Elderly Men Research Articles

Physical activity and nutrient intake levels according to grip strength among single-household elderly in Korea: data from 2014 and 2019 Korea National Health and Nutrition Examination Survey (KNHANES).

We analyzed the differences in physical activity (PA) levels and nutrient intake based on grip strength among elderly men and women in single-person households (ESH) in Korea. Data were obtained from 1,581 ESH individuals (aged ≥65 years) from the Korean National Health and Nutrition Examination Survey (2014-2019). PA levels (occupational and recreational moderate-intensity activities, travel to and from places, walking, and strength training) and nutrient intake (including, total energy, carbohydrates, protein, and fat) were analyzed. Men exhibited no differences in PA related to grip strength, except for the number of strength training days (p=0.000). Women with higher grip strength engaged more in recreational activities, travel, and strength training (all, p=0.000). Men with higher grip strength consumed more protein, while women consumed greater amounts of total fat (p=0.030), monounsaturated fatty acids (MUFA) (p=0.024), and polyunsaturated fatty acids (PUFA) (p=0.011). Both sexes had increased Vitamin C intake (men: p=0.023, women: p=0.020). Sex-related differences in PA levels and nutrient intake based on grip strength were observed among older individuals in ESH. Women require programs to enhance diverse PA and balance fat intake, while men need interventions focused on strength training and protein intake.

MORTALIDADE DE PESSOAS IDOSAS POR NEOPLASIAS MALIGNAS DOS ÓRGÃOS GENITAIS

Introduction: This article discusses malignant neoplasms of the genital organs in the elderly, in both sexes, in the last ten years, as the elderly population and the number of cancers in the reproductive systems are growing. Objective: To investigate the mortality of elderly people due to malignant neoplasms of the genital organs, according to sex, in the state of Minas Gerais, in the last 10 years. Methodology: This is a descriptive study, with a quantitative, longitudinal approach, carried out using secondary data collected through DATASUS (Informatics Department of the Brazilian Unified Health System). Results and Discussion: From 2013 to 2022, 15,036 deaths of elderly men due to malignant neoplasms of the genital organs were recorded, and 7,965 deaths of elderly women, which corresponded to 65.37% and 34.62% respectively. Men were the most affected by neoplasms of the genital organs in the period studied, and deaths increased with age; It is believed that this is due to the greater omission in seeking public health assistance. In men, the most evident cancer was prostate cancer; in women, the cervix. Conclusion: Health monitoring of elderly people is essential, as this is the population that has grown the most in recent years, in addition to being the most affected by neoplasms. The research highlighted an overview of the number of cases that can favor the planning of strategies to approach this population.

A sexually dimorphic hepatic cycle of periportal VLDL generation and subsequent pericentral VLDLR-mediated re-uptake

Recent single-cell transcriptomes revealed spatiotemporal programmes of liver function on the sublobular scale. However, how sexual dimorphism affected this space-time logic remained poorly understood. We addressed this by performing scRNA-seq in the mouse liver, which revealed that sex, space and time together markedly influence xenobiotic detoxification and lipoprotein metabolism. The very low density lipoprotein receptor (VLDLR) exhibits a pericentral expression pattern, with significantly higher mRNA and protein levels in female mice. Conversely, VLDL assembly is periportally biased, suggesting a sexually dimorphic hepatic cycle of periportal formation and pericentral uptake of VLDL. In humans, VLDLR expression is also pericentral, with higher mRNA and protein levels in premenopausal women compared to similarly aged men. Individuals with low hepatic VLDLR expression show a high prevalence of atherosis in the coronary artery already at an early age and an increased incidence of heart attack.

