Endocrinologia, Diabetes y Nutricion最新文献

{"title":"Active insulin time setting in MiniMed™ 780G: Impact on glucose control and patient perception","authors":"Fidel Jesús Enciso Izquierdo ,&nbsp;María José Amaya García ,&nbsp;Paula Gómez Turégano ,&nbsp;María Luengo Andrada ,&nbsp;Ana Alejandra Cordero Vaquero ,&nbsp;José Antonio Lucas Gamero ,&nbsp;Sergio Garrido Domínguez ,&nbsp;Irene Álvarez Reyes","doi":"10.1016/j.endinu.2025.501635","DOIUrl":"10.1016/j.endinu.2025.501635","url":null,"abstract":"<div><h3>Introduction</h3><div>The active insulin time (AIT) is an adjustable parameter of the MiniMed™ 780G (MM780G) system. We analyze glucose outcomes and patient perception at different AIT settings.</div></div><div><h3>Method</h3><div>We conducted a quasi-experimental study on type 1 diabetes mellitus patients treated with MM780G, seen consecutively in our center. AIT was set at 2, 3 and 4<!--> <!-->h consecutively, during a 2-week period each. Glucose metrics, insulin delivery and a questionnaire about patient perception were evaluated. At the end, results were discussed with the patient and the most appropriate AIT was agreed upon.</div></div><div><h3>Results</h3><div>A total of 58 users were included, aged 18–65 years, 58.6% of whom were women. At baseline, 2-h AIT was set in 6.70% of the patients, &gt;2-h AIT and ≤3-h AIT in 24.67%, &gt;3-h AIT and ≤4-h AIT in 58.62%, and &gt;4-h AIT in 10.34%. Under the 2-h AIT, TIR increased by 2.28% and 6.35% vs 3- and 4-h AIT, respectively. The auto-correction boluses percentage was 21.19% at 2-h AIT, 16.90% at 3-h AIT and 14.40% at 4-h AIT.</div><div>A total of 41.4% of the users considered that 3<!--> <!-->h was the AIT that most met their needs and 43.1% felt safer and less vulnerable to hypoglycemia at this setting. After trying on different AIT durations, 2<!--> <!-->h increased from 6.7% of participants to 62%.</div></div><div><h3>Conclusion</h3><div>At 2-h AIT, the system delivers more auto-correction insulin and improves TIR vs 3- and 4-h AIT. Patients feel safer and less susceptible to hypoglycemia at 3-h AIT, but 2 out of 3 would rather choose the 2-h AIT after knowing glycemic outcomes.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 8","pages":"Article 501635"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectopic Cushing's syndrome in a patient with DIPNECH and metastatic lung carcinoid","authors":"Sara Ribeiro ,&nbsp;Telma Moreno ,&nbsp;Maria Lume ,&nbsp;Marisa C. Couto ,&nbsp;Diana Baptista ,&nbsp;Conceição Souto-Moura ,&nbsp;Ana Varela ,&nbsp;Sandra Belo ,&nbsp;Paula Freitas ,&nbsp;Davide Carvalho","doi":"10.1016/j.endinu.2025.501636","DOIUrl":"10.1016/j.endinu.2025.501636","url":null,"abstract":"<div><div>Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare precursor to lung carcinoids. We report a case of ACTH-dependent Cushing's syndrome in a 73-year-old female patient with metastatic lung carcinoid arising on a background of DIPNECH. She presented with lower limb oedema, hypokalaemia, hypertension, and de novo diabetes. Clinical suspicion for hypercortisolism was confirmed by abnormal cortisol tests. A thoracic CT scan showed multiple lung nodules suggestive of DIPNECH and biopsy of one of the nodules identified an ACTH-expressing carcinoid tumour. A PET-Ga-68-DOTATOC revealed pulmonary and multiple tumour lesions in the ganglia, bone and liver with overexpression of somatostatin receptors. A liver biopsy demonstrated involvement by a well-differentiated neuroendocrine neoplasia, consistent with metastasis. Hypercortisolism was managed with octreotide and metyrapone, but the patient succumbed to complications 14 months post-diagnosis. This case suggests DIPNECH's potential to progress to hyperfunctioning, metastatic carcinoids and highlights the necessity for vigilant long-term surveillance and early intervention.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 8","pages":"Article 501636"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Análisis de la disfunción hipofisaria en pacientes con enfermedades del eje hipotálamo-hipofisario no asociadas a adenomas hipofisarios","authors":"Fernando Guerrero-Pérez","doi":"10.1016/j.endinu.2025.501616","DOIUrl":"10.1016/j.endinu.2025.501616","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 8","pages":"Article 501616"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromedin U and BMI correlation in T1DM and T2DM vs healthy controls: A comparative study","authors":"Yasemin Çalışkan ,&nbsp;Emre Sarandöl ,&nbsp;Nizameddin Koca","doi":"10.1016/j.endinu.2025.501631","DOIUrl":"10.1016/j.endinu.2025.501631","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess serum Neuromedin U (NmU) levels in patients with Type 1 (T1DM) and Type 2 diabetes mellitus (T2DM) vs healthy controls and evaluate the correlation between NmU and body mass index (BMI).