MedWorm: Acromegaly

Pregnancy in AcromegalyPregnancy in Acromegaly

Medscape Today Headlines — Wed, 08 Feb 2012 04:00:00 +0100

Pregnancy in women with this pituitary condition is uncommon. What are the outcomes? Clinical Endocrinology (Source: Medscape Today Headlines)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Pattern of adrenal morphology and function in patients with acromegaly

European Journal of Clinical Investigation — Tue, 07 Feb 2012 02:06:19 +0100

Conclusions This study provides evidence of an increased prevalence of anatomic and functional adrenal alterations in patients with acromegaly; further studies will clarify the importance of evaluating these subjects with baseline hormonal investigation along with dynamic testing and modified cut‐offs. (Source: European Journal of Clinical Investigation)

Effect of Hepatic Impairment on the Pharmacokinetics of Pasireotide (SOM230): Results From a Multicenter Phase I Study.

The Journal of Clinical Pharmacology — Thu, 26 Jan 2012 05:00:00 +0100

In conclusion, a single dose of pasireotide SC 600 µg was well tolerated in subjects with hepatic impairment. Drug exposure in subjects with mild hepatic impairment was similar to that seen in healthy volunteers, whereas subjects with moderate and severe hepatic impairment experienced higher exposure to pasireotide. Adjustment of the pasireotide dose may be required for patients with moderate and severe hepatic impairment. PMID: 22282526 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Pharmacology)

Effective Combination Treatment with Cabergoline and Low-Dose Pegvisomant in Active Acromegaly: A Prospective Clinical Trial.

The Journal of Clinical Endocrinology and Metabolism — Wed, 25 Jan 2012 05:00:00 +0100

Conclusion:These data suggest that combination treatment with cabergoline and pegvisomant is more effective at reducing IGF-I levels than either cabergoline or pegvisomant monotherapy. PMID: 22278424 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

Quality of life is impaired in association with the need for prolonged postoperative therapy by somatostatin analogs in patients with acromegaly.

European Journal of Endocrinology — Mon, 16 Jan 2012 05:00:00 +0100

Conclusion: Quality of life is impaired in association with the need for prolonged postoperative therapy by somatostatin analogs in patients with acromegaly despite similar IGF-1 levels. PMID: 22250074 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Diabetes mellitusin a cohort of patients with acromegaly

Arquivos Brasileiros de Endocrinologia e Metabologia — Sat, 14 Jan 2012 00:35:00 +0100

CONCLUSIONS: The presence of DM was associated with active acromegaly and presence of hypertension. However, absolute levels of GH and IGF-1 did not differ between patients with and without diabetes.OBJETIVOS: Avaliar a presença de diabetes melito (DM) em uma coorte de acromegálicos. MÉTODOS: Este é um estudo transversal. RESULTADOS: Cinquenta e oito pacientes acromegálicos foram analisados. Apenas 29% preencheram critérios de cura e 27% estavam com a doença controlada. Vinte e dois pacientes (38%) apresentaram DM, HbA1c 7,34 ± 2,2%. Destes, 18 não preencheram critérios de cura. Pacientes com DM foram mais frequentemente hipertensos [16/22 (73%) vs. 17/36 (46%), p = 0,04] e usavam mais estatina [14/22 (64%) vs.8/36 (21%), p = 0,004]. Após regressão múltipla, hipertensão foi a...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Laboratory diagnosis of acromegaly

Arquivos Brasileiros de Endocrinologia e Metabologia — Sat, 14 Jan 2012 00:35:00 +0100

We describe a SEA case in a 23-year old white woman with diabetes for 14 years, who was successfully treated only with antibiotics, and achieved full recovery at the fourth month of follow-up.O abscesso epidural espinhal (AEE) é uma doença incomum e o diabetes melito é o seu fator predisponente mais importante. O tratamento de escolha é a imediata drenagem cirúrgica, seguida de antibioticoterapia, entretanto, casos já foram relatados em que o AEE foi tratado clinicamente com sucesso. Descrevemos um caso de AEE em um paciente diabético tratado satisfatoriamente com uso isolado de antibióticos e que evoluiu com recuperação total no quarto mês de seguimento. (Source: Arquivos Brasileiros de Endocrinologia e Metabologia)

Recommendations of Neuroendocrinology Department from Brazilian Society of Endocrinology and Metabolism for Diagnosis and Treatment of Acromegaly in Brazil

Arquivos Brasileiros de Endocrinologia e Metabologia — Sat, 14 Jan 2012 00:35:00 +0100

Elevated incidence of sleep apnoea in acromegaly-correlation to disease activity.

Sleep and Breathing — Fri, 13 Jan 2012 05:00:00 +0100

CONCLUSION: RDI correlates positively with disease activity but not with the duration of the disease. The parameters of the metabolic syndrome are positively associated to the degree of SA in acromegalic patients. PMID: 22241151 [PubMed - as supplied by publisher] (Source: Sleep and Breathing)

Elevated incidence of sleep apnoea in acromegaly—correlation to disease activity

Sleep and Breathing — Thu, 12 Jan 2012 16:44:52 +0100

Conclusion RDI correlates positively with disease activity but not with the duration of the disease. The parameters of the metabolic syndrome are positively associated to the degree of SA in acromegalic patients. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s11325-011-0641-7Authors J. Roemmler, Medizinische Klinik - Innenstadt der universität München, LM-University of Munich, Ziemssenstr. 1, 80336 München, GermanyB. Gutt, Department of Endocrinology, Klinikum Schwabing, Klinikum München GmbH, Munich, GermanyR. Fischer, Medizinische Klinik - Innenstadt der universität München, LM-University of Munich, Ziemssenstr. 1, 80336 München, GermanyS. Vay, Medizinische Klinik - Innenstadt der universität München, LM-University of Munich, Zi...

Urinary calcium excretion and insulin resistance in patients with acromegaly

International Urology and Nephrology — Tue, 10 Jan 2012 17:00:42 +0100

Conclusions The present study revealed an association between hypercalciuria and insulin resistance in patients with acromegaly. Further studies are required to fully understand the pathogenesis of these abnormalities in patients with acromegaly. Content Type Journal ArticleCategory Nephrology – Original PaperPages 1-5DOI 10.1007/s11255-011-0116-6Authors Alexandre Braga Libório, Division of Nephrology, Hospital Geral de Fortaleza, Fortaleza, Ceará, BrazilPatrícia R. L. Figueiredo, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, BrazilRenan M. Montenegro Junior, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, BrazilRenan M. Montenegro, Department of Interna...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Pregnancy in acromegaly: experience from two referral centers and systematic review of the literature

Clinical Endocrinology — Sat, 07 Jan 2012 02:18:38 +0100

Conclusions In 13 newly described pregnancies along with systematic review of an additional 34 cases indicate that pregnancy in treated acromegalic women can proceed without significant complications or teratogenicity. Medical treatment during pregnancy with DA or SA appears to be associated with altered neonatal weight. Nevertheless, gestation may have a beneficial impact on acromegaly control both during and following pregnancy. (Source: Clinical Endocrinology)

Regulation of glucose homeostasis

Society for Endocrinology — Tue, 03 Jan 2012 12:00:00 +0100

This study adds to the current knowledge of the effects of somatostatin analogs on glucose homestasis. Schmid & Brueggen. (2012) Journal of Endocrinology 212 49–60. Read the full article at: DOI:10.1530/JOE-11-0224. (Source: Society for Endocrinology)

Does Apolipoprotein E genotype affect cardiovascular risk in subjects with acromegaly?

Endocrine — Mon, 26 Dec 2011 16:47:09 +0100

In this study, we therefore aimed to evaluate whether a well-established cardiovascular risk factor, the Apolipoprotein E (Apo E) genotype, contributes to increased risk of cardiovascular complications in subjects with acromegaly. A total of 102 unrelated acromegaly subjects were prospectively included into this case–control association study and constituted our study group. The study group was comparable by age and gender with 200 unrelated healthy subjects constituting our control group. Genomic DNA was isolated from the peripheral blood leukocytes of all subjects and Apo E genotype (codon 112/158) was assessed by melting temperature analyses after using a real-time PCR protocol. The Apolipoprotein E4 allele was found at a significantly higher frequency in the study group when co...

Royal College of Surgeons reject call to bury skeleton of 'Irish giant'

Guardian Unlimited Science — Thu, 22 Dec 2011 19:08:55 +0100

Ethics experts say exhibit of 7ft 7in tall man, who lived in the 1780s, should be removed from display and put to rest at seaMuseum chiefs have rejected a suggestion by law and medical ethics experts that the skeleton of an 18th century man known as the "Irish giant" should be removed from display and buried at sea.Charles Byrne, originally from County Londonderry, stood just over 7ft 7in tall. He found fame in the 1780s exhibiting himself as a curiosity or "freak" in London. Celebrity life eventually got the better of him, and he took to drink and died at his home in Charing Cross aged just 22.After his death, his body was acquired by the surgeon John Hunter, and his skeleton remains at the Hunterian Museum at the Royal College of Surgeons in London.In the latest issue of the British Medi...

Royal College of Surgeons rejects call to bury skeleton of 'Irish giant'

Guardian Unlimited Science — Thu, 22 Dec 2011 19:08:55 +0100

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Good Outcome Following Copeland Hemiarthroplasty for Acromegalic Arthropathy

Infectious Diseases in Obstetrics and Gynecology — Thu, 22 Dec 2011 15:52:09 +0100

We report the unusual case of a patient with acromegalic arthropathy who presented with severe shoulder arthrosis with marked osteophytosis. This patient is currently pain-free and has good shoulder function 4 years following a Copeland shoulder hemiarthroplasty. Acromegaly is a rare condition of growth hormone oversecretion, but arthropathy is a common feature of the natural history of the disease. This is the first published case report of the outcome of shoulder arthroplasty in a patient with acromegalic arthropathy and demonstrated that a good result can be obtained in this patient. (Source: Infectious Diseases in Obstetrics and Gynecology)

Discordant growth hormone and IGF-1 levels post pituitary surgery in patients with acromegaly naïve to medical therapy and radiation: what to follow, GH or IGF-1 values?

Pituitary — Mon, 19 Dec 2011 16:51:07 +0100

Abstract New criteria that define acromegaly remission are more stringent: normal (age/sex-adjusted) insulin-like growth factor type 1 (IGF-1), growth hormone (GH) random (GHr) <1 μg/L, and a GH nadir (GHn) during oral glucose tolerance test (OGTT) of <0.4 μg/L. Discordance between GH and IGF-1 values is often attributed to somatostatin receptor ligands (SRLs) or radiation. The purpose of this study was to evaluate rates of discordant IGF-1 and GH levels in patients with GH secreting adenomas (after pituitary surgery), who were naïve to any other treatment. We retrospectively analyzed data over a 5 year time period (2006–2010), in post-surgery acromegaly patients who had elevated IGF-1 but normal GH levels (per the new cure criteria). Symptoms of a...

Automated image analysis of hand radiographs reveals widened joint spaces in patients with long term control of acromegaly: relation to disease activity and symptoms.

European Journal of Endocrinology — Wed, 14 Dec 2011 05:00:00 +0100

Conclusions: Using a new semi-automated image analysis of hand radiographs, acromegalic patients with long-term disease control appeared to have increased joint spaces of all hand joints. Joint space widths were positively related to disease activity at diagnosis, but not to duration of follow-up, suggesting irreversible cartilage hypertrophy. Irreversible cartilage hypertrophy may partly explain persisting hand complaints, despite long-term disease control. PMID: 22170798 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Succinate Dehydrogenase (SDH) D Subunit (SDHD) Inactivation in a Growth-Hormone-Producing Pituitary Tumor: A New Association for SDH?

