Aging Male最新文献

Aim: To evaluate the Charlson Comorbidity Index (CCI) for predicting outcomes in elderly long-term care patients.

Methods: A retrospective cohort study analyzed health records of 172 hospitalized patients (aged ≥60) from Rumailah Hospital's Geriatrics and Long-term Care Department, Qatar. CCI weights were updated using hazard ratios. Logistic regression and C-statistics assessed mortality outcomes.

Results: Of the 172 patients, 61.5% were male, and 42% were Qatari. Diabetes without complications was the most common comorbidity (42.5%), while AIDS/HIV was absent. In-hospital or 30-day mortality was 6.3%, and 1-year mortality was 26.4%. Updated CCI weights improved risk prediction for diabetes (weight 6), renal disease (weight 4), and malignancies (weight 6), with myocardial infarction assigned zero weight due to low mortality risk. The revised model achieved a C-statistic of 0.9 for both in-hospital and 1-year mortality, surpassing the original CCI's scores (0.8-0.9).

Conclusions: The updated CCI, tailored for Qatar's long-term care population, improves mortality prediction for conditions such as diabetes and renal disease. This context-specific tool improves risk stratification, underscoring the need for tailored prognostic models in Qatar's evolving healthcare system.

Objective: to report a case of familial hypocalciuric hypercalcemia (FHH) in an older patient and highlight the diagnostic challenges in geriatric populations.

Case presentation: We report the diagnosis of FHH in an 88-year-old polypathological patient with hypercalcemia discovered during a check-up for cardiac decompensation. Despite a confusing clinical presentation with gout symptoms, including repeated episodes of knee arthritis, persistent hypercalcemia conducted further investigations. Biological tests excluded primary or hyperparathyroidism and malignancy-related hyperparathyroidism, confirming the diagnosis of FHH through the detection of an inhibitory mutation in the calcium-sensing receptor gene.

Conclusion: This case suggests to clinicians the possibility of FHH in older patients with unexplained hypercalcemia. In geriatric patients, the diagnosis is complicated because of the poly-pathology: here hypercalcemia was associated with a confusing gout crisis, which was triggered by diuretic treatment for heart failure.

Introduction: To compare the effects of different pelvic floor muscle training (PFMT) modes on improving iatrogenic stress urinary incontinence (SUI) recovery in prostate cancer (PCa) patients after radical prostatectomy (RP). Methods: PCa patients who underwent RP were prospectively enrolled and randomized into standard PFMT (S-PFMT) group, somatosensory interactive PFMT (SI-PFMT, an enhanced PFMT) group, and standard PFMT combined with magnetic stimulation (S-PFMT+MS) group. SUI status was evaluated through the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) scores and 1-hour pad test. Results: 101 subjects were enrolled, including 48 in S-PFMT group, 39 in SI-PFMT group, and 14 in S-PFMT+MS group. All groups showed significant ICIQ-UI SF score improvement at 3 and 6 months post-RP compared with baseline (all p < 0.001). At 6 months post-RP, significant improvement of 1-hour pad test result was observed (p = 0.012). Compared with those in the other two groups, patients in the S-PFMT+MS group exhibited significantly better SUI improvement (p = 0.033 vs. S-PFMT; p = 0.011 vs. SI-PFMT) at 6 months. Bayesian survival analysis revealed the superior efficacy of the S-PFMT+MS intervention over an extended period. Conclusions: PCa patients may benefit from magnetic stimulation in addition to standard PFMT for post-RP SUI recovery. CLINICAL TRIAL REGISTRATION: HKUCTR-3029, https://www.hkuctr.com/.

Introduction: Infertility is a major public health issue, with male factors alone contributing to 20-30% of cases. Non-obstructive azoospermia (NOA) is the most severe form, and although techniques like microdissection testicular sperm extraction (mTESE) offer hope, it remains challenging due to its uncertain causes. This study investigates the correlation between testicular histopathology and clinical parameters to enhance sperm retrieval (SR) prediction.

Materials and methods: We reviewed 57 azoospermic men from Hanoi Medical University Hospital, recruited between January 2021 and September 2023. Inclusion criteria were confirmed azoospermia and exclusion of known NOA causes. All underwent mTESE with testicular biopsies classified into four histopathological patterns.

Results: The patients' mean age was 31.75 ± 5.19 years. SR was successful in 19.3% (11/57). Higher follicle-stimulating hormone (FSH) levels were noted in SR-positive men (p = 0.02). Sertoli cell-only syndrome (SCOS) was the most common pattern. While we found a significant difference in SR rate between testicular histopathology, multivariate analysis showed no strong association. However, FSH levels were predictive of histopathology patterns.

Conclusions: Idiopathic NOA (iNOA) represents over 60% of azoospermia cases. mTESE remains the gold standard, and FSH levels may help predict testicular histopathology patterns and improving patients prognosis of SR outcomes.

Background: Erectile dysfunction (ED) is a common disorder that significantly impacts quality of life, and phosphodiesterase type 5 inhibitors (PDE5is) such as tadalafil are one of the primary treatments. However, some patients remain unresponsive, necessitating further investigation.

