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4.84 (25 votes)

Healthcare Prof:

4.69 (13 votes)

Article Opinions:1 posts

The Related Press examines efforts to prevent the spread of HIV by circumcising “about 50 million guys across Africa – where 70 percent of the world’s HIV-infected population lives.” The procedure has been shown to lower a man’s threat of HIV infection by way of heterosexual sex, prompting “[c]ountries with high HIV rates, such as Botswana, Kenya, Rwanda, Namibia and Zambia,” to include male circumcision in their HIV prevention plans, the news service writes.

The AP looks at a brand new male circumcision device that according to researchers is less painful and requires much less time for health workers compared to traditional circumcision techniques. The Chinese-developed “ShangRing consists of two plastic rings, one slightly smaller than the other, that trap the foreskin in in between them. With the use of some anesthesia, the foreskin can then be snipped off with out significant bleeding or stitches. The device is kept on for ten days to allow the wound to heal,” the news service writes.

“According to Chinese information, the complication rate in thousands of men who have had the ShangRing is less than five percent,” even though with “traditional circumcisions in Africa, it can be as high as 15 percent. A surgical circumcision takes about 20 minutes; 1 using the ShangRing might be done in about five. … Inside the 40 males tested in Kenya, 90 percent mentioned they had been satisfied using the procedure,” the AP reports.

According towards the news service, researchers are scheduled to launch a larger study in Kenya later this year. The Bill & Melinda Gates Foundation plans to spend $4 million to support studies evaluating ShangRing and is examining other adult male circumcision devices, the AP reports.

According to “Kim Dickson, an AIDS expert in the World Wellness Organization, … mass circumcision could avoid about four million adult HIV infections between 2009 and 2025,” the AP reports. “Circumcision will most likely avert far far more deaths per dollar spent than other things we’re spending HIV money on,” Philip Stevens, with the International Policy Network, said. “The main problem I can foresee with this is actually persuading men to sign up for it.”

The post anotes that “[e]xperts are also concerned males who get circumcised will mistakenly think they are immune to HIV” (Cheng, 2/15).

This information was reprinted from globalhealth.kff.org with type permission from the Henry J. Kaiser Family Foundation. It is possible to view the whole Kaiser Every day Global Health Policy Report, search the archives and sign up for e-mail delivery at globalhealth.kff.org.

? Henry J. Kaiser Family Foundation. All rights reserved.

Healthcare Prof:

4 (1 votes)

Merck’s human papillomavirus vaccine, Gardasil, effectively prevented precancerous cervical lesions and genital warts in women ages 24 through 45, and it prevented anal cancer and precancerous anal lesions in young men who’ve sex with guys, based on two studies released by the organization on Wednesday, the AP/Philadelphia Inquirer reports. Merck released the studies in conjunction using a European conference of physicians and researchers who specialize in cancer and genital infections.

Gardasil at the moment is approved for the prevention of cervical cancer and genital warts in girls and females ages nine through 26. Merck is utilizing the information from the women’s study to assistance its application for FDA approval to industry Gardasil for cervical cancer and genital wart prevention in females up to age 45. The company expects a ruling by June on the application to make use of the vaccine in older women (Johnson, AP/Philadelphia Inquirer, 2/17).

Gardasil helps block four with the most typical HPV strains — two types that cause 70% of cervical cancer circumstances and two other varieties that trigger 90% of genital warts cases (Women’s Well being Policy Report, 10/22/09). The vaccine also is approved to stop genital warts in boys and males ages nine by way of 26. Gardasil is amongst Merck’s 10 best-selling products, generating $1.12 billion in sales in 2009.

In late 2009, Merck, which funded each studies, provided FDA with more-detailed information from the women’s study. The agency previously rejected the company’s request to market the drug to older females and requested longer-term follow-up data. The newly released women’s study tracked participants for an further one and 1 half years. The study involved 3,819 females ages 24 by way of 45 from several nations who did not have cervical cancer, genital warts or HPV, the AP/Inquirer reports. Precancerous cervical lesions and genital warts did not take place in about 89% of the ladies who received 3 injections of Gardasil more than six months, compared with girls in a group that received a placebo shot. Twenty-three women receiving the placebo and 1 woman who was vaccinated created lesions or warts. All participants had been periodically examined for an average of about 4 years, the AP/Inquirer reports.

