Gender differences in the relationship between social support and strain and mortality among a national sample of adults.

We assessed gender differences in the relationship between mortality and social support, strain, and affectual solidarity received from family, friends and spouses. Data of 6259 adults from the Midlife Development in the United States (MIDUS) survey were analyzed. Cox proportional hazards were used to assess relationships between mortality and support, strain, and affectual solidarity and whether the associations varied by gender. Support from family, friends, and spouses/partners and friend affectual solidarity were associated with lower mortality in the total sample. Friend strain was associated with higher mortality in the total sample. Family support and family, friend, and spouse affectual solidarity were associated with lower mortality in women. Friend and spouse strain were associated with a higher mortality for women. Support from friends, family and spouse are beneficial for reducing mortality in men and women. Friend and spouse strain are targets for minimizing mortality risk in women.

A Rare Case of Precocious Puberty Secondary to an LH-secreting Pituitary Adenoma.

An 8-year, 7-month-old male presented with puberty symptoms, including a 1.5-year history of facial hair with 9 months of phallic growth, body odor, and acne. Physical examination revealed phallic enlargement but only 4 mL testes bilaterally. Laboratory evaluation revealed markedly elevated LH and testosterone, but a prepubertal FSH level and minimally elevated adrenal androgens. A magnetic resonance imaging scan of the head revealed an anterior pituitary adenoma, and after the patient failed to respond to leuprolide, he was initiated on spironolactone and anastrozole to minimize pubertal progression before transsphenoidal adenomectomy. Postoperatively, the patient had rapid reduction of LH and testosterone, with subsequent cessation of pubertal progression, confirming the diagnosis of an LH-secreting pituitary adenoma despite negative immunoreactivity for LH and FSH. Functioning gonadotroph adenomas are rare and have been documented only in small case series and case reports. When active, these most commonly secrete FSH or co-secrete FSH and LH, and only very rarely result in precocious puberty. Here, we describe a rare case of an isolated LH-secreting functioning gonadotroph adenoma resulting in precocious puberty. This case reinforces the need to critically analyze departures from the typical pubertal sequence and to expand one's differential to include etiologies that can cause unbalanced secretion of gonadotropins.