Associação de características sociodemográficas com fatores de risco cardiovascular em homens hipertensos / Asociación de características sociodemográficas con factores de riesgo cardiovascular en hombres hipertensos / Association of sociodemographic characteristics with cardiovascular risk factors in hypertensive men

Objetivo: investigar a associação de características sociodemográficas com fatores de risco cardiovascular em homens hipertensos. Método: estudo transversal efetuado com 80 homens entrevistados e avaliados clinicamente. Dados analisados descritivamente e pelos testes Qui-Quadrado de Person ou Exato de Fisher. O nível de significância estatística foi de 5%. Resultados: houve maior prevalência de tabagismo em ?60 anos (p=0,002), nível insuficiente de atividade física em ?60 anos (p=0,017), fumantes passivos em brancos (p=0,026) e sem companheira (p=0,039) e consumo excessivo de álcool no final de semana em brancos (p=0,043) e homens com menor escolaridade (p=0,041). Conclusão: foi observada a associação de características sociodemográficas com elevada prevalência de fatores de risco cardiovascular descontrolados em homens hipertensos.

Objetivo: investigar la asociación de características sociodemográficas con factores de riesgo cardiovascular en hombres hipertensos. Método: estudio transversal realizado con 80 hombres entrevistados y evaluados clínicamente. Datos analizados descriptivamente y por pruebas de Persona de Fisher o Chi-Cuadrado Exacto. El nivel de significación estadística fue del 5%. Resultados: hubo mayor prevalencia de tabaquismo en ?60 años (p=0,002), nivel insuficiente de actividad física en ?60 años (p=0,017), fumadores pasivos en blancos (p=0,026) y sin pareja (p=0,039) y consumo excesivo de alcohol en fin de semana en blancos (p=0,043) y hombres con menor escolaridad (p=0,041). Conclusión: se observó la asociación de características sociodemográficas con una alta prevalencia de factores de riesgo cardiovascular no controlados en hombres hipertensos.

Objective: to investigate the association of sociodemographic characteristics with cardiovascular risk factors in hypertensive men. Method: a cross-sectional study was conducted with 80 men interviewed and clinically evaluated. Data were analyzed descriptively and by Fisher's Exact or Person Chi-Square tests. The level of statistical significance was 5%. Results: there was a higher prevalence of smoking in ?60 years (p=0.002), insufficient level of physical activity in ?60 years (p=0.017), passive smokers in whites (p=0.026) and without a partner (p=0.039), and excessive consumption of alcohol at the weekend in whites (p=0.043) and men with lower schooling (p=0.041). Conclusion: sociodemographic characteristics were associated with a high prevalence of uncontrolled cardiovascular risk factors in hypertensive men.

Alternative Treatment for Erectile Dysfunction: a Growing Arsenal in Men's Health.

PURPOSE OF REVIEW: To highlight and review encouraging preliminary studies behind several alternative products and interventions for erectile dysfunction (ED). RECENT FINDINGS: Alternative treatments for ED are becoming more prevalent with increased consumer interest. "Natural" products are sold online, and numerous clinics offer various off-label and investigational interventions. These alternative treatments have demonstrated varying degrees of efficacy in randomized trials and meta-analyses, but none of these interventions has robust enough evidence to be considered first-line therapy. These treatments may find a role in combination with guideline treatments or may be used in novel penile rehabilitation research protocols. With growing interest in alternative treatment for men's health, an awareness of the literature is imperative for patient counsel. Alternative treatments, like L-arginine, have a growing body of evidence for efficacy in combination with PDE5i, and low-intensity shock wave therapy and stem cell therapy continue to demonstrate encouraging outcomes in ED trials.

New insights to guide patient care: the bidirectional relationship between male infertility and male health.

Male reproduction is a complex process, and numerous medical conditions have the potential to alter spermatogenesis. In addition, male factor infertility may be a biomarker for future health. In the present review, we discuss the current literature regarding the association between systemic diseases and fertility, which may impact clinical outcomes or semen parameters. A number of conditions that have systemic consequences were identified, including genetic (e.g., cystic fibrosis, DNA mismatch repair alterations), obesity, psychological stress, exogenous testosterone, and a variety of common medications. As such, the infertility evaluation may offer an opportunity for health counseling beyond the discussion of reproductive goals. Moreover, male infertility has been suggested as a marker of future health, given that poor semen parameters and a diagnosis of male infertility are associated with an increased risk of hypogonadism, cardiometabolic disease, cancer, and even mortality. Therefore, male fertility requires multidisciplinary expertise for evaluation, treatment, and counseling.

