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    Primary aldosteronism patients show skin alterations and abnormal activation of glucocorticoid receptor in keratinocytes.
    Sci Rep 2017 Nov 17;7(1):15806. Epub 2017 Nov 17.
    Instituto de Biomedicina de Valencia-Consejo Superior de Investigaciones Científicas (IBV-CSIC), Jaime Roig 11, E-46010, Valencia, Spain.
    Primary aldosteronism (PA) is a disease characterized by high aldosterone levels caused by benign adrenal tumors being the most frequent cause of secondary hypertension. Aldosterone plays vital physiological roles through the mineralocorticoid receptor (MR) but in certain cell types, it can also activate the glucocorticoid (GC) receptor (GR). Both MR and GR are structurally and functionally related and belong to the same family of ligand-dependent transcription factors that recognize identical GC regulatory elements (GREs) on their target genes. Read More

    Clinicopathological Characteristics of Four Cases of Adrenal Myelolipomas: A Rare Surgical Entity.
    World J Oncol 2012 Dec 4;3(6):294-297. Epub 2013 Jan 4.
    Department of Pathology, Aretaieion University Hospital, Athens, Greece.
    Myelolipomas are unusual benign tumors or tumor-like lesions, composed of hematopoietic cells and mature adipose tissue. They usually are asymptomatic and behave as non-functioning, unilateral, small adrenal tumors often found incidentally on imaging studies. We report the clinicopathological characteristics of four cases of adrenal myelolipomas treated in our hospital, worth to mention because of their rarity and their significant size. Read More

    Adrenocortical Carcinoma: Complete Surgical Resection After 18 Years.
    World J Oncol 2011 Dec 19;2(6):307-310. Epub 2011 Dec 19.
    Departments of Surgery, Abington Memorial Hospital, Abington, PA, USA.
    Adrenal cortical carcinoma (ACC) is a rare neoplasm often associated with an aggressive biological behavior. Complete surgical resection is the mainstay of therapy for ACC and offers the best chance for prolonged disease-free survival. We present an unusual case of a long-standing adrenal mass, well documented over a period of at least 18 years, without the development of metastatic disease, and ultimately proven to represent ACC after successful surgical resection. Read More

    Management of an acute catecholamine-induced cardiomyopathy and circulatory collapse: a multidisciplinary approach.
    Endocrinol Diabetes Metab Case Rep 2017 9;2017. Epub 2017 Nov 9.
    Departments of Endocrinology and Diabetes.
    A phaeochromocytoma (PC) is a rare, catecholamine-secreting neuroendocrine tumour arising from the adrenal medulla. Presenting symptoms of this rare tumour are highly variable but life-threatening multiorgan dysfunction can occur secondary to catecholamine-induced hypertension or hypotension and subsequent cardiovascular collapse. High levels of circulating catecholamines can induce an acute stress cardiomyopathy, also known as Takotsubo cardiomyopathy. Read More

    Three cases of adrenocortical tumors mistaken for hepatocellular carcinomas/diagnostic pitfalls and differential diagnosis.
    Ann Diagn Pathol 2017 Dec 29;31:9-13. Epub 2017 May 29.
    Department of Pathology, Pusan National University Hospital and Pusan National University School of Medicine, Busan, Republic of Korea; BioMedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea. Electronic address:
    Adrenocortical adenomas and carcinomas in other parenchyma are extremely rare, with few cases reported and because of the rarity of these tumors, they occasionally cause problems during diagnosis. Adrenal cortical neoplasms in liver parenchyma can be present in 3 forms, including direct invasion or adhesion to liver parenchyma, tumors arising in adrenohepatic fusion tissue or in ectopic adrenal gland tissue. We report 3 cases of adrenal cortical tumors that were misdiagnosed as hepatocellular carcinoma in the preoperative state. Read More

    Use of Wide-awake Local Anesthesia No Tourniquet in Hand and Wrist Surgery.
    Orthop Clin North Am 2018 Jan;49(1):63-68
    Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA.
    WALANT (wide-awake local anesthesia no tourniquet) appears to be a safe and effective anesthesia technique for many hand and wrist surgeries. Patient satisfaction is high because of the avoidance of preoperative testing and hospital admission. Postoperative recovery is rapid, and procedures can be done in outpatient settings, resulting in substantial savings in time and money. Read More

