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Are you perhaps overdue for your first visit to a urologist? And how uncomfortable is a prostate examination really? Berlin (dpa) – Many a man may feel anxious before seeing a urologist for the first time, perhaps even to the point of getting sweaty palms and going weak at the knees. A digital rectal exam can be a particular object of dread. When should you make an appointment? And what can you expect during your visit? Two urologists have answers: According to Dr Axel Merseburger, spokesman for the German Society for Urology (DGU), a man should see a urologist in cases of frequent or painful urination, blood in urine, recurrent urinary tract infections, kidney stones, erectile dysfunction, testicular pain or unexplained lower abdominal pain. External signs of inflammation in the genital region or lumps in or around the testicles are also cause for an examination by a urologist, says Dr Robert Frese, executive board chairman of the Association of Urologists in Private Practice in Hamburg (VUHH). In addition, urologists can provide consultation on matters relating to fertility, sexual problems or sexually transmitted diseases. "But you should always see your GP first, who can refer you to the proper specialists," Merseburger says. If for nothing else, every man should see a urologist for cancer screening. "Prostate cancer is the most common cancer in men, as breast cancer is in women," points out Frese. Worldwide, there were an estimated 1,414,259 cases in 2020, according to the Global Cancer Observatory, a specialized agency platform of the World Health Organization. At what age should a man be screened for prostate cancer? Annual screening is recommended for men aged 45 and over. However, even though the procedure may be covered by their health insurance, a large percentage of men typically don't get screened regularly, and many don't at all. How does the initial appointment generally go? Whether it's a cancer screening or you want to have acute symptoms checked, a proper visit with a urologist should begin with a thorough conversation about your medical history, touching on such things as any cancer cases in your family, pre-existing conditions you may have, and your use of medicines. "Your sexual function shouldn't be left out for fear of embarrassment either," Frese says. Depending on any symptoms you may have, a physical examination then follows, perhaps complemented by a urinalysis and/or blood test. What exactly is done during a cancer screening exam? Along with examining and palpating – or feeling – the penis and scrotum for any abnormal areas, the urologist palpates the prostate gland and checks the lymph nodes, Frese says. Prostate palpation, also known as a digital rectal exam (DRE), is somewhat controversial because "not every small, early tumour can be adequately felt."  For this reason, professional medical associations such as the DGU recommend prostate-specific antigen (PSA) screening too. PSA is protein produced by cells of the prostate gland, and men with prostate cancer often have an elevated level in their blood. Some non-cancerous conditions can also raise the level, however. Merseburger advises men to consult their urologist about the suitability of having both a DRE and PSA test. Frese, for his part, discourages leaving out a DRE, as "it can provide essential information on the size and shape of the prostate gland as well as palpable abnormalities that could indicate colon cancer." Is the dreaded DRE really so bad? How uncomfortable it's felt to be depends on the individual. In any case, it's not painful and generally takes only a few seconds. You typically lie on your side, knees bent, and the doctor inserts a gloved, lubricated finger into your rectum and palpates the prostate – located just below the urinary bladder – for any hard, lumpy or abnormal areas. "It's a bit unpleasant, but a blood test is worse," remarks Frese. "When you explain its purpose to the patient, they all agree to have it." Along with background information, a little humour can help to ease any embarrassment, he says. Merseburger advises his patients to simply relax and breathe calmly. He also thoroughly explains the importance of a DRE to allay any anxiety or embarrassment. As Frese sees it, the reason that men often neglect to get screened for prostate cancer lies in their psyche: "Men don't like going to a doctor. They tend to regard their body as a machine, and a doctor as a mechanic that you call on only when something isn't working properly." Do only men go to a urologist? No. "Roughly 40% of my patients are women," Frese says, noting that recurrent urinary tract infections, kidney stones or incontinence are the main causes of their visits. "Women can also develop tumours that are treated by a urologist, such as bladder cancer or a kidney tumour." Children, too, get urological treatment. Common causes, according to Merseburger, are congenital anomalies or an undescended testicle. The following information is not intended for publication dpa/tmn ada yyzz a3 bzl rid cja ob

