Using changes in life satisfaction and health to predict the survival status among older men and women in Taiwan.

This study used a subjective measure of quality of life, life satisfaction, to predict survival. Time-varying measures were introduced and comparisons were made across gender to test whether the patterns of associations would differ across gender. Results showed that, among female elders, life satisfaction was a significant predictor of survival over a 12-year period, after objective health was controlled for. Findings seem to support that subjective perceptions of well-being are not simply reflections of objective life conditions. As an indicator of subjective well-being, life satisfaction was as important as objective health in predicting survival among older women.

Gender differences in the association between stress trajectories and depressive symptoms among middle aged and older adults in Taiwan.

PURPOSE: This study investigated the effects of gender differences on the association of chronic stress and depressive symptoms in middle-aged and older adults in Taiwan. METHODS: The population base was of adults aged 50 and older in Taiwan. This study included 2,889 participants and examined the gender differences on the impacts of life stress that exhibited depressive symptoms. RESULTS: Females were more susceptible to depressive symptoms when they felt constant stress from finances, increasing stress from jobs, and fluctuating stress from family relationships. DISCUSSION: Gender differences were evident when assuming social roles, as were psychological susceptibilities.

Menstrual abnormalities in a woman with ACTH-dependent pituitary macroadenoma mimicking polycystic ovary syndrome.

OBJECTIVE: Here, we present a case of ACTH-dependent pituitary macroadenoma (Cushing's disease) resulting in secondary amenorrhea mimicking polycystic ovary syndrome (PCOS). CASE REPORT: A 20-year-old nulligravid woman had been suffering from oligomenorrhea, amenorrhea, and moderate hirsutism since the age of 18 years. She visited a gynecologic clinic where PCOS was impressed according to the clinical manifestation and ultrasound finding. The patient responded to medication in the 1st year, but gradually failed to induce menses. She was advised to visit the endocrinology department for secondary amenorrhea and endocrine survey. Physical examination revealed central obesity, supraclavicle fatpad, abdominal striae, and myopathy of four limbs. Endocrine studies revealed: serum prolactin 21 ng/mL (3.0-20 ng/mL), FSH 5.69 mIU/mL (3.4-10.0 mIU/mL), LH 1.01 mIU/mL (1.1-11.6 mIU/mL), E2 < 20 pg/mL (follicular phase 53-258 pg/mL), ACTH 110 pg/mL (0-46.0 pg/mL), cortisol 26.7 microg/dL at 8 a.m. (5.0-25 microg/dL), cortisol 21.3 microg/dL at 11 p.m. (half of normal morning value). Right pituitary macroadenoma was diagnosed through a series of dexamethasone tests and MRI. The patient received staging surgery including transsphenoidal adenomectomy and right frontotemporal craniotomy. As a result, the patient's physical condition gradually improved, and her menstrual cycle became regular with medication after the operation in the outpatient follow-up. CONCLUSION: PCOS is a common disease resulting in secondary amenorrhea. However, Cushing's syndrome resulting from pituitary macroadenoma should also be considered. Therefore, a careful history, observation, physical examination, and endocrine studies can differentiate between patients with PCOS and Cushing's disease.