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Med Law Rev 2021 May 11. Epub 2021 May 11.

Dickson Poon School of Law, Centre of Medical Law & Ethics, King's College, London WC2R 2LS, UK.

The retention and display of the remains of Charles Byrne, an Irishman with acromegaly, by the Hunterian Museum of the Royal College of Surgeons has been contentious for some years, and the moral case for his release for burial has been repeatedly made. This article makes the legal case through five arguments. The first three concern common law rights and duties; Byrne's right to burial, the duty of the State to ensure his burial where others do not, and the right of his friends to assume that duty. Read More

Growth Horm IGF Res 2021 Apr 30;57-58:101391. Epub 2021 Apr 30.

Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.

Objective: Acromegaly is characterized by an excess of growth hormone (GH) and insulin like growth-factor 1 (IGF1), and it is strongly associated with cardiovascular diseases (CVD). Both acute and long-lasting pro-inflammatory effects have been attributed to IGF1. Previous results suggest the presence of systemic inflammation in treated patients. Read More

Growth Horm IGF Res 2021 Apr 29;57-58:101395. Epub 2021 Apr 29.

Almazov National Medical Research Centre, Ulica Akkuratova 2, St. Petersburg 197341, Russia.

Objective: Acromegaly patients were reported to have an increased arterial stiffness that could contribute to the frequent cardiovascular complications in this population. The chronic excess of GH and IGF-1 may lead to arterial stiffening via different mechanisms, including hypertension, impaired glucose tolerance and dyslipidemia, however, it is not known whether the activation of GH/IGF-1 axis might influence arterial stiffening independently of cardiovascular risk factors. The objective of this prospective case-control study was to compare arterial stiffness assessed with pulse-wave velocity (PWV) in acromegaly versus non-acromegaly group with similar cardiovascular risk profile. Read More

Endocrinol Diabetes Metab Case Rep 2021 Apr 1;2021. Epub 2021 Apr 1.

Department of Endocrinology, Diabetes and Metabolism, Kitasato University School of Medicine.

Summary: Acromegaly is associated with a low quality of life (QoL), which is partially attributable to appearance. However, appearance changes are only partially reversible with treatments of growth hormone excess. This case study describes a 41-year-old Japanese man who presented with mandibular prognathism. Read More

Endocrinol Diabetes Metab Case Rep 2021 Apr 1;2021. Epub 2021 Apr 1.

Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Summary: Acromegaly is a rare disease caused by hypersecretion of the growth hormone (GH). Most cases are caused by either pituitary microadenoma or macroadenoma. The GH producing tumors present with clinical manifestations of acromegaly due to excessive GH secretion or symptoms resulting from mass effects of the enlarging tumor. Read More

Cureus 2021 Apr 2;13(4):e14265. Epub 2021 Apr 2.

Internal Medicine Endocrinology, Armed Forces Hospital, Abha, SAU.

Although acromegaly has been associated with increased mortality rates, evidence shows that the application of the recent treatment modalities has reduced the risk of death in these patients, being comparable with the general population. As a result of the changing trends regarding mortality, the aim is to review the current literature to create enough evidence about the recent trends of mortality in patients with acromegaly. Moreover, this review aims to identify the possible etiology and the related risk factors. Read More

Anticancer Res 2021 May;41(5):2669-2680

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

Background/aim: The histopathological variability of each type of pituitary adenoma (PA) that causes growth hormone (GH) excess influences the phenotype, radiological characteristics and therapy response of acromegaly patients. We correlated the immunohistochemical (IHC) features of GH-secreting PAs with their clinical, laboratory and imaging data.

Patients And Methods: We included 32 patients with documented acromegaly; tumour specimens were histologically and IHC examined: anterior pituitary hormones, pituitary-specific transcription factor-1 (PIT-1), Ki-67 labelling index were evaluated. Read More

Eur J Endocrinol 2021 May 1. Epub 2021 May 1.

