human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Objectives : To compare the clinical efficacy of the on-dem and use of four drugs in the management of patients with premature ejaculation ( PE ) , as the off-label use of selective serotonin-reuptake inhibitors and topical penile anaesthetics is frequently indicated for the management of patients with PE , and tramadol HCl and sildenafil citrate were also tried for managing this disorder , but with recommendations based on weak evidence . Patients and methods : This was a single-centre , single-blind , placebo-controlled clinical trial conducted on 150 patients who had PE for > 1 year . Patients were r and omised equally into five groups .  On-dem and tramadol , sildenafil , paroxetine , local lidocaine gel or placebo was given for patients in groups 1–5 , respectively . During the month before treatment , the intravaginal ejaculation latency time ( IELT ) and sexual satisfaction scores ( on a 0–5-point scale ) were measured and compared to the mean IELT and sexual satisfaction scores recorded during 4 weeks of on-dem and drug administration , with monitoring of any possible side-effects . Results : Tramadol-treated patients had a significantly longer mean ( SD ) IELT , of 351 ( 119 ) s , than the other groups . Local anaesthetic was significantly better than paroxetine in prolonging the IELT , at 278 ( 111 ) vs. 186 ( 65 ) s , respectively . The improvement in sexual satisfaction was significantly better in the sildenafil group , with a mean ( SD ) improvement of 2.9 ( 1 ) points , than in the paroxetine and local anaesthetic groups , at 2.2 ( 0.9 ) and 1.9 ( 0.9 ) points , respectively . Conclusions : The four drugs significantly improved IELT values over placebo . Tramadol was associated with significantly longer IELT values , whilst sildenafil induced significantly better sexual satisfaction than the other drugs . The four drugs had tolerable side-effects BACKGROUND No drugs are approved for treatment of premature ejaculation . Our aim was to determine the efficacy and tolerability of on-dem and dapoxetine in patients with severe premature ejaculation . METHODS We determined the efficacy of dapoxetine in a prospect ively predefined integrated analysis of two 12-week r and omised , double-blind , placebo-controlled , phase III trials of identical design done independently , in parallel , at 121 sites in the USA . Men with moderate-to-severe premature ejaculation in stable , heterosexual relationships took placebo  ( n=870 ) , 30 mg dapoxetine ( 874 ) , or 60 mg dapoxetine ( 870 ) on-dem and ( as needed , 1 - 3 h before anticipated sexual activity ) . The primary endpoint was intravaginal ejaculatory latency time ( IELT ) measured by stopwatch . Safety and tolerability were assessed . All analyses were done on an intention-to-treat basis . The trials are registered at Clinical Trials.gov , numbers NCT00211107 and NCT00211094 . FINDINGS 672 , 676 , and 610 patients completed in the placebo , 30 mg dapoxetine , and 60 mg dapoxetine groups , respectively . Dapoxetine significantly prolonged IELT ( p<0.0001 , all doses vs placebo ) . Mean IELT at baseline was 0.90 ( SD 0.47 ) minute , 0.92 ( 0.50 ) minute , and 0.91 ( 0.48 ) minute , and at study endpoint ( week 12 or final visit ) was 1.75 ( 2.21 ) minutes for placebo , 2.78 ( 3.48 ) minutes for 30 mg dapoxetine , and 3.32 ( 3.68 ) minutes for 60 mg dapoxetine . Both dapoxetine doses were effective on the first dose . Common adverse events ( 30 mg and 60 mg dapoxetine , respectively ) were nausea ( 8.7 % , 20.1 % ) , diarrhoea ( 3.9 % , 6.8 % ) , headache ( 5.9 % , 6.8 % ) , and dizziness ( 3.0 % , 6.2 % ) . INTERPRETATION On-dem and dapoxetine is an effective and generally well tolerated treatment for men with moderate-to-severe premature ejaculation PURPOSE Fluoxetine , a selective serotonin re-uptake inhibitor , has been shown to increase the intravaginal latency of patients with premature ejaculation . We demonstrated the effects of fluoxetine on intravaginal latency , penile