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Riccetto L, Vieira TP, Viguetti-Campos NL, Mazzola TN, Guaragna MS, Fabbri-Scallet H, de Mello MP, Marques-de-Faria AP, Maciel-Guerra AT, Guerra G. Clinical and laboratory differences between chromosomal and undefined causes of non-obstructive azoospermia: A retrospective study. SAO PAULO MED J 2022; 141:e2022281. [PMID: 36449967 PMCID: PMC10065101 DOI: 10.1590/1516-3180.2022.0281.r1.30082022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/30/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Knowledge of clinical and laboratory differences between chromosomal and undefined causes aids etiological research on non-obstructive azoospermia. OBJECTIVE Compare clinical and laboratory differences between men with non-obstructive azoospermia due to chromosomal anomalies versus undefined causes. DESIGN AND SETTING A cross-sectional retrospective study conducted at a public university hospital in Campinas (Brazil). METHODS All men aged 20-40 years with non-obstructive azoospermia were included in the analysis. RESULTS The 107 cases included 14 with Klinefelter syndrome (KS) (13%), 1 with mosaic KS, 4 with sex development disorders (2 testicular XX, 1 NR5A1 gene mutation, and 1 mild androgen insensitivity syndrome) (4%), 9 with other non-obstructive azoospermia etiologies (8%), and 79 with undefined causes. The 22 chromosomal anomaly cases (14 KS, 1 mosaic KS, 2 testicular XX, 4 sex chromosome anomalies, and 1 autosomal anomaly) were compared with the 79 undefined cause cases. The KS group had lower average testicular volume, shorter penile length, and lower total testosterone levels but greater height, arm span, serum luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, and gynecomastia frequency (absent in the undefined group and affecting more than half of the KS group). Patients with testicular XX DSD had LH, FSH, and penile length data intermediate between the KS and undefined cause groups, testicular volume similar to the KS group, and other data similar to the undefined group. CONCLUSION Clinical and laboratory data differentiate men with non-obstructive azoospermia and chromosomal anomalies, particularly KS and testicular XX, from those with undefined causes or other chromosomal anomalies.
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Affiliation(s)
- Luísa Riccetto
- Undergraduate Medicine Student, Pontifícia Universidade Católica de Campinas (PUCCAMP), Campinas (SP), Brazil; and Member, Grupo Interdisciplinar de Estudos da Determinação e Diferenciação do Sexo (GIEDDS), Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Tarsis Paiva Vieira
- PhD. Professor, Department of Translational Medicine, School of Medical Sciences, Laboratory of Human Cytogenetics, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Nilma Lucia Viguetti-Campos
- PhD. Laboratory Worker, Department of Medical Genetics Genomics, School of Medical Sciences, Laboratory of Cytogenetics, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Tais Nitsch Mazzola
- PhD. Laboratory Worker, Laboratory of Human Molecular Genetics, Center of Molecular Biology and Genetic Engineering, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Mara Sanches Guaragna
- PhD. Researcher, Laboratory Worker, Laboratory of Human Molecular Genetics, Center of Molecular Biology and Genetic Engineering, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Helena Fabbri-Scallet
- PhD Researcher, Laboratory Worker, Laboratory of Human Molecular Genetics, Center of Molecular Biology and Genetic Engineering, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Maricilda Palandi de Mello
- PhD. Professor, Laboratory of Human Molecular Genetics, Center of Molecular Biology and Genetic Engineering, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Antonia Paula Marques-de-Faria
- PhD. Professor, Department of Medical Genetics and Genomics Medicine, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP); and Member, Grupo Interdisciplinar de Estudos da Determinação e Diferenciação do Sexo (GIEDDS), Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Andrea Trevas Maciel-Guerra
- PhD. Professor, Department of Medical Genetics and Genomics Medicine, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP); and Member, Grupo Interdisciplinar de Estudos da Determinação e Diferenciação do Sexo (GIEDDS) Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Gil Guerra
- PhD. Professor, Department of Pediatrics, School of Medical Sciences Universidade Estadual de Campinas (UNICAMP); and Member, Grupo Interdisciplinar de Estudos da Determinação e Diferenciação do Sexo (GIEDDS), Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
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Dwyer AA, Héritier V, Llahana S, Edelman L, Papadakis GE, Vaucher L, Pitteloud N, Hauschild M. Navigating Disrupted Puberty: Development and Evaluation of a Mobile-Health Transition Passport for Klinefelter Syndrome. Front Endocrinol (Lausanne) 2022; 13:909830. [PMID: 35813640 PMCID: PMC9264386 DOI: 10.3389/fendo.2022.909830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
Klinefelter syndrome (KS) is the most common aneuploidy in men and has long-term sequelae on health and wellbeing. KS is a chronic, lifelong condition and adolescents/young adults (AYAs) with KS face challenges in transitioning from pediatric to adult-oriented services. Discontinuity of care contributes to poor outcomes for health and wellbeing and transition programs for KS are lacking. We aimed to develop and test a mobile health tool (KS Transition Passport) to educate patients about KS, encourage self-management and support successful transition to adult-oriented care. First, we conducted a retrospective chart review and patient survey to examine KS transition at a university hospital. Second, we conducted a systematic scoping review of the literature on AYAs with KS. Last, we developed a mobile health transition passport and evaluated it with patient support groups. Participants evaluated the tool using the System Usability Scale and Patient Education Materials Assessment Tool (PEMAT). Chart review identified 21 AYAs diagnosed between 3.9-16.8 years-old (median 10.2 years). The survey revealed only 4/10 (40%) were on testosterone therapy and fewer (3/10, 30%) had regular medical care. The scoping review identified 21 relevant articles highlighting key aspects of care for AYAs with KS. An interprofessional team developed the mobile-health KS transition passport using an iterative process. Support group members (n=35) rated passport usability as 'ok' to 'good' (70 ± 20, median 73.5/100). Of PEMAT dimensions, 5/6 were deemed 'high quality' (86-90/100) and participants knew what to do with the information (actionability = 83/100). In conclusion, many patients with KS appear to have gaps in transition to adult-oriented care. Iterative development of a KS transition passport produced a mobile health tool that was usable, understandable and had high ratings for actionability.
