Symptoms In Men Research Articles

A Comparative Analysis of Cystoscopy and Uroflowmetry in the Diagnostic Evaluation of Lower Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia: A Prospective Study

A Comparative Analysis of Cystoscopy and Uroflowmetry in the Diagnostic Evaluation of Lower Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia: A Prospective Study

Tadalafil vs Tamsulosin for the Management of Lower Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia: A Randomised Clinical Trial

Introduction: Tadalafil and tamsulosin have both been approved for use in the management of Lower Urinary Tract Symptoms (LUTS). Limited studies have shown the efficacy of tadalafil in terms of maximum urinary output flow (Qmax) and post-void residual (PVR). Aim: To compare the efficacy of tadalafil 5 mg and tamsulosin 0.4 mg in patients with Benign Prostatic Hyperplasia (BPH). Materials and Methods: A prospective, open-label, Randomised clinical study was conducted in the Department of Urology at Kurnool Medical College, Kurnool, Andhra Pradesh, India. The study duration was one year and five months, from February 2015 to July 2016. A total of 83 patients clinically diagnosed with BPH were included, but 23 patients were excluded from the analysis due to lost follow-up. The remaining 60 patients were randomly assigned to two groups: one receiving tadalafil 5 mg (n=30) and the other receiving tamsulosin 0.4 mg (n=30) for 12 weeks. Demographic characteristics, total International Prostate Symptom Score (IPSS), individual IPSS, Quality of Life (QoL) score, Qmax, PVR, and differences in symptoms were analysed. Data were analysed using the Wilcoxon signed-rank test and Mann-Whitney U test. A p-value<0.05 was considered statistically significant. Results: The mean age for group I (tadalafil 5 mg) and Group II (tamsulosin 0.4 mg) was 62.7 and 61.0 years, respectively (p=0.147). Patients who received tadalafil showed significantly higher efficacy in all measures from baseline to 12 weeks, including increased Qmax (12.0 mL/sec vs 15.1 mL/sec), reduced QoL scores (4.2 vs 3.7), and PVR (26.5 mL vs 15.8 mL), compared to tamsulosin where the increase in Qmax was 11.6 mL/sec vs 13.6 mL/sec, reduction in QoL scores was 4.1 vs 2.4, and PVR was 24.0 mL vs 16.2 mL, between baseline and 12 weeks. Conclusion: Tadalafil 5 mg is a recent drug option available for the treatment of LUTS-BPH. The efficacy and safety of tadalafil 5 mg and tamsulosin 0.4 mg are comparable.

Coronary calcification measures predict mortality in symptomatic women and men

ObjectiveTo assess the prognostic value of absolute and sex-specific, age-specific and race/ethnicity-specific (Multi-Ethnic Study of Atherosclerosis, MESA) percentiles of coronary artery calcification in symptomatic women and men.MethodsThe study population consisted...

Higher Soluble CD163 in Blood Is Associated With Significant Depression Symptoms in Men With HIV.

People with HIV (PWH) are more likely to experience depression, a highly morbid disease. More evidence is needed to better understand mechanisms of depression in PWH. We evaluated a panel of blood biomarkers in relation to depression symptoms in the Multicenter AIDS Cohort Study (MACS). Four sites in the United States. A cross-sectional analysis was performed within the MACS, a prospective study of cisgender men with and without HIV. Depression was assessed with the Center for Epidemiological Studies-Depression Scale, and six blood biomarkers were measured: GlycA, high sensitivity C-reactive protein (CRP), interleukin-6, CCL2, soluble CD14 (sCD14), and soluble CD163 (sCD163). Using univariable and multivariable logistic regression, the biomarkers and other factors were evaluated in relation to significant depression symptoms (SDS) by Center for Epidemiological Studies-Depression score ≥16. 784 men were analyzed; most of whom (63%) were PWH. PWH weremore likely to have SDS (32% vs. 21%). In univariable analysis, higher GlycA, CRP, and sCD163 concentrations were associated with SDS. In multivariable analysis, however, only higher sCD163 concentration was associated with SDS (odds ratio = 2.30, 95% CI = 1.11 to 4.76). This relationship was driven by the PWH group (odds ratio = 2.72, 95% CI = 1.12 to 6.58) and remained significant when controlling for antidepressant use. Lack of college education was also associated with SDS. Higher sCD163, a marker of macrophage activation, was significantly associated with significant depression symptoms in the MACS. Further research on this biomarker and macrophage activation in general is warranted to better understand and treat depression in PWH.

