human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Testosterone has immune-modulating properties , and current in vitro evidence suggests that testosterone may suppress the expression of the proinflammatory cytokines TNFalpha , IL-1beta , and IL-6 and potentiate the expression of the antiinflammatory cytokine IL-10 . We report a r and omized , single-blind , placebo-controlled , crossover study of testosterone replacement ( Sustanon 100 ) vs. placebo in 27 men ( age , 62 + /- 9 yr ) with symptomatic and rogen deficiency ( total testosterone , 4.4 + /- 1.2 nmol/liter ; bioavailable testosterone , 2.4 + /- 1.1 nmol/liter ) . Compared with placebo , testosterone induced reductions in TNFalpha ( -3.1 + /- 8.3 vs. 1.3 + /- 5.2 pg/ml ; P = 0.01 ) and IL-1beta ( -0.14 + /- 0.32 vs. 0.18 + /- 0.55 pg/ml ; P = 0.08 ) and an increase in IL-10 ( 0.33 + /- 1.8 vs. -1.1 + /- 3.0 pg/ml ; P = 0.01 ) ; the reductions of TNFalpha and IL-1beta were positively correlated ( r(S ) = 0.588 ; P = 0.003 ) . In addition , a significant reduction in total cholesterol was recorded with testosterone therapy ( -0.25 + /- 0.4 vs. -0.004 + /- 0.4 mmol/liter ; P = 0.04 ) . In conclusion , testosterone replacement shifts the cytokine balance to a state of reduced inflammation and lowers total cholesterol .  Twenty of these men had established coronary disease , and because total cholesterol is a cardiovascular risk factor , and proinflammatory cytokines mediate the development and complications associated with atheromatous plaque , these properties may have particular relevance in men with overt vascular disease CONTEXT Low T levels have been associated with  ejaculatory dysfunction ( EjD ) in cross-sectional studies ; however , the efficacy of T replacement in improving EjD has not been studied in a r and omized controlled trial . OBJECTIVE To evaluate the efficacy of T replacement in and rogen-deficient men with EjD. DESIGN A multicenter , double-blind , r and omized , placebo-controlled , 16-week trial with T solution 2 % versus placebo . SETTING Medical centers in the United States , Canada , and Mexico . PATIENTS OR OTHER PARTICIPANTS Seventy-six men with one or more EjD symptoms , including delayed ejaculation , anejaculation , reduced ejaculate volume , and /or reduced force of ejaculation , and two total T levels < 300 ng/dL ( < 10.41 nmol/L ) measured with liquid chromatography t and em mass spectrometry . INTERVENTIONS Sixty milligrams of T solution 2 % or placebo applied to the axillae for 16 weeks . MAIN OUTCOME MEASURES The primary outcome was a change in the score of the three-item Male Sexual Health Question naire-Ejaculatory Dysfunction-Short Form ( MSHQ-EjD-SF ) ; secondary outcomes included measured ejaculate volume , scores of the bother/satisfaction item of the MSHQ-EjD-SF , the orgasmic function domain of the International Index of Erectile Function Question naire , and the sexual activity log . RESULTS Seventy-six participants were r and omized ; 66 completed the study . Baseline demographic and clinical characteristics were comparable between the treatment arms . T replacement improved the MSHQ-EjD-SF score ( mean score change , + 3.1 ) ; however , this effect was not statistically different from placebo ( mean score change , + 2.5 ; P = .596 ) . No differences were seen in any of the secondary outcomes or frequency of adverse events . CONCLUSION T replacement was not associated with significant improvement in EjD in and rogen-deficient men Objective —Because male sex is an independent risk factor for the severity of atherosclerosis , it is possible that and rogens may be proatherogenic . There is evidence that sex hormones , particularly estrogens , regulate ( or modulate ) inflammation , a process integral to atherogenesis . Because levels of serum inflammatory markers predict cardiovascular outcomes , we prospect ively assessed the effects of and rogen therapy on these markers in older men . Methods and Results —Levels of high-sensitivity C-reactive protein ( CRP ) , soluble intracellular adhesion molecule-1 ( sICAM-1 ) , and soluble vascular cell adhesion molecule-1 ( sVCAM-1 ) were measured from sera