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https://www.readbyqxmd.com/read/28643208/visual-outcomes-after-endoscopic-endonasal-pituitary-adenoma-resection-a-systematic-review-and-meta-analysis
#1
REVIEW
Ivo S Muskens, Amir H Zamanipoor Najafabadi, Vanessa Briceno, Nayan Lamba, Joeky T Senders, Wouter R van Furth, Marco J T Verstegen, Timothy R S Smith, Rania A Mekary, Christine A E Eenhorst, Marike L D Broekman
PURPOSE: Patients with pituitary adenomas often present with visual deficits. While the aim of endoscopic endonasal transsphenoidal surgery (EETS) is to improve these deficits, permanent worsening is a possible outcome. The aim of this meta-analysis was to evaluate the effect of EETS for pituitary adenomas on visual outcomes. METHODS: A meta-analysis was conducted according to the PRISMA guidelines. Pooled prevalence was calculated for complete recovery, improvement, and deterioration of visual field deficits, visual acuity and unspecified visual function in fixed- and random-effect models, including assessment of heterogeneity (I(2)) and publication bias (Begg's test)...
June 22, 2017: Pituitary
https://www.readbyqxmd.com/read/28642181/surgery-outcome-of-growth-hormone-secreting-pituitary-adenoma-with-empty-sella-using-a-new-classification
#2
Qiang Wang, Xiaopeng Guo, Lu Gao, Zihao Wang, Kan Deng, Wei Lian, Renzhi Wang, Huijuan Zhu, Bing Xing
OBJECTIVE: To investigate the outcomes and identified risk factors for a cure and intraoperative cerebrospinal fluid leak following transsphenoidal surgery using a new classification for growth hormone-secreting pituitary adenoma associated with "empty sella". METHODS: This retrospective cohort study included 51 patients enrolled from January 2010 to June 2016. All subjects were categorized into three groups using a new classification scheme: Grade A, whole tumor occupation area beneath a horizontal line drawn along the lowest level of ES; Grade B, tumor occupation area that crossed the horizontal line on one side; and Grade C, tumor occupation area that crossed the horizontal line on two sides...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28630478/assessment-of-the-role-of-intracranial-hypertension-and-stress-on-hippocampal-cell-apoptosis-and-hypothalamic-pituitary-dysfunction-after-tbi
#3
Huajun Tan, Weijian Yang, Chenggang Wu, Baolong Liu, Hao Lu, Hong Wang, Hua Yan
In recent years, hypopituitarism caused by traumatic brain injury (TBI) has been explored in many clinical studies; however, few studies have focused on intracranial hypertension and stress caused by TBI. In this study, an intracranial hypertension model, with epidural hematoma as the cause, was used to explore the physiopathological and neuroendocrine changes in the hypothalamic-pituitary axis and hippocampus. The results demonstrated that intracranial hypertension increased the apoptosis rate, caspase-3 levels and proliferating cell nuclear antigen (PCNA) in the hippocampus, hypothalamus, pituitary gland and showed a consistent rate of apoptosis within each group...
June 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28629376/radiation-therapy-for-older-patients-with-brain-tumors
#4
REVIEW
Giuseppe Minniti, Andrea Riccardo Filippi, Mattia Falchetto Osti, Umberto Ricardi
The incidence of brain tumors in the elderly population has increased over the last few decades. Current treatment includes surgery, radiotherapy and chemotherapy, but the optimal management of older patients with brain tumors remains a matter of debate, since aggressive radiation treatments in this population may be associated with high risks of neurological toxicity and deterioration of quality of life. For such patients, a careful clinical status assessment is mandatory both for clinical decision making and for designing randomized trials to adequately evaluate the optimal combination of radiotherapy and chemotherapy...
June 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28623533/erratum-to-giovanni-verga-1879-1923-author-of-a-pioneering-treatise-on-pituitary-surgery-the-foundations-of-this-new-field-in-europe-in-the-early-1900s
#5
José M Pascual, Lorenzo Mongardi, Ruth Prieto, Inés Castro-Dufourny, María Rosdolsky, Sewan Strauss, Rodrigo Carrasco, Eduard Winter, Paolo Mazzarello
No abstract text is available yet for this article.
