Biomedical subjects

Debra J Jacobson

Publications and source records attributed to Debra J Jacobson.

26 records · Page 2Linked to original sources

PubMed2004

Inverse association between prostate cancer and the use of calcium channel blockers.

Calcium channel blockers block calcium signal-mediated apoptosis. It is hypothesized that the use of these drugs may be associated with the development of cancer. This study investigated the association between daily use of calcium channel blockers and prostate cancer in a community-based cohort of men who participated in a longitudinal study of lower urinary tract symptoms. Study subjects were men ages 40 to 79 years by January 1, 1990, and were randomly selected from Olmsted County in Minnesota. At baseline, participants underwent an interview to determine all medications taken on a daily basis, including calcium channel blockers and to elicit a family history of prostate cancer. During follow-up, all men with a histological diagnosis of prostate cancer were identified through patient self-report and by a review of the complete medical record. Over 12,668 person years of follow-up, 15 (6.8%) of 220 calcium channel blocker users and 120 (10.5%) of 1142 nonusers developed prostate cancer (P = 0.09; odds ratio, 0.62; 95% confidence interval, 0.36-1.10). With adjustment for age and family history of prostate cancer, the risk (odds ratio, 95% confidence interval) of prostate cancer was 0.55 (0.31-0.97) in calcium channel blocker users compared with nonusers. In analyses stratified by family history of prostate cancer, the risk of prostate cancer was 0.45 (0.23-0.88) in men without a family history and 2.64 (0.82-8.47) in men with a family history of prostate cancer (P = 0.006). These findings suggest an association between prostate cancer and daily use of calcium channel blockers that varies by family history of prostate cancer.

Adult↗

PubMed2004

Lower urinary tract symptoms and sexual dysfunction in community-dwelling men.

OBJECTIVES: To evaluate the cross-sectional association between lower urinary tract symptoms (LUTS) severity and sexual function in a population-based sample of men and the extent to which this association might be explained by age. SUBJECTS AND METHODS: Subjects in The Olmsted County Study of Urinary Symptoms and Health Status Among Men (55% participation rate) included 2115 white men aged 40 to 79 years; subjects were recruited on January 1, 1990, from a random sample identified through the Rochester Epidemiology Project. At baseline in 1990 and biennially thereafter, these men completed a self-administered questionnaire that assessed LUTS severity with questions similar to those of the American Urological Association Symptom Index. At the 6-year follow-up, 11 previously validated questions about male sexual function from the Brief Sexual Function Inventory were added. RESULTS: Overall, each of the sexual function domains (sexual drive, erectile function, ejaculatory function, problem assessment, and overall sexual satisfaction) was inversely associated with the severity of LUTS, with Spearman correlation coefficients ranging from -0.21 to -0.31 (all P<.001). In age-adjusted analyses, the ejaculatory function and problem assessment domains were most strongly associated with overall LUTS severity, whereas the association with sexual drive was substantially diminished. Little difference was noted in the magnitude of association between sexual function and either obstructive or irritative symptoms. CONCLUSIONS: The cross-sectional data suggest that sexual function is inversely associated with LUTS severity and that this association is only partially attributable to the confounding effects of age.

Adult↗

PubMed2003

Insulin-like growth factor I, insulin-like growth factor binding protein 3, and urologic measures of benign prostatic hyperplasia.

Laboratory studies suggest that insulin-like growth factor I (IGF-I) promotes prostatic growth. The authors evaluated the association between benign prostatic hyperplasia and IGF-I and its binding protein IGFBP-3 in community-dwelling men to determine whether this laboratory finding is manifest at the population level. Participants (n = 471) were Olmsted County, Minnesota, Caucasian males aged 40-79 years in 1990. Urologic measures were assessed from the International Prostate Symptom Score, peak urinary flow rates, prostate volume, and serum prostate-specific antigen (PSA), and serum IGF-I and IGFBP-3 levels were measured. After adjustment for age, the relative odds (odds ratios) of an abnormal urologic measure in men with high versus low serum IGF-I levels were 0.98 (95% confidence interval (CI): 0.66, 1.45) for a symptom score of >7, 1.14 (95% CI: 0.72, 1.80) for a peak urinary flow rate of <12 ml/second, 1.11 (95% CI: 0.72, 1.72) for a prostate volume of >30 ml, and 0.71 (95% CI: 0.46, 1.09) for a PSA level of >1.4 ng/ml. A low IGFBP-3 level was associated with an enlarged prostate (odds ratio = 1.72, 95% CI: 1.05, 2.82), after simultaneous adjustment for IGF-I and age, but not with other urologic measures. These data do not provide evidence for an association between benign prostatic hyperplasia and serum IGF-I.