Sociodemographic, mental, and physical health determinants of incident depressive symptoms among ageing men and women in rural South Africa: A longitudinal study from 2015 to 2022

We aimed to assess the associations between sociodemographic, mental, and physical health factors and incident depressive symptoms (IDS) among ageing men and women in rural South Africa over time. Data from the 7-year South African longitudinal Health and Ageing in Africa INDEPTH Community study (HAALSI: 2015–2022) were used in the analysis (study sample: n = 3 122, aged 40 and older). The proportion of IDS was in 28.2% in 2019 and 30.0% in 2022 among men, and 30.3% in 2019 and 2022 among women. Among men, the adjusted model indicated that older age, food insecurity, poor life satisfaction, physical pain, functional disability, diabetes, kidney disease, anaemia, and obesity were positively associated, and hypertension was negatively associated with IDS. Among women, food insecurity, poor life satisfaction, physical pain, and diabetes were positively associated, and current smokeless tobacco use was negatively associated with IDS. By sex, a high proportion of IDS were found, as was the prevalence of food insecurity, poor life satisfaction, physical pain, and diabetes associated with IDS. Among older men only, older age, functional disability, kidney disease, anaemia, and obesity, but not hypertension were associated with higher odds for IDS. Among older women, only current smokeless tobacco use was negatively associated with IDS. Interventions addressing the risk for depression should consider specific sex differences.

Identification of BBC3 as a novel indicator for predicting prostate cancer development and olaparib resistance

Prostate cancer (PCa) is a commonly occurring malignancy in elderly men. Olaparib, a poly ADP-ribose polymerase inhibitor, is utilized in PCa treatment. However, patients often develop resistance to olaparib after a period of treatment. Genetic alterations may play a significant role in this resistance, but the specific genes involved remain unclear. This study collected RNA-sequence data from the Gene Expression Omnibus database on both olaparib-sensitive and -resistant PCa cells to identify genes crucial for resistance. Subsequently, the enriched pathways of these genes were analyzed, and a protein–protein interaction (PPI) network was constructed to identify hub genes. The effect of these hub genes on PCa occurrence, progression, and prognosis was assessed using data from The Cancer Genome Atlas and Chinese Prostate Cancer Genome and Epigenome Atlas databases. Finally, this study validated our findings in clinical PCa samples and cells. From the GSE189186 dataset, 50 upregulated genes and 2 downregulated genes were identified in olaparib-resistant C4-2B and LNCaP cells. Utilizing the PPI network, eight upregulated genes (BBC3, TP53I3, FDXR, DDB2, CDKN1A, GADD45A, ZMAT3, and SESN1) were identified as hub genes for olaparib-resistant PCa cells. Furthermore, some of these genes were central to PCa occurrence, with BBC3 also influencing progression and prognosis. Importantly, BBC3 expression was upregulated in clinical PCa samples and affected PCa cells sensitive to olaparib, suggesting its potential as a predictive marker for PCa development and olaparib resistance.

Влияние COVID-19 на спермиологические показатели у мужчин репродуктивного возраста

Introduction: The new coronavirus infection is dangerous not only in the acute period of the disease, but also during the period of convalescence, causing various complications. The long-term effects of the SARS-CoV 2 virus on male reproductive function are an important prognostic factor requiring comprehensive study. Purpose of the study: to study the long-term results of the impact of COVID-19 mild to moderate severity on spermological indicators in men of reproductive age. Materials and Methods: the study included 14 healthy men of reproductive age who were not vaccinated against COVID 19, who had negative results of an STI examination, normal spermological parameters, TUNEL test values <15%, who subsequently suffered a viral infection caused by the SARS-CoV 2 virus of mild and moderate severity, with persistent negative results of an STI examination. Results: а comparative analysis of the results of spermograms of patients before and after COVID 19 showed that the total number of spermatozoa before and after the disease (422.5 ± 53.9 and 410.2 ± 176.9 million, respectively), the indicator of the number of spermatozoa with progressive translational (PR) mobility (56.4 ± 8.7 and 54.4 ± 8.0%, respectively), morphologically normal male gametes before and after 3 months after COVID-19 (21.2 ± 4.3 and 20.2 ± 3.6%, respectively) are comparable. Normozoospermia was observed in all cases, TUNEL test values <15%. Conclusion: in the conducted study, mild and moderate COVID-19 did not have a clinically significant effect on the spermological parameters of men 3 months after COVID-19. Keywords: COVID-19, SARS-CoV 2 virus, spermological indicators, TUNEL-test.

