General Male Population Research Articles

The effect of testosterone treatment on bone mineral density in Klinefelter syndrome: A retrospective cohort study.

Although Klinefelter syndrome (KS) is the most frequent sex-hormone disorder, there is ongoing uncertainty about the often associated sex-hormone deficiency, its impact on common comorbidities, and therefore about prevention and treatment. In this study, we focus on bone loss, reported to occur in over 40% of KS patients, and the impact of testosterone replacement therapy (TRT) on this comorbidity. This single-center retrospective cohort study in a tertiary hospital compared the effect of treatment with TRT to no TRT on evolution of bone mineral density (BMD) in KS patients. After a medical chart review, a total of 52 KS subjects were included in this study. BMD was measured by dual-energy X-ray absorptiometry (DXA) and expressed as T-scores. The subjects were divided into three groups, according to TRT. In the subgroup that only started TRT after baseline measurements (mean age 31 years), we observed significant gain in BMD T-score at the lumbar spine (0.58 ± 0.60, p = 0.003; mean gain of 0.62% areal BMD per year) and total femur T-score (0.24 ± 0.39, p = 0.041; mean gain of 0.25% areal BMD per year) after a mean follow-up period of 7.5 years. Compared to untreated subjects, a significant difference in evolution was demonstrated at the lumbar level (+0.58 ± 0.60 vs. -0.14 ± 0.42, p = 0.007). In untreated subjects with normal testosterone levels, a loss of BMD (-0.27 ± 0.37, p = 0.029; mean loss of 0.49% areal BMD per year) at the femoral neck was measured. This decline was equal to the predicted loss seen in the general male population. TRT results in BMD gain in patients with KS with testosterone deficiency, mainly at the lumbar spine. However, this effect is limited (0.62% per year). Patients who were not treated with TRT because of sufficient endogenous testosterone levels, showed only the predicted age-related bone loss during follow-up. The need for TRT in maintaining bone health in KS should be evaluated on an individual basis according to the degree of sex steroid deficiency.

Modified Palomo Procedure Is an Effective Intervention for Improving Serum Testosterone Levels and Semen Parameters in Patients With Varicocele: A Prospective Study.

A varicocele can be defined as an abnormal venous dilatation and/or tortuosity of the pampiniform plexus. It is generally reported that varicoceles are present in 15% of the general male population and 35% of men as a cause of primary infertilityand in up to 80% of men as a cause of secondary infertility. Differences in venous drainage anatomy between the left and right internal spermatic veins, venous valve incompetence resulting in venous blood reflux, and increased hydrostatic pressure are the most commonly cited theories. Various surgical and non-surgical techniques are in use for treating patients with varicocele. Here we used a modified Palamoprocedure to treat the patients and observed the outcome. A total of 40 patients with varicocele were recruited for the study. A preoperative evaluation, along with serum testosterone levels and semen analysis, was done. A modified Palomotechnique was used to treat varicocele. A postoperative follow-up with serum testosterone levels and semen analysiswas done to observe improvement. The mean (±SD) left testis size, right testis size, testosterone, sperm concentration, sperm vitality and sperm progressive motility were found statistically significantly higher in patients after surgery as compared to patients before surgery (p<0.05). However, there was statistically insignificant mean difference in semen volume between patients before surgery and patients after surgery (p>0.05). Modified Palomoprocedure can be used to treat varicocele with good improvement in serum testosterone levels and semen parameters.

Health and quality of life of patients with haemophilia: A national study of 124 Danish men.