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Affiliation(s)
- Andrew A. Dwyer
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
- Endocrinology, Diabetes & Metabolism Service of the Department of Medicine, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Vanessa Héritier
- Pediatric Endocrinology, Diabetes and Obesity Unit, Department of Women-Mother-Child, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Sofia Llahana
- School of Health and Psychological Sciences, City University of London, London, United Kingdom
| | - Lauren Edelman
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
| | - Georgios E. Papadakis
- Endocrinology, Diabetes & Metabolism Service of the Department of Medicine, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Laurent Vaucher
- Reproductive Medicine Unit, Department of Obstetrics and Gynecology, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Nelly Pitteloud
- Endocrinology, Diabetes & Metabolism Service of the Department of Medicine, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Michael Hauschild
- Pediatric Endocrinology, Diabetes and Obesity Unit, Department of Women-Mother-Child, Lausanne University Hospital Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
- *Correspondence: Michael Hauschild,
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de Almeida-Neto PF, de Matos DG, Pinto VCM, Dantas PMS, Cesário TDM, da Silva LF, Bulhões-Correia A, Aidar FJ, Cabral BGDAT. Can the Neuromuscular Performance of Young Athletes Be Influenced by Hormone Levels and Different Stages of Puberty? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5637. [PMID: 32764284 PMCID: PMC7460253 DOI: 10.3390/ijerph17165637] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Endocrine mechanisms can be a determining factor in the neuromuscular performance of young athletes. OBJECTIVE The objective of the present study was to relate maturational and hormonal markers to neuromuscular performance, as well as to verify whether young athletes with different testosterone levels show differences in muscle strength. METHODS The sample consisted of 37 young male Brazilian athletes (11.3 ± 0.94 years) who were members of a sports initiation project. Hormonal markers were analyzed biochemically by blood samples, and maturation markers by mathematical models based on anthropometry. Body composition was verified by tetrapolar bioimpedance. The performance of upper and lower limb strength and body speed were analyzed. RESULTS Hormonal and maturational markers were related to neuromuscular performance (p < 0.05). Young people with higher testosterone levels showed higher muscle strength (p < 0.05). Artificial neural networks showed that testosterone predicted the performance of upper limbs by 49%, and maturation by 60%. Maturation foreshadowed the performance of lower limbs by 30.3%. CONCLUSION Biological maturation and hormonal levels can be related to neuromuscular performance, and young people with higher testosterone levels show superior muscle strength in relation to the others.
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Affiliation(s)
- Paulo Francisco de Almeida-Neto
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (V.C.M.P.); (P.M.S.D.); (T.d.M.C.); (L.F.d.S.); (A.B.-C.); (B.G.d.A.T.C.)
| | - Dihogo Gama de Matos
- Group of Studies and Research of Performance, Sport, Healt and Paralympic Sports GEPEPS, the Federal University of Sergipe—UFS, São Cristovão 49100-000, Brazil; (D.G.d.M.); (F.J.A.)
| | - Vanessa Carla Monteiro Pinto
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (V.C.M.P.); (P.M.S.D.); (T.d.M.C.); (L.F.d.S.); (A.B.-C.); (B.G.d.A.T.C.)
| | - Paulo Moreira Silva Dantas
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (V.C.M.P.); (P.M.S.D.); (T.d.M.C.); (L.F.d.S.); (A.B.-C.); (B.G.d.A.T.C.)
| | - Tatianny de Macêdo Cesário
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (V.C.M.P.); (P.M.S.D.); (T.d.M.C.); (L.F.d.S.); (A.B.-C.); (B.G.d.A.T.C.)
| | - Luíz Felipe da Silva
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (V.C.M.P.); (P.M.S.D.); (T.d.M.C.); (L.F.d.S.); (A.B.-C.); (B.G.d.A.T.C.)
| | - Alexandre Bulhões-Correia
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (V.C.M.P.); (P.M.S.D.); (T.d.M.C.); (L.F.d.S.); (A.B.-C.); (B.G.d.A.T.C.)
| | - Felipe José Aidar
- Group of Studies and Research of Performance, Sport, Healt and Paralympic Sports GEPEPS, the Federal University of Sergipe—UFS, São Cristovão 49100-000, Brazil; (D.G.d.M.); (F.J.A.)
