Age-specific testosterone thresholds: reconsidering diagnostic criteria for hypogonadism across generations of Vietnamese men.

The definition and diagnosis of functional hypogonadism (FH) remains challenging due to the nonspecific nature of symptoms and the inconsistency in normal testosterone thresholds. We conducted this single-center cross-sectional study on medical records of men aged 18 and above undergoing annual health check-ups to evaluate the correlation of age and metabolic components with testosterone. A total of 5,374 healthy men were included in the analysis. Total testosterone levels peaked at 18 years and gradually declined to age 40, followed by a mild increase. Based on the American Urology Association guideline, age-specific cutoffs for low testosterone were 14.61 nmol/l, 12.74 nmol/l, 12.70 nmol/l, and 13.98 nmol/l for those under 30, 30-40, 40-50, and over 50 years old respectively. Triglyceride - Glucose index showed a consistent negative correlation with testosterone across all age groups. In conclusion, testosterone levels demonstrated an age-related decline in early adulthood but a potential increase thereafter among healthy Vietnamese men. Metabolic components, rather than aging, had a consistent negative correlation with testosterone. Age-specific cutoffs for low testosterone may improve the detection of functional hypogonadism.

Attitudes toward partner violence in men: An evaluation in terms of narcissism and attachment style in Turkey.

BACKGROUND: Intimate partner violence is quite common around the world. AIM: This study aims to determine the attitudes toward partner violence in men and to evaluate their attitudes toward violence according to narcissistic characteristics and attachment styles. METHOD: This study was conducted using descriptive cross-sectional methods. Data has been collected by using The Experiences in Intimate Relationship Inventory (EIRI), The Pathological Narcissism Inventory (PNI), and Attitude Scales Toward Dating Violence (ASTDV). RESULTS: There was a positive correlation between the PSV and PV of ASTDV in the anxiety sub-dimension of the EIRI-2 (r = .283, p < .05; r = .262, p < .05) and a negative correlation with PSV and PV in the avoidance sub-dimension (r = -.656, p < .05; r = -.656, p < .05). PSV and PV sub-dimension of ASTDV and PNI's expectations of being noticed (r = .423, p < .05; r = .313, p < .05), fragile self (r = .256, p < .05; r = .154, p < .05), self-sacrifice (r = .186, p < .05; r = .106, p < .05), grandiose dreams (r = -.217, p < .05; r = -.109, p < .05). CONCLUSION: In this study, it was determined that attitudes toward psychological and physical violence in men were directly related to anxious attachment, pathological narcissism, expectations of being noticed, fragile self, grandiose dreams, and self-sacrifice. Increasing the duration of the relationship with the partner, living in a village or town, having more siblings, having a father with a low level of education, and having a mental disorder under treatment constitute a risk for increasing positive attitudes toward psychological and physical violence in men.

Progression of aortic calcification among Japanese in Japan and white and Japanese Americans: a prospective cohort study.

AIMS: Continued low mortality from coronary heart disease in Japan, despite deleterious changes in traditional risk factors, remains unexplained. Since aortic calcification (AC) was an early predictor of cardiovascular mortality, we compared the progression and incidence of AC between Japanese in Japan, white Americans, and third-generation Japanese Americans in the ERA JUMP cohort. We examined whether higher blood levels of marine-derived n-3 fatty acids (FAs) in Japanese than in Americans accounted for the difference. METHODS AND RESULTS: Men (n=700) aged 40-49 years (252 Japanese in Japan, 238 white, and 210 Japanese Americans) were examined at baseline and 4-7 years later. AC was evaluated from the aortic arch to the iliac bifurcation with computed tomography and quantified by the Agatston method. Robust linear regression and linear mixed models were used to compare the progression of AC. Multivariable logistic regression models were fitted to compare the incidence of AC (AC≥50 at follow-up) among those with baseline AC<50. Japanese in Japan had a significantly slower progression of AC than white and Japanese Americans after adjusting for age, baseline AC, follow-up time, and traditional risk factors. White Americans had a significantly higher incidence of AC than Japanese in Japan (OR=4.61 [95%CI, 1.27-16.82]). Additional adjustment for blood levels of n-3 FAs accounted for the difference in AC incidence but not progression. CONCLUSION: Japanese in Japan had a significantly slower progression and lower incidence of AC than white Americans. High levels of marine-derived n-3 FAs in Japanese in Japan partly accounted for the difference in incidence.

