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Pituitary surgery

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https://www.readbyqxmd.com/read/27936470/ocular-delivery-of-pacap1-27-protects-the-retina-from-ischemic-damage-in-rodents
#1
Dora Werling, Dora Reglodi, William A Banks, Therese S Salameh, Krisztina Kovacs, Timea Kvarik, Alexandra Vaczy, Laszlo Kovacs, Flora Mayer, Bese Danyadi, Emese Lokos, Andrea Tamas, Gabor Toth, Zsolt Biro, Tamas Atlasz
Purpose: Pituitary adenylate cyclase activating polypeptide (PACAP) is neuroprotective in neuronal injuries. Bilateral common carotid artery occlusion (BCCAO) causes chronic hypoperfusion-induced degeneration in the rat retina, where we proved the retinoprotective effect of intravitreal PACAP. Although this route of administration is a common clinical practice in several diseases, easier routes are clinically important. Our aim was to investigate the potential retinoprotective effects of PACAP eye drops in BCCAO-induced ischemic retinopathy...
December 1, 2016: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/27933171/active-postoperative-acromegaly-sustained-remission-after-discontinuation-of-somatostatin-analogues
#2
Cristina Alvarez-Escola, Jersy Cardenas-Salas
: In patients with active acromegaly after pituitary surgery, somatostatin analogues are effective in controlling the disease and can even be curative in some cases. After treatment discontinuation, the likelihood of disease recurrence is high. However, a small subset of patients remains symptom-free after discontinuation, with normalized growth hormone (GH) and insulin-like growth factor (IGF1) levels. The characteristics of patients most likely to achieve sustained remission after treatment discontinuation are not well understood, although limited evidence suggests that sustained remission is more likely in patients with lower GH and IGF1 levels before treatment withdrawal, in those who respond well to low-dose treatment, in those without evidence of adenoma on an MRI scan and/or in patients who receive long-term treatment...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27932528/comorbidities-treatment-patterns-and-cost-of-illness-of-acromegaly-in-sweden-a-register-linkage-population-based-study
#3
Eva Lesén, Daniel Granfeldt, Aude Houchard, Jérôme Dinet, Anthony Berthon, Daniel S Olsson, Ingela Björholt, Gudmundur Johannsson
OBJECTIVE: Acromegaly is a complex endocrine disease with multiple comorbidities. Treatment to obtain biochemical remission includes surgery, medical therapy and radiation. We aimed to describe comorbidities, treatment patterns and cost-of-illness in patients with acromegaly in Sweden. DESIGN: A nationwide population-based study. METHODS: Patients with acromegaly were identified and followed in national registers in Sweden. Longitudinal treatment patterns were assessed in patients diagnosed between July 2005 and December 2013...
February 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27928434/adrenalectomy-for-cushing-s-syndrome-do-s-and-don-ts
#4
REVIEW
Paduraru Dn, Nica A, Carsote M, Valea A
Aim. To present specific aspects of adrenalectomy for Cushing's syndrome (CS) by introducing well established aspects ("do's") and less known aspects ("don'ts"). Material and Method. This is a narrative review. Results. The "do's" for laparoscopic adrenalectomy (LA) are the following: it represents the "gold standard" for secretor and non-secretor adrenal tumors and the first line therapy for CS with an improvement of cardio-metabolic co-morbidities; the success rate depending on the adequate patients' selection and the surgeon's skills...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27926659/macroprolactinomas-and-nonfunctioning-pituitary-adenomas-and-pregnancy-outcomes
#5
Kimberley Lambert, Kate Rees, Paul T Seed, Mandish K Dhanjal, Marian Knight, David R McCance, Catherine Williamson
OBJECTIVE: To examine the monitoring, management, and outcomes of pituitary tumors in pregnancy. METHODS: A national, prospective, observational, population-based case series study was conducted in all U.K. consultant-led obstetric units over 3 years using the U.K. Obstetric Surveillance System. To evaluate rates of adverse pregnancy outcomes, women with a macroprolactinoma (10 mm or greater) or nonfunctioning pituitary adenoma, diagnosed before or during pregnancy, were compared with two comparison groups: 1) a U...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27910710/management-of-a-pregnant-woman-with-thyrotropinoma-a-case-report-and-review-of-the-literature
#6
Carolina M Perdomo, Jorge A Árabe, Miguel Á Idoate, Juan C Galofré
INTRODUCTION: Pituitary disorders during pregnancy are uncommon. The approach should include a close follow-up in order to reduce maternal and fetal risks associated with physiological changes during pregnancy or treatment side effects. MATERIALS AND METHODS: We report a 21-year-old woman with a thyroid-stimulating hormone-secreting pituitary macroadenoma and positive antithyroid antibodies. She was initially treated using transsphenoidal pituitary surgery. The patient relapsed 17-month post-surgery...
