Craniopharyngioma (CP) is a rare tumor in the elderly whose clinical features and prognosis are not well known in this population.
To evaluate the clinicopathological features and therapeutic ...outcomes of CP diagnosed in the elderly.
This was a retrospective, multicenter, national study of CP patients diagnosed over the age of 65 years and surgically treated.
From a total of 384 adult CP patients, we selected 53 (13.8%) patients (27 women 50.9%, mean age 72.3 ± 5.1 years range 65-83 years) diagnosed after the age of 65 years. The most common clinical symptoms were visual field defects (71.2%) followed by headache (45.3%). The maximum tumor diameter was 2.9 ± 1.1 cm. In most patients, the tumor was suprasellar (96.2%) and mixed (solid-cystic) (58.5%). The surgical approach most commonly used was transcranial surgery (52.8%), and more than half of the patients (54.7%) underwent subtotal resection (STR). Adamantinomatous CP and papillary CP were present in 51 and 45.1%, respectively, with mixed forms in the remaining. Surgery was accompanied by an improvement in visual field defects and in headaches; however, pituitary hormonal hypofunction increased, mainly at the expense of an increase in the prevalence of diabetes insipidus (DI) (from 3.9 to 69.2%). Near-total resection (NTR) was associated with a higher prevalence of DI compared with subtotal resection (87.5 vs. 53.6%, p = 0.008). Patients were followed for 46.7 ± 40.8 months. The mortality rate was 39.6% with a median survival time of 88 (95% CI: 57-118) months. DI at last visit was associated with a lower survival.
CP diagnosed in the elderly shows a similar distribution by sex and histologic forms than that diagnosed at younger ages. At presentation, visual field alterations and headaches are the main clinical symptoms which improve substantially with surgery. However, surgery, mainly NTR, is accompanied by worsening of pituitary function, especially DI, which seems to be a predictor of mortality in this population.
Anorexia nervosa (AN) is a disorder associated with many medical complications. Regarding phosphorus metabolism, the only recognized alteration is hypophosphatemia associated with refeeding syndrome. ...However, in our clinical practice, we have observed a high frequency of hyperphosphatemia in late phases of nutrition therapy in severely undernourished AN patients, which has barely been described.
We carried out a retrospective study of patients with AN hospitalized for severe decompensation of the disease.
Eleven patients were included, all women, with a median age of 23 years 20−46 and a body mass index at admission of 12.2 kg/m2 11.7−13.1. Hyperphosphatemia was noted in 9 of the 11 cases (81.8%) with a median time to onset of 53 days 30−75. The median peak serum phosphorus (P) level was 5.1 mg/dl 4.9−5.4. An inverse relationship was found between the increase in P levels and phosphorus supplementation at the onset of admission. The magnitude of the P increase was associated with the body weight gain achieved during nutrition therapy.
Late hyperphosphatemia during nutrition therapy in severely undernourished AN patients affects more than 80% of cases. Body weight gain throughout nutrition therapy is a predictor of increased P levels.
La anorexia nerviosa (AN) es un trastorno que conlleva numerosas complicaciones médicas. Respecto al metabolismo del fósforo, la única alteración reconocida es la hipofosfatemia asociada al síndrome de realimentación. Sin embargo, en nuestra práctica clínica, hemos objetivado una alta frecuencia de hiperfosfatemia en fases tardías de la renutrición en pacientes con AN severamente desnutridos, que ha sido escasamente descrita.
Estudio retrospectivo de pacientes con AN que hubieran precisado ingreso hospitalario por descompensación grave de la enfermedad.
Se incluyeron 11 pacientes, todas mujeres, con una mediana de edad de 23 años 20−46 y un índice de masa corporal al ingreso de 12.2 kg/m2 11.7−13.1. Se objetivó hiperfosfatemia en 9 de los 11 casos (81.8%) con una mediana de tiempo hasta su aparición de 53 días 30−75. La mediana del nivel máximo de fósforo (P) sérico fue de 5.1 mg/dl 4.9−5.4. Se encontró una relación inversa entre el incremento en los niveles de P y el aporte de suplementos de fósforo al inicio del ingreso. La magnitud del incremento de P se asoció con la ganancia de peso corporal alcanzada durante la renutrición.
La hiperfosfatemia tardía durante la renutrición en pacientes con AN severamente desnutridas afecta a más de 80% de los casos. La ganancia de peso corporal a lo largo de la renutrición es un predictor del incremento en los niveles de P.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Load filters
No result was selected!
Please select the results that you wish to export.
The search was successfully saved.
Editing
The search could not be saved.
Saved searches can be viewed in the list My searches.
The changes made to the saved search were saved successfully.
Save search
Shelf entry
No result was selected!
Adding material to shelf was successful.
Adding material to shelf was partly successful.
Adding material to shelf failed completely.
It was not necessary to add the material to the shelf.
Please select the results that you want to put on shelf!
On shelf the following records have been successfully added:
On shelf the following records have been successfully added:
