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Adrenal surgery

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https://www.readbyqxmd.com/read/29784078/corticoadrenal-and-cardiorespiratory-responses-to-administration-of-propofol-combined-with-dexmedetomidine-or-ketamine-in-rabbits
#1
Alfredo González-Gil, Rosa Ana Picazo, Paul de Bruyn, Juan Carlos Illera
Anesthetic protocols may influence adrenal function. Effective methods for modulating stress are desirable to minimize secondary effects during the perioperative period. The aim of this study was to evaluate the effects of the administration of propofol with dexmedetomidine or ketamine on corticoadrenal function and heart and respiratory rates. A random treatment-order design was used: each rabbit received all treatments, with at least 14 d between experiments. Rabbits were assigned to 3 treatment groups (10 per group): group 1, 1 mL normal saline solution intravenously; group 2, propofol (3 mg/kg IV) and dexmedetomidine (0...
May 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/29774815/robot-assisted-laparoscopic-adrenalectomy
#2
Vignesh T Packiam, Nimrod S Barashi, Arieh L Shalhav
Adrenalectomies are increasingly performed using minimally invasive approaches. The widespread adoption of robot-assisted laparoscopy for other urologic surgeries has dramatically increased the popularity of this approach for adrenal surgery.
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29757442/effect-of-intravenous-fluid-volumes-on-the-adrenal-glucocorticoid-response-after-burn-injury-in-swine
#3
Belinda I Gómez, Celestine He, Tony Chao, Michael A Dubick, David M Burmeister
Objective: Severe thermal injury induces metabolic and physiological stress, prompting a disruption in the hypothalamic-pituitary-adrenal axis. The objective of this study was to evaluate potential confounding effects of Lactated Ringer's (LR) resuscitation on adrenal damage and cortisol production following burn. Methods: Anesthetized swine were instrumented with jugular catheters and sustained 40% TBSA burns from brass probes heated to 100ºC. Animals recovered to consciousness and received IV fluid resuscitation with LR at two different volumes: 15 mL/kg/day (Limited Volume; LV, n=6) or 2 mL/kg/%TBSA/day (Modified Brooke; MB, n=6)...
May 11, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29754639/adrenal-surgery-for-cushing-s-syndrome-an-update
#4
REVIEW
Guido Di Dalmazi, Martin Reincke
Recent advances in the molecular pathogenesis and the natural history of Cushing's syndrome have improved the understanding of the management of this disease. The long-term efficacy of several cortisol-lowering medical treatments is currently under evaluation. However, adrenalectomy is a safe option for the treatment of patients affected by Cushing's syndrome. Unilateral adrenalectomy is the gold standard for treatment of adrenocortical adenomas associated with hypercortisolism. Bilateral adrenalectomy has been widely used in the past as definitive treatment of bilateral macronodular hyperplasia and persistent or recurrent Cushing's disease...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29750932/bilateral-posterior-mediastinal-primary-myelolipoma
#5
Ishan Goel, Parul Kaushik, Rama Anand
Myelolipoma(ML) is an uncommon benign mesenchymal tumor consisting of mature adipocytes and hemopoietic elements mostly found in adrenal glands. Bilateral posterior mediastinal primary myelolipoma presents extremely rarely and only 11 such occurrences have been previously described. With no definite symptoms, pathological evaluation is essential for diagnosis. Here the authors present a case of a 63-year old man diagnosed with bilateral posterior mediastinal primary myelolipoma on basis of radiological findings who underwent surgical resection via video-assisted thoracic surgery (VATS)...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29750931/relative-adrenal-insufficiency-is-associated-with-prolonged-postoperative-hemodynamic-instability
#6
Amine Mazine, Ismail Bouhout, Nadim Saydy, Louis-Mathieu Stevens, Maude Gagné-Loranger, Frédéric Vanden Eynden, Daniel Parent, Yoan Lamarche, Denis Bouchard
BACKGROUND: We assessed the hypothesis that a significant proportion of patients undergoing cardiac surgery suffer from postoperative relative adrenal insufficiency (RAI), and that this puts them at higher risk of persistent hemodynamic instability. METHODS: A prospective study included 135 patients who underwent cardiac surgery using cardiopulmonary bypass between July 2006 and December 2007. Adrenal function was assessed 36 hours after surgery using a 1 μg cosyntropin (ACTH) stimulation test...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29749133/characteristics-of-adrenal-incidentalomas-in-a-large-prospective-computed-tomography-based-multicenter-study-the-coar-study-in-korea
#7
Seong Hee Ahn, Jae Hyeon Kim, Seung Hee Baek, Hyeonmok Kim, Yoon Young Cho, Sunghwan Suh, Beom Jun Kim, Seongbin Hong, Jung Min Koh, Seung Hun Lee, Kee Ho Song
PURPOSE: Previous studies on adrenal incidentalomas (AIs) are limited by their retrospective design, small numbers of patients, Western populations, or use of an outdated imaging technique. We investigated the characteristics of AIs in Korean patients and compared them with those reported in the largest retrospective study in Italy to discover the effects of improved imaging techniques and ethnicity differences. MATERIALS AND METHODS: This was a prospective, multicenter, cross-sectional observational study including 1005 Korean patients...
