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Wyświetlanie 1-10 z 26
Tytuł:
Therapeutic effect of presurgical treatment with longacting octreotide (Sandostatin® LAR®) in patients with acromegaly
Autorzy:
Kajdaniuk, Dariusz
Witek, Przemysław
Andrysiak-Mamos, Elżbieta
Malicka, Joanna
Bednarek-Tupikowska, Grażyna
Rosiek, Violetta
Sowiński, Jerzy
Zieliński, Grzegorz
Bolanowski, Marek
Jawiarczyk-Przybyłowska, Aleksandra
Bałdys-Waligórska, Agata
Zgliczyński, Wojciech
Siemińska, Lucyna
Liebert, Włodzimierz
Marek, Bogdan
Opis:
Introduction: The aim of this study was to assess the therapeutic effect and the safety of pre surgical treatment with long-acting octreotide in patients with acromegaly. Material and methods: This project was conducted in 25 centres across Poland as a non interventional, multicentre, observational study in patients with acromegaly, in which long-acting octreotide (Sandostatin® LAR®) was administered before surgery. They were 148 patients included into the study: 88 females and 60 males aged 18–86 years (51.3 ± 13.4). Results: Eighty patients completed the study (underwent tumour surgery). The CRF included: baseline visit, four follow-up visits every three months before surgery, and two follow-up visits every three months after surgery. Sandostatin® LAR® was administered every four weeks. The efficacy measures were as follows: change of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels, number of patients fulfilling criteria of cure, and change of adenoma (micro- and macroadenomas) size during the treatment. Normalisation of GH and IGF-1 concentrations were obtained in 42.4 and 49.1% of patients at the end of medical therapy, respectively. Normalisation of GH and IGF-1 concentrations were obtained in 77.9 and 83.8% of patients after surgery, respectively. Reduction of microadenoma size was documented in 58.8% of patients, and in 70% of patients with macroadenomas at the end of medical therapy. In 74.0% of patients no pituitary tumour was shown on MRI after surgery. Conclusion: In conclusion, we have shown good surgical outcome in patients with acromegaly after pre-treatment with somatostatin analogue, and good tolerance and safety of the therapy, supporting the national recommendation for pre-surgical treatment with longacting somatostatin analogues in acromegaly patients.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Sex and age differences among patients with acromegaly
Autorzy:
Godlewska, Magdalena
Gilis-Januszewska, Aleksandra
Hubalewska-Dydejczyk, Alicja
Nowak, Andrzej
Starzyk, Jerzy
Bogusławska, Anna
Opis:
Introduction: Acromegaly is a chronic, slowly progressive disorder caused mostly by growth hormone (GH)-producing pituitary neuroendocrine tumors (PitNETs). Recently, the associations between sex and age at the time of diagnosis and the course of acromegaly have been a focus of debate. Objectives: The aim of our study was to evaluate the association between sex and age at the time of diagnosis of acromegaly and the clinical features, biochemical status, severity of the disease, and comorbidities. Patients and methods: This was a single-center study conducted in a group of consecutive patients with acromegaly and no family history of PitNETs. The participants were divded into 2 subgroups according to sex (male, female) and 3 subgroups according to age at the time of diagnosis: i) younger (≤40 years), ii) middle-aged (41–59 years), and iii) elderly patients (≥60 years). Results: Our study included 101 patients (41 men, 60 women) who met the eligibility criteria. The mean (SD) age at the time of diagnosis was 47.3 (14.1) years and the median diagnostic delay was 5 years (interquartile range, 3–10). Age at the time of diagnosis and diagnostic delay were not statistically different in men and women. Levels of insulin-like growth factor 1 (IGF-1) above the upper limit of age-adjusted normal range (%ULN IGF-1) were greater in men than in women (mean [SD], 174.8% [98.9%] vs 109.4% [66.6%]; P = 0.002), while there was no significant difference