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Hypopituitarism and bone disease: pathophysiology, diagnosis and treatment outcomes. 垂体功能减退症和骨病：病理生理学、诊断和治疗效果。
IF 3.3 2区 医学
Pituitary Pub Date : 2024-12-01 Epub Date: 2024-05-06 DOI: 10.1007/s11102-024-01391-2
Amit Akirov, Yaron Rudman, Maria Fleseriu
{"title":"Hypopituitarism and bone disease: pathophysiology, diagnosis and treatment outcomes.","authors":"Amit Akirov, Yaron Rudman, Maria Fleseriu","doi":"10.1007/s11102-024-01391-2","DOIUrl":"10.1007/s11102-024-01391-2","url":null,"abstract":"<p><p>Hypopituitarism is a rare but significant endocrine disorder characterized by the inadequate secretion of one or more pituitary hormones. The intricate relationship between hypopituitarism and bone health is a topic of growing interest in the medical community. In this review the authors explore associations between hypopituitarism and bone health, with specific examination of the impact of growth hormone deficiency, central hypogonadism, central hypocortisolism, and central hypothyroidism. Pathogenesis, diagnosis, and treatment options as well as challenges posed by osteopenia, osteoporosis, and fractures in hypopituitarism are discussed.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"778-788"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of medical therapy for hormone-secreting Pituitary tumors on bone. 激素分泌型垂体瘤的药物治疗对骨骼的影响。
IF 3.3 2区 医学
Pituitary Pub Date : 2024-12-01 Epub Date: 2024-07-05 DOI: 10.1007/s11102-024-01421-z
Pamela U Freda
{"title":"Impact of medical therapy for hormone-secreting Pituitary tumors on bone.","authors":"Pamela U Freda","doi":"10.1007/s11102-024-01421-z","DOIUrl":"10.1007/s11102-024-01421-z","url":null,"abstract":"<p><strong>Purpose: </strong>Bone health is often impaired in patients with hormone-secreting pituitary tumors. Since medical therapy is central to their care, understanding how its use impacts on this is highly important.</p><p><strong>Methods: </strong>This review summarizes a systemmatic review of the literature on the effects of medical therapies for hormone-secreting pituitary tumors on bone.</p><p><strong>Results: </strong>In acromegaly, medical therapy lowers bone turnover marker (BTM) levels, consistent with correction of the high bone turnover of active disease, and overall, areal bone mineral density (aBMD) does not change or increases. Somatostatin-receptor ligand (SRL) and pegvisomant-treated acromegaly patients have persistently reduced volumetric BMD and microarchitectural abnormalities of the peripheral skeleton, deficits that are similar to those in surgically-treated patients. Fracture risk remains elevated in medically-treated acromegaly patients but in conjunction with biochemical control the risk is lessened. Treatment of prolactin-secreting tumors with dopamine agonists is associated with improvements in aBMD, but this does not always fully normalize despite effective medical treatment of the prolactinoma. In one cross-sectional study, prolactinoma patients had lower total volumetric BMD and impaired microarchitecture suggesting that bone microstructure does not fully normalize despite dopamine agonist therapy. Cross-sectional studies show a high rate of VF in patients with prolactin-secreting tumors that is lowered on cabergoline therapy, but still the fracture rate of men and postmenopausal women is higher than that of controls in some studies. Studies on the effects of modern-day medical therapy for Cushing's disease on bone are lacking.</p><p><strong>Conclusion: </strong>More research is needed on the effectsof medical therapies for hormone secreting pituitary tumors on bone health.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"860-873"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pituitary surgery and COVID. 脑垂体手术和 COVID。
IF 3.3 2区 医学
Pituitary Pub Date : 2024-12-01 Epub Date: 2024-07-05 DOI: 10.1007/s11102-024-01423-x
Ameen Farsakh, Sandra Li, Fidel Toomey, Mendel Castle-Kirszbaum, Jeremy Kam, Tony Goldschlager
{"title":"Pituitary surgery and COVID.","authors":"Ameen Farsakh, Sandra Li, Fidel Toomey, Mendel Castle-Kirszbaum, Jeremy Kam, Tony Goldschlager","doi":"10.1007/s11102-024-01423-x","DOIUrl":"10.1007/s11102-024-01423-x","url":null,"abstract":"<p><p>An effect of the COVID-19 pandemic was the disruption of healthcare systems, especially surgical services provided to the community. Pituitary surgery was especially impacted, given the majority of cases were deemed non-urgent with very few exceptions, and the high risk of viral transmission conferred by the endoscopic endonasal transsphenoidal approach. Patients suffering from pituitary lesions with resultant endocrinopathy or visual symptoms saw their treatment delayed or altered, which had implications on their outcomes and care. This disruption extended to surgical training and the usual functioning of academic units, necessitating changes to curricula and implementation of novel methods of progressing surgical education. This review will explore the effect of the COVID pandemic on pituitary surgery, the experiences of various surgeons as well as the adaptations implemented on the frontlines. The lessons learned from the experience of the pandemic may assist specialists in gleaning insights regarding the care of patients in the future.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"909-915"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long COVID and pituitary dysfunctions: a bidirectional relationship? 长 COVID 和垂体功能障碍：双向关系？
