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Sample records for adult male circumcision

  1. Adult male circumcision with a circular stapler versus conventional circumcision: A prospective randomized clinical trial.

    Science.gov (United States)

    Jin, X D; Lu, J J; Liu, W H; Zhou, J; Yu, R K; Yu, B; Zhang, X J; Shen, B H

    2015-06-01

    Male circumcision is the most frequently performed procedure by urologists. Safety and efficacy of the circumcision procedure requires continual improvement. In the present study, we investigated the safety and efficacy of a new male circumcision technique involving the use of a circular stapler. In total, 879 consecutive adult male patients were randomly divided into 2 groups: 441 underwent stapler circumcision, and 438 underwent conventional circumcision. The operative time, pain score, blood loss volume, healing time, treatment costs, and postoperative complications were compared between the two groups. The operative time and blood loss volume were significantly lower in the stapler group than in the conventional group (6.8 ± 3.1 vs 24.2 ± 3.2 min and 1.8 ± 1.8 vs 9.4 ± 1.5 mL, respectively; Pcircumcision required removal of residual staple nails. Overall, the present study has shown that stapler circumcision is a time-efficient and safe male circumcision technique, although it requires further improvement.

  2. Effects of Adult Male Circumcision on Premature Ejaculation: Results from a Prospective Study in China

    OpenAIRE

    Jingjing Gao; Chuan Xu; Jingjing Zhang; Chaozhao Liang; Puyu Su; Zhen Peng; Kai Shi; Dongdong Tang; Pan Gao; Zhaoxiang Lu; Jishuang Liu; Lei Xia; Jiajia Yang; Zongyao Hao; Jun Zhou

    2015-01-01

    The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE). Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group) were evaluated. Detailed evaluations (including circumcision and control groups) on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT), Patie...

  3. AB221. Effects of adult male circumcision on premature ejaculation: results from a prospective study in China

    OpenAIRE

    Gao, Jingjing; Xu, Chuan; Zhang, Xiansheng

    2016-01-01

    Objective The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE). Methods Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group) were evaluated. Detailed evaluations (including circumcision and control groups) on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency ...

  4. Effects of adult male circumcision on premature ejaculation: results from a prospective study in China.

    Science.gov (United States)

    Gao, Jingjing; Xu, Chuan; Zhang, Jingjing; Liang, Chaozhao; Su, Puyu; Peng, Zhen; Shi, Kai; Tang, Dongdong; Gao, Pan; Lu, Zhaoxiang; Liu, Jishuang; Xia, Lei; Yang, Jiajia; Hao, Zongyao; Zhou, Jun; Zhang, Xiansheng

    2015-01-01

    The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE). Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group) were evaluated. Detailed evaluations (including circumcision and control groups) on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT), Patient-Reported Outcome measures, and 5-item version of the International Index of Erectile Function were used to measure the ejaculatory and erectile function for all subjects. The results showed that, during the one-year follow-up, men after circumcision experienced higher IELT and better scores of control over ejaculation, satisfaction with sexual intercourse, and severity of PE than men before circumcision (P circumcised men reported significantly improved IELT, control over ejaculation, and satisfaction with sexual intercourse (P circumcision might have positive effects on IELT, ejaculatory control, sexual satisfaction, and PE severity. In addition, circumcision was significantly associated with the development of PE.

  5. Effects of Adult Male Circumcision on Premature Ejaculation: Results from a Prospective Study in China

    Directory of Open Access Journals (Sweden)

    Jingjing Gao

    2015-01-01

    Full Text Available The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE. Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group were evaluated. Detailed evaluations (including circumcision and control groups on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT, Patient-Reported Outcome measures, and 5-item version of the International Index of Erectile Function were used to measure the ejaculatory and erectile function for all subjects. The results showed that, during the one-year follow-up, men after circumcision experienced higher IELT and better scores of control over ejaculation, satisfaction with sexual intercourse, and severity of PE than men before circumcision (P<0.001 for all. Similarly, when compared with the control group, the circumcised men reported significantly improved IELT, control over ejaculation, and satisfaction with sexual intercourse (P<0.001 for all. These findings suggested that circumcision might have positive effects on IELT, ejaculatory control, sexual satisfaction, and PE severity. In addition, circumcision was significantly associated with the development of PE.

  6. Triggering the decision to undergo medical male circumcision: a qualitative study of adult men in Botswana.

    Science.gov (United States)

    Wirth, Kathleen E; Semo, Bazghina-Werq; Ntsuape, Conrad; Ramabu, Nankie M; Otlhomile, Boyce; Plank, Rebeca M; Barnhart, Scott; Ledikwe, Jenny H

    2016-08-01

    In 2007, the World Health Organization endorsed voluntary medical male circumcision (VMMC) as part of comprehensive HIV-prevention strategies. A major challenge facing VMMC programs in sub-Saharan Africa remains demand creation; there is urgent need for data on key elements needed to trigger the decision among eligible men to seek VMMC. Using qualitative methods, we sought to better understand the circumcision decision-making process in Botswana related to VMMC. From July to November 2013, we conducted 27 focus group discussions in four purposively selected communities in Botswana with men (stratified by circumcision status and age), women (stratified by age) and community leaders. All discussions were facilitated by a trained same-sex interviewer, audio recorded, transcribed and translated to English, and analyzed for key themes using an inductive content analytic approach. Improved hygiene was frequently cited as a major benefit of circumcision and many participants believed that cleanliness was directly responsible for the protective effect of VMMC on HIV infection. While protection against HIV was frequently noted as a benefit of VMMC, the data indicate that increased sexual pleasure and perceived attractiveness, not fear of HIV infection, was an underlying reason why men sought VMMC. Data from this qualitative study suggest that more immediate benefits of VMMC, such as improved hygiene and sexual pleasure, play a larger role in the circumcision decision compared with protection from potential HIV infection. These findings have immediate implications for targeted demand creation and mobilization activities for increasing uptake of VMMC among adult men in Botswana.

  7. AB221. Effects of adult male circumcision on premature ejaculation: results from a prospective study in China

    Science.gov (United States)

    Gao, Jingjing; Xu, Chuan; Zhang, Xiansheng

    2016-01-01

    Objective The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE). Methods Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group) were evaluated. Detailed evaluations (including circumcision and control groups) on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT), patient-reported outcome measures, and 5-item version of the International Index of Erectile Function were used to measure the ejaculatory and erectile function for all subjects. Results The results showed that, during the 1 year follow-up, men after circumcision experienced higher IELT and better scores of control over ejaculation, satisfaction with sexual intercourse, and severity of PE than men before circumcision (Pejaculation, and satisfaction with sexual intercourse (P<0.001 for all). These findings suggested that circumcision might have positive effects on IELT, ejaculatory control, sexual satisfaction, and PE severity. Conclusions In addition, circumcision was significantly associated with the development of PE.

  8. Triggering the decision to undergo medical male circumcision: a qualitative study of adult men in Botswana.

    Science.gov (United States)

    Wirth, Kathleen E; Semo, Bazghina-Werq; Ntsuape, Conrad; Ramabu, Nankie M; Otlhomile, Boyce; Plank, Rebeca M; Barnhart, Scott; Ledikwe, Jenny H

    2016-08-01

    In 2007, the World Health Organization endorsed voluntary medical male circumcision (VMMC) as part of comprehensive HIV-prevention strategies. A major challenge facing VMMC programs in sub-Saharan Africa remains demand creation; there is urgent need for data on key elements needed to trigger the decision among eligible men to seek VMMC. Using qualitative methods, we sought to better understand the circumcision decision-making process in Botswana related to VMMC. From July to November 2013, we conducted 27 focus group discussions in four purposively selected communities in Botswana with men (stratified by circumcision status and age), women (stratified by age) and community leaders. All discussions were facilitated by a trained same-sex interviewer, audio recorded, transcribed and translated to English, and analyzed for key themes using an inductive content analytic approach. Improved hygiene was frequently cited as a major benefit of circumcision and many participants believed that cleanliness was directly responsible for the protective effect of VMMC on HIV infection. While protection against HIV was frequently noted as a benefit of VMMC, the data indicate that increased sexual pleasure and perceived attractiveness, not fear of HIV infection, was an underlying reason why men sought VMMC. Data from this qualitative study suggest that more immediate benefits of VMMC, such as improved hygiene and sexual pleasure, play a larger role in the circumcision decision compared with protection from potential HIV infection. These findings have immediate implications for targeted demand creation and mobilization activities for increasing uptake of VMMC among adult men in Botswana. PMID:26754167

  9. 'It brought joy in my home as in the area of my wife.' How recently circumcised adult men ascribe value to and make sense of male circumcision

    DEFF Research Database (Denmark)

    Lundsby, Katrine; Dræbel, Tania; Wolf Meyrowitsch, Dan

    2012-01-01

    The present study used a phenomenological approach to explore the everyday-life experiences of male circumcision (MC) and to learn how recently circumcised men ascribe value to and make sense of MC. Thirteen recently circumcised Zambian men were identified through the snowball technique...... and interviewed using a semi-structured interviewer's guide. Findings indicate that the post-operational experience of adult MC smoothly fits into the everyday-life experience of the men interviewed and is perceived and experienced as a broader social health issue, which largely transcends both the personal HIV...... that in addition to emphasising the HIV protective effect of MC, MC promotion should also highlight the social, sexual and romantic values perceived and experienced by the interviewees of this study; (3) the analysis reveals potentially harmful misconceptions about the health benefits of MC, demonstrating...

  10. Safety, Feasibility, and Acceptability of the PrePex Device for Adult Male Circumcision in Malawi

    Science.gov (United States)

    Tippett Barr, Beth A.; Kang'ombe, Anderson; Hofstee, Carola; Kilembe, Franklin; Galagan, Sean; Chilongozi, David; Namate, Dorothy; Machaya, Medson; Kabwere, Khuliena; Mwale, Mwawi; Msunguma, Wezi; Reed, Jason; Chimbwandira, Frank

    2016-01-01

    Introduction: Nonsurgical adult male circumcision devices present an alternative to surgery where health resources are limited. This study aimed to assess the safety, feasibility, and acceptability of the PrePex device for adult male circumcision in Malawi. Methods: A prospective single-arm cohort study was conducted at 3 sites (1 urban static, 1 rural static, 1 rural tent) in Malawi. Adverse event (AE) outcomes were stratified to include/exclude pain, and confidence intervals (CIs) were corrected for clinic-level clustering. Results: Among 935 men screened, 131 (14.0%) were not eligible, 13 (1.4%) withdrew before placement, and 791 (84.6%) received the device. Moderate and severe AEs totaled 7.1% including pain [95% CI: 3.4–14.7] and 4.0% excluding pain (95% CI: 2.6 to 6.4). Severe AEs included pain (n = 3), insufficient skin removal (n = 4), and early removal (n = 4). Among early removals, 1 had immediate surgical circumcision, 1 had surgery after 48 hours of observation, 1 declined surgery, and 1 did not return to our site although presented at a nearby clinic. More than half of men (51.9%) reported odor; however, few (2.2%) stated they would not recommend the device to others because of odor. Median levels of reported pain (scale, 1–10) were 2 (interquartile range, 2–4) during application and removal, and 0 (interquartile range, 0–2) at all other time points. Conclusions: Severe AEs were rare and similar to other programs. Immediate provision of surgical services after displacement or early removal proved a challenge. Cases of insufficient skin removal were linked to poor technique, suggesting provider training requires reinforcement and supervision. PMID:27331590

  11. Male circumcision: An overview

    Directory of Open Access Journals (Sweden)

    Bhattacharjee Prosanta

    2008-01-01

    Full Text Available Circumcision is one of the common operations performed worldwide, for various reasons. Controversy exists as to whether circumcision is an operation. This literature review discusses the indications of circumcision, benefits and complications of circumcision, and alternatives to circumcision. Relevant articles on the benefits, complications, indications and alternative to circumcision from 1964 to 2005 were reviewed, from National Library of Medicine′s Pubmed database. Additional articles were obtained from the reference lists of key articles and recent reviews.

  12. Estimating the resources needed and savings anticipated from roll-out of adult male circumcision in sub-Saharan Africa

    NARCIS (Netherlands)

    B. Auvert (Bertran); E. Marseille (Elliot); E.L. Korenromp (Eline); J. Lloyd-Smith (James); R. Sitta (Remi); D. Taljaard (Dirk); C. Pretorius (Carel); B. Williams (Brian); J.G. Kahn (James)

    2008-01-01

    textabstractBackground: Trials in Africa indicate that medical adult male circumcision (MAMC) reduces the risk of HIV by 60%. MAMC may avert 2 to 8 million HIV infections over 20 years in sub-Saharan Africa and cost less than treating those who would have been infected. This paper estimates the fina

  13. Male circumcision for HIV prevention - a cross-sectional study on awareness among young people and adults in rural Uganda

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    Hizaamu Ramadhan NB

    2010-04-01

    Full Text Available Abstract Background Medical male circumcision is now part of a comprehensive approach to HIV prevention. It has been shown that awareness of the protective effect of male circumcision leads to high acceptability towards the introduction of medical male circumcision services within countries. The objective of this survey was to identify factors determining awareness of male circumcision for HIV prevention. Methods We interviewed 452 participants (267 adults >24 years of age; 185 youths 14-24 years living in three rural Ugandan districts in 2008. Using a standardized questionnaire, we assessed socio-demographic parameters, awareness of MC for HIV prevention, general beliefs/attitudes regarding MC and MC status. Determinants for awareness of MC for HIV prevention were examined with multiple logistic regression models. Results Out of all adults, 52.1% were male (mean ± SD age 39.8 ± 11 years, of whom 39.1% reported to be circumcised. Out of all youths, 58.4% were male (18.4 ± 2.5, 35.0% circumcised. Adults were more aware of MC for HIV prevention than youths (87.1% vs. 76.5%; p = 0.004. In adults, awareness was increased with higher educational level compared to no school: primary school (adjusted OR 9.32; 95%CI 1.80-48.11, secondary (5.04; 1.01-25.25, tertiary (9.91; 0.76-129.18, university education (8.03; 0.59-109.95. Younger age and male sex were further significant determinants of increased awareness, but not marital status, religion, district, ethnicity, employment status, and circumcision status. In youths, we found a borderline statistically significant decrease of awareness of MC for HIV prevention with higher educational level, but not with any other socio-demographic factors. Conclusions Particularly Ugandans with low education, youths, and women, playing an important role in decision-making of MC for their partners and sons, should be increasingly targeted by information campaigns about positive health effects of MC.

  14. No-needle, single-visit adult male circumcision with Unicirc: a multi-centre field trial.

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    Peter S Millard

    Full Text Available Voluntary medical male circumcision (VMMC is a priority HIV preventive intervention. Current adult circumcision methods need improvement.Field trial in 3 primary care centres. Minimally invasive VMMC using the Unicirc instrument following topical lidocaine/prilocaine anesthetic. Men were followed up at 1 and 4 weeks.We circumcised 110 healthy volunteers. Two men complained of transient burning pain during circumcision, but none required injectable anaesthesia. Median blood loss was 1ml and median procedure time was 9.0 min. There were 7 (6.3% moderate complications (5 (4.5% post-operative bleeds requiring suture and 2 (1.8% post-operative infections affecting 7 men. No men experienced significant wound dehiscence. 90.4% of men were fully healed at 4 weeks of follow-up and all were highly satisfied.Use of topical anaesthesia obviates the need for injectable anesthetic and makes the Unicirc procedure nearly painless. Unicirc is rapid, easy to learn, heals by primary intention with excellent cosmetic results, obviates the need for a return visit for device removal, and is potentially cheaper and safer than other methods. Use of this method will greatly facilitate scale-up of mass circumcision programs.ClinicalTrials.gov NCT02091726.

  15. Safety, effectiveness and acceptability of the PrePex device for adult male circumcision in Kenya.

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    Paul J Feldblum

    Full Text Available To assess the safety, effectiveness and acceptability of the PrePex device for adult medical male circumcision (MMC in routine service delivery in Kenya.We enrolled 427 men ages 18-49 at one fixed and two outreach clinics. Procedures were performed by trained clinical officers and nurses. The first 50 enrollees were scheduled for six follow-up visits, and remaining men were followed at Days 7 and 42. We recorded adverse events (AEs and time to complete healing, and interviewed men about acceptability and pain.Placement and removal procedures each averaged between 3 and 4 minutes. Self-reported pain was minimal during placement but was fleetingly intense during removal. The rate of moderate/severe AEs was 5.9% overall (95% confidence interval [CI] 3.8%-8.5%, all of which resolved without sequelae. AEs included 5 device displacements, 2 spontaneous foreskin detachments, and 9 cases of insufficient foreskin removal. Surgical completion of MMC was required for 9 men (2.1%. Among the closely monitored first 50 participants, the probability of complete healing by Day 42 was 0.44 (95% CI 0.30-0.58, and 0.90 by Day 56. A large majority of men was favorable about their MMC procedure and would recommend PrePex to friends and family.The PrePex device was effective for MMC in Kenya, and well-accepted. The AE rate was higher than reported for surgical procedures there, or in previous PrePex studies. Healing time is longer than following surgical circumcision. Provider experience and clearer counseling on post-placement and post-removal care should lead to lower AE rates.ClinicalTrials.gov NCT01711411.

  16. Paediatric male circumcision and penile hygiene: a Japanese mothers' view.

    Science.gov (United States)

    Castro-Vázquez, Genaro

    2013-01-01

    This paper analyses the views of 20 Japanese mothers concerning paediatric male circumcision and penile hygiene. In Japan, routine male circumcision has never been implemented for newborns and children, and adult males are mostly circumcised at aesthetic clinics. However, media reports indicate a trend of Japanese mothers willing to have their sons circumcised. In discussing penile hygiene and male circumcision, the construct of a 'sexual script' becomes relevant to understanding how linguistic and gender barriers made references to male genitalia and penile hygiene largely appear as 'vulgar' and 'unfeminine' in daily life conversations. Peers were often identified as the main source of information and only mothers who have struggled with their children's penile infections have learnt about male genital hygiene, a domain of knowledge largely transmitted by men. Male circumcision becomes a double-edged sword that could help prevent penile infections but also an embarrassing conversational topic that could elicit discrimination because most Japanese children are uncircumcised. PMID:24152018

  17. Factors Associated with Knowledge of and Willingness for Adult Male Circumcision in Changsha, China.

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    Mingqiang Zeng

    Full Text Available Male circumcision (MC has been shown to reduce the risk of male genital diseases. MC is not commonly practiced among Chinese males and little is known about the factors associated with their knowledge of and willingness for MC. This study was to explore the knowledge regarding the foreskin among Chinese males and to identify factors associated with their willingness to undergo circumcision.A total of 237 patients with redundant prepuce/phimosis were interviewed through face-to-face interviews. The items on the questionnaire included: demographics, an objective scale assessing knowledge about the foreskin, willingness to have MC, the attitudes of sexual partners and doctors toward redundant prepuce/phimosis, and the approaches that patients used to acquire knowledge regarding the prepuce. Univariate analysis and multiple logistic regression analysis were performed to identify factors that are associated with willingness to be circumcised (WTC.A total of 212 patients completed the interview. Multivariable logistic regression showed that three factors were significantly associated with WTC: being married (OR = 0.43, perceiving redundant prepuce/phimosis as a disease (OR = 1.93, and if a patient's partner supported MC (OR = 1.39. 58% (n = 122 had received information about the foreskin from another party: 18% (n = 37 from school, 8% (n = 17 from family, 17% (n = 36 from friends, 27% (n = 57 from health care providers. About 4% (n = 8 believed that their partners disliked their redundant prepuce/phimosis. 20% (n = 42 had received doctors' advice to undergo circumcision.Knowledge about the foreskin was low among Chinese males. Our study elucidates the factors associated with WTC and suggests that more education of the population about the foreskin can help improve the recognition of a correctible abnormality and help patients assess the potential role of MC in their health.

  18. Piloting PrePex for Adult and Adolescent Male Circumcision in South Africa--Pain Is an Issue.

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    Limakatso Lebina

    Full Text Available The World Health Organisation and the Joint United Nations Programme on HIV/AIDS have recommended the scale-up of Medical Male Circumcision (MMC in countries with high HIV and low MMC prevalence. PrePex device circumcision is proposed as an alternate method for scaling up MMC.Evaluate safety and feasibility of PrePex in South Africa.A multisite prospective cohort PrePex study in adults and adolescents at three MMC clinics. Participants were followed-up 8 times, up to 56 days after PrePex placement.In total, 398 PrePex circumcisions were performed (315 adults and 83 adolescents their median ages were 26 (IQR: 22-30 and 16 years (IQR: 15-17, respectively. The median time for device placement across both groups was 6 minutes (IQR: 5-9 with the leading PrePex sizes being B (30% and C (35% for adults (18-45 years, and A (31% and B (38% for adolescents (14-17 years. Additional sizes (size 12-20 were rarely used, even in the younger age group. Pain of device application was minimal but that of removal was severe. However, described pain abated rapidly and almost no pain was reported 1 hour after removal. The Adverse Events rate were experienced by 2.7% (11/398 of all participants, three of which were serious (2 displacements and 1 self-removal requiring prompt surgery. None of the Adverse Events required hospitalization. The majority of participants returned to work within a day of device placement.Our study shows that PrePex is a safe MMC method, for males 14 years and above. PrePex circumcision had a similar adverse event rate to that reported for surgical MMC, but device removal caused high levels of pain, which subsided rapidly.

  19. Sutureless Adult Voluntary Male Circumcision with Topical Anesthetic: A Randomized Field Trial of Unicirc, a Single-Use Surgical Instrument.

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    Justin Shenje

    Full Text Available The World Health Organization has solicited rapid and minimally invasive techniques to facilitate scale-up of voluntary medical male circumcision (VMMC.Non-blinded randomized controlled field trial with 2:1 allocation ratio.75 adult male volunteers.Outpatient primary care clinic.Open surgical circumcision under local anesthetic with suturing vs. Unicirc disposable instrument under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive.Intraoperative duration.Intraoperative and postoperative pain; adverse events; time to healing; patient satisfaction; cosmetic result.The intraoperative time was less with the Unicirc technique (median 12 vs. 25 min, p < 0.001. Wound healing and cosmetic results were superior in the Unicirc group. Adverse events were similar in both groups.VMMC with Unicirc under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive is rapid, heals by primary intention with superior cosmetic results, and is potentially safer and more cost-effective than open surgical VMMC.Clinicaltrials.gov NCT02443792.

  20. Non-therapeutic infant male circumcision

    Science.gov (United States)

    Alkhenizan, Abdullah; Elabd, Kossay

    2016-01-01

    Objectives: To review the evidence of the benefits and harms of infant male circumcision, and the legal and ethical perspectives of infant male circumcision. Methods: We conducted a systematic search of the literature using PubMed, EMBASE, and the Cochrane library up to June 2015. We searched the medical law literature using the Westlaw and Lexis Library law literature resources up to June 2015. Results: Male circumcision significantly reduced the risk of urinary tract infections by 87%. It also significantly reduced transmission of human immunodeficiency virus among circumcised men by 70%. Childhood and adolescent circumcision is associated with a 66% reduction in the risk of penile cancer. Circumcision was associated with 43% reduction of human papilloma virus infection, and 58% reduction in the risk of cervical cancer among women with circumcised partners compared with women with uncircumcised partners. Male infant circumcision reduced the risk of foreskin inflammation by 68%. Conclusion: Infant male circumcision should continue to be allowed all over the world, as long as it is approved by both parents, and performed in facilities that can provide appropriate sterilization, wound care, and anesthesia. Under these conditions, the benefits of infant male circumcision outweigh the rare and generally minor potential harms of the procedure. PMID:27570848

  1. Decline in male circumcision in South Korea

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    Kim DaiSik

    2012-12-01

    Full Text Available Abstract Background To investigate the changing circumcision rate in South Korea in the last decade and to propose underlying causes for this change, in the context of the present fluctuating world-wide trends in circumcision. Methods From 2009 to 2011, 3,296 South Korean males (or their parents aged 0–64 years were asked about their circumcision status, their age at circumcision, and their information level regarding circumcision. We employed non-probability sampling considering the sensitive questions on the study theme. Results Currently the age-standardized circumcision rate for South Korean males aged 14–29 is found to be 75.8%. In an earlier study performed in 2002, the rate for the same age group was 86.3%. Of particular interest, males aged 14–16 show a circumcision rate of 56.4%, while the same age group 10 years ago displayed a much higher percentage, at 88.4%. In addition, the extraordinarily high circumcision rate of 95.2% found 10 years ago for the 17–19 age group is now reduced to 74.4%. Interestingly, of the circumcised males, the percentage circumcised in the last decade was only 25.2%; i.e., the majority of the currently circumcised males had undergone the operation prior to 2002, indicating that the actual change in the last decade is far greater. Consistent with this conjecture, the 2002 survey showed that the majority of circumcised males (75.7% had undergone the operation in the decade prior to that point. Focusing on the flagship age group of 14–16, this drop suggests that, considering the population structure of Korean males, approximately one million fewer circumcision operations have been performed in the last decade relative to the case of non-decline. This decline is strongly correlated with the information available through internet, newspapers, lectures, books, and television: within the circumcised population, both the patients and their parents had less prior knowledge regarding circumcision, other than

  2. The safety of adult male circumcision in HIV-infected and uninfected men in Rakai, Uganda.

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    Godfrey Kigozi

    2008-06-01

    Full Text Available BACKGROUND: The objective of the study was to compare rates of adverse events (AEs related to male circumcision (MC in HIV-positive and HIV-negative men in order to provide guidance for MC programs that may provide services to HIV-infected and uninfected men. METHODS AND FINDINGS: A total of 2,326 HIV-negative and 420 HIV-positive men (World Health Organization [WHO] stage I or II and CD4 counts > 350 cells/mm3 were circumcised in two separate but procedurally identical trials of MC for HIV and/or sexually transmitted infection prevention in rural Rakai, Uganda. Participants were followed at 1-2 d and 5-9 d, and at 4-6 wk, to assess surgery-related AEs, wound healing, and resumption of intercourse. AE risks and wound healing were compared in HIV-positive and HIV-negative men. Adjusted odds ratios (AdjORs were estimated by multiple logistic regression, adjusting for baseline characteristics and postoperative resumption of sex. At enrollment, HIV-positive men were older, more likely to be married, reported more sexual partners, less condom use, and higher rates of sexually transmitted disease symptoms than HIV-negative men. Risks of moderate or severe AEs were 3.1/100 and 3.5/100 in HIV-positive and HIV-negative participants, respectively (AdjOR 0.91, 95% confidence interval [CI] 0.47-1.74. Infections were the most common AEs (2.6/100 in HIV-positive versus 3.0/100 in HIV-negative men. Risks of other complications were similar in the two groups. The proportion with completed healing by 6 wk postsurgery was 92.7% in HIV-positive men and 95.8% in HIV-negative men (p = 0.007. AEs were more common in men who resumed intercourse before wound healing compared to those who waited (AdjOR 1.56, 95% CI 1.05-2.33. CONCLUSIONS: Overall, the safety of MC was comparable in asymptomatic HIV-positive and HIV-negative men, although healing was somewhat slower among the HIV infected. All men should be strongly counseled to refrain from intercourse until full wound

  3. Factors Associated With Delayed Healing in a Study of the PrePex Device for Adult Male Circumcision in Kenya

    Science.gov (United States)

    Odoyo-June, Elijah; Bailey, Robert C.; Jou Lai, Jaim; Weiner, Debra; Combes, Stephanie; Hart, Catherine; Fischer, Shelly; Obiero, Walter; Cherutich, Peter

    2016-01-01

    Objectives: To explore factors associated with healing requiring more than 6 weeks after placement of the PrePex device for adult medical male circumcision. Methods: We enrolled 427 men ages 18–49 years in an observational study of PrePex at 1 urban and 2 peripheral clinics in western Kenya. Participants were scheduled for device removal at day 7 and a follow-up visit at day 42 (allowable range, 40–44) at which the provider recorded wound status, with complete healing defined as a dry wound without any scab, later confirmed by site investigator review of digital penile photographs. We performed univariate and multivariate logistic regression to explore associations between selected demographic, surgical, and follow-up factors and delayed healing (not healed by day 42 visit). Results: Of the 427 men, 341 completing a day 42 visit with physical examination and recorded healing status were included. Fifty-four percent of included men were healed by day 42 visit. Factors associated with delayed healing in univariate analysis and remaining significant in the multivariate analysis were as follows: age 25 years or older [odds ratio (OR): 1.8; 95% confidence interval (CI): 1.4 to 2.4], an adverse event by day 44 (OR: 1.4; 95% CI: 1.03 to 2.0), and severe pain during device removal (protective association: OR: 0.7; 95% CI: 0.5 to 0.99). Conclusions: Older age (25+ years), occurrence of an adverse event, and lesser self-reported pain at device removal were associated with delayed wound healing. If confirmed by larger surveillance studies, these results should be incorporated into the counseling given to male circumcision clients. PMID:27331586

  4. Circumcision revision in male children

    Directory of Open Access Journals (Sweden)

    Mohammed A. Al-Ghazo

    2006-08-01

    Full Text Available OBJECTIVE: To determine indications for circumcision revision and to identify the specialty of the person who performed unsatisfactory primary circumcision. MATERIALS AND METHODS: The authors reviewed medical records of 52 cases that underwent circumcision revision over a 6-year period (1998 to 2004. Sleeve surgical technique was used for revision in patients with redundant foreskin or concealed penis, penoplasty for partial or complete degloving of the penis and meatotomy for external meatal stenosis. The mean age of children was 32 months (range 6 months to 9 years. RESULTS: Most of unsatisfactory primary circumcisions (86.7% were performed by laymen. All patients who underwent circumcision revision had good to excellent cosmetic results. CONCLUSION: Primary circumcision performed by laymen carry a high complication rate and serious complications may occur. A period of training and direct supervision by physicians is required before allowing laymen to perform circumcision independently.

  5. Adverse events profile of PrePex a non-surgical device for adult male circumcision in a Ugandan urban setting.

    Directory of Open Access Journals (Sweden)

    Moses Galukande

    Full Text Available BACKGROUND: Safe Male Circumcision is a proven approach for partial HIV prevention. Several sub Saharan African countries have plans to reach a prevalence of 80% of their adult males circumcised by 2015. These targets require out of ordinary organization, demand creation, timely execution and perhaps the use of SMC devices. OBJECTIVE: To profile Adverse Events rate and acceptance of PrePex, a non surgical device for adult male circumcision. METHODS: A prospective study, conducted at International Hospital Kampala, Uganda, between August and October 2012. Ethical approval was obtained from Uganda National Council of Science and Technology. RESULTS: Of 1,040 men received to undergo SMC, 678 opted for PrePex, 36 were excluded at an initial physical examination screening. 642 were enrolled and consented, and another 17 were excluded before device placement. 625 underwent the procedure. Average age was 24 years (± 7. Twelve moderate AEs occurred among 10 participants 12/625, (1.9%. These were all reversible. Five had device displacement, one had an everted foreskin; five had bleeding after the device was removed and one had voiding difficulties. The majority (279 out of 300 of men interviewed complained of some pain within the week of placement. Mean pain score at device placement (using visual analogue scale was 0.5, at device removal 4.5 and within 2 min of removal the pain score was 1.4. Over 70% of the devices were placed and removed by non-physician clinicians. Presented with a choice, 60% of men chose PrePex over surgical SMC. Close to 90% would recommend the device to their friends. Odour from the necrotic skin was a concern. Removals done 1-2 days earlier than day 7 were beneficial and conferred no extra risk. CONCLUSION: AEs of a moderate or severe nature associated with PrePex were low and reversible. PrePex is feasible for mass safe male circumcision scaling up.

  6. Reasons for the low uptake of adult male circumcision for the prevention of HIV transmission in Swaziland.

    Science.gov (United States)

    Maibvise, Charles; Mavundla, Thandisizwe R

    2014-09-01

    Swaziland is currently experiencing the worst impact of HIV and AIDS of any country in the world. In an effort to curb further spread of the virus, the country adopted mass male circumcision (MC) as recommended by the World Health Organization in 2007. Despite intense campaigns to promote the procedure over the past three years, the uptake of circumcision remains very low for reasons that are not very clear. The purpose of this study was to explore the reasons for the low uptake of MC in Swaziland despite the massive national MC campaigns. A qualitative research design was used, in which all men who were targeted by the mass MC campaign were eligible. Participants were identified as they came for sexual and reproductive health services at the Family Life Association of Swaziland (FLAS) Clinic, Mbabane. In-depth, individual face-to-face unstructured interviews were conducted to elicit the reasons why men were not going for circumcision. A total of 17 men were interviewed. Results showed that these reasons include fear of the procedure and the possible outcome, perception of no significant benefit of the procedure, impatience about waiting for the procedure or the healing process, religious/cultural beliefs, and worries about the fate of the foreskin. These reasons were attributed to misconceptions and lack of accurate and specific information about some aspects of the circumcision strategy of HIV preventions. Physiological changes and economic activities associated with adulthood were also found to be hindrances to MC uptake. The study recommended that a comprehensive description of the procedure and more precise facts and scientific bases of the MC strategy be incorporated and emphasised in the MC campaigns. Involvement of religious leaders will also facilitate clarification of religious or cultural misunderstandings or misconceptions. A focus on neonatal MC would also help.

  7. Behavior change pathways to voluntary medical male circumcision: narrative interviews with circumcision clients in Zambia.

    Directory of Open Access Journals (Sweden)

    Jessica E Price

    Full Text Available As an HIV prevention strategy, the scale-up of voluntary medical male circumcision (VMMC is underway in 14 countries in Africa. For prevention impact, these countries must perform millions of circumcisions in adolescent and adult men before 2015. Although acceptability of VMMC in the region is well documented and service delivery efforts have proven successful, countries remain behind in meeting circumcision targets. A better understanding of men's VMMC-seeking behaviors and experiences is needed to improve communication and interventions to accelerate uptake. To this end, we conducted semi-structured interviews with 40 clients waiting for surgical circumcision at clinics in Zambia. Based on Stages of Change behavioral theory, men were asked to recount how they learned about adult circumcision, why they decided it was right for them, what they feared most, how they overcame their fears, and the steps they took to make it to the clinic that day. Thematic analysis across all cases allowed us to identify key behavior change triggers while within-case analysis elucidated variants of one predominant behavior change pattern. Major stages included: awareness and critical belief adjustment, norming pressures and personalization of advantages, a period of fear management and finally VMMC-seeking. Qualitative comparative analysis of ever-married and never-married men revealed important similarities and differences between the two groups. Unprompted, 17 of the men described one to four failed prior attempts to become circumcised. Experienced more frequently by older men, failed VMMC attempts were often due to service-side barriers. Findings highlight intervention opportunities to increase VMMC uptake. Reaching uncircumcised men via close male friends and female sex partners and tailoring messages to stage-specific concerns and needs would help accelerate men's movement through the behavior change process. Expanding service access is also needed to meet

  8. Bodily integrity and male and female circumcision.

    NARCIS (Netherlands)

    Dekkers, W.J.M.; Hoffer, C.; Wils, J.-P.

    2005-01-01

    This paper explores the ambiguous notion of bodily integrity, focusing on male and female circumcision. In the empirical part of the study we describe and analyse the various meanings that are given to the notion of bodily integrity by people in their daily lives. In the philosophical part we distin

  9. Circumcision with “no-flip Shang Ring” and “Dorsal Slit” methods for adult males: a single-centered, prospective, clinical study

    Science.gov (United States)

    Lei, Jun-Hao; Liu, Liang-Ren; Wei, Qiang; Xue, Wen-Ben; Song, Tu-Run; Yan, Shi-Bing; Yang, Lu; Han, Ping; Zhu, Yu-Chun

    2016-01-01

    This paper was aimed to compare the clinical effectiveness and safety of adult male circumcision using the Shang Ring™ (SR) with the no-flip technique compared with Dorsal Slit (DS) surgical method. A single-centered, prospective study was conducted at the West China Hospital, where patients were circumcised using the no-flip SR (n = 408) or the DS (n = 94) procedure. The adverse events (AEs) and satisfaction were recorded for both groups, and ring-removal time and percentage of delayed removals were recorded for the SR group. Finally, complete follow-up data were collected for 76.1% of patients (SR: n = 306; DS: n = 76). The average ring-removal time for the SR group was 17.62 ± 6.30 days. The operation time (P flip SR method was found to be superior to the DS method for its short operation time (<5 min), involving less pain, bleeding, infection, and resulting in a satisfactory appearance. However, the time for recovery from edema took longer, and patients may wear device for 2–3 weeks after the procedure. PMID:26585694

  10. Implications of the fast-evolving scale-up of adult voluntary medical male circumcision for quality of services in South Africa.

    Directory of Open Access Journals (Sweden)

    Dino Rech

    Full Text Available BACKGROUND: The scale-up of voluntary medical male circumcision (VMMC services in South Africa has been rapid, in an attempt to achieve the national government target of 4.3 million adult male circumcisions for HIV prevention by 2016. This study assesses the effect of the scale-up on the quality of the VMMC program. METHODS AND FINDINGS: This analysis compares the quality of services at 15 sites operational in 2011 to (1 the same 15 sites in 2012 and (2 to a set of 40 sites representing the expanded program in 2012. Trained clinicians scored each site on 29 items measuring readiness to provide quality services (abbreviated version of the WHO Quality Assessment [QA] Guide and 29 items to assess quality of surgical care provided (pre-op, surgical technique and post-op based on the observation of VMMC procedures at each site. Declines in quality far outnumbered improvements. The negative effects in terms of readiness to provide quality services were most evident in expanded sites, whereas the declines in provision of quality services tended to affect both repeat sites and expanded sites equally. Areas of notable concern included the monitoring of adverse events, external supervision, post-operative counselling, and some infection control issues. Scores on quality of surgical technique tended to be among the highest across the 58 items observed, and the South Africa program has clearly institutionalized three "best practices" for surgical efficiency. CONCLUSIONS: These findings demonstrate the challenges of rapidly developing large numbers of new VMMC sites with the necessary equipment, supplies, and protocols. The scale-up in South Africa has diluted human resources, with negative effects for both the original sites and the expanded program.

  11. Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark

    DEFF Research Database (Denmark)

    Frisch, Morten; Lindholm, Morten; Grønbæk, Morten

    2011-01-01

    One-third of the world's men are circumcised, but little is known about possible sexual consequences of male circumcision. In Denmark (~5% circumcised), we examined associations of male circumcision with a range of sexual measures in both sexes.......One-third of the world's men are circumcised, but little is known about possible sexual consequences of male circumcision. In Denmark (~5% circumcised), we examined associations of male circumcision with a range of sexual measures in both sexes....

  12. Circumcision of male children for reduction of future risk for HIV: acceptability among HIV serodiscordant couples in Kampala, Uganda.

    Directory of Open Access Journals (Sweden)

    Kenneth K Mugwanya

    Full Text Available INTRODUCTION: The ultimate success of medical male circumcision for HIV prevention may depend on targeting male infants and children as well as adults, in order to maximally reduce new HIV infections into the future. METHODS: We conducted a cross-sectional study among heterosexual HIV serodiscordant couples (a population at high risk for HIV transmission attending a research clinic in Kampala, Uganda on perceptions and attitudes about medical circumcision for male children for HIV prevention. Correlates of willingness to circumcise male children were assessed using generalized estimating equations methods. RESULTS: 318 HIV serodiscordant couples were interviewed, 51.3% in which the female partner was HIV uninfected. Most couples were married and cohabiting, and almost 50% had at least one uncircumcised male child of ≤18 years of age. Overall, 90.2% of male partners and 94.6% of female partners expressed interest in medical circumcision for their male children for reduction of future risk for HIV infection, including 79.9% of men and 87.6% of women who had an uncircumcised male child. Among both men and women, those who were knowledgeable that circumcision reduces men's risk for HIV (adjusted prevalence ratio [APR] 1.34 and 1.14 and those who had discussed the HIV prevention effects of medical circumcision with their partner (APR 1.08 and 1.07 were significantly (p≤0.05 more likely to be interested in male child circumcision for HIV prevention. Among men, those who were circumcised (APR 1.09, p = 0.004 and those who were HIV seropositive (APR 1.09, p = 0.03 were also more likely to be interested in child circumcision for HIV prevention. CONCLUSIONS: A high proportion of men and women in Ugandan heterosexual HIV serodiscordant partnerships were willing to have their male children circumcised for eventual HIV prevention benefits. Engaging both parents may increase interest in medical male circumcision for HIV prevention.

  13. Sequential Cross-Sectional Surveys in Orange Farm, a Township of South Africa, Revealed a Constant Low Voluntary Medical Male Circumcision Uptake among Adults despite Demand Creation Campaigns and High Acceptability

    Science.gov (United States)

    Marshall, Esaie; Rain-Taljaard, Reathe; Tsepe, Motlalepule; Monkwe, Cornelius; Hlatswayo, Florence; Tshabalala, Simphiwe; Khela, Simphiwe; Xulu, Lindo; Xaba, Dumazile; Molomo, Tebogo; Malinga, Thobile; Puren, Adrian; Auvert, Bertran

    2016-01-01

    Background WHO recommends a male circumcision (MC) prevalence rate higher than 80% to have a substantial impact on the HIV-AIDS epidemic in Eastern and Southern Africa. Orange Farm, a township in South Africa, has a free-for-service voluntary medical male circumcision (VMMC) clinic in operation since 2008. Following an intense campaign from 2008 to 2010, MC prevalence rate increased to 55.4% (ANRS-12126). Ongoing and past VMMC campaigns focused on youths, through school talks, and adults at a community level. The main objective of the study was to assess the change in MC prevalence rate among adults aged 18–19 and 18–49 years in the past 5 years. Methods A cross-sectional survey (ANRS-12285) was conducted among a random sample of 522 adult men in 2015. MC status and characteristics of participants were collected through a genital examination and a face-to-face questionnaire. Results MC prevalence rate among young adult men aged 18–19 years increased markedly from 61.2% (95%CI: 57.4% to 65.0%) in 2010 to 87.5% (76.0% to 94.6%) in 2015 (pcircumcised. However, we estimated that only 4.6% (11/237; 2.5% to 7.9%) of the uncircumcised men underwent circumcision in 2015, despite 117/185 (63.2%; 95%CI: 56.1% to 69.9%) who reported that they were definitely willing to become circumcised. Conclusions In Orange Farm, VMMC campaigns were successful among the youth and led to a sufficiently high MC prevalence rate to have a substantial impact in the future on the HIV-AIDS epidemic. However, despite high acceptability and a free VMMC service, VMMC campaigns since 2010 have failed to increase MC prevalence rate among adults to above 80%. These campaigns should be revisited. PMID:27427957

  14. Adult bipolar diathermy circumcision and related procedures in adults – a safe and efficient technique

    Directory of Open Access Journals (Sweden)

    Nalavenkata S

    2014-06-01

    Full Text Available Sunny Nalavenkata, Matthew Winter, Rachel Kour, Nam-Wee Kour, Paul RuljancichDepartment of Urology, Eastern Health, Box Hill Hospital, Box Hill, VIC, AustraliaObjectives: To present our novel technique and step-by-step approach to bipolar diathermy circumcision and related procedures in adult males.Methods: We reviewed our technique of bipolar circumcision and related procedures in 54 cases over a 22-month period at our day procedure center. Bipolar diathermy cutting and hemostasis was performed using bipolar forceps with a Valleylab machine set at 15. Sleeve circumcision was used. A dorsal slit was made, followed by frenulum release and ventral slit, and was completed with bilateral circumferential cutting. Frenuloplasties released the frenulum. Preputioplasties used multiple 2–3 mm longitudinal cuts to release the constriction, with frenulum left intact. All wounds were closed with interrupted 4/0 Vicryl Rapide™.Results: A total of 54 nonemergency bipolar circumcision procedures were carried out from November 2010–August 2012 (42 circumcisions, eight frenuloplasties, and four preputioplasties. Patients were aged 18–72 years (mean, 34 years. There was minimal to no intraoperative bleeding in all cases, allowing for precise dissection. All patients were requested to attend outpatient reviews; three frenuloplasty and two circumcision patients failed to return. Of the remaining 49, mean interval to review was 49 days, with a range of 9–121 days. Two circumcision patients reported mild bleeding with nocturnal erections within a week postoperatively, but they did not require medical attention. Two others presented to family practitioners with possible wound infections which resolved with oral antibiotics. All 49 patients had well-healed wounds.Conclusion: The bipolar diathermy technique is a simple procedure, easily taught, and reproducible. It is associated with minimal bleeding, is safe and efficient, uses routine operating equipment and

  15. Male circumcision as strategy for HIV prevention and sexually transmitted diseases: the potential role of traditional birth attendants in neonatal male circumcision

    Directory of Open Access Journals (Sweden)

    Catia Dini

    2010-12-01

    Full Text Available In developing countries, it would be advisable to give priority to human immunodeficiency virus (HIV prevention strategies, because of the high mortality caused by the rapid spread of the pandemic. Furthermore, HIV prevention could contribute to the mitigation of tuberculosis (TB propagation, which is tightly correlated to acquired immune deficiency syndrome (AIDS. As demonstrated, male circumcision (MC confers protection against HIV and sexually transmitted diseases (STD. The suggested strategy considers the neonatal MC advantageous, since it is safer, feasible, culturally more acceptable and less costly than adult MC. This approach is based on the assumption that, if newborn males are circumcised, within the next 15-20 years the sexually active population will be almost entirely circumcised and, consequently, the HIV transmission will be reduced. The employment of retrained traditional birth attendants is considered in order to implement the MC after the child birth and to facilitate its acceptance in those contexts where it is not traditionally performed.

  16. Critical evaluation of unscientific arguments disparaging affirmative infant male circumcision policy.

    Science.gov (United States)

    Morris, Brian J; Krieger, John N; Klausner, Jeffrey D

    2016-08-01

    We evaluate recent claims opposing infant male circumcision, a procedure now supported by the evidence-based policy of the American Academy of Pediatrics. We find those criticisms depend on speculative claims about the foreskin and obfuscation of the strong scientific evidence supporting pediatric policy development. An argument that circumcision should be delayed to allow a boy to make up his own mind as an adult fails to appreciate the psychological, scheduling and financial burdens later circumcision entails, so reducing the likelihood that it will occur. In contrast, early infant circumcision is convenient, safer, quicker, lower risk, healing is faster, cosmetic outcome is routinely good and the lifetime benefits accrue immediately. Benefits include reduction in urinary tract infections, inflammatory skin conditions, foreskin problems, and, when older, substantial protection against sexually transmitted infections and genital cancers in the male and his female sexual partners. Some authorities regard the failure to offer parents early infant circumcision as unethical, just as it would be unethical to fail to encourage the vaccination of children. In conclusion, the criticisms of evidence-based infant male circumcision policy are seriously flawed and should be dismissed as unhelpful to evidence-based development and implementation of pediatric policy intended to improve public health and individual wellbeing. PMID:27610340

  17. Critical evaluation of unscientific arguments disparaging affirmative infant male circumcision policy.

    Science.gov (United States)

    Morris, Brian J; Krieger, John N; Klausner, Jeffrey D

    2016-08-01

    We evaluate recent claims opposing infant male circumcision, a procedure now supported by the evidence-based policy of the American Academy of Pediatrics. We find those criticisms depend on speculative claims about the foreskin and obfuscation of the strong scientific evidence supporting pediatric policy development. An argument that circumcision should be delayed to allow a boy to make up his own mind as an adult fails to appreciate the psychological, scheduling and financial burdens later circumcision entails, so reducing the likelihood that it will occur. In contrast, early infant circumcision is convenient, safer, quicker, lower risk, healing is faster, cosmetic outcome is routinely good and the lifetime benefits accrue immediately. Benefits include reduction in urinary tract infections, inflammatory skin conditions, foreskin problems, and, when older, substantial protection against sexually transmitted infections and genital cancers in the male and his female sexual partners. Some authorities regard the failure to offer parents early infant circumcision as unethical, just as it would be unethical to fail to encourage the vaccination of children. In conclusion, the criticisms of evidence-based infant male circumcision policy are seriously flawed and should be dismissed as unhelpful to evidence-based development and implementation of pediatric policy intended to improve public health and individual wellbeing.

  18. Circumcision

    Science.gov (United States)

    ... and discomfort. previous continue Caring for a Circumcised Penis Following circumcision, it is important to keep the ... easily treated. previous continue Caring for an Uncircumcised Penis As with a penis that's circumcised, an uncircumcised ...

  19. Modeling Costs and Impacts of Introducing Early Infant Male Circumcision for Long-Term Sustainability of the Voluntary Medical Male Circumcision Program

    Science.gov (United States)

    Stegman, Peter; Kripke, Katharine; Mugurungi, Owen; Ncube, Gertrude; Xaba, Sinokuthemba; Hatzold, Karin; Christensen, Alice; Stover, John

    2016-01-01

    Voluntary medical male circumcision (VMMC) has been shown to be an effective prevention strategy against HIV infection in males [1–3]. Since 2007, the President’s Emergency Plan for AIDS Relief (PEPFAR) has supported VMMC programs in 14 priority countries in Africa. Today several of these countries are preparing to transition their VMMC programs from a scale-up and expansion phase to a maintenance phase. As they do so, they must consider the best approaches to sustain high levels of male circumcision in the population. The two alternatives under consideration are circumcising adolescents 10–14 years old over the long term or integrating early infant male circumcision (EIMC) into maternal and child health programs. The paper presents an analysis, using the Decision Makers Program Planning Tool, Version 2.0 (DMPPT 2.0), of the estimated cost and impact of introducing EIMC into existing VMMC programs in several countries in eastern and southern Africa. Limited cost data exist for the implementation of EIMC, but preliminary studies, such as the one detailed in Mangenah, et al. [4–5], suggest that the cost of EIMC may be less than that of adolescent and adult male circumcision. If this is the case, then adding EIMC to the VMMC program will increase the number of circumcisions that need to be performed but will not increase the total cost of the program over the long term. In addition, we found that a delayed or slow start-up of EIMC would not substantially reduce the impact of adding it to the program or increase cumulative long-term costs, which should make introduction of EIMC more feasible and attractive to countries contemplating such a program innovation. PMID:27410233

  20. Modeling Costs and Impacts of Introducing Early Infant Male Circumcision for Long-Term Sustainability of the Voluntary Medical Male Circumcision Program.

    Science.gov (United States)

    Njeuhmeli, Emmanuel; Stegman, Peter; Kripke, Katharine; Mugurungi, Owen; Ncube, Gertrude; Xaba, Sinokuthemba; Hatzold, Karin; Christensen, Alice; Stover, John

    2016-01-01

    Voluntary medical male circumcision (VMMC) has been shown to be an effective prevention strategy against HIV infection in males [1-3]. Since 2007, the President's Emergency Plan for AIDS Relief (PEPFAR) has supported VMMC programs in 14 priority countries in Africa. Today several of these countries are preparing to transition their VMMC programs from a scale-up and expansion phase to a maintenance phase. As they do so, they must consider the best approaches to sustain high levels of male circumcision in the population. The two alternatives under consideration are circumcising adolescents 10-14 years old over the long term or integrating early infant male circumcision (EIMC) into maternal and child health programs. The paper presents an analysis, using the Decision Makers Program Planning Tool, Version 2.0 (DMPPT 2.0), of the estimated cost and impact of introducing EIMC into existing VMMC programs in several countries in eastern and southern Africa. Limited cost data exist for the implementation of EIMC, but preliminary studies, such as the one detailed in Mangenah, et al. [4-5], suggest that the cost of EIMC may be less than that of adolescent and adult male circumcision. If this is the case, then adding EIMC to the VMMC program will increase the number of circumcisions that need to be performed but will not increase the total cost of the program over the long term. In addition, we found that a delayed or slow start-up of EIMC would not substantially reduce the impact of adding it to the program or increase cumulative long-term costs, which should make introduction of EIMC more feasible and attractive to countries contemplating such a program innovation.

  1. 重庆市成年男性对包皮环切手术认知水平的调查%The Analysis on Cognitive Level of Circumcision in Adult Male of Chongqing

    Institute of Scientific and Technical Information of China (English)

    李君; 钟朝晖; 唐晓君; 秦波; 文静; 刘晨煜; 李革

    2012-01-01

    Objective To investigate the knowledge level of Circumcision in adult male of Chongqing, provide the scientific basis for developing circumcision health education materials. Methods This study investigated the related knowledge level of circumcision with Inhabitants and migrants which applied multi-stage stratified cluster sampling method during November to December in 2009. Results In 1502 investigator objects, 83. 36% participants had heard about circumcision, the awareness of people whose age between 27 -35 and high education were higher than other people (all P <0. 05) . 35. 70% participants had known that too long wrapping will cause the phallic cancer, 18. 30% participants had known that circumcision can prevent AIDS and other sexually transmitted diseases, 31. 70% participants thought that circumcision can improve sexual function. There was 43.94% of population were willing to accept the circumcision, the willingness of circumcision of crowd with different education had statistical difference (P <0. 05) , the willingness of circumcision of inhabitants were higher than migrants ( P < 0. 05 ) . Conclusion People in this area have low circumcision related knowledge, the cognitive level is "widely heard but lack of understanding" stage, we should develop nichetargeting health education materials, improve health education and increase the circumcision rate.%目的 了解重庆市成年男性对包皮环切手术的认知水平,为开发包皮环切手术健康宣教材料提供科学依据.方法 于2009年11月-12月采用多阶段分层整群抽样方法,对重庆市常住人口和流动人口对包皮环切手术相关知识的认知水平作现况调查.结果 在1502名调查对象中,83.36%的人听说过包皮环切手术,年龄为27~35岁、文化程度为大专及以上的人群较其他人群知晓率更高(P均<0.05).35.70%的人群知道包皮过长有致阴茎癌的危险,18.30%的人知道包皮环切可以预防艾

  2. Sequential Cross-Sectional Surveys in Orange Farm, a Township of South Africa, Revealed a Constant Low Voluntary Medical Male Circumcision Uptake among Adults despite Demand Creation Campaigns and High Acceptability

    Science.gov (United States)

    Marshall, Esaie; Rain-Taljaard, Reathe; Tsepe, Motlalepule; Monkwe, Cornelius; Hlatswayo, Florence; Tshabalala, Simphiwe; Khela, Simphiwe; Xulu, Lindo; Xaba, Dumazile; Molomo, Tebogo; Malinga, Thobile; Puren, Adrian; Auvert, Bertran

    2016-01-01

    Background WHO recommends a male circumcision (MC) prevalence rate higher than 80% to have a substantial impact on the HIV-AIDS epidemic in Eastern and Southern Africa. Orange Farm, a township in South Africa, has a free-for-service voluntary medical male circumcision (VMMC) clinic in operation since 2008. Following an intense campaign from 2008 to 2010, MC prevalence rate increased to 55.4% (ANRS-12126). Ongoing and past VMMC campaigns focused on youths, through school talks, and adults at a community level. The main objective of the study was to assess the change in MC prevalence rate among adults aged 18–19 and 18–49 years in the past 5 years. Methods A cross-sectional survey (ANRS-12285) was conducted among a random sample of 522 adult men in 2015. MC status and characteristics of participants were collected through a genital examination and a face-to-face questionnaire. Results MC prevalence rate among young adult men aged 18–19 years increased markedly from 61.2% (95%CI: 57.4% to 65.0%) in 2010 to 87.5% (76.0% to 94.6%) in 2015 (p<0.001). In the same period, among men aged 18–49 years, MC prevalence rate varied slightly from 55.4% (53.6% to 57.1%) to 56.7% (52.4% to 60.9%). In 2015, 84.9% (79.2% to 89.5%) of uncircumcised adult men reported that they were willing to be circumcised. However, we estimated that only 4.6% (11/237; 2.5% to 7.9%) of the uncircumcised men underwent circumcision in 2015, despite 117/185 (63.2%; 95%CI: 56.1% to 69.9%) who reported that they were definitely willing to become circumcised. Conclusions In Orange Farm, VMMC campaigns were successful among the youth and led to a sufficiently high MC prevalence rate to have a substantial impact in the future on the HIV-AIDS epidemic. However, despite high acceptability and a free VMMC service, VMMC campaigns since 2010 have failed to increase MC prevalence rate among adults to above 80%. These campaigns should be revisited. PMID:27427957

  3. Should Male Circumcision be Advocated for Genital Cancer Prevention?

    OpenAIRE

    Morris, Brian J.; Mindel, Adrian; Tobian, Aaron AR; Hankins, Catherine A.; Ronald H Gray; Bailey, Robert C.; Bosch, Xavier; Wodak, Alex D

    2012-01-01

    The recent policy statement by the Cancer Council of Australia on infant circumcision and cancer prevention and the announcement that the quadrivalent human papillomavirus (HPV) vaccine will be made available for boys in Australia prompted us to provide an assessment of genital cancer prevention. While HPV vaccination of boys should help reduce anal cancer in homosexual men and cervical cancer in women, it will have little or no impact on penile or prostate cancer. Male circumcision can reduc...

  4. Early infant male circumcision for human immunodeficiency virus prevention: knowledge and attitudes of women attending a rural hospital in Swaziland, Southern Africa.

    Science.gov (United States)

    Jarrett, Prudence; Kliner, Merav; Walley, John

    2014-01-01

    Swaziland has the highest prevalence of human immunodeficiency virus (HIV) in the world at 26% of the adult population. Medical male circumcision (MMC) has been shown to reduce the risk of acquiring HIV from heterosexual sex by up to 60% and the Government of Swaziland has been promoting adult male circumcision. Infant circumcision commenced in 2013 so it is important to understand the knowledge and views of women as potential mothers, around infant circumcision for medical purposes to inform the development of the service. This study interviewed 14 women of reproductive age attending the outpatient department of Good Shepherd Mission Hospital (GSMH), a rural district hospital, on their knowledge of and attitudes to early infant male circumcision (EIMC). Participants were highly knowledgeable about the health benefits of medical circumcision, although knowledge of the comparative risks and benefits of EIMC to adult circumcision was poor. All participants would have a son circumcised; the preferred age varied from early infancy to adolescence. Complications and pain were the main barriers whilst religious and cultural reasons were mentioned both for and against circumcision. A variety of family members are important in the decision to circumcise a young boy. Acceptability of medical circumcision was high in this study, but concerns about safety, pain, autonomy and cultural factors reduce the acceptability of infant circumcision more specifically. It will be important to provide accurate, culturally sensitive information about infant circumcision to mothers, fathers and grandparents using existing hospital and community services provided at GSMH and throughout Swaziland. Where possible services for MMC should be available to males of all ages so that families and young men may choose the most favourable age for circumcision.

  5. Circumcision

    Science.gov (United States)

    Circumcision is a surgical procedure to remove the foreskin, the skin that covers the tip of the ... AAP), there are medical benefits and risks to circumcision. Possible benefits include a lower risk of urinary ...

  6. Evaluating the cost of adult voluntary medical male circumcision in a mixed (surgical and PrePex site compared to a hypothetical PrePex-only site in South Africa

    Directory of Open Access Journals (Sweden)

    Hae-Young Kim

    2015-12-01

    Full Text Available Background: Several circumcision devices have been evaluated for a safe and simplified male circumcision among adults. The PrePex device was prequalified for voluntary male medical circumcision (VMMC in May 2013 by the World Health Organization and is expected to simplify the procedure safely while reducing cost. South Africa is scaling up VMMC. Objective: To evaluate the overall unit cost of VMMC at a mixed site vs. a hypothetical PrePex-only site in South Africa. Design: We evaluated the overall unit cost of VMMC at a mixed site where PrePex VMMC procedure was added to routine forceps-guided scalpel-based VMMC in Soweto, South Africa. We abstracted costs and then modeled these costs for a hypothetical PrePex-only site, at which 9,600 PrePex circumcisions per year could be done. We examined cost drivers and modeled costs, varying the price of the PrePex device. The healthcare system perspective was used. Results: In both sites, the main contributors of cost were personnel and consumables. If 10% of all VMMC were by PrePex at the mixed site, the overall costs of the surgical method and PrePex were similar – US$59.62 and $59.53, respectively. At the hypothetical PrePex-only site, the unit cost was US$51.10 with PrePex circumcisions having markedly lower personnel and biohazardous waste management costs. In sensitivity analysis with the cost of PrePex kit reduced to US$10 and $2, the cost of VMMC was further reduced. Conclusions: Adding PrePex to an existing site did not necessarily reduce the overall costs of VMMC. However, starting a new PrePex-only site is feasible and may significantly reduce the overall cost by lowering both personnel and capital costs, thus being cost-effective in the long term. Achieving a lower cost for PrePex will be an important contributor to the scale-up of VMMC.

  7. Achieving the HIV prevention impact of voluntary medical male circumcision: lessons and challenges for managing programs.

    Science.gov (United States)

    Sgaier, Sema K; Reed, Jason B; Thomas, Anne; Njeuhmeli, Emmanuel

    2014-05-01

    Voluntary medical male circumcision (VMMC) is capable of reducing the risk of sexual transmission of HIV from females to males by approximately 60%. In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended making VMMC part of a comprehensive HIV prevention package in countries with a generalized HIV epidemic and low rates of male circumcision. Modeling studies undertaken in 2009-2011 estimated that circumcising 80% of adult males in 14 priority countries in Eastern and Southern Africa within five years, and sustaining coverage levels thereafter, could avert 3.4 million HIV infections within 15 years and save US$16.5 billion in treatment costs. In response, WHO/UNAIDS launched the Joint Strategic Action Framework for accelerating the scale-up of VMMC for HIV prevention in Southern and Eastern Africa, calling for 80% coverage of adult male circumcision by 2016. While VMMC programs have grown dramatically since inception, they appear unlikely to reach this goal. This review provides an overview of findings from the PLOS Collection "Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up." The use of devices for VMMC is also explored. We propose emphasizing management solutions to help VMMC programs in the priority countries achieve the desired impact of averting the greatest possible number of HIV infections. Our recommendations include advocating for prioritization and funding of VMMC, increasing strategic targeting to achieve the goal of reducing HIV incidence, focusing on programmatic efficiency, exploring the role of new technologies, rethinking demand creation, strengthening data use for decision-making, improving governments' program management capacity, strategizing for sustainability, and maintaining a flexible scale-up strategy informed by a strong monitoring, learning, and evaluation platform.

  8. Parental Decision Making in Male Circumcision

    OpenAIRE

    Sardi, Lauren; Livingston, Kathy

    2015-01-01

    Abstract Purpose: To study which healthcare professionals (HCPs) firstasked parents about their decision regarding circumcision; whether parents felt they were given enough information by their HCP; and what reasons parents cited for their decision. Study Design and Methods: Bilingual questionnaires were administered to parents and expecting parents of boys (N = 60). Close-ended survey responses were analyzed through factor analysis to ascertain what types of beliefs parents used in their dec...

  9. 'If you are circumcised, you are the best': understandings and perceptions of voluntary medical male circumcision among men from KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Humphries, Hilton; van Rooyen, Heidi; Knight, Lucia; Barnabas, Ruanne; Celum, Connie

    2015-01-01

    While the uptake of voluntary medical male circumcision (VMMC) is increasing, South Africa has only attained 20% of its target to circumcise 80% of adult men by 2015. Understanding the factors influencing uptake is essential to meeting these targets. This qualitative study reports on findings from focus-group discussions with men in rural KwaZulu-Natal, South Africa, about what factors influence their perceptions of VMMC. The study found that VMMC is linked to perceptions of masculinity and male gender identity including sexual health, sexual performance and pleasure, possible risk compensation and self-identity. Findings highlight the need to understand how these perceptions of sexual health and performance affect men's decisions to undergo circumcision and the implications for uptake of VMMC. The study also highlights the need for individualised and contextualised information and counselling that can identify, understand and address the perceptions men have of VMMC, and the impacts they believe it will have on them. PMID:25567140

  10. Newborn Male Circumcision with Parental Consent, as Stated in the AAP Circumcision Policy Statement, Is Both Legal and Ethical.

    Science.gov (United States)

    Brady, Michael T

    2016-06-01

    Newborn male circumcision is a minor surgical procedure that has generated significant controversy. Accumulating evidence supports significant health benefits, most notably reductions in urinary tract infections, acquisition of HIV and a number of other sexually transmitted infections, penile cancer, phimosis, paraphimosis, balanitis and lichen sclerosis. While circumcision, like any surgical procedure, has risks for complications, they occur in less than 1 in 500 infants circumcised and most are minor and require minimal intervention. The CDC and the American Academy of Pediatrics (AAP) believe that health benefits of circumcision outweigh the risks. For this reason, the AAP believes that parents should be allowed to make the decision concerning circumcision of their male infants after receiving non-biased information on health risks and health benefits. PMID:27338601

  11. Newborn Male Circumcision with Parental Consent, as Stated in the AAP Circumcision Policy Statement, Is Both Legal and Ethical.

    Science.gov (United States)

    Brady, Michael T

    2016-06-01

    Newborn male circumcision is a minor surgical procedure that has generated significant controversy. Accumulating evidence supports significant health benefits, most notably reductions in urinary tract infections, acquisition of HIV and a number of other sexually transmitted infections, penile cancer, phimosis, paraphimosis, balanitis and lichen sclerosis. While circumcision, like any surgical procedure, has risks for complications, they occur in less than 1 in 500 infants circumcised and most are minor and require minimal intervention. The CDC and the American Academy of Pediatrics (AAP) believe that health benefits of circumcision outweigh the risks. For this reason, the AAP believes that parents should be allowed to make the decision concerning circumcision of their male infants after receiving non-biased information on health risks and health benefits.

  12. Research on Influencing Factors and Circumcision Acceptance Willingness of Adult Males in Chongqing%重庆市成年男性包皮环切术接受意愿及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    刘晨煜; 钟朝晖; 唐晓君; 秦波; 李革; 李君; 文静

    2011-01-01

    Objective To understand the adult male's acceptance of circumcision and its influencing factors in Chongqing, so as to provide scientific evidences for developing male circumcision extension programs and health education materials. Methods The circumcision acceptance of adult males from 18 to 45 years old in Chongqing was investigated by using multistage stratified cluster sampling method. Results Among 1 502 subjects, 661 males persisted in their willingness to do circumcision, and the operation acceptance rate was 44.01%; the acceptance rate in the 18-30 age group was higher than that in the 31-45 age group; the higher the education level, the higher the acceptance of the circumcision; and workers and businessmen had greater willingness to accept than farmers. The multivariate logistic regression analysis showed that the positive factors affecting acceptance rate were "being aware that the circumcision is suitable for phimosis and redundant prepuce" (OR=21.01,95%CI 14.21 to 31.06), "being told by friends who had circumcision before" (OR=1.65, 95%CI 1.25 to 2.19), and "being realized on the risk of phimosis and redundant prepuce" (OR=1.43, 95%CI 1.01 to 2.02); while the negative factors were "being worried about the surgical complications" (OR=0.69, 95%CI 0.50 to 0.95) and "being afraid of the ridicule from people around" (OR=0.63, 95%CI 0.40 to 0.99). Conclusion The willingness rate of adult males to accept circumcision was low in Chongqing; the publicity and education should be strengthened, and the good social atmosphere should be built for increasing the willingness rate of accepting circumcision.%目的 了解重庆市成年男性包皮环切术接受意愿现状及其影因素,为制定包皮环切推广模式及开发健康教育材料提供科学依据.方法 采用分层多级整群随机抽样方法对重庆市18~45岁成年男性进行包皮环切术的接受意愿进行调查.结果 共调查了1 502名成年男性,其中661人表示愿意做包皮

  13. Perceptions and knowledge of voluntary medical male circumcision for HIV prevention in traditionally non-circumcising communities in South Africa.

    Science.gov (United States)

    Hoffman, Jacob Robin; Arendse, Kirsten D; Larbi, Carl; Johnson, Naomi; Vivian, Lauraine M H

    2015-01-01

    Voluntary medical male circumcision (VMMC) has been recommended for the prevention of HIV transmission, particularly in sub-Saharan Africa. Uptake of the campaign has been relatively poor, particularly in traditionally non-circumcising regions. This study evaluates the knowledge, attitudes and practices of medical male circumcision (MC) of 104 community members exposed to promotional campaigns for VMMC for five years. Results show that 93% of participants have heard of circumcision and 72% have heard of some health benefit from the practice. However, detailed knowledge of the relationship with HIV infection is lacking: 12.2% mistakenly believed you could not get HIV after being circumcised, while 75.5% believe that a circumcised man is still susceptible and another 12.2% do not know of any relationship between HIV and MC. There are significant barriers to the uptake of the practice, including misperceptions and fear of complications commonly attributed to traditional, non-medical circumcision. However, 88.8% of participants believe circumcision is an acceptable practice, and community-specific promotional campaigns may increase uptake of the service.

  14. Notes from the Field: Tetanus Cases After Voluntary Medical Male Circumcision for HIV Prevention--Eastern and Southern Africa, 2012-2015.

    Science.gov (United States)

    Grund, Jonathan M; Toledo, Carlos; Davis, Stephanie M; Ridzon, Renee; Moturi, Edna; Scobie, Heather; Naouri, Boubker; Reed, Jason B; Njeuhmeli, Emmanuel; Thomas, Anne G; Benson, Francis Ndwiga; Sirengo, Martin W; Muyenzi, Leon Ngeruka; Lija, Gissenge J I; Rogers, John H; Mwanasalli, Salli; Odoyo-June, Elijah; Wamai, Nafuna; Kabuye, Geoffrey; Zulu, James Exnobert; Aceng, Jane Ruth; Bock, Naomi

    2016-01-22

    Voluntary medical male circumcision (VMMC) decreases the risk for female-to-male HIV transmission by approximately 60%, and the President's Emergency Plan for AIDS Relief (PEPFAR) is supporting the scale-up of VMMC for adolescent and adult males in countries with high prevalence of human immunodeficiency virus (HIV) and low coverage of male circumcision. As of September 2015, PEPFAR has supported approximately 8.9 million VMMCs.

  15. Acceptability of early infant male circumcision as an HIV prevention intervention in Zimbabwe: a qualitative perspective.

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    Webster Mavhu

    Full Text Available BACKGROUND: Early infant male circumcision (EIMC is simpler, safer and more cost-effective than adult circumcision. In sub-Saharan Africa, there are concerns about acceptability of EIMC which could affect uptake. In 2009 a quantitative survey of 2,746 rural Zimbabweans (aged 18-44 indicated that 60% of women and 58% of men would be willing to have their newborn son circumcised. Willingness was associated with knowledge of HIV and male circumcision. This qualitative study was conducted to better understand this issue. METHODS: In 2010, 24 group discussions were held across Zimbabwe with participants from seven ethnic groups. Additionally, key informant interviews were held with private paediatricians who offer EIMC (n = 2 plus one traditional leader. Discussions were audio-recorded, transcribed, translated into English (where necessary, coded using NVivo 8 and analysed using grounded theory principles. RESULTS: Knowledge of the procedure was poor. Despite this, acceptability of EIMC was high among parents from most ethnic groups. Discussions suggested that fathers would make the ultimate decision regarding EIMC although mothers and extended family can have (often covert influence. Participants' concerns centred on: safety, motive behind free service provision plus handling and disposal of the discarded foreskin. Older men from the dominant traditionally circumcising population strongly opposed EIMC, arguing that it separates circumcision from adolescent initiation, as well as allowing women (mothers to nurse the wound, considered taboo. CONCLUSIONS: EIMC is likely to be an acceptable HIV prevention intervention for most populations in Zimbabwe, if barriers to uptake are appropriately addressed and fathers are specifically targeted by the programme.

