scholarly journals Reappraising the Role of Trans-Sphenoidal Surgery in Prolactin-Secreting Pituitary Tumors.

2021 ◽  
Author(s):  
Pier Paolo Mattogno ◽  
Quintino Giorgio D’Alessandris ◽  
Sabrina Chiloiro ◽  
Antonio Bianchi ◽  
Antonella Giampietro ◽  
...  
Keyword(s):  
Pituitary Tumors ◽  
Female Gender ◽  
Clinical History ◽  
Serum Prolactin ◽  
Cure Rate ◽  
Cross Sectional ◽  
Unique Challenge ◽  
Best Management ◽  
Pituitary Diseases

Abstract Backgrounds: Prolactinomas represent a unique challenge for endocrinologists and neurosurgeons. Considering recent innovations in surgical practice, the authors aimed to investigate the best management for prolactinomas.Methods: A retrospective, cross-sectional and monocentric study was designed. Consecutive patients affected for prolactinomas were enrolled if treated with first line treatment with dopamine-agonist (DA) or trans-sphenoidal surgery (TS). Patients carried giant prolactinomas and those with a follow-up < 12 months were excluded. Results: 259 patients were enrolled. The first treatment was DA for 140 patients and TS for 119 cases. 146 of 249 patients (58.6%) needed a second therapy. Mean follow up was 102.2 months (12-438 months). Surgery highly impacted on the cure rate, in particular in females (p=0.0021) and in microprolactinomas (p=0.0020). Considering multivariate analysis, female gender and surgical treatment in the course of clinical history were the only independent positive predictors of cure at the end of 5 years follow-up (p=0.0016, p=0.0005). The evaluation of serum prolactin (24 hours after TS) revealed that 86.4% of patients with post-operative PRL≤10 ng/ml resulted cured at the end of follow-up (p< 0.0001).Conclusion: According to our experience, surgery allows a high cure rate of prolactinomas, particularly in females with microadenoma, with a good safety profile. TS for prolactinomas should be considered as concrete option, during the multidisciplinary evaluation, in centers of reference for pituitary diseases.

scholarly journals Reappraising the Role of Trans-Sphenoidal Surgery in Prolactin-Secreting Pituitary Tumors

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3252
Author(s):  
Pier Paolo Mattogno ◽  
Quintino Giorgio D’Alessandris ◽  
Sabrina Chiloiro ◽  
Antonio Bianchi ◽  
Antonella Giampietro ◽  
...  
Keyword(s):  
Pituitary Tumors ◽  
Female Gender ◽  
Clinical History ◽  
Serum Prolactin ◽  
Cure Rate ◽  
Cross Sectional ◽  
Unique Challenge ◽  
Best Management ◽  
Pituitary Diseases

Background: Prolactinomas represent a unique challenge for endocrinologists and neurosurgeons. Considering recent innovations in surgical practice, the authors aimed to investigate the best management for prolactinomas. Methods: A retrospective, cross-sectional and monocentric study was designed. Consecutive patients affected by prolactinomas were enrolled if treated with a first-line treatment with a dopamine agonist (DA) or trans-sphenoidal surgery (TSS). Patients carried giant prolactinomas, and those with a follow-up <12 months were excluded. Results: Two hundred and fifty-nine patients were enrolled. The first treatment was DA for 140 patients and TS for 119 cases. One hundred and forty-six of 249 patients (58.6%) needed a second therapy. The mean follow-up was 102.2 months (12–438 months). Surgery highly impacted on the cure rate—in particular, in females (p = 0.0021) and in microprolactinomas (p = 0.0020). Considering the multivariate analysis, the female gender and surgical treatment in the course of the clinical history were the only independent positive predictors of a cure at the end of 5 years follow-up (p = 0.0016, p = 0.0005). The evaluation of serum prolactin (24 hours after TSS) revealed that 86.4% of patients with postoperative prolactin (PRL) ≤10 ng/mL were cured at the end of the follow-up (p < 0.0001). Conclusions: According to our experience, surgery allows a high cure rate of prolactinomas, particularly in females with microadenoma, with a good safety profile. TSS for prolactinomas should be considered as a concrete option, during the multidisciplinary evaluation, in centers of reference for pituitary diseases.

scholarly journals Trans-Sphenoidal Surgery in Prolactin Secreting Pituitary Tumors: A Long-Term Referral Center Experience.

