HEATHER WACHTEL, MD

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This study looked at the adrenal glands of 114 older patients (aged 60 and up) who had surgery for primary aldosteronism (PA), a condition that can raise blood pressure. Researchers found that half of the patients had a specific type of growth called an aldosterone-producing nodule (APN), while a significant portion (39%) had an aldosterone-producing adenoma (APA). They also discovered that unique genetic changes were present; specifically, 60% of APNs had changes in the CACNA1D gene, while 32% of APAs had changes in the KCNJ5 gene. Understanding these patterns is important because it can lead to better treatments for older patients with this condition, who often have more health issues and lower chances of being cured after surgery. Who this helps: Patients with primary aldosteronism, especially older adults.

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This study looked at how certain tumors called pheochromocytomas (PCC) and paragangliomas (PGL) spread in the body. Researchers analyzed samples from 27 patients and found that metastatic tumors often have different genetic changes compared to the original tumors, which means they evolve in separate ways. This is important because it highlights the need for new treatments that target these specific genetic changes, especially since about 25% of patients experience metastasis and currently have limited options. Who this helps: Patients with metastatic pheochromocytoma and paraganglioma.

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This study focused on the screening of primary aldosteronism, a condition linked to high blood pressure and kidney problems. It found that fewer than 2% of eligible patients are currently being screened, despite updated guidelines suggesting that more people—especially those with stage 2 hypertension—should be tested. The research shows that early detection can lead to better health outcomes, and new strategies for implementing these screenings could help identify more patients and prevent serious health issues. Who this helps: Patients with high blood pressure and their doctors.

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This study looked at the costs associated with two types of medication used before surgery for patients with pheochromocytoma, a type of tumor on the adrenal glands. It found that those using selective alpha-blockers spent significantly less on medication in the month before surgery—about $19.73 compared to $1,033.70 for nonselective blockers—but the overall costs during and after hospitalization were similar for both groups. This matters because it shows that while selective blockers are cheaper upfront, they do not lead to lower overall costs for patients. Who this helps: Patients preparing for pheochromocytoma surgery.

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This study looked at patients with serious gastrointestinal blockages caused by cancers like colorectal, gynecologic, and hepatobiliary cancers. Researchers found that out of nearly 8,700 patients, those who had been hospitalized for cancer before were 7.8% less likely to receive surgery for their blockage. This information is important because it highlights how previous hospital stays can influence treatment options, which can help doctors make better decisions for their patients. Who this helps: This helps patients facing malignant gastrointestinal obstructions and their healthcare providers.

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This study looked at how two treatment options for primary aldosteronism (a condition that causes high blood pressure) affect the number of medications people need to take and the costs associated with them. Researchers found that one year after surgery to remove the adrenal gland (adrenalectomy), patients used an average of 1.1 fewer blood pressure medications and saved about $908 in prescription costs compared to those who were treated with medication alone. This matters because it shows that surgery can significantly reduce both the number of pills needed and overall treatment costs in the long run. Who this helps: Patients with primary aldosteronism considering treatment options.

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Researchers studied 241 patients who had thyroid or parathyroid surgery and compared outcomes based on whether they'd previously had different types of stomach surgery—particularly whether their intestines had been rerouted to bypass the duodenum (the first part of the small intestine). They found that patients with prior intestinal bypass surgery developed dangerously low calcium levels after their neck surgery at much higher rates than patients who had sleeve gastrectomy (a different weight-loss procedure that doesn't reroute the intestines). The risk was especially severe in patients with nonbariatric bypass surgery—those who had the intestinal rerouting for reasons other than weight loss—where 81% experienced low calcium levels shortly after surgery and 71% had persistent problems months later. Low calcium caused longer hospital stays and more readmissions. This matters because doctors now know they need to screen and monitor calcium levels more carefully before and after

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This study examined how pancreatic neuroendocrine tumors come back after initial treatment and how those recurrences are treated. Out of 284 patients, 44 (or 24%) had their cancer return, typically around 57 months after surgery, mostly in the liver. The research found that having cancer spread to the lymph nodes greatly increased the risk of it coming back. In recent years, doctors have been using more advanced treatments for managing these recurrences. Who this helps: This information benefits doctors treating patients with pancreatic neuroendocrine tumors, allowing them to make better decisions based on recurrence risks and treatment options.

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This study examined how to improve screening for primary aldosteronism (PA), a condition that causes high blood pressure, by using an electronic health record system to prompt doctors to recommend screening for at-risk patients. Before the intervention, only 1.4% of eligible patients were screened for PA, but after implementing an automated reminder system, screening rates jumped to 16.4% in the targeted clinics. This is important because early detection of PA can lead to better management of high blood pressure and overall health outcomes. Who this helps: This helps patients at risk of primary aldosteronism, particularly those with high blood pressure.

