Self-stigma in schizophrenia: a systematic review and meta-analysis of 37 studies from 25 high- and low-to-middle income countries.

In schizophrenia, it is currently thought that stigma experience is increased by psychotic and depressive symptomatology, exposure to stigma at the workplace, and that self-stigma levels vary across countries without knowing the factors explaining these variations. The aim of the present meta-analysis was to synthetize the data of observational studies comprehensively exploring multiple self-stigma dimensions and associated factors. A systematic literature search without language or time restrictions was conducted in Medline, Google Scholar, and Web of Science for studies, last 09/2021. Eligible studies that included ≥80% of patients diagnosed with schizophrenia-spectrum disorders and used a validated scale measuring self-stigma dimensions were meta-analysed using random-effects models, followed by subgroup and meta-regression analyses. Study registration: PROSPERO CRD42020185030. Overall, 37 studies (n = 7717) from 25 countries (5 continents) published between 2007 and 2020 were included, with 20 studies conducted in high-income countries. These studies used two scales with total scores ranging 1-4. The mean estimate of perceived stigma was 2.76 [95% confidence interval (CI) = 2.60-2.94], experienced stigma 2.29 [95% CI = 2.18, 2.41], alienation 2.40 [95% CI = 2.29, 2.52], stereotype endorsement 2.14 [95% CI = 2.03, 2.27], social withdrawal 2.28 [95% CI = 2.17, 2.39] and stigma resistance 2.53 [95% CI = 2.43, 2.63]). Self-stigma levels did not reduce over time. Living outside urban areas, low-income, singleness, unemployment, high antipsychotic dose and low functioning were associated with different stigma dimensions. Some stigma dimensions were lower in studies carried out in Europe compared to other regions. Most studies published since 2007 report that self-stigma is a particular concern for a specific subgroup of patients. This subgroup is characterized by unemployment, high antipsychotic dose and low functioning. We identified important other missing factors that should be explored to improve the effectiveness of public policies and personalized interventions to reduce self-stigma. Importantly, classical illness severity indices (psychotic severity, age at illness onset, illness duration) and sociodemographic variables (age, sex and education) were not associated with self-stigma, moderating previous findings.

Thiol-free multicomponent synthesis of non-racemic ß-acyloxy thioethers from biocatalytically obtained chiral halohydrins.

A novel multicomponent chemoenzymatic strategy for the preparation of enantioenriched ß-acyloxy thioethers has been developed. This robust methodology employs mild bases, air atmosphere, room temperature and avoids the use of foul-smelling thiols. Instead, potassium thioacetate is employed as a universal sulfur source. This chemoselective strategy tolerates aromatic and aliphatic components and diverse functional groups. The chirality is enzymatically defined by ADH-catalyzed bioreduction of α-haloketones delivering an enantioenriched halohydrin which is one of the three components, and the optical purity remains untouched in the final product. Semipreparative scale multicomponent reaction affords high yield of the products (up to 96%).

[Treatment of Hodgkin disease relapse after allogeneic transplantation with nivolumab. Report of two cases]. / Uso de nivolumab en pacientes con recaída postrasplante alogénico de progenitores hematopoyéticos en enfermedad de Hodgkin: reporte de dos casos clínicos.

Hodgkin's Lymphoma has a very good prognosis. In the unusually refractory patients allogeneic transplantation offers a chance of cure. The so-called checkpoint inhibitors, such as Nivolumab can play a relevant role in this type of patients. Their side effects and usefulness after allogeneic transplantation are under investigation. Relapse after allogeneic transplantation has an extremely poor prognosis. We report two patients with refractory Hodgkin's lymphoma who relapsed after an allogeneic transplant and who were successfully treated with Nivolumab.

Thiol-free chemoenzymatic synthesis of ß-ketosulfides.

A preparation of ß-ketosulfides avoiding the use of thiols is described. The combination of a multicomponent reaction and a lipase-catalysed hydrolysis has been developed in order to obtain high chemical diversity employing a single sulfur donor. This methodology for the selective synthesis of a set of ß-ketosulfides is performed under mild conditions and can be set up in one-pot two-step and on a gram-scale.

Clinical Research Office of the Endourological Society Global GreenLight Laser Study: Outcomes from a contemporary series of 713 patients.

