Phthalates Identifed In Numeruous Medicines And Supplements

Main Category: Public Health
Also Included In: Men's health
Article Date: 19 Dec 2011 - 0:00 PST

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Researchers from Boston University's Slone Epidemiology Center (SEC), in collaboration with Harvard School of Public Health, have found numerous prescription and over-the-counter drugs and supplements use certain chemicals called phthalates as inactive ingredients in their products. The findings appear on-line in Environmental Health Perspectives.

Phthalates such as dibutyl phthalate (DBP) and diethyl phthalate (DEP) are used as inactive ingredients in FDA-approved medications where they may serve a variety of functions. Most commonly, they are used in the coating of a drug product to target the delivery of the active ingredients to a specific area of the gastrointestinal tract, or manage their release over time. Some phthalates, including DBP have been identified as causing adverse developmental and reproductive effects in laboratory animals. Limited human studies have suggested a possible association of DBP and DEP with male reproductive health outcomes.

Using a combination of resources, the researchers were able to identify over 100 drug and dietary supplement products that indicated they contained phthalates, including 50 prescription, 40 over-the-counter (OTC) and 26 dietary supplement products with labels that listed DEP or DBP, of which nine contained DBP. In addition, a large number of product labels listed phthalate polymers that are considered to be of little or no known toxicity but which are often used in combination with other phthalates.

"Given the thousands of orally-ingested products on the market (prescription, OTC and dietary supplements), it is difficult to know exactly how many contain phthalates. However, it is informative and important to identify the specific drug products that have included phthalates in their formulations," said lead author Kathy Kelley, MPH, RPh, a research pharmacist at BU's SEC.

According to the researchers, the potential health effects of human exposure to these phthalates through medications are unknown and warrant further investigation. "The present findings should assist researchers in conducting the necessary studies of potential risk of phthalates in human populations, but such efforts are limited by the lack of centralized, comprehensive, and publically-available information on the presence of phthalates in the full range of prescription, OTC and dietary supplement products," added Kelley.

The researchers recommend that future studies should pay particular attention to the amount of phthalate, specifically DBP, used in each dosage form so that estimates of exposure from medications and supplements can be quantified.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our public health section for the latest news on this subject. Funding for this study was provided by the National Institute of Health, The Eunice Kennedy Shriver National Institute of Child Health & Human Development.
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Gay Married Men Enjoy Better Health Than Single Gay Men

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Academic Journal
Main Category: Men's health
Also Included In: Mental Health;  Anxiety / Stress
Article Date: 18 Dec 2011 - 12:00 PST

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Men in same-sex marriages enjoy better health, have fewer doctor visits and lower health care costs compared to other gay or bisexual men, researchers from the Mailman School of Public Health wrote in the American Journal of Public Health. They added that when states offer legal protections for same-sex marriages, as is the case in Massachusetts, gay men generally have lower overall levels of stress. The article is titled "Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment."

Lead author, Mark L. Hatzenbuehler, PhD, said:

"Our results suggest that removing barriers to marriage improves the health of
gay and bisexual men."

During a twelve-month period after the legalization of same-sex marriage in Massachusetts in 2003, the following changes were noted among gay and bisexual males: 13% fewer medical care visitsA significant drop in the number of mental healthcare visits14% lower health care costsHIV-related visits remained about the same among males who were HIV positiveHatzenbuehler and team gathered data on 1,211 patients from a community-based health clinic in Massachusetts that specialized in sexual minorities. After the state approved the same-sex marriage law, they examined the clinic's billing records and found that the following conditions, all stress-related, became considerably less frequent - high blood pressure (hypertension), depression and adjustment disorders.

Dr. Hatzenbuehler said:

"These findings suggest that marriage equality may produce broad public health benefits by reducing the occurrence of stress-related health conditions in gay and bisexual men."

The authors explained that prior studies had indicated that not allowing same sex marriages resulted in more stress for gay and bisexual people. They added that this new study is the first to determine what impact same-sex marriage policies might have on healthcare usage and expenditure among gay and bisexual males.