Adult↗

PubMed2003

Frequency of sexual activity and prostatic health: fact or fairy tale?

OBJECTIVES: To evaluate whether the symptoms associated with benign prostatic hyperplasia can be aggravated by infrequent sex, which has been suggested historically, using cross-sectional data from the Olmsted County Study of Urinary Symptoms and Health Status Among Men. METHODS: In 1989 and 1990, 2115 white men between the ages of 40 and 79 years were recruited from a random sample of Olmsted County residents (55% participation rate). During follow-up, these men completed a self-administered questionnaire that assessed lower urinary tract symptom severity, and 81% reported the frequency of ejaculation during the previous month. RESULTS: Overall, men who reported ejaculating at least once a week were less likely to have moderate to severe (International Prostate Symptom Score greater than 7) symptoms than men reporting no ejaculations (odds ratio 0.62, 95% confidence interval 0.51 to 0.75). The dose-response relation was strong, with men who reported more frequent ejaculations having the lowest prevalence of moderate to severe symptoms. Similar associations were seen for peak urinary flow rates, prostate volume, and health-related quality of life. The associations with urologic measures did not exist within the age decade, however. Thus, after adjusting for age, the odds ratio for ejaculation frequency and symptom severity was 0.99 (95% confidence interval 0.79 to 1.24) and was similar for peak urinary flow rates and prostate volume. CONCLUSIONS: These cross-sectional data suggest that the frequency of ejaculation has no effect on lower urinary tract symptoms, peak urinary flow rates, or prostate volume; the apparent protective association appears to be an artifact caused by the confounding effects of age.

Adult↗

PubMed2003

Comparison of lower urinary tract symptom severity and associated bother between community-dwelling black and white men: the Olmsted County Study of Urinary Symptoms and Health Status and the Flint Men's Health Study.

OBJECTIVES: To determine the magnitude of racial disparity in lower urinary tract symptom (LUTS) severity and bother by combining two large comparable epidemiologic studies of community-dwelling white and black men, thereby avoiding many of the referral biases present in previous studies. Prior studies evaluating racial differences in benign prostatic hyperplasia have been hampered by selection bias, because nearly all have used surgical treatment as a marker for benign prostatic hyperplasia. METHODS: Data from the Olmsted County Study of Urinary Symptoms and Health Status and the Flint Men's Health Study were combined for a total study sample of 2480 men. We examined LUTS severity and associated bother as measured by the self-administered American Urological Association Symptom Index and Symptom Problem Index. RESULTS: Overall 34% of white men reported moderate/severe LUTS compared with 41% of black men (P <0.001). These patterns were consistent across age and persisted after adjustment for age and other sociodemographic factors. The relationship between LUTS severity and bother differed by race in that black men reported less bother for each unit increase in LUTS (P <0.001). CONCLUSIONS: In contrast to studies based on clinical populations, our community-based study demonstrated greater LUTS severity in black men compared with white men but black men reported less bother for any given level of LUTS severity. Although these findings suggest a racial disparity in benign prostatic hyperplasia, additional studies of anatomic, physiologic, and molecular factors may clarify whether these racial differences are real or due to sociocultural differences in reporting symptom morbidity.

Adult↗

PubMed2002

Prevalence of prostatitis-like symptoms in a community based cohort of older men.

