Releases Saturday 3 November 2001
No 7320 Volume 323

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(1) WIDESPREAD UNCONTROLLED USE OF
ANTIBIOTICS TO PREVENT ANTHRAX WILL
LEAD TO RESISTANCE

(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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