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London (PA Media/dpa) – Scientists have created the first new anti-malaria drug in quarter of a century in a bid to cut out resistance to existing treatments. Researchers found their new treatment has a “very high cure rate” of more than 97.4% – and in some assessments over 99.2%. Experts said that they were “very excited” by the findings. “This has a potential to not just treat the disease, but also to work against the resistant parasites, [and] additionally, block the transmission of the disease,” said Dr Sujata Vaidyanathan, head of global health development at Novartis, which created the new drug. The treatment, known as GanLum, works by disrupting the internal protein transport system in the malaria parasite – which is essential for the parasite to survive in the blood. Experts said that they have been sounding the alert about resistance to anti-malaria treatments and the GanLum will help stem the concern. Dr Vaidyanathan went on: “We are starting to see emergence of resistance. “In order to address this, we set about to create a totally new kind of compound. “There has not been major innovation in the treatment of malaria in the past 25 years, because the ACT’s (artemisinin-based combination therapies) have worked so well. “But now, resulting in the resistance that is arising, we have set up to develop a completely new treatment for malaria.” She added: “In addition to treating malaria, [it] has the potential to kill the resistant parasites. “The way the drug works is by disrupting the parasite’s internal protein transport system and which then is essential for these parasites to survive inside the red blood cells. “So this way, it’s able to address the disease, as well as able to work across the different parasite spectrum.” Scientists have now reported back on their large clinical trial assessing the treatment in the real world, presenting their findings to the American Society of Tropical Medicine and Hygiene annual meeting in Toronto. The trial ran across 34 sites in 12 countries in Sub Saharan Africa involving 1,700 adults and children who weighed more than 10kg. “It had a very high cure rate,” Dr Vaidyanathan said. Commenting on the findings, Professor Abdoulaye Djimde – co-ordinator of the West African Network for Clinical Trials of Antimalarial Drugs, said: “I must say that I’m very, very excited and very pleased to see the results of GanLum. “Despite the progress that has been made recently, malaria is actually becoming more of a challenge because of many factors: climate change; funding cuts and others. “The numbers are going in the wrong direction, added to that, the looming development of resistance. “So having a new compound that is that effective and that safe is music to my ears.” He added: “GanLum could represent the biggest advance in malaria treatment for decades, with high efficacy against multiple forms of the parasite as well as the ability to kill mutant strains that are showing signs of resistance to current medicines.” Novartis said that the novel ingredient in GanLum, ganaplacide, was discovered after screening 2.3 million molecules. GanLum is made up of ganaplacide and a new formulation of existing antimalarial lumefantrine, a longer-acting treatment. The treatment is given as a sachet of granules once a day for three days. Novartis said it plans to seek regulatory approvals from health authorities for GanLum as soon as possible. The following information is not intended for publication pa dpa coh

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Berlin (dpa) – People aged 50 and over can help prevent heart disease and gain years of life by having key health values checked regularly, health experts say. A cardiovascular health check should become a regular part of preventive care no later than age 50, and preferably from 35, according to the German Heart Foundation. In the UK, meanwhile, doctors recommend patients have their heart checked every five years from the age of 40. For timely cardiovascular care, here is what heart specialists recommend: Measure your blood pressure regularly:High blood pressure is the most common modifiable risk factor for conditions such as atrial fibrillation or heart failure, often going unnoticed for a long time. Regularly check your blood pressure and have it managed if necessary. Quit smoking, ideally with help:About one in five cardiovascular deaths worldwide is attributable to smoking, according to the WHO. Doctors recommend health programmes designed to help people quit for a higher chance at success. Keep an eye on your body weight: Fat tissue in the abdominal area or around the heart can promote inflammation. A simple way to assess risk is to measure your waist or calculate your body mass index (BMI). Take action with medical support if needed. Check your heart rhythm with an ECG: An ECG can reveal rhythm disorders such as atrial fibrillation. If detected and treated in time, the risk of stroke falls significantly, by up to 70%, the Heart Foundation says. Some smartwatches come with ECG sensors and can alert you to possible problems, but may also create false alarms. Know your cholesterol levels:An elevated LDL cholesterol level is a key risk factor for atherosclerosis and therefore heart attacks. Experts also advise measuring the blood fat Lp(a) at least once in your lifetime. Monitor your long-term blood sugar:An elevated level of glycohemoglobin can indicate diabetes or a precursor, and it is also a warning sign for cardiovascular risk. Regular measurements help with early intervention. Test your kidney function:Kidney disease often occurs together with heart problems. Blood and urine tests can provide early indications and enable targeted treatment. The following information is not intended for publication dpa/tmn lue yyzz n1 amc coh

