The Chiasmal Compression Index: An Integrative Assessment Tool for Visual Disturbances in Patients with Pituitary Macroadenomas

2020 ◽  
Vol 143 ◽  
pp. e44-e50
Author(s):  
Elad Avraham ◽  
Amit Azriel ◽  
Israel Melamed ◽  
Farouq Alguayn ◽  
Abed Al Gawad Siag ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Compression Index ◽  
Chiasmal Compression ◽  
Integrative Assessment ◽  
Visual Disturbances ◽  
Pituitary Macroadenomas

Increased frequency of cataract surgery in patients over age 50 with pituitary macroadenomas and chiasmal compression

Pituitary ◽  
2019 ◽  
Vol 22 (4) ◽  
pp. 405-410
Author(s):  
Mina M. Gerges ◽  
Mohamed M. Arnaout ◽  
Abad Cherif El Asri ◽  
Matthew D. Cummock ◽  
Ahmed Roshdy ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Chiasmal Compression ◽  
Pituitary Macroadenomas

scholarly journals The prevalence rate of hypopituitarism in patients with pituitary macroadenomas with various hormonal activities

2021 ◽  
Vol 49 ◽  
Author(s):  
Yu. G. Krivosheeva ◽  
I. A. Ilovayskaya
Keyword(s):  
Risk Factors ◽  
Relative Risk ◽  
Prevalence Rate ◽  
Pituitary Tumor ◽  
Pituitary Tumors ◽  
Epidemiological Studies ◽  
Newly Diagnosed ◽  
Chiasmal Compression ◽  
Secondary Hypothyroidism ◽  
Pituitary Macroadenomas

Rationale: According to the recent epidemiological studies, prevalence of pituitary tumors amounts to 1 per 865 to 2688 adults. The prevalence rates of hypopituitarism in pituitary macroadenomas are highly variable and comprise 37% to 85% among newly diagnosed non-functioning pituitary adenomas (NFPA). There is virtually no data on the prevalence of hypopituitarism in the cohort of newly diagnosed macroadenomas secreting prolactin and somatotropic hormone.Aim: To assess the prevalence of hypopituitarism in patients with pituitary macroadenomas with various hormonal activities and to identify its potential risk factors.Materials and methods: We analyzed data from 293 patients with pituitary macroadenomas with various hormonal activities: NFPA (n = 121), prolactinomas (n = 59), and somatotropinomas (n = 113). The patients had been examined before any treatment was commenced.Results: The prevalence rate of hypopituitarism was 59/121 (39.9%) among the patients with NFPA, 18/59 (27.3%) among those with prolactinomas, and 19/113 (14%) among those with somatotropinomas (р < 0.001). The symptoms of chiasmal compression and chiasmal syndrome were significantly more prevalent in the patients with hypopituitarism, than in those without it in all subgroups. The relative risk of hypopituitarism in the patients with chiasmal compression was 2.10 for NFPA (95% confidence interval (CI) 1.50–2.95, р = 0.003), 1.667 for prolactinomas (95% CI 1.29–2.18, р = 0.005), and 1.45 for somatotropinomas (95% CI 1.56–2.48, р = 0.001). The relative risk of hypopituitarism in the patients with chiasmal syndrome was 1.66 for NFPA (95% CI 1.26–2.18, р = 0.009), 2.08 for prolactinomas (95% CI 1.60– 2.69, р = 0.001), and 1.97 for somatotropinomas (95% CI 1.56–2.48, р = 0.005). The NFPA subgroup had the highest rate of hypothyroidism (36/59, 61.0%), whereas the prolactinoma subgroup had the highest rate of secondary hypogonadism (34/59, 57.6%); however, hypogonadism is one of the manifestations of persistent pathological hyperprolactinemia typical for prolactinomas. In the somatotropinoma subgroup, secondary hypothyroidism was found in 11/19 (57.9%) of the patients.Conclusion: Identification of hypopituitarism before any treatment depended on the type of hormonal activity of a pituitary tumor and was most frequent in NFPA. The risk factors for hypopituitarism were chiasmal compression, chiasmal syndrome, vertical diameter of the pituitary tumor, and its volume. Secondary adrenal insufficiency, being the most hazardous component of hypopituitarism, manifested most rarely.

