Complications and Comorbidities of Acromegaly—Retrospective Study in Polish Center

IntroductionIn acromegaly, chronic exposure to impaired GH and IGF-I levels leads to the development of typical acromegaly symptoms, and multiple systemic complications as cardiovascular, metabolic, respiratory, endocrine, and bone disorders. Acromegaly comorbidities contribute to decreased life quality and premature mortality. The aim of our study was to assess the frequency of acromegaly complications and to evaluate diagnostic methods performed toward recognition of them.Materials and MethodsIt was a retrospective study and we analyzed data of 179 patients hospitalized in the Department of Endocrinology, Diabetes and Isotope Therapy in Wroclaw Medical University (Poland) in 1976 to 2018 to create a database for statistical analysis.ResultsThe study group comprised of 119 women (66%) and 60 men (34%). The median age of acromegaly diagnosis was 50.5 years old for women (age range 20–78) and 46 for men (range 24–76). Metabolic disorders (hyperlipidemia, diabetes, and prediabetes) were the most frequently diagnosed complications in our study, followed by cardiovascular diseases and endocrine disorders (goiter, pituitary insufficiency, osteoporosis). BP measurement, ECG, lipid profile, fasting glucose or OGTT were performed the most often, while colonoscopy and echocardiogram were the least frequent.ConclusionsIn our population we observed female predominance. We revealed a decrease in the number of patients with active acromegaly and an increase in the number of well-controlled patients. More than 50% of patients demonstrated a coexistence of cardiac, metabolic and endocrine disturbances and only 5% of patients did not suffer from any disease from those main groups.

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Clinical Profile of Subclinical Hypothyroidism:A Retrospective Study

International Journal of Medical and Dental Sciences ◽

10.18311/ijmds/2017/18835 ◽

2017 ◽

Vol 6 (2) ◽

pp. 1475

Author(s):

Mallikarjuna Shetty ◽

Krishna Prasad Adiraju ◽

Nageswar Rao Modugu

Keyword(s):

Retrospective Study ◽

Subclinical Hypothyroidism ◽

Low Dose ◽

Clinical Symptoms ◽

Clinical Profile ◽

Common Symptom ◽

Number Of Patients ◽

Age Range ◽

Symptoms And Signs ◽

Serum Tsh

Background: Subclinical hypothyroidism occurs due to an under functioning thyroid gland and presents with varied symptoms and signs. Thyroid disorders are common in Indian population and the prevalence of subclinical hypothyroidism is high.Objective: This study intended to assess the clinical profile of patients presenting with subclinical hypothyroidism.Materials and Methods: This was a retrospective study that analyzed the medical records of adult patients diagnosed with subclinical hypothyroidism for a period of three years.Results: 71 patients within the age range of 18 years to 77 years were diagnosed with subclinical hypothyroidism. Among these 53 (75%) patients had various clinical symptoms. Body pains were the most common symptom (38 %) followed by weight gain(27%) and tiredness (20%). A significant number of patients were obese (25%). Enlarged thyroid(14%) and dyslipidemia (25%) were also recorded. 63 (75%) patients were initiated on low dose levothyroxine.Conclusion: Patients with subclinical hypothyroidism present with varied non-specific clinical symptoms. Treatment with low dose levothyroxine resulted in lowering of serum TSH to normal range and relief of symptoms.

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Assessment of endocrine disorders of the hypothalamicpituitary axis by nuclear medicine techniques

Nuklearmedizin ◽

10.1055/s-0038-1625645 ◽

2002 ◽

Vol 41 (02) ◽

pp. 80-90 ◽

Cited By ~ 2

Author(s):

F. Jockenhövel ◽

P. Theissen ◽

M. Dietlein ◽

W. Krone ◽

H. Schicha ◽

...

