Increased frequency of cataract surgery in patients over age 50 with pituitary macroadenomas and chiasmal compression
ConclusionsWe reported a high prevalence of cataract surgery in patients over age 50 in patients with pituitary macroadenomas compressing the optic pathway compared with national averages in patients without adenomas. While visual loss from adenoma likely precipitated more cataract surgeries in this group of patients, some who may not have required it, those patients with cataracts who did not have their cataracts extracted were less likely to recover vision after transsphenoidal surgery. Addressing both pathologies is beneficial. (Source: Pituitary)
Source: Pituitary - May 29, 2019 Category: Endocrinology Source Type: research

Preoperative visual evoked potential in the prediction of visual outcome after pituitary macroadenomas surgery
AbstractObjectiveThe purpose of the present study is to investigate longitudinal changes in Visual evoked potential (VEP) parameters as an objective test after transsphenoidal surgery, its correlation with subjective tests and clinical value of VEP in the prediction of visual outcome.MethodsFifty patients with pituitary macroadenoma who underwent surgical removal of the tumor recruited in this study. All the patients underwent ophthalmic examination, static automated perimetry (SAP), VEP and magnetic resonance imaging (MRI) preoperatively and 3  months after surgery.ResultsFifty patients with pituitary macroadenoma (s...
Source: Pituitary - May 28, 2019 Category: Endocrinology Source Type: research

The effects of pre-operative somatostatin analogue therapy on treatment cost and remission in acromegaly
ConclusionsPreoperative medical treatment had no effect on the costs of acromegaly treatment. There was a benefical effect of pre-operative SSA use on early remission in patients with macroadenomas; however, this effect didn ’t persist long term. (Source: Pituitary)
Source: Pituitary - May 16, 2019 Category: Endocrinology Source Type: research

Endoscopic endonasal resection of nonfunctioning pituitary adenoma with radiological calcification
ConclusionsAlthough relatively rare, calcified nonfunctioning pituitary adenoma should be kept in mind to avoid making a wrong preoperative diagnosis. Given various calcification types, multiple surgical tactics is required accordingly. Extra-pseudocapusual resection via endoscopic endonasal approach is helpful for the resection of both adenoma and calcification. (Source: Pituitary)
Source: Pituitary - May 15, 2019 Category: Endocrinology Source Type: research

Ectopic cushing ’s syndrome due to corticotropin releasing hormone
AbstractCushing ’s syndrome (CS) secondary to corticotropin releasing hormone (CRH) producing tumors is rare. In this paper we present an Iranian patient who was admitted to our hospital with classic signs and symptoms of CS. Laboratory evaluation revealed high serum and urine cortisol which could not be suppress ed with dexamethasone. Abdominal CT scan revealed a mass in abdominal cavity. A percutaneous needle biopsy was performed and histopathologic evaluation revealed that the mass was a neuroendocrine tumor. A multi-disciplinary approach including resection of the mass, bilateral adrenalectomy somatostat in analo...
Source: Pituitary - April 30, 2019 Category: Endocrinology Source Type: research

Arthropathy in acromegaly: a questionnaire-based estimation of motor disability and its relation with quality of life and work productivity
ConclusionsThe questionnaires VAS, AIMS symptoms, and WOMAC (this latter both as a whole and with its functionality subscale), with their scores, proved to be the most adequate tools to evaluate motor disability and its consequences on both quality of life and work productivity in acromegaly. Female gender and higher BMI are associated with worse articular symptoms. (Source: Pituitary)
Source: Pituitary - April 29, 2019 Category: Endocrinology Source Type: research

Neuroendocrine responses to traumatic brain injury
(Source: Pituitary)
Source: Pituitary - April 29, 2019 Category: Endocrinology Source Type: research

