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    Epidural Dexamethasone Influences Postoperative Analgesia after Major Abdominal Surgery.
    Pain Physician 2017 May;20(4):261-269
    Yeungnam University School of Medicine and College of Medicine, Korea.
    Background: Epidurally administered dexamethasone might reduce postoperative pain. However, the effect of epidural administration of dexamethasone on postoperative epidural analgesia in major abdominal surgery has been doubtful.

    Objectives: To investigate the effects and optimal dose of epidural dexamethasone on pain after major abdominal surgery. Read More

    Management of Incidental Pancreatic Cysts: A White Paper of the ACR Incidental Findings Committee.
    J Am Coll Radiol 2017 May 12. Epub 2017 May 12.
    Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts.
    The ACR Incidental Findings Committee (IFC) presents recommendations for managing pancreatic cysts that are incidentally detected on CT or MRI. These recommendations represent an update from the pancreatic component of the JACR 2010 white paper on managing incidental findings in the adrenal glands, kidneys, liver, and pancreas. The Pancreas Subcommittee-which included abdominal radiologists, a gastroenterologist, and a pancreatic surgeon-developed this algorithm. Read More

    Takotsubo cardiomyopathy after intravenous epinephrine administration following cardiac arrest provoked by pneumoperitoneum - a case report.
    Pol Merkur Lekarski 2017 Apr;42(250):165-169
    Józef Struś Hospital, Poznań, Poland: Department of General and Colorectal Surgery.
    In stress-induced takotsubo cardiomyopathy (TC) high levels of catecholamines, including epinephrine, may be detected in blood. On the other hand, administration of exogenous epinephrine may occasionally result in TC.

    A Case Report: The authors describe a case of a 58-year-old, otherwise healthy female, with TC which occurred after intravenous injection of 1 mg of epinephrine against cardiac arrest provoked by pneumoperitoneum performed before planned laparoscopic cholecystectomy. Read More

    Abiraterone acetate and prednisone in chemotherapy-naïve prostate cancer patients: rationale, evidence and clinical utility.
    Ther Adv Med Oncol 2017 May 22;9(5):319-333. Epub 2017 Mar 22.
    UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
    Abiraterone acetate 1000 mg/day, combined with prednisone 5 mg PO twice daily, is indicated for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Abiraterone acetate is the oral prodrug of abiraterone, a specific CYP17 inhibitor that blocks androgen biosynthesis within the adrenal glands, testes and tumor microenvironment. In a phase III trial of men with asymptomatic or minimally symptomatic, chemotherapy-naïve mCRPC, treatment with oral abiraterone acetate plus prednisone led to a statistically significant improvement in the co-primary endpoints of overall survival and radiographic progression-free survival when compared with placebo plus prednisone. Read More

    Perioperative hypothalamic pituitary adrenal function in patients with silent corticotroph adenomas.
    Pituitary 2017 May 20. Epub 2017 May 20.
    Division of Clinical and Molecular Endocrinology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH, 44106, USA.
    Background: Silent corticotroph adenomas (SCAs) are characterized by strong ACTH immunostaining without clinical manifestations of hypercortisolism. Patients with SCAs often present with mechanical symptoms related to tumor growth. This study investigates the hypothalamic pituitary adrenal axis (HPA) characteristics after adenomectomy in patients with SCAs. Read More

    Three-Quarters Adrenalectomy for Infantile-Onset Cushing Syndrome due to Bilateral Adrenal Hyperplasia in McCune-Albright Syndrome.
    Horm Res Paediatr 2017 May 19. Epub 2017 May 19.
    Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan.
    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. Read More

    Stigma Associated with Classical Congenital Adrenal Hyperplasia in Women's Sexual Lives.
    Arch Sex Behav 2017 May 18. Epub 2017 May 18.
    Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
    The risk of intersex-related stigma often serves as social indication for "corrective" genital surgery, but has not been comprehensively documented. In preparation for the development of an intersex-specific stigma assessment tool, this qualitative project aimed to explore stigma in girls and women with classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. As part of a comprehensive follow-up project, 62 adult women with classical CAH (age range 18-51 years) took part in an open-ended retrospective interview focusing on the impact of CAH and its treatment on various aspects of girls' and women's lives. Read More