sensory threshold , and variables of sacral evoked response and cortical somatosensorial evoked potential in patients with premature ejaculation . MATERIAL S AND METHODS Of 48 patients 40 who presented to our clinic with premature ejaculation met the study criteria , gave written or oral consent , and were divided r and omly in a double-blind fashion into 2 groups of 20 patients . The study group received 20 mg . fluoxetine daily and the control group received placebo for 1 month . The patients were evaluated during visits before and after treatment for intravaginal latency , penile sensory threshold values , and the variables of sacral evoked response and cortical somatosensory evoked potential tests . RESULTS Patient ages , intravaginal latencies , penile sensory threshold values , and amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential tests in both groups were not significantly different at the beginning of treatment ( p > 0.05 ) . At the end of treatment intravaginal latencies and penile sensory threshold values were increased in the study group compared to before treatment and the control group ( p < 0.05 ) . No change was observed in either group for the amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential tests ( p > 0.05 ) . CONCLUSIONS These findings suggest that fluoxetine is effective treatment for premature ejaculation probably due to its effect of increasing the penile sensory threshold , without changing the amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential BACKGROUND Dapoxetine is being developed for the on-dem and treatment of premature ejaculation ( PE ) . Previous clinical trials have demonstrated its safety and efficacy . OBJECTIVE To evaluate the long-term efficacy and safety of dapoxetine in men with PE . DESIGN , SETTING , AND PARTICIPANTS This r and omized , double-blind , parallel-group , placebo-controlled , phase 3 trial , conducted in 22 countries , enrolled men ( N=1162 ) > or = 18 yr of age who met the Diagnostic and Statistical Manual of Mental Disorders , fourth edition , text revision criteria for PE for > or = 6 mo , with an intravaginal ejaculatory latency time ( IELT ) < or = 2 min in > or = 75 % of intercourse episodes at baseline . INTERVENTION Dapoxetine 30 mg or dapoxetine 60 mg or placebo on dem and ( 1 - 3 h before intercourse ) for 24 wk . MEASUREMENTS Stopwatch-measured IELT , Premature Ejaculation Profile ( PEP ) , Clinical Global Impression ( CGI ) of change , adverse events ( AEs ) . RESULTS AND LIMITATIONS The study was completed by 618 men .  Mean average IELT increased from 0.9 min at baseline ( all groups ) to 1.9 min , 3.2 min , and 3.5 min with placebo and dapoxetine 30 mg and dapoxetine 60 mg , respectively , at study end point ; geometric mean IELT increased from 0.7 min at baseline to 1.1 min , 1.8 min , and 2.3 min , respectively , at study end point . All PEP measures and IELTs improved significantly with dapoxetine versus placebo at week 12 and week 24 ( p<0.001 for all ) . The most common AEs were nausea , dizziness , diarrhea , and headache . AEs led to discontinuation in 1.3 % , 3.9 % , and 8.2 % of subjects with placebo and dapoxetine 30 mg and dapoxetine 60 mg , respectively . Limitations of this study included the exclusion of men who were not in long-term monogamous relationships . CONCLUSIONS Dapoxetine significantly improved all aspects of PE and was generally well tolerated in this broad population Background : Several recent studies have investigated the therapeutic role of phosphodiesterase type 5 ( PDE5 ) inhibitors in premature ejaculation ( PE ) used in the treatment of erectile dysfunction . Objectives : In the present research , the efficacy of paroxetine alone and paroxetine plus tadalafil was compared in patients referred because of premature ejaculation . Patients and Methods : This quasi-experimental study was performed on 100 consecutive 17 to 49-year-old potent men with premature ejaculation and without any clear organic disease . All patients had lifelong PE with an intravaginal