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Washington (dpa) – Engineers at the Massachusetts Institute of Technology (MIT) say they have developed tiny electronic devices, one-billionth the size of a grain of rice, that can be injected into an arm, travel through the bloodstream and attach to the brain. The "microscopic, wireless bioelectronics" are designed to "autonomously self-implant in a target region of the brain," according to MIT, which said the researchers have spent six years working on the project. The idea is that these tiny chips deliver "focused treatment" by electronically stimulating the targeted area of the brain – a development that could lead to new treatments for brain diseases and eliminate the need for risky and complex surgeries to implant devices. The team’s paper was published by the journal Nature Biotechnology and was based on tests on mice that showed the "miniscule implants" as capable of identifying and travelling "to a specific brain region without the need for human guidance." After that the chips can be "wirelessly powered to provide electrical stimulation to the precise area" in a form of stimulation known as "neuromodulation." The human immune system does not reject the robot invaders, as they are "integrated with living, biological cells before being injected," allowing them to cross the blood-brain barrier without causing damage. "We have demonstrated that a bioelectronic implant for the brain … can autonomously implant without external intervention and enables wirelessly controlled, focal brain stimulation," the authors wrote. The researchers say they hope to start clinical trials within three years. The following information is not intended for publication dpa spr coh

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Chronic fatigue and lack of stamina are common symptoms among those suffering from long Covid. Researchers are now hopeful that a programme of resistance exercise can help. London (PA Media/dpa) – A programme of resistance exercise can help improve the physical and mental well-being of people with long Covid, new research suggests. The study involved 233 people who had developed long Covid after being diagnosed with Covid-19, either in hospital or a community healthcare setting. Participants were randomly assigned to one of two arms of the trial – one which included resistance training such as chest presses, lunges and squats, and one which did not. At the start of the study, researchers assessed each participant using a shuttle walk test and repeated it three months later. They found that after three months, those who had done resistance training were able to go notably further in the shuttle walk test than those who had received only standard healthcare. Researchers say the study, which was led by the University of Glasgow in collaboration with NHS Greater Glasgow & Clyde, the University of Dundee and NHS Tayside in the UK, highlights the importance of manageable exercise after a serious Covid-19 infection. Professor Colin Berry, principal investigator of the study and professor of cardiology and imaging at the University of Glasgow, said: “Our study demonstrates the benefits of resistance training on Covid-19 recovery, and suggests that people affected by persisting symptoms after Covid-19 could benefit by adopting this kind of exercise. “Since 2020, research from our group and by others has shown that, for some people, long Covid can have a significant impact on their quality of life, including both mental and physical health. “Our results are another encouraging step forward, adding to our collective understanding of how to better treat this condition.” Long Covid is defined as happening when symptoms of Covid-19 last longer than 12 weeks, and can include fatigue, breathlessness, brain fog and joint pain. Those taking part in the study were given exercises tailored to their level of well-being. Participants who were bedbound were given movements such as lying chest presses, lying leg presses and bridging, while those able to sit up were given seated chest-presses and seated leg extensions. Those who were more mobile were assigned exercises such as press-ups, lunges, calf-raises and squats. The researchers also assessed the wider physical and mental health impacts of the resistance training. They found that participants who were on the exercise arm of the study had a higher grip strength after three months, while exercise also appeared to improve people’s quality of life with less anxiety and depression. Jesse Dawson, professor of stroke medicine at the University of Glasgow and director of research and innovation NHS Greater Glasgow and Clyde, said: “It is exciting that this resistance training intervention, that could be widely implemented, improved physical measures and also anxiety and quality of life.” The latest research is part of the wider Cardiac Imaging in SARS Coronavirus disease study programme was funded in 2020 as part of the Scottish Government Chief Scientist Office Rapid Research Response which aimed to increasing understanding about the pandemic. The research is published in JAMA Network. The following information is not intended for publication pa dpa coh

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London (PA Media/dpa) – Listening to hypnosis techniques can reduce the severity and number of hot flushes menopausal women experience, research suggests. A new study found that 20 minutes per day of recorded hypnosis – where women are encouraged into a hypnotic state and picture scenarios where they feel cool – reduces symptoms, such as sudden feelings of warmth, sweating or heart palpitations. Writing in the journal Jama Network Open, researchers including from Baylor University in Texas said the findings were clinically significant. They concluded that “self-administered clinical hypnosis was shown to be an effective, clinically significant intervention for the treatment of hot flashes due to its efficacy in reducing hot flash scores (ie, frequency and severity) by more than half and yielding improvements in participants’ perception of their quality of life”. During the randomised controlled trial, 250 women were split into two groups. All the women were postmenopausal and were having a minimum of four daily or 28 weekly hot flushes at the start of the study. Women were asked to write down every time they experienced a hot flush and its severity (mild, moderate, severe or very severe). In the hypnosis group, women were asked to listen to daily 20-minute audio-recorded hypnosis sessions for six weeks. These recordings included hypnotic relaxation techniques and also inspired mental imagery of feeling cool. The other group acted as the control group and listened to white noise that was still labelled as hypnosis – this acted as a “sham” intervention. The results showed that women in the genuine hypnosis group experienced significantly greater reductions in hot flush scores and daily interference from hot flushes at week six compared with the other group. Overall, improvement in average hot flush scores was bigger for those given genuine hypnosis (baseline score of 88.7 compared with a six-week score of 41.3, so a reduction of 53.4%) than those in the white noise group (baseline score of 94.6 compared with six-week score of 55.9, a 40.9% reduction). The genuine hypnosis group also reported a significantly greater reduction in how much hot flushes interfered with daily life (a 49.3% decrease) compared with the control group (a 37.4% decrease). They also experienced greater perceived benefits from their technique (90.3% versus 64.3%). The researchers said the findings showed that “hypnosis intervention for hot flushes is a safe and effective option for women”. The following information is not intended for publication pa dpa coh