Applying a genetic risk score for prostate cancer to men with lower urinary tract symptoms in primary care to predict prostate cancer diagnosis: a cohort study in the UK Biobank

BackgroundProstate cancer is highly heritable, with >250 common variants associated in genome-wide association studies. It commonly presents with non-specific lower urinary tract symptoms that are frequently associated with benign conditions.MethodsCohort study using UK Biobank data linked to primary care records. Participants were men with a record showing a general practice consultation for a lower urinary tract symptom. The outcome measure was prostate cancer diagnosis within 2 years of consultation. The predictor was a genetic risk score of 269 genetic variants for prostate cancer.ResultsA genetic risk score (GRS) is associated with prostate cancer in symptomatic men (OR per SD increase = 2.12 [1.86–2.41] P = 3.5e-30). An integrated risk model including age and GRS applied to symptomatic men predicted prostate cancer (AUC 0.768 [0.739–0.796]). Prostate cancer incidence was 8.1% (6.7–9.7) in the highest risk quintile. In the lowest quintile, prostate cancer incidence was <1%.ConclusionsThis study is the first to apply GRS in primary care to improve the triage of symptomatic patients. Men with the lowest genetic risk of developing prostate cancer could safely avoid invasive investigation, whilst those identified with the greatest risk could be fast-tracked for further investigation. These results show that a GRS has potential application to improve the diagnostic pathway of symptomatic patients in primary care.

Voiding Time for the Evaluation of Lower Urinary Tract Symptoms in Men – A Potential Option for Addressing Disparity Related Access to Urodynamic Testing

ObjectiveTo investigate voiding time (VT) in asymptomatic and symptomatic men, and compare VT to other parameters such as maximum flow rates (Qmax) as a possible solution to disparity related lack of access to standard urodynamic testing. MethodsWe conducted a controlled prospective study on a total of 30 patients. Exclusion criteria included ongoing medical therapy for lower urinary tract symptoms (LUTS) or a history of invasive therapy for LUTS. Patients completed International Prostate Symptom Score (IPSS) questionnaire, uroflowmetry, and post-void residual (PVR) testing. Symptomatic LUTS was defined as an IPSS ≥8. ResultsOn univariate analysis, men with a symptomatic LUTS had a significantly longer VT than asymptomatic men (30.6 seconds (Interquartile rage [IQR] 24.2-42.4) vs 20.5 seconds (IQR 16.6-40.5), P = .04). VT was not otherwise associated with age, race, or primary complaint. There was trend towards lower Qmax in symptomatic patients (13.4 vs 20.5 seconds, P = .07), although this was not statistically significant. Our study demonstrated that the sensitivity of a VT ≥23.5 seconds, or probability of observing a VT exceeding 23.5 seconds when the patient has a symptomatic IPSS, is 85%. On sensitivity and specificity analysis, there was no difference between the abilities of VT and Qmax to predict that a patient would have symptomatic LUTS (P = .80). ConclusionIn this controlled prospective study, we found that VT was as accurate as Qmax in predicting symptomatic IPSS scores. This novel finding might improve the ability to diagnose and treat LUTS, especially in primary care offices and underserved areas.

Myocarditis Following COVID-19 Vaccination: Cardiac Imaging Findings in 118 Studies.

We reviewed the reported imaging findings of myocarditis in the literature following COVID-19 vaccination on cardiac imaging by a literature search in online databases, including Scopus, Medline (PubMed), Web of Science, Embase (Elsevier), and Google Scholar. In total, 532 cases of myocarditis after COVID-19 vaccination were reported (462, 86.8% men and 70, 13.2% women, age range 12 to 80) with the following distribution: Pfizer-BioNTech: 367 (69%), Moderna: 137 (25.8%), AstraZeneca: 12 (2.3%), Janssen/Johnson & Johnson: 6 (1.1%), COVAXIN: 1 (0.1%), and unknown mRNA vaccine: 9 (1.7%). The distribution of patients receiving vaccine dosage was investigated. On cardiac MR Imaging, late intravenous gadolinium enhancement (LGE) was observed mainly in the epicardial/subepicardial segments (90.8%, 318 of 350 enhancing segments), with the dominance of inferolateral segment and inferior walls. Pericardial effusion was reported in 13.1% of cases. The vast majority of patients (94%, 500 of 532) were discharged from the hospital except for 4 (0.7%) cases. Post-COVID-19 myocarditis was most commonly reported in symptomatic men after the second or third dose, with CMRI findings including LGE in 90.8% of inferior and inferolateral epicardial/subepicardial segments. Most cases were self-limited.