The Journal of Clinical Endocrinology and Metabolism — Wed, 14 Dec 2011 05:00:00 +0100

Conclusion:We describe the first kindred with a germline SDHD pathogenic mutation, inherited PGL, and acromegaly due to a GH-producing pituitary adenoma. SDHD loss of heterozygosity, down-regulation of protein in the GH-secreting adenoma, and decreased SDH enzymatic activity supports SDHD's involvement in the pituitary tumor formation in this patient. Older cases of multiple PGL and PHEO and pituitary tumors in the literature support a possible association between SDH defects and pituitary tumorigenesis. PMID: 22170724 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

Orthodontic treatment of a transposed gigantic canine --a case report [ClinicalSection]

Journal of Orthodontics — Fri, 09 Dec 2011 05:00:00 +0100

Cuspid gigantism or radicomegaly is a rare occurrence often associatedwith a hereditary, X-linked condition, called oculo-cardio-facio-dental (OFCD)syndrome. This syndrome is also characterized by atrial septal defects and/orventricular septal defects, congenital cataracts and unusual facial characteristics.Confirmation of this syndrome is often provided by dentists or orthodontistswhen they diagnose an extremely large canine root length from the panoramicradiograph. The following case report shows a multidisciplinary approach tothe dental treatment of a patient with OFCD syndrome and a canine-first premolartransposition. The orthodontic approach required a mini-plate to achieve significantmesial movement of a gigantic maxillary canine that erupted in close contactwith the first molar. (So...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Orthodontic treatment of a transposed gigantic canine --a case report [Clinical Section]

Journal of Orthodontics — Fri, 09 Dec 2011 05:00:00 +0100

Non polycystic ovary syndrome–related endocrine disorders associated with hirsutism

European Journal of Clinical Investigation — Thu, 08 Dec 2011 06:48:23 +0100

Conclusions A number of patients presenting with hirsutism and exhibiting similar features to PCOS may have other underlying diagnoses. Unlike PCOS, some of these disorders can occasionally be life threatening and require prompt diagnosis and treatment. (Source: European Journal of Clinical Investigation)

The FGFR4-G388R Polymorphism Promotes Mitochondrial STAT3 Serine Phosphorylation to Facilitate Pituitary Growth Hormone Cell Tumorigenesis

PLoS Genetics — Thu, 08 Dec 2011 05:00:00 +0100

by Toru Tateno, Sylvia L. Asa, Lei Zheng, Thomas Mayr, Axel Ullrich, Shereen Ezzat Pituitary tumors are common intracranial neoplasms, yet few germline abnormalities have been implicated in their pathogenesis. Here we show that a single nucleotide germline polymorphism (SNP) substituting an arginine (R) for glycine (G) in the FGFR4 transmembrane domain can alter pituitary cell growth and hormone production. Compared with FGFR4-G388 mammosomatotroph cells that support prolactin (PRL) production, FGFR4-R388 cells express predominantly growth hormone (GH). Growth promoting effects of FGFR4-R388 as evidenced by enhanced colony formation was ascribed to Src activation and mitochondrial serine phosphorylation of STAT3 (pS-STAT3). In contrast, diminished pY-STAT3 mediated by FGFR4-R388 relie...

Adenoma granulation pattern correlates with clinical variables and effect of somatostatin analogue treatment in a large series of patients with acromegaly

Clinical Endocrinology — Wed, 07 Dec 2011 22:06:41 +0100

Conclusions Densely granulated adenomas were highly responsive to somatostatin analogues in contrast to SG adenomas. The transitional group behaved clinically more like DG adenomas. However, based on E‐cadherin, a marker of dedifferentiation, the transitional group seemed to be a true intermediate. (Source: Clinical Endocrinology)

Familial acromegaly - case study of two sisters with acromegaly.

Endokrynologia Polska — Wed, 07 Dec 2011 15:12:02 +0100

Authors: Malicka J, Swirska J, Nowakowski A Abstract In the majority of cases, acromegaly is sporadic. However, it can also occur in a familial setting as a component of MEN-1, MEN-4, Carney complex (CNC) or as the extremely rare syndrome of isolated familial somatotropinoma (IFS), the latter belonging to familial isolated pituitary adenomas (FIPA). The diagnosis of IFS is based on the recognition of acromegaly/gigantism in at least two family members, given that the family is not affected by MEN-1, MEN-4 or CNC. The authors present a case study of two sisters: a 56 year-old patient (case no. 1) and a 61 year-old patient (case no. 2). In both sisters, acromegaly was recognised in the course of pituitary macroadenoma. Neither of the sisters showed features of MEN-1, MEN-4 or Carney...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Growth Hormone Receptor Variants and Response to Pegvisomant in Monotherapy or in Combination with Somatostatin Analogs in Acromegalic Patients: A Multicenter Study.

The Journal of Clinical Endocrinology and Metabolism — Wed, 07 Dec 2011 05:00:00 +0100

Conclusions:This study did not confirm a better response of d3GHR to PEG-V treatment in acromegaly. Other studies are needed to determine whether deviation from Hardy-Weinberg equilibrium may indicate an association of d3GHR genotype with poor response to usual treatments. PMID: 22162472 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

Hypertension-related factors in patients with active and inactive acromegaly

Arquivos Brasileiros de Endocrinologia e Metabologia — Sun, 04 Dec 2011 08:16:21 +0100

CONCLUSIONS: Our findings suggest that blood pressure levels in patients with active acromegaly are very similar, and depend on excess GH. However, once the disease becomes controlled and IGF-1 levels decrease, their blood pressure levels will depend on the other cardiovascular risk factors.INTRODUÇÃO: Existem várias complicações no sistema cardiovascular causadas pela acromegalia, especialmente a hipertensão. OBJETIVOS: Avaliar as características da hipertensão em pacientes com acromegalia curada/controlada e com doença ativa. PACIENTES E MÉTODOS: Estudo transversal com 44 pacientes com acromegalia seguidos em nosso serviço. Eles foram submetidos a avaliação clínica, exames laboratoriais e ecocardiograma. Pacientes com doença curada/controlada foram avaliados como um grupo ...

Radiation techniques for acromegaly

Radiation Oncology — Fri, 02 Dec 2011 05:00:00 +0100

Radiotherapy (RT) remains an effective treatment in patients with acromegaly refractory to medical and/or surgical interventions, with durable tumor control and often biochemical remission; however, there are still concerns about its potential late toxicity, especially high rates of hypopituitarism. Stereotactic radiotherapy has been developed as a more accurate technique of irradiation with more precise tumour localization and consequently a reduction in the volume of normal tissue, particularly the brain, irradiated to high radiation doses. Radiation can be delivered in a single fraction by stereotactic radiosurgery (SRS) or as fractionated stereotactic radiotherapy (FSRT) in which smaller doses are delivered over 5-6 weeks in 25-30 treatments. A review of the recent literature suggests ...

Variation in Physical and Chemical Characteristics of Common Bean (Phaseolus vulgaris L.) Grain along a Domestication Gradient.

Chemistry and Biodiversity — Thu, 01 Dec 2011 05:00:00 +0100

The objective of this study was to compare six samples of Mexican wild common bean (Phaseolus vulgaris L.) against three landraces and three improved cultivars with respect to physical and chemical attributes, and the culinary quality potential of their grain. A completely randomized experimental design was used to characterize the twelve genotypes. Data were analyzed by analysis of variance and pair-wise comparison of the treatment means by the Tukey test. In addition, correlation and principal-component analysis (PCA) were carried out using twelve characteristics of raw and four of cooked wild and domesticated grains. The results show a larger variability of the physical and chemical characteristics in wild than in domesticated beans. The PCA confirmed that grain gigantism was the main p...

Ambulatory Arterial Stiffness Indexes in Acromegaly.

European Journal of Endocrinology — Tue, 29 Nov 2011 05:00:00 +0100

Conclusion: Ambulatory arterial stiffness indexes are increased in acromegaly independently of blood pressure elevation, and may have an important role in predicting cardiovascular risk in this disease. PMID: 22127491 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Ultrasonographic measurements of adrenal glands in cats with hyperthyroidism

Veterinary Radiology and Ultrasound — Mon, 28 Nov 2011 05:00:00 +0100

Feline hyperthyroidism is potentially associated with exaggerated responsiveness of the adrenal gland cortex. The adrenal glands of 23 hyperthyroid cats were examined ultrasonographically and compared to the adrenal glands of 30 control cats. Ten hyperthyroid cats had received antithyroid drugs until 2 weeks before sonography, the other 13 were untreated. There was no difference in adrenal gland shape between healthy and hyperthyroid cats: bean‐shaped, well‐defined, hypoechoic structures surrounded by a hyperechoic halo in 43/60 (71.6%) healthy cats and 34/46 (73.9%) hyperthyroid cats; more ovoid in 13/60 (21.6%) healthy cats and 9/46 (19.6%) hyperthyroid cats while more elongated in 4/60 (6.7%) healthy cats, 3/46 (6.5%) hyperthyroid cats. Hyperechoic foci were present in 9/23 (39.1%) ...

Endocrine disorders & female infertility

Best Practice and Research. Clinical Endocrinology and Metabolism — Fri, 25 Nov 2011 08:02:59 +0100

Female infertility occurs in about 37% of all infertile couples and ovulatory disorders account for more than half of these. The ovaries are in continuous interaction with the other endocrine organs. The interplay may account for infertility occurring at different levels and may render the diagnosis of infertility a difficult exercise for the involved physician. A hypothalamic cause of female infertility should be considered in an appropriate clinical context, with tests pointing to a hypogonadotropic hypogonadism. It can be functional, physiological or related to organic causes. Hyperprolactinemia has well characterized effects on the normal gonadal function and treatment is well established. Acromegaly and Cushing’s disease may impair fertility at different levels, mechanisms involved ...

Pregnancy and other pituitary disorders (including GH deficiency)

Best Practice and Research. Clinical Endocrinology and Metabolism — Fri, 25 Nov 2011 08:02:59 +0100

The pituitary gland is one of the most affected organs with altered anatomy and physiology during pregnancy. Acromegaly is the second most common pituitary adenoma seen in relation to gestation after prolactinomas. Acromegaly should be treated before conception to prevent potential tumor growth in patients who desire fertility. Medical therapy can be ceased safely after confirmation of pregnancy in acromegalic patients, but octreotide may be used in selected cases with compressive signs. Other hormonal and non-functional tumors are rarer and have been presented as case reports. Sheehan’s syndrome, which is one of the most common causes of hypopituitarism in developing countries, and lymphocytic hypophysitis are known to be associated with pregnancy. They usually result in hypopituitarism...

Clinical and metabolic effects of first-line treatment with somatostatin analogues or surgery in acromegaly: a retrospective and comparative study

Pituitary — Thu, 24 Nov 2011 17:43:41 +0100

Abstract To evaluate the metabolic effects of first-line somatostatin analogues or surgery in acromegaly. Retrospective, comparative, 12-month follow-up. Two hundred and thirty one patients (123 men, age 47.32 ± 14.63 years) with active acromegaly, first line treatments were somatostatin analogues in 151 (65.4%) and surgery in 80 (34.6%). Metabolic syndrome (MS) parameters, glucose, insulin and GH during oral glucose tolerance test, stimulated insulin sensitivity by insulin sensitivity index (ISI Matsuda), early and total insulin-secretion rate by insulinogenic index and AUCINS, visceral adiposity function, expressed by visceral adipose index (VAI). Somatostatin analogues treatment improved all MS parameters and significantly reduced fasting glucose (P ...

The predictive value of the IGF-1 level in acromegaly patients treated by surgery and a somatostatin analogue.

Endokrynologia Polska — Sun, 20 Nov 2011 03:42:05 +0100

Conclusions: The level of IGF-1 prior to surgery and prior to SSLAR treatment is a better predictor of the treatment outcome than hGH. Octreotide LAR was most effective over the first 12 months of treatment. No further significant decrease of hGH or IGF-1 levels was observed past this period. (Pol J Endocrinol 2011; 62 (5): 401-408). PMID: 22069100 [PubMed - in process] (Source: Endokrynologia Polska)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Impact of growth hormone hypersecretion on the adult human kidney.

Annales d'Endocrinologie — Wed, 16 Nov 2011 05:00:00 +0100

Authors: Grunenwald S, Tack I, Chauveau D, Bennet A, Caron P Abstract Acromegaly is most often secondary to a GH-secreting pituitary adenoma with increased Insulin-like Growth Factor type 1 (IGF-1) level. The consequences of GH/IGF-1 hypersecretion reflect the diversity of action of these hormones. The genes of the GH receptor (GHR), IGF-1, IGF-1 receptor (IGF-1R) and IGF-binding proteins (IGF-BP) are physiologically expressed in the adult kidney, suggesting a potential role of the somatotropic axis on renal structure and functions. The expression of these proteins is highly organized and differs according to the anatomical and functional segments of the nephron suggesting different roles of GH and IGF-1 in these segments. In animals, chronic exposure to high doses of GH induces gl...

