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1. Irish endocrine society: Proceedings of the 19th annual meeting of the Irish endocrine society held at University College Hospital, Galway in October 1994

Author

Fearon, U., Clarke, D., McKenna, T. J., Cunningham, S. K., Morrison, P. J., Hughes, A. E., Nevin, N. C., Russell, C. F. J., Powell, D., Hadden, D. R., Bonar, B. D., Smith, D. F., Darke, C., Hetherton, A. M., Smyth, P. P. A., Hunter, S. J., Harper, R., Ennis, C. N., Crothers, E., Sheridan, B., Atkinson, A. B., Bell, P. M., Hayes, F., McKenna, T. J., Sheahan, K., McCabe, M., Conway, D. J., O’Higgins, N. J., Smyth, P. P. A., Garry, P., Laski, J., Brosnan, L., Collins, P., Devlin, J. G., Heaney, A. P., Atkinson, A. B., Curry, W. J, Johnston, C. F., Buchanan, K. D., Sheridan, B., Mirakhur, M., Fiad, T. M., Culliton, M., Cunningham, S. K., McKenna, T. J., Lynn, J. A., O’Shea, D. B., Meeran, M. K., Jackson, J. A., Bloom, S. R., Hunter, S. J., Ennis, C. N., Sheridan, B., Atkinson, A. B., Bell, P. M., Hayes, F., McKenna, T. J., Sheehan, K., Hayes, F., Heffernan, A., McKenna, T. J., Nugent, A. G., McGurk, C., Rutherford, R., Hayes, J. R., Johnson, G. D., Cusack, Y. A., O’Riordan, D., McDermott, E. W. M., O’Higgins, N. J., Smyth, P. P. A., Roche, E. F., McCormack, I., Tempany, E. T., Smyth, P. P. A., Smith, D. S., Deegan, P., Owens, D., Gilligan, S., Collins, P., Johnson, A., Tomkin, G. H., Heaney, A., Harper, R., Ennis, C., Sheridan, B., Atkinson, A. B., Bell, P. M., Wiggam, M. I., O’Kane, M. J., Harper, R., Atkinson, A. B., Hadden, D. R., Trimble, E. R., Bell, P. M., Dunne, F. P., Heath, D. A., Rollason, T., Ratcliffe, W. A., Marshall, T., Cronin, C. C., Barry, D. G., Crowley, B., Ferriss, J. B., Kinsley, B. T., Simonson, D. C., Jones, R., Owens, D., Collins, P., Johnson, A., Tomkin, G. H., Fiad, T. M., Culliton, M., Cunningham, S. K., McKenna, T. J., O’Shea, D. B., Lambert, P. D., Bloom, S. R., Herbert, J., O’Hare, J. A., Abuaisha, F., Razza, Q., Geoghegan, M., Barrett, E., Clarke, D., Fearon, U., Cunningham, S. K., and McKenna, T. J.

Published
1995
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2. Irish endocrine society: Proceedings of the 17th annual general meeting of the irish endocrine society held in Dublin on november 6th and 7th 1992.

Author

Bowie, A., Owens, D., Collins, P., Johnson, A., Tomkin, G. H., Barakat, M., Carson, D., Hetherton, A. M., Smyth, P., Leslie, H., Long, H. A., O’Herlihy, C., Smyth, P. P. A., Kirby, J., Fiad, T. M., Cunningham, S. K., McKenna, T. J., Devlin, J. G., Brosnan, E., Beatty, O. L., Harper, R., Sheridan, B., Atkinson, A. B., Bell, P. M., O’Hare, J. A., Abuaisha, F., Geoghegan, M., Brennan, G. M., Donnelly, J. P., McGrath, L. T., McVeigh, G. E., Johnston, G. D., Hayes, J. R., O’Brien, T., Nguyen, T. T., Kottke, B. A., Drury, R., Powell, D., Dundon, S., Hoey, H., Gill, D., Firth, R. G. H., Humphreys, M., Cronin, C. C., Barry, D. G., Ferriss, J. B., Freaney, R., NcBrinn, Y., McKenna, M. J., Dunne, F. P., Lee, S., Ratcliffe, W. A., Heath, D. A., Gleeson, C. M., Curry, W. J., Johnston, C. F., Buchanan, K. D., Hunter, S. J., Callender, M. E., Daughaday, W. H., McKnight, J. A., Mcllrath, E. M., Teale, J. D., Atkinson, A. B., Hayes, F., O’Brien, A., O’Brien, C., Fitzgerald, M. X., McKenna, M. J., Jones, R., Owens, D., Collins, P. B., Johnson, A. H., Tomkin, G. H., O’Meara, N. M., Blackman, J. D., Ehrmann, D. A., Rosenfield, R. L., Polonsky, K. S., Fiad, T. M., Culliton, M., Cunningham, S. K., Dunbar, J., and McKenna, T. J.

Published
1993
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3. Inaugural national scientific medical meeting

