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PubMed2003

MRI evaluation of left ventricular function in anterior LV aneurysms before and after surgical resection.

OBJECTIVES: Whether resection of a left ventricular (LV) aneurysm leads to improved global LV function remains controversial. Echo-planar magnetic resonance imaging (MRI) is a sensitive tool to detect changes in LV function. Therefore, the purpose of the present study was to monitor changes in global LV function and anatomy following LV aneurysm resection using MRI. METHODS: The present study includes 12 patients with an anterior LV aneurysm. Echo-planar MRI evaluation of LV function was performed before surgery and 6 weeks and 3 months after LV remodeling surgery, in most patients combined with coronary artery by-pass grafting (CABG). RESULTS: Following LV aneurysm resection, a decrease was found in end-diastolic volume from 238+/-63 to 180+/-54 ml at 6 weeks to 198+/-51 ml (P<0.05) at 3 months and in end-systolic volume from 156+/-62 to 105+/-44 to 111+/-43 ml (P<0.01), whereas the ejection fraction increased from 37+/-11 to 43+/-9 to 45+/-10% (P<0.01). CONCLUSIONS: LV remodeling surgery leads to a cardiac anatomy more closely resembling normal anatomy. As a consequence, LV contractile function improved significantly. In addition, it was shown that echo-planar cardiac MRI is a sensitive tool to study subtle changes in heart anatomy and function. In this preliminary experience, pre- and postoperative MRI has demonstrated that LV remodeling surgery may restore cardiac anatomy and improve LV contractile function.

Aged↗

PubMed2002

Simulation of the effects of global normalization procedures in functional MRI.

We report on differences in sensitivity and false-positive rate across five methods of global normalization using resting-state fMRI data embedded with simulated activation. These methods were grand mean session scaling, proportional scaling, ANCOVA, a masking method, and an orthogonalization method. We found that global normalization by proportional scaling and ANCOVA decreased the sensitivity of the statistical analysis and induced artifactual deactivation even when the correlation between the global signal and the experimental paradigm was relatively low. The masking method and the orthogonalization method performed better from this perspective but are both restricted to certain experimental conditions. Based on the results of these simulations, we offer practical guidelines for the choice of global normalization method least likely to bias the experimental results.

Algorithms↗

PubMed2003

Lack of normal association between cerebellar volume and neuropsychological functions in first-episode schizophrenia.

OBJECTIVE: Functional neuroimaging studies have identified a role for the cerebellum in the neuropsychology of schizophrenia. Few studies, however, have examined the relationship between cerebellar size and neuropsychological functioning in schizophrenia. The authors' goal was to examine this relationship in patients and healthy comparison subjects. METHOD: Total cerebellar volume was computed from magnetic resonance images in 48 male and 33 female patients experiencing a first episode of schizophrenia and in 14 male and nine female healthy comparison subjects. Patients and comparison subjects completed a comprehensive neuropsychological assessment encompassing six domains of functioning: executive, motor, language, visuospatial, memory, and attention. A global domain of functioning was computed as the mean of these six domains. RESULTS: Larger cerebellar volume correlated significantly with better global functioning in healthy subjects but not among patients with schizophrenia; this relationship was significantly stronger in healthy subjects than in patients. Additional analyses revealed significant associations between cerebellar volume and visuospatial, executive, and memory functions in healthy volunteers but not among patients. CONCLUSIONS: The cerebellum plays a role in higher cognitive functions in healthy individuals, and normal associations between cerebellar size and function are absent in patients experiencing a first episode of schizophrenia. These findings are consistent with neurobiological models implicating the cerebellum in the pathogenesis of schizophrenia.

Adult↗

PubMed1993

Left atrial thrombi in non-rheumatic atrial fibrillation: assessment of prevalence by transesophageal echocardiography.