Synchronized diaphragmatic stimulation for heart failure using the VisONE system: a first-in-patient study.

AimsSynchronized diaphragmatic stimulation (SDS) modulates intrathoracic and intra‐abdominal pressures with favourable effects on cardiac function for patients with a reduced left ventricular ejection fraction (LVEF) and heart failure (HFrEF). VisONE‐HF is a first‐in‐patient, observational study assessing the feasibility and 1 year effects of a novel, minimally invasive SDS device.Methods and resultsThe SDS system comprises a pulse generator and two laparoscopically delivered, bipolar, active‐fixation leads on the inferior diaphragmatic surface. Fifteen symptomatic men with HFrEF and ischaemic heart disease receiving guideline‐recommended therapy were enrolled (age 60 [56, 67] years, New York Heart Association class II [53%] /III [47%], LVEF 27 [23, 33] %, QRSd 117 [100, 125] ms, & N terminal pro brain natriuretic peptide [NT‐proBNP] 1779 [911, 2,072] pg/mL). Implant success was 100%. Patients were evaluated at 3, 6, and 12 months for device‐related or lead‐related complications, quality of life (SF‐36 QOL), 6 min hall walk distance (6MHWd), and by echocardiography. No implant procedure or SDS‐related adverse event occurred, and patients were unaware of diaphragmatic stimulation. By 12 months, left ventricular end‐systolic volume decreased (136 [123, 170] mL to 98 [89, 106] mL; P = 0.05), 6MHWd increased (315 [300, 330] m to 340 [315, 368] m; P = 0.004), and SF‐36 QOL improved (physical scale 0 [0, 0] to 25 [0, 50], P = 0.006; emotional scale 0 [0, 33] to 33 [33, 67], P = 0.001). Although neither reached statistical significance, LVEF decreased (28 [23, 40]% vs. 34 [29, 38]%; P = ns) and NT‐proBNP was lower (1784 [920, 2540] pg/mL vs. 1492 [879, 2028] pg/mL; P = ns).ConclusionsThese data demonstrate the feasibility of laparoscopic implantation and delivery of SDS without raising safety concerns. These encouraging findings should be investigated further in adequately powered randomized trials.

PD46-06 SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA WITH IMMUNE-ENRICHED LANDSCAPES SHOW LOWER INCIDENCE OF PROSTATE CANCER DEVELOPMENT

