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Pituitary insufficiency

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https://www.readbyqxmd.com/read/28204898/surgical-treatment-and-outcome-of-tsh-producing-pituitary-adenomas
#1
Roman Rotermund, Nina Riedel, Till Burkhardt, Jakob Matschke, Nils-Ole Schmidt, Jens Aberle, Jörg Flitsch
BACKGROUND: Thyrotropin-producing adenomas (TSHomas) account for approximately 1-2% of all pituitary tumors. Recently, there has been debate on primary treatment as some studies suggest a high rate of hypopituitarism after transsphenoidal surgery and therefore suggest primary use of somatostatin analogs (SSA) instead. We would like to challenge this assumption by presenting our single-center experience with transsphenoidal surgery for TSHoma. METHODS: Fifteen patients treated consecutively between May 2010 and December 2016 were analyzed for long-term postoperative remission and pituitary function...
February 15, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28202834/-a-case-of-lymphocytic-adenohypophysitis-presenting-visual-disturbance-in-the-third-trimester-of-pregnancy
#2
Ryo Yaoita, Miiko Ito, Kenichiro Matsuda, Yasuaki Kokubo, Shinya Sato, Yukihiko Sonoda
Lymphocytic hypophysitis(LH)has first been described as an autoimmune endocrinopathy by Goudie in 1962. In particular, lymphocytic adenohypophysitis(LAH)is usually associated with pregnancy and hypopituitarism due to insufficient endocrine of ACTH. However, several cases of LAH in pregnant patients showing only visual disturbances have recently been documented. We treated a patient with LAH presenting only the chiasma syndrome in the third trimester without hypopituitarism. A 27-year-old woman unexpectedly experienced visual disturbance starting in the 28th week of pregnancy...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28196880/agrp-to-kiss1-neuron-signaling-links-nutritional-state-and-fertility
#3
Stephanie L Padilla, Jian Qiu, Casey C Nestor, Chunguang Zhang, Arik W Smith, Benjamin B Whiddon, Oline K Rønnekleiv, Martin J Kelly, Richard D Palmiter
Mammalian reproductive function depends upon a neuroendocrine circuit that evokes the pulsatile release of gonadotropin hormones (luteinizing hormone and follicle-stimulating hormone) from the pituitary. This reproductive circuit is sensitive to metabolic perturbations. When challenged with starvation, insufficient energy reserves attenuate gonadotropin release, leading to infertility. The reproductive neuroendocrine circuit is well established, composed of two populations of kisspeptin-expressing neurons (located in the anteroventral periventricular hypothalamus, Kiss1(AVPV), and arcuate hypothalamus, Kiss1(ARH)), which drive the pulsatile activity of gonadotropin-releasing hormone (GnRH) neurons...
February 14, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28190613/therapeutics-for-equine-endocrine-disorders
#4
REVIEW
Andy E Durham
Equine endocrine disease is commonly encountered by equine practitioners. Pituitary pars intermedia dysfunction (PPID) and equine metabolic syndrome (EMS) predominate. The most logical therapeutic approach in PPID uses dopamine agonists; pergolide mesylate is the most common. Bromocryptine and cabergoline are alternative drugs with similar actions. Drugs from other classes have a poor evidence basis, although cyproheptadine and trilostane might be considered. EMS requires management changes as the primary approach; reasonable justification for use of drugs such as levothyroxine and metformin may apply...
February 9, 2017: Veterinary Clinics of North America. Equine Practice
https://www.readbyqxmd.com/read/28160246/hypogonadotropic-hypogonadism-in-males-with-glycogen-storage-disease-type-1
#5
Evelyn M Wong, Anna Lehman, Philip Acott, Jane Gillis, Daniel L Metzger, Sandra Sirrs
BACKGROUND: Glycogen storage disease type 1 is an autosomal recessive disorder with an incidence of 1 in 100,000. Long-term complications include chronic blood glucose lability, lactic academia, short stature, osteoporosis, delayed puberty, gout, progressive renal insufficiency, systemic or pulmonary hypertension, hepatic adenomas at risk for malignant transformation, anemia, vitamin D deficiency, hyperuricemic nephrocalcinosis, inflammatory bowel syndrome (type 1b), hypertriglyceridemia, and irregular menstrual cycles...
