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https://www.readbyqxmd.com/read/28534681/referral-of-older-thyroid-cancer-patients-to-a-high-volume-surgeon-results-of-a-multidisciplinary-physician-survey
#1
Maria Papaleontiou, Paul G Gauger, Megan R Haymart
OBJECTIVE: Surgical outcomes of thyroid cancer patients are improved with high-volume surgeons. However, age disparities in referral to specialist surgical centers still exist. The factors that influence decision-making regarding referral of older thyroid cancer patients to high-volume surgeons remain unknown. METHODS: We surveyed members of the Endocrine Society, American College of Physicians and American Academy of Family Practice. RESULTS: Overall, 270 physicians completed the survey...
May 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28528327/three-quarters-adrenalectomy-for-infantile-onset-cushing-syndrome-due-to-bilateral-adrenal-hyperplasia-in-mccune-albright-syndrome
#2
Tomoyo Itonaga, Hironori Goto, Manabu Toujigamori, Yasuharu Ohno, Seigo Korematsu, Tatsuro Izumi, Satoshi Narumi, Tomonobu Hasegawa, Kenji Ihara
BACKGROUND: Bilateral adrenalectomy is performed in cases with infantile-onset Cushing syndrome due to bilateral adrenal hyperplasia in McCune-Albright syndrome (MAS) because severe Cushing syndrome with heart failure and liver dysfunction can have a lethal outcome. This procedure can completely ameliorate hypercortisolism, although lifetime steroid replacement therapy and steps to prevent adrenal crisis are necessary. Recently, the efficacy of unilateral adrenalectomy has been reported in adult cases of bilateral macronodular adrenal hyperplasia, but there is no consensus regarding the appropriate surgical treatment for bilateral adrenal hyperplasia in MAS...
May 19, 2017: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/28512043/endoscopic-assisted-supraorbital-keyhole-approach-or-endoscopic-endonasal-approach-in-case-of-tuberculum-sellae-meningioma-which-surgical-route-should-be-favoured
#3
Stefan Linsler, Gerrit Fischer, Volodymyr Skliarenko, Axel Stadie, Joachim Oertel
OBJECTIVE: Keyhole approaches are currently under investigation for skull base tumor surgery. They are expected to have a low complication rate with the same successful resection rate compared to endoscopic endonasal procedures. In this study, the authors compare their current series of tuberculum sellae meningiomas resected via an endoscopic endonasal or microsurgical supraorbital keyhole approach. METHODS: Between 2011 and 2016, 16 patients were treated using the supraorbital keyhole procedure and 6 patients received an endoscopic endonasal procedure...
May 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28511971/learning-curve-for-the-endoscopic-endonasal-approach-for-suprasellar-craniopharyngiomas
#4
Hailin Ding, Ye Gu, Xiaobiao Zhang, Tao Xie, Tengfei Liu, Fan Hu, Yong Yu, Chongjing Sun
The endoscopic endonasal approach is considered an alternative minimally invasive approach for suprasellar craniopharyngiomas. However, the complicated surgical manipulations required by this approach have limited its application. We evaluate whether the approach features a learning curve. Thirty-three patients were retrospectively reviewed and grouped as early (17 patients) and late (16 patient) groups. The operation time, extent of removal, ophthalmology, endocrinology, reconstruction and modifications of standard technique were evaluated...
May 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28490153/prevention-of-complications-in-endoscopic-third-ventriculostomy
#5
REVIEW
Tae-Young Jung, Sangjoon Chong, In-Young Kim, Ji Yeoun Lee, Ji Hoon Phi, Seung-Ki Kim, Jae-Hyoo Kim, Kyu-Chang Wang
A variety of complications in endoscopic third ventriculostomy have been reported, including neurovascular injury, hemodynamic alterations, endocrinologic abnormalities, electrolyte imbalances, cerebrospinal fluid leakage, fever and infection. Even though most complications are transient, the overall rate of permanent morbidity is 2.38% and the overall mortality rate is 0.28%. To avoid these serious complications, we should keep in mind potential complications and how to prevent them. Proper decisions with regard to surgical indication, choice of endoscopic entry and trajectory, careful endoscopic procedures with anatomic orientation, bleeding control and tight closure are emphasized for the prevention of complications...