E Valassi, Endocrinology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Introduction: Patients with acromegaly show musculoskeletal symptoms which may persist despite disease control. Increased intramuscular fat fraction is a known cause of muscle dysfunction in several disorders.

Objective: To assess the degree of fat fraction in thigh muscles of controlled acromegaly patients, and its relationship with muscle dysfunction. Read More

Adv Ther 2021 May 4. Epub 2021 May 4.

Device Development, Sun Pharmaceutical Industries Ltd, Tandalja, Vadodara, Gujarat, India.

Introduction: Octreotide acetate subcutaneous injection is indicated to treat acromegaly and the symptoms of carcinoid tumors and vasoactive intestinal peptide tumors (VIPomas). This formative human factors study assessed the octreotide acetate pen injector and accompanying instructions for use (IFU) with self-trained participants.

Methods: The study enrolled patients with diagnoses of acromegaly, carcinoid tumors, or VIPomas and healthcare practitioners (HCPs) who treat patients with these diagnoses. Read More

Biomedicines 2021 Apr 30;9(5). Epub 2021 Apr 30.

School of Medicine, Emory University, Atlanta, GA 30322, USA.

Pituitary adenomas are tumors that arise in the anterior pituitary gland. They are the third most common cause of central nervous system (CNS) tumors among adults. Most adenomas are benign and exert their effect via excess hormone secretion or mass effect. Read More

Endocrine 2021 May 4. Epub 2021 May 4.

Pituitary Center, Oregon Health and Science University, Portland, OR, USA.

Endocr Pract 2021 Apr 30. Epub 2021 Apr 30.

Ipsen, Cambridge, MA, USA.

Purpose: Acromegaly is associated with increased morbidity and mortality. Limited data are available on the utilization and costs of healthcare by these patients. This study assessed the impact of acromegaly on employees' health benefit (direct and indirect) costs and absenteeism. Read More

Arch Endocrinol Metab 2021 Apr 29. Epub 2021 Apr 29.

Endocrinologist, Practicing at Private Practice, Karaj, Iran.

Carney complex (CNC) is a rare syndrome of multiple endocrine and non-endocrine tumors. In this paper we present a 23-year-old Iranian woman with CNC who harbored a novel mutation (c.642dupT) in gene. Read More

Pituitary 2021 May 3. Epub 2021 May 3.

Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCC Hospital, Via Olgettina 60, 20132, Milan, Italy.

Background: Despite COVID-19 being identified as severe respiratory viral infection, progressively many relevant endocrine manifestations have been reported greatly contributing to the severity of the clinical presentation. Systemic involvement in COVID-19 is due to the ubiquitous expression of angiotensin-converting enzyme 2 (ACE2) receptor, responsible for the entry in the cells of SARS-CoV-2, Several reports in humans and animal models showed a significant ACE2 mRNA expression in hypothalamus and pituitary cells. Moreover, higher mortality and poorer outcomes have been widely described in COVID-19 patients with obesity, diabetes and vertebral fractures, which are all highly prevalent in subjects with pituitary dysfunctions. Read More

Cureus 2021 Mar 28;13(3):e14159. Epub 2021 Mar 28.

Internal Medicine, Detroit Medical Center (DMC) Harper Hospital, Detroit, USA.

McCune Albright Syndrome (MAS) is caused by a mutation in the GNAS gene that results in multiple endocrinopathies such as Cushing syndrome, acromegaly, hyperthyroidism, and precocious puberty. Despite the presence of pleiotropy coupled with a GNAS gene mutation, malignancy is a rare occurrence in MAS. There is minimal literature showcasing squamous cell carcinoma (SCC) of the lung in patients with MAS. Read More

BMC Endocr Disord 2021 May 1;21(1):90. Epub 2021 May 1.

Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 610041, Chengdu, China.

