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Surgical endocrinology

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https://www.readbyqxmd.com/read/28089805/surgical-outcomes-of-endoscopic-endonasal-skull-base-surgery-of-craniopharyngiomas-evaluated-according-to-the-degree-of-hypothalamic-extension
#1
Shigetoshi Yano, Takuichiro Hide, Naoki Shinojima
OBJECTIVE: Sparing the hypothalamus following craniopharyngiomas treatment is a prerequisite to ensure a good quality of life. In this study, the functional prognosis of craniopharyngioma following Endoscopic endonasal skull base surgery (EES) was examined in function of the degree of hypothalamic extension. MATERIALS AND METHODS: Twenty cases of craniopharyngioma treated by EES were categorized according to Puget's classification using preoperative and postoperative MRI...
January 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28078330/pheochromocytoma-in-urologic-practice
#2
Nikhil Waingankar, Gennady Bratslavsky, Camilo Jimenez, Paul Russo, Alexander Kutikov
CONTEXT: Pheochromocytoma is regularly encountered in urological practice and requires a thoughtful and careful clinical approach. OBJECTIVE: To review clinical aspects of management of pheochromocytoma in urologic practice. EVIDENCE ACQUISITION: A systematic review of English-language literature was performed through year 2015 using the Medline database. Manuscripts were selected with consensus of the coauthors and evaluated using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria...
February 2016: European Urology Focus
https://www.readbyqxmd.com/read/28071986/evaluation-of-a-two-year-routine-application-of-molecular-testing-of-thyroid-fine-needle-aspirations-fna-using-a-7-gene-panel-in-a-primary-referral-setting-in-germany
#3
Markus Eszlinger, Katharina Böhme, Maha Ullmann, Fabian Görke, Udo Siebolts, Anna Neumann, Christiane Franzius, Sabine Adam, Thomas Molwitz, Christian Landvogt, Bassam Amro, Anja Hach, Berit Feldmann, Dieter Graf, Antje Wefer, Rainer Niemann, Catharina Bullmann, Günther Klaushenke, Reinhard Santen, Gregor Tönshoff, Velimir Ivancevic, Andreas Kögler, Eberhard Bell, Bernd Lorenz, Gerald Kluge, Christoph Hartenstein, Ilka Ruschenburg, Ralf Paschke
BACKGROUND: Major differences with respect to the diagnostic performance of a "ruling in" approach in the pre-surgical diagnosis of indeterminate thyroid fine needle aspirations (FNAs) have been reported. Therefore, the aim of this prospective multicenter study was to investigate the specific diagnostic impact of mutation testing using a 7-gene-panel in a routine primary referral setting analyzing FNAs from endocrinology and nuclear medicine practices in Germany. METHODS: RNA and DNA was extracted from 564 routine air-dried FNA smears obtained from 64 physicians and cytologically graded by one experienced cytopathologist...
January 10, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28034815/transsphenoidal-posterior-pituitary-lobe-biopsy-in-patients-with-neurohypophysial-lesions
#4
Yasuyuki Kinoshita, Fumiyuki Yamasaki, Atsushi Tominaga, Satoshi Usui, Kazunori Arita, Tetsuhiko Sakoguchi, Kazuhiko Sugiyama, Kaoru Kurisu
OBJECTIVE: The differential diagnosis of neurohypophysial lesions is difficult and surgical biopsies are indispensable in the histological diagnosis of some patients. Although pituitary stalk biopsies are uniformly performed, there is a considerable risk that they will result in impaired hormonal secretion. We attempt to clarify the usefulness and safety of posterior pituitary lobe biopsy by transsphenoidal surgery (TSS). METHODS: The cases of 11 consecutive patients who underwent posterior pituitary lobe biopsies by TSS were retrospectively studied...
December 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27988033/magnetic-resonance-imaging-and-histology-correlation-in-cushing-s-disease
#5
Václav Masopust, David Netuka, Vladimír Beneš, Martin Májovský, Tomáš Belšán, Ondřej Bradáč, Daniel Hořínek, Mikuláš Kosák, Václav Hána, Michal Kršek
INTRODUCTION: We continuously look for new techniques to improve the radicality of resection and to eliminate the negative effects of surgery. One of the methods that has been implemented in the perioperative management of Cushing's disease was the combination of three magnetic resonance imaging (MRI) sequences: SE, SPGR and fSPGR. MATERIAL AND METHODS: We enrolled 41 patients (11 males, 30 females) diagnosed with Cushing's disease. A 3D tumour model with a navigation console was developed using each SPGR, fSPGR and SE sequence...
November 2, 2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27936532/endocrinology-update-hypopituitarism
#6
Joel J Heidelbaugh
Hypopituitarism is defined as a deficiency of one or more pituitary hormones due to a decline in function of the pituitary gland and/or hypothalamus, which can result in higher risks of morbidity and mortality and decreased quality of life. Although hypopituitarism is a rare condition, it commonly develops after traumatic brain injury and in the setting of functioning and nonfunctioning pituitary adenomas. The diagnosis is based on detailed investigation of symptoms of target endocrine gland function relative to the corresponding pituitary hormone deficiency...