    Effects of β-Adrenoceptor and Catechol-O-Methyl-Transferase (COMT) Polymorphism on Postoperative Outcome in Cardiac Surgery Patients.
    Med Sci Monit Basic Res 2017 May 19;23:223-233. Epub 2017 May 19.
    Department of Cardiac Surgery, Heart Center Leipzig University of Leipzig, Leipzig, Germany.
    BACKGROUND There is a long-standing debate about the role of beta-adrenoceptor polymorphisms in the cardiovascular system. We wanted to elucidate whether β1-adrenoceptor-polymorphisms affects the postoperative catecholamine consumption and the length of intermediate care unit stay in patients undergoing cardiac surgery, and whether this might be enhanced or attenuated by catechol-O-methyl-transferase (COMT) polymorphism. MATERIAL AND METHODS We included 116 patients (63±1. Read More

    Single-stage laparoscopic adrenalectomy for pheochromocytoma and enucleation of a pancreatic neuroendocrine tumor in Von Hippel-Lindau disease: A case report.
    Mol Clin Oncol 2017 May 6;6(5):799-801. Epub 2017 Apr 6.
    Department of Surgery, IRCCS - Azienda Ospedaliera Universitaria San Martino-IST, University of Genoa, Ι-16132 Genoa, Italy.
    Von Hippel-Lindau (VHL) disease is an inherited syndrome with autosomal-dominant transmission, characterized by central nervous system and retinal hemangioblastomas, visceral cysts and tumors. Optimal surgical treatment, including its timing, remains a controversial topic. The present study reports the case of a 67-year-old female patient with adrenal and pancreatic manifestations of VHL. Read More

    Total Laparoscopic Management for Stage IV Colorectal Cancer Requiring Multivisceral Resection.
    Ann Surg Oncol 2017 May 16. Epub 2017 May 16.
    Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
    Background: Surgical resection of all sites of disease, in combination with effective systemic chemotherapy, offers the only potential chance for cure for patients with stage IV colorectal cancer (CRC). Coordinated multistage resection using a minimally invasive approach may provide optimal oncologic outcome while potentially offering the benefit of decreased morbidity.

    Patient: A 66-year-old women presented with transverse colon cancer and synchronous metastasis (CRLM) in segment IV involving the middle hepatic vein and main left portal pedicle, as well as the left adrenal gland. Read More

    Adrenal ganglioneuroma: The Padua Endocrine Surgery Unit experience.
    Int J Surg 2017 May;41 Suppl 1:S103-S108
    Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, 35128 Padova, Italy. Electronic address:
    Background: Adrenal ganglioneuroma (AGN) is a rare tumor that originates from the gangliar cells of the sympathetic nervous system. It represents less than 5% of all adrenal masses. AGN occurs as a large mass, with benign behavior and no relevant symptoms and hormonal secretion, but it is often misdiagnosed because the preoperative radiological diagnosis is generally challenging. Read More

    Psychological adjustment in parents of children born with atypical genitalia one year after their child undergoes genitoplasty.
    J Urol 2017 May 11. Epub 2017 May 11.
    Children's Hospital of Michigan, Detroit, MI; Cook Children's Medical Center, Fort Worth, TX.
    Purpose: The current study examined the psychological adjustment of parents of children born with moderate to severe genital atypia 12 months after their child underwent genitoplasty.

    Materials And Methods: Parents were recruited longitudinally from a multi-center collaboration of 10 pediatric hospitals with specialty care for children with a Disorder/Difference of Sex Development and/or Congenital Adrenal Hyperplasia. Parents completed measures of depressive and anxious symptoms, illness uncertainty, quality of life, post-traumatic stress, and decisional regret. Read More