- Department of Physical Education, Federal University of Sergipe—UFS, São Cristovão 49100-000, Brazil
- Graduate Program in Master’s Level at Department of Physical Education, Federal University of Sergipe—UFS, São Cristovão 49100-000, Brazil
- Program of Physiological Science, Federal University of Sergipe—UFS, São Cristovão 49100-000, Brazil
| | - Breno Guilherme de Araújo Tinôco Cabral
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil; (V.C.M.P.); (P.M.S.D.); (T.d.M.C.); (L.F.d.S.); (A.B.-C.); (B.G.d.A.T.C.)
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Gravholt CH, Tartaglia N, Disteche C. Sex chromosome aneuploidies in 2020-The state of care and research in the world. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2020; 184:197-201. [PMID: 32496026 PMCID: PMC7419158 DOI: 10.1002/ajmg.c.31808] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Claus H. Gravholt
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark
| | - Nicole Tartaglia
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
- Developmental Pediatrics, Children’s Hospital Colorado, Aurora, Colorado
| | - Christine Disteche
- Department of Pathology, University of Washington, Seattle, Washington
- Department of Medicine, University of Washington, Seattle, Washington
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Spaziani M, Radicioni AF. Metabolic and cardiovascular risk factors in Klinefelter syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2020; 184:334-343. [PMID: 32452627 DOI: 10.1002/ajmg.c.31792] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 12/12/2022]
Abstract
Klinefelter syndrome (KS), which normally presents with a 47,XXY karyotype, is the most common sex chromosome disorder in males. It is also the most common genetic cause of male infertility. KS subjects are typically tall, with small and firm testes, gynecomastia, broad hips, and sparse body hair, although a less evident presentation is also possible. KS is also characterized by a high prevalence of hypogonadism, metabolic syndrome (MetS) and cardiovascular disease. The aim of this article is to systematically review metabolic and the cardiovascular risk factors in KS patients. Hypogonadism has an important role in the pathogenesis of the changes in body composition (particularly visceral obesity) and hence of insulin resistance and MetS, but the association between KS and MetS may go beyond hypogonadism alone. From childhood, KS patients may show an increase in visceral fat with a reduction in lean body mass and an increase in glucose and impaired fat metabolism. Their increased incidence of congenital anomalies, epicardial adipose tissue, and thromboembolic disease suggests they have a higher risk of cardiovascular disease. There is conflicting evidence on the effects of testosterone therapy on body composition and metabolism.
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Affiliation(s)
- Matteo Spaziani
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy.,Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
| | - Antonio F Radicioni
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy.,Centre for Rare Diseases, Policlinico Umberto I, Rome, Italy
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Biological Maturation and Hormonal Markers, Relationship to Neuromotor Performance in Female Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093277. [PMID: 32397137 PMCID: PMC7246623 DOI: 10.3390/ijerph17093277] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/02/2020] [Accepted: 04/05/2020] [Indexed: 12/21/2022]
Abstract
Background: Mechanisms that influence muscle strength can interfere with neuromotor performance and overall health, thus hormone markers and maturation can interact in this process. Objective: The present study aimed to verify the relationship of hormonal markers and biological maturation on neuromotor abilities in young people. Methods: This is a cross-sectional study with 44 female participants (11.5 ± 1.5 years). Hormones were analyzed biochemically. Skeletal and somatic maturation were analyzed using anthropometry. The muscular power of the upper and lower limbs, body speed with change of direction, and speed of the upper limbs were verified. Results: Bone age was correlated with hormonal markers (estradiol: r = 0.58; p = 0.0007), (testosterone: r = 0.51; p = 0.005). Peak growth velocity correlated with estradiol (r = 0.51; p = 0.004). The power of the lower limbs (estradiol: r = 0.52; p = 0.006; testosterone: r = 0.42; p = 0.03) and of the upper limbs (estradiol: r = 0.51; p = 0.007; testosterone: r = 0.42; p = 0.02) had a positive correlation with hormone levels and had similar results with maturation. The analysis by artificial neural networks indicated that the maturation can predict the neuromotor performance between 57.4% and 76%, while the hormonal markers showed a potential of more than 95% for the foreshadowing of the neuromotor performance of the upper limbs. Conclusion: It was possible to conclude that the hormones had a relationship with maturational development and bone age in female subjects.
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