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Id: lil-757369
Autor: Delibasi, Tuncay; Karbek, Basak; Bozkurt, Nujen Colak; Cakir, Evrim; Gungunes, Askin; Ünsal, Ölknur Öztürk; Aslan, Muyesser Sayki; Cakal, Erman.
Título: Circulating E-selectin levels and insulin resistance are associated with early stages of atherosclerosis in nonfunctional adrenal incidentaloma
Fonte: Arch. endocrinol. metab. (Online);59(4):310-317, Aug. 2015. tab, ilus.
Idioma: en.
Resumo: Objective To evaluate circulating E-selectin levels in patients with nonfunctional adrenal incidentaloma (NFA) in relation to insulin resistance and early atherosclerosis.Subjects and methods A total of 40 patients with NFA (mean [SD] age: 55.6 [10.7] years; 70% were females) and 35 controls (mean [SD] age: 51.5 [8.1] years; 71.4% were females) selected from age-, gender- and body mass index (BMI)- matched healthy subjects were enrolled. Serum hsCRP, lipid profile, insulin levels and the homeostasis model assessment of insulin resistance (HOMA-IR) were evaluated. High-resolution B-mode ultrasonography was performed. Serum levels of E-selectin were evaluated by enzyme-linked immunosorbent assay.Results Patients with NFA had significantly higher values for E-selectin (14.9 (4.8) vs. 12.2 (4.1) ng/mL, p < 0.01) and CIMT (0.6 (0.1) vs. 0.5 (0.1) mm, p < 0.05) than controls. Serum E-selectin levels showed a statistically significant association with hsCRP (r = 0.751, p < 0.001), HOMA-IR (r = 0.575, p < 0.001) and CIMT (r = 0.762, p < 0.001). CIMT (Carotid intima media thickness) was increased in patients with NFA patients with NFA were more insulin resistant than controls and statistically significant relationship was found between size of tumor and HOMA-IR (r = 0.361, p < 0.001).Conclusion In conclusion, based on significantly higher values for E-selectin, CIMT and HOMA-IR in patients with NFA than controls along with significant correlation of E-selectin levels to CIMT, HOMA-IR and hs-CRP, our findings seems to indicate an increased risk of early atherosclerosis and impaired endothelial function in NFA patients, particularly in case of insulin resistance.
Descritores: Resistência à Insulina
Neoplasias das Glândulas Suprarrenais/sangue
Selectina E/sangue
Aterosclerose/sangue
Espessura Intima-Media Carotídea
-Proteína C-Reativa/análise
Ensaio de Imunoadsorção Enzimática
Biomarcadores/sangue
Estudos de Casos e Controles
Neoplasias das Glândulas Suprarrenais/complicações
Diagnóstico Precoce
Aterosclerose/etiologia
Aterosclerose/patologia
Homeostase
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


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Id: biblio-915204
Autor: Olmos, Roberto; Gutiérrez, Javiera; Guarda, Francisco; Allende, Fidel; Huete, Álvaro; San Francisco, Ignacio; Baudrand, René.
Título: ¿Como optimizar el diagnóstico funcional de los incidentalomas suprrarenales? Importancia de un estudio protocolizado / How to optimize the functional diagnosis of suprarenal incidenta- lomas? Importance of a protocolized study
Fonte: Rev. chil. endocrinol. diabetes;11(3):108-113, jul. 2018. ilus.
Idioma: es.
Resumo: Adrenal incidentalomas are an increasingly common pathology. Although historically they have been considered largely non-functioning, recent evidence suggests that the usually performed study is incomplete and/or not sensitive enough. In the last decade the clinical spectrum of adrenal hypercortisolism has expanded considerably, including milder cases which are also associated with cardiovascular morbidity and even mortality. Furthermore, primary aldosteronism has also expanded beyond the classic phenotype with advanced vascular damage, resistant hypertension and hypokalemia, currently including asymptomatic, normotensive and normokalemic patients. For this reason, a correct protocolized study is essential in all adrenal incidentalomas, including a precise radiological characterization, as well as a systematic hormonal evaluation using more sensitive cut points. The findings of this workup are relevant, because they allow a more individualized approach to the medical and surgical management of these patients.