Keyword(s):

Nuclear Medicine ◽

Pituitary Adenomas ◽

Dopamine D2 Receptor ◽

Somatostatin Receptor ◽

D2 Receptor ◽

Ectopic Acth Syndrome ◽

Endocrine Disorders ◽

Ectopic Acth ◽

Number Of Patients ◽

Hypothalamic Pituitary Axis

SummaryThe following article reviews nuclear medicine techniques which can be used for assessment of endocrine disorders of the hypothalamic-pituitary axis. For planar and SPECT imaging somatostatin-receptor- and dopamine- D2-receptor-scintigraphy are the most widely distributed techniques. These nuclear medicine techniques may be indicated in selected cases to answer differential diagnostic problems. They can be helpful to search for presence and localization of receptor positive tissue. Furthermore they can detect metastasis in the rare cases of a pituitary carcinoma. Scintigraphy with Gallium-67 is suitable for further diagnostic evaluation in suspected hypophysitis. Other SPECT radiopharmaca do not have relevant clinical significance. F-18-FDG as PET radiopharmacon is not ideal because obvious pituitary adenomas could not be visualized. Other PET radiopharmaca including C-11-methionine, C-11-tyrosine, F-18-fluoroethylspiperone, C-11-methylspiperone, and C-11-raclopride are available in specialized centers only. Overall indications for nuclear medicine in studies for the assessment of endocrine disorders of the hypothalamic-pituitary-axis are rare. Original studies often report only about a small number of patients. According to the authors’ opinion the relevance of nuclear medicine in studies of clinically important endocrinologic fields, e. g. localization of small ACTH-producing pituitary adenomas, tumor localization in ectopic ACTH syndrome, localization of recurrent pituitary tissue, assessment of small incidentalomas, can not be definitely given yet.

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Diagnosis of helicobacter pylori infection: problems and prospects

Medical alphabet ◽

10.33667/2078-5631-2020-17-54-59 ◽

2020 ◽

pp. 54-59

Author(s):

A. S. Molostova ◽

N. S. Gladyshev ◽

A. V. Svarval ◽

R. S. Ferman ◽

A. B. Karasyova ◽

...

Keyword(s):

Helicobacter Pylori ◽

Urease Activity ◽

Diagnostic Methods ◽

Study Group ◽

Biochemical Method ◽

Antimicrobial Drugs ◽

Non Invasive ◽

Number Of Patients ◽

Pcr Method ◽

Positive Results

(HP) infection was performed using invasive and non-invasive methods. The study group consisted of 95 patients with dyspepsia. HP infection was detected in 47 patients (49.4 %). The expediency of using a set of diagnostic methods for detecting HP (PCR, immunochromatographic, bacteriological and method for determining urease activity) is proved. Most often (100 %) in patients HP infection was detected in biopsies using the PCR method. Somewhat less frequently it was detected when examining biopsies with an invasive biochemical method (AMA RUT Reader) (82 %) and fecal immunochromatographic method (83 %). Despite the fact that helicobacteriosis was detected bacteriologically in a small number of patients (24 %), this method is of particular value, since it allows you to assess the sensitivity to antimicrobial drugs and probiotics, and does not give false positive results.

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Breech Presentation: Vaginal Delivery or Caesarean Section?

European Journal of Interdisciplinary Studies ◽

10.26417/ejis.v2i1.p153-157 ◽

2016 ◽

Vol 2 (1) ◽

pp. 153

Author(s):

Tomescu Cezar Laurentiu ◽

Rodica Sîrbu ◽

Emin Cadar ◽

Brezeanu Dragos ◽

Aneta Tomescu

Keyword(s):

Retrospective Study ◽

Caesarean Section ◽

Vaginal Delivery ◽

Total Population ◽

Population Sample ◽

Breech Presentation ◽

Current Paper ◽

Clinical Hospital ◽

Obstetrics And Gynaecology ◽

Number Of Patients

The incidence of breech presentation is approximately 3,97%. Breech presentation is considered as being “borderline eutocic” and it requires carefully monitoring both the foetus and the mother. The aim of the current paper is to evaluate the preffered method of delivery in case of breech presentation. The paper presents a retrospective study performed in the Obstetrics and Gynaecology Departments of the County Emergency Clinical Hospital “Sf. Apostol Andrei” in Constanta, during a period of 5 years (2010-2014). The methods of birth were analyzed for a lot of 1104 patients with breech presentation with ages ranging between 16 and 44 years old. The total number of patients who gave birth through vaginal delivery was of 139 patients, amounting to 12.59% of the total population sample. The number of patients that gave birth through C-section was 965, which amounts to 87.4% of the total population sample. Birth through C-section is preferred by both obstetricians and patients alike, due to the fact that vaginal delivery is associated with a higher foetal risk in breech presentation.

