Extent In Men Research Articles

Grading facial aging: Comparing the clinical assessments made by three dermatologists with those obtained by an AI-based scoring system that analyses selfie pictures. Afocus on Chinese subjects of both genders.

The objective of this study is to assess the correspondence, in live conditions, between clinical gradings of facial aging signs by three dermatologists and those afforded by an automatic AI-based algorithm that analyses smartphones' selfie images of Chinese subjects. In total, 125 Chinese subjects of both genders, aged 18-62y, took a selfie using their own smartphones and were immediately viewed by three dermatologists. The latter graded the severity of 15 facial signs in women and 9 in men, using the standardized values afforded by a Skin Aging Atlas referential dedicated to Asian skin. The data issued by both methodologies were then statistically compared. The absolute gradings of the automatic system were found highly correlated with clinical assessments, with lower values in most cases. In women, large differences in absolute values were found on the gradings for size of isolated spot, cheek fold, spread macules, and texture of mouth contour women. Analysis of the Mean Absolute Errors (M.A.E) revealed that these rarely exceed 0.6 grading units in women and to a lesser extent in men. The present study confirmed the value of the automatic system towards an extended use towards large human cohorts as a surrogate of clinical evaluations and allowed to detect the points where improvements must be brought to the system.

Activity of oxidative processes and the state of the redox regulating system in tumor tissue in skin cancer

Purpose of the study. To study the intensity of lipid peroxidation (LPO) and the activity of antioxidant protection components in tumor tissues, peritumoral zone and conditionally healthy skin tissue in basal cell carcinoma, depending on the type of tumor growth, gender of patients, and the presence of concomitant diseases.Materials and methods. Tissues from 34 patients with basal cell carcinoma (BCC) were studied, including 17 women (10 with superficial tumor growth and 7 with solid growth) and 17 men (5 and 12 patients, respectively). We used skin flaps obtained during operations on 12 men and 10 women without malignant pathology (“norm”) as a comparison material. The content of malondialdehyde (MDA), diene conjugates (DC), superoxide dismutase (SOD) activity and total peroxidase activity (TPA) were determined. Statistical processing of the results was carried out using the Statistica 10.0 program.Results. In women, the level of MDA was increased in all tissues: with superficial growth of BCC by 2.1–2.5 times (p ≤ 0.05), with solid growth by 1.6–2.1 times (p < 0.05) relative to the “norm”. In men with superficial growth, an MDA increase by 3.2 and 3.1 times in tumor tissue and conditionally healthy tissue was observed (p < 0.02), and no increase in MDA in the tumor was detected in 11 of 12 patients with solid growth. An increase in DC (on average 2–5 times) in BCC patients with concomitant hypertension and diabetes mellitus was observed mainly in women. Activation of SOD in tumor tissue, to a greater extent in men (2.4 times with superficial growth and 1.7 times with solid growth, p < 0.05 relative to conditionally healthy tissue), can be considered as a mechanism of antiradical protection of the tumor.Conclusions. An increase in the level of MDA in BCC was observed in tumor and nearby tissues in women with both types of growth, in men only with superficial growth. Analysis of individual characteristics of LPO indicators in patients with skin carcinoma revealed a dependence of the severity of the increase in MDA and especially DC on the presence of concomitant pathology (hypertension, diabetes mellitus).

Особенности представления о старении у мужчин и женщин в периоды средней и поздней взрослости

The relevance of the study is determined by the necessity for scientific substantiation and development of methods aimed at improving the quality of life in the old age. The research purpose is to study the peculiarities of the perception of aging by men and women during middle and late adulthood. The study hypothesizes that peculiarities of the age perception by men and women are manifested in the idea of the causal role of aging in the context of changes in health, as well as in the emotional attitude towards aging. The gender and age specificity manifests itself in terms of positive and negative effects of aging, as well as in the changes caused by aging and the determination of its causes. Participants: 217 respondents aged 30-68 (nmale= 57; nfemale= 123) living in different regions of the Russian Federation. The sample is represented by 4 age groups: from 30 to 45 years old (n = 37); from 46 to 55 years old (n = 51); from 56 to 59 years old (n = 52); from 60 to 68 years old (n = 77). Methods (tools): to assess the perception of aging, the “Aging perception questionnaire” was used (E. Sexton, B. L. King-Kallimanis, K. Morgan, H. McGee as adapted by K. M. Krupina, M. D. Petrash, D. I. Golubitskaya, O. Y. Strizhitskaya). Results: the research has revealed significant differences in the manifestation degree of the parameter ‘determination of the causes of aging’ with its greater representation in the sample of men. The study has found the influence of the gender and age factor on the parameter ‘determination of the causes of aging’. Main conclusions: the causal role of aging for one’s own life is manifested to a greater extent in men rather than in women. The peculiarities of perceiving aging for male and female subsamples are manifested in different emotional attitudes towards aging, in the possibility of controlling one’s own life and the consequences of aging, as well as in determining the causes of aging. Practical significance: the data obtained can be implemented in psychological counseling in order to form a positive perception of aging. Taking into account the gender and age specifics of the perceiving aging can contribute to the construction of the productive old age stage and the subsequent improvement of the quality of life in old age.

