“Give a man health and a course to steer, and he’ll never stop to trouble about whether he’s happy or not.”

– George Bernard Shaw

 

PNA Spotlight: Dr. Paul A. Gardner

This month the PNA Spotlight focuses on Dr. Paul A. Gardner. 

Paul A. Gardner, MD, joined the faculty at the University of Pittsburgh Department of Neurological Surgery in 2008 after completing his residency and fellowship training at the University of Pittsburgh. He completed his undergraduate studies at Florida State University, majoring in biochemistry, and received his medical degree from the University of Pittsburgh School of Medicine.

Dr. Gardner completed a two-year fellowship in endoscopic endonasal pituitary and endoscopic and open skull base surgery. His research has focused on evaluating patient outcomes following these surgeries and more recently on genomic and molecular analysis of skull base tumors. Dr. Gardner has been the neurosurgical director of the Center for Cranial Base Surgery at the University of Pittsburgh Medical Center since April of 2008 and, along with Carl Snyderman, MD, of the University of Pittsburgh Department of Ophthalmology, leads a renowned course on endoscopic endonasal surgery three times a year.

His answers are below:

PNA Medical Corner: Artificial intelligence and pituitary surgery

The PNA Medical Corner this month features an article co-authored by neurosurgeon Aaron Cohen-Gadol of Indiana University, a longtime member of the PNA. They conclude that A-I and machine learning will improve preoperative planning and surgical strategies in pituitary surgery, but points out challenges on multiple fronts.

Current status of artificial intelligence technologies in pituitary adenoma surgery: a scoping review

Abstract

Purpose: Pituitary adenoma surgery is a complex procedure due to critical adjacent neurovascular structures, variations in size and extensions of the lesions, and potential hormonal imbalances. The integration of artificial intelligence (AI) and machine learning (ML) has demonstrated considerable potential in assisting neurosurgeons in decision-making, optimizing surgical outcomes, and providing real-time feedback.

    Featured News and Updates

    News Articles February 2025

    Pituitary journey: woman learns to slow down while facing melanoma, pituitary inflammation

    Blogger Amanda Goodwin is a hard-charging businesswoman, who was forced to slow down and “embrace the sick” as she battled melanoma in her lungs, liver and brain, and suffered from inflammation of the pituitary. Read more here: https://substack.com/home/post/p-156259244?utm_campaign=post&utm_medium=web

     

    Study: Cushing’s patients develop cataracts at younger ages

    An article in Cushing’s Disease News examines a study published in Graefe’s Archive for Clinical and Experimental Ophthalmology, that finds that Cushing’s patients are at higher risk of developing cataracts at a younger age compared to non-Cushing’s patients.  They developed them at an average age of 48.1. Patients with Cushing’s Syndrome “being 34% more likely to develop cataracts than the general population. For those with Cushing’s disease, the risk was 39% higher.” Read more: https://cushingsdiseasenews.com/news/cushings-patients-higher-risk-developing-cataracts-younger-age/

     

    Pituitary Journey: British celebrity astrologer recounts battle with pituitary tumor

    Russell Grant, a celebrity astrologer in the U.K. who competed on the show “Strictly Come Dancing” recounts his battle with a pituitary tumor, diabetes, and now vision issues. Read more: https://tinyurl.com/44zujvkm

    Houston Hospital gets $2 million in donations for pituitary research

    Houston Methodist hospital announced it has commitments to receive 2 million dollars to support its Kenneth R. Peak Brain & Pituitary Treatment Center. $1.5 million comes from the Henry J.N. Taub Foundation and is paired with an anonymous $500,000 donation. Read more: https://philanthropynewsdigest.org/news/houston-methodist-receives-1.5-million-for-brain-pituitary-research

    Research Articles

    February 2025 Research Articles

    Pituitary Tumors

    Etiology, presentation, and outcomes of hyperprolactinemia due to pituitary masses in children and adolescents.

    Kilci F, Sarikaya E, Murat NÖ, Deniz A.Endocrine. 2025 Feb 2. doi: 10.1007/s12020-025-04176-0. Online ahead of print.

    Conservative medical therapy for a macroprolactinoma presenting with obstructive hydrocephalus.

    Cuaño PMGM, Isip-Tan IT, Chan KIP.BMJ Case Rep. 2025 Jan 31;18(1):e261540. doi: 10.1136/bcr-2024-261540.

    Individual management and prognostic assessment for long-term outcomes using a novel classification system of craniopharyngiomas: a retrospective study of single institution.

    Zhang S, Xie B, He Y, Zhang X, Gong G, Li M, Chen Y, Tang G, Zhang C, Qin C, Liu Q.J Cancer Res Clin Oncol. 2025 Jan 31;151(2):57. doi: 10.1007/s00432-025-06104-1.

    Mental Health and Pituitary Issues

    Psychological burden in patients with sellar masses under conservative and surgical management.

    Kalasauskas D, Ernst A, Mireri S, Keric N, Thavarajasingam SG, Omran W, Wüster C, Ringel F, Conrad J.Neurosurg Rev. 2025 Jan 30;48(1):104. doi: 10.1007/s10143-025-03240-7.

