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Surgical endocrinology

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
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
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
Joseph Scharpf, Michael Tuttle, Richard Wong, Drew Ridge, Russell Smith, Dana Hartl, Robert Levine, Gregory Randolph
This American Head and Neck Society (AHNS) consensus statement focuses on the detection and management of recurrent thyroid cancer. This document describes the radiologic approach to defining structural recurrent disease and the operative and nonoperative rationale in addressing identified structural disease to create equipoise in the personalized treatment strategy for the patient. The recommendations of this AHNS multidisciplinary consensus panel of the American Head and Neck Society are intended to help guide all multidisciplinary clinicians who diagnose or manage adult patients with thyroid cancer...
September 22, 2016: Head & Neck
Stefano M Priola, Felice Esposito, Salvatore Cannavò, Alfredo Conti, Rosaria V Abbritti, Valeria Barresi, Sergio Baldari, Francesco Ferraù, Antonino Germanò, Francesco Tomasello, Filippo F Angileri
BACKGROUND: Although pituitary adenomas are considered benign lesions, a small group may exhibit a clinically aggressive behavior, sometimes independently from the classic markers of aggressiveness, including the Ki67 labeling index and/or p53 expression. METHODS: We selected 7 subjects harboring a pituitary tumor with clinical features of aggressiveness. Patients underwent a full preoperative and postoperative endocrinological and neuroradiological work-up. Two were non-functioning, two PRL-secreting, two ACTH-secreting, and one a GH-secreting adenoma...
October 3, 2016: World Neurosurgery
J Capdevila, J C Galofré, E Grande, C Zafón Llopis, T Ramón Y Cajal Asensio, E Navarro González, P Jiménez-Fonseca, J Santamaría Sandi, J M Gómez Sáez, G Riesco Eizaguirre
Thyroid cancer is the single most prevalent endocrine malignancy; differentiated thyroid cancer (DTC) accounts for more than 90 % of all malignancies and its incidence has been rising steadily. For more patients, surgical treatment, radioactive iodine (RAI) ablation, and thyroid-stimulating hormone (TSH) suppressive therapy achieve an overall survival (OS) rate of 97.7 % at 5 years. Nevertheless, locoregional recurrence occurs in up to 20 % and distant metastases in approximately 10 % at 10 years. Two-thirds of these patients will never be cured with radioactive iodine therapy and will become RAI-refractory, with a 3-year OS rate of less than 50 %...
October 4, 2016: Clinical & Translational Oncology
B C J Majoor, N M Appelman-Dijkstra, M A J van de Sande, H M Kroon, N A T Hamdy, P D S Dijkstra
Fibrous dysplasia is a rare genetic bone disorder with a wide variation in clinical expression, ranging from asymptomatic patients to severely affected patients with extensive bone disease, pain, repetitive fractures and deformities and serious endocrinological symptoms (McCune-Albright syndrome). Here, we report on three different cases of fibrous dysplasia. First, a 46-year-old woman with a small solitary lesion in the proximal femur. Second, a 25-year-old man with polyostotic disease of the left leg who received both surgical and medical treatment...
2016: Nederlands Tijdschrift Voor Geneeskunde
Ji Hwan Jang, Kyu Hong Kim, Young Min Lee, Joon Soo Kim, Young Zoon Kim
BACKGROUND: The aim of this study is to report the results of pure endoscopic endonasal transsphenoidal surgeries (EETSS) for pituitary adenomas (PAs) and to evaluate the efficacy and safety of this procedure. Additionally, we tried to determine the predicting factors for progression of PAs. METHODS: We reviewed the medical records of 331 consecutive patients who underwent pure EETSS of newly diagnosed PAs between April 1998 and December 2014. Demographic, endocrinological, and radiological features and their outcomes, complications, and hospital stay durations were retrospectively assessed in these patients...
September 20, 2016: World Neurosurgery
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
Fatma Chaker, Melika Chihaoui, Meriem Yazidi, Hedia Slimane
The occurrence of polyuria-polydipsia syndrome with hypotonic urine requires careful diagnostic strategy. This study aims to evaluate diagnostic modalities for central diabetes insipidus. We conducted a retrospective study of 41 cases with central diabetes insipidus (CDI). Data were collected at the Department of Endocrinology, University Hospital La Rabta, Tunis, from 1990 to 2013. We identified the circumstances for detecting CDI, the abnormalities in anterior pituitary assessment and pituitary imaging. CDI occurred in the postoperative period in 20 patients...
2016: Pan African Medical Journal
Mateo Ziu, Ian F Dunn, Christopher Hess, Maria Fleseriu, Mary E Bodach, Luis M Tumialan, Nelson M Oyesiku, Kunal S Patel, Renzhi Wang, Bob S Carter, James Y Chen, Clark C Chen, Chirag G Patil, Zachary Litvack, Gabriel Zada, Manish K Aghi
BACKGROUND: Nonfunctioning pituitary adenomas (NFPAs) are the most frequent pituitary tumors. Due to the lack of hormonal hypersecretion, posttreatment follow-up evaluation of NFPAs is challenging. OBJECTIVE: To create evidence-based guidelines in an attempt to formulate guidance for posttreatment follow-up in a consistent, rigorous, and cost-effective way. METHODS: An extensive literature search was performed. Only clinical articles describing postoperative follow-up of adult patients with NFPAs were included...
