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Author db1595 Categories Men's Health Articles, News Leave a comment

High Genital Wart Burden in Unvaccinated Men

The prognosis may seem grim with multiple recurrences over the lifespan attributed to HPV-6/11 infection

  • by Kristin Jenkins, Contributing Writer, MedPage Today
  • Original Article – MedPage Today

When a male patient with genital warts asks whether recurrences will continue, you may find yourself delivering some sobering news.

Results from an analysis nested within the prospective, multinational Human Papillomavirus (HPV) Infection in Men (HIM) study shows that 44% of unvaccinated men ages 18 to 70 years in the U.S., Mexico, and Brazil carry a high burden of genital warts and can experience multiple recurrences that continue into old age.

 

The highest proportion of genital wart recurrence was seen in U.S. men (53.3%), according to Anna R. Giuliano, PhD, founding director of the Center for Infection Research in Cancer (CIRC), at Moffitt Cancer Center, in Tampa, Florida, and colleagues.

Compared to men with genital warts in Brazil and Mexico, U.S. men also had the highest incidence of four or more recurrences (9.7% vs 2.3% and 6.3%, respectively), the researchers reported online in the Journal of Infectious Diseases.

Notably, the incidence rate of each subsequent episode of genital warts increased as the number of recurrences increased. The incidence of the first subsequent event was 13.1 per 1000 person-months. By the fourth recurrence, however, the incidence of genital warts recurrence had tripled to 36.6 per 1000 person-months.

The study also showed that the proportion of genital warts among HPV-6 and/or -11-positive men remained constant across events, and that 63% to 69% were positive for one or more of the 9-valent HPV vaccine types.

 

In the U.S., about $200 million is spent annually for “genital wart treatment, which is often ineffective,” they pointed out.

“The only way to shut this down is with gender-neutral prophylactic HPV vaccination,” Giuliano told the Reading Room.

For vaccination to be effective at the population level in the U.S., she added, “we need to have at least 80% of boys and girls vaccinated.” Currently, HPV vaccine coverage in the U.S. population sits below 50% (approximately 42% of girls and 28% of boys in the recommended age groups).

“We have to make sure that the general population understands the importance of having their children vaccinated and that every age-eligible patient receives a strong recommendation from their provider for HPV vaccination,” Guiliano emphasized.

The American College of Obstetricians and Gynecologists (ACOG) and the U.S. Centers for Disease Control and Prevention (CDC) recommend routine HPV vaccination for females and males ages 9-26 years, she said, noting that licensure extends to age 45 for both men and women.

Persistent HPV infection is the most common sexually transmitted infection worldwide, the investigators pointed out. It is associated with an increased risk of penile, oropharyngeal, and anal cancer in men, and an increased risk of cervical, vulvar, anal, and oropharyngeal cancer in women.

Studies from Australia, Canada, and the U.S. show dramatic declines in genital wart prevalence following the roll-out of HPV vaccination programs, they noted.

“As genital warts are lesions associated with high rates of HPV transmission, vaccination of males against HPV represents an important public health strategy to reduce the large burden of HPV-related diseases in men as well as among their sexual partners,” the study authors wrote.

In 2014, the HIM investigators published evidence showing that men had a higher cumulative probability than women of acquiring HPV, regardless of age. Men also had higher rates of reinfection and reactivation of infections than their female counterparts. The HIM research group reported in 2017 that, in all countries studied, the incidence and prevalence of genital HPV infection in men remained constant over time, even in those middle-age and older.

In a commentary accompanying the 2019 HIM study, Marc Steben, MD, of the Institut National de Santé Publique du Québec, and the Université de Montreal in Montreal, Quebec, Canada, said these results make “the case that we need sex-neutral vaccination programs to better protect men against HPV infection not only because of the risk of cancer but also because of the risk of GWs [genital warts].”

Steben noted that in British Columbia, the annual cost associated with low-risk HPV-6 and HPV-11 infections has been estimated to be 18% of the cost of all HPV-related diseases.

“GWs involve a huge proportion of the HPV burden, and since treatment does not prevent recurrences, we need to emphasize that 4-valent and 9-valent HPV prophylactic vaccines are safe and effective against GWs and remain effective for >10 years after vaccination,” the editorialist wrote. “Although these vaccines may not have a therapeutic effect against GWs, they may act as an adjuvant to existing therapies for the prevention of recurrences.”

