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[PMID]:29505532
[Au] Autor:Li J; Li J; Jiang S; Yu R; Yu Y
[Ad] Endereço:Department of Endocrinology and Metabolism.
[Ti] Título:Case report of a pituitary thyrotropin-secreting macroadenoma with Hashimoto thyroiditis and infertility.
[So] Source:Medicine (Baltimore);97(1):e9546, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Thyrotropin-secreting adenoma (TSHoma) is rare, diagnosis and treatment are often delayed if the condition coexists with Hashimoto thyroiditis. The enlarged pituitary adenoma may eventually induce panhypopituitarism, infertility, or the compression of optic nerves and optic chiasma. PATIENT CONCERNS: This patient was a 36-year-old man who had been referred to the pituitary disease multidisciplinary team (MDT) of the West China Hospital, due to infertility. DIAGNOSES: Examinations revealed pituitary thyrotropin-secreting macroadenoma. INTERVENTIONS: We conducted trans-sphenoidal surgery. Human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) were used for reproductive reconstruction after surgery. OUTCOMES: This patient successfully fathered a child. LESSONS: To date, the multidisciplinary team treatment of TSHoma was rare, TSHomas are often misdiagnosed as macroadenomas, because the clinical features are varied and it often takes a long time to be diagnosed. So the purpose of this case report is to attract attention to the manifestation of increased thyroid stimulating hormone (TSH) concentration and discuss MDT treatment for TSH-secreting adenoma.
[Mh] Termos MeSH primário: Adenoma/complicações
Doença de Hashimoto/complicações
Infertilidade Masculina/etiologia
Neoplasias Hipofisárias/complicações
Tireotropina/secreção
[Mh] Termos MeSH secundário: Adenoma/diagnóstico
Adenoma/secreção
Adenoma/cirurgia
Adulto
Feminino
Seres Humanos
Infertilidade Masculina/terapia
Masculino
Neoplasias Hipofisárias/diagnóstico
Neoplasias Hipofisárias/secreção
Neoplasias Hipofisárias/cirurgia
Gravidez
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
9002-71-5 (Thyrotropin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009546


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[PMID]:29330228
[Au] Autor:McCormack A; Dekkers OM; Petersenn S; Popovic V; Trouillas J; Raverot G; Burman P; ESE survey collaborators
[Ad] Endereço:St Vincent's Hospital and Garvan Institute of Medical ResearchSydney, Australia.
[Ti] Título:Treatment of aggressive pituitary tumours and carcinomas: results of a European Society of Endocrinology (ESE) survey 2016.
[So] Source:Eur J Endocrinol;178(3):265-276, 2018 03.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To collect outcome data in a large cohort of patients with aggressive pituitary tumours (APT)/carcinomas (PC) and specifically report effects of temozolomide (TMZ) treatment. DESIGN: Electronic survey to ESE members Dec 2015-Nov 2016. RESULTS: Reports on 166 patients (40 PC, 125 APT, 1 unclassified) were obtained. Median age at diagnosis was 43 (range 4-79) years. 69% of the tumours were clinically functioning, and the most frequent immunohistochemical subtype were corticotroph tumours (45%). Ki-67 index did not distinguish APT from PC, median 7% and 10% respectively. TMZ was first-line chemotherapy in 157 patients. At the end of the treatment (median 9 cycles), radiological evaluation showed complete response (CR) in 6%, partial response (PR) in 31%, stable disease (SD) in 33% and progressive disease in 30%. Response was more frequent in patients receiving concomitant radiotherapy and TMZ. CR was seen only in patients with low MGMT expression. Clinically functioning tumours were more likely to respond than non-functioning tumours, independent of MGMT status. Of patients with CR, PR and SD, 25, 40 and 48% respectively progressed after a median of 12-month follow-up. Other oncological drugs given as primary treatment and to TMZ failures resulted in PR in 20%. CONCLUSION: This survey confirms that TMZ is established as first-line chemotherapeutic treatment of APT/PC. Clinically functioning tumours, low MGMT and concurrent radiotherapy were associated with a better response. The limited long-term effect of TMZ and the poor efficacy of other drugs highlight the need to identify additional effective therapies.
