Subject(s)
Adenoma, Oxyphilic , Adrenal Cortex Neoplasms , Humans , Adenoma, Oxyphilic/pathology , Adenoma, Oxyphilic/diagnosis , Adenoma, Oxyphilic/diagnostic imaging , Adrenal Cortex Neoplasms/diagnosis , Adrenal Cortex Neoplasms/pathology , Adrenal Cortex Neoplasms/complications , Female , Middle Aged , Male , Aged , AdultSubject(s)
Humans , Male , Young Adult , Kallmann Syndrome/drug therapy , Gonadotropins/administration & dosage , PubertySubject(s)
Hypogonadism , Kallmann Syndrome , Male , Humans , Adult , Kallmann Syndrome/complications , GonadotropinsABSTRACT
OBJECTIVE: Hyperintensity signal in T2-weighted magnetic resonance imaging (MRI) has been related to better therapeutic response during pasireotide treatment in acromegaly. The aim of the study was to evaluate T2 MRI signal intensity and its relation with pasireotide therapeutic effectiveness in real-life clinical practice. DESIGN, PATIENTS AND MEASUREMENTS: Retrospective multicentre study including acromegaly patients treated with pasireotide. Adenoma T2-weighted MRI signal at diagnosis was qualitatively classified as iso-hyperintense or hypointense. Insulin-like growth factor (IGF-I), growth hormone (GH) and tumour volume reduction were assessed after 6 and 12 months of treatment and its effectiveness evaluated according to baseline MRI signal. Hormonal response was considered 'complete' when normalization of IGF-I levels was achieved. Significant tumour shrinkage was defined as a volume reduction of ≥25% from baseline. RESULTS: Eighty-one patients were included (48% women, 50 ± 1.5 years); 93% had previously received somatostatin receptor ligands (SRLs) treatment. MRI signal was hypointense in 25 (31%) and hyperintense in 56 (69%) cases. At 12 months of follow-up, 42/73 cases (58%) showed normalization of IGF-I and 37% both GH and IGF-I. MRI signal intensity was not associated with hormonal control. 19/51 cases (37%) presented a significant tumour volume shrinkage, 16 (41%) from the hyperintense group and 3 (25%) from the hypointense. CONCLUSIONS: T2-signal hyperintensity was more frequently observed in pasireotide treated patients. Almost 60% of SRLs resistant patients showed a complete normalization of IGF-I after 1 year of pasireotide treatment, regardless of the MRI signal. There was also no difference in the percentage tumour shrinkage over basal residual volume between the two groups.
Subject(s)
Acromegaly , Adenoma , Human Growth Hormone , Humans , Female , Male , Acromegaly/drug therapy , Acromegaly/diagnosis , Insulin-Like Growth Factor I/metabolism , Adenoma/complications , Adenoma/diagnostic imaging , Adenoma/drug therapy , Human Growth Hormone/therapeutic use , Magnetic Resonance Imaging/methods , Treatment Outcome , Octreotide/therapeutic useSubject(s)
ACTH-Secreting Pituitary Adenoma , Adenoma , Pituitary Neoplasms , Adenoma/diagnosis , HumansSubject(s)
Adrenal Insufficiency/etiology , Adrenoleukodystrophy/diagnosis , ATP Binding Cassette Transporter, Subfamily D, Member 1/genetics , Adrenoleukodystrophy/complications , Adrenoleukodystrophy/genetics , Adult , Delayed Diagnosis , Dopamine Plasma Membrane Transport Proteins/analysis , Dyslipidemias/complications , Female , Genetic Carrier Screening , Genetic Counseling , Humans , Iodine Radioisotopes , Male , Middle Aged , Nortropanes , Parkinson Disease/complications , Parkinson Disease/diagnostic imaging , Point Mutation , Positron-Emission Tomography , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Adrenal Insufficiency/complications , Adrenal Insufficiency/genetics , Adrenoleukodystrophy/diagnosis , Adrenoleukodystrophy/genetics , X Chromosome/genetics , Hydrocortisone/therapeutic use , Aldosterone/analysis , Adrenal Glands/diagnostic imagingABSTRACT
No disponible
Subject(s)
Humans , Sulfonylurea Compounds/therapeutic use , Insulin/therapeutic use , Diabetes Mellitus, Type 1/classification , Infant, Newborn, DiseasesSubject(s)
Cysts/complications , Hypercalcemia/etiology , Hyperparathyroidism, Primary/etiology , Parathyroid Neoplasms/complications , Bone Density Conservation Agents/therapeutic use , Bone Diseases, Metabolic/drug therapy , Bone Diseases, Metabolic/etiology , Calcitonin/therapeutic use , Colectomy , Colonic Diseases/etiology , Colonic Diseases/surgery , Consciousness Disorders/etiology , Cysts/diagnosis , Cysts/surgery , Diagnostic Imaging , Diphosphonates/therapeutic use , Emergencies , Female , Furosemide/therapeutic use , Humans , Imidazoles/therapeutic use , Intestinal Perforation/etiology , Intestinal Perforation/surgery , Kidney Calculi/etiology , Middle Aged , Parathyroid Hormone/analysis , Parathyroid Neoplasms/diagnosis , Parathyroid Neoplasms/surgery , Parathyroidectomy , Thyroidectomy/methods , Zoledronic AcidABSTRACT
INTRODUCTION: Fine-needle aspiration biopsy (FNAB) is considered the reference diagnostic procedure for thyroid nodules. MATERIALS AND METHODS: Routine performance of thyroid ultrasound and ultrasound-guided FNAB by endocrinologists allows a more efficient approach in the setting of a high-resolution practice, thus reducing costs and the time elapsed until diagnosis. RESULTS: We present our initial results of this procedure 2 years after its introduction, with a total of 286 biopsies performed. After a progressive learning curve over time and according to the endocrinologists' previous experience, 72.72% samples were considered satisfactory for diagnosis. Greater difficulty was observed in obtaining optimal cytological specimens in smaller nodules. In conclusion, we have successfully incorporated thyroid ultrasound and ultrasound-guided FNAB into routine endocrine practice. CONCLUSION: Routine performance of thyroid ultrasound in endocrine practice will considerably aid the management of nodular thyroid disease.
