Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| Baylor College of Medicine | OTHER |
Not provided
Not provided
Not provided
Testosterone (T) replacement prevents bone loss and relieves symptoms associated with androgen deficiency in male patients with hypogonadism, but at the expense of an increase in prostate-related adverse events and in the hematocrit values above the normal which may lead to bad circulatory outcomes. Most of the effects of T on the male skeleton are mediated by its conversion to estradiol (E2) by the enzyme aromatase. Genetic variations in the aromatase (CYP19A1) gene result in enzymes with variable activity and variable levels of E2 and T. This project is designed to determine if genetic variations in the CYP19A1 gene will result in differences in the skeletal response and incidence of side effects from T treatment in patients with low T. A large number of male Veterans are on T. Results from this project will help identify patients who would benefit from the therapy from those at risk for side effects, and would definitely have an impact in the future care of these patients and male patients in general once genetic profiling becomes part of the standard of care.
Estrogen has been gaining recognition as the primary hormone that regulates the male skeleton. Estrogen in males is mainly derived from the conversion of testosterone to estradiol by the enzyme aromatase. Polymorphisms of the aromatase gene (CYP19A1) have been reported to result in variable enzyme activity resulting in variable hormonal profile and differences in bone mineral density (BMD) among the variants. These polymorphisms were also found to influence changes in BMD in response to hormone therapy in postmenopausal women and bone loss from aromatase inhibitors in women with breast cancer. It is possible that these same polymorphisms will also influence skeletal response to testosterone therapy in hypogonadal males given testosterone.
Among the side effects described for testosterone therapy, prostate-related events and an increase in hematocrit represent as the more common and the potentially more serious side effects. However, these side effects do not affect everybody, suggesting that a certain subgroup of patients is predisposed to these side effects. Because polymorphisms in the CYP19A1 gene result differences in activity among variants leading in variable substrate and product accumulation, the investigators hypothesize that these polymorphisms will influence the skeletal response and perhaps susceptibility to side effects from testosterone therapy. Thus the objectives of this proposal are: (1) To evaluate the influence of polymorphisms in the CYP19A1 gene on the skeletal response to testosterone in male patients with low testosterone, (2) To evaluate the influence of polymorphisms in the CYP19A1 gene on the susceptibility to side effects from testosterone therapy, (3) To evaluate the changes in functional activity of the aromatase enzyme in clinically significant CYP19A1 gene polymorphisms. The investigators propose to treat 105 patients with testosterone cypionate 200 mg IM every 2 weeks for an 18-month treatment period. The investigators will do serial measurements of BMD by dual energy X-ray absorptiometry, markers of bone turnover, hematocrit, prostate-specific antigen (PSA), prostate volume and hormonal assays. Changes in BMD and markers of bone turnover with testosterone treatment will be compared among the different CYP19A1 genotypes. The investigators will also compare changes in hematocrit, PSA and prostate volume among the different CYP19A1 genotypes. Changes in functional activity among the variants will be evaluated by CYP19 gene expression studies on the adipose tissues obtained from periumbilical fat biopsies, and by changes the in estradiol to testosterone ratio, a surrogate marker for aromatase activity. The investigators anticipate that variants with increase in activity will have relatively higher estradiol levels than less active variants resulting in greater increments in BMD. Meanwhile, less active variants will have relatively higher levels of testosterone than other variants and have greater increments in hematocrit. On the other hand, variants associated with higher estradiol to testosterone ratio will experience greater increases in PSA and prostate volume with therapy.
