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Acromegaly

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https://www.readbyqxmd.com/read/29043561/clinical-profile-of-silent-growth-hormone-pituitary-adenomas-higher-recurrence-rate-compared-to-silent-gonadotroph-pituitary-tumors-a-large-single-center-experience
#1
Fabienne Langlois, Dawn Shao Ting Lim, Elena Varlamov, Chris G Yedinak, Justin S Cetas, Shirley McCartney, Aclan Dogan, Maria Fleseriu
PURPOSE: Study and comparison of characteristics of silent growth hormone adenomas (SGHA), silent corticotroph adenomas (SCA), and silent gonadotroph adenomas (SGA) in a single institution cohort of surgically treated pituitary adenomas. METHODS: Retrospective analysis of SGHA surgically resected over 10 years: SGHA was defined as no clinical or biochemical evidence of acromegaly and positive GH immunostaining. RESULTS: Of 814 pituitary surgeries; 2...
October 17, 2017: Endocrine
https://www.readbyqxmd.com/read/29027568/-diagnostics-and-treatment-of-acromegaly-necessity-for-targeted-monitoring-of-comorbidities
#2
S Petersenn, M Christ-Crain, M Droste, R Finke, J Flitsch, I Kreitschmann-Andermahr, A Luger, J Schopohl, G Stalla
Acromegaly is a rare and severe condition, presenting with typical signs and symptoms. The diagnosis is often initially made years after the first manifestations of the disease. In more than 99% of patients the disease is caused by a benign pituitary tumor that secretes growth hormone (GH). The diagnosis is based on the presence of increased insulin-like growth factor 1 (IGF-1) levels and a lack of GH suppression in the oral glucose tolerance test. The standard imaging procedure for tumor detection is magnetic resonance imaging in the region of the sella turcica...
October 13, 2017: Der Internist
https://www.readbyqxmd.com/read/29022641/-familial-isolated-pituitary-adenomas-fipa-case-report-of-four-families-and-review-of-literature
#3
Joanna Elżbieta Malicka, Joanna Świrska, Maria Kurowska, Marta Dudzińska, Jerzy S Tarach
BackgroundThe majority of pituitary adenomas are sporadic, but about 5% of them occur in a familial setting, predominantly in multiple endocrine neoplasia type 1 and Carney complex. Familial isolated pituitary adenomas (FIPA), unrelated to the syndromes mentioned above, were also described. The clinical course of FIPA differs significantly from sporadic cases, and is characterized by a larger tumor size, more aggressive course and younger patients' age at the moment of recognition. ObjectivesThe aim of this retrospective study is to present 4 families in which two closely related people were diagnosed with pituitary adenomas...
October 12, 2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/29022276/diagnosis-and-treatment-of-tsh-secreting-adenomas-review-of-a-longtime-experience-in-a-reference-center
#4
D M Nazato, J Abucham
PURPOSE: TSH-secreting pituitary adenomas are among the less prevalent pituitary tumors, corresponding to 0.9-1.5% of all pituitary adenomas in surgical series. METHODS: A series of 11 patients with TSH-secreting and cosecreting adenomas diagnosed and treated in the last 25 years in a single center is described. RESULTS: The mean age at diagnosis was 37 years (range 18-80 years; median 23 years); the ratio of male-to-female patients was similar (6M:5F)...
October 11, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28993415/targeting-either-gh-or-igf-i-during-somatostatin-analogue-treatment-in-patients-with-acromegaly-a-randomized-multicentre-study
#5
Jakob Dal, Marianne Klose, Ansgar Heck, Marianne Skovsager Andersen, Caroline Kistorp, Eigil H Nielsen, Jens Bollerslev, Ulla Feldt-Rasmussen, Jens Otto L Jorgensen
CONTEXT: Discordant GH and IGF-I values are frequent in acromegaly. The clinical significance and its dependence on treatment modality and of glucose-suppressed GH (GHnadir) measurements remain uncertain. OBJECTIVE: To evaluate the effects of targeting either IGF-I or GH during somatostatin analog (SA) treatment. PATIENTS AND METHODS: 84 patients with controlled acromegaly after surgery (n=23) or SA (n=61) underwent a GH-profile including an OGTT, at baseline and after 12 months...
