Prolactin and gonadal function

In most cases, hypogonadism is found in patients with hyperprolactinaemia and galactorrhea, whatever the origin. Correlations between basal levels of gonadotrophins and prolactin have been studied during dynamic tests (LH/FSH-RH, TRH, hypoglycaemia) and after treatment with bromocriptine. There is no evidence for gonadotrophin deficiency associated with hyperprolactinaemia and it would appear that prolactin rather blocks the actions of the gonadotrophins at the gonadal level. Furthermore, an "in vitro" study showed that prolactin blocks the stimulant effect of gonadotrophin on steroidogenesis by the Graafian follicles. This phenomenon may be a mechanism of regulation of the menstrual cycle. The significance of these phenomena is discussed.     

Declining HIV-2 prevalence and incidence among men in a community study from Guinea-Bissau

OBJECTIVE: To assess the present level of HIV-2 infection in an adult population in Bissau and to evaluate sex and age-specific changes in HIV-2 prevalence and incidence between 1987 and 1996. DESIGN AND METHODS: Sex and age-specific changes in HIV-2 prevalence were evaluated comparing a survey from 1987 in a sample of 100 houses with a survey performed in 1996 in an independent sample of 212 houses from the same study area. HIV-2 incidence rates were examined in an adult population (age > or = 15 years) from 100 randomly selected houses followed with four consecutive HIV serosurveys from 1987 to 1996. RESULTS: The HIV-2 prevalence in 1996 was 6.8% (men, 4.7%; women, 8.4%). Compared with the 1987 survey there was a significant decrease in prevalence among men [age-adjusted relative risk (RR), 0.50; 95% confidence interval (CI), 0.31-0.83], whereas it remained unchanged in women (RR, 1.00; 95% CI, 0.67-1.48). The male-to-female RR decreased from 0.99 (95% CI, 0.61-1.61) in 1987 to 0.51 (95% CI, 0.34-0.76) in 1996. The overall annual incidence rate was 0.54 per 100 person-years of observation (PYO), being higher in women (0.72 per 100 PYO) than in men (0.31 per 100 PYO). With the observation time divided into an early and a late period, there was a decrease in incidence with time among men (0.66 to 0.00 per 100 PYO), but no major change among women (0.59 to 0.85 per 100 PYO). The two trends differed significantly (P = 0.03). We observed a higher annual incidence rate amongst older women aged > 44 years (1.77 per 100 PYO) than among younger women (0.55 per 100 PYO; P = 0.05). CONCLUSION: There are no signs of an epidemic spread of HIV-2 in Bissau even though the HIV-1 prevalence is increasing rapidly. A significant reduction in the male HIV-2 prevalence and incidence rates has resulted in a major shift in the pattern of spread of HIV-2, from being equally distributed to being predominantly a female infection. Currently, older women in particular seem to have a high risk of getting infected.     

Male gonadal function in Hodgkin's disease before and after treatment

Twenty eight histologically confirmed cases of Hodgkin's disease were evaluates with regard to libido, sperm count, FSH, LH and urinary ketosteroid levels, before and during different stages of chemotherapy along with testicular biopsy on 16 cases. Decrease in libido during therapy improved following treatment, 50% cases who were oligospermic before treatment became azospermic, Serum FSH levels increased significantly (p 0.001) during the course of treatment. There was no significant change in LH and urinary ketosteroid levels (p 0.05). Testicular biopsy, normal initially, showed germ cell aplasia and absence of spermatogenesis after therapy. Drug induced testicular change leads to sterility.     

Embryonal carcinoma of the testis in elderly men

A rare case of pure embryonal carcinoma of the testis in a black man in the tenth decade of life is presented, as well as a review of the literature on germ cell testicular tumors in men 60 years old or more. It is noteworthy that nearly 9 per cent of testicular tumors occur in this age group and a third of these tumors are of germ cell origin.     

Evaluation of gonadal hormone function in adolescent girls after antineoplastic therapy

In 17 girls after the complex anti-neoplasm therapy we estimated the state of genital organs and the course of menorrhagia cycle together with plasma levels of beta-estradiol, progesterone and prolactin assessed by RIA. We found the secondary lack of menorrhagia together with lowered progesterone and beta-estradiol levels in 3 girls, in whom the abdominal cavity was irradiated. In other 3 girls the transient lack of menorrhagia was stated in the course of chemotherapy.     