  16. The Effect of Circumcision on Infection of High-risk Human Papilloma Virus in Adult Males%包皮环切术对男性高危型HPV感染的预防作用研究

    Institute of Scientific and Technical Information of China (English)

    方卫; 孙杰明; 甘伟胜; 陈俭; 陈武强; 肖艺

    2013-01-01

      目的探讨包皮环切术对男性高危型HPV感染的预防作用。方法收集我院2001年6月至2010年6月十年间普外门诊行包皮环切术的患者临床资料276例,另取我院体检中心体检的包皮过长而未行包皮环切术的健康男性276例作为对照。HPV-DNA分型基因芯片检测高危型HPV病毒的表达。结果552例受试者中共检测到高危型HPV感染157例,感染率为28.4%。治疗前治疗组感染80例,感染率为29.0%;对照组感染77例,感染率为27.9%,两组之间无显著性差异(P>0.05)。包皮环切术后2年,治疗组高危型HPV感染率从29.0%减少到11.9%,二者之间具有显著性差异(P<0.05)。对照组为29.3%,与治疗前无显著性改变(P>0.05)。结论包皮环切术可以预防男性高危型HPV的感染,值得积极推广应用。%Objective To investigate the clinical effects of circumcision on infection of high-risk human papilloma virus(HPV) in adult males. Methods A total of 276 adult males with circumcision were collected and analyzed in our hospital. Another 276 phimosis without circumcision were recruited in the control group. The high-risk HPV was detected by HPV-DNA genotyping chip. Results 157 cases were infected by high-risk HPV in 552 phimosis, and the infection rate was 28.4%. Before circumcision, 80 cases were infected by high-risk HPV with an infection rate of 29.0%in treatment group, and 77 cases were infected by high-risk HPV with an infection rate of 27.9%in control group. There was no significant difference between the two groups(P>0.05). After circumcision, the infection rate of high-risk HPV was significantly decreased from 29.0%to 11.9%in treatment group (P0.05). Conclusion Circumcision can effectively reduce high-risk HPV infection, and which was worthy to promote the clinical application.

  17. Voluntary medical male circumcision in resource-constrained settings.

    Science.gov (United States)

    Tobian, Aaron A R; Adamu, Tigistu; Reed, Jason B; Kiggundu, Valerian; Yazdi, Youseph; Njeuhmeli, Emmanuel

    2015-12-01

    Throughout East and Southern Africa, the WHO recommends voluntary medical male circumcision (VMMC) to reduce heterosexual HIV acquisition. Evidence has informed policy and the implementation of VMMC programmes in these countries. VMMC has been incorporated into the HIV prevention portfolio and more than 9 million VMMCs have been performed. Conventional surgical procedures consist of forceps-guided, dorsal slit or sleeve resection techniques. Devices are also becoming available that might help to accelerate the scale-up of adult VMMC. The ideal device should make VMMC easier, safer, faster, sutureless, inexpensive, less painful, require less infrastructure, be more acceptable to patients and should not require follow-up visits. Elastic collar compression devices cause vascular obstruction and necrosis of foreskin tissue and do not require sutures or injectable anaesthesia. Collar clamp devices compress the proximal part of the foreskin to reach haemostasis; the distal foreskin is removed, but the device remains and therefore no sutures are required. Newer techniques and designs, such as tissue adhesives and a circular cutter with stapled anastomosis, are improvements, but none of these methods have achieved all desirable characteristics. Further research, design and development are needed to address this gap to enable the expansion of the already successful VMMC programmes for HIV prevention.

  18. Voluntary medical male circumcision: logistics, commodities, and waste management requirements for scale-up of services.

    Directory of Open Access Journals (Sweden)

    Dianna Edgil

    2011-11-01

    Full Text Available BACKGROUND: The global HIV prevention community is implementing voluntary medical male circumcision (VMMC programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President's Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. METHODS AND FINDINGS: This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. CONCLUSIONS: Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in

  19. Need for Physician Education on the Benefits and Risks of Male Circumcision in the United States

    Science.gov (United States)

    Carbery, Baevin; Zhu, Julia; Gust, Deborah A.; Chen, Robert T.; Kretsinger, Katrina; Kilmarx, Peter H.

    2012-01-01

    Physicians may be called upon to counsel male patients or parents of newborn males regarding their decision to circumcise their newborn sons. The purpose of the present study was to describe physicians who do not understand the benefits and risks associated with male circumcision well enough to counsel parents of newborn male infants and adult…

  20. : Male circumcision as HIV prevention between controversies and scientific investigation

    OpenAIRE

    Harrous-Paicheler, Genevieve

    2010-01-01

    The randomised controlled trial (RCT) is considered the scientific foundation of medical practice in evidence based medicine. Therefore, the evidence it brings should put an end to controversies. But this was not the case if we look at the demonstration of the protective role of male circumcision (MC) against HIV/AIDS infection. Although based on a series of epidemiological investigations, culminating in RCTs, the benefits of MC are a controversial subject in the medical and scientific commun...

  1. Cost-effectiveness of newborn circumcision in reducing lifetime HIV risk among U.S. males.

    Directory of Open Access Journals (Sweden)

    Stephanie L Sansom

    Full Text Available BACKGROUND: HIV incidence was substantially lower among circumcised versus uncircumcised heterosexual African men in three clinical trials. Based on those findings, we modeled the potential effect of newborn male circumcision on a U.S. male's lifetime risk of HIV, including associated costs and quality-adjusted life-years saved. METHODOLOGY/PRINCIPAL FINDINGS: Given published estimates of U.S. males' lifetime HIV risk, we calculated the fraction of lifetime risk attributable to heterosexual behavior from 2005-2006 HIV surveillance data. We assumed 60% efficacy of circumcision in reducing heterosexually-acquired HIV over a lifetime, and varied efficacy in sensitivity analyses. We calculated differences in lifetime HIV risk, expected HIV treatment costs and quality-adjusted life years (QALYs among circumcised versus uncircumcised males. The main outcome measure was cost per HIV-related QALY saved. Circumcision reduced the lifetime HIV risk among all males by 15.7% in the base case analysis, ranging from 7.9% for white males to 20.9% for black males. Newborn circumcision was a cost-saving HIV prevention intervention for all, black and Hispanic males. The net cost of newborn circumcision per QALY saved was $87,792 for white males. Results were most sensitive to the discount rate, and circumcision efficacy and cost. CONCLUSIONS/SIGNIFICANCE: Newborn circumcision resulted in lower expected HIV-related treatment costs and a slight increase in QALYs. It reduced the 1.87% lifetime risk of HIV among all males by about 16%. The effect varied substantially by race and ethnicity. Racial and ethnic groups who could benefit the most from circumcision may have least access to it due to insurance coverage and state Medicaid policies, and these financial barriers should be addressed. More data on the long-term protective effect of circumcision on heterosexual males as well as on its efficacy in preventing HIV among MSM would be useful.

  2. Male circumcision, alcohol use and unprotected sex among patrons of bars and taverns in rural areas of North-West province, South Africa.

    Science.gov (United States)

    Nkosi, Sebenzile; Sikweyiya, Yandisa; Kekwaletswe, Connie T; Morojele, Neo K

    2015-01-01

    Strong research evidence has shown that medical male circumcision significantly reduces heterosexual HIV acquisition among men. However, its effectiveness is enhanced by behavioural factors such as condom use. Currently, little is known of unprotected sex associated with male circumcision (MC) among alcohol-drinking tavern-going men, or whether engagement in unprotected sex may differ between men who have been traditionally circumcised and those who have been medically circumcised. The study sought to determine the relative importance of alcohol consumption and MC as correlates of unprotected sex and to compare the risk of engaging in unprotected sex between traditionally circumcised and medically circumcised tavern-going men from two rural villages in North-West province, South Africa. Data from 314 adult men (≥18 years) were analysed. The men were recruited from four bars/taverns using systematic sampling. They responded to questions regarding their demographic characteristics, alcohol consumption, circumcision status and method (where applicable), and engagement in unprotected sex. Descriptive analyses and bivariate and multivariate logistic regression analyses were conducted. Age, education, relationship status, alcohol consumption and traditional male circumcision (TMC) were independently and significantly associated with unprotected sex. Specifically, probable alcohol dependence and traditional circumcision were independent risk factors for engaging in unprotected sex among tavern-going men. Traditionally circumcised men had a higher risk of engaging in unprotected sex than medically circumcised men. Interventions aimed at reducing alcohol consumption, encouraging protective behaviour among men who have undergone TMC, and increasing condom use are needed in bar/tavern settings. HIV prevention education must be urgently incorporated into TMC programmes.

  3. Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision

    NARCIS (Netherlands)

    Frisch, M.; Aigrain, Y.; Barauskas, V.; Bjarnason, R.; Boddy, S.A.; Czauderna, P.; Gier, R.P.E. de; Jong, T.P. de; Fasching, G.; Fetter, W.; Gahr, M.; Graugaard, C.; Greisen, G.; Gunnarsdottir, A.; Hartmann, W.; Havranek, P.; Hitchcock, R.; Huddart, S.; Janson, S.; Jaszczak, P.; Kupferschmid, C.; Lahdes-Vasama, T.; Lindahl, H.; Macdonald, N.; Markestad, T.; Martson, M.; Nordhov, S.M.; Palve, H.; Petersons, A.; Quinn, F.; Qvist, N.; Rosmundsson, T.; Saxen, H.; Soder, O.; Stehr, M.; Loewenich, V.C. von; Wallander, J.; Wijnen, R.

    2013-01-01

    The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large numbe

  4. Male circumcision in the general population of Kisumu, Kenya: beliefs about protection, risk behaviors, HIV, and STIs.

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    Matthew Westercamp

    Full Text Available Using a population-based survey we examined the behaviors, beliefs, and HIV/HSV-2 serostatus of men and women in the traditionally non-circumcising community of Kisumu, Kenya prior to establishment of voluntary medical male circumcision services. A total of 749 men and 906 women participated. Circumcision status was not associated with HIV/HSV-2 infection nor increased high risk sexual behaviors. In males, preference for being or becoming circumcised was associated with inconsistent condom use and increased lifetime number of sexual partners. Preference for circumcision was increased with understanding that circumcised men are less likely to become infected with HIV.

  5. Male circumcision: care practices and attitudes in a Muslim community of western Nepal

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    Mohan Paudel

    2011-03-01

    Full Text Available

    Abstract:
    Background: Male circumcision is a removal of the foreskin of the glans penis. There are medical, ritual and religious reasons for male circumcision. The purpose of this study is to explore the current practices, perceptions, future recommendations and health seeking behavior during and after performing male circumcision in a Muslim community of western Nepal. Method: A total of 64 households were sampled by a simple random sampling method. Information was collected using semi-structured questionnaires and focus group discussions. Result: Circumcision was practiced among all Muslim households and the main reason was religious rite and ritual. It was the traditional circumciser, locally known as hazam, who circumcised all male children in the community. Interestingly, in only 5 % of the household children had been circumcised using modern medicines. The rest of the households, i.e. 95%, relied on traditional healing systems, the use of local herbs and homemade ointments (mainly the suspension of ghee and ash.A Non-sterilized knife was the main surgical instrument used during circumcision. The wound healing after circumcision was much longer, even up to 90 days or more. Conclusions: Circumcision is a practice that is still largely carried out outside the domain of the formal health care system in this community. It demands a design of service delivery models from health policy makers in the Ministry of Health, thus bringing circumcision within formal health care systems in those communities. It deserves an urgent attention to provide safe, culturally acceptable and sustainable services from health institutions.

  6. Circumcision

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    Puri Poonam

    2010-01-01

    Full Text Available Circumcision is one of the oldest and the most controversial surgical procedures performed worldwide and is almost universal among Muslim and Jewish men. Most medical institutions in various countries agree that although there may be health benefits, there is no medical justification for routine circumcision in neonates or children. It should be performed only for established medical reasons and should not be universally recommended. There are modern techniques that provide safer, simpler, quicker, and cheaper alternatives to the traditional means of circumcision with good functional and cosmetic results. Female genital mutilation (FGM includes procedure that alters or injures female genital organs for nonmedical reasons. Various degrees of FGM are prevalent, the most mutilating one being infibulation. There are numerous gynecologic and obstetrical complications with infibulation. FGM also plays a significant role in facilitating the transmission of HIV infection through numerous mechanisms. Health care providers have an important role to play in the eradication of this practice. Increased professional and public awareness about such a practice is required.

  7. Male circumcision at different ages in Rwanda: a cost-effectiveness study.

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    Agnes Binagwaho

    2010-01-01

    Full Text Available BACKGROUND: There is strong evidence showing that male circumcision (MC reduces HIV infection and other sexually transmitted infections (STIs. In Rwanda, where adult HIV prevalence is 3%, MC is not a traditional practice. The Rwanda National AIDS Commission modelled cost and effects of MC at different ages to inform policy and programmatic decisions in relation to introducing MC. This study was necessary because the MC debate in Southern Africa has focused primarily on MC for adults. Further, this is the first time, to our knowledge, that a cost-effectiveness study on MC has been carried out in a country where HIV prevalence is below 5%. METHODS AND FINDINGS: A cost-effectiveness model was developed and applied to three hypothetical cohorts in Rwanda: newborns, adolescents, and adult men. Effectiveness was defined as the number of HIV infections averted, and was calculated as the product of the number of people susceptible to HIV infection in the cohort, the HIV incidence rate at different ages, and the protective effect of MC; discounted back to the year of circumcision and summed over the life expectancy of the circumcised person. Direct costs were based on interviews with experienced health care providers to determine inputs involved in the procedure (from consumables to staff time and related prices. Other costs included training, patient counselling, treatment of adverse events, and promotion campaigns, and they were adjusted for the averted lifetime cost of health care (antiretroviral therapy [ART], opportunistic infection [OI], laboratory tests. One-way sensitivity analysis was performed by varying the main inputs of the model, and thresholds were calculated at which each intervention is no longer cost-saving and at which an intervention costs more than one gross domestic product (GDP per capita per life-year gained. RESULTS: Neonatal MC is less expensive than adolescent and adult MC (US$15 instead of US$59 per procedure and is cost

  8. Scaling Up Early Infant Male Circumcision: Lessons From the Kingdom of Swaziland

    Science.gov (United States)

    Fitzgerald, Laura; Benzerga, Wendy; Mirira, Munamato; Adamu, Tigistu; Shissler, Tracey; Bitchong, Raymond; Malaza, Mandla; Mamba, Makhosini; Mangara, Paul; Curran, Kelly; Khumalo, Thembisile; Mlambo, Phumzile; Njeuhmeli, Emmanuel; Maziya, Vusi

    2016-01-01

    ABSTRACT Background: The government of the Kingdom of Swaziland recognizes that it must urgently scale up HIV prevention interventions, such as voluntary medical male circumcision (VMMC). Swaziland has adopted a 2-phase approach to male circumcision scale-up. The catch-up phase prioritizes VMMC services for adolescents and adults, while the sustainability phase involves the establishment of early infant male circumcision (EIMC). Swaziland does not have a modern-day tradition of circumcision, and the VMMC program has met with client demand challenges. However, since the launch of the EIMC program in 2010, Swaziland now leads the Eastern and Southern Africa region in the scale-up of EIMC. Here we review Swaziland’s program and its successes and challenges. Methods: From February to May 2014, we collected data while preparing Swaziland’s “Male Circumcision Strategic and Operational Plan for HIV Prevention 2014–2018.” We conducted structured stakeholder focus group discussions and in-depth interviews, and we collected EIMC service delivery data from an implementing partner responsible for VMMC and EIMC service delivery. Data were summarized in consolidated narratives. Results: Between 2010 and 2014, trained providers performed more than 5,000 EIMCs in 11 health care facilities in Swaziland, and they reported no moderate or severe adverse events. According to a broad group of EIMC program stakeholders, an EIMC program needs robust support from facility, regional, and national leadership, both within and outside of HIV prevention coordination bodies, to promote institutionalization and ownership. Providers and health care managers in 3 of Swaziland’s 4 regional hospitals suggest that when EIMC is introduced into reproductive, maternal, newborn, and child health platforms, dedicated staff attention can help ensure that EIMC is performed amid competing priorities. Creating informed demand from communities also supports EIMC as a service delivery priority

  9. Voluntary medical male circumcision: a cross-sectional study comparing circumcision self-report and physical examination findings in Lesotho.

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    Anne Goldzier Thomas

    Full Text Available BACKGROUND: Overwhelming evidence, including three clinical trials, shows that male circumcision (MC reduces the risk of HIV infection among men. However, data from recent Lesotho Demographic and Health Surveys do not demonstrate MC to be protective against HIV. These contradictory findings could partially be due to inaccurate self-reported MC status used to estimate MC prevalence. This study describes MC characteristics among men applying for Lesotho Defence Force recruitment and seeks to assess MC self-reported accuracy through comparison with physical-examination-based data. METHODS AND FINDINGS: During Lesotho Defence Force applicant screening in 2009, 241 (77% of 312 men, aged 18-25 y, consented to a self-administered demographic and MC characteristic survey and physician-performed genital examination. The extent of foreskin removal was graded on a scale of 1 (no evidence of MC to 4 (complete MC. MC was self-reported by 27% (n = 64/239 of participants. Of the 64 men self-reporting being circumcised, physical exam showed that 23% had no evidence of circumcision, 27% had partial circumcision, and 50% had complete circumcision. Of the MCs reportedly performed by a medical provider, 3% were Grade 1 and 73% were Grade 4. Of the MCs reportedly performed by traditional circumcisers, 41% were Grade 1, while 28% were Grade 4. Among participants self-reporting being circumcised, the odds of MC status misclassification were seven times higher among those reportedly circumcised by initiation school personnel (odds ratio = 7.22; 95% CI = 2.29-22.75. CONCLUSIONS: Approximately 27% of participants self-reported being circumcised. However, only 50% of these men had complete MC as determined by a physical exam. Given this low MC self-report accuracy, countries scaling up voluntary medical MC (VMMC should obtain physical-exam-based MC data to guide service delivery and cost estimates. HIV prevention messages promoting VMMC should provide

  10. Limits of Enlightenment and the Law - On the Legality of Ritual Male Circumcision in Europe today

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    Mark Swatek-Evenstein

    2013-07-01

    Full Text Available The legality of ritual circumcision of male infants is a subject not regularly discussed under European or international Human Rights Law, let alone national law. In Germany, this changed dramatically in 2012, when a regional court declared ritual circumcision of a male infant illegal, even if performed at the parents' request and according to current medical standards. After a fierce public discussion, the German parliament voted towards the end of the year in favour of a bill that explicitly permits male infant circumcision. The discussion on whether this new law is in line with European human rights law and international law is expected to continue. This paper takes no position on whether infant male circumcision should be legal and takes no position on the medical questions attached to the subject. It argues for the legality of infant male circumcision in Western democracies like Germany for historic reasons: Jewish emancipation in the 18th and 19th century throughout Europe meant an incorporation of Jewish laws and customs into the legal fabric of European countries. Taking into account the relatively wide acceptance of the practice of infant male circumcision in communities worldwide, the paper suggests that arguments from international human rights law make simple equations difficult to sustain. Gender and children's rights-based approaches may be utilized to develop a deeper sensibility for the issues related to circumcision, but must not obscure the fact that minority rights sometimes rightfully allow a minority to do things the majority does not understand.

  11. Limits of Enlightenment and the Law - On the Legality of Ritual Male Circumcision in Europe today

    Directory of Open Access Journals (Sweden)

    Mark Swatek-Evenstein

    2013-07-01

    Full Text Available The legality of ritual circumcision of male infants is a subject not regularly discussed under European or international Human Rights Law, let alone national law. In Germany, this changed dramatically in 2012, when a regional court declared ritual circumcision of a male infant illegal, even if performed at the parents' request and according to current medical standards. After a fierce public discussion, the German parliament voted towards the end of the year in favour of a bill that explicitly permits male infant circumcision. The discussion on whether this new law is in line with European human rights law and international law is expected to continue. This paper takes no position on whether infant male circumcision should be legal and takes no position on the medical questions attached to the subject. It argues for the legality of infant male circumcision in Western democracies like Germany for historic reasons: Jewish emancipation in the 18 and 19 century throughout Europe meant an incorporation of Jewish laws and customs into the legal fabric of European countries. Taking into account the relatively wide acceptance of the practice of infant male circumcision in communities worldwide, the paper suggests that arguments from international human rights law make simple equations difficult to sustain. Gender and children's rights-based approaches may be utilized to develop a deeper sensibility for the issues related to circumcision, but must not obscure the fact that minority rights sometimes rightfully allow a minority to do things the majority does not understand.

  12. Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision

    DEFF Research Database (Denmark)

    Frisch, Morten; Aigrain, Yves; Barauskas, Vidmantas;

    2013-01-01

    The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large...... number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision...... associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against...

  13. Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa.

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    Emmanuel Njeuhmeli

    2011-11-01

    Full Text Available BACKGROUND: There is strong evidence showing that voluntary medical male circumcision (VMMC reduces HIV incidence in men. To inform the VMMC policies and goals of 13 priority countries in eastern and southern Africa, we estimate the impact and cost of scaling up adult VMMC using updated, country-specific data. METHODS AND FINDINGS: We use the Decision Makers' Program Planning Tool (DMPPT to model the impact and cost of scaling up adult VMMC in Botswana, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia, Zimbabwe, and Nyanza Province in Kenya. We use epidemiologic and demographic data from recent household surveys for each country. The cost of VMMC ranges from US$65.85 to US$95.15 per VMMC performed, based on a cost assessment of VMMC services aligned with the World Health Organization's considerations of models for optimizing volume and efficiencies. Results from the DMPPT models suggest that scaling up adult VMMC to reach 80% coverage in the 13 countries by 2015 would entail performing 20.34 million circumcisions between 2011 and 2015 and an additional 8.42 million between 2016 and 2025 (to maintain the 80% coverage. Such a scale-up would result in averting 3.36 million new HIV infections through 2025. In addition, while the model shows that this scale-up would cost a total of US$2 billion between 2011 and 2025, it would result in net savings (due to averted treatment and care costs amounting to US$16.51 billion. CONCLUSIONS: This study suggests that rapid scale-up of VMMC in eastern and southern Africa is warranted based on the likely impact on the region's HIV epidemics and net savings. Scaling up of safe VMMC in eastern and southern Africa will lead to a substantial reduction in HIV infections in the countries and lower health system costs through averted HIV care costs.

  14. Costs and impacts of scaling up voluntary medical male circumcision in Tanzania.

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    Veena Menon

    Full Text Available BACKGROUND: Given the proven effectiveness of voluntary medical male circumcision (VMMC in preventing the spread of HIV, Tanzania is scaling up VMMC as an HIV prevention strategy. This study will inform policymakers about the potential costs and benefits of scaling up VMMC services in Tanzania. METHODOLOGY: The analysis first assessed the unit costs of delivering VMMC at the facility level in three regions-Iringa, Kagera, and Mbeya-via three currently used VMMC service delivery models (routine, campaign, and mobile/island outreach. Subsequently, using these unit cost data estimates, the study used the Decision Makers' Program Planning Tool (DMPPT to estimate the costs and impact of a scaled-up VMMC program. RESULTS: Increasing VMMC could substantially reduce HIV infection. Scaling up adult VMMC to reach 87.9% coverage by 2015 would avert nearly 23,000 new adult HIV infections through 2015 and an additional 167,500 from 2016 through 2025-at an additional cost of US$253.7 million through 2015 and US$302.3 million from 2016 through 2025. Average cost per HIV infection averted would be US$11,300 during 2010-2015 and US$3,200 during 2010-2025. Scaling up VMMC in Tanzania will yield significant net benefits (benefits of treatment costs averted minus the cost of performing circumcisions in the long run-around US$4,200 in net benefits for each infection averted. CONCLUSION: VMMC could have an immediate impact on HIV transmission, but the full impact on prevalence and deaths will only be apparent in the longer term because VMMC averts infections some years into the future among people who have been circumcised. Given the health and economic benefits of investing in VMMC, the scale-up of services should continue to be a central component of the national HIV prevention strategy in Tanzania.

  15. Epidemiology of complications of male circumcision in Ibadan, Nigeria

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    Ikuerowo Odunayo S

    2006-08-01

    Full Text Available Abstract Background The number of infants managed for neonatal circumcision injuries in our unit has been on the increase over the past 16 years. In our search for the sources and reasons for these injuries, we were unable to identify any previous studies of circumcision injuries from our environment. We therefore decided to carry out this study in order to shed some light on this growing problem. Methods The patients were made up of 370 consecutive consented children attending our infant welfare clinic for immunization over a period of 3 months. Information on their demographic data, their age at circumcision, where, why and who circumcised them was obtained from their mothers. They were clinically examined for the presence and type of complications of circumcision. Results Our circumcision rate was 87%. Neonatal circumcision had been performed in 270 (83.9% of the children. Two hundred and fifty nine (80.7% were performed in hospitals. The operation was done by nurses in 180 (55.9%, doctors in 113 (35.1% and by the traditional circumcisionist in 29 (9% of the children. Complications of circumcision occurred in 65 [20.2%] of the children. Of those who sustained these complications, 35 (53.8% had redundant foreskin, 16 (24.6% sustained excessive loss of foreskin, 11 (16.9% had skin bridges, 2 (3.1% sustained amputation of the glans penis and 1 (1.5% had a buried penis. One of the two children who had amputation of the glans also had severe hemorrhage and was transfused. Even though the complications tended to be more likely with nurses than with doctors or traditional circumcisionists, this did not reach statistical significance (p = 0.051. Conclusion We have a very high rate of complications of circumcision of 20.2%. We suggest that training workshops should be organized to adequately retrain all practitioners of circumcision on the safe methods available.

  16. Innovative Methods of Male Circumcision for HIV Prevention-Getting the Right Evidence.

    Science.gov (United States)

    Samuelson, Julia; Hargreave, Timothy; Ridzon, Renee; Farley, Tim

    2016-06-01

    World Health Organization recommends that countries with hyperendemic and generalized HIV epidemics implement voluntary medical male circumcision programs for HIV prevention. Innovative methods of male circumcision including devices have the potential to simplify the procedure, reduce time and cost, increase client acceptability, enhance safety, and expand the numbers of providers who may perform circumcision. We describe work led by World Health Organization and supported by global partners to define a pathway for the evaluation of efficacy and safety of male circumcision devices, to set priority criteria, and to establish a process to guide the use of devices in publicly funded voluntary medical male circumcision programs for HIV prevention. A device classification scheme, an expert Technical Advisory Group on Innovations in Male Circumcision, and a formal prequalification program have also guided considerations on safe use of devices. A rigorous approach was deemed appropriate given the intervention is for use among healthy men for public health purposes. The pathway and processes led to coordinated research, better standardization in research outcomes, and guidance that informed the research, introduction and implementation phases. The lessons learnt from this case study can inform evaluation and use of future public health innovations. PMID:27331591

  17. Innovative Methods of Male Circumcision for HIV Prevention-Getting the Right Evidence.

    Science.gov (United States)

    Samuelson, Julia; Hargreave, Timothy; Ridzon, Renee; Farley, Tim

    2016-06-01

    World Health Organization recommends that countries with hyperendemic and generalized HIV epidemics implement voluntary medical male circumcision programs for HIV prevention. Innovative methods of male circumcision including devices have the potential to simplify the procedure, reduce time and cost, increase client acceptability, enhance safety, and expand the numbers of providers who may perform circumcision. We describe work led by World Health Organization and supported by global partners to define a pathway for the evaluation of efficacy and safety of male circumcision devices, to set priority criteria, and to establish a process to guide the use of devices in publicly funded voluntary medical male circumcision programs for HIV prevention. A device classification scheme, an expert Technical Advisory Group on Innovations in Male Circumcision, and a formal prequalification program have also guided considerations on safe use of devices. A rigorous approach was deemed appropriate given the intervention is for use among healthy men for public health purposes. The pathway and processes led to coordinated research, better standardization in research outcomes, and guidance that informed the research, introduction and implementation phases. The lessons learnt from this case study can inform evaluation and use of future public health innovations.

  18. [Clinical studies of shang ring male circumcision in China and Africa].

    Science.gov (United States)

    Cheng, Feng; Lü, Nian-Qing; Xu, Hao-Qin; Barone, Mark A; Lee, Richard; Goldstein, Marc; Li, Philip S

    2014-04-01

    HIV/STIs remain a major global public health problem. One of the global strategies for the prevention and control of HIV/STIs is to interrupt their transmission, which requires the public health methods based on scientific evidence and cost-effectiveness. The scale-up of male circumcision services in the priority countries of the HIV-prevention project in sub-Saharan Africa has been hampered by the scarcity of trained providers and relative technical difficulty of male circumcision techniques recommended by WHO and UNAIDS. Shang Ring is an innovative and disposable device for male circumcision, which has been safely used for over 600 000 males in China since 2006. Clinical studies of more than 3 000 cases of Shang Ring circumcision in China, Kenya, Zambia, and Uganda have demonstrated its safety, effectiveness, acceptability and ease of use. The most obvious advantages of Shang Ring include short procedure time (3-6 min), excellent postoperative cosmesis, low rate of complications, high acceptance by clients and providers, ease of use, and standardization for reliable performance. As an innovative technique, Shang Ring has a great potential for facilitating the safe and effective scale-up of circumcision services. This article comprehensively reviews the clinical studies of Shang Ring male circumcision in China and Africa.

  19. Understanding the impact of male circumcision interventions on the spread of HIV in southern Africa.

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    Timothy B Hallett

    Full Text Available BACKGROUND: Three randomised controlled trials have clearly shown that circumcision of adult men reduces the chance that they acquire HIV infection. However, the potential impact of circumcision programmes--either alone or in combination with other established approaches--is not known and no further field trials are planned. We have used a mathematical model, parameterised using existing trial findings, to understand and predict the impact of circumcision programmes at the population level. FINDINGS: Our results indicate that circumcision will lead to reductions in incidence for women and uncircumcised men, as well as those circumcised, but that even the most effective intervention is unlikely to completely stem the spread of the virus. Without additional interventions, HIV incidence could eventually be reduced by 25-35%, depending on the level of coverage achieved and whether onward transmission from circumcised men is also reduced. However, circumcision interventions can act synergistically with other types of prevention programmes, and if efforts to change behaviour are increased in parallel with the scale-up of circumcision services, then dramatic reductions in HIV incidence could be achieved. In the long-term, this could lead to reduced AIDS deaths and less need for anti-retroviral therapy. Any increases in risk behaviours following circumcision, i.e. 'risk compensation', could offset some of the potential benefit of the intervention, especially for women, but only very large increases would lead to more infections overall. CONCLUSIONS: Circumcision will not be the silver bullet to prevent HIV transmission, but interventions could help to substantially protect men and women from infection, especially in combination with other approaches.

  20. "If You Are Not Circumcised, I Cannot Say Yes": The Role of Women in Promoting the Uptake of Voluntary Medical Male Circumcision in Tanzania.

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    Haika Osaki

    Full Text Available Voluntary Medical Male Circumcision (VMMC for HIV prevention in Tanzania was introduced by the Ministry of Health and Social Welfare in 2010 as part of the national HIV prevention strategy. A qualitative study was conducted prior to a cluster randomized trial which tested effective strategies to increase VMMC up take among men aged ≥20 years. During the formative qualitative study, we conducted in-depth interviews with circumcised males (n = 14, uncircumcised males (n = 16, and participatory group discussions (n = 20 with men and women aged 20-49 years in Njombe and Tabora regions of Tanzania. Participants reported that mothers and female partners have an important influence on men's decisions to seek VMMC both directly by denying sex, and indirectly through discussion, advice and providing information on VMMC to uncircumcised partners and sons. Our findings suggest that in Tanzania and potentially other settings, an expanded role for women in VMMC communication strategies could increase adult male uptake of VMMC services.

  1. Safe male circumcision in Botswana: Tension between traditional practices and biomedical marketing

    OpenAIRE

    Katisi, Masego; Daniel, Marguerite

    2015-01-01

    Botswana has been running Safe Male Circumcision (SMC) since 2009 and has not yet met its target. Donors like the US Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership (funded by the Gates Foundation) in collaboration with Botswana's Ministry of Health have invested much to encourage HIV-negative men to circumcise. Demand creation strategies make use of media and celebrities. The objective of this paper is to explore responses to SMC in relation to circum...

  2. Traditional Male Circumcision In A Rural Community In Kedah, Malaysia

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    Rashid A K

    2009-12-01

    Full Text Available Background: Circumcision though not mentioned inthe Quran is believed to be a compulsory practiceamong the Muslims. In Malaysia, although there areseveral methods of circumcision available andtraditional circumcision is still popular.Methods: A cross-sectional survey was carried out in asmall fishing village of Kedah to study the methods ofcircumcision available to the villagers. This wasfollowed with an in-depth interview conducted with‘Tok Mudim’, a practitioner of traditional method ofcircumcision.Results: Forty three of the eligible 71 subjectsparticipated in the study giving the response rate as60.5%. The most common age for circumcision was9 years old. Despite private clinics being the mostcommon place of circumcisions, there was an increasingnumber of boys going to the ‘Tok Mudim’ forcircumcision. A Mass Circumcision Ceremony istraditionally practiced. The ‘Tok Mudim’ described theprocedure in detail and was of the opinion that thereason traditional method is still popular was because ofthe fear of injections and impotency among the parents.Most common complication faced by the ‘Tok Mudim’was bleeding and infection.Discussion and Conclusion: Till the community shiftsentirely to using modern medicine, there is a need tointegrate traditional practitioners into the system.Training the ‘Tok Mudim’ to use modern instrumentsand aseptic techniques should be considered.

  3. Male Circumcision and STI Acquisition in Britain: Evidence from a National Probability Sample Survey.

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    Virginia Homfray

    Full Text Available It is well-established that male circumcision reduces acquisition of HIV, herpes simplex virus 2, chancroid, and syphilis. However, the effect on the acquisition of non-ulcerative sexually transmitted infections (STIs remains unclear. We examined the relationship between circumcision and biological measures of three STIs: human papillomavirus (HPV, Chlamydia trachomatis and Mycoplasma genitalium.A probability sample survey of 15,162 men and women aged 16-74 years (including 4,060 men aged 16-44 years was carried out in Britain between 2010 and 2012. Participants completed a computer-assisted personal interview, including a computer-assisted self-interview, which asked about experience of STI diagnoses, and circumcision. Additionally, 1,850 urine samples from sexually-experienced men aged 16-44 years were collected and tested for STIs. Multivariable logistic regression was used to calculate adjusted odds ratios (AOR to quantify associations between circumcision and i self-reporting any STI diagnosis and ii presence of STIs in urine, in men aged 16-44 years, adjusting for key socio-demographic and sexual behavioural factors.The prevalence of circumcision in sexually-experienced men aged 16-44 years was 17.4% (95%CI 16.0-19.0. There was no association between circumcision and reporting any previous STI diagnoses, and specifically previous chlamydia or genital warts. However, circumcised men were less likely to have any HPV type (AOR 0.26, 95% confidence interval (CI 0.13-0.50 including high-risk HPV types (HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and/or 68 (AOR 0.14, 95% CI 0.05-0.40 detected in urine.Circumcised men had reduced odds of HPV detection in urine. These findings have implications for improving the precision of models of STI transmission in populations with different circumcision prevalence and in designing interventions to reduce STI acquisition.

  4. Low frequency of male circumcision and unwillingness to be circumcised among MSM in Buenos Aires, Argentina: association with sexually transmitted infections

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    María A Pando

    2013-06-01

    Full Text Available Objective: The aims of this study were to investigate the frequency of male circumcision among men who have sex with men (MSM in Buenos Aires, Argentina; the association between circumcision and sexually transmitted infections (STIs; and, among those uncircumcised, the willingness to be circumcised. Methods: A cross-sectional study was conducted among 500 MSM recruited through the respondent-driven sampling (RDS technique. Participants underwent a consent process, responded to a Web-based survey that included questions on demographic information, sexual behaviour, and circumcision and provided biological samples. HIV, hepatitis B virus (HBV, hepatitis C virus (HCV, Treponema pallidum, and human papiloma virus (HPV diagnoses were performed using standard methodologies. For all analyses, data were weighted based on participants’ network size. Results: Only 64 (13% of the 500 MSM in our study reported being circumcised. Among uncircumcised men (n=418, 302 (70.4% said that they would not be willing to get circumcised even if the procedure could reduce the risk of HIV infection. When considering all participants, circumcision status was not significantly associated with HIV, HBV, HCV, T. pallidum or HPV infections. However, when we restricted the sample to men who do not practice receptive anal intercourse (RAI and compared circumcised to uncircumcised men, the former (N=33 had no cases of HIV infection, while 34 of 231 (14.8% uncircumcised men were HIV positive (p=0.020. Regarding HPV, uncircumcised men had a significantly larger number of different HPV types compared with circumcised men (mean 1.83 vs. 1.09, p<0.001 and a higher frequency of high-risk-HPV genotypes (47.6% vs. 12.5%, p=0.012. Conclusions: Consistent with international evidence, male circumcision appears to have a partial protective effect among MSM. The efficacy of circumcision in reducing risk of HIV infection among MSM appears to be correlated with sexual practices. Given the

  5. Infant male circumcision and the autonomy of the child: two ethical questions.

    Science.gov (United States)

    McMath, Akim

    2015-08-01

    Routine neonatal circumcision--the non-therapeutic circumcision of infant males--has generated considerable ethical controversy. In this article, I suggest that much of the disagreement results from conflicting ideas about the autonomy of the child. I examine two questions about autonomy. First, I ask whether we should be realists or idealists about the future autonomous choices of the child-that is, whether we should account for the fact that the child may not make the best choices in future, or whether we should assume that his future choices will reflect his best interests. Second, I ask whether the child has a right to autonomy with respect to circumcision, an interest in autonomy or neither--that is, whether respect for autonomy overrides considerations of interests, whether it counts as one interest among many or whether it counts for nothing. In response to the first question, I argue that we should be idealists when evaluating the child's own interests, but realists when evaluating public health justifications for circumcision. In response to the second question, I argue that the child has an interest in deciding whether or not to be circumcised, insofar as the decision is more likely to reflect his actual interests and his own values. Finally, I show how these findings may help to resolve some particular disputes over the ethics of infant male circumcision.

  6. HIV prevention: Making male circumcision the 'right' tool for the job.

    Science.gov (United States)

    Bell, Kirsten

    2015-01-01

    In recent years, HIV/AIDS programming has been transformed by an ostensibly 'new' procedure: male circumcision. This article examines the rise of male circumcision as the 'right' HIV prevention tool. Treating this controversial topic as a 'matter of concern' rather than a 'matter of fact', I examine the reasons why male circumcision came to be seen as a partial solution to the problem of HIV transmission in the twenty-first century and to what effect. Grounded in a close reading of the primary literature, I suggest that the embrace of male circumcision in HIV prevention must be understood in relation to three factors: (1) the rise of evidence-based medicine as the dominant paradigm for conceptualising medical knowledge, (2) the fraught politics of HIV/AIDS research and funding, which made the possibility of a biomedical intervention attractive and (3) underlying assumptions about the nature of African 'culture' and 'sexuality'. I conclude by stressing the need to expand the parameters of the debate beyond the current polarised landscape, which presents us with a problematic either/or scenario regarding the efficacy of male circumcision.

  7. Cost analysis of integrating the PrePex medical device into a voluntary medical male circumcision program in Zimbabwe.

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    Emmanuel Njeuhmeli

    Full Text Available BACKGROUND: Fourteen African countries are scaling up voluntary medical male circumcision (VMMC for HIV prevention. Several devices that might offer alternatives to the three WHO-approved surgical VMMC procedures have been evaluated for use in adults. One such device is PrePex, which was prequalified by the WHO in May 2013. We utilized data from one of the PrePex field studies undertaken in Zimbabwe to identify cost considerations for introducing PrePex into the existing surgical circumcision program. METHODS AND FINDINGS: We evaluated the cost drivers and overall unit cost of VMMC at a site providing surgical VMMC as a routine service ("routine surgery site" and at a site that had added PrePex VMMC procedures to routine surgical VMMC as part of a research study ("mixed study site". We examined the main cost drivers and modeled hypothetical scenarios with varying ratios of surgical to PrePex circumcisions, different levels of site utilization, and a range of device prices. The unit costs per VMMC for the routine surgery and mixed study sites were $56 and $61, respectively. The two greatest contributors to unit price at both sites were consumables and staff. In the hypothetical scenarios, the unit cost increased as site utilization decreased, as the ratio of PrePex to surgical VMMC increased, and as device price increased. CONCLUSIONS: VMMC unit costs for routine surgery and mixed study sites were similar. Low service utilization was projected to result in the greatest increases in unit price. Countries that wish to incorporate PrePex into their circumcision programs should plan to maximize staff utilization and ensure that sites function at maximum capacity to achieve the lowest unit cost. Further costing studies will be necessary once routine implementation of PrePex-based circumcision is established.

  8. [Ethical Evaluation of Non-Therapeutic Male Circumcision].

    Science.gov (United States)

    İzgi, M Cumhur

    2015-01-01

    Elective circumcision for nonmedical reasons is a surgical approach which is historically long standing and accepted as the most performed procedure. The necessity of the procedure is usually for religious and traditional reasons alongside some medical ground related benefits to enable its social acceptability. The discussion of the subject from the aspect of ethics becomes necessary as there is no consensus about the benefits or harmfulness of nonmedical circumcision. Fundamental ethical discussions about circumcision, which contradicts legal acceptance criteria of any medical application, are related to the basic concepts of the existence of an individual such as sovereignty, the loss of bodily integrity, and privacy. The recent legal processes and the fact that the European Council and the American Academy of Pediatrics have put the issue on their agenda have increased the necessity of these ethical evaluations. The responsibility of consideration and evaluation of ethical permission of every circumcision procedure, besides discussing the necessity of circumcision for improvement and protection of health rests on the shoulders of the physicians because the dignity and intellectual identity of the profession require so. PMID:26364175

  9. [Ethical Evaluation of Non-Therapeutic Male Circumcision].

    Science.gov (United States)

    İzgi, M Cumhur

    2015-01-01

    Elective circumcision for nonmedical reasons is a surgical approach which is historically long standing and accepted as the most performed procedure. The necessity of the procedure is usually for religious and traditional reasons alongside some medical ground related benefits to enable its social acceptability. The discussion of the subject from the aspect of ethics becomes necessary as there is no consensus about the benefits or harmfulness of nonmedical circumcision. Fundamental ethical discussions about circumcision, which contradicts legal acceptance criteria of any medical application, are related to the basic concepts of the existence of an individual such as sovereignty, the loss of bodily integrity, and privacy. The recent legal processes and the fact that the European Council and the American Academy of Pediatrics have put the issue on their agenda have increased the necessity of these ethical evaluations. The responsibility of consideration and evaluation of ethical permission of every circumcision procedure, besides discussing the necessity of circumcision for improvement and protection of health rests on the shoulders of the physicians because the dignity and intellectual identity of the profession require so.

  10. Readiness of health facilities to deliver safe male circumcision services in Tanzania: a descriptive study

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    Frank Felix Mosha

    2013-03-01

    Full Text Available Assessing the readiness of health facilities to deliver safe male circumcision services is more important in sub-Saharan Africa because of the inadequacy state of health facilities in many ways. The World Health Organization recommends that only facilities equipped with available trained staff, capable to perform at least minor surgery, able to offer minimum MC package and appropriate equipment for resuscitation, and compliant with requirements for sterilization and infection control should be allowed to deliver safe circumcision services. A cross-sectional study using quantitative data collection technique was conducted to assess the readiness of the health facilities to deliver safe circumcision services in selected districts of Tanzania. All hospitals, health centres and 30% of all dispensaries in these districts were selected to participate in the study. Face-toface questionnaires were administered to the heads of the health facilities and to health practitioners. Overall, 49/69 (59% of the facilities visited provided circumcision services and only 46/203 (24% of the health practitioners performed circumcision procedures. These were mainly assistant medical officers and clinical officers. The vast majority – 190/203 (95% – of the health practitioners require additional training prior to providing circumcision services. Most facilities – 63/69 (91% – had all basic supplies (gloves, basin, chlorine and waste disposal necessary for infection prevention, 44/69 (65% provided condoms, HIV counselling and testing, and sexuallytransmitted infections services, while 62/69 (90% had the capability to perform at least minor surgery. However, only 25/69 (36% and 15/69 (22% of the facilities had functioning sterilization equipment and appropriate resuscitation equipment, respectively. There is readiness for roll out of circumcision services; however, more practitioners need to be trained on circumcision procedures, demand forecasting

  11. Exposé of fallacious claims that male circumcision will increase HIV infections in Africa

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    Brian J. Morris

    2011-09-01

    Full Text Available Despite over two decades of extensive research showing that male circumcision protects against heterosexual acquisition of HIV in men, and that includes findings from large randomized controlled trials leading to acceptance by the WHO/UNAIDS and the Cochrane Committee, opponents of circumcision continue to generate specious arguments to the contrary. In a recent issue of the Journal of Public Health in Africa, Van Howe and Storms claim that male circumcision will increase HIV infections in Africa. Here we review the statements they use in support of their thesis and show that there is no scientific basis to such an assertion. We also evaluate the statistics used and show that when these data are properly analyzed the results lead to a contrary conclusion affirming the major role of male circumcision in protecting against HIV infection in Africa. Researchers, policy makers and the wider community should rely on balanced scholarship when assessing scientific evidence. We trust that our assessment may help refute the claims by Van Howe and Storms, and provide reassurance on the importance of circumcision for HIV prevention.

  12. Acceptability of early infant male circumcision among chinese parents: strategy implications of HIV prevention for china

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    Pan Lianjun

    2012-09-01

    Full Text Available Abstract Background Recent evidence has confirmed that circumcision can be performed as a preventive strategy for HIV and early infant male circumcision (EIMC is regarded to be safer than circumcision in adulthood; however, limited data are available in the literature about EIMC in China. Therefore, the present study was designed to determine the willingness and attitudes of Chinese parents on newborn male circumcision so as to provide data for exploring the feasibility of implementing EIMC as an HIV prevention strategy in China. Methods Simple random sampling was used to draw participants from parents who had a newborn son delivered at Nanjing Maternity and Child Health Care Hospital, which is affiliated to Nanjing Medical University, between March and December 2010. A questionnaire was used to determine general medical knowledge or information about circumcision, attitudes about EIMC, and level of decision-making on circumcision for the newborn son. Results Data derived from 558 responses were analyzed and the ratio of respondents was 56.3% for fathers and 43.6% for mothers. Of the respondents, 34.4% agreed to circumcise their newborn son, and the level of agreement was 3.25 ± 1.17 (range, 1–5 with “1” being “reluctantly agree” and “5” being “very strongly agree”. The major reason for EIMC was for health (44.8%, followed by doctor’s advice (31.2%. The major reason not to agree to EIMC was concern about pain (50.5%, followed by the risk of the procedure (23.5%. Conclusion The willingness and acceptability of EIMC in China is low and the parents of newborn sons are usually not very affirmative when making a decision on such a procedure, suggesting that significant effort will be needed if EIMC is to be implemented as an HIV prevention strategy for China.

  13. Factors contributing to the low uptake of medical male circumcision in Mutare Rural District, Zimbabwe

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    Irene O. Chiringa

    2016-03-01

    Full Text Available Background: Medical male circumcision (MMC has become a significant dimension of HIV prevention interventions, after the results of three randomised controlled trials in Uganda, South Africa and Kenya demonstrated that circumcision has a protective effect against contracting HIV of up to 60%. Following recommendations by the World Health Organization, Zimbabwe in 2009 adopted voluntary MMC as an additional HIV prevention strategy to the existing ABC behaviour change model.Purpose: The purpose of this study is thus to investigate the factors contributing to the low uptake of MMC.Methods: The study was a quantitative cross-sectional survey conducted in Mutare rural district, Zimbabwe. Questionnaires with open- and closed-ended questions were administered to the eligible respondents. The target population were male participants aged 15–29 who met the inclusion criteria. The households were systematically selected with a sample size of 234. Statistical Package for the Social Sciences was used to analyse the data.Results: Socioculturally, circumcised men are viewed as worthless (37%, shameful (30% and are tainted as promiscuous (20%, psychological factors reported were infection and delayed healing (39%, being ashamed and dehumanised (58%, stigmatised and discriminated (40.2% and fear of having an erection during treatment period (89.7% whilst socio-economic factors were not having time, as it will take their time from work (58% and complications may arise leading to spending money on treatment (84%.Conclusion: Knowledge deficits regarding male medical circumcision lead to low uptake, education on male medical circumcision and its benefits. Comprehensive sexual health education should target men and dispel negative attitudes related to the use of health services.Keywords: Factors, Low uptake, Medical Male Circumcision (MMC

  14. Women's Perceptions and Misperceptions of Male Circumcision: A Mixed Methods Study in Zambia.

    Science.gov (United States)

    Haberland, Nicole A; Kelly, Christine A; Mulenga, Drosin M; Mensch, Barbara S; Hewett, Paul C

    2016-01-01

    Women's perceptions of male circumcision (MC) have implications for behavioral risk compensation, demand, and the impact of MC programs on women's health. This mixed methods study combines data from the first two rounds of a longitudinal study (n = 934) and in-depth interviews with a subsample of respondents (n = 45) between rounds. Most women correctly reported that MC reduces men's risk of HIV (64% R1, 82% R2). However, 30% of women at R1, and significantly more (41%) at R2, incorrectly believed MC is fully protective for men against HIV. Women also greatly overestimated the protection MC offers against STIs. The proportion of women who believed MC reduces a woman's HIV risk if she has sex with a man who is circumcised increased significantly (50% to 70%). Qualitative data elaborate women's misperception regarding MC. Programs should address women's informational needs and continue to emphasize that condoms remain critical, regardless of male partner's circumcision status.

  15. Early Infant Male Circumcision in Cameroon and Senegal: Demand, Service Provision, and Cultural Context

    Science.gov (United States)

    Kenu, Ernest; Sint, Tin Tin; Kamenga, Claude; Ekpini, Rene

    2016-01-01

    ABSTRACT Background: Male circumcision is almost universal in North and West Africa, and practiced for various reasons. Yet there is little documentation on service delivery, clinical procedures, policies, and programmatic strategies. The United Nations Children’s Fund (UNICEF) commissioned country program reviews in 2014 to shed light on the delivery of male circumcision services for infants in Cameroon and Senegal. Methods: We conducted a policy desk review, key informant interviews, and focus group discussions at health centers and in communities. Between December 2014 and January 2015, we conducted 21 key informant interviews (13 with regional and district officers, 5 with national officers, and 3 with UNICEF officials) and 36 focus group discussions (6 with men, 6 with women, 12 with adolescent boys, and 12 with service providers). Some of the men and women were parents of the adolescents who participated in the focus group discussions. In the French-speaking areas, the focus group discussions were conducted in French through an accredited translator, audio recorded, and transcribed into English. Results: All of the facilities we visited in Cameroon and Senegal offer medical male circumcision, with 10 out of 12 performing early infant male circumcision (EIMC) routinely. Neither country has policies, guidelines, or strategies for EIMC. The procedure is done mainly by untrained service providers, with some providers using modern circumcision devices. There are no key messages on EIMC for families; the increasing demand for EIMC is led by the community. Conclusion: Despite the absence of national policies and strategies, EIMC is routinely offered at all levels of the health care system in Cameroon and Senegal, mainly by untrained service providers. Improving circumcision services will require guidelines for EIMC and improvements in training, equipment, supply chains, recordkeeping, and demand creation. PMID:27413080

  16. Factors influencing Chinese male's willingness to undergo circumcision: a cross-sectional study in western China.

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    Xiaobo Yang

    Full Text Available BACKGROUND: Male circumcision (MC has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore the acceptability of MC among the Chinese and to identify factors associated with circumcision preference. METHODS: A cross-sectional survey was conducted between September 2009 and December 2010. We interviewed 2,219 male community participants, from three high HIV prevalence provinces in western China. A structured questionnaire was used to collect data on MC knowledge, willingness to accept MC, reasons to accept or refuse MC, and sexual behaviors and health. For those who refused MC, a health education intervention providing information on the benefits of circumcision was conducted. We used multiple logistic regression models to identify factors associated with the acceptability of MC. RESULTS: Of the respondents (n = 2,219, 44.6% (989/2,219 reported they would accept MC for the following reasons: promotion of female partners' hygiene (60.3%, redundant foreskin (59.4%, prevention of penile cancer (50.2%, enhanced sexual pleasure (41.4%, and protection against HIV and STDs (34.2%. The multivariable logistic regression showed that five factors were associated with MC willingness: long foreskin (OR = 15.98, residing in Xinjiang province (OR = 3.69, being younger than 25 (OR = 1.60, knowing hazards of redundant foreskin (OR = 1.78, and having a friend who underwent circumcision (OR = 1.36. CONCLUSION: The acceptability of male circumcision was high among the general population in China. Our study elucidates the factors associated with circumcision preference and suggests that more health education campaigns about positive health effects are necessary to increase the MC rate in China.

  17. The When and How of male circumcision and the risk of HIV: a retrosepctive cross-sectional analysis of two HIV surveys from Guiné-Bissau

    DEFF Research Database (Denmark)

    Sodemann, Morten

    2016-01-01

    Introduction: Male circumcision (MC) reduces the risk of HIV, and this risk reduction may be modified by socio-cultural factors such as the timing and method (medical and traditional) of circumcision. Understanding regional variations in circumcision practices and their relationship to HIV...... risk and circumcision status, timing, method of circumcision, and socio-demographic factors. Results: MC was protective against HIV infection in both cohorts, with adjusted odds ratios (AORs) of 0.28 (95% CI 0.12-0.66) and 0.30 (95% CI 0.09-0.93), respectively. We observed that post-pubertal (≥13 years......) circumcision provided the highest level of HIV risk reduction in both cohorts compared to non-circumcised. However, the difference between pre-pubertal (≤12 years) and post-pubertal (≥13 years) circumcision was not significant in the multivariate analysis. Seventy-six percent (678/888) of circumcised males...

  18. The when and how of male circumcision and the risk of HIV: a retrospective cross-sectional analysis of two HIV surveys from Guinea-Bissau

    DEFF Research Database (Denmark)

    Rasmussen, Dlama; Wejse, Christian; Larsen, Olav Ditlevsen;

    2016-01-01

    Introduction: Male circumcision (MC) reduces the risk of HIV, and this risk reduction may be modified by socio-cultural factors such as the timing and method (medical and traditional) of circumcision. Understanding regional variations in circumcision practices and their relationship to HIV...... risk and circumcision status, timing, method of circumcision, and socio-demographic factors. Results: MC was protective against HIV infection in both cohorts, with adjusted odds ratios (AORs) of 0.28 (95% CI 0.12-0.66) and 0.30 (95% CI 0.09-0.93), respectively. We observed that post-pubertal (≥13 years......) circumcision provided the highest level of HIV risk reduction in both cohorts compared to non-circumcised. However, the difference between pre-pubertal (≤12 years) and post-pubertal (≥13 years) circumcision was not significant in the multivariate analysis. Seventy-six percent (678/888) of circumcised males...

  19. Do the benefits of male circumcision outweigh the risks? A critique of the proposed CDC guidelines

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    Brian D. Earp

    2015-03-01

    Full Text Available The Centers for Disease Control and Prevention (CDC have announced a set of provisional guidelines concerning male circumcision, in which they suggest that the benefits of the surgery outweigh the risks. In this perspective article, I highlight a few of the key scientific and ethical issues worth considering in interpreting the new CDC recommendations.

  20. Safe male circumcision in Botswana: tension between traditional practices and biomedical marketing.

    Science.gov (United States)

    Katisi, Masego; Daniel, Marguerite

    2015-01-01

    Botswana has been running Safe Male Circumcision (SMC) since 2009 and has not yet met its target. Donors like the US Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership (funded by the Gates Foundation) in collaboration with Botswana's Ministry of Health have invested much to encourage HIV-negative men to circumcise. Demand creation strategies make use of media and celebrities. The objective of this paper is to explore responses to SMC in relation to circumcision as part of traditional initiation practices. More specifically, we present the views of two communities in Botswana on SMC consultation processes, implementation procedures and campaign strategies. The methods used include participant observation, in-depth interviews with key stakeholders (donors, implementers and Ministry officials), community leaders and men in the community. We observe that consultation with traditional leaders was done in a seemingly superficial, non-participatory manner. While SMC implementers reported pressure to deliver numbers to the World Health Organization, traditional leaders promoted circumcision through their routine traditional initiation ceremonies at breaks of two-year intervals. There were conflicting views on public SMC demand creation campaigns in relation to the traditional secrecy of circumcision. In conclusion, initial cooperation of local chiefs and elders turned into resistance.

  1. Male circumcision for HIV prevention in India: emerging viewpoints and practices of health care providers.

    Science.gov (United States)

    Sinha, Anju; Chandhiok, Nomita; Sahay, Seema; Deb, Sibnath; Bharat, Shalini; Gupta, Abhilasha; Bhatt, Sripad; Kanthe, Vidisha; Kumar, Bijesh; Joglekar, Neelam; Paranjape, Ramesh; Mehendale, Sanjay

    2015-01-01

    A compelling case for promoting male circumcision (MC) as an intervention for reducing the risk of heterosexually acquired HIV infection was made by dissemination of the results of three studies in Africa. The WHO/UNAIDS recommendation for MC for countries like India, where the epidemic in concentrated in high-risk groups, advocates MC for specific population groups such as men at higher risk for HIV acquisition. A multicentre qualitative study was conducted in four geographically distinct districts (Belgaum, Kolkata, Meerut and Mumbai) in India during June 2009 to June 2011. Two categories of health care providers: Registered Healthcare Providers (RHCPs) and traditional circumcisers were interviewed by trained research staff who had received master's level education using interview guides with probes and open-ended questions. Respondents were selected using purposive sampling. A comparative analysis of the perspectives of the RHCP vs. traditional circumcisers is presented. Representatives of both categories of providers expressed the need for Indian data on MC. Providers feared that promoting circumcision might jeopardize/undermine the progress already made in the field of condom promotion. Reservation was expressed regarding its adoption by Hindus. Behavioural disinhibition was perceived as an important limitation. A contrast in the practice of circumcision was apparent between the traditional and the trained providers. MC should be mentioned as a part of comprehensive HIV prevention services in India that includes HIV counselling and testing, condom distribution and diagnosis and treatment of sexually transmitted infections. It should become an issue of informed personal choice rather than ethnic identity.

  2. Safe male circumcision in Botswana: tension between traditional practices and biomedical marketing.

    Science.gov (United States)

    Katisi, Masego; Daniel, Marguerite

    2015-01-01

    Botswana has been running Safe Male Circumcision (SMC) since 2009 and has not yet met its target. Donors like the US Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership (funded by the Gates Foundation) in collaboration with Botswana's Ministry of Health have invested much to encourage HIV-negative men to circumcise. Demand creation strategies make use of media and celebrities. The objective of this paper is to explore responses to SMC in relation to circumcision as part of traditional initiation practices. More specifically, we present the views of two communities in Botswana on SMC consultation processes, implementation procedures and campaign strategies. The methods used include participant observation, in-depth interviews with key stakeholders (donors, implementers and Ministry officials), community leaders and men in the community. We observe that consultation with traditional leaders was done in a seemingly superficial, non-participatory manner. While SMC implementers reported pressure to deliver numbers to the World Health Organization, traditional leaders promoted circumcision through their routine traditional initiation ceremonies at breaks of two-year intervals. There were conflicting views on public SMC demand creation campaigns in relation to the traditional secrecy of circumcision. In conclusion, initial cooperation of local chiefs and elders turned into resistance. PMID:25866013

  3. Traditional male circumcision in Uganda: a qualitative focus group discussion analysis.

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    Amir Sabet Sarvestani

    Full Text Available BACKGROUND: The growing body of evidence attesting to the effectiveness of clinical male circumcision in the prevention of HIV/AIDS transmission is prompting the majority of sub-Saharan African governments to move towards the adoption of voluntary medical male circumcision (VMMC. Even though it is recommended to consider collaboration with traditional male circumcision (TMC providers when planning for VMMC, there is limited knowledge available about the TMC landscape and traditional beliefs. METHODOLOGY AND MAIN FINDINGS: During 2010-11 over 25 focus group discussions (FGDs were held with clan leaders, traditional cutters, and their assistants to understand the practice of TMC in four ethnic groups in Uganda. Cultural significance and cost were among the primary reasons cited for preferring TMC over VMMC. Ethnic groups in western Uganda circumcised boys at younger ages and encountered lower rates of TMC related adverse events compared to ethnic groups in eastern Uganda. Cutting styles and post-cut care also differed among the four groups. The use of a single razor blade per candidate instead of the traditional knife was identified as an important and recent change. Participants in the focus groups expressed interest in learning about methods to reduce adverse events. CONCLUSION: This work reaffirmed the strong cultural significance of TMC within Ugandan ethnic groups. Outcomes suggest that there is an opportunity to evaluate the involvement of local communities that still perform TMC in the national VMMC roll-out plan by devising safer, more effective procedures through innovative approaches.

  4. Acceptability of Voluntary Medical Male Circumcision (VMMC) among Male Sexually Transmitted Diseases Patients (MSTDP) in China.

    Science.gov (United States)

    Wang, Zixin; Feng, Tiejian; Lau, Joseph T F; Kim, Yoona

    2016-01-01

    Voluntary Medical Male circumcision (VMMC) is an evidence-based, yet under-utilized biomedical HIV intervention in China. No study has investigated acceptability of VMMC among male sexually transmitted diseases patients (MSTDP) who are at high risk of HIV transmission. A cross-sectional survey interviewed 350 HIV negative heterosexual MSTDP in Shenzhen, China; 12.0% (n = 42) of them were circumcised at the time of survey. When the uncircumcised participants (n = 308) were informed that VMMC could reduce the risk of HIV infection via heterosexual intercourse by 50%, the prevalence of acceptability of VMMC in the next six months was 46.1%. Adjusted for significant background variables, significant factors of acceptability of VMMC included: 1) emotional variables: the Emotional Representation Subscale (adjusted odds ratios, AOR = 1.13, 95%CI: 1.06-1.18), 2) cognitive variables derived from Health Belief Model (HBM): perceived some chance of having sex with HIV positive women in the next 12 months (AOR = 2.48, 95%CI: 1.15-5.33) (perceived susceptibility), perceived severity of STD infection (AOR = 1.06, 95%CI: 1.02-1.10), perceived benefit of VMMC in risk reduction (AOR = 1.29, 95%CI: 1.16-1.42) and sexual performance (AOR = 1.45, 95%CI: 1.26-1.71), perceived barriers against taking up VMMC (AOR = 0.88, 95%CI: 0.81-0.95), and perceived cue to action (AOR = 1.41, 95%CI: 1.23-1.61) and self-efficacy (AOR = 1.38, 95%CI: 1.26-1.35) related to taking up VMMC. The association between perceived severity of STD infection and acceptability was fully mediated by emotional representation of STD infection. The relatively low prevalence of circumcision and high acceptability suggested that the situation was favorable for implementing VMMC as a means of HIV intervention among MSTDP in China. HBM is a potential suitable framework to guide the design of future VMMC promotion. Future implementation programs should be conducted in STD clinic settings, taking the important findings of

  5. Acceptability of Voluntary Medical Male Circumcision (VMMC among Male Sexually Transmitted Diseases Patients (MSTDP in China.

    Directory of Open Access Journals (Sweden)

    Zixin Wang

    Full Text Available Voluntary Medical Male circumcision (VMMC is an evidence-based, yet under-utilized biomedical HIV intervention in China. No study has investigated acceptability of VMMC among male sexually transmitted diseases patients (MSTDP who are at high risk of HIV transmission. A cross-sectional survey interviewed 350 HIV negative heterosexual MSTDP in Shenzhen, China; 12.0% (n = 42 of them were circumcised at the time of survey. When the uncircumcised participants (n = 308 were informed that VMMC could reduce the risk of HIV infection via heterosexual intercourse by 50%, the prevalence of acceptability of VMMC in the next six months was 46.1%. Adjusted for significant background variables, significant factors of acceptability of VMMC included: 1 emotional variables: the Emotional Representation Subscale (adjusted odds ratios, AOR = 1.13, 95%CI: 1.06-1.18, 2 cognitive variables derived from Health Belief Model (HBM: perceived some chance of having sex with HIV positive women in the next 12 months (AOR = 2.48, 95%CI: 1.15-5.33 (perceived susceptibility, perceived severity of STD infection (AOR = 1.06, 95%CI: 1.02-1.10, perceived benefit of VMMC in risk reduction (AOR = 1.29, 95%CI: 1.16-1.42 and sexual performance (AOR = 1.45, 95%CI: 1.26-1.71, perceived barriers against taking up VMMC (AOR = 0.88, 95%CI: 0.81-0.95, and perceived cue to action (AOR = 1.41, 95%CI: 1.23-1.61 and self-efficacy (AOR = 1.38, 95%CI: 1.26-1.35 related to taking up VMMC. The association between perceived severity of STD infection and acceptability was fully mediated by emotional representation of STD infection. The relatively low prevalence of circumcision and high acceptability suggested that the situation was favorable for implementing VMMC as a means of HIV intervention among MSTDP in China. HBM is a potential suitable framework to guide the design of future VMMC promotion. Future implementation programs should be conducted in STD clinic settings, taking the important findings

  6. Acceptability of Voluntary Medical Male Circumcision (VMMC) among Male Sexually Transmitted Diseases Patients (MSTDP) in China.

    Science.gov (United States)

    Wang, Zixin; Feng, Tiejian; Lau, Joseph T F; Kim, Yoona

    2016-01-01

    Voluntary Medical Male circumcision (VMMC) is an evidence-based, yet under-utilized biomedical HIV intervention in China. No study has investigated acceptability of VMMC among male sexually transmitted diseases patients (MSTDP) who are at high risk of HIV transmission. A cross-sectional survey interviewed 350 HIV negative heterosexual MSTDP in Shenzhen, China; 12.0% (n = 42) of them were circumcised at the time of survey. When the uncircumcised participants (n = 308) were informed that VMMC could reduce the risk of HIV infection via heterosexual intercourse by 50%, the prevalence of acceptability of VMMC in the next six months was 46.1%. Adjusted for significant background variables, significant factors of acceptability of VMMC included: 1) emotional variables: the Emotional Representation Subscale (adjusted odds ratios, AOR = 1.13, 95%CI: 1.06-1.18), 2) cognitive variables derived from Health Belief Model (HBM): perceived some chance of having sex with HIV positive women in the next 12 months (AOR = 2.48, 95%CI: 1.15-5.33) (perceived susceptibility), perceived severity of STD infection (AOR = 1.06, 95%CI: 1.02-1.10), perceived benefit of VMMC in risk reduction (AOR = 1.29, 95%CI: 1.16-1.42) and sexual performance (AOR = 1.45, 95%CI: 1.26-1.71), perceived barriers against taking up VMMC (AOR = 0.88, 95%CI: 0.81-0.95), and perceived cue to action (AOR = 1.41, 95%CI: 1.23-1.61) and self-efficacy (AOR = 1.38, 95%CI: 1.26-1.35) related to taking up VMMC. The association between perceived severity of STD infection and acceptability was fully mediated by emotional representation of STD infection. The relatively low prevalence of circumcision and high acceptability suggested that the situation was favorable for implementing VMMC as a means of HIV intervention among MSTDP in China. HBM is a potential suitable framework to guide the design of future VMMC promotion. Future implementation programs should be conducted in STD clinic settings, taking the important findings of

  7. Prospective investigation of penile length with newborn male circumcision and second to fourth digit ratio

    Science.gov (United States)

    Park, Jong Kwan; Doo, A. Ram; Kim, Joo Heung; Park, Hyung Sub; Do, Jung Mo; Choi, Hwang; Park, Seung Chol; Kim, Myung Ki; Jeong, Young Beom; Kim, Hyung Jim; Kim, Young Gon; Shin, Yu Seob

    2016-01-01

    Introduction: We prospectively investigated the relationship between newborn male circumcision (NMC) and second to fourth digit ratio with penile length. Methods: As participants for our study, we identified already circumcised young patients who visited our hospital for urological treatment. The age at which the circumcision had been done was assessed. The patients’ height and weight were measured. Second to fourth digit ratio was calculated by measuring the second and fourth digit lengths. The flaccid and erectile penile lengths were measured from the base of the penis to the tip of the glans in standing position. Results: A total of 248 patients were included in our study. In univariate analysis, height, second to fourth digit ratio, flaccid penile length, and age of circumcision were associated with erectile penile length. Among these variables, second to fourth digit ratio, flaccid penile length, and age of circumcision were significant predictive factors for erectile penile length in multivariate analysis. The subjects were divided into two groups, including 72 patients in the NMC group and 176 patients in the non-NMC group. No significant difference was found in height, weight, and second to fourth digit ratio between both groups. However, flaccid (p<0.001) and erectile (p=0.001) penile lengths were shorter in the NMC group than in the non-NMC group. Conclusions: Despite the small number of subjects, this study shows that NMC was associated with shorter penile length. Second to fourth digit ratio, flaccid penile length, and age of circumcision were also significant predictive factors for erectile penile length. Further multicentre studies with larger number of subjects and biochemical analyses are needed for potential clinical applicability. PMID:27695583

  8. Benefits and risks of circumcision.

    OpenAIRE

    Warner, E.; Strashin, E.

    1981-01-01

    Circumcisions are performed either prophylactically in the neonatal period or therapeutically at a later age. About 10% of males not circumcised at birth will eventually require circumcision. The present neonatal circumcision rate is about 80% in the United States and 40% in Canada. The single most important determinant of whether a newborn male will be circumcised is the attitude of the attending physician. The literature was reviewed to determine the proven benefits of circumcision and to c...

  9. Neonatal circumcision.

    Science.gov (United States)

    Lerman, S E; Liao, J C

    2001-12-01

    The merits of neonatal circumcision continue to be debated hotly. Some argue that circumcision is a "uniquely American medical enigma." Most of the world's male population remains uncircumcised; however, most boys born in the United States continue to undergo neonatal circumcision. Review of existing literature supports that most children who are uncircumcised do well from a medical standpoint and, thus, the question of whether US health care practitioners are subjecting neonates to an unnecessary surgical procedure remains. The medical benefits of circumcision are multiple, but most are small. The clearest medical benefit of circumcision is the relative reduction in the risk for a UTI, especially in early infancy. Although this risk [figure: see text] is real, the absolute numbers are small (risk ranges from 1 in 100 to 1 in 1000), and one investigator has estimated that it may take approximately 80 neonatal circumcisions to prevent one UTI. In the case of a patient with known urologic abnormalities that predispose to UTI, neonatal circumcision has a clearer role in terms of medical benefit to the patient. Most of the other medical benefits of circumcision probably can be realized without circumcision as long as access to clean water and proper penile hygiene are achieved. Proper penile hygiene should all but eliminate the risk for foreskin-related medical problems that will require circumcision. Moreover, proper hygiene and access to clean water has been shown to reduce the rate of development of squamous cell carcinoma of the penis in the uncircumcised population. Proper techniques on the care of the foreskin are illustrated in the American Academy of Pediatrics pamphlet titled "How to care for the uncircumcised penis." Regarding the relationship between STDs and circumcision, patient education and the practice of low-risk sexual behavior make a far greater impact than does routine circumcision in hopes of reducing the spread of HIV and other STDs. Nevertheless

  10. Modeling the Impact of Uganda's Safe Male Circumcision Program: Implications for Age and Regional Targeting.

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    Katharine Kripke

    Full Text Available Uganda aims to provide safe male circumcision (SMC to 80% of men ages 15-49 by 2016. To date, only 2 million men have received SMC of the 4.2 million men required. In response to age and regional trends in SMC uptake, the country sought to re-examine its targets with respect to age and subnational region, to assess the program's progress, and to refine the implementation approach.The Decision Makers' Program Planning Tool, Version 2.0 (DMPPT 2.0, was used in conjunction with incidence projections from the Spectrum/AIDS Impact Module (AIM to conduct this analysis. Population, births, deaths, and HIV incidence and prevalence were used to populate the model. Baseline male circumcision prevalence was derived from the 2011 AIDS Indicator Survey. Uganda can achieve the most immediate impact on HIV incidence by circumcising men ages 20-34. This group will also require the fewest circumcisions for each HIV infection averted. Focusing on men ages 10-19 will offer the greatest impact over a 15-year period, while focusing on men ages 15-34 offers the most cost-effective strategy over the same period. A regional analysis showed little variation in cost-effectiveness of scaling up SMC across eight regions. Scale-up is cost-saving in all regions. There is geographic variability in program progress, highlighting two regions with low baseline rates of circumcision where additional efforts will be needed.Focusing SMC efforts on specific age groups and regions may help to accelerate Uganda's SMC program progress. Policy makers in Uganda have already used model outputs in planning efforts, proposing males ages 10-34 as a priority group for SMC in the 2014 application to the Global Fund's new funding model. As scale-up continues, the country should also consider a greater effort to expand SMC in regions with low MC prevalence.

