Adrenal

2021 ◽  
pp. 249-328
Author(s):  
Jeremy Tomlinson
Keyword(s):  
Adrenal Gland ◽  
Adrenal Insufficiency ◽  
Imaging Techniques ◽  
Addison’S Disease ◽  
Autoimmune Disorders ◽  
Conn’S Syndrome ◽  
Anatomy And Physiology ◽  
Adrenal Tumours ◽  
Term Management

This chapter covers the adrenal gland. It begins with the anatomy and physiology of the adrenal gland, then continues with imaging techniques. It then covers adrenal disorders, including Conn’s syndrome, adrenal Cushing’s syndrome, Adrenal insufficiency, Addison’s disease, and multiple autoimmune disorders. The investigation, treatment, and long-term management of primary insufficiency is covered. Various adrenal tumours and associated disorders, along with their management, are described.

scholarly journals Adrenal Insufficiency - Aetiology, Diagnosis and Treatment

2015 ◽  
Vol 3 (1) ◽  
pp. 36-47
Author(s):  
Nazma Akter ◽  
Nazmul Kabir Qureshi
Keyword(s):  
Quality Of Life ◽  
Adrenal Insufficiency ◽  
Presenting Symptoms ◽  
Life Saving ◽  
Life Threatening ◽  
Diagnostic Work ◽  
Work Up ◽  
Term Management

Adrenal insufficiency is caused by either primary adrenal failure or by hypothalamic-pituitary impairment of the corticotropic axis. Adrenal insufficiency, first codified in 1855 by Thomas Addison, remains relevant in 2014 because of its lethal nature. Though, it is a rare disease but is life threatening when overlooked. Main presenting symptoms such as fatigue, anorexia and weight loss are nonspecific, thus diagnosis is often delayed. The diagnostic work-up is well established but some pitfalls remain. The diagnosis is adequately established by the 250 ?g ACTH (adrenocorticotropic hormone) stimulation test in most cases. Glucocorticoids provide life saving treatment but long-term quality of life is impaired, perhaps because therapy is not given in a physiologic way. Dehydroepiandrosterone-replacement therapy has been introduced that could help to restore quality of life. It may be useful in pubertal girls, but not in adults. Monitoring of glucocorticoid-replacement is difficult due to lack of objective methods of assessment and is therefore largely based on clinical grounds. Thus, long-term management of patients with adrenal insufficiency remains a challenge, requiring an experienced specialist. DOI: http://dx.doi.org/10.3329/dmcj.v3i1.22238 Delta Med Col J. Jan 2015; 3(1): 36-47

scholarly journals Association of Addison's disease with autoimmune disorders--a long-term observation of 180 patients.

1991 ◽  
Vol 67 (793) ◽  
pp. 984-987 ◽  
Author(s):  
A. A. Kasperlik-Zaluska ◽  
B. Migdalska ◽  
B. Czarnocka ◽  
J. Drac-Kaniewska ◽  
E. Niegowska ◽  
...  
Keyword(s):  
Addison’S Disease ◽  
Autoimmune Disorders ◽  
Addison's Disease ◽  
Long Term Observation

scholarly journals The Incidence of Long-Term Adrenal Insufficiency Following Unilateral Adrenalectomy is Low: Case Series and Review of Literature

2019 ◽  
pp. 1-4
Author(s):  
Jay D. Raman ◽  
Augustyna Gogoj ◽  
Brian D. Saunders ◽  
Daniel J.Canter ◽  
Jay D. Raman ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Adrenal Insufficiency ◽  
Cushing Syndrome ◽  
Case Series ◽  
Large Majority ◽  
Review Of Literature ◽  
Unilateral Adrenalectomy ◽  
Different Types ◽  
One Year

Introduction: Acquired adrenal insufficiency is a known risk of unilateral adrenalectomy. However, the rates of early and prolonged adrenal insufficiency following unilateral adrenalectomy are not well defined in the literature. Patients and Methods: We reviewed a case series of 184 consecutive patients to determine the likelihood of steroid supplementation at 30 days and 1 year following adrenalectomy. 109 lesions were non-functional and 75 (41%) demonstrated functionality, including 33 pheochromocytomas, 20 cortisol-producing adenomas, 19 aldosteronomas, and 3 cases of cortisol-secreting hyperplasia. No patients with a nonfunctional lesion, pheochromocytoma, or aldosteronoma required steroid supplementation following surgery. Eleven of 23 patients (48%) with primary adrenal Cushing syndrome required cortisol supplementation at 30 days, and only 1 patient (4%) necessitated supplementation one year following surgery. Discussion: Approximately 50% of patients with cortisol-producing lesions in the adrenal gland will require supplementation 30-days following surgery. Only 4% will require persistent exogenous steroids at 1-year. Conversely, less than 1% of patients with different types of functional or non-functional tumors required supplementation after surgery. Conclusion: The incidence of adrenal insufficiency following unilateral adrenalectomy is low. A large majority of patients requiring steroid supplementation 30 days following surgery are able to wean off this requirement by 1 year. With this information, we can better counsel our patients and set clearer expectations for the potential need of cortisol supplementation following adrenalectomy

scholarly journals Differentiated approach to surgical treatment of adrenal glands tumors

2021 ◽  
Vol 26 (4) ◽  
pp. 124-131
Author(s):  
О.B. Kutovyi ◽  
E.V. Zhmurenko
Keyword(s):  
Surgical Treatment ◽  
Adrenal Gland ◽  
Adrenal Insufficiency ◽  
Postoperative Period ◽  
Adrenal Glands ◽  
Treatment Algorithm ◽  
Adrenal Tumors ◽  
Hemodynamic Parameters ◽  
Results Of Treatment

Objective – to improve the results of treatment of adrenal tumors by optimizing a differentiated approach based on the analysis of the results of various surgical invasions. The paper analyzed the results of treatment of 145 patients with various adrenal tumors, which were divided into 2 groups: І (n=71) - patients after adrenalectomies, II (n=74) – after adrenal resections. Organ-preserving invasions showed better results during the early and long-term postoperative period in patients with corticosteromas, pheochromocytomas and incidentalomas by reducing the severity of fluctuations in hemodynamic parameters and the frequency of adrenal insufficiency. Due to the introduction of the treatment algorithm, the number of adrenal resections increased by 26.6% in patients with neoplasms more than 4,0 cm in diameter (p=0.0001). The choice of surgical invasion should be individualized, taking into account the clinical features of the disease, hormone indicator parameters, the size of tumors, the comprehensiveness of the adrenal gland lesion and the ratio of the latter to nearby organs and structures. Adrenal insufficiency was detected 14.2% more often after adrenalectomies (р=0.044) compared to adrenal resections. Treatment according to the developed algorithm reduced the incidence of adrenal insufficiency by 5.8% (p=0.028). In the long-term postoperative period, contralateral gland tumors occurred with the same frequency (4.8%) among patients after adrenalectomies and resections. Relapse of the neoplasm after resections was detected in 3 (7.1%), as a result of which 2.4% underwent repeated operations with the final removal of the gland. An increase in the size of a single adrenal gland was more common by 21.4% after adrenalectomies.

Childhood Asthma's Self-Efficacy Scale--Parental Long-Term Management

2012 ◽  
Author(s):  
Misa Iio ◽  
Kosuke Maeba ◽  
Takashi Shimazaki ◽  
Yukihiro Ohya ◽  
Koji Takenaka
Keyword(s):  
Self Efficacy ◽  
Term Management
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