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Multilingualism can delay cognitive ageing and possibly also protect against dementia, a new study demonstrates. The effect even increases with the number of languages you speak. Dublin/Berlin (dpa) – People who regularly speak multiple languages age more slowly on average, a study using data from more than 86,000 adults in 27 European countries found. Published in the journal Nature Aging, an international team led by Agustin Ibañez of Trinity College Dublin matched participants’ chronological ages with biological data and behavioural measures, including health, fitness, lifestyle and social activity. They then calculated whether individuals were biologically younger or older than their chronological age. Participants were aged between 50 and 90. Multilingual people had a markedly lower likelihood of accelerated ageing than those who speak only one language. What's more the effect doesn't stop at two languages, and each additional language strengthened the protective effect, researchers found. Peter Berlit, secretary general of the German Society for Neurology (DGN) and not involved in the study, said the research also points to protection against dementia. "This study confirms smaller observational studies that have shown that multilingualism appears to be a protective factor against dementia." While no people with dementia were included in the study, he said there were important indications of mechanisms that could reduce the risk of cognitive decline in older age. "Resilience to cognitive decline is actually increased by using multiple languages." More languages, stronger effect The researchers attribute the effect to the so-called cognitive reserve. "Multilingualism seems to be a buffer in the brain," explained Berlit. "People who speak several languages have more memory to draw on in old age." The challenge now, say neuroscientists Jason Rothman and Federico Gallo of Lancaster University in a commentary on the study, is to understand the mechanisms of this effect and translate them into strategies for healthy ageing. They say multilingualism could be a cost-effective lever for public health, potentially as significant as programmes promoting physical activity or smoking cessation. Language as dementia prevention Berlit also described it as an effective preventive option. "Learning a new language is a simple and very effective recommendation for dementia prevention. It is a health policy measure that anyone can implement." The researchers now plan to investigate whether learning new languages in later life has the same protective effect as lifelong multilingualism. "Future studies should distinguish between languages learned in childhood and those learned in old age. I believe both are effective, but this still needs to be proven," said Berlit. The research comes at a time when AI has begun to undermine the value of multilingualism in some areas, with software better than ever at translating between spoken and written language in real time. The following information is not intended for publication dpa pls yyzz n1 waw

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Washington (dpa) – It does not matter how fit you are or what age it happens, but a spine injury can be life-altering for survivors who face a higher risk than others from a "myriad" of potentially fatal health problems later on. Published in JAMA Network Open, an American Medical Association journal, the study showed that patients with traumatic spinal cord injury (TSCI) report to doctors years later with seemingly unrelated but sometimes deadly conditions such as diabetes, stroke and hypertension, as well as more predictable concerns such as depression. "TSCI was associated with increased long-term risk of multisystem morbidity and elevated mortality — even in previously healthy patients," according to researchers at Mass General Brigham, a combination of Massachusetts General Hospital and Brigham and Women’s Hospital in the US. Immediate problems related to TSCI, such as difficulty breathing, fluctuating blood pressure and heart rates, have long been studied, according to the researchers. They explained that they wanted to find out more about how such spinal injuries may make patients more likely to suffer from diseases usually associated with poor diet and lack of exercise. The team looked at patient data from Mass General Brigham and from the University of California to compare outcomes for almost 3,000 spine injury patients and others. "Patients with a history of TSCI had significantly higher risk of high blood pressure, high cholesterol, stroke and diabetes, along with other neurologic and psychiatric conditions," the researchers said, warning that such injuries were "associated with an increased risk of death, even in previously healthy patients." "The journey doesn't end when patients with traumatic spinal cord injuries leave the hospital or rehab," said Saef Izzy, a neurologist in the Department of Neurology at Mass General Brigham.  "Programs should be implemented to identify patients at risk so that we can better manage their chronic care and address health issues that put patients at higher risk of death," Izzy added. The following information is not intended for publication dpa spr coh

