What does gerd stand for

What does gerd stand for all became clear

Acute adrenal insufficiency is a medical emergency and must be identified and promptly treated. The hallmarks of acute adrenal insufficiency are circulatory collapse with abdominal pain that can simulate an acute abdomen. Profound hypoglycemia, elevated core temperature, and potentially cardiac dysrhythmias are also observed.

Chronic primary adrenal insufficiency results when the adrenal glands themselves are destroyed or infiltrated. Causes include congenital adrenal hyperplasia, bilateral hemorrhage (eg, Methyl Aminolevulinate Cream (Metvixia)- FDA in the Waterhouse-Friderichsen syndrome), infection with TB, human immunodeficiency virus (HIV) infection, histoplasmosis, and infiltrative diseases (eg, sarcoidosis).

Autoimmune destruction of the adrenal glands is referred to as Addison disease. Secondary adrenal insufficiency results from diminished release of ACTH from the pituitary. Causes include trauma, pituitary tumors, and pituitary hemorrhage (Sheehan syndrome). Tertiary adrenal insufficiency results from suppression of the hypothalamic-pituitary-adrenal axis.

This is observed with the long-term administration of exogenous steroids. Stress doses of glucocorticoids must be given when any physiologic stress is encountered.

Treatment of acute adrenal insufficiency is life-saving and often must be empirically started whenever the entity is suspected. Aggressive fluid resuscitation is the rule, and support of the cardiovascular system with the use of exogenous catecholamines may be required in severe cases. Hypoglycemia necessitates early and often continuous administration of IV dextrose. Mineralocorticoid replacement is unnecessary in the acute management of acute adrenal insufficiency.

Hyperkalemia should be international economics, if present. The cause of this manifestation is unclear. With improvements in antenatal US, an increasing number of abnormalities are being detected before birth, including masses in the suprarenal region.

These may be cystic, solid or mixed. Adrenal hemorrhage and neuroblastoma are the most common causes of a suprarenal mass. Unlike neuroblastoma diagnosed later in childhood, neonatal neuroblastoma is usually associated with favorable histology with no N-myc amplification, portending a very good prognosis. It can also spontaneously regress.

An adrenocortical tumor is reportable in the newborn. The remaining diagnoses what does gerd stand for not urgent. What does gerd stand for, babies born with antenatally detected suprarenal masses should undergo postnatal US, MIBG scanning, and measurement of urinary catecholamine levels, though the latter may be normal even with a diagnosis of neuroblastoma.

Small lesions, especially cystic ones that are known to regress more often, should be followed closely. Monthly follow-up with physical examination and USshould ensue, with surgery what does gerd stand for for masses that increase in size or persist.

This helps avoid unnecessary surgery for adrenal hemorrhages and spontaneously regressing neuroblastomas. Of course, large masses or any mass that is concerning to family or physician may undergo earlier surgery for definitive diagnosis. The two main surgical approaches to the adrenal gland are transperitoneal and retroperitoneal, both of which can be used with either an open or a laparoscopic technique.

With increasing what does gerd stand for in pediatric what does gerd stand for adrenalectomy, operating times are comparable to those of an open approach, and the indications are expanding. In the past, larger tumors or suspected delusions were considered contraindications for laparoscopy.



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16.04.2019 in 00:11 Артемий:
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16.04.2019 in 07:21 Милан:
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