Elderly Men Research Articles

The impact of mosaic loss of the Y chromosome (mLOY) in men of advanced age.

The Y chromosome has long been considered to be a "genetic wasteland" harboring only few genes essentially involved in male sex development and spermatogenesis. However, the discovery of mosaic loss of the Y chromosome (mLOY) in older men has led to revisiting of the potential impact of the Y chromosome on health and the pathophysiological processes of multiple diseases such as cancer, Alzheimer's disease and cardiovascular disease. Hence, developing more sensitive techniques for the detection of mLOY has become an emergent concern. In this article, we present a comprehensive review of the literature regarding mLOY. Additionally, we discuss the emerging discoveries concerning mLOY as well as the underlying mechanisms promoting disease in men of advanced age.

Evaluation of efficacy of cholecalciferol and silymarin in improving lower urinary tract symptoms of benign prostatic hyperplasia: A double-blind, randomized, controlled trial.

Benign prostatic hyperplasia (BPH) mainly leads to lower urinary tract symptoms (LUTS) in aging men. The present study investigates the role of cholecalciferol, Silymarin, and their combined administration in patients with BPH suffering from LUTS. This double-blind, randomized, controlled trial enrolled 80 participants (50-80 years) diagnosed with BPH, from March 2019 to March 2020. Based on serum 25-(OH) vitamin D levels we formed subgroups, each receiving specific interventions. Measurements of International Prostate Symptom Score (IPSS), Maximal Urinary Flow Rate (Q-max), Prostate Volume (PV), Post-Void Residual (PVR), and Prostate-Specific Antigen (PSA) were recorded at baseline and following 3 months of follow-up. Participants with serum concentration of 25-(OH) vitamin D below 20 ng/ml simultaneously received cholecalciferol and Silymarin that significantly improved IPSS, irritation, obstruction, PV, and PVR. In those with concentrations ⩾20 ng/ml, a single use of Silymarin significantly reduced IPSS, irritation, obstruction, and PVR. Adjustment of confounding variables revealed independent and significant effects of both cholecalciferol and Silymarin on PVR, IPSS, and obstruction. Cholecalciferol also improved irritation, while Silymarin reduced prostate volume. These findings highlight potential therapeutic benefits for BPH-associated LUTS, encouraging further exploration and clinical consideration. In this investigation, combination therapy with cholecalciferol at 50,000 IU/w for 8 weeks and Silymarin at a dosage of 480 mg for 3 months resulted in a notable improvement in the IPSS score, PV, and PVR, as well as both irritative and obstructive symptoms. However, the total PSA and free PSA amounts did not reach a significant difference.

The Etiology and Pathogenesis of Benign Prostatic Hyperplasia: The Roles of Sex Hormones and Anatomy.

Benign prostatic hyperplasia (BPH) mainly causes lower urinary tract symptoms in ageing men, but its exact etiology and pathogenesis have not been established. The objective of this review was to design an update on the advances of human BPH research. We undertook a literature search for identifying studies of the roles of sex hormones (androgens and estrogens) in the onset and development of human BPH using the Pubmed database. In literature, many studies have indicated that ageing and obesity are the factors for preceding the onset of BPH. No evidence for the role of testosterone (T) or dihydrotestosterone (DHT) is found in BPH initiation. Since BPH exclusively occurs in the transitional zone (TZ) surrounding the urethra, it is postulated that years of exposure to uncharacterized urinary toxins could disrupt the homeostasis of the stroma and/or epithelium of this prostatic zone that are typically occurring in ageing men. After cellular damage and subsequent inflammation generated, the intraprostatic DHT produced mainly from T by 5α-reductase promotes BPH development. Further, estrogens could take part in the nodular proliferation of stromal cells in some BPH patients. The confounding of BPH may attenuate the development of prostate tumor in the TZ. In conclusion, evidence in literature suggests that androgens are not etiological factors for BPH, and intraprostatic DHT along with chronic inflammation are mainly responsible for nodular proliferation of stromal and/or epithelial cells in prostatic TZ. The urinary factors for the etiology of BPH and BPH as a prediction of PCa progression still need further investigation.

