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Adrenal Mass

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3541. Diagnosis and Treatment of Pheochromocytoma

to Brief Summary: Pheochromocytoma is a tumor of the adrenal gland. This tumor is typically benign (not cancerous) and can be cured by surgical removal. However, pheochromocytomas produce neurohormones called cateholamines (epinephrine and norepinephrine). High levels of catecholamines can result in high blood pressure, headaches, sweating, heart palpitations, nausea, vomiting, and other symptoms. These tumors are considered dangerous because of their unpredictable behavior. Patients (...) information Ages Eligible for Study: Child, Adult, Older Adult Sexes Eligible for Study: All Accepts Healthy Volunteers: Yes Criteria Patients of any age and either sex who are suspected of having a pheochromocytoma on the basis of one or more of the following: 1. hypertensive episodes in a normotensive subject, 2. abnormal levels of blood and/or urinary catecholamines or their metabolites, or 3. an otherwise unexplained abdominal mass. Patients without any evidence of pheochromocytoma are excluded

1999 Clinical Trials

3542. Lamivudine and Adefovir to Treat Chronic Hepatitis B Infection in People With and Without HIV Infection

within 1 month prior to baseline Treatment with immunomodulator drugs (interleukins, corticosteriods for indications other than the treatment of adrenal insufficiency) in the 4 weeks prior to baseline. G-CSF and epoetin use are permitted. Anti-HBV therapy other than lamivudine (such as emtricitabine, lobucavir, entecavir, HBIG, clevudine, MCC-478) with the exception of interferon alpha, famciclovir or foscarnet that ended more than 12 weeks prior to screen. Hepatic mass suggestive of hepatocellular

2001 Clinical Trials

3543. Capecitabine in Treating Patients With Malignant Mesothelioma

at largest diameter with conventional techniques or at least 10 mm with spiral CT scan The following are not considered measurable disease: Bone lesions Leptomeningeal disease Ascites Pleural/pericardial effusion Abdominal masses not confirmed and followed by imaging techniques Cystic lesions Tumor lesions located in a previously irradiated area PATIENT CHARACTERISTICS: Age: 18 and over Performance status: ECOG 0 or 1 Life expectancy: Not specified Hematopoietic: Granulocyte count at least 1,500/mm3 (...) CONCURRENT THERAPY: Biologic therapy: Concurrent epoetin alfa allowed Chemotherapy: No prior systemic cytotoxic chemotherapy for malignant mesothelioma Prior intrapleural cytotoxic or sclerosing agents (including bleomycin) allowed No other concurrent chemotherapy Endocrine therapy: No concurrent hormonal therapy except the following: Steroids administered for adrenal failure Hormonal therapy administered for nonmalignant conditions (e.g., insulin for diabetes) Intermittent use of dexamethasone

2000 Clinical Trials

3544. Positron Emission Tomography for Detecting Non-small Cell Lung Cancer

diagnosed by transbronchial biopsy, and if a separate ipsilateral lung lesion is clearly evident on radiographs, biopsy of the lung tumor is not required for this patient. OR c) Patient may be eligible without histologic or cytologic proof if; The patient is strongly suspected to have primary bronchogenic carcinoma (e.g., heavy smoker with a new peripheral mass with typical appearance of lung cancer on chest radiograph although bronchoscopy and/or fine needle aspiration is nondiagnostic), and The tumor (...) representative prior to study participation. Female patient of childbearing potential must have a negative serum or urine pregnancy test, 72 hours prior to FDG-PET. NOTE: This is in order to avoid unnecessary fetal radiation exposure and because the use of furosemide is contraindicated in pregnancy. Patient must complete the following standard staging procedures 60 days prior to registration. CT scan of the chest and upper abdomen (include adrenals) with contrast NOTE: Non-contrast CT scan may be used

1999 Clinical Trials

3545. Treatment of adults with growth hormone (GH) deficiency with recombinant human GH. (PubMed)

Treatment of adults with growth hormone (GH) deficiency with recombinant human GH. In a double blind, cross-over placebo-controlled trial, we studied the effects of 26 weeks of replacement therapy with recombinant human GH on body composition, metabolic parameters, and well-being in 10 patients with adult-onset GH deficiency (GHD). All patients received appropriate thyroid, adrenal, and gonadal replacement therapy. The dose of recombinant human GH was 0.25-0.5 U/kg.week (0.013-0.026 mg/kg.day (...) ) and was administered sc daily at bedtime. One patient was withdrawn from the study because of edema and atrial fibrillation. Body composition was estimated with three independent methods: computed tomography, bioelectric impedance, and total body potassium combined with total body water assessments. The Comprehensive Psychological Rating Scale and the Symptom Check List-90 were used to assess any change in psychopathology. After 26 weeks of treatment, adipose tissue (AT) mass decreased 4.7 kg (P < 0.001

