A Organização para a Segurança e Cooperação
na Europa (OSCE) é um instrumento fundamental para a cooperação na região Euro-
-Atlântica no combate às novas ameaças que
surgiram com os atentados de 11 de Setembro.
Uma das principais tarefas da OSCE é a de
funcionar como um instrumento de alerta precoce no caso de novos desafios e ameaças à
segurança internacional. A organização pode
ser um fórum onde se estabelecem novas normas e princípios de segurança e processos de
cooperação entre os Estados. A luta contra o
terrorismo tornou-se uma das prioridades da
OSCE, e devido à sua experiência nesse domí-
nio pode vir a ter um papel preponderante no
âmbito das instituições Euro-Atlânticas

Alvarenga, T. A. [UNIFESP]

Andersen, M. L. [UNIFESP]

Bittencourt, L. [UNIFESP]

Cintra, F. [UNIFESP]

Hirotsu, C. [UNIFESP]

Matos, G. [UNIFESP]

Tufik, S. [UNIFESP]

Inflammatory markers like tumour necrosis factor-alpha (TNF-) have been related to erectile dysfunction (ED) and may interact with other cardiovascular risk factors such as obstructive sleep apnoea syndrome (OSAS). the aim of this study was to examine the inflammatory, metabolic and hormonal profile of men with or without ED complaints and/or OSAS recruited through the Epidemiologic Sleep Study (EPISONO). A sample of 363 men completed sexual questionnaires for ED and had physical and blood examinations. OSAS was evaluated by polysomnography and clinical assessment. the blood samples were used for determination of TNF-, interleukin-6, leptin, cholesterol and fractions, triglycerides, homocysteine, glucose and hormonal levels. After controlling for confounding factors, men with ED complaints presented higher systolic blood pressure and TNF-, independent of OSAS. Significant interaction between ED and OSAS was only observed for neck circumference, which was higher in ED men with OSAS than men with OSAS without ED and men with ED without OSAS. Binary logistic regression showed that the predictor factors for ED were age >43years, myocardial infarction events, TNF- and systolic blood pressure. Finally, a receiver-operating characteristics curve suggested a cut-off point of 9.95pg/mL for TNF- with sensitivity of 60% and specificity of 59% in men with ED complaints. Furthermore, there was a significant association between high levels of TNF- (>9.95pg/mL) and the presence of ED complaints. the results showed that there was an association between TNF- levels and ED complaints in men independent of OSAS.Universidade Federal de São Paulo, Dept Psicobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psicobiol, São Paulo, BrazilWeb of ScienceAssociacao Fundo de Incentivo a Pesquisa (AFIP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP: 10/15110-8FAPESP: 10/50129-1FAPESP: 11/12325-

Repositório Institucional UNIFESP

Andrology

The association between TNF-alpha and erectile dysfunction complaints

Matos, G.

Hirotsu, C.

Alvarenga, T. A.

Cintra, F.

Bittencourt, L.

Tufik, S.

Andersen, M. L.

Serveur académique lausannois

The association between TNF-α and erectile dysfunction complaints

Associacao Fundo de Incentivo a Pesquisa (AFIP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Inflammatory markers like tumour necrosis factor-alpha (TNF-) have been related to erectile dysfunction (ED) and may interact with other cardiovascular risk factors such as obstructive sleep apnoea syndrome (OSAS). the aim of this study was to examine the inflammatory, metabolic and hormonal profile of men with or without ED complaints and/or OSAS recruited through the Epidemiologic Sleep Study (EPISONO). A sample of 363 men completed sexual questionnaires for ED and had physical and blood examinations. OSAS was evaluated by polysomnography and clinical assessment. the blood samples were used for determination of TNF-, interleukin-6, leptin, cholesterol and fractions, triglycerides, homocysteine, glucose and hormonal levels. After controlling for confounding factors, men with ED complaints presented higher systolic blood pressure and TNF-, independent of OSAS. Significant interaction between ED and OSAS was only observed for neck circumference, which was higher in ED men with OSAS than men with OSAS without ED and men with ED without OSAS. Binary logistic regression showed that the predictor factors for ED were age >43years, myocardial infarction events, TNF- and systolic blood pressure. Finally, a receiver-operating characteristics curve suggested a cut-off point of 9.95pg/mL for TNF- with sensitivity of 60% and specificity of 59% in men with ED complaints. Furthermore, there was a significant association between high levels of TNF- (>9.95pg/mL) and the presence of ED complaints. the results showed that there was an association between TNF- levels and ED complaints in men independent of OSAS.Universidade Federal de São Paulo, Dept Psicobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psicobiol, São Paulo, BrazilFAPESP: 10/15110-8FAPESP: 10/50129-1FAPESP: 11/12325-6Web of Scienc