  11. Efficient and equitable HIV prevention: A case study of male circumcision in South Africa

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    Verguet Stéphane

    2013-01-01

    Full Text Available Abstract Background We determine efficient, equitable and mixed efficient-equitable allocations of a male circumcision (MC intervention reducing female to male HIV transmission in South Africa (SA, as a case study of an efficiency-equity framework for resource allocation in HIV prevention. Methods We present a mathematical model developed with epidemiological and cost data from the nine provinces of SA. The hypothetical one-year-long MC intervention with a budget of US$ 10 million targeted adult men 15–49 years of age in SA. The intervention was evaluated according to two criteria: an efficiency criterion, which focused on maximizing the number of HIV infections averted by the intervention, and an equity criterion (defined geographically, which focused on maximizing the chance that each male adult individual had access to the intervention regardless of his province. Results A purely efficient intervention would prevent 4,008 HIV infections over a year. In the meantime, a purely equitable intervention would avert 3,198 infections, which represents a 20% reduction in infection outcome as compared to the purely efficient scenario. A half efficient-half equitable scenario would prevent 3,749 infections, that is, a 6% reduction in infection outcome as compared to the purely efficient scenario. Conclusions This paper provides a framework for resource allocation in the health sector which incorporates a simple equity metric in addition to efficiency. In the specific context of SA with a MC intervention for the prevention of HIV, incorporation of geographical equity only slightly reduces the overall efficiency of the intervention.

  12. Modelling the public health impact of male circumcision for HIV prevention in high prevalence areas in Africa

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    Moses Stephen

    2007-03-01

    Full Text Available Abstract Background Recent clinical trials in Africa, in combination with several observational epidemiological studies, have provided evidence that male circumcision can reduce HIV female-to-male transmission risk by 60% or more. However, the public health impact of large-scale male circumcision programs for HIV prevention is unclear. Methods Two mathematical models were examined to explore this issue: a random mixing model and a compartmental model that distinguishes risk groups associated with sex work. In the compartmental model, two scenarios were developed, one calculating HIV transmission and prevalence in a context similar to the country of Botswana, and one similar to Nyanza Province, in western Kenya. Results In both models, male circumcision programs resulted in large and sustained declines in HIV prevalence over time among both men and women. Men benefited somewhat more than women, but prevalence among women was also reduced substantially. With 80% male circumcision uptake, the reductions in prevalence ranged from 45% to 67% in the two "countries", and with 50% uptake, from 25% to 41%. It would take over a decade for the intervention to reach its full effect. Conclusion Large-scale uptake of male circumcision services in African countries with high HIV prevalence, and where male circumcision is not now routinely practised, could lead to substantial reductions in HIV transmission and prevalence over time among both men and women.

  13. Factors associated with the acceptability of male circumcision among men in Jamaica.

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    Melonie M Walcott

    Full Text Available OBJECTIVES: To determine the prevalence of male circumcision (MC among men in the western region of Jamaica, and to identify factors associated with acceptability of MC for self, infants (<1 year and older sons (1-17 years. METHODS: A cross-sectional, interviewer-administered questionnaire survey of 549 men aged 19-54 years was conducted in the western region of Jamaica. The survey included questions about the acceptance of MC for self, infants, and sons before and after an information session about the benefits of MC in preventing HIV/STI transmission. Logistic regression models were used to identify factors that were associated with acceptability of MC. Adjusted odds ratios (AOR and 95% confidence intervals (CI were calculated from the models. RESULTS: Fourteen percent of the men reported that they were circumcised. In the multivariable model, which adjusted for age, education, religion and income, there were increased odds of accepting MC for infants/sons among uncircumcised men who accepted MC for self (AOR=8.1; 95% CI = 4.1-15.9, believed they would experience more pleasure during sex if circumcised (AOR=4.0; 95% CI = 2.0-8.2, and reported having no concerns regarding MC (AOR=3.0; 95% CI = 1.8-4.8. Similarly, uncircumcised men who reported no concerns about MC or who believed that they would experience more pleasure during sex if circumcised were more likely to accept MC for self. CONCLUSION: Providing men with information about MC increased acceptance of MC for self, infants (<17 years and sons (1-17 years. Since targeted education on the benefits of male circumcision for prevention of HIV/STI can be effective in increasing acceptability of MC, health professionals should be trained, and willing to discuss MC with men in healthcare facilities and in the community.

  14. Complications of traditional circumcision amongst young Xhosa males seen at St Lucy’s Hospital, Tsolo, Eastern Cape, South Africa

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    Ugochukwu Anike

    2013-01-01

    Full Text Available Background: Traditional circumcision of males is common amongst many societies in sub-Saharan Africa. Circumcision amongst the Xhosa people of South Africa represents a rite of passage to manhood. Traditional male circumcision has an increased risk for complications that include sepsis, genitalmutilation, gangrenous penis, excessive bleeding, dehydration, renal failure and death. The aim of this study was to describe the complications of traditional circumcisions amongst Xhosa men as seen at St. Lucy’s Hospital in the Eastern Cape Province.Method: A cross-sectional descriptive quantitative study was conducted in 2008. Records of 105 malesadmitted to St. Lucy’s Hospital with complications following traditional circumcision were reviewed. Data collected included age, education level, race, reasons for circumcision, complications, the period of circumcision, duration of hospital stay and the outcomes. Descriptive data analysis was performed using statistical software SPSS 17.0.Results: The ages ranged from 15–35 years with 68 (64.8% between 15–19 years. 83 (79% had a secondarylevel of education, 16 (15.2% primary, 5 (4.8% tertiary and 1% had no education. 60 (57% werecircumcised as initiation to manhood, 21 (20.0% due to peer pressure, 20 (19.0% for cultural reasons, and 1(1.0% was forced. The complications were sepsis (59 [56.2%], genital mutilation (28 [26.7%], dehydration(12 [11.4%] and amputation of genitalia (6 [5.7%].Fifty-nine (56.2% patients were circumcised in winter.79 (75.2% were circumcised in the forest, and 25 (23.8% in initiation centres. Fifty-eight (55.2% werecircumcised by traditionalists, and 47 (44.8% by tribal elders (initiators. Hospital stays ranged from 8 to28 days. 66% were healed and discharged, and 29 (27.6% were referred to higher centres of care.Conclusion: Genital sepsis was the most common complication of traditional male circumcision.Complications were related to the circumciser, advanced age of the patient

  15. Ability and willingness to pay for voluntary medical male circumcision: a cross-sectional survey in Kisumu County, Kenya.

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    Wandei, Stephen; Nangami, Mabel; Egesa, Omar

    2016-01-01

    Voluntary medical male circumcision is one of the most effective measures in preventing male acquisition of HIV during heterosexual intercourse. In Kenya, the voluntary medical male circumcision programme was launched in the year 2008 as part of a comprehensive national HIV prevention strategy. With the global challenge of funding HIV intervention programs, the sustainability of the programme beyond the donor periods need to be assessed. The purpose of this study was to determine the household ability and willingness to pay for voluntary medical male circumcision as an alternative method of funding the programme. The findings show that 62.2% of the households were "able" to pay for medical circumcision. However, 60.4% of them were not "willing" to pay for the service regardless of the cost. The findings indicate that ability to pay is not a significant predictor of willingness to pay for voluntary medical male circumcision within Kisumu County. Knowledge on the role of medical circumcision is a more important factor in determining willingness to pay for the service.

  16. A critical evaluation of arguments opposing male circumcision for HIV prevention in developed countries

    OpenAIRE

    Morris, Brian J.; Bailey, Robert C.; Klausner, Jeffrey D.; Leibowitz, Arleen; Wamai, Richard G; Waskett, Jake H.; Banerjee, Joya; Halperin, Daniel T.; Zoloth, Laurie; Helen A. Weiss; Hankins, Catherine A.

    2012-01-01

    A potential impediment to evidence-based policy development on medical male circumcision (MC) for HIV prevention in all countries worldwide is the uncritical acceptance by some of arguments used by opponents of this procedure. Here we evaluate recent opinion-pieces of 13 individuals opposed to MC. We find that these statements misrepresent good studies, selectively cite references, some containing fallacious information, and draw erroneous conclusions. In marked contrast, the scientific evide...

  17. Female genital mutilation and male circumcision: toward an autonomy-based ethical framework

    OpenAIRE

    Earp, Brian

    2015-01-01

    Brian D Earp Department of History and Philosophy of Science, University of Cambridge, Cambridge, UK Abstract: The non-therapeutic alteration of children’s genitals is typically discussed in two separate ethical discourses: one for girls, in which such alteration is conventionally referred to as “female genital mutilation” (or FGM), and one for boys, in which it is conventionally referred to as “male circumcision.” The former is typically reg...

  18. Acceptability of medical male circumcision among uncircumcised men in Kenya one year after the launch of the national male circumcision program.

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    Amy Herman-Roloff

    Full Text Available BACKGROUND: Numerous studies have demonstrated that male circumcision (MC reduces the incidence of the Type-1 human immunodeficiency virus (HIV among heterosexual men by at least half. METHODS: One year after the launch of a national Voluntary Medical Male Circumcision program in Kenya, this study conducted 12 focus group discussions among uncircumcised men in Nyanza Province to assess the revealed, non-hypothetical, facilitators and barriers to the uptake of MC. RESULTS: The primary barriers to MC uptake included time away from work; culture and religion; possible adverse events; and the post-surgical abstinence period. The primary facilitators of MC uptake included hygiene; social pressure; protection against HIV and other sexually transmitted infections; and improved sexual performance and satisfaction. CONCLUSIONS: Some activities which might increase MC uptake include dispelling MC misconceptions; increasing involvement of religious leaders, women's groups, and peer mobilizers for MC promotion; and increasing the relevance of MC among men who are already practicing an HIV prevention method.

  19. Modelling the public health impact of male circumcision for HIV prevention in high prevalence areas in Africa

    NARCIS (Netherlands)

    N.J.D. Nagelkerke (Nico); S. Moses (Stephen); S.J. de Vlas (Sake); R.C. Bailey (Robert)

    2007-01-01

    textabstractBackground: Recent clinical trials in Africa, in combination with several observational epidemiological studies, have provided evidence that male circumcision can reduce HIV female-to-male transmission risk by 60% or more. However, the public health impact of large-scale male circumcisio

  20. Correlates of male circumcision in Eastern and Southern African countries: establishing a baseline prior to VMMC Scale-up.

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    Khai Hoan Tram

    Full Text Available BACKGROUND: Despite the importance of male circumcision (MC prevalence to HIV prevention efforts in Eastern and Southern Africa, there has been no systematic analysis on the correlates of male circumcision. This analysis identifies correlates of MC in 12 countries in the region with available data. METHODS: Data from the male questionnaire of DHS surveys collected between 2006-2011 in Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe were analyzed. The dependent variable was self-reported male circumcision status. Independent variables included age, education, wealth quintile, place of residence, ethnicity, religion and region. Bivariate and multivariate analyses were conducted separately for each country. RESULTS: MC prevalence ranged from 8.2 percent in Swaziland to 92.2 percent in Ethiopia. Bivariate analyses showed a consistent positive association between age (being older and male circumcision. Education, wealth quintile, and place of residence were either not significantly related or differed in the direction of the relationship by country. Multivariate logistic regression showed three variables consistently associated with MC status: age (being older, religion (being Muslim and ethnicity. DISCUSSION: These data were collected prior to the scale-up of voluntary medical male circumcision (VMMC programs in 11 of the 12 countries. As the VMMC scale-up intensifies in countries across Eastern and Southern Africa, the correlates of VMMC are likely to change, with (younger age and education emerging as key correlates of VMMC performed in medical settings. The centuries-long tradition among Muslims to circumcise should continue to favor MC among this group. Non-circumcising ethnicities may become more open to MC if promoted as a health practice for decreasing HIV risk.

  1. Attitudes, perceptions and potential uptake of male circumcision among older men in Turkana County, Kenya using qualitative methods.

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    Kate Macintyre

    Full Text Available BACKGROUND: In many communities, older men (i.e., over 25 years of age have not come forward for Voluntary Medical Male Circumcision (VMMC services. Reasons for low demand among this group of men are not well understood, and may vary across geographic and cultural contexts. This paper examines the facilitators and barriers to VMMC demand in Turkana County, Kenya, with a focus on older men. This is one of the regions targeted by the VMMC program in Kenya because the Turkana ethnic group does not traditionally circumcise, and the rates of HIV and STD transmission are high. METHODS AND FINDINGS: Twenty focus group discussions and 69 in-depth interviews were conducted with circumcised and uncircumcised men and their partners to elicit their attitudes and perceptions toward male circumcision. The interviews were conducted in urban, peri-urban, and rural communities across Turkana. Our results show that barriers to circumcision include stigma associated with VMMC, the perception of low risk for HIV for older men and their "protection by marriage," cultural norms, and a lack of health infrastructure. Facilitators include stigma against not being circumcised (since circumcision is associated with modernity, protection against disease including HIV, and cleanliness. It was also noted that older men should adopt the practice to serve as role models to younger men. CONCLUSIONS: Both men and women were generally supportive of VMMC, but overcoming barriers with appropriate communication messages and high quality services will be challenging. The justification of circumcision being a biomedical procedure for protection against HIV will be the most important message for any communication strategy.

  2. Age Targeting of Voluntary Medical Male Circumcision Programs Using the Decision Makers' Program Planning Toolkit (DMPPT 2.0.

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    Katharine Kripke

    Full Text Available Despite considerable efforts to scale up voluntary medical male circumcision (VMMC for HIV prevention in priority countries over the last five years, implementation has faced important challenges. Seeking to enhance the effect of VMMC programs for greatest and most immediate impact, the U. S. President's Plan for AIDS Relief (PEPFAR supported the development and application of a model to inform national planning in five countries from 2013-2014.The Decision Makers' Program Planning Toolkit (DMPPT 2.0 is a simple compartmental model designed to analyze the effects of client age and geography on program impact and cost. The DMPPT 2.0 model was applied in Malawi, South Africa, Swaziland, Tanzania, and Uganda to assess the impact and cost of scaling up age-targeted VMMC coverage. The lowest number of VMMCs per HIV infection averted would be produced by circumcising males ages 20-34 in Malawi, South Africa, Tanzania, and Uganda and males ages 15-34 in Swaziland. The most immediate impact on HIV incidence would be generated by circumcising males ages 20-34 in Malawi, South Africa, Tanzania, and Uganda and males ages 20-29 in Swaziland. The greatest reductions in HIV incidence over a 15-year period would be achieved by strategies focused on males ages 10-19 in Uganda, 15-24 in Malawi and South Africa, 10-24 in Tanzania, and 15-29 in Swaziland. In all countries, the lowest cost per HIV infection averted would be achieved by circumcising males ages 15-34, although in Uganda this cost is the same as that attained by circumcising 15- to 49-year-olds.The efficiency, immediacy of impact, magnitude of impact, and cost-effectiveness of VMMC scale-up are not uniform; there is important variation by age group of the males circumcised and countries should plan accordingly.

  3. Age Targeting of Voluntary Medical Male Circumcision Programs Using the Decision Makers’ Program Planning Toolkit (DMPPT) 2.0

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    Kripke, Katharine; Opuni, Marjorie; Schnure, Melissa; Sgaier, Sema; Castor, Delivette; Reed, Jason; Stover, John

    2016-01-01

    Background Despite considerable efforts to scale up voluntary medical male circumcision (VMMC) for HIV prevention in priority countries over the last five years, implementation has faced important challenges. Seeking to enhance the effect of VMMC programs for greatest and most immediate impact, the U. S. President’s Plan for AIDS Relief (PEPFAR) supported the development and application of a model to inform national planning in five countries from 2013–2014. Methods and Findings The Decision Makers’ Program Planning Toolkit (DMPPT) 2.0 is a simple compartmental model designed to analyze the effects of client age and geography on program impact and cost. The DMPPT 2.0 model was applied in Malawi, South Africa, Swaziland, Tanzania, and Uganda to assess the impact and cost of scaling up age-targeted VMMC coverage. The lowest number of VMMCs per HIV infection averted would be produced by circumcising males ages 20–34 in Malawi, South Africa, Tanzania, and Uganda and males ages 15–34 in Swaziland. The most immediate impact on HIV incidence would be generated by circumcising males ages 20–34 in Malawi, South Africa, Tanzania, and Uganda and males ages 20–29 in Swaziland. The greatest reductions in HIV incidence over a 15-year period would be achieved by strategies focused on males ages 10–19 in Uganda, 15–24 in Malawi and South Africa, 10–24 in Tanzania, and 15–29 in Swaziland. In all countries, the lowest cost per HIV infection averted would be achieved by circumcising males ages 15–34, although in Uganda this cost is the same as that attained by circumcising 15- to 49-year-olds. Conclusions The efficiency, immediacy of impact, magnitude of impact, and cost-effectiveness of VMMC scale-up are not uniform; there is important variation by age group of the males circumcised and countries should plan accordingly. PMID:27410966

  4. Informing the scaling up of voluntary medical male circumcision efforts through the use of theory of reasoned action: survey findings among uncircumcised young men in Swaziland.

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    Gurman, Tilly A; Dhillon, Preeti; Greene, Jessica L; Makadzange, Panganai; Khumlao, Philisiwe; Shekhar, Navendu

    2015-04-01

    Assessing predictors of intention to circumcise can help to identify effective strategies for increasing uptake of voluntary medical male circumcision (VMMC). Grounded in the theory of reasoned action (TRA), the current study of uncircumcised males ages 13-29 in Swaziland (N = 1,257) employed multivariate logistic regression to determine predictors of VMMC intention. The strongest predictors were strongly disagreeing/disagreeing that sex was more painful for a circumcised man (odds ratio [OR] = 4.37; p = theory to explore young men's intention to circumcise and can help inform interventions aimed at increasing uptake of VMMC.

  5. Associations between Male Anogenital Human Papillomavirus Infection and Circumcision by Anatomic Site Sampled and Lifetime Number of Female Sex Partners

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    Nielson, Carrie M.; Schiaffino, Melody K.; Dunne, Eileen F.; Salemi, Jason L.; Giuliano, Anna R.

    2016-01-01

    Background Male circumcision may lower men’s risk of human papillomavirus (HPV) infection and reduce transmission to sex partners. Reported associations between circumcision and HPV infection in men have been inconsistent. Methods Four hundred sixty-three men in 2 US cities were tested at 6 anogenital sites and in semen for 37 types of HPV. Men were eligible if they reported sex with a woman within the past year, no history of genital warts or penile or anal cancer, and no current diagnosis of a sexually transmitted infection. Participants completed a self-administered questionnaire. Circumcision status was assessed by the study clinician. Logistic regression was used to examine associations between circumcision and HPV detection at each site and in semen, with adjustment for potential confounders. Results Seventy-four men (16.0%) were uncircumcised. Adjusted odds ratios (AORs) for any HPV genotype and circumcision were 0.53 (95% confidence interval [CI], 0.28–0.99) for any anatomic site/specimen, 0.17 (95% CI, 0.05–0.56) for the urethra, 0.44 (95% CI, 0.23–0.82) for the glans/corona, and 0.53 (95% CI, 0.28–0.99) for the penile shaft. AORs were Circumcision may be protective against HPV infection of the urethra, glans/corona, and penile shaft. PMID:19086813

  6. Reach and cost-effectiveness of the PrePex device for safe male circumcision in Uganda.

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    Kevin Duffy

    Full Text Available INTRODUCTION: Modelling, supported by the USAID Health Policy Initiative and UNAIDS, performed in 2011, indicated that Uganda would need to perform 4.2 million medical male circumcisions (MMCs to reach 80% prevalence. Since 2010 Uganda has completed 380,000 circumcisions, and has set a national target of 1 million for 2013. OBJECTIVE: To evaluate the relative reach and cost-effectiveness of PrePex compared to the current surgical SMC method and to determine the effect that this might have in helping to achieve the Uganda national SMC targets. METHODS: A cross-sectional descriptive cost-analysis study conducted at International Hospital Kampala over ten weeks from August to October 2012. Data collected during the performance of 625 circumcisions using PrePex was compared to data previously collected from 10,000 circumcisions using a surgical circumcision method at the same site. Ethical approval was obtained. RESULTS: The moderate adverse events (AE ratio when using the PrePex device was 2% and no severe adverse events were encountered, which is comparable to the surgical method, thus the AE rate has no effect on the reach or cost-effectiveness of PrePex. The unit cost to perform one circumcision using PrePex is $30.55, 35% ($7.90 higher than the current surgical method, but the PrePex method improves operator efficiency by 60%, meaning that a team can perform 24 completed circumcisions compared to 15 by the surgical method. The cost-effectiveness of PrePex, comparing the cost of performing circumcisions to the future cost savings of potentially averted HIV infections, is just 2% less than the current surgical method, at a device cost price of $20. CONCLUSION: PrePex is a viable SMC tool for scale-up with unrivalled potential for superior reach, however national targets can only be met with effective demand creation and availability of trained human resource.

  7. To mutilate in the name of Jehovah or Allah: legitimization of male and female circumcision.

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    Abu-Sahlieh, S A

    1994-01-01

    Female circumcison is practised in Sudan, Somalia, Egypt and a few other Arab and Muslim countries. It has triggered a passionate public debate in the West. This debate has found somewhat of an echo in the Arab and Muslim world, but some Muslim religious circles such as Al-Azhar (Egypt), the most important Islamic centre in the world, try to justify it on the basis of sunnah (that is, to conform with the tradition of the prophet Mohammed). Male circumcision is practised by all Muslims and Jews and also by some Christians in Egypt, in the United States and Canada). For different reasons, the debate on this topic is still taboo in Western and in Arab and Muslim countries. The object of this study is to define the role of Islamic law and Muslim religious leaders in female and male circumcision. On purpose, it avoids any use of the word 'Islam', and concentrates on the written sources of Islamic law and the opinions of contemporary Arab authors, mostly of Egyptian origin. Juridical logic cannot acknowledge the distinction between female and male circumcision, both being the mutilation of healthy organs which is damaging to the physical integrity of the child, whatever the underlying religious motivations. Furthermore, both practices violate the Koran: 'Our Lord, You did not create all this in vain' (3:191), and '[He] perfected everything He created' (32:7). In our opinion, a god who demands that his believers be mutilated and branded on their genitals the same as cattle, is a god of questionable ethics. To mutilate children, boys or girls, under the pretext that it is for their own good, shows the influence of cynicism and fanaticism. PMID:7731348

  8. The when and how of male circumcision and the risk of HIV: a retrospective cross-sectional analysis of two HIV surveys from Guinea-Bissau

    OpenAIRE

    Rasmussen, Dlama Nggida; Wejse, Christian; Larsen, Olav; da Silva, Zacarias; Aaby, Peter; Sodemann, Morten

    2016-01-01

    Introduction Male circumcision (MC) reduces the risk of HIV, and this risk reduction may be modified by socio-cultural factors such as the timing and method (medical and traditional) of circumcision. Understanding regional variations in circumcision practices and their relationship to HIV is crucial and can increase insight into the HIV epidemic in Africa. Methods We used data from two retrospective HIV surveys conducted in Guinea-Bissau from 1993 to 1996 (1996 cohort) and from 2004 to 2007 (...

  9. Determinants of circumcision and willingness to be circumcised by Rwandan men, 2010

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    Gasasira Rwego A

    2012-02-01

    Full Text Available Abstract Background Male Circumcision (MC has been recommended as one of the preventive measures against sexual HIV transmission by the World Health Organization (WHO. Rwanda has adopted MC as recommended but the country is a non-traditionally circumcising society. The objective was to explore knowledge and perception of Rwandan men on Male Circumcision (MC and to determine the factors associated with the willingness to be circumcised and to circumcise their sons. Methods This cross sectional study was conducted in 29 districts of Rwanda between January and March 2010. Data were collected using a structured questionnaire among men aged 15-59 years. The rate of MC was measured and its perception from respondents, and then the factors associated with the willingness to go for MC were analysed using multiple logistic regressions. Results A total of 1098 men were interviewed. Among respondents 17% (95% CI 14-19% reported being circumcised. About three-quarter (72% could define MC, but 37% of adolescent could not. Half of the participants were willing to get circumcised and 79% of men would accept circumcision for their sons. The main motivators for MC were its benefits in HIV/STI prevention (69% and improving hygiene (49%. Being too old was the main reason (32% reported by men reluctant to undergo MC and younger men were afraid of pain in particular those less than 19 years old (42%. The willingness to circumcise was significantly associated with younger age, living in the Eastern Province, marital status, and the knowledge of the preventive role of circumcision. Conclusions Adolescents and young adults were more willing to be circumcised. It is critical to ensure the availability of pain free services in order to satisfy the increasing demand for the scale up of MC in Rwanda.

  10. Voluntary medical male circumcision for HIV prevention in fishing communities in Uganda: the influence of local beliefs and practice.

    Science.gov (United States)

    Mbonye, Martin; Kuteesa, Monica; Seeley, Janet; Levin, Jonathan; Weiss, Helen; Kamali, Anatoli

    2016-09-01

    Local beliefs and practices about voluntary medical male circumcision (VMMC) may influence uptake and effectiveness. Data were gathered through interviews with 40 people from four ethnically mixed fishing communities in Uganda. Some men believed that wound healing could be promoted by contact with vaginal fluids while sex with non-regular partners could chase away spirits - practices which encouraged unsafe sexual practices. Information given by providers stressed that VMMC did not afford complete protection from sexually-transmitted infections, however, a number of male community members held the view that they were fully protected once circumcised. Both men and women said that VMMC was good not just for HIV prevention but also as a way of maintaining hygiene among the men. The implementation of VMMC in high-HIV prevalence settings needs to take account of local beliefs about circumcision, working with local religious/social group leaders, women and peers in the roll-out of the intervention.

  11. [Long-term benefit of male circumcision to the reduction of urinary tract infections and genitourinary cancers in China].

    Science.gov (United States)

    Zhao, Fu-jun; Li, Philip S; Lü, Nian-qing; Lee, Richard; Peng, Yi-feng; Cheng, Feng; Li, Zheng; Xu, Hao-qin; Barone, Mark; Goldstein, Marc; Xia, Shu-jia

    2014-11-01

    Increasingly accumulated results from randomized controlled trials and other clinical studies have demonstrated that male circumcision reduces the risks of acquisition and transmission of HIV, HPV, HSV-2, and other sexually transmitted infections, and thus has a potential role in preventing cervical cancer, penile cancer and prostate cancer. The prevalence of male circumcision in China is currently less than 5%. The clinical evaluation studies and randomized controlled trials of the Shang Ring device showed excellent safety profiles, extremely high acceptability, and satisfaction among the participants and service providers in Africa and China. Given the recent recommendations by the World Health Organization and the Joint United Nations Program on HIV/AIDS (UNAIDS), voluntary medical male circumcision should be promoted in China at the national level as an important alternative intervention to reduce reproductive tract infections and prevent both males and females from reproductive tract cancers. More emphasis is required on the studies of the long-term health benefits of male circumcision in uro-andrology.

  12. Rural Zulu women’s knowledge of and attitudes towards medical male circumcision

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    Joseph N. Ikwegbue

    2015-02-01

    Full Text Available Background: Medical male circumcision (MMC is a key strategy in the South African HIV infection prevention package. Women may have a potentially powerful role in supporting such a strategy. Circumcision is not a traditional part of Zulu society, and Zulu women may have limited knowledge and ambivalent or negative attitudes towards MMC.Aim: This study employs quantitative data to expand insight into rural Zulu women’s knowledge of and attitudes towards MMC, and is important as women could potentially yield a powerful positive or negative influence over the decisions of their partners and sons.Setting: A hospital-based antenatal clinic in rural KwaZulu-Natal.Methods: Participants were 590 pregnant, mostly isiZulu-speaking women. Data on their knowledge of and attitude towards MMC were collected using a questionnaire and were analysed descriptively.Results: The majority of the women supported MMC; however, knowledge of the potential benefits was generally poor. Most would encourage their partners and sons to undergo MMC. The preferred place for the procedure was a hospital.Conclusion: Zulu participants supported MMC and would support their partners and children being circumcised. Knowledge around potential benefits was worryingly poor, and further research into disseminating information is essential. The findings highlight the need for an expanded campaign of health education for women, and innovative means are suggested to enhance information accessibility. Reasons for preferring that MMC be carried out in hospital need to be explored further.

  13. The perceptions on male circumcision as a preventive measure against HIV infection and considerations in scaling up of the services: a qualitative study among police officers in Dar es Salaam, Tanzania

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    Tarimo Edith AM

    2012-07-01

    Full Text Available Abstract Background In recent randomized controlled trials, male circumcision has been proven to complement the available biomedical interventions in decreasing HIV transmission from infected women to uninfected men. Consequently, Tanzania is striving to scale-up safe medical male circumcision to reduce HIV transmission. However, there is a need to investigate the perceptions of male circumcision in Tanzania using specific populations. The purpose of the present study was to assess the perceptions of male circumcision in a cohort of police officers that also served as a source of volunteers for a phase I/II HIV vaccine (HIVIS-03 trial in Dar es Salaam, Tanzania. Methods In-depth interviews with 24 men and 10 women were conducted. Content analysis informed by the socio-ecological model was used to analyze the data. Results Informants perceived male circumcision as a health-promoting practice that may prevent HIV transmission and other sexually transmitted infections. They reported male circumcision promotes sexual pleasure, confidence and hygiene or sexual cleanliness. They added that it is a religious ritual and a cultural practice that enhances the recognition of manhood in the community. However, informants were concerned about the cost involved in male circumcision and cleanliness of instruments used in medical and traditional male circumcision. They also expressed confusion about the shame of undergoing circumcision at an advanced age and pain that could emanate after circumcision. The participants advocated for health policies that promote medical male circumcision at childhood, specifically along with the vaccination program. Conclusions The perceived benefit of male circumcision as a preventive strategy to HIV and other sexually transmitted infections is important. However, there is a need to ensure that male circumcision is conducted under hygienic conditions. Integrating male circumcision service in the routine childhood vaccination

  14. What Do People Actually Learn from Public Health Campaigns? Incorrect Inferences About Male Circumcision and Female HIV Infection Risk Among Men and Women in Malawi.

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    Maughan-Brown, Brendan; Godlonton, Susan; Thornton, Rebecca; Venkataramani, Atheendar S

    2015-07-01

    Qualitative studies and polling data from sub-Saharan Africa indicate that many individuals may mistakenly believe that male circumcision directly protects women from contracting HIV. This study examines whether individuals who learn that male circumcision reduces female-to-male HIV transmission also erroneously infer a reduction in direct male-to-female transmission risk (i.e. from an HIV-positive man to an uninfected woman). We used data on Malawian men (n = 917) randomized to receive information about voluntary medical male circumcision (VMMC) and HIV risk in 2008 and a random sample of their wives (n = 418). We found that 72 % of men and 82 % of women who believed that male circumcision reduces HIV risk for men also believed that it reduces HIV risk for women. Regression analyses indicated that men randomly assigned to receive information about the protective benefits of circumcision were more likely to adopt the erroneous beliefs, and that the underlying mechanism was the formation of the belief that male circumcision reduces HIV risk for men. The results suggest the need for VMMC campaigns to make explicit that male circumcision does not directly protect women from HIV-infection.

  15. Policy environment and male circumcision for HIV prevention: Findings from a situation analysis study in Tanzania

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    Mshana Gerry

    2011-06-01

    Full Text Available Abstract Background Male circumcision (MC has been shown to be effective against heterosexual acquisition of HIV infection and is being scaled up as an additional strategy against HIV in several countries of Africa. However, the policy environment (whether to formulate new specific policy on MC or adapts the existing ones; and the role of various stakeholders in the MC scale up process in Tanzania was unclear. We conducted this study as part of a situation analysis to understand the attitudes of policy makers and other key community and health authority decision makers towards MC, policy and regulatory environment, and the readiness of a health system to accommodate scaling up of MC services. Methods We conducted 36 key informants' interviews with a broad range of informants including civil servants, religious leaders, cultural and traditional gatekeepers and other potential informants. Study informants were selected at the national level, regional, district and community levels to represent both traditionally circumcising and non-circumcising communities. Results Study informants had positive attitudes and strong beliefs towards MC. Key informants in traditionally non-circumcising districts were willing to take their sons for medically performed MC. Religious leaders and traditional gatekeepers supported MC as it has been enshrined in their holy scripts and traditional customs respectively. Civil servants highlighted the need for existence of enabling policy and regulatory environment in the form of laws, regulations and guidelines that will ensure voluntary accessibility, acceptability, quality and safety for those in need of MC services. Majority of informants urged the government to make improvements in the health system at all levels to ensure availability of adequate trained personnel, infrastructure, equipment, and supplies for MC scale up, and insisted on the involvement of different MC stakeholders as key components in effective roll

  16. Voluntary medical male circumcision for HIV prevention and early resumption of sexual activity: a literature review.

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    Kamath, Veena; Limaye, Rupali J

    2015-01-01

    A number of programs have focused on scale-up and implementation research regarding voluntary medical male circumcision; however, there is limited research with regard to factors and strategies related to abstinence compliance and the effects of resuming sex during the wound healing period (42-day post-circumcision). We searched the literature for peer-reviewed articles examining early resumption of sex during this period. This review identifies factors that may predispose a client to engage in sex during the 42-day postoperative period, examines how early resumption of sex can inhibit wound healing and increase seroconversion, and reviews strategies that may increase adherence to abstinence during the wound healing period. We found that the most common factor that may predispose a client to engage in sex before the end of the postoperative period is marriage or cohabitation with a sexual partner. With regard to the effect of sex during the postoperative period on wound healing and seroconversion, we found that adverse events incurred were mild, and there was an increased risk of seroconversion. The only strategy studied to increase compliance to abstinence during the postoperative period utilized text messaging, and the trial results indicate that text messaging did not increase abstinence compliance. PMID:25738780

  17. Circumcision: pros and cons.

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    Burgu, Berk; Aydogdu, Ozgu; Tangal, Semih; Soygur, Tarkan

    2010-01-01

    Circumcision is possibly the most frequently performed elective surgical procedure in men. It can simply be described as the excision of the preputium. There have been several studies about the association between circumcision and urinary tract infections (UTI). Many studies have demonstrated that the frequency of UTI increase in uncircumcised males, especially in the first year of life. This review discusses the embryology of the preputium, epidemiology, indications, complications and benefits of circumcision, as well as operation and anesthesiology techniques. It especially examines the association between UTI and circumcision and the importance of circumcision in congenital urinary system anomalies. In addition, this review examines the associations between circumcision and sexually transmitted diseases, including HIV, and the protective role of circumcision on penile cancer.

  18. Comparative Cost of Early Infant Male Circumcision by Nurse-Midwives and Doctors in Zimbabwe

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    Mangenah, Collin; Mavhu, Webster; Hatzold, Karin; Biddle, Andrea K; Ncube, Getrude; Mugurungi, Owen; Ticklay, Ismail; Cowan, Frances M; Thirumurthy, Harsha

    2016-01-01

    ABSTRACT Background: The 14 countries that are scaling up voluntary male medical circumcision (VMMC) for HIV prevention are also considering early infant male circumcision (EIMC) to ensure longer-term reductions in HIV incidence. The cost of implementing EIMC is an important factor in scale-up decisions. We conducted a comparative cost analysis of EIMC performed by nurse-midwives and doctors using the AccuCirc device in Zimbabwe. Methods: Between August 2013 and July 2014, nurse-midwives performed EIMC on 500 male infants using AccuCirc in a field trial. We analyzed the overall unit cost and identified key cost drivers of EIMC performed by nurse-midwives and compared these with costing data previously collected during a randomized noninferiority comparison trial of 2 devices (AccuCirc and the Mogen clamp) in which doctors performed EIMC. We assessed direct costs (consumable and nonconsumable supplies, device, personnel, associated staff training, and waste management costs) and indirect costs (capital and support personnel costs). We performed one-way sensitivity analyses to assess cost changes when we varied key component costs. Results: The unit costs of EIMC performed by nurse-midwives and doctors in vertical programs were US$38.87 and US$49.77, respectively. Key cost drivers of EIMC were consumable supplies, personnel costs, and the device price. In this cost analysis, major cost drivers that explained the differences between EIMC performed by nurse-midwives and doctors were personnel and training costs, both of which were lower for nurse-midwives. Conclusions: EIMC unit costs were lower when performed by nurse-midwives compared with doctors. To minimize costs, countries planning to scale up EIMC should consider using nurse-midwives, who are in greater supply than doctors and are the main providers at the primary health care level, where most infants are born. PMID:27413085

  19. Bringing Early Infant Male Circumcision Information Home to the Family: Demographic Characteristics and Perspectives of Clients in a Pilot Project in Tanzania.

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    Amuri, Mbaraka; Msemo, Georgina; Plotkin, Marya; Christensen, Alice; Boyee, Dorica; Mahler, Hally; Phafoli, Semakaleng; Njozi, Mustafa; Hellar, Augustino; Mlanga, Erick; Yansaneh, Aisha; Njeuhmeli, Emmanuel; Lija, Jackson

    2016-07-01

    Iringa region of Tanzania has had great success reaching targets for voluntary medical male circumcision (VMMC). Looking to sustain high coverage of male circumcision, the government introduced a pilot project to offer early infant male circumcision (EIMC) in Iringa in 2013. From April 2013 to December 2014, a total of 2,084 male infants were circumcised in 8 health facilities in the region, representing 16.4% of all male infants born in those facilities. Most circumcisions took place 7 days or more after birth. The procedure proved safe, with only 3 mild and 3 moderate adverse events (0.4% overall adverse event rate). Overall, 93% of infants were brought back for a second-day visit and 71% for a seventh-day visit. These percentages varied significantly by urban and rural residence (97.4% urban versus 84.6% rural for day 2 visit; 82.2% urban versus 49.9% rural for day 7 visit). Mothers were more likely than fathers to have received information about EIMC. However, fathers tended to be key decision makers regarding circumcision of their sons. This suggests the importance of addressing fathers with behavioral change communication about EIMC. Successes in scaling up VMMC services in Iringa did not translate into immediate acceptability of EIMC. EIMC programs will require targeted investments in demand creation to expand and thrive in traditionally non-circumcising settings such as Iringa. PMID:27413081

  20. Bringing Early Infant Male Circumcision Information Home to the Family: Demographic Characteristics and Perspectives of Clients in a Pilot Project in Tanzania.

    Science.gov (United States)

    Amuri, Mbaraka; Msemo, Georgina; Plotkin, Marya; Christensen, Alice; Boyee, Dorica; Mahler, Hally; Phafoli, Semakaleng; Njozi, Mustafa; Hellar, Augustino; Mlanga, Erick; Yansaneh, Aisha; Njeuhmeli, Emmanuel; Lija, Jackson

    2016-07-01

    Iringa region of Tanzania has had great success reaching targets for voluntary medical male circumcision (VMMC). Looking to sustain high coverage of male circumcision, the government introduced a pilot project to offer early infant male circumcision (EIMC) in Iringa in 2013. From April 2013 to December 2014, a total of 2,084 male infants were circumcised in 8 health facilities in the region, representing 16.4% of all male infants born in those facilities. Most circumcisions took place 7 days or more after birth. The procedure proved safe, with only 3 mild and 3 moderate adverse events (0.4% overall adverse event rate). Overall, 93% of infants were brought back for a second-day visit and 71% for a seventh-day visit. These percentages varied significantly by urban and rural residence (97.4% urban versus 84.6% rural for day 2 visit; 82.2% urban versus 49.9% rural for day 7 visit). Mothers were more likely than fathers to have received information about EIMC. However, fathers tended to be key decision makers regarding circumcision of their sons. This suggests the importance of addressing fathers with behavioral change communication about EIMC. Successes in scaling up VMMC services in Iringa did not translate into immediate acceptability of EIMC. EIMC programs will require targeted investments in demand creation to expand and thrive in traditionally non-circumcising settings such as Iringa.

  1. Herpes Simplex [corrected] Virus Type 2 Shedding From Male Circumcision Wounds in Rakai, Uganda.

    Science.gov (United States)

    Grabowski, Mary K; Kigozi, Godfrey; Gray, Ronald H; Armour, Benjamin; Manucci, Jordyn; Serwadda, David; Redd, Andrew D; Nalugoda, Fred; Patel, Eshan U; Wawer, Maria J; Quinn, Thomas C; Tobian, Aaron A R

    2015-11-15

    A prospective observational study of 176 men coinfected with human immunodeficiency virus and herpes simplex virus type 2 (HSV-2) was conducted to assess whether their sexual partners may be at an increased risk of HSV-2 from male circumcision (MC) wounds. Preoperative and weekly penile lavage samples were tested for penile HSV-2 shedding. Prevalence risk ratios (PRRs) were estimated using Poisson regression. Detectable penile HSV-2 shedding was present in 9.7% of men (17 of 176) before MC, compared with 12.9% (22 of 170) at 1 week (PRR, 1.33; 95% confidence interval [CI], .74-2.38) and 14.8% (23 of 155) at 2 weeks (PRR, 1.50; 95% CI, .86-2.62) after MC. HSV-2 shedding was lower among men with healed MC wounds (adjusted PRR, 0.62; 95% CI, .35-1.08). Men undergoing MC should be counseled on sexual abstinence and condom use.

  2. Voluntary medical male circumcision: an introduction to the cost, impact, and challenges of accelerated scaling up.

    Directory of Open Access Journals (Sweden)

    Catherine Hankins

    2011-11-01

    Full Text Available Scaling up voluntary medical male circumcision (VMMC for HIV prevention is cost saving and creates fiscal space in the future that otherwise would have been encumbered by antiretroviral treatment costs. An investment of US$1,500,000,000 between 2011 and 2015 to achieve 80% coverage in 13 priority countries in southern and eastern Africa will result in net savings of US$16,500,000,000. Strong political leadership, country ownership, and stakeholder engagement, along with effective demand creation, community mobilisation, and human resource deployment, are essential. This collection of articles on determining the cost and impact of VMMC for HIV prevention signposts the way forward to scaling up VMMC service delivery safely and efficiently to reap individual- and population-level benefits.

  3. Household-based HIV counseling and testing as a platform for referral to HIV care and medical male circumcision in Uganda: a pilot evaluation.

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    Henry Tumwebaze

    Full Text Available BACKGROUND: Combination HIV prevention initiatives incorporate evidence-based, biomedical and behavioral interventions appropriate and acceptable to specific populations, aiming to significantly reduce population-level HIV incidence. Knowledge of HIV serostatus is key to linkages to HIV care and prevention. Household-based HIV counseling and testing (HBCT can achieve high HIV testing rates. We evaluated HBCT as a platform for delivery of combination HIV prevention services in sub-Saharan Africa. METHODS: We conducted HBCT in a semi-urban area in southwestern Uganda. All adults received standard HIV prevention messaging. Real-time electronic data collection included a brief risk assessment and prevention triage algorithm for referrals of HIV seropositive persons to HIV care and uncircumcised HIV seronegative men with multiple sex partners to male circumcision. Monthly follow-up visits for 3 months were conducted to promote uptake of HIV care and male circumcision. RESULTS: 855 households received HBCT; 1587 of 1941 (81.8% adults were present at the HBCT visit, 1557 (98.1% of those present were tested and received HIV results, of whom, 46.5% were men. A total of 152 (9.8% were HIV seropositive, for whom the median CD4 count was 456 cells/µL, and 50.7% were newly-identified as HIV seropositive. Three months after HBCT, 88.5% of HIV seropositive persons had attended an HIV care clinic; among those with CD4 counts <250 cells/µL, 71.4% initiated antiretroviral therapy. Among 123 HIV seronegative men with an HIV+ partner or multiple partners, 62.0% were circumcised by month 3. CONCLUSIONS: HBCT achieves high levels of knowledge of HIV serostatus and is an effective platform for identifying at-risk persons and achieving higher uptake of HIV prevention and care services through referrals and targeted follow-up than has been accomplished through other single focus strategies.

  4. 重庆市成年男性工人包皮环切知识干预效果的评价%Evaluation of intervention measures about the knowledge of circumcision among adult male workers in Chongqing

    Institute of Scientific and Technical Information of China (English)

    文静; 唐晓君; 钟朝晖; 李君; 刘晨煜; 李革; 秦波

    2011-01-01

    目的:筛选出适合重庆地区该人群包皮环切的推广方式,以达到有效降低人类免疫缺陷病毒(Human immunodeficiency virus,HIV)新发感染率,并提高生殖健康.方法:随机抽取4家工厂,分为3个干预组,分别为普通干预组、特殊干预组1、特殊干预组2,3组分别给予3次、2次、1次干预,并在每次干预后1个月内进行干预效果的评价.结果:各种干预方式干预前后包皮环切术知识知晓率均有所提高,干预前后的差异具有统计学意义(P<0.05);复合干预方式2的知晓率均高于复合干预方式1、复合干预方式3以及单一干预方式1,并且之间的差异具有统计学意义(P<0.05);经趋势卡方检验,普通干预组、特殊干预组1包皮环切知识知晓率的差异均有统计学意义(普通干预组:*9字2趋势=9.362,P<0.05;特殊干预组1:*9字2趋势=22.476,P<0.001);最喜欢的宣传方式是音像材料,最感兴趣的宣传内容是包皮环切与艾滋病预防的关系.结论:普通干预组较其它两干预组最后知晓率的上升幅度高,达20.81%,复合干预方式2为最好的干预方式;包皮环切与艾滋病(Acquired immure deficiency syndrome,AIDS)的相关知识是主要宣传内容;多种强化相结合的宣教方式是有效的干预方式.%To screen the way of promoting the circumcision in Chongqing,to achieve to reduce human immunodeficiency virus(HIV) infections effectively,and to improve the reproductive health. Methods: The subjects collected by randomized control were divided into 3 groups: ordinary intervention group, special intervention group 1, and special intervention group 2. The groups were intervened by 3 times,2 times,and 1 time,respectively,and the results were evaluated within a month after every intervention. Results: The level of circumcision knowledge after every intervention was improved and had statistically significant difference(P<0.05). The awareness rate of composite intervention 2 was

  5. Modeling the Impact of Uganda’s Safe Male Circumcision Program: Implications for Age and Regional Targeting

    Science.gov (United States)

    Kripke, Katharine; Vazzano, Andrea; Kirungi, William; Musinguzi, Joshua; Opio, Alex; Ssempebwa, Rhobbinah; Nakawunde, Susan; Kyobutungi, Sheila; Akao, Juliet N.; Magala, Fred; Mwidu, George; Castor, Delivette

    2016-01-01

    Background Uganda aims to provide safe male circumcision (SMC) to 80% of men ages 15–49 by 2016. To date, only 2 million men have received SMC of the 4.2 million men required. In response to age and regional trends in SMC uptake, the country sought to re-examine its targets with respect to age and subnational region, to assess the program’s progress, and to refine the implementation approach. Methods and Findings The Decision Makers’ Program Planning Tool, Version 2.0 (DMPPT 2.0), was used in conjunction with incidence projections from the Spectrum/AIDS Impact Module (AIM) to conduct this analysis. Population, births, deaths, and HIV incidence and prevalence were used to populate the model. Baseline male circumcision prevalence was derived from the 2011 AIDS Indicator Survey. Uganda can achieve the most immediate impact on HIV incidence by circumcising men ages 20–34. This group will also require the fewest circumcisions for each HIV infection averted. Focusing on men ages 10–19 will offer the greatest impact over a 15-year period, while focusing on men ages 15–34 offers the most cost-effective strategy over the same period. A regional analysis showed little variation in cost-effectiveness of scaling up SMC across eight regions. Scale-up is cost-saving in all regions. There is geographic variability in program progress, highlighting two regions with low baseline rates of circumcision where additional efforts will be needed. Conclusion Focusing SMC efforts on specific age groups and regions may help to accelerate Uganda’s SMC program progress. Policy makers in Uganda have already used model outputs in planning efforts, proposing males ages 10–34 as a priority group for SMC in the 2014 application to the Global Fund’s new funding model. As scale-up continues, the country should also consider a greater effort to expand SMC in regions with low MC prevalence. PMID:27410234

  6. Impact of male circumcision on the HIV epidemic in Papua New Guinea: a country with extensive foreskin cutting practices.

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    Richard T Gray

    Full Text Available The degree to which adult medical male circumcision (MC programs can reduce new HIV infections in a moderate HIV prevalence country like Papua New Guinea (PNG are uncertain especially given the widespread prevalence of longitudinal foreskin cuts among adult males. We estimated the likely impact of a medical MC intervention in PNG using a mathematical model of HIV transmission. The model was age-structured and incorporated separate components for sex, rural/urban, men who have sex with men and female sex workers. Country-specific data of the prevalence of foreskin cuts, sexually transmitted infections, condom usage, and the acceptability of MC were obtained by our group through related studies. If longitudinal foreskin cutting has a protective efficacy of 20% compared to 60% for MC, then providing MC to 20% of uncut males from 2012 would require 376,000 procedures, avert 7,900 HIV infections by 2032, and require 143 MC per averted infection. Targeting uncut urban youths would achieve the most cost effective returns of 54 MC per HIV infection averted. These numbers of MC required to avert an HIV infection change little even with coverage up to 80% of men. The greater the protective efficacy of longitudinal foreskin cuts against HIV acquisition, the less impact MC interventions will have. Dependent on this efficacy, increasing condom use could have a much greater impact with a 10 percentage point increase averting 18,400 infections over this same period. MC programs could be effective in reducing HIV infections in PNG, particularly in high prevalence populations. However the overall impact is highly dependent on the protective efficacy of existing longitudinal foreskin cutting in preventing HIV.

  7. Impact of male circumcision on the HIV epidemic in Papua New Guinea: a country with extensive foreskin cutting practices.

    Science.gov (United States)

    Gray, Richard T; Vallely, Andrew; Wilson, David P; Kaldor, John; MacLaren, David; Kelly-Hanku, Angela; Siba, Peter; Murray, John M

    2014-01-01

    The degree to which adult medical male circumcision (MC) programs can reduce new HIV infections in a moderate HIV prevalence country like Papua New Guinea (PNG) are uncertain especially given the widespread prevalence of longitudinal foreskin cuts among adult males. We estimated the likely impact of a medical MC intervention in PNG using a mathematical model of HIV transmission. The model was age-structured and incorporated separate components for sex, rural/urban, men who have sex with men and female sex workers. Country-specific data of the prevalence of foreskin cuts, sexually transmitted infections, condom usage, and the acceptability of MC were obtained by our group through related studies. If longitudinal foreskin cutting has a protective efficacy of 20% compared to 60% for MC, then providing MC to 20% of uncut males from 2012 would require 376,000 procedures, avert 7,900 HIV infections by 2032, and require 143 MC per averted infection. Targeting uncut urban youths would achieve the most cost effective returns of 54 MC per HIV infection averted. These numbers of MC required to avert an HIV infection change little even with coverage up to 80% of men. The greater the protective efficacy of longitudinal foreskin cuts against HIV acquisition, the less impact MC interventions will have. Dependent on this efficacy, increasing condom use could have a much greater impact with a 10 percentage point increase averting 18,400 infections over this same period. MC programs could be effective in reducing HIV infections in PNG, particularly in high prevalence populations. However the overall impact is highly dependent on the protective efficacy of existing longitudinal foreskin cutting in preventing HIV.

  8. Innovative Demand Creation for Voluntary Medical Male Circumcision Targeting a High Impact Male Population: A Pilot Study Engaging Pregnant Women at Antenatal Clinics in Kampala, Uganda

    Science.gov (United States)

    Semeere, Aggrey S.; Castelnuovo, Barbara; Bbaale, Denis S.; Kiragga, Agnes N.; Kigozi, Joanita; Muganzi, Alex M.; Coutinho, Alex G.

    2016-01-01

    Background: Circumcision has been shown to be an effective method of HIV prevention; however, only 28% of Ugandan men aged 15–49 years are circumcised. There is a paucity of data on the role of intimate partners in generating demand for voluntary medical male circumcision (VMMC). We conducted a pilot study to assess the feasibility of a partner-focused intervention targeting males >25 years. Methods: Among pregnant women in their third trimester attending antenatal care we evaluated the impact of a pilot behavior change intervention on VMMC through a quasi-experimental approach. We observed VMMC numbers among spouses of women as per standard practice (comparison phase), and after introducing a behavioral change communication package (intervention phase). Logistic regression was used to compare the odds of VMMC uptake between comparison and intervention phases. We used qualitative methods to evaluate the casual chain using a thematic approach. Results: Of the 601 women studied, 90% articulated the health benefits of VMMC and 99% expressed interest in their spouse getting circumcised. Women's knowledge was not increased by the intervention. Four men were circumcised in the comparison and 7 in the intervention phase. The intervention was not associated with higher odds of circumcision (odds ratio 1.5, 95% CI: 0.3 to 6.0, P = 0.65). We interviewed 117 individuals overall with the main enablers for VMMC being: free VMMC, transport reimbursement, and health benefits. Deterrents included misconceptions, lost wages and fear of pain. Most of the uncircumcised men interviewed reported interest in VMMC. Conclusions: Our pilot intervention had no significant impact on increasing VMMC demand. The study demonstrated the feasibility of pregnant women engaging their spouses to discuss VMMC. PMID:27404008

  9. Doubt, defiance, and identity: Understanding resistance to male circumcision for HIV prevention in Malawi.

    Science.gov (United States)

    Parkhurst, Justin O; Chilongozi, David; Hutchinson, Eleanor

    2015-06-01

    Global policy recommendations to scale up of male circumcision (MC) for HIV prevention tend to frame the procedure as a simple and efficacious public health intervention. However, there has been variable uptake of MC in countries with significant HIV epidemics. Kenya, for example, has embraced MC and has been dubbed a 'leader' by the global health community, while Malawi has been branded a 'laggard' in its slow adoption of a national programme, with a strong political discourse of resistance forming around MC. Regardless of any epidemiological or technical evidence, the uptake of international recommendations will be shaped by how a policy, and the specific artefacts that constitute that policy, intersect with local concerns. MC holds particular significance within many ethnic and religious groups, serving as an important rite of passage, but also designating otherness or enabling the identification of the social and political self. Understanding how the artefact of MC intersects with local social, economic, and political contexts, is therefore essential to understand the acceptance or resistance of global policy recommendations. In this paper we present an in-depth analysis of Malawi's political resistance to MC, finding that ethnic and religious divisions dominating recent political movements aligned well with differing circumcision practices. Political resistance was further found to manifest through two key narratives: a 'narrative of defiance' around the need to resist donor manipulation, and a 'narrative of doubt' which seized on a piece of epidemiological evidence to refute global claims of efficacy. Further, we found that discussions over MC served as an additional arena through which ethnic identities and claims to power could themselves be negotiated, and therefore used to support claims of political legitimacy.

  10. Veracity and rhetoric in paediatric medicine: a critique of Svoboda and Van Howe's response to the AAP policy on infant male circumcision.

    Science.gov (United States)

    Morris, Brian J; Tobian, Aaron A R; Hankins, Catherine A; Klausner, Jeffrey D; Banerjee, Joya; Bailis, Stefan A; Moses, Stephen; Wiswell, Thomas E

    2014-07-01

    In a recent issue of the Journal of Medical Ethics,Svoboda and Van Howe commented on the 2012 changein the American Academy of Pediatrics (AAP) policy on newborn male circumcision, in which the AAP stated that benefits of the procedure outweigh the risks. Svoboda and Van Howe disagree with the AAP conclusions. We show here that their arguments against male circumcision are based on a poor understanding of epidemiology,erroneous interpretation of the evidence, selective citation of the literature, statistical manipulation of data, and circular reasoning. In reality, the scientific evidence indicates that male circumcision, especially when performed in the newborn period, is an ethically and medically sound low-risk preventive health procedure conferring a lifetime of benefits to health and well-being.Policies in support of parent-approved elective newborn circumcision should be embraced by the medical,scientific and wider communities.

  11. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial.

    Directory of Open Access Journals (Sweden)

    2005-11-01

    Full Text Available BACKGROUND: Observational studies suggest that male circumcision may provide protection against HIV-1 infection. A randomized, controlled intervention trial was conducted in a general population of South Africa to test this hypothesis. METHODS AND FINDINGS: A total of 3,274 uncircumcised men, aged 18-24 y, were randomized to a control or an intervention group with follow-up visits at months 3, 12, and 21. Male circumcision was offered to the intervention group immediately after randomization and to the control group at the end of the follow-up. The grouped censored data were analyzed in intention-to-treat, univariate and multivariate, analyses, using piecewise exponential, proportional hazards models. Rate ratios (RR of HIV incidence were determined with 95% CI. Protection against HIV infection was calculated as 1 - RR. The trial was stopped at the interim analysis, and the mean (interquartile range follow-up was 18.1 mo (13.0-21.0 when the data were analyzed. There were 20 HIV infections (incidence rate = 0.85 per 100 person-years in the intervention group and 49 (2.1 per 100 person-years in the control group, corresponding to an RR of 0.40 (95% CI: 0.24%-0.68%; p < 0.001. This RR corresponds to a protection of 60% (95% CI: 32%-76%. When controlling for behavioural factors, including sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behaviour, the protection was of 61% (95% CI: 34%-77%. CONCLUSION: Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved. Male circumcision may provide an important way of reducing the spread of HIV infection in sub-Saharan Africa. (Preliminary and partial results were presented at the International AIDS Society 2005 Conference, on 26 July 2005, in Rio de Janeiro, Brazil..

  12. Cost and Impact of Voluntary Medical Male Circumcision in South Africa: Focusing the Program on Specific Age Groups and Provinces

    Science.gov (United States)

    Kripke, Katharine; Thambinayagam, Ananthy; Pillay, Yogan; Loykissoonlal, Dayanund; Bonnecwe, Collen; Barron, Peter; Kiwango, Eva; Castor, Delivette

    2016-01-01

    Background In 2012, South Africa set a goal of circumcising 4.3 million men ages 15–49 by 2016. By the end of March 2014, 1.9 million men had received voluntary medical male circumcision (VMMC). In an effort to accelerate progress, South Africa undertook a modeling exercise to determine whether circumcising specific client age groups or geographic locations would be particularly impactful or cost-effective. Results will inform South Africa’s efforts to develop a national strategy and operational plan for VMMC. Methods and Findings The study team populated the Decision Makers’ Program Planning Tool, Version 2.0 (DMPPT 2.0) with HIV incidence projections from the Spectrum/AIDS Impact Module (AIM), as well as national and provincial population and HIV prevalence estimates. We derived baseline circumcision rates from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey. The model showed that circumcising men ages 20–34 offers the most immediate impact on HIV incidence and requires the fewest circumcisions per HIV infection averted. The greatest impact over a 15-year period is achieved by circumcising men ages 15–24. When the model assumes a unit cost increase with client age, men ages 15–29 emerge as the most cost-effective group. When we assume a constant cost for all ages, the most cost-effective age range is 15–34 years. Geographically, the program is cost saving in all provinces; differences in the VMMC program’s cost-effectiveness across provinces were obscured by uncertainty in HIV incidence projections. Conclusion The VMMC program’s impact and cost-effectiveness vary by age-targeting strategy. A strategy focusing on men ages 15–34 will maximize program benefits. However, because clients older than 25 access VMMC services at low rates, South Africa could consider promoting demand among men ages 25–34, without denying services to those in other age groups. Uncertainty in the provincial estimates makes them

  13. Cost and Impact of Voluntary Medical Male Circumcision in South Africa: Focusing the Program on Specific Age Groups and Provinces.

    Directory of Open Access Journals (Sweden)

    Katharine Kripke

    Full Text Available In 2012, South Africa set a goal of circumcising 4.3 million men ages 15-49 by 2016. By the end of March 2014, 1.9 million men had received voluntary medical male circumcision (VMMC. In an effort to accelerate progress, South Africa undertook a modeling exercise to determine whether circumcising specific client age groups or geographic locations would be particularly impactful or cost-effective. Results will inform South Africa's efforts to develop a national strategy and operational plan for VMMC.The study team populated the Decision Makers' Program Planning Tool, Version 2.0 (DMPPT 2.0 with HIV incidence projections from the Spectrum/AIDS Impact Module (AIM, as well as national and provincial population and HIV prevalence estimates. We derived baseline circumcision rates from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey. The model showed that circumcising men ages 20-34 offers the most immediate impact on HIV incidence and requires the fewest circumcisions per HIV infection averted. The greatest impact over a 15-year period is achieved by circumcising men ages 15-24. When the model assumes a unit cost increase with client age, men ages 15-29 emerge as the most cost-effective group. When we assume a constant cost for all ages, the most cost-effective age range is 15-34 years. Geographically, the program is cost saving in all provinces; differences in the VMMC program's cost-effectiveness across provinces were obscured by uncertainty in HIV incidence projections.The VMMC program's impact and cost-effectiveness vary by age-targeting strategy. A strategy focusing on men ages 15-34 will maximize program benefits. However, because clients older than 25 access VMMC services at low rates, South Africa could consider promoting demand among men ages 25-34, without denying services to those in other age groups. Uncertainty in the provincial estimates makes them insufficient to support geographic targeting.

  14. Adolescent Sexual and Reproductive Health Services and Implications for the Provision of Voluntary Medical Male Circumcision: Results of a Systematic Literature Review

    Science.gov (United States)

    Van Lith, Lynn M.; Mallalieu, Elizabeth C.; Waxman, Aliza; Hatzhold, Karin; Marcell, Arik V.; Kasedde, Susan; Lija, Gissenge; Hasen, Nina; Ncube, Gertrude; Samuelson, Julia L.; Bonnecwe, Collen; Seifert-Ahanda, Kim; Njeuhmeli, Emmanuel; Tobian, Aaron A. R.

    2016-01-01

    Background Voluntary medical male circumcision (VMMC) is a critical HIV prevention tool. Since 2007, sub-Saharan African countries with the highest prevalence of HIV have been mobilizing resources to make VMMC available. While implementers initially targeted adult men, demand has been highest for boys under age 18. It is important to understand how male adolescents can best be served by quality VMMC services. Methods and Findings A systematic literature review was performed to synthesize the evidence on best practices in adolescent health service delivery specific to males in sub-Saharan Africa. PubMed, Scopus, and JSTOR databases were searched for literature published between January 1990 and March 2014. The review revealed a general absence of health services addressing the specific needs of male adolescents, resulting in knowledge gaps that could diminish the benefits of VMMC programming for this population. Articles focused specifically on VMMC contained little information on the adolescent subgroup. The review revealed barriers to and gaps in sexual and reproductive health and VMMC service provision to adolescents, including structural factors, imposed feelings of shame, endorsement of traditional gender roles, negative interactions with providers, violations of privacy, fear of pain associated with the VMMC procedure, and a desire for elements of traditional non-medical circumcision methods to be integrated into medical procedures. Factors linked to effective adolescent-focused services included the engagement of parents and the community, an adolescent-friendly service environment, and VMMC counseling messages sufficiently understood by young males. Conclusions VMMC presents an opportune time for early involvement of male adolescents in HIV prevention and sexual and reproductive health programming. However, more research is needed to determine how to align VMMC services with the unique needs of this population. PMID:26938639

  15. Adolescent Sexual and Reproductive Health Services and Implications for the Provision of Voluntary Medical Male Circumcision: Results of a Systematic Literature Review.

    Directory of Open Access Journals (Sweden)

    Michelle R Kaufman

    Full Text Available Voluntary medical male circumcision (VMMC is a critical HIV prevention tool. Since 2007, sub-Saharan African countries with the highest prevalence of HIV have been mobilizing resources to make VMMC available. While implementers initially targeted adult men, demand has been highest for boys under age 18. It is important to understand how male adolescents can best be served by quality VMMC services.A systematic literature review was performed to synthesize the evidence on best practices in adolescent health service delivery specific to males in sub-Saharan Africa. PubMed, Scopus, and JSTOR databases were searched for literature published between January 1990 and March 2014. The review revealed a general absence of health services addressing the specific needs of male adolescents, resulting in knowledge gaps that could diminish the benefits of VMMC programming for this population. Articles focused specifically on VMMC contained little information on the adolescent subgroup. The review revealed barriers to and gaps in sexual and reproductive health and VMMC service provision to adolescents, including structural factors, imposed feelings of shame, endorsement of traditional gender roles, negative interactions with providers, violations of privacy, fear of pain associated with the VMMC procedure, and a desire for elements of traditional non-medical circumcision methods to be integrated into medical procedures. Factors linked to effective adolescent-focused services included the engagement of parents and the community, an adolescent-friendly service environment, and VMMC counseling messages sufficiently understood by young males.VMMC presents an opportune time for early involvement of male adolescents in HIV prevention and sexual and reproductive health programming. However, more research is needed to determine how to align VMMC services with the unique needs of this population.

  16. Aspirations and realities in a North-South partnership for health promotion: lessons from a program to promote safe male circumcision in Botswana

    OpenAIRE

    Katisi, Masego; Daniel, Marguerite; Mittelmark, Maurice B.

    2016-01-01

    Background: International donors support the partnership between the Government of Botswana and two international organisations: U.S. Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership to implement Voluntary Medical Male Circumcision with the target of circumcising 80 % of HIV negative men in 5 years. Botswana Government had started integration of the program into its health system when international partners brought in the Models for Optimizing Volume an...

  17. Single-arm evaluation of the AccuCirc device for early infant male circumcision in Botswana.

    Science.gov (United States)

    Plank, Rebeca M; Wirth, Kathleen E; Ndubuka, Nnamdi O; Abdullahi, Rasak; Nkgau, Maggie; Lesetedi, Chiapo; Powis, Kathleen M; Mmalane, Mompati; Makhema, Joseph; Shapiro, Roger; Lockman, Shahin

    2014-05-01

    : Existing devices for early infant male circumcision (EIMC) have inherent limitations. We evaluated the newly developed AccuCirc device by circumcising 151 clinically well, full-term male infants with birth weight ≥2.5 kg within the first 10 days of life from a convenience sample in 2 hospitals in Botswana. No major adverse events were observed. There was 1 local infection, 5 cases of minor bleeding, and 1 case of moderate bleeding. In 3 cases, the device made only partial incisions that were completed immediately by the provider without complications. Parental satisfaction was high: >96% of mothers stated that they would circumcise a future son. The pre-assembled, sterile AccuCirc kit has the potential to overcome obstacles related to supply chain management and on-site instrument disinfection that can pose challenges in resource-limited settings. In our study, the AccuCirc was safe and it should be considered for programmatic EIMC in resource-limited settings. PMID:24594500

  18. Long-term follow-up for Shang Ring male circumcision

    Institute of Scientific and Technical Information of China (English)

    Cheng Yue; Wu Kerong; Yan Zejun; Yang Shuwei; Li Fang; Su Xinjun

    2014-01-01

    Background Shang Ring male circumcision (MC) is a safe surgery with good short-term effects.This retrospective study was performed to investigate the long-term result of patients who had undergone Shang Ring MC.Methods A total of 103 patients who underwent the surgery were recruited in the study.Before and after the surgery,a questionnaire inquiring sexual function and sexual satisfaction was filled up.Face-to-face interview was executed.Physical examination of the external genitals was performed and complications were evaluated.Results The median follow-up duration was 19.1 months (range from 9 to 28 months).The mean width of penile mucosa was (9.3±2.5) mm.The mean width of scar was (3.7±1.6) mm.No tender pain was found in participants when palpating the penis.No significant or functional complication was observed except of mucosa asymmetry in one case and scar hyperplasia in two cases.The postoperative sexual function did not differ from the preoperative one,although partners showed better satisfaction toward sexual life.Conclusion Shang Ring MC represents a good long-term cosmetic result with no significant complication or adverse effects on sexual function.

  19. Effectiveness of and Financial Returns to Voluntary Medical Male Circumcision for HIV Prevention in South Africa: An Incremental Cost-Effectiveness Analysis.

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    Markus Haacker

    2016-05-01

    Full Text Available Empirical studies and population-level policy simulations show the importance of voluntary medical male circumcision (VMMC in generalized epidemics. This paper complements available scenario-based studies (projecting costs and outcomes over some policy period, typically spanning decades by adopting an incremental approach-analyzing the expected consequences of circumcising one male individual with specific characteristics in a specific year. This approach yields more precise estimates of VMMC's cost-effectiveness and identifies the outcomes of current investments in VMMC (e.g., within a fiscal budget period rather than of investments spread over the entire policy period.The model has three components. We adapted the ASSA2008 model, a demographic and epidemiological model of the HIV epidemic in South Africa, to analyze the impact of one VMMC on HIV incidence over time and across the population. A costing module tracked the costs of VMMC and the resulting financial savings owing to reduced HIV incidence over time. Then, we used several financial indicators to assess the cost-effectiveness of and financial return on investments in VMMC. One circumcision of a young man up to age 20 prevents on average over 0.2 HIV infections, but this effect declines steeply with age, e.g., to 0.08 by age 30. Net financial savings from one VMMC at age 20 are estimated at US$617 at a discount rate of 5% and are lower for circumcisions both at younger ages (because the savings occur later and are discounted more and at older ages (because male circumcision becomes less effective. Investments in male circumcision carry a financial rate of return of up to 14.5% (for circumcisions at age 20. The cost of a male circumcision is refinanced fastest, after 13 y, for circumcisions at ages 20 to 25. Principal limitations of the analysis arise from the long time (decades over which the effects of VMMC unfold-the results are therefore sensitive to the discount rate applied, and

  20. Informing the scaling up of voluntary medical male circumcision efforts through the use of theory of reasoned action: survey findings among uncircumcised young men in Swaziland.

    Science.gov (United States)

    Gurman, Tilly A; Dhillon, Preeti; Greene, Jessica L; Makadzange, Panganai; Khumlao, Philisiwe; Shekhar, Navendu

    2015-04-01

    Assessing predictors of intention to circumcise can help to identify effective strategies for increasing uptake of voluntary medical male circumcision (VMMC). Grounded in the theory of reasoned action (TRA), the current study of uncircumcised males ages 13-29 in Swaziland (N = 1,257) employed multivariate logistic regression to determine predictors of VMMC intention. The strongest predictors were strongly disagreeing/disagreeing that sex was more painful for a circumcised man (odds ratio [OR] = 4.37; p = < .007), a Christian man should not get circumcised (OR = 2.47; p < .001), and circumcision makes penetration more painful and difficult (OR = 2.44; p = .007). Several beliefs about enhanced sexual performance, normative beliefs (parents, sexual partner, and friends), and non-TRA-related factors (e.g., importance of plowing season to daily schedule) were also statistically significant predictors. TRA proved a useful theory to explore young men's intention to circumcise and can help inform interventions aimed at increasing uptake of VMMC. PMID:25915700

  1. Perceptions of HIV and Safe Male Circumcision in High HIV Prevalence Fishing Communities on Lake Victoria, Uganda.

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    Paul E Nevin

    Full Text Available In 2010, the Uganda Ministry of Health introduced its Safe Male Circumcision (SMC strategy for HIV prevention with the goal of providing 4.2 million voluntary medical male circumcisions by 2015. Fishing communities, where HIV prevalence is approximately 3-5 times higher than the national average, have been identified as a key population needing targeted HIV prevention services by the National HIV Prevention Strategy. This study aimed to understand perceptions of HIV and identify potential barriers and facilitators to SMC in fishing communities along Lake Victoria.We conducted 8 focus group discussions, stratified by sex and age, with 67 purposefully sampled participants in 4 communities in Kalangala District, Uganda.There was universal knowledge of the availability of SMC services, but males reported high uptake in the community while females indicated that it is low. Improved hygiene, disease prevention, and improved sexual performance and desirability were reported facilitators. Barriers included a perceived increase in SMC recipients' physiological libido, post-surgical abstinence, lost income during convalescence, and lengthier recovery due to occupational hazards. Both males and females reported concerns about spousal fidelity during post-SMC abstinence. Reported misconceptions and community-held cultural beliefs include fear that foreskins are sold after their removal, the belief that a SMC recipient's first sexual partner after the procedure should not be his spouse, and the belief that vaginal fluids aid circumcision wound healing.Previous outreach efforts have effectively reached these remote communities, where availability and health benefits of SMC are widely understood. However, community-specific intervention strategies are needed to address the barriers identified in this study. We recommend the development of targeted counseling, outreach, and communication strategies to address barriers, misconceptions, and community-held beliefs

  2. Removal of foreskin remnants in circumcised adults for treatment of premature ejaculation

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    Mohammad Reza Namavar

    2011-01-01

    Full Text Available Background and Aim : Premature ejaculation (PE is the most prevalent sexual dysfunction in every country. There are many types of treatment, but the main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medicine. The prepuce is a specific erogenous zone that contains a rich and complex network of nerves. Circumcision radically desensitizes the penis, but incomplete circumcision may cause premature ejaculation. We evaluate the effect of removal of foreskin remnants in adults on PE. Materials and Methods : The sensitive area of penile skin and the remaining parts of foreskin in adult men were recognized in 47 selective patients. Under local anesthesia, the remnant parts of foreskin were incised and removed. They were asked to fill the investigating questionnaire about the changes of intravaginal latency ejaculatory time (IVELT, patients and their sexual partners′ satisfaction with sexual life, control over ejaculation, and penile sensitivity, before and after treatment. Results : There were no signs of inflammation and no serious adverse reactions in all cases after operation. IVELT significantly increased from 64.25 before surgery to 731.49 sec after surgery (P<0.001. The percentage of postoperative satisfaction in both the patient and his partner significantly increased (P<0.001. After surgery, 95.7% of men had better control over their ejaculation. This surgery significantly decreased sensitivity of penis (P<0.001, but it did not change glans penis insensitivity. Conclusions : These results indicate that removal of foreskin remnants in adults is an effective modality in selective patients of PE.