You have accessJournal of UrologyCME1 May 2022PD46-06 SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA WITH IMMUNE-ENRICHED LANDSCAPES SHOW LOWER INCIDENCE OF PROSTATE CANCER DEVELOPMENT Nimrod Barashi Gozal, Tiandao Li, Bo Zhang, Charles Nottingham, Gerald Andriole, Kiran Mahajan, and Eric Kim Nimrod Barashi GozalNimrod Barashi Gozal More articles by this author , Tiandao LiTiandao Li More articles by this author , Bo ZhangBo Zhang More articles by this author , Charles NottinghamCharles Nottingham More articles by this author , Gerald AndrioleGerald Andriole More articles by this author , Kiran MahajanKiran Mahajan More articles by this author , and Eric KimEric Kim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002614.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The association between benign prostatic hyperplasia (BPH) and prostate cancer (PCa) has not been confirmed. However, these two entities share multiple risk factors like chronic inflammation, metabolic disorders, and androgen-dependent growth. Therefore, an association at a molecular level is at least possible, if not likely. We sought to identify variations in gene expression that could help elucidate some of the pathways for development of PCa in patients with BPH. METHODS: We included 98 men with BPH, positive prostate MRI (PIRADS ≥4), and subsequent negative targeted biopsy from 11/2014 – 01/2018. RNA sequencing was performed on tissue cores from the MRI lesion, as well as cores from a distant region (n=2 biopsy regions per patient). All patients were followed for at least 3 years to identify those who went on to develop PCa. We compared the genetic profiles of those who did not develop PCa (“BPH-only”) vs. those who did (“BPH/PCa”). Then, we identified the subset of men with BPH who had the highest AUA symptom scores (AUAss) and compared their gene expression to the group with PCa. RESULTS: At a median follow up of 47.5 months, 83 men had no evidence of cancer and 15 had BPH/PCa. We compared gene expressions of 14 men with symptomatic BPH (AUAss ≥18) vs. 15 with BPH/PCa. There were two clusters of genes, suggesting the two groups had distinctive molecular features. Differential analysis revealed genes that were upregulated in BPH-only and downregulated in BPH/PCa, and vice versa (Figure 1). Symptomatic BPH men had upregulation of T-cell activation markers (TCR-CD3, PKC theta, ZAP70, LCK) and chemokine receptor expression. In contrast, men with BPH/PCa had upregulation of NKX3-1 and HOXB13 transcription factors associated with luminal epithelial progenitors, but depleted of immune cells, suggesting a cell-autonomous role in immune evasion. CONCLUSIONS: Symptomatic BPH with immune-enriched landscapes may support anti-tumor immunity. Furthermore, RNA sequencing of benign biopsy tissue showing upregulation of NKX3-1 and HOXB13 with absence of T-cells, might help identifying men who are at higher risk of developing PCa, which could help tailoring their treatment and potentially prevent the development of PCa. Source of Funding: Midwest Stone Institute © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e790 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nimrod Barashi Gozal More articles by this author Tiandao Li More articles by this author Bo Zhang More articles by this author Charles Nottingham More articles by this author Gerald Andriole More articles by this author Kiran Mahajan More articles by this author Eric Kim More articles by this author Expand All Advertisement PDF DownloadLoading ...

MP34-05 IMPACT OF NASAL, INTRAMUSCULAR, AND SUBCUTANEOUS TESTOSTERONE PELLETS ON INTRATESTICULAR TESTOSTERONE: EVALUATION OF DATA FROM TWO RANDOMIZED CLINICAL TRIALS

You have accessJournal of UrologyCME1 May 2022MP34-05 IMPACT OF NASAL, INTRAMUSCULAR, AND SUBCUTANEOUS TESTOSTERONE PELLETS ON INTRATESTICULAR TESTOSTERONE: EVALUATION OF DATA FROM TWO RANDOMIZED CLINICAL TRIALS Parris Diaz, Rohit Reddy, Ruben Blachman-Braun, Alexandra Dullea, Isaac J. Zucker, Daniel C. Gonzalez, Eliyahu Kresch, and Ranjith Ramasamy Parris DiazParris Diaz More articles by this author , Rohit ReddyRohit Reddy More articles by this author , Ruben Blachman-BraunRuben Blachman-Braun More articles by this author , Alexandra DulleaAlexandra Dullea More articles by this author , Isaac J. ZuckerIsaac J. Zucker More articles by this author , Daniel C. GonzalezDaniel C. Gonzalez More articles by this author , Eliyahu KreschEliyahu Kresch More articles by this author , and Ranjith RamasamyRanjith Ramasamy More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002588.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testosterone replacement therapy (TRT) can potentially cause decreased spermatogenesis and subsequent infertility due to decrease in intratesticular testosterone (ITT) production. Serum 17-hydroxyprogesterone (17-OHP) is a reliable surrogate for ITT that is critical for preserving male fertility. We hypothesized that long-acting T formulations will decrease ITT compared to short-acting formulations. We evaluated data from two open-label, randomized, two-arm clinical trials amongst different testosterone therapies with subcutaneous T pellets (TP), Intranasal Testosterone (NT) or Intramuscular Testosterone cypionate (TC). METHODS: A total of 75 symptomatic hypogonadal men (2 serum T <300 ng/dL drawn before 10AM) were randomized into open-label randomized clinical trials. Eligible subjects received 800mg TP, 11mg TID NT or 200 mg×2 weeks TC. Lab values were evaluated at baseline and follow-up. The primary outcome was changes in serum 17-OHP. Secondary outcome was changes in serum T. Data analyzed via Kruskal Wallis and Chi square test.Trials: NCT04439799 (June 19,2020) & NCT04523480 (August 21,2020). RESULTS: Median participant age was 45 years old, with overall baseline 17-OHP of 46 and serum testosterone of 223.5 ng/dL. Serum 17-OHP significantly decreased in all three TRT regimens (Table 1). The 4-month change in 17-OHP in the NT group (−33.3% from baseline) was less than the change seen in TC (−65.3% from baseline) or TP (−44% from baseline) (p=0.005). All T formulations increased serum testosterone levels at follow-up, with the largest increase seen in TC (+157.6%), followed by NT (+114.3%), and TP (+79.6%) (p=0.005). CONCLUSIONS: Short-acting nasal testosterone appears to decrease 17-OHP less than long-acting T formulations. All modalities saw significant increases in serum T levels at follow-up. Intranasal T and other short acting T formulations may better preserve ITT and be beneficial for hypogonadal men seeking to maintain fertility potential while on TRT. Source of Funding: Investigator Initiated Grant funded by Acerus Pharmaceuticals and Empower Pharmacy (RR). This work was also supported by National Institutes of Health Grant R01 DK130991 and Clinician Scientist Development Grant from the American Cancer Society to RR © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e580 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Parris Diaz More articles by this author Rohit Reddy More articles by this author Ruben Blachman-Braun More articles by this author Alexandra Dullea More articles by this author Isaac J. Zucker More articles by this author Daniel C. Gonzalez More articles by this author Eliyahu Kresch More articles by this author Ranjith Ramasamy More articles by this author Expand All Advertisement PDF DownloadLoading ...