Aortic stiffness is increased in acromegaly regardless the method of assessment

International Journal of Cardiology — Tue, 15 Nov 2011 05:00:00 +0100

Acromegaly is frequently associated with vascular alterations including increased aortic stiffness possibly due to co-existing conventional risk factors, but direct effects of growth hormone (GH) / insulin-like growth-factor (IGF)-1 excess on vasculature should also be considered. Smith et al. were the first to noninvasively assess arterial stiffness and central aortic pressure by the technique of pulse-wave analysis using the SphygmoCor apparatus . Acromegaly was found to be associated with changes in the central arterial pressure waveform suggesting large artery stiffening. They also found that large artery stiffness is reduced in cured acromegaly and partially reversed after pharmacological treatment of active disease. Sakai et al. have demonstrated that brachial-ankle pulse-wave veloci...

[Acromegalic cardiomyopathy].

Orvosi Hetilap — Tue, 08 Nov 2011 21:07:15 +0100

Authors: Bencze A, Rácz K Abstract Acromegaly is an endocrine disease with specific somatic changes due to an excess of growth hormone. The majority of cases are caused by growth hormone producing pituitary tumors. Cardiovascular complications, which can be detected even in the early stages of the disease, are considered as major contributing factors in the increased morbidity and mortality of the patients. In this review authors briefly summarize clinical characteristics of acromegalic cardiomyopathy. Orv. Hetil., 2011, 152, 1875-1878. PMID: 22042313 [PubMed - in process] (Source: Orvosi Hetilap)

Intensity of pituitary adenoma on T2 weighted MRI predicts the response to octreotide treatment in newly diagnosed acromegaly

Clinical Endocrinology — Tue, 08 Nov 2011 05:00:00 +0100

Conclusion: In patients with acromegaly, T2 signal intensity at diagnosis correlates with histological features and predicts biochemical outcome of first line SA treatment. (Source: Clinical Endocrinology)

Glucose status in patients with acromegaly receiving primary treatment with the somatostatin analog lanreotide

Pituitary — Sat, 05 Nov 2011 17:09:44 +0100

Abstract To describe glucose status changes in patients with acromegaly receiving somatostatin analog lanreotide as primary treatment. This retrospective, single-center study conducted during 1996–2008, included acromegalic patients receiving primary lanreotide treatment. Baseline and last follow-up visit assessments included glucose status (according to American Diabetes Association criteria), growth hormone (GH), and insulin-like growth factor-1 (IGF-1) levels. Glucose control was considered improved when fasting plasma glucose or antidiabetic treatments were reduced, and deteriorated if fasting glucose was the same/higher but with increased antidiabetic treatments. 42 patients (median age 50 years; range 29–75 years) were included. At baseline, 26 (62%) we...

MedWorm Sponsor Message: Find the best January Sales in the UK.

The Coexistence of an Intrasellar Adenoma, Lymphocytic Hypophysitis, and Primary Pituitary Lymphoma in a Patient with Acromegaly

Experimental Diabetes Research — Wed, 26 Oct 2011 19:24:29 +0100

We present a case of a 71-year-old female referred for evaluation and treatment of acromegaly. Questioning revealed she was experiencing facial palsy, visual disturbances, and syncopal spells for several weeks. When laboratory evaluation showed elevated somatomedin (IGF-I) levels and an oral glucose tolerance test failed to demonstrate any suppression of her growth hormone (GH) values, an MRI of the pituitary revealed a sellar mass. A presumptive diagnosis of pituitary adenoma was established. The patient underwent transsphenoidal resection of the sellar mass, which proved to be a large B-cell lymphoma (Stage I-E) associated with areas of adenoma and lymphocytic hypophysitis. (Source: Experimental Diabetes Research)

Large dinosaurs migrated huge distances

Guardian Unlimited Science — Wed, 26 Oct 2011 17:00:00 +0100

An analysis of dinosaur teeth suggests the creatures may have migrated from flood plains to uplands during the dry seasonThe largest dinosaurs to walk the Earth may have embarked on seasonal migrations that covered hundreds of kilometres when local watering holes dried up and food became scarce.Evidence that giant sauropods set off on epic journeys came to light when scientists examined fossilised teeth recovered from the remains of beasts unearthed in Wyoming and Utah in the US.The analysis of 32 teeth belonging to two species of Camarasaurus, among the most common sauropods found in North America, suggests the creatures migrated during hot, dry summers, from their usual habitats on flood plains in search of food and water in surrounding uplands.Some return journeys required the dinosaurs...

Lowland–upland migration of sauropod dinosaurs during the Late Jurassic epoch

Nature AOP — Wed, 26 Oct 2011 04:00:00 +0100

Lowland–upland migration of sauropod dinosaurs during the Late Jurassic epoch Nature advance online publication 26 October 2011. doi:10.1038/nature10570 Authors: Henry C. Fricke, Justin Hencecroth & Marie E. Hoerner Sauropod dinosaurs were the largest vertebrates ever to walk the Earth, and as mega-herbivores they were important parts of terrestrial ecosystems. In the Late Jurassic-aged Morrison depositional basin of western North America, these animals occupied lowland river-floodplain settings characterized by a seasonally dry climate. Massive herbivores with high nutritional and water needs could periodically experience nutritional and water stress under these conditions, and thus the common occurrence of sauropods in this basin has remained a paradox. Energetic arguments an...

Growth hormone‐induced STAT5 signaling causes gigantism, inflammation and premature death but protects mice from aggressive liver cancer

Hepatology — Wed, 26 Oct 2011 04:00:00 +0100

Conclusion:Owing to their hepatoprotective functions, STAT5 proteins prevent progressive fatty liver disease and the formation of aggressive HCC in the setting of hyperactivated GH signaling. At the same time, they play a key role in controlling systemic inflammation and regulating organ and body size. (HEPATOLOGY 2011.) (Source: Hepatology)

Lowland–upland migration of sauropod dinosaurs during the Late Jurassic epoch

Nature — Wed, 26 Oct 2011 04:00:00 +0100

Lowland–upland migration of sauropod dinosaurs during the Late Jurassic epoch Nature 480, 7378 (2011). doi:10.1038/nature10570 Authors: Henry C. Fricke, Justin Hencecroth & Marie E. Hoerner Sauropod dinosaurs were the largest vertebrates ever to walk the Earth, and as mega-herbivores they were important parts of terrestrial ecosystems. In the Late Jurassic-aged Morrison depositional basin of western North America, these animals occupied lowland river-floodplain settings characterized by a seasonally dry climate. Massive herbivores with high nutritional and water needs could periodically experience nutritional and water stress under these conditions, and thus the common occurrence of sauropods in this basin has remained a paradox. Energetic arguments and...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Growth‐hormone–induced signal transducer and activator of transcription 5 signaling causes gigantism, inflammation, and premature death but protects mice from aggressive liver cancer

Hepatology — Wed, 26 Oct 2011 04:00:00 +0100

Conclusion: As a result of their hepatoprotective functions, STAT5 proteins prevent progressive fatty liver disease and the formation of aggressive HCC in the setting of hyperactivated GH signaling. At the same time, they play a key role in controlling systemic inflammation and regulating organ and body size. (Hepatology 2012) (Source: Hepatology)

Hypoglycaemia, phaeochromocytoma and features of acromegaly: a unifying diagnosis?

QJM — Sat, 22 Oct 2011 04:00:00 +0100

(Source: QJM)

Restrictive extraocular myopathy: A presenting feature of acromegaly

Indian Journal of Ophthalmology — Wed, 19 Oct 2011 04:00:00 +0100

Steven Heireman, Christophe Delaey, Ilse Claerhout, Christian E DecockIndian Journal of Ophthalmology 2011 59(6):517-519A 45-year-old man presented with binocular diplopia in primary gaze for 1 year. Orthoptic evaluation showed 10-prism diopter right eye hypotropia and 6-prism diopter right eye esotropia. The elevation and abduction of the right eye were mechanically restricted. This was associated with systemic features suggestive of acromegaly. Magnetic resonance imaging (MRI) of the brain demonstrated a pituitary macroadenoma. An elevated serum insulin-like growth factor I level and the failure of growth hormone suppression after an oral glucose load biochemically confirmed the diagnosis of acromegaly. Computed tomography (CT) of the orbit demonstrated bilateral symmetrical enlargement ...

Mitral Valve Repair in a Patient with Acromegaly.

Annals of Thoracic and Cardiovascular Surgery — Mon, 17 Oct 2011 04:00:00 +0100

We report on a successful mitral valve (MV) repair and modified Cox maze procedure in a 35-year-old male patient with acromegaly, associated with severe mitral regurgitation and atrial fibrillation. He underwent a transsphenoidal adenomectomy, 7 months after the cardiac operation, and IGF-I level was normalized postoperatively. Valvular disease in patients with acromegaly is associated with hormonal activity, and control of growth hormone and insulin-like growth factor I excesses is important in the long-term durability of mitral valve repair. PMID: 22001216 [PubMed - as supplied by publisher] (Source: Annals of Thoracic and Cardiovascular Surgery)

Prevalence of antipituitary antibodies in acromegaly

Pituitary — Fri, 14 Oct 2011 10:39:54 +0100

Abstract Acromegaly is a rare disorder due to an excessive production of growth hormone (GH), typically caused by a GH-secreting pituitary adenoma. Anti-pituitary antibodies (APAs) are often seen in patients with different kinds of pituitary pathologies. Because GH has been proposed as a possible antigen recognized by such antibodies, the prevalence of APAs may be higher in conditions characterized by excessive GH secretion. The primary aim of this study was to compare the prevalence of APAs in patients with acromegaly and in controls with other types of pituitary tumors and healthy subjects. Secondary aim was to characterize the pituitary cells targeted by the APAs. Thirty eight acromegaly patients and 215 controls, including 38 patients with prolactinomas, 64 with non-fu...

MedWorm Sponsor Message: Find the best January Sales in the UK.

DISCONTINUATION OF OCTREOTIDE LAR AFTER LONG-TERM, SUCCESFUL TREATMENT OF PATIENTS WITH ACROMEGALY: Is it worth trying?

European Journal of Endocrinology — Wed, 12 Oct 2011 04:00:00 +0100

Conclusion: Withdrawal of SA is possible in a small but distinct subset of patients, particularly in those who are very well controlled on relatively low doses administered at long intervals. PMID: 21993154 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Comparison of oral glucose tolerance test (OGTT) 100 g with OGTT 75 g for evaluation of acromegalic patients and the impact of gender on test reproducibility

Clinical Endocrinology — Wed, 05 Oct 2011 14:50:49 +0100

Conclusions In acromegalic patients, there is no difference in GH nadirs and test interpretation after the ingestion of 100 g or 75 g glucose. The OGTT75 is highly reproducible in men, but in women, it should be performed preferably in the early follicular phase. (Source: Clinical Endocrinology)

Comparison of primary octreotide‐lar and surgical treatment in newly diagnosed patients with acromegaly

Clinical Endocrinology — Wed, 05 Oct 2011 14:50:48 +0100

Conclusion Primary surgical treatment seems to be slightly more effective than Oct‐LAR in terms of biochemical response and IGF‐1 control, besides tumour volume reduction, in patients with acromegaly with noninvasive tumours. Oct‐LAR is associated with more side effects such as cholelithiasis and glucose metabolism disorders and is more expensive. (Source: Clinical Endocrinology)

Initial experience of 3 Tesla versus conventional field strength magnetic resonance imaging of small functioning pituitary tumours

Clinical Endocrinology — Wed, 05 Oct 2011 14:50:46 +0100

Conclusions 3T MRI appears to offer increased conspicuity and detection of GH‐ and ACTH‐secreting pituitary microadenomas. It is potentially clinically useful when 1·5T imaging is negative or equivocal. (Source: Clinical Endocrinology)

Hereditary Pituitary Hyperplasia with Infantile Gigantism.

The Journal of Clinical Endocrinology and Metabolism — Wed, 05 Oct 2011 04:00:00 +0100

Conclusions:This hereditary condition seems to be a result of embryonic pituitary maldevelopment with retention and expansion of the mammosomatotrophs. The findings suggest that it is caused by paracrine or autocrine pituitary GHRH secretion during pituitary development. PMID: 21976722 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Aortic root ectasia & acromegaly

Society for Endocrinology — Tue, 04 Oct 2011 12:00:00 +0100

An excess of growth hormone (GH) results in cardiac complications, causing patients with acromegaly to have a shortened life expectancy. However, the vascular consequences of excess GH, specifically, are unknown. In their commentary, Colao and Grasso discuss the emerging problem of increased aortic root diameter in acromegalic patients. They focus on research published in the same issue of Clinical Endocrinology by Casini et al., who found that the prevalence of aortic ectasia was higher in the 42 acromegalic patients, compared with 42 healthy matched controls. Long exposure to excess GH thus directly affects the aortic root and echocardiographic measurements are needed in clinical practice to fully characterise acromegalic cardiomyopathy. Casini et al. (2011) Clinical Endocrinology 75 495...

