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MedWorm: Acromegaly provides a medical RSS filtering service. Over 7000 RSS medical sources are combined and output via different filters. This feed contains the latest news and research in the Acromegaly category.

Last Build Date: Tue, 22 Mar 2016 08:30:46 +0100


Delayed Diagnosis of Acromegaly in an Elderly Adult that Initially Presented as Cutis Verticis Gyrata

Mon, 21 Mar 2016 00:00:00 +0100

(Source: Journal of the American Geriatrics Society)

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Growth hormone receptor exon 3 isoforms may have no importance in the clinical setting of multiethnic Brazilian acromegaly patients

Mon, 21 Mar 2016 00:00:00 +0100

Conclusion GHR exon 3 genotyping appears to have no clinical significance, at least in Brazilian acromegaly patients. (Source: Pituitary)

Pregnancy and pituitary adenomas.

Thu, 17 Mar 2016 12:09:03 +0100

Authors: Glezer A, Jallad R, Machado MM, Fragoso MC, Bronstein MD Abstract Infertility is frequent in patients harboring pituitary adenomas. The mechanisms involved include hypogonadism secondary to hormonal hypersecretion (prolactin, growth hormone and cortisol), stalk disconnection and pituitary damage. With the Improvement of clinical and surgical treatment, pregnancy in women harboring pituitary adenomas turned into a reality. Pituitary hormonal hyper and hypo secretion influences pregnancy outcomes, as well as pregnancy can interfere on pituitary tumors, especially in prolactinomas. We review literature about specific follow-up and management in pregnant women harboring prolactinomas, acromegaly, or Cushings disease and the impact of clinical and surgical treatment on each con...

Structural tendon changes in patients with acromegaly: assessment of Achilles tendon with sonoelastography.

Fri, 11 Mar 2016 21:35:02 +0100

CONCLUSIONS: Sonoelastography revealed structural changes in the tendinous tissue of patients with acromegaly, but it was not sensitive enough to reflect changes in the serum levels of GH/IGF-1. PMID: 26962551 [PubMed - in process] (Source: Medical Ultrasonography)

Somatostatin and its Analogs.

Fri, 11 Mar 2016 01:40:02 +0100

Authors: Sun L, Coy DH Abstract Somatostatin (SST) is a cyclic hormone-release inhibitory peptide that has high binding affinity to all of its five SST receptors (SSTRs). SST negatively regulates cell proliferation and the release of multiple hormones via activation of its cognate receptors. A variety of SST analogs, some with high affinity and selectivity of receptor subtypes, have been synthesized and developed. Certain longacting SST analogs such as octreotide, lanreotide and pasireotide have been clinically applied to the treatment of human diseases such as those caused by excessive release of growth hormone (acromegaly), or adrenocorticotropic hormone (Cushing's syndrome), and for the treatment of carcinoid syndrome. Investigations into new biological activities of these long-...

Acromegaly is more severe in patients with ahr or aip genes variants living in highly polluted areas.

Thu, 10 Mar 2016 00:00:00 +0100

CONCLUSIONS: Genetic variants potentially inducing functional abnormalities of the AHR pathway are associated with a more severe acromegaly, increased pituitary tumor size and SSa resistance in patients living in highly polluted areas. PMID: 26963951 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

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Low insulin resistance after surgery predicts poor GH suppression one year after complete resection for acromegaly: a retrospective study.

Wed, 09 Mar 2016 08:59:02 +0100

Authors: Edo N, Morita K, Suzuki H, Takeshita A, Miyakawa M, Fukuhara N, Nishioka H, Yamada S, Takeuchi Y Abstract Remission of acromegaly is defined as a nadir in GH <1.0 ng/mL during a 75-g oral glucose tolerance test (75gOGTT) and insulin-like growth factor-1 (IGF-1) normalization. Recently, a lower cut-off value for GH nadir (<0.4 ng/mL) has been proposed. We retrospectively evaluated the prevalence and clinical characteristics of postoperative cases with normalized IGF-1 levels and a GH nadir of 0.4-1.0 ng/mL one year after complete resection of GH-secreting pituitary adenoma (GHoma). We included 110 cases of acromegaly with complete adenoma resection, no preoperative treatment, preoperative glycosylated hemoglobin <6.5%, preoperative basal plasma glucose <126 mg/d...

Teratological Nymphal Ixodes scapularis (Acari: Ixodidae) From Wisconsin

Tue, 08 Mar 2016 00:00:00 +0100

Abnormalities of physiological development (teratological forms) in ticks are rare. The occurrence of gigantism, dwarfism, gynandromorphs, missing legs, extra legs, and asymmetries is most often reported from lab-reared specimens, but has been observed in field-collected specimens. All morphologically anomalous ticks (besides gynandromorphy) described to date are from species other than Ixodes scapularis Say (Acari: Ixodidae). Here we describe four teratological I. scapularis nymphs collected while dragging vegetation in Wisconsin in 2015, including two asymmetrical ticks, one with a missing leg, and one with an extra leg. (Source: Journal of Medical Entomology)

The Modern Criteria for Medical Management of Acromegaly.

Sat, 05 Mar 2016 20:15:03 +0100

Authors: Frara S, Maffezzoni F, Mazziotti G, Giustina A Abstract Acromegaly is an insidious disorder characterized by excess secretion of growth hormone (GH) and elevated circulating levels of insulin-like growth factor-I (IGF-I), generally caused by a pituitary adenoma. It is a rare disease associated with an average 10-year reduction in life expectancy due to metabolic, cardiovascular, and cerebrovascular comorbidities and reduced quality of life caused by paresthesias, fatigue, osteoarthralgia, or bone fractures. In 2000, Cortina Consensus Conference established general criteria for diagnosis and biochemical control of acromegaly, which have been revised in recent years, adapting them to emerging clinical evidences as well as the evolving assay techniques. Authors have proposed ...

The Impact of Adipose Tissue on Insulin Resistance in Acromegaly

Fri, 04 Mar 2016 00:00:00 +0100

Publication date: Available online 2 March 2016 Source:Trends in Endocrinology & Metabolism Author(s): Nicoleta Cristina Olarescu, Jens Bollerslev Adipose tissue (AT) is recognized as key contributor to the systemic insulin resistance and overt diabetes seen in metabolic syndrome. Acromegaly is a disease characterized by excessive secretion of growth hormone (GH) and insulin-like growth factor I (IGF-I). GH is known both for its action on AT and for its detrimental effect on glucose metabolism and insulin signaling. In active acromegaly, while body fat deports are diminished, insulin resistance is increased. Early studies have demonstrated defects in insulin action, both at the hepatic and extrahepatic (i.e., muscle and fat) levels, in active disease. This review discusses rece...

Can immediate postoperative random growth hormone levels predict long-term cure in patients with acromegaly?

Thu, 03 Mar 2016 00:00:00 +0100

Conclusion: Early postoperative GH values may be used to predict long-term cure. A value of ≤1.5 ng/ml at 6 h following surgery may predict long-term cure in two-thirds of the patients with acromegaly who undergo TSS. (Source: Neurology India)

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The Impact of Adipose Tissue on Insulin Resistance in Acromegaly.