Formation of patriotic values as a predictor of psychological and moral stability of young men of conscription age

Introduction. In the conditions of confronting external threats and the need to respond to numerous challenges of modernity, the problem of identifying the predictors of psychological and moral stability of an individual is characterised by special relevance and significance. The aim of the research is to study the extent of formation of patriotic values as a predictor of psychological and moral stability in young people of conscription age. Materials and methods. The research was carried out in four Russian Federation entities: Arkhangelsk-, Kaliningrad-, Murmansk- and Leningrad regions. The total number of respondents was 1,050 – young men aged 16 to 20 (conscription age). The following techniques were used in the research: theoretical methods (analysis of the research subject through investigating statutory documents, psychological and pedagogical literature; synthesis, generalisation, comparison and systematisation of the obtained data), and empirical methods (questioning, testing and interviewing). To achieve the set targets, the following diagnostic tools were used: the Constructive patriotism questionnaire; the Values materialism questionnaire; the Scale of psychological well-being by C. Ryff; the “Behaviour self-regulation style – SSP-98” questionnaire by V.I. Morosanova. Results. It was found that the number of respondents with the formed constructive patriotism prevails twice as much among young people of conscription age. At the same time, it is worth noting that in fact, one in three young men of conscription age who took part in the survey (31.8%) have formed blind patriotism (pseudo-patriotism, patriotism of obedience, ignorance and intolerance). Young people of conscription age with pronounced constructive patriotism, compared to the group of young people with blind patriotism, have more expressed significant basic values: “Independence”; “Power”; “Achievements”; “Traditions”; “Safety”; “Universalism”; “Benevolence”. Meanwhile, the group of young people of conscription age with pronounced blind patriotism demonstrate mostly two basic values: “Stimulation”; “Conformism”. Young people of conscription age with expressed constructive patriotism have statistically significant differences on the scale “Personal growth”. It was also revealed that they have a significantly higher overall level of self-regulation and the levels of individual self-control of various regulatory processes and personal regulation properties according to five indicators (“Modelling”, “Programming”, “Evaluation of results”, “Flexibility”, “Independence”), compared to the group of respondents with the formed blind patriotism. Conclusion. The study provides important data on the extent of the formation of patriotic values serving as a predictor of psychological and moral stability in young people of conscription age. The obtained results are in demand, being relevant since they make it possible to design the personality education and development processes with regard for the bilateral nature of interconditionality of patriotism relative to a person’s psychological and moral stability

O97 RESPONSE TO AEROBIC TRAINING MAY DIFFER BETWEEN ELDERLY MEN AND WOMEN WITH TREATED HYPERTENSION

Background and objective. Hypertension incidence increases with aging, with expressive enhancement in women after the menopause due to the important physiological changes induced by the estrogen levels decline. Aerobic training is recommended for lowering blood pressure (BP) in men and women with hypertension. However, the possible gender-related differences in training responses have been poorly investigated, especially in elderly patients. Therefore, the objective of this study was to analyze responses to aerobic training in elderly men and women with treated hypertension. Methods: Thirty-one elderly hypertensives (15 women, 68±6ys and 16 men, 66±7ys) who were taking regular antihypertensive medication for at least 4 months participated in the study. They underwent 10 weeks of an aerobic training designed in accordance with the guidelines’ recommendations for hypertension (i.e. 3 session/week, cycle ergometer, 30-45 min, moderate intensity). Before and after the training period, peak oxygen uptake (VO2peak, cardiopulmonary exercise test), BP (auscultatory), systemic hemodynamics (CO2 rebreathing technique) and vascular function (brachial doppler ultrasound) were assessed. In each group (men and women), the training effects were evaluated using paired t-tests or Wilcoxon tests, considering p<0.05 as significant. Results: Aerobic training increased aerobic capacity in both sexes (men = 20.8±4.2 vs. 21.8±4.8 ml.kg-1.min-1, p=0.04 and women = 15.3±2.6 vs. 16.4±2.3 ml.kg-1.min-1, p=0.01). In men, systolic BP and systemic vascular resistance decreased (129±13 vs. 125±12 mmHg, p=0.003 and 21.0±3.8 vs. 18.9±4.1 u, p=0.02), while flow mediated dilation increased (5.5±2.9 vs. 7.2±3.1%, p=0.01) after the training period. On the other hand, in women, none of these variables changed with the training (124±15 vs. 126±12 mmHg, p=0.92; 23.2±5.5 vs. 23.5±5.6 u, p=0.80; and 4.2±3.2 vs. 5.4±3.5%, p=0.10). The other variables assessed did not change in either group. Conclusions: The proposed aerobic training program increased aerobic capacity in both male and female elderly hypertensives, but improved BP, systemic vascular resistance, and endothelial function only in males. Key-words: aerobic training, gender, blood pressure, hypertension. Financial Support: CAPES-0001, CNPq-302309/2022-5, and FAPESP- 2022/12605-3.