scholarly journals Effects of task constraints on training workload in elite women’s soccer

2019 ◽  
Vol 15 (1) ◽  
pp. 99-107 ◽  
Author(s):  
Sergio J Ibáñez ◽  
Emilio Pérez-Goye ◽  
Javier García-Rubio ◽  
Javier Courel-Ibáñez
Keyword(s):  
Heart Rate ◽  
Assessment Tool ◽  
Study Data ◽  
Training Load ◽  
Assessment Tools ◽  
Integrative Approach ◽  
Observational Assessment ◽  
Task Constraints ◽  
Integrative Assessment ◽  
Women's Soccer

The purposes of this study were to identify which major constraints contribute to greater task workload and to determine distinctive training task profiles using an integrative approach during a regular season from a professional women’s soccer team. Twenty-seven elite soccer players from a team competing in the first Spanish women’s soccer league participated in this study. Data were obtained from 46 training sessions (112 training tasks) along five competitive months. Workload measures were collected using the SIATE integrative assessment tool and heart rate monitors during the team’s regular training routine. Results from cluster analysis effectively classified four types of training activities that caused a distinct physiological response from players. The most relevant constraints that increased the task workload were, in order of influence: interaction possibilities, opposition degree, simultaneous participation, game space, competitive workload and intensity. In turn, internal training load monitoring by heart rate seems to be worthless during technical-tactical soccer drills. These results provide coaches an easy, affordable and more informative tool to quantify the training workload. Whereas this information requires observational assessment tools to be obtained, these methods should be considered as a complement to wearables devices for training load control and monitoring in field sports.

scholarly journals Outcome of Pituitary Hormone Deficits After Surgical Treatment of Non-functioning Pituitary Macroadenomas (NFPMA)

2021 ◽  
Author(s):  
Orsalia Alexopoulou ◽  
Valérie Everard ◽  
Martine Etoa ◽  
Edward Fomekong ◽  
Stéphane Gaillard ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Primary Treatment ◽  
Endocrine Function ◽  
Pituitary Hormone ◽  
Tumor Diameter ◽  
Sustained Improvement ◽  
One Year ◽  
Postoperative Improvement ◽  
Visual Disturbances ◽  
Pituitary Macroadenomas

Abstract Objectives: Non-functionning pituitary macroadenomas (NFPMA) are benin tumors that cause symptoms of mass effects including hypopituitarism. Their primary treatment is trans-sphenoidal surgery. We aimed to determine the outcome of pituitary hormone deficits after surgical treatment of NFPMA and to identify factors predicting hormonal recovery.Design: We retrospectively included 246 patients with NFPMA diagnosed and operated in one of the two participating centers. All hormonal axes were evaluated except growth hormone (GH). Postoperative improvement of pituitary endocrine function was considered if at least one hormonal deficit had recovered and a lower total number of deficits was observed one year after surgery.Results: 80% (n=197) of patients had one or more pituitary deficits and 28% had complete anterior hypopituitarism. Besides GH, the gonadotropic and thyrotropic axes were the most commonly affected (68% and 62%, respectively). The number of hypopituitary patients dropped significantly to 61% at one year (p<0.001) and a significant improvement was observed for all hormonal axes, except central diabetes insipidus. Among patients with preoperative hypopituitarism, 88/175 (50%) showed improved pituitary function at one year. Both hyperprolactinemia at diagnosis and a lower tumor diameter independently predicted favourable endocrine outcome.Conclusions: Hypopituitarism is present in 80% of patients with NFPMA and nearly half of them will benefit from sustained improvement after surgery. Hyperprolactinae-mia at diagnosis and lower tumor dimensions are associated with favourable endocrine prognosis. This supports the option of early surgery in NFPMA patients with pituitary deficits independent of the presence of visual disturbances.