</div></div><div><h3>Research design and methods</h3><div>We conducted a cross-sectional study with 134 participants: 45 with T1DM, 49 with T2DM, and 40 healthy controls. Serum NmU levels were measured using enzyme-linked immunosorbent assay (ELISA), and the correlation with BMI was assessed.</div></div><div><h3>Results</h3><div>NmU levels were not significantly different between diabetic patients and healthy controls. No significant correlation was observed between NmU and BMI in T1DM or T2DM groups. However, the healthy control group found a significant inverse correlation between NmU and BMI (rho<!--> <!-->=<!--> <!-->−0.373, <em>p</em> <!-->&lt;<!--> <!-->0.05).</div></div><div><h3>Conclusions</h3><div>NmU may not be a direct biomarker for diabetes, but its significant correlation with BMI in healthy individuals suggests a potential role in metabolic regulation. This is the first study ever conducted to compare NmU levels across diabetic subtypes, offering novel insights into the role of in metabolic homeostasis.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 8","pages":"Article 501631"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolución del sodio en la hiponatremia: análisis retrospectivo en un centro de tercer nivel","authors":"Karina Mercedes Becerra Añez ,&nbsp;Carlos Sánchez Juan ,&nbsp;Ana Artero Fullana ,&nbsp;Ana Jiménez Portilla ,&nbsp;Juan Carlos Ferrer García","doi":"10.1016/j.endinu.2025.501563","DOIUrl":"10.1016/j.endinu.2025.501563","url":null,"abstract":"<div><h3>Introduction</h3><div>Hyponatremia is the most common electrolyte disorder in hospitals. This study analyzes the evolution of serum sodium levels during hospitalization.</div></div><div><h3>Materials and methods</h3><div>This is an observational, retrospective, and analytical study. Patients hospitalized for hyponatremia in a tertiary care hospital were included. Demographic and laboratory variables were collected, and hyponatremia was classified according to severity and etiology. Criteria and risk factors for serum sodium overcorrection were defined, and the effectiveness of treatments used for hyponatremia was described. The Chi-square test was used for qualitative variables, while Student's t-test and Mann-Whitney U test were applied for quantitative variables. Predictive models were also used to determine the risk of an event.</div></div><div><h3>Results</h3><div>A total of 216 patients hospitalized for hyponatremia were included, with a higher prevalence in patients over 75 years of age and females. Longer hospital stays were associated with older age and male gender. Severe hyponatremia and hypokalemia were linked to a higher risk of overcorrection. The therapies for hyponatremia correction across the three groups were effective either alone or in combination. Additionally, severe hyponatremia was associated with increased 5-year mortality.</div></div><div><h3>Conclusions</h3><div>Hyponatremia in hospitalized patients is more prevalent in those over 75 years old and in females. Severe hyponatremia increases 5-year mortality. There are factors that increase the risk of overcorrection, so treatment should be carefully managed to avoid osmotic demyelination syndrome (ODS).</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501563"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel approach to finding the compositional differences and biomarkers in gut microbiota in type 2 diabetic patients via meta-analysis, data-mining, and multivariate analysis","authors":"Faezeh Ebrahimi ,&nbsp;Hadi Maleki ,&nbsp;Mansour Ebrahimi ,&nbsp;Amir Hossein Beiki","doi":"10.1016/j.endinu.2025.501561","DOIUrl":"10.1016/j.endinu.2025.501561","url":null,"abstract":"<div><h3>Background/Purpose of the study</h3><div>Type 2 diabetes mellitus (T2DM)—one of the fastest globally spreading diseases—is a chronic metabolic disorder characterized by elevated blood glucose levels. It has been suggested that the composition of gut microbiota plays key roles in the prevalence of T2DM. In this study, a novel approach of large-scale data mining and multivariate analysis of the gut microbiome of T2DM patients and healthy controls was conducted to find the key compositional differences in their microbiota and potential biomarkers of the disease.