Pituitary最新文献_第5页

Vitamin D in pituitary driven osteopathies. 垂体驱动的骨质疏松症中的维生素 D。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-08-24 DOI: 10.1007/s11102-024-01439-3

Sabrina Chiloiro, Flavia Costanza, Elena Riccardi, Antonella Giampietro, Laura De Marinis, Antonio Bianchi, Alfredo Pontecorvi, Andrea Giustina

引用次数: 0

Changes in pituitary adenoma patient presentation and outcomes during the COVID pandemic at a Pituitary Center of Excellence. 在 COVID 大流行期间，垂体腺瘤患者在垂体卓越中心的表现和治疗效果的变化。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-07-24 DOI: 10.1007/s11102-024-01435-7

Anthony Tang, Hussein M Abdallah, Yue-Fang Chang, Georgios A Zenonos, Paul A Gardner, Garret W Choby, Eric W Wang, Carl H Snyderman

{"title":"Changes in pituitary adenoma patient presentation and outcomes during the COVID pandemic at a Pituitary Center of Excellence.","authors":"Anthony Tang, Hussein M Abdallah, Yue-Fang Chang, Georgios A Zenonos, Paul A Gardner, Garret W Choby, Eric W Wang, Carl H Snyderman","doi":"10.1007/s11102-024-01435-7","DOIUrl":"10.1007/s11102-024-01435-7","url":null,"abstract":"Purpose: The COVID-19 pandemic caused significant disruption to the surgical care of patients. The aim of this study was to analyze the impact of the pandemic on endoscopic endonasal surgery (EES) for patients with a pituitary adenoma.Methods: Patients from 2015 to 2022 that had EES for a pituitary adenoma were included in this study. Patients were separated into pre-COVID (January 2015-March 2020) and COVID (March 2020-September 2022) groups. Univariate analysis was done using chi-square, fisher exact tests, and t-tests to compare groups.Results: This study included 492 patients that had EES for their pituitary adenoma. There were 314 patients in the pre-COVID group and 178 patients in the COVID group. Patients in the COVID group had a higher risk analysis index (RAI) frailty score (15 ± 10 pre-COVID vs. 20 ± 9 COVID, P < 0.001) and a higher American Society of Anesthesiology (ASA) physical status score (3 or 4) (72.0% pre-COVID vs. 81.9% COVID, P = 0.02). There were significantly more macroadenoma cases (87.6% pre-COVID vs. 94.4% COVID, P = 0.02) and extrasellar surgical approaches (45.2% pre-COVID vs. 61.2% COVID, P < 0.001) during COVID. There was no significant difference in length of stay (LOS) and readmission rates between groups.Conclusions: Patients that presented during the pandemic tended to be more frail, have more comorbidities, and require additional extrasellar surgical approaches. Despite changes in clinical presentation and operative management, the LOS and readmission rate remained stable during COVID, supporting the safety of this procedure during the recent pandemic.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"986-991"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752474","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

TSH-secreting pituitary adenomas and bone. 分泌促甲状腺激素的垂体腺瘤与骨骼。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1007/s11102-024-01467-z

Marco Losa, Alberto Vassallo, Stefano Frara, Pietro Mortini, Andrea Giustina

{"title":"TSH-secreting pituitary adenomas and bone.","authors":"Marco Losa, Alberto Vassallo, Stefano Frara, Pietro Mortini, Andrea Giustina","doi":"10.1007/s11102-024-01467-z","DOIUrl":"10.1007/s11102-024-01467-z","url":null,"abstract":"TSH-secreting pituitary adenoma (TSHoma) is the rarest functioning pituitary tumor, with an increasing incidence over the last decades. Diagnosis is often delayed, exposing patients to a high risk of developing chronic complications of long-standing hyperthyroidism. Although thyroid hormone excess is a recognized cause of secondary osteoporosis, very few studies have investigated skeletal damage in patients with TSHoma, with data limited to bone turnover markers (BTM) and a study on the prevalence of radiological vertebral fractures (VFs) incidentally detected on chest X-ray, whereas data on bone mineral density (BMD) are anecdotal. Bone resorption is increased in TSHoma compared to controls, whereas few case reports described osteoporosis and spine fractures as early complications of TSHoma. A high prevalence of morphometric VFs was described in TSHoma compared to nonfunctioning pituitary adenoma (NFPA). Patients with fracture were older and had higher free thyroxine (fT4) levels than patients without fracture. In this specific setting, treatment with somatostatin receptor ligands seems to have a protective role on fracture risk. Based on this evidence, a comprehensive osteometabolic evaluation should be performed in all patients with TSHoma, including assessment of BTM, measurement of BMD, and morphometric evaluation of VFs, both at diagnosis and then during follow-up, particularly in patients at high risk for fragility fractures.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"752-760"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546863","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 and COVID-19 vaccination: a systematic review. 脑垂体与 COVID-19 疫苗接种：系统综述。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-05-18 DOI: 10.1007/s11102-024-01402-2

