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Article ; Online: Letter: Dismantling the Apocalypse Narrative: The Myth of the COVID-19 Stroke.

Miller, Aaron / Segan, Scott / Rehmani, Razia / Shabsigh, Ridwan / Rahme, Ralph

2020 Volume 87, Issue 6, Page(s) E703–E704

MeSH term(s)	COVID-19 ; Humans ; Narration ; SARS-CoV-2 ; Stroke
Keywords	covid19
Language	English
Publishing date	2020-09-04
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1093/neuros/nyaa419
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: REVITALISE: A Large Observational Study Assessing the Safety and Effectiveness of Vardenafil in Men With Erectile Dysfunction and Metabolic Syndrome.

Shabsigh, Ridwan / Mattern, Andreas

Sexual medicine

2016 Volume 4, Issue 3, Page(s) e135–44

Abstract: Introduction: Erectile dysfunction (ED) is prevalent in men with metabolic syndrome (MetS); therefore, it is important to characterize ED treatments in this population.: Aims: To investigate the safety and effectiveness of vardenafil in men with ED ... ...

Abstract	Introduction: Erectile dysfunction (ED) is prevalent in men with metabolic syndrome (MetS); therefore, it is important to characterize ED treatments in this population. Aims: To investigate the safety and effectiveness of vardenafil in men with ED and MetS in a clinical setting. Methods: REVITALISE is an international, prospective, single-arm, observational study in men with ED and MetS newly prescribed vardenafil. Vardenafil was prescribed at the discretion of the treating physician in line with the marketing authorization. Treatment effectiveness (International Index of Erectile Function [IIEF]) and health-related quality of life (Aging Males' Symptoms Scale) were assessed at treatment initiation, at an optional dose adjustment visit after approximately 4 weeks, and at the end of the observation period (approximately 12 weeks). Main outcome measures: The primary outcome was an intraindividual improvement in erectile function (EF), defined as an increase of at least four points in the EF domain of the IIEF. Secondary outcomes included assessing normal EF (IIEF-EF score ≥ 26), mild ED (IIEF-EF score = 22-25), and health-related quality of life. Treatment-emergent adverse events were monitored. Results: In the intent-to-treat population (n = 1,832, mean age = 54.0 years, mean body mass index = 31.82 kg/m(2), Asian 36.8%, white 49.9%, 20.4% with severe ED, 75.6% with mild or moderate ED, 4.0% without ED), 82.4% reported an increase of at least four points in IIEF-EF score. Median IIEF-EF score increased from 15.0 (baseline) to 25.0 at 12 weeks (P < .0001). After treatment, 45.4% and 29.4% (intent-to-treat population) had normal EF and mild ED, respectively. Improvements in the sexual, psychological, and somatic subscales of the Aging Males' Symptoms Scale were found (P < .0001). Treatment-emergent adverse events were reported by 7.19% of patients; there were no serious adverse events related to vardenafil. Conclusion: In a clinical setting, men with ED and MetS treated with vardenafil reported improvements in EF and health-related quality of life; and the safety profile of vardenafil was acceptable. REVITALISE demonstrates that vardenafil represents a good treatment option for men with ED and MetS.
Language	English
Publishing date	2016-04-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2734882-9
ISSN	2050-1161
ISSN	2050-1161
DOI	10.1016/j.esxm.2016.03.027
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Article ; Online: Ethics of Artificial Intelligence in Medicine and Ophthalmology.

Abdullah, Yasser Ibraheem / Schuman, Joel S / Shabsigh, Ridwan / Caplan, Arthur / Al-Aswad, Lama A

Asia-Pacific journal of ophthalmology (Philadelphia, Pa.)

2021 Volume 10, Issue 3, Page(s) 289–298

Abstract: Background: This review explores the bioethical implementation of artificial intelligence (AI) in medicine and in ophthalmology. AI, which was first introduced in the 1950s, is defined as "the machine simulation of human mental reasoning, decision ... ...

