7 Ways to Boost your Fertility

If you’re like most couples who are trying to conceive, you want to conceive sooner rather than later.

Having intercourse as close as possible to ovulation can definitely help. There are other ways men and women can boost their fertility. These simple measures can increase the chances that next month will be the month you’ll say: “We’re pregnant!”

Read on for some simple suggestions:

1. Manage your weight: Being under or overweight significantly affects fertility. Women who are underweight—with a body mass index (BMI) lower than 19 Kg/M2—take four times as long to get pregnant as women in the normal range (19 to 24 Kg/M2). On the other hand, women who are overweight may have insulin resistance, meaning that too much insulin circulates in the body, disrupting menstruation. Estrogen production from fat cells can also affect the ovaries and prevent eggs from being released every month—a condition called anovulation. If you’re too thin, gaining as little as five pounds can sometimes be enough to jumpstart ovulation and menstruation. If you’re overweight, losing just 5 to 10 percent of your current body weight is often enough to do the same. You can calculate your BMI by going to this website:
www.nhlbisupport.com/bmi/

2. Manage your stress: In men, stress has been shown to affect fertility by both lowering sperm volume and raising the percentage of abnormal sperm. Women who are chronically stressed can produce less hormones that will prevent ovulation. Learn how to manage stress with exercise and meditation.

3. Stop smoking: Smoking has a negative effect on fertility for both men and women. Smoking is toxic to the reproductive system. Women who smoke go through menopause years before women who do not smoke. Smoking is also strongly associated with an increased risk of miscarriage, and women who smoke are more prone to ectopic pregnancies. Smoking matters for men, too. Men who smoke have lower sperm quality. If your partner smokes, he not only puts his sperm at risk, but he leaves you vulnerable to many of the same problems that plague women smokers. Stop smoking immediately and talk to your doctor about smoking cessation programs and medications that may be right for you.

4. Decrease alcohol and caffeine intake: Caffeine’s role in fertility is one of those issues that surfaces every couple of years. The research is ongoing, and the verdict is still out. But as of now, most experts agree that as long as you limit your intake to less than 300 milligrams a day (the amount contained in two small cups of coffee plus a soda), your fertility shouldn’t be affected. Certainly excessive alcohol consumption has been linked with anovulation (no ovulation), amenorrhea (no periods), and abnormalities with the endometrial lining. Alcohol can also alter estrogen and progesterone levels. An occasional glass of wine is unlikely to affect your fertility, but many experts think it’s best to be on the safe side and forego alcohol as soon as you start trying to conceive

5. Work out Wisely: Now is not the time to go for the burn. Working out too much means you might not be able to produce good eggs. Exercise in moderation.

6. Take Supplements: Begin (or continue) taking either a prenatal vitamin containing folic acid. During the earliest weeks of pregnancy, before you may even realize you’re pregnant, the embryo’s neural tubes (the earliest version of the brain and spinal column) develop. Taking a supplement that contains folic acid will reduce the chance of defects. You and your partner can also consider taking a fertility supplement: www.coastscience.com has more information on the different supplements available. You can also get them from Dr. Aimee’s office.

7. Eat Right: You need to nourish yourself before you can begin nourishing a growing baby. Begin by choosing foods rich in whole grains. Choose a rainbow’s worth of colorful fruits and veggies every day. Choose foods high in omega-3s (from fish oils, canola oil, olive oil, and flaxseed). Eating salmon one or two times a week, or eggs fortified with DHA (a fatty acid found in fish oil that’s an important component in brain tissue) is a great way to get your omega-3s.

Hope this helps!


Sumber : http://draimee.org/

Etika dibidang Kedokteran

(anton_smc@yahoo.com)