A Challenging Case of Pneumonia and Vasculitis

An elderly (76 years old) immunocompromised Iraqi male had carcinoma of colon stage 3c without metastasis operated for seven years before, plus chemotherapy for one year. In winter 2022, this man sorrowed from a sore throat, voice change, and a rise in temperature (37.4 C). Later, dry cough developed in subsequent hours and deteriorated quickly to yellow-colored sputum, plus an increment in his temperature (37.8 C). After that, the patient had non-specific, non-itchy, follicular erythematous papules. The rash varies in size and shape, distributed in the abdomen, lower back, and legs. Two physicians proved pneumonia by clinical means, plus two successive chest x-rays, but the patient refused the laboratory investigations for Covid. He took two doses of the Chinese vaccine (Sinopharm) six months before recent symptoms. After strict treatment, the cough became less frequent, white-colored sputum, fever dropped gradually, at the end of the week. On the tenth day from the beginning of the man's symptoms, the skin rash faded slowly due to prednisolone usage.

Correlations between Personality Traits, Patient-Reported Outcome, and Chronic Prostatitis Symptoms in Men with Different Premature Ejaculation Syndromes.

Although the personality traits (PT), patient-reported outcome (PRO), and chronic prostatitis (CP) symptoms in premature ejaculation (PE) have been evaluated, there was no study to assess their correlations in men with different PE syndromes. The purpose of this study was to assess the correlations between the PT, PRO, and CP symptoms in men with different PE syndromes. Between January 2019 and January 2021, a cross-sectional field study was conducted in our andrology clinic. Men with the complaints of PE were divided into lifelong PE (LPE), acquired PE (APE), variable PE (VPE), and subjective PE (SPE). All subjects were required to complete a verbal questionnaire with the PRO, National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and Temperament and Character Inventory (TCI-R). Finally, 479 men with the complaints of PE and 365 without the complaints of PE were enrolled. The incidence of PE syndromes in PE complaint group was as follows: LPE 16.70%, APE 48.85%, VPE 11.27%, and SPE 23.17%. Mean ages in PE complaint group were 42.53 ± 12.25 years. In the PE complaint group, the novelty seeking (NS) scores were strongest correlated with the personal distress and quality of life (QOL). The harm avoidance (HA) scores were strongest correlated with the severity of PE and pain syndromes. The self-transcendence (ST) scores were strongest correlated with the satisfaction with sexual intercourse and QOL. In addition, strongest association between the total scores of NIH-CPSI and the NS or ST scores was also found in the APE group. The HA scores were also strongest correlated with the total scores of NIH-CPSI in SPE. Strongest association between the total scores of NIH-CPSI and the NS/TI or ST/CI scores was also found in the APE group. The HA/TI scores were also strongest correlated with the total scores of NIH-CPSI in SPE.

