An initial study on the effect of functional electrical stimulation in erectile dysfunction: a randomized controlled trial.

Erectile dysfunction (ED) affects approximately 150 million men worldwide. Functional electrical stimulation (FES) therapy has shown a high regenerative capacity for smooth muscle cells and, therefore, is being increasingly adopted. FES can be a beneficial treatment option when the cause of ED is related to degeneration of cavernous smooth muscle. To evaluate the impact of FES on erectile function in men with erectile dysfunction. Twenty-two patients with ED participated in this randomized clinical trial. Participants were randomly assigned to two groups: intervention (IG) or control (CG). IG participants underwent FES therapy (50 Hz/500 µs) for a total of 4 weeks, divided into two weekly sessions lasting 15 min each, with intensity lower than the motor threshold. CG participants were treated with placebo FES and followed the same routine as the IG. Erectile function was assessed by the validated International Index of Erectile Function (IIEF-5) and Erection Hardness Score (EHS), applied before and after treatment, and quality of life, by the WHOQOL questionnaire. Statistically significant differences in IIEF-5 and EHS were found between the IG and CG after treatment (p < 0.05), as well as a within-group difference in the IG when comparing the post-treatment periods (p < 0.0001) The WHOQOL revealed a significant difference between CG and IG after treatment (p < 0.05), as well as a within-group difference in the IG after treatment (p < 0.0001), except in the Environment domain, in which there was no difference between the pre- and post-treatment periods (50.9 ± 2.8 pre vs. 52.3 ± 3.1 post). This trial showed that FES therapy may improve erectile function and quality of life in men with ED.

Evaluation of acute radiation effects on mandibular movements of patients with head and neck cancer.

OBJECTIVES: To evaluate radiotherapy effects (RT) on mandibular movements of patients with head and neck cancer (H&NC) and associate them to the variables: functional capacity, radiation field, disease staging, type of feeding, concomitant chemotherapy and total dose of RT. METHODS: Twenty-six patients with H&NC were followed up at the RT service. Physical examination was performed in 3 follow up time points: before the beginning of RT (T0), between 14th and 17th session of RT (T1) and after the last session of RT (T2). The physical examination consisted of the assessment of the following variables: mouth opening without pain (MO), maximum mouth opening (MMO), right lateral excursion (RLE), left lateral excursion (LLE) and protrusion (PR) of the jaw. The feeding type and the Karnofsky Performance Status Scale (KPS) were evaluated in each follow up time point. Data with regards to the tumor lesion and the RT were collected from the patient's clinical notes. RESULTS: There was a statistical significant reduction in the values of MO (p=0.006), MMO (p=0.001), LLE (p=0.006) and KPS (p=0.001). There was significant a statistical association among the reduction in KPS and decreased measure of MO (r=0.390, p=0.048) and MMO (r=0.435, p=0.026). The mouth and oropharynx radiation fields when combined showed a significant reduction for both the measure of MO (p=0.005) and for MMO (p=0.004). Patients who used nasoenteric tube feeding (NTF) had greater reduction in the measurement of MMO (p=0.031). The remaining variables showed no statistically significant difference. CONCLUSION: Patients with H&NC present reduction of the measures of MO and MMO during the RT, especially if they present reduced functional capacity, have radiation in the mouth and oropharynx fields and used NTF.

Evaluation of acute radiation effects on mandibular movements of patients with head and neck cancer / Avaliação dos efeitos agudos da radioterapia sobre os movimentos mandibulares de pacientes com câncer de cabeça e pescoço

OBJECTIVES: To evaluate radiotherapy effects (RT) on mandibular movements of patients with head and neck cancer (H&NC) and associate them to the variables: functional capacity, radiation field, disease staging, type of feeding, concomitant chemotherapy and total dose of RT. METHODS: Twenty-six patients with H&NC were followed up at the RT service. Physical examination was performed in 3 follow up time points: before the beginning of RT (T0), between 14th and 17th session of RT (T1) and after the last session of RT (T2). The physical examination consisted of the assessment of the following variables: mouth opening without pain (MO), maximum mouth opening (MMO), right lateral excursion (RLE), left lateral excursion (LLE) and protrusion (PR) of the jaw. The feeding type and the Karnofsky Performance Status Scale (KPS) were evaluated in each follow up time point. Data with regards to the tumor lesion and the RT were collected from the patient's clinical notes. RESULTS: There was a statistical significant reduction in the values of MO (p=0.006), MMO (p=0.001), LLE (p=0.006) and KPS (p=0.001). There was significant a statistical association among the reduction in KPS and decreased measure of MO (r=0.390, p=0.048) and MMO (r=0.435, p=0.026). The mouth and oropharynx radiation fields when combined showed a significant reduction for both the measure of MO (p=0.005) and for MMO (p=0.004). Patients who used nasoenteric tube feeding (NTF) had greater reduction in the measurement of MMO (p=0.031). The remaining variables showed no statistically significant difference. CONCLUSION: Patients with H&NC present reduction of the measures of MO and MMO during the RT, especially if they present reduced functional capacity, have radiation in the mouth and oropharynx fields and used NTF.

OBJETIVOS: Avaliar os efeitos da radioterapia (RT) sobre os movimentos mandibulares de pacientes com câncer de cabeça e pescoço (CCeP) e associá-los às variáveis: capacidade funcional, campo de radiação, estadiamento da doença, tipo de alimentação, quimioterapia concomitante e dose total de RT. MÉTODOS: Vinte e seis pacientes com CCeP foram acompanhados em um serviço de RT. O exame físico ocorreu em três momentos: antes do início da RT (M0), entre a 14º e 17º sessão (M1) e após a última sessão de RT (M2) para verificação de variáveis, como: abertura bucal sem dor (AB), abertura bucal máxima (ABm), excursão lateral direita (EXd), excursão lateral esquerda (EXe) e protrusão (PR) da mandíbula. O tipo de alimentação e a Escala de Karnofsky (EK) foram reavaliados em cada momento. Dados a respeito da lesão tumoral e RT foram coletados do prontuário do paciente. RESULTADOS: Houve redução significativa nos valores de AB (p=0,006), ABm (p=0,001), EXe (p=0,006) e EK (p=0,001). Houve associação estatisticamente significativa entre a redução na EK e a diminuição de AB (r=0,390; p=0,048) e de ABm (r=0,435; p=0,026). Os campos de radiação da boca e orofaringe, quando agrupados, apresentaram redução significativa tanto para a medida de AB (p=0,005) quanto para ABm (p=0,004). Os pacientes que utilizaram sonda nasoentérica (SNE) apresentaram maior redução da medida de ABm (p=0,031). As demais variáveis não apresentaram diferença estatisticamente significativa. CONCLUSÃO: Os pacientes com CCeP apresentam redução das medidas de AB e ABm no decorrer da RT, principalmente se apresentarem redução da capacidade funcional, tiverem irradiação para os campos da boca e orofaringe e fizerem uso de SNE.