Gynecomastia--pathogenesis, diagnosis and treatment

The aim of this review is to present the up-to-date information concerning the prevalence, pathogenesis, diagnosis and treatment of gynecomastia. Gynecomastia is a benign, unilateral or bilateral enlargement of the male breast due to the imbalance between the androgens and estrogens at the breast tissue level. This clinical condition is particularly common in boys during puberty and in aging men. The breast enlargement, especially with accompanying pain can cause serious psychological problem. At the present time there are no generally accepted procedures for the evaluation and treatment of patients with gynecomastia. In the article such recommendations were proposed. There are many studies conducted to find the safe and efficient medical therapy that could ameliorate the quality of life of the patients with gynecomastia. The information on the available treatment options were also presented.     

Hyperprolactinemia: causes, diagnosis, and treatment

The basic data on hyperprolactinemia (i.e. an excess of PRL above a reference laboratory's upper limits), the most common endocrine disorder of the hypothalamic-pituitary axis are given in this review. The following issues are discussed: regulation of prolactin (Prl) secretion, definition of hyperprolactinemia, its etiology and pathogenesis as well as its symptoms, diagnosis, and treatment (including medical and surgical therapy). It should be stressed that finding of elevated PRL serum concentrations constitute the beginning of diagnostic procedure and, after exclusion of physiologic, pharmacologic, and other organic causes of increased PRL levels, should be followed by detailed diagnosis including MRI. In patients in whom hyperprolactinemia has been confirmed the treatment with dopamine agonists (with prevalence of cabergoline, followed by quinagoline) is currently considered first-choice therapy. Surgery should be performed only in the patients resistant or intolerant to these agents, or in patients who refuse long-term therapy.     

Plasmodium falciparum hyperparasitaemia in children. Risk factors, treatment outcomes, and gametocytaemia following treatment

The risk factors associated with hyperparasitemia at presentation and after treatment with different antimalarial drug regimens were evaluated in 1,048 children enrolled prospectively in seven antimalarial drug trials between July 1996 and September 2003 in a hyperendemic area of southwestern Nigeria. The outcomes of treatment of hyperparasitaemia, and gametocyte carriage following treatment were also evaluated. The children were assigned to one of seven treatment groups: chloroquine (CQ) only; pyrimethamine-sulfadoxine (PS) only; amodiaquine (AQ) only; CQ plus chlorpheniramine (CQCP); PS combined with CQ or AQ (COM); PS combined with probenecid (PPS); and halofantrine (HF). Hyperparasitaemia was found in 100 (9.5%) of the 1,048 children at enrolment (day 0). Following oral therapy, 1.2% of all patients (i.e. 13 patients) became hyperparasitaemic, which developed in all patients by day 1 of follow-up. In a multiple regression model, age < or = 5 years, and a core temperature (oral or rectal) > or = 39.5 degrees C were found to be independent risk factors for hyperparasitaemia at enrolment. Following therapy, the cure rate on day 14 was significantly lower in those treated with CQ compared to other treatment groups. Severe resistance (RIII) response to treatment occurred significantly more frequently in those with hyperparasitaemia at enrolment than in those without, and was seen in five and one child with hyperparasitaemia who were treated with CQ and CQCP, respectively. Gametocyte carriage was insignificantly lower at enrolment and at all times following treatment in children with hyperparasitaemia than in age- and gender-matched children without hyperparasitaemia who received the same treatment. The results are discussed in the light of management of uncomplicated hyperparasitaemia in children in endemic settings.     

Amygdala, depression and drug treatment

The problem of the mechanisms of depression and action of the depressive drugs needs theoretical analysis and multichannel investigations. Animal models of depression are important for such investigations. Various neurochemical behavioral and psychological models were analysed in the present paper. Amygdalar model of depression seems to be one of the most important models. The effects of the treatment by amphetamine, imipramine and chlorpromazine on the amygdalar depressive syndrome in dogs were described. The individual differences were stressed, both in respect to forms of particular depression and to the sensitivity to drug treatment.     