The incidence of testosterone deficiency goes up with aging and the presence of co-morbid conditions making male hypogonadism one of the common problems among patients attending the VA clinics who, are for the most part, elderly with various co-morbid conditions. Indeed, a large number of VA patients are already taking testosterone for hypogonadism, some of them primarily to prevent further bone loss. It is possible that some of these patients do not derive benefit from the drug while subjecting them to potential serious side effects. Results from this proposal will identify the genetic profiles of favorable responders from poor responders or those who might be more prone to serious side effects, thus, may impact the future care of male Veterans and hypogonadal patients in general, once genetic profiling becomes part of the standard of care.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1: Testosterone Cypionate | Experimental | All patients who qualify for the study will receive testosterone cypionate |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Testosterone Cypionate | Drug | Testosterone cypionate was administered at 200 mg by intramuscular injection every 2 weeks. DEPo-Testosterone Injection, for intramuscular injection, contains testosterone cypionate which is the oil-soluble 17 (beta)-cyclopentylpropionate ester of the androgenic hormone testosterone. Testosterone cypionate is a white or creamy white crystalline powder, odorless or nearly so and stable in air. It is insoluble in water, freely soluble in alcohol, chloroform, dioxane, ether, and soluble in vegetable oils. The chemical name for testosterone cypionate is androst-4-en-3-one,17-(3-cyclopentyl-1oxopropoxy)-, (178)-. Its molecular formula is CvH400a, and the molecular weight of 412.61. |
| Measure | Description | Time Frame |
|---|---|---|
| Percent Change in Bone Mineral Density (BMD) According to rs700518 Polymorphism in the CYP19A1 Gene | Percent change in bone mineral density from baseline to 18 months | form baseline to 18 months |
| Percent Change in Bone Mineral Density (BMD) According to the rs1062033 Polymorphism in the CYP19A1 Gene | Percent change in bone mineral density from baseline to 18 months. | baseline to 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| Percent Change in Bone Mineral Density According to Body Mass Index (BMI) | Percent changes in bone mineral density from baseline | baseline to 18 months |
| Percent Change in Prostate-specific Antigen (PSA) According to the rs700518 Polymorphism of the CYP19A1 Gene |
Not provided
Inclusion Criteria:
Exclusion Criteria:
history of prostate cancer, breast cancer
history of testicular disease
untreated sleep apnea
any ongoing illness that, in the opinion of the investigator, could prevent the subject from completing the study
patients with a hematocrit of more than 50% (2010 Endocrine Society Guidelines)
prostate-related findings of a palpable prostate nodule on exam, a serum PSA of 4.0 ng/ml or more, International Prostate Symptom Score >8(9), urinary postvoid residual by ultrasound of >149 ml, or an abnormal transrectal ultrasound
patients who are on androgen replacement therapy, selective androgen receptor modulator, or finasteride
patients currently on medications that affects bone metabolism such as:
patients with diseases known to interfere with bone metabolism as hyperparathyroidism, untreated hyperthyroidism, osteomalacia, chronic liver disease, renal failure, hypercortisolism, malabsorption and immobilization
those with current alcohol use of more than 3 drinks per day (62).
history of documented coronary artery disease at high risk for recurrence
Subjects with osteoporosis or a BMD T-score of -2.5 in the lumbar spine, total femur or femoral neck as well as those patients with a history of osteoporosis-related fractures (spine, hip or wrist) or vertebral deformities on lateral spine radiographs deemed as fragility fractures by the team principal investigator.
history of documented coronary artery disease at high risk for recurrence, history of deep vein thrombosis and cerebrovascular event.
Male Veterans with low total testosterone (<300 ng/dl) as defined by the Endocrine Society, who are between 40-75 years of age.
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Reina C Villareal, MD | New Mexico VA Health Care System, Albuquerque, NM | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| New Mexico VA Health Care System, Albuquerque, NM | Albuquerque | New Mexico | 87108-5153 | United States | ||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35027909 | Derived | Joad S, Ballato E, Deepika F, Gregori G, Fleires-Gutierrez AL, Colleluori G, Aguirre L, Chen R, Russo V, Fuenmayor Lopez VC, Qualls C, Villareal DT, Armamento-Villareal R. Hemoglobin A1c Threshold for Reduction in Bone Turnover in Men With Type 2 Diabetes Mellitus. Front Endocrinol (Lausanne). 2021 Dec 28;12:788107. doi: 10.3389/fendo.2021.788107. eCollection 2021. | |
| 33735389 |
Not provided
Not provided
People who ensure quality from the institutions where the research is being done, federal and other regulatory agencies will have access to all of the research data such as Food and Drug Administration (FDA) and Data Monitoring Committee (DMC). The purpose of collecting information covered under 38 U.S.C. 7332 is to conduct scientific research and no personnel involved in this study will identify, directly or indirectly, any individual patient or subject in any report of such research.