Cervical Spondylotic Myelopathy-Diagnostics and Clinimetrics.

Cervical myelopathy is referred to in many ways in the English literature, for example, as cervical spondylotic myelopathy (CSM), spondylotic radiculomyelopathy (SRM) or degenerative cervical myelopathy (DCM). In addition, more frequent occurrences are noted in older adults and to a greater extent in men. The causes of the effects of cervical myelopathy may be the appearance of lesions on the spinal cord, ischemia due to compression of the vertebral artery and repeated micro-injuries during maximal movements-hyperflexion or hyperextension. It is well known that lesions on the spinal cord may occur in a quarter of the population, and this problem is clearly noted in people over 60 years old. The symptoms of SCM develop insidiously, and their severity and side (unilateral or bilateral) are associated with the location and extent of spinal cord compression. Neurological examination most often diagnoses problems in the upper limbs (most often paresis with developing hand muscle atrophy), pyramidal paralysis in one or both lower limbs and disorders in the urinary system. To make a diagnosis of CSM, it is necessary to perform MRI and neurophysiological tests (such as EMG or sensory and/or motor-evoked potentials). The use of appropriately selected scales and specific tests in diagnostics is also crucial. This narrative review article describes the latest knowledge on the diagnosis and clinimetrics of cervical spondylotic myelopathy in adults and provides future directions.

What do prospective parents know about family welfare incentives? Evidence from Hungary and the United States

ABSTRACT Countries facing population decline have increasingly turned to family welfare incentives to encourage higher fertility. Quantitative analyses have revealed mixed evidence that these policies are effective. However, it remains unknown how much individuals know about their countries' family welfare policies. The extent of men’s welfare knowledge in particular remains unexamined. Relying on 26 interviews with prospective parents in Hungary (N = 11) and the US (N = 15), this study examines what knowledge prospective parents have of family welfare policies in two distinct welfare contexts: Hungary, where certain individuals are heavily rewarded for having three or more children, and the US, where individuals do not receive significant financial support for having any number of children. Findings from this study demonstrate how policy knowledge is shaped by the public versus private nature of the welfare state. This study also reveals how policy measures can shape the gendered division of labor years before a child is born – a fruitful area for future research.

Angiotensin II type 2 receptor-mediated dilation is greater in the cutaneous microvasculature of premenopausal women compared with men.

Differential activation of the renin-angiotensin system (RAS) likely contributes to sex differences in cardiovascular outcomes in premenopausal women compared with age-matched men. Women demonstrate reduced activation of the vasoconstrictor angiotensin II type 1 receptors (AT1R) compared with men, and evidence suggests that women also likely have increased sensitivity of the vasodilatory angiotensin II type 2 receptors (AT2R). However, few in vivo studies have directly examined sex differences in AT2R-mediated dilation, or the balance between AT1R- and AT2R-mediated vascular responses in humans. Using the cutaneous microcirculation as a model, we hypothesized that AT2R-mediated dilation would be greater in premenopausal women compared with men, and that AT1R-blockade would augment AT2R-mediated dilation to a greater extent in men than in women. Twelve healthy women (22 ± 3 yr) and 12 men (23 ± 5 yr) had two intradermal microdialysis fibers placed in the ventral forearm for graded infusions of compound 21 (AT2R agonist; 10-12 to 10-8 M) in a control fiber site and a site treated with 43 µM losartan (AT1R antagonist). Red blood cell flux was measured continuously by laser-Doppler flowmetry, and cutaneous vascular conductance [CVC = flux/mean arterial pressure (MAP)] was normalized to maximum [%max; 28 mM sodium nitroprusside (SNP) + 43 °C]. Women had greater AT2R-mediated dilation compared with men (women: 25 ± 4 vs. men: 15 ± 2%max, P = 0.03). Local AT1R inhibition increased AT2R-mediated dilation in men (losartan: 26 ± 4 vs. control: 15 ± 2%max, P < 0.001) but had no effect in women (losartan: 27 ± 6 vs. control: 25 ± 4%max, P > 0.05). These data suggest that premenopausal women have a greater AT2R-mediated vasodilation response than men, and that AT1R activation inhibits AT2R-mediated dilation in men, but not in women.NEW & NOTEWORTHY Premenopausal women have greater protection against cardiovascular disease than age-matched men. However, the role of vasoconstrictor angiotensin II type 1 receptors (AT1R) and vasodilatory angiotensin II type 2 receptors (AT2R) in mediating these sex differences is unclear. Here, we demonstrate that women have greater AT2R-mediated vasodilation than men and that AT1R negates AT2R-mediated dilation in men, but not in women.