Gender Bias in AI's Perception of Cardiovascular Risk.

The study investigated gender bias in GPT-4's assessment of coronary artery disease risk by presenting identical clinical vignettes of men and women with and without psychiatric comorbidities. Results suggest that psychiatric conditions may influence GPT-4's coronary artery disease risk assessment among men and women.

Men with HIV have increased alveolar bone loss.

BACKGROUND: Periodontal health in men with HIV remains understudied, despite suggestions of associations between HIV infection and gingival pocketing, periodontal attachment loss, and gingival inflammation. As antiretroviral therapy (ART) has improved the quality of life for people living with HIV (PLWH), aging-related risk factors and comorbidities, including periodontitis, have emerged. This study aims to assess alveolar bone height, gingival crevicular fluid (GCF) cytokines, and periodontal disease activity in men with and without HIV. METHODS: Ninety-three men (50 HIV+, 43 HIV-) aged 35-70 years were recruited from Columbia University Irving Medical Center clinics. Periodontal examination, GCF collection, and intraoral radiographs were collected. Statistical analysis was conducted with t-tests for continuous variables and chi-squared tests for categorical variables. RESULTS: While no significant differences were observed in bleeding on probing, clinical attachment loss and pocket depths, men with HIV exhibited significantly greater alveolar crestal height on radiographs compared to men without HIV (HIV + 3.41+/-1.35 mm, HIV- 2.64+/-1.01 mm; p = 0.004), reflecting greater alveolar bone loss. CONCLUSIONS: Men living with HIV demonstrate increased alveolar bone loss compared to those without HIV, possibly mediated by elevated IL6 levels. These results underscore the importance of comprehensive oral health management in PLWH and highlight the need for further research understanding the mechanisms linking HIV infection, cytokine dysregulation, and periodontal health.

Distribution and disparities of healthy lifestyles and noncommunicable diseases risk factors between men and women aged 20-59 years in Bangladesh: Evidence from a nationwide survey.

Background: Noncommunicable diseases (NCDs) are public health threats globally and recognized impediments to socioeconomic development. This study aimed to identify the prevalence and clustering of NCDs risk factors among Bangladeshi men and women aged 20-59 years using nationally representative data. Methods: This study was conducted in 82 rural, nonslum urban, and slum clusters across all eight administrative divisions of Bangladesh using multistage cluster sampling. A total of 4917 men and 4905 women aged 20-59 years were included in the study. Descriptive analyses were performed to report the prevalence and distribution of behavioral and clinical risk factors. Multivariable binary logistic regression was performed to identify factors associated with the coexistence of three or more NCD risk factors. Results: The prevalence of tobacco use (any form), insufficient physical activity, inadequate fruit and vegetable consumption, overweight and obesity, and central obesity were 38.3%, 13.6%, 87.1%, 42.3%, and 36.0%, respectively. Furthermore, 21.9% and 4.9% participants had hypertension and self-reported diabetes, respectively. Regarding the clustering of risk factors, 37.1% men and 50.8% women had at least three NCD risk factors. Only 3.0% men and 1.8% women reported no NCD risk factors. Age, place of residence, education, and wealth status were associated with the presence of at least three risk factors for both sexes. Conclusion: Since a large proportion of Bangladeshi 20-59 years old population had multiple risk factors, population-based programs with multisectoral approaches are essential to reduce NCDs among Bangladeshi women and men.

Giant Duodenal Metastatic Gastrointestinal Stromal Tumor (mGIST) in a Young Man.

Gastrointestinal stromal tumors (GISTs) are rare neoplasms affecting the gastrointestinal (GI) tract, primarily in middle-aged and elderly individuals. Originating from interstitial cells of Cajal (ICC), they can develop anywhere in the GI tract, with varying symptoms. Diagnosis involves imaging and tissue acquisition, with surgical excision and tyrosine kinase inhibitors as treatment options. Recurrence rates are high, particularly in larger tumors, which have a significant impact on survival rates. Neoadjuvant therapy may be beneficial in advanced cases. The recent World Health Organization (WHO) classification categorized all GISTs as malignant, emphasizing the importance of prompt diagnosis and management. We are presenting a case of a 24-year-old male who presented with abdominal discomfort and a sensation of pressure while bending forward. The abdominal mass, which was equivalent to the size of a basketball, was disclosed by the physical and radiological examinations. This mass pressurized the surrounding organs and filled the abdominal cavity. During the surgery, we found a well-defined, clearly localized, irregular spherical tumor with two metastases in the greater omentum. The tumor had numerous diverticular expansions of varying diameters. Despite the tumor's substantial size and proximity to adjacent structures and organs, we were able to successfully excise the tumor entirely (R0) and interruptedly suture the duodenum after a partial D4 resection, the tumor's point of origin. The postoperative period was unremarkable. We discharged the patient without any complications and commenced imatinib therapy. During the seven months following the operation, the patient was on adjuvant imatinib therapy and maintained recurrence-free.

