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Adrenalectomy

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https://www.readbyqxmd.com/read/28430608/adrenalectomy-abolishes-hypergravity-induced-gastric-acid-hyposecretion
#1
Kiyong Na, Hyun-Soo Kim
Jet fighter pilots experience high gravitational acceleration forces in the cephalocaudal direction (+Gz), causing severe stress. Stress affects different physiological functions of the gastrointestinal tract. Although the effects of exposure to hypergravity on cardiovascular and cerebral functions have been the subject of numerous studies, crucial information regarding potential pathophysiological alterations following hypergravity exposure in the gastrointestinal tract is lacking. We recently documented a significant decrease in gastric secretory activity in rats after acute exposure to hypergravity...
February 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28422753/steroid-metabolome-analysis-reveals-prevalent-glucocorticoid-excess-in-primary-aldosteronism
#2
Wiebke Arlt, Katharina Lang, Alice J Sitch, Anna S Dietz, Yara Rhayem, Irina Bancos, Annette Feuchtinger, Vasileios Chortis, Lorna C Gilligan, Philippe Ludwig, Anna Riester, Evelyn Asbach, Beverly A Hughes, Donna M O'Neil, Martin Bidlingmaier, Jeremy W Tomlinson, Zaki K Hassan-Smith, D Aled Rees, Christian Adolf, Stefanie Hahner, Marcus Quinkler, Tanja Dekkers, Jaap Deinum, Michael Biehl, Brian G Keevil, Cedric H L Shackleton, Jonathan J Deeks, Axel K Walch, Felix Beuschlein, Martin Reincke
BACKGROUND: Adrenal aldosterone excess is the most common cause of secondary hypertension and is associated with increased cardiovascular morbidity. However, adverse metabolic risk in primary aldosteronism extends beyond hypertension, with increased rates of insulin resistance, type 2 diabetes, and osteoporosis, which cannot be easily explained by aldosterone excess. METHODS: We performed mass spectrometry-based analysis of a 24-hour urine steroid metabolome in 174 newly diagnosed patients with primary aldosteronism (103 unilateral adenomas, 71 bilateral adrenal hyperplasias) in comparison to 162 healthy controls, 56 patients with endocrine inactive adrenal adenoma, 104 patients with mild subclinical, and 47 with clinically overt adrenal cortisol excess...
April 20, 2017: JCI Insight
https://www.readbyqxmd.com/read/28421470/adrenalectomy-indications-and-options-for-treatment
#3
REVIEW
Alemanno Giovanni, Bergamini Carlo, Prosperi Paolo, Valeri Andrea
The history of adrenal surgery is longstanding. Firstly described in 1889 by Thornton, the open adrenalectomy has been for decades the only surgical approach to adrenal diseases. Nowadays, instead, several approaches to adrenal glands have been described in the literature, such as laparoscopic adrenalectomy, robotic-assisted procedure and single-incision technique. Actually, laparoscopic adrenalectomy is considered as the gold standard treatment for adrenal lesions. In fact, all functional tumors, including pheochromocytoma, are candidates for a laparoscopic approach in the absence of other contraindications...
April 18, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28420172/subtype-diagnosis-of-primary-aldosteronism-is-adrenal-vein-sampling-always-necessary
#4
REVIEW
Fabrizio Buffolo, Silvia Monticone, Tracy A Williams, Denis Rossato, Jacopo Burrello, Martina Tetti, Franco Veglio, Paolo Mulatero
Aldosterone producing adenoma and bilateral adrenal hyperplasia are the two most common subtypes of primary aldosteronism (PA) that require targeted and distinct therapeutic approaches: unilateral adrenalectomy or lifelong medical therapy with mineralocorticoid receptor antagonists. According to the 2016 Endocrine Society Guideline, adrenal venous sampling (AVS) is the gold standard test to distinguish between unilateral and bilateral aldosterone overproduction and therefore, to safely refer patients with PA to surgery...
April 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28415786/arterial-stiffness-and-blood-pressure-improvement-in-aldosterone-producing-adenoma-harboring-kcnj5-mutations-after-adrenalectomy
#5
Chia-Hui Chang, Ya-Hui Hu, Yao-Chou Tsai, Che-Hsiung Wu, Shuo-Meng Wang, Lian-Yu Lin, Yen-Hung Lin, Fumitoshi Satoh, Kwan-Dun Wu, Vin-Cent Wu
The aim of this study was to show the effect of KCNJ5 mutational status on arterial stiffness in aldosterone-producing adenomas after adrenalectomy. Between February 2008 and January 2010, we prospectively enrolled 108 aldosterone-producing adenoma patients undergoing adrenalectomy. We conducted repeated measurements of pulse wave velocity at baseline, 6 months, and 12 months after adrenalectomy, grouped by KCNJ5 mutational status. Prognostic factors of arterial stiffness and risk for hypertension at 12 months after adrenalectomy were analyzed after propensity score matching in a 1:1 ratio...
