Offcinale commonly called ginger belongs In the other study, administration of 1000mg/kg to to the family of Zingiberaceae. It contains several com- rats for 28 days showed a signifcant weight increase pounds including acid, resins,vitamin C compounds, fo- compared to the control group. This activities of testicular antioxidant enzymes and restore 5 November 2013, Volume 10, Number 4 sperm motility of cisplatin-treated rats beside protec- crease in the weight of testes, cauda epididymis dies and tion against cisplatin-induced testicular damage [41]. Cinnamomum (family of Lauraceae) species con- Rose Oil tain volatile oils, tannins, terpenoids, mucilage, oxa- lates and starch. Different chemical constituents of Rose oil is extracted from rose fowers by steam dis- C. Rose oil is a lucid, light yellow, and volatile antiulcerogenic andcytotoxic effects. There are fve major constituents in oil such as citro- tract of Cinnamomum increased the weight of testes, nellol, geraniol, nerol, linalool, and phenylethyl alcohol caudae epididymidies and seminal vesicles in the treated [43]. Based on the results of aldehyde/carboxylic acid male mice, indicating a possible stimulation of hormon- test that is used to show long-term antioxidant activity, al levels in the animals. Also, the sperm count and motil- Wei & Shibamo to have reported that rose oil has an ity of the treated animals were signifcantly higher than antioxidant activityalmost equal to a-tocopherol, which the control group [48]. The increase in number and motility of sperm and Leydig cell counts, seminif- In another study, oral administration of erous tubule diameters, and decreasing the number of C. Another study showed vesicles, improved semen quality and quantity, and in- signifcant histopathological improvement in testes and creased serum insulin and testosterone levels. Koul and Kapil, reported that vent adriamycin-induced cytogenetic and damages of piperine, isolated from P. The antioxidant effect of fenugreek is ascribed (ginsenosides Rb1, Rb2, Rc, Re and Rg1) which are more to the presence of favonoids and polyphenols. Flavonoids, the effect of fenugreek against testicular toxicity of carben- main group of total phenolic constituents, are found in dazim may be associated with the antioxidant activity of greater concentration in the ginseng [58]. It has been reported that the polyphe- different effects like protecting muscle from exercise in- nolic extract of fenugreek seeds has an antioxidation effect duced by oxidative stress, improving erectile parameters in vitro [52]. A study showed that in rabbits, a fenugreek such as penile rigidity, girth, erection duration, libido and seed powder containing diet (30%) for 3 months could sig- patient satisfaction [59]. Ginseng causes a signifcant de- nifcantly decrease male testis weight [~25%] and sperm crease in total chromosomal aberrations, sperm abnormal- concentration [~43%] , indicating a toxic effect of fenu- ities and increase in testosterone concentration and sperm greek seeds on seminiferous tubules and the interstitial numbers and motility [57, 60]. Their spermatogenesis hypoplasia when compared with that in protective effect may be due to the higher ability to elimi- the control group [53]. In an- duced higher relative weights of the accessory sex gland, other study, the epididymal sperm count was increased all prostate lobes, the seminal vesicle, and the testes [54]. Tou et al `suggested that it is impor- chemotherapeutics, such as 5-fuorouracil, mitomycin tant to establish the age of exposure and dose of faxseed C, vinblastine, and cyclophosphamide [59]. The ginseng that will provide the most health benefts with the fewest extract could give effective protection against radiation- risks [56]. Administration of ginseng before gamma radiation treatment signifcantly protected Ginseng the germ cell population against the gamma radiation in mice [60]. Ginseng roots contain different pharmaceuti- thenospermic patients were increased by treatment with cal constituents ginsenosides (saponins) , polyacetylenes, P. Until now, 38 ginsenosides have been separated from ginseng roots, with fve main ginsenosides 7 November 2013, Volume 10, Number 4 can effectively prevent the testicular toxicity induced by increases fertility. Piacente et al, found that Maca also contained (1R, 3S) -1-methyltetrahydro?