Extratunical Grafting and Penile Plication for Peyronie's Disease

ABSTRACT Introduction Extratunical grafting is a surgical option for men with Peyronie's disease who have an hourglass deformity or indentation defect. Rather than necessitating neurovascular bundle elevation and tunical incision, the procedure can be done without mobilization of the bundle. This benefit limits the risk of de novo erectile dysfunction and glans hypoesthesia. Here we present a case of a penile plication combined with extratunical grafting for a man with dorsal curvature and a right sided indentation defect. Objective To present a video presentation of extratunical grafting during penile plication for Peyronie's disease Methods An artificial erection is done to confirm the location and extent of the penile deformity and curvature. A midline ventral penile incision is made and carried down to the tunica albunigea as is standard for a penile plication. A penile plication is performed with 2-0 polyester suture to correct the dorsal curvature. At the site of the indentation defect, a pericardium allograft is doubly-folded on itself and sewn to the tunica albuginea. The indentation repair is demonstrated, and the surgical site is closed. Results The patient reports high satisfaction with the indentation correction and improvement in dorsal curvature with no new erectile dysfunction or hypoesthesia. Conclusions Extratunical grafting is a viable, straightforward option for men with Peyronie's disease and indentation defects or an hourglass deformity that can be combined with penile plication to treat symptomatic men. Disclosure No

The Potential Impact of COVID-19 on Male Reproductive Health

Since the beginning of 2020, the whole world is trying to face the coronavirus disease 2019 (COVID-19) pandemic. In the last years, SARS-CoV-2 mutations showed an increased contagion and infection profile, affecting a higher proportion of young men during the last pandemic outbreaks. SARS-CoV-2 penetrates host cells by binding to Angiotensin-Converting Enzyme (ACE2) receptors, highly expressed by testis cells, and a significant hyper-gonadotropic hypogonadism rate in COVID-19 patients has been observed, leading to the hypothesis of a possible impact of this disease on male fertility. Indeed, recent founding demonstrated that 25% of patients healed by COVID-19 showed azoo/oligozoo-spermia. Moreover, a statistically significant decrease of sperm concentration, total number and sperm motility was detected in men with moderate infections, when compared with mild symptomatic men or controls. Thus, pathological levels of inflammatory cytokines in semen of men healed from COVID-19 were reported in a major percentage of studied men, with a significant correlation between oligo-crypto-azoospermia and disease severity. Even if the whole mechanisms of male reproductive damages are still unclear, autoimmune self-maintained inflammation may be one of the main determinants of male reproductive system impairment.

For better or worse: Associations among psychopathology symptoms, interpersonal emotion dynamics, and gender in couples.

Communication has long been associated with the well-being of a couple's relationship, and it is also important to explore associations with individual well-being. This study examined the associations between emotions communicated within couple interactions and each partner's psychopathology symptoms concurrently and up to 3 years later. Vocally-encoded emotional arousal (f₀) was measured during couples' (N = 56) conversations. Analyses examined each partner's trajectories of f₀ and how each partner influenced the other's f₀ across the conversation. The findings indicated that women experienced higher symptoms if they (a) decreased more steeply in f₀ overall and (b) returned to their baseline in f₀ more quickly. Moreover, women had higher symptoms if they had a steeper return to baseline because of men's elevated f₀. In contrast, men experienced higher symptoms when men (a) more slowly returned to baseline and (b) changed their f₀ trajectory because of women's elevated f₀. That is, women who expressed less emotional arousal, independently and as a result of the influence of their male partner, experienced more symptoms. In contrast, men's symptoms were differentially associated with their own independent experience of emotional arousal (in which he experienced fewer symptoms when changing arousal more quickly) from how they responded to women's arousal. Given how differently men's and women's psychopathology were associated with emotional expression, these findings raise questions about how partners can communicate to protect their own and their partner's mental health in the short- and long-term. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Football players with long standing hip and groin pain display deficits in functional task performance