Wed, 02 Mar 2016 00:00:00 +0100

Authors: Olarescu NC, Bollerslev J Abstract Adipose tissue (AT) is recognized as key contributor to the systemic insulin resistance and overt diabetes seen in metabolic syndrome. Acromegaly is a disease characterized by excessive secretion of growth hormone (GH) and insulin-like growth factor I (IGF-I). GH is known both for its action on AT and for its detrimental effect on glucose metabolism and insulin signaling. In active acromegaly, while body fat deports are diminished, insulin resistance is increased. Early studies have demonstrated defects in insulin action, both at the hepatic and extrahepatic (i.e., muscle and fat) levels, in active disease. This review discusses recent data suggesting that AT inflammation, altered AT distribution, and impaired adipogenesis are potential m...

Soluble Klotho protein as a novel serum biomarker in patients with acromegaly.

Tue, 01 Mar 2016 14:14:02 +0100

Authors: Dąbrowska AM, Tarach JS PMID: 26925141 [PubMed - as supplied by publisher] (Source: Archives of Medical Science)

Functional changes are associated with tracheal structural abnormalities in patients with acromegaly.

Tue, 01 Mar 2016 14:14:02 +0100

CONCLUSIONS: Acromegalic patients have tracheal structural abnormalities which are associated with functional indicators of LAO but not with clinical data. PMID: 26925121 [PubMed - as supplied by publisher] (Source: Archives of Medical Science)

Italian Society for the Study of Diabetes (SID)/Italian Endocrinological Society (SIE) guidelines on the treatment of hyperglycemia in Cushing's syndrome and acromegaly

Mon, 22 Feb 2016 00:00:00 +0100

Publication date: Available online 20 February 2016 Source:Nutrition, Metabolism and Cardiovascular Diseases Author(s): M.G. Baroni, F. Giorgino, V. Pezzino, C. Scaroni, A. Avogaro Background Hyperglycemia is a common feature associated with states of increased growth hormone secretion and glucocorticoid levels. Aims The purpose of these guidelines is to assist clinicians and other health care providers to take evidence-based therapeutic decisions for the treatment of hyperglycemia in patients with growth hormone and corticosteroid excess. Methodology Both the SID and SIE appointed members to represent each society and to collaborate in Guidelines writing. Members were chosen for their specific knowledge in the field. Each member agreed to produce—and regularly update—conflict...

Patterns of pharmacologic treatment in US patients with acromegaly.

Thu, 18 Feb 2016 02:49:02 +0100

CONCLUSIONS: This study, representing the largest claims-based analysis of acromegaly to date, used two databases across a 12 year period to examine complex treatment patterns in a difficult-to-study disease. Although wide variation in acromegaly treatment patterns exists in US clinical practice, in first-line, second-line, and third-line therapy, SRL was the most commonly used drug class. Drug combinations also varied considerably across lines of therapy. The switching between different monotherapies and varied use of drugs in combination may suggest an unmet need for alternative treatment options. Our claims-based technique of examining treatment patterns may be used for other rare diseases, although high censoring rates may be a challenge. PMID: 26609770 [PubMed - as supplied by pub...

Evaluation of Retinal Nerve Fiber Layer Thickness in Acromegalic Patients Using Spectral-Domain Optical Coherence Tomography.

Wed, 17 Feb 2016 23:34:06 +0100

CONCLUSIONS: Excessive GH and IGF-1 levels do not affect the optic nerve or RNLF thickness, whereas the RNLF becomes thinner in the inferior quadrant in acromegalic patients with macroadenoma as a result of the chiasmal compression. PMID: 25380485 [PubMed - as supplied by publisher] (Source: Seminars in Ophthalmology)

Pituitary gigantism: a retrospective case series

Wed, 17 Feb 2016 20:09:55 +0100

Journal Name: Journal of Pediatric Endocrinology and MetabolismIssue: Ahead of print (Source: Journal of Pediatric Endocrinology and Metabolism)

Emerging drugs for acromegaly.

Wed, 17 Feb 2016 17:44:02 +0100

This article reviews new medical treatments currently under clinical investigation (such as pasireotide, oral octreotide and somatoprim) and under experimental development (such as octreotide implants, CAM2029 and ATL-1103). EXPERT OPINION: As it seems unlikely that one single agent may achieve cure in 100% of cases, there is an urgent need for new agents that help patients where current medication fails. Imperatively, this means we have to improve our understanding of the underlying pathogenetic and molecular mechanisms. PMID: 24400774 [PubMed - indexed for MEDLINE] (Source: Expert Opinion on Emerging Drugs)

Adverse events associated with somatostatin analogs in acromegaly.

Wed, 17 Feb 2016 17:43:02 +0100

Authors: Grasso LF, Auriemma RS, Pivonello R, Colao A Abstract INTRODUCTION: In patients with acromegaly, somatostatin analogs (SSA) represent the first choice medical treatment. The long-acting SSA have been found to be effective in controlling growth hormone and IGF-I levels in a high percentage of patients, resulting in an improvement in the quality of life; moreover, these peptide analogs have a proven safety record and are generally well tolerated. AREAS COVERED: The most commonly reported adverse events include injection-site discomfort and erythema, gastrointestinal (GI) disturbances such as diarrhea, abdominal pain, nausea and vomiting, biliary sludge or gallstones, and abnormal glucose metabolism. Most SSA-related adverse events are transient and of mild-to-moderate in...

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The impact of diabetes mellitus on the survival of patients with acromegaly.

Wed, 17 Feb 2016 00:00:00 +0100

CONCLUSIONS: DM and malignancy significantly influence the survival of patients with acromegaly; thus, these patients need close follow-up and appropriate therapy. PMID: 26884300 [PubMed - as supplied by publisher] (Source: Endokrynologia Polska)

Exponentially growing osteosarcoma of mandible with acromegaly

Tue, 16 Feb 2016 00:00:00 +0100

ConclusionThis study proved the IGF‐2 and somatostatin receptor from the osteosarcoma of the patient with acromegaly, and this could explain that the growth hormone secreting from the pituitary adenoma might be a risk factor of therapeutic intractability and growth acceleration of osteosarcoma. © 2016 Wiley Periodicals, Inc. Head Neck, 2016 (Source: Head and Neck)

Pasireotide for the treatment of acromegaly.

Sun, 14 Feb 2016 14:10:02 +0100

Authors: Wildemberg LE, Gadelha MR Abstract INTRODUCTION: Acromegaly is a chronic disease with high morbidity and enhanced mortality if left untreated. Treatment options include surgery, medical therapy (somatostatin analogues (SA), dopamine agonists (DA) and growth hormone receptor antagonists) and radiotherapy. Despite these treatment options, "real-life" studies have shown that approximately 50% of patients are not controlled. In this scenario, a next-generation SA, pasireotide, has recently been approved for the treatment of acromegaly. Areas covered: 1) pasireotide's pharmacokinetics and pharmacodynamics; 2) pasireotide's anti-secretory and anti-proliferative effects, from preclinical studies up to phase III clinical trials; and 3) the adverse effects of pasireotide, focusing ...

Lanreotide for the treatment of gastroenteropancreatic neuroendocrine tumors.

Sun, 14 Feb 2016 14:10:02 +0100

Authors: Saif MW Abstract INTRODUCTION: The prevalence of gastropancreatic neuroendocrine tumors (GEP-NETs), a largely sporadically occurring group of neoplasms, has rapidly increased. NET diagnoses often occur late and entail treatment challenges; treatment beyond surgical resection is typically required. Somatostatin analogs (SSAs), the cornerstone of GEP-NET therapy, target somatostatin receptors on NET cell surfaces and can ameliorate NET-related symptoms and prevent tumor progression. AREAS COVERED: This expert review summarizes the development of the SSA lanreotide and its role in treating NETs. Key lanreotide preclinical and clinical findings in acromegaly, carcinoid syndrome, and NETs are discussed, along with future treatment goals and therapeutic prospects. EXPERT...

