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Adrenal surgery

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https://www.readbyqxmd.com/read/27903577/adrenal-cushing-syndrome-with-detectable-acth-from-an-unexpected-source
#1
Thinzar M Lwin, Nehal Galal, Shweta Gera, Jennifer L Marti
Mixed corticomedullary adrenal tumours (MCMT) are rare. We describe the second reported case of a male patient presenting with hypertension and Cushing syndrome with MCMT. A man aged 48 years presented with hypertension and signs of Cushing syndrome. 24-hour urine cortisol was elevated, with detectable adrenocorticotropic hormone (ACTH). A high-dose dexamethasone suppression test indicated an adrenal or ectopic Cushing syndrome. Plasma metanephrines were normal. A 3 cm left adrenal mass was identified without potential ectopic sources of ACTH on imaging...
November 30, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27901414/cognitive-deficits-and-inflammatory-response-resulting-from-mild-to-moderate-traumatic-brain-injury-in-rats-are-exacerbated-by-repeated-pre-exposure-to-an-innate-stress-stimulus
#2
Michaël Ogier, Amor Belmeguenai, Thomas Lieutaud, Béatrice Georges, Sandrine Bouvard, Emilie Carré, Frédéric Canini, Laurent Bezin
Traumatic brain injury (TBI) is common in both military and civilian populations, and often results in neurobehavioral sequelae that impair quality of life in both patients and their family. Although individuals who are chronically exposed to stress are more likely to experience TBI, it is still unknown whether pre-injury stress influences the outcome after TBI. The present study tested whether behavioral and cognitive long-term outcome after TBI in rats is affected by prior exposure to an innate stress stimulus...
November 30, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27896436/risk-factors-for-complications-after-adrenalectomy-results-from-a-comprehensive-national-database
#3
Lo Hallin Thompson, Erik Nordenström, Martin Almquist, Helene Jacobsson, Anders Bergenfelz
PURPOSE: Most knowledge regarding outcome after adrenal surgery stems from retrospective studies reported by highly specialized centres. The aim of this study was to report a national experience of adrenalectomy with particular attention to predictive factors for postoperative complications, conversion from endoscopic to open surgery and length of hospital stay. METHODS: Adrenalectomies reported in the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery (SQRTPA) 2009-2014 were included...
November 28, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27894193/currently-used-and-investigational-drugs-for-cushing%C3%A2-s-disease
#4
Denis Ciato, Aizhar G Mumbach, Marcelo Paez-Pereda, Günter K Stalla
Cushing's disease (CD) is caused by a corticotroph adenoma of the pituitary gland that secretes excess adrenocorticotropic hormone (ACTH) causing increased morbidity and mortality. Surgery is the treatment of choice, but is not always successful. Alternatives include radiotherapy, adrenal surgery, and pharmaceutical therapy. The latter is increasingly gaining momentum due to the recent development of compounds that reduce hypercortisolaemia or its symptoms, acting through different mechanisms. Areas covered: In this article, the authors provide a complete overview of the treatment options for Cushing´s disease, including adrenal-directed, tumor-targeted, and peripheral therapies that are currently used or in development, and discuss their potential advantages and limitations...
November 29, 2016: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27889492/surgical-complications-following-early-genitourinary-reconstructive-surgery-for-congenital-adrenal-hyperplasia-interim-analysis-at-6-years
#5
Pankaj Dangle, Andy Lee, Rajeev Chaudhry, Francis X Schneck
OBJECTIVE: To review the intermediate to long-term surgical complications following feminizing reconstructive surgery for patients with congenital adrenal hyperplasia (CAH), at a single tertiary center. Genitourinary reconstructive surgery is pivotal for favorable cosmetic and functional outcome for patients with CAH. MATERIAL AND METHODS: We conducted a retrospective review identifying 26 patients from April 2003 to April 2015 who underwent genitourinary reconstructive surgeries...