OBJECTIVE: To evaluate the outcome in patients undergoing photoselective vaporization of the prostate for benign prostatic obstruction as part of the Clinical Research Office of the Endourological Society Global GreenLight Laser Study. METHODS: Data were collected on 713 patients with lower urinary tract symptoms suggestive of benign prostatic obstruction undergoing photoselective vaporization of the prostate at 25 centers worldwide, between April 2010 and April 2012. Three types of GreenLight laser powers were used: 80 W, 120 W or 180 W. Intraoperative and postoperative complications were recorded. Outcome parameters measured at baseline, 6-12 weeks, 6 months and 12 months were: uroflow measurements, International Prostate Symptom Score; prostate-specific antigen and International Index of Erectile Function. RESULTS: Operating time was shortest with the 180-W laser at 53.8 min. Intraoperatively, bleeding occurred in 3.1% of patients. Statistically significant changes were reported in maximum flow rate, postvoid residual urine, International Prostate Symptom Score, quality of life score and prostate-specific antigen (P < 0.01) at each time-point assessed for the 80- and 120-W lasers as well as for the 180-W laser, with the exception of prostate-specific antigen at 6 months and 12 months. There were 14 Clavien-Dindo grade III-A complications and two grade III-B. The incontinence rate at 12 months was 6.3%, 4.5%, and 2.6% for the 80, 120 and 180 W lasers, respectively. The overall blood transfusion rate was 0.4%. CONCLUSIONS: Objective and subjective improvement after GreenLight laser treatment worldwide was significant at 1-year follow up. Morbidity and complications were low. Although not a randomized control study, the data can provide an indication of the outcome of the different GreenLight laser powers.

Scintigraphic tracking of mesenchymal stem cells after intravenous regional limb perfusion and subcutaneous administration in the standing horse.

OBJECTIVE: To assess distribution, uptake, and persistence of radiolabeled mesenchymal stem cells (MSC) using scintigraphy after intravenous regional limb perfusion (RLP) and subcutaneous injections in standing, sedated horses. STUDY DESIGN: Experimental study. ANIMALS: Horses (n = 12). METHODS: Six horses had RLP performed through the cephalic vein on 1 limb and subcutaneous injection in the metacarpal area in the opposite limb. The other 6 horses had RLP performed through the lateral palmar digital vein and subcutaneous injection in the coronary band. A pneumatic tourniquet was used for the RLP. MSC were labeled with technetium-HMPAO. Scintigraphic images were obtained at the time of injection, 1, 6, and 24 hours later. Results of RLP were compared with results from previous studies where similar injections were performed in anesthetized horses. RESULTS: Both RLP techniques led to greater variability, lower uptake, lower persistence, and poorer distribution when compared to results previously reported for horses under general anesthesia. The subcutaneous injections in the metacarpal area and coronary band resulted in MSC loss to the general circulation but no evidence of local migration. CONCLUSION: Due to partial or complete failure of the tourniquet, RLP performed in the standing horse as described is less efficient than performed under general anesthesia. Further work is needed to optimize the use of tourniquets to perform RLP for MSC administration in standing patients. The subcutaneous injections did not result in local migration in these normal horses.

Biofoams with untapped enzymatic potential produced from beer bagasse by indigenous fungal strains.

White rot fungi are promising organisms for the production of mycelial-based biofoams, providing a sustainable means of valorizing lignocellulosic wastes. This study explores the utilization of two indigenous fungal species, isolated from Argentina and belonging to the genera Trametes, for producing biofoams from brewery waste. The resulting biofoams exhibited an average density of 0.30 g cm-3, a Young's modulus of approximately 1 MPa, and a compressive stress of around 19 MPa. Additionally, the variation of laccase activity throughout the biofoam production process was evaluated. Surprisingly, residual laccase activity was detected in the biofoams following oven drying at temperatures of 60, 80, and 100 °C. This detection highlights the untapped enzymatic potential of the biofoams and positions them as promising green catalysts for various biotechnological applications.

Metal-Organic Frameworks for Dual Photo-Oxidation and Capture of Arsenic from Water.

Despite rapid technological progress, heavy metal water pollution, and particularly arsenic contamination, remains a significant global challenge. In addition, the stabilization of trivalent arsenic as neutral arsenite (AsIII) species hinders its removal by conventional sorbents. While adsorption of anionic arsenate (AsV) species is in principle more feasible, there are only few adsorbents capable of adsorbing both forms of arsenic. In this work, we explore the potential of two well-known families of Metal-Organic Frameworks (MOFs), UiO-66 and MIL-125, to simultaneously adsorb and photo-oxidize arsenic species from water. Our results demonstrate that the formation of AsV ions upon light irradiation promotes the subsequent adsorption of AsIII species. Thus, we propose the combined utilization of photocatalysis and adsorption with Metal-Organic Framework photocatalysts for water remediation purposes.

