Tag: pubmed

World J Mens Health. 2025 Sep 25. doi: 10.5534/wjmh.250180. Online ahead of print.

ABSTRACT

PURPOSE: To assess the prevalence and predictors of absence of internal spermatic vein (ISV) reflux during varicocele embolization in infertile male.

MATERIALS AND METHODS: Demographic, clinical and laboratory data from 237 infertile males treated with percutaneous varicocele embolization between January 2017 and November 2024 were analyzed. Each patient underwent color Doppler ultrasound (CDUS) and semen analysis, both repeated 6 months post-procedure. Semen analysis values were based on 2021 World Health Organization reference criteria. Descriptive statistics and logistic regression models tested the association between predictors and embolization failure.

RESULTS: Median age was 28 (IQR 22-34) years. Median preoperative semen parameters included sperm concentration of 22 (10.0-44.5) ×10⁶/mL, progressive motility of 35% (25%-40%), and normal morphology of 3% (2%-5%). Nearly half (48.9%) had CDUS grade ≥4 varicocele. Venous access was achieved via the right internal jugular vein in 46.4% and right common femoral vein in 53.6% of cases. Treatment was not performed in 1.3% of patients due to failure in catheterizing the spermatic vein and in 10.5% due to absence of ISV insufficiency during Valsalva. ISV reflux was more frequently absent in patients with grade III vs. grade IV-V varicocele (72.0% vs. 48.3%, p=0.02). After 2020, expert-driven ultrasound reduced the rate of phlebography-negative varicoceles (40% vs. 60%, p=0.03). Patients with confirmed varicocele had lower sperm concentration (20×10⁶/mL vs. 26 ×10⁶/mL, p=0.02). Grade III varicocele (OR 5.2; p=0.01) and higher sperm concentration (OR 1.1; p=0.03) were independent predictors of absent ISV reflux. Those with grade III varicocele and sperm count >20 ×10⁶/mL had a 96% likelihood of reflux absence.

CONCLUSIONS: Grade III varicocele and higher preoperative sperm concentration independently predicted the absence of ISV reflux, highlighting their role in patient selection. After expert-driven US implementation, the rate of no varicocele at phlebography significantly decreased.

PMID:41047365 | DOI:10.5534/wjmh.250180

World J Mens Health. 2025 Aug 29. doi: 10.5534/wjmh.250161. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluates the impact of a structured online medical statistics webinar on researchers in andrology, both clinicians and non-clinicians. The objectives were to: 1) emphasize the critical role of statistical literacy in medical and biomedical research, 2) evaluate participants’ baseline knowledge, 3) determine the impact of the webinar on knowledge acquisition and satisfaction, and 4) analyze the influence of gender and institutional setting on learning outcomes.

MATERIALS AND METHODS: The Global Andrology Forum (GAF) conducted a webinar comprising four expert-led lectures on medical statistics and male infertility research. Participants completed three online surveys evaluating baseline characteristics, pre- and post-course knowledge, and satisfaction.

RESULTS: Post-webinar analysis showed a significant improvement in statistical knowledge, with the mean percentage of correct responses rising from 55.6% (95% confidence interval [95% CI]: 51.35-59.86) to 66.8% (95% CI: 62.48-71.14) (p<0.05). Female participants demonstrated over twice as much a greater average score increase (16.1) compared to males (7.9), though the difference was not statistically significant (p=0.092). Participants from public institutions showed the most substantial improvement (p<0.001), while private sector participants had a more modest and non-significant increase (p=0.054). Overall satisfaction was high, with 77.6% of participants indicating that they would recommend the course to their colleagues.

CONCLUSIONS: This structured online webinar significantly improved the participants’ statistical knowledge, highlighting the importance of such training in medical research. The high levels of participant satisfaction and positive feedback regarding the course underscore the webinar’s success. This study highlights the potential for future targeted online statistical educational initiatives and the need for such training for researchers in andrology and biomedicine.

PMID:41047362 | DOI:10.5534/wjmh.250161

World J Mens Health. 2025 Aug 29. doi: 10.5534/wjmh.250173. Online ahead of print.

ABSTRACT

PURPOSE: With increasing life expectancy worldwide, many patients experience non-life-threatening yet debilitating conditions that affect their quality of life. Among these, lower urinary tract symptoms, a representative urologic disease in men, continue to affect a significant number of aging males in the era of population aging. South Korea and the United States have distinct healthcare systems with notable advantages and limitations. This article aimed to analyze current treatment trends in South Korea using the National Health Insurance Database and compare them with United States trends through literature reviews.