Assessment of static and dynamic plantar data of patients with acromegaly
AbstractPurposeTo determine both static and dynamic plantar data of acromegalic subjects while barefoot.MethodsSeventy acromegalic patients and 48 age-, sex-, weight- and height-matched healthy controls were included. Plantar variables were measured using the footscan gait system. The data included the width and length of each foot, relative force distribution in each quadrant, mean force applied to each foot and maximum pressure while walking. Maximum pressure data were obtained from ten parts of the foot. Injury risk assessments of five different regions were performed. To analyze balance, center of pressure (CoP) measur...
Source: Pituitary - April 25, 2019 Category: Endocrinology Source Type: research

Traumatic brain injury and resultant pituitary dysfunction: insights from experimental animal models
ConclusionsStudies on TBI-induced pituitary dysfunction are still scarce. More research is needed to acquire mechanistic insights into the pathophysiology of PTHP which may eventually open up the horizon toward better treatments, including pituitary-regenerative approaches. (Source: Pituitary)
Source: Pituitary - April 24, 2019 Category: Endocrinology Source Type: research

Rathke ’s cleft cysts: a 6-year experience of surgery vs. observation with comparative volumetric analysis
AbstractBackgroundRathke ’s cleft cysts (RCCs) are common sellar lesions. Their management remains controversial, particularly when small or asymptomatic. Herein we review a consecutive series of RCC patients managed with surgery or observation.MethodsAll patients with a new diagnosis of presumed RCC, based on MRI, from February 2012 –March 2018 were retrospectively divided into observational and surgical cohorts based on an intent-to-treat model. The cohorts were compared for clinical presentation, and cyst volume. The observational cohort was followed for change in cyst size. The surgical cohort was followed ...
Source: Pituitary - April 24, 2019 Category: Endocrinology Source Type: research

Non-functioning pituitary adenomas: indications for pituitary surgery and post-surgical management
ConclusionsIn clinical practice, there is a great variation in the treatment and follow-up of patients with NFPAs. We have, based on available data, suggested an optimal management strategy for patients with NFPAs in relation to pituitary surgery. Prospective trials oriented at drawing up strategies for the management of NFPAs are needed. (Source: Pituitary)
Source: Pituitary - April 22, 2019 Category: Endocrinology Source Type: research

Functional survival of rat pituitary gland in hypothermic storage for pituitary transplantation
ConclusionsExtracted rat pituitary gland supplemented with special preservation solution could be preserved for 3  days under hypothermic condition. (Source: Pituitary)
Source: Pituitary - April 15, 2019 Category: Endocrinology Source Type: research

Clinical picture and the treatment of TBI-induced hypopituitarism
AbstractTraumatic brain injury (TBI) is an important public health problem with an increasing incidence in the last years. Relatively few cases are fatal; most individuals will survive and, in the long-term, the sequalae of TBI will include neuroendocrine dysfunctions with a much higher frequency than previously suspected. Patients who develop hypopituitarism after TBI present manifestations due to the number of deficient hormones, severity of hormonal deficiency, and the duration of hypopituitarism without diagnosis and treatment. The clinical spectrum of hypopituitarism is very large and many signs and symptoms of TBI su...
Source: Pituitary - March 30, 2019 Category: Endocrinology Source Type: research

Traumatic brain injury: neuropathological, neurocognitive and neurobehavioral sequelae
AbstractTraumatic brain injury (TBI) causes substantial neurological disabilities and mental distress. Annual TBI incidence is in magnitude of millions, making it a global health challenge. Categorization of TBI into severe, moderate and mild by scores on the Glasgow coma scale (GCS) is based on clinical grounds and standard brain imaging (CT). Recent research focused  on repeated mild TBI (sport and non-sport concussions) suggests that a considerable number of patients have long-term disabling neurocognitive and neurobehavioral sequelae. These relate to subtle neuronal injury (diffuse axonal injury) visible only by u...
Source: Pituitary - March 30, 2019 Category: Endocrinology Source Type: research

Pituitary pathology in traumatic brain injury: a review
ConclusionFuture research should focus more on experimental and clinical studies to elucidate the exact mechanisms behind post-traumatic pituitary damage. The use of preventive medical measures to limit possible damage in the pituitary gland and hypothalamic pituitary axis in order to maintain or re-establish near normal physiologic functions are crucial to minimize the effects of TBI. (Source: Pituitary)
Source: Pituitary - March 29, 2019 Category: Endocrinology Source Type: research