De novo metastatic breast cancer in men vs women: a Swedish population-based cohort study.

Current evidence on de novo metastatic breast cancer is based on data from women. This Swedish population-based cohort study compared the incidence over time and prognosis of de novo metastatic breast cancer between sexes using data from the Swedish National Quality Register for Breast Cancer. Joinpoint regression analysis was used to compare incidence trends in all stages (104 733 women, 648 men) and multivariate Cox regression analysis to investigate potential sex disparities in de novo metastatic breast cancer prognosis (6005 women, 41 men). For both sexes, increased trends were evident for cancer stages I and II, with a stabilizing trend at the later years for women, while stage III incidence remained stable. An increased trend for de novo metastatic breast cancer in women, and to a lesser extent in men, was observed. No difference in de novo metastatic breast cancer overall survival between sexes was observed (hazard ratio = 1.24; 95% confidence interval = 0.85 to 1.81). The comparable features in terms of incidence and prognosis of de novo metastatic breast cancer between sexes imply similarities, supporting the adoption of common treatment strategies.

The Immune Response Generated against HPV Infection in Men and Its Implications in the Diagnosis of Cancer.

Human papillomavirus (HPV) infection is associated with precancerous lesions and cancer of the genital tract both in women and men. The high incidence of cervical cancer worldwide focused the research on this infection mainly in women and to a lesser extent in men. In this review, we summarized epidemiological, immunological, and diagnostic data associated with HPV and cancer in men. We presented an overview of the main characteristics of HPV and infection in men that are associated with different types of cancer but also associated with male infertility. Men are considered important vectors of HPV transmission to women; therefore, identifying the sexual and social behavioral risk factors associated with HPV infection in men is critical to understand the etiology of the disease. It is also essential to describe how the immune response develops in men during HPV infection or when vaccinated, since this knowledge could help to control the viral transmission to women, decreasing the incidence of cervical cancer, but also could reduce other HPV-associated cancers among men who have sex with men (MSM). Finally, we summarized the methods used over time to detect and genotype HPV genomes, as well as some diagnostic tests that use cellular and viral biomarkers that were identified in HPV-related cancers.

Effect of acute tauroursodeoxycholic acid ingestion on microvascular function in men and women

