Characteristics of adrenal incidentalomas in a New Zealand centre.

Abstract:

BACKGROUND:Management of adrenal incidentalomas (AI) is becoming more conservative, based on international data showing a low incidence of functional or malignant lesions. The clinical characteristics of AI in New Zealand are unknown. Therefore, whether the AI guidelines apply to the New Zealand population is also unknown. AIMS:To investigate the clinical characteristics of patients with AI presenting to a tertiary-care centre in New Zealand. METHOD:This study prospectively evaluated consecutive patients aged 18 or older with AI, 1 cm or larger, diagnosed in Canterbury, New Zealand. A standardised nurse-led dedicated AI clinic was used, including clinical assessment, hormonal evaluation and imaging. RESULTS:From January 2010 to April 2016, 306 patients were referred to the AI clinic, 228 met the inclusion criteria. Most of those excluded were not true AI, due to imaging performed for known or suspected non-adrenal malignancy. The most common reason for imaging was abdominal pain (46%). Most cases were benign (96.5%) and 88.6% of all cases were non-functional. Of the functioning tumours (26 patients), 18 had subclinical Cushing syndrome, four had late-onset congenital adrenal hyperplasia, two had phaeochromocytoma and one had primary hyperaldosteronism. Three patients had primary adrenal cancer, one of whom was secreting excess cortisol. One adrenal metastasis was diagnosed. CONCLUSION:This study found a similar prevalence of functional and malignant AI as international centres, although mild cortisol excess and primary aldosteronism may be under-represented. Therefore, the conservative approach to management of AI recommended in current guidelines is likely to be applicable to New Zealand population.

journal_name

Intern Med J

authors

Goh Z,Phillips I,Hunt PJ,Soule S,Cawood TJ

doi

10.1111/imj.13651

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

173-178

issue

2

eissn

1444-0903

issn

1445-5994

journal_volume

48

pub_type

杂志文章
  • Utility of immunohistochemistry for mismatch repair proteins on colorectal polyps in the familial cancer clinic.

    abstract:BACKGROUND:Immunohistochemistry for loss of expression of one or more of the mismatch repair proteins is performed on colorectal cancer tissue as a screening test for Lynch syndrome; however, its role in pre-malignant polyps remains controversial. AIM:To determine the effectiveness of mismatch repair immunohistochemis...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.13953

    authors: Dow E,Buchanan DD,Winship IM

    更新日期:2018-11-01 00:00:00

  • Are Australasian academic physicians an endangered species?

    abstract::It has been stated that academic medicine is in a worldwide crisis. Is this decline in hospital academic practice a predictable consequence of modern clinical practice with its emphasis on community and outpatient-based services as well as a corporate health-care ethos or does it relate to innate problems in the train...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/j.1445-5994.2007.01490.x

    authors: Wilson A

    更新日期:2007-11-01 00:00:00

  • Implementing "Goals of Care" discussion and palliative care referral for patients with advanced lung cancer - an outpatient-based pilot project.

    abstract:BACKGROUND:Early involvement of palliative care and advance care planning improves quality of life outcomes and survival for patients with advanced lung cancer, however there are barriers to implementation. AIMS AND METHODS:A single-centre prospective audit reviewing "Goals of Care" (GOC) form completion and palliativ...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14817

    authors: Conduit C,Thompson M,Thomas R,Nott L,Wuttke M

    更新日期:2020-03-23 00:00:00

  • Metastatic breast cancer in young women: a population-based cohort study to describe risk and prognosis.

    abstract:BACKGROUND:There is limited information on the risk of metastatic breast cancer (MBC) to inform younger women, particularly those under 40 years. AIMS:We conducted a retrospective analysis of a population-based cohort study to describe the risk, site and prognosis of MBC in young women under 40 years with an initial d...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.12481

    authors: Tjokrowidjaja A,Lee CK,Houssami N,Lord S

    更新日期:2014-08-01 00:00:00

  • Single versus double unrelated umbilical cord blood units for allogeneic transplantation in adults with advanced haematological malignancies: a retrospective comparison of outcomes.

    abstract:BACKGROUND:Unrelated umbilical cord blood has emerged as an alternative stem cell source for allogeneic transplantation for patients with haematological malignancies, but in adults is limited by the low number of stem cells present in banked cord blood units. We report our experience with double cord blood transplants ...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2008.01825.x

    authors: Bradstock K,Hertzberg M,Kerridge I,Svennilson J,George B,McGurgan M,Huang G,Antonenas V,Gottlieb D

    更新日期:2009-11-01 00:00:00

  • Common peroneal neuropathy and cancer.