2020 ◽  
Author(s):  
Pier Paolo Mattogno ◽  
Quintino Giorgio D’alessandris ◽  
Sabrina Chiloiro ◽  
Antonio Bianchi ◽  
Antonella Giampietro ◽  
...  
Keyword(s):  
Safety Profile ◽  
Pituitary Tumors ◽  
Female Gender ◽  
Clinical History ◽  
Serum Prolactin ◽  
Cure Rate ◽  
First Line ◽  
Cross Sectional ◽  
Unique Challenge

Abstract Backgrounds: Prolactin secreting pituitary tumors (PRL-omas) represent a unique challenge for endocrinologists and neurosurgeons. Considering recent innovations in surgical, we aimed to investigate the best management for PRL-omas. Methods: A retrospective, cross-sectional and monocentric study was designed. Consecutive patients affected for PRL-omas were enrolled if treated with first line treatment with dopamine-agonist (DA) or trans-sphenoidal surgery (TSS). Patients carried giant PRL-omas and those with a follow-up < 12 months were excluded. Results: 259 patients were enrolled. The first treatment was DA for 140 patients and TSS for 119 cases. 146 of 249 patients (58.6%) needed a second therapy. Mean follow up was 102.2 months (12-438 months). Surgery highly impacted on the cure rate, in particular in females (p=0.0021) and in micro- PRL-omas (p=0.0020). Considering multivariate analysis, female gender and surgical treatment in the course of clinical history were the only independent positive predictors of cure at the end of 5 years follow-up (p=0.0016, p=0.0005). The evaluation of serum prolactin (24 hours after TSS) revealed that 86.4% of patients with post-operative PRL≤10 ng/ml resulted cured at the end of follow-up (p< 0.0001). Conclusion: According to our experience, surgery allows a higher cure rate of PRL-omas, in particular in females with micro-PRL-omas, with a good safety profile. TSS for PRL-oma should be considered as first line therapy, in the management of patients, during the multidisciplinary evaluation, in center of reference for pituitary diseases, in order guarantee a valid surgical outcome and a safety profile.

Serum Erythropoietin and Aging: A Longitudinal Analysis.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1628-1628
Author(s):  
William B. Ershler ◽  
Sheng Shan ◽  
Julie McKelvey ◽  
Andrew S. Artz ◽  
Neelima Denduluri ◽  
...  
Keyword(s):  
Hematological Parameters ◽  
Clinical History ◽  
Compensatory Mechanism ◽  
Red Cell ◽  
Diverse Populations ◽  
Cross Sectional ◽  
Baltimore Longitudinal Study ◽  
Serum Erythropoietin ◽  
Over Time

Abstract There are conflicting data regarding expected changes in serum erythropoietin (EPO) with advancing age, primarily because prior reports have been based upon cross-sectional analyses of diverse populations. To examine changes in serum EPO with age, we reviewed the clinical history, hematological parameters and serum EPO levels of 143 participants in the Baltimore Longitudinal Study on Aging (BLSA) who were studied at 1 – 2 year intervals for eight to thirty years. None had anemia at the time of the first visit (by WHO criteria: <12g/dL for women; or <13 g/dL for men) but it developed in 10 (7%) over the period of evaluation. An additional 20 individuals (14%) had a fall in hemoglobin of 1.5 g/dL or more, sustained over at least two visits, and for the purpose of this analysis were also considered anemic. EPO levels rose significantly with age for the group as a whole, and the slope of the rise was found to be greater for those who did not have associated diabetes or hypertension. Subjects who developed anemia but did not have hypertension or diabetes had the greatest slope in EPO rise over time. In contrast, those who had, or developed hypertension or diabetes during the period of follow-up within the BLSA, had significantly higher initial EPO levels and a reduced EPO slope over time. The increase in serum EPO with aging may be compensating for increased RBC turnover or increased EPO resistance of red cell precursors. We suspect that with very advanced age, or in those with compromised renal function (e.g., diabetes or hypertension), the compensatory mechanism becomes inadequate. Figure Figure Figure Figure

scholarly journals Perspectives for Early Genetic Screening of Lactose Intolerance: - 13910C/T Polymorphism Tracking in the MCM6 Gene

