Bloodless management of benign prostatic hyperplasia: medical and minimally invasive treatment options

Benign prostatic hyperplasia (BPH) is a medical condition affecting a wide range of the aging male population resulting in various degrees of lower urinary tract symptoms (LUTS). Today, a variety of medical therapies and minimally invasive BPH treatment modalities are available. Medical therapy includes α₁ blockers, 5α reductase inhibitors and combination therapy. When these options fail, surgery is indicated. Transurethral resection of the prostate (TURP) is still considered the gold standard surgical treatment for BPH. Nevertheless, numerous minimally invasive treatment alternatives are available that are comparable in effectiveness to TURP, with significantly less morbidity. In this article, current treatment options for BPH are reviewed with respect to their indications, long-term safety and efficacy in relieving BPH related LUTS. The selection of the type of BPH treatment should be based on the physician's experience, patient's co-morbidities as well as the prostate size and clinical disease progression.     

Administration of daily 5 mg tadalafil improves endothelial function in patients with benign prostatic hyperplasia

Introduction: Tadalafil is a promising phosphodiesterase (PDE) 5 inhibitor prescribed for erectile dysfunction (ED). Daily low dose (5?mg) of tadalafil has also been used for the treatment of male lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH). PDE5 inhibitors induce relaxation of smooth muscle cells in the urethra, prostate, bladder neck, and blood vessels. The aim of this study was to investigate the efficacy of tadalafil on vessels endothelial function, in patients with male LUTS symptoms associated with BPH.

Methods: The Institutional Review Board (IRB) approved this clinical study and informed consents had been obtained from 81 BPH patients.

The following male LUTS parameters: international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), voiding volume, max and mean voiding flow on voiding flowmetry examination and post-voiding residual urine (RU) were compared at 0, 1, 3, 6, and 12 months after a daily dose of 5?mg tadalafil.

In addition, erectile function was evaluated by the sexual health inventory for men (SHIM) score and vessels endothelial function and peripheral neuropathy were assessed by the brachial-ankle pulse wave velocity (baPWV), ankle brachial index (ABI), and vibration perception threshold (VPT) at 0, 3, 6, and 12 months after treatment.

Results: The mean age of 81 patients was 66.4?±?11.4 years old. Their prostate size was 30.2?±?22.1?ml.

Male LUTS parameters including IPSS, OABSS, and RU showed significant improvement from 1 to 12 months after tadalafil administration. Max and mean voiding flow was significantly increased at 6 months after tadalafil treatment.

The SHIM score showed significant improvement after 3 months. Whilst, the results of baPWV also showed significant improvement from 3 to 12 months. ABI was also significantly improved at 6 months. However, there was no change in the VPT at any time point.

Conclusions: Tadalafil is effective for both male LUTS and ED. It is also shown that tadalafil improves baPWV, which we can conclude that higher vessels elasticity has been obtained. This major finding of this study shows that tadalafil has the potency to improve vessels endothelial dysfunction in patients with BPH.     

Evaluation of quality of life in patients undergoing surgery for benign prostatic hyperplasia

Abstract

Introduction: Benign prostatic hyperplasia (BPH) is one of the most common diseases in the world and also one of the most common causes of urinary complaints that occur with increasing age. Thus, BPH should be addressed with surgical procedures. To contribute to the relevant literature, the present study aims to investigate the effects of surgical therapies for BPH on the patients quality of life.

Materials and methods: This study included 120 patients who underwent surgery for BPH at a Training and Research Hospital. The short-form health survey (SF-36) was administered to the patients before the surgery and at three months after the surgery. Eight parameters of the SF-36 and mental (MCS) and physical (PCS) component summary scores were calculated. The Student’s t-test, Wilcoxon, and chi-square test were used in the statistical analysis.

Results: When the eight parameters within the SF-36 health questionnaire were examined separately, the findings showed that patients quality of life increased significantly with respect to physical functioning, social functioning, and role limitations because of emotional problems , vitality, bodily pain, general health perceptions, and mental health domains three months after surgery (p?<?.001). The PCS and MCS significantly increased after surgery (p?<?.001).

Conclusion: The SF-36 questionnaire results showed that a significant improvement in the patients quality of life was observed in patients who underwent surgery for BPH. Our findings suggest that SF-36 could be considered a reliable evaluation test to be used in the patients with BPH after surgery.     