Martina Verrienti, Valentino Marino Picciola, Maria Rosaria Ambrosio, Maria Chiara Zatelli

{"title":"Pituitary and COVID-19 vaccination: a systematic review.","authors":"Martina Verrienti, Valentino Marino Picciola, Maria Rosaria Ambrosio, Maria Chiara Zatelli","doi":"10.1007/s11102-024-01402-2","DOIUrl":"10.1007/s11102-024-01402-2","url":null,"abstract":"Purpose: This systematic review aims to examine the latest research findings and assess the impact of COVID-19 vaccination on the pituitary gland.Method: PubMed and Tripdatabase were searched from January 1st, 2020 to February 12th, 2024. Case reports, case series and reviews related to post COVID-19 vaccination pituitary disease were included. Eligible articles were tabulated and analysed in the attempt to provide an overview on the epidemiology, clinical presentation, imaging, treatment, outcomes and pathophysiological background of post COVID-19 vaccination pituitary disease.Results: Among the 23 case reports included in this review, post COVID-19 vaccination hypophysitis was reported in 9 patients, pituitary apoplexy (PA) in 6 cases, SIADH in 5 cases and Isolated ACTH deficiency in 2 cases. Additionally, precipitating adrenal crisis was registered in 7 patients and pituitary tumor enlargement in 1 patient after receiving COVID-19 vaccination.Conclusion: Despite the rarity of these events, our research findings suggest an association between COVID-19 vaccination and the subsequent development of pituitary diseases. The most common manifestations include hypophysitis with ADH deficiency, PA and SIADH, with symptoms typically emerging shortly after vaccine administration. Potential pathogenetic mechanisms include molecular mimicry, vaccine adjuvants and vaccine-induced thrombotic thrombocytopenia (VITT), with the presence of ACE2 receptors in the hypothalamus-pituitary system contributing to the process. These findings can aid in diagnostic and treatment decisions for patients presenting with these syndromes. Nevertheless, given the rarity of these events, safety and efficacy of the currently available COVID-19 vaccines remain robust and we strongly advocate continuing pursuing vaccination efforts.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"970-985"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956848","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

Approach to the patient with controlled acromegaly and acromegalic arthropathy: clinical diagnosis and management. 控制性肢端肥大症和肢端肥大性关节病患者的治疗方法：临床诊断和管理。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-11-01 DOI: 10.1007/s11102-024-01465-1

Iris C M Pelsma, Herman M Kroon, Cornelie D Andela, Enrike M J van der Linden, Margreet Kloppenburg, Nienke R Biermasz, Kim M J A Claessen

{"title":"Approach to the patient with controlled acromegaly and acromegalic arthropathy: clinical diagnosis and management.","authors":"Iris C M Pelsma, Herman M Kroon, Cornelie D Andela, Enrike M J van der Linden, Margreet Kloppenburg, Nienke R Biermasz, Kim M J A Claessen","doi":"10.1007/s11102-024-01465-1","DOIUrl":"10.1007/s11102-024-01465-1","url":null,"abstract":"Following the description of an illustrative case of a 70-year-old female patient with longstanding active acromegaly and invalidating, progressive joint complaints, current insights regarding diagnosis, treatment, and long-term management of acromegalic arthropathy are summarized. Since clinical trials on this topic are lacking, the reported recommendations are based on extensive clinical and research experience with this clinical entity, and on established diagnostics and interventions in patients with other rheumatic diseases. The cornerstones of the management of acromegalic arthropathy remains normalization of growth hormone and insulin growth factor-1 levels. However, patients with severe or progressive acromegalic arthropathy require a multidisciplinary approach to determine adequate diagnostics and treatment options. Because of the high prevalence and invalidating character of acromegalic arthropathy, developing evidence-based effective prevention and treatment strategies, preferably by international collaboration within rare disease networks, e.g., Endo-ERN, is a clear unmet need.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"824-836"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562453","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

