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Given the increasing prevalence of diabetes and obesity worldwide, the deleterious effects of non-alcoholic fatty liver disease (NAFLD) are becoming a growing challenge for public health. NAFLD is the most common chronic liver disease in the Western world. NAFLD is closely associated with metabolic disorders, including central obesity, dyslipidaemia, hypertension, hyperglycaemia and persistent abnormalities of liver function tests. In general NAFLD is a common denominer for a broad spectrum of damage to the liver, which can be due to hepatocyte injury, inflammatory processes and fibrosis. This is normally seen on liver biopsy and can range from milder forms (steatosis) to the more severe forms (non-alcoholic steatohepatitis (NASH), advanced fibrosis, cirrhosis and liver failure). In these patients, advanced fibrosis is the major predictor of morbidity and liver-related mortality, and an accurate diagnosis of NASH and NAFLD is mandatory. Histologic evaluation with liver biopsy remains the gold standard to diagnose NAFLD. Diagnosis of NAFLD is defined as presence of hepatic steatosis, ballooning and lobular inflammation with or without fibrosis. Weight loss, dietary modification, and the treatment of underlying metabolic syndrome remain the mainstays of therapy once the diagnosis is established. Dietary recommendations and lifestyle interventions, weight loss, and the treatment of underlying metabolic syndrome remain the mainstays of therapy once the diagnosis is established with promising results but are difficult to maintain. Pioglitazone and vitamin E are recommended by guidelines in selected patients. This review gives an overview of NAFLD and its treatment options.

Polycystic ovary syndrome (PCOS) is a common condition affecting reproductive-aged women with reproductive, metabolic and psychological consequences. Weight and lifestyle (diet, physical activity and behavioural) management are first-line therapy in international evidence-based guidelines for PCOS. While these recommend following population-level diet and physical activity guidelines, there is ongoing interest and research in the potential benefit of including psychological and sleep interventions, as well as a range of traditional, complimentary and integrative medicine (TCIM) approaches, for optimal management of PCOS. There is limited evidence to recommend a specific diet composition for PCOS with approaches including modifying protein, carbohydrate or fat quality or quantity generally having similar effects on the presentations of PCOS. With regards to physical activity, promising evidence supports the provision of vigorous aerobic exercise, which has been shown to improve body composition, cardiorespiratory fitness and insulin resistance. Psychological and sleep interventions are also important considerations, with women displaying poor emotional wellbeing and higher rates of clinical and subclinical sleep disturbance, potentially limiting their ability to make positive lifestyle change. While optimising sleep and emotional wellbeing may aid symptom management in PCOS, research exploring the efficacy of clinical interventions is lacking. Uptake of TCIM approaches, in particular supplement and herbal medicine use, by women with PCOS is growing. However, there is currently insufficient evidence to support integration into routine clinical practice. Research investigating inositol supplementation have produced the most promising findings, showing improved metabolic profiles and reduced hyperandrogenism. Findings for other supplements, herbal medicines, acupuncture and yoga is so far inconsistent, and to reduce heterogeneity more research in specific PCOS populations, (e.g. defined age and BMI ranges) and consistent approaches to intervention delivery, duration and comparators are needed. While there are a range of lifestyle components in addition to population-recommendations for diet and physical activity of potential benefit in PCOS, robust clinical trials are warranted to expand the relatively limited evidence-base regarding holistic lifestyle management. With consumer interest in holistic healthcare rising, healthcare providers will be required to broaden their knowledge pertaining to how these therapies can be safely and appropriately utilised as adjuncts to conventional medical management.

Background Type 2 diabetes mellitus (T2DM) comprises the vast majority of all diabetes cases in adults, with alarmingly increasing prevalence over the past few decades worldwide. A particularly heavy healthcare burden of diabetes is noted in Europe, where 8.8% of the population aged 20–79 years is estimated to have diabetes according to the International Diabetes Federation. Multiple risk factors are implicated in the pathogenesis of T2DM with complex underlying interplay and intricate gene-environment interactions. Thus, intense research has been focused on studying the role of T2DM risk factors and on identifying vulnerable groups for T2DM in the general population which can then be targeted for prevention interventions. Methods For this narrative review, we conducted a comprehensive search of the existing literature on T2DM risk factors, focusing on studies in adult cohorts from European countries which were published in English after January 2000. Results Multiple lifestyle-related and sociodemographic factors were identified as related to high T2DM risk, including age, ethnicity, family history, low socioeconomic status, obesity, metabolic syndrome and each of its components, as well as certain unhealthy lifestyle behaviors. As Europe has an increasingly aging population, multiple migrant and ethnic minority groups and significant socioeconomic diversity both within and across different countries, this review focuses not only on modifiable T2DM risk factors, but also on the impact of pertinent demographic and socioeconomic factors. Conclusion In addition to other T2DM risk factors, low socioeconomic status can significantly increase the risk for prediabetes and T2DM, but is often overlooked. In multinational and multicultural regions such as Europe, a holistic approach, which will take into account both traditional and socioeconomic/socioecological factors, is becoming increasingly crucial in order to implement multidimensional public health programs and integrated community-based interventions for effective T2DM prevention.