Abstract	Background: This review explores the bioethical implementation of artificial intelligence (AI) in medicine and in ophthalmology. AI, which was first introduced in the 1950s, is defined as "the machine simulation of human mental reasoning, decision making, and behavior". The increased power of computing, expansion of storage capacity, and compilation of medical big data helped the AI implementation surge in medical practice and research. Ophthalmology is a leading medical specialty in applying AI in screening, diagnosis, and treatment. The first Food and Drug Administration approved autonomous diagnostic system served to diagnose and classify diabetic retinopathy. Other ophthalmic conditions such as age-related macular degeneration, glaucoma, retinopathy of prematurity, and congenital cataract, among others, implemented AI too. Purpose: To review the contemporary literature of the bioethical issues of AI in medicine and ophthalmology, classify ethical issues in medical AI, and suggest possible standardizations of ethical frameworks for AI implementation. Methods: Keywords were searched on Google Scholar and PubMed between October 2019 and April 2020. The results were reviewed, cross-referenced, and summarized. A total of 284 references including articles, books, book chapters, and regulatory reports and statements were reviewed, and those that were relevant were cited in the paper. Results: Most sources that studied the use of AI in medicine explored the ethical aspects. Bioethical challenges of AI implementation in medicine were categorized into 6 main categories. These include machine training ethics, machine accuracy ethics, patient-related ethics, physician-related ethics, shared ethics, and roles of regulators. Conclusions: There are multiple stakeholders in the ethical issues surrounding AI in medicine and ophthalmology. Attention to the various aspects of ethics related to AI is important especially with the expanding use of AI. Solutions of ethical problems are envisioned to be multifactorial.
MeSH term(s)	Artificial Intelligence ; Diabetic Retinopathy ; Glaucoma/diagnosis ; Glaucoma/therapy ; Humans ; Ophthalmology
Language	English
Publishing date	2021-08-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2756329-7
ISSN	2162-0989 ; 2162-0989
ISSN (online)	2162-0989
ISSN	2162-0989
DOI	10.1097/APO.0000000000000397
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Article ; Online: Testosterone and Covid-19: An update.

Yassin, Aksam / Shabsigh, Ridwan / Al-Zoubi, Raed M / Aboumarzouk, Omar M / Alwani, Mustafa / Nettleship, Joanne / Kelly, Daniel

Reviews in medical virology

2022 Volume 33, Issue 1, Page(s) e2395

Abstract: There is overwhelming evidence to suggest that male gender is at a higher risk of developing more severe Covid-19 disease and thus having poorer clinical outcomes. However, the relationship between testosterone (T) and Covid-19 remains unclear with both ... ...

Abstract	There is overwhelming evidence to suggest that male gender is at a higher risk of developing more severe Covid-19 disease and thus having poorer clinical outcomes. However, the relationship between testosterone (T) and Covid-19 remains unclear with both protective and deleterious effects on different aspects of the disease suggested. Here, we review the current epidemiological and biological evidence on the role of testosterone in the process of SARS-CoV-2 infection and in mediating Covid-19 severity, its potential to serve as a biomarker for risk stratification and discuss the possibility of T supplementation as a treatment or preventative therapy for Covid-19.
MeSH term(s)	Male ; Humans ; COVID-19 ; SARS-CoV-2 ; Testosterone/therapeutic use
Chemical Substances	Testosterone (3XMK78S47O)
Language	English
Publishing date	2022-09-03
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	1086043-5
ISSN	1099-1654 ; 1052-9276
ISSN (online)	1099-1654
ISSN	1052-9276
DOI	10.1002/rmv.2395
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Article: Testosterone therapy in erectile dysfunction.