    Primary malignant melanoma of the gallbladder with multiple metastases: A case report.
    Medicine (Baltimore) 2017 Nov;96(46):e8793
    aDepartment of Biliary Surgery bDepartment of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
    Rational: Primary malignant melanoma of the gallbladder is an extremely rare tumor, with fewer than 40 cases reported in the literature worldwide. The majority of patients presented as a solitary lesion in the gallbladder. To our knowledge, only one case of primary malignant melanoma of the gallbladder with multiple metastases has been reported, which involved the stomach, duodenum, pancreas, jejunum and a mesenteric lymph node. Read More

    PHEOCHROMOCYTOMA: A GENETIC AND DIAGNOSTIC UPDATE.
    Endocr Pract 2017 Nov 16. Epub 2017 Nov 16.
    Department of Nuclear Medicine, La Timone University Hospital & CERIMED & Inserm UMR1068 Marseille Cancerology Research Center, Institut Paoli-Calmettes, Aix Marseille Univ, Marseille, France.
    Objective: Pheochromocytomas and paragangliomas (PPGLs) are neuroendocrine tumors derived from adrenal or extra-adrenal locations, respectively. Upon suspicion of PPGL, specific metabolomic, molecular, biochemical, imaging, and histopathological studies are performed to prove, localize, treat, and monitor disease progression. Recently, improved diagnostic tools allow physicians to accurately diagnose PPGL, even in patients presenting with small (less than 1 cm) or biochemically silent tumors, which previously delayed proper detection and treatment. Read More

    ENDOSCOPIC ULTRASOUND-GUIDED FINE-NEEDLE ASPIRATION (EUS-FNA) IN THE DIAGNOSIS OF ADRENAL METASTASIS IN A HIGH-RISK POPULATION.
    Endocr Pract 2017 Nov 16. Epub 2017 Nov 16.
    Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota.
    Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the diagnosis of adrenal metastasis in a high-risk population Objective: While the left adrenal gland is readily accessible via endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), data regarding the utility of EUS-FNA in the diagnosis of adrenal lesions remain limited. We aimed to 1) describe the clinical context, adverse event rate, and diagnostic performance of EUS-FNA and 2) compare the safety profile and diagnostic accuracy of EUS-FNA with percutaneous adrenal biopsy.

    Design: Single-center, retrospective cohort study. Read More

    A case report of hyponatremia after surgery for Conn's adenoma.
    J Renin Angiotensin Aldosterone Syst 2017 Oct-Dec;18(4):1470320317740240
    1 Department of Medical Sciences, University of Trieste, Italy.
    Primary aldosteronism (PA), also known as Conn's syndrome, is a frequent cause of secondary hypertension. If PA is due to a documented unilateral adrenal adenoma, adrenalectomy is the treatment of choice. Endocrine Society guidelines suggest monitoring potassium after adrenalectomy, while there is no mention of sodium disorders after surgery. Read More

    Endoscopic Carpal Tunnel Release with and without Sedation.
    Plast Reconstr Surg 2017 Nov 11. Epub 2017 Nov 11.
    #Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
    Background: This study evaluates outcomes and complications with endoscopic carpal tunnel release (eCTR) performed with local anesthesia (LOCAL) only versus local anesthesia with sedation (SEDATION). We hypothesize that patient outcomes and satisfaction will be equivalent in both groups irrespective of anesthesia type.

    Methods: One hundred fifty-four consecutive patients undergoing eCTR with either LOCAL or SEDATION protocols were prospectively enrolled in a study of satisfaction and outcomes. Read More

    Bupivacaine as an Adjunct to Lidocaine in Mohs Micrographic Surgery: A Prospective Randomized Controlled Trial.
    Dermatol Surg 2017 Nov 14. Epub 2017 Nov 14.
    *Oxford Dermatology, Mt Hawthorn, Western Australia, Australia; †Royal Perth Hospital, Perth, Western Australia, Australia; ‡University of Western Australia, Crawley, Western Australia, Australia.
    Background: In Mohs micrographic surgery (MMS), the standard local anesthetic agent used is lignocaine with adrenaline. However, MMS can be prolonged; thus reinjections of local anesthetics are often required.