LAReferencia - Red Federada de Repositorios Institucionales de Publicaciones Científicas Latinoamericanas

G. Matos

C. Hirotsu

T. A. Alvarenga

F. Cintra

L. Bittencourt

S. Tufik

M. L. Andersen

Crossref

Alexander, Alekseev

Repositório Comum

35Outono-Inverno 2002N.º 103 - 2.ª Sériepp. 35-42N e w  R i s k s  a n d  C h a l l e n g e swithin  the  Context  of  OSCEAlexander AlekseevRepresentante Permanente da Federação Russa na OSCE, VienaResumoA Organização para a Segurança e Cooperaçãona Europa (OSCE) é um instrumento funda-mental para a cooperação na região Euro--Atlântica no combate às novas ameaças quesurgiram com os atentados de 11 de Setembro.Uma das principais tarefas da OSCE é a defuncionar como um instrumento de alerta pre-coce no caso de novos desafios e ameaças àsegurança internacional. A organização podeser um fórum onde se estabelecem novas nor-mas e princípios de segurança e processos decooperação entre os Estados. A luta contra oterrorismo tornou-se uma das prioridades daOSCE, e devido à sua experiência nesse domí-nio pode vir a ter um papel preponderante noâmbito das instituições Euro-Atlânticas.AbstractThe OSCE is a fundamental instrument ofco-operation in the Euro-Atlantic region on the fightagainst new threats after September 11.One of its main tasks is the one of functioning as anearly warning instrument towards new challengesand threats to the international security. Theorganization may become a forum, which contributesto build up new security norms, principles andco-operation processes among States. The fightagainst terrorism became one of the priorities of theOSCE and due to its experience in that field it mayhave, in the future, an even more outstanding role inthe context of Euro-Atlantic institutions.37The theme of Seminar is of utmost importance for all of us and for the future of ourOrganization as a whole. OSCE’s ability to play a productive role in global efforts tocombat new threats and challenges will, to a great extent, determine the strategic choicesof our Organization for years to come and its relevance in an evolving security environmentin Europe.The events of 11 September made us realize how vulnerable and unprepared we and oursecurity institutions are to deal with a global threats of this new generation of terrorism. Thelives of thousands of innocent people, buried under the debris of World Trade Center vividlydemonstrated that these threats are no longer a product of Hollywood movie-makers’imagination but are a real and mortal danger to lives of all of us wherever we live; Itdemonstrated the reality that no State or Organization can effectively counter them unilaterally.Overwhelmed by this tragedy almost every international institution, including theOSCE, began desperate, sometimes chaotic and overlapping, search for its contribution inthe fight against global terror. Anti-terrorism becomes “growing industry” sometimeswith no clear objectives. Obsessed by this truly burning issue, we do forget that terrorismdoes not exist in a vacuum but travels hand in hand with other threats of no less danger.To eradicate scourge of terror and to make the world a safer place, we need to address thewhole range of new unconventional risks in their full complexity through a systematic andwell-phased collective approach. The international community cannot sit on the fence andwait for new tragedies catch us off guard.Over the last few years the Russian Federation has been trying to convince our partnersto take the topic of new threats and challenges through different formats and internationalorganizations, including the OSCE.Role of the OSCEWe truly believe that the unique advantageous and comprehensive mandate of ourOrganization made it an effective instrument for cooperation in the Euro-Atlantic regionin combating those new threats.One of the principle role of the OSCE is to function as a tool of early warning inemerging security risks and challenges. So, the OSCE has clearly a role to play as a forumwhere participating states can exchange signals of early warning and could act as facilitatorof solutions to problems through interaction of competent organizations: seminars andround-tables, possible focal points.New Risks and Challenges within the Context of OSCE38On one hand, the Organization can be effectively employed as a norm-setting mechanismestablishing the principles and procedures of cooperation and making the national legislationin compliance with relevant international convention; on the other hand, it could be aprovider of organizational framework for exchange of ideas and information, elaborationof specific programs and projects, coordination of efforts with other internationalorganizations, etc.The Organization could enhance the political awareness of pressing new risks at a highpolitical level, thereby contributing to the creation of a favourable political environmentfor enhanced international cooperation.Those of us who were involved in the preparation