As there were not enough lesbians visiting the clinic, they could not include this group of people in their study.

Dr. Hatzenbuehler said:

"This research makes important contributions to a growing body of evidence on the social, economic, and health benefits of marriage equality."

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our men's health section for the latest news on this subject. "Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment"
Mark L. Hatzenbuehler, PhD, Conall O'Cleirigh, PhD, Chris Grasso, MPH, Kenneth Mayer, MD, Steven Safren, PhD, and Judith Bradford, PhD
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posted by Josh on 18 Dec 2011 at 3:51 pm

I support homosexual marriage, but to make claims to progress that right based on these supposed health benefits is a little ridiculous in my opinion. It seems to me all to probably that this is simply a spurious relationship that might have other underlying factors effecting the reality of the situation.

If there are actual stress-related health benefits as consequence gay men being allowed to marry each other, I feel they are minimal, the importance of which is over-exaggerated by this article.

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The Mental Health Of Widowers Improves With New Relationship

Main Category: Mental Health
Also Included In: Men's health;  Sleep / Sleep Disorders / Insomnia
Article Date: 16 Dec 2011 - 0:00 PST

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Men who have lost their partner to cancer and who are still single four to five years after their loss run a far greater risk of developing mental illness than those who have managed to find a new partner, reveals a unique study of 691 Swedish widowers carried out at the Sahlgrenska Academy.

More than 22,000 people die of cancer in Sweden each year. It has been scientifically proven that relatives of the deceased are at greater risk of dying themselves or developing mental and physical illness, although studies have tended to focus on widows, and on the short-term risks.

Unique long-term study

Researchers at the University of Gothenburg's Sahlgrenska Academy have now carried out a unique long-term study of 691 Swedish men who lost their wives to cancer. Part-funded by the Swedish Cancer Society and the Swedish Research Council, the study shows that widowers who had found a new partner four to five years after the death of their wife managed to deal with their loss relatively well.

Sleeping pills and antidepressants

However, those who remained single were at far greater risk of developing depression, anxiety, sleep disorders and emotional blunting, and were also more likely to use sleeping pills and antidepressants.

Long-term risk

"Previous studies have shown that people who lose their partner are at greater short-term poor mental health," says professor Gunnar Steineck who worked on the study. "Our study is the first to show that the risk of poor mental health last for many years but, on the average, the risk is restricted to those who don't find a new partner."

Can your results be interpreted as proof that love heals?

"We need more research to understand the underlying mechanisms, but yes, emotional support from a new partner does probably help to process grief and protect against mental illness," says Steineck. "But it could also be the case that those men who cope best with their loss are more likely to show an interest in finding a new partner."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our mental health section for the latest news on this subject. THE SURVEY
The study was based on a questionnaire sent out to 691 widows in Sweden. It included questions on medication and perceived quality of life, and the answers were then compared with those from a control group of around 300 married men.
The study has been published in the journal Psycho-Oncology. Link to article: http://bit.ly/w0gh5P
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posted by James Bond on 16 Dec 2011 at 1:23 am

This sounds 'shallow' so to say.
The people should have been thoroughly evaluated(mentally and phisically) at the time their spouse died.
The fact that some of them find a new partner might be a CONSEQUENCE from their better mental or physical health, not the REASON for it.

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Unpleasant Smell Linked To Gonorrhea In Men

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Academic Journal
Main Category: Sexual Health / STDs
Also Included In: Men's health
Article Date: 09 Dec 2011 - 18:00 PST

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A much higher percentage of men with an unpleasant smell were found to have gonorrhea compared to other men, researchers from the Institute of Cytology and Genetics in Novosibirsk, Russia revealed in the Journal of Sexual Medicine. The authors explained that adult males with gonorrhea had a putrid smell, as far as many adult females were concerned.

As background information, the authors explained that animal research had demonstrated that rats and mice pick up on chemical signals to avoid sexual contact with infected potential mates. However, studies into body odor in humans have so far been limited to medical diagnostics. No studies had ever looked into smell modifications in humans, due to infection, and what impact that might have in choosing a sexual partner.