    Objective: Is 0. Read More

    Contralateral suppression of aldosterone at adrenal venous sampling predicts hyperkalemia following adrenalectomy for primary aldosteronism.
    Surgery 2017 Nov 9. Epub 2017 Nov 9.
    Department of Surgery, Mayo Clinic, Rochester, MN.
    Background: We aimed to determine whether a greater degree of contralateral suppression of aldosterone secretion at adrenal venous sampling predicted the development of postoperative hyperkalemia after unilateral adrenalectomy for primary aldosteronism.

    Methods: A retrospective analysis of patients undergoing unilateral adrenalectomy for primary aldosteronism between 2004-2015 was performed. Clinical and biochemical parameters of patients who developed hyperkalemia (≥5. Read More

    Less is more: cost-effectiveness analysis of surveillance strategies for small, nonfunctional, radiographically benign adrenal incidentalomas.
    Surgery 2017 Nov 9. Epub 2017 Nov 9.
    UCSF Department of Surgery, University of California, San Francisco, San Francisco, CA.
    Background: Guidelines for management of small adrenal incidentalomas are mutually inconsistent. No cost-effectiveness analysis has been performed to evaluate rigorously the relative merits of these strategies.

    Methods: We constructed a decision-analytic model to evaluate surveillance strategies for <4cm, nonfunctional, benign-appearing adrenal incidentalomas. Read More

    Fifteen years of adrenalectomies: impact of specialty training and operative volume.
    Surgery 2017 Nov 8. Epub 2017 Nov 8.
    Department of Surgery, Massachusetts General Hospital, Boston, MA. Electronic address:
    Background: Previous associations between surgeon volume with adrenalectomy outcomes examined only a sample of procedures. We performed an analysis of all adrenalectomies performed in New York state to assess the effect of surgeon volume and specialty on clinical outcomes.

    Methods: Adrenalectomies performed in adults were identified from the New York Statewide Planning and Research Cooperative System from 2000-2014. Read More

    Is there any role for minimally invasive surgery in NET?
    Rev Endocr Metab Disord 2017 Nov 11. Epub 2017 Nov 11.
    Section of Endocrine Surgery, Department of General, Visceral and Thoracic Surgery, Academic Teaching Hospital University of Hamburg, Reinbek, Germany.
    Neuroendocrine tumors (NET) represent the variability of almost benign lesions either secreting hormones occurring as a single lesion up to malignant lesions with metastatic potential. Treatment of NET is usually performed by surgical resection. Due to the rarity of NET, surgical treatment is mainly based on the experience and recommendations of experts and less on the basis of prospective randomized studies. Read More

    Preoperative genetic testing in pheochromocytomas and paragangliomas influences the surgical approach and the extent of adrenal surgery.
    Surgery 2017 Nov 7. Epub 2017 Nov 7.
    Endocrine Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Surgery, The George Washington University, School of Medicine and Health Sciences, Washington, DC. Electronic address:
    Background: Our knowledge of the susceptibility genes for pheochromocytomas/paragangliomas has increased; however, data on its impact on surgical decision-making has not been described. The aim of this study was to determine the effect of routine preoperative genetic testing on the operative intervention in patients with pheochromocytomas/paragangliomas.

    Methods: One-hundred-eight patients diagnosed with pheochromocytomas/paragangliomas who underwent 118 operations had preoperative genetic testing for 9 known pheochromocytoma/paraganglioma susceptibility genes. Read More

    A Multi-institutional Comparison of Adrenal Venous Sampling in Patients with Primary Aldosteronism: Caution Advised if Successful Bilateral Adrenal Vein Sampling is Not Achieved.
    World J Surg 2017 Nov 9. Epub 2017 Nov 9.
    Department of Surgery, Section of General Surgery and Surgical Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
    Introduction: In patients with primary aldosteronism (PA), adrenal venous sampling (AVS) is recommended to differentiate between unilateral (UNI) or bilateral (BIL) adrenal disease. A recent study suggested that lateralization could be predicted, based on the ratio of aldosterone/cortisol levels (A/C) between the left adrenal vein (LAV) and inferior vena cava (IVC), with a 100% positive predictive value (PPV). This study aimed to validate those findings utilizing a larger, multi-institutional cohort. Read More

