Reduction mammaplasty improves levels of anxiety, depression and body image satisfaction in patients with symptomatic macromastia in the short and long term

Abstract Gynecomastia is defined as an enlargement of the male breast. Although it is commonly seen during puberty, it is often overlooked by many physicians. As adolescent medicine specialists, we believe there is a gap in the literature concerning both the etiology and maybe more importantly the care of these adolescents. Thus, we have been dedicated to conducting research on this topic. The aim of this review article was to evaluate the studies concerning pubertal gynecomastia that took place at the Division of Adolescent Medicine, Hacettepe University, published between the years 2003 and 2016. The review covers in detail both the short- and long-term effectivity and safety of tamoxifen used for the treatment of pubertal gynecomastia. As the exact basis for the pathogenesis of gynecomastia remains unknown, we also evaluate three studies that aimed to answer this question. We additionally review a study that aimed to assess the psychological distress and effect on body image that gynecomastia may have on the adolescent male. An important contribution this review article adds to the literature is as a conclusion to all the studies performed, we present the ‘Hacettepe indications for tamoxifen treatment for pubertal gynecomastia’. These indications will aid physicians when considering treating these patients.

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Prospective evaluation of biomarkers for prediction of quality of life in community-acquired pneumonia

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2016-0001 ◽

2016 ◽

Vol 54 (11) ◽

Cited By ~ 10

Author(s):

Manuela Nickler ◽

Daniela Schaffner ◽

Mirjam Christ-Crain ◽

Manuel Ottiger ◽

Robert Thomann ◽

...

Keyword(s):

Quality Of Life ◽

White Blood Cells ◽

Secondary Analysis ◽

Multicenter Trial ◽

Community Acquired Pneumonia ◽

Reactive Protein ◽

Short And Long Term ◽

Anxiety Depression

AbstractBackground:Most clinical research investigated prognostic biomarkers for their ability to predict cardiovascular events or mortality. It is unknown whether biomarkers allow prediction of quality of life (QoL) after survival of the acute event. Herein, we investigated the prognostic potential of well-established inflammatory/cardiovascular blood biomarkers including white blood cells (WBC), C-reactive protein (CRP), procalcitonin (PCT), pro-adrenomedullin (proADM) and pro-atrial natriuretic peptide (proANP) in regard to a decline in QoL in a well-defined cohort of patients with community-acquired pneumonia (CAP).Methods:Within this secondary analysis including 753 patients with a final inpatient diagnosis of CAP from a multicenter trial, we investigated associations between admission biomarker levels and decline in QoL assessed by the EQ-5D health questionnaire from admission to day 30 and after 6 years.Results:Admission proADM and proANP levels significantly predicted decline of the weighted EQ-5D index after 30 days (n=753) with adjusted odds ratios (ORs) of 2.0 ([95% CI 1.1–3.8]; p=0.027) and 3.7 ([95% CI 2.2–6.0]; p<0.001). Results for 6-year outcomes (n=349) were similar with ORs of 3.3 ([95% CI 1.3–8.3]; p=0.012) and 6.2 ([95% CI 2.7–14.2]; p<0.001). The markers were associated with most of the different QoL dimensions including mobility, self-care, and usual activities, but not pain/discomfort and to a lesser degree anxiety/depression and the visual analogue scale (VAS). Initial WBC, PCT and CRP values did not well predict QoL at any time point.Conclusions:ProADM and proANP accurately predict short- and long-term decline in QoL across most dimensions in CAP patients. It will be interesting to reveal underlying physiopathology in future studies.

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Effects of Brexpiprazole Across Symptom Domains in Patients With Schizophrenia: Post Hoc Analysis of Short- and Long-Term Studies

Schizophrenia Bulletin Open ◽

10.1093/schizbullopen/sgab014 ◽

2021 ◽

Author(s):

Stephen R Marder ◽

Stine R Meehan ◽

Catherine Weiss ◽

Dalei Chen ◽

Mary Hobart ◽

...

Keyword(s):

