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Giulia Cossu, Roy Thomas Daniel, Katarzyna Pierzchala, Moncef Berhouma, Nelly Pitteloud, Faiza Lamine, Annamaria Colao, Mahmoud Messerer
PURPOSE: TSH-secreting pituitary adenomas are rare pituitary tumors. An efficient treatment is essential to limit the mortality and morbidity in untreated patients. The aim of this study is to summarize the evidence about the postoperative outcomes and management of this rare pathology. METHODS: A systematic search and meta-analysis of surgical series was performed. RESULTS: Our analysis included 23 articles (536 patients). No sex difference was observed and mean age at diagnosis was 45 years...
November 2, 2018: Pituitary
Zihao Wang, Lu Gao, Wenze Wang, Xiaopeng Guo, Chenzhe Feng, Wei Lian, Yongning Li, Bing Xing
PURPOSE: Coagulative necrotic pituitary apoplexy (CNPA) is a clinical entity with unique intraoperative and histopathological manifestations. We aimed to improve the knowledge of this rare disease through the largest case series published to date. METHODS: A retrospective review of 21 CNPA patients was performed from among 5095 patients who underwent surgery for pituitary adenomas at a single institution between January 2009 and June 2017. The demographic, clinical, endocrine, neuroimaging, intraoperative, and histopathological findings, management and prognosis were summarized...
November 2, 2018: Pituitary
(no author information available yet)
No abstract text is available yet for this article.
October 31, 2018: Pituitary
F Albarel, F Castinetti, I Morange, N Guibert, T Graillon, H Dufour, T Brue
PURPOSE: To determine whether pre-surgical medical treatment (PSMT) using long-acting Somatostatin analogues in acromegaly may improve long-term surgical outcome and to determine decision making criteria. METHODS: This retrospective study included 110 consecutive patients newly diagnosed with acromegaly, who underwent surgery in a reference center (Marseille, France). The mean long-term follow-up period was 51.4 ± 36.5 (median 39.4) months. Sixty-four patients received PSMT during 3-18 (median 5) months before pituitary surgery...
October 26, 2018: Pituitary
Adnan Ajmal, Erin McKean, Stephen Sullivan, Ariel Barkan
PURPOSE: Hypopituitary patients are assumed to have decreased QoL due to GHD. However, in placebo controlled trials, the effects of GH replacement are no different from placebo. Hydrocortisone dose > 20 mg/day and pituitary radiation are independently associated with poorer QoL. We assessed QoL in panhypopituitary GH- deficient patients never treated with GH. METHODS: Study group was divided into: (a) surgery followed by radiation (n = 21) and (b) surgery alone (n = 32)...
October 22, 2018: Pituitary
Roxana Maria Tudor, Christopher J Thompson
Neurohypophysial dysfunction is common in the first days following traumatic brain injury (TBI), manifesting as dysnatremia in approximately 1 in 4 patients. Both hyponatremia and hypernatremia can impair recovery from TBI and in the case of hypernatremia, there is a significant association with excess mortality. Hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIAD) is the commonest electrolyte disturbance following TBI. Acute adrenocorticotropic hormone (ACTH)/cortisol deficiency occurs in 10-15% of TBI patients and can present with a biochemical picture identical to SIAD...
October 17, 2018: Pituitary
Channabasappa Shivaprasad, Yalamanchi Aiswarya, Atluri Sridevi, Biswas Anupam, Goel Amit, Boppana Rakesh, Pulikkal A Annie, Kolly Anish
PURPOSE: Hypopituitarism (HP) is an uncommon consequence of Russell's viper envenomation (RVE). Delayed hypopituitarism (DHP) presents months to years after recovering from snake bites (SB). The clinical presentation, manifestations, and outcomes of DHP following RVE have not been systematically studied. Here, we present a case series of HP following RVE with delayed diagnosis and conduct a literature review. METHODS: We retrospectively reviewed data of eight DHP cases and literature to outline the presentation, manifestations, hormonal profiles, and radiological features of DHP following RVE...
