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Sildenafil in the treatment of erectile dysfunction: efficacy in patients taking concomitant antihypertensive therapy buy discount phenazopyridine 200mg on-line gastritis nursing care plan. Desc: Rx: sildenafil [5 phenazopyridine 200 mg discount gastritis diet ìóëüòôèëüìû,100] Grp: 2 No antihypertensives + sildenafil age: duration: Pts: Pt safe 200 mg phenazopyridine gastritis meal plan. Desc: Rx: sildenafil [5,100] Grp: 90 On antihypertensives + placebo age: duration: Pts: Pt. Desc: Rx: Placebo [5,100] Grp: 91 No antihypertensives + palcebo age: duration: Pts: Pt. Efficacy and safety of oral sildenafil in the treatment of erectile dysfunction: a double-blind, placebo-controlled study of 329 patients. Desc: organic 1%, psychogenic 59%, mixed 40%, Rx: sildenafil 10 Lost: /1/ Discontinued: /7/ Discont. Desc: organic 1%, psychogenic 61%, mixed 38%, Rx: sildenafil 25 Lost: /1/ Discontinued: /7/ Discont. Desc: organic 0%, psychogenic 59%, mixed 41%, Rx: sildenafil 50 Lost: /0/ Discontinued: /11/ Discont. Desc: Rx: sildenafil 10 Grp: 5 Mixed etiology patients on 10mg sildenafil age: duration: Pts: 36 Pt. Desc: Rx: sildenafil 10 Grp: 6 Psychogenic patients on 25 mg sildenafil age: duration: Pts: 52 Pt. Desc: Rx: sildenafil 25 Grp: 7 Mixed etiology pts on 25 mg sildenafil age: duration: Pts: 32 Pt. Desc: Rx: sildenafil 25 Grp: 8 Psychogenic patients on 50 mg sildenafil age: duration: Pts: 48 Pt. Desc: Rx: sildenafil 50 Grp: 9 Mixed etiology patients on 50 mg sildenafil age: duration: Pts: 33 Pt. Desc: organic 0%, psychogenic 54%, mixed 46%, Rx: Placebo 999 Lost: /4/ Discontinued: /9/ Discont. Desc: Rx: Placebo Grp: 92 Mixed etiology patients on placebo age: duration: Pts: 44 Pt. Desc: mixed 100%, Rx: sildenafil [25,100]T Grp: 90 entire placebo group age: 54(23,82) duration: 5. Desc: neurogenic 100%, Rx: Lost: /2/ Grp: 1 25 mg sildenafil age: (19,35) duration: Pts: 17 Pt. Desc: neurogenic 100%, Rx: sildenafil 25 Grp: 2 50 mg sildenafil age: (19,35) duration: Pts: 17 Pt. Desc: neurogenic 100%, Rx: sildenafil 50 Grp: 3 All patients getting sildenafil age: duration: Pts: 17 Pt. Desc: Rx: sildenafil Grp: 90 25 mg placebo = placebo #1 age: (19,35) duration: Pts: 17 Pt. Desc: neurogenic 100%, Rx: Placebo 25 Grp: 91 50 mg placebo = placebo #2 age: (19,35) duration: Pts: 17 Pt. Desc: neurogenic 100%, Rx: Placebo 50 Grp: 92 All patients getting placebo age: duration: Pts: 17 Pt. Desc: Post-proctectomy for rectal cancer 38%, Post-proctectomy for Rx: inflammatory bowel disease 62%, Lost: /0/ Discont. Desc: Rx: sildenafil T Grp: 3 All pts receiving sildenafil (before and after age: duration: Pts: 9 crossover) s/p rectal cancer resection Pt. Desc: Rx: sildenafil [25,100]T Grp: 6 1 risk factor on sildenafil age: duration: Pts: Pt. Desc: Rx: sildenafil [25,100]T Grp: 7 2 or more risk factors on sildenafil age: duration: Pts: Pt. Desc: Rx: sildenafil [25,100]T Grp: 90 Black patients on placebo age: 54(23,81) duration: 5. Desc: Rx: Placebo [25,100]T Grp: 95 1 risk factor on placebo age: duration: Pts: Pt. Desc: Rx: Placebo [25,100]T Grp: 96 2 or more risk factors on placebo age: duration: Pts: Pt. Desc: organic 39%, psychogenic 44%, mixed 16%, Rx: Grp: 1 Patients taking sildenafil age: 57. Desc: organic 59%, psychogenic 15%, mixed 26%, Rx: Grp: 1 Sildenafil treatment in broad spectrum study age: duration: Pts: Pt. Desc: spinal cord injury 100%, Rx: Grp: 2 Sildenafil treatment for spinal cord injury age: duration: Pts: 178 study. Desc: Rx: tadalafil 10 Grp: 4 20mg Tadalafil age: 59(31,80) duration: Pts: 258 Pt. Effects of testosterone undecanoate on sexual potency and the hypothalamic-pituitary- gonadal axis of impotent males. Desc: Rx: Grp: 1 Experimental (testosterone) age: (45,75) duration: (1,) Pts: 18 Pt. Desc: psychogenic 100%, Rx: trazodone 150 Grp: 90 Placebo treated age: [55](39,81) duration: Pts: 37 Pt. Desc: organic 100%, Rx: yohimbine 100T Grp: 90 Placebo age: 58(28,69) duration: Pts: 22 Pt. Double-blind, placebo-controlled safety and efficacy trial with yohimbine hydrochloride in the treatment of nonorganic erectile dysfunction. Desc: psychogenic 100%, Rx: yohimbine 18 Grp: 90 Placebo age: (18,70) duration: Pts: 19 Pt. Desc: organic 100%, Rx: yohimbine 18 Grp: 2 Placebo pts who subsequently got yohimbine age: (18,70) duration: Pts: Pt. Desc: organic 100%, diabetes 38%, Rx: yohimbine Grp: 4 Pts who had no response age: 54.
