scholarly journals An unrecognized endocrinology emergency masquerading as a hypertensive emergency: A can’t miss diagnosis

2016 ◽  
Vol 4 (1) ◽  
pp. 21
Author(s):  
Yanerys Agosto Vargas ◽  
Sharon Velez Maymi ◽  
Paola Mansilla Letelier ◽  
Luis Raul Hernandez-Vazquez ◽  
Samayra Miranda Rodriguez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pituitary Adenoma ◽  
Mortality Rate ◽  
Pituitary Gland ◽  
Pituitary Apoplexy ◽  
Systemic Hypertension ◽  
Pituitary Macroadenoma ◽  
Rare Entity ◽  
Factors Associated ◽  
Multiple Risk Factors

Pituitary apoplexy secondary to sellar tumors is a rare entity that carries a high mortality rate. It could be secondary to infarction or hemorrhage of the pituitary gland. The incidence remains unclear, most are reported in men between the ages of 50 to 60. In the majority of times, apoplexy is idiopathic in nature, without a clear discernible cause. However, there are multiple risk factors associated with this entity, such as systemic hypertension, among others. There are few cases of pituitary apoplexy caused by infarction of a pituitary macroadenoma. We present this case of pituitary apoplexy secondary to infarction of a nonfunctional pituitary adenoma in a young woman, with a fortunate resolution.

scholarly journals MON-299 Risk Factors of Re-Growth of Non-Functional Pituitary Adenomas

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zamira Yusufovna Khalimova ◽  
Yulduz Mahkhakamovna Urmanova
Keyword(s):  
Risk Factors ◽  
Pituitary Adenoma ◽  
Tumor Growth ◽  
Pituitary Gland ◽  
Pituitary Adenomas ◽  
Small Cell ◽  
Pituitary Macroadenoma ◽  
Large Tumor ◽  
Number Of Patients ◽  
The Brain

Abstract The aim of investigation to determine clinical aggressiveness diagnostic markers in patients with non-functional pituitary adenomas (NFPA) in the formation of gravity neuroendocrine disease symptoms. Material and Methods: We observed in 87 patients (including man - 44 women -43) of which have a verified diagnosis of NFPA after surgery - 31 which were subjected transnasal adenomectomy of the pituitary (TAG). Further analysis was performed on these patients, who were followed from 1 to 3 years. Results. After the analysis of the frequency of remission and relapse NFPA data selectively in patients we studied the correlation between various parameters and the frequency of relapses. NFPA developed the scale of aggressiveness allowed to identify the risk factors of markers on the 3rd degrees, allowing to create a set of measures of tumor growth relapse prevention. According to MRI data of the brain and pituitary gland, in 15 patients an endosellar tumor was found, in 16 - an endo-extrasellar tumor. In an MRI study, the structure of the NFPA had a predominantly soft tissue (n = 16) and cystic (n = 11) structure. In 4 cases (13%), the structure of the NFPA was represented by a hemorrhagic component, and in 2 (6.4%) of them, both cystic and hemorrhagic components were present. In 18 patients, microadenoma was revealed, in 12 - pituitary macroadenoma and in 1 - a giant pituitary adenoma. The developed scale of aggression markers of NFPA allowed identifying factors by 3 degrees, which allows developing a complex of measures for the prevention of tumor growth recurrence. Conclusions. 1) According to our data, the number of patients with large-cell chromophobic pituitary adenoma predominated - 24 (77.5%). In 2nd place were patients with small cell NFPA - 6 cases (19.3%). And only in 1 case was observed (3.2%) a giant malignant pituitary macroadenoma with recurrence of growth and metastasis in the brain of a teenage girl, in which dark-cell pituitary adenoma was histologically determined, 2) According to our preliminary data, the markers of aggressiveness of the course of NFPA are: young patient age, first symptoms of the disease manifest, large tumor size, asymmetry and deformation of the pituitary gland, signs of tumor invasion into adjacent tissues / arteries / cavernous sinus, presence of small cell and / or dark extracellular chromophobic adenomas, STH hypopituitarism, panhypopituitarism.

scholarly journals Metastasis of a Dorsal Melanoma to a Pituitary Adenoma Mimicking Pituitary Apoplexy

2017 ◽  
Vol 36 (04) ◽  
pp. 238-242
Author(s):  
Rui Ramos ◽  
Maria Machado ◽  
Cristiano Antunes ◽  
Vera Fernandes ◽  
Olinda Marques ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pituitary Adenoma ◽  
Adjuvant Radiotherapy ◽  
Transsphenoidal Surgery ◽  
Pituitary Apoplexy ◽  
Clinical Presentation ◽  
Pituitary Macroadenoma ◽  
Histology Result ◽  
History Of ◽  
Transcranial Approach

