Publications by authors named "Paja M"
A simplified four-tier classification for thyroid core needle biopsy.
J Endocrinol Invest
November 2024
Purpose: To propose a simplified histological classification for core-needle biopsy (CNB) of thyroid nodules with four diagnostic categories (DC) and provide the risk of malignancy (ROM) and the expected incidence for each DC. There is no uniform scheme for categorizing CNB specimens, except for a Korean diagnostic classification similar to the Bethesda system for FNAC.
Methods: Data from a single institution using CNB as a routine diagnostic tool for thyroid nodules.
Long 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
Article Synopsis
- The study aimed to identify patients with chronic hypoparathyroidism who either had adequate (AC) or not adequately controlled (NAC) disease, as poor control is linked to complications and increased mortality.
- Researchers analyzed data from 337 patients across 16 Spanish hospitals to assess disease control through biochemical criteria and clinical wellness, finding that many patients were not adequately controlled.
- Findings revealed that 45.9% to 63.1% of patients met the NAC criteria, with those who had dyslipidemia being at a greater risk, and NAC patients exhibited higher rates of associated comorbidities like chronic kidney disease and eye disorders compared to AC patients.
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
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.
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.
Objective: The aim of this study is to compare the response to first-line medical treatment in treatment-naive acromegaly patients with pure growth hormone (GH)-secreting pituitary adenoma (GH-PA) and those with GH and prolactin cosecreting PA (GH&PRL-PA).
Design: This is a retrospective multicentric study of acromegaly patients followed from 2003 to 2023 in 33 tertiary Spanish hospitals with at least 6 months of first-line medical treatment.
Methods: Baseline characteristics, first-line medical treatment strategies, and outcomes were analyzed.
Purpose: Population-based and registry studies have shown that chronic hypoparathyroidism is accompanied by long-term complications. We aimed to evaluate the risk of incident comorbidity among patients with chronic postsurgical hypoparathyroidism in real-life clinical practice in Spain.
Methods: We performed a multicenter, retrospective cohort study including patients with chronic postsurgical hypoparathyroidism lasting ≥3 years with at least a follow-up visit between January 1, 2022 and September 15, 2023 (group H).
Article Synopsis
- A study evaluated the differences in clinical presentation and surgical outcomes between two types of pituitary adenomas: growth hormone secreting (GH-PAs) and those that cosecrete growth hormone and prolactin (GH&PRL-PAs).
- GH&PRL-PAs were found to occur more frequently as macroadenomas, had a lower average age at diagnosis, and were more likely to show signs of invasiveness and hypopituitarism compared to GH-PAs.
- Despite these differences in presentation, both groups had similar rates of surgical success in terms of biochemical cure, although GH&PRL-PA patients experienced a higher incidence of permanent arginine-vasopressin deficiency
Objective: There is hardly any information on the consumption of healthcare resources by older people with differentiated thyroid cancer (DTC). We analyzed these consumptions in older patients with DTC and compared patients 75 years and older with subjects aged 60-74 years.
Methods: A multicenter, retrospective analysis was designed.
Context: There are no data on mortality of acromegaly diagnosed in older individuals.
Objective: This work aimed to compare clinical characteristics, growth hormone-related comorbidities, therapeutic approaches, and mortality rate of patients diagnosed before or after 2010 and to assess overall mortality rate compared with the general Spanish population.
Methods: A retrospective evaluation was conducted among Spanish tertiary care centers of 118 patients diagnosed with acromegaly at age 65 or older.
Metastatic pheochromocytoma and paraganglioma (PPGL) have poor prognosis and limited therapeutic options. The recent advent of immunotherapies showing remarkable clinical efficacies against various cancer types offers the possibility of novel opportunities also for metastatic PPGL. Most PPGLs are pathogenically linked to inactivating mutations in genes encoding different succinate dehydrogenase (SDH) subunits.
View Article and Find Full Text PDFFactors associated with therapeutic response in acromegaly diagnosed in the elderly in Spain.