Limits for Treating Asymptomatic Bacteriuria

A 2019 clinical practice guideline update on the management of asymptomatic bacteriuria has confirmed that there are only a limited number of populations in whom screening and antimicrobial treatment should be considered. Results from an expert review of the evidence published since the 2005 clinical practice guideline demonstrate that these populations include pregnant women and individuals undergoing invasive urologic procedures.

For other groups, treatment of asymptomatic bacteriuria is not beneficial, according to Lindsay E. Nicolle, MD, professor emeritus in the School of Medicine at the University of Manitoba, in Winnipeg, Manitoba, Canada, and other members of the expert panel.

Treatment of asymptomatic bacteriuria in these groups may be associated with substantial harms, including the development of antimicrobial resistance, C. difficileinfection, and adverse antimicrobial effects, they reported online in Clinical Infectious Diseases.

“Inappropriate treatment of asymptomatic bacteriuria is a major contribution to inappropriate antimicrobial use,” Nicolle told the Reading Room. “Addressing this issue should be a priority for antimicrobial stewardship programs.”

Although there are no changes to the 2005 recommendations, the 2019 update includes a number of important populations not considered in the earlier guideline, Nicolle pointed out. These groups include children, solid organ transplant recipients, patients with neutropenia, and patients undergoing elective non-urologic surgery.

“For all of these groups, we found no evidence of benefit with treatment, so recommendations not to screen or treat were made,” said Nicolle.

In addition, the panel looked at issues affecting populations with a high prevalence of asymptomatic bacteriuria, such as patients with a spinal cord injury and adults age 65 years and older.

Although the evidence was limited, it did not support the use of non-localizing clinical signs and symptoms, such as increased confusion and falls to ascertain symptoms of infection, said Nicolle. She added that “alternate diagnoses rather than urinary tract infection should be considered.”

The HPV study was funded by the National Cancer Institute at the National Institutes of Health and by Merck Sharp & Dohme. Guiliano and study co-author Luisa L. Villa, PhD, reported a relationship with Merck. Editorialist Steben also disclosed a relationship with Merck, as well as with Valeant and Paladin. The ASB guideline update was funded by the Infectious Diseases Society of America. Nicolle disclosed relationships with Paratek, Tetraphase, Utility, and GlaxoSmithKline. A number of other expert panellists also reported relationships with industry.

Author db1595 Categories Men's Health Articles, News, Women's Health Articles Leave a comment

How Anxiety Affects Men and Women Differently

How Anxiety Affects Men and Women Differently

  • February 19, 2019
  • By Texas Health Resources
  • Link to Story – https://areyouawellbeing.texashealth.org/anxiety-affects-men-and-women/?utm_source=enewsletter&utm_medium=email&utm_campaign=2019-03-thr-health-e-news.

While there are some people who seem to take everything that life throws at them in stride, the rest of us struggle with feelings of uncertainty, worry and fear of the unknown from time to time. Normally, our attitudes brighten with a change in circumstances or a fresh perspective, but for some people, a cloud of anxiety hangs around, no matter what.

We’re taking a closer look at generalized anxiety disorder this month, and how it affects men and women, with the help of Ken Jones, a psychologist and the director of behavioral health at Texas Health Arlington Memorial.

The National Institutes of Health defines generalized anxiety disorder as excessive worry or anxiety about normal daily life, occurring more days than not, for a period of six months or more. With little ability to control their overwhelming fears, people may see the negative effects of anxiety trickle down to their relationships, health, school and/or work performance, and feelings of overall well-being.

According to the Anxiety and Depression Association of America (ADAA), the most common signs and symptoms of anxiety are as follows:

  • Feelings of nervousness, irritability or being “on edge”
  • Feelings of panic or sensing impending danger or doom
  • Increased heart rate, hyperventilation, sweating or shaking
  • Feelings of weakness or exhaustion
  • Difficulty concentrating or sleeping
  • Gastrointestinal disturbances

General anxiety disorder usually comes on gradually and can occur at any time in life, but is most common between childhood and middle age. Evidence points to biological factors, family history and stressful life experiences and/or trauma as potential causes.

The NIH reports that generalized anxiety affects approximately 2.7 percent of American adults, with women experiencing the disorder at a higher rate (3.4 percent) versus men (1.9 percent). Around 5.7 percent of adults will experience anxiety at some point in life. Additionally, 2.2 percent of American teenagers ages 13-18 experience generalized anxiety disorder, with girls (3.0 percent) experiencing it at double the rate of boys (1.5 percent).

