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Adrenal Mass

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3381. Strategies to Reduce Antipsychotic-Associated Weight Gain in Youth

: placebo 500/0mg tablets, 250-2000mg/day divided BID to TID, po, 26 weeks Outcome Measures Go to Primary Outcome Measures : Change From Baseline to Week 24 in Body Mass Index (BMI) [ Time Frame: 0-24 weeks ] Change in BMI-Body Mass Index (BMI) is a measure of body fat based on height, weight,gender and chronological age. Change in BMI is calculated as 24 weeks BMI minus the baseline BMI. Change From Baseline to Week 24 in Weight [ Time Frame: 24 weeks ] Change in weight is calculated as 24 weeks weight (...) minus the baseline weight. Change From Baseline to Week 24 in Fat Mass [ Time Frame: 24 weeks ] Fat mass is a measure of excess body fat. Change in Fat Mass is calculated as 24 weeks fat mass minus the baseline fat mass. Secondary Outcome Measures : Change From Baseline to Week 24 in Insulin Level [ Time Frame: 24 weeks ] Insulin is a peptide hormone and regulates carbohydrate and fat metabolism in the body.Change in Insulin level is calculated as the 24 weeks insulin level minus the baseline

2008 Clinical Trials

3382. Improving Metabolic Parameters of Antipsychotic Child Treatment With Ziprasidone, Aripiprazole, and Clozapine

] Percent Change in Fat Mass [ Time Frame: 24 weeks ] Percent Change in Weight [ Time Frame: 24 weeks ] Secondary Outcome Measures : Percent Change in Insulin Levels [ Time Frame: 24 weeks ] Percent Change in Total Cholesterol [ Time Frame: 24 weeks ] Percent Change in Triglycerides [ Time Frame: 24 weeks ] Incidence of Metabolic Syndrome [ Time Frame: 24 weeks ] Percent Change in Glucose Levels [ Time Frame: 24 weeks ] Percent Change in HDL [ Time Frame: 24 weeks ] Percent Change in LDL [ Time Frame (...) program. Current active thyroid (TSH >18 microIU/ml), hepatic (2 LFTs >4x upper limits of normal), renal (serum Creatinine >1.4 mg/dL in females and serum Creatinine >1.5 mg/dL in males), cardiac, gastrointestinal, or adrenal disease. Fasting glucose > 125 mg/dL on two occasions indicating need for prompt treatment for diabetes. Child meets DSM-IV criteria for substance abuse or dependence disorder within the past month, not including tobacco abuse or dependence • Current treatment with more than one

2008 Clinical Trials

3383. Insulin Resistance, Polycystic Ovary Syndrome, and Bone Research Study

syndrome (PCOS). Condition or disease Intervention/treatment Phase Polycystic Ovary Syndrome Drug: rosiglitazone Drug: drospirenone/ethinyl estradiol Phase 4 Detailed Description: The purpose of this study is to: 1) to compare effects of treatment with drospirenone/ethinyl estradiol (Yasmin)versus rosiglitazone (Avandia) on hyperandrogenism, insulin resistance/hyperinsulinemia, adrenal hyperresponsiveness, body composition, chronic inflammation, bone mass and turnover. OCPs are the first-line therapy (...) . [ Time Frame: Baseline and 6 months ] Glucose tolerance status was classified according to the ADA (American Diabetes Association) criteria. Secondary Outcome Measures : Total Fat Mass at Baseline and 6 Months [ Time Frame: Baseline and 6 months ] DXA (dual-energy x-ray absorptiometry) scans were done to measure total fat mass. Total Testosterone at Baseline and 6 Months [ Time Frame: Baseline and 6 months ] Total testosterone was measured by HPLC(high-performance liquid chromatography)-tandem mass

2008 Clinical Trials

3384. Night eating status and influence on body weight, body image, hunger, and cortisol pre- and post- Roux-en-Y Gastric Bypass (RYGB) surgery Full Text available with Trip Pro

Night eating status and influence on body weight, body image, hunger, and cortisol pre- and post- Roux-en-Y Gastric Bypass (RYGB) surgery Night Eating Syndrome is a common disorder in severely obese individuals and may be associated with hypothalamic pituitary adrenal (HPA) axis dysregulation. This study compared night eaters (NE) and comparably obese controls (C) pre- and post-Roux-en- Y Gastric Bypass surgery at 2 and 5 months, following an overnight fast on hormonal measures associated (...) with HPA axis and related appetite and psychological measures. There were 24 (10 NE, 14 C) clinically severely obese participants (body mass index =47.0+/-8.4 SD). At pre-surgery baseline, afternoon fasting hunger ratings differed significantly and were lower for NE than for C (p=0.01). Eight of the participants (4 NE, 4C) returned for all 3 study visits. At 5 months post-surgery, NE and C did not differ in weight loss, reductions in waist circumference, insulin levels, and insulin resistance