Etika adalah ilmu tentang norma-norma tingkah laku manusia sebagai manusia. Oleh karena itu, “bagaimana seharusnya” manusia bertindak (what ought), menjadi pertanyaan sentral dalam etika. Etika berbicara tentang apa yang seharusnya dilakukan manusia : tentang apa yang “benar”, apa yang “baik”, dan apa yang “tepat”. Etika bertugas menilai kenyataan sekaligus merubahnya ke arah yang benar, baik dan tepat.
Etika (“ethics”) is the discipline - dealing with what is good and what is bad, it is concerned with standards of conducts among people in a social group.
Etika merupakan bagian dari filsafat aksiologi yang mempelajari baik - buruk, salah – benar, pantas – tidak pantas dan sebagainya. Dalam penggunaan sehari – hari ada : moral (“mos” atau “mores” dalam bahasa Latin) yang berarti nilai / norma yang berlaku untuk masyarakat umum atau disebut juga etik dasar, sedangkan etik (rule of conduct) berasal dari bahasa Yunani “ethos”merupakan nilai / norma yang ditentukan dan berlaku untuk kelompok masyarakat tertentu atau disebut juga etik terapan.
Bila etika menggunakan ukuran baik dan buruk ada 7 ukuran yaitu : pertama, Religioisme yaitu melaksanakan perintah Tuhan dan menghindari larangan Tuhan. Kedua, Sosialisme yaitu masyarakat yang menentukan baik dan buruk. Ketiga, Humanisme yaitu menghormati hak azasi memanusiakan manusia. Keempat, Altruisme yaitu perhatian pada kebaikan, kesejahteraan dan kebahagian orang lain. Kelima, Anarkisme yaitu tiap orang dapat menentukan baik-buruk sendiri tanpa usah diatur oleh penguasa. Keenam, Autisme yaitu terbelenggu oleh gagasan dan pemikirannya sendiri atau tidak memperhatikan orang lain. Ketujuh, Hedonisme yaitu baik bila mendatangkan kenikmatan, kepuasan, menengkan diri.
Etika mengenal tiga cara berpikir etis, yaitu : deontologis, teleologis dan kontekstual. Pertama, deontologis adalah cara pikir etik yang mendasarkan diri pada hukum, prinsip, atau norma objektif yang dianggap harus berlaku dalam situasi dan kondisi apapun. Filusuf Immanuel Kant (Jerman) mengajukan patokan tentang prinsip atau hukum bagi etika deontologis, yaitu ukuran objektif untuk menyatakan suatu tindakan itu secara etis “benar” atau “salah”. Pertama, kata Kant, “bertindaklah atas dalil, bahwa apa yang anda lakukan itu dapat berlaku sebagai hukum yang bersifat universal”. Artinya, apa yang kita lakukan itu “benar” apabila dimanapun dan kapanpun adalah seharusnya dilakukan oleh siapapun. Kedua, apa yang “benar” adalah apabila anda memperlakukan manusia, baik itu orang lain atau diri kita sendiri, di dalam setiap hal, sebagi tujuan, dan bukan sekedar alat. Artinya, suatu tindakan itu pasti “salah”, apabila ia memperlakukan manusia sebagai objek, bukan sebagai subjek yang penuh sebagi manusia. Dua prinsip itulah yang dikenal dengan Imperiatif kategories (kategorisher imperative) Imanuel Kant. Mentaati prinsip berarti benar. Melanggar prinsip, berarti salah. Tidak ada kompromi.
Kedua, teleologis (teleos = tujuan) adalah yang terpenting ialah tujuan, berikut akibat-nya. Cara berpikir ini bukan tida mengacuhkan hukum, tetap mengakui hukum. Batapun “salah”-nya, tetapi kalau berangkat dati tujuan “baik” apalagi akaibatnya “baik”, maka tindakan itu baik secara etis. Sebaliknya betapapun “benar”nya, kalu dilakukan dengan tujuan “jahat”, apalagi berakibat “buruk”, maka ia jahat. Menurut filusuf John Stuart Mill (Inggris) yang beraliran utilitarianisme, mengusulkan sebuah dalil : The greatest good for the greatest number. Yaitu sebuah tindakan dapat dikatakan “baik”, apabila ia bertujuan dan berakibat “membawa kebaikan yang paling besar bagi sebanyak mungkin orang”. Filusuf Aristoteles (Yunani) dalam buku Nicomachean Ethics, ia menulis : “Kebahagiaan adalah sesuatu yang final, serba cukup pada dirinya, dan tujuan dari segala tindakan ….”. Jadi, semua tindakan yang bertujuan dan berakibat pada kebahagiaan manusia adalah “baik”.
Ketiga, konstektual adalah apa yang secara konstektual paling pantas dan paling dapat dipertanggungjawabkan. Tidak ada tindakan ataupun keadaan yang dalam dirinya baik atau jahat, baik atau jahat tergantung konteks situasinya. Josep Fletcher (1966) mengajukan nama : Etika situasi, sedangkan Richard H. Niebuhr dalam bukunya : The Responsible self (1973) memberikan nama lain untuk etika ini : etika tanggung jawab.