March 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28410600/primary-adrenal-non-hodgkin-lymphoma-a-case-report-and-review-of-the-literature
#6
Nanik Ram, Owais Rashid, Saad Farooq, Imran Ulhaq, Najmul Islam
BACKGROUND: Lymphomas are cancers that arise from the white blood cells and have been traditionally divided into two large subtypes: Hodgkin and non-Hodgkin lymphoma. B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma; almost 85% of patients with lymphoma have this variant. Lymphomas can potentially arise from any lymphoid tissue located in the body; however, primary adrenal non-Hodgkin lymphoma is extremely rare. We report the history, examination findings, and laboratory results of a 50-year-old man diagnosed with a primary left adrenal diffuse large B-cell lymphoma...
April 15, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28410304/diagnostic-rate-of-primary-aldosteronism-in-emilia-romagna-northern-italy-during-16-years-2000-2015
#7
Ermanno Rossi, Franco Perazzoli, Aurelio Negro, Antonia Magnani
BACKGROUND: Although primary aldosteronism is considered the most common form of endocrine hypertension, the diagnostic rate of primary aldosteronism in the territory is unknown. OBJECTIVES: The aims of the current study were to compare the number of patients discharged with International Classification of Diseases 9 Clinical Modification codes compatible with primary aldosteronism from all the hospitals in Emilia-Romagna during 16 years (from 2000 to 2015) with the number of expected cases of primary aldosteronism, and to compare the number of patients with primary aldosteronism who underwent adrenalectomy in the period 2000-2015 with the number of expected cases of unilateral primary aldosteronism...
April 13, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28405951/posterior-retroperitonoscopic-adrenalectomy-a-back-door-access-with-an-unusually-rapid-learning-curve
#8
Sohail Bakkar, Gabriele Materazzi, Lorenzo Fregoli, Piermarco Papini, Paolo Miccoli
Posterior retroperitonoscopic adrenalectomy (PRA) has become a standard approach to the adrenal gland. The aim of this study was to report an initial experience with the procedure following a proper preparatory phase highlighting the rapidity, safety and effectiveness by which it could be introduced into a surgeon's practice. Between May 2015 and July 2016, 14 PRAs were performed in 14 patients (9 females and 5 males). The average age was 46 years, BMI: 25.5 kg/m(2), and ASA score: 2. Indications included: incidenatloma (n = 5), Conn's adenoma (n = 5), and Cushing's adenoma (n = 4)...
April 12, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28403121/pheochromocytoma-crisis-in-icu-a-french-multicenter-cohort-study-with-emphasis-on-rescue-extracorporeal-membrane-oxygenation
#9
Bertrand Sauneuf, Nicolas Chudeau, Benoit Champigneulle, Claire Bouffard, Marion Antona, Nicolas Pichon, David Marrache, Romain Sonneville, Antoine Marchalot, Camille Welsch, Antoine Kimmoun, Bruno Bouchet, Elmi Messai, Sylvie Ricome, David Grimaldi, Jonathan Chelly, Jean-Luc Hanouz, Alain Mercat, Nicolas Terzi
OBJECTIVES: To describe the characteristics, management, and outcome of patients admitted to ICUs for pheochromocytoma crisis. DESIGN: A 16-year multicenter retrospective study. SETTING: Fifteen university and nonuniversity ICUs in France. PATIENTS: Patients admitted in ICU for pheochromocytoma crisis. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: We included 34 patients with a median age of 46 years (40-54 yr); 65% were males...
April 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403043/plasma-galectin-3-concentrations-in-patients-with-primary-aldosteronism
#10
T N A Daniëlle van den Berg, Wouter C Meijers, A Rogier T Donders, Antonius E Van Herwaarden, Gerard A Rongen, Rudolf A de Boer, Jaap Deinum, Niels P Riksen
BACKGROUND: The incidence of cardiovascular events is higher in patients with primary aldosteronism than in patients with essential hypertension (EHT), despite similar blood pressure levels. This suggests detrimental cardiovascular effects of aldosterone. Amongst others, it has been suggested that galectin-3 (Gal-3) is a key mediator in aldosterone-induced myocardial fibrosis. OBJECTIVE: We studied whether patients with primary aldosteronism have higher plasma Gal-3 concentrations than patients with EHT and evaluated its reversibility after adrenalectomy...