To determine the prevalence of left atrial thrombus in hospitalized patients with non-rheumatic atrial fibrillation, 48 patients were consecutively studied with single-plane transesophageal echocardiography. There were 23 males (48%) and 25 females (52%). The mean age was 66 +/- 11 years (range 43-87). Thrombus was detected in 13 patients (27%): 11 were confined to the left atrial appendage, 1 to the atrial body and appendage, and 1 to the left upper pulmonary vein. Prevalence of atrial thrombus was not different among those patients with or without previous stroke [4/16 (25%) vs 9/32 (28%), p = NS] or between patients > 65 years and patients < or = 65 years old (p = NS). Atrial thrombus was detected more frequently in patients with reduced left ventricular global systolic function than in those with normal function [7/14 (50%) vs 6/34 (17%), p < 0.05]. In patients with spontaneous contrast echoes in the left atrium, thrombi were visualized more often than in those without spontaneous echoes [10/24 (41%) vs 3/24 (12%), p < 0.05]. The finding of the atrial spontaneous contrast echoes was more frequent among patients with reduced left ventricular global systolic function [11/14 (78%) vs 13/34 (37%), p < 0.02]. We conclude that in hospitalized patients with non-rheumatic atrial fibrillation the prevalence of left atrial thrombus is high. Reduced left ventricular global systolic function identifies a subset of patients at high risk for formation of thrombus in the left atrium.

Aged↗

PubMed2004

Association study of a functional catechol-O-methyltransferase genetic polymorphism with age of onset, cognitive function, symptomatology and prognosis in chronic schizophrenia.

The gene coding for catechol-O-methyltransferase (COMT), which is involved in the metabolism of catecholamines, has long been implicated as a candidate gene for schizophrenia. This study aimed to assess the relationship between a functional polymorphism (Val158Met) of the COMT gene and age of onset (AOO), symptomatology, global cognitive function and prognosis in patients with schizophrenia. The study enrolled 154 patients with schizophrenia from chronic wards. Results failed to show a significant association between the Val158Met polymorphism and the Brief Psychiatric Rating Scale scores, Mini-Mental State Examination scores, and Social and Occupational Functioning Assessment Scale scores, but COMT Val158Met heterozygotes had a later AOO than homozygous patients. However, by further expanding the number of patients to 228 patients, the differences in AOO among the three COMT genotypic groups was not significant. The COMT Val158Met polymorphism did not appear to significantly affect susceptibility, symptomatology, global cognitive function and prognosis in Chinese patients with schizophrenia, but the possible association with AOO merits further investigation.

Adolescent↗

PubMed1977

Graded global ischemia and reperfusion. Cardiac function and lactate metabolism.

The effect of global ischemia of different degrees of severity and reperfusion was studied in the isolated working rat heart. Four degrees of ischemia were induced by reducing the control total coronary flow of 8 ml/min to 0, 0.04, 0.4, or 0.8 ml/min for 30 minutes, after which the coronary flow was returned to the control level. After severe ischemia (0 and 0.04 ml/min ischemic coronary flow groups), recovery of contractility was to less than 30% of the control, pre-ischemic value of ventricular developed pressure and dP/dt, and irreversible cardiac contracture and an increased pacing threshold occurred. After moderate ischemia (0.4 and 0.8 ml/min ischemic coronary flow groups), contractile function recovered completely, ischemic contracture was rapidly reversible and the pacing threshold did not increase. The moderately ischemic groups were able to function at a stable, low level of contractility for the 30 minute ischemic period, whereas the severely ischemic groups had no contractile activity. The amount of calculated tissue lactate accumulation correlated with the occurrence of irreversible ischemic injury; the severely ischemic groups which failed to recover with reperfusion accumulated 3-5 times as much lactate as the moderately ischemic groups which recovered completely. The results suggest that relatively small differences in the severity of the ischemic condition can markedly affect the degree of tissue injury.

Animals↗

PubMed2006

Global myocardial perfusion and diastolic function are impaired to a similar extent in patients with type 2 diabetes mellitus and in patients with coronary artery disease--evaluation by contrast echocardiography and pulsed tissue Doppler.

