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1.
Abstract

“Usefulness of Screening Chest Roentgenograms in Preoperative Patients,” Lloyd Rucker, Elizabeth B. Frye, Myrlene A. Staten. We proposed that clinical criteria could define a group of patients very unlikely to have abnormal preoperative chest roentgenograms. Nine hundred five surgical admissions were screened for the presence of clinical factors we thought would make those patients more likely to have abnormal preoperative chest roentgenograms. Of these, 368 had no risk factors. One patient (0.3%) of the 368 had an abnormal x-ray film, which did not affect the surgery. No material abnormalities were found in the remainder of the group without risk factors. Five hundred four patients had identifiable risk factors. Of these, 114 (22%) were found to have serious abnormalities on preoperative chest roentgenograms. (Journal of the American Medical Association 1983;250:3209–3211)

“Effect of Treatment Regimens for Neisseria Gonorrhoeae on Simultaneous Infection With Chlamydia Trachomatis,” Walter E. Stamm, et al. We evaluated the effect of treatment for gonorrhea on simultaneous Chlamydia trachomatis infection by randomly assigning 293 heterosexual men and 246 heterosexual women with gonorrhea to receive one of the following treatment regimens: (1) 4.8 million units of aqueous procaine penicillin plus 1 g of probenecid, (2) nine tablets of trimethoprim-sulfamethoxazole daily for three days, or (3) 500 mg of tetracycline four times a day for five days. Among the men, gonococcal infection was cured in 99 per cent given penicillin plus probenecid, 96 per cent given trimethoprim-sulfamethoxazole, and 98 per cent given tetracycline. Among the women, only 90 per cent given tetracycline were cured, in contrast to 97 per cent given penicillin plus probenecid and 99 per cent given trimethoprim-sulfamethoxazole.  相似文献   

2.
Abstract

This pa per de scribes the find ings from a pur pos ive sample of 152 male and fe male Rus sian-speak ing drug ad diets who im migrated to Is rael dur ing the last ten years. Ap prox i mately one-third of the co hort was not Jew ish, in clud ing 47 per cent of the women. Forty-one per cent of the subjects re ported be ing phys i cally abused and 25 per cent of the women, com pared to 5 per cent of the men, re ported be ing sex u ally abused as a child. Al co hoi abuse was found to be dif fer ent among the par ents of male and fe male ad diets: 46% of the women com pared to 31% of the men had fa thers who drank ex ces sively; 14% of the women compared to 5% of the men had moth ers who were heavy drink ers. Also, female ad diets were more likely than male ad diets to have a mother who used il licit drugs. Treat ment re lated is sues are dis cussed along with the need for specialized, culturally sen si tiveser vice pro vision.  相似文献   

3.
Objective: The present subanalysis of the EARTH study investigates the effects of one year testosterone replacement therapy (TRT) on sleep disturbance among hypogonadal men without obstructive sleep apnea.

Methods: Sleep disturbance was defined as three or more points in question 4 of the aging males symptoms (AMS) questionnaire. All participants completed the AMS scale, International Prostatic Symptoms Score (IPSS), Sexual Health Inventory for Men (SHIM) and Short Form 36 (SF-36) health survey at baseline and after 12?months. Sexual symptoms were also evaluated based on three AMS subscores (Q15, 16 and 17).

Results: We identified 100 patients with sleep disturbance, of whom 48 (24 each in the TRT and control groups) were ultimately included for analysis. All SF-36 categories , AMS scale, IPSS and SHIM score subdomains were significantly worse in patients with sleep disturbance than in those without disturbance. Statistically significant differences in sleep disturbance, erectile symptoms, sexual desire and some domains of the SF-36 were observed between the TRT and control groups after 12?months.

