A qualitative exploration of South African men's perceived effects of Androgen Deprivation Therapy (ADT) as a treatment for advanced prostate cancer.

OBJECTIVE: We undertake qualitative research with men treated in a Pretoria, South Africa Oncology clinic to address men's self-reported experiences on androgen deprivation therapy (ADT). METHODS: Analyses rely upon 22 men's responses to open-ended questions during interviews. These men were 63-78 years of age, and almost all married (three widowed), had children and were no longer engaged in paid work. RESULTS: In addressing questions about the anticipated and experienced positive and broader side effects of ADT, men referred to its treatment for prostate cancer, with several generally specifying health or life. Patients also referred to a variety of more specific effects such as pain, nausea, difficulties urinating, gaining weight, low energy and sleep disruptions that appeared to reflect a mixture of influences of prostate cancer, ADT and oncological treatment. In addressing a question about the effects of ADT on romantic/sex life, 16 of 19 married men referred to deleterious impacts on their sex lives. With respect to perceived family, work or broader social life impacts, some men noted others' worries and social support. CONCLUSION: Findings are situated within discussions of existing research on ADT largely from North American or European samples, and broader views of testosterone and male social behavior.

Hormonal correlates of human paternal interactions: a hospital-based investigation in urban Jamaica.

To expand our understanding of the neuroendocrine mechanisms underlying human fatherhood, including its cross-cultural expression, we investigated the hormonal correlates of fatherhood in the greater Kingston, Jamaica area. We recruited 43 men, aged 18-38, to participate: 15 single men; 16 "coresidential" fathers (men who live with their adult female partner and youngest child); and 12 "visiting" fathers (men who live apart from their adult female partner and youngest child). The research protocol entailed biological sampling before and after a 20-min behavioral session during which single men sat alone and fathers interacted with their partner and youngest child. Hormone measures relied upon minimally invasive techniques (salivary testosterone and cortisol, finger prick blood spot prolactin, urinary oxytocin and vasopressin). Results revealed significant group differences in average male testosterone levels (p=0.006), with post hoc contrasts indicating that visiting fathers had significantly (p<0.05) lower testosterone levels than single men. Prolactin profiles also differed significantly across groups (p=0.010) whereby post hoc contrasts showed that prolactin levels of single men declined significantly compared with the flat levels of visiting fathers (p<0.05). No group differences in cortisol, oxytocin or vasopressin levels were observed. However, among fathers, vasopressin levels were significantly and negatively (r=-.431, p=0.022) correlated with the age of a man's youngest child. These results thus implicate lower testosterone levels as well as prolactin and vasopressin in human fatherhood. These findings also highlight the importance of sociocultural context in human fatherhood while exhibiting parallels with existing data on the non-human vertebrate hormonal bases of paternal care.

Predictors of South African male testosterone levels: the THUSA study.

The process of urbanization occurring in many developing countries may have consequences for reproductive endocrine function. Here, we test predictions concerning variation in South African male testosterone levels among subgroups across an urbanization gradient representing differences in both geography and socioeconomic status. Subjects included 364 males aged between 20 and 82 comprising a cross-sectional study conducted between 1996 and 1998. Testosterone levels were measured from serum samples obtained between 08:00 and 11:00. In ANCOVA analysis, male testosterone levels differed significantly along this rural-to-urban gradient, with members of the most urban group having higher testosterone levels than groups of farmers and inhabitants of informal housing areas adjacent to towns. Testosterone levels declined with age and were negatively related to body mass index (BMI). Testosterone levels did not differ according to HIV status. Further exploratory ANCOVA analyses revealed that physical activity levels, depression, affect, and hostility were not significantly associated with variation in testosterone levels. These data help document causes of variation in male testosterone levels in a context of urbanization and may have implications for clinical outcomes such as the development of a male hormonal contraceptive or prostate cancer.

Effects of testosterone replacement in human immunodeficiency virus-infected women with weight loss.

