Aging Male最新文献

Objective: To investigate the safety and efficacy of wide local excision combined with aminolevulinic acid (ALA) photodynamic therapy (PDT) for the treatment of scrotal Paget's disease in patients of advanced age.

Methods: Data were collected for 16 patients (mean age, 68.44 years) with scrotal Paget's disease treated with wide local excision combined with ALA PDT and followed up from June 2014 to February 2018. Pathological examination after wide local excision confirmed Paget's disease. The patients underwent three courses of ALA PDT postoperatively and were followed up to determine the curative effect and complications in the short and middle term.

Results: The disease duration ranged from 4 to 76 months (mean, 36 months). Ten patients underwent simple excision, six underwent skin flap transfer, and two required reoperations due to skin flap necrosis and infection. The patients were followed up for 3 to 42 months after ALA PDT, during which time two patients developed metastasis (recurrence rate, 12.50%). No other serious complications occurred during follow-up except for lower limb movement disorder in one patient (6.25%).

Conclusions: Wide local excision combined with ALA PDT shows good clinical efficacy and a low complication rate in patients of advanced age with scrotal Paget's disease.

Several questionnaires have been developed to assist the diagnostic process in obstructive sleep apnea syndrome (OSAS). Berlin Sleep Questionnaire (BSQ) represents a validated screening tool for OSAS. Totally 450 patients admitted to the Sleep Center at Dicle University Medical Faculty were included prospectively. A risk analysis was performed for presence of OSAS using the BSQ. Arterial blood gas measurements were performed including bicarbonate (HCO3) level. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of BSQ for presence of OSAS and severe OSAS were determined. In patients with arterial HCO₃ >24.94 mEq/L; sensitivity, specificity, PPV and NPV, of the BSQ were 93.04, 57.1, 98.3, and 23.5%, respectively. The addition of arterial HCO₃ value increased the sensitivity of the BSQ in detecting OSAS patients. Although the cost of sleep studies is high for false positives from the BSQ plus arterial HCO3 level, this cost should be compared with the loss of work efficiency and severe healthcare costs of undiagnosed cases in the future. Therefore, finding possible OSAS cases in primary care health centers is important and adding serum HCO3 value to BSQ questionnaire may contribute to this topic.

Background: Anomaly of internal carotid artery (ICA) is a very rare variation. In almost all the cases, the anomaly was on the right side. This right-sided predominance may be attributed to anatomical influences and factors affecting blood pressure.

Case report: A 67-years-old man presented to ear, nose and throat (ENT) outpatient clinic in Al Wakra Hospital complain of sore throat, there was associated medical co-morbidities (diabetic, hypertensive, hyperlipidemia and coronary artery diseases). ENT examination showed a pulsating, bulging mass on the right posterolateral oropharyngeal wall with normal mucosal covering. CT scan with contrast showed aberrant course of the right ICA which is coursing medially in prevertebral space and right posterolateral hypopharyngeal wall over a length of approximately 1.7 cm, making an acute U-turn before resuming the normal course and its distal aspects, only a thin layer of mucosa noted over the aberrant course of ICA.

Conclusion: Anomaly of ICA must be kept in mind in the evaluation of patients with sore throat associated with oropharyngeal mass especially in old-aged patients with atherosclerotic diseases.

Objective: The purpose of the study was to investigate the association between andropause symptoms and sickness absence in Japanese male workers over 2 years.

Methods: A baseline survey asking about andropause symptoms, along with blood sampling for testosterone level, was conducted in June 2009. A total of 418 men (mean age = 52.4 years, SD = 8.6) participated and were followed through 2011. Hazard ratios (HRs) and 95% confidence intervals (CIs) for sickness absence were calculated using Cox proportional hazard models.

Results: During the follow-up period, 31 of 35 participants who took sickness absences had physical illnesses. A higher andropause symptom score was associated with an increased risk of sickness absence. Testosterone deficiency (<350 ng/dL) was not associated with sickness absence. Among the subscales of andropause symptoms, the somatic symptom score was positively associated with sickness absence, whereas testosterone deficiency combined with high sexual symptoms was not associated with sickness absence. Results were similar when limited to sickness absence because of physical illness. No significant interaction between andropause symptoms and testosterone deficiency was found.

Conclusions: Non-specific andropause symptoms unrelated to testosterone deficiency were positively associated with sickness absence.

Aim: Myocardial performance index (MPI) is an easy-to-apply and non-invasive method that shows both systolic and diastolic functions of the heart. In this study, it was aimed to evaluate the relationship between erectile dysfunction (ED) and MPI. Methods: The study included 45 male patients admitted to the urology outpatient clinic for ED and 48 healthy male volunteers. Echocardiographic evaluation of all participants was performed. Isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT) and ejection time (ET) were measured. MPI was calculated using the IVCT + IVRT/ET formula. Results: The average age of the study population was 50 ± 5.3. Early diastolic mitral inflow (E)/late diastolic mitral inflow (A) ratio was significantly lower in the ED group (p ≤ 0.05). In the TDI evaluation between the groups, while early diastolic mitral annular velocity (Em) was significantly higher in the ED group, there was no significant difference in late diastolic mitral annular velocity (Am) and systolic peak velocities (Sm) (p < 0.01 and p = 0.417 and p = 0.092, respectively). While IVRT was significantly lower in the ED group (p < 0.05), there was no significant difference in IVCT and ET (p = 311 and p = 0.261, respectively). MPI was statistically significantly higher in the ED group (p < 0.05). Conclusion: ED has been found to affect MPI. This parameter, which is easily and non-invasively measured, can be used to predict the risk of CVDs in ED.

