scholarly journals Clinical and Etiological Aspects of Gynecomastia in Adult Males: A Multicenter Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Pablo René Costanzo ◽  
Néstor Antonio Pacenza ◽  
Sergio Mario Aszpis ◽  
Sebastián Matías Suárez ◽  
Uriel Marcelo Pragier ◽  
...  
Keyword(s):  
Medical Records ◽  
Anabolic Steroids ◽  
Low Frequency ◽  
Final Diagnosis ◽  
Pharmaceutical Drugs ◽  
Adult Males ◽  
Breast Pain ◽  
History Of Disease ◽  
History Of ◽  
Pubertal Gynecomastia

Objectives. To evaluate the characteristics of presentation, biochemical profile, and etiology of gynecomastia in adults. Methods. Medical records of 237 men aged 18-85 years with gynecomastia were evaluated. Results. Highest prevalence of gynecomastia was observed between 21 and 30 years (n = 74; 31.2%). The most common presenting complaints were aesthetic concerns (62.8%) and breast pain (51.2%). 25.3% of the subjects had a history of pubertal gynecomastia. 56.5% had bilateral gynecomastia. 39.9% were overweight and 22.8% were obese. The etiology could not be identified in 45.1% of the cases; the most frequent identified causes were anabolic steroids consumption (13.9%), hypogonadism (11.1%), and use of pharmaceutical drugs (7.8%). Patients with bilateral gynecomastia had a longer history of disease, higher BMI, and lower testosterone levels. Conclusions. Patients with gynecomastia presented more often with aesthetic concerns and secondarily with breast pain. The most frequent final diagnosis was idiopathic gynecomastia, whereas the most frequent identified etiologies were anabolic steroids consumption, hypogonadism, and use of pharmaceutical drugs. Despite the low frequency of etiologies such as thyroid dysfunction or adrenal carcinoma, we emphasize the importance of a thorough assessment of the patient, as gynecomastia may be the tip of the iceberg for the diagnosis of treatable diseases.

The frequency and characteristics of MS misdiagnosis in patients referred to the multiple sclerosis centre of Catalonia

2021 ◽  
pp. 135245852098814 ◽  
Author(s):  
Luciana Midaglia ◽  
Jaume Sastre-Garriga ◽  
Agustín Pappolla ◽  
Laura Quibus ◽  
René Carvajal ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Low Frequency ◽  
White Matter Lesions ◽  
Final Diagnosis ◽  
Personal History ◽  
Contributing Factors ◽  
Mri Findings ◽  
History Of ◽  
A Prospective Study

Background: Multiple sclerosis (MS) misdiagnosis may cause physical and emotional damage to patients. Objectives: The objective of this study is to determine the frequency and characteristics of MS misdiagnosis in patients referred to the Multiple Sclerosis Centre of Catalonia. Methods: We designed a prospective study including all new consecutive patients referred to our centre between July 2017 and June 2018. Instances of misdiagnosis were identified, and referral diagnosis and final diagnosis were compared after 1 year of follow-up. Association of misdiagnosis with magnetic resonance imaging (MRI) findings, presence of comorbidities and family history of autoimmunity were assessed. Results: A total of 354 patients were referred to our centre within the study period, 112 (31.8%) with ‘established MS’. Misdiagnosis was identified in eight out of 112 cases (7.1%). MRI identified multifocal white matter lesions, deemed non-specific or not suggestive of MS in all misdiagnosed cases. Patients with MS misdiagnosis had more comorbidities in general than patients with MS ( p = 0.026) as well as a personal history of autoimmunity ( p < 0.001). Conclusion: A low frequency of MS misdiagnosis was found in our clinical setting. Multifocal non-specific white matter lesions in referral MRI examinations and the presence of comorbidities, including a personal history of autoimmunity, seem to be contributing factors to misdiagnosis.

scholarly journals Muscle manifestations and CK levels in COVID infection: results of a large cohort of patients inside a Pandemic COVID-19 Area

