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Pituitary insufficiency

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https://www.readbyqxmd.com/read/29746990/hindbrain-5-monophosphate-activated-protein-kinase-mediates-short-term-food-deprivation-inhibition-of-the-gonadotropin-releasing-hormone-luteinizing-hormone-axis-role-of-nitric-oxide
#1
Manita Shakya, Prem K Shrestha, Karen P Briski
Hindbrain-derived stimuli restrain the gonadotropin-releasing hormone (GnRH)-pituitary luteinizing hormone (LH) reproductive neuroendocrine axis during energy insufficiency. Interruption of food intake, planned or unplanned, is emblematic of modern life. This study investigated the premise that the hindbrain energy sensor adenosine 5'-monophosphate-activated protein kinase (AMPK) inhibits reproductive neuroendocrine function in short-term, e.g. 18 hr food-deprived (FD) estradiol (E)-implanted ovariectomized female rats...
May 7, 2018: Neuroscience
https://www.readbyqxmd.com/read/29732365/corticosteroids-in-pediatric-heart-surgery-myth-or-reality
#2
REVIEW
Daniel P Fudulu, Ben Gibbison, Thomas Upton, Serban C Stoica, Massimo Caputo, Stafford Lightman, Gianni D Angelini
Background: Corticosteroids have been administered prophylactically for more than 60 years in pediatric heart surgery, however, their use remains a matter of debate. There are three main indications for corticosteroid use in pediatric heart surgery with the use of cardiopulmonary bypass (CPB): (1) to blunt the systemic inflammatory response (SIRS) induced by the extracorporeal circuit; (2) to provide perioperative supplementation for presumed relative adrenal insufficiency; (3) for the presumed neuroprotective effect during deep hypothermic circulatory arrest operations...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29731953/adrenal-insufficiency-in-cystic-fibrosis-a-rare-phenomenon
#3
Sébastien Préville-Ratelle, Adèle Coriati, Aurélie Ménard, Isabelle Bourdeau, François Tremblay, Yves Berthiaume
Background: The prevalence of adrenal insufficiency (AI) in cystic fibrosis (CF) is unknown. The frequent use of glucocorticoids (inhaled or systemic) may induce the long-term suppression of the hypothalamic-pituitary-adrenal axis. Methods: We reviewed the results of adrenocorticotropic hormone (ACTH) stimulation tests done over a 10-year period to evaluate adrenal function in 69 CF patients of the CHUM CF clinic. Clinical characteristics of AI patients were compared to adrenal-sufficient (AS) patients...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29730618/role-of-sampling-times-and-serum-cortisol-cut-off-concentrations-on-the-routine-assessment-of-adrenal-function-using-the-standard-cosyntropin-test-in-an-academic-hospital-from-spain-a-retrospective-chart-review
#4
Andrés E Ortiz-Flores, Elisa Santacruz, Lucía Jiménez-Mendiguchia, Ana García-Cano, Lia Nattero-Chávez, Héctor F Escobar-Morreale, Manuel Luque-Ramírez
OBJECTIVES: Aiming to validate the use of a single poststimulus sampling protocol for cosyntropin test short standard high-dose test (SST) in our institution, our primary objectives were (1) to determine the concordance between 30 and 60 min serum cortisol (SC) measurements during SST; and (2) to evaluate the diagnostic agreement between both sampling times when using classic or assay-specific and sex-specific SC cut-off values. The secondary objectives included (1) estimating the specificity and positive predictive value of 30 and 60 min sampling times while considering the suspected origin of adrenal insufficiency (AI); and (2) obtaining assay-specific cut-off values for SC after SST in a group of subjects with normal hypothalamic-pituitary-adrenal (HPA) axis...
May 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29730106/imaging-evaluation-of-the-location-and-fenestration-of-sellar-floor-during-endonasal-transsphenoidal-surgery-in-patients-with-pituitary-adenomas
#5
Shousen Wang, Yong Qin, Deyong Xiao, Zhifeng Wu, Liangfeng Wei
To evaluate the clinical value of three-dimensional (3D) CT reconstruction of the sphenoidal sinus separation in localizing sellar floor during endonasal transsphenoidal surgery, and determine the size and location of sellar floor fenestration. After exclusion,51 patients were eligible for study inclusion. A pre-operative CT scan of the paranasal sinus and CT scan and MRI of the pituitary gland were obtained. Sphenoidal sinus separation was reconstructed using Mimics 15.0 software and the quantity, shape, and orientation were observed and compared with intra-operative data, the purpose of which was to guide the localization of sellar floor...
