dysfunction
(dis-fŭngk'shŏn 
)
[ dys- + function ]
Abnormal, inadequate, or impaired action of an organ or part.
asymptomatic left ventricular d.
ABBR: ALVD
A reduction in the ability of the heart to push blood into the aorta without overt symptoms of heart failure. ALVD is demonstrated by an ejection fraction of less than 40%. It is usually caused by cardiac muscle damage, e.g., after myocardial infarction or cardiotoxic chemotherapies. About 10% of people with ALVD develop heart failure each year.constitutional hepatic d.Gilbert syndrome.
coronary microvascular d.Coronary microvascular disease.
diastolic d.Heart failure with preserved ejection fraction.
environmental enteric d.Tropical sprue
ABBR: ED
The inability to achieve or sustain a penile erection for sexual intercourse. SYN: impotence.SEE: table - Risk Factors for Erectile Dysfunction.
It is a common disorder that chronically affects about a third of all men over the age of 50 but is not an inevitable part of aging.
The many causes of (and diseases associated with) erectile dysfunction include diabetes mellitus and cardiovascular diseases, vascular diseases of the pelvis, spinal cord injuries, autonomic nervous system disorders, testosterone deficiencies, pelvic injuries resulting from surgery, pelvic radiation, stroke, and side effects from intoxicants such as alcohol or medications (some antihypertensives, sedatives, opiates, and antidepressants).
Physical examination should cover examination of the abdomen and genitalia, assessment of secondary sex characteristics and of peripheral pulses and blood pressure, and a digital rectal examination to evaluate prostate size.
Laboratory testing to rule out underlying causes should include serum chemistries, fasting glucose and lipid levels, thyroid function tests, and testosterone levels. In some patients, ultrasonography or arteriography may be helpful. Healthy males have involuntary erections during sleep. The presence of these erections helps to focus concern away from an emphasis on purely physical causes. Psychological assessment may be indicated to rule out depression or other mental conditions.
Commonly prescribed drugs to treat ED may have serious side effects and drug interactions. Selective phosphodiesterase inhibitors like sildenafil (Viagra) or tadalafil (Cialis), which are currently the primary drug therapies because of their ease of use and effectiveness, should never be given to patients who use nitrates to control angina pectoris. The combination can cause severe and even fatal hypotension. Colorful visual disturbances while taking erectile aids may precipitate loss of vision. Other common side effects of these ED medications include headache, upset stomach, and priapism (an erection that does not go away after several hours).
Nonmedical treatments for ED include vacuum constriction devices (a plastic tube placed around the penis). Such devices are available without prescription. Pumping the air out of the tube creates a vacuum that draws blood into the penis, producing an erection, which then is maintained by placing one or more tension band s around the base of the penis for up to 30 min. These devices are often not well tolerated.
Surgical therapies include the implantation of devices in the penis that can be manipulated to create an erection. All patients being treated for ED should be taught that sexual problems can be reduced by avoiding recreational drugs and excessive alcohol, getting treatment for hypertension (and medication dosage adjustment as related to ED), and for patients with diabetes, maintaining glucose control. Exercising regularly, avoiding tobacco, maintaining low cholesterol levels and ideal body weight, and good communications between sexual partners can help men to manage ED.
Lack of information and emotional barriers such as embarrassment, fear, and anxiety can worsen ED. Because some patients with ED may be reluctant to discuss it, primary practitioners should include questions about sexual function as a routine part of history-taking.
hypertonic uterine d.Polysystole.
hypotonic uterine d.The slowing or complete arrest of the progress of labor, caused by weak or infrequent contractions of the uterus. SYN: secondary uterine inertia.
ABBR: MBD
Former term for attention-deficit hyperactivity disorder.olfactory d.Any impairment in the sense of smell.
proximal renal tubular d.Fanconi syndrome.
pursuit d.Inability of the eyes to follow or track a moving object.
respiratory pump d.Any disease or condition that impairs ventilation caused by failure of the nerves, muscles, or skeleton of the abdomen and thorax to function properly. It may be caused by a variety of purely neurological diseases, e.g., the polyneuropathy that paralyzes respiration in Guillain-Barré syndrome. Alternatively it may be caused by skeletal conditions, e.g., multiple rib fractures or ankylosing spondylitis; by excessive adipose tissue, as in obesity/hypoventilation; or by diaphragmatic paralysis from surgical injury to the phrenic nerves.
right ventricular d.Inadequate ejection of blood from the right ventricle of the heart during ventricular systole. It is characterized by a variety of complementary measurements: a right-ventricular ejection fraction of <50%; a right ventricular diameter that is 90% or greater of the left ventricular diameter; a reduced systolic excursion of the annulus of the tricuspid valve; and /or a B-type natriuretic peptide level >500 pg/mL.
sexual d.A state in which an individual experiences a change in sexual function during the sexual response phases of desire, excitation, and /or orgasm, which is viewed as unsatisfying, unrewarding, or inadequate. There may be multiple causes, including lack of sexual interest or desire; impairments in sexual arousal, e.g., erectile function in men or lack of vaginal lubrication or clitoral enlargement in women; inability to achieve or delay orgasm until one's partner is satisfied; pain during intercourse; medical or hormonal conditions that impair sexual function; and problems with substance abuse or prescription drugs. A careful history and physical examination will help determine the possible pathological aspects of the various phases. Is desire absent, overactive, or is there aversion? Is arousal sufficient to maintain desire and , in men, to attain erection? Does orgasm occur, and , if so, is it delayed or premature? Do the partners experience satisfaction at the completion of orgasm? Is pain present at any stage of the sexual activity?
The physical or mental factors that are involved should be treated and , when medications are responsible, alternative drugs should be substituted for those that appear to cause the disorder.
vocal cord d.A disorder that mimics asthma in that it causes episodic wheezing and often inspiratory stridor. It is caused by closure of the vocal cords during inspiration. Unlike asthma, it does not improve with bronchodilating drugs such as albuterol or ipratropium. It can be definitively diagnosed with direct laryngoscopic visualization of the vocal cords. It is primarily treated with patient education, biofeedback, and speech therapy. SYN: paradoxical vocal cord motion .