Shift Work Throws Urologic Health Off Schedule

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Nonstandard shifts and a circadian rhythm disturbance known as shift work sleep disorder contribute to a significant increase in urinary tract symptoms and reproductive problems, according to three studies conducted at the Baylor College of Medicine in Houston.

“A 45-year-old shift worker with shift work sleep disorder might look like a 75-year-old man in terms of his lower urinary tract symptoms,” John Sigalos, a medical student and investigator on one of the studies, said here at the American Urological Association 2017 Annual Meeting.

The other studies presented demonstrate that male shift workers with shift work sleep disorder have lower testosterone levels and more hypogonadal symptoms than daytime workers, and that infertile shift workers, especially those who work rotating shifts, have significantly worse semen parameters than infertile men who work the day shift.

In the United States, approximately 15% of the labor force works late-night or rotating shifts.

Lower Urinary Tract Symptoms Study

To determine the effect of poor sleep quality and shift work on lower urinary tract symptoms, Sigalos and his colleagues retrospectively reviewed the medical records of men treated at the Baylor andrology clinic from 2014 to 2016.

All the men had completed the International Prostate Symptom Score (IPSS) to evaluate lower urinary tract symptoms, completed questionnaires about work schedules and sleep disorders, and had blood samples taken.

Of the 2487 participants, 766 (30.8%) reported working nonstandard shifts in the previous month and, of these, 36.8% were considered to be at high risk for sleep disorders.

Mean IPSS score was higher in shift workers with sleep disorders than in shift workers without, and daytime workers (7.77 vs 5.37 vs 6.84; P < .0001 between all groups).

IPSS scores were 3.1 points lower in shift workers with sleep disorders than in shift workers without, after age, comorbidities, and testosterone levels were controlled for (= .0001).

These findings suggest that poor sleep quality — rather than shift work itself — contributes to the increase in lower urinary tract symptoms. Patients at risk for shift work sleep disorder should be screened for lower urinary tract symptoms and counseled about the risk, Sigalos told Medscape Medical News.

Hypogonadism Study

The potential for hypogonadal symptoms and sexual dysfunction was examined by another group of Baylor investigators who used the same cohort of men.

On multivariable analyses that controlled for age, Charlson comorbidity score, and testosterone levels, mean scores on the quantitative Androgen Deficiency in the Aging Male (qADAM) questionnaire were 0.8 points lower in nonstandard shift workers than in daytime workers (P < .01). And mean qADAM score was 3.9 points lower in shift workers at high risk for sleep disorders than in shift workers at low risk (P < .01).

In addition, there was an independent association between high risk for shift work sleep disorder and lower testosterone levels after age, comorbidities, and history of testosterone supplementation were controlled for (P < .01).

Semen Parameters Study

The effects of shift work and sleep quality on semen parameters and reproductive hormones in men were assessed in a prospective study by Taylor Kohn, MD, and his colleagues.

The study participants — 75 infertile shift workers, 96 infertile nonshift workers, and a control group of 26 fertile men — completed questionnaires about shift work and sleep quality, and underwent semen analysis and hormone testing.

Sperm density was significantly lower in infertile shift workers than in infertile nonshift workers (P = .012), as were total motile counts (P = .019) and testosterone levels (= .026).

However, the differences in sperm motility, forward progression measures, luteinizing hormone levels, and follicle-stimulating hormone levels were not significant.

All semen parameters were significantly lower in the infertile shift workers than in the fertile control group, and luteinizing hormone and follicle-stimulating hormone levels were significantly higher. Testosterone levels were about the same in the two groups.

On linear regression that controlled for age, Charlson comorbidity index, tobacco use, and average income, there was a significant negative association between total motile count and shift work (P = .039), and a significant positive association between total motile count and previous fertility (P = .041).

In addition, total motile counts were significantly lower in men who worked rotating shifts than in those who worked fixed shifts (P < .05).

