The winners in life treat their body as if it were a magnificent spacecraft that gives them the finest transportation and endurance for their lives.

-Denis Waitley

 

PNA Spotlight: Dr. William Couldwell

This month the PNA Spotlight focuses on William Couldwell, MD, PhD, who serves as Professor and Chair of the Department of Neurosurgery at the University of Utah. He is also a member of the PNA’s Scientific Advisory Panel. He studied at the University of British Columbia in Vancouver and at Dalhousie University in Halifax, Nova Scotia, majoring in physical chemistry and biology. Dr. Couldwell attended medical school at McGill University in Montreal. He did internship in surgery at the University of Southern California and completed a neurosurgical residency there in 1989. He served as a research fellow in neuroimmunology at the Montreal Neurological Institute and Hospital and research fellow in the neurosurgical service in Lausanne, Switzerland. He returned to U-S-C as an assistant professor of neurological surgery in 1991, where he stayed for four years. Later he became professor and chairman of the Department of Neurological Surgery at New York Medical College, as well as program director of neurosurgical residency in 1997. In 2001 he became professor and chairman of the Department of Neurosurgery at the University of Utah. Dr. Couldwell was kind enough to answer some questions from the PNA. His answers follow.

PNA Medical Corner: Fascia Lata in Reconstructive Neurosurgery

This month the PNA Medical Corner showcases an article co-authored by a member of the PNA, Dr. Varun Kshettry of the Cleveland Clinic. The study concludes that the use of fascia lata in challenging cases of skull base reconstruction is highly effective with few side effects for cases of craniopharyngioma, meningioma and more.

https://pubmed.ncbi.nlm.nih.gov/37081750/

Abstract

Background: Multiple methods exist for skull base reconstruction of defects created by expanded endonasal approaches. While the nasoseptal flap (NSF) has been well established as the workhorse of mucosal reconstruction in complex skull base defects in multi-layered closures, a variety of options exist for the inner layer of multilayer reconstruction, including fascia lata (FL).

Objective: To present our experience and outcomes in utilizing FL in multiple ways to reconstruct a wide variety of complex skull base defects

Featured News and Updates

News Articles October 2024

New acromegaly drug on the horizon

A new drug for treatment and long-term maintenance therapy for acromegaly is now on the horizon. Crinetics Pharmaceuticals recently submitted its first new drug application (NDA) to the U.S. Food and Drug Administration for paltusotine, which is a once-daily oral selectively-targeted somatostatin receptor type 2 nonpeptide agonist.

Crinetics says researchers used data from from 18 clinical trials in the application, including two Phase 3 trials that evaluated paltusotine for acromegaly in medically untreated and treated patients.   Patients tolerated the treatment well, the medication achieved biochemical control by maintaining IGF-1 levels and improved patients’ symptoms compared to placebo.   The company says it expects to hear back from the FDA by December.

Paltusotine, is the first drug of its type to complete Phase 3 clinical development for acromegaly and is now in Phase 2 clinical development for carcinoid syndrome associated with neuroendocrine tumors.  Read the company’s press release here. 

 

Can machine learning to predict hormone deficiency after pituitary surgery?

A study featured on Nature.com used machine learning algorithms to predict whether patients would develop arginine vasopressin deficiency after transsphenoidal surgery to remove a pituitary adenoma. Read more here: https://www.nature.com/articles/s41598-024-72486-w

 

Pituitary apoplexy strikes groom on wedding day

An article in People.com tells the story of a groom in England who had to leave his wedding reception early due to a severe headache – one that turned out to be a hemorrhaging pituitary tumor. Read more here: https://people.com/groom-migraine-wedding-day-tumor-popped-8718083

 

Researchers try to make synthetic oxytocin for pain relief

An article in the Focus.news looks at efforts to replicate the hormone oxytocin in the lab – in an effort to develop a painkiller that would be safer than opioids. Read more here: https://www.thefocus.news/lifestyle/scientists-are-hoping-to-replicate-the-cuddle-hormone-for-healthy-long-term-pain-relief/

Research Articles

October 2024 Research Articles

Pituitary Tumors

Investigating the relationship between cognitive impairment and brain white matter tracts using diffusion tensor imaging in patients with prolactinoma.

