Total AMS Research Articles

PMON264 TESTOSTERONE IMPROVES QUALITY OF LIFE, SEXUAL FUNCTION AND DELAYED VERBAL RECALL- RANDOMISED PLACEBO-CONTROLLED STUDY IN HYPOGONADAL MEN WITH UNCONTROLLED TYPE 2 DIABETES – STRIDE STUDY

Abstract Objective The objective of the study was to assess the effect of long-acting intra-muscular testosterone on Quality of Life (QoL), sexual symptoms, memory and constitutional symptoms in men with hypogonadism and poorly-controlled type 2 diabetes. Research design and methods: This is a randomised double-blinded placebo-controlled add-on trial of intramuscular testosterone undecanoate (Nebido®) administered every 12 weeks in 65 hypogonadal men with poorly-controlled diabetes. Phase 1 patients were randomly assigned to either treatment or placebo arm for 6 months of TRT. Phase 2 was an open-labelled phase for 6 months and patients on placebo moved on to the treatment group wherein patients in the treatment group continued. Outcomes (AMS, SF-36, IIEF-5 questionnaires, MMSE (Mini-Mental State Examination), BDHQ (Barnsley Diabetes Hypogonadism Questionnaire) and NERI questionnaire) were assessed at baseline and every 3 months. Results Mean age of the cohort was 59(42-77) years. Baseline characteristics were comparable between active/placebo groups. Phase 1 - Our study is the first RCT to show a significant reduction in the mean total AMS score from baseline of 48.34±13.13 to 37.72±12.25 at 6 months after testosterone treatment compared to placebo (p<0.05). The proportions of patients with severe symptoms moving to a less severe category (low/mild/moderate severity) was 46% in the active vs only 28% in placebo group(p=0.0024). There was no significant difference in either the SF-36 scores, MMSE scores, BDHQ, NERI or IIEF-5 scores or its domains at baseline and after 6 months of testosterone treatment. In phase 2 of the trial questionnaires were performed at 0,3,6,9,12 months on the testosterone and data presented here as significance between 0 and 12 months. The AMS total score (p=001) and all its subscales (Physical p=0.01), Psychological (p=0.026) and Sexual (p<0.001) with improvement in Libido (p<0.001) showed significant improvement. The BDHQ found significant improvement in two domains - Sexual wellbeing (p=0.002) and Emotional wellbeing (p=0.011) respectively) with the Total score p=0.07. SF-36 QoL score had improvement in the mean scores of physical health domain (p=0.019) and health change domain (0.019). MMSE found a highly significant improvement in Delayed Verbal Recall (p=0.0004). No significant difference to NERI or IIEF-5 scores were found. Conclusions Our trial is the first RCT to show a significant improvement in sexual symptoms, libido, symptom severity, delayed verbal recall (an important Symptom of Dementia) and constitutional symptoms with TRT in a cohort with poorly-controlled type 2 diabetes and hypogonadism. This study demonstrates that symptoms of hypogonadism can continue to improve up to 12 months. It is important to recognize that men with type 2 diabetes have obesity, complications of diabetes, co-morbidities, erectile dysfunction which all compromise their QoL. An improvement in their QoL and other parameters found in this study represent major improvements in health and life situation. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

The “Aging Males’ Symptoms” Scale (AMS): predictive value for lowered circulating androgens

Background: Symptoms of the “male climacteric” are often at least in part referred to an age-dependent decline of serum androgen levels. Therefore, we evaluated the relationship of climacteric symptoms as assessed by the “Aging Males’ Symptoms” (AMS) Questionnaire with circulating androgen levels. Methods: 146 ambulatory men (age, 27–85 years) were surveyed with the AMS Questionnaire and sampled for serum values of total testosterone (tT) and sexual hormone binding globulin (SHBG). Free testosterone (fT) was calculated from tT and SHBG. A total AMS score ≥37 was considered pathological; the lower limits for tT and fT were set to 8 nmol/l and 180 pmol/l, respectively. Results: A significant deficit in tT and fT was shown in 25 (17.1%) and 34 (24.5%) men, respectively; the AMS Questionnaire showed pathological results for 66 (45.2%) men. In predicting a tT deficit, the AMS Questionnaire rendered a sensitivity of 76% and a specificity of 61.6%, only. However, multiple regression analysis revealed a significant correlation of lowered tT with a pathological somatovegetative and psychological AMS subscore (p = 0.042 and p = 0.01) and a correlation of lowered fT with a pathological sexual subscore (p = 0.039). Conclusion: In predicting hypogonadism the AMS Questionnaire in total did not render a sufficient diagnostic efficiency.

