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Marta Araujo-Castro
Marta Araujo-Castro
Neuroendocrinology Unit, Department of Endocrinology and Nutrition
Department of Health Science, Universidad de Alcalá, Madrid, Spain
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Department of Health Science, Universidad de Alcalá, Madrid, Spain
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Rogelio Garcia Centeno
Rogelio Garcia Centeno
Department of Endocrinology & Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain
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María-Carmen López-García
María-Carmen López-García
Department of Endocrinology & Nutrition, Hospital Universitario de Albacete, Albacete, Spain
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Cristina Lamas
Cristina Lamas
Department of Endocrinology & Nutrition, Hospital Universitario de Albacete, Albacete, Spain
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Cristina Álvarez-Escolá
Cristina Álvarez-Escolá
Department of Endocrinology & Nutrition, Hospital Universitario La Paz, Madrid, Spain
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María Calatayud Gutiérrez
María Calatayud Gutiérrez
Department of Endocrinology & Nutrition, Hospital Universitario Doce de Octubre, Madrid, Spain
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Concepción Blanco-Carrera
Concepción Blanco-Carrera
Department of Endocrinology & Nutrition, Hospital Universitario Príncipe de Asturias, Madrid, Spain
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Paz de Miguel Novoa
Paz de Miguel Novoa
Department of Endocrinology & Nutrition, Hospital Universitario Clínico San Carlos, Madrid, Spain
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Nuria Valdés
Nuria Valdés
Department of Endocrinology & Nutrition, Hospital Universitario de Cabueñes, Asturias, Spain
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Paola Gracia Gimeno
Paola Gracia Gimeno
Department of Endocrinology & Nutrition, Hospital Royo Villanova, Zaragoza, Spain
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Mariana Tomé Fernández-Ladreda
Mariana Tomé Fernández-Ladreda
Department of Endocrinology & Nutrition, Hospital Universitario de Puerto Real, Cádiz, Spain
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César Mínguez Ojeda
César Mínguez Ojeda
Department of Urology, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Juan Carlos Percovich Hualpa
Juan Carlos Percovich Hualpa
Department of Endocrinology & Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain
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Mireia Mora
Mireia Mora
Department of Endocrinology & Nutrition, Hospital Clinic, Barcelona, Spain
Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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Óscar Vidal
Óscar Vidal
Department of General Surgery, Hospital Clinic, Barcelona, Spain
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Ana Serrano Romero
Ana Serrano Romero
Department of Anesthesia, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Felicia Alexandra Hanzu
Felicia Alexandra Hanzu
Department of Endocrinology & Nutrition, Hospital Clinic, Barcelona, Spain
Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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Victoria Gómez Dos Santos
Victoria Gómez Dos Santos
Department of Urology, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
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We aimed to identify presurgical and surgical risk factors for intraoperative complications in patients with pheochromocytomas. A retrospective study of patients with pheochromocytomas who underwent surgery in ten Spanish hospitals between 2011 and 2021 was performed. One hundred and sixty-two surgeries performed in 159 patients were included. The mean age was 51.6 ± 16.4 years old and 52.8% were women. Median tumour size was 40 mm (range 10–110). Laparoscopic adrenalectomy was performed in 148 patients and open adrenalectomy in 14 patients. Presurgical alpha- and beta-blockade was performed in 95.1% and 51.9% of the surgeries, respectively. 33.3% of the patients (n = 54) had one or more intraoperative complications. The most common complication was the hypertensive crisis in 21.0%, followed by prolonged hypotension in 20.0%, and hemodynamic instability in 10.5%. Patients pre-treated with doxazosin required intraoperative hypotensive treatment more commonly than patients pre-treated with other antihypertensive drugs (51.1% vs 26.5%, P = 0.002). Intraoperative complications were more common in patients with higher levels of urine metanephrine (OR = 1.01 for each 100 μg/24 h, P = 0.026) and normetanephrine (OR = 1.00 for each 100 μg/24 h, P = 0.025), larger tumours (OR = 1.4 for each 10 mm, P < 0.001), presurgical blood pressure > 130/80 mmHg (OR = 2.25, P = 0.027), pre-treated with doxazosin (OR = 2.20, P = 0.023) and who had not received perioperative hydrocortisone (OR = 3.95, P = 0.008). In conclusion, intraoperative complications in pheochromocytoma surgery are common and can be potentially life-threatening. Higher metanephrine and normetanephrine levels, larger tumour size, insufficient blood pressure control before surgery, pre-treatment with doxazosin, and the lack of treatment with perioperative hydrocortisone are associated with higher risk of intraoperative complications.