Performance of the Columbia,Missouri, treatment wetland

Constructed treatment wetlands have served the City of Columbia, MO, for fourteen years. Four free water surface wetland units in series, comprised of 23 cells, are an addition to the activated sludge wastewater treatment plant, for the purpose of added biochemical oxygen demand (BOD) and total suspended solids (TSS) control. The system operates year-round, and supplies water to the Eagle Bluffs Conservation Area for wetland maintenance. The cattail wetlands processed an average of 57,000 m³/d, at a water depth of 20 cm. The resulting detention time was approximately 2 days, and the hydraulic loading was 13 cm/d. Water temperatures were warm leaving the treatment plant and in the wetlands in winter, because of the short detention. The period of record average carbonaceous biochemical oxygen demand (CBOD) leaving the wetlands was 5.0 mg/L, and the TSS was 14.7 mg/L. Dissolved oxygen was depressed in summer, likely because of the high sediment demand. Nutrient concentrations were only minimally reduced, total nitrogen (TN) by 22% and total phosphorus (TP) by 6%. However, load reductions were maximal, 98 t/yr for nitrogen, and 3.6 t/yr for phosphorus. Fecal coliforms were reduced by 98%, and E. coli by 95%. First order rate coefficients were high for CBOD (64 m/yr), nitrate (61 m/yr) and organic nitrogen (42 m/yr), but relatively low for ammonia (8 m/yr) and phosphorus (5.7 m/yr). Nitrogen removal was strongly affected by vegetative uptake. Sediment accretion in the wetland inlets was substantial, at 1.6 cm/yr in the inlets to the upstream wetland units. Muskrats caused vegetation damage, and waterfowl use was high in winter, causing TSS excursions.     

Dupuytren's disease: history, diagnosis, and treatment

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Describe the clinical features of the disease. 2. Describe the pathoanatomical structures in Dupuytren's disease. 3. Outline the various factors associated with Dupuytren's disease. 4. Describe the modalities for surgical and nonsurgical treatment of the condition. 5. Outline recent biomolecular knowledge about the basis of Dupuytren's disease. SUMMARY: Dupuytren's disease is characterized by nodule formation and contracture of the palmar fascia, resulting in flexion deformity of the fingers and loss of hand function. The authors review the historical background, clinical features, and current therapy of Dupuytren's disease; preview treatment innovations; and present molecular data related to Dupuytren's disease. These new findings may improve screening for Dupuytren's disease and provide a better understanding of the disease's pathogenesis.     

Public impact,prevention, and treatment of cataracts

<正>The human lens is composed anteriorly of a single layer of epithelial cells,which undergo mitosis and migrate to the lens equator where they differentiate into lens fiber cells[1].The elongated lens fiber cells express high levels of soluble crystallin proteins that do not undergo turnover and must     

Cigarette smoking,nicotine dependence,and treatment.

Since the 1988 Surgeon General''s report on nicotine addiction, more attention is being given to nicotine dependence as a substantial contributing factor in cigarette smokers'' inability to quit. Many new medications are being investigated for treating nicotine withdrawal and for assisting in long-term smoking abstinence. Medications alone probably will not be helpful; they should be used as adjuncts in comprehensive smoking abstinence programs that address not only the physical dependence on nicotine but also the psychological dependence on cigarette smoking.     

Etiologic theories,methods of treatment,and results

Although it has been postulated that a pterygium develops from the ordinary pinguecula which is a phenomenon of aging, the average age of patients in a Veterans Administration hospital who were operated upon for removal of pterygia was 34.9 years. Mexicans appeared to be particularly susceptible to the disease. Analysis of the literature and review of observations in the present series of cases indicated that long-continued exposure to the elements, particularly the sun's rays, is a prime etiologic factor and that dust and other irritants are of less importance. In a study of 285 patients who had pterygia, no correlation of this disease with other local or general disease was observed. An operation which brings previously unexposed conjunctiva into the area from which a pterygium is removed, and which does not bury the epithelium, was used successfully.