    abstract::Common peroneal neuropathy (CPN) may develop unexpectedly in patients with underlying cancer. To clarify the underlying pathophysiology, clinical and neurophysiological data were prospectively collected from 10 oncology clinic patients referred for neurological assessment after the onset of foot weakness. In all patie...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2012.02836.x

    authors: Simon NG,Kiernan MC

    更新日期:2012-07-01 00:00:00

  • Colon cancer surveillance in inflammatory bowel disease: unclear gain but no psychological pain?

    abstract:BACKGROUND:Surveillance for colorectal neoplasia in inflammatory bowel disease (IBD) is widely practised despite a lack of convincing mortality reduction. The psychological impact of this approach is largely unexplored. AIM:To examine psychological well-being among IBD subjects undergoing colonoscopic surveillance for...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.12317

    authors: Mountifield R,Bampton P,Prosser R,Mikocka-Walus A,Andrews JM

    更新日期:2014-02-01 00:00:00

  • High Frequency of Anticoagulation Management Errors Preceding Ischemic Strokes in Atrial Fibrillation.

    abstract:BACKGROUND AND AIMS:Anticoagulants are recommended to prevent cardioembolic stroke in most patients with atrial fibrillation (AF). Management errors with anticoagulation and use of aspirin instead of anticoagulants have been documented worldwide, especially with vitamin K antagonists. We assessed the rate of anticoagul...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.15167

    authors: Wong E,Aaqib M,Thijs V

    更新日期:2020-12-21 00:00:00

  • Media reporting of health interventions in New Zealand: a retrospective analysis.

    abstract:AIM:To evaluate New Zealand media articles on their coverage of key issues regarding health interventions and whether it is consistent with available evidence. METHODS:A retrospective analysis was carried out of all articles published in five New Zealand media sources over a 6-week period between 15 October and 26 Nov...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/imj.13936

    authors: Robinson C,Cutfield N,Mottershead J,Sharples K,Richards R,Kingan J,Ledgard C,Liyanage A,McLean J,Nahab F,Stewart F,Strachan S,Tucker K,Zhang Z

    更新日期:2018-08-01 00:00:00

  • Scleroderma lung disease, variation in screening, diagnosis and treatment practices between rheumatologists and respiratory physicians.

    abstract:BACKGROUND:Interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) represent the leading causes of death in systemic sclerosis (SSc). Screening for these complications has assumed greater importance, but is not universal. The aim of this study is to determine the self-reported screening, diagnosis and...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2009.01990.x

    authors: Mangat P,Conron M,Gabbay E,Proudman SM,Pulmonary Interstitial Vascular Organisational Taskforce (PIVOT).

    更新日期:2010-07-01 00:00:00

  • Knowledge and confidence of junior medical doctors in discussing and documenting resuscitation plans: A cross-sectional survey.

    abstract:BACKGROUND:A Resuscitation Plan is a medically authorised order to use or withhold resuscitation interventions. Absence of appropriate resuscitation orders exposes patients to the risk of invasive medical interventions that may be of questionable benefit depending on individual circumstances. AIMS:To describe among ju...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14994

    authors: Bryant J,Waller A,Pickles R,Hullick C,Price E,White B,Willmott L,Bowman MA,Knight A,Ryall MA,Sanson-Fisher R

    更新日期:2020-07-20 00:00:00

  • Unrelated umbilical cord blood transplantation for adults with haematological malignancies: results from a single Australian centre.

    abstract:BACKGROUND:A number of haematological malignancies can be cured by allogeneic stem cell transplantation but only approximately 30% of Australians have a suitable histocompatible related donor. Matched donors can be found on international registries of unrelated volunteers for a proportion of the remaining patients. For...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2006.01079.x

    authors: Bradstock KF,Hertzberg MS,Kerridge IH,Svennilson J,McGurgan M,Huang G,Antonenas V,Gottlieb DJ

    更新日期:2006-06-01 00:00:00

  • Urgent liver transplantation for acute liver failure due to parvovirus B19 infection complicated by primary Epstein-Barr virus and cytomegalovirus infections and aplastic anaemia.

    abstract::An 11-year-old boy presented with hepatic failure secondary to parvovirus B19 infection, requiring urgent liver transplantation. His recovery was complicated by primary Epstein-Barr virus and cytomegalovirus infections. He subsequently developed aplastic anaemia that has been refractory to antithymocyte globulin and c...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2006.01293.x

    authors: So K,Macquillan G,Garas G,Delriviere L,Mitchell A,Speers D,Mews C,Augustson B,de Boer WB,Baker D,Jeffrey GP