Perspectives on investigational drugs for acromegaly.

Sun, 14 Feb 2016 14:09:02 +0100

Authors: Störmann S, Schopohl J PMID: 26765281 [PubMed - as supplied by publisher] (Source: Expert Opinion on Investigational Drugs)

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Budget impact of pasireotide LAR for the treatment of acromegaly, a rare endocrine disorder.

Sat, 13 Feb 2016 13:53:03 +0100

CONCLUSIONS: The budget impact of pasireotide LAR is expected to be modest, with an expected increase of 1.42 cents PMPM on the total health plan budget in the third year after FDA approval. The efficacy of pasireotide LAR in acromegaly, as demonstrated in head-to-head trials compared with currently available treatment options, is expected to be associated with a reduction of the prevalence of comorbidities. PMID: 26629745 [PubMed - as supplied by publisher] (Source: Journal of Medical Economics)

Arterial properties in acromegaly: relation to disease activity and associated cardiovascular risk factors

Fri, 12 Feb 2016 00:00:00 +0100

Conclusions Patients with acromegaly have significantly impaired endothelial function as assessed by FMD, but other tested vascular parameters were similar to a control group that was adequately matched for cardiovascular risk factors. (Source: Pituitary)

Serum heart type fatty acid binding protein levels are not changed in hyperthyroidism.

Thu, 11 Feb 2016 11:41:01 +0100

CONCLUSION: Serum H-FABP levels are not altered in patients with hyperthyroidism. PMID: 26859315 [PubMed - as supplied by publisher] (Source: Minerva Endocrinologica)

Serum paraoxonase level and paraoxonase polymorphism in patients with acromegaly.

Thu, 11 Feb 2016 00:00:00 +0100

Conclusions Elevated serum PON levels were detected in acromegalic patients, independently of their remission status. This suggests protective effects for cardiometabolic risk parameters. PMID: 26863932 [PubMed - as supplied by publisher] (Source: Redox Report : communications in free radical research)

Utility of 11C-Methionine and 18F-FDG PET/CT in Patients With Functioning Pituitary Adenomas

Sat, 06 Feb 2016 19:19:05 +0100

Conclusions: PET/CT may be useful to detect tumors in patients with equivocal MRI results. 11C-MET PET/CT can provide valuable diagnostic information when 18F-FDG PET/CT yields negative results, especially in patients with recurrent microadenomas. (Source: Clinical Nuclear Medicine)

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Evolution of Glucose Tolerance After Treatment of Acromegaly: A Study in 57 Patients

Fri, 05 Feb 2016 00:00:00 +0100

In conclusion, we found that more than 50% of patients still have IGT or diabetes after treatment of acromegaly. Improvement of glucose metabolism is mainly observed in cured patients and in patients treated with pegvisomant.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Hormone and Metabolic Research)

Screening for Acromegaly in Patients with Carpal Tunnel Syndrome: A Prospective Study (ACROCARP)

Fri, 05 Feb 2016 00:00:00 +0100

Horm Metab ResDOI: 10.1055/s-0042-100913Early diagnosis of acromegaly prevents irreversible comorbidities and facilitates surgical cure. Carpal tunnel syndrome (CTS) is common in acromegaly and patients have often undergone surgery for CTS prior to the diagnosis of acromegaly. We hypothesized that screening CTS-patients for acromegaly could facilitate active case-finding. We prospectively enrolled 196 patients [135 women, 56.9 (range 23–103) years] who presented with CTS for surgery. Patients were asked about 6 symptoms suggestive of acromegaly using a questionnaire calculating a symptom score (0–6 points), and insulin-like-growth factor 1 (IGF-1) was measured. If IGF-1 was increased, IGF-1 measurement was repeated, and random growth hormone (GH) and/or an oral glucose tolerance test (...

Circadian variation in serum cortisol during hydrocortisone replacement is not attributable to changes in cortisol‐binding globulin concentrations

Tue, 02 Feb 2016 00:00:00 +0100

ConclusionCircadian variation in serum cortisol during hydrocortisone replacement is not attributable to changes in cortisol‐binding globulin concentration. Changes in serum cortisol levels may thus be explained by other factors including 11 β‐hydroxysteroid dehydrogenase type 1 activity or circadian changes in the binding properties of CBG. (Source: Clinical Endocrinology)

GHRH excess and blockade in X-LAG syndrome

Fri, 29 Jan 2016 00:00:00 +0100

X-linked acrogigantism (X-LAG) syndrome is a newly described form of inheritable pituitary gigantism that begins in early childhood and is usually associated with markedly elevated GH and prolactin secretion by mixed pituitary adenomas/hyperplasia. Microduplications on chromosome Xq26.3 including the GPR101 gene cause X-LAG syndrome. In individual cases random GHRH levels have been elevated. We performed a series of hormonal profiles in a young female sporadic X-LAG syndrome patient and subsequently undertook in vitro studies of primary pituitary tumor culture following neurosurgical resection. The patient demonstrated consistently elevated circulating GHRH levels throughout preoperative testing, which was accompanied by marked GH and prolactin hypersecretion; GH demonstrated a paradoxical...

Analysis of GPR101 and AIP genes mutations in acromegaly: a multicentric study

Wed, 27 Jan 2016 00:00:00 +0100

Abstract This multicentric study aimed to investigate the prevalence of the G protein-coupled receptor 101 (GPR101) p.E308D variant and aryl hydrocarbon receptor interacting protein (AIP) gene mutations in a representative cohort of Italian patients with acromegaly. 215 patients with GH-secreting pituitary adenomas, referred to 4 Italian referral centres for pituitary diseases, have been included. Three cases of gigantism were present. Five cases were classified as FIPA. All the patients have been screened for germline AIP gene mutations and GPR101 gene p.E308D variant. Heterozygous AIP gene variants have been found in 7 patients (3.2 %). Five patients carried an AIP mutation (2.3 %; 4 females): 3 patients harboured the p.R3O4Q mutation, one had the p.R304* mutation and the last...

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Efficacy and safety of monotherapy by pegvisomant, a growth hormone receptor antagonist, in Japanese patients with acromegaly.

Sun, 24 Jan 2016 12:17:03 +0100

Authors: Shimatsu A, Nagashima M, Hashigaki S, Ohki N, Chihara K Abstract Pegvisomant is a GH receptor antagonist and strong inhibitor of insulin-like growth factor I (IGF-I) production. The treatment goal for acromegaly is to normalize serum IGF-I levels and attenuate associated symptoms. The efficacy and safety of pegvisomant as treatment for acromegaly have been reported in Caucasians, but not in Japanese. Here we report the clinical experience of using pegvisomant in Japanese patients with acromegaly. The efficacy and safety data for pegvisomant from two open-labeled clinical studies in Japan, conducted from 2004 to 2007, were re-analyzed using the new Japanese age- and sex-matched normative ranges for IGF-I. Eighteen patients with active acromegaly were enrolled in an initial ...