Trends in nutritional intake and coronary risk factors over 60 years among Japanese men in Tanushimaru.

We investigated the relationship between time trends in nutrient intake and coronary risk factors/mortality rates in Tanushimaru, a Japanese cohort of the Seven Countries Study. All men between the ages of 40 and 64 were enrolled. Subjects numbered 628 in 1958, 539 in 1977, 602 in 1982, 752 in 1989, 402 in 1999, 329 in 2009, and 160 in 2018. Eating patterns were evaluated by 24-h dietary recall from 1958 through 1989, and by a food frequency questionnaire administered from 1999 through 2018. The total daily energy intake decreased from 2,837 kcal in 1958 to 2,096 kcal in 2018. Carbohydrate intake as a percentage of the total decreased remarkably from 84% (1958) to 53% (2018), whereas there was a large increase in fat intake (from 5 to 24%) during the same period. Age-adjusted mean cholesterol levels rose sharply (from 167.9 to 209.4 mg/dl) and body mass index levels also increased (from 21.7 to 24.4 kg/m2), but smoking rate decreased from 69% (1958) to 30% (2018). The mortality rates from stroke and cancer declined, but mortality from myocardial infarction and sudden death remained stable at low levels. The remarkable changes in dietary patterns over the last 60 years can be related to coronary risk factors, but not currently to the mortality of coronary artery disease; more follow-up is needed.

Necessidades humanas de cuidado no homem em tratamento cirúrgico oncológico: implicações para a enfermagem / Necesidades humanas de cuidado en el hombre en tratamiento cirúrgico oncológico: implicaciones para la enfermería / The human care needs for men undergoing oncological surgical treatment: implications towards the nursing profession

Objective: The study's goal has been to identify the basic human needs of men undergoing oncologic surgical treatment and its implications for nursing care. Methods: It is a descriptive study with a qualitative approach. The scenario is the Nursing Consultation Ambulatory, INCA-RJ. The participants were 25 men bearing mouth neoplasm under exclusively surgical treatment. Study approved by the Research Ethics Committee under the CAAE No. 52647116430015274. Data collection was carried out through a semi-structured interview. The Bardin's thematic content analysis was used. Results: Three thematic categories emerged, as follows: the human needs for health care of the physical body; the human needs for social health care and the human needs for spiritual health care. Conclusion: The human needs affected by organic imbalances point to the importance of planning a care service that provides an effective result to human health necessities

Objetivo: Identificar as necessidades humanas básicos da saúde do homem em tratamento cirúrgico oncológico e suas implicações para o cuidado de enfermagem. Método: Estudo descritivo, qualitativo. Cenário ambulatório de Consulta de Enfermagem, INCA-RJ. Participantes foram 25 homens com neoplasia de boca em tratamento exclusivamente cirúrgico. Após aprovação do CEP n°52647116430015274. A coleta de dados foi à entrevista semiestruturada. Utilizou-se a análise temática de conteúdo de Bardin. Resultados: Emergiram três categorias temáticas: as necessidades humanas de cuidado à saúde do corpo físico; as necessidades humanas de cuidado a saúde social e as necessidades humanas de cuidado a saúde espiritual. Conclusão: Deste modo, as necessidades humanas afetadas com desequilíbrios orgânicos, aponta a importância de planejar um cuidado que proporcione resultado efetivo às necessidades à saúde do homem

Objetivo: Identificar las necesidades humanas básicas de la salud del hombre en tratamiento quirúrgico oncológico y sus implicaciones para el cuidado de enfermería. Método: Estudio descriptivo, cualitativo. Escenario ambulatorio de Consulta de Enfermería, INCA-RJ. Los participantes fueron 25 hombres con neoplasia de boca en tratamiento exclusivamente quirúrgico. Tras la aprobación del CEP n ° 52647116430015274. La recolección de datos fue a la entrevista semiestructurada. Se utilizó el análisis temático de contenido de Bardin. Resultados: emergieron tres categorías temáticas: las necesidades humanas de cuidado de la salud del cuerpo físico; Las necesidades humanas de cuidado de la salud social y las necesidades humanas de cuidado de la salud espiritual. Conclusión: De este modo, las necesidades humanas afectadas con desequilibrios orgánicos, apunta la importancia de planificar un cuidado que proporcione resultado efectivo a las necesidades de la salud del hombre

Male infertility as a window to health.