    Patients' comorbidities reduce the clinical value of emergency colonoscopy: results of a retrospective cohort study.
    Endosc Int Open 2017 Nov 8;5(11):E1119-E1127. Epub 2017 Nov 8.
    EC2M3: Department of Academic Research (EA7375) Université Paris Est Créteil (UPEC) - Val de Marne, France.
    Background And Study Aims:  Urgent endoscopy is often used to diagnose and sometimes treat acute upper gastrointestinal syndromes (hemorrhage, toxic ingestion, and occlusion). However, its suitability concerning the management of lower gastrointestinal conditions in emergency circumstances is controversial.

    Patients And Methods:  We studied the role of emergency colonoscopy in diagnosis and treatment of all consecutive patients presenting with acute lower gastrointestinal symptoms referred to our hospital on an emergency basis. Read More

    Each procedure matters: threshold for surgeon volume to minimize complications and decrease cost associated with adrenalectomy.
    Surgery 2017 Nov 6. Epub 2017 Nov 6.
    Duke University School of Medicine, Durham, NC; Duke Cancer Institute, Durham, NC; Department of Surgery, Duke University School of Medicine, Durham, NC; Duke Clinical Research Institute, Durham, NC. Electronic address:
    Background: An association has been suggested between increasing surgeon volume and improved patient outcomes, but a threshold has not been defined for what constitutes a "high-volume" adrenal surgeon.

    Methods: Adult patients who underwent adrenalectomy by an identifiable surgeon between 1998-2009 were selected from the Healthcare Cost and Utilization Project National Inpatient Sample. Logistic regression modeling with restricted cubic splines was utilized to estimate the association between annual surgeon volume and complication rates in order to identify a volume threshold. Read More

    Acute development of Cushing syndrome in an HIV-infected child on atazanavir/ritonavir based antiretroviral therapy.
    Endocrinol Diabetes Metab Case Rep 2017 28;2017. Epub 2017 Oct 28.
    Divisions of Infectious Diseases.
    An 11-year-old male with perinatally acquired human immune deficiency virus (HIV) infection on antiretroviral regimen, which included abacavir plus lamivudine (Epzicom), didanosine, ritonavir and atazanavir presented with bilateral axillary striae, increased appetite, fatigue, facial swelling and acute weight gain. Two months prior to presentation, the patient had received a diagnostic and therapeutic intra-articular triamcinolone injection in the knee for pain relief and subsequently became progressively swollen in the face, developed striae bilaterally at the axillae, experienced increased appetite, fatigue and an 8 pound weight gain. During the endocrine workup, suspicion for adrenal insufficiency prompted 24-h urine collection for free cortisol, which was found to be undetectable (below LLQ of 1. Read More

    Successful Treatment of Iatrogenic External Iliac Artery Perforation With Covered Stent: Case Report and Review of the Literature.
    Cardiol Res 2017 Oct 27;8(5):246-253. Epub 2017 Oct 27.
    Division of Cardiology, University of South Alabama, Mobile, AL 36617, USA.
    Retroperitoneal hemorrhage from iliac artery injury is a potentially serious complication of vascular interventional procedures leading to hemorrhagic shock and death if not diagnosed early and treated promptly. We report a 70-year-old male admitted to our facility with non-ST-elevation myocardial infarction, whose heart catheterization revealed left anterior descending artery (LAD) with 80% proximal, 95% mid and 100% distal disease. The left circumflex and right coronary arteries were 100% occluded proximally and received collaterals from the LAD. Read More