Objective: To investigate the association between systemic inflammatory response index (SIRI) and tadalafil unresponsiveness in erectile dysfunction patients.

Methods: A total of 106 male patients who applied to the Andrology outpatient clinic with ED complaints between January and June 2024 were included in the study. Patients were started on daily tadalafil 5 mg therapy, and response was assessed after one month using the International Index of Erectile Function Erectile Function domain (IIEF-EF). SIRI values, calculated using neutrophil, monocyte, and lymphocyte counts, were compared between tadalafil-responsive and unresponsive groups.

Results: Tadalafil unresponsiveness was observed in 48.1% of patients. Non-responders had significantly higher mean age(57.44 ± 12.52 vs. 47.22 ± 11.49, p < 0.001), BMI(27.22 ± 3.17 vs. 25.85 ± 2.92, p = 0.023), and SIRI values(1.33 ± 0.82 vs. 1.02 ± 0.40, p = 0.016) compared to responders. Multivariate analysis identified age(OR = 1,641, p = 0.001) and SIRI(OR = 2.420, p = 0.014) as independent predictors of tadalafil failure. ROC curve analysis revealed a SIRI cutoff of 1.03 (AUC = 0.617) with 69.1% sensitivity and 61.2% specificity.

Conclusion: Findings suggest that systemic inflammation plays a key role in ED pathophysiology and may impair PDE5i efficacy.

Background: The aim of this study was to examine the relationship between the type/frequency of consuming beverages and ED among men in America.

Methods: We used data on erectile function and the frequency of beverage consumption from the National Health and Nutrition Examination Survey (NHANES) 2003-2004. Associations between ED and beverage consumption were analyzed using univariate and multivariate logistic regression. We also stratified by age and adjusted for potential confounders using propensity score matching (PSM).

Results: After fully adjusting for covariates, logistic regression showed that regular grape juice consumption (≥ 5 times/week) was related to a lower prevalence of ED (OR = 0.21, 95% CI: 0.08-0.54, p = 0.001). Subgroup analyses found that this correlation remained significant for those over 40 years of age (all p < 0.05). After PSM adjustment, the association between grape juice consumption and ED remained statistically significant (OR = 0.12, 95% CI: 0.03-0.44, p = 0.001). Various beverage types, encompassing tomato, orange, apple, pineapple, and lemonade juices, as well as soft drinks, exhibited a correlation with ED in the initial univariate regression analysis.

Conclusions: In men, regular intake of grape juice (≥ 5 times/week) was associated with a lower prevalence of ED, which was particularly significant in men over 40 years of age.

Introduction: Hypogonadism, while common, can be devastating with long-term ramifications. There are multiple treatment options, but most are burdensome leading to poor compliance. Administration of testosterone (T) pellets offers consistent blood levels based on the implantation of pellets that dissolve over months. Guidelines for pellet dosing has been absent and often men are overdosed with T. The goal of the study was to evaluate the effect of pellet dose versus surface area on blood levels over 3 months in healthy men.

Methods: One group of men were administered small individual pellets that resulted in higher surface than the other group, but at a lower dose.

Results: Within 2 weeks the T levels had risen over two times the baseline level in both groups, but the cohort administered the lowest T dose (but highest surface area) had the greatest response whether calculated as peak change or when analyzed according to age-adjusted values. Increasing the pellet surface area resulted in fewer extrusions, no adverse events, and higher serum T levels compared to subjects that received a higher dose with a lower surface area.

Conclusion: Presently there appears to be no negative consequences of administering T pellets using methods that maximize the total pellet surface area.

Purpose: The quantitatively measured sperm DNA damage and disturbed chromatin condensation indexes (%DNA fragmentation index [DFI%] and %high DNA staining index [%HDS]) and their relationships with sperm quality in normospermic men with unexplained infertility were investigated. The aim was also highlighting the impact of age on both DFI and CMA3 staining and on sperm quality, and their associations with male infertility.

Methods: In this retrospective study, conventional semen tests, including sperm motility and morphological evaluations and DFI and disturbed chromatin condensation indexes (DFI, CMA3) were performed according to the World Health Organization (WHO) 2021 criteria. DFI and CMA3 were evaluated using sperm chromatin dispersion (SCD) and chromomycin A3 (CMA3) staining assays and then correlation and regression analysis were done.

Results: By analyzing SCD and CMA3 results, notable differences were found in sperm parameters among different DFI and CMA3 groups (all p < 0.05). It was found that in the male fertility quality sperm concentration, progressive (PR)/non-progressive (NP) motility, immobility, and morphology were significantly associated with sperm DFI and CMA3, but not with age (p < 0.05).

Conclusions: Sperm molecular index DFI and CMA3 negatively affect male fertility quality through semen parameters (sperm concentration, motility, and morphology). SCD and CMA3 indexes show a significant negative correlation with sperm quality in normospermic males, which highlights its role in the assessment of male fertility potential and molecular evaluation of infertility treatment.