February 4, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28152431/blunted-cortisol-response-to-psychosocial-stress-in-atopic-patients-is-associated-with-decrease-in-salivary-alpha-amylase-and-aldosterone-focus-on-sex-and-menstrual-cycle-phase
#6
N Hlavacova, P Solarikova, M Marko, I Brezina, D Jezova
A decreased responsiveness of the hypothalamic-pituitary-adrenocortical axis to stress stimuli in patients with atopy is well documented. The aim of this study was to investigate personality traits, salivary alpha-amylase activity and the aldosterone response to psychosocial stress procedure based on public speech in atopic patients with respect to sex and the menstrual cycle (MC) phase. The study was performed in 106 subjects of both sexes, 53 atopic patients suffering from allergic rhinitis, allergic asthma or atopic dermatitis and 53 age-, sex-, the MC phase- and BMI- matched healthy controls...
January 16, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28129900/-atypical-and-rare-cardiac-revelation-about-sheehan-s-syndrome-a-report-of-three-cases
#7
N Bouznad, G El Mghari, M El Hattaoui, N El Ansari
Sheehan syndrome is a potentially serious complication in the postpartum period corresponding to ischemic necrosis of the anterior pituitary related to postpartum haemorrhage. We report three original observations showing an unusual mode of revelation of this syndrome. The first observation is that of a 46-year-old patient admitted initially to resuscitation for a recovered cardiorespiratory arrest, severe hypoglycemia and profound hyponatremia. The second is that of a 45-year-old patient, admitted for recurrent cardiac tamponade after pericardial and pleural puncture and pericardial drainage; clinical survey found signs of slight panhypopituitarism...
January 24, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28077499/dynamic-gnrh-and-hcg-testing-establishment-of-new-diagnostic-reference-levels
#8
A Kirstine Bang, Loa Nordkap, Kristian Almstrup, Lærke Priskorn, Jørgen Holm Petersen, Ewa Rajpert-De Meyts, Anna-Maria Andersson, Anders Juul, Niels Jørgensen
OBJECTIVE: Gonadotropin-releasing hormone (GnRH) and human chorionic gonadotropin (hCG) stimulation tests may be used to evaluate the pituitary and testicular capacity. Our aim was to evaluate changes in follicular-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone after GnRH and hCG stimulation in healthy men and assess the impact of six single nucleotide polymorphisms on the responses. DESIGN: GnRH and hCG stimulation tests were performed on 77 healthy men, 18-40 years (reference group) at a specialized andrology referral center at a university hospital...
April 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28067604/central-hypogonadism-due-to-a-giant-silent-fsh-secreting-atypical-pituitary-adenoma-effects-of-adenoma-dissection-and-short-term-leydig-cell-stimulation-by-luteinizing-hormone-lh-and-human-chorionic-gonadotropin-hcg
#9
Daniele Santi, Giorgia Spaggiari, Livio Casarini, Flaminia Fanelli, Marco Mezzullo, Uberto Pagotto, Antonio R M Granata, Cesare Carani, Manuela Simoni
We present a case report of an atypical giant pituitary adenoma secreting follicle-stimulating hormone (FSH). A 55-year-old patient presented for erectile dysfunction, loss of libido and fatigue. The biochemical evaluation showed very high FSH serum levels in the presence of central hypogonadism. Neither testicular enlargement nor increased sperm count was observed, thus a secretion of FSH with reduced biological activity was supposed. The histological examination after neuro-surgery showed an atypical pituitary adenoma with FSH-positive cells...
January 9, 2017: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
https://www.readbyqxmd.com/read/28029028/the-recovery-of-hypothalamic-pituitary-adrenal-axis-is-rapid-in-subclinical-cushing-syndrome
#10
Hee Kyung Kim, Jee Hee Yoon, Yun Ah Jeong, Ho Cheol Kang
BACKGROUND: In subclinical Cushing syndrome (SC), it is assumed that glucocorticoid production is insufficient to cause a clinically recognizable syndrome. Differences in hormonal levels or recovery time of the hypothalamic-pituitary-adrenocortical (HPA) axis after adrenalectomy between patients with overt Cushing syndrome (OC) and SC remain unknown. METHODS: Thirty-six patients (10 with OC and 26 with SC) with adrenal Cushing syndrome who underwent adrenalectomy from 2004 to 2014 were reviewed retrospectively...