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Pleural Solitary Fibrous Tumors—A Retrospective Study on 45 Patients

Medicina ◽

10.3390/medicina56040185 ◽

2020 ◽

Vol 56 (4) ◽

pp. 185 ◽

Cited By ~ 1

Author(s):

Cornel Savu ◽

Alexandru Melinte ◽

Radu Posea ◽

Niculae Galie ◽

Irina Balescu ◽

...

Keyword(s):

Retrospective Study ◽

Ct Scan ◽

Single Case ◽

Postoperative Mortality ◽

Diagnostic Methods ◽

Chest Wall Resection ◽

En Bloc ◽

Curative Intent ◽

Solitary Fibrous Tumors ◽

Thoracic Ct

Introduction: The purpose of this paper is to study the type, the clinical presentation, and the best diagnostic methods for pleural solitary fibrous tumors (PSFTs), as well as to evaluate which is the most appropriate treatment, especially as PSFTs represent a rare occurrence in the thoracic pathology. Material and Method: A retrospective study was conducted on a group of 45 patients submitted to surgery between January 2015 and December 2019. In most cases, the diagnosis was established through imaging studies—thoracic computed tomography (CT) scan with or without contrast—but also using magnetic resonance imaging (MRI) or positron emission tomography (PET) scans when data from CT scans were scarce. All patients were submitted to surgery with curative intent. Results: Most patients included in this study were asymptomatic, with this pathology being more common in patients over 60 years of age, and more common in women. The occurrence of malignant PSFT in our study was 17.77% (8 cases). All cases were submitted to surgery with curative intent, with a single case developing further recurrence. In order to achieve complete resection en bloc resection of the tumor with the chest wall, resection was performed in two cases, while lower lobectomy, pneumectomy, and hemidiaphragm resection, respectively, were needed in each case. Postoperative mortality was null. Conclusion: Thoracic CT scan remains the most important imagistic investigation in diagnosing. MRI is superior to thoracic CT, especially in cases that involved the larger blood vessels within the thorax, spinal column, or diaphragm. Complete surgical resection is the gold standard in treatment of PSFT, and the prognosis in benign cases is very good.

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Characteristics of Osteoporosis & Osteoporotic Fractures in Korea Based on Health Insurance Review and Assessment (HIRA) Database: 2009–2017

Healthcare ◽

10.3390/healthcare9030324 ◽

2021 ◽

Vol 9 (3) ◽

pp. 324

Author(s):

Ho-Seok Oh ◽

Sung-Kyu Kim ◽

Hyoung-Yeon Seo

Keyword(s):