[Mh] Termos MeSH primário: Adenoma/terapia
Antineoplásicos Alquilantes/uso terapêutico
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Carcinoma/terapia
Irradiação Craniana
Dacarbazina/análogos & derivados
Procedimentos Neurocirúrgicos
Neoplasias Hipofisárias/terapia
[Mh] Termos MeSH secundário: Adenoma/metabolismo
Adenoma/patologia
Adolescente
Adulto
Idoso
Bevacizumab/administração & dosagem
Capecitabina/administração & dosagem
Carcinoma/metabolismo
Carcinoma/patologia
Carmustina/administração & dosagem
Criança
Pré-Escolar
Metilases de Modificação do DNA/metabolismo
Enzimas Reparadoras do DNA/metabolismo
Dacarbazina/administração & dosagem
Dacarbazina/uso terapêutico
Endocrinologia
Europa (Continente)
Feminino
Seres Humanos
Antígeno Ki-67/metabolismo
Masculino
Meia-Idade
Invasividade Neoplásica
Neoplasias Hipofisárias/metabolismo
Neoplasias Hipofisárias/patologia
Sociedades Médicas
Inquéritos e Questionários
Talidomida/administração & dosagem
Proteínas Supressoras de Tumor/metabolismo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Alkylating); 0 (Ki-67 Antigen); 0 (Tumor Suppressor Proteins); 2S9ZZM9Q9V (Bevacizumab); 4Z8R6ORS6L (Thalidomide); 6804DJ8Z9U (Capecitabine); 7GR28W0FJI (Dacarbazine); EC 2.1.1.- (DNA Modification Methylases); EC 2.1.1.63 (MGMT protein, human); EC 6.5.1.- (DNA Repair Enzymes); U68WG3173Y (Carmustine); YF1K15M17Y (temozolomide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180114
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-0933


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[PMID]:29267504
[Au] Autor:Mendes GA; Haag T; Trott G; Rech CGSL; Ferreira NP; Oliveira MC; Kohek MB; Pereira-Lima JFS
[Ad] Endereço:Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
[Ti] Título:Expression of E-cadherin, Slug and NCAM and its relationship to tumor invasiveness in patients with acromegaly.
[So] Source:Braz J Med Biol Res;51(2):e6808, 2017 Dec 11.
[Is] ISSN:1414-431X
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Pituitary adenomas account for 10-15% of primary intracranial tumors. Growth hormone (GH)-secreting adenomas account for 13% of all pituitary adenomas and cause acromegaly. These tumors can be aggressive, invade surrounding structures and are highly recurrent. The objective of this study was to evaluate E-cadherin, Slug and neural cell adhesion molecule (NCAM) expression in GH-secreting pituitary adenomas and its relationship to tumor invasiveness. A cross-sectional study of patients who underwent hypophysectomy due to GH-secreting pituitary adenoma from April 2007 to December 2014 was carried out. The medical records were reviewed to collect clinical data. Immediately after surgery, tumor samples were frozen in liquid nitrogen and stored in a biofreezer at -80°C for assessment of E-cadherin 1 (CDH1), SLUG (SNAI2), and NCAM (NCAM1) by real-time PCR. The samples were fixed in formalin and embedded in paraffin for immunohistochemical analysis of E-cadherin and NCAM. Thirty-five patients with acromegaly were included in the study. Of these, 65.7% had invasive tumors. Immunohistochemically, E-cadherin was expressed in 96.7% of patients, and NCAM in 80% of patients. There was no statistically significant relationship between tumor grade or invasiveness and immunohistochemical expression of these markers. Regarding gene expression, 50% of cases expressed CDH1, none expressed SNAI2, and 53.3% expressed NCAM1. There was no statistically significant relationship between tumor grade or invasiveness and gene expression of CDH1, SNAI2, and NCAM1. The absence of Slug overexpression and of E-cadherin and NCAM suppression suggests that expression of these markers is not associated with tumor invasiveness in GH-secreting pituitary adenomas.