There is an emerging body of evidence suggesting that male infertility may be a harbinger of future health. Potential associations between infertility and health may arise from genetic, developmental, and lifestyle factors. Studies have explored possible links between male infertility and oncologic, cardiovascular, metabolic, and autoimmune diseases. Male infertility may also be a predictor of hospitalization and mortality. Additional research is required to elucidate the mechanisms by which male infertility affects overall health.

Acciones que realiza el hombre para prevenir el embarazo ante el virus del Zika / Action that man performs to prevent pregnancy against the Zika virus

Según la Organización Mundial de la Salud (OMS), el virus del Zika es "un flavivirus transmitido por mosquitos que se identificó por vez primera en Macacos, Uganda 1947 a través de una red de monitoreo de la fiebre amarilla". Objetivo: Identificar el conoci-miento y acciones que realizan los emplea-dos masculinos de mantenimiento de la Uni-versidad Nacional Autónoma de Honduras en el Valle de Sula (UNAH-VS) para la prevención del embarazo ante el virus del Zika, durante el segundo semestre del año 2016. Pacientes y métodos Estudio cuanti-tativo exploratorio, descriptivo. Población 29 hombres, muestra 28. Instrumento tipo cuestionario, previo consentimiento informa-do. Resultados: El 61% (17) tenían edad reproductiva (20-35 años), 96% (27) esta-ban activos sexualmente, 14% (4) sí tenían conocimiento que el virus del Zika permane-ce en el semen del hombre. El 89% (25) sí conocia que el virus del Zika en el embarazo causa microcefalia en el bebé por nacer, 11% (3) no, 21% (6) sí utiliza algún método para prevenir el embarazo con su pareja, 79% (22) no utilizan métodos anticoncepti-vos y 83% (23) no saben cuanto tiempo abs-tenerse sin protección en las relaciones sexuales. Conclusión: Los resultados señalan que el personal masculino de man-tenimiento de la UNAH-VS, la mayoría des-conoce que el virus permanece en el semen Artículos Originalesdel hombre despues de la patología; por lo tanto no toman medidas preventivas ante un posible embarazo...(AU)

A implementação da política nacional de atenção integral à saúde do homem: estado da arte / The implementation of the national policy of integral attention to the health of the man: state of art

Considera-se oportuna a continuidade das pesquisas sobre a PNAISH, sua implementação, desafios e conquistas, no intuito de favorecer uma visão e postura crítico reflexiva para que a política efetivamente aconteça em nosso país e o homem possa de maneira 83 qualificada e humanizada ter acesso à saúde, um direito conquistado. No decorrer desta revisão são observadas fragilidades na implementação da PNAISH, como a vontade da gestão em planejar e articular ações voltadas ao público masculino; sensibilizar os profissionais/serviços de saúde, promovendo educação em saúde, prevenção e cuidado integral; e ainda, chamar o próprio homem para o diálogo, com escuta ativa, percebendo suas reais necessidades. Essas demandas pautam-se na necessidade de contribuir para o crescimento e fortalecimento da PNAISH, inserindo o homem na pauta das discussões, considerando suas necessidades e peculiaridades

Rastreamento populacional para o câncer de próstata: mais riscos que benefícios / Population screening for prostate cancer: more risks than benefits

Resumo Recentemente, inúmeras campanhas nacionais promovidas por hospitais, sociedades médicas e outras organizações têm estimulado o rastreamento do câncer de próstata, em consonância com iniciativas mundiais conhecidas como Novembro Azul. Essas campanhas aconselham a utilização do toque retal acompanhado da dosagem sérica do antígeno prostático específico em faixas etárias definidas. A motivação seria a detecção precoce da neoplasia, com redução de sua mortalidade e das complicações e impactos associados ao seu tratamento. A dosagem do PSA para fins de rastreamento é alvo de grande controvérsia, visto que a maioria dos tumores detectados pelo rastreamento é de evolução lenta e não interfeririam na sobrevida ou na qualidade de vida do paciente. O rastreamento de base populacional não é a indicação de inúmeras instituições estrangeiras e, no Brasil, o Instituto Nacional de Câncer também não recomenda à organização programas de rastreamento desse tipo. O artigo discute os riscos e benefícios associados a esse tipo de estratégia e reforça a preocupação com o uso inadequado e indiscriminado do rastreamento para o câncer de próstata.