    The Penetrance of Paraganglioma and Pheochromocytoma in SDHB germline mutation carriers.
    Clin Genet 2017 May 14. Epub 2017 May 14.
    Department of Otorhinolaryngology - Head Neck Surgery, VU University Medical Center, Amsterdam, the Netherlands.
    Germline mutations in SDHB predispose to hereditary paraganglioma syndrome type 4. The risk of developing paraganglioma (PGL) or pheochromocytoma (PHEO) in SDHB mutation carriers is subject of recent debate. In the present nationwide cohort study of SDHB mutation carriers identified by the clinical genetics centers of the Netherlands, we have calculated the penetrance of SDHB associated tumors using a novel maximum likelihood estimator. Read More

    Stress-Related and Circadian Secretion and Target Tissue Actions of Glucocorticoids: Impact on Health.
    Front Endocrinol (Lausanne) 2017 28;8:70. Epub 2017 Apr 28.
    Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens, Greece.
    Living organisms are highly complex systems that must maintain a dynamic equilibrium or homeostasis that requires energy to be sustained. Stress is a state in which several extrinsic or intrinsic disturbing stimuli, the stressors, threaten, or are perceived as threatening, homeostasis. To achieve homeostasis against the stressors, organisms have developed a highly sophisticated system, the stress system, which provides neuroendocrine adaptive responses, to restore homeostasis. Read More

    The Role of Platelet Function Analyzer Testing in Cardiac Surgery Transfusion Management.
    Transfus Med Hemother 2017 Apr 1;44(2):106-113. Epub 2017 Feb 1.
    University of Zagreb, School of Medicine, Zagreb, Croatia.
    Background: Identifying high-risk patients for transfusion after cardiac operations would alter postoperative management. The aim of this study was to investigate closure time (CT) measured by platelet function analyzer (PFA) for prediction of bleeding and transfusions.

    Methods: 66 patients were scheduled for coronary artery bypass graft (CABG) surgery and 30 patients for valve repair and replacement (non-CABG). Read More

    Successful use of lipid emulsion to resuscitate a foal after intravenous lidocaine induced cardiovascular collapse.
    Equine Vet J 2017 May 14. Epub 2017 May 14.
    Veterinary Teaching Hospital, University of Extremadura, Avda, Universidad s/n, Cáceres, 10003, Spain.
    Background: Lipid emulsion has been reported to be effective for the treatment of local anaesthetic overdoses in rats, dogs and humans.

    Objectives: To describe the successful treatment of cardiovascular lidocaine toxicity in a foal with intravenous lipid administration.

    Study Design: Observational study: case report. Read More

    A confirmed case of sugammadex-induced anaphylaxis in a UK hospital.
    BMJ Case Rep 2017 May 13;2017. Epub 2017 May 13.
    Department of Anaesthetics, Ashford and St. Peter's Hospitals NHS Trust, Chertsey, UK.
    We report the first published case of confirmed anaphylaxis to sugammadex in a UK hospital. The patient was given a bolus of sugammadex at the end of surgery. Four minutes later, he developed hypotension and a widespread erythematous rash. Read More

    Laparoscopic Adrenalectomy for Conn's Syndrome is Beneficial to Patients and is Cost Effective in England.
    J Invest Surg 2017 May 12:1-7. Epub 2017 May 12.
    a Department of Endocrine Surgery, Churchill Hospital , Oxford University Hospitals NHS Trust , Oxford , United Kingdom.
    Purpose: Adrenalectomy has the potential to cure or improve the control of hypertension in patients with primary hyperaldosteronism due to unilateral adrenal adenoma (Conn's syndrome). This study assesses the patients' perception of, and costs associated with, laparoscopic adrenalectomy for Conn's syndrome.

    Materials And Methods: Clinical, radiological, operative, and pathological data were collected on patients undergoing adrenalectomy for Conn's syndrome over 8-years period in a UK tertiary referral center. Read More

    Robot-assisted adrenalectomy: indications and drawbacks.
    Updates Surg 2017 May 12. Epub 2017 May 12.
    Department of Digestive, Hepatobiliary, Endocrine, and Oncology Surgery, University of Lorraine, CHU Nancy-Brabois (Adultes), 54511, Vandoeuvre-Les-Nancy, France.
    Adrenal tumors can vary from a benign adrenocortical adenoma with no hormonal secretion to a secretory adrenocortical malignancy (adrenocortical carcinoma) or a hormone-secreting tumor of the adrenal medulla (pheochromocytoma). Currently, laparoscopic adrenalectomy is regarded as the preferred surgical approach for the management of most adrenal surgical disorders, although there are no prospective randomized trials comparing this technique with open adrenalectomy. However, widespread adoption of robotic technology has positioned robotic adrenalectomy as an option in some medical centers. Read More

