Pub Date : 2024-12-01Epub Date: 2023-12-26DOI: 10.1080/13685538.2023.2288347
Chunlin Wang, Hui Zhang, Fu Wang, Jun Guo, Jianlin Yuan, Guangdong Hou, Ming Gao, Zheng Li, Yan Zhang
Purpose: Although several reviews have evaluated the use of PDE5 inhibitors (PDE5i) for treating erectile dysfunction (ED), their specific use in middle-aged and old patients has not been fully evaluated. Given that elderly patients with ED often have a complex combination of systemic and sexual health risk factors, the safety and efficacy of PDE5i in such a context are hereby reviewed.
Materials and methods: A thorough examination of existing literature has been conducted on PubMed.
Results: PDE5i has good safety and efficacy, but the situation is more complex for patients with hypogonadism than those with normal testosterone levels, with reduced responsiveness to PDE5i. In this case, combination therapy with testosterone is recommended, safe and effective.
Conclusions: Eliminating or reducing reversible risk factors and controlling or slowing the development of irreversible factors is an important foundation for using PDE5i to treat ED in all patients, especially middle-aged and elderly ones.
目的:尽管已有多篇综述对使用PDE5抑制剂(PDE5i)治疗勃起功能障碍(ED)进行了评估,但尚未对其在中老年患者中的具体应用进行全面评估。鉴于患有 ED 的老年患者通常具有复杂的全身性和性健康风险因素组合,本文对 PDE5i 在这种情况下的安全性和有效性进行了综述:结果:PDE5i 具有良好的安全性和有效性:PDE5i具有良好的安全性和有效性,但性腺功能减退症患者的情况比睾酮水平正常的患者更为复杂,他们对PDE5i的反应性降低。在这种情况下,建议与睾酮联合治疗,既安全又有效:消除或减少可逆的危险因素,控制或减缓不可逆因素的发展,是使用PDE5i治疗所有患者(尤其是中老年患者)ED的重要基础。
{"title":"Efficacy and safety of PDE5 inhibitors in middle-aged and old patients with and without hypogonadism.","authors":"Chunlin Wang, Hui Zhang, Fu Wang, Jun Guo, Jianlin Yuan, Guangdong Hou, Ming Gao, Zheng Li, Yan Zhang","doi":"10.1080/13685538.2023.2288347","DOIUrl":"10.1080/13685538.2023.2288347","url":null,"abstract":"<p><strong>Purpose: </strong>Although several reviews have evaluated the use of PDE5 inhibitors (PDE5i) for treating erectile dysfunction (ED), their specific use in middle-aged and old patients has not been fully evaluated. Given that elderly patients with ED often have a complex combination of systemic and sexual health risk factors, the safety and efficacy of PDE5i in such a context are hereby reviewed.</p><p><strong>Materials and methods: </strong>A thorough examination of existing literature has been conducted on PubMed.</p><p><strong>Results: </strong>PDE5i has good safety and efficacy, but the situation is more complex for patients with hypogonadism than those with normal testosterone levels, with reduced responsiveness to PDE5i. In this case, combination therapy with testosterone is recommended, safe and effective.</p><p><strong>Conclusions: </strong>Eliminating or reducing reversible risk factors and controlling or slowing the development of irreversible factors is an important foundation for using PDE5i to treat ED in all patients, especially middle-aged and elderly ones.</p>","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139038163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-02-22DOI: 10.1080/13685538.2024.2317165
Hyeyun Kim, Keun Tae Kim, Won Chul Shin, Kwang Ik Yang, Ji Yong Ha, Yong Won Cho
Background: Obstructive sleep apnea (OSA) is linked to various health complications, including erectile dysfunction (ED), which is more prevalent in individuals with OSA. This study explored ED in Korean OSA patients and assessed the impact of continuous positive airway pressure (CPAP) therapy on ED.
Methods: A total of 87 male patients with OSA from four different sleep centers underwent physical measurements and completed sleep and mental health (MH) questionnaires, including the Korean version of the International index of erectile function (IIEF), before and three months after initiating CPAP therapy.
