Male hypogonadism is an increasingly prevalent clinical condition that affects patients' quality of life and overall health. Obesity and metabolic syndrome can both cause and result from hypogonadism.Although testosterone remains the gold standard for hypogonadism management, its benefits are not always conserved across different populations, especially with regards to changes in body composition. Partially in response to this, growth hormone secretagogues (GHS) have emerged as a potential novel adjunctive therapy for some of the symptoms of hypogonadism, although current data on their clinical efficacy largely remain lacking. The present review examines the existing literature on the use of GHS and explores their potential complementary role in the management of hypogonadal and eugonadal males with metabolic syndrome or subclinical hypogonadism (SH). The GHS that will be discussed include sermorelin, growth hormone-releasing peptides (GHRP)-2, GHRP-6, ibutamoren, and ipamorelin. All are potent GH and IGF-1 stimulators that can significantly improve body composition while ameliorating specific hypogonadal symptoms including fat gain and muscular atrophy. However, a paucity of data examining the clinical effects of these compounds currently limits our understanding of GHS' role in the treatment of men with hypogonadism, but does open opportunities for future investigation.
end, we measured patient and provider satisfaction with video and faceto-face (FTF) consults for inpatient urology consultations and sought to identify the urologic conditions most suitable for video consults.METHODS: New inpatient urology consults between August 2021-October 2021 were randomized to either video or FTF consult. Patient surveys were administered within 24 hours to assess satisfaction and perceived quality of care during the consult (3-point ordinal Likert scale). Survey results were analyzed using Mann-Whitney U tests. Participating urology attendings completed a survey assessing satisfaction and utility of both consultation mediums (3point ordinal Likert scale), and suitability of video consults for common urologic consultation conditions (5-point ordinal Likert scale).RESULTS: A total of 48 patients were included; 23 (48%) received video consult and 25 (52%) FTF consults. There were no significant differences in age or race between the cohorts. The most common reasons for consultation were acute urinary retention (Video: 5 [22%], FTF: 5 [20%]) and urolithiasis (Video: 5 [25%], FTF: 3 [12%]). Both cohorts agreed that they were overall satisfied with their visit (Video: 22 [95.7%], FTF: 25 [100%]; p[0.297), received high-quality care (Video: 22 [95.7%], FTF: 23 [92.0%]; p[0.61), and would accept the visit modality again in the future (Video: 21 [91.3%], FTF: 25 [100%]; p[0.14). Urologists agreed on the utility of both consultation mediums, including ability to gather complete information (Video: 7 [100%], FTF: 7 [100%]) and manage the patient (Video: 6 [85.7%], FTF: 7 [100%]; p[0.71). Physician satisfaction was lower for video consult than FTF (Video: 5 [71.4%], FTF: 7 [100%]; p[0.38), and physicians were less likely to agree that video consults were satisfactory compared to FTF visits (4 [57.1%]). The most suitable urologic conditions for video consultation were elevated PSA and urinary retention (4.85AE0.38), followed by urinary incontinence and nephrolithiasis (4.71AE0.49). The least suitable was scrotal wall swelling (2.71AE0.76).CONCLUSIONS: With increasing telemedicine utilization, video consults offer an alternative to FTF rounding that may combat difficulties of urologist shortages. Video consults enable urologists to see a wide variety of inpatient consults without hindering patient satisfaction. However, adoption of this tool will rely on physician preference and competence with video technology.
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