As STDs or STIs (sexually transmitted infections) have no clear visible external signs, the researchers wondered whether odor might be a sign that has been overlooked.

Mikhail Moshkin and team set out to determine whether odor unpleasantness in young adult males might be linked to infection with Neisseria gonorrhoeae (gonorrhea).

The researchers collected saliva and armpit samples from 16 healthy, 13 gonorrhea infected, and 5 other men who had recovered from gonorrhea after medical treatment. Healthy young female volunteers then assessed the sweat samples for odor (smell). With the saliva samples, the researchers measured for concentrations of testosterone, cortisol, immunoglobulin G (IgG), and immunoglobulin A (IgA). All the male participants were aged from 17 to 25 years and the female ones from 17 to 20.

Their aim was to determine whether the females could distinguish pleasant and unpleasant armpit sweat smells, and whether the differences might be linked to gonorrhea infection, no infection, or recent infection.

They found that: The women described the odor from infected individuals as less pleasant compared to the healthy and recently recovered men. A very high proportion of samples from the infected men were rated as putrid (rotten, rancid).There was a negative correlation between odor pleasantness and concentrations of nonspecific salivary IgA and IgC.In an Abstract in the journal, the authors wrote:

"Perhaps, the immune-dependent reduction of the scent pleasantness in the acute phase of STI is part of an evolutionary mechanism ensuring, unconsciously, avoidance of a risky romantic partner."

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our sexual health / stds section for the latest news on this subject. "Scent Recognition of Infected Status in Humans"
Mikhail Moshkin DrSci, Nadezhda Litvinova DrSci, Ekaterina A. Litvinova PhD, Alena Bedareva PhD, Andrey Lutsyuk MD, and Ludmila Gerlinskaya DrSci
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Gender Disparity In Skin-Cancer Rate May Be Explained By Antioxidant Levels

Main Category: Melanoma / Skin Cancer
Also Included In: Men's health
Article Date: 05 Dec 2011 - 1:00 PST

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Men are three times more likely than women to develop a common form of skin cancer but medical science doesn't know why. A new study may provide part of the answer.

Researchers at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James) have found that male mice had lower levels of an important skin antioxidant than female mice and higher levels of certain cancer-linked inflammatory cells.

The antioxidant, a protein called catalase, inhibits skin cancer by mopping up hydrogen peroxide and other DNA-damaging reactive-oxygen compounds that form during exposure to ultraviolet B light (UVB), a common source of sunburn and cancer-causing skin damage. Studies by others have linked low catalase activity to skin cancer progression.

The research is published online in the Journal of Investigative Dermatology.

The findings suggest that women may have more natural antioxidant protection in the skin than men," say study co-leaders Gregory Lesinski and Tatiana Oberyszyn, both of the OSUCCC - James.

"As a result, men may be more susceptible to oxidative stress in the skin, which may raise the risk of skin cancer in men compared to women," says Lesinski, an assistant professor of molecular virology, immunology and medical genetics;.

The study also found that UVB exposure caused a unique inflammatory white blood cell population called 'myeloid-derived suppressor cells' to migrate from the bone marrow into the exposed skin. Furthermore, higher numbers of these cells moved into the skin of male mice than female mice.

"To our knowledge, we've shown for the first time that UVB exposure causes a migration of systemic myeloid-derived suppressor cells, and it suggests that these cells might be a novel source of UVB-induced immune suppression," says first author Nicholas Sullivan, a research scientist in the Oberyszyn lab in the Department of Pathology.

This, in turn, might mean that these UVB-induced inflammatory cells contribute to the genesis of skin tumors and perhaps other tumors rather than simply facilitating cancer progression, as generally thought, Sullivan notes.

Normally, the body mobilizes the suppressor cells to limit immune responses to infection, sepsis or trauma so that healing can begin, Lesinski says.

"However, in the cancer setting, repeated UV light exposure or after other chronic or repeated inflammatory stimuli, these cells persist and become immunosuppressive," he says. "They can render helpful immune cells such as T cells or natural killer cells unable to recognize and eliminate cancer cells in the skin."

