Biochemical Syndrome Research Articles

Immunometabolic risks in calves during the period of changing the type of feeding and the possibility of their pharmacological adjustment

Most diseases of young animals are initiated by pathologies of non-contagious etiology, such as disorders of degenerative processes, the imbalance of metabolism in the occurrence of which the leading role belongs to negative environmental factors. The purpose of our work was to study the state of the immune system and metabolism in calves during the period of changes in the type of feeding and the possibility of pharmacological correction of their disorders. An experiment was conducted on a dairy farm located in the Pscov’s region, the object of which was clinically healthy heifers. To conduct the experiment, using the method of selecting analogues, two groups of clinically healthy calves were formed at the age of 52 days: № 1 (control, n = 60) animals received feed in accordance with the technology, № 2 (n = 62) - in addition to basic diets, calves received three courses of 7 days with an interval of 5 days of sorption-metabolic premix at a dose of 0.20 g/kg per day. This feed additive has the properties of an enterosorbent, hepatoprotective and ruminoprotective agent, and its constituent flavonoids and humic acid affect the immune system. During the period of the experiment, i.e., from 53 to 86 days of life, calves undergo metabolic restructuring, which puts a functional load on all body systems with a corresponding risk of disruption of their functions. In particular, there is a risk of biochemical deficiency syndrome in the rumen, toxic liver dystrophy and anemia, the initiating factor of which, as our research has shown, is endogenous toxins, including proinflammatory interleukins. The administration of the phytopos-rum premix eliminated the accumulation of endotoxins and has a hepatoprotective effect, which reduces the risks of metabolic disorders, liver and bone marrow functions and digestive processes in the rumen, and increases the metabolic and immunological uniformity of the livestock.

Cross-sectional Study of Correlation Between Andropause and Anxiety Disorders Among Police Officers in Bali

Background: Andropause is a clinical and biochemical syndrome associated with increasing age characterized by a decreased testosterone level. Anxiety disorders are mental disorders that differ from normal feelings of nervousness or anxiousness and involve excessive fear or anxiety. Police officers has a high risk of experiencing andropause and anxiety disorders because of the andropause. Objective: This research aims to determine the correlation between andropause and anxiety disorders in Bali police officers. Methods: This research was carried out with a cross-sectional analytic design. Andropause was measured using an ADAM questionnaire. Anxiety disorder was measured using a BAI questionnaire. The sample for this research was male police officers aged between 35-58 years who worked at the Ditreskrimsus Polda Bali. The sample was determined using a purposive sampling technique. The sample for this research consisted of 50 people. Results: The results showed that 60% of samples were positive for andropause and 62% of samples were positive for anxiety disorders. There are 52% sample that tested positive for both andropause and anxiety. There is a significant correlation between andropause and anxiety disorders with p value <0.001. Calculated Odds Ratio (OR 95% CI) between andropause and anxiety disorders was 19.5 (4.527-83.992). Police officers that experiencing andropause have a 19.5 times higher risk of experiencing anxiety disorders compared to police officers that not experiencing andropause. Conclusion: There is a significant correlation between andropause and the occurrence of anxiety in police officers in Bali.

Management and use of healthcare resources in patients with chronic lymphocytic leukemia initiating venetoclax in routine clinical practice

Venetoclax is a first-in-class B-cell lymphoma-2 (BCL-2) inhibitor approved as continuous monotherapy and in combination with rituximab as fixed-treatment duration for relapsed and refractory chronic lymphocytic leukemia (R/R CLL). DEVOTE was a 24-week, multicenter observational study (NCT03310190) evaluating the safety, healthcare resource utilization (HCRU) and health-related quality of life (HRQoL) of patients initiating venetoclax for R/R CLL in Canada. Overall, 89 patients received 1 dose of venetoclax; 80% had prior exposure (42% resistant) to ibrutinib. Biochemical tumor lysis syndrome (TLS) occurred in five patients. We observed differences in hospitalization across Canadian provinces including in patients at low risk for TLS with no clear impact on TLS incidence. Additionally, a rapid and sustained improvement in several domains of HRQoL was observed during venetoclax initiation. Early adoption of venetoclax was mainly for R/R CLL patients with few treatment options; nonetheless, acceptable toxicity and a positive impact on HRQoL were observed.

