Glasses Online

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

four.83 (6 votes)

Healthcare Prof:

3.5 (two votes)

In a study published inside the March 2010 issue of The American Journal of Medicine, researchers determined that standard use of aspirin, acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) increases the threat of hearing loss in men, particularly in younger guys, below age 60.

Hearing loss will be the most common sensory disorder in the US, afflicting over 36 million people. Not only is hearing loss highly prevalent among the elderly, but approximately 1 third of those aged 40-49 years already suffer from hearing loss. Even mild hearing loss can compromise the ability to realize speech within the presence of background noise or multiple speakers, leading to social isolation, depression, and poorer quality of life.

Investigators from Harvard University, Brigham and Women’s Hospital, Vanderbilt University and also the Massachusetts Eye and Ear Infirmary, Boston looked at factors other than age and noise that might influence the risk of hearing lose. Aspirin, acetaminophen, and ibuprofen are the three most commonly used drugs within the US. The ototoxic effects of aspirin are nicely known along with the ototoxicity of NSAIDs has been suggested, but the relation between acetaminophen and hearing loss has not been examined previously. The relationship between these drugs and hearing loss is an important public wellness issue.

Study participants were drawn from the Well being Professionals Follow-up Study, which tracked over 26,000 males each and every two years for 18 years. A questionnaire determined analgesic use, hearing loss and a variety of physiological, medical and demographic aspects.

For aspirin, normal users under 50 and those aged 50-59 years were 33% much more most likely to have hearing loss than were nonregular users, but there was no association amongst guys aged 60 years and older. For NSAIDs, regular users aged under 50 had been 61% a lot more likely, those aged 50-59 had been 32% more most likely, and those aged 60 and older were 16% more probably to develop hearing loss than nonregular users of NSAIDs. For acetaminophen, normal users aged under 50 were 99% a lot more probably, regular users aged 50-59 were 38% a lot more probably, and those aged 60 and older were 16% far more most likely to have hearing loss than nonregular users of acetaminophen.

Writing within the write-up, Sharon G. Curhan, MD, ScM, Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Boston, and colleagues state, “Regular use of analgesics, specifically aspirin, NSAIDs, and acetaminophen, might increase the threat of adult hearing loss, particularly in younger people. Given the high prevalence of normal analgesic use and well being and social implications of hearing impairment, this represents an important public well being issue.”

The write-up is “Analgesic Use along with the Threat of Hearing Loss in Men” by Sharon G. Curhan, MD, ScM, Roland Eavey, MD, Josef Shargorodsky, MD, Gary C. Curhan, MD, ScD. It appears in The American Journal of Medicine, Volume 123, Issue 3 (March 2010) published by Elsevier.

Source:
Pamela Poppalardo
Elsevier Health Sciences

4.38 (8 votes)

Healthcare Prof:

Like any successful team effort, the best qualities of two drugs commonly prescribed for enlarged prostate yielded much better outcomes than either with the medicines alone, according to a brand new study from UT Southwestern Medical Center.

The findings, published in a recent issue of the journal European Urology, compared treatments for 3 groups of study participants with enlarged prostates over 4 years. The study, which included much more than 4,800 guys, is one with the initial to compare single and combo medication regimens in such a large group.

The first group of study participants received the drug dutasteride; the second group received tamsulosin; and the third received a combination of the two medicines.

“We found the combination therapy to be superior at reducing threat of BPH progression,” stated Dr. Claus Roehrborn, chairman of urology at UT Southwestern and lead author with the study. “The two medications joined forces in terms of symptom manage. On the strengths of each dutasteride and tamsulosin, participants reported fewer symptoms, and we observed a 25 percent reduction in prostate volume.”

Dr. Roehrborn added that subjects who received the combination therapy also showed a 50 percent reduction of prostate-specific antigen (PSA), a protein produced by both cancerous and noncancerous prostate tissue. PSA levels can be an indication of increased risk of cancer due to the fact cancer cells usually make far more PSA than do benign cells, causing PSA levels inside the blood to rise. Really should PSA levels continue to rise right after beginning therapy, patients really should be monitored closely since the combination medicines do lower PSA readings, Dr. Roehrborn said.

Enlarged prostate, also called benign prostatic hyperplasia (BPH), is a common urologic condition that affects about 50 percent of males between the ages of 51 and 60 and up to 90 percent of men over the age of 80.