Lesinski, Oberyszyn, Sullivan and their colleagues conducted the study using a strain of hairless mice that develops squamous cell carcinoma of the skin ?" the second most common skin cancer in humans - when exposed to UVB.

The investigators also found that treating mice with topical catalase inhibited the migration of the suppressor cells into UVB-exposed skin, suggesting that the influx of these cells in males might be due to the relatively lower skin-catalase activity.

In fact, male mice with UVB-induced skin tumors had 55 percent more of the suppressor cells in the skin than did their female counterparts.

"This is the first report to our knowledge of a sex discrepancy in this group of inflammatory cells in tumor-bearing mice, and it suggests that our findings might translate to other types of cancer," says Oberyszyn, associate professor of pathology. "Men face a higher risk of numerous types of cancers, and relatively higher levels of inflammatory myeloid cells might contribute to this susceptibility."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our melanoma / skin cancer section for the latest news on this subject. Funding from the National Cancer Institute and The Valvano Foundation for Cancer Research supported this research.
Other Ohio State researchers involved in this study were Kathleen L. Tober, Erin M. Burns, Jonathan S. Schick, Judith A. Riggenbach, Thomas A. Mace, Matthew A. Bill, and Gregory S. Young.
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Prostate Cancer Screening Carried Out On 20% Of Males Aged Over 75 Years, Australia

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Main Category: Prostate / Prostate Cancer
Also Included In: Men's health
Article Date: 17 Nov 2011 - 5:00 PST

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The Cancer Council NSW will present evidence of research at the Clinical Oncological Society of Australia (COSA) Annual Scientific Meeting that GPs were prescribing tests to screen men above the age of 75 years for prostate cancer, despite the fact that there is likely to be no benefit.

Each year one in five Australian men between the age of 75 to 84 years is tested for prostate cancer against international guidelines, which recommend not to test patients in this age bracket.

Lead researcher, Professor Dianne O'Connell stated that according to previous evidence, suggested prostate cancer in men above the age of 75 years was progressing slowly and they were far more likely to die from other causes. She added: "A positive test in this group may do more harm than good."

Although the majority of men in this age bracket will have prostate cancer, it will never cause a problem for most, yet discovering that they have prostate cancer often means they will opt for treatment, which in turn means they are exposing themselves to a high risk of serious side-effects, such as incontinence and impotency.

Professor O'Connell explained:

"Organizations around the world offer varying guidelines about when men should begin testing for prostate cancer, if at all. But there is consensus that from age 75, men who do not have a life expectancy of at least 10 years, should not be screened."

According to screening data obtained from Medicare claims, 20% of men aged between 75 to 84 years surveyed received a Prostate Specific Antigen (PSA) blood-screening test in the previous year, with 35% of men receiving the test in the previous two years.

Dr O'Connell stated:

"We don't have information from doctors about what is driving the decision-making process. This should be investigated, along with the reasons why doctors continue to order these tests for men in this age bracket."

COSA President, Professor Bogda Koczwara commented that there had been a worldwide debate over the value of PSA test. She referred to a statement made by Doctor Richard Albin, the test's founder, who recently called it a ''hugely expensive public health disaster'' and ''hardly more effective than a coin toss''.

She added:

"While there are disparate views of whether or not the PSA test is of benefit, there is broad consensus that we should not be testing men over age 75. So it is concerning that this sound advice is not getting through."

Written by Petra Rattue
Copyright: Medical News Today
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posted by beebee on 17 Nov 2011 at 1:13 pm

I had a PSA test at age 70, subsequent biopsy. Confirmed cancer, spread to abdominal lymph glands. Gleeson index 9 - 2 to 10 years survival prediction. Went on to hormone treatment, bit uncomfortable. PSA dropped to zero and stayed there for 2 years. Discontinued treatment until PSA rises to 10. 2 more years and PSA is still only 2. I'm a believer and will have PSA test ecery 6 months for the rest of my life

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Drug-Related Side Effects A Problem For Male Breast Cancer Patients Taking Tamoxifen

Main Category: Breast Cancer
Also Included In: Men's health
Article Date: 17 Nov 2011 - 0:00 PST

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The largest study to investigate the tolerability of the breast cancer drug tamoxifen in male breast cancer patients has shown that men stop taking their prescribed therapy early because of problems with side effects caused by the drug.