1993 The Journal of clinical endocrinology and metabolism

3546. Intraoperative ultrasound aids in dissection during laparoscopic partial adrenalectomy. (PubMed)

technique that provided a 5 mm. margin. Tumors were removed intact and sent for pathological examination.Since 1998, 11 patients have undergone laparoscopic partial adrenalectomy. Intraoperative ultrasound was performed in 7 patients with suspected multiple adrenal masses, including 4 and 3 who underwent unilateral and bilateral laparoscopic partial nephrectomy, respectively. Six of the 7 patients had germline defects in the von Hippel-Lindau disease gene and 1 had no identifiable alteration in the von (...) Hippel-Lindau disease or RET gene. A solitary tumor was identified in 3 cases and multiple lesions were noted in 4. In 1 case intraoperative ultrasound localized a tumor not identified on preoperative imaging that was not readily visible via laparoscopy. Intraoperative ultrasound guided surgical dissection in all cases and identified an extra-adrenal mass in 1 patient with bilateral adrenal masses. There were no complications due to intraoperative ultrasound and no conversions to open surgery. Mean

2002 Journal of Urology

3547. Synchronous presentation of primary non-small cell lung carcinoma and pheochromocytoma. (PubMed)

Synchronous presentation of primary non-small cell lung carcinoma and pheochromocytoma. A 54-year-old man was diagnosed with a 3.2-cm primary right lower lobe non-small cell lung cancer and a synchronously present 2.5-cm right adrenal gland mass. Workup of the adrenal lesion revealed a pheochromocytoma. The patient underwent combined mediastinoscopy, laparoscopic right adrenalectomy, and right thoracotomy with right lower lobectomy. This case illustrates the importance of establishing a firm (...) diagnosis for all synchronously present adrenal lesions that are discovered in the setting of primary lung carcinoma.

2002 Annals of Thoracic Surgery

3548. Pubertal and gender-related changes in the sympathoadrenal system in healthy children. (PubMed)

children (ages, 5-17 yr; 37 boys and 43 girls) in relation to age, pubertal stage, gender, physical activity, body mass index, and serum levels of sex steroids, dehydroepiandrosterone sulfate, cortisol, leptin, and insulin. Plasma concentrations of the adrenomedullary hormone, epinephrine (E), and its metabolite metanephrine (MN), decreased significantly with advancing puberty and were higher in boys than in girls. E and MN correlated significantly and inversely with dehydroepiandrosterone sulfate (...) a possible modulatory role of the adrenal medulla in the body weight-related timing of adrenarche and/or gonadarche.

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2002 Journal of Clinical Endocrinology and Metabolism

3549. The molecular pathogenesis of hereditary and sporadic adrenocortical and adrenomedullary tumors. (PubMed)

The molecular pathogenesis of hereditary and sporadic adrenocortical and adrenomedullary tumors. Modern imaging modalities lead to frequent detection of adrenal masses, most of them incidental findings. Although the majority of adrenocortical and adrenomedullary tumors are benign, there are no reliable clinical and laboratory markers to distinguish most of them from malignant neoplasms. The molecular mechanisms underlying the pathogenesis of these tumors have recently begun to be unraveled (...) . A fruitful avenue for the elucidation of tumorigenesis has been the study of adrenal tumors that are manifestations of hereditary or postzygotic genetic syndromes, because one knows the "first hit", i.e. the primary gene defect. In contrast, in sporadic adrenal tumors the first hit, possibly a somatic mutation of a tumor-related gene, is unknown, and therefore the sequence of genetic alterations is difficult to establish. In this article we review in addition to our own work the literature on molecular

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2002 Journal of Clinical Endocrinology and Metabolism

3550. Long-term (15 years) outcome in an infant with metastatic adrenocortical carcinoma. (PubMed)

Long-term (15 years) outcome in an infant with metastatic adrenocortical carcinoma. Adrenocortical carcinoma is a rare malignancy in children, with a high mortality. Little is known about long-term outcome, especially in infants treated with mitotane. We report the successful long-term outcome of a case of metastatic adrenocortical carcinoma presenting in infancy treated with surgical resection and mitotane. The patient presented at 2 months of age with Cushing's syndrome, a large adrenal mass (...) , and elevated adrenal steroid levels. The tumor was removed surgically. Intraoperative findings included an adrenal tumor (confirmed malignant pathologically) invading the adrenal vein and vena cava. After surgery he was treated with mitotane at a dose of 2 g/d. Six months after surgery 11-deoxycortisol levels increased, and a computed tomography scan showed a pulmonary metastasis. Mitotane was increased to 2.5 g/d, and the metastasis was removed surgically. Plasma mitotane levels ranged 10-15 micro g/ml