[Mh] Termos MeSH primário: Acromegalia/patologia
Adenoma/patologia
Caderinas/análise
Moléculas de Adesão de Célula Nervosa/análise
Neoplasias Hipofisárias/patologia
Fatores de Transcrição da Família Snail/análise
[Mh] Termos MeSH secundário: Acromegalia/genética
Acromegalia/metabolismo
Adenoma/química
Adenoma/genética
Adolescente
Adulto
Idoso
Biomarcadores Tumorais/análise
Antígeno CD56/análise
Estudos Transversais
Feminino
Expressão Gênica
Seres Humanos
Imuno-Histoquímica
Masculino
Meia-Idade
Gradação de Tumores
Invasividade Neoplásica
Neoplasias Hipofisárias/química
Neoplasias Hipofisárias/genética
Reação em Cadeia da Polimerase em Tempo Real
Estatísticas não Paramétricas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (CD56 Antigen); 0 (Cadherins); 0 (NCAM1 protein, human); 0 (Neural Cell Adhesion Molecules); 0 (SNAI1 protein, human); 0 (Snail Family Transcription Factors)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


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[PMID]:29267283
[Au] Autor:Milewski D; Balli D; Ustiyan V; Le T; Dienemann H; Warth A; Breuhahn K; Whitsett JA; Kalinichenko VV; Kalin TV
[Ad] Endereço:Division of Pulmonary Biology, the Perinatal Institute of Cincinnati Children's Research Foundation, Cincinnati, Ohio, United States of America.
[Ti] Título:FOXM1 activates AGR2 and causes progression of lung adenomas into invasive mucinous adenocarcinomas.
[So] Source:PLoS Genet;13(12):e1007097, 2017 12.
[Is] ISSN:1553-7404
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Lung cancer remains one of the most prominent public health challenges, accounting for the highest incidence and mortality among all human cancers. While pulmonary invasive mucinous adenocarcinoma (PIMA) is one of the most aggressive types of non-small cell lung cancer, transcriptional drivers of PIMA remain poorly understood. In the present study, we found that Forkhead box M1 transcription factor (FOXM1) is highly expressed in human PIMAs and associated with increased extracellular mucin deposition and the loss of NKX2.1. To examine consequences of FOXM1 expression in tumor cells in vivo, we employed an inducible, transgenic mouse model to express an activated FOXM1 transcript in urethane-induced benign lung adenomas. FOXM1 accelerated tumor growth, induced progression from benign adenomas to invasive, metastatic adenocarcinomas, and induced SOX2, a marker of poorly differentiated tumor cells. Adenocarcinomas in FOXM1 transgenic mice expressed increased MUC5B and MUC5AC, and reduced NKX2.1, which are characteristics of mucinous adenocarcinomas. Expression of FOXM1 in KrasG12D transgenic mice increased the mucinous phenotype in KrasG12D-driven lung tumors. Anterior Gradient 2 (AGR2), an oncogene critical for intracellular processing and packaging of mucins, was increased in mouse and human PIMAs and was associated with FOXM1. FOXM1 directly bound to and transcriptionally activated human AGR2 gene promoter via the -257/-247 bp region. Finally, using orthotopic xenografts we demonstrated that inhibition of either FOXM1 or AGR2 in human PIMAs inhibited mucinous characteristics, and reduced tumor growth and invasion. Altogether, FOXM1 is necessary and sufficient to induce mucinous phenotypes in lung tumor cells in vivo.
