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[Combination of a hormonally active adrenal tumor with hypertensive disease of the kidneys].

The author observed 230 patients with hormone-active tumor of the adrenal attended with arterial hypertension. In 90 patients there were concomitant hypertensive diseases of the kidneys. The diagnosis of the concomitant disease was verified during roentgenography, aortography included. In 66 of 90 patients (73.3%) arterial hypertension followed a malignant course. The presence of adrenal tumor was verified morphologically after the operation in 208 patients and during autopsy in 22. The concomitant renal disease was confirmed histologically on autopsy in 7 fatal cases and by kidney biopsy in 36. The clinical characteristics of the variants of combined lesions of the kidneys and adrenals and the methods of their diagnosis are discussed. The author recommends examining the adrenals in all patients suffering from malignant arterial hypertension.

Adrenal Cortex Function Tests↗

[Adrenal cortex hormones in acute myocardial infarct complicated by pulmonary edema].

The results of the study of adrenal cortical function in 94 patients (including 20 patients with acute myocardial infarction and pulmonary edema) and in 20 practically healthy persons are discussed. Marked activation of adrenal cortical hormones was noted in patients with acute myocardial infarction and edema of the lungs.

Adrenal Cortex Function Tests↗

[Perioperative steroid substitution in patients with adrenal cortex diseases].

OBJECTIVE: To provide clinically feasible recommendations for diagnosis and replacement therapy with glucocorticoids in patients with adrenocortical disease and primary, secondary or iatrogenic adrenocortical failure. SOURCES: Personal clinical experiences and major clinical reviews pertinent to the problem. RESULTS: The internationally recommended therapeutic regimens are often controversial. Therefore, emphasis is put on detailed and reliable therapeutic schemes which consider the increased glucocorticoid requirement of patients with adrenocortical failure in perioperative or stressful conditions. A sufficient steroid cover is essential to prevent an acute adrenal crisis. It has to be taken into account that adrenocortical dysfunction frequently goes unrecognized in the emergency condition of critical illness if the possibility of its presence is not borne in mind. Moreover, special attention has to be paid, in particular, to the inadvertent corticosteroid withdrawal and its sequelae. CONCLUSION: The perioperative management of patients with diseases of the adrenal cortex is a continuing challenge to the interdisciplinary cooperation of surgeon, neurosurgeon, gynecologist, anesthesiologist and internist.

Adrenal Cortex Function Tests↗