1,720,964 research outputs found
SLOW WAVE SLEEP AND RESPONSE TO COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA
No full textIntroduction
Cognitive Behavioral Therapy for Insomnia (CBT-I) is recognized to be the first-choice treatment for chronic insomnia. Since the subjective evaluation of nocturnal sleep in mandatory for the diagnosis of insomnia, the efficacy of CBT-I has been mostly investigated with subjective measures. Only few studies examined the efficacy of CBT-I with an objective evaluation. However, polysomnography (PSG) could provide important information regarding objective sleep phenotypes and its influence on CBT-I response. Aim of our study was to evaluate if PSG variables before treatment could predict CBT-I outcomes.
Methods
29 chronic insomnia patients (15 females and 14 males, mean age 40.8±12.0) underwent an ambulatory PSG recording before CBT-I treatment. Patients also reported subjective sleep by means of sleep diary during PSG evaluation and throughout the duration of CBT-I (9 weeks). PSG data were used as primary outcomes to evaluate possible different response to CBT-I. Moreover, we used a general linear model to assess if any PSG sleep measures could predict patients’ response to CBT-I in terms of Insomnia Severity Index (ISI) or subjective sleep diary variables.
Results
All patients demonstrated a significant improvement after CBT-I both at ISI (19.1±3.7 vs 10.8±4.9; p=.000) and at sleep variables (Sleep Latency: 38.1±28.6 vs 22.9±22.5, p=.005; Wake after Sleep Onset (WASO): 98.6±79.9 vs 51.7±52.1, p=.002; Sleep Efficiency: 67.2±19.1 vs 82±11.9, p=.000).The general linear model analysis with PSG data showed that only Slow Wave Sleep (SWS) % predicted the decrease of WASO subjectively reported at Sleep Diaries. In particular, patients by a higher SWS % were the ones showing a greater improvement at WASO after CBT-I (98.6±79.9 vs 51.7±52.2; p= .032).
Conclusion
Our study demonstrated that SWS % before treatment predict a better response to CBT-I. This result might support the hypothesis of a possible phenotype of insomnia characterized by % of SWS that could be the natural mediator of “process S” pressure that would result in a greater improvement of subjectively reported WASO and therefore in a better outcome after CBT-I
Recovery of spontaneous erectile function after nerve-sparing radical retropubic prostatectomy with and without early intracavernous injections of alprostadil: Results of a prospective, randomized trial
No full textPurpose: This study was aimed at assessing prospectively the effect of postoperative intracavernous injections of alprostadil on the recovery of spontaneous erectile function after nerve-sparing radical retropubic prostatectomy. Materials and Methods: A total of 30 potent patients with clinically localized prostate cancer (clinical stage B1 or B2, Gleason sum 7 or greater, prostatic specific antigen less than 20 ng./ml.) underwent nerve-sparing radical retropubic prostatectomy and was subsequently randomized to alprostadil injections 3 times per week for 12 weeks (group 1, 15 patients) or observation without any erectogenic treatment (group 2, 15 patients). Patients were assessed at the 6-month followup by sexual history, physical examination, color Doppler sonography of the cavernous arteries and polisomnographic recording of nocturnal erections. Results: In group 1, 12 patients (80%) completed the entire treatment schedule and were evaluated at the long-term followup. Eight patients in this group (67%) reported the recovery of spontaneous erection sufficient for satisfactory sexual intercourse, compared with 3 patients (20%) in group 2. The difference between the 2 groups was statistically significant (p < 0.01). In group 1, all but 1 patient reporting normal postoperative erections also showed normal erections at nocturnal testing, whereas color Doppler sonography demonstrated normal penile hemodynamics in all of them. In these patients, failures were the result of cavernous veno-occlusive dysfunction (2 cases, 17%) and cavernous nerve injury (2 cases, 17%). In group 2, patients with normal erections showed both normal nocturnal testing and penile hemodynamics, whereas failures were the result of cavernous veno-occlusive dysfunction (8 cases, 53%), cavernous arterial insufficiency (2 cases, 13%) or cavernous nerve injury (3 cases, 20%). Complications in patients treated with alprostadil injections accounted for 2 cases (13%) of a penile nodule and 1 further case (6%) of prolonged penile erection. Complications were not seen in group 2 patients. Conclusions: Early postoperative administration of alprostadil injections significantly increases the recovery rate of spontaneous erections after nerve-sparing radical retropubic prostatectomy. It is our belief that programmed vasoactive injections improve cavernous oxygenation, thereby limiting the development of hypoxia-induced tissue damage. The potential complications related to the use of intracavernous injections must be clearly explained to patients
Sildenafil taken at bedtime significantly increases nocturnal erections: Results of a placebo-controlled study
No full textObjectives. Nighttime erections occur at all ages and contribute to the maintenance of the morphodynamic integrity of smooth muscle cells within the corpora cavernosa, This study was aimed at evaluating the effect on nocturnal erections of sildenafil versus a placebo taken at bedtime. Methods. A double-blind, crossover, placebo-controlled study design was used to examine the effects of sildenafil and placebo on sleep-related erectile activity. Thirty selected patients with erectile dysfunction (vasculogenic etiology, 22 patients [73%]; psychogenic etiology, 8 patients [27%]) were submitted to a polysomnographic recording of nocturnal erections, using a RigiScan device during 3 consecutive nights. After a first night of adaptation, the 2 following nights were used to study patients after the administration of sildenafil (100 mg) or a placebo taken at bedtime. Results. Twenty-three patients (77%) showed a significantly improved nocturnal erectile activity (according to the calculation of rigidity and tumescence activity units) after the administration of sildenafil (P < 0.01), 5 patients (17%) showed comparable nocturnal erections with sildenafil and placebo, and 2 patients (6%) showed a significantly improved nocturnal erectile activity after taking the placebo (P < 0.05), Overall, mean rigidity and tumescence activity values at the tip and base of the penis were significantly improved after sildenafil rather than placebo administration (P < 0.001). The duration of tip rigidity greater than 60% was significantly longer during the night with sildenafil (P < 0.001). Although the number of erectile episodes was greater during the sildenafil night, this did not reach statistical significance. Conclusions. In most patients with good sleep efficiency and who have erectile dysfunction, sildenafil, rather than a placebo, taken at bedtime produces a significantly improved nocturnal erectile activity. Further studies are needed to verify whether this preliminary finding may constitute the basis for the use of sildenafil as a tool for preventing erectile dysfunction. UROLOGY 56: 906-911, 2000. (C) 2000, Elsevier Science Inc
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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