The authors of the research paper, published in the cancer journal Annals of Oncology, looked at records of 64 male breast cancer patients at their institution who had received tamoxifen for an average of four years and found that 53% (34) of the patients experienced one or more drug-related side effects. Of these 64 patients, 20.3% (13) of the men discontinued taking their prescribed tamoxifen therapy early because of the side effects. The research suggests that male breast cancer patients who discontinue tamoxifen therapy early may have an increased risk of the cancer recurring.

Male breast cancer is a rare disease and the world age-standardised incidence rate is 0.4 per 100,000 in men compared with 66.7 per 100,000 in women. Tamoxifen is the standard of care for the hormone treatment of men with breast cancer and works by blocking the growth-promoting action of the hormone oestrogen on the cancer cells. Almost all (90%) breast cancers in men are hormone-receptor-positive and drugs that target the hormone oestrogen are usually given after surgery.

Dr Naveen Pemmaraju, who carried out the research under the direction of Dr Sharon Giordano at the Department of Breast Medical Oncology at the University of Texas MD Anderson Cancer Center, Houston, USA, said "This is the largest study to specifically assess tamoxifen-related side effects in men because in our institution we treated a relatively large number of male breast cancer patients. We found that, after adjusting for patient age and stage of the disease, the prognosis for men with breast cancer is similar to that of women. Tamoxifen has been shown to improve survival rates for breast cancer patients, so early discontinuations may have the potential to increase the risk of the cancer recurring in this group of male breast cancer patients.

"Male breast cancer is a very rare and unique cancer affecting approximately 2,000 men in the USA per year. As there are so few male breast cancer cases, clinical practice and optimal treatment strategies have been extrapolated from female breast cancer patients with very little published evidence to guide clinical decisions. In our institution, we noted that several of our male patients were having difficulty with taking tamoxifen therapy, and these side effects appeared to be a little bit different to those reported with women receiving the same drug."

Weight gain and loss of sex drive were the most frequently occurring tamoxifen-related side effects observed in the study. Of the 13 male patients who stopped taking tamoxifen early because of side effects, four of the discontinuation decisions (31%) were physician-directed (four thromboembolic events) and nine (69%) were patient-directed preferences based on the intolerable side-effects. Nine patients died after stopping tamoxifen early in the study.

Dr Pemmaraju said: "Tamoxifen is a hormonal treatment, specifically an anti-oestrogen. We think that men might experience some different side effects than women because men have a different hormonal environment than women (for instance they have more testosterone and less oestrogen). This difference in hormone levels could result in different side effects when using a drug that blocks hormones.

"The results of this study should not change the recommendation for prescribing tamoxifen for male breast cancer patients. However, clinicians need to be aware of the possible side effects that men may experience when receiving tamoxifen so that the patients can be counselled appropriately," Dr Pemmaraju added. "This study also highlights the importance of funding and conducting research for rare disease so that we understand the true toxicities and benefits of treatment.

"Our next step will be to prospectively collect data on the side effects that men get when they are prescribed to take tamoxifen for breast cancer. This follow-up study will be very important because it will provide much more detailed and comprehensive information on the tolerability profile of tamoxifen in male breast cancer patients," Dr Pemmaraju concluded.

Male breast cancer is very rare and statistical records are not available for most European countries. In the UK, around 300 men are diagnosed with breast cancer each year compared with about 45,700 cases in women. In the US in 2011, about 2,140 new cases of invasive breast cancer will be diagnosed in men compared with 230,480 new cases in women and approximately 450 men will die from breast cancer compared with 39,520 women.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Gender Differences In Teen Sleep Deprivation And Related Weight Gain

Main Category: Sleep / Sleep Disorders / Insomnia
Also Included In: Obesity / Weight Loss / Fitness;  Pediatrics / Children's Health;  Men's health
Article Date: 25 Oct 2011 - 0:00 PST

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Sleeping less than 8 hours a night may be linked to weight gain in teens, shows a new study presented at CHEST 2011, the 77th annual meeting of the American College of Chest Physicians (ACCP). Furthermore, obesity was linked to short sleep duration in teen males, with the fewest hours slept linked to the highest BMI levels.

