ABSTRACT
With the introduction of effective pharmacologic therapies for erectile dysfunction, more men are seeking treatment. The underlying cause of erectile dysfunction is usually a chronic medical illness or a side effect of certain drugs. Less commonly, the problem is psychogenic. Even after optimal treatment of common medical disorders such as diabetes mellitus and hypertension, erectile dysfunction may persist. Pharmacologic treatments, such as the intracavernosal or transurethral administration of alprostadil or the use of the new oral medication sildenafil, may offer patients substantial benefit. Before any of these drugs are prescribed, consideration should be given to existing medical illnesses and medications, partner satisfaction, comfort with the method of administration and the side effect profile.
Subject(s)
Alprostadil/therapeutic use , Erectile Dysfunction/drug therapy , Erectile Dysfunction/etiology , Phosphodiesterase Inhibitors/therapeutic use , Piperazines/therapeutic use , Vasodilator Agents/therapeutic use , Diagnosis, Differential , Erectile Dysfunction/chemically induced , Erectile Dysfunction/diagnosis , Humans , Male , Patient Education as Topic , Purines , Sildenafil Citrate , Sulfones , Teaching MaterialsABSTRACT
A left ventricular assist system presents a very complex set of interfaces to the blood. The interactions of the various components, their junctions, and fluid dynamic effects have been discussed at a macroscopic, cellular and molecular level. Failure of any part of the system can seriously compromise LVAS function or host response whether due to gross thrombosis with occlusion, proliferative PNI formation, or thromboembolic events. It has been stated that: "When artificial hearts are designed properly, nearly any surface goes." Unfortunately, the blood interface within any circulatory support system, and indeed in much simpler systems, is a much more complex function than design, which includes the surface, materials and many other factors (Table 6).
