Laparoscopic Bilateral Transperitoneal Adrenalectomy For Cushing Syndrome

Posted on July 16, 2013 by MaryO

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 07/16/2013  Clinical Article

Aggarwal S et al. –

Laparoscopic adrenalectomy is well established for treatment of adrenal lesions. However, bilateral adrenalectomy for Cushing syndrome is a challenging and time–consuming operation.

The authors report their experience of laparoscopic bilateral adrenalectomy for this disease in 19 patients. Laparoscopic bilateral adrenalectomy for Cushing syndrome is feasible and safe. It confers all the advantages of minimally invasive approach such as less postoperative pain, shorter hospitalization, lesser wound complications, and faster recovery.

The advantages of the laparoscopic approach have led to an earlier referral for bilateral adrenalectomy by endocrinologist in patients with failed pituitary surgery.

 

This article is available on PubMed

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Doctor’s Notes: Part 2, Adrenal

Posted on July 6, 2013 by MaryO
The adrenal glands sit atop the kidneys.

The adrenal glands sit atop the kidneys. (Photo credit: Wikipedia)

Acronyms or abbreviations for “Adrenal”

AD: adrenal vein
AG: adrenal gland
AdNA: adrenal gland
AC: adrenal cortex
adc: adrenal cortex
ADM: adrenal medulla
AA: adrenal adenoma
AF: adrenal failure
AM: adrenal medulla
AA: adrenal androgen
PA: pituitary-adrenal
AA: adrenal androgens
AAs: adrenal androgens
AM: adrenal medullary
LAV: left adrenal vein
AH: adrenal hypoplasia
AH: adrenal hemorrhage
AE: adrenal enucleation
AG: adrenal glomerulosa
AH: adrenal hyperplasia
HFA: human fetal adrenal
BAC: bovine adrenal cells
ADM: adrenal demedullation
AI: adrenal incidentaloma
AI: adrenal insufficiency
AVS: adrenal vein sampling
AI: adrenal incidentalomas
BAM: Bovine Adrenal Medulla
PAA: pituitary-adrenal axis
AMQD: Adrenal Move Quick Draw
AVS: Adrenal venous sampling
ach: adrenal cortical hormone
ACCs: adrenal chromaffin cells
AZF: adrenal zona fasciculata
BAM: Bovine adrenal medullary
PAL: Primary adrenal lymphoma
Ad4BP: Adrenal 4-binding protein
BAC: bovine adrenal chromaffin
ACC: adrenal cortical carcinoma
acca: adrenal cortical carcinoma
BAG: bovine adrenal glomerulosa
SAM: sympatho-adrenal-medullary
NAH: neonatal adrenal hemorrhage
PAH: primary adrenal hyperplasia
AHC: adrenal hypoplasia congenita
ACA: adrenal cortex autoantibodies
ACTH: adrenal corticotropic hormone
BAH: bilateral adrenal hyperplasia
CAH: congenital adrenal hypoplasia
HPA: hypothalamo-pituitary-adrenal
PAI: primary adrenal insufficiency
SAM: sympathetic-adrenal medullary
cah: congenital adrenal hyperplasia
HPA: hypothalamic-pituitary-adrenal
IAH: idiopathic adrenal hyperplasia
ACTH: adrenal corticotrophic hormone
ahc: adrenal hypoplasia, congenital
BAMC: bovine adrenal medullary cells
H-P-A: hypothalamic-pituitary-adrenal
HPA: hypothalamic-adrenal-pituitary
HPA: hypothalamus-pituitary-adrenal
HPAA: hypothalamic-pituitary-adrenal
IHA: idiopathic adrenal hyperplasia
LOAH: late-onset adrenal hyperplasia
NCAH: nonclassic adrenal hyperplasia
UAH: unilateral adrenal hyperplasia
BACC: bovine adrenal chromaffin cells
BACCs: bovine adrenal chromaffin cells
BCC: Bovine adrenal chromaffin cells
CAH: congenital adrenal hyperplasias
HHA: hypothalamo-hypophyseal-adrenal
BAC: bovine adrenal fasciculata cells
ARH: adrenal regeneration hypertension
HPAA: hypothalamo-pituitary-adrenal axis
ASNA: adrenal sympathetic nerve activity
HPA: hypothalamo-pituitary-adrenal axis
BAMC: bovine adrenal medullary chromaffin
FAH: Functional adrenal hyperandrogenism
HPA: hypothalamic-pituitary-adrenal axis
HPA-axis: hypothalamic-pituitary-adrenal axis
HPAA: hypothalamic-pituitary-adrenal axis
HPAA: hypothalamus-pituitary-adrenal axis
AASH: adrenal androgen stimulating hormone
BAME: bovine adrenal medullary endothelial
HPA: hypothalamus-pituitary-adrenal gland
NADF: National Adrenal Diseases Foundation
PAMC: porcine adrenal medullary chromaffin
CLAH: congenital lipoid adrenal hyperplasia
APA: aldosterone-producing adrenal adenoma
HPA: hypothalamic-pituitary-adrenal system
HPAT: hypothalamus-pituitary-adrenal-thymus
LHPA: limbic-hypothalamic-pituitary-adrenal
PCAI: primary chronic adrenal insufficiency
HHAS: hypothalamo-hypophyseal-adrenal system
HPA: hypothalamo-pituitary-adrenal cortical
HPA: hypothalamic-pituitary-adrenal cortical
RAMEC: rat adrenal medullary endothelial cells
CVAH: congenital virilizing adrenal hyperplasia
CAH: congenital virilizing adrenal hyperplasia
LOCAH: late-onset congenital adrenal hyperplasia
LHPA: limbic-hypothalamic-pituitary-adrenal axis
NC-CAH: non-classical congenital adrenal hyperplasia
AIMAH: ACTH-independent bilateral macronodular adrenal
pre-ASNA: preganglionic adrenal sympathetic nerve activity
AIMAH: ACTH-independent macronodular adrenal hyperplasia
CAHSA: Congenital Adrenal Hyperplasia Support Association
AIMAH: ACTH-independent bilateral macronodular adrenal hyperplasia

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Looking at your Doctor’s Notes?

