scholarly journals Acromegaly and pregnancy: a prospective study

2014 ◽  
Vol 170 (2) ◽  
pp. 301-310 ◽  
Author(s):  
Monike Dias ◽  
Cesar Boguszewski ◽  
Monica Gadelha ◽  
Leandro Kasuki ◽  
Nina Musolino ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Drug Treatment ◽  
Tumor Growth ◽  
Magnetic Resonance Image ◽  
Exclusion Criterion ◽  
Prospective Data ◽  
Multicentric Study ◽  
Previous Diagnosis ◽  
Active Acromegaly ◽  
A Prospective Study

Context and objectiveThe interaction between pregnancy and acromegaly has been studied only retrospectively. We used prospective data to assess those interactions.DesignProspective, interventional, multicentric study.PatientsTen pregnancies in eight acromegalic patients were included according to the following criteria: previous diagnosis of acromegaly; and active acromegaly before pregnancy. Sellar magnetic resonance image (MRI), GH, and IGF1 measurements were carried out before pregnancy. The exclusion criterion was radiotherapy.InterventionWithdrawal of pharmacological treatment (octreotide and/or cabergoline and/or pegvisomant) following pregnancy diagnosis.Main outcome measuresClinical/biochemical evaluations throughout pregnancy/puerperium and sellar MRI after delivery; and GH and IGF1 measurements before pregnancy. GH was measured by an interference-free IFMA assay during pregnancy and IGF1 by measured by Immulite 2000 assay in patients and 64 control pregnancies.ResultsNo tumor growth was observed. Nine deliveries were at term and one at 35 weeks (preeclampsia). All newborns were healthy. Mean IGF1 levels before and during pregnancy were similar, but increased significantly during puerperium. As IGF1 in controls increased after midgestation, the prevalence of controlled IGF1 rose significantly from 2/10 (<20 weeks) to 9/10 (>30 weeks). Diabetes mellitus and hypertension/preeclampsia developed in one patient in each group; both complications were nonsignificantly (P=0.06) associated with IGF1 >1.3 ULN before pregnancy.ConclusionsAcromegaly control usually improved and tumor growth was not stimulated during pregnancy in spite of withdrawal of drug treatment. Drug treatment can be discontinued in most patients. Uncontrolled disease before pregnancy may pose a higher risk for diabetes and hypertension.

scholarly journals A prospective study of the natural history of incidental meningioma—Hold your horses!

2019 ◽  
Vol 6 (6) ◽  
pp. 438-450
Author(s):  
Maziar Behbahani ◽  
Geir Olve Skeie ◽  
Geir Egil Eide ◽  
Annbjørg Hausken ◽  
Morten Lund-Johansen ◽  
...  
Keyword(s):  
Natural History ◽  
Tumor Growth ◽  
Prospective Study ◽  
Growth Pattern ◽  
Volumetric Analysis ◽  
Prospective Data ◽  
History Of ◽  
Linear Regression Modeling ◽  
A Prospective Study ◽  
Mean Time

Abstract Background The number of incidental meningiomas has increased because of the increased availability of neuroimaging. Lack of prospective data on the natural history makes the optimal management unclear. We conducted a 5-year prospective study of incidental meningiomas to identify risk factors for tumor growth. Methods Sixty-four of 70 consecutive patients with incidental meningioma were included. Clinical and radiological status was obtained at 0, 0.5, 1, 1.5, 2, 3, 4, and 5 years. GammaPlan and mixed linear regression modeling were utilized for volumetric analysis with primary endpoint tumor growth. Results None of the patients developed tumor-related symptoms during the study period, although 48 (75%) tumors increased (&gt;15%), 13 (20.3%) remained unchanged, and 3 (4.7%) decreased (&gt;15%) in volume. Mean time to growth was 2.2 years (range, 0.5-5.0 years). The growth pattern was quasi-exponential in 26%, linear in 17%, sigmoidal in 35%, parabolic in 17%, and continuous reduction in 5%. There was significant correlation among growth rate, larger baseline tumor volume (P &lt; .001), and age in years (&lt;55 y: 0.10 cm3/y, 55-75 y: 0.24 cm3/y, and &gt;75 y: 0.85 cm3/y). Conclusion The majority of meningiomas will eventually grow. However, more than 60% display a self-limiting growth pattern. Our study provides level-2 evidence that asymptomatic tumors can be safely managed utilizing serial imaging until persistent radiological and/or symptomatic growth.

