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J E Heller

Publications and source records attributed to J E Heller.

9 recordsLinked to original sources

Erectile impotence: evaluation and management.

Dramatic progress in the understanding and treatment of erectile impotence has occurred over the past decade. Most cases have an organic cause that is related to vascular (arterial or venous) supply, innervation, or the hormonal milieu of the penis. Multifactorial causes of organic impotence are common and include diabetes mellitus, alcoholism, renal failure, and liver failure. Medications may cause impotence by a variety of mechanisms. The history and physical examination, along with simple laboratory tests, are the mainstay of evaluation and may be performed appropriately by family physicians. Successful new forms of nonsurgical treatment include penile self-injection with papaverine (sometimes with phentolamine) and penile-suction devices. Penile prostheses have been improved greatly in recent years. The patient may select among semirigid, multicomponent inflatable, and self-contained inflatable devices. New surgical treatments include penile arterial revascularization (for atherosclerosis) and ligation of the dorsal vein of the penis (for venous leak).

Erectile Dysfunction↗

Potential pitfalls of the 2-hour calcium-to-creatinine ratio and urinary cyclic adenosine monophosphate excretion in the differential diagnosis of idiopathic hypercalciuria.

We studied 44 patients with calcium urolithiasis on high (900 mg. daily) and low (400 mg. daily) calcium diets. With 24-hour urinary data, we categorized the patients as normocalciuric or hypercalciuric and subdivided the hypercalciuric patients into absorptive and renal types. Abbreviated tests, including the 2-hour fasting urinary calcium-to-creatinine ratio and 24-hour urinary (nephrogenous) cyclic adenosine monophosphate, did not predict accurately whether hypercalciuria was of the idiopathic, absorptive or renal type. However, 24-hour urinary calcium excretions on the low calcium diet had a sensitivity and specificity of more than 90 per cent for reproducing the categorized diagnoses.

Calcium↗