Elderly Men Research Articles

The effect of probiotic-fortified kefir on depression, appetite, oxidative stress, and inflammatory parameters in Iranian overweight and obese elderly: a randomized, double-blind, placebo-controlled clinical trial

BackgroundIt has been shown that the microflora of the gastrointestinal tract undergoes changes in obese individuals. The present study aimed to investigate the effect of kefir fortified with two strains, Lactobacillus helveticus and Bifidobacterium longum, on depression, appetite, oxidative stress, and inflammatory parameters in overweight and obese elderly individuals.MethodsThis study was a double-blind, randomized, and placebo-controlled clinical trial conducted on 67 elderly men aged over 65, who were randomly divided into two groups. One group (n = 35) received one bottle (240 cc) of regular kefir as a placebo, while the intervention group (n = 32) received one bottle of probiotic-fortified kefir for eight weeks. Depression and appetite were evaluated using the Geriatric Depression Scale-15 (GDS-15) and a validated Visual Analogue Scale (VAS), respectively. Oxidative stress parameters were assessed using the standard calorimetric method, and inflammatory parameters were measured via the enzyme-linked immunosorbent assay method (ELISA). The differences between the two groups were compared using the independent samples T-test.ResultsThe median age of participant in both groups was 65 years. A significant difference in depression scores and the mean change between the two groups was observed after eight weeks (p = 0.001 and p = 0.042, respectively). Within-group comparison revealed a significant increase in appetite scores in both groups (p < 0.05 for both). Moreover, a significant difference in the changes in total antioxidant capacity (TAC) was noted (p = 0.009). However, no significant differences were observed in other oxidative and inflammatory parameters between the two groups (p˃0.05 for all).ConclusionsThe results demonstrated the positive impact of two specific strains of Bifidobacterium and Lactobacillus on improving depression in the elderly. However, when comparing the two groups, no significant effects were observed on appetite, inflammation, and oxidative stress parameters, except for TAC.

Testosterone in long-term sedentary aging males: Effect of antiaging strategies.

Physical activity can provide health benefits if done regularly and of sufficient duration and intensity. TheWorld Health Organization recommends adults do 150-300 min of moderate-intensity activity per week, 75-150 min of vigorous-intensity activity, or an equivalent combination.Physical inactivity is the fourth leading cause of early death globally, with 31% of the world's population not getting enough physical activity. Aging is defined by rapid decline in physical activity, loss of mobility, and premature morbidity.Low testosterone levels in men decline from 30 to 40 years of age, and this continues until death. Antiaging strategies, such as caloric restriction, balanced diet, regular exercise, weight management, diabetes control, and smoking cessation can prevent and treat aging-related diseases. Exercise significantly boosts testosterone production, with levels varying based on type, frequency, volume, intensity, and duration. It increases muscle steroidogenesis, total testosterone, and free testosterone in the elderly. Testosterone replacement therapy in elderly men improves physical function, strength, protein synthesis, cholesterol, bone density, sexual desire, erectile function, and overall cognition. However, some studies suggest dehydroepiandrosterone supplementation may provide health improvements without negative effects, potentially reversing arterial aging and reducing the risk of cardiovascular diseases. Senolytic therapeutics focus on cellular senescence, and stem cell transplantation investigates the therapeutic potential of older stem cells.

Etiological factors and clinical outcomes in extracapsular and intracapsular hip fractures among older adults: A gender-specific analysis.

