DOCSLIB.ORG

Corticomedullary Mixed Adrenal Tumor: Case Report and Literature Review

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Corticomedullary Mixed Adrenal Tumor: Case Report and Literature Review Endocrine Journal 2009, 56 (6), 817-824 NOTE Corticomedullary Mixed Adrenal Tumor: Case Report and Literature Review KRYSTALLENIA I. ALEXANDRAKI*, OTHON P. MICHAIL**, AFRODITE NONNI***, DIMITRIOS DIamaNTIS**, IOANNA GIANNOPOULOU***, GREGORY A. KALTSAS*, SOFIA TSELENI-BALAFOUTA***, VASSILIKI SYRIOU* AND PANAYIOTIS O. MICHAIL** *Division of Endocrinology, Department of Pathophysiology, Laiko University Hospital, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, Athen, Greece **1 st Department of Surgery, Laiko University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece ***Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece Abstract. We report a 66-year-old woman with a mixed corticomedullary tumor of the left adrenal gland. The patient was found to harbor an adrenal incidentaloma while investigated for a spigelian hernia. Due to the atypical radiological features and the relatively large size of the adrenal lesion she underwent a left adrenalectomy following endocrine testing to exclude a functional lesion. Subclinical Cushing’s syndrome was suggested by the failure to obtain adequate cortisol suppression (less than 1.8 μg/dL) following dexamethasone administration pre-operatively; cortisol suppression was restored post- operatively following the excision of the tumor. Histology was consistent with a corticomedullary mixed adenoma, a lesion for which, there is paucity of published data regarding its natural history and long term outcome. The finding of this case highlights the importance of this extremely rare entity which should be included in the long list of causes of adrenal incidentaloma since cases with intra-operative complications have been described. The previously reported reappearance of this tumor in the contralateral adrenal gland emphasizes the need for prolonged follow-up. Key words: Corticomedullary mixed adrenal tumor, Cortical adenoma, Phaeochromocytoma (Endocrine Journal 56: 817-824, 2009) THE WIDESPREAD use of abdominal imaging, par- dices to distinguish potentially malignant from benign ticularly computed tomography (CT) and magnetic lesions [3]. resonance imaging (MRI), during diagnostic testing or Corticomedullary mixed tumor is a single adrenal treatment for many clinical conditions has resulted in tumor mass composed of an intimately admixed pop- the identification of previously unsuspected adrenal le- ulation of both adrenal cortical cells and phaeochro- sions defined as adrenal incidentalomas [1, 2]. Since mocytes [4]. Such tumors exhibit histologic features the management of adrenal incidentalomas is influ- of both adrenocortical adenoma and phaechromocy- enced by the functional status and malignant potential toma different from simultaneously tumors arising in of these lesions it is mandatory to exclude a hormo- the same gland [4]. Currently, no data has been pub- nal hypersecretory state, particularly the presence of a lished regarding the prevalence of these tumors. As pheochromocytoma, and use accurate radiological in- only a small number of cases has been described in the medical literature there is a lack of information re- garding their pathogenesis, optimal treatment and long Received Jan. 9, 2009; Accepted Apr. 10, 2009 as K09E-010 term outcome. Although these tumors are exclusively Released online in J-STAGE as advance publication May 20, 2009 derived from the adrenal glands they are currently not Correspondence to: Krystallenia ALEXANDRAKI, MD., MSc, MSc, Ph.D., Department of Endocrinology, Laiko General Hospital included in the long list of adrenal incidentalomas ae- School of Medicine, National & Kapodistrian University of Athens tiology [5, 6]. E-mail: [email protected] We present a 66-year-old woman