Marta Araujo-Castro
Marta Araujo-Castro
Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain & Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain
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Betina Biagetti
Betina Biagetti
Department of Endocrinology and Nutrition, Hospital Universitario Vall de Hebrón, CIBERER U747 (ISCIII), ENDO-ERN, Barcelona, Spain
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Edelmiro Menéndez Torre
Edelmiro Menéndez Torre
Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias & Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain
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Iría Novoa-Testa
Iría Novoa-Testa
Department of Endocrinology and Nutrition, Hospital Universitario de A Coruña, A Coruña, Spain
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Fernando Cordido
Fernando Cordido
Department of Endocrinology and Nutrition, Hospital Universitario de A Coruña, A Coruña, Spain
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Eider Pascual-Corrales
Eider Pascual-Corrales
Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain & Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain
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Víctor Rodríguez Berrocal
Víctor Rodríguez Berrocal
Department of Neurosurgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Fernando Guerrero-Pérez
Fernando Guerrero-Pérez
Department of Endocrinology and Nutrition, Hospital Universitario de Bellvitge, Cataluña L’Hospitalet de Llobregat, Spain
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Almudena Vicente
Almudena Vicente
Department of Endocrinology and Nutrition, Hospital Universitario de Toledo, Toledo, Spain
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Juan Carlos Percovich Hualpa
Juan Carlos Percovich Hualpa
Department of Endocrinology and Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain
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Rogelio García-Centeno
Rogelio García-Centeno
Department of Endocrinology and Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain
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Laura González-Fernández
Laura González-Fernández
Department of Endocrinology and Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain
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María Dolores Ollero García
María Dolores Ollero García
Department of Endocrinology and Nutrition, Hospital Universitario Navarra, Pamplona, Spain
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Ana Irigaray Echarri
Ana Irigaray Echarri
Department of Endocrinology and Nutrition, Hospital Universitario Navarra, Pamplona, Spain
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María Dolores Moure Rodríguez
María Dolores Moure Rodríguez
Department Endocrinology and Nutrition, Hospital Universitario de Cruces, Bilbao, Spain
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Cristina Novo-Rodríguez
Cristina Novo-Rodríguez
Department of Endocrinology and Nutrition, Hospital Universitario Virgen de las Nieves, Granada, Spain
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María Calatayud
María Calatayud
Department of Endocrinology and Nutrition, Hospital Universitario Doce de Octubre, Madrid, Spain
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Rocío Villar-Taibo
Rocío Villar-Taibo
Department of Endocrinology and Nutrition, Hospital Universitario de Santiago de Compostela, Madrid, Spain
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Ignacio Bernabéu
Ignacio Bernabéu
Department of Endocrinology and Nutrition, Hospital Universitario de Santiago de Compostela, Madrid, Spain
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Cristina Alvarez-Escola
Cristina Alvarez-Escola
Department of Endocrinology and Nutrition, Hospital Universitario La Paz, Madrid, Spain
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Pamela Benítez Valderrama
Pamela Benítez Valderrama
Department of Endocrinology and Nutrition, Hospital Universitario La Paz, Madrid, Spain
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Carmen Tenorio-Jiménez
Carmen Tenorio-Jiménez
Department of Endocrinology and Nutrition, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Pablo Abellán Galiana
Pablo Abellán Galiana
Department of Endocrinology and Nutrition, Hospital General Universitario de Castellón, Castellón, Spain
Department of Medicine and Surgery, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, Spain
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Department of Medicine and Surgery, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, Spain
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Eva Venegas
Eva Venegas
Department of Endocrinology and Nutrition, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Inmaculada González-Molero
Inmaculada González-Molero
Endocrinology and Nutrition Department, Hospital Regional Universitario de Málaga, IBIMA Plataforma Bionand, Málaga, Spain
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Pedro Iglesias
Pedro Iglesias
Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro, Madrid, Spain
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Concepción Blanco-Carrera
Concepción Blanco-Carrera
Department of Endocrinology and Nutrition, Hospital Universitario Príncipe de Asturias, Madrid, Spain
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Fernando Vidal-Ostos De Lara
Fernando Vidal-Ostos De Lara
Department of Endocrinology and Nutrition, Hospital Universitario Príncipe de Asturias, Madrid, Spain
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Paz de Miguel Novoa
Paz de Miguel Novoa
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Madrid, Spain
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Elena López Mezquita
Elena López Mezquita
Department of Endocrinology and Nutrition, Hospital Universitario Clínico San Cecilio, Granada, Spain