GPR101 Mutations are not a Frequent Cause of Congenital Isolated Growth Hormone Deficiency

Thu, 21 Jan 2016 00:00:00 +0100

Horm Metab ResDOI: 10.1055/s-0042-100733Patients with Xq26.3 microduplication present with X-linked acrogigantism (X-LAG) syndrome, an early-childhood form of gigantism due to marked growth hormone (GH) hypersecretion from mixed GH-PRL adenomas and hyperplasia. The microduplication includes GPR101, which is upregulated in patients’ tumor tissue. The GPR101 gene codes for an orphan G protein coupled receptor that is normally highly expressed in the hypothalamus. Our aim was to determine whether GPR101 loss of function mutations or deletions could be involved in patients with congenital isolated GH deficiency (GHD). Taking advantage of the cohort of patients from the GENHYPOPIT network, we studied 41 patients with unexplained isolated GHD. All patients had Sanger sequencing of the GPR101 g...

Effect of growth hormone treatment on diastolic function in patients who have developed growth hormone deficiency after definitive treatment of acromegaly.

Wed, 20 Jan 2016 06:20:02 +0100

CONCLUSIONS: There were no significant differences in LVM/BSA or parameters of diastolic function in patients with a history of acromegaly treated for GHD as compared to those who were untreated. These data are reassuring with respect to cardiovascular safety with GH use after treatment for acromegaly, although further longer term study is necessary to evaluate the safety and efficacy of GH treatment in this population. PMID: 26774401 [PubMed - in process] (Source: Growth Hormone and IGF Research)

Clinical features and natural course of acromegaly in patients with discordance in the nadir GH level on the oral glucose test and the IGF-1 value at 3 months after adenomectomy

Wed, 20 Jan 2016 00:00:00 +0100

Abstract Discordant GH and IGF-1 levels after adenomectomy are well recognized in acromegalics. The aim of this study was to evaluate the clinical features and natural course of postoperative acromegaly associated with discordant GH and IGF-1 levels over a postoperative period. A total of 69 acromegalics underwent surgery with at least 1 year of follow-up and received 75-g oral glucose tolerance tests (OGTTs) at 3 months postoperatively. The patients were categorized into four groups according to the postoperative nadir GH levels and IGF-1 levels: controlled group (normal GH and normal IGF-1), high-IGF-1 group (normal GH and high IGF-1), high-GH group (high GH and normal IGF-1), and uncontrolled group (high GH and high IGF-1). The incidence of discordant GH and IGF-1 levels was ...

Incidence and prevalence of acromegaly in a large US health plan database

Wed, 20 Jan 2016 00:00:00 +0100

Conclusion This study examined 5 years of recent data to estimate the incidence and prevalence of acromegaly in a large geographically-diverse managed care population. The incidence rates were higher on average than published rates outside the US (11 vs. 3.3 PMPY), but prevalence estimates were consistent with previous reports. Incidence and prevalence both increased by age, did not differ for males and females, and varied slightly by US geographic region. The age and sex distribution of the selected population matched the known epidemiology of the disease. Using a claims-based approach, this analysis only captured acromegaly cases with an acromegaly-related medical claim. As a result, these estimates may underestimate the incidence and prevalence of acromegaly in US commercial ...

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Pros and cons in endocrine practice: pre-surgical treatment with somatostatin analogues in acromegaly

Tue, 19 Jan 2016 00:00:00 +0100

Abstract The aim of this commentary is to balance the pros and cons for pre-surgical SSA treatment in a modern perspective ending up with a pragmatic recommendation for treatment based on the current evidence and expertise of the authors. Even though prospective and randomized studies in this particular area are hampered by obvious limitations, the interpretation of the four published trials has in general been in favor of pre-treatment with SSA, showing a better outcome following surgery. However, major drawbacks of these studies, such as non-optimal diagnostic criteria for cure, potential selection bias, and timing of the postoperative evaluation in SSA pre-treated patients, limit their overall interpretation. Three matched-controlled studies showed remarkably similar results wi...

A Possible New Multiple Endocrine Neoplasia Mutation in a Patient with a Prototypic Multiple Endocrine Neoplasia Presentation

Fri, 15 Jan 2016 10:34:11 +0100

We report the case of a 40-year-old male without significant family history of endocrine disease who was found to have primary hyperparathyroidism, a pituitary tumor causing acromegaly, thyroid cancer, renal cell carcinoma, and pancreatic cysts. We posit that this represents a new version of MEN-4. While renal tumors (angiomyolipoma) have been reported as part of the MEN-4 phenotype, to our knowledge, this is the first case reported of the association of MEN-1 and/or MEN-4 phenotype with this unique constellation of tumors, including renal cell carcinoma. Interestingly, this patient tested negative (DNA sequencing/deletion) for MEN-1 (menin), MEN-4 (CDKN1B) and VHL genes. Key Message: Thus, while this case has clinical characteristics consistent with either MEN-1 or MEN-4, it may represent...

Italian Society for the Study of Diabetes (SID)/Italian Endocrinological Society (SIE) guidelines on the treatment of hyperglycemia in Cushing’s syndrome and acromegaly

Wed, 13 Jan 2016 22:46:14 +0100

Abstract Hyperglycemia is a common feature associated with states of increased growth hormone secretion and glucocorticoid levels. The purpose of these guidelines is to assist clinicians and other health care providers to take evidence-based therapeutic decisions for the treatment of hyperglycemia in patients with growth hormone and corticosteroid excess. Both the SID and SIE appointed members to represent each society and to collaborate in Guidelines writing. Members were chosen for their specific knowledge in the field. Each member agreed to produce—and regularly update—conflicts of interest. The authors of these guidelines prepared their contributions following the recommendations for the development of Guidelines, using the standard classes of recommendation shown below. ...

Genomic insights into growth and its disorders: an update

Wed, 13 Jan 2016 22:45:34 +0100

This article provides an update of the most striking new developments in the field of growth genetics over the past 12 months. Recent findings: A number of large genome-wide association studies have identified new genetic loci and pathways associated to human growth and adult height as well as related traits and comorbidities. New genetic causes of primordial dwarfism and several short stature syndromes have been elucidated. Moreover, a breakthrough finding of Xq26 microduplications as a cause of pituitary gigantism was made. Several new developments in imprinted growth-related genes (including the first human mutation in insulin-like growth factor II) and novel insights into the epigenetic regulation of growth have been reported. Summary: Genomic investigations continue to provide new i...

Pituitary gigantism: update on molecular biology and management

Wed, 13 Jan 2016 22:45:34 +0100

Purpose of review: To provide an update on the mechanisms leading to pituitary gigantism, as well as to familiarize the practitioner with the implication of these genetic findings on treatment decisions. Recent findings: Prior studies have identified gigantism as a feature of a number of monogenic disorders, including mutations in the aryl hydrocarbon receptor interacting protein gene, multiple endocrine neoplasia types 1 and 4, McCune Albright syndrome, Carney complex, and the paraganglioma, pheochromocytoma, and pituitary adenoma association because of succinate dehydrogenase defects. We recently described a previously uncharacterized form of early-onset pediatric gigantism caused by microduplications on chromosome Xq26.3 and we termed it X-LAG (X-linked acrogigantism). The age of onset...

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SAGIT ® : clinician-reported outcome instrument for managing acromegaly in clinical practice—development and results from a pilot study

Wed, 13 Jan 2016 22:45:25 +0100

Conclusions The SAGIT instrument is promising as a tool for use by endocrinologists in everyday practice to assess the status and evolution of disease in patients with acromegaly and to guide treatment decision-making. (Source: Pituitary)

Acromegaloidism Associated with Pituitary Incidentaloma.

