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Gynecomastia HELP
Based on 620 articles published since 2008

These are the 620 published articles about Gynecomastia that originated from Worldwide during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline ACR Appropriateness Criteria 2018

Anonymous2731124 / Niell, Bethany L / Lourenco, Ana P / Moy, Linda / Baron, Paul / Didwania, Aarati D / diFlorio-Alexander, Roberta M / Heller, Samantha L / Holbrook, Anna I / Le-Petross, Huong T / Lewin, Alana A / Mehta, Tejas S / Slanetz, Priscilla J / Stuckey, Ashley R / Tuscano, Daymen S / Ulaner, Gary A / Vincoff, Nina S / Weinstein, Susan P / Newell, Mary S. ·H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. Electronic address: bethany.niell@gmail.com. · Alpert Medical School of Brown University, Providence, Rhode Island. · Panel Vice-Chair, NYU Clinical Cancer Center, New York, New York. · Roper St Francis Physician Partners Breast Surgery, Charleston, South Carolina; American College of Surgeons. · Northwestern University Feinberg School of Medicine, Chicago, Illinois; American College of Physicians. · Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. · New York University School of Medicine, New York, New York. · Emory University Hospital, Atlanta, Georgia. · The University of Texas MD Anderson Cancer Center, Houston, Texas. · Beth Israel Deaconess Medical Center, Boston, Massachusetts. · Women and Infants Hospital, Providence, Rhode Island; American Congress of Obstetricians and Gynecologists. · Mecklenburg Radiology Associates, Charlotte, North Carolina. · Memorial Sloan Kettering Cancer Center, New York, New York. · Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York. · Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania. · Panel Chair, Emory University Hospital, Atlanta, Georgia. ·J Am Coll Radiol · Pubmed #30392600.

ABSTRACT: Although the majority of male breast problems are benign with gynecomastia as the most common etiology, men with breast symptoms and their referring providers are typically concerned about whether or not it is due to breast cancer. If the differentiation between benign disease and breast cancer cannot be made on the basis of clinical findings, or if the clinical presentation is suspicious, imaging is indicated. The panel recommends the following approach to breast imaging in symptomatic men. In men with clinical findings consistent with gynecomastia or pseudogynecomastia, no imaging is routinely recommended. If an indeterminate breast mass is identified, the initial recommended imaging study is ultrasound in men younger than age 25, and mammography or digital breast tomosynthesis in men age 25 and older. If physical examination is suspicious for a male breast cancer, mammography or digital breast tomosynthesis is recommended irrespective of patient age. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

2 Editorial From the Editor-in-Chief's Desk. 2015

Koplewicz, Harold S. ·Child Mind Institute , New York, New York. ·J Child Adolesc Psychopharmacol · Pubmed #26579628.

ABSTRACT: -- No abstract --

3 Editorial Male breast cancer imaging. 2015

Khalkhali, Iraj / Cho, John. ·LA BioMed at Harbor-UCLA Medical Center, Torrance, California. ·Breast J · Pubmed #25900306.

ABSTRACT: -- No abstract --

4 Editorial An aroma of complexity: how the unique genetics of aromatase (CYP19A1) explain diverse phenotypes from hens and hyenas to human gynecomastia, and testicular and other tumors. 2013

Stratakis, Constantine A. ·Room 1-3330, East Laboratories, Building 10-CRC, 10 Center Drive, Section on Endocrinology & Genetics/Program on Developmental Endocrinology & Genetics, National Institute of Child Health & Human Development, National Institutes of Health, Bethesda, Maryland 20892. stratakc@mail.nih.gov. ·J Clin Endocrinol Metab · Pubmed #24311795.

ABSTRACT: -- No abstract --

5 Editorial Endocrinology and metabolism. 2008

Root, Allen W. · ·Curr Opin Pediatr · Pubmed #18622202.

ABSTRACT: -- No abstract --

6 Editorial Environmental gynecomastia. 2008

Braunstein, Glenn D. · ·Endocr Pract · Pubmed #18558589.

ABSTRACT: -- No abstract --

7 Review Surgical Management of Gynecomastia: A Review of the Current Insurance Coverage Criteria. 2019

Rasko, Yvonne M / Rosen, Carly / Ngaage, Ledibabari M / AlFadil, Sara / Elegbede, Adekunle / Ihenatu, Chinezi / Nam, Arthur J / Slezak, Sheri. ·Baltimore, Md. From the Department of Plastic Surgery, University of Maryland Medical Center; and the Department of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center. ·Plast Reconstr Surg · Pubmed #31033818.