International female students’ experiences of navigating the Canadian health care system in a small town setting

Abstract

This pilot study explored the international female (IF) students’ (n = 17) lived experiences of health care accessibility while studying in a small town in Canada. Analysis guided by a phenomenological method resulted in three major themes – (1) after arriving to attend university, IF students experienced challenges in staying healthy, such as learning how Canadian medical insurance works and how to access medical help, (2) IF students developed a support system over time, consisting of their university’s student advisors, host families and friends and (3) as IF students became familiar with living in Canada, they developed self-directed care strategies such as taking care of each other if they became sick. They also became comfortable reaching out through social media to ask questions and connect with others who were also new to Canada. Recommendations included providing (1) alternative times for IF students to access medical care on campus, (2) a fund where IF students could borrow the upfront costs to see a doctor and (3) health care knowledge dissemination through various media throughout the school year. The outcomes of this study are generally encouraging and may assist IF students to make effective health care decisions while in Canada resulting in a less stressful academic experience.     

The association between triglyceride high density lipoprotein cholesterol ratio and benign prostate hyperplasia in non-diabetic patients:a cross-sectional study

Objectives: To assess the association between triglyceride (TG)/high density lipoprotein (HDL) ratio and benign prostate hyperplasia/lower urinary tract symptoms (BPH/LUTS).

Methods: Four hundred patients who were admitted to the Urology Clinic between January and December 2014 with complaints of BPH/LUTS were enrolled in this cross-sectional study. Patients were divided into two groups according to their International Prostate Symptom Score and prostate volume (PV). They were compared in terms of age, body mass index (BMI), PV, PSA, post micturional residual volume, uroflowmetry Q max value, fasting blood sugar, TG and high density lipoprotein-cholesterol (HDL-C) level and TG/HDL ratio.

Results: Although univariate analyses reveal that age, BMI, waist circumference (WC), FBS, TG, HDL-C level, and TG/HDL ratio were correlated with PV, only age [1.125 OR (1.088–1.164), p?=?.00001], BMI [1.119 OR (1.040–1.204), p?=?.003], TG [(1.043 OR (1.016–1.071), p?=?.002], HDL-C [(0.923 OR (0.860–0.990), p?=?.025], and TG/HDL ratio [(1.224 OR (1.130–1.315), p?=?.014] were statistically significant in multivariate analysis. The calculated area under the curve (AUC) for PV of 30?ml, 40?ml, and 50?ml was 0.668 (0.608–0.727), 0.617 (0.561–0.673), and 0.592 (0.530–0.654), respectively.

Conclusions: Our results indicate that the TG/HDL ratio correlates with enhancement in PV. Further studies are warranted to better evaluate this relationship.     

Androgen replacement therapy contributes to improving lower urinary tract symptoms in patients with hypogonadism and benign prostate hypertrophy: a randomised controlled study

Purpose.?We performed a randomised controlled study regarding the effects of androgen replacement therapy (ART) on lower urinary tract symptoms (LUTS) in hypogonadal men with benign prostate hypertrophy (BPH).

Methods.?Fifty-two patients with hypogonadism and BPH were randomly assigned to receive testosterone (ART group) as 250?mg of testosterone enanthate every 4 weeks or to the untreated control group. We compared International Prostate Symptom Score (IPSS), uroflowmetry data, post-voiding residual volume (PVR) and systemic muscle volume at baseline and 12 months after treatment.

Results.?Forty-six patients (ART group, n?=?23; control, n?=?23) were included in the analysis. At the 12-month visit, IPSS showed a significant decrease compared with baseline in the ART group (15.7?±?8.7 vs. 12.5?±?9.5; p?<?0.05). No significant changes were observed in the control group. The ART group also showed improvement in maximum flow rate and voided volume (p?<?0.05), whereas no significant improvements were observed in the controls. PVR showed no significant changes in either group. In addition, the ART group showed significant enhancement of mean muscle volume (p?<?0.05), whereas no significant changes were seen in the controls.

Conclusion.?ART improved LUTS in hypogonadal men with mild BPH.     

Treatment of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction

Abstract

This article summarizes years of challenging research on erectile dysfunction (ED), a condition that has an important social and cultural relevance. Preclinical and clinical research progress has led to new therapeutic approaches to ED in patients with different comorbidities and particularly in those with low urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). These goals were possible only by combined work of specialists and researchers of different and intertwined medical disciplines. Currently, tadalafil (5?mg/d) is the best choice; other phosphodiesterase-5 inhibitors (PDE5i) are not included among options, despite the growing evidence of therapeutic effects. Different regimens of tadalafil may be prescribed based on patient needs, severity of LUTS/BPH – ED profile, and clinical experience. An integrated approach is necessary to choose for a combined therapy with PDE5i and α-blockers following urological and cardiac counseling in terms of outcomes and adverse effects.     

