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Pituitary

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https://www.readbyqxmd.com/read/29218459/discordance-between-mass-spectrometry-and-immunometric-igf-1-assay-in-pituitary-disease-a-prospective-study
#1
Vivien Bonert, John Carmichael, Zengru Wu, James Mirocha, Daniel A Perez, Nigel J Clarke, Richard E Reitz, Michael J McPhaul, Adam Mamelak
PURPOSE: Measuring IGF-1, a biomarker for GH activity, is critical to evaluating disordered hypothalamic-pituitary GH axis. Inconsistent IGF-1 measurements among different immunoassays are well documented. We switched from Immulite 2000 immunoassay to narrow-mass-extraction, high-resolution liquid chromatography mass-spectrometry (LC-MS) compliant with recent consensus recommendations on assay standardization. Comparability of these two assays in patients with pituitary disease in a clinical practice setting is not known...
December 7, 2017: Pituitary
https://www.readbyqxmd.com/read/29214508/bone-histomorphometry-in-acromegaly-patients-with-fragility-vertebral-fractures
#2
L Dalle Carbonare, V Micheletti, E Cosaro, M T Valenti, M Mottes, G Francia, M V Davì
CONTEXT: The high risk of vertebral fractures (VFs) in acromegaly patients despite normal bone mineral density (BMD) is well known. The reasons for this paradoxical finding of skeleton fragility are poorly understood due to the limited data on bone histomorphometry in acromegaly. OBJECTIVE: This study aimed to analyze histomorphometric parameters including bone microarchitecture in acromegaly patients with VFs and normal BMD compared to normal subjects, and also to evaluate the differences between active and controlled acromegaly patients...
December 6, 2017: Pituitary
https://www.readbyqxmd.com/read/29143885/consensus-driven-in-hospital-cortisol-assessment-after-acth-secreting-pituitary-adenoma-resection
#3
Yana Stolyarov, James Mirocha, Adam N Mamelak, Anat Ben-Shlomo
PURPOSE: Remission from Cushing disease (CD) after pituitary adenoma resection may be predicted by a postoperative reduction in serum cortisol level. A 2008 consensus statement recommends assessing morning cortisol levels during the first postoperative week, and replacing glucocorticoid (GC) if cortisol nadir of < 2 or < 5 µg/dL is achieved. We sought to evaluate adherence to consensus recommendations following adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma resection at our tertiary medical center, and assess time to cortisol nadir to better define the window for assessment and intervention...
November 16, 2017: Pituitary
https://www.readbyqxmd.com/read/29124563/excellence-in-the-treatment-of-patients-with-pituitary-tumors
#4
LETTER
Mark E Molitch, James W Findling, David R Clemmons
No abstract text is available yet for this article.
November 9, 2017: Pituitary
https://www.readbyqxmd.com/read/29081004/cardiovascular-autonomic-dysfunction-in-patients-with-idiopathic-diabetes-insipidus
#5
Mattia Barbot, Filippo Ceccato, Marialuisa Zilio, Nora Albiger, Riccardo Sigon, Giuseppe Rolma, Marco Boscaro, Carla Scaroni, Franca Bilora
INTRODUCTION: Central diabetes insipidus (DI) is a rare disease characterized by the excretion of excessive volumes of dilute urine due to reduced levels of the antidiuretic hormone arginine vasopressin (AVP), caused by an acquired or genetic defect in the neurohypophysis. The aim of this study was to identify any autonomic dysfunction (AD) in patients with DI as a possible cofactor responsible for their reportedly higher mortality. METHODS: The study involved 12 patients (6 females) with central idiopathic DI and a well-controlled electrolyte balance, and 12 controls matched for age, sex and cardiovascular risk factors, who were assessed using the tilt, lying-to-standing, hand grip, deep breath, Valsalva maneuver and Stroop tests...
October 28, 2017: Pituitary
https://www.readbyqxmd.com/read/29075986/a-practical-method-for-prevention-of-readmission-for-symptomatic-hyponatremia-following-transsphenoidal-surgery
#6
William T Burke, David J Cote, Sherry I Iuliano, Hasan A Zaidi, Edward R Laws
INTRODUCTION: Patients undergoing transsphenoidal pituitary surgery (TSS) are at risk for several serious complications, including the syndrome of inappropriate antidiuretic hormone and subsequent hyponatremia. OBJECTIVE: In this study, we examined the effect of 1 week of post-discharge fluid restriction to 1.0 L daily on rates of post-operative readmission for hyponatremia. METHODS: We retrospectively analyzed all patients undergoing TSS from 2008 to 2014 and prospectively recorded patient data from 2015 to 2017...