Results: After three months of CPAP therapy, the patients demonstrated a significant improvement in ED as measured on the IIEF. However, the study found no significant correlation between the duration of CPAP use and the improvement in IIEF score. It did identify the SF36 quality of life assessment as a significant factor influencing ED improvement after CPAP.
Conclusions: ED is a prevalent issue that escalates with age and is associated with OSA. CPAP therapy has shown potential in alleviating ED symptoms, particularly in those with underlying psychological conditions, although further research is required to confirm these findings and understand the underlying mechanisms.
背景:阻塞性睡眠呼吸暂停(OSA)与多种健康并发症有关,其中包括勃起功能障碍(ED),而勃起功能障碍在OSA患者中更为普遍。本研究探讨了韩国 OSA 患者的勃起功能障碍问题,并评估了持续气道正压疗法(CPAP)对勃起功能障碍的影响:方法:共有 87 名来自四个不同睡眠中心的 OSA 男性患者在开始接受 CPAP 治疗前和三个月后接受了身体测量,并填写了睡眠和心理健康(MH)问卷,包括韩国版国际勃起功能指数(IIEF):结果:在使用 CPAP 治疗三个月后,根据国际勃起功能指数(IIEF)的测量结果,患者的 ED 有了明显改善。然而,研究发现使用 CPAP 的持续时间与 IIEF 分数的改善之间没有明显的相关性。研究还发现,SF36 生活质量评估是影响 CPAP 治疗后 ED 改善的一个重要因素:ED是一个普遍问题,随着年龄的增长而加剧,并与OSA有关。CPAP疗法在缓解ED症状方面具有潜力,尤其是对那些有潜在心理疾病的患者,不过还需要进一步的研究来证实这些发现并了解其潜在机制。
{"title":"Erectile dysfunction in patient with obstructive sleep apnea: effects of continuous positive airway pressure.","authors":"Hyeyun Kim, Keun Tae Kim, Won Chul Shin, Kwang Ik Yang, Ji Yong Ha, Yong Won Cho","doi":"10.1080/13685538.2024.2317165","DOIUrl":"10.1080/13685538.2024.2317165","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is linked to various health complications, including erectile dysfunction (ED), which is more prevalent in individuals with OSA. This study explored ED in Korean OSA patients and assessed the impact of continuous positive airway pressure (CPAP) therapy on ED.</p><p><strong>Methods: </strong>A total of 87 male patients with OSA from four different sleep centers underwent physical measurements and completed sleep and mental health (MH) questionnaires, including the Korean version of the International index of erectile function (IIEF), before and three months after initiating CPAP therapy.</p><p><strong>Results: </strong>After three months of CPAP therapy, the patients demonstrated a significant improvement in ED as measured on the IIEF. However, the study found no significant correlation between the duration of CPAP use and the improvement in IIEF score. It did identify the SF36 quality of life assessment as a significant factor influencing ED improvement after CPAP.</p><p><strong>Conclusions: </strong>ED is a prevalent issue that escalates with age and is associated with OSA. CPAP therapy has shown potential in alleviating ED symptoms, particularly in those with underlying psychological conditions, although further research is required to confirm these findings and understand the underlying mechanisms.</p>","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2023-12-27DOI: 10.1080/13685538.2023.2296460
Kristina Groti Antonič, Michael Zitzmann
Introduction: In the past decade, there has been a significant augmentation in the corpus of evidence pertaining to functional hypogonadism. Despite this, prevailing clinical guidelines continue to advise against the universal screening for hypogonadism in middle-aged and elderly males.
Findings: Numerous randomized controlled trials have scrutinized the effects of testosterone therapy in males afflicted with type 2 diabetes and/or obesity. However, these guidelines uniformly assert that lifestyle modifications and weight reduction should be the primary intervention strategies in overweight and obese males, relegating testosterone therapy to a secondary, selective option. It is extensively documented that testosterone therapy can yield substantial improvements in various metabolic parameters as well as ameliorate symptoms of erectile dysfunction. Moreover, recent studies have demonstrated the potential of testosterone therapy in reversing type 2 diabetes in males with low-normal testosterone levels who are at elevated risk for this condition, in comparison to the outcomes achievable through lifestyle modifications alone.