Author

Cooke, T. T., Sheahan, R., Foley, D., D’Arcy, G., Gibney, M., Jauch, W., Gearty, G., Crean, P., Walsh, M., Murchan, P. M., O’Donoghue, M. K., Marks, P., Leen, E. J., Shanik, G. D., Feely, T. M., O’Riordan, J., Kellett, J. G., Sheahan, N. F., MacMahon, M., Colgan, M., Walsh, J. B., .Shanik, G, Moore, R., Malone, J. F., Coakley, D., Subareddy, K., Hurley, J., McGovern, E., Sullivan, P. A., O’Mahony, S., Carroll, K., Chua, A., Keeling, R. W. N., O’Kane, A., Dinan, T., Collins, J. K., O’Sullivan, G., Hahnvajanawong, C., McCarthy, M., O’Brien, F., Collins, R. A., Beattie, S., Hamilton, H., O’Morain, C. A., Lynch, S., Murphy, A., Weir, D. G., Feighery, C., O’Farrelly, C., Kelleher, D., Murphy, D., O’Brien, M., Harte, P., Shahi, C. N., Fan, X. J., Huang, J., Smyth, C. J., McDevitt, J., Keeling, P. W. N., Cleary, M., Morrow, G., O’Loughlin, S., Murphy, G. M., Elder, G., Abouzakouk, M., Casey, E., Veale, D., Fitzgerald, O., Bradford, A., O’Regan, R. G., Nolan, P., McKeogh, D., Howell, F., O’Connor, C. M., Rook, G., FitzGerald, M. X., Power, C., Sreenan, S., Poulter, L. W., Burke, C. M., Shanahan, P., O’Donnell, N., Birthistle, K., O’Mahony, M., Shattock, A. G., Hillery, I. B., Bolger, C., Sheehan, N., Hutchinson, M., Phillips, J. P., Malone, J., Esmonde, T. F. G., Will, R. G., Faller, D., Ryan, M. P., Manning, B., Martin, F., McCormack, P. M. E., McGrath, A., Lawlor, R., Donegan, C., Boyce, C., O’Neill, D., Smith, S., Moloney, C., Feely, J., Stanton, A., Atkins, N., O’Brien, E., O’Malley, K., Gough, D. B., Jordan, A., Mannick, J. A., Rodrick, M. L., McCarthy, E., Cooney, C. M., Bourke, J., Phelan, D. M., Robertson, A. M., McShane, A. J., Buggy, D., Breathnach, A., Keogh, B., Coole†, T., Behan, P. O., Cavanagh, H. M. A., Gow, J. W., Simpson, K., Behan, W. M. H., Foley, M., Firth, R., Stronge, J., Bonnar, J., Sheppard, B. L., McClelland, R. J., Watson, D. R., Lawless, V., Houston, H. G., Adams, D., Fitzpatrick, C., Keary, K., Jennings, S., Matthews, T. G., Gormally, S., O’Regan, M., Ward, O. C., Kehoe, S., Luesley, D., Chan, K., Ward, K., Cox, M., Caird, J., Owens, D., Gilligan, S., McBrinn, S., Collins, P., Johnson, A., Tomkin, G., Fiad, T. M., Culliton, M., McKenna, T. J., Collins, P. B., Tomkin, G. H., Stinson, J. C., Clancy, L., Shannon, A., Lucey, M., Cooney, M., Stinson, J., Corcoran, P., Kelly, P., Hayes, C., Laffoy, M., McKnight, J. A., McCance, D. R., O’Hare, F., Wisdom, B., Hayes, J. R., Thornton, L., Fogarty, J., O’Flanagan, D., Corcoran, R., O’Mahony, D., Rowan, M., Clyne, M. G., Duffy, M. J., Davis, M., Kelly, D. G., Quinlan, D. M., Corbally, N., Keane, M. M., Grogan, L., Dervan, P. A., Carney, D. N., Duffy, K., Nugent, A., McDermott, E. W. M., O’Higgins, N. J., Fennelly, J. J., Atkinson, A. B., Ferrett, C. G., Leslie, H., Mcllrath, E. M., Ritchie, C. M., Russell, C. F. J., Sheridan, B., Bashyam, M., O’Sullivan, N., Baker, H., Duggan, P. F., Mitchell, T. H., Beatty, O., Browne, J., Clarke, K., Bell, P. M., Devlin, J. G., Laski, J., O’Neill, S., Redington, F., Dominique, A. V., Scanlan, P., Firth, R. G. R., Fiad, T., Freaney, R., Murray, B., McKenna, M. J., Murphy, J., Love, Wm. C., Cunningham, S. K., Crothers, J. G., McIlrath, E., Chiardha, F. Ni, Gebruers, E. M., Hall, W. J., Hegarty, D. A., O’Hare, J., Geoghegan, M., Abuaisha, F., Passmore, A. P., Whitehead, E. M., Crawford, V., Johnson, G. D., Gallagher, H. G., Stokes, M., Plank, L., Knight, G., Mitra, S., Hill, G., Buckley, P., O’Callaghan, E., Redmond, O., Stack, J. T., Ennis, J. T., Waddington, J. L., Larkin, C., Cannon, M., Byrne, M., Cotter, D., Sham, P., Colgan, K., Walsh, D., Gillian, A. M., Byrne, N., Breen, K. C., Lane, A., Mulvaney, F., Wadding-ton, J. L., Walsh, D., Lawlor, B. A., Colohan, H. A., Walshe, D., Gibson, T., Ronayne, E., Maguire, T. M., Staunton, H., Coughlin, A., Ming, P. Shu, Phillips, J., Youssef, H. A., Adebayo, G., Feely, G., Daly, S. A., Fennell, J. S., Coakley, F., Johnson, Z., Hall, M., McCormack, P. M., Martin, M., O’Connor, M., Curley, P., O’Connell, Y., Mulryan, G., Meenan, E., Kelly, J., Kilfeather, S., Cotter, T., McGlynn, H., Gharbháin, F. Ó, Chambers, P. L., Campbell, H., Stout, R. W., Hegarty, V., Scott, T., Keane, C. T., Healy, M., O’Moore, R. R., Coakley, D., Mulkerin, E., Brain, A., Hampton, D., Penney, M., Woodhouse, K., and Treacy, F.

Published
1993
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4. Irish endocrine society: 23rd annual meeting: Proceedings of meeting held at the Institute of Clinical Science, University College Hospital, Galway on November 13th and 14th, 1998

Author

Kokaly, W. J., McKenna, T. J., Kong, W. M., O’sShea, D., Alaghband-Zadeh, J., Jones, J., Carter, G., Smyth, P. P. A., O’Herlihy, C., Lazarus, J. H., Premawardhana, L. D. K. E., Parkes, A. B., Kularatna, C. S., Rees, A., Evans, J., Wijeyaratne, C., Da Silva, H., Gleeson, A., Anderton, K., Owens, D., Collins, P., Johnson, A., Collins, P., Tomkin, G. H., Smith, D., Finucane, F., McKenna, K., Finucane, J., Thompson, C. J., Phillips, J., McConnell, E. M., Atkinson, A. B., Ennis, C., McCance, D. R., Hadden, D. R., Sheridan, B., Bell, P. M., Suliman, A. M., Al-Saber, F., Hayes, F., Fiad, T., Culliton, M., Cunningham, S., McKenna, T. J., Smith, T. P., McKenna, T. J., Campbell, W., Johnston, C. F., Curry, W. J., Buchanan, K. D., Leary, A. C., Grealy, G., Higgins, T. M., Buckley, N., Barry, D. G., Ferriss, J. B., McNeill, K. M. S., Curry, W. J., Cunningham, R. T., Johnston, C. F., Buchanan, K. D., O’Hare, J. A., Burke, P., Grace, P., Murphy, E., Reynolds, J., Nolan, J. J., Chan, N. N., Darko, D., Jackson, A., Dhillo, W. S., O’Shea, D., Tomkin, G. H., Collins, P., Johnson, A., Owens, D., Kilbane, M. T., Ajjan, R. A., Weetman, A. P., Shering, S. G., McDermott, E. W. M., O’Higgins, N. J., Smyth, P. P. A., Johansson, ÁA. N., Johnston, C. F., Curry, W. J., Cunningham, R. T., Buchanan, K. D., O’Kane, D., Allen, J. D., Courtney, C. H, McAllister, A. S., McCance, D. R., Hadden, D. R., Atkinson, A. B., Sheridan, B., Kinsley, B. T., Smith, T., MacMahon, J., McKenna, T. J., McConnell, E. M., Atkinson, A. B., Bell, P. M., Hadden, D. R., McCance, D. R., Courtney, C. H, McAllister, A. S., McCance, D. R., Hadden, D. R., Atkinson, A. B., Leslie, H., Sheridan, B., Cannon, D., Powell, D., Kinsley, B. T., Smith, T., MacMahon, J., McKenna, T. J., Leslie, H., Sheridan, B., Courtney, C. H., Bell, P. M., McCance, D. R., Hadden, D. R., Atkinson, A. B., McSorley, P. T., Bell, P. M., Atkinson, A. B., Ennis, C. N., Sheridan, B., McCance, D. R., Young, I. S., and Fee, J. P. H.