May 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28458908/endoscopic-ultrasound-guided-ethanol-ablation-therapy-for-pancreatic-insulinoma-an-unusual-strategy
#6
Adriana de Sousa Lages, Isabel Paiva, Patrícia Oliveira, Francisco Portela, Francisco Carrilho
SUMMARY: Insulinomas are the most frequent cause of hyperinsulinaemic hypoglycaemia. Although surgical enucleation is the standard treatment, a few other options are available to high-risk patients who are elderly or present with co-morbidities. We present a case report of an 89-year-old female patient who was admitted to the emergency department due to recurrent hypoglycaemia, especially during fasting. Laboratory work-up raised the suspicion of hyperinsulinaemic hypoglycaemia, and abdominal CT scan revealed a 12 mm nodular hypervascular lesion of the pancreatic body suggestive of neuroendocrine tumour...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28458889/an-unusual-case-of-adult-onset-multi-systemic-langerhans-cell-histiocytosis-with-perianal-and-incident-thyroid-involvement
#7
Ozen Oz Gul, Pinar Sisman, Soner Cander, Erdem Gozden, Meral Kurt, Ozlem Saraydaroglu, Turkay Kirdak, Canan Ersoy, Erdinc Erturk
SUMMARY: Langerhans cell histiocytosis (LCH) is a rare sporadic disease characterized by histiocytic neoplastic infiltration of various organ systems and a wide spectrum of clinical manifestations, ranging from benign and self-limiting to lethal. Herein, we report a rare case of adult-onset multi-systemic LCH in a 36-year-old male patient with an initial perianal presentation and incidental finding of subsequent thyroid gland involvement in the follow-up period. The patient with a history of perianal LCH treated with surgical excision and local radiotherapy was referred to our Endocrinology Department upon detection of hypermetabolic nodular lesions in the left lateral lobe of thyroid gland on positron emission tomography-computed tomography (PET/CT) scan in the nineth month of follow-up...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28433845/clinical-outcome-after-extended-endoscopic-endonasal-resection-of-craniopharyngiomas-two-institution-experience
#8
Hye Ran Park, Varun R Kshettry, Christopher J Farrell, Jae Meen Lee, Yong Hwy Kim, Tae Bin Won, Doo Hee Han, Hyunwoo Do, Gurston Nyguist, Marc Rosen, Dong Gyu Kim, James J Evans, Sun Ha Paek
BACKGROUND: The extended endoscopic endonasal approach (EEA) to the anterior cranial base is used for the resection of craniopharyngiomas. OBJECTIVE: We present clinical experience and outcomes utilizing EEA for craniopharyngiomas. METHODS: A total of 116 patients in two remote institutions were enrolled in this retrospective study. Surgical, endocrinological and ophthalmological outcomes were assessed. RESULTS: The mean follow-up was 35 months (range, 1-115)...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28432675/transoral-thyroidectomy-advantages-and-limitations
#9
G Dionigi, R P Tufano, J Russell, H Y Kim, E Piantanida, A Anuwong
In this opinion paper of the Journal of Endocrinological Investigation, leading experts in the field report on their current clinical experience with a novel approach for thyroid gland surgery, namely, "transoral thyroidectomy" (TOT). This feasible and novel surgical procedure does not require visible incisions and is, therefore, a truly scarless surgery. Patients meeting the following criteria can be considered as candidates for TOT: (a) an ultrasonographically (US) estimated thyroid diameter ≤10 cm; (b) US-estimated gland volume ≤45 mL; (c) nodule size ≤50 mm; (d) presence of a benign tumor such as a thyroid cyst or a single- or multi-nodular goiter; (e) Bethesda 3 and/or 4 category and (f) papillary microcarcinoma without the evidence of metastasis...