In the past decades, haemophilia treatment has greatly improved the health of persons with haemophilia (PWH). This study compares PWH to the general population on social conditions and health. In December 2021, all Danes with moderate or severe haemophilia A or B, or von Willebrands disease type 3 were invited to participate in an online self-report survey concerning sociodemographic factors, self-rated health, teeth status, chronic health conditions, symptoms and loneliness. This study compares responses from the 124 adult male PWH with responses from a male general population sample (N=4849). Analyses used logistic regression, controlling for age and highest completed education. Fewer PWH were in the oldest age group (65-84 years). Controlling for age, no significant differences were found regarding cohabitation status or education. Fewer PWH were employed (OR=.48, [.33-.71])-particularly in the 45-64 age group. PWH were less likely to report good health (OR=.49, [.31-.77]). The odds of joint disease was much higher (OR=13.00, [8.37-20.28]). Also, hypertension (OR=2.25, [1.13-5.65]) and previous stroke (OR=2.51, [1.44-3.50]) were more frequent. PWH were more likely to report pain in the arms/hands/legs/hips (OR=2.94, [1.92-4.52]), but less likely to report pain in the head/neck/shoulder (OR=.66, [.45-.96]). The disease burden of haemophilia has improved so PWH resembles the general population in areas such as marriage and education. However, even for young PWH, the disease still imposes a significant burden from hemophilia arthropathy and pain in extremities and joints. Middle-aged PWH also have poorer levels of employment than same-aged peers.

Health-related Quality of Life of Patients Treated With Different Fractionation Schedules for Early Prostate Cancer Compared to the Age-standardized General Male Population.

The effects of radiotherapy (RT) patients' health-related quality of life (HRQoL) are usually compared to those of other treatment modalities instead of HRQoL of the general population in oncological studies. We examined HRQoL of patients with an early prostate cancer (PC) not receiving hormonal treatment up to 3 years after RT using the 15D instrument and the FACT-P questionnaire. The 15D results were compared to those in the age-standardized general male population (N=952) using an independent-sample t test. The study population (N=73) received RT either with 78/2 Gy, 60/3 Gy or 36.25/7.25 Gy fractionation. No significant differences in the mean total HRQoL scores were found between the RT groups and the general male population at any time point. Patients with PC had more depression (P=.015) and distress (P=.029) than the general male population before the treatment and depression up to 3 months after treatment (P=.019), which did not persist at 3 years. The sexual activity dimension had declined by the end of treatment, and this decline persisted 3 years later (P=.033). Excretion functions were worse compared to those in peers at the end of treatment (P < .001) but no longer at 3 months and later after RT. Regarding the FACT-P, HRQoL remained good at 3 years after RT in all the treatment groups and there were no significant differences between the different RT groups at this time point. This study demonstrated that patients treated with RT for early PC had similar HRQoL compared to the age-standardized general male population at 3 years after treatment.

Impact of Advanced External Beam Radiotherapy on Second Haematological Cancer Risk in Prostate Cancer Survivors

AimsExternal beam radiotherapy (EBRT) for prostate cancer (PCa) has rapidly advanced over the years. Advanced techniques with altered dose distributions may have an impact on second haematological cancer (SHC) risks. We assessed SHC risk after EBRT for PCa and explored whether this risk has changed over the years. Materials and methodsPatients diagnosed with a T1-T3 PCa between 1990 and 2015 were selected from the Netherlands Cancer Registry. Patients treated with EBRT were assigned to EBRT eras based on the date of diagnosis. These eras represented two-dimensional radiotherapy (2D-RT; 1991–1996), three-dimensional conformal radiotherapy (3D-CRT; 1998–2005) or advanced EBRT (2008–2015). Standardised incidence ratios (SIR) and absolute excess risks (AER) were calculated overall and by EBRT era. Sub-hazard ratios (sHRs) were calculated for the comparison of EBRT versus radical prostatectomy and active surveillance. ResultsPCa patients with EBRT as the primary treatment (n = 37 762) had an increased risk of developing a SHC (SIR = 1.20; 95% confidence interval 1.13–1.28) compared with the Dutch male general population. Estimated risks were highest for the 2D-RT era (SIR = 1.32; 95% confidence interval 1.14–1.67) compared with the 3D-CRT era (SIR = 1.16; 95% confidence interval 1.05–1.27) and the advanced EBRT era (SIR = 1.21; 95% confidence interval 1.07–1.36). AER were limited, with about five to six extra cases per 10 000 person-years. Relative risk analysis (EBRT versus radical prostatectomy/active surveillance) showed significant elevation with EBRT versus active surveillance (sHR = 1.17; 95% confidence interval 1.03–1.33; P = 0.017), but not for EBRT versus radical prostatectomy (sHR = 1.08; 95% confidence interval 0.94–1.23; P = 0.281). ConclusionIncreased SHC risks after EBRT for PCa cancer were observed for all EBRT eras compared with the general Dutch male population. Excess risks for EBRT versus other PCa treatment groups were found for only EBRT versus active surveillance.