Identification of somatostatin receptor type 5 gene polymorphisms associated with acromegaly.

European Journal of Endocrinology — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions Our results demonstrate a previously undetected strong association of two SSTR5 SNPs with acromegaly. The data also suggest a possible involvement of SSTR5 variants in decreased suppression of GH production and increased tumor proliferation. PMID: 21810856 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Surgical facial corrections in acromegaly

International Journal of Oral and Maxillofacial Surgery — Sat, 01 Oct 2011 04:00:00 +0100

Acromegaly is an acquired disorder characterized by overproduction of growth hormone in adults. It results in enlargement of the neurocranium and orofacial skeleton with exception of the maxilla. Obstructive sleep apnea is also common. (Source: International Journal of Oral and Maxillofacial Surgery)

Orthognatic surgery and acromegaly, important considerations before surgery

International Journal of Oral and Maxillofacial Surgery — Sat, 01 Oct 2011 04:00:00 +0100

We present a case of a 52-years-old male with acromegaly consecutive to a pituitary tumor resected 12 years before surgery. He remained stable at substitution therapy with hydrocortisone and sodium levothyroxine daily. The clinical features found were mandibular prognathism with left mandibular deviation and prominent supraorbital ridges. The surgical correction treatment was segmentary LeFort-I osteotomy and BSSO with midline alignment. A special pharmacological scheme prior, during and after surgery was carried out. In the postoperative course, the patient developed a bradycardic episode managed and controlled with atropine administration, showing the cardiovascular risk to which these patients are exposed. A complete surgical-endocrine management is shown. (Source: International Journal...

Pituitary Tumors and Transsphenoidal Surgery

Disease a Month — Sat, 01 Oct 2011 04:00:00 +0100

Pituitary adenomas are among the most common brain tumors, with an estimated prevalence of 16% on autopsy studies. The patient advocacy organization, Pituitary Network, recently conducted a “1 in 5” campaign, to increase public awareness of this common entity. While many patients harbor these adenomas, the lesions are nearly always benign and often asymptomatic. Pituitary adenomas are classified according to size, with those less than 10 mm considered microadenomas and those reaching 10 mm or greater in size considered macroadenomas. The vast majority of patients with macroadenomas will have headaches. The most common presenting symptom for large tumors is visual field loss, because of elevation and compression of the optic nerve(s) and chiasm from the tumor as it grows upward from the...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Comparison of two immunoassays in the determination of IGF-I levels and its correlation with oral glucose tolerance test (OGTT) and with clinical symptoms in acromegalic patients

Pituitary — Fri, 30 Sep 2011 05:54:22 +0100

In conclusion, discrepant GH and IGF-I levels in the diagnosis and follow-up of patients with acromegaly requires consideration of many factors that influence these parameters. Content Type Journal ArticlePages 1-6DOI 10.1007/s11102-011-0351-yAuthors Laura Boero, Departamento de Neuroendocrinología (Neuroendocrinology Department), Sociedad Argentina de Endocrinología y Metabolismo, Diaz Velez 3889, (1200), Buenos Aires, ArgentinaMarcos Manavela, Departamento de Neuroendocrinología (Neuroendocrinology Department), Sociedad Argentina de Endocrinología y Metabolismo, Diaz Velez 3889, (1200), Buenos Aires, ArgentinaKarina Danilowicz, Departamento de Neuroendocrinología (Neuroendocrinology Department), Sociedad Argentina de Endocrinología y Metabolismo, Diaz Velez 3889, (1200), B...

Acromegaly due to an ectopic pituitary adenoma in the clivus: case report and review of literature

Pituitary — Fri, 30 Sep 2011 05:54:21 +0100

We describe a 50-year-old female who presented with clinical signs and biochemical evidence of acromegaly. Pituitary MRI demonstrated a 2 mm hypointense lesion on the right side of the pituitary gland. However upon drilling of the upper clival bone to expose the sella during endoscopic transsphenoidal surgery, soft tumor-like tissue was encountered within the clivus. Exploration of the sella, including the area of hypointensity noted on preoperative imaging, did not identify any other abnormality. Immunohistochemical examination of the fully resected tumor demonstrated growth hormone immunoreactivity. Failed preoperative diagnosis of this rare ectopic GH-producing tumor was compounded by the presence of a misleading pituitary abnormality consistent with a microadenoma. The epide...

Growth hormone deficiency in patients after cure of acromegaly by surgery alone.

European Journal of Endocrinology — Fri, 30 Sep 2011 04:00:00 +0100

Conclusions: This is the first large-scale, single-center, clinical study to evaluate sGHD in patients after cure of acromegaly by surgery alone. This study found that sGHD occurred in approximately 9% of patients and assessment of GHD by stimulation tests is critical after successful treatment of acromegaly by surgery. PMID: 21964960 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Beckwith–Wiedemann syndrome with placental chorangioma due to H19‐differentially methylated region hypermethylation: A case report

Journal of Obstetrics and Gynaecology Research — Wed, 28 Sep 2011 04:00:00 +0100

We report a case of BWS, prenatally diagnosed with ultrasonography. A large and well‐circumscribed tumor also existed on the fetal surface of the placenta, which was histologically diagnosed as chorangioma after delivery. Polyhydramnios was obvious and the fetal heart enlarged progressively during pregnancy. Because the biophysical profiling score dropped to 4 points at 33 weeks of gestation, we carried out cesarean section. By epigenetic analysis, H19‐differentially methylated region hypermethylation was observed in the placental tumor, normal placental tissue, and cord blood mononuclear cells. This is the first report of BWS with placental tumor due to H19‐differentially methylated region hypermethylation. (Source: Journal of Obstetrics and Gynaecology Research)

Safety review: Dose optimization of somatostatin analogs in patients with acromegaly and neuroendocrine tumors.

Advances in Therapy — Wed, 28 Sep 2011 04:00:00 +0100

CONCLUSION: A review of published clinical studies demonstrates that dose optimization provides additional biochemical control in patients with acromegaly and NET who are inadequately controlled with conventional starting doses of octreotide LAR and lanreotide ATG. The benefits of dose optimization include improved efficacy without a significant change in the recorded adverse events and the tolerability of the treatment. Therefore, patient response to treatment should be routinely monitored and their somatostatin analog dose increased or decreased thereafter according to their individual response. PMID: 21964965 [PubMed - as supplied by publisher] (Source: Advances in Therapy)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Aortic Root Ectasia in Patients With AcromegalyAortic Root Ectasia in Patients With Acromegaly

Medscape Today Headlines — Wed, 21 Sep 2011 18:35:33 +0100

What do we know about vascular consequences of growth hormone excess? Clinical Endocrinology (Source: Medscape Today Headlines)

[Hindfoot amputations.]

Operative Orthopadie und Traumatologie — Sat, 17 Sep 2011 04:00:00 +0100

Authors: Rammelt S, Olbrich A, Zwipp H Abstract OBJECTIVE: Obtaining a durable, weight-bearing stump with minimal or no loss of limb length, and stable soft tissue coverage with preservation of the original sensation of the sole of the foot at the heel. INDICATIONS: Complex trauma to the foot with devitalized or nonreconstructable forefoot and midfoot, deep bony and soft tissue infection, infected Charcot foot with threatening sepsis, necrosis or gangrene of the forefoot and midfoot with vasculopathy, malignant tumors, certain infections, gigantism of the forefoot. CONTRAINDICATIONS: Possible reconstruction of the midfoot and forefoot beyond the midtarsal (Chopart) joint, loss or irreversible destruction of the sole of the foot or the distal tibial metaphysis. SURGICAL TECHNIQUE: T...

Aortic root ectasia in patients with acromegaly: experience at a single center

Clinical Endocrinology — Fri, 16 Sep 2011 01:00:54 +0100

Conclusion The aortic root diameter was higher, and the prevalence of aortic ectasia was more common in acromegalic patients than in controls. In addition, only acromegalic disease was associated with aortic ectasia, suggesting the direct effects of GH and insulin‐like growth factor‐I excess on the cardiovascular system. (Source: Clinical Endocrinology)

Aortic root ectasia in patients with acromegaly: an emerging complication*

Clinical Endocrinology — Fri, 16 Sep 2011 01:00:31 +0100

(Source: Clinical Endocrinology)

Clinical factors involved in the recurrence of pituitary adenomas after surgical remission: a structured review and meta-analysis

Pituitary — Wed, 14 Sep 2011 16:08:12 +0100

Abstract To study the currently available data of recurrence rates of functioning and nonfunctioning pituitary adenomas following surgical cure and to analyze associated predisposing factors, which are not well established. A systematic literature search was conducted using Medline, Embase, Web of Science and the Cochran Library for studies reporting data on recurrence of pituitary adenoma after surgery, in nonfunctioning adenoma (NF), prolactinoma (PRL) acromegaly (ACRO) and Cushing’s disease (CUSH). Of 557 initially retrieved potential relevant studies 143 were selected. Recurrence in NFA was defined as reappearance of tumor on MRI or CT. Increase of hormone levels above normal limits as set by the authors after initial remission was used to indicate recurrence in the ...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Affected Illness Perceptions and the Association with Impaired Quality of Life in Patients with Long-Term Remission of Acromegaly.

The Journal of Clinical Endocrinology and Metabolism — Wed, 14 Sep 2011 04:00:00 +0100

Conclusion:Illness perceptions of patients after long-term remission of acromegaly are affected and strongly related to QoL. Patients reported more negative illness perceptions than patients with acute illness but more positive illness perceptions than patients with chronic diseases. Additional research is necessary to assess whether a self-management intervention might help in improving affected illness perceptions and thereby improve QoL. PMID: 21917873 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

UK Acromegaly Register

Society for Endocrinology — Mon, 12 Sep 2011 12:00:00 +0100

The Society for Endocrinology are grateful to Ipsen for their continued financial support. (Source: Society for Endocrinology)

Guidelines for the treatment and diagnosis of acromegaly have been published by the American Association of Clinical Endocrinologists (AACE).

PharmacoEconomics and Outcomes News — Sun, 11 Sep 2011 01:57:51 +0100

(Source: PharmacoEconomics and Outcomes News)

NETAG issues recommendation on pegvisomant (Somavert) for acromegaly

NeLM - Drug Specific Reviews — Mon, 29 Aug 2011 23:00:00 +0100

Source: NETAG Area: Evidence > Drug Specific Reviews The NHS North East Treatment Advisory Group (NETAG) has issued a recommendation and associated appraisal report on pegvisomant (Somavert) for acromegaly. The Group did not recommend its use as it considered that pegvisomant is unlikely to meet conventional cost effectiveness criteria. However it accepted that individual patients in exceptional circumstances may be suitable for treatment, and such cases must be referred via local individual funding request mechanisms. (Source: NeLM - Drug Specific Reviews)

A case of acromegaly (Greece, 7th c. AD).

European Journal of Endocrinology — Wed, 24 Aug 2011 23:00:00 +0100

CONCLUSIONS: This skeletal case, and other ancient ones are discussed, in order to better describe the history of the disease, and the possibilities of diagnosis. PMID: 21868602 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Determinants of cardiac disease in newly diagnosed patients with acromegaly. Results of a 10 years survey study.

European Journal of Endocrinology — Wed, 24 Aug 2011 23:00:00 +0100

Conclusions The prevalence of different features of cardiomyopathy is 3.3-14.2 times higher in the acromegalic than in the non-acromegalic population. The major determinant of cardiomyopathy is disease duration. PMID: 21868601 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Comparison of octreotide LAR and lanreotide autogel as post-operative medical treatment in acromegaly

Pituitary — Tue, 23 Aug 2011 15:53:08 +0100

Abstract Long-acting somatostatin analogs are frequently used as adjuvant treatment of acromegaly patients after noncurative surgery. This sudy aims to compare the efficacy of octreotide long-acting release (OCT) and lanreotide Autogel (LAN) in acromegaly patients. Sixty-eight patients not cured by transsphenoidal endoscopic or microscopic pituitary surgery between 2003 and 2009 were retrospectively analyzed (25 men; 43 women; mean age 41.1 ± 10.9 years [range 18–65 years]). The patients were assigned randomly to OCT (n = 36) and LAN (n = 32) groups. Evaluations included insulin-like growth factor I (IGF-I) and growth hormone (GH) after oral glucose tolerance test (OGTT) 3, 6, 12 and 18 months after starting medical treatment;...