Subject(s)
Biopsy, Fine-Needle , Thyroid Diseases/pathology , Thyroid Neoplasms/pathology , Ultrasonography, Interventional , Adenocarcinoma, Follicular/diagnostic imaging , Adenocarcinoma, Follicular/epidemiology , Adenocarcinoma, Follicular/pathology , Adenoma/diagnostic imaging , Adenoma/epidemiology , Adenoma/pathology , Adult , Biopsy, Fine-Needle/adverse effects , Biopsy, Fine-Needle/methods , Biopsy, Fine-Needle/statistics & numerical data , Carcinoma, Papillary/diagnostic imaging , Carcinoma, Papillary/epidemiology , Carcinoma, Papillary/pathology , Cysts/diagnostic imaging , Cysts/epidemiology , Cysts/pathology , Endocrinology/organization & administration , Female , Goiter, Nodular/diagnostic imaging , Goiter, Nodular/pathology , Hematoma/etiology , Hospital Departments , Hospitals, University/organization & administration , Humans , Lymphoma, Non-Hodgkin/diagnostic imaging , Lymphoma, Non-Hodgkin/epidemiology , Lymphoma, Non-Hodgkin/pathology , Male , Pregnancy , Pregnancy Complications/diagnostic imaging , Pregnancy Complications/pathology , Spain/epidemiology , Syncope, Vasovagal/etiology , Thyroid Diseases/diagnostic imaging , Thyroid Neoplasms/diagnostic imaging , Thyroid Neoplasms/epidemiology , Ultrasonography, Interventional/statistics & numerical dataABSTRACT
Introducción La PAAF es el procedimiento de referencia para el diagnóstico del nódulo tiroideo. Material y métodos La incorporación de la ecografía cervical y la PAAF guiada por ecografía a la actividad del médico endocrinólogo permite abordar esta patología en el ámbito de una consulta de alta resolución, con la consiguiente reducción en el coste del proceso y en la demora del diagnóstico. Resultados Presentamos los resultados iniciales de esta consulta; tras los dos primeros años y con un total de 286 punciones, nos situamos en un 72,72% de citologías aptas para diagnóstico, siguiendo una curva de aprendizaje acorde con el tiempo transcurrido y con la experiencia previa. Observamos una mayor dificultad en la obtención de citologías óptimas para diagnóstico en los nódulos de menor tamaño. En resumen, hemos incorporado la ecografía y la PAAF guiada por ecografía de manera satisfactoria a la consulta endocrinológica. Conclusión El uso de manera rutinaria de la ecografía en la consulta de endocrinología permite agilizar el manejo de la patología nodular tiroidea (AU)
Introduction Fine-needle aspiration biopsy (FNAB) is considered the reference diagnostic procedure for thyroid nodules. Materials and methods Routine performance of thyroid ultrasound and ultrasound-guided FNAB by endocrinologists allows a more efficient approach in the setting of a high-resolution practice, thus reducing costs and the time elapsed until diagnosis. Results We present our initial results of this procedure 2 years after its introduction, with a total of 286 biopsies performed. After a progressive learning curve over time and according to the endocrinologists previous experience, 72.72% samples were considered satisfactory for diagnosis. Greater difficulty was observed in obtaining optimal cytological specimens in smaller nodules. In conclusion, we have successfully incorporated thyroid ultrasound and ultrasound-guided FNAB into routine endocrine practice. Conclusion Routine performance of thyroid ultrasound in endocrine practice will considerably aid the management of nodular thyroid disease (AU)
Subject(s)
Humans , Male , Female , Infant , Adult , Biopsy, Fine-Needle , Thyroid Diseases/pathology , Thyroid Neoplasms , Ultrasonography, Interventional , Hospitals, University , Spain/epidemiology , Syncope, Vasovagal/etiology , Thyroid Diseases , Thyroid Neoplasms/epidemiologyABSTRACT
No disponible