Conclusion: Sleep disturbance may be one of the clinical signs for severe hypogonadism. Moreover, TRT improved sleep conditions, sexual function and quality of life among hypogonadal men with sleep disturbance.  相似文献   

4.
Abstract

Objective: To examine human immunodeficiency virus (HIV)–related knowledge, attitudes, and behaviors in at-risk college men who have sex with men (MSM), focusing on knowledge about acute HIV infection (AHI). Participants and Methods: A one-time anonymous survey was administered to college students attending a lesbian, gay, bisexual, transgender, and queer conference in February 2012. This article reports on a study subsample of MSM. Results: A total of 100 MSM completed the survey. Participants had an average age of 20.4 years. Sixty-six percent reported condom use the last time they had sex. Only 46% had ever heard of symptoms related to AHI. Forty-two percent would likely seek medical care when showing acute symptoms in a setting consistent with AHI. Conclusion: Despite having multiple risk factors for HIV infection, many MSM college students are unaware of AHI. HIV prevention programs should target this population and include information about signs, symptoms, and diagnosis of AHI.  相似文献   

5.
Abstract

This study is part of a nationwide research project dealing with all suicides in Finland. It includes all suicides among university students during the 1-year period from April 1, 1987, to March 31, 1988. Ten students (6 men and 4 women) committed suicide during the period studied. The observed suicide rates per 100,000 students per year were 13.8 (95% CI = 5.1–30.1) for men and 9.0 (95% CI = 2.4–22.8) for women. The difference between the observed and expected suicide rate for men (13.8 v 47.7, standard mortality rate [SMR] = 29) was statistically significant. For women (9.0 v 8.3, SMR = 108), the difference was not statistically significant. Most of the suicides had experienced serious difficulties since early childhood, including narcissistic problems, difficulties in human relations, severe depressive periods, previous suicidal behavior, and alcohol problems; they had also had earlier psychiatric treatment.  相似文献   

6.
Abstract

Objectives: To evaluate the association between handgrip strength and erectile dysfunction (ED) in community-dwelling older men.

Methods: This cross-sectional study included 1771 participants of the Dong-gu Study. Handgrip strength was measured with a handheld dynamometer. ED was assessed with the Korean version of the International Index of Erectile Function (IIEF). ED was categorized as none to mild (IIEF-EF scores of 13–30) and moderate to severe (IIEF-EF scores of 0–12). Multivariable logistic regression was conducted with adjustment for potential confounders.

Results: The proportion of men with moderate to severe ED was 48.8%. The age-adjusted ED score increased with increasing quartile of handgrip strength (11.0, 12.4, 13.4, and 14.0 in the lowest, second, third, and highest quartiles, respectively). After adjustment for potential confounders, greater handgrip strength was associated with a lower risk of ED (odds ratio (OR): 0.82 per 5?kg; 95% confidence interval (CI): 0.74–0.90). In addition, a high level of moderate to vigorous physical activity was associated with a lower risk of ED (OR: 0.75; 95% CI: 0.61–0.93).

Conclusion: In this study, aging men with greater handgrip strength had a lower risk of ED. This result suggests that reduced physical functioning may contribute to ED.  相似文献   

7.
Abstract

“Mucopurulent Cervicitis—The Ignored Counterpart in Women of Urethritis in Men,” Robert C. Brunham, et al. Among 100 randomly selected nonmenstruating women attending a clinic for sexually transmitted diseases, we assessed objective criteria for the clinical diagnosis of mucopurulent cervicitis. Visualization of yellow mucopurulent endocervical secretions on a white swab and the presence of 10 or more polymorphonuclear leukocytes per microscopical field (at a magnification of 1000) in satisfactory gram-stained endocervical smears were independently correlated with cervical Chlamydia trachomatis infection. Neither finding correlated with gonorrhea or genital herpes, although herpes caused characteristic cervical ulcerations. C. trachomatis was isolated from the cervix of 20 of 40 women with mucopurulent cervicitis but of only 2 of 60 without it. The overall prevalence of mucopurulent cervicitis among women attending the clinic (40 per cent) exceeded that of nongonococcal urethritis among men in the same clinic, and the prevalence of C. trachomatis infection was higher in mucopurulent cervicitis than in nongonococcal urethritis, a condition that is conventionally treated with tetracyclines. These findings support recommendations for the treatment of mucopurulent cervicitis and should guide the selective use of confirmatory diagnostic tests for C. trachomatis infection. (New England Journal of Medicine 1984;311:1–6.)

