AIM To determine whether recent evidence-based United States polices on male circumcision(MC) apply to comparable Anglophone countries,Australia and New Zealand.METHODS Articles in 2005 through 2015 were retrieved fro...AIM To determine whether recent evidence-based United States polices on male circumcision(MC) apply to comparable Anglophone countries,Australia and New Zealand.METHODS Articles in 2005 through 2015 were retrieved from PubM ed using the keyword "circumcision" together with 36 relevant subtopics.A further PubM ed search was performed for articles published in 2016.Searches of the EMBASE and Cochrane databases did not yield additional citable articles.Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further.The most relevant andrepresentative of the topic were included.Bibliographies were examined to retrieve further key references.Randomized controlled trials,recent high quality systematic reviews or meta-analyses(level 1++ or 1+ evidence) were prioritized for inclusion.A risk-benefit analysis of articles rated for quality was performed.For efficiency and reliability,recent randomized controlled trials,metaanalyses,high quality systematic reviews and large welldesigned studies were used if available.Internet searches were conducted for other relevant information,including policies and Australian data on claims under Medicare for MC.RESULTS Evidence-based policy statements by the American Academy of Pediatrics(AAP) and the Centers for Disease Control and Prevention(CDC) support infant and later age male circumcision(MC) as a desirable public health measure.Our systematic review of relevant literature over the past decade yielded 140 journal articles that met our inclusion criteria.Together,these showed that early infant MC confers immediate and lifelong benefits by protecting against urinary tract infections having potential adverse long-term renal effects,phimosis that causes difficult and painful erections and "ballooning" during urination,inflammatory skin conditions,inferior penile hygiene,candidiasis,various sexually transmissible infections in both sexes,genital ulcers,and penile,prostate and cervical cancer.Our risk-benefit analysis showed that benefits exceeded procedural risks,which are predominantly minor,by up to 200 to 1.We estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime.Wide-ranging evidence from surveys,physiological measurements,and the anatomical location of penile sensory receptors responsible for sexual sensation strongly and consistently suggested that MC has no detrimental effect on sexual function,sensitivity or pleasure.United States studies showed that early infant MC is cost saving.The evidence supporting early infant MC has further strengthened since the positive AAP and CDC reviews.CONCLUSION Affirmative MC policies are needed in Australia and New Zealand.Routine provision of accurate,unbiased education,and access in public hospitals,will maximize health and financial benefits.展开更多
This Special Issue provides reflections after 20 years, summarized in 12 papers, on the controversial issue of alleged decline in human sperm output due to global oestrogen pollution by industrial chemicals.
If scandal is the engine of progress in politics, and sensation is that of the media, while anti-modern panic is that of environmentalism, what is the dynamic of medical science？ Certainly discovery and invention rep...If scandal is the engine of progress in politics, and sensation is that of the media, while anti-modern panic is that of environmentalism, what is the dynamic of medical science？ Certainly discovery and invention represent the admirable high road, whereas competition and controversy represent the quotidian low road. This Special Issue is directed to reviewing the lessons learned from the most public, fervent and durable controversy in the short history of Andrology, the claims of world-wide falling sperm counts, due to global pollution by industrial estrogenic chemicals, published two decades ago.展开更多
It is unknown whether the reduced blood testosterone among unselected older men （＂andropause＂） compared to healthy younger men is due to ageing per se or as a non-specific adaptive reaction to chronic diseases acc...It is unknown whether the reduced blood testosterone among unselected older men （＂andropause＂） compared to healthy younger men is due to ageing per se or as a non-specific adaptive reaction to chronic diseases accumulating during ageing.展开更多
Puberty is a pivotal biological process that completes sexual maturation to achieve full reproductive capability.It is a major transformational period of life,whose timing is strongly affected by genetic makeup of the...Puberty is a pivotal biological process that completes sexual maturation to achieve full reproductive capability.It is a major transformational period of life,whose timing is strongly affected by genetic makeup of the individual,along with various internal and external factors.Although the exact mechanism for initiation of the cascade of molecular events that culminate in puberty is not yet known,the process of pubertal onset involves interaction of numerous complex signaling pathways of hypothalamopituitary-testicular(HPT)axis.We developed a classification of the mechanisms involved in male puberty that allowed placing many genes into physiological context.These include(i)hypothalamic development during embryogenesis,(ii)synaptogenesis where gonadotropin releasing hormone(GnRH)neurons form neuronal connections with suprahypothalamic neurons,(iii)maintenance of neuron homeostasis,(iv)regulation of synthesis and secretion of GnRH,(v)appropriate receptors/proteins on neurons governing GnRH production and release,(vi)signaling molecules activated by the receptors,(vii)the synthesis and release of GnRH,(viii)the production and release of gonadotropins,(ix)testicular development,(x)synthesis and release of steroid hormones from testes,and(xi)the action of steroid hormones in downstream effector tissues.Defects in components of this system during embryonic development,childhood/adolescence,or adulthood may disrupt/nullify puberty,leading to long-term male infertility and/or hypogonadism.This review provides a list of 598 genes involved in the development of HPT axis and classified according to this schema.Furthermore,this review identifies a subset of 75 genes for which genetic mutations are reported to delay or disrupt male puberty.展开更多
