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Pituitary disease

Donato Iacovazzo, Márta Korbonits
X-linked acrogigantism (XLAG) is a recently identified condition of early-onset GH excess resulting from the germline or somatic duplication of the GPR101 gene on chromosome Xq26.3. Thirty patients have been formally reported so far. The disease affects mostly females, occurs usually sporadically, and is characterised by early onset and marked overgrowth. Most patients present with concomitant hyperprolactinaemia. Histopathology shows pituitary hyperplasia or pituitary adenoma with or without associated hyperplasia...
September 29, 2016: Growth Hormone & IGF Research
Francisca Caimari, Márta Korbonits
Recently, a number of novel genetic alterations have been identified that predispose individuals to pituitary adenomas. Clinically relevant pituitary adenomas are relatively common, present in 0.1% of the general population. They are mostly benign monoclonal neoplasms that arise from any of the five hormone-secreting cell types of the anterior lobe of the pituitary gland, and cause disease due to hormonal alterations and local space-occupying effects. The pathomechanism of pituitary adenomas includes alterations in cell-cycle regulation and growth factor signaling, which are mostly due to epigenetic changes; somatic and especially germline mutations occur more rarely...
October 15, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Andrea B Schote, Martina Bonenberger, Haukur Pálmason, Christiane Seitz, Jobst Meyer, Christine M Freitag
Stress results in a variety of neuroendocrine, immune and behavioral responses and represents a risk factor for many disorders. Following exposure to stress, glucocorticoids are secreted from the adrenal cortex and act via the ligand-activated glucocorticoid receptor (GR). Several polymorphisms of the GR-encoding gene NR3C1 have been described and functionally investigated. However, the impact of these variants on complex diseases such as Attention-Deficit/Hyperactivity Disorder (ADHD) is still unclear. In this study, 251 children with ADHD, 19 affected and 35 unaffected siblings, and their parents were included in a family-based association study assessing seven common variants of NR3C1 (TthIIII_rs10052957; NR3C1-I_rs10482605; ER22/23EK_rs6189/rs6190; N363S_rs56149945; BclI_rs41423247; GR-9beta_rs6198)...
October 2, 2016: Psychiatry Research
Robert Fenstermaker, Ajay Abad
PURPOSE OF REVIEW: This article reviews sellar and parasellar anatomy and the appearance of normal bone and soft tissue components on both CT and MRI. Pituitary gland structure and function are discussed with respect to hormone secretion, along with clinical syndromes caused by perturbations in hormone levels. Syndromes and specific diseases in the sellar and parasellar regions are discussed along with characteristic clinical features and imaging findings. RECENT FINDINGS: Bone and calcifications are best visualized with CT scans, while soft tissues are better defined using MRI...
October 2016: Continuum: Lifelong Learning in Neurology
Koji Hori, Kimiko Konishi, Misa Hosoi, Hiroi Tomioka, Masayuki Tani, Yuka Kitajima, Mitsugu Hachisu
Given the relationship between anticholinergic activity (AA) and Alzheimer's disease (AD), we rereview our hypothesis of the endogenous appearance of AA in AD. Briefly, because acetylcholine (ACh) regulates not only cognitive function but also the inflammatory system, when ACh downregulation reaches a critical level, inflammation increases, triggering the appearance of cytokines with AA. Moreover, based on a case report of a patient with mild AD and slightly deteriorated ACh, we also speculate that AA can appear endogenously in Lewy body disease due to the dual action of the downregulation of ACh and hyperactivity of the hypothalamic-pituitary-adrenal axis...
2016: Parkinson's Disease
Karolína Drbalová, Kateřina Herdová, Petr Krejčí, Monika Nývltová, Svatopluk Solař, Lenka Vedralová, Pavel Záruba, David Netuka, Petr Bavor
Multiple Endocrine Neoplasia (MEN) is a condition in which several endocrine organs of an individual are affected by adenoma, hyperplasia and less often carcinoma, either simultaneously or at different stages of life. Two existing syndromes, MEN1 and MEN2 (2A, 2B), in literature is also mentioned MEN4, are associated also with other non-endocrine disorders. MEN1 (Wermer syndrome) affects the pituitary, parathyroid, and pancreatic area. 95 % of patients show very early manifestation of hyperparathyroidism, often before 40 years of age...
2016: Vnitr̆ní Lékar̆ství
Chiara Diazzi, Giulia Brigante, Giulia Ferrannini, Anna Ansaloni, Lucia Zirilli, Maria Cristina De Santis, Stefano Zona, Giovanni Guaraldi, Vincenzo Rochira
Biochemical growth hormone deficiency is prevalent among human immunodeficiency virus-infected patients, but if this condition is clinically relevant remains challenging. The aim is to prospectively compare the growth hormone deficiency/insulin-like growth factor-1 status of 71 human immunodeficiency virus-infected patients with impaired growth hormone response to growth hormone releasing hormone + Arginine with that of 65 hypopituitary patients affected by a true growth hormone deficiency secondary to pituitary disease...