    A case of confirmed primary hyperaldosteronism diagnosed despite normal screening investigations.
    N Z Med J 2017 May 12;130(1455):129-132. Epub 2017 May 12.
    Department of Surgery, Wellington Regional Hospital, Newtown, Wellington.
    Primary hyperaldosteronism is a common cause of hypertension in the adult population. We report a case of histologically and biochemically confirmed hyperaldosteronism related to an adrenal adenoma, where initial screening and biochemical tests were potentially misleading. The case highlights the importance of clinical suspicion in the current diagnostic approach to primary hyperaldosteronism. Read More

    Aldosterone and Mineralocorticoid Receptors-Physiology and Pathophysiology.
    Int J Mol Sci 2017 May 11;18(5). Epub 2017 May 11.
    Hudson Institute of Medical Research, Monash University, 27-31 Wright St., Clayton 3168, Australia.
    Aldosterone is a uniquely terrestrial hormone, first appearing in lungfish, which have both gills and lungs. Mineralocorticoid receptors (MRs), on the other hand, evolved much earlier, and are found in cartilaginous and bony fish, presumptive ligand cortisol. MRs have equivalent high affinity for aldosterone, progesterone, and cortisol; in epithelia, despite much higher cortisol circulating levels, aldosterone selectively activates MRs by co-expression of the enzyme 11β-hydroxysteroid dehydrogenase, Type 11. Read More

    Portal Vein Thrombosis in the Setting of Newly Diagnosed Cushing's Syndrome.
    J Investig Med High Impact Case Rep 2017 Apr-Jun;5(2):2324709617703672. Epub 2017 Apr 10.
    Southern Illinois University, Springfield, IL, USA.
    The hallmark manifestations of Cushing's syndrome (CS) are well known, but hypercoagulability is perhaps least recognized. Patients with CS are at increased risk of both spontaneous and postoperative thromboembolism, with the significant majority of events occurring in the lower extremity and pulmonary venous circulations. We present a case of portal vein thrombosis (PVT) occurring in the setting of newly diagnosed CS due to a left adrenal adenoma. Read More

    Epinephrine-induced Takotsubo Cardiomyopathy During Laparoscopic Myomectomy: Case Report and Review of the Literature.
    J Minim Invasive Gynecol 2017 May 6. Epub 2017 May 6.
    Department of Obstetrics and Gynecology.
    Laparoscopic myomectomy, a minimally invasive procedure performed for the management of uterine leiomyomas involves a challenging aspect: excessive local bleeding. Hemorrhage control during laparoscopic myomectomy could be reached through the use of a wide range of vasoconstrictors including epinephrine. Epinephrine is frequently used for the control of local bleeding during surgery; however, it has been associated with several complications. Read More

    [Laparoscopic adrenalectomy: advantages of the minimally invasive approach].
    Cir Pediatr 2016 Oct 10;29(4):162-165. Epub 2016 Oct 10.
    Hospital Universitari i Politécnic La Fe. Valencia.
    Aim: To describe our experience as a tertiary center on the use of laparoscopic adrenal surgery in children.

    Material And Methods: A descriptive, retrospective study of patients with pathologic adrenal masses undergoing laparoscopic adrenal surgery, between 2012 and 2015. Epidemiological variables, surgical technique, complications and follow-up were studied. Read More

    Effectiveness of Bupivacaine Liposome Injectable Suspension for Postoperative Pain Control in Total Knee Arthroplasty: A Prospective, Randomized, Double Blind, Controlled Study.
    J Arthroplasty 2017 Apr 6. Epub 2017 Apr 6.
    Department of Biological Sciences, Wayne State University, Detroit, Michigan.
    Background: We compared the effectiveness of liposomal bupivacaine to ropivacaine, each as part of multimodal pain management, in total knee arthroplasty (TKA) postoperative pain control.