Social media (SoMe) offers great potential to expand access to health information, but a significant proportion of users consume its content instead of consulting a physician. We sought to quantify the volume and characterize the accuracy of men’s health-related content on TikTok and Instagram. We searched TikTok and Instagram for the terms: testosterone, erectile dysfunction, male infertility, semen retention, Peyronie’s disease, and vasectomy. The top 10 hashtags for each term were used to estimate the total impressions for each term on each platform, and posts were then characterized by creator type, content type, and accuracy (1 to 5 scale). TikTok had 2,312,407,100 impressions and Instagram had 3,107,300 posts across all topics. Semen retention had the most impressions on TikTok (1,216,074,000) and posts on Instagram (1,077,000). Physicians created only a small portion of total TikTok and Instagram posts (10.3% and 12.9%, respectively). Across all topics, the accuracy of content was poor (2.6 ± 1.7), however, physician posts were more accurate than non-physician posts (mean 4.2 ± 1.2 vs 2.3 ± 1.6, p  < 0.001, respectively). Men’s health content is popular on TikTok and Instagram but is not accurate. We recommend that physicians actively engage in SoMe to address misinformation.

Coronavirus disease 2019 (COVID-19) pandemic has been continuing to affect the lives of all people globally. It has been shown that restrictions due to changes in lifestyles lead to mental health problems. This study aims to investigate the effect of COVID-19 pandemic on couples’ sexuality. A total of 245 volunteers (148 men and 97 women) were enrolled in the study. Generalized Anxiety Disorder-7, Patient Health Questionnaire, Perceived Stress Scale were administered to screen anxiety and depression symptoms. International Index of Erectile Function (IIEF-15) and Female Sexual Function Index (FSFI) along with self-constructed sexual behavior questionnaire were administered to participants, in order to evaluate sexual functions and behavioral changes during the pandemic. Sexual function scores (IIEF erectile function domain and total FSFI) during pandemic (24.55 ± 5.79 and 24.87 ± 7.88, respectively) were lower compared to the prepandemic period (26.59 ± 4.51 and 26.02 ± 6.22, respectively) (p = 0.001 and p = 0.027, respectively). During pandemic compared to prepandemic period, the frequency of sexual intercourse decreased in men (p = 0.001) and women (p = 0.001) while sexual avoidance and solitary sexual approach behaviors (masturbation or watching sexual content videos, etc.) increased in men (p = 0.001) and women (p = 0.022). However, the couples that spent more time together during the pandemic reported better sexual function scores (men; p = 0.001, women; p = 0.006). Although this is the first study evaluating couples from Turkey with a convenience sample, further studies with a greater number may better elucidate the effects of this pandemic on sexuality.

In June 2022 the United States Supreme Court issued a ruling in the case Dobbs v. Jackson that overturned Roe v. Wade , the 1973 ruling establishing a federally protected right to abortion in the United States. Anecdotal reports suggested increased vasectomy volume following this event; however, no published data exist. We sought to describe trends in vasectomy consultation before and after the Dobbs v. Jackson ruling (referred to as pre- and post- Dobbs herein). Following IRB approval, we reviewed charts of all adults seeking vasectomy consultation in July–August 2021 and July–August 2022 at a large healthcare organization. We then aggregated vasectomy procedural billing data from 2018 to present. The primary outcome was volume of vasectomy consultation appointments and the secondary outcome was number of vasectomies performed. In July–August 2021 (Pre- Dobbs ), 116 men attended vasectomy consultation versus 142 men in July–August 2022 (Post- Dobbs ). Median age Post- Dobbs was significantly younger than Pre- Dobbs (35 vs 38 years, respectively, p  = 0.01) with a significant increase in Post- Dobbs men under 30 seeking vasectomy ( p  = 0.005). A total of 16.9% (24/142) of Post- Dobbs men were childless, compared to 8.6% (10/116) of Pre- Dobbs men ( p  = 0.05). Of those with children, median number of offspring was unchanged at 2. Billing data showed a significant increase in vasectomy procedural volumes Post- Dobbs . While overturning Roe v Wade directly impacted female reproductive rights, number of vasectomy consultations and procedures increased significantly following this decision. Younger men, especially those under 30, as well as childless men were significantly more likely to seek consultation Post- Dobbs compared to the prior reproductive legal climate. While longer-term data are needed, findings indicate that men are invested in maintaining reproductive autonomy for themselves and their partners.