scholarly journals PITUITARY MACROADENOMAS

2010 ◽  
Vol 17 (04) ◽  
pp. 623-627
Author(s):  
KHALID FAROOQ ◽  
TAYYABA GUL MALIK ◽  
ANJUM RASHID
Keyword(s):  
Motor Nerve ◽  
Visual Disturbance ◽  
Visual Field Defects ◽  
Sphenoidal Sinus ◽  
Optic Chiasma ◽  
Female Ratio ◽  
Cavernous Sinus Invasion ◽  
Tumour Extension ◽  
Visual Disturbances ◽  
Pituitary Macroadenomas

Objectives: To describe the demographic profile, patterns of visual disturbance and imaging studies of patients with Macroadenoma. Design: Retrospectively. Reviewed the clinical charts and neuroradiologic imaging of 125 patients who were diagnosed as cases of Macroadenoma. Duration: 2000 to 2009. Subjects and Methods: 100 patients were selected who had visual disturbances along with Macroadenomas. Age, sex, visual symptoms and other associated systemic problems of these patients were reviewed. The Neuroimaging data (Magnetic Resonance Imaging) was correlated with the clinical picture. The data was analysed using Statistical package for social sciences (SPSS). The Descriptive Statistics were calculated for age and MR findings. Results: The age ranged from 9 to 85 years (mean 42.92). Male to female ratio was 1.4: 1. 90% patients had visual disturbances including visual field defects and 10% had ocular motor nerve palsies. Tumour extension on MR studies showed optic chiasma compression in 69% patients, cavernous sinus invasion in 57% and Sphenoidal sinus invasion in 14%. Haemorrhagic foci were seen in 8% and intra tumour necrosis was found in 9% patients. Conclusions: The most common path for the extension of pituitary macroadenomas is towards the optic chiasma. Hence majority of these patients present with visual disturbances. MRI is an excellent aid to see the extent and invasion of Macroadenomas to the surrounding structures.

Age Norms for Auditory-Perceptual Neurophonetic Parameters: A Prerequisite for the Assessment of Childhood Dysarthria

2020 ◽  
Vol 63 (4) ◽  
pp. 1071-1082
Author(s):  
Theresa Schölderle ◽  
Elisabet Haas ◽  
Wolfram Ziegler
Keyword(s):  
Assessment Tool ◽  
Developmental Trajectories ◽  
Voice Quality ◽  
Typically Developing ◽  
Typically Developing Children ◽  
Age Norms ◽  
Elementary School Age ◽  
Speech Characteristics ◽  
Substantial Progress ◽  
Computer Based

Purpose The aim of this study was to collect auditory-perceptual data on established symptom categories of dysarthria from typically developing children between 3 and 9 years of age, for the purpose of creating age norms for dysarthria assessment. Method One hundred forty-four typically developing children (3;0–9;11 [years;months], 72 girls and 72 boys) participated. We used a computer-based game specifically designed for this study to elicit sentence repetitions and spontaneous speech samples. Speech recordings were analyzed using the auditory-perceptual criteria of the Bogenhausen Dysarthria Scales, a standardized German assessment tool for dysarthria in adults. The Bogenhausen Dysarthria Scales (scales and features) cover clinically relevant dimensions of speech and allow for an evaluation of well-established symptom categories of dysarthria. Results The typically developing children exhibited a number of speech characteristics overlapping with established symptom categories of dysarthria (e.g., breathy voice, frequent inspirations, reduced articulatory precision, decreased articulation rate). Substantial progress was observed between 3 and 9 years of age, but with different developmental trajectories across different dimensions. In several areas (e.g., respiration, voice quality), 9-year-olds still presented with salient developmental speech characteristics, while in other dimensions (e.g., prosodic modulation), features typically associated with dysarthria occurred only exceptionally, even in the 3-year-olds. Conclusions The acquisition of speech motor functions is a prolonged process not yet completed with 9 years. Various developmental influences (e.g., anatomic–physiological changes) shape children's speech specifically. Our findings are a first step toward establishing auditory-perceptual norms for dysarthria in children of kindergarten and elementary school age. Supplemental Material https://doi.org/10.23641/asha.12133380

Exploring the Validity and Operational Impact of Using Allied Health Assistants to Conduct Dysphagia Screening for Low-Risk Patients Within the Acute Hospital Setting