The endoplasmic reticulum is a multipurpose organelle found in most human cells, including endothelial and smooth muscle cells of blood vessels. It plays a key role in posttranslational folding of new proteins and reprocessing of misfolded or damaged proteins. Under certain conditions, the accumulation of unfolded proteins can trigger a quality control system (i.e., the unfolded protein response) that restores protein homeostasis in the endoplasmic reticulum. However, the unfolded protein response can simultaneously augment the formation of reactive oxygen species and inflammatory mediators which can induce vascular dysfunction. Despite our understanding of the relation between endoplasmic reticulum stress and vascular dysfunction in animal and human models, the sex-dependent influence of the endoplasmic reticulum on microvascular function has not been explored. Therefore, we tested the hypothesis that compared with placebo, acute ingestion of tauroursodeoxycholic acid (TUDCA) would improve microvascular function to the same extent in men and women. Twelve young healthy adults (6 women, 26 ± 5 yrs) were studied ~8 hours following ingestion of a placebo or 1,500 mg of TUDCA, a chemical chaperone that inhibits endoplasmic reticulum stress. Experiments were randomized, counterbalanced, and separated by at least 7 days. Venous plasma TUDCA and its taurine conjugated form, ursodeoxycholic acid, were measured for both conditions via high-performance liquid chromatography. Microvascular function was assessed using post-occlusive reactive hyperemia (Doppler ultrasound) and was normalized to mean arterial blood pressure. Compared with placebo (men, 13 ± 15 ng/ml; women, 6 ± 2 ng/ml), TUDCA ingestion increased plasma concentrations (men, 80 ± 43 ng/ml; women, 140 ± 93 ng/ml; P = 0.05). Similarly, compared with placebo (men, 13 ± 14 ng/ml; women, 7 ± 4 ng/ml), plasma ursodeoxycholic acid increased following TUDCA ingestion (men, 666 ± 237 ng/ml; women, 559± 458 ng/ml; P &lt; 0.01). Plasma TUDCA and ursodeoxycholic acid concentrations did not vary between sexes (both P &gt; 0.4). Peak vascular conductance did not differ between placebo and TUDCA conditions ( P = 0.7), an effect that did not vary between men and women (men: placebo, 4.1 ± 1.1 ml/min/mmHg vs. TUDCA, 4.1 ± 1.1 ml/min/mmHg; women: placebo, 3.2 ± 1.1 ml/min/mmHg vs. TUDCA, 3.0 ± 1.1 ml/min/mmHg; P = 0.6). Likewise, reactive hyperemia area under the curve did not differ between placebo and TUDCA conditions ( P = 0.5), nor did it vary by sex ( P = 0.2). Contrary to our hypothesis, these data suggest that acute ingestion of tauroursodeoxycholic acid does not alter microvascular function in young healthy men and women. UNTHSC Seed Grant This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Angiotensin II type 2 receptor-mediated dilation is greater in the cutaneous microvasculature of premenopausal women compared to men

Sex differences in the activation of the renin-angiotensin system (RAS) likely contribute to differences in cardiovascular outcomes in premenopausal women compared to age-matched men. It is established that women have a reduced activation of the vasoconstrictor angiotensin II – angiotensin II type 1 receptor (AT 1 R) pathway. Emerging evidence suggests that this may be mediated by a shift toward the more recently described vasodilatory RAS, including increased sensitivity of the vasodilatory angiotensin II type 2 receptor (AT 2 R). However, few in vivo studies have directly examined sex differences in AT 2 R-mediated dilation, or the balance between AT 1 R- and AT 2 R-mediated vascular responses in humans. Using the cutaneous microcirculation as a model, we hypothesized that AT 2 R-mediated dilation would be greater in premenopausal women compared to men, and that AT 1 R-blockade would augment AT 2 R-mediated dilation to a greater extent in men than in women. Eight healthy women (22±3 years) and 11 healthy men (23±5 years) participated in 1 experimental visit. Two intradermal microdialysis fibers were placed in the skin of the ventral forearm for graded infusions of either compound 21 (C21, AT 2 R agonist; 10 -12 - 10 -3 mol/L) alone or C21 + 43 μmol/L losartan (AT 1 R antagonist). Red blood cell flux was measured over each microdialysis site by laser-Doppler flowmetry. Cutaneous vascular conductance was calculated (CVC=doppler flux/mean arterial pressure) and normalized to maximum (%CVCmax; 28mM SNP+43°C). Women had a greater peak vasodilation response to C21 compared to men (27.2±5.7 versus 18.2±2.7 %CVCmax; p=0.03). AT 1 R-inhibition augmented peak C21-mediated dilation in men (31.3±4.5 versus 18.2±2.7 %CVCmax; p=0.009) but had no effect in women (24.5±6.5 versus 27.2±5.7 %CVCmax; p=0.34). These data suggest that premenopausal women have a greater AT 2 R-mediated vasodilation response than men, and that AT 1 R activation inhibits AT 2 R-mediated dilation in men, but not in women. This study is supported by National Heart, Lung, and Blood Institute Grant R00HL138133. Clinicaltrials.gov identifier: NCT05576155 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The Effect of Spinal Muscle Fatigue and Psychosocial Factors on Pressure-Pain Threshold in Healthy Adults.

