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Infertility in men could point to more serious health problems later in life
Poor sperm quality affects about one in ten men and may lead to fertility problems. These men also have an increased risk of developing testicular cancer, which is the most common malignant disease of young males. And, even if they don’t develop testicular cancer, men with poor sperm quality tend to die younger than men who don’t have fertility problems.
Couples who can’t achieve pregnancy usually go to fertility clinics for treatment. At these clinics, emphasis is put on deciding whether the couple needs assisted reproduction or not, and, if so, to choose between different methods (such as IVF, IUI, or ICSI) for doing this. In most cases, these treatments lead to pregnancy and a live birth. So the problem seems to be solved. But if infertility is an early symptom of an underlying disease in the man, fertility clinics won’t pick it up.
Missed opportunity
Testicular cancer is easy to detect. In men seeking treatment for fertility problems, a simple ultrasound scan of the testes can reveal early cancer, so a life-threatening tumour can be prevented. If detected, 95% of all cases can be cured. But, unfortunately, testicular ultrasound scans are rarely performed at fertility clinics as the focus tends to be on sperm numbers and which method of assisted reproduction to use.
And testicular cancer is not the only threat to young infertile men’s health. Serious health problems, such as metabolic syndrome (high blood pressure, high blood sugar and obesity), type 2 diabetes and loss of bone mass are also much more common conditions among infertile men. These disorders are possible to prevent, but if left untreated often lead to premature death.
A possible culprit
At Lund University in Malmö, Sweden, we have – together with other research groups – made a number of studies focusing on the link between male fertility problems and subsequent risk of serious diseases. We cannot yet explain the causes, but testosterone deficiency is a strong candidate. My research team found that 30% of all men with impaired semen quality have low testosterone levels. And men totally lacking the hormone have early signs of diabetes and bone loss.
We recently conducted a study in which we investigated almost 4,000 men below the age of 50 and who had had their testosterone measured 25 years ago. We found that the risk of dying at a young age was doubled among those with low testosterone levels compared with men with normal levels of this hormone.
Although testosterone treatment may not necessarily be the best preventive measure, these findings makes it possible to identify men at high risk so that they can be advised about lifestyle changes, such as losing weight or quitting smoking – lifestyle changes that will help reduce the risk of developing type 2 diabetes, cardiovascular disease and osteoporosis.
A relatively high proportion of men get in touch with their doctor about infertility problems and, as they represent a high-risk group for some of the most common diseases occurring later in life, perhaps it is time to change the routines for managing them. With the knowledge we now have regarding these men’s health, the least we can demand from doctors is to identify those who are at risk of serious diseases after they have become fathers. This is cheap and only requires simple tests. It is no longer enough to just evaluate the number of sperm.
Written by: Aleksander Giwercman And Yvonne Lundberg Giwercman, The Conversation
Article Source: https://medicalxpress.com/news/2017-05-infertility-men-health-problems-life.html
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Jerking Off Cuts Prostate Cancer Risk By 33 Percent: Male Orgasm Flushes Out Harmful Toxins, Theory Says
Many men know a healthy diet and lifestyle provides some protection against prostate cancer. Eating less red meat, animal fats, and dairy fats and adding more fruits and vegetables promote good health, but science suggests men can also give their prostate a helping hand, literally. A study published in European Urology found having sex or jerking off can lower the risk of prostate cancer via the male orgasm.
There’s a link between how much men masturbate and their likelihood of developing prostate cancer. A total of 21 orgasms a month, either by having lots of sex or jerking off, can reduce the risk of disease by 33 percent.
“These findings provide additional evidence of a beneficial role of more frequent ejaculation throughout adult life in the etiology of PCa [prostate cancer], particularly for low-risk disease,” wrote the researchers from Harvard T.H. Chan School of Public Health, in the study.
However, it remains unclear why having this many orgams per month is good for the prostate.
One theory is that ejaculation flushes out harmful toxins and bacteria in the prostate gland that could cause inflammation. The prostate works by providing a fluid into semen during ejaculation that activates sperm, and prevents them from sticking together. High concentrations of potassium, zinc, fructose, and citric acid are drawn from the bloodstream.
Previous research has shown carcinogens found in cigarette smoke, like 3-methylcholanthrene, are also found in the prostate. This means carcinogens can build up over time, especially if men ejaculate less, which is known as the prostatic stagnation hypothesis. In theory, the more a man “flushes out” the ducts, the fewer carcinogens that are likely to linger around and damage the cells that line them.
Another theory proposed is ejaculation can lead the prostate glands to mature fully, which makes them less susceptible to carcinogens.
Approximately 32,000 men were surveyed on their number of orgasms as researchers tracked those who developed prostate cancer over the course of decades. The study was a 10-year follow-up on questions answered on ejaculation frequency in 1992 and followed through to 2010. Average monthly ejaculation frequency was assessed during three periods: age 20–29; age 40–49; and the year before the questionnaire was distributed.
The researchers concluded daily masturbation throughout adulthood had a protective effect against prostate cancer. These findings echo results from a 2008 Harvard study that found there was no increased risk of prostate cancer related to age of ejaculation, but benefits increased as men aged. Yet, other studies have found men experience a reduced risk of prostate cancer if they frequently masturbated during young adulthood.
Jerking off as an effective preventative measure for prostate cancer remains murky. These studies suggest there is a connection between the two, but its effects seem to fluctuate depending on a man’s age. This warrants further research to determine what age group can reap the most benefits from daily masturbation for prostate health.
