Maurita Carrejo | Baylor College of Medicine (original) (raw)

Uploads

Papers by Maurita Carrejo

International Journal of Impotence Research, 2007

We investigated whether a preference by patients regarding the gender of a health care provider t... more We investigated whether a preference by patients regarding the gender of a health care provider to manage erectile dysfunction (ED) may be a factor in the diagnosis and care of this condition, whose broader medical significance is an area of increasing interest. A brief questionnaire was completed by 1087 adult males in a primary care setting. The questionnaire explored provider gender preference and other possible biases. The prevalence of ED in the 40-69 age group in our population was 68.8%. The prevalence was 81% in the age group of 70 and more. Of those who reported having experienced ED, 51.5% had discussed it with a provider, and 28.1% had been treated. Approximately, 57% expressed no provider gender preference, regardless of history of ED. Of those who stated a preference, approximately 75% prefer male providers. However, also among those who state a preference, Hispanics are not as likely as non-Hispanics to prefer a male provider (P ¼ 0.03). Most believe that males and females are equally qualified to manage ED, but among those who have a different opinion, the gender perceived more favorably is male.

Andrologia, 2009

Many male patients are discovered on screening to suffer from hypogonadism and age related hypogo... more Many male patients are discovered on screening to suffer from hypogonadism and age related hypogonadism is being increasingly recognized. However, secondary causes of hypogonadism should not be overlooked, especially in patients who may have concomitant morbidity as highlighted in this case. Our patient with vascular hypogonadism was treated with testosterone and clomiphene citrate in cycles; with a hope of improving not only androgen levels but overall pituitary function as there were co-existing endocrine pathologies of albeit primary hypothyroidism and low IGF-1 levels. Treatment with exogenous testosterone is fairly well established; but there is also increasing evidence of the effectiveness and short-term safety of clomiphene citrate in restoring not only biological levels but functional states in males as well. As such, we report an unusual case of a patient seen at our Men’s Health & Andrology clinic in which both the cause of some otherwise unremarkable symptoms and the treatment, using a combination of clomiphene citrate and testosterone, were remarkable.

American Journal of Mens Health, 2012

Erectile dysfunction (ED) has long been correlated with psychological well-being. More recently, ... more Erectile dysfunction (ED) has long been correlated with psychological well-being. More recently, an understanding has developed of ED being, in some cases, a vascular condition of the penile artery. Given the narrowness of the penile artery, a small amount of atherosclerosis may result in ED before any other manifestations are evident, making ED a useful marker for other vascular conditions with potentially greater clinical implications. In light of this, possible underreporting of ED takes on added significance. A questionnaire regarding ED prevalence and management was distributed for self-administration to men in the waiting room of primary care clinics; the data were analyzed with a focus on the relationship between ED and age. The study had a remarkable response rate of >95%. The prevalence of ED in the ≥70-year age-group was 77%, compared with 61% in the 40-to 69-year age-group (p = .0001). ED correlated linearly with age (R 2 = .80, p < .0001). Among those who had ED, more than half had not discussed it with any provider; the likelihood of discussing ED did increase with the reported severity of symptoms (p < .0001). Older men had more severe ED than younger men (p < .0001). Furthermore, 72% of men with a history of ED were never treated. Younger men were more likely to be treated than older men (p = .004). Given the potential implications of underreporting ED, and the willingness of the men in this study to complete the questionnaire, further work may be merited on new models for ED assessment and follow-up.

Genetic Epidemiology, 1995

Genetic variation at the apolipoprotein (apo) A-I/C-III/A-IV gene cluster on chromosome 11 has be... more Genetic variation at the apolipoprotein (apo) A-I/C-III/A-IV gene cluster on chromosome 11 has been associated with differences in occurrence of atherosclerosis and with variability in lipid levels among hypercholesterolemic-hypertriglyceridemic individuals. The functional cause of the association is not known, but polymorphisms of the apo A-IV gene are of interest because apo A-IV is involved in both triglyceride and cholesterol metabolism. Two mutations in the apo A-IV gene, 347T→S and 360Q→H, are known to cause amino acid substitutions in the mature protein. These polymorphisms were typed in a sample of 119 subjects with high cholesterol and high triglycerides in whom carotid artery wall thickness was previously shown to be strongly associated with silent polymorphic variation in the A-I/C-III/A-IV gene cluster.The relative allele frequencies were 0.83 and 0.17 for codon 347T→S, and 0.95 and 0.05 for codon 360Q→H. These polymorphisms did not show a statistically significant relationship with prevalent hypertension, diabetes, or cardiovascular disease or with plasma lipid levels. Most importantly, these amino acid substitutions in apo A-IV were not associated with carotid artery wall thickness. Therefore, the genetic cause of disease variability in a sample of mixed hyperlipidemics is not amino acid substitutions in codons 347 or 360 of the apolipoprotein A-IV gene. ©1995 Wiley-Liss, Inc.