Thyrotropin secreting pituitary adenoma accompanying a silent somatotropinoma.

Turkish Neurosurgery — Fri, 19 Aug 2011 22:22:03 +0100

In conclusion, we always recommend hormonal examinations for all patients who have pituitary adenoma without signs and symptoms of acromegaly. PMID: 21845579 [PubMed - in process] (Source: Turkish Neurosurgery)

Partial inactivation of Ankrd26 causes diabetes with enhanced insulin responsiveness of adipose tissue in mice

Diabetologia — Sat, 13 Aug 2011 06:12:48 +0100

Conclusions/interpretation These findings show that the ANKRD26 protein has at least two functions in mice. One is to control the response of white adipose tissue to insulin; the other is to control appetite, which when Ankrd26 is mutated, leads to hyperphagia and diabetes in an obesity-dependent manner. Content Type Journal ArticlePages 1-12DOI 10.1007/s00125-011-2263-9Authors G. A. Raciti, Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 37 Convent Drive, Room 5106, Bethesda, MD 20892-4264, USAT. K. Bera, Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 37 Convent Drive, Room 5106, Bethesda, MD 20892-4264, USAO. Gavrilova, Mous...

Is Placental Iodine Content Related to Dietary Iodine Intake?Is Placental Iodine Content Related to Dietary Iodine Intake?

Medscape Today Headlines — Fri, 12 Aug 2011 11:04:21 +0100

Who is more accurate at diagnosing early acromegaly, a computer model or a general physician? Clinical Endocrinology (Source: Medscape Today Headlines)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Surgical Management of Obstructive Sleep Apnea in Acromegaly With Mandibular Prognathism and Macroglossia: A Treatment Dilemma

Journal of Oral and Maxillofacial Surgery — Mon, 08 Aug 2011 04:00:00 +0100

Acromegaly is a rare disease resulting from chronic growth hormone excess largely owing to a growth hormone-secreting pituitary adenoma. Males and females appear to be equally affected, with an annual incidence of 3 to 4 per million. The diagnosis of the disease often occurs late, with an average age of 40 years, owing to its insidious onset and slow progression. The prominent cosmetic features include enlarged extremities, thickened skin, widened nose, prominent cheekbones, course facial lines, and, occasionally, frontal bossing. The oral manifestations include mandibular overgrowth, resulting in prognathism, maxillary widening, dental malocclusion, macroglossia, and enlarged lips. Systemic manifestations, including rheumatologic, cardiovascular, respiratory, and metabolic consequences, d...

Acromegaly surgery in Manchester revisited – The impact of reducing surgeon numbers and the 2010 consensus guidelines for disease remission

Clinical Endocrinology — Sun, 07 Aug 2011 23:00:00 +0100

Conclusions: Remission rates for acromegaly surgery have improved following establishment of a specialist surgical service, with a reduction in surgeon numbers. Endoscopic trans‐sphenoidal surgery remains an effective first‐line treatment for achieving biochemical remission in acromegaly, despite the introduction of the more stringent 2010 consensus guidelines. (Source: Clinical Endocrinology)

Acromegaly and pregnancy.

Annales d'Endocrinologie — Tue, 02 Aug 2011 23:00:00 +0100

Authors: Caron P In women with acromegaly due to growth hormone (GH)-secreting pituitary adenomas, the occurrence of pregnancy warrants consideration of: (1) the consequences of pregnancy on the pituitary adenoma including the tumor syndrome and GH/IGF-1 secretion, (2) the consequence of GH/IGF-1 hypersecretion on the pregnant woman and the fetus, (3) the consequences of pituitary surgery and medical treatment (dopamine agonists, somatostatin analogs, GH receptor antagonist) on the pregnant woman and the developing fetus. PMID: 21820101 [PubMed - as supplied by publisher] (Source: Annales d'Endocrinologie)

Identification of Somatostatin Receptor Type 5 (SSTR5) gene polymorphisms associated with acromegaly.

European Journal of Endocrinology — Mon, 01 Aug 2011 23:00:00 +0100

Conclusions: Our results demonstrate a previously undetected strong association of two SSTR5 SNPs with acromegaly. The data also suggest a possible involvement of SSTR5 variants in decreased suppression of growth hormone (GH) production and increased tumor proliferation. PMID: 21810856 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Refractory DKA as first presentation of acromegaly and a potential role for continuous venovenous hemofiltration in its successful management.

Connecticut Medicine — Mon, 01 Aug 2011 04:00:00 +0100

We present a unique patient with refractory diabetic ketoacidosis (DKA) as a first presentation of acromegaly. In addition to an insulin drip and intravenous fluids, our patient was managed with octreotide therapy. As he developed acute renal failure in the context of renal hypoperfusion, continuous venovenous hemofiltration (CVVH) was instituted. After only three days of therapy, the growth hormone (GH) level dropped circa fourfold and insulin growth factor 1 (IGF-1) level dropped ninefold. We postulate a hypothetical role of CVVH in removal of plasma GH and IGF-1, similar to the clearance of other medium size molecules such as brain natriuretic peptide and procalcitonin. If this is confirmed in future studies, CVVH may have therapeutic implications for the above category of patients. ...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Primary hypothyroidism presenting as pseudoacromegaly

Pituitary — Fri, 29 Jul 2011 16:04:48 +0100

We report an unusual presentation of primary hypothyroidism with pseudoacromegaly and thyrotroph hyperplasia mimicking a pituitary macroadenoma. The thyrotroph hyperplasia resolved completely with levothyroxine therapy. Content Type Journal ArticlePages 1-4DOI 10.1007/s11102-011-0336-xAuthors K. V. S. Hari Kumar, Department of Endocrinology, Command Hospital, Lucknow, UP 226002, IndiaAltamash Shaikh, Department of Endocrinology, PD Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, 400016 IndiaIrfan Anwar, Department of Neurosurgery, Command Hospital, Lucknow, UP 226002, IndiaP. Prusty, Department of Endocrinology, Command Hospital, Lucknow, UP 226002, India Journal PituitaryOnline ISSN 1573-7403Print ISSN 1386-341X (Source: Pituitary)

Pregnancy and acromegaly: a review

Pituitary — Mon, 25 Jul 2011 15:45:36 +0100

Abstract To review the literature regarding the diagnosis and management of acromegaly during pregnancy. A systematic literature search was performed using MEDLINE including hand-searching reference lists from original articles. The diagnosis of acromegaly during pregnancy is made difficult due to the physiologic changes in pituitary GH secretion and IGF-1 production resulting from placental GH secretion and the inability of commercial assays to discriminate between pituitary and placental GH. Most patients with acromegaly during pregnancy do not have an increase in tumor size, metabolic complications are uncommon, and neonatal outcome is largely unaffected. IGF-1 levels tend to be stable in such patients possibly due to the high estrogen levels causing GH resistance. Dopa...

Carotid Artery Injury After Endonasal Surgery

Otolaryngologic clinics of North America — Thu, 21 Jul 2011 04:00:00 +0100

Carotid artery injury during endonasal surgery is the most feared and catastrophic complication. Internal carotid artery injury is more frequent during skull base surgery, and risk factors include acromegaly, previous revision surgery, and prior radiotherapy and bromocriptine therapy. Nasal packing is frequently used to gain hemostasis, often resulting in vascular occlusion. Recent research recommends the crushed muscle patch treatment as an effect hemostat that maintains vascular patency. Endovascular techniques are recommended for vascular control and complication management. Coil or balloon embolization is preferred in patients with adequate collateral cerebral blood flow, and stent-graft placement or bypass surgery is indicated in those who do not. (Source: Otolaryngologic clinics of N...

Rheumatoid Arthritis Associated with the Use of Sandostatin® LAR® Depot in a Patient with Pancreatic Neuroendocrine Tumor. An Association or a Coincidence? The First Case Report.

JOP — Wed, 13 Jul 2011 16:30:03 +0100

Authors: Saif MW Sandostatin® LAR® depot is a synthetic analogue of the naturally occurring hormone somatostatin and is indicated for certain patients with acromegaly and severe diarrhea and flushing episodes associated with metastatic carcinoid tumors and for the long-term treatment of the profuse watery diarrhea associated with VIP-secreting tumors in patients in whom initial treatment with immediate release Sandostatin® injection has been shown to be effective and tolerated. The most common toxicities include biliary disorders, gastrointestinal disorders, injection-site pain, hypoglycemia and hyperglycemia. Rheumatoid arthritis or similar toxicities have not been associated with Sandostatin® LAR® depot. PMID: 21737909 [PubMed - in process] (Source: JOP)

Early diagnosis of acromegaly: computers vs clinicians

Clinical Endocrinology — Wed, 13 Jul 2011 09:00:56 +0100

Conclusions The present computer model can sort photographs of patients with acromegaly from photographs of normal subjects and is much more accurate than the sorting by practicing generalists. Even normal subjects have some of the features of acromegaly. Screening with this approach can be improved with automation of the procedure, software development and the identification of target populations in which the prevalence of acromegaly may be increased over that in the general population. (Source: Clinical Endocrinology)

MedWorm Sponsor Message: Find the best January Sales in the UK.

The effects of long‐term growth hormone and insulin‐like growth factor‐1 exposure on the development of cardiovascular, cerebrovascular and metabolic co‐morbidities in treated patients with acromegaly

Clinical Endocrinology — Wed, 13 Jul 2011 09:00:55 +0100

Conclusion This study identifies associations of raised GH and IGF‐1 burden with cardiovascular, cerebrovascular and metabolic complications of acromegaly. Results from this study therefore suggest that consideration of the overall level of GH and IGF‐1 exposure may provide important information for the management and surveillance of patients with treated acromegaly. (Source: Clinical Endocrinology)

Pattern of adrenal morphology and function in acromegalic patients

European Journal of Clinical Investigation — Tue, 12 Jul 2011 23:00:00 +0100

Conclusions: This study provides evidence of an increased prevalence of anatomic and functional adrenal alterations in acromegalic patients; further studies will clarify the importance of evaluating these subjects with baseline hormonal investigation along with dynamic testing and modified cut‐offs. (Source: European Journal of Clinical Investigation)

The growth hormone receptor polymorphism in patients with acromegaly: relationship to BMI and glucose metabolism

Pituitary — Sun, 10 Jul 2011 05:49:40 +0100

Abstract The aim of this study was to investigate association between the frequencies of Growth Hormone receptor (d3GHR) gene polymorphisms and some clinical parameters of acromegalic patients. Total of 35 acromegalic patients were enrolled to study. The d3GHR polymorphism was identified by using polymerase chain reaction from peripheral blood samples. The levels of systolic and diastolic blood pressure, BMI, fasting plasma glucose (FPG), Fasting insulin, HOMA-IR, IGF-I, GH, IGFBP3, triglyceride, HDL and LDL cholesterol concentrations were evaluated. The frequencies of d3GHR genotypes were found as follows; 5 (14.3%) subjects had d3/d3, 11 (31.4%) had d3/fl and 19 (54.3%) had fl/fl in patients. The prevalence of the d3 and fl alleles was 30 and 70%, respectively. Systolic ...

Somatotroph pituitary adenoma with acromegaly and autosomal dominant polycystic kidney disease: SSTR5 polymorphism and PKD1 mutation

Pituitary — Sat, 09 Jul 2011 06:18:50 +0100

Abstract A 39-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) presented with acromegaly and a pituitary macroadenoma. There was a family history of this renal disorder. She had undergone surgery for pituitary adenoma 6 years prior. Physical examination disclosed bitemporal hemianopsia and elevation of both basal growth hormone (GH) 106 ng/mL (normal 0–5) and insulin-like growth factor (IGF-1) 811 ng/mL (normal 48–255) blood levels. A magnetic resonance imaging scan disclosed a 3.0 cm sellar and suprasellar mass with both optic chiasm compression and left cavernous sinus invasion. Pathologic, cytogenetic, molecular and in silico analysis was undertaken. Histologic, immunohistochemical and ultrastructural studies of the lesion ...