Conclusion: This focused review article aims to present a comprehensive update on the latest data concerning the innovative aspects of testosterone therapy in males with functional hypogonadism, particularly in the context of type 2 diabetes and/or obesity. Additionally, it will delve into the cardiovascular safety of such interventions within this high-risk demographic, with a special emphasis on insights gleaned from the TRAVERSE trial.
{"title":"Novel perspectives of testosterone therapy in men with functional hypogonadism: traversing the gaps of knowledge.","authors":"Kristina Groti Antonič, Michael Zitzmann","doi":"10.1080/13685538.2023.2296460","DOIUrl":"10.1080/13685538.2023.2296460","url":null,"abstract":"<p><strong>Introduction: </strong>In the past decade, there has been a significant augmentation in the corpus of evidence pertaining to functional hypogonadism. Despite this, prevailing clinical guidelines continue to advise against the universal screening for hypogonadism in middle-aged and elderly males.</p><p><strong>Findings: </strong>Numerous randomized controlled trials have scrutinized the effects of testosterone therapy in males afflicted with type 2 diabetes and/or obesity. However, these guidelines uniformly assert that lifestyle modifications and weight reduction should be the primary intervention strategies in overweight and obese males, relegating testosterone therapy to a secondary, selective option. It is extensively documented that testosterone therapy can yield substantial improvements in various metabolic parameters as well as ameliorate symptoms of erectile dysfunction. Moreover, recent studies have demonstrated the potential of testosterone therapy in reversing type 2 diabetes in males with low-normal testosterone levels who are at elevated risk for this condition, in comparison to the outcomes achievable through lifestyle modifications alone.</p><p><strong>Conclusion: </strong>This focused review article aims to present a comprehensive update on the latest data concerning the innovative aspects of testosterone therapy in males with functional hypogonadism, particularly in the context of type 2 diabetes and/or obesity. Additionally, it will delve into the cardiovascular safety of such interventions within this high-risk demographic, with a special emphasis on insights gleaned from the TRAVERSE trial.</p>","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To investigate the practical value of the transrectal two-dimensional shear-wave elastography (SWE) in benign prostatic hyperplasia (BPH).
Methods: Consecutive male participants with and without BPH constituted the BPH and control group respectively were enrolled prospectively between March and December 2022. Transrectal conventional ultrasound and SWE examinations for the prostate were performed on these participants. Data of quantitative stiffness of the transitional zone (TZ) and peripheral zone (PZ) of prostate, volume of prostate (VP) and volume of TZ (VTZ) and prostate specific androgen (PSA), etc., were collected. Linear regression analyses were used to investigate the associations between quantitative stiffness data and other clinical parameters.
Results: There were 200 participants evaluated, including 100 healthy participants and 100 BPH patients. For every one-year increment in age, it was correlated with 0.50 kPa increasement of TZ stiffness. VP and VTZ were correlated with TZ stiffness. Higher TZ stiffness was associated with higher free prostate specific antigen (PSA) and total PSA.
Conclusions: The prostate is stiffer and larger in BPH group compared to control group. Quantitative stiffness of the TZ was related with age, VP, VTZ and PSA.