June 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29747617/pheochromocytoma-as-a-rare-cause-of-hypertension-in-a-46-x-i-x-q10-turner-syndrome-a-case-report-and-literature-review
#8
Ji Yeon Shin, Bo Hyun Kim, Young Keum Kim, Tae Hwa Kim, Eun Heui Kim, Min Jin Lee, Jong Ho Kim, Yun Kyung Jeon, Sang Soo Kim, In Joo Kim
BACKGROUND: Cardiovascular disease (CVD) presents the most serious health problems and contributes to the increased mortality in young women with Turner syndrome. Arterial hypertension in Turner syndrome patients is significantly more prevalent than that in a general age-matched control group. The aetiology of hypertension in Turner syndrome varies, even in the absence of cardiac anomalies and obvious structural renal abnormalities. Pheochromocytoma is an extremely rare cause among various etiologies for hypertension in patients with Turner syndrome...
May 10, 2018: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29746848/nitric-oxide-alterations-in-cardiovascular-system-of-rats-with-parkinsonism-induced-by-6-ohda-and-submitted-to-previous-exercise
#9
Lorena de Jager, Eric Diego Turossi Amorim, Bruno Fernando Cruz Lucchetti, Fernanda Novi Cortegoso Lopes, Carlos Cesar Crestani, Phileno Pinge-Filho, Marli Cardoso Martins-Pinge
Studies showed that physical exercise decreases the risk of developing Parkinson's disease (PD) as slowing its progression. During aerobic training, nitric oxide (NO) increases in the substantia nigra pars compacta (SNpc) of individuals with PD. However, no study has evaluated the effects of exercise on peripheral NO levels and its modulatory effects on cardiovascular dysfunctions of subjects with PD. Trained (T) or sedentary (S) animals underwent stereotactic surgery for bilateral 6-hydroxydopamine (6-OHDA) or vehicle microinfusion (Sham group)...
May 7, 2018: Life Sciences
https://www.readbyqxmd.com/read/29741215/role-of-dotatate-pet-ct-in-preoperative-assessment-of-phaeochromocytoma-and-paragangliomas
#10
Matti L Gild, Nikita Naik, Jeremy Hoang, Edward Hsiao, Rachel T McGrath, Mark Sywak, Stan Sidhu, Leigh Walter Delbridge, Bruce Gregory Robinson, Geoff Schembri, Roderick John Clifton-Bligh
CONTEXT: Diagnosis of paragangliomas (PGL) and phaeochromocytomas (PC) can be challenging particularly if the tumour is small. Detection of metastatic disease is important for comprehensive management of malignant PC/PGL. Somatostatin receptor imaging (SRI) agents have high sensitivity for these tumours, particularly the DOTA family of radiopharmaceuticals labelled with 68 Gallium. OBJECTIVE: To describe the utility of SRI in primary assessment (i.e. before surgery) for PC/PGL and whether measures of maximum standardized uptake (SUVmax) could be used to distinguish between adrenal adenomas and PCs...