Around 264 million people across the globe have an anxiety disorder, which includes generalized anxiety disorder, panic disorder and panic attacks, agoraphobia, social anxiety disorder, selective mutism, separation anxiety and specific phobias. Women are twice as likely to be diagnosed with an anxiety disorder, and the prevalence of anxiety disorders is significantly higher for women (23.4 percent) than men (14.3 percent).

Jones says that while everyone will experience and react to anxiety differently, the medical community doesn’t completely understand why it occurs at different rates and leads to different responses among the sexes.

“The reality is that we still have a lot to learn about how gender affects other aspects of anxiety, such as age of onset, duration of symptoms or patterns of response,” he says. “The responses and coping strategies that individuals deploy in response to anxiety would likely be the product of heredity, social upbringing and personality traits.”

In an article published in the Journal of Psychiatric Research, experts conducted research into the gender differences in anxiety disorders. The authors acknowledged the higher rate of incidence in women and sought to dig deeper into how it affects women and men differently.

Their research resulted in the following findings:

  • Women experience higher lifetime diagnosis rates of all anxiety disorders, except social anxiety disorder, which occurs at the same rate for both men and women.
  • There are no differences in the age of onset and chronicity of the illness between the genders.
  • Women diagnosed with one anxiety disorder are more likely than men to be diagnosed with an additional anxiety disorder, bulimia nervosa and/or major depressive disorder, while men are more likely to be diagnosed with a substance abuse disorder, attention deficit/hyperactivity disorder (ADHD) or intermittent explosive disorder.
  • Experts saw a significant interaction between race and gender specific to people diagnosed with bulimia nervosa, as anxious Hispanic men were more likely to be diagnosed with the disorder (3.6 percent) than Hispanic women (2.1 percent).
  • Women with anxiety disorders, particularly white and Hispanic women, were found to experience a greater illness burden than men, which signals a higher rate of disability for women with the disorders.
  • Women tend to deal with their anxiety by agoraphobic avoidance, while men more often turn to substance abuse.

In addition, researchers found that emergency room, urgent care and doctor visits were more common for both women (1.04 visits vs. 0.59 visits) and men (0.71 visits vs. 0.49 visits) with an anxiety disorder than those without one. Women with anxiety also missed significantly more days of work (2.25 days/month) than those without anxiety (1.27 days), but there were no differences for men.

Jones says that employing healthy, familiar coping strategies can be helpful in managing anxiety.

“Self-care is always important and is becoming a lost art amidst the day-by-day demands imposed by both our culture and our internal expectations of performance,” he explains. “Intentionally creating space for relaxation, spiritual re-connection and meditation can be important to managing anxiety.

“It can also be helpful to identify effective coping strategies from our own past. Most of us have already been successful in managing anxiety-producing situations. Reviewing and re-adopting healthy coping strategies from the past can provide a practical roadmap for facing current challenges.”

Jones explains that people with anxiety should focus on helping themselves be the best version of themselves so they can best deal with the disorder.

“Gaining the perspective of a healthy, trusted third party or a professional counselor can be of great assistance in helping us when anxiety becomes overwhelming or we feel stuck,” he says. “It’s also important to remember that the mind and body are inextricably linked. Therefore, getting adequate sleep, eating healthy and getting regular exercise each week places our immune system in the best position to support the cognitive energies we need to rationally sort through anxiety.”

If you or a loved one needs behavioral health support from a professional, Texas Health provides outpatient and inpatient care across North Texas. For information on physicians and services near you, visit Texas Health Behavioral Health or call the helpline at 682-236-6023, which is available 24/7.

Author db1595 Categories Men's Health Articles, News, Women's Health Articles Leave a comment

Blood Pressure, Cholesterol Drugs Could Help Treat Bipolar Disorder and Other Mental Illnesses

Medical science has proven certain medications have the versatility to treat multiple conditions.

Aspirin, for instance, can help with short-term inflammation and pain, but it also works on a long-term basis to reduce the risk of stroke and heart attack.

Now, new research indicates that drugs used to treat physical health issues could potentially do double duty for people with serious mental illness.

The study, written by researchers in the United Kingdom, Sweden, and Hong Kong, was published this month in JAMA Psychiatry.

Researchers assessed the records of patients with serious mental health issues, such as bipolar disorder, who’d been treated with statins, L-type calcium channel antagonists, and biguanides — typically used to treat cholesterol, high blood pressure, and diabetes, respectively.

Researchers said they found that exposure to these drugs was associated with reduced rates of psychiatric hospitalizations and self-harm incidents.

Joseph Hayes, PhD, a clinical research fellow consultant at the University College London’s division of psychiatry and a lead study author, told Healthline the results weren’t unexpected.