ABSTRACT: BACKGROUND: Gynecomastia is a common condition that can be corrected with surgical excision of the breast tissue. Unlike the policies available for reduction mammaplasty in women, gynecomastia policies are variable and not based on strong scientific evidence. This study reviews U.S. insurance policies for coverage of gynecomastia surgery and compares these policies to the guidelines put forth by the American Society of Plastic Surgeons. METHODS: Sixty U.S. insurance companies were selected based on their market share value. Medicare was also evaluated. The policy for each company was identified using a Web-based search or by contacting the company directly. Policies were reviewed to abstract coverage criteria. All information gathered was compared to national recommendations. RESULTS: Of the 61 companies evaluated, 38% did not have a well-defined policy for gynecomastia surgery and assessed each request on a case-by-case basis with no defined criteria. The remaining 62% of providers held a defined policy. Companies often required thorough documentation of breast size, body mass index, extent and duration of symptoms, and prior treatments, but requirements varied between insurers. Many of these policies were limited in their coverage, e.g. they would cover tissue excision but not liposuction. Fourteen companies would consider of coverage for patients younger than 18 years. CONCLUSIONS: Coverage of gynecomastia surgery varies across insurers. Insurance company considerations do not often align with patient concerns and physician recommendations on gynecomastia and its treatment options. Coverage criteria should be reevaluated and universally established, to expand access to care and improve treatment efficiency.

8 Review Ultrasonographic and Mammographic Findings of Male Breast Disease. 2019

Kim, Su Hong / Kim, Young-Seon. ·Department of Radiology, College of Medicine, Yeungnam University, Daegu, Korea. ·J Ultrasound Med · Pubmed #29708282.

ABSTRACT: Most male breast diseases are benign, although malignancies can also occur. Gynecomastia, the most common abnormality in the male breast, has characteristic imaging findings differentiating it from cancer. Fewer than 1% of patients with breast cancer are men, but the incidence of male breast cancer is increasing worldwide. Additionally, breast cancer often presents at a more advanced stage in men than in women due to delayed diagnosis. Understanding imaging features of male breast disease is important for an accurate diagnosis and optimal care. This article reviews ultrasonography and mammography findings of benign and malignant diseases of the male breast.

9 Review Diagnosis and Management of Gynecomastia for Urologists. 2018

Baumgarten, Lee / Dabaja, Ali A. ·Henry Ford Health System, 2799 W. Grand Blvd, Detroit, MI, 48202, USA. · Henry Ford Health System, 2799 W. Grand Blvd, Detroit, MI, 48202, USA. adabaja2@hfhs.org. ·Curr Urol Rep · Pubmed #29774423.

ABSTRACT: PURPOSE OF REVIEW: Our aim is to review the steps of diagnosis and management of gynecomastia with a special focus on treatment of gynecomastia associated with androgen deprivation therapy for prostate cancer. RECENT FINDINGS: Recent studies investigating tamoxifen and radiation therapy for both therapy and prophylaxis of bicalutamide-induced gynecomastia are reviewed. Gynecomastia is a common clinical problem, affecting between one and two thirds of middle-aged men. Diagnosis is typically made by history and physical exam. Common causes include chronic medical conditions and medications; however, unexplained gynecomastia should prompt laboratory work-up, followed by appropriate imaging studies to evaluate for hormone producing cancers. For patients taking bicalutamide for treatment of prostate cancer, tamoxifen or radiation therapy for gynecomastia are excellent options.

10 Review [Gynaecomastia]. 2018

Paulsen, Jakob Felbo / Berg, Jais Oliver / Kroman, Niels / Mieritz, Mikkel / Jørgensen, Niels. ·jfelbo@hotmail.com. ·Ugeskr Laeger · Pubmed #29393033.

ABSTRACT: Gynaecomastia (GM) is a benign proliferation of the glandular tissue of the male breast and results from an imbalance between androgen and oestrogen. Pubertal GM is found in 50% and often resolves spontaneously without treatment. GM in adult men can be the first symptom of an underlying disease, and thorough investigation is recommended. Treatment of an underlying cause of GM is the first-line treatment. If GM persists, surgical excision with liposuction can provide excellent results and a low rate of complications.

