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BACKGROUND: Craniopharyngioma (CP) is a rare tumor, leading to several post-treatment sequelae which may have significant clinical and social implications, including impaired academic performance or employability. METHODS: We conducted a retrospective study involving CP patients followed at our center between 1986 and 2020. Data on demographics, clinical, imaging, and treatment characteristics were collected from the clinical records. RESULTS: There were 33 patients (current mean age of 49.8±18.7 years), being 22 diagnosed in adulthood. The average follow-up duration was 16.03±9.3 years. Twelve patients were treated with surgery alone, while 21 underwent surgery and radiotherapy. Pituitary and hypothalamic deficits were more frequent in treated with surgery, whereas visual defects and metabolic diseases were more frequent in treated with surgery and radiotherapy. There were no differences between age of onset groups and type of sequelae. After diagnosis, nine patients concluded their academic training. In childhood-onset group, after diagnosis, one patient was retired, three continue studying and the others concluded schooling. In the other group, six patients were retired and two concluded schooling. There was no association between academic performance or employability and the type of treatment. CP patients academic performance was not worse comparing with general Portuguese population. CONCLUSIONS: Long-term sequelae may not be related with the age of CP onset, but may vary according to the type of treatment. There was a wide variety of clinical sequelae with extended follow-up, however academic performance and employability seemed not affected. CP diagnosis in an early period of life may not compromise the academic success of patients.
RESUMO
INTRODUCTION: Slight weight losses (5%) are consensually accepted as important in the treatment of obesity today. Some authors also consider that maintaining weight is an indicator of success in the treatment of this condition. OBJECTIVE: Characterisation and assessment of changes in weight in obese patients monitored at an obesity clinic in a hospital endocrinology department. METHODOLOGY: Retrospective analysis of the clinical files of the Endocrinology Clinic. The patients included were overweight adults (BMI = 25 kg/m2) who had been monitored since 1999 and were not suffering from thyroid dysfunction or hypercortisolism. Data were gathered on bio-demographic and anthropometric characteristics, reason for consultation, type of treatment, results achieved and dropouts. The statistical analysis included calculating central tendency measures and dispersion for the continuous variables and building frequency tables to describe the categorical variables. We used the t-test to compare average values between samples. Frequencies were compared by means of the chi-squared test or Fisher's exact test. The significance level was 5%. RESULTS: We studied 457 patients (60.6% female) with an average age of 53 years (DP +/- 15) and an average BMI of 32.4 +/- 5.1 Kg/m2. 51.9% of the patients came to the clinic because of overweight (n = 237) (Obesity Group-OBG), while the rest did so because of diabetes mellitus (35.4%) or some other disease (12.7%) (Other Cause Group-OCG). A dietary plan was prescribed for 86.1% (OBG) and 81.8% (OCG), drugs for 16.9% (OBG) and 6.4% (OCG) and physical activity for 77.6% (OBG) and 77.7% (OCG). The average weight loss was 2.1% in the OBG. The individuals who dropped out of the clinic had lost less weight (1.3% vs. 2.9%), although the difference was not significant. More than half (57.7%) of the individuals studied lost weight, 14.4% remained the same and 27.8% gained weight. CONCLUSIONS: 1) Only 50% of overweight patients come to our department to lose weight. 2) More than 75% of overweight patients have a prescribed, structured diet plan, regardless of the reason for their first visit. 3) About 75% of patients achieve acceptable objectives (maintaining or losing weight), and 25% of these have lost more than 5% of their initial weight.