December 2016: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28024972/efficacy-and-complications-of-endoscopic-skull-base-surgery-for-giant-pituitary-adenomas
#11
Shigetoshi Yano, Takuichiro Hide, Naoki Shinojima
OBJECTIVE: Treatment of giant pituitary adenomas is challenging. Endoscopic endonasal skull base surgery (EES) was estimated the surgical results and complication for giant pituitary adenomas. METHODS: Thirty-four pituitary adenomas larger than 40 mm treated by EES between 2002 and 2015 were studied. Removal rates, symptoms, and complications were analyzed by direction of tumor extension. RESULTS: Average tumor size was 45.5 mm. Near-total resection (NTR) was achieved in 16 of 34 (47...
December 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28018694/anterior-hypopituitarism-and-treatment-response-in-hunter-syndrome-a-comparison-of-two-patients
#12
Munier A Nour, Paola Luca, David Stephure, Xing-Chang Wei, Aneal Khan
Hypopituitarism is a clinically important diagnosis and has not previously been reported in Hunter syndrome. We contrast two cases with anatomic pituitary anomalies: one with anterior panhypopituitarism and the other with intact pituitary function. Patient 1, a 10-year-old boy with Hunter syndrome, was evaluated for poor growth and an ectopic posterior pituitary gland. Endocrine testing revealed growth hormone (GH) deficiency, secondary adrenal insufficiency, and tertiary hypothyroidism. An improvement in growth velocity with hormone replacement (GH, thyroxine, and corticosteroid) was seen; however, final adult height remained compromised...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28018463/concomitant-occurrence-of-turner-syndrome-and-growth-hormone-deficiency
#13
Jung Yu, Ha Young Shin, Chong Guk Lee, Jae Hyun Kim
Turner syndrome (TS) is a genetic disorder in phenotypic females that has characteristic physical features and presents as partial or complete absence of the second sex chromosome. Growth hormone deficiency (GHD) is a condition caused by insufficient release of growth hormone from the pituitary gland. The concomitant occurrence of TS and GHD is rare and has not yet been reported in Korea. Here we report 2 cases of TS and GHD. In case 1, GHD was initially diagnosed. Karyotyping was performed because of the presence of the typical phenotype and poor response to growth hormone therapy, which revealed 45,X/45,X+mar...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28013434/the-effect-of-local-injection-of-methylprednisolone-acetate-on-the-hypothalamic-pituitary-adrenal-axis-among-patients-with-greater-trochanteric-pain-syndrome
#14
George Habib, Shada Elias, Muhanned Abu-Elhaija, Fahed Sakas, Fadi Khazin, Suheil Artul, Adel Jabbour, Haneen Jabaly-Habib
Greater trochanteric pain syndrome (GTPS) is a common clinical entity for which the most effective treatment is local corticosteroid injection (LCI). There are no studies on the effect of LCI among patients with GTPS on the hypothalamic-pituitary-adrenal axis. The present study recruited nonselected patients diagnosed with GTPS. After consenting, participants received low dose (1 μg) of adrenocorticotropin hormone (ACTH) stimulation test at 09:00. Immediately following the test, participants received a LCI of 80 mg of methylprednisolone acetate at the greater trochanteric region...
December 24, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27932596/infantile-lhermitte-duclos-disease-treated-successfully-with-rapamycin
#15
Megan Zak, Mark Ledbetter, Paul Maertens
Lhermitte-Duclos disease is a rare hamartomatous tumor of the cerebellum resulting from a mutation in the phosphatase and tensin homolog (PTEN) gene: it has been reported in fewer than 10 infants. Rapamycin treatment has not yet been described in Lhermitte-Duclos disease. The infant underwent shunt placement shortly after birth for aqueductal stenosis. Her clinical progression included failure to thrive, seizures, episodes of decerebrate posturing, loss of respiratory drive, and pituitary insufficiency from mass effect...