11 Review [Primary mediastinal choriocarcinoma: A case report and literature review]. 2017

Luo, Man / Peng, Hong / Song, Min / Zhou, Qianhui / Long, Yaomei / Chen, Ping. ·Department of Respiratory Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China. ·Zhong Nan Da Xue Xue Bao Yi Xue Ban · Pubmed #29093257.

ABSTRACT: Primary mediastinal choriocarcinoma in male is not a very common disease, with nonspecific clinical manifestations. Gynecomastia and testicular atrophy are present in some cases. The levels of serum human chorionic gonadotropin are often significantly increased. Giant lump in the mediastinum and bilateral lungs multiple metastases can be seen on the computed tomography for lung. The diagnosis for it depends on pathological biopsy. Current treatment method is a comprehensive, consisting of chemotherapy, radiotherapy and surgery. This paper reported a case of primary mediastinal choriocarcinoma in male, who were diagnosed and treated in the Second Xiangya Hospital of Central South University. He was admitted for cough and hemoptysis, and finally diagnosed by biopsy. The prognosis is very poor. Therefore, it is important to take physical examination regularly because it can be detected and diagnosed early.

12 Review Management of Adolescent Gynecomastia: An Update. 2017

Soliman, Ashraf T / De Sanctis, Vincenzo / Yassin, Mohamed. ·. vdesanctis@libero.it. ·Acta Biomed · Pubmed #28845839.

ABSTRACT: Gynecomastia refers to an enlargement of the male breast caused by benign proliferation of the glands ducts and stromal components including fat. It is the most common form of breast swelling seen in adolescent males. During pubertal development, gynecomastia can develop as a result of transient relative imbalances between androgens and estrogens. Pubertal gynecomastia is self-limited in 75 to 90% of adolescents and regresses over 1 to 3 years. However it may cause significant psychological stress and depression in adolescents. For boys with persistent gynecomastia that is causing substantial tenderness or embarrassment a tailored approach of close follow-up and use of anti-estrogen drugs may be recommended. These drugs block the effects of estrogens in the body and can reduce the size of the breasts somewhat. It appears that pharmacological therapy of persistent adolescent gynecomastia is reasonable effective if given early in the course of the disease and more successful in cases with small or moderate breast enlargement.  However, neither of these drugs is universally approved for the treatment of gynecomastia because the risks and benefits have not been studied completely. Surgical approach may be needed under special conditions for cosmetic reasons. In this update, we review the different published trials for managing adolescent gynecomastia.

13 Review Adolescent Gynecomastia. 2017

Guss, Carly E / Divasta, Amy D. ·Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, MA, USA. ·Pediatr Endocrinol Rev · Pubmed #28613047.

ABSTRACT: Gynecomastia, defined as the presence of glandular breast tissue in men, is a common, typically benign physical exam finding during adolescence. Although the exact pathogenesis of gynecomastia is unknown, it is likely due to a hormonal imbalance between estrogens and androgens. Most cases are idiopathic and do not require further evaluation if the history and physical examination are reassuring. Although the majority of cases will resolve spontaneously, surgical correction may be an option for adolescents with persistent and problematic gynecomastia. Gynecomastia can have significant negative impact on one's self-esteem, and it is crucial that primary care providers screen adolescents with gynecomastia for mental health concerns. Future studies are necessary to elucidate the true incidence and prevalence of gynecomastia in adolescent males, and to further investigate the short-term and long-term physical and emotional effects of gynecomastia.

14 Review Gynecomastia in Infants, Children, and Adolescents. 2017

Leung, Alexander K C / Leung, Alexander A C. ·The University of Calgary, Alberta Children's Hospital, #200, 233 - 16th Avenue NW, Calgary, Alberta. Canada. · Departments of Medicine, Community Health Sciences, and Oncology, The University of Calgary, Calgary, Alberta. Canada. ·Recent Pat Endocr Metab Immune Drug Discov · Pubmed #28260521.

