Health Problems In Men Research Articles

Suicide and mental health problems in men in Poland

Background: Women in Poland suffer from mental disorders more often than men (except for addictions). However, men are about six times more likely to commit suicide than women. What could be the cause of this situation? The aim of the article was to analyse the potential correlation between mental health and suicide in men. Materials and methods: The review was based on the available scientific literature on male depression and suicide. We searched Pubmed, Scopus and Google Schoolar (from 1.11.2019 to 31.01.2020). Results: Polish statistics may differ from others due to the fact that current diagnostic criteria often fail to take into consideration the typical symptoms of mental disorders in men. Male suicide attempts are more commonly lethal. Men are also more likely to try to deal with mental problems on their own, often using alcohol, which, in many cases, leads to suicidal behaviour and addictions. This disparity between the numbers of suicides among men and women in recent years indicates an urgent need to promote mental health among men. Conclusions: Polish health policies should focus more on the mental health of men. It is very important to develop standards of promoting male mental health, which would meet the specific health needs of this group. It is necessary to provide physicians with new diagnostic tools which will allow for better identification of typical male symptoms of mental disorders.

Prevalence of Erectile Dysfunction among men of the Uzbek Population who were on the Inpatient Examination and Treatment

In order to study the prevalence of erectile dysfunction (ED) in men of the Uzbek population, an anonymous survey of men who were on a stationary examination and gave consent was conducted. 648 questionnaires were analyzed. It was found that ED symptoms were present in 587 (90.6%) men. Age-related symptoms (according to the AMS questionnaire) were detected in 259 (44.1%) patients, and most of them were aged 45-60 years. It is necessary to actively detect ED in men, since it can be one of the early manifestations of serious diseases. Erectile dysfunction (ED) - a continuing inability to achieve and/or maintain an erection sufficient for satisfactory sexual activity. ED is a symptom complex that is part of the clinical picture of a number of somatic diseases, which in its severity directly depends on them. Numerous risk factors are known that create favorable conditions for the development of ED: systemic diseases (atherosclerosis, cardiovascular diseases, renal and liver failure), nervous diseases (neurosis, multiple sclerosis, Alzheimer's disease), mental illness (depression, astheno-depressive and hypochondria) endocrine diseases (diabetes mellitus, hypo- and hyperthyroidism, androgen deficiency, hyperprolactinemia). The risk of developing ED increases with age due to the process of increased comorbidity. ED is a common disorder affecting men of all ages; it often does not lend itself to proper diagnosis and treatment. There are numerous well-reasoned evidences that ED is functionally reversible damage to the arteries - endothelial dysfunction (EnD). Currently, EnD is considered as a functional stage in the development of atherosclerosis [1-3]. EnD is a generalized process that occurs due to: oxidative stress, impaired metabolism of nitric oxide, processes of redox phosphorylation of blood vessels, in particular endothelium. A manifestation of EnD can be disturbances in the mechanisms of normal blood flow in the pelvis, which can manifest as erectile dysfunction, lower urinary tract syndrome (LUTS), interstitial cystitis, and overactive bladder (OAB) [4]. EnD as a manifestation of endothelial dysfunction can be a predictor of cardivascular diseases, which means that it can be used as a screening assessment of the cardiovascular system in men after 35-40 years. The social and psychological discomfort of the modern world, the prevalence and increased mortality from cardiovascular disease (CVD), the increase in ED have become one of the main health problems of men of the XXI century. Keywords: Erectile dysfunction; Andrology; Male health

Urogenital and pelvic complications in the Ehlers-Danlos syndromes and associated hypermobility spectrum disorders: A scoping review.