with a left adre- 818 ALEXANDRAKI et al. nal incidentaloma identified by CT while being investi- gated for a spigelian hernia. Due to subclinical autono- mous glucocorticoid secretion and suspicious imaging characteristics she underwent a left adrenalectomy. The diagnosis of corticomedullary mixed tumor was an in- advertent discovery of the pathology report. Case Report A 66-year-old female was admitted to the Surgical Department for an elective repair of a spigelian her- nia [7]. Clinical examination and review of systems as well as family and past medical history were unre- markable. The patient reported occasionally a mild increase of blood pressure in the range of systolic blood pressure 140-145mmHg and diastolic blood pressure 85-90mmHg which was controlled by weight reduction and salt restriction; increased blood pres- sure was not confirmed in the present admission or previous medical recordings. Patient’s body mass in- dex (BMI) was 28.13 kg/m2 and waist circumference Fig. 1. Computed tomography imaging describing the adrenal was 92cm. Following an abdominal CT, a 4 cm left tumor with punctuated calcification pre-operatively. adrenal lesion was identified. Since the patient had no symptoms suggestive of a functioning adrenal neo- Pathology report plasm and no evidence of another systemic disease, a provisional diagnosis of an adrenal incidentaloma was Macroscopically, the tumor was well circum- made. However, the CT imaging described an adeno- scribed and encapsulated, weighing 65 g and measur- ma with punctuated calcification along with the pres- ing 4.2x3.7x3.4 cm. Histology was consistent with ence of two simple cysts in the liver and the spige- an adrenocortical adenoma that exhibited features of lian hernia of the anterior abdominal wall (Figure 1). neuroendocrine differentiation (Figure 3 A-D). The Due to the atypical CT imaging characteristics, MRI cut surface was yellow-orange in colour, with a few of the abdomen was also performed which confirmed foci of dark discoloration. Microscopically, sections the presence of a heterogeneous left adrenal mass, 3.5 showed clusters, cords or alveoli of cells with round cm in maximum diameter, with cystic components to oval, not pleomorphic nuclei (low grade- Fuhrman that were not compatible with an adenoma or myelol- 1 and 2) and abundant pale-staining cytoplasm (Figure ipoma raising the suspicion of malignancy (Figure 2) 3A). Focally, there were nests of cells having com- as well as the presence of simple liver cysts. As en- pact, eosinophilic cytoplasm. Mitoses were absent. docrine investigations revealed concomitant mild au- Among the above described cells, there were enlarged tonomous glucocorticoid secretion (Table 1) it was de- cells present, distributed either as single cells or as cided to proceed to surgical removal of the left adrenal small clusters. They were characterised by abundant and concomitant hernia repair. The patient was sub- eosinophilic cytoplasm, containing pigmented granu- mitted in a combined uneventful resection of left adre- lar material and enlarged nuclei with prominent nucle- nal and hernia repair; during the operation the patient oli or nuclear inclusions (Figure 3B). Mitotic activity was covered with hydrocortisone administration [8]. was not found in these areas. Immunohistochemically, The patient had an uneventful recovery and was dis- the enlarged cells were positive to synaptophysin charged after 5 days without any medications. (Figure 3C) and chromogranin A (Figure 3D). There was no evidence of vascular or capsular invasion in the encapsulated sections. CORTICOMEDULLARY MIXED ADRENAL TUMOR 819 PRE-OPERATIVE INVESTIGATION WITH MAGNETIC RESONANCE IMAGING POST-OPERATIVE INVESTIGATION WITH MAGNETIC RESONANCE IMAGING Fig. 2. Magnetic resonance imaging during the pre-operative and post-operative investigation. The white arrow is indicating the adrenal tumor pre-operatively and the black arrow the post-operative changes in the surgical area. Fig. 3. A. Nests of clear cells, low nuclear grade (Fuhrman 1 and 2) (Hematoxylin and Eosin x 200). B. Large cells with abundant cytoplasm and enlarged nuclei including prominent nucleoli. Brown granules within the cytoplasm are evidenced (Hematoxylin and Eosin x 200). C. Positive immunostaining of large cells for synaptophysin (Avidin Biotin Peroxidase Complex x 200). D. Positive immunostaining of large cells for chromogranin (Avidin Biotin Peroxidase Complex x 200). 