April 21, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28409727/clival-chordomas-considerations-after-16-years-of-endoscopic-endonasal-surgery
#10
Matteo Zoli, Laura Milanese, Rocco Bonfatti, Marco Faustini-Fustini, Gianluca Marucci, Giovanni Tallini, Corrado Zenesini, Carmelo Sturiale, Giorgio Frank, Ernesto Pasquini, Diego Mazzatenta
OBJECTIVE In the past decade, the role of the endoscopic endonasal approach (EEA) has relevantly evolved for skull base tumors. In this study, the authors review their surgical experience with using an EEA in the treatment of clival chordomas, which are deep and infiltrative skull base lesions, and they highlight the advantages and limitations of this ventral approach. METHODS All consecutive cases of chordoma treated with an EEA between 1998 and 2015 at a single institution are included in this study. Preoperative assessment consisted of neuroimaging (MRI and CT with angiography sequences) and endocrinological, neurological, and ophthalmological evaluations, which were repeated 3 months after surgery and annually thereafter...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28387647/management-of-childhood-thyroid-nodules-surgical-and-endocrinological-experience-in-more-than-one-hundred-cases
#11
Emre Divarcı, Ülgen Celtik, Zafer Dökümcü, Orkan Ergün, Geylani Özok, Samim Özen, Damla Gökşen Şimşek, Şükran Darcan, Nazan Çetingül, Aylin Oral, Yeşim Ertan, Bengü Demirağ, Ahmet Çelik
OBJECTIVE: The management of childhood thyroid nodules is still a big challenge for clinicians. In this study, we aimed to present our surgical and endocrinological experience in more than one hundred cases as a large experience in children. METHODS: Retrospective analysis of patients admitted with a thyroid nodule between 2006-2014 was performed. Detailed ultrasonography and fine needle aspiration biopsy(FNAB) were the corner stones of the diagnostic approach. RESULTS: One hundred-three children(72F,31M) with a mean age of 13...
April 7, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28377092/interdisciplinary-medication-decision-making-by-pharmacists-in-pediatric-hospital-settings-an-ethnographic-study
#12
Ellie Rosenfeld, Sharon Kinney, Carlye Weiner, Fiona Newall, Allison Williams, Noel Cranswick, Ian Wong, Narelle Borrott, Elizabeth Manias
OBJECTIVE: Children are particularly vulnerable to experiencing medication incidents in hospitals. Making sound medication decisions is therefore of paramount importance. Prior research has principally described pharmacists' role in reducing medication errors. There is a dearth of information about pharmacists' interactions with pediatric hospital staff across disciplines in resolving medication issues. The aim of this study was to examine interdisciplinary medication decision making by pharmacists in pediatric hospital settings...
March 22, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28346969/the-comparison-of-laparoscopic-and-microsurgical-varicocoelectomy-in-infertile-men-with-varicocoele-on-paternity-rate-12%C3%A2-months-after-surgery-a-prospective-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
P Bryniarski, P Taborowski, P Rajwa, Z Kaletka, M Życzkowski, A Paradysz
The best surgical approach for varicocoelectomy is still unknown, however more and more physicians favour subinguinal microsurgery. The aim of this study was to find whether microsurgical approach is superior to laparoscopic varicocoelectomy in terms of pregnancy rate, fertility potential, endocrinological function of the testis, erectile dysfunction and testicle volume increase. It was a prospective, non-masked, parallel-group randomized controlled trial with one to one allocation. It was conducted at authors' institution and designed as per protocol study...
May 2017: Andrology
https://www.readbyqxmd.com/read/28341364/decreased-access-to-bariatric-care-an-analysis-of-referral-practices-to-bariatric-specialists
#14
John A Primomo, Tanyaradzwa Kajese, Garth Davis, Robert Davis, Shinil Shah, Maddie Orsak, Christina Morrison
BACKGROUND: Substantial evidence reveals tolerability and co-morbid disease resolution after bariatric surgery; however, few physicians refer morbidly obese patients for bariatric consultation. OBJECTIVE: To evaluate morbidly obese patient access to bariatric surgical consultation. SETTING: A multidisciplinary, private, bariatric center of excellence. METHODS: Patient surveyed in person regarding preconsultation co-morbidities, physician discussion and support for bariatric surgery, and physician referral practices...