Tue, 12 Jan 2016 19:40:03 +0100

We present a case of a 28-year old male with typical features of acromegaly for 11 years.with a pituitary tumor. He had characteristic acromegaloid facial features, clubbing of hands and feet, enlargement of fingers and toes. The natural history of the disease is reviewed and the differential diagnosis is discussed. PMID: 26710410 [PubMed - in process] (Source: Journal of the Association of Physicians of India)

Multidisciplinary approach for acromegaly: a single tertiary center’s experience

Tue, 12 Jan 2016 00:00:00 +0100

Acromegaly is a multisystemic disease that requires a multidisciplinary approach. The aim of this study was to determine early and late remissions of patients who underwent surgery at our center, and to evaluate relations between pathologic and radiologic properties of adenoma and medical and radiosurgical treatments with remissions. (Source: World Neurosurgery)

Diagnosis and management of acromegaly: the patient’s perspective

Thu, 07 Jan 2016 00:00:00 +0100

Conclusions Our findings confirm the urgent need to increase awareness of the clinical manifestation of acromegaly to facilitate an earlier diagnosis of the disease and to provide diagnostic equality across the sexes. (Source: Pituitary)

Considering GH replacement for GH-deficient adults with a previous history of cancer: a conundrum for the clinician

Tue, 05 Jan 2016 00:00:00 +0100

Abstract Previous studies have shown that GH and IGF-I may enhance tumorigenesis, metastasis, and cell proliferation in humans and animals. Evidence supporting this notion is derived from animal model studies, epidemiological studies, experience from patients with acromegaly, molecular therapeutic manipulation of GH and IGF-I actions, and individuals with GH receptor and congenital IGF-I deficiencies. Prior exposure to radiation therapy, aging, family history of cancer, and individual susceptibility may also contribute to increase this risk. Therefore, the use of GH replacement in patients with a history of cancer raises hypothetical safety concerns for patients, caregivers, and providers. Studies of GH therapy in GH-deficient adults with hypopituitarism and childhood cancer survi...

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The role of cumulative growth hormone exposure in determining mortality and morbidity in acromegaly: a single centre study

Sat, 02 Jan 2016 00:00:00 +0100

Conclusion There has been significant improvement in mortality and morbidity associated with acromegaly, in the setting of routine care in a specialized endocrine unit. Early and effective treatment to ‘control’ acromegaly could reduce GH exposure and hence vascular comorbidities. (Source: Pituitary)

Acromegaly: 130 Years Later Introductory Remarks

Tue, 22 Dec 2015 18:32:53 +0100

Neuroendocrinology (Source: Neuroendocrinology)

Comprehensive evaluation of thyrotropinomas: single-center 20-year experience

Mon, 21 Dec 2015 00:00:00 +0100

Conclusion In our series, more thyrotropinomas were operated in recent years. These tumors were often plurihormonal with heterogenous clinical presentation and frequent GH co-secretion. Surgical outcomes were good but long-term follow up is necessary. (Source: Pituitary)

Corrigendum: Gigantism and comparative life-history parameters of tyrannosaurid dinosaurs

Wed, 16 Dec 2015 00:00:00 +0100

Nature advance online publication 16 December 2015. doi:10.1038/nature16487 Authors: Gregory M. Erickson, Peter J. Makovicky, Philip J. Currie, Mark A. Norell, Scott A. Yerby & Christopher A. Brochu (Source: Nature AOP)

Current therapies and mortality in acromegaly.

Tue, 15 Dec 2015 21:30:04 +0100

CONCLUSION: Mortality in acromegaly can be reduced to expected levels from general population by using modern therapies either in monotherapy or by using multimodal approaches in experienced centers. PMID: 26664461 [PubMed - as supplied by publisher] (Source: Journal of Medicine and Life)

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Bilateral renal dysplasia, nephroblastomatosis, and bronchial stenosis. A new syndrome?

Tue, 15 Dec 2015 18:12:02 +0100

We report a full-term boy with anteverted nose, bilateral bronchial stenosis due to lack of cartilage, bilateral obstructive renal dysplasia and NB with glomeruloid features. The infant had visceromegaly, but neither gigantism nor hemihypertrophy. Immunohistochemistry for PAX2 (Paired box gene-2) and WT-1 (Wilms Tumor 1) were strongly positive in the areas of NB. GLEPP-1 (Glomerular Epithelial Protein) did not stain the areas of NB with a glomeruloid appearance, but was positive in the renal glomeruli as expected. We found neither associated bronchial stenosis nor the histology of NB resembling giant glomeruli in any of the reported cases of NB. PMID: 25871299 [PubMed - in process] (Source: Fetal and Pediatric Pathology)

Clinical and psychosocial challenges in the treatment of a patient with Proteus syndrome

Fri, 11 Dec 2015 20:31:52 +0100

This article reports on the clinical course of a pediatric patient with this syndrome. The child had severe malnutrition associated with extreme gigantism of the lower limbs and also psychosocial problems related to social exclusion. As the disease progressed it exacerbated and evolved into a wasting syndrome. After several years, the parents agreed to amputation of the hypertrophic lower limbs. One year after the amputations the child had been rehabilitated and had adapted to prostheses, with nutritional improvement and notable psychological recovery and social reintegration, which represented a significant improvement in his quality of life. (Source: Jornal Vascular Brasileiro)

Combined treatment of somatostatin analogues with pegvisomant in acromegaly

Thu, 10 Dec 2015 00:00:00 +0100

Abstract Treatment of acromegaly with monotherapy long-acting somatostatin analogues (LA-SSA) as primary treatment or after neurosurgery can only achieve complete normalization of insulin-like growth factor I (IGF-I) in roughly 40 % of patients. Recently, one of the acromegaly consensus groups has recommended switching to combined treatment of LA-SSA and pegvisomant (PEGV) in patients with partial response to LA-SSAs. This combination of LA-SSA and PEGV, a growth hormone receptor antagonist, can normalize IGF-I levels in virtually all patients, requiring that the adequate dose of PEGV is used. The required PEGV dose varies significantly between individual acromegaly patients. One of the advantages of the combination therapy is that tumor size control or even tumor shrinkage can b...

Long‐term treatment with pegvisomant for acromegaly: a 10‐year experience

Thu, 10 Dec 2015 00:00:00 +0100

ConclusionsWe reassure the efficacy and safety of long‐term PEG. An escape phenomenon may occur, but it can be overcome by adjusting therapy.This article is protected by copyright. All rights reserved. (Source: Clinical Endocrinology)

6'6″ United States Marine Seeks Treatment for Gynecomastia Only to Learn It Is All in His Head.

Sat, 05 Dec 2015 12:46:03 +0100

We present an active duty male diagnosed with acromegaly after presenting to his primary care provider with chronic gynecomastia. The most common cause of GH excess is a pituitary somatotroph adenoma; however, it is important to remember that magnetic resonance imaging of the pituitary does not distinguish between functioning and nonfunctioning tumors. Subsequently, the diagnosis of GH excess is based on biochemical studies, not imaging. PMID: 26633678 [PubMed - in process] (Source: Military Medicine)

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Growth hormone-secreting macroadenoma of the pituitary gland successfully treated with the radiolabeled somatostatin analog (90)Y-DOTATATE: case report.

Fri, 04 Dec 2015 00:00:00 +0100

Authors: Waligórska-Stachura J, Gut P, Sawicka-Gutaj N, Liebert W, Gryczyńska M, Baszko-Błaszyk D, Blanco-Gangoo AR, Ruchała M Abstract Pituitary tumors causing acromegaly are usually macroadenomas at the time of diagnosis, and they can grow aggressively, infiltrating surrounding tissues. Difficulty in achieving complete tumor removal at surgery can lead toward a strong tendency for recurrence, making it necessary to consider a means of treatment other than those currently used such as somatostatin analogs (SSAs), growth hormone (GH) receptor antagonist, surgical removal, and radiotherapy. The purpose of this paper is to describe a patient diagnosed with an aggressive, giant GH-secreting tumor refractory to medical therapy but ultimately treated with the radiolabeled somatostat...