  3. Cost drivers for voluntary medical male circumcision using primary source data from sub-Saharan Africa.

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    Lori Bollinger

    Full Text Available BACKGROUND: As voluntary medical male circumcision (VMMC programs scale up, there is a pressing need for information about the important cost drivers, and potential efficiency gains. We examine those cost drivers here, and estimate the potential efficiency gains through an econometric model. METHODS AND FINDINGS: We examined the main cost drivers (i.e., personnel and consumables associated with providing VMMC in sub-Saharan Africa along a number of dimensions, including facility type and service provider. Primary source facility level data from Kenya, Namibia, South Africa, Tanzania, Uganda, and Zambia were utilized throughout. We estimated the efficiency gains by econometrically estimating a cost function in order to calculate the impact of scale and other relevant factors. Personnel and consumables were estimated at 36% and 28%, respectively, of total costs across countries. Economies of scale (EOS is estimated to be eight at the median volume of VMMCs performed, and EOS falls from 23 at the 25th percentile volume of VMMCs performed to 5.1 at the 75th percentile. CONCLUSIONS: The analysis suggests that there is significant room for efficiency improvement as indicated by declining EOS as VMMC volume increases. The scale of the fall in EOS as VMMC volume increases suggests that we are still at the ascension phase of the scale-up of VMMC, where continuing to add new sites results in additional start-up costs as well. A key aspect of improving efficiency is task sharing VMMC procedures, due to the large percentage of overall costs associated with personnel costs. In addition, efficiency improvements in consumables are likely to occur over time as prices and distribution costs decrease.

  4. Risk compensation is not associated with male circumcision in Kisumu, Kenya: a multi-faceted assessment of men enrolled in a randomized controlled trial.

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    Christine L Mattson

    Full Text Available BACKGROUND: Three randomized controlled trials (RCTs have confirmed that male circumcision (MC significantly reduces acquisition of HIV-1 infection among men. The objective of this study was to perform a comprehensive, prospective evaluation of risk compensation, comparing circumcised versus uncircumcised controls in a sample of RCT participants. METHODS AND FINDINGS: Between March 2004 and September 2005, we systematically recruited men enrolled in a RCT of MC in Kenya. Detailed sexual histories were taken using a modified Timeline Followback approach at baseline, 6, and 12 months. Participants provided permission to obtain circumcision status and laboratory results from the RCT. We evaluated circumcised and uncircumcised men's sexual behavior using an 18-item risk propensity score and acquisition of incident infections of gonorrhea, chlamydia, and trichomoniasis. Of 1780 eligible RCT participants, 1319 enrolled (response rate = 74%. At the baseline RCT visit, men who enrolled in the sub-study reported the same sexual behaviors as men who did not. We found a significant reduction in sexual risk behavior among both circumcised and uncircumcised men from baseline to 6 (p<0.01 and 12 (p = 0.05 months post-enrollment. Longitudinal analyses indicated no statistically significant differences between sexual risk propensity scores or in incident infections of gonorrhea, chlamydia, and trichomoniasis between circumcised and uncircumcised men. These results are based on the most comprehensive analysis of risk compensation yet done. CONCLUSION: In the context of a RCT, circumcision did not result in increased HIV risk behavior. Continued monitoring and evaluation of risk compensation associated with circumcision is needed as evidence supporting its' efficacy is disseminated and MC is widely promoted for HIV prevention.

  5. Voluntary medical male circumcision: a framework analysis of policy and program implementation in eastern and southern Africa.

    OpenAIRE

    Dickson, Kim E; Tran, Nhan T.; Samuelson, Julia L.; Emmanuel Njeuhmeli; Peter Cherutich; Bruce Dick; Tim Farley; Caroline Ryan; Hankins, Catherine A.

    2011-01-01

    Editors' Summary Background Every year, more than 2.5 million people (mostly in sub-Saharan Africa) become infected with HIV, the virus that causes AIDS. There is no cure for HIV/AIDS and no HIV vaccine. Consequently, global efforts to combat HIV/AIDS are concentrating on evidence-based prevention strategies such as voluntary medical male circumcision (VMMC). Circumcision—the removal of the foreskin, a loose fold of skin that covers the head of the penis—reduced HIV transmission through sexua...

  6. Psychosocial Results from a Phase I Trial of a Nonsurgical Circumcision Device for Adult Men in Zimbabwe.

    Science.gov (United States)

    Kasprzyk, Danuta; Montaño, Daniel E; Hamilton, Deven T; Down, Kayla L; Marrett, Karl D; Tshimanga, Mufuta; Xaba, Sinokuthemba; Mugurungi, Owen

    2016-01-01

    Male circumcision (MC), an effective HIV prevention tool, has been added to Zimbabwe's Ministry of Health and Child Care HIV/AIDS Prevention Program. A Phase I safety trial of a nonsurgical male circumcision device was conducted and extensive psychosocial variables were assessed. Fifty-three men (18 and older) were recruited for the device procedure; 13 follow-up clinical visits were completed. Interviews conducted three times (before the procedure, at 2 weeks and 90 days post-procedure) assessed: Satisfaction; expectations; actual experience; activities of daily living; sexual behavior; and HIV risk perception. Using the Integrated Behavioral Model, attitudes towards MC, sex, and condoms, and sources of social influence and support were also assessed. Men (mean age 32.5, range 18-50; mean years of education = 13.6; 55% employed) were satisfied with device circumcision results. Men understand that MC is only partially protective against HIV acquisition. Most (94.7%) agreed that they will continue to use condoms to protect themselves from HIV. Pain ratings were surprisingly negative for a procedure billed as painless. Men talked to many social networks members about their MC experience; post-procedure (mean of 14 individuals). Minimal impact on activities of daily living and absenteeism indicate possible cost savings of device circumcisions. Spontaneous erections occurred frequently post-procedure. The results had important implications for changes in the pre-procedure clinical counseling protocol. Clear-cut counseling to manage pain and erection expectations should result in improved psychosocial outcomes in future roll-out of device circumcisions. Men's expectations must be managed through evidence-based counseling, as they share their experiences broadly among their social networks. PMID:26745142

  7. Transfer of the Kenyan Kikuyu Male Circumcision Ritual to Future Generations Living in the United States

    Science.gov (United States)

    Mbito, Michael N.; Malia, Julia A.

    2009-01-01

    This phenomenological research report from analysis of interviews with 18 participants focuses on the theme of transferring an age-old initiation-into-manhood circumcision ritual to future generations of Kenyan Kikuyu who are living in the US. We identified three subthemes and found a strong indication that, while personally meaningful to the…

  8. Penile injury due to blunt trauma after circumcision in a male child: A case report

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    Hulya Ozturk

    2014-08-01

    Full Text Available Injury in the case presented here is different from the cause of penile trauma. Our case has been exposed to blunt trauma after circumcision. Type developments of the penile trauma, treatment, and precautions have been discussed with the literature.

  9. Knowledge, attitudes and perceptions of pharmacy and nursing students towards male circumcision and HIV in a KwaZulu-Natal University, South Africa

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    Panjasaram V. Naidoo

    2012-07-01

    Full Text Available Background: Male circumcision is currently being promoted in South Africa as a HumanImmunodeficiency Virus (HIV prevention method. Effective implementation requires thathealthcare providers should believe in the procedure’s efficacy and should possess a positiveattitude. A study was undertaken amongst pharmacy and nursing students with differentobjectives.Objectives: To ascertain students’ knowledge, attitudes and perceptions regarding malecircumcision and (HIV prevention.Method: A descriptive cross-sectional study using anonymous questionnaires was undertakenamongst 4th year pharmacy and nursing students studying at a university in KwaZulu-Natal,after obtaining their consent. Data were captured and analysed using SPSS version 15.Results: A response rate of 83.18% and a mean knowledge score of 66.43% with relativelypositive attitudes (62.7 were obtained; 85.4% of the respondents felt that promoting malecircumcision is appropriate, with all Muslim students (n < 11 supporting the promotion ofmale circumcision. Even though all Muslim students supported male circumcision, only 3students were willing to perform the procedure if adequately trained (p < 0.03. The majorityof the female students were unwilling to perform the procedure (p < 0.005. A third of therespondents indicated that male circumcision would both undermine existing protectivebehaviours and strategies as well as increase riskier sexual behaviour. Over 54% of therespondents believed that the South African Health System would be able to cope with themassive male circumcision drive. The majority of the respondents favoured the procedure tobe done at birth. Pain was cited as the most important reason for not wanting to be circumcised.Conclusion: Pharmacy and nursing students have a moderate knowledge of male circumcisionand HIV prevention with relatively positive attitudes. The majority felt that promoting malecircumcision is appropriate and should be encouraged.

  10. Comparative Study on the Effects of Shang Ring Circumcision,Sleeve Circumcision and Improved Circumcision in Treatment of Adults and Children%商环包皮环切术、袖套包皮环切术和改良包皮环切术在成人与儿童中的疗效对比

    Institute of Scientific and Technical Information of China (English)

    谈健; 何永辉; 崔飞伦; 宁松毅

    2015-01-01

    文章选取包皮过长或包茎患者266例,根据患者入院时间随机分为商环组(85例)、袖套组(103例)和改良组(78例),比较手术时间、失血量、疼痛评分、愈合时间、外观满意率、治疗费用和术后并发症等。对比分析商环包皮环切术、袖套包皮环切术和改良包皮环切术在成人与儿童中的手术疗效和手术并发症。得出结论:儿童包皮过长或包茎患者更适合选用商环包皮环切术;袖套包皮环切术更适合用于成人包皮过长或包茎患者。%This paper took 266 adults and children patients,with excess foreskin or phimosis were treated with Shang ring circumcision,sleeve circumcision or improved circumcision. Surgical duration,blood loss,pain score, wound healing time,satisfaction with the penile appearance,treatment cost and postoperative were recorded and analyzed. To evaluate the effects of Shang ring circumcision ,sleeve circumcision and improved circumcision on treating the excess foreskin and phimosis of adults and children. Come to conclusion:For treatment of children with excess foreskin and phimosis,Shang ring circumcision might be the better method. For treatment of adults with excess foreskin and phimosis,sleeve circumcision might be the better method.

  11. Voluntary medical male circumcision: strategies for meeting the human resource needs of scale-up in southern and eastern Africa.

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    Kelly Curran

    2011-11-01

    Full Text Available Voluntary medical male circumcision (VMMC reduces female-to-male HIV transmission by approximately 60%; modeling suggests that scaling up VMMC to 80% of men 15- to 49-years-old within five years would avert over 3.3 million new HIV infections in 14 high priority countries/regions in southern and eastern Africa by 2025 and would require 20.33 million circumcisions. However, the shortage of health professionals in these countries must be addressed to reach these proposed coverage levels. To identify human resource approaches that are being used to improve VMMC volume and efficiency, we looked at previous literature and conducted a program review. We identified surgical efficiencies, non-surgical efficiencies, task shifting, task sharing, temporary redeployment of public sector staff during VMMC campaign periods, expansion of the health workforce through recruitment of unemployed, recently retired, newly graduating, or on-leave health care workers, and the use of volunteer medical staff from other countries as approaches that address human resource constraints. Case studies from Kenya, Tanzania, and Swaziland illustrate several innovative responses to human resource challenges. Although the shortage of skilled personnel remains a major challenge to the rapid scale-up of VMMC in the 14 African priority countries/regions, health programs throughout the region may be able to replicate or adapt these approaches to scale up VMMC for public health impact.

  12. Towards a gender perspective in qualitative research on voluntary medical male circumcision in east and southern Africa.

    Science.gov (United States)

    Martínez Pérez, Guillermo; Triviño Durán, Laura; Gasch, Angel; Desmond, Nicole

    2015-01-01

    The World Health Organization endorsed voluntary medical male circumcision (VMMC) in 2007 as an effective method to provide partial protection against heterosexual female-to-male transmission of HIV in regions with high rates of such transmission, and where uptake of VMMC is low. Qualitative research conducted in east and southern Africa has focused on assessing acceptability, barriers to uptake of VMMC and the likelihood of VMMC increasing men's adoption of risky sexual behaviours. Less researched, however, have been the perceptions of women and sexual minorities towards VMMC, even though they are more vulnerable to HIV/AIDS transmission than are heterosexual men. The purpose of this paper is to identify core areas in which a gendered perspective in qualitative research might improve the understanding and framing of VMMC in east and southern Africa. Issues explored in this analysis are risk compensation, the post-circumcision appearance of the penis, inclusion of men who have sex with men as study respondents and the antagonistic relation between VMMC and female genital cutting. If biomedical and social science researchers explore these issues in future qualitative inquiry utilising a gendered perspective, a more thorough understanding of VMMC can be achieved, which could ultimately inform policy and implementation. PMID:25727455

  13. Modeling the population-level effects of male circumcision as an HIV-preventive measure: a gendered perspective.

    Directory of Open Access Journals (Sweden)

    Jonathan Dushoff

    Full Text Available BACKGROUND: Evidence from biological, epidemiological, and controlled intervention studies has demonstrated that male circumcision (MC protects males from HIV infection, and MC is now advocated as a public-health intervention against HIV. MC provides direct protection only to men, but is expected to provide indirect protection to women at risk of acquiring HIV from heterosexual transmission. How such indirect protection interacts with the possibility that MC campaigns will lead to behavior changes, however, is not yet well understood. Our objective here is to investigate the link between individual-level effects of MC campaigns and long-term population-level outcomes resulting from disease dynamics, looking at both genders separately, over a broad range of parameters. METHODS AND FINDINGS: We use simple mathematical models of heterosexual transmission to investigate the potential effects of a circumcision scale-up, combined with possible associated behavioral disinhibition. We examine patterns in expected long-term prevalence using a simple equilibrium model based on transmission factors, and validate our results with ODE-based simulations, focusing on the link between effects on females and those on males.We find that the long-term population-level effects on females and males are not strongly linked: there are many possible ways in which an intervention which reduces prevalence in males might nonetheless increase prevalence in females. CONCLUSIONS: Since an intervention that reduces long-term male prevalence could nonetheless increase long-term female prevalence, MC campaigns should explicitly consider both the short-term and long-term effects of MC interventions on females. Our findings strongly underline the importance of pairing MC programs with education, support programs and HIV testing and counseling, together with other prevention measures.

  14. Circumcision of male infants and children as a public health measure in developed countries

    DEFF Research Database (Denmark)

    Frisch, Morten; Earp, Brian D

    2016-01-01

    in contrast to the more recent 2015 policy from the Canadian Paediatric Society as well as prior policies (still in force) from medical associations in Europe and Australasia - the CDC suggested that the benefits of the surgery outweigh the risks. In this article, we provide a brief scientific and...... conceptual analysis of the CDC's assessment of benefit versus risk, and argue that it deserves a closer look. Although we set aside the burgeoning bioethical debate surrounding the moral permissibility of performing non-therapeutic circumcisions on healthy minors, we argue that, from a scientific and medical...... perspective, current evidence suggests that such circumcision is not an appropriate public health measure for developed countries such as the United States....

  15. The characteristics of circular disposable devices and in situ devices for optimizing male circumcision: a network meta-analysis.

    Science.gov (United States)

    Fan, Yu; Cao, Dehong; Wei, Qiang; Tang, Zhuang; Tan, Ping; Yang, Lu; Liu, Liangren; Liu, Zhenhua; Li, Xiang; Xue, Wenbin

    2016-01-01

    In situ device (ISD) and circular disposable device (CDD) are used for optimizing male circumcision (MC), but evidence to explore the characteristics of these two devices is insufficient. In order to explore this issue systematically and provide reliable evidence, ten published randomized controlled trials (RCTs) exploring the safety and efficacy of ISDs and CDDs were included (involving 4649 men). Moderate quality of the RCTs included was found after assessment. Pairwise meta-analyses and network meta-analyses were processed in stata 13.0 and AIDDS v1.16.6 respectively. According to the outcomes that were statistically significant in both pairwise and network meta-analyses, ISD was found to have less intraoperative blood loss (IB), less operative time (OT) and less incidence of wound bleeding (WB) than conventional circumcision (CC); ISD was found to have less WB but more wound healing time (WHT) than CDD; CDD was found to have less IB and less OT than CC. CDD tended to have the best wound healing condition and least pain experience; ISD tended to have the least IB, least OT, least WB, and highest satisfaction rate. With their own superiorities in many aspects, CDD and ISD are both safe and effective devices for optimizing MC. PMID:27156368

  16. Voluntary Medical Male Circumcision for HIV Prevention in Malawi: Modeling the Impact and Cost of Focusing the Program by Client Age and Geography

    Science.gov (United States)

    Kripke, Katharine; Chimbwandira, Frank; Mwandi, Zebedee; Matchere, Faustin; Schnure, Melissa; Reed, Jason; Castor, Delivette; Sgaier, Sema

    2016-01-01

    Background In 2007, the World Health Organization (WHO) recommended scaling up voluntary medical male circumcision (VMMC) in priority countries with high HIV prevalence and low male circumcision (MC) prevalence. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), an estimated 5.8 million males had undergone VMMC by the end of 2013. Implementation experience has raised questions about the need to refocus VMMC programs on specific subpopulations for the greatest epidemiological impact and programmatic effectiveness. As Malawi prepared its national operational plan for VMMC, it sought to examine the impacts of focusing on specific subpopulations by age and region. Methods We used the Decision Makers’ Program Planning Toolkit, Version 2.0, to study the impact of scaling up VMMC to different target populations of Malawi. National MC prevalence by age group from the 2010 Demographic and Health Survey was scaled according to the MC prevalence for each district and then halved, to adjust for over-reporting of circumcision. In-country stakeholders advised a VMMC unit cost of $100, based on implementation experience. We derived a cost of $451 per patient-year for antiretroviral therapy from costs collected as part of a strategic planning exercise previously conducted in- country by UNAIDS. Results Over a fifteen-year period, circumcising males ages 10–29 would avert 75% of HIV infections, and circumcising males ages 10–34 would avert 88% of infections, compared to the current strategy of circumcising males ages 15–49. The Ministry of Health’s South West and South East health zones had the lowest cost per HIV infection averted. Moreover, VMMC met WHO’s definition of cost-effectiveness (that is, the cost per disability-adjusted life-year [DALY] saved was less than three times the per capita gross domestic product) in all health zones except Central East. Comparing urban versus rural areas in the country, we found that circumcising men in urban

  17. Voluntary Medical Male Circumcision for HIV Prevention in Malawi: Modeling the Impact and Cost of Focusing the Program by Client Age and Geography.

    Directory of Open Access Journals (Sweden)

    Katharine Kripke

    Full Text Available In 2007, the World Health Organization (WHO recommended scaling up voluntary medical male circumcision (VMMC in priority countries with high HIV prevalence and low male circumcision (MC prevalence. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS, an estimated 5.8 million males had undergone VMMC by the end of 2013. Implementation experience has raised questions about the need to refocus VMMC programs on specific subpopulations for the greatest epidemiological impact and programmatic effectiveness. As Malawi prepared its national operational plan for VMMC, it sought to examine the impacts of focusing on specific subpopulations by age and region.We used the Decision Makers' Program Planning Toolkit, Version 2.0, to study the impact of scaling up VMMC to different target populations of Malawi. National MC prevalence by age group from the 2010 Demographic and Health Survey was scaled according to the MC prevalence for each district and then halved, to adjust for over-reporting of circumcision. In-country stakeholders advised a VMMC unit cost of $100, based on implementation experience. We derived a cost of $451 per patient-year for antiretroviral therapy from costs collected as part of a strategic planning exercise previously conducted in- country by UNAIDS.Over a fifteen-year period, circumcising males ages 10-29 would avert 75% of HIV infections, and circumcising males ages 10-34 would avert 88% of infections, compared to the current strategy of circumcising males ages 15-49. The Ministry of Health's South West and South East health zones had the lowest cost per HIV infection averted. Moreover, VMMC met WHO's definition of cost-effectiveness (that is, the cost per disability-adjusted life-year [DALY] saved was less than three times the per capita gross domestic product in all health zones except Central East. Comparing urban versus rural areas in the country, we found that circumcising men in urban areas would be both cost

  18. Time to complete wound healing in HIV-positive and HIV-negative men following medical male circumcision in Kisumu, Kenya: a prospective cohort study.

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    John H Rogers

    Full Text Available BACKGROUND: While voluntary medical male circumcision (VMMC has been shown to be protective against HIV-acquisition, the procedure may place men and their partners at risk of HIV infection in the period following circumcision if sex is resumed before the wound is healed. This prospective cohort study evaluates post-circumcision wound healing to determine whether the 42-day post-circumcision abstinence period, recommended by the World Health Organization and adopted by VMMC programs, is optimal. METHODS AND FINDINGS: Men were circumcised by forceps-guided method and their post-circumcision wounds examined weekly for seven weeks and at 12 weeks. Time to complete healing was recorded in completed weeks since circumcision, and its associations with baseline covariates were assessed by Kaplan-Meier methods and Cox Proportional Hazard Models. A total of 215 HIV-negative and 108 HIV-positive men aged 18-35 years (median 26, IQR 23-30 were enrolled. 97.1% of scheduled follow-up visits were completed. At week 4, 59.3% of HIV-positive men and 70.4% of age-matched HIV-negative men were healed. At week 6, these percentages rose to 93.4% in HIV-positive men and 92.6% in age-matched HIV-negative men. There was no difference in the hazard of healing between 108 HIV-positive and 108 age-matched HIV-negative men (HR 0.91 95% CI 0.70-1.20. Early post-operative infection was associated with delayed healing in both HIV-positive and HIV-negative men (HR 0.48 95% CI 0.23-1.00. CONCLUSIONS: Our results indicate that the WHO recommendation for 42-days post-circumcision sexual abstinence should be maintained for both HIV-positive and HIV-negative men. It is important to stress condom use upon resumption of sex in all men undergoing circumcision.

  19. Removal of foreskin remnants in circumcised adults for treatment of premature ejaculation

    OpenAIRE

    Mohammad Reza Namavar; Boroomand Robati

    2011-01-01

    Background and Aim : Premature ejaculation (PE) is the most prevalent sexual dysfunction in every country. There are many types of treatment, but the main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medicine. The prepuce is a specific erogenous zone that contains a rich and complex network of nerves. Circumcision radically desensitizes the penis, but incomplete circumcision may cause premature ejaculation. We evaluate the effect of removal of fo...

  20. Male circumcision and its association with HIV infection and sexually transmitted diseases: evidence from 18 demographic and health surveys in sub-Saharan Africa.

    Science.gov (United States)

    Gebremedhin, Samson

    2011-01-01

    The study aimed to assess the association between male circumcision and HIV infection and STDs. The issue is controversial as various studies reported conflicting findings. A cross-sectional comparative study based on the secondary data of 18 Demographic Health Surveys (DHS), carried out in Sub-Saharan Africa starting from 2003, was conducted. From all surveys, information on 70 554 males aged 15 - 59 years was extracted. The association between male circumcision and HIV infection and STD symptoms (genital discharge or genital ulcer/sore) was assessed using binary logistic regression. Adjustment was made for sexual history and basic socio-demographic variables. The weighted prevalence of HIV among men 15 - 59 years was 3.1%. In the bivariate analysis uncircumcised status was significantly associated with risk of HIV, with odds ratio (OR) of 4.12 (95% CI: 3.85 - 4.42). The association was even more significant (4.95 (95% CI: 4.57-5.36)) after adjustment for number of lifetime sexual partners and socio-demographic variables. The risk associated with uncircumcised status is significantly lower among younger men aged 15 - 29 years than those in 30 - 59-year age category. About 5.5% of the study subjects reported either genital discharge or genital sore/ulcer in the preceding 12 months of the surveys. Circumcision status was not significantly associated with either of the symptoms, with adjusted OR of 1.07 (95% CI: 0.99 - 1.15). The study concludes that there is a strong association between uncircumcised status and HIV infection. Hence, male circumcision can be considered as a possible way of reducing the spread of HIV infection in areas where the practice is rare. A comprehensive study to assess the association between circumcision and different types of STDs is recommended.

  1. Ischemic glans penis after circumcision

    Institute of Scientific and Technical Information of China (English)

    Yuan-ShengTzeng; Shou-HungTang; EnMeng; Teng-FuLin; Guang-HuanSun

    2004-01-01

    A 33-year-old male receiving dorsal penile nerve block (DPNB) for circumcision exhibited a postoperative ischemic change over the glans penis. The event occurred nearly 24 hours after the procedure. The patient was treated with intravenous pentoxifyllin and hyperbaric oxygenation. Total reverse of the ischemia was observed. The complications associated with circumcision and DPNB were reviewed and discussed.

  2. Perspectives of Parents and Health Care Workers on Early Infant Male Circumcision Conducted Using Devices: Qualitative Findings From Harare, Zimbabwe

    Science.gov (United States)

    Mavhu, Webster; Hatzold, Karin; Ncube, Getrude; Fernando, Shamiso; Mangenah, Collin; Chatora, Kumbirai; Mugurungi, Owen; Ticklay, Ismail; Cowan, Frances M

    2016-01-01

    ABSTRACT Background: The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) recommend early infant male circumcision (EIMC) for prevention of HIV. Here, we present findings from a qualitative study in Zimbabwe that assessed parental and health care workers' perspectives of EIMC conducted using devices. Methods: This qualitative study was nested within a trial of EIMC devices. Between January and May 2013, we held 4 focus group discussions (FGDs) and 12 in-depth interviews with parents and 12 in-depth interviews with clinicians (7 trial clinicians and 5 non-trial clinicians). We also conducted 95 short telephone interviews with parents who had arranged to bring their sons for EIMC but then defaulted. Results: Parents who had adopted EIMC spoke of their initial anxieties about the procedure. Additionally, they commented on both the procedure and outcome. Parents who decided against EIMC cited fear of harm, specifically the infant's death, penile injury, and excessive pain. Misperceptions about male circumcision in general and EIMC specifically were a significant barrier to EIMC adoption and were prevalent among health care workers as well as parents. In particular, the findings suggest strong parental concerns about the fate of the discarded foreskin. Parents who chose EIMC for their newborn sons felt that the procedure was safe and expressed satisfaction with the outcome. For their part, health care workers largely thought that EIMC was safe and that the outcome was aesthetically pleasing. They also felt that it would be feasible to offer wide-scale EIMC for HIV prevention in the public sector; they recommended strategies to increase EIMC uptake, in addition to highlighting a few concerns. Conclusions: The qualitative study enables us to better understand parental and health care workers' perspectives of EIMC conducted using devices, especially their perspectives on EIMC safety, feasibility, acceptability, and barriers. These findings

  3. Barriers and motivators to voluntary medical male circumcision uptake among different age groups of men in Zimbabwe: results from a mixed methods study.

    Directory of Open Access Journals (Sweden)

    Karin Hatzold

    Full Text Available BACKGROUND: We conducted quantitative and qualitative studies to explore barriers and motivating factors to VMMC for HIV prevention, and to assess utilization of existing VMMC communication channels. METHODS AND FINDINGS: A population-based survey was conducted with 2350 respondents aged 15-49. Analysis consisted of descriptive statistics and bivariate analysis between circumcision and selected demographics. Logistic regression was used to determine predictors of male circumcision uptake compared to intention to circumcise. Focus group discussions (FGDs were held with men purposively selected to represent a range of ethnicities. 68% and 53% of female/male respondents, respectively, had heard about VMMC for HIV prevention, mostly through the radio (71%. Among male respondents, 11.3% reported being circumcised and 49% reported willingness to undergo VMMC. Factors which men reported motivated them to undergo VMMC included HIV/STI prevention (44%, improved hygiene (26%, enhanced sexual performance (6% and cervical cancer prevention for partner (6%. Factors that deterred men from undergoing VMMC included fear of pain (40%, not believing that they were at risk of HIV (18%, lack of partner support (6%. Additionally, there were differences in motivators and barriers by age. FGDs suggested additional barriers including fear of HIV testing, partner refusal, reluctance to abstain from sex and myths and misconceptions. CONCLUSIONS: VMMC demand-creation messages need to be specifically tailored for different ages and should emphasize non-HIV prevention benefits, such as improved hygiene and sexual appeal, and need to address men's fear of pain. Promoting VMMC among women is crucial as they appear to have considerable influence over men's decision to get circumcised.

  4. Prevalence and associated factors of behavioral intention for risk compensation following voluntary medical male circumcision among male sexually transmitted diseases patients in China.

    Science.gov (United States)

    Wang, Zixin; Feng, Tiejian; Lau, Joseph T F

    2016-10-01

    Risk compensation was an important concern of voluntary medical male circumcision (VMMC) promotion campaigns. No study investigated risk compensation following VMMC among male sexually transmitted diseases patients (MSTDP). A cross-sectional survey interviewed 308 uncircumcised MSTDP in Shenzhen, China. 26.9% of them intended to perform at least one of the five types of risk compensation behaviors following VMMC. In the summary stepwise model, provision of incorrect response to HIV/sexually transmitted diseases knowledge items (multivariate odds ratios (ORm) = 2.30), genital herpes infection (ORm = 3.19), Risk Reduction Score for Unprotected Sex, and Negative Condom Attitudes Scale (ORm = 1.13) were significantly associated with behavioral intention to perform at least one type of risk compensation behavior following VMMC. The results provided a framework for developing related interventions. Prevention of risk compensation should be an essential component of VMMC promotion for all MSTDP, irrespective of their intention for VMMC.

  5. Vasectomy as a proxy: extrapolating health system lessons to male circumcision as an HIV prevention strategy in Papua New Guinea

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    Tynan Anna

    2012-09-01

    Full Text Available Abstract Background Male circumcision (MC has been shown to reduce the risk of HIV acquisition among heterosexual men, with WHO recommending MC as an essential component of comprehensive HIV prevention programs in high prevalence settings since 2007. While Papua New Guinea (PNG has a current prevalence of only 1%, the high rates of sexually transmissible diseases and the extensive, but unregulated, practice of penile cutting in PNG have led the National Department of Health (NDoH to consider introducing a MC program. Given public interest in circumcision even without active promotion by the NDoH, examining the potential health systems implications for MC without raising unrealistic expectations presents a number of methodological issues. In this study we examined health systems lessons learned from a national no-scalpel vasectomy (NSV program, and their implications for a future MC program in PNG. Methods Fourteen in-depth interviews were conducted with frontline health workers and key government officials involved in NSV programs in PNG over a 3-week period in February and March 2011. Documentary, organizational and policy analysis of HIV and vasectomy services was conducted and triangulated with the interviews. All interviews were digitally recorded and later transcribed. Application of the WHO six building blocks of a health system was applied and further thematic analysis was conducted on the data with assistance from the analysis software MAXQDA. Results Obstacles in funding pathways, inconsistent support by government departments, difficulties with staff retention and erratic delivery of training programs have resulted in mixed success of the national NSV program. Conclusions In an already vulnerable health system significant investment in training, resources and negotiation of clinical space will be required for an effective MC program. Focused leadership and open communication between provincial and national government, NGOs and

  6. Microbial diversity of genital ulcer disease in men enrolled in a randomized trial of male circumcision in Kisumu, Kenya.

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    Supriya D Mehta

    Full Text Available BACKGROUND: Medical male circumcision (MMC reduces the risk of genital ulcer disease (GUD in men by 50%. In Ugandan and Kenyan trials, a sexually transmissible agent was not identified in 50-60% of GUD specimens by polymerase chain reaction (PCR assay. We sought to better define the etiology of GUD in men participating in the Kenyan trial and examine how MMC affects GUD etiology. METHODS: We defined GUD of unknown etiology as negative for HSV (type 1 and type 2, T. pallidum, and H. ducreyi by PCR, and negative for HSV-2 and T. pallidum by serology. We identified bacterial microbiota in a subset of 59 GUD specimens using multitag pyrosequencing of the 16S rRNA gene, and compared results by unknown vs. STI-associated etiology. Statistical analysis employed Bray-Curtis similarity measure of bacterial community by etiology, hierarchical clustering and logistic regression. RESULTS: In 59 GUD specimens from 59 men, 23 (39% had unknown etiology. Bacterial diversity was greater in GUD of unknown than STI etiology (p = 0.01. Fusobacteria (Fusobacterium spp. and Sneathia spp. were more commonly detected in men with GUD of unknown etiology [adjusted OR = 5.67; 95% CI: 1.63-19.8] as were Oxobacter spp. and Anaerovorax spp. [adjusted OR = 3.12; 95% CI: 0.83-11.7]. Sequences from these four anaerobic bacterial taxa were more often detected in uncircumcised men than circumcised men (p<0.05. CONCLUSIONS: Anaerobic bacteria are more common in genital ulcers of uncircumcised men. The specific anaerobic bacteria associated with GUD of unknown etiology have cytotoxic properties that can exacerbate epithelial disruptions leading to ulcer-like appearance. MMC may reduce GUD through a reduction in these anaerobic bacteria.

  7. [Circumcision: history, religion and law].

    Science.gov (United States)

    Totaro, Angelo; Volpe, Andrea; Racioppi, Marco; Pinto, Francesco; Sacco, Emilio; Bassi, Pier Francesco

    2011-01-01

    The aim of this article is to describe the circumcision procedure during history, its therapeutic and preventive goals, with focus on bioethical, economic and law issues. The origins of this practice are lost in antiquity. It was performed since 3000 BC by the Egyptians for hygienic and religious reasons. Moreover, male circumcision is a religious commandment in Judaism and Islam, and it is customary in some Oriental Orthodox and other Christian churches of Africa. Nowadays, circumcision is performed as a routine procedure by the Jews and the Muslims for religious reasons. The world prevalence of men with circumcision is 12.5-33%, especially in USA, Canada, Islamic people and Africa; in Europe the prevalence rate is low (in Great Britain it is 1.5%). Currently, male circumcision is being highly debated because of ethical, law and scientific issues and the different roles of this procedure: therapeutic, prophylactic (but there is no universal consensus) and ritualistic role. Nowadays, in Italy there is a strong debate about the consensus for this practice and its indications. The Italian law does not allow performing ritualistic circumcision, as a free of charge procedure in public hospitals, at the government's expenses, because the Italian law must protect different religious cultures, in name of the laity of the State. Thus, national bioethical committee (CNB) has established that ritualistic circumcision may only be performed on a paying basis in public hospitals. As a protective practice, circumcision has decreased in the entire world because of the improvement of hygienical conditions and, above all, the lack of unanimous consent on the real usefulness of protective circumcision, even if several studies have recently demonstrated the protecting role of male circumcision against HIV infection. PMID:21452153

  8. Surgical Efficiencies and Quality in the Performance of Voluntary Medical Male Circumcision (VMMC) Procedures in Kenya, South Africa, Tanzania, and Zimbabwe

    OpenAIRE

    Dino Rech; Bertrand, Jane T; Nicholas Thomas; Margaret Farrell; Jason Reed; Sasha Frade; Christopher Samkange; Walter Obiero; Kawango Agot; Hally Mahler; Delivette Castor; Emmanuel Njeuhmeli

    2014-01-01

    INTRODUCTION: This analysis explores the association between elements of surgical efficiency in voluntary medical male circumcision (VMMC), quality of surgical technique, and the amount of time required to conduct VMMC procedures in actual field settings. Efficiency outcomes are defined in terms of the primary provider's time with the client (PPTC) and total elapsed operating time (TEOT). METHODS: Two serial cross-sectional surveys of VMMC sites were conducted in Kenya, Republic of South Afri...

  9. The PrePex device is unlikely to achieve cost-savings compared to the forceps-guided method in male circumcision programs in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Walter Obiero

    Full Text Available BACKGROUND: Male circumcision (MC reduces the risk of heterosexual HIV acquisition in men by approximately 60%. MC programs for HIV prevention are currently being scaled-up in fourteen countries in sub-Saharan Africa. The current standard surgical technique for MC in many sub-Saharan African countries is the forceps-guided male circumcision (FGMC method. The PrePex male circumcision (PMC method could replace FGMC and potentially reduce MC programming costs. We compared the potential costs of introducing the PrePex device into MC programming to the cost of the forceps-guided method. METHODS: Data were obtained from the Nyanza Reproductive Health Society (NRHS, an MC service delivery organization in Kenya, and from the Kenya Ministry of Health. Analyses are based on 48,265 MC procedures performed in four Districts in western Kenya from 2009 through 2011. Data were entered into the WHO/UNAIDS Decision Makers Program Planning Tool. The tool assesses direct and indirect costs of MC programming. Various sensitivity analyses were performed. Costs were discounted at an annual rate of 6% and are presented in United States Dollars. RESULTS: Not including the costs of the PrePex device or referral costs for men with phimosis/tight foreskin, the costs of one MC surgery were $44.54-$49.02 and $54.52-$55.29 for PMC and FGMC, respectively. CONCLUSION: The PrePex device is unlikely to result in significant cost-savings in comparison to the forceps-guided method. MC programmers should target other aspects of the male circumcision minimum package for improved cost efficiency.

  10. Circumcision in Baby Boys (Beyond the Basics)

    Science.gov (United States)

    ... in male infants less than one year old. Studies consistently report that uncircumcised male infants are at higher risk of UTI compared with circumcised male infants. UTIs in infants can result in kidney infection requiring ... suggest that circumcision helps decrease the risk of ...

  11. Progress in the clinical studies of male circumcision using the Shang Ring%中国商环(Shang Ring)男性包皮环切技术临床应用研究进展

    Institute of Scientific and Technical Information of China (English)

    吕年青; 李石华; David Sokal; 程跃; 彭弋峰; Mark Barone; 黄翼然; Marc Goldstein

    2011-01-01

    reported complications are few. A standardized adult male circumcision surgical protocol utilizing the Shang Ring device was developed in 2008 in China. Several surgical training courses using this protocol were successfully held in 2009 and 2010 in China. A recent pilot clinical study of the Shang Ring was conducted to evaluate its safety and efficiency in Kenya in 2009. The results and acceptability among study participants were excellent and confirmed many of the advantages seen in the earlier Chinese studies from Wuhu, Ningbo and Xi'an, suggesting that the Shang Ring is safe for further studies in Africa, thus, could facilitate more rapid roll-out of adult male circumcision through task shifting, surgical efficiencies and better acceptability. Further international investigations of the Shang Ring technique have now been planned for Kenya and Zambia in 2011. Moreover, adult male circumcision utilizing the Shang Ring device is now being considered as one of the potential candidate techniques to be used in the scale-up of adult male circumcision services for HIV prevention in WHO priority countries in Africa. This review article summarizes Shang Ring related clinical studies, seminars and surgical workshops, publications and presentations conducted between February 2008 and December 2010 in China, the United States and Africa.

  12. Voluntary medical male circumcision: a framework analysis of policy and program implementation in eastern and southern Africa.

    Directory of Open Access Journals (Sweden)

    Kim E Dickson

    2011-11-01

    Full Text Available BACKGROUND: Following confirmation of the effectiveness of voluntary medical male circumcision (VMMC for HIV prevention, the World Health Organization and the Joint United Nations Programme on HIV/AIDS issued recommendations in 2007. Less than 5 y later, priority countries are at different stages of program scale-up. This paper analyzes the progress towards the scale-up of VMMC programs. It analyzes the adoption of VMMC as an additional HIV prevention strategy and explores the factors may have expedited or hindered the adoption of policies and initial program implementation in priority countries to date. METHODS AND FINDINGS: VMMCs performed in priority countries between 2008 and 2010 were recorded and used to classify countries into five adopter categories according to the Diffusion of Innovations framework. The main predictors of VMMC program adoption were determined and factors influencing subsequent scale-up explored. By the end of 2010, over 550,000 VMMCs had been performed, representing approximately 3% of the target coverage level in priority countries. The "early adopter" countries developed national VMMC policies and initiated VMMC program implementation soon after the release of the WHO recommendations. However, based on modeling using the Decision Makers' Program Planning Tool (DMPPT, only Kenya appears to be on track towards achievement of the DMPPT-estimated 80% coverage goal by 2015, having already achieved 61.5% of the DMPPT target. None of the other countries appear to be on track to achieve their targets. Potential predicators of early adoption of male circumcision programs include having a VMMC focal person, establishing a national policy, having an operational strategy, and the establishment of a pilot program. CONCLUSIONS: Early adoption of VMMC policies did not necessarily result in rapid program scale-up. A key lesson is the importance of not only being ready to adopt a new intervention but also ensuring that factors

  13. The Economic and Epidemiological Impact of Focusing Voluntary Medical Male Circumcision for HIV Prevention on Specific Age Groups and Regions in Tanzania

    Science.gov (United States)

    2016-01-01

    Background Since its launch in 2010, the Tanzania National Voluntary Medical Male Circumcision (VMMC) Program has focused efforts on males ages 10–34 in 11 priority regions. Implementers have noted that over 70% of VMMC clients are between the ages of 10 and 19, raising questions about whether additional efforts would be required to recruit men age 20 and above. This analysis uses mathematical modeling to examine the economic and epidemiological consequences of scaling up VMMC among specific age groups and priority regions in Tanzania. Methods and Findings Analyses were conducted using the Decision Makers’ Program Planning Tool Version 2.0 (DMPPT 2.0), a compartmental model implemented in Microsoft Excel 2010. The model was populated with population, mortality, and HIV incidence and prevalence projections from external sources, including outputs from Spectrum/AIDS Impact Module (AIM). A separate DMPPT 2.0 model was created for each of the 11 priority regions. Tanzania can achieve the most immediate impact on HIV incidence by circumcising males ages 20–34. This strategy would also require the fewest VMMCs for each HIV infection averted. Circumcising men ages 10–24 will have the greatest impact on HIV incidence over a 15-year period. The most cost-effective approach (lowest cost per HIV infection averted) targets men ages 15–34. The model shows the VMMC program is cost saving in all 11 priority regions. VMMC program cost-effectiveness varies across regions due to differences in projected HIV incidence, with the most cost-effective programs in Njombe and Iringa. Conclusions The DMPPT 2.0 results reinforce Tanzania’s current VMMC strategy, providing newfound confidence in investing in circumcising adolescents. Tanzanian policy makers and program implementers will continue to focus scale-up of VMMC on men ages 10–34 years, seeking to maximize program impact and cost-effectiveness while acknowledging trends in demand among the younger and older age groups

  14. Libertarianism and Circumcision

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    Patrick Testa

    2014-06-01

    Full Text Available Despite the millenniums-old tradition in Abrahamic circles of removing the foreskin of a penis at birth, the involuntary and aggressive practice of circumcision must not be made an exception to the natural, negative right to self-ownership—a birthright which should prevent a parent from physically harming a child from the moment of birth going forward. This paper will present a natural rights argument against the practice of male child circumcision, while also looking into some of the potential physical and psychological consequences of the practice. It will compare the practice with that of female circumcision, which is banned in developed nations but still practiced in the third world, as well as other forms of aggressive action, some once-prevalent, while disputing arguments made for parental ownership of the child, religious expression, cultural tradition, cleanliness, cosmetics, and conformity.

  15. Hybrid forum or network? The social and political construction of an international 'technical consultation': male circumcision and HIV prevention.

    Science.gov (United States)

    Giami, Alain; Perrey, Christophe; Mendonça, André Luiz de Oliveira; de Camargo, Kenneth Rochel

    2015-01-01

    The technical consultation in Montreux, organised by World Health Organization and UNAIDS in 2007, recommended male circumcision as a method for preventing HIV transmission. This consultation came out of a long process of releasing reports and holding international and regional conferences, a process steered by an informal network. This network's relations with other parties is analysed along with its way of working and the exchanges during the technical consultation that led up to the formal adoption of a recommendation. Conducted in relation to the concepts of a 'hybrid forum' and 'network', this article shows that the decision was based on the formation and consolidation of a network of persons. They were active in all phases of this process, ranging from studies of the recommendation's efficacy, feasibility and acceptability to its adoption and implementation. In this sense, this consultation cannot be described as the constitution of a 'hybrid forum', which is characterised by its openness to a debate as well as a plurality of issues formulated by the actors and of resources used by them. On the contrary, little room was allowed for contradictory discussions, as if the decision had already been made before the Montreux consultation.

  16. Acceptability of Male Circumcision among College Students in Medical Universities in Western China: A Cross-Sectional Study.

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    Junjun Jiang

    Full Text Available Male circumcision (MC has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore MC's acceptability and the factors associated with MC among college students in medical universities in western China.A cross-sectional study was carried out in three provinces in western China (Guangxi, Chongqing and Xinjiang to assess the acceptability of MC as well as to discover factors associated with the acceptability among college students in medical universities. A total of 1,790 uncircumcised male students from three medical universities were enrolled in this study. In addition, 150 students who had undergone MC were also enrolled in the survey, and they participated in in-depth interviews.Of all the uncircumcised participants (n = 1,790, 55.2% (n = 988 were willing to accept MC. Among those who accepted MC, 67.3% thought that MC could improve their sexual partners' hygiene, 46.3% believed that HIV and sexually transmitted diseases (STDs could be partially prevented by MC. The multivariable logistic regression indicates that MC's acceptability was associated with three factors: the redundant foreskin (OR = 10.171, 95% CI = 7.629-13.559, knowing the hazard of having a redundant foreskin (OR = 1.597, 95% CI = 1.097-2.323, and enhancing sexual pleasure (OR = 1.628, 95% CI = 1.312-2.021. The in-depth interviews for subjects who had undergone MC showed that the major reason for having MC was the redundant foreskin (87.3%, followed by the benefits and the fewer complications of having MC done. In addition, most of these participants (65.3% said that the MC could enhance sexual satisfaction.MC's acceptance among college students in medical universities is higher than it is among other populations in western China. An implementation of an MC programme among this population is feasible in the future.

  17. Circumcision: Perspective in a Nigerian teaching hospital

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    L O Abdur-Rahman

    2013-01-01

    Full Text Available Background: The practice and pattern of male infants circumcised is influenced by culture, religion and socio-economic classification. The debate about the benefits and risks of circumcision has made a hospital-based practice the most acceptable. Objective: The objective of this study is to evaluate the ages, indications, co-morbidity, types and methods of circumcision, usage and mode of anaesthesia and outcome of male circumcision at a tertiary health centre in Nigeria. Materials and Methods: A retrospective review of male circumcision in a paediatric surgery unit was done from January 2002 to December 2007. The data was analysed using SPSS software version 15. Results: There were 438 boys with age ranged between 6 days and 10 years (median 28 days, mean 53.6 days standard deviation 74.2. Neonatal circumcision (<29 days was 201 (46% and 318 (72.6% of the children were circumcised by the 3 rd month of live. Religion or tradition were the major indicators in 384 (87.7% patients while phimosis 38 (8.7%, paraphimosis 4 (1%, redundant post circumcision skin 10 (2.3% and defective prepuce in 2 (0.5% were other indications. Plastibel™ (PD was used in 214 (48.9%, classical circumcision 194 (44.2%, guillotine technique (GT and Gomco™ 10 (2.3% cases each while 10 (2.3% had a refashioning/re-excision post previous circumcision. There was an increase in use of PD, drop in the use of GT; and increase in the number of circumcision done over the years. Only 39.7% had anaesthesia administered and complication rate was 6.7%. Conclusion: Neonatal circumcision was highest in the hospital-based circumcision practice, which allowed the expected ideals in the use of devices in a tertiary health centre. However, the low rate of anaesthetic use is unacceptable.

  18. Association of Low-Risk Human Papillomavirus Infection with Male Circumcision in Young Men: Results from a Longitudinal Study Conducted in Orange Farm (South Africa

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    Chloé Tarnaud

    2011-01-01

    Full Text Available Background. Low-Risk Human Papillomavirus (LR-HPV genotypes 6 and 11 cause genital warts. This study investigated the association of LR-HPV infection with male circumcision (MC. Methods. We used data from the South African MC trial conducted among young men. Urethral swabs, collected among intervention (circumcised and control (uncircumcised groups, were analyzed using HPV linear array. Adjusted LR-HPV prevalence rate ratio (aPPR and Poisson mean ratio (aPMR of number of LR-HPV genotypes were estimated using log-Poisson regression, controlling for background characteristics, sexual behaviour, and HIV and HSV-2 statuses. Results. Compared to controls, LR-HPV prevalence and mean number of genotypes were significantly lower among the intervention group ((8.5% versus 15.8%; aPRR: 0.54, P<.001 and (0.33 versus 0.18; aPMR: 0.54, P<.001, resp.. Mean number of LR-HPV genotypes increased with number of lifetime sexual partners and decreased with education level and consistent condom use. Conclusions. This study shows a reduction in LR-HPV infection among circumcised men.

  19. How much does it cost to improve access to voluntary medical male circumcision among high-risk, low-income communities in Uganda?

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    Bruce Larson

    Full Text Available The Ugandan Ministry of Health has endorsed voluntary medical male circumcision as an HIV prevention strategy and has set ambitious goals (e.g., 4.2 million circumcisions by 2015. Innovative strategies to improve access for hard to reach, high risk, and poor populations are essential for reaching such goals. In 2009, the Makerere University Walter Reed Project began the first facility-based VMMC program in Uganda in a non-research setting. In addition, a mobile clinic began providing VMMC services to more remote, rural locations in 2011. The primary objective of this study was to estimate the average cost of performing VMMCs in the mobile clinic compared to those performed in health facilities (fixed sites. The difference between such costs is the cost of improving access to VMMC.A micro-costing approach was used to estimate costs from the service provider's perspective of a circumcision. Supply chain and higher-level program support costs are not included.The average cost (US$2012 of resources used per circumcision was $61 in the mobile program ($72 for more remote locations compared to $34 at the fixed site. Costs for community mobilization, HIV testing, the initial medical exam, and staff for performing VMMC operations were similar for both programs. The cost of disposable surgical kits, the additional upfront cost for the mobile clinic, and additional costs for staff drive the differences in costs between the two programs. Cost estimates are relatively insensitive to patient flow over time.The MUWRP VMMC program improves access for hard to reach, relatively poor, and high-risk rural populations for a cost of $27-$38 per VMMC. Costs to patients to access services are almost certainly less in the mobile program, by reducing out-of-pocket travel expenses and lost time and associated income, all of which have been shown to be barriers for accessing treatment.

  20. Prevalence and associated factors of behavioral intention for risk compensation following voluntary medical male circumcision among male sexually transmitted diseases patients in China.

    Science.gov (United States)

    Wang, Zixin; Feng, Tiejian; Lau, Joseph T F

    2016-10-01

    Risk compensation was an important concern of voluntary medical male circumcision (VMMC) promotion campaigns. No study investigated risk compensation following VMMC among male sexually transmitted diseases patients (MSTDP). A cross-sectional survey interviewed 308 uncircumcised MSTDP in Shenzhen, China. 26.9% of them intended to perform at least one of the five types of risk compensation behaviors following VMMC. In the summary stepwise model, provision of incorrect response to HIV/sexually transmitted diseases knowledge items (multivariate odds ratios (ORm) = 2.30), genital herpes infection (ORm = 3.19), Risk Reduction Score for Unprotected Sex, and Negative Condom Attitudes Scale (ORm = 1.13) were significantly associated with behavioral intention to perform at least one type of risk compensation behavior following VMMC. The results provided a framework for developing related interventions. Prevention of risk compensation should be an essential component of VMMC promotion for all MSTDP, irrespective of their intention for VMMC. PMID:27120407

  1. Assessing Odor Level when Using PrePex for HIV Prevention: A Prospective, Randomized, Open Label, Blinded Assessor Trial to Improve Uptake of Male Circumcision.

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    Vincent Mutabazi

    Full Text Available The PrePex is a WHO--prequalified medical device for adult male circumcision for HIV prevention. The Government of Rwanda was the first country to implement the PrePex device and acts as the leading center of excellence providing training and formal guidelines. As part of the Government's efforts to improve PrePex implementation, it made efforts to improve the psychological acceptability of device by men, thus increasing uptake with VMMC in sub-Saharan Africa. Some men who underwent the PrePex procedure complained of foreskin odor while wearing the PrePex 3-7 days after it was placed. This complaint was identified as potential risk for uptake of the device. Researchers from Rwanda assumed there is a possible relation between the level of foreskin odor and patient foreskin hygiene technique. The Government of Rwanda decided to investigate those assumptions in a scientific way and conduct a trial to test different hygiene-cleaning methods in order to increase the acceptability of PrePex and mitigate the odor concern. The main objective of the trial was to compare odor levels between three arms, having identical personal hygiene but different foreskin hygiene techniques using either clear water with soap during a daily shower, soapy water using a syringe, or chlorhexidine using a syringe. One hundred and one subjects were enrolled to the trial and randomly allocated into three trial arms. Using chlorhexidine solution daily almost completely eliminated odor, and was statistically significant more effective that the other two arms. The trial results suggest that odor from the foreskin, while wearing the PrePex device, could be related to the growth of anaerobic bacteria, which can be prevented by a chlorhexidine cleaning method. This finding can be used to increase acceptability by men when considering PrePex as one of the leading methods for HIV prevention in VMMC programs.

  2. Assessing Odor Level when Using PrePex for HIV Prevention: A Prospective, Randomized, Open Label, Blinded Assessor Trial to Improve Uptake of Male Circumcision.

    Science.gov (United States)

    Mutabazi, Vincent; Bitega, Jean Paul; Ngeruka, Leon Muyenzi; Karema, Corine; Binagwaho, Agnes

    2015-01-01

    The PrePex is a WHO--prequalified medical device for adult male circumcision for HIV prevention. The Government of Rwanda was the first country to implement the PrePex device and acts as the leading center of excellence providing training and formal guidelines. As part of the Government's efforts to improve PrePex implementation, it made efforts to improve the psychological acceptability of device by men, thus increasing uptake with VMMC in sub-Saharan Africa. Some men who underwent the PrePex procedure complained of foreskin odor while wearing the PrePex 3-7 days after it was placed. This complaint was identified as potential risk for uptake of the device. Researchers from Rwanda assumed there is a possible relation between the level of foreskin odor and patient foreskin hygiene technique. The Government of Rwanda decided to investigate those assumptions in a scientific way and conduct a trial to test different hygiene-cleaning methods in order to increase the acceptability of PrePex and mitigate the odor concern. The main objective of the trial was to compare odor levels between three arms, having identical personal hygiene but different foreskin hygiene techniques using either clear water with soap during a daily shower, soapy water using a syringe, or chlorhexidine using a syringe. One hundred and one subjects were enrolled to the trial and randomly allocated into three trial arms. Using chlorhexidine solution daily almost completely eliminated odor, and was statistically significant more effective that the other two arms. The trial results suggest that odor from the foreskin, while wearing the PrePex device, could be related to the growth of anaerobic bacteria, which can be prevented by a chlorhexidine cleaning method. This finding can be used to increase acceptability by men when considering PrePex as one of the leading methods for HIV prevention in VMMC programs.

  3. Mucosal cuff length to penile length ratio may affect the risk of premature ejaculation in circumcised males.

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    Yuruk, E; Temiz, M Z; Colakerol, A; Muslumanoglu, A Y

    2016-01-01

    Data regarding the relation between premature ejaculation (PE) and post-circumcision mucosal cuff length are controversial. The aim of this study is to analyze the relation between post-circumcision mucosal cuff length/penile length ratio (MCR) and PE. After exclusion of patients with erectile dysfunction, penile deformity, history of penile surgery and severe lower urinary tract symptoms, 49 circumcised men with PE were included. The control group is constituted of 50 healthy volunteers with normal ejaculatory function. Self-estimated intravaginal ejaculation latency time (IELT) and premature ejaculation profile (PEP) measures of all subjects were recorded, and the MCRs of patients and controls were compared. The mean age of PE patients and controls was 35.82 ± 7.73 (range 23-54) and 38.78 ± 13.42 (range 19-71) years, respectively (P=0.183). Although mucosal cuff length was not associated with either self-estimated IELT (r=-0.185, P=0.067) or PEP (r=-0.098, P=0.336), there was a negative correlation between MCR and self-estimated IELT (r=-0.205, P=0.0001) and PEP measures (r=-0.308, P=0.002). The length of the mucosal cuff after circumcision may have an impact on ejaculatory function. Surgeons should avoid leaving excessive amount of mucosa during circumcision. PMID:26700215

  4. Urinary tract infection following ritual Jewish circumcision.

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    Goldman, M; Barr, J; Bistritzer, T; Aladjem, M

    1996-11-01

    Circumcision seems to reduce the overall incidence of urinary tract infections (UTI), although a few studies have suggested that ritual circumcision may be a predisposing factor for UTI within the first 2 weeks following the procedure. The aim of this study was to investigate a possible causal relationship between ritual circumcision and UTI. The study comprised 82 infants with UTI, 55 females and 27 males under the age of 1 year. All males were circumcised on the eighth day of life. The median age of infection was 0.75 and 7.0 months for males and females, respectively. Fifty-two percent (14/27) of UTI episodes were diagnosed within the 2 weeks following circumcision. A significantly lower incidence in Escherichia coli-induced UTI was observed in males compared to females, 67% and 93%, respectively. Similarly, the incidence of E. coli-induced UTI was also significantly lower in males presenting within 2 weeks following circumcision (57%) compared to infants presenting prior or more than 2 weeks following the procedure (92%). Positive blood cultures of an identical microorganism were observed in 6/27 males compared to 2/55 females. The incidence of urinary tract malformations and their severity were similar in both sexes. We conclude that the high incidence of UTI following a ritual Jewish circumcision, as well as the relatively high preponderance of bacteria other than E. coli, may suggest a causal relationship between circumcision and UTI.

  5. Effects of medical male circumcision (MC on plasma HIV viral load in HIV+ HAART naive men; Rakai, Uganda.

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    Godfrey Kigozi

    Full Text Available BACKGROUND: Medical male circumcision (MC of HIV-infected men may increase plasma HIV viral load and place female partners at risk of infection. We assessed the effect of MC on plasma HIV viral load in HIV-infected men in Rakai, Uganda. METHODS: 195 consenting HIV-positive, HAART naïve men aged 12 and above provided blood for plasma HIV viral load testing before surgery and weekly for six weeks and at 2 and 3 months post surgery. Data were also collected on baseline social demographic characteristics and CD4 counts. Change in log10 plasma viral load between baseline and follow-up visits was estimated using paired t tests and multivariate generalized estimating equation (GEE. RESULTS: Of the 195 men, 129 had a CD4 count ≧ 350 and 66 had CD4 <350 cells/mm3. Men with CD4 counts <350 had higher baseline mean log10 plasma viral load than those with CD4 counts ≧ 350 cells/mm3 (4.715 vs 4.217 cps/mL, respectively, p = 0.0005. Compared to baseline, there was no statistically significant increase in post-MC HIV plasma viral loads irrespective of CD4. Multivariate analysis showed that higher baseline log10 plasma viral load was significantly associated with reduction in mean log10 plasma viral load following MC (coef.  = -0.134, p<0.001. CONCLUSION: We observed no increase in plasma HIV viral load following MC in HIV-infected, HAART naïve men.

  6. A Cross Sectional Study of the Prevalence of Preputial and Penile Scrotal Abnormalities among Clients Undergoing Voluntary Medical Male Circumcision in Soweto, South Africa

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    Mukudu, Hillary; Otwombe, Kennedy; Laher, Fatima; Lazarus, Erica; Manentsa, Mmatsie; Lebina, Limakatso; Mapulanga, Victor; Bowa, Kasonde; Martinson, Neil

    2016-01-01

    Objective Medical device use is currently approved for males without preputial or major penile scrotal abnormalities for voluntary medical male circumcision (VMMC). We determined the prevalence of preputial abnormalities at a busy VMMC centre in Soweto, South Africa. Methods This was a cross-sectional record review at a high-volume VMMC centre in South Africa. We collated pre-circumcision demographic and genital examination findings from clients 8 years and older who had undergone VMMC from 01 May 2013 to 30 April 2014. Logistic regression was used to determine factors associated with preputial abnormalities. Findings During the review period, 6861 circumcisions were conducted and 37.1% (n = 2543) were 8–13 year olds. Median age was 15 years (IQR: 12–23 years). Fifteen percent (n = 1030) had preputial abnormalities or major penile scrotal abnormalities. Age-specific prevalence of preputial or major genital abnormalities were 27.3%, 10.6% and 6.0% in 8–13, 14–18 and > 18 year olds respectively. The odds of preputial or major penile scrotal abnormality were higher in younger clients aged 8–13 years (OR = 5.9; 95% CI = 4.8–7.1) and 14–18 years (OR = 1.9; 95% CI = 1.5–2.4) compared to older clients above18 years and in those testing for HIV outside our clinic network (OR = 1.9; 95% CI = 1.4–2.7). Conclusion The high prevalence of preputial and penile scrotal abnormalities observed suggests a need for VMMC sites to provide for both open surgical and devices methods in the provision of VMMC services. This is especially so among young male subjects presenting themselves for VMMC services at the various sites being developed in sub Saharan African countries. PMID:27253372

  7. Long-term benefits of male circumcision for reproductive health in China%推广男性包皮环切术对降低生殖道感染促进生殖健康的意义

    Institute of Scientific and Technical Information of China (English)

    吕年青; 谷翊群; 夏术阶; 王一飞; 李石华

    2012-01-01

    男性包皮环切能显著降低60%男性阴茎-阴道性交获得性HIV感染风险,被WHO和联合国艾滋病规划署推荐为HIV预防策略中的一个重要干预措施.越来越多的研究已经证实,男性包皮环切也能降低人乳头瘤病毒、单纯疱疹病毒2型和其他性传播疾病感染风险,降低前列腺癌风险,为男女性生殖健康提供长远的益处.然而,男性包皮环切对促进两性生殖健康的长远益处与可接受性在中国一直被低估.最近累积的研究证据提示,男性包皮环切术,特别是应用创新的男性包皮环切术,例如中国商环将在HIV预防和促进人类生殖健康中发挥十分重要的作用,本文即对上述问题进行阐述.%Male circumcision (MC) can reduce HIV transmission through heterosexual intercourse by 60% and is therefore recommended as an important strategy for HIV prevention by WHO and UNAIDS. Several observational and epidemiological studies have also demonstrated significant reduction in the risk of human papillomavirus, herpes simplex virus 2 as well as the incidence of other sexual transmitted infections and prostate cancer with male circumcision, providing long - term healthy benefits for both men and women. However, the long term benefits and the acceptability of MC are currently underestimated in China. Recently, accumulated evidence shows that the ShangRing device for simplified adult circumcision may play an important role in preventing HIV transmission and promoting reproductive health for both men and women in China.

  8. Assessing Progress, Impact, and Next Steps in Rolling Out Voluntary Medical Male Circumcision for HIV Prevention in 14 Priority Countries in Eastern and Southern Africa through 2014

    Science.gov (United States)

    Kripke, Katharine; Samuelson, Julia; Schnure, Melissa; Dalal, Shona; Farley, Timothy; Hankins, Catherine; Thomas, Anne G.; Reed, Jason; Stegman, Peter; Bock, Naomi

    2016-01-01

    Background In 2007, the World Health Organization and the Joint United Nations Programme on HIV/AIDS (UNAIDS) identified 14 priority countries across eastern and southern Africa for scaling up voluntary medical male circumcision (VMMC) services. Several years into this effort, we reflect on progress. Methods Using the Decision Makers’ Program Planning Tool (DMPPT) 2.1, we assessed age-specific impact, cost-effectiveness, and coverage attributable to circumcisions performed through 2014. We also compared impact of actual progress to that of achieving 80% coverage among men ages 15–49 in 12 VMMC priority countries and Nyanza Province, Kenya. We populated the models with age-disaggregated VMMC service statistics and with population, mortality, and HIV incidence and prevalence projections exported from country-specific Spectrum/Goals files. We assumed each country achieved UNAIDS’ 90-90-90 treatment targets. Results More than 9 million VMMCs were conducted through 2014: 43% of the estimated 20.9 million VMMCs required to reach 80% coverage by the end of 2015. The model assumed each country reaches the UNAIDS targets, and projected that VMMCs conducted through 2014 will avert 240,000 infections by the end of 2025, compared to 1.1 million if each country had reached 80% coverage by the end of 2015. The median estimated cost per HIV infection averted was $4,400. Nyanza Province in Kenya, the 11 priority regions in Tanzania, and Uganda have reached or are approaching MC coverage targets among males ages 15–24, while coverage in other age groups is lower. Across all countries modeled, more than half of the projected HIV infections averted were attributable to circumcising 10- to 19-year-olds. Conclusions The priority countries have made considerable progress in VMMC scale-up, and VMMC remains a cost-effective strategy for epidemic impact, even assuming near-universal HIV diagnosis, treatment coverage, and viral suppression. Examining circumcision coverage by five

  9. Implementation of adolescent-friendly voluntary medical male circumcision using a school based recruitment program in rural KwaZulu-Natal, South Africa.

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    Carl Montague

    Full Text Available BACKGROUND: Epidemiological data from South Africa demonstrate that risk of human immunodeficiency virus (HIV infection in males increases dramatically after adolescence. Targeting adolescent HIV-negative males may be an efficient and cost-effective means of maximising the established HIV prevention benefits of voluntary medical male circumcision (VMMC in high HIV prevalence-, low circumcision practice-settings. This study assessed the feasibility of recruiting male high school students for VMMC in such a setting in rural KwaZulu-Natal. METHODS AND FINDINGS: Following community and key stakeholder consultations on the acceptability of VMMC recruitment through schools, information and awareness raising sessions were held in 42 high schools in Vulindlela. A three-phase VMMC demand-creation strategy was implemented in partnership with a local non-governmental organization, ZimnadiZonke, that involved: (i community consultation and engagement; (ii in-school VMMC awareness sessions and centralized HIV counselling and testing (HCT service access; and (iii peer recruitment and decentralized HCT service access. Transport was provided for volunteers to the Centre for the AIDS Programme of Research in South Africa (CAPRISA clinic where the forceps-guided VMMC procedure was performed on consenting HIV-negative males. HIV infected volunteers were referred to further care either at the CAPRISA clinic or at public sector clinics. Between March 2011 and February 2013, a total of 5165 circumcisions were performed, the majority (71% in males aged between 15 and 19 years. Demand-creation strategies were associated with an over five-fold increase in VMMC uptake from an average of 58 procedures/month in initial community engagement phases, to an average of 308 procedures/month on initiation of the peer recruitment-decentralized service phase. Post-operative adverse events were rare (1.2%, mostly minor and self-resolving. CONCLUSIONS: Optimizing a high volume

  10. PrePex Male Circumcision: Follow-Up and Outcomes during the First Two Years of Implementation at the Rwanda Military Hospital.

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    Albert Ndagijimana

    Full Text Available PrePex Male Circumcision (MC has been demonstrated as an effective and scalable strategy to prevent HIV infection in low- and middle-income countries. This study describes the follow-up and outcomes of clients who underwent PrePex MC between January 2011 and December 2012 with weekly follow-up at the Rwanda Military Hospital, the first national hospital in Rwanda to adopt PrePex.Data on 570 clients age 21 to 54 were extracted from patient records. We compared socio-demographic and clinical characteristics, the operator's qualification, HIV status, pain before and after device removal, urological status, device size and follow-up time between clients who were formally discharged and those who defaulted. We reported bivariate associations between each covariate and discharge status, number of people with adverse events by discharge status, and time to formal discharge or defaulting using life table methods. Data were entered into Epidata and analyzed with Stata v 13.Among study participants, 96.5% were circumcised by non-physician operators, 85.4%were under 30 years, 98.9% were HIV-negative and 97.9% were without any urological problems that could delay the healing time. Most (70.7% defaulted before formal discharge. Pain before (p<0.001 and after PrePex device removal (p = 0.001 were associated with discharge status, although very few cases were reported, and pain was more commonly missing among defaulters. Twenty-seven adverse events were reported (7 formally discharged, 20 defaulters. Median follow-up time was seven weeks among formally discharged and six weeks among defaulters (p<0.001.Given that all socio-demographic and most clinical characteristics were not associated with defaulting, we hypothesize that clients stopped returning once they determined they were healed. We recommend less frequent follow-up protocols to encourage clinical visits until formal discharge. Based on these results and recommendations, we believe PrePex MC is a

  11. 三种包皮环切术的临床比较与分析%Clinical Comparison of Three Ways of Male Circumcision

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    杜青山; 郑涛; 张帆; 祝强; 张旭

    2012-01-01

    Objective: To evaluate the clinical advantages of improved one clamp circumcision. Methods: There were 870 cases with the operation of circumcision in our hospital from December 2009 to March 2012, which categorized into 3 groups, unproved one clamp circumcision (n=470 group A), traditional one clamp circumcision (n=337 group B) and sleeve circumcision (n=63, group C). Indices including operation time, operative pain incidence, frenum injury rate, satisfaction rate of postoperative appearance and complications incidence of hematoma, edema, delay healing and stenosis of incision were compared and analyzed among 3 groups. Results: The operation time (min), the pain incidence in group A were significantly lower than group B and C (20.88± 4.96 vs 26.6± 6.48 vs 56.22± 7.09,5.5% vs 28.2% vs 100%, respectively. P<0.01), while the incidence of edema in group C was lower than the other 2 groups(1.6% vs 10.9% vs 14.8% P<0.01). The incidence of frenum injury, hematoma and stenosis in group A were lower than group B(0 vs 3.6% ,0.4% vs 5.9% ,0 vs 0.9% P<0.01). The satisfaction rate of postoperative appearance in group A was higher than the other 2 groups (98.1% vs 93.2% vs 95.2% P<0.01). There is no difference among the 3 groups in the incidence of delay healing of incision. Conclusions: An optimal choice of ways of male circumcision should be determined according to the individual characters of patients. The improved one clamp circumcision is clinical applicable as its advantages of wider indications, shorter operation time, safer frenum, better postoperative appearance in the most cases of redundant prepuce and phimosis.%目的:观察并评价改良后一钳式环切法临床应用优势.方法:回顾2009年12月至2012年3月间在我院实施的870例包皮环切术资料,对比分析改良一钳法(470例)、传统一钳法(337例)、袖套切除法(63例)三组术式在手术时间、术中疼痛发生率、系带损伤率、患者对外观满意率及并发症(血肿

  12. Willingness of men who have sex with men (MSM in the United States to be circumcised as adults to reduce the risk of HIV infection.

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    Elin B Begley

    Full Text Available BACKGROUND: Circumcision reduces HIV acquisition among heterosexual men in Africa, but it is unclear if circumcision may reduce HIV acquisition among men who have sex with men (MSM in the United States, or whether MSM would be willing to be circumcised if recommended. METHODS: We interviewed presumed-HIV negative MSM at gay pride events in 2006. We asked uncircumcised respondents about willingness to be circumcised if it were proven to reduce risk of HIV among MSM and perceived barriers to circumcision. Multivariate logistic regression was used to identify covariates associated with willingness to be circumcised. RESULTS: Of 780 MSM, 133 (17% were uncircumcised. Of these, 71 (53% were willing to be circumcised. Willingness was associated with black race (exact odds ratio [OR]: 3.4, 95% confidence interval [CI]: 1.3-9.8, non-injection drug use (OR: 6.1, 95% CI: 1.8-23.7 and perceived reduced risk of penile cancer (OR: 4.7, 95% CI: 2.0-11.9. The most commonly endorsed concerns about circumcision were post-surgical pain and wound infection. CONCLUSIONS: Over half of uncircumcised MSM, especially black MSM, expressed willingness to be circumcised. Perceived risks and benefits of circumcision should be a part of educational materials if circumcision is recommended for MSM in the United States.

