HPG function in men and women stratified by drug use and HIV status

Most studies of hypothalamic-pituitary-gonadal (HPG) function and depression in illicit drug users focus only on men or do not consider the impact of HIV infection along with drug use. This study investigated relationships between illicit drug use and HIV status with depressive symptoms and HPG function in both men and women. Illicit drug use and HIV status were differentially associated with HPG function and depressive symptoms in men and women. Specifically, free testosterone concentrations were lower in men who use drugs and in women who are HIV positive. Estradiol concentrations were marginally lower in women, but not in men, who are HIV positive. Women and drug users reported the most depressive symptoms; however, impaired HPG function was associated with increased depressive symptoms in men only. Neither HPG function nor depression was impacted in an additive or synergistic manner by both drug use and HIV in either sex. These data indicate that illicit drug use is associated with altered HPG function in men and HIV infection is associated with altered HPG function in women. Furthermore, altered HPG function was associated with depressive symptoms in men, but not in women. Sex specific natural histories of illicit drug use and HIV infection, as they relate to endocrine and mental health, suggest a potential role for sex specific treatments to ameliorate these problems. The present data support recommendations of The National Academy of Science to consider gender differences in medical research

46,XY DSD with Female or Ambiguous External Genitalia at Birth due to Androgen Insensitivity Syndrome, 5α-Reductase-2 Deficiency, or 17β-Hydroxysteroid Dehydrogenase Deficiency: A Review of Quality of Life Outcomes

Disorders of sex development refer to a collection of congenital conditions in which atypical development of chromosomal, gonadal, or anatomic sex occurs. Studies of 46,XY DSD have focused largely on gender identity, gender role, and sexual orientation. Few studies have focused on other domains, such as physical and mental health, that may contribute to a person's quality of life. The current review focuses on information published since 1955 pertaining to psychological well-being, cognition, general health, fertility, and sexual function in people affected by androgen insensitivity syndromes, 5-α reductase-2 deficiency, or 17β-hydroxysteroid dehydrogenase-3 deficiency—reared male or female. The complete form of androgen insensitivity syndrome has been the focus of the largest number of investigations in domains other than gender. Despite this, all of the conditions included in the current review are under-studied. Realms identified for further study include psychological well-being, cognitive abilities, general health, fertility, and sexual function. Such investigations would not only improve the quality of life for those affected by DSD but may also provide information for improving physical and mental health in the general population

"Sexual differentiation: From genes to gender"

Amy Wisniewski is Assistant Professor of Biology at Drake University, Des Moines, Iowa. She can be contacted at [email protected] person's sex can be considered across various levels. To illustrate, genes, hormones, and genitalia can all be considered physical markers of a person's sex. In addition to physical markers, behaviors such as gender role, gender identity and sexual orientation can be perceived as stereotypically male or female. The purpose of this review is to summarize current knowledge of sexual differentiation which emphasizes genetic and hormonal mechanisms that result in male and female development of gonads and genitalia. Finally, consideration is given to associations between genetic sex, gonadal sex, and hormonal sex with gender. Copyright 1998 S Karger AG

"Human sex differentiation: From transcription factors to gender"

Amy B. Wiesniewski is an Assistant Professor of Biology at Drake University, Des Moines, Iowa. She can be contacted at [email protected] the past decade, knowledge of the genetic control of human sex differentiation has greately expanded our understanding of the developmental processes needed to form a male or female. The purpose of this review is to discuss how transcription factors are relevant to such processes. Additionally, an attempt is made to relate current knowledge of these factors with gender development of subjects with intersex conditions. Finally, we discuss how information about the genetic control of sex differentiation may contribute to decisions about medical treatment of individuals with conditions of abnormal sex differentiation. Copyright (C) 2000 S. Karger AG, Basel.This work was supported by a grant from The Genentech Foundation for Growth and Development 98-33C to C.J.M., an NIH NRSA grant F32HD08544 to A.B.W. and an NIH, NCRR, GCRC grant RR00052. This work was originally presented as the 1999 Robert L. Ney Memorial Lecture at Johns Hopkins University by C.J.M

Mission Impossible? Putting the Patient Back in Patient Care

The primary focus of this teaching case is the patient journey, as facilitated and influenced by an e-system or electronic health record (EHR) system. The goal of this case is to provide the learner with the knowledge and skills needed to effectively incorporate patient-centered e-health (PCEH) principles into existing and planned e-health systems such as EHRs. This case can be used to help students understand a hospital experience from the perspective of a patient and her family. It is loosely based on an experience one of the authors had with an actual patient. This case is intended for use with upper level undergraduate and graduate health informatics, information systems, and nursing students. Students assigned to this case should have a working knowledge of clinical terms and the general workings of a hospital. This teaching case is best suited to an advanced course in a health informatics curriculum. Possible applications of the case include, but are not limited to, describing the patient journey, modeling the process flow, diagramming the data flow, and applying the principles of patient-centered e-health

"Evaluation of high-dose estrogen and high-dose estrogen plus methyltestosterone treatment on cognitive task performance in postmenopausal women"

Amy B. Wisniewski is an Assistant Professor of Biology at Drake University, Des Moines, Iowa. She can be contacted at [email protected]: To investigate the cognitive effects of high-dose oral estrogen alone or in combination with oral methyltestosterone in postmenopausal women. Methods: Participants were tested with a randomized, double-blind design on the Identical Pictures, Cube Comparisons, Building Memory and Shape Memory tasks before and after 4 months of hormone treatment. Results: Women receiving estrogen and methyltestosterone maintained a steady level of performance on the Building Memory task, whereas those receiving estrogen alone showed a decrease in performance. Conclusions: These results indicate that the addition of testosterone to high-dose estrogen replacement exerts a protective effect on memory performance in postmenopausal women. Copyright © 2002 S. Karger AG, Basel.Portions of this manuscript were presented at the 1999 Endocrine Society Meeting, San Diego, Calif., USA and the 1999 North American Menopause Society Meeting, New York, N.Y., USA This research was partially supported by the Johns Hopkins University School of Medicine General Clinical Research Center, NIH/NCRR grant M01 RR00052. This research was also funded in part by Solvay Pharmaceuticals, Inc., Marietta, Ga., USA