    Methods: This prospective, double blind study randomized 96 TKA patients into a control group (periarticular injection of ropivacaine, ketorolac, morphine, and epinephrine in saline; 100cc) or an experimental group (periarticular injection of bupivacaine, ketorolac, morphine, and epinephrine in saline; 80cc plus 1.3% liposomal bupivacaine 20cc; total injection 100cc). Read More

    A case of long-term survival after surgical resection for solitary adrenal recurrence of esophageal squamous carcinoma.
    Surg Case Rep 2017 Dec 5;3(1):61. Epub 2017 May 5.
    Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
    Background: Esophageal carcinomas are highly malignant tumors with a high frequency of lymph node and distant organ metastasis. Treatment for recurrent tumors is generally decided on an individual basis. Although multidisciplinary treatments involving chemotherapy, surgical resection, and radiation are performed, the prognosis remains poor. Read More

    Routine genetic screening with a multi-gene panel in patients with pheochromocytomas.
    Endocrine 2017 May 5. Epub 2017 May 5.
    Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK, OX3 7LE, UK.
    Purpose: Several new gene mutations have been reported in recent years to be associated with a risk of familial pheochromocytoma. However, it is unclear as to whether extensive genetic testing is required in all patients.

    Methods: The clinical data of consecutive patients operated for pheochromocytoma over a decade in a tertiary referral center were reviewed. Read More

    Surgical Resection of Malignancies Invading Inferior Vena Cava Level I and II. Issues Still Need to Be Discussed.
    Anticancer Res 2017 05;37(5):2523-2528
    Sanchinarro University Hospital, Madrid, Spain.
    Background/aim: Abdominal malignancies invading inferior vena cava present high postoperative morbidity and poor prognosis that has been decreasing in the last years. Our aim was to present and discuss a series of resected tumors invading the inferior vena cava from the origin of the hepatic vein to the common iliac veins (Level I and II).

    Materials And Methods: We retrospectively evaluated from 2005 to 2015 short- and long-term results of 20 consecutive surgical resections of tumors with associated inferior vena cava resection at Levels I and II performed at the Sanchinarro Hospital, Madrid, Spain. Read More

    Patients treated with immunosuppressive steroids are less aware of sick day rules Than those on endocrine replacement therapy and may be at greater risk of adrenal crisis.
    Ir J Med Sci 2017 May 4. Epub 2017 May 4.
    Academic Department of Endocrinology, Beaumont Hospital/RCSI Medical School, Beaumont Road, Dublin 9, Co. Dublin, Ireland.
    Background: Patients taking corticosteroids for immune suppression are vulnerable to adrenal crisis during acute illness or if steroids are stopped abruptly. Although patients treated for adrenal failure in endocrine units are routinely provided with sick day guidelines, we wished to ascertain whether patients on immunosuppressive steroids are appropriately advised.

    Aim: This study sets out to compare patient awareness of steroid sick day rules in endocrine and non-endocrine patients. Read More

    A Normotensive Patient with Primary Aldosteronism.
    Case Rep Endocrinol 2017 2;2017:5159382. Epub 2017 Apr 2.
    Department of VIP, Fujian Provincial Hospital, Fujian Medical University, 134 East Street, Fuzhou 350001, China.
    This study was to report a case of normotensive patient with primary aldosteronism who was admitted to our department recently. The patient was a 33-year-old male with right adrenal incidentaloma, but without any symptom. He has no history of hypertension, and blood pressure was normal when measured at multiple time points during hospitalization stay. Read More

    Refractory Vasoplegic Syndrome in an Adult Patient with Infective Endocarditis: A Case Report and Literature Review.
    J Tehran Heart Cent 2017 Jan;12(1):27-31
    Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
    Postoperative vasoplegic syndrome (VS) is characterized by low systemic vascular resistance, normal or elevated cardiac output, and poor response to volume expansion. The incidence of VS after cardiac surgery requiring cardiopulmonary bypass is about 20%. Sometimes, VS becomes refractory and initial treatments do not work, rendering treatment a great challenge. Read More