December 2016: FP Essentials
https://www.readbyqxmd.com/read/27936531/endocrinology-update-hirsutism
#7
Joel J Heidelbaugh
Hirsutism is defined as excessive terminal hair growth, such as coarse sexual or secondary hair, that typically appears in a male growth pattern in androgen-dependent areas of the female body. It can occur in men and women. Common etiologies include polycystic ovary syndrome, idiopathic hyperandrogenemia, idiopathic hirsutism, adrenal hyperplasia due to 21-hydroxylase deficiency, androgen-secreting tumors, iatrogenic hirsutism, acromegaly, Cushing syndrome, hyperprolactinemia, and hypo- or hyperthyroidism. Diagnostic guidelines are predominantly aimed at premenopausal women but an appropriate evaluation for underlying endocrinopathies in postmenopausal women and men may be required...
December 2016: FP Essentials
https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#8
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27908811/decreased-serum-levels-of-high-mobility-group-box-1-hmgb-1-after-graft-replacement-or-stenting-of-abdominal-aortic-aneurysm
#9
Daiki Ousaka, Yasuhiro Fujii, Susumu Oozawa, Masahiro Nishibori, Yosuke Kuroko, Zenichi Masuda, Shunji Sano
OBJECTIVES: High-mobility group box 1 (HMGB-1) is a key substance mediating inflammation and development of atherosclerotic lesions (AL), including abdominal aortic aneurysms (AAA). Serum levels of HMGB-1 are increased in patients with AAA than in normal controls because the ALs in AAAs secrete HMGB-1. We therefore postulate that the serum HMGB-1 level should decrease after endovascular aortic repair (EVAR) or open aortic repair (OAR). However, there is no evidence of this in the literature...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903128/postoperative-outcome-of-body-core-temperature-rhythm-and-sleep-wake-cycle-in-third-ventricle-craniopharyngiomas
#10
Matteo Zoli, Luisa Sambati, Laura Milanese, Matteo Foschi, Marco Faustini-Fustini, Gianluca Marucci, Dario de Biase, Giovanni Tallini, Annagrazia Cecere, Francesco Mignani, Carmelo Sturiale, Giorgio Frank, Ernesto Pasquini, Pietro Cortelli, Diego Mazzatenta, Federica Provini
OBJECTIVE One of the more serious risks in the treatment of third ventricle craniopharyngiomas is represented by hypothalamic damage. Recently, many papers have reported the expansion of the indications for the endoscopic endonasal approach (EEA) to be used for these tumors as well. The aim of this study was to assess the outcome of sleep-wake cycle and body core temperature (BCT), both depending on hypothalamic control, in patients affected by craniopharyngiomas involving the third ventricle that were surgically treated via an EEA...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27903115/aggressive-surgery-based-on-an-anatomical-subclassification-of-craniopharyngiomas
#11
Hiroki Morisako, Takeo Goto, Hiroyuki Goto, Christian Aisse Bohoun, Samantha Tamrakar, Kenji Ohata
OBJECTIVE Craniopharyngiomas remain a particularly formidable challenge in the neurosurgical field. Because these lesions involve the hypothalamus and ophthalmological systems, their resection is associated with either higher rates of mortality and recurrence or a lower rate of radical resection. The authors report the outcomes of aggressive surgeries based on an anatomical subclassification of craniopharyngiomas. METHODS Clinical and ophthalmological examinations, imaging studies, endocrinological studies, neuropsychological function, and surgical complications in all patients who had undergone microsurgical resection for craniopharyngioma at Osaka City University hospital between January 2000 and December 2014 were retrospectively reviewed through the medical records...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27900213/adrenal-masses-a-urological-perspective
#12
REVIEW
Amr F Fergany
Adrenal masses have become increasingly common due to widespread use of sectional imaging. Urologists are commonly faced with management decisions in patients with adrenal masses. Systemic review of available literature related to surgical adrenal disease was performed to summarise the most pertinent information related to adrenal masses, diagnostic evaluation and surgical treatment. Detailed hormonal evaluation of adrenal disease was not included, being part of endocrinological rather than urological practice...
December 2016: Arab Journal of Urology
https://www.readbyqxmd.com/read/27899081/endoscopic-endonasal-pituitary-adenomas-surgery-the-surgical-experience-of-178-consecutive-patients-and-learning-curve-of-two-neurosurgeons
#13
Xuefei Shou, Ming Shen, Qilin Zhang, Yichao Zhang, Wenqiang He, Zengyi Ma, Yao Zhao, Shiqi Li, Yongfei Wang
BACKGROUND: We aim to study surgical technique and analyze the related factors affecting tumor total removal and postoperative endocrinological remission for endoscopic endonasal pituitary adenomas surgery. METHODS: We retrospectively analyzed 178 endoscopic endonasal pituitary adenomas surgery from March 2011 to May 2014. Endonasal approach included the routine transnasal-sphenoidal approach, transnasal- maxillary sinus approach in four cases and transnasal-clivus approach in one case...