of the Charter for European Securityin 1998-99 may remember the intensive discussions within the formal of the specialworking group “A” to formulate a language on new risks and challenges. A lot of fruitfulideas were suggested. Most of them remain relevant and might be successfully used infuture work.An attempt was made to identify and systematize the new risks along three maindimensions of security:1) political-military– terrorism– proliferation of weapons of mass destruction (WMD)– smuggling of components and materials of WMD– organized crime and money-laundering– drug trafficking– illegal transfers of arms and “dual use” production2) economic– economic disparities– environment and technological risks– impediments to free trade– social problems– corruption and money-laundering3) human– intolerance, agressive nationalisme, racisme, chauvinisme, xénophobie– uncontrolled and involuntary migration– human traffickingAlexander Alekseev39– ethnic tensions, violations of rights of persons belonging to national minorities– anti-Semitism– non-respect of rights of the migrant workersIt was a shared understanding that it is impossible to draw up a comprehensive,all-inclusive list of new risks and challenges. The dynamic nature of the subject precludesa static listing. The list should remain open-ended to be added as far as new threats emergeand are identified as such.Unfortunately, the prevailing view at that on the eve of Istambul Summit was that thestudy was too academic and lacking practicality with no “added value” for the Organization.An opposition to the idea of OSCE’s deep involvement in this topic, including terrorism,was voiced by a number of our European partners. Our U.S. partners were as wellreluctant. We obviously were unprepared at that time to address the issue seriously. As aresult, only a small portion of tabled ideas was reflected in the final version of the Charter.Most ideas, however, remain relevant and might be successfully used in future work.New realityA real breakthrough in the attitude of the Organization towards the issue of new threatsand challenges took place after 11 September. The impact of that horrific disaster brought anew spirit of partnership and solidarity within the Organization and subsequent importantpractical steps in promoting inter-state cooperation in this regard. The issue of anti-terrorismbecame a central element of OSCE’s agenda. At the same time, an understanding grew thatdue attention should also be given to the over all issue of unconventional risks which, liketerrorism, are not limited by national borders but concern absolutely all of us. We need tomake OSCE well prepared, adequately equipped, and not to be caught off guard by them.That is why the Bucharest Ministerial tasked the Permanent Council, together with theForum for Security Cooperation, to develop a strategy for the OSCE to do its part to counternew threats to security and stability in the 21st century. The positive experience of the OSCEon anti-terrorism makes us confident that the Organization is capable of adding a substantialvalue on the topic of new risks and to some extent to play a leading role in this regardamong other Euro-Atlantic institutions.We have to admit that there are no obvious solutions or prepared receipts. This is quitea new sphere for all of us both in conceptual and practical terms. It obviously requiresNew Risks and Challenges within the Context of OSCE40systematic and collective approach, constructive inputs from other partner Organizations,exchange of ideas with others, including academic community.We do not need to start from the blank pageOur Organization has already accumulated a number of valuable ideas in this regard.Besides the Lisbon and Istanbul Summit documents, conceptual ideas originating fromabove-mentioned Working Group on new threats, there is also a number of documentsadopted by other international fora and bilaterally. May I draw your attention, forexample, to the Russian-American Summit joint statement on common security challenges atthe threshold of the 21st century of September 4, 1998. We just need to have them allthoroughly screened and see what is particularly feasible and applicable for the OSCE needs.In this regard, I would also like to mention the draft on new threats and challenges tosecurity prepared by the Russian Federation on the eve of last years’ Ministerial (PC.DEL//741/01 of 05.10.2001). Unfortunately, this document was not given due consideration– 1ack of time or obsolete stereotypes may have obviously played a role.Russian contributionI would not like use this seminar for advertising this or that paper. New experienceaccumulated since Bucharest has obviously broadened our perceptions both of the natureof these new threats and of the best ways to tackle them within the Organization.Nevertheless, a number of ideas and basic principles of this document remain relevant andcould be creatively used later in the work on OSCE new