Andropausal syndrome in men with systolic heart failure.

INTRODUCTION: Andropausal syndrome (AS) is an element of male aging, being associated with the age-related decline in circulating androgens. OBJECTIVES: We investigated the prevalence of AS, the severity of andropausal symptoms, and their clinical and hormonal determinants in men with heart failure (HF) and healthy peers. PATIENTS AND METHODS: We examined 232 men with systolic HF aged from 40 to 80 years (New York Heart Association [NYHA] class I/II/III-IV: 17%/54%/29%, left ventricular ejection fraction: 30% ±8%) and 362 healthy peers. The severity of 17 andropausal symptoms were assessed using the Aging Males' Symptoms Rating Scale. RESULTS: In men with HF aged from 40 to 59 years, the prevalence of AS and the severity of andropausal symptoms were greater than in healthy peers (28% vs. 7%; 40 ±14 vs. 35 ±10 points; both P <0.001), while in the age group of 60 to 80 years, there were no differences in the prevalence of AS and the severity of andropausal symptoms between men with HF and healthy peers (31% vs. 40%; 44 ±12 vs. 46 ±10 points; respectively; both P >0.1). In men with HF aged from 40 to 59 years, advanced NYHA class, low hemoglobin, increased platelet number, and low serum dehydroepiandrosterone sulphate were independently associated with the greater prevalence of AS (all P <0.05). In men aged from 60 to 80 years, only reduced hemoglobin was borderline related to the higher prevalence of AS (P = 0.07). CONCLUSIONS: AS affects almost one-third of men with HF regardless of the age group. The clinical and hormonal determinants of the severity of andropausal symptoms differ between younger and older male patients. Endocrinological and sexual counseling is recommended in men with HF.

[The operations of the abdominal hernias with the use propylene material in patients operated due to abdominal aortic aneurysm]. / Stosowanie siatek propylenowych w operacjach przepuklin brzusznych u chorych, operowanych z powodu tetniaka aorty brzusznej.

The correlation between abdominal hernias and aortic aneurysm has been well documented in literature. The pathophysiology of aneurysm and hernia formation is seen within the abnormal collagen metabolism, resulting in extracellular matrix defects. This study presents a group of 8 men in the age of 36 to 78 years old (average 63, 5 years old) who underwent both an operation for the aneurysm and for the abdominal hernia. Of the reported 8 patients, 7 had postoperative hernias, where 4 of the cases there were recurrent postoperative hernias. The remaining patient had an inguinal hernia. In 7 cases patients underwent an abdominal aortic aneurysm (AAA) operation and in one case a hepatic artery aneurysm endovascular operation was performed. Due to the fact that postoperative hernias are an immense problem, especially within the group of patient with collagen defects, the area of research and improvement of the materials that are used in prosthetic hernia surgery today needs to progress. This study also presents a short review of the various types of prosthetic materials used in the production of hernial meshes. This is to emphasize the necessity of improving operational techniques to minimize the risk of herniation, especially within a group of patients with collagen defects.