New prospects in the treatment of premature ejaculation

At the moment, the scientific community recognizes two main treatments of premature ejaculation: (1) the “classical” method elaborated by Masters and Johnson in 1970 and (2) a pharmacological method consisting in using antidepressant drugs, mostly those with a serotoninergic action. Although they are both relatively effective, these methods also have their drawbacks: uncertain theoretical basis, frequently unsuitable application, need for partner’s collaboration, a certain lack of eroticism and frequent relapses for the classical method; strictly symptomatic action and side effects for the pharmacological method. A synthesis of several works throws new light on the causes of premature ejaculation and offers thus a theoretical justification to a set of original therapeutic techniques elaborated by De Carufel (1996) and Desjardins (1985). The particularity of these techniques is that they stress the importance of regulating the sexual arousal in order to increase the ejaculatory latency and to promote a specific behaviour in order to achieve this goal during coitus. Clinical studies conducted over the past few years show that treatments including these techniques are at least as effective as the classical method and are probably able to overcome some of its drawbacks: the regulation techniques seem clearer from a theoretical point of view, easier to apply and more able to work without the partner’s collaboration.On connaît actuellement deux grandes formes de traitement de l’éjaculation précoce : la méthode « classique » lancée par Masters et Johnson en 1970 et, d’apparition plus récente, l’utilisation d’antidépresseurs sérotoninergiques. Bien qu’elles présentent toutes deux une certaine efficacité, ces méthodes comportent également plusieurs inconvénients : justification théorique imprécise, exécutions fréquemment inadéquates, nécessité d’une collaboration de la partenaire, inélégance relative et rechutes fréquentes pour la méthode mastersienne ; action purement symptomatique et effets indésirables pour la méthode pharmacologique. Une synthèse de plusieurs travaux permet de poser un regard neuf sur les causes de l’éjaculation précoce et de légitimer ainsi au plan théorique une série de techniques thérapeutiques originales proposées par De Carufel (1996) et Desjardins (1985). Ces techniques ont pour particularité d’insister sur le rôle d’une modulation de l’excitation sexuelle pour prolonger la latence éjaculatoire et de favoriser à cette fin le développement d’une gestuelle coïtale spécifique. Des études cliniques menées ces dernières années indiquent que les traitements qui intègrent ces techniques s’avèrent au moins aussi efficaces que la méthode classique et permettent probablement de dépasser certains inconvénients liés à cette dernière : plus claire au niveau théorique, elle serait également d’usage plus souple et davantage capable de réaliser l’économie d’une collaboration active de la partenaire

Fighting against premature ejaculation

Aujourd’hui, environ un homme sur cinq se plaint d’éjaculer trop rapidement. Face à ce constat, les auteurs ont rédigé un guide pratique, le premier publié en langue française dont l’efficacité à été démontrée par des études cliniques. Cet ouvrage peut être assimilé à un véritable traitement car il offre à tous les hommes et à tous les couples confrontés à ce problème, des information et des conseils afin de tenter d’y remédier. Ce guide intéressera également les intervenants en santé soucieux d’accompagner leurs patients ou clients confrontés à une éjaculation précoce (médecins, psychologues, sexologues …). Ils y trouveront un modèle et des lignes directrices thérapeutiques aisément applicables en première intention.BibliothEP : étude d'efficacité clinique d'une bibliothérapie de l'éjaculation précoc

quantification and characterization of mineral oil in fish feed BY LC-GC-FID and LC-GC×GC-TOFMS/FID.

Mineral oil is a ubiquitous food contaminant potentially toxic. It is generally divided into 2 classes: the aromatic hydrocarbons (MOAH) and the saturated hydrocarbons (MOSH). These compounds are currently under investigation by the European Union to determine their occurrence and their toxicity before legislating on the matter. Although the discussion is mainly focus on food, feed can contribute indirectly to human exposition to such a contaminant. In this study 22 different fish feed products were analysed (7 commercial feed, 5 feedstuff and 10 from experimental diets). The analyses were performed by LC-GC-FID and compared by two Universities involved in this project (Udine and Liege). Further investigation was performed by LC-GC×GC-TOFMS/FID to validate the novel proposed quantification with such a platform and for a more detailed characterization of the contamination [1]. Simultaneous saponification and extraction of the mineral oil fraction was performed by microwave-assisted saponification. The extract was divided into two aliquots to perform MOSH and MOAH analysis separately, The fraction for the MOAH analysis underwent offline epoxidation to remove the interferents, while the MOSH fraction was further purified by aluminum oxide when overloading alkanes were observed. The MOSH contamination observed ranged from 7 to 30 mg/kg while the MOAH contamination was ranging from 0.5 to 5 mg/kg. The data provided by the two laboratories were in good agreement, as well as the quantification performed with the LC- GC×GC-TOFMS/FID platform, along with extra characterization.CDR projects-MOHPlatform, J.0170.2

QUANTIFICATION AND CHARACTERIZATION OF MINERAL OIL IN FISH FEED BY LC-GC-FID AND LC-GC×GC-TOFMS/FID.