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This study examined how certain health conditions and surgeries that affect nutrient absorption impact the risk of low calcium levels after thyroid and parathyroid surgeries. Researchers looked at data from over 25,000 patients, finding that 8.8% experienced low calcium levels shortly after surgery, and the rate increased to 18.3% within a year. Specifically, patients who had surgeries on their foregut or midgut faced a higher risk, especially after total thyroidectomy, compared to those who did not have such surgeries. Who this helps: This information is vital for doctors and patients, particularly those with prior gastrointestinal surgeries, to manage postoperative care effectively.

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This study examined the delays in treatment for patients with adrenocortical carcinoma (ACC), a rare cancer, to see if certain factors affected how quickly individuals received care. Researchers looked at data from 1,399 patients treated between 2010 and 2019 and found that the average time to treatment was 27 days. Non-Hispanic Black patients and those aged 40 to 64 experienced longer delays, while women and patients with more advanced cancer received care more quickly; importantly, these delays did not lead to worse survival rates. Who this helps: This research helps patients and healthcare providers understand the factors that can lead to treatment delays in ACC.

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This study looked at the frequencies of genetic variants associated with cancer risk (specifically for genes like BRCA1 and BRCA2) across different ethnic groups to help improve guidance for couples considering reproductive choices. The researchers found that, on average, about 0.33% of people carry a variant in BRCA1, while about 0.43% carry a variant in BRCA2, with rates varying significantly by ancestry. Understanding these frequencies is important because it helps doctors provide better advice to patients about the genetic risks that could affect their children. Who this helps: This helps patients and couples planning to start families.

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This study looked at how often a surgery called metastasectomy, which removes cancer that has spread to other parts of the body, is used for different types of metastatic cancer from 2016 to 2021. It found that this surgery was most commonly performed on colorectal cancer patients (57,644 cases) and lung cancer patients (55,090 cases), while its use increased significantly for breast cancer (up 10.6%) and melanoma (up 8.3%). This information is important because as new treatments improve survival rates, the role of metastasectomy may change, affecting how patients are treated. Who this helps: Patients with metastatic cancer and their doctors.

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This research paper looks at adrenal incidentalomas, which are adrenal gland growths found by accident during imaging tests for other health issues. The study found that while most of these growths are harmless, some can produce hormones or be cancerous, particularly if they are larger than 4 cm. Proper evaluation is crucial because hormone imbalances can lead to serious health problems, and if a tumor is suspicious, surgery may be necessary. Who this helps: This information benefits patients with adrenal tumors and their healthcare providers.

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This study looked at how treatments for low-risk thyroid cancer have changed over the past 20 years. Researchers found that instead of major surgeries, like removing the entire thyroid, patients are now more often receiving only partial surgery or simply monitored without immediate treatment. They also discussed new techniques like ablative therapy, which can serve as a middle ground between just observing the cancer and doing surgery. Who this helps: This benefits patients with low-risk thyroid cancer and their doctors by providing more treatment options.

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This study focused on a rare case of a 5 cm adrenal mass that was initially thought to be a type of cancer called adrenocortical carcinoma. After surgery, it was found to be a benign adrenal cortical pseudocyst instead, which means it was not cancerous. The findings emphasize the importance of thorough imaging and hormone testing for adrenal tumors that appear suspicious, to avoid unnecessary panic and ensure correct treatment. Who this helps: This helps patients with adrenal masses and their doctors in diagnosing and managing adrenal tumors accurately.

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This study focuses on a patient who was diagnosed with a rare condition called ALECT2 amyloidosis after having surgery to remove an adrenal cyst that was thought to be harmless. During the surgery, doctors found that the cyst was actually related to ALECT2 amyloidosis, which can affect other parts of the body before causing kidney problems. Identifying this condition early can help prevent kidney damage in these patients, which is important for their long-term health. Who this helps: Patients with ALECT2 amyloidosis and their doctors.

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This study focused on patients who had part of their thyroid removed and aimed to create a simple score to predict if they would need thyroid hormone therapy afterward. Out of 425 patients, 178 (about 42%) ended up needing this therapy, with certain factors like a higher preoperative thyroid hormone level and a cancer diagnosis making it more likely. This score can help doctors and patients understand the chances of needing treatment after surgery, which can influence decisions about the surgery itself. Who this helps: Patients undergoing partial thyroid surgery and their doctors.