Antibody array strategy for human growth factor secretome profiling of GH-secreting adenomas
ConclusionsThis study suggests that the broad proteomic strategy of antibody arrays may be utilized to study the growth factors secretion pattern of GH-adenomas and its regulation by somatostatin analogs or other compounds. (Source: Pituitary)
Source: Pituitary - March 20, 2019 Category: Endocrinology Source Type: research

Ectopic pituitary adenomas: common presentations of a rare entity
ConclusionsEPA should be considered as a differential diagnosis of juxta-sellar lesions. Appropriate hormonal testing may lead to early diagnosis, avoidance of unnecessary biopsy or surgery, and improved outcomes. (Source: Pituitary)
Source: Pituitary - March 20, 2019 Category: Endocrinology Source Type: research

The role of autoimmunity in pituitary dysfunction due to traumatic brain injury
ConclusionsHPA seems to contribute to TBI-induced pituitary damage and related PTHP. However, further prospective studies in a larger cohort of patients are needed to define etiopathogenic and diagnostic role of APA/AHA in development of post-traumatic hypothalamic/pituitary dysfunctions after a TBI. (Source: Pituitary)
Source: Pituitary - March 7, 2019 Category: Endocrinology Source Type: research

Radiological and endocrinological evaluations with grading of hypothalamic perifocal edema caused by craniopharyngiomas
ConclusionHypothalamic dysfunctions greatly influence the quality of daily living following craniopharyngioma surgery. The grading of perifocal edema ’s extension could be a new index suggesting pre- and post-operative hypothalamic dysfunction caused by craniopharyngioma in addition to their anatomical involvement. (Source: Pituitary)
Source: Pituitary - March 7, 2019 Category: Endocrinology Source Type: research

The history of pituitary dysfunction after traumatic brain injury
ConclusionsThe interest for the damage suffered by anterior pituitary as a result of TBI continues to remain high both in the adulthood and childhood. (Source: Pituitary)
Source: Pituitary - March 2, 2019 Category: Endocrinology Source Type: research

Pretreatment with somatostatin analogs does not affect the anesthesiologic management of patients with acromegaly
ConclusionsSRL-pretreatment of patients with acromegaly had no significant impact on intraoperative anesthesiologic management. Despite a better Cormack –Lehane score in SRL-pretreated than in naïve patients, the rate of difficult intubation was similar in both groups. SRL-pretreatment did not affect the rate of surgical remission or complications as well. (Source: Pituitary)
Source: Pituitary - March 2, 2019 Category: Endocrinology Source Type: research

Use of a wrist-mounted device for continuous outpatient physiologic monitoring after transsphenoidal surgery: a pilot study
AbstractPurposePatients who undergo transsphenoidal surgery can experience hormonal, electrolyte, and fluid disturbances in the postoperative period leading to outpatient readmissions for medical management. Our goal was to determine whether use of a wrist-mounted physiologic tracking device is feasible in this setting and whether changes or trends in these parameters after discharge can help predict aberrant physiology in these patients.MethodsWrist-mounted physiologic tracking devices that transmit data via Bluetooth to a mobile device were used to monitor patients. Preoperative baseline data and postoperative data were ...
Source: Pituitary - February 26, 2019 Category: Endocrinology Source Type: research

The incidence of Cushing ’s disease: a nationwide Swedish study
AbstractBackgroundStudies on the incidence of Cushing ’s disease (CD) are few and usually limited by a small number of patients. The aim of this study was to assess the annual incidence in a nationwide cohort of patients with presumed CD in Sweden.MethodsPatients registered with a diagnostic code for Cushing ’s syndrome (CS) or CD, between 1987 and 2013 were identified in the Swedish National Patient Registry. The CD diagnosis was validated by reviewing clinical, biochemical, imaging, and histopathological data.ResultsOf 1317 patients identified, 534 (41%) had confirmed CD. One-hundred-and-fifty-six (12%) patie...
Source: Pituitary - February 25, 2019 Category: Endocrinology Source Type: research