Front Endocrinol (Lausanne)
October 2022
Context: Some reports suggest that acromegaly in elderly patients has a more benign clinical behavior and could have a better response to first-generation long-acting somatostatin receptor ligands (SRL). However, there is no specific therapeutic protocol for this special subgroup of patients.
Objective: This study aimed at identifying predictors of response to SRL in elderly patients.
White blood cell count: a valuable tool for suspecting Cushing's syndrome.
J Endocrinol Invest
January 2023
Purpose: Simple screening tests to determine whether Cushing's syndrome (CS) should be ruled out are lacking. Tools that enable early diagnosis could reduce morbidity and associated sequelae. The potential of glucocorticoid-induced changes in the white blood cell (WBC) count for raising suspicion of CS is assessed.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to analyze how the age at which patients are diagnosed with differentiated thyroid carcinoma (DTC) affects their risk of disease progression and mortality after initial treatment, focusing on patients over 60 years old.
- Researchers compared two age groups: elderly (60-74 years) and very old (75 years and older) among 1,668 patients, finding that older patients generally had larger tumors, more vascular invasion, and lower rates of lymphocytic thyroiditis.
- The results indicated that while older age correlates with lower overall survival, very old patients do not face an increased risk of structural disease compared to their younger counterparts throughout the follow-up period.
Objective: We aimed to study the predictive factors for recovery of parathyroid function in hypoparathyroid patients after total thyroidectomy for thyroid cancer.
Methods: We designed a retrospective, multicentre and nation-wide analysis of patients with total thyroidectomy who were seen in twenty endocrinology departments from January to March 2018. We selected patients with histologically proven thyroid cancer and retrieved information related to surgical procedure and thyroid cancer features.
Objectives: To evaluate disease activity status using the Acromegaly Disease Activity Tool (ACRODAT) in a cohort of Spanish acromegaly patients, to assess the relationship between the level of disease activity according to both ACRODAT and the physicians' clinical evaluation, and to study the potential discrepancies in the perception of symptoms between physicians and patients.
Design: Multicenter, observational, descriptive and cross-sectional study.
Methods: Disease activity was assessed in adult patients with acromegaly under pharmacological treatment during at least 6 months using ACRODAT.
The clinical characteristics of patients with postoperative hypoparathyroidism who recover parathyroid function more than 12 months after surgery have not been studied. We aimed to evaluate whether the intensity of replacement therapy with calcium and calcitriol is related to the late recovery of parathyroid function. We compared the demographic, surgical, pathological, and analytical features of two groups of patients: cases, i.
View Article and Find Full Text PDFPurpose: To determine the rate of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in a multi-institutional series from the Iberian Peninsula and describing this NIFTP cohort.
Methods: Retrospective study of papillary thyroid carcinoma (PTC) or well-differentiated tumours of uncertain malignant potential (WDT-UMP) diagnosed between 2005 and 2015 and measuring ≥5 mm in adult patients from 17 hospitals. Pathological reports were reviewed to determine the cases that fulfil the original criteria of NIFTP and histology was reassessed.
Background: Recent guidelines for the treatment of hypoparathyroidism emphasize the need for long-term disease control, avoiding symptoms and hypocalcaemia. Our aim has been to analyze the prevalence of poor disease control in a national cohort of patients with hypoparathyroidism, as well as to evaluate predictive variables of inadequate disease control.
Methods: From a nation-wide observational study including a cohort of 1792 patients undergoing total thyroidectomy, we selected 260 subjects [207 women and 53 men, aged (mean ± SD) 47.
Background: Craniopharyngioma (CP) is a rare tumor in the elderly whose clinical features and prognosis are not well known in this population.
Aim: To evaluate the clinicopathological features and therapeutic outcomes of CP diagnosed in the elderly.
Patients And Methods: This was a retrospective, multicenter, national study of CP patients diagnosed over the age of 65 years and surgically treated.
Aim: The ACROPRAXIS program aims to describe the management of acromegaly in Spain and provide guidance.
Methods: Ninety-three endocrinologists were organized into 13 panels to discuss the practical issues in managing acromegaly. Based on the key learnings, an online Delphi survey with 62 statements was performed, so those statements achieving consensus could be used as guidance.
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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