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1. The coexistence of infundibular pituicytoma and Cushing’s disease due to pituitary adenoma: A case report

Author

Gezer Emre, Selek Alev, Cetinarslan Berrin, Canturk Zeynep, Tarkun Ilhan, and Ceylan Savaş

Subjects
pituicytoma, cushing’s disease, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Objectives. Pituicytomas are rare, solid, well-circumscribed, low grade (grade I), non-neuroendocrine, and noninfiltrative tumors of the neurohypophysis or infundibulum, which appear in the sellar/suprasellar regions. Herein, we present a case with Cushing’s disease (CD) caused by an ACTH-secreting pituitary adenoma in association with an infundibular pituicytoma.

Published
2019
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4. Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options

Author

Heelkunde Opleiding, MS CGO, Cancer, Agcaoglu, Orhan, Sezer, Atakan, Makay, Ozer, Erdogan, Murat Faik, Bayram, Fahri, Guldiken, Sibel, Raffaelli, Marco, Sonmez, Yusuf Alper, Lee, Yong-Sang, Vamvakidis, Kyriakos, Mihai, Radu, Duh, Quan-Yang, Akinci, Baris, Alagol, Faruk, Almquist, Martin, Barczynski, Marcin, Bayraktaroglu, Taner, Berber, Eren, Bukey, Yusuf, Cakmak, Guldeniz Karadeniz, Canturk, Nuh Zafer, Canturk, Zeynep, Celik, Mehmet, Celik, Ozlem, Ceyhan, Banu Ozturk, Cherenko, Sergii, Clerici, Thomas, Coombes, David Scott, Demircan, Orhan, Deyneli, Oguzhan, Dionigi, Gianlorenzo, Emre, Ali Ugur, Erbil, Yesim, Filiz, Ali Ilker, Gozu, Hulya Ilıksu, Gurdal, Sibel Ozkan, Gurleyik, Gunay, Haciyanli, Mehmet, Kebudi, Abut, Kim, Seokmo, Koutelidakis, Giannis, Kuru, Bekir, Mert, Meral, Oruk, Guzide Gonca, Ozbas, Serdar, Palazzo, Fausto, Pandev, Rumen, Riss, Phillip, Sabuncu, Tevfik, Sahin, Ibrahim, Sakman, Gurhan, Saygili, Fusun, Senyurek, Yasemin Giles, Sleptsov, Ilya, Van Slycke, Sam, Teksoz, Serkan, Terzioglu, Tarik, Tezelman, Serdar, Tunca, Fatih, Ugurlu, Mustafa Umit, Uludag, Mehmet, Villar-Del-Moral, Jesus, Vriens, Menno, Yazici, Dilek, Heelkunde Opleiding, MS CGO, Cancer, Agcaoglu, Orhan, Sezer, Atakan, Makay, Ozer, Erdogan, Murat Faik, Bayram, Fahri, Guldiken, Sibel, Raffaelli, Marco, Sonmez, Yusuf Alper, Lee, Yong-Sang, Vamvakidis, Kyriakos, Mihai, Radu, Duh, Quan-Yang, Akinci, Baris, Alagol, Faruk, Almquist, Martin, Barczynski, Marcin, Bayraktaroglu, Taner, Berber, Eren, Bukey, Yusuf, Cakmak, Guldeniz Karadeniz, Canturk, Nuh Zafer, Canturk, Zeynep, Celik, Mehmet, Celik, Ozlem, Ceyhan, Banu Ozturk, Cherenko, Sergii, Clerici, Thomas, Coombes, David Scott, Demircan, Orhan, Deyneli, Oguzhan, Dionigi, Gianlorenzo, Emre, Ali Ugur, Erbil, Yesim, Filiz, Ali Ilker, Gozu, Hulya Ilıksu, Gurdal, Sibel Ozkan, Gurleyik, Gunay, Haciyanli, Mehmet, Kebudi, Abut, Kim, Seokmo, Koutelidakis, Giannis, Kuru, Bekir, Mert, Meral, Oruk, Guzide Gonca, Ozbas, Serdar, Palazzo, Fausto, Pandev, Rumen, Riss, Phillip, Sabuncu, Tevfik, Sahin, Ibrahim, Sakman, Gurhan, Saygili, Fusun, Senyurek, Yasemin Giles, Sleptsov, Ilya, Van Slycke, Sam, Teksoz, Serkan, Terzioglu, Tarik, Tezelman, Serdar, Tunca, Fatih, Ugurlu, Mustafa Umit, Uludag, Mehmet, Villar-Del-Moral, Jesus, Vriens, Menno, and Yazici, Dilek