December 8, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27907849/association-between-dehydroepiandrosterone-sulfate-and-attention-in-long-term-survivors-of-childhood-acute-lymphoblastic-leukemia-treated-with-only-chemotherapy
#16
Yin Ting Cheung, Wassim Chemaitilly, Daniel A Mulrooney, Tara M Brinkman, Wei Liu, Pia Banerjee, Deokumar Srivastava, Ching-Hon Pui, Leslie L Robison, Melissa M Hudson, Kevin R Krull
Long-term survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for neurocognitive impairment, as well as compromised hypothalamic-pituitary-adrenal (HPA) function. Dehydroepiandrosterone-sulfate (DHEAS) is an adrenal androgen commonly used as a marker of HPA function. In the general population, a low level of DHEAS has been associated with poorer cognition. At ≥2years post-treatment, we examined the association of DHEAS with attention outcomes in 35 male and 34 female long-term survivors of childhood ALL (mean[standard deviation] age at evaluation 14...
February 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/27869423/-progressive-moderate-mitral-regurgitation-in-a-children-with-axenfeld-rieger-syndrome-the-importance-of-cardiologic-follow-up
#17
Francisco Sánchez Ferrer, María D Grima Murcia
Axenfeld-Rieger syndrome is a congenital disease with an estimated prevalence of one in 200,000 individuals. This is an ophthalmic disorder related to anterior segment dysgenesis, which may be present from the neonatal period. It is associated with extraocular affectations such as cranial dimorphism, maxillofacial or dental anomalies. Cardiological or pituitary manifestations are less common. The congenital heart disease in Axenfeld-Rieger syndrome has been described in very few cases in the literature. We report a 7-year-old patient with Axenfeld-Rieger syndrome and mild mitral insufficiency since the age of 3 years, which is progressing to moderate mitral regurgitation at the present time...
December 1, 2016: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/27821225/understanding-oral-stereotypies-in-calves-alternative-strategies-hypothalamic-pituitary-adrenal-axis-re-activity-and-gene-by-environment-interactions
#18
L E Webb, C G van Reenen, B Engel, H Berends, W J J Gerrits, E A M Bokkers
Stereotypies are used as indicators of poor animal welfare and it is, therefore, important to understand underlying factors mediating their development. In calves, two oral stereotypies, that is, tongue playing and object manipulation, result mostly from insufficient structure in the diet. Three hypotheses were studied: (1) oral stereotypies in calves are one of two alternative strategies, the alternative being hypo-activity; (2) stereotyping and non-stereotyping calves differ in terms of cortisol secretion; (3) oral stereotypy development in calves rests on a gene by environment interaction...
November 8, 2016: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/27803964/adrenal-crisis-while-on-high-dose-steroid-treatment-what-rheumatologist-should-consider
#19
REVIEW
Döndü Üsküdar Cansu, Güven Barış Cansu, Deniz Arik, Cengiz Korkmaz
Steroid treatment is commonly recommended for autoimmune disorders in rheumatology practice. While adrenal crisis may occur upon existence of an inducing factor in patients with known or unknown adrenal insufficiency as well as in those with a suppressed hypothalamic-pituitary-adrenal (HPA) axis due to chronic steroid use, addisonian crisis rarely develops in patients on supraphysiological doses of steroid and, when emerged, it might be very difficult to recognize. Here, we present a patient who developed adrenal crisis while receiving high-dose methylprednisolone treatment due to retroperitoneal fibrosis and we also discuss possible mechanisms with a brief literature review...
November 1, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27795552/efficacy-and-safety-of-bariatric-surgery-for-craniopharyngioma-related-hypothalamic-obesity-a-matched-case-control-study-with-2-years-of-follow-up
#20
M Wijnen, D S Olsson, M M van den Heuvel-Eibrink, V Wallenius, J A M J L Janssen, P J D Delhanty, A J van der Lely, G Johannsson, S J C M M Neggers
BACKGROUND: Hypothalamic obesity is a devastating consequence of craniopharyngioma. Bariatric surgery could be a promising therapeutic option. However, its efficacy and safety in patients with craniopharyngioma-related hypothalamic obesity remain largely unknown. OBJECTIVES: We investigated the efficacy of bariatric surgery for inducing weight loss in patients with craniopharyngioma-related hypothalamic obesity. In addition, we studied the safety of bariatric surgery regarding its effects on hormone replacement therapy for pituitary insufficiency...
November 22, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
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