Publications by authors named "Paz De Miguel Novoa"
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.
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.
The objective of the study was to evaluate the efficacy of second-line therapies in patients with acromegaly caused by a growth hormone (GH) and prolactin (PRL) co-secreting pituitary neuroendocrine tumor (GH&PRL-Pit-NET) compared to their efficacy in patients with acromegaly caused by a GH-secreting pituitary neuroendocrine tumor (GH-Pit-NET). This is a multicenter retrospective study of patients with acromegaly on treatment with pasireotide and/or pegvisomant. Patients were classified in two groups: GH&PRL-Pit-NETs when evidence of hyperprolactinemia and immunohistochemistry (IHC) for GH and PRL was positive or if PRL were >200 ng/dL regardless of the PRL-IHC and GH-Pit-NETs when the previously mentioned criteria were not met.
View Article and Find Full Text PDFPurpose: To evaluate the rate of recurrence among patients with pheochromocytomas and sympathetic paragangliomas (PGLs; together PPGLs) and to identify predictors of recurrence (local recurrence and/or metastatic disease).
Methods: This retrospective multicenter study included information of 303 patients with PPGLs in follow-up in 19 Spanish tertiary hospitals. Recurrent disease was defined by the development of local recurrence and/or metastatic disease after initial complete surgical resection.
Purpose: To identify presurgical and surgical risk factors for intraoperative hypertensive crisis in patients with pheochromocytomas and sympathetic paragangliomas (PGLs) (PPGLs).
Methods: Retrospective multicenter cohort study of patients with PPGLs from 18 tertiary hospitals. Intraoperative hypertensive crisis was defined as systolic blood pressure (SBP) greater than 200 mmHg lasting more than 1 min and postoperative hypertensive crisis as SBP greater than 180 mmHg or diastolic blood pressure (DBP) greater than 110 mmHg.
Purpose: to perform an external validation of our predictive model to rule out pheochromocytoma (PHEO) based on unenhanced CT in a cohort of patients with PHEOs and adenomas who underwent adrenalectomy.
Methods: The predictive model was previously developed in a retrospective cohort of 1131 patients presenting with adrenal lesions. In the present study, we performed an external validation of the model in another cohort of 214 patients with available histopathological results.
Introduction: It is estimated that 30-40% of patients with apparently sporadic pheochromocytomas (PHEOs) have an inherited predisposition syndrome. The aim of our study was to develop a predictive model of hereditary PHEO based on the clinical, hormonal, and radiological features present at the diagnosis of patients with PHEOs.
Methods: A retrospective multicenter cohort study of patients with PHEOs with available genetic study from 18 tertiary hospitals.
The objective of our study was to determine the prevalence of glycemic disorders (diabetes mellitus and prediabetes) in patients with pheochromocytomas and sympathetic paragangliomas (PPGLs) and identify risk factors for their development and the likelihood of their resolution after surgery. A multicentric retrospective study of patients with PPGLs submitted to surgery between 2000 and 2021 in 17 Spanish hospitals was performed. Diabetes-specific data were collected at diagnosis, in the immediate- and long-term postsurgical follow-up.
View Article and Find Full Text PDFArticle Synopsis
- * A retrospective analysis of 122 hyponatremic patients showed that SC levels increased in HH patients but decreased in EH patients, indicating distinct patterns in SC changes for each condition.
- * The findings suggest that measuring the percentage change in SC from normal sodium levels can effectively differentiate between HH and EH, with specific thresholds indicating a higher likelihood of each condition.
The purpose of our study was to develop a predictive model to rule out pheochromocytoma among adrenal tumours, based on unenhanced computed tomography (CT) and/or magnetic resonance imaging (MRI) features. We performed a retrospective multicentre study of 1131 patients presenting with adrenal lesions including 163 subjects with histological confirmation of pheochromocytoma (PHEO), and 968 patients showing no clinical suspicion of pheochromocytoma in whom plasma and/or urinary metanephrines and/or catecholamines were within reference ranges (non-PHEO). We found that tumour size was significantly larger in PHEO than non-PHEO lesions (44.
View Article and Find Full Text PDFArticle Synopsis
- The study investigated presurgical and surgical risk factors linked to intraoperative complications in patients with pheochromocytomas from ten Spanish hospitals between 2011 and 2021, involving 162 surgeries on 159 patients.
