Publications by authors named "R A Feelders"
Up to 30% of adrenocortical carcinoma (ACC) patients have metastasised disease upon initial presentation and systemic treatments currently fail to sufficiently improve survival. Palliative primary tumour resection can be considered for symptomatic relief, but its potential survival benefit remains a topic of debate. This systematic review therefore aims to assess the effect of primary tumour resection on overall survival in patients with metastatic ACC.
View Article and Find Full Text PDFAdrenal masses are being found more and more often over the years. Given the association of these masses with advancing age, the decision to perform surgery in older, sometimes asymptomatic patients presents a clinical dilemma. These patients are potentially more vulnerable to adverse postoperative outcomes due to increased frailty.
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- - Midgut neuroendocrine tumors (NET) are linked to enterochromaffin cells and have shown a unique fecal microbial signature in patients, indicating an altered gut microbiome compared to healthy controls.
- - A study involving sequencing of fecal samples from 60 NET patients and 20 matched controls revealed specific differences in microbial communities, with 16 species and 18 pathways significantly varying between groups, yet no notable differences in microbial composition were found between patients with and without carcinoid syndrome (CS).
- - The research identifies potential microbial signatures that could serve as biomarkers for diagnosing midgut NET and distinguishing between patients with and without CS, with high accuracy in predicting presence based on microbial pathways and species.
Purpose: To assess whether simultaneous normalization of late-night salivary cortisol (LNSC) and mean urinary free cortisol (mUFC) in patients with Cushing disease treated with osilodrostat is associated with better clinical outcomes than control of mUFC or LNSC alone.
Methods: Pooled data from two phase III osilodrostat studies (LINC 3 and LINC 4) were analyzed. Both comprised a 48-week core phase and an optional open-label extension.
Article Synopsis
- Cushing's syndrome (CS) has significant neurocognitive and psychiatric impacts that reduce quality of life, prompting a systematic review of affected patients compared to healthy controls and those with non-functioning pituitary adenomas (NFPA).
- The study analyzed 40 eligible research papers, identifying 2603 participants, 45.2% of whom had Cushing's disease (CD), with a focus on their psychiatric symptoms and cognitive performance before and after surgical treatment.
- Findings indicate that higher baseline cortisol levels in patients with CS correlate with worse cognitive function, even post-surgery, and prolonged periods of uncontrolled CS may lead to persistent cognitive challenges.