June 16, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28620498/diabetes-insipidus-and-hypopituitarism-in-hiv-an-unexpected-cause
#6
Carlos Tavares Bello, Francisco Sousa Santos, João Sequeira Duarte, Carlos Vasconcelos
Central diabetes insipidus (DI) is a rare clinical entity characterized by low circulating levels of antidiuretic hormone (ADH) presenting with polyuria and volume depletion. Pituitary surgery is the most common cause of central DI in adults. Pituitary and hypothalamic disease, particularly invasive neoplasms, rarely cause DI, being idiopathic cases responsible for the majority of non-surgical cases. HIV patients, especially those with poor virulogical control, are prone to the development of CNS neoplasms, particularly lymphomas...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28616673/contribution-of-sellar-dura-integrity-to-symptom-manifestation-in-pituitary-adenomas-with-intratumoral-hemorrhage
#7
Yasuhiko Hayashi, Yasuo Sasagawa, Daisuke Kita, Issei Fukui, Masahiro Oishi, Osamu Tachibana, Fumiaki Ueda, Mitsutoshi Nakada
PURPOSE: Although hemorrhage within pituitary adenomas frequently exacerbates the symptoms, there are many grades of severity. Moreover, the contributing factors for symptom severity are still controversial. METHODS: This retrospective study included 82 patients who underwent transsphenoidal surgery for pituitary adenomas with intratumoral hemorrhage. The grades of preoperative symptoms were classified into group A, asymptomatic or minor symptoms; group B, moderate symptoms sufficient for complain; and group C, severe symptoms disturbing daily life...
June 14, 2017: Pituitary
https://www.readbyqxmd.com/read/28614036/an-individualized-approach-to-the-evaluation-of-cushing-syndrome
#8
Susmeeta T Sharma
Cushing syndrome (CS) is caused by chronic exposure to excess glucocorticoids. Early recognition and treatment of hypercortisolemia can lead to decreased morbidity and mortality. The diagnosis of CS and thereafter, establishing the cause can often be difficult, especially in patients with mild and cyclic hypercortisolism. Surgical excision of the cause of excess glucocorticoids is the optimal treatment for CS. Medical therapy (steroidogenesis inhibitors, medications that decrease adrenocorticotropic hormone [ACTH] levels or glucocorticoid antagonists) and pituitary radiotherapy may be needed as adjunctive treatment modalities in patients with residual, recurrent or metastatic disease, in preparation for surgery, or when surgery is contraindicated...
June 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28614003/biochemical-control-during-long-term-follow-up-of-230-adult-patients-with-cushing-s-disease-a-multi-center-retrospective-study
#9
Eliza B Geer, Ismat Shafiq, Murray B Gordon, Vivien Bonert, Alejandro Ayala, Ronald S Swerdloff, Laurence Katznelson, Yelena Lalazar, Ekaterina Manuylova, Karen J Pulaski-Liebert, John D Carmichael, Zeina Hannoush, Vijaya Surampudi, Michael S Broder, Dasha Cherepanov, Marianne Eagan, Jackie Lee, Qayyim Said, Maureen P Neary, Beverly Mk Biller
OBJECTIVES: Cushing's disease (CD) results from excessive exposure to glucocorticoids caused by an adrenocorticotropic hormone-secreting pituitary tumor. Inadequately-treated CD is associated with significant morbidity and elevated mortality. Multi-center data on CD patients treated in routine clinical practice are needed to assess treatment outcomes in this rare disorder. The study purpose was to describe the burden of illness and treatment outcomes for CD patients. METHODS: Eight pituitary centers in 4 US regions participated in this multi-center retrospective chart review study...