Journal of Men's Health, 2010

International Journal of Impotence Research, 2007

We investigated whether a preference by patients regarding the gender of a health care provider t... more We investigated whether a preference by patients regarding the gender of a health care provider to manage erectile dysfunction (ED) may be a factor in the diagnosis and care of this condition, whose broader medical significance is an area of increasing interest. A brief questionnaire was completed by 1087 adult males in a primary care setting. The questionnaire explored provider gender preference and other possible biases. The prevalence of ED in the 40-69 age group in our population was 68.8%. The prevalence was 81% in the age group of 70 and more. Of those who reported having experienced ED, 51.5% had discussed it with a provider, and 28.1% had been treated. Approximately, 57% expressed no provider gender preference, regardless of history of ED. Of those who stated a preference, approximately 75% prefer male providers. However, also among those who state a preference, Hispanics are not as likely as non-Hispanics to prefer a male provider (P ¼ 0.03). Most believe that males and females are equally qualified to manage ED, but among those who have a different opinion, the gender perceived more favorably is male.

Andrologia, 2009

Many male patients are discovered on screening to suffer from hypogonadism and age related hypogo... more Many male patients are discovered on screening to suffer from hypogonadism and age related hypogonadism is being increasingly recognized. However, secondary causes of hypogonadism should not be overlooked, especially in patients who may have concomitant morbidity as highlighted in this case. Our patient with vascular hypogonadism was treated with testosterone and clomiphene citrate in cycles; with a hope of improving not only androgen levels but overall pituitary function as there were co-existing endocrine pathologies of albeit primary hypothyroidism and low IGF-1 levels. Treatment with exogenous testosterone is fairly well established; but there is also increasing evidence of the effectiveness and short-term safety of clomiphene citrate in restoring not only biological levels but functional states in males as well. As such, we report an unusual case of a patient seen at our Men’s Health & Andrology clinic in which both the cause of some otherwise unremarkable symptoms and the treatment, using a combination of clomiphene citrate and testosterone, were remarkable.

American Journal of Mens Health, 2012

Erectile dysfunction (ED) has long been correlated with psychological well-being. More recently, ... more Erectile dysfunction (ED) has long been correlated with psychological well-being. More recently, an understanding has developed of ED being, in some cases, a vascular condition of the penile artery. Given the narrowness of the penile artery, a small amount of atherosclerosis may result in ED before any other manifestations are evident, making ED a useful marker for other vascular conditions with potentially greater clinical implications. In light of this, possible underreporting of ED takes on added significance. A questionnaire regarding ED prevalence and management was distributed for self-administration to men in the waiting room of primary care clinics; the data were analyzed with a focus on the relationship between ED and age. The study had a remarkable response rate of >95%. The prevalence of ED in the ≥70-year age-group was 77%, compared with 61% in the 40-to 69-year age-group (p = .0001). ED correlated linearly with age (R 2 = .80, p < .0001). Among those who had ED, more than half had not discussed it with any provider; the likelihood of discussing ED did increase with the reported severity of symptoms (p < .0001). Older men had more severe ED than younger men (p < .0001). Furthermore, 72% of men with a history of ED were never treated. Younger men were more likely to be treated than older men (p = .004). Given the potential implications of underreporting ED, and the willingness of the men in this study to complete the questionnaire, further work may be merited on new models for ED assessment and follow-up.

Genetic Epidemiology, 1995

Genetic variation at the apolipoprotein (apo) A-I/C-III/A-IV gene cluster on chromosome 11 has be... more Genetic variation at the apolipoprotein (apo) A-I/C-III/A-IV gene cluster on chromosome 11 has been associated with differences in occurrence of atherosclerosis and with variability in lipid levels among hypercholesterolemic-hypertriglyceridemic individuals. The functional cause of the association is not known, but polymorphisms of the apo A-IV gene are of interest because apo A-IV is involved in both triglyceride and cholesterol metabolism. Two mutations in the apo A-IV gene, 347T→S and 360Q→H, are known to cause amino acid substitutions in the mature protein. These polymorphisms were typed in a sample of 119 subjects with high cholesterol and high triglycerides in whom carotid artery wall thickness was previously shown to be strongly associated with silent polymorphic variation in the A-I/C-III/A-IV gene cluster.The relative allele frequencies were 0.83 and 0.17 for codon 347T→S, and 0.95 and 0.05 for codon 360Q→H. These polymorphisms did not show a statistically significant relationship with prevalent hypertension, diabetes, or cardiovascular disease or with plasma lipid levels. Most importantly, these amino acid substitutions in apo A-IV were not associated with carotid artery wall thickness. Therefore, the genetic cause of disease variability in a sample of mixed hyperlipidemics is not amino acid substitutions in codons 347 or 360 of the apolipoprotein A-IV gene. ©1995 Wiley-Liss, Inc.

Journal of Men's Health, 2010