bluuebunny/crossref_metadata_2025_split huggingface dataset:
LBODP091 The Reasons For Loss To Follow-up Of Patients With Gender Dysphoria
Authors: Kadioglu Pinar , Uysal Ayten Cavus , Durcan Emre , Uysal Serhat , Sulu Cem , Turan Senol 
Published: November 2022

Abstract

Aim
To assess the effect of social function, motivation, support, and traumatic childhood experiences on follow-up behavior of patients with gender dysphoria (GD). Method: All the patients with GD who came to our clinic for endocrinological visit between September 2020 and July 2021 were asked to participate in this cross-sectional study. People with GD that provided consent were included in trans group. We also assigned age-matched cis-gender healthy controls. Data regarding gender transition process were collected retrospectively from medical charts. All the participants were administered Social Adaptation Self-evaluation Scale (SASS), Childhood Trauma Questionnaire (CTQ), and Multidimensional Scale of Perceived Social Support (MSPSS). The results were compared between groups.

Results
The study included 50 male-to-female with GD (MtF), 50 female-to-male with GD (FtM), 48 cis-females, 28 cis-males. The ratio of regular follow-up was higher in FtMs (n=48, 77.1%) than MtFs (n=39, 56.4%) (p&lt;0. 05). Among lost to follow-up patients with GD, MtFs (n=17, %64.7) had a higher suicide rate than FtMs (n=11, %9.1) (p&lt;0. 05). MtFs had lower CTQ and emotional abuse scores and higher sexual abuse scores than FtMs (p&lt;0. 05).

Conclusion
Childhood traumas, emotional and sexual abuse may serve the reason for the loss to follow-up of MtFs.
Presentation: No date and time listed
LBSAT133 Dilemmas In The Diagnosis Of Osteoporosis In Transgender Population
Authors: Vasanthaakumar Vijaykiran P , De La Torre Sebastian , Vietor Nicole O , Shakir Mohamed K M , Hoang Thanh Duc 
Published: November 2022

Abstract

Although hormone therapy is associated with an increase in the bone mineral density (BMD) in transgender (TG) women the clinical significance of this on fracture risk is unknown. There are also no clear guidelines to define the interpretation of BMD data by DXA scan in the TG population. We are reporting three cases to illustrate the dilemmas involved in the interpretation of BMD in this population.

Case 1
A 30-year-old TG female to male (FTM) was started on testosterone treatment and 12 months later patient noted deepening of voice, facial hair growth and, increased muscle strength. Laboratory: serum testosterone 533 ng/dL, sex hormone binding globulin (SHBG) 23.2 nmol/L, FSH 7.1 mIU/mL, LH 8.2 mIU/mL estradiol 59.3 pg/mL, leptin 24.4 ng/mL. A DXA done 12 months after the initiation of treatment: Male Z scores LS spine -1. 0, femoral neck -0.8, total hip 0.2, forearm -2.8. Female: LS spine -0.6, femoral neck -0.4, total hip 0.9, forearm 0.4.

Case 2
A 25-year-old TG FTM was started on testosterone treatment for the last 9 months. Patient developed hair growth on the face and voice changes. Laboratory done 9 months later: serum testosterone 714 ng/dL, SHBG 22.5 nmol/L, FSH 4. 0 mIU/mL, LH 2.37 mIU/mL, estradiol 45.6 pg/mL, leptin 18.5ng/mL. A DXA done 9 months after the treatment: male Z scores LS spine 0.5, femoral neck -0.4, | total hip 0. 0, forearm -2.5. Female: LS spine 1. 0, femoral neck 0.2, total hip 0.8, and forearm -0.1.

Case 3
A 29-year-old TG MTF taking estradiol and spironolactone for 8 months and with this treatment she noted breast development and decreased facial hair. Laboratory done 9 months later: estradiol 139 pg/mL, serum testosterone 11.9 ng/dL, SHBG 70.3 nmol/L, FSH 1. 0 mIU/mL, LH 0.87 mIU/mL, leptin 8.2 ng/mL. DXA done 9 months after estradiol treatment: male Z scores A-P spine -2.5, femoral neck -1.6, total hip -1.3, forearm -1.3. Female: LS spine -2. 0, femoral neck -1.3, total hip -1.1, forearm 0.9.