Los incidentalomas suprarrenales son una patología cada vez más frecuente. Si bien históricamente han sido considerados no funcionantes en su gran mayoría, evidencia reciente sugiere que el estudio habitual es incompleto y/o poco sensible. En la última década el espectro clínico del hipercortisolismo de origen adrenal se ha ampliado de forma considerable, incluyendo casos leves que también se asocian a morbilidad cardiovascular e incluso mortalidad. Por otro lado, el hiperaldosteronismo primario también ha expandido su fenotipo más allá del clásicamente descrito con daño vascular avanzado, hipertensión resistente e hipokalemia, abarcando en la actualidad a pacientes asintomáticos, normotensos y normokalemicos. Por esta razón es imprescindible un correcto estudio protocolizado en todo incidentaloma suprarrenal, incluyendo una precisa caracterización radiológica, así como una evaluación hormonal sistemática utilizando puntos de corte más sensibles. Los hallazgos de este estudio son relevantes, pues permiten guiar de forma más individualizada el manejo médico y quirúrgico de estos pacientes.
Descritores: Neoplasias das Glândulas Suprarrenais/diagnóstico
Neoplasias das Glândulas Suprarrenais
Achados Incidentais
-Hidrocortisona
Neoplasias das Glândulas Suprarrenais/terapia
Aldosterona
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-887599
Autor: Kavinga Gunawardane, P T; Grossman, Ashley.
Título: The clinical genetics of phaeochromocytoma and paraganglioma
Fonte: Arch. endocrinol. metab. (Online);61(5):490-500, Sept.-Oct. 2017. tab, graf.
Idioma: en.
Resumo: ABSTRACT Phaeochromocytoma and paraganglioma are rare catecholamine-producing tumours, recognised to have one of the richest hereditary backgrounds of all neoplasms, with germline mutations seen in approximately 30% of patients. They can be a part of genetic syndromes such as MEN 2 or Neurofibromatosis type 1, or can be found as apparently sporadic tumours. Germline mutations are almost always found in syndromic patients. Nonetheless, apparently sporadic phaeochromocytoma too show high germline mutation rates. Early detection of a genetic mutation can lead to early diagnosis of further tumours via surveillance, early treatment and better prognosis. Apart from this, the genetic profile has important relevance for tumour location and biochemical profile, and can be a useful predictor of future tumour behaviour. It also enables family screening and surveillance. Moreover, recent studies have demonstrated significant driver somatic mutations in up to 75% of all tumours. Arch Endocrinol Metab. 2017;61(5):490-500
Descritores: Paraganglioma/genética
Feocromocitoma/genética
Neoplasias das Glândulas Suprarrenais/genética
Mutação em Linhagem Germinativa/genética
Limites: Humanos
Tipo de Publ: Revisão
Responsável: BR1.1 - BIREME


