Approach to the Patient: Erectile Dysfunction
A good physician-patient relationship helps to unravel the possible causes of ED, many of which require discussion of personal and sometimes embarrassing topics. For this reason, a primary care provider is often ideally suited to initiate the evaluation. A complete medical and sexual history should be taken in an effort to assess whether the cause of ED is organic, psychogenic, or multifactorial (Fig. 492). Initial questions should focus on the onset of symptoms, the presence and duration of partial erections, and the progression of ED.
Female Sexual Dysfunction: Treatment
General An open discussion with the patient is important as couples may need to be educated about normal anatomy and physiologic responses, including role of orgasm in sexual encounters. Physiologic changes associated with aging and/or disease should be explained. Couples may need to be reminded that clitoral stimulation rather than coital intromission may be more beneficial.
Behavioral modification and nonpharmacologic therapies should be a first step. Patient and partner counseling may improve communication and relationship strains.
Male Sexual Dysfunction: Treatment
Patient Education Patient and partner education is essential in the treatment of ED. In goaldirected therapy, education facilitates understanding of the disease, results of the tests, and selection of treatment. Discussion of treatment options helps to clarify how treatment is best offered and stratify first- and second-line therapies. Patients with high-risk lifestyle issues, such as smoking, alcohol abuse, or recreational drug use, should be counseled on the role these factors play in the development of ED.
Tham khảo sách 'erectile dysfunction – disease-associated mechanisms and novel insights into therapy edited by kenia pedrosa nunes', y tế - sức khoẻ, y học thường thức phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả
The risk of sudden death from cardiac causes is increased among survivors of acute
myocardial infarction with reduced left ventricular systolic function. We assessed the
risk and time course of sudden death in high-risk patients after myocardial infarction.
We studied 14,609 patients with left ventricular dysfunction, heart failure, or both after
myocardial infarction to assess the incidence and timing of sudden unexpected death
or cardiac arrest with resuscitation in relation to the left ventricular ejection fraction....
Defects in insulin secretion by pancreatic cells and⁄or decreased sensitivity
of target tissues to insulin action are the key features of type 2 diabetes. It
has been shown that excessive generation of reactive oxygen species (ROS)
is linked to glucose-induced b-cell dysfunction.
Obesity is associated with a high prevalence of erectile dysfunction; how-ever, the pathophysiological link between obesity and erectile dysfunction
remains poorly understood. In this minireview, we have attempted to eval-uate the existing literature pertaining to obesity and erectile dysfunction to
determine whether a common pathophysiological link exists.
From clinical studies sepsis can be seen as a continuum of severity that begins with an
infection, followed in some cases by sepsis, severe sepsis – with organ dysfunction – and
septic shock. There has been a substantial increase in the incidence of sepsis during the last
decades, and it appears to be rising over time, with an increasing number of deaths
occurring despite a decline in overall in-hospital mortality (Bone, 1992).
Improve Your Thinking, Improve Your Life, Can Your Thinking Be Your Problem, A How-to List for Dysfunctional Living, Taking Thinking Seriously, No Intellectual Pain, No Intellectual Gain, The Twenty Five Day Plan,... To help you answer the questions above, you are invited to consult the ebook content "25 days to better thinking and better living".
The area of treatment of sexual disorders has undergone an enormous expansion
during the last few decades. The introduction of pharmacological treatment of
these disorders (e.g., sildenafil for erectile dysfunction or antidepressants for
paraphilias) rekindled the interest of physicians from different disciplines
(psychiatrists, urologists, gynecologists) in sexual dysfunctions. Physicians are
finding these disorders amenable to pharmacotherapy
Disorders that affect the sacral spinal cord or the autonomic fibers to the penis preclude nervous system relaxation of penile smooth muscle, thus leading to ED. In patients with spinal cord injury, the degree of ED depends on the completeness and level of the lesion. Patients with incomplete lesions or injuries to the upper part of the spinal cord are more likely to retain erectile capabilities than those with complete lesions or injuries to the lower part.
Pathways that control erection and detumescence. A. Erection is mediated by cholinergic parasympathetic pathways, and nonadrenergic,
noncholinergic (NANC) pathways, which release nitric oxide (NO). Endothelial cells also release NO, which induces vascular smooth-muscle cell relaxation, allowing enhanced blood flow, and leading to erection. Detumescence is mediated by sympathetic pathways that release norepinephrine and stimulate α-adrenergic pathways, leading to contraction of vascular smooth-muscle cells. Endothelin, released from endothelial cells, also induces contraction.
Physiology of the Female Sexual Response
The female sexual response requires the presence of estrogens. A role for androgens is also likely but less well-established. In the CNS, estrogens and androgens work synergistically to enhance sexual arousal and response. A number of studies report enhanced libido in women during preovulatory phases of the menstrual cycle, suggesting that hormones involved in the ovulatory surge (e.g., estrogens) increase desire.
Sexual motivation is heavily influenced by context, including the environment and partner factors.
Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: SOFA is superior to MOD score for the determination of non-neurologic organ dysfunction in patients with severe traumatic brain injury: a cohort study...
Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Early lactate clearance is associated with biomarkers of inflammation, coagulation, apoptosis, organ dysfunction and mortality in severe sepsis and septic shock...
Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài:
Liver mitochondrial dysfunction is reverted by insulin-like growth factor II (IGF-II) in aging rats
Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: CD200-CD200R dysfunction exacerbates microglial activation and dopaminergic neurodegeneration in a rat model of Parkinson’s disease
Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí hóa hoc quốc tế đề tài : Use of [18F]FDOPA-PET for in vivo evaluation of dopaminergic dysfunction in unilaterally 6-OHDA-lesioned rats
Among the swallowing disorders, dysphagia is the most prevalent and dangerous due
to the fact it can lead to tumor formation. The classification of swallowing disorders
into obstructive and non-obstructive including e.g. lower motor neuron dysfunction,
autoimmune disease and achalasia were discussed in this chapter. The authors also
referred to motility disorders in diabetic neuropathy, alcoholism, psychiatric illness
and scleroderma – an autoimmune disease that causes weakening of the tissues of the