AIMS/HYPOTHESIS: Using modern echocardiography, we quantified the extent of global myocardial function and perfusion abnormalities in patients with type 2 diabetes and compared this with the hypothetically similar extent of impairments in patients with coronary artery disease (CAD). SUBJECTS AND METHODS: This case-control study (66 patients) compared four age-matched groups: control, type 2 diabetic, CAD, and diabetic subjects with CAD (DCAD) and left ventricular ejection fraction >50%. CAD patients had 1-2 vessel disease. Diastolic and systolic myocardial velocities were assessed with pulsed tissue Doppler. Global myocardial perfusion was assessed with contrast echocardiography as indices of capillary blood volume and myocardial blood flow at maximal vasodilatation. In CAD and DCAD patients, functional and perfusion parameters were additionally assessed in the territory with a normal coronary angiogram reading, providing a model for comparison with the global data from control and diabetic patients. RESULTS: Comparing diabetic with control subjects, myocardial velocity at early diastole was impaired (8.8+/-1.8 vs 10.1+/-1.7 cm/s; p=0.02) and correlated inversely with age, HbA(1c) and pulse pressure (R (2)=0.761). Capillary blood volume (16.6+/-5.0 vs 24.4+/-4.9%) and blood flow (56+/-35 vs 114+/-40) were decreased (p=0.001). In CAD patients, myocardial velocity at early diastole was similarly decreased (p=0.02). CAD and DCAD patients were receiving more cardiovascular preventive therapy for the same extent of impaired global perfusion as in the less extensively treated diabetes group without CAD (p<0.002), but had superior perfusion of the 'normal' coronary territory than that group (p<0.05). CONCLUSIONS/INTERPRETATION: In patients with diabetes, global diastolic function and myocardial capillary blood volume and blood flow are impaired to the same extent as in patients with CAD. These impairments could form the basis of new therapeutic concepts.

Blood Pressure↗

PubMed2006

A systematic literature review to investigate if we identify those patients who can cope with anterior cruciate ligament deficiency.

Rupture of the anterior cruciate ligament (ACL) results in increased tibiofemoral laxity in the knee, thereby ultimately resulting in knee instability and dysfunction. However, ACL rupture does not automatically infer functional impairment and instability as confirmed by the ACL deficient (ACLD) coper, who can resume pre-morbid activity levels. Alternatively, an authentic ACLD non-coper is unable to return to pre-injury levels of activity due to repeated incidents of giving-way. Little is known as to the contributory factors, which allows copers dynamic stability and render non-copers functionally impaired. This systematic literature review aims to examine the evidence presented by relevant trials in order to identify measurement tools, which could differentiate ACLD copers and non-copers. A literature search found nine trials; four adhered to the inclusion criteria of this review. Consensus was achieved within the studies that laxity measurements and IKDC ratings are incapable of distinguishing the functional status of the ACLD patient. Alternatively, Lysholm, KOS-Sport, KOS-ADL and Global Knee Function Rating Scores were regarded as capable of discriminating between ACLD copers and non-copers. Disagreement existed as to the efficacy of the Quadriceps Index and the single leg hop in categorising the ACLD patient according to function level. It was concluded that no single measurement tool is sufficient in determining the functional status of the ACLD individual. Consequently, a collaboration of tests is recommended, specifically incorporating the KOS-Sport, Global Knee Function Rating, hop tests and Quadriceps Index.

Adaptation, Physiological↗

PubMed2006

Antiviral therapy decreases GpIIb/IIIa activation of platelets in patients with chronic hepatitis C.

Interferon alpha (IFN-alpha) is used to treat haematological and solid malignancies and is the gold standard therapy for chronic hepatitis C infection in combination with ribavirin. It has a well known platelet lowering effect and was recently shown to impair platelet aggregation in the presence of various agonists and has been accused to increase patients' bleeding risk during IFN-alpha therapy. Thus, we hypothesised that antiviral treatment decreases GpIIb/IIIa activation and affects global platelet function. In a prospective clinical trial, we examined the effects of combination therapy with pegylated IFN-alpha 2a (PegIFN-alpha 2a) and ribavirin on platelet GpIIb/IIIa activation and platelet secretion in 20 patients with chronic hepatitis C at week 2, 4, 8 and 12 after the beginning of therapy. In addition, we determined global platelet function (CEPI-CT) with the PFA-100 and vWF-Ag levels. Antiviral therapy significantly decreased GpIIb/IIIa activation in a time dependent manner, whereas markers of platelet secretion (P-selectin, beta-thromboglobulin) remained unchanged. Despite a marked elevation of vWF-Ag levels, CEPI-CT did not change compared to baseline levels. Antiviral therapy significantly decreases GpIIb/IIIa activation in patients with chronic hepatitis C, while vWG-Antigen levels are markedly increased and alpha-granule secretion is not affected. This does not result in an alteration of global platelet function as assessed by the PFA-100, because elevated vWF-Antigen levels might compensate for the acquired defect.

Adult↗

PubMed2004

Global longitudinal strain: a novel index of left ventricular systolic function.