“There has been a lack of new drug development for these devastating disorders, but there is some research suggesting that a number of drugs already licensed for other indications may have positive effects on psychiatric symptoms,” Hayes said.

Hiding in plain sight?

The research conducted by Hayes and his team is just the latest in a long history of alternative uses for existing drugs.

Dr. Kevin Johns, a psychiatrist with Ohio State University’s Wexner Medical Center, notes that the first antipsychotic drug, chlorpromazine, was actually a repurposed antihistamine developed in the 1950s.

Johns says the findings of this most recent study make sense.

“Studies like this remind me that the brain is a human organ subject to the same biological forces as the rest of the body. We are increasingly discovering biological underpinnings for mental illnesses, so I’m not surprised to learn that drugs which treat common medical conditions may also treat mental illnesses,” Johns told Healthline.

“While we are currently able to treat a wide variety of mental health conditions, our available treatments are far from perfect. Studies like this bring hope for new treatments that may be hiding in plain sight,” he said.

Hayes also notes that people with schizophrenia, bipolar disorder, and other mental health conditions are often undertreated when it comes to physical health. This puts them at an increased risk for cardiovascular disease, high blood pressure, and diabetes.

“It is therefore worth patients working with their doctors to optimize prescribing for these physical conditions, which may then have additional beneficial effects on mental health,” he pointed out.

While the research could open new avenues for treating mental health conditions, it’s important to note these are still early days.

Hayes says that, at this stage, he and his team don’t recommend people with mental health conditions to change their treatment.

He adds that medications for physical conditions shouldn’t be seen as a magic bullet for treating severe mental health conditions.

It’s also important for people to be mindful of the way mental illnesses can manifest themselves, Johns says. He points out that many conditions are unpredictable and can wax and wane over time.

“Treatment of severe mental illness is not one-size-fits-all, so it’s important for patients to work with their doctors to find the regimen that works best for them,” he wrote.

New frontiers for treatments

To build on their promising research, Hayes says he’d like to see additional randomized controlled trials of these medications for severe mental health conditions.

Unlike newly developed drugs, these drugs are already licensed and well-understood, Hayes says. That should help streamline the process.

The research conducted by Hayes and his colleagues is just one example of the changing face of treatments for psychiatric disorders.

Johns notes that ketamine is another medication that could be repurposed. Generally used as an anesthetic, it’s shown promise in recent years as a treatment for various mood disorders.

Moving forward, some of the tried and tested treatments are being refined and improved upon.

“Electroconvulsive therapy (ECT) remains one of the most effective treatments for many mental health conditions, but newer ‘neuromodulation’ techniques are coming down the pipeline,” Johns said.

“For example, repetitive transcranial magnetic stimulation (TMS) employs a powerful magnet to stimulate targeted parts of the brain to treat mental illness,” he explained. “Unlike ECT, it does not require the patient to be under anesthesia. TMS is already being used to treat depression, and it is being studied to treat a number of other mental health conditions.”

While the field is full of promising findings and new technology, a number of issues unrelated to medical breakthroughs make living with mental illness a continuing challenge.

Johns says that accessing mental health services is a major hurdle for patients and physicians alike, with a shortage of mental health professionals in the United States. This tends to overburden primary care physicians, who are then tasked with providing mental health treatment.

Then there are societal issues, such as stigma.

“I think the stigma surrounding mental illnesses is one of the greatest challenges for the people who are affected by these conditions,” Johns stressed.

“Unlike many other medical conditions, mental illnesses often lack obvious outward signs. As a result, patients often suffer in silence or are told to ‘just get over it’. People living with mental illness are often misconceived as untrustworthy, dangerous, feeble, or lazy, when in fact they can be some of the brightest, bravest, and most caring people in our communities,” he said.ADVERTISING

The bottom line

Drugs used for physical conditions, such as high blood pressure and cholesterol, may be able to do double duty as a treatment for mental health conditions.

Researchers say a recent study showed statins, L-type calcium channel antagonists, and biguanides helped reduce psychiatric hospitalizations and self-harm incidents.

The researchers do caution this research is in its early stages, and people with mental health conditions shouldn’t stop their current treatments to take alternative medications.

Article link: https://www.healthline.com/health-news/blood-pressure-drug-may-be-useful-in-treatment-mental-health-illnesses?fbclid=IwAR2W80pmhM8pX7r_uwH_TKmOwICjEY3y_3gMl7bbWrMIIkkobftaz-WraoY#Hiding-in-plain-sight? Written by Dan Gray on January 14, 2019
Author db1595 Categories Health Stories, News, Uncategorized, Women's Health Articles Leave a comment

How Long Does Menopause Last on Average?