2020 ◽  
Author(s):  
Anna De Rosa ◽  
Elena Pinuccia Verrengia ◽  
Ivan Merlo ◽  
Federico Rea ◽  
Gabriele Siciliano ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Medical Records ◽  
Logistic Regression Model ◽  
Fatal Outcome ◽  
Final Diagnosis ◽  
Preliminary Evidence ◽  
Large Cohort ◽  
Respiratory Involvement ◽  
History Of ◽  
Damage Symptoms

Abstract Objective: to investigate both muscular manifestations and CK levels of a large cohort of patients with COVID-19 infection and to determine whether hyperckemia is associated with morbidity and mortality.Methods: Data of 615 patients discharged from ASST Ovest Milanese (Milan, Lombardy, Italy) with final diagnosis of COVID-19 infection were retrospectively extracted from electronical medical records from 21 February to 1 May 2020. Patients were descriptively analyzed with respect to the following variables: sex, age, muscular manifestations (including myalgia/arthralgia and fatigue), respiratory involvement (SARS pneumonia or respiratory failure) and history of falls. Association between patients’ characteristics and CK levels was investigated. In addition, the proportion of patients who died following access to the ER was calculated. Finally, the effect of CK levels and other patients’ features on mortality was estimated using a logistic regression model.Results: 176 (28.6%) patients had raised serum CK levels. 88 (14.3%) had muscular manifestations, of which 81 (13.2%) complained fatigue and 17 (2.8%) had myalgia and/or arthralgia. CK levels were significantly associated with respiratory involvement and fatal outcome.Conclusions: Our study provides preliminary evidence that hyperckemia is a predictor of respiratory involvement and fatal outcome in patients with COVID-19 infection. For patients with muscle damage symptoms, screening for COVID-19 infection is recommended together with the dosage of CK level.

scholarly journals The Importance of Histopathological Examination to the Final Diagnosis of Peripheral Odontogenic Tumors: A Case Report of a Peripheral Odontoma

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Marcio Augusto de Oliveira ◽  
Bruna Reis ◽  
Debora Pallos ◽  
Yeon Jung Kim ◽  
Paulo Henrique Braz-Silva ◽  
...  
Keyword(s):  
Medical Records ◽  
Histological Analysis ◽  
Histopathological Examination ◽  
Final Diagnosis ◽  
Radiographic Examination ◽  
Surgical Removal ◽  
Incisional Biopsy ◽  
Mineralized Tissue ◽  
History Of ◽  
The Right

A 30-year-old Caucasian man presented with an 18-month history of an asymptomatic calcified mass, located on the buccal side of the alveolar ridge. Medical records did not present any underlying conditions. On intraoral examination, the lesion was located on the right side of the maxilla, showing mucosal fenestration with mineralized tissue measuring approximately 1 cm in diameter. Radiographic examination showed multiple radiopaque masses. Incisional biopsy was performed, and histological analysis revealed a presence of enamel matrix, dentin, and cementum, resembling tooth-like structures. Surgical removal was offered after the diagnostic confirmation of peripheral odontoma, but the patient refused because of the asymptomatic nature of the lesion.

Voices and Visions: Mind, Body and Affect in Medieval Writing

2018 ◽  
Author(s):  
Corinne Saunders
Keyword(s):  
Medical Humanities ◽  
Family Care ◽  
Literary Texts ◽  
Cultural Perspective ◽  
Historical Sources ◽  
Disease Treatment ◽  
History Of Disease ◽  
Health And Illness ◽  
History Of ◽  
Cultural Texts