BACKGROUND: Echocardiographic estimation of global left ventricular (LV) function is subjective and time consuming. Our aim was to develop a novel approach for assessment of global LV function from 2-dimensional echocardiographic images METHODS: Novel computer software for tissue tracking was developed and applied as follows: digital loops were acquired from apical 2-, 3-, and 4-chamber views and a line was loosely traced along the LV endocardium at the frame wherein it was best defined. Around this line, the software selected natural acoustic markers moving with the tissue. Automatic frame-by-frame tracking of these markers during the heart cycle yielded a measure of contractility along the selected region of interest. Global longitudinal strain (GLS) and GLS rate (GLSR) were calculated for the entire U-shaped length of LV myocardium (basal, mid, and apical segments of 2 opposite walls in each view). To test this software, computer-derived GLS and GLSR were analyzed by a nonechocardiographer, blinded to the echocardiographic interpretation, in 27 consecutive patients after myocardial infarction (MI) (age 64.4 +/- 12.9 years; 19 men; mean wall-motion score index of 1.79 +/- 0.44) and compared with those obtained in 12 consecutive control patients (age 59.0 +/- 9.7 years; 8 women), with a normal echocardiographic study. RESULTS: GLS and GLSR, averaged from the 3 apical views, differed significantly in patients post-MI compared with control patients (GLS -14.7 +/- 5.1% vs -24.1 +/- 2.9% and GLSR -0.57 +/- 0.21/s vs -1.02 +/- 0.09/s for patients post-MI vs control patients, respectively; both P <.0001). There was a good linear correlation between the wall-motion score index and the GLS and GLSR (R = 0.68 and R = 0.67, respectively; both P <.0001). A cut-off value for GLS of -21% had 92% sensitivity and 89% specificity and a cut-off value for GLSR -0.9/s had 92% sensitivity and 96% specificity for the detection of patients post-MI. CONCLUSIONS: GLS and GLSR are novel indices for assessment of global LV function from 2-dimensional echocardiographic images. Early validation studies with the method are suggestive of high sensitivity and specificity in the detection of LV systolic dysfunction in patients post-MI.

Adult↗

PubMed2002

How the inner world is reflected in relation to perceived ward atmosphere among patients with psychosis.

BACKGROUND: This study focused on how cognitive ability, personality traits, self-rated psychiatric symptoms, and social functioning were related to the way in which patients with psychosis perceived supportive aspects of the ward atmosphere. METHODS: Patients at a psychiatric rehabilitation unit (PRU) in southern Sweden completed a ward atmosphere questionnaire (COPES), rated their psychiatric symptoms (SCL-90), self-image (SASB), and were tested on cognitive functioning (WAIS-R) and global social functioning (GAF). They were diagnosed according to ICD-10. Data were analysed by means of logistic regression analyses. RESULTS: Self-monitoring and restraining (self-control), one cluster in the SASB, was the strongest factor associated with how the patients perceived the ward atmosphere. A perceived high level of self-control indicated high levels of perceived Support, Practical orientation, and Order and organisation of the ward atmosphere. A high level of self-rated paranoid symptoms (SCL-90) increased the risk of perceiving a high level of Anger and aggression and a low level of Program clarity. Regarding cognitive ability (WAIS-R), two factors were important for predicting perceived ward atmosphere. A low level of social competence was associated with a low level of perceived Order and organisation. Furthermore, a low level of abstract thinking was related to a low level of perceived Anger and aggression, while a high level of abstract thinking was associated with a low level of Program clarity. Patients with schizophrenia exhibited a lower level of Self-monitoring and restraining than patients with other psychoses. CONCLUSION: The results from this study indicate that individual factors such as self-control, paranoid symptoms and social competence may be important for how the ward atmosphere is perceived. This is important knowledge when monitoring the ward atmosphere to better fit a unit's target group.

Adult↗

PubMed1995

Detection of viability after myocardial infarction: available techniques and clinical relevance--a review.

The differentiation of viable from nonviable myocardium in patients with myocardial infarction (MI) and left ventricular (LV) dysfunction is of important clinical relevance. It is now known that impaired LV function after infarction not always represents an irreversible process. LV ejection fraction is significantly reduced in many patients after infarction and, although abnormally contracting myocardial segments may result from irreversible scarring, numerous studies have shown that many asynergic zones have sustained metabolic activity. An accurate detection of myocardial viability aids in clinical decision making to select the appropriate therapy for patients with MI. Recently, cardiac imaging techniques that evaluate myocardial viability on the basis of myocardial perfusion, cell membrane integrity, metabolic activity and residual coronary reserve, have been developed with clinical success. These methods provide greater precision in the assessment of viable myocardium than can be achieved by analysis or coronary anatomy, regional function or the presence or absence of electrocardiographic Q waves, criteria that were used in the past. The clinical challenge is to predict which myocardial regions are viable and will improve systolic function after revascularization, thereby enhancing global LV function. In this review, the currently available imaging techniques for assessment of myocardial viability are discussed.