June 14, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28603682/an-automated-methodology-for-assessing-anatomy-specific-instrument-motion-during-endoscopic-endonasal-skull-base-surgery
#10
R Alex Harbison, Yangming Li, Angelique M Berens, Randall A Bly, Blake Hannaford, Kris S Moe
Objectives  Describe instrument motion during live endoscopic skull base surgery (ESBS) and evaluate kinematics within anatomic regions. Design  Case series. Setting  Tertiary academic center. Participants  A single skull base surgeon performed six anterior skull base approaches to the pituitary. Main Outcomes and Measures  Time-stamped instrument coordinates were recorded using an optical tracking system. Kinematics (i.e., mean cumulative instrument travel, velocity, acceleration, and angular velocity) was calculated by anatomic region including nasal vestibule, anterior and posterior ethmoid, sphenoid, and lateral opticocarotid recess (lOCR) regions...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28602880/intraoperative-scoring-system-to-predict-postoperative-remission-in-endoscopic-endonasal-transsphenoidal-surgery-for-growth-hormone-secreting-pituitary-adenomas
#11
Shigetoshi Yano, Naoki Shinojima, Junji Kawashima, Tatsuya Kondo, Takuichiro Hide
OBJECTIVE: This study aimed to determine the predictive factors for endocrinological remission of patients with growth hormone (GH)-secreting pituitary adenomas. METHODS: In 47 patients with GH-secreting pituitary adenomas who underwent endoscopic endonasal transsphenoidal surgery with intraoperative GH measurements from 2002 to 2011, the relationship between the intraoperative GH levels and postoperative remission was analyzed, and two items that predicted remission (GH half-life obtained 30 min or less after removal and a minimum surgical GH level less than 2...
June 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28599454/differential-expression-of-the-notch1-receptor-and-its-ligands-dll1-dll3-and-dll4-in-distinct-human-pituitary-adenoma-subtypes
#12
Jianfu Zhang, Hua Gao, Yazhuo Zhang
Pituitary adenoma (PA) is a common type of benign tumor of the pituitary gland that is characterized by specific signs and symptoms, primarily associated with hypersecretion of pituitary glycoprotein hormones (thyroid-stimulating, growth and adrenocorticotrophic hormones, and prolactin). Surgery is the first-line treatment, although postoperative residual tissues/cells and subsequent recurrence remain notable complications. Gene therapy is an effective approach for treatment, as previous studies have demonstrated that the Notch signaling pathway participates in the pathogenesis of PA...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28596198/pituitary-abscess
#13
Jameela Mohammed Al Salman, Rawan Al Muataz Billa Al Agha, Mohamed Helmy
Pituitary abscess is an uncommon pituitary lesion. Its clinical diagnosis can be difficult to distinguish from other pituitary lesions. This pathology is characterised by vague symptoms of headaches, generalised tiredness and hypopituitarism manifestations. A history of recent meningitis, paranasal sinusitis or head surgery can be a suggestive of the source of infection.A 20-year-old man was admitted to neurosurgery department with complain of headache, fatigue, polyuria, polydipsia, blurred vision and sexual dysfunction...
June 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28593737/influence-of-opioids-on-immune-function-in-patients-with-cancer-pain-from-bench-to-bedside
#14
REVIEW
Jason W Boland, A Graham Pockley
In patients with cancer, opioids are principally used for the management of acute surgical and chronic cancer-related pain. However, opioids have many non-analgesic effects, including direct and indirect effects on cancer cells and on anti-tumour immunity (natural killer (NK) cells, macrophages and T-cells). Direct effects on immune cells are manifested via opioid and non-opioid Toll-like receptors, whereas indirect effects are manifested via the sympathetic nervous system and hypothalamic-pituitary-adrenal axis...
June 8, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28593114/transient-exacerbation-of-nasal-symptoms-following-endoscopic-transsphenoidal-surgery-for-pituitary-tumors-a-prospective-study
#15
Benjamin M Davies, Erica Tirr, Yi Yuen Wang, Kanna K Gnanalingham
Object  Endoscopic transsphenoidal surgery is the commonest approach to pituitary tumors. One disadvantage of this approach is the development of early postoperative nasal symptoms. Our aim was to clarify the peak onset of these symptoms and their temporal evolution. Methods  The General Nasal Patient Inventory (GNPI) was administered to 56 patients undergoing endoscopic transsphenoidal surgery for pituitary tumors preoperatively and at 1 day, 3 days, 2 weeks, 3 months, and 6 to 12 months postoperatively...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28591475/gamma-knife-radiosurgery-for-hypothalamic-hamartoma-preserves-endocrine-functions
#16
Frederic Castinetti, Thierry Brue, Isabelle Morange, Romain Carron, Jean Régis
Gamma Knife radiosurgery (GK) is an effective treatment for hypothalamic hamartoma. No precise data are available on the risk of endocrine side effects of this treatment. In this study, 34 patients with hypothalamic hamartoma (HH) were followed prospectively at the Department of Endocrinology, La Timone Hospital, Marseille, France, for a mean follow-up of >2 years (mean ± standard deviation [SD] 3.6 ± 2 years). Initial pre- and post-GK radiosurgery evaluations were performed, including weight, body mass index (BMI), and a complete endocrinological workup...
