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(2) ARE MEN IN DANGER OF EXTINCTION?
(3) FUNDAMENTAL
CHANGE NEEDED TO
IMPROVE MEN'S
HEALTH
(4) BODY
IMAGE ISN'T JUST A WOMEN'S
PROBLEM
(1) WIDESPREAD
UNCONTROLLED USE OF
ANTIBIOTICS TO PREVENT ANTHRAX WILL
LEAD TO RESISTANCE
(Prophylactic treatment of anthrax
with antibiotics)
http://bmj.com/cgi/content/full/323/7320/1017
Giving antibiotics to large numbers of
potentially
exposed individuals to prevent anthrax
will lead to
resistance, according to researchers from
Liverpool in
this week's BMJ. As such, it is essential
that they are
used carefully and according to national
guidelines.
Although generally safe, the antimicrobial
drug
ciprofloxacin, which has been purchased
in large
amounts by the US and several other national
governments, is associated with tendon
ruptures and
neuropsychiatric disorders, and in most
countries it is
not licensed for use in pregnancy or children,
say the
authors. Furthermore, it's value has already
been
compromised by the development of resistance
following over-use. We cannot exclude
the possibility of
the development of resistance in the anthrax
bacterium,
they write.
"The important thing is to ensure that
prophylaxis is
given only to those who really need it
and discourage
mass usage by an understandably alarmed
public. To
induce antimicrobial resistance on a mass
scale would
be an even greater triumph for the terrorists,
they
conclude."
Contacts:
Anthony Hart, Professor of Medical Microbiology,
University of Liverpool, Liverpool, UK
Email: cahmm@liv.ac.uk
Nicholas Beeching, Senior Lecturer in Tropical
Medicine, Liverpool School of Tropical
Medicine,
Liverpool, UK
(2) ARE MEN IN DANGER OF EXTINCTION?
(The future of men and their health)
http://bmj.com/cgi/content/full/323/7320/1013
Despite having had most of the social determinants
of
health in their favour, men have higher
mortality rates for
all 15 leading causes of death and have
a life
expectancy about seven years shorter than
women's.
An editorial in this week's BMJ asks are
men in danger
of extinction?
Men's reluctance to embrace preventive
strategies has
also contributed substantially to the
spread of AIDS.
There is a sustained increase in psychosocial
disorders
in men, including alcohol and substance
abuse, mid-life
crisis, depression, and domestic violence,
while men's
increasing aggression also remains an
unsolved health
and societal problem.
Although there is still a long way to go
in many societies
around the world, in most developed countries
women
are making rapid gains in terms of equality
and
opportunities in the workforce. With the
advent of
sperm banks, in vitro fertilisation, sex
sorting
techniques, human cloning, and same sex
marriages, it is
reasonable to wonder about the future
role of men in
society, say the authors.
There is an urgent need to advertise and
promote men's
health in a positive way, stress the authors.
They hope
that initiatives such as the first World
Congress on
Men's Health and Men's World Health Day
on 3
November 2001 will act as strong platforms
to support
long-term strategic and innovative research
on men's
health.
Contact:
Siegfried Meryn, Professor of Medicine
and Chairman
and President of the First World Congress
on Men's
Health, University of Vienna, Austria
Email: siegfried.meryn@univie.ac.at
(3) FUNDAMENTAL
CHANGE NEEDED TO
IMPROVE MEN'S HEALTH
(No man's land: men, illness, and
the NHS)
http://bmj.com/cgi/content/full/323/7320/1058
Men worry about their health but feel unable
to talk
about their concerns or seek help until
it is often too
late, according to Dr Ian Banks, President
of the
European Men's Health Forum in this week's
BMJ.
Why do men delay seeking help, and what
can be done
to overcome the problem?
Men's knowledge of health matters is often
poor, and
there is very little health information
specifically aimed at
adolescent boys and young men. Attending
a general
practice surgery can be difficult for
many men, and they
often find it male unfriendly. Men may
also be deterred
from using new services like NHS Direct
and walk-in
centres because they are led by nurses.
Men who do see a general practitioner receive
significantly less of a doctor's time
than women do, says
the author. Even the nature of medical
school and
medical training may contribute to potential
problems in
consultations between male doctors and
patients.
Uptake of health information and health
services can be
improved by making them male friendly,
anonymous,
and more convenient, says the author.
The Men's
Health Forum seeks a fundamental change
in areas such
as school education, placing health on
the national
curriculum, and awareness of gender when
structuring
health policies. Without these changes,
the NHS will
effectively remain a no man's land, he
concludes.
Contact:
Ian Banks, President, European Men's Health
Forum,
London, UK
Email: ian@medic40.freeserve.co.uk
(4) BODY IMAGE
ISN'T JUST A WOMEN'S
PROBLEM
(Body dysmorphic disorder in men)
http://bmj.com/cgi/content/full/323/7320/1015
Body dysmorphic disorder - a severe form
of body
image disturbance - affects as many men
as women, yet
it remains underrecognised and underdiagnosed,
according to an editorial in this week's
BMJ.
Men with body dysmorphic disorder are most
commonly preoccupied with their skin (for
example,
with acne or scarring), hair (thinning),
nose (size or
shape), or genitals. A recently recognised
form of body
dysmorphic disorder that occurs almost
exclusively in
men is muscle dysmorphia, a preoccupation
that one's
body is too small, "puny", and inadequately
muscular,
which may lead to potentially dangerous
abuse of
anabolic steroids.
Patients with body dysmorphic disorder
can be
challenging to treat, say the authors.
Many require
admission to hospital, become housebound,
and
attempt suicide. However, recent research
suggests that
drug treatment and cognitive behavioural
therapy are
effective. Surgical or other non-psychiatric
treatments
appear to usually be ineffective.
Body image isn't just a women's problem,
say the
authors. The challenge is to enhance both
physicians'
and the public's awareness of body dysmorphic
disorder so that effective treatments
can be offered and
unnecessary suffering and morbidity avoided,
they
conclude.
Contact:
Katharine Phillips, Director, Body Dysmorphic
Program, Brown University School of Medicine,
Rhode
Island, USA Email: Katharine_Phillips@Brown.edu
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