[Mh] Termos MeSH primário: Adenocarcinoma Mucinoso/patologia
Adenocarcinoma/metabolismo
Adenocarcinoma/patologia
Adenoma/patologia
Proteína Forkhead Box M1/metabolismo
Neoplasias Pulmonares/metabolismo
Neoplasias Pulmonares/patologia
Proteínas/metabolismo
[Mh] Termos MeSH secundário: Células A549
Adenocarcinoma/genética
Adenocarcinoma Mucinoso/genética
Adenocarcinoma Mucinoso/metabolismo
Adenoma/genética
Adenoma/metabolismo
Animais
Carcinoma Pulmonar de Células não Pequenas/genética
Carcinoma Pulmonar de Células não Pequenas/metabolismo
Carcinoma Pulmonar de Células não Pequenas/patologia
Linhagem Celular Tumoral
Progressão da Doença
Proteína Forkhead Box M1/genética
Xenoenxertos
Seres Humanos
Neoplasias Pulmonares/genética
Masculino
Camundongos
Camundongos Endogâmicos NOD
Camundongos Transgênicos
Regiões Promotoras Genéticas
Proteínas/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (FOXM1 protein, human); 0 (Forkhead Box Protein M1); 0 (Proteins); EC 5.3.4.1 (AGR2 protein, human)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pgen.1007097


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[PMID]:28450657
[Au] Autor:Hendarto H; Pramono LA; Harbuwono DS; Yunir E; Subekti I
[Ad] Endereço:Department of Internal Medicine, Faculty of Medicine and Health Science, Syarif Hidayatullah Islamic State University (UIN), Jakarta, Indonesia. hari.hendarto@uinjkt.ac.id.
[Ti] Título:Parathyroid Adenoma in a Young Female Presenting Multiple Fractures and Postoperative Hungry Bone Syndrome.
[So] Source:Acta Med Indones;49(1):69-73, 2017 Jan.
[Is] ISSN:0125-9326
[Cp] País de publicação:Indonesia
[La] Idioma:eng
[Ab] Resumo:A young 18-year-old female patient with general bone pain and history of multiple fractures brought her to our medical attention. Laboratory work showed hypercalcemia and high parathyroid hormone levels in the blood. Radiograph imaging revealed severe scoliosis with multiple vertebrae fractures with decreased bone mineral density. Sestamibi showed parathyroid adenoma. This case emphasizes the importance of maintaining a primary hyperparathyroidism as a differential diagnosis when a young patient presents with a multiple pathologic fractures history.
[Mh] Termos MeSH primário: Adenoma/diagnóstico por imagem
Hormônio Paratireóideo/sangue
Neoplasias das Paratireoides/diagnóstico por imagem
Escoliose/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adenoma/cirurgia
Adolescente
Densidade Óssea
Cálcio/sangue
Diagnóstico Diferencial
Feminino
Fraturas Múltiplas/diagnóstico
Seres Humanos
Hipercalcemia/etiologia
Dor/etiologia
Neoplasias das Paratireoides/cirurgia
Radiografia
Tecnécio Tc 99m Sestamibi
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Parathyroid Hormone); 971Z4W1S09 (Technetium Tc 99m Sestamibi); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29390279
[Au] Autor:Yang J; Liu S; Yang Z; Shi YB
[Ad] Endereço:Department of Endocrinology.
[Ti] Título:Ectopic thyrotropin secreting pituitary adenoma concomitant with papillary thyroid carcinoma: Case report.