Compared to patients with intracapsular fractures (ICFs), those with extracapsular fractures (ECFs) had worse outcomes. However, most studies of risk factors for these fractures lacked relevant potential reasons, particularly nutritional status, and adjustment for confounding factors. Furthermore, less is known about their effects on clinical outcomes. To conduct a gender-specific analysis of community-dwelling individuals admitted with hip fractures to examine the association of clinical risk factors and health care measures. Monocentric cross-sectional study. Orthopedic trauma department. A total of 787 women and 318 men of similar mean age (±SD): 83.1 years (±8.6) and 82.5 years (±9.0), respectively. Multivariable logistic regression analyzed risk factors including age, gender, dementia, stroke, ischemic heart disease, diabetes, prefracture mobility, alcohol consumption, American Society of Anesthesiologists grades, drug history, and nutrition status for assessing risk factors and outcomes associated with ECFs and ICFs. Compared to ICFs, for each additional year of age, women had a 3% and men 4% greater association with ECFs. Among women only, ECFs were associated with risk of malnutrition: odds ratio [OR] = 1.70 (95% CI, 1.17-2.48) or malnourishment: OR = 1.93 (95% CI, 1.06-3.52), stroke: OR = 1.85 (95% CI, 1.16-2.97), and diabetes: OR = 1.92 (95% CI, 1.21-3.06). Women with ECFs were less likely to be discharged to their own homes: OR = 0.56 (95% CI, 0.38-0.83); but more likely to be discharged to a rehabilitation unit: OR = 1.81 (95% CI, 1.21-2.71) and readmitted to hospital within 30 days of discharge ≥1 time: OR: 2.39 (95% CI, 1.27-4.50) or ≥2 times: OR = 3.48 (95% CI, 1.05-11.57): they did not differ in discharge to residential or nursing care or in-hospital mortality. Among men, there were no differences in discharge destinations or readmissions between types of fractures. Compared to ICFs, a greater number of risk factors associated with ECFs were identified more often in women than in men, and ECFs also have greater influences on clinical outcomes in women.

Estrogen receptor alpha ablation reverses muscle fibrosis and inguinal hernias.

Fibrosis of the lower abdominal muscle (LAM) contributes to muscle weakening and inguinal hernia formation, an ailment affecting a noteworthy fifty percent of men by age 75, necessitating surgical correction as the singular therapy. Despite its prevalence, the mechanisms driving LAM fibrosis and hernia development remain poorly understood. Utilizing a humanized mouse model that replicates elevated skeletal muscle tissue estrogen concentrations akin to aging men, we identified estrogen receptor alpha (ESR1) as a key driver of LAM fibroblast proliferation, extracellular matrix deposition, and hernia formation. Fibroblast-specific ESR1 ablation effectively prevented muscle fibrosis and herniation, while pharmacological ESR1 inhibition with fulvestrant reversed hernias and restored normal muscle architecture. Multiomic analyses on in vitro LAM fibroblasts unveiled an estrogen/ESR1-mediated activation of a distinct profibrotic cistrome and gene expression signature, concordant with observations in inguinal hernia tissues in human males. Our findings hold significant promise for prospective medical interventions targeting fibrotic conditions and presenting non-surgical avenues for addressing inguinal hernias.

Physical determinants of daily physical activity in older men and women.

The ability to perform bodily movement varies in ageing men and women. We investigated whether physical fitness may explain sex differences in daily physical activity energy expenditure (PAEE) among older people. In this cross-sectional study, a population-based cohort of 75, 80, and 85-year-old men and women (n = 409, 62% women) underwent laboratory-based assessment of walking speed, maximal knee extension strength, and body fat percentage. Free-living physical activity was assessed as total PAEE, and light (LPA) and moderate-to-vigorous physical activity (MVPA) using individually calibrated combined accelerometry and heart rate sensing. Path modelling was used to examine indirect associations between sex, physical fitness, and physical activity. Men had better physical fitness and higher overall PAEE (mean 34.0 (SD 10.8) kJ/kg/day) than women (28.3 (8.4) kJ/kg/day, p<0.001). The path model for PAEE explained 33% of the variance. The direct association between sex and PAEE was non-significant, whereas the association between sex and PAEE mediated by body fat (β = 0.20, p<0.001) and walking speed (β = 0.05, p = 0.001) were statistically significant. Similarly, associations between sex and MVPA mediated by body fat (β = 0.11, p = 0.002) and walking speed (β = 0.05, p = 0.001) were significant, as were the associations between sex and LPA mediated by body fat (β = 0.24, p<0.001) and walking speed (β = 0.03, p = 0.019). Differences in physical activity between men and women may reflect underlying differences in cardiorespiratory fitness and adiposity. These results highlight the importance of maintaining physical fitness to support active living in older adults.