- Findings revealed that 33.3% of the patients experienced intraoperative complications, with hypertensive crises being the most common, followed by prolonged hypotension and hemodynamic instability.
- Factors increasing the risk of complications included higher levels of urine metanephrine and normetanephrine, larger tumor sizes, uncontrolled blood pressure before surgery, pre-treatment with doxazosin, and the absence of perioperative hydrocortisone treatment.
Purpose: To identify presurgical and surgical risk factors for postsurgical complications in the pheochromocytoma surgery.
Methods: A retrospective study of pheochromocytomas submitted to surgery in ten Spanish hospitals between 2011 and 2021. Postoperative complications were classified according to Clavien-Dindo scale.
Prognostic Impact of Hyponatremia and Hypernatremia in COVID-19 Pneumonia. A HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19) Registry Analysis.
Front Endocrinol (Lausanne)
January 2021
Unlabelled: Dysnatremia is associated with increased mortality in patients with community-acquired pneumonia. SARS-COV2 (Severe-acute-respiratory syndrome caused by Coronavirus-type 2) pneumonia can be fatal. The aim of this study was to ascertain whether admittance dysnatremia is associated with mortality, sepsis, or intensive therapy (IT) in patients hospitalized with SARS-COV2 pneumonia.
View Article and Find Full Text PDFSEEN guidelines for the management and prevention of acute adrenal insufficiency.
Endocrinol Diabetes Nutr (Engl Ed)
January 2020
Acute adrenal insufficiency (AAI) is a potentially fatal medical emergency whose prevention and treatment should be known by all medical professionals. AAI is an underdiagnosed condition because of its non-specific symptoms, but its diagnosis and early treatment with glucocorticoids is vital. It may be triggered by a de novo deficiency in cortisol synthesis or occur secondarily to omission of hormone replacement therapy (corticosteroids) or inadequate adjustment of the dose required in stress situations in patients previously diagnosed with adrenal insufficiency.
View Article and Find Full Text PDFArticle Synopsis
- Genetic diagnosis for pheochromocytoma and paraganglioma is crucial, as around 80% of cases have identifiable driver mutations, prompting the need for efficient testing methods.
- This study focused on optimizing targeted next-generation sequencing (NGS) to analyze 18 key PPGL genes in both germline and tumor DNA, validating two customized NGS assays with a diverse group of 453 patients.
- The NGS assays demonstrated over 99% sensitivity and identified numerous mutations, including 89 pathogenic mutations, proving to be a reliable alternative to traditional sequencing methods and useful for patients with unclear clinical histories.
Adrenal insufficiency (AI) is a disease characterized by a deficient production or action of glucocorticoids, with or without deficiency in mineral corticoids and/or adrenal androgens. It can result from disease intrinsic to the adrenal cortex (primary AI), from pituitary diseases that hamper the release of corticotropin (secondary AI) or from hypothalamic disorders that impair the secretion of the corticotropin-releasing hormone (tertiary AI). It is a disease with a low prevalence but its impact on the affected individual is very high as it can be life-threathening if not treated or lead to health problems if inadequately treated.
View Article and Find Full Text PDFObjective: Most cases of familial isolated pituitary adenomas with mutated aryl hydrocarbon receptor-interacting protein (AIP:HGNC:358) gene develop somatotropinomas. They are characterised by an aggressive clinical phenotype including early age at diagnosis, large tumours and frequent invasiveness. There is little information on AIP gene mutations' prevalence in isolated somatotropinomas characterised by poor response to somatostatin analogue treatment.
View Article and Find Full Text PDFContext: The deletion of exon 3 in the GH receptor (GHR) has been associated with a different biochemical picture and response to therapy in acromegaly.
Objective: The aim of the study was to determine whether or not the GHR genotype influences the efficacy of pegvisomant treatment.
Design And Setting: A cross-sectional study was conducted in six Spanish university hospitals.
Long-term treatment of acromegalic patients resistant to somatostatin analogues with the GH receptor antagonist pegvisomant: its efficacy in relation to gender and previous radiotherapy.
Eur J Endocrinol
April 2009
Context: Pegvisomant is an effective treatment for somatostatin analogue-resistant acromegaly, but the determinants defining the response to this treatment are largely unknown.
Objective: To investigate the efficacy of pegvisomant treatment in resistant acromegalic patients (e.g.