Procalcitonin can be used as a marker of premature atherosclerosis in acromegaly

Pituitary — Thu, 07 Jul 2011 05:42:40 +0100

The objective of the study was to evaluate arterial morphologic changes of early atherosclerosis and changes in procalcitonin (PCT) levels in patients with acromegaly according to disease activity. Thirty-three active and 20 inactive acromegaly patients followed at Endocrinology-Metabolism out-patient clinic of Cerrahpasa Medical Faculty between 2004 and 2008 were included in the study. Twenty gender and age matched healthy subjects were included as the control group. Intima-media thickness (IMT) of the carotid arteries was measured by ultrasonography. Blood was drawn for biochemical tests and the serum concentrations of C-reactive protein (CRP) and PCT. Intergroup analysis revealed no significant differences between Growth hormone (GH), insulin like growth factor-1 (IGF-1), and IMT ...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Cognitive function in acromegaly: description and brain volumetric correlates

Pituitary — Thu, 07 Jul 2011 05:42:40 +0100

Abstract In acromegaly, we reported on increased rates of affective disorders such as dysthymia and depression, as well as structural brain changes. Objective of this study was to determine if cognitive impairments in patients with acromegaly exist and whether such impairments are associated with structural brain alterations defined by magnetic resonance imaging (MRI). In this cross-sectional study, 55 patients with biochemically confirmed acromegaly were enrolled. MRI data were compared with 87 control subjects. Main outcome measures were performance levels in 13 cognitive tests covering the domains of attention, memory and executive function, with performance below the cut-off level of the 16th percentile rated as impaired. In addition, individual global and hippocampal ...

Pegvisomant adds little if acromegaly is under control

Modern Medicine — Tue, 05 Jul 2011 23:00:00 +0100

NEW YORK (Reuters Health) - When acromegaly is controlled with a somatostatin analog (SA), the only benefit to adding the growth hormone receptor antagonist pegvisomant is a reduction in the SA dose, researchers report. (Source: Modern Medicine)

Macrodactyly with skin hypertrophy: a minimal form of the Proteus syndrome

Anais Brasileiros de Dermatologia — Sun, 03 Jul 2011 18:03:30 +0100

The Proteus syndrome was described 1983 . It has asymmetric gigantism of the limbs, verrucous epidermal naevi, cerebriform enlargement of the plantar region, vascular malformations and neoplasms, as lipomas. It received this denomination after Proteus from the Greek mythology, who had the ability to change his form . A 15 year-old boy, reported a congenital hypertrophy with syndactily of the second and third right fingers . The second case is a 35 year-old man, who reported that since birth the second right toe was bigger than the other toes, skin hypertrophy was also observed. These cases document a localized form if the Proteus syndrome, which may widen the spectrum of its variabilityA síndorme de Proteus foi descrita por Wiedemann em 1983. Ela é caracterizada por gigantismo assimétri...

Adenoma granulation pattern correlates to clinical variables and effect of somatostatin analogue treatment in a large series of patients with acromegaly

Clinical Endocrinology — Thu, 30 Jun 2011 23:00:00 +0100

Conclusions: Densely granulated adenomas were highly responsive to somatostatin analogues in contrast to sparsely granulated adenomas. The transitional group behaved clinically more like densely granulated adenomas. However, based on E‐cadherin, a marker of dedifferentiation, the transitional group seemed to be a true intermediate. (Source: Clinical Endocrinology)

Endoscopic Transsphenoidal Surgery for Acromegaly: Remission Using Modern Criteria, Complications, and Predictors of Outcome.

The Journal of Clinical Endocrinology and Metabolism — Tue, 28 Jun 2011 23:00:00 +0100

Conclusions: ETSS for GH adenomas is associated with high rates of remission and a low incidence of new endocrinopathy. Despite the panoramic views offered by the endoscope, invasive tumors continue to have lower rates of remission. PMID: 21715544 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Improvement of cardiac parameters in patients with acromegaly treated with medical therapies

Pituitary — Tue, 28 Jun 2011 15:51:54 +0100

Abstract In acromegaly, growth hormone (GH) and insulin-like growth factor-1 (IGF-1) excess results in a specific cardiomyopathy characterized by concentric cardiac hypertrophy primarily associated with diastolic dysfunction that can lead to impaired systolic function and eventually heart failure. This review of the literature evaluates the effect of therapeutic intervention on cardiac parameters. Clinical studies investigating the impact of treatments for acromegaly on cardiac function published between January 1980 and January 2009 were identified through electronic searches of Medline. Suppression of GH and IGF-1 following surgery or medical treatment with somatostatin analogue therapy is effective in decreasing left ventricular (LV) hypertrophy, with subsequent improve...

Birmingham Mid-Head Resection Hip Arthroplasty in a Young Man with Gigantism

The Journal of Arthroplasty — Mon, 27 Jun 2011 04:00:00 +0100

We present the case of a young man with Sotos syndrome (cerebral gigantism) with associated extraordinary stature (height, 2.16 m; weight, 157 kg) who underwent Birmingham Mid-Head Resection arthroplasty. The large stature of this patient required a custom manufactured prosthesis (a femoral head 68 mm in diameter with an acetabular cup 76 mm in diameter). We believe this to be the largest metal-on-metal resurfacing articulation and hip arthroplasty reported to date. (Source: The Journal of Arthroplasty)

Paternal deprivation prior to adolescence and vulnerability to pituitary adenomas

Pituitary — Thu, 23 Jun 2011 16:27:27 +0100

Abstract It has been reported that women with prolactinoma were exposed, early in life, to an environment characterized by an absent or violent father. The present study was designed to evaluate whether paternal absence or violent paternal behavior were more prevalent in patients with pituitary adenomas (prolactinoma, acromegaly, non-secreting adenoma and Cushing’s disease) compared to a control population. We conducted an observational case–control multicenter study. We interviewed 395 patients with prolactinoma (296 females and 99 males), 130 with acromegaly (87 females and 43 males), 237 with non-secreting adenoma (144 females and 93 males) and 68 with Cushing’s disease (61 females and 7 males) and 365 patients from the same clinics with nodular thyroid disease or...

The Glucose‐Dependent Insulinotropic Polypeptide Receptor is Overexpressed Amongst GNAS1 Mutation‐Negative Somatotropinomas and Drives Growth Hormone (GH)‐Promoter Activity in GH3 Cells

Journal of Neuroendocrinology — Sat, 18 Jun 2011 16:59:10 +0100

Somatic mutations in the GNAS1 gene, encoding the α‐subunit of the heterotrimeric stimulatory G protein (Gαs), occur in approximately 40% of growth hormone (GH)‐secreting pituitary tumours. By altering the adenylate cyclase‐cAMP‐protein kinase A pathway, they unequivocally give somatotroph cells a growth advantage. Hence, the pathogenesis of somatotropinomas could be linked to anomalies in receptors coupled to the cAMP second‐messenger cascade. Among them, the glucose‐dependent insulinotropic polypeptide receptor (GIPR) is already known to play a primary role in the impaired cAMP‐dependent cortisol secretion in patients affected by food‐dependent Cushing’s syndrome. In the present study, 43 somatotropinomas and 12 normal pituitary glands were investigated for GIPR expre...

Acromegaly: presentation, morbidity and treatment outcomes at a single centre

International Journal of Clinical Practice — Wed, 15 Jun 2011 23:00:00 +0100

Conclusions: Acromegaly is associated with an increased morbidity. About half of the treated patients achieved remission (2/3 of microadenomas). The best outcomes were reported for the combination of surgery with radiotherapy, in spite of a higher risk of hypopituitarism. SSA led to remission in a significant percentage of microadenomas, but was associated with increased rates of cholelithiasis and impaired glucose homeostasis. (Source: International Journal of Clinical Practice)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Pasireotide (SOM230), a Novel Multi-Receptor-Targeted Somatostatin Analogue, Is Well Tolerated When Administered as a Continuous 7-Day Subcutaneous Infusion in Healthy Male Volunteers.

The Journal of Clinical Pharmacology — Mon, 13 Jun 2011 23:00:00 +0100

This study assessed the safety, tolerability, and pharmacokinetics (PK) of a continuous infusion of pasireotide in healthy volunteers. In this single-center, open-label, dose escalation study, healthy male volunteers received a 7-day continuous SC infusion of pasireotide in sequential ascending-dose cohorts. Single and/or 8-hour blood samples were taken on days 1 to 10 to assess PK and on days 1, 2, and 7 and a control day to assess glucose metabolism. Adverse events were evaluated throughout. Forty-four participants were enrolled into 8 cohorts: pasireotide 450, 900, 1350, 1800 (3 cohorts were enrolled at this dose level), 2250, and 2025 μg/d. Doses were well tolerated up to 2025 μg/d. Adverse events were generally mild and gastrointestinal. Pasireotide steady-state clearance was reduce...

What Is Acromegaly? What Causes Acromegaly?

Health News from Medical News Today — Thu, 09 Jun 2011 07:00:00 +0100

Acromegaly is a syndrome that is brought about by the pituitary gland producing too much growth hormone after puberty. In most cases it is the result of a tumor developing within the gland, the changes caused by this growth hormone excess are not noticeable straight away, but will vastly change the person's appearance after a number of years. If left untreated, acromegaly can lead to a number of medical complications and premature death, not to mention the continuation of visual disfigurement. Acromegaly is a rare condition and affects less than one hundredth of a percent of people in the US... (Source: Health News from Medical News Today)

Acromegaly and sleep apnea: Cephalometric evaluations.

Annales d'Endocrinologie — Mon, 06 Jun 2011 23:00:00 +0100

Authors: Bruwier A, Albert A, Beckers A, Limme M, Poirrier R Lateral teleradiography is a standard and quick examination. It has enabled us to define differences as regards to the craniofacial morphology between 20 acromegalic patients and 20 control subjects. The height of the mandibular ramus (from the posterior condyle point to the gonion point) increases significantly with the acromegalic patient and the cranial base angle (basion-superior tuberculum sellae-M point) is more extended. As acromegalic patients are more subject to sleep apnea (30% prevailing), the relationship between the amount of sleep apnea and hypopnea (AHI) in an acromegalic patient and his bone, tissue and hormone factors has been researched, in order to act on the causes of sleep apnea. It has emerged that confr...

Medical and non‐medical correlates of carpal tunnel syndrome in a Taiwan cohort of one million

European Journal of Neurology — Tue, 31 May 2011 23:00:00 +0100

Conclusions: Identification of the CTS correlates in younger group would be of greater value in timely detection and treatment for these diseases. Correcting these disorders may aid in removing possible causes of CTS. This is the first report on the effect of aging on probable CTS risk factors. How factors associated with aging contribute to the development of CTS remains to be determined. (Source: European Journal of Neurology)

Cotreatment with Pegvisomant and a Somatostatin Analog (SA) in SA-Responsive Acromegalic Patients.

The Journal of Clinical Endocrinology and Metabolism — Tue, 31 May 2011 23:00:00 +0100

Conclusion: Acromegalic patients well controlled on SA monotherapy can maintain safe IGF-I levels during 24 wk of cotreatment with low-dose pegvisomant and a 50% reduced SA dose. This treatment modality, however, does not seem to provide significant benefits for the patients. PMID: 21632808 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Electrophysiological Assessment of the Autonomic Nervous System in Male Patients with Acromegaly

European Neurology — Tue, 31 May 2011 14:12:20 +0100

Eur Neurol 2011;66:1–5 (DOI:10.1159/000328025) (Source: European Neurology)

[Good improvement of intubation conditions in a patient with acromegaly.]