Scottish Firefighters Occupational Cancer and Disease Mortality Rates: 2000-2020.

Increased mortality from cancers and other diseases has been reported in USA, Canadian, and Nordic firefighters. However, UK firefighters are understudied. To determine whether UK firefighters suffer increased mortality from cancers and other diseases when compared with the general population. Mortality from cancer and other diseases in Scottish male firefighters between 2000 and 2020 was compared with the general Scottish male population and expressed as standardized mortality ratios (SMRs) (with 95% confidence intervals, CI). Significant overall excess cancer mortality was found for Scottish firefighters compared with the general population (SMR 1.61, CI 1.42-1.81). Scottish firefighters were nearly three times more likely to die of malignant neoplasms (unspecified sites) (SMR 2.71, CI 1.71-4.00). Excess cancer mortality was also found for several site-specific cancers, including prostate (SMR 3.80, CI 2.56-5.29), myeloid leukaemia (SMR 3.17, CI 1.44-5.58), oesophagus (SMR 2.42, CI 1.69-3.29) and urinary system (kidney and bladder) (SMR 1.94, CI 1.16-2.91). Mortality from neoplasms of unknown behaviour was over six times greater in Scottish firefighters (SMR 6.37, CI 2.29-12.49). Additionally, significantly higher mortality was found for: acute ischaemic heart diseases (SMR 5.27, CI 1.90-10.33), stroke (SMR 2.69, CI 1.46-4.28), interstitial pulmonary diseases (SMR 3.04, CI 1.45-5.22), renal failure (SMR 3.28, CI 1.18-6.44) and musculoskeletal system diseases (SMR 5.64, CI 1.06-13.83). UK firefighters suffer significant excess mortality from cancer and other diseases when compared with the general population. Preventative health monitoring and presumptive legislation are urgently required to protect UK firefighters' health.

Varicocele – impact on fertility and results of various methods of surgical treatment

Introduction: Varicoceles, a dilation of veins within the pampiniform plexus, are present in ∼15% of the general male population. In this article we reviewed the epidemiology, symptoms, and various surgical techniques for the treatment of varicoceles and the results of following treatment.Material and methods: The work was based on medical articles collected in PubMed, websites and medical books. The research was conducted by looking at keywords such as: "Varicoceles", "varicocelectomy" and “infertility”. Results: There are many methods of treating varicoceles ranging from Microsurgical subinguinal varicocelectomy (MSV) or Laparoscopic varicocelectomy. Conclusions: The interdisciplinary approach to the patient and innovative surgical techniques can provide us with many solutions in the treatment of the disease. Doctors should adjust treatment to provide the best therapeutic effects.

Incidence of Prostate Cancer in Transgender Women Undergoing Androgen Deprivation Therapy: A Review.

Transwomen frequently undergo androgen deprivation therapy (ADT) incorporated with oestrogen, but they are still prone to the occurrence of prostatic cancer since the prostate remains intact. The probability of this clinical condition reduces as compared with the general male population. This study aimed to study the occurrence of prostatic malignancy under hormonal therapy such as ADT in transwomen. An extensive literature search was performed using online searches on transgender health, centring on the incidence, diagnosis, treatment and management of prostate cancer in transgender women. Original articles from 1975 to 2022 were searched using PubMed, Scopus, EMBASE, DOAJ and Cochrane databases. Physical, mental and communal deliberation of health development is the major constituent of trans-health. It exhibits a fivefold reduction in prostatic malignancies in transwomen undergoing hormonal therapy contrasted with the extensive male community of indistinguishable age.

The learning curve of bilateral laparoscopic varicocelectomy: a prospective study.

