Pub Date : 2025-06-01DOI: 10.1016/j.endien.2025.501563
Karina Mercedes Becerra Añez , Carlos Sánchez Juan , Ana Artero Fullana , Ana Jiménez Portilla , Juan Carlos Ferrer García
Introduction
Hyponatremia is the most common electrolyte disorder in hospitals. This study analyses the evolution of serum sodium levels during hospitalization.
Materials and methods
This is an observational, retrospective, and analytical study. Patients hospitalized for hyponatremia in a tertiary care hospital were included. Demographic and laboratory variables were collected, and hyponatremia was classified according to severity and etiology. Criteria and risk factors for serum sodium overcorrection were defined, and the effectiveness of treatments used for hyponatremia was described. The Chi-square test was used for qualitative variables, while Student’s t-test and Mann–Whitney U test were applied for quantitative variables. Predictive models were also used to determine the risk of an event.
Results
A total of 216 patients hospitalized for hyponatremia were included, with a higher prevalence in patients over 75 years of age and females. Longer hospital stays were associated with older age and male gender. Severe hyponatremia and hypokalemia were linked to a higher risk of overcorrection. The therapies for hyponatremia correction across the three groups were effective either alone or in combination. Additionally, severe hyponatremia was associated with increased 5-year mortality.
Conclusions
Hyponatremia in hospitalized patients is more prevalent in those over 75 years old and in females. Severe hyponatremia increases 5-year mortality. There are factors that increase the risk of overcorrection, so treatment should be carefully managed to avoid osmotic demyelination syndrome (ODS).
{"title":"Sodium evolution in hyponatremia: A retrospective analysis in a tertiary care center","authors":"Karina Mercedes Becerra Añez , Carlos Sánchez Juan , Ana Artero Fullana , Ana Jiménez Portilla , Juan Carlos Ferrer García","doi":"10.1016/j.endien.2025.501563","DOIUrl":"10.1016/j.endien.2025.501563","url":null,"abstract":"<div><h3>Introduction</h3><div>Hyponatremia is the most common electrolyte disorder in hospitals. This study analyses the evolution of serum sodium levels during hospitalization.</div></div><div><h3>Materials and methods</h3><div>This is an observational, retrospective, and analytical study. Patients hospitalized for hyponatremia in a tertiary care hospital were included. Demographic and laboratory variables were collected, and hyponatremia was classified according to severity and etiology. Criteria and risk factors for serum sodium overcorrection were defined, and the effectiveness of treatments used for hyponatremia was described. The Chi-square test was used for qualitative variables, while Student’s <em>t</em>-test and Mann–Whitney <em>U</em> test were applied for quantitative variables. Predictive models were also used to determine the risk of an event.</div></div><div><h3>Results</h3><div>A total of 216 patients hospitalized for hyponatremia were included, with a higher prevalence in patients over 75 years of age and females. Longer hospital stays were associated with older age and male gender. Severe hyponatremia and hypokalemia were linked to a higher risk of overcorrection. The therapies for hyponatremia correction across the three groups were effective either alone or in combination. Additionally, severe hyponatremia was associated with increased 5-year mortality.</div></div><div><h3>Conclusions</h3><div>Hyponatremia in hospitalized patients is more prevalent in those over 75 years old and in females. Severe hyponatremia increases 5-year mortality. There are factors that increase the risk of overcorrection, so treatment should be carefully managed to avoid osmotic demyelination syndrome (ODS).</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 6","pages":"Article 501563"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.endien.2025.501576
Mónica Baptista Lopes , Ricardo Fonseca , João Fernandes Serôdio , Ricardo Paquete Oliveira , José Delgado Alves
Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is a cause of Cushing's syndrome usually associated with neuroendocrine tumors. Olfactory neuroblastoma (ONB) is a rare malignant neoplasm of the olfactory epithelium. This is the case of a 56-year-old woman with an ONB presenting with EAS. After initiating metyrapone, she developed a Pneumocystis jirovecii pneumonia. Following successful treatment of the infection, she underwent surgical tumor excision and radiotherapy, which has been in remission for the past 3 years. The authors provide a literature review of the 30 previously published cases of ONB presenting with EAS. Most were reported in middle-aged men, with a recurrence rate of 15.6% (3 patients eventually died). A total of 9.5% of all reported had an infection after starting corticosteroid-blocking therapy. ONB is a very rare cause of EAS with poor prognosis and a relapsing course. In the presence of severe hypercortisolism, chemoprophylaxis for common opportunistic agents must be considered.