Discussion
In these three patients when the BMD were analyzed in the current assigned gender and it showed discrepancies and presently there are no guidelines to select the BMD interpretation ie whether to depend on the native gender or current gender. Additionally, it is not clear whether treatment will alter the fracture risk in this population. Further studies are needed.
Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.
ODP423 Postmenopausal Virilization Secondary to A Rare Left Ovarian Androgen-Secreting Leydig Cell Tumor Localized Using Ovarian Vein Sampling
Authors: Shuster Shirley , Awad Sara 
Published: November 2022

Abstract

Introduction
Postmenopausal virilization can be caused by androgen-secreting tumours from either the adrenal glands or ovaries. Ovarian androgen-secreting tumours are rare, accounting for &lt;0.2% of all cases of hyperandrogenism, and &lt;1% of ovarian tumours. Leydig cell tumours account for &lt;0.1% of all ovarian tumours and may represent a diagnostic challenge given their small size and difficulty to visualize radiologically.

Clinical Case
A 57-year-old female with a past medical history of hypertension presented with a 10-year history of hirsutism, and a 4-year history of virilization. She denied exogenous testosterone or supplement use. Examination was significant for voice deepening, excessive hair growth on her face, back, chest, and upper leg (Ferriman-Gallwey score of 20), male pattern baldness, and clitoromegaly. Investigations revealed markedly elevated total testosterone 11.5nmol/L (reference range (RR)=0.3-1.3) and bioavailable testosterone 7.19nmol/L (RR=0.1-0.6). DHEAS was normal at 4. 0umol/L (RR=0.8-4.9). TSH, prolactin, 17-OH-progesterone, ACTH, IGF-1 and GH were normal, and cortisol suppressed to &lt;50nmol/L after 1-mg dexamethasone. Abdominal and transvaginal ultrasound, and adrenal and pelvic MRI did not identify adrenal or ovarian masses. Given normal DHEAS, there was a high suspicion for an ovarian source despite unremarkable imaging, thus ovarian vein sampling was undertaken. This revealed lateralization to the left gonad with total testosterone level of 780nmol/L (RR=0.3-1.8) and right gonadal testosterone level of 18.6nmol/L (RR=0.3-1.3). Left-to-right ovarian ratio was 41.94 (&gt;15 is a strong lateralization to the left ovary as the likely source). After discussion with Gynecology, the patient underwent bilateral salpingo-oopherectomy given she was postmenopausal. The ovarian pathology revealed a left ovarian Leydig cell tumour with normal right ovarian pathology. Post-operatively, her total testosterone normalized to 0.4nmol/L, and the patient's virilizing symptoms improved.

Conclusion and Implications for Practice
This case illustrates the importance of considering rare androgen-secreting ovarian tumours in the differential diagnosis of post-menopausal virilization. It also demonstrates the diagnostic challenge associated with such tumours particularly given their difficulty to visualize radiologically. This demonstrates the importance of considering ovarian vein sampling as a diagnostic tool for localization when there is a high suspicion for an ovarian tumour, even when not identified on imaging studies.
Presentation: No date and time listed
ODP059 Torn Between Two Adrenal Cancers: A Case Report
Authors: Beronio Rae Angeli , Pingoy Noel , Galia Analyza 
Published: November 2022