October 11, 2016: Endocrine
Teresa A Burns
Endocrine diseases, such as equine metabolic syndrome and pituitary pars intermedia dysfunction, are common in domesticated horse populations, and the frequency with which these diseases are encountered and managed by equine veterinary practitioners is expected to increase as the population ages. As clinicians learn more about the effects of these diseases on equine reproductive physiology and efficiency (including effects on reproductive seasonality, ovulation efficiency, implantation, early pregnancy loss, duration of pregnancy, and lactation), strategies and guidelines for improving fertility in affected animals continue to evolve...
October 8, 2016: Veterinary Clinics of North America. Equine Practice
Rafael Carvalho Torres, Nathalia Santos Magalhães, Patrícia M R E Silva, Marco A Martins, Vinicius F Carvalho
Increased hypothalamus-pituitary-adrenal axis (HPA) activity in diabetes is strongly associated with several morbidities noted in patients with the disease. We previously demonstrated that hyperactivity of HPA axis under diabetic conditions is associated with up-regulation of adrenocorticotrophic hormone (ACTH) receptors (MC2R) in adrenal and down-regulation of glucocorticoid receptors (GR and MR) in pituitary. This study investigates the role of peroxisome proliferator-activated receptor (PPAR)-γ in HPA axis hyperactivity in diabetic rats...
October 8, 2016: Experimental and Molecular Pathology
Jeroen Melief, Jan W Koper, Erik Endert, Holger J Møller, Jörg Hamann, Bernard M Uitdehaag, Inge Huitinga
As high cortisol levels are implicated in suppressed disease activity of multiple sclerosis (MS), glucocorticoid receptor (GR) polymorphisms that affect glucocorticoid (GC) sensitivity may impact on this by changing local immunomodulation or regulation of the hypothalamus-pituitary-adrenal (HPA)-axis. In this post-mortem study, we investigated whether GR haplotypes affect MS disease course and production of cortisol and soluble CD163 (sCD163), a molecule induced by GC on microglia/macrophages. We found that GR haplotypes that confer high GC sensitivity are associated with more aggressive MS but do not affect levels of cortisol secreted by the HPA-axis or shedding of CD163...
October 15, 2016: Journal of Neuroimmunology
Thierry Brue, Frederic Castinetti
Secreting pituitary adenomas that cause acromegaly and Cushing's disease, as well as prolactinomas and thyrotroph adenomas, are uncommon, usually benign, slow-growing tumours. The rarity of these conditions means that their diagnosis is not familiar to most non-specialist physicians. Consequently, pituitary adenomas may be overlooked and remain untreated, and affected individuals may develop serious comorbidities that reduce their quality of life and life expectancy. Because many signs and symptoms of pituitary adenomas overlap with those of other, more common disorders, general practitioners and non-endocrinology specialists need to be aware of the "red flags" suggestive of these conditions...
October 6, 2016: Orphanet Journal of Rare Diseases
Ryuya Yamanaka, Azusa Hayano, Tomohiko Kanayama
By conducting a systemic search of the PubMed database, we performed a comprehensive literature review to characterize secondary gliomas following radiotherapy treatment and to determine the most appropriate treatment strategy. Our analysis included 296 cases of radiation-induced gliomas. The primary lesion was characterized as a hematological malignancy in 104 cases (35.1 %), pituitary adenoma in 35 (11.8 %), craniopharyngioma in 19 (6.4 %), medulloblastoma in 38 (12.8 %), germ cell tumor in 13 (4.3 %), low-grade glioma in 28 (9...
October 5, 2016: Neurosurgical Review
Laura E Dichtel, Melanie Schorr, Corey M Gill, Konstantinos P Economopoulos, Anu V Gerweck, Brooke Swearingen, Richard Hodin, Miriam A Bredella, Karen K Miller
Hypercortisolemia is associated with abdominal adiposity. Prior studies have quantified visceral adipose tissue (VAT) versus subcutaneous adipose tissue (SAT) accumulation as assessed by CT and MRI in patients with pituitary Cushing's disease (1-3) but not of other etiologies. Hormone differences in women with Cushing's syndrome due to pituitary versus adrenal and iatrogenic etiologies, including differences in DHEA production, may affect body composition. This article is protected by copyright. All rights reserved...