MATERIALS AND METHODS: We obtained statistical medical data using the Korean Healthcare Big Data Opening System provided by the Korea Health Insurance Review and Assessment Service. Data were collected across four categories: medical treatment for benign prostatic hyperplasia (BPH), surgical treatment for BPH, overactive bladder (OAB), and nocturia. The collected data were analyzed based on annual patient cases, medical expenses, age distribution, and prescribed medications.

RESULTS: Medical expenses for BPH surged significantly from $165 million in 2019 to $266 million in 2023. Although medication prescriptions followed a similar upward trend, the increase in surgical procedures was relatively modest. For OAB, medical costs have also shown a sharp rise, from $40 million in 2019 to $59 million in 2023, with a proportional increase in prescription volume. Regarding nocturia, anticholinergics (32.7%) and alpha-blockers (31.3%) were the most frequently prescribed medications, whereas desmopressin accounted for 19.9%.

CONCLUSIONS: It is essential to acknowledge the treatment disparities arising from differences in the healthcare systems of the United States and Korea and to adopt a patient-centered approach that prioritizes health in various contexts. A gradual transition toward developing a patient-centered and progressive healthcare system is imperative globally to address these disparities.

PMID:41047361 | DOI:10.5534/wjmh.250173

World J Mens Health. 2025 Sep 9. doi: 10.5534/wjmh.250144. Online ahead of print.

ABSTRACT

PURPOSE: Artificial intelligence (AI) tools have demonstrated considerable potential for the dissemination of medical information. However, variability may exist in the quality and readability of prostate-cancer-related content generated by different AI platforms. This study aimed to evaluate the quality, accuracy, and readability of prostate-cancer-related medical information produced by ChatGPT and DeepSeek.

MATERIALS AND METHODS: Frequently asked questions related to prostate cancer were collected from the American Cancer Society website, ChatGPT, and DeepSeek. Three urologists with over 10 years of clinical experience reviewed and confirmed the relevance of the selected questions. The Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) was used to assess the understandability and actionability of AI-generated content. The DISCERN instrument was used to evaluate the quality of the treatment-related information. Additionally, readability was assessed using four established indices: Automated Readability Index (ARI), Flesch Reading Ease Score, Gunning Fog Index, and Flesch-Kincaid Grade Level.

RESULTS: No statistically significant differences were observed between ChatGPT and DeepSeek in PEMAT-P scores (70.66±8.13 vs. 69.35±8.83) or DISCERN scores (59.07±3.39 vs. 58.88±3.66) (p>0.05). However, the ARI for DeepSeek was higher than that for ChatGPT (12.63±1.42 vs. 10.85±1.93, p<0.001), indicating greater textual complexity and reading difficulty.

CONCLUSIONS: AI tools, such as ChatGPT and DeepSeek, hold significant potential for enhancing patient education and disseminating medical information on prostate cancer. Nevertheless, further refinement of content quality and language clarity is needed to prevent potential misunderstandings, decisional uncertainty, and anxiety among patients due to difficulty in comprehension.

PMID:41047358 | DOI:10.5534/wjmh.250144

Endocr J. 2025 Oct 4. doi: 10.1507/endocrj.EJ25-0179. Online ahead of print.

ABSTRACT

Few studies have investigated the distribution of blood pressure (BP) and associated factors in pediatric patients with X-linked hypophosphatemic rickets (XLH). We analyzed snapshot baseline data from the SUNFLOWER study, a longitudinal observational cohort study of patients with XLH in Japan and South Korea (NCT03745521/UMIN000031605). We used data from pediatric participants aged 5-17 years who were 120-189.9 cm (males) and 120-179.9 cm (females) in height and had a history of conventional treatment. Systolic and diastolic BP (SBP and DBP, respectively) were categorized into percentile ranks based on age, sex, and height. Ordinal logistic regression analyses were performed to investigate the association between BP and exposure factors, including estimated glomerular filtration rate, serum intact parathyroid hormone levels, serum intact fibroblast growth factor 23 levels, urinary calcium/creatinine ratio, and body mass index standard deviation score (BMI-SDS). Forty-five participants were eligible for the subgroup analysis. Of these, 44 were evaluated after one patient with missing BP data was excluded. After height adjustment, three patients (6.8%) were at or above the 95th percentile for SBP, and five (11.4%) were at or above the 95th percentile for DBP. Regarding age adjustment, one patient (2.3%) was at or above the 95th percentile for SBP and three (6.8%) were at or above the 95th percentile for DBP. In the association analysis, age- and height-adjusted BP was positively correlated with BMI-SDS. These results suggest that some pediatric patients with XLH exhibit high BP and that a high BMI-SDS may be a risk factor.

PMID:41047346 | DOI:10.1507/endocrj.EJ25-0179

Environ Health Prev Med. 2025;30:78. doi: 10.1265/ehpm.25-00173.

