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Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nephrotic syndrome is a clinical syndrome characterized by massive proteinuria, called nephrotic range proteinuria (over 3.5 g per day in adults or 40 mg/m2 per hour in children), hypoalbuminemia, oncotic edema, and hyperlipidemia, with an increasing incidence over several years. Nephrotic syndrome carries severe morbidity and mortality risk. The main pathophysiological event in nephrotic syndrome is increased glomerular permeability due to immunological, paraneoplastic, genetic, or infective triggers. Because of the marked increase in the glomerular permeability to macromolecules and the associated urinary loss of albumins and hormone-binding proteins, many metabolic and endocrine abnormalities are present. Some of them are well known, such as overt or subclinical hypothyroidism, growth hormone depletion, lack of testosterone, vitamin D, and calcium deficiency. The exact prevalence of these disorders is unknown because of the complexity of the human endocrine system and the differences in their prevalence. This review aims to comprehensively analyze all potential endocrine and hormonal complications of nephrotic syndrome and, vice versa, possible kidney complications of endocrine diseases that might remain unrecognized in everyday clinical practice. [ABSTRACT FROM AUTHOR]

In the UK approximately 1000 new patients are diagnosed with a pituitary tumour every year. Although a predominantly benign condition, untreated it can lead to visual compromise and become complicated by endocrine effects of hypersecretion or hypopituitarism, resulting in significant morbidity and mortality. This article provides an overview of the presentation and management of pituitary tumours. [ABSTRACT FROM AUTHOR]

Abstract Serotonin [5‐hydroxytryptamine (5‐HT)] modulates ovarian function. The precursor of 5‐HT, 5‐hydroxytryptophan (5‐HTP), has been used to treat depression. However, the effects of 5‐HTP on ovarian and reproductive physiology remain unknown. In this research, we analysed the impact of 5‐HTP on the monoaminergic system and its interactions with the reproductive axis and ovarian estradiol secretion when administered by distinct routes. Female rats 30 days of age were injected with 5‐HTP i.p. (100 mg/kg), into the ovarian bursa (1.5 µg/40 µL) or into the median raphe nucleus (20 µg/2.5 µL) and were killed 60 or 120 min after injection. As controls, we used rats of the same age injected with vehicle (0.9% NaCl). Monoamine, gonadotrophin and steroid ovarian hormone concentrations were measured. The injection of 5‐HTP either i.p. or directly into the ovarian bursa increased the concentrations of 5‐HT and the metabolite 5‐hydroxyindole‐3‐acetic acid in the ovary. For both routes of administration, the serum concentration of estradiol increased. After i.p. injection of 5‐HTP, the concentrations of luteinizing hormone were decreased and follicle‐stimulating hormone increased after 120 min. Micro‐injection of 5‐HTP into the median raphe nucleus increased the concentrations of 5‐HT in the anterior hypothalamus and dopamine in the medial hypothalamus after 120 min. Our results suggest that the administration of 5‐HTP either i.p. or directly into the ovarian bursa enhances ovarian estradiol secretion.

Serotonin [5‐hydroxytryptamine (5‐HT)] modulates ovarian function. The precursor of 5‐HT, 5‐hydroxytryptophan (5‐HTP), has been used to treat depression. However, the effects of 5‐HTP on ovarian and reproductive physiology remain unknown. In this research, we analysed the impact of 5‐HTP on the monoaminergic system and its interactions with the reproductive axis and ovarian estradiol secretion when administered by distinct routes. Female rats 30 days of age were injected with 5‐HTP i.p. (100 mg/kg), into the ovarian bursa (1.5 µg/40 µL) or into the median raphe nucleus (20 µg/2.5 µL) and were killed 60 or 120 min after injection. As controls, we used rats of the same age injected with vehicle (0.9% NaCl). Monoamine, gonadotrophin and steroid ovarian hormone concentrations were measured. The injection of 5‐HTP either i.p. or directly into the ovarian bursa increased the concentrations of 5‐HT and the metabolite 5‐hydroxyindole‐3‐acetic acid in the ovary. For both routes of administration, the serum concentration of estradiol increased. After i.p. injection of 5‐HTP, the concentrations of luteinizing hormone were decreased and follicle‐stimulating hormone increased after 120 min. Micro‐injection of 5‐HTP into the median raphe nucleus increased the concentrations of 5‐HT in the anterior hypothalamus and dopamine in the medial hypothalamus after 120 min. Our results suggest that the administration of 5‐HTP either i.p. or directly into the ovarian bursa enhances ovarian estradiol secretion. What is the central question of this study?Does the route of administration of 5‐hydroxytryptophan affect the synthesis of steroid sex hormones in prepubertal female rats?What is the main finding and its importance?The injection of 5‐hydroxytryptophan either i.p. or directly into the ovarian bursa in prepubertal female rats stimulated the serotoninergic system of the reproductive axis. In turn, this increased the secretion of estradiol, a gonadal hormone that regulates sexual maturation and several physiological processes in females. [ABSTRACT FROM AUTHOR]

Nephrotic syndrome is a clinical syndrome characterized by massive proteinuria, called nephrotic range proteinuria (over 3.5 g per day in adults or 40 mg/m2 per hour in children), hypoalbuminemia, oncotic edema, and hyperlipidemia, with an increasing incidence over several years. Nephrotic syndrome carries severe morbidity and mortality risk. The main pathophysiological event in nephrotic syndrome is increased glomerular permeability due to immunological, paraneoplastic, genetic, or infective triggers. Because of the marked increase in the glomerular permeability to macromolecules and the associated urinary loss of albumins and hormone-binding proteins, many metabolic and endocrine abnormalities are present. Some of them are well known, such as overt or subclinical hypothyroidism, growth hormone depletion, lack of testosterone, vitamin D, and calcium deficiency. The exact prevalence of these disorders is unknown because of the complexity of the human endocrine system and the differences in their prevalence. This review aims to comprehensively analyze all potential endocrine and hormonal complications of nephrotic syndrome and, vice versa, possible kidney complications of endocrine diseases that might remain unrecognized in everyday clinical practice.