A Single-Center, Randomized, Double-Blind, and Placebo-Controlled Comparative Human Study to Verify the Functionality and Safety of the Lespedeza cuneata G. Don Extract for the Improvement of Aging Male Syndrome.

Aging male syndrome is a clinical biochemical syndrome characterized by typical aging symptoms and serum testosterone deficiency. Although it is accompanied by various health problems, directly affects life satisfaction, and requires proper management, no clear prevention or treatment other than hormone replacement therapy is currently available for this syndrome. Here, we aimed to determine the efficacy and safety of the Lespedeza cuneata extract in the management of the aging male syndrome. Males aged 43-70 years who provided consent for participation and had a total Aging Males' Symptom questionnaire score ≥ 37 and testosterone level ≤ 500 ng/dL were enrolled in this study. This study was conducted in a randomized, double-blind manner. Participants were randomly assigned to either the experimental or control groups and orally administered the assigned product twice a day. Efficacy was evaluated by measuring changes in Aging Males' Symptom score, Androgen Deficiency in the Aging Male questionnaire score, International Index of Erectile Function score, International Prostatic Symptom Score, blood test results, and body mass index at 8 weeks. After 8 weeks, the experimental group had significantly improved symptom scores compared to the control group on the Aging Males' Symptom and Androgen Deficiency in the Aging Male questionnaires. However, no significant differences in the International Index of Erectile Function score, International Prostatic Symptom Score score, blood test results, and body mass index were observed between the experimental and control groups. Lespedeza cuneata extract safely alleviates andropause symptoms without any significant side effects, suggesting its potential for the treatment of the aging male syndrome.

Prevalence and Risk Factors of Anemia in the MASHAD Cohort Study.

Anemia is a serious public health problem which may be associated with cardiovascular diseases (CVDs) and brain damage. This survey aims to determine the prevalence of anemia and its association with demographic and biochemical factors and metabolic syndrome in a human sample derived from the MASHAD cohort study. This survey was conducted on a sub-sample of 9847 individuals aged 35 to 65 as part of the MASHAD cohort study. Demographic characteristics and biochemical and anthropometrics indices were recorded. Data were analyzed using SPSS version 20. Anemia was seen in 11.5% of the population. Anemia was significantly more prevalent in younger subject (P<0.001), females (P<0.001) and those with elevated body mass index (BMI) (P<0.001). Mean high-density lipoprotein (HDL) was higher in anemic participant (P=0.032). The incidence of anemia was significantly lower in smokers (P<0.001) and also participant with hypertension (HTN) (P<0.001), diabetes mellitus (DM) (P<0.001) and metabolic syndrome (MetS) (P<0.001). Mean FBG (P<0.001), TG (P<0.001), total cholesterol (P<0.001), LDL (P<0.001) and uric acid (P<0.001) were significantly lower in anemic subjects. Cholesterol, MetS, low-density lipoprotein (LDL), BMI, uric acid, diabetes mellitus and also TG remained significantly different after multivariate analysis between anemic and healthy participants. The studied population had a lower prevalence of anemia compared to the previous WHO report for Iranians. Iron deficiency is recognized as the most important cause of anemia in Iran; however, further investigations will be need to confirm this pattern. We demonstrated that anemia is adversely associated with MetS and DM.

Pathological Analysis of down Syndrome and Its Nursing Care

Down Syndrome sounds like a rare case that can only be found in biology courses that are unrelated to normal peoples life. However, it occurs once every 1200 people according to CDC. Scientifically, Down syndrome is a genetic disease caused by trisomy 21 that cannot be cured by direct means of surgery or drugs. People must study the biochemical pathway Down Syndrome interferes with human body development, symptoms usually exhibit in patients, and Down Syndromes relationship with other diseases like Alzheimers in-depth and provide advanced detection for parents inclined to have Down Syndrome babies. Due to patients intellectual disability, someone must make important decisions for them so that they can receive needed treatments, Nursing patients with it not only requires extensive medical care but also patient emotional support. Well-trained nursing is required to protect this vulnerable group, not only to bring patients the chance to live a normal life but also to help their families avoid living in conflicts.

Expert Opinion on the Diagnosis and Management of Male Hypogonadism in India.