820 ALEXANDRAKI et al. Table 1. The pre-operative investigation of the adrenal incidentaloma modified by the suspicion for malignancy and the post-operative investigation one year after the adrenalectomy. Values Hormonal Parameters (morning values) Reference Range Pre-operatively Post-operatively Adrenocorticotrophin (pmol/L) 1.93 9.4 0.22-11 Total cortisol (nmol/L) 382 281 260-720 Plasma Renin Activity (ng/ml/h) 0.66 1.88 0.15-2.33 Aldosterone (pmol/L) 425.2 192 27.70-443.2 Dehydroepiandrosterone Sulphate (μmol/L) 1.35 0.16 2.7-21.6 Carcinoembryonic antigen (mcg/L) 1.39 2.1 <5 Ca- 15.3 (U/mL) 15.7 19.6 3-28 Ca-125 (U/mL) 6.26 6.71 <30 Ca 19.9 (U/mL) 3.5 4.29 <37 Alpha-fetoprotein (ng/mL) 8.39 6.1 <6 Thyroid-stimulating hormone (mU/L) 2 2.45 0.3-4.0 Free thyroxine (pmol/L) 17.6 15.1 10-25 3,5,3’-triiodothyronine (nmol/L) 1.97 2.36 1.23-3.08 Calcitonin (mIU/L) 4.4 4.6 0-10 Biochemical parameters (morning values) Sodium (mmol/L) 141 142 135-144 Potassium (mmol/L) 4.5 4.2 3.6-4.8 Glucose (mmol/L) 5.44 4.88 3.89-6.66 Urea (mmol/L) 12.9 10.71 5-17.80 Creatinine (mmol/L) 0.11 0.8 0.07-1.12 Aspartate aminotransferase (U/L) 18 17 <45 Alanine aminotransferase (U/L) 15 13 <45 Gamma glutamyl transferase (U/L) 14 8 <32 Hormonal Parameters (afternoon values) Total cortisol (nmol/L)
Load more

Recommended publications
  • Read the Conference Programme
    Conference Programme 14th International Conference on Thalassaemia and Other Haemoglobinopathies & 16th TIF Conference for Patients and Parents 17-19 November 2017 Grand Hotel Palace, Thessaloniki, Greece Greek Thalassaemia Association 2 Join TIF e-Academy Take the Thal e-Course and learn about: • the genetic mechanisms that cause thalassaemia • the history of thalassaemia • blood, its components, and the blood-making process • ineffective erythropoiesis and the life-saving value of blood transfusions in thalassaemia • iron overload, iron therapy and drugs: why and how does iron overload happen, how is it monitored and treated? • Haemopoietic Stem Cell Transplantation and the current clinical advances in thalassaemia cure • the effects of dietary iron intake, recommended diet and physical exercise for patients with thalassaemia • the rights of patients with thalassaemia in education, employment, and other key aspects of life: What national legislations and policies protect their rights across the globe? and many more Become an expert patient Expert patients can delve deep into the whats and whys of their condition and make meaningful decisions about their health. Very importantly, they can play a key role in the improvement of health, social, economic policies related to their condition and quality of life. Host: Thalassaemia International Federation (TIF) For more information, visit TIF e-Academy at www.thalassaemia.org.cy or contact [email protected] 17 - 19 NOVEMBER 2017 • THESSALONIKI • GREECE 3 Contents • Welcome Message 4 • Conference Committees 6 • Opening Ceremony 11 • Scientific Programme 13 • Patients/Parents Programme 16 • Faculty 19 • Oral Presentations 24 • Poster Abstracts 26 • Thessaloniki City Walks & Tours 32 • Side Meetings 34 • Supporters 35 14TH INTERNATIONAL CONFERENCE ON THALASSAEMIA AND OTHER HAEMOGLOBINOPATHIES & THE 16TH TIF CONFERENCE FOR PATIENTS AND PARENTS 4 Welcome Message by the Conference Chairpersons Dear Friends, The host today, Greece, has not been selected by chance.
