Predictors and clinical consequences of starting androgen therapy in men with low testosterone: results from the SIAMO-NOI registry.

PURPOSE: Management of late onset hypogonadism (LOH) is not homogenous. The aim of the study is to observe the management of patients with low testosterone (T) in highly specialized Italian centres. METHODS: The SIAMO-NOI is an observational longitudinal disease registry for the evaluation of the clinical management of patients with low T levels (total T < 12 nmol/L, calculated free T < 225 pmol/l or already in treatment) in 15 Italian centers members of the Italian Society for Andrology and Sexual Medicine (SIAMS). Clinical and biochemical data were collected for four visits during 12 months of observation. RESULTS: 432 patients (mean age 50.9 ± 14.9 years) were enrolled. Of them, 247 men were receiving androgen therapy, whereas 145 were naive. After the first visit (V0), 80 men started androgen therapy, whereas 55 remained untreated during the entire observation. Younger age [odds ratio (OR) 0.57 (0.35-0.92)], total T < 8 nmol/l [OR 4.69 (1.59-13.81)], complaining at least one sexual symptom [OR 11.55 (2.01-66.35)] and reporting more severe lower urinary tract symptoms [OR 1.27 (1.01-1.60)] predicted starting an androgen therapy. Sixty-four men started therapy immediately after V0 and maintained it until the observation end. When compared to V0, they reported an increase in all the domains of the International Index of Erectile Function-15 (IIEF-15), in the sexual and physical subdomains of the Aging Male Scale as well as in the International Prostate Symptom Score. Conversely, the untreated group reported a significant improvement, although lower than the treated group, only in the erectile function domain of the IIEF-15. CONCLUSIONS: Management of LOH in SIAMS centres is in line with the international guidelines and the newest knowledge about the role of T on prostate health. Androgen therapy is associated with an improvement in all the aspects of sexual life and in the perception of physical strength.

[Eye health promotion and early visual problem detection in the public health services]. / Promoção da saúde ocular e prevenção precoce de problemas visuais nos serviços de saúde pública.

INTRODUCTION: The main purpose of the study was to verify knowledge about eye health care attention of the pediatricians and nurses at public health centers in the city of Campinas, state of São Paulo, Brazil. METHODS: Knowledge, attitudes and practices regarding eye health on behalf of pediatricians and nurses who worked at health centers in Campinas were studied through questionnaires and forms. RESULTS: The implementation of primary health care actions in children wasn't usual in the public services due to the little knowledge that both pediatricians and nurses had about it. Of 61% pediatricians, 82,0% (50) and 91,0% of the 22 nurses didn't know the age at which visual development is finished; 86,3% (53) of the pediatricians and 100,0% the nurses didn't know what was amblyopia. CONCLUSIONS: Therefore, the eye health promotion and the early visual problem detection in children were not run by the professionals from the public health services in the city of Campinas.