June 2020 Extra Articles

 

 

Can Gluten-free Diet Help Lymphocytic Hypophysitis?

A study featured on celiac.com finds that a gluten-free diet in patients with celiac disease can help with lymphocytic hypophysitis.   Read more:
https://www.celiac.com/articles.html/gluten-free-diet-in-patients-with-celiac-disease-triggers-remission-of-pituitary-autoimmunity-r5205/.

Anaesthetics and Pituitary Function After Transsphenoidal Surgery

 A study reviewed on MDLinx found that 3 months after endoscopic transsphenoidal surgery, patients who were given sevoflurane and propofol anesthesia had similar outcomes.Read more : https://www.mdlinx.com/journal-summary/effects-of-anesthetics-on-postoperative-3-month-neuroendocrine-function-after-endoscopic/2uw6Cym7fYvY2R1nr5Bwko

Sea Cucumbers And the Pituitary

An article in phys.org discusses a scientific theory that the kisspeptin system that controls hormones can be traced biologically back in evolution to the sea cucumber. Read more: https://phys.org/news/2020-06-scientists-ancient-key-hormone.html

 

Hydrocortisone Not Recommended for Adrenal Insufficiency in Prader-Willi

An article in praderwillinews looks at new recommendations that people with adrenal insufficiency due to Prader-Willi syndrome avoid hydrocortisone. Read more: https://praderwillinews.com/2020/05/26/cortisol-deficiency-rare-in-pws-patients-routine-hydrocortisone-replacement-therapy-not-advised-study/

 

 

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PNA Spotlight: Dr. Edward El Rassi

 

edwad el rassi

 This month the PNA Spotlight shines on Dr. Edward El Rassi, Assistant Professor of
Rhinology, Allergy, and Skull Base Surgery in the Department of Otolaryngology- Head and Neck Surgery at the University of Oklahoma Health Sciences Center in Oklahoma City, OK. He attended medical school at the University of Oklahoma College of Medicine graduating with special distinction. He then completed residency in Otolaryngology - Head and Neck Surgery at Oregon Health and Science University in Portland, OR. After residency, he furthered his training by completing a fellowship in Rhinology and Skull Base Surgery at Massachusetts Eye and Ear Infirmary and Massachusetts General Hospital in Boston, MA. He was kind enough to answer some questions from the PNA. His answers follow.

 

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Medical Corner June 2020

 

PNA Medical Corner: Stereotactic Radiosurgery for Acromegaly.

This month the PNA Medical Corner showcases an article co-written by PNA member Dr. Jason Sheehan of the University of Virginia Medical Center in Charlottesville.  The authors reviewed many studies on the outcomes in stereotactic radiosurgery for acromegaly jason sheehanand conclude that patients achieved endocrine remission and control of about 60-70 percent over time, with visual loss being an uncommon side-effect.

 Stereotactic Radiosurgery for Acromegaly: An International Systematic Review and Meta-Analysis of Clinical Outcomes
Raj Singh 1, Prabhanjan Didwania 2, Eric J Lehrer 3, Darrah Sheehan 4, Kimball Sheehan 4, Daniel M Trifiletti 5, Jason P Sheehan 6
Affiliations expand
PMID: 32506372 DOI: 10.1007/s11060-020-03552-2

Abstract

 

Introduction: We performed a systematic review and meta-analysis of clinical outcomes for patients with acromegaly treated with stereotactic radiosurgery (SRS).

 

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Research Articles June 2020

 

 

Knowledge is power and we believe keeping abreast of news on the research front is imperative. Each month in Highlights we feature a few of the top news stories, which you can read below. In addition, we update our website on a regular basis with the latest breaking news related to pituitary and hormonal disorders by gathering stories we think you'll be interested in from MD Linx, Medscape, MedPage Today, PubMed, Touch Endocrinology, News-Medical.net and WebMD.

 

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Pituitary Adenoma Clinical Trial

 

There are limited treatment options for pituitary adenomas outside of surgery, radiation and endocrine therapy. Recent data indicate that some pituitary adenomas can respond to chemotherapy, such as temozolomide (TMZ). Further, studies of other neuroendocrine tumors have shown that the addition of another chemotherapy agent, capecitabine (CAP), may allow better responses. This is an open label study to assess the efficacy of capecitabine (CAP) and temozolomide (TMZ) in recurrent pituitary adenomas. Patients are treated in 28-day cycles with both agents (up to six cycles) with MRI imaging completed after every two cycles, and they are followed closely for any potential side effects associated with treatment. This trial may be a good option for patients who cannot (or prefer not to) receive additional radiation therapy or surgery.