Published
1998
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5. Irish endocrine society: Proceedings of 18th annual meeting held at Cork Regional Hospital, Wilton, Cork on November 5th & 6th, 1993

Author

Dimitriadis, E., Owens, D., Collins, P., Johnson, A., Tomkin, G., Cronin, C. C., Barry, D., Crowley, B., Ferriss, J. B., Hetherton, A. M., Smith, D. F., O’Herlihy, C., Smyth, P. P. A., Fiad, T. M., Culliton, M., Dunbar, J., Cunningham, S. K., McKenna, T. J., Heaney, A. P., Loughrey, G. L., McCance, D. R., Mcllrath, E., Hadden, D. R., Kennedy, L., Sheridan, B., Ferris, J. B., Whyte, A., Cleary, P. E., McAuley, D. J., Mathew, B., Bailey, I. C., Curtin, A., Lenehan, K., Deegan, P., Henry, M., Stapleton, M., Baker, H., Duggan, P. F., Mitchell, T. H., O’Hare, J. A., Geoghegan, M., Abuaisha, F., Fearon, U., Clarke, D., Roberts, R. N., Traub, A. I., Thompson, W., Whitehead, H., Holmes, J., Roberts, R., Al-Mandhari, N. A., Greer, A., Carson, D., Traub, T., Hadden, D., Heaney, A. P., Ferguson, T., Atkinson, A. B., O’Keeffe, S., Devlin, J. G., Donnellan, C., Russell, C. R., Kennedy, T. L., Kennedy, A. L., Atkinson, A. B., Long, H. A., Conway, D. J., Mercer, P. M., Murphy, D., Stokes, M., Sheahan, K., O’Higgins, N. J., Dunne, F. P., Ratcliffe, W. A., Mansour, P., Heath, D. A., O’Meara, N. M., Sturis, J., Herold, K. C., Polonsky, K. S., Beatty, O. L., Ritchie, C. M., Bell, P. M., Kennedy, A. L., Clarke, D., Fearon, U., Levy, J. C., Turkington, E., Hadden, D. W., Harper, R., Ennis, C. N., Johnston, G. D., Scanlan, P., Foley, M., Stronge, J., Firth, R., Hanson, R. L., Jacobsson, L. T. H., Bennett, P. H., Bishop, D. T., and Knowler, W. C.

Published
1994
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6. Irish endocrine society: Proceedings of the 16th Annual General Meeting held at the Ulster Hospital, Dundonald on November 1/2,1991

Author

Smyth, P. P. A., Lazarus, J. H., Parkes, A. B., Hetherton, A. M., Ndiaye, M., Devlin, J. G., Brosnan, E., Lee, P., Paton, C., Burke, C., Jenkins, A. J., Steele, J. S., Janus, E. D., Santamaria, J. D., Best, J. D., Beatty, O. L., Atkinson, A. B., Browne, J., Clarke, K., Sheridan, B., Bell, P. M., McCance, D. R., Russell, C. F. J., Kennedy, T. L., Hadden, D. R., Kennedy, L., Young, I. S., Torney, J. J., Trimble, E. R., Qiu, H. X., Zhang, S. H., Johnston, C. F., Buchanan, K. D., Cunningham, S. K., MKenna, T. J., Rooney, D. P., Neely, R. D. G., Cullen, C., Ennis, C. N., Trimble, E. R., McAteer, D. S., Mulholland, G., Ekeke, N., Fillmore, D., Ardill, J. E. S., Thompson, W., Cuny, W. J., Shaw, C., Harper, M. A., Murnaghan, G. A., Kennedy, L., O’Hare, J., Geoghegan, M., O’Herlihy, C., Ryan, R., Smyth, P. P. A., Dineen, S. F., Silverberg, J. D., Batts, K. P., Ballard, D. J., Rizza, R. A., Brennan, G. M., McVeigh, G. E., Johnston, G. D., McDermott, B. J., Hayes, J. R., Montwill, J., Fiad, T. M., and Culliton, M.

Published
1992
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7. Irish Endocrine Society: Proceedings of 15th Annual Meeting, University College Hospital Galway, November 2nd–3rd, 1990

Author

O’Connell, Y., McKenna, T. J., Cunningham, S. K., Morrison, P. J., Hadden, D. R., Hughes, A. E., Kennedy, L., Russell, C. F. J., Nevin, N. C., Brennan, D., Powell, D., Bell, P. M., Neely, R. D. G., Rooney, D. P., Ennis, C. N., Sheridan, B., Atkinson, A. B., Trimble, E. R., Whitehead, H. M., Kennedy, A. L., Scanlan, P., Dowling, M., Dervan, P., Corrigan, T., Heffeman, S., Firth, R., O’Hare, J., Abuaisha, B., Barrett, E., Smyth, P. P. A., Hetherton, A. M., Ryan, R., Herlihy, C. O., Smith, A., Montwill, J., McCance, D. R., Fannin, T. F., Gordon, D. S., Fiad, T. M., Golden, J., Rollins, M. D., Jenkins, J. G., Carson, D. J., McClure, B. G., Keenan, P., Cregan, D., Wade, B., Stinson, J. C., Tighe, O., Tyndall, P., Owens, D., Collins, P., Johnson, A., Tomkin, G. H., Neery, R. D. G., Ennis, K., Trimble, E., McKnight, J. A., Roberts, G., Dunne, F. P., Barry, D. G., Ferriss, J. B., Grealy, G., Murphy, D., Traub, A. I., Leslie, H., Atkinson, R. J., Grimes, H., and Skehill, R.

Published
1991
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9. Royal academy of medicine in Ireland section of medicine: Proceedings of registrar’s prize meeting held in the royal college of physicians, april 28th 1993.

Author

Sheahan, N., Chan, R., Hemeryck, L., Stinson, J., Clancy, L., Feely, J., Fiad, T. M., Culliton, M., Cunningham, S. K., Dunbar, J., McKenna, T. J., Liston, R., Deegan, P. C., McCreery, C., Costello, R., Maurer, B., McNicholas, W. T., Herity, N. A., McCarthy, J., Redmond, H. P., Bouchier-Hayes, D., Donnell, R. O, Gibson, G., O’Grady, T., Carmody, M., Donohoe, J., Walsh, J., Leader, M., Murphy, G. M., Abuaisha, F., Geoghegan, M., and O’Hare, J. A.