The only research data that will leave the MEDVA MC will be emailed to the FDA and Data Monitoring Committee, and will include only data on subjects who developed side effects including heart attacks, strokes, high hematocrit, high PSA, psychiatric problems and other adverse events, and the results of their tests. None of the 18 HIPAA identifiers will be included.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Title | Description |
|---|---|---|
| FG000 | Arm 1: Testosterone Cypionate | All patients who qualify for the study will receive testosterone cypionate Testosterone Cypionate: DEPo-Testosterone Injection, for intramuscular injection, contains testosterone cypionate which is the oil-soluble 17 (beta)-cyclopentylpropionate ester of the androgenic hormone testosterone. Subjects were divided into different groups of BMI. Testosterone cypionate is a white or creamy white crystalline powder, odorless or nearly so and stable in air. It is insoluble in water, freely soluble in alcohol, chloroform, dioxane, ether, and soluble in vegetable oils. The chemical name for testosterone cypionate is androst-4-en-3-one,17-(3-cyclopentyl-1oxopropoxy)-, (178)-. Its molecular formula is CvH400a, and the molecular weight 412.61.is available in two strengths, 100 mg/mL and 200 mg/mL testosterone cypionate. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Not provided
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Arm 1: Testosterone Cypionate | All patients who qualify for the study will receive testosterone cypionate Testosterone Cypionate: DEPo-Testosterone Injection, for intramuscular injection, contains testosterone cypionate which is the oil-soluble 17 (beta)-cyclopentylpropionate ester of the androgenic hormone testosterone. Subjects were divided into different groups of BMI. Testosterone cypionate is a white or creamy white crystalline powder, odorless or nearly so and stable in air. It is insoluble in water, freely soluble in alcohol, chloroform, dioxane, ether, and soluble in vegetable oils. The chemical name for testosterone cypionate is androst-4-en-3-one,17-(3-cyclopentyl-1oxopropoxy)-, (178)-. Its molecular formula is CvH400a, and the mole |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percent Change in Bone Mineral Density (BMD) According to rs700518 Polymorphism in the CYP19A1 Gene | Percent change in bone mineral density from baseline to 18 months | Analysis was by intention to treat with the last value carry forward. Those who had at least one follow-up from baseline were included in the analysis. The data from 84 subjects were available for analysis; 15 in the GG, 44 in the GA and 25 in the AA genotype. | Posted | Mean | Standard Deviation | percent change | form baseline to 18 months |
|
18 months
Not provided
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Arm 1: Testosterone Cypionate | All patients who qualify for the study will receive testosterone cypionate Testosterone Cypionate: DEPo-Testosterone Injection, for intramuscular injection, contains testosterone cypionate which is the oil-soluble 17 (beta)-cyclopentylpropionate ester of the androgenic hormone testosterone. Testosterone cypionate is a white or creamy white crystalline powder, odorless or nearly so and stable in air. It is insoluble in water, freely soluble in alcohol, chloroform, dioxane, ether, and soluble in vegetable oils. The chemical name for testosterone cypionate is androst-4-en-3-one,17-(3-cyclopentyl-1oxopropoxy)-, (178)-. Its molecular formula is CvH400a, and the mole |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| stroke | Nervous system disorders | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Congestive heart failure | Cardiac disorders | Systematic Assessment |
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Reina Villareal, MD | Michael E. DeBakey VA Medical Center | 713-794-7534 | reina.villareal@va.gov |
Not provided
| ID | Term |
|---|---|
| D007006 | Hypogonadism |
| ID | Term |
|---|---|
| D006058 | Gonadal Disorders |
| D004700 | Endocrine System Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| C016131 | testosterone 17 beta-cypionate |
| D043343 | Testosterone Propionate |
| ID | Term |
|---|---|
| D013739 | Testosterone |
| D000737 | Androstenols |
| D000736 | Androstenes |