Male hypogonadism (MH) is a clinical and biochemical syndrome caused by inadequate synthesis of testosterone. Untreated MH can result in long-term effects, including metabolic, musculoskeletal, mood-related, and reproductive dysfunction. Among Indian men above 40 years of age, the prevalence of MH is 20%-29%. Among men with type 2 diabetes mellitus, 20.7% are found to have hypogonadism. However, due to suboptimal patient-physician communication, MH remains heavily underdiagnosed. For patients with confirmed hypogonadism (either primary or secondary testicular failure), testosterone replacement therapy (TRT) is recommended. Although various formulations exist, optimal TRT remains a considerable challenge as patients often need individually tailored therapeutic strategies. Other challenges include the absence of standardized guidelines on MH for the Indian population, inadequate physician education on MH diagnosis and referral to endocrinologists, and a lack of patient awareness of the long-term effects of MH in relation to comorbidities. Five nationwide advisory board meetings were convened to garner expert opinions on diagnosis, investigations, and available treatment options for MH, as well as the need for a person-centered approach. Experts' opinions have been formulated into a consensus document with the aim of improving the screening, diagnosis, and therapy of men living with hypogonadism.

Treatment of Idiopathic Membranous Nephropathy (IMN)

We present a 59-year-old patient with type 2 diabetes mellitus and massive nephrotic syndrome (anasarca) and biochemical syndrome

Study regarding the interrelation between subclinical hypothyroidism &amp; insulin resistance among PCOS women

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder (5-10%) in women of reproductive age. It is characterized by clinical and biochemical hyperandrogenism, menstrual irregularities, infertility and metabolic syndrome. Hypothyroidism is more common in PCOS. Subclinical hypothyroidism may aggravate insulin resistance. Objective: To find any relationship between subclinical hypothyroidism and Insulin resistance in PCOS patients. Materials and Methods: Study Design: A hospital based cross sectional study, Study Subjects: PCOS cases fulfilling the inclusion and exclusion criteria, SAMPLE SIZE: 100 PCOS cases attending to Gynaecology OPD, Study Setting: Gynaecology OPD of a Medical College hospital, Study Duration: January 2015 to August 2016. This included all PCOS patients, who had the criteria of Rotterdam for PCOS. Clinical examination, height, weight, BMI and lab data were measured including thyroid hormone and biochemical profile. Data were analysed by SPSS software version 21. Results: Out of 100 study subjects 52 were Euthyroid (TSH &lt; 5) and 48 were SCH (TSH ≥ 5). Fasting serum Insulin, and HOMA IR were significantly elevated in SCH group compared to Euthyroid group (p = &lt; 0.05.).

Clomiphene citrate for men with hypogonadism: a systematic review and meta-analysis.

Male hypogonadism is a clinical and biochemical androgen insufficiency syndrome, becoming more prevalent with age. Exogenous testosterone is first-choice therapy, with several side effects, including negative feedback of the hypothalamic-pituitary-gonadal axis, resulting in suppression of intratesticular testosterone production and spermatogenesis. To preserve these testicular functions while treating male hypogonadism, clomiphene citrate is used as off-label therapy. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of clomiphene citrate therapy for men with hypogonadism. The EMBASE, PubMed, Cochrane databases were searched in May 2021, for effectiveness studies of men with hypogonadism treated with clomiphene citrate. Both intervention and observational studies were included. The Effective Public Health Practice Project Quality Assessment Tool, a validated instrument, was used to assess methodological study quality. The primary outcome measure was the evaluation of serum hormone concentration. Secondary outcomes were symptoms of hypogonadism, metabolic and lipid profile, side effects, safety aspects. We included 19 studies, comprising four randomized controlled trials and 15 observational studies, resulting in 1642 patients. Seventeen studies were included in the meta-analysis, with a total of 1279 patients. Therapy and follow-up duration varied between one and a half and 52 months. Total testosterone increased with 2.60 (95% CI 1.82-3.38) during clomiphene citrate treatment. An increase was also seen in free testosterone, luteinizing hormone, follicle stimulating hormone, sex hormone-binding globulin and estradiol. Different symptom scoring methods were used in the included studies. The most frequently used instrument was the Androgen Deficiency in Aging Males questionnaire, whose improved during treatment. Reported side effects were only prevalent in less than 10% of the study populations and no serious adverse events were reported. Clomiphene citrate is an effective therapy for improving both biochemical as well as clinical symptoms of males suffering from hypogonadism. Clomiphene citrate has few reported side effects and good safety aspects.