Abstract Recently, numerous national campaigns promoted by hospitals, medical societies and other organizations have stimulated prostate cancer screening, in line with worldwide initiatives known as Blue November. These campaigns advise the use of rectal examination accompanied by dosage of serum prostate specific antigen (PSA) levels in defined age groups. The motivation would be the early detection of neoplasia, with reduction of mortality and complications and impacts associated with its treatment. The PSA dosage for screening purposes is highly controversial, since most of such tumors detected by screening are of slow progression and would not interfere with patient survival or quality of life. Population-based screening for prostate cancer is not recommended by numerous foreign institutions, including the National Cancer Institute in Brazil. The article discusses the risks and benefits associated with this type of strategy and reinforces concern about the inappropriate and indiscriminate use of screening for prostate cancer.

Utilización de los servicios del Cesac N°35 focalizado en los varones: 2005-2011 CABA / Use of CESAC No. 35´s services focused on men: 2005-2011 CABA

Resumen de la tesis de Maestría del mismo nombre, realizada por el autor principal, que se considera de importancia, no solo por las características del contenido en términos epidemiológicos, sus resultados y conclusiones, sino en particular por el debate en torno al lugar que ocupa el Primer Nivel de Atención que éste propone. Desde el Plan de Salud en vigencia, se está desarrollando un importante fortalecimiento de este nivel como puerta de entrada. Este trabajo, entre otras cosas, posibilita revisar críticamente los procesos de trabajo a desarrollar por parte de los Equipos Básicos en el escenario de la salud de la Ciudad de Buenos Aires en el 2018 y permite continuar entendiendo la importancia de realizar actividades más allá de la asistencia dentro del CeSAC. El propósito de la siguiente investigación es contribuir con el conocimiento existente sobre la problematización y visibilización del rol de los varones en cuanto a la manera que utilizan los servicios de salud del PNAFS y generar recomendaciones para los diferentes niveles de intervención política y transmitir la información resultante de la investigación. El objetivo general fue analizar la diferencia en la utilización de los servicios entre varones y mujeres pertenecientes al CeSAC 35,CABA, entre los años 2005 y 2011. (AU)

Vulnerabilidades de pescadores de comunidades ribeirinhas às Infecções Sexualmente Transmissíveis / Vulnerabilidad de los pescadores de las comunidades costeras a las infecciones de transmisión sexual / Vulnerability of fishermen from coastal communities to sexually transmitted infections

RESUMO Introdução: as Infecções Sexualmente Transmissíveis, especificamente a Síndrome da Imunodeficiência Adquirida são patologias que representam grandes desafios para a saúde no contexto mundial, merecendo destaque devido ao seu alto potencial de disseminação. No universo masculino, verifica-se que vem se intensificando o aumento da incidência dessas patologias, sobretudo nos grupos representados pelos adolescentes e jovens. Objetivo: analisar as vulnerabilidades de pescadores de comunidades ribeirinhas às infecções sexualmente transmissíveis. Métodos: trata-se de uma pesquisa exploratória e descritiva de abordagem qualitativa, realizada nas comunidades ribeirinhas do interior piauiense, Brasil. A amostra foi composta por 18 homens que vivem nessas comunidades. Resultados: os resultados foram divididos em duas categorias, a saber: Vulnerabilidades de pescadores relacionadas as infecções sexualmente transmissíveis e práticas preventivas; Políticas públicas de saúde voltadas para a saúde sexual dos homens. Percebeu-se que há uma grande deficiência de conhecimento dos pescadores sobre essas infecções, devido ao baixo grau de escolaridade e a ausência de ações educativas em saúde por parte da Estratégia de Saúde da Família, o que os torna muito vulneráveis às Infecções Sexualmente Transmissíveis. Conclusão: há uma necessidade de realizar ações educativas em saúde para os pescadores, por parte da Estratégia Saúde da Família, visto que as políticas de saúde para os homens contemplam ações para as populações mais vulneráveis(AU)