</div></div><div><h3>Methods</h3><div>First, suitable datasets were identified (9 in total with 946 samples), analyzed, and their operational taxonomic units (OTUs) were computed by identical parameters to increase accuracy. The following OTUs were merged and compared based on their health status, and compositional differences detected. For biomarker identification, the OTUs were subjected to 9 different attribute weighting models. Additionally, OTUs were independently analyzed by multivariate algorithms (LEfSe test) to verify the realized biomarkers.</div></div><div><h3>Results</h3><div>Overall, 23 genera and 4 phyla were identified as possible biomarkers. At genus level, the decrease of <em>Bacteroides</em>, <em>Methanobrevibacter</em>, <em>Paraprevotella</em>, and [<em>Eubacterium</em>] <em>hallii group</em> in T2DM and the increase of <em>Prevotella</em>, <em>Megamonas</em>, <em>Megasphaera</em>, <em>Ligilactobacillus</em>, and <em>Lachnoclostridium</em> were selected as biomarkers; and at phylum level, the increase of <em>Synergistota</em> and the decrease of <em>Euryarchaeota</em>, <em>Desulfobacterota</em> (<em>Thermodesulfobacteriota</em>), and <em>Ptescibacteria</em>.</div></div><div><h3>Conclusion</h3><div>This is the first study ever conducted to find the microbial compositional differences and biomarkers in T2DM using data mining models applied on a widespread metagenome dataset and verified by multivariate analysis.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501561"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of length of hospital stay in patients presenting to the emergency department with hyperosmolar hyperglycemic crises","authors":"Tomás González-Vidal ,&nbsp;Diego Rivas-Otero ,&nbsp;Carmen Lambert ,&nbsp;Jessica Ares Blanco ,&nbsp;Elías Delgado-Álvarez ,&nbsp;Edelmiro Menéndez Torre","doi":"10.1016/j.endinu.2025.501577","DOIUrl":"10.1016/j.endinu.2025.501577","url":null,"abstract":"<div><h3>Objective</h3><div>To predict the length of hospital stay in hyperosmolar hyperglycemic crises (HHC) using variables available on admission.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study with 132 patients (65 [49.2%] men; median age 72 years; range 19–98 years) hospitalized for HHC (including hyperosmolar hyperglycemic state and diabetic ketoacidosis with elevated osmolality) in a Spanish teaching hospital. Baseline variables and those upon arrival to the emergency department were collected (both variables related to physical examination and biochemical tests), as well as the in-hospital mortality rate and overall length of hospital stay in survivors.</div></div><div><h3>Results</h3><div>Patients who died (<em>n</em> <!-->=<!--> <!-->13) had higher total serum osmolality and higher C-reactive protein concentrations on admission vs survivors. Among survivors, the length of stay correlated positively with total serum osmolality (Rho<!--> <!-->=<!--> <!-->0.398; <em>p</em> <!-->&lt;<!--> <!-->0.001) and C-reactive protein (Rho<!--> <!-->=<!--> <!-->0.342; <em>p</em> <!-->&lt;<!--> <!-->0.001) on admission. Older age, female sex, lack of pre-admission diagnosis of insulin-requiring diabetes, impaired mental status on arrival, non-ketotic metabolic acidosis, and low serum potassium concentrations were also associated with long lengths of stay. In multivariate analysis, only serum glucose (one of the three components of total osmolality) and C-reactive protein concentrations on admission kept a positive association with the length of stay.</div></div><div><h3>Conclusions</h3><div>Hyperglycemia and elevated C-reactive protein on admission are independent predictors of long lengths of stay in survivors with HHC.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501577"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adipopatía y disglucemia en la enfermedad metabólica sistémica: hacia un abordaje integral multidisciplinar liderado por el endocrinólogo","authors":"Núria Alonso ,&nbsp;María Teresa Julián","doi":"10.1016/j.endinu.2025.501600","DOIUrl":"10.1016/j.endinu.2025.501600","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501600"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valoración en vida real de la eficacia y de la seguridad del cambio de dulaglutida semanal a semaglutida semanal: estudio SEMA-SWITCH","authors":"Felipe Pardo Lozano ,&nbsp;Arantxa Rubio Marcos ,&nbsp;Rosa Casañ Fernández ,&nbsp;Amparo Bartual Rodrigo ,&nbsp;Sergio Martínez-Hervás ,&nbsp;Francisco Javier Ampudia-Blasco","doi":"10.1016/j.endinu.2025.501574","DOIUrl":"10.1016/j.endinu.2025.501574","url":null,"abstract":"<div><h3>Introduction</h3><div>Dulaglutide and semaglutide are once-weekly administered GLP-1 receptor agonists (GLP-1 RAs) indicated for the treatment of hyperglycemia in individuals with type<!