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Target Concepts:
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Query: UMLS:C0018799 (
heart disease
)
34,133
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
For women whose health cannot support pregnancy, the author's obstetrics department has formed a multidisciplinary team to counsel couples on psychological and practical aspects of contraception and abortion. High risk pregnancies are those occuring in women with such disorders as
cardiopathy
, nephropathy, hypertension, diabetes, cancer, Rhesus isoimmunization and psychosis. Two approaches are used: to prevent or terminate pregnancy. Contraception must be explained concretely, addressing the couples' particular situation and personality. Pills are often contraindicated, in high risk patients as are IUDs in nulliparas and those taking anticoagulants. Many couples used to careful medical surveillance can adjust to temperature rhythm or diaphragms. For women who must have Tubal ligation, the decision is made jointly by the couple, obstetrician, psychotherapist and specialist. Counseling is usually necessary to prevent psychological or
sexual dysfunction
, particularly in those sterilized during caesarean section if the infant's survival is also at risk. A similar multidisciplinary team is consulted for therapeutic abortion alone or combined with tubal ligation.
...
PMID:[Fecundity and high risk pregnancy]. 507 55
The interval from the initiation of declining estrogen levels to final ovarian failure usually encompasses many years. The age of onset and duration of this perimenopausal time can vary greatly. While many patients may have minimal to no symptoms as estrogen levels first begin to decrease, most patients will eventually develop symptoms and sequelae as they approach ovarian failure. The consequences of this decline in ovarian function are numerous, and include vasomotor symptoms, declining bone mass, urogenital changes, infertility, irregular uterine bleeding, and
psychosexual dysfunction
. The women of today entering the perimenopausal period are unique because of their vast numbers, a consequence of the aging of the "baby boomers." Their reproductive history is also different from that of their ancestors in that many have chosen to delay childbearing into their thirties and even forties, and many have elected not to have children. Because of the unique characteristics of this extremely large population of women that are approaching or currently in the perimenopausal period, it is vital that healthcare providers fully understand the variability, consequences, and treatment modalities of this time of declining ovarian function. Risk factors for such common health problems as osteoporosis,
heart disease
, and cancers must be assessed and managed appropriately. Screening tests including mammography and cholesterol profiles should be offered along with dietary and exercise recommendations. Low-dose oral contraceptive pills and hormone replacement therapy are often effective in preventing and treating many of the common problems encountered during the perimenopausal period.
...
PMID:The perimenopause: a critical time in a woman's life. 882 3
During the last decade there were extensive investigations in clinical and molecular andrology with emphasis on assisted reproduction, micromanipulation techniques of gametes, sperm/egg interaction, male contraception, diabetes mellitus, varicocele, andropause versus menopause,
sexual dysfunction
, associated hypertension/stress, prostatic carcinoma and molecular parameters of male reproduction. Sperm hyperactivation is a required step in capacitation sequence. Sperm motility is measured by videotape to evaluate the Straight Line Velocity (microm/s) (VSLI). Fertilization/embryonic development results from single sperm transfer (S-MIST) and multiple sperm transfer. Fertilization/embryo development is achieved by injection of immotile sperm into the perivitelline space. To assess sperm viability, a supravital stain suitable for use in combination with immunofluorescent assay, Hoeschst 33258, is used. The dye fluoresces with an intense blue when bound to DNA. To assess sperm plasma membrane integrity, a hypo-osmotic swelling test (HOST) is performed, using fluoresceinated D-mannose enriched albumin (FITC-DMA). The ability of sperm to swell under hypo-osmotic conditions indicates an intact membrane. A human protein, C-peptide, thought to be a useless byproduct of insulin may protect against devastating heart and nerve damage that diabetes causes. Human diabetics may benefit from the substance. Over 15 million Americans have diabetes, in which blood sugar levels rise out of control. There are two types of diabetics: Type I diabetics produce no insulin, the hormone that regulates blood sugar. Type II diabetics are unable to use their insulin properly. Diabetics are at great risk of
heart disease
and nerve damage, as arteries throughout the body leak and nerve-cell impulses fail. C-peptide is a byproduct of insulin production; it can be produced by the body or synthetically. Production of this protein is not induced by insulin, so diabetics who take insulin do not get C-peptide with it. Varicocele occurs unilaterally on the left side in 78% to 93% of men. Typically the presence of a varicocele is associated with an abnormal semen analysis (sperm density and morphology) and a decreased testicular volume on the affected side. Impaired sperm motility occurs in 89.5% of all varicocele patients. Varicocele ligation improves semen parameters in two thirds of patients. A few studies on andropause included