Research Progress on the Mechanism of Chinese Herbal Compounds Treating Benign Prostatic Hyperplasia by Regulating Inflammatory Response

Benign prostatic hyperplasia (BPH) is one of the most common benign diseases in middle-aged and elderly men. Its main clinical manifestations are frequent urination, urgent urination, weak urine flow, other lower urinary tract symptoms, serious urinary retention, and urinary incontinence. Chinese herbal compounds are widely used in the clinical treatment of BPH with good efficacy and safety, reflecting the advantages of multi-target and multi-approach traditional Chinese medicine (TCM) treatment. There is usually a high level of inflammation in the affected area of BPH, and its persistence affects the whole body, causing multiple complications and accelerating the development of the disease. Inflammation can directly stimulate the proliferation of prostate cells and drive other pathological mechanisms to jointly promote the development of diseases, such as participating in oxidative stress, driving growth factor synthesis, destroying the imbalance between apoptosis and proliferation, and promoting fibrosis. To more fully elucidate the mechanism of action of Chinese herbal compounds in the treatment of BPH, this paper reviews the literature in recent years, beginning with basic research on the intervention of Chinese herbal compounds in BPH inflammation, to provide further ideas for relevant research on the prevention and treatment of BPH inflammation by TCM.

Impact of Androgen Deprivation Therapy on Cognitive Function of Elderly Men With Prostate Cancer.

Background Prostate cancer affects millions of men worldwide. Androgen deprivation therapy is the most prescribed medication for elderly men with prostatic cancer to slow and suppress the disease progression. Androgen deprivation therapy works on decreasing testosterone levels, and that can cause multiple side effects, including potential cognitive affection in the form of accelerating cognitive aging and potentially increasing the risk of dementia. This study is aimed at evaluating the impact of androgen deprivation therapy on the cognitive function of elderly men recently diagnosed with prostate cancer. Methods The current research is a prospective cohort study conducted on 85 elderly patients recently diagnosed with prostate cancer who are about to start androgen deprivation therapy within two weeks of the diagnosis. These patients were recruited from the oncology and geriatrics outpatient clinics of Ain Shams University hospitals and were followed up on androgen deprivation therapy for at least six months. Cognitive and depression assessments were done using the Montreal Cognitive Assessment Test and Montreal Cognitive Assessment Test-Basic (according to their education) and the Patient Health Questionnaire-9. The cases were assessed at the start, after two months, and after six months of androgen deprivation therapy use. Cognitively impaired or depressed patients were excluded at the beginning of the study. Results This study showed that 49 out of 85 (57.6%) of the studied participants had a lower Montreal cognitive assessment test score average after six months, indicating mild cognitive impairment. Cognitive domains such as visuospatial, language, and attention were affected. About one-third of the participants were diagnosed with depression after six months of the androgen deprivation therapy. All the depressed participants had cognitive impairment. Conclusion The use of androgen deprivation therapy carries the risk of cognitive decline and regression of some of the cognitive domains such as language, visuospatial, attention, and depression in the elderly with recently diagnosed prostate cancer who received ADT for six months. Conversely, depression could not be linked to cognitive decline. Further research should continue exploring the relationship between cognitive decline and ADT and seek strategies to mitigate these effects, ensuring comprehensive patient care targetingcognitive and psychological well-being.

Influence of Age and Sex on Stability Indicators of the Right-Left Hemodynamic Balance of Skin Microcirculation in Symmetrical Areas of the Human Head.