Pain sensitivity decreases following isometric exercise. It is not clear whether this exercise-induced hypoalgesia (EIH) occurs to the same extent in men and women. It is also unclear if the effect is systemic or local to the exercised musculature. The aim of our study was to investigate whether fatiguing isometric exercise of the spinal and hip extensors would result in increased pressure pain threshold (PPT) at sites local to and remote from the exercised muscles in healthy men and women and whether there is a relationship between central sensitization, psychosocial factors, and PPT. 35 healthy adults (age 27.1 ± 4.5 years, 22 women). This was a within-subjects cohort study. Participants completed questionnaires quantifying central sensitization, pain catastrophizing, sleepiness/insomnia, anxiety, and depression. PPT was assessed at the lumbar and thoracic paraspinals, hamstrings, gastrocnemius, wrist, and third digit before and immediately after participants performed the Biering-Sorensen test to failure. PPT increased postexercise in the thoracic paraspinals, hamstrings, and gastrocnemius in men and women and in the lumbar paraspinals in men only but did not change at the wrist and digit sites. A lower average PPT at baseline was associated with a higher central sensitization scores. A greater increase in average PPT postfatigue was significantly associated with higher average PPT at baseline. Exercise-induced hypoalgesia occurs at sites overlying the muscles involved in fatiguing exercise, but not at remote sites, and is more evident in males than females. The magnitude of EIH depends upon baseline PPT. Even in healthy individuals, greater central sensitization is associated with lower baseline PPT.

Estrogen Receptor Genes, Cognitive Decline, and Alzheimer Disease.

Lifetime risk of Alzheimer's disease (AD) dementia is two-fold higher in women compared with men, and low estrogen levels in post menopause have been suggested as a possible contributor. We examined 3 ERs (GPER1, ER2, ER1) variants in association with AD traits as an indirect method to test the association between estrogen and AD in women. While the study focus was on women, in a comparison we separately examined ER molecular variants in men. Participants were followed for an average 10 years in one of two longitudinal clinical pathological studies of aging. Global cognition was assessed using a composite score derived from 19 neuropsychological tests' scores. Postmortem pathological assessment included examination of 3 AD (amyloid-β and tau tangles determined by immunohistochemistry, and a global AD pathology score derived from diffuse and neurotic plaques and neurofibrillary tangles count) and 8 non-AD pathology indices. ER molecular genomic variants included genotyping and examining ER DNA methylation and RNA expression in brain regions including dorsolateral prefrontal cortex (DLPFC) that are major players in cognition and often have AD pathology. Mean age of women (N=1711) at baseline was 78.0 (SD=7.7) years. In women, GPER1 molecular variants had the most consistent associations with AD traits. GPER1 DNA methylation was associated with cognitive decline, tau tangles density, and global AD pathology score. GPER1 RNA expression in DLPFC was related to cognitive decline and tau tangles density. Other associations included associations of ER2 and ER1 SNPs and DNA methylation with cognition. RNA expressions in DLPFC of genes involved in signaling mechanisms of activated ERs were also associated with cognitive decline and tau tangles density in women. In men (N=651, average age at baseline: 77.4 (SD=7.3)), there were less robust associations between ER molecular genomic variants and AD cognitive and pathological traits. No consistent association was seen between ER molecular genomic variations and non-AD pathologies in either of sexes. ER DNA methylation and RNA expression, and to some extent ER polymorphisms, were associated with AD cognitive and pathologic traits in women, and to a lower extent in men.

Sex modulates the outcome of subthalamic nucleus deep brain stimulation in patients with Parkinson's disease.

There are many documented sex differences in the clinical course, symptom expression profile, and treatment response of Parkinson's disease, creating additional challenges for patient management. Although subthalamic nucleus deep brain stimulation is an established therapy for Parkinson's disease, the effects of sex on treatment outcome are still unclear. The aim of this retrospective observational study, was to examine sex differences in motor symptoms, non-motor symptoms, and quality of life after subthalamic nucleus deep brain stimulation. Outcome measures were evaluated at 1 and 12 months post-operation in 90 patients with Parkinson's disease undergoing subthalamic nucleus deep brain stimulation aged 63.00 ± 8.01 years (55 men and 35 women). Outcomes of clinical evaluations were compared between sexes via a Student's t-test and within sex via a paired-sample t-test, and generalized linear models were established to identify factors associated with treatment efficacy and intensity for each sex. We found that subthalamic nucleus deep brain stimulation could improve motor symptoms in men but not women in the on-medication condition at 1 and 12 months post-operation. Restless legs syndrome was alleviated to a greater extent in men than in women. Women demonstrated poorer quality of life at baseline and achieved less improvement of quality of life than men after subthalamic nucleus deep brain stimulation. Furthermore, Hoehn-Yahr stage was positively correlated with the treatment response in men, while levodopa equivalent dose at 12 months post-operation was negatively correlated with motor improvement in women. In conclusion, women received less benefit from subthalamic nucleus deep brain stimulation than men in terms of motor symptoms, non-motor symptoms, and quality of life. We found sex-specific factors, i.e., Hoehn-Yahr stage and levodopa equivalent dose, that were related to motor improvements. These findings may help to guide subthalamic nucleus deep brain stimulation patient selection, prognosis, and stimulation programming for optimal therapeutic efficacy in Parkinson's disease.