Comparing two acromegalic patients with respect to central corneal thickness, intraocular pressure, and tear insulin-like growth factor levels before and after treatment

Thu, 03 Dec 2015 00:00:00 +0100

Kan Emrah, Kiliç Kan Elif, Okuyucu AliIndian Journal of Ophthalmology 2015 63(9):731-732The aim of the study was to compare the central corneal thickness (CCT), intraocular pressure (IOP), and tear insulin-like growth factor-1 (IGF-1) levels of 2 patients with acromegaly before and after the surgical treatment of the disease. CCTs, IOP levels, and tear IGF-1 values showed a decrease after the treatment in 2 patients. As we found higher CCT, IOP, and tear IGF-1 levels in the active phase of the disease in two acromegaly patients, detailed information about the activity of the disease may be important before the examination of these patients. (Source: Indian Journal of Ophthalmology)

Gigantism Remains a Clinical Challenge.

Tue, 01 Dec 2015 00:00:00 +0100

Authors: Daly AF, Beckers A PMID: 26621024 [PubMed - in process] (Source: Archives of Iranian Medicine)

New therapeutic agents for acromegaly

Fri, 27 Nov 2015 00:00:00 +0100

Nature Reviews Endocrinology 12, 90 (2016). doi:10.1038/nrendo.2015.196 Author: Shlomo Melmed The currently available somatostatin receptor ligands (SRLs) and growth hormone (GH) antagonists are used to control levels of GH and insulin-like growth factor 1 (IGF-1) in patients with acromegaly. However, these therapies are limited by wide variations in efficacy, associated adverse effects and the need (Source: Nature Reviews Endocrinology)

Cardiovascular System Changes and Related Risk Factors in Acromegaly Patients: A Case-Control Study.

Thu, 26 Nov 2015 03:37:56 +0100

Conclusions. Ageing and increased BMI are independent risk factors for acromegalic cardiomyopathy, and a long disease duration results in the expansion of great vessels. Increased efforts should be made to diagnose acromegaly at an early stage and to advise acromegaly patients to maintain a healthy weight. PMID: 26600803 [PubMed - as supplied by publisher] (Source: International Journal of Endocrinology)

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Aggressive tumor growth and clinical evolution in a patient with X-linked acro-gigantism syndrome

Wed, 25 Nov 2015 00:00:00 +0100

We describe the clinical progress of a sporadic male X-LAG syndrome patient with an Xq26.3 microduplication, highlighting the aggressive natural history of pituitary tumor growth in the absence of treatment. The patient first presented elsewhere aged 5 years 8 months with a history of excessive growth for >2 years. His height was 163 cm, his weight was 36 kg, and he had markedly elevated GH and IGF-1. MRI showed a non-invasive sellar mass measuring 32.5 × 23.9 × 29.1 mm. Treatment was declined and the family was lost to follow-up. At the age of 10 years and 7 months, he presented again with headaches, seizures, and visual disturbance. His height had increased to 197 cm. MRI showed an invasive mass measuring 56.2 × 58.1 × 45.0 mm, with compression of optic chiasma, ...

Severe sleep apnea–hypopnea syndrome is related to left ventricle dysfunction and hypertrophy in acromegalic patients

Wed, 25 Nov 2015 00:00:00 +0100

Conclusion SAHS is highly prevalent in patients with acromegaly. Only in these patients was severe SAHS associated to hypertrophy, LV diastolic dysfunction, and cardiac events. (Source: Endocrinologia y Nutricion)

Effects of lanreotide Autogel primary therapy on symptoms and quality-of-life in acromegaly: data from the PRIMARYS study

Tue, 24 Nov 2015 00:00:00 +0100

Conclusions Primary treatment with lanreotide Autogel over 1 year was associated with rapid and sustained improvements in clinical signs and symptoms and HRQoL in patients with acromegaly. Improvements in HRQoL, but not symptoms, were greater in those achieving biochemical control ( NCT00690898; EudraCT: 2007–000155–34). (Source: Pituitary)

Morphometric changes correlate with poor psychological outcomes in patients with acromegaly.

Sun, 22 Nov 2015 11:32:04 +0100

CONCLUSIONS: Our study demonstrates a correlation between physical changes associated with acromegaly and poor psychological outcomes, whereas no such correlation existed with modes of therapy, disease control status, RT, malignancy, initial or recent GH/IGF1 or secondary hormonal deficiency. Our data support the utility of the morphometric scale as a clinical tool for grading facial changes. PMID: 26586838 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Cushing, acromegaly, GH deficiency and tendons.

Thu, 19 Nov 2015 04:50:20 +0100

Authors: Galdiero M, Auriemma RS, Pivonello R, Colao A Abstract Cushing's syndrome, induced by an endogenous or exogenous cortisol excess, and acromegaly, the clinical syndrome caused by growth hormone (GH) excess in adulthood, as well as the disease induced by GH deficiency (GHD), represent perfect models for the evaluation of the effects induced by chronic exposure in vivo, respectively, to cortisol and GH/IGF-1 excess or deficiency on the complex structure of the tendons as well as on the related post-traumatic repair mechanism. Although the literature is still scant, here in main scientific evidence on this topic is summarized in order to provide suggestions about the management of the above mentioned illnesses, to translate such information in the field of sports medicine and/...

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Glycemic profile in patients with acromegaly treated with somatostatin analogue.

Wed, 18 Nov 2015 20:14:32 +0100

Conclusions. Octreotide therapy induces an improvement in glycemic profile in patients with active acromegaly without diabetes mellitus consistent with decreased levels of GH and IGF1. In patients with diabetes, partial control of glucose metabolism is due to inadequate suppression of GH and IGF1 after one year of treatment. PMID: 26361517 [PubMed - in process] (Source: Journal of Medicine and Life)

Locally produced estrogen through aromatization might enhance tissue expression of pituitary tumor transforming gene and fibroblast growth factor 2 in growth hormone-secreting adenomas

Tue, 17 Nov 2015 00:00:00 +0100

Abstract Aromatase, a key enzyme in local estrogen synthesis, is expressed in different pituitary tumors including growth hormone (GH)-secreting adenomas. We aimed to evaluate aromatase, estrogen receptor α (ERα), estrogen receptor β (ERβ), pituitary tumor transforming gene (PTTG), and fibroblast growth factor 2 (FGF2) expressions in GH-secreting adenomas, and investigate their correlation with clinical, pathologic, and radiologic parameters. This cross-sectional study was conducted in a tertiary center in Turkey. Protein expressions were determined via immunohistochemical staining in ex vivo tumor samples of 62 patients with acromegaly and ten normal pituitary tissues. Concordantly increased aromatase, PTTG, and FGF2 expressions were detected in the tumor samples as compared ...

