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Torremolinos, Spain

Villar J.M.,Virgen Of Las Nieves Universitary Hospital | Moreno P.,Bellvitge Universitary Hospital | Ortega J.,Clinico Universitary Hospital | Bollo E.,Donostia Hospital | And 16 more authors.
Langenbeck's Archives of Surgery

Purpose: Given the availability of laparoscopy and the rising detection of incidentalomas, indications for adrenalectomy may be changing. The Endocrine Surgery Section of the Spanish Association of Surgeons designed a survey to assess its indications, techniques, and results in Spanish Surgical Departments. Methods: Collected data included hospital and department type, yearly hospital volume of procedures; location studies and preoperative preparation performed, indications, surgical approach and instruments used, and results in terms of morbidity and overall hospital stay. The analysis included a comparison between results of high- or low-volume centers and surgeons, using the Student's t test for quantitative and chi-square test for qualitative variables. Level of significance was set at 0.05. Results: Nineteen centers returned the questionnaire, including 155 adrenalectomies performed in 2008. Most frequent indications were pheochromocytoma (23.2%), aldosteronoma (16.7%), incidentaloma (12.2%), metastasis (10.3%), Cushing adenoma (9.6%), and carcinoma (3.8%). Laparoscopy was performed in 83.9% of cases (9.4% required conversion to laparotomy). Four patients required urgent reoperation. Average hospital stay: 4.6 days (3.3 days after laparoscopy, 7 days after laparotomy). High-volume centers had a greater proportion of laparoscopically treated cases (p∈=∈0.008), more malignant lesions treated (p∈=∈0.03), a shorter overall stay (p∈<∈0.0001), and a shorter stay after laparotomic adrenalectomy (p∈=∈0.01). High-volume surgeons had similar results, and less in-hospital morbidity (p∈=∈0.02). Conclusions: In Spain, adrenalectomy is performed in hospitals of varying complexity. Laparoscopic approach is the rule, with good results in terms of morbidty and stay. High-volume centers and surgeons had best results in terms of use of minimally invasive surgery and hospital stay. © 2010 Springer-Verlag. Source

Martinez-Garcia F.,University of Valencia | Martinez-Garcia F.,CIBER ISCIII | Mansego M.L.,Genotyping and Genetic Diagnosis Unit | Mansego M.L.,CIBER ISCIII | And 15 more authors.
BMC Genetics

Background: The objective was to investigate the association between BMI and single nucleotide polymorphisms previously identified of obesity-related genes in two Spanish populations. Forty SNPs in 23 obesity-related genes were evaluated in a rural population characterized by a high prevalence of obesity (869 subjects, mean age 46 yr, 62% women, 36% obese) and in an urban population (1425 subjects, mean age 54 yr, 50% women, 19% obese). Genotyping was assessed by using SNPlex and PLINK for the association analysis.Results: Polymorphisms of the FTO were significantly associated with BMI, in the rural population (beta 0.87, p-value <0.001). None of the other SNPs showed significant association after Bonferroni correction in the two populations or in the pooled analysis. A weighted genetic risk score (wGRS) was constructed using the risk alleles of the Tag-SNPs with a positive Beta parameter in both populations. From the first to the fifth quintile of the score, the BMI increased 0.45 kg/m2 in Hortega and 2.0 kg/m2 in Pizarra. Overall, the obesity predictive value was low (less than 1%).Conclusion: The risk associated with polymorphisms is low and the overall effect on BMI or obesity prediction is minimal. A weighted genetic risk score based on genes mainly acting through central nervous system mechanisms was associated with BMI but it yields minimal clinical prediction for the obesity risk in the general population. © 2013 Martínez-García et al.; licensee BioMed Central Ltd. Source

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