Objective: Craniopharyngiomas are tumors derived from the remains of epithelial cells that are attributed to incomplete closure of the pituitary or cricopharyngeal ducts. Although the tumor is considered benign, it has significant complications at diagnosis and following full resolution. The present study aimed to determine the prevalence and predictive factors of diabetes insipidus (DI) shortly after craniopharyngioma surgery. Methods: This study was retrospectively performed on 46 patients suffering from craniopharyngioma referred to Loghman Hakim Hospital sparing from 2011 to 2016. In patients with magnetic resonance imaging (MRI) and computerized tomography (CT) scans, endocrinology tests, other related tests, and complete neuromuscular examinations were performed before and after surgery. All patient information was collected descriptively according to their case, and quantitative data are displayed using mean, Standard Deviation, intermediate, and Interquartile range, and qualitative data are displayed using frequency and percentage. For analytical analysis, the data were calculated from independent samples t, Mann-Whitney statistical tests, K2 test, and, if necessary, Fisher's precise P-Value. A significant level was considered for the 5 % statistical tests, and the SPSS statistical software version 25 was used to analyze the data. Results: Most patients were male (58 %), and the mean age of patients was 33 years, the youngest being 5 years and the oldest being 71 years. Patients' symptoms at the time of referral include visual impairment (58 %), headache (56 %), balance disorder 19 %, nausea and vomiting 13 %, and memory impairment (8 %). The prevalence of DI was reported to be 50 % after surgery, significantly associated with tumor size. No other significant association was found between the plurality of DI after surgery and other variables studied. Conclusions: The present study showed no predictive factor for post-operative DI in patients with craniopharyngioma. It can only be concluded that patients with larger tumor sizes are more likely to develop DI; however, more studies are warranted to achieve a definitive conclusion.

Since the advent of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, an increased incidence of several endocrinological anomalies in acute-phase and/or long-term complications has been described. The aim of this review is to provide a broad overview of the available literature regarding changes in the worldwide epidemiology of endocrinological involvement in children since December 2019 and to report the evidence supporting its association with coronavirus disease 2019 (COVID-19). Although little is known regarding the involvement of endocrine organs during COVID-19 in children, the current evidence in adults and epidemiological studies on the pediatric population suggest the presence of a causal association between the virus and endocrinopathies. Untreated transient thyroid dysfunction, sick euthyroid syndrome, nonthyroidal illness syndrome, and hypothalamic–pituitary–adrenal (HPA) axis and central precocious puberty have been observed in children in acute infection and/or during multisystem inflammatory syndrome development. Furthermore, a higher frequency of ketoacidosis at onset in children with a new diagnosis of type 1 diabetes is reported in the literature. Although the direct association between COVID-19 and endocrinological involvement has not been confirmed yet, data on the development of different endocrinopathies in children, both during acute infection and as a result of its long-term complications, have been reported. This information is of primary importance to guide the management of patients with previous or current COVID-19. [ABSTRACT FROM AUTHOR]

Post-traumatic hypopituitarism (PTHP), described for the first time in 1918, used to be neglected and only considered a rare consequence of traumatic brain injury (TBI). The research conducted in the past 20 years, however, elucidated that it has been significantly underestimated. A PubMed search was conducted in order to find literature on the topic of PTHP. Efforts were made to identify the wide point of view on this problem, from the historical perspective to the most recent data. The pathogenesis of PTHP is heterogenous, and various hypotheses concerning the etiology of this condition have been proposed. Unrecognized and untreated PTHP has negative socioeconomic consequences and influences the quality of life. Although a few attempts to create a screening algorithm have already been performed, there is still no clear answer regarding follow-up. The prevalence of PTHP, a rare consequence of TBI, has been significantly underestimated in the past 20 years. The issue is multifaceted so in order to make reliable guidelines a collaboration of specialists from different fields is required. Due to the increasing prevalence of TBI, and because patients after initial treatment at emergency department usually remain under control of a neurologist, both neurologists and emergency medicine specialists should be aware of clinical picture and mechanisms of PTHP. [ABSTRACT FROM AUTHOR]

Although pituitary adenomas and meningiomas are among the commonly encountered benign tumors, the co-existence of these tumors is rare. One of the most important complications of pituitary adenomas is the development of apoplexy, often resulting in death if left untreated. In this article, we present a patient admitted to the emergency department with complaints of sudden-onset headache, nausea, vomiting, and optic nerve paralysis. On examination, the case was found to have parietal lobe meningioma and pituitary adenoma. Therefore, the case underwent emergent transsphenoidal surgery considering pituitary apoplexy and was treated with l-thyroxine and hydrocortisone in the post-operative period. Although the co-existence of a pituitary adenoma and a meningioma is known in the literature, such a co-existence with apoplexy is the first case to be described in the literature.

Simple Summary: The pituitary gland is crucial in regulating metabolic processes. Tumors in this gland can be subtle, meaning that establishing reference values for the pituitary dimensions is pivotal. Computed tomography is commonly used to identify pituitary alterations, plan surgery or radiation therapy, and monitor treatment responses. This study aimed to determine the normal pituitary size, and the pituitary-to-brain ratio, in a group of domestic short-haired cats by computed tomography. The study also aimed to explore the correlations between body weight, age, sex, and pituitary dimensions, and assess the inter- and intra-agreement between operators in measuring pituitary dimensions. The study showed that the normal range for pituitary dimensions is wider than previously reported. The study also showed a low correlation between body weight, age, and pituitary dimensions. The intra-operator agreement in measuring pituitary dimensions was good/excellent, but the inter-operator agreement was moderate/good, likely due to differences in expertise. The reference values obtained from this study could help in better evaluating the pituitary gland in domestic short-haired cats with suspected pituitary neoplastic lesions. The detection of subtle changes in the pituitary dimensions has relevant clinical implications. In cats, a few studies have established the cut-off values of the pituitary gland's dimensions using small and inhomogeneous samples. The aims of this study were: to determine by computed tomography (CT) the pituitary linear dimensions and the pituitary-to-brain (P:B) ratio in a sample of domestic short-haired (DSH) cats; to assess the effects of sex, age, and weight on pituitary dimensions; and to evaluate the inter- and intra-observer agreement for such measurements. All skull CTs of DSH cats performed over four years using a multidetector CT and a standardized protocol were retrospectively reviewed. The exclusion criteria were: clinical, laboratory, or CT alterations of the pituitary gland, brain diseases, fractures of the neurocranium, and diabetes. The pituitary dimensions and brain area were assessed by two different observers using multiplanar reconstructions and automated segmentation tools. Fifty-one cats were included in the final sample. The intraclass correlation coefficients for intra- and inter-observer reliability were good/excellent, and moderate/good, respectively. No differences between sexes were detected, and negligible correlations were found between age and weight. According to this study, a pituitary gland with a height > 4 mm or a P:B ratio > 0.49 mm should be considered enlarged. [ABSTRACT FROM AUTHOR]

Primary intracranial germ cell tumors are rare, often affecting children and young patients. Germinomas are the most common type of germ cell tumors. We present the case of a 10-year-old child, who was admitted with decreased visual acuity, asthenia, polyuro-polydipsic syndrome, and gait disorder. His biological assessment showed an hypocortisolemia and diabetes insipidus. Imaging found a bifocal process in the suprasellar and pineal region, suggestive of a bifocal germinoma. Imaging data and the positivity of human chorionic gonadotrophin in the cerebrospinal fluid were in favor of the diagnosis of bifocal germinal tumor confirmed by biopsy. Currently the patient is hospitalized in pediatric oncology department.The diagnosis of germ cell tumors is based on imaging, tumor marker assays, and biopsy. They are treated by radiation therapy alone or in combination with reduction chemotherapy, and surgery for tumor residues. The location of the tumor usually makes surgery difficult.