A properly critical medical humanities is also a historically grounded medical humanities. Such historical grounding requires taking a long cultural perspective, going beyond traditional medical history – typically the history of disease, treatment and practice – to trace the origins and development of the ideas that underpin medicine in its broadest sense – ideas concerning the most fundamental aspects of human existence: health and illness, body and mind, gender and family, care and community. Historical sources can only go so far in illuminating such topics; we must also look to other cultural texts, and in particular literary texts, which, through their imaginative worlds, provide crucial insights into cultural and intellectual attitudes, experience and creativity. Reading from a critical medical humanities perspective requires not only cultural archaeology across a range of discourses, but also putting past and present into conversation, to discover continuities and contrasts with later perspectives. Medical humanities research is illuminated by cultural and literary studies, and also brings to them new ways of seeing; the relation is dynamic. This chapter explores the ways mind, body and affect are constructed and intersect in medieval thought and literature, with a particular focus on how voice-hearing and visionary experience are portrayed and understood.

Beneficiary and Adverse Effects of Phytoestrogens: A Potential Constituent of Plant Based Diet

2020 ◽  
Vol 26 ◽  
Author(s):  
Sridevi Vaadala ◽  
Naveen Ponneri ◽  
Venkat Shashank Karnam ◽  
Ramachandra Reddy Pamuru ◽  
Mohammed Arifullah
Keyword(s):  
Dairy Products ◽  
Metabolic Disorders ◽  
Hormone Replacement ◽  
Pharmaceutical Drugs ◽  
Adult Males ◽  
Flax Seed ◽  
Green Beans ◽  
The World ◽  
Pros And Cons ◽  
Derivatives Of

Background: Phytoestrogens are non-endocrine, non-steroidal secondary derivatives of plants and consumed through plant-based diet also named as “dietary estrogens”. The major sources of phytoestrogens are soy and soy-based foods, flax seed, chickpeas, green beans, dairy products, etc. The dietary inclusion of phytoestrogen based foods play a crucial role in the maintenance of metabolic syndrome cluster including obesity, diabetes, blood pressure, cancer, inflammation, cardiovascular diseases, postmenopausal ailments and their complications. In recent days, phytoestrogens are the preferred molecules for hormone replacement therapy. On the other hand, they act as endocrine disruptors via estrogen receptor mediated pathways. These effects are not restricted to adult males or females and identified even in development. Objective: Since phytoestrogenic occurrence is high at daily meal for most people from all over the world, they focused to study for its beneficiary effects towards developing pharmaceutical drugs for treating various metabolic disorders by keeping an eye on endocrine disruption. Conclusion: The present review emphasizes the pros and cons of phytoestrogens on human health, which may help to direct the pharmaceutical industry to produce various phytoestrongen based drugs against various metabolic disorders.

Corticosteroids in Inflammatory Bowel Disease patients: a practical guide for physicians.

2020 ◽  
Vol 15 ◽  
Author(s):  
Maria Carla Di Paolo ◽  
Cristiano Pagnini ◽  
Maria Giovanna Graziani
Keyword(s):  
Severe Disease ◽  
Unknown Etiology ◽  
History Of Disease ◽  
Bowel Diseases ◽  
Literature Evidence ◽  
History Of ◽  
Inflammatory Bowel ◽  
Favorable Safety ◽  
Pass Metabolism

: Inflammatory bowel diseases (IBDs) are chronic conditions characterized by unknown etiology and pathogenesis with deregulation of mucosal immunity. Among possible treatments, corticosteroids, already available from the 50’, are still the mainstay of treatment for moderate-severe disease. Nonetheless, the use of steroids is still largely empirical and solid evidence about therapeutic schemes are lacking. Moreover, due to the important side-effects and for the unsatisfactory impact on long-term natural history of disease, the steroid sparing has become an important therapeutic goal in IBD management. Besides conventional steroids, the so called “low bioavailability” steroids, which are steroids with high affinity for peripheral receptors and elevated hepatic first-pass metabolism, have demonstrated efficacy and more favorable safety profile. In the present review of the literature evidence of efficacy and safety of conventional and low bioavailability steroids in IBD patients are evaluated, and practical suggestions for a correct use in clinical practice are presented according to the current clinical guidelines.