- In another study, it was found that the sperm count in carboline-3 carboxylic acid [69]. Maca has been found the testes and epididymides of the male rats treated with to have antioxidant properties in vitro and in vivo [67]. Flavonoids, the major group of total phenolic com- pounds, are found in parsley which either scavenge free Pumpkin (Cucurbita pepo L. The protein level is high cated that parsley oil contain favonoids (apiin, luteolin-, in seeds [25–51%] [72] and in seed oil [40% to 60%]. Pumpkin seeds improve libido and semen quality by elevating the serum testosterone level [74, 75]. It has Lepidium meyenii, a traditional Peruvian crucifer- been demonstrated that pumpkin seeds and daily rich ous vegetableknown as Maca used in the distant past, diet of zinc can decrease the undesirable side effect of belongs to the Brassicaceae family. The hypocotyl, the lead contaminants and improve the sexual health status comestible part of the plant, can increase sperm produc- [72]. Traditionally, the dried hypocotyls of Maca are perplasia of the ventral prostate lobe by reducing protein boiled and used as juice [67]. Therefore, it may bohydrates, 10•2% proteins, 8•5%fber, 2•2% lipids and be helpful in the management of benign prostatic hyper- a number of other compounds,including most of the es- plasia [3]. Pumpkin seeds improve sexual stimulation sential amino acids Arginine, a constituent of Maca, that and intromission and ejaculatory latency [76]. Therefore, Pumpkin is proposed for fertility effect in male rats rather than a compound that 8 November 2013, Volume 10, Number 4 both the prevention and treatment of infertility in male anti oxidant with inhibitory effect on lipid perioxidases, animals [4]. Sesame can also increase the diameter of the no effect on testicular histology when administered at a seminiferous tubules in a dose-dependent manner [82]. Tannins are classifed as antioxidants, at a high dose and could be- Allium cepa come pro-oxidant by increasing lipid per oxidation [77]. S-Methylcysteine sulphoxide is bioactive organosulphur components of Sesame onion which have antioxidant properties [23]. Sesame rat/day) for 20days increases sperm count, viability, and improves epididymal sperm reserved with larger sper- motility. The onion fresh juice can signifcantly increase matocytes in a dose-dependent manner. Sesame can also the recovery of sperm health parameters, such as count, increase body weight in a dose-dependent manner. Sesame has positive effects on the storage capac- ity for the sperm in the epididymis in a dose-dependent Apium graveolens manner [82]. However, a diet con- revealed the presence of terpenes such as limonene, taining sesame seed did not affect on epididymal tissue favonoids like apigenin and phthalide glycosides [91]. Furostanol is one of the saponins in Tribulus terres- annual wormwood or sweet Annie isan aromatic an- tris stimulates spermatogenesis and improves the quality nual plant which is the source of essential oils and ar- and quantity of sperm [96]. Also, it enlarges central lumen of the seminiferous stimulates germinative and endocrine functions of the tubules. Tribu- and the number of leydig cells, which secrete testoster- lus terrestris (protodioscin) treatment lead to an invari- one, due to the increasing spermatogenic activity. Ajah able increase in spermatozoa concentration in humans to and Eteng reported that intraperitoneal administration of approximately 160% [1]. Tribulus Terrestris Urtica dioica Tribulus terrestris [family: Zygophyllaceae] , is a fow- Urtica dioica is known as stinging nettle, grows in ering plant. It is about 30 to 70cm high; it grows annually many countries such as Iran, Greece and Turkey [103]. Flavonoids contains steroids, saponins,essence, favonoids, alka- generally have antioxidant properties.
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X-rays Vesicles Forms of electromagnetic radiation that are Blisters or small sacs in the skin that contain emitted by a machine as individual particles fluid impotence viriesiem order 100 mg kamagra visa. Aphrodisiacs are medicines that induce their pictures and nomenclature erectile dysfunction treatment hyderabad purchase kamagra without prescription, is followed by certain or probable mechanisms of achieving the certain erectile dysfunction hormone treatment order kamagra 50mg online, drug dependent erectile dysfunction caused by steroids kamagra 50mg amex, arousal of sexual desire aphrodisiac and sometimes toxic effect, that and the ability to perform the sexual act, which, were available in the literature since 1929 till idealy, lasts a few hours4. We mention the most usual locations, macologists consider that an ideal aphrodisiac is mainly in Asia, where they are found and con- a two hours’ erectant5. The review includes the following arthropods: lobster, Arizona bark scor- according to the place of effect is