Capecitabine and Temozolomide for Treatment of Recurrent Pituitary Adenomas (TMZ-Cap)

 

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Treatment of Aggressive Pituitary Tumors with Immunotherapy

Individuals with tumors of the pituitary (adenomas and carcinomas) that grow in spite of treatment with radiation are eligible for our clinical trial investigating whether the two immunotherapies, nivolumab and ipilimumab, are able to shrink these tumors.  
The two immunotherapies, nivolumab and ipilimumab, are intravenous drugs that have revolutionized the treatment of melanoma and several other malignancies.  These drugs allow the immune system to recognize and attack tumor cells.  Individuals with pituitary tumors that grow in spite of standard treatments (in particular radiation) have few treatment options.   For that reason, we are performing this phase II trial evaluating the efficacy of this drug combination on eligible patients.  
For further information, please reach out to Andrew Lin, MD at 212-639-8392.  Additional information is on the ClinicalTrials.gov website (https://clinicaltrials.gov/ct2/show/NCT04042753).

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May 2020 Highlights Research Articles

Knowledge is power and we believe keeping abreast of news on the research front is imperative. Each month in Highlights we feature a few of the top news stories, which you can read below. In addition, we update our website on a regular basis with the latest breaking news related to pituitary and hormonal disorders by gathering stories we think you'll be interested in from MD Linx, Medscape, MedPage Today, PubMed, Touch Endocrinology, News-Medical.net and WebMD.

 

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PNA Medical Corner: Endocrinology in the Era of COVID-19

  thumb_Fleseriu1

An article co-written by PNA member Dr. Maria Fleseriu, an endocrinologist at Oregon Health Sciences University, makes recommendations on how to maintain and even improve patient outcomes despite the challenges posed by COVID-19. 

Eur J Endocrinol. 2020 May 1. pii: EJE-20-0473. doi: 10.1530/EJE-20-0473. [Epub ahead of print]

Endocrinology in the time of COVID-19: Management of pituitary tumours.

Fleseriu M1, Karavitaki N2, Dekkers OM3.

Author information

Abstract

Patients with pituitary tumours, ensuing hormonal abnormalities and mass effects are usually followed in multidisciplinary pituitary clinics and can represent a management challenge even during times of non-pandemic. The COVID-19 pandemic has put on hold routine medical care for hundreds of millions of patients around the globe, while many pituitary patients' evaluations cannot be delayed for too long. Furthermore, the majority of patients with pituitary tumours have co-morbidities potentially impacting the course and management of COVID-19 (e.g. hypopituitarism, diabetes mellitus, hypertension, obesity, cardiovascular disease). Here, we summarize some of the diagnostic and management dilemmas for these patients, and we provide guidance on safe and as effective as possible delivery of care in the COVID-19 era. We also attempt to address how pituitary services should be remodeled in the event of similar crises, while maintaining or even improving patient outcomes. Regular review of these recommendations and further adjustments are needed, depending on the evolution of the COVID-19 pandemic status. We consider that utilization of successful models of pituitary multidisciplinary care implemented during the COVID-19 pandemic should continue after the crisis is over by using the valuable and exceptional experience gained during these challenging times.

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In Memorium Dr. Donald P. Becker

  Donald Becker, MD

The PNA would like to honor the memory of Dr. Donald P. Becker, a longtime member of the PNA who passed away on May 1, 2020. Dr. Becker was a respected neurosurgeon at UCLA Medical Center. At UCLA, he served as a Professor and Chief of Neurosurgery from 1985 – 2001 and then Senior Associate Dean for Academic Affairs in the David Geffen School of Medicine (2001-2007). He graduated from Case Western Reserve University School of Medicine in 1968 and completed his neurosurgical residency at the University Hospitals of Cleveland.  From 1972-1985 he was Professor and Chairman at the Medical College of Virginia. 

He wrote many scholarly articles and served as President of the Neurosurgical Society of America, served on the Board of Directors of the American Board of Neurological Surgery and the Journal of Neurosurgery Editorial Board. He retired as Director of the UCLA Brain Tumor Program in 2007. He was an avid horseman and golfer. The PNA expresses our deepest condolences to Dr. Becker’s family, friends and colleagues. 

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