May 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29706935/neonatal-overnutrition-increases-testicular-size-and-expression-of-luteinizing-hormone-%C3%AE-subunit-in-peripubertal-male-rats
#6
Pilar Argente-Arizón, David Castro-González, Francisca Díaz, María J Fernández-Gómez, Miguel A Sánchez-Garrido, Manuel Tena-Sempere, Jesús Argente, Julie A Chowen
Proper nutrition is important for growth and development. Maturation of the reproductive axis and the timing of pubertal onset can be delayed when insufficient nutrition is available, or possibly advanced with nutritional abundance. The childhood obesity epidemic has been linked to a secular trend in advanced puberty in some populations. The increase in circulating leptin that occurs in association with obesity has been suggested to act as a signal that an adequate nutritional status exists for puberty to occur, allowing activation of central mechanisms...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29696788/delayed-peak-response-of-cortisol-to-insulin-tolerance-test-in-patients-with-prader-willi-syndrome
#7
Yuji Oto, Keiko Matsubara, Tadayuki Ayabe, Masahisa Shiraishi, Nobuyuki Murakami, Hiroshi Ihara, Tomoyo Matsubara, Toshiro Nagai
Deaths among children with Prader-Willi syndrome (PWS) are often related to only mild or moderate upper respiratory tract infections, and many causes of death remain unexplained. Several reports have hypothesized that patients with PWS may experience latent central adrenal insufficiency. However, whether PWS subjects suffer from alteration of the hypothalamus-pituitary-adrenal (HPA) axis remains unclear. This study aimed to explore the HPA axis on PWS. We evaluated the HPA axis in 36 PWS patients (24 males, 12 females; age range, 7 months to 12 years; median age 2...
April 25, 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29695647/a-case-of-tsh-secreting-pituitary-adenoma-with-cyclic-fluctuations-in-serum-tsh-levels
#8
Hideyuki Okuma, Koshi Hashimoto, Takuya Ohashi, Masatomo Mihara, Isao Minami, Hajime Izumiyama, Shigekazu Sasaki, Naoko Inoshita, Hiroshi Nishioka, Shozo Yamada, Takanobu Yoshimoto
A 29-year-old man was referred to our department due to adrenal insufficiency with the inappropriate secretion of TSH (SITSH). Magnetic resonance imaging revealed a pituitary tumor. A weak TSH response in the TRH test, elevated sex hormone binding globulin (SHBG) levels, and the absence of a family medical history of SITSH or TRβ gene mutations supported the diagnosis of TSH-secreting pituitary adenoma (TSHoma). However, complete TSH suppression and a blunted cholesterol response in the T3 suppression test as well as normal glycoprotein α-subunit (α-GSU) levels were not compatible with TSHoma...
April 26, 2018: Endocrine Journal
https://www.readbyqxmd.com/read/29678524/hypopituitarism-after-single-fraction-pituitary-adenoma-radiosurgery-dosimetric-analysis-based-on-patients-treated-using-contemporary-techniques
#9
Christopher S Graffeo, Michael J Link, Paul D Brown, William F Young, Bruce E Pollock
PURPOSE: To analyze factors associated with post-stereotactic radiosurgery (SRS) hypopituitarism among radiation-naïve patients with pituitary adenomas who underwent single-fraction SRS between 2007 and 2014. METHODS AND MATERIALS: This was a retrospective review of 97 patients having single-fraction SRS from 2007 until 2014. Eligible patients had no history of prior radiation, normal age- and sex-specific pituitary function before SRS, and at least 24 months of endocrine follow-up...
March 8, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29595045/the-endoscopic-surgical-resection-of-intrasellar-lesions-conserves-the-hormonal-function-a-negative-correlation-to-the-microsurgical-technique
#10
Stefan Linsler, Sebastian Senger, Renate Hero-Gross, Wolf-Ingo Steudel, Joachim Oertel
BACKGROUND: The endonasal endoscopic approach is still currently under investigation for sellar tumour surgery: a higher resection rate is to be expected and complications should be minimized. The authors report their surgical results of endonasal endoscopic neurosurgery with special focus on postoperative hypopituitarism in comparison to microsurgical procedures. METHODS: Sixty patients received endoscopic endonasal transsphenoidal procedures for sellar pathologies...