Shabsigh, R

The aging male : the official journal of the International Society for the Study of the Aging Male

2005 Volume 7, Issue 4, Page(s) 312–318

Abstract: Studies in animals have indicated that the nitric oxide erectile pathway is testosterone-dependent. Castration induces erectile dysfunction and a reduction in nitric oxide synthase-stained nerves in erectile tissue. Furthermore, castration adversely ... ...

Abstract	Studies in animals have indicated that the nitric oxide erectile pathway is testosterone-dependent. Castration induces erectile dysfunction and a reduction in nitric oxide synthase-stained nerves in erectile tissue. Furthermore, castration adversely affects penile hemodynamics and smooth muscle content, leading to veno-occlusive dysfunction. Testosterone replenishment reverses these physiological, biochemical and structural changes. Several clinical studies have demonstrated the benefits of a combination of testosterone and sildenafil. A recently published, multicenter study evaluated the safety and efficacy of testosterone gel 1% (Testogel; Schering AG, Germany/AndroGel; Solvay Pharmaceuticals) vs. placebo gel in conjunction with sildenafil, in producing an erectile response in hypogonadal men who did not respond to treatment with sildenafil alone for erectile dysfunction. The selection criteria required subjects to have had erectile dysfunction for at least 3 months, to be non-responsive to 100 mg sildenafil and to have low testosterone levels (< 400 ng/dl). The primary efficacy measurement was the mean change from baseline in the Erectile Function domain of the International Index of Erectile Function (IIEF). Secondary outcome measures included the mean change from baseline in the other domains and the total sum of the IIEF. Subjects were randomized to receive either testosterone gel + sildenafil, or placebo gel + sildenafil for 12 weeks. Testosterone therapy with testosterone gel improved the erectile response to sildenafil. Therefore, testosterone therapy may be considered for the treatment of erectile dysfunction in men with low to low-normal testosterone levels, who have failed prior treatment with sildenafil alone. Consequently, it is important to screen for hypogonadism in men who fail PDE5 inhibitors.
MeSH term(s)	Androgens/administration & dosage ; Androgens/therapeutic use ; Drug Therapy, Combination ; Erectile Dysfunction/drug therapy ; Erectile Dysfunction/etiology ; Gels ; Humans ; Hypogonadism/complications ; Male ; Phosphodiesterase Inhibitors/administration & dosage ; Testosterone/administration & dosage ; Testosterone/therapeutic use
Chemical Substances	Androgens ; Gels ; Phosphodiesterase Inhibitors ; Testosterone (3XMK78S47O)
Language	English
Publishing date	2005-03-04
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2108146-3
ISSN	1368-5538
ISSN	1368-5538
DOI	10.1080/13685530400016540
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Zs.A 5776: Show issues

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Article: Diagnosing premature ejaculation: a review.

Shabsigh, Ridwan

The journal of sexual medicine

2006 Volume 3 Suppl 4, Page(s) 318–323

Abstract: Introduction: Premature ejaculation (PE) is one of the most prevalent male sexual dysfunctions, yet it is frequently misdiagnosed or overlooked as a result of numerous patient and physician barriers. In particular, there is no universally used ... ...

