Internal carotid artery stenosis and risk of cerebrovascular ischemia following stereotactic radiosurgery for recurrent or residual pituitary adenomas
ConclusionAs compared to the general population, SRS for pituitary adenomas does not seem to confer appreciable increased risk for ICA steno-occlusive disease and ischemic stroke. However, post-SRS radiation vessel injuries do occur and physicians should be aware about this rare event. Prompt identification and management according to current guidelines are essential to prevent ischemic strokes. (Source: Pituitary)
Source: Pituitary - February 20, 2021 Category: Endocrinology Source Type: research

Psychological well-being and illness perceptions in patients with hypopituitarism
ConclusionDespite normalization of hormonal disturbances, patients with hypopituitarism in general can still experience problems during daily living, such as negative mood states and a decreased psychological well-being. (Source: Pituitary)
Source: Pituitary - February 19, 2021 Category: Endocrinology Source Type: research

Glucocorticoid use in patients with adrenal insufficiency following administration of the COVID-19 vaccine: a pituitary society statement
ConclusionsMost clinicians plan to maintain the current glucocorticoid dose with vaccine administration. The vast majority plan and to increase glucocorticoid dose in case of fever, and just under half in case of arthralgias and myalgias. These survey results offer suggested management guidance for glucocorticoid management in patients with adrenal insufficiency. (Source: Pituitary)
Source: Pituitary - February 10, 2021 Category: Endocrinology Source Type: research

Virtual magnetic resonance elastography has the feasibility to evaluate preoperative pituitary adenoma consistency
ConclusionEvaluation of PA consistency in preparation for surgery seems to be feasible using the vMRE-method. Our findings also address the need for high resolution diagnostic methods that can non-invasively display focal regions of increased stiffness, as such regions may increase the difficulty of transsphenoidal PA-resection. (Source: Pituitary)
Source: Pituitary - February 8, 2021 Category: Endocrinology Source Type: research

Neural network modeling for prediction of recurrence, progression, and hormonal non-remission in patients following resection of functional pituitary adenomas
ConclusionWe demonstrate capability of predicting suboptimal postoperative outcomes with high accuracy. NNs may aid in stratifying patients for risk of suboptimal outcomes, thereby guiding implementation of adjuvant treatment in high-risk patients. (Source: Pituitary)
Source: Pituitary - February 2, 2021 Category: Endocrinology Source Type: research

Increased oxytocin release precedes hyponatremia after pituitary surgery
ConclusionTaken together, these results show for the first time that urinary OXT output remains normally stable after transsphenoidal pituitary surgery. OXT excretion however becomes abnormally high on or around 4  days after surgery in patients later developing hyponatremia, suggesting that this abnormal dynamics of OXT secretion might serve as an early marker for transsphenoidal surgery-related hyponatremia attributed to SIADH. (Source: Pituitary)
Source: Pituitary - January 28, 2021 Category: Endocrinology Source Type: research

Descriptive epidemiology of craniopharyngiomas in the United States
ConclusionsCraniopharyngiomas are rare tumors with a bimodal age distribution and an equal male-to-female incidence. Black patients had the highest incidence, and adamantinomatous craniopharyngiomas were significantly more common than papillary tumors in adolescent, adult, and elderly populations. (Source: Pituitary)
Source: Pituitary - January 28, 2021 Category: Endocrinology Source Type: research

Development and validation of a novel index for the differential diagnosis of corticotropin ‐dependent Cushing syndrome
ConclusionsACTH-UFC index provides a rapid, convenient and non-invasive adjunctive approach for the differential diagnosis of corticotropin-dependent CS, with no risk of aggravating metabolic disturbances. Investigations for ectopic causes of corticotropin-dependent CS should be performed with ACTH-UFC index  >  11 and negative contrasted pituitary MRI. (Source: Pituitary)
Source: Pituitary - January 27, 2021 Category: Endocrinology Source Type: research

