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BMC Endocrine Disorders Nov 2022Ovarian steroid cell tumors (SCTs), not otherwise specified (NOS), are rare, with few large studies. The purpose of this study was to analyze the clinical features,... (Review)
Review
BACKGROUND
Ovarian steroid cell tumors (SCTs), not otherwise specified (NOS), are rare, with few large studies. The purpose of this study was to analyze the clinical features, prognosis, and treatment choices for these patients of different age groups.
METHODS
This was a retrospective study. We identified nine cases of ovarian steroid cell tumor, not otherwise specified, confirmed by post-operative histopathological examination, and analyzed clinical features, surgical procedures, and follow up outcomes. We also reviewed cases reports of ovarian steroid cell tumors, not otherwise specified.
RESULTS
A total of nine cases were included. The age range was 9-68 years (mean, 41.89 ± 19.72 years). Clinical features included virilization, amenorrhea, abdominal pain, vaginal bleeding, isosexual precocious puberty, Cushing's syndrome, and abnormal weight gain with elevated testosterone levels. The follow up interval ranged 5-53 months and no recurrence was observed.
CONCLUSION
Ovarian steroid cell tumors covered all age groups, with manifestations of androgen excess. Younger patients appeared to have a more favorable prognosis, which provided more opportunities for these patients to pursue treatment options that will preserve reproductive function.
Topics: Female; Humans; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Retrospective Studies; Sex Cord-Gonadal Stromal Tumors; Ovarian Neoplasms; Virilism; Steroids
PubMed: 36316664
DOI: 10.1186/s12902-022-01170-9 -
Social Science & Medicine (1982) Jul 2022Existing studies have examined how economic and cultural factors affect individuals selling organs and human tissues. But how social interactions and community...
Existing studies have examined how economic and cultural factors affect individuals selling organs and human tissues. But how social interactions and community relationships shape individuals' decisions and experiences has received much less attention. This research focuses on the intersection between economic disparities and gendered lineage structures to explain why and how people engage in bodily commodification. Drawing on oral history interviews with 32 former plasma sellers in central rural China, I find that villagers entered collection stations in two ways: 1) individual recruitment through which migrant men and married women on the margin of local lineage hierarchies in richer villages sold plasma as individuals and 2) familial recruitment through which multiple men of dominant lineage groups in poorer villages sold plasma in groups. While individual sellers struggled with self-blame and shame, familial sellers were shielded from gendered stigma as their communities adapted lineage rules to align plasma sale with masculinity. The results highlight the utility of a relational framework of gender in highlighting commodification as a dynamic social process shaped by participants' power locations in relation to not only each other but also the local patriarchal order.
Topics: China; Commerce; Female; Humans; Male; Masculinity; Rural Population; Social Stigma
PubMed: 35636053
DOI: 10.1016/j.socscimed.2022.115067 -
Qualitative Health Research Aug 2022Deleterious effects of separation and divorce on men's mental health are well-documented; however, little is known about their help-seeking when adjusting to these...
Deleterious effects of separation and divorce on men's mental health are well-documented; however, little is known about their help-seeking when adjusting to these all-too-common life transitions. Employing interpretive descriptive methods, interviews with 47 men exploring their mental health help-seeking after a relationship break-up were analyzed in deriving three themes: (1) Solitary work and tapping established connections, (2) Reaching out to make new connections, and (3) Engaging professional mental health care. Men relying on solitary work and established connections accessed relationship-focused self-help books, online resources, and confided in friends and/or family. Some participants supplemented solitary work by reaching out to make new connections including peer-based men's groups and education and social activities. Comprising first-time, returning, and continuing users, many men responded to relationship break-up crises by engaging professional mental health care. The findings challenge longstanding commentaries that men actively avoid mental health promotion by illuminating wide-ranging help resources.
Topics: Humans; Male; Masculinity; Men; Men's Health; Mental Health; Sexual Partners
PubMed: 35758178
DOI: 10.1177/10497323221110974 -
Journal of Investigative Medicine High... 2022Androgen-producing steroid cell ovarian tumors are rare, comprising less than 1% of ovarian neoplasms, and can present with infertility and rapid virilization. Here we...