Integrin‐Targeted, Activatable Nanophototherapeutics for Immune Modulation: Enhancing Photoimmunotherapy Efficacy in Prostate Cancer Through Macrophage Reprogramming

ABSTRACTProstate cancer is an epithelial malignancy with a high incidence among elderly men. Photochemistry‐based dye photodrugs (known as photosensitizers) offer a promising clinical approach for treating tumors. These agents work by inducing immunogenic cell death (ICD), which activates antitumor immune response. This approach is favored owing to its minimal invasiveness, low toxicity, and high efficiency. However, the immunosuppressive microenvironment of characteristics of “cold” tumors significantly restricts the clinical efficacy of photodrugs. Developing an advanced nanocarrier system to deliver photodrugs and immune agonists for efficient drug delivery to tumor lesion sites and to reshape the immunosuppressive microenvironment is crucial in clinical practice. Therefore, in this study, we designed an integrin‐targeted, activatable nano photodrug co‐assembly with an immune agonist (RPST@IMQ) for enhancing photoimmunotherapy in prostate cancer via the reprogramming of tumor‐associated macrophages. The active‐targeted nanosystem enhanced the dosage of photodrug at the lesion site through systemic administration. High doses of glutathione at the tumor site cleaved the disulfide bonds of RPST@IMQ, releasing the photodrug and the immune agonist imiquimod (IMQ). Under photoirradiation, the photodrug generated significant doses of singlet oxygen to eliminate tumor cells, thereby inducing ICD to activate antitumor immune responses. Simultaneously, the released IMQ reprograms immunosuppressive M2‐type tumor‐associated macrophages (TAMs) in the tumor microenvironment into M1‐type TAMs with tumor‐killing capabilities, thereby converting “cold” tumors into “hot” tumors. This conversion enhances the therapeutic efficacy against primary and distant tumors in vivo. This study offers new insights into the development of innovative, smart, activatable nano photodrugs to enhance anticancer therapeutic outcomes.

Risk factors for mortality in patients with chikungunya: A systematic review and meta-analysis.

Chikungunya fever is a debilitating arthritic disease that can lead to atypical severe complications and sometimes be fatal. The risk factors for fatal outcomes of chikungunya fever have not been thoroughly studied. This systematic review and meta-analysis aimed to identify mortality risk factors in patients with chikungunya. These findings will aid clinicians in targeting high-risk groups with severe chikungunya for timely interventions, ultimately improving patient outcomes. The objective of this study is to identify mortality risk factors in patients with chikungunya. We conducted a systematic review and meta-analysis by searching the MEDLINE, Embase, Cochrane, BVS, BDTD and OpenGrey databases to identify eligible observational studies on patients with chikungunya. These studies analysed mortality risk factors, providing adjusted risk measures along with their corresponding confidence intervals (CIs). We estimated the pooled weighted mean difference and 95% CIs using a random-effects model, and the methodological quality was assessed using the Newcastle-Ottawa Scale. Our search yielded a total of 334 records. After removing duplicates, we screened 275 records, reviewed 31 full articles and included seven studies in the systematic review and four in the meta-analysis, with a total of 220,215 patients and 908 fatal cases. Diabetes Mellitus (OR = 2.86, 95% CI 1.75-4.69), hypertension (OR = 3.10, 95% CI 2.02-4.77), age ≥ 60 years (OR = 19.49, 95% CI 1.98-191.88), chronic kidney disease (OR = 5.81, 95% CI 1.30-25.99), male sex (OR = 2.07, 95% CI 1.71-2.51) and vomiting (OR = 2.18, 95% CI 1.75-2.73) are significantly and positively associated with mortality in chikungunya. Elderly men with chronic diseases have a higher risk of death from chikungunya; therefore, they deserve more careful evaluation.

Elderly Man With Abdominal Pain.

Elderly Man With Abdominal Pain.

The role of RhoA-ROCK signaling in benign prostatic hyperplasia: a review.

Benign prostatic hyperplasia (BPH) is a common urological disease in middle-aged and elderly men. The main pathological mechanisms of BPH include static factors that increase prostate volume and dynamic factors that increase prostate tension. The RhoA/ROCK signaling pathway is a classical pathway that regulates cell contraction, migration, and growth. In this review, we summarize the potential role of RhoA/ROCK signaling in the development of BPH. The RhoA/ROCK signaling pathway can enhance the contraction of prostate smooth muscle through the Ca2+ sensitization pathway and increase passive tension in the prostate through tissue fibrosis. Additionally, RhoA/ROCK signaling promotes cell proliferation by regulating cell division and may influence apoptosis by affecting the actin cytoskeleton. Furthermore, risk factors, such as inflammation, metabolic syndrome, and hormonal changes, can upregulate RhoA/ROCK signaling, which in turn promotes these risk factors, eventually leading to the development of BPH. Given the role of RhoA/ROCK signaling in regulating multiple pathogenic factors of BPH, this pathway represents a promising molecular target for BPH treatment and warrants further study.