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London (PA Media/dpa) – Existing evidence does not show a clear link between taking paracetamol in pregnancy and autism and ADHD in children, an in-depth review has concluded. Researchers trawled all studies on the issue and concluded they were low quality, with “low to critically low” confidence in any findings suggesting a link. US President Donald Trump said in September there has been a “meteoric rise” in cases of autism and that Tylenol – which is called paracetamol in the UK – was a potential cause. He said the painkiller should not be taken during pregnancy, suggesting pregnant women should “tough it out”. His comments were criticised by autism campaigners and scientists around the world. Now in a new study, published in the British Medical Journal (BMJ), experts including from the universities of Liverpool and Birmingham concluded that women should continue to be advised to take paracetamol when needed to treat pain and fever in pregnancy. They said there was a “lack of robust evidence linking paracetamol use in pregnancy and autism and ADHD in offspring”. Furthermore, untreated fever, particularly in the first trimester, has been linked to an increased risk of miscarriage, birth defects and premature birth – underlining the need for women to be able to take paracetamol. The team also suggested that any apparent link between paracetamol and autism and ADHD in previous studies may be driven by shared genetic and environmental factors within families. For the latest study, researchers examined nine systematic reviews that included a total of 40 observational studies reporting on paracetamol use during pregnancy and the risk of autism, ADHD, or other neurodevelopmental outcomes. All reviews reported a possible to strong association between a mother’s paracetamol intake and autism or ADHD, or both, in children, but seven of the nine reviews advised caution when interpreting the findings. Overall, experts in the BMJ concluded that confidence in the findings of these reviews was low (for two reviews) to critically low (for seven reviews). They added: “Existing evidence does not show a clear link between in utero exposure to paracetamol and autism and ADHD in offspring. “Any apparent effect observed after in utero exposure to paracetamol on autism and ADHD in childhood might be driven by familial genetic and environmental factors and unmeasured confounders.” Dimitrios Siassakos, professor in obstetrics and gynaecology from University College London, said: “The high-quality methodology used in this new umbrella review confirms what experts around the globe have been saying. “The evidence that links paracetamol use in pregnancy to autism is tenuous and those studies which do report an association are confounded by the association of autism or ADHD with factors shared by families such as genetics and lifestyle.” The following information is not intended for publication pa dpa coh

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It's a dental service that's rarely covered by health insurance – and yet it's one that many dentists recommend. How effective is a professional teeth cleaning really in protecting against tooth decay or periodontitis? Experts are surprisingly divided on this issue. Berlin (dpa) – Professional dental cleaning is a common add-on service in dental practices, but some patients may wonder if it's worth the extra cost. A professional teeth cleaning is a step above your usual toothbrush and flossing routine, involving a more intensive procedure performed by specially trained staff. It includes removing deposits such as tartar and plaque from tooth and root surfaces, smoothing tooth surfaces, and cleaning the spaces between teeth. Finally, the teeth are fluoridated in gel or varnish form for protection against tooth decay. The aim is to remove harmful and cosmetically bothersome deposits that increase the risk of tooth decay and gum disease such as periodontitis. Evidence on the effectiveness of professional dental cleaning is mixed. A review by the Cochrane research network in 2018 found that the benefits for people with good oral hygiene were not sufficiently proven. Studies have also yet to clearly prove that this treatment protects against tooth decay, gingivitis or periodontitis more than a dentist removing plaque and tartar – a process known as scaling – during a routine trip to the dentist, the review concluded. However, it may make a difference if a condition such as periodontitis is already present, according to the consumer advice centre. This can also make a difference in health insurance coverage. Despite scientific findings being lukewarm on dental cleanings, some dentist organizations are more enthusiastic in their support. "Most people may need their teeth cleaned every six or 12 months," says the Australian Dental Association. The German Dental Association says professional dental cleaning has a positive effect on oral hygiene. The association points to Swedish long-term studies dating back to the 1970s which, it said, showed that "with a prophylaxis programme with dental cleaning as a core service, tooth decay and periodontitis can be almost completely avoided for most people." Side effects during or after a professional dental cleaning are very rare, the German Dental Association says. Immunosuppressed people and those with cardiovascular disease, metabolic disorders or allergies should inform practice staff in advance. Patients with very sensitive teeth or inflamed gums may experience pain. Whether or not you decide for a professional tooth cleaning, at home you should be brushing your teeth thoroughly twice a day for about two minutes using a fluoride toothpaste. Dental floss or interdental brushes can also help clean between your teeth. The following information is not intended for publication dpa mah yyzz a3 swe

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