--> <!-->2 diabetes mellitus (T2DM) and obesity (BMI ≥<!--> <!-->30<!--> <!-->kg/m²).</div></div><div><h3>Objective</h3><div>To evaluate the efficacy and safety of switching from subcutaneous (SC) dulaglutide to SC semaglutide, in real-world conditions.</div></div><div><h3>Materials and methods</h3><div>A total of 123 individuals with T2DM on SC dulaglutide, either as monotherapy or with other antihyperglycemic drugs, who switched to SC semaglutide were included. This switch was motivated by insufficient reduction in glycated hemoglobin (HbA1c), the need for greater weight loss, or gastrointestinal intolerance associated with dulaglutide. Changes with semaglutide in HbA1c and weight at 6, 12, 18, and 24<!--> <!-->months, as well as any changes in associated adverse effects. Data are expressed as mean ±<!--> <!-->standard deviation.</div></div><div><h3>Results</h3><div>Previous treatment with dulaglutide (duration 16.9<!--> <!-->±<!--> <!-->13.8 months) reduced HbA1c by 0.38% (<em>P</em> <!-->=<!--> <!-->.003 vs. baseline) and weight by −1.3<!--> <!-->kg (<em>P</em> <!-->=<!--> <!-->.003 vs. baseline). After switching to semaglutide, an additional reduction in HbA1c levels was observed at 6, 12, 18, and 24<!--> <!-->months (−0.43%, <em>P</em> <!-->=<!--> <!-->.000; −0.54%, <em>P</em> <!-->=<!--> <!-->.000; −0.38%, <em>P</em> <!-->=<!--> <!-->.021; −0.12%, <em>P</em> <!-->=<!--> <!-->.622, respectively) and in weight at 6, 12, 18, and 24<!--> <!-->months (−2.7<!--> <!-->kg, <em>P</em> <!-->=<!--> <!-->.000; −3.7<!--> <!-->kg, <em>P</em> <!-->=<!--> <!-->.000; −5.4<!--> <!-->kg, <em>P</em> <!-->=<!--> <!-->.001; −4.2<!--> <!-->kg, <em>P</em> <!-->=<!--> <!-->.000, respectively) With no significant differences in the frequency of adverse effects after switching to semaglutide.</div></div><div><h3>Conclusions</h3><div>In real-world conditions, switching dulaglutide to semaglutide in obese patients with T2DM is associated with an additional reduction in HbA1c and weight, without notable changes in the frequency of adverse effects.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501574"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proyecto CANTCAM (Carcinoma ANaplásico de Tiroides en CAstilla-La Mancha). Estudio retrospectivo multicéntrico","authors":"Sandra Herranz-Antolín ,&nbsp;Rosa Quílez-Toboso ,&nbsp;Jesús Moreno-Fernández ,&nbsp;Javier González-López ,&nbsp;María López-Iglesias ,&nbsp;Julia Sastre","doi":"10.1016/j.endinu.2025.501580","DOIUrl":"10.1016/j.endinu.2025.501580","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the clinical presentation, diagnosis, management and survival of Anaplastic Thyroid Carcinomas (ATC) in the Hospitals of Castilla-La Mancha (Spain).</div></div><div><h3>Material and methods</h3><div>Retrospective multicenter descriptive study. Adult patients with ATC diagnosed from 2002 to 2022 were included.</div></div><div><h3>Results</h3><div>Of the 43 patients included, 53.5% were women, with a mean age of 72 years (SD 10) at the time of diagnosis. Symptoms were present in 100% of the patients and the most frequent symptom was a rapidly growing mass (79.1% of the cases). Infiltration of neighboring structures (76.7%), lymph node involvement (78.1%) and distant metastasis (51.2%). The AJCC-TNM category was IVa in 9.3%, IVb in 39.5% and IVc in 51.2%. <em>BRAF</em>^{<em>V600E</em>} determination was not performed in 74.4% and 5 of the 11 cases in which it was evaluated (45.4%) had the mutation. Active treatment was received in 76.7% of patients in the first 3 months. Surgical approach was performed in 63.6% of the cases, with complete resection in 23.8%, and 51.5% received multimodality treatment in this period. 42.3% received active treatment during follow-up (≥<!--> <!-->3 months), primarily systemic chemotherapy (72.7%), and 54.4% received multimodality treatment during this period. The median specific survival was 3.5 months (95% CI 1.7-5.2). Factors associated with longer specific survival were initial multimodality treatment (p<!--> <!-->&lt;<!--> <!-->0.01) or during follow-up (p<!--> <!-->=<!--> <!-->0.01) and initial BRAF/MEK inhibitor treatment (p<!--> <!-->=<!--> <!-->0.04).</div></div><div><h3>Conclusion</h3><div>CAT is an infrequent and aggressive tumor that requires early, multidisciplinary, personalized and multimodal treatment.</div></div>","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"72 6","pages":"Article 501580"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}