The type of job shift workers performed also made a difference. Men who performed physical labor in environments where chemical use was common (such as oil fields and refineries) had significantly lower total motile counts than physical laborers without chemical exposure, medical workers, white-collar workers, and first responders (P < .05).

Sleep satisfaction also seemed to play a role. “When assessing reported overall sleep amounts in the previous month, follicle-stimulating hormone and testosterone levels trended downward as men became more unsatisfied with the amount of sleep they were getting,” Dr Kohn reported.

Thinking Beyond the Prostate

It is important for urologists to think beyond the prostate when treating men with lower urinary tract symptoms or sexual dysfunction, said Howard Adler, MD, clinical associate professor of medicine at the Stony Brook University School of Medicine in New York.

When men present with symptoms like those reported in these studies, clinicians need to consider not only prostate-related symptoms, but also age-related changes in bladder function, renal function, and other medical conditions, such as diabetes, he told Medscape Medical News.

At Stony Brook, Dr Adler explained, he and his colleagues have begun “asking patients about sleep habits and snoring, and are sending them for sleep studies to see if they have apnea or something else, especially patients with a lot of night-time urination.”

The studies were supported by the Baylor College of Medicine. The authors and Dr Adler have disclosed no relevant financial relationships.

American Urological Association (AUA) 2017 Annual Meeting: Abstracts MP13-12 and PD13-08 presented May 12, 2017; Abstract MP91-06 presented May 16, 2017.

Written By: Neil Osterweil

Article Source: http://www.medscape.com/viewarticle/880096#vp_1

 

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Gout Patients Should Be Screened for Erectile Dysfunction

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Erectile dysfunction (ED) is common and often severe in men suffering from gout, according to the results of a cross-sectional survey of men who presented to a rheumatology clinic.

“These results strongly support the proposal to screen all men with gout for the presence of ED. Increasing awareness should in turn lead to earlier medical attention and treatment for this distressing condition,” said lead author Naomi Schlesinger, MD, chief, Division of Rheumatology, and professor of medicine at Rutgers–Robert Wood Johnson Medical School, in New Brunswick, New Jersey.

The results of the study were presented here at the European League Against Rheumatism (EULAR) Congress 2014.

The most common inflammatory arthritis in men older than 40 years, gout is caused by deposits of urate crystals in the joints and is associated with uricemia. The crystals cause inflammation, pain, and swelling, and the inflammatory component of the disease is linked to risk factors for cardiovascular disease and coronary artery disease.

The cross-sectional study included 201 men aged 18 to 89 years who presented at a rheumatology clinic between August 2010 and May 2013. Of these, 83 had gout.

Participants filled out a Sexual Health Inventory in Men (SHIM) questionnaire, which evaluates the ability to have an erection, the firmness of the erection, the ability to penetrate sufficiently for sexual intercourse, and sexual satisfaction. A score of ≤21 indicates ED; a score of ≤10 indicates severe ED.

“Men don’t usually volunteer sexual complaints,” said Dr. Schlesinger. “The gout patients in our study were generally delighted and grateful that someone finally asked them about ED.”

The mean SHIM score for all participants was 16.88. Patients with gout had a mean SHIM score of 14.38 compared with 18.53 in patients without gout (P < .0001).

A significantly greater percentage of patients with gout had ED compared with patients without gout (76% vs 52%, P = .0007). Also, significantly more men with gout had severe ED vs men without gout (43% vs 30%, P = .007).

The presence of ED was significantly more frequent in gout patients aged 65 years or older, compared with men of the same age without gout (P = .0001), and was significantly more likely to be severe (P = .0002).

A multivariate analysis adjusted for age, hypertension, low-density cholesterol level, glomerular filtration rate, obesity, and depression found that the association between gout and ED was statistically significant (P = .0096).