October 13, 2018: Pituitary
Daniel J Lobatto, Anath N V Steffens, Amir H Zamanipoor Najafabadi, Cornelie D Andela, Alberto M Pereira, Wilbert B van den Hout, Wilco C Peul, Thea P M Vliet Vlieland, Nienke R Biermasz, Wouter R van Furth
INTRODUCTION: Pituitary tumors may have a considerable impact on patients' functional status, including paid employment, yet research in this area is sparse. OBJECTIVE: To describe work disability and its determinants in patients treated for a pituitary tumor. METHODS: Cross-sectional study including patients treated for a pituitary tumor in the working age (18-65 years), who completed five validated questionnaires assessing work disability [Short Form-Health and Labour Questionnaire, Work Role Functioning Questionnaire 2...
October 4, 2018: Pituitary
Mirjana Doknic, Dragana Miljic, Sandra Pekic, Marko Stojanovic, Dragan Savic, Emilija Manojlovic-Gacic, Tatjana Milenkovic, Vera Zdravkovic, Maja Jesic, Dusan Damjanovic, Slobodan Lavrnic, Ivan Soldatovic, Aleksandar Djukic, Milan Petakov
BACKGROUND: The etiological spectrum of pituitary stalk lesions (PSL) is wide and yet specific compared to the other diseases of the sellar and suprasellar region. Because of the pituitary stalk's (PS) critical location and role, biopsies of these lesions are rarely performed, and their underlying pathology is often a conundrum for clinicians. A pituitary MRI in association with a clinical context can facilitate their diagnosis. AIM: To present the various causes of PSL-their clinical, hormonal, histopathological, and MRI characteristics in order to gain better insight into this pathology...
October 1, 2018: Pituitary
Felipe F Casanueva, Ariel L Barkan, Michael Buchfelder, Anne Klibanski, Edward R Laws, Jay S Loeffler, Shlomo Melmed, Pietro Mortini, John Wass, Andrea Giustina
The original version of this article unfortunately contained an affiliation error in 'Collaborators for The Pituitary Society, Expert Group on Pituitary Tumors' section. Dr. Misa Pfeifer is affiliated with Medical Faculty, University of Ljubljana, Slovenia and the correct email address to contact is
September 20, 2018: Pituitary
Matteo Parolin, Francesca Dassie, Chiara Martini, Roberto Mioni, Lucia Russo, Francesco Fallo, Marco Rossato, Roberto Vettor, Pietro Maffei, Claudio Pagano
OBJECTIVE: Multiple studies investigated preclinical markers of peripheral vascular damage in acromegaly (ACRO) reporting discordant results. The aim of this study was to run a meta-analysis to examine whether intima media thickness (IMT), flow mediated dilation (FMD) and arterial pulse wave velocity (PWV) are affected in acromegalic patients and to assess the impact of effective treatment of growth hormone excess on these outcomes. STUDY SELECTION: Twenty-seven studies comparing ACRO vs control (CON) populations and active (ACT) vs inactive (INACT) ACRO were included in the meta-analysis...
September 17, 2018: Pituitary
Sheri K Palejwala, Andrew R Conger, Amy A Eisenberg, Pejman Cohan, Chester F Griffiths, Garni Barkhoudarian, Daniel F Kelly
PURPOSE: In most clinical series of Cushing's disease (CD), over 80% of patients are women, many of whom are of reproductive age. The year following pregnancy may be a common time to develop CD. We sought to establish the incidence of CD onset associated with pregnancy. METHODS: A retrospective review was conducted for patients with biochemically-proven CD. Demographics, clinical history, biochemistry, imaging, pathology, and outcomes were reviewed. Pregnancy-associated CD was defined as symptom onset within 1 year of childbirth...
September 14, 2018: Pituitary
Emanuele La Corte, Iyan Younus, Francesca Pivari, Adelina Selimi, Malte Ottenhausen, Jonathan A Forbes, David J Pisapia, Georgiana A Dobri, Vijay K Anand, Theodore H Schwartz
PURPOSE: To describe the clinical, radiographic and surgical outcomes in a cohort of patients with BRAF V600E mutant papillary craniopharyngiomas. METHODS: A retrospective review was performed to identify all patients with a histological diagnosis of CP operated upon at a single institution between 2005 and 2017. All cases with adequate material were sequenced to confirm the presence of BRAF V600E mutation. RESULTS: Sixteen patients were included in the present study...
