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PubMed · 11365837

Therapy side effects update.

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1998. Therapy side effects update.. https://pubmed.ncbi.nlm.nih.gov/11365837/

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The impact of testosterone imbalance on depression and women's health.

Women suffer more often from depression than males, indicating that hormones might be involved in the etiology of this disease. Low as well as high testosterone (T) levels are related to depression and well-being in women, T plasma levels correlate to depression in a parabolic curve: at about 0.4-0.6 ng/ml plasma free T a minimum of depression is detected. Lower levels are related to depression, osteoporosis, declining libido, dyspareunia and an increase in total body fat mass. Androgen levels in women decrease continuously to about 50% before menopause compared to a 20-year-old women. Androgen levels even decline 70% within 24 h when women undergo surgical removal of the ovaries. Conventional oral contraception or HRT cause a decline in androgens because of higher levels of SHBG. Hyperandrogenic states exist, like hirsutism, acne and polycystic ovary syndrome. Social research suggests high androgen levels cause aggressive behavior in men and women and as a consequence may cause depression. Higher androgen values are more pronounced at young ages and before and after delivery of a baby and might be responsible for the "baby blues". It was found that depression in pubertal girls correlated best with an increase in T levels in contrast to the common belief that "environmental factors" during the time of growing up might be responsible for emotional "up and downs". T replacement therapy might be useful in perimenopausal women suffering from hip obesity, also named gynoid obesity. Abdominal obesity in men and women is linked to type 2 diabetes and coronary heart diseases. Testosterone replacement therapy in hypoandrogenic postmenopausal women might not only protect against obesity but also reduce the risk of developing these diseases. Antiandrogenic progestins might be useful for women suffering from hyperandrogenic state in peri- and postmenopause. Individual dosing schemes balancing side effects and beneficial effects are absolutely necessary. Substantial interindividual variability in T plasma values exists, making it difficult to utilize them for diagnostic purposes. Therefore a "four-level-hormone classification scheme" was developed identifying when estradiol (E) and T levels are out of balance. (1) Low E-low T levels are correlated with osteoporosis, depression, and obesity; (2) high E-low T with obesity, decreased libido; (3) high T-low E levels with aggression, depression, increased libido, and substance abuse; (4) high E-high T with type II diabetes risk, breast cancer and cardiovascular risk. Testosterone delivery systems are needed where beneficial and negative effects can be balanced. Any woman diagnosed for osteoporosis should be questioned for symptoms of depression.

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Leptin levels and IgF-binding proteins in malnourished children: effect of weight gain.

OBJECTIVES: Although it is well known that leptin reflects body fat content in adults, the regulation of leptin levels during childhood malnutrition is poorly understood. Insulin-like growth factor I (IGF-I) and the IGF-binding proteins (IGFBPs) may play important roles in the regulation of body composition. We investigated the relation between leptin, IGF-I, and IGFBPs in children with protein-energy malnutrition (PEM; before and after recovering 10% of their initial body weights) in comparison with well-nourished children. METHODS: Fifteen PEM and 16 healthy children were studied on admission and after 10% weight gains in the malnourished group. Leptin was measured with radioimmunoassay, IGF-I and IGFBPs were measured with immunoradiometric assay. RESULTS: Patients with PEM had a significantly lower body mass index and percentage of body fat than did the control children. Before weight gain, leptin, IGF-I, and IGFBP-3 were significantly lower and IGFBP-1 was elevated in the malnourished group compared with the control group. Among PEM patients, after 10% weight gains, the levels of leptin, IGF-I, and IGFBP-3 were significantly higher and IGFBP-1 significantly lower compared with the control group. Leptin correlated significantly with IGF-I in the normal children (r(s) = 0.86, P < 0.005). On admission, no correlation was observed between leptin and IGF-I (r(s) = 0.08, P < 0.16) and between leptin and IGFBP-3 (r(s) = 0.02, P < 0.27) in the malnourished group, but those levels improved after 10% recovery of their body weights (r(s) = 0.47, P < 0.002 and r(s) = 0.42, P < 0.005, respectively). In the PEM group, IGF-I correlated significantly with IGFBP-3 when the children gained weight (before: r(s) = 0.006, P < 0.31; after: r(s) = 0.32, P < 0.01). Our study showed results similar to those of anorexia nervosa studies, but the normalization of study variables was obtained in considerable less time for the same weight gain. CONCLUSIONS: The main finding of this study was that, after refeeding with only a 10% weight gain, the PEM children normalized their leptin, IGF-I, and IGFBP-3 levels. These results provide evidence that leptin can function as link between this hormonal response and improved nutrition status.

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Post-iontophoresis recovery of human skin impedance in vivo.

The objective of this study was to better understand the recovery of human skin impedance following iontophoresis in vivo. Volunteers were subjected to a 15-min period of iontophoresis in the presence of aqueous solutions of either NaCl, KCl, CaCl(2) or MgCl(2) at 133 mM. Subsequently, the low-frequency impedance (at 1 Hz) recovery was followed for a further 30 min. Assuming direct proportionality between the reciprocal impedance and the ion concentration in the membrane, the experimental data were fitted to the appropriate solutions of Fick's second law of diffusion to derive characteristic diffusion parameters (D/L(2)), apparent diffusivities (D), diffusion pathlengths (L) and mobilities, and ion concentrations in the skin immediately post-iontophoresis. Ion fluxes out of the membrane after termination of current flow were also deduced. In general, recovery was relatively independent of the background electrolyte as previously reported, and the data were consistent with ion transport in predominantly aqueous pathways. Compared to its mobility in aqueous solution, however, the apparent Cl- mobility in the skin was smaller, presumably due to the fact that, under normal physiological conditions, the human skin barrier supports a net negative charge. In parallel, the initial "release" of Na+ and K+ from the skin post-iontophoresis was faster than that of Ca(2+) and Mg(2+), the latter cations of higher charge density being able to associate more strongly, it seems, with the negatively-charged skin. The simple physicochemical analysis of the data presented serves to emphasize that a decrease in skin impedance is not a manifestation of damage to the barrier--rather, it is a natural response to the relevant electrical potential and ion concentration gradients involved.

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