{"title":"Ectopic adrenocorticotropic hormone syndrome due to olfactory neuroblastoma: A case report and literature review","authors":"Mónica Baptista Lopes , Ricardo Fonseca , João Fernandes Serôdio , Ricardo Paquete Oliveira , José Delgado Alves","doi":"10.1016/j.endien.2025.501576","DOIUrl":"10.1016/j.endien.2025.501576","url":null,"abstract":"<div><div>Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is a cause of Cushing's syndrome usually associated with neuroendocrine tumors. Olfactory neuroblastoma (ONB) is a rare malignant neoplasm of the olfactory epithelium. This is the case of a 56-year-old woman with an ONB presenting with EAS. After initiating metyrapone, she developed a <em>Pneumocystis jirovecii</em> pneumonia. Following successful treatment of the infection, she underwent surgical tumor excision and radiotherapy, which has been in remission for the past 3 years. The authors provide a literature review of the 30 previously published cases of ONB presenting with EAS. Most were reported in middle-aged men, with a recurrence rate of 15.6% (3 patients eventually died). A total of 9.5% of all reported had an infection after starting corticosteroid-blocking therapy. ONB is a very rare cause of EAS with poor prognosis and a relapsing course. In the presence of severe hypercortisolism, chemoprophylaxis for common opportunistic agents must be considered.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 6","pages":"Article 501576"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.endien.2025.501580
Sandra Herranz-Antolín , Rosa Quílez-Toboso , Jesús Moreno-Fernández , Javier González-López , María López-Iglesias , Julia Sastre
Objective
To analyze the clinical presentation, diagnosis, management and survival of Anaplastic Thyroid Carcinomas (ATC) in the Hospitals of Castilla-La Mancha (Spain).
Material and methods
Retrospective multicenter descriptive study. Adult patients with ATC diagnosed from 2002 to 2022 were included.
Results
Of the 43 patients included, 53.5% were women, with a mean age of 72 years (SD 10) at the time of diagnosis. Symptoms were present in 100% of the patients and the most frequent symptom was a rapidly growing mass (79.1% of the cases). Infiltration of neighboring structures (76.7%), lymph node involvement (78.1%) and distant metastasis (51.2%). The AJCC-TNM category was IVa in 9.3%, IVb in 39.5% and IVc in 51.2%. BRAFV600E determination was not performed in 74.4% and 5 of the 11 cases in which it was evaluated (45.4%) had the mutation. Active treatment was received in 76.7% of patients in the first 3 mo. Surgical approach was performed in 63.6% of the cases, with complete resection in 23.8%, and 51.5% received multimodality treatment in this period. 42.3% received active treatment during follow-up (≥ 3 mo), primarily systemic chemotherapy (72.7%), and 54.4% received multimodality treatment during this period. The median specific survival was 3.5 mo (95% CI 1.7–5.2). Factors associated with longer specific survival were initial multimodality treatment (p < 0.01) or during follow-up (p = 0.01) and initial BRAF/MEK inhibitor treatment (p = 0.04).
Conclusion
CAT is an infrequent and aggressive tumor that requires early, multidisciplinary, personalized and multimodal treatment.