Published
2022

5. Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options

Author

Agcaoglu, Orhan, Sezer, Atakan, Makay, Ozer, Erdogan, Murat Faik, Bayram, Fahri, Guldiken, Sibel, Raffaelli, Marco, Sonmez, Yusuf Alper, Lee, Yong-Sang, Vamvakidis, Kyriako, Mihai, Radu, Duh, Quan-Yang, Akinci, Bari, Alagol, Faruk, Almquist, Martin, Barczynski, Marcin, Bayraktaroglu, Taner, Berber, Eren, Bukey, Yusuf, Cakmak, Guldeniz Karadeniz, Canturk, Nuh Zafer, Canturk, Zeynep, Celik, Mehmet, Celik, Ozlem, Ceyhan, Banu Ozturk, Cherenko, Sergii, Clerici, Thoma, Coombes, David Scott, Demircan, Orhan, Deyneli, Oguzhan, Dionigi, Gianlorenzo, Emre, Ali Ugur, Erbil, Yesim, Filiz, Ali Ilker, Gozu, Hulya Ilıksu, Gurdal, Sibel Ozkan, Gurleyik, Gunay, Haciyanli, Mehmet, Kebudi, Abut, Kim, Seokmo, Koutelidakis, Gianni, Kuru, Bekir, Mert, Meral, Oruk, Guzide Gonca, Ozbas, Serdar, Palazzo, Fausto, Pandev, Rumen, Riss, Phillip, Sabuncu, Tevfik, Sahin, Ibrahim, Sakman, Gurhan, Saygili, Fusun, Senyurek, Yasemin Gile, Sleptsov, Ilya, Van Slycke, Sam, Teksoz, Serkan, Terzioglu, Tarik, Tezelman, Serdar, Tunca, Fatih, Ugurlu, Mustafa Umit, Uludag, Mehmet, Villar-Del-Moral, Jesu, Vriens, Menno, Yazici, Dilek, Raffaelli, Marco (ORCID:0000-0002-1259-2491), Agcaoglu, Orhan, Sezer, Atakan, Makay, Ozer, Erdogan, Murat Faik, Bayram, Fahri, Guldiken, Sibel, Raffaelli, Marco, Sonmez, Yusuf Alper, Lee, Yong-Sang, Vamvakidis, Kyriako, Mihai, Radu, Duh, Quan-Yang, Akinci, Bari, Alagol, Faruk, Almquist, Martin, Barczynski, Marcin, Bayraktaroglu, Taner, Berber, Eren, Bukey, Yusuf, Cakmak, Guldeniz Karadeniz, Canturk, Nuh Zafer, Canturk, Zeynep, Celik, Mehmet, Celik, Ozlem, Ceyhan, Banu Ozturk, Cherenko, Sergii, Clerici, Thoma, Coombes, David Scott, Demircan, Orhan, Deyneli, Oguzhan, Dionigi, Gianlorenzo, Emre, Ali Ugur, Erbil, Yesim, Filiz, Ali Ilker, Gozu, Hulya Ilıksu, Gurdal, Sibel Ozkan, Gurleyik, Gunay, Haciyanli, Mehmet, Kebudi, Abut, Kim, Seokmo, Koutelidakis, Gianni, Kuru, Bekir, Mert, Meral, Oruk, Guzide Gonca, Ozbas, Serdar, Palazzo, Fausto, Pandev, Rumen, Riss, Phillip, Sabuncu, Tevfik, Sahin, Ibrahim, Sakman, Gurhan, Saygili, Fusun, Senyurek, Yasemin Gile, Sleptsov, Ilya, Van Slycke, Sam, Teksoz, Serkan, Terzioglu, Tarik, Tezelman, Serdar, Tunca, Fatih, Ugurlu, Mustafa Umit, Uludag, Mehmet, Villar-Del-Moral, Jesu, Vriens, Menno, Yazici, Dilek, and Raffaelli, Marco (ORCID:0000-0002-1259-2491)