Abstract
The adrenals are affected by Non-Hodgkin's lymphoma (NHL) in only 1 percent of cases. We report a rare case of NHL presenting as a large irregular mass at the adrenal gland in an elderly male. A 62-year-old male with hypertension and diabetes presented with 6-month history of vague right sided abdominal pain with recent extension to the left flank accompanied by body malaise and unintentional weight loss. Abdominal ultrasound revealed a 9-cm left suprarenal mass in addition to bilateral nephrolithiases and prostate enlargement. There was also left-sided minimal pleural effusion. CT scan and MRI contrast studies both confirmed a large left adrenal mass with infiltration of the spleen, pancreatic tail, and left kidney. High-Resolution CT scan of the chest confirmed left-sided pleural effusion with subsegmental atelectasis. Hormonal tests showed normal 24-hour urinary metanephrines, 24-hour urinary free cortisol, aldosterone-renin ratio, and serum DHEAS. Intact PTH and calcium were also normal. Multidisciplinary consultations involving endocrinology, medical oncology, hematology, pulmonology, surgical oncology, urology, thoracic cardiovascular surgery, anesthesiology, radiology, and pathology were done. He underwent exploratory laparotomy with resection of left adrenal mass and en bloc left nephrectomy, splenectomy and distal pancreatectomy. Histopathologic findings and immunostaining were consistent with diffuse large B-cell lymphoma. He completed R-CHOP chemotherapy and adjuvant radiotherapy with good clinical response and he has been on remission for two years.
Presentation: No date and time listed
PMON206 Pregnancy Rate and Outcomes Following a Randomized Controlled Three-component Lifestyle Intervention in Women with PCOS
Authors: van der Ham Kim , Jiskoot Geranne , Louwers Yvonne , Beerthuizen Annemerle , Busschbach Jan , Laven Joop , de Loos Alexandra Dietz 
Published: November 2022

Abstract
PCOS (polycystic ovary syndrome) is associated with overweight and obesity. Women with PCOS and overweight or obesity present with more pronounced reproductive derangements. Moreover, when pregnant, pregnancy complications such as gestational diabetes, hypertensive disorders and preterm birth seem to be more prevalent in this population. The present study is a one-year randomized controlled trial to investigate the effect of a three-component (cognitive behavioral therapy, healthy diet and physical therapy) lifestyle intervention (LSI) with or without Short Message Service (SMS) on pregnancy leading to live birth, pregnancy complications and outcomes within 24 months after the start of the lifestyle intervention compared to care as usual (CAU). We hypothesized that pre-pregnancy weight loss and the adoption of a healthy lifestyle would cause more pregnancies, shorter time to conception and less pregnancy complications. Women diagnosed with PCOS according to the Rotterdam 2003 criteria and a BMI above 25 kg/m2 were included. A total of 183 participants were randomly assigned to three groups: 1) three-component lifestyle intervention with SMS (LSI SMS+); 2) three-component lifestyle intervention without SMS (LSI SMS-); 3) care as usual (CAU): encourage to lose weight autonomously (control group). Pregnancy and neonatal outcomes were collected from the Dutch Bureau of Statistics (CBS) combined with the Dutch Perinatal registry (Perined). Within 24 months after the start of the intervention the pregnancy rate leading to live birth was 41.7% (25/60) within SMS+, 38.1% (24/63) within SMS- and 38.3% (23/60) within CAU. This was non-significant between the groups. Mean time to pregnancy for SMS+ was 18.3 months, 19.1 months for SMS- and 19.4 months for CAU (p=0.775). Gestational diabetes (LSI: 8.2% vs CAU: 21.7%, p=0.133), hypertensive disorders (LSI: 8.2% vs CAU: 13.0%, p=0.673) and preterm birth (LSI: 12.2% vs CAU: 17.4%, p=0.716) rates were all lower in the LSI groups (SMS+ and SMS- combined) compared to CAU. This trial demonstrated a non-significant positive trend in pregnancy outcomes in favor of the lifestyle intervention groups. We believe that a pre-pregnancy three-component lifestyle intervention in overweight or obese women with PCOS supports the attempts to get a healthy pregnancy by creating weight loss with positive effects on their physical and mental health.
Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.
PMON275 GONAD-on-CHIP to study early gonad development and DSD
Authors: Bashamboo Anu , Gonen Nitzan , Eozenou Caroline , Mitter Richard , Bernardo Andreia Sofia , Chervova Almira Chervova , Frachon Emmanuel , Commère Pierre-Henri , Brailly-Tabard Sylvie , Mazen Inas , Gobaa Samy , Smith James , McElreavey Kenneth , Lovell-Badge Robin 
Published: November 2022