Immune checkpoint inhibitors (ICIs) are widely used for various types of advanced cancers. Currently, three types of ICIs are clinically available, a monoclonal antibody targeting cytotoxic T-lymphocyteassociated antigen 4 (CTLA-4), and antibodies targeting the programmed cell death protein-1 (PD-1) and its ligand, programmed cell death ligand 1 (PD-L1). Although ICIs have improved the survival rates of several types of cancers, they induce immune-related adverse events (irAE) by their enhancement of immune responses. The pituitary gland is one of the common targets of irAE. In general, different clinical presentations of autoimmune pituitary dysfunctions are observed between anti-CTLA-4 and anti-PD-1/anti-PD-L1 antibodies, with anti-CTLA-4 inducing hypophysitis with multiple pituitary hormone deficiencies and targeting the PD-1/PD-L1 axis inducing isolated adrenocorticotropic hormone deficiency. This review describes the current understanding of the pathophysiology, clinical manifestation, and management of hypophysitis caused by ICIs. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI) is often the first modality of choice in the detection of pituitary pathologies due to its excellent contrast resolution and high spatial resolution. However, evaluating the size of the pituitary gland is somewhat difficult since the gland morphology varies widely among individuals. Objective: The aim of this study was to provide normal reference values for pituitary volumes in the pediatric population using three-dimensional (3-D) MRI data. We also aimed to compare the volumetric data measured through 3-D images with the mathematical volumes obtained by the ellipsoid formula from 2-D images, considering the demographic subgroups of age and sex. Materials and methods: This study was performed retrospectively using PACS-archived brain MRIs obtained in the Pediatric Radiology Unit. Eight hundred children under the age of 18 who underwent brain MRI between January 2014 and May 2018 for headaches, seizures or trauma and who had no brain anomaly or endocrine pathology were recruited. Pituitary volumes were separately calculated from those brain MRIs by means of ellipsoid formula and volumetry. The mean, standard deviation, maximum and minimum and median values were achieved for each 1-year age group in both sexes. Normal reference ranges containing 5th -10th -25th -50th -75th -90th -95th percentiles of volumetric pituitary values were tabulated. Results: Pituitary gland volumes in both sexes were found to increase gradually with age. The average 3-D volume values were greater in girls than boys except for the age groups 1–2 years and 8–9 years. Pituitary volumes showed a growth spurt during early puberty, which was more prominent in girls. Moreover, a strong positive correlation was noted between the 2-D calculated and 3-D measured volumes in both sexes. Conclusion: Normative data obtained through this study can be used for clinical diagnostic purposes as well as a reference for future research. The 2-D calculated volumes be used where it is not possible to obtain 3-D volumetric values. [ABSTRACT FROM AUTHOR]

The paper presents data about the artificial reproduction of the H. molitrix species. The artificial reproduction took place in the station destined to the reproduction of the phytoplanktonophag fish of the Carja 1 fish farm – Vaslui. The annual batch of breeders came from the personal stock of the Carja 1 farm.The experimental work took place between 2005-2007, following the work methodology and the phases of the technological process. The stimulation of the maturation was done with neristin and carp hypophysis, watching through comparison the technological indicators specific to the artificial reproduction.The results of the experiments are presented in tables and in graphs.

Objective(s): Most male patients with type 2 diabetes mellitus (T2DM) experience infertility. It is well established that regular physical activity could alleviate diabetic infertility symptoms. This study was designed to determine the effect of voluntary exercise on sperm malformation. Materials and Methods: Thirty-two male Wistar rats were randomly divided into control (C), diabetic (D), voluntary exercise (Ex), and diabetic-voluntary exercise (D-Ex) groups. Diabetes was induced by an intraperitoneal injection of streptozotocin (35 mg/kg) followed by a high-fat diet for four weeks. Voluntary exercise was performed by placing the animals in the rotary wheel cages for ten weeks. Sperm malformations were analyzed. Moreover, the hypothalamic leptin, kisspeptin, kisspeptin receptors (KissR), as well as plasma LH, FSH, testosterone, and leptin levels were evaluated. Results: Results showed that induction of T2DM caused increased sperm malformation, plasma, and hypothalamic leptin as well as decreased hypothalamic kisspeptin, KissR, and plasma LH levels compared with the C group (P

Context: Involvement of the pituitary gland in SARS-CoV-2 infection has been clinically suggested by pituitary hormone deficiency in severe COVID-19 cases, by altered serum adrenocorticotropic hormone (ACTH) levels in hospitalized patients, and by cases of pituitary apoplexy. However, the direct viral infection of the gland has not been investigated. Objective: To evaluate whether the SARS-CoV-2 genome and antigens could be present in pituitary glands of lethal cases of COVID-19, and to assess possible changes in the expression of immune-related and pituitary-specific genes. Methods: SARS-CoV-2 genome and antigens were searched in the pituitary gland of 23 patients who died from COVID-19 and, as controls, in 12 subjects who died from trauma or sudden cardiac death. Real-time reverse transcription polymerase chain reaction (PCR), in situ hybridization, immunohistochemistry, and transmission electron microscopy were utilized. Levels of mRNA transcripts of immune-related and pituitaryspecific genes were measured by the nCounter assay. Results: The SARS-CoV-2 genome and antigens were detected in 14/23 (61%) pituitary glands of the COVID-19 group, not in controls. In SARSCoV-2–positive pituitaries, the viral genome was consistently detected by PCR in the adeno- and the neurohypophysis. Immunohistochemistry, in situ hybridization, and transmission electron microscopy confirmed the presence of SARS-CoV-2 in the pituitary. Activation of type I interferon signaling and enhanced levels of neutrophil and cytotoxic cell scores were found in virus-positive glands. mRNA transcripts of pituitary hormones and pituitary developmental/regulatory genes were suppressed in all COVID-19 cases irrespective of virus positivity. Conclusion: Our study supports the tropism of SARS-CoV-2 for human pituitary and encourages exploration of pituitary dysfunction after COVID-19. [ABSTRACT FROM AUTHOR]