Indicators (markers) of microcirculation stability (MCR) of the skin in symmetric areas of the head were studied in young (18-19-years-old) and elderly (60-80-years-old) male and female subjects. We performed synchronous MCR measurements of symmetrical areas of the head using laser Doppler flowmetry in 40 healthy volunteers (10 men and 10 women in each age group). Numerical values of stability markers (T1, T2, and ζ) and indicators of the right-left hemodynamic balance of the MCR (regression coefficients a1, a2, b1, b2) were obtained using the previously developed computational and experimental methods. The coefficients a2 and b2 that determine the contribution of the right MCR bed to the right-left hemodynamic balance were higher in elderly men than in young men, while in young and elderly women, no significant differences in the values of these coefficients were revealed. In young men, coefficients a2 and b2 were lower than in young women, while in elderly subjects, the sex differences in these coefficients were leveled. Young men have lower stability markers than women, while in elderly subjects, these stability markers were similar in men and women. No significant age and sex differences in the level of perfusion of the symmetrical temporal regions were found. The results attest to low stability of MCR in young men in comparison with young women and similar stability in old age, which, apparently, can be explained by the influence of sex hormones on the regulation of human cardiovascular functions.

The association of 5-alpha reductase inhibitors treatment with prostate cancer in benign prostate hyperplasia patients: A population-based case-control study

Purpose: Benign prostatic hyperplasia (BPH) is the most common cause of difficult voiding in elderly men. Alpha-blockers and 5-alpha reductase inhibitors (5ARIs) are evidence-based standards of care in treating BPH according to current guidelines. We have conducted a nationwide population-based study to evaluate the association of 5ARIs treatment with prostate cancer in patients with benign prostate hyperplasia. Materials and methods: Between 2005 and 2010, patient data from the National Health Insurance Research Database were obtained. Newly diagnosed patients with BPH were divided into 2 groups: prostate cancer group and BPH group. We conducted a retrospective study on their history of medication usage with 5ARIs. Results were compared with a matched noncancerous control group. The outcome measurements were the incidence and the prostate cancer diagnosis-free survival rate after the BPH index date. Statistical analyses included t test, chi-square test, multivariable logistic regression analysis, and Kaplan-Meier curves with log-rank tests. Results: A total of 18,620 newly diagnosed patients with BPH were selected. After eliminating patients according to the exclusion criteria, a total of 17,716 patients were enrolled as the study subjects. Among them, 530 patients (2.99%) developed prostate cancer and 17,186 (97.01%) did not. The mean age of the total case-control study was 69.1 years. The odds ratio of prostate cancer in patients with BPH with 5ARIs usage was 1.14 with a P value of 0.539, indicating that the use of 5ARIs was not associated with a higher risk of developing prostate cancer. Multivariate analysis showed no significant intergroup difference in the risk of developing prostate cancer (odds ratio = 1.14, 95% CI: 0.75–1.74, P = 0.539). A subgroup survival analysis, observing the time interval from BPH diagnosis to the development of prostate cancer based on 5ARIs usage, revealed a nonsignificant difference in the prostate cancer diagnosis-free survival rate, with a P value of 0.3592. Conclusion: The 5ARI usage in patients with BPH was not associated with increased risk of developing prostate cancer. Furthermore, the prostate cancer diagnosis-free survival rate, when stratified based on 5ARIs usage, showed no statistically significant difference. Under our health insurance regulation and clinical practice, 5ARIs are consider safe in treating BPH.

Romantic bias in judging the attractiveness of faces wearing masks.

The spread of COVID-19 has drastically increased the number of people wearing masks in public areas and the opportunities to evaluate others' faces based on limited information. This study investigates the cognitive bias in judging the attractiveness of faces partially hidden by sanitary masks. Experiment 1 revealed that men rated women's faces as more attractive when wearing masks, specifically in the context of rating women as romantic partners; however, this mask bias was absent when men rated women as friends. On the other hand, women did not show the mask bias irrespective of the assumed social relationship. Experiment 2 demonstrated that the mask bias among elderly men was less affected by the assumed social relationship (or the possibility of reproduction), compared to young men, though they showed the bias itself. These results suggest that the cognitive strategies related to reproduction underlie the attractiveness judgment of the partial faces.