Filamin A and DRD2 expression in corticotrophinomas
ConclusionsIn our cohort of corticotrophinomas, DRD2 expression was not associated with FLNA expression nor to the response to CAB. Nonetheless, FLNA expression could be related to tumor invasiveness. (Source: Pituitary)
Source: Pituitary - February 25, 2019 Category: Endocrinology Source Type: research

Increased androgen secretion in patients with prolactinomas: the impact of altered HPA function
AbstractBackground and objectivesEarlier studies suggested that hyperprolactinemia was associated with elevated serum DHEA-S levels. The importance of DHEA-S measurements in the diagnosis of adrenal insufficiency prompted us to assess adrenal androgen levels in hyperprolactinemic subjects with normal or impaired function.MethodsProspective study including 122 medically treated and 26 surgically patients with prolactinomas. Serum PRL, DHEA and DHEA-S levels were measured before and repeatedly after cabergoline therapy and also in the perioperative period of surgically treated patients.ResultsSerum PRL levels decreased (P  
Source: Pituitary - February 23, 2019 Category: Endocrinology Source Type: research

AcroVoice: the controversial values in reflecting acromegaly disease activity
(Source: Pituitary)
Source: Pituitary - February 22, 2019 Category: Endocrinology Source Type: research

Treatment adherence to pegvisomant in patients with acromegaly in Spain: PEGASO study
ConclusionsPatient adherence to pegvisomant was high (60.7 –92.1%), but more than a third of the patients in the study made mistakes during the administration process, with a potential impact on disease control. Besides dosing compliance, correct administration of medication should be carefully assessed in these patients. (Source: Pituitary)
Source: Pituitary - February 13, 2019 Category: Endocrinology Source Type: research

Traumatic brain injury induced neuroendocrine changes: acute hormonal changes of anterior pituitary function
ConclusionsAcute hypocortisolism should be diagnosed and managed promptly, as it can be life-threatening, but currently there is no evidence to support treatment of acute GH, thyroid hormones or gonadotropins deficiencies. However, a more comprehensive assessment of anterior pituitary function should be undertaken both in the early and in the post-acute phase, since ongoing hormone deficiencies may adversely affect the recovery and quality of life of these patients. (Source: Pituitary)
Source: Pituitary - February 12, 2019 Category: Endocrinology Source Type: research

Clinical score system in the treatment of Cushing ’s disease: failure to identify discriminative variables from the German Cushing’s Registry
ConclusionIt was not possible to provide clinical key parameters in our population of patients with CD discriminating biochemical cured from non-cured patients and to construct a clinical scoring system reflecting clinical treatment benefits. (Source: Pituitary)
Source: Pituitary - February 7, 2019 Category: Endocrinology Source Type: research

A clinical and pathophysiological approach to traumatic brain injury-induced pituitary dysfunction
ConclusionThe underlying pathophysiology responsible for post-TBI pituitary dysfunction is not clear. The main proposed mechanisms are vascular injury, direct traumatic injury to the pituitary gland, genetic susceptibility, autoimmunity, and transient medication effects. (Source: Pituitary)
Source: Pituitary - February 7, 2019 Category: Endocrinology Source Type: research

Response to letter to the editor from Professor Jean-Fran çois Bonneville
(Source: Pituitary)
Source: Pituitary - February 2, 2019 Category: Endocrinology Source Type: research

Long term MRI surveillance of pituitary macroadenomas: gadolinium is not obligatory
(Source: Pituitary)
Source: Pituitary - January 28, 2019 Category: Endocrinology Source Type: research