Kandungan Selenium di dalam Jaringan Tubuh

(anton_smc@yahoo.com)

Kandungan Selenium di jaringan tubuh merupakan pencerminan dari makanan yang di konsumsi. Absorpsi Selenium terutama terjadi di bagian ujung bawah usus halus. Semua bentuk Selenium baik organik maupun anorganik dapat diserap. Penyerapan senyawa organik seperti selenomethionine lebih efisien di serap daripada bentuk anorganik seperti selenite yaitu sekitar 90 % berbanding 60 %. Selenomethionine adalah komponen senyawa Selenium dalam sereal, kacang kedelai dan ragi. Sumber terkaya akan Selenium adalah kacang Brazil. Bawang putih, bawang merah, brokoli merupakan sumber Selenium yang mengandung senyawa Se-methylselenocysteine (Best, 2008).

Selenium di simpan dalam sel darah merah, hati, ginjal, otot, plasma, limpa, jantung, kuku dan enamel gigi. Menurut laporan WHO / FAO tahun 2002 kandungan Selenium di hati sekitar 30 %, 15 % di ginjal, 30 % di otot, dan 10 % di plasma. Ekskresi Selenium yang terserap dikeluarkan melalui urine, beberapa hilang melalui keringat dan juga dalam rambut, dan sedikit dikeluarkan melalui kandung empedu, pankreas, dan sekresi usus dalam feces (Reilly, 2006).
Plasma dan serum mengandung sekitar 75 % Selenium darah. Rentang kadar serum Selenium pada orang dewasa sehat adalah 0,046 - 0,143 µg/ml sebagaimana yang telah diusulkan oleh International Atomic Energy Agency (Reilly, 2006).
Selenium yang terserap disirkulasi dalam darah terutama berikatan dengan protein, diikuti dengan initial reduction ke dalam eritrosit menjadi selenide. Proses ini juga dipakai untuk mereduksi glutathione dan terlibat pada enzyme glutathione reductase. Pada tubuh manusia, hampir semua ikatan protein Selenium di darah dilaporkan dalam fraksi very low-density-β-lipoprotein (Reilly, 2006).
Jumlah total Selenium yang tersimpan dalam tubuh manusia dewasa berkisar pada rentang 2 sampai lebih dari 20 mg. Total kandungan Selenium pada orang Amerika dewasa berkisar sekitar 15 mg dengan rentang 13 sampai 20,3 mg (Reilly, 2006).
Semua atribut fungsi biologi Selenium dimediasi oleh selenoprotein. Selenium masuk ke dalam struktur utama protein sebagai asam amino selenocystein (sec). Lebih dari 40 selenoprotein berbeda telah diidentifikasi di mamalia dengan sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) dari jaringan yang telah dilabel Se.

Komposisi selenoprotein sama dengan GPX4 kecuali pada sekuen N-terminal, yang telah ditemukan oleh pelabelan Se dan pemisahan oleh SDS-PAGE. Hal ini hanya terjadi pada testis dan spermatozoa tikus setelah masa puber dan berlokasi di nukleus spermatid akhir. Diidentifikasi sebagai specific sperm nuclei GPX (SnGPX) dan menunjukkan kerja sebagai mana protamine thiol peroxidase untuk cross-linking disulphide dan dibutuhkan untuk maturasi spermatozoa dan fertilitas pria (Bene dan Kyriakopoulos, 2001 dalam Reilly, 2006).
Pada manusia Selenium dalam bentuk selenocysteine berfungsi sebagai pusat katalitik seperti glutathione peroxidase antioxidant enzymes (Hawkes, 2001). Selenocysteine sebagai asam amino ke 21 memiliki struktur yang mirip dengan 2 asam amino lainnya yaitu serine dan cystein.