  13. Prepuce: Phimosis, Paraphimosis, and Circumcision

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    Yutaro Hayashi

    2011-01-01

    Full Text Available Phimosis is a condition in which the prepuce cannot be retracted over the glans penis. Actually, physiologic phimosis is common in male patients up to 3 years of age, but often extends into older age groups. Balanoposthitisis a common inflammation occurring in 4–11% of uncircumcised boys. Circumcision is generally undertaken for three reasons: first, as an item of religious practice, typically neonatally although occasionally transpubertally, as a rite of passage; second, as a prophylactic measure against future ailments for the reduction in the risk of penile cancer, urinary tract infection, and sexually transmitted infection; and third, for immediate medical indication. Balanitisxeroticaobliterans is an infiltrative skin condition that causes a pathological phimosis and has been considered to be the only absolute indication for circumcision. Various kinds of effective alternatives to circumcision have been described, including manual retraction therapy, topical steroid therapy, and several variations of preputioplasty. All of these treatments have the ability to retract the foreskin as their goal and do not involve the removal of the entire foreskin. Paraphimosis is a condition in which the foreskin is left retracted. When manipulation is not effective, a dorsal slit should be done, which is usually followed by circumcision.

  14. Qualitative study of male circumcision about HIV prevention among medical students in western China%我国西部地区医学大学生对包皮环切预防HIV的定性研究

    Institute of Scientific and Technical Information of China (English)

    石艺; 王倩; 唐晓君; 蒋俊俊; 邓伟; 杨晓波; 哈木拉提·吾甫尔; 秦波; 梁浩

    2013-01-01

    目的 比较广西、新疆和重庆3所医科大学的男性学生对包皮环切术作为HIV的一项干预措施的知、信、行信息,为相应宣传材料及推广模式的开发研究提供一些基础数据.方法 选择广西、新疆和重庆3地18岁及以上未做过包皮环切的医科大学学生各30人,进行40 min左右的结构式个人深入访谈.结果 在3个地区中,仅有12人知道包皮环切术可以“预防HIV感染”;约84% (76/90)的人认为“包茎或包皮过长者”是做包皮环切手术的主要原因;65%(58/90)的人能说出包皮环切相关知识.当知道包皮环切术预防HIV的流行病证据及生物学机制,并被告之可免费手术后,广西、新疆和重庆3省均有2/3的人明确愿意接受手术,并愿意作为顶层设计的志愿者参与课题研究.被访者对艾滋病相关知识有所了解,但缺乏对艾滋病的重视.结论 引导医学大学生在思想上真正重视艾滋病,普及包皮环切手术预防HIV的相关研究成果,将是包皮环切术在该人群中推广的关键.%OBJECTIVE To compare the cognition, attitude and behavior towards circumcision as an intervention for HIV prevention among medical students in Guangxi, Xinjiang and Chongqing medical university, and to provide based data for developing promotional materials and spreading models. METHODS 30 male medical students were recruited from Guangxi, Xinjiang and Chongqing each. Information about acceptability, cognition, attitude and behavior of male circumcision was collected by 40-minute face to face interview. RESULTS Only twelve men could correctly answered the effectiveness of circumcision for HIV prevention in these three cities. 84% (76/90) of the interviewees considered that circumcision is for the primary reason of phimosis or redundant prepuce, and 65% (58/90) of interviewees had certain knowledge of circumcision. After some epidemi-ological evidences and biological mechanisms of circumcision were

  15. Circuncisão masculina e infecção pelo HIV: uma polêmica mundial sem voz brasileira Male circumcision and HIV infection: an international debate with no Brazilian participation

    Directory of Open Access Journals (Sweden)

    Euclides Ayres de Castilho

    2004-02-01

    Full Text Available Os autores trazem para reflexão a questão da circuncisão masculina como fator de proteção para infecção pelo HIV. Em breve histórico da abordagem do problema, na literatura mundial, identificam a ausência de pesquisas brasileiras sobre o tema. Por fim, problematizam a situação, lembrando que circuncisão masculina autodeclarada é passível de erros de classificação de relevante magnitude, implicando, por isso, vícios nas estimativas de riscos.The authors discuss male circumcision as a protective factor against HIV transmission. The absence is noted of Brazilian data published in the international literature regarding this issue. Finally, it is emphasized that self-declared circumcision status is subject to substantial misclassification with the generation of biased risk estimates.

  16. Circumcision: The Good, the Bad and American Values

    Science.gov (United States)

    Buie, Mary E.

    2005-01-01

    National statistics estimate that 1.2 million newborn males are circumcised annually in the United States (70% to 80%). Such values as sanctity, equity, fraternity, paternity and liberty affect circumcision rates in America. The value of sanctity allows freedom of religious beliefs and traditions that often overcome medical impetus in…

  17. Voluntary medical male circumcision: matching demand and supply with quality and efficiency in a high-volume campaign in Iringa Region, Tanzania.

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    Hally R Mahler

    2011-11-01

    Full Text Available The government of Tanzania has adopted voluntary medical male circumcision (VMMC as an important component of its national HIV prevention strategy and is scaling up VMMC in eight regions nationwide, with the goal of reaching 2.8 million uncircumcised men by 2015. In a 2010 campaign lasting six weeks, five health facilities in Tanzania's Iringa Region performed 10,352 VMMCs, which exceeded the campaign's target by 72%, with an adverse event (AE rate of 1%. HIV testing was almost universal during the campaign. Through the adoption of approaches designed to improve clinical efficiency-including the use of the forceps-guided surgical method, the use of multiple beds in an assembly line by surgical teams, and task shifting and task sharing-the campaign matched the supply of VMMC services with demand. Community mobilization and bringing client preparation tasks (such as counseling, testing, and client scheduling out of the facility and into the community helped to generate demand. This case study suggests that a campaign approach can be used to provide high-volume quality VMMC services without compromising client safety, and provides a model for matching supply and demand for VMMC services in other settings.

  18. Male circumcision for protection against HIV infection in sub-Saharan Africa: the evidence in favour justifies the implementation now in progress.

    Science.gov (United States)

    Wamai, Richard G; Morris, Brian J; Bailey, Robert C; Klausner, Jeffrey D; Boedicker, Mackenzie N

    2015-01-01

    This article responds to a recent 'controversy study' in Global Public Health by de Camargo et al. directed at three randomised controlled trials (RCTs) of male circumcision (MC) for HIV prevention. These trials were conducted in three countries in sub-Saharan Africa (SSA) and published in 2005 and 2007. The RCTs confirmed observational data that had accumulated over the preceding two decades showing that MC reduces by 60% the risk of HIV infection in heterosexual men. Based on the RCT results, MC was adopted by global and national HIV policy-makers as an additional intervention for HIV prevention. Voluntary medical MC (VMMC) is now being implemented in 14 SSA countries. Thus referring to MC for HIV prevention as 'debate' and viewing MC through a lens of controversy seems mistaken. In their criticism, de Camargo et al. misrepresent and misinterpret current science supporting MC for HIV prevention, omit previous denunciations of arguments similar to theirs, and ignore evidence from ongoing scientific research. Here we point out the flaws in three areas de Camargo et al. find contentious. In doing so, we direct readers to growing evidence of MC as an efficacious, safe, acceptable, relatively low-cost one-off biomedical intervention for HIV prevention.

  19. Erectile Dysfunction in the Older Adult Male.

    Science.gov (United States)

    Mola, Joanna R

    2015-01-01

    Erectile dysfunction (ED) in the older adult male is a significant problem affecting more than 75% of men over 70 years of age in the United States. Older men have an increased likelihood of developing ED due to chronic disease, comorbid conditions, and age-related changes. Research has demonstrated that while the prevalence and severity of ED increases with age, sexual desire often remains unchanged. This article discusses the clinical picture of ED, including relevant pathophysiology, clinical presentation, and evaluation and treatment options. PMID:26197627

  20. STUDY ON METHODS OF HEALTH EDUCATION FOR MALE CIRCUMCISION AMONG DRUG ADDICTS IN CHONGQING%重庆市美沙酮服药者包皮环切术健康教育方式研究

    Institute of Scientific and Technical Information of China (English)

    李凌竹; 窦贵旺; 秦波; 何有志; 王婷; 李革

    2011-01-01

    Objective :To discuss methods of health education for male circumcision among drug addicts in Chongqing, provide basis for disseminating the education widely among the population and increase the rate of circumcision to prevent AIDS. Methods: We selected from three clinics 437 male drug addicts who had not undergone circumcision and were willing to participant in the research as the study subjects. Subjects in three clinics received the health education with three different methods; general education,special Ⅰ education and special Ⅱ education . Questionnaire survey was conducted for the willingness of circumcision before and after health education to see the changes in the willingness for accepting circumcision and their favorite methods receiving health education. Factors influencing willingness of circumcision was studied with Logistic multiple regression analysis. Results: Except occupation, indicators of the general demographic characteristics of the subjects from different clinics with different methods of health education showed no significant difference ( P < 0. 05 ). According to the result of Logistic multiple regression analysis, redundant prepuce and having no idea of the complications was the factors influencing willingness of accepting circumcision. Fundamental information of AIDS was the most favorite content the subjects were interested in,then the relationship between circumcision and AIDS prevention and the basic knowledge of circumcision. Almost half (48% ) of the subjects preferred to paper documentation as the method of receiving health education. The difference of willingness to accept circumcision before and after the education was statistically significant ( P < 0. 05 ) in subjects received any education method. However, the special Ⅰ and special Ⅱ had better effects. Conclusion: Health education on circumcision is effective, and the effects of special Ⅰ and Ⅱ are sound. Medical practitioners can choose different methods to

  1. Surgical efficiencies and quality in the performance of voluntary medical male circumcision (VMMC procedures in Kenya, South Africa, Tanzania, and Zimbabwe.

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    Dino Rech

    Full Text Available INTRODUCTION: This analysis explores the association between elements of surgical efficiency in voluntary medical male circumcision (VMMC, quality of surgical technique, and the amount of time required to conduct VMMC procedures in actual field settings. Efficiency outcomes are defined in terms of the primary provider's time with the client (PPTC and total elapsed operating time (TEOT. METHODS: Two serial cross-sectional surveys of VMMC sites were conducted in Kenya, Republic of South Africa, Tanzania and Zimbabwe in 2011 and 2012. Trained clinicians observed quality of surgical technique and timed 9 steps in the VMMC procedure. Four elements of efficiency (task-shifting, task-sharing [of suturing], rotation among multiple surgical beds, and use of electrocautery and quality of surgical technique were assessed as explanatory variables. Mann Whitney and Kruskal Wallis tests were used in the bivariate analysis and linear regression models for the multivariate analyses to test the relationship between these five explanatory variables and two outcomes: PPTC and TEOT. The VMMC procedure TEOT and PPTC averaged 23-25 minutes and 6-15 minutes, respectively, across the four countries and two years. The data showed time savings from task-sharing in suturing and use of electrocautery in South Africa and Zimbabwe (where task-shifting is not authorized. After adjusting for confounders, results demonstrated that having a secondary provider complete suturing and use of electrocautery reduced PPTC. Factors related to TEOT varied by country and year, but task-sharing of suturing and/or electrocautery were significant in two countries. Quality of surgical technique was not significantly related to PPTC or TEOT, except for South Africa in 2012 where higher quality was associated with lower TEOT. CONCLUSIONS: SYMMACS data confirm the efficiency benefits of task-sharing of suturing and use of electrocautery for decreasing TEOT. Reduced TEOT and PPTC in high volume

  2. The ultrasonic harmonic scalpel for circumcision:experimental evaluation using dogs

    Institute of Scientific and Technical Information of China (English)

    Mou Peng; Zhe Meng; Zhong-Hua Yang; Xing-Huan Wang

    2013-01-01

    Male circumcision is one of the most commonly performed operations worldwide,and many novel techniques have been developed for better postoperative outcomes.The purpose of this study was to explore the feasibility of applying the ultracision harmonic scalpel (UHS) for circumcision by using dogs.Sixteen adult male dogs were divided into two groups:the UHS group and the control group.The dogs were circumcised with either the UHS or a conventional scalpel.The UHS circumcision procedure and the effects were imaged 1 week after surgery.The two groups were compared with respect to the operative time and volume of blood loss.Postoperative complications,including oedema,infection,bleeding of the incision and wound dehiscence,were recorded for both groups.The mean operative time for the UHS group was only 5.1 min compared with the 35.5 min of the conventional group.The mean blood loss was less than 2 ml for the UHS group and 15 ml for the conventional group.There was only one case of mild oedema in the UHS group,but the postoperative complications in the conventional group included two cases of mild oedema,one infection of the incision and one case of bleeding of the incision.In conclusion,circumcision using UHS is a novel technique to treat patients with phimosis and excessive foreskin,and this method has a short operative time,less blood loss and fewer complications than the conventional scalpel method.This small animal study provides a basis for embarking on a larger-scale clinical trial of the UHS.

  3. 非穆斯林男性吸毒者包皮环切术接受意愿调查%Willingness to take circumcision among non-Muslim male drug users

    Institute of Scientific and Technical Information of China (English)

    黄永迪; 巴哈古丽·阿尔斯郎; 许瑞玮; 严卫丽; 哈木拉提·吾甫尔; 杨蕾; 王倩; 王琛琛; 翟啸虎; 严恺; 樊于生; 阿依丁·西热牙孜旦; 哈木拉提·吐送

    2013-01-01

    目的 了解非穆斯林男性吸毒者对包皮环切术的接受意愿及其影响因素.方法 采用横断面调查研究,于2010年1-11月对新疆乌鲁木齐市350名非穆斯林男性吸毒者进行问卷调查.结果 350名非穆斯林男性吸毒人员中,55.1% (193/350)有意愿接受包皮环切术,其中74.6% (144/193)完全是出于个人意愿,其次是医生的建议、周围朋友的影响、配偶或女友的支持和父母的安排,分别占15.5% (30/193)、13.0% (25/193)、11.9% (23/193)和8.8%(17/193);有44.8%(157/350)不愿意接受,其中,87.9%(138/157)认为没有必要、不影响健康;不愿意选择该手术的人有93.0%(146/157)完全是出于个人意愿;多因素logistic回归分析结果显示,身边有亲戚朋友或者同学做过该手术(OR=2.071,95% CI=1.043 ~4.110)和感觉自己包茎或包皮过长(OR=9.355,95%CI=4.607 ~ 18.993)与包皮环切术的接受意愿相关.结论 该人群中大部分人有意愿接受包皮环切术,但其预防艾滋病的相关知识了解不够.%Objective To examine the willingness, knowledge, and attitude to male circumcision and factors affecting the willingness among non-Muslim male drug users in Xinjiang Uygur Autonomous Region. Methods A cross-sectional questionnaire survey was conducted from January to October 2010 in Urumqi. Results Among 350 representative samples of non-Muslim male drug users,55. 1% (193) reported the willingness to take circumcision. The main reasons for the willingness were to improve genital hygiene,to prevent penile cancer,and to treat foreskin or phimosis. Multivari-ate analyses indicated that those with family member or friends circumcised(odds ratio[ OR] = 2. 071,95% confidence intervale [95 %CI]:1. 043 -4. 110) and self-judgement of redundant prepuce or phimosis(OR =9. 355,95% CI: 4. 607 -18. 993) were more likely to take circumcision. Conclusion More than half of non-Muslim male drug users are absolutely willing to take

  4. How do you circumcise a nation? The Rwandan case study

    OpenAIRE

    Mutabazi, Vincent; Forrest, Jamie I; Ford, Nathan; Mills, Edward J

    2014-01-01

    Voluntary medical male circumcision has been conclusively demonstrated to reduce the lifetime risk of male acquisition of HIV. The strategy has been adopted as a component of a comprehensive strategy towards achieving an AIDS-free generation. A number of countries in which prevalence of HIV is high and circumcision is low have been identified as a priority, where innovative approaches to scale-up are currently being explored. Rwanda, as one of the priority countries, has faced a number of cha...

  5. A Phase II Randomized Controlled Trial Comparing Safety, Procedure Time, and Cost of the PrePex™ Device to Forceps Guided Surgical Circumcision in Zimbabwe

    Science.gov (United States)

    Tshimanga, Mufuta; Mangwiro, Tonderayi; Mugurungi, Owen; Xaba, Sinokuthemba; Murwira, Munyaradzi; Kasprzyk, Danuta; Montaño, Daniel E.; Nyamukapa, Daisy; Tambashe, Basile; Chatikobo, Pesanai; Gundidza, Patricia; Gwinji, Gerald

    2016-01-01

    Background The World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS promote MC (male circumcision) as a key HIV prevention strategy where HIV prevalence and incidence are high and MC prevalence is low. In Zimbabwe, to achieve the 1.26 million circumcisions needed to be performed by 2015 to achieve optimal MC coverage, a new approach was needed. The primary objective of the current trial was to assess the performance (safety, procedure time, and cost) of the PrePex device compared to forceps-guided surgical circumcision. Methods and Findings This Phase II, randomized, open-label trial in Zimbabwe involved healthy, non-circumcised adult male volunteers who were randomly assigned to the PrePex device (n = 160) or surgical arm (n = 80). Three doctors and 4 nurses, all certified on both circumcision methods, performed the procedures. The PrePex device procedure involves a plastic ring with a rubber O-ring that necrotizes the foreskin to facilitate easy and minimally invasive removal. Total procedure time was the primary endpoint. Adverse event (AE) data were also gathered for 90 days post-procedure. All 80 participants in the surgical arm and 158 participants in the PrePex arm achieved complete circumcision. The total procedure time for the PrePex device was approximately one-third of the total surgical procedure (4.8 minutes, Standard Deviation [SD]: 1.2 versus 14.6 minutes; SD: 4.2; pcircumcision. The PrePex device has great potential for use in overburdened health systems and in resource-limited settings and is recommended for use in rapid scale-up of adult MC in Zimbabwe. Trial Registration ClinicalTrials.gov NCT01956370 PMID:27227679

  6. Delivering PrePex Medical Male Circumcision Services Through a Mobile Clinic: The Experience From a Pilot Project in North West Province, South Africa.

    Science.gov (United States)

    Kufa, Tendesayi; Chetty-Makkan, Candice; Maraisane, Mpho; Charalambous, Salome; Chihota, Violet; Toledo, Carlos

    2016-06-01

    We describe the implementation of a pilot project to demonstrate the safety and feasibility of providing PrePex circumcision from a mobile clinic. We analyzed available project diary entries and staff meeting minutes to identify challenges encountered. The main challenges identified were (1) daily time constraints because of setting up procedures, (2) transportation logistics for clients when the mobile clinic had moved to a different location, (3) integration and coordination of staff responsibilities, and (4) recruitment for PrePex services in the mobile clinic. The provision of PrePex device circumcision through a mobile clinic was feasible but careful planning and review of operational procedures were needed to resolve the implementation challenges. PMID:27331594

  7. Acceptability and related factors of male circumcision among farmer workers in coal mine%煤矿农民工包皮环切术接受性及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    蒋俊俊; 梁旭; 杨晓波; 邓伟; 韦波; 张志勇; 柳志豪; 梁浩

    2011-01-01

    目的 研究农民工对包皮环切术的接受性,并分析其接受性影响因素.方法 采用整群抽样方法选取广西壮族自治区百色市煤矿中569名男性农民工作为研究对象,通过一对一问卷调查收集其包皮环切术的接受性及其影响因素.结果 研究对象中有包皮环切意愿的占25.13%(143/569);当研究对象被告知包皮环切并发症小、可预防艾滋病性病和保护生殖健康、检查时发现有包皮过长或包茎、手术免费时,农民工对包皮环切术的接受性有较大改变,分别为43.23%、58.52%、70.12%、48.86%,与告知前比较差异有统计学意义;单因素分析显示,婚姻状况、包皮环切术知识、人类免疫缺陷病毒(HIV)抗体检测等6个因素与包皮环切的接受性有关;多因素分析显示,未婚者、自觉有包皮过长或包茎、进行过HIV抗体检测者更愿意接受手术,其OR(95%CI)值分别为2.37(1.30~4.32)、8.19(4.25~15.77)、1.95(1.15~3.32).结论 广西农民工包皮环切术接受意愿较低,艾滋病和包皮环切术相关知识知晓率低及担心手术安全性和费用是主要影响因素.%Objective To explore the acceptability of male circumcision and its related factors among farmer workers in coal mine. Methods Questionnaire survey on the acceptability of male circumcision (MC) and its related factors was conducted among farmer workers in a coal mine in Guangxi Zhuang Autonomous Region with random cluster sampling. Resuits A total of 569 male farmer workers were selected. Among the interviewees,25. 13% ( 143/569)expressed the willingness to accept MC. When knowing that the operation would be free of charge and with few complication and could prevent AIDS and sexually transmitted diseases(STDS), more interviewees expressed the willingness to accept MC with a significantly increased acceptable rate. Univariate analysis showed that the acceptability of MC was associated with marital status,knowledge on male

  8. Sexual maturation and aging of adult male mealybug (Hemiptera: Pseudococcidae).

    Science.gov (United States)

    Mendel, Z; Protasov, A; Jasrotia, P; Silva, E B; Zada, A; Franco, J C

    2012-08-01

    The physiological age of adult males of seven mealybug species was measured in relation to the elongation of the male pair of the waxy caudal filaments. These filaments begin to emerge after eclosion and reached their maximum length from 29.4-46.6 h. The studied males were divided into three age groups, expressed as percentages of the total waxy caudal filaments length. Attraction to a sex pheromone source was significantly higher in the oldest male group (maximum filaments growth) compared with youngest one. Only the oldest male group copulated successfully; few of the younger males tested displayed 'courtship' behavior towards conspecific virgin females. The calculated duration of the sexually active phase of the adult male life cycle varied among species ranging from 34.4 to 46.6 h. There were marked variations in the strength of attraction to a pheromone source according to time of day. There was a continuous decrease in sexual activity from morning to evening. Our findings reveal clear maturation periods for adult males of the seven studied species. The long immature phase of the adult male mealybug is probably also related to several physiological processes that are needed to complete male maturation. The most noticeable change is the elongation of the waxy caudal filaments. However, mating may be performed at any time ambient conditions are suitable. Whereas male mealybug flight towards a pheromone source is restricted to a few hours, the male may continue mating activity throughout its sexually active period.

  9. Adult male coatis play with a band of juveniles.

    Science.gov (United States)

    Logan, C J; Longino, J T

    2013-05-01

    This study examined the play behaviour in one group of coatis (Nasua narica) at La Selva Biological Station in Costa Rica. We incidentally found adult males playing with juvenile coatis, and conducted post-hoc analyses to investigate this interaction. Coati groups consist of adult females and juveniles of both sexes until male juveniles reach two years of age and leave the band to become solitary. Adult males only tolerate juveniles for a brief period during breeding season when the males court females to mate. Outside of the breeding season, adult males are known to prey on juveniles. In this study, when adult males were present with the band, play occurred more than was expected by chance, and adult males engaged in many of these play bouts. Because the mechanisms driving infanticidal behaviour are not well understood, and adult male coatis show a range of behaviours from infanticide to highly affiliative interactions with juveniles, using coatis as a model system may elucidate mechanisms underlying infanticide.

  10. Histomorphometric study on blood cells in male adult ostrich

    Directory of Open Access Journals (Sweden)

    Mina Tadjalli

    2013-09-01

    Full Text Available In order to perform a histomorphometric study of blood cells in male adult ostrich, blood samples were obtained from jugular vein of 10 clinically healthy male adult ostriches (2 - 3 years old. The slides were stained with the Giemsa methods and the smears were evaluated for cellular morphology, with cellular size being determined by micrometry. The findings of this study revealed that the shape of the cell, cytoplasm and nucleus of erythrocytes in male adult ostriches were similar to those in other birds such as quails, chickens, Iranian green-head ducks.

  11. Using the economics of certification to improve the safety and quality of male circumcision in developing countries: three models of implementation.

    Science.gov (United States)

    Richards, Michael R

    2012-03-01

    Although male circumcision (MC) has been a widespread practice in some regions, while relatively new in others, it has recently ascended in popularity as a HIV-reduction intervention, particularly in areas with high rates of HIV but low rates of MC. However, the uptake and potential effectiveness of MC may be hampered by uneven levels of provider training and procedure skill within developing country settings. Indeed, this procedure that is otherwise considered simple and safe has witnessed complication rates as high as 25-35% in some areas, leaving some men with irreversible injuries. To improve the transparency of procedure quality for prospective patients, I borrow from a classic economics approach and advocate a new application in the form of provider certification. Building on some experience in the healthcare systems and economic rationale of high-income counties, I explore the potential for certifying providers of MC in low-income countries and compare and contrast three models of implementation: government agency, private certifiers and private MC device manufacturers. The hope is that increased transparency of provider quality through any or all three types of certifying programmes can better assist local men as they navigate this otherwise complex and unclear medical care market. As more resources are being devoted to MC scale up, I argue that certification should be considered for incorporation as a means of complementing both current and future efforts in order to enhance the effectiveness of MC campaigns. The two models based on privatized certification, as opposed to having the local government underwrite the intervention, may prove most useful when public or philanthropic funding is volatile or incomplete for a given location. The timing for MC campaign adoption and desired speed of scale up may vary across countries in ways that international assistance efforts cannot always immediately and flexibly adapt to. As such, the role of the diverse MC

  12. "When I was circumcised I was taught certain things": risk compensation and protective sexual behavior among circumcised men in Kisumu, Kenya.

    Directory of Open Access Journals (Sweden)

    Thomas H Riess

    Full Text Available BACKGROUND: Male circumcision has been shown to reduce the transmission of HIV from women to men through vaginal sex by approximately 60%. There is concern that men may engage in risk compensation after becoming circumcised, diminishing the benefits of male circumcision. METHODS AND FINDINGS: We conducted qualitative interviews with 30 sexually active circumcised men in Kisumu, Kenya from March to November 2008. Most respondents reported no behavior change or increasing protective sexual behaviors including increasing condom use and reducing the number of sexual partners. A minority of men reported engaging in higher risk behaviors either not using condoms or increasing the number of sex partners. Circumcised respondents described being able to perform more rounds of sex, easier condom use, and fewer cuts on the penis during sex. CONCLUSIONS: Results illustrate that information about MC's protection against HIV has disseminated into the larger community and MC accompanied by counseling and HIV testing can foster positive behavior change and maintain sexual behavior.

  13. QUALITATIVE STUDY ON WILLINGNESS FOR ACCEPTING MALE CIRCUMCISION IN DRUG ADDICTS ON METHADONE MAINTENANCE TREATMENT IN CHONGQING%重庆美沙酮门诊男性服药者包皮环切术接受意愿定性研究

    Institute of Scientific and Technical Information of China (English)

    李凌竹; 窦贵旺; 秦波; 王婷; 李革

    2012-01-01

    目的:了解重庆市美沙酮门诊男性服药者包皮环切术接受意愿.方法:在2009年10月至2009年12月期间选取50名美沙酮门诊男性服药者,采用个人深入访谈的方式对每位服药者进行个人访谈,归纳总结美沙酮门诊男性服药者包皮环切术接受意愿.结果:50名访谈对象中,9名访谈对象自觉包皮过长,其中7位愿意进行包皮环切术.在自觉无包皮过长情况的41名访谈对象中,22名在进行包皮环切术能预防艾滋病的前提下愿意(或考虑)进行包皮环切手术.在医疗机构和医疗费用的访问中,24名愿意进行手术的访谈对象选择三甲医院进行手术,并且有23名的访谈对象认为费用不应超过一千元.结论:包皮过长和行包皮环切术后,预防艾滋病能提高包皮环切术的接受意愿.医疗花费能部分影响包皮环切术接受意愿.在包皮环切术的推广中着重提高包皮过长检出率;强调该手术对艾滋病的预防作用和降低医疗花费,能够提高该人群包皮环切术接受意愿.%Objective: To understand the situation on willingness of accepting male circumcision in drug addicts on methadone maintenance treatment ( MMT) in Chongqing, and provide information for the establishment of a good extension model of male circumcision. Methods: Individual in - depth interviews were conducted among 50 drug addicts from October to December in 2009, the willingness for accepting male circumcision in drug addicts on methadone maintenance treatment( MMT) were summaried. Results: Nine drug addicts believed that they had redundant prepuce, and 7 of them accepted male circumcision. However, 22 of 41 drug addicts who had not redundant prepuce accepted male circumcision if this surgery was a way to prevent AIDS. Most of the drug addicts who accepted male circumcision chose Three -A hospitals for their surgeries, and more than half thought that the cost should be less than 1000 RMB. Conclusion: Redundant prepuce

  14. Experience of Using Amniotic Membrane After Circumcision

    International Nuclear Information System (INIS)

    It is compulsory, for boys to undergone circumcision before getting adult in Moslem region. It can be done by General Surgeon, General Practitioner, Nurse, Midwife or Quack. The place to carry out the circumcision can be inside or outside hospital. The utmost problems are injections, point for secondary wound covering and delay of using underpants. To overcome those problem amniotic membranes can be used as wound covering, based on : they are soft, easy to shape wound surface, satisfactory adhesive properties, good elasticity and sufficient, transparency which allows wound control without redressing of the wound. From January until December 1999, 165 boys at an age between 6-10 years, which have been carried out circumcision, were evaluated. Radiation sterilized lyophilized amniotic membranes were used in this work as wound covering Result show that amniotic membrane gave a good result in wound healing. All the patients observed, showed early mobilization as well as early using underpants. There is no different result between circumcision which had been done either inside or out hospital, carried out by surgeon or non-surgeon

  15. "What do You Mean I've Got to Wait for Six Weeks?!" Understanding the Sexual Behaviour of Men and Their Female Partners after Voluntary Medical Male Circumcision in the Western Cape.

    Directory of Open Access Journals (Sweden)

    Yoesrie Toefy

    Full Text Available Several studies have shown that voluntary male medical circumcision (VMMC reduces the incidence of the Type-1 human immunodeficiency virus (HIV in heterosexual men by up to 60%. However, there is an increased risk of transmission of STIs, including HIV, in the immediate post-operative period after receiving VMMC. This study is to understand sexual practices of couples in the post-operative period in a Coloured population in the Western Cape Province of South Africa.Coloured Males who had undergone VMMC in the previous six months in the Cape Town area and their partners participated in eight single-gender focus group discussions. The groups explored why the men decided to undergo VMMC, what kind of counselling they received, and how they experienced the 6-week post-operative period, including sexually.The primary motivation to VMMC uptake included religious injunction and hygiene reasons and protection against sexually transmitted infections not necessarily HIV. There was some exploration of alternative sexual practices. During the period immediately post operation the respondents spoke of pain and fear of any sexual arousal, but towards the end of the six week period, sexual desire returned. Both men and women felt that sex was important to maintain the relationship. Gaps were identified in the pre- and post-MC procedure counselling.There is a real risk that men in this population may begin sex before complete healing has occurred. VMMC counselling to encourage men to stay sexually safe in the wound-healing period, needs to take into account the real-life factors of the circumcised men. It is essential from a public health, and gender perspective that effective counselling strategies for the VMMC post-operative period, and the longer term, are developed and tested.

  16. Circumcision and 'uncircumcision'.

    Science.gov (United States)

    Schneider, T

    1976-03-27

    The origin of circumcision is shrouded in antiquity. Mummies, 6 000 years old, have been reported to show evidence of circumcision but the first definite account appears in Genesis, chapter 17. Many nations practise it as a rite, the time of its performance varying from soon after birth to early manhood. Antiochus Epiphanes prohibited it in Palestine and the introduction of Greek gymnasia where nudity was the practice, led to many seeking to become uncircumcised. Celsus has described such an operation which appears to have been successful. In Rome under Hadrian and in 16th century Spain a heavy funnel-shaped copper tube fitting was used as another method of restoring the prepuce. The debate concerning the value of circumcision has continued up until the present day. PMID:775659

  17. [Ethics and ritual circumcision].

    Science.gov (United States)

    Castagnola, C; Faix, A

    2014-12-01

    Circumcision dates back to ancient times, nowadays, this ritual is practiced mainly in the context of Jewish and Muslim religions. The purpose of this article is to give urologists elements of reflection on the act according to the ethical principles of autonomy, beneficence, non-maleficence and justice. According to a Kantian vision, priority should be given to the respect and wishes of the individuals. In contrast, for the utilitarian theory, circumcision can be justified by a contribution to the happiness of the majority of community members at the expense of a given few. In the event of a request for ritual circumcision, urologists find themselves in the middle, uncomfortable for some, questioning the ethics of its meaning. The main pitfall for the surgeon remains in respecting the child's autonomy. PMID:25199723

  18. Complications of Circumcision

    Directory of Open Access Journals (Sweden)

    Aaron J. Krill

    2011-01-01

    Full Text Available In the United States, circumcision is a commonly performed procedure. It is a relatively safe procedure with a low overall complication rate. Most complications are minor and can be managed easily. Though uncommon, complications of circumcision do represent a significant percentage of cases seen by pediatric urologists. Often they require surgical correction that results in a significant cost to the health care system. Severe complications are quite rare, but death has been reported as a result in some cases. A thorough and complete preoperative evaluation, focusing on bleeding history and birth history, is imperative. Proper selection of patients based on age and anatomic considerations as well as proper sterile surgical technique are critical to prevent future circumcision-related adverse events.

  19. High Flow Priapism in a Pediatric Patient after Circumcision with Dorsal Penile Nerve Block

    Science.gov (United States)

    Fantony, Joseph J.; Routh, Jonathan C.

    2016-01-01

    We report the first documented case of high flow priapism after circumcision with dorsal penile nerve block. A 7-year-old male who had undergone circumcision three years before presented to our institution with a 3-year history of persistent nonpainful erections. Workup revealed a high flow priapism and, after discussion of the management options, the patient's family elected continued observation. PMID:27648333

  20. Incomplete urethral duplication in an adult male.

    LENUS (Irish Health Repository)

    Davis, N F

    2012-09-01

    Urethral duplication is a rare congenital anomaly with less than 200 cases reported. It predominantly occurs in males and is nearly always diagnosed in childhood or adolescence. It is defined as a complete second passage from the bladder to the dorsum of the penis or as an accessory pathway that ends blindly on the dorsal or ventral surface.

  1. Paediatric sutureless circumcision-an alternative to the standard technique.

    LENUS (Irish Health Repository)

    2012-01-31

    INTRODUCTION: Circumcision is one of the most commonly performed surgical procedures in male children. A range of surgical techniques exist for this commonly performed procedure. The aim of this study is to assess the safety, functional outcome and cosmetic appearance of a sutureless circumcision technique. METHODS: Over a 9-year period, 502 consecutive primary sutureless circumcisions were performed by a single surgeon. All 502 cases were entered prospectively into a database including all relevant clinical details and a review was performed. The technique used to perform the sutureless circumcision is a modification of the standard sleeve technique with the use of a bipolar diathermy and the application of 2-octyl cyanoacrylate (2-OCA) to approximate the tissue edges. RESULTS: All boys in this study were pre-pubescent and the ages ranged from 6 months to 12 years (mean age 3.5 years). All patients had this procedure performed as a day case and under general anaesthetic. Complications included: haemorrhage (2.2%), haematoma (1.4%), wound infection (4%), allergic reaction (0.2%) and wound dehiscence (0.8%). Only 9 (1.8%) parents or patients were dissatisfied with the cosmetic appearance. CONCLUSION: The use of 2-OCA as a tissue adhesive for sutureless circumcisions is an alternative to the standard suture technique. The use of this tissue adhesive, 2-OCA, results in comparable complication rates to the standard circumcision technique and results in excellent post-operative cosmetic satisfaction.

  2. The Cost of Medicaid Savings: The Potential Detrimental Public Health Impact of Neonatal Circumcision Defunding

    Directory of Open Access Journals (Sweden)

    Annie L. Andrews

    2012-01-01

    Full Text Available Objective. To project the increased incidence of HIV and subsequent costs resulting from the expected decreased rate of circumcision due to Medicaid defunding in one southeastern state. Methods. Using 2009 South Carolina (SC Medicaid birth cohort (n=29,316, we calculated expected heterosexually acquired HIV cases at current circumcision rates. To calculate age/race/gender specific HIV incidence rates, we used 2009 South Carolina Department of Health and Environmental Control reported gender and race specific HIV cases, CDC reported age distribution of HIV cases, and 2009 S.C. population data. Accounting for current circumcision rates, we calculated the change in incidence of heterosexually acquired HIV assuming circumcision provides 60% protection against HIV transmission to males and 46% protection against male to female transmission. Published lifetime cost of HIV was used to calculate the cost of additional HIV cases. Results. Assuming Medicaid circumcision rates decrease from current nationally reported levels to zero secondary to defunding, we project an additional 55 male cases of HIV and 47 female cases of HIV among this birth cohort. The total cost discounted to time of infection of these additional HIV cases is $20,924,400 for male cases and $17,711,400 for female cases. The cost to circumcise males in this birth cohort at currently reported rates is $4,856,000. Conclusions. For every year of decreased circumcision rates due to Medicaid defunding, we project over 100 additional HIV cases and $30,000,000 in net medical costs.

  3. Risk factors for HIV infection among circumcised men in Uganda: a case-control study

    Directory of Open Access Journals (Sweden)

    Michael Ediau

    2015-01-01

    Full Text Available Introduction: Male circumcision (MC reduces the risk of HIV infection. However, the risk reduction effect of MC can be modified by type of circumcision (medical, traditional and religious and sexual risk behaviours post-circumcision. Understanding the risk behaviours associated with HIV infection among circumcised men (regardless of form of circumcision is critical to the design of comprehensive risk reduction interventions. This study assessed risk factors for HIV infection among men circumcised through various circumcision approaches. Methods: This was a case-control study which enrolled 155 cases (HIV-infected and 155 controls (HIV-uninfected, all of whom were men aged 18–35 years presenting at the AIDS Information Center for HIV testing and care. The outcome variable was HIV sero-status. Using SPSS version 17, multivariable logistic regression was performed to identify factors independently associated with HIV infection. Results: Overall, 83.9% among cases and 56.8% among controls were traditionally circumcised; 7.7% of cases and 21.3% of controls were religiously circumcised while 8.4% of cases and 21.9% of controls were medically circumcised. A higher proportion of cases than controls reported resuming sexual intercourse before complete wound healing (36.9% vs. 14.1%; p18 years (AOR: 5.0, CI: 2.4–10.2; resuming sexual intercourse before wound healing (AOR: 3.4, CI: 1.6–7.3; inconsistent use of condoms (AOR: 2.7, CI: 1.5–5.1; and having sexual intercourse under the influence of peers (AOR: 2.9, CI: 1.5–5.5. Men who had religious circumcision were less likely to have HIV infection (AOR: 0.4, 95% CI: 0.2–0.9 than the traditionally circumcised but there was no statistically significant difference between those who were traditionally circumcised and those who were medically circumcised (AOR: 0.40, 95% CI: 0.1–1.1. Conclusions: Being circumcised at adulthood, resumption of sexual intercourse before wound healing, inconsistent

  4. A Phase II Randomized Controlled Trial Comparing Safety, Procedure Time, and Cost of the PrePex™ Device to Forceps Guided Surgical Circumcision in Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Mufuta Tshimanga

    Full Text Available The World Health Organization (WHO and the Joint United Nations Program on HIV/AIDS promote MC (male circumcision as a key HIV prevention strategy where HIV prevalence and incidence are high and MC prevalence is low. In Zimbabwe, to achieve the 1.26 million circumcisions needed to be performed by 2015 to achieve optimal MC coverage, a new approach was needed. The primary objective of the current trial was to assess the performance (safety, procedure time, and cost of the PrePex device compared to forceps-guided surgical circumcision.This Phase II, randomized, open-label trial in Zimbabwe involved healthy, non-circumcised adult male volunteers who were randomly assigned to the PrePex device (n = 160 or surgical arm (n = 80. Three doctors and 4 nurses, all certified on both circumcision methods, performed the procedures. The PrePex device procedure involves a plastic ring with a rubber O-ring that necrotizes the foreskin to facilitate easy and minimally invasive removal. Total procedure time was the primary endpoint. Adverse event (AE data were also gathered for 90 days post-procedure. All 80 participants in the surgical arm and 158 participants in the PrePex arm achieved complete circumcision. The total procedure time for the PrePex device was approximately one-third of the total surgical procedure (4.8 minutes, Standard Deviation [SD]: 1.2 versus 14.6 minutes; SD: 4.2; p<0.00001. There were 2 AEs for 2 participants (rate of 1.3%, 95% Confidence Interval: 0.0025-4.53%, which were resolved with simple intervention. The AEs were device related, including 1 case of pain leading to device removal and 1 case of removal of the device.The trial supports previous studies' conclusions that the PrePex procedure is safe, quick, easy to apply, and effective in terms of procedure time as an alternative to traditional surgical circumcision. The PrePex device has great potential for use in overburdened health systems and in resource-limited settings and is

  5. Dietary glucose regulates yeast consumption in adult Drosophila males

    OpenAIRE

    Sebastien eLebreton; Peter eWitzgall; Marie eOlsson; Becher, Paul G.

    2014-01-01

    The adjustment of feeding behavior in response to hunger and satiety contributes to homeostatic regulation in animals. The fruit fly Drosophila melanogaster feeds on yeasts growing on overripe fruit, providing nutrients required for adult survival, reproduction and larval growth. Here, we present data on how the nutritional value of food affects subsequent yeast consumption in Drosophila adult males. After a period of starvation, flies showed intensive yeast consumption. In comparison, flies ...

  6. Outpatient Treatment of Primary Anorexia Nervosa in Adult Males.

    Science.gov (United States)

    Ziesat, Harold A., Jr.; Ferguson, James M.

    1984-01-01

    Describes three cases of adult-onset primary anorexia nervosa in males. For each case, the history and diagnostic patterns are considered, followed by a discussion of the course of outpatient treatment. The therapy was multimodal and included elements of behavioral contingency management, cognitive therapy, and dynamic psychotherapy. (JAC)

  7. The International Student: Female Circumcision Issues.

    Science.gov (United States)

    Bengston, Barbara; Baldwin, Cynthia

    1993-01-01

    Describes the process and practice of female circumcision, the impact it may have on circumcised female international college students, and some counseling strategies for the college counselor who works with this population. Explains variety of reasons for performing female circumcision, different types of female circumcisions, and psychological…

  8. Circumcision for Prevalent HIV Infection Among Male Drug Users in Guangxi, China: a Case-control Study%广西男性吸毒人群HIV感染的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    蒋俊俊; 梁浩; 韦所苏; 韦富梅; 廖艳研; 黎明强; 石珊; 何斌; 向绍密

    2013-01-01

    Objective To analyze the association between HIV infection and circumcision and other influencing factors among male drug users in Guangxi,China.Methods A case-control study consisting of HIV-positive patients as cases and HIV-negative person as controls was conducted.Each HIV case was matched by one HIV negative who participated consecutively right after the HIV case was identified at the same survey,same time and in the same city.Cases and controls were interviewed about risk factors including social and demographic characteristics,AIDS knowledge and attitudes,abuse-related behavior,sexual behavior,STDs and whether to operate circumcision.Results 258 HIV-positive patients and 258 HIV-negative people were investigated.Multivariate logistic regression indicated that the average income under $ 500,needle sharing,injection drug used in recent months,the steady sex partners were drug users,never used condom after drug use was more likely to infect HIV,and people who was circumcised had lower probability in HIV infection.Conclusion Redundant foreskin might be a factor in the risk of HIV infection among male drug users.The social demographic characteristics,abuse-related behavior,sexual behavior and their AIDS knowledge were the factors on HIV infection.%目的 了解广西男性吸毒人群HIV感染的影响因素,探讨包皮环切与该人群HIV感染的关系.方法 应用病例对照研究方法,以男性吸毒人群中HIV感染者为病例组,对照组为按照年龄、调查地区、调查时段进行1∶1匹配的男性吸毒人群中非HIV感染者.回顾性调查研究对象的人口学特征、艾滋病相关知识和态度、吸毒史、性行为特征、性病史、是否做过包皮环切手术等信息.结果 共调查258例HIV感染者,对照匹配258名非HIV感染者.多因素Logistic回归分析显示,平均月收入低于500元、与别人共用过针具、最近一个月注射过毒品、固定性伴吸毒、吸毒后发生性

  9. Bloodless, sutureless circumcision

    Directory of Open Access Journals (Sweden)

    Nisar A Bhat

    2013-01-01

    Full Text Available Background: W e present our experience of sutureless and bloodless elective circumcision in neonates and infants with Gomco clamp. Patients and Methods: From March 2008 to May 2011, 200 babies with age ranging from 2 weeks to 7 months underwent Gomco circumcision. All patients were given chlorohydrate 50 mg/kg, paracetamol suppository 15 mg/kg, and local anesthesia. Procedure was done in minor operation theatre (OT and babies were observed for 1 h in recovery room before discharging them home. Results: Two of our patients (1% required immediate suturing on table after Gomco clamp was removed, five patients (2.5% were shifted back from the recovery room to minor OT for suture repair and eight patients (4% required reinforcement of primary dressing to control the minor ooze. There was no other complication. Cosmesis was to the satisfaction of the surgeon as well as the parents. Conclusion: Gomco clamp is a bloodless, sutureless, simple, and safe method of circumcision in newborns and infants. It is cost-effective and can be performed under local anesthesia and sedation with excellent cosmetic results.

  10. Cohort study on circumcision of newborn boys and subsequent risk of urinary-tract infection.

    Science.gov (United States)

    To, T; Agha, M; Dick, P T; Feldman, W

    1998-12-01

    A prospective population-based cohort study assessed the association between male circumcision and subsequent urinary tract infection (UTI) in children born in Ontario, Canada, in a 12-month period in 1993-94. Of the 69,100 eligible infants, 30,105 (43.6%) were circumcised in the first month of life. 29,217 uncircumcised boys were matched to circumcised boys by date of birth and followed for 24-36 months. Information on UTIs was extracted from the Canadian Institute for Health Information computerized database on hospital discharges. There were 83 UTI cases in the circumcised cohort (1.88/1000 person-years of observation) and 247 in the uncircumcised group (7.02/1000 person-years) (p 0.0001). The relative risk of UTI in uncircumcised compared to circumcised boys was 4.5 (95% CI, 2.4-8.4) in the first month of life and 3.7 (95% CI, 2.8-4.9) in the year after the procedure. Calculation of the attributable risk indicated 195 circumcisions would be necessary to prevent one admission for UTI in the first year of life. Previous studies have recorded UTI rates 10-20 times higher in uncircumcised than circumcised boys. These findings support the hypothesis that circumcision protects boys from UTI, but the magnitude of this effect may be less than previously estimated.

  11. Complication rate after circumcision in a paediatric surgical setting should not be neglected

    DEFF Research Database (Denmark)

    Thorup, Jørgen; Thorup, Sebastian Cortes; Ifaoui, Inge Botker Rasmussen

    2013-01-01

    As a consequence of the discussion on whether the health benefits of newborn male circumcision outweigh the risks and the discrepancies in reported figures of complications, we evaluated our results from a paediatric surgical department.......As a consequence of the discussion on whether the health benefits of newborn male circumcision outweigh the risks and the discrepancies in reported figures of complications, we evaluated our results from a paediatric surgical department....

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  15. Sex is never the same: Men's perspectives on refusing circumcision from an in-depth qualitative study in Kwaluseni, Swaziland

    NARCIS (Netherlands)

    A. Adams; E. Moyer

    2015-01-01

    Faced with an HIV prevalence of 31% among 18- to 49-year-olds, Swaziland developed a male circumcision policy in 2009, following compelling scientific evidence from three randomised controlled trials. Utilising United States Agency for International Development funds, the state set out to circumcise

  16. 广西部分男男性行为者包皮环切术接受意愿分析%ACCEPTABILITY OF MALE CIRCUMCISION AMONG MEN WHO HAVE SEX WITH MEN IN GUANGXI

    Institute of Scientific and Technical Information of China (English)

    蓝光华; 刘伟; 黄玉满; 梁浩

    2011-01-01

    目的:了解广西男男性行为人群对包皮环切术的接受意愿情况.方法:利用滚雪球法招募302名男男性行为者(MSM),并进行包皮体检和面对面问卷调查.结果:302名MSM中,平均男性性伴数中位数为3.5个,19.5%与女性有过性关系,41.1%最近1年接受过HIV检测,18.5%自述最近1年出现过性病相关症状.与男性发生性关系时每次都是用安全套的比例为46.1%,与女性发生性关系时每次都是用安全套的比例为37.3%.既往12.3%接受过包皮环切术,主要原因为包皮过长、父母安排、能预防艾滋病等.25.7%未接受包皮环切术者愿意接受包皮环切术,多因素回归分析结果显示,包皮长度(OR=2.63,95%CI 1.93~3.58)、最近6个月与女性发生过性关系(OR=0.38,95%CI 0.16~0.91)与包皮环切术接受意愿比较差异有统计学意义(P<0.05).结论:MSM是艾滋病的高风险人群和桥梁人群,包皮过长和与女性有过性关系的MSM更愿意接受包皮环切术.%Objective: To learn the willing of male circumcision (MC) among men who have sex with men (MSM) in Guangxi. Methods:To recruit 302 MSM by snow-balling. Questionnaire interviews and foreskin check were administrated to MSM participants. Results:Overall 302 MSM attended the survey. The average of male sex partner was 3. 5; 19. 5% of MSM had female sexual partners;41. 1% of MSM had received HIV test; 18. 5% of MSM appeared sexually transmitted disease (STD) related symptoms in the past year. The proportions of condom use each time in male-male sex and male female sex were 46. 1 % and 37. 3% respectively; 12. 3% of MSM experienced MC. The reasons of MS were prepuce redundant, parents arrangement, for the HIV prevention; 25. 7% of uncircumcised MSM were willing to accept MC. In multiple regression analysis, the foreskin length (OR=2. 63, 95% CI 1. 93-3. 58), the last six months had sexual relations with women (OR = 0. 38, 95% CI 0. 16-0. 91) were significantly associated with the

  17. Photometric facial analysis of the Igbo Nigerian adult male

    OpenAIRE

    Ukoha Ukoha Ukoha; Onochie Okwudili Udemezue; Chidi Kingsley Oranusi; Azuoma Lasbrey Asomugha; Uchechukwu Dimkpa; Lynda Chinenye Nzeukwu

    2012-01-01

    Background: A carefully performed facial analysis can serve as a strong foundation for successful facial reconstructive and plastic surgeries, rhinoplasty or orthodontics. Aim: The purpose of this study is to determine the facial features and qualities of the Igbo Nigerian adult male using photometry. Materials and Methods: One hundred and twenty subjects aged between 18 and 28 years were studied at the Anambra State University, Uli, Nigeria. The frontal and right lateral view photographs of ...

  18. Circumcision: is the risk of urinary tract infection really the pivotal issue?

    Science.gov (United States)

    Chessare, J B

    1992-02-01

    Recent information regarding the increased risk of urinary tract infections in the first year of life for uncircumcised boys has created confusion regarding the appropriate guidance to be given to parents confronting the circumcision issue. A decision model was built that addressed the question of whether or not to circumcise a newborn male considering the probability of a non-circumcised boy having a UTI in the first year of life (0.041), the probability of a circumcised boy having a UTI in the first year of life (0.002), and the likelihood of renal scarring from a UTI (0.075). After considering the morbidity associated with the procedure, all possible outcomes were ranked from worst to best (circumcised-renal pathology to uncircumcised-no infection) and given a value on a 0 to 1 scale. For the set of values assigned to the outcomes, the choice of no circumcision yielded the highest expected utility. For the set of assigned utilities, sensitivity analysis showed that unless the probability of a UTI in the first year of life for an uncircumcised male was greater than or equal to 0.29, then non-circumcision was still the preferred choice. The decision was most sensitive to the degree of aversion to the morbidity associated with the procedure (pain, bleeding, inflammation).

  19. A 'snip' in time: what is the best age to circumcise?

    Directory of Open Access Journals (Sweden)

    Morris Brian J

    2012-02-01

    Full Text Available Abstract Background Circumcision is a common procedure, but regional and societal attitudes differ on whether there is a need for a male to be circumcised and, if so, at what age. This is an important issue for many parents, but also pediatricians, other doctors, policy makers, public health authorities, medical bodies, and males themselves. Discussion We show here that infancy is an optimal time for clinical circumcision because an infant's low mobility facilitates the use of local anesthesia, sutures are not required, healing is quick, cosmetic outcome is usually excellent, costs are minimal, and complications are uncommon. The benefits of infant circumcision include prevention of urinary tract infections (a cause of renal scarring, reduction in risk of inflammatory foreskin conditions such as balanoposthitis, foreskin injuries, phimosis and paraphimosis. When the boy later becomes sexually active he has substantial protection against risk of HIV and other viral sexually transmitted infections such as genital herpes and oncogenic human papillomavirus, as well as penile cancer. The risk of cervical cancer in his female partner(s is also reduced. Circumcision in adolescence or adulthood may evoke a fear of pain, penile damage or reduced sexual pleasure, even though unfounded. Time off work or school will be needed, cost is much greater, as are risks of complications, healing is slower, and stitches or tissue glue must be used. Summary Infant circumcision is safe, simple, convenient and cost-effective. The available evidence strongly supports infancy as the optimal time for circumcision.

  20. The Strong Protective Effect of Circumcision against Cancer of the Penis

    Directory of Open Access Journals (Sweden)

    Brian J. Morris

    2011-01-01

    Full Text Available Male circumcision protects against cancer of the penis, the invasive form of which is a devastating disease confined almost exclusively to uncircumcised men. Major etiological factors are phimosis, balanitis, and high-risk types of human papillomavirus (HPV, which are more prevalent in the glans penis and coronal sulcus covered by the foreskin, as well as on the penile shaft, of uncircumcised men. Circumcised men clear HPV infections more quickly. Phimosis (a constricted foreskin opening impeding the passage of urine is confined to uncircumcised men, in whom balanitis (affecting 10% is more common than in circumcised men. Each is strongly associated with risk of penile cancer. These findings have led to calls for promotion of male circumcision, especially in infancy, to help reduce the global burden of penile cancer. Even more relevant globally is protection from cervical cancer, which is 10-times more common, being much higher in women with uncircumcised male partners. Male circumcision also provides indirect protection against various other infections in women, along with direct protection for men from a number of genital tract infections, including HIV. Given that adverse consequences of medical male circumcision, especially when performed in infancy, are rare, this simple prophylactic procedure should be promoted.

  1. Circumcision Is Unethical and Unlawful.

    Science.gov (United States)

    Svoboda, J Steven; Adler, Peter W; Van Howe, Robert S

    2016-06-01

    The foreskin is a complex structure that protects and moisturizes the head of the penis, and, being the most densely innervated and sensitive portion of the penis, is essential to providing the complete sexual response. Circumcision-the removal of this structure-is non-therapeutic, painful, irreversible surgery that also risks serious physical injury, psychological sequelae, and death. Men rarely volunteer for it, and increasingly circumcised men are expressing their resentment about it.Circumcision is usually performed for religious, cultural and personal reasons. Early claims about its medical benefits have been proven false. The American Academy of Pediatrics and the Centers for Disease Prevention and Control have made many scientifically untenable claims promoting circumcision that run counter to the consensus of Western medical organizations.Circumcision violates the cardinal principles of medical ethics, to respect autonomy (self-determination), to do good, to do no harm, and to be just. Without a clear medical indication, circumcision must be deferred until the child can provide his own fully informed consent.In 2012, a German court held that circumcision constitutes criminal assault. Under existing United States law and international human rights declarations as well, circumcision already violates boys› absolute rights to equal protection, bodily integrity, autonomy, and freedom to choose their own religion. A physician has a legal duty to protect children from unnecessary interventions. Physicians who obtain parental permission through spurious claims or omissions, or rely on the American Academy of Pediatrics' position, also risk liability for misleading parents about circumcision. PMID:27338602

  2. Impact of circumcision on the sexual function of adult patients with phimosis%包皮环切术对成年包茎患者性功能的影响

    Institute of Scientific and Technical Information of China (English)

    韩精超; 白焱; 张继伟; 夏溟; 蔡建良; 何群

    2015-01-01

    Objectives:To investigate the adult patients’sexual life after phimosis circumcision.Meth-ods:216 patients were investigated on erectile function changes,masturbation frequency,frequency of sexual inter-course,sexual intercourse,pain during intercourse,and other aspects by questionnaire before and after circumcision respectively.Results:There was no obvious difference in the postoperative International Index of Erectile Function-5 (IIEF -5)and the frequency of sexual intercourse,but the difference in sexual intercourse,pain during inter-course and masturbation frequency were statistically significant.Conclusion:Circumcision can improve the erectile function in patients with phimosis,prolong sexual intercourse,reduce the frequency of painful intercourse and mas-turbation,thereby enhancing their sexual satisfaction.%目的:评价包皮环切术对成年包茎患者性功能的影响。方法:采用问卷调查的方法对216例施行包皮环切术的成年包茎患者手术前后勃起功能、手淫频率、性交频率、性交时间、性交疼痛等方面的变化进行随访。结果:手术前后患者国际勃起功能指数-5(IIEF -5)、性交频率之间的差异均无统计学意义,而性交时间、性交疼痛和手淫频率之间的差异均有统计学意义。结论:包皮环切术对改善包茎患者性功能有一定帮助,可延长性交时间,减少性交疼痛和手淫频率,提高性生活的质量。

  3. Fertility of male adult rats submitted to forced swimming stress

    Directory of Open Access Journals (Sweden)

    G.Z. Mingoti

    2003-05-01

    Full Text Available We investigated whether stress interferes with fertility during adulthood. Male Wistar rats (weighing 220 g in the beginning of the experiment were forced to swim for 3 min in water at 32ºC daily for 15 days. Stress was assessed by the hot-plate test after the last stressing session. To assess fertility, control and stressed males (N = 15 per group were mated with sexually mature normal females. Males were sacrificed after copulation. Stress caused by forced swimming was demonstrated by a significant increase in the latency of the pain response in the hot-plate test (14.6 ± 1.25 s for control males vs 26.0 ± 1.53 s for stressed males, P = 0.0004. No changes were observed in body weight, testicular weight, seminal vesicle weight, ventral prostate weight or gross histological features of the testes of stressed males. Similarly, no changes were observed in fertility rate, measured by counting live fetuses in the uterus of normal females mated with control and stressed males; no dead or incompletely developed fetuses were observed in the uterus of either group. In contrast, there was a statistically significant decrease in spermatid production demonstrated by histometric evaluation (154.96 ± 5.41 vs 127.02 ± 3.95 spermatids per tubular section for control and stressed rats, respectively, P = 0.001. These data demonstrate that 15 days of forced swimming stress applied to adult male rats did not impair fertility, but significantly decreased spermatid production. This suggests that the effect of stress on fertility should not be assessed before at least the time required for one cycle of spermatogenesis.

  4. Dietary glucose regulates yeast consumption in adult Drosophila males

    Directory of Open Access Journals (Sweden)

    Sebastien eLebreton

    2014-12-01

    Full Text Available The adjustment of feeding behavior in response to hunger and satiety contributes to homeostatic regulation in animals. The fruit fly Drosophila melanogaster feeds on yeasts growing on overripe fruit, providing nutrients required for adult survival, reproduction and larval growth. Here, we present data on how the nutritional value of food affects subsequent yeast consumption in Drosophila adult males. After a period of starvation, flies showed intensive yeast consumption. In comparison, flies stopped feeding after having access to a nutritive cornmeal diet. Interestingly, dietary glucose was equally efficient as the complex cornmeal diet. In contrast, flies fed with sucralose, a non-metabolizable sweetener, behaved as if they were starved. The adipokinetic hormone and insulin-like peptides regulate metabolic processes in insects. We did not find any effect of the adipokinetic hormone pathway on this modulation. Instead, the insulin pathway was involved in these changes. Flies lacking the insulin receptor did not respond to nutrient deprivation by increasing yeast consumption. Together these results show the importance of insulin in the regulation of yeast consumption in response to starvation in adult D. melanogaster males.

  5. Dietary glucose regulates yeast consumption in adult Drosophila males.

    Science.gov (United States)

    Lebreton, Sébastien; Witzgall, Peter; Olsson, Marie; Becher, Paul G

    2014-01-01

    The adjustment of feeding behavior in response to hunger and satiety contributes to homeostatic regulation in animals. The fruit fly Drosophila melanogaster feeds on yeasts growing on overripe fruit, providing nutrients required for adult survival, reproduction and larval growth. Here, we present data on how the nutritional value of food affects subsequent yeast consumption in Drosophila adult males. After a period of starvation, flies showed intensive yeast consumption. In comparison, flies stopped feeding after having access to a nutritive cornmeal diet. Interestingly, dietary glucose was equally efficient as the complex cornmeal diet. In contrast, flies fed with sucralose, a non-metabolizable sweetener, behaved as if they were starved. The adipokinetic hormone and insulin-like peptides regulate metabolic processes in insects. We did not find any effect of the adipokinetic hormone pathway on this modulation. Instead, the insulin pathway was involved in these changes. Flies lacking the insulin receptor (InR) did not respond to nutrient deprivation by increasing yeast consumption. Together these results show the importance of insulin in the regulation of yeast consumption in response to starvation in adult D. melanogaster males. PMID:25566097

  6. Patient-specific FDG dosimetry for adult males, adult females, and very low birth weight infants

    Science.gov (United States)

    Niven, Erin

    Fluorodeoxyglucose is the most commonly used radiopharmaceutical in Positron Emission Tomography, with applications in neurology, cardiology, and oncology. Despite its routine use worldwide, the radiation absorbed dose estimates from FDG have been based primarily on data obtained from two dogs studied in 1977 and 11 adults (most likely males) studied in 1982. In addition, the dose estimates calculated for FDG have been centered on the adult male, with little or no mention of variations in the dose estimates due to sex, age, height, weight, nationality, diet, or pathological condition. Through an extensive investigation into the Medical Internal Radiation Dose schema for calculating absorbed doses, I have developed a simple patient-specific equation; this equation incorporates the parameters necessary for alterations to the mathematical values of the human model to produce an estimate more representative of the individual under consideration. I have used this method to determine the range of absorbed doses to FDG from the collection of a large quantity of biological data obtained in adult males, adult females, and very low birth weight infants. Therefore, a more accurate quantification of the dose to humans from FDG has been completed. My results show that per unit administered activity, the absorbed dose from FDG is higher for infants compared to adults, and the dose for adult women is higher than for adult men. Given an injected activity of approximately 3.7 MBq kg-1, the doses for adult men, adult women, and full-term newborns would be on the order of 5.5, 7.1, and 2.8 mSv, respectively. These absorbed doses are comparable to the doses received from other nuclear medicine procedures.

  7. The Strong Protective Effect of Circumcision against Cancer of the Penis

    OpenAIRE

    Morris, Brian J.; Gray, Ronald H.; Xavier Castellsague; F. Xavier Bosch; Halperin, Daniel T.; Waskett, Jake H; Hankins, Catherine A.

    2011-01-01

    Male circumcision protects against cancer of the penis, the invasive form of which is a devastating disease confined almost exclusively to uncircumcised men. Major etiological factors are phimosis, balanitis, and high-risk types of human papillomavirus (HPV), which are more prevalent in the glans penis and coronal sulcus covered by the foreskin, as well as on the penile shaft, of uncircumcised men. Circumcised men clear HPV infections more quickly. Phimosis (a constricted foreskin opening imp...

  8. 男男性接触者包皮环切术接受意愿调查%Acceptability of male circumcision among men who have sex with men

    Institute of Scientific and Technical Information of China (English)

    徐俊杰; 张旻; 楚振兴; 胡清海; 刘静; 丁海波; 赵彬; 尚红

    2009-01-01

    目的 了解男男性接触者(MSM)对进行包皮环切术(Male Circumcision,MC)的接受意愿.方法 2008年8-9月,通过"滚雪球"和方便抽样招募方式对辽宁省沈阳市123名MSM进行访谈式问卷调查.结果 123名调查对象中,61.8%的MSM存在异性性伴,其中57.9%在最近1个月与女性性伴的性行为中未使用安全套.4.9%的MSM曾接受过包皮环切手术.未进行过包皮环切术的MSM中47.O%愿意接受MC.而对于免费提供的MC,接受比例为60.0%.Logistic回归分析显示,存在包茎现象及认为包皮环切可预防性病感染与MSM愿意接受MC存在显著的关联性(P<0.05).结论 MSM存在向其异性性伴传播人类免疫缺陷病毒(HIV)的危险性.MC干预可降低MSM的HIV感染率及向普通人群传播的风险.

  9. 广西艾滋病高发区一般人群对包皮环切术认知宣教初步研究%Benefits of promoting male circumcision among the general population in the high HIV prevalence areas of Guangxi Province

    Institute of Scientific and Technical Information of China (English)

    韦富梅; 徐娜; 韦波; 张志勇; 梁浩; 杨晓波; 蒋俊俊; 袁湘意; 陈义海; 林兆森; 黄秀清; 庞耀; 韦所苏

    2012-01-01

    Objective; To evaluate the effect of promoting male circumcision among the general population in the high HIV prevalence areas of Guangxi Province. Methods; We interviewed 590 male residents from Hezhou and Qinzhou areas of Guangxi Province and conducted intervention using male circumcision promotion materials and various methods. If the subjects were willing and had no contraindication, they were referred to the appointed hospitals to receive circumcision. We conducted follow-up visits at 6 and 9 months after intervention for the changes in the subjects'knowledge, attitude and practice related to male circumcision. Results; The male circumcision knowledge, willingness and operation rate were significantly improved after intervention ( P 0.05). The number of those who knew that phimosis and redundant prepuce were the reasons for circumcision increased from 66. 1% at baseline to 81.9% and 79. 8% at the two follow-up visits; those who knew that circumcision could prevent AIDS and sexually transmitted diseases increased from 28.0% to 77.4% and 78.6% ; those who knew that surgical complications could be pain, bleeding and infection increased from 29. 5% , 19.3% and 39.3% to 72.5% , 58.2% and 59.4% at the first follow-up and 75.0% , 57,0% and 63.0% at the second; those who were willing to receive circumcision increased from 35.3% at baseline to 59.6% and 61.3% at the two follow-up visits; and the rate of surgery increased from zero to 12.7% and 16.1 %. Conclusion: The promotion of male circumcision among the general population in the high HIV prevalence areas of Guangxi Province significantly improved their knowtedge, attitude and practice related to AIDS prevention. And the promotion activities should focus on the publicity of AIDS knowledge, risks of phimosis and redundant prepuce, and safety of circumcision.%目的:在广西艾滋病高发区一般人群中评价包皮环切术推广的效果,为推广包皮环切术提供参考依据.方法:在

  10. Photometric facial analysis of the Igbo Nigerian adult male

    Directory of Open Access Journals (Sweden)

    Ukoha Ukoha Ukoha

    2012-01-01

    Full Text Available Background: A carefully performed facial analysis can serve as a strong foundation for successful facial reconstructive and plastic surgeries, rhinoplasty or orthodontics. Aim: The purpose of this study is to determine the facial features and qualities of the Igbo Nigerian adult male using photometry. Materials and Methods: One hundred and twenty subjects aged between 18 and 28 years were studied at the Anambra State University, Uli, Nigeria. The frontal and right lateral view photographs of their faces were taken and traced out on tracing papers. On these, two vertical distances, nasion to subnasal and subnasale to menton, and four angles, nasofrontal (NF, nasofacial, nasomental (NM and mentocervical, were measured. Results: The result showed that the Igbo Nigerian adult male had a middle face that was shorter than the lower one (41.76% vs.58.24%, a moderate glabella (NF=133.97°, a projected nose (NM=38.68° and a less prominent chin (NM=125.87°. Conclusion: This study is very important in medical practice as it can be used to compare the pre- and post-operative results of plastic surgery and other related surgeries of the face.

  11. Risk factors for adult male criminality in Colombia.

    Science.gov (United States)

    Klevens, Joanne; Roca, Juanita; Restrepo, Ofelia; Martinez, Adriana

    2001-01-01

    OBJECTIVES: This study sought to establish, in Colombia, the importance of factors alleged to be causes or correlates of adult criminality according to the published literature from other countries. METHODS: A comparison was made of arrested male offenders from ages 18 to 30 (n = 223) and similar community controls (n = 222) selected from five cities in Colombia as to their family background, exposure to abuse, family stressors, perceived care and history of childhood disruptive behaviour problems. RESULTS: Compared with neighbourhood controls from similar social classes, offenders were significantly more likely to report having had parents with less education, a mother under the age of 18 or over the age of 35 at time of birth, family members involved in crime, experiencing extreme economic deprivation, parental absence, family conflict, severe punishments, physical abuse, and maternal unavailability, rejection and lack of supervision. Prevalence of childhood disruptive behaviour problems was similar among offenders and controls. These findings appear to be independent of economic status, family size or type, birth order, or primary caregiver. Although the independent contribution of most of these factors is small, once all others have been controlled for, their cumulative effect is strong. CONCLUSIONS: The findings obtained in this Latin American setting do not support the generalized view that adult antisocial behaviour is necessarily preceded by a history of childhood behaviour problems. However, they do add evidence for the importance of family factors in the risk for adult criminality. PMID:12048531

  12. Fibrodysplasia Ossificans Progressiva in an Adult Indian Male

    Directory of Open Access Journals (Sweden)

    Rachit Harjai

    2014-08-01

    Full Text Available Following its first description by Guy Patin in 1692 as a disease that turned a woman into wood, Fibrodysplasia Ossificans Progressiva has maintained its low profile that too mainly in textbooks and rarely does one encounter a live walking individual affected by this entity. The hallmarks of this deadly disease are the short size of only the big toes and uninhibited progressive ossification of soft tissues. It can have a sporadic occurrence or may even be inherited through autosomal dominant pattern and has a wide range of expression. A wrong clinical diagnosis exposes the patient to unnecessary surgical excision and even harmful radiotherapy.Hence a case of Fibrodysplasia Ossificans Progressiva in an adult Indian male is being reported here for the benefit of one and all. [Cukurova Med J 2014; 39(4.000: 927-931

  13. Effect of piperine on the epididymis of adult male rats

    Institute of Scientific and Technical Information of China (English)

    S. C. D'cruz; P. P. Mathur

    2005-01-01

    Aim: To study the effect of piperine on the epididymal antioxidant system of adult male rats. Methods: Adult male rats were orally administered piperine at doses of 1 mg/kg, 10 mg/kg and 100 mg/kg body weight each day for 30consecutive days. Twenty-four hours after the last treatment, the rats were weighed and killed with ether and the epididymis was dissected from the bodies. Sperm collected from the cauda region of the epididymis was used for the assessment of its count, motility and viability. Caput, corpus and cauda regions of the epididymis were separated and homogenized separately to obtain 10 % homogenates. The supernatants were used for the assays of sialic acid,superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, lipid peroxidation and hydrogen peroxide generation. Results: Body weight of the piperine-treated rats remained unchanged. The weights of the caput,corpus and cauda regions of the epididymis significantly decreased at dose of 100 mg/kg. Epididymal sperm count and motility decreased at 10 mg/kg and 100 mg/kg, and sperm viability decreased significantly at 100 mg/kg. Sialic acid levels in the epididymis decreased significantly at 100 mg/kg while significant decrease in the cauda region alone was observed at 10 mg/kg. A significant decline in the activities of superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase, along with an increase in hydrogen peroxide generation and lipid peroxidation were observed at 10 mg/kg and 100 mg/kg. Conclusion: Piperine caused a decrease in the activity of antioxidant enzymes and sialic acid levels in the epididymis and thereby increased reactive oxygen species levels that could damage the epididymal environment and sperm function.