Prostate cancer mainly affects men over 50, and risk increases with age. About six in 10 cases of prostate cancer are found in men older than 65, according to the American Cancer Society. Other risk factors include race, genetics, weight, physical activity, diet, height, and chemical exposure.
The exact causes of prostate cancer remain unknown, but sticking to a healthy diet and lifestyle could offer protection. Perhaps men who give themselves a helping hand in the bedroom can also improve their prostate health. After all, relaxing and reducing stress can help increase longevity, and decrease the onset of disease.
Source: Rider JR, Wilson KM, Sinnott JA et al. Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow-up. European Urology . 2016.
Written By Lizette Borreli
Article Source: http://www.medicaldaily.com/jerking-cuts-prostate-cancer-risk-33-percent-male-orgasm-flushes-out-harmful-419783
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New Study: Standard American Diet Causes Nearly Half of All Deaths from Heart Disease, Stroke and Type 2 Diabetes
It should come as no surprise that our diet plays a critical role in our health and longevity, but the sheer level of influence may come as a shock to you.
A new study published in the March 7 issue of JAMA found that poor diet is responsible for an astonishing 45 percent of all deaths from heart disease, stroke and type 2 diabetes in the US. The researchers attributed this high mortality rate to the Standard American Diet (SAD), which is high in sodium, processed meats, sugar-sweetened beverages and unprocessed red meats.
The good news is, just as diet can be our downfall, it’s also just as powerful in promoting exceptional health and longevity — as seen in “Blue Zone” cultures, who are known for their extraordinary lifespan and phenomenal vitality.
A Deadly Trinity of Disease, Directly Linked to Poor Food Choices
According to the newly released JAMA study, which was funded by the National Heart, Lung and Blood Institute (NHLBI), nearly half of all US deaths in 2012 caused by cardiometabolic diseases — like heart disease, stroke and type 2 diabetes — are due to poor diet. Out of the 702,308 adult deaths from cardiometabolic diseases, 318,656 — about 45 percent — were linked with over-consumption of certain unhealthy foods, as well as low consumption of specific nutrient dense edibles.
“Nationally, estimated cardiometabolic deaths related to insufficient healthier foods/nutrients remained at least as substantial as those related to excess unhealthful foods/nutrients,” said lead researcher Renata Micha, RD, PhD, of the Tufts Friedman School of Nutrition Science and Policy, Boston.
Excess consumption of sodium was associated with the highest percentage of death. Consuming high amounts of processed meats, sugar-sweetened beverages and unprocessed red meat were also linked with high mortality. Americans also don’t eat enough of certain health-promoting foods — like fruit, vegetables, nuts and seeds, whole grains, polyunsaturated fats and seafood omega-3 fats.
“Among unhealthful foods/nutrients, the present findings suggest that sodium is a key target,” noted the researchers. “Population-wide salt reduction policies that include a strong government role to educate the public and engage industry to gradually reduce salt content in processed foods (for example, as implemented in the United Kingdom and Turkey) appear to be effective, equitable, and highly cost-effective or even cost-saving.”
According to a press release from the NHLBI:
“The study also shows that the proportion of deaths associated with diet varied across population groups. For instance, death rates were higher among men when compared to women; among blacks and Hispanics compared to whites; and among those with lower education levels, compared with their higher-educated counterparts.”
The findings of the study were based on death certificate data from the National Center of Health Statistics.
With annual US healthcare spending hitting $3.8 trillion in 2014 and $3.2 trillion in 2016 — heart disease and stroke costing nearly $1 billion a day in medical costs along with lost productivity, and diabetes totaling $245 billion annually — the results of this study come as a stark reality check. However, they can also help encourage positive outcomes, such as new public health strategies, public education programs, and revamped industry standards.
For inspiration, we can also look to cultures and communities that have outstanding health and longevity for guidance — and a perfect place to start is with the Blue Zones.
The Island Where People Forgot to Die
Just off the coast of Turkey, very close to Samos, where Pythagoras and Epicurus lived, is a Greek island named Ikaria that is renown as “the island where people forgot to die” because of the exceptional lifespan of its inhabitants. Included in what is referred to as the Blue Zones — five regions in Europe, Latin America, Asia and the US with the highest concentrations of centenarians in the world — the people of Ikaria live about eight years longer than average and have exceedingly good health. These communities are also largely free of health complaints like obesity, cancer, diabetes and heart disease. Moreover, they’re sharp to the very end, whereas in the US, almost half the population over 85 suffers from dementia.
Diet is a key ingredient to their robust health and longevity. In Ikaria, they’re eating a variety of a Mediterranean diet, but with lots of potatoes. They also consume high amounts of beans. One unique foodstuff is called horta , a weed-like green that’s eaten as a salad, lightly steamed or baked into pies. Goat’s milk, wine, honey, some fruit and small amounts of fish are also enjoyed. Other foods include feta cheese, lemons and herbs such as sage and marjoram, which are made into tea.
Lifestyle also comes into play. Plenty of sex (even in old age) and napping are integral aspects of the culture, as is physical activity. There are no treadmills or aerobic classes here. Instead, exercise involves planting and maintaining a garden, manual labor (houses in Ikaria only have hand tools) and walking to run errands.
Another Blue Zone region is Sardinia, Italy where goat’s milk and sheep’s cheese are staples, along with moderate amounts of flat bread, sourdough bread and barley. They also eat plenty of fennel, fava beans, tomatoes, chickpeas, almonds, milk thistle tea and wine from Grenache grapes.
