“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 August 2026

    Secretary of Defense concerned about low testosterone in the military

    Secretary of Defense Pete Hegseth is mandating testing of male troops over age 30 for low testosterone and will offer testosterone replacement therapy. Many endocrinologists say this approach is problematic. Read more: https://arstechnica.com/health/2026/07/hegseth-wants-a-high-t-military-doctors-call-it-a-clinical-minefield/

    The Endocrine Society issue statement in the wake of Hegseth’s announcement:

    https://www.endocrine.org/news-and-advocacy/news-room/2026/statement-on-testosterone-replacement-therapy

    Pituitary story: Lionel Messi

    Soccer mega-star Lionel Messi was diagnosed with growth hormone deficiency as a child. Read more: https://www.msn.com/en-in/health/other/lionel-messi-overcame-growth-hormone-deficiency-as-a-child-a-condition-that-almost-derailed-his-football-dream/ar-AA280JJc

    Vision issues in acromegaly

    PNA member Dr. Maria Fleseriu is featured in an article in EverydayHealth.com about how acromegaly can affect a patient’s eyesight. Read more: https://www.everydayhealth.com/hormones-metabolic-disorders/how-acromegaly-can-affect-your-eyesight/

    Delayed diagnosis of Cushing’s in Japanese children

    An article in Cushing’s Disease News looks at a study that found Japanese children often face delays in diagnosis of Cushing’s disease, but many are successfully treated with surgery. Read more: https://cushingsdiseasenews.com/news/japanese-children-face-long-delays-cushings-disease-diagnosis/

    Pituitary story: Idaho teen battles germinoma near pituitary gland

    Delayed puberty and growth, combined with diabetes insipidus, led doctors to diagnose a 16-year-old boy from Idaho with a germ cell tumor near his pituitary gland. Read more: https://www.fredhutch.org/en/news/blog/2026/07/college-bound-16-year-old-didnt-let-germinoma-get-him-down.html

    Pituitary surgery story: Transsphenoidal surgery at Walter Reed

    A story in the Times of India highlights the work of an Indian American pituitary surgeon at Walter Reed National Military Medical Center in Bethesda, Maryland: Major Jagatkumar “J.” Patel, and his colleague Army neurosurgeon Lt. Col. Charles Miller.  Read more: https://timesofindia.indiatimes.com/health/indian-american-army-surgeon-removes-golf-ball-sized-brain-tumour-through-a-patients-nose-avoiding-open-skull-surgery/amp_articleshow/132781973.cms

    Experts play down the idea of “male menopause”

    An article in the Kansas City Star explains that men do not experience a sharp drop-off in hormones in the same way women do; the process is more gradual. Read more: https://www.kansascity.com/living/article316673842.html

    The same reporter looks at testosterone replacement therapy in an article in the Miami Herald: https://www.miamiherald.com/living/article316675898.html

    Research Articles

    Research Articles August 2026

    Pituitary tumors

    Predicting hormonal deterioration following transsphenoidal surgery for non-functioning pituitary adenomas: A systematic review and meta-analysis.

    Ameen D, ElSabban Y, Kalaitzoglou D, Shapey J, Barazi S, Thomas N, Aylwin S, Maratos E.Endocrine. 2026 Aug 1;91(1):243. doi: 10.1007/s12020-026-04712-6.

     

    Effect of sellar and parasellar brain tumors on retinal thickness and visual fields: A cross-sectional comparative study.

    Kasireddy HD, Sahu V, Sharma A, Kumar A, Shrivastava S.Indian J Ophthalmol. 2026 Aug 1;74(8):1185-1190. doi: 10.4103/IJO.IJO_215_26. Epub 2026 Jul 31.


    Case report of two growth hormone-secreting invasive pituitary adenomas and literature review.

    Zhou J, Wen J, Leng H, Yi J.Arch Med Sci. 2026 Jun 23;22(3):1926-1931. doi: 10.5114/aoms/224312. eCollection 2026.


    Statistical Geometric Morphometric Shape Analysis of Ventricular Shape Changes in Giant Pituitary Adenomas Invading the Third Ventricle.