Abstract P447: Impact of Altered Receptor Expression On the Cardiovascular Response to Estrogen

Premenopausal women benefit from estrogen's protective effects, including lower arterial stiffness than men of the same age. Despite estrogen's protective role, menopausal hormone therapy showed no cardiovascular benefits in the Women's Health Initiative. One theory is that the response to menopausal hormone therapy is modulated by the presence of pre-existing cardiovascular disease. Estrogen signals through nuclear estrogen receptors ERα and ERβ, and the membrane-bound G protein-coupled estrogen receptor (GPER). Our lab has shown that GPER induces protective cardiovascular effects including decreased blood pressure, protection from renal damage, and attenuation of arterial remodeling. In this study, we hypothesized that GPER deletion would attenuate the protective vascular effects of estrogen after menopause. Female C57Bl/6J wildtype (wt) and global GPER knockout (ko) mice underwent ovariectomy (OVX) at 46 weeks of age and concurrently administered estrogen (E) or vehicle (Veh). Angiotensin II (Ang II; 700 ng/kg/day) infusion was used to induce hypertension either four weeks prior (Ang-E) or at the time of OVX (E-Ang) to evaluate the impact of cardiovascular diseases preceding or coinciding with menopause. Blood pressure was measured by tail-cuff plethysmography and arterial stiffness was assessed by pulse wave velocity (PWV). Statistical analysis was performed using one-way ANOVA. Ang II induced a similar level of hypertension in wt and ko mice and was not impacted by E or timing. In wt mice, PWV was significantly higher in Veh-treated compared with E-treated hypertensive animals, independent of timing (P<0.001). In contrast, PWV was not impacted by E in GPER ko mice (P=0.99). In conclusion, we found that E did not affect the hypertensive response to Ang II in both wt and GPER ko mice. GPER deletion reduced estrogen’s protection from arterial stiffening. Whether Ang II preceded or coincided with menopause did not alter the effects of E. These studies are important for determining whether cardiovascular status should be a factor when considering menopausal hormone therapy.

The association between lower urinary tract symptoms secondary to benign prostatic hyperplasia and multimorbidity among Chinese middle-aged and elderly males: evidence based on propensity score matching.

With the aging population, patients with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) often face multiple chronic conditions (multimorbidity), significantly impacting their quality of life. This study aims to determine the relationship between LUTS/BPH, multimorbidity, and various chronic diseases in middle-aged and elderly Chinese populations. This cross-sectional study utilizes data from the China Health and Retirement Longitudinal Study (CHARLS), involving 6,645 residents aged 45 and above. Data on 14 chronic diseases were collected, with multimorbidity defined based on the presence of 2-5 chronic conditions. The number of chronic conditions was further categorized into five groups. Propensity score matching (PSM) was used to control for 11 confounding factors. Linear regression was employed to analyze the relationship between LUTS/BPH and the number of chronic conditions in middle-aged and elderly Chinese men before and after PSM. Both univariate and multivariate logistic regression analyses were used to explore the association between LUTS/BPH and multimorbidity as well as each chronic disease. The prevalence of multimorbidity was significantly higher among middle-aged and elderly individuals with LUTS/BPH compared to those without. Before PSM, LUTS/BPH was positively correlated with the number of chronic diseases (β=0.175, P<0.001), and the risk of multimorbidity significantly increased, showing a dose-response relationship. The risk of having at least two chronic diseases in patients with LUTS/BPH was 2.39 times higher than in those without LUTS/BPH [odds ratio (OR) =2.39, 95% confidence interval (CI): 2.04-2.80], and the risk of having five chronic diseases was 3.97 times higher (OR =3.97, 95% CI: 3.14-4.99). After PSM, 819 pairs were successfully matched. The positive correlation between LUTS/BPH and multimorbidity still existed, with the risks of having at least two and five chronic diseases being 2.37 times (OR =2.37, 95% CI: 1.94-2.90) and 3.69 times (OR =3.69, 95% CI: 2.62-5.29) higher, respectively. Among them, the risk of emotional/nervous/psychiatric problems was the highest in LUTS/BPH patients (OR =6.58, 95% CI: 2.22-28.13), while the risk of arthritis/rheumatism was the lowest (OR =1.60, 95% CI: 1.30-1.98). In the Chinese population, LUTS/BPH is closely associated with multimorbidity and each of the 14 chronic diseases examined, with a dose-response relationship based on the number of chronic diseases defined within multimorbidity. It is imperative to incorporate LUTS/BPH into multimorbidity research and management. We recommend that clinicians and policymakers consider the increased risk of multimorbidity and various chronic diseases among male LUTS/BPH patients.