AbstractMetastases to pituitary adenomas are very rare. From the 20 cases found in the literature, none originated from a cutaneous melanoma. We present the case of a 67-year-old man with a history of transcranial approach to treat a pituitary macroadenoma followed by adjuvant radiotherapy. Fifteen years later, he presented a dorsal nodular melanoma, and three years after that, he developed symptoms of pituitary apoplexy. He was submitted to transsphenoidal surgery, and the histology result revealed metastasis of the melanoma into a pituitary adenoma.The similarity in the clinical presentation of the two entities—pituitary apoplexy and metastasis of the melanoma into a pituitary adenoma—and the rarity of this type of metastization alert to challenges in the differential diagnosis that may confound the neurosurgeon's decision.

scholarly journals 346. Factors Associated with Hypertension in Young Adults with Perinatally-Acquired HIV Infection: a Case–Control Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S184-S184
Author(s):  
Patrick O’Neil ◽  
Patrick Ryscavage ◽  
Kristen A Stafford
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Family History ◽  
Case Control Study ◽  
Case Control ◽  
Systemic Hypertension ◽  
Early Management ◽  
Factors Associated ◽  
History Of ◽  
Control Study

Abstract Background The incidence of systemic hypertension (HTN) among perinatally-HIV-infected (PHIV) patients appears to increase as they enter adulthood. Among non-perinatally HIV-infected adults both traditional and HIV-associated risk factors have been found to contribute to HTN. Whether these same factors contribute to HTN in PHIV is unknown. The purpose of this study was to determine the socio-demographic, clinical, virologic, and immunologic factors associated with HTN among a cohort of PHIV adolescents and young adults, aged ≥18 years. Methods We conducted a case–control study among a population of 160 PHIV adults with and without HTN who were receiving care at the University of Maryland and aged 18–35 years as of December 31, 2017. Covariates assessed included traditional risk factors such as age, family history of HTN, and smoking, as well as HIV- and antiretroviral-associated covariates. Results We identified 49 HTN cases (30.6%) and 111 (69.4%) controls. There were no significant differences in the odds of most traditional (age, gender, race, family history of HTN, tobacco, alcohol, and/or other drug use) or HIV-associated (CD4 nadir <100 cells/mm3, individual ART exposure, ART interruption) risk factors among PHIV adults with HTN compared with those with no diagnosis of HTN. Cases had lower odds of a history of treatment with lopinavir/ritonavir (LPV/r). Cases had 3.7 (95% CI 1.11, 12.56) times the odds of a prior diagnosis of chronic kidney disease (CKD) compared with controls after controlling for CD4 nadir and ARV treatment history. Conclusion The results of this study suggest that most traditional and HIV-related risk factors do not appear to increase the odds of having HTN in this PHIV cohort. However, HTN among PHIV may be driven in part by CKD, and a focus on the prevention and early management of CKD in this group may be necessary to prevent the development of HTN. Additionally, there may be as yet unidentified risk factors for HTN among PHIV which require further exploration. Given the large and growing population of PHIV entering adulthood worldwide, it is imperative to explore risk factors for and effects of HTN in large, diverse PHIV populations. Disclosures All authors: No reported disclosures.

scholarly journals Risk Factors for Mortality in Colombian Patients with Candidemia

2021 ◽  
Vol 7 (6) ◽  
pp. 442
Author(s):  
Jorge Alberto Cortés ◽  
Anita María Montañez ◽  
Ana María Carreño-Gutiérrez ◽  
Patricia Reyes ◽  
Carlos Hernando Gómez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Mortality Rate ◽  
Glycemic Control ◽  
Antifungal Treatment ◽  
Catheter Removal ◽  
Factors Associated ◽  
Reference Centre ◽  
Parametric Survival ◽  
Overall Mortality

The aim of the study was to describe the microbiology and susceptibility profile of candidemia and to identify the risk factors associated with mortality in Colombia. A cohort of patients was followed for 30 days during 2008 to 2010. Microbiological identification and susceptibility assessments were performed in a reference centre. Demographic, clinical and treatment variables were evaluated for their associations with mortality. A parametric survival regression analysis was used to identify the risk factors associated with mortality. A total of 109 patients with candidemia in four hospitals in Colombia were identified, with a median age of 30 years old. C. parapsilosis was the most frequently identified microorganism (38.5%); the susceptibility of all isolates was high to fluconazole and anidulafungin, except for C. glabrata isolates. The overall mortality was 35.7%, and the risk factors associated with mortality included lack of antifungal treatment (HR 5.5, 95% CI 3.6–11.4), cancer (HR 3.9, 95% CI 2.3–8.0), diabetes (HR 2.5, 95% CI 1.03–6.4), and age (HR 1.13 per every 10 years, 95% CI 1.02–1.24). Catheter removal was associated with a low mortality rate (HR 0.06, 95% CI 0.00–0.49). Prompt antifungal treatment, better glycemic control and catheter removal should be prioritized in the management of candidemia.