SEE PDF] To Table 3 The literature reporting the incidence of preoperative recurrent laryngeal nerve (RLN) palsy in patients undergoing surgery for thyroid disease Ref no. 1st author N RLNP in total RLNP by histology Fisher exact testa Total Histology N (%) N Incidence Histology N Incidence P value OR (95%CI) [1] Greisen 233 M 39 (17%) 16 6.87% M 11 28.2% < 0.0001 14.850 (4.979—44.058) B 194 (83%) B 5 2.58% [2] Rowe-Jones 2408 M 87 (4%) 29 1.20% M 7 8.05% < 0.0001 9.144 (3.888—21.555) B 2321 (96%) B 22 0.95% [5] Steurer 459 M 123 (27%) 9 1.96% M 6 4.88% 0.013 5.692 (1.532—21.088) B 336 (73%) B 3 0.89% [6] Chiang 622 M 156 (25%) 16 2.57% M 15 9.61% < 0.0001 49.468 (8.250—295.187) B 466 (75%) B 1 0.21% [7] Randolph 365 M 135 (37%) 16 4.38% M 15 11.1% < 0.0001 28.625 (4.754—171.224) B 230 (63%) B 1 0.43% [8] Schlosser 695 M 51 (7%) 7 1.01% M 3 5.88% 0.011 10.000 (2.434—41.227) B 644 (93%) B 4 0.62% [9] Wang 187 M 42 (22%) 12 6.42% M 4 9.52% 0.472 1.803 (0.548—5.973) B 145 (78%) B 8 5.52% [11] O'Duffy 830 M 206 (25%) 14 1.69% M 3 1.46% 0.697 1.522 (0.414—5.610) B 624 (75%) B 6 0.96% Iatrogenic 5 / [12] Xin 1619 M 907 (56%) 39 2.41% M 11 1.21% 0.0005 0.300 (0.150—0.599) B 712 (44%) B 28 3.93% [13] Kay-Rivest 1923 M 1162 (60%) 25 1.30% M 19 1.64% 0.214 1.859 (0.761—4.541) B 677 (35%) B 6 0.89% Unknown 84 (4%) [14] Birben 2070 M 743 (36%) 17 0.82% M 12 1.62% 0.004 4.340 (1.588—11.856) B 1327 (64%) B 5 0.38% [16] Li 12530 M 7159 (57%) 99 0.79% M 81 1.13% < 0.0001 3.403 (2.051—5.648) B 5371 (43%) B 18 0.34% 1. Ref no. reference number, RLNP recurrent laryngeal nerve palsy, M malignant, B benign, OR odds ratio, CI confidence interval 2. aBecause statistical comparisons were lacking in all but the study by Li et al., we examined the statistical difference in each study The original article [1] has been updated. Table 1 has been updated from figure a To Table 1 The literature regarding preoperative recurrent laryngeal nerve (RLN) palsy in patients undergoing surgery for benign thyroid disease Ref no. Year 1st author Country N Sex RLNP side Intraoperative RLN preservation Postoperative vocal cord motion recovery rate M F R L Yes No [1] 1984 Greisen, O Denmark 5 NA NA 5 0 20% (1/5) [2] 1993 Rowe-Jones, JM USA 22 NA 13 9 22 0 89.5% (17/19)a [3] 1994 Fenton, JE USA 3 2 1 1 2 3 0 100% (3/3) [4] 1995 Collazo-Clavell, ML USA 1 0 1 1 0 1 0 100% (1/1) [5] 2002 Steurer, M Austria 3 NA NA NA NA [6] 2006 Chiang, FY Taiwan 1 1 0 NA 1 0 100% (1/1) [7] 2006 Randolph, GW USA 1 NA NA 1 0 NA [8] 2007 Schlosser, K Germany 4 NA NA 4 0 25% (1/4) [9] 2011 Wang, CC Taiwan 8 2 6 5 3 6 2b 25% (2/8) [10] 2012 Moorthy, R UK 5 0 5 2 3 5 0 40% (2/5) [11] 2013 O'Duffy, F Ireland 6 NA 0 6 6 0 100% (6/6) [12] 2014 Xin, J China 28 NA NA 28 0 100% (28/28) [13] 2015 Kay-Rivest, E Canada 6 0 6 1 5 NA NA [14] 2019 Birben, B Turkey 5 NA NA NA NA [15] 2021 Oscé, H Belgium 1 0 1 0 1 1 0 100% (1/1) [16] 2022 Li, WH China 18 9 9 8 10 16 2 88.9% (16/18) Ref no. reference number, M male, F female, R right, L left, NA not assigned or not available, RLNP recurrent laryngeal nerve palsy aThree cases of NA were excluded bTransected and repaired Table 3 has been updated from: figure b To Table 3 The literature reporting the incidence of preoperative recurrent laryngeal nerve (RLN) palsy in patients undergoing surgery for thyroid disease Ref no. 1st author N RLNP in total RLNP by histology Fisher exact testa Total Histology N (%) N Incidence Histology N Incidence P value OR (95%CI) [1] Greisen 233 M 39 (17%) 16 6.87% M 11 28.2% < 0.0001 14.850 (4.979—44.058) B 194 (83%) B 5 2.58% [2] Rowe-Jones 2408 M 87 (4%) 29 1.20% M 7 8.05% < 0.0001 9.144 (3.888—21.555) B 2321 (96%) B 22 0.95% [5] Steurer 459 M 123 (27%) 9 1.96% M 6 4.88% 0.013 5.692 (1.532—21.088) B 336 (73%) B 3 0.89% [6] Chiang 622 M 156 (25%) 16 2.57% M 15 9.61% < 0.0001 49.468 (8.250—295.187) B 466 (75%) B 1 0.21% [7] Randolph 365 M 135 (37%) 16 4.38% M 15 11.1% < 0.0001 28.625 (4.754—171.224) B 230 (63%) B 1 0.43% [8] Schlosser 695 M 51 (7%) 7 1.01% M 3 5.88% 0.011 10.000 (2.434—41.227) B 644 (93%) B 4 0.62% [9] Wang 187 M 42 (22%) 12 6.42% M 4 9.52% 0.472 1.803 (0.548—5.973) B 145 (78%) B 8 5.52% [11] O'Duffy 830 M 206 (25%) 14 1.69% M 3 1.46% 0.697 1.522 (0.414—5.610) B 624 (75%) B 6 0.96% Iatrogenic 5 / [12] Xin 1619 M 907 (56%) 39 2.41% M 11 1.21% 0.0005 0.300 (0.150—0.599) B 712 (44%) B 28 3.93% [13] Kay-Rivest 1923 M 1162 (60%) 25 1.30% M 19 1.64% 0.214 1.859 (0.761—4.541) B 677 (35%) B 6 0.89% Unknown 84 (4%) [14] Birben 2070 M 743 (36%) 17 0.82% M 12 1.62% 0.004 4.340 (1.588—11.856) B 1327 (64%) B 5 0.38% [16] Li 12530 M 7159 (57%) 99 0.79% M 81 1.13% < 0.0001 3.403 (2.051—5.648) B 5371 (43%) B 18 0.34% Ref no. reference number, RLNP recurrent laryngeal nerve palsy, M malignant, B benign, OR odds ratio, CI confidence interval aBecause statistical comparisons were lacking in all but the study by Li et al., we examined the statistical difference in each study The original article [1] has been updated.