RESUMEN Introducción: las infecciones de transmisión sexual son enfermedades que constituyen importantes desafíos para la salud en el contexto global, y el síndrome de inmunodeficiencia adquirida merece una mención especial debido a su alto potencial de propagación. En el universo masculino, parece que se está intensificando la creciente incidencia de estas enfermedades, especialmente en los grupos representados por adolescentes y jóvenes. Objetivo: analizar las vulnerabilidades de pescadores de comunidades ribereñas con las infecciones de transmisión sexual. Métodos: estudio con enfoque cualitativo, exploratorio y descriptivo, llevado a cabo en las comunidades ribereñas de Piauí interior. La muestra consistió en 18 hombres que viven en estas comunidades. Resultados: se dividieron en dos categorías, a saber: los pescadores de vulnerabilidad relacionados con las prácticas de prevención de infecciones y las políticas públicas de salud centrados en la salud sexual de los hombres de transmisión sexual. Se observó que existe deficiencia de los conocimientos de los pescadores sobre estas infecciones, debido al bajo nivel de educación y la falta de las acciones en salud en la Estrategia Salud de la Familia, que los hace muy vulnerables a las infecciones de transmisión sexual. Conclusión: se necesitan actividades de educación en la salud de los pescadores, mediante la estrategia de salud de la familia, como las políticas de salud para los hombres que incluyen acciones para las poblaciones más vulnerables(AU)

ABSTRACT Introduction: Sexually transmitted infections, specifically the acquired immunodeficiency syndrome are diseases that pose major challenges for health in the global context deserves special mention because of its high potential for spread. In the male universe, it appears that is intensifying the increasing incidence of these diseases, especially in the groups represented by adolescents and youth. Objective: Analyze the fishing vulnerabilities related to sexuality and sexually transmitted infections prevention practices. Methods: This is an exploratory and descriptive qualitative approach, carried out in the riverine communities of Piaui interior. The sample consisted of 18 men who live in these communities. Results: The results were divided into two categories, namely: Vulnerability fishermen related and prevention practices Sexually Transmitted Infections; health public policies focused on the sexual health of men. It was noticed that there is a big fishermen's knowledge deficiency on these infections, due to the low level of education and lack of educative health actions by the Family Health Strategy, which makes them very vulnerable to sexually transmitted infections. Conclusion: There is a need for educational activities in health for fishermen, by the Family Health Strategy, as health policies for men include actions for the most vulnerable populations(AU)

O acesso do homem ao serviço de saúde na atenção primária / Acceso a la salud del hombre a servicios de salud em atención primaria / Man’s access to health services in primary care

Objective: To investigate the factors that influence man’s access to health services in primary care. Method: It is a descriptive exploratory study with a qualitative approach, carried out with eight men through focus group in October 2010. The data were analyzed based on the technique of the Collective Subject Discourse. Results: The users expressed little investment in the service organization from a gender perspective reinforcing common sense that men are not the primary users, and remain subsidized by a patriarchal ideology. Conclusion: It is necessary to think about determining of man’s current socio-historical-cultural ways of life, illness and death and establish a new paradigm about men’s health in modern life.

Objetivo: Investigar os aspectos que influenciam no acesso do homem ao serviço de saúde da atenção primária. Método: Trata-se de um estudo exploratório descritivo, com abordagem qualitativa, realizado com oito homens através de grupo focal em outubro de 2010. Os dados foram analisados com base na técnica do Discurso de Sujeito Coletivo. Resultados: Os usuários expressaram pouco investimento na organização do serviço numa perspectiva de gênero reforçando o senso comum de que os homens não são usuários da atenção primária, tendo ainda uma ideologia subsidiada pelo patriarcado. Conclusão: É preciso pensar nos determinantes sócio-históricos-culturais dos modos de viver, adoecer e morrer do homem na atualidade e instaurar um novo paradigma acercada saúde do homem na vida moderna.

Objetivo: Investigar los factores que influyen em el acceso del hombre a los servicios de salud en atención primaria. Método: Se trata de um estudio exploratorio descriptivo con enfoque cualitativo, realizado com ocho hombres a través de grupos focales em octubre de 2010. Los datos fueron analizados sobre la base de la técnica del Discurso del Sujeto Colectivo. Resultados: Los usuários expresaron su poca inversión em la organización de servicio a partir de uma perspectiva de género refuerza la creencia convencional de que los hombres no son los principales usuarios, e incluso subvencionados por um patriarcado ideología. Conclusión: Ha que pensar en la determinación de los modos de vida socio-históricocultural, enfermedad y muerte del hombre de hoy y establecer un nuevo paradigma sobre la salud del hombre en la vida moderna.