    Pheochromocytoma in a Child without Hypertension: A Contribution to the "Rule of 10s".
    Indian J Med Paediatr Oncol 2017 Jan-Mar;38(1):59-61
    Department of Pediatric Surgery, SCB Medical College, Cuttack, Odisha, India.
    Pheochromocytoma (PCC) is a neuroendocrine tumor originating from chromaffin tissue in adrenal medulla. Its diagnosis and treatment are well defined in adults, but experience in children is limited. Children constitute only 10% of reported cases, the average age at presentation being 11 years. Read More

    A multiparametric approach to discriminate the impacts of different degrees of invasiveness of surgical procedures in sheep.
    Animal 2017 May 4:1-10. Epub 2017 May 4.
    1Institut National de la Recherche Agronomique,UMR 1213 Herbivores,F-63122 Saint-Genès-Champanelle,France.
    Traumatic situations in animals induce responses including pain, expressed through behavioural and physiological pathways such as inflammation, oxidative stress, hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system. As some of these systems can also be activated during excitement and situations with a positive valence, their use as a means to assess pain response is difficult. We explored (i) how these five aforementioned pathways change in sheep exposed to various degrees of invasiveness of surgical procedures despite a therapeutic regimen and (ii) whether a multiparametric analysis that combines information from these five pathways enhances the discrimination between these situations, and estimates the relative importance of these pathways in the response. Read More

    Complete laparoscopic excision of a giant retroperitoneal paraganglioma.
    Ann R Coll Surg Engl 2017 May;99(5):e148-e150
    HPB Surgery and Dept of Cardiology and Endocrinology, Hammersmith Hospital, Imperial College Healthcare Trust, Du Cane Road , London , UK.
    Paragangliomas (or 'extra-adrenal phaeochromocytomas') are rare tumours arising from neural crest cells. They occur most commonly in the abdomen along the paraspinal sympathetic ganglion. The malignancy rate can be up to 35% and surgical resection is the recommended treatment. Read More

    Multiple Recurrent Paraganglioma in a Pediatric Patient with Germline SDH-B Mutation.
    Urol Case Rep 2017 Jul 27;13:107-109. Epub 2017 Apr 27.
    National Cancer Institute, National Institutes of Health, Urologic Oncology Branch, Bethesda, MD, USA.
    Magnetic Resonance Imaging (MRI) and fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) are recognized approaches for locating paragangliomas. Recently, gallium-68 DOTA-octreotate (DOTATATE) scans have shown promise detecting neuroendocrine tumors missed by FDG-PET and MRI. 13-year-old male with SDH-B mutation presented with symptoms of paraganglioma and elevated catecholamines. Read More

    An International Survey of Corticosteroid Use for the Management of Low Cardiac Output Syndrome.
    Pediatr Crit Care Med 2017 Apr 27. Epub 2017 Apr 27.
    1Section of Critical Care Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, TX. 2Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH. 3Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH. 4The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH. 5Division of Cardiology, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR. 6Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH. 7Division of Pediatric Critical Care, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
    Objective: Limited evidence exists on use of corticosteroids in low cardiac output syndrome following cardiac surgery. We sought to determine physicians' practices and beliefs with regard to corticosteroids therapy for low cardiac output syndrome.

    Design: Multinational internet-based survey. Read More

    Efficacy of pasireotide in controlling severe hypercortisolism until cardiac transplantation.
    Endocrinol Diabetes Metab Case Rep 2017 8;2017. Epub 2017 Mar 8.
    Endocrinology Service, Galeazzi Institute IRCCS, Milan, Italy.
    Summary: Cushing's syndrome is associated with increased morbidity and mortality. Although surgery is the first-line treatment, drugs can still play a role as an ancillary treatment to be employed while waiting for surgery, after unsuccessful operation or in patients unsuitable for surgery. We were asked to evaluate a 32-year-old male waiting for cardiac transplantation. Read More