    Validation of pathological grading systems for predicting metastatic potential in pheochromocytoma and paraganglioma.
    PLoS One 2017 8;12(11):e0187398. Epub 2017 Nov 8.
    Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
    Purpose: The Grading system for Adrenal Pheochromocytoma and Paraganglioma (GAPP) was proposed for predicting the metastatic potential of pheochromocytoma and paraganglioma to overcome the limitations of the Pheochromocytoma of the Adrenal Scaled Score (PASS). However, to date, no study validating the GAPP has been conducted, and previous studies did not include mutations in the succinate dehydrogenase type B (SDHB) gene in the score calculation. In this retrospective cohort study, we validated the prediction ability of GAPP and assessed whether it would be improved by inclusion of the loss of SDHB immunohistochemical staining. Read More

    Impact of hypercortisolism on skeletal muscle mass and adipose tissue mass in patients with adrenal adenomas.
    Clin Endocrinol (Oxf) 2017 Nov 8. Epub 2017 Nov 8.
    Department of Endocrinology, Metabolism University Hospital of Patras, Greece.
    Context: Abdominal visceral adiposity and central sarcopenia are markers of increased cardiovascular risk and mortality.

    Objective: To assess whether central sarcopenia and adiposity can serve as a marker of disease severity in patients with adrenal adenomas and glucocorticoid secretory autonomy.

    Design: Retrospective cohort study. Read More

    Behavior of Anesthesiology Residents in a Situation of Intravenous Route Occlusion During Syringe Pump Use in a Simulated Intensive Care Unit.
    J Patient Saf 2017 Nov 4. Epub 2017 Nov 4.
    From the Department of Anesthesiology, Yokohama City University Hospital, Yokohama City, Japan.
    Introduction: Unintentional catecholamine flush caused by inappropriate release of an intravenous occlusion during use of a syringe pump in the intensive care unit (ICU) can have dangerous consequences in patients receiving critical care. We investigated whether anesthesiology residents understood how to deal with syringe pump occlusion in a simulated ICU setting.

    Methods: We set up a mannequin that virtually simulated a sedated patient under mechanical ventilation after cardiac surgery, with epinephrine and dopamine being infused by syringe pumps to maintain blood pressure at 100/50 mm Hg. Read More

    Effects of low-dose epinephrine on perioperative hemostasis and inflammatory reaction in major surgeries: a randomized clinical trial.
    J Thromb Haemost 2017 Nov 6. Epub 2017 Nov 6.
    Center for Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China.
    Background: Haemostasis, thrombosis, and surgical stress-induced immune reaction are important for perioperative morbidity and recovery in major surgeries.

    Objectives: This study aimed to evaluate the effects of combined administration of low-dose epinephrine (LDEPI) plus tranexamic acid (TXA) on perioperative blood loss, thromboembolic complications, and inflammatory response in total hip arthroplasty (THA).

    Patients /methods: Patients scheduled for THA (n = 195) were randomized into 3 interventions: intravenous (IV) LDEPI plus TXA (Group IV); topical (TP) diluted-epinephrine plus TXA (Group TP); and TXA alone as control (CT) (Group CT). Read More

    Different therapeutic options in patients with Cushing's syndrome due to bilateral macronodular adrenal hyperplasia.
    Minerva Endocrinol 2017 Nov 3. Epub 2017 Nov 3.
    Endocrinology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy.
    Bilateral macronodular adrenal hyperplasia (BMAH) is a relatively rare cause of Cushing's syndrome (CS). In recent years, growing evidence has shown that steroidogenesis is regulated by aberrant G-protein-coupled receptors (GPCR) expression and their ligands, in a significant proportion of patients with BMAH. The screening of patients with overt or subclinical CS demonstrate the frequent expression of several GPCR that opened the option to potential therapeutic applications. Read More

    Endothelial Regulator of Calcineurin 1 Promotes Barrier Integrity and Modulates Histamine-Induced Barrier Dysfunction in Anaphylaxis.
    Front Immunol 2017 20;8:1323. Epub 2017 Oct 20.
    Department of Immunology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain.
    Anaphylaxis, the most serious and life-threatening allergic reaction, produces the release of inflammatory mediators by mast cells and basophils. Regulator of calcineurin 1 (Rcan1) is a negative regulator of mast-cell degranulation. The action of mediators leads to vasodilation and an increase in vascular permeability, causing great loss of intravascular volume in a short time. Read More

