Journal of Mens Health最新文献

Background

Understanding the reciprocal role that multiple problematic behaviours play in men's health is important for intervention delivery and for reducing the healthcare burden. Data regarding the concurrence of problematic health behaviours is currently limited but offers insights into risk profiles, and should now include total time spent sitting/day.

Methods

Self-reported data on lifestyle health behaviours was collected from 232 men aged ≥18 years who engaged in a men's health promotion programme delivered by 16 English Premier League Clubs.

Results

Men at risk due to high sitting display multiple concurrent lifestyle risk factors, 88.6% displayed at least two ancillary risk factors and were three times more likely to report ≥2 lifestyle risk factors (OR = 3.13, 95% confidence interval (CI) = 1.52–6.42) than those with low sitting risk. Significant differences in the mean number of risk factors reported between those participants in the higher risk (2.43 ± 0.90) and lower risk (2.13 ± 0.96) sitting categories were also found (P = 0.015).

Conclusions

Hard-to-reach men displayed multiple problematic concurrent behaviours, strongly linked to total sitting time.

The management of male anterior urethral strictures is complex and continues to evolve. Due to high success rates and low morbidity, open reconstruction has become the preferred primary treatment modality over repeated minimally invasive options. Urethroplasty describes this diverse group of open reconstructive techniques applied to a heterogenous disease process. As controlled trials are scarce, a comparison of different techniques across varied circumstances is difficult. Furthermore, long-term success is also dependent upon patient comorbidities. Ultimately, accurate determination of the stricture length, location, and etiology is imperative for procedure selection. Therefore, we describe our approach and rationale behind the evaluation and treatment planning of patients with anterior urethral strictures, addressing current controversies and proposing future directions of research.

Background

Many men with prostate cancer experience elevated levels of anxiety and distress which may interfere with their quality of life. Furthermore, there are challenges to providing supportive care in regional centers such as transportation difficulties. The purpose of this collaborative research project was to evaluate an informational pamphlet, and explore self-ratings of various emotional symptoms and optimal ways to provide psychosocial oncology to men with prostate cancer in a regional cancer centre.

Methods

Men with prostate cancer accessing medical treatment were invited to complete a survey about their emotional experiences and completed a quality of life measure. These men were given an informational pamphlet on distress, and were contacted approximately three weeks later to evaluate the pamphlet and the quality of life measure was re-administered. Qualitative comments on supportive care were elicited.

Results

Sixty-four men participated in the initial survey and 50 (78%) completed the evaluation of the pamphlet. The pamphlet was reported to be easy to read and contained useful information, though men would have preferred to receive this information at an earlier time. Distress and quality of life scores were similar to other samples of men with prostate cancer, and there were no statistically significant differences in quality of life scores for patients receiving radiation (n = 44) compared to the other types (n = 15) of medical treatment (F (1, 57) = 0.610, P < 0.438). Of the emotional symptoms, “worry” and “anxiety” were rated as most problematic and “distress” as least problematic.

Conclusions

Overall, participants rated the pamphlet as very good, though improvements in content and timing are warranted. While many men did not report high levels of distress, there remains a concern for a few patients with elevated levels of distress and patients who expressed difficulty accessing counselling support.

Background

Little research effort has been put in to examining the impact of obesity on the young male population.

Method

A total of 8080 young male adults, aged 19–23 years, were screened by means of a physical examination. Hypertension, abnormal liver function, proteinuria, glucosuria, anemia and leukocytosis were defined as medical problems. The main outcome evaluated among the subjects was the number answering in the affirmative (% yes) for medical problems. All subjects were assigned to a BMI group, which was based on the criteria for the Asian and Pacific region (obesity class II = BMI ≥ 30 kg/m²; obesity class I = 25–29.9 kg/m²), for further assessment and comparison.

Results

The prevalence of obesity classes I and II was 18.0% and 7.1%, respectively, among the subjects. The obesity class II group had a higher odds ratio for developing hypertension (4.0–6.0 times), abnormal liver function (15.6–23.2 times), glucosuria (1.9–7.8 times) and leukocytosis (3.7–6.0 times); while the obesity class I group had a higher odds ratio for developing hypertension (1.8–2.5 times), abnormal liver function (4.9–6.4 times), glucosuria (1.7–5.3 times) and leukocytosis (0.8–1.4 times) than the reference group (BMI < 23 kg/m²).

Conclusion

Our data has reconfirmed the close association between obesity and medical problems in male adults aged 19–23 years, even if they were in a healthy state.