Characterizing HIV-1 transmission by genetic cluster analysis among newly diagnosed patients in the China-Myanmar border region from 2020 to 2023

ABSTRACT Cluster analysis of HIV sequence can provide insights into viral transmission patterns in border regions. This study aims to illuminate the HIV-1 subtype distribution and transmission dynamics among newly diagnosed individuals in Dehong prefecture, a region along the China-Myanmar border. Among 948 participants with pol gene sequences, 36 HIV-1 subtypes were identified, with URFs (18.8%, 178/948) being the dominant strain, followed by CRF01_AE (18.5%, 175/948) and CRF07_BC (10.9%, 103/948). Additionally, 287 sequences (30.3%, 287/948) were grouped into 91 clusters, 31 of which contained both Chinese and Burmese individuals. Multivariable logistic regression indicated that men who have sex with men (MSM), CD4 + cell count of 200∼499 cells/μl, and 500 cells/μl and above, and CRF01_AE were risk factors for entering the network. Through Chord diagram, we found frequent transmission relationships among heterosexual China male group, especially those over 35 years of age. Additionally, the correlation between heterosexual Myanmar female group and heterosexual China male group among cross-risk groups deserved to be emphasized. Furthermore, the network exhibited a growing trend over time, with the largest active transmission cluster identified in Ruili county. In conclusion, the HIV-1 subtype landscape in Dehong has become increasingly complex, and the region has faced risks of transmission from both domestic and international sources. Targeted intervention strategies should be implemented for MSM, heterosexual Chinese middle-aged and elderly men, and heterosexual Burmese young adults to mitigate these risks. These findings provided evidence-based insights for local government to formulate coordinated transnational intervention approaches.

Network pharmacology combined with molecular docking revealed the potential targets of Coridius chinensis in prostate cancer treatment.

Prostate cancer (PCa) has high morbidity and mortality rates in elderly men. With a history of thousands of years, traditional Chinese medicine derived from insects could be an important source for developing cancer-targeted drugs to prevent tumorigenesis, enhance therapeutic effects, and reduce the risk of recurrence and metastasis. Multiple studies have shown that Coridius chinensis (Cc) has anticancer effects. To elucidate the mechanism of action of Cc against PCa via network pharmacology and molecular docking. Potential targets for Cc and PCa were predicted using ChemDraw 19.0 software, the PharmMapper database and the GeneCards database. Then, the STRING database was used to construct the protein-protein interaction network. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment and molecular docking analyses were subsequently conducted to identify the key targets, active ingredients and pathways involved. GO and KEGG analyses indicated that the PI3K-Akt signalling pathway was the critical pathway (P value < 1.0 × 10-8). Multiple targeting ingredients that can affect multiple pathways in PCa have been identified in Cc. Seven active compounds (asponguanosines A, asponguanine B, asponguanine C, aspongpyrazine A, N-acetyldopamine, aspongadenine B and aspongpyrazine B) were selected for molecular docking with 9 potential targets, and the results revealed that aspongpyrazine A and asponguanosine A are the main components by which Cc affects PCa (affinity<-5 kcal/mol, hydrogen bonding), but more studies are needed. We used network pharmacology to predict the bioactive components and important targets of Cc for the treatment of PCa, supporting the development of Cc as a natural anticancer agent.

Осложнения и нарушения мочеиспускания после проведенного оперативного лечения ДГПЖ методом лазерной энуклеации.

Introduction. Benign prostatic hyperplasia (BPH) is a common disease in elderly men, manifested by symptoms of the lower urinary tract. Drug treatment of BPH often allows you to delay or even avoid performing surgery. Laser endoscopic enucleation, which shows excellent functional results regardless of the patient's age and prostate volume, can be considered the modern «gold standard» of surgical treatment of BPH. However, complications and urinary disorders after surgical treatment are also inherent in this method. The purpose of this article was to systematize information on the quality of urination and the preservation of symptoms of the lower urinary tract in patients after endoscopic enucleation of BPH. Materials and methods. The literature review was compiled from analyzed materials from three scientific databases (PubMed, Scopus and Web of Science, eLibrary), focusing on the following keywords: «laser enucleation», «lower urinary tract symptoms», «complications after enucleation of prostate». Results. The obtained results of many studies allow us to state the existence of a new «gold standard» of surgical treatment of BPH and to consider the possibility of introducing HoLEP into the standards of medical care for urological patients with BPH. In the postoperative period, long-term monitoring of patients is necessary. Currently, there are no clear standards for the necessary examinations and the timing of their implementation in the postoperative period. Conclusion. Laser enucleation is a reliable method of surgical treatment of LUTS due to BPH.