Seventh-day Adventists in Loma Linda, California made the list as well. The community shuns smoking, drinking and dancing, while also avoiding movies, television and other media distractions. Their diet focuses on grains, fruits, nuts, vegetables — and they only drink water. Sugar, except for natural sources found in whole fruit, is taboo. Adventists who follow the religion’s lifestyle live about 10 years longer than those who don’t. Interestingly, pesco-vegetarians in the community, who include up to one serving of fish per day with their plant-based diet, live longer than vegan Adventists. Avocados, salmon, beans, oatmeal, avocados, whole wheat bread and soy milk make up the bulk of their diet.
Nicoya Peninsula in Costa Rica also has a high number of centenarians. Theirs is a traditional Mesoamerican diet of beans, corn and squash — plus papayas, yams, bananas and peach palms (an oval fruit dense in vitamins A and C).
The final Blue Zone is Okinawa, Japan. Their “top longevity foods” are bitter melons, seaweed, turmeric, sweet potato, tofu, garlic, brown rice, green tea and shitake mushrooms.
All Blue Zones share the following characteristics:
- Only eat until you’re 80 percent full.
- The smallest meal of the day is always in the late afternoon or evening.
- Diet consists mostly plants, especially beans. Meat is eaten rarely — on average of just five times a month — and in small portions of about 3 to 4 ounces.
- Moderate amounts of wine is consumed with 1-2 glasses per day (doesn’t apply to Seventh-day Adventists).
- A sense of community and close social bonds, often with religious underpinnings.
Although the secret to Blue Zone longevity doesn’t rely exclusively on diet, it’s certainly a core foundation for their exceptional health and vitality. We can take a cue from these regions and integrate their wisdom into our own lives for improved well-being. Have a look at these quick and easy Blue Zone recipes for inspiration.
Written By: Carolanne Wright
Article Source: https://wakeup-world.com/2017/04/24/new-study-standard-american-diet-causes-nearly-half-all-deaths-heart-disease-stroke-type-2-diabetes/
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Porn Use Linked to Erectile Dysfunction
Men who are obsessed with pornography and prefer masturbation to sexual intercourse appear to be at increased risk for erectile dysfunction, a new study suggests.
Although these results need validation, urologists and other clinicians who treat men with erectile dysfunction and other forms of sexual dysfunction should ask patients about their use of pornography, and potentially recommend abstention, said Matthew Christman, MD, a urologist at the Naval Medical Center San Diego, California.
“The latest version of the Diagnostic Statistical Manual of Mental Disorders has added internet gaming disorder. Internet porn has been shown in studies to be more addictive than internet gaming,” so it doesn’t seem to be much of a stretch to add something related to internet pornography use, said Dr Christman at a press briefing here at the American Urological Association (AUA) 2017 Annual Meeting.
A 2014 US armed forces health surveillance survey found that rates of erectile dysfunction had more than doubled during the preceding decade, from about 6 per 1000 person-years to about 13 per 1000 person-years, he reported. This increase was primarily accounted for by an increase in the incidence of psychogenic, rather than organic, erectile dysfunction, and coincided with the growth of pornography on the internet.
Web sites dedicated to pornography videos were first identified in 2006, “and soon after that, Kinsey Institute researchers became the first group to really identify what they describe as ‘pornography-induced erectile dysfunction,’ ” said Dr Christman.
Various research groups have postulated that sexual behavior acts on the same circuitry in the brain as addictive substances, and that internet pornography is a particularly strong stimulus of that circuitry. It is postulated that internet pornography increases sensitivity to pornographic cues and decreases sensitivity to normal stimuli, he explained.
Probably not a shocker, but men viewed pornography more than women. Dr Matthew ChristmanTo see whether there is a correlation between addiction to pornography and sexual dysfunction, Dr Christman and coauthor Jonathan Berger, MD, also from the Naval Medical Center San Diego, used an anonymous survey that included questions about sexual function, preferences, and pornography use, as well as the usual demographic and medical history questions.
The survey was offered to 20- to 40-year-old patients who presented to their urology clinic.
A total of 439 men received questionnaires, and 314 (71.5%) responded. In all, 71 women were given the surveys, and 48 (68%) responded. The majority of both male and female responders were active-duty military (96.8% and 58%, respectively).
Men were evaluated for sexual function with the International Index of Erectile Function 15-item questionnaire, and women with the validated Female Sexual Function Index. Addiction to pornography was measured by two validated instruments: the Pornography Craving Questionnaire and the Obsessive Passion Scale.
“Probably not a shocker, but men viewed pornography more than women,” Dr Christman said.
Among men, 81% reported viewing pornography at least some of the time compared with 38% of women ( P ≤ .001)
There were no significant differences in the duration of pornography episodes, with the majority of both men and women reporting they used it for 15 minutes or less at a time.
Preferred sources for pornography were also similar for men and women, with internet porn on computers being the most common, followed by internet porn on telephones. Women reported using books more frequently than men.
In all, 27% of male respondents had sexual dysfunction, as defined by an International Index of Erectile Function score of 25 or less, and 52% of females had sexual dysfunction, as defined by a Female Sexual Function Index score of 26.55 or less.
When they looked at correlations between erectile dysfunction and preferences for pornography in men, the investigators found that the rate of dysfunction was lowest among the 85% of respondents who reported preferring intercourse without pornography (22%). The incidence of dysfunction increased in men who preferred intercourse with pornography (31%), and was highest among men who preferred masturbation with pornography (79%).
The finding was consistent across all five domains of the sexual dysfunction questionnaire: erection, orgasm, libido, intercourse satisfaction, and overall satisfaction.