November 30, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27888088/endoscopic-endonasal-management-of-rare-sellar-lesions-clinical-and-surgical-experience-on-78-cases-and-review-of-the-literature
#14
Teresa Somma, Domenico Solari, Andre Beer-Furlan, Lelio Guida, Bradley Otto, Daniel Prevedello, Luigi Maria Cavallo, Ricardo Carrau, Paolo Cappabianca
OBJECTIVE: In the present study we aim to provide further definition of a group of rare sellar pathologies treated by the endoscopic endonasal approach. MATHERIAL AND METHODS: A retrospective analysis of data obtained from a series of 1729 patients who underwent endoscopic endonasal surgery at two academic institutions (Università degli Studi di Napoli Federico II, Naples, Italy - between January 1997 and December 2013, and The Wexner Medical Center at The Ohio State University - between July 2010 and September 2015)...
November 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27882768/-adrenocortical-oncocytoma-presenting-as-cushing%C3%A2-s-syndrome-in-pregnancy-with-spontaneous-postpartum-uterine-rupture
#15
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/27822133/ten-steps-to-plan-design-and-implement-an-endocrinology-and-endocrine-surgery-module-for-the-faculty-of-medicine-al-baha-university
#16
Walyeldin Em Elfakey, Ahmed H Al-Ghamdi
INTRODUCTION: The Faculty of Medicine, Al-Baha University (FMBU), is a newly established medical school that implements a community-oriented and integrated system-based curriculum which is suitable for both medical students and serving the needs of the local community. OBJECTIVE: The aim of this study is to describe the steps that were followed to plan, design, and implement an endocrinology and endocrine surgery module (EESM) for the fourth-year medical students, as an example of how system-based modules are designed at FMBU...
2016: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/27807735/-treatment-of-fibromyalgia-syndrome-with-gamma-hydroxybutyrate-a%C3%A2-randomized-controlled-study
#17
E Reuter, S Tafelski, K Thieme, C West, U Haase, L Beck, M Schäfer, C Spies
BACKGROUND: The etiology of fibromyalgia syndrome is not yet fully understood. Current hypotheses suggest a potential role of gamma-hydroxybutyrate (GHB) in influencing endocrinological abnormalities in patients with fibromyalgia. OBJECTIVE: The aim of the study was to investigate whether low dose GHB as a growth-hormone releasing substance reduces pain intensity and improves depressive mood, physical impairment and sleep quality in outpatients with fibromyalgia...
November 2, 2016: Der Schmerz
https://www.readbyqxmd.com/read/27768542/why-thyroid-surgeons-are-frustrated-with-radiologists-lessons-learned-from-pre-and-postoperative-us
#18
Sachin S Kumbhar, Ryan B O'Malley, Tracy J Robinson, Suresh Maximin, Neeraj Lalwani, David R Byrd, Carolyn L Wang
Optimal treatment of thyroid cancer is highly dependent on accurate staging of the extent of disease at presentation. Preoperative ultrasonography (US) is the most sensitive method for detecting metastatic lymph nodes and is recommended as part of the standard preoperative workup. Missed findings on preoperative scans may lead to understaging and inadequate surgical management, which subsequently predispose these patients to residual disease postoperatively and a higher risk for recurrence, possibly requiring repeat surgery...
October 21, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27753873/ish-aha-2-a-case-of-chronic-indolent-pheochromocytoma-which-caused-medically-controlled-hypertension-but-treatment-resistant-diabetes-mellitus
#19
Hae-Young Lee, Chan-Soon Park, Sang-Hoon Na, Kyung-Jin Kim, Chan Joo Lee, Sungha Park
A 47-year-old woman was admitted via emergency department due to dyspnea NYHA Fc II-III aggravated for 2 months after upper respiratory infection. Her height and body weight were 161 cm / 67 kg. Initial vital signs were 110/70 mmHg - 112 BPM - 24/min - 36.5°C. Chest PA showed cardiomegaly and pulmonary congestion (Figure 1). B-natriuretic peptide level was markedly increased (2002 pg/mL, normal range ≤ 100 pg/mL). The echocardiographic examination showed severely dilated LV cavity (61/72 mm) and severe LV systolic dysfunction (EF 28%) with normal left ventricular wall thickness (9/11 mm) (Figure 2)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753549/military-considerations-in-transsexual-care-of-the-active-duty-member
#20
Irene Folaron, Monica Lovasz
Retention standards and policies applied to active duty members in the U.S. military who identify as transgender have recently been in evolution. The Secretary of Defense recently released a new directive allowing transgender members to serve openly with the option to transition gender while in active duty, abrogating the old policy disqualifying transgender members from continued service. There is a reasonable expectation that some may pursue medical and surgical options toward gender transition. The clinical pathway for gender transition relies heavily on Mental Health and Endocrinology services...
October 2016: Military Medicine
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