Immune profiling of pituitary tumors reveals variations in immune infiltration and checkpoint molecule expression
ConclusionImmune cell infiltration and checkpoint regulator expression vary depending on functional status and presence of pituitary tumor initiating cells. Functional tumors may have a particularly immunosuppressive microenvironment. Further studies of immune checkpoint blockade of pituitary tumors, particularly functional tumors, are warranted, though combination therapy may be required. (Source: Pituitary)
Source: Pituitary - January 25, 2021 Category: Endocrinology Source Type: research

Diagnostic value of Knosp grade and modified Knosp grade for cavernous sinus invasion in pituitary adenomas: a systematic review and meta ‐analysis
ConclusionsModifying the KG improved its prognostic role in CSI and gross total resection. However, these grading systems cannot be used as the group standard for invasive and non-invasive pituitary adenomas (PAs) because of the weak reliability of the scale ’s middle grades (grades 2 and 3A). Authors of future PA studies should consider reporting KG as high (grades 3B and 4), medium (grades 2 and 3A) and low (grades 0 and 1) to optimise the application of the scale. (Source: Pituitary)
Source: Pituitary - January 25, 2021 Category: Endocrinology Source Type: research

Long-term cardiometabolic outcome in patients with pituitary adenoma diagnosed in chilhood and adolescence
AbstractPurposePituitary adenomas (PAs) rarely occur in childhood and adolescence. Management of PAs in this critical age can be particularly challenging considering the auxological sequelae and potential long-term cardiometabolic consequences. We aimed to describe the clinical characteristics of patients with PA aged  
Source: Pituitary - January 19, 2021 Category: Endocrinology Source Type: research

Aerosolisation in endonasal endoscopic pituitary surgery
AbstractPurposeTo determine the particle size, concentration, airborne duration and spread during endoscopic endonasal pituitary surgery in actual patients in a theatre setting.MethodsThis observational study recruited a convenience sample of three patients. Procedures were performed in a positive pressure operating room. Particle image velocimetry and spectrometry with air sampling were used for aerosol detection.ResultsIntubation and extubation generated small particles (
Source: Pituitary - January 19, 2021 Category: Endocrinology Source Type: research

Outcomes of pituitary apoplexy: a comparison of microadenomas and macroadenomas
AbstractPurposeWe aimed to assess clinical characteristics of apoplexy of pituitary microadenomas compared to macroadenomas.Methods We retrieved clinical records of patients  >  18 years old, hospitalized in Rambam hospital between January 2001 and October 2017, with pituitary apoplexy and follow-up of at least one year. We compared clinical course and outcomes of apoplexy between patients with microadenomas and macroadenomas, and between patients who received conservat ive or surgical treatment. Statistical analysis was done using Fisher’s exact and Mann–Whitney tests.ResultsTwenty-seve...
Source: Pituitary - January 19, 2021 Category: Endocrinology Source Type: research

Extending lifespan by modulating the growth hormone/insulin-like growth factor-1 axis: coming of age
AbstractProgress made in the  years of aging research have allowed the opportunity to explore potential interventions to slow aging and extend healthy lifespan. Studies performed in yeast, worms, flies and mice subjected to genetic and pharmacological interventions have given insight into the cellular and molecular mechanisms associated with longevity. Furthermore, it is now possible to effectively modulate pathways that slow aging at different stages of life (early life or at an adult age). Interestingly, interventions that extend longevity in adult mice have had sex-specific success, suggesting a potential link...
Source: Pituitary - January 18, 2021 Category: Endocrinology Source Type: research

Familial neurohypophyseal diabetes insipidus: clinical, genetic and functional studies of novel mutations in the arginine vasopressin gene
ConclusionThe intracellular accumulation of mutant vasopressin precursors supports the role of cellular toxicity of the mutant proteins in the etiology of the disorder and explains the progressive onset of the disorder. These findings further expand theAVP mutational spectrum in FNDI and contribute to the understanding of the molecular pathogenic mechanisms involved in FNDI. (Source: Pituitary)
Source: Pituitary - January 12, 2021 Category: Endocrinology Source Type: research