November 23, 2016: Urology
https://www.readbyqxmd.com/read/27887913/prospective-assessment-of-cosmesis-before-and-after-genital-surgery
#6
N J Nokoff, B Palmer, A J Mullins, C E Aston, P Austin, L Baskin, K Bernabé, Y-M Chan, E Y Cheng, D A Diamond, A Fried, D Frimberger, D Galan, L Gonzalez, S Greenfield, T Kolon, B Kropp, Y Lakshmanan, S Meyer, T Meyer, L L Mullins, A Paradis, D Poppas, P Reddy, M Schulte, K J Scott Reyes, J M Swartz, C Wolfe-Christensen, E Yerkes, A B Wisniewski
INTRODUCTION: Little data exist about the surgical interventions taking place for children with disorders of sex development (DSD). Most studies that have evaluated cosmetic outcomes after genitoplasty have included retrospective ratings by a physician at a single center. OBJECTIVE: The present study aimed to: 1) describe frequency of sex assignment, and types of surgery performed in a cohort of patients with moderate-to-severe genital ambiguity; and 2) prospectively determine cosmesis ratings by parents and surgeons before and after genital surgery...
October 8, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27882768/-adrenocortical-oncocytoma-presenting-as-cushing%C3%A2-s-syndrome-in-pregnancy-with-spontaneous-postpartum-uterine-rupture
#7
M Kotoulová, I Mikysková, J Dušková, J Vláčil, M Dvořák, M Halaška
OBJECTIVE: The description of rare case of the Cushings syndrome in pregnancy resulting in the spontaneous rupture of uterus. DESIGNS: A case report. SETTING: Department of Gynecology and Obstetrics, 1st Medical Faculty of Charles University and Hospital Na Bulovce. CASE REPORT: The authors report the case of a 33 year old woman, who was admitted to the clinic in 30th week of pregnancy for elevated blood pressure and hypokalemia...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27881355/-comparison-of-open-versus-laparoscopic-surgeries-for-adrenal-tumor-a-meta-analysis
#8
Mao-Hu Lin, Xiao-Ying Zhu, Rui Miao, Lei He, Ning Jia
OBJECTIVE: To systematically review the effectiveness and safety of open and laparoscopic surgeries for treatment of adrenal tumors. METHODS: The online databases including CNKI, PUBMED, SinoMed, EBSCO, Springerlink, WanFang Data, and VIP were searched for clinical trials published from 1999 to 2016. A meta-analysis was performed using RevMan 5.2 software. RESULTS: A total of 2340 patients in 25 trials were included. The results of meta-analysis showed that laparoscopic surgery was better than open surgery in terms of intestinal function recovery time (OR=-0...
November 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27878955/primary-aldosteronism-from-case-detection-to-histopathology-with-up-to-6%C3%A2-years-of-follow-up
#9
Gudbjörg Jonsdottir, Jon Gudmundsson, Gudjon Birgisson, Helga Agusta Sigurjonsdottir
The authors aimed to investigate the clinical characteristics, accuracy of diagnostic tests, and long-term outcomes after interventions in patients diagnosed with primary aldosteronism (PA) in Iceland throughout 5 years. A retrospective chart review was performed for all patients diagnosed with PA during the years 2007-2011 at Landspitali Hospital in Iceland, a referral center for the whole country. Workup after detection included salt loading test, positional test, computed tomography, and adrenal vein sampling...
November 23, 2016: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/27878115/supradiaphragmatic-inferior-vena-caval-thrombectomy-without-cardiopulmonary-bypass-a-case-series-at-a-single-center
#10
Mohammad Soleimani, Reza Mohammadi, Navid Masoumi, Mohammad Reza Safarinejad
INTRODUCTION: Inferior vena cava tumor thrombectomy in renal cell carcinoma patients is a challenging procedure, frequently requiring the vascular bypass technique for high-level thrombi with additional complications. Adopting a technique such as intrapericardial control in selected cases will circumvent these problems. Here, we present the results of our intrapericardial control technique during supradiaphragmatic inferior vena caval tumor thrombectomy. CASE PRESENTATION: The records of six patients with supradiaphragmatic tumor thrombi, who underwent radical nephrectomy and thrombectomy at our center with intrapericardial control between the years 2008 and 2015, were retrospectively reviewed...