October 3, 2016: Clinical Endocrinology
Lu Gao, Xiaopeng Guo, Rui Tian, Qiang Wang, Ming Feng, Xinjie Bao, Kan Deng, Yong Yao, Wei Lian, Renzhi Wang, Bing Xing
PURPOSE: Pituitary abscess (PA) is rare and commonly described in case reports or small case series. This study aimed to better determine salient clinical manifestations related to the diagnosis and appropriate treatment of PA using by far the largest case series of this disease. METHODS: A total of 6361 consecutive patients underwent surgery for pituitary diseases in Peking Union Medical College Hospital between January 1991 and December 2013. Among this cohort, sixty-six patients were diagnosed with PA based on both intraoperative findings and postoperative histopathological evidence...
September 30, 2016: Pituitary
Renzhi Wang, Yakun Yang, Miaomiao Sheng, Dechao Bu, Fengming Huang, Xiaohai Liu, Cuiqi Zhou, Congxin Dai, Bowen Sun, Jindong Zhu, Yi Qiao, Yong Yao, Huijuan Zhu, Lin Lu, Hui Pan, Ming Feng, Kan Deng, Bing Xing, Wei Lian, Yi Zhao, Chengyu Jiang
Adrenocorticotrophin (ACTH)-secreting pituitary adenoma, also known as Cushing disease (CD), is rare and causes metabolic syndrome, cardiovascular disease and osteoporosis due to hypercortisolism. However, the molecular pathogenesis of CD is still unclear because of a lack of human cell lines and animal models. Here, we study 106 clinical characteristics and gene expression changes from 118 patients, the largest cohort of CD in a single-center. RNA deep sequencing is used to examine genotypic changes in nine paired female ACTH-secreting pituitary adenomas and adjacent nontumorous pituitary tissues (ANPT)...
September 29, 2016: International Journal of Molecular Sciences
Claire Greenhill
No abstract text is available yet for this article.
September 30, 2016: Nature Reviews. Endocrinology
Marco Losa, Giorgio Spatola, Luigi Albano, Alessandra Gandolfi, Antonella Del Vecchio, Angelo Bolognesi, Pietro Mortini
Gamma Knife radiosurgery is often used in pituitary adenomas. Aim of our study is to describe the characteristics and long-term outcome of patients with adenoma recurrence after Gamma Knife radiosurgery. We conducted a retrospective analysis of patients with pituitary adenoma treated by Gamma Knife radiosurgery between 1994 and 2014. Tumor recurrence was labeled as "in field" when the tumor growth occurred adjacent or within the prescribed isodose, whereas it was classified as "out of field" when the tumor growth occurred outside the prescribed isodose...
September 29, 2016: Endocrine
Dimitrios Kaldrymidis, Georgios Papadakis, Georgios Tsakonas, Philippos Kaldrymidis, Theofanis Flaskas, Andreas Seretis, Eleni Pantazi, Ifigenia Kostoglou-Athanassiou, Melpomeni Peppa, Paraskevi Roussou, Evanthia Diamanti-Kandarakis
PURPOSE: Several studies have suggested that patients with acromegaly have an increased risk of thyroid, colorectal, breast and prostate cancers. In this study we determined the prevalence of malignant neoplasms in patients with acromegaly. METHODS: Cancer risk was evaluated in a cohort of 110 patients (M/F 48/62, age 58.63±13.8 years, range 30-86) with acromegaly. Mean age at diagnosis of acromegaly was 46.37±13.11 years. Mean period of time since diagnosis of acromegaly was 12...
July 2016: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Diane Donegan, John L D Atkinson, Mark Jentoft, Neena Natt, Tod B Nippoldt, Bradley Erickson, Fredric Meyer, Dana Erickson
OBJECT: Prolactinomas are primarily treated with medical therapy. Given the efficacy of Dopamine agonists (DA), surgery has remained a second line treatment option. Despite medical therapy, some tumors display resistance and or patients maybe intolerant of DA requiring alternative treatment options. We examined the indications, efficacy and safety of pituitary surgery for the treatment of prolactinomas. METHODS: We performed a retrospective analysis of all patients who had surgery for a prolactinoma at our institution from January 1993 to October 2014...
September 28, 2016: Endocrine Practice
Galina Yordanova, Lee Martin, Farhad Afshar, Ian Sabin, Ghassan Alusi, Nicholas P Plowman, Fiona Riddoch, Jane Evanson, Matthew Matson, Ashley B Grossman, Scott A Akker, John P Monson, William M Drake, Martin O Savage, Helen L Storr
PURPOSE: Pediatric Cushing's disease (CD) is rare and there are limited data on the long-term outcomes. We assessed CD recurrence, body composition, pituitary function and psychiatric comorbidity in a cohort of pediatric CD patients. METHODS: Retrospective review of 21 CD patients, mean age at diagnosis 12.1 years (5.7-17.8), managed in our center between 1986 and 2010. Mean follow-up from definitive treatment was 10.6 years (2.9-27.2). RESULTS: Fifteen patients were in remission following transsphenoidal surgery (TSS) and 5 were in remission following TSS + external pituitary radiotherapy (RT)...
September 27, 2016: Pituitary
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