Varicocele occurs in 15% of general male population and in 35% of infertile men. Since 1992, surgical correction with laparoscopic varicocelectomy is the gold standard for treatment of symptomatic patients or patients with abnormal seminal analysis. The learning curve for this frequently performed procedure has not yet been described. In the present study, we investigated the learning curve of a single urologist in training performing his first 21 laparoscopic varicocelectomies using qualitative and quantitative tools to evaluate his performance during the process. Our results show that 14 bilateral laparoscopic varicocelectomies are enough to achieve the plateau of the learning curve.

Colorectal cancer screening in patients with inherited bleeding disorders: high cancer detection rate in hemophilia patients

BackgroundThe population-based colorectal cancer (CRC) screening program in individuals aged 55 to 75 years in the Netherlands uses fecal immunochemical testing (FIT), to detect hemoglobin in feces, followed by colonoscopy in individuals with a positive FIT. ObjectivesThe objectives of this study are to assess the false-positive rate, detection rate, and positive predictive value of FIT for CRC and advanced adenoma (AA) in patients with Von Willebrand disease (VWD) or hemophilia. MethodsWe performed a multicenter, nationwide cross-sectional study embedded in 2 nationwide studies on VWD and hemophilia in the Netherlands. ResultsIn total, 493 patients with hemophilia (n = 329) or VWD (n = 164) were included, of whom 351 patients participated in the CRC screening program (71.2%). FIT positivity and false-positive rate in patients with hemophilia and VWD were significantly higher than those in the general population (14.8% vs. 4.3%, p < .001 and 10.3% vs. 2.3%, p <.001, respectively). In patients with hemophilia, the detection rate of CRC/AA was significantly higher than that in the general male population (4.5% vs. 1.8%, p = .02), and the positive predictive value of FIT for CRC/AA was comparable (32.3% vs. 39.7%, n.s.). In patients with VWD, the detection rate was similar to that of the general population (0.8% vs. 1.4%, n.s.), whereas the positive predictive value was significantly lower than that in the general population (6.3% vs. 36.8%, p = .02). ConclusionThis study indicates that despite a high false-positive rate of FIT in patients with inherited bleeding disorders, the detection rate of CRC and/or AA in hemophilia patients is high. FIT performs different in patients with hemophilia or VWD compared with the general population.

A nomogram of suicidal ideation among men who have sex with men in China: Based on the integrated motivational-volitional model of suicidal behavior.

Men who have sex with men (MSM) are a high-risk group for suicide, with a much higher prevalence of suicidal ideation (SI) than the general population and male population. The aim of this study was to explore the risk factors influencing the development of SI and to develop and validate a nomogram among MSM. A cross-sectional study was conducted in 915 MSM from Shanghai, Shenyang, Shenzhen and Kunming, China using the snowball sampling method. The integrated motivational-volitional (IMV) model of suicidal behavior was used as a theoretical framework to collect different potential influencing factors of SI including diathesis-environment-life events factors and psychosocial factors. The risk factors of SI were screened by logistic regression analysis, and a nomogram for predicting SI were developed. Model properties including discrimination, calibration and decision curves were evaluated to validate the prediction model. 882 MSM were included in the statistical analysis, with a lifetime prevalence of SI of 34.4% (303/882). Logistic regression analysis showed that age group, sexual orientation disclosure, high-risk sexual behavior, entrapment, defeat and interpersonal needs were associated with SI. A nomogram was constructed based on the above six predictors. AUC values of ROC for prediction model were 0.761 (0.641-0.770) and 0.754 (0.565-0.822) in the training set (n = 662) and validation set (n = 220), respectively. And there was no statistical difference of the AUC values between the two sets (P > 0.05). The calibration plots of the prediction model in both sets fit well with the ideal model (P > 0.05). The decision curves demonstrated that the threshold probability of prediction model in training set was 1-85%, whereas in validation set was 1-63%. The lifetime prevalence of SI among Chinese MSM is high. The nomogram can serve as a useful tool to predict the development of SI among MSM. Defeat, entrapment and interpersonal needs, as significant predictors of SI, can be measured to identify SI in advance. Early assessment of SI and the enhancement of psychosocial interventions are important to prevent suicide-related behaviors. Future studies could incorporate more variables of interest to refine the prediction model to better guide behavioral and psychological intervention strategies among MSM.