Copyright of Biologie Aujourd'hui is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This case report describes for the first time the cytologic characteristics of a hormonally secreting pituitary adenoma in a cat. An 8-year-old female spayed domestic long-haired cat was referred with a previous diagnosis of hypersomatotropism and secondary diabetes mellitus 7 months prior. Clinical signs included weight loss, polyphagia, polyuria, and polydipsia. Serum insulin-like growth factor-1 was 340 nmol/L (RI: 12-92), and CT scan revealed a hypophyseal mass, and a presumptive diagnosis of acromegaly was made. A transsphenoidal hypophysectomy was performed. A fragment of the pituitary gland was subjected to a squash preparation and cytology revealed a neuroendocrine neoplasm characterized by anisokaryosis and prominent nucleoli. Additional cytologic findings included cell cohesiveness, indistinct cytoplasmic borders, nuclear crowding, molding, and fragmentation. A diagnosis of adenoma was based on a lack of histopathologic or imaging evidence of invasion. A week later, during post-surgical hospitalization, the patient worsened and died. Histopathology from a necropsy procedure revealed fibrinosuppurative meningitis as a post-surgical complication. Pituitary adenomas might have an aggressive cytologic appearance, despite a lack of histopathologic invasion or dissemination.

The detection of subtle changes in the pituitary dimensions has relevant clinical implications. In cats, a few studies have established the cut-off values of the pituitary gland’s dimensions using small and inhomogeneous samples. The aims of this study were: to determine by computed tomography (CT) the pituitary linear dimensions and the pituitary-to-brain (P:B) ratio in a sample of domestic short-haired (DSH) cats; to assess the effects of sex, age, and weight on pituitary dimensions; and to evaluate the inter- and intra-observer agreement for such measurements. All skull CTs of DSH cats performed over four years using a multidetector CT and a standardized protocol were retrospectively reviewed. The exclusion criteria were: clinical, laboratory, or CT alterations of the pituitary gland, brain diseases, fractures of the neurocranium, and diabetes. The pituitary dimensions and brain area were assessed by two different observers using multiplanar reconstructions and automated segmentation tools. Fifty-one cats were included in the final sample. The intraclass correlation coefficients for intra- and inter-observer reliability were good/excellent, and moderate/good, respectively. No differences between sexes were detected, and negligible correlations were found between age and weight. According to this study, a pituitary gland with a height > 4 mm or a P:B ratio > 0.49 mm should be considered enlarged.

• Longitudinal study tracking pituitary height on routine follow-up MRI scans of pediatric brain tumors. • Cranial irradiation reduces pituitary height in children, evident within two years. • Pituitary height was a predictor of endocrine deficiencies ten years after diagnosis. • The expected effects of age, gender, and pubertal status on pituitary height were diminished ten years after diagnosis. Multiple studies demonstrated hypothalamic–pituitary dysfunction in survivors of pediatric brain tumors. However, few studies investigated the trajectories of pituitary height in these patients and their associations with pituitary function. We aimed to evaluate longitudinal changes of pituitary height in children and adolescents with brain tumors, and their association with endocrine deficiencies. We conducted a retrospective analysis of 193 pediatric patients (54.9% male) diagnosed with brain tumors from 2002 to 2018, with a minimum of two years of radiological follow-up. Pituitary height was measured using MRI scans at diagnosis and at 2, 5, and 10 years post-diagnosis, with clinical data sourced from patient charts. Average age at diagnosis was 7.6 ± 4.5 years, with a follow-up of 6.1 ± 3.4 years. 52.8% underwent radiotherapy and 37.8% experienced pituitary hormone deficiency. Radiation treatment was a significant predictor of decreased pituitary height at all observed time points (p = 0.016, p < 0.001, p = 0.008, respectively). Additionally, chemotherapy (p = 0.004) or radiotherapy (p = 0.022) history and pituitary height at 10 years (p = 0.047) were predictors of endocrine deficiencies. ANOVA revealed an expected increase in pituitary height over time in pediatric patients, but this growth was significantly impacted by radiation treatment and gender (p for interaction = 0.005 and 0.025, respectively). Cranial irradiation in pediatric patients is associated with impairment of the physiologic increase in pituitary size; in turn, decreased pituitary height is associated with endocrine dysfunction. We suggest that pituitary gland should be evaluated on surveillance imaging of pediatric brain tumor survivors, and if small for age, clinical endocrine evaluation should be pursued. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the expression of pituitary gonadotropin genes between three populations of native birds in Iran and Hyline W-36. One hundred and twenty-eight 37-week-old chickens (Golpayegan, Marandi, Isfahan, and Hyline W-36) were studied for 12 weeks. All birds were reared in the same cage system and under similar nutritional and managerial conditions. Quantitative characteristics such as egg number, egg weight, egg production percentage, egg mass, feed intake, and feed conversion ratio were calculated. At the end of the trial, five hens in each group were slaughtered after weighing, and their heads, livers, ovaries, and oviducts were removed. The gene expression of LH and FSH was determined by reverse transcription-polymerase chain reaction (RT-PCR), after RNA extraction from the pituitary gland. The results showed that Hyline W-36 had the highest egg number, egg weight, percentage of egg production, and egg mass. The feed conversion ratio was the highest in the Marandi, but the lowest was observed in the Hyline W-36. Expression of the FSH gene in Hyline W-36 was higher than in other groups. A positive and significant correlation was observed between the expression of the pituitary gland FSH gene, egg mass, and relative ovarian weight. The difference in production performance of various genetic populations seems to be mainly due to the differential expression of the FSH gene in the pituitary gland. Therefore, for genetic enhancement programs in native chicken, these results may help identify the metabolic pathways of gonadotropins gene expression, their effects on the ovaries, and reproductive activity. [ABSTRACT FROM AUTHOR]

Transcranial color‐coded duplex sonography (TCCS) allows to study intracranial vessels through the intact skull, but the visualization of normal and pathologic brain structures in adults is often suboptimal due to inadequate acoustic window. The full potential of TCCS for clinical practice remains unfulfilled. Here, we describe the ability of TCCS to detect a non‐functioning pituitary macroadenoma in a 58‐year‐old man affected by headache. The macroadenoma was visualized as a roundish, well‐defined mass, mildly hyperechogenic compared to the hypoechogenic mesencephalic brainstem but mainly hypoechogenic compared to the surrounding intracranial structures. Intracranial vessels represented useful landmarks. Using tissue harmonic imaging mode, the borders of the macroadenoma were visualized more clearly. Macroadenoma characteristics were confirmed by magnetic resonance imaging. Neurosonologists should be aware of the possibility to incidentally find, during routinary TCCS, pituitary macroadenomas or other brain tumors (as incidentalomas), worthy to be recognized and referred for further investigations. [ABSTRACT FROM AUTHOR]