    [Show full text]
  • Correlation Between LGR5 Stem Cells and Location of Tumor As Well As Age
    JBUON 2020; 25(4): 1827-1831 ISSN: 1107-0625, online ISSN: 2241-6293 • www.jbuon.com Email: [email protected] ORIGINAL ARTICLE Correlation between LGR5 stem cells and location of tumor as well as age, sex and metastasis in colon adenocarcinoma David Symeonidis1, Andreas Lazaris2, Adamantia Zizi-Zerbetzoglou3, Panagiotis Christo- doulou4, Nikolaos Kavantzas2, Nikolaos Tsavaris5, Georgia-Eleni Thomopoulou6 1Resident doctor in Medical Oncology Department, Metaxa Cancer Hospital, Piraeus, Greece. 2istopathologist, National and Kapodistrian University of Athens, Pathology Department, Laiko General Hospital, Athens, Greece. 3Pathology Department, Tzaneio General Hospital of Piraeus, Greece. 4Resident doctor, Department of Internal Medicine, Evaggelismos General Hospital, Athens, Greece. 5Medical Oncologist, Former Professor, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece. 6National and Kapodistrian University of Athens, Attiko General Hospital, Athens, Greece. Summary Purpose: G-protein receptors belong to a large family of Whitney U test showed no statistical significance between receptors which includes more than 800 kinds. An interest LGR5 and sex with p=0.778. Fisher’s test, however, showed for these receptors arose upon noticing their expression on a statistically significant result between metastasis and ex- skin, intestine and breast stem cells. pression of LGR5 with p=0.025. Methods: We examined the tissues of 53 patients who had Conclusions: It becomes apparent that patients with in- been diagnosed with adenocarcinoma of the colon. There were creased expression of these two markers are characterized no exclusion criteria. We measured the expression levels of by a more aggressive form of the disease with an increased LGR5 by immunohistochemistry and we correlated those and rate of metastasis.
    [Show full text]
  • 9Thinternmedcongress2017.Pdf
    ORGANIZATION Organizers: INSTITUTE OF INTERNAL MEDICINE & HEPATOLOGY, LARISSA, GREECE DEPARTMENT OF MEDICINE & RESEARCH LABORATORY OF INTERNAL MEDICINE, UNIVERSITY OF THESSALY MEDICAL SCHOOL, LARISSA, GREECE Director: Professor G.N. Dalekos ORGANIZING COMMITTEE (BOARD MEMBERS OF THE INSTITUTE OF INTERNAL MEDICINE & HEPATOLOGY): President: G.N. Dalekos Members: K. Krapis K.P. Makaritsis C. Mandros G. Ntaios SCIENTIFIC COMMITTEE & FACULTY MEMBERS M. Akova S. Georgiadou M.N. Manoussakis M. Samson A. Alexopoulou S. Georgopoulos C. Marañón D. Sereni Q. Anstee E. Giannitsioti H. Mattle P.P. Sfikakis I. Baskozos L. Guillevin F. Menichetti K. Spengos M. Blank C. Hadjichristodoulou D.L. Menucci A. Stefos S. Blot S.J. Hadziyannis N. Montano D. Strbian Y. de Boer Α. Hatzitolios P. Montravers H. Toplak E. Boutati G. Hirschfield V. Mouchtouri Ε.V. Tsianos M. Burnier T. Hofmann H.Μ. Moutsopoulos E.A. Tsochatzis H.R. van Buuren G.K. Hovingh P. Nilsson S. Unal L. Christou C. Jamin G. Ntaios P. Valensi G.L. Daikos J. Jordan C.J. Packard Κ. Vemmos E. Cholongitas Ν.L. Katsilambros R. Pálsson D. Vergani G.N. Dalekos M. Kohrmann N. Papanas P.G. Vlachoyiannopoulos M. Deutch J. Koskinas G. Papatheodoridis M. Voulgarelis M. Dichgans V. Kotsis D. Papazoglou H. Wedemeyer G.D. Dimitriadis C. Labropoulou-Karatza V. Papavasileiou C. Weimar G. Dimopoulos V. Lambadiari A. Pares C. Yurdaydin Μ.Α. Dimopoulos R. Liberal T.R. Pedersen Κ. Zachou S. Dourakis G. Lip G. Petrikkos A. Zanchetti M. Ekstedt J.A. Lopes J. Putaala D. Ziegler Μ. Elisaf Κ.P. Makaritsis V. Ratziu M. Rizzo J.M. Ferro Ε.