“Oral Contraceptives, Chlamydia trachomatis Infection, and Pelvic Inflammatory Disease: A Word of Caution About Protection,” A. EUGENE WASHINGTON, et al. Management of pelvic inflammatory disease (PID) and decisions about contraception are being influenced by reports that oral contraceptives decrease the risk of PID. To evaluate the validity of this association, we have examined published epidemiologic evidence and reviewed relevant information from other disciplines. Current information does not permit the generalization that oral contraceptives protect against all forms of PID. Most studies conducted (1) have been limited to hospitalized women, who represent less than 25% of all PID cases and are likely to have relatively severe forms of the disease, and (2) have failed to distinguish between gonococcal and nongonococcal PID. While oral contraceptives may provide some protection against gonococcal PID, no basis exists for assuming similar protection is provided against chlamydial PID. In fact, epidemiologic and biologic evidence suggests that infection with Chlamydia trachomatis, the leading cause of nongonococcal PID, is enhanced by oral contraceptives. We judge the conclusion that oral contraceptives protect against all PID to be premature, and urge caution in its application in health policy and clinical decisions. (Journal of the American Medical Association 1985;253:2246–50.)  相似文献   

8.
Abstract

Replication of an earlier survey, using the same questionnaire in the same college course, reveals an increase in proportion of male students with premarital heterosexual experience, from 45 per cent in 1943–44 to 61.8 per cent in 1967–68 and 74.9 per cent in 1969–73. While the mean number of episodes is also greatly increased, the tendency is toward reducing the number of partners. Since the proportion condoning premarital intercourse has risen to over 90 per cent, still further increments in activity may be anticipated. The number reporting homosexual behavior (most often limited to the pre‐ and early‐adolescent years) has declined from 27 per cent to 13.7 per cent, but the amount of activity during the college years has increased. Students having experienced a particular sexual activity impute that activity to a higher proportion of the general population than do the inexperienced.  相似文献   

9.
Objective: To study the prevalence of bone mineral density (BMD) and osteoporosis in the distal forearm among Thai men over 40 years of age in Mae Chaem District, Chiang Mai Province, Thailand.

Methods: The subjects in this study were 194 Thai men, aged between 40 and 87 years who resided in Mae Chaem District, Chiang Mai Province, Thailand. Self-administered questionnaires were used for receiving the demographic characteristics information. BMD was measured by peripheral dual energy X-ray absorptiometry at the nondominant distal forearm in all men.

Results: The BMD was highest in the age-group 40–49 years and lowest in the age-group 70–87 years. The average T-score at the distal forearm was also highest in the age-group 40–49 years and lowest in the age-group 70–87 years. The BMD decreased as a function of age-group (p?p?p?>?.05). The percentage of osteopenia and osteoporosis are increased as a function of age-group in, while decreased in that of normal bone density.

Conclusions: We found the prevalence of osteoporosis in men who resided in Mae Chaem District, Chiang Mai Province, Thailand.  相似文献   

10.
Abstract

Background: Electronic media use is an important avenue for reaching stigmatized populations. We examined Internet access and use of sexually related electronic media among men who have sex with men (MSM) in 4 cities in Tanzania. Methods: A questionnaire was administered to 231 MSM in Dar es Salaam, Mwanza, Arusha, and Tanga regarding electronic media type, times of use, type of use and frequency of use of sexually-related media. Results: Mean age was 25.7?years, and 52% had completed high school. Half had access to the internet through personal electronic devices, a further quarter had access through work, 10% through friends’ devices, and only 2% had no access to the internet. Most frequently used electronic devices were personal computer followed by work smartphone, with work computer a close third. These patterns were consistent for both seeking other men for sex and finding sexual health information. All respondents had accessed sexual material electronically at some time. Substantial logged-in time was reported each week seeking/chatting with potential sexual partners (median?=?48 hr), looking at “porn” (median?=?24 hr), and searching for health information (median?=?7 hr). Over 98% indicated that they would use an anonymous/confidential online service for HIV and sexually transmitted infection testing. The majority (79%) had found sexual partners throughout the Internet in the last 24?hours, and 52% sought sexual health education online 2–3 times per week. Peak search time was evenings, increasing during weekends. Discussion: For Tanzanian MSM in cities, sexual electronic media use is high and includes work devices. Sexual health information seeking, and openness to electronic counseling and testing was almost universal. Electronic sites for sexual health access should be explored and evaluated.  相似文献   