[So] Source:Medicine (Baltimore);96(50):e8912, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Ectopic thyrotropin (TSH)-secreting pituitary adenomas are exceedingly rare. To date, there are only 6 cases reported. Here, we describe an even rarer ectopic TSH-secreting pituitary adenoma (TSH-oma) concomitant with papillary thyroid carcinoma. PATIENT CONCERNS: A 27-year-old female was admitted to the hospital in 2002 for neck enlargement and palpitation. Thyroid function test showed increased thyroid hormones and unrepressed TSH. Thyroid ultrasound examination displayed diffuse goiter. The patient was presumptively diagnosed as primary hyperthyroidism and treated with anti-thyroid drugs. Her condition was then improved, but the serum TSH was persistently unrepressed. Therefore, central hyperthyroidism due to TSH-oma or pituitary resistance to thyroid hormone (PRTH) was suspected. Pituitary magnetic resonance imaging (MRI) examination was deservedly performed to rule out TSH-oma, which turned out to be normal. In addition, T3 suppression test was negative. Thus, PRTH, as an uncommon cause of inappropriate TSH secretion, was regarded as the working diagnosis. Triiodothyroacetic acid, which was reported to be effective for PRTH, was then administrated. But it did not work well. To control the symptoms completely and normalize the level of thyroid hormones, radioiodine therapy was carried out in 2007, followed by levothyroxine replacement therapy. Consequently, the symptoms were relieved, whereas serum TSH remained at high levels even with adequate levothyroxine. Unexpected, thyroid papillary carcinoma and a neoplasm in her nasopharynx were successively detected in 2012, which were then removed by surgery. Somewhat interestingly, the serum TSH declined to normal after the operation. DIAGNOSES: The patient was ultimately diagnosed as an ectopic TSH-secreting pituitary adenoma concomitant with papillary thyroid carcinoma. INTERVENTIONS: Thyroidectomy and removal of the ectopic TSH-secreting pituitary adenoma by surgery were carried out, followed by levothyroxine replacement therapy. OUTCOME: Three years after the surgery, the patient felt well with levothyroxine 125ug daily. Serum thyroid hormones and TSH kept in normal and no signs of neoplasm recurrence. LESSONS: Although extremely rare, ectopic TSH-secreting pituitary adenoma, as an uncommon cause of thyrotoxicosis, should be taken into consideration among those who have a longstanding hyperthyroidism with unsuppressed TSH.
[Mh] Termos MeSH primário: Adenoma/diagnóstico
Carcinoma Papilar/diagnóstico
Neoplasias Hipofisárias/diagnóstico
Neoplasias da Glândula Tireoide/diagnóstico
Tireotropina/secreção
[Mh] Termos MeSH secundário: Adenoma/metabolismo
Adenoma/cirurgia
Adulto
Carcinoma Papilar/cirurgia
Diagnóstico Diferencial
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Neoplasias Hipofisárias/metabolismo
Neoplasias Hipofisárias/cirurgia
Doenças Raras
Testes de Função Tireóidea
Neoplasias da Glândula Tireoide/cirurgia
Tireoidectomia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
9002-71-5 (Thyrotropin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008912


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[PMID]:28450390
[Au] Autor:East JE; Atkin WS; Bateman AC; Clark SK; Dolwani S; Ket SN; Leedham SJ; Phull PS; Rutter MD; Shepherd NA; Tomlinson I; Rees CJ
[Ad] Endereço:Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK.
[Ti] Título:British Society of Gastroenterology position statement on serrated polyps in the colon and rectum.
[So] Source:Gut;66(7):1181-1196, 2017 07.
[Is] ISSN:1468-3288
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Serrated polyps have been recognised in the last decade as important premalignant lesions accounting for between 15% and 30% of colorectal cancers. There is therefore a clinical need for guidance on how to manage these lesions; however, the evidence base is limited. A working group was commission by the British Society of Gastroenterology (BSG) Endoscopy section to review the available evidence and develop a position statement to provide clinical guidance until the evidence becomes available to support a formal guideline. The scope of the position statement was wide-ranging and included: evidence that serrated lesions have premalignant potential; detection and resection of serrated lesions; surveillance strategies after detection of serrated lesions; special situations-serrated polyposis syndrome (including surgery) and serrated lesions in colitis; education, audit and benchmarks and research questions. Statements on these issues were proposed where the evidence was deemed sufficient, and re-evaluated modified via a Delphi process until >80% agreement was reached. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool was used to assess the strength of evidence and strength of recommendation for finalised statements. : we suggest that until further evidence on the efficacy or otherwise of surveillance are published, patients with sessile serrated lesions (SSLs) that appear associated with a higher risk of future neoplasia or colorectal cancer (SSLs ≥10 mm or serrated lesions harbouring dysplasia including traditional serrated adenomas) should be offered a one-off colonoscopic surveillance examination at 3 years ( ).