  14. Voice-Message–Based mHealth Intervention to Reduce Postoperative Penetrative Sex in Recipients of Voluntary Medical Male Circumcision in the Western Cape, South Africa: Protocol of a Randomized Controlled Trial

    Science.gov (United States)

    Skinner, Donald; Toefy, Yoesrie; Esterhuizen, Tonya; McCaul, Michael; Petzold, Max; Diwan, Vinod

    2016-01-01

    Background There is an increased risk of transmission of sexually transmitted infections (STIs), including HIV, in the postoperative period after receiving voluntary medical male circumcision (VMMC). In South Africa, over 4 million men are being targeted with VMMC services but the health system is not able to offer quality counseling. More innovative strategies for communicating with and altering behavior in men and their partners in the postoperative period after VMMC are needed. Objective This paper presents a study protocol to test the effectiveness of an mHealth intervention designed to task-shift behavior change communication from health care personnel to an automated phone message system, encouraging self-care. Methods A single-blind, randomized controlled trial will be used. A total of 1188 participants will be recruited by nurses or clinicians at clinics in the study districts that have a high turnover of VMMC clients. The population will consist of men aged 18 years and older who indicate at the precounseling session that they possess a mobile phone and consent to participating in the study. Consenting participants will be randomized into either the control or intervention arm before undergoing VMMC. The control arm will receive the standard of care (pre- and postcounseling). The intervention arm will received standard of care and will be sent 38 messages over the 6-week recovery period. Patients will be followed up after 42 days. The primary outcome is self-reported sexual intercourse during the recovery period. Secondary outcomes include nonpenetrative sexual activity, STI symptoms, and perceived risk of acquiring HIV. Analysis will be by intention-to-treat. Results Enrollment is completed. Follow-up is ongoing. Loss to follow-up is under 10%. No interim analyses have been conducted. Conclusions The intervention has the potential of reducing risky sexual behavior after VMMC. The platform itself can be used for many other areas of health that require task

  15. Traumatic neuroma of the penis after circumcision--Case report.

    Science.gov (United States)

    Cardoso, Thaís Abrão; dos Santos, Karen Regina; Franzotti, Aline Martinez; Avelar, Juliana Centofanti Dentello; Tebcherani, Antonio José; Pegas, José Roberto Pereira

    2015-01-01

    Traumatic neuromas are tumors resulting from hyperplasia of axons and nerve sheath cells after section or injury to the nervous tissue. We present a case of this tumor, confirmed by anatomopathological examination, in a male patient with history of circumcision. Knowledge of this entity is very important in achieving the differential diagnosis with other lesions that affect the genital area such as condyloma acuminata, bowenoid papulosis, lichen nitidus, sebaceous gland hyperplasia, achrochordon and pearly penile papules. PMID:26131873

  16. Traumatic neuroma of the penis after circumcision - Case report*

    Science.gov (United States)

    Cardoso, Thaís Abrão; dos Santos, Karen Regina; Franzotti, Aline Martinez; Avelar, Juliana Centofanti Dentello; Tebcherani, Antonio José; Pegas, José Roberto Pereira

    2015-01-01

    Traumatic neuromas are tumors resulting from hyperplasia of axons and nerve sheath cells after section or injury to the nervous tissue1. We present a case of this tumor, confirmed by anatomopathological examination, in a male patient with history of circumcision. Knowledge of this entity is very important in achieving the differential diagnosis with other lesions that affect the genital area such as condyloma acuminata, bowenoid papulosis, lichen nitidus, sebaceous gland hyperplasia, achrochordon and pearly penile papules. PMID:26131873

  17. Can circumcision prevent recurrent urinary tract infections in hospitalized infants?

    Science.gov (United States)

    Cason, D L; Carter, B S; Bhatia, J

    2000-12-01

    Urinary tract infection (UTI) is an uncommon but concerning condition for hospitalized premature infants. A retrospective chart review of all male infants admitted to the neonatal intensive care unit (NICU) from June 1996 through March 1999 was conducted at the Medical College of Georgia--a large academic medical center with a tertiary Level III NICU--to investigate the frequency and potential prevention of recurrent UTI in hospitalized infants. The effect of circumcision on recurrence of UTI was also investigated. There were 38 infants with 53 UTIs among 744 male infants admitted during the study period (5.1%). Infants were divided into two groups: A1 UTI and A2 UTI. In groups A1 and A2, 57% of the first UTIs were due to Candida or E. coli, the remaining were due to other gram-negative organisms and Staphylococcus species. Mean gestational age (GA) in groups A1 and A2 were similar (29 +/- 2 weeks, and 29 +/- 4 weeks); however, mean GA of infants with Candida UTI was 27 +/- 2 weeks, and for bacterial UTI, 30 +/- 3 weeks (pUTI once a circumcision was performed. Premature uncircumcised males had an increased risk for UTI (Odds Ratio=11.1, 95% CI, 3.3-28.9, pCircumcision appears beneficial in reducing the risk for recurrent UTI in these infants.

  18. The effect of circumcision on the frequency of urinary tract infection, growth and nutrition status in infants with antenatal hydronephrosis.

    Science.gov (United States)

    Kose, Engin; Yavascan, Onder; Turan, Ozlem; Kangin, Murat; Bal, Alkan; Alparslan, Caner; Sirin Kose, Seda; Kuyum, Pinar; Aksu, Nejat

    2013-01-01

    The objective of this study was to determine the effect of circumcision on the frequency of urinary tract infection (UTI), growth development, and the nutrition status in infants with antenatal hydronephrosis (AH). The data were collected prospectively between 1998 and 2010. Infants with a fetal pelvis diameter of >5 mm identified with antenatal ultrasound were followed-up. Body height and weight were expressed as HZ scores (observed height - median height/standard deviation) and WZ scores (observed weight - median weight/Standard deviation). The nutritional status was evaluated and the body weight was transformed to a weight-for-height index (WHI = weight/median weight for the height age × 100). The HZ and WZ scores or WHI were calculated for each patient at the first and last visits. The chi-square and Student's t tests were used for statistical analysis. A p value circumcised. The mean monitoring time was 45±24.9 months and the mean age of circumcision was 14 ± 16.06 months. The pre-circumcision UTI frequency (2.97 ± 1.14/y) was significantly higher than post-circumcision period (0.25 ± 0.67/y) (p circumcision UTI frequency (2.97 ± 1.14/y) was significantly higher than the UTI frequency observed in female cases (0.85 ± 0.91/y) and in the overall study group (0.73 ± 0.79/y) (p circumcised subjects (0.18 ± 1.01) was statistically higher than uncircumcised subjects (-0.26 ± 0.92) (p circumcised males (0.13 ± 1.24) with VUR was higher than the uncircumcised patients (0.03 ± 0.55) (p > 0.05). In obstructive uropathy groups, the HZ of the circumcised males (-0.13 ± 0.54) was also found to be higher than uncircumcised males (-0.49 ± 0.66) (p circumcised males, no statistically significant effect of circumcision on the nutrition status was detected. In conclusion, postnatal early circumcision of infants with AH seems to prevent frequent UTIs and nutritional disturbances enabling

  19. Dobutamine stress echocardiography in healthy adult male rats

    Directory of Open Access Journals (Sweden)

    Couet Jacques

    2005-10-01

    Full Text Available Abstract Background Dobutamine stress echocardiography is used to investigate a wide variety of heart diseases in humans. Dobutamine stress echocardiography has also been used in animal models of heart disease despite the facts that the normal response of healthy rat hearts to this type of pharmacological stress testing is unknown. This study was performed to assess this normal response. Methods 15 normal adult male Wistar rats were evaluated. Increasing doses of dobutamine were infused intravenously under continuous imaging of the heart by a 12 MHz ultrasound probe. Results Dobutamine stress echocardiography reduced gradually LV diastolic and systolic dimensions. Ejection fraction increased by a mean of +24% vs. baseline. Heart rate increased progressively without reaching a plateau. Changes in LV dimensions and ejection fraction reached a plateau after a mean of 4 minutes at a constant infusion rate. Conclusion DSE can be easily performed in rats. The normal response is an increase in heart rate and ejection fraction and a decrease in LV dimensions. A plateau in echocardiographic measurements is obtained after 4 minutes of a constant infusion rate in most animals.

  20. Loud calls of adult male red howling monkeys (Alouatta seniculus).

    Science.gov (United States)

    Schön Ybarra, M A

    1986-01-01

    Loud calls of adult male red howlers (Alouatta seniculus) inhabiting a deciduous and semideciduous open woodland site in Venezuela were recorded opportunistically and categorized by ear and sonographically as barks and roars. Five to six different bark syllables were identified as occurring singly or in sequences of doublets and triplets. In barks, spectral energy was concentrated in bands at 350-400 Hz, 900-1,100 Hz, 1,800-2,200 Hz and 3,000-3,500 Hz, but not all higher bands were present in each syllable. Roars appeared sonographically like prolonged barks composed of a pulsated preface, a long legato climax and a brief, fractionated and at times pulsated coda; each part varied internally to the ear and in acoustic structure. All loud calls were of the noisy type (nonharmonic energy over a broad frequency range). Acoustic characteristics of the calls are interpreted in terms of the subserving vocal tract anatomy. I compare loud calls of red howlers with those of mantled (A. palliata) and black (A. caraya) howlers. PMID:3609972

  1. Complications of Circumcision: Report of Four Cases

    OpenAIRE

    S Delshad

    1997-01-01

    Circumcision is a common surgical procedure in the world. It seems to prevent phimosis, urinary tract infection, transsexual diseases, adhesion between foreskin and glans, and the possibility of penis and uterus cervical cancer. In addition to Jews and Muslims, who practice circumcision as a religious ritual, a remarkable percentage of Christians also take advantage of the prophylactic effect of the procedure. The complications of circumcision are not numerous but some may be serious. In this...

  2. Personality Profiles of Adult Males Sexually Molested by Their Maternal Caregivers: Preliminary Findings.

    Science.gov (United States)

    Roys, Deloris T.; Timms, Robert J.

    1995-01-01

    Examined two groups of adult males who had been sexually abused as children by female maternal caregivers: those in treatment at a clinic specializing in sexual abuse survivor work, and those in treatment at a clinic specializing in sexual offender work. These groups show greater psychological disruption than adult males who as children had not…

  3. File list: NoD.Adl.05.AllAg.Adult_male_fatbody [Chip-atlas[Archive

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  11. Pubertal Timing and Growth Influences Cardiometabolic Risk Factors in Adult Males and Females

    OpenAIRE

    Widén, Elisabeth; Silventoinen, Karri; Sovio, Ulla; Ripatti, Samuli; Cousminer, Diana L.; Hartikainen, Anna-Liisa; Laitinen, Jaana; Pouta, Anneli; Kaprio, Jaakko; Järvelin, Marjo-Riitta; Peltonen, Leena; Palotie, Aarno

    2012-01-01

    OBJECTIVE Early pubertal onset in females is associated with increased risk for adult obesity and cardiovascular disease, but whether this relationship is independent of preceding childhood growth events is unclear. Furthermore, the association between male puberty and adult disease remains unknown. To clarify the link between puberty and adult health, we evaluated the relationship between pubertal timing and risk factors for type 2 diabetes and cardiovascular disease in both males and female...

  12. Urosepsis and postrenal acute renal failure in a neonate following circumcision with Plastibell device

    Science.gov (United States)

    McQueen, Derrick; Sykes, Joseph; Phatak, Tej; Malik, Farhaan; Raghava, Preethi S.

    2015-01-01

    Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut. Necrosis of penile skin, followed by urethral obstruction and renal failure, is a serious surgical mishap requiring immediate corrective surgery and medical attention. We report a case of fulminant urosepsis, acute renal failure, and pyelonephritis in a 4-day-old male neonate secondary to impaction of a Plastibell circumcision device. Immediate medical management was initiated with fluid resuscitation and mechanical ventilation; thereby correcting life threatening complications. Pediatricians and Emergency Department physicians should be cognizant of the complications from Plastibell circumcision device in order to institute appropriate and timely management in neonates. PMID:25932038

  13. Longer-Term Follow-Up of Kenyan Men Circumcised Using the ShangRing Device.

    Directory of Open Access Journals (Sweden)

    Paul J Feldblum

    Full Text Available To ascertain clinical sequelae, client satisfaction and sexual behavior 2+ years after male circumcision using the ShangRing device.We enrolled 199 men from the Kenya sites (Homa Bay district participating in a 2012 study of the ShangRing device used in routine male circumcision services (N = 552. We enrolled men who had had the ShangRing placed successfully, and over-sampled men who had had an adverse event and/or were HIV-positive during the field study. In the present study, each participant was examined and interviewed by a study clinician, and penile photographs were taken to document longer-term cosmetic results and any abnormal findings.194 men were included in the analysis. The mean and median times between circumcision and the longer-term follow-up visit in this study were 31.8 and 32 months, respectively. Four men (2.1% had signs/symptoms of a sexually transmitted infection (STI. Virtually all (99.5% of the men were very satisfied with the appearance of their circumcised penis, and all would recommend a ShangRing circumcision to friends or family members. The most prevalent reported advantage of the circumcision was the ease of bathing and enhanced cleanliness of the penis (75.8%. 94.3% of the men did not cite a single negative feature of their circumcision. 87.5% of men reported more sexual pleasure post-MC, the most common reason being more prolonged intercourse. The majority of men (52.6% reported one sexual partner post-MC, but more than a quarter of the men (28.1% reported an increased number of partners post-MC. Less than half of the men (44.3% reported using condoms half of the time or more, but the great majority of condom users stated that condom use was much easier post-MC, and 76.9% of users said they used condoms more after circumcision than before.This study supports the safety and acceptability of ShangRing male circumcision during 2-3 years of follow-up. It should allay worries that the ShangRing procedure could lead to

  14. Analysis on curative effect and safety of Shang ring circumcision%商环包皮切除术的疗效及安全性分析

    Institute of Scientific and Technical Information of China (English)

    肖卫忠; 潘森

    2016-01-01

    Objective To compare the curative effect and safety of Shang ring circumcision and conventional circumcision .Methods Retrospectively analyzed the clinical data of 329 adult patients who were admitted into our hospital from January 2013 to May 2015, including 205 cases of Shang ring circumcision and 124 cases of conventional circumcision .The operation time , intraoperative and postoperative VAS pain scores , intraoperative bleeding , wound healing time , complications , and degree of penile appearances and overall satisfaction between the two groups were compared .Results Compared with conventional circumcision , Shang ring circumcision was associated with shorter oper-ative time, less intraoperative blood loss , lower intraoperative and postoperative VAS pain scores , lower adverse event rate , higher penile ap-pearances and overall satisfaction , and the difference was statistically significant (P<0.05).Conclusion Shang ring circumcision may be a safer and more effective choice in comparison with conventional circumcision for male patients , as it can shorten the time of operation and save the cost of health care .%目的:比较商环包皮切除术与传统包皮切除术的临床效果及手术安全性。方法回顾性分析2013年1月至2015年5月于我院行包皮切除术的329例成年患者的临床资料,其中205例行商环包皮切除术,另外124例行传统包皮环切术,对比分析2组手术时间、术中及术后VAS疼痛评分、术中出血量、切口愈合时间、并发症以及阴茎外观满意度和总体满意度。结果商环包皮切除术在手术时间、术中出血量、术中及术后疼痛评分、总体并发症发生率、阴茎外观满意度及总体满意度上均明显优于传统包皮切除术,差异具有统计学意义(P<0.05)。结论与传统包皮切除术相比,商环包皮切除术具有更好的手术效果和较高的安全性,并能明显缩短手术时间,节约医疗成本。

  15. Fertility of male adult rats submitted to forced swimming stress

    OpenAIRE

    Mingoti G.Z.; Pereira R.N.; Monteiro C.M.R.

    2003-01-01

    We investigated whether stress interferes with fertility during adulthood. Male Wistar rats (weighing 220 g in the beginning of the experiment) were forced to swim for 3 min in water at 32ºC daily for 15 days. Stress was assessed by the hot-plate test after the last stressing session. To assess fertility, control and stressed males (N = 15 per group) were mated with sexually mature normal females. Males were sacrificed after copulation. Stress caused by forced swimming was demonstrated by a s...

  16. Alaska northern fur seal adult male satellite telemetry data, 2009-2010

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set is comprised of satellite-linked telemetry data collected to investigate winter migration patterns and foraging strategies of adult male northern fur...

  17. PREPUBERTAL EXPOSURES TO COMPOUNDS THAT INCREASE PROLACTIN SECRETION IN THE MALE RAT: EFFECTS ON ADULT PROSTATE

    Science.gov (United States)

    Prepubertal exposure to compounds that increase prolactin secretion in the male rat: effects on the adult prostate.Stoker TE, Robinette CL, Britt BH, Laws SC, Cooper RL.Endocrinology Branch, Reproductive Toxicology Division, National Health and Environmental Effec...

  18. Combination of Circumcision and Microwave in Treatment of Genital Warts in Uncircumcised Patients

    Institute of Scientific and Technical Information of China (English)

    樊翌明; 马泽粦; 吴志华; 李顺凡; 陈秋霞

    2003-01-01

    Objective: To investigate the efficacy of combina-tion of circumcision and microwave on genital warts in uncircumcised men.Methods: A randomized, prospective study of 109 uncircumcised adult men with genital warts was con-ducted in a STD clinic in Zhanjiang, Guangdong. One group (n=54) received microwave therapy only, while the other group (n=55) was taken the combination of circumcision and microwave therapy. The recurrences were observed at the end of months 3, 6 and 12, and operative complications were also recorded.Results: There were no significant differences in the mean age and duration of the disease between two groups (P>0.05). No serious operative complications were documented. The recurrence rate in circumci-sion plus microwave group was markedly lower than that in microwave group (12.7% vs 29.6%, PO.05).Conclusion: Circumcision can be safely performed under local anesthesia in an outpatient setting. Com-bination of circumcision and microwave can produce excellent effect as well as less tissue damage,therefore, it may be ideal for uncircumcised patients with extensive condvlomas.

  19. Depressive-Like Behavioral Response of Adult Male Rhesus Monkeys during Routine Animal Husbandry Procedure

    OpenAIRE

    Hennessy, Michael B.; Brenda McCowan

    2014-01-01

    Social isolation is a major risk factor for the development of depressive illness; yet, no practical nonhuman primate model is available for studying processes involved in this effect. In a first study, we noted that adult male rhesus monkeys housed individually indoors occasionally exhibited a hunched, depressive-like posture. Therefore, Study 2 investigated the occurrence of a hunched posture by adult males brought from outdoor social groups to indoor individual housing. We also scored two ...

  20. Chinmo is sufficient to induce male fate in somatic cells of the adult Drosophila ovary.

    Science.gov (United States)

    Ma, Qing; de Cuevas, Margaret; Matunis, Erika L

    2016-03-01

    Sexual identity is continuously maintained in specific differentiated cell types long after sex determination occurs during development. In the adult Drosophila testis, the putative transcription factor Chronologically inappropriate morphogenesis (Chinmo) acts with the canonical male sex determinant DoublesexM (Dsx(M)) to maintain the male identity of somatic cyst stem cells and their progeny. Here we find that ectopic expression of chinmo is sufficient to induce a male identity in adult ovarian somatic cells, but it acts through a Dsx(M)-independent mechanism. Conversely, the feminization of the testis somatic stem cell lineage caused by loss of chinmo is enhanced by expression of the canonical female sex determinant Dsx(F), indicating that chinmo acts in parallel with the canonical sex determination pathway to maintain the male identity of testis somatic cells. Consistent with this finding, ectopic expression of female sex determinants in the adult testis disrupts tissue morphology. The miRNA let-7 downregulates chinmo in many contexts, and ectopic expression of let-7 in the adult testis is sufficient to recapitulate the chinmo loss-of-function phenotype, but we find no apparent phenotypes upon removal of let-7 in the adult ovary or testis. Our finding that chinmo is necessary and sufficient to promote a male identity in adult gonadal somatic cells suggests that the sexual identity of somatic cells can be reprogrammed in the adult Drosophila ovary as well as in the testis. PMID:26811385

  1. Rett Syndrome Symptomatology of Institutionalized Adults with Mental Retardation: Comparison of Males and Females.

    Science.gov (United States)

    Burd, Larry; And Others

    1991-01-01

    The study of 297 institutionalized adults with mental retardation found no symptom of Rett syndrome occurred more frequently in males than in females and no single cluster of symptoms appeared to differentiate males from females. Only females were found to meet the necessary criteria for diagnosis of Rett syndrome. (Author/DB)

  2. High Fetal Estrogen Concentrations: Correlation with Increased Adult Sexual Activity and Decreased Aggression in Male Mice

    Science.gov (United States)

    Vom Saal, Frederick S.; Grant, William M.; McMullen, Carol W.; Laves, Kurt S.

    1983-06-01

    In the house mouse (Mus musculus), fetuses may develop in utero next to siblings of the same or opposite sex. The amniotic fluid of the female fetuses contains higher concentrations of estradiol than that of male fetuses. Male fetuses that developed in utero between female fetuses had higher concentrations of estradiol in their amniotic fluid than males that were located between other male fetusesw during intrauterine development. They were also more sexually active as adults, less aggressive, and had smaller seminal vesicles than males that had developed between other male fetuses in utero. These findings raise the possibility that during fetal life circulating estrogens may interact with circulating androgens both in regulating the development of sex differences between males and females and in producing variation in phenotype among males and among females.

  3. Adolescent social defeat alters neural, endocrine and behavioral responses to amphetamine in adult male rats

    OpenAIRE

    Burke, Andrew R.; Renner, Kenneth J.; Forster, Gina L.; Watt, Michael J.

    2010-01-01

    The mesocorticolimbic dopamine system, which governs components of reward and goal-directed behaviors, undergoes final maturation during adolescence. Adolescent social stress contributes to adult behavioral dysfunction, and is linked to adult psychiatric and addiction disorders. Here, behavioral, corticosterone, and limbic dopamine responses to amphetamine were examined in adult male rats previously exposed to repeated social defeat stress during mid-adolescence. Amphetamine (2.5 mg/kg, ip) w...

  4. [Severe Haemophilus influenzae b infection in healthy male adult

    DEFF Research Database (Denmark)

    Vilmar, A.C.; Gjorup, I.; David, Kim Peter

    2008-01-01

    Haemophilus influenzae b (Hib) can be the cause of serious infections, and is mainly observed affecting children and immuno-compromised patients. We report a case of a healthy 49-year old male with a severe Hib infection complicated by septicaemia, meningitis and anuria. The risk of invasive Hib...

  5. S-value of Radioiodine(131I) in Korean Reference Adult Male

    International Nuclear Information System (INIS)

    In order to better understand the effects of absorbed radioiodine upon Korean reference adult male, a mathematical phantom representation was contrived based on composite data of the physiology of Korean reference adult male. Using this, S-values of radioiodine() per each organ were calculated. The calculated S-values were compared to the existing data described in the TM-8381 report of ORNL calculated on the basis of an ICRP-23 reference male. The results indicated that S-values were higher for the phantom based on Korean reference adult male. The results of this study illustrate that, while the bio-chemical constitution of each source and target organ of the torso are important, the relative location of the organs and characteristics of the radionuclides also exert important influences.

  6. Vocalizations during electroejaculation in anaesthetized adult and young pampas deer (Ozotoceros bezoarticus) males.

    Science.gov (United States)

    Fumagalli, F; Damián, J P; Ungerfeld, R

    2015-04-01

    The aim of this study was to characterize the vocalizations produced during electroejaculation under general anaesthesia in pampas deer males and to determine whether the characteristics of those vocalizations differ in adult and young pampas deer males. Electroejaculation was applied to 13 adults (AM) and 13 young (YM) males under general anaesthesia. Vocalizations were digitally recorded, and the number and duration of vocalizations, the latency in relation to each voltage, the total time vocalizing, and the structure of the fundamental frequency (F0) [initial frequency (F(start)), maximal frequency (F(max)), minimal frequency (F(min)) and final frequency (F(end))] were analysed. No male vocalized with 0 V; the number of animals that vocalized increased at 2 and 3 V and increased again at 4, 5 and 6 V (p electroejaculation in pampas deer under general anaesthesia are related to the voltage applied during the process. Young males vocalize more time, probably due to a greater sensibility to the electric stimulation. The differences in the characteristics of the vocalizations between adult and young males may be related to the anatomic differences in the neck of adult or young males. PMID:25683788

  7. EFFECT OF SIMULATED WEIGHTLESSNESS ON REPRODUCTION OF ADULT MALE RATS

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Numerous studies had mainly focused on thehar mful effects of space environment on human be-ing's muscle,skeleton and blood circulation[1-3].However,the studies concerningthe effects of spaceenvironment on male reproduction are scare.The space environment is complicated,andweightlessness is one of the most i mportant healthrisk factors.Tail-suspension model is widely usedfor si mulated weightlessness in space health re-search[4].Therefore,the present study was designed toclarify the adverse effects of si mu...

  8. The social behavior of male rats administered an adult-onset calorie restriction regimen.

    Science.gov (United States)

    Govic, Antonina; Levay, Elizabeth A; Kent, Stephen; Paolini, Antonio G

    2009-03-23

    The behavioral outcomes of a calorie restricted diet are often neglected in favour of a more physiological examination of the consequences of calorie restriction (CR). This is especially the case with social behavior. A few findings within the maternal CR literature suggest that adult male social behavior is altered by this regimen. Despite the paucity of findings within the maternal CR literature, a systematic investigation of the behavioral phenotype of males administered an adult-onset CR is completely lacking and was the focus of the current study. Adult male hooded Wistar rats were administered a three week CR, with one group receiving a 25% CR and another group receiving a 50% CR before male-to-male social behavior was examined and compared with ad libitium fed males. Various behavioral elements were modulated by CR, both the CR25% and 50% group initiated contact sooner and engaged in greater social activity compared to the ad libitum fed controls. The CR25% group also demonstrated less non-social (self-grooming) behavior and a greater frequency of walkovers compared to all groups, indicating a propensity towards dominance. The CR50% group demonstrated greater environmental assessment/exploration, as measured by the frequency of rearing. As with the maternal CR literature, an adult-onset chronic CR induces a more socially active behavioral phenotype and reduces interest in non-social behavior in the moderately CR group. Taken together, the social behavioral phenotype can be modulated by a CR initiated and maintained during adulthood.

  9. Comparison of post circumcision complications and wound

    International Nuclear Information System (INIS)

    The objective of this study is to compare the frequency of post circumcision complications like bleeding and infection along with wound healing in infants by conventional open method and the bone-cutter method. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital and Military Hospital Rawalpindi, from March 2009 to March 2010. Patients and Methods: A total of 400 patients were included in the study that underwent circumcision. Patients were randomly allotted to either group A in whom the circumcision was done with conventional open technique (n = 200) or to group B, in whom circumcision was done with bone-cutter (n = 200). Patients were followed up in the surgical OPD after 5 days for assessment and earlier in case of any complication. Outcomes were measured by absence or presence of infection, post operative bleeding and cosmetic acceptance by the parents. Results: Comparison between the two groups showed that the bleeding rate was 8% in group A and 7% in group B (p = 0.704). Infection rate was 6% in group A and 5% in group B (p = 0.661). Delayed wound healing was seen in 4% of circumcisions in group A as opposed to 2% in group B ( p = 0.241). Conclusion: Complication is a part of any surgical procedure. So is the case with circumcision however no significant difference was found between the two procedures in terms of bleeding, infection, trauma to the glans and the cosmetic outcome. (author)

  10. Effect of naloxone on serum testosterone in adult male rabbits.

    Science.gov (United States)

    Pedrón, N; Pedroza, D; Calzada, L; Salazar, L; Fuentes, V

    1996-01-01

    Considerable evidence suggests that endogenous opioids may play an important role in the hypothalamic LH-releasing hormone. Administration of high doses of naloxone, an opiate antagonist, produces an increase in plasma concentration of LH. Naltrexone administration to healthy males produces an increase in both immunoactive and bioactive LH. The objective of the present work was to assess the effect of low doses of naloxone during 10 consecutive days on testosterone serum levels in rabbit. Three groups of five rabbits were injected with naloxone or saline. Naloxone was tested at 0.1 and 0.01 mg/kg day-1. Blood samples were taken at 90 min and 1, 2, 4, 7, 10, and 14 days after starting naloxone administration. Plasma testosterone (T) levels were measured by RIA. T levels increased progressively through the study in the experimental groups. The differences were significant after days 4 and 7 for 0.01-mg/kg and 0.1-mg/kg doses, respectively. T levels in both groups peaked at day 10 and decreased at day 14 (4 days after treatment). PMID:8827343

  11. Craniofacial norms in white adult males. Final report 1 Oct 80-30 Sep 83

    Energy Technology Data Exchange (ETDEWEB)

    Kapur, K.K.; Lestrel, P.

    1983-01-01

    The objective of this investigation was to establish clinical 'norms' of craniofacial skeletal orientation and the associated soft tissue facial profile for adult white males. Lateral and frontal cephalometric radiographs and study casts taken on 305 white males, with 28 or more teeth and 25-75 years of age, were used to develop these craniofacial standards. The goal of the research program has been to develop a computerized approach based upon dentofacial templates for the fabrication of complete dentures and to define clinical standards that can be applied in assessing the prosthodontic and orthodontic treatment needs of adult patients.

  12. Best Clinical Practices for Male Adult Survivors of Childhood Sexual Abuse: “Do No Harm”

    OpenAIRE

    Gallo-Silver, Les; Anderson, Christopher M; Romo, Jaime

    2014-01-01

    The health care literature describes treatment challenges and recommended alterations in practice procedures for female survivors of childhood sexual abuse, a subtype of adverse childhood experiences. Currently, there are no concomitant recommendations for best clinical practices for male survivors of childhood sexual abuse or other adverse clinical experiences. Anecdotal information suggests ways physicians can address the needs of adult male survivors of childhood sexual abuse by changes in...

  13. Validation of social skills of adolescent males in an interview conversation with a previously unknown adult.

    OpenAIRE

    Spence, S H

    1981-01-01

    Seventy convicted young male offenders were videotaped during a 5-min standardized interview with a previously unknown adult. In order to determine the social validity of the behavioral components of social interaction for this population, measures of 13 behaviors were obtained from the tapes. These measures were then correlated with ratings of friendliness, social anxiety, social skills performance, and employability made by four independent adult judges from the same tapes. It was found tha...

  14. A behavioral comparison of male and female adults with high functioning autism spectrum conditions.

    Directory of Open Access Journals (Sweden)

    Meng-Chuan Lai

    Full Text Available Autism spectrum conditions (ASC affect more males than females in the general population. However, within ASC it is unclear if there are phenotypic sex differences. Testing for similarities and differences between the sexes is important not only for clinical assessment but also has implications for theories of typical sex differences and of autism. Using cognitive and behavioral measures, we investigated similarities and differences between the sexes in age- and IQ-matched adults with ASC (high-functioning autism or Asperger syndrome. Of the 83 (45 males and 38 females participants, 62 (33 males and 29 females met Autism Diagnostic Interview-Revised (ADI-R cut-off criteria for autism in childhood and were included in all subsequent analyses. The severity of childhood core autism symptoms did not differ between the sexes. Males and females also did not differ in self-reported empathy, systemizing, anxiety, depression, and obsessive-compulsive traits/symptoms or mentalizing performance. However, adult females with ASC showed more lifetime sensory symptoms (p = 0.036, fewer current socio-communication difficulties (p = 0.001, and more self-reported autistic traits (p = 0.012 than males. In addition, females with ASC who also had developmental language delay had lower current performance IQ than those without developmental language delay (p<0.001, a pattern not seen in males. The absence of typical sex differences in empathizing-systemizing profiles within the autism spectrum confirms a prediction from the extreme male brain theory. Behavioral sex differences within ASC may also reflect different developmental mechanisms between males and females with ASC. We discuss the importance of the superficially better socio-communication ability in adult females with ASC in terms of why females with ASC may more often go under-recognized, and receive their diagnosis later, than males.

  15. Adult male circumcision for military men: History and future%军队男性包皮环切的历史回顾与展望

    Institute of Scientific and Technical Information of China (English)

    Philip Shihua LI; 吕年青; Puneet Masson; 黄宇烽; 孙颖浩

    2010-01-01

    成人包皮环切可以预防大多数生殖道感染,显著降低男性获得性HPV、HSV和HIV的感染风险.有关男性包皮环切对军队服役人员健康益处的报道很少.前线的士兵不能保持阴囊与包皮足够的局部卫生条件,容易受到感染,影响执行任务和作战,辅助治疗也会直接给军队增加开支.在服役期间和在派遣之前进行包皮环切可以节省大量时间和成本,对改善官兵生殖健康状况起到长效的益处.这些研究发现正在受到非洲各国军队卫生部门的重视,将成为未来军队卫生和服务的发展方向.在HIV流行可能恶化的亚洲,在军队倡导男性包皮环切术预防生殖道感染和性传播疾病,对提高战斗力和降低医疗成本,增进全社会公众健康状况与国民经济将具有十分显著的战略意义.

  16. Effect of methoprene application, adult food and feeding duration on male melon fly starvation survival

    Science.gov (United States)

    The application of methoprene and access to protein in adult diet has been shown to enhance mating success in male melon fly Bactrocera cucurbitae Coquillett (Diptera: Tephritidae), supporting their incorporation into operational area-wide programmes integrating the Sterile Insect Technique (SIT). T...

  17. The neuropsychology of male adults with high-functioning autism or Asperger syndrome

    NARCIS (Netherlands)

    C.E. Wilson; F. Happé; S.J. Wheelwright; C. Ecker; M.V. Lombardo; P. Johnston; E. Daly; C.M. Murphy; D. Spain; M-C. Lai; B Chakrabarti; D.A. Sauter; - MRC AIMS Consortium; S. Baron-Cohen; D.G.M. Murphy

    2014-01-01

    Autism Spectrum Disorder (ASD) is diagnosed on the basis of behavioral symptoms, but cognitive abilities may also be useful in characterizing individuals with ASD. One hundred seventy-eight high-functioning male adults, half with ASD and half without, completed tasks assessing IQ, a broad range of c

  18. Long term effects of parenting and family characteristics on delinquency of male young adults

    NARCIS (Netherlands)

    M. Hoeve; W. Smeenk; R. Loeber; M. Southamer-Loeber; P.H. van der Laan; J.R. Gerris; J.S. Dubas

    2007-01-01

    Drawing from the criminology literature and family studies, we investigated the long-term effects of established family risk factors and parenting styles on male young adult delinquency. We used data sets from two longitudinal studies, the Pittsburgh Youth Study (N474) and the Child-Rearing and Fami

  19. The Remodeling Process: A Grounded Theory Study of Perceptions of Treatment among Adult Male Incest Offenders.

    Science.gov (United States)

    Scheela, Rochelle A.

    1992-01-01

    Conducted grounded theory study to explore incest offender perceptions of treatment to generate explanatory theory of sexual abuse treatment process. Findings from theoretical sampling of 20 adult male incest offenders revealed that offenders felt remodeling process occurred as they faced discovery of their abuse and went through treatment.…

  20. Young Adult Male Satisfaction with Drug & Alcohol Rehabilitation Facilities: Interior Design Implications.

    Science.gov (United States)

    Potthoff, Joy K.

    1991-01-01

    Examined young adult male patient (n=18) satisfaction with interior environments of three different in-patient drug and alcohol rehabilitation facilities: renovated Elk's Club; hospital wing; and facility built for drug and alcohol treatment. Findings indicated satisfaction declined over four-week treatment period; familiar objects were missed;…

  1. A role for the adult fat body in Drosophila male courtship behavior.

    Directory of Open Access Journals (Sweden)

    Anna A Lazareva

    2007-01-01

    Full Text Available Mating behavior in Drosophila depends critically on the sexual identity of specific regions in the brain, but several studies have identified courtship genes that express products only outside the nervous system. Although these genes are each active in a variety of non-neuronal cell types, they are all prominently expressed in the adult fat body, suggesting an important role for this tissue in behavior. To test its role in male courtship, fat body was feminized using the highly specific Larval serum protein promoter. We report here that the specific feminization of this tissue strongly reduces the competence of males to perform courtship. This effect is limited to the fat body of sexually mature adults as the feminization of larval fat body that normally persists in young adults does not affect mating. We propose that feminization of fat body affects the synthesis of male-specific secreted circulating proteins that influence the central nervous system. In support of this idea, we demonstrate that Takeout, a protein known to influence mating, is present in the hemolymph of adult males but not females and acts as a secreted protein.

  2. Injury prevention for adult male soccer players. Blessure preventie voor volwassen, mannelijke voetballers

    NARCIS (Netherlands)

    Beijsterveldt, A.M.C. van

    2013-01-01

    Soccer causes the largest number of injuries each year (18% of all sports injuries) in the Netherlands. The aim of this dissertation is to contribute to the body of evidence on injury prevention for adult male soccer players. Chapter 1 is a general introduction and presents the “sequence of preventi

  3. Adolescent and Young Adult Male Sex Offenders: Understanding the Role of Recidivism

    Science.gov (United States)

    Riser, Diana K.; Pegram, Sheri E.; Farley, Julee P.

    2013-01-01

    The current review explores the complex paths that can lead to adolescent and young adult males becoming sexually abusive. Because sexual abuse is an ongoing issue in our society that is often oversimplified, this article distinguishes between the various risk factors that predict sexually abusive behavior and types of sex offenders, particularly…

  4. Future Life Goals of HIV-Positive Gay and Bisexual Male Emerging Adults

    Science.gov (United States)

    Bruce, Douglas; Harper, Gary W.

    2012-01-01

    This qualitative study explores the future life goals reported by a sample of HIV-positive gay/bisexual male emerging adults. Semi-structured interviews were conducted with 54 participants ages 17-24 at four geographically and demographically diverse adolescent HIV medicine programs to explore the content of participants' goals, perceived…

  5. Detection of transgenerational spermatogenic inheritance of adult male acquired CNS gene expression characteristics using a Drosophila systems model.

    Directory of Open Access Journals (Sweden)

    Abhay Sharma

    Full Text Available Available instances of inheritance of epigenetic transgenerational phenotype are limited to environmental exposures during embryonic and adult gonadal development. Adult exposures can also affect gametogenesis and thereby potentially result in reprogramming of the germline. Although examples of epigenetic effects on gametogenesis exist, it is notable that transgenerational inheritance of environment-induced adult phenotype has not yet been reported. Epigenetic codes are considered to be critical in neural plasticity. A Drosophila systems model of pentylenetetrazole (PTZ induced long-term brain plasticity has recently been described. In this model, chronic PTZ treatment of adult males causes alterations in CNS transcriptome. Here, we describe our search for transgenerational spermatogenic inheritance of PTZ induced gene expression phenotype acquired by adult Drosophila males. We generated CNS transcriptomic profiles of F(1 adults after treating F(0 adult males with PTZ and of F(2 adults resulting from a cross between F(1 males and normal females. Surprisingly, microarray clustering showed F(1 male profile as closest to F(1 female and F(0 male profile closest to F(2 male. Differentially expressed genes in F(1 males, F(1 females and F(2 males showed significant overlap with those caused by PTZ. Interestingly, microarray evidence also led to the identification of upregulated rRNA in F(2 males. Next, we generated microarray expression profiles of adult testis from F(0 and F(1 males. Further surprising, clustering of CNS and testis profiles and matching of differentially expressed genes in them provided evidence of a spermatogenic mechanism in the transgenerational effect observed. To our knowledge, we report for the first time detection of transgenerational spermatogenic inheritance of adult acquired somatic gene expression characteristic. The Drosophila systems model offers an excellent opportunity to understand the epigenetic mechanisms underlying

  6. Accessory gland as a site for prothoracicotropic hormone controlled ecdysone synthesis in adult male insects

    DEFF Research Database (Denmark)

    Hentze, Julie Lilith; Bengtsson, Meghan S; Warren, James;

    2013-01-01

    Insect steroid hormones (ecdysteroids) are important for female reproduction in many insect species and are required for the initiation and coordination of vital developmental processes. Ecdysteroids are also important for adult male physiology and behavior, but their exact function and site...... of synthesis remains unclear, although previous studies suggest that the reproductive system may be their source. We have examined expression profiles of the ecdysteroidogenic Halloween genes, during development and in adults of the flour beetle Tribolium castaneum. Genes required for the biosynthesis...... of ecdysone (E), the precursor of the molting hormone 20-hydroxyecdysone (20E), are expressed in the tubular accessory glands (TAGs) of adult males. In contrast, expression of the gene encoding the enzyme mediating 20E synthesis was detected in the ovaries of females. Further, Spookiest (Spot), an enzyme...

  7. Development of a Korean adult male computational phantom for internal dosimetry calculation

    International Nuclear Information System (INIS)

    A Korean adult male computational phantom was constructed based on the current anthropometric and organ volume data of Korean average adult male, and was applied to calculate internal photon dosimetry data. The stylised models of external body, skeleton, and a total of 13 internal organs (brain, gall bladder, heart, kidneys, liver, lungs, pancreas, spleen, stomach, testes, thymus, thyroid and urinary bladder) were redesigned based on the Oak Ridge National Laboratory (ORNL) adult phantom. The height of trunk of the Korean phantom was 8.6% less than that of the ORNL adult phantom, and the volumes of all organs decreased up to 65% (pancreas) except for brain, gall bladder wall and thymus. Specific absorbed fraction (SAF) was calculated using the Korean phantom and Monte Carlo code, and compared with those from the ORNL adult phantom. The SAF of organs in the Korean phantom was overall higher than that from the ORNL adult phantom. This was caused by the smaller organ volume and the shorter inter-organ distance in the Korean phantom. The self SAF was dominantly affected by the difference in organ volume, and the SAF for different source and target organs was more affected by the inter-organ distance than by the organ volume difference. The SAFs of the Korean stylised phantom differ from those of the ORNL phantom by 10-180%. The comparison study of internal dosimetry will be extended to tomographic phantom and electron source in the future. (authors)

  8. A New Adult Diet Formulation for Sterile Males of Anastrepha ludens and Anastrepha obliqua (Diptera: Tephritidae).

    Science.gov (United States)

    Orozco-Dávila, Dina; Quintero-Fong, Luis

    2015-08-01

    A new adult diet formulation was evaluated for sterile Anastrepha ludens (Loew) and Anastrepha obliqua (Macquart) males at the emergence and release facility of fruit flies in Mexico. The formulation consists of hydrolyzed protein, sugar, juvenile hormone analogue methoprene, and water. The proportion of the ingredients between the solute (4% hydrolyzed protein and 96% sugar) and solvent (10% methoprene and 90% water) was 5:1. This new formulation was called the 1:24 formulation. The main objectives of this study were to develop a simple way to supply the 1:24 formulation to adults and to compare the sexual performance of these flies with the performance of flies fed a standard diet (called the Mubarqui formulation) used at the emergence and release facility of fruit flies in Mexico. The preparation, time, and cost also were evaluated. The results showed no significant differences in the sexual behaviors of the males (number of males mating, number of males calling, mating latency, and mating duration) between the 1:24 formulation and the Mubarqui formulation. However, the cost and the required preparation time are much lower for the 1:24 formulation process than for the Mubarqui formulation process. Based on these results, we recommend the 1:24 formulation as an additional adult diet option in the handling of sterile flies. Its application is practical and does not require changes in packaging systems. The contribution of our findings and their potential application to the improvement of the sterile insect technique are discussed. PMID:26470310

  9. Depressive-Like Behavioral Response of Adult Male Rhesus Monkeys during Routine Animal Husbandry Procedure

    Directory of Open Access Journals (Sweden)

    Michael B Hennessy

    2014-09-01

    Full Text Available Social isolation is a major risk factor for the development of depressive illness; yet, no practical nonhuman primate model is available for studying processes involved in this effect. In a first study, we noted that adult male rhesus monkeys housed individually indoors occasionally exhibited a hunched, depressive-like posture. Therefore, Study 2 investigated the occurrence of a hunched posture by adult males brought from outdoor social groups to indoor individual housing. We also scored two other behaviors—lying on the substrate and day time sleeping—that convey an impression of depression. During the first week of observation following individual housing, 18 of 26 adult males exhibited the hunched posture and 21 of 26 displayed at least one depressive-like behavior. Over 2 weeks, 23 of 26 males showed depressive-like behavior during a total of only 20 min observation. Further, the behavior during the first week was positively related to the level of initial response to a maternal separation procedure experienced in infancy. In Study 3, more than half of 23 adult males of a new sample displayed depressive-like behavior during 10 min of observation each of Weeks 7 to 14 of individual housing. The surprisingly high frequency of depressive-like behavior in Studies 2 and 3 may have been due to recording behavior via camera with no human in the room to elicit competing responses. These results suggest that a common animal husbandry procedure might provide a practical means for examining effects of social isolation on depression-related endpoints in a nonhuman primate. The findings also suggest that trait-like differences in emotional responsiveness during separation in infancy may predict differences in responsiveness during social isolation in adulthood.

  10. Depressive-like behavioral response of adult male rhesus monkeys during routine animal husbandry procedure.

    Science.gov (United States)

    Hennessy, Michael B; McCowan, Brenda; Jiang, Jing; Capitanio, John P

    2014-01-01

    Social isolation is a major risk factor for the development of depressive illness; yet, no practical nonhuman primate model is available for studying processes involved in this effect. In a first study, we noted that adult male rhesus monkeys housed individually indoors occasionally exhibited a hunched, depressive-like posture. Therefore, Study 2 investigated the occurrence of a hunched posture by adult males brought from outdoor social groups to indoor individual housing. We also scored two other behaviors-lying on the substrate and day time sleeping-that convey an impression of depression. During the first week of observation following individual housing, 18 of 26 adult males exhibited the hunched posture and 21 of 26 displayed at least one depressive-like behavior. Over 2 weeks, 23 of 26 males showed depressive-like behavior during a total of only 20 min observation. Further, the behavior during the first week was positively related to the level of initial response to a maternal separation procedure experienced in infancy. In Study 3, more than half of 23 adult males of a new sample displayed depressive-like behavior during 10 min of observation each of Weeks 7-14 of individual housing. The surprisingly high frequency of depressive-like behavior in Studies 2 and 3 may have been due to recording behavior via camera with no human in the room to elicit competing responses. These results suggest that a common animal husbandry procedure might provide a practical means for examining effects of social isolation on depression-related endpoints in a nonhuman primate. The findings also suggest that trait-like differences in emotional responsiveness during separation in infancy may predict differences in responsiveness during social isolation in adulthood. PMID:25249954

  11. LUNG FUNCTION: A COMPARATIVE STUDY OF FORCED VITAL CAPACITY (FVC) AND BODY MASS INDEX IN YOUNG ADULT MALES

    OpenAIRE

    MR Swaroop

    2014-01-01

    Obesity is becoming a serious public health issue and is related to lung dysfunction. This study was planned to assess the correlation between the pulmonary function like FVC and increasing BMI in young adult males. This study was undertaken in normal weight and overweight young adult males of Balagangadaranatha nagara. The study and control groups were comprised of 120 male subjects between the age group 18-24 years randomly selected from the population of Balagangadarana...

  12. Connectivity differences between adult male and female patients with attention deficit hyperactivity disorder according to resting-state functional MRI

    OpenAIRE

    Bo-yong Park; Hyunjin Park

    2016-01-01

    Attention deficit hyperactivity disorder (ADHD) is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. ...

  13. The organizational effects of pubertal testosterone on sexual proficiency in adult male Syrian hamsters.

    Science.gov (United States)

    De Lorme, Kayla C; Sisk, Cheryl L

    2016-10-15

    Social proficiency requires making appropriate behavioral adaptations as a result of social experience. For example, male rodents become sexually proficient with experience as demonstrated by a reduction in ectopic (misdirected) mounts, mount-to-intromission ratio, and latency to ejaculation. We previously found that over a series of timed tests with a receptive female, male hamsters deprived of testosterone specifically during puberty (NoT@P) have overall lower levels of sexual behavior and continue to display high levels of ectopic mounts, compared with males that experienced endogenous testosterone during puberty (T@P). These results suggested that pubertal testosterone programs sexual proficiency in adulthood, but because NoT@P males engaged in less sexual behavior than T@P males in these tests, the amount of sexual experience may have been insufficient to improve sexual proficiency. To more rigorously test the hypothesis that pubertal testosterone is necessary for social proficiency in adulthood, the present study compared the behavior of NoT@P and T@P males in a series of 4 trials with a 48-h interval between each trial. Sexual experience was equated by limiting each trial to 5 intromissions. Sexually-naïve males were either gonadectomized prepubertally (NoT@P) or in adulthood (T@P) and received subcutaneous testosterone capsules four weeks later. Two weeks after testosterone replacement, these groups and a group of adult gonad-intact controls began sexual behavior testing. We found that NoT@P males had more ectopic mounts/min across all four tests compared to gonad-intact and T@P males. Moreover, both gonad-intact and T@P males, but not NoT@P males, showed an increase in the number of mounts and intromissions/min between trials 1 and 3. Unexpectedly, both gonad-intact and T@P, but not NoT@P, males showed a decrease in sexual behaviors during trial 4. Thus, T@P males display multiple behavioral adaptations to sexual experience that are not observed in No

  14. PREVALENCE OF TOBACCO USE AMONG THE ADULT MALES IN A SOUTH INDIAN VILLAGE

    Directory of Open Access Journals (Sweden)

    Kalyan

    2014-11-01

    Full Text Available : BACKGROUND: Tobacco usage is widely prevalent in both the developed and developing countries. It is one of the important preventable causes of premature death in developing countries. It has been estimated that nearly 50% of men are dependent on some form of tobacco use. MATERIALS AND METHODS: The aim of the study was to find out the prevalence of tobacco usage among the adult male population in rural areas. The objectives were to find out the tobacco usage in various forms and the impact of pictorial warnings on the packing to quit tobacco. A cross sectional observational study was conducted in Pedaparimi village of Guntur district, Andhra Pradesh, Rural Field Practice area of NRI Medical College, Guntur for 3 months (from January to March 2014. Ten percent of the houses were studied using systematic random sampling method. The data was collected from 105 adult male respondents residing in the village

  15. Effect of oily Rosmarinus Officinalis extract on some reproductive and sperm parameters in adult male rats

    Directory of Open Access Journals (Sweden)

    H. M. Hameed

    2011-01-01

    Full Text Available The present investigation was conducted to examine the effect of oral administration of oily Rosmarinus Officinalis extract on spermatogenesis, accessory sex glands and serum testosterone level in adult male rats aged 2.5-3 months. The extract was administered orally daily at 250, 500 and 1000 mg/kg body weight for 6 weeks. The results showed that the extract at the three doses significantly reduced testis weight and testosterone level. Furthermore a significant reduction in sperm count, weight of body, tail of epididymis, seminal vesicles and prostate gland in rats treated with extract at 500 and 1000 mg/kg compared with control, associated with a significant reduction in the percentage of live sperms and significant increase in the percentage of dead sperms and morphologically abnormal sperms compared with control. It was concluded that Rosmarinus Officinalis extract administration to adult male rats caused adverse effects on some reproductive and semen parameters.

  16. Memory and Motor Coordination Improvement by Folic Acid Supplementation in Healthy Adult Male Rats

    OpenAIRE

    Shooshtari, Maryam Khombi; Moazedi, Ahmad Ali; Parham, Gholam Ali

    2012-01-01

    Objective(s) Previous studies have shown that vitamin B as well as folate supplementation has been implicated in cognitive and neurodegenerative disorders including Alzheimer’s and Parkinson's diseases. The aim of present study was to evaluate the effects of folic acid on passive avoidance task and motor coordination in healthy adult male rats. Materials and Methods Animals were randomly divided into five groups with 10 in each. 1) Sham treated (Veh); received same volume of normal saline as ...

  17. The Neuropsychology of Male Adults With High-Functioning Autism or Asperger Syndrome†

    OpenAIRE

    Wilson, C. Ellie; Happé, Francesca; Wheelwright, Sally J.; Ecker, Christine; Lombardo, Michael V.; Johnston, Patrick; Daly, Eileen; Murphy, Clodagh M; Spain, Debbie; Lai, Meng-Chuan; Chakrabarti, Bhismadev; Sauter, Disa A.; ,; Baron-Cohen, Simon; Murphy, Declan G. M.

    2014-01-01

    Autism Spectrum Disorder (ASD) is diagnosed on the basis of behavioral symptoms, but cognitive abilities may also be useful in characterizing individuals with ASD. One hundred seventy-eight high-functioning male adults, half with ASD and half without, completed tasks assessing IQ, a broad range of cognitive skills, and autistic and comorbid symptomatology. The aims of the study were, first, to determine whether significant differences existed between cases and controls on cognitive tasks, and...

  18. A Behavioral Comparison of Male and Female Adults with High Functioning Autism Spectrum Conditions

    OpenAIRE

    Meng-Chuan Lai; Lombardo, Michael V.; Greg Pasco; Ruigrok, Amber N V; Wheelwright, Sally J.; Sadek, Susan A; Bhismadev Chakrabarti; Simon Baron-Cohen

    2011-01-01

    Autism spectrum conditions (ASC) affect more males than females in the general population. However, within ASC it is unclear if there are phenotypic sex differences. Testing for similarities and differences between the sexes is important not only for clinical assessment but also has implications for theories of typical sex differences and of autism. Using cognitive and behavioral measures, we investigated similarities and differences between the sexes in age- and IQ-matched adults with ASC (h...

  19. Protective Effect of Rosemary (Rosmarinus Officinalis) Extract on Naphthalene Induced Nephrotoxicity in Adult Male Albino Rat

    OpenAIRE

    Neveen M. El-Sherif; Noha Mohy Issa

    2015-01-01

    Background: Naphthalene (NA) is a common environmental contaminant and is abundant in tobacco smoke. Rosemary (Rosmarinus officinalis) is a herb commonly used as a spice and flavoring agents in food processing and is useful in the treatment of many diseases. Aim of the work: To study the nephrotoxicity of NA and to evaluate the possible protective role of rosemary extract in adult male albino rat. Materials and Methods: 25 animals were divided into three groups: Group I (Control group), G...

  20. Effects of early life stress on adult male aggression and hypothalamic vasopressin and serotonin

    OpenAIRE

    Veenema, Alexa H.; Blume, Annegret; Niederle, Daniela; Buwalda, Bauke; Neumann, Inga D.

    2006-01-01

    Early life stress in humans enhances the risk for psychopathologies, including excessive aggression and violence. In rodents, maternal separation is a potent early life stressor inducing long-lasting changes in emotional and neuroendocrine responsiveness to stress, associated with depression- and anxiety-like symptoms. However, effects of maternal separation on adult male aggression and underlying neurobiological mechanisms remain unknown. Therefore, we investigated the effects of maternal se...

  1. Investigation of curcumin effects on liver tissue in adult male rats treated with cyclophosphamide

    OpenAIRE

    Zahra khodaparast; ali reza yousofi; ameneh khoshvagti

    2014-01-01

     Background & Objective: Cyclophosphamide is an antineoplastic drug that has many clinical uses in cancer treatment, but it has toxic effects due to creation of free radicals. In this study, the effects of curcumin" as an antioxidant drug” on liver tissue was investigated. Materials & methods: 50 wistar adult male rats were selected randomly and were divided in to five groups including control, sham (receiving normal saline and olive oil), cyclophosp...

  2. Patterns of coping preferences for male and female caregivers of frail older adults.

    Science.gov (United States)

    DeVries, H M; Hamilton, D W; Lovett, S; Gallagher-Thompson, D

    1997-06-01

    The similarities and differences in male and female caregivers' preferred strategies for coping and the perceived helpfulness of these strategies in managing caregiving stressors were examined in this study. Respondents were 170 caregivers (139 women and 31 men) who were primary caregivers for an elderly adult relative who was either cognitively impaired or physically frail. Results provide preliminary evidence that gender is related to frequency of use but not to the perceived helpfulness of specific coping strategies. PMID:9189986

  3. Ketamine-propofol sedation in circumcision

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    Handan Gulec

    2015-10-01

    Full Text Available ABSTRACTBACKGROUND AND OBJECTIVE: To compare the therapeutic effects of ketamine alone or ketamine plus propofol on analgesia, sedation, recovery time, side effects in premedicated children with midazolam-ketamine-atropin who are prepared circumcision operation.METHODS: 60 American Society of Anaesthesiologists physical status I-II children, aged between 3 and 9 years, undergoing circumcision operations under sedation were recruited according to a randomize and double-blind institutional review board-approved protocol. Patients were randomized into two groups via sealed envelope assignment. Both groups were administered a mixture of midazolam 0.05 mg/kg + ketamine 3 mg/kg + atropine 0.02 mg/kg intramuscularly in the presence of parents in the pre-operative holding area. Patients were induced with propofol-ketamine in Group I or ketamine alone in Group II.RESULTS: In the between-group comparisons, age, weight, initial systolic blood pressure, a difference in terms of the initial pulse rate was observed (p > 0.050. Initial diastolic blood pressure and subsequent serial measurements of 5, 10, 15, 20th min, systolic blood pressure, diastolic blood pressure and pulse rate in ketamine group were significantly higher (p < 0.050.CONCLUSION: Propofol-ketamine (Ketofol provided better sedation quality and hemodynamy than ketamine alone in pediatric circumcision operations. We did not observe significant complications during sedation in these two groups. Therefore, ketofol appears to be an effective and safe sedation method for circumcision operation.

  4. Acceptability of neonatal circumcision by pregnant women in KwaZulu-Natal, South Africa

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    Rogerio Phili

    2015-02-01

    Full Text Available Background: Studies on voluntary medical male circumcision (VMMC have provided convincing evidence on its efficacy to provide partial protection against female-to-male HIV transmission in circumcised men. The World Health Organization and UNAIDS subsequently formulated recommendations for VMMC implementation that included implementation of neonatal medical male circumcision (NMMC to all infants up to two months old. Knowledge regarding the acceptability of NMMC by pregnant women who are candidates for granting of consents for NMMC procedures or its ideal placement within health programmes is low.Objectives: We sought to establish NMMC acceptability by pregnant women and the feasibility of its integration within Maternal, Child and Women’s Health (MCWH programmes to inform implementation guidelines.Method: Nurses and counsellors at two public health facilities were trained to provide NMMC counselling and offer NMMC to 1778 pregnant women presenting for antenatal care services. Univariate and bivariate analyses were performed on data collected on NMMC acceptance and refusals. Thematic analysis was also performed on qualitative reasons for refusals.Results: Acceptability of NMMC by women was high (82.9%. Refusals resulted from the need for consultations with partners and/or family members prior to consenting (41.3%, fear of the procedure (23.8%, cultural reasons (15.9% and no reasons given (15.3%.Conclusion: The acceptability of NMMC by pregnant women and its integration with MCWH services was feasible. However socio-cultural factors, including the need for further consultation prior to consenting for NMMC procedures and preference of traditional circumcision by some women, need to be addressed in order to increase uptakes.

  5. Reproductive abnormalities in adult male mice following preimplantation exposures to estradiol or pesticide methoxychlor.

    Science.gov (United States)

    Amstislavsky, Sergei Ya; Amstislavskaya, Tamara G; Amstislavsky, Vjacheslav S; Tibeikina, Marina A; Osipov, Kiril V; Eroschenko, Victor P

    2006-02-01

    Adult females of ICR strain of mice were bred, separated into different experimental groups, and treated as follows. On Days 2-4 of pregnancy, the mice received daily subcutaneous injections of either 0.05 ml sesame oil (vehicle) or same volume of 5.0mg of purified methoxychlor (MXC) suspended in the vehicle. Another group received a single subcutaneous injection of 1.0 microg of estradiol-17beta (E) on Day 2 of pregnancy only. Male offspring were tested at 3 and 6 months of age. At 3 months, E or MXC did not alter the weights of seminal vesicles, preputial glands, or testes, although after exposure for 30 min to a female in estrus behind a partition, testosterone levels were significantly reduced in treated males in comparison to control males exposed to the same partition test. At 6 months, the preputial glands and testes weight remained unchanged, while the seminal vesicles were significantly heavier in E- and MXC-treated males. Same partition tests again revealed that in E and MXC groups, testosterone levels remained significantly lower in comparison to control males. MXC or E exposures during preimplantation appear to induce long-term effects on the sexual development in 3 and 6 month-old-males by compromising their sexual arousal and altering seminal vesicles weights in the older group.

  6. Neonatal Maternal Separation Augments Carotid Body Response to Hypoxia in Adult Males but Not Female Rats

    Science.gov (United States)

    Soliz, Jorge; Tam, Rose; Kinkead, Richard

    2016-01-01

    Perinatal exposure to adverse experiences disrupts brain development, including the brainstem network that regulates breathing. At adulthood, rats previously subjected to stress (in the form of neonatal maternal separation; NMS) display features reported in patients suffering from sleep disordered breathing, including an increased hypoxic ventilatory response and hypertension. This effect is also sex-specific (males only). Based on these observations, we hypothesized that NMS augments the carotid body's O2-chemosensitivity. Using an isolated and perfused ex vivo carotid body preparation from adult rats we compared carotid sinus nerve (CSN) responses to hypoxia and hypercapnia in carotid bodies harvested from adult rats that either experienced control conditions (no experimental manipulation) or were subjected to NMS (3 h/day from postnatal days 3 to 12). In males, the CSN response to hypoxia measured in preparations from NMS males was 1.5 fold higher than controls. In control rats, the female's response was similar to that of males; however, the increase in CSN activity measured in NMS females was 3.0 times lower than controls. The CSN response to hypercapnia was not influenced by stress or sex. We conclude that NMS is sufficient to have persistent and sex-specific effects on the carotid body's response to hypoxia. Because NMS also has sex-specific effects on the neuroendocrine response to stress, we propose that carotid body function is influenced by stress hormones. This, in turn, leads to a predisposition toward cardio-respiratory disorders. PMID:27729873

  7. Physiological responses of the adult male collared peccary, Tayassu tajacu (Tayassuidae), to severe dietary restriction.

    Science.gov (United States)

    Lochmiller, R L; Hellgren, E C; Varner, L W; Greene, L W; Amoss, M S; Seager, S W; Grant, W E

    1985-01-01

    Metabolic and hormonal responses of eight adult male collared peccaries (Tayassu tajacu) to an ad libitum diet intake, or 25% of an ad libitum intake, were examined. Blood samples for hematological, serum-biochemical and hormonal profiles were collected at three week intervals during the nine week experiment starting 4 August 1983. Males fed on the restricted diet lost an average of 26% of their body weight during the trial, compared to a slight weight gain for those fed ad libitum. Characteristics of the red and white blood cell populations were not influenced by diet intake, with the exception of mean corpuscular volume, which was consistently lower amongst males fed on the restricted diet. Restricted food intake resulted in significantly elevated serum values for urea nitrogen, urea nitrogen:creatinine, urea index, alpha globulin:beta globulin, gamma globulin:albumin, nonesterified fatty acids, alkaline phosphatase and lactate dehydrogenase isozymes (LD1 and LD2). Restricted food intake resulted in significantly lowered serum values for total alpha globulin, alpha-1 globulin, total beta globulin, beta-1 globulin, beta-2 globulin, glucose, triglycerides, calcium, magnesium, sodium, chloride, copper and triiodothyronine. Serum levels of creatinine, total protein, albumin, alpha-2 globulin, uric acid, total bilirubin, cholesterol, aspartate aminotransferase, alanine aminotransferase, gamma glutamyltransferase, lactate dehydrogenase, phosphorus, calcium:phosphorus, potassium, iron, zinc and thyroxine were unaffected by diet intake level. Semen evaluation indicated spermatogenesis was not affected by dietary restriction despite reductions in scrotal circumference and ejaculate gel volume. Serum testosterone levels were significantly lower among males fed on the restricted diet after nine weeks. These data suggest male libido might be depressed during poor range conditions, while maintenance of spermatogenesis might permit them to take immediate advantage of improved

  8. Testes and brain gene expression in precocious male and adult maturing Atlantic salmon (Salmo salar

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    Houeix Benoit

    2010-03-01

    Full Text Available Abstract Background The male Atlantic salmon generally matures in fresh water upon returning after one or several years at sea. Some fast-growing male parr develop an alternative life strategy where they sexually mature before migrating to the oceans. These so called 'precocious' parr or 'sneakers' can successfully fertilise adult female eggs and so perpetuate their line. We have used a custom-built cDNA microarray to investigate gene expression changes occurring in the salmon gonad and brain associated with precocious maturation. The microarray has been populated with genes selected specifically for involvement in sexual maturation (precocious and adult and in the parr-smolt transformation. Results Immature and mature parr collected from a hatchery-reared stock in January were significantly different in weight, length and condition factor. Changes in brain expression were small - never more than 2-fold on the microarray, and down-regulation of genes was much more pronounced than up-regulation. Significantly changing genes included isotocin, vasotocin, cathepsin D, anamorsin and apolipoprotein E. Much greater changes in expression were seen in the testes. Among those genes in the testis with the most significant changes in expression were anti-Mullerian hormone, collagen 1A, and zinc finger protein (Zic1, which were down-regulated in precocity and apolipoproteins E and C-1, lipoprotein lipase and anti-leukoproteinase precursor which were up-regulated in precocity. Expression changes of several genes were confirmed in individual fish by quantitative PCR and several genes (anti-Mullerian hormone, collagen 1A, beta-globin and guanine nucleotide binding protein (G protein beta polypeptide 2-like 1 (GNB2L1 were also examined in adult maturing testes. Down-regulation of anti-Mullerian hormone was judged to be greater than 160-fold for precocious males and greater than 230-fold for November adult testes in comparison to July testes by this method. For

  9. Sexual odor discrimination and physiological profiles in adult male rats after a neonatal, short term, reversible nasal obstruction.

    Science.gov (United States)

    Thornton, S N; Padzys, G S; Trabalon, M

    2014-05-01

    The present study was designed to examine behavioral responses (interpreted as preferences) to olfactory cues (nest bedding odor and odors of estrous and anestrus females) in adult male rats after they had a short term reversible, bilateral, nasal obstruction (RbNO) as developing rat pups. These results were compared to behavior of control (untreated) and sham operated male littermates. Behavioral tests and physiological parameters were analyzed 90 days after recovery of nasal breathing. Experiments investigated the time spent in arms or the center of a maze of male rats in response to odors from the nest bedding or from adult females. There were no differences in responses between untreated, sham and RbNO adult male rats to fresh and nest bedding odors. RbNO males spent more time in the center of the maze when given a choice of estrus or anestrus female odors, or bedding odors from untreated or sham operated female rats. In contrast untreated and sham male rats preferred the odors of estrous females and of untreated or sham females. Plasma corticosterone levels in the males increased during the behavioral tests. Plasma testosterone levels were significantly lower in RbNO males compared to untreated males and did not increase during the behavioral tests compared to sham operated males. Males from all groups had similar preferences for the odor of bedding from adult RbNO females. Plasma levels of cholesterol and triglycerides were increased in RbNO adults. In conclusion, short term nasal obstruction in males while juvenile has long term consequences on hormones and behavioral preferences, thus potential partner selection when adult. PMID:24769524

  10. Mass mortality of adult male subantarctic fur seals: are alien mice the culprits?

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    P J Nico de Bruyn

    Full Text Available BACKGROUND: Mass mortalities of marine mammals due to infectious agents are increasingly reported. However, in contrast to previous die-offs, which were indiscriminate with respect to sex and age, here we report a land-based mass mortality of Subantarctic fur seals with apparent exclusivity to adult males. An infectious agent with a male-predilection is the most plausible explanation for this die-off. Although pathogens with gender-biased transmission and pathologies are unusual, rodents are known sources of male-biased infectious agents and the invasive Mus musculus house mouse, occurs in seal rookeries. METHODOLOGY/ PRINCIPAL FINDINGS: Molecular screening for male-biased pathogens in this potential rodent reservoir host revealed the absence of Cardiovirus and Leptospirosis genomes in heart and kidney samples, respectively, but identified a novel Streptococcus species with 30% prevalence in mouse kidneys. CONCLUSIONS/ SIGNIFICANCE: Inter-species transmission through environmental contamination with this novel bacterium, whose congenerics display male-bias and have links to infirmity in seals and terrestrial mammals (including humans, highlights the need to further evaluate disease risks posed by alien invasive mice to native species, on this and other islands.

  11. Lead exposure in adult males in urban Transvaal Province, South Africa during the apartheid era.

    Science.gov (United States)

    Hess, Catherine A; Cooper, Matthew J; Smith, Martin J; Trueman, Clive N; Schutkowski, Holger

    2013-01-01

    Human exposure to lead is a substantial public health hazard worldwide and is particularly problematic in the Republic of South Africa given the country's late cessation of leaded petrol. Lead exposure is associated with a number of serious health issues and diseases including developmental and cognitive deficiency, hypertension and heart disease. Understanding the distribution of lifetime lead burden within a given population is critical for reducing exposure rates. Femoral bone from 101 deceased adult males living in urban Transvaal Province (now Gauteng Province), South Africa between 1960 and 1998 were analyzed for lead concentration by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Of the 72 black and 29 white individuals sampled, chronic lead exposure was apparent in nearly all individuals. White males showed significantly higher median bone lead concentration (ME = 10.04 µg·g(-1)), than black males (ME = 3.80 µg·g(-1)) despite higher socioeconomic status. Bone lead concentration covaries significantly, though weakly, with individual age. There was no significant temporal trend in bone lead concentration. These results indicate that long-term low to moderate lead exposure is the historical norm among South African males. Unexpectedly, this research indicates that white males in the sample population were more highly exposed to lead.

  12. Subacute toxicity assessment of diflubenzuron, an insect growth regulator, in adult male rats.

    Science.gov (United States)

    de Barros, Aline Lima; Cavalheiro, Gabriela Finoto; de Souza, Alexsandra Vila Maior; Traesel, Giseli Karenina; Anselmo-Franci, Janete A; Kassuya, Cândida Aparecida Leite; Arena, Arielle Cristina

    2016-04-01

    Diflubenzuron (DFB), an insecticide and acaricide insect growth regulator, can be used in agriculture against insect predators and in public health programs, to control insects and vectors, mainly Aedes aegypti larvae. Due to the lack of toxicological assessments of this compound, the objective of the present study was to evaluate the toxicological effects of subacute exposure to the DFB insecticide in adult male rats. Adult male rats were exposed (gavage) to 0, 2, 4, or 8 mg/kg of DFB for 28 days. No clinical signs of toxicity were observed in the DFB-treated animals of the experimental groups. However, there was an increase in serum levels of alanine aminotransferase in the group that received 8 mg/kg/DFB/day and urea at doses of 4 and 8 mg/kg/DFB/day, without altering other biochemical or hematological parameters. The subacute exposure to the lowest dose of DFB caused significant decrease in testis weight, daily sperm production, and in number of sperm in the epididymis in relation to the control group. However, no alterations were observed in the sperm morphology, testicular, epididymis, liver and kidney histology, or testosterone levels. These findings unveiled the hazardous effects of DFB on male reproduction after the subacute exposure and special attention should be addressed to the effects of low doses of this pesticide.

  13. Castration modulates singing patterns and electrophysiological properties of RA projection neurons in adult male zebra finches

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    Songhua Wang

    2014-04-01

    Full Text Available Castration can change levels of plasma testosterone. Androgens such as testosterone play an important role in stabilizing birdsong. The robust nucleus of the arcopallium (RA is an important premotor nucleus critical for singing. In this study, we investigated the effect of castration on singing patterns and electrophysiological properties of projection neurons (PNs in the RA of adult male zebra finches. Adult male zebra finches were castrated and the changes in bird song assessed. We also recorded the electrophysiological changes from RA PNs using patch clamp recording. We found that the plasma levels of testosterone were significantly decreased, song syllable’s entropy was increased and the similarity of motif was decreased after castration. Spontaneous and evoked firing rates, membrane time constants, and membrane capacitance of RA PNs in the castration group were lower than those of the control and the sham groups. Afterhyperpolarization AHP time to peak of spontaneous action potential (AP was prolonged after castration.These findings suggest that castration decreases song stereotypy and excitability of RA PNs in male zebra finches.

  14. Reactions to First Postpubertal Male Same-Sex Sexual Experience in the Kinsey Sample: A Comparison of Minors With Peers, Minors With Adults, and Adults With Adults.