June 2017: Epilepsia
https://www.readbyqxmd.com/read/28591390/long-term-follow-up-of-growth-hormone-secreting-pituitary-adenomas-submitted-to-endoscopic-endonasal-surgery
#17
Caroline Martins Dos Santos Leopoldo, Felippe Martins Dos Santos Leopoldo, Américo Rubens Leite Dos Santos, José Carlos Esteves Veiga, José Viana Lima, Nilza Maria Scalissi, Paulo Roberto Lazarini, Ricardo Landini Lutaif Dolci
Objective: The aim of this study was to evaluate the results of the endoscopic transsphenoidal technique for growth hormone (GH)-secreting adenomas. Methods: A retrospective analysis based on medical records of 23 acromegalic patients submitted to endoscopic transsphenoidal surgery. Biochemical control was defined as basal GH < 1ng/ml, nadir GH < 0.4ng/ml after glucose load and age-adjusted IGF-1 normal at the last follow-up. Results: The overall endocrinological remission rate was 39...
May 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28589048/the-cushing-reflex-oliguria-as-a-reflection-of-an-elevated-intracranial-pressure
#18
K Leyssens, T Mortelmans, T Menovsky, D Abramowicz, Marcel Th B Twickler, L Van Gaal
Oliguria is one of the clinical hallmarks of renal failure. The broad differential diagnosis is well known, but a rare cause of oliguria is intracranial hypertension (ICH). The actual knowledge to explain this relationship is scarce. Almost all literature is about animals where authors describe the Cushing reflex in response to ICH. We hypothesize that the Cushing reflex is translated towards the sympathetic nervous system and renin-angiotensin-aldosterone system with a subsequent reduction in medullary blood flow and oliguria...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28588668/fluid-fluid-level-on-magnetic-resonance-images-may-predict-the-occurrence-of-pituitary-adenomas-in-cystic-sellar-suprasellar-masses
#19
Deyong Xiao, Shousen Wang, Lin Zhao, Qun Zhong, Yinxing Huang, Chenyu Ding
The aim of the present study was to evaluate the value of identifying fluid-fluid level via preoperative magnetic resonance (MR) images in differentiating pituitary adenomas from craniopharyngioma, Rathke's cleft cyst (RCC), and other cystic sellar-suprasellar lesions. The data of 293 consecutive patients who underwent surgery for sellar-suprasellar lesions between July 2010 and December 2012 was retrospectively reviewed, and a total of 133 cystic cases were included in the present study. MR images and pathological features of all subjects were examined...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28588003/pituitary-adenoma-apoplexy-in-an-adolescent-a-case-report-and-review-of-the-literature
#20
Hero Zijlker, Sebastian Schagen, Jan Maarten Wit, Biermasz Nienke, Wouter van Furth, Wilma Oostdijk
We present a 13-year-old boy who became progressively sleepy and experienced a sudden headache with vomiting and fever. Laboratory testing showed hypoglycemia, multiple pituitary hormonal deficiencies and elevated C-Reactive Protein (CRP). A cranial MRI showed an opaque sphenoid sinus and an intrasellar mass suspect for hemorrhage, so that we suspected a pituitary apoplexy (PA) originating from a non-functioning adenoma, although a pituitary abscess could not completely be excluded. The boy was treated with antibiotics, hydrocortisone and levothyroxine and a close follow-up to monitor the clinical course...
June 7, 2017: Journal of Clinical Research in Pediatric Endocrinology
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