April 11, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28401356/development-of-novel-nomograms-to-predict-renal-functional-outcomes-after-laparoscopic-adrenalectomy-in-patients-with-primary-aldosteronism
#11
Takanobu Utsumi, Naoto Kamiya, Mayuko Kaga, Takumi Endo, Masashi Yano, Shuichi Kamijima, Koji Kawamura, Takashi Imamoto, Tomohiko Ichikawa, Hiroyoshi Suzuki
PURPOSE: Most patients with primary aldosteronism (PA) show a significant decrease in kidney function after surgery. Glomerular hyperfiltration peculiar to PA can mask mild renal failure before surgery. The aim of this retrospective study was to investigate postoperative renal functional outcomes in PA patients from different viewpoints and to develop novel nomograms that can predict renal functional outcomes in PA patients after surgery. METHODS: 130 Japanese PA patients treated by unilateral laparoscopic adrenalectomy were retrospectively surveyed...
April 11, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28400922/pheochromocytoma-and-stress-cardiomyopathy-insight-into-pathogenesis
#12
Sahil Agrawal, Jamshid Shirani, Lohit Garg, Amitoj Singh, Santo Longo, Angelita Longo, Mark Fegley, Lauren Stone, Muhammad Razavi, Nicoleta Radoianu, Sudip Nanda
AIM: To investigate the occurrence of cardiomyopathy (CMP) in a cohort of patients with histologically proven pheochromocytoma (pheo), and to determine if catecholamine excess was causative of the left ventricular (LV) dysfunction. METHODS: A retrospective chart review spanning years 1998 through 2014 was undertaken and patients with a diagnosis of pheo confirmed with histopathologic examination were included. Presenting electrocardiograms and cardiac imaging studies were reviewed...
March 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28391254/primary-pigmented-nodular-adrenocortical-disease-literature-review-and-case-report-of-a-6-year-old-boy
#13
Dragan Katanić, Dejan Kafka, Mirjana Živojinov, Jovan Vlaški, Zorana Budakov, Marija Knežević Pogančev, Ivana Vorgučin, Tomislav Ćuk
Cushing's syndrome is rare in childhood and is usually caused by a pituitary adenoma. Primary hyperfunction of adrenal glands is less frequent, particularly primary pigmented nodular adrenocortical disease (PPNAD). It occurs usually in children and adolescents, with female preponderance, while Cushing's disease has increased frequency in prepubertal males. A case of a 6-year-old boy is presented with isolated non-familiar PPNAD. The clinical pattern involved Cushingoid appearance, hypertension, virilization and depressive mood...
April 10, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28390062/outcome-of-laparoscopic-adrenalectomy-for-resection-of-unilateral-noninvasive-adrenocortical-tumors-in-11-cats
#14
Jeffrey W Mitchell, Philipp D Mayhew, William T N Culp, J Brad Case, Ameet Singh, Mark C Fuller, Ann Della Maggiore
OBJECTIVE: To describe the technique and outcomes of laparoscopic adrenalectomy (LA) in cats with adrenocortical neoplasia. STUDY DESIGN: Retrospective case series. ANIMALS: Eleven client-owned cats with unilateral adrenal tumors. METHODS: Medical records of cats that underwent LA for unilateral functional adrenal tumors at 3 veterinary teaching hospitals were reviewed. Data collected included signalment, clinical signs, physical examination findings, diagnostic imaging results, preoperative laboratory tests, laparoscopic port placement and techniques, duration of anesthesia and surgery, complications, concomitant procedures, need for conversion to an open celiotomy, histopathological diagnosis, and postoperative survival...
April 8, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28385115/preoperative-adrenal-artery-embolization-followed-by-surgical-excision-of-giant-hypervascular-adrenal-masses-report-of-three-cases
#15
Ismail Cem Sormaz, Fatih Tunca, Arzu Poyanlı, Yasemin Giles Şenyürek
BACKGROUND: Transcatheter arterial embolization (TAE) is an effective minimally invasive adjunct to surgery for the management and/or palliation of adrenal tumors. METHODS: In this case study, we reported three patients who underwent preoperative TAE before adrenalectomy for large hypervascular adrenal tumors. All patients underwent preoperative embolization 24 h before the operation and were then followed up at the intensive care unit surgery. RESULTS: The largest diameter of the adrenal lesions ranged between 8 and 17 cm...