ejaculation latency time ( IELT ) shorter than 1.5 minutes . Informed consent was obtained from all patients who were r and omly divided into two groups using a computer-generated r and om tabulation list . In group A , patients received 10 mg paroxetine daily , in addition to four hours before planned sexual activity . In group B , 10 mg paroxetine was taken daily , plus 10 mg tadalafil one hour before planned sexual activity . The duration of the intervention was six months and patients were evaluated for IELT three and six months after the beginning of therapy . Results : The mean age of patients in groups A and B were 33 ± 9.6 and 31.2 ± 9.3 years , respectively ( P = 0.368 ) . The mean number of intercourses were 1.08 ± 0.6 and 1.12 ± 0.6 per week in groups A and B , respectively ( P = 0.791 ) . Mean IELT at the 3-month follow up in groups A and B was 4.5 ± 1.5 and 5 ± 2.4 minutes , respectively ( P = 0.285 ) and at the 6-month follow up was 4.8 ± 1 and 5.3 ± 2 minutes , respectively ( P = 0.278 ) . Conclusions : The results of the study show that tadalafil can increase the mean IELT and can be used for treatment of premature ejaculation in combination with paroxetine Depression is a common cause of sexual dysfunction , but also antidepressant medication is often associated with sexual side effects . This article includes two related studies . The first double-blind , placebo-controlled study was conducted in men with lifelong rapid ejaculation and aim ed to assess putative differences between the major selective serotonin reuptake inhibitors ( SSRIs ) ( fluoxetine , fluvoxamine , paroxetine , and sertraline ) with regard to their ejaculation-delaying effect .  Sixty men with an intravaginal ejaculation latency time ( IELT ) of 1 minute or less were r and omly assigned to receive fluoxetine 20 mg/day , fluvoxamine 100 mg/day , paroxetine 20 mg/day , sertraline 50 mg/day , or placebo for 6 weeks . During the 1-month baseline and 6-week treatment periods , the men measured their IELT at home using a stopwatch . The trial was completed by 51 men . During the 6-week treatment period , the geometric mean IELT in the placebo group was constant at approximately 20 seconds . Analysis of variance revealed a between-groups difference in the evolution of IELT delay ( p = 0.0004 ) ; in the paroxetine , fluoxetine , and sertraline groups there was a gradual increase to about 110 seconds , whereas in the fluvoxamine group , IELT was increased to only approximately 40 seconds . The paroxetine , fluoxetine , and sertraline groups differed significantly ( p < 0.001 , p < 0.001 , p = 0.017 , respectively ) from placebo but the fluvoxamine group did not ( p = 0.38 ) . Compared with baseline , paroxetine exerted the strongest delay in ejaculation , followed by fluoxetine and sertraline . There was no clinical ly relevant delay in ejaculation with fluvoxamine . In men with lifelong rapid ejaculation , paroxetine  delayed ejaculation most strongly , whereas fluvoxamine delayed ejaculation the least . The second double-blind , placebo-controlled study was carried out in men with lifelong rapid ejaculation ( IELT < or = 1 minute ) and in men with lifelong less-rapid ejaculation ( IELT > 1 minute ) to investigate whether data about SSRI-induced delayed ejaculation in men with rapid ejaculation may be extrapolated to men with less-rapid ejaculation . After measurement of IELT at home ( using a stopwatch ) during a 1-month baseline assessment , 32 men with an IELT of 1 minute or less ( group 1 ) or more than 1 minute ( group 2 ) were r and omly assigned to receive paroxetine 20 mg/day or placebo for 6 weeks in a double-blind manner . Patients continued to measure their IELTs at home during the 6 weeks of the study . At baseline , 24 patients consistently had IELTs of one minute or less ( group 1 ) , and eight patients had IELTs of more than 1 minute ( group 
    Output:
    
agent
Conclusions PDE5Is were significantly more effective than placebo or SSRIs for treating PE , while SSRIs were better than placebo .