the most suit- pion, deathstalker, banana spider, Mediterranean able: black widow, Burmeister’s triatoma, giant water bug, diving-beetle, Korean bug, diaclina, flannel 1. Stimulators of the lower abdomen and pelvis moth, Spanish fly, migratory locust, red wood structures, especially the ones of the urogenital ant and honeybee. Stimulators of the spinal cord (strychnine, Aphrodisiac, Arthropod, Beetle, Bug, Lobster, Penile damiana active principles) erection, Scorpion, Spanish fly. In the animal kingdom (Regnum Animalia) Impotence in a wider sense of the word, be- systematisation, one Phylum is consisted of Poly- sides the loss of libido, implies the inability to meria, which are divided in to Anellidae and achieve and hold an erection, and the inability of Arthropodae. It is a are used as aphrodisiacs for many millennia, es- very widespread phenomenon, present in almost pecially in Asia, so many of these have passed 40% of men in sexually active couples1. Bjelogrlic different forms in market places or at street mer- very rarely with deadly outcome. They are used as spice in food, as a main pain, numbness, tingling, sometimes paralysis, course, or as a medicine. People who were stung re- deathstalker, banana spider, Mediterranean black port that it felt like getting struck with a bolt of widow, Burmeister’s triatoma, giant water bug, lightening or electrical current. Scorpion venom Supraclassis: Crustacea may contain multiple compounds in varying con- Classis: Crustacea centrations of neurotoxin, cardiotoxin, nephro- Subclassis: Malacostraca toxin, hemolytic toxin, phosphodiesterases, phos- Familia: Palirunidae pholipases, glycosaminoglycans, hyaluronidases, Genus: Palinurus histamine, serotonin, tryptophan, etc. Also, San- nels, which lead to prolonged excessive neuronal soni’s encyclopedic dictionary puts lobsters in and neuromuscular activity, such as erection. Lobster’s meat is soft, very tasteful causes stabilization of voltage-dependent sodium and known as an exceptional delicacy. It has been channels in the open position, leading to continu- proved that occasional abundant lobster meals of ous, prolonged, repetitive firing of the somatic, high quality can cause hyperaemia in abdominal sympathetic, and parasympathetic neurons. This and pelvic organs, and thus bring to an aphrodisi- repetitive firing results in autonomic and neuro- ac effect. Besides that, the enjoyment in such muscular over excitation symptoms, and it pre- high value food rises general mental state and so vents normal nerve impulse transmissions14. Supraclassis: Chelicerata There is also a very interesting fact concerning Classis: Arachnida lobster’s fertility. Actually, older lobsters are more fer- Familia: Buthidae tile than younger lobsters. In- Species: Leiurus quinquestriatus (Hector) take of those whose characteristics are wanted, may be the point of lobster’s aphrodisiac effect. Scorpionism caused by the sting of this North American scorpion is often characterised by Arizona Bark Scorpion pathological erections – the priapism15-17. Almost Supraclassis: Chelicerata complete symptomatology produced by the neuro- Classis: Arachnida toxin poisoning if these Buthoidae is a conse- Ordo: Scorpiones quence of the autonomic nervous system stimula- Familia: Buthidae tion14,15,17,18,19. The poison consists of four compo- Subfamilia: Buthinae nents: chlorotoxin, charybdotoxin, scyllatoxin and Genus: Centruroides agitoxins. The venom stimulates sacral parasym- Species: Centruroides sculpturatus (Ewing) pathetic nerves which leads to changes in periph- eral non-adrenergic and non-cholinergic transmis- It is a small brown scorpion, whose habitat is sion in vascular and nonvascular smooth muscles. The ancient Authors, even Avicen- relaxant of the penile vascular and smooth muscle na, noticed that erections, priapism and libido structures, leading to tumescence and erection of arousal appeared in contrast to the bad general the penis20. Banana Spider Maretic considers that, beside the autonomic Classis: Arachnida nerve stimulation, blood viscosity lays a certain Ordo: Araneae role21,24. Subordo: Labidognatha Bettini and Cantore27 reported about a patient Familia: Ctenidae who was treated in hospital for latrodectism, in a Genus: Phoneutria phase of severe pain experienced erection and a Species: Phoneutria nigriventer (Keyserling) compelling sexual desire. In South America women mix spi- Burmeister’s Triatoma ders in the food they give their impotent spouses Supraclassis: Tracheata seu Antennata to increase their sexual desire21. Classis: Insecta In Brasil, Phoneutria nigriventer is called the Ordo: Hemiptera seu Rhynchota “aranha armadeira” because of its defensive-ag- Subordo: Heteroptera gressive posture in the state of fright. It is also Familia: Reduviidae called the “brasilian wandering spider” or “ba- Subfamilia: Triatominae nana spider”. Adult specimens have up to 4 cm Genus: Triatoma long trunk and 12 to 15 cm wide leg span. Sub- Species: Triatoma phyllosoma (Burmeister) cutaneous application of sublethal doses of this spider’s toxin induces penile erection in dogs. It Inhabitants of a Mexican province Nayarit eat lasts for hours, often longer than 24 hours. The relation between the dose and the fol- from the family of Kissing bugs, which lives in lowing erection is different in dogs and mice. In animal lairs in the southern parts of North Ameri- dogs, only high doses induce erection, while in ca, Central and South America. The human blood, and when attached inflicts a very higher the dose the smaller number of mice has painful bite. Mice which receive smaller doses of the causative agent of Chagas disease, it is also the venom demonstrate only penile erection22. Butanoic acid derived interesting fact is that children with this araneism from the Brindley’s scent glands is a strong irri- often mention erection as a symptom. It has an unpleasant smell and acrid system stimulation, because it can be induced in taste, with a sweetish aftertaste. It can be detect- dogs with cut spinal cord at twelfth thoracic ver- ed by mammals with good scent detection abili- tebra. It is thought that the erection is not a result ties (such as dogs) at 10 ppb, whereas humans of reflexes produced by urogenital stimulation22. Subjects describe the bite of Triatoma as virtually Mediterranean Black Widow painless with a slight tingling sensation. It is as- Familia: Theridionidae sumed that consuming of this insect produces an Genus: Latrodectus aphrodisiac effect by irritating abdominal and Species: Latrodectus mactans (Fabricius) pelvic organs, or it acts as pheromone – natural Subspecies: Latrodectus tredecimguttatus (Rossi) sexual attractant. Bjelogrlic Giant Water Bug Korean bug is used in Malysia, Singapure, Classis: Insecta Sumatra and Java as aphrodisiac. In Indonesia, it is Ordo: Hemiptera seu Rhynchot called “bobok”, and it is eaten alive or in gelati- Familia: Belostomatidae nous capsules. Swingers of the Singapure jet-set Genus: Belostoma seu Lethocerus highly appreciate and pay well for this insect42. For Species: Lethocerus indicus (Lepeletier et Serville) now, it is proved that it is a vector of causative agent of a hymenolepiasis39,49. If it possesses a true Belostomatidae are big water insects with a aphrodisiac effect, it is achieved by catharidin, in- flattened body. They are the biggest representa- hibition of phosphodiesterase, protein phosphatase tives of the Hemiptera order, reaching the length activity and stimulation of -adrenergic receptors, of 12 cm35. Their bite can The effect of catharidin is described in Span- be very painful, similar to a wasp’s one34. Viet- Diaclina – Panzer’s Darkling Beetle namese people really love to use their metaster- Classis: Insecta nal scent glands as spice38. These glands produce Ordo: Coleoptera some alkenol esters which serve them in defense Subordo: Polyphaga or as pheromone, sexual attractant34,40,41. Familia: Tenebrionidae Subfamilia: Ulominae Diving-Beetle Genus: Diaclina Classis: Insecta Species: Diaclina fagi (Panzer) Ordo: Coleoptera Familia: Dytiscidae Diaclina is used as aphrodisiac in China and Genus: Dytiscus Korea, under a local name “young-chun”. It is Species: Dytiscus marginalis (Linnaeus) consumed after fed by some Chinese aphrodisiac plants. Chinese Authors consider that it this way, Diving-beetle specimens are sold and used as the curative power of the plants is enhanced up to aphrodisiac in Singapure38. Consumers claim that it tastes like fense purposes, beetles from Dytiscidae family in pepper. If many bugs are taken at once, the upper their two prothoracal glands produce and excrete respiratory and alimentary system can be irritat- steroid molecules and even sex hormones like: ed. Recommended dose is five to seven insects testosterone, estrone, progesterone and some an- that are chewed slowly with some other food and drosterones42-45. The dose can be mones even in microdoses significantly stimulate li- increased up to ten pieces, three times a day50. Andro- The aphrodisiac effect is probably achieved by gens and estrogens do not differ in the process of stimulating the urogenital structures. Free fraction of testosterone is transformed metabolically in estradi- Flannel Moth ol-17 (E2) by aromatisation in all sexually compe- Classis: Insecta tent tissues. E2 is circa hundred times more effec- Ordo: Lepidoptera tive than testosterone itself and is considered to be Familia: Megalopigydae sexually active in the brain48.