    Altunyuva O, Balcin N, Ocakoglu G, Taskapilioglu MO, Yilmazlar S.Turk Neurosurg. 2026;36(4):509-516. doi: 10.5137/1019-5149.JTN.49331-25.2.

     

    Personalized prediction of local control after stereotactic radiosurgery for craniopharyngioma: a multicenter machine learning survival model.

    Reyes JS, Hadjipanayis CG, Bernstein K, Speckter H, Gonzalez I, Chytka T, Liscak R, Bowden GN, Sumi T, Narita K, Kano H, Martínez-Moreno N, Martínez-Álvarez R, Picozzi P, Franzini A, Tripathi M, Rai A, Kumar N, Douri K, Mathieu D, Dono A, Amezquita-Contreras C, Blanco AI, Esquenazi Y, Tos SM, Mantziaris G, Peker S, Samanci Y, Duzkalir AH, Meng Y, Sheehan JP, Kondziolka D, Lunsford LD, Niranjan A.J Neurooncol. 2026 Jul 31;179(1):22. doi: 10.1007/s11060-026-05736-8.

    Editor’s note: Dr. Sheehan is a member of the PNA.

     

    Cushing’s

    Annexin A1 as a diagnostic biomarker for cyclic Cushing disease.

    Rao Z, Wu L, Jiang L, Su T, Cao Y, Lin S, He X, Ye Y, Ning G, Wang W, Zhang C.iScience. 2026 Jul 22;29(8):116907. doi: 10.1016/j.isci.2026.116907. eCollection 2026 Aug 21.

     

    MRI predictive value for adenoma detection in Cushing’s disease and reader dependence: a multi-observer study.

    Constanthin PE, Ferrière A, Sanchez-Gallardo F, Nunes ML, Berge J, Engelhardt J.J Neurosurg. 2026 Jul 31:1-9. doi: 10.3171/2026.2.JNS252331. Online ahead of print.

     


    Baseline biochemical evaluation for etiologic differentiation in ACTH-dependent Cushing’s syndrome: machine learning and composite score analysis in a multicenter cohort of 566 patients.

    Detomas M, Prada Salcedo JP, Altieri B, Stüfchen I, Nasi-Kordhishti I, Wolfsberger S, Losa M, Quinkler M, Kimpel O, Vila G, Honegger JB, Rubinstein G, Fassnacht M, Deutschbein T.Eur J Endocrinol. 2026 Jul 31:lvag141. doi: 10.1093/ejendo/lvag141. Online ahead of print.

     

    Acromegaly

     

    Assessment of nurses’ knowledge and awareness of acromegaly in a high-volume tertiary center: a cross-sectional study.

    Genc B, Polat SB, Koc A, Ersoy R.Pituitary. 2026 Jul 31;29(4):136. doi: 10.1007/s11102-026-01737-y.

     

    Hormonal health

     

    Pituitary Apoplexy Without Chiasmal Compression Presenting With Radiographic Oculomotor Nerve Compression in a Prolactinoma: A Case Report.

    Holz EA, Imran M, Reyes N, Izquierdo-Pretel G.Cureus. 2026 Jun 30;18(6):e111830. doi: 10.7759/cureus.111830. eCollection 2026 Jun.

     

     

    Progressive Cerebellar Dysfunction, Pituitary Insufficiency, and Severe Skeletal Fragility in Adult Survivorship of Childhood Multisystem Langerhans Cell Histiocytosis: A Case Report.

    Alnahar S, Senjab A, Gharib S, Gharib Z, Hadid L.Clin Case Rep. 2026 Jul 29;14(8):e73261. doi: 10.1002/ccr3.73261. eCollection 2026 Aug.


    A Novel LHX3 Variant Associated With Combined Pituitary Hormone Deficiency in an Indian Kindred.

    Palaniappan S, Sridhar S, Thasarathan S, Shanmugam D, Dutta P.Cureus. 2026 Jun 29;18(6):e111778. doi: 10.7759/cureus.111778. eCollection 2026 Jun.

     

     

    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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