scholarly journals GCT-61. CORRELATION OF PATTERNS OF DISEASE RECURRENCE WITH RADIOTHERAPY TECHNIQUES AND DOSE IN INTRACRANIAL GERM CELL TUMOURS (icGCT): LESSONS FROM THE UK COHORT OF SIOP GCT96 STUDY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii340-iii340
Author(s):  
Thankamma Ajithkumar ◽  
Henry Mandeville ◽  
Fernando Carceller ◽  
Milind Ronghe ◽  
Tina Foord ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Disease Recurrence ◽  
Germ Cell Tumours ◽  
Prospective Data ◽  
Data Collection And Analysis ◽  
Radiotherapy Techniques ◽  
The Uk ◽  
A Prospective Study ◽  
Patterns Of Recurrence

Abstract BACKGROUND There are global variations in radiotherapy approaches for icGCT. An understanding of patterns of disease recurrence correlated with radiation techniques and doses is important in standardising and improving the quality of radiotherapy using high-precision techniques. METHODS AND RESULTS Data from 20 patients with tumour recurrence after treatment within the SIOP GCT96 study in the UK were analysed. Seven (35%) patients had germinoma and 13 (65%) had non-germinoma. Twelve patients had local recurrence, 5 had metastatic and 3 had local and metastatic disease. Radiotherapy details were retrieved in only 8 patients (40%). Six patients had received focal radiotherapy and two craniospinal radiotherapy. Of the patients who received focal radiotherapy, 4 had recurrence within the radiation portal, one had periventricular recurrence and one had marker-positive recurrence with no radiological lesions. Both patients who received CSI recurred within the CSF space. The main reasons for poor retrieval of treatment details were difficulty in retrieving archived information and that the study was conducted during a period before PACS or electronic radiotherapy records. CONCLUSION This study highlights the importance prospective data collection and analysis to understand the patterns of recurrence in icGCT. Even within a prospective study, radiotherapy techniques varied between centres. There is therefore an urgent need for centralised radiological review and prospective radiotherapy quality assurance measures in future clinical trials.

Correction of hemodynamics of the pelvic organs in patients with uterine myoma

1982 ◽  
Vol 63 (2) ◽  
pp. 43-45
Author(s):  
B. G. Tebelev
Keyword(s):  
Drug Treatment ◽  
Tumor Growth ◽  
Vascular Tone ◽  
Clinical Course ◽  
Uterine Myoma ◽  
Pelvic Organs

116 patients with uterine myoma before and 69 after hormonal-drug treatment were examined by the method of rheopelveography. Changes in hemodynamics and vascular tone of the pelvic organs were revealed, depending on the leading symptoms of the disease (pain, tumor growth, hypermenstrual syndrome). Taking into account rheographic indices made it possible to differentially prescribe antispasmodics and oxytotic drugs. Differentiated treatment helped improve the clinical course of the disease and normalize the hemodynamics of the pelvic organs.

scholarly journals Predictors and Protectors of Pathological Menopause

2019 ◽  
pp. 1-8
Author(s):  
Dilrabo T. Kayumova
Keyword(s):  
Diabetes Mellitus ◽  
Higher Education ◽  
Metabolic Syndrome ◽  
Medical Education ◽  
Uterine Fibroids ◽  
Menopausal Syndrome ◽  
The Metabolic Syndrome ◽  
Metabolic Imbalance ◽  
Main Components ◽  
A Prospective Study

A prospective study of 1484 women aged 35-70 years was conducted, which were divided into 3 groups - late reproductive, perimenopausal and postmenopausal. Menopausal syndrome (MS) was detected in 1369 (93.3%) women. Every third woman in peri- and postmenopause had a moderately severe MS. The metabolic imbalance worsened more as the severity of the MS increased, rather than with increasing age. Predictors of pathological menopause are identified - these are the main components of the metabolic syndrome (diabetes mellitus, hypertension, obesity); uterine fibroids, as well as urbanization and higher education. The protective factors for the development of the MS was the absence of the fact of marriage (single), medical education and waist circumference of 80 cm or less.Late reproductive stage

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