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Biomedical subjects

F E Kaiser

Publications and source records attributed to F E Kaiser.

At least 55 records · Page 3Linked to original sources
PubMed1991

Sexuality and impotence in the aging man.

Decreased sexual function commonly occurs with aging but should not be considered a normal event. This article discusses normal physiologic changes and the pathologic events that can lead to erectile difficulties. Proper evaluation can lead to a more appropriate choice of therapeutic agent or device and can benefit the quality of life of the older man and his partner.

Aged↗
PubMed1990

Principles of geriatric care.

The increase in the numbers of elderly in the United States, and their projected continued increase to 21% or more of the population by 2030, has provided impetus for the growth of geriatrics. Recognition of change that is age-related rather than disease-related, and the ways in which the elderly differ from their young counterparts is vital in the care of the elderly. A functional approach and appropriate geriatric assessment have been shown to be beneficial to the individual.

Activities of Daily Living↗
PubMed1990

Use of a vacuum tumescence device in the management of impotence.

This study evaluated the use of a vacuum tumescence device in the treatment of impotence in older men. Twenty couples with sexual dysfunction due to erectile impotence and who were interested in restoration of sexual function were treated by providing them with both a vacuum tumescence device to engorge the penis and an obstructing band to impede venous return. Nineteen patients established firm to hard erections lasting an average of 16 minutes and were able to have satisfactory coitus with vaginal ejaculation an average of three times per month. The penile-brachial pressure index, supine and after exercise (a measure of the adequacy of penile arterial flow), exhibited a significant increase following six month's use of the vacuum tumescence device. The only significant complications were mild, self-limited hematomas on three occasions of use. Thus in this limited series the vacuum tumescence device provided a well-accepted, relatively inexpensive therapeutic approach to impotence.

Aged↗
PubMed1990

Secondary hypogonadism in older men: its relation to impotence.

The relation of the reproductive endocrine system to impotence in older men was examined by measuring the concentrations of testosterone (T), bioavailable testosterone (BT), LH, and PRL and body mass index (BMI) in 57 young controls (YC), 50 healthy potent older controls attending a health fair (HF), and 267 impotent patients (SD). The SD and HF had markedly reduced mean T and BT values compared to YC. When adjusted for age and BMI there was no difference in BT between potent and impotent older men. The percent BT was much higher in YC than in the older groups. While the percent BT rose significantly with increased T in YC, it was inversely related to T in the older subjects, suggesting that increased sex hormone-binding globulin binding was a primary event leading to a low BT. Forty-eight percent of HF and 39% of SD were hypogonadal, as defined by a mean BT of 2.5 SD or more below the mean of YC (less than or equal to 2.3 nmol/L). Ninety percent of these had LH values in the normal range, suggesting hypothalamic-pituitary dysfunction. Thirty-four SD and six each of YC and older control volunteers (OC) underwent GnRH testing. Older subjects showed impaired responsiveness to GnRH compared to YC. A low basal LH level correlated very highly with hyporesponsiveness to GnRH. Thus, secondary hypogonadism and impotence are two common, independently distributed conditions of older men.

Aged↗
PubMed1990

Unique aspects of diabetes mellitus in the elderly.

Diabetes mellitus is a common condition in the geriatric population. In older subjects it may present in unusual ways and may be associated with unusual conditions. Hyperglycemia produces a variety of effects, including osmotic diuresis and cognitive dysfunction, which seriously impair the quality of life of the older individual. Older diabetics need to have their diabetes well controlled. The approach to diabetic control in older individuals is similar to that in younger individuals, with some notable exceptions.

Age Factors↗
PubMed1989

Sexual function with advancing age.

Impotence occurs commonly with advancing age. Approximately one half of impotent males over 50 years of age have a vascular cause for their impotence. Vascular impotence is often the harbinger of vascular disease in other organs of the body. Hypogonadism occurs in up to one fourth of older men. The relationship of hypogonadism to impotence is uncertain. Medications and neurologic diseases (both central and peripheral) are other major causes of impotence. The treatment of impotence has been revolutionized with the widespread availability of vacuum tumescent devices. The alterations in female sexuality with advancing age have been less well studied. Hysterectomies and bilateral oophorectomies are most probably done more often than necessary in the United States and may alter sexuality. There is some evidence supporting a role for estrogens and testosterone in the regulation of female libido. Physicians need to be more aware of the rapid changes in our understanding of human sexuality and aging.

Aged↗
PubMed1989

Biweekly intracavernous administration of papaverine for erectile dysfunction.