Acute renal injury due to rhabdomyolysis: A tertiary hospital experiencee

Aim: Rhabdomyolysis (RML) is a clinical and biochemical syndrome caused by acute necrosis of striated muscle fibers and the subsequent transportation of potentially toxic cellular contents into the systemic circulation. In this study, we present data from rhabdomyolysis patients that developed acute renal failure who were hospitalized and treated in our clinic in 2019. Materials and Methods: We reviewed all cases of RML treated in the tertiary hospital within a 12-month period, which was defined as serum creatinine kinase (CK) levels > five times the upper normal limit. The inclusion criteria were as follow: (a) being aged ≥ 18 years, (b) being treated for RML within the designated time period, (c) AKI development. The exclusion criteria are as follows: (a) being aged 5 time upper normal limit (UNL), 14 conformed to the inclusion criteria and were selected as subjects Results: A total of 14 patients were included in the study, 12 of which were male. The mean age of the patients was 48.1 (18–80). The etiologies were as follows: hypothyroidism, 3; prolonged exposure to sun, 2; electrolyte imbalance due to severe diarrhea, 1; viral upper respiratory tract infection (URTI), 3; intramuscular injection, 1; heavy exercise or falls.Conclusion: Rhabdomyolysis is an interdisciplinary clinical condition that can lead to life-threatening outcomes including AKI. Rapid diagnosis and treatment can be life-saving. AKI is a significant potential complication of RML and renal function should be evaluated irrespective of CK levels or the presence of myoglobinuria.

Alleviating effects of the mixture of Elaeagnus multiflora and Cynanchum wilfordii extracts on testosterone deficiency syndrome

Testosterone deficiency syndrome (TDS), also known as late-onset hypogonadism, is a clinical and biochemical syndrome associated with advanced age and characterized by deficient serum testosterone levels. The Elaeagnus multiflora fruit (EMF) and Cynanchum wilfordii (CW) have been used in traditional herbal medicine. This study aimed to investigate the therapeutic effects of EMF and CW mixtures (at the ratios of 3:7, 5:5, and 7:3) on TDS using TM3 cells and aging male rats. EMF, and mixtures of EMF and CW (at the ratios of 3:7, 5:5, and 7:3) significantly increased testosterone levels in TM3 cells (p <0.05). The rats were orally administered EMCW (EMF and CW mixed at the ratio of 3:7 50, 100 and 200 mg/kg/day) for 4 weeks consecutively. After 4 weeks of EMCW administration, latency time on the rotarod test, and serum testosterone and dehydroepiandrosterone sulfate levels were significantly increased (p <0.05 and p <0.01). Moreover, the levels of globulin-bound sex hormones were decreased in the EMCW-fed groups. However, prostate-specific antigen levels did not differ among the groups. These results suggest that EMCW can be effectively used to alleviate TDS.

Androgen-dependent miR-125a-5p targets LYPLA1 and regulates global protein palmitoylation level in late-onset hypogonadism males.

Late-onset hypogonadism (LOH) is defined as a clinical and biochemical syndrome with multiple symptoms caused by testosterone deficiency in aging males. An in-depth exploration of the molecular mechanism underlying LOH development is insufficient. We previously identified miR-125a-5p as a dysregulated microRNA in LOH patients and potential diagnostic biomarker for LOH. The present study demonstrated that plasma miR-125a-5p was upregulated after testosterone supplementation in both LOH patients and castrated mice, and positively associated with the testosterone concentrations, suggesting direct regulation of miR-125a-5p expression by testosterone. Androgen response element in the promoter of miR-125a-5p was subsequently identified. Target gene screening and confirmation verified that LYPLA1, encoding acyl-protein thioesterase 1 which catalyzed protein depalmitoylation process, was a target gene of miR-125a-5p. Furthermore, in cells cultured with testosterone deprivation and organs from castrated mice, testosterone deficiency led to decreased global protein palmitoylation level. In aging males, global protein palmitoylation in peripheral blood showed a notable decline in LOH patients contrast to the normal elderly males. And the palmitoylation level was positively correlative with serum testosterone concentrations. Our results suggested that testosterone could regulate global palmitoylation level through miR-125a-5p/LYPLA1 signaling pathway. Given that protein palmitoylation is pivotal for protein function and constitutes the pathogenesis of various diseases, testosterone/miR-125a-5p/LYPLA1 may contribute to the molecular mechanism underlying multiple symptoms caused by testosterone deficiency in LOH patients, and aberrant global palmitoylation could be a potential biomarker for LOH.