Mineral oil, mainly composed by mineral oil saturated and aromatic hydrocarbons (MOSH and MOAH), is an ubiquitous food contaminants of high concern in the European Union for it potential toxicity. Moreover, the analytical procedure for their determination is highly sample dependent and not robustly validated. High attention is devoted to human food, while oftenreduced attention is paid to animal feed, turning out in higher contamination occurrence. In this study 22 different fish feed products were selected (7 commercial feed, 5 feedstuff and 10 from sperimental diets). The analysis were performed by both LC-GC-FID as the reference method and LC-GC×GC-TOFMS/FID for confirmation of the quantity found and a more detailed characterization of the contamination [1]. The samples were first extracted by performing a microwave-assisted saponification and simultaneous extraction step, followed by an offline auxiliary technique, such as epoxidation to remove most of the interferents of the MOAH fraction and an aluminum oxide purification step when necessary on the MOSH fraction to remove overloading alkanes. The results indicate a constant contamination of MOSH ranging between 7 and 30 mg/kg and a contamination of MOAH ranging from 0.5 to 5 mg/kg.CDR projects-MOHPlatform, J.0170.2

QUANTIFICATION AND CHARACTERIZATION OF MINERAL OIL IN FISH FEED BY LIQUID CHROMATOGRAPHY-GAS CHROMATOGRAPHY-FLAME IONIZATION DETECTOR AND LIQUID CHROMATOGRAPHY-COMPREHENSIVE MULTIDIMENSIONAL GAS CHROMATOGRAPHY-TIME-OF-FLIGHT MASS SPECTROMETER/FLAME IONIZATION DETECTOR

peer reviewe

Clinical outcomes of a new cognitive-behaviour bibliotherapy for premature ejaculation

INTRODUCTION. Premature ejaculation (PE) is a common sexual disorder. However, only few affected people consult clinicians in order to overcome this problem. Although no definitive consensus about its aetiology emerges, some mechanisms of PE are now well known. This allows more precise and efficient treatments, both at pharmacological as well as cognitive-behavioural levels. Further, studies have shown that reading didactical documents about their PE problem might be useful to men. Such approach is called “bibliotherapy”. AIM. The aim of the present study was to improve the bibliotherapy approach on the basis of up to date knowledge and techniques. The expected benefits were: (1) an efficient manual shorter than previous ones, (2) therapeutic principles easier to assimilate and (3) a method thereby made accessible to a large public which usually does not consult for this type of sexual problem. METHOD. A short bibliotherapy named Practical Guide of PE [in French] was tested among 421 PE subjects (DSM-IV diagnosis criteria). Self-reported anxiety, sexual satisfaction, ejaculatory latency time, feeling of control and distress were measured: (1) at baseline, (2) at 4-8 months and (3) at 10-14 months after reading the Practical guide of PE. A control condition was composed by 67 subjects left on a waiting-list for two months after baseline. RESULTS. Significant improvements were found for all the self-reported parameters, either at 4-8 and at 10-14 months after the bibliotherapy. The improvements were associated with an adjustment of sexual cognitions (SIQ, McCormick & Jordan). The response to treatment seemed better when the severity of PE was moderate, but did not seem related to variables such as age, educational level and personality traits (TCI-R, Cloninger; STAI Y-B, Spielberger.) CONCLUSION: Its cost/benefit ratio makes the Practical Guide an ideal first line therapeutic tool. Its large diffusion might be useful in order to improve sexual health in population

BibliothEP: a study evaluating the effectiveness of bibliotherapy for premature ejaculation

Objective. The BibliothEP study aimed to assess the efficacy of a bibliotherapy for premature ejaculation (PE) Design and method. The study was conducted in two phases. First, a sample of 120 participants suffering from PE read a concise cognitive behavioural self-help manual for PE (51 A5 pages including illustrations) and were compared after treatment to 66 waiting list controls. Second, 36 subjects received and read the self-help manual and were compared after treatment to 32 subjects having received the same manual plus a complementary brief guidance (45-90 minutes) from a coach not specialised in sex therapy, but who had been specifically trained to support the bibliotherapy intervention (by attending a 5-hour training module). The main outcome measures were self-determined latency time to ejaculation, feelings of control, sexual satisfaction, PE-related distress and subjective impression of improvement. Results. At 6-month posttreatment, all participants showed significant improvements as compared to waiting list condition. The improvements were maintained at 12 month. They were slightly greater in the case of complementary therapist support. Improvements were demonstrated for all forms of PE, but the intervention appeared to be slightly more effective when the problem was of moderate severity. In all cases, improvements in sexual functioning were accompanied by improvements in sexual cognitions. Conclusions. The cost-effectiveness of the self-help manual makes it a valuable first-line treatment for any form of PE. Moreover, the outcome of the bibliotherapy process might be increased by coaching from a health worker specifically trained to this aim

BibliothEP : a study evaluating the effectiveness of bibliotherapy for premature ejaculation

Objective. The BibliothEP study aimed to assess the efficacy of a bibliotherapy for premature ejaculation (PE) Design and method. The study was conducted in two phases. First, a sample of 120 participants suffering from PE read a concise cognitive behavioural self-help manual for PE (51 A5 pages including illustrations) and were compared after treatment to 66 waiting list controls. Second, 36 subjects received and read the self-help manual and were compared after treatment to 32 subjects having received the same manual plus a complementary brief guidance (45-90 minutes) from a coach not specialised in sex therapy, but who had been specifically trained to support the bibliotherapy intervention (by attending a 5-hour training module). The main outcome measures were selfdetermined latency time to ejaculation, feelings of control, sexual satisfaction, PErelated distress and subjective impression of improvement. Results. At 6-month posttreatment, all participants showed significant improvements as compared to waiting list condition. The improvements were maintained at 12 month. They were slightly greater in the case of complementary therapist support. Improvements were demonstrated for all forms of PE, but the intervention appeared to be slightly more effective when the problem was of moderate severity. In all cases, improvements in sexual functioning were accompanied by improvements in sexual cognitions. Conclusions. The cost-effectiveness of the self-help manual makes it a valuable first-line treatment for any form of PE. Moreover, the outcome of the bibliotherapy process might be increased by coaching from a health worker specifically trained to this aim

The BibliothEP project: Development and validation of a bibliotherapy for premature ejaculation (PE) for use alone or in a therapeutic relationship

BbibliothEP: étude d'efficacité clinique d'une bibliothérapie de l'éjaculation précoce (EP