Background: Hypercalcemia associated with acromegaly is mostly parathyroid hormone (PTH)-dependent, being caused by parathyroid hyperplasia or adenoma, which are common in individuals with multiple endocrine adenomatosis-1 (MEN-1). The rare occurrence of non-PTH-dependent hypercalcemia associated with acromegaly is attributable to complex factors involving increased intestinal calcium absorption, enhanced bone calcium release, and reduced urinary calcium elimination. Although patients with acromegaly often have mild hyperphosphatemia and hypercalciuria, clinically significant hypercalcemia is extremely rare. Read More

J Clin Med 2021 Apr 26;10(9). Epub 2021 Apr 26.

Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University, 70-204 Szczecin, Poland.

Objective: To determine the effect of transsphenoidal surgery on quality of life and sleep in patients with pituitary adenomas depending on tumor type and compression of the optic chiasm.

Methods: In this prospective study, patients with pituitary adenomas who were scheduled for transsphenoidal surgery completed the Short Form 36 Questionnaire, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale preoperatively and 7.5 (±1. Read More

Cancers (Basel) 2021 Apr 10;13(8). Epub 2021 Apr 10.

Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.

First-generation somatostatin receptor ligands (fg-SRLs), such as octreotide (OCT), represent the first-line medical therapy in acromegaly. Fg-SRLs show a preferential binding affinity for somatostatin receptor subtype-2 (SST), while the second-generation ligand, pasireotide (PAS), has high affinity for multiple SSTs (SST > SST > SST > SST). Whether PAS acts via SST in somatotroph tumors, or through other SSTs (e. Read More

Front Oncol 2021 12;11:641359. Epub 2021 Apr 12.

Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.

Background: The growth hormone (GH) and insulin-like-growth factor 1 (IGF-1) axis has long been recognized for its critical role in brain growth, development. This study was designed to investigate microstructural pathology in the cortex and white matter in growth hormone-secreting pituitary adenoma, which characterized by excessive secretion of GH and IGF-1.

Methods: 29 patients with growth hormone-secreting pituitary adenoma (acromegaly) and 31 patients with non-functional pituitary adenoma as controls were recruited and assessed using neuropsychological test, surface-based morphometry, T1/T2-weighted myelin-sensitive magnetic resonance imaging, neurite orientation dispersion and density imaging, and diffusion tensor imaging. Read More

J Med Case Rep 2021 Apr 29;15(1):207. Epub 2021 Apr 29.

Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Background: Adjuvant endocrine therapy is recommended for the treatment of hormone-receptor-positive breast cancer. Aromatase inhibitors are associated with significant musculoskeletal adverse effects, likely through growth hormone/insulin-like growth factor 1 modulation, while tamoxifen reduces insulin-like growth factor 1 production. We describe the case of a patient who was treated successfully with tamoxifen for her hormone-receptor-positive breast cancer and acromegaly. Read More

Endocrine 2021 Apr 27. Epub 2021 Apr 27.

Pituitary Unit, Department of Endocrinology and Diabetes, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.

Introduction: Disorders of glucose metabolism are a serious acromegaly comorbidity and may be differently impacted by medical treatments of acromegaly. In this retrospective longitudinal multicenter study, we investigated the outcome of glucose metabolism and its predictors in patients treated with Pasireotide LAR (PAS-LAR) alone or in combination with Pegvisomant (PAS-LAR + Peg-V).

Subjects And Methods: Acromegaly patients treated continously with PAS-LAR or PAS-LAR + Peg-V for at least 6 months. Read More

J Endocrinol Invest 2021 Apr 24. Epub 2021 Apr 24.

Department of Neurological Surgery, Oregon Health & Science University, Mail Code CH8N, 3303 South Bond Ave, Portland, OR, 97239, USA.

Purpose: Acromegaly is a rare disease and is associated with increased cardiovascular (CV) morbidity and mortality, especially in patients with uncontrolled disease. We aimed to analyze the prevalence and severity of cardiomyopathy and valvular heart disease in a large cohort of patients with a confirmed acromegaly diagnosis, at baseline and after treatment.