October 2016: Neurosurgery
Vaclav Masopust, David Netuka, Daniel Horinek, Mikulas Kosak, Vaclav Hana, Michal Krsek
INTRODUCTION: To increase radicality and avoid surgical complications new treatment options are under investigation. One of the promising possibilities is to assess early morning cortisol levels on the first and second postoperative day. MATERIAL AND METHODS: We enrolled 34 patients (9 males, 25 females) diagnosed with Cushing's disease. Blood samples to determine cortisol level were taken always at 06:00 and sent to the lab. The samples were taken on the first and second postoperative day...
July 16, 2016: Neuro Endocrinology Letters
Temitope A Ajadi, Oladele S Gazal
Welfare concerns are growing regarding surgical castration (SC) in pets, necessitating the need for non-surgical alternatives. Administration of vaccines against gonadotropins releasing hormone (GnRH) have been reported as alternative to SC. This study determined the effect of surgical and immunological castrations (IC) on complete blood counts, plasma testosterone (T), luteinizing hormone (LH) concentrations and ejaculate characteristics in mongrel dogs. Ten intact male dogs were randomly divided into two groups (A & B)...
2016: Nigerian Journal of Physiological Sciences: Official Publication of the Physiological Society of Nigeria
Mihaela Vlad, Ioana Zosin, Bogdan Timar, Fulger Lazar, Adrian Vlad, Romulus Timar, Marioara Cornianu
Medullary thyroid carcinoma (MTC) is a rare form of malignancy, having an intermediate prognosis. Controversies exist regarding the best surgical approach. The aim of the study was to analyze the outcome in a group of patients with MTC, diagnosed and followed up in a single care center. We performed a retrospective analysis of all the patients diagnosed with MTC in the Department of Endocrinology from the County Emergency Hospital Timisoara between 1992 and 2012. The study group included 19 patients, 6 men (31...
August 2016: Indian Journal of Surgery
Ioannis Petrakakis, Ariyan Pirayesh, Joachim K Krauss, Peter Raab, Christian Hartmann, Makoto Nakamura
OBJECTIVE: Apart from the "common" lesions (e.g. pituitary adenomas, Rathke's cleft cysts, meningiomas and craniopharyngiomas), there is a plethora of rare tumors or tumor-mimicking lesions in the sellar and suprasellar region (SSR). Due to a lack of characteristic imaging features, there is a dilemma in distinguishing these rare lesions from the more "common" ones preoperatively. Consequently, both diagnosis and definition of surgical goals, as well as further treatment strategies continue to be challenging for all attending physicians...
October 2016: Clinical Neurology and Neurosurgery
Kosuke Mukai, Tetsuhiro Kitamura, Daisuke Tamada, Masahiko Murata, Michio Otsuki, Iichiro Shimomura
Non-functioning pituitary adenoma (NFPA) is often associated with hypopituitarism. Diagnosis of hypopituitarism is important because of its poor prognosis and low quality of life. Among hypopituitarism, it is difficult to diagnose secondary adrenocortical insufficiency and GH deficiency without hormone stimulation test. Therefore, the aim of our study was to identify patients with NFPA who require more careful endocrinological examination. We examined the relationship between NFPA size and the prevalence of each hypopituitarism or the response of each anterior pituitary hormone by insulin tolerance test, LHRH test and TRH test...
August 18, 2016: Endocrine Journal
Desanka Grković, Sava Barisić
INTRODUCTION: Craniopharyngiomas are rare tumors which are typically focused in the sellar and suprasellar region. Secondary to mass effect, these tumors commonly mediate neurologic, endocrinologic or visual functions. The purpose of this study was to investigate the pre and postoperative visual acuity in patients with a craniopharyngioma in the area of the optic chiasm. MATERIAL AND METHODS: This retrospective study included 42 patients with a craniopharyngioma demonstrated by computerized tomography or magnetic resonance imaging...
March 2016: Medicinski Pregled
Yoshikazu Ogawa, Kuniyasu Niizuma, Shunji Mugikura, Teiji Tominaga
BACKGROUND: Several retrospective investigations have recommended more passive surgical indications for intratumoral hemorrhage of pituitary adenomas due to probable spontaneous resolution. However, no definitive analyses have compared pituitary adenomas with hemorrhagic apoplexy and intratumoral hemorrhage without evident apoplectic symptoms or pituitary adenoma infarction. METHODS: This study retrospectively identified 43 patients with symptomatic pituitary apoplexy among 1067 patients with pituitary adenomas initially treated by surgery at a single institute between April 2005 and May 2015, with 27 cases of hemorrhagic (2...
September 2016: Clinical Neurology and Neurosurgery
Ercan Bal, Kamil Öge, Mustafa Berker
OBJECTIVE: Craniopharyngioma resection is one of the most challenging surgical procedures. Herein, we have describe our extended endoscopic endonasal transsphenoidal surgery (EETS) technique, and the results of nine years of use in primary and recurrent/residual craniopharyngiomas. METHOD: This study reviewed 28 EETSs in 25 patients with craniopharyngiomas between January of 2006 and September of 2015. The patients were divided into two groups, newly diagnosed patients (group A, n=15), and patients having residual or recurrent tumors (group B, n=10)...
July 11, 2016: World Neurosurgery
Herman Tournaye, Csilla Krausz, Robert D Oates
An accurate medical history and directed physical examination are essential in diagnosis of male infertility. We review the hormonal assessments and specific genetic analyses that are useful additional tests, and detail other evidence-based examinations that are available to help guide therapeutic strategies. By contrast with female infertility treatments-especially hormonal manipulations to stimulate or enhance oocyte production-spermatogenesis and sperm quality abnormalities are much more difficult to affect positively...
July 6, 2016: Lancet Diabetes & Endocrinology
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