scholarly journals Association of different pathologic subtypes of growth hormone producing pituitary adenoma and remission in acromegaly patients: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maryam Dehghani ◽  
Zahra Davoodi ◽  
Farahnaz Bidari ◽  
Amin Momeni Moghaddam ◽  
Davood Khalili ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Cohort Study ◽  
Cavernous Sinus ◽  
Retrospective Cohort Study ◽  
Pituitary Adenomas ◽  
Retrospective Cohort ◽  
Remission Rate ◽  
Cavernous Sinus Invasion ◽  
Dual Staining

Abstract Background Regarding the inconclusive results of previous investigations, this study aimed to determine the association between pathology, as a possible predictor, with remission outcomes, to know the role of pathology in the personalized decision making in acromegaly patients. Methods A retrospective cohort study was performed on the consecutive surgeries for growth hormone (GH) producing pituitary adenomas from February 2015 to January 2021. Seventy-one patients were assessed for granulation patterns and prolactin co-expression as dual staining adenomas. The role of pathology and some other predictors on surgical remission was evaluated using logistic regression models. Results Among 71 included patients, 34 (47.9%) patients had densely granulated (DG), 14 (19.7%) had sparsely granulated (SG), 23 (32.4%) had dual staining pituitary adenomas. The remission rate was about 62.5% in the patients with SG and DG adenomas named single staining and 52.2% in dual staining groups. Postoperative remission was 1.53-folds higher in the single staining adenomas than dual staining-one (non-significant). The remission rate was doubled in DG group compared to two other groups (non-significant). By adjusting different predictors, cavernous sinus invasion and one-day postoperative GH levels decreased remission rate by 91% (95% CI: 0.01–0.67; p = 0.015) and 64% (95% CI: 0.19–0.69; p < 0.001), respectively. Responses to the medications were not significantly different among three groups. Conclusion Various pathological subtypes of pituitary adenomas do not appear to have a predictive role in estimating remission outcomes. Cavernous sinus invasion followed by one-day postoperative GH is the strongest parameter to predict biochemical remission.

scholarly journals Role of quality measurement in inappropriate use of screening for colorectal cancer: retrospective cohort study

BMJ ◽  
2014 ◽  
Vol 348 (feb26 2) ◽  
pp. g1247-g1247 ◽  
Author(s):  
S. D. Saini ◽  
S. Vijan ◽  
P. Schoenfeld ◽  
A. A. Powell ◽  
S. Moser ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Quality Measurement ◽  
Inappropriate Use

Outcomes after a purely endoscopic transsphenoidal resection of growth hormone–secreting pituitary adenomas

2010 ◽  
Vol 29 (4) ◽  
pp. E5 ◽  
Author(s):  
Peter G. Campbell ◽  
Erin Kenning ◽  
David W. Andrews ◽  
Sanjay Yadla ◽  
Marc Rosen ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenomas ◽  
Remission Rate ◽  
Csf Leak ◽  
Oral Glucose ◽  
Cure Rate ◽  
Cavernous Sinus Invasion ◽  
Remission Criteria ◽  
Biochemical Cure ◽  
Transsphenoidal Resection