There were no significant correlations between pornography use and sexual dysfunction in women, however.
Asked by Medscape Medical News whether a patient’s use of pornography mattered clinically, Dr Christman replied that mental health providers at his center who have treated patients for pornography addiction have observed resolution of sexual dysfunction once those patients were able to curtail their pornography use.
I think these investigators are characterizing something that is a real clinical entity. Dr Joseph Alukal“I think these investigators are characterizing something that is a real clinical entity,” said Joseph Alukal, MD, director of male reproductive health at New York University in New York City and moderator of the briefing in which the data were presented.
“This research represents a beginning to asking this question of how we identify these people and treat them,” he added.
“The clinical impact of erectile dysfunction is a common problem and a burdensome problem, so if this represents some subset of patients who have this common and burdensome problem, and we can treat them with an intervention as simple as ‘you should doing behavior X,’ that’s important,” he said in an interview with Medscape Medical News .
He routinely asks younger patients about pornography use and masturbation habits, and can confirm that for patients with a serious pornography habit, discontinuation can improve their sexual function, he said.
The study was internally supported. Dr Christman, Dr Berger, and Dr Alukal have disclosed no relevant financial relationships. Dr Christman stated that the views expressed in the presentation are those of the authors and do not reflect official policy or position of the US Navy, Department of Defense, or US government.
American Urological Association (AUA) 2017 Annual Meeting: Abstracts PD44-11 and PD69-12, Presented in a briefing May 12, 2017.
Written By: Neil Osterweil
Article Source: http://www.medscape.com/viewarticle/879982#vp_1
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Bone Density, Anemia Improve With Testosterone in Low-T Men
Study Highlights
- Snyder and colleagues:
- Study participants were men at least 65 years old with 2 serum testosterone results of less than 275 ng/dL.
- Men were randomly assigned to receive testosterone gel with titration to maintain serum testosterone levels commensurate with those of a young man, or placebo gel. The treatment period was 12 months.
- The main study outcome was BMD. Participants underwent BMD testing with quantitative computed tomography and dual energy x-ray absorptiometry of the spine and hip at baseline and at 12 months.
- 211 men participated in the trial. The mean age of participants was 72.3 years, and the baseline mean testosterone level was slightly more than 230 ng/dL.
- vBMD increased in the testosterone group by a mean of 7.5%, compared with an increase of only 0.8% in the placebo group ( P <.01).
- Measurements of hip trabecular and peripheral vBMD were also superior in the testosterone group vs the placebo group.
- Testosterone appeared more effective in increasing trabecular vs peripheral BMD, and in improving BMD in the spine vs the hip.
- 19 fractures were reported during the treatment year and 1 year after the treatment period, with no evidence of a difference in fracture rates in comparing the testosterone group vs the placebo group.
- Roy and colleagues:
- The study was conducted as a double-blind, placebo-controlled trial among men 65 years or older. All participants had a serum testosterone level of less than 275 ng/dL.
- Men were randomly assigned to receive testosterone gel with titration to maintain serum testosterone levels commensurate with those of a young man, or placebo gel. The treatment period was 12 months.
- There were 788 men in the study, of whom 126 were anemic, as defined by a hemoglobin level of 12.7 g/dL or lower. Approximately half of men with anemia had no known cause for anemia.
- The main study outcome was the effect of testosterone therapy on hemoglobin levels among men with anemia.
- The mean age of participants was 74.8 years, and the mean serum testosterone level among men with anemia was 222 ng/dL at baseline.
- 54% of men with unexplained anemia who were treated with testosterone experienced an increase in hemoglobin levels of 1.0 g/dL or more, compared with only 15% of men with similar anemia treated with placebo (adjusted OR, 31.5; 95% CI, 3.7-277.8).
- 58.3% of men treated with testosterone experienced resolution of their anemia, compared with 22.2% of men treated with placebo.
- Testosterone also raised hemoglobin levels vs placebo among men with a known cause of anemia.
- Hemoglobin levels increased past 17.5 g/dL in 6 men without anemia at baseline.
Clinical Implications
- A retrospective cohort study by Cheetham and colleagues finds that testosterone therapy among men with evidence of testosterone deficiency is associated with lower risks for cardiac disease and cerebrovascular disease, even among men older than 65 years and those with preexisting cardiovascular disease.
- Two new studies demonstrate that testosterone treatment can correct anemia and improve BMD among men with low testosterone levels at baseline.
- Implications for the Healthcare Team: The current studies further demonstrate potential benefits of testosterone therapy among men with testosterone deficiency. Testosterone therapy was also associated with a lower risk for cardiovascular events in one study. Nonetheless, clinicians should continue to perform shared decision making regarding testosterone therapy and apply this treatment only among men with established testosterone deficiency.
Article Source: http://www.medscape.org/viewarticle/876307
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Shift Work Throws Urologic Health Off Schedule
Nonstandard shifts and a circadian rhythm disturbance known as shift work sleep disorder contribute to a significant increase in urinary tract symptoms and reproductive problems, according to three studies conducted at the Baylor College of Medicine in Houston.
“A 45-year-old shift worker with shift work sleep disorder might look like a 75-year-old man in terms of his lower urinary tract symptoms,” John Sigalos, a medical student and investigator on one of the studies, said here at the American Urological Association 2017 Annual Meeting.
The other studies presented demonstrate that male shift workers with shift work sleep disorder have lower testosterone levels and more hypogonadal symptoms than daytime workers, and that infertile shift workers, especially those who work rotating shifts, have significantly worse semen parameters than infertile men who work the day shift.