The epidemiology and management patterns of pediatric pituitary tumors in the United States
AbstractPurposeHypothalamic-pituitary axis dysfunction and mass effect symptoms in the pediatric population can indicate a pituitary region tumor. Herein, we evaluate the epidemiology and management of this rare entity.MethodsPediatric patients ( ≤ 21yo) who presented from 2004 to 2017 with a pituitary tumor were evaluated from the U.S. National Cancer Database. The distributions and management patterns of pituitary tumors were assessed by patients’ tumor type, age, sex, race/ethnicity, tumor size, and insurance status.Results19.7% of intracranial tumors in the pediatric population originated in the pituita...
Source: Pituitary - January 12, 2021 Category: Endocrinology Source Type: research

Transcriptome profiling of insulin sensitive tissues from GH deficient mice following GH treatment
ConclusionsAs expected, GH caused expression changes of many known target genes, although new candidate GH targets were identified. Liver and muscle appear to be more GH sensitive than adipose tissue due to the larger number of DEG and pathways significantly altered, but adipose still has a characteristic GH response. The diversity of changes uncovered in all three tissues after 5 days of GH treatment highlights the multiplicity of GH ’s effects in its target tissues. (Source: Pituitary)
Source: Pituitary - January 12, 2021 Category: Endocrinology Source Type: research

Characterization of the ability of a, second-generation SST-DA chimeric molecule, TBR-065, to suppress GH secretion from human GH-secreting adenoma cells
AbstractContextSomatostatin (SST) and dopamine (DA) inhibit growth hormone (GH) secretion and proliferation of GH-secreting pituitary adenomas (GHomas) through binding to SSTR2 and D2R receptors. Chimeric SST-DA compounds (Dopastatins) display increased potency in inhibiting GH secretion, as compared with individual SST or DA analogs (alone or combined).ObjectiveTo assess the efficacy of a second-generation dopastatin, TBR-065, in suppressing GH secretion from human GH- and GH/prolactin(PRL)-omas.DesignWe compared the ability of TBR-065 to inhibit GH secretion from primary cultures of human GH- or GH/PRLoma cells to that o...
Source: Pituitary - January 12, 2021 Category: Endocrinology Source Type: research

Rathke ’s cleft cyst infections and pituitary abscesses: case series and review of the literature
ConclusionPAs occurring in RCCs are infrequent. Clinical manifestations are commonly subacute, without septic symptoms. Imaging is usually non-specific. Preoperative diagnosis is infrequent and a broad differential diagnosis should be considered. Empirical antimicrobial therapy should be initiated and adjusted after obtaining cultures to reduce the rate of recurrence and improve clinical outcomes. (Source: Pituitary)
Source: Pituitary - January 12, 2021 Category: Endocrinology Source Type: research

Correction to: Levoketoconazole improves clinical signs and symptoms and patient-reported outcomes in patients with Cushing ’s syndrome
The original version of the article unfortunately contained an error in the first name and the surname of one of the authors in the author group. The last author name was incorrectly published as ‘F. Pecori Giraldi’ and the corrected name is ‘Francesca Pecori Giraldi’ (First name: Francesca; Surname: Pecori Giraldi). (Source: Pituitary)
Source: Pituitary - December 14, 2020 Category: Endocrinology Source Type: research

The direct and indirect impact of the COVID-19 pandemic on the care of patients with pituitary disease: a cross sectional study
ConclusionsWhilst only a small percentage of patients had confirmed or suspected COVID-19 infection, over half were still indirectly impacted by the pandemic through a delay or change to their planned care. (Source: Pituitary)
Source: Pituitary - November 24, 2020 Category: Endocrinology Source Type: research