Published
1993
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11. Royal academy of medicine in Ireland section of medicine: Proceedings of case reports meeting held November 26th, 1992

Author

Goggins, M. G., Daly, P., Weir, D. G., Stinson, J. C., Gharabhain, F. O., Adebayo, G., Chambers, P. L., Feely, J., Liston, R., McNicholas, W. T., Fiad, T. M., McKenna, T. J., Mulherin, D., McCabe, M., FitzGerald, O., Mahmud, N., Jackson, F., Kelleher, D., Hayes, J. P., Ward, K., Muldowney, F., Fitzgerald, M. X., Maguire, C., MacMathuna, P., Sugrue, D., and Crowe, J.

Published
1993
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12. Cerebrospinal fluid rhinorrhoea in patients with pituitary adenoma treated medically

Author

Fiad, T M and McKenna, T J

Subjects
Adenoma, Adult, Male, Letter, Vision Disorders, Middle Aged, Combined Modality Therapy, Hypopituitarism, Humans, Female, Pituitary Neoplasms, Neoplasm Recurrence, Local, Aged, Follow-Up Studies, Hypophysectomy
Abstract

A consecutive series of 35 clinically non-secretory pituitary adenomas treated surgically by the transethmodial approach is presented. Mean age at presentation was 60 years, with a male-to-female ratio of 2:1. These tumours present later than hormone secreting tumours: 90% were over 2 cm in diameter at operation. Seventy-one per cent of patients had impaired vision and 89% had hypopituitarism. Surgical treatment relieved or significantly improved visual fields in 79% of patients with impaired vision. Ninety-one per cent required permanent hormone replacement. Mean follow-up was for 4.4 years. Five tumours recurred, causing recurrent visual symptoms. No tumours recurred in those patients treated with postoperative radiotherapy, but follow-up in this group was only for a mean of 2.7 years.

Published
1992

16. Irish endocrine society

Author

Fearon, U., primary, Clarke, D., additional, McKenna, T. J., additional, Cunningham, S. K., additional, Morrison, P. J., additional, Hughes, A. E., additional, Nevin, N. C., additional, Russell, C. F. J., additional, Powell, D., additional, Hadden, D. R., additional, Bonar, B. D., additional, Smith, D. F., additional, Darke, C., additional, Hetherton, A. M., additional, Smyth, P. P. A., additional, Hunter, S. J., additional, Harper, R., additional, Ennis, C. N., additional, Crothers, E., additional, Sheridan, B., additional, Atkinson, A. B., additional, Bell, P. M., additional, Hayes, F., additional, Sheahan, K., additional, McCabe, M., additional, Conway, D. J., additional, O’Higgins, N. J., additional, Garry, P., additional, Laski, J., additional, Brosnan, L., additional, Collins, P., additional, Devlin, J. G., additional, Heaney, A. P., additional, Curry, W. J, additional, Johnston, C. F., additional, Buchanan, K. D., additional, Mirakhur, M., additional, Fiad, T. M., additional, Culliton, M., additional, Lynn, J. A., additional, O’Shea, D. B., additional, Meeran, M. K., additional, Jackson, J. A., additional, Bloom, S. R., additional, Sheehan, K., additional, Heffernan, A., additional, Nugent, A. G., additional, McGurk, C., additional, Rutherford, R., additional, Hayes, J. R., additional, Johnson, G. D., additional, Cusack, Y. A., additional, O’Riordan, D., additional, McDermott, E. W. M., additional, Roche, E. F., additional, McCormack, I., additional, Tempany, E. T., additional, Smith, D. S., additional, Deegan, P., additional, Owens, D., additional, Gilligan, S., additional, Johnson, A., additional, Tomkin, G. H., additional, Heaney, A., additional, Ennis, C., additional, Wiggam, M. I., additional, O’Kane, M. J., additional, Trimble, E. R., additional, Dunne, F. P., additional, Heath, D. A., additional, Rollason, T., additional, Ratcliffe, W. A., additional, Marshall, T., additional, Cronin, C. C., additional, Barry, D. G., additional, Crowley, B., additional, Ferriss, J. B., additional, Kinsley, B. T., additional, Simonson, D. C., additional, Jones, R., additional, Lambert, P. D., additional, Herbert, J., additional, O’Hare, J. A., additional, Abuaisha, F., additional, Razza, Q., additional, Geoghegan, M., additional, Barrett, E., additional, and Fearon, U., additional

Published
1995
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19. Irish endocrine society

Author

Dimitriadis, E., primary, Owens, D., additional, Collins, P., additional, Johnson, A., additional, Tomkin, G., additional, Cronin, C. C., additional, Barry, D., additional, Crowley, B., additional, Ferriss, J. B., additional, Hetherton, A. M., additional, Smith, D. F., additional, O’Herlihy, C., additional, Smyth, P. P. A., additional, Fiad, T. M., additional, Culliton, M., additional, Dunbar, J., additional, Cunningham, S. K., additional, McKenna, T. J., additional, Heaney, A. P., additional, Loughrey, G. L., additional, McCance, D. R., additional, Mcllrath, E., additional, Hadden, D. R., additional, Kennedy, L., additional, Sheridan, B., additional, Ferris, J. B., additional, Whyte, A., additional, Cleary, P. E., additional, McAuley, D. J., additional, Mathew, B., additional, Bailey, I. C., additional, Curtin, A., additional, Lenehan, K., additional, Deegan, P., additional, Henry, M., additional, Stapleton, M., additional, Baker, H., additional, Duggan, P. F., additional, Mitchell, T. H., additional, O’Hare, J. A., additional, Geoghegan, M., additional, Abuaisha, F., additional, Fearon, U., additional, Clarke, D., additional, Roberts, R. N., additional, Traub, A. I., additional, Thompson, W., additional, Whitehead, H., additional, Holmes, J., additional, Roberts, R., additional, Al-Mandhari, N. A., additional, Greer, A., additional, Carson, D., additional, Traub, T., additional, Hadden, D., additional, Ferguson, T., additional, Atkinson, A. B., additional, O’Keeffe, S., additional, Devlin, J. G., additional, Donnellan, C., additional, Russell, C. R., additional, Kennedy, T. L., additional, Kennedy, A. L., additional, Long, H. A., additional, Conway, D. J., additional, Mercer, P. M., additional, Murphy, D., additional, Stokes, M., additional, Sheahan, K., additional, O’Higgins, N. J., additional, Dunne, F. P., additional, Ratcliffe, W. A., additional, Mansour, P., additional, Heath, D. A., additional, O’Meara, N. M., additional, Sturis, J., additional, Herold, K. C., additional, Polonsky, K. S., additional, Beatty, O. L., additional, Ritchie, C. M., additional, Bell, P. M., additional, Levy, J. C., additional, Turkington, E., additional, Hadden, D. W., additional, Harper, R., additional, Ennis, C. N., additional, Johnston, G. D., additional, Scanlan, P., additional, Foley, M., additional, Stronge, J., additional, Firth, R., additional, Hanson, R. L., additional, Jacobsson, L. T. H., additional, Bennett, P. H., additional, Bishop, D. T., additional, and Knowler, W. C., additional