ABSTRACT: BACKGROUND: Gynecomastia may occur physiologically in the neonatal period, during puberty, and in old age. It may also develop in association with various pathologic states. The challenge for the physician is to distinguish physiological gynecomastia from those with an underlying pathology. OBJECTIVE: To review in depth the pathophysiology, clinical manifestations, and treatment of gynecomastia. METHOD: A PubMed search was completed in Clinical Queries using the key term "gynecomastia". Patents were searched using the key term "gynecomastia" from www.google.com/patents, www.uspto.gov, and www.freepatentsonline.com. RESULTS: Gynecomastia is caused by an imbalance between the stimulatory effect of estrogen and the inhibitory effect of androgen at the breast tissue level. Clinically, gynecomastia is characterized by the presence of a firm or rubbery, discrete, subareolar ridge of glandular tissue that is symmetrical in shape, freely movable, and nonadherent to skin or underlying tissue. Since most cases of physiological gynecomastia regress spontaneously with time, reassurance is all that is necessary. For pathological gynecomastia, treatment should be directed at the underlying cause, if possible. If gynecomastia persists in spite of the above measures, pharmacologic therapy and reduction mammoplasty may be considered. Recent patents related to the management of gynecomastia are discussed. CONCLUSION: The majority of cases are physiological and do not require treatment other than reassurance. For pathological cases, the underlying cause should be treated if possible. If gynecomastia persists in spite of the above measures and treatment becomes necessary, tamoxifen is the treatment of choice. Reduction mammoplasty may be considered for resistant cases.

15 Review Gynecomastia Classification for Surgical Management: A Systematic Review and Novel Classification System. 2017

Waltho, Daniel / Hatchell, Alexandra / Thoma, Achilleas. ·Ottawa and Hamilton, Ontario, Canada From the Department of Medicine, Faculty of Medicine, University of Ottawa; and the Division of Plastic Surgery and the Surgical Outcomes Research Center, Department of Surgery, and the Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University. ·Plast Reconstr Surg · Pubmed #28234829.

ABSTRACT: BACKGROUND: Gynecomastia is a common deformity of the male breast, where certain cases warrant surgical management. There are several surgical options, which vary depending on the breast characteristics. To guide surgical management, several classification systems for gynecomastia have been proposed. METHODS: A systematic review was performed to (1) identify all classification systems for the surgical management of gynecomastia, and (2) determine the adequacy of these classification systems to appropriately categorize the condition for surgical decision-making. RESULTS: The search yielded 1012 articles, and 11 articles were included in the review. Eleven classification systems in total were ascertained, and a total of 10 unique features were identified: (1) breast size, (2) skin redundancy, (3) breast ptosis, (4) tissue predominance, (5) upper abdominal laxity, (6) breast tuberosity, (7) nipple malposition, (8) chest shape, (9) absence of sternal notch, and (10) breast skin elasticity. On average, classification systems included two or three of these features. Breast size and ptosis were the most commonly included features. CONCLUSIONS: Based on their review of the current classification systems, the authors believe the ideal classification system should be universal and cater to all causes of gynecomastia; be surgically useful and easy to use; and should include a comprehensive set of clinically appropriate patient-related features, such as breast size, breast ptosis, tissue predominance, and skin redundancy. None of the current classification systems appears to fulfill these criteria.

16 Review None 2017

Hess, Melanie / Zumsteg, Urs. ·1 Pädiatrische Endokrinologie/Diabetologie, Universitätskinderspital beider Basel UKBB, Basel. ·Praxis (Bern 1994) · Pubmed #28169596.

ABSTRACT: -- No abstract --

17 Review Aldosterone receptor antagonists decrease mortality and cardiovascular hospitalizations in chronic heart failure with reduced left ventricular ejection fraction, but not in chronic heart failure with preserved left ventricular ejection fraction: a meta-analysis of randomized controlled trials. 2017

DE Vecchis, Renato / Ariano, Carmelina. ·Cardiology Unit, Presidio Sanitario Intermedio "Elena d'Aosta", ASL Napoli 1 Centro, Naples, Italy - devecchis.erre@virgilio.it. · Geriatric Department, Casa di Cura "S. Maria del Pozzo", Somma Vesuviana, Naples, Italy. ·Minerva Cardioangiol · Pubmed #27958695.

ABSTRACT: INTRODUCTION: Aldosterone receptor antagonists (ARAs) were introduced in the treatment of chronic heart failure (CHF), as a result of the demonstration of their protective effect on the failing heart. However, important questions remain unanswered regarding the clinical efficacy of the ARAs on the clinical and echocardiographic phenotype of heart failure, called heart failure with preserved left ventricular ejection fraction (HFpEF). EVIDENCE ACQUISITION: The aim of the present meta-analysis was to verify the impact of the ARAs on some hard endpoints, such as all-cause death and hospitalizations from cardiovascular cause, making a comparative evaluation of these outcomes in CHF patients with reduced left ventricular ejection fraction (HFREF) and in those with HFpEF, respectively. Only randomized controlled trials (RCTs) were incorporated in our meta-analysis. The studies were included if they met the following criteria: experimental groups included patients with CHF treated with ARAs in addition to the conventional therapy; control groups included patients with CHF receiving conventional therapy without ARAs. Outcomes of interest were all-cause mortality, cardiovascular hospitalizations, hyperkalemia, or gynecomastia. EVIDENCE SYNTHESIS: Overall, 15 RCTs comprising a total of 15671 patients were eligible for inclusion in the meta-analysis. ARA use in patients with heart failure was associated with a significant reduction in adverse outcomes. Indeed, a significant reduced odds of all-cause death among CHF patients treated with ARAs compared to controls was found (OR=0.79; 95% CI: 0.73-0.87). Subgroup analysis based on the HF type revealed a statistically significant benefit as regards all-cause death for patients with HFREF (OR=0.77; 95% CI: 0.69-0.84), whereas a protective effect against the all-cause death was not attained by ARAs in the HFpEF subset (OR=0.91; 95% CI: 0.76-1.1). Furthermore reduced odds of CV hospitalizations was detected in the entire group of CHF patients under treatment with ARAs (OR=0.73; 95% CI: 0.61-0.89) as well as among HFREF patients treated with ARAs, compared to controls (OR=0.66; 95% CI: 0.51-0.85). Hyperkalemia was significantly more frequent with ARA use. In addition, subgroup analysis by ARA type documented that both nonselective and selective ARAs were similarly associated with increased odds of episodes of hyperkalemia compared to controls. Besides, ARA use was shown to be associated with the occurrence of gynecomastia. In particular, selective ARAs proved not to produce significant amounts of gynecomastia compared to controls (OR=0.74; 95% CI: 0.43-1.27), while nonselective ARAs did (OR 8.22; 95% CI: 4.9-13.81. CONCLUSIONS: Our meta-analysis provides further evidence that ARAs should be systematically used in patients with HFREF, in whom these drugs improve some hard clinical endpoints, such as all-cause mortality and hospitalizations from cardiac cause. Conversely, based on the present meta-analysis, ARA usage in HFpEF patients is questionable since in this CHF setting no significant improvement in clinical endpoints has been demonstrated so far, in the face of the well-known risks of hyperkalemia and/or gynecomastia that chronic ARA therapy entails. Furthermore, new selective ARAs are not burdened by significant risk of gynecomastia, while are similar to nonselective ARAs with regard to the efficacy profile as well as to the risk of eliciting hyperkalemia.

18 Review Gynecomastia and hormones. 2017

Sansone, Andrea / Romanelli, Francesco / Sansone, Massimiliano / Lenzi, Andrea / Di Luigi, Luigi. ·Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza, University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. andrea.sansone@uniroma1.it. · Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza, University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. · Department of Movement, Human and Health Sciences, Unit of Endocrinology, University of Rome "Foro Italico", Largo Lauro de Bosis 15, 00135, Rome, Italy. ·Endocrine · Pubmed #27145756.

ABSTRACT: Gynecomastia-the enlargement of male breast tissue in men-is a common finding, frequently observed in newborns, adolescents, and old men. Physiological gynecomastia, occurring in almost 25 % of cases, is benign and self-limited; on the other hand, several conditions and drugs may induce proliferation of male breast tissue. True gynecomastia is a common feature often related to estrogen excess and/or androgen deficiency as a consequence of different endocrine disorders. Biochemical evaluation should be performed once physiological or iatrogenic gynecomastia has been ruled out. Non-endocrine illnesses, including liver failure and chronic kidney disease, are another cause of gynecomastia which should be considered. Treating the underlying disease or discontinuing medications might resolve gynecomastia, although the psychosocial burden of this condition might require different and careful consideration.

19 Review Aromatase deficiency in a male patient - Case report and review of the literature. 2016

Miedlich, Susanne U / Karamooz, Nima / Hammes, Stephen R. ·Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. Electronic address: susanne_miedlich@urmc.rochester.edu. · Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. Electronic address: nkaramooz@gmail.com. · Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. Electronic address: stephen_hammes@urmc.rochester.edu. ·Bone · Pubmed #27693882.