Pre-operative serum inflammation-based scores in patients with pituitary adenomas
AbstractObjectiveFull blood count (FBC) and serum inflammation-based scores reflect systemic inflammation and predict outcomes in cancer, but little is known in pituitary adenomas (PAs). We aimed to characterise FBC and inflammation-based scores in PA patients and investigate their usefulness in predicting challenging disease course.MethodsWe studied 424 PA patients first operated at our centre with available pre-operative biochemical data. Patients with infection, malignancies, autoimmune or haematological conditions were excluded. Inflammation-based scores studied: Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lympho...
Source: Pituitary - November 24, 2020 Category: Endocrinology Source Type: research

Prior testosterone replacement therapy may impact spermatogenic response to combined gonadotropin therapy in severe congenital hypogonadotropic hypogonadism
ConclusionPrior-TRT may interfere with spermatogenic response to CGT in CHH patients, especially in those with a severe phenotype. (Source: Pituitary)
Source: Pituitary - November 23, 2020 Category: Endocrinology Source Type: research

Levoketoconazole improves clinical signs and symptoms and patient-reported outcomes in patients with Cushing ’s syndrome
AbstractPurposeThe efficacy of levoketoconazole in treating hypercortisolism was demonstrated in an open-label phase 3 study (SONICS) of adults with endogenous Cushing ’s syndrome (CS) and baseline mean urinary free cortisol (mUFC) ≥  1.5× ULN. Clinical signs and symptoms and patient-reported outcomes from the SONICS trial were evaluated in the current manuscript.MethodsPatients titrated to an individualized therapeutic dose entered a 6-month maintenance phase. Secondary endpoints included investigator-graded clinical signs and symptoms of CS during the maintenance phase, and patient-reported q...
Source: Pituitary - November 20, 2020 Category: Endocrinology Source Type: research

Integrated multi-omics profiling of nonfunctioning pituitary adenomas
ConclusionThis study presents comprehensive multi-omics views of CNV, DNA methylation, and gene expression in 8 NFPAs. Pathway analysis and network maps of key genes provide clues to elucidate the molecular basis of hpNFPA. (Source: Pituitary)
Source: Pituitary - November 18, 2020 Category: Endocrinology Source Type: research

Risk factors for tumor recurrence and progression of spindle cell oncocytoma of the pituitary gland: a systematic review and pooled analysis
ConclusionOur study demonstrated the characteristic clinicopathological features of SCOs with a high recurrence/progression rate and outlined the predictor for tumor relapse. Failure to achieve gross total resection is the only risk factor for tumor recurrence/progression. (Source: Pituitary)
Source: Pituitary - November 18, 2020 Category: Endocrinology Source Type: research

Management of sellar and parasellar tumors becoming symptomatic during pregnancy: a practical algorithm based on multi-center experience and systematic literature review
ConclusionsSPTs becoming symptomatic in pregnancy deserve careful monitoring and multidisciplinary management. Overall, wait-and-see approach is suggested, reserving surgery to patients with rapidly progressive/life-threatening situations, significant risk of permanent neurological impairment or malignant lesions. (Source: Pituitary)
Source: Pituitary - November 17, 2020 Category: Endocrinology Source Type: research

Cephalocaudal tumor diameter is a predictor of diabetes insipidus after endoscopic transsphenoidal surgery for non-functioning pituitary adenoma
AbstractPurposeDiabetes insipidus (DI) develops commonly after endoscopic transsphenoidal surgery (ETS). We retrospectively investigated the incidence, onset, duration and predictors of DI after ETS in patients with non-functioning pituitary adenoma (NFPA).MethodsA total of 168 patients who underwent ETS to remove NFPAs were included. Various perioperative data on demographics, comorbidities, previous treatments, perioperative hormone deficiencies, tumor characteristics, surgery, anesthesia, intraoperative fluid balance, perioperative laboratory findings, postoperative complications, readmission and hospital length of stay...
Source: Pituitary - November 16, 2020 Category: Endocrinology Source Type: research