Androgen-producing steroid cell ovarian tumors are rare, comprising less than 1% of ovarian neoplasms, and can present with infertility and rapid virilization. Here we discuss the case of a 28-year-old woman who presented with an unusually insidious 2-year history of infertility, hirsutism, and clitoromegaly who was found to have an elevated serum testosterone and a left ovarian mass. She underwent oophorectomy and pathology revealed a steroid cell tumor, not otherwise specified (NOS), with no malignant features. Following surgery, the patient's hyperandrogenic symptoms resolved with normalization of testosterone within 6 months, and she was able to conceive spontaneously. In reproductive-aged women with progressive hyperandrogenic symptoms, androgen-producing tumors, including those of ovarian origin, should be suspected. Thorough investigation, including plasma hormone levels and tumor histology, can lead to accurate diagnosis and management. Treatment should be guided by histology and surgical staging, with consideration for future fertility desires. Women who have not completed childbearing can undergo unilateral oophorectomy or tumor resection for benign tumors, with close monitoring of sex hormone levels postoperatively.
Topics: Adult; Androgens; Female; Humans; Infertility; Ovarian Neoplasms; Sex Cord-Gonadal Stromal Tumors; Testosterone; Virilism
PubMed: 35596563
DOI: 10.1177/23247096211056494 -
Journal of Health, Population, and... Aug 2022In Bangladesh, men's sexual and reproductive health (SRH) needs and related services are often neglected. Little is known of men's SRH concerns, and of the phenomenal...
BACKGROUND
In Bangladesh, men's sexual and reproductive health (SRH) needs and related services are often neglected. Little is known of men's SRH concerns, and of the phenomenal growth of the informal and private health actors in the provision of sexual health services to men in rural and urban areas of Bangladesh.
METHODS
Using a mixed methods approach, a survey of 311 married men in three rural and urban sites was conducted in three different districts of Bangladesh and 60 in-depth interviews were conducted to understand their SRH concerns and choice of providers to seek treatment.
RESULTS
The research findings reveal that- men's various SRH concerns are embedded in psychosocial and cultural concerns about their masculinity and expectations of themselves as sexual beings, with worries about performance, loss of semen and virility being dominant concerns. Sexually transmitted infections (STIs) were also mentioned as a concern but ranked much lower. Informal providers such as village doctors (rural medical practitioners and palli chikitsoks), drug store salespeople, homeopaths, traditional healers (Ojha/pir/fakir, kabiraj, totka) and street sellers of medicines are popular, accessible and dominate the supply chain.
CONCLUSION
There is a need of appropriate interventions to address men's anxieties and worries about their sexual abilities, well-being and choice of providers. This would go a long way to address and alleviate concerns, as well as identify and push men to seek formal care for asymptomatic STIs, and thereby reduce costs incurred and gender tensions in households.
Topics: Bangladesh; Humans; Male; Patient Acceptance of Health Care; Reproductive Health; Sexual Behavior; Sexually Transmitted Diseases
PubMed: 36042467
DOI: 10.1186/s41043-022-00313-x -
Social Science & Medicine (1982) Aug 2020In our field sites and clinical practice in East Africa, we regularly encounter men who have become overwhelmed by "thinking too many thoughts" and "gone crazy from...
In our field sites and clinical practice in East Africa, we regularly encounter men who have become overwhelmed by "thinking too many thoughts" and "gone crazy from confusion," brought about by the problems of life created by deepening social, economic and political precarity. Across diverse settings, many African men continue to be enmeshed in social and material obligations and expectations that position them as economic consumers and providers for those they care for and love. When these gendered obligations, expectations and fantasies are left unfulfilled, this sense of failure can be embodied to produce particular kinds of health effects. Namely, men may become plagued by troublesome and confusing thoughts, leading them in some cases to "give up on" (as our research subjects put it) pursuing work and education, to become immersed in problematic drug and alcohol use, and even to take their own lives. While these afflictions can be glossed using the language of depression, anxiety, addiction and suicide, such medicalizing frames may obscure more nuanced social, structural and affective diagnoses of what is happening to men across Africa and globally. Anthropology provides us with alternative frames through which to understand how psychological wounds are made-and healed.