Abstract
During embryonic development, mutually antagonistic signaling cascades determine the fate of the bipotential gonad towards a testicular or ovarian identity. Errors in this process result in human Disorders of Sex Development (DSDs), where there is discordance between chromosomal, gonadal, and anatomical sex. The absence of an appropriate, accessible in-vitro system is a major obstacle in understanding mechanisms of sex-determination/DSDs. Here, we describe protocols for differentiation of mouse and human pluripotent cells towards gonadal progenitors. Transcriptomic analysis reveals that the in-vitro-derived murine gonadal cells are equivalent to E11.5 in-vivo progenitors. Using similar conditions, Sertoli-like cells derived from 46,XY human induced pluripotent stem cells (hiPSCs) exhibit sustained expression of testis-specific genes, secrete AMH, migrate and form 3D tubular structures on a specially designed microfluidic device. The cells derived from a 46,XY DSD female hiPSCs, carrying a NR5A1 variant, show aberrant gene expression and absence of tubule formation. CRISPR/Cas9-mediated correction of the variant rescued the phenotype. This is a robust tool to understand mechanisms of sex-determination and model DSDs.
Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.
ODP067 Long-term Systemic Steroid Use And Its Impact on In-hospital Outcomes Among Patients Admitted With Acute Pericarditis
Authors: Kumi Dennis , Ramirez Marcelo , Akaho Elikplim , Soon-shiong Raquel , Shrestha Prajwal , Karki Sadicchya , Nissan Ninos , Patel Birju 
Published: November 2022

Abstract

Background
Early use of systemic steroids in the acute setting of acute pericarditis has been associated with increased recurrence rate and a longer course of treatment. It is not clear if long-term systemic steroids use, has a similar unfavorable impact in patients admitted for acute pericarditis. Our study aimed to determine if the presence of long-term systemic steroid use as a comorbidity during admission for acute pericarditis, was associated with worse outcomes. Method: A retrospective cohort study was designed using data obtained from the 2016 to 2018 combined National Inpatient Sample (NIS) database. The international diseases classification code, tenth revision (ICD-10), was used to identify patients admitted with a principal diagnosis of acute pericarditis who were further dichotomized into 2 cohorts, based on the presence of a secondary diagnosis of long-term systemic steroid use. Primary outcomes of the study were, mortality rate, length of stay (LOS) and total hospital charge. Secondary outcomes assessed included rates of pericardial effusion, cardiac tamponade, cardiogenic shock, pericardial window, and cardiac arrest. A multivariate linear and logistic regression were used to adjust for confounders.

Results
Our sample included a total of 36,570 adult hospitalizations for acute pericarditis, out of which 2.24% had associated long-term systemic steroid use as a secondary diagnosis. There was a 3- fold increased odds of mortality among patients with long-term systemic steroid use compared to the group without, (2.44% vs 0.84%, AOR: 2.92, 95% CI: 1. 06 to 8. 01, p: 0. 038). Both length of stay (LOS) and total charge were increased among patients with long-term systemic steroid use compared to their counterpart cohort, with an adjusted mean difference of 0.2 days and 1,693.65 USD respectively but these did not meet statistical significance. There was no statistically significant difference in terms of secondary clinical outcomes including, pericardial effusions, cardiac tamponade, cardiogenic shock, rate of pericardial window and cardiac arrest between the two groups analyzed.

Conclusion
The presence of long-term corticosteroid therapy as a comorbidity during admission for acute pericarditis was associated with a 3–fold increased odds of mortality during hospitalization and there was a trend towards increased LOS and total charge among such patients, though the latter did not meet statistical significance. Further prospective studies need to be done on this topic to better improve understanding and to assess its impact on patient care.
Presentation: No date and time listed
RF10 | PMON204 Eucaloric High Fat Diet Does Not induce insulin Resistance But May Stimulate Fat Oxidation in Normal Weight Women
Authors: Schauer Irene , Kuhn Katherine , Fought Angela , Pretzel Shannon , Bradford Andrew , Santoro Nanette 
Published: November 2022