The aging males’ symptoms scale for Japanese men: reliability and applicability of the Japanese version

We aimed to confirm the reliability of the Japanese version of the Aging Males' Symptoms rating scale (JPN-AMS) and its applicability in patients with testosterone deficiency syndrome (TDS)-like symptoms, comparing it for young, middle-aged and elderly Japanese men. The study included 93 patients with TDS-like symptoms, 39 men younger than 30 years old, and 125 normal men 40 years old and older, who agreed to respond to a self-administered questionnaire using the JPN-AMS. Testing-retesting was done to confirm the reliability of the questionnaire, with a 2-week interval between tests. The total AMS score and three domain scores were clearly higher in patients with TDS-like symptoms than in young men and in normal males, respectively. The test-retest analysis showed good reliability and internal consistency for the JPN-AMS. The JPN-AMS can be reliably used for measuring health-related quality of life of aging Japanese males.

Efficacy and safety of a new testosterone-in-adhesive matrix patch applied every 2 days for 1 year to hypogonadal men

Objectives To study long-term efficacy and safety of a testosterone-in-adhesive matrix patch, delivering 4.8 mg of testosterone daily. Methods Randomized, open label, multicenter 1-year study. 224 hypogonadal patients were included. 188 received 2 patches of 60 cm 2 every 48 h and 36 patients had IM testosterone enanthate injection every 3 weeks. T, bioavailable T (BT), DHT, E 2, LH, FSH and SHBG and clinical symptom scores (AMS and MSF-4) were assessed at 3, 6 and 12 months. Results In the patch group, T serum levels were above 3 ng/mL in 85% of patients and remained stable over time. BT, DHT and E 2 levels were restored within physiological range. BT/T ratio varied from 20 to 70%. In the IM group, the percentages of “normalized” patients appeared to be lower, although the two groups cannot be adequately compared due to the kinetic profile of T following IM administration, resulting in greater variations of serum T levels, blood samplings occurring randomly at time of peak, trough, or in between. A significant correlation was found between T, BT and the MSF-4 changes. BT levels were significantly related to total AMS score. PSA values showed a mean (S.D.) increase of 0.13 (0.38), 0.23 (0.79) and 0.30 (1.47) ng/mL at weeks 14, 27 and 53, respectively. The patch was well tolerated with no negative impact either on lipid profile, or red blood cells. Administration site reactions occurred in 35 patients (18.8%). Adhesiveness was good (≥75%) in >90% patients over the 1 year application period. Conclusion Two 60 cm 2 patches, allowed constant physiological levels of sexual hormones over time. This new patch was well tolerated, easy to use, well accepted by the patients and displayed a very good adhesiveness. Clinical efficacy was more related to BT than to T.

Identification of the Mass Spectral Signature of Organic Aerosols from Wood Burning Emissions

Throughout the winter months, the village of Roveredo, Switzerland, frequently experiences strong temperature inversions that contribute to elevated levels of particulate matter. Wood is used as fuel for 75% of the domestic heating installations in Roveredo, which makes it a suitable location to study wood burning emissions in the atmosphere in winter. An Aerodyne quadrupole aerosol mass spectrometer (Q-AMS) was used to characterize the composition of the submicrometer, non-refractory aerosol particles at this location during two field campaigns in March and December 2005. Wood burning was found to be a major source of aerosols at this location in winter. Organics dominated the composition of the aerosols from this source, contributing up to 85% of the total AMS measured mass during the afternoon and evening hours. Carbonaceous particle analysis showed that organic carbon composed up to 86% of the total carbon mass collected at evening times. Results from 14C isotope determination revealed that up to 94% of the organic mass came from non-fossil sources, which can be attributed mostlyto wood burning. The unique combination of off-line 14C isotope analysis and on-line aerosol mass spectrometry was used to identify periods during which organic mass was mainly from wood burning emissions and allowed for the identification of the AMS spectral signature of this source in the atmosphere. The identified ambient signature of wood burning was found to be very similar to the mass spectral signature obtained during the burning of chestnut wood samples in a small stove and also to the spectrum of levoglucosan. Particles from wood burning appeared to be composed of highly oxygenated organic compounds, and mass fragments 60, 73, and 137 have been suggested as marker fragments for wood burning aerosols. Mass fragment 44, which is used as a marker for oxygenated organic aerosols (OOA), contributed about 5% to the total organic signal from primary wood burning sources. The ratio of the organic mass emitted from wood burning to m/z 60 in Roveredo is 36. This ratio may be used to provide an estimate of the organic aerosol mass emitted from wood burning in other locations.

The Aging Males' Symptoms rating scale: cultural and linguistic validation into English

Unlike in women, where instruments are available to measure the severity of symptoms, cross-culturally validated instruments are lacking for aging males. This study set out to conduct a translation andcultural validation of the 'Aging Males' Symptoms' (AMS) scale, originally developed in German, into English for use in North America and the UK.Following international methodological recommendations,the AMS scale was translated in a standardized way consisting of forward translation, quality control, backward translation and a pretest. Five experienced bilingual translators and reviewers were involved.Many difficulties of compatibility between the cultural backgrounds of Germany, the UK and North America were identified and resolved by consensus. This resulted in one version for British and AmericanEnglish. A pretest in volunteers demonstrated clarity and understandability across social classes, but also suggested minor changes in the instrument. A preliminary test-retest comparison of the final scaleshowed high reliability with a correlation coefficient of 0.93 for the total AMS score.The AMS scale is a valuable tool for assessing symptoms in the aging male. This scale can be used in German andEnglish speaking countries. Flemish and Finnish versions are also in use.

