Endocrine
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The introduction of the endoscope to transsphenoidal pituitary surgery is not new and it has been abandoned in the past. Now, after some technological advances has been proposed again as an advancement in this field. However, there is still a debate on this topic and some authors consider endoscopic surgery a form of developing surgery in an evolution step. ⋯ At present pure endoscopic transsphenoidal surgery is not a cost effective technology. In fact, the operative time is longer than in microscopic approaches and the number of surgeons required for the procedure is usually double compared to microscopic approaches. This paper will outline on the basis of the data available in literature the reasons why, at present, the pure endoscopic endonasal transsphenoidal surgery should not be yet considered the standard technique for transsphenoidal surgery in patients with pituitary adenomas.
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The introduction of the endoscope to transsphenoidal pituitary surgery is relatively new, but represents a major advancement in the field. The use of the endoscope to visualize the sella via a direct endonasal approach offers the surgeon dramatically better visualization as well as improved range of motion compared to the operating microscope. ⋯ Further, patient comfort and satisfaction are higher with the endonasal method compared with other transsphenoidal approaches, and it is a cost effective technology. This position paper will outline the reasons that endoscopic endonasal transsphenoidal surgery is the preferred method for pituitary surgery, and why it will likely be adopted as the standard technique for transsphenoidal surgery worldwide.
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Excess visceral adipose tissue (VAT) is associated with a cluster of metabolic abnormalities. A new dual-energy X-ray absorptiometry (DXA)-based VAT measurement approach, CoreScan™, computes VAT mass and volume within the android region of a total body DXA scan. However, there have been no reference values developed for this method. ⋯ VAT significantly correlated with HDL (R = -0.193; P = 0.03), glucose (R = 0.252; P = 0.005) and HOMA (R = 0.184; P = 0.049). In this study, we provide normal values of VAT mass and volume measured by DXA and determined for healthy, normal weight, Caucasian women aged 20-40 years. Even in such strictly selected population VAT correlated positively with insulin resistance and inversely with HDL.