    [Show full text]
  • Review Article the Beliefs, Myths, and Reality Surrounding the Word Hema
    Hindawi Publishing Corporation Anemia Volume 2010, Article ID 857657, 6 pages doi:10.1155/2010/857657 Review Article The Beliefs, Myths, and Reality Surrounding theWordHema(Blood)fromHomertothePresent John Meletis and Kostas Konstantopoulos First Department of Internal Medicine, School of Medicine, Laiko General Hospital Athens, National and Kapodistrian University of Athens, Athens 11527, Greece Correspondence should be addressed to John Meletis, [email protected] Received 10 February 2010; Revised 7 April 2010; Accepted 4 May 2010 Academic Editor: Edward F. Bell Copyright © 2010 J. Meletis and K. Konstantopoulos. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. All ancient nations hinged their beliefs about hema (blood) on their religious dogmas as related to mythology or the origins of religion. The Hellenes (Greeks) especially have always known hema as the well-known red fluid of the human body. Greek scientific considerations about blood date from Homeric times. The ancient Greeks considered hema as synonymous with life. In Greek myths and historical works, one finds the first references to the uninterrupted vascular circulation of blood, the differences between venous and arterial blood, and the bone marrow as the site of blood production. The Greeks also speculated about mechanisms of blood coagulation and the use of blood transfusion to save life. “...Iητρικη´, δε πα´ντα
    [Show full text]
  • Scientific Programme Table of Contents
    SCIENTIFIC PROGRAMME TABLE OF CONTENTS Welcome Message .............................................................................................................. 3 Organization ..................................................................................................................... 4-5 Scientific Information ................................................................................................ 6-10 - Guidelines for Invited Faculty & Presenting Authors .......................... 6-8 - Oral Presentations ......................................................................................... 9-10 - e-Poster Viewing .................................................................................................10 Scientific Programme .............................................................................................. 11-40 - Thursday, March 22, 2018 ........................................................................ 11-20 - Friday, March 23, 2018 .............................................................................. 21-32 - Saturday, March 24, 2018 ......................................................................... 33-40 e-Posters ........................................................................................................................ 41-92 Index of Invited Faculty ........................................................................................ 93-101 Index of Oral Presentations & e-Posters .................................................... 102-118 Satellite
    [Show full text]
  • Clinical Guidelines on Calcium and Vitamin D Supplementation
    Journal of Research and Practice on the Musculoskeletal System JOURNAL OF RESEARCH AND PRACTICE ON THE MUSCULOSKELETAL SYSTEM Proceedings Abstracts of the Scientific Meeting of the Hellenic Osteoporosis Foundation Clinical Guidelines on Calcium and Vitamin D supplementation Certainties and concerns on the osteoporosis treatment 14th-16th December 2018, Thessaloniki, Greece Organizer: George Trovas, MD, PhD DIAGNOSIS AND CLINICAL SIGNIFICANCE OF for the differential diagnosis of a bone lesion inside a OSTEOPOROTIC VERTEBRAL FRACTURES vertebrae, including primary or metastatic bone tumors. MRI provides evidence of a recent vertebral fracture, Konstantinos D. Stathopoulos Postgraduate Course on Bone Metabolic Diseases, National and which is accompanied by bone marrow oedema, and has Kapodistrian University of Athens, School of Medicine, Athens, no radiation, but is an expensive and not readily available technique. The clinical significance of osteoporotic Greece vertebral fractures in the context of bone strength is that Vertebral fractures of the thoracic and lumbar spine are they are indicators of increased fracture risk, especially considered the most common type of fracture in patients in untreated individuals. It has been shown that previous with osteoporosis. They may present as early as the sixth vertebral fractures increase about 3-fold the risk of a new decade of life and their prevalence increases with age. vertebral fracture and about 1,5-2-fold of a non vertebral They are usually attributed to low energy falls (i.e fall fracture in osteoporotic women. It has also been shown from a standing height), but can also occur without falling, that the number and severity of prevalent vertebral most often while bending or trying to lift a heavy object.