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This study examined specific genetic mutations in patients with primary aldosteronism, a condition that can lead to high blood pressure due to excessive production of the hormone aldosterone. Researchers identified three mutations in a gene related to calcium regulation in adrenal tumors, which were found in four male patients. These mutations resulted in increased aldosterone production in the adrenal cells, which is important for understanding the disease and developing targeted treatments. Who this helps: Patients with primary aldosteronism.

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This study looked at how bariatric surgery affects high blood pressure (hypertension) in obese patients. It found that patients who had the surgery had significantly better blood pressure control, with an average drop of 5.4 mm Hg in systolic blood pressure and 1.8 mm Hg in diastolic blood pressure over about 5 years. Additionally, these patients were 32% more likely to stop taking blood pressure medications altogether and had a 14% lower chance of developing treatment-resistant high blood pressure. Who this helps: This benefits patients with obesity and high blood pressure, particularly those considering surgical options to improve their health.

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This study looked at how the ethnic backgrounds of both patients and psychiatrists affect risk assessments in individuals experiencing their first episode of psychosis. Researchers found that Arab patients were rated as being at immediate risk more often (59.11%) than Jewish patients (49.52%), and this difference was partly due to Jewish psychiatrists being more likely to classify Arab patients as high risk. Understanding these biases is important because it shows the need for more culturally aware psychiatric evaluations to ensure all patients receive fair treatment. Who this helps: This helps patients, especially those from minority ethnic groups, as well as doctors by promoting better understanding and care practices.

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This study looked at how changing the airflow resistance in a Respimat inhaler affects how well medication is delivered to the lungs. Researchers tested different designs of airflow restrictors and found that they can change the speed and pattern of the aerosol being released, which can lead to better delivery to the lungs and fewer side effects from the medication. Specifically, using these flow restrictors can help patients breathe in slower and more effectively, improving how the inhaler works overall. Who this helps: This benefits patients who use inhalers for respiratory conditions.

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This study looked at the differences in violent suicide attempts between Israeli Jews and Arabs over a five-year period. Out of 791 analyzed suicide attempts, 90% were non-violent, but Israeli Arabs and men were found to be more likely to attempt suicide in a violent manner. This is important because it shows that ethnic background influences how people attempt suicide, highlighting the need for tailored prevention strategies for different cultural groups. Who this helps: This helps mental health professionals and community organizations working with at-risk populations.

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This study looked at how to create better powdered medicines that can be inhaled, specifically focusing on a drug called itraconazole (ITZ). Researchers tested different methods of making the powder and two types of inhalers to see which combination worked best for getting the medicine into the lungs. They found that a special formulation achieved a high delivery of 4 mg of medicine and better performance using the HandiHaler inhaler compared to the GyroHaler, with some formulations reaching up to 49% of fine particles that can effectively be inhaled. This matters because improving how well inhaled medications work can make treatments for respiratory conditions more effective. Who this helps: This helps patients with respiratory diseases who need inhaled medications.

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This study looked at how often different surgeons decide to perform surgery on patients with emergency conditions. It found that for common issues like complicated diverticulitis, surgeons operated on only 44% of patients, while for cholecystitis, they went with surgery 74% of the time. The results show that the choice to operate varies significantly depending on which surgeon is in charge, impacting how patients are treated in emergencies. Who this helps: Patients facing emergency surgeries benefit from understanding these variations in care.

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This study looked at patients with kidney failure who had surgery to remove parathyroid glands, specifically focusing on whether they had the surgery as inpatients (staying in the hospital) or outpatients (going home the same day). The researchers found that 19% of all patients returned to the hospital within 30 days, but those admitted as inpatients had a higher readmission rate of 22% compared to 15% for outpatients. Importantly, outpatient surgery costs less, averaging $6,357 compared to $9,615 for inpatient care, making outpatient surgery a safer and more economical option for suitable patients. Who this helps: This benefits patients with kidney failure and their healthcare providers by offering a less expensive and effective treatment option.

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This study looked at how doctors can tell if a patient with primary aldosteronism has a single gland causing their condition, which is important because those patients can be cured with surgery. Out of 461 patients studied, 324 were found to have unilateral aldosterone secretion, and using a new clinical risk score can predict this accurately 86% of the time. This matters because it can help identify patients who may benefit from surgery, leading to better treatment outcomes. Who this helps: Doctors and patients with resistant hypertension.