    更新日期:2007-03-01 00:00:00

  • Assessment of renal involvement in patients with familial Mediterranean fever: a clinical study from Ardabil, Iran.

    abstract:BACKGROUND AND AIM:Familial Mediterranean fever (FMF) is an autosomal recessive disease characterised by recurrent episodes of painful inflammation in the abdomen, chest or joints. The association between FMF and non-amyloid glomerulopathies are unusual. In this study, we describe our experiences and observations about...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.12520

    authors: Bashardoust B,Maleki N

    更新日期:2014-11-01 00:00:00

  • Post-stroke sleep disturbances and rehabilitation outcomes: a prospective cohort study.

    abstract:BACKGROUND:Poor sleep is common after stroke, and data regarding its effect on rehabilitation outcomes are limited. Controversial evidence was found concerning the effect of sedatives on improving sleep quality in poor sleepers after stroke. AIM:To assess the prevalence of poor sleep in post-stroke patients and its ef...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,多中心研究

    doi:10.1111/imj.14372

    authors: Iddagoda MT,Inderjeeth CA,Chan K,Raymond WD

    更新日期:2020-02-01 00:00:00

  • Renin-angiotensin system inhibition and risk of infection and mortality in COVID-19: a systematic review and meta-analysis.

    abstract:BACKGROUND:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, enters human cells by binding of its viral protein to the aminopeptidase angiotensin-converting enzyme 2 (ACE2). This has led to speculation whether treatment with renin-angiotensin system (RAS) inhibitors was asso...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,meta分析

    doi:10.1111/imj.15002

    authors: Koshy AN,Murphy AC,Farouque O,Ramchand J,Burrell LM,Yudi MB

    更新日期:2020-12-01 00:00:00

  • Analysis of multidisciplinary lung cancer practice.

    abstract:BACKGROUND:The aim of this study was to describe the activity of a lung cancer multidisciplinary clinic (MDC) and examine whether this model of clinical practice results in adherence to best-practice guidelines. METHODS:Prospective analysis of demographic and clinical data in 431 patients referred to a lung cancer MDC...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2006.01237.x

    authors: Conron M,Phuah S,Steinfort D,Dabscheck E,Wright G,Hart D

    更新日期:2007-01-01 00:00:00

  • Spontaneous pneumothorax: time for some fresh air.

    abstract::Conventional teaching on the mechanisms and treatment of spontaneous pneumothorax is either obviously wrong or based on a misunderstanding of the natural history of the condition. Spontaneous pneumothorax is a generally benign, self-limiting condition where conservative management should be considered. If intervention...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/j.1445-5994.2009.02155.x

    authors: Simpson G

    更新日期:2010-03-01 00:00:00

  • Vitamin D deficiency in a multinational refugee population.

    abstract:BACKGROUND:Populations with increased skin pigmentation who have migrated to countries of high latitude are at increased risk of low vitamin D. This study aimed to determine the prevalence of low vitamin D among the refugee population arriving in New Zealand. METHODS:An audit of all refugees arriving at the national r...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2007.01385.x

    authors: Wishart HD,Reeve AM,Grant CC

    更新日期:2007-12-01 00:00:00

  • Using simulation models to teach junior doctors how to insert chest tubes: a brief and effective teaching module.

    abstract:BACKGROUND:Pleural procedures may cause serious complications when incorrectly carried out. There is a need to find effective methods for teaching how to insert a chest drain safely. AIM:To assess the effectiveness of a programme for teaching chest tube insertion using a simulation model (SuperAnnie). METHODS:Groups ...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2007.01586.x

    authors: Hutton IA,Kenealy H,Wong C

    更新日期:2008-12-01 00:00:00

  • Prothrombin complex concentrates used alone in urgent reversal of warfarin anticoagulation.

    abstract:BACKGROUND:Prothrombinex-VF (a three-factor prothrombin complex concentrate) contains little factor VII. Therefore, the Warfarin Reversal Consensus Guidelines from 2004 published by The Australasian Society of Haemostasis and Thrombosis recommend that it be administered with fresh frozen plasma to reverse warfarin anti...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2010.02237.x

    authors: Tran H,Collecutt M,Whitehead S,Salem HH

    更新日期:2011-04-01 00:00:00

  • Insulin-sensitizing antihyperglycaemic medications are associated with better outcome in patients with diabetes undergoing cardiac stress testing.