The combined treatment had better efficacy than PDE5Is or SSRIs alone
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Objectives : To compare the clinical efficacy of the on-dem and use of four drugs in the management of patients with premature ejaculation ( PE ) , as the off-label use of selective serotonin-reuptake inhibitors and topical penile anaesthetics is frequently indicated for the management of patients with PE , and tramadol HCl and sildenafil citrate were also tried for managing this disorder , but with recommendations based on weak evidence . Patients and methods : This was a single-centre , single-blind , placebo-controlled clinical trial conducted on 150 patients who had PE for > 1 year . Patients were r and omised equally into five groups .  On-dem and tramadol , sildenafil , paroxetine , local lidocaine gel or placebo was given for patients in groups 1–5 , respectively . During the month before treatment , the intravaginal ejaculation latency time ( IELT ) and sexual satisfaction scores ( on a 0–5-point scale ) were measured and compared to the mean IELT and sexual satisfaction scores recorded during 4 weeks of on-dem and drug administration , with monitoring of any possible side-effects . Results : Tramadol-treated patients had a significantly longer mean ( SD ) IELT , of 351 ( 119 ) s , than the other groups . Local anaesthetic was significantly better than paroxetine in prolonging the IELT , at 278 ( 111 ) vs. 186 ( 65 ) s , respectively . The improvement in sexual satisfaction was significantly better in the sildenafil group , with a mean ( SD ) improvement of 2.9 ( 1 ) points , than in the paroxetine and local anaesthetic groups , at 2.2 ( 0.9 ) and 1.9 ( 0.9 ) points , respectively . Conclusions : The four drugs significantly improved IELT values over placebo . Tramadol was associated with significantly longer IELT values , whilst sildenafil induced significantly better sexual satisfaction than the other drugs . The four drugs had tolerable side-effects BACKGROUND No drugs are approved for treatment of premature ejaculation . Our aim was to determine the efficacy and tolerability of on-dem and dapoxetine in patients with severe premature ejaculation . METHODS We determined the efficacy of dapoxetine in a prospect ively predefined integrated analysis of two 12-week r and omised , double-blind , placebo-controlled , phase III trials of identical design done independently , in parallel , at 121 sites in the USA . Men with moderate-to-severe premature ejaculation in stable , heterosexual relationships took placebo  ( n=870 ) , 30 mg dapoxetine ( 874 ) , or 60 mg dapoxetine ( 870 ) on-dem and ( as needed , 1 - 3 h before anticipated sexual activity ) . The primary endpoint was intravaginal ejaculatory latency time ( IELT ) measured by stopwatch . Safety and tolerability were assessed . All analyses were done on an intention-to-treat basis . The trials are registered at Clinical Trials.gov , numbers NCT00211107 and NCT00211094 . FINDINGS 672 , 676 , and 610 patients completed in the placebo , 30 mg dapoxetine , and 60 mg dapoxetine groups , respectively . Dapoxetine significantly prolonged IELT ( p<0.0001 , all doses vs placebo ) . Mean IELT at baseline was 0.90 ( SD 0.47 ) minute , 0.92 ( 0.50 ) minute , and 0.91 ( 0.48 ) minute , and at study endpoint ( week 12 or final visit ) was 1.75 ( 2.21 ) minutes for placebo , 2.78 ( 3.48 ) minutes for 30 mg dapoxetine , and 3.32 ( 3.68 ) minutes for 60 mg dapoxetine . Both dapoxetine doses were effective on the first dose . Common adverse events ( 30 mg and 60 mg dapoxetine , respectively ) were nausea ( 8.7 % , 20.1 % ) , diarrhoea ( 3.9 % , 6.8 % ) , headache ( 5.9 % , 6.8 % ) , and dizziness ( 3.0 % , 6.2 % ) . INTERPRETATION On-dem and dapoxetine is an effective and generally well tolerated treatment for men with moderate-to-severe premature ejaculation PURPOSE Fluoxetine , a selective serotonin re-uptake inhibitor , has been shown to increase the intravaginal latency of patients with premature