Clinicopathologic findings following intra-articular injection of autologous and allogeneic placentally derived equine mesenchymal stem cells in horses.

BACKGROUND AIMS: The development of an allogeneic mesenchymal stem cell (MSC) product to treat equine disorders would be useful; however, there are limited in vivo safety data for horses. We hypothesized that the injection of self (autologous) and non-self (related allogeneic or allogeneic) MSC would not elicit significant alterations in physical examination, gait or synovial fluid parameters when injected into the joints of healthy horses. METHODS: Sixteen healthy horses were used in this study. Group 1 consisted of foals (n = 6), group 2 consisted of their dams (n = 5) and group 3 consisted of half-siblings (n = 5) to group 1 foals. Prior to injection, MSC were phenotyped. Placentally derived MSC were injected into contralateral joints and MSC diluent was injected into a separate joint (control). An examination, including lameness evaluation and synovial fluid analysis, was performed at 0, 24, 48 and 72 h post-injection. RESULTS: MSC were major histocompatibility complex (MHC) I positive, MHC II negative and CD86 negative. Injection of allogeneic MSC did not elicit a systemic response. Local responses such as joint swelling or lameness were minimal and variable. Intra-articular MSC injection elicited marked inflammation within the synovial fluid (as measured by nucleated cell count, neutrophil number and total protein concentration). However, there were no significant differences between the degree and type of inflammation elicited by self and non-self-MSC. CONCLUSIONS: The healthy equine joint responds similarly to a single intra-articular injection of autologous and allogeneic MSC. This pre-clinical safety study is an important first step in the development of equine allogeneic stem cell therapies.

Effects of extracorporeal shock wave therapy on desmitis of the accessory ligament of the deep digital flexor tendon in the horse.

OBJECTIVE: To evaluate the effects of extracorporeal shock wave therapy (ESWT) on collagenase-induced lesions in the accessory ligament of the deep digital flexor tendon (ALDDFT) of horses. STUDY DESIGN: Paired, blinded controlled study. ANIMALS: Eight Thoroughbred horses (3 mares, 5 geldings; mean ± SD weight, 464 ± 26 kg, mean age, 8 ± 1.7 years). METHODS: Lesions were created in both ALDDFTs of all horses by injection of 2 × 10(3) IU of collagenase type I. Percent lesion and structure (fiber alignment and echogenicity) were quantified with ultrasonographic imaging 3, 6, and 9 weeks after collagenase injection. After ultrasound examinations, ESWT (1000 shocks at 0.15 mJ/mm2) was applied to 1 ALDDFT in each horse. ALDDFT were harvested 15 weeks after collagenase injection and the microstructure, mRNA levels of collagen types I and III, and collagen and glycosaminoglycan content were evaluated. RESULTS: There were no differences in percent lesion, echogenicity, or fiber alignment between control- and ESWT-treated ligaments at each evaluation time; however, compared with 3-week values, there was a significant increase in percent lesion and echogenicity for EWST treated ligaments at 6 weeks and significant decrease in both variables for treated and control ligaments at 12 weeks. Fiber alignment improved significantly at 9 weeks in controls and at 12 weeks in treated and control ligaments. Collagen type I mRNA levels were significantly higher in the ESWT treatment group compared with the control group 15 weeks after collagenase injection though differences in other mRNA levels, microstructure, and composition were not significant. CONCLUSIONS: Our results do not support an effect of ESWT on collagenase-induced lesions in the equine ALDDFT.

Betacellulin inhibits osteogenic differentiation and stimulates proliferation through HIF-1alpha.

Cellular signaling via epidermal growth factor (EGF) and EGF-like ligands can determine cell fate and behavior. Osteoblasts, which are responsible for forming and mineralizing osteoid, express EGF receptors and alter rates of proliferation and differentiation in response to EGF receptor activation. Transgenic mice over-expressing the EGF-like ligand betacellulin (BTC) exhibit increased cortical bone deposition; however, because the transgene is ubiquitously expressed in these mice, the identity of cells affected by BTC and responsible for increased cortical bone thickness remains unknown. We have therefore examined the influence of BTC upon mesenchymal stem cell (MSC) and pre-osteoblast differentiation and proliferation. BTC decreases the expression of osteogenic markers in both MSCs and pre-osteoblasts; interestingly, increases in proliferation require hypoxia-inducible factor-alpha (HIF-alpha), as an HIF antagonist prevents BTC-driven proliferation. Both MSCs and pre-osteoblasts express EGF receptors ErbB1, ErbB2, and ErbB3, with no change in expression under osteogenic differentiation. These are the first data that demonstrate an influence of BTC upon MSCs and the first to implicate HIF-alpha in BTC-mediated proliferation.

