One-Year Outcomes of the ROBUST II Study Evaluating the Use of a Drug-Coated Balloon for Treatment of Urethral Stricture

Objective To report 1-year results of the ROBUST II study investigating the safety and efficacy of a paclitaxel-coated balloon for the treatment of recurrent urethral strictures. Methods Subjects were adult men with a single anterior urethral stricture ≤ 3 cm in length and at least 2 prior stricture treatments. After treatment with the Optilume urethral drug-coated balloon (DCB), subjects were followed through 1 year. The primary safety endpoint was the rate of treatment-related serious complications at 90 days post-procedure. Efficacy outcomes included symptomatic assessments, erectile function measured using the International Index of Erectile Function (IIEF), Qmax, and anatomic success. Results Sixteen men with an average of 4.1 prior dilations were treated with the DCB. Anatomic success was achieved at 6 months in 73%. Average IPSS improved from 18.4 to 6.0 at 1 year (P < 0.001). Qmax improved from 6.9 mL/sec to 20.8 mL/sec (P < 0.001). There was no change in IIEF. Four subjects received additional treatment within 1 year. There were no treatment-related serious complications. Conclusions Short-term follow-up of men with urethral stricture treated with the Optilume DCB showed durable anatomic results at 6 months and sustained symptomatic improvement through 1 year. Treatment with the device was safe.

The Meaning of Home in Male Migration: Listening to Men’s Experiences

We assessed the sense of psychological home among adult men (n = 17; M age = 29.7 years old) who had experienced migration to Italy, focusing on the relationship between psychological home and the process of integration into the new country. Psychological home is a dynamic process in which people sense a safe and secure environment that ranges beyond the confines of a structured dwelling, a process which is reflective and which communicates one’s self-identity. Participants engaged in a semistructured interview with the aim of establishing a generic concept of psychological home and identifying the issues that arise at the intersection of psychological home and migration. The results highlighted certain themes about the meaning that psychological home assumes in the lives of migrants and about the way in which the migration experience acts to support or hinder the process of building this sense of home. Of special interest is the idea that individuals might develop multiple psychological homes related to the different places and relationships that they experience. In this sense, establishment of a psychological home might be considered the ideal affective state for psychological adaptation to a new country.

Characteristic of spermogram parameters in men with reproductive pathology in age-related aspect