Symptoms with the condition can be prolonged and severe. Prostate enlargement creates pressure on the urethra, generating it difficult to urinate, which can lead to acute urinary retention. This retention causes a host of other issues, including extreme discomfort and infections.

Researchers also looked at the data to determine if the number of study participants needing surgery for BPH decreased using the combination medication regimen. Compared with tamsulosin alone, the combination of drugs decreased the incidence of acute urinary retention by 67 percent and reduced the want for BPH-related surgery by 70 percent.

“We found a 65 percent decrease within the relative threat of acute urinary retention or BPH-related surgery compared with tamsulosin alone and just over a 19 percent reduction compared with dutasteride alone,” stated Dr. Roehrborn.

Those taking the combination of drugs also had been less probably than those within the other two groups to discontinue therapy, he stated. Participants themselves noted that the combo medicines were most effective at reducing symptoms.

“There is currently no combination drug for doctors to prescribe for these patients,” Dr. Roehrborn stated. “This investigation must provide physicians much better details when they decide on a course of treatment for patients with BPH.”

Other researchers contributing to the study had been from the Deaconess Clinic in Evansville, Ind.; State University of Rio de Janeiro; Universita Vita Salute San Raffaele, Italy; University of Toronto; and GlaxoSmithKline.

The study was funded by GlaxoSmithKline. Dr. Roehrborn is a consultant to the pharmaceutical company.

Source: UT Southwestern Medical Center

View drug details on dutasteride.

3.67 (three votes)

Healthcare Prof:

Members of America’s Prostate Cancer Organizations are concerned that the issuance this morning of yet another set of new guidelines on screening for prostate cancer is only adding to the confusion most guys already feel about whether or not they really should or shouldn’t be tested for the most common form of cancer in American men.

“It is time for us all to come together and make one, straightforward recommendation about screening and early detection of prostate cancer that is easily understood by men and their doctors,” mentioned Thomas Kirk, President/CEO of Us TOO International Prostate Cancer Education and Support Network.

“In the past 12 months we have seen new guidance on prostate cancer screening from the American Urological Association (a professional society), the National Comprehensive Cancer Network (a network of cancer centers), and now the American Cancer Society (a cancer nonprofit),” stated Skip Lockwood, President of ZERO The Project to Finish Prostate Cancer. “Each set of guidelines is complex, as well as the details in each set of guidance are all slightly different.”

America’s Prostate Cancer Organizations, which seek to act inside the best interests of guys at risk for prostate cancer and those already diagnosed with this disease, believe that it truly is high time that the various groups function together to issue one, simple guidance document for males and their households and another for the primary care community. Such guidance must represent a consensus position with the U.S. professional societies and other stakeholders on the risks and benefits of screening for prostate cancer, as opposed to the viewpoints of selected groups of specialists.

“These guideline discrepancies only add to the confusion around two key issues when to be screened and what to do with the screening results,” mentioned Wendy Poage, President of the Prostate Conditions Education Council. “By collectively issuing clear guidelines, we can finally address these questions and encourage guys to take appropriate steps to safe guard their health.”

“There appears to be significant overlap in between the recommendations with the various groups issuing these differing guidelines,” noted Scott T. Williams, Vice President of Men’s Health Network. “The members of America’s Prostate Cancer Organizations are far more than willing to function closely using the interested sectors to support to develop standard and simple guidelines that can be universally promoted to guys and their households and to the provider community.”

About America’s Prostate Cancer Organizations: Prostate cancer may be the most prevalent form of cancer among American males. Nearly 200,000 men will be diagnosed with prostate cancer in 2010, and about 28,000 will die from this disease. This group of independent, not-for-profit organizations cooperates to foster the development of policies that support the early detection of clinically significant prostate cancer, the effective treatment of men with this disease, as well as the suitable education of all men at danger for this disease.

The above statement has been issued on behalf of and endorsed by:

Malecare Prostate Cancer Support

Men’s Health Network

National Alliance of State Prostate Cancer Coalitions

Prostate Cancer Foundation

Prostate Cancer International

Prostate Conditions Education Council

The Prostate Net

Us TOO International Prostate Cancer Education and Support Network

Women Against Prostate Cancer

ZERO The Project to End Prostate Cancer

Source: America’s Prostate Cancer Organizations