Should All Men with Type 2 Diabetes Be Routinely Prescribed a Phosphodiesterase Type 5 Inhibitor?

Hackett Geoffrey 대한남성과학회 2020 The World Journal of Men's Health Vol.38 No.3

Important health problems in men such as type 2 diabetes (T2DM), insulin resistance, erectile dysfunction, benign prostatic hyperplasia and depression have been shown to have to share common pathological processes, such as endothelial dysfunction and inflammation. This paper discusses the role of phosphodiesterase type 5 (PDE5) inhibitors, through beneficial effects on endothelial function and mediators of chronic inflammation and the possibility to treat or preventing these common conditions. We explore possible barriers to this approach, namely the lack of multiple product licences to treat each of these conditions and how these can be overcome by involving the patient in personalised decisions. We also discuss how opportunities are lost by patients with multiple medical conditions being referred to specialists, primarily interested in one specific problem, with little motivation to treat or prevent conditions outside their remit. We explore how these problems might be related to time and financial restraints or simply a lack of awareness of evidence published in journals related to other specialities. As specialists, we often pride ourselves on providing “personalised” or “patient centred” care, but we can only truly be doing so if we assess the specific needs of the patient across a range of conditions. As part of personalised care in T2DM, we routinely prescribe statins, angiotensin converting enzyme inhibitors and metformin, often with poor compliance. In this paper we explore whether the licensed daily PDE5 inhibitor tadalafil should be added routinely to this list as it will potentially improve and prevent bothersome symptoms and improve compliance with other medications.

Type 2 Diabetes and Testosterone Therapy

Geoffrey Hackett 대한남성과학회 2019 The World Journal of Men's Health Vol.37 No.1

A third of men with type 2 diabetes (T2DM) have hypogonadotrophic hypogonadism (HH) and associated increased risk of cardiovascular and all-cause mortality. Men with HH are at increased risk of developing incident T2DM. We conducted MEDLINE, EMBASE, and COCHRANE reviews on T2DM, HH, testosterone deficiency, cardiovascular and all-cause mortality from May 2005 to October 2017, yielding 1,714 articles, 52 clinical trials and 32 randomized controlled trials (RCT). Stud-ies with testosterone therapy suggest significant benefits in sexual function, quality of life, glycaemic control, anaemia, bone density, fat, and lean muscle mass. Meta-analyses of RCT, rather than providing clarification, have further confused the issue by including under-powered studies of inadequate duration, multiple regimes, some discontinued, and inbuilt bias in terms of studies included or excluded from analysis.

Long-Term Testosterone Therapy in Type 2 Diabetes Is Associated with Decreasing Waist Circumference and Improving Erectile Function

Geoffrey Hackett,Nigel Cole,Akhilesh Mulay,Richard C. Strange,Sudarshan Ramachandran 대한남성과학회 2020 The World Journal of Men's Health Vol.38 No.1

UKPurpose: To describe the 4-year metabolic follow-up results from the BLAST study.Materials and Methods: Baseline hemoglobin A1c (HbA1c), weight, and waist circumference (WC) data were recorded in 185 men recruited for the BLAST randomised controlled trial (RCT) and erectile function (EF) scores were also available in an additional 48 men screened for the RCT. Intra/inter-group associations between these parameters and testosterone replacement therapy (TRT) were assessed at 1) end of the RCT (30 weeks), 2) open-label phase (82 weeks), and 3) final assessment via non-parametric statistics.Results: Improvement in HbA1c and weight at the end of the RCT and open-label phase in men on TRT was not maintained long-term. The convergence in HbA1c could have been due to incentivised care with HbA1c targets. Interestingly those on TRT at final assessment required fewer anti-diabetic agents. The weight increase in routine care may have been due to changes in diabetes medication or an increase in lean muscle mass. WC continued to decrease in men on TRT indicating possible reduction in visceral fat. Improvement in EF scores continued with long-term TRT, this was abolished when TRT was discontinued.Conclusions: This study hints at benefits in glycaemic control, weight and WC, and long-term RCTs studying mechanisms of benefit and clinical outcomes are necessary. Our results also show that EF scores continued to improve with long-term TRT, even beyond the 6 months that we previously reported in the BLAST RCT.