Introduction. The prevalence of andrological diseases among adolescents and young adults resulting in lowered reproductive potential has been noted to progressively increase. At the same time, the number of couples starting to manage reproductive issues after 35–40 years of age highlighting the onset of male androgen deficiency continues to rise. Therefore, the analysis of spermogram as the key element in assessing male reproductive potential is better to conduct at different age periods of man's life.Aim: to compare spermogram parameters in different age groups of patients with reproductive pathology.Materials and Мethods. The analysis of spermograms in adolescents with left-sided grade II–III varicocele aged 17 years and in infertile males aged 22–48 years was performed. Semen analysis was conducted in accordance with the standards of the 5 th edition of the World Health Organization and included the following parameters: semen volume (ml), sperm concentration (million/ml), total sperm count (million), acidity, viscosity, progressive motility, total motility, viability, morphology, detected mucus, leukocytes, amyloid bodies, lecithin grains as well as sperm aggregation and agglutination. The stained preparations were used to assess the morphology of spermatozoa and spermatogenesis cells. According to the spermogram data obtained, the following conclusions were drawn: normozoospermia, oligozoospermia, asthenozoospermia, teratozoospermia. Statistical analysis was performed by using Statistica 10.0 software (StatSoft Inc., USA). The normality distribution was assessed using the χ2 test. Quantitative parameters were presented as arithmetic means and standard deviations (M ± SD). Assessing significance of differences was performed by using the Student's t-test, whereas inter-parameter correlation relations were analyzed by using the linear Pearson's correlation coefficient. A significance level between inter-group parameters was set at p < 0.05.Results. It was found that adolescents with varicocele vs. adult men had significantly decreased ejaculate volume. In particular, the average ejaculate volume in adolescents and adult men was 2.32 ± 1.22 ml and 3.50 ± 1.44 ml, respectively, so that the larger number of young patients were noted to have ejaculate volume below 1.5 ml. Compared to young subjects, aged patients had decreased sperm concentration (35.88 ± 25.74 versus 72.20 ± 49.32 million/ml) and total sperm count (120.58 ± 91.72 versus 173.07 ± 163.92 million). Young patients were found to have significantly superior data in all categories of sperm motility, whereas infertile men were diagnosed with impaired sperm motility. In particular, adolescents were featured with the average number of spermatozoa displaying fast and slow translational movement comprising 17.12 ± 11.04 % and 29.30 ± 12.29 %, respectively, the proportion of progressive motility spermatozoa was 46.20 ± 19.82 %. In contrast, similar parameters in adult men were 5.10 ± 6.36 %, 19.80 ± 9.61 %, and 24.95 ± 11.23 %, respectively. In infertile men prevalence of lacked spermatozoa with rapid forward movement was 46 (46.0 %), in adolescents – 8 (8.6%), whereas rate of immotile spermatozoa in infertile men, on average, accounted for 53.10 ± 14.56 %, in adolescents – 34.40 ± 21.83 %. In addition, adolescents with varicocele had significantly fewer spermatozoa with normal morphology – 14.14 ± 8.06 % (in adult men – 30.08 ± 17.94 %), there were more abundant defects in the sperm head – 58.01 ± 12.43 % (in men – 48.83 ± 18.95 %) and flagella – 17.24 ± 6.31 % (in men – 10.29 ± 6.21 %). The data obtained showed that adolescents were more often diagnosed with normozoospermia – in 49 (52.7 %) cases, in infertile men – in 12 (12.0 %) cases, whereas in aged men asthenozoospermia was detected in 82 (82.0 %) cases, in adolescents – 5 (5.4 %) cases.Conclusion. The abnormalities in the spermogram revealed in adolescents may be associated with unestablished spermatogenesis. Normozoospermia more common in adolescents with varicocele may evidence about preserved reproductive potential. Impaired sperm motility in aged patients seems to be related to the formation of oxidative stress and damage to spermatozoa by reactive oxygen species due to combined age-related changes, cumulation of the negative effects of environmental and lifestyle factors, as well as comorbidities.

Socio-economic Correlates of Marital Status and Marriage Timing Among Adult Men in Nigeria

There is a gradual tendency towards prolonged bachelorhood among men in Nigeria. Studies have linked this to socio-economic factors, but this evidence is sparsely explored in the context of Nigeria. Hence, this study fills the knowledge gap. The 2016/17 Nigeria Multiple Indicator Cluster Survey data of 7803 adult men (aged 18–34 years) was analysed by using descriptive and fitting binary logitic regression and Cox regression models. Results show that slightly more than one-third of adult men in Nigeria (35%) had a marriage history and their median age at first marriage was about 24 years. Educated men (than the uneducated) and those in middle wealth group (than the poor men) were less likely to have ever been married and to delay marriage, respectively. Wealthy men were more likely to delay marriage. Employed men were more likely to have a marriage history and to delay marriage.

Hematological Parameters and Iron Status in Adult Men and Women Using Altitude Adjusted and Unadjusted Hemoglobin Values for Anemia Diagnosis in Cusco, Peru (3400 MASL)

(1) Background: Current diagnosis of anemia in high altitude populations uses an adjustment of observed hemoglobin (Hb) values. Such an approach has been challenged by findings in different populations in Tibet, Ethiopia and the Andes as inappropriate, as it might incorrectly classify an individual with complete iron stores as anemic. We aimed to assess the suitability of this approach in adult men and women from Cusco, Peru (3400 m); (2) Methods: Complete blood count and iron status biomarkers were measured in 345 subjects (189 females and 156 males), iron status biomarkers were quantified with enzyme-linked immunoassays; (3) Results: Anemia prevalence was overestimated when the altitude-adjustment factor was applied. Hematological parameters were better correlated to iron status biomarkers in the non-adjusted anemia category. When stratified by sex, only women showed a significant association between Hb and other hematological parameters with iron storage and availability (Hepcidin and TFR-F); (4) Conclusion: The prevalence of anemia is overestimated with current guidelines. The rate of anemia using non-adjusted Hb values is more closely related to the rates of anemia or iron deficiency when used hematological parameters, markers of iron status, and measurements of hepcidin and erythropoietin. Sex differences related to iron status were observed, suggesting that men are at a higher risk of iron overload than women at high altitudes. It could be highlighted that a personalized approach is important when assessing a subject, taking in to account hematological parameters as well as origin (Southern Andean or other).