April 7, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28382959/treatment-of-primary-aldosteronism-is-associated-with-a-reduction-in-the-severity-of-obstructive-sleep-apnoea
#16
M J Wolley, E Pimenta, D Calhoun, R D Gordon, D Cowley, M Stowasser
Obstructive sleep apnoea (OSA) is known to commonly co-exist with primary aldosteronism (PA), but it is unknown if treatment of PA improves sleep apnoea parameters in these patients. We therefore aimed to determine whether specific medical or surgical treatment of PA improves OSA, as measured by the apnoea-hypopnoea index (AHI). We recruited patients undergoing diagnostic workup for PA if they had symptoms suggestive of OSA. Patients with confirmed PA underwent polysomnography (PSG) at baseline and again at least 3 months after specific treatment for PA...
April 6, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28368884/unilateral-adrenal-cryptococcosis-on-fdg-pet-ct
#17
Jinxin Zhou, Jing Lv, Yu Pan, Jing Xie, Yifan Zhang
A 70-year-old man with T-cell deficiency experienced continuous right waist pain and a low degree of fever. Abdominal CT found a large right adrenal mass. FDG PET/CT imaging was acquired to identify the nature of this likely malignant mass and search for potential metastases. The images revealed increased FDG activity in the mass. The patient received right adrenalectomy. Postsurgical pathological and microbial examination demonstrated adrenal cryptococcosis.
March 31, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28368480/genetic-and-histopathologic-inter-tumor-heterogeneity-in-primary-aldosteronism
#18
Kei Omata, Yuto Yamazaki, Yasuhiro Nakamura, Sharath K Anand, Justine A Barletta, Hironobu Sasano, William E Rainey, Scott A Tomlins, Anand Vaidya
Context: Whether primary aldosteronism (PA) is the consequence of a monoclonal or multiclonal process is unclear. Case Description: A 48-year-old man with severe bilateral PA refractory to medical therapy underwent unilateral adrenalectomy of the dominant adrenal. Although computed tomography (CT) showed three left-sided cortical nodules, post-surgical histopathology and genetic analysis revealed five different adrenocortical adenomas. Two zona fasciculata (ZF)-like aldosterone producing adenomas (APAs) each harbored distinct known somatic KCNJ5 mutations (L168R and T158A)...
March 24, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28359725/dysfunctional-skin-derived-glucocorticoid-synthesis-is-a-pathogenic-mechanism-of-psoriasis
#19
R Hannen, C Udeh-Momoh, J Upton, M Wright, A Michael, A Gulati, S Rajpopat, N Clayton, D Halsall, J Burrin, R Flower, L Sevilla, V Latorre, J Frame, S Lightman, P Perez, M Philpott
Glucocorticoids (GC) are the primary steroids that regulate inflammation and have been exploited therapeutically in inflammatory skin diseases. Despite the broad-spectrum therapeutic use of GC the biochemical rationale for locally treating inflammatory skin conditions is poorly understood, as systemic GC production remains largely functional in these patients. GC synthesis has been well characterised in healthy skin but the pathological consequence has not been examined. Here we show de novo GC synthesis and GR expression is dysfunctional in both non-lesional and lesional psoriatic skin...
March 27, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28356749/adrenalectomy-does-not-improve-survival-rates-of-patients-with-solitary-adrenal-metastasis-from-non-small-cell-lung-cancer
#20
Shao-Hong Huang, Qing-Lei Kong, Xue-Xia Chen, Jin-Yuan He, Jie Qin, Zhuang-Gui Chen
BACKGROUND AND PURPOSE: Several case reports and studies have suggested that there is an increased survival rate for patients who undergo resection of solitary adrenal metastasis from non-small cell lung cancer (NSCLC). This study aimed to investigate whether NSCLC patients with solitary adrenal metastasis could gain a higher survival rate after adrenalectomy (ADX) when compared with those patients undergoing nonsurgical treatment, and to investigate the potential prognostic factors. PATIENTS AND METHODS: A total of 1,302 NSCLC inpatients' data from 2001 to 2015 were retrospectively reviewed to identify those with solitary adrenal metastasis...
2017: Therapeutics and Clinical Risk Management
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