Genetic variants in 5p13.2 and 7q21.1 are associated with treatment for benign prostatic hyperplasia with the α-adrenergic receptor antagonist

Background: The etiology of benign prostatic hyperplasia (BPH) has not been well established. The preferred medical treatment for many men with symptomatic benign prostatic hyperplasia is either an α-adrenergic receptor antagonist (α-blocker), or a 5α-reductase inhibitor. Single nucleotide polymorphism (SNP) is a powerful tool for successful implementation of individualized treatment.

Methods: Eighteen SNPs associated with drug efficacy in a Chinese population were genotyped in 790 BPH cases (330 aggressive and 460 non-aggressive BPH cases) and 1008 controls. All BPH patients were treated with α-adrenergic blockers for at least 9 months. We tested the associations between tagging single nucleotide polymorphism and BPH risk/aggressiveness, clinical characteristics at baseline, including the International Prostate Symptom Score (IPSS) and total prostate volume, and changes in clinical characteristics after treatment.

Results: There were nine SNPs associated with BPH risk, clinical progression and therapeutic effect. (1) There were nine tSNPs been chosen in CYP3A4, CYP3A5 and RANBP3L genes. (2) The SNP, rs16902947 in RANBP3L at 5p13.2 (p?=?.01), was significantly associated with BPH. (3) We found two SNPs, rs16902947 in RANBP3L at 5p13.2 (p?=?.0388) and rs4646437 in CYP3A4 at 7q21.1 (p?=?.0325), associated with drug effect. (4) Allele “G” for rs16902947 was found to be risk alleles for BPH risk (OR=?2.357, 95%CI 1.01–1.48). The “A” allele of rs4646437 was associated with lower IPSS at baseline (β=??0.4232, p=?.03255).

Conclusions: rs16902947, rs16902947 and rs4646437 single nucleotide polymorphisms are significantly associated with the clinical characteristics of benign prostatic hyperplasia and the efficacy of benign prostatic hyperplasia treatment.     

Efficacy and safety of orally disintegrating tamsulosin tablets in Taiwanese patients with benign prostatic hyperplasia

Objectives: Tamsulosin is an alpha-1 adrenoceptor antagonist applied in treating lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). This study aimed to evaluate safety, efficacy and acceptance of newly formulated orally disintegrating tamsulosin tablets in Taiwanese patients with LUTS/BPH. Methods: This single center, non-comparative, observational study enrolled 45 male patients over age 50 years. All patients received 0.2?mg tamsulosin orally disintegrating tablets daily and were evaluated at weeks 0, 4, 8, 12 of the 12-week treatment period. Tamsulosin efficacy was evaluated by International Prostate Symptom Score (I-PSS) with 7 questions on urinary symptoms and one disease-specific quality-of-life question, with scores ranging from 0 (no symptoms) to 35 (highly symptomatic). Maximum flow rate (ml/s), voided volume (ml), flow time (s), and mean flow rate (ml/s) were measured. Danish prostatic symptom sexual function scale rated severity and associated concerns of erection quality, ejaculatory function and pain/discomfort were also assessed. Results: Patients’ mean ± SD age was 62.47?±?7.77 (range: 50–89) and mean ± SD I-PSS was 13.98?±?5.50. Statistically significant changes from baseline were found in post-test I-PSS and quality of life (both P < 0.001). Mean ± SD I-PSS decreased from 14.30?±?9.34 to 6.73?±?0.88 at patients’ final visit. Statistically significant increases in mean maximum flow rate and mean flow rate were found over 12-week study period (P < 0.05). No adverse events were reported. No significant differences were found in pulse, SBP/DBP or sexual function. Conclusion: Orally disintegrating tamsulosin tablets demonstrate acceptable safety and efficacy for acceptance and well tolerance by Taiwanese LUTS/BPH patients.     

Does age affect the efficacy and safety of GreenLight HPS™ laser photoselective vaporization prostatectomy?