Assessing the Effectiveness of an mHealth Intervention to Support Men Who Have Sex With Men Engaging in Chemsex (Budd): Single-Case and Pre-Post Experimental Design Study.

BACKGROUND: This study focuses on the Budd app, a mobile health intervention designed for gay, bisexual, and other men who have sex with men who participate in chemsex. Chemsex, the use of psychoactive drugs in a sexual context, presents substantial health risks including increased HIV transmission and mental health issues. Addressing these risks requires innovative interventions tailored to the unique needs of this population. OBJECTIVE: This study aims to evaluate the effectiveness of the Budd app in promoting drug harm reduction practices among its users, focusing on knowledge, behavioral intention, risk behavior awareness, and self-efficacy. METHODS: The study used a mixed methods approach, combining a single-case experimental design and a pre-post study. A total of 10 participants from an outpatient clinic were recruited, and each attended the clinic 3 times. During the first visit, participants installed a restricted version of the Budd app, which allowed them to report daily mood and risk behavior after chemsex sessions. Phase A (baseline) lasted at least 2 weeks depending on chemsex participation. In the second visit, participants gained full access to the Budd app, initiating phase B (intervention). Phase B lasted at least 6 weeks, depending on chemsex participation, with identical data input as phase A. Participants completed pre- and postintervention surveys assessing behavioral determinants during the first and third visit. RESULTS: The study observed an increased knowledge about chemsex substances postintervention, with a mean percentage improvement in knowledge scores of 20.59% (SD 13.3%) among participants. Behavioral intention and self-efficacy showed mixed results, with some participants improving while others experienced a decrease. There was also a variable impact on awareness of risk behavior, with half of the participants reporting a decrease postintervention. Despite these mixed results, the app was generally well-received, with participants engaging with the app's features an average of 50 times during the study. CONCLUSIONS: The Budd app showed effectiveness in enhancing knowledge about chemsex substances among gay, bisexual, and other men who have sex with men. However, its impact on safe dosing behavior, behavioral intention, self-efficacy, and risk behavior awareness was inconsistent. These findings suggest that while educational interventions can increase knowledge, translating this into behavioral change is more complex and may require more participants, a longer follow-up period, and additional strategies and support mechanisms.

Experiences of harm and mental ill-health among gay, bisexual and other men-who-have-sex-with-men who use methamphetamine or GHB/GBL in different combinations: findings from the COMeT study in Taiwan.

INTRODUCTION: Polydrug use in the context of chemsex is commonplace among gay, bisexual, and other men-who-have-sex-with-men (GBMSM). This study aimed to examine the differences in experiences of physical, social, and psychological harms, as well as mental ill-health among GBMSM who use different combinations of methamphetamine and gamma-hydroxybutyric acid/gamma-butyrolactone (GHB/GBL) during chemsex. METHOD: Adult GBMSM participants who had experience of chemsex in the past 12 months participated in a cross-sectional online survey in Taiwan and self-reported their sociodemographic background, sexual behaviours, mental health, and experiences of harm following a chemsex session. We used univariable and multivariable logistic regression to assess the different experiences of harm and mental ill-health among GBMSM who engaged in chemsex without using methamphetamine, used methamphetamine but not GHB/GBL, and who used both drugs. RESULTS: Out of 510 participants who completed all items included in the analysis, 24.1% engaged in chemsex without using methamphetamine, 36.9% used methamphetamine but not GHB/GBL, and 39.0% used both drugs. Eighty five percent of men who used both methamphetamine and GHB/GBL reported at least one kind of social harm after a chemsex session, such as missing dates or appointments, or appearing "high" at work, followed by used methamphetamine but not GHB/GBL (69.7%) and those without using methamphetamine (37.4%). After controlling for polydrug and frequency of drug use in the multivariable logistic regression, those who used methamphetamine but not GHB/GBL and those who used both drugs were more likely to report experiencing physical and psychological harms compared to those who did not use methamphetamine (p < 0.003). CONCLUSION: GBMSM who used both methamphetamine and GHB/GBL in a chemsex context were more likely to report experience of harms than those who only used a single chemsex drug or engaged in chemsex without methamphetamine or GHB/GBL. Harm reduction should focus on both preventing HIV and STI transmission and on minimising psychosocial harm to GBMSM, with varying impacts depending on drug use.