Duru M, Demir AN, Oz A, Kargin OA, Altunc AT, Demirel O, Arslan S, Kizilkilic O, Poyraz BC, Kadioglu P.J Endocrinol Invest. 2024 Oct 3. doi: 10.1007/s40618-024-02442-y. Online ahead of print.

 

Androgen Receptor Mediates Dopamine Agonist Resistance by Regulating Intracellular reactive oxygen species (ROS) in Prolactin-secreting Pituitary Adenoma.

Xu L, Lei Z, Wang Q, Jiang Q, Xing B, Li X, Guo X, Wang Z, Li S, Huang Y, Lei T.Antioxid Redox Signal. 2024 Oct 3. doi: 10.1089/ars.2024.0611. Online ahead of print.

 

Beyond Epistaxis: A Rare Case of Ectopic Sinonasal Adamantinomatous Craniopharyngioma.

Selva Kumaran K, Shamsudin NS, Dalip Singh HS, Devesahayam PR.Cureus. 2024 Sep 1;16(9):e68357. doi: 10.7759/cureus.68357. eCollection 2024 Sep.


Posterior pituitary tumors and other rare entities involving the pituitary gland.

Roncaroli F, Giannini C.Brain Pathol. 2024 Sep 30:e13307. doi: 10.1111/bpa.13307. Online ahead of print.PMID: 39350562 Review.

 

Pituitary Apoplexy in Pregnancy: Neonatal Implications.

Megan Y, Melissa S.Neoreviews. 2024 Oct 1;25(10):e660-e663. doi: 10.1542/neo.25-10-e660.

 

Giant pituitary macroadenoma with apoplexy presenting with isolated bilateral hypoglossal nerve palsy: illustrative case.

Zaher M, Kolmetzky DW, Al-Atrache Z, Vimawala S, Kolia NR, Godil SS.J Neurosurg Case Lessons. 2024 Sep 30;8(14):CASE24326. doi: 10.3171/CASE24326. Print 2024 Sep 30.

 

Typical Morphological Characteristics of the Immunohistochemistrical Subtypes of Pituitary Microadenomas: A dual center study.

Zhang L, Yan S, Xie SK, Wei YT, Liu HP, Li Y, Wu HB, Wang HL, Xu PF.Endocr Connect. 2024 Sep 1:EC-24-0378. doi: 10.1530/EC-24-0378. Online ahead of print.

 

 

Acromegaly

 

Efficacy and safety of pasireotide treatment in acromegaly: A systematic review and single arm meta-analysis.

Aliyeva T, Muniz J, Soares GM, Firdausa S, Mirza L.Pituitary. 2024 Oct 1. doi: 10.1007/s11102-024-01461-5. Online ahead of print.

 

Cushing’s

 

Frequency of clinical signs in patients with Cushing’s syndrome and mild autonomous cortisol secretion (MACS): Overlap is common.

Braun LT, Vogel F, Nowak E, Rubinstein G, Zopp S, Ritzel K, Beuschlein F, Reincke M.Eur J Endocrinol. 2024 Oct 1:lvae127. doi: 10.1093/ejendo/lvae127. Online ahead of print.

 

 

Pituitary Surgery

 

Stereotactic radiosurgery for recurrent/residual nonfunctioning pituitary adenoma: a single-arm systematic review and meta-analysis.

De Nigris Vasconcellos F, Vilela MAD, Torrico FG, Scalise MA, Vargas VPS, Mendieta CD, Pichardo-Rojas P, Rosi MEA, Fleury LT, de Brito Rebelo ND, Benjamin C, Sheehan JP.Acta Neurochir (Wien). 2024 Oct 2;166(1):392. doi: 10.1007/s00701-024-06296-4.PMID: 39356336 Review.

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

 

Hormonal Health


Prolactin deficiency in the context of other pituitary hormone abnormalities : Special issue: hypoprolactinemia: a neglected endocrine disorder.

Shimon I.Rev Endocr Metab Disord. 2024 Oct 2. doi: 10.1007/s11154-024-09902-z. Online ahead of print.PMID: 39356415 Review.

 

The Ser434Phe Androgen Receptor Gene Mutation Does Not Affect Fertility but is Associated with Increased Prolactin.

Saadeh NA, Obeidat M, Shboul M.Appl Clin Genet. 2024 Sep 26;17:143-149. doi: 10.2147/TACG.S466919. eCollection 2024.

 

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