[Mad pride and metaphors for dissidence: a linguistic and symbolic analysis]. / Orgullo loco y metáforas para una disidencia: un análisis lingüístico y simbólico.

This paper presents a linguistic and interpretative analysis of the use of conceptual metaphors in the field of mental health, taking as a field of observation the use of Twitter in the first edition of Mad Pride Day in Spain, held on May 20, 2018. The objective is to give a first-person account of the attitudes expressed by activists. The results show a questioning of the coercive logics produced by psychiatric care, a problematization of the hegemonic model as a whole, a criticism of the oppression implied by stigma, communication problems with professionals in the field of mental health, as well as demands for greater dialogue with them. This analysis has allowed us to understand linguistic modes of resignifying the field of mental health, and also to account for the tensions between subjective perceptions of the people diagnosed and the productions of the hegemonic medical model.

El presente artículo expone un análisis lingüístico e interpretativo sobre el uso de la metáfora conceptual en el campo de la salud mental, tomando como campo de observación el uso de Twitter en la primera edición del Día del Orgullo Loco en España, celebrada el 20 de mayo de 2018. El objetivo es dar cuenta de los posicionamientos expresados por los activistas en primera persona. Los resultados muestran un cuestionamiento a las lógicas coercitivas producidas por la atención psiquiátrica, una problematización del modelo hegemónico en su conjunto, una denuncia a la opresión que implica el estigma, problemas de comunicación y demandas de mayor diálogo con los profesionales del campo de la salud mental. Este análisis nos ha permitido comprender el modo lingüístico de re-semantizar el campo de la salud mental, así como dar cuenta de las tensiones existentes entre las percepciones subjetivas de las personas diagnosticadas y las producciones del modelo médico hegemónico.

In vitro Differentiation Potential of Mesenchymal Stem Cells.

SUMMARY: Mesenchymal stem cells (MSCs) represent a class of multipotent progenitor cells that have been isolated from multiple tissue sites. Of these, adipose tissue and bone marrow offer advantages in terms of access, abundance, and the extent of their documentation in the literature. This review focuses on the in vitro differentiation capability of cells derived from adult human tissue. Multiple, independent studies have demonstrated that MSCs can commit to mesodermal (adipocyte, chondrocyte, hematopoietic support, myocyte, osteoblast, tenocyte), ectodermal (epithelial, glial, neural), and endodermal (hepatocyte, islet cell) lineages. The limitations and promises of these studies in the context of tissue engineering are discussed.

Comparison of chondrogenic potential in equine mesenchymal stromal cells derived from adipose tissue and bone marrow.

OBJECTIVE: To compare the chondrogenic potential of adult equine mesenchymal stem cells derived from bone marrow (MSCs) or adipose tissue (ASCs). STUDY DESIGN: In vitro experimental study. ANIMALS: Adult Thoroughbred horses (n=11). METHODS: BM (5 horses; mean [+/-SD] age, 4+/-1.4 years) or adipose tissue (6 horses; mean age, 3.5+/-1.1 years) samples were obtained. Cryopreserved MSCs and ASCs were used for pellet cultures in stromal medium (C) or induced into chondrogenesis+/-transforming growth factor-3 (TGFbeta(3)) and bone morphogenic factor-6 (BMP-6). Pellets harvested after 3, 7, 14, and 21 days were examined for cross-sectional size and tissue composition (hematoxylin and eosin), glycosaminoglycan (GAG) staining (Alcian blue), collagen type II immunohistochemistry, and by transmission electron microscopy. Pellet GAG and total DNA content were measured using dimethylmethylene blue and Hoechst DNA assays. RESULTS: Collagen type II synthesis was predominantly observed in MSC pellets from Day 7 onward. Unlike ASC cultures, MSC pellets had hyaline-like matrix by Day 14. GAG deposition occurred earlier in MSC cultures compared with ASC cultures and growth factors enhanced both MSC GAG concentrations (P<.0001) and MSC pellet size (P<.004) after 2 weeks in culture. CONCLUSION: Equine MSCs have superior chondrogenic potential compared with ASCs and the equine ASC growth factor response suggests possible differences compared with other species. CLINICAL RELEVANCE: Elucidation of equine ASC and MSC receptor profiles will enhance the use of these cells in regenerative cartilage repair.