December 2, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27901414/cognitive-deficits-and-inflammatory-response-resulting-from-mild-to-moderate-traumatic-brain-injury-in-rats-are-exacerbated-by-repeated-pre-exposure-to-an-innate-stress-stimulus
#7
Michaël Ogier, Amor Belmeguenai, Thomas Lieutaud, Béatrice Georges, Sandrine Bouvard, Emilie Carré, Frédéric Canini, Laurent Bezin
Traumatic brain injury (TBI) is common in both military and civilian populations, and often results in neurobehavioral sequelae that impair quality of life in both patients and their family. Although individuals who are chronically exposed to stress are more likely to experience TBI, it is still unknown whether pre-injury stress influences the outcome after TBI. The present study tested whether behavioral and cognitive long-term outcome after TBI in rats is affected by prior exposure to an innate stress stimulus...
November 30, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27901326/tuberculuma-sellae-meningiomas-a-systematic-review-of-transcranial-approaches-in-the-endoscopic-era
#8
Mazda Turel, Georgios Tsermoulas, Abdulmounem Yasssin-Kassab, Deven Reddy, Hugo Andrade-Barazarte, Lior Gonen, Gelareh Zadeh, Fred Gentili
INTRODUCTION: With the advent of skull base endoscopy, tuberculum sellae meningiomas (TSMs) are currently operated both from the traditional transcranial (TC) route as well as the extended endonasal endoscopic trasnssphenoidal approach (EETS). The aim of this study was to conduct a systematic review of TSMs excised via the TC route in the modern era when the EETS excision is gaining popularity. EVIDENCE ACQUISITION: We performed a systematic review in the medical literature following the PRISMA guidelines...
November 30, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27899081/endoscopic-endonasal-pituitary-adenomas-surgery-the-surgical-experience-of-178-consecutive-patients-and-learning-curve-of-two-neurosurgeons
#9
Xuefei Shou, Ming Shen, Qilin Zhang, Yichao Zhang, Wenqiang He, Zengyi Ma, Yao Zhao, Shiqi Li, Yongfei Wang
BACKGROUND: We aim to study surgical technique and analyze the related factors affecting tumor total removal and postoperative endocrinological remission for endoscopic endonasal pituitary adenomas surgery. METHODS: We retrospectively analyzed 178 endoscopic endonasal pituitary adenomas surgery from March 2011 to May 2014. Endonasal approach included the routine transnasal-sphenoidal approach, transnasal- maxillary sinus approach in four cases and transnasal-clivus approach in one case...
November 30, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27894339/the-identification-of-human-pituitary-adenoma-initiating-cells
#10
Branavan Manoranjan, Sujeivan Mahendram, Saleh A Almenawer, Chitra Venugopal, Nicole McFarlane, Robin Hallett, Thusyanth Vijayakumar, Almunder Algird, Naresh K Murty, Doron D Sommer, John P Provias, Kesava Reddy, Sheila K Singh
Classified as benign central nervous system (CNS) tumors, pituitary adenomas account for 10% of diagnosed intracranial neoplasms. Although surgery is often curative, patients with invasive macroadenomas continue to experience significant morbidity and are prone to tumor recurrence. Given the identification of human brain tumor-initiating cells (TICs) that initiate and maintain tumor growth while promoting disease progression and relapse in multiple CNS tumors, we investigated whether TICs also drive the growth of human pituitary adenomas...