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Id: biblio-887643
Autor: Andrade, Matheus de Oliveira; Cunha, Vinícius Santos da; Oliveira, Dayana Carla de; Moraes, Olívia Laquis de; Lofrano-Porto, Adriana.
Título: What determines mortality in malignant pheochromocytoma? - Report of a case with eighteen-year survival and review of the literature
Fonte: Arch. endocrinol. metab. (Online);62(2):264-269, Mar.-Apr. 2018. tab, graf.
Idioma: en.
Resumo: SUMMARY Pheochromocytoma (PCC) is a tumor derived from adrenomedullary chromaffin cells. Prognosis of malignant PCC is generally poor due to local recurrence or metastasis. We aim to report a case of malignant PCC with 18-year survival and discuss which factors may be related to mortality and long-term survival in malignant pheochromocytoma. The patient, a 45-year-old man, reported sustained arterial hypertension with paroxysmal episodes of tachycardia, associated with head and neck burning sensation, and hand and foot tremors. Diagnosis of PCC was established biochemically and a tumor with infiltration of renal parenchyma was resected. No genetic mutation or copy number variations were identified in SDHB, SDHD, SDHC, MAX and VHL. Over 18 years, tumor progression was managed with 131I-MIBG (iodine-metaiodobenzylguanidine) and 177Lutetium-octreotate therapy. Currently, the patient is asymptomatic and presents sustained stable disease, despite the presence of lung, para-aortic lymph nodes and femoral metastases. Adequate response to treatment with control of tumor progression, absence of significant cardiovascular events and other neoplasms, and lack of mutations in the main predisposing genes reported so far may be factors possibly associated with the prolonged survival in this case. Early diagnosis and life-long follow-up in patients with malignant pheochromocytoma are known to be crucial in improving survival.
Descritores: Feocromocitoma/mortalidade
Neoplasias das Glândulas Suprarrenais/mortalidade
-Feocromocitoma/genética
Feocromocitoma/diagnóstico por imagem
Prognóstico
Fatores de Tempo
Tomografia Computadorizada de Emissão de Fóton Único
Neoplasias das Glândulas Suprarrenais/genética
Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem
Progressão da Doença
Sobrevivência
Mutação
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Revisão
Responsável: BR1.1 - BIREME


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Id: biblio-970828
Autor: Cordero A, Francisco; Pineda B, Pedro.
Título: Incidentalomas endocrinos, más que una imagen / Endocrine incidentalomas, more than an image
Fonte: Rev. Hosp. Clin. Univ. Chile;28(3):237-244, 20170000. ilus, tab.
Idioma: es.
Resumo: Endocrine incidentalomas are nodular lesions located in endocrine glands, diagnosed serendipitously by different image techniques requested for non-endocrine reasons. They can be located in many sites, but this review describes those that compromise pituitary, adrenal and thyroid gland. The main diagnostic challenges of endocrine incidentalomas are discrimination between benign and malignant lesions, and their functional or non-functional endocrine activity. The relevance of adequate image interpretation and associated hormonal study is discussed. (AU)
Descritores: Neoplasias Hipofisárias/diagnóstico por imagem
Neoplasias da Glândula Tireoide/diagnóstico por imagem
Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem
-Achados Incidentais
Limites: Humanos
Masculino
Feminino
Tipo de Publ: Revisão
Responsável: CL36.1 - Biblioteca Hospital Clínico


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Id: biblio-1019359
Autor: Gómez, Ana Milena; Soares, Diogo Cordeiro; Costa, Alexandre André Balieiro; Pereira, Daniele Paixão; Achatz, Maria Isabel; Formiga, Maria Nirvana.
Título: Pheochromocytoma and paraganglioma: implications of germline mutation investigation for treatment, screening, and surveillance
Fonte: Arch. endocrinol. metab. (Online);63(4):369-375, July-Aug. 2019. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective Paraganglioma (PGL) and pheochromocytoma (PCC) are rare neuroendocrine tumors that were considered to be predominantly sporadic. However, with the identification of novel susceptibility genes over the last decade, it is currently estimated that up to 40% of cases can occur in the context of a hereditary syndrome. We aimed to characterize PGL/PCC families to exemplify the different scenarios in which hereditary syndromes can be suspected and to emphasize the importance for patients and their families of making an opportune genetic diagnosis. Materials and methods Retrospective analysis of patients diagnosed with PGL/PCC. Germline mutations were studied using next-generation sequencing panels including SDHA, SDHB, SDHC and SDHD. Clinical data were collected from clinical records, and all patients received genetic counseling. Results We describe 4 families with PGL/PCC and germline mutations in SDH complex genes. 2 families have SDHB mutations and 2 SDHD mutations. The clinical presentation of the patients and their families was heterogeneous, with some being atypical according to the literature. Conclusions PGL/PCC are more commonly associated with a germline mutation than any other cancer type, therefore, all individuals with these types of tumors should undergo genetic risk evaluation. NGS multigene panel testing is a cost-effective approach given the overlapping phenotypes. Individuals with germline mutations associated with PGL/PCC should undergo lifelong clinical, biochemical and imaging surveillance and their families should undergo genetic counseling. For all these reasons, it is critical that all medical staff can suspect and diagnose these inherited cancer predisposition syndromes.
Descritores: Paraganglioma/genética
Feocromocitoma/genética
Neoplasias das Glândulas Suprarrenais/genética
Mutação em Linhagem Germinativa/genética
-Linhagem
Testes Genéticos/métodos
Estudos Retrospectivos
Vigilância de Evento Sentinela
Predisposição Genética para Doença
Limites: Humanos
Masculino
Feminino
Responsável: BR1.1 - BIREME