PURPOSE: We describe a community based study to estimate the prevalence of prostatitis-like symptoms using questions similar to the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). MATERIALS AND METHODS: Study subjects were a randomly selected sample of Olmsted County, Minnesota white men 40 to 79 years old in January 1990 who participated in a longitudinal study of lower urinary tract symptoms. Subjects were evaluated biennially using self-administered questionnaires. In 2000 questions similar to the NIH-CPSI were incorporated into the questionnaire and questionnaire responses were used to categorize men as having prostatitis-like symptoms. RESULTS: Of 1,541 men 182 (12%) had at least 1 urogenital pain symptom. Pubic (76 men, 4.9%) and testicular (73, 4.7%) pain were the most frequent pain symptoms. A total of 34 men with prostatitis-like symptoms (2.2%) had higher mean pain (6.7 versus 0.5), urinary symptom (3.5 versus 2.1) and quality of life impact (3.7 versus 1.9) scores compared to men who did not (all p <0.001). Pain frequency (OR 39.2, 95% CI 18.8, 81.9) and pain intensity (OR 21.5, 95% CI 8.7, 52.9) were more strongly associated with prostatitis-like symptoms than urinary symptom score (OR 2.8, 95% CI 1.4, 5.6) or quality of life impact score (OR 4.5, 95% CI 1.9, 10.7). CONCLUSIONS: Although urogenital pain is common among community dwelling men, prostatitis-like symptoms based on the modified questions from the NIH-CPSI are less common. While pain measures may be useful in distinguishing between men with and without prostatitis-like symptoms, the urinary symptom and quality of life impact scores could partly reflect benign prostatic hyperplasia.

Adult↗

PubMed2002

Concomitant longitudinal changes in frequency of and bother from lower urinary tract symptoms in community dwelling men.

PURPOSE: Care for men with benign prostatic hyperplasia consumes a sizable amount of health care resources, which is largely driven by bother from lower urinary tract symptoms. While cross-sectional studies have demonstrated a strong correlation between frequency of symptoms and associated bother, there are few longitudinal data demonstrating how these track together. MATERIALS AND METHODS: In 1989, 2,115 white men between 40 and 79 years old were recruited from a random sample of the Olmsted County population. These men completed a self-administered questionnaire that assessed lower urinary tract symptom severity and associated bother with questions similar to those in the American Urological Association Symptom Index. Questionnaires were completed biennially thereafter through 1996. RESULTS: Annualized changes in symptom score increased from a median of 0.02 per year (25th, 75th percentile -0.35, 0.60) for men in their forties to 0.43 (-0.12, 1.16) for men in their sixties. The median change in bother scores was 0 (-0.30, 0.29) across all ages. The correlation between longitudinal symptom score slopes and bother score slopes was 0.55 (p <0.001) overall and did not differ substantively across age. CONCLUSIONS: These results demonstrate that there is a great deal of variability between individuals in the amount of longitudinal change in lower urinary tract symptom severity and bother. While for bother, there is little change across individuals on average, within individual frequency and bother track together fairly closely. However, there remain some men with increases in frequency who do not report similar increases in bother, possibly representing some component of adaptation or acceptance of worsening symptom severity with age.

Adult↗

PubMed2002

A population-based study of daily nonsteroidal anti-inflammatory drug use and prostate cancer.

OBJECTIVE: To investigate the association between daily use of nonsteroidal anti-inflammatory drugs (NSAIDs) and prostate cancer. PATIENTS AND METHODS: Subjects were 50- to 79-year-old white men randomly selected in January 1990 from the Olmsted County, Minnesota, community (n=1362) from among participants in a longitudinal study of lower urinary tract symptoms. At the beginning of the study, all medications that were used daily, including prescription and nonprescription NSAIDs, were ascertained by trained interviewers. Men who developed a histologically proved diagnosis of prostate cancer during a median of 66 months (maximum, 6 years) of follow-up were identified from a complete review of the community medical record. RESULTS: Twenty-three (4%) of 569 NSAID users and 68 (9%) of 793 nonusers developed prostate cancer during follow-up (P=.001). The relative odds of prostate cancer were 0.45 (95% confidence interval [CI], 0.28-0.73) in NSAID users compared with nonusers. This inverse association with NSAID use increased with increasing age at study onset. Thus, the relative odds of prostate cancer among NSAID users were 0.9 (95% CI, 0.4-2.2) in men aged 50 to 59 years, 0.4 (95% CI, 0.2-0.8) in men aged 60 to 69 years, and 0.2 (95% CI, 0.1-0.5) in men aged 70 to 79 years compared with similarly aged men who did not use NSAIDs. CONCLUSION: The study findings suggest that daily use of NSAIDs may be associated with a lower incidence of prostate cancer in men aged 60 years or older. The stronger effect among older men suggests that NSAIDs may prevent the progression of prostate cancer from latent to clinical disease.

Age Distribution↗