    Science.gov (United States)

    Rind, Bruce; Welter, Max

    2016-10-01

    Rind and Welter (2014) examined first postpubertal coitus using the Kinsey sample, finding that reactions were just as positive, and no more negative, among minors with adults compared to minors with peers and adults with adults. In the present study, we examined first postpubertal male same-sex sexual experiences in the Kinsey same-sex sample (i.e., participants mostly with extensive postpubertal same-sex behavior), comparing reactions across the same age categories. These data were collected between 1938 and 1961 (M year: 1946). Minors under age 18 years with adults (M ages: 14.0 and 30.5, respectively) reacted positively (i.e., enjoyed the experience "much") often (70 %) and emotionally negatively (e.g., fear, disgust, shame, regret) infrequently (16 %). These rates were the same as adults with adults (M ages: 21.2 and 25.9, respectively): 68 and 16 %, respectively. Minors with peers (M ages: 13.3 and 13.8, respectively) reacted positively significantly more often (82 %) and negatively nominally less often (9 %). Minors with adults reacted positively to intercourse (oral, anal) just as often (69 %) as to outercourse (body contact, masturbation, femoral) (72 %) and reacted emotionally negatively significantly less often (9 vs. 25 %, respectively). For younger minors (≤14) with adults aged 5-19 years older, reactions were just as positive (83 %) as for minors with peers within 1 year of age (84 %) and no more emotionally negative (11 vs. 7 %, respectively). Results are discussed in relation to findings regarding first coitus in the Kinsey sample and to the cultural context particular to Kinsey's time. PMID:27178172

  15. Northern fur seal pup production, adult male counts and harvest data for the Pribilof Islands, Alaska 1909 to Present

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This database contains information on pup production estimates, adult male counts and harvests (commercial and subsistence) for the Pribilof Islands of St. Paul and...

  16. Constancy of Adult Personality Structure in Males: Longitudinal, Cross-Sectional and Times-of-Measurement Analyses.

    Science.gov (United States)

    McCrae, Robert R.; And Others

    1980-01-01

    The invariance of factor structures in the Guilford Zimmerman Temperament Survey is clearly evident. Basic personality structure appears little affected by social and historical change. Results favor the stability model for objectively measured personality traits in adult males. (JAC)

  17. Organ doses for reference adult male and female undergoing computed tomography estimated by Monte Carlo simulations

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Choonsik; Kim, Kwang Pyo; Long, Daniel; Fisher, Ryan; Tien, Chris; Simon, Steven L.; Bouville, Andre; Bolch, Wesley E. [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Bethesda, Maryland 20852 (United States); Department of Nuclear Engineering, Kyung Hee University, Yongin 446-701 (Korea, Republic of); Department of Nuclear and Radiological Engineering, University of Florida, Gainesville, Florida 32611 (United States); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Bethesda, Maryland 20852 (United States); Department of Nuclear and Radiological Engineering, University of Florida, Gainesville, Florida 32611 (United States)

    2011-03-15

    Purpose: To develop a computed tomography (CT) organ dose estimation method designed to readily provide organ doses in a reference adult male and female for different scan ranges to investigate the degree to which existing commercial programs can reasonably match organ doses defined in these more anatomically realistic adult hybrid phantomsMethods: The x-ray fan beam in the SOMATOM Sensation 16 multidetector CT scanner was simulated within the Monte Carlo radiation transport code MCNPX2.6. The simulated CT scanner model was validated through comparison with experimentally measured lateral free-in-air dose profiles and computed tomography dose index (CTDI) values. The reference adult male and female hybrid phantoms were coupled with the established CT scanner model following arm removal to simulate clinical head and other body region scans. A set of organ dose matrices were calculated for a series of consecutive axial scans ranging from the top of the head to the bottom of the phantoms with a beam thickness of 10 mm and the tube potentials of 80, 100, and 120 kVp. The organ doses for head, chest, and abdomen/pelvis examinations were calculated based on the organ dose matrices and compared to those obtained from two commercial programs, CT-EXPO and CTDOSIMETRY. Organ dose calculations were repeated for an adult stylized phantom by using the same simulation method used for the adult hybrid phantom. Results: Comparisons of both lateral free-in-air dose profiles and CTDI values through experimental measurement with the Monte Carlo simulations showed good agreement to within 9%. Organ doses for head, chest, and abdomen/pelvis scans reported in the commercial programs exceeded those from the Monte Carlo calculations in both the hybrid and stylized phantoms in this study, sometimes by orders of magnitude. Conclusions: The organ dose estimation method and dose matrices established in this study readily provides organ doses for a reference adult male and female for different

  18. Predictors of onset of cannabis and other drug use in male young adults: results from a longitudinal study

    OpenAIRE

    Haug, Severin; López Núñez, Carla; Becker, Julia; Gmel, Gerhard; Schaub, Michael P

    2014-01-01

    Background: The use of cannabis and other illegal drugs is particularly prevalent in male young adults and is associated with severe health problems. This longitudinal study explored variables associated with the onset of cannabis use and the onset of illegal drug use other than cannabis separately in male young adults, including demographics, religion and religiosity, health, social context, substance use, and personality. Furthermore, we explored how far the gateway hypothesis and the commo...

  19. Treatment for convicted adult male sex offenders: an overview of systematic reviews

    Directory of Open Access Journals (Sweden)

    Paula Corabian

    2011-06-01

    Full Text Available Background: In countries with developed economies, a common approach to protecting communities from sexual offending is to provide specialized treatment for convicted sex offenders to reduce recidivism. Many psychotherapy and pharmacotherapy interventions are currently in widespread use as sex offender treatment (SOT options delivered within programs to prevent recidivism or reoffending among convicted adult male sex offenders. A number of systematic reviews (SRs have already evaluated the evidence from primary research studies on the effectiveness of these interventions.Methods: A structured overview of SRs published in English since January 1998 was conducted to evaluate the effectiveness of psychotherapy and pharmacotherapy delivered within programs to reduce recidivism among convicted adult male sex offenders.Results: Eight SRs met the inclusion criteria. Evidence from seven moderate-to-high quality SRs suggests that cognitive behavioural therapy (CBT delivered within programs adhering to the risk/need/responsivity (RNR model has the potential to reduce recidivism. These findings must be tempered as they are mostly based on poor quality primary research. The reviewed evidence was inconclusive as to the components or framework of an effective SOT program or the setting in which a program should be delivered.Conclusions: This overview provides decision-makers in the SOT field with an accessible, good quality synthesis of the best evidence available on the effectiveness of psychotherapy and pharmacotherapy delivered within programs to reduce recidivism among convicted adult male sex offenders. While further research is warranted, the available evidence suggests that CBT delivered within programs adhering to the RNR model represents the most promising approach.

  20. The Role of Antioxidants in Biochemical Disorders Induced by Arsenic in Adult male Rats

    International Nuclear Information System (INIS)

    The present investigation included biochemical, radiometric, molecular studies and histopathological examination to evaluate the protective role of Antox tablets toward Arsenic toxicity in adult male albino rats (Rattus rattus). Arsenic were given as sodium arsenate to different groups in drinking water at a dose of 100 mg/L, for 3 and 6 weeks led to severe tissue damage as revealed by an elevation of serum total protein and alteration of serum protein fractions. Using radioimmunoassay it was found that serum total testosterone level was significantly decreased. The decreased level of total testosterone paralleled the observed testicular damage. Treatment of male rats with antioxidant (Antox) along with arsenic led to an improvement in both the biochemical and histological alterations induced by arsenic. Thus the protective role of Antox is attributed to its antioxidant and free radicals scavenging properties of its components (selenium, vitamin A acetate, ascorbic acid and vitamin E).

  1. PES PLANUS (FLATFOOT IN MALE AND FEMALE ADULTS OF BAYELSA- NIGERIA

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    Dare NW

    2012-03-01

    Full Text Available The aim of this research was to provide and document an accurate record of the noticeable occurrence of pes planus amongst adults in Bayelsa State (Nigeria. A random sample of 510 persons (235 males and 275 females; aged 33 ± 15 years and totally Bayelsa's natives was analyzed. An ink imprint on white paper of their weight-bearing surface of the feet was carried out with diagnostic purposes. 48 males (20.4% and 81 females (29.5% revealed pes planus whereas the rest of the sample did not show it. The incidence of pes planus was 1:4. The well known frequent excess of bodyweight in these native groups may be responsible for this abnormality and obliges to pay due attention to the related habits. Furthermore, the obtained results could probably have anthropological and forensic medicine impact.

  2. Primary Mature Cystic Teratoma Mimicking As An Adrenal Mass In An Adult Male Patient

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    Emrah Okulu

    2014-03-01

    Teratomas are bizarre neoplasms derived from embryonic tissues that are typically found only in the gonadal and sacrococcygeal regions of adults. Primary retroperitoneal teratomas are rare and present challenging management options. We report a case of unilateral primary retroperitoneal mature cystic teratoma mimicking as an adrenal mass in 54-year-old male patient. Adrenal mass complete resection was performed by flank approach using the 11th rib resection. Because of the risk of malignancy, follow-up radiographic studies were performed to ensure the oncologic efficacy of resection. The patient has been free of recurrence for longer than 12 months.

  3. 包皮环切术对减少男性高危型人乳头瘤病毒感染的作用研究%Effect of circumcision in reducing high-risk human papilloma virus infection

    Institute of Scientific and Technical Information of China (English)

    董文; 廖蓓; 黄海; 姚友生; 黄健

    2011-01-01

    目的 了解包皮环切术在减少成年男性高危型人乳头瘤病毒(HPV)感染中的作用.方法 通过对128例已婚成年男性包皮环切术前及术后2年尿道分泌物高危型HPV的检测,观察手术前后高危型HPV感染率的变化,并同期选择128例包皮过长而未行包皮环切术的已婚成年男性为对照组,比较2组高危型HPV感染率的差异.结果 2组患者入组时高危型HPV的感染率相当,具有可比性.其中包皮环切术组术前高危型HPV的感染率为27.3%,术后2年复测高危型HPV的感染率降为12.5%,差异有统计学意义(x2=8.839,P=0.005);对照组第1次检测高危型HPV的感染率为28.1%,2年后再次检测时感染率为25.0%,二者比较差异无统计学意义(x2=0.350,P=0.671).结论 包皮环切术能够明显降低成年男性高危型HPV的感染率,在我国积极推广包皮环切术对预防高危型HPV感染相关疾病的发生可能具有重要作用.%Objective To understand the effect of circumcision in reducing high-risk human papilloma virus (HPV) infection in male adults. Methods One hundred and twenty-eight married adults with phimosis who underwent circumcision enrolled in the case group and high-risk HPV of urethral discharge specimens were detected before and 2 years after operation. A total of 128 cases of phimosis without circumcision were recruited in the control group. High-risk HPV infection rates were compared between the two groups. Results The highrisk HPV infection rates in the two groups were comparable at baseline. In the circumcision group, high-risk HPV infection rate was 27. 3% preoperative and it significantly decreased to 12.5% two years after operation( x2 =8. 839 ,P =0. 005). In the control group,high risk HPV infection rate was 28. 1% at baseline and it was 25.0%two years later, with no significant difference (x2 =0.320,P = 0.671).Conclusion Circumcision can significantly reduce high-risk HPV infection. Promoting circumcision actively in our

  4. A SELF-PRIMING EFFECT OF LHRH ON LH SECRETION IN DISPERSED ANTERIOR PITUITARY CELLS OF ADULT MALE RAT

    Institute of Scientific and Technical Information of China (English)

    QUZhi-Chao; GUOJing; GUOJian

    1989-01-01

    LHRH self-priming effect is simply defmed as an enhancement of LH response to LHRH, i. e., a second challenge with LHRH elicits more LH secretion as compared to the first challenge. The present study is to observe whether this phenomenon exists in perfused anterior pituitary (AP) cells of adult male rat. Dispersed AP cells of adult SD

  5. Transcript levels of ten caste-related genes in adult diploid males of Melipona quadrifasciata (Hymenoptera, Apidae: a comparison with haploid males, queens and workers

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    Andreia A. Borges

    2011-01-01

    Full Text Available In Hymenoptera, homozygosity at the sex locus results in the production of diploid males. In social species, these pose a double burden by having low fitness and drawing resources normally spent for increasing the work force of a colony. Yet, diploid males are of academic interest as they can elucidate effects of ploidy (normal males are haploid, whereas the female castes, the queens and workers, are diploid on morphology and life history. Herein we investigated expression levels of ten caste-related genes in the stingless bee Melipona quadrifasciata, comparing newly emerged and 5-day-old diploid males with haploid males, queens and workers. In diploid males, transcript levels for dunce and paramyosin were increased during the first five days of adult life, while those for diacylglycerol kinase and the transcriptional co-repressor groucho diminished. Two general trends were apparent, (i gene expression patterns in diploid males were overall more similar to haploid ones and workers than to queens, and (ii in queens and workers, more genes were up-regulated after emergence until day five, whereas in diploid and especially so in haploid males more genes were down-regulated. This difference between the sexes may be related to longevity, which is much longer in females than in males.

  6. Temporal dynamics of attentional selection in adult male carriers of the fragile X premutation allele and adult controls

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    Ling Mei Wong

    2015-02-01

    Full Text Available Carriers of the fragile X premutation allele (fXPCs have an expanded CGG trinucleotide repeat size within the emph{FMR1} gene and are at increased risk of developing Fragile X-associated Tremor Ataxia Syndrome (FXTAS. Previous research has shown that male fXPCs with FXTAS exhibit cognitive decline, predominantly in executive functions such as inhibitory control and working memory. Recent evidence suggests fXPCs may also exhibit impairments in processing temporal information. The attentional blink (AB task is often used to examine the dynamics of attentional selection, but disagreements exist as to whether the AB is due to excessive or insufficient attentional control. In this study, we used a variant of the AB task and neuropsychological testing to explore the dynamics of attentional selection, relate AB performance to attentional control, and determine whether fXPCs exhibited temporal and/or attentional control impairments. Participants were adult male fXPCs, aged 18--48 years and asymptomatic for FXTAS (emph{n} = 19 and age-matched male controls (emph{n} = 20. We found that fXPCs did not differ from controls in the AB task, indicating that the temporal dynamics of attentional selection were intact. However, they were impaired in the letter-number sequencing task, a test of attentional control. In the combined fXPC and control group, letter-number sequencing performance correlated positively with AB magnitude. This finding supports models that posit the AB is due to excess attentional control. In our two-pronged analysis approach, we contribute to the theoretical literature in controls by extending the AB literature, and we enhance our understanding of fXPCs by demonstrating that at least some aspects of temporal processing may be spared.

  7. Impacts of prenatal nanomaterial exposure on male adult Sprague-Dawley rat behavior and cognition.

    Science.gov (United States)

    Engler-Chiurazzi, Elizabeth B; Stapleton, Phoebe A; Stalnaker, Jessica J; Ren, Xuefang; Hu, Heng; Nurkiewicz, Timothy R; McBride, Carroll R; Yi, Jinghai; Engels, Kevin; Simpkins, James W

    2016-01-01

    It is generally accepted that gestational xenobiotic exposures result in systemic consequences in the adult F1 generation. However, data on detailed behavioral and cognitive consequences remain limited. Using our whole-body nanoparticle inhalation facility, pregnant Sprague-Dawley rats (gestational day [GD] 7) were exposed 4 d/wk to either filtered air (control) or nano-titanium dioxide aerosols (nano-TiO2; count median aerodynamic diameter of 170.9 ± 6.4 nm, 10.4 ± 0.4 mg/m(3), 5 h/d) for 7.8 ± 0.5 d of the remaining gestational period. All rats received their final exposure on GD 20 prior to delivery. The calculated daily maternal deposition was 13.9 ± 0.5 µg. Subsequently, at 5 mo of age, behavior and cognitive functions of these pups were evaluated employing a standard battery of locomotion, learning, and anxiety tests. These assessments revealed significant working impairments, especially under maximal mnemonic challenge, and possible deficits in initial motivation in male F1 adults. Evidence indicates that maternal engineered nanomaterial exposure during gestation produces psychological deficits that persist into adulthood in male rats.

  8. Association of television violence exposure with executive functioning and white matter volume in young adult males.

    Science.gov (United States)

    Hummer, Tom A; Kronenberger, William G; Wang, Yang; Anderson, Caitlin C; Mathews, Vincent P

    2014-07-01

    Prior research has indicated that self-reported violent media exposure is associated with poorer performance on some neuropsychological tests in adolescents. This study aimed to examine the relationship of executive functioning to violent television viewing in healthy young adult males and examine how brain structure is associated with media exposure measures. Sixty-five healthy adult males (ages 18-29) with minimal video game experience estimated their television viewing habits over the past year and, during the subsequent week, recorded television viewing time and characteristics in a daily media diary. Participants then completed a battery of neuropsychological laboratory tests quantifying executive functions and underwent a magnetic resonance imaging (MRI) scan. Aggregate measures of executive functioning were not associated with measures of overall television viewing (any content type) during the past week or year. However, the amount of television viewing of violent content only, as indicated by both past-year and daily diary measures, was associated with poorer scores on an aggregate score of inhibition, interference control and attention, with no relationship to a composite working memory score. In addition, violent television exposure, as measured with daily media diaries, was associated with reduced frontoparietal white matter volume. Future longitudinal work is necessary to resolve whether individuals with poor executive function and slower white matter growth are more drawn to violent programming, or if extensive media violence exposure modifies cognitive control mechanisms mediated primarily via prefrontal cortex. Impaired inhibitory mechanisms may be related to reported increases in aggression with higher media violence exposure. PMID:24836970

  9. Neuroanatomy of Individual Differences in Language in Adult Males with Autism.

    Science.gov (United States)

    Lai, Meng-Chuan; Lombardo, Michael V; Ecker, Christine; Chakrabarti, Bhismadev; Suckling, John; Bullmore, Edward T; Happé, Francesca; Murphy, Declan G M; Baron-Cohen, Simon

    2015-10-01

    One potential source of heterogeneity within autism spectrum conditions (ASC) is language development and ability. In 80 high-functioning male adults with ASC, we tested if variations in developmental and current structural language are associated with current neuroanatomy. Groups with and without language delay differed behaviorally in early social reciprocity, current language, but not current autistic features. Language delay was associated with larger total gray matter (GM) volume, smaller relative volume at bilateral insula, ventral basal ganglia, and right superior, middle, and polar temporal structures, and larger relative volume at pons and medulla oblongata in adulthood. Despite this heterogeneity, those with and without language delay showed significant commonality in morphometric features when contrasted with matched neurotypical individuals (n = 57). In ASC, better current language was associated with increased GM volume in bilateral temporal pole, superior temporal regions, dorsolateral fronto-parietal and cerebellar structures, and increased white matter volume in distributed frontal and insular regions. Furthermore, current language-neuroanatomy correlation patterns were similar across subgroups with or without language delay. High-functioning adult males with ASC show neuroanatomical variations associated with both developmental and current language characteristics. This underscores the importance of including both developmental and current language as specifiers for ASC, to help clarify heterogeneity. PMID:25249409

  10. Validation of social skills of adolescent males in an interview conversation with a previously unknown adult.

    Science.gov (United States)

    Spence, S H

    1981-01-01

    Seventy convicted young male offenders were videotaped during a 5-min standardized interview with a previously unknown adult. In order to determine the social validity of the behavioral components of social interaction for this population, measures of 13 behaviors were obtained from the tapes. These measures were then correlated with ratings of friendliness, social anxiety, social skills performance, and employability made by four independent adult judges from the same tapes. It was found that measures of eye contact and verbal initiations were correlated significantly with all four criterion rating scales. The frequencies of smiling and speech dysfluencies were both significantly correlated with ratings of friendliness and employability. The amount spoken was found to be a significant predictor of social skills performance whereas the frequency of head movements influenced judgments of social anxiety. The latency of response was negatively correlated with social skills and employability ratings and the frequency of question-asking and interruptions correlated significantly with friendliness, social skills, and employability ratings. Finally, the levels of gestures, gross body movements, and attention feedback responses were not found to influence judgments on any of the criterion scales. The implications of the study for selection of targets for social skills training for adolescent male offenders are discussed. PMID:7287599

  11. Maternal immune activation differentially impacts mature and adult-born hippocampal neurons in male mice.

    Science.gov (United States)

    Zhang, Zhi; van Praag, Henriette

    2015-03-01

    Schizophrenia is associated with deficits in the hippocampus, a brain area important for learning and memory. The dentate gyrus (DG) of the hippocampus develops both before and after birth. To study the relative contribution of mature and adult-born DG granule cells to disease etiology, we compared both cell populations in a mouse model of psychiatric illness resulting from maternal immune activation. Polyriboinosinic-polyribocytidilic acid (PolyIC, 5mg/kg) or saline was given on gestation day 15 to pregnant female C57Bl/6 mice. Male offspring (n=105), was administered systemic bromodeoxyuridine (BrdU, 50mg/kg) (n=52) or intracerebral retroviral injection into the DG (n=53), to label dividing cells at one month of age. Two months later behavioral tests were performed to evaluate disease phenotype. Immunohistochemistry and whole-cell patch clamping were used to assess morphological and physiological characteristics of DG cells. Three-month-old PolyIC exposed male offspring exhibited deficient pre-pulse inhibition, spatial maze performance and motor coordination, as well as increased depression-like behavior. Histological analysis showed reduced DG volume and parvalbumin positive interneuron number. Both mature and new hippocampal neurons showed modifications in intrinsic properties such as increased input resistance and lower current threshold, and decreased action potential number. Reduced GABAergic inhibitory transmission was observed only in mature DG neurons. Differential impairments in mature DG cells and adult-born new neurons may have implications for behavioral deficits associated with maternal immune activation. PMID:25449671

  12. Impacts of prenatal nanomaterial exposure on male adult Sprague-Dawley rat behavior and cognition.

    Science.gov (United States)

    Engler-Chiurazzi, Elizabeth B; Stapleton, Phoebe A; Stalnaker, Jessica J; Ren, Xuefang; Hu, Heng; Nurkiewicz, Timothy R; McBride, Carroll R; Yi, Jinghai; Engels, Kevin; Simpkins, James W

    2016-01-01

    It is generally accepted that gestational xenobiotic exposures result in systemic consequences in the adult F1 generation. However, data on detailed behavioral and cognitive consequences remain limited. Using our whole-body nanoparticle inhalation facility, pregnant Sprague-Dawley rats (gestational day [GD] 7) were exposed 4 d/wk to either filtered air (control) or nano-titanium dioxide aerosols (nano-TiO2; count median aerodynamic diameter of 170.9 ± 6.4 nm, 10.4 ± 0.4 mg/m(3), 5 h/d) for 7.8 ± 0.5 d of the remaining gestational period. All rats received their final exposure on GD 20 prior to delivery. The calculated daily maternal deposition was 13.9 ± 0.5 µg. Subsequently, at 5 mo of age, behavior and cognitive functions of these pups were evaluated employing a standard battery of locomotion, learning, and anxiety tests. These assessments revealed significant working impairments, especially under maximal mnemonic challenge, and possible deficits in initial motivation in male F1 adults. Evidence indicates that maternal engineered nanomaterial exposure during gestation produces psychological deficits that persist into adulthood in male rats. PMID:27092594

  13. Validation of social skills of adolescent males in an interview conversation with a previously unknown adult.

    Science.gov (United States)

    Spence, S H

    1981-01-01

    Seventy convicted young male offenders were videotaped during a 5-min standardized interview with a previously unknown adult. In order to determine the social validity of the behavioral components of social interaction for this population, measures of 13 behaviors were obtained from the tapes. These measures were then correlated with ratings of friendliness, social anxiety, social skills performance, and employability made by four independent adult judges from the same tapes. It was found that measures of eye contact and verbal initiations were correlated significantly with all four criterion rating scales. The frequencies of smiling and speech dysfluencies were both significantly correlated with ratings of friendliness and employability. The amount spoken was found to be a significant predictor of social skills performance whereas the frequency of head movements influenced judgments of social anxiety. The latency of response was negatively correlated with social skills and employability ratings and the frequency of question-asking and interruptions correlated significantly with friendliness, social skills, and employability ratings. Finally, the levels of gestures, gross body movements, and attention feedback responses were not found to influence judgments on any of the criterion scales. The implications of the study for selection of targets for social skills training for adolescent male offenders are discussed.

  14. Severity of psoriasis among adult males is associated with smoking, not with alcohol use

    Directory of Open Access Journals (Sweden)

    N Asokan

    2014-01-01

    Full Text Available Context: Lifestyle factors such as tobacco smoking and alcohol use can affect the presentation and course of psoriasis. There is a paucity of data on this subject from India. Aims: To find out whether increased severity of psoriasis in adult Indian males is associated with tobacco smoking and alcohol use. Settings and Design: Cross-sectional study in the Department of Dermatology of a Tertiary Care Teaching Hospital. Subjects and Methods: Male patients above 18 years of age attending a psoriasis clinic between March 2007 and May 2009 were studied. Severity of psoriasis (measured using Psoriasis Area and Severity Index - PASI among smokers and non-smokers was compared. We also studied the correlation between severity of psoriasis and nicotine dependence (measured using Fagerström Test for Nicotine Dependence and alcohol use disorders (measured using Alcohol Use Disorders Identification Test- AUDIT. Statistical Analysis: Z-test, Odd′s ratio, Chi-square test, Spearman′s correlation coefficient. Results: Of a total of 338 patients, 148 were smokers and 173 used to consume alcohol. Mean PASI score of smokers was more than that of non-smokers (Z-test, z = −2.617, P = 0.009. Those with severe psoriasis were more likely to be smokers (χ2 = 5.47, P = 0.02, OR = 1.8, Confidence Interval 1.09-2.962. There was a significant correlation between PASI scores and Fagerström score (Spearman′s correlation coefficient = 0.164, P 0.05. Conclusions: Increased severity of psoriasis among adult males is associated with tobacco smoking, but not with alcohol use.

  15. Factors Associated with Successful Smoking Cessation in Korean Adult Males: Findings from a National Survey.

    Directory of Open Access Journals (Sweden)

    Youngmee Kim

    2014-11-01

    Full Text Available Smoking cessation rates have remained stagnant globally. This study was conducted to explore the factors associated with successful smoking cessation among South Korean adult males using nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES from 2007 to 2012. A comparison was made between successful quitters and those who failed to quit after attempts to stop smoking.A total of 7,839 males, aged 19-65 years, were included in this cross-sectional study. The outcome measures were the success and failure rates in smoking cessation, sociodemographic and clinical characteristics, health behaviors, perceived health status, quality of life, and mental health. Multiple logistic regression analyses were used to examine the various factors associated with smoking cessation success.The cessation success and failure rates were 45.5% and 54.5%, respectively. Smoking cessation was related to older age, marriage, higher income, smoking larger amounts of cigarettes, use of willpower, alcohol abstinence, cancer history, better mental health, and higher levels of quality of life, after controlling for multiple variables. Second-hand smoke exposure at home and using nicotine replacement therapy were associated with a lower likelihood of smoking cessation.A smoke-free environment, use of willpower, alcohol abstinence, and better stress management are important for smoking cessation. Unlike previous studies, not using nicotine replacement therapy and higher levels of daily cigarette consumption were associated with successful smoking cessation, suggesting that motivation appears to be important to smoking cessation in Korean adult male population.

  16. Occupational HIV Transmission Among Male Adult Film Performers - Multiple States, 2014.

    Science.gov (United States)

    Wilken, Jason A; Ried, Christopher; Rickett, Pristeen; Arno, Janet N; Mendez, Yesenia; Harrison, Robert J; Wohlfeiler, Dan; Bauer, Heidi M; Joyce, M Patricia; Switzer, William M; Heneine, Walid; Shankar, Anupama; Mark, Karen E

    2016-02-12

    In 2014, the California Department of Public Health was notified by a local health department of a diagnosis of acute human immunodeficiency virus (HIV) infection* and rectal gonorrhea in a male adult film industry performer, aged 25 years (patient A). Patient A had a 6-day history of rash, fever, and sore throat suggestive of acute retroviral syndrome at the time of examination. He was informed of his positive HIV and gonorrhea test results 6 days after his examination. Patient A had a negative HIV-1 RNA qualitative nucleic acid amplification test (NAAT)(†) 10 days before symptom onset. This investigation found that during the 22 days between the negative NAAT and being informed of his positive HIV test results, two different production companies directed patient A to have condomless sex with a total of 12 male performers. Patient A also provided contact information for five male non-work-related sexual partners during the month before and after his symptom onset. Patient A had additional partners during this time period for which no locating information was provided. Neither patient A nor any of his interviewed sexual partners reported taking HIV preexposure prophylaxis (PrEP). Contact tracing and phylogenetic analysis of HIV sequences amplified from pretreatment plasma revealed that a non-work-related partner likely infected patient A, and that patient A likely subsequently infected both a coworker during the second film production and a non-work-related partner during the interval between his negative test and receipt of his positive HIV results. Adult film performers and production companies, medical providers, and all persons at risk for HIV should be aware that testing alone is not sufficient to prevent HIV transmission. Condom use provides additional protection from HIV and sexually transmitted infections (STIs). Performers and all persons at risk for HIV infection in their professional and personal lives should discuss the use of PrEP with their medical

  17. Patterns of Dating Violence Perpetration and Victimization in U.S. Young Adult Males and Females.

    Science.gov (United States)

    Spencer, Rachael A; Renner, Lynette M; Clark, Cari Jo

    2016-09-01

    Dating violence (DV) is frequently reported by young adults in intimate relationships in the United States, but little is known about patterns of DV perpetration and victimization. In this study, we examined sexual and physical violence perpetration and victimization reported by young adults to determine how the violence patterns differ by sex and race/ethnicity. Data from non-Hispanic White, non-Hispanic Black, and Hispanic participants in Wave 3 of the National Longitudinal Study of Adolescent to Adult Health were analyzed. DV was assessed using responses to four questions focused on perpetration and four questions focused on victimization. The information on DV was taken from the most violent relationship reported by participants prior to Wave 3. Latent class analysis was first conducted separately by sex, adjusting for age, race/ethnicity, and financial stress, then by race/ethnicity, adjusting for age and financial stress. Relative model fit was established by comparing Bayesian Information Criteria (BIC), adjusted BIC, entropy, interpretability of latent classes, and certainty of latent class assignment for covariate-adjusted models. The results indicate that patterns of violence differed by sex and for females, by race/ethnicity. A three-class model was the best fit for males. For females, separate four-class models were parsimonious for White, Black, and Hispanic females. Financial stress was a significant predictor of violence classification for males and females and age predicted membership in White and Black female models. Variations in DV patterns by sex and race/ethnicity suggest the need for a more nuanced understanding of differences in DV. PMID:25846756

  18. Comparative profiling of microRNAs in male and female adults of Ascaris suum.

    Science.gov (United States)

    Xu, Min-Jun; Fu, Jing-Hua; Nisbet, Alasdair J; Huang, Si-Yang; Zhou, Dong-Hui; Lin, Rui-Qing; Song, Hui-Qun; Zhu, Xing-Quan

    2013-03-01

    Ascaris nematodes, which cause ascariasis in humans and pigs, are among the most important nematodes from both health and economic perspectives. microRNA (miRNA) is now recognized as key regulator of gene expression at posttranscription level. The public availability of the genome and transcripts of Ascaris suum provides powerful resources for the research of miRNA profiles of the parasite. Therefore, we investigated and compared the miRNA profiles of male and female adult A. suum using Solexa deep sequencing combined with bioinformatic analysis and stem-loop reverse transcription polymerase chain reaction. Deep sequencing of small RNAs yielded 11.71 and 11.72 million raw reads from male and female adults of A. suum, respectively. Analysis showed that the noncoding RNA of the two genders, including tRNA, rRNA, snRNA, and snoRNA, were similar. By mapping to the A. suum genome, we obtained 494 and 505 miRNA candidates from the female and male parasite, respectively, and 87 and 82 of miRNA candidates were consistent with A. suum miRNAs deposited in the miRBase database. Among the miRNA candidates, 154 were shared by the two genders, and 340 and 351 were female and male specific with their target numbers ranged from one to thousands, respectively. Functional prediction revealed a set of elongation factors, heat shock proteins, and growth factors from the targets of gender-specific miRNAs, which were essential for the development of the parasite. Moreover, major sperm protein and nematode sperm cell motility protein were found in targets of the male-specific miRNAs. Ovarian message protein was found in targets of the female-specific miRNAs. Enrichment analysis revealed significant differences among Gene Ontology terms of miRNA targets of the two genders, such as electron carrier and biological adhesion process. The regulating functions of gender-specific miRNAs was therefore not only related to the fundamental functions of cells but also were essential to the germ

  19. Stimulating effects of quercetin on sperm quality and reproductive organs in adult male rats

    Institute of Scientific and Technical Information of China (English)

    Ladachart Taepongsorat; Prakong Tangpraprutgul; Noppadon Kitana; Suchinda Malaivijitnond

    2008-01-01

    Aim: To investigate effects of quercetin on weight and histology of testis and accessory sex organs and on sperm quality in adult male rats. Methods: Male Sprague-Dawley rats were injected s.c. with quercetin at the dose of 0, 30,90, or 270 mg/kg body weight/day (hereafter abbreviated Q0, Q30, Q90 and Q270, respectively), and each dose was administered for treatment durations of 3, 7 and 14 days. Results: From our study, it was found that the effects of quercetin on reproductive organs and sperm quality depended on the dose and duration of treatment. After Q270 treatment for 14 days, the weights of testes, epididymis and vas deferens were significantly increased, whereas the weights of seminal vesicle and prostate gland were significantly decreased, compared with those of Q0. The histo-logical alteration of those organs was observed after Q270 treatment for 7 days as well as 14 days. The sperm motility, viability and concentration were significantly increased after Q90 and Q270 injections after both of 7 and 14 days. Changes in sperm quality were earlier and greater than those in sex organ histology and weight, respectively.Conclusion: Overall results indicate that quercetin might indirectly affect sperm quality through the stimulation of the sex organs, both at the cellular and organ levels, depending on the dose and the duration of treatment. Therefore, the use of quercetin as an alternative drug for treatment of male infertility should be considered.

  20. Control of Adult Pests by the Irradiation-of-Male Method

    International Nuclear Information System (INIS)

    The Grosch effect (i.e., of radiation interfering with utilization of nutrients in insects) became applicable to pest control when Galun and Warburg discovered that irradiated ticks fed once would seldom if ever feed again. This lifelong sensation of 'impletion' does not interfere with sexual competitiveness, but it does render harmless a pest that is a pest during the adult stage of its life cycle. It would seem that the general principle of treating adult pests to limit their feeding capacity could be extended to other pests. When insect pests are- living in stored food products, it is a general rule that desirably low levels of radiation can be used to eradicate the pest if sterilizing doses rather than insecticidal doses are used. With the entire population of both males and females being irradiated, the sterilizing dose is often much lower than that which would be desirable when the insects are mass-reared for irradiation and release. Where mass-rearing techniques are not feasible, or where the pestiferousness of adults cannot be overcome by radiation or other treatments, field-irradiation facilities in baited traps can be devised. These have some advantages over similar traps containing chemosterilants. Wherever it can be used, the method of mass-rearing, irradiation, and release is still the most desirable way to control insect pests. (author)

  1. AVPV neurons containing estrogen receptor-beta in adult male rats are influenced by soy isoflavones

    Directory of Open Access Journals (Sweden)

    Bu Lihong

    2007-02-01

    Full Text Available Abstract Background Isoflavones, the most abundant phytoestrogens in soy foods, are structurally similar to 17beta-estradiol. It is known that 17beta-estradiol induces apoptosis in anteroventral periventricular nucleus (AVPV in rat brain. Also, there is evidence that consumption of soy isoflavones reduces the volume of AVPV in male rats. Therefore, in this study, we examined the influence of dietary soy isoflavones on apoptosis in AVPV of 150 day-old male rats fed either a soy isoflavone-free diet (Phyto-free or a soy isoflavone-rich diet (Phyto-600. Results The occurrence of apoptosis in AVPV was examined by TUNEL staining. The incidence of apoptosis was about 10 times higher in the Phyto-600 group (33.1 ± 1.7% than in the Phyto-free group (3.6 ± 1.0%. Furthermore, these apoptotic cells were identified as neurons by dual immunofluorescent staining of GFAP and NeuN as markers of astrocytes and neurons, respectively. Then the dopaminergic neurons in AVPV were detected by immunohistochemistry staining of tyrosine hydroxylase (TH. No significant difference in the number of TH neurons was observed between the diet treatment groups. When estrogen receptor (ER alpha and beta were examined by immunohistochemistry, we observed a 22% reduction of ERbeta-positive cell numbers in AVPV with consumption of soy isoflavones, whereas no significant change in ERalpha-positive cell numbers was detected. Furthermore, almost all the apoptotic cells were ERbeta-immunoreactive (ir, but not ERalpha-ir. Last, subcutaneous injections of equol (a major isoflavone metabolite that accounts for approximately 70–90% of the total circulating plasma isoflavone levels did not alter the volume of AVPV in adult male rats. Conclusion In summary, these findings provide direct evidence that consumption of soy isoflavones, but not the exposure to equol, influences the loss of ERbeta-containing neurons in male AVPV.

  2. Quality of life, social situation, and sexual satisfaction, in adult males with congenital adrenal hyperplasia.

    Science.gov (United States)

    Falhammar, Henrik; Nyström, Helena Filipsson; Thorén, Marja

    2014-09-01

    To determine quality of life (QoL) in adult males with congenital adrenal hyperplasia (CAH). CAH males with 21-hydroxylase deficiency (n = 30), 19-67 years old, were compared with controls (n = 32). QoL was assessed using questionnaires on general living conditions and sexual issues, and the psychological well-being index (PGWB) form. Fewer CAH males than controls were students (3 vs. 25 %, P = 0.028) and more had blue-collar work (57 vs. 33 %, P = 0.023). Patients were less interested in sports (47 vs. 72 %, P = 0.034) and art/literature/film (10 vs. 47 %, P = 0.004). PGWB total score was 82.7 ± 13.7 versus 87.0 ± 11.1 (P = NS), but hydrocortisone/cortisone acetate treated scored lower than controls and prednisolone treated. Glucocorticoid over-treated had lower QoL than those with poor control (PGWB total score 77.1 ± 13.5 vs. 92.4 ± 11.1, P = 0.026) and controls (P = 0.025). Total PGWB score was positively correlated with adrenal androgens and steroid precursors. Subscale scores indicated that patients with late diagnosis were more depressive (12.1 ± 2.8 vs. 13.9 ± 1.4, P = 0.011) and had a lower self-control (11.3 ± 3.6 vs. 13.1 ± 1.0, P = 0.019) compared with controls. Sexual satisfaction was similar in spite of more patients being sexually inactive (27 vs. 6 %, P = 0.040). Adult CAH males differed from controls with respect to type of occupation and spare time interests but had similar QoL despite being less sexually active. Optimizing glucocorticoid therapy might further improve QoL. Some disadvantages found in patients diagnosed late will hopefully not be seen in patients diagnosed by neonatal screening, but this has yet to be studied. PMID:24408051

  3. Effect of lidocaine-prilocaine eutectic mixture of local anaesthetic cream compared with oral sucrose or both in alleviating pain in neonatal circumcision procedure

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    Reem Al Qahtani

    2014-01-01

    Full Text Available Background: Neonatal circumcision is one of the oldest and most frequently performed surgical procedures on males. Newborns demonstrate strong endogenous reaction to pain and therefore modalities are being explored for optimum pain relief during circumcision. Pediatric nurses have a vital role for the use of these modalities and minimising the pain response during the neonatal minor procedures. Aim: The aim of this study was to assess the effectiveness of eutectic mixture of local anaesthetic (EMLA cream compared with oral sucrose and both in alleviating pain in neonatal circumcision. Materials and Methods: This study was conducted in the Day Care Surgery Department of Maternity and Children Hospital, Dammam City, KSA. 90 full-term newborn males who underwent circumcision were divided randomly into three groups (30 each. Each group was assigned to receive a different type of analgesics such as EMLA cream (Group A, oral sucrose (Group B or combination of EMLA cream and oral sucrose (Group C. Neonatal pain agitation and sedation scale (N-PASS was used 5 min before, during and 5 min after the circumcision procedure to assess the neonatal response to pain. Results: N-PASS scores were significantly lower in Group C (median Group C = 5.2, Group A = 5.8, Group B = 8.5; P< 0.001. The endogenous response to pain in terms of escalation of heart rate and reduction in O 2 saturation were minimal among Group C (P < 0.0001. Duration of crying was comparable among all the groups. Conclusion: The combination of sucrose and EMLA cream revealed a higher analgesic effect and minimal adverse response to pain than either EMLA cream or sucrose alone during neonatal circumcision.

  4. Effects of Chronic Lead Acetate Intoxication on Blood Indices of Male Adult Rat

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    Mohammadhosein Noori Mugahi

    2003-10-01

    Full Text Available Lead as one of the environmental pollutants can threats the life of living creatures in many ways. In this study, hematological effects of chronic toxicity of the lead acetate in adult male rats through measurement of the lead concentration in the blood of animal’s heart by atomic absorption as well as hematological analyses and differential cell count were investigated. Results showed that lead concentration in the treatment group was significantly higher than that of the control groups (P<0.001, and basophilic stippling, Howell-Jolly bodies, decreased RBC count (anemia, increased leukocyte count (leukocytosis, monocytosis, eosinopenia, neutrophilia, and thrombocytosis were observed in the test group (P<0.001. It is concluded that microcytic hypochromic anemia can be attributed to the interaction of lead with iron and copper metabolism and increased leukocyte count may be linked to the inflammatory effects of lead on lymphatic organs.

  5. Surgical reimplantation of penile glans amputation in children during circumcision

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    Bouassida Khaireddine

    2014-01-01

    Full Text Available Circumcision is one of the oldest and most commonly performed surgical procedures. Unfortunately, various complications may occur during circumcision, ranging from trivial to tragic such as penile amputation which is a serious complication and a challenging injury to treat. We describe two cases of non-microsurgical successful reattachment of a distal penile glans which were amputated during circumcision. In the first case, a 5-year-old child underwent circumcision by an urologist under local anesthesia. In the second one, a 3-year-old child underwent circumcision by a general practitioner who used to make circumcision. In this article, the literature is reviewed; results and potential complications of this surgery are also discussed. Glans sensation was present, early morning erection was maintained, and there was an erectile response during penile manipulation in both cases. Although circumcision is not technically difficult, it should be taken seriously. The use of microsurgical reattachment is not always possible, especially in pediatric cases; it also requires special equipment and training.

  6. Does circumcision alter the periurethral uropathogenic bacterial flora

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    Mushtaq Ahmad Laway

    2012-01-01

    Full Text Available Background: The aim of this study was to assess the pattern of periurethral bacterial flora in uncircumcised boys and to evaluate the effect of circumcision on alteration of periurethral uropathogenic bacterial flora. Materials and Methods: Pattern of periurethral bacterial flora before and after circumcision was studied prospectively in 124 boys. The results were analysed to compare change in bacterial colonisation before and after circumcision. Results: The age range was 6 weeks to 96 months. Most (94.3% of the boys had religious indication and 5.7% had medical indication for circumcision. E. coli, Proteus and Klebsiella were most common periurethral bacterial flora in uncircumcised subjects. Coagulase-negative staphylococcus and Staphylococcus aureus was most common periurethral bacterial flora in circumcised subjects. In 66.1% of circumcised subjects, no bacteria were grown from periurethral region. Conclusion: We conclude that presence of prepuce is associated with great quantity of periurethral bacteria, greater likelihood of the presence of high concentration of uropathogens and high incidence of urinary tract infection (UTI. This study provides circumstantial evidence supporting the idea that early circumcision may be beneficial for prevention of UTI.

  7. Normative values of hip strength in adult male association football players assessed by handheld dynamometry.

    Science.gov (United States)

    Hanna, Chris M; Fulcher, Mark L; Elley, C Raina; Moyes, Simon A

    2010-05-01

    Chronic groin pain is a common problem in association football players. Normative values for the strength of hip muscles, measured in an accurate and accessible manner, are needed to gauge strength and inform return to play decisions in this group. The purpose of this study was to define normative values of hip muscle strength using handheld dynamometry. A series of reliable clinical tests that are commonly used when making return to sport decisions in athletes with chronic adductor related groin pain have been selected. One hundred and twenty adult male association football players, free from injury, were recruited. Isometric strength of the hip flexors and adductor muscles was measured using a handheld dynamometer. Mean age was 24.9 years (SD 5.9). Eighty participants (67%) had experienced groin pain in the past. Mean strength for dominant leg hip flexion was 47.3 kg (95% confidence interval 45.6-49.0), non-dominant leg hip flexion was 42.5 kg (41.1-43.9), adduction at 0 degrees hip flexion was 35.6 kg (34.1-37.1), adduction at 45 degrees was 32.0 kg (30.9-33.1), and adduction at 90 degrees was 25.5 kg (24.4-26.5). This study establishes reference ranges and predictive equations for maximal isometric contraction strength of the hip muscles in non-injured adult male association football players. This information will assist assessment and management of an athlete's return to play following injury. PMID:19574097

  8. In vivo brain anatomy of adult males with Fragile X syndrome: an MRI study.

    LENUS (Irish Health Repository)

    Hallahan, Brian P

    2011-01-01

    Fragile X Syndrome (FraX) is caused by the expansion of a single trinucleotide gene sequence (CGG) on the X chromosome, and is a leading cause of learning disability (mental retardation) worldwide. Relatively few studies, however, have examined the neuroanatomical abnormalities associated with FraX. Of those that are available many included mixed gender populations, combined FraX children and adults into one sample, and employed manual tracing techniques which measures bulk volume of particular regions. Hence, there is relatively little information on differences in grey and white matter content across whole brain. We employed magnetic resonance imaging to investigate brain anatomy in 17 adult males with FraX and 18 healthy controls that did not differ significantly in age. Data were analysed using stereology and VBM to compare (respectively) regional brain bulk volume, and localised grey\\/white matter content. Using stereology we found that FraX males had a significant increase in bulk volume bilaterally of the caudate nucleus and parietal lobes and of the right brainstem, but a significant decrease in volume of the left frontal lobe. Our complimentary VBM analysis revealed an increased volume of grey matter in fronto-striatal regions (including bilaterally in the caudate nucleus), and increased white matter in regions extending from the brainstem to the parahippocampal gyrus, and from the left cingulate cortex extending into the corpus callosum. People with FraX have regionally specific differences in brain anatomy from healthy controls with enlargement of the caudate nuclei that persists into adulthood.

  9. Personality dimensions in adult male rhesus macaques: prediction of behaviors across time and situation.

    Science.gov (United States)

    Capitanio, J P

    1999-01-01

    The idea that consistencies in behavior exist over time and across situations underlies human personality research. Although several studies have examined personality in nonhuman primates, there are very few data showing the predictive power of personality factors. The goal of the present study was to determine whether personality dimensions, identified in adult male rhesus monkeys living in half-acre cages, predicted behavior in situations different from the one from which the dimensions were originally derived and at time points of up to 4.5 years after the original assessments. Four personality dimensions (Sociability, Confidence, Excitability, and Equability) were identified using psychometric procedures and were correlated with behaviors recorded in several situations: the animals' natal groups, during tests of behavioral responsiveness while in individual cages, in small stable and unstable social groups, while viewing stimulus videotapes, and during stable social dyads. Results indicated substantial predictability. Sociability reflected a greater tendency to engage in affiliative interactions. Confidence correlated with more aggressive behaviors and with behaviors that suggest less attractiveness. Animals high in Excitability were somewhat inconsistent in their social behavior, perhaps reflecting hyper-responsiveness to novel circumstances and thwarted opportunities for escape. Equability appeared to be related to a less aggressive, more passive, style of interaction. Excitability and Equability appear to reflect more stylistic components of social behavior, whereas Sociability and Confidence may be more content-based dimensions. Sociability was strongly related to size of kin network in the animals' natal groups, suggesting an important role for ontogeny in this dimension. These data suggest that a limited number of personality dimensions exist in adult male rhesus macaques, and that these dimensions have predictive power that is both long-term and cross

  10. [Plasma lipid concentration in smoking and nonsmoking male adults treated from alcohol addiction].

    Science.gov (United States)

    Słodczyk, Ewa; Szołtysek-Bołdys, Izabela; Kozar-Konieczna, Aleksandra; Goniewicz, Jerzy; Ptak, Małgorzata; Olszowy, Zofia; Kośmider, Leon; Goniewicz, Maciej Łukasz; Sobczak, Andrzej

    2013-01-01

    Alcohol drinking and tobacco smoking affect plasma lipid levels and are both independent risk factors of cardiovascular diseases. Alcohol and nicotine addictions are more common among man than women in Poland. The aim of the study was to evaluate changes in plasma lipid levels after cessation of heavy drinking in smoking and nonsmoking Polish male adults. Subjects were recruited from individuals who participated in an inpatient addiction program following alcohol detoxification. We recruited 119 male adults: 48 non-smokers in age between 31 and 60 years (mean 48.7 +/- 8.8) and 71 smokers in age between 30 and 60 years (mean 46.1 +/- 7.8). Each subjects provided three blood samples: at baseline, after 3 weeks, and after 6 weeks of treatment. Plasma samples were analyzed for lipids by manual precipitation and automatic enzymatic methods. Changes in plasma lipid concentrations were analyzed using two-way analysis of variances with repeated measures with smoking status as between subjects factor and time post alcohol cessation as within-subject factors. All analyses were adjusted for age, and BMI. We found that plasma levels of HDL decreased in smoking and nonsmoking subjects by 30% and 24%, respectively (p smoking subjects, plasma levels of triglycerides and LDL increased significantly after 6 weeks post cessation of heavy drinking cessation by 17% and 16%, respectively (p = 0.001). We also found that total cholesterol levels remained high in smoking subjects, but decreased significantly by 7% (p = 0.022) in nonsmoking subjects after 6 weeks post cessation of heavy drinking. We concluded that cigarette smoking increased LDL and inhibited the decline in plasma cholesterol among subjects addicted to alcohol following cessation of heavy drinking. Alcohol addiction therapy should be complemented with smoking cessation to prevent increase in cardiovascular risk.

  11. Antioxidant Effect of Carica papaya on Ethanol Induced Gastric Lesion in Adult Male Wistar Rats

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    A.A. Okesina

    2012-06-01

    Full Text Available This study was performed to elucidate the role of some important constituents of antioxidant defence such as Glutathione Peroxidase (GPx, Thiobarbituric Acid Reaction (TBAR, the activity of the enzyme Glucose-6-Phosphate Dehydrogenase (G-6-PDH of Carica papaya on ethanol induced gastric lesion in adult male wistar rats. Twenty-four male adult Wistar rats weighing 180- 220 g were used in this study. Animals were divided into three groups (n = 8 per group. The control group A received phosphate buffered saline orally, with the aid of a cannula. 1 mL of 50% ethanol was administered orally, by a cannula, to produce the gastric lesion in group B (n = 8. And in the group C, 500 mg/kg body weight of paw paw leaf extract was administered orally, with a cannula, twelve hours after ethanol administration to the rats. This experiment lasted for twenty one consecutive days. The result showed that TBARS in gastric mucosa as an index for oxidative stress level was significantly increased after ethanol administration. CPL did not reduce significantly the levels of TBARS in the gastric mucosa. G-6-PDH activity was significantly increased in gastric mucosa after ethanol administration, but in rats treated with CPL, a reverse of G-6-PDH activity was observed. Ethanol induced a remarkable and significant decrease of GPx activity in gastric mucosa, whereas CPL induced a significant reversion of ethanol’s effect on the enzyme. The results therefore demonstrate that CPL treatment exerts antioxidant effects on ethanol-induced gastric lesions in wistar rats.

  12. Scale-Dependent Habitat Selection and Size-Based Dominance in Adult Male American Alligators.

    Science.gov (United States)

    Strickland, Bradley A; Vilella, Francisco J; Belant, Jerrold L

    2016-01-01

    Habitat selection is an active behavioral process that may vary across spatial and temporal scales. Animals choose an area of primary utilization (i.e., home range) then make decisions focused on resource needs within patches. Dominance may affect the spatial distribution of conspecifics and concomitant habitat selection. Size-dependent social dominance hierarchies have been documented in captive alligators, but evidence is lacking from wild populations. We studied habitat selection for adult male American alligators (Alligator mississippiensis; n = 17) on the Pearl River in central Mississippi, USA, to test whether habitat selection was scale-dependent and individual resource selectivity was a function of conspecific body size. We used K-select analysis to quantify selection at the home range scale and patches within the home range to determine selection congruency and important habitat variables. In addition, we used linear models to determine if body size was related to selection patterns and strengths. Our results indicated habitat selection of adult male alligators was a scale-dependent process. Alligators demonstrated greater overall selection for habitat variables at the patch level and less at the home range level, suggesting resources may not be limited when selecting a home range for animals in our study area. Further, diurnal habitat selection patterns may depend on thermoregulatory needs. There was no relationship between resource selection or home range size and body size, suggesting size-dependent dominance hierarchies may not have influenced alligator resource selection or space use in our sample. Though apparent habitat suitability and low alligator density did not manifest in an observed dominance hierarchy, we hypothesize that a change in either could increase intraspecific interactions, facilitating a dominance hierarchy. Due to the broad and diverse ecological roles of alligators, understanding the factors that influence their social dominance

  13. Atypically rightward cerebral asymmetry in male adults with autism stratifies individuals with and without language delay.

    Science.gov (United States)

    Floris, Dorothea L; Lai, Meng-Chuan; Auer, Tibor; Lombardo, Michael V; Ecker, Christine; Chakrabarti, Bhismadev; Wheelwright, Sally J; Bullmore, Edward T; Murphy, Declan G M; Baron-Cohen, Simon; Suckling, John

    2016-01-01

    In humans, both language and fine motor skills are associated with left-hemisphere specialization, whereas visuospatial skills are associated with right-hemisphere specialization. Individuals with autism spectrum conditions (ASC) show a profile of deficits and strengths that involves these lateralized cognitive functions. Here we test the hypothesis that regions implicated in these functions are atypically rightward lateralized in individuals with ASC and, that such atypicality is associated with functional performance. Participants included 67 male, right-handed adults with ASC and 69 age- and IQ-matched neurotypical males. We assessed group differences in structural asymmetries in cortical regions of interest with voxel-based analysis of grey matter volumes, followed by correlational analyses with measures of language, motor and visuospatial skills. We found stronger rightward lateralization within the inferior parietal lobule and reduced leftward lateralization extending along the auditory cortex comprising the planum temporale, Heschl's gyrus, posterior supramarginal gyrus, and parietal operculum, which was more pronounced in ASC individuals with delayed language onset compared to those without. Planned correlational analyses showed that for individuals with ASC, reduced leftward asymmetry in the auditory region was associated with more childhood social reciprocity difficulties. We conclude that atypical cerebral structural asymmetry is a potential candidate neurophenotype of ASC.

  14. Female Adult Aedes albopictus Suppression by Wolbachia-Infected Male Mosquitoes

    Science.gov (United States)

    Mains, James W.; Brelsfoard, Corey L.; Rose, Robert I.; Dobson, Stephen L.

    2016-01-01

    Dengue, chikungunya and zika viruses are pathogens with an increasing global impact. In the absence of an approved vaccine or therapy, their management relies on controlling the mosquito vectors. But traditional controls are inadequate, and the range of invasive species such as Aedes albopictus (Asian Tiger Mosquito) is expanding. Genetically modified mosquitoes are being tested, but their use has encountered regulatory barriers and public opposition in some countries. Wolbachia bacteria can cause a form of conditional sterility, which can provide an alternative to genetic modification or irradiation. It is unknown however, whether openly released, artificially infected male Ae. albopictus can competitively mate and sterilize females at a level adequate to suppress a field population. Also, the unintended establishment of Wolbachia at the introduction site could result from horizontal transmission or inadvertent female release. In 2014, an Experimental Use Permit from the United States Environmental Protection Agency approved a pilot field trial in Lexington, Kentucky, USA. Here, we present data showing localized reduction of both egg hatch and adult female numbers. The artificial Wolbachia type was not observed to establish in the field. The results are discussed in relation to the applied use of Wolbachia-infected males as a biopesticide to suppress field populations of Ae. albopictus. PMID:27659038

  15. Effects of Red Palm Oil on Serum Lipids and Plasma Carotenoids Level in Chinese Male Adults

    Institute of Scientific and Technical Information of China (English)

    JIAN ZHANG; CHUN-RONG WANG; AN-NA XUE; KE-YOU GE

    2003-01-01

    Objective Effects of red palm oil on major plasma carotenoids, tocopherol, retinol and serumlipids were evaluated when used in Chinese diet. Methods Red palm oil group (RPO) composed of 20 male subjects(aged 18-32) and soybean oil group (SBO) composed of 22 male subjects (aged18-32). Dietary fat provided about 28% of total calories, and the test oil accounted for about 60% of total dietary fat. In the 3 weeks of pretest period, diets were prepared with soybean oil, and then in the next 6 weeks subjects in each group consumed the diet prepared by test oil. Results Plasmaα-carotene, β-carotene and lycopene concentration of RPO group significantly increased at the time of interim (21 days) and of the end (42 days) (P<0.05), and α-tocopherol concentration significantly increased at the time of the end (42 days) in this study. Though Chinese plasma retinol level was relatively low when compared with that of Westerners, red palm oil diet showed no significant effect on adult Chinese plasma retinol level. Serum concentration of total cholesterol, triglyceride, high density lipoprotein cholesterol, apolipoprotein AI and apolipoprotein B of all subjects showed no significant changes in RPO group during the study. Conclusions The data in our study suggest that red palm oil is a good source of carotenoids and vitamin E when used in Chinese diet preparation, and it can significantly increase plasma concentration of α-carotene, β-carotene, lycopene andα-tocopherol.

  16. Anatomic aspects of the male genital organs of adult galea (Galea spixii Wagler, 1831

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    Maria Angelica Miglino

    2013-03-01

    Full Text Available The Galea spixii are hystricomorpha with reproductive and feeding activity subject to rainfall and climatic factors. Due to lack of knowledge on the reproductive system in Galea this study aimed to describe its macroscopic anatomy and topography. Ten adult animals from the Centre for Wild Animals Multiplication of Universidade Federal Rural do Semiarido were used. Then, dissections, photographs, and in situ organ description in order to better preserve topography. The male genitalia were represented by the testes, epididymis, accessory genital glands (represented by the prostate and the vesicular and bulbourethral glands, besides penis and scrotum. The testes were ovoid and located at different sites, depending on the animal’s reproductive activity. The epididymis had three regions: head, body, and tail. The prostate was divided into two lateral portions, with two lobes. The penis was cylindrical and it had a cranial flexure, bending it caudally. The gland was lined by a rough epithelium, keratinized with superficial spicules. The findings described for the male reproductive system of the Galea are similar to those described for rodents like the agouti and rock cavy, especially with regard to testicular gross anatomy, penis shape, and presence of spicules in the glands.

  17. Early postnatal caloric restriction protects adult male intrauterine growth-restricted offspring from obesity.

    Science.gov (United States)

    Garg, Meena; Thamotharan, Manikkavasagar; Dai, Yun; Thamotharan, Shanthie; Shin, Bo-Chul; Stout, David; Devaskar, Sherin U

    2012-06-01

    Postnatal ad libitum caloric intake superimposed on intrauterine growth restriction (IUGR) is associated with adult-onset obesity, insulin resistance, and type 2 diabetes mellitus (T2DM). We hypothesized that this paradigm of prenatal nutrient deprivation-induced programming can be reversed with the introduction of early postnatal calorie restriction. Ten-month-old male rats exposed to either prenatal nutrient restriction with ad libitum postnatal intake (IUGR), pre- and postnatal nutrient restriction (IPGR), or postnatal nutrient restriction limited to the suckling phase (50% from postnatal [PN]1 to PN21) (PNGR) were compared with age-matched controls (CON). Visceral adiposity, metabolic profile, and insulin sensitivity by hyperinsulinemic-euglycemic clamps were examined. The 10-month-old male IUGR group had a 1.5- to 2.0-fold increase in subcutaneous and visceral fat (P metabolic inflexibility (Vo(2)) versus CON. The IPGR group remained lean, euglycemic, insulin sensitive, and active while maintaining metabolic flexibility. The PNGR group was insulin sensitive, similar to IPGR, but less active while maintaining metabolic flexibility. We conclude that IUGR resulted in obesity without insulin resistance and energy metabolic perturbations prior to development of glucose intolerance and T2DM. Postnatal nutrient restriction superimposed on IUGR was protective, restoring metabolic normalcy to a lean and active phenotype. PMID:22461568

  18. Atypically rightward cerebral asymmetry in male adults with autism stratifies individuals with and without language delay.

    Science.gov (United States)

    Floris, Dorothea L; Lai, Meng-Chuan; Auer, Tibor; Lombardo, Michael V; Ecker, Christine; Chakrabarti, Bhismadev; Wheelwright, Sally J; Bullmore, Edward T; Murphy, Declan G M; Baron-Cohen, Simon; Suckling, John

    2016-01-01

    In humans, both language and fine motor skills are associated with left-hemisphere specialization, whereas visuospatial skills are associated with right-hemisphere specialization. Individuals with autism spectrum conditions (ASC) show a profile of deficits and strengths that involves these lateralized cognitive functions. Here we test the hypothesis that regions implicated in these functions are atypically rightward lateralized in individuals with ASC and, that such atypicality is associated with functional performance. Participants included 67 male, right-handed adults with ASC and 69 age- and IQ-matched neurotypical males. We assessed group differences in structural asymmetries in cortical regions of interest with voxel-based analysis of grey matter volumes, followed by correlational analyses with measures of language, motor and visuospatial skills. We found stronger rightward lateralization within the inferior parietal lobule and reduced leftward lateralization extending along the auditory cortex comprising the planum temporale, Heschl's gyrus, posterior supramarginal gyrus, and parietal operculum, which was more pronounced in ASC individuals with delayed language onset compared to those without. Planned correlational analyses showed that for individuals with ASC, reduced leftward asymmetry in the auditory region was associated with more childhood social reciprocity difficulties. We conclude that atypical cerebral structural asymmetry is a potential candidate neurophenotype of ASC. PMID:26493275

  19. Smoking-Related Knowledge, Attitudes, Behaviors, Smoking Cessation Idea and Education Level among Young Adult Male Smokers in Chongqing, China

    Directory of Open Access Journals (Sweden)

    Xianglong Xu

    2015-02-01

    Full Text Available Introduction: In 2012 in China, 52.9% of men were reported to smoke while only 2.4% of women smoked. This study explored the smoking-related Knowledge, Attitudes and Practices (KAP among young adult male smokers. Methods: A cross-sectional study was conducted in four municipal areas of Chongqing using a questionnaire administered to 536 natives young male smokers aged 18–45 years old. Results: The total score of smoking cognition, the total score of smoking attitude and the total score of positive behavior to quit smoking was significantly different among the three groups by education. Besides, 30.97% of male smokers never seriously thought about quitting smoking. Logistic regression analysis found smoking-related knowledge, attitudes, behaviors and sociodemographic factors affect having smoking cessation idea. But no statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking in a sample of higher education. No statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking (Pearson correlation coefficient = 0.03012, p = 0.6811, and also no statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking (Pearson correlation coefficient = 0.08869, p = 0.2364  in the sample of higher education young adult males Conclusions: Young adult males with higher education have a better knowledge of smoking hazards and a more positive attitude toward smoking, however, this knowledge and attitude do not necessarily translate into health behavioral outcomes such as not smoking. Overall the present findings indicate that no statistically significant correlation between the education level and quitting smoking idea exists among young adult male smokers in China. This survey gives a snapshot of the impact of education on smoking-related KAP among young adults male smokers.

  20. Ischemic stroke following abuse of Marijuana in a Nigerian adult male

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    Olalekan Oyinloye

    2014-01-01

    Full Text Available Cannabis is the most widely used illicit drug among adolescents and young adults. Despite its widespread use, only a few reports exist on the association of cannabis use and stroke. A 26-year-old Nigerian male, developed right-sided ischemic stroke few hours after smoking three wraps of cannabis. He had smoked cannabis consistently for the past 4 years prior to the development of the stroke. Known stroke etiology and abuse of other illicit drugs were ruled out from history and investigations. Neuroimaging studies of the brain revealed infarcts in basal ganglia secondary to occlusion of blood flow in the left anterior and middle cerebral arteries. The mechanism of stroke in this patient was thought to be a cannabis-induced vasculopathy. Many cases of stroke in the young are increasingly being seen in hospitals in resource scarce countries. There seems to be a predilection for the basal ganglia in ischemic stroke following cannabis abuse. Therefore, cannabis abuse should be considered in young adults with basal ganglia infarcts, after excluding other known etiologies.

  1. Ischemic stroke following abuse of Marijuana in a Nigerian adult male.

    Science.gov (United States)

    Oyinloye, Olalekan; Nzeh, Donald; Yusuf, Ayodeji; Sanya, Emmanuel

    2014-10-01

    Cannabis is the most widely used illicit drug among adolescents and young adults. Despite its widespread use, only a few reports exist on the association of cannabis use and stroke. A 26-year-old Nigerian male, developed right-sided ischemic stroke few hours after smoking three wraps of cannabis. He had smoked cannabis consistently for the past 4 years prior to the development of the stroke. Known stroke etiology and abuse of other illicit drugs were ruled out from history and investigations. Neuroimaging studies of the brain revealed infarcts in basal ganglia secondary to occlusion of blood flow in the left anterior and middle cerebral arteries. The mechanism of stroke in this patient was thought to be a cannabis-induced vasculopathy. Many cases of stroke in the young are increasingly being seen in hospitals in resource scarce countries. There seems to be a predilection for the basal ganglia in ischemic stroke following cannabis abuse. Therefore, cannabis abuse should be considered in young adults with basal ganglia infarcts, after excluding other known etiologies. PMID:25288854

  2. Chronic effect of gabapentin on liver function in adult male rats.

    Directory of Open Access Journals (Sweden)

    Mohammad Hassan Meshkibaf

    2013-12-01

    Full Text Available Gabapentin (GPN is a new antiepileptic agent currently in used as add-on therapy in adult patients suffering from partial seizures. The extent of liver damage at different dosage and long term treatment with GPN is not yet clear. Therefore this study was undertaken to find out the possibility of liver damage by this drug. Adult male (Wistar rats of 180-220 g were administered intraperitoneally with GPN (20 or 100 mg/kg for 45 days. After the experimental period, the liver function tests were carried out in control and experimental groups. The activity of liver enzymes, with 20 mg/kg of GPN were not significantly different from the control group but, the serum levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, direct bilirubin and total bilirubin were enhanced significantly with 100 mg/kg of GPN. Total protein and albumin decreased in this group as compared with control animals. The histopathology of the liver parenchymal cells also showed minute foci of necrosis in a few rats treated with high dose of GPN, whereas, at therapeutic dose the histopathology and biochemical indices showed almost normal values. At therapeutic dose GPN is a safer drug with regards to liver function and hepatocellular damage as compared with other antiepileptic drugs.

  3. Quercetin-induced changes in femoral bone microstructure of adult male rabbits

    Directory of Open Access Journals (Sweden)

    Ramona Babosová

    2016-06-01

    Full Text Available Flavonoids are a group of plant metabolites with antioxidant effects. One of the most abundant flavonoids in the human diet is quercetin. It is found widely in fruits, vegetables and has a lot of beneficial effects on human health. Quercetin has a positive pharmacological effect on bone metabolism and it prevents the organism against bone loss. However, its impact on the size of basic structural units of the compact bone is still unknown. Therefore, the aim of present study was to investigate the impact of the quercetin on femoral bone microstructure in 5-month-old male rabbits. Five rabbits of Californian broiler line were randomly divided into two groups. In the experimental group (E group; n=3, animals were intramuscularly injected with quercetin at dose 1000 μg.kg-1 body weight (bw for 90 days, 3 times per week. Two rabbits without quercetin administration served as a control group (C group. According to our results, intramuscular application of quercetin had an insignificant effect on cortical bone thickness in male rabbits. In these rabbits, changes in qualitative histological characteristics were present in the middle part of the compacta, where primary vascular longitudinal bone tissue was present and expanded there from the periosteum. Also, a lower number of secondary osteons was found in these animals. From the histomorphometrical point of view, significantly decreased sizes of primary osteons' vascular canals and secondary osteons (p <0.05 were found in rabbits administered by quercetin. Our findings indicate that subchronic administration of quercetin at the dose used in our study had considerable impact on both qualitative and quantitative histological characteristics of the compact bone in adult male rabbits.

  4. An assessment of knowledge and attitude of vasectomy in adult males: a cross sectional study from Pokhara, Western Nepal

    Directory of Open Access Journals (Sweden)

    Gnanakshi. Dayanand

    2014-12-01

    Full Text Available Background Vasectomy is a simple, reliable, safe, effective and permanent method of birth control for men. The failure rate is less than 1%. The objective of this study was to assess the knowledge and attitude of vasectomy in adult males residing in Pokhara, Nepal. Methods Descriptive cross-sectional survey approach was adopted for the present study. 100 adult males of 26-49 years of age were selected for this study. Data was collected from 31-03-2014 to 30-04-2014 by using structured questionnaire and finally analyzed by Statistical Package for the Social Sciences (SPPS for Windows Version 16.0 (SPSS Inc.; Chicago, IL, USA. Results In the present study majority of the participants had average level of knowledge 69%; 26% had poor and remaining 5% had good level of knowledge regarding vasectomy. Most of the participants had good attitude 60%, 40% of them had average attitude and none of them had poor attitude regarding vasectomy. Conclusion Majority of adult males had average knowledge on vasectomy. So, adult males should be educated about the advantages of vasectomy. This may bring changes in controlling population explosion, sharing the decisions of contraception burden equally with their partners, more awareness of reproductive roles and closes the gap in male and female sterilization rates.

  5. Association between Periodontal Status, Oral Hygiene Status and Tooth Wear among Adult Male Population in Benin City, Nigeria

    OpenAIRE

    Umoh, AO; Azodo, CC

    2013-01-01

    Background: The association between periodontal status, oral hygiene status and severity of tooth wear lesion varies from community to community and also from occupation to occupation. Aim: To determine the association between periodontal status, oral hygiene status and tooth wear among the adult male population in Benin City, Nigeria. Subjects and Methods: This study was conducted among 65 male drivers, aged 25-64 years, with a mean age of 48.6 (9.1) years in an organized private motor park ...

  6. Effect of Pistacia Vera Oil on Pituitary Gonad Axis and Histological Testis Changes in Adult Male Rats

    OpenAIRE

    f Porhemmat; M Shariati; L Sepehrara

    2013-01-01

    Abstract Background & aim: Pistachio oil contains the chemical compounds such as saturated and unsaturated fatty acids. Saturated fatty acids can inhibit 5-α- reductase enzyme and unsaturated fatty acids increase cholesterol levels in the body. The aim of the present study was to determine the effects of pistachio oil on adult male rats’ reproductive status. Methods: In the present experimental study, 40 male Wistar rat were divided into five groups of eight. The control group received ...

  7. The Relationship among Pulse Wave Velocity, Ankle-Brachial Pressure Index and Heart Rate Variability in Adult Males

    OpenAIRE

    Ahn, Jeong-Hwan; Kong, Mihee

    2011-01-01

    Background Pulse wave velocity (PWV) and ankle-brachial pressure index (ABI) are non-invasive tools to measure atherosclerosis and arterial stiffness. Heart rate variability (HRV) has proven to be a non-invasive powerful tool in the investigation of the autonomic cardiovascular control. Therefore, the purpose of this study was to determine the relationship among PWV, ABI, and HRV parameters in adult males. Methods The study was carried out with 117 males who visited a health care center from ...

  8. Epidemiology of smoking among Malaysian adult males: prevalence and associated factors

    Directory of Open Access Journals (Sweden)

    Lim Hock Kuang

    2013-01-01

    Full Text Available Abstract Background Three National Health and Morbidity Surveys (NHMSs had been conducted in Malaysia in 10-year intervals from 1986–2006. Based on the latest NHMS survey in 2006, we describe the prevalence of smoking and identify the social and demographic factors associated with smoking among adult males in Malaysia. Methods A cross-sectional study among 15,639 Malaysian adult males aged 18 years and above was conducted using proportional to size stratified sampling method. The socio-demographic variables examined were level of education, occupation, marital status, residential area, age group and monthly household income. Results The prevalence of smoking among adult males in Malaysia was 46.5% (95% CI: 45.5–47.4%, which was 3% lower than a decade ago. Mean age of smoking initiation was 18.3 years, and mean number of cigarettes smoked daily was 11.3. Prevalence of smoking was highest among the Malays (55.9% and those aged 21–30 years (59.3%. Smoking was significantly associated with level of education (no education OR 2.09 95% CI (1.67–2.60, primary school OR 1.95, 95% CI (1.65–2.30, secondary school OR 1.88, 95% CI (1.63–2.11, with tertiary education as the reference group. Marital status (divorce OR 1.67, 95% CI (1.22–2.28, with married as the reference group, ethnicity (Malay, OR 2.29, 95% CI ( 1.98–2.66; Chinese OR 1.23 95% CI (1.05–1.91, Other Bumis OR 1.75, 95% CI (1.46–2.10, others OR 1.48 95% CI (1.15–1.91, with Indian as the reference group, age group (18–20 years OR 2.36, 95% CI (1.90–2.94; 20–29 years OR 3.31 , 95% CI 2.82–3.89; 31–40 years OR 2.85 , 95% CI ( 2.47–3.28; 41–50 years OR 1.93, 95% CI (1.69–2.20 ; 51–60 years OR 1.32, 95% CI (1.15–1.51, with 60 year-old and above as the reference group and residential area (rural OR 1.12 , 95% CI ( 1.03–1.22 urban as reference. Conclusion The prevalence of smoking among Malaysian males remained high in spite of several population

  9. Pheromones from males of different familiarity exert divergent effects on adult neurogenesis in the female accessory olfactory bulb.