{"title":"Clinical practice of the transrectal shear-wave elastography in benign prostatic hyperplasia.","authors":"Xuhui Zhang, Zeyu Chen, Jia You, Qiang Lu, Liangren Liu, Diming Cai","doi":"10.1080/13685538.2024.2363267","DOIUrl":"https://doi.org/10.1080/13685538.2024.2363267","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the practical value of the transrectal two-dimensional shear-wave elastography (SWE) in benign prostatic hyperplasia (BPH).</p><p><strong>Methods: </strong>Consecutive male participants with and without BPH constituted the BPH and control group respectively were enrolled prospectively between March and December 2022. Transrectal conventional ultrasound and SWE examinations for the prostate were performed on these participants. Data of quantitative stiffness of the transitional zone (TZ) and peripheral zone (PZ) of prostate, volume of prostate (VP) and volume of TZ (VTZ) and prostate specific androgen (PSA), etc., were collected. Linear regression analyses were used to investigate the associations between quantitative stiffness data and other clinical parameters.</p><p><strong>Results: </strong>There were 200 participants evaluated, including 100 healthy participants and 100 BPH patients. For every one-year increment in age, it was correlated with 0.50 kPa increasement of TZ stiffness. VP and VTZ were correlated with TZ stiffness. Higher TZ stiffness was associated with higher free prostate specific antigen (PSA) and total PSA.</p><p><strong>Conclusions: </strong>The prostate is stiffer and larger in BPH group compared to control group. Quantitative stiffness of the TZ was related with age, VP, VTZ and PSA.</p>","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-05-29DOI: 10.1080/13685538.2024.2357548
Karim Sultan Haider, Michael Zitzmann, Pravinath Ramachandran, Carola S König, Geoffrey Hackett, Ahmad Haider, Farid Saad, Pieter Desnerck, Richard Strange, Amar Mann, Sudarshan Ramachandran
Objective: We evaluated change (Δ) in AMSS in men with adult-onset testosterone deficiency (TD) on/not on testosterone undecanoate (TU) by analysing a registry of men with adult-onset TD.
Methods: Analyses were performed using non-parametric statistics to determine ΔAMSS at 6-12 monthly intervals in men on/not on TU and movement in AMSS. Factors predicting ΔAMSS were established via linear/multiple regression.
Results: TU was significantly associated with lower AMSS values compared with that at baseline/prior assessment during the initial 42 months treatment; 259 of the 260 men showed improvement. In the 361 men not on TU, AMSS values increased during 60 months of follow-up compared with that at baseline/prior assessment; improvement after 60 months was evident in 1 man, whilst AMSS remained the same or worsened in 213 and 147 men, respectively. In men on TU, baseline AMSS was inversely associated with ΔAMSS (R2 = 0.97), with no other factors reaching significance. Baseline AMSS, age, serum total testosterone (TT), waist circumference (WC), and diastolic blood pressure (BP) were associated with ΔAMSS in men not on TU.
Discussion: We show that TU was associated with lower AMSS in men with adult-onset TD whilst non-treatment led to increased values. Baseline AMSS values inversely predicted ΔAMSS in both groups.
{"title":"Testosterone therapy over 60 months improves aging male symptoms scores in all men with adult-onset testosterone deficiency.","authors":"Karim Sultan Haider, Michael Zitzmann, Pravinath Ramachandran, Carola S König, Geoffrey Hackett, Ahmad Haider, Farid Saad, Pieter Desnerck, Richard Strange, Amar Mann, Sudarshan Ramachandran","doi":"10.1080/13685538.2024.2357548","DOIUrl":"https://doi.org/10.1080/13685538.2024.2357548","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated change (Δ) in AMSS in men with adult-onset testosterone deficiency (TD) on/not on testosterone undecanoate (TU) by analysing a registry of men with adult-onset TD.</p><p><strong>Methods: </strong>Analyses were performed using non-parametric statistics to determine ΔAMSS at 6-12 monthly intervals in men on/not on TU and movement in AMSS. Factors predicting ΔAMSS were established <i>via</i> linear/multiple regression.</p><p><strong>Results: </strong>TU was significantly associated with lower AMSS values compared with that at baseline/prior assessment during the initial 42 months treatment; 259 of the 260 men showed improvement. In the 361 men not on TU, AMSS values increased during 60 months of follow-up compared with that at baseline/prior assessment; improvement after 60 months was evident in 1 man, whilst AMSS remained the same or worsened in 213 and 147 men, respectively. In men on TU, baseline AMSS was inversely associated with ΔAMSS (<i>R</i><sup>2</sup> = 0.97), with no other factors reaching significance. Baseline AMSS, age, serum total testosterone (TT), waist circumference (WC), and diastolic blood pressure (BP) were associated with ΔAMSS in men not on TU.</p><p><strong>Discussion: </strong>We show that TU was associated with lower AMSS in men with adult-onset TD whilst non-treatment led to increased values. Baseline AMSS values inversely predicted ΔAMSS in both groups.</p>","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Erectile dysfunction (ED) is a common issue among males, and the use of platelet-rich plasma (PRP) therapy for treating ED has gained increasing attention, but there is still no conclusive evidence regarding its efficacy.
