Nicola Pende (1880-1970) and his "big lazy children". Parable of a clinical syndrome.

In the first half of the twentieth century, more than a million young Italians were found affected by a new disease: the Pende's hyperthymic syndrome. Nicola Pende was the renowned clinician who wrote the first great Italian treatise of endocrinology and who later founded the "sciences" of biotypology and orthogenesis. The paper tells the parable of the syndrome, the story of big lazy children and their fate in radiation therapy for the greater glory of Roman Italic race.

Terapia de privación de andrógenos y obesidad mórbida: ¿tienen en común el riesgo cardiovascular por síndrome metabólico? / Androgen Deprivation Therapy And Morbid Obesity: Do They Share Cardiovascular Risk Through Metabolic Syndrome?

Antecedentes: A pesar de que el uso de la terapia de privación de andrógenos (TPA) ha producido una mejora en la supervivencia de hombres con cáncer de próstata avanzado, el hipogonadismo resultante se asocia con efectos negativos acusados, comparables a los que se observan en la obesidad mórbida, estando el riesgo cardiovascular entre los más letales. Objetivos: Evaluar el síndrome metabólico, las anomalías metabólicas y el riesgo cardiovascular en pacientes con cáncer de próstata sometidos a TPA, sin TPA y con obesidad mórbida. Métodos: Se trata de un estudio transversal que incluye a 79 hombres con cáncer de próstata, de los cuales 54 están sometidos a TPA y en 25 está ausente esta terapia, incluyéndose también a 91 pacientes con obesidad mórbida agrupados por sexo y edad. Para definir el síndrome metabólico empleamos los criterios de la Federación Internacional de Diabetes (FID). Se compararonl as anomalías metabólicas, los marcadores metabólicos y la puntuación Framingham entre los pacientes en terapia TPA, sin terapia TPA y con obesidad mórbida con el fin de predecir el riesgo de enfermedad coronaria a 10 años. Resultados: Los pacientes en terapia TPA presentaron una incidencia mucho mayor de diabetes y obesidad centralizada, así como mayores niveles de colesterol total y lipoproteínas de baja densidad (LBD), en comparación con los varones eugonadales. El riesgo cardiovascular medio fue significativamente superior en pacientes sometidos a TPA (39,97±12,53% vs. 26,09±14,80%; p = 0,021). Los sujetos con obesidad mórbida tenían un mayor riesgo de enfermedad coronaria a 10 años, comparable a la de los pacientes sometidos a TPA (p = 0,054). Conclusión: Este estudio apunta a que en los pacientes sometidos a TPA la preponderancia de anomalías metabólicas y riesgos cardiovasculares es mayor, siendo similar a la observada en sujetos con obesidad mórbida. Es posible que ambos procesos tengan en común el riesgo cardiovascular por vía de síndrome metabólico (AU)

Background: Although the use of androgen deprivation therapy (ADT) has resulted in improved survival in men with advanced prostate cancer, the resulting hypogonadism is associated with profound adverse effects comparable to those found in morbid obesity, being cardiovascular risk among the most lethal. Objectives: Evaluate metabolic syndrome, metabolic abnormalities and cardiovascular risk in patients with prostate cancer under ADT, not under ADT and morbid obese men. Methods: This is a cross-sectional study that involves 79 men presenting prostate cancer, of whom 54 under ADT and 25 not under ADT and 91 morbidly obese patients paired by sex and age. To define metabolic syndrome, we used the International Diabetes Federation (IDF) criteria. Metabolic abnormalities, metabolic markers and Framingham score to predict the ten year coronary heart disease risk were compared among patients under ADT, not under ADT and morbid obese. Results: Patients under ADT presented significantly greater occurrence of diabetes and central obesity and higher levels of total cholesterol and low density lipoprotein (LDL) compared to eugonadal men. The mean cardiovascular risk was significantly higher in patients under ADT (39.97±12.53% vs. 26.09±14.80%; p = 0.021). Morbidly obese subjects had increased ten year coronary heart disease risk; comparable to patients under ADT (p = 0.054). Conclusion: This study suggests that patients under ADT show higher prevalence of metabolic abnormalities and cardiovascular risk similar to those found in morbidly obese subjects. It is possible that both processes share cardiovascular risk through metabolic syndrome (AU)

[A brief history of testosterone]. / Eine kurze Geschichte des Testosterons.

The history of testosterone is closely connected with the application of aphrodisiacs, research on sexual differentiation, and several therapies for rejuvenation around the year 1900. Chemical isolation and synthesis of androgens was achieved between 1931 and 1935 and only since then has clinically effective substitution therapy with testosterone for hypogonadism been available.

[Giantism. A historical and medical view]. / Reuzengroei. Een historische en medische beschouwing.

Patients with giantism were displayed as curiosities to large audiences in the past. The (medical) histories of famous giants like Daniel Cajanus (born in 1702 or 1703, Finland), Charles Byrne (1761, Ireland), Edouard Beaupré (1881, Canada) and Robert Wadlow (1918, Illinois, USA) are well described in the international medical literature. Extensive data from the entertainment world and/or medical data exist on famous Dutch giants like Klaas van Kyeten (end of 13th century), Gerrit Bastiaansz. de Hals (1620), Albert Johan Kramer (1897) and Rigardus Rijnhout (1922). Famous Dutch giantesses are Trijntje Kornelisse Keever (1614) and Kaatje van Dijk (1904). In most giants, excessive growth was caused by a somatotroph pituitary adenoma, sometimes in combination with hypogonadotrophic hypogonadism. In the western world, it is unlikely that there will be many more people with fully developed giantism due to the current high level of medical care.

Congenital eunuchism and Favorinus.

Ancient Hebrew literature as well as the New Testament differentiate between castrated eunuchs and congenital eunuchs. Congenital eunuchism is very rare today, and assuming that this was also the case in classical times, we investigated possible reasons why congenital eunuchs feature prominently. We discuss the probability that the concept 'congenital eunuchism' might in ancient times have included effeminate men who, according to cultural views on 'maleness' and androgyny, were almost equated with eunuchs. The causes of congenital hypogonadism are reviewed in order to attempt clarification of the condition of Favorinus, a congenital eunuch in the second century AD. We suggest that although he might have been a true hermaphrodite, as suggested by some authors, it is more likely that he had one of the following conditions: functional prepubertal castrate syndrome, testicular gonadotrophin insensitivity, selective gonadotrophin deficiency or Reifenstein's syndrome.