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Recent guidance on nontherapeutic male circumcision (NTMC) from the UK focuses on ethical and legal issues, addressing in particular religious NTMC. The guidance is generally negative, especially regarding NTMC of minors. This contrasts to guidance provided in other countries where a wider range of literature has been reviewed. There is strong medical data showing that NTMC protects against urinary tract and sexually transmitted infections, dermatological problems, and genital cancers. A risk-benefit analysis of infant NTMC for the UK shows that benefits exceed risks by 200 to one, and that more than half of uncircumcised males may experience a foreskin-related adverse medical condition over their lifetime. Infancy presents a window of opportunity for NTMC, because the procedure is simpler, adverse event risk is low, convenience, quicker healing, good cosmetic outcome, lower costs, and provides immediate and lifelong benefits. This article reviews the evidence for possible benefit and offers a global perspective on NTMC which may be helpful in considering the merits and demerits of NTMC by families. [ABSTRACT FROM AUTHOR]

An article by Darby disparaging male circumcision (MC) for syphilis prevention in Victorian times (1837–1901) and voluntary medical MC programs for HIV prevention in recent times ignores contemporary scientific evidence. It is one-sided and cites outlier studies as well as claims by MC opponents that support the author's thesis, but ignores high quality randomised controlled trials and meta-analyses. While we agree with Darby that risky behaviours contribute to syphilis and HIV epidemics, there is now compelling evidence that MC helps reduce both syphilis and HIV infections. Although some motivations for MC in Victorian times were misguided, others, such as protection against syphilis, penile cancer, phimosis, balanitis and poor hygiene have stood the test of time. In the absence of a cure or effective prophylactic vaccine for HIV, MC should help lower heterosexually acquired HIV, especially when coupled with other interventions such as condoms and behaviour. This should save lives, as well as reducing costs and suffering. In contrast to Darby, our evaluation of the evidence leads us to conclude that MC would likely have helped reduce syphilis in Victorian times and, in the current era, will help lower both syphilis and HIV, so improving global public health. [ABSTRACT FROM AUTHOR]

A polymorphism in intron 10 of the serine-threonine kinase with no lysine (K) 4 gene WNK4 (G-->A, base 1156666 on chromosome 17) has recently been associated with essential hypertension in a white American population. We have attempted to replicate this finding in a well characterized cohort of 184 unrelated hypertensive Australians of British extraction in which biological power was enhanced by them each having 2 hypertensive parents. Controls were 219 normotensive ethnically matched subjects whose parents were both normotensive. Genotyping was performed using the homogeneous MassEXTEND Assay. This showed a frequency of 0.10 for the minor allele in each group (P=0.88). Moreover, blood pressure, body mass index, sex, and plasma lipid levels were similar across genotypes. In conclusion, our study provides no support for an association of the intron 10 variant of WNK4 with essential hypertension in the Anglo-Australian population studied.