Hypopituitarism and COVID-19. 垂体功能减退症和 COVID-19。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-11-19 DOI: 10.1007/s11102-024-01463-3

Giulia Carosi, Arianna Cremaschi, Claudia Giavoli, Emanuele Ferrante, Giovanna Mantovani

{"title":"Hypopituitarism and COVID-19.","authors":"Giulia Carosi, Arianna Cremaschi, Claudia Giavoli, Emanuele Ferrante, Giovanna Mantovani","doi":"10.1007/s11102-024-01463-3","DOIUrl":"10.1007/s11102-024-01463-3","url":null,"abstract":"Purpose: This review aims to collect and examine recent research findings regarding hypopituitarism and COVID-19, focusing on the virus's impact on the pituitary gland and the outcomes for infected patients with hormonal deficiencies.Methods: Literature review using PubMed (pubmed.ncbi.nlm.nih.gov). The search included the following terms: \"COVID19\" in combination with \"Pituitary\" and \"Hypopituitarism\".Results: Many studies have aimed to evaluate the function of the pituitary gland in infected patients, revealing variable degrees of deficiencies. The results are very heterogenous mostly because many different tests and hormonal cut-off have been adopted. It is unclear whether primary virus damage or the inflammatory response is responsible for these hormonal alterations. Interestingly, pituitary defects may persist long after the initial infection, possibly contributing to the \"Long COVID syndrome\". However, data on the recovery of pituitary function and long-term follow-up are not yet available. On the other hand, although findings are not consistent, patients with hypopituitarism may be at a higher risk for COVID-19 infection rate, complications, and mortality.Conclusion: The COVID-19 pandemic presented challenges for endocrinologists. The endocrine system appears to be involved in both the acute phase of infection and the recovery period. Hypopituitarism can be a consequence of SARS-COV-2 infection, and patients with existing hypopituitarism may face higher risks of complications. It is advisable to educate these patients on how to adjust their replacement therapies. Long-term follow-up data on pituitary function after recovery from COVID-19 are needed.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"925-934"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668808","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

Growth hormone and bone: a basic perspective. 生长激素与骨骼：基本观点。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1007/s11102-024-01464-2

Simona Bolamperti, Isabella Villa, Luigi di Filippo

引用次数: 0

Syndrome of inappropriate antidiuresis/hyponatremia in COVID-19. COVID-19 中的不当抗利尿/高钠血症综合征。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-08-28 DOI: 10.1007/s11102-024-01446-4

Alessandro Peri, Laura Naldi, Dario Norello, Benedetta Fibbi

{"title":"Syndrome of inappropriate antidiuresis/hyponatremia in COVID-19.","authors":"Alessandro Peri, Laura Naldi, Dario Norello, Benedetta Fibbi","doi":"10.1007/s11102-024-01446-4","DOIUrl":"10.1007/s11102-024-01446-4","url":null,"abstract":"Hyponatremia is the most frequent electrolyte alteration among hospitalized patients and it has been reported in 20-40% of patients with SARS-CoV-2 (COVID-19) infection. Multiple causes of hyponatremia have been hypothesized in these patients. The syndrome of inappropriate antidiuresis (SIAD) has been considered one of the main reasons leading to hyponatremia in this condition. SIAD can be secondary to cytokines release, in particular IL-6. Positive pressure ventilation can be another cause of hyponatremia due to SIAD. Other possible etiologies of hyponatremia in COVID-19 patients can be related to secondary hypocortisolism, nausea, vomiting, heart and kidney damage. Similar to many other clinical conditions, there is strong evidence that hyponatremia is associated with a worse prognosis also in patients with COVID-19 infection. In particular, hyponatremia has been identified as an independent risk of ICU transfer, need of non-invasive ventilation and death. Hyponatremia in COVID-19 patients is in principle acute and symptomatic and should be treated as such, according to the published guidelines. Therefore, patients should be initially treated with i.v. hypertonic saline (3% NaCl) infusion and serum [Na+] should be frequently monitored, in order to remain within a safe rate of correction. There is evidence showing that serum [Na+] correction is associated with a better outcome in different pathologies, including COVID-19 infection.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"889-897"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081280","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