2008 Eating and Weight Disorders

3385. Undiagnosed Pheochromocytoma: The Anesthesiologist Nightmare Full Text available with Trip Pro

Undiagnosed Pheochromocytoma: The Anesthesiologist Nightmare A male, 62 years of age, presented to the operating room for the removal of a right adrenal mass. Induction of anesthesia triggered a severe hypertensive crisis resistant to high doses of nitroprusside, nitroglycerin and labetalol. The crisis was ultimately resolved with the administration of 5 mg bolus of phentolamine. Surgery was canceled, the patient was transported to the intensive care unit with a continuous drip of phentolamine (...) . High urinary and plasma catecholamines suggested the presence of pheochromocytoma. Three weeks of oral phenoxybenzamine therapy subsequently allowed uneventful induction of anesthesia and open adrenalectomy. Pathologic examination of the resected adrenal tissue confirmed the presence of pheochromocytoma. Anesthetic drugs can exacerbate the life-threatening cardiovascular effects of catecholamines secreted by pheochromocytomas. Treating patients preoperatively with alpha-adrenergic blockade

2004 Clinical Medicine and Research

3386. Hypertension from targeted ablation of chromogranin A can be rescued by the human ortholog Full Text available with Trip Pro

for hypertension. We generated Chga and humanized mice through transgenic insertion of a human CHGA haplotype in order to probe CHGA and catestatin in vivo. Chga mice displayed extreme phenotypic changes, including: (a) decreased chromaffin granule size and number; (b) elevated BP; (c) loss of diurnal BP variation; (d) increased left ventricular mass and cavity dimensions; (e) decreased adrenal catecholamine, neuropeptide Y (Npy), and ATP contents; (f) increased catecholamine/ATP ratio in the chromaffin

2005 Journal of Clinical Investigation

3387. Surgical treatment of malignant involvement of the inferior vena cava Full Text available with Trip Pro

carcinoma (n = 6), and hepatocarcinoma (n = 2). In all but 2 patients, inferior vena cava surgical treatment was associated with multivisceral resection, including extended nephrectomy (n = 5), resection of neoplastic mass (n = 3), major hepatic resection (n = 2), and adrenal gland resection (n = 1). Prosthetic repair was performed in 5 patients (45%).There were no early deaths. Major complications occurred in 1 patient (9%). Mean length of stay was 16 days. Late graft thrombosis or infection did

2006 International Seminars in Surgical Oncology

3388. Urinary cortisol and cortisol metabolite excretion in chronic fatigue syndrome. (Abstract)

Urinary cortisol and cortisol metabolite excretion in chronic fatigue syndrome. Reduced basal hypothalamic-pituitary-adrenal (HPA) axis output in chronic fatigue syndrome (CFS) has been inferred from low cortisol levels in blood, saliva, and urine in some studies. Because > 95% of cortisol is metabolized before excretion, we assessed cortisol output by assay of both cortisol metabolites and free cortisol in 24-hour urine collections and also investigated sex differences in these between CFS (...) and control groups.We calculated total urinary cortisol metabolites (TCM) and cortisol metabolite ratios from individual steroid data in 40 patients (20 males and 20 females) with CFS who were free of medication or comorbid psychiatric disorder likely to influence the HPA axis. Results were compared with those of 40 healthy volunteers (20 males and 20 females) well matched for age and body mass index. Data for free cortisol was obtained on 28 of the patients and 27 of the controls.The mean of TCM

2006 Psychosomatic Medicine

3389. Bone mineral density, bone turnover, and osteoprotegerin in depressed women with and without borderline personality disorder. Full Text available with Trip Pro

-adrenal system and subsequent hypercortisolemia. To date, it is unclear whether comorbid BPD in depressed patients modulates the extent of bone mass reduction. Therefore, we examined bone density, markers of bone turnover, and proinflammatory cytokines in depressed patients with and without BPD. Patients with BPD alone and healthy women served as comparison groups.Twenty-four patients with MDD and 23 patients with comorbid MDD and BPD were included. Sixteen patients with BPD and 20 healthy women (...) of similar body mass index served as the comparison group. BMD was assessed by means of dual-energy x-ray absorptiometry. Markers of bone turnover, endocrine and immune parameters were determined. For data analysis, the group of depressed patients without comorbid BPD was divided according to age into two groups (younger depressed patients with a mean age of 30 years and older patients with a mean age of 42.9 years).BMD at the lumbar spine was significantly reduced in a) depressed women with comorbid BPD