Research prioritization of men's health and urologic diseasess

ABSTRACT Objectives We sought to determine whether disease representation in the Cochrane Database of Systematic Reviews (CDSR) reflects disease burden, measured by the Global Burden of Disease (GBD) Study as disability-adjusted life-years (DALYs). Materials and Methods Two investigators performed independent assessment of ten men’s health and urologic diseases (MHUDs) in CDSR for systematic review and protocol representation, which were compared with percentage of total 2010 DALYs for the ten conditions. Data were analyzed for correlation using Spearman rank analysis. Results Nine of ten MHUDs were represented by at least one CDSR review. There was a poor and statistically insignificant positive correlation between CDSR representation and disease burden (rho = 0.42, p = 0.23). CDSR representation was aligned with disease burden for three conditions, greater than disease burden for one condition, and less than disease burden for six conditions. Conclusions These results yield high-quality estimates to inform future research prioritization for MHUDs. While prioritization processes are complex and multi-faceted, disease burden should be strongly considered. Awareness of research priority setting has the potential to minimize research disparities on a global scale.

Research prioritization of men's health and urologic diseases.

OBJECTIVES: We sought to determine whether disease representation in the Cochrane Database of Systematic Reviews (CDSR) reflects disease burden, measured by the Global Burden of Disease (GBD) Study as disability-adjusted life-years (DALYs). MATERIALS AND METHODS: Two investigators performed independent assessment of ten men's health and urologic diseases (MHUDs) in CDSR for systematic review and protocol representation, which were compared with percentage of total 2010 DALYs for the ten conditions. Data were analyzed for correlation using Spearman rank analysis. RESULTS: Nine of ten MHUDs were represented by at least one CDSR review. There was a poor and statistically insignificant positive correlation between CDSR representation and disease burden (rho = 0.42, p = 0.23). CDSR representation was aligned with disease burden for three conditions, greater than disease burden for one condition, and less than disease burden for six conditions. CONCLUSIONS: These results yield high-quality estimates to inform future research prioritization for MHUDs. While prioritization processes are complex and multi-faceted, disease burden should be strongly considered. Awareness of research priority setting has the potential to minimize research disparities on a global scale.

Young Black Gay/Bisexual and Other Men Who Have Sex With Men: A Review and Content Analysis of Health-Focused Research Between 1988 and 2013.

Black young gay, bisexual, and other men who have sex with men (YGBMSM) are at high risk for negative health outcomes, though this population is underrepresented in the health literature. An extensive literature review and content analysis of health-related peer-reviewed articles (1988-2013) was conducted that targeted Black YGBMSM, examining five content areas: sexual health, health care, substance use, psychosocial functioning, and sociostructural factors. A coding sheet was created to collect information on all content areas and related subtopics and computed descriptive statistics. Out of 54 articles, most were published after 2004 ( N = 49; 90.7%) and addressed some aspect of sexual health ( N = 50; 92.6%). Few articles included content on psychosocial functioning, including bullying/harassment, suicide, and racial/ethnic identity. Data on health care delivery/receipt and health insurance were underrepresented; tobacco use and substance abuse were seldom addressed. Important sociostructural factors, including sexual networks and race-based discrimination, were poorly represented. Last, there was a noteworthy deficit of qualitative studies and research exploring intersectional identity and health. This review concludes that studies on Black YGBMSM health places sex at the forefront to the neglect of other critical health domains. More research is needed on the diverse health issues of a vulnerable and underexamined population.

Secular changes in cardiovascular risk factors in Swedish 50-year-old men over a 50-year period: The study of men born in 1913, 1923, 1933, 1943, 1953 and 1963.

Background During the past decades, declining trends in mean cholesterol levels and smoking have been observed in Western Europe, whereas obesity and a sedentary lifestyle have increased. Simultaneously, there has been a marked decrease in mortality from cardiovascular (CV) diseases. Methods The aim of the study was to determine whether these trends in CV risk factors continued over a period of 50 years. Six systematic or random population samples of 50-year-old men ( n = 3563) living in Gothenburg, Sweden, were investigated between 1963 and 2013. Results During the 50 years, mean body mass index (BMI) at 50 years of age increased by 2 kg/m2, from 24.8 kg/m2 in 1963 to 26.8 kg/m2 in 2013 ( p < 0.001). A decrease in systolic blood pressure of nearly 10 mmHg was observed from 1963 to 1993, but was not sustained through the past two decades. Mean serum cholesterol fell from 6.42 (SD 1.12) mmol/L to 5.34 (SD 0.97) mmol/L. The prevalence of smoking at 50 years of age decreased markedly from 56.1% in 1963 to 11.9% in 2013. The number of participants with a sedentary lifestyle during leisure time decreased until 1993, but has remained unchanged since. In 2013, 50-year-old men had a 6.9-times higher likelihood of lacking CV risk factors than 50-year-old men in 1963 (95% confidence interval (CI): 3.5-13.3, p < 0.001). The odds ratio for having four or more risk factors was only 0.13 (95% CI: 0.062-0.29, p < 0.001). Conclusion Despite increasing body weight, the total CV risk factor burden has decreased in 50-year-old men over the past 50 years.