Object Using strict biochemical remission criteria, the authors assessed surgical outcomes after endoscopic transsphenoidal resection of growth hormone (GH)–secreting pituitary adenomas and identified preoperative factors that significantly influence the rate of remission. Methods A retrospective review of a prospectively maintained database was performed. The authors reviewed cases in which an endoscopic resection of GH-secreting pituitary adenomas was performed. The cohort consisted of 26 patients who had been followed for 3–60 months (mean 24.5 months). The thresholds of an age-appropriate, normalized insulin-like growth factor–I concentration, a nadir GH level after oral glucose load of less than 1.0 μg/l, and a random GH value of less than 2.5 μg/l were required to establish biochemical cure postoperatively. Results Overall, in 57.7% of patients undergoing a purely endoscopic transsphenoidal pituitary adenectomy for acromegaly, an endocrinological cure was achieved. The mean clinical follow-up duration was 24.5 months. In patients with microadenomas (4 cases) the cure rate was 75%, whereas in patients harboring macroadenomas (22 cases) the cure rate was 54.5%. Cavernous sinus invasion (Knosp Grades 3 and 4) was associated with a significantly lower remission rate (p = 0.0068). Hardy Grade 3 and 4 tumors were also less likely to achieve biochemical cure (p = 0.013). The overall complication rate was 11.5% including 2 incidents of transient diabetes insipidus and 1 postoperative CSF leak, which were treated nonoperatively. Conclusions A purely endoscopic transsphenoidal approach to GH-secreting pituitary adenomas leads to similar outcome for noninvasive macroadenomas compared with traditional microsurgical techniques. Furthermore, this approach may often provide maximal visualization of the tumor, the pituitary gland, and the surrounding neurovascular structures.

scholarly journals Influence of Vitamin D3 Supplementation on Infliximab Effectiveness in Chinese Patients With Crohn's Disease: A Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Sheng-long Xia ◽  
Quan-jia Min ◽  
Xiao-xiao Shao ◽  
Dao-po Lin ◽  
Guo-long Ma ◽  
...  
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Vitamin D3 ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Remission Rate ◽  
Serum Cytokine ◽  
Cytokine Profiles ◽  
Tnf Α

Background: It remains uncertain whether vitamin D3 (vitD3) supplementation is beneficial for remission of Crohn's disease (CD). The influence of vitD3 supplementation on Infliximab (IFX) effectiveness was analyzed in Chinese CD patients.Methods: In this retrospective cohort study, moderate-to-severe CD patients, who were bio-naïve and prescribed with IFX treatment for at least 54 weeks, were recorded from January 2014 to December 2019. VitD3 supplementation was defined as patients additionally took oral vitD3 (125 IU/d) within 3 days after the first infusion and persisted in the whole follow-up period. Disease activity was assessed using Harvey-Bradshaw Index (HBI). Serum cytokine profiles (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) were quantitatively analyzed in a subset of all patients at baseline and 54-week after intervention.Results: Among 73 enrolled patients, 37 took vitD3 regularly (D3-patients), the others (non-D3-patients) did not. At 54-week, the mean 25-hydroxyvitaminD level increased in D3-patients (20.33 vs. 15.07 ng/mL, P &lt; 0.001). The clinical remission rate was higher in D3-patients compared to non-D3-patients (83.8 vs. 61.6%, P = 0.030). The decrease of HBI from baseline to 54-week was more in D3-patients than non-D3-patients (7.41 ± 3.0 vs. 6.28 ± 2.75, P = 0.023). Furthermore, vitD3 supplementation was independently related to the increase of remission rate at 54-week in D3-patients (β = −1.667, P = 0.015). The benefit of vitD3 supplementation was significant only in patients with deficient vitD3 (all P &lt; 0.05), but not in non-deficient vitD3. A total of nine patients (four non-D3-patients and five D3-patients) were selected to determine serum cytokine profiles after 54-week IFX treatment. In non-D3-patients, the decreases of TNF-α and IL-6 at 54-week were more obvious than at baseline (P = 0.032, 0.022, respectively). In D3-patients, however, only IL-10 increased at 54-week compared with its baseline value (P = 0.037).Conclusions: VitD3 supplementation could improve IFX effectiveness in CD patients, especially for patients with vitD3 deficiency. This beneficial effect of vitD3 supplementation probably arose from the up-regulation of IL-10.Trial Registration: NCT04606017.

scholarly journals The role of social determinants on tuberculosis/HIV co-infection mortality in southwest Ethiopia: a retrospective cohort study

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Hailay Gesesew ◽  
Birtukan Tsehaineh ◽  
Desalegn Massa ◽  
Amanuel Tesfay ◽  
Hafte Kahsay ◽  
...  
Keyword(s):  
Cohort Study ◽  
Social Determinants ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Southwest Ethiopia
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