collected at baseline and at the end of 2 r and omized double-blind placebo-controlled trials evaluating the effects of 3 months of and rogen treatment with either dihydrotestosterone ( DHT ) or recombinant human chorionic gonadotropin ( rhCG ) in healthy men aged > 60 years with partial and rogen deficiency ( serum testosterone levels < 15 nmol/L ) . For the DHT study ( 70 mg transdermally daily ) , 33 men completed 3 months of treatment ( 16 men were treated with DHT , and there were 17 controls ) . For the rhCG ( 250 & mgr;g twice weekly ) study , 20 men were treated with rhCG , and there were 20 controls . In both studies , groups were well matched for age and vascular risk factors . And rogen levels ( DHT and testosterone ) were consistently maintained at eugonadal levels throughout the trials , with estradiol markedly increased by rhCG but not DHT .  Baseline CRP levels were 0.74 to 1.49 mg/L , sVCAM-1 levels were 847 to 950 ng/mL , and sICAM-1 levels were 256 to 292 ng/mL in all groups . Neither DHT nor rhCG result ed in significant changes in CRP , sVCAM-1 , or sICAM-1 compared with placebo ( P > 0.3 in both studies ) . Conclusions —Exogenous and rogen therapy with or without increased estradiol levels does not alter serum inflammatory markers in older men ; this finding is in contrast to the effects of estrogens on inflammatory markers that have been found in postmenopausal women . These data provide a measure of reassurance concerning potential adverse cardiovascular effects of and rogen therapy in older men CONTEXT Testosterone in Older Men with Mobility Limitations Trial determined the effects of testosterone on muscle performance and physical function in older men with mobility limitation . Trial 's Data and Safety Monitoring Board recommended enrollment cessation due to increased frequency of adverse events in testosterone arm . The changes in muscle performance and physical function were evaluated in relation to participant 's perception of change . METHODS Men aged 65 years and older , with mobility limitation , total testosterone 100 - 350 ng/dL , or free testosterone less than 50 pg/mL , were r and omized to placebo or 10 g testosterone gel daily for 6 months . Primary outcome was leg-press strength . Secondary outcomes included chest-press strength , stair-climb , 40-m walk , muscle mass , physical activity , self-reported function , and fatigue . Proportions of participants exceeding minimally important difference in study arms were compared . RESULTS Of 209 r and omized participants , 165 had follow-up efficacy measures . Mean ( SD ) age was 74 ( 5.4 ) years and short physical performance battery score 7.7 ( 1.4 ) .  Testosterone arm exhibited greater improvements in leg-press strength , chest-press strength and power , and loaded stair-climb than placebo . Compared with placebo , significantly greater proportion of men receiving testosterone improved their leg-press and chest-press strengths ( 43 % vs 18 % , p = .01 ) and stair-climbing power ( 28 % vs 10 % , p = .03 ) more than minimally important difference . Increases in leg-press strength and stair-climbing power were associated with changes in testosterone levels and muscle mass . Physical activity , walking speed , self-reported function , and fatigue did not change . CONCLUSIONS Testosterone administration in older men with mobility limitation was associated with patient-important improvements in muscle strength and stair-climbing power . Improvements in muscle strength and only some physical function measures should be weighed against the risk of adverse events in this population The elevated estradiol/testosterone ( E2/T ) ratio had been proved to be a risk factor for coronary heart disease ( CHD ) in elderly men . We conducted a r and omized placebo controlled crossover study on the effects of a new and rogenic preparation " And riol " in 62 elderly men with CHD over a period of 2.5 months . The results showed significant differences between And riol- and placebo-treated groups at the end of this period : in the former , serum T level was elevated significantly ( P < 0.001 ) , E2 level was unchanged ( P > 0.05 ) , E2/T