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This study looked at how the surgery to remove parathyroid glands (parathyroidectomy) has been performed over the years, specifically focusing on whether patients stay overnight or go home the same day. From 2013 to 2019, researchers found that 67.3% of these surgeries were done as same-day procedures, and the overall number of same-day surgeries increased while overnight stays decreased, particularly for conditions like primary hyperparathyroidism. This is important because it shows that more patients can safely have this surgery without needing to stay in the hospital, which can lead to less recovery time and lower healthcare costs. Who this helps: Patients needing parathyroidectomy, especially those with primary hyperparathyroidism.

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This study looked at how many patients had adrenal surgery done as outpatient procedures from 2016 to 2020. Researchers found that the percentage of these surgeries performed on an outpatient basis increased from 44.1% in 2016 to 59.2% in 2020, with similar costs and readmission rates regardless of whether patients stayed overnight or were discharged the same day. This is important because it shows that more patients can go home the same day without compromising their safety or increasing costs. Who this helps: This helps patients who may prefer to recover at home rather than in a hospital.

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Researchers studied whether a simple blood test during parathyroid surgery—measuring how much a hormone called PTH drops during the operation—could predict whether the surgery would successfully cure a specific type of parathyroid disease and avoid a dangerous drop in calcium levels afterward. They tested this prediction method in over 1,000 patients from multiple hospitals and confirmed that a 50-65% drop in PTH during surgery reliably indicates the operation will work and help doctors avoid dangerously low calcium levels after surgery. This matters because doctors can now use this quick, real-time measurement during surgery to know whether they've removed the right amount of diseased tissue, without having to wait for results afterward.

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This study looked at thyroid nodule biopsies in patients who may not need them because they have a limited life expectancy, focusing on those who died within two years of their biopsy. Out of 2,565 biopsies performed, only 37 patients died within two years, and 78% of these had a different type of cancer. This is important because it shows that many of these biopsies might not be necessary, potentially saving over $98,000 in healthcare costs and helping doctors make better decisions for patients with serious health issues. Who this helps: Patients with limited life expectancy and their doctors.

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This study looked at patients with primary aldosteronism (PA) who had surgery based on certain test results. They found that 16% of these patients still had PA after surgery, especially if their tests only suggested one part of the adrenal gland was the problem. This is important because it shows that even strong test results might not catch all cases of PA, and patients need regular check-ups after surgery to ensure they get the right treatment if needed. Who this helps: This helps patients with primary aldosteronism and their doctors.

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This research studied how different inhalers used for Chronic Obstructive Pulmonary Disease (COPD) release the medication into the lungs. The team tested nine inhalers, including soft mist, pressurized metered-dose inhalers (pMDIs), and dry powder inhalers (DPIs), and found that the soft mist inhaler had the slowest release speed (0.99 m/s) and the longest spray duration (1447 ms) compared to pMDIs and DPIs, which were much faster. These findings are important because they help determine which inhaler types may be more effective for delivering medication based on how patients breathe. Who this helps: This helps patients with COPD by providing insights into which inhalers might work best for them.

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This study looked at how surgery can impact the survival of patients with metastatic adrenocortical carcinoma (ACC), a type of aggressive cancer that spreads to other parts of the body. Researchers found that of the 976 patients studied, those who had their main tumor removed had a median survival time of 7.6 months. Specifically, removing both the primary tumor and any metastatic tumors together led to a better survival outcome compared to just removing the primary tumor alone. Who this helps: This information can benefit doctors and patients with metastatic ACC by guiding treatment decisions.

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Researchers worked with surgical experts in Vietnam and the U.S. to create a new teaching program for medical students focusing on surgery. They developed 25 online lectures combined with in-person sessions over six months, helping students learn important surgical skills. This program is significant because it uses both local resources and international expertise to improve medical education in Vietnam. Who this helps: This benefits medical students in Vietnam, enhancing their training and preparation for future surgical careers.

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This study examined pheochromocytomas and paragangliomas, tumors that often release hormones affecting heart health and blood pressure. It found that about 40% of these tumors are caused by genetic factors, making genetic testing important for all patients. Surgery can cure these tumors if they haven't spread, but those that have are harder to treat with fewer options available. Who this helps: This helps patients with pheochromocytomas and paragangliomas, their families, and healthcare providers.

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This study looked at patients with high levels of certain hormones, specifically those with nonsuppressed plasma renin activity (PRA), to see how adrenal vein sampling (a test to find hormone-producing tumors) and surgery would impact their health. Among 23 patients with nonsuppressed PRA, 43% had a significant lateralization index compared to 62% in a larger group of 69 patients with suppressed PRA, and both groups had similar success in managing high blood pressure after surgery—75% of the nonsuppressed group improved versus 78% of the suppressed group. This research shows that even patients with nonsuppressed PRA can benefit from adrenal vein sampling and surgery, which is important for treating their high blood pressure. Who this helps: This helps patients with high blood pressure linked to hormone levels.

