Preventive medicine of von Hippel-Lindau disease-associated pancreatic neuroendocrine tumors

Pancreatic neuroendocrine tumors (PanNETs) are rare in von Hippel-Lindau disease (VHL) but cause serious morbidity and mortality. Management guidelines for VHL-PanNETs continue to be based on limited evidence, and survival data to guide surgical management are lacking. We established the European-American-Asian-VHL-PanNET-Registry to assess data for risks for metastases, survival and long-term outcomes to provide best management recommendations. Of 2330 VHL patients, 273 had a total of 484 PanNETs. Median age at diagnosis of PanNET was 35 years (range 10-75). Fifty-five (20%) patients had metastatic PanNETs. Metastatic PanNETs were significantly larger (median size 5 vs 2\u2009cm; P\u20091.5\u2009cm in diameter were operated. Ten-year survival was significantly longer in operated vs non-operated patients, in particular for PanNETs <2.8\u2009cm vs 652.8\u2009cm (94% vs 85% by 10 years; P\u2009=\u20090.020; 80% vs 50% at 10 years; P\u2009=\u20090.030). This study demonstrates that patients with PanNET approaching the cut-off diameter of 2.8\u2009cm should be operated. Mutations in exon 3, especially of codons 161/167 are at enhanced risk for metastatic PanNETs. Survival is significantly longer in operated non-metastatic VHL-PanNETs

Russian Association of Endocrinologists clinical practice guideline for adrenal incidentalomas differential diagnosis

This article discusses the management guidelines for serendipitously diagnosed adrenal masses cases, assessment of their hormonal activity and malignancy potential, pro- and contra indications for surgical treatment and follow-up algorithm for hormonally inactive tumors. Hypercathecholaminemya, endogenous hypercortisolism, primary hyperaldosteronism should be considered as variants of specific hormonal activity of tumor. The midnight suppression test with dexametasone 1 mg is recommended in all cases. Evaluation of basal ACTH in case of negative result of the test with dexametasone 1 mg (absence of morning cortisol level suppression) should be considered as confirmation test. For primary diagnosis of pheohromocytoma/paraganglioma (PPGL) a free plasma or fractionated urine methanephrines concentrations evaluation should be recommended. If test is positive, comprehensive examination to exclude or confirm PPGL is necessity. The aldosterone/rennin ratio exposure should be considered for patients with arterial hypertension to exclude primary hyperaldosteronism. To evaluate malignant pattern of a tumor in all unclear cases should be provide assessment of computed tomography quantitative indices. Adrenal incidentalomas treatment guidelines isnt considered in the field of this recommendations and reported in relevant guidelines

A Comparative Study of Cathodic Electrodeposited Nickel Hydroxide Films Electrocatalysts

This paper describes the cathodic electrodeposition of Ni hydroxides from NiCl2 at const. potentials. In a single compartment electrochem. cell, the procedure yields black films that have the appearance of glassy C. XPS analyses reveal that the films consist of a mixt. of Ni(OH)2 and NiOOH in a proportion that depends on the deposition potential; also, SIMS analyses indicate that the coatings are richer in NiOOH in the inner regions towards the support. The electrochem. behavior was compared with data obtained on electrodes based on pure Ni(OH)2 prepd. by cathodic electrodeposition from Ni(NO3)2, following literature procedures. This comparison confirms the composite nature of black Ni hydroxide (BN) coatings, adding that Ni(OH)2 and NiOOH are present in nearly equal amts. The electrocatalytic activity of BN electrodes was tested in the oxidn. of MeOH in alk. solns. Exptl. results are consistent with a mechanism previously proposed in literature for the oxidn. of org. compds. on Ni electrodes. Comparison with electrodes based on pure Ni(OH)2 shows that, in the low potentials region, the presence of a high amt. of NiOOH causes a decrease of activity, while an opposite effect is obsd. when the potential is increased. The black Ni electrodes show a remarkable stability in repeated cycles of oxidn. of MeOH and O2 evolution; under similar conditions, conventional Ni(OH)2 films show an appreciable decrease in thickness, as evidenced by the decrease of peak charge in cyclic voltammetry expts