Continuing gonadal function in rats with ventromedial hypothalamic area lesions.

Gonads of 24 female and 20 male rats with ventromedial hypothalamic (VMH) or sham lesions were examined after 67 days in constant light. Results show that VMH- and sham-lesioned males had normal testes. Sham-lesioned females had small ovaries and no corpora lutea (CL). 7 VMH females had larger ovaries with CL and numerous follicles, 4 had larger ovaries with no CL but numerous follicles, and 4 had ovaries resembling those of sham-lesioned females. Damage was confined to the VMH in females with CL, but it included less or more of the anterior hypothalamus in females lacking CL. Results suggest that since VMH damage permits estrous cycling to continue, the intact VMH acts to inhibit cycling in constant light. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Apolipoprotein e4 allele and cognitive decline in elderly men

OBJECTIVES: To determine whether polymorphism of apolipoprotein E--notably, the e4 allele--predicts cognitive deterioration in the general population. DESIGN: Population based cohort investigated in 1990 and in 1993. SETTING: Zutphen, the Netherlands. SUBJECTS: Representative cohort of 538 Dutch men aged 70-89 at baseline. MAIN OUTCOME MEASURES: Cognitive function assessed by mini mental state examination, change in cognitive function and incidence of impaired cognitive function at three years. RESULTS: The baseline prevalence of impaired cognitive function (mini mental state examination score < or = 25) was higher among carriers of the e4 allele compared with men without the allele (41.0% (55) v 31.1% (122) P = 0.03), and this result was still valid after adjustment for age, occupation, smoking, alcohol use, and cardiovascular diseases. The decline in cognitive function at three years was largest in men homozygous for e4 (-2.4 points), intermediate in those heterozygous for e4 (-0.7 points), and lowest in men without e4 (-0.1 points), and it was independent of other risk factors (P = 0.02). The risk of developing impaired cognitive function during follow up was significantly increased in allele carriers compared with non-carriers (27.6% (16/58) v 15.5% (32/207)). The adjusted odds ratio was 2.87 (95% confidence interval 1.29 to 6.42). Twenty two per cent of the risk of developing impaired cognitive function in this population may be attributable to the e4 allele. CONCLUSIONS: The apolipoprotein e4 allele predisposes to cognitive decline in a general population of elderly men.     

Cortisol differentially affects memory in young and elderly men.

Nine young and 11 elderly men participated in this placebo-controlled, double-blind, crossover study (0.5 mg/kg cortisol or intravenous placebo). Participants learned a word list before cortisol administration, and delayed recall was then tested. A 2nd word list was learned and recalled after drug administration. In addition, the Paragraph Recall Test and tests measuring working memory (Digit Span), attention (timed cancellation), and response inhibition (Stroop Color and Word Test) were administered at 2 time points after drug administration. Cortisol reduced recall from the word list learned before treatment in both groups but did not influence recall of the list learned after treatment. In contrast, Digit Span performance was decreased by cortisol in young but not elderly participants. The possibility that differential age-associated brain changes might underlie the present results is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of vasectomy on pituitary-gonadal function in men

The testosterone concentration in allantoic fluid between 90 and 150 days of gestation in cattle can be used to determine the fetal sex; values were 442 +/- 20-3 (S.E.M.) pg testosterone/ml for males fetuses and 215 +/- 8-2 pg/ml for female fetuses.     

Exercise tolerance in asymptomatic elderly men with fluoroscopically detected coronary artery calcification

STUDY OBJECTIVE: The value of detecting coronary artery calcification (CAC), by cardiac imaging, for the diagnosis of coronary artery disease (CAD) in asymptomatic middle-aged men has been demonstrated. However, the incidence of CAC increases with age. The functional significance of CAC remains unknown in asymptomatic elderly men. The purpose of this study is to explore whether CAC in asymptomatic aging men signifies the presence of cardiovascular dysfunction during exercise. DESIGN: This study was designed to address whether elderly asymptomatic men, selected because they have CAC, have reduced exercise tolerance due to functionally significant CAD. Participants and setting: Thirty-eight asymptomatic male volunteers (ages 50 to 75 years, mean [+/-SD] 64+/-7 years) with a normal resting ECG and at least one coronary risk factor, in a population study. Nineteen subjects had CAC detected by digital subtraction fluoroscopy in at least two major coronary arteries, and 19 subjects had no identifiable CAC. METHODS AND RESULTS: Each subject underwent a symptom-limited incremental exercise test with 12-lead ECG monitoring and respiratory gas analysis. Four indexes of exercise oxygen transport were evaluated: peak oxygen uptake (VO2), lactic acidosis threshold, peak VO2/heart rate ratio, and VO2 relative to a work rate increase. Eleven of 38 subjects (28%) were found to have reduced oxygen transport, which was defined as an abnormal reduction in more than two of the above four indexes of oxygen transport. Five of the 11 subjects with reduced oxygen transport had CAC, and 6 subjects did not (not significant). Only one subject with CAC had exercise ST depression. CONCLUSION: Significant CAC in asymptomatic men over age 50 does not signify exercise limitation due to CAD.     