The association between consumption of ultra-processed foods and sperm quality parameters: a cross-sectional study

BackgroundWhile recent studies suggest a correlation between unhealthy dietary patterns, oxidative stress, inflammation, and male infertility, the potential association between ultra-processed foods (UPFs) and male infertility remains underexplored. Therefore, the aim of the present study was to investigate the association between UPF intake and male infertility by evaluating sperm quality parameters.MethodsThe participants (n = 260) of the current cross-sectional study were recruited from an infertility center in Isfahan Province, Iran. Four semen parameters—such as total sperm motility, sperm concentration, sperm volume, and normal sperm morphology—were evaluated. Also, the participants’ food intake was assessed using a validated 168-item food frequency questionnaire. Moreover, the NOVA system was employed to calculate the UPF index. The association between UPFs and sperm parameters was analyzed using logistic regression.ResultsIn the crude model, no significant associations were observed between the second and last tertiles of UPFs with abnormalities in sperm concentration, total motility, and morphology (p > 0.05 for all). However, after adjusting for age, marriage duration, body mass index, physical activity, depression, anxiety, stress, energy intake, cigarette history, and mineral and vitamin supplements, a significantly higher association was identified between the second tertile of UPFs and abnormalities in sperm concentration (odds ratio (OR) = 3.962, 95% confidence interval (CI): 1.345–11.670, p = 0.013).ConclusionsIn conclusion, although the analysis did not find significant associations between UPF consumption and impaired sperm motility and morphology, it revealed significant trends linking higher UPF intake with lower sperm concentration. If future studies confirm these results, they could aid in designing interventional and preventive programs aimed at addressing infertility in men of reproductive age in the field of public health.

Developing, Piloting and Evaluating a Patient Support Portal for Men With Prostate Cancer in Victoria: An Action Research Study.

Men with prostate cancer (PCa) and their support providers face challenges in accessing high-quality, impartial information tailored to their specific needs to enhance their overall care and decision-making. We describe the development, piloting and evaluation of the co-designed web portal 'BroSupPORT'. IT teams developed and integrated BroSupPORT into the Victorian Prostate Cancer Outcomes Registry (PCOR-Vic) electronic patient-reported outcome follow-up process. A comparator tool was built enabling men to compare their patient-reported outcome results against men of similar age, risk profile and after the same treatment. PCOR-Vic participants were invited to access BroSupPORT after 12 months of follow-up patient-reported outcome measure completion. Factors associated with consent to BroSupPORT were determined using logistic regression. Portal access data were gathered from PCOR-Vic data extracts and Google Analytics. A survey on portal exit and 2 weeks after consent was used to collect feedback. Over a 4-month pilot, 331/583 (57%) men consented to accessing BroSupPORT. Among those men who accessed the portal, the majority (209/331 =63%) were diagnosed in a private hospital and resided in a major city (214/331=65%). On average, men spent 3:20 min on the portal, with sexual function aspects receiving the most attention. Twenty-three percent of men revisited the portal during the pilot. Most men found the portal easy to use, reassuring and informative, while 9% found the patient-reported comparisons difficult to interpret. A patient portal-enabling men to compare their patient-reported outcomes with other similar men and providing access to information and resources-may be a scalable solution in addressing the complex supportive care needs of men with PCa on a population basis.

Point-of-Care Ultrasound Diagnosis of Pyocele: A Rare Complication of Testicular Infection

Epididymo-orchitis is one of the common causes of acute scrotal pain that requires an accurate diagnosis as delayed management can result in complications such as pyocele, abscess, or testicular infarction. Point-of-care ultrasound (PoCUS) has emerged as a valuable diagnostic tool in the management of testicular emergencies in the emergency department (ED) including testicular infections CASE REPORT: Here we report a case of an elderly man who presented to the ED with a complaint of right-sided testicular pain and swelling. The diagnosis of pyocele was made using a PoCUS, facilitating an early referral to urology services. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case underscores the important role of PoCUS in the timely and accurate diagnosis of pyocele. The prompt identification of pyocele enabled early referral to urology services, highlighting the significance of integrating PoCUS into the management of testicular emergencies in the ED.

Biochemical Hypogonadism in Aging Testicular Cancer Survivors: A Clinical Challenge.

