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Sunday, 16 November 2008

Low testosterone and the association with type 2 diabetes.

Low testosterone and the association with type 2 diabetes.
Diabetes Educ. 2008 Sep-Oct
Farrell JB, Deshmukh A, Baghaie AA.
Medical Affairs, Men's Health, Solvay Pharmaceuticals, Inc, 901 Sawyer Road, Marietta, GA 30062, USA. joanne.farrell@solvay.com
PURPOSE: The purpose of this article is to describe androgen deficiency in men, the consequences of this clinically underdiagnosed endocrine disorder, and its relationship to the metabolic syndrome and the association with type 2 diabetes. An overview of prevalence, screening, diagnosis, treatment, and monitoring of male hypogonadism is presented. Method Established guidelines were used to provide definition, diagnosis, treatment, and monitoring information for male hypogonadism. A literature review from 1990 to 2007 revealed study findings that identify the link between low testosterone in men and the development of type 2 diabetes. The following databases were used to review and analyze the current literature: CINAHL, PubMed, and MEDLINE.
RESULTS: An analysis of 26 studies was completed. The key findings in all of these studies show that there is a link between low levels of testosterone and an adverse metabolic profile (ie, obesity and insulin resistance). There is evidence that hypogonadism is associated with metabolic syndrome and type 2 diabetes in men.
CONCLUSION: Male hypogonadism is a clinical condition that affects a significant number of men in the United States and can affect up to 50% of men diagnosed with type 2 diabetes. The implications for diabetes educators are two-fold: first, there is a high prevalence of low testosterone in men with type 2 diabetes, and second, educators need to have a better understanding of this disease state to provide instructional guidance for their patients and to coordinate care with other clinicians.
Complete Text available at link below.
Sage Publications
Who has sex with whom? Characteristics of heterosexual partnerships reported in a national probabili

Who has sex with whom? Characteristics of heterosexual partnerships reported in a national probability survey and implications for STI risk.
Int J Epidemiol. 2008 Nov 11
Mercer CH, Copas AJ, Sonnenberg P, Johnson AM, McManus S, Erens B, Cassell JA.
Centre for Sexual Health & HIV Research, Research Department of Infection & Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK.
BACKGROUND: Sexually transmitted infection (STI) risk is determined both by partner numbers and partnership characteristics. Studies describing only recent partnership(s) overestimate long-term partnerships and underestimate the contribution of casual partnerships to STI transmission in populations. We describe all heterosexual partnerships in the past year in terms of partnership type, age and geographical mixing and how these characteristics relate to condom use.
METHODS: Probability sample survey of 11 161 men and women aged 16-44 resident in Britain, 1999-2001. Computer-assisted self-interviews asked respondents about partner numbers and detailed questions about their three most recent partnerships. We weight these data to represent partnerships for which detailed questions were not asked to present estimates for the population of partnerships.
RESULTS: Of 15 488 heterosexuals partnerships, 39.1% (95% CI 36.6-41.7%) of men's partnerships were 'not (yet) regular' vs 20.0% (95% CI 18.2-21.9%) of women's partnerships. While condoms were used at last sex in 37.1% (95% CI 35.0-39.3%) of men's and 28.8% (95% CI 27.1-30.6%) of women's partnerships, and for 55.3% (95% CI 52.6-58.0%) of first sex with new partners, these proportions declined with age. When partnerships involved an age difference of 5+ years [26.2% (95% CI 23.0-29.6%) of men's and 36.5% (95% CI 33.0-40.1%) of women's partnerships], condoms were less commonly used at first sex than when partners were closer in age [44.1% (95% CI 39.1-48.4%) vs 60.8% (95% CI 57.3-64.2%)]. Sex occurred within 24 h in 23.4% (95% CI 19.7-27.5%) of men's and 10.7% (95% CI 8.3-13.6%) of women's partnerships.
CONCLUSIONS: A substantial minority of partnerships in the population is casual. The proportion of partnerships not protected by condoms is high, especially for partnerships involving larger age differences and people in their 30s and 40s. Condom use with new partners needs to be promoted among all age-groups.
Complete Article at link below
International Journal of Epidemiology