雄激素受体(AR ) 调停了雄激素行动提供在男开发和功能的不仅一个古典枢轴的角色而且在女繁殖生理学的一个最近证明的角色。拼接 AR 的变体被报导发生在各种各样的雄激素敏感的癌症和现在，由王等的最近的研究。建议 AR 拼接变体在 poly...雄激素受体(AR ) 调停了雄激素行动提供在男开发和功能的不仅一个古典枢轴的角色而且在女繁殖生理学的一个最近证明的角色。拼接 AR 的变体被报导发生在各种各样的雄激素敏感的癌症和现在，由王等的最近的研究。建议 AR 拼接变体在 polycystic 卵巢症候群(PCOS ) 有一个 etiological 角色。尽管进一步的调查被要求充分估价他们的发现的意义，这些精液的调查结果为在在 PCOS 的起源和致病发信号的 AR 的角色的理解打开新章有令人激动、重要的含意。展开更多
Surgical sperm retrieval(SSR)is currently one of the most common procedures in in vitro fertilization(IVF).However,a gap between the guidelines and routine clinical practice regarding antibiotic use in sSR,which might...Surgical sperm retrieval(SSR)is currently one of the most common procedures in in vitro fertilization(IVF).However,a gap between the guidelines and routine clinical practice regarding antibiotic use in sSR,which might lead to antibiotic resistance,is a challenging problem worldwide.A cross-sectional survey was conducted from May 1,2021,to July 15,2021,to investigate antibiotic usage by medical professionals when performing SSR in IVF centers in Vietnam.The confidential questionnaire comprised 12 items,including characteristics of the study population,awareness of antimicrobial resistance,attitude toward prescribing antibiotics,and current practice of prescribing antibiotics when performing SSR.Surveys were completed by 30 of 45 registered IVF centers(66.7%).Among 67 physicians working at those centers,the age and work-experience years(mean±standard deviation[s.d.])were 38.6±6.6 years and 11.2±7.0 years,respectively.Over 60%of them held a degree in Obstetrics and Gynecology,and over four-fifths were men.Most respondents"often/very often/always"raised awareness of antimicrobial resistance to their patients(83.3%),but only half of them"often/occasionally"prescribed antibiotics to patients with SSR in cases where the prescription would be optional.About one-tenth of respondents followed the recommendation from the American Urological Association using"prophylaxis only"for SSR patients.For more invasive SSR,physicians tended to prescribe more complicated and sometimes inappropriate regimens.In conclusion,antibiotic usage in SSR was not always appropriate among IVF centers.Further studies may define specific recommendations for regimens,intervention strategies,and programs to promote appropriate antibiotic use for SSR patients among IVF specialists.展开更多
FOREWORD FROM TREVOR G COOPER Roger V Short,Fellow of the Royal Society(FRS),born in England in 1930,itally trained as a vet at Bristol University,then completed a Fulbright Scholarship in the states and a PhD at the ...FOREWORD FROM TREVOR G COOPER Roger V Short,Fellow of the Royal Society(FRS),born in England in 1930,itally trained as a vet at Bristol University,then completed a Fulbright Scholarship in the states and a PhD at the University of Cambridge.After research in the University's Department of Veterinary Clinical studies until 1972,he became the director of the Medical Research Council Unit of Reproductive Biology in Edinburgh for the next decade,teaming up with Professor David Baird to run a globally renowned research institute where he trained numerous famous scientists.From 2007 to 2014,he was an Editorial Board Member of Asian Journal of Andrology.展开更多
文摘AIM To determine whether recent evidence-based United States polices on male circumcision(MC) apply to comparable Anglophone countries,Australia and New Zealand.METHODS Articles in 2005 through 2015 were retrieved from PubM ed using the keyword "circumcision" together with 36 relevant subtopics.A further PubM ed search was performed for articles published in 2016.Searches of the EMBASE and Cochrane databases did not yield additional citable articles.Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further.The most relevant andrepresentative of the topic were included.Bibliographies were examined to retrieve further key references.Randomized controlled trials,recent high quality systematic reviews or meta-analyses(level 1++ or 1+ evidence) were prioritized for inclusion.A risk-benefit analysis of articles rated for quality was performed.For efficiency and reliability,recent randomized controlled trials,metaanalyses,high quality systematic reviews and large welldesigned studies were used if available.Internet searches were conducted for other relevant information,including policies and Australian data on claims under Medicare for MC.RESULTS Evidence-based policy statements by the American Academy of Pediatrics(AAP) and the Centers for Disease Control and Prevention(CDC) support infant and later age male circumcision(MC) as a desirable public health measure.Our systematic review of relevant literature over the past decade yielded 140 journal articles that met our inclusion criteria.Together,these showed that early infant MC confers immediate and lifelong benefits by protecting against urinary tract infections having potential adverse long-term renal effects,phimosis that causes difficult and painful erections and "ballooning" during urination,inflammatory skin conditions,inferior penile hygiene,candidiasis,various sexually transmissible infections in both sexes,genital ulcers,and penile,prostate and cervical cancer.Our risk-benefit analysis showed that benefits exceeded procedural risks,which are predominantly minor,by up to 200 to 1.We estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime.Wide-ranging evidence from surveys,physiological measurements,and the anatomical location of penile sensory receptors responsible for sexual sensation strongly and consistently suggested that MC has no detrimental effect on sexual function,sensitivity or pleasure.United States studies showed that early infant MC is cost saving.The evidence supporting early infant MC has further strengthened since the positive AAP and CDC reviews.CONCLUSION Affirmative MC policies are needed in Australia and New Zealand.Routine provision of accurate,unbiased education,and access in public hospitals,will maximize health and financial benefits.