Multiple endocrine neoplasia type 2B (MEN2B) diagnosis: a case report.

Background: Multiple endocrine neoplasia type 2B (MEN2B) is a rare autosomal dominant syndrome characterized by medullary carcinoma of the early thyroid, pheochromocytoma, and non-endocrine manifestations, such as marfanoid habits and other skeletal abnormalities as well as mucosal neuromas and ganglioneuromatosis of the gastrointestinal tract. Case Description: A 10-year-old male began follow-up at our service at 3 years of age through pediatric gastroenterology due to intestinal constipation. The mother also reported that the child had painless lesions on the tip of the tongue since birth with progressive worsening. The patient simultaneously began follow-up with pediatric endocrinology due to low gains in weight and height, between which only isolated low weight was found, and the onset of follow-up with the pediatric neurology team due to longstanding headache combined with vomiting, photophobia, and phonophobia as well as a specific reading and writing disorder. The patient was sent to clinical genetics. The child's karyotype was 46, XY (normal). Through a physical examination, the pediatric neurology team identified joint hypermobility, important muscle hypotrophy, gingival hypertrophy, and lipodystrophy. The patient was sent to neurogenetics, initiating a set of general laboratory exams for the investigation of the lipodystrophy and a panel of exams for lipodystrophy, neuropathy, and muscle hypotrophy as well as electroneuromyography. MEN2B due to genetic mutation was confirmed and the patient was sent to the pediatric endocrinology clinic for follow-up. Currently 10 years of age and again with the pediatric endocrinology team for the diagnosis of MEN2B, the investigation of pheochromocytoma and medullary thyroid cancer was initiated. Conclusions: An additional mutation occurs in most cases of MEN2B. The diagnosis is only established when the child or, in most cases, adolescent presents with medullary thyroid cancer in an advanced and even metastatic stage. However, non-endocrine manifestations, can lead to an early diagnosis and timely intervention. The diagnosis of MEN2B is made with the confirmation of the autosomal dominant genetic mutation or a mutation of the RET gene. In the absence of these mutations, the majority of clinical manifestations should be present.

Invited Response on: "Letter to the Editor: Neuromodulators Raising Eyebrows: Having Is Not So Pleasing, After All, As Wanting".

This response letter emphasizes the relevance of adopting a psychosocial approach for cosmetic surgeons, particularly concerning the impact of social media on the acceptance of cosmetic surgery among both women and men. Special attention has been directed toward social phenomena that appear to contribute to the formation and maintenance of positive attitudes toward aesthetic surgery and its normalization, including Snapchat Dysmorphia, the Angelina Jolie Effect, and the Mirror Effect, the Exposure Bias. Furthermore, this response letter highlights the critical importance of comprehensive aesthetic education and appropriate training for professionals in the field of cosmetic procedures, especially regarding the topic of body image.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The relationship between remnant cholesterol and the risk of testosterone deficiency in US adults: a cross-sectional study based on the NHANES database.

Background: Testosterone deficiency (TD) is an urgent health issue that requires attention, associated with various adverse health outcomes including cardiovascular diseases (CVD) and metabolic syndrome. Remnant cholesterol (RC) has emerged as a potential biomarker for cardiovascular risk, but its relationship with testosterone levels and TD has not been thoroughly investigated. This study aims to explore the association between RC and TD in adult American males using data from the National Health and Nutrition Examination Survey (NHANES). Methods: This cross-sectional study utilized data from three NHANES cycles (2011-2016), including 2,848 adult male participants. RC was calculated as total cholesterol minus high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL). TD was defined as total testosterone levels below 300 ng/dL. Multivariable linear and logistic regression analyses, as well as smooth curve fitting and generalized additive models, were performed to assess the associations between RC and total testosterone levels and TD, adjusting for potential confounders. Subgroup analyses were conducted based on age, BMI, smoking status, diabetes, hypertension, CVD, and chronic kidney disease (CKD). Results: Higher RC levels were significantly associated with lower total testosterone levels (ß = -53.87, 95% CI: -77.69 to -30.06, p<0.001) and an increased risk of TD (OR = 1.85, 95% CI: 1.29 to 2.66, p=0.002) in fully adjusted models. When RC was analyzed as quartiles, participants in the highest quartile (Q4) had significantly lower total testosterone levels (ß = -62.19, 95% CI: -93.62 to -30.76, p<0.001) and higher odds of TD (OR = 2.15, 95% CI: 1.21 to 3.84, p=0.01) compared to those in the lowest quartile (Q1). Subgroup analyses revealed consistent associations across different age groups, particularly strong in participants over 60 years, and in never smokers. The associations remained significant in both hypertensive and non-hypertensive groups, as well as in those with and without CKD. No significant interactions were found across subgroups. Conclusion: This study demonstrates a significant inverse association between RC levels and total testosterone levels, along with a positive association with the risk of TD. These findings suggest that RC could serve as a valuable biomarker for early identification of individuals at risk for TD. Future longitudinal studies are needed to confirm these findings and explore the underlying mechanisms.