Neural changes after training with transcranial direct current stimulation to increase speech fluency in adults who stutter

In a randomised controlled trial, we showed that a five-day intervention combining anodal transcranial direct current stimulation over the left inferior frontal cortex with temporary speech fluency enhancing techniques reduces stuttering. Speech fluency was unchanged by the fluency training alone, as predicted. Here, we report the neural changes associated with the intervention, measured using functional MRI during sentence reading before the training and one-week later. We obtained imaging data in 25 adult men who stutter (median age = 32 y, inter-quartile range = 11) at the pre-intervention baseline and again one-week post-intervention. A control group of 15 adult men who do not stutter (median age = 30 y, inter-quartile range = 10) and did not complete the intervention were scanned on one occasion. In a whole-brain analysis of perceptibly fluent sentence reading, we compared the change in task-evoked neural activity in the sub-group of men who stutter who had received active stimulation during the intervention (N=13) with those who had sham stimulation (N=12). We hypothesised that the combination of anodal stimulation over the left inferior frontal cortex and fluency-enhancing training would result in lasting change to the brain networks supporting fluent speech production. An additional region-of-interest analysis explored effects on basal ganglia nuclei, which are thought to have a key role in the casual mechanism of stuttering, and which we hypothesised would be engaged by the behavioural approach used during training (choral and metronome-timed speaking). One week after the intervention, the group who had received active transcranial stimulation showed increased activity in speech-related brain regions, relative to the group who had received sham stimulation. Cortically, these changes were evident in left inferior frontal cortex (pars opercularis and orbitalis), anterior insula, anterior superior temporal gyrus, anterior cingulate cortex, and supplementary motor area. Subcortically, activation increased in the caudate nuclei and putamen bilaterally, and in right globus pallidus and thalamus. Together these regions form cortico-striatal-thalamo-cortical loops involved in the planning and initiation and control of speech movements.Our findings reveal that the mechanism of action of the tDCS intervention involved increasing activity across the network involved in the production of fluent speech, indicating that tDCS can be used to promote neural plasticity to strengthen networks supporting natural fluency. This study advances the potential of using non-invasive brain stimulation to improve therapy efficacy for those people who stutter who choose to work on increasing fluency.

Eating Slowly Is Associated with Undernutrition among Community-Dwelling Adult Men and Older Adult Women

The double burden of malnutrition refers to the co-occurrence of overweight and obesity and undernutrition. Eating quickly has been linked to overweight and obesity. However, no study has examined the association between eating speed and undernutrition. This retrospective, cross-sectional study analyzed data from 3529 community-dwelling residents. Eating speed was divided into three categories: fast, medium, and slow. Undernutrition was defined as body mass index (BMI) of <18.5 kg/m2 in adults aged < 70 years (adults) and as <20 kg/m2 in adults aged ≥ 70 years (older adults), in accordance with the Global Leadership Initiative on Malnutrition criteria for Asians. Multivariable logistic regression analysis was used to examine the association between eating speed and undernutrition. Among adult men, compared with eating quickly, eating slowly was associated with elevated prevalence of undernutrition (odds ratio (OR) 9.68, 95% confidence interval (CI) 2.32–40.51, p = 0.001). Among older adult women, the prevalence of undernutrition in the slow-eating group was higher than that in the fast-eating group (OR 3.82, 95% Cl 1.51–9.69, p = 0.005). Eating slowly is independently associated with the prevalence of undernutrition among community-dwelling adult men and older adult women in Japan.