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2002 Journal of Clinical Endocrinology and Metabolism

3551. 5 alpha-reductase and 11 beta-hydroxysteroid dehydrogenase activity in prepubertal Hispanic girls with premature adrenarche. (PubMed)

5 alpha-reductase and 11 beta-hydroxysteroid dehydrogenase activity in prepubertal Hispanic girls with premature adrenarche. Girls with idiopathic premature adrenarche, characterized by the early appearance of pubic hair and adrenal hyperandrogenism, may be at an increased risk for polycystic ovarian syndrome and its associated complications. Alterations of peripheral metabolism of adrenal steroids, specifically increased 5 alpha-reductase and 11 beta-hydroxysteroid dehydrogenase activities (...) , have been documented in patients with polycystic ovarian syndrome and proposed as an underlying mechanism for the adrenal hyperandrogenism in this syndrome. We sought to investigate whether alterations in 5 alpha-reductase and 11 beta-hydroxysteroid dehydrogenase activities are present in girls with premature adrenarche, suggesting a possible role in the pathogenesis of the hyperandrogenism of this condition. We studied C19 and C21 urinary steroid metabolites, 5 alpha/5 beta and 11 oxo/11 hydroxy

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2002 Journal of Clinical Endocrinology and Metabolism

3552. Endoscopic ultrasound-guided fine-needle aspiration biopsy: a study of 103 cases. (PubMed)

stains were performed on cell blocks wherever required. Cytologic diagnoses were then correlated with the final diagnoses. The latter was based on histologic examination of biopsies/resected pathology materials (n = 54) and clinical follow up (n = 48). Follow-up information was not available for one lesion.Of 103 EUS-FNABs, 42 FNABs were from the pancreas, 38 from the lymph nodes (10 mediastinal and 28 intraabdominal), 10 from the gastrointestinal tract, 7 from the liver, 4 from the adrenal gland, 1 (...) from the biliary tract, and 1 from a retroperitoneal mass. The mean number of passes to obtain diagnostic materials was 3.3. Of 103 EUS-FNABs, 45, 9, 6, and 37 were reported as malignant, suspicious, atypical, and benign, respectively. Six FNABs were nondiagnostic. The authors did not encounter any false-positive cases. There were three false-negative cases (two pancreatic carcinomas and one gastrointestinal stromal tumor of the stomach). No complications were encountered. The sensitivity

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2002 Cancer

3553. A case of pheochromocytoma presenting as low back pain. (PubMed)

, and hypotension. Computed tomographic image of the abdomen revealed a right-sided adrenal mass that was confirmed via laboratory analysis to be a pheochromocytoma.The patient underwent laparoscopic adrenalectomy and made a full recovery. Her initial back symptoms resolved with tumor excision.Pheochromocytomas are rare catecholamine-producing tumors of the adrenal glands that can mimic musculoskeletal conditions such as low back pain. Chiropractic physicians should be aware of the various clinical

2007 Journal of Manipulative and Physiological Therapeutics

3554. A systematic review of evidence for the appropriateness of neonatal screening programmes for inborn errors of metabolism. (PubMed)

and infrastructure necessary for the collection and testing of neonatal blood spots. There was insufficient evidence in the literature to assess the cost-effectiveness of screening for any other IEMs. There was reasonable evidence to support inclusion in extended neonatal screening of four other IEMs: biotinidase deficiency, congenital adrenal hyperplasia (CAH), medium-chain acyl CoA dehydrogenase (MCAD) deficiency and glutaric aciduria type 1 (GA1).Large-scale trials of screening for biotinidase, CAH, MCAD (...) and GA1 should be conducted, with careful evaluation to establish their clinical effectiveness and cost-effectiveness in practice. Screening for the latter two disorders would be dependent upon the use of tandem mass spectrometry (tandem MS). The application of tandem MS to newborn screening requires further evaluation. The extension of neonatal screening programmes to other IEMs is not currently justified.