The Evolving Role of Microrna Subtypes 21, 155 and 10b as Oncogenes and Biomarkers in Breast Cancer in a Decade: A Systematic Review Article

Breast cancer is a malignant disease with a high incidence worldwide in women- and to less extent in men-, thus remains a health burden. miRNA plays a key role in the development and prognosis of breast cancer; as a single miRNA has the ability to regulate multiple gene targets and adversely alter their expression. In this review, we attempt to systematically analyze the rapidly accumulating body of research regarding the role of miRNAs subtypes particularly as oncogenes and biomarkers in breast cancer, and their clinical implications. A total of 11 pertinent articles in the past 10 years were extracted from high-rank reviews, analyzed, and summarized. Amongst many (eight miRNA subtypes), three subtypes (miR21, 155, and 10b) were selected in order to evaluate the validity of their oncogenicity as well as their diagnostic value as biomarkers.

Microstructural white matter abnormalities in Lesch-Nyhan disease.

Lesch-Nyhan disease is a rare, sex-linked, genetic neurodevelopmental disorder that is characterized by hyperuricemia, dystonia, cognitive impairment and recurrent self-injury. We previously found reduced brain white matter volume in patients with Lesch-Nyhan disease compared with healthy adults using voxel-based morphometry. Here, we address the structural integrity of white matter via diffusion tensor imaging. We hypothesized that white matter integrity would be decreased in men with Lesch-Nyhan disease and to a lesser extent in men with a milder variant of the disease (Lesch-Nyhan variant) relative to healthy men. After acquiring diffusion-weighted brain images from Lesch-Nyhan disease (n = 5), Lesch-Nyhan variant (n = 6) and healthy participants (n = 10), we used both tract-based spatial statistics and a regions of interest approach to analyse between-group fractional anisotropy differences. We first replicated earlier findings of reduced intracranial, grey matter and white matter volumes in patients. We then discovered marked reductions of fractional anisotropy relative to the healthy control group. The Lesch-Nyhan disease group showed more pronounced reductions in white matter integrity than the Lesch-Nyhan variant group. In addition to whole brain fractional anisotropy group differences, reductions in white matter integrity were observed in the corpus callosum, corona radiata, cingulum, internal capsule and superior longitudinal fasciculus. Moreover, the variant group had attenuated dystonia severity symptoms and cognitive deficits. These findings highlight the need to better understand the role of white matter in Lesch-Nyhan disease.

Sex Differences in Characteristics Associated with Potentially Inappropriate Medication Use and Associations with Functional Capacity in Older Participants of the Berlin Aging Study II

Introduction: Medication safety is a vital aim in older adults’ pharmacotherapy. Increased morbidity and vulnerability require particularly careful prescribing. Beneath avoiding unnecessary polypharmacy and prescribing omissions, physicians have to be aware of potentially inappropriate medications (PIMs) and related outcomes to optimize older adults’ drug therapy, and to reduce adverse drug events. Objective: The aim of this study was to identify participants characteristics associated with PIM use and associations of PIM use with functional capacity with a focus on sex differences. Methods: Multivariable logistic regression analyses of cross-sectional Berlin Aging Study II (BASE-II) data (N = 1,382, median age 69 years, interquartile range 67–71, 51.3% women) were performed with PIM classification according to the EU(7)-PIM list. Results: In the overall study population, higher education was associated with lower odds of PIM use (odds ratio [OR] 0.93, confidence interval [CI] 95% 0.87–0.99, p = 0.017). Falls (OR 1.53, CI 95% 1.08–2.17, p = 0.016), frailty/prefrailty (OR 1.68, 1.17–2.41, p = 0.005), and depression (OR 2.12, CI 95% 1.32–3.41, p = 0.002) were associated with increased odds of PIM use. A better nutritional status was associated with lower odds of PIM use (OR 0.88, CI 95% 0.81–0.97, p = 0.008). In the sex-stratified analysis, higher education was associated with lower odds of PIM use in men (OR 0.90, CI 95% 0.82–0.99, p = 0.032). Frailty/prefrailty was associated with increased odds of PIM use in men (OR 2.04, CI 95% 1.18–3.54, p = 0.011) and a better nutritional status was associated with lower odds of PIM use in men (OR 0.83, CI 95% 0.72–0.96, p = 0.011). Falls in the past 12 months were related to an increased prevalence of PIM use in women (OR 1.74, CI 95% 1.10–2.75, p = 0.019). Depression was associated with a higher prevalence of PIM use in both men (OR 2.74, CI 95% 1.20–6.24, p = 0.016) and women (OR 2.06, CI 95% 1.14–3.71, p = 0.017). We did not detect sex differences regarding the overall use of drugs with anticholinergic effects, but more men than women used PIMs referring to the cardiovascular system (p = 0.036), while more women than men used PIMs referring to the genitourinary system and sex hormones (p < 0.001). Conclusion: We found similarities, but also differences between men and women as to the associations between PIM use and participants’ characteristics and functional capacity assessments. The association of lower education with PIM use may suggest that physicians’ prescribing behavior is modified by patient education, a relationship that could evolve from more critical attitudes of educated patients towards medication use. We conclude that sex differences in associations of PIM use with functional capacities might be partly attributable to sex differences in drug classes used, but not with regard to anticholinergics, as these are used to a similar extent in men and women in the cohort studied here.