文摘This Special Issue provides reflections after 20 years, summarized in 12 papers, on the controversial issue of alleged decline in human sperm output due to global oestrogen pollution by industrial chemicals.
文摘If scandal is the engine of progress in politics, and sensation is that of the media, while anti-modern panic is that of environmentalism, what is the dynamic of medical science？ Certainly discovery and invention represent the admirable high road, whereas competition and controversy represent the quotidian low road. This Special Issue is directed to reviewing the lessons learned from the most public, fervent and durable controversy in the short history of Andrology, the claims of world-wide falling sperm counts, due to global pollution by industrial estrogenic chemicals, published two decades ago.
文摘It is unknown whether the reduced blood testosterone among unselected older men （＂andropause＂） compared to healthy younger men is due to ageing per se or as a non-specific adaptive reaction to chronic diseases accumulating during ageing.
文摘Puberty is a pivotal biological process that completes sexual maturation to achieve full reproductive capability.It is a major transformational period of life,whose timing is strongly affected by genetic makeup of the individual,along with various internal and external factors.Although the exact mechanism for initiation of the cascade of molecular events that culminate in puberty is not yet known,the process of pubertal onset involves interaction of numerous complex signaling pathways of hypothalamopituitary-testicular(HPT)axis.We developed a classification of the mechanisms involved in male puberty that allowed placing many genes into physiological context.These include(i)hypothalamic development during embryogenesis,(ii)synaptogenesis where gonadotropin releasing hormone(GnRH)neurons form neuronal connections with suprahypothalamic neurons,(iii)maintenance of neuron homeostasis,(iv)regulation of synthesis and secretion of GnRH,(v)appropriate receptors/proteins on neurons governing GnRH production and release,(vi)signaling molecules activated by the receptors,(vii)the synthesis and release of GnRH,(viii)the production and release of gonadotropins,(ix)testicular development,(x)synthesis and release of steroid hormones from testes,and(xi)the action of steroid hormones in downstream effector tissues.Defects in components of this system during embryonic development,childhood/adolescence,or adulthood may disrupt/nullify puberty,leading to long-term male infertility and/or hypogonadism.This review provides a list of 598 genes involved in the development of HPT axis and classified according to this schema.Furthermore,this review identifies a subset of 75 genes for which genetic mutations are reported to delay or disrupt male puberty.
文摘Surgical sperm retrieval(SSR)is currently one of the most common procedures in in vitro fertilization(IVF).However,a gap between the guidelines and routine clinical practice regarding antibiotic use in sSR,which might lead to antibiotic resistance,is a challenging problem worldwide.A cross-sectional survey was conducted from May 1,2021,to July 15,2021,to investigate antibiotic usage by medical professionals when performing SSR in IVF centers in Vietnam.The confidential questionnaire comprised 12 items,including characteristics of the study population,awareness of antimicrobial resistance,attitude toward prescribing antibiotics,and current practice of prescribing antibiotics when performing SSR.Surveys were completed by 30 of 45 registered IVF centers(66.7%).Among 67 physicians working at those centers,the age and work-experience years(mean±standard deviation[s.d.])were 38.6±6.6 years and 11.2±7.0 years,respectively.Over 60%of them held a degree in Obstetrics and Gynecology,and over four-fifths were men.Most respondents"often/very often/always"raised awareness of antimicrobial resistance to their patients(83.3%),but only half of them"often/occasionally"prescribed antibiotics to patients with SSR in cases where the prescription would be optional.About one-tenth of respondents followed the recommendation from the American Urological Association using"prophylaxis only"for SSR patients.For more invasive SSR,physicians tended to prescribe more complicated and sometimes inappropriate regimens.In conclusion,antibiotic usage in SSR was not always appropriate among IVF centers.Further studies may define specific recommendations for regimens,intervention strategies,and programs to promote appropriate antibiotic use for SSR patients among IVF specialists.
文摘FOREWORD FROM TREVOR G COOPER Roger V Short,Fellow of the Royal Society(FRS),born in England in 1930,itally trained as a vet at Bristol University,then completed a Fulbright Scholarship in the states and a PhD at the University of Cambridge.After research in the University's Department of Veterinary Clinical studies until 1972,he became the director of the Medical Research Council Unit of Reproductive Biology in Edinburgh for the next decade,teaming up with Professor David Baird to run a globally renowned research institute where he trained numerous famous scientists.From 2007 to 2014,he was an Editorial Board Member of Asian Journal of Andrology.
