Acromegaly
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  • ||||||||||  Clinical, Journal:  Sleep disturbance and delirium in patients with acromegaly in the early postoperative period after transsphenoidal pituitary surgery. (Pubmed Central) -  Nov 26, 2020   
    The incidence of postoperative delirium was comparable between the 2 groups (6/969 [0.6%] vs 0/317 [0%]; P = .346).Patients with acromegaly showed increased incidence of sleep disturbance than those with nonfunctioning tumors in the early postoperative period after transsphenoidal tumor surgery. A prospective study evaluating sleep quality in patients with GH-secreting tumors in the early postoperative period could be conducted based on our findings.
  • ||||||||||  Clinical, Journal:  Semen quality in hypogonadal acromegalic patients. (Pubmed Central) -  Nov 25, 2020   
    By contrast non-acromegalic pituitary patients had reduced sperm motility. Our data do not support reduced semen quality in acromegaly.
  • ||||||||||  Review, Journal:  Acromegaly and ultrasound: how, when and why? (Pubmed Central) -  Nov 22, 2020   
    Acromegaly patients frequently present systemic complications and a diagnostic delay. US features of acromegaly are not specific, but could potentially have a key role in early detection of the disease in the presence of typical clinical features.
  • ||||||||||  Clinical, Journal:  Whole Sella vs Targeted Stereotactic Radiosurgery for Acromegaly: A Multicenter Matched Cohort Study. (Pubmed Central) -  Nov 21, 2020   
    Although not statistically significant, the higher rates of tumor regression and lower rates of mortality and new visual deficit may suggest consideration of targeted SRS over whole-sella SRS in acromegaly treatment. Further research is needed to determine the association between visual deficits and mortality with whole-sella SRS.
  • ||||||||||  Journal:  Digenic Variants in the FGF21 Signaling Pathway Associated with Severe Insulin Resistance and Pseudoacromegaly. (Pubmed Central) -  Nov 21, 2020   
    Analysis of the function of the FGFR1 and KLB variants in vitro showed greatly attenuated ERK phosphorylation in response to FGF21, but not FGF2, suggesting that these variants act synergistically to inhibit endocrine FGF21 signaling but not canonical FGF2 signaling. Therefore, digenic variants in FGFR1 and KLB provide a potential explanation for the subject's severe insulin resistance and may represent a novel category of insulin resistance syndromes related to FGF21.
  • ||||||||||  bromocriptine / Generic mfg.
    Clinical, Journal:  Missed diagnosis and delayed treatment of acromegaly in a patient with severe diabetes: A case report. (Pubmed Central) -  Nov 19, 2020   
    The case highlights the importance of hyperglycemia and abnormal manifestations of the feet in patients with acromegaly. In addition, these findings highlight the need for a thorough examination of the feet in diabetic patients, and the critical importance of the early diagnosis of acromegaly for preventing the consequences of inappropriate patient care.
  • ||||||||||  Somavert (pegvisomant) / Pfizer
    Clinical, Journal:  Drug treatment strategies for secondary diabetes in patients with acromegaly. (Pubmed Central) -  Nov 18, 2020   
    Glucose imbalance is an important aspect of acromegaly comorbidity and deserves more attention. Even though numerous studies have investigated glucose homeostasis in acromegaly, there is still a clear need for more basic, translational, and also clinical research to advance the understanding of the underlying mechanisms and how to best address them.
  • ||||||||||  Clinical, Journal:  Evaluation of Dental Health in Terminally Ill Patients. (Pubmed Central) -  Nov 18, 2020   
    Out of 120 admitted terminally ill patients, 27 subjects had respiratory diseases, 17 had gastrointestinal disorders, 5 had disorders of the circulatory system, 39 had liver disorders, and 32 had endocrine disorders. A need for added comprehension is mandatory to link the inter-relationships between dentistry and medicine to further perk up the management of the overall health of patients, which will further reinforce the partnership between dental and medical communities.
  • ||||||||||  Clinical, Journal:  Differentiated thyroid carcinoma in sporadic and familial presentations of acromegaly: a case series. (Pubmed Central) -  Nov 14, 2020   
    Dermoscopy can be a useful tool to distinguish acanthosis nigricans from other pigmentary disorders in patients who are not willing for histopathological examination and helps in treatment making decisions. In our cohort of sporadic and familial forms of acromegaly with DTC, AIP did not appear to influence thyroid cancer progression.