Acute effects of high-volume compared to low-volume resistance exercise on lung function

Daniel Hackett 한국운동재활학회 2020 JER Vol.16 No.5

캐나다 텔레비젼의 외국 뉴스보도: 쿠데타, 지진, 그리고 인질

로버트 해커트 연세대학교 동서문제연구원 캐나다 연구센터 1991 캐나다 연구 Vol.3 No.-

Cancer imaging: Lighting up tumours

Ling, Daishun,Hackett, Michael J.,Hyeon, Taeghwan Nature Publishing Group 2014 NATURE MATERIALS Vol.13 No.2

Synthesis, Characterization, and Application of Ultrasmall Nanoparticles

Kim, Byung Hyo,Hackett, Michael J.,Park, Jongnam,Hyeon, Taeghwan American Chemical Society 2014 Chemistry of materials Vol.26 No.1

<P>Nanomaterials in the size range of 3–50 nm have received increased attention in the last few decades because they exhibit physical properties that are intermediate to those of individual molecules and bulk materials. Similarly, ultrasmall nanoparticles (USNPs), with sizes in the 1–3 nm range, exhibit unique properties distinct from those of free molecules and larger-sized nanoparticles. These properties are greatly sensitive to both the composition and size of the particles, and thus, the ability to control the synthesis for both of these variables is of paramount importance. This review summarizes various methods for the synthesis of USNPs of metals, metal oxides, and metal chalcogenides as well as recent advances in the development of unique characterization methods for these USNPs. Last is a discussion of several novel applications of USNPs in biomedical imaging, catalysis, and semiconductor development, all of which benefit from the large surface-to-volume ratio and/or other characteristic properties inherent in USNPs.</P><P><B>Graphic Abstract</B> <IMG SRC='http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/cmatex/2014/cmatex.2014.26.issue-1/cm402225z/production/images/medium/cm-2013-02225z_0011.gif'></P>

An exploratory study of exercise behaviours and barriers to participation in people with Charcot-Marie-Tooth disease: a focus on resistance training

Laura Newman,Che Fornusek,Daniel Hackett 한국운동재활학회 2023 JER Vol.19 No.1

The aim of this study was to explore and describe the exercise behaviours and barriers in people with Charcot-Marie-Tooth disease (CMT), with a particular focus on resistance training (RT). Ninety-four Australian adults with a diagnosis of CMT completed an online survey. Fifty-seven percent of respondents reported performing some form of RT each week. Those performing RT engaged in more aerobic activity (P≤ 0.01) and were involved in longer periods of structured exercise (P< 0.01) compared to those not performing RT. The RT group was more likely to perceive their exercise levels as acceptable (P< 0.01), that following a program was important (P= 0.02), and that exercise is beneficial (P= 0.04). The RT group were more likely to have been advised to exercise (P= 0.02). Common barriers to exercise were fatigue (64.9%), pain (57.4%), motivation (51.1%), and time (46.8%). RT status did not influence the type of barriers experienced. Weekly RT time was positively associated with exercise satisfaction (r= 0.43, P< 0.01) and walking distance prior to resting (r= 0.29, P= 0.04). The findings suggest that positive exercise experiences, advice, assistance from a trainer, and potentially greater resources may influence participation in RT for people with CMT.

Size Characterization of Ultrasmall Silver Nanoparticles Using MALDI-TOF Mass Spectrometry

Byung Hyo Kim,Hogeun Chang,Michael J. Hackett,Jinkyung Park,Pilsun Seo,현택환 대한화학회 2014 Bulletin of the Korean Chemical Society Vol.35 No.3

pH-Sensitive Nanoformulated Triptolide as a Targeted Therapeutic Strategy for Hepatocellular Carcinoma

Ling, Daishun,Xia, Hongping,Park, Wooram,Hackett, Michael J.,Song, Changyeong,Na, Kun,Hui, Kam Man,Hyeon, Taeghwan American Chemical Society 2014 ACS NANO Vol.8 No.8

<P>Hepatocellular carcinoma (HCC) has one of the worst prognoses for survival as it is poorly responsive to both conventional chemotherapy and mechanism-directed therapy. This results from a lack of therapeutic concentration in the tumor tissue coupled with the highly toxic off-site effects exhibited by these compounds. Consequently, we believe the best packaging for holistic therapy for HCC will involve three components: a potent therapeutic, a rationally designed drug delivery vehicle to enrich the target site concentration of the drug, and a surface ligand that can enable a greater propensity to internalization by tumor cells compared to the parenchyma. We screened a library containing hundreds of compounds against a panel of HCC cells and found the natural product, triptolide, to be more effective than sorafenib, doxorubicin, and daunorubicin, which are the current standards of therapy. However, the potential clinical application of triptolide is limited due to its poor solubility and high toxicity. Consequently, we synthesized tumor pH-sensitive nanoformulated triptolide coated with folate for use in an HCC-subpopulation that overexpresses the folate receptor. Our results show triptolide itself can prevent disease progression, but at the cost of significant toxicity. Conversely, our pH-sensitive nanoformulated triptolide facilitates uptake into the tumor, and specifically tumor cells, leading to a further increase in efficacy while mitigating systemic toxicity.</P><P><B>Graphic Abstract</B> <IMG SRC='http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/ancac3/2014/ancac3.2014.8.issue-8/nn502074x/production/images/medium/nn-2014-02074x_0007.gif'></P><P><A href='http://pubs.acs.org/doi/suppl/10.1021/nn502074x'>ACS Electronic Supporting Info</A></P>