MP27-08 CLINICAL CORRELATES AND ECONOMIC CONSEQUENCES OF EMPLOYER BENEFIT EXCLUSION FOR PENILE PROSTHESIS IMPLANTATION FOR ERECTILE DYSFUNCTION

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I (MP27)1 Sep 2021MP27-08 CLINICAL CORRELATES AND ECONOMIC CONSEQUENCES OF EMPLOYER BENEFIT EXCLUSION FOR PENILE PROSTHESIS IMPLANTATION FOR ERECTILE DYSFUNCTION Sirikan Rojanasarot, Samir Bhattacharyya, and Arthur L. Burnett Sirikan RojanasarotSirikan Rojanasarot More articles by this author , Samir BhattacharyyaSamir Bhattacharyya More articles by this author , and Arthur L. BurnettArthur L. Burnett More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002024.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Employed men with erectile dysfunction (ED) covered by employer-sponsored health insurance (ESHI) often have limited access to penile prosthesis implantation (PPI). This study quantified the clinical correlates and economic consequences of the benefit exclusion by examining the prevalence and comorbid correlations of ED among men with ESHI; the population size of ED men affected by the issue; and the economic impact of work productivity loss due to benefit exclusion for PPI. METHODS: A cost-consequence analysis was developed to quantify the impact of employer exclusion for PPI. The analysis was selected as it displays results in natural units of effect, including the number of men affected and the days and costs of work productivity lost, enabling clinicians and decision makers to select the most relevant components to them. IBM MarketScan Commercial data from 2010-2018 were analyzed to determine the prevalence and comorbid correlations of ED. The American Community Survey and published literature were used to estimate the number of ED men with ESHI affected by benefit exclusion for PPI. The economic impact of work productivity loss due to ED was calculated using National Occupational Employment and Wage Estimates and converted into 2019 US dollars. RESULTS: The prevalence rates of ED among men with ESHI increased from 1.6% in men aged 18-24 years to 24.6% in men aged 55-64 years (Figure). Most ED men were ≥45 years of age (78.5%), had a Charlson Comorbidity Index of 0 (76.1%). Common comorbidities were hyperlipidemia (48.0%) and hypertension (46.4%). An estimated 1.29 million men with ESHI in 2019 were affected by benefit exclusion for PPI. Men with ED had an additional 283 hours/year of work impairment compared to men without ED, resulting in an annual indirect mean cost of $7,270. An average US company with 5,000 employees that excluded PPI from their plan could lose $1.28 million of work productivity due to additional work impairment from ED. CONCLUSIONS: The extent of men with ED affected by benefit exclusion for PPI as well as economic impact of work productivity loss due to this exclusion issue are substantial. Removing benefit exclusion for PPI may improve patient access to effective ED treatment and reduce the burden of ED on both patients and employers . Source of Funding: Boston Scientific © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e474-e474 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sirikan Rojanasarot More articles by this author Samir Bhattacharyya More articles by this author Arthur L. Burnett More articles by this author Expand All Advertisement Loading ...