Posted on July 6, 2013 by MaryO
The anterior pituitary is the anterior, glandu...

The anterior pituitary is the anterior, glandular lobe of the pituitary gland. (Photo credit: Wikipedia)

Acronyms or abbreviations for “Pituitary”

PIT: pituitary
P: Pituitary
PI: pituitary
PT: pituitary
PG: pituitary gland
PIT: pituitary gland
PS: pituitary stalk
NP: normal pituitary
PT: pituitary tumors
PV: pituitary venous
SP: sellar pituitary
PA: pituitary-adrenal
PA: pituitary adenoma
PEX: Pituitary Extract
ap: anterior pituitary
PA: pituitary adenomas
PA: pituitary apoplexy
PAs: pituitary adenomas
PP: posterior pituitary
oPRL: ovine pituitary PRL
phTSH: pituitary human TSH
Pitx1: pituitary homeobox 1
Ptx1: pituitary homeobox 1
BPG: brain-pituitary-gonad
HP: hypothalamo-pituitary
H-P: hypothalamic-pituitary
HP: hypothalamic-pituitary
HP: hypothalamus/pituitary
PAA: pituitary-adrenal axis
A.P.L.: anterior pituitary like
AP: anterior pituitary lobe
pgh: pituitary growth hormone
AP: anterior pituitary gland
APG: anterior pituitary gland
BPE: bovine pituitary extract
EPE: equine pituitary extract
PA: pituitary-adrenocortical
PP: posterior pituitary lobe
AP: Anterior pituitary glands

Filed under: pituitary | Tagged: , , , , , , , , , | 2 Comments »

Approach to testing growth hormone (GH) secretion in obese subjects.

Posted on July 5, 2013 by MaryO

Source

Faculty of Medicine, University of Belgrade, Department of Neuroendocrinology, Clinical Center Serbia, Dr Subotic 13, 11000 Belgrade, Serbia. popver@eunet.rs

Abstract

Identification of adults with GH deficiency (GHD) is challenging because clinical features of adult GHD are not distinctive and because clinical suspicion must be confirmed by biochemical tests.

Adults are selected for testing for adult GHD if they have a high pretest probability of GHD, ie, if they have hypothalamic-pituitary disease, if they have received cranial irradiation or central nervous system tumor treatment, or if they survived traumatic brain injury or subarachnoid hemorrhage.

Testing should only be carried out if a decision has already been made that if deficiency is found it will be treated. There are many pharmacological GH stimulation tests for the diagnosis of GHD; however, none fulfill the requirements for an ideal test having high discriminatory power; being reproducible, safe, convenient, and economical; and not being dependent on confounding factors such as age, gender, nutritional status, and in particular obesity.

In obesity, GH secretion is reduced, GH clearance is enhanced, and stimulated GH secretion is reduced, causing a false-positive result. This functional hyposomatotropism in obesity is fully reversed by weight loss. In conclusion, GH stimulation tests should be avoided in obese subjects with very low pretest probability.

PMID:
23650336
[PubMed – in process]

J Clin Endocrinol Metab. 2013 May;98(5):1789-96. doi: 10.1210/jc.2013-1099.

From http://www.ncbi.nlm.nih.gov/pubmed/23650336

Filed under: Cushing's, pituitary, Rare Diseases | Tagged: , , , , , , , , , , , | Leave a comment »

Pregnancy and pituitary disorders

Posted on June 29, 2013 by MaryO
Pituitary and pineal glands

Pituitary and pineal glands (Photo credit: Wikipedia)

Z Karaca, F Tanriverdi, K Unluhizarci and F Kelestimur
+ Author Affiliations

Department of Endocrinology,
Erciyes University Medical School, 38039 Kayseri, Turkey
(Correspondence should be addressed to F Kelestimur; Email: fktimur@erciyes.edu.tr)

Abstract

Major hormonal changes emerge during pregnancy. The pituitary gland is one of the most affected organs with altered anatomy and physiology. The pituitary gland is enlarged as a result of lactotroph hyperplasia. Due to physiological changes in the pituitary and target hormone levels, binding globulins, and placental hormones, hormonal evaluation becomes more complex in pregnant women. As a consequence of physiological hormonal changes, the evaluation of pituitary functions in pregnant women is quite different from that done in the prepregnant state. Pituitary adenomas may cause problems by their hormone secretion that affects the mother and the fetus besides causing an increased risk of tumor growth.

Furthermore, diagnosis, course, and treatment of pituitary diseases point out differences. The changes in anatomy and physiology of the pituitary gland during pregnancy are reviewed.

Pituitary disorders namely Cushing’s disease; acromegaly; prolactinoma; TSH-secreting, gonadotropin-producing, and clinically nonfunctioning adenomas; craniopharyngioma; and Sheehan’s syndrome, which is one of the most common causes of hypopituitarism, lymphocytic hypophysitis, and hypopituitarism, in relation to pregnancy are discussed. Being aware of all this information will prevent any serious problems which mother and child will be exposed to.

Read the entire article here: http://www.eje-online.org/content/162/3/453.full

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Filed under: Cushing's, pituitary, Rare Diseases | Tagged: , , , , , , , , , , , , , , , | Leave a comment »

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