Primary aldosteronism in patients with adrenal incidentaloma: Is screening appropriate for everyone?

Stavropoulos, Konstantinos; Imprialos, Κonstantinos; Katsiki, Niki; Petidis, Konstantinos; Kamparoudis, Apostolos; Petras, Panagiotis; Georgopoulou, Vasiliki; Finitsis, Stephanos; Papadopoulos, Christodoulos; Athyros, Vasilios G.; Doumas, Michael; Karagiannis, Asterios

doi:10.1111/jch.13291

Cited by 13 publications

(9 citation statements)

References 37 publications

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“…The discovery of hyperaldosteronism in the context of an AI is relatively uncommon, compared with the detection of cortisol hypersecretion or pheochromocytoma ( 45 , 270 ). Normokalemic primary aldosteronism (PA) has been reported in up to 5.5% of AI ( 271 ).…”

Section: Endocrine Work-up Of Aimentioning

confidence: 99%

Adrenal Incidentaloma

et al. 2020

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An adrenal incidentaloma is now established as a common endocrine diagnosis that requires a multidisciplinary approach for effective management. The majority of patients can be reassured and discharged, but a personalized approach based upon image analysis, endocrine workup and clinical symptoms and signs are required in every case. ACC remains a real concern but is restricted to <2% of all cases. Functional AI lesions are commoner (but still probably <10% of total) and the greatest challenge remains the diagnosis and optimum management of autonomous cortisol secretion. Modern-day surgery has improved outcomes and novel radiological and urinary biomarkers will improve early detection and patient stratification in future years to come.

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Section: Endocrine Work-up Of Aimentioning

confidence: 99%

Adrenal Incidentaloma

et al. 2020

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“…ПА необходимо исключать у больных с инциденталомой, если имеется АГ или гипокалиемия [1,9,42,43]. В исследовании, выполненном в Китае, частота ПА среди пациентов с адреналовой инциденталомой составила 4,33 % [44].…”

Section: научные обзоры литературыunclassified

“…В исследовании воздействия наночастиц селена размером 20-60 нм, синтезированных путём восстановления селенита глутатионом, на Oryzias latipes было показано, что наночастицы вызывали 100%-ю смертность в концентрации 3,2 мг Se на литр, тогда как селенит в концентрации 2 мг/л приводил только к 10%-й смертности, а в концентрации 8 мг/л -к 80%-й гибели рыб. При этом рассчитанное значение LC 50 по прошествии 48 ч для наночастиц составило 1,0 мг Se на литр, а для селенита -4,7 мг Se на литр [42].…”

Section: токсичность селена в наноформе для объектов биоценозаunclassified

Changes in Temperature Fields and Microcirculation in the Walls of Coccygeal Pilonidal Cysts During and After Laser-Induced Thermotherapy

Zolotukhin¹,

Krochek²,

Sergiyko³

2022

BMJ

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Introduction. As of today, many options for conservative and surgical treatment of patients with pilonidal cysts have been developed. Our studies on the use of laser radiation in the treatment of epithelial coccygeal passage, which began in 2007, showed its positive clinical effect, which is expressed in a decrease in the number of complications and relapses. The principle of the method is the thermal ablation of the walls of the coccygeal passage with laser radiation. The aim. To study the effect of high-intensity laser radiation on the tissues of pilonidal cyst in patients with epithelial coccygeal passage, in order to improve the results of their treatment. Materials and methods. The study was conducted from 2018 to 2021. The patients were divided into 2 groups depending on the type of surgical treatment. The first group consisted of 124 patients who underwent cyst excision with primary sutures. The second group included 60 patients who underwent laser-induced interstitial thermotherapy. To study microcirculatory changes in the tissues of the pilonidal cyst while doing operational injury, SPECTROTEST (Spectro Analytical Instruments, Germany) spectrometer was used. Results. We have revealed changes in microcirculation and tissue saturation parameters depending on the type of surgical treatment. In the first group, a statistically significant microcirculatory and tissue saturation disorders were found in the walls of postoperative wounds. In the second group, microcirculatory disorders were less pro-nounced, and their normalization occurred much earlier. This indicates the absence of ischemia of the surrounding tissues around the treated area. Temperatures in the walls of pilonidal cysts at laser-induced interstitial thermom-etry vary from 56 to 65 °C, which are the temperatures of destruction of proteins that make up the structure of the cyst walls. On the surface and in the tissues surrounding the cyst, the maximum recorded temperature was 40 °C, and this does not cause protein destruction. Conclusions. High-intensity laser radiation leads to obliteration of the cystic cavity, the formation of scar tissue, the elimination of specific symptoms and the decrease in the risk of recurrence of pilonidal disease, which is confirmed by spectroscopy, thermometry and histological studies.

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“…Диагноз ПА был подтверждён у 9 из 269 пациентов с инциденталомой и АГ (3,3 %). У 4 пациентов отмечалось сочетание АГ и гипокалиемии, у 4 -резистентная АГ, у 1 -резистентная АГ в сочетании с гипокалиемией [42].…”

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Primary aldosteronism: current diagnostic approach

Енисеева¹

2022

BMJ

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Primary aldosteronism is characterized by autonomous hypersecretion of aldosterone which is not associated with acti-vation of the renin-angiotensin system. Activation of mineralocorticoid receptors causes hypertension, hypokalemia, and increases the risk of cardiovascular and kidney disease and death. Present knowledge suggests that the prevalence of primary aldosteronism is much higher than they previously thought, and that milder forms of renin-independent aldosterone secretion are not detected. The review discusses the features of screening, the reasons for the low detection of the disease, the groups of patients with a high probability of primary aldosteronism, and methodological approaches to evaluating the screening results. Attention is drawn to the necessity of genetic testing in young patients with a family history of primary aldosteronism. Various methods for studying renin and aldosterone, the influence of the choice of method on the assessment of the aldosterone-renin ratio, and the reasons for the erroneous interpre-tation of the results are discussed. The indications for confirmatory tests and evaluation of their results are considered. The necessity of identifying unilateral or bilateral lesions of the adrenal glands for determining the choice of treat-ment method is substantiated. The capabilities of computed tomography and comparative selective blood sampling from the adrenal veins in revealing unilateral lesion are compared. The importance of timely diagnosis of primary aldo-steronism and its targeted treatment to reduce the risk of cardiovascular complications associated with aldosterone hypersecretion is emphasized.

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Primary aldosteronism in patients with adrenal incidentaloma: Is screening appropriate for everyone?

Cited by 13 publications

References 37 publications

Adrenal Incidentaloma

Adrenal Incidentaloma

Changes in Temperature Fields and Microcirculation in the Walls of Coccygeal Pilonidal Cysts During and After Laser-Induced Thermotherapy

Primary aldosteronism: current diagnostic approach

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