A multi-center, randomized, open label, two-arm study to evaluate safety & efficacy of nutraceutical tablet as adjuvant when compared with standard of care in patients with benign prostatic hyperplasia

BackgroundBenign Prostrate Hyperplasia (BPH) is a progressive disease of ageing men that may be associated with enlargement of the prostate and lower urinary tract symptoms (LUTS). Herbal/Nutraceutical formulations in addition to standard of care (SOC) could alleviate the symptoms, and thus improve the quality of life of patients. ObjectivesTo evaluate safety & efficacy of nutraceutical tablet as an adjuvant with SOC. Materials and MethodsThis was a prospective, randomized two-arm study aimed to assess the safety and efficacy of Herbal/Nutraceutical Formulation (IP) + SOC versus only SOC, in BPH patients. The primary efficacy endpoint was the change in international prostate symptom score (IPSS) within and between two arms. The safety was evaluated in terms of adverse events and change in prostate specific antigen (PSA) levels. Results140 eligible patients (70 / arm) were evaluated for efficacy and safety endpoints. The baseline characteristics of patients in two arms differed nonsignificantly. The change in IPSS-storage, voiding and QoL scores, from day 1 to 90 were statistically significant in both the arms (p < 0.0001). However, by day 90, the change in these scores in SOC+IP arm were significantly higher than that of SOC arm. Further, the change in International Index of Erectile Function (IIEF) scores was significant in SOC+IP arm (p < 0.05), while non-significant in SOC arm. The adverse events non-significantly differed between two arms. ConclusionThe herbal/nutraceutical formulation combined with SOC are safe and effective for the treatment of BPH. The combination therapy was effective in reducing urine-related symptoms and improving the QoL of BPH patients.

Trends, transitions and patterning in social activity over time among aging women and men: A secondary analysis of the Canadian Longitudinal Study on Aging (CLSA)

Social isolation matters for health and longevity, but little research examines transitions into or out of social isolation or whether transitions are gendered or socially patterned. We described gender-specific trends in breadth and lack of social participation over 6 years overall and by age, country of origin, geographic location, education, wealth, and household income. We used three waves of CLSA data to evaluate changes in social isolation (0–1 activities) and broad social participation (5+ activities) in adults aged 45–75 (n = 24,788), by gender and socio-demographics, in linear and multinomial logistic regressions with post-estimated predicted probabilities. The number of social activities decreased over time, with greater declines for women. About half the sample (more men than women) stayed not highly socially active (<5 activities) and almost 1 in 5 became not highly socially active. Most adults (77 %) remained not socially isolated and 14 % became or remained socially isolated. Women were more likely than men to remain not highly socially active and less likely to have multiple social isolation transitions. Broad social participation changed over time for several subgroups of women and men, with gender differences notable for income levels. Social disparities in social isolation transitions differed by gender only for education. Older age and socioeconomically disadvantaged adults had higher probabilities of becoming socially isolated or becoming less socially active. Findings indicated the diversity of social activities declined as Canadians age into later life and transitions in both social isolation and social participation differed between genders, especially for specific vulnerable subpopulations.

노인의 성별에 따른 골관절염 유병 관련 영향요인

This study aims to identify the factors influencing the prevalence of osteoarthritis among the elderly aged 65 and older, and to provide fundamental data for developing intervention measures for osteoarthritis management. The subjects of this study were 8,175 elderly individuals (3,521 men and 4,654 women) aged 65 and older, drawn from the 2016-2020 Korea National Health and Nutrition Examination Survey data. The analysis was performed using the SPSS/WIN 25 program, applying complex sample analysis methods. Frequencies, percentages, means, standard deviations, and gender comparisons were analyzed using chi-square tests for cross-tabulations, and logistic regression analysis was conducted to identify factors influencing the prevalence of osteoarthritis. The results revealed significant differences in age, education level, cohabitation with a spouse, home ownership, smoking, drinking, aerobic physical activity, walking, BMI, depression experience, and presence of arthritis between male and female elderly subjects. The estimated prevalence of osteoarthritis among the Korean elderly aged 65 and older, based on the sample, was 25.0% (10.3% for men and 35.9% for women). When examining the differences in osteoarthritis prevalence according to sociodemographic and health-related characteristics, it was found that among elderly men, there were statistically significant differences in osteoarthritis prevalence related to education level, drinking, walking, and obesity. Among elderly women, significant differences were observed in education level, presence of a spouse, walking, obesity, and depression. Furthermore, the factors influencing the prevalence of osteoarthritis among elderly men were education level, while for elderly women, the influencing factors were education level, residential area, and BMI. Based on these results, it is necessary to develop multifaceted and individualized nursing intervention programs tailored to gender.