The objective of this study was to determine whether physiological testosterone replacement increases fat-free mass (FFM) and muscle strength and contributes to weight maintenance in HIV-infected women with relative androgen deficiency and weight loss. Fifty-two HIV-infected, medically stable women, 18-50 yr of age, with more than 5% weight loss over 6 months and testosterone levels below 33 ng/dl were randomized into this double-blind, placebo-controlled trial of 24-wk duration. Subjects in the testosterone group applied testosterone patches twice weekly to achieve a nominal delivery of 300 mug testosterone over 24 h. Data were evaluable for 44 women. Serum average total and peak testosterone levels increased significantly in the testosterone group, but did not change in the placebo group. However, there were no significant changes in FFM (testosterone, 0.7 +/- 0.4 kg; placebo, 0.3 +/- 0.4 kg), fat mass (testosterone, 0.3 +/- 0.7 kg; placebo, 0.6 +/- 0.7 kg), or body weight (testosterone, 1.0 +/- 0.9 kg; placebo, 0.9 +/- 0.8 kg) between the two treatment groups. There were no significant changes in leg press strength, leg power, or muscle fatigability in either group. Changes in quality of life, sexual function, cognitive function, and Karnofsky performance scores did not differ significantly between the two groups. High-density lipoprotein cholesterol levels decreased significantly in the testosterone group. The patches were well tolerated. We conclude that physiological testosterone replacement was safe and effective in raising testosterone levels into the mid to high normal range, but did not significantly increase FFM, body weight, or muscle performance in HIV-infected women with low testosterone levels and mild weight loss. Additional studies are needed to fully explore the role of androgens in the regulation of body composition in women.

Men in committed, romantic relationships have lower testosterone.

Variation in human male testosterone levels may reflect, and effect, differential behavioral allocation to mating and parenting effort. This proposition leads to the hypothesis that, among North American men, those involved in committed, romantic relationships will have lower testosterone levels than men not involved in such relationships. Our study is the first to examine whether being in such a relationship (rather than being married) is the meaningful predictor of male testosterone levels. To test this hypothesis, 122 male Harvard Business School students filled out a questionnaire and collected one saliva sample (from which testosterone level was measured). Results revealed that men in committed, romantic relationships had 21% lower testosterone levels than men not involved in such relationships. Furthermore, the testosterone levels of married men and unmarried men who were involved in committed, romantic relationships did not differ, suggesting that, at least for this sample, male pair bonding status is the more significant predictor of testosterone levels than is marital status.

Fluctuating asymmetry of a foraging population: the Hadza of Tanzania.

PRIMARY OBJECTIVES: We present the first data on non-facial fluctuating asymmetry (FA) in a foraging population, the Hadza of Tanzania. We compare Hadza FA with FA of college students in New Mexico. SUBJECTS AND METHODS: We measured FA on 10 traits using digital calipers, and calculated a composite FA value for 63 Hadza between the ages of 18 and 72. MAIN OUTCOMES AND RESULTS: We found Hadza FA to be significantly higher than US FA. Female FA was higher than male FA among the Hadza, but not among the US sample. Hadza FA increases with age, unlike US FA. We discuss possible influences on FA across the lifespan.

Adenocarcinoma at the ileo-cutaneous junction following subtotal colectomy for ulcerative colitis. Case report.

Adenocarcinoma of the ileo-cutaneous junction is exceedingly rare. We report a case. The clinical presentation and pathogenesis are discussed.

Aspiration needle biopsy for solitary, peripheral lung lesions: a review of 50 examinations.

Percutaneous aspiration needle biopsy forms a simple method of obtaining histological material from solitary peripheral lung lesions. A new method for separating and preparing the material for histological examination is described. The results in 50 cases are recorded with a positive diagnosis in 46. The number of symptomatic complications with this technique is low. The clinical place of the biopsy in management is discussed.

Transbronchial lung biopsy: A review of 85 cases.

Transbronchial lung biopsy using the fibreoptic bronchoscope was carried out in 85 patients. There were no serious complications; two patients had a 10% pneumothorax and 17 had slight haemoptysis lasting less than 24 hours. The problems of interpreting small biopsy specimens are considered. Satisfactory specimens were obtained without fluoroscopic guidance, particularly in diffuse and lobar lesions. A histological diagnosis was made in 62% of diffuse lesions and compatible histology was found in a further 22%. In a further case Pneumocytis carinii infection was diagnosed. Blind biopsy of discrete periheral lesions was less successful with only one positive diagnosis in 12 patients.

Pseudomonas aeruginosa and the general hospital: a six-year survey.

The incidence of infections caused by Pseudomonas aeruginosa did not increase significantly among general surgical and medical patients between 1967 and 1972, and the majority of such infections were trivial. Serious infections were virtually confined to the intensive care unit and the renal transplant unit, and were usually associated with major trauma, surgical mishap or immunosuppression. The majority of these patients had received prior antibiotic therapy. Persistent isolation of Ps. aeruginosa from surgical wounds was often associated with severe intra-abdominal sepsis, and antibacterial therapy was commonly ineffective in these cases. Apparently susceptible patients did not necessarily acquire infection, though the organism was present in their environment. It is suggested that this may reflect a variation of virulence among environmental strains of Ps. aeruginosa, and that further study of this aspect may contribute to improved control of infection.