  • ||||||||||  dexamethasone / Generic mfg.
    Journal:  Cushings syndrome and acromegaly based on picoadenoma of the pituitary gland. (Pubmed Central) -  Nov 12, 2020   
    A 2 mg dexamethasone blockade was performed without adequate cortisol suppression in serum and urine up to 8 mg blockade resulted in suppression of 24 hour urine free cortisol. A magnetic resonance imaging (MR) scan revealed suspect pikoadenoma of the pituitary gland (size 2mm)...Later 3 years after first surgery another trans-sphenoidal resection of residue was performed. Histological and immunohistochemical examinations did not confirm adenoma with ACTH and RH secretion. After second surgery, IGF-1 plasma levels were not normalized with persistence of hypercortisolism. The treatment with Lanreotide at the initial dose as well as Ketoconazole was reinitiated (with increased dose of Ketoconazole to 1-1-1 tbl per 200mg).
  • ||||||||||  Journal:  Heart failure as a manifestation of acromegaly. (Pubmed Central) -  Nov 12, 2020   
    An early diagnosis of acromegaly significantly influences both morbidity and mortality of patients suffering from this disease. We describe a 39-year-old patient with undiagnosed acromegaly presented with acute heart failure caused by acromegalic cardiomyopathy.
  • ||||||||||  [VIRTUAL] Intramucosal adenocarcinoma on foveolar-type adenoma in proximal oesophagus: a rare case report () -  Nov 9, 2020 - Abstract #ECP2020ECP_4507;    
    The most common diagnostic challenge with foveolar-type adenomas have a well-formed apical mucin cap, label inmunohitochemically with MUC5AC, and are negative for MUC6, in contrast to pyloryc glands adenomas. Inmunohistochemical profile revealed positive MUCA5 and focal MUC6.Althought most of them are asymptomatic, as our patient, they can cause dysphagia or hearburn; even a rare association with adenocarcinomas has been described Conclusion We think the patient has a inlet patch which proliferated and degenerated into an adenoma and adenocarcinoma, a extremely infrequent sequence for this frequent disorders.
  • ||||||||||  [VIRTUAL] Intramucosal adenocarcinoma on foveolar-type adenoma in proximal oesophagus: a rare case report () -  Nov 9, 2020 - Abstract #ECP2020ECP_2813;    
    The most common diagnostic challenge with foveolar-type adenomas have a well-formed apical mucin cap, label inmunohitochemically with MUC5AC, and are negative for MUC6, in contrast to pyloryc glands adenomas. Inmunohistochemical profile revealed positive MUCA5 and focal MUC6.Althought most of them are asymptomatic, as our patient, they can cause dysphagia or hearburn; even a rare association with adenocarcinomas has been described Conclusion We think the patient has a inlet patch which proliferated and degenerated into an adenoma and adenocarcinoma, a extremely infrequent sequence for this frequent disorders.
  • ||||||||||  [VIRTUAL] Intramucosal adenocarcinoma on foveolar-type adenoma in proximal oesophagus: a rare case report () -  Nov 9, 2020 - Abstract #ECP2020ECP_1139;    
    The most common diagnostic challenge with foveolar-type adenomas have a well-formed apical mucin cap, label inmunohitochemically with MUC5AC, and are negative for MUC6, in contrast to pyloryc glands adenomas. Inmunohistochemical profile revealed positive MUCA5 and focal MUC6.Althought most of them are asymptomatic, as our patient, they can cause dysphagia or hearburn; even a rare association with adenocarcinomas has been described Conclusion We think the patient has a inlet patch which proliferated and degenerated into an adenoma and adenocarcinoma, a extremely infrequent sequence for this frequent disorders.
  • ||||||||||  Journal:  Carotid Artery Injury during Transsphenoidal Pituitary Surgery: Lessons from a 15-Year Modern Microsurgery Cohort. (Pubmed Central) -  Nov 3, 2020   
    Adjuncts to prevent this complication include careful review of the coronal magnetic resonance imaging, identification of the midline, as needed use of the Doppler, and initial caudal opening of the sellar dura. Although potentially disastrous, good neurologic outcomes may be obtained, with immediate judicious packing followed by immediate digital subtraction angiography to assess vessel patency and secondary complications such as pseudoaneurysm.