Epidemiology and risk factors of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction

Benign prostatic hyperplasia (BPH) is very common in aging men and causes lower urinary tract symptoms (LUTS), which decrease health-related quality of life. A number of evidence suggests that other than ageing, modifiable factors, such as increasing prostate volume, obesity, diet, dyslipidemia, hormonal imbalance, hypertension, metabolic syndrome, alcohol, and smoking, also contribute to the development of BPH and/or LUTS. More recently, erectile dysfunction (ED) has been linked to LUTS/BPH as a part of this syndrome, suggesting that patients with BPH or LUTS easily develop ED, and that LUTS/BPH symptoms often coexist with ED. This article focuses on the epidemiology and risk factors of the combined phenotype LUTS/BPH – ED.     

Late-onset hypogonadism: the advantages of treatment with human chorionic gonadotropin rather than testosterone

The traditional pharmacological treatment of patients with late onset hypogonadism (LOH) is represented by different formulations of testosterone (T) or alternatively by the extractive human chorionic gonadotropin (HCG). The hormone replacement treatment (HRT) is associated with the potential increase of hematocrit, serum concentrations of prostate-specific antigen (PSA) and prostate volume. Moreover, the gynecomastia represent a condition frequently associated with HRT. Recent evidences showed the role of leydig cells in the 25-hydroxylation of vitamin D and the elevated frequency of hypovitaminosis D among LOH patients. Finally, another important aspect of LOH is represented by the frequency of secondary infertility due to age or to traditional HRT. This study evaluated 40 LOH patients treated for 6 months with extractive HCG (n?=?10 patients) and three different formulations of T: transdermal (n?=?10 patients), undecaonate (n?=?10 patients) and enantate (n?=?10 patients). Hormonal, anthropometric, metabolic and sperm parameters were evaluated and compared. Moreover, the main safety parameters and the results of the main questionnaires were evaluated. After treatment, HCG group showed serum concentrations of 25-OH-vitamin D significantly higher (p?p?p?p?相似文献   

Conditional inference under simultaneous stochastic ordering constraints

Testing for stochastic ordering is of considerable importance when increasing does of a treatment are being compared, but in applications involving multivariate responses has received much less attention. We propose a permutation test for testing against multivariate stochastic ordering. This test is distribution-free and no assumption is made about the dependence relations among variables. A comparative simulation study shows that the proposed solution exhibits a good overall performance when compared with existing tests that can be used for the same problem.     

On the definition of risk aversion

Two definitions of risk aversion have recently been proposed for non-expected utility theories of choice under uncertainty: the former refers the measure of risk aversion (Montesano 1985, 1986 and 1988) directly to the risk premium (i.e. to the difference between the expected value of the action under consideration and its certainty equivalent); the latter defines risk aversion as a decreasing preference for an increasing risk (introduced as mean preserving spreads) (Chew, Karni and Safra 1987, Machina 1987, Röell 1987, Yaari 1987).When the von Neumann-Morgenstern utility function exists both these definitions indicate an agent as a risk averter if his or her utility function is concave. Consequently, the two definitions are equivalent. However, they are no longer equivalent when the von Neumann-Morgenstern utility function does not exist and a non-expected utility theory is assumed. Examples can be given which show how the risk aversion of the one definition can coexist with the risk attraction of the other. Indeed the two definitions consider two different questions: the risk premium definition specifically concerns risk aversion, while the mean preserving spreads definition concerns the increasing (with risk) risk aversion.The mean preserving spreads definition of risk aversion, i.e. the increasing (with risk) risk aversion, requires a special kind of concavity for the preference function (that the derivatives with respect to probabilities are concave in the respective consequences). The risk premium definition of local risk aversion requires that the probability distribution dominates on the average the distribution of the derivatives of the preference function with respect to consequences. Besides, when the local measure of the first order is zero, there is risk aversion according to the measure of the second order if the preference function is concave with respect to consequences.Yaari's (1969) measure of risk aversion is closely linked to the r.p. measure of the second order. Its sign does not indicate risk aversion (if positive) or attraction (if negative) when the measure of the first order is not zero (i.e., in Yaari's language, when subjective odds differ from the market odds).     

Ecological Economic Policy for Sustainable Development: Potentials and Domains of Intervention for Delinking Approaches

Due to the increasing environmental problems, conventional environmental policy will not suffice to secure a development path that can be sustainable on a global scale. This article establishes a conceptual framework for general strategies to reach the goals of ecological sustainability and individual well-being. Environmental impact, material input, income/production, the amount of services utilised, and well-being are the fundamental elements of this framework and their linkages are highlighted as possible targets of ecological economic policy. It is clear that current environmental policies, based on a rather narrow, reductionist view of the man-nature relationship, will not suffice. We investigate under which conditions a de-linking of individual well-being from environmental impacts can be achieved; a dramatic dematerialisation of the industrialised economies turns out to be a crucial element. This dematerialisation, we argue, can be achieved only putting a limit to quantitative economic growth, but nevertheless without decreasing the individual well-being, by concentrating the attention on highly valuable eco-efficient services rather than on the production/acquisition of material goods.