November 28, 2016: Acta Neuropathologica Communications
https://www.readbyqxmd.com/read/27894193/currently-used-and-investigational-drugs-for-cushing%C3%A2-s-disease
#11
Denis Ciato, Aizhar G Mumbach, Marcelo Paez-Pereda, Günter K Stalla
Cushing's disease (CD) is caused by a corticotroph adenoma of the pituitary gland that secretes excess adrenocorticotropic hormone (ACTH) causing increased morbidity and mortality. Surgery is the treatment of choice, but is not always successful. Alternatives include radiotherapy, adrenal surgery, and pharmaceutical therapy. The latter is increasingly gaining momentum due to the recent development of compounds that reduce hypercortisolaemia or its symptoms, acting through different mechanisms. Areas covered: In this article, the authors provide a complete overview of the treatment options for Cushing´s disease, including adrenal-directed, tumor-targeted, and peripheral therapies that are currently used or in development, and discuss their potential advantages and limitations...
December 8, 2016: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27892895/prothymosin-alpha-and-ki-67-expression-in-pituitary-adenomas
#12
Iga Wierzbicka-Tutka, Grzegorz Sokołowski, Agata Bałdys-Waligórska, Dariusz Adamek, Edyta Radwańska, Filip Gołkowski
INTRODUCTION: Prothymosin alpha (PTMA), a nuclear oncoprotein involved in cell cycle regulation, is used as a prognostic marker in many cancers. The histopathology of pituitary carcinomas and locally invasive adenomas is indistinguishable from that of benign tumors. A new marker is needed to differentiate these lesions. We evaluated PTMA in pituitary adenomas to determine its usefulness as a prognostic factor of tumor proliferation. MATERIAL/METHODS: We conducted a retrospective analysis of a group of 27 patients, including 15 females (56%) and 12 males (44%) with a mean age of 58...
November 7, 2016: Postȩpy Higieny i Medycyny Doświadczalnej
https://www.readbyqxmd.com/read/27885957/visual-pathway-impairment-by-pituitary-adenomas-quantitative-diagnostics-by-diffusion-tensor-imaging
#13
Ylva Lilja, Oscar Gustafsson, Maria Ljungberg, Göran Starck, Bertil Lindblom, Thomas Skoglund, Henrik Bergquist, Karl-Erik Jakobsson, Daniel Nilsson
OBJECTIVE Despite ample experience in surgical treatment of pituitary adenomas, little is known about objective indices that may reveal risk of visual impairment caused by tumor growth that leads to compression of the anterior visual pathways. This study aimed to explore diffusion tensor imaging (DTI) as a means for objective assessment of injury to the anterior visual pathways caused by pituitary adenomas. METHODS Twenty-three patients with pituitary adenomas, scheduled for transsphenoidal tumor resection, and 20 healthy control subjects were included in the study...
November 25, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27876186/randomized-trial-for-superiority-of-high-field-strength-intra-operative-magnetic-resonance-imaging-guided-resection-in-pituitary-surgery
#14
Vivek Tandon, Amol Raheja, Ashish Suri, P Sarat Chandra, Shashank S Kale, Rajinder Kumar, Ajay Garg, Mani Kalaivani, Ravindra M Pandey, Bhawani S Sharma
Till date there are no randomized trials to suggest the superiority of intra-operative magnetic resonance imaging (IOMRI) guided trans-sphenoidal pituitary resection over two dimensional fluoroscopic (2D-F) guided resections. We conducted this trial to establish the superiority of IOMRI in pituitary surgery. Primary objective was to compare extent of tumor resection between the two study arms. It was a prospective, randomized, outcome assessor and statistician blinded, two arm (A: IOMRI, n=25 and B: 2D-F, n=25), parallel group clinical trial...
November 18, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27875509/osseous-repair-in-minimally-invasive-reconstruction-of-anterior-skull-base-defects
#15
Vijay R Ramakrishnan, Adam M Terella, Seerat Poonia, Alexander G Chiu, James N Palmer
Management of anterior skull base defects is an area of continued innovation for skull base surgeons. Various grafting materials have been advocated for the repair of skull base defects depending on needs, availability, harvest site morbidity, and surgeon preference. Spontaneous bony closure of small skull defects is known to occur in animal models without bone grafts, but this phenomenon has been unexplored in the human skull base. The objective of this study was to evaluate osseous skull base closure in patients undergoing endoscopic repair of skull base defects...