strategy.Nevertheless, the paper mentioned enlists other “untraditional” threats in addition tothose mentioned above such as crimes with the use of high technology, penetration ofcriminals into the information data banks, breaches of information security of the states.A cause of deep concern is an increased wave of radical right-wing ideology, politicaland religious extremism, national, racial, cultural or other forms of intolerance. Theyundermine the OSCE core values based on respect of human rights regardless of nationality,religion, face or social status. It is essential to take up some timely and well-addressed stepsto label as illegal all organizations, groups or movements which participate in violence andterrorist activity.Alexander Alekseev41Particular attention should be given to ensuring the rights of persons belonging tonational minorities.All mentioned risks equally apply to all Participating States, regardless of historical,socio-economic or political backgrounds.New threats and challenges to security – being complex in their nature – require acomprehensive approach based on solidarity, cooperation and partnership. The solution ofthose tasks should be based on full respect for the UN Charter, principles of the HelsinkiAct and legitimate interests of all Participating States.Cooperation between international organizations, including those of a specializednature, should be based on the Platform for Cooperative Security. It will allow us to avoidcompetition and overlapping and will prove our Organization’s ability to play its role asa link between global and regional security efforts.Some lessons learnedThe OCSE work on anti-terrorism provides us with some lessons on how to addressother tasks as well.First, declarations – no matter how good they are – can serve only as “publicproclamation of war” against new risks, i.e., a formal start of the OSCE new engagement.But to solve the problem, declarations are not evidently enough. They should besupplemented by concrete Actions Plans, “road maps” and realistic timetables with clearand concise interim and final goals for each institute.As in the case of the Bucharest Action Plan on anti – terrorism, each OSCE instituteshould receive its “piece of cake” in accordance with its specific mandate. For example,ODIHR could take care of a manifestations of political extremism and unconstitutionalradical activity to monitor the organizations and movements based on nazi ideology andkeep the PC regularly appraised of it. The Office on Freedom of the Media should payattention to the use of mass media for inciting hatred, discrimination and provokingviolence, etc. Similar agenda can be established for the Secretariat, HCNM, ParliamentaryAssembly. Close day-to-day coordination with the Forum for Security Cooperation isindispensable. Of course, the key role should be played by Participating States.Second, as long as all those risks concern all of us and are spread along the wholeEuro-Atlantic area, the main burden of practical work should be laid upon the OSCEcentral organs and institutions under the guidance of the Permanent Council. It does notNew Risks and Challenges within the Context of OSCE42certainly preclude the role for field operations. They should also do the job provided forthe relevant request of the Host country and PC agreement on their project-orientedactivity are in place.The idea of “rowing missions” staffed with experts on specific issues deservesconsideration.Third, a creation of any new structures by the CiO or within Secretariat should bebased on real needs and judged against its practical merits. Policy “first new office, staffand budget – then real need and substance” should be avoided.Forth, a proper flexible mechanism for coordination of efforts with other Euro-Atlanticsecurity institutions taken into account specific mandates of each of them should beconsidered as a priority. An invitation to discuss the entire spectrum of those issues withother partner organizations is worth looking at.Fifth, a separate Seminar or a Workshop on new risks and challenges with a broadparticipation of OSCE academic community could be a positive brain-storming supplementto our thinking.These are only some preliminary observations. I am sure much more suggestions andideas will follow which will no doubt add to the common knowledge of our Organization.High stakesIn conclusion, I would like to re-reiterate what was said in the very beginning. Thestakes are too high. The OSCE is at the cross-road: whether it will manage to find its newpolitical agenda in evolving European landscape to remain a key player or continue to loseits relevance, to be subsequently squeezed out by more ambitious self-motivated actors.This topic provides the Organization with a unique opportunity to take a leading rolein devising a new pan-European conceptual and organizational framework for collectiveefforts in countering new threats and thus to prove its future for Europe.Alexander Alekseev