Dari sintesis selenoprotein yang ditunjukkan oleh Eschericia coli terlibat 4 buah gen. SelC, sec-charged tRNA (Sec-tRNAsec) yang mengandung triplet UCA, antikodon untuk UGA. SelA, enzym untuk sintesa Sec. SelD, enzim lainnya, selenophosphate synthetase (kedua enzim adalah penting untuk formasi Sec-tRNAsec dari seryl-tRNAsec) dan selB, sebuah faktor elongasi yang mengenali secara spesifik Sec-tRNAsec.
Langkah pertama aminoakrilasi asam amino serine dengan enzym serine synthetase untuk menghasilkan Seryl-tRNAsec. Dengan bantuan kerja pyridoxal phosphate dependent enzyme sec synthase yang mengubah seryl-tRNAsec menjadi Sec-tRNAsec melalui senyawa intermediat aminoacrylyl-tRNAsec. Intermediat ini bertindak sebagai acceptor untuk aktivasi selenium, menghasilkan selenocysteyl-tRNAsec. Donor pada reaksi ini adalah monoselenophosphate yang disintesis dari Selenium dalam bentuk selenide.
Selenoprotein P (Se-P) adalah sebuah glycoprotein 43 KDa yang mengandung 10 – 12 Sec residual per molekul. Hanya Selenoenzim yang sejauh ini memiliki kandungan lebih dari satu sec. Molekul juga kaya akan residu histidine dan cysteine yang berikatan kuat dengan metal. Untuk mengerti bagaimana Selenium disisipkan ke dalam protein fungsional setidaknya melibatkan implikasi genetik. Satu diantaranya, Selenium disisipkan ke protein posttranslational sebagai dissociable cofactor, yang lainnya Selenium disisipkan cotranslational ke dalam protein sebagai asam amino sec.

Hubungan Selenium dengan Kualitas Semen

      Hubungan antara motilitas dengan Selenium dapat dijelaskan oleh sifat Selenium dalam semen yakni bersifat potensial suatu antioksidan terhadap sejumlah senyawa oksigen reaktif (ROS = Reactive Oxygen Species). ROS ini menimbulkan reaksi oksidatif pada membran spermatozoa sehingga motilitas spermatozoa menjadi lebih buruk. Bila kadar Selenium semen lebih rendah, kapasitas terhadap ROS berkurang, motilitas yang semula baik (terutama motilitas (a+b) ) akan menjadi jelek. Specific sperm nuclei GPX (SnGPX) dan menunjukkan kerja sebagai mana protamine thiol peroxidase untuk cross-linking disulphide dan dibutuhkan untuk maturasi sperma dan fertilitas pria (Bene dan Kyriakopoulos, 2001 dalam Reilly, 2006).

      Konsentrasi spermatozoa ditentukan oleh aktivitas / kegiatan tubular testis yaitu spermatogenesis. Spermatogenesis sendiri dipengaruhi androgen yang diproduksi dan disekresi oleh sel Leydig testis (Sono et al, 1997).

      Normal tidaknya bentuk spermatozoa sangat ditentukan oleh proses spermatogenesis dalam testis, defisiensi Selenium pada spermatozoa adalah distorsi pada arsitektur mid piece, dimana mitokondria normal diselubungi oleh matrik keratin yang disebut kapsul mitokondria. Bahan ini mengandung bahan terbanyak Selenium spermatozoa, dikomposisi oleh protein yang cross linked oksidatif. Peran Selenium pada infertilitas pria terutama pada peranan selenoprotein P dan phospholipid hydroperoxidase gluthatione peroxidase (PHGSH-Px) dalam spermatogenesis. Selenoprotein P ditransformasi pada tingkat akhir spermatogenesis dari selenoperoxidase aktif ke dalam struktur protein yang akan menjadi bagian mitokondria sheath spermatozoa. Transformasi ini paralel dengan hilangnya glutathione. Mekanismenya, proses ini menginaktivasi GSH-Px dari reaksi bentuk selenenik dengan thiol GSH-Px itu sendiri dan protein lain. Komponen terbanyak Selenoprotein PHGSH-Px, PHGSH-Px disintesis di round spermatid dibawah kontrol tak langsung testosteron.