Background

The aim of the study was to measure plasma levels of the vascular endothelial growth factors (VEGF) A and D in serially collected blood specimens from non-localized prostate cancer (PCa) subjects.

Methods

Plasma VEGF A and D levels were measured in two serial specimens 3–6 months apart in two groups of non-localized stage PCa patients. Group 1 was comprised of patients with biochemical relapse after localized PCa treatments and/or patients with clinically metastatic hormone-sensitive stage PCa prior to receiving hormonal therapy. Group 2 included patients failing hormonal therapy for non-localized hormone-sensitive stage PCa. VEGF A and D levels were compared within each cancer group between the two time-points using the Wilcoxon Rank Sum test.

Results

At the first time-point in Group 1 (n = 46), median VEGF-A and D levels were measured at 5.2 (pg/ml) (range = 0–97) and 319 (range = 172–780) (pg/ml). For Group 2 (n = 34) VEGF-A level was 9.6 pg/ml (range = 0–78) and VEGF-D level was 377 pg/ml (range = 243–989) for the first measurement. Median time-period for the serial second specimen was 189 days in Group 1 and 84 days in Group 2. At the second time-point, in Group 1, VEGF-A levels were 0.0 pg/ml (P = 0.0002) while VEGF-D increased to 349 pg/ml (P = 0.002). For Group 2 patients at the second time-point, median VEGF-A was 0.0 pg/ml (P = 1.0) and VEGF-D was measured at 442 pg/ml (P = 0.008).

Conclusions

Higher plasma VEGF-D than VEGF-A expression in advanced PCa stages suggests a greater role for VEGF-D dependent lymph angiogenesis in advanced stage PCa, which needs further evaluation.

Background

Sexual behaviors of men who have sex with men (MSM) that occur in sexually charged venues (e.g., bathhouse, sex club, public park) are a target for research and intervention due to concerns about the role these venues may have in the transmission of HIV and other sexually transmitted infections (STIs). However, these efforts often exclude how individuals perceive HIV risk in terms of sex venue use. This paper analyzes how venue-specific perceptions of HIV transmission risk differ across venues and by onsite sexual behavior.

Method

Cross-sectional data collected using an Internet survey completed by 139 MSM who attended at least one sex venue (e.g., bathhouse, sex club, gym/health club, public park) in the past month.

Results

Risk perceptions were highest for bathhouses and sex clubs, though no significant differences were detected between any of the venues. With few exceptions, men who reported not engaging in sex or low-risk behaviors (i.e., masturbation or mutual masturbation) during venue attendance perceived higher risks than those who engaged in high-risk behaviors (i.e., anal sex). Interestingly, risk perceptions of public bathrooms, parks, and video/buddy booths were lower for attendees who reported unprotected oral sex with ejaculation than men who reported safer or riskier behaviors.

Conclusion

These findings provide important insights into how MSM perceive HIV risk in sex venues and highlight a need for expanded outreach and education in locations where sexual risk taking may be underestimated.

Background

Although osteoporosis is a major public concern, little research attention has been paid to evaluating the manner in which osteoporotic patients perceive their illness.

The aim of the current study was to examine osteoporotic patients’ cognitive and emotional illness representations and to see, specifically, if any differences could be correlated with gender.

Methods

A convenience sample of 102 women and 100 men (mean age 66 years in both groups) who were diagnosed with osteoporosis, and who were attending bone and mineral clinics at four major medical centers in Israel, participated in the study. Participants were interviewed face-to-face at the clinics or in their homes, using an adapted version of the Illness Perceptions Questionnaire (IPQ). Emotional illness representations were assessed using the state anxiety subscale from the State-Trait Personality Inventory (SPTI).

Results

Participants perceived osteoporosis as a chronic but controllable disease. They perceived the disease as having few symptoms and mild consequences on their lives.

Conclusions

Osteoporotic patients maintained a logical cognitive and emotional structure of their illness. Regarding gender differences, findings showed that women were more pessimistic than men regarding most of the illness representations’ dimensions. Gender differences in illness representations suggest women and men may benefit from different intervention programs, tailored according to their unique perceptions.

Background

Gender differences in glycaemic control and diabetes’ complications have been well studied overseas but not locally. Gender is one of the non-modifiable factors for the diabetes patient but it is an important factor for effective personalized diabetes care. This paper examined the gender differences in glycaemic control and diabetes’ complications.