In the United States, approximately 15% of the labor force works late-night or rotating shifts.
Lower Urinary Tract Symptoms Study
To determine the effect of poor sleep quality and shift work on lower urinary tract symptoms, Sigalos and his colleagues retrospectively reviewed the medical records of men treated at the Baylor andrology clinic from 2014 to 2016.
All the men had completed the International Prostate Symptom Score (IPSS) to evaluate lower urinary tract symptoms, completed questionnaires about work schedules and sleep disorders, and had blood samples taken.
Of the 2487 participants, 766 (30.8%) reported working nonstandard shifts in the previous month and, of these, 36.8% were considered to be at high risk for sleep disorders.
Mean IPSS score was higher in shift workers with sleep disorders than in shift workers without, and daytime workers (7.77 vs 5.37 vs 6.84; P < .0001 between all groups).
IPSS scores were 3.1 points lower in shift workers with sleep disorders than in shift workers without, after age, comorbidities, and testosterone levels were controlled for ( P = .0001).
These findings suggest that poor sleep quality — rather than shift work itself — contributes to the increase in lower urinary tract symptoms. Patients at risk for shift work sleep disorder should be screened for lower urinary tract symptoms and counseled about the risk, Sigalos told Medscape Medical News.
Hypogonadism Study
The potential for hypogonadal symptoms and sexual dysfunction was examined by another group of Baylor investigators who used the same cohort of men.
On multivariable analyses that controlled for age, Charlson comorbidity score, and testosterone levels, mean scores on the quantitative Androgen Deficiency in the Aging Male (qADAM) questionnaire were 0.8 points lower in nonstandard shift workers than in daytime workers ( P < .01). And mean qADAM score was 3.9 points lower in shift workers at high risk for sleep disorders than in shift workers at low risk ( P < .01).
In addition, there was an independent association between high risk for shift work sleep disorder and lower testosterone levels after age, comorbidities, and history of testosterone supplementation were controlled for ( P < .01).
Semen Parameters Study
The effects of shift work and sleep quality on semen parameters and reproductive hormones in men were assessed in a prospective study by Taylor Kohn, MD, and his colleagues.
The study participants — 75 infertile shift workers, 96 infertile nonshift workers, and a control group of 26 fertile men — completed questionnaires about shift work and sleep quality, and underwent semen analysis and hormone testing.
Sperm density was significantly lower in infertile shift workers than in infertile nonshift workers ( P = .012), as were total motile counts ( P = .019) and testosterone levels ( P = .026).
However, the differences in sperm motility, forward progression measures, luteinizing hormone levels, and follicle-stimulating hormone levels were not significant.
All semen parameters were significantly lower in the infertile shift workers than in the fertile control group, and luteinizing hormone and follicle-stimulating hormone levels were significantly higher. Testosterone levels were about the same in the two groups.
On linear regression that controlled for age, Charlson comorbidity index, tobacco use, and average income, there was a significant negative association between total motile count and shift work ( P = .039), and a significant positive association between total motile count and previous fertility ( P = .041).
In addition, total motile counts were significantly lower in men who worked rotating shifts than in those who worked fixed shifts ( P < .05).
The type of job shift workers performed also made a difference. Men who performed physical labor in environments where chemical use was common (such as oil fields and refineries) had significantly lower total motile counts than physical laborers without chemical exposure, medical workers, white-collar workers, and first responders ( P < .05).
Sleep satisfaction also seemed to play a role. “When assessing reported overall sleep amounts in the previous month, follicle-stimulating hormone and testosterone levels trended downward as men became more unsatisfied with the amount of sleep they were getting,” Dr Kohn reported.
Thinking Beyond the Prostate
It is important for urologists to think beyond the prostate when treating men with lower urinary tract symptoms or sexual dysfunction, said Howard Adler, MD, clinical associate professor of medicine at the Stony Brook University School of Medicine in New York.
When men present with symptoms like those reported in these studies, clinicians need to consider not only prostate-related symptoms, but also age-related changes in bladder function, renal function, and other medical conditions, such as diabetes, he told Medscape Medical News.
At Stony Brook, Dr Adler explained, he and his colleagues have begun “asking patients about sleep habits and snoring, and are sending them for sleep studies to see if they have apnea or something else, especially patients with a lot of night-time urination.”
The studies were supported by the Baylor College of Medicine. The authors and Dr Adler have disclosed no relevant financial relationships.
American Urological Association (AUA) 2017 Annual Meeting: Abstracts MP13-12 and PD13-08 presented May 12, 2017; Abstract MP91-06 presented May 16, 2017.
Written By: Neil Osterweil
Article Source: http://www.medscape.com/viewarticle/880096#vp_1
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Gout Patients Should Be Screened for Erectile Dysfunction
Erectile dysfunction (ED) is common and often severe in men suffering from gout, according to the results of a cross-sectional survey of men who presented to a rheumatology clinic.
“These results strongly support the proposal to screen all men with gout for the presence of ED. Increasing awareness should in turn lead to earlier medical attention and treatment for this distressing condition,” said lead author Naomi Schlesinger, MD, chief, Division of Rheumatology, and professor of medicine at Rutgers–Robert Wood Johnson Medical School, in New Brunswick, New Jersey.
The results of the study were presented here at the European League Against Rheumatism (EULAR) Congress 2014.
The most common inflammatory arthritis in men older than 40 years, gout is caused by deposits of urate crystals in the joints and is associated with uricemia. The crystals cause inflammation, pain, and swelling, and the inflammatory component of the disease is linked to risk factors for cardiovascular disease and coronary artery disease.