The Ehlers-Danlos syndromes (EDS) and associated hypermobility spectrum disorders (HSD) are a heterogenous group of connective tissue disorders associated with significant morbidity. The urogenital aspects of these disorders are understudied and there is little guidance on the prevalence, types, or outcomes of urogenital complications in EDS/HSD. Our objective was to perform a scoping review to characterize and synthesize the literature reporting urogenital and pelvic complications in EDS/HSD patients. We performed a systematic search of three databases (Medline, CINAHL, Embase) to January 2019. English language, full-text articles reporting on urogenital or pelvic complications in EDS/HSD were included. A total of 105 studies were included (62 case reports/series, 43 observational) involving patients with hypermobile (23%), vascular (20%), classical (12%) EDS, and HSD (24%). Some studies looked at multiple subtypes (11%) or did not report subtype (33%). Reported complications included urinary (41%), gynecological (36%), obstetrical (25%), renal (9%), and men's health problems (7%), with some studies reporting on multiple areas. Urinary and gynecological complications were most prevalent in patients with HSD, while a broad range of complications were reported in EDS. While further research is required, results suggest a higher index of suspicion for urogenital problems is probably warranted in this population.

The correlation between symptoms of benign prostatic hyperplasia and the quality of life: A field study

Is there any correlation between symptoms of benign prostatic hyperplasia (BPH) and quality of life in men aged 40 years and over? This study aimed to investigate the correlation between the BPH symptoms and the quality of life and to determine the views and attitudes about this disease. BPH is one of the most common health problems in men and adversely affects the quality of life. The study was conducted in 2016 by using quantitative and qualitative research methods. The data were collected using the Information Form, the International Prostate Symptom Score (IPSS), the Benign Prostatic Hypertrophy Quality of Life Scale (BPH‐QLS) and the Semi‐structured Interview Form. While quantitative data were assessed by numbers, percentages, chi‐square test, Kruskal‐Wallis test, Mann‐Whitney U test and Spearman's correlation coefficient, qualitative data were assessed using content analysis. There was a statistically significant correlation between BPH‐QLS score and age, educational level, presence of micturition problem and the state of applying to health institution (P < 0.005). A positive correlation was found between IPSS and BPH‐QLS (Spearman's r = 0.695, P = 0.000). When qualitative data were evaluated, views such as “identification of the disease as virility or sexual inability,” “feeling of embarrassment about the disease,” “being hesitant to be examined” and “seeming unnecessary to pay a fee to be examined” were determined. In this context, it is recommended for public health nurses to conduct population‐based studies on BPH.

عمليات فتح الظهر بطريقة فتح الصفائح العظمية مقابل عمليات الفتحة الصغيرة بدون فتح الصفائح العظمية لحالات انزلاق الفقرات القطنية

Background: Low back pain is the most common health problem in men and women between the ages of 20 and 50 years. The lumbar disc prolapse has a major role in this condition. Treatment is either conservative or surgical. The most common surgical interventions are either laminectomy or interlaminar approach. Objective: To determine which is the best surgical approach for the patient according to his/her type of disc herniation. Patients and methods: A comparative clinical study conducted in the Neurosciences Hospital, Baghdad, Iraq from January 2016 to January 2018. In this paper we evaluated the clinical outcome following both approaches Results: We studied sixty cases; thirty-four patients had interlaminar approach for lumbar discectomy while twenty-six patients had laminectomy with discectomy. Conclusion: Both methods can manage different types of lumbar disc prolapse, apart from far-lateral disc which favors laminectomy approach.

Laminectomy versus interlaminar approach for Lumbar disc herniation

Background: Low back pain is the most common health problem in men and women between the ages of 20 and 50 years. The lumbar disc prolapse has a major role in this condition. Treatment is either conservative or surgical. The most common surgical interventions are either laminectomy or interlaminar approach.
 Objective: To determine which is the best surgical approach for the patient according to his/her type of disc herniation.
 Patients and methods: A comparative clinical study conducted in the Neurosciences Hospital, Baghdad, Iraq from January 2016 to January 2018. In this paper we evaluated the clinical outcome following both approaches
 Results: We studied sixty cases; thirty-four patients had interlaminar approach for lumbar discectomy while twenty-six patients had laminectomy with discectomy.
 Conclusion: Both methods can manage different types of lumbar disc prolapse, apart from far-lateral disc which favors laminectomy approach.