Coping with conflict situations: Middle-aged and elderly men.

In this study we investigated the coping responses of fairly healthy, middle-aged (40–64 years, n?=?76) and elderly (65–92 years, n?=?106) men to five conflict situations (i.e., decision making, defeat in a competitive circumstance, frustration, authority conflict, and peer disagreement). Coping responses were measured by the Life Situations Inventory, developed to assess three forms of coping: problem-solving, avoidance, and resignation. Scales were based on a 28-item questionnaire and were derived rationally through item analysis. Alpha coefficients ranged from .75 to .82. Elderly subjects used avoidance significantly less often than did middle-aged subjects in handling decision-making and authority-conflict situations. No differences were noted between the age groups in use of problem solving or resignation. Both middle-age and elderly persons favored use of problem solving in managing all conflicts. Results suggest that studies that do not address potential interactions between age and stress situation may be missing an important element in the age–coping relation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Orthostatic hypotension predicts mortality in elderly men: the Honolulu Heart Program

BACKGROUND: Population-based data are unavailable concerning the predictive value of orthostatic hypotension on mortality in ambulatory elderly patients, particularly minority groups. METHODS AND RESULTS: With the use of data from the Honolulu Heart Program's fourth examination (1991 to 1993), orthostatic hypotension was assessed in relation to subsequent 4-year all-cause mortality among a cohort of 3522 Japanese American men 71 to 93 years old. Blood pressure was measured in the supine position and after 3 minutes of standing, with the use of standardized methods. Orthostatic hypotension was defined as a drop in systolic blood pressure (SBP) of >/=20 mm Hg or in diastolic blood pressure of >/=10 mm Hg. Overall prevalence of orthostatic hypotension was 6.9% and increased with age. There was a total of 473 deaths in the cohort over 4 years; of those who died, 52 had orthostatic hypotension. Four-year age-adjusted mortality rates in those with and without orthostatic hypotension were 56.6 and 38.6 per 1000 person-years, respectively. With the use of Cox proportional hazards models, after adjustment for age, smoking, diabetes mellitus, body mass index, physical activity, seated systolic blood pressure, antihypertensive medications, hematocrit, alcohol intake, and prevalent stroke, coronary heart disease and cancer, orthostatic hypotension was a significant independent predictor of 4-year all-cause mortality (relative risk 1.64, 95% CI 1.19 to 2.26). There was a significant linear association between change in systolic blood pressure from supine position to standing and 4-year mortality rates (test for linear trend, P<0.001), suggesting a dose-response relation. CONCLUSIONS: Orthostatic hypotension is relatively uncommon, may be a marker for physical frailty, and is a significant independent predictor of 4-year all-cause mortality in this cohort of elderly ambulatory men.     

The elderly homeless men in Bloomsbury hostels: their needs for services

OBJECTIVES: The objectives of this study are: (1) to assess the feasibility and usefulness of using the Needs Schedule on older homeless individuals; (2) to measure the needs of the elderly homeless individual for mental health services and whether these needs could be met by the same services that cater for younger individuals. DESIGN AND SETTING: This article analyses the needs of a subsample of 37 elderly residents in four inner London hostels for homeless people. Their needs were compared with those of 64 younger residents within the same hostels. RESULTS: The data related to demographic characteristics and health problems showed that the elderly homeless were physically frail and socially isolated. This group demonstrated more need for physical health services than the younger sample. However, the needs assessment method used in this study failed to show significant differences between the needs of these elderly and those of the younger residents. CONCLUSIONS: The article discusses ways of improving the assessment of needs for services in the elderly homeless and the way forward in meeting the needs of this disadvantaged group.