Background: Testicular injury is one of the most serious problems associated with diabetes mellitus. The present study aimed to compare the effects of two different doses of nobiletin and analyze its mechanisms of action against diabetes-induced testicular impairment in rats. Methods and results: Streptozotocin injection was used to induce diabetes. Diabetic rats received nobiletin orally at 10 or 25 mg/kg daily for 30 days. Diabetic rats displayed significant elevations in glucose, glycosylated hemoglobin (HbA1c), Homeostatic Model of Insulin Resistance (HOMA-IR), and pro-inflammatory cytokines, while the serum levels of insulin, testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were significantly reduced. Histological changes to positivity for caspase-3 and decreased androgen receptors (AR) immunoexpression were observed in diabetic rats. Both doses of nobiletin improved hyperglycemia, reduced pro-inflammatory cytokines, and augmented insulin, testosterone, LH, and FSH levels. LH and FSH receptors and cytochrome P450 17 α-hydroxylase (CYP17A1) were markedly downregulated in terms of both gene and protein expression in testicular tissues of the diabetic group, effects that were markedly ameliorated with both doses of nobiletin. In addition, both doses significantly reduced lipid peroxidation and caspase-3 immunoexpression and improved the activity of the antioxidant enzymes and AR in testicular tissues of the diabetic group. Conclusion: Both nobiletin doses showed protective effects against diabetes-induced testicular injury by reducing oxidative stress, hyperglycemia, inflammation, and caspase-3 and upregulating the hypophysis–gonadal axis and AR. The high dose of nobiletin was more effective than the lower one. [ABSTRACT FROM AUTHOR]

Objective(s): Most male patients with type 2 diabetes mellitus (T2DM) experience infertility. It is well established that regular physical activity could alleviate diabetic infertility symptoms. This study was designed to determine the effect of voluntary exercise on sperm malformation. Materials and Methods: Thirty-two male Wistar rats were randomly divided into control (C), diabetic (D), voluntary exercise (Ex), and diabetic-voluntary exercise (D-Ex) groups. Diabetes was induced by an intraperitoneal injection of streptozotocin (35 mg/kg) followed by a high-fat diet for four weeks. Voluntary exercise was performed by placing the animals in the rotary wheel cages for ten weeks. Sperm malformations were analyzed. Moreover, the hypothalamic leptin, kisspeptin, kisspeptin receptors (KissR), as well as plasma LH, FSH, testosterone, and leptin levels were evaluated. Results: Results showed that induction of T2DM caused increased sperm malformation, plasma, and hypothalamic leptin as well as decreased hypothalamic kisspeptin, KissR, and plasma LH levels compared with the C group (P<0.001 to P<0.01). Voluntary exercise in the Ex group increased hypothalamic KissR, plasma FSH, LH, and testosterone levels compared with the C group; however, it decreased sperm malformation and hypothalamic leptin levels (P<0.001 to P<0.05). Voluntary exercise in the D-Ex group reduced sperm malformation, hypothalamic leptin, and plasma testosterone while elevated hypothalamic kisspeptin and KissR protein levels compared with the D group (P<0.001 to P<0.01). Conclusion: The results illustrated voluntary exercise reduces sperm malformations by improving the HHG axis and kisspeptin/leptin signaling in rats with T2DM. [ABSTRACT FROM AUTHOR]

Hypophyseal homogenate of common carp is considered one of the different hormonal sources for spawning induction in the teleosts. The present work aimed to measure the hormonal concentration of the hypophysis in different carp species, which can be used as a source of hormones for spawning induction in teleosts. The hypophysis of different mature carp species (both males and females); namely, common carp (Cyprinus carpio), grass carp (Ctenopharyngodon idella) and silver carp (Hypophthalmichthys molitrix) were evaluated biochemically to discuss their hormonal source. Five hormones in the pituitary gland, including: adrenocorticotropin hormone (ACTH), prolactin hormone (PRL), growth hormone (GH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were analyzed using electrochemiluminescence immunoassay (ECLIA). Compared to female carps, the hypophysis homogenate of male carps recorded lower levels of the measured hormones. The biochemical results showed that the hypophysis homogenate of H. molitrix showed higher levels of 426±13, 118±6, 2355±47, and 1005±35 ng/mg for PRL, GH, LH, and FSH, respectively. Whereas, lower level of ACTH (5±0.5 ng/mg) was recorded compared to those obtained in C. carpio and C. idella. However, the concentrations of those hormones recorded the lowest values in male carpfish, while the concentration of ACTH hormone was higher in male common carp, recording 13±1.2 ng/mg. The present biochemical observations revealed the suitability and effectiveness of the cheap silver carp hypophysis as a spawning inducer in fishes. [ABSTRACT FROM AUTHOR]

The aim of this study is to determine the morphometry of hypophysis of the New Zealand rabbit by using the computed tomography images and its topography according to the anatomical structures in the cavum cranii. For this purpose, the head of 12 (6 female, 6 male) New Zealand Rabbits was scanned in a prone position by using Multi-Detector Computed Tomography. Three-dimensional modeling of the images obtained was performed. Morphometric analysis of the hypophysis, the three-dimensional modeling of which was performed, and its topographic measurements were taken according to the adjacent structures. When the data were examined, it was found that protuberantia occipitalis externa value was statistically significant in terms of sexes (P<0.05). There was no statistically significant difference between other data in terms of sexes (P>0.05). When the correlation analysis was examined, positive correlations between the gland volume and volume of cavum cranii (P<0.01) and between volume and surface area of cavum cranii were detected (P<0.05). Consequently, it is thought that the data of the study would contribute to the operative and experimental studies to be conducted on the region by determining the morphometry and topography of the hypophysis in New Zealand rabbits. [ABSTRACT FROM AUTHOR]