MON-309 Prevalence of Silent Corticotroph Adenomas in a Large Cohort of Nonfunctioning Pituitary Adenomas: Plasma Proopiomelanocortin(POMC) Levels and Response to Pasireotide LAR

Silent corticotroph adenomas (SCAs) are tumors of the TPIT anterior pituitary cell lineage that do not lead to biochemical or clinical Cushings syndrome. Thus, they present as clinically nonfunctioning pituitary adenomas (CNFPAs) and are only diagnosed pathologically. Since they are often aggressive tumors, identification of a peripheral blood marker of SCA activity would be useful for diagnosis and monitoring. Some data suggest that aberrant processing of POMC, the precursor of ACTH, underlies the lack of elevated biologically active ACTH and thus cortisol excess in SCAs. We hypothesized that these tumors could secrete POMC, resulting in elevated plasma levels of POMC in patients with SCAs. Therefore, we investigated plasma POMC levels as a potential marker of this tumor type and correlated with tumor ACTH immunoreactivity (IR), which may be detecting unprocessed POMC. We studied 267 patients (134M, 133F, age 56.3±13.6yr) with CNFPAs (Cushings excluded) prior to surgery and at enrollment in a prospective, observational study. We also studied 9 patients with known SCAs with residual macroadenomas after surgery. Peripheral blood was sampled for POMC, ACTH and cortisol levels. POMC was measured by in-house two-site ELISA (detects POMC and 22kD pro-ACTH) and ACTH and cortisol by Immulite(Siemens). POMC levels were compared to the 95%CI of the mean of 70 healthy subjects and considered elevated if ≥ the 97.5 percentile of 39 fmol/mL. Of the CNFPA cohort, 12/267 had elevated POMC levels (range 39-166 fmol/mL) and 4 of the 12 had elevated ACTH levels (> 50 pg/ml)(range 53.6-76 pg/ml). Of the 12 with elevated POMC, 9 underwent surgery and 6 of them had positive ACTH IR in their tumors. An additional 13 patients in the CNFPA cohort had weak ACTH IR tumors, but POMC <39 fmol/mL and normal ACTH. POMC levels were elevated in all 9 known SCA patients (range 40-996 fmol/mL), being highest in those with the most aggressive tumors. ACTH levels were elevated in 6 of them (range 50.6-397 pg/ml). POMC levels were lowered with surgery in 4 of 4 SCA patients followed longitudinally. Two SCAs were treated with monthly pasireotide LAR (40 mg escalated to 60 mg) for 8 months. Plasma POMC levels fell from 104 to 21 fmol/mL in 1 patient, but did not change in the 2nd, 124 to 112 fmol/mL. Both patients had no change in the size of their macroadenomas during treatment. In summary, patients with elevated plasma POMC levels were correctly identified as SCAs in most surgically treated patients and POMC levels were lowered by tumor removal in all who were tested longitudinally. Although POMC levels were not elevated in some other patients with weakly positive ACTH IR tumors, further characterization of these tumors by lineage specific transcription factors is underway to confirm them to be of corticotroph cell origin. These data suggest that plasma POMC measurements may have clinical utility in the evaluation of SCAs and this warrants further study.

Blood Metabolite Signatures of Metabolic Syndrome in Two Cross-Cultural Older Adult Cohorts.

Metabolic syndrome (MetS) affects an increasing number of older adults worldwide. Cross-cultural comparisons can provide insight into how factors, including genetic, environmental, and lifestyle, may influence MetS prevalence. Metabolomics, which measures the biochemical products of cell processes, can be used to enhance a mechanistic understanding of how biological factors influence metabolic outcomes. In this study we examined associations between serum metabolite concentrations, representing a range of biochemical pathways and metabolic syndrome in two older adult cohorts: The Tsuruoka Metabolomics Cohort Study (TMCS) from Japan (n = 104) and the Baltimore Longitudinal Study of Aging (BLSA) from the United States (n = 146). We used logistic regression to model associations between MetS and metabolite concentrations. We found that metabolites from the phosphatidylcholines-acyl-alkyl, sphingomyelin, and hexose classes were significantly associated with MetS and risk factor outcomes in both cohorts. In BLSA, metabolites across all classes were uniquely associated with all outcomes. In TMCS, metabolites from the amino acid, biogenic amines, and free fatty acid classes were uniquely associated with MetS, and metabolites from the sphingomyelin class were uniquely associated with elevated triglycerides. The metabolites and metabolite classes we identified may be relevant for future studies exploring disease mechanisms and identifying novel precision therapy targets for individualized medicine.