In present study, we aimed to investigate anemia etiologies, underlying causes, laboratory markers of anemia, required interventions in postmenopausal women and elderly men. The medical data of the anemic subjects were recorded from the patients' files and computerized database of the institution and retrospectively analyzed. Study population grouped into two according to the gender; men and women. Medical data of men and women were compared. A total of 113 subjects enrolled to the study; 78 women and 35 men. 51 (65%) of women and 21 (60%) of men had iron deficiency anemia, 5 (6.4%) of women and 1 (2.9%) of men had anemia of chronic disease, 2 (2.6%) of women and 10 (28.6%) of men had vitamin B12 deficiency anemia. Forty seven (60.3%) of the women and 30 (85.7%) of the men had comorbidities. 47% of colonoscopies were normal in study population (44% of women and 50% of men). Etiology and causes of anemia should be carefully investigated in subjects with advanced age. Physicians should kept in mind that B12 deficiency and comorbidities were more common in elderly men and about half of the colonoscopy procedures in this population is unnecessary.

Prostate cancer is one of the most common cancers in the male population. The objective of this investigation was to study the relationship of components of transforming growth factor-B (TGF-β)/phosphoinositide-3-kinases (PI3K)/AKT/mammalian target of rapamycin (mTOR)/nuclear factor kappa B (NF-kB) transduction pathway with clinical-pathological markers. By immunohistochemical methods, we determined the expression of several factors [TGF-β, Transforming Growth Factor B Receptor I (TGFBRI), TGFBRII, PI3K, AKT-Ser, AKT-Thr, mTOR, p-mTOR, inhibitor kB kinase (IKK), pIKK, inhibitor kB (IkB), pIkB, NF-kBp50, and NF-kBp65]. To know their relationship with established classical markers (Preoperative serum prostate specific antigen, pathological tumor stage, clinical tumor stage, Gleason score, perineural invasion, node involvement, positive surgical margins, biochemical progression, and survival) and their importance in the prognosis of biochemical progression, Spearman test, survival analysis, Log-rang test, Kaplan-Meier curves, univariate and multivariate Cox proportional Hazard regression analyses were performed. Spearman analysis showed that there was at least one correlation between TGF-β, TGFBRI, PI3K, pAKT-Thr, p-mTOR, NF-kBp50, and classical markers. Cox multivariate analysis between the prognostic variables (pathological tumor stage, Gleason score, and node involvement) and inmunohistochemical parameters confirmed TGFBR1 and PI3K as a prognostic and independent marker of biochemical progression in prostate cancer. Our results suggest that TGFBR1 and PI3K could be used as useful biomarkers for early diagnosis and prognoses for biochemical recurrence in prostate cancer after radical prostatectomy.

Aim: Symptoms of cardiac arrhythmias and the perception of the implantation of a cardiac pacemaker can negatively affect mental health including sexuality and sexual behaviors. The aim of this study was to assess the attitude towards sexuality and sexual behaviors among men with cardiac arrhythmias.

Methods: The study included 80 men (aged 58.6 ± 9.23 years) with heart rhythm disorders who had qualified for cardiac pacemaker implantation. The International Index of Erectile Function IIEF-15 was completed at least one day before cardiac pacemaker implantation by all of the patients.

Results: The average results of the IIEF for all of the included patients was 41.87 ± 7.57 and were statistically worse in the population with atrioventricular blocks (39.60 ± 7.79) compared to those with sinus node dysfunction (44.15 ± 6.71) (p = .0110). The same relationships were found in the subcategory of orgasmic function (p = .0108) as well as intercourse satisfaction (p = .0111). Erectile dysfunction occurred in 88.75% of the patients with diagnosed arrhythmias. There was no statistically significant difference between the occurrence of erectile dysfunction in patients with sinus node dysfunction (87.5%) compared to patients with atrioventricular blocks (90%); p = .7236.

Conclusion: We demonstrated that sexuality and sexual behaviors among men with cardiac arrhythmias was found to be statistically worse in the population with atrioventricular blocks compared to those with sinus node dysfunction. It was especially marked in the area of orgasmic function as well as for intercourse satisfaction.

Background: Skeletal muscle is an important site for storing proteins and providing general physical function. Recent research has shown that muscle strength decreases earlier than muscle mass decreases, as shown during the aging process. Our article aimed to compare the association between testosterone levels and grip strength to provide an earlier biomarker to detect muscle weakness.

Method: We adopted quartile-based analysis by dividing handgrip power into quartiles, with all participants in the lowest quartile serving as the reference group. Linear regression analysis was conducted between handgrip power and testosterone. Logistic regression models were used to analyze the longitudinal correlation between testosterone levels and the presence of low muscle strength.

Results: Serum testosterone levels had a significant correlation with grip strength in all models (p < .001). In addition, high testosterone levels were negatively associated with low muscle strength in all groups (p < .001). A stronger relationship was observed between testosterone levels and grip strength among non-obese participants than among obese participants.

Conclusions: In conclusion, our study highlighted that testosterone levels are related to greater grip strength.