Pituitary incidentalomas in paediatric age are different from those described in adulthood
ConclusionsTo the best of our knowledge, this is the first series of pituitary incidentalomas in pediatric age. Comparing our series with those conducted in adults, we have observed a higher preponderance of pituitary hypertrophy over adenomas, a lower prevalence of hormonal hyper/hyposecretion and lower risk of dimensional progression during follow-up. (Source: Pituitary)
Source: Pituitary - January 25, 2019 Category: Endocrinology Source Type: research

The frequency and the diagnosis of pituitary dysfunction after traumatic brain injury
ConclusionSurvivors of head injury are at risk of pituitary hormone dysfunction and we suggest an approach to the diagnosis of post-traumatic hypopituitarism in routine clinical practice. (Source: Pituitary)
Source: Pituitary - January 25, 2019 Category: Endocrinology Source Type: research

Oxytocin alterations and neurocognitive domains in patients with hypopituitarism
ConclusionsPlasma oxytocin levels were found higher in patients with hypopituitarism compared to controls and highest in those with diabetes insipidus. Longer duration of hypopituitarism was also associated with higher plasma levels of oxytocin. Further study is needed to better define oxytocin deficiency and investigate response to treatment. (Source: Pituitary)
Source: Pituitary - January 17, 2019 Category: Endocrinology Source Type: research

Pituitary adenomas in patients with multiple endocrine neoplasia type 1: a single-center experience in China
ConclusionsThe treatment of MEN1 requires cooperation between multidisciplinary teams. Individualized treatment according to the severity of glandular involvement is needed. GH-secreting and ACTH-secreting pituitary adenomas require active treatment, while nonfunctioning pituitary adenomas can be observed closely. (Source: Pituitary)
Source: Pituitary - January 14, 2019 Category: Endocrinology Source Type: research

Pituitary dysfunction due to sports-related traumatic brain injury
ConclusionsEven mild and forgotten SR-TBIs may cause PD that may have distressing consequences in some cases if remain undiagnosed. More studies are needed to elucidate epidemiology and pathophysiology of PD after SR-TBIs. Also studies to establish screening algorithms for PD as well as strategies for prevention of SR-TBIs are urgently required. (Source: Pituitary)
Source: Pituitary - January 14, 2019 Category: Endocrinology Source Type: research

Neuroendocrine changes after aneurysmal subarachnoid haemorrhage
ConclusionsHypopituitarism following aSAH necessitates screening despite lack of gold standard evaluation tests and cut-off values in the follow up, because missed diagnosis may lead to untoward consequences. (Source: Pituitary)
Source: Pituitary - January 14, 2019 Category: Endocrinology Source Type: research

Paul Kelly, PhD (1943 –2018)
(Source: Pituitary)
Source: Pituitary - January 10, 2019 Category: Endocrinology Source Type: research

AcroVoice: eliciting the patients ’ perspective on acromegaly disease activity
ConclusionAll five ACRODAT ® parameters had some influence on disease activity from the patients’ perspective. To account for patients’ preferences and optimize treatment and outcomes, a holistic disease management approach should be employed. (Source: Pituitary)
Source: Pituitary - January 9, 2019 Category: Endocrinology Source Type: research

Evaluation of expression of somatostatin receptor 1, 2, 3, 5 and dopamine D2 receptor in spindle cell oncocytomas of posterior pituitary
ConclusionsWe demonstrated presence of different SST subtypes and D2DR in spindle cell oncocytomas. The most commonly expressed subtype was SST2 and SST3, while no expression of SST5 was observed. Expression showed spatial heterogeneity and temporal changes as seen in the recurrent case. The biological meaning of SSTs expression in SCOs is unclear as well as whether it may be exploited in treatment of selected cases. (Source: Pituitary)
Source: Pituitary - January 4, 2019 Category: Endocrinology Source Type: research

IgG4-related hypophysitis in patients with autoimmune pancreatitis
ConclusionsAlthough a large-scale study is necessary to validate these results, these data suggest that the prevalence of hypophysitis in patients with autoimmune pancreatitis may be underestimated. Based on our findings, we recommend screening for hypophysitis, especially in patients with multiple organ involvement. (Source: Pituitary)
Source: Pituitary - January 4, 2019 Category: Endocrinology Source Type: research