Ejakulat

Spermatozoa diproduksi dalam testis, ketika bercampur dengan cairan kelenjar sex aksesori, menjadi semen (biasanya dikenal juga sebagai ejakulat).
Mekanisme neurofisik yang menginduksi emisi dan ekspulsi adalah orgasme. Orgasme pada manusia tergantung pada mekanisme feedback antara stimulasi langsung penis dan eksitasi sistem saraf pusat. Sekali orgasme terjadi, emisi dan ekspulsi seharusnya secara otomatis terjadi.



Semen manusia mempunyai volume yang bervariasi antara satu individu dengan individual lain tetapi berukuran antara 2 sampai 6 ml. Dapat dipakai untuk mengetahui perubahan yang terjadi di cairan seminal dalam menentukan letak lesi penyebab infertilitas. Sangat penting untuk mengetahui asal ejakulat dan proporsi masing – masing komponen.

Disfungsi testis karena penyakit endokrin

(anton@trb-media.com)

Penyakit Gondok mempengaruhi fungsi reproduksi pria dengan terbanyak mengubah kadar sirkulasi SHBG. Hormon tiroid menstimulasi sintesis SHBG hepar jadi hipertiroid meningkatkan kadar sirkulasi SHBG dan hipotiroid menyebabkan kadar SHBG rendah dan perubahan tersebut dapat dinormalkan oleh kadar hormon tiroid. Peningkatan SHBG menurunkan klearence testosteron menyebabkan peningkatan kadar testosteron total, estradiol dan gonadotropin. Secara keseluruhan kerja androgen di jaringan masih belum jelas. Gambaran klinis seperti ginekomastia dan penurunan fungsi seksual pada beberapa kasus. Spermatogenesis ditekan pada tirotoksikosis dan hipotiroid jangka panjang pada onset prepubertas tetapi sedikit efek setelah pubertas.

Hiperkortisolisme dari berbagai penyebab dapat menginhibisi fungsi testis pada berbagai tingkat aksis HPT diikuti penurunan kadar sirkulasi testosteron dan gonadotropin yang kembali semula setelah setelah terputusnya paparan glukokortikoid yang berlebihan. Derajat defisiensi androgen berkontribusi pada keadaan katabolik dan gejala disfungsi seksual dan kelemahan selama hiperkortisolism belum jelas. Mekanisme yang terlibat pada berbagai tingkat aksis HPT termasuk inhibisi sekresi GnRH hipotalamus, GnRH menstimulasi hipofise mensekresi LH dan LH menstimulasi sel Leydig biosintesis testosteron.

Efek diabetes pada fungsi reproduksi pria terutama karena neuropati dan komplikasi diabetes vaskuler menyebabkan disfungsi ereksi dan / atau ejakulasi. Efek langsung pada fungsi testis masih belum banyak eviden.

Testosterone Therapy

(bhattacharyyad@scientist.com)

The possibilities are enticing — increase your muscle mass, sharpen your memory and mental focus, boost your libido, and improve your energy level. If you're an aging man, this may sound like the ultimate anti-aging formula. But such health benefits from testosterone therapy aren't quite so clear-cut.

Testosterone therapy has been used successfully for years to treat men with abnormally low testosterone levels — a medical condition called male hypogonadism. More recently, healthy, aging men have taken the hormone to boost waning testosterone levels. But not enough is known about the effects of testosterone therapy for this purpose. No long-term studies have weighed the potential benefits against the possible risks, including infertility and prostate problems.

Despite the lack of scientific evidence, testosterone therapy is growing in popularity. Pharmacies filled 2.4 million testosterone prescriptions in 2004 — more than twice the number filled in 2000, according to IMS Health, a company that tracks pharmaceutical sales. Though the number appears to be growing, there are no data that track who's filling these prescriptions — men or women — and for what purpose.

At the core of the controversy is whether gradually declining testosterone levels are a natural phenomenon or a health problem. And the practical question for men and their doctors is whether to treat it, particularly in the absence of scientific evidence. Before you buy into the tempting claims, find out what's known — and not known — about testosterone therapy so that you can make the best decision for you and your long-term health.

The natural decline of testosterone
Starting around age 40, a man's body produces less testosterone. Testosterone is the main male hormone that maintains muscle mass and strength, fat distribution, bone mass, sperm production, sex drive, and potency.