October 9, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28992711/-treatment-of-pituitary-adenomas
#6
Jana Ježková, Josef Marek, Manuela Vaněčková
Pituitary adenomas are the most common tumours of the sellar region. A combination of neurosurgery, radiation and pharmacological approaches are applied for the treatment of pituitary adenomas. In certain cases, patient observation is another option. Neurosurgery is the first-choice treatment for acromegaly, Cushing´s disease and TSH secreting adenomas. Leksell gamma knife irradiation is used in the treatment of tumour residues. Until the effect of the irradiation is evident, pharmacological treatment must be administered...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28990677/left-ventricular-twist-is-impaired-in-acromegaly-insights-from-the-three-dimensional-speckle-tracking-echocardiographic-magyar-path-study
#7
Árpád Kormányos, Péter Domsik, Anita Kalapos, Andrea Orosz, Csaba Lengyel, Zsuzsanna Valkusz, Attila Trencsányi, Tamás Forster, Attila Nemes
INTRODUCTION: Acromegaly is a rare, chronic, disfiguring, and debilitating disease caused, in 90% of cases, by a benign monoclonal growth hormone-secreting pituitary adenoma. The present study aimed to assess left ventricular (LV) rotational and twist mechanics in acromegalic patients and to compare their results to age- and gender-matched healthy controls. METHODS: The present study comprised 24 acromegalic patients, from which 4 were excluded due to insufficient image quality (mean age: 57...
October 9, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28977166/long-term-follow-up-of-patients-with-elevated-igf-1-and-nadir-gh-0-4-%C3%A2%C2%B5g-l-but-1-%C3%A2%C2%B5g-l
#8
Pedro Weslley Rosario, Maria Regina Calsolari
OBJECTIVE: To report the results of initial investigation and after 5 years of patients with a suspicious clinical scenario for acromegaly, elevated IGF-1, and nadir GH during an oral glucose tolerance test (OGTT) > 0.4 µg/L but < 1 µg/L. SUBJECTS AND METHODS: Seventeen patients who had elevated IGF-1 (outside puberty and pregnancy) in two measurements and GH between 0.4 and 1 µg/L during OGTT were selected. RESULTS: During initial assessment, only one patient had microadenoma on magnetic resonance imaging (MRI) of the pituitary...
September 18, 2017: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28973408/fatal-carney-complex-in-siblings-due-to-de-novo-large-gene-deletion
#9
Maria Stelmachowska-Banas, Wojciech Zgliczynski, Piotr Tutka, J Aidan Carney, Márta Korbonits
Context: Carney complex (CNC) is a rare multiple neoplasia syndrome involving cardiac, endocrine, neural and cutaneous tumours and a variety of pigmented skin lesions. CNC can be inherited as an autosomal dominant trait, but in about one third of patients the disease is caused by de novo mutation in the PRKAR1A gene localized on chromosome 17q22-24. Most of the mutations include single base substitutions and small deletions/insertions not exceeding 15 base pairs. Recently, large germline PRKAR1A deletions have been described and may cause a more severe phenotype...
July 26, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28963390/acromegaly-with-hypophosphataemia-mccune-albright-syndrome
#10
Rimesh Pal, Pinaki Dutta, Kanchan Kumar Mukherjee, Anil Bhansali
A 38-year-old man presented with excessive height gain and progressive enlargement of the extremities since childhood. This was compounded by lower limb deformities over the past 5 years. On examination, his height was 196 cm, he had macroglossia, acral enlargement, seborrhoea, hyperhidrosis-suggesting acrogigantism. He had facial asymmetry, wind-swept deformity of lower limbs and a café-au-lait macule over his trunk. Investigations revealed normal-sized pituitary gland with dysplastic cranial bones. Isotope bone scintigraphy was suggestive of polyostotic fibrous dysplasia...
September 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28961022/an-unusual-pituitary-adenoma-coexistent-with-bilateral-meningiomas-case-report
#11
Ashwin Kumaria, Ian S Scott, Iain J Robertson
The association of pituitary adenomas and meningioma is rare. We present the case of a 46 year old lady who initially presented with large bilateral meningiomas and acromegaly. Histology demonstrated mammosomatotroph cell adenoma co-expressing Growth Hormone. This appears to be the first description of mammosomatotroph cell adenoma associated with meningiomas in the literature.
September 29, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28951345/diabetic-ketoacidosis-in-acromegaly-a-rare-complication-precipitated-by-corticosteroid-use
#12
REVIEW
Jeremy Weiss, Anna J Wood, Jeffrey D Zajac, Mathis Grossmann, Sofianos Andrikopoulos, Elif I Ekinci
Diabetic ketoacidosis has been described in the literature as a rare possible initial presentation of acromegaly before a diagnosis of acromegaly is eventually made. Indeed, diabetic ketoacidosis is a recognised complication of acromegaly. There are a number of factors that can predispose patients with acromegaly to diabetes as well as to diabetic ketoacidosis. These include high levels of growth hormone and insulin-like growth factor 1 in acromegaly and the effect on glycaemia by medications used in the management of acromegaly...