A small 3D-printing model of macroadenomas for endoscopic endonasal surgery
ConclusionsThe use of 3D printing technology has unquestionable potential applications to endoscopic endonasal approach for macroadenomas, in particular reflecting the complicated anatomy of sphenoid sinus and tumor location. Owing to the advantages of 3D printing technology, it may help the patients get a good prognosis. (Source: Pituitary)
Source: Pituitary - November 30, 2018 Category: Endocrinology Source Type: research

A plea for the T2W MR sequence for pituitary imaging
(Source: Pituitary)
Source: Pituitary - November 28, 2018 Category: Endocrinology Source Type: research

Cell specific interaction of pasireotide: review of preclinical studies in somatotroph and corticotroph pituitary cells
ConclusionsThe analysis of preclinical studies carried out in somatotroph and corticoph adenomas points out that pasireotide shows a cell-specific activity, exerting its biological effects via different SSTs in the different adenoma histotypes. (Source: Pituitary)
Source: Pituitary - November 27, 2018 Category: Endocrinology Source Type: research

A neurosurgical approach to traumatic brain injury and post-traumatic hypopituitarism
ConclusionsPost-traumatic hypopitutiarism is a serious and potentially debilitating condition that is likely under-recognised and under-diagnosed. From a neurosurgical perspective, we advocate a pragmatic approach, i.e. screening those considered at high risk of developing PTHP based on clinical features and biochemical/endocrinological testings; and referring them to a specialist endocrinologist for further management as indicated. (Source: Pituitary)
Source: Pituitary - November 27, 2018 Category: Endocrinology Source Type: research

Physicians ’ awareness of gadolinium retention and MRI timing practices in the longitudinal management of pituitary tumors: a “Pituitary Society” survey
ConclusionsInternational pituitary endocrinologists and pituitary neurosurgeons experts suggest ongoing MRIs for the management of pituitary tumors; strategies vary based on clinical context, but also on individual experience and practice. (Source: Pituitary)
Source: Pituitary - November 19, 2018 Category: Endocrinology Source Type: research

Evaluation of the natural course of thyroid nodules in patients with acromegaly
AbstractPurposeTo investigate the nodular thyroid disease (NTD) and the natural course of thyroid nodules in patients with acromegaly.Methods138 patients with acromegaly (73  F/65 M), whose initial thyroid ultrasonography performed in our university hospital, were included in this study. The frequencies of NTD, papillary thyroid cancer (PTC) and associated factors on nodule formation were investigated at initial assessment. Patients who had NTD continued to follow-up (n = 56) were re-evaluated with a ultrasonography performed after a mean 7-years follow-up period. The nodule size changes were compar...
Source: Pituitary - November 14, 2018 Category: Endocrinology Source Type: research

Coagulative necrotic pituitary adenoma apoplexy: A retrospective study of 21 cases from a large pituitary center in China
ConclusionsCNPA can be correctly diagnosed preoperatively by typical clinical and MRI characteristics. Early surgery combined with hyperbaric oxygen therapy early postoperatively usually yields satisfactory endocrine and neuro-ophthalmic outcomes. (Source: Pituitary)
Source: Pituitary - November 2, 2018 Category: Endocrinology Source Type: research

Thyrotropin-secreting pituitary adenomas: a systematic review and meta-analysis of postoperative outcomes and management
AbstractPurposeTSH-secreting pituitary adenomas are rare pituitary tumors. An efficient treatment is essential to limit the mortality and morbidity in untreated patients. The aim of this study is to summarize the evidence about the postoperative outcomes and management of this rare pathology.MethodsA systematic search and meta-analysis of surgical series was performed.ResultsOur analysis included 23 articles (536 patients). No sex difference was observed and mean age at diagnosis was 45  years. Hyperthyroidism was reportedly clinical in 67% and biochemical in 90% of patients. Co-secretion of other pituitary hormones w...
Source: Pituitary - November 2, 2018 Category: Endocrinology Source Type: research