目的：分析西班牙卡斯蒂利亚-拉曼查医院甲状腺间变性癌（ATC）的临床表现、诊断、治疗及生存情况。材料和方法：回顾性多中心描述性研究。纳入了2002年至2022年诊断为ATC的成年患者。结果：纳入的43例患者中，53.5%为女性，诊断时平均年龄为72岁（SD 10）。100%的患者出现症状，最常见的症状是快速增长的肿块（79.1%的病例）。邻近组织浸润（76.7%）、淋巴结受累（78.1%）和远处转移（51.2%）。AJCC-TNM分类中IVa占9.3%，IVb占39.5%，IVc占51.2%。74.4%的患者未进行BRAFV600E检测，11例患者中有5例（45.4%）存在突变。在前3个 月内，76.7%的患者接受了积极治疗。63.6%的病例行手术入路，23.8%的病例行完全切除，51.5%的病例在此期间接受了多模式治疗。42.3%的人在随访期间接受了积极治疗（≥ 3 mo），主要是全身化疗（72.7%），54.4%的人在此期间接受了多模式治疗。中位特异性生存期为3.5 mo （95% CI 1.7-5.2）。结论：CAT是一种罕见的侵袭性肿瘤，需要早期、多学科、个性化和多模式的治疗。
{"title":"CANTCAM project (ANaplastic Thyroid Carcinoma in CAstilla-La Mancha). Multicenter retrospective study","authors":"Sandra Herranz-Antolín , Rosa Quílez-Toboso , Jesús Moreno-Fernández , Javier González-López , María López-Iglesias , Julia Sastre","doi":"10.1016/j.endien.2025.501580","DOIUrl":"10.1016/j.endien.2025.501580","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the clinical presentation, diagnosis, management and survival of Anaplastic Thyroid Carcinomas (ATC) in the Hospitals of Castilla-La Mancha (Spain).</div></div><div><h3>Material and methods</h3><div>Retrospective multicenter descriptive study. Adult patients with ATC diagnosed from 2002 to 2022 were included.</div></div><div><h3>Results</h3><div>Of the 43 patients included, 53.5% were women, with a mean age of 72 years (SD 10) at the time of diagnosis. Symptoms were present in 100% of the patients and the most frequent symptom was a rapidly growing mass (79.1% of the cases). Infiltration of neighboring structures (76.7%), lymph node involvement (78.1%) and distant metastasis (51.2%). The AJCC-TNM category was IVa in 9.3%, IVb in 39.5% and IVc in 51.2%. <em>BRAF<sup>V600E</sup></em> determination was not performed in 74.4% and 5 of the 11 cases in which it was evaluated (45.4%) had the mutation. Active treatment was received in 76.7% of patients in the first 3 mo. Surgical approach was performed in 63.6% of the cases, with complete resection in 23.8%, and 51.5% received multimodality treatment in this period. 42.3% received active treatment during follow-up (≥ 3 mo), primarily systemic chemotherapy (72.7%), and 54.4% received multimodality treatment during this period. The median specific survival was 3.5 mo (95% CI 1.7–5.2). Factors associated with longer specific survival were initial multimodality treatment (p < 0.01) or during follow-up (p = 0.01) and initial BRAF/MEK inhibitor treatment (p = 0.04).</div></div><div><h3>Conclusion</h3><div>CAT is an infrequent and aggressive tumor that requires early, multidisciplinary, personalized and multimodal treatment.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 6","pages":"Article 501580"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.endien.2025.501600
Núria Alonso , María Teresa Julián
{"title":"Adipopathy and dysglycaemia in systemic metabolic disease: Towards an integrated multidisciplinary approach led by the endocrinologist","authors":"Núria Alonso , María Teresa Julián","doi":"10.1016/j.endien.2025.501600","DOIUrl":"10.1016/j.endien.2025.501600","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 6","pages":"Article 501600"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.endien.2025.501561
Faezeh Ebrahimi , Hadi Maleki , Mansour Ebrahimi , Amir Hossein Beiki
Background/Purpose of the study
Type 2 diabetes mellitus (T2DM)—one of the fastest globally spreading diseases—is a chronic metabolic disorder characterized by elevated blood glucose levels. It has been suggested that the composition of gut microbiota plays key roles in the prevalence of T2DM. In this study, a novel approach of large-scale data mining and multivariate analysis of the gut microbiome of T2DM patients and healthy controls was conducted to find the key compositional differences in their microbiota and potential biomarkers of the disease.
Methods
First, suitable datasets were identified (9 in total with 946 samples), analyzed, and their operational taxonomic units (OTUs) were computed by identical parameters to increase accuracy. The following OTUs were merged and compared based on their health status, and compositional differences detected. For biomarker identification, the OTUs were subjected to 9 different attribute weighting models. Additionally, OTUs were independently analyzed by multivariate algorithms (LEfSe test) to verify the realized biomarkers.
Results
Overall, 23 genera and 4 phyla were identified as possible biomarkers. At genus level, the decrease of Bacteroides, Methanobrevibacter, Paraprevotella, and [Eubacterium] hallii group in T2DM and the increase of Prevotella, Megamonas, Megasphaera, Ligilactobacillus, and Lachnoclostridium were selected as biomarkers; and at phylum level, the increase of Synergistota and the decrease of Euryarchaeota, Desulfobacterota (Thermodesulfobacteriota), and Ptescibacteria.