Very Rare Case of Pulmonary Lepidic Adenocarcinoma at a Young Age Man

Introduction: Lung cancer remains one of the higher prevalence of cancer and leading cause of death in the world. Smoking and genetic factors are two important etiologies in lung cancer. Adenocarcinoma is the most common type of non-small cell lung carcinoma. Lepidic predominant adenocarcinoma is one type of adenocarcinoma that has a good prognosis. Case Illustration: A 24-year-old male came with chronic cough and chest pain. He had a history of smoking and no prior family history of cancer. Plain chest Xray and Thorax computed tomography (CT) showed pleural effusion and presence of lung mass with suggestion of bone and liver involvement, respectively. The cytology from pleural effusion and bronchial lavage initially found no malignancy cell. Later thoracostomy biopsy and pathology study suggested lepidic adenocarcinoma. Discussion: Lung cancer is still one of the leading causes of death in men. Even though rarely found in young male, patients with a history of smoking or genetic factor with clinical manifestation suggestive chronic respiratory condition with weight loss should be suspected of the diagnosis. Adenocarcinoma, as the most common non-small cell lung carcinoma, could be later divided into several subtypes. Lepidic adenocarcinoma is distinguished by the pathology finding of a large invasion focus of stromal, lymphatic, vascular, or pleural space. Considered one of the most favorable, lepidic predominant adenocarcinoma has a very high rate of 5 year survival when diagnosed early and responds well to lobe resection. Advanced state however has poor outcome due to limited choice of therapy. Promising trial of targeted chemotherapy have been reported and could improve outcome in the future. Conclusion: Lung cancer in young male is a rare disease but should be suspected in those with chronic cough, chest pain and weight loss. The history of smoking and family history are crucial for this suspicion. Lepidic predominant adenocarcinoma has a good prognosis when diagnosed early. Studies in the future could enhance overall survival in these patients.

The influence of sex, age, and body height on the pulmonary vascular permeability index – a prospective observational study

The pulmonary vascular permeability index (PVPI) is a quotient of the extravascular lung water (EVLW) and the pulmonary blood volume (PBV). In acute respiratory distress syndrome (ARDS), the alveolar-capillary membrane integrity is disrupted. The result is a disproportionate increase of EVLW compared to the PBV and, hence, an increase in PVPI. Thus, PVPI has repetitively been discussed to extend the definition of ARDS. Besides sex, the influence of other anthropometric variables on PVPI has not been studied so far. However, since it is known that EVLW depends on body height and sex, we hypothesize that PVPI depends on anthropometric variables as well. This prospective single-center observational study included 1533 TPTD measurements of 251 non-critically ill patients (50.6% men) undergoing elective neuro-, thoracic, or abdominal surgery at the Munich Clinic Bogenhausen of the Technical University of Munich. Multivariate regressions were used to measure the influence of sex, age, and body height on PVPI. In all patients, PVPI was significantly higher in women (P < 0.001), with 34.4% having a PVPI > 2 compared to 15.9% of men. Mean PVPI significantly decreased with height (P < 0.001) and age (P < 0.001). Multivariate regressions allowed the calculation of mean reference surfaces. The 95th percentile surface for PVPI was > 3 for small and young women and well above 2 for all but tall and elderly men. In patients who underwent (lung reduction) thoracic surgery, the PVPI before and after surgery did not differ significantly (P = 0.531), and post-surgical PVPI did not correlate with the amount of lung resected (P = 0.536). Hence, we conclude that PVPI may be independent of the extent of lung volume reduction. However, PVPI is heavily dependent on sex, age, and body height. Anthropometric variables thus have a significant impact on the likelihood of misclassified abnormal PVPI. This warrants further studies since an increased PVPI, e.g. in the context of an ARDS, may be overlooked if anthropometric variables are not considered. We suggest reference surfaces based on the 95th-percentile corrected for sex, age, and height as a novel approach to normalize PVPI.