October 26, 2017: Pituitary
https://www.readbyqxmd.com/read/29032459/predictors-of-silent-corticotroph-adenoma-recurrence-a-large-retrospective-single-center-study-and-systematic-literature-review
#7
Fabienne Langlois, Dawn Shao Ting Lim, Chris G Yedinak, Isabelle Cetas, Shirley McCartney, Justin Cetas, Aclan Dogan, Maria Fleseriu
PURPOSE: Silent corticotroph adenomas (SCAs) are clinically silent and non-secreting, but exhibit positive adrenocorticotropic hormone (ACTH) immunostaining. We characterized a single center cohort of SCA patients, compared the SCAs to silent gonadotroph adenomas (SGAs), identified predictors of recurrence, and reviewed and compared the cohort to previously published SCAs cases. METHODS: Retrospective review of SCA and SGA surgically resected patients over 10 years and 6 years, respectively...
October 14, 2017: Pituitary
https://www.readbyqxmd.com/read/29027644/treatment-of-empty-sella-associated-with-visual-impairment-a-systematic-review-of-chiasmapexy-techniques
#8
REVIEW
Lina Raffaella Barzaghi, Carmine Antonio Donofrio, Pietro Panni, Marco Losa, Pietro Mortini
PURPOSE: Chiasmapexy is a poorly described surgical procedure adopted to correct the downward displacement of suprasellar visual system (SVS) into an empty sella (ES) causing visual worsening. The aim of our study is to define the indications for extradural and intradural chiasmapexy. METHODS: A systematic literature review has been performed on MEDLINE database (US National Library of Medicine), including only articles that depicted cases of surgically treated patients affected by ES and progressive delayed visual worsening...
October 13, 2017: Pituitary
https://www.readbyqxmd.com/read/28936751/guidelines-versus-real-life-practice-the-case-of-colonoscopy-in-acromegaly
#9
M Parolin, F Dassie, L Russo, S Mazzocut, M Ferrata, E De Carlo, R Mioni, F Fallo, R Vettor, C Martini, P Maffei
PURPOSE: The aim of this study is to investigate guideline application and colonoscopy findings in real-life practice in acromegaly. METHODS: We conducted a retrospective observational non-interventional and cross-sectional analysis on 146 patients with acromegaly (ACRO) referred to our clinic. We evaluated colonoscopy data, focusing on the correlation between colonoscopy findings and hormonal/metabolic values. RESULTS: The total number of colonoscopies performed in ACRO patients increased from 6 in the period 1990-1994 to 57 in the period 2010-2014...
September 21, 2017: Pituitary
https://www.readbyqxmd.com/read/28916976/preoperative-risk-factors-for-postoperative-complications-in-endoscopic-pituitary-surgery-a-systematic-review
#10
REVIEW
Daniel J Lobatto, Friso de Vries, Amir H Zamanipoor Najafabadi, Alberto M Pereira, Wilco C Peul, Thea P M Vliet Vlieland, Nienke R Biermasz, Wouter R van Furth
BACKGROUND: The ability to preoperatively predict postoperative complication risks is valuable for individual counseling and (post)operative planning, e.g. to select low-risk patients eligible for short stay surgery or those with higher risks requiring special attention. These risks however, are not well established in pituitary surgery. METHODS: We conducted a systematic review of associations between preoperative characteristics and postoperative complications of endoscopic transsphenoidal surgery according to the PRISMA guidelines...
September 15, 2017: Pituitary
https://www.readbyqxmd.com/read/28913579/association-between-fto-gene-polymorphisms-and-hdl-cholesterol-concentration-may-cause-higher-risk-of-cardiovascular-disease-in-patients-with-acromegaly
#11
Aleksandra Franczak, Katarzyna Kolačkov, Aleksandra Jawiarczyk-Przybyłowska, Marek Bolanowski
INTRODUCTION: Cardiovascular diseases are main cause of morbidity and mortality in acromegaly. Polymorphisms of FTO gene are associated with obesity and increased risk of CVD (independently of BMI). Aim of this study was to investigate the allele frequencies of two FTO gene polymorphisms: rs9939609 and rs9930506 in patients with acromegaly and to examine the association of FTO gene polymorphisms with BMI and selected metabolic parameters. MATERIALS AND METHODS: Identification of two single nucleotide polymorphisms of FTO gene was carried out in 51 patients with acromegaly using the minisequencing method...