March 28, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29581015/suprasellar-hemangioblastoma-with-reversible-edema-like-change-along-the-optic-tract-a-case-report
#11
Yujiro Hattori, Shigeyuki Tahara, Osamu Yamada, Masahiro Yamaguchi, Eitaro Ishisaka, Akio Morita
BACKGROUND: Hemangioblastomas usually occur in the cerebellum, and are often a component of the von Hippel-Lindau disease. Edema-like changes along the optic tract are commonly observed in association with tumors in the sellar and suprasellar regions, such as craniopharyngiomas and pituitary adenomas. Here, we describe a case of sporadic suprasellar hemangioblastoma with edema-like changes along the optic tract that completely resolved after surgery CASE DESCRIPTION: The patient was a 28-year-old woman with failing vision and a bitemporal hemianopia...
March 23, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29580720/endonasal-endoscopic-surgery-in-pituitary-adenomas-surgical-results-in-a-series-of-86-consecutive-patients
#12
R López-García, J Abarca-Olivas, I Monjas-Cánovas, A M Picó Alfonso, P Moreno-López, J R Gras-Albert
INTRODUCTION: The endoscopic endonasal approach has become the gold standard for the surgical treatment of pituitary adenomas. OBJECTIVES: The aim of this study is to present the results obtained in our hospital in purely endoscopic surgery of pituitary adenomas. METHODS: From February 2011 to August 2016, we conducted a prospective study on a series of 86 patients with pituitary adenoma, all of whom underwent surgery with a purely endoscopic endonasal approach...
March 23, 2018: Neurocirugía
https://www.readbyqxmd.com/read/29570013/value-of-pituitary-gland-mri-at-7-t-in-cushing-s-disease-and-relationship-to-inferior-petrosal-sinus-sampling-case-report
#13
Meng Law, Regina Wang, Chia-Shang J Liu, Mark S Shiroishi, John D Carmichael, William J Mack, Martin Weiss, Danny J J Wang, Arthur W Toga, Gabriel Zada
Cushing's disease is caused by adrenocorticotrophic hormone (ACTH)-secreting pituitary adenomas, which are often difficult to identify on standard 1.5-T or 3-T MRI, including dynamic contrast imaging. Inferior petrosal and cavernous sinus sampling remains the gold standard for MRI-negative Cushing's disease. The authors report on a 27-year-old woman with Cushing's disease in whom the results of standard 1.5-T and 3-T MRI, including 1.5-T dynamic contrast imaging, were negative. Inferior petrosal sinus sampling showed a high central-to-peripheral ACTH ratio (148:1) as well as a right-to-left ACTH gradient (19:1), suggesting a right-sided pituitary microadenoma...
March 23, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29534899/single-and-multi-fraction-stereotactic-radiosurgery-dose-tolerances-of-the-optic-pathways
#14
Michael T Milano, Jimm Grimm, Scott G Soltys, Ellen Yorke, Vitali Moiseenko, Wolfgang A Tomé, Arjun Sahgal, Jinyu Xue, Lijun Ma, Timothy D Solberg, John P Kirkpatrick, Louis S Constine, John C Flickinger, Lawrence B Marks, Issam El Naqa
PURPOSE: Dosimetric and clinical predictors of radiation-induced optic nerve/chiasm neuropathy (RION) after single-fraction stereotactic radiosurgery (SRS) or hypofractionated (2-5 fractions) radiosurgery (fSRS) were analyzed from pooled data that were extracted from published reports (PubMed indexed from 1990 to June 2015). This study was undertaken as part of the American Association of Physicists in Medicine Working Group on Stereotactic Body Radiotherapy, investigating normal tissue complication probability (NTCP) after hypofractionated radiation...
January 31, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29532430/complete-evaluation-of-pituitary-tumours-in-a-single-tertiary-care-institution
#15
Dimitrios Askitis, Damianos Tsitlakidis, Nicolle Müller, Albrecht Waschke, Gunter Wolf, Ulrich Alfons Müller, Christof Kloos
INTRODUCTION: We retrospectively evaluated all patients with pituitary tumours treated in our department from 1/1/1997 to 01/11/2014. PATIENTS AND METHODS: Two hundred and fifteen patients (124 females, 91 males, mean age 50.9 years) were treated because of pituitary tumours. All patients underwent basal hormonal analysis and when required dynamic testing in order to check for hormonal activity. Pituitary masses were divided into groups concerning their hormonal status and were further classified according to gender, age at diagnosis, tumour size, and the development of postoperative pituitary insufficiency when neurosurgical intervention was conducted...
