Introduction Morbidity/mortality is higher in men with below-normal serum testosterone. Restoring testosterone to normal is beneficial. Aim Assessment of safety and effectiveness of injectable long-acting testosterone undecanoate (TU) in hypogonadal men in daily clinical practice. Methods An international, multicenter, one-arm, prospective observational study in 23 countries. Main Outcome Measures Parameters of erectile function, libido, vigor/vitality, mood, and ability to concentrate assessed by physician interview using items and five-point Likert scales. Physical and circulatory parameters as well as hematocrit, prostate-specific antigen (PSA) levels, glucose control, and lipid profiles. IPASS An International, multicenter, Post-Authorisation (after authorized use in respective country) Surveillance Study on long-acting-intramuscular TU conducted at 155 centers in 23 countries in Europe, Asia, Latin America, and Australia. Patients received up to five TU injections during 9–12 months. Results Of the 1,493 hypogonadal men enrolled, 1,438 (aged 49.2 ± 13.9 years) having received 6,333 injections were analyzed. Scores of mental and psychosexual functions (libido, vigor, overall mood, and ability to concentrate) improved markedly, while mean waist circumference decreased from 100 to 96 cm. Blood pressure and lipid parameters were altered in a favorable and significant manner. After four TU injection intervals, the percentage of patients with “low” or “very low” levels of sexual desire/libido decreased from 64% at baseline to 10%; moderate, severe, or extremely severe erectile dysfunction decreased from 67% to 19%. At the last observation, 89% of patients were “satisfied” or “very satisfied” with TU therapy. Adverse events and adverse drug reactions (ADRs) occurred in 12% and 6% of patients, respectively, mostly mild to moderate. The most common ADRs were increase in hematocrit, increase in PSA, and injection site pain (all <1%). No case of prostate cancer was observed. Conclusion In this largest worldwide sample of hypogonadal men, injectable long-acting TU was effective and well tolerated.
The solvent acid‐base properties of AlCl3‐normalNaCl melts containing 50–70 mole per cent AlCl3 at temperatures of 175°–355°C are fully described by the use of three equilibrium constants 2AlCl3)(1=Al2Cl6)(1 Knormalo AlCl4−+AlCl3=Al2Cl7− K2 2AlCl4−=Al2Cl7−+Cl− KM At 175°C the K values on the mole fraction scale are 2.86×107,2.4×104,normaland 1.06×10−7 , respectively. The ΔH and ΔS values for each equilibrium were found to be temperature independent and calculated values for previously unreported formation constants for the liquid NaAlCl4 , NaAl2Cl7 , and Al2Cl6 species are reported. Emf data for the aluminum electrode AlCl4−+3e−=normalAl↓+4Cl− determined as a function of the mole per cent AlCl3, are used to evaluate the equilibrium constants. In the calculations it was necessary to use a variable AlCl4− activity coefficient when the mole per cent AlCl3 exceeded 50%. An experimental nondestructive in situ procedure for the determination of the exact composition and pCl of any melt is described. This procedure is essential when working in volatile melts.
There has traditionally been a widely held belief that testosterone is a risk factor for cardiovascular disease in men. This belief was based on the observation that men have both a higher incidence of cardiovascular events and higher testosterone levels than women of similar ages. However, few, if any, recent observations support a causal relation between higher testosterone levels and heart disease (1-3). On the contrary, several studies suggest that higher testosterone levels are associated with a more favourable risk effect on the risk of cardiovascular disease (4,5). Studies of testosterone therapy have not demonstrated an increased incidence of cardiovascular disease or events such as myocardial infarction, stroke or angina (6,7). Evidence that testosterone therapy may be beneficial for men with cardiac disease is becoming stronger (8,9). This paper will analyse the interrelationship between the metabolic syndrome, diabetes mellitus, cardiovascular disease, (visceral) obesity, erectile dysfunction (ED) and hypogonadism in (ageing) men. Until recently, they were viewed as more or less independent entities befalling the ageing male, if necessary, treated by various medical specialties. With a more integrative approach to the health situation of middle-aged and elderly men, these conditions appear closely interrelated in their manifestations, hypothetically in their aetiology, diagnostic strategy and also their treatment. This paper takes the position that (improving) sexual health is a portal to identify health hazards and improving men's health. Appropriate diagnosis and medical work up of men presenting with sexual symptoms may have the benefit of the diagnosing and treating other important conditions, such as obesity, diabetes, hypertension and hyperlipidaemia.OnlineOpen: This article is available free online at www.blackwell-synergy.com S U M M A R YAim: To identify the relationship of erectile dysfunction, hypogonadism and the metabolic syndrome in the context of men's health. Methods: An Expert Panel Meeting was held in December 2006 in Vienna, Austria. In addition a comprehensive literature search was conducted. Results: Men have a higher incidence of cardiovascular events than women of similar ages which has led to the belief that testosterone is a risk factor for cardiovascular disease in men. The latter hypothesis is no longer tenable. On the contrary, low testosterone levels are associated with (visceral) obesity, the metabolic syndrome, diabetes mellitus, cardiovascular disease and erectile dysfunction (ED). Testosterone therapy does not lead to an increased incidence of cardiovascular disease or events such as myocardial infarction, stroke or angina. Until recently (visceral) obesity, the metabolic syndrome, diabetes mellitus, cardiovascular disease and ED were viewed as more or less independent entities affecting the ageing male. It was not recognised that hypogonadism is a common denominator. With a more integrative approach to the health situation of middle-aged and elderly men, these conditi...
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