Health Insurance ◽

Age Groups ◽

Osteoporotic Fractures ◽

Prescription Data ◽

Diagnostic Codes ◽

Number Of Patients ◽

Upper And Lower Extremities ◽

Fractures Of The Spine ◽

And Gender ◽

Age Range

To investigate the incidence and characteristics of osteoporosis and osteoporotic fractures in Korea, we used the Health Insurance Review and Assessment Service (HIRA) database. Patients over 50 years old, who were diagnosed or treated for osteoporosis and osteoporotic fractures in all hospitals and clinics, were analyzed between 1 January 2009 and 31 December 2017 by using the HIRA database that contains prescription data and diagnostic codes. These data were retrospectively analyzed by decade and age-specific and gender-specific incidents in each year. We also evaluated other characteristics of patients including medication state of osteoporosis, primary used medical institution, regional-specific incidence of osteoporosis, and incidence of site-specific osteoporotic fractures. The number of osteoporosis patients over 50 years old, as diagnosed by a doctor, steadily increased from 2009 to 2017. The number of osteoporosis patients was notably greatest in the 60′s and 70′s age groups in every study period. Patients undergoing treatment for osteoporosis increased significantly (96%) from 2009 to 2017. Among the patients diagnosed with osteoporosis, the proportion who experienced osteoporotic fracture increased gradually (60%) from 2009 to 2017. The number of patients with osteoporotic fractures of the spine and hip was highest in the 70 to 90 age range, and the number of patients with osteoporotic fractures in the upper and lower extremities was highest in the 50 to 70 age range. Understanding the trends of osteoporosis in Korea will contribute to manage the increased number of patients with osteoporosis and osteoporotic fractures.

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Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study

Journal of Clinical Interventional Radiology ISVIR ◽

10.1055/s-0041-1728998 ◽

2021 ◽

Author(s):

Pushpinder S. Khera ◽

Pawan K. Garg ◽

Sarbesh Tiwari ◽

Narendra Bhargava ◽

Taruna Yadav ◽

...

Keyword(s):

Retrospective Study ◽

Clinical Success ◽

Gastric Varices ◽

Early Recurrence ◽

Single Institution ◽

Vascular Plug ◽

Acute Bleeding ◽

Sclerosing Agents ◽

Age Range ◽

Refractory Hepatic Encephalopathy

Abstract Introduction Retrograde transvenous obliteration (RTO) with the assistance of a balloon (BRTO) or a vascular plug (PARTO) is an established method for treating gastric varices (GVs) secondary to portal hypertension. Most of the available studies on RTO have used lipiodol along with sclerosing agents like ethanolamine oleate or sodium tetradecyl sulfate (STS). We evaluated the safety and efficacy of RTO for treating GVs using STS as a sclerosant without lipiodol. Materials and Methods Sixteen patients (nine men, age range 16–74 years) were included in this retrospective study. Twelve patients presented with acute bleeding, two with chronic bleeding, one with large varices without bleeding, and one with refractory hepatic encephalopathy (HE). BRTO was attempted in 14 patients and PARTO in 2 patients. The technical and clinical success and complications of RTO were studied. Results The RTO procedure was technically successful in 14 (14/16, 87.5%) patients, with 13 (13/14, 93%) obtaining clinical success. One patient died due to the early recurrence of bleeding. Three patients had minor intraprocedural complications. Conclusion Retrograde gastric variceal obliteration using STS is safe and technically feasible with high technical and clinical success and low complication rate.

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Comparative study between fat plug and inlay butterfly cartilage grafts for myringoplasty in adults

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00076-y ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Ahmed Gamal Khafagy ◽

Mohamed El-Begermy ◽

Marwa Mohamed El-Begermy ◽

Pretty O. Afifi

Keyword(s):

Tympanic Membrane ◽

Chronic Otitis Media ◽

Fat Graft ◽

Cartilage Graft ◽

Tympanic Membrane Perforations ◽

Number Of Patients ◽

Significant Difference ◽

Hearing Outcomes ◽

Age Range

Abstract Background This study aims to compare the graft uptake rate and hearing improvement of fat graft versus inlay butterfly tragal cartilage in the repair of perforations in chronic otitis media mucosal in adults. In this retrospective study, twenty-eight patients were included with small dry anteroinferior tympanic membrane perforations (less than 1/3 of the tympanic membrane). The age range was 18 to 44 years old. Myringoplasty was done under general anesthesia for 8 patients with a fat graft (FG) and 20 patients with inlay butterfly cartilage graft (IBCG). Six months postoperatively, a follow-up evaluation was done for successful graft uptake and hearing outcomes. Results The success rate of graft uptake in the first group (fat graft) was 6/8 cases (75%) while in the second group (IBCG) was 19/20 (95%) with no statistically significant difference (P = 0.0148). Also, there was no statistical difference between the two groups as regards postoperative ABG, improvement changes in ABG, and number of patients with improved hearing. Conclusions Inlay butterfly cartilage graft is a useful graft in repairing small tympanic membrane perforations as regard graft take and hearing outcomes.