Cell Membrane↗

PubMed2006

Fine tuning recommendations for older adults with memory complaints: using the Independent Living Scales with the Dementia Rating Scale.

The purpose of this study was to describe how functional test performance changed as global cognitive functioning dropped, as well as to examine the relationship of demographic variables and depression with functional test results. We found that level of performance on the Independent Living Scales (ILS) correlated highly with Dementia Rating Scale (DRS) scores in 83 older adults presenting for clinical neuropsychological assessment, while correlations with demographic factors and depression were nonsignificant or modest. Based on DRS scores, we divided our sample into four groups: normal cognitive status, borderline cognitive impairment, likely mild dementia, and likely moderate dementia. ILS profiles of the borderline impairment and mild dementia groups were similar and reflected particularly poor performance on subscales tapping financial management and everyday memory. Individuals with likely moderate dementia were markedly impaired on all subscales.

Activities of Daily Living↗

PubMed1997

Selected MMPI-2 scales' ability to predict premature termination and outcome from psychotherapy.

Research examining the MMPI's ability to predict premature termination has yielded discrepant findings. This may be due, in part, to previous operational definitions of premature termination and extensive analysis on inadequately sized samples. This study addressed both methodological issues. This study examined MMPI-2 clinical Scales 2, 4, and 7 and content scales DEP, ASP, ANX, and TRT as predictors of premature termination and psychotherapeutic outcome in 86 adult clients seeking services at a university-based clinic. Premature termination was operationalized as therapists' ratings of clients' readiness for termination. Psychotherapeutic outcome was operationalized as therapists' ratings of the clients' progress in therapy goals, improvement in global psychopathology, improvement in current functioning, and global improvement. None of MMPI-2 scales predicted readiness for termination. However, significant associations were found between specific MMPI-2 scales and three of the four outcome ratings, with the content scales emerging as better predictors. The implications of these findings are discussed to help guide future research in this area.

Adolescent↗

PubMed2005

The angiotensin II type 2 receptor and improved adjacent region function post-MI.

Angiotensin II type 2 receptor (AT2-R) overexpression in the mouse heart preserves left ventricular (LV) size and global LV function during post-MI remodeling. We hypothesized that CMR tagging would localize regional improvements in myocardial function during post-MI remodeling in AT2-R cardiac overexpressed transgenic mice (TG), which could explain the preservation of global LV function post-MI. Six male wild-type (WT) C57BL/6 mice and 10 TG mice were studied by CMR at baseline (day 0) and days 1, 7, and 28 post-MI. MI was induced by 1 hour occlusion of the LAD followed by reperfusion. On day 1 post-MI, gadolinium-DTPA was injected to assess infarct size. LV size and function was assessed by cine CMR. Mean % circumferential shortening (%CS) was calculated within infarcted, adjacent, and remote regions at each time point in WT and TG mice. Quantitative interstitial collagen and mean myocyte cross-sectional area was measured postmortem at day 28 post-MI. LV end-systolic volume was lower and ejection fraction higher at baseline in the TG group and these differences were maintained post-MI. Within infarcted and remote zones, although %CS was higher in TG mice at day 0, there was no difference by day 28 between groups. Within adjacent regions, while there was no difference at day 0 or 1 in TG vs. WT, %CS was significantly higher in TG mice by day 7, and these changes persisted out to day 28 post-MI. Regional interstitial collagen and myocyte size were similar between groups. Thus, myocardial tagging can detect regional differences in contractile function post-MI in TG mice, and AT2-R overexpression is associated with improved contractile function in adjacent noninfarcted myocardium.

Angiotensin II↗

PubMed2003

Detection of an intermediate during unfolding of bacterial cell division protein FtsZ: loss of functional properties precedes the global unfolding of FtsZ.