Is recession bad for your mental health? The answer could be complex: evidence from the 2008 crisis in Spain

BackgroundWe explored the impact of 2008 recession on the prevalence of mental health problems in Spain.MethodsRepeated cross-sectional survey design. Datasets from 2006 and 2011 were used, and temporal change was examined. The study was conducted on the economically active population (16–64 years old). The two surveys included 29,478 and 21,007 people, obtaining a 96 and 89.6% response rate, respectively.Multiple logistic regression models were adjusted to identify poor mental health risk factors. A standardisation analysis was performed to estimate the prevalence of people at risk of poor mental health (GHQ+).ResultsThe prevalence of GHQ+ following the crisis increased in men and decreased in women. Two logistic regression analyses identified GHQ+ risk factors. From 2006 to 2011, unemployment rose and income fell for both men and women, and there was a decline in the prevalence of somatic illness and limitations, factors associated with a higher prevalence of GHQ+. After controlling for age, the change in employment and income among men prompted an increase in the prevalence of GHQ+, while the change in somatic illness and limitations tended to mitigate this effect. After the recession, unemployed men showed a better level of somatic health. The same effects were not detected in women.ConclusionsThe economic recession exerted a complex effect on mental health problems in men. The reduction of prevalence in women was not associated with changes in socioeconomic factors related to the economic crisis nor with changes in somatic health.

Critical Issues in Men's Mental Health.

This narrative review highlights key issues in men's mental health and identifies approaches to research, policy and practice that respond to men's styles of coping. Issues discussed are: 1) the high incidence of male suicide (80% of suicide deaths in Canada, with a peak in the mid-50 s age group) accompanied by low public awareness; 2) the perplexing nature of male depression, manifesting in forms that are poorly recognised by current diagnostic approaches and thus poorly treated; 3) the risky use of alcohol among men, again common and taking a huge toll on mental and physical health; 4) the characteristic ways in which men manage psychological suffering, the coping strengths to be recognised, and the gaps to be addressed; 5) the underutilization of mental health services by men, and the implication for clinical outcomes; and 6) male-specific approaches to service provision designed to improve men's accessing of care, with an emphasis on Canadian programs. The main conclusion is that a high proportion of men in Western society have acquired psychological coping strategies that are often dysfunctional. There is a need for men to learn more adaptive coping approaches long before they reach a crisis point. Recommendations are made to address men's mental health through: healthcare policy that facilitates access; research on tailoring interventions to men; population-level initiatives to improve the capacity of men to cope with psychological distress; and clinical practice that is sensitive to the expression of mental health problems in men and that responds in a relevant manner.

Renal toxicity of nanoparticles of cadmium sulphide in rat

During present investigations, renal toxicity of CdSNPs (cadmium sulphide nanoparticles) (ranged 5–9 nm) was estimated in rat employing specific parameters. Treatment on each alternate day for 45 days with CdSNPs (10 mg/kg b.w.) yielded significant increase in Cd-MT (cadmium metallothionein), lipid peroxidation and H2O2 generation in the kidney of rat in comparison to bulk cadmium. Concentration of creatinine also increased in urine of CdSNPs treated rats. Histopathological observations revealed extensive damage in proximal tubules. Ultrastructural studies showed mitochondrial, nuclear and ER (endoplasmic reticulum) changes. Finally, renal toxicity of CdSNPs was confirmed by loss of alkaline phosphatase from the brush border of proximal convoluted tubules. These observations conclude that CdSNPs manifest greater toxicity in kidney than cadmium sulphide bulk particles. These effects have been attributed to their specific physicochemical properties, greater potential to generate ROS and induction of oxidative stress and impairment of renal structure and function. Present observations suggest that commercial/industrial use of CdSNPs may pose serious renal health problems in man.