Purpose: Pituitary metastases (PM) are uncommon findings and are mainly derived from breast and lung cancers. No extensive review of PM from neuroendocrine neoplasms (NENs) is on record. Here we describe a clinical case of PM from pancreatic NEN and review the clinical features of PM from NENs reported in the literature. Methods: A case of PM from a pancreatic NEN followed at our institution is described. We also reviewed the 43 cases of PM from NENs reported in the literature. Results: A 59-year old female patient, previously submitted to duodeno-cephalo-pancreasectomy for a well-differentiated pancreatic NEN, with known hepatic metastases, underwent a 68 Ga-DOTATOC PET/CT that revealed an uptake in the pituitary gland. A subsequent MRI displayed a pituitary lesion, with suprasellar extension. After a hormonal and genetic diagnostic workup that excluded the diagnosis of MEN 1, the worsening of headache and visual impairment and the growth of the lesion lead to its surgical removal. A pituitary localization of the pancreatic NEN was identified. Regarding the published cases of PM from NENs, the most common tumour type was small cell lung cancer (SCLC), accounting for nearly half of the cases, followed by bronchial and pancreatic well differentiated NENs. The most frequent symptom was a variable degree of visual impairment, while headache was reported in half of the cases. Partial or total anterior hypopituitarism was present in approximately three quarters of the cases, while diabetes insipidus was less common. The most frequent treatment for PM was surgical resection, followed by radiotherapy and chemotherapy. The clinical outcome was in line with previous reports of PM from solid tumours, with a median survival of 14 months. Surgery of PM was associated with prolonged survival. Conclusions: PM from NENs have clinical features similar to metastases derived from other solid tumours, albeit the involvement of the anterior pituitary seems more frequent; a thorough pituitary hormonal evaluation is mandatory, after focused radiological studies, particularly if a surgical approach is considered. The optimal management of PM remains disputed and seems mainly driven by the aggressiveness of the primary tumour and the presence of symptoms. In well-differentiated NENs, particularly in the case of symptomatic PM, surgical removal may be a reasonable approach. [ABSTRACT FROM AUTHOR]

Introduction: is an endocrine gland located upon the hypophysial fossa of the sphenoid bone in the center of the middle cranial fossa and is surrounded by a small bony cavity (sella turcica). Radiological procedures are playing essential role in present diagnostic of pituitary gland. Pituitary tumours can now be visualized more accurately due to continued improvements in magnetic resonance imaging (MRI) techniques with gadolinium enhancement. Aim of the study: This article summarizes the current knowledge about radiological imaging of pituitary gland and in particular MRI scan procedures. In this paper we also want to show how the imaging of the pituitary gland looked like in the past and nowadays. Description of knowledge: Diagnostic procedures play primary role in present diagnosis and treatment of pituitary gland and sella turcica tumours. It is crucial for further diagnostic procedures to locate the tumour its size and margins. Currently magnetic resonance imaging is the more important examination just after the laboratory results. That modality easily shows exact location and tumours smaller than 1 cm. Radiological differentiation of lessions wouldn’t be possible without contrast agents. The latest MRI study protocols involve dynamic and delayed sequences for better visualisation and differential diagnostic. Conclusions: During the years radiological techniques evolved and gave us the perfect tool to visualize the pituitary gland and its pathologies.

Background: Folliculo-stellate cells were first identified with electron microscopy as a non-hormone secreting accessory cells, star-shaped and follicleforming cells. They represent about 4-20% of pituitary cells from the anterior pituitary lobe. The folliculo-stellate cells control several anterior pituitary activities. However, they do not produce hormones, but they produce growth factors, cytokines, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), leukemia inhibitory factor (LIF), IL-6, and macrophage migration inhibitory factor (MIF), IL-1β and TNF-α. Regardless of a long period of pituitary research and many morphological, cytophysiological studies, it has been reported that a precise understanding of the major functions of folliculo-stellate in the pituitary gland remains unknown. Consequently, there are still many unsolved issues. Conclusions: This article intends to review the characteristics of folliculo-stellate cells and their uncertain functions in the adenohypophysis, such as their importance as stem cells, in the process of maturation and aging. New researches about the origin and differentiation of folliculo-stellate cells may provide many relevant answers about physiopathology of the pituitary gland and the pathogenesis of pituitary tumors, as well as their influence on the quality of life. Immunohistochemical profile studies of folliculo-stellate cells in pituitary gland, can be useful in elucidation of morphological features and may have a predictive role for the early identification of pituitary microadenomas, prognosis of pituitary tumors and treatment.

Pregnancy is strictly regulated by neuronal and hormonal factors with an essential role being played by the pituitary gland. We screened for differentially expressed genes (DEGs) in the pituitary that function in goat gestational development. Pregnant (AWGp) and non-pregnant Anhui white goats (AWGn) were analysed by deep-sequencing technology. A total of 12 774 092 and 13 872 327 clear reads were obtained in the AWGp and AWGn libraries, respectively. A total of 2593 genes were labelled as significantly differentially expressed in AWGp compared to AWGn, including 2158 upregulated genes and 435 downregulated genes. These genes included follicle stimulating hormone beta (FSHB) and luteinizing hormone beta (LHB), which showed an involvement in reproductive regulation and downregulation (AWGp vs AWGn). Quantitative real-time PCR (qPCR) results validated the DEG data. Subsequent gene ontology analysis indicated that a large number of these DEGs function in cellular processes, cell structures, and cell binding. The DEGs were also found by Kyoto Gene and Genomic Encyclopaedia analysis to be significantly enriched in 54 pathways, including the GnRH and TGF-beta signalling pathways that affect cell proliferation and hormone secretion. These data also identify genes that may play a role in pregnancy and reproduction in the goat and thus provide avenues for future research.

Growth hormone deficiency is a rare cause of low stature. Early recognition of the disease results in effective treatment, leading to a final height as closely as possible to the genetic target. The authors present the case of a 1 year 2 months old girl admitted for growth evaluation in our department. She had been previously diagnosed with isolated growth hormone deficiency in an Endocrinology Unit and was now sent to complete the investigations and undergo imaging studies. The laboratory investigations excluded other pathologies. The MRI showed adenohypophysis hypoplasia, thin hypophyseal stalk. Se is started on growth hormone substitution treatment with good results.

Hypopituitarism is defined as a decreased release of hypophyseal hormones, which may be caused by disease of the pituitary gland disease or hypothalamus. The clinical findings of neonatal hypopituitarism depend on the causes and on presence and extent of hormonal deficiency. Patients may be asymptomatic or may demonstrate non-specific symptoms, but may still be at risk for development of pituitary hormone deficiency over time. Patient history, physical examination, endocrinological, radiological and genetic evaluations are all important for early diagnosis and treatment. The aim of this paper was to present a review of etiological factors, clinical findings, diagnosis and treatment approaches in neonatal hypopituitarism.