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Felicia Alexandra Hanzu
Felicia Alexandra Hanzu
Department of Endocrinology and Nutrition, Hospital Clinic de Barcelona, Barcelona, Spain
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Iban Aldecoa
Iban Aldecoa
Biomedical Diagnostic Center, Department of Pathology, Hospital Clinic - University of Barcelona, Barcelona, Spain
Neurological Tissue Bank of the Biobank, FCRB-IDIBAPS-Hospital Clinic Barcelona, Barcelona, Spain
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Neurological Tissue Bank of the Biobank, FCRB-IDIBAPS-Hospital Clinic Barcelona, Barcelona, Spain
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Silvia Aznar
Silvia Aznar
Department of Endocrinology and Nutrition, Hospital Universitario De Albacete, Albacete, Spain
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Cristina Lamas
Cristina Lamas
Department of Endocrinology and Nutrition, Hospital Universitario De Albacete, Albacete, Spain
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Anna Aulinas
Anna Aulinas
Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, IR-SANT PAU, CIBERER U747 (ISCIII), Barcelona, Spain
Department of Medicine, Universitat de Vic-Universitat Central de Catalunya, Vic, Spain
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Department of Medicine, Universitat de Vic-Universitat Central de Catalunya, Vic, Spain
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Queralt Asla
Queralt Asla
Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, IR-SANT PAU, CIBERER U747 (ISCIII), Barcelona, Spain
Department of Medicine, Universitat de Vic-Universitat Central de Catalunya, Vic, Spain
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Department of Medicine, Universitat de Vic-Universitat Central de Catalunya, Vic, Spain
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Paola Gracia Gimeno
Paola Gracia Gimeno
Department of Endocrinology and Nutrition, Hospital Royo Villanova, Zaragoza, Spain
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José María Recio-Córdova
José María Recio-Córdova
Department of Endocrinology and Nutrition, Hospital Royo Villanova, Zaragoza, Spain
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María Dolores Avilés-Pérez
María Dolores Avilés-Pérez
Department of Endocrinology and Nutrition, Hospital Universitario Clínico San Cecilio, Granada, Spain
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Diego Asensio-Wandosell
Diego Asensio-Wandosell
Department of Endocrinology and Nutrition, Hospital Universitario Germans Trias i Pujol, Cataluña, Spain
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Miguel Sampedro-Núñez
Miguel Sampedro-Núñez
Department of Endocrinology and Nutrition, Hospital Universitario La Princesa Madrid, Spain
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Rosa Cámara
Rosa Cámara
Department of Endocrinology and Nutrition, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Miguel Paja Fano
Miguel Paja Fano
Department of Endocrinology and Nutrition, OSI Bilbao-Basurto, Hospital Universitario de Basurto & University of the Basque Country UPV/EHU, Bilbao, Spain
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Ignacio Ruz-Caracuel
Ignacio Ruz-Caracuel
Department of Pathology, Hospital Universitario Ramón y Cajal, IRYCIS & CIBER Cáncer (CIBERONC), Madrid, Spain
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Carmen Fajardo
Carmen Fajardo
Department of Endocrinology and Nutrition, Hospital Universitario La Ribera, Valencia, Spain
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Mónica Marazuela
Mónica Marazuela
Department of Endocrinology and Nutrition, Hospital Universitario La Princesa Madrid, Spain
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Manel Puig-Domingo
Manel Puig-Domingo
Department of Endocrinology and Nutrition, Hospital Universitario Germans Trias i Pujol, Cataluña, Spain
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The objective of the study was to evaluate the efficacy of second-line therapies in patients with acromegaly caused by a growth hormone (GH) and prolactin (PRL) co-secreting pituitary neuroendocrine tumor (GH&PRL-Pit-NET) compared to their efficacy in patients with acromegaly caused by a GH-secreting pituitary neuroendocrine tumor (GH-Pit-NET). This is a multicenter retrospective study of patients with acromegaly on treatment with pasireotide and/or pegvisomant. Patients were classified in two groups: GH&PRL-Pit-NETs when evidence of hyperprolactinemia and immunohistochemistry (IHC) for GH and PRL was positive or if PRL were >200 ng/dL regardless of the PRL-IHC and GH-Pit-NETs when the previously mentioned criteria were not met. A total of 28 cases with GH&PRL-Pit-NETs and 122 with GH-Pit-NETs met the inclusion criteria. GH&PRL-Pit-NETs presented at a younger age, caused hypopituitarism, and were invasive more frequently than GH-Pit-NETs. There were 124 patients treated with pegvisomant and 49 with pasireotide at any time. The efficacy of pegvisomant for IGF-1 normalization was of 81.5% and of pasireotide of 71.4%. No differences in IGF-1 control with pasireotide and with pegvisomant were observed between GH&PRL-Pit-NETs and GH-Pit-NETs. All GH&PRL-Pit-NET cases treated with pasireotide (n = 6) and 82.6% (n = 19/23) of the cases treated with pegvisomant normalized PRL levels. No differences in the rate of IGF-1 control between pegvisomant and pasireotide were detected in patients with GH&PRL-Pit-NETs (84.9% vs 66.7%, P = 0.178). We conclude that despite the more aggressive behavior of GH&PRL-Pit-NETs than GH-Pit-NETs, no differences in the rate of IGF-1 control with pegvisomant and pasireotide were observed between both groups, and both drugs have shown to be effective treatments to control IGF-1 and PRL hypersecretion in these tumors.