Prevalence of Mental Health problems in sentenced men in prisons from Andalucía (Spain).

To estimate the prevalence of different mental health problems in men serving prison sentences in Andalusia. Descriptive, cross-sectional study of a random sample of 472 men interned in two prisons located in Andalusia. We collected socio-demographic and general criminal and penitentiary data, and we identified mental health problems with two validated instruments for epidemiological research in mental health: the SCID-I interview to diagnose Axis 1 disorders of the DSM-IV and the self-applied questionnaire IPDE to estimate personality disorders. We analyzed the data (proportions and confidence intervals) with the SPSS-18 statistical package. 82.6% of the sample had a history of having suffered some type of mental health problem throughout their life (prevalence-life) and 25.8 have suffered from them in the past month (month prevalence). The most common disorders of the Axis I (DSM-IV) are related to abuse of and dependence on psychoactive substances (prevalence life of 65.9% and month prevalence of 6.6%), with an important but less frequent presence of affective (31.4%-9.3%), anxiety (30.9%-10, 4%) and psychotic disorders (9.5%-3, 4%). As regards personality disorders, the estimated probable prevalence lies between the 56.6% ("5" cutoff point) and the 79.9 ("4" cut-off point). The male inmate population in prisons in Andalucía shows a high prevalence of mental health problems, similar to that found in other Spanish and international prisons, but their care needs should take into account the different pathologies that they present.

Men's health: an overlooked inequality.

Men's health outcomes are problematic globally, regionally and nationally. Male life expectancy was 3.6 years shorter than female life expectancy in the UK in 2015. Men take more risks with their health and are less likely than women to be aware of disease symptoms. They use primary care services less frequently than women, with likely impacts on health outcomes, especially for mental health, although there is evidence that for some conditions men may seek help just as quickly as women. Men's health initiatives have increased and there is growing evidence that 'gender-sensitive' interventions aimed at men can be effective. However, a strategic response, locally or nationally, to men's health problems in the UK has been absent. A number of actions, including by nurses, could make a difference. A national men's health policy, extended open hours in primary care, more outreach work and professional training, are among the measures suggested.

Efficacité et tolérance des IPDE-5 dans le traitement de la dysfonction érectile chez le patient schizophrène : une revue de la littérature

IntroductionSexual dysfunction is an important public health problem in men and is associated with reduced quality of life. It is more common in patients with schizophrenia. It is well-established that antipsychotic drugs cause sexual dysfunction with consequences on the quality of life of patients, adherence to treatment, and public health costs. Phosphodiesterase type 5 inhibitors (PDE5 inhibitors) are indicated for the management of erectile dysfunction. However, there is little information on such treatment in schizophrenic patients. This literature review aimed to summarize the current data on the efficacy and tolerability of PDE-5 inhibitors in the erectile dysfunction in schizophrenic patients. Material and methodsPubMed, PsycInfo and Cochrane databases were searched for studies published until August 2014. ResultsOnly 6 studies met the inclusion criteria. Three were randomized, double-blind, cross-over, placebo-controlled trials and three were open studies. Various scales were used to measure erectile and orgasmic function, desire, satisfaction during intercourse, overall satisfaction, quality of life and intensity of schizophrenic symptoms. In the 3 randomized studies (one with sildenafil 25–50 mg, one with lodenafil carbonate 80 mg/j and the last one with tadalafil 10 mg), the rate of participants who completed the trial was high (around 95 %). All three included patients with schizophrenia or schizophrenia spectrum disorders. Patients reported significant improvement on sexual dysfunction. However, no statistical difference was reported between lodenafil and placebo, on different scales, suggesting a very important placebo effect in patients with schizophrenia. All three found a good tolerance of PDE-5 inhibitors. Side effects were rare and were mainly nasal congestion, headaches, nausea and dizziness. There were no major side effects or drug interactions. Considering the 3 open studies, 2 involved sildenafil and one tadalafil. All concluded in improved erectile and orgasmic function, desire, satisfaction during intercourse, overall satisfaction, and even the quality of life when it was studied. However, very few patients were included. DiscussionLittle data are available on the use of PDE5 inhibitors in schizophrenic patients. The 6 studies included few patients which reduces the power and the scope of their conclusions. There is also an important bias due to the use of self-questionnaires. The methodologies of the studies differ in many aspects which limits the comparability. Inclusion and exclusion criteria, drugs used and scales varied among the studies. However, the management of erectile disorder seems to be a consistent target in an integrative approach for the overall well-being of schizophrenic patients. PDE-5 inhibitors appear to be safe and could improve erectile function in schizophrenic patients. ConclusionIn total, the current data suggest efficiency and good tolerance of the use of PDE-5 inhibitors in schizophrenic patients with erectile dysfunction. However, further studies focusing on PDE-5 inhibitors are needed to more deeply assess their efficacy and safety in patients with schizophrenia.