    [Show full text]
  • Government Debt Crisis and the Impact on National Health Systems: a Retrospective Study and Policy Recommendations to Greece
    Open Access Original Article DOI: 10.7759/cureus.10786 Government Debt Crisis and the Impact on National Health Systems: A Retrospective Study and Policy Recommendations to Greece Evangelos Diamantis 1 , Vasileios Charalampopoulos 2 , Christos Damaskos 3, 4 , Paraskevi Farmaki 5 , Nikolaos Garmpis 2 , Anna Garmpi 6 , Alexandros Patsouras 7 , Georgios Kyriakos 8 , Spyridon Savvanis 9 , Vasiliki E. Georgakopoulou 10, 11 , Nikolaos Trakas 12 , Kostas Kounetas 13 1. Internal Medicine: Diabetes and Endocrinology, Evangelismos Hospital, Athens, GRC 2. Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC 3. Surgery, Renal Transplantation Unit, Laiko General Hospital, Athens, GRC 4. Surgery, N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, GRC 5. Pediatrics, Agia Sofia Children’s Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC 6. Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, GRC 7. Internal Medicine, Tzaneio General Hospital, Pireas, GRC 8. Internal Medicine: Diabetes and Endocrinology, Hospital General Universitario Santa Lucia, Cartagena, ESP 9. Internal Medicine, General Hospital of Athens “Elpis”, Athens, GRC 10. Internal Medicine: Pulmonology, Laiko General Hospital, Athens, GRC 11. Internal Medicine: Pulmonology, Sismanogleio Hospital, Athens, GRC 12. Laboratory Medicine, Sismanogleio Hospital, Athens, GRC 13. Economics, University of Patras, Patras, GRC Corresponding author: Christos Damaskos, [email protected] Abstract This article aims to explore the impact of the government debt crisis on the national health system (NHS) using a representative sample of respondents in Greek hospitals and provides certain suggestions regarding health policies that could be implemented at the national or local level.
    [Show full text]
  • Touchreviews in Endocrinology
    touchREVIEWS in Endocrinology VOLUME 1 • ISSUE 1 • 2021 EDITOR-IN-CHIEF: JOHN DOUPIS The Role of Individualized Exercise Prescription in Type 2 Diabetes Management John Doupis, Konstantinos Karras and Konstantinos Avramidisan Dapagliflozin as Adjunct Therapy to Insulin in Patients with Type 1 Diabetes Mellitus: Efficacy and Safety of this Combination Johan H Jendle, Francisco Javier Ampudia-Blasco, Martin Fuchtenbusch and Paolo Pozzilli Clinical, Metabolic and Hormonal Profiles of Bangladeshi Adolescents with Polycystic Ovary Syndrome ABM Kamrul-Hasan, Fatema Tuz Zahura Aalpona and Shahjada Selim Potential Role of Dexamphetamine in the Treatment of Non-alcoholic Fatty Liver Disease: Hopes and Pitfalls CS Gautam, Jatin Sharma, Mandeep Singla, Ilmjot Kaur Tiwana and Harmanjit Singh SSN 2752-5457 eI www.touchENDOCRINOLOGY.com touchREVIEWS in Endocrinology Cover image: Fat cells – 3d rendered illustration Volume 1 • Issue 1 • Spring 2021 By xrender © shutterstock.com Editorial Directors Helen Fowler Editor-in-Chief Gina Furnival Commissioning Editors John Doupis Director of the Diabetes Division of Iatriko Palaiou Falirou Medical Center and the Internal Medicine and Diabetes Department, Sophie Nickelson (Therapy Lead) the NS Naval Hospital, Athens, Greece Katey Gabrysch Victoria Jones Editorial Workflow Lisa Glass Heather Hall Section Editors Joanna Macdiarmid Editorial Assistant George P Chrousos Ashley Grossman Professor and Chairman, First Department of Professor of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Louise Taylor
    [Show full text]
