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Esophageal Perforation-II: Clinical Manifestations and Management01:28

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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
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Barrett Esophagus-II: Clinical Manifestations and Management01:21

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
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EAA clinical practice guidelines-gynecomastia evaluation and management.

G A Kanakis1, L Nordkap2, A K Bang2

  • 1First Department of Obstetrics and Gynecology, Unit of Reproductive Endocrinology, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Andrology
|May 18, 2019
PubMed
Summary
This summary is machine-generated.

Gynecomastia (GM) is a common benign breast tissue proliferation in males. Guidelines recommend thorough evaluation for underlying causes in adults and specific treatments like testosterone replacement for deficiency, while generally advising against other medications and favoring surgery for persistent cases.

Keywords:
diagnosisgynecomastiamale breast cancermanagementtestosterone

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Area of Science:

  • Endocrinology
  • Urology
  • Oncology

Background:

  • Gynecomastia (GM) is a benign proliferation of male breast glandular tissue, with prevalence varying by age.
  • Infantile and pubertal GM often resolve spontaneously, while adult GM may indicate underlying pathology in 45-50% of cases.

Purpose of the Study:

  • To establish clinical practice guidelines for the evaluation and management of gynecomastia.
  • To differentiate GM from other breast conditions, including male breast cancer.

Main Methods:

  • A literature search for 'gynecomastia' was conducted.
  • Evidence-based recommendations were developed using the GRADE system.

Main Results:

  • Five statements and fifteen clinical recommendations were formulated.
  • Key recommendations include thorough medical history, physical examination (including genitalia), and selective laboratory/imaging investigations.

Conclusions:

  • GM assessment aims to detect underlying pathologies and reversible causes.
  • Management strategies include watchful waiting, testosterone treatment for deficiency, and surgery for persistent cases.
  • Non-aromatizable androgens, SERMs, and AIs are generally not recommended.