DECOUPLING OF ARICULTURAL SUPPORT PROGRAMS: APPROPRIATE ACTION FOR SOUTH AFRICA, THE CAIRNS GROUP AND DEVELOPING COUNTRIES / ONTKOPPELING VAN LANDBOU-ONDERSTEUNINGSPROGRAMME: TOEPAS-LIKE OPTREDE VIR SUID-AFRIKA, DIE CAIRNS GROEP EN ONTWIKKELENDE LANDE

Protectionist agricultural support policies became progressively more distortionist, expensive and ineffective. The 1994 GATT agreement is intended to reduce this. However, particularly the U.S.A., E.U. and Japan are likely to continue supporting their farmers. Decoupled payments have been proposed to substitute for production and price related programs. Decoupling will undoubtedly be much less trade distorting. Its advantages should outweigh side effects involving farmers' capital position, possible managerial effects, land price effects and environmental aspects; some of these may, in any event, be positive. CAIRNS group and developing countries should insist on accompaniment of decoupled payments by reduced total AMS support expenditure.

On the identification of carbonaceous aerosols via 14C accelerator mass spectrometry, and laser muprobe mass spectrometry

Carbon isotopic measurements ( 12C, 14C), derived from chemical measurements of total carbon plus AMS measurements of 14C/ 12C have become an accepted means for estimating fossil and contemporary carbon source contributions to atmospheric carbon. Because of the limited sensitivity of these techniques, however, such measurements are restricted to “bulk” samples comprising at least 10–100 μg of carbon. Laser microprobe mass spectrometry (LMMS) offers an important complementary opportunity to investigate the chemical nature of individual particles as small as 0.1 μm in diameter. Although there is little hope to measure 14C/ 12C in such small samples, the compositional and structural information available with the laser microprobe is of interest for possible source discrimination. Also, the analysis of individual particles, which may reflect individual sources, yields significant potential increases in spatial, temporal and source resolution, in comparison to bulk sample analysis. Results of our exploratory investigation of known sources of carbonaceous particles, using LMMS, are presented. By applying multivariate techniques to laser mass spectra of soot from the combustion of heptane and wood, we found striking differences in the alkali metals (notably potassium) in the positive ion mass spectra. For ambient particles, 14C has proved to be a crucial adjunct for the development and validation of the LMMS approach to single particle source assignment via carbon cluster pattern recognition. The combined techniques offer great promise for objective modeling (number and types of carbon sources) and for extension of the dichotomous carbon apportionment (fossil, contemporary) to subclasses such as soot from wood and agricultural burning, and that from coal and petroleum combustion.

RELATION BETWEEN AGING MALE SYMPTOM SCORE (AMS SCORE) AND AGE

Objective: To study the relation of the Aging Male Symptom Score (AMS score) with age groups, and to find the age when the AMS score increases. Material & method: In all, 347 patients with age beginning at 50 years underwent an interview with the AMS Score questionnaire, then they were divided according to age in groups, less than or equal to 50 years, 51 – 55 years, 56 – 60 years, and more than 60 years. Results: In the age group less than or equal to 50 years, there were 26 men (7,5%). With an abnormal AMS psychology, there were 18 men, with abnormal AMS somatovegetative score there were 20 men, with an abnormal AMS sexual score 20 men, and with abnormal total AMS Score 14 men. In the age group 51 – 55 years, there were 146 men (42,07%), with an abnormal AMS psychology in 75 men, with abnormal AMS somatovegetative score 114 men, abnormal AMS sexual in 123 men, and abnormal total AMS Score in 71 men. In age group 56 - 60 years there were 48 men (13,83%), abnormal AMS psychology in 35 men, abnormal AMS somatovegetative score in 44 men, abnormal AMS sexual in 45 men, and abnormal total AMS Score in 35 men. In the age group of more than 60 years, there were 127 men (36,6%), abnormal AMS psychology was found in 87 men, abnormal AMS somatovegetative score in 112 men, abnormal AMS total sexual score 122 men, and abnormal total AMS score was in 96 men. All of the AMS score values significantly increased after 55 years old, p value at AMS psychology was 0,005, AMS somatovegetative was 0,000, AMS sexual was 0,000, and at total AMS Score was 0,000. To define the age when AMS score increases. The conclusion was that AMS psychology values begin to increase after 55 years (sensitivity 69,71, specificity 45,93), AMS somatovegetative values increase after 55 years (sensitivity 89,14, specificity 22,09), and total AMS score value begins to increase at 55 years (sensitivity 74,86, specificity 50,58). However, AMS sexual value increase at 50 years (sensitivity 90,34, specificity 23,08). Conclusion: All of the AMS score values increase significantly at 55 years.