The second study located that 3 injections of Gardasil prevented precancerous anal lesions and anal cancer in about 77% of young guys. Whilst no males in either the Gardasil group or perhaps a placebo group created anal cancer, 24 who received the placebo and five who were vaccinated created precancerous lesions. The males were tracked for an average of three years right after the very first shot. According to Merck spokesperson Pam Eisele, the firm plans to submit data on anal cancer in men to FDA and apply for advertising approval (AP/Philadelphia Inquirer, 2/17).

Reprinted with kind permission from http://www.nationalpartnership.org. It is possible to view the whole Daily Women’s Health Policy Report, search the archives, or sign up for e-mail delivery here. The Day-to-day Women’s Health Policy Report is a free service with the National Partnership for Ladies & Families, published by The Advisory Board Company.

? 2010 The Advisory Board Business. All rights reserved.

View drug data on Gardasil.

5 (1 votes)

Healthcare Prof:

Measuring levels with the active form of the protein EGFR within the tumor and its vicinity can give a much more trustworthy prognosis for people with prostate cancer. This is what Ume? University researcher Peter Hammarsten and his associates write in a study in the leading scientific journal Clinical Cancer Study.

One of the main problems with prostate cancer is the fact that, with today’s prognosis markers, some 70-80 percent of patients wind up in a group where quite small may be mentioned about their prognosis. However, nowadays no techniques to are great enough establish which patients truly need to have therapy and which ones can get along fine without the hard remedy. This in turn implies that certain patients are over-treated with therapies that may result in serious side effects and that other patients who actually require intensive remedy don’t get it or get it too late.

In a study lately published inside the scientific journal Clinical Cancer Research, Hammarsten studied tissue biopsies from prostate tumors in 259 patients and located a new prognosis marker for prostate cancer. It’s the active type of the protein EFGR (Epidermal Growth Factor Receptor) that was shown to give data regarding the aggressiveness of the tumor, each when it’s measured within the tumor or within the healthy tissue surrounding the tumor.

EGFR belongs to the same household as the prognosis marker HER2, that is utilized right now for breast cancer to decide the aggressiveness of a tumor which is to be treated with inhibitors of HER2, that’s, the drug Herceptin. In a comparable way, it might be feasible in the future to use the active type of EGFR to choose patients having a poor prognosis and are appropriate for remedy with inhibitors of EGFR. As a way to use EGFR as a prognosis marker clinically within the future, further studies will have to target its expressions in other and bigger material in prostate tumors.

Prostate cancer may be the most frequent cancer form among guys in Sweden. Each year some 10,000 men are diagnosed with prostate cancer. Some two,500 of them will die of their disease. In other words, some patients have an aggressive fatal illness, whereas others have a slowly growing tumor that can not trigger any key troubles.

Source: Expertanswer

View drug info on Herceptin.

Healthcare Prof:

A new study points to the health rewards of living in neighborhoods with built-in physical activity resources.

Researchers conducted a study among community-dwelling guys age 65 years or older from the Portland, Ore., metropolitan region. They sought to discover regardless of whether older men who live within one-eighth, one-quarter, or one-half mile of physical activity resources, including parks, trails and recreational facilities, are a lot more most likely than males who live farther from these resources to preserve or increase the amount of time they devote walking. Participants had been enrolled from March 2000 via April 2002 at six U.S. clinical centers and were followed an typical of three.6 years to assess adjustments in time spent walking. The outcomes of the study revealed a positive association amongst urban-dwelling older males among living inside one-eighth mile of parks and one-half mile of trails and sustaining or growing time spent walking, although the association was limited to men living in high-socioeconomic status neighborhoods.

The study’s authors stated, “Proximity to physical activity resources like parks and trails could be critical for maintaining moderate physical activity over time amongst older guys residing in high-socioeconomic status neighborhoods. These findings support an eco-social model of physical activity promotion incorporating neighborhood-level resources and parks and trails.”