IF 3.3 2区 医学
Pituitary Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1007/s11102-024-01442-8
Luigi di Filippo, Vincenzo Franzese, Simona Santoro, Mauro Doga, Andrea Giustina
{"title":"Long COVID and pituitary dysfunctions: a bidirectional relationship?","authors":"Luigi di Filippo, Vincenzo Franzese, Simona Santoro, Mauro Doga, Andrea Giustina","doi":"10.1007/s11102-024-01442-8","DOIUrl":"10.1007/s11102-024-01442-8","url":null,"abstract":"<p><p>Long COVID is a novel emerging syndrome known to affect multiple health areas in patients previously infected by SARS-CoV-2 markedly impairing their quality of life. The pathophysiology of Long COVID is still largely poorly understood and multiple mechanisms were proposed to underlie its occurrence, including alterations in the hormonal hypothalamic-pituitary axes. Aim of this review is to present and discuss the potential negative implications of these hormonal dysfunctions in promoting and influencing the Long COVID syndrome. To date, the hypothalamic-pituitary-adrenal axis is the mostly investigated and several studies have reported a prolonged impairment leading to mild and subclinical forms of central adrenal insufficiency. Few data are also available regarding central hypogonadism, central hypothyroidism and growth hormone (GH) deficiency. A high prevalence of central hypogonadism in COVID-19 survivors several months after recovery was consistently reported in different cohorts. Conversely, very few data are available on the hypothalamic-pituitary-thyroid axis function that was mainly shown to be preserved in COVID-19 survivors. Finally, a potential impairment of the hypothalamic-GH axis in Long COVID has also been reported. These data altogether may suggest a novel possible pituitary-centred pathophysiological view of Long COVID syndrome which if confirmed by large clinical studies may have relevant implication for the diagnostic and therapeutic approach at least in a subset of patients with the syndrome.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"955-969"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acromegaly and COVID-19, lessons, and new opportunities. 肢端肥大症和 COVID-19、教训和新机遇。
IF 3.3 2区 医学
Pituitary Pub Date : 2024-12-01 Epub Date: 2024-05-31 DOI: 10.1007/s11102-024-01404-0
Elena V Varlamov, Maria Fleseriu
{"title":"Acromegaly and COVID-19, lessons, and new opportunities.","authors":"Elena V Varlamov, Maria Fleseriu","doi":"10.1007/s11102-024-01404-0","DOIUrl":"10.1007/s11102-024-01404-0","url":null,"abstract":"<p><p>The COVID-19 pandemic created challenges in effective management of patients with acromegaly. Specifically, with regards to timely diagnosis, delays in surgeries, and disruption(s) to routine patient care. A transition to telemedicine did help to overcome safety restrictions that were placed on in-person care. Creation of surgical safety protocols in conjunction with widespread testing for COVID-19 has also helped with the resumption of pituitary surgery cases. However, acromegaly related comorbidities including cardiovascular disease, diabetes mellitus, sleep apnea and respiratory disease, vertebral fractures, and hypopituitarism, may increase the risk of a more severe COVID-19 infection course. Of note and to date, no negative trends in COVID-19 related outcomes have been reported in patients with acromegaly. Nevertheless, anxiety and depression rates in patients with acromegaly are higher than those in the general population. More studies are needed to assess the true impact of the COVID-19 pandemic on morbidity, mortality, and neuropsychiatric health of patients with acromegaly.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"935-944"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cushing's disease and bone. 库欣氏病与骨骼
IF 3.3 2区 医学
Pituitary Pub Date : 2024-12-01 Epub Date: 2024-07-15 DOI: 10.1007/s11102-024-01427-7
Aleksandra Zdrojowy-Wełna, Barbara Stachowska, Marek Bolanowski
{"title":"Cushing's disease and bone.","authors":"Aleksandra Zdrojowy-Wełna, Barbara Stachowska, Marek Bolanowski","doi":"10.1007/s11102-024-01427-7","DOIUrl":"10.1007/s11102-024-01427-7","url":null,"abstract":"<p><p>Bone impairment associated with Cushing's disease (CD) is a complex disorder, mainly involving deterioration of bone quality and resulting in an increased fracture rate, often despite normal bone mineral density. Bone complications are common in patients with CD at the time of diagnosis but may persist even after successful treatment. There is currently no agreement on the optimal diagnostic methods, thresholds for anti-osteoporotic therapy and its timing in CD. In this review, we summarize the current data on the pathophysiology, diagnostic approach and management of bone complications in CD.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"837-846"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Precocious puberty, pandemic and beyond. 性早熟、大流行病及以后。
IF 3.3 2区 医学
Pituitary Pub Date : 2024-12-01 Epub Date: 2024-07-26 DOI: 10.1007/s11102-024-01434-8
Guillermo F Alonso