September 5, 2018: Pituitary
Letícia P Leonart, Helena H L Borba, Vinicius L Ferreira, Bruno S Riveros, Roberto Pontarolo
PURPOSE: Acromegaly is a rare disease that results in the enlargement of body extremities and in organomegaly. Treatments include surgery, drugs, and radiotherapy, which are all onerous. Therefore, well-conducted cost-analyses are crucial in the decision-making process. METHODS: A systematic review of cost-effectiveness studies on acromegaly therapies was performed following PRISMA and Cochrane recommendations. The search for records was conducted in PubMed, Scopus, and Web of Science (May 2018)...
August 30, 2018: Pituitary
Richard J Blanch, Jonathan A Micieli, Nelson M Oyesiku, Nancy J Newman, Valérie Biousse
PURPOSE: To report patients with sellar tumors and chiasmal compression with normal visual fields, who demonstrate damage to the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) on optical coherence tomography (OCT). METHODS: Seven patients with sellar tumors causing mass effect on the optic chiasm without definite visual field defect, but abnormal GCC are described. GCC/RNFL analyses using Cirrus-OCT were classified into centiles based on the manufacturer's reference range...
October 2018: Pituitary
Etienne Lefevre, Schahrazed Bouazza, Franck Bielle, Anne-Laure Boch
PURPOSE: Pituicytomas and spindle cell oncocytomas (SCOs) are two rare neoplasms of the sellar and suprasellar region, known to be challenging as they are extremely vascular and almost always misdiagnosed, altering our surgical planning and the patients' outcomes. Also we argue that recent update concerning the pathology findings of these tumors should be more widely generalized to our practice. METHODS: This is a retrospective multicenter study, reporting the clinical manifestations, radiological characteristics, histopathological features, treatment strategies and long-term outcomes of patients who have been treated for a Pituicytoma at various institutions in Paris, France over the past 10 years...
October 2018: Pituitary
Jürgen Honegger, Florian Grimm
PURPOSE: Surgical experience is considered paramount for excellent outcome of transsphenoidal surgery (TSS). However, objective data demonstrating the surgical success in relation to the experience of pituitary surgery units or individual experience of pituitary surgeons is sparse. METHODS: Based on literature data, we have investigated the influence of experience with TSS for pituitary adenomas on endocrinological remission rates and on operative complications...
October 2018: Pituitary
Marco Losa, Valentina Pieri, Michele Bailo, Filippo Gagliardi, Lina Raffaella Barzaghi, Lorenzo Gioia, Antonella Del Vecchio, Angelo Bolognesi, Pietro Mortini
PURPOSE: The optimal management of residual or recurring craniopharyngioma is still a matter of debate even though adjuvant radiation therapy plays a crucial role. Aim of our study is to report the results of single fraction or multisession Gamma Knife radiosurgery (GKRS) in patients with craniopharyngioma. METHODS: We included 50 consecutive patients treated from 1994 to 2016. All patients had at least one post GKRS magnetic resonance imaging reviewed at our center...
October 2018: Pituitary
Erik Uvelius, Peter Höglund, Stig Valdemarsson, Peter Siesjö
PURPOSE: The present study evaluates the usefulness of an ACTH suppression test shortly after surgery, and to determine optimal cut-off values of included laboratory analyses, in predicting short- and long-term remission after surgery of Cushing's disease. METHODS: A 48 h suppression test with betamethasone 2 mg/day applied after 45 transphenoidal adenomectomies in 28 patients was evaluated. Receiver operating characteristic (ROC)-curves were created for the included assays: plasma cortisol, plasma adrenocorticotropic hormone (ACTH) and urinary free cortisol (UFC)...
October 2018: Pituitary
Elizabeth Culpin, Matthew Crank, Mark Igra, Daniel J A Connolly, Paul Dimitri, Showkat Mirza, Saurabh Sinha
OBJECTIVES: To evaluate clinical presentations, diagnosis and management of paediatric patients presenting with pituitary apoplexy. METHODS: A retrospective case series describing a cohort of paediatric patients presenting with this condition from 2010-2016 to a tertiary referral children's hospital in the United Kingdom. RESULTS: Pituitary apoplexy is a rare condition that seems to have a higher relative incidence in children than adults...
October 2018: Pituitary
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