    An unusual cause of back pain: a case of large nonfunctioning retroperitoneal paraganglioma presented as a large cystic lesion. A case report and review of literature.
    J Surg Case Rep 2017 Apr 21;2017(4):rjx059. Epub 2017 Apr 21.
    Department of Radiology, United Christian Hospital, Hong Kong.
    Pheochromocytoma arising from outside the adrenal glands is also called paraganglioma. When it occurs below the diaphragm, in the organ of Zuckerkandl or retroperitoneum, it is also called extra-adrenal pheochromocytoma. Paragangliomas are rare tumors which arise from neuroendocrine cells and extra-adrenal paragangliomas (EAPs) account for only 10-15% if all paragangliomas and may present incidentally as a symptomless mass. Read More

    Acute intestinal obstruction due to metastatic lung cancer-case report.
    J Surg Case Rep 2017 Feb 17;2017(2):rjx031. Epub 2017 Feb 17.
    Department of Abdominal Surgery, University Medical Centre Ljubljana,Ljubljana, Slovenia, Europe.
    We present a case of male patient, who was referred to our department because of acute intestinal obstruction, which was the initial clinical symptom of primary lung cancer. The abdominal computed tomography (CT) prior to the emergency operation showed small intestinal obstruction and metastases to both adrenal glands. The patient underwent an emergency abdominal exploratory laparotomy, that confirmed small bowel obstruction and diffuse metastatic lesions along the entire small bowel length. Read More

    Surgical approaches in hereditary endocrine tumors.
    Updates Surg 2017 Apr 28. Epub 2017 Apr 28.
    Minimally Invasive Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
    Endocrine tumors of thyroid, adrenal and parathyroid glands may be due to germline and inheritable mutations in 5-30% of patients. Medullary Thyroid Carcinoma, Pheochromocytoma, Paraganglioma, and Familial Primary Hyperparathyroidism are the most frequent entity. Hereditary endocrine tumors usually have a suggestive familial history; they occur earlier than sporadic variants, are multifocal, and have increased recurrence rates. Read More

    Unique and novel urinary metabolomic features in malignant versus benign adrenal neoplasms.
    Clin Cancer Res 2017 Apr 27. Epub 2017 Apr 27.
    Endocrine Oncology Branch, National Cancer Institute.

    Adrenal incidentalomas must be differentiated from adrenocortical cancer (ACC). Currently, size, growth, and imaging characteristics determine the potential for malignancy but are imperfect. The aim was to evaluate whether urinary small molecules (<800 Da) are associated with ACC. Read More

    Primary mediastinal myelolipoma: a case report and literature review.
    J Thorac Dis 2017 Mar;9(3):E219-E225
    Department of Cardiothoracic Surgery, The First People's Hospital of Yangzhou, Yangzhou 225000, China.
    Myelolipoma is a kind of rare benign tumour composed of mature adipocytes and hemopoietic elements, and is most often found in the adrenal glands. Primary mediastinal myelolipoma (PMM) more rarely happens and has no definite symptoms, and mediastinal masses are usually found in chest examination. The patients normally receive a surgical resection and have a favorable prognosis after postoperative pathological diagnosis. Read More

    Malignant pheochromocytoma in the anterior mediastinum with sternal invasion: a case report.
    J Thorac Dis 2017 Mar;9(3):E202-E209
    Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China.
    Pheochromocytomas are catecholamine-producing neuroendocrine tumors that usually occur in the adrenal medulla or sympathetic paraganglia. Anterior mediastinum involvement with pheochromocytoma is rare and may not present with typical symptoms. Its clinical manifestation may be unclear and a high index of suspicion is required for accurate diagnosis. Read More

    Autoimmune polyendocrine syndrome type 1 in an Indian cohort: a longitudinal study.
    Endocr Connect 2017 Apr 26. Epub 2017 Apr 26.
    E Bhatia, Endocrinology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
    Objective: Autoimmune polyendocrine syndrome type 1 (APS 1) is a rare autosomal recessive disorder characterized by progressive organ-specific autoimmunity. There is scant information on APS1 in ethnic groups other than European Caucasians. We studied clinical aspects and autoimmune regulator (AIRE) gene mutations in a cohort of Indian APS1 patients. Read More