Few longitudinal studies have described the prevalence and development of biochemical hypogonadism in aging testicular cancer survivors (TCSs) in comparison to men from the general population (control subjects). Serum total and free testosterone (Ttotal, Tfree) were measured in 593 TCSs median11 and 27 years after TC diagnosis (Survey-First; Survey-Last). Post-treatment adverse health outcomes (AHOs) were recorded. The results were compared to those in 578 control subjects. Treatment was stratified as surgery alone, radiotherapy alone, or platinum-based chemotherapy. Biochemical hypogonadism was defined as Ttotal <8nmol/l, or as Ttotal <12nmol/l and Tfree <225pmol/l. We used multivariable logistic regression analysis to explore associations with age and treatment intensity. Statistical significance was set at p<0.05. Between the first and last survey the prevalence of biochemical hypogonadism increased from 12% to 41% in the TSC group and from 5% to 11% in the control group. Three decades after diagnosis, the probability of biochemical hypogonadism was significantly correlated with increasing age and greater treatment intensity. The combined age- and treatment- related probability of hypogonadism was more than threefold higher in the TCS group than in the control group. At the last survey, fewer eugonadal than hypogonadal TCS men reported at least one AHO attributable to androgen deficiency (54% vs 72%; p<0.001). Limitations include the availability of only one blood sample per survey wave. For aging TCSs, the probability of biochemical hypogonadism depends on age and prior treatment intensity and is threefold higher than for control subjects at 30yr after diagnosis. As late hypogonadism is associated with AHO incidence, the development of hypogonadism should be monitored via regular blood tests during TCS follow-up. Depending on the treatment they received, older survivors of testicular cancer (TC) are at persistent risk of lower testosterone levels. Our study revealed low testosterone in 40% of TC survivors older than 60 years compared to 10% of similarly aged men from the general population. Low testosterone is associated with chronic conditions such as diabetes, fatigue, and/or erectile dysfunction. Testosterone should be regularly monitored during follow-up for TC survivors.

Thymelaea hirsuta extract attenuates testosterone-induced benign prostatic hyperplasia in rats: Effect on oxidative stress, inflammation and apoptosis.

Benign prostatic hyperplasia (BPH) is one of the most prominent diseases of the aged men urinary system. It is associated with cellular proliferation, hormonal imbalance, oxidative stress, inflammation and apoptosis. Traditionally, Thymelaea hirsuta (L.) (TH) leaves and flowers were used as a decoction or infusion in traditional medicine to treat skin disorders, urinary tract infection and infertility. To date, its potential protective effects for benign prostatic hyperplasia (BPH) have not been investigated. This study explored the effects of Thymelaea hirsuta extract (THE) on the development of BPH using a rat model of testosterone induced BPH. The THE phenolic composition was identified by liquid chromatography with a diode array detector (LC-DAD). Then, 21 male Wistar rats (Ten-week old) weighting 200-250g were separated into three groups: the group 1 was considered as a control while the group 2 and 3 received intramuscular injection of testosterone at dose of 3mg/kg (BPH). Only the group 3 received orally THE at dose of 36mg/kg. After four-week experimental time, the animals were sacrificed, and reproductive tissue was taken for histological and immunohistochemical analyses. Biochemical tests were also carried out. Additionally, the protein expression levels including in the inflammation pathway were analyzed by western blot. Our results revealed that THE treatment reduced the prostate weight and index. Orally THE administration improved the prostate biochemical and morphological characteristic in BPH rats and then lead to a normal prostate morphology restoration. As expected, THE supplementation significantly inhibited rat prostate enlargement, improved the pathological feature and reduced the epithelial thickness. Additionally, the anti-hyperplasic effect of THE is related to its possible ability to regulate the apoptotic and inflammatory pathways. Indeed, immunohistochemical and western blot analyses displayed a significant regulation of the apoptotic markers (Bax and Bcl-2) and a decrease in the inflammatory protein expression (NF-κB and TNF-α). Similarly, THE treatment increased the prostate cells' endogenous antioxidant capacity through the improvement of GSH level and the SOD activity. Conversely, it decreased the prostatic lipid peroxidation content. The HPLC-ESI-MSn analysis showed that chlorogenic acid and vicenin-2 were putatively identified as the major compounds of THE. The advanced results revealed the THE efficiency in the prevention of the testosterone-induced BPH in rats indicating that THE can be used as an alternative therapy for BPH management.

Enhanced patient recovery with early extensive surgical deb-ridement in Fournier's Gangrene: evaluation of perioperative outcomes in a multicentric experience.