The cross-sectional study included 201 men aged 18 to 89 years who presented at a rheumatology clinic between August 2010 and May 2013. Of these, 83 had gout.
Participants filled out a Sexual Health Inventory in Men (SHIM) questionnaire, which evaluates the ability to have an erection, the firmness of the erection, the ability to penetrate sufficiently for sexual intercourse, and sexual satisfaction. A score of ≤21 indicates ED; a score of ≤10 indicates severe ED.
“Men don’t usually volunteer sexual complaints,” said Dr. Schlesinger. “The gout patients in our study were generally delighted and grateful that someone finally asked them about ED.”
The mean SHIM score for all participants was 16.88. Patients with gout had a mean SHIM score of 14.38 compared with 18.53 in patients without gout ( P < .0001).
A significantly greater percentage of patients with gout had ED compared with patients without gout (76% vs 52%, P = .0007). Also, significantly more men with gout had severe ED vs men without gout (43% vs 30%, P = .007).
The presence of ED was significantly more frequent in gout patients aged 65 years or older, compared with men of the same age without gout ( P = .0001), and was significantly more likely to be severe ( P = .0002).
A multivariate analysis adjusted for age, hypertension, low-density cholesterol level, glomerular filtration rate, obesity, and depression found that the association between gout and ED was statistically significant ( P = .0096).
Silent Coronary Artery Disease
“It is estimated that 1 in 5 men who present with ED have silent coronary artery disease. A man with ED, even with no cardiac symptoms, is a cardiac patient until proven otherwise,” said Dr. Schlesinger. “Perhaps we could say that the 3 ‘EDs’ are related: endothelial dysfunction leads to erectile dysfunction leads to early death.“Gout patients who present with ED have an increased rate of cardiovascular risk factors and concomitant silent coronary artery disease and should be evaluated,” she added.
Maya Buch, MD, from the Leeds Institute of Rheumatology and Musculoskeletal Medicine, at the University of Leeds, United Kingdom, praised the authors of this study for providing new information on these conditions with overlapping risk factor — gout and cardiovascular disease.“These patients are at risk for cardiomyopathies, and there is no literature on ED and gout. We know that patients with gout have multiple comorbidities, and it’s clear that rheumatologists need to address that,” she explained.“I was surprised at how many patients with gout have ED. In addition to treating hyperuricemia in our patients with gout, we need to pay attention to cardiovascular risk factors. I hope that this study makes doctors more receptive to evaluating patients for ED,” she added.
Dr. Schlesinger has disclosed no relevant financial relationships. Dr. Buch has received honoraria and consulting fees from AbbVie, Bristol-Myers Squibb, and Roche-Chugai and has a research grant from Pfizer, Inc.
European League Against Rheumatism (EULAR) Congress 2014: Abstract OP0135. Presented June 13, 2014.Written By: Alice Goodman
Article Source: http://www.medscape.com/viewarticle/826773
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Exercise can boost brain power, prevent heart damage
Looking for a magic elixir for health? There’s more evidence exercise may be it, improving thinking skills in older adults and protecting against heart damage in obese people, two separate studies published Monday show.
“Exercise has many, many benefits. … I don’t know that we fully understand why it has so many beneficial effects for so many organs and systems,” Dr. Roberta Florido, a cardiology fellow at the Johns Hopkins Hospital, told TODAY, as she listed some of the other known benefits, including improving depression, lowering blood pressure and strengthening muscles.
“We should do a better job of telling our patients to exercise,” she added.
In the first paper, published in the British Journal of Sports Medicine, researchers at the University of Canberra in Australia analyzed 39 previous studies looking into the effect of exercise on thinking skills in people over 50. That included things like memory, alertness and the ability to quickly process information.
They found physical activity improved all of those skills regardless of a person’s cognitive status.
The key was 45-60 minutes of moderate to vigorous exercise per session “on as many days of the week as feasible.” A combination of both aerobic exercise and resistance training worked best.
Each type of exercise seemed to have different effects on the factors responsible for the growth of new neurons and blood vessels in the brain, said co-author Joe Northey, a PhD student at the University of Canberra Research Institute for Sport and Exercise.
Tai chi was also helpful, though more evidence is needed to confirm this effect, the researchers note.
“Age is a risk factor no one can avoid when it comes to cognitive decline,” Northey said. “As our study shows, undertaking just a few days of moderate intensity aerobic and resistance training during the week is a simple and effective way to improve the way your brain functions.
Written By: A. Pawlowski
Article Source: http://www.today.com/health/exercise-can-boost-thinking-skills-protect-against-heart-damage-t110740
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Understanding Inflammation
Inflammation has been found to be an underlying cause in many diseases, making it a hot topic in the health media. But what do we really know about chronic inflammation and its effects on the body?As scientists have searched for the mysteries behind the diseases most likely to afflict us, they have alighted on one factor common to virtually all of them: inflammation. Chronic inflammation, headlines now regularly state, has a role in a host of common and often deadly diseases, including Alzheimer’s, arthritis, cancer, diabetes, heart disease, and possibly even depression.
Unsurprisingly, this news brings with it a raft of self-proclaimed remedies purporting to fight inflammation. Diets, herbs, supplements, and exercise regimens have flooded the market with promises to keep inflammation in check and improve overall health.