May 9, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29737320/posterior-mediastinal-myelolipoma-resected-by-video-assisted-thoracic-surgery
#11
Luigi Ventura, Eugenia Marta Martella, Michele Rusca, Luca Ampollini
Myelolipoma (ML) is a benign tumour composed of haematopoietic and mature adipose tissue commonly found in adrenal glands. Prognosis is usually good with an indolent clinical course. The occurrence of an ML in the extra-adrenal site is very rare. Herein, we report a very interesting and unusual case of ML located in the posterior mediastinum successfully resected by video-assisted thoracic surgery. The clinical and histological features are largely discussed.
May 4, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29732365/corticosteroids-in-pediatric-heart-surgery-myth-or-reality
#12
REVIEW
Daniel P Fudulu, Ben Gibbison, Thomas Upton, Serban C Stoica, Massimo Caputo, Stafford Lightman, Gianni D Angelini
Background: Corticosteroids have been administered prophylactically for more than 60 years in pediatric heart surgery, however, their use remains a matter of debate. There are three main indications for corticosteroid use in pediatric heart surgery with the use of cardiopulmonary bypass (CPB): (1) to blunt the systemic inflammatory response (SIRS) induced by the extracorporeal circuit; (2) to provide perioperative supplementation for presumed relative adrenal insufficiency; (3) for the presumed neuroprotective effect during deep hypothermic circulatory arrest operations...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29716804/root-cause-analysis-of-diagnostic-and-surgical-failures-in-the-treatment-of-suspected-cushing-s-disease
#13
Hasan A Zaidi, David L Penn, David J Cote, Edward R Laws
Cushing's disease (CD) is a condition characterized by excess glucocorticoid from an ACTH pituitary adenoma. Identifying surgical candidates represents a major diagnostic challenge. We performed a root cause analysis (RCA) of treatment failures for patients with suspected CD. The present study aims to categorize failures in treatment. Medical records were reviewed from 2008 to 2017 for all patients treated surgically for suspected CD. Demographics, past medical history, endocrine outcomes, imaging findings, laboratory studies and clinical features were collected...
April 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29707681/hershberger-assays-for-di-2-ethylhexyl-phthalate-and-its-substitute-candidates
#14
Hee-Su Kim, Yong-Pil Cheon, Sung-Ho Lee
In the present study, we employed Hershberger assay to determine possible androgenic or antiandrogenic activities of three di-2-ethylhexyl phthalate (DEHP) substitute candidates. The assay was carried out using immature castrated Sprague-Dawley male rats. After 7 days of the surgery, testosterone propionate (TP, 0.4 mg/kg/day) and test materials (low dose, 40 mg/kg/day; high dose, 400 mg/kg/day) were administered for 10 consecutive days by subcutaneous (s.c.) injection and oral gavage, respectively. Test materials were DEHP, 2-ethylhexyl oleate (IOO), 2-ethylhexyl stearate (IOS) and triethyl 2-acetylcitrate (ATEC)...
March 2018: Balsaeng'gwa Saengsig
https://www.readbyqxmd.com/read/29697927/robotic-excision-of-complex-adrenal-mass-with-retrocaval-extension-and-encasement-of-renal-hilum-with-renal-preservation
#15
Vishnu Raveendran, Ramaprasad Manasseri Koduveli, Kishore Thekke Adiyat
OBJECTIVE: The purpose of this video is to present robotic excision of a complex adrenal mass with retrocaval extension and encasement of renal hilum in a 16 year old boy. Biochemical screening was negative for metabolically active component. Computerized tomographic scan with contrast revealed a homogenous mass of approximately 10.8 cm x 6.2 cm x 4.2 cm in the suprarenal area on right side that was extend-ing behind inferior vena cava and encasing renal hilar vessels. Imaging findings were that of a classical ganglioneuroma...
April 5, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29695647/a-case-of-tsh-secreting-pituitary-adenoma-with-cyclic-fluctuations-in-serum-tsh-levels
#16
Hideyuki Okuma, Koshi Hashimoto, Takuya Ohashi, Masatomo Mihara, Isao Minami, Hajime Izumiyama, Shigekazu Sasaki, Naoko Inoshita, Hiroshi Nishioka, Shozo Yamada, Takanobu Yoshimoto
A 29-year-old man was referred to our department due to adrenal insufficiency with the inappropriate secretion of TSH (SITSH). Magnetic resonance imaging revealed a pituitary tumor. A weak TSH response in the TRH test, elevated sex hormone binding globulin (SHBG) levels, and the absence of a family medical history of SITSH or TRβ gene mutations supported the diagnosis of TSH-secreting pituitary adenoma (TSHoma). However, complete TSH suppression and a blunted cholesterol response in the T3 suppression test as well as normal glycoprotein α-subunit (α-GSU) levels were not compatible with TSHoma...