The use of a Domain Ontology for the Management of Essential Hypertension (Preprint)

2020 ◽  
Author(s):  
Emma Chavez ◽  
Vanessa Perez ◽  
Angélica Urrutia
Keyword(s):  
Decision Making ◽  
Essential Hypertension ◽  
Medical History ◽  
Medical Records ◽  
Medical Training ◽  
Relevant Information ◽  
Domain Ontology ◽  
Free Text ◽  
Snomed Ct ◽  
History Of

BACKGROUND : Currently, hypertension is one of the diseases with greater risk of mortality in the world. Particularly in Chile, 90% of the population with this disease has idiopathic or essential hypertension. Essential hypertension is characterized by high blood pressure rates and it´s cause is unknown, which means that every patient might requires a different treatment, depending on their history and symptoms. Different data, such as history, symptoms, exams, etc., are generated for each patient suffering from the disease. This data is presented in the patient’s medical record, in no order, making it difficult to search for relevant information. Therefore, there is a need for a common, unified vocabulary of the terms that adequately represent the diseased, making searching within the domain more effective. OBJECTIVE The objective of this study is to develop a domain ontology for essential hypertension , therefore arranging the more significant data within the domain as tool for medical training or to support physicians’ decision making will be provided. METHODS The terms used for the ontology were extracted from the medical history of de-identified medical records, of patients with essential hypertension. The Snomed-CT’ collection of medical terms, and clinical guidelines to control the disease were also used. Methontology was used for the design, classes definition and their hierarchy, as well as relationships between concepts and instances. Three criteria were used to validate the ontology, which also helped to measure its quality. Tests were run with a dataset to verify that the tool was created according to the requirements. RESULTS An ontology of 310 instances classified into 37 classes was developed. From these, 4 super classes and 30 relationships were obtained. In the dataset tests, 100% correct and coherent answers were obtained for quality tests (3). CONCLUSIONS The development of this ontology provides a tool for physicians, specialists, and students, among others, that can be incorporated into clinical systems to support decision making regarding essential hypertension. Nevertheless, more instances should be incorporated into the ontology by carrying out further searched in the medical history or free text sections of the medical records of patients with this disease.

The Great Influenza

2018 ◽  
Author(s):  
Samuel K. Cohn, Jr.
Keyword(s):  
Social Behaviour ◽  
East Coast ◽  
World History ◽  
Collective Violence ◽  
Large Cities ◽  
Surgeon General ◽  
The Us ◽  
History Of Disease ◽  
The World ◽  
History Of

This chapter examines evidence principally from the US that the Great Influenza provoked profiteering by landlords, undertakers, vendors of fruit, pharmacists, and doctors, but shows that such complaints were rare and confined mostly to large cities on the East Coast. It then investigates anti-social advice and repressive decrees on the part of municipalities, backed by advice from the US Surgeon General and prominent physicians attacking ‘spitters, coughers, and sneezers’, which included state and municipal ordinances against kissing and even ‘big talkers’. It then surveys legislation on compulsory and recommended mask wearing. Yet this chapter finds no protest or collective violence against the diseased victims or any other ‘others’ suspected of disseminating the virus. Despite physicians’ and lawmakers’ encouragement of anti-social behaviour, mass volunteerism and abnegation instead unfolded to an extent never before witnessed in the world history of disease.

scholarly journals The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Robert J. Sanchez ◽  
Wenzhen Ge ◽  
Wenhui Wei ◽  
Manish P. Ponda ◽  
Robert S. Rosenson
Keyword(s):  
Acute Pancreatitis ◽  
Medical Records ◽  
Adult Population ◽  
Baseline Period ◽  
Prior History ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Recurrent Acute Pancreatitis ◽  
History Of ◽  
Nationally Representative

Abstract Background This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels. Methods Data were obtained from IQVIA’s US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis. Results In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08–0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1–34.9%). Conclusion The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.

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