Elevated Fatty Liver Index Is Independently Associated With New Onset of Hypertension During a 10‐Year Period in Both Male and Female Subjects

BackgroundFatty liver index (FLI), a predictor of nonalcoholic fatty liver disease, has been reported to be associated with several metabolic disorders. Because of a sex difference in FLI level, we hypothesized that FLI is associated with development of hypertension to a greater extent in men or women.Methods and ResultsWe investigated the relationship between FLI and development of hypertension during a 10‐year period in a general population of subjects who received annual health examinations (n=28 990). After exclusion (44.9%) of subjects with missing data and those with hypertension at baseline, a total of 15 965 subjects (men/women: 9466/6499) were included. FLI level was significantly higher in men than in women. During the 10‐year period, 2304 men (24.3%) and 745 women (11.5%) had new onset of hypertension. Multivariable Cox proportional hazard models with a restricted cubic spline showed that the hazard ratios (HRs) for development of hypertension after adjustment of age, systolic blood pressure, estimated glomerular filtration rate, habits of smoking and alcohol drinking, family history of hypertension, and diagnosis of diabetes mellitus and dyslipidemia increased gradually with increase in FLI in men and increased rapidly and then slowly with increase in FLI in women. There was a significant interaction between FLI and sex for the risk of hypertension in all of the subjects (P=0.049). The addition of FLI to traditional risk factors significantly improved the discriminatory capability.ConclusionsA high level of FLI predicts the development of hypertension in both men and women, although distribution patterns of HRs were different between sexes.

Rectus Abdominis Muscle Thickness is a Valid Measure of Cross-Sectional Area: Implications for Ultrasound

The rectus abdominis muscle exhibits early and significant muscle atrophy, which has largely been characterized using ultrasound measured muscle thickness. However, the validity of rectus abdominis muscle thickness as a metric of muscle size has not been established, limiting precise interpretation of age-related changes. In a heterogeneous cohort of women and men, our objectives were to: (1) evaluate the association between rectus abdominis muscle thickness and cross-sectional area (CSA), and (2) examine if the visceral adipose tissue (VAT) compartment confounds the validity of rectus abdominis muscle thickness. Abdominal computed tomography scans of the third lumbar vertebrae from clinical and healthy populations were used to evaluate rectus abdominis thickness and CSA, and VAT CSA. Computed tomography scans were utilized due to the limited field of view of ultrasound imaging to capture the rectus abdominis CSA. A total of 348 individuals (31% women) were included in this analysis, with a mean ± standard deviation age and body mass index of 51.2 ± 15.4 years and 28.0 ± 5.1 kg/m2, respectively. Significant correlations were observed between rectus abdominis thickness and CSA for women (r=0.758; p < 0.001) and men (r=0.688; p < 0.001). Independent of age, VAT CSA was negatively associated with rectus abdominis thickness in men (p = 0.011), but not women (p = 0.446). These data support the use of rectus abdominis muscle thickness as a measurement of muscle size in both women and men; however, the VAT compartment may confound its validity to a minor extent in men.

Prevalence of vitamin D deficiency in various regions of the Russian Federation: results of the first stage of the multicenter cross-sectional randomized study

Background. A vitamin D deficiency is a global wide health problem. Inadequate vitamin D status leads to serious medical, social and economic consequences and requires timely diagnosis and adequate correction.Aim: to assess the incidence of vitamin D deficiency among the population living in regions of the Russian Federation located at latitudes from 45° to 70° and to study its relationship to various factors (demographic, socio-economic, geographical, etc.).Materials and methods. A multicenter, cross-sectional, randomized study of individuals of both sexes aged 18 to 50 years. The study of 25ОНD level in the blood serum was carried out by INVITRO LLC laboratories using chemilumescent analysis in two stages: in the period from March to May 2020 and from October to November 2020. The first stage of the study involved 500 volunteers (77% women, 23% men). Demographic and socioeconomic characteristics, factors associated with vitamin D levels, were assessed using a specially designed questionnaire.Results. In this article we present the results of the first stage. A countrywide high prevalence of vitamin D deficiency (56.4%) and insufficiency (27.9%) was revealed, that is, 84.3% of the population aged 18–50 years requires cholecalciferol supplementation. The lowest vitamin D status was found in St. Petersburg, Arkhangelsk, Kyzyl and Rostov-on-Don (over 90% of participants had inadequate levels). A decrease in the level of 25ОНD was observed to a greater extent in men than in women (p &lt;0.05), as well as in young people aged 18–25 years (p &lt;0.05). No major association of vitamin D status with anthropometric parameters, the number of days of disability, were not found. However, those who went to tanning beds or were in direct sunlight for at least 30 days a year had higher levels of 25ОНD, and those using sunscreens had lower levels.Conclusion. The data obtained confirms the widespread prevalence of vitamin D deficiency and insufficiency in the country (84.3% of participants), generally not related to the geographical latitude of residence, which indicates the need for vitamin D supplementation in a significant part of the population.