Methods: We retrospectively reviewed an institutional approved database; 190 patients with confirmed acromegaly and follow-up data available (years 2006-2018). Read More

J Int Med Res 2021 Apr;49(4):300060521999541

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

A giant retrosternal goiter can lead to compression of vital organs in the mediastinum with high risk of acute cardiorespiratory decompensation. Additionally, patients with acromegaly are prone to developing severe airway obstruction and ventilation difficulties during anesthetic induction, leading to hypoxia and an increased partial pressure of carbon dioxide. Therefore, more comprehensive airway management strategies are needed. Read More

Telemed J E Health 2021 Apr 20. Epub 2021 Apr 20.

Service of Endocrinology, University Hospital, Faculty of Medicine, University of Brasilia, Brasilia, Brazil.

Telemedicine is a resource to provide health care to patients social distancing and prevent their exposure to the risk of contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in medical-hospital settings. This study evaluated a virtual model of care in acromegalic patients. We recruited 78 acromegalic patients, 65% female, median age 63 years. Read More

J Clin Endocrinol Metab 2021 Apr 19. Epub 2021 Apr 19.

Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil.

Context: Acromegaly can impair bone integrity, increasing the risk of vertebral fractures (VF).

Objective: To evaluate the impact of isolated GH/IGF-I hypersecretion on bone turnover markers,Wnt inhibitors, BMD, microarchitecture, bone strength and vertebral fractures in female patients with acromegaly (Acro), compared to healthy control group (HC).

Design, Setting, And Patients: Cross-sectional study including 83 premenopausal women without any pituitary deficiency:18 acromegaly in remission (AcroR), 12 in group with active acromegaly (AcroA) and 53 HC. Read More

Front Oncol 2021 2;11:640999. Epub 2021 Apr 2.

Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China.

Cardiovascular-related complications are one of the most common complications in patients with acromegaly, and can lead to an increased risk of death. Hypertension and cardiomyopathy are the main cardiovascular complications. The characteristics of acromegalic cardiomyopathy are concentric biventricular hypertrophy and diastolic dysfunction. Read More

J Clin Endocrinol Metab 2021 Apr 17. Epub 2021 Apr 17.

Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Munich, Germany.

Context: Soluble alpha klotho (sαKL) has been linked to growth hormone (GH) action, but systematic evaluation and comparison to traditional biomarkers in acromegaly are lacking.

Objective: To evaluate the potential of sαKL to aid classification of disease activity.

Design And Setting: Retrospective study at two academic centers. Read More

Endocrine 2021 Apr 15. Epub 2021 Apr 15.

Neurology Department, Galilee Medical Center Bar-Ilan Faculty of Medicine, Safed, Israel.

Purpose: Diabetes mellitus (DM) represents one of the most frequent comorbidities in patients with acromegaly. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) represent an important class for diabetes management. However, limited data is reported regarding the use of this class in patients with acromegaly and diabetes. Read More

Cureus 2021 Mar 12;13(3):e13852. Epub 2021 Mar 12.

Department of Medicine, Section of Endocrinology, Aga Khan University Hospital, Karachi, PAK.

Background:  Chronic exposure to high levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) leads to metabolic complications, most importantly dysglycemia in the form of diabetes mellitus and pre-diabetes. Dysglycemia if diagnosed early in the course of the disease can decrease complications. Treatment modalities in the form of surgery and medical therapy have varied impacts on glucose metabolism. Read More

Acta Neurochir (Wien) 2021 Apr 15. Epub 2021 Apr 15.

Division of Endocrinology, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland.

Background: Acromegaly is associated with various comorbidities, such as arterial hypertension (aHT), type 2 diabetes mellitus (DM2), obstructive sleep apnoea syndrome (OSAS), carpal tunnel syndrome (CTS) and polyposis coli. For therapeutic decisions, it is essential to know if, and to what extent, these associated morbidities are reversible or preventable. The aim of this study is to assess the prevalence and course of aHT, obesity, OSAS, CTS, DM2 and polyposis coli in acromegalic patients. Read More