Annales Francaises d'Anesthesie et de Reanimation — Sun, 29 May 2011 23:00:00 +0100

Authors: Frappart M, Hamidi A, Gomis P, Malinovsky JM PMID: 21632202 [PubMed - as supplied by publisher] (Source: Annales Francaises d'Anesthesie et de Reanimation)

Congenital pseudoarthrosis of the tibia with localised gigantism in a case of congenital constriction band syndrome

Indian Journal of Plastic Surgery — Fri, 20 May 2011 23:00:00 +0100

Mandar V Agashe, Chasanal M Rathod, Jaideep A DhameleIndian Journal of Plastic Surgery 2011 44(1):139-141 (Source: Indian Journal of Plastic Surgery)

Rosiglitazone as an option for patients with acromegaly: a case series

BioMed Central — Fri, 20 May 2011 23:00:00 +0100

We present the clinical and laboratory responses to six months of treatment with rosiglitazone in four cases. In all four cases, the patients had persistent growth hormone overproduction despite previous surgical treatment and other conventional therapy. Case 1 is a 57-year-old Caucasian woman, case 2 is a 51-year-old Hispanic man, case 3 is a 32-year-old Hispanic woman, and case 4 is a 36-year-old Hispanic man. In three of these patients, basal and nadir growth hormone and insulin-like growth factor 1 levels were significantly decreased (P (Source: BioMed Central)

Clinical, quality of life, and economic value of acromegaly disease control

Pituitary — Thu, 19 May 2011 16:34:54 +0100

Abstract Although acromegaly is a rare disease, the clinical, economic and health-related quality of life (HRQoL) burden is considerable due to the broad spectrum of comorbidities as well as the need for lifelong management. We performed a comprehensive literature review of the past 12 years (1998–2010) to determine the benefit of disease control (defined as a growth hormone [GH] concentration <2.5 μg/l and insulin-like growth factor [IGF]-1 normal for age) on clinical, HRQoL, and economic outcomes. Increased GH and IGF-1 levels and low frequency of somatostatin analogue use directly predicted increased mortality risk. Clinical outcome measures that may improve with disease control include joint articular cartilage thickness, vertebral fractures, left ventri...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Influence of diabetes mellitus on vertebral fractures in men with acromegaly

Endocrine — Wed, 18 May 2011 21:24:26 +0100

In conclusion, this study suggests that diabetes mellitus may be associated with an increased prevalence of vertebral fractures in males with acromegaly. However, this effect seems to be relatively attenuated in the presence of persistent GH hypersecretion. Content Type Journal ArticlePages 1-7DOI 10.1007/s12020-011-9486-xAuthors Gherardo Mazziotti, Department of Medical and Surgical Sciences University of Brescia, Endocrine Service, Montichiari Hospital, Brescia, ItalyMonica Gola, Department of Medical and Surgical Sciences University of Brescia, Endocrine Service, Montichiari Hospital, Brescia, ItalyAntonio Bianchi, Department of Endocrinology, Pituitary Unit, Catholic University of Rome, 00168 Rome, ItalyTeresa Porcelli, Department of Medical and Surgical Sciences University of...

Six‐month preoperative octreotide treatment in unselected, de novo patients with acromegaly: effect on biochemistry, tumour volume, and postoperative cure

Clinical Endocrinology — Mon, 16 May 2011 03:15:28 +0100

Conclusion Six months of long‐acting octreotide using a fixed dose, 1/3 of the patients came in biochemical remission, while 2/3 had significant tumour reduction. Moreover, an acute effect of octreotide seemed to be a prerequisite for long‐term effect. (Source: Clinical Endocrinology)

Recommendations of Neuroendocrinology Department from Brazilian Society of Endocrinology and Metabolism for diagnosis and treatment of acromegaly in Brazil

Arquivos Brasileiros de Endocrinologia e Metabologia — Sat, 14 May 2011 19:17:02 +0100

A acromegalia é uma doença associada à elevada morbidade e à redução da expectativa de vida. Em virtude do seu caráter insidioso e do seu não reconhecimento, o diagnóstico é frequentemente realizado com atraso, o que, associado às complicações relacionadas ao excesso do GH/IGF-I, determina elevada morbimortalidade. No entanto, um diagnóstico precoce e um tratamento efetivo minimizam a morbidade e normalizam a taxa de mortalidade. Nesta publicação, o objetivo do Departamento de Neuroendocrinologia da Sociedade Brasileira de Endocrinologia e Metabologia é divulgar quando suspeitar clinicamente da acromegalia e como diagnosticá-la. Além disso, discute-se a maneira mais eficaz e segura de realizar o tratamento da acromegalia, enfatizando que este deve ser realizado em centro...

Computer Outperforms Doctors in Identifying Rare Hormone Disorder

ICMCC: The International Council on Medical and Care Compunetics — Tue, 10 May 2011 16:13:47 +0100

Source: iHealthBeat Content: “A computer program that analyzes facial characteristics outperformed physicians in identifying signs of acromegaly, a rare hormone disorder, according to a study published in the Journal of Clinical Endocrinology and Metabolism, Reuters reports. For the study, researchers took front and side facial photographs of 57 people with acromegaly and 60 people without the [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

New Funding for Clinical Endocrine Audit available from the Clinical Endocrinology Trust

Society for Endocrinology — Tue, 10 May 2011 12:00:00 +0100

The Clinical Endocrinology Trust (CET), a charity which derives its income from a profit-share of the Society’s official clinical journal, Clinical Endocrinology) has long supported Endocrine Audit projects within the UK. Recent examples include the UK Acromegaly Database, the CaHASE audit of adults with CAH, and the multicentre study on cabergoline and cardiac valvulopathy. The CET-funded British Thyroid Association study of iodine status of teenage girls across the UK, funded with the BTA, was presented at the 2011 Society for Endocrinology BES conference in Birmingham and received wide publicity through the BBC and other news media. The Trustees now invite further Clinical Endocrine Audit applications from Societies or Endocrine Centres. Preference will be given to projects inv...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Computer beats doctors in finding hormone disorder (Reuters, 6 May 2011)

Society for Endocrinology — Mon, 09 May 2011 12:00:00 +0100

Researchers from Germany have developed a computer programme that outperforms humans at identifying patients with acromegaly using images of their faces. Full article (Source: Society for Endocrinology)

Micronucleus evaluation in mitogen-stimulated lymphocytes of patients with acromegaly

Metabolism - Clinical and Experimental — Mon, 09 May 2011 04:00:00 +0100

This study aims to evaluate the spontaneous micronucleus (MN) frequency by using the cytokinesis-block MN assay to determine genetic damage in the lymphocytes of patients with acromegaly. The study was carried out in 20 patients who had active acromegaly and in 20 age- and sex-matched healthy controls. The MN values were measured in binucleated cells obtained from mitogen-stimulated lymphocytes of patients and control subjects. The distribution of binucleated cells with 1, 2, 3, or more MNs was also measured. We found significantly higher MN frequency values in the lymphocytes of acromegalic patients than in those of the control subjects (2.23 ± 0.68 vs 1.03 ± 0.54, P = .001). The MN frequency increased with increasing IGF-1 levels of acromegalic patients (P = .036, R = 0.47). We observe...

Pharmacodynamic Modeling of the Effects of Lanreotide Autogel on Growth Hormone and Insulin-Like Growth Factor 1.

The Journal of Clinical Pharmacology — Thu, 05 May 2011 23:00:00 +0100

The objective of the study was to develop a population pharmacodynamic model describing the relationship between serum concentrations of lanreotide (C(P)) and its GH and IGF-1 effects in patients with acromegaly receiving lanreotide Autogel (LA) at doses of 60, 90, or 120 mg by deep subcutaneous route every 28 days. Data were analyzed from 104 patients. The GH and IGF-1 profiles were fit simultaneously using the population approach with NONMEM. The GH vs C(P) and the IGF-1 vs GH relationships were described using inhibitory I(max) and E(max) models, respectively. Results indicated that lanreotide cannot abolish GH completely. C(P) levels of 3.4 ng/mL are required to achieve percentages of hormonal control (GH and IGF-1) of 21% and 36% in not treated and previously treated patients. If the ...

Biochemical diagnosis and assessment of disease activity in acromegaly: a two-decade experience

Pituitary — Wed, 04 May 2011 14:51:45 +0100

The objective of this study is to assess the secretory pattern of GH after Oral Glucose Tolerance Test (OGTT) or day-curve (DC), in relation with IGF-I and to evaluate the influence of therapy on OGTT. A retrospective analysis in 279 OGTTs performed in 93 acromegalic patients in our unit from January 1988 to December 2005, in 77 patients also DC data were retrived. GH concentration was evaluated by 3 different systems (RIA, IRMA and chemiluminescence assays), and IGF-I by two RIAs. About 12% of OGTT samples were discordant with the baseline, while discordance between nadir and 120th minute was much lower (5%), with all discordant values, except one, near the cut-off lines. Correlation between DC and OGTT data was around 0.99 among all values, discordance rate between nadir and minimu...

Adrenal insufficiency uncommon after transsphenoidal surgery for acromegaly

Modern Medicine — Tue, 03 May 2011 23:00:00 +0100

NEW YORK (Reuters Health) - Long-term rates of adrenal insufficiency are low after transsphenoidal surgery for growth hormone-secreting pituitary adenomas, researchers from the Netherlands report in the April 6th online issue of The Journal of Clinical Endocrinology & Metabolism. (Source: Modern Medicine)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Increased Prevalence of Gallbladder Polyps in Acromegaly.

The Journal of Clinical Endocrinology and Metabolism — Tue, 03 May 2011 23:00:00 +0100

Conclusions: This is the first study to demonstrate an increased prevalence of GBP in patients with newly diagnosed acromegaly. Further studies are required to determine whether these patients are at increased risk of developing gallbladder carcinoma and to define the role, if any, of biliary ultrasound surveillance. PMID: 21543430 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

Effects of Long-acting Release Octreotide on Glucose Homeostasis in Acromegaly Patients after Trans-Sphenoidal Surgery

Hormone and Metabolic Research — Sun, 01 May 2011 23:00:00 +0100

Horm Metab ResDOI: 10.1055/s-0031-1275703AbstractThe present study was aimed to investigate glucose homeostasis and insulin secretion in acromegalic patients during octreotide-long acting release (LAR) therapy and designed as an observational prospective study. 18 acromegalic patients who had undergone trans-sphenoidal surgery with active disease were included. All patients were treated with octreotide-LAR injection for 1 year. These patients received oral glucose tolerance test (OGTT) before, 21 days after, and 1 year after octreotide-LAR treatment. Primary outcomes were changes in glucose levels and insulin secretion during an OGTT. We also determined the differences between subjects with normalized and uncontrolled IGF-1 levels. Of the 18 patients treated with octreotide-LAR for 1 year,...

[Role of somatostatin receptor ligands in the treatment of acromegaly - review of literature.]

Orvosi Hetilap — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Nemes O, Mezősi E Acromegaly is a rare disease with typical clinical manifestations. Untreated acromegaly carries a 2-4-fold increase in mortality in long-term outcome. The goal of treatment is double, including biochemical control of the disease (normalization of serum IGF1 levels compared to age and gender matched controls, GH levels below 1 ng/ml after oral glucose load, or random GH below 2.5 ng/ml) and control of the tumor mass. The therapeutic modalities currently available for the treatment of acromegaly are: surgery, medical therapy, radiation therapy and their combinations. The cornerstones of medical therapy in acromegaly are the somatostatin receptor ligands due to their effectiveness in controlling GH excess in 60-70 % of patients and their beneficial effects on t...

[Growth hormone receptor antagonist in the treatment of acromegaly.]

Orvosi Hetilap — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Hubina E, Tóth A, Kovács GL, Dénes J, Kovács L, Góth M Exploration of construction, function and interaction of human growth hormone and growth hormone receptor in details resulted in the innovation of the new growth hormone receptor antagonist, pegvisomant. Pegvisomant with different mechanism of action extended the tools of medical management of acromegaly. Importance of the novel treatment modality is high. In one hand the necessity of the strict control of growth hormone/insulin-like growth factor-I axis has been proven regarding the mortality of the disease. On the other hand, despite the use of all current modes of treatment (surgery, radiotherapy, dopamine agonists, somatostatin analogs), a significant cohort of patients with acromegaly remains inadequately control...

[Consensus on the change of criteria for cure of acromegaly during the last decade.]

Orvosi Hetilap — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Kovács GL, Dénes J, Hubina E, Kovács L, Czirják S, Góth M The Acromegaly Consensus Group redefined the consensus criteria for cure of acromegaly. 74 neurosurgeons and experienced endocrinologists summarized the latest results on diagnosis and treatment of acromegaly. In this consensus statement the reliable growth hormone and insulin-like growth factor-1 assays were established. Definition of disease control was discussed based on the available publications and evidence. This short communication summarizes the clinical aspects of consensus criteria for diagnosis and cure of acromegaly based on the original article. Orv. Hetil., 2011, 152, 703-708. PMID: 21498158 [PubMed - as supplied by publisher] (Source: Orvosi Hetilap)

MedWorm Sponsor Message: Find the best January Sales in the UK.