[Mh] Termos MeSH primário: Pólipos do Colo/diagnóstico
Pólipos do Colo/cirurgia
Pólipos/diagnóstico
Pólipos/cirurgia
Doenças Retais/diagnóstico
Doenças Retais/cirurgia
[Mh] Termos MeSH secundário: Adenoma/diagnóstico
Adenoma/genética
Adenoma/cirurgia
Polipose Adenomatosa do Colo/diagnóstico
Benchmarking
Biomarcadores/análise
Transformação Celular Neoplásica
Colite/complicações
Pólipos do Colo/genética
Colonoscopia
Ilhas de CpG/genética
DNA/isolamento & purificação
Metilação de DNA
Fezes/química
Seres Humanos
Parassimpatolíticos/uso terapêutico
Pólipos/genética
Lesões Pré-Cancerosas/diagnóstico
Lesões Pré-Cancerosas/cirurgia
Doenças Retais/genética
Terminologia como Assunto
Conduta Expectante
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers); 0 (Parasympatholytics); 9007-49-2 (DNA)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1136/gutjnl-2017-314005


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[PMID]:28461279
[Au] Autor:Yao A; Balchandani P; Shrivastava RK
[Ad] Endereço:Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York, USA.
[Ti] Título:Metabolic In Vivo Visualization of Pituitary Adenomas: a Systematic Review of Imaging Modalities.
[So] Source:World Neurosurg;104:489-498, 2017 Aug.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Pituitary adenomas (PAs) are the most common intrasellar mass. Functional PAs constitute most of pituitary tumors and can produce symptoms related to hormonal overproduction. Timely and accurate detection is therefore of vital importance to prevent potentially irreversible sequelae. Magnetic resonance imaging is the gold standard for detecting PAs, but is limited by poor sensitivity for microadenomas and an inability to differentiate scar tissue from tumor residual or predict treatment response. Several new modalities that detect PAs have been proposed. METHODS: A systematic review of the PubMed database was performed for imaging studies of PAs since its inception. Data concerning study characteristics, clinical symptoms, imaging modalities, and diagnostic accuracy were collected. RESULTS: After applying exclusion criteria, 25 studies of imaging PAs using positron emission tomography (PET), magnetic resonance spectroscopy (MRS), and single photon emission computed tomography were reviewed. PET reliably detects PAs, particularly where magnetic resonance imaging is equivocal, although its efficacy is limited by high cost and low availability. Single photon emission computed tomography possesses good sensitivity for neuroendocrine tumors but its use with PAs is poorly documented. MRS consistently detects cellular proliferation and hormonal activity, but warrants further study at higher magnetic field strength. CONCLUSIONS: PET and MRS appear to have the strongest predictive value in detecting PAs. MRS has the advantage of low cost, but the literature is lacking in specific studies of the pituitary. Due to high recurrence rates of functional PAs and low sensitivity of existing diagnostic workups, further investigation of metabolic imaging is necessary.
[Mh] Termos MeSH primário: Adenoma/diagnóstico por imagem
Adenoma/metabolismo
Hormônios Ectópicos/metabolismo
Neuroimagem/métodos
Hormônios Hipofisários/metabolismo
Neoplasias Hipofisárias/diagnóstico por imagem
Neoplasias Hipofisárias/metabolismo
[Mh] Termos MeSH secundário: Adenoma/cirurgia
Seres Humanos
Imagem Tridimensional
Imagem por Ressonância Magnética
Espectroscopia de Ressonância Magnética
Neoplasias Hipofisárias/cirurgia
Tomografia por Emissão de Pósitrons
Sensibilidade e Especificidade
Tomografia Computadorizada de Emissão de Fóton Único
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Hormones, Ectopic); 0 (Pituitary Hormones)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:29339530
[Au] Autor:Kasuki L; Wildemberg LE; Gadelha MR
[Ad] Endereço:Neuroendocrinology Research Center/Endocrine Section and Medical SchoolHospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
[Ti] Título:MANAGEMENT OF ENDOCRINE DISEASE: Personalized medicine in the treatment of acromegaly.