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Opioid Induced Hyperalgesia, a Research Phenomenon or a Clinical Reality? Results of a Canadian Survey

Journal of Personalized Medicine ◽

10.3390/jpm10020027 ◽

2020 ◽

Vol 10 (2) ◽

pp. 27

Author(s):

Grisell Vargas-Schaffer ◽

Suzie Paquet ◽

Andrée Neron ◽

Jennifer Cogan

Keyword(s):

Chronic Pain ◽

Nmda Antagonist ◽

Treatment Modalities ◽

Clinical Test ◽

Physician Practice ◽

Clinical Tests ◽

Opioid Rotation ◽

Number Of Patients ◽

Opioid Induced Hyperalgesia ◽

Age Range

Background: Very little is known regarding the prevalence of opioid induced hyperalgesia (OIH) in day to day medical practice. The aim of this study was to evaluate the physician’s perception of the prevalence of OIH within their practice, and to assess the level of physician’s knowledge with respect to the identification and treatment of this problem. Methods: An electronic questionnaire was distributed to physicians who work in anesthesiology, chronic pain, and/or palliative care in Canada. Results: Of the 462 responses received, most were from male (69%) anesthesiologists (89.6%), in the age range of 36 to 64 years old (79.8%). In this study, the suspected prevalence of OIH using the average number of patients treated per year with opioids was 0.002% per patient per physician practice year for acute pain, and 0.01% per patient per physician practice year for chronic pain. Most physicians (70.2%) did not use clinical tests to help make a diagnosis of OIH. The treatment modalities most frequently used were the addition of an NMDA antagonist, combined with lowering the opioid doses and using opioid rotation. Conclusions: The perceived prevalence of OIH in clinical practice is a relatively rare phenomenon. Furthermore, more than half of physicians did not use a clinical test to confirm the diagnosis of OIH. The two main treatment modalities used were NMDA antagonists and opioid rotation. The criteria for the diagnosis of OIH still need to be accurately defined.

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Computed Tomography and Bronchoscopy in Endobronchial Tuberculosis

Canadian Respiratory Journal ◽

10.1155/2003/496296 ◽

2003 ◽

Vol 10 (8) ◽

pp. 445-448 ◽

Cited By ~ 11

Author(s):

Halil Yanardag ◽

Cüneyt Tetikkurt ◽

Seza Tetikkurt ◽

Sabriye Demirci ◽

Tuncer Karayel

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Therapeutic Response ◽

Histopathological Examination ◽

Computed Tomographic ◽

Before And After ◽

Endobronchial Tuberculosis ◽

Age Range

BACKGROUND: The therapeutic response to endobronchial tuberculosis is usually evaluated by bronchoscopy. Currently, there are no published studies investigating the use of computed tomography for the evaluation of therapeutic response in endobronchial tuberculosis.OBJECTIVE: A retrospective study was performed to evaluate the bronchoscopic and computed tomographic features of endobronchial tuberculosis before and after treatment. The aim of this study was to investigate the usefulness of computed tomography for the assessment of treatment.METHODS: The clinical, pathological and bronchoscopic features of endobronchial tuberculosis were evaluated in 55 patients. The age range of the patients was 21 to 52 years. Computed tomography and bronchoscopy were performed before and after treatment.RESULTS: Diagnosis of tuberculosis was confirmed by culture and histopathological examination. Bronchoscopic examination revealed 89 endobronchial lesions of various types in 55 patients. The exudative type was the most common. Follow-up bronchoscopy revealed that exudative-, ulcerative- and granular-type lesions healed completely. Computed tomography performed after treatment correlated well with the follow-up bronchoscopic findings.CONCLUSION: The results suggest that follow-up computed tomography is useful for the evaluation of therapeutic response and complications associated with endobronchial tuberculosis, and may replace bronchoscopy.

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