To determine the efficacy of the intracavernous administration of papaverine hydrochloride every 2 weeks to treat male impotence, we recruited 50 patients from a sexual dysfunction clinic. Of these, 8 did not complete the course of papaverine therapy. A total of 8 had complications, including priapism in 3 and ecchymoses or urethral bleeding in 5. In 30 patients who had substantial vasculogenic disease, there was a notable improvement in the penile blood pressure after papaverine treatment, although only 9 reported successful sexual intercourse. The penile blood pressure in the remaining 12 patients without substantial vascular disease increased modestly after therapy, and 5 persons reported satisfactory sexual activity. We conclude that administering papaverine intracavernosally every 2 weeks improves sexual potency in a subset of sexually impotent patients. Those with severe vasculogenic disease and a penile-brachial pressure index of less than 0.65 are not good candidates for this regimen.

Adult↗
PubMed1988

Impotence in diabetic men.

Studies relating to pathogenetic mechanisms resulting in impotence in diabetic subjects have been reviewed. Erectile dysfunction was reported to occur in 50 to 75 percent of diabetic patients and the prevalence appeared to increase with age. Contributions of vascular, endocrine, and neurologic system alterations result in this disturbing condition, but a detailed analysis of all the parameters was not found in any individual study. In our review of 301 veterans presenting to a sexual dysfunction clinic, the clinical and hormonal alterations in the diabetic patients closely resemble those seen in nondiabetic impotent subjects. Atherosclerotic vascular changes play an important predisposing role in the development of impotence. A difference exists between the prevalences of associated medical conditions in diabetic patients taking insulin, compared with those receiving oral agents or receiving dietary management. The high prevalence of impotence in diabetic patients seems to be due to the high prevalence of its vascular complications. Considering the availability of useful therapeutic approaches, it is mandatory to evaluate all diabetic men for the presence of impotence.

Diabetes Complications↗
PubMed1988

Relationship of penile brachial pressure index to myocardial infarction and cerebrovascular accidents in older men.

Vascular disease is a major cause of impotence in patients over the age of 40. In a prospective study of 130 impotent patients followed for 24 to 36 months, patients with a penile brachial pressure index (PBPI) of 0.65 or less had a significantly greater risk of a myocardial infarction or a cerebrovascular accident than patients with higher PBPIs. It is concluded that impotence in association with a low PBPI should be considered an indicator of a future major vascular event.

Arteriosclerosis↗
PubMed1988

Impotence and aging: clinical and hormonal factors.

A cross-sectional study of 216 impotent men aged 40 to 79 years (mean age 60.9 years) was conducted to determine if there are age-related changes in clinical and hormonal parameters in an impotent population. There was a slight increase in the degree of sexual dysfunction with age, with complete erectile failure occurring in a larger percent of the 60- and 70-year-olds than in the younger patients (41% vs 27% for the 40 year olds, P less than .05). No patient above the age of 70 years reported any full erections, even of short duration. In contrast, reported levels of libido did not vary significantly with age. Abnormal penile Doppler studies diagnostic of vasculogenic impotence were found in 17.8% of the patients tested, and an additional 17.8% were found to have evidence suggestive of a vascular etiology. These abnormal vascular findings were associated with an extremely high prevalence of clinically apparent atherosclerosis in this population. In 22.9% of the subjects, an abnormal vascular response was found only on exercise, ie, a "pelvic steal", which only occurred above the age of 50 years. There was a marked age-related alteration in the concentration of testosterone (T) and bioavailable testosterone (BT), but no statistically significant change in the levels of gonadotropins with age. An increase in the prevalence of eugonadotropic hypogonadism with age was found, which suggested an increasing prevalence of hypothalamic pituitary dysfunction in this patient group. For both vascular and hormonal changes (such as low T and BT), the greatest changes appear to occur after the age of 50.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Variability of response to thyroid-releasing hormone in normal elderly.

The present study was undertaken to define the hormonal response to thyroid-releasing hormone (TRH) further in a large, healthy, ambulatory elderly group. Seventy-seven subjects over 60 years old, 30 males (MA) and 47 females (FA), and control subjects, 22 males (MC) and 42 females (FC) were studied. No difference in thyroxine (T4), free thyroxine index (FT4I), baseline prolactin, and thyrotropin (TSH) concentrations were found between the four groups. Tri-iodothyronine resin uptake was only different between MC and FA groups. Post-TRH, TSH concentrations were higher in control males and females (MC + FC), compared to their aged counterparts (MA + FA), (P less than 0.05). This was, in part, due to a large number of female controls who exhibited a hyper-response to TRH (delta TSH greater than 35 microU/ml). A blunted response, defined as a delta TSH less than 6 microU/ml, occurred in 36.7% of MA, 29.8% FA, 13.6% MC, and only 4.8% of FC subjects. As expected, there was a significantly higher response of prolactin to TRH in all females (P less than 0.01) than in males; but no age-related difference among the female population was seen. These data indicate that the response of TSH to TRH declines with age, blunting of the response increases with age, and that TRH use has an extremely limited role as a diagnostic test, especially in an elderly population.

Age Factors↗