2010 ◽  
Vol 3 (1) ◽  
pp. 66-71
Author(s):  
Marta A.S. Arroyo ◽  
Ana Cláudia P. Lopes ◽  
Vania B. Piatto ◽  
José Victor Maniglia
Keyword(s):  
Lactose Intolerance ◽  
Fragment Length Polymorphism ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Specific Primers ◽  
Cross Sectional ◽  
Lactose Tolerance ◽  
Polymerase Chain ◽  
Positive Results

Introduction: For many years Lactose intolerance has been, considered as a universal problem in many children and adults. Objective: The aim is to investigate the prevalence of polymorphism -13910C/T, in a neonatal tracking, for early diagnosis of lactose tolerance/intolerance. Materials and Methods: In a cross-sectional study of 310 Brazilian newborns, DNA was extracted from leukocyte umbilical cord and specific primers were used to amplify the region that encloses the -13910C/T polymorphism of the MCM6 gene, using the polymerase chain reaction and the restriction fragment length polymorphism tests. Results: One hundred and sixty (52%) male newborns and 150 (48%) female new borns were evaluated. Out of these, 191 (62%) presented CC genotype (lactose intolerant), 95 (31%) CT genotype, and 24 (7%) TT genotype, comprising a total of 119 (38%) lactose tolerant newborns. Accordingly the newborns´ gender distribution in relation to the phenotypes has been found; 97 (32%) of male gender and 94 (30%) of female gender lactose intolerant, and 63 (20%) male and 56 (18%) female lactose tolerant newborns, not being such distribution statistically significant (p = 0.801). Conclusions: The molecular analysis made possible the identification of the presence or absence of lactase persistence variant in the Brazilian newborns. The neonatal molecular diagnosis can optimize the follow-up of positive results in newborn screening for lactose intolerance.

scholarly journals Prevalence of depressive symptoms among elderly in the city of Tremembé, Brazil: Preliminary findings of an epidemiological study

2013 ◽  
Vol 7 (3) ◽  
pp. 252-257 ◽  
Author(s):  
Karolina G. César ◽  
Leonel T. Takada ◽  
Sonia M.D. Brucki ◽  
Ricardo Nitrini ◽  
Luiz Fernando C. Nascimento ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Depressive Symptoms ◽  
Epidemiological Study ◽  
Psychiatric Symptoms ◽  
Mental Disease ◽  
Population Sample ◽  
Female Gender ◽  
Clinical History ◽  
Cross Sectional ◽  
The City

ABSTRACT Depression is a heterogeneous mental disease classified as a set of disorders, which manifest with a certain duration, frequency and intensity. The prevalence of depression in the elderly ranges from 0.5 to 16%. Objective To establish, in an epidemiological study, the prevalence of significant depressive symptoms in the population aged 60 years or older. Methods: Results of a cross-sectional epidemiological study, involving home visits, being carried out in the city of Tremembé, Brazil, were reported. The sample was randomly selected by drawing 20% of the population over 60 years from each of the city's census sectors. In this single-phase study, the assessment included clinical history, physical and neurological examination, cognitive evaluation, the Cornell scale and the Patient Health Questionnaire for psychiatric symptoms. Scores greater than or equal to 8 on the Cornell scale were taken to indicate the presence of depressive symptoms. Results: A total of 455 elders were assessed, and of these 169 (37.1%) had clinically significant depressive symptoms (CSDS). Depression prevalence was higher among women (p<0.001) and individuals with lower education (p=0.033). The Chi-square test for trends showed a significant relationship where lower socioeconomic status was associated with greater likelihood of depressive symptoms (p=0.005). Conclusion: The prevalence of depressive symptoms was high in this sample of the population-based study and was associated with female gender, low educational level and socioeconomic status. The assessment of the entire population sample must be completed.

scholarly journals Agoraphobia in adults: Incidence and longitudinal relationship with panic