September 14, 2017: Pituitary
https://www.readbyqxmd.com/read/28900805/mgmt-and-msh6-immunoexpression-for-functioning-pituitary-macroadenomas
#12
Alexander S G Micko, Adelheid Wöhrer, Romana Höftberger, Greisa Vila, Christine Marosi, Engelbert Knosp, Stefan Wolfsberger
PURPOSE: Knowledge of biological behavior is crucial for clinical management of functioning pituitary macroadenomas. For recurrent cases unresponsive to standard treatment, temozolomide (TMZ) has been used as a therapeutic alternative. MGMT (O6-methyl-guanine-DNA methyltransferase) and MSH6 (mutS homolog 6) immunoexpression have been linked to the response to TMZ treatment and MGMT immunoexpression has been additionally linked to early recurrence of non-functioning pituitary adenomas...
December 2017: Pituitary
https://www.readbyqxmd.com/read/28887782/development-of-acrodat%C3%A2-a-new-software-medical-device-to-assess-disease-activity-in-patients-with-acromegaly
#13
Aart J van der Lely, Roy Gomez, Andreas Pleil, Xavier Badia, Thierry Brue, Michael Buchfelder, Pia Burman, David Clemmons, Ezio Ghigo, Jens Otto Lunde Jørgensen, Anton Luger, Joli van der Lans-Bussemaker, Susan M Webb, Christian J Strasburger
PURPOSE: Despite availability of multimodal treatment options for acromegaly, achievement of long-term disease control is suboptimal in a significant number of patients. Furthermore, disease control as defined by biochemical normalization may not always show concordance with disease-related symptoms or patient's perceived quality of life. We developed and validated a tool to measure disease activity in acromegaly to support decision-making in clinical practice. METHODS: An international expert panel (n = 10) convened to define the most critical indicators of disease activity...
December 2017: Pituitary
https://www.readbyqxmd.com/read/28871375/walter-e-dandy-his-contributions-to-pituitary-surgery-in-the-context-of-the-overall-johns-hopkins-hospital-experience
#14
Andrea Corsello, Giulia Di Dalmazi, Fabiana Pani, Paulina Chalan, Roberto Salvatori, Patrizio Caturegli
BACKGROUND: Walter E. Dandy (1886-1946) was an outstanding neurosurgeon who spent his entire career at the Johns Hopkins Hospital. After graduating from medical school in 1910, he completed a research fellowship in the Hunterian laboratory with Harvey Cushing and then joined the Department of Surgery as resident, rising to the rank professor in 1931. Dandy made several contributions that helped building the neurosurgical specialty, most famously the introduction of pneumo-ventriculography to image brain lesions for which he received a Nobel prize nomination...
December 2017: Pituitary
https://www.readbyqxmd.com/read/28853001/sphenoid-sinus-microbiota-in-pituitary-apoplexy-a-preliminary-study
#15
Gavin J Humphreys, Mueez Waqar, Andrew J McBain, Kanna K Gnanalingham
PURPOSE: There is a high incidence of abnormal sphenoid sinus changes in patients with pituitary apoplexy (PA). Their pathophysiology is currently unexplored and may reflect an inflammatory or infective process. In this preliminary study, we characterised the microbiota of sphenoid sinus mucosa in patients with PA and compared findings to a control group of surgically treated non-functioning pituitary adenomas (NFPAs). METHODS: In this prospective observational study of patients undergoing trans-sphenoidal surgery for PA or NFPA, sphenoid sinus mucosal specimens were microbiologically profiled through PCR-cloning of the 16S rRNA gene...