11.
ABSTRACT

Data were collected via the Internet on sexual behaviors of Indian men who have sex with men (MSM; n = 171); these data were compared to online American MSM (n = 682). Among Indian MSM, 51% had never been tested for HIV, 100% believed themselves to be HIV-uninfected, and 22% (secondary Internet male partners) to 43% (primary male partners) reported not using condoms during last anal intercourse. While U.S. MSM were more likely to not use condoms (42% for secondary Internet partners to 67% for primary male partners), most (88%) had been tested for HIV (.0001 ≤ p ≤ .002, all comparisons). Low rates of HIV testing, beliefs about being HIV-uninfected, and significant levels of unsafe anal intercourse could fuel the spread of infection among Indian MSM.  相似文献   

12.
Abstract

“The Inverse Relation Between Fish Consumption and 20-Year Mortality From Coronary Heart Disease,” DAAN KROMHOUT, et al. The low death rate from coronary heart disease among the Greenland Eskimos has been ascribed to their high fish consumption. We therefore decided to investigate the relation between fish consumption and coronary heart disease in a group of men in the town of Zutphen, the Netherlands. Information about the fish consumption of 852 middle-aged men without coronary heart disease was collected in 1960 by a careful dietary history obtained from the participants and their wives. During 20 years of follow-up 78 men died from coronary heart disease. An inverse dose-response relation was observed between fish consumption in 1960 and death from coronary heart disease during 20 years of follow-up. This relation persisted after multiple logistic-regression analyses. Mortality from coronary heart disease was more than 50 per cent lower among those who consumed at least 30g of fish per day than among those who did not eat fish.

We conclude that the consumption of as little as one or two fish dishes per week may be of preventive value in relation to coronary heart disease. (New England Journal of Medicine 1985;312:1205–9.)

“Teaching Touch at Medical School,” JULES OLDER. The association between touch and healing is ancient and worldwide. Skilled hands are among the physician's most important diagnostic and therapeutic tools. Yet a survey of medical schools in the English-speaking world revealed that most offer no touch training in their curricula. Of 169 medical schools, only 12 give any formal instruction in the uses and meaning of therapeutic touch in medicine. The teaching modes of these 12 schools are discussed, and the program of the most touch-conscious school, the University of Otago, is described. (Journal of the American Medical Association 1984;252:931–3.)

“Tubal Infertility and the Intrauterine Device,” DANIEL W. CRAMER, et al. To study the association between intrauterine devices (IUDs) and pelvic inflammatory disease, we compared contraceptive histories in 4185 white women—283 nulliparous women with primary tubal infertility, 69 women with secondary tubal infertility, and 3833 women admitted for delivery at seven collaborating hospitals from 1981 to 1983. The relative risk of tubal infertility associated with IUD use was calculated by means of multivariate logistic regression to control for confounding factors, including region, year of menarche, religion, education, smoking, and reported number of sexual partners. The adjusted risk of primary tubal infertility associated with any IUD use before a first live birth was 2.0 (95 per cent confidence limits, 1.5 to 2.6) relative to nonuse. Users of the Dalkon Shield had an adjusted risk of 3.3 (1.7 to 6.1), users of the Lippes Loop or Saf-T-Coil had a risk of 2.9 (1.7 to 5.2), and users of copper IUDs had a risk of 1.6 (1.1 to 2.4). Women who reported having only one sexual partner had no increased risk of primary tubal infertility associated with IUD use. The adjusted risk of secondary tubal infertility associated with use of a copper IUD after a first live birth was not statistically significant (1.5; 95 per cent confidence limits, 0.8 to 3.0), whereas the risk from similar use of noncopper devices was significant (2.8; 1.3 to 5.9). We conclude that tubal infertility is associated with IUD use, but less so with copper IUDs. (New England Journal of Medicine 1985;312:941–7.)  相似文献   

13.
SUMMARY

As we approach the third decade of AIDS, HIV prevention in the United States confronts expanding public concern about continuing infections among gay men. This paper provides a brief history of HIV prevention efforts among gay men in the United States, as well as a succinct analysis of its successes and failures. By focusing on lessons learned from work in the 1980s-as well as lessons which have not yet' been learned-the author suggests future directions in HIVprevention for gay men which emphasize critical analysis of epidemiological trends, and countering the merging of gay identity with HIV infection. Supporting men to gain greater authority and responsibility1 for their sexual community-building and redevelopment is necessary for lowering the infection rate among successive generations of gay men.  相似文献   