Colorectal Cancer Screening in Patients with Inherited Bleeding Disorders: High Cancer Detection Rate in Hemophilia Patients

Introduction: Non-invasive stool tests are the most commonly used colorectal cancer (CRC) screening modalities worldwide. The population-based CRC screening program in the Netherlands uses fecal immunochemical testing (FIT), to detect human hemoglobin in feces, followed by colonoscopy in individuals with a positive FIT. The target population consists of women and men aged 55-75 years. No studies have been conducted on the performance of this screening program in patients with inherited bleeding disorders, such as Von Willebrand disease (VWD) and hemophilia, whereas the FIT performance in these patients may substantially differ from the general population. We hypothesized that the false-positive rate of FIT is higher in patients with inherited bleeding disorders than in the general population. Therefore, our study aims to assess the false-positive rate and positive predictive value of FIT for CRC and advanced adenoma (AA) in patients with VWD or hemophilia. Methods: We performed a multicenter, nationwide cross-sectional study embedded in two nationwide studies on VWD and hemophilia in the Netherlands, the Willebrand in the Netherlands-Prospective study and the Haemophilia in the Netherlands 6 study, respectively. Results: In total, 551 patients with inherited bleeding disorders (hemophilia, n=387; VWD, n=164) were included of whom 351 patients participated in the CRC screening program (63.7%). The FIT positivity rate and false-positive rate in hemophilia and VWD patients were significantly higher than in the general population (14.8% vs 4.3%, p<0.001 and 10.3% vs 2.3%, p<0.001, respectively). In hemophilia patients, the detection rate of CRC and/or AA (i.e., the proportion of participants in whom CRC and/or AA was detected) was significantly higher than in the general male population (4.5% vs 1.8% respectively, p=0.012). The positive predictive value of FIT for CRC and/or AA in hemophilia patients was comparable to the general male population (32.3% vs 39.6% respectively, p=0.28). In VWD patients, the positive predictive value of FIT for CRC and/or AA was significantly lower than in the general population (6.3% vs 36.8% respectively, p=0.01). However, the detection rate in VWD patients was similar to the general population (0.8% vs 1.4% respectively, p=0.83). Conclusion: This study indicates that the false-positive rate of FIT is higher in patients with inherited bleeding disorders than in the general population. Nevertheless, the detection rate of CRC and/or AA in hemophilia patients is high and the positive predictive value of FIT for CRC and/or AA is not affected. In VWD patients, the positive predictive value is lower than in the general population. Therefore, the benefit of the CRC screening program seems different in patients with hemophilia and VWD compared to the general population. Additional studies are needed to evaluate possible adjustment of the CRC screening program for these patients.

Causal relationship between serum uric acid and abnormal blood pressure based on the panel model study: A 5-year cohort study

Background and aimsTo investigate the relationship between elevated serum uric acid (SUA) levels and blood pressure (BP). Methods and resultsBased on the Beijing Health Management Cohort, 5276 health examination people were enrolled. Cross-lagged model was used to explore the relationship between SUA levels and blood pressure. The results showed: (1) increased SUA and increased systolic blood pressure (SBP): ① The path coefficients from baseline SUA to follow-up SBP were statistically significant in both the general population (β = 0.034, P < 0.05) and men (β = 0.048, P < 0.05). The path coefficients from baseline SBP to follow-up SUA were not statistically significant in either the general population (β = 0.010, P > 0.05) or men (β = 0.011, P > 0.05). ② The path coefficients from baseline SUA to follow-up SBP and from baseline SBP to follow-up SUA were not statistically significant in women with BMI ≥ 25 kg/m2 and BMI < 25 kg/m2. (2) Increased SUA and diastolic blood pressure (DBP): ① There was no statistical significance between the path coefficients from baseline DBP to follow-up SUA and the path coefficients from baseline SUA to follow-up DBP. ② In men and women, BMI ≥ 25 kg/m2 and BMI < 25 kg/m2, the path coefficients from baseline DBP to follow-up SUA and from baseline SUA to follow-up DBP were not statistically significant. ConclusionsSUA can increase blood pressure in the general male population; no reverse time sequence relationship was found. The temporal relationships between SUA levels and SBP abnormalities were different in the sex and BMI subgroups. No bidirectional causal temporal relationship was found between SUA elevation and DBP abnormality.