Barriers and facilitators to health screening in men: A systematic review.

RATIONALE: Men have poorer health status and are less likely to attend health screening compared to women. OBJECTIVE: This systematic review presents current evidence on the barriers and facilitators to engaging men in health screening. METHODS: We included qualitative, quantitative and mixed-method studies identified through five electronic databases, contact with experts and reference mining. Two researchers selected and appraised the studies independently. Data extraction and synthesis were conducted using the 'best fit' framework synthesis method. RESULTS: 53 qualitative, 44 quantitative and 6 mixed-method studies were included. Factors influencing health screening uptake in men can be categorized into five domains: individual, social, health system, healthcare professional and screening procedure. The most commonly reported barriers are fear of getting the disease and low risk perception; for facilitators, they are perceived risk and benefits of screening. Male-dominant barriers include heterosexual -self-presentation, avoidance of femininity and lack of time. The partner's role is the most common male-dominant facilitator to screening. CONCLUSIONS: This systematic review provides a comprehensive overview of barriers and facilitators to health screening in men including the male-dominant factors. The findings are particularly useful for clinicians, researchers and policy makers who are developing interventions and policies to increase screening uptake in men.

Da apreensão de informações aos itinerários terapêuticos de homens diante de suspeita ou com diagnóstico de infecções sexualmente transmissíveis. A internet em pauta / From information's assimilation to men's therapeutic itineraries of men with or suspect of sexually transmitted diseases. The internet in focus

Resumo Explora-se como os homens, diante de suspeita ou diagnóstico de doenças sexualmente transmissíveis (DSTs), apreendem as informações sobre elas e como tal apreensão se articula com seus itinerários terapêuticos. O estudo é parte de pesquisa sobre acesso de homens a diagnóstico e tratamento de DSTs (exceto HIV/aids) e envolveu 18 entrevistas individuais em profundidade, com pacientes em seguimento em serviços de saúde, e quatro grupos focais, com trabalhadores do ramo de serviços. Todos acessaram informações sobre DSTs por meio de palestras e campanhas, sobretudo sobre aids. As informações assumem significados distintos, na ausência de sinais/sintomas e na vigência da DST: o sentimento de invulnerabilidade cede espaço para dúvidas, temores e vergonha. O sigilo propiciado pela internet a torna importante fonte de informações quando da suspeita/diagnóstico de DST, mas seu conteúdo reproduz o discurso biomédico, não fornecendo respostas que aplaquem julgamentos morais e o estigma das DSTs. Os homens elegem o médico como principal referência de cuidado, justificando a persistência na peregrinação que fizeram para obter atendimento. Aliada à oferta de serviços, parece oportuno que as informações transitem para uma comunicação em saúde que dialogue com as necessidades da população e que a inclusão digital seja sinônimo de cidadania digital.

Abstract This paper aims to explore how men, in the presence of suspect or diagnosis, can assimilate information about sexually transmitted diseases (STD) and how this comprehension can integrate with their therapeutic itineraries. This study is part of a larger research about the access to diagnosis and treatment of STD (excluding HIV/Aids). It involved 18 individual in-depth interviews with men attending in health services, and four focus groups with service workers. All participants have access to information on STD by lectures and campaigns, especially about Aids. Information has different meanings when there is lack of signs/symptoms or when there is the presence of STD's: feeling of invulnerability or doubts, fears and shame, respectively. The secrecy that internet can provide became a prime source of information when there is a suspicion/diagnosis of STD, but this information can reproduce the biomedical discourses, and do not give answers able to mitigate moral judgments and STD's stigma. Men choose the doctor as the mainly way of treatment and care, which justifies the persistence to look for health care services. Besides the range of services, it seems seasonable that information follows health communication, according to the population's needs, and digital inclusion can be synonymous with digital citizenship.