Nocturia:Current Levels of Evidence and Recommendations from the International Consultation on Male Lower Urinary Tract Symptoms

OBJECTIVE To evaluate published evidence on nocturia in men and derive expert recommendations. METHODS The International Consultations on Urological Diseasese-Societe Internationale d'Urologie convened a Consultation of experts on male lower urinary tract symptoms. The Consultation assigned standardized levels of evidence and grades of recommendation to various studies of nocturia epidemiology, pathophysiology, assessment, and treatment. RESULTS Evidence review and consensus recommendations were made in the areas of epidemiology, pathophysiology, assessment, and treatment. CONCLUSION The review presents a condensed summary of the International Consultations on Urological Diseasese-Societe Internationale d'Urologie evaluation of nocturia, which offers contemporaneous expert consensus on this topic, with an assessment algorithm emphasizing the potential contribution of systemic conditions to the symptom. (C) 2015 Elsevier Inc

Lean mass, muscle strength, and physical function in a diverse population of men: a population-based cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Age-related declines in lean body mass appear to be more rapid in men than in women but our understanding of muscle mass and function among different subgroups of men and their changes with age is quite limited. The objective of this analysis is to examine racial/ethnic differences and racial/ethnic group-specific cross-sectional age differences in measures of muscle mass, muscle strength, and physical function among men.</p> <p>Methods</p> <p>Data were obtained from the Boston Area Community Health/Bone (BACH/Bone) Survey, a population-based, cross-sectional, observational survey. Subjects included 1,157 black, Hispanic, and white randomly-selected Boston men ages 30-79 y. Lean mass was assessed by dual-energy x-ray absorptiometry. Upper extremity (grip) strength was assessed with a hand dynamometer and lower extremity physical function was derived from walk and chair stand tests. Upper extremity strength and lower extremity physical function were also indexed by lean mass and lean mass was indexed by the square of height.</p> <p>Results</p> <p>Mean age of the sample was 47.5 y. Substantial cross-sectional age differences in grip strength and physical function were consistent across race/ethnicity. Racial/ethnic differences, with and without adjustment for covariates, were evident in all outcomes except grip strength. Racial differences in lean mass did not translate into parallel differences in physical function. For instance, multivariate modeling (with adjustments for age, height, fat mass, self-rated health and physical activity) indicated that whereas total body lean mass was 2.43 kg (approximately 5%) higher in black compared with white men, black men had a physical function score that was approximately 20% lower than white men.</p> <p>Conclusions</p> <p>In spite of lower levels of lean mass, the higher levels of physical function observed among white compared with non-white men in this study appear to be broadly consistent with known racial/ethnic differences in outcomes.</p

Familial ovarian cancer survival.

Familial ovarian cancer survival

Change in ED and CVD Risks

IntroductionErectile dysfunction (ED) is associated with cardiovascular disease (CVD); however, the association between change in ED status over time and future underlying CVD risk is unclear.AimThe aim of this study was to investigate the association between change in ED status and Framingham CVD risk, as well change in Framingham risk.MethodsWe studied 965 men free of CVD in the Boston Area Community Health (BACH) Survey, a longitudinal cohort study with three assessments. ED was assessed with the five-item International Index of Erectile Function at BACH I (2002-2005) and BACH II (2007-2010) and classified as no ED/transient ED/persistent ED. CVD risk was assessed with 10-year Framingham CVD risk algorithm at BACH I and BACH III (2010-2012). Linear regression models controlled for baseline age, socio-demographic and lifestyle factors, as well as baseline Framingham risk. Models were also stratified by age (≥/&lt; 50 years).Main outcome measuresFramingham CVD risk and change in Framingham CVD risk were the main outcome measures.ResultsTransient and persistent ED was significantly associated with increased Framingham risk and change in risk over time in univariate and age-adjusted models. In younger men, persistent ED was associated with a Framingham risk that was 1.58 percentage points higher (95% confidence interval [CI]: 0.11, 3.06) and in older men, a Framingham risk that was 2.54 percentage points higher (95% CI: -1.5, 6.59), compared with those without ED. Change in Framingham risk over time was also associated with transient and persistent ED in men &lt;50 years, but not in older men.ConclusionsData suggest that even after taking into account other CVD risk factors, transient and persistent ED is associated with Framingham CVD risk and a greater increase in Framingham risk over time, particularly in younger men. Findings further support clinical assessment of CVD risk in men presenting with ED, especially those under 50 years

Nocturia and Quality of Life: Results from the Boston Area Community Health Survey

Background: Nocturia, a common complaint in aging men and women, is frequently cited as the cause of nocturnal awakenings leading to sleep loss, daytime fatigue, and reduced quality of life (QOL). Objective: Investigate the association of nocturia with QOL and depressive symptoms among men and women. Design, setting, and participants: A population-based epidemiologic survey of urologic symptoms among persons aged 30-79 yr. A multistage stratified cluster sample design was used to randomly sample 5503 residents of Boston, MA, USA. Measurements: Nocturia was defined as a self-report of two or more voiding episodes nightly or having to get up to urinate more than once nightly "fairly often,'' "usually,'' or "almost always.'' QOL was assessed using the physical and mental health component scores of the 12-Item Short-Form Survey (SF-12). Depression was assessed using the Center for Epidemiological Studies Depression Scale. Multiple linear and logistic regression methods were used to model the nocturia and QOL association and to control for confounders. Results and limitations: Nocturia was associated with decreased SF-12 scores for both the physical and mental health components after multivariate adjustment. Nocturia was also associated with increased odds of depressive symptoms (men: adjusted odds ratio [OR]: 2.79; 95% confidence interval [CI], 1.81-4.31; women: adjusted OR: 1.80; 95% CI, 1.29-2.51). Among women who reported sleep interference due to urologic symptoms, nocturia was associated with a threefold increase in odds of depression. In this cross-sectional analysis, the temporal sequence of causality of the nocturia and depression association could not be assessed. Conclusions: Nocturia is associated with decreased QOL and with an increased prevalence of depressive symptoms in both men and women. (C) 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved