Glenn Braunstein | Cedars-Sinai Medical Center (original) (raw)

Papers by Glenn Braunstein

Oncology & Haematology, 2021

Journal of Women's Health

American family physician, Jan 15, 2006

Thyroiditis is an inflammation of the thyroid gland that may be painful and tender when caused by... more Thyroiditis is an inflammation of the thyroid gland that may be painful and tender when caused by infection, radiation, or trauma, or painless when caused by autoimmune conditions, medications, or an idiopathic fibrotic process. The most common forms are Hashimoto's disease, subacute granulomatous thyroiditis, postpartum thyroiditis, subacute lymphocytic thyroiditis, and drug-induced thyroiditis (caused by amiodarone, interferon-alfa, interleukin-2, or lithium). Patients may have euthyroidism, hyperthyroidism, or hypothyroidism, or may evolve from one condition to another over time. Diagnosis is by clinical context and findings, including the presence or absence of pain, tenderness, and autoantibodies. In addition, the degree of radioactive iodine uptake by the gland is reduced in most patients with viral, radiation-induced, traumatic, autoimmune, or drug-induced inflammation of the thyroid. Treatment primarily is directed at symptomatic relief of thyroid pain and tenderness, if...

The Journal of Clinical Endocrinology & Metabolism, 1972

1: J Clin Endocrinol Metab. 1972 Dec;35(6):857-62. In vivo and in vitro production of human chori... more 1: J Clin Endocrinol Metab. 1972 Dec;35(6):857-62. In vivo and in vitro production of human chorionic gonadotropin and alpha-feteoprotein by a virilizing hepatoblastoma. Braunstein GD, Bridson WE, Glass A, Hull EW, McIntire KR. ...

Fertility and Sterility, 2004

Objective: Review of literature with regard to androgen replacement therapy in women. Design: Rev... more Objective: Review of literature with regard to androgen replacement therapy in women. Design: Review of the MEDLINE database and references from articles. Conclusions: Androgens affect sexual function, bone health, muscle mass, body composition, mood, energy, and the sense of well-being. Androgen insufficiency clearly has been demonstrated in patients with hypopituitarism, adrenalectomy, oophorectomy, and in some women placed on oral estrogen therapy which increases sex hormone-binding globulin (SHBG) levels and lowers the free and bioavailable forms of T. Symptoms of androgen insufficiency in women may include a diminished sense of well-being, low mood, fatigue, and hypoactive sexual desire disorder with decreased libido, or decreased sexual receptivity and pleasure that causes a great deal of personal distress. The preponderance of evidence from clinical trials supports the correlation of decreased endogenous androgen levels with these symptoms and alleviation of many of the symptoms with the administration of T or, in some cases, DHEA. There are no Food and Drug Administrationapproved androgen preparations on the market for treating androgen insufficiency in women. The safety profile of androgens in doses used for the treatment of hypoactive sexual desire disorder has been excellent with only mild acne and hirsutism being noted in a minority of patients.

Fertility and Sterility, 2002

The American Journal of Cardiology, 2008

Diabetes mellitus (DM) portends a higher risk of coronary heart disease mortality in women compar... more Diabetes mellitus (DM) portends a higher risk of coronary heart disease mortality in women compared to men. This relationship appears to be independent of traditional cardiac risk factors and the role of reproductive hormones has been postulated. We assessed the relationship between DM, Hypothalamic hypoestrogenemia (HHE), angiographic coronary artery disease (CAD) and major adverse cardiovascular events (MACE) over a median 5.9 years in premenopausal women enrolled in the Women's Ischemia Syndrome Evaluation (WISE) study. We evaluated 95 premenopausal WISE women who underwent coronary angiography for suspected ischemia and were not taking exogenous reproductive hormones. Results showed that there was no difference in age between women with (n=30) and without (n=65) DM (43±6 yrs). DM was associated with hypertension, HHE, angiographic CAD and coronary artery severity score (CSS) (all p<0.05). Women with DM were twice as likely to have HHE (50% vs. 26% p=0.02) compared to women without DM. Presence of both DM and HHE was associated with increased prevalence (40% vs. 12% or 13%, p=0.006) and severity of angiographic coronary artery disease (CSS 19.9 (19.2) vs. 7.7 (4.6) or 12.3 (18.8), p=0.008) as compared to either HHE or DM alone, respectively. DM was moderately predictive of MACE. In conclusion, among premenopausal women undergoing coronary angiography for suspected myocardial ischemia, DM is associated with HHE. Presence of both DM and HHE predicts greater burden of angiographic CAD. Prospective research is