Abstract	Introduction: Premature ejaculation (PE) is one of the most prevalent male sexual dysfunctions, yet it is frequently misdiagnosed or overlooked as a result of numerous patient and physician barriers. In particular, there is no universally used definition of the condition. There are no validated assessments or laboratory assays which distinguish men with PE from men without PE, and there are no risk factors or definitive correlates identified for this condition. Patients fail to seek medical help because of the stigma and embarrassment over the condition. In addition, patients (and clinicians) often misdiagnose PE as erectile dysfunction (ED). Aim: To review the barriers to diagnosing PE, the factors to consider in diagnosing PE and how to diagnose PE. Methods: The Sexual Medicine Society of North America hosted a State of the Art Conference on Premature Ejaculation on June 24-26, 2005 in collaboration with the University of South Florida. The purpose was to have an open exchange of contemporary research and clinical information on PE. There were 16 invited presenters and discussants; the group focused on several educational objectives. Main outcome measure: Data were utilized from the American Urological Association (AUA) Guideline on the Pharmacologic Management of Premature Ejaculation. Results: The AUA recommends the diagnosis of PE be based solely upon sexual history. In addition to a shortened latency time, recent research has identified three key factors associated with--and necessary for--a diagnosis of PE: (i) patient reports of reduced control over ejaculation; (ii) patient (and/or partner) reports of reduced satisfaction with sexual intercourse; and (iii) patient (and/or partner) distress over the condition. Conclusions: The diagnosis of PE is based upon sexual history of a shortened latency time, poor control over ejaculation, low satisfaction with intercourse, and distress regarding the condition.
MeSH term(s)	Adult ; Aged ; Ejaculation ; Erectile Dysfunction/diagnosis ; Humans ; Male ; Medical History Taking/methods ; Middle Aged ; Penile Erection ; Physical Examination/methods ; Practice Guidelines as Topic ; Sex Counseling/methods ; Sexual Dysfunction, Physiological/diagnosis ; Sexual Dysfunction, Physiological/epidemiology ; Sexual Dysfunction, Physiological/therapy ; Sexual Dysfunctions, Psychological/diagnosis ; Sexual Dysfunctions, Psychological/epidemiology ; Sexual Dysfunctions, Psychological/therapy ; United States/epidemiology
Language	English
Publishing date	2006-09
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2251959-2
ISSN	1743-6109 ; 1743-6095
ISSN (online)	1743-6109
ISSN	1743-6095
DOI	10.1111/j.1743-6109.2006.00307.x
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Zs.A 6417: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 505: Show issues

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Article ; Online: Sex-based differences in severity and mortality in COVID-19.

Alwani, Mustafa / Yassin, Aksam / Al-Zoubi, Raed M / Aboumarzouk, Omar M / Nettleship, Joanne / Kelly, Daniel / Al-Qudimat, Ahmad R / Shabsigh, Ridwan

Reviews in medical virology

2021 Volume 31, Issue 6, Page(s) e2223

Abstract: The current coronavirus disease (COVID-19) pandemic caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a male bias in severity and mortality. This is consistent with previous coronavirus pandemics such as SARS-CoV and MERS- ... ...

Abstract	The current coronavirus disease (COVID-19) pandemic caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a male bias in severity and mortality. This is consistent with previous coronavirus pandemics such as SARS-CoV and MERS-CoV, and viral infections in general. Here, we discuss the sex-disaggregated epidemiological data for COVID-19 and highlight underlying differences that may explain the sexual dimorphism to help inform risk stratification strategies and therapeutic options.
MeSH term(s)	Adaptive Immunity ; Angiotensin-Converting Enzyme 2/genetics ; Angiotensin-Converting Enzyme 2/immunology ; COVID-19/immunology ; COVID-19/mortality ; COVID-19/pathology ; COVID-19/prevention & control ; COVID-19 Vaccines/administration & dosage ; Female ; Gene Expression ; Hospitalization/statistics & numerical data ; Humans ; Immunity, Innate ; Male ; Receptors, Virus/genetics ; Receptors, Virus/immunology ; SARS-CoV-2/immunology ; SARS-CoV-2/pathogenicity ; Severity of Illness Index ; Sex Characteristics ; Sex Factors ; Survival Analysis ; Virus Internalization
Chemical Substances	COVID-19 Vaccines ; Receptors, Virus ; ACE2 protein, human (EC 3.4.17.23) ; Angiotensin-Converting Enzyme 2 (EC 3.4.17.23)
Language	English
Publishing date	2021-03-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1086043-5
ISSN	1099-1654 ; 1052-9276
ISSN (online)	1099-1654
ISSN	1052-9276
DOI	10.1002/rmv.2223
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Article: Testosterone therapy in erectile dysfunction and hypogonadism.