Meeting Men Where they are: Motivators and Barriers to Accessing Health Services through a Men's Mobile Wellness Clinic, October 2019 to March 2020, Blantyre, Malawi.

BACKGROUND: In Malawi approximately, 88.3% people living with HIV are aware of their HIV status. Significant gaps are among men aged 15-34 years; only 72% know their HIV status. To reach men, Jhpiego, in collaboration with the Ministry of Health (MOH), implemented the Men's Mobile Wellness Clinic (MMWC) at workplace settings in Blantyre, Malawi between October 2019 and March 2020. METHODS: We conducted a descriptive qualitative study to understand motivators and barriers to MMWC service uptake by employees and employers. Primary data was drawn from in-depth telephone interviews from four study populations: employers who accepted or declined to host the MMWC at their worksite, and employees who accessed or did not access the services. We performed a thematic analysis using Nvivo 12 software to identify patterns and themes across the dataset. FINDINGS: Main reasons given for using the service among male employees were a desire to know their health status, availability of free health services at the workplace, and good quality services offered by MMWC staff, and support from their supervisor. Men who did not access services stated reasons such as work-clinic scheduling conflicts, lack of adequate promotion of the service, and miscommunication on the criteria about who should attend the MMWC. Employers who accepted to host the MMWC stated convenience and employee's rights to know their health status. Those who declined either stated that employees did not want the services or COVID-19 preventive measures by the MOH between October 2019 and March 2020 restricted participation. CONCLUSION: This study underscores the potential utility of MMWC services including HIV testing among men. The desire to know their health status, availability of free MMWC services at the workplace, good quality services offered by MMWC staff, and the endorsement of MMWC by supervisors were main motivators to access the MMWC services. Sensitizing supervisors and employees about the benefits of the MMWC services, strengthening demand creation, and clarifying eligibility are important to facilitate MMWC uptake among men in Malawi.

International trends in male youth suicide and suicidal behaviour.

OBJECTIVE: Suicide and suicidal behaviour strongly contribute to overall male youth mortality. An understanding of worldwide data contextualises suicide and suicidal behaviour in young men within any given country. METHOD: Members and colleagues of the World Federation of Societies of Biological Psychiatry's Task Force on Men's Mental Health review the relevant data from several regions of the world. The review identifies notable findings across regions of relevance to researchers, policymakers, and clinicians. RESULTS: Male suicide and suicidal behaviour in adolescence and emerging adulthood within North America, Latin America and the Caribbean, Europe, the Mediterranean and the Middle East, Continental Africa, South Asia, East Asia, China, and Oceania share similarities as well as significant points of divergence. CONCLUSIONS: International data provide an opportunity to obtain a superior understanding of suicide and suicidal behaviour amongst young men.

Optimising Abdominal Aortic Aneurysm Screening of 65 Year Old Men by Exploring Risk Factor Based Targeted Screening Strategies in Light of Declining Prevalence of the Disease.