Aim: To evaluate the efficacy of PRP therapy for ED.
Methods: We systematically searched PubMed, Embase, Cochrane Library, and Web of Science databases up to November 2023 to identify randomized controlled trials (RCTs) on PRP therapy for ED. We used Review Manager version 5.4 for data analysis and management.
Result: After applying inclusion and exclusion criteria for screening, a total of 4 studies involving 413 patients were finally included in our meta-analysis. According to our analysis, the PRP group showed significant advantages over the placebo group in terms of MCID at the first month (p = 0.03) and sixth months (p = 0.008), while there was no significant difference between the two groups at the third month (p = 0.19). Additionally, in terms of IIEF, PRP showed significantly better efficacy than placebo at the first, third, and sixth months (p < 0.00001).
Conclusions: PRP shows more effectiveness in treating ED compared to placebo, offering hope as a potential alternative treatment for ED.
背景:勃起功能障碍(ED)是男性的常见问题,使用富血小板血浆(PRP)疗法治疗ED已受到越来越多的关注,但关于其疗效仍没有确凿的证据:我们系统地检索了截至 2023 年 11 月的 PubMed、Embase、Cochrane Library 和 Web of Science 数据库,以确定 PRP 治疗 ED 的随机对照试验 (RCT)。我们使用Review Manager 5.4版本进行数据分析和管理:结果:在采用纳入和排除标准进行筛选后,我们的荟萃分析最终纳入了共 4 项研究,涉及 413 名患者。根据我们的分析,在第一个月(p = 0.03)和第六个月(p = 0.008)的 MCID 方面,PRP 组比安慰剂组有显著优势,而在第三个月(p = 0.19),两组之间没有显著差异。此外,在 IIEF 方面,PRP 在第一个月、第三个月和第六个月的疗效明显优于安慰剂(p 结论:PRP 对治疗男性性功能障碍更有效:与安慰剂相比,PRP 在治疗 ED 方面更有效,有望成为 ED 的一种潜在替代疗法。
{"title":"The efficacy of platelet rich plasma in the treatment of erectile dysfunction: a systematic review and meta-analysis of randomized controlled trials.","authors":"Qiancheng Mao, Yingying Yang, Yang Liu, Hongquan Liu, Gonglin Tang, Xiaofeng Wang, Yuanshan Cui, Jitao Wu","doi":"10.1080/13685538.2024.2358944","DOIUrl":"10.1080/13685538.2024.2358944","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) is a common issue among males, and the use of platelet-rich plasma (PRP) therapy for treating ED has gained increasing attention, but there is still no conclusive evidence regarding its efficacy.</p><p><strong>Aim: </strong>To evaluate the efficacy of PRP therapy for ED.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Cochrane Library, and Web of Science databases up to November 2023 to identify randomized controlled trials (RCTs) on PRP therapy for ED. We used Review Manager version 5.4 for data analysis and management.</p><p><strong>Result: </strong>After applying inclusion and exclusion criteria for screening, a total of 4 studies involving 413 patients were finally included in our meta-analysis. According to our analysis, the PRP group showed significant advantages over the placebo group in terms of MCID at the first month (<i>p</i> = 0.03) and sixth months (<i>p</i> = 0.008), while there was no significant difference between the two groups at the third month (<i>p</i> = 0.19). Additionally, in terms of IIEF, PRP showed significantly better efficacy than placebo at the first, third, and sixth months (<i>p</i> < 0.00001).</p><p><strong>Conclusions: </strong>PRP shows more effectiveness in treating ED compared to placebo, offering hope as a potential alternative treatment for ED.</p>","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To assess various management options for renal angiomyolipoma (AML) to guide clinical practice.
Methods: A single center retrospectively reviewed an AML series from 2002 to 2022. The image reports and chart reviews of patients who received two abdominal scans at least 6 months between the first and last scans were assessed.