The menopausal transition, or simply “menopause,” is a normal part of female aging. Once you start the transition, you’ll probably want to know exactly how long symptoms will last.

While every woman is different, here’s what to expect on average.

About Menopause

Estrogen Levels During Menopause Ages Graphic - Arizona Gynecology Consultants

All women experience menopause, with several different symptoms.

Menopause symptoms may include:

  • Hot flashes
  • Chills
  • Sleep problems
  • Moodiness
  • Pain during sex
  • Depression

In few cases, women don’t have trouble with these symptoms. Once the menopausal transition is complete, you will no longer have to worry about periods or getting pregnant.

For most women, menopause is a relief that feels freeing in many ways. Getting through the transition, however, can be trying.

Knowing about how long your symptoms will last can help you focus on the light at the end of the tunnel. While you’re going through abrupt hot flashes and night sweats that keep you awake at night as well as irritability from lack of sleep, knowing that you’re just X amount of days from it being over can ease your mind.

While there is no guarantee of exactly how long the transition will last, you can get a good idea of where you are on the journey by understanding the process and studying an average timeline.

The Average Timeline for Menopause

The menopause age range varies by more than a decade. The average age is 51, but menopause can start in women from their mid-40s to late 50s. Most women experience the menopause stage in this age range, while some report symptoms into their 60s.

Late menopause and early menopause are possible, and can occur for a variety of reasons, such as surgeries or hormonal changes.

Symptoms such as mood swings, vaginal dryness, and hot flashes mark the start of the change. Premenopausal symptoms and age can vary. Talk to your doctor if you’re not sure whether you’re beginning the menopausal transition.

The premenopausal stage can last from 10 months to four years. It involves the body gradually decreasing in estrogen production. Premenopause officially ends when a women does not have her period for 12 consecutive months. At this point, the woman enters menopause.

From the start of premenopause to the final cessation of all menopausal symptoms, the average transition takes between two and 10 years. There are some women who go through the process more quickly or more slowly than usual.

If you experience early or late menopause, you may need to add or subtract a year or two to this average timeline. Every woman should rely on medical professionals to assess symptoms, estimate the duration and prescribe treatments for symptom relief.

Do You Have Early or Late Menopause?

Is Menopause Right Around The Corner - Arizona Gynecology Consultants

Figuring out if you’re going through the transition early or late can help you gain a better understanding of how long menopause will last. If you start having irregular periods in your mid-40s, you may be experiencing early or premature menopause.

Heavy bleeding, spotting, a period after a year of no periods, or periods that are noticeably longer or shorter than normal can all signal early menopause, especially in combination with other common menopausal symptoms.

If you are 55 or older and still haven’t noticed menopause symptoms, your doctor may diagnose you with late-onset menopause.

Late menopause may actually have some health benefits, while early menopause could potentially cause problems. During menopause, the production of estrogen and progesterone by the ovaries declines. In early-onset menopause, this cessation may cause problems such as osteoporosis. The longer your ovaries produce estrogen and progesterone, the longer you can avoid osteoporosis.

If you’re still having periods in your late 50s and 60s, see your doctor. Each woman’s reproductive system is different, so don’t be alarmed until you’ve spoken to a doctor.

Treating Menopause Symptoms

You may experience one or several symptoms, or hardly any symptoms at all. You may not notice premenopausal symptoms until you’ve almost reached the menopause phase. Your entire transition could finish in just a few years, or could last longer than a decade.

Everyone is unique, and there is no concrete answer. It takes seeing a primary doctor to evaluate your symptoms, locate where you are on the general timeline, and estimate how much longer you will have to put up with symptoms.

While you are combating symptoms for an unknown period of time, look into common forms of relief. If you have medical conditions exacerbating the symptoms of menopause, such as arthritis, chronic pain, anxiety or depression, your doctor can help address these issues to potentially reduce menopause symptoms.

Menopause is a normal part of life, and several tried-and-true treatment options exist to help control and tolerate common symptoms. You can maintain your desired lifestyle while experiencing menopause with a tailored treatment plan.

Article link – https://www.azgyn.com/blog/how-long-does-menopause-last-on-average/

By:
Arizona Gynecology Consultants

 

Author db1595 Categories Cardiac, Medical Leave a comment

Adding Milk to Tea Destroys its Antixidants

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s sta.It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more Aldus PageMaker including versions of Lorem Ipsum.

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