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Id: biblio-1038509
Autor: Ventura, Mara; Melo, Miguel; Carrilho, Francisco.
Título: Outcome and long-term follow-up of adrenal lesions in multiple endocrine neoplasia type 1
Fonte: Arch. endocrinol. metab. (Online);63(5):516-523, Sept.-Oct. 2019. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective To describe the prevalence, clinical characteristics and outcome of adrenal lesions in long-term follow-up of Multiple endocrine neoplasia type 1 (MEN1) patients. Subjects and methods We retrospectively studied sixteen patients from six families of individuals with MEN1. Adrenal involvement was evaluated using clinical, biochemical and imaging data. Results Adrenal lesions were identified in nine of sixteen (56.3%) patients: seven women and two men (mean age: 52.2 years). Adrenal involvement was detected at MEN1 diagnosis in more than half of the patients. Eighteen adrenal nodules were founded (median of two nodules per patient) with mean adrenal lesion diameter of 17.4 mm. Three patients had unilateral adrenal involvement. Hormonal hypersecretion (autonomous cortisol secretion) was found in two patients. None of the patients was submitted to adrenalectomy, presented an aldosterone-secreting lesion, a pheochromocytoma, an adrenal carcinoma or metastatic disease during the follow-up. A predominance of stable adrenal disease, in terms of size and hormonal secretion, was observed. Adrenal lesions were evenly distributed between the germline mutations. Conclusion Adrenal tumours are a common feature of MEN1 that can affect more than half of the patients. Most of the tumours are bilateral non-functional lesions, but hormonal secretion may occur and should be promptly identified to reduce the morbidity/mortality of the syndrome. Periodic surveillance of these patients should be performed.
Descritores: Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem
Neoplasia Endócrina Múltipla Tipo 1/diagnóstico por imagem
-Estudos Retrospectivos
Seguimentos
Neoplasias das Glândulas Suprarrenais/genética
Neoplasia Endócrina Múltipla Tipo 1/genética
Limites: Humanos
Masculino
Feminino
Criança
Adolescente
Adulto
Pessoa de Meia-Idade
Idoso
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: lil-289397
Autor: Robledo, Hernán; Kometter, Fritz; Tan, Jesús; Melendez, Rosa; Salsavilca, Elizabeth; De las Casas, Isabel; Millones, Bernardo.
Título: Adenoma Suprarrenal con ACTH en valores normales, resección por vía laparoscópica. A proposito de un caso / Laparoscopic surgery in a case of Non-ACTH-Hyposecretion Adrenal Adenoma
Fonte: An. Fac. Med. (Perú);62(2):151-5, 2001.
Idioma: es; en.
Resumo: Se presenta un caso de síndrome de Cushing por adenoma suprarrenal con niveles no suprimidos de ACTH, el cual fue intervenido con éxito por vía laparoscópica. El seguimiento ha sido de 2 años comprobándose en este tiempo normalidad y bioquímica
Descritores: Patologia
Laparoscopia
Neoplasias das Glândulas Suprarrenais
Glândulas Suprarrenais
Síndrome de Cushing
Limites: Humanos
Responsável: PE13.1 - Oficina de Biblioteca, Hemeroteca y Centro de Documentación