Background: To evaluate the efficacy and safety of GreenLight HPS^? (High Performance System) laser photoselective vaporization prostatectomy (PVP) for the treatment of benign prostatic hyperplasia (BPH) in patients of different age groups. Methods: 164 consecutive patients were stratified into two groups: age <70 (group I, n?=?93) and age ≥70 (group II, n?=?71) years. Transurethral PVP was performed using a GreenLight HPS? side-firing laser system. Voiding parameters were measured preoperatively and at 1 and 4 weeks and 3, 6, 12, 18, 24 and 36 months postoperatively. Results: Among the preoperative parameters evaluated, there were significant differences (p?<?0.05) in prostate volume (I: 58.7; II: 73.6?mL) and serum prostate-specific antigen (I: 1.9; II: 2.9?ng/mL), while American Urological Association Symptom Score (AUASS), Quality of Life (QoL), maximum flow rate (Qmax), Sexual Health Inventory for Men (SHIM) and post void residual (PVR) were similar (p?>?0.05) between groups. No significant differences in laser utilization, energy usage and operating time were noted. Clinical outcomes (AUASS, QoL, Qmax, PVR) showed immediate and stable improvement from baseline (p?<?0.05) within each group, but no significant differences between the two groups were observed during the follow-up period. The incidence of adverse events was low and similar in both groups. Conclusions: The results suggest that age has little effect on the efficacy and safety of GreenLight HPS? laser PVP.     

Use of thermobalancing therapy in ageing male with benign prostatic hyperplasia with a focus on etiology and pathophysiology

Introduction: We investigated if “thermobalancing” therapy (TT), using Dr Allen’s therapeutic device (DATD) in men with benign prostatic hyperplasia (BPH), can aid in understanding the etiology and pathophysiology of BPH.

Methods: We compared urinary and other parameters of BPH patients who received TT over 6 months (treatment group) with those of healthy volunteers who had not received the treatment (control group). Dynamics of symptoms and indicators in each group were evaluated in comparison with their data at the beginning and end of the study. Parameters were the International Prostate Symptom Score (IPSS) for urinary symptoms and quality of life (QoL), ultrasound measurement of prostate volume (PV) and uroflowmetry (maximum flow rate, Q_max). TT effectiveness was examined in 124 men with BPH and PV?<60?mL. We also investigated the data of five patients with BPH and PV?>60?mL.

Results: TT decreased urinary symptoms and PV, increased Q_max and improved QoL in men with BPH, PV?<60?mL, and in men with BPH, PV?>60?mL.

Conclusions: The present study demonstrated that TT is effective for BPH, suggesting that blood circulation plays a crucial role in its cause. The continuous heat exposure that does not exceed the normal body temperature terminates the trigger of BPH development, “micro-focus” of hypothermia, and the following spontaneous expansion of capillaries. TT could be considered to be a useful tool in BPH treatment.     

The effect of testosterone treatment on prostate histology and apoptosis in men with late-onset hypogonadism

Objectives: To investigate the effect of testosterone replacement therapy (TRT) on prostate histology and apoptosis in men with late-onset hypogonadism (LOH).

Methods: The study included 25 men, having LOH with prostate-specific antigen (PSA) level of 4?ng/ml or less. All patients underwent transrectal ultrasound guided prostate biopsy at baseline, and received testosterone undecanoate treatment for 1 year. Prostate biopsy was repeated at the end of 1 year of testosterone therapy. In addition to clinical and biochemical parameters, prostate histology and apoptotic index (AI) were compared before and after the TRT.

Results: The mean serum total testosterone significantly increased from 178.04?±?51.92 to 496.28?±?103.73?ng/dl (p?=?0.001). No significant differences were observed in serum total and free PSA level, prostate volume and maximal urinary flow rate. There were also no significant differences in AI, stroma/epithelial cells ratio, Ki-67 positive cells and atrophy score of prostate tissue before and after the TRT.

Conclusions: This study demonstrated that TRT did not affect serum PSA level, prostate volume and maximal urinary flow rate. This study also suggests that TRT does not cause the risk for prostate cancer development, because of no significant differences in prostate histology after TRT.     