2006 Psychosomatic Medicine

3390. Increased urinary cortisol levels during the menopause transition. (Abstract)

, or mood or sleep disturbances that affected hypothalamic-pituitary-adrenal axis function.One hundred sixty-nine women in the middle or late MT or early postmenopause stages provided monthly urine specimens for cortisol, FSH, and E1G, and rated symptoms and stress levels as part of a longitudinal study of the MT. Of these women, 91 completed a transition to the next MT stage: from early to middle (n = 30), middle to late (n = 39), or late to postmenopause (n = 22) and were eligible for inclusion (...) in the analyses.Cortisol increased from 7 to 12 months before the late MT stage to 7 to 12 months after onset of the late MT stage. There were no differences before and after the middle MT stage or the final menstrual period. Women with increased cortisol (>10 ng/mg creatinine) during the late MT stage had more severe vasomotor symptoms than those without changes, but did not differ in terms of age, body mass index, levels of FSH or E1G, health practices, exercise, mood, sleep, cognition, or stress levels.Cortisol

2006 Menopause

3391. Primary intraosseous paraganglioma of the sacrum: a case report. (Abstract)

Primary intraosseous paraganglioma of the sacrum: a case report. Paragangliomas are neuroendocrine tumors that most frequently arise in the adrenal medulla, carotid body, and glomus jugulare. However, they have been reported in many other sites throughout the body. Within the central nervous system, the overwhelming majority of paragangliomas arise intradurally in the area of the cauda equina. We report a case of a woman who presented with back pain and radiculopathy and was found to have (...) an intraosseous sacral mass on magnetic resonance imaging (MRI). Operative biopsy revealed that this lesion was a paraganglioma. Chest, abdomen, and pelvis computed tomography scans revealed no other tumors. This lesion was treated with limited resection, decompression, stabilization, and radiation therapy.To report a rare case of an intrasacral paraganglioma that presented with back pain and radiculopathy and was treated with intralesional decompression, stabilization, and radiation.Observational case

2007 The Spine Journal

3392. Correlation between endocrinological parameters and acne severity in adult women. Full Text available with Trip Pro

Correlation between endocrinological parameters and acne severity in adult women. Many studies demonstrate increased androgen levels and high prevalence of polycystic ovaries in women affected by acne. We evaluated the relationship between clinical features, ultrasonographic data on polycystic ovaries and hormonal parameters in 129 women >17 years of age with acne. Serum levels of androgens of ovarian and adrenal origin were measured. Menstrual cycle regularity, hirsutism, body mass index

2004 Acta Dermato-Venereologica

3393. Type-D personality and cortisol in survivors of acute coronary syndrome. (Abstract)

infarction, body mass index and concurrent depressed mood (p = .044). Type-D personality accounted for 6% over the variance in cortisol output over the day, after covariates had been taken into account.Type-D personality may be associated with prolonged disruption of the hypothalamic-pituitary-adrenal axis function in survivors of acute cardiac events and may contribute to biological responses influencing future cardiac morbidity.

2008 Psychosomatic Medicine

3394. Retroperitoneoscopic adrenalectomy: lateral versus dorsal approach. Full Text available with Trip Pro

Retroperitoneoscopic adrenalectomy: lateral versus dorsal approach. For tumours of the adrenal gland different surgical retroperitoneal approaches have been established, including the lateral and the dorsal approach. It is still unclear if the lateral or the dorsal approach should be preferred.A retrospective comparison between 21 patients who underwent retroperitoneoscopic adrenalectomy in lateral position (LRA) and 24 patients who underwent a retroperitoneoscopic adrenalectomy in dorsal (...) position (DRA).There were no significant differences with regard to the age, sex, tumour localisation, and the size of the tumour. The body-mass-index as well as the operation time was significantly higher of patients who underwent surgery in lateral position. Complications were comparable in both groups.The dorsal and the lateral retroperitoneal approach are ideal approaches for patients having had an intraabdominal surgery before. Due to the missing intraabdominal pressure the lateral approach

2008 Journal of Surgical Oncology

3395. Long-term follow-up status of patients with neuroblastoma after undergoing either aggressive surgery or chemotherapy--a single institutional study. (Abstract)

complications, the authors retrospectively investigated the long-term morbidity of patients who had reached adulthood.Sixteen patients with neuroblastoma currently 18 years of age or older were incorporated into the study. All were non-mass screening cases, and 13 of the patients had undergone aggressive surgery, whereas the remaining 3 cases had received aggressive chemotherapy.In the 13 patients who had undergone aggressive surgical treatment, a unilateral atrophy of the kidney was noted in 2 cases (...) of adrenal and retroperitoneal neuroblastomas, respectively. Dry ejaculation was noted in one case of a giant presacral neuroblastoma. A maldevelopment of the unilateral lower extremity was also noted in another case with a presacral tumor, which had been resected by abdominal and sacral approaches. In the 3 patients who had undergone aggressive chemotherapy, severe hearing loss occurred in 2 cases. However, social adaptation was well preserved in all 16 cases.Treatment-specific complications were found

