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Nature Reviews. Endocrinology Jul 2023Adrenal cysts are rare lesions representing approximately 1-2% of adrenal incidentalomas. The majority of these rare lesions are benign. Rarely, phaeochromocytomas and... (Review)
Review
Adrenal cysts are rare lesions representing approximately 1-2% of adrenal incidentalomas. The majority of these rare lesions are benign. Rarely, phaeochromocytomas and adrenal malignant masses can present as cystic lesions and can occasionally be difficult to distinguish from benign cysts. Histologically, adrenal cysts are subdivided into pseudocysts, endothelial cysts, epithelial cysts and parasitic cysts. The radiological appearance of an adrenal cyst is generally similar to that of cysts in the kidney. They are thus well demarcated, usually rounded, with a thin wall and homogenous internal structure, low attenuating (<20 Hounsfield Units) on CT, low signalling on T1-weighted MRI sequences and high signalling on T2-weighted MRI sequences, and anechoic or hypoechoic on ultrasonography. Benign adrenal cysts have a slight female predominance and are usually diagnosed between the ages of 40 and 60. Most adrenal cysts are asymptomatic and are detected incidentally, although very large adrenal cysts can lead to mass effect symptoms, with surgery required to alleviate the symptoms. Thus, conservative management is usually recommended for asymptomatic cysts. However, when uncertainty exists regarding the benign nature of the cyst, additional work-up or follow-up is needed. The management of an adrenal cyst should preferably be discussed at an adrenal multidisciplinary team meeting.
Topics: Humans; Female; Adult; Middle Aged; Male; Adrenal Gland Neoplasms; Tomography, X-Ray Computed; Adrenal Gland Diseases; Pheochromocytoma; Cysts; Diagnosis, Differential
PubMed: 37095252
DOI: 10.1038/s41574-023-00835-2 -
Current Opinion in Gastroenterology Sep 2023Some children with acute recurrent and chronic pancreatitis stand to benefit from therapeutic endoscopic interventions. The purpose of this review is to summarize... (Review)
Review
PURPOSE OF REVIEW
Some children with acute recurrent and chronic pancreatitis stand to benefit from therapeutic endoscopic interventions. The purpose of this review is to summarize specific endoscopic therapies used for these conditions and highlight areas of future research.
RECENT FINDINGS
Multicenter collaboration and consortium efforts have provided more data now than ever on the technical outcomes and safety of therapeutic endoscopic procedures for pancreatitis in children. Indications are growing but more research is needed to help guide patient selection.
SUMMARY
Advanced endoscopic procedures including endoscopic retrograde cholangiopancreatography, endoscopic-ultrasound guided therapies, and single-operator pancreatoscopy may be used in patients with acute recurrent or chronic pancreatitis to manage pancreatic duct obstruction or local complications including pseudocysts and walled-off necrosis. Patient and procedural factors differ between adults and children. Access to these procedures for younger children is growing, and technical outcomes and adverse event rates appear similar between adults and children.
Topics: Adult; Humans; Child; Cholangiopancreatography, Endoscopic Retrograde; Pancreatic Diseases; Pancreatitis, Chronic; Cysts; Treatment Outcome; Multicenter Studies as Topic
PubMed: 37523027
DOI: 10.1097/MOG.0000000000000955 -
Gastrointestinal Endoscopy Clinics of... Oct 2023In the last half century, endotherapy for pancreatic diseases has changed considerably. Although endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic... (Review)
Review
In the last half century, endotherapy for pancreatic diseases has changed considerably. Although endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) were introduced initially as diagnostic tools, they quickly evolved into therapeutic tools for preventing and managing complications of pancreatitis. More recently, therapeutic endoscopy has shown potential in palliation and cure of pancreatic neoplasms. This article discusses the changing landscape of pancreatic endotherapy as therapeutic ERCP and EUS were introduced and because they have evolved to treat different diseases.
Topics: Humans; Pancreas; Cholangiopancreatography, Endoscopic Retrograde; Endosonography; Pancreatitis; Pancreatic Diseases
PubMed: 37709404
DOI: 10.1016/j.giec.2023.03.012 -
Trends in Parasitology Dec 2023Recent studies have proposed that Trichomonas vaginalis, the causative agent of trichomoniasis [the most common nonviral sexually transmitted infection (STI) in humans]... (Review)
Review
Recent studies have proposed that Trichomonas vaginalis, the causative agent of trichomoniasis [the most common nonviral sexually transmitted infection (STI) in humans] can establish persistent infections in the vagina. T. vaginalis infections are often asymptomatic but can have adverse consequences such as increased risk of HIV-1 infection and cervical cancer. Despite this, it remains an understudied infection. A potential agent of persistent infections is the 'pseudocyst', a spherical form of T. vaginalis identified by several laboratories and linked to persistence in related species such as the avian parasite Trichomonas gallinae and cattle parasite Tritrichomonas foetus. Additional robust and reproducible research on pseudocysts and persistent T. vaginalis infections is required, which may ultimately shed light on how to better diagnose and treat trichomoniasis.
Topics: Female; Humans; Animals; Cattle; Trichomonas vaginalis; Persistent Infection; Trichomonas Infections
PubMed: 37806787
DOI: 10.1016/j.pt.2023.09.009