Congenital hypopituitarism in two brothers with a duplication of the ‘acrogigantism gene’ GPR101 : clinical findings and review of the literature
ConclusionIn our patients with hypopituitarism we found a 6  Mb duplication which includesGPR101, a gene associated with X- linked gigantism, andSOX3, a gene involved in early pituitary organogenesis that is associated with variable degrees of hypopituitarism. Our findings show that in duplications containing bothGPR101 andSOX3, the growth hormone deficiency phenotype is dominant. This suggests that, ifGPR101 is duplicated, it might not be expressed phenotypically when early patterning of the embryonic pituitary is affected due toSOX3 duplication. These results, together with the review of the literature, shed a new l...
Source: Pituitary - November 13, 2020 Category: Endocrinology Source Type: research

Meeting abstracts from the 2020 International Meeting on GH/IGF: actions in the shadow of COVID19
(Source: Pituitary)
Source: Pituitary - November 11, 2020 Category: Endocrinology Source Type: research

Biliary adverse events in acromegaly during somatostatin receptor ligands: predictors of onset and response to ursodeoxycholic acid treatment
AbstractPurposeSomatostatin receptor ligands (SRL) are the first-line medical treatment for acromegaly. Gallbladder alterations are one of most important SRL side effect, but according to some authors growth hormone hypersecretion itself is a risk factor for gallstones. This single center, longitudinal retrospective study evaluated the incidence and the predictors of biliary adverse events (BAE) in acromegaly during SRL therapy and their response to ursodeoxycholic acid (UDCA).Methods91 acromegaly patients with indication to SRL were enrolled. Evaluations of acromegaly activity (GH, IGF-I, IGF-I/ULN) and metabolic profile ...
Source: Pituitary - November 9, 2020 Category: Endocrinology Source Type: research

Genetics, clinical features and outcomes of non-syndromic pituitary gigantism: experience of a single center from Sao Paulo, Brazil
ConclusionWe characterize the clinical and molecular findings and long-term outcome of the largest single-center PG cohort described so far. (Source: Pituitary)
Source: Pituitary - November 6, 2020 Category: Endocrinology Source Type: research

Chiasmapexy for secondary empty sella syndrome: diagnostic and therapeutic considerations
ConclusionT2-weighted or CISS/FIESTA sequence MRI is mandatory to visualize adhesions, ON kinking and neurovascular conflict. TS approach is the most commonly used approach. The literature review could not conclude on the need for an intra or extradural approach suggesting case by case adapted strategy. Intrasellar packing with non-absorbable material such as bone should be considered. Severity of the visual loss clearly decreases the visual outcome suggesting early chiasmapexy. In case of severe and long standing symptoms before surgery, benefits and surgical risks should be carefully balanced. (Source: Pituitary)
Source: Pituitary - November 2, 2020 Category: Endocrinology Source Type: research

International meeting on GH/IGF actions in the shadow of COVID19
(Source: Pituitary)
Source: Pituitary - October 31, 2020 Category: Endocrinology Source Type: research

Prognostic value of nadir GH levels for long-term biochemical remission or recurrence in surgically treated acromegaly
AbstractContextOutcome of acromegaly surgery is assessed by IGF-1 and glucose-suppressed GH, but whether the latter provides additional clinically relevant information when IGF-1 is normal is unclear. The role of GH suppression testing after surgery requires clarification.MethodsWe studied 97 acromegaly patients with normal IGF-1 after surgery by measuring GH after oral glucose longitudinally, initially at ≥ 3 months after surgery and repeated one or more times ≥ 1 year later. Nadir GH was categorized as normal or abnormal relative to the 97.5th percentile of nadir GH in 100 healthy subjects, ...
Source: Pituitary - October 30, 2020 Category: Endocrinology Source Type: research