September 19, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28945897/body-composition-and-ectopic-lipid-changes-with-biochemical-control-of-acromegaly
#13
Miriam A Bredella, Melanie Schorr, Laura E Dichtel, Anu V Gerweck, Brian J Young, Whitney W Woodmansee, Brooke Swearingen, Karen K Miller
Context: Acromegaly is characterized by GH and IGF-1 hypersecretion, and GH and IGF-1 play important roles in regulating body composition and glucose homeostasis. Objective: The purpose of our study was to investigate body composition, including ectopic lipids, measures of glucose homeostasis, and gonadal steroids in patients with active acromegaly compared to age-, BMI-, and sex-matched controls and to determine changes in those parameters following biochemical control of acromegaly...
September 18, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28944744/progress-in-the-formulation-and-delivery-of-somatostatin-analogs-for-acromegaly
#14
Sarinj Fattah, David J Brayden
A 14 amino acid cystin bridge containing neuropeptide was discovered in 1973 and designated as growth hormone-inhibiting hormone, in other words, somatostatin. Its discovery led to the synthesis of three analogs which were licensed for the treatment of acromegaly: octreotide, lanreotide and pasireotide. Somatostatin analogs are currently approved only as either subcutaneous or intramuscular long-acting injections. We examine the challenges that must be overcome to create oral formulations of somatostatin analogs and examine selected clinical trial data...
October 2017: Therapeutic Delivery
https://www.readbyqxmd.com/read/28943223/-the-mouth-of-patients-with-acromegaly
#15
REVIEW
Christine Cortet-Rudelli
Orofacial changes are frequent in acromegaly. Their evolution is slowly progressive. The lips (everted and thickened), the mandibular morphology (prognathism), the tongue (macroglossia), the soft palate and the uvula (increased and thickened), the parodontis (gingival hyperplasia, paradontitis), the teeth (increased interdental spaces, hypercementosis, increased dental mobility, multiple tooth loss) are concerned. Functional consequences are significant (obstructive sleep apnea syndrome, malocclusion, pain of the oral maxillofacial area, decrease of the quality of life)...
September 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28936751/guidelines-versus-real-life-practice-the-case-of-colonoscopy-in-acromegaly
#16
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/28931779/the-efficacy-of-medical-treatment-in-patients-with-acromegaly-in-clinical-practice
#17
Seo Young Lee, Jung Hee Kim, Ji Hyun Lee, Yong Hwy Kim, Hyang Jin Cha, Sang Wan Kim, Sun Ha Paek, Chan Soo Shin
Although somatostatin analogues (SSAs) are recommended as the first-line medical therapy for acromegaly, dopamine agonists (DAs) are also a therapeutic option for treatment. We aimed to assess and compare the efficacies of DAs and SSAs in treating acromegaly in clinical practice. We included 89 patients with acromegaly who took DAs (bromocriptine [BCT], n = 63; cabergoline [CAB], n = 11) or SSAs (n = 15) as a primary medical therapy for more than 3 months in the Seoul National University Hospital. The CAB (45...
September 20, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28931175/fibroblast-growth-factor-21-in-patients-with-acromegaly
#18
Jowita Halupczok-Żyła, Aleksandra Jawiarczyk-Przybyłowska, Marek Skrzypski, Mathias Z Strowski, Marek Bolanowski
Introduction The goal of the study was to investigate fibroblast growth factor-21 (FGF-21) levels in acromegalic patients in relation to the disease activity and to compare them with controls. Further, we aimed to evaluate the associations between FGF-21 and random growth hormone (GH), insulin-like growth factor-1 (IGF-1), metabolic and anthropometric parameters. Materials and methods The study group consisted of 50 acromegalic patients divided into 3 subgroups on the basis of disease activity (AA - active acromegaly, CD - controlled disease, CA - cured acromegaly)...
September 20, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28913667/microsurgical-versus-endoscopic-transsphenoidal-resection-for-acromegaly-a-systematic-review-of-outcomes-and-complications
#19
REVIEW
Ching-Jen Chen, Natasha Ironside, I Jonathan Pomeraniec, Srinivas Chivukula, Thomas J Buell, Dale Ding, Davis G Taylor, Robert F Dallapiazza, Cheng-Chia Lee, Marvin Bergsneider
PURPOSE: The aim of this systematic review is to evaluate the long-term endocrine outcomes and postoperative complications following endoscopic vs. microscopic transsphenoidal resection (TSR) for the treatment of acromegaly. METHODS: A literature review was performed, and studies with at least five patients who underwent TSR for acromegaly, reporting biochemical remission criteria and long-term remission outcomes were included. Data extracted from each study included surgical technique, perioperative complications, biochemical remission criteria, and long-term remission outcomes...
September 14, 2017: Acta Neurochirurgica
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
#20
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
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