May 2018: Endocrine
https://www.readbyqxmd.com/read/29523633/management-of-endocrine-disease-management-of-cushing-s-syndrome-during-pregnancy-solved-and-unsolved-questions
#16
REVIEW
Thierry Brue, Vincent Amodru, Frederic Castinetti
With fewer than 200 reported cases, Cushing's syndrome (CS) in pregnancy remains a diagnostic and therapeutic challenge. In normal pregnancies, misleading signs may be observed such as striae or hypokalemia, while plasma cortisol and urinary free cortisol may rise up to 2- to 3-fold. While the dexamethasone suppression test is difficult to use, reference values for salivary cortisol appear valid. Apart from gestational hypertension, differential diagnosis includes pheochromocytoma and primary aldosteronism...
June 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29518865/-clinical-characteristics-of-central-diabetes-insipidus-a-retrospective-analysis-of-230-cases
#17
J P Zhang, Q H Guo, Y M Mu, Z H Lyu, W J Gu, G Q Yang, J Du, J M Ba, J M Lu
Objective: To evaluate the clinical characteristics and etiologies of central diabetes insipidus (CDI). Methods: The clinical data of 230 patients with CDI in the Department of Endocrinology of Chinese PLA General Hospital from 2008 June to 2014 December were collected and analyzed retrospectively. Results: The three most common causes of CDI were idiopathic CDI, lymphocytic hypophysitis and intracranial germ cell tumors. Among all the CDI, the idiopathic CDI accounted for 37.48%. There were significant differences in age onset and gender distribution among the different causes of CDI...
March 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29514896/semen-quality-in-patients-with-pituitary-disease-and-adult-onset-hypogonadotropic-hypogonadism
#18
Mikkel Andreassen, Anders Juul, Ulla Feldt-Rasmussen, Niels Jørgensen
OBJECTIVE: Gonadotropins (luteinizing hormone (LH) and follicle-stimulating hormone (FSH)) are released from the pituitary gland and stimulate Leydig cells to produce testosterone and initiates spermatogenesis. Little is known about how and when the deterioration of semen quality occurs in patients with adult-onset gonadotropin insufficiency. DESIGN AND METHODS: A retrospective study comprising 20 testosterone-deficient men (median age, 29 years) with acquired pituitary disease who delivered semen for cryopreservation before initiation of testosterone therapy...
April 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29510819/primary-empty-sella-syndrome-and-the-prevalence-of-hormonal-dysregulation
#19
Matthias K Auer, Mareike R Stieg, Alexander Crispin, Caroline Sievers, Günter K Stalla, Anna Kopczak
BACKGROUND: Empty sella is the neuroradiological or pathological finding of an apparently empty sella turcica containing no pituitary tissue. The prevalence of primary empty sella, i.e., empty sella without any discernible cause, is not precisely known; estimates range from 2% to 20%. Technical advances in neuroradiology have made empty sella an increasingly common incidental finding. It remains unclear whether, and to what extent, asymptomatic adult patients with an incidentally discovered empty sella should undergo diagnostic testing for hormonal disturbances...
February 16, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29501516/plurihormonal-acth-gh-pituitary-adenoma-case-report-and-systematic-literature-review
#20
Elena Roca, Pier Paolo Mattogno, Teresa Porcelli, Luigi Poliani, Francesco Belotti, Alberto Schreiber, Filippo Maffezzoni, Marco Maria Fontanella, Francesco Doglietto
BACKGROUND: Plurihormonal adenomas (PHAs) represent 10%-15% of all functioning pituitary adenomas. The most frequent hormonal associations are with prolactin and growth hormone (GH). Here we describe a rare case of functional adrenocorticotropic hormone (ACTH) and GH microadenoma and report our findings from a systematic literature review of PHA. METHODS: We searched PubMed using the terms "plurihormonal pituitary adenoma," "ACTH GH pituitary adenoma," and "acromegaly AND Cushing's disease"...
March 6, 2018: World Neurosurgery
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