Prevalence of Depression, Anxiety, Stress, and Insomnia in Iranian Gay Men During the COVID-19 Pandemic

ABSTRACT Internationally, gay men have been found to be at a higher risk of mental health problems than heterosexual men. However, there is little information about the mental health situation of Iranian gay men, a population facing serious legal repercussions. Additionally, there is limited international data on the effect of the COVID-19 pandemic on the mental health of gay men. The aim of this study was to evaluate Iranian gay men’s mental health during this pandemic. We assessed depression, anxiety, and stress with the DASS and insomnia with the ISI in N = 176 Iranian gay men. We compared their DASS subscores with those of the general male population during the COVID-19 pandemic. 65.9% of Iranian gay men showed mild to extremely severe depression symptoms, 63.6% reported mild to extremely severe anxiety symptoms, 65.3% had mild to extremely severe stress symptoms, and 43.3% had mild to severe insomnia symptoms. Compared to the general Iranian male population, gay men reported significantly more depressive, anxiety, and stress symptoms. Iranian gay men show a high number of depression, anxiety, stress, and insomnia symptoms during the COVID-19 pandemic. Gay men reported significantly more mental health symptoms in the DASS subscores than the general population of Iranian men recruited during the pandemic. They showed descriptively more insomnia symptoms than Iranian adults before the pandemic. The mental health of Iranian gay men should be improved by abolishing punishments for same-sex sexual activities and establishing specialized mental health units for this population.

Trends in working years lost due to different types of work disability and unemployment

Abstract Background Little is known about working years lost (WYL) due to work disability and unemployment by industrial sector. This information would help in directing interventions promoting healthy working careers, knowing that the sectors have been differently affected by economic fluctuations and other changes in the labour market. We examined trends in WYL in the general Finnish population and by industrial sector in the period after the 2008 financial crisis with a particular focus on different types of work disability. Methods Utilising register data on the Finnish working-age population and the Sullivan method, we calculated expected WYL due to sickness absence, other temporary work disability, partial disability retirement, full disability retirement, unemployment and other reasons in years 2010, 2013 and 2016 for the general male and female populations and by industrial sector. Results In 2010, a 30-year-old person was expected to have around two-and-a-half to three WYL due to full disability retirement and unemployment until reaching age 65, depending on gender and the reason. By 2016, WYL due to full disability retirement decreased to less than two years and that due to unemployment increased to around four years among both genders. WYL due to sickness absence, other temporary work disability, partial disability retirement and other reasons remained relatively stable. The total WYL increased between 2010 and 2016 particularly among women. The differences by industrial sector in WYL were attributable more to unemployment than to the different work disability statuses. Conclusions After the financial crisis unemployment appears to have replaced disability retirement as the most important reason for WYL. Furthermore, as individuals with a defined industrial sector are initially employed, sectoral differences in WYL are not largely attributable to disability retirement, disability pensioners typically having been outside the labour market for a long time. Key messages

Histopathological Findings of Lung Cancer in Black Coal Miners in the Czech Republic

