18 F-FDOPA PET/CT of Paraganglioma in the Spermatic Cord.

ABSTRACT: A 53-year-old man with chronic kidney failure was referred to perform an 18 F-FDOPA PET/CT to characterize a mass located on the right spermatic cord. Previously, the pathological analysis of CT-guided biopsies suggested paraganglioma or metastatic lesion of pheochromocytoma. Serum normetanephrine and serum metanephrine values were respectively 2- and 1.5-fold greater than the normal upper limit, which could be explained by the chronic kidney failure. PET/CT images revealed intense 18 F-FDOPA uptake of the mass without any other pathological findings, suggesting the diagnosis of paraganglioma. Pathological examination of surgical specimen confirmed the diagnosis of paraganglioma of the spermatic cord, which is exceptional.

Adrenalectomy for Pheochromocytoma: Complications and Predictive Factors of Intraoperative Hemodynamic Instability.

BACKGROUND: Surgery is the treatment of choice for pheochromocytoma. However, this surgery carries a risk of hemodynamic instability (HDI). The aim of this study was to report complications associated with this procedure, to identify risk factors for HDI during surgery, and its impact on postoperative outcomes. METHODS: The charts of all patients who underwent adrenalectomy for pheochromocytoma in two academic centers between 2006 and 2020 were retrospectively reviewed. The primary outcome was HDI defined by a systolic blood pressure >160 mmHg or a mean blood pressure <60 mmHg intraoperatively. The secondary outcomes of interest were the total duration of HDI, the occurrence of intraoperative arrhythmia, perioperative cardiovascular events, and postoperative complications. RESULTS: 205 patients were included. HDI occurred intraoperatively in 155 patients (75.6%) but only 6 (3.2%) experienced arrhythmia. Thirty-eight postoperative complications were reported (18.6%) but only nine were ≥3 according to Clavien-Dindo (4.4%). There were 10 postoperative cardiovascular events (5.7%). Patients with intraoperative HDI had higher rates of postoperative complications (21.3% vs 10%; P = .07), major postoperative complications (5.8% vs 0%; P = .12) and cardiovascular events (6.5% vs 0%; P = .12). Factors associated with intraoperative HDI in univariate analysis were age (OR = 8.14; P = .006), high blood pressure preoperatively (OR = 2.16; P = .04), tumor size (OR = 15.83; P = .0001), and urinary normetanephrine level (OR = 9.33; P = .04). DISCUSSION: In multidisciplinary centers, the overall morbidity of adrenalectomy for pheochromocytoma is low. HDI during adrenalectomy for pheochromocytoma is highly prevalent but rarely associated with major cardiovascular events. There might be a link between HDI and postoperative cardiovascular events.

[Side effects of longterm oral corticosteroid therapy]. / Effets indésirables de la corticothérapie orale au long cours.

Side effects of long-term oral corticosteroid therapy. Systemic corticosteroid therapy has been used for over 70 years, and is still the cornerstone of the treatment of many conditions, in particular systemic, autoimmune or inflammatory diseases. Side effects of corticosteroids are numerous, and for most of them well known by prescribers. Nonetheless, guidelines for the prevention of corticosteroids toxicity are scarce, and the implementation of protective measures by prescribers is heterogenous. Hence, corticosteroids related complications entail a significant morbidity, which, importantly, could be largely prevented. We conducted therefore a systematic literature, through the Medline database, the Cochrane database and the grey literature until January 2021. After recalling the history of the discovery of corticosteroid therapy and its main pharmacological properties, we present the various complications associated with long-term corticosteroid therapy, and discuss the relevance of the preventive measures that may be proposed in daily practice in the light of available scientific evidence. This work highlights the importance of multidisciplinary follow-up, but above all of a thorough screening of the risk factors of complications at treatment initiation, and of a repeated evaluation of the complications all along the treatment course, in order to reduce the significant burden of morbidity associated with long-term corticosteroid therapy and to improve patient quality of life.

Effets indésirables de la corticothérapie orale au long cours. La corticothérapie systémique est utilisée depuis plus de 70 ans et reste la pierre angulaire du traitement de nombreuses affections. Ses effets indésirables sont nombreux et, pour la plupart, bien connus. Pour autant, les recommandations concernant leur prévention sont parfois manquantes, et souvent hétérogènes, y compris dans leur mise en œuvre par les prescripteurs. De ce fait, les complications induites par la corticothérapie sont à l'origine d'une morbidité importante, la plupart du temps évitables. Nous avons donc réalisé une revue systématique de la littérature, à travers les bases Medline, Cochrane et la littérature grise, jusqu'à janvier 2021. Après avoir rappelé l'histoire de la découverte de la corticothérapie et ses principales caractéristiques pharmacologiques, nous présentons les différentes complications associées à une corticothérapie au long cours et les mesures de prévention disponibles, en discutant leur efficacité et leur pertinence à la lumière des recommandations actuelles ou, à défaut, des dernières données scientifiques disponibles. Ce travail met en évidence l'importance du suivi multidisciplinaire des patients traités par corticothérapie systémique au long cours, mais surtout celle d'un dépistage préalable des facteurs associés à la survenue de complications et de réévaluations répétées de ces complications sous traitement, afin de diminuer le poids très important de la morbidité qui y est associée et ainsi d'améliorer la qualité de vie des patients.