Silent Coronary Artery Disease

 “It is estimated that 1 in 5 men who present with ED have silent coronary artery disease. A man with ED, even with no cardiac symptoms, is a cardiac patient until proven otherwise,” said Dr. Schlesinger. “Perhaps we could say that the 3 ‘EDs’ are related: endothelial dysfunction leads to erectile dysfunction leads to early death.

“Gout patients who present with ED have an increased rate of cardiovascular risk factors and concomitant silent coronary artery disease and should be evaluated,” she added.

 Maya Buch, MD, from the Leeds Institute of Rheumatology and Musculoskeletal Medicine, at the University of Leeds, United Kingdom, praised the authors of this study for providing new information on these conditions with overlapping risk factor — gout and cardiovascular disease.
 “These patients are at risk for cardiomyopathies, and there is no literature on ED and gout. We know that patients with gout have multiple comorbidities, and it’s clear that rheumatologists need to address that,” she explained.

“I was surprised at how many patients with gout have ED. In addition to treating hyperuricemia in our patients with gout, we need to pay attention to cardiovascular risk factors. I hope that this study makes doctors more receptive to evaluating patients for ED,” she added.

Dr. Schlesinger has disclosed no relevant financial relationships. Dr. Buch has received honoraria and consulting fees from AbbVie, Bristol-Myers Squibb, and Roche-Chugai and has a research grant from Pfizer, Inc.

 European League Against Rheumatism (EULAR) Congress 2014: Abstract OP0135. Presented June 13, 2014.

Written By: Alice Goodman

Article Source: http://www.medscape.com/viewarticle/826773

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Exercise can boost brain power, prevent heart damage

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Looking for a magic elixir for health? There’s more evidence exercise may be it, improving thinking skills in older adults and protecting against heart damage in obese people, two separate studies published Monday show.

“Exercise has many, many benefits. … I don’t know that we fully understand why it has so many beneficial effects for so many organs and systems,” Dr. Roberta Florido, a cardiology fellow at the Johns Hopkins Hospital, told TODAY, as she listed some of the other known benefits, including improving depression, lowering blood pressure and strengthening muscles.

“We should do a better job of telling our patients to exercise,” she added.

In the first paper, published in the British Journal of Sports Medicine, researchers at the University of Canberra in Australia analyzed 39 previous studies looking into the effect of exercise on thinking skills in people over 50. That included things like memory, alertness and the ability to quickly process information.

They found physical activity improved all of those skills regardless of a person’s cognitive status.

The key was 45-60 minutes of moderate to vigorous exercise per session “on as many days of the week as feasible.” A combination of both aerobic exercise and resistance training worked best.

Each type of exercise seemed to have different effects on the factors responsible for the growth of new neurons and blood vessels in the brain, said co-author Joe Northey, a PhD student at the University of Canberra Research Institute for Sport and Exercise.

Tai chi was also helpful, though more evidence is needed to confirm this effect, the researchers note.

“Age is a risk factor no one can avoid when it comes to cognitive decline,” Northey said. “As our study shows, undertaking just a few days of moderate intensity aerobic and resistance training during the week is a simple and effective way to improve the way your brain functions.

Written By: A. Pawlowski

Article Source: http://www.today.com/health/exercise-can-boost-thinking-skills-protect-against-heart-damage-t110740

 

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Benefits of Sermorelin w/GHRP2 in the First Six Months

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Sermorelin and GHRP2 both stimulate the patient’s own pituitary gland by binding to specific receptors that increase production and secretion of endogenous Human Growth Hormone (HGH).  GHRP2 also acts as an appetite suppressant allowing for increased weight loss.

