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Enlace permanente de la investigaciónPituitary society expert Delphi consensus: operative workflow in endoscopic transsphenoidal pituitary adenoma resection / Luis Vicente Syro Moreno
Título : Pituitary society expert Delphi consensus: operative workflow in endoscopic transsphenoidal pituitary adenoma resection Tipo de documento : documento electrónico Autores : Luis Vicente Syro Moreno, Fecha de publicación : 2021 Títulos uniformes : Pituitary Idioma : Inglés (eng) Palabras clave : Consensus Delphi Endoscopic endonasal Endoscopic transsphenoidal surgery Pituitary Pituitary adenoma Skull base surgery Resumen : Purpose: Surgical workflow analysis seeks to systematically break down operations into hierarchal components. It facilitates education, training, and understanding of surgical variations. There are known educational demands and variations in surgical practice in endoscopic transsphenoidal approaches to pituitary adenomas. Through an iterative consensus process, we generated a surgical workflow reflective of contemporary surgical practice. Methods: A mixed-methods consensus process composed of a literature review and iterative Delphi surveys was carried out within the Pituitary Society. Each round of the survey was repeated until data saturation and > 90% consensus was reached. Results: There was a 100% response rate and no attrition across both Delphi rounds. Eighteen international expert panel members participated. An extensive workflow of 4 phases (nasal, sphenoid, sellar and closure) and 40 steps, with associated technical errors and adverse events, were agreed upon by 100% of panel members across rounds. Both core and case-specific or surgeon-specific variations in operative steps were captured. Conclusions: Through an international expert panel consensus, a workflow for the performance of endoscopic transsphenoidal pituitary adenoma resection has been generated. This workflow captures a wide range of contemporary operative practice. The agreed "core" steps will serve as a foundation for education, training, assessment and technological development (e.g. models and simulators). The "optional" steps highlight areas of heterogeneity of practice that will benefit from further research (e.g. methods of skull base repair). Further adjustments could be made to increase applicability around the world. Mención de responsabilidad : Hani J. Marcus, Danyal Z. Khan, Anouk Borg, Michael Buchfelder, Justin S. Cetas, Justin W. Collins, Neil L. Dorward, Maria Fleseriu, Mark Gurnell, Mohsen Javadpour, Pamela S. Jones, Chan Hee Koh, Hugo Layard Horsfall, Adam N. Mamelak, Pietro Mortini, William Muirhead, Nelson M. Oyesiku, Theodore H. Schwartz, Saurabh Sinha, Danail Stoyanov, Luis V. Syro, Georgios Tsermoulas, Adam Williams, Mark J. Winder, Gabriel Zada & Edward R. Laws Referencia : Pituitary. 2021 Dec;24(6):839-853. DOI (Digital Object Identifier) : 10.1007/s11102-021-01162-3 PMID : 34231079 Derechos de uso : CC BY En línea : https://link.springer.com/article/10.1007%2Fs11102-021-01162-3 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5816 Pituitary society expert Delphi consensus: operative workflow in endoscopic transsphenoidal pituitary adenoma resection [documento electrónico] / Luis Vicente Syro Moreno, . - 2021.
Obra : Pituitary
Idioma : Inglés (eng)
Palabras clave : Consensus Delphi Endoscopic endonasal Endoscopic transsphenoidal surgery Pituitary Pituitary adenoma Skull base surgery Resumen : Purpose: Surgical workflow analysis seeks to systematically break down operations into hierarchal components. It facilitates education, training, and understanding of surgical variations. There are known educational demands and variations in surgical practice in endoscopic transsphenoidal approaches to pituitary adenomas. Through an iterative consensus process, we generated a surgical workflow reflective of contemporary surgical practice. Methods: A mixed-methods consensus process composed of a literature review and iterative Delphi surveys was carried out within the Pituitary Society. Each round of the survey was repeated until data saturation and > 90% consensus was reached. Results: There was a 100% response rate and no attrition across both Delphi rounds. Eighteen international expert panel members participated. An extensive workflow of 4 phases (nasal, sphenoid, sellar and closure) and 40 steps, with associated technical errors and adverse events, were agreed upon by 100% of panel members across rounds. Both core and case-specific or surgeon-specific variations in operative steps were captured. Conclusions: Through an international expert panel consensus, a workflow for the performance of endoscopic transsphenoidal pituitary adenoma resection has been generated. This workflow captures a wide range of contemporary operative practice. The agreed "core" steps will serve as a foundation for education, training, assessment and technological development (e.g. models and simulators). The "optional" steps highlight areas of heterogeneity of practice that will benefit from further research (e.g. methods of skull base repair). Further adjustments could be made to increase applicability around the world. Mención de responsabilidad : Hani J. Marcus, Danyal Z. Khan, Anouk Borg, Michael Buchfelder, Justin S. Cetas, Justin W. Collins, Neil L. Dorward, Maria Fleseriu, Mark Gurnell, Mohsen Javadpour, Pamela S. Jones, Chan Hee Koh, Hugo Layard Horsfall, Adam N. Mamelak, Pietro Mortini, William Muirhead, Nelson M. Oyesiku, Theodore H. Schwartz, Saurabh Sinha, Danail Stoyanov, Luis V. Syro, Georgios Tsermoulas, Adam Williams, Mark J. Winder, Gabriel Zada & Edward R. Laws Referencia : Pituitary. 2021 Dec;24(6):839-853. DOI (Digital Object Identifier) : 10.1007/s11102-021-01162-3 PMID : 34231079 Derechos de uso : CC BY En línea : https://link.springer.com/article/10.1007%2Fs11102-021-01162-3 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5816 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001750 AC-2021-066 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