scholarly journals Pituitary adenoma apoplexy

2017 ◽  
Vol 95 (2) ◽  
pp. 177-180
Author(s):  
Irina V. Tereshchenko
Keyword(s):  
Risk Factors ◽  
Pituitary Adenoma ◽  
Young Women ◽  
Pituitary Apoplexy ◽  
Clinical Presentation ◽  
Diagnostic Errors

We present 3 cases of pituitary adenoma apoplexy in young women (one microadenoma and two macroadenomas). The possible risk factors, clinical presentation and outcome of pituitary apoplexy are discussed. Diagnostic errors as regards pituitary adenoma apoplexy are analyzed.

scholarly journals Risk factors associated with the mortality rate of oral squamous cell carcinoma patients

Medicine ◽  
2021 ◽  
Vol 100 (36) ◽  
pp. e27127
Author(s):  
Paras Ahmad ◽  
Rubbia Nawaz ◽  
Maria Qurban ◽  
Gul Muhammad Shaikh ◽  
Roshan Noor Mohamed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Mortality Rate ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Factors Associated

scholarly journals Early postoperative complications and 90-day mortality in patients undergoing radical cystectomy

2020 ◽  
Vol 74 ◽  
pp. 354-361
Author(s):  
Paweł Hackemer ◽  
Bartosz Małkiewicz ◽  
Fryderyk Menzel ◽  
Krzysztof Tupikowski ◽  
Aleksandra Drabik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Radical Cystectomy ◽  
Complication Rate ◽  
Wound Dehiscence ◽  
Treatment Method ◽  
Regional Lymph Nodes ◽  
Factors Associated ◽  
American Society ◽  
Muscle Invasive

Introduction: The standard treatment method of muscle-invasive bladder cancer is radical cystectomy. This complex procedure consists of removing the urinary bladder with distal ureters and regional lymph nodes. Additionally, the prostate with seminal vesicles in men and uterus with ovaries in women should be excised. Therefore, this demanding oncological surgery is associated with a high occurrence of complications. The aim of this study was to assess the complications after radical cystectomy and identify the factors associated with severe complications and high mortality rate. Materials/Methods: We retrospectively analyzed medical data of 213 patients who underwent a radical cystectomy. Preoperative risk factors were assessed based on American Society of Anesthesiologists classification (ASA) and the Charlson Comorbidity Index (CCI). Clavien-Dindo classification was also included in our analysis. We investigated various factors associated with 30-day and 90-day mortality. Results: Complications after surgery were reported in 38% (n = 81) of patients in the studied group. Excluding perioperative high fever, the complication rate was 18%. The following complications were observed in 30-day postoperative period: wound infection (n = 6), wound dehiscence (n = 4), mechanical bowel obstruction (n = 3), hemorrhage (n = 2), cardiological (n = 8), stroke (n = 3). Observed 30-day mortality was 2.3% (n = 5), while 90-day mortality was 8.9% (n = 19). The mortality rate was associated with the stage of cancer and the type of urinary diversion. Conclusions: Radical cystectomy is a complex and traumatic urological surgery. It is associated with a significant complication rate and mortality, and it negatively affects quality of life. Therefore, all known risk factors should be thoroughly assessed preoperatively to select optimal treatment. Furthermore, the patient should be carefully informed about the risks associated with the surgery.

scholarly journals Pituitary apoplexy following endoscopic nasal surgery: A case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1985586
Author(s):  
Teemu Harju ◽  
Juha Alanko ◽  
Jura Numminen
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Apoplexy ◽  
Sudden Onset ◽  
Pituitary Macroadenoma ◽  
Nasal Surgery ◽  
Resonance Imaging ◽  
Acute Haemorrhage ◽  
Endoscopic Nasal Surgery ◽  
Precipitating Factor ◽  
Field Defects

Pituitary apoplexy develops as a consequence of acute haemorrhage and/or infarction in a pre-existing pituitary adenoma. Typical symptoms include sudden onset headache, visual acuity/field defects, and ocular palsies. We report a male patient with a known pituitary macroadenoma who underwent a right-sided endoscopic nasal surgery. Preoperatively, thickening of sphenoid mucosa was seen in computed tomography and magnetic resonance imaging. The patient developed pituitary apoplexy postoperatively. The presented report indicates that in patients with a pituitary adenoma, nasal surgery – like any other kind of surgery – is a possible precipitating factor for pituitary apoplexy. Isolated thickening of sphenoid mucosa is associated with pituitary apoplexy. It may also precede an apoplectic event.

Sign in / Sign up

Export Citation Format

Share Document