1998 Journal of public health medicine

3555. Decreased cholesteryl ester transfer protein (CETP) mRNA and protein and increased high density lipoprotein following lipopolysaccharide administration in human CETP transgenic mice. (PubMed)

, the effects of LPS on CETP and plasma lipoproteins were examined in human CETP transgenic mice. Administration of LPS to mice expressing a CETP transgene linked to its natural flanking sequences (NFR-CETP Tg) resulted in a rapid marked decrease in hepatic CETP mRNA and plasma CETP concentration. Corticosteroid injection produced a similar decrease in hepatic CETP mRNA and adrenalectomy abolished this response to LPS. LPS caused disproportionate reductions in plasma CETP activity compared to mass (...) mRNA, primarily as a result of adrenal corticosteroid release. The decrease in plasma CETP activity after LPS administration may reflect both this effect as well as a direct interaction between CETP and LPS. The decrease of CETP in response to LPS has major effects on HDL levels, and may represent an adaptive response to preserve or increase HDL and thereby modify the response to LPS.

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1995 Journal of Clinical Investigation

3556. Laparoscopic adrenalectomy: lessons learned from 100 consecutive procedures. (PubMed)

Laparoscopic adrenalectomy: lessons learned from 100 consecutive procedures. One hundred consecutive laparoscopic adrenal procedures for a variety of endocrine disorders were reviewed. There was no mortality, morbidity was 12%, and conversions was 3%. During follow-up, none had recurrence of hormonal excess. Laparoscopic adrenalectomy is the procedure of choice for adrenal removal except in carcinoma or masses > 15 cm.The authors evaluate the effectiveness of laparoscopic adrenalectomy (...) for a variety of endocrine disorders.Since the first laparoscopic adrenalectomy was performed in 1992, this approach quickly has been adopted, and increasing numbers are being reported. However, the follow-up period has been too short to evaluate the completeness of these operations.One hundred consecutive laparoscopic adrenal procedures from January 1992 until November 1996 were reviewed and followed for adequacy of resection.Eighty-eight patients underwent 97 adrenalectomies and biopsies. The mean age

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1997 Annals of Surgery

3557. Simultaneous adrenocortical carcinoma and ganglioneuroblastoma in a child with Turner syndrome and germline p53 mutation. (PubMed)

with failure to thrive and congenital heart defects was found to have unilateral adrenal masses which, at surgical removal, proved to be an adrenocortical carcinoma and a ganglioneuroblastoma. Further investigation showed a germline p53 mutation and Turner syndrome. It remains to be determined what effect the 45,X chromosomal complement may have on the expression of neoplasms seen in patients with p53 germline mutations.

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1998 Journal of Medical Genetics

3558. Pheochromocytoma manifesting with shock presents a clinical paradox: a case report (PubMed)

Pheochromocytoma manifesting with shock presents a clinical paradox: a case report A 46-year-old man presented with shock and adult respiratory distress syndrome. Investigations revealed an adrenal mass that was diagnosed, by fine-needle aspiration biopsy, as pheochromocytoma. Because biopsy is contraindicated in patients with pheochromocytoma, this confusing presentation underscores the value of excluding this diagnosis by biochemical means before performing fine-needle aspiration of adrenal

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1997 CMAJ: Canadian Medical Association Journal

3559. Pituitary Apoplexy Presenting as Addisonian Crisis: after Coronary Artery Bypass Grafting (PubMed)

Pituitary Apoplexy Presenting as Addisonian Crisis: after Coronary Artery Bypass Grafting Addisonian crisis, also commonly referred to as adrenal crisis, occurs when the cortisol produced by the adrenal glands is insufficient to meet the body's acute needs. The symptoms are nonspecific and can mimic other processes, such as sepsis. Hypotension, lethargy, and fever can all be presenting signs. Secondary addisonian crisis can also result from pituitary apoplexy. Pituitary apoplexy usually occurs (...) were overlooked; however, once recognized, they were reduced dramatically with standard stress-dose cortisone. A suprasellar mass with a cystic component was found on magnetic resonance imaging. The hemorrhagic pituitary gland was treated by transsphenoidal decompression, which relieved the patient's bitemporal hemianopia and 6th-nerve palsy.

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2002 Texas Heart Institute Journal

3560. Low-dose dexamethasone challenge in women with atypical major depression: pilot study (PubMed)

Low-dose dexamethasone challenge in women with atypical major depression: pilot study To examine if atypical depression may be associated with hypersuppression of the hypothalamic-pituitary-adrenal (HPA) axis.Eight women with atypical major depression and 11 controls with no history of psychiatric illness, matched on age and body mass index, were challenged with low-dose dexamethasone (0.25 mg and 0.50 mg in random order and 1 week apart). Dexamethasone was self administered at 11 pm

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2002 Journal of Psychiatry and Neuroscience

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