Source
American Journal of Public Health

four (1 votes)

Healthcare Prof:

4 (2 votes)

A new study has identified that many male cancer survivors who develop testosterone deficiency soon after receiving chemotherapy or radiation therapy have an impaired good quality of life and reduced power levels. Published early on the web in Cancer, a peer-reviewed journal of the American Cancer Society, the study suggests that young male cancer survivors with testosterone deficiency could benefit from testosterone replacement therapy.

Testosterone deficiency can be a late side effect of radiation therapy and chemotherapy that occurs in approximately 15 percent of male cancer survivors. Investigators led by Professor Richard Ross, MD, FRCP, of the University of Sheffield inside the United Kingdom examined the relationship in between testosterone levels, top quality of life, self-esteem, fatigue and sexual function in 176 young male cancer survivors compared with 213 young men with out cancer.

Young male cancer survivors mentioned they skilled a marked impairment in high quality of life, together with reduced energy levels and high quality of sexual function. These experiences were exacerbated in survivors with testosterone deficiency. Psychological distress was not elevated, self-esteem was normal, and sexual relationships had been not impaired in male cancer survivors, nonetheless.

Professor Ross commented: “This is an important study demonstrating that low testosterone levels are typical in male cancer survivors and connected with an impaired top quality of life. Nonetheless, the relationship among testosterone levels and good quality of life is complex and appears to depend on a threshold level instead of on a direct correlation. We now need to have interventional trials with testosterone to figure out which young male cancer survivors will benefit from replacement therapy.”

Article: “Quality of life, self-esteem, fatigue and sexual function in young men following cancer: a controlled cross-sectional study.” Diana M. Greenfield, Stephen J. Walters, Robert E. Coleman, Barry W. Hancock, John A. Snowden, Stephen M. Shalet, Leonard R. DeRogatis, Richard J.M. Ross. Cancer; Published On the internet: February 22, 2010 (DOI: 10.1002/cncr.24898).

Source:
David Sampson
American Cancer Society

Healthcare Prof:

The introduction of prostate-specific antigen (PSA) testing as a screening tool for early detection of prostate cancer (PCa) in the starting of the 1990s drastically increased the detection of PCa. The risk of suicide is elevated amongst cancer patients which includes males with PCa. To assess the danger of suicide amongst guys diagnosed with PCa subsequent to PSA testing, a nation-wide study was carried out in Sweden. The final results are published in the March issue of European Urology, the scientific journal of the European Association of Urology (EAU).

Anxiety related to a crisis reaction might create into a depression, and several studies have shown that there is certainly a high anxiety level amongst screeners in several screening programs. Even so, as in most nations, males who underwent PSA testing in Sweden in the time represent an opportunistic screening population and not a accurate population-based screening program by invitation. Therefore, they may happen to be far more well being conscious, much less prone to develop depression, and a lot more prepared to accept the prospective side effects of curative remedy than the common population.

The quantity of suicides registered for situations within the Prostate Cancer Base Sweden (a database in which numerous different registers are merged) cohort was compared with the expected quantity of suicides in an age-matched general male Swedish population. The strengths of this study incorporate the population-based style with inclusion of approximately 98% of all guys in Sweden diagnosed with PCa between1997 and 2006.

There was no evidence for an elevated threat of suicide among guys diagnosed with early nonpalpable PCa detected by PSA testing. The suicide rate, nevertheless, was twice as high among males diagnosed with locally advanced or metastatic disease compared with the common male population. This is important to acknowledge as a way to focus on the have to identify signs of depression and optimise treatment amongst this category of patients.

Source: European Association of Urology

five (1 votes)

Healthcare Prof:

In a study published on-line within the Journal of Urology, researchers from the Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, examined the postoperative outcomes of both ORP and LRP and found similar rates of success. They advise that guys thinking about prostate cancer surgery ought to understand the expected advantages and risks of each technique to facilitate selection making and set realistic expectations.

Of the 200,000 guys newly diagnosed with prostate cancer each year within the United States, about one-third will undergo surgical treatment. Though open radical prostatectomy (ORP) is regarded as the standard treatment, laparoscopic radical prostatectomy (LRP) with or with out robotic assistance is becoming a lot more common.