in terms of %ULN IGF-1 between the age groups. Median basal and nadir GH levels did not differ between the sexes. Men presented with hypogonadism more frequently than women (54% vs 26%; P = 0.005). Hyperprolactinemia, hypogonadism, and macroadenoma were more frequently observed in the younger patients than in the middle-aged and elderly individuals (all P <⁠0.05). Conclusions: According to our results, hypogonadism and greater IGF-1 values were more frequently observed in men with acromegaly. Hyperprolactinemia, hypogonadism, and macroadenoma were more frequent in patients with acromegaly aged 40 years or younger.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Assessment of real-world usage of lanreotide AUTOGEL 120 in Polish acromegalic patients - results from
Autorzy:
Juraniec, Olga
Babińska, Anna
Rosiek, Violetta
Zdunowski, Piotr
Sowiński, Jerzy
Syrenicz, Anhelli
Jawiarczyk-Przybyłowska, Aleksandra
Bałdys-Waligórska, Agata
Ruchała, Marek
Pynka, Sławomir
Strzelczyk, Janusz
Bandurska-Stankiewicz, Elżbieta
Zalewska-Rydzkowska, Danuta
Zemczak, Anna
Matyjaszek-Matuszek, Beata
Orlewska, Ewa
Orłowska-Florek, Renata
Sworczak, Krzysztof
Rutkowska, Joanna
Foltyn, Wanda
Waligórska-Stachura, Joanna
Mucha, Sławomir
Jakubczyk, Danuta
Zgliczyński, Wojciech
Peszel-Barlik, Marta
Junik, Roman
Kos-Kudła, Beata
Lewczuk, Anna
Andrysiak-Mamos, Elżbieta
Witek, Przemysław
Słynko-Krzyzostaniak, Julia
Lewkowicz, Ewelina
Waśko, Ryszard
Michałek, Krzysztof
Trofimiuk-Müldner, Małgorzata
Błaut, Krzysztof
Bolko, Paweł
Stefańska, Agnieszka
Opis:
Aim of the study: To assess resource utilization and costs of treatment with lanreotide AUTOGEL 120 mg (ATG120) administered as part of routine acromegaly care in Poland. Material and methods: A multicentre, non-interventional, observational study on resource utilization in Polish acromegalic patients treated with ATG120 at 4 weeks or extended (> 4 weeks) dosing interval. The study recruited adult acromegalic patients treated medically for ≥ 1 year including at least 3 injections of ATG120. Data on dosing interval, aspects of administration, and resource utilization were collected prospectively during 12 months. Costs were calculated in PLN from the public health-care payer perspective for the year 2013. Results: 139 patients were included in the analysis. Changes in dosing regimen were reported in 14 (9.4%) patients. Combined treatment was used in 11 (8%) patients. Seventy patients (50%) received ATG120 at an extended dosing interval; the mean number of days between injections was 35.56 (SD 8.4). ATG120 was predominantly administered in an out-patient setting (77%), by health-care professionals (94%). Mean time needed for preparation and administration was 4.33 and 1.58 min, respectively, mean product wastage - 0.13 mg. Patients were predominantly treated in an out-patient setting with 7.06 physician visits/patient/ year. The most common control examinations were magnetic resonance imaging of brain and brain stem (1.36/ patient/year), ultrasound of the neck (1.35/patient/year), GH (1.69/pa tient/ year), glycaemia (1.12/patient/year), IGF-1 (0.84/patient/year), pituitary-thyroid axis hormone levels assessment (TSH-0.58/patient/year, T4-0.78/patient/ year). There were 0.43 hospitalizations/ patient/year. For direct medical costs estimated at PLN 50 692/pa tient/ year the main item was the costs of ATG120 (PLN 4103.87/patient/month; 97%). The mean medical cost, excluding pharmacotherapy, was PLN 1445/patient/year (out-patient care - 49%, hospitalization - 23%, diagnostics/laboratory tests - 28%). Conclusions: These results represent the current use of ATG120 in the population of Polish acromegalic patients in a realistic clinical setting. Findings that 50% of patients could be treated with dose intervals of longer than 28 days support the potential of ATG120 to reduce the treatment burden.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Prevalence of neoplasms in patients with acromegaly – the need for a national registry
Autorzy:
Matyjaszek-Matuszek, B.