Fournier's gangrene (FG) is a rare, life-threatening necrotizing fasciitis primarily affecting the perineal, genital, and perianal regions. This rapidly progressing bacterial infection predominantly affects middleaged and elderly men. This multicenter study aims to describe the management in a wide cohort of Fournier's gangrene cases that presented to three tertiary centers with early extensive surgical debridement. We retrospectively collect data from patients with FG who were referred to the Urology Clinic of the Department of Medicine and Surgery (Perugia), the Urological Andrological Surgery and Minimally Invasive Techniques Unit (Terni) of the University of Perugia, and the Urology Unit of the Surgery Department of the Macerata Civic Hospital between January 2019 and March 2024 for onset of classic signs and symptoms of FG. Extensive surgical debridement was immediately performed under general anesthesia to reach normochromic and vascularized tissue in wide and depth extension, assuring vital and healthy margins. For all patients, intravenous daptomycin plus piperacillin/tazobactam were administered. 28 male patients with FG underwent early surgical debridement. In two cases, orchidectomy and partial penectomy were required during surgical debridement due to extensive necrosis. Colon diversion and urinary diversion were not necessary for any of the patients. 32.1% complications were recorded according to the Clavien Dindo classification; 6 patients died in the perioperative. Excluding death data, the average duration of antibiotic therapy was 22.0±9.1 days, and the average length of stay was 17.6±11.8 days. Fournier's gangrene has high mortality rates. It requires timely surgical debridement and antibiotic therapy to achieve positive outcomes. This study shows that a primary extensive debridement can help reduce the need for further intervention and shorten the hospital stay.

Integrative perspectives on managing benign prostatic hyperplasia: The role of homeopathy as a complementary approach

Benign Prostatic Hyperplasia (BPH) is a prevalent urological condition among aging men, characterized by lower urinary tract symptoms (LUTS) such as frequent urination, nocturia, and weak urinary stream, significantly impacting quality of life. Conventional treatments like alpha-blockers, 5-alpha reductase inhibitors, and surgical interventions provide symptomatic relief but are often associated with adverse effects, including sexual dysfunction and hypotension. Homeopathy offers a holistic and individualized approach to BPH management, addressing physical symptoms, hormonal imbalances, and inflammation. This review explores the etiology and pathophysiology of BPH, compares conventional treatments with homeopathy, and evaluates clinical evidence supporting homeopathic remedies such as Sabal serrulata, Thuja occidentalis, Conium maculatum, and Chimaphila umbellata. While small-scale studies demonstrate the potential of homeopathy to relieve symptoms and improve quality of life, challenges such as the lack of standardized protocols and large-scale trials remain. Future research should focus on rigorous clinical trials, molecular mechanism studies, and integrative treatment approaches to establish homeopathy as a complementary therapy for BPH.

Changing dynamics of bloodstream infections due to methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium in Germany, 2017–2023: a continued burden of disease approach

BackgroundAntimicrobial resistance is a global threat to public health, with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VREfm) being major contributors. Despite their clinical impact, comprehensive assessments of changes of the burden of bloodstream infections in terms of Disability-Adjusted Life Years (DALYs) and attributable deaths over time are lacking, particularly in Germany.MethodsWe used data from the Antimicrobial Resistance Surveillance system, which covered about 30% of German hospitals. Bloodstream infections were defined by a VREfm or MRSA-positive blood culture. We estimated incidences as a first step to further use these rates to calculate DALYs and attributable deaths using the Burden of Communicable Disease in Europe toolkit. The analysis included stratification by age, sex and region.ResultsFrom 2017 to 2023, 6262 MRSA and 5442 VREfm blood culture-positive isolates were identified. The incidence of MRSA bloodstream infections decreased from 4.0 to 2.1 per 100,000 population, with estimated DALYs decreasing from 14.6 to 8.6 per 100,000 and attributable deaths from 591 to 316. Conversely, VREfm-BSI incidence doubled from 1.7 to a peak of 3.0 (2021) before declining back to 1.7 per 100,000 in 2023, with estimated DALYs increasing from 8.9 to 16.5 and then decreasing to 8.5 per 100,000 and attributable deaths increasing from 317 to 327. Men and people over 60 years had the highest burden, with noticeable regional differences.ConclusionMRSA and VREfm bloodstream infections followed different trends in the past and now present a comparable burden in Germany. Both pathogens pose a significant threat, particularly to hospitalised older aged men. Our findings highlight the need for targeted prevention and continued surveillance of MRSA and VREfm to reduce infections and their impact.