Conclusion
This is the first study ever conducted to find the microbial compositional differences and biomarkers in T2DM using data mining models applied on a widespread metagenome dataset and verified by multivariate analysis.
{"title":"A novel approach to finding the compositional differences and biomarkers in gut microbiota in type 2 diabetic patients via meta-analysis, data-mining, and multivariate analysis","authors":"Faezeh Ebrahimi , Hadi Maleki , Mansour Ebrahimi , Amir Hossein Beiki","doi":"10.1016/j.endien.2025.501561","DOIUrl":"10.1016/j.endien.2025.501561","url":null,"abstract":"<div><h3>Background/Purpose of the study</h3><div>Type 2 diabetes mellitus (T2DM)—one of the fastest globally spreading diseases—is a chronic metabolic disorder characterized by elevated blood glucose levels. It has been suggested that the composition of gut microbiota plays key roles in the prevalence of T2DM. In this study, a novel approach of large-scale data mining and multivariate analysis of the gut microbiome of T2DM patients and healthy controls was conducted to find the key compositional differences in their microbiota and potential biomarkers of the disease.</div></div><div><h3>Methods</h3><div>First, suitable datasets were identified (9 in total with 946 samples), analyzed, and their operational taxonomic units (OTUs) were computed by identical parameters to increase accuracy. The following OTUs were merged and compared based on their health status, and compositional differences detected. For biomarker identification, the OTUs were subjected to 9 different attribute weighting models. Additionally, OTUs were independently analyzed by multivariate algorithms (LEfSe test) to verify the realized biomarkers.</div></div><div><h3>Results</h3><div>Overall, 23 genera and 4 phyla were identified as possible biomarkers. At genus level, the decrease of <em>Bacteroides</em>, <em>Methanobrevibacter</em>, <em>Paraprevotella</em>, and [<em>Eubacterium</em>] <em>hallii group</em> in T2DM and the increase of <em>Prevotella</em>, <em>Megamonas</em>, <em>Megasphaera</em>, <em>Ligilactobacillus</em>, and <em>Lachnoclostridium</em> were selected as biomarkers; and at phylum level, the increase of <em>Synergistota</em> and the decrease of <em>Euryarchaeota</em>, <em>Desulfobacterota</em> (<em>Thermodesulfobacteriota</em>), and <em>Ptescibacteria</em>.</div></div><div><h3>Conclusion</h3><div>This is the first study ever conducted to find the microbial compositional differences and biomarkers in T2DM using data mining models applied on a widespread metagenome dataset and verified by multivariate analysis.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 6","pages":"Article 501561"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.endien.2025.501577
Tomás González-Vidal , Diego Rivas-Otero , Carmen Lambert , Jessica Ares Blanco , Elías Delgado-Álvarez , Edelmiro Menéndez Torre
Objective
To predict the length of hospital stay in hyperosmolar hyperglycemic crises (HHC) using variables available on admission.
Methods
We conducted a retrospective cohort study with 132 patients (65 [49.2%] men; median age 72 years; range 19–98 years) hospitalized for HHC (including hyperosmolar hyperglycemic state and diabetic ketoacidosis with elevated osmolality) in a Spanish teaching hospital. Baseline variables and those upon arrival to the emergency department were collected (both variables related to physical examination and biochemical tests), as well as the in-hospital mortality rate and overall length of hospital stay in survivors.
Results
Patients who died (n = 13) had higher total serum osmolality and higher C-reactive protein concentrations on admission vs survivors. Among survivors, the length of stay correlated positively with total serum osmolality (Rho = 0.398; p < 0.001) and C-reactive protein (Rho = 0.342; p < 0.001) on admission. Older age, female sex, lack of pre-admission diagnosis of insulin-requiring diabetes, impaired mental status on arrival, non-ketotic metabolic acidosis, and low serum potassium concentrations were also associated with long lengths of stay. In multivariate analysis, only serum glucose (one of the three components of total osmolality) and C-reactive protein concentrations on admission kept a positive association with the length of stay.
Conclusions
Hyperglycemia and elevated C-reactive protein on admission are independent predictors of long lengths of stay in survivors with HHC.