But is there evidence that over-the-counter products or sweeping lifestyle changes will reduce inflammation’s damaging effects? Scientists caution that despite its current high profile, inflammation remains a mystery. “Basic science hasn’t yet answered the major questions about inflammation,” says Michelle Petri, a rheumatologist and a director of the Johns Hopkins Lupus Center. Researchers like Petri have been studying low-level inflammation as a culprit in a number of diseases for decades. What they have discovered has led to an emerging understanding of how lifestyle choices—like diet, dental health, and exercise—may influence inflammation and its potentially damaging downsides.
Despite its current high profile, Petri says, inflammation remains a mystery.
Inflammation is a vital part of the human immune system. When harmful bacteria or viruses enter your body, when you scrape or twist your knee, the body’s defense system kicks into high gear. Chemicals ramp up the body to fight, bathing the damaged area with blood, fluid, and proteins; creating swelling and heat to protect and repair damaged tissue; and setting the stage for healing.
Sentinel cells first alert the immune system to the presence of invaders. Another set of cells releases chemicals that signal the capillaries to leak blood plasma, which surrounds and slows down trespassers. Another group of sentinels, called macrophages, releases cytokines, which are specialized germ fighters. Immunizing B- and T-cells join in, destroying both the pathogens and the tissues they have damaged. Finally, a last wave of cytokines is released to end the job and signal the immune system that its work is done. Its mission completed, the immune system calls off its dogs.
When our body’s powers of correction go wrong, however, they can work against us. Think of the acute heat and swelling that protect us during a normal immune response—a fever, or the redness and pain that surround a new injury, for example—and you can get a hint of what chronic inflammation is. Unlike the inflammation that follows a sudden infection or injury, the chronic kind produces a steady, low level of inflammation within the body that can contribute to the development of disease. It’s the result, in part, of an overfiring immune system. Low levels of inflammation can get triggered in the body even when there’s no disease to fight or injury to heal, and sometimes the system can’t shut itself off. Arteries and organs break down under the pressure, leading to other diseases, including cancer and diabetes.
Scientists don’t fully understand how the immune system becomes short-circuited, but they have long known that some diseases, such as lupus and rheumatoid arthritis, emerge after the immune system has gone awry and attacked healthy tissue. Increasingly, as Americans and other Westerners live longer and get larger (35 percent of Americans are obese), researchers have also found that low-level immune responses triggered by extra weight and a lack of exercise can contribute to the development of other illnesses.
“For a long time, we had the idea that inflammation was involved in certain autoimmune diseases, but now we’re seeing this lower level of inflammation in people who are obese and people who are sedentary,” says Kimberly Gudzune, a physician at Johns Hopkins and a clinical researcher who focuses on obesity. “We see a link between obesity and some diagnostic markers for inflammation, but we don’t know what causes them. We worry that there’s something brewing for these people, that they are at higher risk for heart disease, cancer, and diabetes.”
‘We see a link between obesity and some diagnostic markers for inflammation, but we don’t know what causes them. We worry that there’s something brewing for these people, that they are at higher risk for heart disease, cancer, and diabetes.’
Researchers have discovered that fat cells can trigger the release of a steady, low hum of cytokines that, in lieu of an invader to attack, go after healthy nerves, organs, or tissues. As we gain weight, the release becomes prolific, affecting our body’s ability to use insulin, sometimes leading to type 2 diabetes.
They have also learned that inflammatory cells can have an effect elsewhere in the body—for example, chronically infected and inflamed gums in the mouth can cause damage that leads to heart attack and stroke. And they know that inflammation contributes to congestive heart failure and uncontrolled hypertension, and that it somehow has a role in the tangled cells that are the hallmarks of Alzheimer’s disease.
Researchers continue to find answers about how inflammation contributes to cancer. Inflammatory cells produce free radicals that destroy genetic material, including DNA, leading to mutations that cause cells to endlessly grow and divide. More immune cells are then called in, creating inflammation that feeds the growth of tumors.
The link between inflammation and cancer can sometimes be direct. When too much stomach acid—a feature of the immune system that evolved to fight foodborne bacteria—creeps up the esophagus, it causes inflammation and chronic heartburn. Extended exposure to this acid changes the nature of the cells lining the esophagus, increasing the risk of cancer.
In colon cancer patients, certain communities of bacteria associated with diarrhea can create cancer with help from inflammatory cytokines. Cells protected by mucus can become inflamed when that mucus wall is breached by bacteria, says Cynthia Sears, a doctor who specializes in infectious disease research at Johns Hopkins. “The lining in the colon makes peptides”—short chains of amino acids that act to protect the lining of the organ—“to thwart bacteria. If there aren’t enough peptides, bacteria can get a foothold, which means even more bacteria,” Sears says. As inflammation ramps up to fight it, so does the risk of cancer.
If inflammation is the behind -the-curtain factor in so many diseases, what can we do to keep it at bay? Researchers admit that they’re still figuring this out.
Petri has studied lupus for more than three decades and has been investigating the effects of chronic inflammation. “Lupus is basically friendly fire,” Petri explains. “We can’t get the immune system to calm itself down.”
Treating chronic inflammation, whether for lupus or other chronic ailments, is a challenge. Researchers have an idea that inflammation exists as part of a self-reinforcing loop system. If they could figure out how to interrupt or reverse one stage in that loop, then they might be able to develop drugs to stop it. But how do you tone down the immune response enough to control the inflammation but not so much that a body can’t fight disease? “We’ve done 20 to 25 years of clinical trials on lupus drugs,” Petri says, by way of example. “We’ve had maybe one success and 30 failures.”
Finding a drug that both interrupts the immune cycle and maintains a healthy immune response is important not just for people battling illness but for all of us as we age.