Physician’s Listening and Adherence to Medical Recommendations among Persons with Diabetes

Every year, millions of people die of diabetes-related complications. Despite this risk, patients’ nonadherence to lifesaving medical recommendations remains a persistent crisis. One factor that could increase adherence is the formation of an alliance with the medical staff. This alliance, in turn, may increase when the patient perceives that the health care staff is willing to listen. To test this model, we asked people with diabetes, N = 76, to report (a) perceptions of listening by their nurse and physician, (b) their working alliance with the medical-staff members, and (c) several indicators of adherence with medical recommendations. The results suggested that listening is highly correlated with working alliance, r = .84, both with the nurse and the physician. Furthermore, both listening by the physician, r = .27, and alliance with the physician, r = .44, were associated with medication adherence. Listening by the physician, and alliance with the physician were not associated with adherence to life-style recommendations, but hinted at possible associations with glycemic control, r’s = .19, and .22, respectively. Our findings suggest that listening is an important facet of a working alliance, which in turn appears to positively affect the health of patients with diabetes.     

Association of elevated interleukin-17 and angiopoietin-2 with prostate size in benign prostatic hyperplasia

Introduction: Inflammation and angiogenesis are known to play a role in the development prostate tumors. The present study was designed to assess the levels of markers of inflammation and angiogenesis like interleukin-17 (IL-17) and angiopoietin-2 (ANGPT2) levels and their association with prostate size in patients with benign prostatic hyperplasia (BPH).

Materials and methods: 42 BPH cases and 42 controls were enrolled in the study. IL-17 and ANGPT2 were estimated in both the groups.

Results: IL-17 and ANGPT2 were significantly increased in BPH cases when compared with controls. Multivariate analysis showed that ANGPT2 predicts the prostate size in patients with BPH (R²?=?0.203, beta?=?0.355, p?=?0.028). Linear regression analysis showed that IL-17 was significantly associated with ANGPT2 in BPH cases (R^2?=^?0.129, beta – 0.359, p?=?0.020).

Conclusions: We conclude that IL-17 and ANGPT2 are elevated in BPH cases and ANGPT2 was associated with IL-17 and prostate size.     

Freshman year alcohol and marijuana use prospectively predict time to college graduation and subsequent adult roles and independence

Objective: This study examined how freshman year substance use prospectively predicted time to college graduation, and whether delayed graduation predicted postponed adoption of adult roles and future substance use. Participants: Participants were part of a longitudinal study that began in 2004. The first analyses focused on freshman year (N = 2,050). The second analyses corresponded to a subset of participants at age 27 (N = 575). Methods: Measures included self-reported substance use, adult role adoption, and university reported graduation dates. Results: Results indicated that frequent binge drinking and marijuana use during freshman year predicted delayed college graduation. Those who took longer to graduate were more likely to have lower incomes and were less likely to obtain a graduate degree. Taking 5–6 years to graduate was associated with greater likelihood of alcohol-related problems. Conclusions: Findings support the importance of interventions during freshman year of college to decrease substance use and promote timely graduation.     

Longitudinal changes in anthropometry and body composition in university freshmen

Objective: We investigated predictors of weight gain in college freshmen. Participants: A longitudinal cohort study followed a representative sample of freshmen (N = 264) from 8/2011 to 6/2012. Methods: Repeated measurements of anthropometry, dual-energy X-ray absorptiometry (DXA), physical activity, and diet were collected. We investigated predictors of 9-month weight gain using regression models. Results: 172 participants completed follow-up: 75% gained >0.5 kg. Mean weight change was +2.3 kg (SD 3.2) and +2.0 kg (SD 3.2) and mean adiposity change was +1.3% (SD 1.6) and +0.7% (SD 2.2) in men and women, respectively. In participants gaining >0.5 kg, weight increased 5.6% and body fat increased 1.6%. Anthropometric change in men occurred in the first semester, while women increased in both semesters. Leaner DXA-defined body composition at baseline was consistently associated with greater weight gain (p-values 0.029–0.049). Conclusions: Freshman weight gain is common and reflects increased adiposity. Leaner body composition at the beginning of college predicted greater weight gain in men and women during the first year of college.     