{"title":"Predictors of length of hospital stay in patients presenting to the emergency department with hyperosmolar hyperglycemic crises","authors":"Tomás González-Vidal , Diego Rivas-Otero , Carmen Lambert , Jessica Ares Blanco , Elías Delgado-Álvarez , Edelmiro Menéndez Torre","doi":"10.1016/j.endien.2025.501577","DOIUrl":"10.1016/j.endien.2025.501577","url":null,"abstract":"<div><h3>Objective</h3><div>To predict the length of hospital stay in hyperosmolar hyperglycemic crises (HHC) using variables available on admission.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study with 132 patients (65 [49.2%] men; median age 72 years; range 19–98 years) hospitalized for HHC (including hyperosmolar hyperglycemic state and diabetic ketoacidosis with elevated osmolality) in a Spanish teaching hospital. Baseline variables and those upon arrival to the emergency department were collected (both variables related to physical examination and biochemical tests), as well as the in-hospital mortality rate and overall length of hospital stay in survivors.</div></div><div><h3>Results</h3><div>Patients who died (<em>n</em> <!-->=<!--> <!-->13) had higher total serum osmolality and higher C-reactive protein concentrations on admission vs survivors. Among survivors, the length of stay correlated positively with total serum osmolality (Rho<!--> <!-->=<!--> <!-->0.398; <em>p</em> <!--><<!--> <!-->0.001) and C-reactive protein (Rho<!--> <!-->=<!--> <!-->0.342; <em>p</em> <!--><<!--> <!-->0.001) on admission. Older age, female sex, lack of pre-admission diagnosis of insulin-requiring diabetes, impaired mental status on arrival, non-ketotic metabolic acidosis, and low serum potassium concentrations were also associated with long lengths of stay. In multivariate analysis, only serum glucose (one of the three components of total osmolality) and C-reactive protein concentrations on admission kept a positive association with the length of stay.</div></div><div><h3>Conclusions</h3><div>Hyperglycemia and elevated C-reactive protein on admission are independent predictors of long lengths of stay in survivors with HHC.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 6","pages":"Article 501577"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.endien.2025.101532
Juan J. Díez
{"title":"New therapeutic options in the management of chronic hypoparathyroidism","authors":"Juan J. Díez","doi":"10.1016/j.endien.2025.101532","DOIUrl":"10.1016/j.endien.2025.101532","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 5","pages":"Article 101532"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.endien.2025.501579
María Carmen López García , Andrés Ruiz de Assin Valverde , Alejandro Sirvent Segovia , Cristina Lamas Oliveira , José Joaquín Alfaro Martínez
{"title":"Adrenal hemorrhage: Case series and review of their management","authors":"María Carmen López García , Andrés Ruiz de Assin Valverde , Alejandro Sirvent Segovia , Cristina Lamas Oliveira , José Joaquín Alfaro Martínez","doi":"10.1016/j.endien.2025.501579","DOIUrl":"10.1016/j.endien.2025.501579","url":null,"abstract":"","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 5","pages":"Article 501579"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.endien.2025.501560
Elena González Arnáiz , Juan José López Gómez , Diana Ariadel Cobo , Brisamar Estébanez , María García Duque , Carmen Dameto Pons , David Barajas Galindo , Diana García Sastre , Ana Urioste Fondo , María J. Cuevas , María D. Ballesteros Pomar
Background
Hand grip strength—measured by dynamometry—is an essential tool in nutritional assessment, particularly for detecting sarcopenia, even before weight or muscle mass loss is evident. In individuals with obesity, hand grip strength can help identify muscle weakness that may not be apparent due to high body mass. The purpose of this study is to describe the absolute and adjusted hand grip strength values for weight, height, body mass index (BMI), and appendicular skeletal muscle mass (ASMM) in obese patients. It also aims to determine the prevalence of low muscle strength in this group of patients and to compare these results with those obtained in a healthy population.
Methods
Prospective observational study including patients with obesity and healthy volunteers. Absolute and adjusted hand grip strength values for weight, height, BMI and appendicular muscle mass were determined in patients with obesity and compared with the results of healthy volunteers. Muscle strength was measured by hand grip strength according to Sánchez-Torralvo, Dodds, and < −2SD cut-off points of healthy reference population.
