scholarly journals Adrenal incidentaloma: management of patients with functionally autonomous cortisol synthesis

2019 ◽  
Vol 100 (2) ◽  
pp. 277-287
Author(s):  
T R Chzhen ◽  
T P Kiseleva ◽  
M R Torosyan
Keyword(s):  
Diagnostic Errors ◽  
Adrenal Incidentaloma ◽  
Lipid Metabolism Disorders ◽  
Choice Of Treatment ◽  
Fat Redistribution ◽  
Specific Organ ◽  
Radiologic Investigation ◽  
The Moment

Over recent decades due to improved visualization (ultrasound, computer tomography and magnetic resonance imaging) prevalence of adrenal incidentaloma has increased. The term «adrenal incidentaloma» is generic and includes a group of tumors of various morphology and over 1 cm in diameter accidentally discovered during radiologic investigation. The found tumor can be hormonally inactive or actively releasing different hormones, malignant or benign, and originating from different adrenal zones or having non-specific organ origin. Based on the frequency of revealing and clinical significance the most noteworthy is functionally autonomous cortisol synthesis. It means changes of hypothalamic pituitary adrenal axis without classic clinically prominent signs of cortisol excess such as proximal myopathy, stretch marks, body fat redistribution and other metabolic changes related to cortisol. Currently a large number of recommendations on the management and tactics of treatment of adrenal incidentaloma can be found in the literature. Based on the analysis of these guidelines the conclusions were made about the diagnostic errors and incorrect approaches to the choice of treatment of such patients. Recently a lot of studies have been directed to the early detection of carbohydrate and lipid metabolism disorders, relation with obesity and type 2 diabetes mellitus, arterial hypertension and osteoporosis for preserved quality of life of such patients. Influence of hypercorticism is considered to worsen the course of these conditions but at the moment no effect of adrenalectomy on mortality and life duration was confirmed.

Evaluation of concomitant gynecological pathology in group of patients of reproductive age with tumors and tumor formations

2020 ◽  
pp. 10-14
Author(s):  
N. V. Spiridonova ◽  
A. A. Demura ◽  
V. Yu. Schukin
Keyword(s):  
Diagnostic Errors ◽  
Ovarian Tumors ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Predisposing Factor ◽  
Ovarian Tumours ◽  
Preoperative Diagnostic ◽  
Neoplastic Process ◽  
History Of ◽  
The Moment

According to modern literature, the frequency of preoperative diagnostic errors for tumour-like formations is 30.9–45.6%, for malignant ovarian tumors is 25.0–51.0%. The complexity of this situation is asymptomatic tumor in the ovaries and failure to identify a neoplastic process, which is especially important for young women, as well as ease the transition of tumors from one category to another (evolution of the tumor) and the source of the aggressive behavior of the tumor. The purpose of our study was to evaluate the history of concomitant gynecological pathology in a group of patients of reproductive age with ovarian tumors and tumoroid formations, as a predisposing factor for the development of neoplastic process in the ovaries. In our work, we collected and processed complaints and data of obstetric and gynecological anamnesis of 168 patients of reproductive age (18–40 years), operated on the basis of the Department of oncogynecology for tumors and ovarian tumours in the Samara Regional Clinical Oncology Dispensary from 2012 to 2015. We can conclude that since the prognosis of neoplastic process in the ovaries is generally good with timely detection and this disease occurs mainly in women of reproductive age, doctors need to know that when assessing the parity and the presence of gynecological pathology at the moment or in anamnesis, it is not possible to identify alarming risk factors for the development of cancer in the ovaries.

Social support and health-related quality of life among type 2 DM (T2DM) patients attending a public hospital in Lagos, Nigeria

2019 ◽  
Author(s):  
Olufolake Olabode ◽  
Timothy Omoluru ◽  
Olawunmi Olagundoye ◽  
Akinyele Akinlade ◽  
Henry Akujobi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Public Hospital ◽  
Health Related Quality ◽  
Type 2 Dm ◽  
Related Quality ◽  
Health Related

Can conversation analytic findings help with differential diagnosis in routine seizure clinic interactions?

2016 ◽  
Vol 12 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Katie Ekberg ◽  
Markus Reuber
Keyword(s):  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Diagnostic Errors ◽  
Epileptic Seizures ◽  
Routine Clinical Setting ◽  
Choice Of Treatment ◽  
Transient Loss ◽  
Factual Content ◽  
Patient’S History ◽  
Linguistic Methods

There are many areas in medicine in which the diagnosis poses significant difficulties and depends essentially on the clinician’s ability to take and interpret the patient’s history. The differential diagnosis of transient loss of consciousness (TLOC) is one such example, in particular the distinction between epilepsy and ‘psychogenic’ non-epileptic seizures (NES) is often difficult. A correct diagnosis is crucial because it determines the choice of treatment. Diagnosis is typically reliant on patients’ (and witnesses’) descriptions; however, conventional methods of history-taking focusing on the factual content of these descriptions are associated with relatively high rates of diagnostic errors. The use of linguistic methods (particularly conversation analysis) in research settings has demonstrated that these approaches can provide hints likely to be useful in the differentiation of epileptic and non-epileptic seizures. This paper explores to what extent (and under which conditions) the findings of these previous studies could be transposed from a research into a routine clinical setting.

1538-P: Quality of Life Decrements for Complications of Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1538-P
Author(s):  
SIMON NEUWAHL ◽  
THOMAS J. HOERGER
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes

851-P: Sleep and Quality of Life in Adolescents with Type 1 or Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 851-P
Author(s):  
MELISSA S. FAULKNER
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes

“Position Paper” Timely Insulinisation in Type 2 Diabetes Patients

2012 ◽  
Vol 19 (4) ◽  
pp. 441-444
Author(s):  
László Barkai ◽  
Nicolae Hâncu ◽  
György Jermendy ◽  
Maya Konstantinova ◽  
Radu Lichiardopol ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Life Expectancy ◽  
Insulin Therapy ◽  
Metabolic Control ◽  
Current Medical ◽  
Position Paper ◽  
Medical Evidence

AbstractThe objective of this position paper is to review the current medical evidence andguidelines regarding the treatment of type 2 diabetes (T2DM) and to issue medicalrecommendations strengthening the timely use of insulin in patients with T2DMuncontrolled on noninsulin therapy. When noninsulin therapy fails to achieve or tomaintain HbA1c targets, insulin therapy is required. Timely insulin therapy couldprovide proper metabolic control that might prevent complications, lead toimprovement of life expectancy and quality of life.

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