Topics: Africa; Africa, Eastern; Humans; Male; Masculinity; Suicide
PubMed: 32540514
DOI: 10.1016/j.socscimed.2020.113097 -
Social Science & Medicine (1982) Feb 2021Globally, the prevalence of tuberculosis (TB) disease is significantly higher among men compared to women. This is compounded by men's poorer uptake of TB testing and...
RATIONALE
Globally, the prevalence of tuberculosis (TB) disease is significantly higher among men compared to women. This is compounded by men's poorer uptake of TB testing and treatment, and worse outcomes for smear conversion and successful treatment completion compared to women; in South Africa specifically, TB accounts for a large portion of sex-specific life expectancy differences.
OBJECTIVE
To understand men's unique barriers to accessing care and their needs while engaged in TB treatment, we conducted a qualitative study with men currently in or who recently completed TB treatment to understand how social norms for masculinity influence resource access and health behaviors, and in turn affect their engagement in care.
METHODS
We interviewed 31 men using a semi-structured protocol, with domains including: social network composition and support; TB illness; and testing, treatment, and clinical care experiences. Interviews were analyzed using a constant comparison approach to identify resources and how these are exchanged within men's social networks for TB care.
RESULTS
We found that men's prioritizing of work ensured food security and maintenance of masculinity norms, but delayed seeking and engagement in care. Once in treatment, men found it difficult both to negotiate clinic hours and work schedules and to navigate clinic environments without being labeled as weak. To mitigate individual resource gaps and losses, men typically accessed women family members who provided key resources (e.g., food, money, and emotional encouragement). Masculine identification with fatherhood was a key motivator to remain engaged in TB care and treatment. Loss from care was facilitated by isolation and limited access to social network resources.
CONCLUSION
To improve men's engagement in care and successful treatment outcomes, interventions that leverage their social networks and build upon existing resources should be strongly considered.
Topics: Female; Humans; Male; Masculinity; Men; Men's Health; Retention in Care; South Africa; Tuberculosis
PubMed: 33493956
DOI: 10.1016/j.socscimed.2020.113639 -
Social Science & Medicine (1982) Sep 2023Loneliness has been extensively linked to negative physical and mental health outcomes. Often defined as a subjective emotion, the influence of sex and gender has...
Loneliness has been extensively linked to negative physical and mental health outcomes. Often defined as a subjective emotion, the influence of sex and gender has regularly been cited as vital to understanding individuals' experiences. Despite this, little research has explored men's perspectives of loneliness using interpretivist approaches. This study addresses this by exploring how gender influences men's constructions and experiences of loneliness in an interview study with a diverse sample of 20 UK-based men. Theoretical thematic analysis led to the generation of a novel conceptualisation of loneliness comprising four interconnected themes: socially negotiated self-worth (an intersubjectively defined mental state); being positively occupied (a mental state of meaningful focus/action); social connections (vital for consistently achieving these mental states); and capacity to form social connections. A second 'layer' in the findings describes how cultural norms of masculinity impacted loneliness defined in this way. Notions of invulnerability and social comparison could render it more difficult for men to form intimate and supportive connections or seek help for loneliness. However, as they were normative, they could also promote self-worth, and facilitate social connections, despite these negative effects. Similarly, masculine roles, in particular family roles, represented a normative framework for preventing loneliness, and could be both beneficial or problematic depending on other aspects of life, identity, or needs. The study offers insight into how men negotiate loneliness within a habitus incorporating multiple and varied gendered norms, values, and structures. Policy and practice interventions could usefully consider and mitigate the risks posed by non-conformity, aim to promote mental states of self-worth and positive occupation, and work to deconstruct masculine norms and values where appropriate.
Topics: Male; Humans; Loneliness; Men; Masculinity; Qualitative Research; United Kingdom; Men's Health
PubMed: 37531906
DOI: 10.1016/j.socscimed.2023.116129 -
Revista Da Associacao Medica Brasileira... 2022In this study, the hormone profile, lipid profile, and inflammatory parameters of patients with polycystic ovary syndrome were compared with those of non-polycystic...
OBJECTIVE
In this study, the hormone profile, lipid profile, and inflammatory parameters of patients with polycystic ovary syndrome were compared with those of non-polycystic ovary syndrome patients to determine predictive markers in young polycystic ovary syndrome patients who have not yet had children.