First Month

Weight loss/Body fat reduction

Vivid dreams

Better, sounder sleep

Improved stamina

Optimistic attitude

 

Second Month 

Improved muscle tone

Increased strength

Improved skin tone

Improved nail growth

Better digestion

Weight loss/Body fat reduction

Improved vision

Enhanced sexual function

 

Third Month

Improved mental process

Enhanced productivity

Faster wound healing

Hair re-growth

Increased libido

Increased muscle size

Faster recovery from muscle soreness

Reduced PMS symptoms

Greater body flexibility

Reduced pain

 

Fourth Month

Heightened improvements with all of the above

At times improvements may seem to diminish or plateau

Rejuvenation is still a process. Benefits should resume with continued improvements

 

Fifth Month

Improved weight loss and reduction of inches

Improved skin texture and appearance

Skin thickening and greater elasticity

Reduction of skin wrinkles

Thickening of hair with a shiny, healthy appearance

Continuation of improved muscle tone

 

Sixth Month

Diminished cellulite

Improved resistance to colds, flu and other illnesses

Improved eyesight

Healing of old wounds

Disappearance of pain and soreness

Improved body contour

 

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A Man’s Body by Decade

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Heart

The problem: As men age, blood pressure and cholesterol levels often increase. The fix: Eat a heart-healthy diet, exercise, and have your blood pressure and cholesterol levels checked annually. Consider a coronary calcium scan above age 50, if heart disease runs in the family.

Skin

The problem: Men ignore their skin more often than women. The fix: Get an annual head-to-toe skin screen by a dermatologist to evaluate suspicious moles and other skin conditions.

Muscle

The problem: Men begin losing muscle mass by age 30. The fix: Incorporate muscle training into your fitness routine to help increase bone density, metabolism, and muscle-fat ratio, while maintaining flexibility and balance.

Colon

The problem: Colon cancer is the third most common cancer in men. The fix: Eat a diet high in vegetables, fruits, and whole grains, and low in red meat and alcohol. Consider a colon­oscopy at age 50, particularly if colon cancer runs in the family.

Prostate

The problem: Benign prostatic hyperplasia (an enlarged prostate) affects about 50 percent of men between the ages of 51 and 60 and up to 90 percent of men older than 80. The fix: Eat a low-fat diet, exercise, and undergo a prostate exam by age 50 or sooner if at high risk for prostate cancer.

Testosterone

The problem: Levels typically decrease with age, with about 20 percent of men having low T by their 60s. The fix: See a doctor to get your testosterone levels checked, if experiencing a drop in libido, energy level, unexplained weight gain, or ongoing depression.

Article Source: http://www.johnshopkinshealthreview.com/issues/spring-summer-2017/articles/a-users-guide-to-mens-health

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Why glutathione is important to us

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 One important protein that appears in every human cell is a tripeptide known as glutathione.

Found in the highest concentrations in the liver, it consists of three amino acids: glutamic acid, L-cysteine and L-glycine.

The first record of glutathione was in 1888, but it was not until 1984 that its function in the body began to be researched in detail.

It turns out that glutathione serves as an antioxidant and detoxifier that protects cells from free radicals and oxidative stress, thus, improving the immune system.

But glutathione levels in human cells begin to decline after you turn 20. In order to produce more glutathione, supplementation of L-cysteine is recommended.

In the absence of glutathione, the body will experience several things. All the cells in the body would face premature death, causing the liver, which cleanses your body of toxic materials, to malfunction.

Worse, the entire immune system will break down – in other words, without glutathione, humans would cease to exist.

How glutathione works

Glutathione is the only antioxidant that is intracellular, meaning that it acts inside the cells. This helps to resist disease by neutralising free radicals and keeping other antioxidants like vitamins C and E in their active form.

Many scientists believe there is a link between low glutathione levels and cell death, which could be why the levels of glutathione in patients with serious diseases such as AIDS and cancer, are typically very low.

On the other hand, clinical observations of people aged 100 and more in various countries like Poland, Italy and Denmark, have found very high levels of glutathione in their cells.

Other functions of this protein include helping to process toxins in the liver; DNA and protein synthesis; and regulating the nitric oxide cycle and the metabolism of iron.