Selective loss of Y chromosomes in lung adenocarcinoma modulates the tumor immune environment through cancer/testis antigens.

There is increasing recognition that the sex chromosomes, X and Y, play an important role in health and disease that goes beyond the determination of biological sex. Loss of the Y chromosome (LOY) in blood, which occurs naturally in aging men, has been found to be a driver of cardiac fibrosis and heart failure mortality. LOY also occurs in most solid tumors in males and is often associated with worse survival, suggesting that LOY may give tumor cells a growth or survival advantage. We analyzed LOY in lung adenocarcinoma (LUAD) using both bulk and single-cell expression data and found evidence suggesting that LOY affects the tumor immune environment by altering cancer/testis antigen expression and consequently facilitating tumor immune evasion. Analyzing immunotherapy data, we show that LOY and changes in expression of particular cancer/testis antigens are associated with response to pembrolizumab treatment and outcome, providing a new and powerful biomarker for predicting immunotherapy response in LUAD tumors in males.

Mobilisation of polish into german army from occupies polish territory in Second world war

At the outbreak of the Second World War, some of the local population of the territory annexed to the German Reich were granted partial or full German citizenship by Heinrich Himmler’s decree on the Deutsche Volksliste (German People’s List). At the same time, men of draft age, like other Reich citizens, became subject to military service. However, the first mass conscriptions to the German army in the annexed territory took place even earlier, in the spring of 1940. At the time, a rather strange term Deutsch-Polen (German Pole) was used in German internal correspondence to describe conscripts from the annexed part of Poland

The Effect of Eight Weeks of Selected Vestibular Exercises on Functional Balance, Walking Speed and Quality of Life of Sedentary Elderly Men

Introduction: Aging and sedentary lifestyle are associated with a decrease in physical and mental abilities. The purpose of this study is to investigate the effect of eight weeks of selected vestibular exercises on functional balance, walking speed, and quality of life of sedentary elderly men. Methods: This semi-experimental research was conducted from the winter of 1402 to the summer of 1403 with the participation of 30 sedentary elderly men from Tawheed Golmkan Elderly Care Center in Mashhad. The samples were selected purposefully and based on previous studies (25) and were divided into two experimental and control groups of 15 people. The experimental group performed selected vestibular exercises three sessions a week for eight weeks, while the control group did not perform any exercises. Dynamic comparison test, 10-meter walking speed and short-term life questionnaire were used to evaluate the quality of life. Data analysis was performed using Shapiro-Wilk test, analysis of covariance, and t-test at a significance level of P&lt;0/05. Results: The results of paired t test showed that dynamic balance (P=0/001), walking speed (P=0/001), and quality of life (P=0/001) of the experimental group improved significantly after the exercise program. This was while there was no improvement in the control group. The covariance results did not show a significant difference between the groups in the pre-test phase, but there was a significant increase in the scores of the experimental group in the post-test phase. Conclusion: It is recommended to use exercises to prevent the disabilities of the elderly and improve their quality of independent life.

Integrated stress response mediates HSP70 to inhibit testosterone synthesis in aging testicular Leydig cells

The integrated stress response (ISR) is implicated in age-related diseases, while the molecular chaperone heat shock protein 70 (HSP70) can facilitate proper protein folding. However, the regulatory mechanism of ISR in insufficient testosterone synthesis of aging Leydig cells (LCs) remains unclear. This study aims to elucidate the regulatory role of ISR in inadequate testosterone synthesis of aging LCs. We observed a positive correlation between testosterone and HSP70 levels, which were found to be decreased in elderly men. ISR was detected in testicular tissue from old mice. The expression of testosterone synthesis related protein and the content of testosterone decreased in testicular tissue of old mice. Conversely, inhibition of the integrated stress response in testicular tissue led to an increase in steroid synthase expression among old mice. Furthermore, inhibiting ISR specifically within aging LCs resulted in enhanced protein translation efficiency and increased expression levels of new HSP70 and steroidogenic acute regulatory protein (StAR). These findings suggest that ISR occurrence within aging LCs affects StAR protein expression through regulation of HSP70-mediated translation, consequently impairing testosterone synthesis.