Shabsigh, Ridwan

The journal of sexual medicine

2005 Volume 2, Issue 6, Page(s) 785–792

Abstract: Introduction: Laboratory experiments indicate that the nitric oxide erectile pathway is testosterone-dependent. Castration induces erectile dysfunction (ED) and reduction in nitric oxide synthase and in phosphodiesterase type 5 (PDE5) in the erectile ... ...

Abstract	Introduction: Laboratory experiments indicate that the nitric oxide erectile pathway is testosterone-dependent. Castration induces erectile dysfunction (ED) and reduction in nitric oxide synthase and in phosphodiesterase type 5 (PDE5) in the erectile tissue. Furthermore, castration causes apoptosis adversely affecting smooth muscle content and penile hemodynamics leading to veno-occlusive dysfunction. Testosterone therapy reverses these structural, biochemical, and physiological changes. In humans, testosterone therapy improves erectile function in men with hypogonadism. However, the efficacy of testosterone monotherapy may not be adequate because of the multifactorial nature of the pathophysiology of ED. Methods: Preliminary data from a number of studies have been reviewed. Results: There are emerging evidence-based benefits to using the combination of testoterone and PDE5 inhibitors. A recently published multicenter, randomized, placebo-controlled study evaluated the safety and efficacy of testosterone gel 1% plus sildenafil vs. placebo gel plus sildenafil, in producing an erectile response in hypogonadal men who had failed prior sildenafil alone for ED. Screening yielded a prevalence of hypogonadism in ED patients who failed prior sildenafil. Following randomization, the double-blinded treatment phase was 12 weeks. Testosterone therapy with testosterone gel significantly improved erectile function in response to sildenafil. In addition, it significantly improved orgasmic function and patient satisfaction. Conclusion: It is important to screen all men with ED for hypogonadism, especially those with a history of inadequate response to prior PDE5 inhibitors. The combination of testosterone plus PDE5 inhibitors may be considered for the treatment of ED in men with low to low-normal testosterone levels, who had inadequate response to prior treatment with PDE5 inhibitors alone.
MeSH term(s)	Androgens/administration & dosage ; Androgens/therapeutic use ; Drug Therapy, Combination ; Erectile Dysfunction/drug therapy ; Gels ; Humans ; Hypogonadism/drug therapy ; Male ; Models, Animal ; Phosphodiesterase Inhibitors/administration & dosage ; Phosphodiesterase Inhibitors/therapeutic use ; Piperazines/administration & dosage ; Piperazines/therapeutic use ; Purines ; Sildenafil Citrate ; Sulfones ; Testosterone/administration & dosage ; Testosterone/therapeutic use
Chemical Substances	Androgens ; Gels ; Phosphodiesterase Inhibitors ; Piperazines ; Purines ; Sulfones ; Testosterone (3XMK78S47O) ; Sildenafil Citrate (BW9B0ZE037)
Language	English
Publishing date	2005-11
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2251959-2
ISSN	1743-6109 ; 1743-6095
ISSN (online)	1743-6109
ISSN	1743-6095
DOI	10.1111/j.1743-6109.2005.00139.x
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Zs.MO 505: Show issues

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Article: Hypogonadism and erectile dysfunction: the role for testosterone therapy.

Shabsigh, R

International journal of impotence research

2003 Volume 15 Suppl 4, Page(s) S9–13

Abstract: The role of low testosterone levels in erectile dysfunction (ED) remains unclear. Both organic and psychogenic factors contribute to ED, with vasculogenic causes being the most common etiology. Approximately 10-20% of patients with ED are diagnosed with ... ...

