Publications by authors named "Marta Araujo Castro"
Acromegaly-induced diabetes presents unique features due to the direct effects of excess growth hormone (GH) and insulin-like growth factor 1 (IGF-) on glucose metabolism, especially insulin resistance in association to low body fat content and water retention. Increased cardiovascular risk is much higher when acromegaly is complicated with diabetes, thus requiring a holistic management that addresses also these specific characteristics which differ from those of classical type 2 diabetes.The optimal management of diabetes in acromegaly requires not only an effective control of carbohydrate disturbances per se, but also the concurrent control of GH hypersecretion as it will directly impact on glucose control.
View Article and Find Full Text PDFPurpose: Studies focused on the effects of sellar and/or perisellar (S/PS) meningiomas on pituitary function are scarce. The primary objective of the present study was to determinate the effects that S/PS meningiomas and their treatments have on pituitary function. Also, we described the clinical characteristics and therapeutic outcomes of the cohort of adult Spanish patients.
View Article and Find Full Text PDFBackground: Adrenal Cushing's syndrome is caused by an adrenal tumor that produces hypercortisolism and requires glucocorticoid supplementation following resection of the tumour to prevent adrenal insufficiency. Few studies have examined whether glucocorticoid replacement (GR) therapy is required after retroperitoneal laparoscopic unilateral adrenal adenoma resection in patients with non-cortisol secreting tumors, or whether there is any correlation between preoperative biochemical indicators and postoperative cortisol function. This study sought to investigate which patients with non-cortisol secreting tumors required GR therapy after undergoing retroperitoneal laparoscopic resection of unilateral adrenal cortical adenoma.
View Article and Find Full Text PDFBackground And Objective: Currently, the management for pituitary apoplexy (PA) has been promoted toward a more conservative approach, particularly for patients with low-grade PA scores. Our aim was to investigate trends in PA management and compare clinical presentation, therapeutic approaches, and outcomes before and after 2017, additionally to evaluate long-term outcomes in conservatively treated patients.
Methods: Spanish multicenter, retrospective study.
Article Synopsis
- This study assesses the outcomes of adrenalectomy for pheochromocytoma in obese versus nonobese patients, using data from 46 centers from 2012 to 2022.
- It finds that while obesity does not significantly increase the rate of complications or comprehensive complication index (CCI), it does lead to a longer hospital stay for patients.
- Furthermore, minimally invasive surgical techniques, like laparoscopic and robotic surgeries, are associated with less morbidity in obese patients, and a retroperitoneal approach may provide additional benefits.
: Mild autonomous cortisol secretion (MACS) can coexist with primary aldosteronism (PA). The purpose of our study was to evaluate whether (MACS) influences parameters analyzed during adrenal venous sampling (AVS) in patients with PA. : Patients with PA from the SPAIN-ALDO Registry and the German Conn's Registry with available 1 mg-dexamethasone suppression test (DST) and AVS were included.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to assess the impact of smoking on the health profile and surgical outcomes of patients with primary aldosteronism (PA).
- In a retrospective analysis of 881 PA patients from 36 Spanish hospitals, smokers exhibited higher rates of left ventricular hypertrophy (LVH) and larger adrenal tumors compared to non-smokers, although their blood pressure and potassium levels were similar at diagnosis.
- The results indicated that while smoking is linked to a greater prevalence of LVH and mild autonomous cortisol secretion (MACS), it does not significantly influence hypertension cure rates after surgery for PA.
Article Synopsis
- * A study involving 49 patients with pituitary apoplexy showed that while many experienced improvement in vision and eye movement after surgery, the timing of surgery (within 3 days vs. later) did not significantly affect these outcomes.
- * Overall, the results indicate that the timing of neurosurgical decompression for pituitary apoplexy patients may not play a crucial role in improving their visual symptoms.
Pasireotide long-acting release (PAS-LAR) is a second-generation somatostatin receptor ligand (SRL) approved for acromegaly treatment. This meta-analysis aimed to evaluate the real-world effectiveness and safety of PAS-LAR in patients with acromegaly resistant to first-generation somatostatin receptor ligands (fgSRL). A systematic literature search was conducted in PubMed and Web of Science for real-world studies on PAS-LAR in acromegaly published between 2014 and 2023.
View Article and Find Full Text PDFLong term outcomes of pituitary adenomas in Multiple Endocrine Neoplasia type 1: a nationwide study.
Front Endocrinol (Lausanne)
October 2024
Article Synopsis
- MEN1-related pituitary adenomas (PAs) were traditionally thought to be more aggressive than regular pituitary adenomas, but recent research indicates that their behaviors may be similar.
- A study evaluated long-term outcomes of MEN1 PAs using data from 84 cases, focusing on factors like patient demographics, tumor size, and treatment effectiveness.
- The findings suggest that while MEN1 micro-PAs generally have a low risk of becoming invasive, microPRLomas have a higher risk, indicating that less frequent long-term monitoring may be suitable for patients with MEN1-related PAs.
Article Synopsis
- - The study analyzed 202 patients with head and neck paragangliomas (HN-PGL) across 16 Spanish hospitals, noting that 67.8% of participants were women, with a mean age of 53.1 years and 264 tumors examined, primarily located in the carotid body.
- - Among patients, 20.8% had multiple tumors and 4% had metastatic disease; genetic testing revealed a pathogenic variant in SDHx in half of those tested, which was linked to younger patients and more complex tumor profiles.
- - The results showed that while surgery was the most common treatment, radiotherapy and observation (monitoring without active treatment) were also effective, and long-term survival rates remained high
Executive summary of the Spanish consensus for the diagnosis, management, and follow-up of primary hyperaldosteronism.