A recent publication described pathological findings in the pituitary gland incidentally discovered during routine necropsies of the brain of dogs and cats; however, imaging characteristics of these lesions were not reported. Aims of this retrospective, observational study were to characterize MRI variants and incidental lesions in pituitary glands of dogs with no clinical signs of pituitary disease. Cranial MRIs from dogs with no suspicion of pituitary disease, based on history and presenting clinical signs, were retrieved from a veterinary teleradiology database during the period of January 2014 to January 2016. Images were reinterpreted by two observers and pituitary lesions were described based on consensus. A total of 580 scans were evaluated and pituitary lesions were detected in 78 dogs (13.44%). Pituitary cystic lesions were the most common finding and occurred in 31 dogs (5.34%). Of these 31 dogs, the majority (74%) were of toy or brachycephalic breed. Partial or total empty sella lesions were detected in 14 dogs (2.41%), and all of these were small or toy breeds. A significantly increased incidence of the partial empty sella lesion was found in male dogs (P =.034). Pituitary lesions greater than 1 cm occurred rarely (0.69%). There was a significant association between low‐field (LF) MRI strength and detection of a partial or total empty sella lesion (P =.0112), and detection of a pituitary lesion greater than 1 cm (P =.0125). A significant difference was present between the MRI field strength (FS) that identified pituitary cysts and the FS that detected an empty sella (P =.0068), with the former being a high FS and the latter a LF strength. The findings from this study indicated that up to 13% of dogs with no presenting clinical signs of pituitary disease may have MRI pituitary lesions. [ABSTRACT FROM AUTHOR]

Background: Equine pituitary pars intermedia dysfunction, also known as equine Cushing's syndrome, is a neurodegenerative disease. An important risk factor for Cushing's is advanced aging and it is the most common endocrine disorder in older horses. The prevalence in horses aged over 10 and 15 years is reported as 9.3% and 21%, respectively. Due to the slow progressive nature of the disease, seasonal variation in hormone output and overlapping endocrine response to other events, accurate diagnosis is challenging. The diagnosis requires the combination of anamnesis, clinical signs, in addition to laboratory tests results. This study aimed to report Cushing's syndrome in a Crioulo breed horse focusing on diagnostic methods. Case: A 13-year-old male Crioulo breed, orchiectomized, was attended at the Universidade de Passo Fundo (UPF), in Passo Fundo, RS, Brazil. The owner reported that the animal had progressive weight loss and coat abnormal growth, with curly appearance. From visual inspection, body condition score was 4 (1-9) bulging abdomen was noticed, hirsutism, depression and lethargy. Also, there was a large neoplastic mass on the left side of gluteal region. Later, this mass was classified in histopathological examination as a fibroblastic sarcoid and was treated. The animal presented physical parameters within the physiological limits of the specie. Normochromic normocytic anemia and neutrophilic leukocytosis were reported in the hematologic evaluation. In coproparasitological examination, there were 300 eggs per gram of feaces. Hyperadrenocorticism was suspected in the clinical examination and dexamethasone suppression test was performed to confirm the fact. Basal serum was collected at 17 h (M0) and subsequently 40 µg/kg of dexamethasone was administered intramuscularly. Serum samples were taken after 15 (M15) and 19 (M19) h, resulting in cortisol levels of 1.7 and 1.8 µg/dL, respectively. The M15 and M19 results were above reference values for horses (below 1 µg/dL). Combination of information gathered from anamnesis, clinical examination and dexamethasone suppression test resulted in the definitive diagnosis of hyperadrenocorticism, also known as Cushing's syndrome. Paliative treatment included shearing all over the body and vitamin supplementation. Discussion: In animals without obvious clinical signs, Cushing's syndrome diagnosis is challenging. The most unique and specific clinical signs are the development of abnormal hair coat, mainly hirsutism, delayed or incomplete shedding, and in aged horse, lightening of coat color. The mechanistic cause of these signs is still barely understood. Cushing's is a collection of syndromes each with a unique set of clinical signs and hormone profiles, which varies according to each individual. Complementary examinations are extremely important and endocrine tests are highly recommended in addition to suggestive findings. However, despite the variety of existing tests, false negatives or false positives can frequently happen. Dexamethasone suppression test is considered the gold standard, well validated, practical and low cost for the diagnosis of this disease. In the present report, the combination of anamnesis (13 years old, weight loss, and abnormal coat), clinical exam (hirsutism) and dexamethasone suppression test (over 1 µg/dL of cortisol 15 h and 19 h after dexamethasone administration) resulted in the definitive diagnosis of Cushing's syndrome. Measurements of plasma concentrations of cortisol and adrenocorticotropic hormone (ACTH), thyrotropin releasing hormone (TRH) stimulation test, serum insulin concentration and necropsy are other available tests. History, clinical signs and test results are important to achieve the definitive diagnoses, and when possible, it is advisable to perform post mortem evaluation of the pituitary gland. [ABSTRACT FROM AUTHOR]

Introduction: Hyperinsulinemic Hypoglycemia (HH) is a rare condition characterized by inappropriately elevated insulin levels in the presence of low glucose levels. A proper diagnostic framework is fundamental to avoid patients undergoing unnecessary diagnostic and therapeutic invasive procedures., Objective: The study aimed to assess the clinical presentation, diagnostic work-up, and treatment of a single-center cohort of patients affected by HH., Methods: We conducted a retrospective analysis of data collected from January 2000-2023., Results: Our study included 104 patients: 81 (58% F) affected by insulinoma, 11 (91% F) by autoimmune hypoglycemia, 7 (71% M) by post-gastric surgery hypoglycemia, and 5 (80% F) by factitious hypoglycemia. HH was more frequent in females (63 F vs. 41 M, p-value 0.039). The median age at diagnosis was lower in insulinoma than in the autoimmune group (52.7 vs. 63.7 y, p < 0.001). During the hypoglycemic event, insulin and C-peptide levels were significantly higher in autoimmune hypoglycemia than in insulinoma (insulin 324.6 vs. 36.4 μU/ml, p-value 0.033; C-peptide 14.25 vs. 3.99 ng/ml, p-value 0.003). Specifically, C-peptide levels <9.6 ng/ml and insulin levels <75 μU/ml exhibited 97.3% vs. 93.4% sensitivity and 80% vs. 90% specificity for insulinoma diagnosis, respectively. Regarding insulinoma, the sensitivity of localizing imaging was 88% for Endoscopic Ultrasound (EUS), 86% for Magnetic Resonance Imaging (MRI), 82% for Computed Tomography (CT) scan, 52% for nuclear imaging, and 100% for angiography with the Doppman test. Among insulinoma patients, 79% received surgical treatment while 4% radiofrequency ablation. Symptomatic remission occurred in 100% of cases., Conclusion: We have confirmed insulinoma as the primary cause of HH. The autoimmune form should be suspected when insulin and C-peptide levels are markedly elevated., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Pituitary apoplexy (PA) can arise from haemorrhage or ischaemia of pituitary tissue and is characterized by abrupt onset of headache, visual impairment and hypopituitarism. COVID-19 may be associated with various degrees of vascular complications and, recently, its relationship with PA has been suggested. Cases Presentation Case 1: A 64-year-old male with type 2 diabetes, hypertension and coronary heart disease was admitted to the ER, after several days of asymptomatic COVID-19 infection, with symptoms of PA of a known non-functioning pituitary macroadenoma. The hormonal panel was consistent with anterior panhypopituitarism and the sellar MRI showed haemorrhagic changes of macroadenoma tissue. Transsphenoidal resection of the pituitary lesion was carried out seven days after admission. Although a volumetric reduction of the lesion was apparent during follow-up, some degree of visual symptoms endured. Case 2: An 18-year-old, otherwise healthy, female presented to the ER with symptoms of PA of a recently-diagnosed non-functioning pituitary macroadenoma, after ten days of asymptomatic COVID-19 infection. Central hypocortisolism and hypothyroidism were diagnosed and, after six days, the lesion was surgically resected. At two months follow-up, clinical symptoms had completely resolved, and the hormonal panel was normal., Conclusion: Alongside known risk factors (hypertension, anticoagulation, pregnancy, surgery, etc.), COVID-19 infection might represent an emerging predisposing factor for PA onset. The two cases hereby presented are both significant: the first confirms the role of "classic" vascular predisposing factors for PA, while the second demonstrates that PA might arise also in young patients without known risk factors., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

