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H Mitchell Perry

Publications and source records attributed to H Mitchell Perry.

6 recordsLinked to original sources
PubMed2006

Validation of salivary testosterone as a screening test for male hypogonadism.

BACKGROUND: Saliva collection is an easy, non-invasive method to measure hormones. METHODS: Two studies were performed. In the first, a convenience sample of 1,454 males who had submitted saliva for salivary testosterone measurements were studied. In the second study, we intensively studied symptoms and measurements of total testosterone, free testosterone symptoms and measurements of total testosterone, free testosterone and bioavailable testosterone in relationship to salivary testosterone in 127 men. A secondary endpoint was to examine the relationship of salivary testosterone to hypogonadal symptoms in the ADAM and AMS questionnaires. RESULTS: In the first study, we have shown that salivary testosterone, measured in 1,454 males aged 20 to 89 years, declines by 47% over the lifespan. In the second study, salivary testosterone was strongly correlated with bioavailable testosterone (p < 0.000001) calculated free testosterone (p < 0.00001) and total testosterone (p < 0.002). Salivary testosterone was significantly related to hypogonadal symptoms on the St. Louis University ADAM questionnaire and the Aging Male Survey. CONCLUSIONS: These studies support the use of salivary testosterone as an acceptable assay for screening for hypogonadism. Salivary testosterone is not a better assay than other measures to diagnose hypogonadism.

Adult↗
PubMed2003

Air pollution, blood pressure, and their long-term associations with mortality.

This article addresses the importance of blood pressure as a covariate in studies of long-term associations between air quality and mortality. We focus on a cohort of about 50,000 U.S. veterans who had been diagnosed as hypertensive at some time and whose survival rates were predicted by blood pressure (BP) and ambient air quality, among other factors. The relationship between BP and air quality is considered by reviewing the literature, by deleting variables from the proportional hazards regression model, and by stratifying the cohort by diastolic blood pressure (DBP) level. The literature review shows BP to be an important predictor of survival and finds small transient associations between air quality and BP that may be either positive or negative. The regression model sensitivity runs showed that the associations with air pollution are robust to the deletion of the BP variables, for the entire cohort. For stratified regressions, the confidence intervals for the air pollution-mortality associations overlap for the two DBP groups. We conclude that associations between mortality and air quality are not mediated through blood pressure, nor vice versa.

Adolescent↗
PubMed2003

Erectile dysfunction: etiology and treatment in young and old patients.

This study shows that endocrine and vascular etiologies of erectile dysfunction are more common in the older age group, whereas depression and marital discord are more common in the younger age group. There is considerable overlap between various factors pointing to the multifactorial nature of erectile dysfunction. Review of the treatment option chosen reveals that the invasive modalities were least common as compared with the popular vacuum tumescence device (although cumbersome) and testosterone replacement. Persons with low testosterone have an improved efficacy of sildenafil when hypogonadism is treated. Sildenafil with its ease of administration and high efficacy seems to be the logical first choice for most of the patients. If contraindications exist or treatment failures occur, other treatment options should be offered to patients.

Adult↗
PubMed2003

Andropause: an old concept in new clothing.

There is increasing evidence that the common condition of hypogonadism in older men when associated with symptoms responds well to testosterone replacement. Over the last few years there has been a marked increase in the awareness and treatment of the andropause [137]. Long-term side effects of testosterone are uncertain with only eight people over 50 years having been studied for 10 years [138]. Testosterone needs to be considered a quality-of-life drug, similar to sildenafil, and at present it should be used only if it produces symptomatic improvement. There is a need for a men's health study to determine the long-term efficacy and safety of testosterone replacement in older persons.

Aged↗