Endocrinol Diabetes Nutr (Engl Ed)
October 2024
Primary hyperaldosteronism (PH) is the most common cause of secondary hypertension (HTN) and is associated with a higher cardiometabolic risk than essential HTN. Nevertheless, PH remains clearly underdiagnosed. An early diagnosis and adequate treatment of this disease are essential to reduce the cardiometabolic morbimortality associated with aldosterone excess.
View Article and Find Full Text PDFBackground: Pituitary apoplexy (PA) is the paradigm of endocrine and neurosurgical emergency.
Objective: To evaluate the comorbidities, risk factors, clinical presentation, pituitary apoplexy score (PAS) and the outcomes of surgical vs. conservative management of PA in Spain.
Background And Objective: Robotic adrenalectomy (RA) has attracted interest as an alternative to laparoscopic adrenalectomy (LA) for patients with pheochromocytoma, although its beneficial effects are uncertain. Our aim was to compare RA and LA outcomes for these patients.
Methods: Data for patients who underwent RA or LA for pheochromocytoma in 46 international centers between 2012 and 2022 were reviewed.
Article Synopsis
- The study aimed to analyze genetic testing rates for familial hyperaldosteronism (FH) in patients with primary aldosteronism (PA) within the SPAIN-ALDO Registry and to describe the clinical aspects of these patients.
- Out of 855 patients with PA, only 25 (3%) underwent genetic testing for FH, with complete results for just 24, highlighting a significant gap in testing as only 14% met appropriate criteria for genetic evaluation.
- The findings indicate that FH is rare, accounting for only 0.2% of PA cases in the registry, though it might be more prevalent (up to 4%) in patients suspected of having the condition, illustrating the need for increased genetic assessment in
Aim: To evaluate the impact of aldosterone excess on renal function in individuals with primary aldosteronism and to compare its evolution after surgery or mineralocorticoid receptor antagonist (MRA) treatment.
Methods: A multicentre, retrospective cohort study of primary aldosteronism patients in follow-up in 36 Spanish tertiary hospitals, who underwent specific treatment for primary aldosteronism (MRA or adrenalectomy).
Results: A total of 789 patients with primary aldosteronism were included, with a median age of 57.
Article Synopsis
- Rathke's cleft cysts (RCC) are common lesions in the sellar region, often monitored without treatment, but some may require surgery; however, their natural progression and surgery outcomes are still unclear.
- A national study tracked 177 patients with RCC over an average of 67.3 months, with additional data on 88 patients who had surgery, revealing that most cysts remained stable or shrank, while only a small percentage grew significantly.
- Results indicated that conservative management is preferable for asymptomatic RCC, as most patients achieved symptom relief post-surgery, but recurrences can occur later without identifiable predictors.
Background: Adrenalectomy for pheochromocytoma (PHEO) is challenging because of the high risk of intraoperative hemodynamic instability (HDI). This study aimed to compare the incidence and risk factors of intraoperative HDI between laparoscopic left adrenalectomy (LLA) and laparoscopic right adrenalectomy (LRA).
Methods: We retrospectively analyzed two hundred and seventy-one patients aged > 18 years with unilateral benign PHEO of any size who underwent transperitoneal laparoscopic adrenalectomy at our hospitals between September 2016 and September 2023.
Personalized Medicine in Acromegaly: The ACROFAST Study.
J Clin Endocrinol Metab
December 2024
Context: Medical treatment of acromegaly is currently performed through a trial-and-error approach using first-generation somatostatin receptor ligands (fgSRLs) as first-line drugs, with an effectiveness of about 50%, and subsequent drugs are indicated through clinical judgment. Some biomarkers can predict fgSRLs response.
Objective: Here we report the results of the ACROFAST study, a clinical trial in which a protocol based on predictive biomarkers of fgSRLs was evaluated.
Aim: To investigate the impact of pituitary surgery on glucose metabolism and to identify predictors of remission of diabetes after pituitary surgery in patients with acromegaly.
Methods: A national multicenter retrospective study of patients with acromegaly undergoing transsphenoidal surgery for the first time at 33 tertiary Spanish hospitals (ACRO-SPAIN study) was performed. Surgical remission of acromegaly was evaluated according to the 2000 and 2010 criteria.
Purpose: To identify clinical and radiological factors associated with a higher risk of developing a severe pituitary apoplexy (PA).
Methods: Multicenter retrospective study of patients presenting with clinical PA in three Spanish tertiary hospitals of Madrid between 2008 and 2022. We classified PA as severe when presenting with an altered level of consciousness (Glasgow Coma Scale (GCS) < 15) or visual involvement.
Pheochromocytomas are rare neuroendocrine tumors that derive from the chromaffin cells of the adrenal medulla and secrete catecholamines. The measurement of plasma or fractionated urine metanephrines is the hormonal determination of choice for the biochemical diagnosis. Once the biochemical diagnosis is confirmed, the next step is the localization study.
View Article and Find Full Text PDFClinical presentation and surgical outcomes of very large and giant pituitary adenomas: 80 cases in a cohort study of 306 patients with pituitary adenomas.
Acta Neurochir (Wien)
May 2024
Purpose: To identify differences in the presentation and surgical outcomes between very large (30-39 mm) and giant (≥ 40 mm) (LARGE group) pituitary adenomas (PAs) compared to the smaller group (< 30 mm) (non-LARGE group).
Methods: Eighty patients with very large (n = 44) or giant (n = 36) PAs and 226 patients in the non-LARGE group who underwent tumor resection by pituitary surgery between 2008 and 2023 were studied. Hormonal, radiological, ophthalmological, and pathological data, and surgical outcomes were evaluated.