Comorbidities as predictors of incidental prostate cancer after Holmium laser enucleation of the prostate: diabetes and high-risk cancer

Prostate cancer can be diagnosed as an incidental finding during the pathological examination of benign prostatic hyperplasia (BPH) specimens by Holmium laser enucleation of the prostate (HoLEP). BPH and comorbidities such as hypertension, diabetes, and dyslipidemia often coexist in elderly people. We identified which comorbidities can be used to predict the presence of incidental prostate cancer, particularly high-risk cancer, in men who had undergone HoLEP. On the basis of pathological findings of HoLEP specimens, patients with incidental cancer were categorized as low-risk (Gleason ≤6 and T1a) or high-risk (all others). Of the 654 patients who underwent HoLEP, 41 patients (6.3%) were identified as having incidental cancer (25 low-risk and 16 high-risk). There were no significant factors for overall prostate cancers. However, a significantly higher frequency of diabetes was observed in patients with high-risk cancer compared to those with BPH (31% vs. 13%; p?=?.033). Logistic regression analysis using prostate-specific antigen (PSA) and prostate volume (PV), and smoking showed that diabetes was an independent predictor of high-risk cancer (odds ratio, 3.15; 95% confidence interval, 1.06–9.43). Diabetes may be an important predictor of the presence of high-risk prostate cancer in men with BPH who have undergone HoLEP.     

Gene expression of insulin receptor,insulin-like growth factor increases and insulin-like growth factor-binding protein-3 reduces with increase in prostate size in benign prostatic hyperplasia

Introduction: Although the role of insulin in the development of benign prostatic hyperplasia (BPH) is well established, there are no studies regarding alteration in the gene expression of components of insulin-signaling pathway and their association with prostate size in BPH. Hence, the study was designed to analyze the gene and protein expression of insulin receptor and its related components in patients with BPH.

Materials and methods: Twenty-seven BPH patients aged between 55 and 75 years were recruited in the study and prostatic tissues were obtained after transurethral resection of the prostate. Gene expression levels of Insulin receptor (IR), insulin receptor substrate (IRS), insulin-like growth factor (IGF) and insulin-like growth factor-binding protein-3 (IGFBP-3) were assessed by q-PCR.

Results: Insulin receptor (IR-A and B) and insulin-like growth factors (IGF-1 and IGF-2) gene expression were significantly increased and IGFBP-3 gene expression was reduced in BPH patients with larger prostate size. Also, serum insulin was significantly increased and IGFBP-3 was significantly reduced in patients with larger prostate size.

Conclusion: Increased expression of IR-A, B and IGF-1, 2 genes and reduced IGFBP-3 gene expression was associated with larger prostate size in BPH.     

Preventing diseases of the prostate in the elderly using hormones and nutriceuticals

The prostate has only one function, namely to secrete fluid containing substances that are needed for reproduction. This requires an extremely high concentration of androgens in the tissues. Benign prostatic hypertrophy (BPH) seems to be related to the long-term exposure of the prostate to the strong androgen 5α-dihydrotestosterone (DHT) and, possibly, to estrogens. The relation between prostate cancer and androgens is suggested to be U-shaped, with both extremes of androgen concentrations being associated with increased risk of invasive cancer.

In the treatment of patients with BPH, the lipidic liposterolic extracts of Serenoa repens were as effective as the pharmaceutical inhibitors of the 5α-reductase enzyme or α₁-adrenergic blockers in relieving urinary symptoms. In addition to moderately inhibiting the 5α-reductase activity, Serenoa seems to exert anti-inflammatory and complementary cellular actions with beneficial effects on the prostate. Unlike the pharmaceutical 5α-reductase inhibitors, finasteride and dutasteride, Serenoa does not suppress serum PSA, facilitating the follow-up and the early detection of prostate cancer.

We suggest a strategy to prevent prostate cancer that aims at providing men with partial androgen deficiency correct testosterone substitution with a sustained release buccal bio-adhesive tablet. In addition, food supplementation with extracts of Serenoa repens and a combination of the antioxidants selenium, (cis)-lycopene and natural vitamin E, together with fish oil rich in long-chain polyunsaturated essential fatty acids of the omega-3 group seems warranted. Clearly, a holistic approach including careful clinical and biological monitoring of the aging man and his prostate remains mandatory.     

Ethnic Differences in Financial Outcomes Among Low-Income Older Asian Immigrants: A Financial Capability Perspective

ABSTRACT

This exploratory study examined ethnic differences in financial outcomes among low-income older Asian immigrants from a financial capability perspective. We used survey data collected from a convenience sample of Chinese, Korean, and “Other Asian” ethnic participants in a subsidized employment program (n = 159). We ran logit regressions of dichotomous financial outcomes. Regression analysis showed significant ethnic differences in some financial outcomes after controlling for financial capability and other factors. Findings did not support our hypothesis that financial capability explains ethnic differences in financial outcomes. Findings suggest the need to develop culturally suitable financial capability measures for future research.