Marta Araujo-Castro
Marta Araujo-Castro
Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain & Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain
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Betina Biagetti
Betina Biagetti
Department of Endocrinology and Nutrition, Hospital Universitario Vall de Hebrón, CIBERER U747 (ISCIII), ENDO-ERN, Barcelona, Spain
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Edelmiro Menéndez Torre
Edelmiro Menéndez Torre
Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias & Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain
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Iría Novoa-Testa
Iría Novoa-Testa
Department of Endocrinology and Nutrition, Hospital Universitario de A Coruña, A Coruña, Spain
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Fernando Cordido
Fernando Cordido
Department of Endocrinology and Nutrition, Hospital Universitario de A Coruña, A Coruña, Spain
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Eider Pascual-Corrales
Eider Pascual-Corrales
Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain & Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain
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Víctor Rodríguez Berrocal
Víctor Rodríguez Berrocal
Department of Neurosurgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Fernando Guerrero-Pérez
Fernando Guerrero-Pérez
Department of Endocrinology and Nutrition, Hospital Universitario de Bellvitge, Cataluña L’Hospitalet de Llobregat, Spain
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Almudena Vicente
Almudena Vicente
Department of Endocrinology and Nutrition, Hospital Universitario de Toledo, Toledo, Spain
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Juan Carlos Percovich Hualpa
Juan Carlos Percovich Hualpa
Department of Endocrinology and Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain
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Rogelio García-Centeno
Rogelio García-Centeno
Department of Endocrinology and Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain
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Laura González-Fernández
Laura González-Fernández
Department of Endocrinology and Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain
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María Dolores Ollero García
María Dolores Ollero García
Department of Endocrinology and Nutrition, Hospital Universitario Navarra, Pamplona, Spain
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Ana Irigaray Echarri
Ana Irigaray Echarri
Department of Endocrinology and Nutrition, Hospital Universitario Navarra, Pamplona, Spain
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María Dolores Moure Rodríguez
María Dolores Moure Rodríguez
Department Endocrinology and Nutrition, Hospital Universitario de Cruces, Bilbao, Spain
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Cristina Novo-Rodríguez
Cristina Novo-Rodríguez
Department of Endocrinology and Nutrition, Hospital Universitario Virgen de las Nieves, Granada, Spain
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María Calatayud
María Calatayud
Department of Endocrinology and Nutrition, Hospital Universitario Doce de Octubre, Madrid, Spain
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Rocío Villar-Taibo
Rocío Villar-Taibo
Department of Endocrinology and Nutrition, Hospital Universitario de Santiago de Compostela, Madrid, Spain
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Ignacio Bernabéu
Ignacio Bernabéu
Department of Endocrinology and Nutrition, Hospital Universitario de Santiago de Compostela, Madrid, Spain
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Cristina Alvarez-Escola
Cristina Alvarez-Escola
Department of Endocrinology and Nutrition, Hospital Universitario La Paz, Madrid, Spain
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Pamela Benítez Valderrama
Pamela Benítez Valderrama
Department of Endocrinology and Nutrition, Hospital Universitario La Paz, Madrid, Spain
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Carmen Tenorio-Jiménez
Carmen Tenorio-Jiménez
Department of Endocrinology and Nutrition, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Pablo Abellán Galiana
Pablo Abellán Galiana
Department of Endocrinology and Nutrition, Hospital General Universitario de Castellón, Castellón, Spain
Department of Medicine and Surgery, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, Spain
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Department of Medicine and Surgery, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, Spain
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Eva Venegas
Eva Venegas
Department of Endocrinology and Nutrition, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Inmaculada González-Molero
Inmaculada González-Molero
Endocrinology and Nutrition Department, Hospital Regional Universitario de Málaga, IBIMA Plataforma Bionand, Málaga, Spain
