mortality ( 2 ). Transsphenoidal surgery (TSS) of pituitary adenoma is the primary treatment modality, with varying remission rates (52–96.6%) reported across different centres ( 3 ). Various demographic, biochemical, radiological and histopathological
Prachi Bansal, Anurag Lila, Manjunath Goroshi, Swati Jadhav, Nilesh Lomte, Kunal Thakkar, Atul Goel, Abhidha Shah, Shilpa Sankhe, Naina Goel, Neelam Jaguste, Tushar Bandgar, and Nalini Shah
Magnolia Ariza-Nieto, Joshua B Alley, Sanjay Samy, Laura Fitzgerald, Francoise Vermeylen, Michael L Shuler, and José O Alemán
, 19 ). We report that high levels of MIR148A in plasma and low levels in liver DNMT1 mRNA transcripts in liver are related to adiponectin insensitivity in patients following metabolic surgery for weight loss at 12 weeks. Materials and methods
Ann-Cathrin Koschker, Bodo Warrings, Caroline Morbach, Florian Seyfried, Nicole Rickert, Pius Jung, Andreas Geier, Ulrich Dischinger, Maike Krauthausen, Martin J. Herrmann, Christine Stier, Stefan Frantz, Uwe Malzahn, Stefan Störk, and Martin Fassnacht
Obesity is a rapidly emerging health problem and an established risk factor for cardiovascular diseases. Bariatric surgery profoundly reduces body weight and mitigates sequelae of obesity. The open, randomized controlled WAS trial compares the effects of Roux-en-Y gastric bypass (RYGB) versus psychotherapy-supported lifestyle modification in morbidly obese patients. The co-primary endpoint addresses 1-year changes in cardiovascular function (peak VO2 during cardiopulmonary exercise testing) and quality of life (Short-Form-36 physical functioning scale). Prior to randomization, all included patients underwent a multimodal anti-obesity treatment for 6-12 months. Thereafter, patients were randomized and followed through month 12 to collect primary endpoints. Afterwards, patients in the lifestyle group could opt for surgery, and final visit was scheduled for all patients 24 months after randomization. Sample size calculation suggested to enroll 90 patients in order to arrive at minimally 22 patients per group evaluable for the primary endpoint. Secondary objectives were to quantify changes in body weight, left ventricular hypertrophy, systolic and diastolic function (by echocardiography and cardiac magnet resonance imaging [MRI]), functional brain MRI, psychometric scales, endothelial and metabolic function. WAS enrolled 93 patients (72 women, median age 38 years, BMI 47.5 kg/m2) exhibiting a relevantly compromised exercise capacity (median peakVO2 18.3 ml/min/kg) and quality of life (median physical functioning scale 50). WAS is the first randomized controlled trial focusing on the effects of RYGB on cardiovascular function beyond hypertension. In addition, it will provide a wealth of high-quality data on cerebral, psychiatric, hepatic, and metabolic function in obese patients after RYGB. The trial is registered at ClinicalTrials.gov (NCT01352403).
Magdalena Fortova, Lenka Hanouskova, Martin Valkus, Jana Cepova, Richard Prusa, and Karel Kotaska
Background: Fibroblast growth factor-23 (FGF23) is a key regulator of urine phosphate excretion. The aim of the study was to investigate the perioperative (intraoperative and postoperative) changes of plasma intact and C-terminal FGF23 (iFGF23, cFGF23) concentrations in patients with primary hyperparathyroidism (pHPT) submitted to surgery.
Materials and methods: Study involved 38 adult patients with pHPT caused by adenoma. PTH levels were investigated intraoperatively (just before the incision and 10 minutes after adenoma excision). cFGF23, iFGF23, phosphate, eGFR and P1NP were measured intraoperatively and postoperatively (next day after the surgery).
Results: PTH levels decreased intraoperatively (13.10 vs. 4.17 pmol/L, P<0.0001). FGF23 levels measured intraoperatively were at the upper level of reference interval. cFGF23 decreased postoperatively compared with values measured just before the incision (cFGF23: 89.17 vs. 22.23 RU/mL, P<0.0001). iFGF23 decreased as well, but postoperative values were low. Postoperative inorganic phosphate values increased (1.03 mmol/L vs. 0.8 mmol/L, P=0.0025). We proved significant negative correlation of perioperative FGF23 with inorganic phosphate (cFGF23: Spearman r=-0.253,P=0.0065; iFGF23: Spearman r =-0.245, P=0.0085). We also found FGF23 values just before incision correlated with eGFR (cystatin C) (cFGF23: Spearman r=-0.499, P=0.0014; iFGF23: Spearman r=-0.413, P=0.01).
Conclusion: Intraoperative iFGF23 and cFGF23 did not change despite PTH decreased significantly. cFGF23 and iFGF23 significantly decreased one day after parathyroidectomy and are associated with increase of inorganic phosphate in pHPT patients. cFGF23 and iFGF23 just before incision correlated with eGFR (cystatin C). The similar results found in both iFGF23 and cFGF23 suggest each could substitute the other.
Kristin Godang, Karolina Lundstam, Charlotte Mollerup, Stine Lyngvi Fougner, Ylva Pernow, Jörgen Nordenström, Thord Rosén, Svante Jansson, Mikael Hellström, Jens Bollerslev, Ansgar Heck, and the SIPH Study Group
demonstrated improvement of cardiovascular disease or risk factors after surgery ( 3 , 8 , 9 ). Furthermore, it has been demonstrated that PHPT patients with diabetes or dyslipidemia can improve their dysmetabolic status after parathyroidectomy ( 10 , 11
Alberto Giacinto Ambrogio, Massimiliano Andrioli, Martina De Martin, Francesco Cavagnini, and Francesca Pecori Giraldi
surgery but sometimes even decades after cure. Estimates of recurrence vary from 5 to 30% ( 4 , 5 , 6 ) indicating that up to one-fifth of the patients may experience a relapse of hypercortisolism. From a clinical viewpoint, this translates into the need
Cristina Lamas, Elena Navarro, Anna Casterás, Paloma Portillo, Victoria Alcázar, María Calatayud, Cristina Álvarez-Escolá, Julia Sastre, Evangelina Boix, Lluis Forga, Almudena Vicente, Josep Oriola, Jordi Mesa, and Nuria Valdés
timing for surgery, both at initial diagnosis and at recurrence. Hyperplasia affecting all the parathyroid tissue is the most common pathological finding, making recurrences much more frequent than in sporadic hyperparathyroidism, so PHPT often represents
Anna Eremkina, Julia Krupinova, Ekaterina Dobreva, Anna Gorbacheva, Ekaterina Bibik, Margarita Samsonova, Alina Ajnetdinova, and Natalya Mokrysheva
severe hypercalcemia or an HC should begin with adequate hydration with isotonic saline. Therapy with hypocalcemic drugs is also an option, which allows the patient to prepare for surgery. Bisphosphonates are widely used and approved for the treatment of
Dong Cen, Hui Liu, Zhe Wan, Zhongjie Lin, Yanting Wang, Junjie Xu, and Yuelong Liang
, surgery remains effective for localized tumors and systemic treatment options have expanded for patients with metastatic status ( 4 ). According to the World Health Organization (WHO) classification of NEN, NEN includes differentiated neuroendocrine tumors
Alexis Sudlow, Carel W le Roux, and Dimitri J Pournaras
Introduction The early concept of surgical intervention to mediate weight loss in patients suffering from obesity stemmed from the observation of the substantial and often problematic weight loss following gastrointestinal surgery for cancer