Table of contents :
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macroscopic | consistence |
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lymph node involvement | diffuse | diffuse | asymmetric | |
adhesion to surrounding structures | no or mild | no or mild | strong | |
microscopic | microabscesses | present | absent | absent |
lymphatic infiltration | minimal | diffuse with presence of germinal centres | minima | |
giant cells | frequent | rare | absent | |
fibrous tissue | increased | mildly increased | strongly increased |
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stage I | any T, any N, M0 | T1, N0, M0 |
stage II (80%) | any T, any N, M1 | T2 or T3, N0, M0 |
stage III | - | T4, N0, M0 any T, N1, M0 |
stage IV (1%) | - | any T, any N, M1 |
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stage I | any T, any N, M0 | T1, N0, M0 |
stage II | any T, any N, M1 | T2 or T3, N0, M0 |
stage III | - | T4, N0, M0 any T, N1, M0 |
stage IV | - | any T, any N, M1 |
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Europids : in the USA, the ATP III
values (102 cm male; 88 cm female) are likely to continue to be used for clinical purposes |
male | >= 94 cm |
female | >= 80 cm | |
South Asians : based on a Chinese, Malay and Asian-Indian population | male | >= 90 cm |
female | >= 80 cm | |
Chinese | male | >= 90 cm |
female | >= 80 cm | |
Japanese | male | >= 90 cm |
female | >= 80 cm | |
Ethnic South and Central Americans | use South Asian recommendations until more specific data are available | |
Sub-Saharan Africans | use European data until more specific data are available | |
Eastern Mediterranean and Middle East (Arab) populations | use European data until more specific data are available |
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high |
< 130
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< 40
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> 400
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borderline |
100-129
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40-60
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150-400
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low |
< 100 (therapeutic goal)
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> 60
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< 150
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Therapy :oral hypoglycemizing
drugs are contraindicated in chronic
renal
failure
and liver
failure
(=> shift to insulin
replacement therapy
)
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A (no infection or ischemia) | ||||
B (+ infection) | ||||
C (+ ischemia) | ||||
D (+ infection and ischemia) |
HbA1c (%) |
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4.0–5.9 |
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6.0–6.5 | target | |||
6.6–6.9 | action | Target Aa | Target | Target |
7.0–7.9 | Target Bb | Action | Action | |
8.0–8.9 | Target Cc | |||
> 9.0 | Action |
Diabetes news
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P value | |
maximal diameter > 4 cm | 78% :
> 5 cm : adrenal carcinoma) |
22% | 0.0001 |
irregular margin | 63% | 53.8% | NS |
inhomogeneity | 80% | 100% | NS |
calcifications | 13% | 31% | NS |
hypodensity | 100% | 100% | NS |
no cortical uptake at 131I-norcholesterol scintigraphy | 27.7% | 100% | 0.001 |
cortical uptake at 131I-MIBG scintigraphy | 84.4% | 100% | 0.001 |
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steroidogenic acute regulatory (StAR) protein : death during childhood |
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none | all |
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HSD3B2![]() |
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salt wasting |
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DHEA, 17-OH -pregnenolone | aldo, T, cort, estradiol | ||
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DHEA, 17-OH- pregnenolone | aldo, T, cort, estradiol | ||
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DHEA, 17-OH- pregnenolone | - | ||
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CYP21A2 / 21
hydroxylase![]() ![]()
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![]() ![]() |
progesterone, 17-OH- progesterone, D4- androstenedione | aldo, cort | ||
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17-OH- progesterone, D4-A | cort | ||
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17-OH- progesterone, D4-A | - | ||
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CYP11B1
/ 11b hydroxylase![]() |
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![]() |
11-DOC, 11- deoxycortisol | cort, aldo |
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11-deoxycortisol ± 11-DOC | - | ||
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CYP17A1![]() |
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![]() |
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![]() |
11-DOC, corticosterone | aldo, andro, cort, estro |
CYP17A1![]() |
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- | DHEA, T, D4-A | |
multiple deficiency |
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BP | +++ | + |
[aldosterone![]() |
> 25 ng/dl | < 25 ng/dl |
[aldosterone![]() |
> 30 ng/day | < 30 ng/day |
age | < 50 years | > 50 years |
sensitivity | specificity | |
[total catecholamines]urine, 24h,
beginning collection during hypertensive crisis
> 250 mg/die or > 1480 nmol/die
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85-100% | 72-99% |
[metanephrine]urine, 24h,
beginning collection during hypertensive crisis >
1.3 mg/die or > 7 mmol/die
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97-100% | 84-100% |
[vanilmandelic
acid
(VMA)![]() |
50-75% | 83-88% |
hypercatecholaminemia (66%) : increased
[catecholamines]plasma, during hypertensive
crisis (t1/2 = 2-3' !)
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75-85% | 75-98% |
[metanephrine]plasma | 88-100 | 75-88 |
chromogranine A | 65-85% | 89-98% |
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CT![]() |
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MRI![]() |
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131I-metaiodobenzylguanidine (MIBG) adrenal
scintigraphy![]() |
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octreotide scintigraphy |
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6-18F-dopamine or 11C-hydroxyephedrine
PET![]() |
Symptoms & signs \ Aetiology |
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hyalinization of seminiferous tubules |
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microorchidism![]() |
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azoospermia |
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decreased [testosterone![]() |
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decreased face hairs |
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increased [FSH![]() ![]() |
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decreased sexual function |
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gynecomastia![]() |
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decreased axillary hairs |
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micropenis |
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increased [estradiol![]() |
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biological | taller than peers but may end up short | short stature but later should achieve normal height; osteoporosis |
psychological | psychological effects positive in boys (higher self esteem), negative in girls (low self esteem) | low self esteem in boys; no major problems in girls |
social | different from peers; treated as adolescent while still a child | treated by adults and peers as less mature than real age; difficulty in separating from parents and in getting work |
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gastric
banding (lap-band)![]() |
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vertical
banded gastroplasty / silastic ring gastroplasty![]() |
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gastric
bypass (Roux-en-Y anastomosis)![]() |
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partial
pancreaticobiliary bypass / biliopancreatic
diversion (with/without duodenal switch)![]() |
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