ABSTRACT: OBJECTIVE: Aromatase, or CYP19A1, is a type II cytochrome CYP450 enzyme that catalyzes the conversion of C19 androgens to C18 estrogens. Its crucial role in both female and male physiology has been deduced from human and animal studies using aromatase inhibitors, genetically altered mice, and patients with aromatase deficiency. The latter is an extremely rare disorder. Its diagnosis is particularly difficult in males, who go through puberty normally and therefore usually present as adults with elevated testosterone, bone abnormalities (e.g., delayed bone age and low bone mass), and metabolic syndrome. In this report, we describe a new case of a male patient with aromatase deficiency harboring a known mutation who presented with less severe clinical and biochemical features. CASE REPORT: The patient presented with low bone mass and delayed bone age after a finger fracture at age 25years. FSH, LH and testosterone levels were normal, but estradiol and estrone levels were absent or barely detectable, raising suspicion for aromatase deficiency. A homozygous c.628G>A mutation in exon 5 was confirmed by direct sequencing. Unlike previously reported cases of aromatase deficiency, he did not display biochemical features of insulin resistance, dyslipidemia, or overweight/obese status. Therapy with estradiol led to the closure of growth plates and a dramatic increase in bone mass. CONCLUSIONS: Here we explore genotype/phenotype associations of this new case compared to cases reported previously. We conclude that the specific nature of mutation c.628G>A, which can potentially result in several different forms of the aromatase enzyme, may lend an explanation to the variable phenotypes associated with this particular genotype.

20 Review Radiation therapy for primary breast lymphoma in male gynecomastia: a rare case report and review of the literature. 2016

Ishibashi, Naoya / Hata, Masaharu / Mochizuki, Takao / Ogawa, Kogi / Sugiura, Hiroaki / Takekawa, Yoshinori / Maebayashi, Toshiya / Aizawa, Takuya / Sakaguchi, Masakuni / Abe, Osamu. ·Department of Radiology, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho Itabashi-ku, Tokyo, 173-8610, Japan. ishibashi.naoya@nihon-u.ac.jp. · Division of Radiation Oncology, Department of Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan. · Department of Radiology, Yokosuka City Hospital, Yokosuka, Kanagawa, Japan. · Department of Hematology, Yokosuka City Hospital, Yokosuka, Kanagawa, Japan. · Department of Surgery, Yokosuka City Hospital, Yokosuka, Kanagawa, Japan. · Department of Pathology, Yokosuka City Hospital, Yokosuka, Kanagawa, Japan. · Department of Radiology, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho Itabashi-ku, Tokyo, 173-8610, Japan. ·Int J Hematol · Pubmed #27225235.

ABSTRACT: Primary breast lymphoma is a rare type of non-Hodgkin lymphoma and usually affects women, although a few cases have been reported in men. Chemotherapy and radiation therapy, or a combination of both, are frequently administered for treatment of primary breast lymphoma, as local control by surgical resection is poor. No standard therapy has been established, and the optimal radiation dose and irradiation field for male patients are unknown. The present report describes a 75-year-old man with bilateral cirrhosis-induced gynecomastia who was diagnosed with primary breast lymphoma; specifically, diffuse large B-cell lymphoma. Because of his hepatic dysfunction, he was treated with radiation therapy alone. Radiation therapy was followed by eight cycles of rituximab monotherapy. Clinical response was good, with no signs of relapse. Clinicians may benefit from knowledge regarding effective treatment of primary breast lymphoma in male patients, which has been rarely reported owing to the low incidence of this condition. The outcome in the present case may help to establish effective treatment guidelines in similar cases.

21 Review Tamoxifen in men: a review of adverse events. 2016

Wibowo, E / Pollock, P A / Hollis, N / Wassersug, R J. ·Vancouver Prostate Centre, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada. · Solid Organ Transplant Clinic, Vancouver General Hospital, Vancouver, BC, Canada. · Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada. ·Andrology · Pubmed #27152880.

