Objective: To provide estimates of normal variations in penile measurements and testicular volumes, and to establish reference ranges for clinical use.
Design: Cross-sectional, population-based study.
Setting: Schools, kindergartens, and child care centers in different parts of Bulgaria.
Participants: A population of 6200 clinically healthy white males aged 0 to 19 years.
Interventions: The study physician chose schools, kindergartens, and child care centers randomly and examined children at random until he reached the required number. Each of the 20 age groups (age range, 0-19 years) had an equal number of males (ie, 310).
Main Outcome Measures: The mean (SD) values and fifth, 50th, and 95th percentiles of height (Siber Hegner anthropometer), weight (beam balance), testicular volume (Prader orchidometer), penile length (rigid tape), and penile circumference (measuring tape) from birth to 19 years of age.
Results: Testes did not show any increase in size until the onset of puberty at age 11 years, whereas penile growth was gradual after birth. However, both penile and testicular development demonstrated peak growth from 12 to 16 years of age, which coincided with the maximal male pubertal growth spurt. Data indicate an earlier pubertal development for this study population than that for a similar population several decades ago. Significant differences between urban and rural populations regarding penile length were also noticed.
Conclusions: Our study provides the contemporary reference range values for height, weight, testicular volume, and penile length and circumference of males aged 0 to 19 years. Our data show that, even by the end of 20th century, there is still some acceleration of male pubertal development. For the first time are reported somatic differences in genitalia within a population between urban and rural representatives.
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http://dx.doi.org/10.1001/archpediatrics.2010.223 | DOI Listing |
JAMA Netw Open
January 2025
Amazon Health Services, Seattle, Washington.
Importance: Medication nonadherence imposes high morbidity, mortality, and costs but is challenging to address given its multiple causes. Subscription models are increasingly used in health care to encourage healthy behaviors; in January 2023, Amazon Pharmacy launched RxPass, a subscription program offering Amazon Prime members (hereafter, company members) in 45 states access to 60 common generic medications for a flat $5 monthly fee.
Objective: To evaluate the associations of program enrollment with medication refills, days' supply, and out-of-pocket costs.
JAMA Netw Open
January 2025
Division of Surgical Oncology, University of Utah, Salt Lake City.
Importance: An increasing number of older adults are undergoing surgery. Older adults face significant challenges throughout the spectrum of perioperative care. No frameworks exist to support primary care clinicians in helping older adults navigate perioperative care beyond preoperative medical clearance.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Epidemiology and Biostatistics, University of California, San Francisco.
Importance: Incidence of distant stage prostate cancer is increasing in the United States. Research is needed to understand trends by social and geographic factors.
Objective: To examine trends in prostate cancer incidence and mortality rates in California by stage, age, race and ethnicity, and region.
JAMA Neurol
January 2025
Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore.
Importance: Biomarkers would greatly assist decision-making in the diagnosis, prevention, and treatment of chronic pain.
Objective: To undertake analytical validation of a sensorimotor cortical biomarker signature for pain consisting of 2 measures: sensorimotor peak alpha frequency (PAF) and corticomotor excitability (CME).
Design, Setting, And Participants: This cohort study at a single center (Neuroscience Research Australia) recruited participants from November 2020 to October 2022 through notices placed online and at universities across Australia.
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