Methods

This was a registry-based observational study from May–December 2008. An online standard case record form was available for site data providers to register their diabetes patients aged 18 years old and above annually. Demographic data, diabetes duration, treatment modalities, as well as various risk factors and diabetes complications were reported. Multivariate analysis was performed.

Results

A total of 20,646 diabetes patients were included. The majority (99.2%) had been diagnosed with type 2 diabetes mellitus (T2D); 42.8% of the sample were men; 57.1% were Malay. The mean age was 58.0 years (standard deviation (SD) = 11.49) with 77.6% of the sample being 50 years old and above. Despite similar diabetes control (HbA1c < 6.5%), females suffered more microvascular complications (estimated glomerular filtration rate (eGFR) <60 mls/min: X² = 753.54, P = <0.001) while men suffered more from macrovascular complications (ischaemic heart disease (X² = 57.61, P = <0.001) and stroke (X² = 13.87, P = <0.001)). Multivariate logistic regression analyses showed that T2D men were more likely to suffer from stroke (odds ratio (OR) = 1.21, 95% confidence interval (CI) = 0.89–1.64), ischaemic heart disease (OR = 1.55, CI = 1.35–1.78) and nephropathy (OR = 1.59, CI = 1.44–1.75).

Conclusion

We observed that men suffered more diabetes-related complications despite similar glycaemic control and better risk factor control. This finding requires further verification from future studies.

Evaluation of cardiometabolic risk has become vital in the primary prevention of adverse vascular events (coronary artery disease, heart attack, stroke or congestive heart failure), particularly in younger middle-aged men (aged 40–60 years old). To discern the prevalence of events in these men, clinicians often stratify cardiovascular risk and treat according to traditional Framingham risk criteria. The Framingham Risk Score (FRS) is a useful and often used tool for estimating the 10-year risk for myocardial infarction or coronary death of an individual. It is supported by the 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults. The FRS is based on data obtained from the Framingham Heart Study and it incorporates age, gender, total and high-density lipoprotein (HDL) cholesterol, smoking, systolic blood pressure (BP), and use of antihypertensive medications. However, it is important to note that the Framingham study includes few data from patients <40 years of age and few minority patients (African American and Hispanic). Thus, the FRS may not adequately estimate risk in younger patients and minorities. The FRS also lacks some important risk factors (e.g., family history, fasting glucose, testosterone) that should be considered when estimating cardiovascular risk in the man with ED. It is evident that the traditional Framingham risk assigned to intermediate and low-risk men will miss several of these individuals deemed at high “cardiometabolic risk”, also known as residual cardiovascular risk. This review will elaborate the definition of cardiometabolic risk, and apply the use of erectile dysfunction and testosterone deficiency as gender-specific surrogate markers for cardiovascular risk stratification in men in addition to the traditional Framingham-based markers. Lastly, it will examine minority men's health, racial differences and the need to include the role of social determinants in future research studies of cardiovascular risk.

Background

Low testosterone (T) has been associated with insulin resistance and diabetes mellitus (DM) among men in population-based studies. These studies included racially diverse men, but did not target for inclusion individuals with opiate use, Hepatitis C Virus (HCV) infection, or Human Immunodeficiency Virus (HIV) infection, which disproportionately affect inner-city populations and may alter the relationship between T and DM.

Methods

The association between free T (FT) and abnormal glucose metabolism was studied among male participants in the Study of HIV, Injection Drug Use, Nutrition, and Endocrinology (SHINE). Logistic regression was used to examine the relationship between log FT and both insulin resistance and prediabetes/DM.

Results

Of 175 men, 43 (24.6%) had low levels of FT (< 52 pg/ml). There were more men in the low FT group on methadone maintenance (39.5% vs. 15.2%, P = 0.001), but there was no difference in FT by HIV or HCV status. Overall, 23 men (13.1%) had prediabetes/DM, which was unrelated to FT (odds ratio (OR) of prediabetes/DM for each log increase in FT = 0.56, 95% Confidence Interval (CI) = 0.13–2.41). FT was also not related to insulin resistance.

Conclusions

The prevalence of hypogonadism was high in this inner-city cohort and was associated with methadone use. However, low FT was not related to insulin resistance or prediabetes/DM. Continued work to identify diabetes risk factors among inner-city populations will help determine targets for intervention to reduce diabetes incidence. Treatment trials of testosterone to reduce diabetes among hypogonadal men may be of particular relevance to opiate users, many of whom are hypogonadal.