Analysis of the Interobserver Variability in Penile Length Assessment.

INTRODUCTION: Many men seek penile augmentation treatments-a standard tool for their counseling is to inform them of what is "normal." Although some studies suggest good correlation between stretched and erect penile length, those that have measured stretched and erect length simultaneously have shown significant variability. AIM: To assess the accuracy of differing penile measurements with multiple observers. METHODS: We recruited 201 adult men (mean age 49.6 years) who achieved full erection using intracavernosal injection. MAIN OUTCOME MEASURES: Penile measurements were taken by one of seven andrology specialists in a private, temperature-controlled (21°C, 72°F) environment. Stretched flaccid and erect length and circumference were measured. We analyzed the accuracy of each flaccid measurement using the erect measurements as a reference, for the overall patient population and for each observer. RESULTS: The mean underestimate of length from stretched flaccid to erect was 2.64 cm (21.4%) and girth 2.27 cm (19.5%). Interobserver variability ranged from a mean underestimate of 16-27% (length) and 15-27% (girth). CONCLUSIONS: In this large, multicenter, multi-observer study of penis size, flaccid measurements underestimated erect size. It also seems likely that there is significant interobserver variability. We believe erect penis measurements should be used for men being considered for treatment of small penis anxiety.

Current practices underestimate environmental exposures to methamphetamine: inhalation exposures are important.

Current practice for determining the exposure to methamphetamine in contaminated homes relies on the analysis of surface wipe sample to address direct contact exposures. The movement of methamphetamine into the air phase, and the potential for inhalation exposures to occur within residential homes contaminated from former clandestine manufacture or smoking of methamphetamine has been generally poorly characterised and understood. All available risk-based guidelines for determining safe levels of methamphetamine in residential properties do not include any consideration of the inhalation pathway as an exposure route. This study showed that methamphetamine can readily move from contaminated materials in a home into the air phase. This movement of methamphetamine into the air phase provides both an exposure pathway and a mechanism for the transfer of methamphetamine throughout a property. The inhalation exposure pathway has the potential to result in significant intake of methamphetamine, adding to dermal absorption and ingestion exposure routes. Guidelines that are established for the assessment of methamphetamine contaminated properties that ignore inhalation exposures can significantly underestimate exposure and result in guidelines that are not adequately protective of health. This study also demonstrates that sampling methamphetamine in air can be undertaken using commercially available sorption tubes and analytical methods.

Satisfaction with body weight among adolescents with excess weight: findings from a cross-sectional population-based study

ABSTRACT BACKGROUND: Individuals who are overweight or obese often underestimate their size, and they are less likely to consider their weight status to be a health problem and consequently to make lifestyle changes. OBJECTIVES: To estimate the proportion of satisfaction with weight among adolescents classified as overweight/obese, according to sociodemographic factors, morbidities and health-related behaviors. DESIGN AND SETTING: Cross-sectional population-based study conducted among adolescents aged 10 to 19 years in the city of Campinas (SP), Brazil. METHODS: The sample (n = 217) included participants with self-reported weight and height who were classified as overweight or obese, based on body mass index (BMI) according to age-specific cutoff points recommended by the World Health Organization. Participants whose answer to the question: "Would you like to gain or lose weight?" was "no" (i.e. no change) were deemed to be satisfied with their body weight. Odds ratios and 95% confidence intervals (95% CI) were calculated using logistic regression. RESULTS: The proportions of the respondents who were satisfied with their weight were 75.8% (95% CI: 65.3-83.9) among the overweight adolescents and 24.2% (95% CI: 16.1-34.7) among the obese adolescents (P < 0.01). Satisfaction was lower among individuals aged 15 to 19 years (versus 10 to 14 years), those born outside of Campinas (versus in Campinas), those with ≥ 8 household appliances (versus < 8), and those reporting ≥ two health complaints (versus none). CONCLUSIONS: More than half of the overweight adolescents and almost a quarter of the obese adolescents were satisfied with their weight. These results support the need for strategies for healthy weight management among Brazilian adolescents.

Underestimate the histologic grade by biopsy preoperative in bladder urotheliai carcinoma / 中华泌尿外科杂志

Objective To compare the histologic grade between biopsy and postoperative specimen in bladder urothelial carcinoma,and approach the state and the reasons of underestimate the histologic grade preoperative.Methods We retrospectively 82 cases of urothelial carcinoma at the Third Affiliated Hospi- tal of the Sun Yat-Sen University.For all the cases in this study,the histologic grade,using the 1998 World Health Organization and International Society of Urological Pathologists(WHO/ISUP)classification,was i- dentical when the biopsy specimen and postoperative specimen were compared.Results In this study,35 cases,28 cases and 19 cases were G_1、G_2、G_3 by biopsy preoperative,respectively;while 22 cases,32 cases、28 cases were G_1、G_2、G_3 postoperative,respectively.There were 24 cases(29.3%)underestimate the histo- logic grade by biopsy preoperative in the 82 cases,while 4 cases(4.9%)overestimate preoperative.The state of underestimate the histologic grade is correlated with the location of biopsy,tissue dose and the conser- vation of pathology judgment.Conclusions There were 24 cases(29.3%)underestimate the histologic grade by biopsy preoperative.We should pay more attention to this state of underestimate the histologic grade preoperative in the treatment of bladder urothelial carcinoma.