METHODS
Patients' age, height, weight, body mass index, waist circumference, degree of hirsutism, and ultrasound findings were recorded. Hormone profile, lipid levels, ratio of complete blood count parameters, monocyte/high-density lipoprotein ratio, and total cholesterol/high-density lipoprotein ratio were compared between groups.
RESULTS
No statistically significant differences were found between groups in terms of age, weight, waist circumference, body mass index, and dysmenorrhea (p>0.05). A significant relationship was found between the height and the degree of hirsutism in the groups (p<0.05). It was found that prolactin, total testosterone, and dehydroepiandrosterone sulfate levels were statistically significantly higher in the polycystic ovary syndrome group compared to the control group. The polycystic ovary syndrome group had hemoglobin, leukocytes, lymphocytes, neutrophils, platelets, and statistically higher ratios of total cholesterol/high-density lipoprotein, Low-density lipoprotein/high-density lipoprotein, and triglycerides/high-density lipoprotein. No statistically significant relationships were found between homeostatic model assessment insulin resistance, neutrophil-to-lymphocyte ratio, and monocyte-to-high-density lipoprotein ratio between the groups (p<0.05). There was no significant difference in systemic immune inflammation index values between the groups.
CONCLUSION
Polycystic ovary syndrome patients are at risk for short- and long-term complications, and the use of the total cholesterol/high-density lipoprotein, Low-density lipoprotein/high-density lipoprotein, and triglycerides/high-density lipoprotein ratios in clinical practice during the follow-up of these patients may allow easy follow-up for patients. The health status of polycystic ovary syndrome patients can be objectively determined by tracking these outcomes at regular intervals.
Topics: Child; Female; Humans; Lipoproteins, HDL; Hirsutism; Polycystic Ovary Syndrome; Lipoproteins, LDL; Triglycerides; Testosterone; Cholesterol
PubMed: 36449764
DOI: 10.1590/1806-9282.20220854 -
Epigenetics Dec 2023Research suggests that polycystic ovary syndrome (PCOS) traits (e.g., hyperandrogenism) may create a suboptimal intrauterine environment and induce epigenetic...
Research suggests that polycystic ovary syndrome (PCOS) traits (e.g., hyperandrogenism) may create a suboptimal intrauterine environment and induce epigenetic modifications. Therefore, we assessed the associations of PCOS traits with neonatal DNA methylation (DNAm) using two independent cohorts. DNAm was measured in both cohorts using the Infinium MethylationEPIC array. Multivariable robust linear regression was used to determine associations of maternal PCOS exposure or preconception testosterone with methylation β-values at each CpG probe and corrected for multiple testing by false-discovery rate (FDR). In the birth cohort, 12% (102/849) had a PCOS diagnosis (8.1% PCOS without hirsutism; 3.9% PCOS with hirsutism). Infants exposed to maternal PCOS with hirsutism compared to no PCOS had differential DNAm at cg02372539 [β(SE): -0.080 (0.010); FDR = 0.009], cg08471713 [β(SE):0.077 (0.014); FDR = 0.016] and cg17897916 [β(SE):0.050 (0.009); FDR = 0.009] with adjustment for maternal characteristics including pre-pregnancy BMI. PCOS with hirsutism was also associated with 8 differentially methylated regions (DMRs). PCOS without hirsutism was not associated with individual CpGs. In an independent preconception cohort, total testosterone concentrations were associated with 3 DMRs but not with individual CpGs, though the top quartile of testosterone compared to the lowest was marginally associated with increased DNAm at cg21472377 near an uncharacterized locus (FDR = 0.09). Examination of these probes and DMRs indicate they may be under foetal genetic control. Overall, we found several associations among newborns exposed to PCOS, specifically when hirsutism was reported, and among newborns of women with relatively higher testosterone around conception.
Topics: Pregnancy; Infant; Humans; Infant, Newborn; Female; Polycystic Ovary Syndrome; Hirsutism; DNA Methylation; Hyperandrogenism; Testosterone
PubMed: 37992405
DOI: 10.1080/15592294.2023.2282319