The abuse continued for about 2 years until order phenazopyridine 200mg on line gastritis yahoo, at age 14 cheap 200mg phenazopyridine with mastercard gastritis gastroenteritis, she threatened to inform his parents of his actions and he ceased his abuse of her order phenazopyridine 200mg overnight delivery gastritis diet åëüäîðàäî. Joyce began dating at age 15 and was sexually active fairly quickly in each of a succession of relationships. The majority of her relationships are characterized by relatively early onset of physical intimacy, which included intercourse and oral sex (both fellatio and cunnilingus). Sexual behavior always began as pleasurable for her but fairly rapidly became unpleasant. She reports that she felt very sexually attracted to her male partners initially, but at the point in the relationship that sex became routine or expected, her respon- siveness declined and sexual behavior became aversive to her. Intercourse became painful and disgusting to her and she experienced revulsion at even the idea of sex with her current partner. Importantly, she maintained sexual drive such that she masturbated to orgasm on a regular (once a week) basis and she also continued to experience sexual attraction and desire for men other than her partner. She was frustrated when their sex became aversive to her but decided to tough it out, assuming, she supposes in retrospect, that her sexual response would improve given enough time and love. Joyce also hoped that the state of being married would also help her response since she had some guilt over nonmarital sex and expected to feel a postmarital reduction in the anxiety she associated with sexual behavior. Joyce reports that at no point during marriage did her sexual aversion dis- sipate. On the contrary, Bill became increasingly frustrated with her avoidance of sex and demanded more frequent intercourse. Joyces attempts to explain her aversive response to him were not helpful and he became irritated and verbally abusive of her. At the point that she disclosed her history of sexual abuse in therapy, she and Bill were in considerable marital distress. Their frequency of intercourse had declined to roughly monthly, and then only with considerable endurance of distress from Joyce and verbal intimidation from Bill. Joyce also meets the Con- sensus Panel criteria that emphasize personal rather than partner distress as the relevant feature. Her symptoms are clearly related to the acquisition of fear and subsequent avoidance. Joyce did not evidence or report particular fear or avoidance of sexual interactions until sexual behavior was paired with abuse and victimization. She retained sexual drive and desire even while she felt pressured into sex in each of her relationships after her childhood sexual abuse. In each case, including her marriage, sexual interactions after the early relationship phase (limerance) became negatively conditioned. Joyce acquired an aversion response which then was maintained by sexual avoidance. General Treatment Considerations In Joyces case, effective treatment rst required relating her history of sexual abuse to her husband, Bill, so that we could begin to interpret her aversion to him in the context of her adolescent experience. This revelation evoked some sensitivity to Joyces response from Bill and temporarily tempered his insistence on intercourse. We used this period to assess more fully their sexual history, to describe her sexual disorder to them both, and to develop a treatment plan. The theory and methods that characterize systematic desensitization were reviewed and the couple agreed to the treatment plan. In addition, Joyce was taught diaphragmatic deep breathing and an autogenic relaxation technique. The least anxiety-provoking stimuli were addressed rst, with Joyce imagining each situ- ation and reporting being able to remain relaxed and anxiety-free before each stimulus was subsequently approached in vivo. Importantly, sexual situations were designed to remain fully in her control; Bill had agreed to allow Joyce to determine the rate at which each of the items on the hierarchy was engaged. Fifteen sessions conducted over a period of 5 months were needed to help Joyce and Bill resume the healthier sexual life that had characterized their early history. The persistence of avoidance behavior was rst articulated by Freud (14); Mowrer (15) subsequently described this phenomenon as the neurotic paradox. The common observation that avoidance is remarkably difcult to extinguish has been explained by the theory of conservation of anxiety. The theory suggests that individuals learn rapid avoidance over time, which prevents the elicitation of fear. The theory of conservation of anxiety explains why sexual aversion rarely abates on its own and can be so treatment resistant. Crenshaw (1) posits that the sexual aversion syndrome is progressive and rarely reverses spontaneously. Patients like Joyce are treatable in so far as they are willing to purposefully expose themselves to the anxiety accompanying sexual behavior. We have found (11) that this exposure process can be facilitated by the following: 1. This understanding should allow her to generate specic examples of the process of exposure; 3. We have found that patients are likely to adhere to record-keeping instructions to the degree that clin- icians make those records integral to the process of psychotherapy; 4. Sexual Aversion Disorder 119 those patients who report psychic pain as a component of their sexual aversion or who conceptualize their problems as symptomatic of early childhood issues (16). Patients who desire insight and express psychological curiosity about themselves are particularly likely to benet from insight-oriented treatment. There is evidence that sexual aversion may be predicted by a history of childhood sexual abuse.