OBJECTIVE: A decline in abdominal aortic aneurysm (AAA) prevalence calls into question the credibility of general population screening of 65 year old men. Selectively targeting high risk individuals among this group could be more effective in preventing death from AAA rupture. This cross sectional study analysed risk factor data in a cohort of 65 year old men screened in the Swedish general population based AAA screening program, with the aim of exploring the effectiveness of hypothetical targeted screening strategies. METHODS: All men attending AAA screening in four neighbouring counties in Sweden between 2006 and 2010 completed a health questionnaire on smoking habits and medical history. Abdominal aortic aneurysm was defined as measuring ≥ 30 mm. The sensitivity and specificity of different targeted screening strategies, with targeted subpopulations defined by duration of smoking with and without additional risk factors, were explored using receiver operating characteristic (ROC) curves. RESULTS: A total of 16 232 men were screened, with 236 (1.5%) screening detected AAAs. A strategy combining smoking, presence of coronary artery disease (CAD), or both was associated with the mathematically optimal balance between sensitivity and specificity (optimal threshold) in the ROC analysis. The optimal threshold corresponded to targeting men having smoked for thirty years or more, a history of CAD, or both, where 74.0% of all AAAs could be detected by screening 33.0% of the population, compared with general screening. Targeting men that have smoked for ten years or more indicated that 84.0% of all AAAs could be detected by screening 55.0% of the population. A simplified strategy of targeting ever smokers resulted in detecting 85.0% of all AAAs by screening 61.0% of the population. CONCLUSION: Targeted screening of men at high risk of AAA, focusing on smoking history for inclusion, may be a safe and effective alternative to general population screening.

[The effect of ω-3 polyunsaturated fatty acids on carbohydrate metabolism in northern men].

Omega-3 polyunsaturated fatty acids (PUFA) are known for being one of the most important classes of bioactive lipids; of them, the long-chain ones, namely eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, have many positive effects on the human body. The aim of this study was to assess the carbohydrate metabolism in northern men living in the Magadan Region before and after the administration of a dietary supplement with PUFA. Material and methods. The study included 45 men (mean age 40.0±0.8 years), of whom 2 groups comparable in age and analyzed parameters were formed by random sampling. The participants of the main group (n=30) consumed PUFA (2 capsules containing 1200 mg, including 660 mg EPA and 440 mg DHA), and the control group (n=15) had no impact on the diet. Fasting venous blood was collected using a vacuum system to determine glycated hemoglobin (HbA1c) using the turbidimetric immunoinhibition, glucose by the hexokinase method, insulin by the immune chemiluminescence using paramagnetic particles at the beginning (late October, 2023) and the end (mid-December, 2023) of the study, and HOMA-IR index was calculated. The daily diet was assessed using the ASPON-nutrition program (St. Petersburg) based on the results of the food diary keeping for 3 days (weekdays). Results. In men of the main group, positive changes in the carbohydrate profile were noted, associated with the intake of ω-3 PUFAs, manifested in HbA1c decrease (from 5.5±0.1 to 5.2±0.1%, p<0.05) while maintaining blood concentration of glucose and insulin and HOMA-IR at the same level. Unlike the main group, the control group experienced disadaptation in their carbohydrate metabolism as they exhibited the signs of hyperinsulinemia (increased basal fasting insulin level from 8.8±1.2 to 11.4±1.1 mIU/l, p<0.05) and insulin resistance (the increase in the HOMA-IR from 2.0±0.2 to 2.6±0.3, p<0.05), which was apparently due to the autumn-winter period of the study. Conclusion. Resulting from the data obtained, this study showed the presence of a leveling function and even an optimizing role of additional ω-3 PUFAs intake with respect to seasonal changes in the biochemical parameters of the northern residents during the crucial period of the year with its temperature curve transition through 0 °C.

Cellular senescence by loss of Men1 in osteoblasts is critical for age-related osteoporosis.

Recent evidence suggests an association between age-related osteoporosis and cellular senescence in the bone; however, the specific bone cells that play a critical role in age-related osteoporosis and the mechanism remain unknown. Results revealed that age-related osteoporosis is characterized by the loss of osteoblast Men1. Osteoblast-specific inducible knockout of Men1 caused structural changes in the mice bones, matching the phenotypes in patients with age-related osteoporosis. Histomorphometrically, Men1-knockout mice femurs decreased osteoblastic activity and increased osteoclastic activity, hallmarks of age-related osteoporosis. Loss of Men1 induces cellular senescence via mTORC1 activation and AMPK suppression, rescued by metformin treatment. In bone morphogenetic protein-indued bone model, loss of Men1 leads to accumulation of senescent cells and osteoporotic bone formation, which are ameliorated by metformin. Our results indicate that cellular senescence in osteoblasts plays a critical role in age-related osteoporosis and that osteoblast-specific inducible Men1-knockout mice offer a promising model for developing therapeutics for age-related osteoporosis.