ABSTRACT

BACKGROUND: This cross-sectional study examined meal patterns based on daily energy intake distribution and their associations with nutrient and food intake, diet quality, and body mass index (BMI).

METHODS: Body height, weight, habitual dietary intake and the Healthy Eating Index (HEI)-2020 score by eating occasion were assessed using the validated Meal-based Diet History Questionnaire among employees (465 males and 193 females aged 20-75 years) in the Tokyo Metropolitan Area. Meal patterns were extracted based on % energy intake from breakfast, lunch, dinner, and snacks using K-means clustering by sex. Dietary intake, HEI-2020 score, and BMI were then compared between sex-specific meal patterns.

RESULTS: The identified patterns were “large lunch and dinner” (n = 299), “three meals-balanced” (n = 97), and “large dinner” (n = 69) patterns in males and “large dinner” (n = 79); “large afternoon snack” (n = 54) and “large lunch” (n = 60) patterns in females. The HEI-2020 scores were the highest for dinner, followed by breakfast, lunch, and snacks in any meal pattern. Males with the “large dinner” pattern had lower intakes of rice, bread, carbohydrates, dietary fibre, and thiamine; higher intake of alcoholic beverages; and higher HEI-2020 scores than those with other patterns. Females with a “large dinner” pattern had a lower intake of bread, confectionery, total and saturated fats, and carbohydrates; higher intake of fish, meat, and alcoholic beverages; higher HEI-2020 scores; and lower BMI. Thus, a meal pattern with higher energy intake distribution at dinner was associated with higher diet quality among males and females and lower BMI among females in Japanese workers.

CONCLUSIONS: These findings suggest that improving the quality of the meal with the highest energy contribution could help enhance overall dietary quality and metabolism.

PMID:41047335 | DOI:10.1265/ehpm.25-00173

Urol Oncol. 2025 Oct 4:S1078-1439(25)00355-2. doi: 10.1016/j.urolonc.2025.09.001. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the diagnostic performance of IsoPSA density for detecting clinically significant prostate cancer (csCaP), and its utility in guiding biopsy decision-making.

MATERIALS AND METHODS: We conducted a retrospective review of 574 patients who underwent IsoPSA testing, prostate MRI, and image-guided biopsy within 1 year. IsoPSA density was calculated as IsoPSA value divided by MRI-derived prostate volume. Multivariable logistic regression, receiver operating characteristic (ROC) analysis, and decision curve analysis were used to assess predictive value. Subgroup analyses were performed in patients with large prostates (>70 ml) and negative MRI (PI-RADS 1-2).

RESULTS: The overall prevalence of csCaP on biopsy was 33.8%. IsoPSA density was an independent predictor of csCaP and performed similarly to PSA density, while outperforming PSA and IsoPSA in ROC and decision curve analyses. In the full cohort, IsoPSA density achieved an AUC of 0.69 and demonstrated a high negative predictive value (NPV) of 79% at the optimal cutoff of 0.21. Among men with negative MRI (n = 238), an IsoPSA density threshold of 0.17 yielded an NPV of 97% and sensitivity of 85% for ruling out csCaP. In men with large prostates, higher IsoPSA density trended with increased csCaP risk, though not statistically significant.

CONCLUSIONS: IsoPSA density performed comparably to PSA density and outperformed traditional clinical predictors of csCaP. In MRI-negative men, its high negative predictive value supports its use as a non-invasive tool to reduce unnecessary biopsies. IsoPSA density may serve as a valuable adjunct in contemporary prostate cancer diagnostic pathways and warrants further validation.

PMID:41047326 | DOI:10.1016/j.urolonc.2025.09.001

Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Sep 2:S2212-4403(25)01196-4. doi: 10.1016/j.oooo.2025.08.018. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the clinical and radiographic outcomes of temporomandibular joint (TMJ) total joint replacement (TJR) in osteoporotic patients receiving preoperative antiresorptive therapy.

STUDY DESIGN: This retrospective chart review included osteoporotic patients who underwent TMJ TJR at a single institution. Data collected included demographics, medical history, type and duration of antiresorptive therapy, surgical details, and postoperative outcomes. Clinical parameters included range of motion (ROM), joint noise, and dietary limitations. Radiographic assessment evaluated periprosthetic bone changes and implant stability. Descriptive statistics summarized outcomes.

RESULTS: Eight patients (62.5% female; mean age 61.5 ± 11.4 years) with osteoporosis and history of antiresorptive therapy were analyzed. The average therapy duration was 3.75 ± 3 years. Mean clinical and CBCT follow-up was 16 ± 9.6, and 6.5 ± 3.6 months respectively. No patients developed medication-related osteonecrosis of the jaw (MRONJ), prosthetic failure, hardware loosening, or periprosthetic osteolysis. Functional outcomes were favorable, with mean postoperative ROM of 35.1 ± 4.8 mm and no joint noise.