ejaculation . We demonstrated the effects of fluoxetine on intravaginal latency , penile sensory threshold , and variables of sacral evoked response and cortical somatosensorial evoked potential in patients with premature ejaculation . MATERIAL S AND METHODS Of 48 patients 40 who presented to our clinic with premature ejaculation met the study criteria , gave written or oral consent , and were divided r and omly in a double-blind fashion into 2 groups of 20 patients . The study group received 20 mg . fluoxetine daily and the control group received placebo for 1 month . The patients were evaluated during visits before and after treatment for intravaginal latency , penile sensory threshold values , and the variables of sacral evoked response and cortical somatosensory evoked potential tests . RESULTS Patient ages , intravaginal latencies , penile sensory threshold values , and amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential tests in both groups were not significantly different at the beginning of treatment ( p > 0.05 ) . At the end of treatment intravaginal latencies and penile sensory threshold values were increased in the study group compared to before treatment and the control group ( p < 0.05 ) . No change was observed in either group for the amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential tests ( p > 0.05 ) . CONCLUSIONS These findings suggest that fluoxetine is effective treatment for premature ejaculation probably due to its effect of increasing the penile sensory threshold , without changing the amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential BACKGROUND Dapoxetine is being developed for the on-dem and treatment of premature ejaculation ( PE ) . Previous clinical trials have demonstrated its safety and efficacy . OBJECTIVE To evaluate the long-term efficacy and safety of dapoxetine in men with PE . DESIGN , SETTING , AND PARTICIPANTS This r and omized , double-blind , parallel-group , placebo-controlled , phase 3 trial , conducted in 22 countries , enrolled men ( N=1162 ) > or = 18 yr of age who met the Diagnostic and Statistical Manual of Mental Disorders , fourth edition , text revision criteria for PE for > or = 6 mo , with an intravaginal ejaculatory latency time ( IELT ) < or = 2 min in > or = 75 % of intercourse episodes at baseline . INTERVENTION Dapoxetine 30 mg or dapoxetine 60 mg or placebo on dem and ( 1 - 3 h before intercourse ) for 24 wk . MEASUREMENTS Stopwatch-measured IELT , Premature Ejaculation Profile ( PEP ) , Clinical Global Impression ( CGI ) of change , adverse events ( AEs ) . RESULTS AND LIMITATIONS The study was completed by 618 men .  Mean average IELT increased from 0.9 min at baseline ( all groups ) to 1.9 min , 3.2 min , and 3.5 min with placebo and dapoxetine 30 mg and dapoxetine 60 mg , respectively , at study end point ; geometric mean IELT increased from 0.7 min at baseline to 1.1 min , 1.8 min , and 2.3 min , respectively , at study end point . All PEP measures and IELTs improved significantly with dapoxetine versus placebo at week 12 and week 24 ( p<0.001 for all ) . The most common AEs were nausea , dizziness , diarrhea , and headache . AEs led to discontinuation in 1.3 % , 3.9 % , and 8.2 % of subjects with placebo and dapoxetine 30 mg and dapoxetine 60 mg , respectively . Limitations of this study included the exclusion of men who were not in long-term monogamous relationships . CONCLUSIONS Dapoxetine significantly improved all aspects of PE and was generally well tolerated in this broad population Background : Several recent studies have investigated the therapeutic role of phosphodiesterase type 5 ( PDE5 ) inhibitors in premature ejaculation ( PE ) used in the treatment of erectile dysfunction . Objectives : In the present research , the efficacy of paroxetine alone and paroxetine plus tadalafil was compared in patients referred because of premature ejaculation . Patients and Methods : This quasi-experimental study was performed on 100 consecutive 17 to 49-year-old potent men with