Challenges in molecular diagnosis of multiple endocrine neoplasia.

Multiple endocrine neoplasia (MEN) is a group of rare genetic diseases characterized by the occurrence of multiple tumors of the endocrine system in the same patient. The first MEN described was MEN1, followed by MEN2A, and MEN2B. The identification of the genes responsible for these syndromes led to the introduction of family genetic screening programs. More than twenty years later, not all cases of MENs have been resolved from a genetic point of view, and new clinicogenetic entities have been described. In this review, we will discuss the strategies and difficulties of genetic screening for classic and newly described MENs in a clinical setting, from limitations in sequencing, to problems in classifying variants, to the identification of new candidate genes. In the era of genomic medicine, characterization of new candidate genes and their specific tumor risk is essential for inclusion of patients in personalized medicine programs as well as to permit accurate genetic counseling to be proposed for families.

Impact of Androgen Deprivation Therapy on Cognitive Function of Elderly Men With Prostate Cancer.

Background Prostate cancer affects millions of men worldwide. Androgen deprivation therapy is the most prescribed medication for elderly men with prostatic cancer to slow and suppress the disease progression. Androgen deprivation therapy works on decreasing testosterone levels, and that can cause multiple side effects, including potential cognitive affection in the form of accelerating cognitive aging and potentially increasing the risk of dementia. This study is aimed at evaluating the impact of androgen deprivation therapy on the cognitive function of elderly men recently diagnosed with prostate cancer. Methods The current research is a prospective cohort study conducted on 85 elderly patients recently diagnosed with prostate cancer who are about to start androgen deprivation therapy within two weeks of the diagnosis. These patients were recruited from the oncology and geriatrics outpatient clinics of Ain Shams University hospitals and were followed up on androgen deprivation therapy for at least six months. Cognitive and depression assessments were done using the Montreal Cognitive Assessment Test and Montreal Cognitive Assessment Test-Basic (according to their education) and the Patient Health Questionnaire-9. The cases were assessed at the start, after two months, and after six months of androgen deprivation therapy use. Cognitively impaired or depressed patients were excluded at the beginning of the study. Results This study showed that 49 out of 85 (57.6%) of the studied participants had a lower Montreal cognitive assessment test score average after six months, indicating mild cognitive impairment. Cognitive domains such as visuospatial, language, and attention were affected. About one-third of the participants were diagnosed with depression after six months of the androgen deprivation therapy. All the depressed participants had cognitive impairment. Conclusion The use of androgen deprivation therapy carries the risk of cognitive decline and regression of some of the cognitive domains such as language, visuospatial, attention, and depression in the elderly with recently diagnosed prostate cancer who received ADT for six months. Conversely, depression could not be linked to cognitive decline. Further research should continue exploring the relationship between cognitive decline and ADT and seek strategies to mitigate these effects, ensuring comprehensive patient care targeting cognitive and psychological well-being.

Diversity of Chemsex Experiences among Men Who Have Sex with Men: Results from the French ANRS PaacX Study Using Q-Methodology.

Chemsex is mostly approached through the prism of risk-taking, neglecting the pleasure and social linking dimensions. However, feedback from the field and few studies highlights a diversity of chemsex practices and relationships to chemsex (RtC). Using Q-methodology, we identified the main RtC and their divergences and convergences, to help develop tailored prevention and care programs. Q-methodology enables the exploration of complex subjective structures and provides a multifaceted picture of a phenomenon. In 2019-2020, we asked 126 men who have sex with men living in France and practicing chemsex to rank order 37 statements. RtC were defined through by-person factor analysis and interpreted using a holistic process. Five RtC emerged, highlighting various motivations for practicing chemsex, relationships to substance use and to sexuality, and regulation strategies implemented: (1) From compensation to fulfillment; (2) The pleasure-seeking manager; (3) Between addiction and management; (4) From curiosity to the destruction of sexuality; and (5) From the hope of compensation to disillusion. Respondents all agreed on two statements: the need to first accept oneself as a drug user in order to be able to manage drug use, and the possibility of harm reduction during chemsex sessions. Our results are the first to elicit the main RtC and the intricacies between the dimensions at stake. The five analysis-based narratives derived from RtC might facilitate discussion during interviews or support groups on chemsex, and could serve as a standardized survey tool. Our findings advocate longitudinal studies to identify factors associated with shifting from one RtC to another.