Published
1994
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20. Irish endocrine society

Author

Bowie, A., primary, Owens, D., additional, Collins, P., additional, Johnson, A., additional, Tomkin, G. H., additional, Barakat, M., additional, Carson, D., additional, Hetherton, A. M., additional, Smyth, P., additional, Leslie, H., additional, Long, H. A., additional, O’Herlihy, C., additional, Smyth, P. P. A., additional, Kirby, J., additional, Fiad, T. M., additional, Cunningham, S. K., additional, McKenna, T. J., additional, Devlin, J. G., additional, Brosnan, E., additional, Beatty, O. L., additional, Harper, R., additional, Sheridan, B., additional, Atkinson, A. B., additional, Bell, P. M., additional, O’Hare, J. A., additional, Abuaisha, F., additional, Geoghegan, M., additional, Brennan, G. M., additional, Donnelly, J. P., additional, McGrath, L. T., additional, McVeigh, G. E., additional, Johnston, G. D., additional, Hayes, J. R., additional, O’Brien, T., additional, Nguyen, T. T., additional, Kottke, B. A., additional, Drury, R., additional, Powell, D., additional, Dundon, S., additional, Hoey, H., additional, Gill, D., additional, Firth, R. G. H., additional, Humphreys, M., additional, Cronin, C. C., additional, Barry, D. G., additional, Ferriss, J. B., additional, Freaney, R., additional, NcBrinn, Y., additional, McKenna, M. J., additional, Dunne, F. P., additional, Lee, S., additional, Ratcliffe, W. A., additional, Heath, D. A., additional, Gleeson, C. M., additional, Curry, W. J., additional, Johnston, C. F., additional, Buchanan, K. D., additional, Hunter, S. J., additional, Callender, M. E., additional, Daughaday, W. H., additional, McKnight, J. A., additional, Mcllrath, E. M., additional, Teale, J. D., additional, Hayes, F., additional, O’Brien, A., additional, O’Brien, C., additional, Fitzgerald, M. X., additional, Jones, R., additional, Collins, P. B., additional, Johnson, A. H., additional, O’Meara, N. M., additional, Blackman, J. D., additional, Ehrmann, D. A., additional, Rosenfield, R. L., additional, Polonsky, K. S., additional, Culliton, M., additional, and Dunbar, J., additional

Published
1993
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21. Irish endocrine society

Author

Smyth, P. P. A., primary, Lazarus, J. H., additional, Parkes, A. B., additional, Hetherton, A. M., additional, Ndiaye, M., additional, Devlin, J. G., additional, Brosnan, E., additional, Lee, P., additional, Paton, C., additional, Burke, C., additional, Jenkins, A. J., additional, Steele, J. S., additional, Janus, E. D., additional, Santamaria, J. D., additional, Best, J. D., additional, Beatty, O. L., additional, Atkinson, A. B., additional, Browne, J., additional, Clarke, K., additional, Sheridan, B., additional, Bell, P. M., additional, McCance, D. R., additional, Russell, C. F. J., additional, Kennedy, T. L., additional, Hadden, D. R., additional, Kennedy, L., additional, Young, I. S., additional, Torney, J. J., additional, Trimble, E. R., additional, Qiu, H. X., additional, Zhang, S. H., additional, Johnston, C. F., additional, Buchanan, K. D., additional, Cunningham, S. K., additional, MKenna, T. J., additional, Rooney, D. P., additional, Neely, R. D. G., additional, Cullen, C., additional, Ennis, C. N., additional, McAteer, D. S., additional, Mulholland, G., additional, Ekeke, N., additional, Fillmore, D., additional, Ardill, J. E. S., additional, Thompson, W., additional, Cuny, W. J., additional, Shaw, C., additional, Harper, M. A., additional, Murnaghan, G. A., additional, O’Hare, J., additional, Geoghegan, M., additional, O’Herlihy, C., additional, Ryan, R., additional, Smyth, P. P. A., additional, Dineen, S. F., additional, Silverberg, J. D., additional, Batts, K. P., additional, Ballard, D. J., additional, Rizza, R. A., additional, Brennan, G. M., additional, McVeigh, G. E., additional, Johnston, G. D., additional, McDermott, B. J., additional, Hayes, J. R., additional, Montwill, J., additional, Fiad, T. M., additional, and Culliton, M., additional

Published
1992
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22. Irish Endocrine Society

Author

O’Connell, Y., primary, McKenna, T. J., additional, Cunningham, S. K., additional, Morrison, P. J., additional, Hadden, D. R., additional, Hughes, A. E., additional, Kennedy, L., additional, Russell, C. F. J., additional, Nevin, N. C., additional, Brennan, D., additional, Powell, D., additional, Bell, P. M., additional, Neely, R. D. G., additional, Rooney, D. P., additional, Ennis, C. N., additional, Sheridan, B., additional, Atkinson, A. B., additional, Trimble, E. R., additional, Whitehead, H. M., additional, Kennedy, A. L., additional, Scanlan, P., additional, Dowling, M., additional, Dervan, P., additional, Corrigan, T., additional, Heffeman, S., additional, Firth, R., additional, O’Hare, J., additional, Abuaisha, B., additional, Barrett, E., additional, Smyth, P. P. A., additional, Hetherton, A. M., additional, Ryan, R., additional, Herlihy, C. O., additional, Smith, A., additional, Montwill, J., additional, McCance, D. R., additional, Fannin, T. F., additional, Gordon, D. S., additional, Fiad, T. M., additional, Golden, J., additional, Rollins, M. D., additional, Jenkins, J. G., additional, Carson, D. J., additional, McClure, B. G., additional, Keenan, P., additional, Cregan, D., additional, Wade, B., additional, Stinson, J. C., additional, Tighe, O., additional, Tyndall, P., additional, Owens, D., additional, Collins, P., additional, Johnson, A., additional, Tomkin, G. H., additional, Neery, R. D. G., additional, Ennis, K., additional, Trimble, E., additional, McKnight, J. A., additional, Roberts, G., additional, Dunne, F. P., additional, Barry, D. G., additional, Ferriss, J. B., additional, Grealy, G., additional, Murphy, D., additional, Traub, A. I., additional, Leslie, H., additional, Atkinson, R. J., additional, Grimes, H., additional, and Skehill, R., additional

Published
1991
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24. Cerebrospinal fluid rhinorrhoea in patients with pituitary adenoma treated medically.

Author

Fiad, T. M. and McKenna, T. J.