ABSTRACT: Tamoxifen is an off-label option to treat men for breast cancer, infertility, and idiopathic gynecomastia. Lately, tamoxifen has been proposed as a treatment to prevent gynecomastia in prostate cancer patients receiving antiandrogen therapy. We reviewed the adverse events (AEs) reported in studies of men prescribed tamoxifen for these conditions to better understand its side-effect profile. We searched PubMed for randomized controlled trials (RCTs) that included safety data of tamoxifen treatment in men with prostate cancer, breast cancer, infertility, and idiopathic gynecomastia. Non-RCTs were also reviewed. The results demonstrate that the AE profile in tamoxifen-treated male populations varied. Excluding breast events, gastrointestinal, and cardiovascular problems were the most commonly reported AEs in prostate cancer patients, whereas more psychiatric disorders were reported in male breast cancer patients. Few AEs have been documented in men receiving tamoxifen for infertility and idiopathic gynecomastia. Less than 5% of men withdrew from tamoxifen therapy because of toxicity. This suggests that for most men, tamoxifen is well-tolerated. Of those who discontinued tamoxifen, the majority were male breast cancer patients, and cardiovascular events were the most common reason for stopping tamoxifen treatment. Unfortunately, in many cases, the reasons for withdrawing tamoxifen were unspecified. Based on the available evidence, tamoxifen's AE profile appears to vary depending upon which male population is treated. Also, the frequency at which AEs occur varies - less AEs in men with infertility and idiopathic gynecomastia compared to men with prostate cancer or breast cancer. Long-term studies that rigorously document the side-effect profile of tamoxifen in men are lacking.

22 Review Impact of Aldosterone Antagonists on Sudden Cardiac Death Prevention in Heart Failure and Post-Myocardial Infarction Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 2016

Le, Hai-Ha / El-Khatib, Chadia / Mombled, Margaux / Guitarian, Frédéric / Al-Gobari, Muaamar / Fall, Mor / Janiaud, Perrine / Marchant, Ivanny / Cucherat, Michel / Bejan-Angoulvant, Théodora / Gueyffier, François. ·Laboratoire de Biologie et Biométrie Evolutive - Equipe Modélisation des Effets Thérapeutiques, UMR 5558 Université Claude Bernard Lyon1, Lyon, France. · Lausanne University Hospital (CHUV), Institute of social & preventive medicine (IUMSP), Lausanne, Switzerland. · Escuela de Medicina, Departamento de Pre-clínicas, Universidad de Valparaíso, Valparaíso, Chile. · CHRU de Tours, Service de Pharmacologie Clinique, Hôpital Bretonneau, Tours, France. · CNRS UMR 7292, Tours, France. · Université François-Rabelais, GICC, Tours, France. · Service de Pharmacologie Clinique et essais thérapeutiques, Hospices Civils de Lyon, Lyon, France. ·PLoS One · Pubmed #26891235.

ABSTRACT: BACKGROUND AND OBJECTIVES: Sudden cardiac death (SCD) is a severe burden of modern medicine. Aldosterone antagonist is publicized as effective in reducing mortality in patients with heart failure (HF) or post myocardial infarction (MI). Our study aimed to assess the efficacy of AAs on mortality including SCD, hospitalization admission and several common adverse effects. METHODS: We searched Embase, PubMed, Web of Science, Cochrane library and clinicaltrial.gov for randomized controlled trials (RCTs) assigning AAs in patients with HF or post MI through May 2015. The comparator included standard medication or placebo, or both. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Event rates were compared using a random effects model. Prospective RCTs of AAs with durations of at least 8 weeks were selected if they included at least one of the following outcomes: SCD, all-cause/cardiovascular mortality, all-cause/cardiovascular hospitalization and common side effects (hyperkalemia, renal function degradation and gynecomastia). RESULTS: Data from 19,333 patients enrolled in 25 trials were included. In patients with HF, this treatment significantly reduced the risk of SCD by 19% (RR 0.81; 95% CI, 0.67-0.98; p = 0.03); all-cause mortality by 19% (RR 0.81; 95% CI, 0.74-0.88, p<0.00001) and cardiovascular death by 21% (RR 0.79; 95% CI, 0.70-0.89, p<0.00001). In patients with post-MI, the matching reduced risks were 20% (RR 0.80; 95% CI, 0.66-0.98; p = 0.03), 15% (RR 0.85; 95% CI, 0.76-0.95, p = 0.003) and 17% (RR 0.83; 95% CI, 0.74-0.94, p = 0.003), respectively. Concerning both subgroups, the relative risks respectively decreased by 19% (RR 0.81; 95% CI, 0.71-0.92; p = 0.002) for SCD, 18% (RR 0.82; 95% CI, 0.77-0.88, p < 0.0001) for all-cause mortality and 20% (RR 0.80; 95% CI, 0.74-0.87, p < 0.0001) for cardiovascular mortality in patients treated with AAs. As well, hospitalizations were significantly reduced, while common adverse effects were significantly increased. CONCLUSION: Aldosterone antagonists appear to be effective in reducing SCD and other mortality events, compared with placebo or standard medication in patients with HF and/or after a MI.