Results
The results obtained show that the absolute hand grip strength values are higher in healthy volunteers (30.7 ± 10.5 kg) vs patients with obesity (26.6 ± 9.7 kg); p < 0.008. As for hand grip strength values adjusted for height, weight, BMI and ASMM, they are also statistically significantly higher in healthy volunteers (18.0 ± 5.5 vs. 15.9 ± 5.4, p < 0.014; 05 ± 0.10 vs. 0.2 ± 0.06, p < 0.001; 1.4 ± 0.4 vs. 0.6 ± 0.2, p < 0.001; 1.5 ± 0.2 vs. 0.9 ± 0.3, p < 0.001). According to sex, men had significantly higher absolute and adjusted hand grip strength values in both obese patients and healthy volunteers. The prevalence of low muscle strength in patients with obesity goes from 14.5% up and 23.4% depending on the cut-off points used, being higher with those of Sánchez-Torralvo´s cut-off points. Based on sex distribution, obese men had a higher prevalence of low muscle strength with absolute hand grip strength values vs women, being these differences statistically significant only with the Sánchez-Torralvo´s cut-off points. In terms of the prevalence of low muscle strength with adjusted hand grip strength values, more variable percentages (3.2%–96.8%) were observed without clear differences across sexes.
Conclusions
Hand grip strength values in obese patients vary according to absolute or adjusted measurements. Obese patients have lower absolute and adjusted hand grip strength values vs the healthy population. However, more studies are needed to establish specific cut-off points for hand grip strength in patients with obesity.
{"title":"Absolute and adjusted hand grip strength values in obese patients","authors":"Elena González Arnáiz , Juan José López Gómez , Diana Ariadel Cobo , Brisamar Estébanez , María García Duque , Carmen Dameto Pons , David Barajas Galindo , Diana García Sastre , Ana Urioste Fondo , María J. Cuevas , María D. Ballesteros Pomar","doi":"10.1016/j.endien.2025.501560","DOIUrl":"10.1016/j.endien.2025.501560","url":null,"abstract":"<div><h3>Background</h3><div>Hand grip strength—measured by dynamometry—is an essential tool in nutritional assessment, particularly for detecting sarcopenia, even before weight or muscle mass loss is evident. In individuals with obesity, hand grip strength can help identify muscle weakness that may not be apparent due to high body mass. The purpose of this study is to describe the absolute and adjusted hand grip strength values for weight, height, body mass index (BMI), and appendicular skeletal muscle mass (ASMM) in obese patients. It also aims to determine the prevalence of low muscle strength in this group of patients and to compare these results with those obtained in a healthy population.</div></div><div><h3>Methods</h3><div>Prospective observational study including patients with obesity and healthy volunteers. Absolute and adjusted hand grip strength values for weight, height, BMI and appendicular muscle mass were determined in patients with obesity and compared with the results of healthy volunteers. Muscle strength was measured by hand grip strength according to Sánchez-Torralvo, Dodds, and < −2SD cut-off points of healthy reference population.</div></div><div><h3>Results</h3><div>The results obtained show that the absolute hand grip strength values are higher in healthy volunteers (30.7 ± 10.5 kg) vs patients with obesity (26.6 ± 9.7 kg); p < 0.008. As for hand grip strength values adjusted for height, weight, BMI and ASMM, they are also statistically significantly higher in healthy volunteers (18.0 ± 5.5 vs. 15.9 ± 5.4, p < 0.014; 05 ± 0.10 vs. 0.2 ± 0.06, p < 0.001; 1.4 ± 0.4 vs. 0.6 ± 0.2, p < 0.001; 1.5 ± 0.2 vs. 0.9 ± 0.3, p < 0.001). According to sex, men had significantly higher absolute and adjusted hand grip strength values in both obese patients and healthy volunteers. The prevalence of low muscle strength in patients with obesity goes from 14.5% up and 23.4% depending on the cut-off points used, being higher with those of Sánchez-Torralvo´s cut-off points. Based on sex distribution, obese men had a higher prevalence of low muscle strength with absolute hand grip strength values vs women, being these differences statistically significant only with the Sánchez-Torralvo´s cut-off points. In terms of the prevalence of low muscle strength with adjusted hand grip strength values, more variable percentages (3.2%–96.8%) were observed without clear differences across sexes.</div></div><div><h3>Conclusions</h3><div>Hand grip strength values in obese patients vary according to absolute or adjusted measurements. Obese patients have lower absolute and adjusted hand grip strength values vs the healthy population. However, more studies are needed to establish specific cut-off points for hand grip strength in patients with obesity.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 5","pages":"Article 501560"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.endien.2025.501564
Berta Bella Burgos , Ruben Carrera Salas , Ricard Onieva Carbajo , Catalina Padilla Navas , María del Carmen Ramos Guijo , Laura Escudero Larrá , Rosa María Rodríguez Millán , José Antonio Vázquez Luque , Silvia Hurtado Mas , Adrià Asensi Puig , Carmen María Blázquez Mañá , Santi Barcons Vilaplana , Ismail Capel Flores , Xavier Guirao Garriga , Víctor Pérez-Riverola , Mario Prenafeta Moreno , Neus Combalia Soriano , Ruth Orellana Fernández , Joan Carles Ferreres Piñas , María Rosa Bella-Cueto
Introduction
Since the C228T mutation in theTERT promoter (TERTp) has been identified almost exclusively in thyroid malignancies, our objective was to study the usefulness of its determination in thyroid fine needle aspirations (FNA) of the IV category of the Bethesda classification (B.IV).