| D000731 | Androstanes |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
|
Percent change in PSA from baseline to 18 months |
| From baseline to 18 months |
| Percent Change in Prostate-specific Antigen (PSA) According to the rs1062033 Polymorphism of the CYP19A1 Gene | Percent change in PSA from baseline at 18 months | from baseline to 18 months |
| Percent Change in Hematocrit According to the Genotype of the 700518 Polymorphism of the CYP19A1gene | Percent change in hematocrit from baseline to 18 months | baseline to 18 months |
| Percent Change in Hematocrit According to re1062033 Polymorphism of the CYP19A1 Gene | Percent change in hematocrit from baseline to 18 months | Baseline to 18 months |
| Percent Change in Aromatase Gene Activity From the Buffy Coat According to the 700518 Polymorphism of the CYP19A1 Gene | Percent change in gene expression from baseline to 18 months | Baseline to 6 months |
| Percent Change in Bone Turnover Markers According to the rs700518 Polymorphism of the CYP19A1 Gene | Percent change in bone turnover from baseline to 18 months. | Baseline to 18 months |
| Percent Change in Bone Turnover Markers According to the rs1062033 Polymorphism of the CYP19A1 Gene | Percent change in bone turnover markers | Baseline to 18 months |
| Percent Change in Bone Mineral Density According the Presence of Diabetes Mellitus | Percent change in bone mineral density from baseline to 18 months | Baseline to 18 months |
| Percent Change in Bone Turnover Markers According the Presence of Diabetes Mellitus | Percent change in bone turnover markers from baseline to 18 months. | Baseline to 18 months |
| Michael E. DeBakey VA Medical Center, Houston, TX |
| Houston |
| Texas |
| 77030 |
| United States |
| Colleluori G, Aguirre L, Napoli N, Qualls C, Villareal DT, Armamento-Villareal R. Testosterone Therapy Effects on Bone Mass and Turnover in Hypogonadal Men with Type 2 Diabetes. J Clin Endocrinol Metab. 2021 Jul 13;106(8):e3058-e3068. doi: 10.1210/clinem/dgab181. |
| years |
|
| Sex: Female, Male | Participants were divided into BMI groups. | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| Body mass index | Mean | Standard Deviation | kg/m2 |
|
| patients with diabetes mellitus | Count of Participants | Participants |
|
| aromatase activity as assessed using estradiol to testosterone ratio | Aromatase activity was assessed using estradiol to testosterone ratio and the whole groups was divided equally according to tertiles of estradiol to testosterone ratio. | Only the first 87 participants analyzed for this assessment | Mean | Standard Deviation | estradiol to testosterone ratio |
|
| OG001 | GA Genotype for the rs700518 Polymorphisms of the CYP19A1 Gene | All patients who qualify for the study will receive testosterone cypionate Testosterone Cypionate: DEPo-Testosterone Injection, for intramuscular injection, contains testosterone cypionate which is the oil-soluble 17 (beta)-cyclopentylpropionate ester of the androgenic hormone testosterone. Subjects were divided into the different genotypes for the rs700518 polymorphism of the CYP19A1 gene. |
| OG002 | AA Genotype for the rs700518 Polymorphism of the CYP19A1 Gene | All patients who qualify for the study will receive testosterone cypionate Testosterone Cypionate: DEPo-Testosterone Injection, for intramuscular injection, contains testosterone cypionate which is the oil-soluble 17 (beta)-cyclopentylpropionate ester of the androgenic hormone testosterone. Subjects were divided into the different genotypes for the rs700518 polymorphism of the CYP19A1 gene. |
|
|
|
| Primary | Percent Change in Bone Mineral Density (BMD) According to the rs1062033 Polymorphism in the CYP19A1 Gene | Percent change in bone mineral density from baseline to 18 months. | Analysis was by intention to treat with the last value carry forward. Those who had at least one follow-up from baseline were included in the analysis . The data of 82 subjects were available for analysis; 14 in the GG, 38 in the GC and 32 in the CC genotype. | Posted | Mean | Standard Deviation | PERCENT CHANGE | baseline to 18 months |
|
|
|
|
