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Due to the great variability of devices and e-liquid combinations among users, in vitro and animal models have been used to examine the specific biological effects of e-cig constituents

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Corticosteroids may also potentiate the replication of some organisms contained in live attenuated vaccines

Important aspects of the physical examination include evaluation of the male breast tissue with palpation to evaluate for breast cancer and pseudogynecomastia (male breast tissue enlargement solely due to excess fatty tissue), evaluation of penile size and development, evaluation of testicular development and an assessment for masses that raise suspicion for testicular cancer, and proper development of secondary sex characteristics such as the amount and distribution of pubic and underarm hair