premature ejaculation and without any clear organic disease . All patients had lifelong PE with an intravaginal ejaculation latency time ( IELT ) shorter than 1.5 minutes . Informed consent was obtained from all patients who were r and omly divided into two groups using a computer-generated r and om tabulation list . In group A , patients received 10 mg paroxetine daily , in addition to four hours before planned sexual activity . In group B , 10 mg paroxetine was taken daily , plus 10 mg tadalafil one hour before planned sexual activity . The duration of the intervention was six months and patients were evaluated for IELT three and six months after the beginning of therapy . Results : The mean age of patients in groups A and B were 33 ± 9.6 and 31.2 ± 9.3 years , respectively ( P = 0.368 ) . The mean number of intercourses were 1.08 ± 0.6 and 1.12 ± 0.6 per week in groups A and B , respectively ( P = 0.791 ) . Mean IELT at the 3-month follow up in groups A and B was 4.5 ± 1.5 and 5 ± 2.4 minutes , respectively ( P = 0.285 ) and at the 6-month follow up was 4.8 ± 1 and 5.3 ± 2 minutes , respectively ( P = 0.278 ) . Conclusions : The results of the study show that tadalafil can increase the mean IELT and can be used for treatment of premature ejaculation in combination with paroxetine Depression is a common cause of sexual dysfunction , but also antidepressant medication is often associated with sexual side effects . This article includes two related studies . The first double-blind , placebo-controlled study was conducted in men with lifelong rapid ejaculation and aim ed to assess putative differences between the major selective serotonin reuptake inhibitors ( SSRIs ) ( fluoxetine , fluvoxamine , paroxetine , and sertraline ) with regard to their ejaculation-delaying effect .  Sixty men with an intravaginal ejaculation latency time ( IELT ) of 1 minute or less were r and omly assigned to receive fluoxetine 20 mg/day , fluvoxamine 100 mg/day , paroxetine 20 mg/day , sertraline 50 mg/day , or placebo for 6 weeks . During the 1-month baseline and 6-week treatment periods , the men measured their IELT at home using a stopwatch . The trial was completed by 51 men . During the 6-week treatment period , the geometric mean IELT in the placebo group was constant at approximately 20 seconds . Analysis of variance revealed a between-groups difference in the evolution of IELT delay ( p = 0.0004 ) ; in the paroxetine , fluoxetine , and sertraline groups there was a gradual increase to about 110 seconds , whereas in the fluvoxamine group , IELT was increased to only approximately 40 seconds . The paroxetine , fluoxetine , and sertraline groups differed significantly ( p < 0.001 , p < 0.001 , p = 0.017 , respectively ) from placebo but the fluvoxamine group did not ( p = 0.38 ) . Compared with baseline , paroxetine exerted the strongest delay in ejaculation , followed by fluoxetine and sertraline . There was no clinical ly relevant delay in ejaculation with fluvoxamine . In men with lifelong rapid ejaculation , paroxetine  delayed ejaculation most strongly , whereas fluvoxamine delayed ejaculation the least . The second double-blind , placebo-controlled study was carried out in men with lifelong rapid ejaculation ( IELT < or = 1 minute ) and in men with lifelong less-rapid ejaculation ( IELT > 1 minute ) to investigate whether data about SSRI-induced delayed ejaculation in men with rapid ejaculation may be extrapolated to men with less-rapid ejaculation . After measurement of IELT at home ( using a stopwatch ) during a 1-month baseline assessment , 32 men with an IELT of 1 minute or less ( group 1 ) or more than 1 minute ( group 2 ) were r and omly assigned to receive paroxetine 20 mg/day or placebo for 6 weeks in a double-blind manner . Patients continued to measure their IELTs at home during the 6 weeks of the study . At baseline , 24 patients consistently had IELTs of one minute or less ( group 1 ) , and eight patients had IELTs of more than 1 minute ( group 
    Output:
    