Prognostic factors for the postoperative outcome of percutaneous treatment of erectile disorders of venous penile venous surgery for venogenic erectile dysfunction erectile dysfunction icd 9 code cheap kamagra master card. Patient venoablation with ethanol for the treatment of erectile selection criteria in the surgical treatment of veno-occlusive dysfunction due to erectile dysfunction medications online order kamagra 100 mg on line veno-occlusive dysfunction erectile dysfunction treatment in singapore purchase cheap kamagra line. In Bennett [193] Peskircioglu L erectile dysfunction help purchase 100 mg kamagra with mastercard, Tekin I, Boyvat F, Karabulut A, ozkardes A ed, Impotence - Diagnosis and Management of Erectile H. Preliminary report- revascularization in nonresponders to intracavernous -combined surgical and radiological penile vein occlusion injections using a modiied microsurgical technique. Deep dorsal vein 2000 Sep: 6:172-4 arterialization in pure cavernoocclusive dysfunction. Triple/quadruple operation for venogenic [205] Consensus development conference statement - National impotence. Is Giuliano, H Padma-Nathan, R Rosen ed, 1st International dorsale penile vein ligation (dpvl) still a treatment option in Consultation on Erectile Dysfunction. Extraperitoneal laparoscopic ligation of veins the treatment of male erectile dysfunction. Tunica albuginea ed, Sexual Medicine-Sexual dysfunctions in men and overlapping: a novel technique for the treatment of erectile women. Surgical therapy for the treatment of veno-occlusive dysfunction in aging rats: evaluation by erectile dysfunction. Hypothesis of human penile anatomy, erection postoperative success in penile revascularization. Congruence between predictor of postoperative results in venoocclusive erectile veno-occlusive parameters during dynamic infusion dysfunction. Insuficient response implantation of a penile venous compression device: initial to venous stripping surgery: is the penile vein recurrent or experience in the canine model. The mechanics of corporal veno-occlusion in penile [218] WalshT,TranK,BergerR,WessellsH. Traumaticintracorporal erection: a theory on the effect of stretch-associated septal avulsion resulting in cavernous veno-occlusive luminal constrictability on outlow resistance. Interested readers For most men with erectile dysfunction, pharmaco-- are referred to the publications that have followed therapy provides the initial form of therapy. The second group of drugs cally, locally active agents were used, such as in-- includes those that are currently under clinical jectable papaverine, phentolamine and prostaglan-- development. In the late 1990s, the irst effective oral agent, relating to these drugs and we have reviewed that namely sildenail, became available and it was soon which is available, although much of it is published followed by other similar drugs such as vardenail only in abstract form. While all these agents acted peripher-- our ability to make signiicant recommendations ally within the penis, drugs that work within the cen-- regarding these drugs. It proven more dificult to develop, with apomorphine should be the starting point for interested readers and currently the only licensed agent. Overall we are able to make the following Brief resumes of the relevant physiology are supple-- general recommendations: mented by short sections outlining the mechanisms of action and relevant basic science that underpins the most commonly used and investigated agents. Almost all currently dence based review of the clinical data that relates available evidence relates to sildenail, tadalatt to the available orally active agents. The eficacy, il and vardenail (Grade A) tolerability and safety of the drugs are reviewed, with much of the data being presented in tables which sum-- marise the many large controlled trials that have been 2. We have not included unpublished data, menwitherectiledysfunctionwhodonothavea since it will not have undergone peer review. Apomorphine is an effective and well tolertt such agents is small, and our recommendations are ated treatment for men with erectile dysfunctt accordingly less strong. We recommend some standardisation of the the erectile response and stimulation of this nucleus results in seminal discharge in unanaesthetised rats assessment of psychosocial outcomes within [3] and erection and ejaculation in anaesthetised