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Pedro Iglesias
Pedro Iglesias
Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro, Madrid, Spain
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Concepción Blanco-Carrera
Concepción Blanco-Carrera
Department of Endocrinology and Nutrition, Hospital Universitario Príncipe de Asturias, Madrid, Spain
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Fernando Vidal-Ostos De Lara
Fernando Vidal-Ostos De Lara
Department of Endocrinology and Nutrition, Hospital Universitario Príncipe de Asturias, Madrid, Spain
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Paz de Miguel Novoa
Paz de Miguel Novoa
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Madrid, Spain
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Elena López Mezquita
Elena López Mezquita
Department of Endocrinology and Nutrition, Hospital Universitario Clínico San Cecilio, Granada, Spain
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Felicia Alexandra Hanzu
Felicia Alexandra Hanzu
Department of Endocrinology and Nutrition, Hospital Clinic de Barcelona, Barcelona, Spain
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Iban Aldecoa
Iban Aldecoa
Biomedical Diagnostic Center, Department of Pathology, Hospital Clinic - University of Barcelona, Barcelona, Spain
Neurological Tissue Bank of the Biobank, FCRB-IDIBAPS-Hospital Clinic Barcelona, Barcelona, Spain
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Neurological Tissue Bank of the Biobank, FCRB-IDIBAPS-Hospital Clinic Barcelona, Barcelona, Spain
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Silvia Aznar
Silvia Aznar
Department of Endocrinology and Nutrition, Hospital Universitario De Albacete, Albacete, Spain
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Cristina Lamas
Cristina Lamas
Department of Endocrinology and Nutrition, Hospital Universitario De Albacete, Albacete, Spain
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Anna Aulinas
Anna Aulinas
Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, IR-SANT PAU, CIBERER U747 (ISCIII), Barcelona, Spain
Department of Medicine, Universitat de Vic-Universitat Central de Catalunya, Vic, Spain
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Department of Medicine, Universitat de Vic-Universitat Central de Catalunya, Vic, Spain
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Queralt Asla
Queralt Asla
Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, IR-SANT PAU, CIBERER U747 (ISCIII), Barcelona, Spain
Department of Medicine, Universitat de Vic-Universitat Central de Catalunya, Vic, Spain
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Department of Medicine, Universitat de Vic-Universitat Central de Catalunya, Vic, Spain
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Paola Gracia Gimeno
Paola Gracia Gimeno
Department of Endocrinology and Nutrition, Hospital Royo Villanova, Zaragoza, Spain
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José María Recio-Córdova
José María Recio-Córdova
Department of Endocrinology and Nutrition, Hospital Universitario de Salamanca, Salamanca, Spain
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María Dolores Avilés-Pérez
María Dolores Avilés-Pérez
Department of Endocrinology and Nutrition, Hospital Universitario Clínico San Cecilio, Granada, Spain
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Diego Asensio-Wandosell
Diego Asensio-Wandosell
Department of Endocrinology and Nutrition, Hospital Universitario Germans Trias i Pujol, Cataluña, Spain
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Miguel Sampedro-Núñez
Miguel Sampedro-Núñez
Department of Endocrinology and Nutrition, Hospital Universitario La Princesa Madrid, Spain
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Rosa Cámara
Rosa Cámara
Department of Endocrinology and Nutrition, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Miguel Paja Fano
Miguel Paja Fano
Department of Endocrinology and Nutrition, OSI Bilbao-Basurto, Hospital Universitario de Basurto & University of the Basque Country UPV/EHU, Bilbao, Spain
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Ignacio Ruz-Caracuel
Ignacio Ruz-Caracuel
Department of Pathology, Hospital Universitario Ramón y Cajal, IRYCIS & CIBER Cáncer (CIBERONC), Madrid, Spain
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Carmen Fajardo
Carmen Fajardo
Department of Endocrinology and Nutrition, Hospital Universitario La Ribera, Valencia, Spain
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Mónica Marazuela
Mónica Marazuela
Department of Endocrinology and Nutrition, Hospital Universitario La Princesa Madrid, Spain
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Manel Puig-Domingo
Manel Puig-Domingo
Department of Endocrinology and Nutrition, Hospital Universitario Germans Trias i Pujol, Cataluña, Spain
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