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This research paper looks at pheochromocytomas and paragangliomas (PPGL), which are tumors that can cause serious heart problems by releasing certain hormones. It was found that about 25% of these tumors are linked to genetic changes that increase the risk of developing multiple tumors or metastatic disease. Understanding these genetic factors, along with tumor behaviors, helps in finding new ways to diagnose and treat these cancers, especially since current treatment options for advanced cases are limited. Who this helps: This helps patients with pheochromocytomas and paragangliomas, as well as their healthcare providers.

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This study looked at a type of tumor in the adrenal glands called aldosterone-producing adenomas (APAs), which cause a condition known as primary aldosteronism. Researchers found new mutations in a gene called TRPML3 that seem to lead to excess production of aldosterone, a hormone that can raise blood pressure. Specifically, they identified two mutations in three patients that led to increased calcium levels in adrenal cells, which boosted aldosterone production. Who this helps: This research benefits patients with high blood pressure due to primary aldosteronism and their doctors, by providing insights into the underlying genetic causes of their condition.

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Researchers studied trends in primary hyperparathyroidism (PHPT), a condition where the body produces too much parathyroid hormone, affecting calcium levels. They examined over 1,000 patients who had surgery to remove the parathyroid glands between 2002 and 2019 and found that patients were showing milder symptoms and lower hormone and calcium levels. Despite these milder cases, the surgery successfully cured 93.7% of patients, indicating that even those with less severe disease can benefit from surgical intervention. Who this helps: This helps patients with primary hyperparathyroidism and their doctors by expanding treatment options.

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This study examined the differences in certain microRNAs (miRNAs) between postmenopausal women with Primary Hyperparathyroidism (PHPT) and those without the condition. Researchers found that 9 specific miRNAs were present in different amounts in women with PHPT, and these levels were linked to parathyroid hormone and calcium in the blood. This is important because it helps identify a unique biochemical signature for PHPT, which could improve diagnosis and treatment options for patients with this condition. Who this helps: This helps patients with Primary Hyperparathyroidism.

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This study looked at the use and costs of same-day surgery versus overnight stays for total thyroid removal between 2013 and 2019. Researchers found that 19.4% of patients had surgery and went home the same day, a trend that increased from 14.8% to 20.8% during the study. The same-day surgery was cheaper, saving about $974 on average compared to overnight stays, and it was more common in specialized hospitals. Who this helps: Patients who undergo thyroid surgery can benefit from same-day discharge, potentially saving money and experiencing more convenience.

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This study looked at how men and women, as well as different racial and ethnic groups, experience and are treated for medullary thyroid cancer (MTC). They found that out of 6,154 patients, 68% received recommended surgery. Men and Hispanic patients tended to have larger tumors, while Black and Hispanic patients often had more advanced cancer and waited longer for surgery; Black patients were also less likely to receive the recommended surgical treatment. Who this helps: This research benefits patients with medullary thyroid cancer, particularly those who are men or from non-White backgrounds, by highlighting disparities in treatment and outcomes.

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This study looked at how necessary in-person health check-ups are before surgeries and whether they could be done online instead. Researchers found that most updates (60.8%) involved changes to patient histories, but only a few (11.6%) affected surgical plans. Patients spent about 7,000 hours traveling and waiting for these visits in 2019, suggesting these check-ups could be less burdensome if done through telehealth. Who this helps: This helps patients by reducing travel and wait times for pre-surgery appointments.

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This study examined how negative patient outcomes affect surgeons and surgical trainees, focusing on their emotional reactions and support needs. Out of 216 trainees surveyed, 82.8% reported being involved in at least one adverse event, with many feeling embarrassed (84.8%), ruminating on the experience (82.1%), and fearing future procedures (65.4%); notably, 35.9% even considered quitting their training. The findings reveal a substantial emotional toll on these medical professionals and highlight the importance of offering support, like debriefing sessions with experienced doctors, to help them cope, especially for female trainees and those from diverse backgrounds. Who this helps: This supports surgical trainees and faculty members facing emotional challenges after adverse events.

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This study looked at how the size of tumors affects survival in patients with well-differentiated thyroid cancer. Researchers found that patients with tumors larger than 4 cm had a 63% higher risk of dying compared to those with smaller tumors, but when combined with other high-risk features, the risk increased even more. Notably, the biggest drops in survival were seen when tumors grew beyond 2 cm and again at 5 cm, suggesting that the 4 cm mark isn't as critical as previously thought. Who this helps: This helps doctors make better treatment decisions for patients with thyroid cancer.