Results: A total of 203 patients with 209 tumors were identified and followed up for a median of 42.6 months. Active surveillance (AS) was the most frequently selected option (70.9% of cases). Interventions were required for 59 AMLs, of which 20 were treated with embolization, 29 with partial nephrectomy, 9 with radical nephrectomy, and 1 with radiofrequency (RF) ablation. The median size of the lesions at intervention was 5 cm. The average growth rate of the lesions was 0.12 cm/year, and there was a significant difference in the average growth rate of lesions ≤4 cm and those >4 cm (0.11 vs. 0.24 cm/year; p = 0.0046).
Conclusion: This series on AMLs confirms that lesions >4 cm do not require early intervention based on size alone. Appropriately selected cases of renal AML can be managed by AS.KEYWORDS: Angiomyolipoma; active surveillance; embolization; nephrectomy; nephron-sparing surgery.
{"title":"Evolving horizons in renal angiomyolipoma: two decades of management strategies and clinical perspectives in a single institutional study.","authors":"Ahmet Keles, Ayberk Iplikci, Ozgur Arikan, Meftun Culpan, Kursad Nuri Baydili, Ferhat Keser, Asif Yildirim","doi":"10.1080/13685538.2024.2346308","DOIUrl":"https://doi.org/10.1080/13685538.2024.2346308","url":null,"abstract":"<p><strong>Objective: </strong>To assess various management options for renal angiomyolipoma (AML) to guide clinical practice.</p><p><strong>Methods: </strong>A single center retrospectively reviewed an AML series from 2002 to 2022. The image reports and chart reviews of patients who received two abdominal scans at least 6 months between the first and last scans were assessed.</p><p><strong>Results: </strong>A total of 203 patients with 209 tumors were identified and followed up for a median of 42.6 months. Active surveillance (AS) was the most frequently selected option (70.9% of cases). Interventions were required for 59 AMLs, of which 20 were treated with embolization, 29 with partial nephrectomy, 9 with radical nephrectomy, and 1 with radiofrequency (RF) ablation. The median size of the lesions at intervention was 5 cm. The average growth rate of the lesions was 0.12 cm/year, and there was a significant difference in the average growth rate of lesions ≤4 cm and those >4 cm (0.11 <i>vs.</i> 0.24 cm/year; <i>p</i> = 0.0046).</p><p><strong>Conclusion: </strong>This series on AMLs confirms that lesions >4 cm do not require early intervention based on size alone. Appropriately selected cases of renal AML can be managed by AS.KEYWORDS: Angiomyolipoma; active surveillance; embolization; nephrectomy; nephron-sparing surgery.</p>","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-09-28DOI: 10.1080/13685538.2024.2401161
Hanadi Al Hamad, Sameer Acharath Valappil, Brijesh Sathian
Background: Worldwide, the evidence-based 4Ms framework of the Age-Friendly Health System (AFHS) improves the experience of caring for older adults. This study aimed to examine healthcare professionals' perceptions, attitudes, and behaviors regarding the AFHS and 4Ms before they were implemented.
Methods: This study was a questionnaire-based survey of 252 healthcare professionals in geriatrics and long-term care departments, Rumailah Hospital, Acute Care Services in Hamad General Hospital, and home healthcare services to assess their perceptions, attitudes, and behaviors regarding 4Ms from November 1, 2022, to July 31, 2023.
Results: Most respondents acknowledged the benefits of providing care through AFHS. However, only 62% of respondents reported using the 4Ms framework. The most commonly used types of age-friendly care provided by health care professionals were reviews of high-risk medication use (64.2%) and screening for mobility limitations (55.8%).
Conclusion: The findings suggest that there is a need for more training and education regarding the 4Ms framework for health care providers. This training should focus on specific aspects of the framework, such as how to assess what matters most to older adults; how to manage their mobility, mentation, and medication; and how to coordinate care across settings.