Women’s access to justice in Ukraine: the invisibility of the problem

The article considers women’s access to justice as an invisible problem, the existence of which is overlooked or denied. Cases where women in similar situations experience more adverse legal consequences are not perceived as linked to gender inequality. The reasons for the invisibility of the problem are rooted in the Soviet past, in the patriarchal traditions of Ukrainian society, as well as in the reluctance to abandon myths and stereotypes, the lack of proper reflection on the past and the lack of a culture of public discussion of important social problems, the marginalization of “women’s” topics. To illustrate the invisibility of the problem, results of the questioning of training participants (judges, court staff and law enforcement officers) has been used, i.e. the discussion regarding manifestations of gender inequality, acknowledged in the Concept Paper of the State Programme for Ensuring Equal Rights and Opportunities of Women and Men, approved by the order of the Cabinet of Ministers of Ukraine dated November 21, 2012, No. 1002. The author noted, that during many years of delivering gender equality trainings only those participants who de facto contribute to caregiving/family responsibilities admitted that inadequate level of providing conditions for “a harmonious combination of family and professional responsibilities” is an actual problem; the same is observed in relation to other manifestations of inequality between women and men, which confirms the opinion that the perception of relevance or irrelevance of specific manifestations of gender inequality is determined by the individual’s own experience. The trend of reducing gender gap is perceived as the irrelevance of a certain manifestation of gender inequality, since “the situation has been improved significantly”, even if the gap remains large. In addition to the experience of delivering trainings, “stories from life” were also used to demonstrate the invisibility of the problem, particularly cases that illustrate the superior, prejudiced and sexist attitude towards women in high level (deputy minister) positions, especially when compared with the attitude towards men of the same age and status. Since a problem that is invisible has no chance of being solved, the ability to “notice”, “see”, “make visible”, “name”, “qualify”, etc. are the first steps towards its solution.

Association between serum uric acid levels and cardio-ankle vascular index stratified by circulating level of CD34-positive cells among elderly Japanese men: a cross-sectional study

Although serum uric acid (UA) has been reported to be positively associated with increased arterial stiffness as evaluated by cardio-ankle vascular index (CAVI), UA also has an antioxidative effect that prevents endothelial damage. Therefore, the status of endothelial repair induced by endothelial damage might affect the correlation between UA and CAVI. To clarify the correlation between UA and CAVI in relation to endothelial repair activity, we performed a cross-sectional study with 246 Japanese men aged 60–69 years undergoing a general health check-up. The analysis was stratified by the median circulating level of CD34-positive cells because circulating levels of CD34-positive cells could indicate the degree of endothelial repair activity. Independent of known cardiovascular risk factors, among participants with high circulating levels of CD34-positive cells (0.95 cells/μL ≤), UA was significantly positively correlated with CAVI (standardized parameter estimate β = 0.23, p = 0.009), but not among participants with low circulating levels of CD34-positive cells (< 0.95 cells/μL) (β = 0.07, p = 0.445). Independent of established cardiovascular risk factors, UA levels were significantly positively correlated with increased arterial stiffness only among participants with aggressive endothelial repair as evaluated by circulating levels of CD34-positive cells. These results might help clarify some background mechanisms related to endothelial activity.

Beyond T-Trials, T4DM and TRAVERSE: the next large testosterone randomized controlled trial.