    Social functioning longitudinal trajectory and its predictors in young and middle-aged postoperative pituitary tumor patients: A growth mixture model.

    Zhou Y, Qian M, Wang S, Zhou X, Zhou M, Gu Z, Sun M, Yang T.Eur J Oncol Nurs. 2025 Jan 28;74:102815. doi: 10.1016/j.ejon.2025.102815. Online ahead of print.

    Pituitary Surgery


    Giant and irregular pituitary neuroendocrine tumors surgery: comparison of simultaneous combined endoscopic endonasal and transcranial and purely endoscopic endonasal surgery at a single center.

    Fu J, Luo W, Zhang C, Wang Z, Fan W, Lin Y, Kang D, Song J, Jiang C, Yan X.Chin Neurosurg J. 2025 Feb 3;11(1):3. doi: 10.1186/s41016-025-00389-4.PMID: 39894800

    Modified graded skull base reconstruction for intraoperative CSF leak repair in endoscopic endonasal surgeries: a single-surgeon experience in initial years of practice and nuances in the early learning curve.

    Khaleghi M, Shahid AH, Suggala S, Dyess G, Hummel UN, Chason DN, Butler D, Thakur JD.Neurosurg Focus. 2025 Feb 1;58(2):E6. doi: 10.3171/2024.11.FOCUS24733.

    Does the crafted abdominal fat grafting technique completely eliminate risk of postoperative CSF leak in endonasal pituitary surgery? Technical note and preliminary clinical outcome.

    Lasica N, Lesha E, Beckfort NS, Arnautovic KI.Neurosurg Focus. 2025 Feb 1;58(2):E3. doi: 10.3171/2024.11.FOCUS24665.

    Multicenter study on 2-year outcomes of dual application of hydroxyapatite cranioplasty and a nasoseptal flap following endoscopic endonasal surgery for tuberculum sellae meningiomas or craniopharyngiomas.

    Kong DS, Kim YH, Hong SD, Ryu G, Kim JH, Hong CK, Kim YH.Neurosurg Focus. 2025 Feb 1;58(2):E2. doi: 10.3171/2024.11.FOCUS24624.


    Risk Factors for Development of Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone Secretion after Transsphenoidal Resection of Pituitary Adenoma.

    Petito G, Hu A, Zhang G, Min S, Tripathi SH, Kumar A, Shukla G, Shah S, Phillips KM, Jana S, Forbes JA, Zuccarello M, Andaluz NO, Sedaghat AR.J Neurol Surg B Skull Base. 2024 Feb 2;86(1):39-45. doi: 10.1055/a-2235-7419. eCollection 2025 Feb.PMID: 39881750

    Cushing’s

    Performance of Vasopressin Stimulated Bilateral Inferior Petrosal Sinus Sampling in Corticotropin Dependent Cushing’s Syndrome with Negative or Equivocal 3 Tesla Contrast Enhanced Magnetic Resonance Imaging of Pituitary.

    Shivnani P, Kasliwal R, Goyal G, Sharma J, Balani U, Gupta P, Sharma BS, Yadav D, Mishra V, Sharma SK.Indian J Endocrinol Metab. 2024 Nov-Dec;28(6):589-595. doi: 10.4103/ijem.ijem_60_24. Epub 2024 Dec 30.

    Hormonal health

    The hypothalamus and pituitary gland regulate reproduction and are involved in the development of polycystic ovary syndrome.

    Long BY, Liao X, Liang X.Neuroendocrinology. 2025 Jan 31:1-26. doi: 10.1159/000543877. Online ahead of print.

    Cabergoline-induced NDFIP1 upregulation in pituitary neuroendocrine tumor cells activates mTOR signaling and contributes to cabergoline resistance.

    Gu W, Zhang W, Wu Z, Cai Y.J Neurooncol. 2025 Feb 1. doi: 10.1007/s11060-025-04949-7. Online ahead of print.

    The FDA has approved NGENLA (somatrogon-ghla)

    The FDA has approved NGENLA (somatrogon-ghla), a once-weekly, human growth hormone analog indicated for treatment of pediatric patients aged three years and older who have growth failure due to an inadequate secretion of endogenous growth hormone.

    See the Press Release here>

    Count on your Xeris CareConnection™ Team for unparalleled Cushing’s Support

    Cushing’s can be challenging, but there is support so patients can feel like themselves again. The main goal of treating Cushing’s is to get cortisol levels back to normal. This Pituitary Awareness Month, Xeris Pharmaceuticals® is highlighting the importance of one-on-one support for patients living with Cushing’s Syndrome and support for HCPs treating Cushing’s Syndrome.

    Sign up to get dedicated support:

    Patients: Sign up for support | Recorlev® (levoketoconazole)

    HCP’s: Connect with Xeris support | RECORLEV® (levoketoconazole)

    Have more questions? Call for more support at 1-844-444-RCLV (7258)

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