Study of vitamin D status in male patients with hypogonadism

Background Male hypogonadism is a clinical and biochemical syndrome that results from failure to produce adequate testosterone levels, normal sperm count, or both. Male hypogonadism may adversely affect multiple organ functions and quality of life. Vitamin D is a steroid hormone; the major action of vitamin D is linked to maintaining musculoskeletal health. However, several epidemiological studies have suggested extraskeletal benefits of vitamin D. There is an accumulating body of evidence which suggests that vitamin D is involved in reproductive and gonadal functions. Although some studies have demonstrated that vitamin D levels are positively associated with androgen levels and that vitamin D supplementation may increase testosterone levels, other studies have observed a U-shaped association of vitamin D and hypogonadism in middle-aged men, in contrast, other studies fail to find an association between vitamin D and testosterone especially in young healthy men after exclusion of other confounding factors. Thus, the aim of our study was to study the possible association of vitamin D status with male hypogonadism among different age groups. Patients and methods The study included 80 men. Group I included 40 male patients aged 20 to less than 45 years who were further subdivided into two subgroups: group Ia included 20 male patients diagnosed with hypogonadism and group Ib included 20 eugonadal men serving as a control. Group II: included 40 male patients aged 45–70 years subdivided into two subgroups: group IIa included 20 male patients diagnosed with hypogonadism and group IIb included eugonadal men serving as a control. Using enzyme-linked fluorescent assay technique, serum total testosterone (TT), 25-hydroxyvitamin D3 [25(OH)D3], luteinizing hormone, follicle stimulating hormone, estradiol, and prolactin were assessed for all enrolled individuals. Sex-hormone-binding globulin (SHBG) was assessed using the electrochemiluminescence immunoassay technique. Free androgen index (FAI) was calculated using the equation [100×TT (nmol/l)/SHBG (nmol/l)]. Results It was found that TT, FAI, and SHBG were lower in hypogonadal men versus eugonadal men in both groups, there was no significant statistical difference between hypogonadal men in groups I and II as regards TT and SHBG (P=0.708, 0.124, respectively), whereas FAI was found to be significantly statistically lower in hypogonadal men aged 45–70 years as compared with hypogonadal men aged 20 to less than 45 years (P=0.021). There was a high prevalence of vitamin D deficiency and insufficiency in both hypogonadal and eugonadal men in the four studied subgroups. 25(OH)D3 was not statistically different between subgroups in both groups (P=0.681, 0.823, respectively), whereas 25(OH)D3 was significantly higher in hypogonadal men in group II versus hypogonadal men in group I (P=0.037). 25(OH)D3 was found to be positively correlated with TT, FAI, and SHBG, but not to serum estradiol, prolactin. Correlation of 25(OH)D3 was stronger in hypogonadal men aged 45–70 years (P=0.001) as compared with hypogonadal men aged from 20 to less than 45 years (P=0.023). Conclusion Low vitamin D is associated with male hypogonadism across all age groups. This association is more pronounced in elderly hypogonadal men with vitamin D deficiency.

Late-onset hypogonadism: a concept comes of age.

The term Late-onset hypogonadism (LOH) was coined in 2002 and defined as a disease entity in the ISA, ISSAM, EAU, EAA and ASA endorsed Recommendations for Investigation, Treatment and Monitoring of LOH (2005 and 2008) as 'a clinical and biochemical syndrome associated with advancing age, characterized by symptoms and a deficiency in serum testosterone (T)'. LOH was classified as a combined primary and secondary hypogonadism since the endocrine capacity of the testes and the pituitary are impaired. Symptoms of LOH include loss of libido, erectile dysfunction, loss of muscle mass, increased body fat, anemia, osteoporosis, depressed mood, decreased vitality, sweating, and hot flushes. Since these symptoms may also have origins other than LOH, exclusion of other disease entities and subnormal serum T levels are considered prerequisites for the diagnosis and possible treatment of LOH. However, during following years these guidelines were often neglected and, especially in the USA, indiscriminate prescribing of T was widely practised so that the US FDA warned against such irresponsible behavior. In Europe, T prescribing remained largely restricted to LOH as defined above. Nevertheless, a discussion started whether LOH really exists or is only a consequence of age-related comorbidities. Numerous studies have helped to clarify the situation, in particular, the European Male Aging Study (EMAS) and the US-initiated 7T trials. Consequently, the newest US Endocrine Society Practice Guideline on T treatment (2018) includes advanced age as a cause of organic hypogonadism and recommends that 'in men >65years who have symptoms or conditions suggestive of T deficiency … and consistently and unequivocally low morning T concentrations we suggest that clinicians offer T therapy on an individualised basis after explicit discussion of the potential risks and benefits'. Thus, the concept of LOH as conceived two decades ago has weathered criticism and survived the times.