Methodology
From the FNAs performed between 1993 and 2015, we selected those with a diagnosis of B.IV or equivalent and subsequent thyroidectomy. A retrospective study of the C228T mutation in TERTp was performed by pyrosequencing in neoplastic cases (adenomas, low risk neoplasms and carcinomas), both from the surgical specimen and from the FNA material if feasible.
Results
79 cases with a diagnosis of B.IV were identified, and mutational study was performed in the 61 cases corresponding to neoplasms, identifying 10 cases with the mutation (12.6% of the series), with a higher presence in Poorly Differentiated Carcinomas (PDC) or with a minor PDC component (45%), in cases with death attributable to thyroid carcinoma (50%) and in patients alive but with persistence of thyroid carcinoma (50%). The mutation was confirmed in 7 of 8 cases with the mutation and satisfactory cytological material. In 4 cases, preoperative knowledge of the mutation could have avoided a two-stage thyroidectomy.
Conclusion
The study of the C228T mutation ofTERTp can be useful to detect malignancy and establish the best surgical approach in patients with thyroid FNA with a diagnosis of B.IV.
{"title":"Study of the C228T mutation of the TERT promoter in thyroid aspirative punctures of IV category of the Bethesda classification","authors":"Berta Bella Burgos , Ruben Carrera Salas , Ricard Onieva Carbajo , Catalina Padilla Navas , María del Carmen Ramos Guijo , Laura Escudero Larrá , Rosa María Rodríguez Millán , José Antonio Vázquez Luque , Silvia Hurtado Mas , Adrià Asensi Puig , Carmen María Blázquez Mañá , Santi Barcons Vilaplana , Ismail Capel Flores , Xavier Guirao Garriga , Víctor Pérez-Riverola , Mario Prenafeta Moreno , Neus Combalia Soriano , Ruth Orellana Fernández , Joan Carles Ferreres Piñas , María Rosa Bella-Cueto","doi":"10.1016/j.endien.2025.501564","DOIUrl":"10.1016/j.endien.2025.501564","url":null,"abstract":"<div><h3>Introduction</h3><div>Since the C228T mutation in the<em>TERT</em> promoter (<em>TERTp</em>) has been identified almost exclusively in thyroid malignancies, our objective was to study the usefulness of its determination in thyroid fine needle aspirations (FNA) of the IV category of the Bethesda classification (B.IV).</div></div><div><h3>Methodology</h3><div>From the FNAs performed between 1993 and 2015, we selected those with a diagnosis of B.IV or equivalent and subsequent thyroidectomy. A retrospective study of the C228T mutation in <em>TERTp</em> was performed by pyrosequencing in neoplastic cases (adenomas, low risk neoplasms and carcinomas), both from the surgical specimen and from the FNA material if feasible.</div></div><div><h3>Results</h3><div>79 cases with a diagnosis of B.IV were identified, and mutational study was performed in the 61 cases corresponding to neoplasms, identifying 10 cases with the mutation (12.6% of the series), with a higher presence in Poorly Differentiated Carcinomas (PDC) or with a minor PDC component (45%), in cases with death attributable to thyroid carcinoma (50%) and in patients alive but with persistence of thyroid carcinoma (50%). The mutation was confirmed in 7 of 8 cases with the mutation and satisfactory cytological material. In 4 cases, preoperative knowledge of the mutation could have avoided a two-stage thyroidectomy.</div></div><div><h3>Conclusion</h3><div>The study of the C228T mutation of<em>TERTp</em> can be useful to detect malignancy and establish the best surgical approach in patients with thyroid FNA with a diagnosis of B.IV.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"72 5","pages":"Article 501564"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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