sexual dysfunction
, hormonal changes, medical/psychological correlates of impotence, ostenopenia/osteoporosis and bone loss; indices of bone remodeling, testosterone supplementation, androgen, negative feedback and hypothalamo-pituitary-testicular axis. Prostatic cancer is the second leading cause of cancer death for men between the ages of 60 and 80. Early detection involves a simple blood test for prostate specific antigen (PSA). Regular screening and early detection are essential. This is an important test because a high antigen count can be the only symptom. Since no screening is 100% accurate, physicians recommend both a PSA blood test and a physical examination. Although heredity plays a major role in whether a man will develop prostate cancer, men who lead healthy lives can dramatically reduce their chances of cancer: low-fat diet, eating plenty of fruits and vegetables and not smoking. Recent advances in molecular andrology include peptide hormone binding proteins; gonadotropin-releasing hormone (GnRH) agonists/antagonists analog; gonadotropins/their receptors; growth factors/reproduction; peptides as intratesticular regulators; molecular cloning of reproductive proteins/peptides. Gene cloning is applied for characterization/expression of genes coding. The interaction of gp120 with CD4 receptor plays a role in syncytium formation, apoptosis and CD4 cell deletion in human immunodeficiency virus (HIV) infection. The recombinant V3 peptide of fragment 307-330 of HIV-1 can induce sperm head agglutination. The generation process of react
...
PMID:Recent advances in clinical/molecular andrology. 958 57
Menopause is associated with myths about the death of sexual vitality. While menopause causes many women to experience vasomotor instability, problems with osteoporosis, urogenital aging, and increased risk of
heart disease
, these issues can now be addressed with hormonal replacement strategies or alternative therapies. The menopausal woman today can be relatively comfortable with regard to direct menopausal symptoms of estrogen deficiency as a result of medical therapies. Sexual health and intimacy should also be considered in a holistic approach to the menopausal patient. The mature or postmenopausal woman need not abandon sexual intimacy. This review article presents information about sexual health in woman who are perimenopausal or postmenopausal. It explores a variety of medical, psychiatric, and psychological factors that can lead to either sexual health and comfort or
sexual dysfunction
and dissatisfaction. Given the benefit of good health, a loving relationship, and appropriate medical care, sexual vigor can continue in the mature years of a woman's life.
...
PMID:Sex and the mature woman. 1083 92
Modern cardiac rehabilitation is a comprehensive program of secondary prevention for patients with
heart disease
. Moreover, it is an important context in which to broach issues of impaired sexual function. Sexual problems plague a large portion of our cardiac patient population. Unspoken+ concerns about impotence, now more correctly called erectile dysfunction (ED), are common, as are concerns about the safety of engaging in sexual activity, especially after major cardiac events or therapeutic interventions. A large proportion of patients do not return to normal sexual activity after a cardiac event. Many factors, including normal age-related changes in sexual response, medication-induced dysfunction, and vascular changes associated with risk factors (e.g., diabetes and dyslipidemia), as well as the emotional impact of symptomatic
heart disease
, may influence sexual function in these patients. These factors, occurring alone or in combination, probably explain the discouraging prevalence of
sexual dysfunction
in patients with manifest cardiac disease. Because so few patients have specific cardiac reasons for limiting sexual activity, a clear opportunity exists for cardiologists and their staff to help enhance the emotional well-being and overall quality of life of their cardiac patients.
...
PMID:Sexual activity and the cardiovascular patient: guidelines. 1050 70
The conditions of depression, erectile dysfunction (ED), and cardiovascular disease may seem at a superficial level as independent medical problems managed by 3 separate and unrelated healthcare disciplines. Various studies, however, have revealed significant associations between depression and cardiovascular disease, ED and cardiovascular disease, and depression and ED. The purpose of this research was to identify whether the 3 medical conditions share mutually reinforcing associations and predictors. Population-based epidemiologic studies were utilized where possible. Variables including age,
heart disease
, hypertension, sedentary behavior, related medications, cigarette smoking, and abnormal lipids have been found to be highly associated with depressive symptoms, cardiovascular disease, and ED. It was concluded that all 3 medical conditions share many of the same risk factors and etiologic associations and may be best modeled in a 3-way holistic, mutually reinforcing relation. Of particular relevance, patients with
sexual dysfunction
have a likely comorbidity of cardiovascular disease and depression, as well as the potential increased risk for cardiac morbidity and mortality.
...