Effects of cisplatin on the LSD1-mediated invasion and metastasis of prostate cancer cells.

Prostate cancer poses a major public health problem in men. Metastatic prostate cancer is incurable, and ultimately threatens the life of patients. Lysine-specific demethylase 1 (LSD1) is an androgen receptor-interacting protein that exerts a key role in regulating gene expression and is involved in numerous biological processes associated with prostate cancer. Cisplatin, also known as cis-diamminedichloroplatinum or DDP, is a standard chemotherapeutic agent used to treat prostate cancer; however, it has the disadvantage of various serious side effects. The present study aimed to investigate the effects of LSD1 knockdown, and the interplay between LSD1 and DDP, on prostate cancer cell proliferation, apoptosis and invasion, and, therefore, the potential of LSD1 as a target for prostate cancer therapy. Flow cytometric analysis, Cell Counting kit 8 assay, Transwell assay and western blotting results revealed that LSD1 knockdown, in combination with DDP treatment, exerted antiproliferative, proapoptotic and anti–invasive effects on PC3 prostate cancer cells. In addition, knockdown of LSD1 acted synergistically with DDP, thereby enhancing the induction of apoptosis, and the inhibition of proliferation and invasion in prostate cancer cells. These results indicated that LSD1 may serve as a potential therapeutic target, and may enhance the sensitivity of PC3 cells to DDP.

Employment, family and health in men of working age in Germany : Results of the GEDA studies 2009-2012

Today's men want to participate in their children's upbringing more than in the past, but they are heavily involved in their occupation at the same time. This article describes the significance of parenthood, partnership and occupation in relation to health and health behaviours among men of working age in Germany. We summarised data from the "German Health Update" (GEDA) studies conducted in 2009, 2010 and 2012. Data on 18,465 men aged 18-64years were available, 11,429 of which were living with children. We included mental health problems, general health awareness, sports activity and smoking as outcomes. Full-time employees working more than 48h per week and unemployed persons had mental health problems more frequently (OR1.44 and 2.35, p< 0.05) than full-time employees working 48h or fewer. Similar associations can be shown for health awareness, physical activity and smoking. Concerning partnership and parenthood, the associations were considerably weaker: men living together with children and a partner in the household were overall less burdened and their behaviour was also healthier than single men without children. After simultaneous consideration of employment status, parenthood and partnership, our results show that the unemployed and employees with long working hours were the most burdened. The results provide supporting evidence regarding health problems of men in Germany due to unemployment and long working hours that are of importance for their health whether they are living with apartner and/or with children or not. The association between health and occupation was stronger than between health and fatherhood or partnership.

Association of psychological factors, patients' knowledge, and management among patients with erectile dysfunction.