23 Review Postoperative Granulomas at Liposuction Incision Sites. 2016

Weniger, Frederick G / White, Peter F / Barrero Castedo, Carlos E. ·Dr Weniger is a plastic surgeon in private practice in Bluffton, SC. Dr White is a dermatopathologist in private practice in Ridgeland, SC. Mr Barrero Castedo is an undergraduate student at Duke University, Durham, NC. ·Aesthet Surg J · Pubmed #26647136.

ABSTRACT: Since most liposuction incisions heal uneventfully, difficult healing in such incisions must be investigated. In the cases of two gynecomastia liposuction patients in which a water-based lubricating gel was used on the liposuction incisions, the incisions failed to heal. For both patients, workup uncovered palisading granulomas at the lateral inframammary fold incision sites several months after otherwise successful surgeries. These two cases are presented and the previous literature is reviewed, with consideration given to the etiology and prevention of such granulomas. LEVEL OF EVIDENCE 5: Risk.

24 Review Breast enlargement in Malawian males on the standard first-line antiretroviral therapy regimen: Case reports and review of the literature. 2015

Kwekwesa, A / Kandionamaso, C / Winata, N / Mwinjiwa, E / Joshua, M / Garone, D / Bedell, R / van Oosterhout, J J. ·Dignitas International, Zomba, Malawi. · Dignitas International, Zomba, Malawi ; University of Calgary, Calgary, Canada. · Zomba Central Hospital, Ministry of Health, Zomba, Malawi. · Dignitas International, Zomba, Malawi ; Department of Medicine, College of Medicine, Blantyre, Malawi. ·Malawi Med J · Pubmed #26715960.

ABSTRACT: -- No abstract --

25 Review Bloody nipple discharge as a benign, self-limiting disorder in young children: A systematic review including two related case reports. 2015

Acer, Tuğba / Derbent, Murat / Hiçsönmez, Akgün. ·Department of Pediatric Surgery, Faculty of Medicine, Başkent University, 6th Road, 70/1, 06490, Bahçelievler, Ankara, Turkey. Electronic address: tugba_acer@yahoo.com. · Department of Pediatrics, Faculty of Medicine, Başkent University, 24 Temel Kuğuluoğlu Street, 06490, Bahçelievler, Ankara, Turkey. Electronic address: murat_derbent@yahoo.com. · Department of Pediatric Surgery, Faculty of Medicine, Başkent University, 6th Road, 70/1, 06490, Bahçelievler, Ankara, Turkey. Electronic address: akgunh@baskent-ank.edu.tr. ·J Pediatr Surg · Pubmed #26410727.

ABSTRACT: BACKGROUND/PURPOSE: Bloody nipple discharge (BND) is rare, distressing for parents, and presents a challenge for physicians. METHODS: We used PubMed to search for cases of BND that were diagnosed before adolescence and added data from two of our cases. RESULTS: The analyzed cohort comprised 46 patients (28 boys and 18 girls; mean [SD] age, 12.5±13.3months; range, 20days to 4years). The mean time for spontaneous resolution was 2.8±2.4months (range, 1week to 8months) after onset of BND without any intervention. The diagnosis was mammary ductal ectasia (MDE) in 15 patients, gynecomastia with MDE in two patients, hemorrhagic cysts in two patients, and gynecomastia alone in one patient. The majority (89.3%) of patients <1year old were managed conservatively, but half of them aged >1year (50.0%) underwent surgery. Surgery was performed more often in patients in whom a mass had been identified. CONCLUSIONS: Age and findings at physical examination affect selection of treatment, but not sex. We found no reported cases of malignancy. Symptoms in children who are managed conservatively resolve within 10months. Children with BND should be conservatively managed to avoid the risk of developing breast deformities before adolescence.