    abstract:BACKGROUND:There are several treatment modalities available for diabetes; however, the effects of the different medications on coronary artery disease are less understood. The purpose of this study was to evaluate the correlation of insulin-sensitizing therapy with the outcome of stress myocardial perfusion testing and...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2007.01480.x

    authors: Kapinya K,Nijjar PS,Stanek M,Amanullah A

    更新日期:2008-04-01 00:00:00

  • Atypical haemolytic uraemic syndrome treated with the complement inhibitor eculizumab: the experience of the Australian compassionate access cohort.

    abstract:BACKGROUND/AIM:This study aimed to report the clinical characteristics and outcomes of Australian patients treated with eculizumab for atypical haemolytic uraemic syndrome (aHUS). METHODS:A retrospective cohort study was undertaken of all patients in Australia treated with eculizumab provided in a compassionate access...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.12864

    authors: Mallett A,Hughes P,Szer J,Tuckfield A,Van Eps C,Cambell SB,Hawley C,Burke J,Kausman J,Hewitt I,Parnham A,Ford S,Isbel N

    更新日期:2015-10-01 00:00:00

  • Food allergy: is prevalence increasing?

    abstract::It is generally accepted that the prevalence of food allergy has been increasing in recent decades, particularly in westernised countries, yet high-quality evidence that is based on challenge confirmed diagnosis of food allergy to support this assumption is lacking because of the high cost and potential risks associat...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.13362

    authors: Tang ML,Mullins RJ

    更新日期:2017-03-01 00:00:00

  • Stochastic processes in the aetiopathogenesis of scleroderma.

    abstract::We review the aetiology of scleroderma from an epidemiological perspective examining genetic, environmental and stochastic risk factors. The presence of familial clustering (but with low twin concordance) suggests a genetic contribution, and this has been confirmed with recent candidate gene and genome-wide associatio...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/j.1445-5994.2011.02706.x

    authors: Roberts-Thomson PJ,Walker JG

    更新日期:2012-03-01 00:00:00

  • Mortality and airflow obstruction in asthma: a 17-year follow-up study.

    abstract:BACKGROUND:Asthma is associated with fixed airflow obstruction and an increased risk of death. The aim of this study was to relate asthma mortality and airflow obstruction to severity of asthma in a cohort of patients with chronic asthma studied over a 17-year period. METHODS:In 1980, asthma severity based on symptoms...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2006.01214.x

    authors: Panizza JA,James AL,Ryan G,de Klerk N,Finucane KE

    更新日期:2006-12-01 00:00:00

  • Gender, age and ethnic aspects of analgesia in acute abdominal pain: is analgesia even across the groups?

    abstract:BACKGROUND:Numerous studies have shown differences in pain perception between men and women, which may affect pain management strategies. AIM:Our primary aim was to investigate whether there are gender-based differences in pain management in patients admitted to our emergency department with acute, non-specific abdomi...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2010.02255.x

    authors: Banz VM,Christen B,Paul K,Martinolli L,Candinas D,Zimmermann H,Exadaktylos AK

    更新日期:2012-03-01 00:00:00

  • Patterns of inflammatory activation associated with precipitants of acute coronary syndromes: a case-crossover study.

    abstract:AIMS:We sought to assess a broad array of possible precipitants of acute coronary syndromes (ACS) and evaluate their association with detectable inflammatory activation. METHODS AND RESULTS:Within a case-crossover design, using a standardised questionnaire, interviews among 348 ST-elevation myocardial infarction (44%)...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2011.02583.x

    authors: Chew DP,Mattschoss S,Horsfall M,Astley C,Vaile JC,Joseph MX

    更新日期:2012-10-01 00:00:00

  • Permanent peritoneal ports for the management of recurrent malignant ascites: a retrospective review of safety and efficacy.

    abstract::Large volume paracentesis is effective in relieving the symptoms of malignant ascites, but frequent procedures are often required. Permanent peritoneal ports are an alternative to repeated procedures. We describe our experience with the use of peritoneal ports in patients at Middlemore Hospital (Auckland, New Zealand)...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14137

    authors: Chen BS,Wong SHC,Hawkins S,Huggins L

    更新日期:2018-12-01 00:00:00

  • The efficacy and tolerability of febuxostat in gout patients on dialysis.

    abstract:BACKGROUND:There are no sufficient data available on the use of febuxostat in patients undergoing dialysis. AIM:We investigated the efficacy and tolerability of febuxostat in gout patients on dialysis. METHODS:We retrospectively reviewed clinical and laboratory data available from a referral center from January 2012 ...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14776

    authors: Choi SY,Choi SW,Lee S,So MW,Oh JS,Lim DH

    更新日期:2020-02-11 00:00:00