Abstract Background Coal miners with coal workers’ pneumoconiosis (CWP, J60 according to ICD-10) were previously found to have a significantly higher risk of lung carcinoma compared to the general male population. The presented study aimed to analyze the incidence of lung carcinoma in miners, histopathological findings in cohorts with and without CWP, and effect of smoking cessation on the histopathological profile. Methods Analysed cohorts consisted of miners with (n = 3476) and without (n = 6687) CWP. Data on personal and working history obtained from the medical records were combined with information on lung cancer from the Czech Oncological Register and histopathological findings. Statistical analysis was performed using non-parametric tests and the incidence risk ratio (significance level of 5%). Results In 1992-2015, 180 miners (2.7%) without CWP and 169 (4.9%) with CWP, respectively, were diagnosed with lung carcinoma. The risk of lung cancer in miners with CWP was 1.82 (95% CI: 1.48-2.25) times higher than in those without CWP. Squamous cell carcinoma (37%) was the most common histopathological type, followed by adenocarcinoma (22%) and small cell carcinoma (21%). A statistically significant difference between the cohorts (p = 0.003) was found in the histopathological subtypes, with the incidence of small cell carcinoma being 2 times higher in miners without CWP than in those with CWP. Only a few individuals with lung carcinoma were non-smokers. The incidence of small cell carcinoma, which is strongly associated with smoking, is significantly higher in miners without CWP. Conclusions Smoking constitutes the most important risk factor for developing lung carcinoma even in that cohort. However, CWP remains a very important risk factor. This work was supported by grant of Research Support Foundation, Vaduz. Markus R. Tödtli Consulting and project Healthy Aging in the Industrial Environment CZ.02.1.01/0.0/0.0/16_019/0000798 (HAIE). Key messages

Treatment and 30-Day Mortality after Myocardial Infarction in Prostate Cancer Patients: A Population-Based Study from Norway

Introduction: There is limited knowledge about the use of invasive treatment and mortality after acute myocardial infarction (AMI) in prostate cancer (PCa) patients. We therefore wanted to compare rates of invasive treatment and 30-day mortality between AMIs in patients with PCa and AMIs in the general Norwegian male population. Methods: Norwegian population-based registry data from 2013 to 2019 were used in this cohort study to identify AMIs in patients with a preceding PCa diagnosis. We compared invasive treatment rates and 30-day mortality in AMI patients with PCa to the same outcomes in all male AMI patients in Norway. Invasive treatment was defined as performed angiography with or without percutaneous coronary intervention or coronary artery bypass graft surgery. Standardized mortality (SMR) and incidence ratios, and logistic regression were used to evaluate the association between PCa risk groups and invasive treatment. Results: In 1,018 patients with PCa of all risk groups, the total rates of invasive treatment for AMIs were similar to the rates in the general AMI population. In patients with ST-segment elevation AMIs, rates were lower in metastatic PCa compared to localized PCa (OR 0.15, 95% CI: 0.04–0.49). For non-ST-segment elevation AMIs, there were no differences between PCa risk groups. The 30-day mortality after AMI was lower in PCa patients than in the total population of similarly aged AMI patients (SMR 0.77, 95% CI: 0.61–0.97). Conclusion: Except for patients with metastatic PCa experiencing an ST-segment elevation AMI, PCa patients were treated as frequent with invasive treatment for their AMI as the general AMI population. 30-day all-cause mortality was lower after AMI in PCa patients compared to the general AMI population.

Inflammation, sauna bathing, and all-cause mortality in middle-aged and older Finnish men: a cohort study

Inflammation and sauna bathing are each related to the risk of all-cause mortality. The interplay between inflammation, sauna bathing and all-cause mortality is not well understood. We aimed to evaluate the separate and joint associations of inflammation (high sensitivity C-reactive protein, hsCRP) and frequency of sauna bathing (FSB) with all-cause mortality in a cohort of Caucasian men. We used the Kuopio Ischaemic Heart Disease Study cohort comprising 2575 men aged 42–61 years at baseline. Serum hsCRP was measured using an immunometric assay and sauna bathing habits were assessed by a self-administered questionnaire. High sensitivity CRP was categorized as normal and high (≤ 3 and > 3 mg/L, respectively) and FSB as low and high (defined as ≤ 2 and 3–7 sessions/week respectively). A total of 1618 deaths occurred during a median follow-up of 27.8 years. Comparing high vs normal hsCRP levels, the multivariable-adjusted HR (95% CI) for all-cause mortality was 1.27 (1.13–1.44). Comparing high vs low FSB, the multivariable-adjusted HR (95% CI) for all-cause mortality was 0.86 (0.76–0.97). Compared with normal hsCRP-low FSB, high hsCRP-low FSB was associated with an increased risk of all-cause mortality 1.28 (1.12–1.47), with no evidence of an association for high hsCRP-high FSB and all-cause mortality risk 1.06 (0.81–1.40). Positive additive and multiplicative interactions were found between hsCRP and FSB in relation to mortality. In a general Finnish male population, both hsCRP and FSB are each independently associated with all-cause mortality. However, frequent sauna baths appear to offset the increased all-cause mortality risk related to high hsCRP levels.