Objectivesi) Compare functional task performance between football players with and without hip/groin pain. ii) Explore the relationship, and sex-specific effects, between functional tasks and the Copenhagen Hip and Groin Outcome Score (HAGOS) in players with hip/groin pain. DesignCross-sectional. SettingLaboratory. Participants183 (38 women) football players with a self-reported history of >6months of non-time-loss hip/groin pain and a positive flexion-adduction-internal rotation test, and 61 (14 women) asymptomatic players. Main outcomeParticipants completed the hop-for-distance (HFD), one leg rise (OLR), side bridge (SB) endurance, and HAGOS. Study aims were assessed using linear models, controlling for body mass index and age, incorporating sex-specific interaction terms. ResultsPlayers with hip/groin pain could not hop as far (adjusted mean difference: -9 cm, 95% CI: -15 cm to -2cm, P=0.012) and completed fewer OLR repetitions (adjusted mean difference −7, 95% confidence interval −11 to −3 repetitions, P=0.001) compared to asymptomatic players. Symptomatic women, but not symptomatic men, with worse HAGOS scores had lower SB endurance. Independent of sex, football players with worse HAGOS scores could not hop as far and completed fewer OLR repetitions. ConclusionFootball players with hip/groin pain demonstrated deficits in HFD and OLR with the performance of these tasks associated with their HAGOS results. The study identifies potential impairments that can be targeted as a component of rehabilitation programs for football players with hip/groin pain.

Shigella is common in symptomatic and asymptomatic men who have sex with men visiting a sexual health clinic in Amsterdam

IntroductionShigellosis is a reportable infectious disease. It can present as a severe bloody diarrhoea but is often asymptomatic. Shigella can be sexually transmissible. We performed a study among symptomatic and...

The Perceptions and Self-management of Depressive Symptoms in Men: A Qualitative Study in a Province of Northeastern Thailand

Men and women may experience depression very differently. The previous studies found that women expressed emotional distress mean that they were more likely to be diagnosed with depression, while some men with depression tried to hide their emotions, so causing them to have delayed treatment. This qualitative research aimed to study the perception and management of depressive symptoms in Thai males before receiving treatment with psychiatric specialists. The participants who were diagnosed major depressive disorders and dysthymic disorders were 23 men by purposive sampling was used. Data were collected through in-depth interviews by a semi-structured interview, which was based on literature review and it was verified by advisor, the second author who experienced of qualitative study. Analyzed by content analysis based on the process of Colaizzi. The finding revealed that the perception and management of depressive symptoms were divided into 3 phases. Phrase 1 was the perception of abnormal symptoms affecting daily activities but an attempt to hide it and struggling for a normal life. Phrase 2 showed that Thai men’s perception of symptoms were thinking too much, ruminative thought causing suffering, and then trying to release the suffering and control ruminative thought. Phrase 3 was the perception of loneliness, hopelessness, suicidal thoughts, and then trying to seek help. Healthcare providers can use the findings as information for developing screening tools specific to Thai men. The information can also be used to develop psycho-education tools for close ones or family members to recognize and understand early symptoms so that care, assistance and access to treatment can be provided before severe depression is developed. The research was only carried out in 1 area, the results could not be generalized, besides that it could have multiple meanings or be biased if it was carried out in other areas with different cultures.&#x0D; HIGHLIGHTS&#x0D; &#x0D; Men and women may express symptoms of depression differently, women expressed emotional distress which meant that they were more likely to be diagnosed with depression, while some men with depression tried to hide their emotions&#x0D; The finding revealed that the perception and management of depressive symptoms were divided into 3 phases according to the duration and the perceived severity of the symptoms&#x0D; Phrase 1 was the perception of abnormal symptoms affecting daily activities but an attempt to hide it and struggling for a normal life. Phrase 2 showed that Thai men’s perception of symptoms were thinking too much, ruminative thought causing suffering, and then trying to release the suffering and control ruminative thought. Phrase 3 was the perception of loneliness, hopelessness, suicidal thoughts, and then trying to seek help&#x0D;

Qualitative Assessment of the Conservative Management of Nocturia with Standardised Written Materials for Lower Urinary Tract Symptoms in Men Treated in Primary Care