Vasculometabolic effects in patients with congenital growth hormone deficiency with and without GH replacement therapy during adulthood
ConclusionsNo differences in vascular properties were observed in congenital GHD adult patients with or without GHRT despite patients without GHRT had an unfavorable body composition. GHRT currently remains an individualized decision in adults with GHD and these findings bring new insight into the treatment and follow-up of these patients. (Source: Pituitary)
Source: Pituitary - October 24, 2020 Category: Endocrinology Source Type: research

HOMA-IR in acromegaly: a systematic review and meta-analysis
ConclusionHOMA-IR in treatment-na ïve ACRO patients is higher than in the reference population, even in patients without diabetes. This finding, confirms that insulin resistance is an early event in ACRO. Our results also suggest that HOMA-IR is not an adequate tool for assessing insulin resistance in those patients treated with SS As. (Source: Pituitary)
Source: Pituitary - October 21, 2020 Category: Endocrinology Source Type: research

A Pituitary Society update to acromegaly management guidelines
AbstractGuidelines and consensus statements ensure that physicians managing acromegaly patients have access to current information on evidence-based treatments to optimize outcomes. Given significant novel recent advances in understanding acromegaly natural history and individualized therapies, the Pituitary Society invited acromegaly experts to critically review the current literature in the context of Endocrine Society guidelines and Acromegaly Consensus Group statements. This update focuses on how recent key advances affect treatment decision-making and outcomes, and also highlights the likely role of recently FDA-appro...
Source: Pituitary - October 20, 2020 Category: Endocrinology Source Type: research

Clinical, biological, radiological, and pathological comparison of sparsely and densely granulated somatotroph adenomas: a single center experience from a cohort of 131 patients with acromegaly
AbstractPurposeGrowth hormone-producing pituitary adenomas are divided into two clinically relevant histologic subtypes, densely (DG-A) and sparsely (SG-A) granulated. Histologic subtype was evaluated in a large cohort of patients with acromegaly, separating DG-A and SG-A, and correlated with clinicopathological characteristics.MethodsPatients with acromegaly undergoing surgery as initial therapy between 1995 and 2015 were identified. Histologic subtype was determined by keratin expression pattern with CAM5.2 and correlated with clinical and imaging parameters, somatostatin receptor subtype 2 (SST2) expression, post-surgic...
Source: Pituitary - October 19, 2020 Category: Endocrinology Source Type: research

The effect of somatostatin analogs and acromegaly on the upper gastrointestinal system
ConclusionThe study showed that octreotide LAR treatment could be a risk factor in addition to known factors for the development of gastritis in patients with acromegaly. (Source: Pituitary)
Source: Pituitary - October 19, 2020 Category: Endocrinology Source Type: research

Corticotroph tumor progression during long-term therapy with osilodrostat  in a patient with persistent Cushing’s disease
ConclusionThis case highlights the importance of monitoring ACTH and corticotroph tumor size in patients with persistent CD, either under effective treatment with steroidogenesis inhibitors or after bilateral adrenalectomy. (Source: Pituitary)
Source: Pituitary - October 19, 2020 Category: Endocrinology Source Type: research

Increased risk of preneoplastic colonic lesions and colorectal carcinoma in acromegaly: multicenter case –control study
ConclusionsOur findings show an increased risk of preneoplastic colonic lesions and colorectal carcinoma in patients with chronic and sustained GH excess compared to a control group. This supports the recommendation to perform screening colonoscopy at diagnosis of acromegaly. (Source: Pituitary)
Source: Pituitary - October 15, 2020 Category: Endocrinology Source Type: research

Chiasmal herniation following treatment of pituitary macroadenoma
ConclusionHerniation does not appear to have clinical relevance with respect to VF outcome. The newly designed CHS is the first scoring system to quantify the severity of herniation and, in the absence of alternatives, may be useful to describe MRI findings to serve future added value in larger sized outcome studies. (Source: Pituitary)
Source: Pituitary - October 15, 2020 Category: Endocrinology Source Type: research

