Pituitary最新文献_第7页

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":"Purpose: 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.Methods: This review summarizes a systemmatic review of the literature on the effects of medical therapies for hormone-secreting pituitary tumors on bone.Results: 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.Conclusion: More research is needed on the effectsof medical therapies for hormone secreting pituitary tumors on bone health.","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

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":"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.","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

Skeletal fragility in pituitary disease: how can we predict fracture risk? 垂体疾病的骨骼脆性：如何预测骨折风险？

IF 3.3 2区医学

Pituitary Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1007/s11102-024-01447-3

Fabio Bioletto, Alessandro Maria Berton, Marco Barale, Luigi Simone Aversa, Lorenzo Sauro, Michela Presti, Francesca Mocellini, Noemi Sagone, Ezio Ghigo, Massimo Procopio, Silvia Grottoli

{"title":"Skeletal fragility in pituitary disease: how can we predict fracture risk?","authors":"Fabio Bioletto, Alessandro Maria Berton, Marco Barale, Luigi Simone Aversa, Lorenzo Sauro, Michela Presti, Francesca Mocellini, Noemi Sagone, Ezio Ghigo, Massimo Procopio, Silvia Grottoli","doi":"10.1007/s11102-024-01447-3","DOIUrl":"10.1007/s11102-024-01447-3","url":null,"abstract":"Pituitary hormones play a crucial role in regulating skeletal physiology, and skeletal fragility is a frequent complication of pituitary diseases. The ability to predict the risk of fracture events is crucial for guiding therapeutic decisions; however, in patients with pituitary diseases, fracture risk estimation is particularly challenging. Compared to primary osteoporosis, the evaluation of bone mineral density by dual X-ray absorptiometry is much less informative about fracture risk. Moreover, the reliability of standard fracture risk calculators does not have strong validations in this setting. Morphometric vertebral assessment is currently the cornerstone in the assessment of skeletal fragility in patients with pituitary diseases, as prevalent fractures remain the strongest predictor of future fracture events. In recent years, new tools for evaluating bone quality have shown promising results in assessing bone impairment in patients with pituitary diseases, but most available data are cross-sectional, and evidence regarding the prediction of incident fractures is still scarce. Of note, apart from measures of bone density and bone quality, the estimation of fracture risk in the context of pituitary hyperfunction or hypofunction cannot ignore the evaluation of factors related to the underlying disease, such as its severity and duration, as well as the specific therapies implemented for its treatment. Aim of this review is to provide an up-to-date overview of all major evidence regarding fracture risk prediction in patients with pituitary disease, highlighting the need for a tailored approach that critically integrates all clinical, biochemical, and instrumental data according to the specificities of each disease.","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":" ","pages":"789-801"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140848","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

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

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

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

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":"Purpose: 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.Methods: Literature review using PubMed (pubmed.ncbi.nlm.nih.gov). The search included the following terms: \"COVID19\" in combination with \"Cushing syndrome\", \"Hypercortisolism\" and \"Glucocorticoid\".Results: 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.Conclusion: There are enough evidence for an increased prevalence and severity of COVID-19 to recommend a specific attention and caution in patients with CS.","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":"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.","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

引用次数: 0