September 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27867895/gender-of-rearing-and-psychosocial-aspect-in-46-xx-congenital-adrenal-hyperplasia
#11
Arushi Gangaher, Viveka P Jyotsna, Vasundhera Chauhan, Jomimol John, Manju Mehta
BACKGROUND: In congenital adrenal hyperplasia (CAH) with ambiguous genitalia, assigning gender of rearing can be complex, especially If genitalia is highly virilized. Apart from karyotype, prenatal androgen exposure, patient's gender orientation, sociocultural, and parental influences play a role. The aim of this study was to assess gender dysphoria and psychosocial issues in patients of CAH raised as males and females. MATERIALS AND METHODS: This is a cross-sectional study that includes patients (old and new) with CAH who were treated by us in the last 6 months...
November 2016: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27866303/anesthetic-technique-and-cancer-recurrence-in-oncologic-surgery-unraveling-the-puzzle
#12
Ryungsa Kim
Surgery/anesthetic technique-stimulated immunosuppression in the perioperative period might cause an increase in cancer-related mortality. Whether anesthetic technique can affect the outcomes of cancer patients remains inconclusive. This review discusses data from the available literature on anesthetic techniques applied in oncologic surgery, the long-term outcomes of anesthetic technique, and their relation to survival and cancer recurrence. Searches of the PubMed database up to June 30, 2016, were conducted to identify publications with the terms "anesthetic technique and cancer recurrence," "regional anesthesia and cancer recurrence," "local anesthesia and cancer recurrence," "anesthetic technique and immunosuppression," and "anesthetic technique and oncologic surgery...
November 19, 2016: Cancer Metastasis Reviews
https://www.readbyqxmd.com/read/27845698/laparoscopic-surgery-in-great-adrenal-malignant-masses
#13
Miguel Ángel Arrabal-Polo, Paolo Fabiano, Almudena Moreno, María Carmen Cano-García, Jaime Jorge, Rafael Rosado
OBJECTIVE: The aim of this article is to describe the surgical technique of laparoscopic resection in malignant tumors greater than 10 cm. METHODS: We present two cases, a 63 year old woman with a left adrenal heterogeneous mass of 11 cm in maximum diameter and an 80 year old man with a left adrenal heterogeneous mass 13 cm in maximum diameter. In both cases excision was performed laparoscopically using 4 trocars and the Alexis® wound retractor for specimen extraction...
November 2016: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/27834023/laparoscopic-adrenalectomy-by-transabdominal-lateral-approach-20%C3%A2-years-of-experience
#14
Thibaut Coste, Robert Caiazzo, Fanelly Torres, Marie Christine Vantyghem, Bruno Carnaille, François Pattou, Christine Do Cao, Claire Douillard
BACKGROUND: Laparoscopic adrenalectomy (LA) has become the standard technique for most indications. The aim of this study was to determine the predictive factors of intra- and postoperative complications in order to inform the orientation of patient to a surgeon with more experience in adrenal surgery. METHODS: From January 1994 to December 2013, 520 consecutive patients benefited from LA at Huriez Hospital, Lille, France. Each complication was graded according to the Dindo-Clavien-grade scale...
November 10, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27833904/surgical-treatment-after-failed-primary-correction-of-urogenital-sinus-in-female-patients-with-virilizing-congenital-adrenal-hyperplasia-are-good-results-possible
#15
Maria Helena Palma Sircili, Tania Sartori Sanchez Bachega, Guiomar Madureira, Larissa Gomes, Berenice Bilharinho Mendonca, Francisco Tibor Dénes
PURPOSE: Genital reconstruction in female patients with virilizing congenital adrenal hyperplasia (CAH) is very challenging. Our aim was to evaluate the techniques employed to treat complications after failure of primary urogenital sinus (UGS) surgery, as well as the result of these reoperations. PATIENTS AND METHODS: Twenty girls with virilizing CAH who were previously submitted to genitoplasty in our service and elsewhere had recurrent UGS stenosis and vaginal introitus stenosis that required surgical treatment...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27823645/neuroblastoma-peripheral-neuroblastic-tumours
#16
REVIEW
Roberto Luksch, Maria Rita Castellani, Paola Collini, Bruno De Bernardi, Massimo Conte, Claudio Gambini, Lorenza Gandola, Alberto Garaventa, Davide Biasoni, Marta Podda, Angela Rita Sementa, Gemma Gatta, Gian Paolo Tonini
Peripheral neuroblastic tumours (PNTs), a family of tumours arising in the embryonal remnants of the sympathetic nervous system, account for 7-10% of all tumours in children. In two-thirds of cases, PNTs originate in the adrenal glands or the retroperitoneal ganglia. At least one third present metastases at onset, with bone and bone marrow being the most frequent metastatic sites. Disease extension, MYCN oncogene status and age are the most relevant prognostic factors, and their influence on outcome have been considered in the design of the recent treatment protocols...