ratio was reduced ( P < 0.05 ) , angina pectoris ( AP ) was relieved ( total effective rate , 77.4 % ) , and myocardial ischemia in ECG and Holter recordings were improved ( total effective rate , respectively 68.8 % and 75 % ) . Doppler echocardiography showed that 12 parameters of cardiac function were unchanged in both groups . No obvious side effect was found in those who took And riol The prospect s of wider application of testosterone ( T ) in novel indications such as male contraception have prompted renewed interest in the investigation of nonreproductive actions and safety of and rogens . This study investigated potential changes in mood and behavior in response to elevations in circulating T concentrations produced by the new long-acting preparation , T undecanoate ( TU ) .  Twenty-eight eugonadal men were r and omized into one of two treatment groups : A1 ) active , receiving 1000 mg TU i.m . followed by A2 ) washout , followed by A3 ) placebo , receiving 4 ml castor oil i.m . ; B1 ) placebo , 4 ml castor oil i.m . ; B2 ) washout followed by B3 ) active , receiving 1000 mg TU i.m .. Mood , self- and partner-reported physical and verbal aggression , anger , hostility , irritability , assertiveness , self-esteem , and sexual function were assessed . A single injection of 1000 mg TU i.m . increased plasma T concentrations from 20.7 + /- 1.5 to 37.5 + /- 2.2 nmol/liter at wk 1 and 31.6 + /- 1.5 nmol/liter at wk 2 , and estradiol from 74.0 + /- 4.9 to 120.4 + /- 10.7 pmol/liter at wk 1 , and 100.0 + /- 6.3 pmol/liter at wk 2 . The T increment was associated with detectable but minor mood changes . Increased circulating T was associated with significant increases in anger-hostility from baseline ( mean score = 7.48 ) to wk 2 ( mean score = 10.71 ) accompanied by an overall reduction in fatigue-inertia ( treatment = 6.21 vs. placebo = 7.84 ) . TU treatment did not increase aggressive behavior or induce any changes in nonaggressive or sexual behavior . Changes in estradiol were not associated with any behavioral alterations . Our results suggest that exogenous TU-induced elevation of circulating T , to the range likely to be used in hormonal male contraception , has limited psychological effects . Future research should investigate the implication s of these minor mood changes OBJECTIVE To assess the effect of short-term testosterone supplementation on health-related quality of life in elderly males . METHOD As part of a double-blind , placebo-controlled study , healthy males > or = 65-year-old were r and omised to receive a total of four doses of 200 mg testosterone enanthanate ( n = 14 ) or placebo ( n = 8) intramuscularly every 2 weeks . Health-related quality of life ( HRQOL ) was assessed using the Short Form 36-item ( SF-36 ) and Psychological General Well-Being ( PGWB ) scales , at baseline , week 8 and during therapy withdrawal , 6 weeks after the last dose . RESULTS The baseline SF-36 scores were similar between the groups in seven domains ; only vitality was significantly lower in the placebo group ( T : 80.4 , P : 65.6 ; P = 0.007 ) . After the 8-week treatment period and withdrawal phase , SF-36 scores were not significantly different between the groups . The PGWB scores at baseline , on treatment and off treatment were not significantly different between the groups . Moreover , the SF-36 and PGWB scores within each group did not change significantly over time . CONCLUSION This pilot study suggests that intramuscular testosterone , administered at a dose of 200 mg every 2 weeks , does not affect the HRQOL of elderly males OBJECTIVE Serum testosterone levels are known to inversely correlate with insulin sensitivity and obesity in men . Furthermore , there is evidence to suggest that testosterone replacement therapy reduces insulin resistance and visceral adiposity in type 2 diabetic men . Adipocytokines are hormones secret 
    Output:
    
agent
Testosterone supplementation did not show consistent benefit for cardiovascular risk , sexual function , mood and behavior , or cognition .
Studies that examined clinical cardiovascular endpoints have not favored testosterone therapy over placebo .