BackgroundErectile dysfunction (ED) is one of the most common health problems in men. ED can significantly affect a man’s psychological well-being and overall health.PurposeTo investigate the association of psychological factors, patients’ knowledge, and management among ED patients.Patients and methodsA total of 93 patients with an age range from 31 to 81 years who have undergone treatment for ED were included in this study.ResultsIt was found that the feeling of blame (P=0.001), guilt (P=0.001), anger or bitterness (P=0.001), depression (P=0.001), feeling like a failure (P=0.001), and the feeling of letting down a partner during intercourse (P=0.001) were significantly associated with ED. Age was also found to be significantly associated with patients’ psychological scale (P=0.004). In addition, the majority of patients in this study practice the right method of administration of ED therapy. However, no significant correlation was found between patients’ knowledge of ED therapy and demographic characteristics.ConclusionThis study concluded that ED does affect psychological well-being of people. In addition, patient’s knowledge about ED and its management is also crucial in ensuring that the patient achieves optimal therapeutic outcomes from ED therapy.

Prostatic Tissue Levels of 43 Trace Elements in Patients with Prostate Adenocarcinoma

Adenocarcinoma of prostate gland is an internationally important health problem in men, particularly in developed countries. The aim of this exploratory study was to evaluate whether significant changes in the prostatic tissue levels of trace elements exist in the malignantly transformed prostate. Prostatic tissue levels of 43 trace elements were prospectively evaluated in 36 patients with prostate adenocarcinoma and 37 healthy males. Measurements were performed using a combination of non-destructive and destructive methods: instrumental neutron activation analysis and inductively coupled plasma mass spectrometry, respectively. Tissue samples were divided into two portions. One was used for morphological study while the other was intended for trace element analysis. The reliability of difference in the results between normal and cancerous prostate tissues was evaluated by Student’s t-test. It was found that the contents of Ag, Al, Au, B, Be, Br, Ce, Cr, Dy, Er, Fe, Gd, Hg, Li, Mn, Nd, Ni, Pr, Sb, Sn, Th, Tl, Y, and Zr were significantly higher while those of Cd, Co, Rb, Sc, Se, and Zn were significantly lower in cancerous tissues than in normal tissues. Moreover, it was shown that malignant transformation significantly changed the relationships of trace elements in prostate. Thus, in adenocarcinoma transformed prostate tissue the trace element metabolism is significantly disturbed.

Core principles of sexual health treatments in cancer for men.

The considerable prevalence of sexual health problems in men after cancer treatment coupled with the severity of impact and challenges to successful intervention make sexual dysfunction one of the most substantial health-related quality of life burdens in all of cancer survivorship. Surgeries, radiation therapies, and nontreatment (e.g., active surveillance) variously result in physical disfigurement, pain, and disruptions in physiological, psychological, and relational functioning. Although biomedical and psychological interventions have independently shown benefit, long-term, effective treatment for sexual dysfunction remains elusive. Recognizing the complex nature of men's sexual health in an oncology setting, there is a trend toward the adoption of a biopsychosocial orientation that emphasizes the active participation of the partner, and a broad-spectrum medical, psychological, and social approach. Intervention research to date provides good insight into the potential active ingredients of successful sexual rehabilitation programming. Combining a biopsychosocial approach with these active intervention elements forecasts an optimistic future for men's sexual rehabilitation programming within oncology. However, significant gaps remain in our understanding of patient experience and appropriate sexual health intervention for gay men and men of diverse race and culture.

Cross-Cultural Adaptation of the Male Genital Self-Image Scale in Iranian Men.