Abstract

PURPOSE: The COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic.METHODS: We used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire.RESULTS: Overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole±beta-blocker combination for Graves' disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3-4 cytological results and papillary microcarcinoma.CONCLUSION: This survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible.

Published
2021

7. The Effect of Chronic Glucocorticoid Exposure on Brown Adipose Tissue in Cushing's Disease.

Author

Selek, Alev, Sozen, Mehmet, Cayir, Berat Furkan, Tarkun, Ilhan, Cetinarslan, Berrin, Canturk, Zeynep, Gezer, Emre, and Koksalan, Damla

Subjects
THERAPEUTIC use of glucocorticoids, BLOOD testing, PROTEINS, CUSHING'S syndrome, DRUG resistance, ENZYME-linked immunosorbent assay, DESCRIPTIVE statistics, ADIPOSE tissues, LONGITUDINAL method, HYDROCORTISONE
Abstract

Aim: In this study, we aimed to evaluate the levels of brown adipose tissue markers uncoupling protein-1 (UCP-1), irisin, bone morphogenetic protein-7 (BMP-7) and PR-Domain Zinc Finger Protein-16 (PRDM-16) in Cushing's disease (CH) with hypercortisolism. Methods: The study was conducted prospectively with 48 CH patients and 40 healthy volunteers between 2018 and 2019. Two cc of peripheral blood taken from the participants was centrifuged and stored at -80° C degrees. Cushing's syndrome was excluded by performing 1 mg dexamethasone suppression test in the control group. Blood samples were analyzed by Enzyme-linked Immunosorbent Assay method. Results: The patient group included 11 males (22.9%), 37 female (77.1%); 9 male (22.5%) and 31 females (77.5%) in the control group. Body mass index was 31.29±5.76 kg/m² in the patient group and 33.42±3.11 kg/m² in the control group. PRDM-16, Irisin, BMP-7, UCP-1 levels were not significantly different between the two groups. While there was a positive correlation between serum cortisol and irisin, a negative correlation was observed between urinary free cortisol and UCP-1. Conclusion: These data suggest that long-term exposure to high doses of glucocorticoids in CH patients causes loss of adipose tissue functionality and development of resistance in vivo. [ABSTRACT FROM AUTHOR]

Published
2021
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14. Evaluation of the foot health with baropodometric analysis of acromegaly patients followed after pituitary surgery.

Author

Karatoprak, Ayfer Peker, Aydin, Levent, Yuksel, Burcu, Demirhan, Yeliz, Baydemir, Canan, Selek, Alev, Canturk, Zeynep, and Cetinarslan, Berrin

Subjects
*SOMATOMEDIN C, *FLATFOOT, *ACROMEGALY, *MUSCULOSKELETAL system, *SOMATOTROPIN, CORN development
Abstract