Testosterone is ineffective in treating erectile dysfunction and controlled trials did not show a consistent effect on libido .
Testosterone supplementation consistently increased muscle strength but did not have beneficial effects on physical function .
Most studies on mood-related endpoints found no beneficial effect of testosterone treatment on personality , psychological well-being , or mood .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Testosterone has immune-modulating properties , and current in vitro evidence suggests that testosterone may suppress the expression of the proinflammatory cytokines TNFalpha , IL-1beta , and IL-6 and potentiate the expression of the antiinflammatory cytokine IL-10 . We report a r and omized , single-blind , placebo-controlled , crossover study of testosterone replacement ( Sustanon 100 ) vs. placebo in 27 men ( age , 62 + /- 9 yr ) with symptomatic and rogen deficiency ( total testosterone , 4.4 + /- 1.2 nmol/liter ; bioavailable testosterone , 2.4 + /- 1.1 nmol/liter ) . Compared with placebo , testosterone induced reductions in TNFalpha ( -3.1 + /- 8.3 vs. 1.3 + /- 5.2 pg/ml ; P = 0.01 ) and IL-1beta ( -0.14 + /- 0.32 vs. 0.18 + /- 0.55 pg/ml ; P = 0.08 ) and an increase in IL-10 ( 0.33 + /- 1.8 vs. -1.1 + /- 3.0 pg/ml ; P = 0.01 ) ; the reductions of TNFalpha and IL-1beta were positively correlated ( r(S ) = 0.588 ; P = 0.003 ) . In addition , a significant reduction in total cholesterol was recorded with testosterone therapy ( -0.25 + /- 0.4 vs. -0.004 + /- 0.4 mmol/liter ; P = 0.04 ) . In conclusion , testosterone replacement shifts the cytokine balance to a state of reduced inflammation and lowers total cholesterol .  Twenty of these men had established coronary disease , and because total cholesterol is a cardiovascular risk factor , and proinflammatory cytokines mediate the development and complications associated with atheromatous plaque , these properties may have particular relevance in men with overt vascular disease CONTEXT Low T levels have been associated with  ejaculatory dysfunction ( EjD ) in cross-sectional studies ; however , the efficacy of T replacement in improving EjD has not been studied in a r and omized controlled trial . OBJECTIVE To evaluate the efficacy of T replacement in and rogen-deficient men with EjD. DESIGN A multicenter , double-blind , r and omized , placebo-controlled , 16-week trial with T solution 2 % versus placebo . SETTING Medical centers in the United States , Canada , and Mexico . PATIENTS OR OTHER PARTICIPANTS Seventy-six men with one or more EjD symptoms , including delayed ejaculation , anejaculation , reduced ejaculate volume , and /or reduced force of ejaculation , and two total T levels < 300 ng/dL ( < 10.41 nmol/L ) measured with liquid chromatography t and em mass spectrometry . INTERVENTIONS Sixty milligrams of T solution 2 % or placebo applied to the axillae for 16 weeks . MAIN OUTCOME MEASURES The primary outcome was a change in the score of the three-item Male Sexual Health Question naire-Ejaculatory Dysfunction-Short Form ( MSHQ-EjD-SF ) ; secondary outcomes included measured ejaculate volume , scores of the bother/satisfaction item of the MSHQ-EjD-SF , the orgasmic function domain of the International Index of Erectile Function Question naire , and the sexual activity log . RESULTS Seventy-six participants were r and omized ; 66 completed the study . Baseline demographic and clinical characteristics were comparable between the treatment arms . T replacement improved the MSHQ-EjD-SF score ( mean score change , + 3.1 ) ; however , this effect was not statistically different from placebo ( mean score change , + 2.5 ; P = .596 ) . No differences were seen in any of the secondary outcomes or frequency of adverse events . CONCLUSION T replacement was not associated with significant improvement in EjD in and rogen-deficient men Objective —Because male sex is an independent risk factor for the severity of atherosclerosis , it is possible that and rogens may be proatherogenic . There is evidence that sex hormones , particularly estrogens , regulate ( or modulate ) inflammation , a process integral to atherogenesis . Because levels of serum inflammatory