14.
Abstract

The author and associates surveyed 1,300 college students in classrooms at eight academic institutions to identify how the students' use of the Internet has affected their social or academic lives. Although the typical Internet-using student uses the Internet for 100 minutes per day, a small group of students use the Internet to a degree that interferes with other aspects of their lives. Most of them are men and are found among the hard science academic majors. Some ideas for dealing with this problem are suggested.  相似文献   

15.
Black men who have sex with men (MSM) and black men who have sex with both men and women (MSMW) may not perceive themselves to be part of the larger gay community and hence may not heed prevention messages aimed at the community. Objective and Participants: To better understand the participants behaviors, the authors examined differences in condom use between black MSM/W (including MSM and MSMW) and men who have sex with women (MSW) at historically black colleges and universities (HBCUs). Methods: A paper-and-pencil questionnaire survey investigated sexual behaviors of 1,865 freshmen from 35 HBCUs during the 2001-2002 school year. Results: MSM/W were about 0.37 times less likely to always use condoms compared with MSW (adjusted odds ratio = 0.63, 95% confidence interval = 0.42-0.95). Sexual behavior, age at survey, total family income, and religion were also associated with condom use. Conclusions: These findings offer new directions for sexually transmitted disease and HIV prevention aimed at a highly marginalized population that remains at high risk for infection.  相似文献   

16.
Objective: To investigate the association between serum levels of testosterone and biomarkers of subclinical atherosclerosis based on data from 119 middle-aged men of the general population.

Methods: Testosterone, Apolipoprotein A-1 (ApoA-1), Apolipoprotein B (ApoB), Apolipoprotein B-to-Apolipoprotein A-1 ratio (ApoB-to-ApoA-1), high-sensitive C-reactive protein (hsCRP), and fibrinogen levels were measured. Data were also gathered based on age, BMI, waist circumference, smoking, alcohol consumption, and family history of cardiovascular diseases. Men were classified into two groups based on testosterone levels: hypogonadal (testosterone ≤12?nmol/L) and eugonadal men (testosterone >12?nmol/L).

Results: When compared to eugonadal, the hypogonadal men were significantly older (56?years vs. 55?years, p?=?.03), had greater BMI (28?kg/cm2 vs. 26?kg/cm2, p?=?.01), and higher waist circumference (104?cm vs. 100?cm, p?=?.01). Moreover, ApoB, ApoB-to-ApoA-1 ratio, and hsCRP were significantly higher in hypogonadal men compared to eugonadal men (1.1?g/L vs. 1.0?g/L, p?=?.03), (0.8 vs. 0.7, p?=?.03), (3.3?mg/L vs. 2.0?mg/L, p?=?.01), respectively. On the other hand, ApoA-1 and fibrinogen levels did not differ significantly between groups (p?>?.05). In an adjusted multivariate regression analysis model, only ApoB showed a significant negative association with testosterone levels (β?=??0.01; 95% CI?=??0.02, ?1.50; p?=?.04).

Conclusion: Testosterone levels showed an inverse relation to ApoB, a biomarker implicated in subclinical atherosclerosis. These findings support the hypothesis that low testosterone levels play a role in atherosclerosis.  相似文献   

17.
Objective: The authors examined perceived norms and drinking among college students who attended high schools in rural and urban communities. Participants and Methods: Undergraduates (99 men and 85 women) who attended high schools in communities with populations ranging from less than 100 to more than 400,000 completed surveys assessing perceived norms and alcohol consumption. Results: Analyses revealed that students from smaller towns and in smaller high school graduating classes reported heavier drinking and that perceived norms were positively associated with drinking. Perceived norms were unrelated to population variables, and the relationship between perceived norms and drinking did not vary as a function of population variables. Results suggest that differences in drinking as a function of coming from more rural areas contribute to drinking behavior in college independently of perceived norms. Conclusions: College students may adjust to campus drinking norms relatively quickly, and longitudinal research would be useful in understanding this transition.  相似文献   