December 2017: Pituitary
https://www.readbyqxmd.com/read/28831662/pituitary-apoplexy-and-rivaroxaban
#16
S Ly, A Naman, B Chaufour-Higel, M Patey, C Arndt, B Delemer, C F Litre
Pituitary apoplexy (PA), defined by the occurrence of a massive hemorrhagic necrotic rearrangement within a pituitary adenoma, is rare. Its occurrence can be associated with certain risk factors, including anticoagulation. We report the first case of PA with rivaroxaban which is one of the new oral anticoagulants: a 73 year-old patient presenting with severe headache and visual field deterioration. Surgery was performed. Radiotherapy treatment was decided three months after surgery because of tumor residue.
December 2017: Pituitary
https://www.readbyqxmd.com/read/28828722/the-changing-sella-internal-carotid-artery-shift-during-transsphenoidal-pituitary-surgery
#17
Carlo Serra, Nicolai Maldaner, Giovanni Muscas, Victor Staartjes, Athina Pangalu, David Holzmann, Michael Soyka, Christoph Schmid, Luca Regli
PURPOSE: Injuries to the internal carotid artery (ICA) are potentially lethal complications in transsphenoidal surgery (TSS) for pituitary lesions. The intercarotid distance (ICD) is thus a major parameter, determining the width of the surgical corridor in TSS. The purpose of the study is to investigate changes in ICD at different levels of the ICA during and after TSS using high definition intraoperative MRI (3T-iMRI). METHODS: Pre-, intra- and 3 months postoperative MRI images of 85 TSS patients were reviewed...
December 2017: Pituitary
https://www.readbyqxmd.com/read/28828544/vasculogenic-hyperprolactinemia-severe-prolactin-excess-in-association-with-internal-carotid-artery-aneurysms
#18
Sunita M C De Sousa, Emily J Meyer, Wayne Rankin, Peter J Brautigan, Morton G Burt, David J Torpy
PURPOSE: Internal carotid artery (ICA) aneurysms have rarely been found in association with marked hyperprolactinemia in the absence of prolactinoma; the cause of hyperprolactinemia has never been investigated. We aimed to determine if the observed hyperprolactinemia is due to a vascular-derived or known prolactin secretagogue from the injured ICA, analogous to pregnancy-associated hyperprolactinemia putatively due to placental factors. METHODS: We conducted a case series and literature review of individuals with severe hyperprolactinemia in association with ICA aneurysms...
December 2017: Pituitary
https://www.readbyqxmd.com/read/28825168/surgical-debulking-of-pituitary-adenomas-improves-responsiveness-to-octreotide-lar-in-the-treatment-of-acromegaly
#19
Rudolf Fahlbusch, David Kleinberg, Beverly Biller, Vivien Bonert, Michael Buchfelder, Paolo Cappabianca, John Carmichael, William Chandler, Annamaria Colao, Ajax George, Anne Klibanski, Edmond Knopp, Juergen Kreutzer, Neehar Kundurti, Martin Lesser, Adam Mamelak, Rosario Pivonello, Kalmon Post, Brooke Swearingen, Mary Lee Vance, Ariel Barkan
BACKGROUND: Studies comparing primary medical treatment of acromegaly with surgery are often non-randomized, and not stratified by illness severity. We prospectively compared primary medical therapy with pituitary surgery in patients with acromegaly. All patients had macroadenomas, at least one random human growth hormone (GH) level ≥12.5 ng/mL, elevated IGF-I levels and failure to suppress GH to <1 ng/mL during an oral glucose tolerance test (oGTT). METHODS: Forty-one patients from seven centers were randomized to primary treatment with octreotide LAR, 30 mg every 4 weeks × 3 months (ARM A, N = 15), or pituitary surgery (ARM B, N = 26) using a 1:2 randomization design...
December 2017: Pituitary
https://www.readbyqxmd.com/read/28823099/evidence-of-dysexecutive-syndrome-in-patients-with-acromegaly
#20
Shaobo Shan, Lingling Fang, Jia Huang, Raymond C K Chan, Guijun Jia, Weiqing Wan
PURPOSE: This study aimed to explore different aspects of executive function in patients with acromegaly and investigate the cause of dysexecutive syndrome in these patients. METHODS: We conducted five typical executive function tests (Stroop test, verbal fluency [VF] test, Hayling Sentence Completion Test [HSCT], N-back test, and Sustained Attention to Response Task [SART]) on 42 acromegalic patients and 42 strictly matched healthy controls. Comparative analyses were conducted for five major executive function domains...
December 2017: Pituitary
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