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Id: lil-83001
Autor: Acosta Seal, Carlos M.
Título: Adrenalectomia por feocromocitoma: revisión y reporte de casos / Adrenalectomy due to pheochromocytoma: review and report of cases
Fonte: Diagnóstico (Perú);23(1/3):26-30, ene.-mar. 1989. tab.
Idioma: es.
Resumo: Adrenalectomía por Feocromocitoma es la condición clínico quirúrgica que respecto a Anestesiología mide la pericia del personal en cuanto a manejo clínico, farmacológico y de monitoreo. En los dos casos reportados se siguieron pautas semejantes de manejo. en cuanto a premedicación se empleó terapia ansiolítica pesada a base de Diazepám además de drogas bloqueadoras alfa y beta, buscando la desactivación del eje simpático adrenérgico en forma parcial, en la inducción se continuó con benzodiazepinas agregando esta vez Flunitrazepám, complementadas con Fentanest. Para la intubación se utilizó Vecuronio como relajante muscular con resultados óptimos, el mantenimiento fue a base de Fentanest y Oxido Nitroso, los medicamentos vasoactivos empleados fueron NTP y Dopamina, los antiarrítmicos Lidocaina y Verapamil, las reposiciones de líquidos (cristaloides y coloides) fueron en forma racional sólo a demanda, el monitoreo fue prolijo, las complicaciones presentadas a consecuencia tanto de las descargas catecolaminicas previas a la extirpación del tumor (Crisis HTA y Arritmias Cardiacas) así como las hipotensivas luego de resecado este, fueron fácilmente controladas mediante el empleo de drogas y líquidos antes citados. Los tiempos quirúrgicos no fueron perturbados durante el manejo anestesiológico y la calidad del campo respecto a relajación fue bueno, referido esto por el equipo de cirujanos. Respecto al post operatorio inmediato como mediato fue satisfactorio. Por lo tanto pensamos que el esquema de manejo planteado en los presentes casos es una alternativa bastante seria en el manejo de futuros casos de Adrenalectomía para Feocromocitoma. Se deja abierta la espectativa de ampliar la presente casuística en el futuro, con nuevos casos
Descritores: Neoplasias das Glândulas Suprarrenais
Hipertensão Maligna/terapia
Limites: Humanos
Adulto
Pessoa de Meia-Idade
Masculino
Feminino
Tipo de Publ: Relatos de Casos
Estudo Comparativo
Responsável: PE1.1 - Oficina Universitária de Biblioteca


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Id: lil-54420
Autor: Barboza B., E; Castillo Y., M. del; Silicani D., A; Dulanto, J; Seclén S., S; Fisfalen, E; Agusti C., R; Choy, E; Escalante, H.
Título: Feocromocitoma: tratamiento médico-quirurgico / Pheochromocytoma: medical-surgical treatment
Fonte: Cir. rev. Soc. Cir. Perú;2(1):15-8, ene.-abr. 1985. ilus, tab.
Idioma: es.
Resumo: Se presenta el caso de una paciente de 37 años que consultó por crisis hipertensiva e hiperglicemia, habiéndose sospechado desde un inicio el diagnóstico de Feocromocitoma el cual fue corroborado por pruebas bioquímicas y tomográficas. Luego de un tratamiento pre operatorio fundamentalmente a base de Fenoxibenzamina, la paciente fue intervenida quirúrgicamente extirpándose dicha tumoración que correspondió anatomo patológicamente a Feocromocitoma de la glándula suprarenal derecha. La evolución post-operatoria fue satisfactoria habiendo sido controlada por espacio de 1 año. Se discuten los diferentes aspectos relacionados al diagnóstico y manejo tanto médico como quirúrgico enfatizándose el trabajo en conjunto por los diferentes especialistas involucrados en el manejo de estos enfermos
Descritores: Feocromocitoma/cirurgia
Neoplasias das Glândulas Suprarrenais
-Peru
Cuidados Pós-Operatórios
Cuidados Pré-Operatórios
Cuidados Intraoperatórios
Limites: Adulto
Humanos
Feminino
Tipo de Publ: Relatos de Casos
Responsável: PE1.1 - Oficina Universitária de Biblioteca



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