Lower testosterone concentrations have been associated with poorer health outcomes in ageing men, but proving causality and demonstrating potential for therapeutic benefit requires randomized clinical trials (RCTs). This review discusses recent observational findings and results of major testosterone RCTs, to explore the need for another, larger trial. Evidence of Leydig cell impairment emerges in men above the age of 70 years. Lower testosterone is associated with diabetes risk, and also risk of incident dementia. An individual participant data meta-analysis found that below thresholds of testosterone of 7.4 nmol/L and 5.3 nmol/l respectively, risks of all-cause mortality and cardiovascular deaths in men increased. Testosterone for the Prevention of Type 2 Diabetes Mellitus (T4DM), a multicentre RCT, showed that testosterone treatment prevented or reverted type 2 diabetes in men at high risk. Testosterone Replacement Therapy for Assessment of Long-term Vascular Events and Efficacy Response in Hypogonadal Men (TRAVERSE), a cardiovascular safety trial, demonstrated cardiovascular and prostate safety of testosterone treatment in men with or at risk of cardiovascular disease. T4DM confirmed findings from the Testosterone Trials (T-Trials) that testosterone improved sexual function, and bone microarchitecture and density. However, in TRAVERSE, testosterone-treated men had a higher risk of clinical bone fractures, but not major osteoporotic fractures. Men with disorders of the hypothalamic-pituitary-testicular (HPT) axis causing androgen deficiency warrant consideration for testosterone therapy. In men with an intact HPT axis, testosterone treatment is a pharmacological intervention which requires justification from high quality RCT data. Currently, there is insufficient evidence to justify wider use of testosterone for prevention of cardiometabolic disease. However, there is scope for another large testosterone RCT to investigate whether testosterone treatment might, in older men, extend disability-free survival.

The Epidemiology of Syphilis and Co-infection with HIV in a Tertiary Care Center in Lebanon: A Retrospective Review

Introduction: Syphilis is an ancient STI causing a new worldwide outbreak in general and in Lebanon specifically. Methods: We conducted a retrospective chart review to assess the rate of syphilis increase in an infectious diseases clinic in Lebanon from 2006 to 2023. We studied the epidemiology of these cases, stage and treatment response and their association to HIV infection and its control. Results: There was an 862% increase in syphilis cases from 2006 to 2019.Most of our cases were middle aged men living with HIV. Most of them had well-controlled HIV infection with good CD4 counts. Most of the diagnosed cases of syphilis were primary and secondary, responding to penicillin G. Discussion: Our data mostly parallels international data, except for gender distribution. Despite successful treatment of most cases in our clinic, the alarming rise of new cases highlights the urgent need for public health measures to mitigate this epidemic. Conclusion: Inclusive awareness is needed to stop syphilis spread in Lebanon, and more screening is key in identifying new cases early for a successful eradication.

Characteristics of anti-contactin1 antibody positive autoimmune nodopathies combined with membranous nephropathy

BackgroundAutoimmune nodopathy (AN) is a very rare new disease entity, especially when combined with membranous nephropathy (MN). MethodsAntibodies against nodal-paranodal cell adhesion molecules in the serum were detected using cell-based assays. Antibody subtypes against contactin-1 (CNTN1) were confirmed. Cases of anti-CNTN1 antibody-positive AN with and without MN were retrieved through a literature search to compare clinical and electrophysiological characteristics. ResultsA 65-year-old male patient with MN developed limb numbness and weakness, along with walking instability. Serum CNTN1 antibodies were positive, primarily those of the IgG4 subtype. Electromyography showed prominent demyelination patterns in both the proximal and distal segments of the nerves compared to the middle nerve trunk. Magnetic resonance imaging revealed enlargement of the bilateral brachial and lumbosacral plexuses and local hyperintensity of the right C5-C6 nerve roots. Thirty-five cases with anti-CNTN1 antibody-positive AN with MN and 51 cases with anti-CNTN1 antibody-positive AN without MN were compared. Furthermore, the proportion of patients with MN combined with AN presenting with acute or subacute onset was higher than that observed in the MN without AN group. Nevertheless, no substantial differences were noted between the two groups concerning the clinical and electrophysiological characteristics, which were mainly elderly men, manifested as sensory ataxia, IgG4 antibody subtype, electrophysiological demyelination, and a certain effect on immunotherapy. ConclusionIn cases of electrophysiological manifestation of demyelinating peripheral neuropathy, especially in distal and poximal segments of nerves, AN should be considered, and further screening for renal function should be performed. Concomitant MN does not aggravate or alleviate peripheral nerve symptoms.