Novel approach to bone comorbidity in resistant acromegaly. 抗药性肢端肥大症骨合并症的新方法。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-11-21 DOI: 10.1007/s11102-024-01468-y

Stefano Frara, Matteo Acanfora, Vincenzo Franzese, Maria Luisa Brandi, Marco Losa, Andrea Giustina

{"title":"Novel approach to bone comorbidity in resistant acromegaly.","authors":"Stefano Frara, Matteo Acanfora, Vincenzo Franzese, Maria Luisa Brandi, Marco Losa, Andrea Giustina","doi":"10.1007/s11102-024-01468-y","DOIUrl":"10.1007/s11102-024-01468-y","url":null,"abstract":"Active acromegaly may lead to irreversible complications. Among them, acromegaly osteopathy and fragility (vertebral and hip) fractures have emerged as frequent and precocious events in the natural history of the disease, being correlated with longer disease duration and higher growth hormone (GH) levels, accounting for patients' reported poor quality of life, physical performance and other life-impacting complications. Differently from primary osteoporosis, bone mineral density is not a reliable tool to predict fracture risk in this clinical setting, as patients with active disease frequently have normal or slightly reduced bone mass; whereas bone quality is particularly compromised, as determined by low trabecular bone score (TBS) in patients with active disease as compared to healthy controls or patients with cured/controlled disease. The evidence of impaired bone microstructure has been profoundly investigated with different computed tomography (CT) techniques, reporting low trabecular number and thickness as well as wide but more porous cortical bone, providing an explanation for such a high prevalence of vertebral fractures (up to 40-50% in selected cohorts). Since data on bone-active drugs are scanty, disease control remains a cornerstone to prevent fractures. Nonetheless, some potential protective effects may derive from vitamin D supplementation and pasireotide therapies, independently from disease status. Aim of this manuscript is to review the current and emerging evidence on skeletal fragility in patients with active and resistant acromegaly.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"813-823"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682362","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

Modern approach to bone comorbidity in prolactinoma. 泌乳素瘤骨合并症的现代治疗方法。

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-11-14 DOI: 10.1007/s11102-024-01469-x

Meliha Melin Uygur, Sara Menotti, Simona Santoro, Andrea Giustina

{"title":"Modern approach to bone comorbidity in prolactinoma.","authors":"Meliha Melin Uygur, Sara Menotti, Simona Santoro, Andrea Giustina","doi":"10.1007/s11102-024-01469-x","DOIUrl":"10.1007/s11102-024-01469-x","url":null,"abstract":"Prolactinomas account for more than half of pituitary adenomas, and besides their clinical impact on fertility and gonadal function, they lead to detrimental effects on bone. Patients with prolactinoma are prone to deterioration of bone structure caused not only by prolactin (PRL) induced hypogonadism but also by its direct actions on bone cells and calcium metabolism. However, clinical studies have shown inconsistent evidence regarding whether PRL could have a deleterious effect independently from gonadal insufficiency on skeletal integrity. Seminal studies from our group reported an increased prevalence of vertebral fractures (VFs) in both female and male patients with prolactinoma. Treatment of prolactinoma with dopamine agonists can restore gonadal function and improve bone mineral density. Since the presence of VFs may be related to more aggressive disease, bone comorbidities in prolactinoma should be managed by a multidisciplinary team in line with the recent concept of 'pituitary tumors centers of excellence'. The review aims to evaluate the mechanism of PRL actions on bone, as well as to provide practical indications for a modern approach to the management of skeletal complications of patients with prolactin-secreting adenoma considering different clinical characteristics and outcomes.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"802-812"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626679","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