Subjects
LETTERS to the editor, ADENOMA, PATIENTS
Abstract

A letter to the editor is presented in response to an article about the development of cerebrospinal fluid rhinorrhoea in the postoperative period in patients with non-secretory pituitary adenomas in the March 1991 issue.

Published
1992

25. Experience of X-linked hypophosphatemic rickets in the Gulf Cooperation Council countries: case series.

Author

Al-Juraibah F, Al Shaikh A, Al-Sagheir A, Babiker A, Al Nuaimi A, Al Enezi A, Mikhail GS, Mundi HA, Penninckx HK, Mustafa H, Al Ameri M, Al-Dubayee M, Ali NS, Fawzy N, Al Shammari S, and Fiad T

Abstract

Summary: X-linked hypophosphatemic rickets (XLH), the most prevalent form of inherited hypophosphatemic rickets, is caused by loss-of-function mutations in the gene encoding phosphate-regulating endopeptidase homolog, X-linked (PHEX). This case series presents 14 cases of XLH from Gulf Cooperation Council (GCC) countries. The patients' medical history, biochemical and radiological investigative findings, as well as treatment responses and side effects from both conventional and burosumab therapy, are described. Cases were aged 2-40 years at diagnosis. There were two male cases and 12 female cases. All cases were treated with conventional therapy which resulted in a lack of improvement in or worsening of the clinical signs and symptoms of rickets or biochemical parameters. Side effects of conventional therapy included nausea, diarrhea, abdominal pain, nephrocalcinosis, and hyperparathyroidism, which affected the patients' quality of life and adherence to treatment. In the 10 patients treated with burosumab, there was a marked improvement in the biochemical markers of rickets, with a mean increase in serum phosphate of +0.56 mmol/L and tubular maximum phosphate reabsorption (TmP) to glomerular filtration rate (GFR) ratio (TmP/GFR) of +0.39 mmol/L at 12 months compared to baseline. Furthermore, a mean decrease in serum alkaline phosphatase (ALP) of -80.80 IU/L and parathyroid hormone (PTH) of -63.61 pmol/L at 12 months compared to baseline was observed in these patients. Additionally, patients treated with burosumab reported reduced pain, muscle weakness, and fatigue as well as the ability to lead more physically active lives with no significant side effects of treatment., Learning Points: Conventional therapy resulted in a suboptimal response, with a lack of improvement of clinical signs and symptoms. Side effects of conventional therapy included nausea, diarrhea, abdominal pain, nephrocalcinosis, and hyperparathyroidism, which affected the patients' quality of life and adherence to treatment. Burosumab demonstrated marked improvements in the biochemical markers of rickets, in addition to reducing pain, muscle weakness, and fatigue. There were no significant side effects associated with burosumab therapy.

Published
2024
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26. A Practical Approach to the Management of Residual Cardiovascular Risk: United Arab Emirates Expert Consensus Panel on the Evidence for Icosapent Ethyl and Omega-3 Fatty Acids.

Author

Sabbour H, Bhatt DL, Elhenawi Y, Aljaberi A, Bennani L, Fiad T, Hasan K, Hashmani S, Hijazi RA, Khan Z, and Shantouf R

Abstract

Purpose: Patients with hyperlipidemia treated with statins remain at a residual cardiovascular (CV) risk. Omega-3 polyunsaturated fatty acids hold the potential to mitigate the residual CV risk in statin-treated patients, with persistently elevated triglyceride (TG) levels., Method: We reviewed the current evidence on the use of icosapent ethyl (IPE), an omega-3 fatty acid yielding a pure form of eicosapentaenoic acid., Results: REDUCE-IT reported a significant 25% reduction in CV events, including the need for coronary revascularization, the risk of fatal/nonfatal myocardial infarction, stroke, hospitalization for unstable angina, and CV death in patients on IPE, unseen with other omega-3 fatty acids treatments. IPE was effective in all patients regardless of baseline CV risk enhancers (TG levels, type-2 diabetes status, weight status, prior revascularization, or renal function). Adverse events (atrial fibrillation/flutter) related to IPE have occurred mostly in patients with prior atrial fibrillation. Yet, the net clinical benefit largely exceeded potential risks. The combination with other omega-3 polyunsaturated fatty acids, in particular DHA, eliminated the effect of EPA alone, as reported in the STRENGTH and OMEMI trials. Adding IPE to statin treatment seems to be cost-effective, especially in the context of secondary prevention of CVD, decreasing CV event frequency and subsequently the use of healthcare resources., Conclusion: Importantly, IPE has been endorsed by 20 international medical societies as a statin add-on treatment in patients with dyslipidemia and high CV risk. Robust medical evidence supports IPE as a pillar in the management of dyslipidemia., (© 2024. The Author(s).)

Published
2024
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27. Granulomatous hypophysitis: rare disease with challenging diagnosis.

Author

Elgamal ME, Mohamed RMH, Fiad T, and Elgamal EA

Abstract

Granulomatous hypophysitis is rare pathology that mimics pituitary adenoma. Diagnosis is only confirmed by histopathology examination. Trans-sphenoidal surgery is considered diagnostic when descent tissue specimen is obtained and therapeutic by decompressing optic pathway and the sella. Pathological findings always reveal granulomatous areas, multinucleated giant cells, plasma cells, and lymphocytes.

Published
2017
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28. Hyperprolactinaemia: analysis of presentation, diagnosis and treatment in the endocrine service of a general hospital.

Author

Suliman AM, al-saber F, Hayes F, Fiad T, Culliton M, Cunningham S, and McKenna TJ

Subjects
Bromocriptine adverse effects, Combined Modality Therapy, Female, Hormone Antagonists adverse effects, Hospitals, Teaching, Humans, Magnetic Resonance Imaging, Male, Retrospective Studies, Tomography, X-Ray Computed, Treatment Outcome, Bromocriptine therapeutic use, Hormone Antagonists therapeutic use, Hyperprolactinemia diagnosis, Hyperprolactinemia etiology, Hyperprolactinemia therapy
Abstract

The charts of 184 patients with clinically significant hyperprolactinaemia who presented to a teaching hospital between 1978-1995 were reviewed, 158 (86%) females and 26 (14%) males. Hyperprolactinaemia was due to a microadenoma or was idiopathic in 36.4%, drug induced in 16%, associated with a macroadenoma in 12%, due to epilepsy in 7%, with other causes each contributing 5% or less. The presenting symptoms were amenorrhoea in 64%, galactorrhoea in 40.5%, infertility in 15%, visual field defect in 9%, with impotence in 30% and, gynaecomastia in 8% of men. One hundred and one patients were treated with bromocriptine (80%), surgery (35.4%) and radiotherapy (10.7%). Twenty-five percent of patients developed side-effects of bromocriptine for which cabergoline, a new long-lasting dopaminergic agonist, was successfully substituted. Presenting features responded to drug treatment in 70-80% of patients.