BackgroundMany men prefer conservative treatment of lower urinary tract symptoms (LUTS) but education and self-help guidance are limited in primary care. ObjectiveTo report qualitative interview findings for men reporting nocturia in a primary care setting for LUTS. Design, setting, and participantsTRIUMPH (Treating Urinary Symptoms in Men in Primary Healthcare) is a multicentre cluster randomised trial of standardised manualised care (a booklet delivered by a health care professional) versus usual care for LUTS. The participants (524 in the intervention arm and 553 in the usual care arm) were men presenting for primary care for LUTS at 30 general practice (GP) sites in the UK. InterventionDelivery of a LUTS self-management booklet by health care staff in comparison to usual care for men with LUTS. Outcome measurements and statistical analysisThe qualitative component included 58 early-stage (0–3 mo after study enrolment) and 33 late-stage (3–9 mo later) interviews with participants to assess their experience of LUTS and conservative treatment in primary care. Purposive sampling was used to select participants for interview. Results and limitationsNocturia is a common driver for seeking health care and is perceived by men as relatively acceptable to discuss. Information and self-help guidance were largely absent from descriptions of GP consultations, other than reducing evening caffeine and fluid intake. The TRIUMPH LUTS intervention booklet offers explanations and self-management guidance. Men with long-term disruptive symptoms, a perception that the booklet content was novel or worthwhile, and a belief that self-management might help, were more receptive to the intervention. In follow-up, improvements in nocturia were related to successful implementation of several aspects of the guidance. Most men were willing to complete a bladder diary, but some found it inconvenient, especially men in employment. The characteristics of the trial population mean that the findings may not apply to all men. ConclusionsReassuring men that nocturia is part of ageing without offering them information and support risks reinforcing the tendency to discount problematic LUTS. The trial booklet and the training of health care professionals support guidance on nocturia self-management, which is most effective for men receptive to this approach. However, the nature of the trial population means that the findings may not apply to all men. Patient summaryMen are more comfortable in discussing waking at night to urinate than talking about other urinary symptoms with their GP. This problem should lead to a detailed discussion of all urinary symptoms rather than being thought of as a sign of ageing. An information booklet and nurse consultation helped many men to improve this symptom.

Comparison of Intratesticular Testosterone between Men Receiving Nasal, Intramuscular, and Subcutaneous Pellet Testosterone Therapy: Evaluation of Data from Two Single-Center Randomized Clinical Trials.

Testosterone replacement therapy (TRT) can potentially cause decreased spermatogenesis and subsequent infertility. Recent studies have suggested that 17-hydroxyprogesterone (17-OHP) is a reliable surrogate for intratesticular testosterone (ITT) that is essential for spermatogenesis. We evaluated data from two ongoing open-label, randomized, two-arm clinical trials amongst different treatment preparations (Trial I) subcutaneous testosterone pellets (TP) and (Trial II) intranasal testosterone (NT) or intramuscular testosterone cypionate (TC). Seventy-five symptomatic hypogonadal men (2 serum testosterone <300 ng/dL) were randomized into open label randomized clinical trials. Eligible subjects received 800 mg TP, 11 mg TID NT or 200 mg ×2 weeks TC. 17-OHP and Serum testosterone were evaluated at baseline and follow-up. The primary outcome was changes in 17-OHP. Secondary outcome was changes in serum testosterone. Data was analyzed by two-sample and single-sample t-tests, and determination of equal or unequal variances was computed using F-tests. Median participant age was 45 years old, with overall baseline 17-OHP of 46 and serum testosterone of 223.5 ng/dL. 17-OHP significantly decreased in subjects prescribed long-acting TP or TC. The 4-month change in 17-OHP in the NT group (-33.3% from baseline) was less than the change seen in TC (-65.3% from baseline) or TP (-44% from baseline) (p=0.005). All testosterone formulations increased serum testosterone levels at follow-up, with the largest increase seen in TC (+157.6%), followed by NT (+114.3%) and TP (+79.6%) (p=0.005). Short-acting nasal testosterone appear to have no impact on serum 17-OHP especially in comparison to long-acting testosterone formulations. All modalities saw significant increases in serum testosterone levels at follow-up. NT and other short acting testosterone formulations may better preserve ITT and be beneficial for hypogonadal men seeking to maintain fertility potential while on TRT.