Characterization of equine adipose tissue-derived stromal cells: adipogenic and osteogenic capacity and comparison with bone marrow-derived mesenchymal stromal cells.

OBJECTIVE: To characterize equine adipose tissue-derived stromal cell (ASC) frequency and growth characteristics and assess of their adipogenic and osteogenic differentiation potential. STUDY DESIGN: In vitro experimental study. ANIMALS: Horses (n=5; aged, 9 months to 5 years). METHODS: Cell doubling characteristics of ASCs harvested from supragluteal subcutaneous adipose tissue were evaluated over 10 passages. Primary, second (P2), and fourth (P4) passage ASCs were induced under appropriate conditions to undergo adipogenesis and osteogenesis. Limit dilution assays were performed on each passage to determine the frequency of colony-forming units with a fibroblastic (CFU-F) phenotype and the frequency of ASC differentiation into the adipocyte (CFU-Ad) and osteoblast (CFU-Ob) phenotype. RESULTS: ASC isolates exhibited an average cell-doubling time of 2.1+/-0.9 days during the first 10 cell doublings. Approximately 1 in 2.3+/-0.4 of the total stromal vascular fraction nucleated cells were ASCs, based on the CFU-F assays, and 1 in 3.6+/-1.3 expressed alkaline phosphatase, an osteogenic marker. Primary ASCs differentiated in response to adipogenic (1 in 4.9+/-5.4, CFU-Ad) and osteogenic (1 in <2.44, CFU-Ob) inductive conditions and maintained their differentiation potential during subsequent passages (P2 and P4). CONCLUSION: The frequency, in vitro growth rate, and adipogenic and osteogenic differentiation potential of equine ASCs show some differences to those documented for ASCs in other mammalian species. CLINICAL RELEVANCE: Adipose tissue is a potential source of adult stem cells for tissue engineering applications in equine veterinary medicine.

[Erythrodermic psoriasis in young man: suspect HIV infection]. / Eritrodermia psoriática en un hombre joven: sospechar infección por VIH.

HIV infection can be manifested with different skin symptoms, which are sometimes considered infection markers. Erythrodermic psoriasis is a possible manifestation, which is a widespread form of psoriasis. We report a clinical case of a young man suspected of HIV infection due to a psoriatic erythroderma confirmed by biopsies, associated with Kaposi sarcoma. Afterwards, HIV infection was confirmed by serological tests. Antiretroviral therapy was started, with positive response at one month of treatment. Erythrodermic psoriasis can be considered a skin marker of HIV infection when occurs in previously healthy patients or in recalcitrant psoriasis.

Tenogenically Induced Allogeneic Peripheral Blood Mesenchymal Stem Cells in Allogeneic Platelet-Rich Plasma: 2-Year Follow-up after Tendon or Ligament Treatment in Horses.

Poor healing of tendon and ligament lesions often results in early retirement of sport horses. Therefore, regenerative therapies are being explored as potentially promising treatment for these injuries. In this study, an intralesional injection was performed with allogeneic tenogenically induced mesenchymal stem cells and platelet-rich plasma 5-6 days after diagnosis of suspensory ligament (SL) (n = 68) or superficial digital flexor tendon (SDFT) (n = 36) lesion. Clinical, lameness and ultrasonographic evaluation was performed at 6 and 12 weeks. Moreover, a survey was performed 12 and 24 months after treatment to determine how many horses were competing at original level and how many were re-injured. At 6 weeks, 88.2% of SL (n = 68) and 97.3% of SDFT lesions (n = 36) demonstrated moderate ultrasonographic improvement. At 12 weeks, 93.1% of SL (n = 29) and 95.5% of SDFT lesions (n = 22) improved convincingly. Moreover, lameness was abolished in 78.6% of SL (n = 28) and 85.7% (n = 7) of SDFT horses at 12 weeks. After 12 months (n = 92), 11.8% of SL and 12.5% of SDFT horses were re-injured, whereas 83.8 of SL and 79.2% of SDFT returned to previous performance level. At 24 months (n = 89) after treatment, 82.4 (SL) and 85.7% (SDFT) of the horses returned to previous level of performance. A meta-analysis was performed on relevant published evidence evaluating re-injury 24 months after stem cell-based [17.6% of the SL and 14.3% of the SDFT group (n = 89)] versus conventional therapies. Cell therapies resulted in a significantly lower re-injury rate of 18% [95% confidence interval (CI), 0.11-0.25] 2 years after treatment compared to the 44% re-injury rate with conventional treatments (95% CI, 0.37-0.51) based on literature data (P < 0.0001).