markers predict cardiovascular outcomes , we prospect ively assessed the effects of and rogen therapy on these markers in older men . Methods and Results —Levels of high-sensitivity C-reactive protein ( CRP ) , soluble intracellular adhesion molecule-1 ( sICAM-1 ) , and soluble vascular cell adhesion molecule-1 ( sVCAM-1 ) were measured from sera collected at baseline and at the end of 2 r and omized double-blind placebo-controlled trials evaluating the effects of 3 months of and rogen treatment with either dihydrotestosterone ( DHT ) or recombinant human chorionic gonadotropin ( rhCG ) in healthy men aged > 60 years with partial and rogen deficiency ( serum testosterone levels < 15 nmol/L ) . For the DHT study ( 70 mg transdermally daily ) , 33 men completed 3 months of treatment ( 16 men were treated with DHT , and there were 17 controls ) . For the rhCG ( 250 & mgr;g twice weekly ) study , 20 men were treated with rhCG , and there were 20 controls . In both studies , groups were well matched for age and vascular risk factors . And rogen levels ( DHT and testosterone ) were consistently maintained at eugonadal levels throughout the trials , with estradiol markedly increased by rhCG but not DHT .  Baseline CRP levels were 0.74 to 1.49 mg/L , sVCAM-1 levels were 847 to 950 ng/mL , and sICAM-1 levels were 256 to 292 ng/mL in all groups . Neither DHT nor rhCG result ed in significant changes in CRP , sVCAM-1 , or sICAM-1 compared with placebo ( P > 0.3 in both studies ) . Conclusions —Exogenous and rogen therapy with or without increased estradiol levels does not alter serum inflammatory markers in older men ; this finding is in contrast to the effects of estrogens on inflammatory markers that have been found in postmenopausal women . These data provide a measure of reassurance concerning potential adverse cardiovascular effects of and rogen therapy in older men CONTEXT Testosterone in Older Men with Mobility Limitations Trial determined the effects of testosterone on muscle performance and physical function in older men with mobility limitation . Trial 's Data and Safety Monitoring Board recommended enrollment cessation due to increased frequency of adverse events in testosterone arm . The changes in muscle performance and physical function were evaluated in relation to participant 's perception of change . METHODS Men aged 65 years and older , with mobility limitation , total testosterone 100 - 350 ng/dL , or free testosterone less than 50 pg/mL , were r and omized to placebo or 10 g testosterone gel daily for 6 months . Primary outcome was leg-press strength . Secondary outcomes included chest-press strength , stair-climb , 40-m walk , muscle mass , physical activity , self-reported function , and fatigue . Proportions of participants exceeding minimally important difference in study arms were compared . RESULTS Of 209 r and omized participants , 165 had follow-up efficacy measures . Mean ( SD ) age was 74 ( 5.4 ) years and short physical performance battery score 7.7 ( 1.4 ) .  Testosterone arm exhibited greater improvements in leg-press strength , chest-press strength and power , and loaded stair-climb than placebo . Compared with placebo , significantly greater proportion of men receiving testosterone improved their leg-press and chest-press strengths ( 43 % vs 18 % , p = .01 ) and stair-climbing power ( 28 % vs 10 % , p = .03 ) more than minimally important difference . Increases in leg-press strength and stair-climbing power were associated with changes in testosterone levels and muscle mass . Physical activity , walking speed , self-reported function , and fatigue did not change . CONCLUSIONS Testosterone administration in older men with mobility limitation was associated with patient-important improvements in muscle strength and stair-climbing power . Improvements in muscle strength and only some physical function measures should be weighed against the risk of adverse events in this population The elevated estradiol/testosterone ( E2/T ) ratio had been proved to be a risk factor for coronary heart disease ( CHD ) in elderly men . We conducted a r and omized placebo controlled crossover study on the effects of a new and rogenic preparation " And riol " in 62 elderly men with CHD over a period of 2.5 months . The results showed significant differences between And riol- and placebo-treated groups at the end of this period : in the former , serum T level was elevated significantly ( P < 0.001 ) , E2 level was unchanged ( P > 0.05 ) , E2/T ratio was reduced ( P < 0.05 ) , angina pectoris ( AP ) was relieved ( total effective rate , 77.4 % ) , and myocardial ischemia in ECG and Holter recordings were improved ( total effective rate , respectively 68.8 % and 75 % ) . Doppler echocardiography showed that 12 parameters of cardiac function were unchanged in both groups . No obvious side effect was found in those who took And riol The prospect s of wider application of testosterone ( T ) in novel indications such as male contraception have prompted renewed interest in the investigation of nonreproductive actions and safety of and rogens . This study investigated potential changes in mood and behavior in response to elevations in circulating T concentrations produced by the new long-acting preparation , T undecanoate ( TU ) .  Twenty-eight eugonadal men were r and omized into one of two treatment groups : A1 ) active , receiving 1000 mg TU i.m . followed by A2 ) washout , followed by A3 ) placebo , receiving 4 ml castor oil i.m . ; B1 ) placebo , 4 ml castor oil i.m . ; B2 ) washout followed by B3 ) active , receiving 1000 mg TU i.m .. Mood , self- and partner-reported physical and verbal aggression , anger , hostility , irritability , assertiveness , self-esteem , and sexual function were assessed . A single injection of 1000 mg TU i.m . increased plasma T concentrations from 20.7 + /- 1.5 to 37.5 + /- 2.2 nmol/liter at wk 1 and 31.6 + /- 1.5 nmol/liter at wk 2 , and estradiol from 74.0 + /- 4.9 to 120.4 + /- 10.7 pmol/liter at wk 1 , and 100.0 + /- 6.3 pmol/liter at wk 2 . The T increment was associated with detectable but minor mood changes . Increased circulating T was associated with significant increases in anger-hostility from baseline ( mean score = 7.48 ) to wk 2 ( mean score = 10.71 ) accompanied by an overall reduction in fatigue-inertia ( treatment = 6.21 vs. placebo = 7.84 ) . TU treatment did not increase aggressive behavior or induce any changes in nonaggressive or sexual behavior . Changes in estradiol were not associated with any behavioral alterations . Our results suggest that exogenous TU-induced elevation of circulating T , to the range likely to be used in hormonal male contraception , has limited psychological effects . Future research should investigate the implication s of these minor mood changes OBJECTIVE To assess the effect of short-term testosterone supplementation on health-related quality of life in elderly males . METHOD As part of a double-blind , placebo-controlled study , healthy males > or = 65-year-old were r and omised to receive a total of four doses of 200 mg testosterone enanthanate ( n = 14 ) or placebo ( n = 8) intramuscularly every 2 weeks . Health-related quality of life ( HRQOL ) was assessed using the Short Form 36-item ( SF-36 ) and Psychological General Well-Being ( PGWB ) scales , at baseline , week 8 and during therapy withdrawal , 6 weeks after the last dose . RESULTS The baseline SF-36 scores were similar between the groups in seven domains ; only vitality was significantly lower in the placebo group ( T : 80.4 , P : 65.6 ; P = 0.007 ) . After the 8-week treatment period and withdrawal phase , SF-36 scores were not significantly different between the groups . The PGWB scores at baseline , on treatment and off treatment were not significantly different between the groups . Moreover , the SF-36 and PGWB scores within each group did not change significantly over time . CONCLUSION This pilot study suggests that intramuscular testosterone , administered at a dose of 200 mg every 2 weeks , does not affect the HRQOL of elderly males OBJECTIVE Serum testosterone levels are known to inversely correlate with insulin sensitivity and obesity in men . Furthermore , there is evidence to suggest that testosterone replacement therapy reduces insulin resistance and visceral adiposity in type 2 diabetic men . Adipocytokines are hormones secret 
    Output:
    