The Facial Width-to-Height Ratio Predicts Sex Drive, Sociosexuality, and Intended Infidelity.

Previous research has linked the facial width-to-height ratio (FWHR) to a host of psychological and behavioral characteristics, primarily in men. In two studies, we examined novel links between FWHR and sex drive. In Study 1, a sample of 145 undergraduate students revealed that FWHR positively predicted sex drive. There were no significant FWHR × sex interactions, suggesting that FWHR is linked to sexuality among both men and women. Study 2 replicated and extended these findings in a sample of 314 students collected from a different Canadian city, which again demonstrated links between the FWHR and sex drive (also in both men and women), as well as sociosexuality and intended infidelity (men only). Internal meta-analytic results confirm the link between FWHR and sex drive among both men and women. These results suggest that FWHR may be an important morphological index of human sexuality.

Preliminary evidence that testosterone's association with aggression depends on self-construal.

A contribution to a special issue on Hormones and Human Competition. Previous research and theory suggest testosterone is an important hormone for modulating aggression and self-regulation. We propose that self-construal, a culturally-relevant difference in how individuals define the self in relation to others, may be an important moderator of the relationship between testosterone and behaviors linked to aggression. Within two studies (Study 1 N=80; Study 2 N=237) and an integrated data analysis, we find evidence suggesting that acute testosterone changes in men are positively associated with aggressive behavior for those with more independent self-construals, whereas basal testosterone is negatively associated with aggression when individuals have more interdependent self-construals. Although preliminary, these findings suggest that self-construal moderates the association between testosterone and aggression, thereby paving the way toward future work examining the potential cultural moderation of the behavioral effects of testosterone.

Effects of exogenous testosterone and mating context on men's preferences for female facial femininity.

Correlational research suggests that men show greater attraction to feminine female faces when their testosterone (T) levels are high. Men's preferences for feminine faces also seem to vary as a function of relationship context (short versus long-term). However, the relationship between T and preferences for female facial femininity has yet to be tested experimentally. In the current paper, we report the results of two experiments examining the causal role of T in modulating preferences for facial femininity across both short and long-term mating contexts. Results of Experiment 1 (within-subject design, n=24) showed that participants significantly preferred feminized versus masculinized versions of women's faces. Further, participants showed a stronger preference for feminine faces in the short versus the long-term context after they received T, but not after they received placebo. Post-hoc analyses suggested that this effect was driven by a lower preference for feminine faces in the long-term context when on T relative to placebo, and this effect was found exclusively for men who received placebo on the first day of testing, and T on the second day of testing (i.e., Order x Drug x Mating context interaction). In Experiment 2 (between-subject design, n=93), men demonstrated a significant preference for feminized female faces in the short versus the long-term context after T, but not after placebo administration. Collectively, these findings provide the first causal evidence that T modulates men's preferences for facial femininity as a function of mating context.

Exogenous testosterone increases men's perceptions of their own physical dominance.

Men's testosterone is associated with several constructs that are linked to dominance rank, such as risk-taking, mating success, and aggression. However, no study has directly tested the relationship between men's self-perceived dominance and testosterone using an experimental design. We employed a within-subjects, double-blind, placebo-controlled paradigm to assess whether testosterone influences men's self-perceived dominance. Exogenous testosterone or a placebo was administered to healthy adult men and self-perceptions of physical dominance were subsequently assessed by having participants select what they believed to be their true face from an array of images digitally manipulated in masculinity. Men picked a more masculine version of their own face after testosterone versus placebo--an effect that was particularly pronounced among men with relatively low baseline testosterone. These findings indicate that a single administration of testosterone can rapidly modulate men's perceptions of their own physical dominance, which may explain links between testosterone and dominance-related behaviors.

Digit ratio (2D:4D) and psychopathic traits moderate the effect of exogenous testosterone on socio-cognitive processes in men.

Recent evidence suggests that testosterone is negatively correlated with empathic processes in both men and women. Also, administration of testosterone to young women impairs socio-cognitive performance as assessed using the "Reading the Mind in the Eyes Task", especially among those exposed to elevated testosterone concentrations prenatally. However, the extent to which testosterone plays a similar causal role in socio-cognitive abilities in men is currently unknown. Here, using a crossover, double-blind, placebo-controlled, within-subject design, we investigated the extent to which a single administration of testosterone to healthy young men (N=30) would impair socio-cognitive abilities assessed using the "Reading the Mind in the Eyes Task" (RMET). Also, we investigated whether individual differences in 2D:4D ratio and psychopathic traits would moderate the effect of testosterone on task performance. Results indicated that testosterone administration on its own did not impair RMET performance. However, variability in both 2D:4D ratio and psychopathic traits moderated the effect of testosterone on task performance. Specifically, testosterone impaired RMET performance among individuals with relatively low (i.e., masculinized) 2D:4D ratio and among individuals scoring relatively low on the interpersonal/affective facet (i.e., Factor 1) of psychopathy. Our findings highlight the importance of considering theoretically- and empirically-based individual difference factors when attempting to characterize the neuroendocrine mechanisms underlying socio-cognitive processes.