Uso de nivolumab en pacientes con recaída postrasplante alogénico de progenitores hematopoyéticos en enfermedad de Hodgkin: reporte de dos casos clínicos / Treatment of Hodgkin disease relapse after allogeneic transplantation with nivolumab. Report of two cases

Hodgkin's Lymphoma has a very good prognosis. In the unusually refractory patients allogeneic transplantation offers a chance of cure. The so-called checkpoint inhibitors, such as Nivolumab can play a relevant role in this type of patients. Their side effects and usefulness after allogeneic transplantation are under investigation. Relapse after allogeneic transplantation has an extremely poor prognosis. We report two patients with refractory Hodgkin's lymphoma who relapsed after an allogeneic transplant and who were successfully treated with Nivolumab.

Orgullo loco y metáforas para una disidencia: un análisis lingüístico y simbólico / Mad pride and metaphors for dissidence: a linguistic and symbolic analysis

RESUMEN El presente artículo expone un análisis lingüístico e interpretativo sobre el uso de la metáfora conceptual en el campo de la salud mental, tomando como campo de observación el uso de Twitter en la primera edición del Día del Orgullo Loco en España, celebrada el 20 de mayo de 2018. El objetivo es dar cuenta de los posicionamientos expresados por los activistas en primera persona. Los resultados muestran un cuestionamiento a las lógicas coercitivas producidas por la atención psiquiátrica, una problematización del modelo hegemónico en su conjunto, una denuncia a la opresión que implica el estigma, problemas de comunicación y demandas de mayor diálogo con los profesionales del campo de la salud mental. Este análisis nos ha permitido comprender el modo lingüístico de re-semantizar el campo de la salud mental, así como dar cuenta de las tensiones existentes entre las percepciones subjetivas de las personas diagnosticadas y las producciones del modelo médico hegemónico.

ABSTRACT This paper presents a linguistic and interpretative analysis of the use of conceptual metaphors in the field of mental health, taking as a field of observation the use of Twitter in the first edition of Mad Pride Day in Spain, held on May 20, 2018. The objective is to give a first-person account of the attitudes expressed by activists. The results show a questioning of the coercive logics produced by psychiatric care, a problematization of the hegemonic model as a whole, a criticism of the oppression implied by stigma, communication problems with professionals in the field of mental health, as well as demands for greater dialogue with them. This analysis has allowed us to understand linguistic modes of resignifying the field of mental health, and also to account for the tensions between subjective perceptions of the people diagnosed and the productions of the hegemonic medical model.

[Efficacy and safety of vardenafil in patients with erectile dysfunction. Results of the Mexican Multicentric Study]. / Eficacia y seguridad del vardenafil en pacientes con disfunción eréctil. Resultados del estudio multicéntrico mexicano.

UNLABELLED: The objective of the present study was to determine the efficacy and safety of a fixed dose of vardenafil in the treatment of patients with erectile dysfunction (ED). MATERIAL AND METHODS: This was an open label, prospective and multicentric trial. After a 4-week wash out period, all patients received 20 mg of vardenafil given on demand for 12 weeks. Primary efficacy variables were the erectile function domain of the International Index of Erectile Function (IIEF), answers to questions 2 and 3 of the Sexual Encounter Profile (SEP) and the Global Assessment Question (GAQ). All adverse events were recorded and reported. RESULTS: 229 patients were screened. 177 received at least one dose of vardenafil and were included in the safety analysis. Mean age was 54.4 years old. Etiology of ED was organic or mixed in 77% of the patients. Erectile function domain of the IIEF changed from a basal mean score of 14.8 to 25.5 at the end of the study. 80.5% of the patients reported erections of rigidity and duration enough for satisfactory sexual intercourse and 93.3% improved their erections at the end of the study. Adverse events were mild to moderate and the most common were headache, dyspepsia, rhinitis and facial flushing. The drop out rate due to adverse events was 1.7%. CONCLUSIONS: This multicenter study confirms the high efficacy of this new phosphodiesterase type 5 inhibitor, vardenafil. There was a low rate of discontinuations due to adverse events and a favorable safety profile. The results of this study are similar to the results of other studies conducted in other parts of the world.