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    Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options
    (SPRINGER-VERLAG ITALIA SRL, 2022-01-01) Agcaoglu, Orhan; Sezer, Atakan; Makay, Ozer; Erdogan, Murat Faik; Bayram, Fahri; Guldiken, Sibel; Raffaelli, Marco; Sonmez, Yusuf Alper; Lee, Yong-Sang; Vamvakidis, Kyriakos; Mihai, Radu; Duh, Quan-Yang; Akinci, Baris; Alagol, Faruk; Almquist, Martin; Barczynski, Marcin; Bayraktaroglu, Taner; Berber, Eren; Bukey, Yusuf; Cakmak, Guldeniz Karadeniz; Canturk, Nuh Zafer; Canturk, Zeynep; Celik, Mehmet; Celik, Ozlem; Ceyhan, Banu Ozturk; Cherenko, Sergii; Clerici, Thomas; Coombes, David Scott; Demircan, Orhan; Deyneli, Oguzhan; Dionigi, Gianlorenzo; Emre, Ali Ugur; Erbil, Yesim; Filiz, Ali Ilker; Gozu, Hulya Iliksu; Gurdal, Sibel Ozkan; Gurleyik, Gunay; Haciyanli, Mehmet; Kebudi, Abut; Kim, Seokmo; Koutelidakis, Giannis; Kuru, Bekir; Mert, Meral; Oruk, Guzide Gonca; Ozbas, Serdar; Palazzo, Fausto; Pandev, Rumen; Riss, Phillip; Sabuncu, Tevfik; Sahin, Ibrahim; Sakman, Gurhan; Saygili, Fusun; Senyurek, Yasemin Giles; Sleptsov, Ilya; Van Slycke, Sam; Teksoz, Serkan; Terzioglu, Tarik; Tezelman, Serdar; Tunca, Fatih; Ugurlu, Mustafa Umit; Uludag, Mehmet; Villar-del-Moral, Jesus; Vriens, Menno; Yazici, Dilek
    Purpose The COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic. Methods We used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire. Results Overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole +/- beta-blocker combination for Graves' disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3-4 cytological results and papillary microcarcinoma. Conclusion This survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible.
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    Efficacy of PET-CT in the prediction of metastatic adrenal masses that are detected on follow-up of the patients with prior nonadrenal malignancy: A nationwide multicenter case-control study
    (LIPPINCOTT WILLIAMS \& WILKINS, 2022-01-01) Arikan, Akif Enes; Makay, Ozer; Teksoz, Serkan; Vatansever, Safa; Alptekin, Husnu; Albeniz, Gurcan; Demir, Ali; Ozpek, Adnan; Tunca, Fatih
    Metastasis is the second most common type of adrenal gland mass. In patients undergoing follow-up for nonadrenal malignancy, adrenalectomy is performed when metastasis to adrenal gland is suspected on the basis of positron emission tomography-computed tomography (PET-CT) imaging. This study investigated the efficacy of PET-CT in the discrimination of metastatic lesions from nonmetastatic lesions in the adrenal glands. In this multicentric study, data was collected from enrolled centers. Forty-one patients who underwent surgery for suspected adrenal metastases were evaluated retrospectively. The following data types were collected: demographic, primary tumor, maximum standardized uptake value of adrenal mass (a-SUVx) and detectability in computed tomography and/or magnetic resonance imaging, and specimen size and histopathology. Six patients were excluded due to unavailability of PET-CT reports and 4 for being primary adrenal malignancy. The rest were divided into 2 groups (metastatic: n = 17, 55\% and nonmetastatic: n = 14, 45\%) according to histopathology reports. There was no statistical difference between the analyzed values, except the a-SUVx (P < .05). The a-SUVx cutoff value was defined as 5.50 by receiver operating characteristic curves and compared with literature. There was no statistical difference when each group was divided as low and high (P > .05). It was found that PET-CT was able to discriminate metastatic lesions from primary benign lesions (P = .022). PET-CT can discriminate primary benign lesions and metastatic lesions by cutoff 5.5 value for a-SUVx.