November 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28321374/ectopic-pituitary-adenomas-presenting-as-sphenoid-or-clival-lesions-case-series-and-management-recommendations
#15
Bobby A Tajudeen, Edward C Kuan, Nithin D Adappa, Joseph K Han, Rakesh K Chandra, James N Palmer, David W Kennedy, Marilene B Wang, Jeffrey D Suh
Background An ectopic pituitary adenoma presenting as a clival or sphenoid mass is a rare clinical occurrence that may mislead the clinician and result in unnecessary interventions or potential medicolegal consequences. Here, we present one of the largest multi-institutional case series and review the literature with an emphasis on radiological findings and critical preoperative workup. Methods Retrospective chart review. Results Nine patients were identified with ectopic pituitary adenomas of the sphenoid or clivus...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28291214/-modern-diagnosis-and-postoperative-monitoring-of-acromegaly-patients-at-a-neurosurgical-clinic
#16
L I Astaf'eva, P L Kalinin, B A Kadashev
Acromegaly is a severe disease associated with chronic overproduction of the growth hormone (GH) and insulin-like growth factor-1 (IGF-1), which is caused in most cases by pituitary adenoma. The main causes of mortality in acromegaly are cardiovascular diseases, respiratory diseases, and cancers. At present, the most effective treatment for acromegaly is surgical pituitary adenomectomy. Complete resection of pituitary tumors leads to the normalization of GH and IGF-1 levels, regression of symptoms, and a reduction in the risk of death...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28286277/extent-of-resection-visual-and-endocrinological-outcomes-for-endoscopic-endonasal-surgery-for-recurrent-pituitary-adenomas
#17
Hyunwoo Do, Varun R Kshettry, Alan Siu, Irina Belinsky, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
OBJECTIVE: To assess outcomes after endoscopic endonasal surgery for recurrent or residual pituitary adenomas. METHODS: We retrospectively analyzed 61 patients from 2009 - 2016 that underwent endoscopic endonasal surgery for recurrent or residual pituitary adenomas after prior microscopic or endoscopic transphenoidal operation. RESULTS: Prior surgical approach was endoscopic endonasal in 55.7% and microscopic in 44.2%. The mean preoperative maximal tumor diameter was 2...
March 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28281942/pituitary-hyperplasia-in-a-female-patient-with-a-severe-childhood-abuse-history
#18
Andrea Fragoso Perozo, Tiago Figueiredo, Michelle Botelho Caarls, Daniel Segenreich, Leonardo Vieira Neto
A 24-year-old Caucasian female patient was referred to our endocrinology service to investigate a structural magnetic resonance imaging (sMRI) finding of "pituitary mass". The first two sMRI were identified as pituitary adenoma but the following two exams suggested the possibility of pituitary hyperplasia (PH). The patient was referred to our service for diagnostic clarification and therapy due to the divergence in sMRI reports and the surgical procedure indicated by the neurosurgical team of the other institution...
March 10, 2017: Journal of Trauma & Dissociation
https://www.readbyqxmd.com/read/28272259/rathke-cleft-cyst-masquerading-as-pituitary-abscess-a-case-report
#19
Chengxian Yang, Xinjie Bao, Xiaohai Liu, Kan Deng, Ming Feng, Yong Yao, Renzhi Wang
BACKGROUND: Rathke cleft cyst (RCC) is a rare cystic sellar entity, which is usually small in size and asymptomatic in most patients. RCC presenting panhypopituitarism and a cystic lesion with rim enhancement on magnetic resonance imaging is extremely rare. Therefore, it is easy to be misdiagnosed as pituitary abscess because of the similar clinical manifestations and neuroimaging changes. CASE SUMMARY: We report a rare case of RCC masquerading as pituitary abscess clinically and radiologically with no evidence of central nervous system infection...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28272006/solitary-metastasis-of-clear-renal-cell-carcinoma-to-thyroid-gland-three-reported-cases-with-review-of-the-literature
#20
Jaromir Astl, Abdulrahman Ali Bahannan, Jaroslava Dušková, Z Novák, P Vlcek, Jan Betka
Metastasis to the head and neck and more specifically to the thyroid gland from distant primary tumors is less common in comparison to the local regional metastasis of squamous cell carcinomas of the upper aero-digestive tract. Preoperative diagnosis of these cases can be difficult. The authors present three cases with distant solitary metastases of clear renal cell carcinoma to the thyroid gland with ambiguous mechanism of tumor spread to the thyroid. Solitary metastases of clear renal cell carcinomas are an uncommon variant of metastasis of this tumor and may imitate thyroid well differentiated carcinoma which most commonly affects the thyroid gland...
January 2017: Gulf Journal of Oncology
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