Prevalence and predictors of selenium and vitamin E supplementation in a urology population.

OBJECTIVES: Preclinical and epidemiological studies have suggested the use of supplements such as selenium and vitamin E for prostate cancer (PCa) prevention; however, clinical trials have not demonstrated clear benefit in patients. This study aims to investigate the current prevalence and predictors for use of these supplements in men in a urology population. DESIGN, SUBJECTS, AND OUTCOMES MEASURED: Three hundred and twelve (312) men visiting the Princess Margaret Hospital Ambulatory Urology Clinic were enrolled in this University Health Network Research Ethics Board-approved questionnaire-based study investigating supplement use, reasons for use and demographic characteristics. RESULTS: It was observed that 13.5% and 20.8% of the participants are currently using selenium and vitamin E, respectively, while 10.6% and 15.7% previously used selenium and vitamin E, respectively. Both education (percentage of users comparing less than college education versus college or above education: selenium: 14% versus 28%; p=0.008, vitamin E: 26% versus 41%; p=0.013) and health literacy (mean scores±standard error of the mean of users versus nonusers: selenium question 1: 1.4507±0.09576 versus 1.6083±0.07211; p=0.023, selenium question 2: 2.8750±0.04395 versus 2.7106±0.03774; p=0.000, selenium question 3: 1.4583±0.08377 versus 1.7064±0.06278; p=0.025, vitamin E question 1: 2.8036±0.04545 versus 2.7179±0.04097; p=0.010, vitamin E question 2: 1.5446±0.06698 versus 1.7077±0.07241; p=0.006) are predictors of selenium and vitamin E use on univariable analysis. On multivariable analysis education (selenium odds ratio=2.095, 95% confidence interval=1.019-4.305, p=0.044; vitamin E odds ratio=1.855, 95% confidence interval=1.015-3.338, p=0.045) remains a significant predictor of selenium and vitamin E use. Examining the data on use by education, it was found that more men with a higher education attributed their use of selenium to urologist advice (24%), and those with a lower education attributed their use of selenium to naturopath/homeopath advice (28%). CONCLUSIONS: Many men who visit urology clinics use selenium and vitamin E despite the lack of clinical support for chemoprevention. Education and health literacy are important variables in determining the use of these supplements in these men. This information may aid in addressing the needs of the diverse patient population using these supplements for the prevention of PCa.

Semiología renal y genitourinaria en pediatría: primera parte / Nephrologoy and urology semiology in children: first part

A pesar de los avances tecnológicos, la historia clínica y el examen físico continúan y continuarán siendo la base de un buen enfoque y aproximación diagnóstica correcta, por ésto, la semiología sigue siendo un área muy importante en la medicina. En ésta revisión se plantea una guía sistemática e integral para la evaluación del sistema nefro-urológico en el niño desde las herramienta básicas y fundamentales como la historia clínica, el examen físico con sus componentessemiológicos en lo normal y lo patológico, integrando además los métodos diagnósticos de laboratorio e imagen disponibles en la actualidad, para lograr un buen enfoque y aproximación diagnóstica en niños con enfermedad renal.

Despite technological advances, medical history and physical examination remain the foundation of a good approach and correct diagnosis; semiology remains a very important area in medicine. In this review a systematic and comprehensive guide for the evaluation of nephron urological system in children is presented, with emphasis in medical history, physical examination and semiotic aspects, in normal and pathological conditions; additionally laboratory and imaging studies available to achieve a good diagnostic approach in children with renal disease are presented.