Journal of Minimally Invasive Gynecology, 2009

Journal of Occupational & Environmental Medicine

The Journal of Clinical Endocrinology & Metabolism

G ynecomastia is the benign proliferation of breast glandular tissue in males (1). This definitio... more G ynecomastia is the benign proliferation of breast glandular tissue in males (1). This definition differentiates it from breast enlargement due to the deposition of fat (pseudogynecomastia, lipomastia), neoplasms, or inflammation. All males have some breast glandular tissue; gynecomastia often represents an imbalance between the stimulatory effects of estrogen and the inhibitory effects of androgens on the glandular component, while pseudogynecomastia is commonly found in boys and men who are overweight (1, 2). Nevertheless, some authors and physicians lump all causes of breast enlargement in males together under the term "gynecomastia" (3). This situation is not helped by the diagnostic terminology utilized by the tenth revision of the International Statistical Classification of Diseases and Related Health Problems, which lists "gynecomastia" under Code N62, which also includes hypertrophy of the breast from any benign cause as well as true gynecomastia. The prevalence of gynecomastia has been studied in different populations and 3 major peaks over the lifespan have been found: infants (60-90% with gynecomastia), pubertal and young adults (4-69% with gynecomastia), and aging males (24-65% with gynecomastia) (1). The wide range of prevalence is due, in part, to differences in the definition of gynecomastia. In some studies, gynecomastia was diagnosed if the breast tissue diameter was ≥ 0.5 cm by palpation, while in others, the minimum diameter of breast

Journal of the Endocrine Society

Background: Among premenopausal women presenting with ischemia, hypothalamic hypoestrogenemia (HH... more Background: Among premenopausal women presenting with ischemia, hypothalamic hypoestrogenemia (HHE) has been associated with angiographic coronary artery disease (CAD). Further, serum amyloid-alpha (SAA), a marker of systemic inflammation strongly predicts future adverse cardiovascular events. We sought to relate inflammatory markers to HHE and understand if inflammation mediates relations between HHE and CAD. Methods: We assessed premenopausal women not on exogenous hormones undergoing coronary angiography for suspected ischemia. HHE was defined as estradiol<50 pg/ml, luteinizing hormone<10 IU/l and follicle stimulating hormone<10 IU/l. Serum inflammatory markers, reproductive hormones, and angiographic CAD were measured. Results: Overall, 40 (31%) of the 127 women had HHE with similar age and body mass index compared to no HHE (p=0.48 and p=0.77, respectively). Women with HHE had lower estradiol compared to no HHE (30.4+11.7 vs 112.5+62.4 pg/ml, p<0.0001). There were n...

Pharmacogenomics

Aim: To compare pharmacogenetic test predictions with self-reported treatment experience and side... more Aim: To compare pharmacogenetic test predictions with self-reported treatment experience and side effect tolerability among patients with depression taking psychotherapeutic medications. Methods: Subjects completed a survey recalling medication effectiveness and side effects and then underwent pharmacogenetic testing. Results: Our 15 gene pharmacogenetic panel predicted efficacy (p < 0.001) but did not predict side effect tolerability (p = 0.70) in a group of 352 patients. The pharmacogenetic panel and reported efficacy corresponded 60% of the time and medication tolerability agreed 71% of the time. Conclusion: Pharmacogenetic testing may be a useful adjunct to predict efficacy of medications used to treat depression.