2020 ◽  
Vol 29 (4) ◽  
pp. 1944-1955 ◽  
Author(s):  
Maria Schwarz ◽  
Elizabeth C. Ward ◽  
Petrea Cornwell ◽  
Anne Coccetti ◽  
Pamela D'Netto ◽  
...  
Keyword(s):  
At Risk ◽  
Allied Health ◽  
Assessment Tool ◽  
Hospital Setting ◽  
Low Risk ◽  
False Negatives ◽  
Exact Agreement ◽  
Risk Patients ◽  
Impact Phase ◽  
Operational Impact

Purpose The purpose of this study was to examine (a) the agreement between allied health assistants (AHAs) and speech-language pathologists (SLPs) when completing dysphagia screening for low-risk referrals and at-risk patients under a delegation model and (b) the operational impact of this delegation model. Method All AHAs worked in the adult acute inpatient settings across three hospitals and completed training and competency evaluation prior to conducting independent screening. Screening (pass/fail) was based on results from pre-screening exclusionary questions in combination with a water swallow test and the Eating Assessment Tool. To examine the agreement of AHAs' decision making with SLPs, AHAs ( n = 7) and SLPs ( n = 8) conducted an independent, simultaneous dysphagia screening on 51 adult inpatients classified as low-risk/at-risk referrals. To examine operational impact, AHAs independently completed screening on 48 low-risk/at-risk patients, with subsequent clinical swallow evaluation conducted by an SLP with patients who failed screening. Results Exact agreement between AHAs and SLPs on overall pass/fail screening criteria for the first 51 patients was 100%. Exact agreement for the two tools was 100% for the Eating Assessment Tool and 96% for the water swallow test. In the operational impact phase ( n = 48), 58% of patients failed AHA screening, with only 10% false positives on subjective SLP assessment and nil identified false negatives. Conclusion AHAs demonstrated the ability to reliably conduct dysphagia screening on a cohort of low-risk patients, with a low rate of false negatives. Data support high level of agreement and positive operational impact of using trained AHAs to perform dysphagia screening in low-risk patients.

Measuring “Language Access Profiles” in Deaf and Hard-of-Hearing Children With the DHH Language Exposure Assessment Tool

2020 ◽  
pp. 1-25
Author(s):  
Matthew L. Hall ◽  
Stephanie De Anda
Keyword(s):  
Cluster Analysis ◽  
Exposure Assessment ◽  
Hard Of Hearing ◽  
Assessment Tool ◽  
Communication Mode ◽  
Developmental Potential ◽  
Language Access ◽  
Retest Reliability ◽  
Language Exposure ◽  
Test Retest Reliability

Purpose The purposes of this study were (a) to introduce “language access profiles” as a viable alternative construct to “communication mode” for describing experience with language input during early childhood for deaf and hard-of-hearing (DHH) children; (b) to describe the development of a new tool for measuring DHH children's language access profiles during infancy and toddlerhood; and (c) to evaluate the novelty, reliability, and validity of this tool. Method We adapted an existing retrospective parent report measure of early language experience (the Language Exposure Assessment Tool) to make it suitable for use with DHH populations. We administered the adapted instrument (DHH Language Exposure Assessment Tool [D-LEAT]) to the caregivers of 105 DHH children aged 12 years and younger. To measure convergent validity, we also administered another novel instrument: the Language Access Profile Tool. To measure test–retest reliability, half of the participants were interviewed again after 1 month. We identified groups of children with similar language access profiles by using hierarchical cluster analysis. Results The D-LEAT revealed DHH children's diverse experiences with access to language during infancy and toddlerhood. Cluster analysis groupings were markedly different from those derived from more traditional grouping rules (e.g., communication modes). Test–retest reliability was good, especially for the same-interviewer condition. Content, convergent, and face validity were strong. Conclusions To optimize DHH children's developmental potential, stakeholders who work at the individual and population levels would benefit from replacing communication mode with language access profiles. The D-LEAT is the first tool that aims to measure this novel construct. Despite limitations that future work aims to address, the present results demonstrate that the D-LEAT represents progress over the status quo.

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