PMID:The mutually reinforcing triad of depressive symptoms, cardiovascular disease, and erectile dysfunction. 1089 78
Several links have been established between
sexual dysfunction
and
heart disease
. Indeed, many risk factors for developing
sexual dysfunction
are shared by coronary artery disease: age, smoking, diabetes, hypertension, and hypercholesterolaemia. It should also be borne in mind that in men several cardiac drugs are responsible for erectile dysfunction (ED). Lastly it should be remembered that treatment of ED may be associated with cardiovascular side-effects. Data from the literature show that men with coronary artery disease, hypertension or diabetes have an up to fourfold higher risk of developing ED than have age-matched controls. Thiazide diuretics and beta-blockers are the most common drugs that produce ED. Current therapies for ED are safe and effective in the large majority of patients with cardiovascular disease. However, the concomitant use of nitrates and sildenafil may be life-threatening, and nitrate therapy is therefore contra-indicated in patients taking sildenafil--and vice versa.
...
PMID:[Incidence and treatment of sexual dysfunction in heart disease]. 1240 76
Sexual dysfunction is a highly prevalent condition in ageing men that considerably affects their quality of life, although it is a frequently neglected aspect of healthcare. The main predictors of
sexual dysfunction
are age and cardiovascular comorbidities such as hypertension,
heart disease
, hypercholesterolaemia and diabetes. Recently, the severity of lower urinary tract symptoms (LUTS) has also been identified as a crucial risk factor for
sexual dysfunction
, independent of age and comorbidities. Despite the increased prevalence of
sexual dysfunction
with age, health-related problems and psychological factors, there is evidence that many older men remain sexually active. Currently available self-administered questionnaires assessing male
sexual dysfunction
focus almost exclusively on erectile function. There is evidence from recent large-scale epidemiological studies that ejaculatory dysfunction (EjD) is almost as prevalent as erectile dysfunction (ED), affecting nearly half of men aged > or = 50 years. Other domains such as orgasm, desire, and satisfaction with sex life are important and should be considered. There is thus a need to develop and validate more comprehensive and multidimensional instruments for assessing
sexual dysfunction
in ageing men. A new instrument, the Male Sexual Health Questionnaire (MSHQ), was developed and validated to assess these specific aspects of male
sexual dysfunction
. It consists of a 25-item self-administered questionnaire including three core domains (erection, ejaculation, satisfaction with sex life) and additional items related to sexual activity, desire and bother related to
sexual dysfunction
. The MSHQ scale has excellent psychometric properties and is well suited for use in clinical and research settings. A short form of the MSHQ scale is currently under development.
...
PMID:Assessment of sexual dysfunction in patients with benign prostatic hyperplasia. 1650 51
Testosterone treatment is controversial for men and even more so for women. Although long-term outcome data are not available, prescriptions for testosterone are becoming more common. Testosterone is used primarily to treat symptoms of
sexual dysfunction
in men and women and hot flashes in women. Potential benefits include improved libido, increased bone mass, and increased sense of well-being. In individuals with human immunodeficiency virus infection or other chronic diseases, testosterone has been shown to improve mood and energy levels, even in patients with normal testosterone levels. Testosterone can be administered by injection, patch, topical gel, pill, or implant. Side effects in men include polycythemia and acne. Side effects in women include acne, hepatotoxicity, and virilization and usually only occur when testosterone is used in supraphysiologic doses. Long-term studies of the effects of testosterone on prostate cancer, breast cancer, and
heart disease
have not been completed. Mammograms and monitoring of prostate-specific antigen, hematocrit, and lipid levels are recommended for patients taking testosterone.
...
PMID:Testosterone treatments: why, when, and how? 1718 8
Heart disease
in general and acute myocardial infarction involve
sexual dysfunction
caused by anxiety and by the same physiological problems that caused the heart problem, namely endothelial dysfunction. Unfortunately, many patients and their spouses hesitate to approach their doctor on issues related to their sexual concerns. Furthermore, the medical team in general and doctors in particular are irresolute in bringing up sexual issues when dealing with overall cardiac rehabilitation. Although patients can safely resume sexual activity at some point, only one in four actually return to their previous level of sexual activity. If we really want to assist in the rehabilitation of patients we have to advise them about resuming their sex life. Solving sexual problems can serve as a tool in primary, secondary and tertiary prevention of cardiac problems, as it can be used as an "arm swinger" for changing one's life habits. We urge increased research and treatment of sexual problems, in cardiac patients in general and in female patients in particular.
...
PMID:[Heart to heart: rehabilitation of sexuality in cardiac patients]. 1680 16
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