"Sleep is food for the brain. When teens do not get enough sleep, they fall asleep in class, struggle to concentrate, look and feel stressed, get sick more often, and do not meet their obligations due to tiredness," said study author Lata Casturi, MA, RPSGT, Baylor College of Medicine Sleep Center in Houston, TX. "Teens who sleep fewer than eight hours may also consume more calories than those who sleep more than eight hours. Therefore, they have a higher risk for obesity and associated health problems, including high blood pressure, heart disease, and stroke."

Ms. Casturi and colleagues, including coauthor Anita Rao, presently a 10th grader at Dawson High School in Pearland, TX, surveyed 255 teens (108 males and 147 females) in high school to obtain self-reported measures of height and weight (used for BMI calculation) and both weekday and weekend quantity of sleep. Among males, results indicated the average sleep time on weekdays was 6 hours 32 minutes and on weekends 9 hours 10 minutes. Among females, the average weekday sleep time was 6 hours 30 minutes and the average weekend sleep duration was 9 hours 22 minutes. Teen males who slept 7 hours or less on weekdays had an average BMI that was 3.8 percent higher than those who slept more than 7 hours. Likewise, teen females who slept 7 hours or less had a BMI that was 4.7 percent higher than females who got more than 7 hours of sleep per weekday.

But how does lack of sleep really affect weight gain? According to researchers, hormones leptin and ghrelin work in a "checks and balances" system to control feelings of hunger and fullness. Ghrelin, which is produced in the gastrointestinal tract, stimulates appetite, while leptin, produced in fat cells, sends a signal to the brain when you are full. "When you don't get enough sleep, it drives leptin levels down, which means you don't feel as satisfied after you eat. Lack of sleep also causes ghrelin levels to rise, which means your appetite is stimulated, so you want more food," said co-author Radha Rao, MD, DeBakey VA Medical Center, Houston, TX. "The two combined, can set the stage for overeating, which in turn may lead to weight gain."

Furthermore, after adjusting for potential cofounders, short sleep duration (<8 hours) was associated with obesity in male teens. A negative correlation also was found between weekday sleep duration and obesity in males, with the fewest hours of weekday sleep associated with the highest BMI. There was no evident correlation between obesity and weekday sleep hours in teen females.

The researchers believe the sex-related difference in sleep and weight gain may be due to the differences in body composition during puberty. "Males and females experience differential growth rates and hormone secretion during puberty. The sleep factors that impact metabolism may increase weight gain differently in the two sexes," explained Ms. Casturi.

In addition to weight gain, lack of sleep during teenage years can result in poor sleep habits that continue into adulthood and result in long-term health consequences.

"Sleep promotes growth in children and adolescents and strengthens the immune and nervous systems. Hence, sleep deprivation early in life may cause the youngsters to suffer from a lifetime of irreversible higher health risks," said Anita Rao. Researchers recommend that parents educate teens about good sleep habits early in life, which include setting a regular sleep schedule, turning off technological devices at night, and avoiding caffeine and exercise at bedtime.