    Science.gov (United States)

    Wu, Jyun-Han; Han, Yueh-Ting; Yu, Jenn-Yah; Wang, Tsu-Wei

    2013-08-01

    Pheromones from urine of unfamiliar conspecific male animals can reinitiate a female's estrus cycle to cause pregnancy block through the vomeronasal organ (VNO)-accessory olfactory bulb (AOB)-hypothalamic pathway. This phenomenon is called the Bruce effect. Pheromones from the mate of the female, however, do not trigger re-entrance of the estrus cycle because an olfactory memory toward its mate is formed. The activity of the VNO-AOB-hypothalamic pathway is negatively modulated by GABAergic granule cells in the AOB. Since these cells are constantly replenished by neural stem cells in the subventricular zone (SVZ) of the lateral ventricle throughout adulthood and adult neurogenesis is required for mate recognition and fertility, we tested the hypothesis that pheromones from familiar and unfamiliar males may have different effects on adult AOB neurogenesis in female mice. When female mice were exposed to bedding used by a male or lived with one, cell proliferation and neuroblast production in the SVZ were increased. Furthermore, survival of newly generated cells in the AOB was enhanced. This survival effect was transient and mediated by norepinephrine. Interestingly, male bedding-induced newborn cell survival in the AOB but not cell proliferation in the SVZ was attenuated when females were subjected to bedding from an unfamiliar male. Our results indicate that male pheromones from familiar and unfamiliar males exert different effects on neurogenesis in the adult female AOB. Given that adult neurogenesis is required for reproductive behaviors, these divergent pheromonal effects may provide a mechanism for the Bruce effect. © 2013 Wiley Periodicals, Inc. Develop Neurobiol 73: 632-645, 2013. PMID:23696538

  10. The effects of adult sex ratio on mating competition in male and female guppies (Poecilia reticulata) in two wild populations.

    Science.gov (United States)

    Chuard, Pierre J C; Brown, Grant E; Grant, James W A

    2016-08-01

    When competing for mates, males typically exhibit higher rates of intrasexual aggression and courtship than females. Operational sex ratio, represented here by adult sex ratio (ASR) as a proxy, is likely the best predictor of this competition, which typically increases between members of one sex as members of the opposite sex become rarer. Moreover, in populations subject to high predation, males often decrease mating competitive behaviour due to predation risk. We explored the combined effects of ASR and population of origin (low vs. high ambient predation risk) on mating competition in male and female wild-caught Trinidadian guppies. Both male and female aggression rates increased with ASR, but the increase for males was only significant in the low-predation population. In regard to male mating tactics, courtship propensity was unaffected by ASR, while the propensity to sneak increased at male-biased ASRs. Guppies from a high predation population had lower aggression rates than their low predation counterpart, but male courtship and sneaking attempts did not differ between populations. Surprisingly, females were just as aggressive as males when competing for mates. These results highlight the trade-offs between antipredator and agonistic behaviour, which may affect sexual selection pressures in wild populations. PMID:27208810

  11. Male reproductive health after childhood, adolescent, and young adult cancers: a report from the Children's Oncology Group.

    Science.gov (United States)

    Kenney, Lisa B; Cohen, Laurie E; Shnorhavorian, Margarett; Metzger, Monika L; Lockart, Barbara; Hijiya, Nobuko; Duffey-Lind, Eileen; Constine, Louis; Green, Daniel; Meacham, Lillian

    2012-09-20

    The majority of children, adolescents, and young adults diagnosed with cancer will become long-term survivors. Although cancer therapy is associated with many adverse effects, one of the primary concerns of young male cancer survivors is reproductive health. Future fertility is often the focus of concern; however, it must be recognized that all aspects of male health, including pubertal development, testosterone production, and sexual function, can be impaired by cancer therapy. Although pretreatment strategies to preserve reproductive health have been beneficial to some male patients, many survivors remain at risk for long-term reproductive complications. Understanding risk factors and monitoring the reproductive health of young male survivors are important aspects of follow-up care. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) were created by the COG to provide recommendations for follow-up care of survivors at risk for long-term complications. The male health task force of the COG-LTFU Guidelines, composed of pediatric oncologists, endocrinologists, nurse practitioners, a urologist, and a radiation oncologist, is responsible for updating the COG-LTFU Guidelines every 2 years based on literature review and expert consensus. This review summarizes current task force recommendations for the assessment and management of male reproductive complications after treatment for childhood, adolescent, and young adult cancers. Issues related to male health that are being investigated, but currently not included in the COG-LTFU Guidelines, are also discussed. Ongoing investigation will inform future COG-LTFU Guideline recommendations for follow-up care to improve health and quality of life for male survivors.

  12. Vasoactive intestinal peptide antagonist treatment during mouse embryogenesis impairs social behavior and cognitive function of adult male offspring.

    Science.gov (United States)

    Hill, Joanna M; Cuasay, Katrina; Abebe, Daniel T

    2007-07-01

    Vasoactive intestinal peptide (VIP) is a regulator of rodent embryogenesis during the period of neural tube closure. VIP enhanced growth in whole cultured mouse embryos; treatment with a VIP antagonist during embryogenesis inhibited growth and development. VIP antagonist treatment during embryogenesis also had permanent effects on adult brain chemistry and impaired social recognition behavior in adult male mice. The neurological deficits of autism appear to be initiated during neural tube closure and social behavior deficits are among the key characteristics of this disorder that is more common in males and is frequently accompanied by mental retardation. The current study examined the blockage of VIP during embryogenesis as a model for the behavioral deficits of autism. Treatment of pregnant mice with a VIP antagonist during embryonic days 8 through 10 had no apparent effect on the general health or sensory or motor capabilities of adult offspring. However, male offspring exhibited reduced sociability in the social approach task and deficits in cognitive function, as assessed through cued and contextual fear conditioning. Female offspring did not show these deficiencies. These results suggest that this paradigm has usefulness as a mouse model for aspects of autism as it selectively impairs male offspring who exhibit the reduced social behavior and cognitive dysfunction seen in autism. Furthermore, the study indicates that the foundations of some aspects of social behavior are laid down early in mouse embryogenesis, are regulated in a sex specific manner and that interference with embryonic regulators such as VIP can have permanent effects on adult social behavior.

  13. Phenology of Maconellicoccus hirsutus (Green) Hemiptera: Pseudococcidae) in Florida based on attraction of adult males to pheromone traps

    Science.gov (United States)

    Research was conducted in Florida to assess the phenology of pink hibiscus mealybug, Maconellicoccus hirsutus (Green), based on numbers of adult males captured at traps baited with a synthetic pheromone. Trapping was conducted at three locations in east central Florida in ornamental plantings of hib...

  14. Connectivity differences between adult male and female patients with attention deifcit hyperactivity disorder according to resting-state functional MRI

    Institute of Scientific and Technical Information of China (English)

    Bo-yong Park; Hyunjin Park

    2016-01-01

    Attention deifcit hyperactivity disorder (ADHD) is a pervasive psychiatric disorder that affects both chil-dren and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. Group-wise differences between male and female patients were quantiifed using degree centrality for different brain regions. The medial-, middle-, and inferior-frontal gyrus, superior parietal lobule, precuneus, supramarginal gyrus, superior- and middle-temporal gyrus, middle occipital gyrus, and cuneus were identiifed as regions with signiifcant group-wise differences. The identiifed regions were correlated with clinical scores relfecting de-pression and anxiety and signiifcant correlations were found. Adult ADHD patients exhibit different levels of depression and anxiety depending on sex, and our study provides insight into how changes in brain cir-cuitry might differentially impact male and female ADHD patients.

  15. Oxytocin enhances orienting to social information in a selective group of high-functioning male adults with autism spectrum disorder

    NARCIS (Netherlands)

    Althaus, M.; Groen, Y.; Wijers, A. A.; Noltes, H.; Tucha, O.; Hoekstra, P. J.

    2015-01-01

    Objective: The study investigated the effects of nasally administered oxytocin on neurophysiological orienting to empathy-evoking pictures in normally intelligent male adults with and without an autism spectrum disorder (ASD). It further investigated whether these effects might be moderated by the i

  16. Connectivity differences between adult male and female patients with attention deficit hyperactivity disorder according to resting-state functional MRI

    Directory of Open Access Journals (Sweden)

    Bo-yong Park

    2016-01-01

    Full Text Available Attention deficit hyperactivity disorder (ADHD is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. Group-wise differences between male and female patients were quantified using degree centrality for different brain regions. The medial-, middle-, and inferior-frontal gyrus, superior parietal lobule, precuneus, supramarginal gyrus, superior- and middle-temporal gyrus, middle occipital gyrus, and cuneus were identified as regions with significant group-wise differences. The identified regions were correlated with clinical scores reflecting depression and anxiety and significant correlations were found. Adult ADHD patients exhibit different levels of depression and anxiety depending on sex, and our study provides insight into how changes in brain circuitry might differentially impact male and female ADHD patients.

  17. Variants of psychopathy in adult male offenders: A latent profile analysis.

    Science.gov (United States)

    Mokros, Andreas; Hare, Robert D; Neumann, Craig S; Santtila, Pekka; Habermeyer, Elmar; Nitschke, Joachim

    2015-05-01

    As measured with the Psychopathy Checklist-Revised (PCL-R), psychopathy is a dimensional construct underpinned by 4 correlated factors: Interpersonal, Affective, Lifestyle, and Antisocial. Theorists and clinicians (e.g., Karpman and Arieti) have posited 2 variants of "primary" or "true" psychopathy, both distinct from so-called "secondary" or "pseudopsychopathy." We used latent profile analysis to determine if homogeneous classes exist within a sample of 1,451 male offenders with high PCL-R scores (≥ 27). The 4 PCL-R factors were the dependent variables for clustering. A solution with 3 latent classes showed a better fit to the data than did a unitary model without latent classes. Tentative labels for the latent classes are Manipulative (Latent Class 1 [LC1]), Aggressive (Latent Class 2 [LC2]), and Sociopathic (Latent Class 3 [LC3]). The latter class represented an antisocial group that lacked the emotional detachment observed in the other 2 groups. We propose that LC1 and LC2 reflect phenotypic variations on a theme of the traditional construct of psychopathy, and that LC3 is consistent with conceptions of antisocial personality disorder and sociopathy. Replication and external classification with an independent data set of 497 adult male offenders again yielded clearly separable clusters, as well as meaningful differences or trends among latent classes on education, intelligence, symptoms of antisocial personality disorder, and self-reported psychopathic traits and negative affect. The conceptualization of psychopathy in terms of manipulative and aggressive variants is consistent with clinical theory and is empirically grounded. PMID:25643206

  18. The inhibitory effects on adult male reproductive functions of crude garlic (Allium sativum) feeding

    Institute of Scientific and Technical Information of China (English)

    Imen Hammami; Afef Nahdi; Claire Mauduit; Mohamed Benahmed; Mohamed Amri; Awatef Ben Amar; Semy Zekri; Ahmed El May; Michele Veronique El May

    2008-01-01

    Aim: To investigate the effects of crude garlic on adult male rat reproductive functions. Methods: Thirty male rats were divided into five groups: group 1 (untreated) and groups 2, 3, 4 and 5 were fed for 30 days with 5%, 10%, 15% and 30% crude garlic, respectively. Testes and accessory organs were weighed and some markers were assessed. Light and electron microscopy observations were also performed. Results: A significant decrease was observed in the body weight of groups 4 (14%; P < 0.01) and 5 (20%; P < 0.01); of the prostate weight in group 5 (29.1%; P < 0.05) and of seminal vesicle weight in groups 3 (14.4%; P < 0.01), 4 (18.3%; P < 0.01) and 5 (27.3%; P < 0.01). In contrast, testis and epididymis weights were unchanged. In epididymis tissue, the alpha glucosidase activity and the spermatozoa density were unchanged. The treatment resulted in a significant decrease in testosterone serum levels in groups 3 (77.3%; P < 0.01), 4 (77.3%; P < 0.01) and 5 (90.9%; P < 0.01), associated with a significant increase in LH serum levels (P < 0.01). Testicular histology showed a dose-dependent increase in the percentage of empty seminiferous tubules. Moreover, testicular function was affected; a significant decrease in phosphatase acid activity (P < 0.01) and testosterone (P < 0.05) contents were observed. Conclusion: Crude garlic consumption during 1 month reduced testosterone secretion and altered spermatogenesis at 10%, 15% and 30% doses. (Asian J Androl 2008 Jul; 10: 593-601)

  19. Reproductive biology of Oligosarcus argenteus (Gunther, 1864 adult males and description of the gonadal maturation stages

    Directory of Open Access Journals (Sweden)

    Sérgio Luis Pinto da Matt

    2009-02-01

    Full Text Available Oligosarcus argenteus belongs to the Acestrorhynchinae subfamily, being restricted to South America, and found in several Brazilian hydrographic basins, in lotic and lentic environments, where they are able to reproduce. With the purpose of studying the reproductive biology of the males from this species, many morphological parameters were analyzed during a 24 month period, as well as characterizing the different testicular maturation stages. A maturity scale, with three stages (I - Initial Maturing, II - Intermediate Maturing, III - Final Maturing was proposed for the adult males of Oligosarcus argenteus. The reproductive period was established by the bimonthly frequency of spermatogenesis and by the gonadal maturation stages.Oligosarcus argenteus é uma espécie pertencente à subfamília Acestrorhynchinae, restrita à América do Sul, sendo comumente encontrada nas várias bacias hidrográficas brasileiras, em ambientes lóticos e lênticos, onde se reproduzem. Com o objetivo de estudar a biologia reprodutiva de machos desta espécie, vários parâmetros morfológicos foram analisados durante um período de 24 meses, assim como foram caracterizados os diferentes estádios de maturação testicular. Estes foram descritos, considerando-se exemplares adultos, em: Estádio I - Maturação Inicial, Estádio II - Maturação Intermediária e Estádio III - Maturação Final. Pela freqüência bimestral das células germinativas e dos estádios de maturação gonadal, a época de reprodução foi determinada.

  20. An Echocardiographic Study of Heart in a Group of Male Adult Elite Athletes

    Directory of Open Access Journals (Sweden)

    Ahmad Mohebi

    2008-08-01

    Full Text Available Background: Severe and prolonged physical training is associated with morphological and physiological cardiac changes, often termed as the “athlete’s heart”. Echocardiographic features peculiar to elite Iranian athletes have not been previously described. The aim was to examine the echocardiographic characteristics of highly trained Iranian athletes involved in three different sports. Methods: We studied cardiac morphology and function as assessed by rest echocardiography in 50 elite adult male athletes referring to a university hospital in Tehran between February 2001 and March 2006. Resting ejection fraction, interventricular septal wall thickness (IVSWT, left ventricular posterior wall thickness (LVPWT, left ventricular internal end diastolic dimension (LVEdD, left ventricular internal systolic dimension (LVIsD, left ventricular (LV mass, and relative wall thickness (RWT were measured. The control group consisted of 50 age- and weight-matched normal healthy men. Results: Of the athletes, 38 were engaged in predominantly dynamic (running and soccer and 12 in predominantly static (weightlifting sports. The overall mean LVEdD (51.06±5.49mm and IVSWT (10.24±1.43mm were higher in the athletes than those in the normal subjects. The mean of IVSWT in the 38 endurance-trained athletes was significantly more than that of the 12 strength-trained athletes (11.1 mm vs. 10.3 mm, P<0.05. LVEdD was also greater in the endurance-trained athletes, but the difference was not statistically significant (51.2 mm vs. 50.6 mm. Conclusion: Our results of higher LVEdD and IVSWT in Iranian male athletes are in line with previous reports. To generalize the results, we require more studies with larger sample sizes (with female athletes included.

  1. The new progress of circumcision operation mode%包皮环切术手术方式新进展

    Institute of Scientific and Technical Information of China (English)

    王骏

    2015-01-01

    As people living standard rise, They put forward higher requirements?for atient's effect on male circumcision and beautiful.In this paper,the author sums up 11 kinds of different operative methods of circumcision, and each has different characteristics, to provide more choices for surgeons.In the actual clinical operations, doctor can use them flexiblely.%目的:随着人们生活水平的提高,患者对包皮手术效果及外观提出更高的要求。本文总结归纳了11种包皮环切的不同术式,各有不同的特点,为外科医师提供了更多的选择,在实际的临床操作中,可以因地制宜地灵活运用。

  2. Embryonic co-exposure to methoxychlor and Clophen A50 alters sexual behavior in adult male quail.

    Science.gov (United States)

    Halldin, Krister; Axelsson, Jeanette; Brunström, Björn

    2005-04-01

    Embryonic exposure to estrogens and estrogenic pollutants is known to demasculinize sexual behavior in adult male Japanese quail. In the present study, we administered the insecticide methoxychlor to quail eggs at a dose of 150 microg/g egg and then studied sexual behavior and other reproductive variables in adult males. In a second experiment we administered the same dose of methoxychlor together with 10 microg/g egg of the commercial polychlorinated biphenyl (PCB) mixture Clophen A50 (CA50) and also CA50 alone. Neither methoxychlor nor CA50 had any significant effects by themselves, but when they were administered together a significant reduction in male sexual behavior was observed. It seems likely that induction of biotransformation enzymes in the embryos by CA50 resulted in increased conversion of methoxychlor to the more estrogenic metabolite 2,2-bis(p-hydroxyphenyl)-1,1,1-trichloroethane (HPTE).

  3. LUNG FUNCTION: A COMPARATIVE STUDY OF FORCED VITAL CAPACITY (FVC AND BODY MASS INDEX IN YOUNG ADULT MALES

    Directory of Open Access Journals (Sweden)

    Swaroop

    2014-09-01

    Full Text Available Obesity is becoming a serious public health issue and is related to lung dysfunction. This study was planned to assess the correlation between the pulmonary function like FVC and increasing BMI in young adult males. This study was undertaken in normal weight and overweight young adult males of Balagangadaranatha nagara. The study and control groups were comprised of 120 male subjects between the age group 18-24 years randomly selected from the population of Balagangadaranatha nagara. Anthropometric measurements and spirometry was performed in all subjects. FVC was used as a measure of lung function. There was significant differences in FVC in the study group and there was inverse relationship between FVC and increase in BMI.

  4. Phthalates in Commercial Chinese Rice Wines: Concentrations and the Cumulative Risk Assessment to Adult Males in Shanghai.

    Science.gov (United States)

    Huang, Yue; Lu, Wen Wei; Chen, Bo; You, Jie; Wu, Min; Li, Shu Guang

    2014-10-01

    The concentrations of 16 phthalates in 164 commercial Chinese rice wines (CRW) were detected by GC-MS, and consumption data on CRW in different packaging types was investigated from 634 adult males in Shanghai using a food frequency questionnaire. Based on the principles of probabilistic modelling and cumulative risk assessment, the exposure and health risk of phthalates from CRW to adult males in Shanghai was evaluated. DMP, DEP, DIBP, DnBP, BBP, and DEHP were detected in the samples, the range of detection frequency of individual phthalates varied from 6.10% for BBP to 15.24% for DIBP, and the detected concentrations were 51.06-200.34 ng/mL. All the respondents consumed CRW, 90.69% of them consumed CRW 0.01-49.9 mL/d, the minimum value of the average daily intake of CRW was 6.25 mL/d, the median was 13.72 mL/d and the maximum was 300 mL/d. The median exposure level of the 6 detected Phthalates to adult males in Shanghai were 6.58-7.10 ng/(d•kg), and the maximum exposure level were 137.38-540.47 ng/(d•kg). The cumulative exposure health risk index (HI) based on the median and maximum exposure level of the 6 Phthalates (DMP, DEP, DIBP, DnBP, BBP, and DEHP) were 0.001147 and 0.063396, both were far less than 1. In conclusion, CRW were generally consumed by the adult males in Shanghai, although multiple phthalates were detected in commercial CRW, health risk of such exposure levels from commercial CRW to the target adult males in Shanghai was very low.

  5. MAX - a Male Adult voXel model for radiation protection dosimetry

    International Nuclear Information System (INIS)

    Models or phantoms used in Monte Carlo computer codes are representations of the human body, designed to allow equivalent dose calculations in organs and tissues. Mathematical phantoms (MIRD-5, ADAM, EVA, etc.), in shape and form a rather limited representation of a real human body, have been widely used in the past to calculate conversion coefficients between equivalent dose to relevant organs and tissues of the human body and measurable quantities for various types of radiation and field geometries. Progress of image processing, clock speed and memory capacity of computers over the last 20 years made it possible to create the so-called voxel phantoms, which are a more realistic representation of the human body. Voxel (Volume pixel) phantoms are constructed from segmented CT and/or MRI images of real persons. A complete set of such images can be joined to a 3-dimensional representation of the human body, which can be linked to a Monte Carlo computer code to allow particle transport calculations. This study describes the modifications done to the VOXTISS8 human voxel phantom (YALE University) in order to create the MAX (Male Adult voXel) phantom whose organ and tissue masses correspond better to the data recommended by ICRP in Publications No. 23 and 70. (author)

  6. The neuropsychology of male adults with high-functioning autism or asperger syndrome.

    Science.gov (United States)

    Wilson, C Ellie; Happé, Francesca; Wheelwright, Sally J; Ecker, Christine; Lombardo, Michael V; Johnston, Patrick; Daly, Eileen; Murphy, Clodagh M; Spain, Debbie; Lai, Meng-Chuan; Chakrabarti, Bhismadev; Sauter, Disa A; Baron-Cohen, Simon; Murphy, Declan G M

    2014-10-01

    Autism Spectrum Disorder (ASD) is diagnosed on the basis of behavioral symptoms, but cognitive abilities may also be useful in characterizing individuals with ASD. One hundred seventy-eight high-functioning male adults, half with ASD and half without, completed tasks assessing IQ, a broad range of cognitive skills, and autistic and comorbid symptomatology. The aims of the study were, first, to determine whether significant differences existed between cases and controls on cognitive tasks, and whether cognitive profiles, derived using a multivariate classification method with data from multiple cognitive tasks, could distinguish between the two groups. Second, to establish whether cognitive skill level was correlated with degree of autistic symptom severity, and third, whether cognitive skill level was correlated with degree of comorbid psychopathology. Fourth, cognitive characteristics of individuals with Asperger Syndrome (AS) and high-functioning autism (HFA) were compared. After controlling for IQ, ASD and control groups scored significantly differently on tasks of social cognition, motor performance, and executive function (P's diagnostic process when used in conjunction with other data sources-including clinical history. PMID:24903974

  7. Reliability of handheld dynamometry in assessment of hip strength in adult male football players.

    Science.gov (United States)

    Fulcher, Mark L; Hanna, Chris M; Raina Elley, C

    2010-01-01

    The aim of this study was to evaluate the intra- and interrater reliability of handheld dynamometry (HHD) for measuring hip muscle strength in a sample of 30 healthy semi-professional adult male football players. The reliability of HHD had not been assessed in athletes who were likely to be stronger than populations tested previously. Maximal isometric strength of resisted hip flexion and adduction were measured. Mean strength ranged from 51.5 kg for dominant hip flexion to 26.7 kg for hip adduction at 90 degrees of hip flexion. Intrarater reliability intraclass correlation coefficients (ICCs) ranged from 0.70 to 0.89. ICCs for interrater reliability ranged from 0.66 to 0.87. As expected, muscle strength in this group of athletes was significantly higher than that of populations in which HHD reliability has been assessed. Despite this, muscle strength testing of hip flexor and adductor muscles can be performed with good to excellent intra- and interrater reliability in this population. PMID:19376747

  8. Androgens inhibit the osteogenic response to mechanical loading in adult male mice.

    Science.gov (United States)

    Sinnesael, Mieke; Laurent, Michaël R; Jardi, Ferran; Dubois, Vanessa; Deboel, Ludo; Delisser, Peter; Behets, Geert J; D'Haese, Patrick C; Carmeliet, Geert; Claessens, Frank; Vanderschueren, Dirk

    2015-04-01

    Androgens are well known to enhance exercise-induced muscle hypertrophy; however, whether androgens also influence bone's adaptive response to mechanical loading remains unclear. We studied the adaptive osteogenic response to unilateral in vivo mechanical loading of tibia in adult male mice in both a long- and a short-term experimental set-up. Mice were divided into four groups: sham operated, orchidectomized (ORX), T (ORX+T), or nonaromatizable dihydrotestosterone (ORX+DHT) replacement. Significant interactions between androgen status and osteogenic response to mechanical loading were observed. Cortical thickness increased by T (0.14 vs 0.11 mm sham, P<.05) and DHT (0.17 vs 0.11 mm sham, P<.05). However, T partially (+36%) and DHT completely (+10%) failed to exhibit the loading-related increase observed in sham (+107%) and ORX (+131%, all P<.05) mice. ORX decreased periosteal bone formation, which was restored to sham levels by T and DHT. However, both androgens completely suppressed the loading-related increase in periosteal bone formation. Short-term loading decreased the number of sclerostin-positive osteocytes in sham, whereas in control fibulas, ORX decreased and T increased the number of sclerostin-positive osteocytes. Loading no longer down-regulated sclerostin in the ORX or T groups. In conclusion, both T and DHT suppress the osteogenic response to mechanical loading.

  9. BIOEQUIVALENCE STUDY OF TWO BRANDS OF PHENYTOIN SODIUM 100MG FORMULATIONS IN HEALTHY ADULT MALE RABBITS

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    Saroj Nepal , Suhrid Banskota , Nirmal Marasini, Biki Gupta , Shyam Prasad Lohani , Shova Basnet and Bal Mukunda Regmi*

    2013-01-01

    Full Text Available The objective of the study was to compare the bioavailability of a single oral 100 mg dose of two brands of phenytoin sodium formulations available in the Nepalese market. Formulation B was taken as test drug and compared with the innovator brand which was taken as reference standard. A randomized, two-way crossover study was done in six healthy adult male rabbits. All six rabbits received a single oral 100 mg dose of both the formulations with a two-week washout period between the formulations. Blood samples for plasma phenytoin levels were collected at 0.25, 1, 2, 4, 6, 8, 10, 12, 16, 24 hours. The pharmacokinetic parameters of the two brands of phenytoin sodium calculated were area under the concentration versus time curve from time zero to 24 hours (AUC 0–24, Area under the Curve from time zero to infinity (AUC0–∞, peak plasma concentration (Cmax and time of peak concentration (tmax. Formulation B failed to comply in terms of Area under the Curve (AUC, an important pharmacokinetic parameter to test bioequivalency, which was tested at significance level 0.05. This showed that the test formulation is not bioequivalent with the innovator. Taken together, our preliminary findings suggest that further studies in a large population is needed before switching phenytoin brands once a patient is carefully titrated to a given phenytoin brand.

  10. Oral toxic exposure of titanium dioxide nanoparticles on serum biochemical changes in adult male Wistar rats

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    Dasal Vasantharaja

    2015-01-01

    Full Text Available Objective(s: Titanium dioxide (TiO2 nanoparticles (NPs are widely used in commercial food additives and cosmetics worldwide. Uptake of these nanoparticulate into humans by different routes and may exhibit potential side effects, lags behind the rapid development of nanotechnology. Thus, the present study designed to evaluate the toxic effect of mixed rutile and anatase TiO2 NPs on serum biochemical changes in rats. Materials and Methods: In this study, adult male Wistar rats were randomly allotted into the experimental and control groups (n=6, which were orally administered with 50 and 100 mg/kg body weight of TiO2 NPs. Toxic effects were assessed by the changes of serum biochemical parameters such as glucose, total protein, albumin, globulin, cholesterol, triglyceride, high density lipoprotein, alanine transaminase, aspartate transaminase, alkaline phosphatase, total bilirubin, blood urea nitrogen, uric acid and creatinine. All the serum biochemical markers were experimented in rats, after 14-days of post exposure. Results: Changes of the serum specific parameters indicated that liver and kidney were significantly affected in both experimental groups. The changes between the levels of total protein, glucose, aspartate transaminase, alanine transaminase and alkaline phosphatase indicate that TiO2 NPs induces liver damage. Significant increase in the blood urea nitrogen and uric acid indicates the renal damage in the TiO2 NPs treated rats. Conclusion: The data shows that the oral administration of TiO2 NPs (

  11. Specific absorbed fractions of energy at various ages from internal photon sources: 7, Adult male

    International Nuclear Information System (INIS)

    Specific absorbed fractions (PHI's) in various organs of the body (target organs) from sources of monoenergetic photons in various other organs (source organs) are tabulated. In this volume PHI-values are tabulated for an adult male (70-kg Reference Man). These PHI-values can be used in calculating the photon component of the dose-equivalent rate in a given target organ from a given radionuclide that is present in a given source organ. The International Commission on Radiological Protection recognizes that the endosteal, or bone surface, cells are the tissue at risk for bone cancer. We have applied the dosimetry methods developed for beta-emitting radionuclides deposited in bone to follow the transport of secondary electrons that were freed by photon interactions through the microscopic structure of the skeleton. With these methods we can estimate PHI in the endosteal cells and can better estimate PHI in the active marrow; the latter is overestimated with other methods at photon energies below 200 keV. 12 refs., 2 tabs

  12. Applicability of dose conversion coefficients of ICRP 74 to Asian adult males: Monte Carlo simulation study

    International Nuclear Information System (INIS)

    International Commission on Radiological Protection (ICRP) reported comprehensive dose conversion coefficients for adult population, which is exposed to external photon sources in the Publication 74. However, those quantities were calculated from so-called stylized (or mathematical) phantoms composed of simplified mathematical surface equations so that the discrepancy between the phantoms and real human anatomy has been investigated by several authors using Caucasian-based voxel phantoms. To address anatomical and racial limitations of the stylized phantoms, several Asian-based voxel phantoms have been developed by Korean and Japanese investigators, independently. In the current study, photon dose conversion coefficients of ICRP 74 were compared with those from a total of five Asian-based male voxel phantoms, whose body dimensions were almost identical. Those of representative radio-sensitive organs (testes, red bone marrow, colon, lungs, and stomach), and effective dose conversion coefficients were obtained for comparison. Even though organ doses for testes, colon and lungs, and effective doses from ICRP 74 agreed well with those from Asian voxel phantoms within 10%, absorbed doses for red bone marrow and stomach showed significant discrepancies up to 30% which was mainly attributed to difference of phantom description between stylized and voxel phantoms. This study showed that the ICRP 74 dosimetry data, which have been reported to be unrealistic compared to those from Caucasian-based voxel phantoms, are also not appropriate for Asian population

  13. Carbachol-Induced Reduction in the Activity of Adult Male Zebra Finch RA Projection Neurons.

    Science.gov (United States)

    Meng, Wei; Wang, Song-Hua; Li, Dong-Feng

    2016-01-01

    Cholinergic mechanism is involved in motor behavior. In songbirds, the robust nucleus of the arcopallium (RA) is a song premotor nucleus in the pallium and receives cholinergic inputs from the basal forebrain. The activity of projection neurons in RA determines song motor behavior. Although many evidences suggest that cholinergic system is implicated in song production, the cholinergic modulation of RA is not clear until now. In the present study, the electrophysiological effects of carbachol, a nonselective cholinergic receptor agonist, were investigated on the RA projection neurons of adult male zebra finches through whole-cell patch-clamp techniques in vitro. Our results show that carbachol produced a significant decrease in the spontaneous and evoked action potential (AP) firing frequency of RA projection neurons, accompanying a hyperpolarization of the membrane potential, an increase in the evoked AP latency, afterhyperpolarization (AHP) peak amplitude, and AHP time to peak, and a decrease in the membrane input resistance, membrane time constant, and membrane capacitance. These results indicate that carbachol reduces the activity of RA projection neurons by hyperpolarizing the resting membrane potential and increasing the AHP and the membrane conductance, suggesting that the cholinergic modulation of RA may play an important role in song production. PMID:26904300

  14. Physiological Responses During Multiplay Exergaming in Young Adult Males are Game-Dependent

    Science.gov (United States)

    McGuire, Stephen; Willems, Mark ET

    2015-01-01

    Regular moderate-intensity exercise provides health benefits. The aim of this study was to examine whether the selected exercise intensity and physiological responses during exergaming in a single and multiplayer mode in the same physical space were game-dependent. Ten males (mean ±SD, age: 23 ±5 years, body mass: 84.2 ±15.6 kg, body height: 180 ±7 cm, body mass index: 26.0 ±4.0 kg·m−2) played the games Kinect football, boxing and track & field (3 × ∼10 min, ∼ 2 min rest periods) in similar time sequence in two sessions. Physiological responses were measured with the portable Cosmed K4b2 pulmonary gas exchange system. Single play demands were used to match with a competitive opponent in a multiplay mode. A within-subjects crossover design was used with one-way ANOVA and a post-hoc t-test for analysis (pExergaming in a multiplayer mode can provide higher physiological demands but the effects are game-dependent. It seems that exergaming with low intensity in a multiplayer mode may provide a greater physical challenge for participants than in a single play mode but may not consistently provide sufficient intensity to acquire health benefits when played regularly as part of a programme to promote and maintain health in young adults. PMID:26240669

  15. Effects of different exercise protocols on ethanol-induced spatial memory impairment in adult male rats.

    Science.gov (United States)

    Hashemi Nosrat Abadi, T; Vaghef, L; Babri, S; Mahmood-Alilo, M; Beirami, M

    2013-06-01

    Chronic ethanol consumption is often accompanied by numerous cognitive deficits and may lead to long-lasting impairments in spatial learning and memory. The aim of the present study was to evaluate the therapeutic potential of regular treadmill exercise on hippocampal-dependent memory in ethanol-treated rats. Spatial memory was tested in a Morris Water Maze task. Adult male Wistar rats were exposed to ethanol (4 g/kg, 20% v/v for 4 weeks) and effects of three exercise protocols (pre-ethanol, post-ethanol and pre-to-post-ethanol treatment) were examined. Results showed that ethanol exposure resulted in longer escape latencies during the acquisition phase of the Morris Water Maze task. Moreover, all three exercise protocols significantly decreased the latency to locate the hidden platform. During the probe trial, ethanol led to decreased time spent in the target quadrant. In contrast, performance on the probe trial was significantly better in the rats that had done the post- and pre-to-post-ethanol, but not pre-ethanol, exercises. These findings suggest that treadmill running can attenuate the adverse effects of chronic ethanol exposure on spatial memory, and may serve as a non-pharmacological alcohol abuse treatment. PMID:23683528

  16. Screening Neuropharmacological Activities of Kaempferia parviflora (Krachai Dam in Healthy Adult Male Rats

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    Thaneeya Hawiset

    2011-01-01

    Full Text Available Problem statement: Although the global prevalence of psychological disorders is increasing continually, the efficacies of therapeutic strategies are still very limited. Oxidative stress has been implicated in the pathogenesis of psychiatric disorders and substance possessing antioxidant activity can alleviate the mentioned conditions. Therefore, we hypothesized that Kaempferia parviflora, a medicinal plant claimed for nerve tonic, also possessed the neuropharmacological activities which provide the advantage for psychiatric disorders. Approach: Adult male Wistar rats, weighing 180-220 grams, were orally given the ethanolic extract of K. parviflora at doses of 150, 200 and 250 mg kg-1 BW once daily for 2 weeks. Then, they were determined the neuropharmacological activities including anxiolytic, anti-depression like behavior and cognitive enhancement after single dose, 1 and 2 weeks of treatment. Results: K. parviflora possessed anti-depression like behavior and cognitive enhancement at all treatment duration. Unfortunately, this substance failed to show anxiolytic like activity. Conclusion: Our results suggested that K. parviflora might be used as a novel therapeutic strategy for psychiatric disorder and cognitive enhancement. However, further investigations about precise underlying mechanism are still required.

  17. Influence of circumcision technique on frequency of urinary tract infections in neonates.

    Science.gov (United States)

    Harel, Liora; Straussbergr, Rachel; Jackson, Shlomo; Amir, Jacob; Tiqwa, Petah

    2002-09-01

    An increase in urinary tract infection (UTI) during the first weeks after traditional Jewish circumcision has been reported. Circumcision can be performed by a nonmedical person (mohel) or by a physician, with the main difference being in hemostasis techniques. We assessed the effect of circumcision procedure on development of UTI in neonates. Circumcision performed by a mohel was associated with higher incidence of UTI compared with that by physicians. Hemostasis technique and shaft wrapping are postulated risk factors.

  18. Comparative study on the effects of Plastibell device circumcision and conventional circumcision in treatment of the excess foreskin and phimosis%包皮环套术及传统包皮环切术的应用效果对比

    Institute of Scientific and Technical Information of China (English)

    廖波; 李雨根; 程树林; 杨雪松; 余晓东; 邓显忠

    2011-01-01

    Objective To evaluate the effects of plastibell device circumcision and conventional circumcision on treating the excess foreskin and phimosis of adult or children. Methods Total of 197 adults and children patients, with excess foreskin or phimosis were treated with plastibell device or conventional circumcision. Followed up for 3 months, pain intensity after surgery l~10 days was recorded using visual analog scales (VAS) method, and postoperative complications were also recorded. The incidence of complications was calculated for comparative analysis. Results The operation time and bleeding volume of plastibell device circumcision was significantly lower than that of traditional circumcision. The VAS score of adult patients treated with plastibell device circumcision were significantly higher than that of children in the 1,3,7 days after surgery, and children conventional circumcision group's VAS scores were significantly higher than that of the plastibell group. In adult, the incidence of postoperative edema of the foreskin in the plastibell and conventional group were 21% and 10% respectively, but in children, the incidence were 5% and 15% respectively. Conclusion For treatment of children with prepuce or phimosis, the plastibell device circumcision might be better method. But the effects of plastilbell device circumcision on adult patient might be worse than on children patients. Plastjbell device circumcision was the best choice if patients required good appearance after circumcision or shorter operation time.%目的 对比分析包皮环套术和包皮环切术两种术式在治疗成人与儿童包皮过长或包茎中的应用效果.方法 临床上顺序收集成人(18~35岁)及儿童(6~13岁)包皮过长或包茎患者197例,予以包皮环套术或包皮环切术.术后随访3个月,采用视觉模拟评分法(VAS)记录患者术后ld至10d的疼痛强度,同时记录各组患者的常见术后并发症情况,计算并发症发

  19. Anti-diabetic effects of hydroalcohlic juglans regia male flower extract on blood glucose level and on liver enzymes activity in intact and diabetogenized adult male rat

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    Seyyed Ebrahim Hosseini

    2012-08-01

    Full Text Available Background and Aim: Diabetes is a metabolic disorder resulting from defects in insulin secretion or function. Walnut is a nutrient used in traditional medicine to treat diabetes. In the current study, anti-diabetic effects of the Hydroalcoholic extract of walnut male flowers on diabetogenized rats by using Streptozocin were evaluated.   Materials and Methods: Seventy two adult male Wistar rats weighing 200-225 g each were randomly selected and divided into three main groups, i.e. control, diabetic, and non-diabetic(intact The control group included 8 rats (n=8. The diabetic and non-diabetic groups covered 32 rats each. Each of these groups were divided into four 8 rats including the control, diabetic, experimental 1, 2, and 3 which received 2, 4, or 6 g/kg of the extract per day for 15 days ,respectively. The three diabetic groups were each treated with the above doses of the extract, and the fourth group received no treatment. Diabetes was induced in diabetic rats through intraperitoneal injection of 60 mg/kg of Streptozotocin. At the end, blood samples were taken from the experimental and control groups and the serum levels of insulin and glucose were measured.   Results: A significant reduction in blood sugar and increase of insulin in diabetics receiving Hydroalcoholic extract of male flowers walnut was observed compared with non-diabetic ones.   Conclusion: Hydroalcoholic extract of male Walnut flowers, due to increasing insulin, causes reduction of blood sugar.

  20. Circumcision for the prevention of significant bacteriuria in boys.

    Science.gov (United States)

    Nayir, A

    2001-12-01

    The aim of this study was to determine whether circumcision affects significant bacteriuria in boys. During a 60-month prospective study, 100 boys with microbiologically confirmed symptomatic urinary tract infection (UTI) were evaluated. Twelve patients with abnormal ultrasonography findings were excluded from the study. Eighteen of the boys had not been circumcised due to parental choice. The remaining 70 boys with normal renal ultrasonography were randomly allocated into two groups. In the first group 35 boys ranging in age from 6 months to 10 years (mean 33.2+/-30.9 months) were observed for 6 months and urinary cultures were taken monthly. When they had a positive urine culture (with or without any symptoms), they received antibiotic treatment. After 6 months they were circumcised and then observed for another 6-month period. Group 2 comprised 35 boys aged from 3 months to 9 years (mean 29.1+/-36.7 months). They were circumcised immediately after the first UTI and were followed for 6 months. Urine samples were obtained by the bag technique in infants and by the mid-stream technique in older patients. In the uncircumcised group, the rate of significant bacteriuria per patient did not change in two 6-month follow-up periods (3.46+/-0.91 and 3.33+/-0.97 episodes). In group 1, the rate of positive urine cultures dropped from 3.57+/-1.11 to 0.14+/-0.35 episodes after circumcision (Pcircumcision. Among the uncircumcised patients, symptomatic UTI was observed in 6 cases (3 cases in the first period of group 1, 1 case in the first and 2 cases in the second period of the uncircumcised group), whereas after circumcision no patient had symptomatic UTI. The mean age at circumcision was 42.7+/-28.4 months. No complication due to circumcision occurred in any patient. UTI may also occur in boys after the 1st year of life. The present study indicated that circumcision in boys decreases the rate of positive urine cultures. Therefore circumcision could be considered as a part of

  1. The Effect of Health Education Program for Caregivers on Circumcision Outcome in Neonates and Infants

    Science.gov (United States)

    Gafer, Youser abd Elsalam; Nafee, Houda Mohammed; Pal, Kamlish

    2015-01-01

    Circumcision is a surgical excision of the foreskin to the level of the coronal sulcus which may perform in the neonatal period or in later life. Circumcision has many medical benefits such as minimizing urinary tract infection, reduces the incidence of balanitis and enhances of penile hygiene, prevents of penile cancer. However, Circumcision may…

  2. Influence of Posture and Frequency Modes in Total Body Water Estimation Using Bioelectrical Impedance Spectroscopy in Boys and Adult Males

    Directory of Open Access Journals (Sweden)

    Masaharu Kagawa

    2014-05-01

    Full Text Available The aim of the study was to examine differences in total body water (TBW measured using single-frequency (SF and multi-frequency (MF modes of bioelectrical impedance spectroscopy (BIS in children and adults measured in different postures using the deuterium (2H dilution technique as the reference. Twenty-three boys and 26 adult males underwent assessment of TBW using the dilution technique and BIS measured in supine and standing positions using two frequencies of the SF mode (50 kHz and 100 kHz and the MF mode. While TBW estimated from the MF mode was comparable, extra-cellular fluid (ECF and intra-cellular fluid (ICF values differed significantly (p < 0.01 between the different postures in both groups. In addition, while estimated TBW in adult males using the MF mode was significantly (p < 0.01 greater than the result from the dilution technique, TBW estimated using the SF mode and prediction equation was significantly (p < 0.01 lower in boys. Measurement posture may not affect estimation of TBW in boys and adult males, however, body fluid shifts may still occur. In addition, technical factors, including selection of prediction equation, may be important when TBW is estimated from measured impedance.

  3. Reproductive development of male goat kids reared with or without permanent contact with adult females until 10 months of age.

    Science.gov (United States)

    Lacuesta, L; Orihuela, A; Ungerfeld, R

    2015-01-01

    Adult male ruminants that were reared in contact with females display greater sexual behavior than those reared in single male groups. The aim of the experiment was to compare the reproductive development of prepubertal male kids reared with or without direct permanent contact with adult females until they were 10 months old. Seventeen Saanen male kids were maintained in two groups until 44 weeks of age: kids reared in permanent direct contact with four adult goats (group FEM, N = 8) and kids that remained isolated from females (group ISO, N = 9). All goats in the FEM group became pregnant approximately when bucks attained 28 weeks of age. Scrotal circumference and testosterone concentration were measured, and semen was obtained by electroejaculation to avoid female contact in the ISO group. Scrotal circumference was greater in FEM kids at 12 and 14 weeks of age (P < 0.0001) and testosterone when they were 20 and 22 weeks old (P < 0.0001). Testosterone concentration was greater in ISO kids from 28 to 44 weeks of age. All semen characteristics increased with age (P < 0.0001). Individual motility was greater in FEM kids than that in ISO kids at 15 and 17 weeks (P < 0.005); mass motility was greater in ISO than that in FEM kids at 32 weeks (P < 0.05); total number of spermatozoa/ejaculate was greater in ISO kids at 30, 32, and 40 weeks and in FEM kids at 43 weeks (P < 0.005); total number of motile spermatozoa was greater in ISO kids at 32 and 40 weeks, whereas at 43 weeks, it was greater in FEM kids (P < 0.005). It was concluded that permanent contact with adult goats had transient and short-time positive effects in male kids' reproductive traits during prepubertal development. However, positive effects stopped after goats used as stimulus became pregnant. PMID:25277528

  4. FASH and MASH: female and male adult human phantoms based on polygon mesh surfaces: I. Development of the anatomy

    International Nuclear Information System (INIS)

    Among computational models, voxel phantoms based on computer tomographic (CT), nuclear magnetic resonance (NMR) or colour photographic images of patients, volunteers or cadavers have become popular in recent years. Although being true to nature representations of scanned individuals, voxel phantoms have limitations, especially when walled organs have to be segmented or when volumes of organs or body tissues, like adipose, have to be changed. Additionally, the scanning of patients or volunteers is usually made in supine position, which causes a shift of internal organs towards the ribcage, a compression of the lungs and a reduction of the sagittal diameter especially in the abdominal region compared to the regular anatomy of a person in the upright position, which in turn can influence organ and tissue absorbed or equivalent dose estimates. This study applies tools developed recently in the areas of computer graphics and animated films to the creation and modelling of 3D human organs, tissues, skeletons and bodies based on polygon mesh surfaces. Female and male adult human phantoms, called FASH (Female Adult meSH) and MASH (Male Adult meSH), have been designed using software, such as MakeHuman, Blender, Binvox and ImageJ, based on anatomical atlases, observing at the same time organ masses recommended by the International Commission on Radiological Protection for the male and female reference adult in report no 89. 113 organs, bones and tissues have been modelled in the FASH and the MASH phantoms representing locations for adults in standing posture. Most organ and tissue masses of the voxelized versions agree with corresponding data from ICRP89 within a margin of 2.6%. Comparison with the mesh-based male RPIAM and female RPIAF phantoms shows differences with respect to the material used, to the software and concepts applied, and to the anatomies created.

  5. FASH and MASH: female and male adult human phantoms based on polygon mesh surfaces: I. Development of the anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Cassola, V F; Kramer, R; Khoury, H J [Department of Nuclear Energy, Federal University of Pernambuco, Avenida Prof. Luiz Freire, 1000, CEP 50740-540, Recife (Brazil); De Melo Lima, V J [Department of Anatomy, Federal University of Pernambuco, Avenida Prof. Moraes Rego, 1235, CEP 50670-901, Recife (Brazil)], E-mail: rkramer@uol.com.br

    2010-01-07

    Among computational models, voxel phantoms based on computer tomographic (CT), nuclear magnetic resonance (NMR) or colour photographic images of patients, volunteers or cadavers have become popular in recent years. Although being true to nature representations of scanned individuals, voxel phantoms have limitations, especially when walled organs have to be segmented or when volumes of organs or body tissues, like adipose, have to be changed. Additionally, the scanning of patients or volunteers is usually made in supine position, which causes a shift of internal organs towards the ribcage, a compression of the lungs and a reduction of the sagittal diameter especially in the abdominal region compared to the regular anatomy of a person in the upright position, which in turn can influence organ and tissue absorbed or equivalent dose estimates. This study applies tools developed recently in the areas of computer graphics and animated films to the creation and modelling of 3D human organs, tissues, skeletons and bodies based on polygon mesh surfaces. Female and male adult human phantoms, called FASH (Female Adult meSH) and MASH (Male Adult meSH), have been designed using software, such as MakeHuman, Blender, Binvox and ImageJ, based on anatomical atlases, observing at the same time organ masses recommended by the International Commission on Radiological Protection for the male and female reference adult in report no 89. 113 organs, bones and tissues have been modelled in the FASH and the MASH phantoms representing locations for adults in standing posture. Most organ and tissue masses of the voxelized versions agree with corresponding data from ICRP89 within a margin of 2.6%. Comparison with the mesh-based male RPI{sub A}M and female RPI{sub A}F phantoms shows differences with respect to the material used, to the software and concepts applied, and to the anatomies created.

  6. THE RELATIONSHIP BETWEEN HAND LENGTH AND HEIGHT IN ADULT MALES OF NORTH INDIAN PUNJABI POPULATION

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    Maheshwar

    2013-02-01

    Full Text Available INTRODUCTION: Stature of an individual is an inherent characteris tic, the estimate of which is considered to be an important a ssessment in identification of unknown human remains 12 .The stature prediction occupies relatively a central position both in anthropological research and in the identification n ecessitated by the medical jurisprudence or by medico legal experts. Estimation of stature of an individual from the skeletal material or from the mutilated or amputated limbs or parts of limbs ha s obvious significance in the personal identification in the events of the murders, accide nts or natural disasters mainly concerns with forensic identification analysis 8 . Whether this is true for the North Indian Punjabi m ale population is not known till date. AIMS: The present study was done with an aim to establish relationship between height and hand length in adult males of north Indian Punjabi population, as it is not seen in the accessible literature till date to the best of our knowledge. MATERIALS AND METHOD: Height of 150 healthy male students between 18 to 25 years of age was measured with the help of an anthropometric rod. The height of all the students was measured in anatomical position keeping all the subjects erect . The height measured was vertical distance from the vertex to floor. Hand length is the direct linear distance between the distal wrist crease and the distal ends of most anterior projecting poin t i.e., tip of the middle finger. It is also the distance between midpoint of line joining the two st ylion and Dactylion of middle finger. Result: - A positive correlation between height and hand leng th was observed and it was statistically significant. Regression equation for height estimat ion was formulated using hand length. For statistical analysis IBM ( Statistical Package for Social Sciences SPSS + Version 20 was used. The mean difference of the height was 1773.273 ± 78.832 mm and Hand length (Right and Left were 196

  7. Estimation of Aedes aegypti (Diptera: Culicidae population size and adult male survival in an urban area in Panama

    Directory of Open Access Journals (Sweden)

    Marco Neira

    2014-11-01

    Full Text Available Traditional mosquito control strategies rely heavily on the use of chemical insecticides. However, concerns about the efficiency of traditional control methods, environmental impact and emerging pesticide resistance have highlighted the necessity for developing innovative tools for mosquito control. Some novel strategies, including release of insects carrying a dominant lethal gene (RIDL®, rely on the sustained release of modified male mosquitoes and therefore benefit from a thorough understanding of the biology of the male of the species. In this report we present the results of a mark-release-recapture study aimed at: (i establishing the survival in the field of laboratory-reared, wild-type male Aedes aegypti and (b estimating the size of the local adult Ae. aegypti population. The study took place in Panama, a country where recent increases in the incidence and severity of dengue cases have prompted health authorities to evaluate alternative strategies for vector control. Results suggest a life expectancy of 2.3 days for released male mosquitoes (confidence interval: 1.78-2.86. Overall, the male mosquito population was estimated at 58 males/ha (range 12-81 males/ha, which can be extrapolated to an average of 0.64 pupae/person for the study area. The practical implications of these results are discussed.

  8. Adult male mice emit context-specific ultrasonic vocalizations that are modulated by prior isolation or group rearing environment.

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    Jonathan Chabout

    Full Text Available Social interactions in mice are frequently analysed in genetically modified strains in order to get insight of disorders affecting social interactions such as autism spectrum disorders. Different types of social interactions have been described, mostly between females and pups, and between adult males and females. However, we recently showed that social interactions between adult males could also encompass cognitive and motivational features. During social interactions, rodents emit ultrasonic vocalizations (USVs, but it remains unknown if call types are differently used depending of the context and if they are correlated with motivational state. Here, we recorded the calls of adult C57BL/6J male mice in various behavioral conditions, such as social interaction, novelty exploration and restraint stress. We introduced a modulator for the motivational state by comparing males maintained in isolation and males maintained in groups before the experiments. Male mice uttered USVs in all social and non-social situations, and even in a stressful restraint context. They nevertheless emitted the most important number of calls with the largest diversity of call types in social interactions, particularly when showing a high motivation for social contact. For mice maintained in social isolation, the number of calls recorded was positively correlated with the duration of social contacts, and most calls were uttered during contacts between the two mice. This correlation was not observed in mice maintained in groups. These results open the way for a deeper understanding and characterization of acoustic signals associated with social interactions. They can also help evaluating the role of motivational states in the emission of acoustic signals.

  9. Steady as he goes: at-sea movement of adult male Australian sea lions in a dynamic marine environment.

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    Andrew D Lowther

    Full Text Available The southern coastline of Australia forms part of the worlds' only northern boundary current system. The Bonney Upwelling occurs every austral summer along the south-eastern South Australian coastline, a region that hosts over 80% of the worlds population of an endangered endemic otariid, the Australian sea lion. We present the first data on the movement characteristics and foraging behaviour of adult male Australian sea lions across their South Australian range. Synthesizing telemetric, oceanographic and isotopic datasets collected from seven individuals enabled us to characterise individual foraging behaviour over an approximate two year time period. Data suggested seasonal variability in stable carbon and nitrogen isotopes that could not be otherwise explained by changes in animal movement patterns. Similarly, animals did not change their foraging patterns despite fine-scale spatial and temporal variability of the upwelling event. Individual males tended to return to the same colony at which they were tagged and utilized the same at-sea regions for foraging irrespective of oceanographic conditions or time of year. Our study contrasts current general assumptions that male otariid life history strategies should result in greater dispersal, with adult male Australian sea lions displaying central place foraging behaviour similar to males of other otariid species in the region.

  10. The Ginkgo biloba Extract Reverses the Renal Effects of Titanium Dioxide Nanoparticles in Adult Male Rats

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    Carlos Enrique Escárcega-González

    2016-01-01

    Full Text Available The Ginkgo biloba extract (GbE is a commercial product used as a nutraceutic herbal remedy in Europe and US. It contains 27% of the polyphenols isorhamnetin, kaempferol, and quercetin, as antioxidants. We used male adult Wistar rats (200–300 g, divided into four groups: control group (treated with 5.0 mg/kg of sodium chloride, intravenous, titanium dioxide nanoparticles (TiO2-NPs group (5.0 mg/kg, intravenous, GbE group (10 mg/kg, intraperitoneal, and GbE + TiO2-NPs group (treated 24 h before with 10 mg/kg of GbE, intraperitoneal, followed, 24 h later, by 5.0 mg/kg of TiO2-NPs intravenously. The statistical analysis was performed using Student’s t-test for grouped data with ANOVA posttest. The GbE protected renal cells against the effects of TiO2-NPs because it reversed the increased activity of γ-glutamyltranspeptidase and the enzymatic activity of dipeptidylaminopeptidase IV at all times tested (0–5, 5–24, 24–48, and 48–72 h. Also it reversed the glucosuria, hypernatriuria, and urine osmolarity at three times tested (5–24, 24–48, and 48–72. Thus, we conclude that GbE has a beneficial activity in the cytoplasmic membranes of brush border cells on the renal tubules, against the adverse effects that can be produced by some xenobiotics in this case the TiO2-NPs, in experimental rats.

  11. Physiological Responses During Multiplay Exergaming in Young Adult Males are Game-Dependent

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    McGuire Stephen

    2015-06-01

    Full Text Available Regular moderate-intensity exercise provides health benefits. The aim of this study was to examine whether the selected exercise intensity and physiological responses during exergaming in a single and multiplayer mode in the same physical space were game-dependent. Ten males (mean ±SD, age: 23 ±5 years, body mass: 84.2 ±15.6 kg, body height: 180 ±7 cm, body mass index: 26.0 ±4.0 kg·m−2 played the games Kinect football, boxing and track & field (3 × ~10 min, ~ 2 min rest periods in similar time sequence in two sessions. Physiological responses were measured with the portable Cosmed K4b2 pulmonary gas exchange system. Single play demands were used to match with a competitive opponent in a multiplay mode. A within-subjects crossover design was used with one-way ANOVA and a post-hoc t-test for analysis (p<0.05. Minute ventilation, oxygen uptake and the heart rate were at least 18% higher during a multiplayer mode for Kinect football and boxing but not for track & field. Energy expenditure was 21% higher during multiplay football. Single play track & field had higher metabolic equivalent than single play football (5.7 ±1.6, range: 3.2-8.6 vs 4.1 ±1.0, range: 3.0-6.1, p<0.05. Exergaming in a multiplayer mode can provide higher physiological demands but the effects are game-dependent. It seems that exergaming with low intensity in a multiplayer mode may provide a greater physical challenge for participants than in a single play mode but may not consistently provide sufficient intensity to acquire health benefits when played regularly as part of a programme to promote and maintain health in young adults.

  12. Coffee polyphenol consumption improves postprandial hyperglycemia associated with impaired vascular endothelial function in healthy male adults.

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    Jokura, Hiroko; Watanabe, Isamu; Umeda, Mika; Hase, Tadashi; Shimotoyodome, Akira

    2015-10-01

    Epidemiological studies indicate that habitual coffee consumption lowers the risk of diabetes and cardiovascular diseases. Postprandial hyperglycemia is a direct and independent risk factor for cardiovascular diseases. We previously demonstrated that coffee polyphenol ingestion increased secretion of Glucagon-like peptide 1 (GLP-1), which has been shown to exhibit anti-diabetic and cardiovascular effects. We hypothesized coffee polyphenol consumption may improve postprandial hyperglycemia and vascular endothelial function by increasing GLP-1 release and/or reducing oxidative stress. To examine this hypothesis, we conducted a randomized, acute, crossover, intervention study in healthy male adults, measuring blood parameters and flow-mediated dilation (FMD) after ingestion of a meal with or without coffee polyphenol extract (CPE). Nineteen subjects consumed a test meal with either a placebo- or CPE-containing beverage. Blood biomarkers and FMD were measured at fasting and up to 180 minutes postprandially. The CPE beverage led to a significantly lower peak postprandial increase in blood glucose and diacron-reactive oxygen metabolite, and significantly higher postprandial FMD than the placebo beverage. Postprandial blood GLP-1 increase tended to be higher after ingestion of the CPE beverage, compared with placebo. Subclass analysis revealed that the CPE beverage significantly improved postprandial blood GLP-1 response and reduced blood glucose increase in the subjects with a lower insulinogenic index. Correlation analysis showed postprandial FMD was negatively associated with blood glucose increase after ingestion of the CPE beverage. In conclusion, these results suggest that coffee polyphenol consumption improves postprandial hyperglycemia and vascular endothelial function, which is associated with increased GLP-1 secretion and decreased oxidative stress in healthy humans.

  13. Protective effects of vitamin E and selenium on spermatogenesis in adult male rat insulin-resistant

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    Alireza Zakerabasali

    2013-03-01

    Full Text Available Background & Objective: Diabetes mellitus is a metabolic disease and is a multifactorial disorder characterized by chronic hyperglycemia resulting from impaired insulin secretion and insulin factional or both. In this study, the protective role of vitamin E and sodium selenite in preventing the harmful effects of insulin resistance (diabetes type 2 on spermatogenesis was studied.   Materials & Methods: Male adults (180-200 g of Wistar rats were divided into five groups, each containing 7 rats (control, sham, and three experimental groups. The rats were fed daily with water-soluble fructose (10%, mg/kg 200 of vitamin E (gavage, and 5/0 mg/kg of sodium selenite (intraperitoneal injection or both for 110 days. Subsequently, sperm parameters, levels of testosterone, LH, and daily sperm production (DSP were checked. Additionally, testicular histopathology and malondialdehyde (MDA in the testis were examined.   Results: Sperm count, sperm motility and viability, and insulin resistance in the rats decreased DSP. A significant decrease was observed in the number of Leydig cells, spermatogonia, spermatogenesis, and spermatozoa in the testis of the insulin-resistant animals, whereas MDA and testosterone rose in the insulin-resistant rats. Vitamin E and sodium selenite intake reduced the levels of MDA and harmful effects of fructose on testicles, as well as sperm parameters and testicular pathology. A simultaneous intake of vitamin E and sodium selenite conferred the highest level of protection.   Conclusion: These findings suggest that vitamin E and sodium selenite can have a protective role in the testes of rats against oxidative stress induced by diabetes type 2.

  14. The Ginkgo biloba Extract Reverses the Renal Effects of Titanium Dioxide Nanoparticles in Adult Male Rats.

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    Escárcega-González, Carlos Enrique; Reynoso-Andeola, Irma Guadalupe; Jaramillo-Juárez, Fernando; Martínez-Ruvalcaba, Haydée; Posadas Del Rio, Francisco A

    2016-01-01

    The Ginkgo biloba extract (GbE) is a commercial product used as a nutraceutic herbal remedy in Europe and US. It contains 27% of the polyphenols isorhamnetin, kaempferol, and quercetin, as antioxidants. We used male adult Wistar rats (200-300 g), divided into four groups: control group (treated with 5.0 mg/kg of sodium chloride, intravenous), titanium dioxide nanoparticles (TiO2-NPs) group (5.0 mg/kg, intravenous), GbE group (10 mg/kg, intraperitoneal), and GbE + TiO2-NPs group (treated 24 h before with 10 mg/kg of GbE, intraperitoneal), followed, 24 h later, by 5.0 mg/kg of TiO2-NPs intravenously. The statistical analysis was performed using Student's t-test for grouped data with ANOVA posttest. The GbE protected renal cells against the effects of TiO2-NPs because it reversed the increased activity of γ-glutamyltranspeptidase and the enzymatic activity of dipeptidylaminopeptidase IV at all times tested (0-5, 5-24, 24-48, and 48-72 h). Also it reversed the glucosuria, hypernatriuria, and urine osmolarity at three times tested (5-24, 24-48, and 48-72). Thus, we conclude that GbE has a beneficial activity in the cytoplasmic membranes of brush border cells on the renal tubules, against the adverse effects that can be produced by some xenobiotics in this case the TiO2-NPs, in experimental rats. PMID:27042354

  15. Effect of cyanotoxins on the hypothalamic-pituitary-gonadal axis in male adult mouse.

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    Xiaolu Xiong

    Full Text Available BACKGROUND: Microcystins LR (MC-LR are hepatotoxic cyanotoxins that have been shown to induce reproductive toxicity, and Hypothalamic-Pituitary-Gonadal Axis (HPG is responsible for the control of reproductive functions. However, few studies have been performed to evaluate the effects of MC-LR on HPG axis. This study aimed to investigate the MC-LR-induced toxicity in the reproductive system of mouse and focus on the HPG axis. METHODS: Adult male C57BL/6 mice were exposed to various concentrations of MC-LR (0, 3.75, 7.50, 15.00 and 30.00 µg/kg body weight per day for 1 to 14 days, and it was found that exposure to different concentrations of MC-LR significantly disturbed sperm production in the mice testes in a dose- and time-dependent manner. To elucidate the associated possible mechanisms, the serum levels of testosterone, follicle-stimulating hormone (FSH and luteinizing hormone (LH were assessed. Meanwhile, PCR assays were employed to detect alterations in a series of genes involved in HPG axis, such as FSH, LH, gonadotropin-releasing hormone (GnRH and their complement receptors. Furthermore, the effect of MC-LR on the viability and testosterone production of Leydig cells were tested in vitro. RESULTS: MC-LR significantly impaired the spermatogenesis of mice possibly through the direct or indirect inhibition of GnRH synthesis at the hypothalamic level, which resulted in reduction of serum levels of LH that lead to suppression of testosterone production in the testis of mice. CONCLUSIONS: MC-LR may be a GnRH toxin that would disrupt the reproductive system of mice.

  16. Postnatal manganese exposure does not alter dopamine autoreceptor sensitivity in adult and adolescent male rats.

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    McDougall, Sanders A; Mohd-Yusof, Alena; Kaplan, Graham J; Abdulla, Zuhair I; Lee, Ryan J; Crawford, Cynthia A

    2013-04-15

    Administering manganese chloride (Mn) to rats on postnatal day (PD) 1-21 causes long-term reductions in dopamine transporter levels in the dorsal striatum, as well as a persistent increase in D1 and D2 receptor concentrations. Whether dopamine autoreceptors change in number or sensitivity is uncertain, although D2S receptors, which may be presynaptic in origin, are elevated in Mn-exposed rats. The purpose of this study was to determine if early Mn exposure causes long-term changes in dopamine autoreceptor sensitivity that persist into adolescence and adulthood. To this end, male rats were exposed to Mn on PD 1-21 and autoreceptor functioning was tested 7 or 70 days later by measuring (a) dopamine synthesis (i.e., DOPA accumulation) in the dorsal striatum after quinpirole or haloperidol treatment and (b) behavioral responsiveness after low-dose apomorphine treatment. Results showed that low doses (i.e., "autoreceptor" doses) of apomorphine (0.06 and 0.12 mg/kg) decreased the locomotor activity of adolescent and adult rats, while higher doses increased locomotion. The dopamine synthesis experiment also produced classic autoreceptor effects, because quinpirole decreased dorsal striatal DOPA accumulation; whereas, haloperidol increased DOPA levels in control rats, but not in rats given the nerve impulse inhibitor γ-butyrolactone. Importantly, early Mn exposure did not alter autoreceptor sensitivity when assessed in early adolescence or adulthood. The lack of Mn-induced effects was evident in both the dopamine synthesis and behavioral experiments. When considered together with past studies, it is clear that early Mn exposure alters the functioning of various dopaminergic presynaptic mechanisms, while dopamine autoreceptors remain unimpaired. PMID:23458069

  17. Early Life Manipulations of the Nonapeptide System Alter Pair Maintenance Behaviors and Neural Activity in Adult Male Zebra Finches.

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    Baran, Nicole M; Tomaszycki, Michelle L; Adkins-Regan, Elizabeth

    2016-01-01

    Adult zebra finches (T. guttata) form socially monogamous pair bonds characterized by proximity, vocal communication, and contact behaviors. In this experiment, we tested whether manipulations of the nonapeptide hormone arginine vasotocin (AVT, avian homolog of vasopressin) and the V1a receptor (V1aR) early in life altered species-typical pairing behavior in adult zebra finches of both sexes. Although there was no effect of treatment on the tendency to pair in either sex, males in different treatments exhibited profoundly different profiles of pair maintenance behavior. Following a brief separation, AVT-treated males were highly affiliative with their female partner but sang very little compared to Controls. In contrast, males treated with a V1aR antagonist sang significantly less than Controls, but did not differ in affiliation. These effects on behavior in males were also reflected in changes in the expression of V1aR and immediate early gene activity in three brain regions known to be involved in pairing behavior in birds: the medial amygdala, medial bed nucleus of the stria terminalis, and the lateral septum. AVT males had higher V1aR expression in the medial amygdala than both Control and antagonist-treated males and immediate early gene activity of V1aR neurons in the medial amygdala was positively correlated with affiliation. Antagonist treated males showed decreased activity in the medial amygdala. In addition, there was a negative correlation between the activity of V1aR cells in the medial bed nucleus of the stria terminalis and singing. Treatment also affected the expression of V1aR and activity in the lateral septum, but this was not correlated with any behaviors measured. These results provide evidence that AVT and V1aR play developmental roles in specific pair maintenance behaviors and the neural substrate underlying these behaviors in a bird. PMID:27065824

  18. Early Life Manipulations of the Nonapeptide System Alter Pair Maintenance Behaviors and Neural Activity in Adult Male Zebra Finches

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    Nicole M. Baran

    2016-03-01

    Full Text Available Adult zebra finches (T. guttata form socially monogamous pair bonds characterized by proximity, vocal communication, and contact behaviors. In this experiment, we tested whether manipulations of the nonapeptide hormone arginine vasotocin (AVT, avian homologue of vasopressin and the V1a receptor (V1aR early in life altered species-typical pairing behavior in adult zebra finches of both sexes. Although there was no effect of treatment on the tendency to pair in either sex, males in different treatments exhibited profoundly different profiles of pair maintenance behavior. Following a brief separation, AVT-treated males were highly affiliative with their female partner but sang very little compared to Controls. In contrast, males treated with a V1aR antagonist sang significantly less than Controls, but did not differ in affiliation. These effects on behavior in males were also reflected in changes in the expression of V1aR and immediate early gene activity in three brain regions known to be involved in pairing behavior in birds: the medial amygdala, medial bed nucleus of the stria terminalis, and the lateral septum. AVT males had higher V1aR expression in the medial amygdala than both Control and antagonist-treated males and immediate early gene activity of V1aR neurons in the medial amygdala was positively correlated with affiliation. Antagonist treated males showed decreased activity in the medial amygdala. In addition, there was a negative correlation between the activity of V1aR cells in the medial bed nucleus of the stria terminalis and singing. Treatment also affected the expression of V1aR and activity in the lateral septum, but this was not correlated with any behaviors measured. These results provide evidence that AVT and V1aR play developmental roles in specific pair maintenance behaviors and the neural substrate underlying these behaviors in a bird.

  19. Abnormal secretion of reproductive hormones and antioxidant status involved in quinestrol-induced reproductive toxicity in adult male rat.

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    Li, Jian; Wang, Hongwei; Zhang, Jiliang; Zhou, Bianhua; Si, Lifang; Wei, Lan; Li, Xiang

    2014-02-01

    This study aimed to evaluate the effects of quinestrol, a synthetic oestrogen homologue with reproductive toxicity, on the secretion of reproductive hormones and antioxidant status in adult male rat. Our results showed that quinestrol exposure significantly decreased the weight of the testis, epididymides, seminal vesicle, and prostate, as well as the sperm counts in the cauda epididymis of rats. Quinestrol significantly reduced the size of seminiferous tubules and the total number of spermatogenic cells. Serum testosterone, follitropin, and lutropin were also significantly reduced in a dose-related manner after quinestrol exposure. Meanwhile, the activity of superoxide dismutase, glutathione peroxidase, and total antioxide capacity significantly decreased, whereas the malondialdehyde and nitric oxide concentrations significantly increased in the testes. These findings revealed that endocrine disorders of reproductive hormones and oxidative stress may be involved in reproductive toxicity induced by quinestrol in adult male rats. PMID:24183492

  20. [Circumcision in the newborn child and risk of urinary tract infection during the first year of life. A meta-analysis].

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    Amato, D; Garduño-Espinosa, J

    1992-10-01

    To assess if neonatal circumcision may decrease the incidence of urinary tract infection (UTI), published papers on these topics were reviewed, to address their methodological shortcomings, and to analyze them in individual and grouped form. A systematic search of the papers on circumcision and UTI was conducted in Index Medicus (1975-1991) and MEDLINE (1988-1991). Six papers were included in the meta-analysis because all of them presented original data obtained from groups of patients. All of the elected articles were considered in individual and grouped form to calculate odds ratio (OR) and confidence interval at 95% (CI 95%). The number of patients included in each paper ranged from 112 to 219,775. Clustering of the articles enabled us to obtain a global sample number of 221,799 patients. In each individual article there was a higher risk of UTI in uncircumcised patients (OR from 10.82 to 156.42). Global risk obtained from the six clustered papers was of 13.05 with a CI 95% from 10.86 to 15.70. Uncircumcised males have low risk of UTI during their first year of life, but the risk may decrease even more with circumcision. This conclusion may not be considered as definitive because of the methodological shortcomings of the papers reviewed. Recommendation of routinely circumcision to all newborns in not justified with these data.