2004 Journal of Pediatric Surgery

3396. Retroperitoneal hemangioma of infancy. (Abstract)

Retroperitoneal hemangioma of infancy. A premature infant presented with an incidental finding of a mass in the retroperitoneum adjacent to the adrenal gland seen on a renal ultrasound study. A clinical diagnosis of neuroblastoma was made based on imaging and laboratory studies; however, upon resection, histological examination revealed a cellular capillary hemangioma of infancy. Hemangioma should be considered in the differential diagnosis of asymptomatic retroperitoneal mass lesions

2006 Journal of Pediatric Surgery

3397. Carotid body tumor in a 13-year-old child: Case report and review of the literature. Full Text available with Trip Pro

Carotid body tumor in a 13-year-old child: Case report and review of the literature. Carotid body tumor (CBT), an extra-adrenal paraganglioma, represents an uncommon entity arising in chemoreceptor tissue located at the carotid bifurcation. Only a few cases have been reported in the literature in the pediatric age group less than 14 years of age, primarily as case reports. Surgical excision is advisable in almost all ages, however, in childhood, it is known to carry risks and difficulties due (...) to the smaller size of the involved anatomical structures. We report an unusual case of a large (50 x 43 x 30 mm) carotid paraganglioma of Shamblin type III in a 13-year-old female, living at high altitude until the age of 9 years. This cervical mass was present, but smaller in size, several years before admission. However, an intense hypoxic stimulus at high altitude for 2 months at the age of 13 years probably induced a fast growing period of the lesion. The tumor was removed en bloc with the involved

2008 Journal of Vascular Surgery

3398. Fetus in fetu--diagnostic criteria and differential diagnosis--a case report and literature review. (Abstract)

. Pathologic examination showed an irregular fetiforme mass, weighing 8 g, attached to an amniotic sac by a rudimentary umbilical cord with 2 rudimentary limbs, vertebral bodies, encephalus, coroidal plexus, stomach, duodenum, bowel, adrenal glands, upper and lower respiratory tissue, spleen, lymphoid tissue, single cavity heart, and kidney. Molecular analysis using an informative genetic marker, for uniparental isodisomy of chromosomes 14 and 15 showed no genetic difference between the host infant (...) Fetus in fetu--diagnostic criteria and differential diagnosis--a case report and literature review. Fetus-in-fetu (FIF) is a rare congenital condition in which a vertebrate fetus is incorporated within its twin. The authors report the case of a newborn boy with prenatal ultrasonographic diagnosis of intraabdominal mass, provoking compression of the left kidney. Plain abdominal radiography, ultrasonography, and computer tomography showed a cystic mass containing multiple calcifications

2004 Journal of Pediatric Surgery

3399. Experience with laparoscopic adrenalectomy in children. (Abstract)

and girls. Case selection was based mainly on the size of the lesion and its localized nature as seen on the imaging studies. The transperitoneal approach was used in all cases.Eleven laparoscopic adrenalectomies were performed in 10 children (1 was bilateral adrenalectomy). Presenting features were virilization (n = 3), Cushing's syndrome (n = 1), antenatally detected adrenal cyst (n = 1), hypertension (n = 1), hepatomegaly (n = 1), loin pain with hematuria (n = 1) and an incidental adrenal mass (n = 1 (...) ). One was a child with stage IV adrenal neuroblastoma postchemotherapy for resection of the residual tumor. On imaging studies, the tumors were between 2.8 and 7 cm in their largest dimension. Operating time ranged from 118 to 180 minutes in the unilateral resections, whereas the bilateral laparoscopic adrenalectomy required 330 minutes. Two had to be converted to open procedures. Postoperative hospital stay was between 2 and 15 days. Pathologic diagnoses were as follows: adrenal cortical adenoma (n

2004 Journal of Pediatric Surgery

3400. Laparoscopic Adrenalectomy for a Large Pheochromocytoma in a Morbidly Obese Patient. (Abstract)

Laparoscopic Adrenalectomy for a Large Pheochromocytoma in a Morbidly Obese Patient. The high prevalence of obesity is associated with diverse health problems, including endocrine disorders. Laparoscopic adrenalectomy has become the preferred approach for removal of the adrenal gland, but several authors still debate the role of laparoscopic adrenalectomy in pheochromocytoma. We describe a case of a morbidly obese man (weight, 142 kg; body mass index, 40.2 kg/m(2)) who underwent elective

2008 Obesity Surgery

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