    Management of Anaphylaxis.
    Otolaryngol Clin North Am 2017 Dec;50(6):1175-1184
    Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Mercy Hospital, 1400 Locust Street, Building B, Suite 11500, Pittsburgh, PA 15219, USA. Electronic address:
    Anaphylaxis is a severe systemic reaction that can be managed appropriately with expedient diagnosis and treatment. Intramuscular epinephrine continues to be the mainstay of treatment of anaphylaxis; however, it is still underused in the community and in the medical setting. Further education and counseling of patients and health care providers is required to prevent and manage anaphylaxis successfully. Read More

    Giant phaeochromocytoma presenting with an acute stroke: reappraising phaeochromocytoma surveillance for the neurofibromatosis type 1 phakomatosis.
    BMJ Case Rep 2017 Nov 3;2017. Epub 2017 Nov 3.
    Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Asia.
    Neurofibromatosis type 1 (NF1) is a multisystem genetic disorder associated with reduced lifespan attributed largely to malignancy and vascular causes. One of the tumours associated with NF1 is phaeochromocytoma. The phaeochromocytoma has earned the moniker, a 'great mimicker', due to its varied means of presentation. Read More

    An isolated metachronous metastasis to the adrenal gland from a pancreatic neuroendocrine tumor: A case report.
    Int J Surg Case Rep 2017 Oct 19;41:169-173. Epub 2017 Oct 19.
    Department of Surgery, Jichi Medical University, Tochigi, Japan. Electronic address:
    Introduction: Pancreatic neuroendocrine tumors are rare. Treatment includes aggressive local management of the primary lesion and metastases, and systemic somatostatin. This is the first report of an isolated metachronous metastasis to the adrenal gland from a pancreatic neuroendocrine tumor that presented 90 months after the primary tumor. Read More

    Articaine Versus Lidocaine Concentration in the Palatal Tissues After Supraperiosteal Buccal Infiltration Anesthesia.
    J Oral Maxillofac Surg 2017 Oct 10. Epub 2017 Oct 10.
    Associate Professor, Biomedical Dental Sciences Department, College of Dentistry, University of Dammam, Dammam, Saudi Arabia.
    Purpose: Palatal local anesthetic injection is a painful procedure. Previous studies have reported successful extraction of maxillary teeth using only buccal infiltration of 4% articaine without palatal anesthesia. The aim of the present study was to determine levels of 4% articaine solution in palatal bone and mucosal tissues after buccal injection and compare those levels with 2% lidocaine solution in New Zealand white rabbits. Read More

    Effectiveness of Intracameral Phenylephrine in Achieving Mydriasis and Reducing Complications During Phacoemulsification: A Systematic Review and Meta-Analysis.
    J Ocul Pharmacol Ther 2017 Nov 3. Epub 2017 Nov 3.
    2 Social Pharmacy Department, University of Granada , Granada, Spain .
    Purpose: To compare the effectiveness of intracameral phenylephrine and topical mydriatics in achieving mydriasis and protecting against complications during phacoemulsification.

    Methods: A systematic search of the literature comparing the mydriatic effect and surgical safety profile of intracameral phenylephrine and topical mydriatics in phacoemulsification was conducted in the Medline, Embase, Lilacs, Web of Science, Cochrane, ClinicalTrials.gov , and Teseo databases. Read More

    Temozolomide treatment of a malignant pheochromocytoma and an unresectable MAX-related paraganglioma.
    Anticancer Drugs 2017 Nov 2. Epub 2017 Nov 2.
    Departments of Clinical and Experimental Oncology aFamilial Cancer Clinic and Oncoendocrinology bMedical Oncology 1 cImmunology and Molecular Oncology Unit dDepartment of Radiological Sciences and Medical Physics, Radiology Unit eDepartment of Medicine, Scientific Direction, Veneto Institute of Oncology IOV-IRCCS fDepartment of Surgery, Oncology and Gastroenterology, Endocrine Surgery Unit, University of Padua, Padua gOperative Unit of Endocrinology, Bentivoglio Hospital, Bologna, Italy.
    Pheochromocytomas (PCCs) and paragangliomas (PGLs) are neuroendocrine tumors with a strong genetic background. The mainstay of treatment for PCC/PGLs is surgery. However, for unresectable lesions, no curative treatment is currently available. Read More

    Clues for early detection of autoimmune Addison's disease - myths and realities.
    J Intern Med 2017 Nov 3. Epub 2017 Nov 3.
    Department of Clinical Medicine, University of Bergen, Bergen, Norway.
    Background: Early detection of autoimmune Addison's disease (AAD) is important as delay in diagnosis may result in a life-threatening adrenal crisis and death. The classical clinical picture of untreated AAD is well-described, but methodical investigations are scarce.