CONCLUSION: Preoperative antiresorptive therapy in osteoporotic patients does not appear to increase the risk of complications or impair functional outcomes following TMJ TJR. Larger sample sizes, possibly through multicenter investigations, are critical to establishing high-level evidence regarding its safety and efficacy.

PMID:41047323 | DOI:10.1016/j.oooo.2025.08.018

BMJ Open. 2025 Oct 5;15(10):e099692. doi: 10.1136/bmjopen-2025-099692.

ABSTRACT

INTRODUCTION: Achieving universal health coverage requires the use of health research evidence in decision-making; however, this remains understudied in lower and middle-income countries (LMICs) such as Tanzania. Despite several health sector reforms and the availability of locally generated research, evidence indicates that the use of such research in health planning and decision-making remains limited in Tanzania, creating a gap between research production and its practical application. This study examined the extent of research evidence used in health planning and the factors influencing its use among health planning teams.

METHODS AND ANALYSIS: A sequential exploratory mixed-methods design was employed, starting with qualitative data from focus group discussions (N=6) and KIIs (N=34) with health planners from selected regions in Tanzania, recruited based on their direct involvement in health planning, using semistructured guides informed by the Capability, Opportunity, Motivation-Behaviour (COM-B) model. This was followed by a quantitative survey of 422 participants meeting the same inclusion criteria, administered with a structured questionnaire derived from the model. The COM-B framework guided both tool development and analysis. Qualitative data were thematically analysed using a framework approach, yielding three themes, while quantitative data were analysed using descriptive statistics and binary logistic regression.

RESULTS: Qualitative findings revealed barriers such as limited knowledge and skills, inadequate access to knowledge translation tools, poor dissemination processes, financial and technical constraints, and lack of training. Opportunities included supportive guidelines, research coordinators, collaborations, dedicated budgets and improved internet access. Motivators such as job promotions, professional development, allowances and targeted training were also identified. Quantitative results showed moderate evidence use (66.2%), slightly higher than in other LMICs. Barriers included suboptimal dissemination (74.5%; OR=2.035, p=0.0008), inadequate resources (70.0%; OR=0.965, p=0.8759) and lack of training (63.7%; OR=1.361, p=0.1806). Integrated findings highlighted convergence on dissemination, resource and training challenges, with divergence in statistical significance between methods.

CONCLUSIONS: Barriers related to dissemination, resources and training hinder evidence use. Interventions such as digital repositories, guideline development and capacity building, alongside institutionalised frameworks, resource allocation and accountability mechanisms, are essential to strengthen evidence-based health planning in Tanzania.

PMID:41047277 | DOI:10.1136/bmjopen-2025-099692

BMJ Open. 2025 Oct 5;15(10):e103724. doi: 10.1136/bmjopen-2025-103724.

ABSTRACT

OBJECTIVE: This study aims to develop a methodology to retrieve, harmonise and evaluate the completeness of national body mass index (BMI) data from linked electronic health record (EHR) sources to build a longitudinal research-ready data asset (RRDA).

DESIGN: A longitudinal study of BMI records spanning 23 years (1 January 2000 to 31 December 2022) from four data sources.

SETTING: The national BMI RRDA is created within the Secure Anonymised Information Linkage (Databank), encompassing the entire population of Wales, UK.

PROCEDURE AND PARTICIPANTS: We built a methodology that provides a reproducible framework for extracting and harmonising BMI data from four major linked EHRs across two age groups: children and young people (CYP; 2-18 years old) and adults (19 years and older). The methodology is adaptable across different trusted research environments. We evaluated the completeness and retention of records over 1-, 5- and 23-year periods by calculating the proportion of missing data relative to each year’s population.

RESULTS: We retrieved 53.4 million records for 3.2 million individuals across Wales from 1st January 2000 to 31 December 2022. Among these, 3% of CYP and 34% of adults had repeat BMI measurements recorded over periods ranging from 5 to 23 years. Throughout the entire population of Wales during this period, 49% of CYP and 26% of adults had at least one BMI reading recorded, resulting in a missingness rate of 51% for CYP and 74% for adults. Preserving BMI information by retaining the most recently recorded BMI over 1-, 5- and 23-year intervals from 2022 showed coverage rates of 10%, 33% and 68%, respectively, for CYP, and 25%, 51% and 73%, respectively, for adults.

CONCLUSIONS: Our findings highlight substantial variations in BMI data availability and retention across CYP and adults, as well as time periods within EHR in Wales. Wider adoption of this approach can enhance standardised approaches in using accessible measures like BMI to assess disease risk in population-based studies, strengthening public health initiatives and research efforts.

PMID:41047276 | DOI:10.1136/bmjopen-2025-103724