Friday, 18 July 2008

Imaging Advance Tracks Prostate Cancer in Lymph Nodes

Imaging Advance Tracks Prostate Cancer in Lymph Nodes
HealthDay

By HealthDay staff

Tuesday, July 15, 2008
TUESDAY, July 15 (HealthDay News) -- A new imaging technique, based on an engineered version of the common cold virus, may help doctors detect the spread of prostate cancer to the lymph nodes earlier.
This, in turn, could help guide more effective treatment decisions, said the authors of a study published in the July 11 edition of Nature Medicine.
"It would represent a treatment advance in patients for whom outcome is not good," study senior author Dr. Lily Wu, a researcher at UCLA's Jonsson Cancer Center, said in a university news release. "This would help improve the prognosis for these patients by letting us find and treat these metastases early. If we can catch the cancer before it invades other organs, we have a better chance to change the outcomes for these patients."
Patients whose prostate cancer has traveled to their lymph nodes are more likely to have a recurrence. Finding these tiny metastases in the pelvic lymph nodes is key to making future treatment decisions, yet it is also supremely difficult to do with conventional imaging techniques.
Wu and her colleagues engineered a common cold virus armed with a specific "genetic payload" to travel directly to lymph nodes in mice and to express its payload only in prostate cells.
The payload consists of a protein that can be picked up on PET scans.
Wu and her colleagues next want to combine the imaging technique with treatment, so that a drug contained in the genetic payload could kill the traveling tumor cells.
"I think this is very exciting for many reasons," said Wu. "We now know we can reach these prostate cancer metastases at an earlier stage than before, and we know we can deliver genes to those cancer cells that produce proteins that can be imaged by PET. Now we will find out how effective this genetic toxic payload is in preventing further spread of the cancer to other vital organs."
MedlinePlus
Men, masculine identities, and health care utilisation.

Men, masculine identities, and health care utilisation.
Sociol Health Illn. 2008 Jun 18Noone JH, Stephens C.
Department of Psychology, Massey University, New Zealand.
Seeking medical help early is critical for recovery, yet evidence indicates that men do not utilise general practitioner services as often as women. This paper draws on Connell's (1995) theory of hegemonic masculinity to critically examine how men's under-utilisation of medical services may be influenced by the social construction of masculine identities. Interviews with seven older rural men about their help-seeking behaviour, used a movie extract and hypothetical scenarios to stimulate discussion. Transcribed data were analysed using discourse analysis, which showed that in this particular social context, the men faced a dilemma when identifying with two conflicting subject positions: the virtuous regular health care user, and the masculine infrequent user of health care services. They solved this dilemma by positioning women as frequent and trivial users of health care and themselves as legitimate users of health care. By using biomedical and morality discourses in this way the men could maintain a masculine identity whilst also identifying as virtuous users of health care services. These results support the utility of hegemonic masculinity as a theoretical basis for examining the construction and maintenance of gendered identities by highlighting the complexity of multiple masculine identities.
PubMed
Men's health promotion: A new frontier in Australia and the UK?

Men's health promotion: A new frontier in Australia and the UK?
Health Promot Int. 2008 Jul Smith JA, Robertson S.
1Department of Paramedic and Social Health Sciences, School of Medicine, Flinders University, Adelaide, South Australia, Australia.
The field of men's health has grown markedly over the past few decades. Increased activity specifically relating to men's health promotion in both Australia and the UK has been noted during this period. There has, however, been a reticence to critically examine men's health promotion work within a broader discourse relating to gender and gender relations. Indeed, the vast majority of health-related gender discussion to date has been focused on women's health experiences and their health practices. In this paper, we argue that grounding men's health within this broad gender discourse is important for building an evidence base in, and advancing, men's health promotion work at a range of levels. We specifically explore the research, practice and policy contexts relating to men's health in Australia and the UK, and describe the facilitators for, and barriers to, promoting men's health. We conclude by suggesting that a critical gender lens ought to be applied to current men's health promotion work and provide strategies for researchers, practitioners and policy makers to move towards this new frontier.
Oxford Journal