2006 ◽  
Vol 188 (5) ◽  
pp. 432-438 ◽  
Author(s):  
O. Joseph Bienvenu ◽  
Chiadi U. Onyike ◽  
Murray B. Stein ◽  
Li-Shiun Chen ◽  
Jack Samuels ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Female Gender ◽  
Diagnostic Interview ◽  
Panic Attacks ◽  
Cross Sectional ◽  
Younger Age ◽  
General Population Cohort ◽  
First Onset ◽  
Longitudinal Relationships

BackgroundTheories regarding how spontaneous panic and agoraphobia relate are based mostly on cross-sectional and/or clinic data.AimsTo determine how spontaneous panic and agoraphobia relate longitudinally, and to estimate the incidence rate of and other possible risk factors for first-onset agoraphobia, using a general population cohort.MethodA sample of 1920 adults in east Baltimore were assessed in 1981 -1982 and the mid-1990s with the Diagnostic Interview Schedule (DIS). Psychiatristdiagnoses were made in a subset of the sample at follow-up (n=816).ResultsForty-one new cases of DIS/DSM–III–R agoraphobia were identified (about 2 per 1000 person-years at risk). As expected, baseline DIS/DSM-III panic disorder predicted first incidence of agoraphobia (OR=12, 95% CI 3.2-45), as did younger age, female gender and other phobias. Importantly, baseline agoraphobia without spontaneous panic attacks also predicted first incidence of panic disorder (OR=3.9, 95% CI 1.8-8.4). Longitudinal relationships between panic disorder and psychiatrist-confirmed agoraphobia were strong (panic before agoraphobia OR=20, 95% CI 2.3–180; agoraphobia before panic OR=16, 95% CI 3.2–78).ConclusionsThe implied one-way causal relationship between spontaneous panic attacks and agoraphobia in DSM–IV appears incorrect.

scholarly journals Follow-up Strategies in Focal Liver Lesions and Treatment Methods

2022 ◽  
Vol 6 (2) ◽  
pp. 01-07
Author(s):  
Vedat Goral ◽  
Kerem Mert Goral ◽  
Necati Ormeci
Keyword(s):  
Early Recognition ◽  
Clinical History ◽  
Underlying Disease ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Careful Management ◽  
Incidental Lesions

Today, advances in cross-sectional imaging have led to the detection and early recognition of incidental/focal liver lesions (FCL). In approximately 17,000 cases of chest CT, incidental liver lesions were found in 6% [1]. In general, FCL consists of hepatocytes, biliary epithelium, mesenchymal tissue, connective tissue, or metastasized cells from distant sites. Most incidental lesions are benign, some may require careful management and treatment. In evaluating the lesion, the patient's clinical history, underlying disease and age factor should be considered. FCL can be detected at a rate of 10-30% in normal healthy and chronic liver disease patients, and even in oncology patients with malignancy, FCLs can be highly benign (50-80%)

State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Fabian Rengier ◽  
Philipp Geisbüsch ◽  
Paul Schoenhagen ◽  
Matthias Müller-Eschner ◽  
Rolf Vosshenrich ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Imaging Modality ◽  
Open Surgical Repair ◽  
Cross Sectional ◽  
Transcatheter Aortic Valve ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

Theoretical and Methodological Problems of a 10-Year Follow-Up Program Evaluation Study

2002 ◽  
Vol 18 (3) ◽  
pp. 229-241 ◽  
Author(s):  
Kurt A. Heller ◽  
Ralph Reimann
Keyword(s):  
Program Evaluation ◽  
Evaluation Studies ◽  
Evaluation Study ◽  
Control Groups ◽  
Cross Sectional ◽  
Long Term Study ◽  
Partial Inclusion ◽  
Methodological Problems

Summary In this paper, conceptual and methodological problems of school program evaluation are discussed. The data were collected in conjunction with a 10 year cross-sectional/longitudinal investigation with partial inclusion of control groups. The experiences and conclusions resulting from this long-term study are revealing not only from the vantage point of the scientific evaluation of new scholastic models, but are also valuable for program evaluation studies in general, particularly in the field of gifted education.

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