Using environment-sensitive fluorescence of 1-anilinonaphthalene-8-sulfonic acid, polarization of fluorescein 5'-isothiocyanate-labeled FtsZ, and far-UV circular dichroism spectroscopy, the chemical unfolding of FtsZ was found to proceed through two steps. The first step of the urea-induced unfolding produced an intermediate, which then unfolded at higher concentrations of urea. The intermediate state contains native-like secondary structure and much less tertiary structure compared with the native state. It is distinct from the native state as well as from the unfolded state. Similar to urea-induced unfolding of FtsZ, thermal unfolding of FtsZ also occurs in two steps. The midpoints for the first and second thermal unfolding transitions were found to be 38 +/- 4 and 77 +/- 5 degrees C, respectively. Further, the functional properties of FtsZ are extremely sensitive to urea, guanidium chloride, and sodium dodecyl sulfate. For example, 50% inhibition of the FtsZ assembly and GTP hydrolysis occurred at 0.1 and 0.2 m of urea, respectively. FtsZ lost its functional properties before any significant perturbation in the secondary or tertiary structure was detected by using several fluorescence techniques and far UV-CD indicating preferential local unfolding of the functional region(s). In addition, the unfolded FtsZ regains its ability to polymerize fully upon removal of urea. The data taken together suggest that FtsZ unfolds reversibly through a multistep process, and local responses that inhibit functional properties precede the global transition of FtsZ to the unfolded state.

Anilino Naphthalenesulfonates↗

PubMed1985

Effect of carnitine on myocardial function and metabolism following global ischemia.

Carnitine has therapeutic potential for the postischemic heart by facilitating the oxidation of acylated fatty acid metabolites, the intracellular accumulation of which has a deleterious effect on myocardial function and metabolism. To test this hypothesis, two groups of dogs were given preischemic treatment with carnitine, 50 mg per kilogram of body weight (Group 1) or 100 mg/kg (Group 2), and were compared with untreated controls (N = 12 for all groups). The canine hearts underwent 30 minutes of global 37 degrees C ischemic arrest with reperfusion. Left ventricular systolic and diastolic function was assessed by an intracavitary balloon while metabolic derangements were quantitated by serial myocardial biopsies assayed for adenosine triphosphate (ATP). Comparable 49 to 53% (p less than 0.01) declines in preischemic ATP levels occurred during the study period in the controls and both experimental groups. However, postischemic systolic left ventricular function was better preserved in Group 2: these hearts generated 61 +/- 3% of preischemic peak developed pressure compared with 37 +/- 4% in the controls and 42 +/- 3% in Group 1 (p less than 0.01 for each), and 60 +/- 2% of preischemic maximum rate of rise of left ventricular pressure as opposed to 45 +/- 4% in the controls and 49 +/- 6% in Group 1 (p less than 0.02 for each).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗

PubMed2005

Pilot intervention to enhance sexual rehabilitation for couples after treatment for localized prostate carcinoma.

BACKGROUND: The majority of prostate carcinoma survivors experience enduring sexual difficulties and associated distress in the years after definitive treatment. A counseling intervention aimed at improving levels of sexual satisfaction and increasing successful utilization of medical treatment for erectile dysfunction (ED) was developed and pilot-tested for both the survivor of prostate carcinoma and his partner. METHODS: All male participants were 3-month to 5-year survivors of localized prostate carcinoma who had been treated with radical prostatectomy or radiation therapy, and were married or in a committed relationship. Couples were randomized to attend four sessions of counseling together or to have the man attend alone. In both groups, partners completed behavioral homework. The sessions included education on prostate carcinoma and sexual function and options to treat ED as well as sexual communication and stimulation skills. Standardized questionnaires at baseline, posttreatment, and at 3-month and 6-month follow-up assessed sexual function, marital adjustment, psychologic distress, and utilization of treatments for ED. RESULTS: Fifty-one of 84 couples randomized to treatment completed the intervention (61%). Attendance by the partner did not affect outcomes. Participants completing the intervention demonstrated improvement in male overall distress (P < 0.01), male global sexual function (P < 0.0001), and female global sexual function (P < 0.05) at 3-month follow-up, but regression toward baseline was noted at 6-month follow-up. However, utilization of ED treatments increased from 31% at the time of study entry to 49% at the 6-month follow-up (P = 0.003). CONCLUSIONS: The results of this brief pilot counseling intervention demonstrated significant gains in sexual function and satisfaction and increased utilization of treatments for ED. However, modifications are needed in future randomized trials to reduce the rate of premature termination and to improve long-term maintenance of gains.

Aged↗