Obel, E.
Lewicki, M.
Kowalczyk-Bołtuć, J.
Smoleń, A.
Tematy:
cancer
acromegaly
registry
IGF-1
GH
neoplasms
Pokaż więcej
Wydawca:
Instytut Medycyny Wsi
Powiązania:
https://bibliotekanauki.pl/articles/2081765.pdf  Link otwiera się w nowym oknie
Opis:
Introduction. Acromegaly is an endocrine disorder caused predominantly by pituitary adenoma leading to autonomic oversecretion of growth hormone and secondary elevation of insulin-like growth factor 1 (IGF-1). Consequently, there are both theoretical and experimental grounds for establishing a correlation between this disorder and the higher incidence of neoplasms. Objective. The aim of the study is to evaluate the incidence and types of neoplasms among patients with acromegaly. Materials and method. The study included 67 patients with acromegaly, aged between 24 and 75±18.8 years, 46 women (68.7%) and 21 men (31.3%), BMI: 30.7±5.7 kg/m2, age at diagnosis 49.1±12.5 years, with the medians of GH and IGF-1 levels at diagnosis of 11.3 ng/ml and 663.8 ng/ml, respectively. A retrospective analysis of medical records with particular regard to physical examination, medical history, laboratory and imaging tests was performed. Results. Fifty-one patients (76.1%) suffered from at least one neoplasm, among whom 48 patients (71.6%) had benign proliferations, whereas malignant neoplasms (larynx, endometrial and colon cancers) were found in only three patients (4.5%). Conclusions. Benign neoplasms were found in majority of patients with acromegaly (71.6%) most notably: nodular goiter and colon polyps; malignant lesions were rare (4.5%). Only every fifth patient suffered from no neoplastic proliferations. No correlations between the studied parameters and the incidence of neoplasms were found, most likely due to the small number of patients. This is the reason for proposing the creating of the first national register of incidences of neoplasms among acromegalic patients.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Long-standing acromegaly in a patient with a pituitary adenoma not visible on MRI
Autorzy:
Kurowska, Maria
Malicka, Joanna
Tarach, Jerzy S.
Tematy:
acromegaly
ectopic GHRH secretion
microadenoma
neuroendocrine tumour
Pokaż więcej
Wydawca:
Medical Education
Powiązania:
https://bibliotekanauki.pl/articles/1061851.pdf  Link otwiera się w nowym oknie
Opis:
Introduction: Acromegaly in the course of a pituitary microadenoma or neuroendocrine GHRH-secreting tumour (GHRH, growth hormone-releasing hormone) invisible on MRI is very rare. Objective: To present the difficulties in determining the cause behind an excessive production of the growth hormone in a patient suffering from long-standing acromegaly, without a pituitary focal lesion that would be visible on MRI. Case report: The authors describe a case of a 69-year-old female with acromegaly, diagnosed 22 years earlier based on the typical somatic symptoms, and confirmed by the elevated concentration of insulin- like growth factor type 1 and lack of growth hormone suppression in the oral glucose tolerance test. The initial MRI scan (1994) had revealed a hypoechogenic 2 x 3 mm lesion in the anterior lobe of the pituitary gland, whose presence was not reported in the subsequent MRI tests. As ectopic GHRH or growth hormone secretion was suspected, a neuroendocrine tumour was searched for. The 47.7 × 54 × 35.7 mm tumour, located in the thoracic outlet, accumulating tektreotide in receptor scintigraphy, turned out to be a nodular goitre on histopathology. Due to the undetermined location of the source of growth hormone overproduction, failure to measure GHRH levels, and the patient’s lack of consent to undergo sella turcica exploration, long-acting release octreotide had been used for many years to manage the patient’s condition. Conclusion: The long-lasting and ineffective search for a neuroendocrine tumour producing GHRH or growth hormone as well as the absence of a focal lesion in the repeated MRI scans render it impossible to unequivocally determine the cause of the patient’s acromegaly, and illustrate the difficulties in discovering the source of growth hormone overproduction.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Acromegaly and thyroid cancer – a clinical case report and discussion