18.
Abstract

“A Double-Blind Study of Oral Acyclovir for Suppression of Recurrences of Genital Herpes Simplex Virus Infection,” JOHN M. DOUGLAS, et al. Patients with frequently recurring genital herpes were enrolled in a double-blind placebo-controlled trial comparing 200-mg acyclovir capsules, given five or two times daily, with placebo. Of 47 placebo recipients, 44 (94 per cent) had recurrences during the 120-day treatment period, compared with 13 (29 per cent) of 45 patients treated with acyclovir five times daily and 18 of 51 (35 per cent) treated with acyclovir twice daily (P < 0.001 for each regimen compared with placebo). The median time to the first clincial recurrence was 18 days in placebo recipients, compared with over 120 days in both acyclovir-treated groups (P < 0.001 for both groups compared with placebo). The mean monthly recurrence rate during the medication period was 0.86 in placebo recipients, compared with 0.13 in patients treated with acyclovir five times daily and 0.14 in patients treated with acyclovir twice daily (P < 0.001 for both groups compared with placebo). While receiving therapy, 86 of 96 acyclovir-treated patients had over a 50 per cent reduction in their pretreatment recurrence rate. Breakthrough recurrences in acyclovir recipients were of shorter duration and associated with a lower frequency of viral shedding than recurrences in placebo recipients. After medication was discontinued, the subsequent recurrence rate returned to pretreatment frequencies. Daily oral acyclovir was well tolerated. We conclude that oral acyclovir given for four months markedly reduces but does not completely prevent recurrences of genital herpes and does not influence the long-term natural history of the disease. (New England Journal of Medicine 1984 July;310:1551–6.)  相似文献   

19.
Objectives.?Anabolic-androgenic steroids such as Nandrolone phenpropionate (NP) dramatically improve the tolerance to acute stress conditions, strength, and subsequently the quality of life in elderly men. We hypothesize that preoperative pulse-dose supraphysiological NP administration might improve the early morbid symptoms in older patients undergoing open prostatectomy.

Methods.?From 2005 to 2006, 54 patients with a mean age of 70 years, diagnosed as benign prostatic hyperplasia and hospitalized for open prostatectomy were enrolled in the study. They were randomly selected to receive preoperative supraphysiological NP (100 mg, intramuscularly, pulse-dose) or sesame oil placebo, prospectively. Early postoperative morbid symptoms including subjective urinary symptoms (dysuria, bladder retention sensation), incision site pain and general satisfaction of their current urinary condition were assessed by a 6-point scale, self-administrated questionnaire at 24 and 48 h, postoperatively. The sex hormone binding globulin and the testosterone levels were also measured.

Results.?The 24-h postoperative symptoms were significantly reduced in the NP group compared to the placebo (6.18 ± 2.81 versus 9.77 ± 2.15; P < 0.001). The postoperative symptoms were reported to have a decline in the 48 h following operation, though was calculated to be statistically insignificant (4.48 ± 2.32 versus 5.55 ± 1.84; P = 0.06). There was no complication attributed to NP therapy.

Conclusions.?The data supported the hypothesis that the preoperative anabolic steroid supplements (such as NP) could result in a better postoperative endurance in elderly men undergoing open prostatectomy. Further studies, longer and repeated pulse injections in a larger number of older men are mandatory to prove the claim.  相似文献   

20.
Objective: The authors examined the feasibility of conducting serologic testing for the herpes simplex virus 2 (HSV-2) among university students and assessed the psychosocial impact of an HSV-2 diagnosis. Methods: The authors recruited a convenience sample of 100 students (aged 18-39 years) without a history of genital herpes from 1 university between September 2004 and March 2006. Participants received HSV-2 antibody testing by Focus ELISA and Western Blot assays and completed a questionnaire that addressed psychological functioning. Twenty-eight participants completed the questionnaire again at a 3-month follow-up visit. Results: The study revealed (1) low test-reliability in the student population, (2) that positive test results may cause a decline in psychological well-being, and (3) that substantial resources are required to support students with positive HSV-2 results. Conclusions: Test performance, psychological impact, and availability of resources for counseling students with positive diagnoses should be considered before implementing HSV testing programs.  相似文献   

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