Effect of eight weeks of swimming on cardiovascular health: Reduction of risk factors in middle-aged men with hypertension

The aim of this study was to determine the effect of a swimming training course on cardiovascular risk factors in 50-60 year old men with high blood pressure. For this purpose, 20 hypertensive men aged 54.95±3.18 years, height 174.05±18.5 cm and weight 82.20±5.36 kg were selected in a targeted manner and they were randomly selected. They were placed in two groups of swimming training and control (10 people in each group). The swimming training group participated in an 8-week swimming training program. Aerobic swimming training with an intensity of 70% of the maximum heart rate, three sessions per week and 15 minutes in the first week, which gradually reached 45 minutes in the last week. During this period, the control group did not follow any regular physical activity program and only did their normal daily activities. Blood pressure, resting heart rate, body weight, cholesterol, triglyceride, LDL and HDL serum levels were evaluated before and after the intervention. Student's t statistical method for dependent and independent groups was also used for intra-group and inter-group comparison of variables, respectively. The results showed that a period of swimming training decreased weight, cholesterol, triglycerides, LDL, resting heart rate and blood pressure, as well as increased HDL in 50-60-year-old men with high blood pressure (P&lt;0.05). Therefore, based on these findings, it is concluded that a course of swimming training improves the profile of blood lipids and blood pressure in elderly men with high blood pressure, and since high blood pressure threatens health and heart attacks, swimming training can improve the health of old and elderly men is beneficial. The aim of this study was to determine the effect of a swimming training course on cardiovascular risk factors in 50-60 year old men with high blood pressure. For this purpose, 20 hypertensive men aged 54.95±3.18 years, height 174.05±18.5 cm and weight 82.20±5.36 kg were selected in a targeted manner and they were randomly selected. They were placed in two groups of swimming training and control (10 people in each group). The swimming training group participated in an 8-week swimming training program. Aerobic swimming training with an intensity of 70% of the maximum heart rate, three sessions per week and 15 minutes in the first week, which gradually reached 45 minutes in the last week. During this period, the control group did not follow any regular physical activity program and only did their normal daily activities. Blood pressure, resting heart rate, body weight, cholesterol, triglyceride, LDL and HDL serum levels were evaluated before and after the intervention. Student's t statistical method for dependent and independent groups was also used for intra-group and inter-group comparison of variables, respectively. The results showed that a period of swimming training decreased weight, cholesterol, triglycerides, LDL, resting heart rate and blood pressure, as well as increased HDL in 50-60-year-old men with high blood pressure (P&lt;0.05).

Epstein–Barr virus-positive mucocutaneous ulcer resulting in severe methotrexate intoxication: a case report

BackgroundEpstein–Barr virus-positive mucocutaneous ulcer is one of the mature B-cell lymphoproliferative diseases occurring in patients with immune dysfunction including those with immunosuppressive treatment such as methotrexate.Case presentationA Japanese elderly man in his 80s with rheumatoid arthritis on methotrexate was admitted to our hospital complaining persistent pharyngeal pain. Laboratory tests revealed severe pancytopenia, elevated C-reactive protein, and increased creatinine levels. An otolaryngological examination showed ulceration of the right tonsil, from which diagnostic biopsy was performed. The diagnosis of Epstein–Barr virus-positive mucocutaneous ulcer was made and bone marrow aspiration revealed hypocellularity and megaloblastic changes. Pancytopenia was improved after discontinuing methotrexate, and repeated bone marrow aspiration test revealed recovery of normal cellularity and disappearance of dysplasia, confirming the diagnosis of methotrexate intoxication. Tonsil ulcer was improved only with discontinuation of methotrexate, which strongly supported the diagnosis of EBV-MCU.ConclusionOur case suggested that even this best prognosis form of lymphoproliferative disease could lead to fatal complications if not appropriately managed.

