05). The majority of the patients in our study were females, suggesting an underlying hormonal pathology. The association with obesity suggested that anatomical differences can be present in lipid distribution. Dermal edema and lymphatic dilatation suggested the primary pathology is lymphatic system.”
“Context: Data on mortality associated with Cushing’s disease (CD) and Cushing’s syndrome (CS) are scarce. Objective: To perform a systematic

review and meta-analysis of mortality studies in patients with CD and CS secondary to a benign adrenal Selleck NVP-AUY922 adenoma.\n\nData sources: A search was performed in seven electronic databases. Sixty-six articles were retrieved for analysis and 7 included in the final study. The main outcome measure was standardized mortality ratio (SMR). Study eligibility criteria, participants, and interventions: Studies reporting SMR for

patients diagnosed with CD and/or CS. Outcomes were stratified by subtype of Cushing’s syndrome.\n\nStudy appraisal and synthesis methods: Studies were appraised by two authors and were synthesized using a weighted estimate based on the standard error of the SMR.\n\nResults: The weighted mean of SMR for patients with CD was 1.84 (95% confidence interval (CI): 1.28-2.65). CD patients with persistent disease after initial surgery had a SMR of 3.73 (95% CI: 2.31-6.01), BTSA1 chemical structure whereas mortality of CD patients with initial remission did not differ significantly from the general population (SMR: 1.23 (95% CI: 0.51-2.97)).

SMR for patients with a benign adrenal adenoma was 1.90 (95% CI: 0.93-3.91). Age, sex and observation time did not significantly impact mortality.\n\nConclusions: CD as opposed to CS due to a benign adrenal adenoma is associated with an excess mortality, which is attributed to patients in whom initial surgical cure is not obtained. This underlines the importance of a rigorous and early follow-up of newly operated patients with CD. (C) 2011 European SBC-115076 Others inhibitor Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.”
“Objectives/Hypothesis: To evaluate our initial experience with a novel technique, endoscopic anterior maxillotomy (EAM), for improved access to the anterior-lateral skull base. Clinical and radioanatomic data are presented to describe and define this novel technique.\n\nStudy Design: Case series.\n\nMethods: Surgical patients with lesions of the pterygopalatine fossa, infratemporal fossa, and anterior-lateral maxilla treated from 2006 to 2008 are reviewed. Demographic data and surgical technique are presented. A radioanatomic analysis pre- and post-EAM is performed to describe increased access. Matched-paired analysis was performed for statistical evaluation.\n\nResults: Thirty-two patients had surgical treatment of anterior-lateral skull base lesions. EAM was utilized in 16 cases. Fifty-six percent extended lateral to V2 and 56% extended posterior to the maxillary sinus. Complete resection was achieved in 11 patients.