| Secondary | Percent Change in Bone Mineral Density According to Body Mass Index (BMI) | Percent changes in bone mineral density from baseline | Analysis was by intention to treat with the last value carry forward. Thirty subjects in BMI group 1, 31 in BMI group 2 and 23 subjects in BMI groups 3 have complete dataset available for analysis. There were a total 84 patients who were able to provide data for this outcome at 18 months. | Posted | Mean | Standard Error | Percent change | baseline to 18 months |
|
|
|
|
| Secondary | Percent Change in Prostate-specific Antigen (PSA) According to the rs700518 Polymorphism of the CYP19A1 Gene | Percent change in PSA from baseline to 18 months | More participants came for their 6-month blood test than for other outcomes e.g. BMD. Since our analysis was intention to treat with the last value carry forward, there were more patients with evaluable PSA data at 18 months, as some patients who had PSA but had no BMD testing etc. who dropped out of the study were also included in the analysis. | Posted | Mean | Standard Deviation | percent change | From baseline to 18 months |
|
|
|
|
| Secondary | Percent Change in Prostate-specific Antigen (PSA) According to the rs1062033 Polymorphism of the CYP19A1 Gene | Percent change in PSA from baseline at 18 months | More participants came for their 6-month blood test than for other outcomes e.g. BMD. Since our analysis was intention to treat with the last value carry forward, there were more patients with evaluable PSA data at 18 months, as some patients who had PSA but had no BMD testing etc. who dropped out of the study were also included in the analysis. | Posted | Mean | Standard Deviation | precent change | from baseline to 18 months |
|
|
|
|
| Secondary | Percent Change in Hematocrit According to the Genotype of the 700518 Polymorphism of the CYP19A1gene | Percent change in hematocrit from baseline to 18 months | Analysis was by intention to treat with the last value carry forward. Those who had at least one follow-up from baseline were included in the analysis. The data of 85 subjects were available for analysis; 16 subjects in the GG, 43 in the GC and 26 subjects in the CC genotype. | Posted | Mean | Standard Deviation | Percent change | baseline to 18 months |
|
|
|
|
| Secondary | Percent Change in Hematocrit According to re1062033 Polymorphism of the CYP19A1 Gene | Percent change in hematocrit from baseline to 18 months | Analysis was by intention to treat with the last value carry forward. Those who had at least one follow-up from baseline were included in the analysis. The data of 85 subjects were available for analysis; 15 subjects in the GG, 37 in the GC and 33 subjects in the CC genotype. | Posted | Mean | Standard Deviation | percent change | Baseline to 18 months |
|
|
|
|
| Secondary | Percent Change in Aromatase Gene Activity From the Buffy Coat According to the 700518 Polymorphism of the CYP19A1 Gene | Percent change in gene expression from baseline to 18 months | Gene expression studies were successful in 27 samples; 6 in the GG, 17 in the GA and 4 in the AA genotype. | Posted | Mean | Standard Deviation | percent change | Baseline to 6 months |
|
|
|
| Secondary | Percent Change in Bone Turnover Markers According to the rs700518 Polymorphism of the CYP19A1 Gene | Percent change in bone turnover from baseline to 18 months. | Analysis was by intention to treat with the last value carry forward. Those who had at least one follow-up from baseline were included in the analysis. The data of 79 subjects were analyzed; 15 in the GG, 43 in the GA and 21 in the AA genotype. | Posted | Mean | Standard Deviation | perecent change | Baseline to 18 months |
|
|
|
|
| Secondary | Percent Change in Bone Turnover Markers According to the rs1062033 Polymorphism of the CYP19A1 Gene | Percent change in bone turnover markers | Analysis was by intention to treat with the last value carry forward. Those who had at least one follow-up from baseline were included in the analysis. The data of 79 subjects with acceptable assay coefficient of variability were available for analysis; 15 subjects in the GG, 37 in the GC and 27 in the CC genotype. | Posted | Mean | Standard Deviation | Percent change | Baseline to 18 months |
|
|
|
|
| Secondary | Percent Change in Bone Mineral Density According the Presence of Diabetes Mellitus | Percent change in bone mineral density from baseline to 18 months | Analysis was by intention to treat with the last value carry forward. Thirty-nine subjects with diabetes mellitus group and 45 without diabetes mellitus have complete dataset available for analysis. | Posted | Mean | Standard Deviation | Percent change | Baseline to 18 months |