Currently, there are no prescription drugs that specifically target chronic inflammation. (There are, of course, over-the-counter medications that treat the minor and temporary inflammation and accompanying pain caused by injuries or procedures, such as surgery. These are not meant to treat chronic inflammation.) Some drugs, such as hydroxychloroquine, once used to battle malaria, are useful in treating some lupus patients, but they don’t cure the disease. Aspirin and statins have shown promise in reducing inflammation in some people, but researchers aren’t sure how broadly useful such drugs are in that role. With the exception of far-from-perfect anti-inflammatory drugs, such as prednisone, a corticosteroid that brings with it a slew of side effects, scientists are still researching how best to contain inflammation. “We need something that can work broadly and quickly, and without a lot of side effects,” says Petri.
Finding a drug that both interrupts the immune cycle and maintains a healthy immune response is important not just for people battling illness but for all of us, because as we age, inflammation increases in the body. Scientists aren’t sure how and why, but interestingly, the study of HIV is offering some insight.
HIV triggers chronic inflammation in the body, even after medications have rendered levels of the virus undetectable in blood tests. Certain cytokines involved in that inflammation process can profoundly decrease testosterone levels, leading to muscle loss. “It’s possible that the chronic inflammation in people with HIV is similar to the chronic inflammation we see in aging,” says Todd Brown, an endocrinologist who researches the link between bodily markers for inflammation and chronic diseases found in people with HIV. If researchers can understand that process and create treatments to disrupt it in people with HIV, they could potentially translate their findings into treatments for similar muscle loss in aging.
Jeremy Walston is a Johns Hopkins geriatrician who investigates immune system response and muscle function in the elderly. He has been searching for markers that highlight the early signs of inflammation. Some blood tests for inflammation markers exist, but the researchers have uncovered two new markers that they believe may predict mortality and mark signs of late-in-life decline. “These are powerful inflammatory molecules that, when chronically expressed, lead to declines in stem cells and a remodulation of the immune system,” says Walston. “They also contribute to cell death,” particularly in the elderly, he says.
As the quest for diagnostic measures and therapies continues, researchers point to simple lifestyle measures we can all take to help prevent chronic inflammation. Scientists are skeptical of cure-all claims found in the new crop of anti-inflammation diet books, but they do recommend dropping pounds (and the harmful fat cells that come with obesity) and avoiding the now common American diet high in fats and sugars.
“Losing weight can have profound effects on lowering inflammation,” says Brown, who adds that eating a diet rich in fruits and vegetables and low in fats, processed foods, and sugars is generally a good idea, though more study needs to be done to determine how it might affect inflammation. Exercising, which causes an acute inflammatory response in the short term, but an anti-inflammatory one when we regularly get moving, is another strong step to take, he adds.
For most of us, keeping inflammation in check comes down to common sense basics: eat well, don’t smoke, get moving, get more rest, and see your doctor for regular physicals, which could help stop chronic inflammation before it becomes rampant.
Other researchers advise getting plenty of sleep, lowering stress levels, and seeking out treatment for inflammation-inducing culprits, such as gum disease and high cholesterol levels. Avoid contact with heavy metals such as mercury, which is found in dangerous amounts in some large fish, and limit exposure to substances, such as diesel exhaust and cigarette smoke, that can set off the immune system. Additional studies by Brown and his colleagues have also shown some advantage in increasing our intake of omega-3 fatty acids and vitamin D, though more research is needed.
Walston and others caution against popping dietary supplements touted as anti-inflammatory cures. Some so-called remedies, such as turmeric, taken in large amounts, may actually be toxic to the liver and other organs.
For most of us, keeping inflammation in check comes down to common sense basics: eat well, don’t smoke, get moving, get more rest, and see your doctor for regular physicals, which could help stop chronic inflammation before it becomes rampant. “All of the things our grandmothers told us were good for us are actually good for us,” says Brown. “Until we have a more nuanced understanding of what inflammation does, that’s what we have to fall back on.”
Written By: Michael Anft
Article Source: http://www.johnshopkinshealthreview.com/issues/spring-summer-2016/articles/understanding-inflammation
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Benefits of Sermorelin w/GHRP2 in the First Six Months
Sermorelin and GHRP2 both stimulate the patient’s own pituitary gland by binding to specific receptors that increase production and secretion of endogenous Human Growth Hormone (HGH). GHRP2 also acts as an appetite suppressant allowing for increased weight loss.
First Month
Weight loss/Body fat reduction
Vivid dreams
Better, sounder sleep
Improved stamina
Optimistic attitude
Second Month
Improved muscle tone
Increased strength
Improved skin tone
Improved nail growth
Better digestion
Weight loss/Body fat reduction
Improved vision
Enhanced sexual function
Third Month
Improved mental process
Enhanced productivity
Faster wound healing
Hair re-growth
Increased libido
Increased muscle size
Faster recovery from muscle soreness
Reduced PMS symptoms
Greater body flexibility
Reduced pain
Fourth Month
Heightened improvements with all of the above
At times improvements may seem to diminish or plateau
Rejuvenation is still a process. Benefits should resume with continued improvements
Fifth Month
Improved weight loss and reduction of inches
Improved skin texture and appearance
Skin thickening and greater elasticity
Reduction of skin wrinkles
Thickening of hair with a shiny, healthy appearance
Continuation of improved muscle tone
Sixth Month
Diminished cellulite
Improved resistance to colds, flu and other illnesses
Improved eyesight
Healing of old wounds
Disappearance of pain and soreness
Improved body contour
Contact us today for more information on Sermorelin/ghrps
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