  • The Relevance and Added Value of Geriatric Medicine (GM): Introducing GM to Non-Geriatricians
    Journal of Clinical Medicine Review The Relevance and Added Value of Geriatric Medicine (GM): Introducing GM to Non-Geriatricians Marina Kotsani 1,2,3,* , Evrydiki Kravvariti 1,4,5 , Christina Avgerinou 1,6, Symeon Panagiotakis 1,7, Katerina Bograkou Tzanetakou 1,8, Eleftheria Antoniadou 1,9, Georgios Karamanof 1,10, Athanasios Karampeazis 1,11, Anastasia Koutsouri 1,12, Kyriaki Panagiotopoulou 1,13, George Soulis 1,12,14, Konstantinos Stolakis 1,15, Ioannis Georgiopoulos 1,2,3 and Athanase Benetos 1,2,3,16 1 Working Group on the Development of Geriatric Medicine in Greece of the Hellenic Society for the Study and Research of Aging, 15342 Athens, Greece; [email protected] (E.K.); [email protected] (C.A.); [email protected] (S.P.); [email protected] (K.B.T.); [email protected] (E.A.); [email protected] (G.K.); [email protected] (A.K.); [email protected] (A.K.); [email protected] (K.P.); [email protected] (G.S.); [email protected] (K.S.); [email protected] (I.G.); [email protected] (A.B.) 2 Department of Geriatrics, CHRU de Nancy, 54500 Vandœuvre-lès-Nancy, France 3 FHU CARTAGE-PROFILES, Université de Lorraine, 54505 Vandœuvre-lès-Nancy, France 4 1st Department of Propaedeutic Internal Medicine, Laiko General Hospital, 11527 Athens, Greece 5 Postgraduate Medical Studies in the Physiology of Aging and Geriatric Syndromes, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece 6 Department of Primary Care and Population Health, University
    [Show full text]
  • Touchreviews in Endocrinology
    touchREVIEWS in Endocrinology VOLUME 17 • ISSUE 1 • 2021 EDITOR-IN-CHIEF: JOHN DOUPIS The Role of Individualized Exercise Prescription in Type 2 Diabetes Management John Doupis, Konstantinos Karras and Konstantinos Avramidisan Dapagliflozin as Adjunct Therapy to Insulin in Patients with Type 1 Diabetes Mellitus: Efficacy and Safety of this Combination Johan H Jendle, Francisco Javier Ampudia-Blasco, Martin Fuchtenbusch and Paolo Pozzilli Clinical, Metabolic and Hormonal Profiles of Bangladeshi Adolescents with Polycystic Ovary Syndrome ABM Kamrul-Hasan, Fatema Tuz Zahura Aalpona and Shahjada Selim Potential Role of Dexamphetamine in the Treatment of Non-alcoholic Fatty Liver Disease: Hopes and Pitfalls CS Gautam, Jatin Sharma, Mandeep Singla, Ilmjot Kaur Tiwana and Harmanjit Singh SSN 2752-5457 eI www.touchENDOCRINOLOGY.com touchREVIEWS in Endocrinology Cover image: Fat cells – 3d rendered illustration Volume 17 • Issue 1 By xrender © shutterstock.com Editorial Directors Helen Fowler Editor-in-Chief Gina Furnival Commissioning Editors John Doupis Director of the Diabetes Division of Iatriko Palaiou Falirou Medical Center and the Internal Medicine and Diabetes Department, Sophie Nickelson (Therapy Lead) the NS Naval Hospital, Athens, Greece Katey Gabrysch Victoria Jones Editorial Workflow Lisa Glass Heather Hall Section Editors Joanna Macdiarmid Editorial Assistant George P Chrousos Ashley Grossman Professor and Chairman, First Department of Professor of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Louise Taylor Paediatrics,
    [Show full text]
  • Final Program Programme Complet