"Sleep deprivation can have an immediate impact on our physical performance and cognitive function, but can also lead to long term health problems, including cardiovascular and respiratory conditions," said Suhail Raoof, MBBS, FCCP, President of the American College of Chest Physicians. "Developing good sleep habits in adolescence may help to reduce the risk of related health conditions later in life."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our sleep / sleep disorders / insomnia section for the latest news on this subject. CHEST 2011 is the 77th annual meeting of the American College of Chest Physicians, held October 22 -26 in Honolulu, Hawaii. The ACCP represents 18,300 members who provide patient care in the areas of pulmonary, critical care, and sleep medicine in the United States and throughout the world. The mission of the ACCP is to promote the prevention, diagnosis, and treatment of chest diseases through education, communication, and research. For more information about the ACCP, please visit the ACCP Web site at http://www.chestnet.org/.
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Rwanda Begins Non-Surgical Circumcision Drive Against HIV

Editor's Choice
Main Category: HIV / AIDS
Also Included In: Urology / Nephrology;  Sexual Health / STDs;  Men's health
Article Date: 08 Dec 2011 - 8:00 PST

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Circumcision has been shown to lower the risk of HIV transmission and infection in Africa. Now, a new device known as the PrePex enables circumcision to be performed without surgery or any blood loss, by nurses, who don't need extensive training to use the apparatus.

The Rwandan Government has completed its third trial of PrePex with nearly 600 volunteers and has concluded the device is a safe and efficient way of performing circumcisions. It now aims to reduce new HIV infections by fifty percent, in part through a campaign to circumcise two million adult men over the next two years.

The results were presented at the 16th International Conference on AIDS and Sexually Transmitted Infections (STIs) in Africa (ICASA).

Michel Sidibé, Executive Director of UNAIDS said :

"Innovation is key to achieving our target of 20 million voluntary adult male circumcisions by 2015 and saving millions of lives. Devices such as PrePex have the potential to facilitate safe and rapid scale up of male circumcision for HIV prevention, an urgent need in Sub Saharan Africa ...

We commend the government of Rwanda for progressing the science of HIV prevention for the benefit of the region."

An evaluation from the World Health Organization said the study of the PrePex device provides further clinical evidence that circumcision performed by nurses when using the PrePex device is fast, safe and effective, enabling a bloodless procedure that requires no injected anesthesia, no sutures and no sterile settings.

Agnes Binagwaho, MD, M(Ped) PhD hc, The Minister of Health of Rwanda said :

"We are unwilling to allow our health system resource challenges to dissuade us from our mission: to create a healthier, HIV-free Rwanda. We are committed to finding innovative, safe and effective solutions to make this happen ...

This study shows that with the non-surgical PrePex device we can safely task-shift circumcision from surgeons and family physicians to nurses, which if nationally scaled up, would make a significant contribution to our public health system."

There has been some controversy regarding the effectiveness of circumcision to prevent the spead of the HIV virus. Circumcision rates are far higher in the United States than in Western Europe, yet HIV cases remain stubbornly higher in the US and W. Europe, contrary to what might be expected if circumcision is so effective.

While many doctors are in agreement as to its effectiveness in Africa, the topic has its detractors that range from those demanding more research and scientific proof, some who point to contradictory findings from several studies, to wild conspiracy theories.

The device basically works by stopping the flow of blood to the foreskin. It remains in situ for a week, after which time it is removed along with the foreskin that has died due to lack of circulation.

The average time for installation of the device is less than three minutes, with the advantage that it doesn't involve surgery or cause blood loss, and thus can be performed by nurses.

The device and procedure, which can be performed in a regular doctor's consulting room has an AE rate of 0.34% (2 out of 590), and the total study adverse event (AE) rate when performed by nurses was 0.83%. All resolved with minimal intervention, and the AE rate was lower than previously reported AE rates for surgical male circumcision when performed by surgeons (4.8%).

In Rwanda there are only 300 trained physicians for around 10 million people, and nearly 90 percent of the population live in rural areas that lack sterile facilities.

Analysis shows that scaling up circumcision via surgical procedures would drain resources from surgeons who work in vital life saving areas, not to mention the likely resistance from the local population.

The study was approved by the Rwanda National Ethics Committee and was conducted in Kanombe Hospital, Kigali Rwanda, between July 2011 and October 2011.

Written by Rupert Shepherd.
Copyright: Medical News Today
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Rupert Shepherd B.Sc. "Rwanda Begins Non-Surgical Circumcision Drive Against HIV." Medical News Today. MediLexicon, Intl., 8 Dec. 2011. Web.
8 Dec. 2011. APA

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