Akromegalia i rak tarczycy - opis przypadku i dyskusja
Autorzy:
Kulpa, Justyna
Opis:
Introduction: A clinical case of a patient treated for acromegaly with concomitant follicular thyroid cancer and non-small-cell lung cancer in the Clinical Department of Endocrinology at the University Hospital, UJCM, is presented. The most important issues of epidemiology, pathogenesis, diagnostics, signs and symptoms of acromegaly and its comorbidities – with particular reference to metabolic disorders and thyroid cancer are discussed. Additionally, general nutrition guidelines and a seven-day menu for an out-patient after surgery are provided.Case report: A 49-year-old patient was admitted to the Hospital in 1996 for surgical treatment of acromegaly. In April 2005, total thyroidectomy was performed due to follicular thyroid cancer with metastases to the lungs. In MRI, diagnosis of relapse of pituitary adenoma was made in December 2005 confirmed by increased levels of IGF-1 and hGH. Long-acting somatostatin analogues were introduced – initially octreotide (Sandostatin LAR), then lanreotide (Somatuline Autogel). Between May 2006 and March 2013 the patient was treated with radioactive iodine ten times, with the aid of human recombinant TSH. In January 2014, detailed diagnostics was performed. In the PET/CT scans left lung tumour was found with 18F-FDG uptake. In March 2014 thoracotomy and lobectomy were performed. In histopathology non-small-cell lung cancer was diagnosed. The patient died in 2015.Conclusions: A patient with acromegaly should be screened for thyroid cancer. Proper nutrition therapy with a special focus on undernourishment risk is one of the elements of comprehensive diagnostic and therapeutic management.
Wstęp: W pracy zaprezentowano przypadek pacjenta z akromegalią oraz współistniejącym rakiem pęcherzykowym tarczycy, leczonego w Klinice Endokrynologii UJCM. Przedstawiono również najważniejsze problemy z zakresu epidemiologii, patogenezy, diagnostyki oraz obraz kliniczny akromegalii i chorób z nią współwystępujących, ze szczególnym uwzględnieniem zaburzeń gospodarki węglowodanowej i nowotworu złośliwego tarczycy. Dodatkowo, zaprezentowano ogólną charakterystykę żywienia w trybie ambulatoryjnym oraz 7-dniowy jadłospis dla pacjenta po operacyjnym leczeniu nowotworu.Opis przypadku: Pacjent, lat 49, został przyjęty do Kliniki w 1996 r. celem leczenia operacyjnego akromegalii. W kwietniu 2005 r. wykonano u chorego całkowite wycięcie tarczycy z powodu raka pęcherzykowego tarczycy z przerzutami do płuc. W badaniu MRI w grudniu 2005 r., rozpoznano nawrót guza przysadki, o czym świadczyły również podwyższone poziomy hGH i IGF-1. Do terapii wprowadzono syntetyczne analogi somatostatyny – początkowo oktreotyd (Sandostatin LAR), a następnie lanreotyd (Somatuline Autogel). Od maja 2006 r. do marca 2013 r. pacjent był leczony radiojodem dziesięciokrotnie za pomocą rekombinowanego ludzkiego TSH. W styczniu 2014 r. przeprowadzono kolejne badania diagnostyczne przed planowanym leczeniem radiojodem 131I. W badaniu PET/CT uwidoczniono rozproszone guzki bez pobudzenia metabolicznego w obu płucach oraz guz w płucu lewym gromadzący 18F-FDG. W marcu 2014 r. wykonano torakotomię lewostronną i lobektomię dolną lewą. W badaniu histopatologicznym rozpoznano raka niedrobnokomórkowego płuc. Pacjent ostatecznie zmarł w 2015 r.Wnioski: Pacjent z akromegalią i wolem guzowatym powinien być systematycznie monitorowany ze względu na częstsze występowanie nowotworów tarczycy w tej grupie chorych. Odpowiednia terapia żywieniowa uwzględniająca ryzyko niedożywienia w chorobie nowotworowej jest jednym z elementów kompleksowego postępowania diagnostyczno-terapeutycznego.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
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