Correlation between Prostate Volume and Intravesical Prostate Protrusion to Bladder Detrusor Muscle Thickness in Patients with Benign Prostate Enlargement by Transabdominal Ultrasound Examination in Banjar Jagatamu, Meliling, Kerambitan, Tabanan 2024

Benign prostate enlargement (BPE) is a common degenerative condition in elderly men, often leading to lower urinary tract symptoms (LUTS) such as urgency, frequent urination, and incomplete bladder emptying. This study investigates the correlation between prostate volume, intravesical prostate protrusion (IPP), and bladder detrusor muscle thickness in patients with BPE using transabdominal ultrasonography. Conducted in Banjar Jagatamu, Meliling Village, Tabanan Regency, the study employed a cross-sectional design with 71 participants aged 60 years and older. Inclusion criteria required an International Prostate Symptom Score (IPSS) ≥ 8 or prostate volume &gt; 20 mL. The results revealed a significant correlation between prostate volume and bladder detrusor muscle thickness (r = 0.665, p &lt; 0.001) and between IPP and detrusor thickness (r = 0.806, p &lt; 0.001). These findings highlight the utility of ultrasonography in assessing structural changes caused by chronic urinary obstruction. The study provides valuable insights into the role of prostate volume and IPP as predictive markers for bladder remodeling in BPE patients. By focusing on a rural population, this research emphasizes the need for accessible diagnostic tools to improve early detection and management of BPE, ultimately enhancing patient outcomes in underserved communities.

Long-term Persistence of Moderate or Low Normal Testosterone Levels and Prostate Gland Volume in Men 35–45 Years Old

In our outpatient practice, we are increasingly seeing men aged from 35 to 45 years who have a long-term persistence of moderate or low normal testosterone levels. We aimed to investigate whether there is a link between long-term persistence of moderate or low normal testosterone levels and prostate volume. For the period from January 2013 to December 2015 in the Department of Andrology of “St. Sofia” Hospital we investigated 73 men aged 35 to 45 years with normal or elevated body mass index and long-term persistence of moderate or low testosterone levels. To compare our results, at the beginning of the study we formed a control group of 20 healthy men of the same age. The prostate volume was calculated by ultrasound. We obtained, within the reference range, significantly lower values for total testosterone (p &lt; 0.001) and higher prostate volume (p &lt; 0.001) in the 73 men we investigated compared to those in the control group. In some men at a young age, certain deviations in the normal secretion of testosterone occur, in parallel with an increase in total prostate volume, which differs significantly from the same indicator in their peers with a high normal level of testosterone. In most cases overweight or obesity were a prerequisite for young men to increase their prostate volume, but with a weaker correlation dependence than testosterone. Without going into cellular processes, we determined that long-term persistence of moderate or low normal testosterone levels, was a prerequisite for men aged between 35 and 45 years to increase their prostate volume.

Late-onset hypogonadism: current methods of clinical diagnosis and treatment in Japan.

Testosterone affects several organs in the body and is very important for male well-being. Aging men with late-onset hypogonadism (LOH) experience physiologic, psychiatric, and sexual symptoms related to a decline in the serum concentration of testosterone with age. However, it is well-known that the extent of the decline in testosterone concentration does not correlate with the severity of LOH-related symptoms. Therefore, it is difficult to diagnose and treat patients with LOH. In addition, the symptoms, response to testosterone replacement therapy (TRT), and medical insurance coverage differ among ethnicities and countries. The evaluation of testosterone is essential for the diagnosis and treatment of LOH. The effects of testosterone are determined not only by the serum testosterone concentration but also by the androgen receptor sensitivity. A low number of glutamine repeats is indicative of high androgenic activity, and the number shows ethnicity-related differences (fewer in African American than in Caucasian people and more in East Asian people). The diagnosis of LOH is typically made using subjective symptoms and the serum testosterone concentration. The Aging Male Symptoms scale is widely used to evaluate the symptoms. The normal range of total testosterone concentration varies around the world; therefore, clinicians should follow the guidelines of their regional academic society. The principal treatment for LOH is TRT. There are many types of TRT and other treatment strategies are also available. Thus, physicians should treat LOH according to each patient's situation, considering related disorders, such as diabetes, osteoporosis, metabolic syndrome, and depression.