Cancer Medicine

The majority of colorectal cancers (CRC) harbor somatic mutations and epigenetic modifications in... more The majority of colorectal cancers (CRC) harbor somatic mutations and epigenetic modifications in the tumor tissue, and some of these mutations can be detected in plasma as circulating tumor DNA (ctDNA). Precancerous colorectal lesions also contain many of these same mutations. This study examined plasma for ctDNA from patients undergoing a screening or diagnostic colonoscopy to determine the sensitivity and specificity of the ctDNA panel for detecting CRC and precancerous lesions. Two hundred patients without a history of nonskin cancer had blood drawn before a colonoscopy. Plasma ctDNA was measured with a 96 mutation panel for nine cancer driver genes. The ctDNA results were correlated with the findings at colonoscopy. Of the 200 patients, 176 (88%) had wild-type DNA, 12 (6%) had mutations detected, and 12 (6%) had indeterminate results. Colonoscopy was normal in 80% of the patients and 20% were found to have polyps. No CRC was found in this study, precluding a determination of true-positive rate for CRC detection. Our ctDNA panel was positive in 13.2% of patients with colonic polyps found at colonoscopy, while 4.7% of patients with normal colonoscopy also had ctDNA detected, which may represent ctDNA released from a benign process, an occult tumor, or an acquired somatic mutation from clonal hematopoiesis.

International journal of molecular epidemiology and genetics, 2018

The primary purpose of this study was to clinically evaluate circulating tumor DNA (ctDNA) with a... more The primary purpose of this study was to clinically evaluate circulating tumor DNA (ctDNA) with a nine gene, 96 mutation panel among subjects at increased risk for cancer with no previous cancer diagnosis. DNA from 1059 asymptomatic subjects was analyzed for detection of low levels ctDNA using a blood plasma liquid biopsy assay. Subjects with detectable copies of ctDNA were asked to provide additional blood samples and relevant medical records throughout their one-year of participation. Subjects with a negative result were followed-up at one-year with a questionnaire. Mutations were detected in 58 subjects and not detected in 1001 subjects. Among the subjects who tested positive for one or more mutations, four were diagnosed with cancer, two of which through study-triggered clinical follow-up. Two subjects who tested negative on the screen received an early cancer diagnosis over the course of the year. The sensitivity of the assay at a threshold of ≥2 copies in this population was 6...

PAIN Reports

Introduction: Genotyping-based treatment decisions may optimize treatment response and minimize a... more Introduction: Genotyping-based treatment decisions may optimize treatment response and minimize adverse drug events (ADEs) in patients with chronic pain. Objectives: To estimate the financial impact of genotyping-based treatment decisions in patients with moderate to severe chronic pain in a managed care setting. Methods: A budget impact model was built with a 1-year time horizon to estimate costs of genotyping-based treatment decisions in a 1000-patient cohort. The model includes drug costs, type and cost of ADEs, distribution of treatments used, and genotyping costs. Event rates and health care costs were derived from primary literature. Three patient cohorts were assessed with and without genotyping-based treatment decisions: no genetic testing; 50% genetic testing; and 100% genetic testing. Sensitivity analysis was performed varying costs, adherence, and the percentage of patients treated according to genotyping results. Results: Medical and ADE costs varied by patient severity and genotyping rates. Without genotyping, drug

Fertility and Sterility, 1985

ABSTRACT

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, Jan 13, 2016

Whether or not autoimmune thyroid disease influences progression of differentiated thyroid cancer... more Whether or not autoimmune thyroid disease influences progression of differentiated thyroid cancer (DTC) remains controversial. Findings of previous studies are influenced by lead time bias and/or procedure bias selection These biases can be reduced by studying a single-institution patient population that underwent similar extent of surgical resection. From a cohort of 660 patients with DTC who underwent thyroidectomy, we retrospectively studied 357 patients who underwent total thyroidectomy and central compartment node dissection (CCND) for DTC between 2003 and 2013. Forty-one percent (140/345) of study patients had lymphocytic thyroiditis (LT) and 30% (91/301) had positive serum anti-thyroglobulin antibody (TgAb). LT was reported in 78% of the TgAb-positive cases. Sixty percent (213/357) of cases had metastatic thyroid carcinoma in one or more neck lymph nodes [55% (198/357) central compartment, and 22% (77/356) lateral compartment]. Patients with LT had fewer metastatic cervical l...

Annals of Internal Medicine, 1973

Circulation, Oct 31, 2007