November 2016: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/27819642/a-rare-complication-of-left-open-adrenalectomy
#17
Sanjay Kumar Yadav, Sapna Bothra, Aromal S Chekavar, Sabaretnam Mayilvaganan, Ashok Kumar Verma
Chyle leakage after left open adrenalectomy is a quite rare complication. We encountered a young male patient who was operated for left adrenal pheochromocytoma, left laparoscopic adrenalectomy converted to open due to dense adhesions. Postoperatively patient developed chylous fluid drainage on day 2. He was managed conservatively with high protein and MCT oil diet. This case highlights the unusual complication of left adrenalectomy surgery and how it can be managed.
2016: Chirurgia
https://www.readbyqxmd.com/read/27812903/expanding-the-horizon-of-robotic-surgery-to-large-pelvic-paraganglioma
#18
Santosh Kumar, M Pragatheeswarane, Aditya Prakash Sharma, Kshitij Bishnoi, Manjeet Kumar Sharma, Vikas Kumar Panwar, Sameer Sethi
INTRODUCTION: Paragangliomas are the most common extra-adrenal pheochromocytoma. Symptomatic and growing tumors demand surgical extirpation. Minimally invasive techniques allow surgeons to perform the procedure without wide exposure and mobilization of intra-abdominal organs. To our knowledge, we present the fourth case of robotic excision of a large retroperitoneal paraganglioma. MATERIALS AND METHODS: An 18-year-old unmarried female presented with occipital headache for past 3 years...
November 3, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/27783154/hypoparathyroidism-after-total-thyroidectomy-in-patients-with-previous-gastric-bypass
#19
Raoul A Droeser, Johan Ottosson, Andreas Muth, Hella Hultin, Karin Lindwall-Åhlander, Anders Bergenfelz, Martin Almquist
PURPOSE: Case reports suggest that patients with previous gastric bypass have an increased risk of severe hypocalcemia after total thyroidectomy, but there are no population-based studies. The prevalence of gastric bypass before thyroidectomy and the risk of hypocalcemia after thyroidectomy in patients with previous gastric bypass were investigated. METHODS: By cross-linking The Scandinavian Quality Registry for Thyroid, Parathyroid and Adrenal Surgery with the Scandinavian Obesity Surgery Registry patients operated with total thyroidectomy without concurrent or previous surgery for hyperparathyroidism were identified and grouped according to previous gastric bypass...
October 26, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27779350/adrenal-insufficiency-in-neonates-after-cardiac-surgery-with-cardiopulmonary-bypass
#20
Jack H Crawford, Matthew S Hull, Santiago Borasino, Brad L Steenwyk, Kristal M Hock, Kevin Wall, Jeffrey A Alten
BACKGROUND: Cardiopulmonary bypass (CPB) may lead to adrenal insufficiency (AI). Emerging evidence supports association of AI with morbidity after cardiac surgery. AIMS: The aim of this study was to define AI incidence in neonates undergoing complex cardiac surgery with CPB and its association with intraoperative post-CPB outcomes. METHODS: Forty subjects enrolled in a prior randomized control trial who received preoperative methylprednisolone as part of our institutional neonatal bypass protocol were included...
October 25, 2016: Paediatric Anaesthesia
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