Background The exposure to growth hormone (GH) and increase in insulin-like growth factor 1 (IGF-1) in acromegaly can cause various clinical findings related to the cardiovascular, respiratory, and musculoskeletal systems. GH exerts its anabolic effects directly or indirectly through IGF-1, by increasing cell proliferation and maturation in varioustissues, including bone, cartilage, skeletal muscle, and tendons. The aim of this study is to analyze these changes using baropodometric gait analysis. Methods Our study was conducted with a sample of 41 acromegaly patients and 42 control group individuals. Static, dynamic, and stabilometric baropodometric analyses were performed, as well as podoscanner analysis. Results According to the dynamic and static baropodometric analyses of both groups, the standing load distribution and stabilometric Romberg index findings were similar. However, the acromegaly group showed a higher prevalence of pes planus findings compared to the control group (p<0.003). Conversely, the control group showed a higher incidence of callus and corn formation (p=0.01). Conclusions Pes planus can disturb the load distribution in the foot, leading to the formation of pressure points. High pressure on the plantar surface of the foot is associated with the development of callus and corn. In this study, although pes planus was more common in the acromegaly group than in the control group, callus and corn formation in the forefoot region were higher in the control group (p=0.01). It was suggested that the soft tissue hypertrophy in acromegaly may be protective against callus and corn formation, which are expected to develop due to pressure. The podiatric approach can be used in other endocrinological diseases that affect the musculoskeletalsystem,such as acromegaly, especially in diabetic patients. Conducting baropodometric analysis and balancing load distribution with insoles can contribute to reducing the risk of fracture in acromegaly patients. Future studies with larger patient groups, including clinical and radiological findings, can be performed to further evaluate these results. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Clinical and demographic aspects of Paget disease of bone: A multicentric study from Turkey

Author

Mustafa Kulaksizoglu, Ferhat Deniz, Zeliha Hekimsoy, Oğuzhan Deyneli, Alev Selek, Nilüfer Özdemir, Şevki Çetinkalp, Zeynep Cantürk, Alper Gürlek, Suleyman Hilmi Ipekci, Dilek Gogas Yavuz, Semra Ayturk, Ersin Akarsu, Cevdet Duran, Aysegul Atmaca, Fulden Sarac, Meral Mert, Firat Bayraktar, Hasan Aydin, Seda Sancak, Melin Uygur, Eda Ertorer, Yavuz, Dilek Gogas, Ayturk, Semra, Cetinkalp, Sevki, Bayraktar, Firat, Kulaksizoglu, Mustafa, Hekimsoy, Zeliha, Aydin, Hasan, Uygur, Melin, Deniz, Ferhat, Ipekci, Suleyman, Atmaca, Aysegul, Sarac, Fulden, Ozdemir, Nilufer, Canturk, Zeynep, Mert, Meral, Sancak, Seda, Ertorer, Eda, Duran, Cevdet, Akarsu, Ersin, Deyneli, Oguzhan, Selek, Alev, Gurlek, Alper, OMÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Atmaca, Ayşegül, Deyneli, Oğuzhan (ORCID 0000-0001-6582-7031 & YÖK ID 171914), Aytürk, Semra, Çetinkalp, Şevki, Bayraktar, Fırat, Kulaksızoğlu, Mustafa, Aydın, Hasan, İpekçi, Süleyman, Saraç, Fulden, Özdemir, Nilüfer, Cantürk, Zeynep, Ertörer, Eda, Gürlek, Alper, and School of Medicine

Subjects
medicine.medical_specialty, Hearing loss, Medicine, Endocrinology metabolism, Disease, serum alkaline phosphatase, DIAGNOSIS, Metabolic bone disease, bisphosphonate therapy, Rheumatology, Internal medicine, medicine, MANAGEMENT, polyostotic disease, Femur, Bone pain, Pelvis, business.industry, RC581-607, medicine.disease, PREVALENCE, Zoledronic acid, medicine.anatomical_structure, Paget disease of bone, Polyostotic disease, Serum alkaline phosphatase, Bisphosphonate therapy, paget disease of bone, Cohort, Original Article, Immunologic diseases. Allergy, medicine.symptom, business, medicine.drug
Abstract