Comparative Studies on Hormonal Changes and Metabolic Syndrome in Perimenopausal and Premenopausal Igbo Women in Enugu Metropolis Nigeria: A Cross-sectional Study

Background and Objective:Few studies have focused on the epidemiology of perimenopausal syndrome, and its prevalence in African women is concerningly high. This study investigated selected biochemical parameters, hormonal changes, and possible metabolic syndrome (MetS) in perimenopausal and premenopausal women among Igbo women in Enugu, Southeast of Nigeria.Methods:This study was conducted between March 2018 and November 2018. A total of 200 apparently healthy women, comprising 120 perimenopausal women (mean age 50 years) and 80 premenopausal women (mean age 35 years), living in Enugu, were randomly recruited for this study. Anthropometric indices (blood pressure, waist circumference, weight, and height) of these women were measured. Fasting blood samples were collected and used for measurement of luteinizing hormone (LH), estradiol (E2), follicle stimulating hormone (FSH), fasting plasma glucose (FPG), and lipid profile using standard methods. MetS in the perimenopausal and premenopausal women was observed using three different criteria: the National Cholesterol Education Program- Adult Treatment Panel 111 (NCEP-ATP 111), the World Health Organization (WHO), and International Diabetes Federation (IDF). Student’s t-test and Chi-square were used to compare continuous and categorical variables.Results:There were significantly (p&lt;0.05) higher values of blood pressure (systolic and diastolic), FPG, waist circumference, LH, FSH, total cholesterol, and LDL-C, but significantly (p&lt;0.05) lower values of estradiol in perimenopausal women as compared to premenopausal women. The incidence of MetS was higher in perimenopausal women as compared to premenopausal women in all the three criteria studied.Interpretation and Conclusion:Perimenopausal women have a higher risk for the development of metabolic syndrome-associated diseases than premenopausal women.

Efficacy and safety of acupuncture as a complementary therapy for sepsis: A protocol of systematic review and meta-analysis.

Sepsis is a physiological, pathological, and biochemical syndrome caused by infection. Acupuncture may be useful for sepsis. This systematic review aims to assess the efficacy and safety of acupuncture as a complementary therapy for sepsis. We will search PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI), Wan Fang Database, Chinese Biomedicine (CBM) database, VIP database, and TCM Literature Analysis and Retrieval Database from inception to October 31, 2019 to identify any eligible study. We include all randomized controlled trials (RCTs) without any limitation of blinding or publication language, exclude cohort studies and case reports. Two reviewers will independently select studies, extract and manage data. The primary outcomes include the mortality at 28 days, acute physiology, and chronic health evaluation II scores. The secondary outcomes include the tumor necrosis factor α (TNF-α) counts, interleukin 6 (IL-6) counts, interleukin 10 (IL-10) counts, procalcitonin (PCT), lactic acid, the level of T cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+), monocytes of human leukocyte antigen DR (HLA-DR), C-reactive protein (CRP), the numeration of leukocyte, intra-abdominal pressure, and adverse events or reactions. Statistical analyses will be performed using the Review Manager V.5.3 and R packages Metafor. We will use the Cochrane risk of bias tool for randomized trials to assess the risk of bias of included studies. This study will not involve personal information. Ethical approval will not be required. We will publish the results in a peer-reviewed journal. CRD42019141491.

Does anti-mullerian hormone (AMH) predict biochemical hyperandrogenism, oligo-anovulation (OA), metabolic dysfunction (MD), and metabolic syndrome (METS)?: results from a longitudinal study

Does anti-mullerian hormone (AMH) predict biochemical hyperandrogenism, oligo-anovulation (OA), metabolic dysfunction (MD), and metabolic syndrome (METS)?: results from a longitudinal study