Abstract
Obesity and metabolic syndrome are associated with defects in the hypothalamic pituitary ovarian (HPO) axis termed the reprometabolic syndrome. We have previously shown that lipid infusion induces insulin resistance and the reprometabolic syndrome of obesity in normal weight women. We hypothesized that the induced insulin resistance is the underlying cause of the attenuation of the hypothalamic pituitary ovarian (HPO) axis. 16 women of normal BMI (18-24.9g/m2), mean age 29.7 ± 6.4, were recruited for a study including a 30-day, prescribed, eucaloric, high fat (48% of calories from fat) dietary intervention. Diet was adjusted to ensure that participants remained weight stable throughout the study. Insulin sensitivity was measured by 2 stage euglycemic hyperinsulinemic clamp (8 and 40 mU/m2*min) pre and post diet. Final stage 2 glucoses were not different pre vs post diet (mg/dL, 86±7 vs 89±6, p=0.08). Muscle insulin sensitivity (glucose infusion rate, mg/kg*min) was different pre versus post diet (10.9±3.3 vs 10.6±3.5, p=0.013) after exclusion of one participant for multiple protocol deviations. Adipose insulin sensitivity as measured by fatty acid suppression during the low insulin infusion stage of the clamp was also not different pre versus post diet [final fatty acid level in µEg/L; median 115 (IQR 84, 224) vs 158 (IQR 67,274; p&gt;0.99). However, the final high insulin stage 2 fatty acid suppression trended towards greater suppression after high fat diet [median 17.8 (IQR 9.8,33.8), vs 11.7 (IQR 7.7, 18.7) p=0.06]. This may reflect higher fatty acid oxidation on the high fat diet.
We have previously reported that this diet, like the lipid infusion, did attenuate the HPO axis (reduced baseline early follicular LH and FSH and reduced LH response to GnRH). In contrast to lipid infusion, however, this dietary intervention did not induce the same degree of insulin resistance, possibly due to the emphasis on neutral energy balance, suggesting that the suppression of the HPO axis by high fat diet may be partially independent of insulin sensitivity.
Presentation: Saturday, June 11, 2022 1:24 p.m. - 1:29 p.m., Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.
RF34 | PMON229 TNFa-Induced Altered miRNA Expression Links to Inflammation in Endometriosis
Authors: Chowdhury Indrajit , Driss Adel , Taylor Robert N , Nezhat Ceana , Sidell Neil , Thompson Winston E , Xu Wei , Banerjee Saswati , Chowdhury Indrajit 
Published: November 2022

Abstract
Endometriosis is a common gynecological inflammatory disorder, which is characterized by immune system dysregulation with initiation and progression. It affects 5% to 15% of reproductive-age women and is present in as many as 30% to 50% of patients with infertility and/or pain. In previous studies, including ours, have demonstrated that several cytokines have been associated with the evolution of endometriosis, including tumor necrosis factor-a (TNFa). TNFa is a non-glycosylated protein which has potent inflammatory, cytotoxic, and angiogenic potential. Therefore, in the current studies, we examined the effects of TNFa over a time course in the regulation of proinflammatory and proangiogenic microRNAs (miRNAs) in primary cultures of normal endometrial stromal cells (NESC) and compared with the untreated cells derived from eutopic endometrium of endometriosis subjects (EESC). miRNAs are short, 18- to 22-nucleotide– size, non-coding RNAs that act as post-transcriptional modulators of gene expression and are involved in the pathogenesis of endometriosis. Using NanoString nCounter-based assays and quantitative RT-PCR, we have identified levels of several proinflammatory and proangiogenic miRNAs higher in EESC than NESC. NESC treatment with TNFa significantly altered the expression of proinflammatory and proangiogenic miRNAs in a time-dependent manner. Notably, TNFa significantly decreased phosphorylation of the PI3K, AKT, and ERK signaling pathways. Moreover, treatment of EESC and NESC with curcumin (diferuloylmethane, CUR), an anti-inflammatory folk medicine in Asian countries, significantly increased the expression of anti-inflammatory and anti-angiogenic miRNAs in a dose- and time-dependent manner. These findings demonstrate higher inflammatory, and proangiogenic miRNA production in EESC may be due to a higher concentration of TNFa than NESC under basal conditions. Therefore, suppressing TNFa may reduce the inflammatory and angiogenic miRNA associated with endometriosis.
Sources of Research Support: This study was supported in part by National Institutes of Health Grants 1SC3 GM113751, U01, 1SC1 GM130544, HD66439, 1R01HD057235, U54 CA118948, HD41749, S21MD000101 and G12-MD007602. This investigation was conducted in a facility constructed with support from Research Facilities Improvement Grant #C06 RR018386 from NIH/NCRR.
Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m., Monday, June 13, 2022 1:06 p.m. - 1:11 p.m.