Abstract	The role of low testosterone levels in erectile dysfunction (ED) remains unclear. Both organic and psychogenic factors contribute to ED, with vasculogenic causes being the most common etiology. Approximately 10-20% of patients with ED are diagnosed with hormonal abnormalities. At the physiologic level, two second messenger systems are involved in mediating erections, one involving cyclic adenosine monophosphate (cAMP) and the other involving cyclic guanosine monophosphate (cGMP). PDE5 inhibitors such as sildenafil promote the cGMP pathway, while alprostadil affects the cAMP pathway. Evidence is strong that, in animal systems, testosterone has direct effects on erectile tissue. However, although testosterone clearly has an impact on libido in humans, its effect on penile function is less clear. Evaluation of ED includes medical, sexual, and psychosocial history assessments, as well as laboratory tests to check for diabetes and hormonal abnormalities. Initial interventions should involve correction of potentially reversible causes of ED, such as hypogonadism. First-line therapy for other patients is typically oral PDE5 inhibitors, such as sildenafil, tadalafil, or vardenafil. For patients who fail treatment with PDE5 inhibitors, local therapies such as intracavernous alprostadil are highly successful. Recent data also support the success of combination therapy with sildenafil and testosterone. This opens the possibility of other combinations of testosterone and other treatments of ED. The ability to exploit multiple pathways in the physiologic processes leading to erection may help improve therapy for ED.
MeSH term(s)	Adult ; Aged ; Drug Therapy, Combination ; Erectile Dysfunction/diagnosis ; Erectile Dysfunction/drug therapy ; Erectile Dysfunction/epidemiology ; Erectile Dysfunction/etiology ; Humans ; Hypogonadism/complications ; Male ; Middle Aged ; Penile Erection ; Testosterone/deficiency
Chemical Substances	Testosterone (3XMK78S47O)
Language	English
Publishing date	2003-08
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1034295-3
ISSN	1476-5489 ; 0955-9930
ISSN (online)	1476-5489
ISSN	0955-9930
DOI	10.1038/sj.ijir.3901030
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Article: Therapy of ED: PDE-5 Inhibitors.

Shabsigh, Ridwan

Endocrine

2004 Volume 23, Issue 2-3, Page(s) 135–141

Abstract: The development of phosphodiesterase inhibitors, which are selective for the type 5 isoenzyme, has revolutionized the initial evaluation and treatment of men with erectile dysfunction. These agents can be taken orally and are effective in 60-70% of ... ...

Abstract	The development of phosphodiesterase inhibitors, which are selective for the type 5 isoenzyme, has revolutionized the initial evaluation and treatment of men with erectile dysfunction. These agents can be taken orally and are effective in 60-70% of patients with erectile dysfunction, and they have low incidences of side effects when taken as recommended. The major contraindications are concomitant use with nitrates or the alpha-blockers terazosin and doxazosin. The major difference in the three approved inhibitors is that tadalafil has a considerably longer serum half-life, which provides a longer window of opportunity and potentially side effects.
MeSH term(s)	Carbolines/adverse effects ; Carbolines/therapeutic use ; Dose-Response Relationship, Drug ; Erectile Dysfunction/drug therapy ; Humans ; Imidazoles/adverse effects ; Imidazoles/therapeutic use ; Male ; Phosphodiesterase Inhibitors/therapeutic use ; Piperazines/administration & dosage ; Piperazines/adverse effects ; Piperazines/metabolism ; Piperazines/therapeutic use ; Purines ; Sildenafil Citrate ; Sulfones ; Tadalafil ; Treatment Outcome ; Triazines ; Vardenafil Dihydrochloride
Chemical Substances	Carbolines ; Imidazoles ; Phosphodiesterase Inhibitors ; Piperazines ; Purines ; Sulfones ; Triazines ; Vardenafil Dihydrochloride (5O8R96XMH7) ; Tadalafil (742SXX0ICT) ; Sildenafil Citrate (BW9B0ZE037)
Language	English
Publishing date	2004-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1194484-5
ISSN	1355-008X ; 0969-711X
ISSN	1355-008X ; 0969-711X
DOI	10.1385/ENDO:23:2-3:135
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