    Objective: Perform a retrospective audit of patient records with the aim of identifying biochemical markers for early diagnosis of AAD. Read More

    Ectopic Thyroid Tissue in the Adrenal Gland Mimicking a Pheochromocytoma.
    J Endourol Case Rep 2017 1;3(1):149-151. Epub 2017 Oct 1.
    Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
    Ectopic thyroid tissue in the adrenal gland (ETTAG) usually presents as a well-circumscribed cystic mass on a CT scan. However, the MRI features of ETTAG are incompletely understood. We report a case of ectopic thyroid tissue in the adrenal gland, which demonstrates findings similar to those of a pheochromocytoma on the MRI. Read More

    Simultaneous Bilateral Laparoscopic Adrenalectomy for Adrenal Metastases of Renal Cell Carcinoma: A Case Report.
    J Endourol Case Rep 2017 1;3(1):142-145. Epub 2017 Sep 1.
    Urology and Nephrology Research Center, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
    The possibility of bilateral adrenal gland metastasis from renal cell carcinoma (RCC) has been extremely rarely reported. Surgery may be the preferred treatment strategy for adrenal metastasis from RCC. In this article, we present a patient with bilateral large adrenal metastases from the left RCC, which was managed with simultaneous bilateral laparoscopic excision. Read More

    Malignant pheochromocytoma with multiple vertebral metastases causing acute incomplete paralysis during pregnancy: Literature review with one case report.
    Medicine (Baltimore) 2017 Nov;96(44):e8535
    aDepartment of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences bDepartment of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College cDepartment of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China dDepartment of Neurosurgery, Wayne State University School of Medicine, Detroit, MI.
    Rationale: We present a rare case of malignant pheochromocytoma with thoracic metastases during pregnancy that presented with symptoms of myelopathy and was treated with circumferential decompression, stabilization, and radiation. The management of this unique case is not well documented. The clinical manifestations, imaging results, pathological characteristics, treatment and prognosis of the case were analyzed. Read More

    Estradiol metabolites as biomarkers of endometrial cancer prognosis after surgery.
    J Steroid Biochem Mol Biol 2017 Oct 29. Epub 2017 Oct 29.
    Centre Hospitalier Universitaire de Québec (CHU de Québec) Research Center and Faculty of Pharmacy, Laval University, Québec, Canada; Canada Research Chair in Pharmacogenomics, Canada. Electronic address:
    Endometrial cancer (EC) is the most common gynecologic malignancy prevailing after menopause. Defining steroid profiles may help predict the risk of recurrence after hysterectomy, which remains limited due to the lack of reliable markers. Adrenal precursors, androgens, parent estrogens and catechol estrogen metabolites were measured by mass spectrometry (MS) in preoperative serums and those collected one month after hysterectomy from 246 newly diagnosed postmenopausal EC cases. Read More

    The Perspective of the Intensivist on Inotropes and Postoperative Care Following Pediatric Heart Surgery: An International Survey and Systematic Review of the Literature.
    World J Pediatr Congenit Heart Surg 2017 Jan 1:2150135117731725. Epub 2017 Jan 1.
    2 Department of Neonatal Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
    Introduction: Inotropes are frequently being used in children undergoing heart surgery to prevent or treat low cardiac output syndrome (LCOS). There is only limited evidence that inotropes actually positively influence postoperative outcome. Our aim was to describe the current international practice variation in the use of inotropes following congenital heart surgery. Read More