In a study published on the internet in The Journal of Urology, researchers from the Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, examined the postoperative outcomes of each ORP and LRP and found similar rates of success. They advise that males considering prostate cancer surgery must comprehend the expected rewards and risks of each technique to facilitate choice making and set realistic expectations.

Enthusiasm for LRP, specifically for LRP with robotic assistance, has grown rapidly despite limited evidence of its superiority to ORP. Whilst most studies to date happen to be according to a limited number of patients or from single institutions, the authors with the current study compared ORP and LRP outcomes in a population based cohort of almost 6000 guys 66 years of age or older with clinically localized prostate cancer, controlling for patient and tumor characteristics, and examined the impact of surgeon volume in men treated with LRP.

Dr. Yair Lotan, Department of Urology, University of Texas Southwestern Medical Center, Dallas, comments on the study, “A concern of these authors is the perception amongst patients that the robotic approach to prostatectomy is significantly superior. This perception is often reinforced by advertising from market and physicians. Patients deserve to have a realistic expectation of surgical outcomes, especially considering the multiple other accessible treatment alternatives. Notably the main information that a patient must know is not the prostatectomy approach but surgeon experience. Several studies show that the primary determinant of prostatectomy outcome is surgical volume. Patients ought to be educated on likely outcomes of a procedure according to individual surgeon experience. Unfortunately this data is often harder to obtain than published reports from experts within the field.”

After adjusting for patient and tumor characteristics, there had been no differences in the rate of general medical/surgical complications or genitourinary/bowel complications, or in postoperative radiation and/or androgen deprivation. LRP was connected with a 35% shorter hospital stay and a lower bladder neck/urethral obstruction rate. In laparoscopic cases, the surgeon’s experience with the procedure was inversely associated with hospital stay and also the odds of any genitourinary/bowel complication.

Writing inside the write-up, William T. Lowrance, MD, and colleagues state, “Results suggest that ORP and LRP have similar rates of postoperative mortality and morbidity. Controlling for important patient and tumor characteristics, the only differences favoring LRP had been shorter length of stay and a lower threat of bladder neck or urethral obstruction. All guys taking into consideration radical prostatectomy really should be clearly informed about the differences among the two techniques and similarities in their expected outcomes, and make treatment decisions in collaboration with an experienced surgeon.”

Source: Elsevier

1 (four votes)

Healthcare Prof:

Researchers have found that non-invasive magnetic resonance imaging (MRI) is a good diagnostic tool for the evaluation and staging of testicular cancer and may possibly improve patient care by sparing some men unnecessary surgery, according to a study inside the March issue of the American Journal of Roentgenology (http://www.ajronline.org).

“Medical imaging plays an important role inside the investigation of testicular masses,” stated Athina C. Tsili, MD, lead author with the study. “Sonography, even though the primary imaging technique for the evaluation of scrotal contents, doesn’t always allow confident characterization with the nature of a testicular mass. The purpose of our study was to assess the role of MRI within the preoperative characterization and local staging of testicular masses,” stated Tsili.

Prior surgery and histological examination revealed 28 malignant and 8 benign lesions in 33 patients. “Of those 36 lesions, MRI correctly identified all 28 malignant lesions and 7/8 benign lesions,” she mentioned.

“A achievable diagnosis of benign lesion according to MRI features may possibly improve patient care and decrease the number of unnecessary surgical procedures,” said Tsili.

“MRI is an efficient diagnostic tool for the evaluation of testicular masses. It truly is accurate inside the preoperative differentiation of benign and malignant masses, facilitating accurate estimation of the local extent of disease in patients with malignant tumors,” she stated.

This study appears inside the February issue of the American Journal of Roentgenology.

Source:
Heather Curry
American College of Radiology / American Roentgen Ray Society

5 (1 votes)

Healthcare Prof:

Single or unhappily married males may have an elevated danger of fatal stroke in the coming decades, according to a large study presented at the American Stroke Association’s International Stroke Conference 2010.

The findings are based on earlier work in which researchers examined ten,059 civil servants and municipal workers (average age 49) who participated inside the Israeli Ischemic Heart Disease Study in 1963. Using the national death registry and other records, researchers tracked the fate of the guys by means of 1997, the last year for which underlying causes of death had been coded.