Published
2000

29. Gender difference in the response of growth hormone (GH)-deficient adults to GH therapy.

Author

Hayes FJ, Fiad TM, and McKenna TJ

Subjects
Adipose Tissue drug effects, Adipose Tissue metabolism, Adult, Blood Glucose metabolism, Body Composition drug effects, Body Water drug effects, Body Weight drug effects, Female, Glycated Hemoglobin metabolism, Growth Hormone adverse effects, Human Growth Hormone adverse effects, Human Growth Hormone deficiency, Humans, Insulin-Like Growth Factor I metabolism, Male, Sex Factors, Growth Hormone therapeutic use, Hormone Replacement Therapy adverse effects, Human Growth Hormone therapeutic use, Hypopituitarism drug therapy
Abstract

While individual hypopituitary patients undoubtedly benefit from growth hormone (GH) therapy, there is considerable variability in the response to treatment. Given the expense, possible lack of benefit, and potential risks associated with long-term therapy, we sought to identify characteristics potentially associated with a favorable response to GH replacement. Twelve GH-deficient adults (seven men and five women aged 35.4+/-2.5 years, mean +/- SEM) participated in a 12-month open study of GH replacement (0.125 IU/kg/wk for 4 weeks and 0.25 IU/kg/wk thereafter) designed to examine the impact of GH on body composition, lipid profile, and psychological well-being. Using bioelectrical impedance analysis (BIA), there was a reduction in body fat (BF) and an increase in lean body mass (LBM) and total body water (TBW) (P < .05) following 12 months of GH treatment. In addition, there was a significant improvement in psychological well-being as indicated by a decrease in the Nottingham Health Profile (NHP) score (P < .05) and a decrease in both total cholesterol (P = .005) and low-density lipoprotein (LDL) cholesterol (P < .03). GH therapy was associated with an increase in fasting plasma glucose (P = .008) and hemoglobin A1c (HbA1c (P = .06). When analyzed by gender, the beneficial effect of GH was greater in men versus women for the increment in insulin-like growth factor-1 ([IGF-1] 375+/-59 v 148+/-73 microg/L, mean +/- SEM), increase in LBM (6.8+/-2.5 v -0.06+/-1.6 kg), reduction in BF (5.6+/-1.6 v 1.0+/-1.9 kg), and increase in TBW (5.0+/-1.6 v 0.14+/-1.29 L) (P < .05). HbA1c increased significantly in women (P < .05). The beneficial effect of GH tended to be greatest in those with the most significant abnormality in baseline values (P < .05). The duration of hypopituitarism showed an indirect correlation with the change in total cholesterol (P < .005). Baseline IGF-1 levels correlated directly with changes in TBW (P < .05). These data indicate that men with GH deficiency appear more responsive to GH therapy than women with respect to the increase in IGF-1 levels and improvement in body composition. In general, patients with the most significant abnormality in baseline values, the highest IGF-1 levels, and the shortest duration of hypopituitarism respond best. With long-term GH therapy, careful monitoring of glucose tolerance is indicated.

Published
1999
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30. Decline in insulin-like growth factor I levels after clomiphene citrate does not correct hyperandrogenemia in polycystic ovary syndrome.

Author

Fiad TM, Smith TP, Cunningham SK, and McKenna TJ

Subjects
Adult, Case-Control Studies, Estrogens metabolism, Female, Gonadotropins metabolism, Humans, Polycystic Ovary Syndrome blood, Secretory Rate drug effects, Androgens metabolism, Clomiphene therapeutic use, Fertility Agents, Female therapeutic use, Insulin-Like Growth Factor I metabolism, Ovary metabolism, Polycystic Ovary Syndrome drug therapy
Abstract

It is widely accepted that the action of clomiphene citrate (CC) is mediated through its antiestrogenic properties on the hypothalamic-pituitary axis. Although insulin-like growth factor I (IGF-I) enhances the thecal cell response to LH, and estrogen treatment is associated with a reduction in IGF-I levels, CC is known to decrease circulatory IGF-I levels in polycystic ovary syndrome (PCOS) patients. The impact of lowering IGF-I levels on androgen levels in PCOS is unknown. This study was designed to examine the impact of CC treatment on the interrelationships of IGF-I, androgens, and estrogens in normal subjects and patients with PCOS. IGF-I, gonadotropin, androgen, estrogen, and sex hormone-binding globulin levels were measured in 8 PCOS patients and 10 normal subjects before and after treatment with the antiestrogen CC. Studies were performed in the early follicular phase, days 4-6 of the menstrual cycle in normal subjects. In normal subjects, CC treatment led to a significant increase in estradiol (84 +/- 10 to 234 +/- 62 pmol/L, untreated and CC treated; P < 0.05) and estrone (125 +/- 14 to 257 +/- 29 pmol/L; P < 0.05) levels with a significant lowering of IGF-I levels (297 +/- 25 to 230 +/- 17 micrograms/L; P < 0.05). Similarly, in PCOS patients a significant increase in estradiol (110 +/- 11 to 245 +/- 58 pmol/L; P < 0.05) and estrone (301 +/- 32 to 401 +/- 90 pmol/L; P < 0.05) levels and a significant lowering of IGF-I levels (330 +/- 43 to 214 +/- 27 micrograms/L; P < 0.05) were observed after CC treatment. However, no significant correlation was observed between changes in IGF-I and changes in estradiol in either group. Compared to pretreatment levels, no significant changes in the following parameters were observed after 5 days of CC treatment in either study group: testosterone, testosterone/sex hormone-binding globulin ratio, and androstenedione. The relationship among CC treatment, gonadotropin, estrogen, and IGF-I levels is complex. Changes in blood IGF-I levels are not associated with changes in androgen levels, although paracrine and or autocrine effects cannot be excluded.

Published
1998
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32. Role of progesterone deficiency in the development of luteinizing hormone and androgen abnormalities in polycystic ovary syndrome.

