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.     

Discourse,affect and affliction

While much recent theorizing into affect has challenged the primacy of discourse in understanding social life, this paper is premised on the intertwining of affective experience with discursive meaning. Furthermore, appreciating the entwining of affect and discourse facilitates broader understanding into the illness experience, medical decision‐making and experiences of healing. Today, the biomedical discourse carries particular affective weight that can saturate experiences of affliction. Cultural understandings of disease similarly shape affect that may emerge in affliction. Social meaning, more specifically stereotypes pertaining to identities, interweave with emotion also in the context of medical practice. The doctor‐patient relationship is an affect‐laden encounter where the entwining of affect with social assumptions carries important, yet poorly understood, repercussions for treatment decisions and for the furthering of health inequalities. Both the elusiveness and the power of affect that unfolds in relation to discursive meaning rest on the way in which affect dwells in and resounds through the body.     

Pure Gold for Broken Bodies: Discursive Techniques Constructing Milk Banking and Peer Milk Sharing in U.S. News

Technological advances provide increased ability to transfer human tissues—blood, organs, milk—from one body to another. This article analyzes mechanisms of reality construction in U.S. news to construct shared human breast milk. Articles used typifications and human interest stories to convey participants as victims, lay heroes, and villains. Milk banking was portrayed as institutionally integrated through associations, expert testimonies, and formalized procedures, making banked milk “pure gold.” Peer sharing was portrayed as institutionally opposed through institutional warnings, expert testimonies, informal procedures, and hypothetical atrocities, making peer milk “fool's gold.” Findings suggest that “biovalue” of human milk is interconnected with institutional processing.     

Discourses of service user involvement in meeting places in Norwegian community mental health care: a discourse analysis of staff accounts

In previous research, meeting places have been favourably addressed by service users, but they have also been contested as exclusionary. In this participatory explorative study, we sought to perform a contextual analysis of meeting places in Norway based on a discourse analysis of three focus group discussions with 15 staff members. We asked the following question: how do meeting-place employees discuss their concrete and abstract encounters with service users and their experiences? We focused on service user involvement, which was largely analysed as neoliberal consultation and responsibilisation. Service users were positioned as resisting responsibility trickling down and defending staffed meeting places. Social democratic discourse was identified in the gaps of neoliberal discourse, which is noteworthy given that Norway is a social democracy. This relates to global concerns about displacements of democracy. We suggest that meeting places appear to hold the potential for staff and service users to collaborate more democratically.     

Making Sense of After‐School Care Dilemmas in Mothers' Stories of After‐School Care in Finland and Sweden

The study focuses on dilemmas in storied experiences of everyday after‐school care arrangements among Swedish and Finnish mothers. Finland and Sweden, which share a history of strong labour market attachment among women, arrange institutional after‐school care in similar ways. The data consist of interviews with three Swedish and six Finnish mothers. A positioning analysis of four stories shows how decisions related to children's after‐school hours were allocated among different actors. Two reoccurring dilemmas, Competent‐dependent child stories and Unburdened‐deficient mother stories, emerged from the data analysis as related to prevailing moral discourses on childhood and motherhood.     

Fighting words? Joning as conflict talk and identity performance among African American preadolescents

This study examines how preadolescent African American students in Washington, D.C., used a linguistic practice called ‘joning,’ a style of verbal play similar to ritual insults, in peer interactions. Sociolinguists have focused on how children socialize each other into vernacular styles appropriate for peer group use but often assume that they disalign with social and linguistic norms for classroom behavior. Drawing from a nine‐month ethnographic study that the author conducted in an after‐school program, this article analyzes the structure and function of joning as a vernacular style of African American Vernacular English and its uses in constructing classroom identities. Joning often facilitated student learning, but it was perceived as a socially and physically risky linguistic practice because of its uses as conflict talk in the local community. Focusing on preadolescence as a key stage of language socialization, this article shows how minority students modify peer‐learned linguistic practices to pursue academic success on their own terms.     

Impact of metabolic syndrome and its components on kidney stone in aging Taiwanese males

Objectives: Metabolic syndrome (MtS) and kidney stone are two common aging diseases with male dominant. This is the first study regarding the potential impact of MtS and its components on kidney stone in aging Chinese population.

Methods: A total of 694 males with a mean age of 55.6 years were enrolled. The definition of MtS was according to the modified criteria developed by the Bureau of Health Promotion in Taiwan. Subjects were classified as having a disease of kidney stones according to diagnosis by a physician with available medical records or evidence from ultrasonography judged by an investigator of urologist.

Results: Using age-adjusted multivariate logistic regression analysis, our results showed that subjects with kidney stone had significantly higher prevalence of MtS (p?=?0.04, OR?=?1.74, 95% CI: 1.0 1–3.00). The presence of MtS had significant correlation with kidney stone (p?=?0.01, OR?=?1.83, 95% CI: 1.1 4–2.93), which were associated with the increment of MtS components (p?p?Conclusions: In aging Taiwanese males, the presence of MtS and its components are strongly associated with kidney stone. Abnormal BP is the most significant risk component of MtS for kidney stone.     

Are urge incontinence and aging risk factors of erectile dysfunction in patients with male lower urinary tract symptoms?

Introduction: Several studies have indicated that erectile dysfunction (ED) patients also suffer from lower urinary tract symptoms (LUTS). We investigated a group of men with LUTS and assessed their sexual function with the aim of being able to predict ED risk factors and introduce ED treatments earlier for this patient group.

Methods: International Prostate Symptom Score (IPSS), Overactive Bladder Symptoms Score (OABSS) and Sexual Health Inventory for Men (SHIM) score were obtained from 236 men with LUTS at their first out-patients visit. Clinical parameters such as body mass index, prostate volume, residual urine volume and prostate specific antigen were also evaluated. The relationship between the SHIM score and other clinical data was analyzed.

Results: According to the SHIM score, ED in men with LUTS was severe 15%, moderate 19%, moderate to mild 28%, mild 17%, normal 7% and data was incomplete in 14%. Based on the results of a multivariate analysis, aging (p?p?=?0.024) were significantly correlated to severe and moderate ED. Furthermore, among OAB symptoms score items, urge urinary incontinence was a risk factor for severe and moderate ED (p?=?0.005).

Conclusion: Aging and OAB (notably urinary urge incontinence) are risk factors for severe and moderate ED in men with LUTS.     

Making Sense of Neoliberal Subjectivity: A Discourse Analysis of Media Language on Self-development

The influence of neoliberalism on culture and subjectivity is well documented. This paper contributes to understanding of how neoliberal ideology enters into the production of subjectivity. While subject formation takes place in multiple and contradictory ways and across multiple social sites, we focus on the increasingly popular media discourse of self-development, and examine it as a technology of neoliberal subjectification. Drawing on Foucauldian understandings, we analyze data from two different newspapers from two different national contexts, both of which are heavily influenced by neoliberalism. Based on our analysis, we detail four interrelated discourses—rationality, autonomy and responsibility, entrepreneurship, and positivity and self-confidence—demonstrating how these discourses constitute the neoliberal subject in ways consonant with neoliberal governmentality. There is no observable resistance to subject positions offered within these discourses. Self-development discourse instills stronger individualism in society, while constraining collective identity, and thus provides social control and contributes to preserving status quo of neoliberal societies.