Many call this progressive decline of hormones "male menopause" or "andropause" and equate it to women's menopause. But this isn't a valid comparison, says Todd Nippoldt, M.D., an endocrinologist at Mayo Clinic, Rochester, Minn. "In women, ovulation ceases and female hormone production plummets over a relatively short time frame," says Dr. Nippoldt. "In men, there's a gradual decline in the production of male hormones."

For most men, testosterone levels naturally decline but still remain within the normal range throughout their lifetimes, causing no significant problems. But about two in 10 men age 60 and older have testosterone levels below the normal range (testosterone deficiency).

Testosterone deficiency can have several effects on the body, including:
Decreased energy
Reduced muscle mass and strength
Decreased cognitive function
Less sexual interest or potency
Depressed mood

If you experience these signs or symptoms, you may have testosterone deficiency. Other medical conditions — such as liver disease, hypothyroidism and depression — can cause these effects as can certain medications, including beta blockers, painkillers and certain drugs for depression or anxiety. In addition, some healthy men encounter these changes as a part of the aging process, possibly because of declining hormones other than testosterone.

Talk to your doctor if you're experiencing these signs and symptoms. He or she can help determine the likely cause and suggest the best treatment plan, if any.

The male hormone testosterone plays an important role in the development and maintenance of typical masculine physical characteristics.
Potential benefits and risks

In men with testosterone deficiency, testosterone therapy can restore sexual function and muscle strength, prevent bone loss and protect against heart disease (atherosclerosis). Also, some men taking testosterone therapy report an increase in energy, sex drive and well-being.

Some anti-aging enthusiasts claim that increasing the level of testosterone in older and healthy men provides these same benefits. Though potentially beneficial for some of these men, testosterone therapy isn't risk-free. High doses of testosterone may result in sleep apnea, infertility and excess blood production, which could increase the risk of stroke.

Increasing testosterone levels may also pose problems for the prostate, a small male gland that produces most of the fluids in semen. Testosterone naturally stimulates the growth of the prostate. Long-term testosterone treatment could cause prostate gland enlargement. Also, doctors are concerned that testosterone therapy might fuel the growth of prostate cancer that is already present. This is especially worrisome since prostate cancer is common in older men, and many men may have prostate cancer that is undiagnosed.

In addition, scientists have linked testosterone therapy to breast cancer in men. Breast cancer, like prostate cancer, is a hormone-dependent cancer. Because long-term testosterone treatment could cause breast enlargement in men (gynecomastia), doctors are concerned that testosterone therapy might also fuel the growth of breast cancer that is already present.

All men, especially those with a family history of prostate or breast cancer, should discuss the potential benefits and risks of testosterone therapy with their doctors before beginning treatment.

To carefully weigh the potential pros and cons for you, consider the following:Potential benefits Potential risks
Improve muscle mass and strength
Increase bone mineral density
Thicken body hair and skin
Improve sexual desire
Boost energy
Decrease irritability and depression
Improve cognitive function Cause skin reactions
Cause fluid retention
Cause baldness
Cause or aggravate sleep apnea (brief, repeated cessation of breathing during sleep)
Stimulate noncancerous (benign) growth of the prostate and cause or worsen urinary symptoms
Stimulate growth of prostate cancer that's already present
Enlarge breasts (gynecomastia)
Stimulate growth of breast cancer that's already present
Cause testicle shrinkage (testicular atrophy)
Limit sperm production (infertility)
Stimulate excess blood production (polycythemia)
Cause acne


Learning from experience
Men aren't the only ones evaluating the benefits and risks of hormone therapy. For years, women have wrestled with the decision whether to take hormone therapy for the treatment of menopausal symptoms. They've had to assess the pros and cons based on the available scientific evidence. Dr. Nippoldt says that men should learn from women's experience.

"Early studies suggested that taking hormone therapy might protect postmenopausal women from heart disease. But a large, long-term study found just the opposite results," he says. "We learned from these studies that we just can't predict all the potential harmful effects of taking hormones even though on the surface they may seem beneficial."
Who should take testosterone therapy?


Testosterone therapy is clearly beneficial for men whose testicles fail to produce sufficient levels of testosterone (male hypogonadism). For this group of men, it can restore sexual function and muscle strength and prevent bone loss.