Frequent sauna bathing offsets the increased risk of death due to low socioeconomic status: A prospective cohort study of middle-aged and older men.

Low socioeconomic status (SES) and frequent sauna bathing are associated with increased and decreased risk of all-cause mortality, respectively. Whether there is an interplay among SES, sauna bathing and all-cause mortality risk is not known. We aimed to evaluate the separate and joint associations of SES and frequency of sauna bathing (FSB) with all-cause mortality risk in a prospective cohort study. We employed the Kuopio Ischaemic Heart Disease Study cohort comprising of 2575 men aged 42-61years at study entry. Self-reported SES and sauna bathing habits were assessed at baseline. Socioeconomic status was categorized as low and high (median cutoff) and FSB as low and high (defined as ≤2 and 3-7 sessions/week, respectively). During a median follow-up of 27.8years, 1618 deaths occurred. Comparing low vs high SES, the multivariable-adjusted HR (95% CI) for all-cause mortality was 1.31 (1.18-1.45). Comparing high vs low FSB, the multivariable-adjusted HR (95% CI) for all-cause mortality was 0.86 (0.76-0.97). Compared with high SES-low FSB, low SES-low FSB was associated with an increased risk of all-cause mortality 1.35 (1.20-1.51), without significant evidence of an association for low SES-high FSB and all-cause mortality risk 1.07 (0.89-1.29). Positive additive and multiplicative interactions were found between SES and FSB. There exists an interplay among SES, sauna bathing and all-cause mortality risk in a general Finnish male population. Frequent sauna baths may offset the increased overall mortality risk due to low SES.

What is the global prevalence of depression among men who have sex with men? A systematic review and meta-analysis

BackgroundDepression due to stigma resulting from their sexual identity, isolation, social exclusion, and insufficient access to care and counseling services has become a health problem among men who have sex with men (MSM).ObjectivesThis study aimed to determine the global prevalence of depression among MSM as a systematic review and meta-analysis.MethodsThis study was a systematic review and meta-analysis performed in five steps of search strategy, screening and selecting articles, data extraction, evaluation of the risk of bias, and meta-analysis. In this study, the determined keywords were searched in the databases of PubMed, Scopus, Embase, and Web of Science from January 1913 to July 2021 to find the initial articles, from which data were extracted according to the set checklist in the data extraction stage. Finally, the studies were included in the present meta-analysis according to the inclusion and exclusion criteria, to be evaluated using the Newcastle Ottawa scale checklist. I Square and Q Cochrane were also used to assess the degree of heterogeneity. The analyses were performed using the random-effects model in STATA 16.ResultsThe results showed the quality score of the majority of cross-sectional studies included in the meta-analysis (62 studies) was equal to six or seven (moderate), and five ones had a high-quality score. After combining these studies, the pooled prevalence of depression among MSM in the world was 35% (95% CI 31%–39%, I square; 98.95%, P-value < 0.001). Population subgroup analysis showed the pooled prevalence of depression among MSM living with HIV was 47% (95% CI 39%-55%, I square; 95.76%, P-value < 0.001). Continent subgroup analysis showed the highest pooled prevalence of depression among Asian MSM at 37% (95% CI 31%-43%, I square; 99.07%, P-value < 0.001). Also, in the subgroup analysis of the sampling method, the pooled prevalence in the studies which used the respondent-driven sampling method was equal to 34% (95% CI 25%-43%, I square; 99.32%, P-value < 0.001). Sensitivity analysis revealed the pooled prevalence of depression in studies included in the meta-analysis was near or around the pooled estimate.ConclusionThe pooled prevalence of depression among MSM was almost three times higher than the general male population. Therefore, particular and therapeutic interventions such as screening, and harm reduction programs for mental disorders, especially depression, are suggested to be considered in service packages.