Objective: Paget disease of bone (PDB) is a metabolic bone disease that has been rarely reported in the Eastern countries. This study aimed to evaluate the clinical and demographic characteristics of patients with PDB followed up at endocrinology clinics in Turkey. Methods: an invitation was sent to tertiary endocrinology clinics to complete a survey on the demographic, clinical, radiological, and laboratory parameters, as well as treatment modalities of patients with PDB. This study enrolled clinically and radiologically proven 185 patients with PDB from 18 endocrinology centers based in 10 cities of Turkey. Results: this cohort of PDB had female preponderance (women/men: 105/80) with a mean age, during diagnosis, of 57±10 years. Most of the patients (59.6%) were symptomatic at diagnosis. Bone pain and headache were the predominant clinical symptoms. Polyostotic disease was observed in 67.5% (n=125) of patients. Frequently affected bones were skull (41.6%), pelvis (53.5%), spine (41%), and femur (25.4%). Moreover, 17 patients with skull involvement had hearing loss. Mean serum alkaline phosphatase (ALP) level (552±652 IU/L; range: 280-5762 IU/L) was over the normal reference cutoff with normal serum calcium levels. Intravenous bisphosphonates (zoledronic acid, 5 mg; pamidronate, 60-90 mg) were the most used drugs (75%) for the treatment of PDB. Most of the patients (87.1%) treated with intravenous bisphosphonates responded well, with a decrease in serum ALP level (117±114 IU/L) in the 12th month of therapy. Furthermore, 16 patients relapsed after the second year of therapy; 3 patients did not respond to the initial intravenous bisphosphonate treatment. Conclusion: the patients with PDB followed up by endocrinology clinics of Turkey exhibited polyostotic disease with classical clinical, radiological, and biochemical features and women's predominance with good response to intravenous bisphosphonate therapy., NA