    Recurrent Hepatocellular Carcinoma in the Right Adrenal Gland 11 Years After Liver Transplantation for Hepatocellular Carcinoma: a Case Report and Literature Review.
    Indian J Surg 2017 Oct 17;79(5):450-454. Epub 2017 Aug 17.
    Istanbul Faculty of Medicine, Department of General Surgery, Istanbul University, Millet Caddesi Capa, Fatih, 34093 Istanbul, Turkey.
    Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver, and extrahepatic metastases are typically found during disease progression. The incidence of adrenal metastasis (AM) from HCC in autopsy series ranges from 4.6 to 12. Read More

    Continuous Posterior Lumbar Plexus Nerve Block Versus Periarticular Injection with Ropivacaine or Liposomal Bupivacaine for Total Hip Arthroplasty: A Three-Arm Randomized Clinical Trial.
    J Bone Joint Surg Am 2017 Nov;99(21):1836-1845
    1Departments of Anesthesiology (R.L.J., A.W.A., H.P.S., C.B.M., and S.L.K.), Orthopedic Surgery (M.P.A., T.M.M., and M.W.P.), and Health Sciences Research (D.R.S.), Mayo Clinic, Rochester, Minnesota.
    Background: Debate surrounds the issue of whether peripheral nerve blockade or periarticular infiltration (PAI) should be employed within a contemporary, comprehensive multimodal analgesia pathway for total hip arthroplasty. We hypothesized that patients treated with a continuous posterior lumbar plexus block (PNB) would report less pain and consume less opioid medication than those treated with PAI.

    Methods: This investigator-initiated, independently funded, 3-arm randomized clinical trial (RCT) performed at a single high-volume institution compared postoperative analgesia interventions for elective, unilateral primary total hip arthroplasty: (1) PNB; (2) PAI with ropivacaine, ketorolac, and epinephrine (PAI-R); and (3) PAI with liposomal bupivacaine, ketorolac, and epinephrine (PAI-L) using computerized randomization. Read More

    Adrenal ganglioneuroma: What you need to know.
    World J Clin Cases 2017 Oct;5(10):373-377
    Surgery Working Group, Society of Junior Doctors, 11852 Athens, Greece.
    Adrenal ganglioneuromas (GNs) constitute rare, differentiated tumors which originate from neural crest cells. GNs are usually hormonally silent and tend to be discovered incidentally on imaging tests. Adrenalectomy is the gold standard for the treatment of primary adrenal GNs. Read More

    Effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy.
    World J Gastroenterol 2017 Sep;23(36):6733-6740
    Department of Hepatobiliary Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.
    Aim: To prospectively evaluate the effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy.

    Methods: A total of 56 patients undergoing open hepatectomy were randomly divided into two groups: a ropivacaine group (wound infiltration with ropivacaine solution) and a control group (infiltration with isotonic saline solution). A visual analog scale (VAS) at rest and on movement was used to measure postoperative pain for the first 48 h after surgery. Read More

    Left Adrenal Tumor Disappeared Outside a Field of Vision During Laparoscopic Surgery: The True Identity Was Gastrointestinal Stromal Tumor.
    J Endourol Case Rep 2017 1;3(1):102-104. Epub 2017 Aug 1.
    Department of Urology, Shiga Medical Center for Adults, Moriyama, Japan.
    Background: We report a case of gastrointestinal stromal tumor (GIST) mimicking a left adrenal tumor. Case Presentation: A 62-year-old female was referred to our hospital for the treatment of left adrenal tumor of 2.8 × 2. Read More

    [Surgery versus conservative management for subclinical Cushing's syndrome in adrenal incidentalomas].
    Zhonghua Yi Xue Za Zhi 2017 Oct;97(40):3152-3157
    Department of Endocrinology, PLA Lanzhou General Hospital, Lanzhou 730030, China.
    Objective: To determine the effect of the surgical and conservative approaches on the metabolic profiles in patients with subclinical Cushing's syndrome (SCS) in adrenal incidentalomas (AI). Methods: A hundred and thirty AI patients with SCS in Department of Endocrinology, PLA General Hospital between January 2008 and December 2016 were studied, surgery was performed in 88 patients (surgical group), and the rest received conservative approach (conservative group). The improvement/worsening of blood pressure, blood glucose, lipid profiles and body weight after a duration of >18 months follow-up were analyzed, respectively. Read More

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