|
|
|
|
| Secondary | Percent Change in Bone Turnover Markers According the Presence of Diabetes Mellitus | Percent change in bone turnover markers from baseline to 18 months. | Analysis was by intention to treat with the last value carry forward. Thirty-seven subjects with diabetes mellitus group and 41 without diabetes mellitus have complete dataset available for analysis. | Posted | Mean | Standard Error | Percentage Changes | Baseline to 18 months |
|
|
|
|
| 0 |
| 105 |
| 18 |
| 105 |
| 51 |
| 105 |
| abscess | Infections and infestations | Systematic Assessment |
|
| appendicitis | Gastrointestinal disorders | Systematic Assessment |
|
| GI tract perforation | Gastrointestinal disorders | Systematic Assessment |
|
| infection of an appendectomy wound | Infections and infestations | Systematic Assessment |
|
| pyschiatric ilness | Psychiatric disorders | Systematic Assessment | suicidal ideation |
|
| knee arthroscopy | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| knee replacement surgery | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| coronary stent | Cardiac disorders | Systematic Assessment |
|
| atypical chest pain | Cardiac disorders | Systematic Assessment |
|
| new-onset atrial fibrillation | Cardiac disorders | Systematic Assessment |
|
| myocardial infarction | Cardiac disorders | Systematic Assessment |
|
| appendicitis | Gastrointestinal disorders | Systematic Assessment |
|
| diverticulitis | Gastrointestinal disorders | Systematic Assessment |
|
| heartburn | Gastrointestinal disorders | Systematic Assessment |
|
| gallstones | Hepatobiliary disorders | Systematic Assessment |
|
| infected appendectomy wound | Gastrointestinal disorders | Systematic Assessment |
|
| infected spider bite | Infections and infestations | Systematic Assessment |
|
| shingles | Infections and infestations | Systematic Assessment |
|
| cellulitis | Infections and infestations | Systematic Assessment |
|
| high hematocrit | Blood and lymphatic system disorders | Systematic Assessment |
|
| hemochromatosis | Blood and lymphatic system disorders | Systematic Assessment |
|
| upper respiratory infection | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| dyspnea | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| lung carcinoma | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| priapism | Reproductive system and breast disorders | Systematic Assessment |
|
| mastitis | Reproductive system and breast disorders | Systematic Assessment |
|
| prostate enlargement | Renal and urinary disorders | Systematic Assessment |
|
| alopecia | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| acne | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| laceration | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| mood swings | Psychiatric disorders | Systematic Assessment |
|
| irritability | Psychiatric disorders | Systematic Assessment |
|
| depression | Psychiatric disorders | Systematic Assessment |
|
| headache | Nervous system disorders | Systematic Assessment |
|
| ingrown toenail | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| heel pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| arthroplasty | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| foot pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| vertebral fracture | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| osteoarthritis | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| excision of bone spur | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| knee replacement | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| sleep apnea | General disorders | Systematic Assessment |
|
| back pain | Injury, poisoning and procedural complications | Systematic Assessment |
|
| retinal injury | Injury, poisoning and procedural complications | Systematic Assessment |
|
Not provided
Not provided
Not provided
| D013256 |
| Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D045165 | Testosterone Congeners |
| D012739 | Gonadal Steroid Hormones |
| D042341 | Gonadal Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
|
| TOTAL HIP |
|
|
| femoral neck |
|
|
|
| FEMORAL NECK |
|