[So] Source:Eur J Endocrinol;178(3):R89-R100, 2018 Mar.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Acromegaly is associated with high morbidity and elevated mortality when not adequately treated. Surgery is the first-line treatment for most patients as it is the only one that can lead to immediate cure. In patients who are not cured by surgery, treatment is currently based on a trial-and-error approach. First-generation somatostatin receptor ligands (fg-SRL) are initiated for most patients, although approximately 25% of patients present resistance to this drug class. Some biomarkers of treatment outcome are described in the literature, with the aim of categorizing patients into different groups to individualize their treatments using a personalized approach. In this review, we will discuss the current status of precision medicine for the treatment of acromegaly and future perspectives on the use of personalized medicine for this purpose.
[Mh] Termos MeSH primário: Acromegalia/tratamento farmacológico
Adenoma/tratamento farmacológico
Agonistas de Dopamina/uso terapêutico
Adenoma Hipofisário Secretor de Hormônio do Crescimento/tratamento farmacológico
Medicina de Precisão
Receptores da Somatotropina/antagonistas & inibidores
Somatostatina/análogos & derivados
[Mh] Termos MeSH secundário: Seres Humanos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Dopamine Agonists); 0 (Receptors, Somatotropin); 51110-01-1 (Somatostatin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-1006


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[PMID]:29330227
[Au] Autor:Ironside N; Chatain G; Asuzu D; Benzo S; Lodish M; Sharma S; Nieman L; Stratakis CA; Lonser RR; Chittiboina P
[Ad] Endereço:Surgical Neurology BranchNational Institute of Neurological Diseases and Stroke, Bethesda, Maryland, USA.
[Ti] Título:Earlier post-operative hypocortisolemia may predict durable remission from Cushing's disease.
[So] Source:Eur J Endocrinol;178(3):255-263, 2018 Mar.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:CONTEXT: Achievement of hypocortisolemia following transsphenoidal surgery (TSS) for Cushing's disease (CD) is associated with successful adenoma resection. However, up to one-third of these patients recur. OBJECTIVE: We assessed whether delay in reaching post-operative cortisol nadir may delineate patients at risk of recurrence for CD following TSS. METHODS: A retrospective review of 257 patients who received 291 TSS procedures for CD at NIH, between 2003 and 2016. Early biochemical remission (serum cortisol nadir <5 µg/dL) was confirmed with endocrinological and clinical follow-up. Recurrence was detected by laboratory testing, clinical stigmata or medication dependence during a median follow-up of 11 months. RESULTS: Of the 268 unique admissions, remission was recorded in 241 instances. Recurrence was observed in 9% of these cases with cortisol nadir ≤5 µg/dL and 6% of cases with cortisol nadir ≤2 µg/dL. The timing of hypocortisolemia was critical in detecting late recurrences. Morning POD-1 cortisol <3.3 µg/dL was 100% sensitive in predicting durable remission and morning POD-3 cortisol ≥18.5 µg/dL was 98.6% specific in predicting remote recurrence. AUROC analysis revealed that hypocortisolemia ≤5 µg/dL before 15 h (post-operative) had 95% sensitivity and an NPV of 0.98 for durable remission. Serum cortisol level ≤2 µg/dL, when achieved before 21 h, improved sensitivity to 100%. CONCLUSIONS: In our cohort, early, profound hypocortisolemia could be used as a clinical prediction tool for durable remission. Achievement of hypocortisolemia ≤2 µg/dL before 21 post-operative hours appeared to accurately predict durable remission in the intermediate term.
[Mh] Termos MeSH primário: Adenoma Hipofisário Secretor de ACT/cirurgia
Adenoma/cirurgia
Hidrocortisona/sangue
Recidiva Local de Neoplasia/epidemiologia
Procedimentos Neurocirúrgicos
Hipersecreção Hipofisária de ACTH/cirurgia
[Mh] Termos MeSH secundário: Área Sob a Curva
Seres Humanos
Estimativa de Kaplan-Meier
Modelos Logísticos
Recidiva Local de Neoplasia/sangue
Período Pós-Operatório
Curva ROC
Indução de Remissão
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180114
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-0873



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