    Adrenal Vein Catecholamine Levels and Ratios: Reference Intervals Derived from Patients with Primary Aldosteronism.
    Horm Metab Res 2017 Apr 26. Epub 2017 Apr 26.
    Department of Endocrinology, St Bartholomew's Hospital, London, UK.
    Phaeochromocytoma localisation is generally reliably achieved with modern imaging techniques, particularly in sporadic cases. On occasion, however, there can be diagnostic doubt due to the presence of bilateral adrenal abnormalities, particularly in patients with mutations in genes predisposing them to the development of multiple phaeochromocytomas. In such cases, surgical intervention is ideally limited to large or functional lesions due to the long-term consequences associated with hypoadrenalism. Read More

    A Prospective Randomized Trial Comparing the Effects of Lidocaine in Breast Reduction Surgery.
    Plast Reconstr Surg 2017 May;139(5):1074e-1079e
    Madison, Wis.; and Houston, Texas From the Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health; and the Department of Plastic and Reconstructive Surgery, The University of Texas M. D. Anderson Cancer Center.
    Background: Use of dilute epinephrine tumescent solution in breast reduction surgery has been shown to significantly decrease operative blood loss without increasing perioperative complications. Lidocaine is commonly added to epinephrine to decrease postoperative pain. Evidence supporting this practice, however, is limited, and lidocaine toxicity has been reported. Read More

    Analysis of treatment of large abdominal malignancies in children complicated with abdominal compartment syndrome: Report of six cases.
    Medicine (Baltimore) 2017 Apr;96(17):e6705
    aDepartment of Pediatric Surgery bDepartment of Endocrinology, Sun Yat-sen Memorial Hospital, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation Medical Research Center, Sun Yat-sen University, Guangzhou, China.
    To explore effective treatment of large abdominal malignancies in children complicated with abdominal compartment syndrome (ACS).Six children with large abdominal malignancies complicated with ACS were admitted to our department from January 2013 to January 2016, and the changes in their breathing, heart rate, oxygen saturation, abdominal circumference, bladder pressure, and urine output, as well as the treatment measures and outcomes, were retrospectively analyzed.The 6 children included 1 child with bilateral nephroblastoma, 1 child with abdominal alveolar rhabdomyosarcoma, 1 child with right ovarian malignant teratoma complicated with abdominal glioma, 1 child with abdominal malignant teratoma, 1 child with right nephroblastoma, and 1 child with left adrenal gland neuroblastoma. Read More

    A Case Report of Giant Adrenal Ganglioneuroma.
    Urol Case Rep 2017 Jul 19;13:37-38. Epub 2017 Apr 19.
    Department of Urology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, PR China.
    Adrenal ganglioneuroma (AGN) is an extremely rare and benign entity comprising Schwann cells and ganglion cells. If the lesion approaches to 6 cm, laparoscopic resection is considered as relative contraindication. Now we present a giant adrenal AGN in a 25-year-old male patient. Read More

    Surgical Management of Non-small Cell Lung Cancer with Solitary Hematogenous Metastases.
    In Vivo 2017 May-Jun;31(3):451-454
    Second Department of Propedeutic Surgery, Laikon Hospital, Athens School of Medicine, Athens, Greece.
    Background/aim: The treatment of patients with solitary hematogenous metastases from non-small cell lung cancer (NSCLC) remains controversial, although numerous retrospective studies have reported favorable results for patients offered combined surgical therapy. Our aim was to determine the role of surgical resection in the management of NSCLC with solitary extrapulmonary metastases and to investigate for possible prognostic factors.

    Patients And Methods: Between January 2004 and December 2012, 12 patients with NSCLC, from two Institutions, underwent metastasectomy for their solitary metastatic lesion. Read More

    Skin to Intramuscular Compartment Thigh Measurement by Ultrasound in Pediatric Population.
    West J Emerg Med 2017 Apr 7;18(3):479-486. Epub 2017 Feb 7.
    Southern Illinois University, School of Medicine, Center for Clinical Research, Springfield, Illinois.
    Introduction: Pediatric obesity threatens the efficacy of medications given intramuscularly. In anaphylactic patients, epinephrine auto-injector needle lengths are potentially too short to reach the muscle compartment in patients with elevated body habitus. The objective of the study was to determine needle-length requirements for intramuscular injections in pediatric patients. Read More

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