    Organized by the Hellenic Section of the Balkan Medical Union Final Program Programme complet Main Venue Hotel “Athinais” 25, 26 and 27 September 2018 Hotel “Alexandros” 26 September 2018 COMMITTEES / COMITÉS ORGANIZING COMMITTEE (COMITÉ D’ORGANISATION) Presidents (Présidents) Theodoros Papaioannou, Associate Professor of Biomedical Engineering, Medical School, National and Kapodistrian University of Athens, Athens, Greece, Vice - President of the Hellenic Section of B.M.U. Marianna Karamanou, Associate Professor of History of Medicine, Medical School, University of Crete, Crete, Greece, President of the Hellenic Section of B.M.U. Members (Membres) Niki Agnantis, Em. Professor of Pathology, former vice Rector of the University of Ioannina, Greece, Honorary President of B.M.U. Gregory Tsoucalas, Lecturer of History of Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece, General Secretary of the Hellenic Section of B.M.U. Presidents and Board Members of the National Sections of the B.M.U. (Présidents et Membres du Conseil d’Administration des Sections Νationales de B.M.U.) Albania Former Yugoslav Republic of Macedonia Serbia Prof. Ylli Popa, President, Tirana (FYROM) Prof. Jovan Vasiljevic, Honorary President, Prof. Mentor Petrela, General Secretary, Tirana Prof. Ninoslav Ivanovski, President, Skopje Belgrade Prof. Koko Cakalaroski, Vice-President, Skopje Prof. Vladmila Bojanic, President, Nis Bulgaria Doc. Dr. Igor Nikolov, General Secretary, Skopje Doc. Dr. Zoran Bojanic, Vice-President, Nis Prof. Venko Alexandrov, Honorary President, Prof. Boris Djindjic, Vice-President, Nis Sofia Romania Dr. Dijana Stojanovic, General Secretary, Nis Prof. Latchezar Traykov, President, Sofia Dr. Camelia Diaconu, President, Bucharest, Prof. Valentina Petkova, General Secretary, Sofia International Secretary General of the B.M.U.
    [Show full text]
  • Re-Operative Laparoscopic Colorectal Surgery: a Systematic Review
    Journal of Clinical Medicine Review Re-Operative Laparoscopic Colorectal Surgery: A Systematic Review Constantine Halkias 1,* , Athanasios Zoikas 2 , Zoe Garoufalia 3 , Michalis K. Konstantinidis 4, Argyrios Ioannidis 4 and Steven Wexner 5 1 General Surgery Department, Brighton and Sussex University Hospitals, Brighton BN2 5BE, UK 2 The 2nd Department of Surgery, Sismanoglio General Hospital of Attica, 15126 Athens, Greece; [email protected] 3 The 2nd Department of Propaedeutic Surgery, Laiko General Hospital, 11527 Athens, Greece; [email protected] 4 Department of General, Laparoscopic, Oncologic and Robotic Surgery, Athens Medical Center, 15125 Athens, Greece; [email protected] (M.K.K.); [email protected] (A.I.) 5 Digestive Disease Center, Cleveland Clinic Florida, Weston, FL 33331, USA; [email protected] * Correspondence: [email protected] Abstract: Introduction: Re-operative laparoscopic colorectal surgery is becoming increasingly com- mon. It can be a challenging procedure, but its benefits can outweigh the associated risks. Methods: A systematic review of the literature reporting re-operative laparoscopic surgery was carried out. Retrospective and prospective cohort studies and case series were included, with case reports being excluded. Results: Seventeen articles dated from 2007 to 2020 were included in the systematic review. In total, 1555 patients were identified. Five hundred and seventy-four of them had a laparoscopic procedure and 981 an open re-operation. One hundred and eighty-three women had a laparoscopic operation. The median age ranged from to 44.9 years to 68.7 years. In seven studies, the indication of the index operation was malignancy, one study regarded re-laparoscopy for excision of lateral Citation: Halkias, C.; Zoikas, A.; pelvic lymph nodes, and one study looked at redo surgery of ileal J pouch anal anastomosis.
    [Show full text]