The influence of HIV status on the duration of chemoradiotherapy for anal squamous cell carcinoma.

Background: The HIV epidemic has changed the demographic of patients with anal squamous cell carcinoma. The influence of HIV status on the ability to complete standard chemoradiotherapy was studied.

Methods: A retrospective analytic observational study was conducted of all patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital radiation oncology department with anal squamous cell carcinoma from January 2014 to December 2016.

The 'ins and outs' of colonoscopy at Wits Donald Gordon Medical Centre, South Africa: A practice audit of the outpatient endoscopy unit.

Background: In South Africa, there are no national guidelines for the conduct or quality assessment of colonoscopy, the gold standard for investigation and diagnosis of bowel pathology.

Objectives: To describe the clinical profile of patients and evaluate the practice of colonoscopy using procedural quality indicators at the Wits Donald Gordon Medical Centre (WDGMC) outpatient endoscopy unit (OEU).

Methods: We conducted a prospective, clinical practice audit of colonoscopies performed on adults (≥18 years of age).

It's contrary - comorbidity does not affect survival of South Africans with colorectal cancer: An analysis from the Colorectal Cancer in South Africa cohort.

Background: The Colorectal Cancer South Africa (CRCSA) study is an observational cohort of patients with colorectal cancer (CRC) in Johannesburg, South Africa (SA). We found that the mean age at the time of CRC diagnosis was 56.6 years, consistent with studies from SA and sub-Saharan Africa.

Design and methodology of a study on colorectal cancer in Johannesburg, South Africa.

Background And Aim: Cancer is one of the foremost causes of morbidity and mortality worldwide. Globally, colorectal cancer (CRC) is the third most diagnosed and fourth most important cause of cancer death. A total of 70% of all CRC-related deaths occur in low- and middle-income countries.

The prevalence and influence of significant psychiatric abnormalities in men undergoing comprehensive management of organic erectile dysfunction.

Psychiatric factors are etiologically important in a proportion of patients with erectile dysfunction. We determined the prevalence of psychopathology and the impact it has on current erectile dysfunction (ED) assessment and management. A group of 120 consecutive men with ED presenting to the Human Sexuality Clinic for the first time was prospectively investigated.

Topical nitroglycerin: a potential treatment for impotence.

The effect of 2 per cent nitroglycerin paste applied to the penile shaft of impotent subjects was evaluated in a placebo controlled double-blind study under laboratory conditions. After application of nitroglycerin paste or a placebo ointment base, penile tumescence was recorded through a strain gauge transducer while subjects viewed an erotic video presentation. Relative to the placebo paste the number of subjects demonstrating an increase in penile circumference after nitroglycerin (18 of 26) was significantly different than all other outcome possibilities (p less than 0.

Oral and transcutaneous pharmacologic agents in the treatment of impotence.

The pharmacologic treatment of erectile failure is now a reality. However, current agents have major drawbacks. Some require invasive administration, whereas others offer only marginal effect.

Double-blind trial of yohimbine in treatment of psychogenic impotence.

48 subjects meeting strict diagnostic criteria for psychogenic impotence took part in a 10 week placebo-controlled, double-blind, partial crossover trial of yohimbine (18 mg a day) for restoring erectile function. At the end of the first arm of the trial 62% of the yohimbine group and 16% of the placebo group reported some improvement in sexual function (chi 2 = 10.41, df = 2, p less than 0.

Is yohimbine effective in the treatment of organic impotence? Results of a controlled trial.

Yohimbine is an alpha-adrenoceptor blocker that has been used in the treatment of erectile dysfunction. Adequate trials of this substance in a clearly defined organically impotent population are not available. We conducted a randomized, controlled study with partial cross-over of yohimbine versus placebo in 100 organically impotent men.

Screening assessment of penile tumescence and rigidity. Clinical test of Snap-Gauge.

A study was conducted to investigate the clinical usefulness of the Snap-Gauge, a device intended to provide an economical alternative to complete nocturnal penile tumescence (NPT) recording. Twenty-one patients were assessed using the Snap-Gauge either during NPT recording or during the corporeal calibration test (CCT), or both. Patient acceptance of the device was excellent.

The pharmacokinetics of yohimbine in man.

The kinetic disposition of yohimbine was examined in eight young male subjects following a single oral dose of 10 mg yohimbine hydrochloride. The drug was rapidly absorbed (absorption half-time 0.17 +/- 0.

Prevalence and significance of tobacco smoking in impotence.