Key benefits of glutathione

Decreased levels of glutathione have several consequences that are linked to a number of age-related illnesses. This includes:

Alzheimer’s disease and macular degeneration – A University of Alabama study in the United States revealed that the red blood cells in male Alzheimer’s patients indicated a significant lack of glutathione.

Heart disease – A study of patients with heart disease found that the lower their levels of glutathione, the higher the likelihood of them experiencing a heart attack.

Cancer – While glutathione is not able to cure cancer, several studies suggest that the growth of new cancer cells may be reduced. Its strong antioxidant properties make it suitable as a supplement.

This is why some doctors recommend it as a supplement to treat cancer, as it improves the effectiveness of chemotherapy drugs and reduces their side effects.

Psychiatric illnesses, including bipolar disorder, schizophrenia and depression – These have been linked to low levels of glutathione. The lack of antioxidant abilities in the brain can cause oxidative stress.

Glutathione has also been used to treat Parkinson’s disease, sickle cell anaemia, idiopathic pulmonary fibrosis and poisoning, as it is able to cleanse the body of unhealthy metals such as mercury.

Glutathione has been found to improve the quality of the human male sperm. This is achieved by the lowering of blood pressure and decreasing oxidative stress on the sensitive sperm cells, hence, minimising damage to their DNA cargo.

Couples who are trying to conceive should look for micronutrient supplements, especially n-acetyl-cysteine (NAC), which is used in the body to produce L-glutathione.

The aspiring father could also benefit from consuming scientifically-proven nutrients such as arginine, carnitine and pine bark extract.

Because it is a protein, a fair amount of glutathione that you ingest is broken down in your gut and eliminated before reaching the cells.

 

Article Source: http://www.star2.com/living/viewpoints/2016/05/29/why-glutathione-is-important-to-us/#v9QZZBkX3X5BqJzk.99

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Weight-Bearing Exercises Promote Bone Formation in Men

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Human hormone and protein linked to bone mass are impacted by 12 months of targeted exercise

COLUMBIA, Mo. – Osteoporosis affects more than 200 million people worldwide and is a serious public health concern, according to the National Osteoporosis Foundation. Now, Pamela Hinton, associate professor in the Department of Nutrition and Exercise Physiology, has published the first study in men to show that long-term, weight-bearing exercises decrease sclerostin, a protein made in the bone, and increase IGF-1, a hormone associated with bone growth. These changes promote bone formation, increasing bone density.

“People may be physically active, and many times people know they need to exercise to prevent obesity, heart disease or diabetes,” Hinton said. “However, you also really need to do specific exercises to protect your bone health.”

In the study, men 25- to 60-years-old who had low-bone mass were split into two groups. One group performed resistance training exercises such as lunges and squats using free weights. The other group performed various types of jumps, such as single-leg and double-leg jumps. After 12 months of performing the exercises, Hinton then compared the levels of bone proteins and hormones in the blood.

“We saw a decrease in the level of sclerostin in both of these exercise interventions in men,” Hinton said. “When sclerostin is expressed at high levels, it has a negative impact on bone formation. In both resistance and jump training, the level of sclerostin in the bone goes down, which triggers bone formation.”

The other significant change Hinton observed was an increase in the hormone IGF-1. Unlike sclerostin, IGF-1 triggers bone growth. The decrease of harmful sclerostin levels and the increase in beneficial IGF-1 levels confirmed Hinton’s prior research that found both resistance training and jump training have beneficial effects on bone growth.

To increase bone mass and prevent osteoporosis, Hinton recommends exercising specifically to target bone health. While exercises such as swimming and cycling are beneficial to overall health, these activities do not strengthen the skeleton. Hinton suggests also doing exercise targeted for bone health, such as resistance training and jump training.

The study, “Serum sclerostin decreases following 12 months of resistance- or jump-training in men with low bone mass,” was published in Bone.

https://www.eurekalert.org/pub_releases/2017-03/uom-wep032217.php

 

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