November 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27872697/co-occurrence-of-pituitary-adenoma-with-suprasellar-and-olfactory-groove-meningiomas
#16
Kai-Zheong Lim, Tony Goldschlager, Ronil V Chandra, Jonathan Hall, Brent Uren, Michael Pullar
INTRODUCTION: The co-existence of pituitary adenoma and meningioma is extremely rare. It is even rarer in patients with no previous known risk factors for either tumour. Here, we present a case of synchronous non-functioning pituitary adenoma with suprasellar and olfactory groove meningiomas in a patient without previous irradiation. METHODS: The tumours were diagnosed on MRI in the 65-year-old patient who presented with patchy visual deficits. The decision was made to undergo surgery for resection of the suprasellar meningioma and the pituitary adenoma, leaving the small olfactory groove meningioma intact...
October 2016: Basic and Clinical Neuroscience
https://www.readbyqxmd.com/read/27866938/ovulation-induction-in-polycystic-ovary-syndrome-current-options
#17
REVIEW
Richard S Legro
There are a variety of effective treatment options to induce ovulation in women with polycystic ovary syndrome (PCOS). The most effective treatments are primarily reproductive and target the hypothalamic-pituitary-ovarian (HPO) axis. Letrozole, an aromatase inhibitor, is headed toward replacing clomiphene, a selective estrogen receptor modulator, as the first-choice option. Metabolic treatments likely work indirectly through the HPO axis. Many metabolic treatments have shown initial promise and later failed (troglitozone or d-chiro-inositol) or disappointed (metformin); further studies are needed of newer agents to treat type 2 diabetes...
September 21, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27866303/anesthetic-technique-and-cancer-recurrence-in-oncologic-surgery-unraveling-the-puzzle
#18
Ryungsa Kim
Surgery/anesthetic technique-stimulated immunosuppression in the perioperative period might cause an increase in cancer-related mortality. Whether anesthetic technique can affect the outcomes of cancer patients remains inconclusive. This review discusses data from the available literature on anesthetic techniques applied in oncologic surgery, the long-term outcomes of anesthetic technique, and their relation to survival and cancer recurrence. Searches of the PubMed database up to June 30, 2016, were conducted to identify publications with the terms "anesthetic technique and cancer recurrence," "regional anesthesia and cancer recurrence," "local anesthesia and cancer recurrence," "anesthetic technique and immunosuppression," and "anesthetic technique and oncologic surgery...
November 19, 2016: Cancer Metastasis Reviews
https://www.readbyqxmd.com/read/27859437/characteristics-and-outcome-of-surgically-treated-pituitary-tumours-in-south-africa-a-single-centre-experience
#19
Khaled K Elmezughi, Fraser J Pirie, Ayesha A Motala
AIMS: To describe the clinical, biochemical, radiological and histological features and to determine the outcome of all patients with pituitary tumours treated surgically at Inkosi Albert Luthuli Central Hospital in Durban over a 5 year period. RESEARCH DESIGN: Retrospective chart review from 2008 to 2012. Clinical, biochemical and radiologic data were collected before and one year after surgery. Histopathology findings and peri-operative complications were recorded...
November 12, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27857869/endoscopic-transmaxillary-transposition-of-temporalis-flap-for-recurrent-cerebrospinal-fluid-leak-closure
#20
Regi Thomas, Shabari Girishan, Ari George Chacko
Objective To describe the technique of endoscopic transmaxillary temporalis muscle flap transposition for the repair of a persistent postoperative sphenoidal cerebrospinal fluid leak. Design The repair of a recurrent cerebrospinal fluid leak for a patient who had undergone endoscopic transsphenoidal excision of an invasive silent corticotroph Hardy C and Knosp Grade IV pituitary adenoma was undertaken. The patient had completed postoperative radiotherapy for the residual tumor and presented with cerebrospinal fluid leak, 1 year later...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
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