We investigated the incidence of cigarette smoking in a sample of patients and compared these figures with estimates of smoking among males in the general population. Among 178 impotent patients the number of current smokers (58.4%) and current ex-smokers combined (81%) was significantly higher than would be expected among males in the general population.

The unreliability of nocturnal penile tumescence recording as an outcome measurement in the treatment of organic impotence.

We investigated the degree of congruence between outcome measures used to evaluate pharmacological treatment of impotence. After a comprehensive multidisciplinary assessment 17 patients were treated with an adrenergic blocker during an 8-week interval. Nocturnal penile tumescence recordings were made before treatment (as part of the assessment procedure) and at its conclusion.

Sub-nanogram analysis of yohimbine and related compounds by high-performance liquid chromatography.

A sensitive (50 pg/ml) method is described for the analysis of yohimbine in blood by high-performance liquid chromatography with fluorescence detection. The chromatographic behaviour of eserine (employed as internal standard), reserpine, corynanthine, yohimbinic acid, and yohimbine are examined on a series of reversed-phase and normal-phase chromatographic columns with methanol-water mobile phases.

Psychiatric aspects of diabetes mellitus.

A descriptive study of the psychiatric findings in 50 insulin--dependent diabetics is presented. Among the symptoms found were a marked reduction in energy level, increased fatigue and irritability, depression, and delayed psychosexual maturation. Diabetes mellitus is commonly considered to be a disease that, if properly controlled, allows the patient to lead a relatively normal life.

Neuropsychological function in diabetic patients with neuropathy.

Psychometric examination of a group of diabetic patients and a group of age-matched controls failed to provide evidence of impaired intellectual functioning in the diabetic group. The cognitive status of the diabetics was not related to the duration of the illness, the age at diagnosis, or clinical ratings of peripheral or autonomic neuropathy.

Functional correlates of reduced central conduction velocity in diabetic subjects.

In a previous publication, we presented evidence of slowed conduction speed in the central nervous systems of insulin-dependent diabetic subjects, manifest in a delay in the latency of the brainstem auditory-evoked response (BAER). In this article, we present the results of a multivariate study conducted on a larger sample of 50 insulin-dependent, adult diabetic subjects. The purpose of the study was to determine some of the functional correlates of the BAER delay; each patient received an assessment of the BAER, the late auditory-evoked potential (EP), the conduction velocities of the sural, median, and common peroneal nerves, and intellectual and emotional function, in addition to neurologic and audiologic examinations.

Endocrine dysfunction in impotence: incidence, significance and cost-effective screening.

A comprehensive evaluation of impotence includes assessment of the functional integrity of the hypothalamic-pituitary-gonadal axis. However, little is known about the incidence or significance of hormonal abnormalities in an unselected group of men with erectile failure. A systematic multidisciplinary, multidimensional assessment of 256 impotent men showed clearly an organic etiology in 35.

Evaluation of the urological assessment in impotence: findings with a new diagnostic rating scale.

We report the findings of a critical evaluation of urological assessment in impotence. Initially, a rating scale (Q scale) was developed, which included the individual elements of the urological assessment, such as testicular size, serum testosterone level and so forth. The items in the scale were derived from the files of patients with erectile dysfunction and were scaled according to predetermined categories.

Penile elongation: a method for the screening of impotence.

Circumferentially assessed penile responses less than 10 per cent of maximal tumescence usually are regarded as random variation. However, several investigators have hypothesized that one of the initial responses to sexual stimulation is a lengthening of the penile shaft. Circumferential measurements detect this lengthening as a decrease in penile circumference.

A new device for diagnostic screening of nocturnal penile tumescence.

An erectometer for the measurement of sleep erections is described. Comparative studies using simultaneously strain gauges and the new device indicate that it possesses a significant potential for valid measurement of the circumferential increase that may occur during sleep. Because of its reliability, simplicity and low cost the erectometer is proposed as a screening procedure or as a diagnostic alternative when sleep laboratory facilities are not feasible.

Diagnostic significance of penile erections during sleep.

The evidence for the validity of nocturnal penile tumescence as a means of differentiating between psychogenic and organic impotence is reviewed. Five necessary stages in the validation process are described, and the relevance of the research literature to each stage is examined. Problems and issues in the clinical application of NPT recording are discussed, including (1) the need to validate NPT against independent diagnostic criteria; (2) the high probability of misdiagnosis when the absolute magnitude of NPT is used to determine cause; and (3) the need for follow-up studies to establish that NPT can be of value in the diagnoses of those patients who do not clearly belong to either the psychogenic or organic categories.