IntroductionCertain sexual health problems in men can be attributed to genital self-image. Therefore, a culturally adapted version of a Male Genital Self-Image Scale (MGSIS) could help health professionals understand this concept and its associated correlates.AimTo translate the original English version of the MGSIS into Persian and to assess the psychometric properties of this culturally adapted version (MGSIS-I) for use in Iranian men.MethodsIn total, 1,784 men were recruited for this cross-sectional study. Backward and forward translations of the MGSIS were used to produce the culturally adapted version. Reliability of the MGSIS-I was assessed using Cronbach α and intra-class correlation coefficients. Divergent and convergent validities were examined using Pearson correlation and known-group validity was assessed in subgroups of participants with different sociodemographic statuses. Factor validity of the scale was investigated using exploratory and confirmatory factor analyses.Main Outcome MeasuresDemographic information, the International Index of Erectile Function, the Body Appreciation Scale, the Rosenberg Self-Esteem Scale, and the MGSIS.ResultsMean age of participants was 38.13 years (SD = 11.45) and all men were married. Cronbach α of the MGSIS-I was 0.89 and interclass correlation coefficients ranged from 0.70 to 0.94. Significant correlations were found between the MGSIS-I and the International Index of Erectile Function (P < .01), whereas correlation of the scale with non-similar scales was lower than with similar scale (confirming convergent and divergent validity). The scale could differentiate between subgroups in age, smoking status, and income (known-group validity). A single-factor solution that explained 70% variance of the scale was explored using exploratory factor analysis (confirming uni-dimensionality); confirmatory factor analysis indicated better fitness for the five-item version than the seven-item version of the MGSIS-I (root mean square error of approximation = 0.05, comparative fit index > 1.00 vs root mean square error of approximation = 0.10, comparative fit index > 0.97, respectively).ConclusionThe MGSIS-I is a useful instrument to assess genital self-image in Iranian men, a concept that has been associated with sexual function. Further investigation is needed to identify the applicability of the scale in other cultures or populations.

The University Hospital Zurich Offers a Medical Online Consultation Service for Men With Intimate Health Problems.

The University Hospital of Zurich offers a text-based, Medical Online Consultation Service to the public since 1999. Users asked health questions anonymously to tele-doctors. This study focused on the characteristics of male enquirers with intimate health problems, the content of their questions, the medical advice given by tele-doctors and the rating of the service to prove the benefit of an online service for medical laymen. This retrospective study included 5.1% of 3,305 enquiries from 2008 to 2010 using the International Classification of Diseases-10 and International Classification of Primary Care codes relevant for intimate and sexual health problems in men. A professional text analysis program (MAXQDA) supported the content analysis, which is based on the procedure of inductive category development described by Mayring. The average age was 40 years, 63.1% enquirers had no comorbidity, in 62.5% it was the first time they consulted a doctor, and 70.2% asked for a specific, single, intimate health issue. In 64.3%, the most important organ of concern was the penis. Overall, 30.4% asked about sexually transmitted diseases. In 74.4% a doctor visit was recommended to clarify the health issue. The rating of the problem solving was very good. The service was mainly used by younger men without comorbidity and no previous contact with a doctor with regard to an intimate health problem. The anonymous setting of the teleconsultation provided men individual, professional medical advice and decision support. Teleconsultation is suggested to empower patients by developing more health literacy.

English

The livers of slaughtered cattle were examined by visualization, palpation and incision. Macroscopically, some of the infected livers appeared to be slightly swollen with pale color at the round edges, while some appeared greatly swollen, with a few small irregular whitish areas indicating fibrosis over the parietal surface. In some cases, the capsule was thick and rough with whitish or reddish discoloration and parenchyma was hard due to fibrous tissue. Fibrosis of the bile ducts with numerous small and large patches scattered over the parietal surface and the pipe stem appearance of the liver were noticed. It could be concluded that the histopathological changes in the livers of cattle infected with Fasciola gigantica reflected tissue damage, which can amount to significant economic losses in animals and great health problems in man. Serious care and attention are required of both the veterinary workers and the public health planners in the state to ensure that seriously damaged livers are not passed on for human consumption despite their deranged nutritional values and health risk problems. The grazing of cattle should be highly restricted to areas of lesser snail infected site to reduce the rate of animal infection and the consequent economic losses. &nbsp; Key words: Fascioliasis, Fasciola gigantica, histopathology, cirrhosis.