Deciphering glial contributions to CSF1R-related disorder via single-nuclear transcriptomic profiling: a case study

CSF1R-related disorder (CSF1R-RD) is a neurodegenerative condition that predominantly affects white matter due to genetic alterations in the CSF1R gene, which is expressed by microglia. We studied an elderly man with a hereditary, progressive dementing disorder of unclear etiology. Standard genetic testing for leukodystrophy and other neurodegenerative conditions was negative. Brain autopsy revealed classic features of adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP), including confluent white matter degeneration with axonal spheroids and pigmented glial cells in the affected white matter, consistent with CSF1R-RD. Subsequent long-read sequencing identified a novel deletion in CSF1R that was not detectable with short-read exome sequencing. To gain insight into potential mechanisms underlying white matter degeneration in CSF1R-RD, we studied multiple brain regions exhibiting varying degrees of white matter pathology. We found decreased CSF1R transcript and protein across brain regions, including intact white matter. Single nuclear RNA sequencing (snRNAseq) identified two disease-associated microglial cell states: lipid-laden microglia (expressing GPNMB, ATG7, LGALS1, LGALS3) and inflammatory microglia (expressing IL2RA, ATP2C1, FCGBP, VSIR, SESN3), along with a small population of CD44+ peripheral monocyte-derived macrophages exhibiting migratory and phagocytic signatures. GPNMB+ lipid-laden microglia with ameboid morphology represented the end-stage disease microglia state. Disease-associated oligodendrocytes exhibited cell stress signatures and dysregulated apoptosis-related genes. Disease-associated oligodendrocyte precursor cells (OPCs) displayed a failure in their differentiation into mature myelin-forming oligodendrocytes, as evidenced by upregulated LRP1, PDGFRA, SOX5, NFIA, and downregulated NKX2-2, NKX6.2, SOX4, SOX8, TCF7L2, YY1, ZNF488. Overall, our findings highlight microglia–oligodendroglia crosstalk in demyelination, with CSF1R dysfunction promoting phagocytic and inflammatory microglia states, an arrest in OPC differentiation, and oligodendrocyte depletion.

Mechanisms and Efficacy of Chinese Herbal Medicines in Benign Prostatic Hyperplasia.

Benign prostatic hyperplasia (BPH) is one of the most common diseases in elderly men, the incidence of which gradually increases with age and leads to lower urinary tract symptoms (LUTS), which seriously affects the quality of life of patients. Chinese herbal medicines (CHMs) are widely used for the treatment of BPH in China and some other countries. To explore the molecular mechanisms of CHMs for BPH, we conducted a review based on peer-reviewed English-language publications in PubMed and Web of Science databases from inception to December 31, 2023. This article primarily reviewed 32 papers on the use of CHMs and its active compounds in the treatment of BPH, covering animal and cell experiments, and identified relevant mechanisms of action. The results suggest that the mechanisms of action of CHMs in treating BPH may involve the regulation of sex hormones, downregulation of cell growth factors, anti-inflammatory and antioxidative effects, inhibition of cell proliferation, and promotion of apoptosis. CHMs also exhibit α-blocker-like effects, with the potential to relax urethral smooth muscle and alleviate LUTS. Additionally, we also reviewed 4 clinical trials and meta-analyses of CHMs for the treatment of BPH patients, which provided initial evidence of the safety and effectiveness of CHMs treatment. CHMs treatment for BPH shows advantages as a multi-component, multi-target, and multi-pathway therapy, which can mitigate the severity of the disease, improve LUTS, and may become a reliable treatment option in the future.

Infertility: A Family Nurse Practitioner Approach in Primary Care

Infertility affects ∼19% of women between the ages of 15 and 49 years, and ∼9% of men of reproductive age in the United States. Rising infertility rates have led to couples presenting with infertility concerns in the primary care setting, emphasizing the nurse practitioner's vital role in beginning the infertility workup. Using an infertility algorithm can aid in the diagnosis and seamless transition to a fertility specialist. The nurse practitioner can obtain a detailed medical and reproductive history, perform an appropriate physical examination, order initial diagnostic testing, perform a medication reconciliation, provide patient education, and initiate referrals to specialists.