[The importance of early diagnosis of acromegaly.]

Orvosi Hetilap — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Valkusz Z, Tóth M, Boda J, Nagy E, Julesz J The authors review the historical and epidemiological aspects, clinical features and complications of acromegaly while emphasizing the importance of the early diagnosis and treatment. Acromegaly is a rare and mostly sporadic disorder due to excessive production of growth hormone. It is characterized by progressive somatic disfigurement (mainly involving the face and extremities) and systemic manifestations. The prevalence is estimated between 40 and 125 cases/million. Generally, it is diagnosed in middle-aged adults (mean age 40 years, men and women equally affected). Due to its insidious onset and slow progression, acromegaly is often diagnosed 7 to more than 10 years after its onset. The disease has cardiovascular, rheumatological...

The glucose‐dependent insulinotropic polypeptide receptor (GIPR) is overexpressed amongst GNAS1 mutation‐negative somatotropinomas and drives GH‐promoter activity in GH3 cells

Journal of Neuroendocrinology — Sat, 30 Apr 2011 23:00:00 +0100

AbstractSomatic mutations in the GNAS1 gene –encoding the α‐subunit of the heterotrimeric stimulatory G protein (Gαs)– occur in about 40% of GH‐secreting pituitary tumours. By altering the adenylate cyclase‐cAMP‐PKA pathway, they unequivocally give somatotroph cells a growth advantage. Hence, the pathogenesis of somatotropinomas could be linked to anomalies in receptors coupled to the cAMP second‐messenger cascade. Among them, the glucose‐dependent insulinotropic polypeptide receptor (GIPR) is already known to play a primary role in the impaired cAMP‐dependent cortisol secretion in patients affected by food‐dependent Cushing’s syndrome.In this work, 43 somatotropinomas and 12 normal pituitary glands were investigated for GIPR expression by quantitative RT‐PCR, wes...

Fibrous dysplasia & McCune-Albright syndrome: An experience from a tertiary care centre in north India.

Indian J Med Res — Sat, 30 Apr 2011 23:00:00 +0100

We describe the clinical profile and therapeutic outcome of 25 patients with FD observed over a period of 14 yr in a tertiary care centre from north India. Methods : In this retrospective study patients (n = 25) with diagnosis of fibrous dysplasia based on either classical radiological features and/or histological evidence on bone biopsy, were analyzed. Associated endocrinopathies if any, were evaluated. The diagnosis of McCune Albright syndrome (MAS) was considered when fibrous dysplasia was accompanied by either cafι-au-lait macules and/or endocrinopathies. The clinical presentation, biochemical parameters and imaging were analysed. Seven patients received bisphosphonate therapy. The final outcome and side effects were noted. Results : Age of the patients ranged from 7 to 48 yr (mean ±...

A Novel Approach to the Detection of Acromegaly: Accuracy of Diagnosis by Automatic Face Classification.

The Journal of Clinical Endocrinology and Metabolism — Tue, 19 Apr 2011 23:00:00 +0100

Conclusions: Acromegaly can be detected by computer software using photographs of the face. Classification accuracy by software is higher than by medical experts or general internists, particularly in patients with mild features of acromegaly. This is a promising tool to help detecting acromegaly. PMID: 21508144 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

Body Fluid Expansion in Acromegaly Is Related to Enhanced Epithelial Sodium Channel (ENaC) Activity.

The Journal of Clinical Endocrinology and Metabolism — Tue, 19 Apr 2011 23:00:00 +0100

Conclusion: GH/IGF-I excess in humans is associated with enhanced renal and extrarenal ENaC activity that may contribute to soft-tissue swelling and volume expansion in acromegaly. PMID: 21508131 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Polycythemia as rare secondary direct manifestation of acromegaly: management and single-centre epidemiological data

Pituitary — Tue, 19 Apr 2011 07:15:56 +0100

In conclusions, polycythemia can be a direct, albeit rare, secondary manifestation of acromegaly, that must be considered during the diagnostic work-up of acromegalic patients presenting with such disorder. Content Type Journal ArticlePages 1-6DOI 10.1007/s11102-011-0311-6Authors Gabriele Zoppoli, Department of Internal Medicine, University of Genoa, Genoa, ItalyFederico Bianchi, Department of Endocrine and Medical Sciences and Center of Excellence for Biomedical Research, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, ItalyAndrea Bruzzone, Department of Internal Medicine, University of Genoa, Genoa, ItalyAlessandro Calvia, Department of Internal Medicine, University of Genoa, Genoa, ItalyCaterina Oneto, Department of Internal Medicine, University of Genoa, Genoa, ItalyCa...

Combination treatment with somatostatin analogues and pegvisomant in acromegaly.

Growth Hormone and IGF Research — Thu, 14 Apr 2011 23:00:00 +0100

Authors: Neggers SJ, van der Lely AJ Mono-therapy using long-acting somatostatin analogues and surgery cannot provide optimal biochemical control in a large proportion of patients with acromegaly. This results in increased mortality, poor control of signs and symptoms of disease and decreased quality of life. Combined treatment with somatostatin analogues and pegvisomant (a growth-hormone-receptor antagonist) seems to be an attractive option. Combination treatment is highly effective at normalising the level of insulin-like growth factor 1 in over 90% of patients and has a favourable effect on quality of life in those with biochemically controlled acromegaly. Moreover, combination therapy with somatostatin analogues results in a clinically relevant decrease in tumour size in about 20% ...

Clinically silent somatotroph adenomas are common.

European Journal of Endocrinology — Wed, 13 Apr 2011 23:00:00 +0100

Conclusions: Clinically silent somatotroph adenomas are more common than previously appreciated, representing one third of all somatotroph adenomas. IGF-1 should be measured in all patients with a sellar mass, since identification of a mass as a somatotroph adenoma expands the therapeutic options and provides a tumor marker to monitor treatment. PMID: 21493729 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Acromegaly Caused by Ectopic Growth Hormone-Releasing Hormone Production from a Bronchial Carcinoid Tumor

The Thoracic and Cardiovascular Surgeon — Thu, 07 Apr 2011 23:00:00 +0100

We report a case of acromegaly due to ectopic production of GHRH from a bronchial carcinoid in a 42-year-old female. The carcinoid tumor was successfully treated with bilobectomy.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: The Thoracic and Cardiovascular Surgeon)

Excess mortality for patients with residual disease following resection of pituitary adenomas

Pituitary — Thu, 07 Apr 2011 17:08:14 +0100

Abstract The importance of achieving tumor control in pituitary adenoma surgery is not entirely established. This manuscript reviews the literature linking residual pituitary tumor and hormonal hypersecretion to increases in long term mortality. When possible, we utilized meta-analysis methods to estimate a pooled standardized mortality ratio (SMR), which relates the risk of mortality for a cohort of patients compared to a similar age and gender matched cohort in the general population, for patients with endocrinologic evidence of residual disease. When this was not possible, we review the existing literature in the results and discussion section of this review. We identified 10 articles regarding acromegaly and three articles regarding Cushing’s disease which presented ...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Clinical and metabolic characteristics of acromegalic patients with high IGF-I/normal GH levels during somatostatin analog treatment.

European Journal of Endocrinology — Tue, 05 Apr 2011 23:00:00 +0100

Conclusion: 41% of treated acromegalic patients had a high IGF-I and normal GH level. In these divergent patients treated with somatostatin analogs these clinical and metabolic parameters might either play a causal role or be a marker of disease activity. PMID: 21471168 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Low Incidence of Adrenal Insufficiency after Transsphenoidal Surgery in Patients with Acromegaly: A Long-Term Follow-Up Study.

The Journal of Clinical Endocrinology and Metabolism — Tue, 05 Apr 2011 23:00:00 +0100

Conclusion: The prevalence of adrenal insufficiency 1 yr after surgery was 9%, whereas during prolonged follow-up, the incidence rate of adrenal insufficiency was only 2/1000 person-years in patients in remission after surgery. Therefore, development of late-onset adrenal insufficiency is a very infrequent complication in patients with acromegaly in remission after transsphenoidal surgery only. PMID: 21470989 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

Diabetes in acromegaly, prevalence, risk factors and evolution; data from the French acromegaly register.

European Journal of Endocrinology — Sun, 03 Apr 2011 23:00:00 +0100

Conclusions: In our population, the prevalence of diabetes was estimated to be 22.3%. Growth hormone and IGF-1 levels did not appear as predictive factors for the presence of diabetes. In contrast, age, BMI and hypertension were significant risk factors as in the general population of type 2 diabetics. PMID: 21464140 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

Hormonal control of pituitary adenomas by transsphenoidal surgery: results of the first five years of experience

Arquivos Brasileiros de Endocrinologia e Metabologia — Fri, 01 Apr 2011 18:00:45 +0100

CONCLUSION: Our results, although restricted to the beginning of our experience, lie below the reported range of other surgical series with much longer experience. During these years, there was a significant improvement in initial post surgery urinary cortisol levels in Cushing's disease as a function of surgical experience. (Source: Arquivos Brasileiros de Endocrinologia e Metabologia)

Acromegaly caused by ectopic growth hormone-releasing hormone production from a bronchial carcinoid tumor.

The Thoracic and Cardiovascular Surgeon — Thu, 31 Mar 2011 23:00:00 +0100

We report a case of acromegaly due to ectopic production of GHRH from a bronchial carcinoid in a 42-year-old female. The carcinoid tumor was successfully treated with bilobectomy. PMID: 21480145 [PubMed - in process] (Source: The Thoracic and Cardiovascular Surgeon)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Systemic and maxillofacial characteristics of patients with Beckwith-Wiedemann syndrome not treated with glossectomy

American Journal of Orthodontics and Dentofacial Orthopedics — Thu, 31 Mar 2011 15:59:40 +0100

Conclusions: As intrinsic characteristics of BWS, individuals exhibited macroglossia resulting in an anterior open bite and a wide dental arch. A long facial height and an enlarged anterior cranial base and mandibular body were also noted. (Source: American Journal of Orthodontics and Dentofacial Orthopedics)

Colonic neoplasia in acromegaly: increased proliferation or deceased apoptosis?

Pituitary — Wed, 30 Mar 2011 23:52:14 +0100

Abstract Patients with acromegaly have higher prevalence of colorectal neoplasms. The pathogenetic mechanism is still unclear and may be related to sustained increase in serum GH-IGF1. We aimed to evaluate the proliferative and apoptotic markers in samples of colonic mucosa obtained during screening colonoscopic biopsy from patients with acromegaly and study their relationship to serum IGF-1 and GH levels. The study subjects included 32 patients with acromegaly (4 female), 10 healthy controls (irritable bowel syndrome) and 10 positive controls (non-acromegalic colonic adenocarcinoma). Patients with acromegaly were divided into two groups, active disease (AD) and disease in remission (AR). Two biopsies each were obtained during colonoscopy from the right colon, transverse c...

Musculoskeletal complications of acromegaly: what radiologists should know about early manifestations

La Radiologia Medica — Sat, 19 Mar 2011 16:55:01 +0100

Abstract The purpose of this article is to summarise the early musculoskeletal complications of acromegaly. Some of the early signs of acromegaly may be evaluated by the musculoskeletal radiologist. In the early stage of disease, peripheral nerve enlargement associated with carpal tunnel syndrome or cubital tunnel syndrome and thickening of retinacula, such as A1 pulley in trigger finger, represent the features that may be seen by radiologists and are worthy of an endocrinological evaluation. Due to the insidious nature of the disease, the diagnosis of acromegaly is significantly delayed. Few and nonspecific symptoms characterise the initial phases of the disease, and therefore, most patients will have generally consulted many specialists (most frequently musculoskeletal r...

Growth hormone and physical performance.

Trends in Endocrinology and Metabolism: TEM — Thu, 17 Mar 2011 00:00:00 +0100

Authors: Birzniece V, Nelson AE, Ho KK There has been limited research and evidence that GH enhances physical performance in healthy adults or in trained athletes. Even so, human growth hormone (GH) is widely abused by athletes. In healthy adults, GH increases lean body mass, although it is possible that fluid retention contributes to this effect. The most recent data indicate that GH does not enhance muscle strength, power, or aerobic exercise capacity, but improves anaerobic exercise capacity. In fact, there are adverse effects of long-term GH excess such that sustained abuse of GH can lead to a state mimicking acromegaly, a condition with increased morbidity and mortality. This review will examine GH effects on body composition and physical performance in health and disease. PMI...