In the UK approximately 1000 new patients are diagnosed with a pituitary tumour every year. Although a predominantly benign condition, untreated it can lead to visual compromise and become complicated by endocrine effects of hypersecretion or hypopituitarism, resulting in significant morbidity and mortality. This article provides an overview of the presentation and management of pituitary tumours. [ABSTRACT FROM AUTHOR]

Purpose: Glucagon-like peptide-1 (GLP-1) receptor agonists (RA) reduce appetite and energy intake. Recent findings from animal studies suggest a role of GLP-1 in drinking and water homeostasis. We aimed to elucidate whether GLP-1 RA reduce fluid intake in healthy volunteers. Methods: Double-blind, randomized, placebo-controlled, crossover study. 20 healthy volunteers received dulaglutide 1.5 mg and placebo (0,9% sodium chloride) subcutaneously once weekly for 3 weeks. At the end of each treatment period, participants attended an 8-h evaluation visit, during which they were requested to eat two standardized meals and to drink water ad libitum. The primary outcome was the total fluid intake (ml) during the evaluation visit. Results: Mean [SD] age of participants (60% female) was 27 [9.2] years. All but four participants drank less on dulaglutide versus placebo treatment despite identical food intake. The median [IQR] difference of fluid intake on dulaglutide compared to placebo treatment was −100 ml [−400–0]. Median [IQR] total fluid intake was 1300 ml [888–1600] versus 1600 ml [1000–1720], on dulaglutide and placebo treatment, p = 0.06. Median [IQR] 24-h urine output was reduced in dulaglutide versus placebo-treated participants: 1250 ml [975–2080] versus 1680 ml [1400–2040], p = 0.04. Median serum sodium levels were 140 mmol/L on both visits and no difference in thirst perception was noted. Conclusions: GLP-1 RA such as dulaglutide seem to modulate fluid balance in humans. This leads us to speculate that GLP-1 RA may be an interesting therapeutic options for patients with excessive drinking behavior e.g., primary polydipsia. [ABSTRACT FROM AUTHOR]

Ciliopathies are a heterogeneous group of disorders, related to abnormal ciliary function. Severe biliary ciliopathy, caused by bi‐allelic mutations in TTC26, has been recently described in the context of a syndrome of polydactyly and severe neonatal cholestasis, with brain, kidney and heart involvement. Pituitary involvement has not been previously reported for patients with this condition. Pituitary stalk interruption syndrome (PSIS) is a congenital anomaly of the pituitary gland, diagnosed by characteristic MRI findings. We now describe four patients with TTC26 ciliopathy due to a homozygous c.695A>G p.Asn232Ser mutation and delineate PSIS as a novel clinical feature of this disorder, highlighting an important role of TTC26 in pituitary development. [ABSTRACT FROM AUTHOR]

Background and Importance: Abscess of the hypophysis or pituitary adenoma is a very rare entity, and its preoperative diagnosis could be challenging. The clinical presentation is less specific, and despite the recent advancement in imaging, diagnosis before surgery is still difficult. Case Presentation: We reported two cases of pituitary abscesses in patients aged 38 and 42 years. The first patient was managed for maxillary sinusitis associated with pituitary adenoma whose diagnosis was made following surgery. For the second patient, the diagnosis was proposed before surgery following an MRI which showed a ring enhancement lesion of the hypophysis. Both patients benefitted from surgery where one had sub-labial rhino-septal trans-sphenoidal approach and the other through endoscopic endonasal trans-sphenoidal approach. Both received intravenous broad spectrum antibiotics. Conclusion: Post-operative evolution was good with control MRI showing complete disappearance of the sellar lesion. Early diagnosis and treatment improved the prognosis.

Background: Pituitary transposition preserving gland function is possible when approaching superior clival region tumors. Clinical experience along with detailed anatomical knowledge makes this technique safe and effective. Method: We present a step by step description of our technique based on the most recent anatomical references to get a pituitary transposition through the different compartments of the cavernous sinus. By this technique, we achieve minor gland manipulation and a better surgical view of this area. We support this technique with an anatomical analysis on cadaveric specimens and clarifying dissection images. Conclusions: Transcavernous sinus pituitary gland transposition is an easily feasible technique and allows gland shifting preserving pituitary function. [ABSTRACT FROM AUTHOR]

Background: Tumor consistency is an important factor impeding transsphenoidal resection of some pituitary macroadenomas. Preoperative prediction of the tumor consistency may help neurosurgeons in preparing the patients for other therapeutic options after a subtotally resected growth hormone (GH)-producing macroadenoma. We present the preliminary results of our study about the application of the preoperative diffusion-weighted (DW) magnetic resonance imaging (MRI) to predict the consistency and resection rate of GH-producing pituitary macroadenomas. Materials and Methods: Sixteen primary patients with solid GH-producing pituitary macroadenomas were enrolled. Hormonal assays as well as standard and DW-MRI were obtained before surgery. All the patients were operated via an endoscopic transsphenoidal approach. The intraoperative tumor consistencies (suctionable versus nonsuctionable) were documented. The samples were stained for measurement of the collagen content (low, moderate, and high). Postoperative hormonal study and MRI were performed after 8 weeks to evaluate the resection ratio and the hormonal remission. Results: On DW images, the tumor diffusion was enhanced (free) in four, moderate in ten, and restricted in two patients. The tumor was suctionable in 14 cases; gross total resection and hormonal remission were achieved in 12/14 of these. All the 14 suctionable tumors had moderate to enhanced diffusion on DW imaging (DWI). The two patients with a nonsuctionable fibrous tumor had a restricted diffusion in DWI. These were the only ones to have high collagen content in the histopathologic study. Conclusion: DWI could help identify the fibrous nonsuctionable GH-producing adenomas from the others. [ABSTRACT FROM AUTHOR]