As the COVID-19 spread globally, social distancing, self-isolation/quarantine, and national lockdowns have become crucial to control the pandemic. However, these measures may also lead to increases in social isolation, loneliness, and stress, which can alter the consumption of pornography habits. The aim of the study was thus to explore the interest pattern in pornography and coronavirus-themed pornography during the COVID-19 outbreak. Google Trends® was employed to determine the most popular porn websites (Porn, XNXX, PornHub, xVideos, and xHamster), and coronavirus-themed pornography worldwide and in six nations with different COVID-19 outbreak and self-isolation recommendations. We analyzed every search trend on Google® from January 9, 2020 to May 25, 2020 using “joint point regression analysis”. Comparisons of week relative search volume (WRSV) and temporal patterns were analyzed to assess the change of interest in search terms during nations lockdowns. Paired t-test was used to compare WRSV values among the porn websites during the national lockdowns and the equivalent timespan of the weeks in the previous 4 years. The research trend of almost every keyword increased with significant inflection points for those nations with a straight “stay at home orders” (China, Italy, Spain, and France). “PornHub” and “Porn” showed the highest increase of interest worldwide with an average weekend percentage change (AWPC) of 4.9 and 3.8, respectively. The mean WRSV for keywords in USA and Sweden did not show a similar increase as the other nations. The WRSV percentage change with the historical data had a peak during the straight nations’ lockdowns (p < 0.01). All the nations had a significant increase in WRSV coronavirus-themed pornography for each keyword (p < 0.01) with an AWPC, ranging worldwide between 18.5 and 61.8 (p < 0.01), after the beginning of self-quarantine. As strengths this study uses a big data technology to collect worldwide trend of interest, however, data are anonymous and do not allow analysis of subpopulation groups. In conclusion, we demonstrated an increased interest in pornography and coronavirus-themed pornography after the outbreak of COVID-19 in nations with a straight “stay at home orders”.