Genetic Alterations in Differentiated Thyroid Cancer Patients with Acromegaly

Tue, 17 Nov 2015 00:00:00 +0100

Conclusion: NRAS codon 61 is the most frequent genetic alteration in this acromegaly series with DTC. Since acromegalic patients have lower prevalance of BRAF V600E mutation, BRAF V600E mutation may not be a causative factor in development of DTC in acromegaly. Despite the relation of BRAF V600E and NRAS codon 61 mutations with aggresive histopathologic features, their impact on tumor prognosis remains to be defined in acromegaly in further studies.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Experimental and Clinical Endocrinology and Diabetes)

High Prolidase Levels may be a Marker of Irreversible Extracellular Matrix Changes in Controlled Acromegaly Patients?

Tue, 17 Nov 2015 00:00:00 +0100

In conclusion, serum prolidase activity and oxidative stress levels were high in controlled acromegaly patients. These results suggest that extracellular matrix changes continue eventhough the disease is controlled, and elevated oxidative stress is involved in the increased prolidase activity in acromegaly patients.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Experimental and Clinical Endocrinology and Diabetes)

Pegvisomant treatment in patients with acromegaly in clinical practice: The French ACROSTUDY.

Tue, 17 Nov 2015 00:00:00 +0100

CONCLUSION: This analysis showed a significant decrease in IGF-1 levels throughout the follow-up period, and confirmed that pegvisomant treatment is safe in acromegaly. The results of this interim analysis remain to be confirmed by the final analysis. PMID: 26596374 [PubMed - as supplied by publisher] (Source: Annales d'Endocrinologie)

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Pregnancy in acromegaly

Sun, 15 Nov 2015 00:00:00 +0100

With advances in surgical and medical treatment and the availability of assisted reproductive techniques, pregnancy in women with acromegaly is more frequently encountered. Diagnosis of acromegaly during pregnancy is difficult because of changes in growth hormone and insulin like growth factor-1 (IGF-1) axis secondary to placental production of growth hormone. The difficulty is compounded by the inability of routine hormone assays to detect placental growth hormone. In the majority of patients with acromegaly, pregnancy does not have an adverse effect on mother or fetus and pituitary mass does not increase in size. The level of IGF-1 usually remains stable because of the effect of estrogen causing a growth hormone resistant state. In patients with pituitary macroadenoma, the possibility of...

Pituitary gigantism: Causes and clinical characteristics.

Fri, 13 Nov 2015 00:00:00 +0100

We describe these recent discoveries and focus on some important settings in which gigantism can occur, including familial isolated pituitary adenomas (FIPA) and the newly described X-linked acrogigantism (X-LAG) syndrome. PMID: 26585365 [PubMed - as supplied by publisher] (Source: Annales d'Endocrinologie)

An Association Between Visual Morphometric Changes and Psychiatric Outcomes in Patients With Acromegaly

Thu, 12 Nov 2015 00:00:00 +0100

Publication date: December 2015 Source:Canadian Journal of Diabetes, Volume 39, Issue 6 Author(s): Ali Imran, Michael Vallis, Steve Doucette, David B. Clarke, Stephanie M. Kaiser (Source: Canadian Journal of Diabetes)

Vitamin D-binding protein and free vitamin D concentrations in acromegaly

Sat, 07 Nov 2015 00:00:00 +0100

Abstract Free 25-hydroxyvitamin D [25(OH)D] is suggested to be important in the determination of vitamin D deficiency, since vitamin D-binding protein (VDBP) may affect total 25(OH)D levels. There are no data about free 25(OH)D concentrations in acromegaly. We aimed to investigate serum VDBP and total and free 25(OH)D levels in patients with acromegaly in comparison with control subjects. We recruited 54 patients with acromegaly and 32 control subjects who were similar according to age, gender, and body mass index. Serum VDBP levels were found to be increased in patients with acromegaly compared to control subjects [90.35 (72.45–111.10) vs. 69.52 (63.89–80.13) mg/l, p = 0.001]. There was statistically no significant difference in serum total 25(OH)D levels between the patien...

Novel Techniques in the Surgical Treatment of Acromegaly: Applications and Efficacy

Fri, 06 Nov 2015 06:07:03 +0100

Since the establishment of transsphenoidal microsurgery as the operative treatment of choice in most patients with acromegaly 40 years ago, a few novel technical developments have evolved. Their application, utility and efficacy will be briefly discussed in this review article based on an analysis of published results and the authors' personal experience. The endoscope was additionally used to search for residual tumour in locations which could not be visualized with the operating microscope. In many centers it has to date fully replaced the operating microscope. Extended endoscopic operations have hardly limits in respect to accessible pathology. Over all, results and complications reported from microsurgical and endoscopic series are comparable. Intraoperative magnetic resonance imaging ...

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Genotypic variation in host response to infection affects parasite reproductive rate.

Fri, 06 Nov 2015 00:00:00 +0100

Authors: Tavalire HF, Blouin MS, Steinauer ML Abstract Parasite fitness is largely influenced by a variation in host response due to the host's genetic background. Here we investigated the impact of host genotype on pathogen success in the snail vector of its castrating parasite, Schistosoma mansoni. We infected five inbred lines of Biomphalaria glabrata with two infection doses and followed their growth, reproductive output and parasite production throughout the course of infection. There was no difference in resistance to infection among inbred lines, but lines varied in their responses to infection and the numbers of parasites produced. Snails did not compensate for castration by increasing their fecundity during the early phase of infection (fecundity compensation). However, so...

Does acromegaly suffice to explain the origin of Pulcinella? A novel interpretation.

Fri, 06 Nov 2015 00:00:00 +0100

Authors: Armocida E, Böni T, Rühli FJ, Galassi FM PMID: 26553000 [PubMed - as supplied by publisher] (Source: European Journal of Internal Medicine)

Lanreotide Autogel ® in acromegaly: a guide to its use in the EU

Thu, 05 Nov 2015 00:00:00 +0100

Abstract Subcutaneous lanreotide Autogel® (Somatuline® Autogel®; Somatuline® Depot), a somatostatin analogue, is indicated for the treatment of acromegaly in patients who have had an inadequate response to surgery and/or radiotherapy, or for whom surgery and/or radiotherapy is not an option. Clinical data in these patient populations indicates that recommended dosages (60–120 mg once every 4–8 weeks) of lanreotide Autogel® provides effective control of biochemical parameters, improves clinical symptoms and health-related quality of life, reduces tumour volume and is generally well tolerated. (Source: Drugs and Therapy Perspectives)

Surgery induced hypopituitarism in acromegalic patients: a systematic review and meta-analysis of the results

Fri, 30 Oct 2015 10:16:29 +0100

Conclusion Our study provides new data on the incidence rates of hypopituitarism, specific pituitary axis deficiencies and diabetes insipidus after surgical treatment of acromegaly. Somatotroph function appears to be more prone to deficit than the other axes. However, there is a high heterogeneity between studies and several factors may influence the incidence of hypopituitarism. (Source: Pituitary)

Impact of gsp mutations in somatotroph pituitary adenomas on growth hormone response to somatostatin analogs: a meta-analysis

Fri, 30 Oct 2015 10:16:28 +0100

Conclusions The present meta-analysis suggests a role for gsp mutation as a prognostic factor of treatment response to somatostatin analogs. (Source: Pituitary)

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The quality of life in acromegalic patients with biochemical remission by surgery alone is superior to that in those with pharmaceutical therapy without radiotherapy, using the newly developed Japanese version of the AcroQoL

Fri, 30 Oct 2015 10:16:28 +0100

Conclusions The reliability of the Japanese version of the AcroQoL was satisfactory. Younger age and a history of radiotherapy were associated with lower QoL in patients with acromegaly. In biochemically-controlled acromegaly, patients who underwent surgery alone exhibited better QoL than those under pharmaceutical therapy. (Source: Pituitary)

Prevalence of AIP mutations in a series of Turkish acromegalic patients: are synonymous AIP mutations relevant?