Negative Symptoms ◽

Positive Symptoms ◽

Confidence Limits ◽

Double Blind ◽

Post Hoc Analysis ◽

Short And Long Term ◽

Post Hoc ◽

Anxiety Depression ◽

Long Term Studies

Abstract The successful treatment of schizophrenia entails improvement across a spectrum of symptoms. The aim of this post hoc analysis was to characterize the short- and long-term effects of brexpiprazole on Positive and Negative Syndrome Scale (PANSS) ‘Marder factors’. Data were included from three 6-week, randomized, double-blind, placebo-controlled studies; a 52-week, randomized, double-blind, placebo-controlled maintenance treatment study; and two 52-week open-label extension (OLEx) studies – all in schizophrenia (DSM-IV-TR criteria). Patients receiving oral brexpiprazole were dosed at 2–4 mg/day (short-term studies) or 1–4 mg/day (long-term studies). At Week 6, least squares mean differences (LSMDs, with 95% confidence limits) for brexpiprazole (n=868) versus placebo (n=517) were: Positive symptoms: -1.55 (-2.30, -0.80), p<0.0001, Cohen’s d effect size (ES)=0.27; Negative symptoms: -1.12 (-1.63, -0.61), p<0.0001, ES=0.29; Disorganized thought: -1.26 (-1.78, -0.74), p<0.0001, ES=0.32; Uncontrolled hostility/excitement: -0.76 (-1.15, -0.37), p=0.0002, ES=0.26; Anxiety/depression: -0.56 (-0.91, -0.22), p=0.0014, ES=0.22. At last visit of the maintenance study, LSMDs (95% confidence limits) for brexpiprazole (n=96) versus placebo (n=104) were: Positive symptoms: -3.44 (-4.99, -1.89), p<0.0001, ES=0.62; Negative symptoms: -1.23 (-2.52, 0.07), p=0.063, ES=0.27; Disorganized thought: -1.69 (-2.81, -0.56), p=0.0035, ES=0.42; Uncontrolled hostility/excitement: -1.26 (-2.12, -0.39), p=0.0046, ES=0.41; Anxiety/depression: -0.72 (-1.47, 0.03), p=0.061, ES=0.27. In the OLEx studies, improvements were maintained over 58 (6 + 52) weeks of brexpiprazole treatment. In conclusion, these data suggest that brexpiprazole treats the continuum of schizophrenia symptoms, in the short- and long-term. Trial Registration: Data used in this post hoc analysis came from ClinicalTrials.gov identifiers: NCT01396421, NCT01393613, NCT01810380, NCT01668797, NCT01397786, NCT01810783.

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Youth, Caregiver, and Prescriber Experiences of Antipsychotic-Related Weight Gain

ISRN Obesity ◽

10.1155/2013/390130 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Andrea Lynn Murphy ◽

David Martin Gardner ◽

Steve Kisely ◽

Charmaine Cooke ◽

Stanley Paul Kutcher ◽

...

Keyword(s):

Body Image ◽

Weight Gain ◽

Management Strategies ◽

Metabolic Changes ◽

Metabolic Effects ◽

Recent Experience ◽

Weight Changes ◽

Short And Long Term ◽

Long Term Consequences

Objectives. To explore the lived experience of youth, caregivers, and prescribers with antipsychotic medications. Design. We conducted a qualitative interpretive phenomenology study. Youth aged 11 to 25 with recent experience taking antipsychotics, the caregivers of youth taking antipsychotics, and the prescribers of antipsychotics were recruited. Subjects. Eighteen youth, 10 caregivers (parents), and 11 prescribers participated. Results. Eleven of 18 youth, six of ten parents, and all prescribers discussed antipsychotic-related weight gain. Participants were attuned to the numeric weight changes usually measured in pounds. Significant discussions occurred around weight changes in the context of body image, adherence and persistence, managing weight increases, and metabolic effects. These concepts were often inextricably linked but maintained the significance as separate issues. Participants discussed tradeoffs regarding the perceived benefits and risks of weight gain, often with uncertainty and inadequate information regarding the short- and long-term consequences. Conclusion. Antipsychotic-related weight gain in youth influences body image and weight management strategies and impacts treatment courses with respect to adherence and persistence. In our study, the experience of monitoring for weight and metabolic changes was primarily reactive in nature. Participants expressed ambiguity regarding the short- and long-term consequences of weight and metabolic changes.

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Experience with Short and Long Term Courses of Local Adrenal Steroid Therapy For Ulcerative Colitis

Gastroenterology ◽

10.1016/s0016-5085(62)80117-6 ◽

1962 ◽

Vol 42 (6) ◽

pp. 669-677 ◽

Cited By ~ 18

Author(s):

Jean A. Spencer ◽

Joseph B. Kirsner

Keyword(s):

Ulcerative Colitis ◽

Steroid Therapy ◽

Adrenal Steroid ◽

Short And Long Term

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Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽

10.1024/1023-9332.7.1.20 ◽

2001 ◽

Vol 7 (1) ◽

pp. 20-24 ◽

Cited By ~ 14

Author(s):

Robert ◽

Mariéthoz ◽

Pache ◽

Bertin ◽

Caulfield ◽

...

Keyword(s):

Recurrent Laryngeal Nerve ◽

Nerve Palsy ◽

Recurrent Laryngeal Nerve Palsy ◽

Laryngeal Nerve ◽

Long Term Results ◽

Graves Disease ◽

Laryngeal Nerve Palsy ◽

Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

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