Few studies have evaluated possible benefits and risks of testosterone therapy for healthy aging men. And those that have been done provide conflicting results. Many questions remain unanswered, particularly the extent and the duration of the beneficial effects, which men might benefit, and the possible long-term risks.

In November 2003, the Institute of Medicine (IOM) reviewed the current evidence surrounding testosterone therapy and reported that this treatment is appropriate only for men who produce little or no testosterone. The IOM concluded that the long-term effects of supplemental testosterone on otherwise healthy men aren't known. And until more studies have been done, the institute recommends that testosterone therapy not be used to prevent or relieve the physical or psychological effects of aging.


TYPES OF TESTOSTERONE THERAPY:
Several types of testosterone therapy exist. Choosing a specific therapy depends on your preference of a particular delivery system, the side effects and the cost. Types include:
Injection. Intramuscular testosterone injections (Delatestryl, Depo-Testosterone) are safe and effective. Injections are given approximately every two weeks. You may experience fluctuations in symptom relief between doses. You or a family member can learn to administer this method of testosterone replacement therapy at home. If you're uncomfortable administering injections, a nurse or doctor can give the injection.
Patch. A patch containing testosterone (Androderm) is applied each night to your back, abdomen, upper arm or thigh. The site of the application is rotated to maintain seven-day intervals between applications to the same site to lessen skin reactions.
Gel. You rub testosterone gel (AndroGel, Testim) into your skin on your lower abdomen, upper arm or shoulder. As the gel dries, your body absorbs testosterone through your skin. Gel application of testosterone replacement therapy appears to cause fewer skin reactions than patches cause. Avoid showering or bathing for several hours after an application to ensure adequate absorption. A potential side effect of the gel is the possibility of transferring the medication to your partner. You can avoid this by avoiding skin-to-skin contact until the gel is completely dry or by covering the area after an application.

Gum and cheek (buccal cavity). Striant, a small putty-like substance, delivers testosterone through the natural depression above your top teeth where your gum meets your upper lip (buccal cavity). This product rapidly adheres to your gumline and, as exposed to saliva, softens into a gel-like form, allowing testosterone to be absorbed directly into your bloodstream. Side effects may include gum irritation or pain, bitter taste or headache. A recent study found this form of testosterone therapy may deliver a steadier dose of testosterone throughout the day.

Oral. Taking testosterone orally (Android, Testred, Virilon) is not recommended for long-term replacement. Testosterone taken by this method may cause an unfavorable cholesterol profile and increase your risk of blood clots and heart and liver problems.
The debate continues


There's no question a man faces emotional and physical challenges as he gets older. Changes at home, at work and within his body all can affect a man's general health. If you're concerned that you might have a hormone deficiency, talk to your doctor. A decline in testosterone that falls below normal values may be a reason to take supplemental testosterone. But it remains unclear whether restoring the testosterone levels to those of youth benefits older men.


PRECOCIOUS PUBERTY:

Important
It is possible that the main title of the report Precocious Puberty is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

General Discussion

Precocious Puberty means an abnormally early onset of puberty. A sequence of events occurs during which a child develops into a young adult beginning at an unexpectedly early age. Glands that secrete growth and sex hormones begin to function abnormally early in life resulting in this condition. The exact cause of Precocious Puberty is not known.

For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc. ® (NORD). A copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html

The information provided in this report is not intended for diagnostic purposes. It is provided for informational purposes only. NORD recommends that affected individuals seek the advice or counsel of their own personal physicians.

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Tinggi badan anak

(anton.smc@gmail.com)

Rumus tinggi badan anak :
Laki - laki : ((TB ibu + TB ayah) + 13) / 2)= ..... +/- 8,5 cm.
Perempuan : ((TB ibu + TB ayah) - 13) / 2)= ..... +/- 8,5 cm.

Contoh :
Diketahui Tinggi badan ibu 160 cm, TB ayah 175 cm.

Bila mempunyai anak laki-laki maka tinggi badan anak
akan berkisar 165,5 sampai 182,5 cm.

Bila mempunyai anak perempuan maka tinggi badan anak
akan berkisar 152,5 sampai 169,5 cm.