Fri, 30 Oct 2015 10:16:25 +0100

Conclusion The prevalence of AIPmut in Turkish patients was found to be 1 % in sporadic acromegaly in the present study. This ratio increases when younger age groups are taken into account 6 % among patients <30 years of age at the time of diagnosis of acromegaly. The clinical features of acromegaly, such as having large and invasive tumours, may be affected by the presence of synonymous AIPmut. (Source: Pituitary)

Thyroid autoimmune disorders in patients with acromegaly

Fri, 30 Oct 2015 10:16:25 +0100

Conclusion We found a high prevalence of thyroid autoimmunity in our patients with acromegaly as compared to the normal population. Thyroid autoimmunity seems to be an additional mechanism for the development of thyroid disorders in acromegaly. (Source: Pituitary)

Prediction of therapy response in acromegalic patients under pegvisomant therapy within the German ACROSTUDY cohort

Fri, 30 Oct 2015 10:16:25 +0100

Conclusions Age, BMI and baseline IGF-1 but not subjective perceived health measures predict therapy response under second line medical therapy with pegvisomant. (Source: Pituitary)

Acromegaly presenting with low insulin-like growth factor-1 levels and diabetes: a case report

Fri, 30 Oct 2015 00:00:00 +0100

Conclusions Systemic illnesses, including catabolic states, hepatic or renal failure, malnutrition, and diabetes mellitus, are known to decrease insulin-like growth factor-1 levels and may result in false-negative values in patients with acromegaly A low insulin-like growth factor-1 level does not exclude acromegaly in a patient with supportive clinical features and poorly controlled diabetes. (Source: Journal of Medical Case Reports)

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Interpreting biochemical control response rates with first-generation somatostatin analogues in acromegaly

Fri, 30 Oct 2015 00:00:00 +0100

Conclusions The wide range of reported response rates with somatostatin analogues may be confusing and could lead to misinterpretation by both the patient and the physician in certain situations. Understanding the factors that potentially drive the variation in response rates should allow clinicians to better gauge treatment expectations in specific patients. (Source: Pituitary)

Acromegaly Patients with Inadequate Response to Maximum Dose Octreotide-Lar Who Progress to Treatment with Pegvisomant: Economic Evaluation and Incremental Budget Impact Analysis from the Public Perspective to São Paulo State

Fri, 23 Oct 2015 20:23:13 +0100

This study evaluated the cost-effectiveness of pegvisomant compared to octreotide-LAR and the incremental Budget Impact Analysis (iBIA) from the public perspective in São Paulo State Health Secretariat (SHS/SP). (Source: Value in Health)

Cost-Effectiveness of Pasireotide Long-Acting in a Treatment of Acromegaly in Finland. Economic Evaluation Based on Finnish Auria Biobank Data on Health Care Resource Utilization

Fri, 23 Oct 2015 19:51:36 +0100

The objective is to describe disease progression and treatment patterns of acromegaly in patients with inadequate biochemical control, assess how biochemical control will impact disease progression and treatment pathways and estimate the economic efficiency of pasireotide long-acting (PASI) in a treatment of acromegaly in Finland. PASI is compared to pegvisomant + somatostatin analoque (PEG+SSA) in patients with inadequately controlled acromegaly. (Source: Value in Health)

Development of a Prediction Model of Disease Activity in Support of Clinical Practice – the Acrodat Experience

Fri, 23 Oct 2015 19:43:13 +0100

The objective of this study was to develop and validate a decision algorithm that replicates expert opinion regarding the level of disease activity in patients with acromegaly. (Source: Value in Health)

Current status and future directions of the pharmacological therapy of Acromegaly.

Wed, 21 Oct 2015 14:16:30 +0100

Authors: Mercado M, Espinosa E, Ramírez C Abstract Acromegaly is a chronic systemic disorder caused in the vast majority of cases by a GH-secreting pituitary adenoma and resulting in significant morbidity and mortality if left untreated. The treatment of choice is the transsphenoidal resection of the adenoma, and although 80% of patients with microadenomas or confined macroadenomas achieve biochemical remission, the surgical success rate for patients harboring tumors with extrasellar extension is below 50%. Thus, a considerable proportion of patients will require some form of adjuvant treatment. Acromegaly can be approached pharmacologically by inhibiting GH secretion by the tumor (somatostatin analogues, dopamine agonists) or by antagonizing GH actions at its target tissues (GH r...

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Greeks Gone West: The Geneticist Helping To Treat 'Gigantism'

Fri, 16 Oct 2015 20:12:58 +0100

Constantine A. Stratakis - Greeks Gone West by HuffPost_Greece In the third episode of HuffPost Greece's video series 'Greeks Gone West,' we introduce Constantine A. Stratakis, M.D. D.Sc., a tenured investigator in the NICHD, who has been the head of the Section on Genetics and Endocrinology (SEGEN) since its inception in 1999. His work is focused on treating the rare condition of 'gigantism.' The research began with a family who came to the the U.S. National Institutes of Health for treatment for gigantism in the mid-1990s. In that family, the mother and two of her sons all had the condition. This is his story. Watch the first and second episodes of 'Greeks Gone West' here and here. -- This feed and its contents are the property of The Huffington Post, a...

Quantitative analyses of T2-weighted MRI as a potential marker for response to somatostatin analogs in newly diagnosed acromegaly

Fri, 16 Oct 2015 00:00:00 +0100

The objectives of this study are (I) to explore the feasibility of quantitative T2-weighted MRI histogram analyses in newly diagnosed somatotroph adenomas and their relation to clinical and histological parameters and (II) to compare the quantitative method to conventional, visual assessment of T2 intensity. The study was a retrospective cohort study of 58 newly diagnosed patients. In 34 of these, response to primary SSA treatment after median 6 months was evaluated. Parameters from the T2 histogram analyses (T2 intensity ratio and T2 homogeneity ratio) were correlated to visually assessed T2 intensity (hypo-, iso-, hyperintense), baseline characteristics, response to SSA treatment, and histological granulation pattern (anti-Cam5.2). T2 intensity ratio was lowest in the hypointense tumors...

Ganglion cell tumours in the sella turcica in close morphological connection with pituitary adenomas.

Fri, 09 Oct 2015 15:42:02 +0100

We report the clinicopathological studies of five cases diagnosed as ganglion cell tumours located in the intrasellar region: four mixed/collision tumours composed of gangliocytoma and pituitary adenoma, and one isolated ganglioglioma unrelated to adenoma. Clinically, two patients presented with acromegaly, while three others were initially diagnosed as non-functioning adenomas. In four cases, the histopathological examination of surgical specimens revealed intermixed lesions composed of pituitary adenoma and ganglion cell elements. The adenomas appeared to secrete growth hormone. Electron microscopy enabled identification of the sparsely granulated somatotroph cells. Neoplastic neuronal lesions were composed of mature ganglion cells, including binucleate or multinucleate cells. In all cas...

Accelerated Telomere Shortening in Acromegaly; IGF-I Induces Telomere Shortening and Cellular Senescence

Thu, 08 Oct 2015 00:00:00 +0100

Conclusion Shortened telomeres in acromegaly and cellular senescence induced by IGF-I can explain, in part, the underlying mechanisms by which acromegaly exhibits an increased morbidity and mortality in association with the excess secretion of IGF-I. (Source: PLoS One)