Author

Fiad TM, Cunningham SK, and McKenna TJ

Subjects
Cohort Studies, Female, Gonadotropins blood, Hirsutism etiology, Humans, Medroxyprogesterone Acetate therapeutic use, Polycystic Ovary Syndrome drug therapy, Progesterone Congeners therapeutic use, Prospective Studies, Reference Values, Androgens blood, Luteinizing Hormone blood, Polycystic Ovary Syndrome blood, Progesterone deficiency
Abstract

The aetiology of polycystic ovary syndrome (PCOS) is unknown. It is uniquely characterized by oligomenorrhoea or amenorrhoea associated with normal or high oestrogen levels. This prospective clinical study was designed to examine the possible role of the lack of cyclical exposure to progesterone in the development of gonadotrophin and androgen abnormalities in PCOS. Gonadotrophin, androgen and oestrogen levels were measured in 15 PCOS patients and 10 normal subjects untreated and following treatment with the progestogen medroxyprogesterone acetate (MPA). When compared to control subjects, PCOS patients had significantly higher luteinizing hormone (LH) pulse height, pulse amplitude, integrated LH levels, LH response to gonadotrophin-releasing hormone (GnRH) and LH/FSH ratio; LH pulse frequency was similar in the two groups. In addition, the testosterone/sex hormone binding globulin ratio (T/SHBG), androstenedione and oestrone concentrations in the plasma were significantly higher in PCOS than in control subjects. When PCOS patients were treated with MPA for 5 days, there were significant decreases (p < 0.02-0.001) to values no longer different from normal: from 8.7 +/- 1.2 to 5.6 +/- 0.8 IU/l for integrated LH levels (untreated and MPA-treated PCOS); from 31.2 +/- 3.5 to 12.9 +/- 1.5 IU/l for LH response to GnRH; from 2.4 +/- 0.26 to 1.3 +/- 0.2 for LH/FSH ratio; and from 10.4 +/- 0.63 to 8.5 +/- 0.7 nmol/l for androstenedione. Significant decreases (p < 0.05-0.005) to values that still remained significantly higher than in normal subjects occurred for: LH pulse height, 11.05 +/- 1.3 to 6.88 +/- 0.79 IU/l (untreated and MPA-treated PCOS); LH pulse amplitude, 2.8 +/- 0.5 to 1.8 +/- 0.2 IU/l; total testosterone, 2.5 +/- 0.2 to 2.0 +/- 0.2 nmol/l; T/SHBG ratio, 14.1 +/- 1.7 to 11 +/- 1.5; and oestrone, 265 +/- 24 to 208 +/- 29 pmol/l. These results are consistent with the concept that ovulation failure and progesterone deficiency play a facilitatory role in the development of the hypothalamic-pituitary abnormality giving rise to disordered LH secretion in PCOS.

Published
1996
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33. The overnight single-dose metyrapone test is a simple and reliable index of the hypothalamic-pituitary-adrenal axis.

Author

Fiad TM, Kirby JM, Cunningham SK, and McKenna TJ

Subjects
Adrenal Insufficiency physiopathology, Adrenocorticotropic Hormone, Cortodoxone blood, Humans, Hydrocortisone blood, Hypoglycemia physiopathology, Hypothalamo-Hypophyseal System physiopathology, Medical Audit, Metyrapone, Pituitary-Adrenal System physiopathology
Abstract

Objective: The ACTH stimulation test examines adrenal responsiveness but may not examine the entire hypothalamic-pituitary-adrenal (HPA) axis and requires parenteral administration. The cortisol response to hypoglycaemia provides an index of activity of the entire HPA axis but is demanding for patients and medical staff. The aim of the present study was to examine the performance of the overnight single-dose metyrapone test as it provides a simple alternative test for HPA axis function., Design: Audit of the overnight metyrapone test performed in one centre between 1979 and 1991., Patients: Three hundred and ninety-eight patients underwent 576 tests. Comparisons between the responses to metyrapone and the ACTH stimulation test and of the responses to metyrapone and insulin induced hypoglycaemia test were possible in 87 and 17 patients respectively., Measurements: Following the midnight administration of metyrapone tablets, 30 mg/kg orally, blood samples were obtained between 0800 and 0930 h for radioimmunoassay of both 11-deoxycortisol and cortisol., Results: Five hundred and seventy-six metyrapone tests were performed on 398 patients with no serious side-effects encountered. Adrenal insufficiency was diagnosed in 105 patients. Of these, 18 had a primary adrenal disorder and 87 had a disorder of the hypothalamic-pituitary unit. One hundred per cent concordance between the metyrapone, the ACTH and the hypoglycaemia test was seen in patients with primary adrenal insufficiency. In 19 patients with secondary adrenal insufficiency, who underwent both the metyrapone and the ACTH tests, discord between these two tests was observed in 10 patients (53%). Nine of these patients demonstrated a normal response to ACTH and a subnormal response to metyrapone. In only one patient was an abnormal cortisol response to ACTH associated with a normal response to metyrapone. In contrast, in 17 patients discord between the metyrapone and the hypoglycaemia test was seen in only 1 patient who demonstrated a normal response to the metyrapone test and a subnormal response to hypoglycaemia., Conclusion: Since the metyrapone test gives similar information about hypothalamic-pituitary axis function as does the hypoglycaemia test, we recommend the use of the overnight metyrapone test as a safe, simple and reliable index of the hypothalamic-pituitary axis integrity. The ACTH stimulation test should not be used for patients suspected of having secondary adrenal insufficiency.

Published
1994
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34. Meningitis as a late complication of surgically and medically treated pituitary adenoma.

Author

Fiad TM and McKenna TJ

Subjects
Adenoma drug therapy, Adenoma surgery, Adult, Bromocriptine therapeutic use, Female, Humans, Hypophysectomy adverse effects, Pituitary Gland diagnostic imaging, Pituitary Neoplasms diagnostic imaging, Pituitary Neoplasms drug therapy, Pituitary Neoplasms surgery, Sphenoid Sinus diagnostic imaging, Time Factors, Tomography, X-Ray Computed, Adenoma complications, Meningitis etiology, Pituitary Neoplasms complications
Abstract

Objective: To report meningitis occurring as a late complication of both medical and surgical treatment of pituitary tumour., Design: Two case reports., Patients: One patient developed meningitis 9 years after she underwent transsphenoidal hypophysectomy for Nelson's syndrome. The second patient developed rhinorrhoea while on treatment with bromocriptine for a prolactin-secreting pituitary adenoma and subsequently developed meningitis., Measurements: In Patient 1, CT scanning identified a small defect in the floor of the sella turcica. In Patient 2, CT scan examinations performed with a 3-year interval demonstrated marked shrinkage of a pituitary tumour which had invaded the sphenoid sinus so that the tumour no longer plugged the erosion., Results: Both patients experienced rhinorrhoea for over a year prior to the onset of meningitis. Both patients dismissed the occurrence of rhinorrhoea as insignificant and did not bring it to medical attention. In Patient 1, rhinorrhoea and presumably the entry site for pneumococaal infection was through a defect in the floor of the sella turcica consistent with transsphenoidal hypophysectomy performed 9 years previously. In Patient 2, rhinorrhoea and presumably entry of infection was facilitated by unplugging of a defect in the wall of the sphenoid sinus by bromocriptine-induced shrinkage of the pituitary adenoma., Conclusions: Meningitis can occur as a late complication of surgical or medical treatment of pituitary tumours. This may be preceded by rhinorrhoea which should be regularly enquired for as the symptom may not prompt patients to disclose its presence spontaneously. These reports document only the third occurrence of meningitis as a late complication of transsphenoidal hypophysectomy and the first occurrence of meningitis as a consequence of treatment of a pituitary tumour with bromocriptine.

Published
1991
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