{"title":"Precocious puberty, pandemic and beyond.","authors":"Guillermo F Alonso","doi":"10.1007/s11102-024-01434-8","DOIUrl":"10.1007/s11102-024-01434-8","url":null,"abstract":"<p><p>WHO declared SARS-COVID19 a pandemic in March 2020. Most governments declared health emergency states and implemented various measures. Since then, changes in the reasons for medical consultations were observed in healthcare institutions. Pediatric endocrinologists perceived an increase in the number of consultations related to early or accelerated CPP during the months following the lockdown that different governments had established. Several papers reported the increment in incidence in Central Precocious Puberty, especially in girls. Reports from different parts of the world highlighted a two to threefold rise in the number of cases of precocious puberty treated in Pediatric Endocrinology Centers. This trend of CPP incidence strongly suggests that changes in habits and the environment in which boys and girls were immersed during the lockdown, have played a significant role in triggering the early onset of the gonadotrophic axis.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"916-924"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cushing's syndrome and COVID-19. 库欣综合征和 COVID-19。
IF 3.3 2区 医学
Pituitary Pub Date : 2024-12-01 Epub Date: 2024-11-14 DOI: 10.1007/s11102-024-01466-0
Amina Attia, Jérôme Bertherat
{"title":"Cushing's syndrome and COVID-19.","authors":"Amina Attia, Jérôme Bertherat","doi":"10.1007/s11102-024-01466-0","DOIUrl":"10.1007/s11102-024-01466-0","url":null,"abstract":"<p><strong>Purpose: </strong>This review aims to present current data on the course of COVID-19 in patients with Cushing syndrome (CS) and discuss treatment for CS during to the pandemic.</p><p><strong>Methods: </strong>Literature review using PubMed (pubmed.ncbi.nlm.nih.gov). The search included the following terms: \"COVID19\" in combination with \"Cushing syndrome\", \"Hypercortisolism\" and \"Glucocorticoid\".</p><p><strong>Results: </strong>Chronic hypercortisolism has been reported to increase infectious risk and worsens prognostic of patients with COVID-19 potentially due to its direct impact on the immune system: lymphopenia, impairment of monocytes and neutrophils activity, diminution of complement activation. Main metabolic complications of CS - i.e. diabetes, hypertension and obesity - have been recognized as COVID-19 complications risk factors. Patients with CS treated with steroidogenesis inhibitors might experience adrenal insufficiency during COVID-19. Special attention should be paid to patients with CS and COVID-19. The pandemic has impacted - and delayed - care of chronic illnesses including CS. Specific recommendations had been provided during the pandemic: favor telemedicine consultations, limit in-hospital explorations and postpone surgery when feasible.</p><p><strong>Conclusion: </strong>There are enough evidence for an increased prevalence and severity of COVID-19 to recommend a specific attention and caution in patients with CS.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"945-954"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pituitary Apoplexy: a re-appraisal of risk factors and best management strategies in the COVID-19 era. 垂体性脑卒中：重新评估 COVID-19 时代的风险因素和最佳管理策略。
IF 3.3 2区 医学
Pituitary Pub Date : 2024-12-01 Epub Date: 2024-08-05 DOI: 10.1007/s11102-024-01420-0
Andre E Boyke, Michelot Michel, Adam N Mamelak
{"title":"Pituitary Apoplexy: a re-appraisal of risk factors and best management strategies in the COVID-19 era.","authors":"Andre E Boyke, Michelot Michel, Adam N Mamelak","doi":"10.1007/s11102-024-01420-0","DOIUrl":"10.1007/s11102-024-01420-0","url":null,"abstract":"<p><p>Pituitary apoplexy (PA) is a clinical syndrome caused by acute hemorrhage and/or infarction of the pituitary gland, most commonly in the setting of a pituitary macroadenoma. PA generally presents with severe headache, nausea, vomiting, visual disturbance, and, in more severe cases, altered mental status. Many factors have been attributed to the risk of developing PA, including most recently, numerous reports showcasing an association with COVID-19 infection or vaccination. Initial management of PA includes evaluation and correction of deficient hormones and electrolytes and an assessment if surgical decompression to relieve pressure on optic nerves and other brain structures is needed. While prompt recognition and treatment are crucial to avoid morbidity and mortality, in the modern era, PA is less commonly considered a true neurosurgical emergency requiring immediate (< 24 h) surgical decompression. Traditionally, surgical decompression has been the standard of care for significant mass effects. However, several studies have shown similar outcomes in visual and hormonal recovery with either surgical decompression or conservative medical management. Unfortunately, most evidence on optimal management strategies is limited to retrospective case series, small prospective studies, and one multi-center observational study. This review aims to provide the most up-to-date evidence on the role of COVID-19 in PA and best management strategies.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"898-908"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Craniofacial impact of acromegaly: when muscle ma-sse-tter. 肢端肥大症对颅面的影响：当肌肉变粗时。
IF 3.3 2区 医学
Pituitary Pub Date : 2024-10-01 Epub Date: 2024-07-26 DOI: 10.1007/s11102-024-01436-6
Thomas Cuny
{"title":"Craniofacial impact of acromegaly: when muscle ma-sse-tter.","authors":"Thomas Cuny","doi":"10.1007/s11102-024-01436-6","DOIUrl":"10.1007/s11102-024-01436-6","url":null,"abstract":"","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"437-439"},"PeriodicalIF":3.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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