Men’s Health briefs

When a man, 55, consulted his family doctor complaining of persistent pain in his left leg for three days and a numb feeling in his left foot, he was diagnosed with sciatica and given anti-inflammatory painkillers. Six days later he went to hospital in agony. Not enough blood was getting to his lower leg, the tissue was dying and there was no option but to amputate above the knee. According to a report in the BMJ, every year there are more than 20 medico-legal cases in the UK of ‘acute leg ischaemia’ leading to limb loss. This condition doesn’t always lead to amputation, although the risk is high when there is reduced muscular power and reduced sensation in the limb. But it is easy to miss, particularly in those under 60 when the initial examination is cursory. Discolouration of the leg, its coldness and a subtle loss of sensation may also go unnoticed. In most legal cases, delayed diagnosis was the principal cause of amputation.

In recent years, robotic surgery has been increasingly used to remove a bladder that has become cancerous. The belief is that the robot reduces complications and death. Surgeons at Memorial Sloan-Kettering Cancer Centre in New York decided to test this belief with a randomised trial involving high-risk patients with bladder cancer. Last week they told the American Urological Association meeting in San Diego that the trial had ended early after an interim analysis showed the robot did not reduce complications. It was associated with less blood loss, but took about two hours longer than open surgery. Called a cystectomy, this operation can involve the removal of lymph nodes and the diversion of the passage of urine and has a death rate as high as 60 per cent in some centres. Surgeons are modifying the robot to enhance its performance.

We intuitively know that if we are hungry when we shop for food, calorie-dense items look more attractive. Now researchers from Cornell University have shown with food deprivation of just five hours, hungry people shopping in a virtual grocery store selected a greater number of high-calorie products than those who had recently eaten. Their findings, published in JAMA Internal Medicine, were supported by field studies in actual stores. Previous research has shown people who are fasting have greater activation in areas of their brain associated with reward in response to high-calorie foods than they do with low-calorie foods.

People with terminal cancer who have strong support from a religious community are more likely to seek aggressive end-of-life care than those without such connections. Rather than dying in hospice, their odds of having “life extending treatment" and dying in an intensive care unit were five-fold higher, according to research at the Dana-Faber Cancer Institute in Boston and reported in JAMA Internal Medicine. The researchers speculated that religious communities may consider medicine to be a primary means of divine intervention and that “God acts through physicians to cure illness". Also possible was these communities encourage “perseverance through and hope found within suffering". Unexpectedly, the study showed that when the terminally ill felt supported spiritually by their medical team, they tended to have less intervention and more likely to opt for palliative care. They used the hospice more.

The Australian Financial Review