rats clinical trials in the ield of erectile dysfunctt [4]. Intracavernosal injection therapy with altt important role in the central control of erection. Dopamine prostadilshouldbeofferedtopatientsassecond receptors are divided in to two main families D 1 and D2- line therapy for erectile dysfunction. Intraurethral alprostadil is a less effective enhanced erections induced in the periphery [11]. A sublingual formulation of Apomorphine has been approved for Although the mechanisms underlying erectile function the treatment of erectile dysfunction in several parts are not fully understood, some advances have been of the world at the doses of 2 and 3 mg. The erec- made regarding the interplay of central and periphe- togenic effects are usually seen within 20 minutes of ral mechanisms. New aspects on the melanocortins and an intranasal formulation of this compound for the their receptors. A role for not yet been licensed, and at the time of writing, the melanocortin 4 receptor in sexual function. Participation of paraventricular nucleus of hypothalamus in central regula- tion of penile erection in the rat. The identiication of a brainstem However, a resume of the relevant physiology and site controlling spinal sexual relexes in male rats. A role for 5-hydroxytryptamine of the peripherally acting agents, whether they be in descending inhibition of spinal sexual relexes. Another source of nitric oxide is vascular induced by dopamine injection in the paraventricular nucleus endothelial cells. Dopaminergic phosphorylation of several proteins, and lowering neurotransmission at the paraventricular nucleus of hypothalamus in central regulation of penile erection in the of cell calcium or reduction in sensitivity to calcium, rat. Without sexual arousal, which triggers Neurons or the nerve-nitric oxide pathway, these inhibitors are Endothelium ineffective. This increases relax-- two identical subunits with molecular weight of about ation of the smooth muscle, which dilates the cor-- 100,000 daltons per subunit. Each of the two subunits poreal sinusoids resulting in increased blood low, has a catalytic domain and a regulatory domain. The catalytic machinery has been shown to as sildenail and some, such as tadalail, have utilize divalent cations such as Zn++ [6]. The inhibitors For example, were it not for this built-in enzyme do not bind to the regulatory domain. A is thought to be the main physiological catalyst for result of this regulation is physiological enhancement this phosphorylation reaction. The two allosteric site and phosphorylation of the enzyme are stimulatory actions together represent a physiological stimulated. The combined result of partly explain erectile dysfunction, priapism, or other these interactions represents a powerful negative aflictions is unknown. So far, no recommended compared with 25-100 mg doses of such proteins have been found. However, it should be noted inhibitor from plasma are all important factors (Table that these isoforms may not differ signiicantly in their 2). It is a relection in the smooth muscle of corpora cavernosa of the of intestinal absorption and the effects of irst-pass penis. This may explain the broadly similar t, which predicts a similar time max complaint of some patients that sildenail or vardena-- of onset of action. The myocytes), testes (germinal cells and Leydig cells), extended t of tadalail provides a longer therapeutic 1/2 and anterior pituitary. Newer inhibitors, including some still in the development [16] Sweetnam P, Campbell S, Grogan M, Kirk B, McGonigle pipeline, have different proiles of dosage, side S, Paradise E, Goldstein I. This translates in to greater physician and (Suppl 1) Abstract 51 patient lexibility. J Biol E (2008) Phosphodiesterase 5 Inhibitors and Erectile Chem 267(2):1015-1019. Urology 62(1):121-125; discus-- smooth muscle in vitro, in vivo evidence suggest sion 125-126. In vitro, papaverine evokes mescence, which is mediated by noradrenaline, relaxation of isolated corpus cavernosum smooth contributing to the maintenance of penile erection. Phen- by stimulation of adrenergic nerves and exogenous tolamine mesylate relaxes penile corpus cavernosum tissue by adrenergic and non-adrenergic mechanisms. Adren-- tone via inhibition of voltage-dependent L-type Ca2+ ergic mechanism in penile erection. Nitric oxide e) Combinations synthase and vasoactive intestinal polypeptide colocaliza-- tion in neurons innervating the human penile circulation. Cholinergic nerves in human corpus cavernosum and spongiosum contain nitric Combination therapy is not only predictably more oxide synthase and heme oxygenase.