Psychosexual gynecology.

The psychosexual health of the female patient not only is affected by her overall gynecologic well-being but also may be greatly influenced by cultural myths and attitudes, psychological health, and social support. For primary care physicians to incorporate the psychosexual issues of a woman into her overall medical care, there must exist a sensitivity to the patient's needs, an atmosphere for open discussion regarding sexual and psychological concerns, an office staff to provide appropriate medical support, and the availability of experienced specialists in cases in which referral is necessary. The quality of the physician-patient interaction as well as the degree of empathy shown to women with gynecologic problems may exacerbate or improve psychosexual outcomes.

Renal angioplasty: current status.

Percutaneous transluminal angioplasty has attracted a great deal of attention in recent years and is being used with increasing frequency for the treatment of renovascular hypertension from renal artery stenosis. One hundred forty dilatation procedures have been performed in 90 patients with 119 renal artery stenoses. Ten of the patients were treated for renal insufficiency alone. An initial success rate of 95% was achieved. The blood pressure response has been followed for 1-52 months (mean, 22 months). The mean diastolic pressure decreased by 36.7 mm Hg in response to the treatment. Of the 80 hypertensive patients, 25 were classified as cured, 47 as improved, and eight as nonresponders. Patient selection, the proper balloon size, and a good initial response are the major factors in determining long-term success. Percutaneous transluminal angioplasty is technically feasible and clinically effective for the treatment of renovascular hypertension.

The axillary approach to percutaneous renal artery dilatation.

The axillary approach to percutaneous transluminal angioplasty of the renal arteries is described. This technique simplifies renal dilatation in patients with severe atherosclerotic disease in the vessels distal to the renal arteries.

The Charlottesville blood pressure survey: the role of the physician in hypertension case finding.

The population of a community of 29,608 adults was screened door-to-door for elevated blood pressure. A questionnaire was administered and analyzed to profile the hypertensive person who is most likely to be unaware of his problem. One hundred and one people with documented sustained hypertension were "unaware" of their problem. Of these, 58% had a diastolic blood pressure consistently greater than 100 mm Hg. Sixteen per cent of all hypertensive males were unaware of their problem compared to 5% of hypertensive females. Of those less than 35 years old, 38% of males were unaware compared with 4% of females. White (11%) persons were more apt to be unaware than non-white persons (6%). No person with a positive family history of hypertension was unaware. Ninety-one per cent of all unaware hypertensives had a regular physician. Sixty per cent had consulted a physician within 18 months, and 92% had consulted a physician within 60 months of the survey. The screening process was completed on only 21% of all adults in the target community. These data suggest that the young, white, hypertensive male with no family history of hypertension is most likely to be unaware of his problem. Routine measurement of blood pressure by physicians may be more efficient than door-to-door surveys in contacting the unaware hypertensive person.