Establishing a papillary craniopharyngioma cell line by SV40LT-mediated immortalization
ConclusionWe successfully developed PCP cell lines by SV40LT-mediated immortalization. These cell lines represent a powerful tool for fundamental and therapeutical studies on craniopharyngioma. (Source: Pituitary)
Source: Pituitary - October 12, 2020 Category: Endocrinology Source Type: research

Healthcare utilization and costs among prolactinoma patients: a cross-sectional study and analysis of determinants
ConclusionHealthcare utilization and costs of prolactinoma patients are related to patient-reported HRQoL, bother by disease and needs for support. Therefore, addressing patients ’ HRQoL and needs is a way forward to improve efficiency of care and patients’ health status. (Source: Pituitary)
Source: Pituitary - October 5, 2020 Category: Endocrinology Source Type: research

Machine learning in predicting early remission in patients after surgical treatment of acromegaly: a multicenter study
This study aims to train and validate machine learning prediction models for early endocrine remission of acromegalic patients.MethodsThe training cohort included 833 patients with growth hormone (GH) secreting pituitary adenoma from 2010 to 2018. We trained a partial model (only using pre-operative variables) and a full model (using all variables) to predict off-medication endocrine remission at six-month follow-up after surgery using multiple algorithms. The models were validated in 99 prospectively collected patients from a second campus and 52 patients from a third institution.ResultsC-statistic and the accuracy of the...
Source: Pituitary - October 5, 2020 Category: Endocrinology Source Type: research

AIP variant causing familial prolactinoma
AbstractPathogenic variants in the aryl hydrocarbon  receptor-interacting protein (AIP) gene are increasingly recognised as a cause of familial isolated pituitary adenoma.AIP-associated tumours are most commonly growth hormone (GH) producing. In our cohort of 175AIP mutation positive patients representing 93 kindreds, 139 (79%) have GH excess, 19 have prolactinoma (17 familial and 2 sporadic cases) and out of the 17 clinically non-functioning tumours 4 were subsequently operated and found to be GH or GH& prolactin immunopositive adenoma. Here we report a family with anAIP variant, in which multiple family members ...
Source: Pituitary - October 2, 2020 Category: Endocrinology Source Type: research

Co-expression of intermediate filaments glial fibrillary acidic protein and cytokeratin in pituitary adenoma
AbstractPurposeTo analyze the co-expression of the intermediate filaments GFAP and cytokeratin in 326 pituitary adenomas with regard to the distribution pattern, the subtype of the adenoma and clinical prognostic data.MethodsTissue from 326 pituitary adenomas and 13 normal anterior pituitaries collected in the Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, between 2006 and 2009 was investigated by immunohistochemistry, immunofluorescence and electron microscopy.ResultsCo-expression of intermediate filaments GFAP and cytokeratin was associated with hormone expression in 62/278 cases (22%), but onl...
Source: Pituitary - September 30, 2020 Category: Endocrinology Source Type: research

Postoperative diabetes insipidus: how to define and grade this complication?
ConclusionsTo improve reliability and comparability we propose the following definition for postoperative DI: polyuria (urine production  >  300 ml/hour for 3 h) accompanied by a urine specific gravity (USG)   300 mosmol/kg, or serum sodium >  145 mmol/L. To prevent unnecessary treatment with desmopressin, we present an algorithm for the diagnosis and treatment of postoperative DI. (Source: Pituitary)
Source: Pituitary - September 28, 2020 Category: Endocrinology Source Type: research

Incidence, mortality, and cardiovascular diseases in pituitary adenoma in Korea: a nationwide population-based study
ConclusionSouth Korea had a relatively high incidence of NFPA. The incidence of stroke was highest for ACTH  + TSH and NFPA, which was directly related to mortality during long-term follow-up. Patients with these types of PA should receive stroke prevention measures to reduce their risk of mortality. (Source: Pituitary)
Source: Pituitary - September 18, 2020 Category: Endocrinology Source Type: research