{"title":"Needs assessment survey among healthcare professionals to implement the 4Ms framework: a cross-sectional study from Qatar.","authors":"Hanadi Al Hamad, Sameer Acharath Valappil, Brijesh Sathian","doi":"10.1080/13685538.2024.2401161","DOIUrl":"https://doi.org/10.1080/13685538.2024.2401161","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, the evidence-based 4Ms framework of the Age-Friendly Health System (AFHS) improves the experience of caring for older adults. This study aimed to examine healthcare professionals' perceptions, attitudes, and behaviors regarding the AFHS and 4Ms before they were implemented.</p><p><strong>Methods: </strong>This study was a questionnaire-based survey of 252 healthcare professionals in geriatrics and long-term care departments, Rumailah Hospital, Acute Care Services in Hamad General Hospital, and home healthcare services to assess their perceptions, attitudes, and behaviors regarding 4Ms from November 1, 2022, to July 31, 2023.</p><p><strong>Results: </strong>Most respondents acknowledged the benefits of providing care through AFHS. However, only 62% of respondents reported using the 4Ms framework. The most commonly used types of age-friendly care provided by health care professionals were reviews of high-risk medication use (64.2%) and screening for mobility limitations (55.8%).</p><p><strong>Conclusion: </strong>The findings suggest that there is a need for more training and education regarding the 4Ms framework for health care providers. This training should focus on specific aspects of the framework, such as how to assess what matters most to older adults; how to manage their mobility, mentation, and medication; and how to coordinate care across settings.</p>","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-10-04DOI: 10.1080/13685538.2024.2406547
François Rozet, Christophe Hennequin, Pierre Mongiat-Artus, Nathalie Pello-Leprince-Ringuet, Anne-Sophie Grandoulier, Morgan Roupret
Objectives: To compare the evolution of health-related quality of life (HRQoL) over 6 months of GnRH agonist (GnRHa) therapy among age groups for patients with prostate cancer (PCa).
Patients and methods: PRISME (NCT03516110) was a non-interventional, prospective study conducted in France in patients aged ≥60 years with PCa initiating GnRHa therapy within routine care. HRQoL was evaluated at baseline and after 6 months using the EORTC quality of life in ELDerly cancer patients 14 items (QLQ-ELD14) questionnaire. Cognitive status was assessed using the Mini Mental State Examination (MMSE). Analyses of covariance compared the evolution of the change from baseline of the QLQ-ELD14 scores among age groups.
Results: 814 patients were enrolled (245, 60-70 years; 314, 70-75 years; 252, ≥75 years). Slight or no changes were observed in each QLQ-ELD14 dimension between baseline and 6 months, overall and by age. In the primary effectiveness analysis, there was no difference among age groups in the change from baseline in QLQ-ELD14 scores. Baseline cognitive status was lower in the oldest age group, but there were no changes in all age groups. As expected, sexual function declined in all age groups.
Conclusion: GnRHa therapy influence on HRQoL, cognition and sexuality appeared independent of age.
{"title":"Health-related quality of life of patients with prostate cancer initiating GnRH agonist therapy: the PRISME study.","authors":"François Rozet, Christophe Hennequin, Pierre Mongiat-Artus, Nathalie Pello-Leprince-Ringuet, Anne-Sophie Grandoulier, Morgan Roupret","doi":"10.1080/13685538.2024.2406547","DOIUrl":"https://doi.org/10.1080/13685538.2024.2406547","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the evolution of health-related quality of life (HRQoL) over 6 months of GnRH agonist (GnRHa) therapy among age groups for patients with prostate cancer (PCa).</p><p><strong>Patients and methods: </strong>PRISME (NCT03516110) was a non-interventional, prospective study conducted in France in patients aged ≥60 years with PCa initiating GnRHa therapy within routine care. HRQoL was evaluated at baseline and after 6 months using the EORTC quality of life in ELDerly cancer patients 14 items (QLQ-ELD14) questionnaire. Cognitive status was assessed using the Mini Mental State Examination (MMSE). Analyses of covariance compared the evolution of the change from baseline of the QLQ-ELD14 scores among age groups.</p><p><strong>Results: </strong>814 patients were enrolled (245, 60-70 years; 314, 70-75 years; 252, ≥75 years). Slight or no changes were observed in each QLQ-ELD14 dimension between baseline and 6 months, overall and by age. In the primary effectiveness analysis, there was no difference among age groups in the change from baseline in QLQ-ELD14 scores. Baseline cognitive status was lower in the oldest age group, but there were no changes in all age groups. As expected, sexual function declined in all age groups.</p><p><strong>Conclusion: </strong>GnRHa therapy influence on HRQoL, cognition and sexuality appeared independent of age.</p>","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-02-05DOI: 10.1080/13685538.2024.2310308
Ren-Dan Zhang, Shi-Qin Jiang, Feng-Juan Yan, Lei Ruan, Cun-Tai Zhang, Xiao-Qing Quan
Objective: As people get older, the innate and acquired immunity of the elderly are affected, resulting in immunosenescence. Prealbumin (PAB), transferrin (TRF), and albumin (ALB) are commonly used markers to monitor protein energy malnutrition (PEM). However, their relationship with the immune system has not been fully explored.