Published
2021

16. Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options

Author

Orhan Agcaoglu, Sam Van Slycke, Sibel Özkan Gürdal, Ali Ugur Emre, Atakan Sezer, Marcin Barczyński, Fusun Saygili, Marco Raffaelli, Giannis Koutelidakis, Banu Ozturk Ceyhan, Murat Faik Erdogan, Orhan Demircan, Mehmet Celik, Yusuf Bukey, Yong Sang Lee, Fatih Tunca, Seok Mo Kim, Oğuzhan Deyneli, Ibrahim Sahin, Ali İlker Filiz, Abut Kebudi, Mehmet Haciyanli, Yeşim Erbil, Martin Almquist, Menno R. Vriens, Tevfik Sabuncu, Meral Mert, Mehmet Uludag, Taner Bayraktaroglu, Serdar Özbaş, Dilek Yazici, Yusuf Alper Sonmez, Zeynep Cantürk, Kyriakos Vamvakidis, Guldeniz Karadeniz Cakmak, Gianlorenzo Dionigi, Baris Akinci, Thomas Clerici, Eren Berber, Tarik Terzioglu, Gunay Gurleyik, Hulya Iliksu Gozu, Gurhan Sakman, Ozlem Celik, P. Riss, Ilya Sleptsov, Rumen Pandev, Özer Makay, David Scott Coombes, Jesus Villar-Del-Moral, Nuh Zafer Cantürk, Radu Mihai, Sergii Cherenko, Yasemin Giles Şenyürek, Mustafa Umit Ugurlu, Fahri Bayram, Guzide Gonca Oruk, Faruk Alagol, Sibel Guldiken, Serdar Tezelman, Quan-Yang Duh, Fausto Palazzo, Serkan Teksoz, Bekir Kuru, Agcaoglu, Orhan, Sezer, Atakan, Makay, Ozer, Erdogan, Murat Faik, Bayram, Fahri, Guldiken, Sibel, Raffaelli, Marco, Sonmez, Yusuf Alper, Lee, Yong-Sang, Vamvakidis, Kyriakos, Mihai, Radu, Duh, Quan-Yang, Akinci, Baris, Alagol, Faruk, Almquist, Martin, Barczynski, Marcin, Bayraktaroglu, Taner, Berber, Eren, Bukey, Yusuf, Cakmak, Guldeniz Karadeniz, Canturk, Nuh Zafer, Canturk, Zeynep, Celik, Mehmet, Celik, Ozlem, Ceyhan, Banu Ozturk, Cherenko, Sergii, Clerici, Thomas, Coombes, David Scott, Demircan, Orhan, Deyneli, Oguzhan, Dionigi, Gianlorenzo, Emre, Ali Ugur, Erbil, Yesim, Filiz, Ali Ilker, Gozu, Hulya Iliksu, Gurdal, Sibel Ozkan, Gurleyik, Gunay, Haciyanli, Mehmet, Kebudi, Abut, Kim, Seokmo, Koutelidakis, Giannis, Kuru, Bekir, Mert, Meral, Oruk, Guzide Gonca, Ozbas, Serdar, Palazzo, Fausto, Pandev, Rumen, Riss, Phillip, Sabuncu, Tevfik, Sahin, Ibrahim, Sakman, Gurhan, Saygili, Fusun, Senyurek, Yasemin Giles, Sleptsov, Ilya, Van Slycke, Sam, Teksoz, Serkan, Terzioglu, Tarik, Tezelman, Serdar, Tunca, Fatih, Ugurlu, Mustafa Umit, Uludag, Mehmet, Villar-del-Moral, Jesus, Vriens, Menno, Yazici, Dilek, Ağcaoğlu, Orhan (ORCID 0000-0003-1617-3953 & YÖK ID175476), Alagöl, Faruk, Deyneli, Oğuzhan (ORCID 0000-0001-6582-7031 & YÖK ID 171914), Yazıcı, Dilek, Sezer, A., Makay, O., Erdoğan, M. F., Bayram, F., Güldiken, S., Raffaelli, M., Sönmez, Y. A., Lee, Y.-S., Vamvakidis, K., Mihai, R., Duh, Q.-Y., Akıncı, B., Almquist, M., Barczynski, M., Bayraktaroğlu, T., Berber, E., Bukey, Y., Çakmak, G. K., Cantürk, N. Z., Cantürk, Z., Çelik, M., Çelik O., Ceyhan, B. O., Cherenko, S., Clerici, T., Coombes, D. S., Demircan, O., Dionigi, G., Emre, A. U., Erbil, Y., Filiz, A. I., Gozu, H. I., Gürdal, S. O., Gürleyik, G., Hacıyanlı, M., Kebudi, A., Kim, S., Koutelidakis, G., Kuru, B., Mert, M., Oruk, G. G., Özbaş, S., Palazzo, F., Pandev, R., Riss, P., Sabuncu, T., Şahin, I., Sakman, G., Saygılı, F., Şenyürek, Y. G., Sleptsov, I., Van Slycke, S., Teksöz, S., Terzioğlu, T., Tunca, F., Uğurlu, M. U., Uludağ, M., Villar-del-Moral, J., Vriens, M., School of Medicine, and Acibadem University Dspace

Subjects
Qualtrics, medicine.medical_specialty, Cinacalcet, Consensus, Settore MED/18 - CHIRURGIA GENERALE, education, Delphi method, Disease, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Pandemic, Health care, medicine, Humans, Intensive care medicine, Survey, Endocrine disease, Expert Testimony, Pandemics, business.industry, SARS-CoV-2, COVID-19, Guideline, medicine.disease, Surgery, Expert opinion, 030220 oncology & carcinogenesis, Original Article, business, Primary hyperparathyroidism, medicine.drug
Abstract

Purpose: the COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic. Methods: we used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire. Results: overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole ± β-blocker combination for Graves’ disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3–4 cytological results and papillary microcarcinoma. Conclusion: this survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible., NA

Published
2021

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