April 26, 2018: Endocrine Journal
https://www.readbyqxmd.com/read/29694638/a-review-of-cushing-s-disease-treatment-by-the-department-of-neuroendocrinology-of-the-brazilian-society-of-endocrinology-and-metabolism
#17
Márcio Carlos Machado, Maria Candida Barisson Vilares Fragoso, Ayrton Custódio Moreira, César Luiz Boguszewski, Leonardo Vieira Neto, Luciana A Naves, Lucio Vilar, Luiz Antônio de Araújo, Nina Rosa Castro Musolino, Paulo Augusto C Miranda, Mauro A Czepielewski, Monica R Gadelha, Marcello Delano Bronstein, Antônio Ribeiro-Oliveira
The treatment objectives for a patient with Cushing's disease (CD) are remission of hypercortisolism, adequate management of co-morbidities, restoration of the hypothalamic-pituitary-adrenal axis, preservation of fertility and pituitary function, and improvement of visual defects in cases of macroadenomas with suprasellar extension. Transsphenoidal pituitary surgery is the main treatment option for the majority of cases, even in macroadenomas with low probability of remission. In cases of surgical failure, another subsequent pituitary surgery might be indicated in cases with persistent tumor imaging at post surgical magnetic resonance imaging (MRI) and/or pathology analysis of adrenocorticotropic hormone-positive (ACTH+) positive pituitary adenoma in the first procedure...
February 2018: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29685132/acth-independent-cushing-s-syndrome-with-bilateral-cortisol-secreting-adrenal-adenomas-a-case-report-and-review-of-literatures
#18
Jia Wei, Sheyu Li, Qilin Liu, Yuchun Zhu, Nianwei Wu, Ying Tang, Qianrui Li, Kaiyun Ren, Qianying Zhang, Yerong Yu, Zhenmei An, Jing Chen, Jianwei Li
BACKGROUND: Adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome (CS) with bilateral cortisol-secreting adenomas has been rarely reported in the literatures. Precise recognition and management of this disorder constitute a challenge to clinicians due to the difficulty of exact location of the functional lesions. CASE PRESENTATION: We herein report a new case of a Chinese female patient with a complaint of exertional dyspnea for over 10 years. ACTH-independent CS was diagnosed based on undetectable ACTH and unsuppressed cortisol levels by dexamethasone...
April 23, 2018: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29682390/hydatid-cyst-of-the-adrenal-gland-is-radical-surgery-necessary-for-recurrent-hydatid-disease
#19
Sami Akbulut, Mehmet Yilmaz
Hydatid cyst disease caused by E. granulosus is a zoonotic disease that may involve many body tissues and organs, mainly liver. Adrenal glands are rarely involved even in regions where hydatid cyst disease is endemic. A limited number of studies have been reported on adrenal gland involvement by hydatid cyst disease. Herein, we aimed to report a recurrent case of adrenal hydatid cyst that was misdiagnosed as a hepatic hydatid cyst. A 16-year-old boy with a history of partial cyst excision and evacuation for perforated adrenal hydatid cyst disease three years ago presented to our outpatient clinic with nonspecific abdominal pain...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29677033/characterization-of-the-glucocorticoid-receptor-in-children-undergoing-cardiac-surgery
#20
Saul Flores, David S Cooper, Amy M Opoka, Ilias Iliopoulos, Sarah Pluckebaum, Matthew N Alder, Kelli A Krallman, Rashmi D Sahay, Lin Fei, Hector R Wong
OBJECTIVES: Postoperative administration of corticosteroids is common practice for managing catecholamine refractory low cardiac output syndrome. Since corticosteroid activity is dependent on the glucocorticoid receptor, we sought to characterize glucocorticoid receptor levels in children undergoing cardiac surgery and examined the association between glucocorticoid receptor levels and cardiovascular dysfunction. DESIGN: Prospective observational cohort study. SETTING: Large, tertiary pediatric cardiac center...
April 19, 2018: Pediatric Critical Care Medicine
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