Methods: In our study, a total of 93 subjects (≥65 years) were recruited from Tongji Hospital between January 2015 and February 2017. According to the serum levels of these proteins (PAB, TRF, and ALB), we divided the patients into the high serum protein group and the low serum protein group. Then, we compared the percent expression of lymphocyte subsets between two groups.
Results: All the low serum protein groups (PAB, TRF, and ALB) had significant decreases in the percentage of CD4+ cells, CD3+CD28+ cells, CD4+CD28+ cells and significant increases in the percentage of CD8+ cells, CD8+CD28- cells. PAB, TRF, and ALB levels revealed positive correlations with CD4/CD8 ratio, proportions of CD4+ cells, CD3+CD28+ cells, CD4+CD28+ cells, and negative correlation with proportions of CD8+ cells, CD8+CD28- cells.
Conclusions: This study suggested PAB, TRF, and ALB could be used as immunosenescence indicators. PEM might accelerate the process of immunosenescence in elderly males.
{"title":"The association of prealbumin, transferrin, and albumin with immunosenescence among elderly males.","authors":"Ren-Dan Zhang, Shi-Qin Jiang, Feng-Juan Yan, Lei Ruan, Cun-Tai Zhang, Xiao-Qing Quan","doi":"10.1080/13685538.2024.2310308","DOIUrl":"10.1080/13685538.2024.2310308","url":null,"abstract":"<p><strong>Objective: </strong>As people get older, the innate and acquired immunity of the elderly are affected, resulting in immunosenescence. Prealbumin (PAB), transferrin (TRF), and albumin (ALB) are commonly used markers to monitor protein energy malnutrition (PEM). However, their relationship with the immune system has not been fully explored.</p><p><strong>Methods: </strong>In our study, a total of 93 subjects (≥65 years) were recruited from Tongji Hospital between January 2015 and February 2017. According to the serum levels of these proteins (PAB, TRF, and ALB), we divided the patients into the high serum protein group and the low serum protein group. Then, we compared the percent expression of lymphocyte subsets between two groups.</p><p><strong>Results: </strong>All the low serum protein groups (PAB, TRF, and ALB) had significant decreases in the percentage of CD4+ cells, CD3<sup>+</sup>CD28<sup>+</sup> cells, CD4<sup>+</sup>CD28<sup>+</sup> cells and significant increases in the percentage of CD8<sup>+</sup> cells, CD8<sup>+</sup>CD28<sup>-</sup> cells. PAB, TRF, and ALB levels revealed positive correlations with CD4/CD8 ratio, proportions of CD4<sup>+</sup> cells, CD3<sup>+</sup>CD28<sup>+</sup> cells, CD4<sup>+</sup>CD28<sup>+</sup> cells, and negative correlation with proportions of CD8<sup>+</sup> cells, CD8<sup>+</sup>CD28<sup>-</sup> cells.</p><p><strong>Conclusions: </strong>This study suggested PAB, TRF, and ALB could be used as immunosenescence indicators. PEM might accelerate the process of immunosenescence in elderly males.</p>","PeriodicalId":55542,"journal":{"name":"Aging Male","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}