scholarly journals Long term effect of external pituitary irradiation on IGF1 levels in patients with acromegaly free of adjunctive treatment

2009 ◽  
Vol 161 (4) ◽  
pp. 547-551 ◽  
Author(s):  
K Mullan ◽  
C Sanabria ◽  
W P Abram ◽  
E M McConnell ◽  
H C Courtney ◽  
...  
Keyword(s):  
Medical Records ◽  
Term Effect ◽  
Adjunctive Treatment ◽  
Reference Ranges ◽  
Age Related ◽  
Long Term Effect ◽  
Number Of Patients ◽  
Pituitary Irradiation ◽  
Serum Gh

ObjectiveIt is established that external pituitary irradiation (EPI) effectively reduces serum GH levels in acromegaly. However, its effect in normalising serum IGF1 has been disputed. We looked at the number of our patients who achieved persistently normal IGF1 levels whilst free of adjunctive treatment for at least 1 year after EPI.Patients and designWe identified 63 acromegalic patients between 1964 and 2004 who received EPI. Six were excluded: three had surgery after EPI, two had no medical records available, and one had a pituitary Yttrium implant.MeasurementsPatients received 4500–5000 cGy in fractionated doses. IGF1 levels were correlated with their respective age-related reference ranges.ResultsAfter EPI, the number of patients with normal IGF1 and free of adjunctive medical treatment for at least 1 year were four patients by 3 years, nine patients by 5 years and seventeen by 10 years, with the current number of 25/57 (44%). Concordance between IGF1 levels and random GH dropped from 90% at the time of EPI to 65% at 3 years, 66% at 5 years and 71% at 10 years.ConclusionsWe have demonstrated that, with time, EPI achieves a normal IGF1 in significant numbers of patients with acromegaly, thus obviating the need for life-long expensive medical therapy. For each patient this benefit has to be weighed against the possibility of new hypopituitarism as a result of the treatment. Any decision to use EPI is easier in the context of pre-existent hypopituitarism.

Long-term effect of 90Y pituitary implantation in acromegaly

1987 ◽  
Vol 115 (3) ◽  
pp. 301-306 ◽  
Author(s):  
A. Jadresic ◽  
L. E. Jimenez ◽  
G. F. Joplin
Keyword(s):  
Hormone Replacement ◽  
Cumulative Effect ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Pituitary Fossa ◽  
Long Term Effect ◽  
Long Term Trends ◽  
Pituitary Irradiation ◽  
Serum Gh

Abstract. This report examines the long-term trends in GH levels and pituitary function in a group of 38 acromegalic patients who were selected insofar as we were able to follow them up for more than 10 years after a single dose of 90Y interstitial pituitary irradiation as the sole treatment. Mean serum GH had fallen from 106 to 24 mIU/l within 3–6 months and then slowly declined to 4 mIU/l after 10 years. GH levels of ≤ 5 mIU/l during a 50 g oral glucose tolerance test were obtained in 8% of patients at 3–6 months and in 18% at 1 year, the cumulative percentage increasing to 53% at 10, and 76% at 14 years. The percentage of patients requiring hormone replacement therapy rose from nil pre-implant to 16% by 3–6 months, and then slowly increased to 39% by 14 years. Serial coned radiographs of the pituitary fossa were available for 32 patients. By 10 years, 16 showed thickening of the dorsum sellae and/or reduction of at least one diameter by 3 mm. Concerning symptoms, all 29 patients whose GH level fell to ≤ 5 mIU/l showed improvements, 22 becoming asymptomatic. Seven patients with lesser falls in GH levels (from a mean of 193 to a mean of 15 mIU/l) all improved, one becoming asymptomatic. Two showed no variation. These results show that 90Y pituitary implants have a cumulative effect over the years in inducing remission and hypopituitarism in acromegalic patients, the early decline in GH levels being swifter than from other forms of irradiation.

scholarly journals Arrowroot as a treatment for diarrhoea in irritable bowel syndrome patients: a pilot study

2000 ◽  
Vol 37 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Caroline COOKE ◽  
Irene CARR ◽  
Keith ABRAMS ◽  
John MAYBERRY
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Pilot Study ◽  
Term Effect ◽  
Treatment Results ◽  
Long Term Effect ◽  
Number Of Patients ◽  
Bowel Action ◽  
Irritable Bowel

Objectives - Arrowroot is an old-fashioned remedy for diarrhoea, but no clinical studies have been done to evaluate its effectiveness. The aim of this pilot study was to assess its efficacy as a treatment for diarrhoea in 11 patients, all of whom had irritable bowel syndrome with diarrhoea as a feature. Methods - The patients were interviewed and a questionnaire completed on entry into the trial. They then took 10 mL arrowroot powder three times a day for one month and discontinued the treatment for the subsequent month. Questionnaires were completed after one month on treatment and at the end of the trial after one month off treatment. Results - Arrowroot reduced diarrhoea and had a long-term effect on constipation. It also eased abdominal pain. Conclusion - Arrowroot is an effective treatment for diarrhoea. Its action could be explained by several theories which relate to an increase in faecal bulk and thus a more efficient bowel action. The number of patients was small, and further studies are needed to substantiate preliminary results.

Long-term effect of intravitreal ranibizumab therapy on retinal nerve fiber layer in eyes with exudative age-related macular degeneration

2019 ◽  
Vol 257 (7) ◽  
pp. 1459-1466 ◽  
Author(s):  
Alicia Valverde-Megías ◽  
Aurora Ruiz-Calvo ◽  
Antonio Murciano-Cespedosa ◽  
Samuel Hernández-Ruiz ◽  
Jose María Martínez-de-la-Casa ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Nerve Fiber ◽  
Retinal Nerve Fiber Layer ◽  
Term Effect ◽  
Age Related Macular Degeneration ◽  
Intravitreal Ranibizumab ◽  
Fiber Layer ◽  
Age Related ◽  
Long Term Effect

Long-Term Effect of Laser Treatment for Dry Age-Related Macular Degeneration on Choroidal Hemodynamics

2006 ◽  
Vol 141 (5) ◽  
pp. 863-867 ◽  
Author(s):  
Mauricio Figueroa ◽  
Lisa S. Schocket ◽  
Joan DuPont ◽  
Tatyana I. Metelitsina ◽  
Juan E. Grunwald
Keyword(s):  
Macular Degeneration ◽  
Laser Treatment ◽  
Term Effect ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Long Term Effect

scholarly journals Long-Term Effect of Anti-VEGF Agents on Intraocular Pressure in Age-Related Macular Degeneration

2016 ◽  
Vol 56 (1) ◽  
pp. 30-34 ◽  
Author(s):  
João Beato ◽  
Ana Catarina Pedrosa ◽  
João Pinheiro-Costa ◽  
Paulo Freitas-da-Costa ◽  
Manuel S. Falcão ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Macular Degeneration ◽  
Term Effect ◽  
Age Related Macular Degeneration ◽  
Anti Vegf ◽  
Age Related ◽  
Long Term Effect
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