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Rosebud O Roberts

Publications and source records attributed to Rosebud O Roberts.

30 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

Trends and risk factors for prostate biopsy complications in the pre-PSA and PSA eras, 1980 to 1997.

OBJECTIVES: To assess the secular trends in postbiopsy complications and to identify the risk factors for complications. METHODS: Olmsted County residents who underwent a prostate biopsy between 1980 and 1997 were identified. All community medical records for the study subjects were reviewed to identify prostate biopsy-related complications, including gross hematuria, infection, pain, hematospermia, and acute urinary retention. RESULTS: Of the 2258 prostate biopsies, 377 (17%) were associated with at least one complication. The total complication rate per biopsy remained relatively consistent at about 17% from 1980 to 1986, 1987 to 1992, and 1993 to 1997 (P for trend = 0.8). The age-adjusted complication rate (per 100,000 men) increased from 26 to 60 in 1980 to 1986 and 1993 to 1997, respectively (P <0.001). This paralleled the increase in prostate biopsy use from 138 to 374 per 100,000 men in the same periods. The prevalence (per biopsy) of gross hematuria increased, 7.5% to 12.8% (P = 0.04); postbiopsy infection declined, 4.6% to 1.4% (P = 0.001); and hospitalization for infection declined, 1.2% to 0.2% (P = 0.06) between 1980 to 1986 and 1993 to 1997. A urogenital infection 6 weeks before biopsy was associated with an increased risk of a postbiopsy complication (odds ratio = 1.7, 95% confidence interval = 1.0 to 2.8) and an increased risk of a postbiopsy infection (odds ratio = 5.5, 95% confidence interval = 2.2 to 13.8). CONCLUSIONS: Although the complications per biopsy have stayed constant, the prevalence of postbiopsy complications in the community has increased tremendously because of the increased use of prostate biopsies. Specific strategies may be needed to reduce the incidence of postbiopsy infection in men with a recent urogenital infection before biopsy.

Age Factors↗
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↗
PubMedDate not supplied

Dementia and low testosterone and bioavailable testosterone levels in men: possible increased risk.

This study examines associations of serum total and bioavailable testosterone (T) with dementia in a community-based cohort of men. Study subjects (n=128; ages 65 y and older at baseline) were recruited in 1990 and followed through 2006. Dementia was assessed from the subject medical records on the basis of the criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Serum from a blood draw performed in 1994 was assayed for total and bioavailable T. Twenty-one men developed dementia over 1186 person-years of follow-up. The cumulative incidence of dementia was 14.7% in men with total T <410 ng/mL (median) and 8.0% in men with higher levels [>/=410 ng/mL; age-adjusted hazard ratio (HR)=2.09; 95% confidence interval (CI)=0.76, 5.75]. Similarly, the cumulative incidence of dementia was 18.8% in men with bioavailable T <12 ng/mL (median) and 2.2% in men with bioavailable T >/=12 ng/mL; age-adjusted HR=1.22 (95% CI=0.38, 3.87). These findings do not demonstrate a significant association between T levels and dementia. However, they suggest a need for further investigation of these potential associations.

Aged↗
PubMedDate not supplied

Postmenopausal estrogen therapy and Alzheimer disease: overall negative findings.

An inverse association between estrogen therapy (ET) and Alzheimer disease (AD) has been reported in some, but not in all studies. We investigated the association between ET and AD in postmenopausal women using a population-based case-control design. Women who developed AD from 1985 through 1989 in Rochester, MN (cases, n=264) were individually matched by age (+/-1 y) to control women free of dementia from the same population (controls, n=264). ET exposure (>/=6 mo after menopause) was ascertained by abstracting the complete medical records archived in the records-linkage system of the Rochester Epidemiology Project. The frequency of ET use was similar in cases (11.4%) and controls [10.6%; odds ratio=1.10; 95% confidence interval (CI)=0.63-1.93]. However, cases who used ET had a suggestive trend for an earlier age at start of ET compared with controls (median, 49.0 vs. 50.5 y; P=0.06). Although smoking (ever vs. never) was not associated with AD overall, we observed an interaction between smoking and ET. The odds ratio of AD in ET users was 4.55 (95% CI=1.33-15.53) among smokers, but was 0.68 (95% CI=0.35-1.32) among never-smokers (P for interaction=0.01). Our findings do not confirm a significant association between ET and AD overall; however, the possible interaction with smoking deserves further study.

Aged↗