Among the men who in 1963 had been single, 8.4 percent died of stroke inside the following 34 years, compared with 7.1 percent with the married males. Thinking about age at death and adjusting for socioeconomic status, obesity, blood pressure, smoking habits and family size, as well as existing diabetes and heart disease in the time of the earlier survey, single guys had a 64 percent higher risk of fatal stroke than did married guys. That figure is comparable to the threat of fatal stroke faced by men with diabetes, mentioned Uri Goldbourt, Ph.D., author with the study.

Furthermore, in 1965, the married men had been asked to evaluate their marriages as very successful, quite successful, not so successful, or unsuccessful. In an analysis with the 3.6 percent of males who had reported dissatisfaction in their marriage, adjusted risk of a fatal stroke was also 64 percent greater, compared with males who considered their marriages very successful.

“I had not expected that unsuccessful marriage would be of this statistical importance,” said Goldbourt, a professor of epidemiology and preventive medicine at Tel Aviv University in Israel.

The new study has many limitations, he stated, including a lack of data on nonfatal vs. fatal strokes and on participants’ medical treatment soon after the very first five years of the initial study. Ladies also weren’t included.

While the effects of marital status and success could be similar in women, “there are still differences, and analysis on ladies is clearly needed,” Goldbourt mentioned.

The investigation is a snapshot of Israel from more than 4 decades ago, he mentioned. “How much this reflects associations between being happily or relatively happily married and stroke-free survival in other populations, at later times, is not readily deduced.”

Author disclosures can be found on the abstract.

The study was funded by a collaborative project of Hadassah Medical Organization, The Israeli Ministry of Health along with the U.S. National Heart, Lung, and Blood Institute.

Click here to download audio clips offering perspective on this analysis from American Stroke Association spokesperson, Daniel Lackland, DrPH, M.S.P.H., Professor and Director of Graduate Training, Medical University of South Carolina, Charleston, S.C.

Source
American Heart Association

Healthcare Prof:

4.67 (3 votes)

According to a brand new study accepted for publication inside the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM), older guys with high levels with the hormone IGF-I (insulin-like growth factor 1) are at increased risk of cancer death, independent of age, lifestyle and cancer history.

IGF-I is a protein hormone similar in structure to insulin and is regulated in the body by growth hormone (GH). Levels of GH and IGF-I decline progressively with age in both males and ladies and this drop is thought to be related to deteriorating health conditions found with advanced age. In an attempt to combat aging some people use GH as its actions elevate IGF-1.This study nevertheless showed that older men who had greater levels of IGF-I were far more probably to die from a cancer-related cause within the following 18 years than males with lower levels.

“This is the initial population-based study to show an association of higher IGF-I levels with increased threat of a cancer-related death in older men,” said Gail Laughlin, PhD, with the University of California San Diego, and corresponding author of the study. “Although the design of this study will not explicitly show that the higher IGF-I levels caused the cancer death, it does encourage more study at the same time as a reexamination with the use of IGF-I enhancing therapies as an anti-aging strategy.”

In this study researchers used data on 633 males aged 50 and older from the Rancho Bernardo Study, a population-based study of healthy aging. Study participants took part in a analysis clinic examination in between the years of 1988 and 1991 where their blood was obtained and IGF-1 was measured. All participants had their vital status followed via July 2006. Researchers found that guys in this study who had IGF-I levels above 100 ng/ml had almost twice the danger of cancer death in the following 18 years than males with lower levels.

“In this study, the elevated risk of cancer death for older men with high levels of IGF-I was not explained by differences in age, body size, lifestyle or cancer history,” mentioned Jacqueline Major, PhD, lead author on the study, now at the National Cancer Institute. “If these results are confirmed in other populations, these findings recommend that serum IGF-I may have possible importance as a biomarker for prognostic testing.”

Other researchers working on the study include: the Principal Investigator and founder with the Rancho Bernardo Study, Elizabeth Barrett-Connor; and Donna Kritz-Silverstein and Deborah Wingard with the University of California, San Diego.

The post, “Insulin-like Growth Factor-I (IGF-I) and Cancer Mortality in Older Men,” will appear within the March 2010 issue of JCEM.

Source:
Aaron Lohr
The Endocrine Society