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Título : Pituitary pathology in traumatic brain injury: a review Tipo de documento : documento electrónico Autores : Luis Vicente Syro Moreno, Fecha de publicación : 2019 Títulos uniformes : Pituitary Idioma : Inglés (eng) Palabras clave : Hypothalamic-pituitary autoimmunity (HP-A) pathology pituitary post traumatic hypopituitarism (PTHP) Traumatic brain injury (TBI) Resumen : Purpose: Traumatic brain injury most commonly affects young adults under the age of 35 and frequently results in reduced quality of life, disability, and death. In long-term survivors, hypopituitarism is a common complication. Results: Pituitary dysfunction occurs in approximately 20–40% of patients diagnosed with moderate and severe traumatic brain injury giving rise to growth hormone deficiency, hypogonadism, hypothyroidism, hypocortisolism, and central diabetes insipidus. Varying degrees of hypopituitarism have been identified in patients during both the acute and chronic phase. Anterior pituitary hormone deficiency has been shown to cause morbidity and increase mortality in TBI patients, already encumbered by other complications. Hypopituitarism after childhood traumatic brain injury may cause treatable morbidity in those survivors. Prospective studies indicate that the incidence rate of hypopituitarism may be ten-fold higher than assumed; factors altering reports include case definition, geographic location, variable hospital coding, and lost notes. While the precise pathophysiology of post traumatic hypopituitarism has not yet been elucidated, it has been hypothesized that, apart from the primary mechanical event, secondary insults such as hypotension, hypoxia, increased intracranial pressure, as well as changes in cerebral flow and metabolism may contribute to hypothalamic-pituitary damage. A number of mechanisms have been proposed to clarify the causes of primary mechanical events giving rise to ischemic adenohypophysial infarction and the ensuing development of hypopituitarism. Conclusion: Future research should focus more on experimental and clinical studies to elucidate the exact mechanisms behind post-traumatic pituitary damage. The use of preventive medical measures to limit possible damage in the pituitary gland and hypothalamic pituitary axis in order to maintain or re-establish near normal physiologic functions are crucial to minimize the effects of TBI. Mención de responsabilidad : Aydin Sav, Fabio Rotondo, Luis V Syro, Carlos A Serna, Kalman Kovacs Referencia : Pituitary. 2019 Jun;22(3):201-211 DOI (Digital Object Identifier) : 10.1007/s11102-019-00958-8 PMID : 30927184 En línea : https://link.springer.com/article/10.1007%2Fs11102-019-00958-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4256 Pituitary pathology in traumatic brain injury: a review [documento electrónico] / Luis Vicente Syro Moreno, . - 2019.
Obra : Pituitary
Idioma : Inglés (eng)
Palabras clave : Hypothalamic-pituitary autoimmunity (HP-A) pathology pituitary post traumatic hypopituitarism (PTHP) Traumatic brain injury (TBI) Resumen : Purpose: Traumatic brain injury most commonly affects young adults under the age of 35 and frequently results in reduced quality of life, disability, and death. In long-term survivors, hypopituitarism is a common complication. Results: Pituitary dysfunction occurs in approximately 20–40% of patients diagnosed with moderate and severe traumatic brain injury giving rise to growth hormone deficiency, hypogonadism, hypothyroidism, hypocortisolism, and central diabetes insipidus. Varying degrees of hypopituitarism have been identified in patients during both the acute and chronic phase. Anterior pituitary hormone deficiency has been shown to cause morbidity and increase mortality in TBI patients, already encumbered by other complications. Hypopituitarism after childhood traumatic brain injury may cause treatable morbidity in those survivors. Prospective studies indicate that the incidence rate of hypopituitarism may be ten-fold higher than assumed; factors altering reports include case definition, geographic location, variable hospital coding, and lost notes. While the precise pathophysiology of post traumatic hypopituitarism has not yet been elucidated, it has been hypothesized that, apart from the primary mechanical event, secondary insults such as hypotension, hypoxia, increased intracranial pressure, as well as changes in cerebral flow and metabolism may contribute to hypothalamic-pituitary damage. A number of mechanisms have been proposed to clarify the causes of primary mechanical events giving rise to ischemic adenohypophysial infarction and the ensuing development of hypopituitarism. Conclusion: Future research should focus more on experimental and clinical studies to elucidate the exact mechanisms behind post-traumatic pituitary damage. The use of preventive medical measures to limit possible damage in the pituitary gland and hypothalamic pituitary axis in order to maintain or re-establish near normal physiologic functions are crucial to minimize the effects of TBI. Mención de responsabilidad : Aydin Sav, Fabio Rotondo, Luis V Syro, Carlos A Serna, Kalman Kovacs Referencia : Pituitary. 2019 Jun;22(3):201-211 DOI (Digital Object Identifier) : 10.1007/s11102-019-00958-8 PMID : 30927184 En línea : https://link.springer.com/article/10.1007%2Fs11102-019-00958-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4256 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001235 AC-2019-024 Archivo digital Producción Científica Artículos científicos Disponible
Título : 65 YEARS OF THE DOUBLE HELIX: Treatment of pituitary tumors with temozolomide: an update Tipo de documento : documento electrónico Autores : Luis Vicente Syro Moreno, Fecha de publicación : 2018 Títulos uniformes : Endocrine Related Cancer Idioma : Inglés (eng) Palabras clave : Chemotherapy neoplasms neuroendocrine tumors pituitary temozolomide Resumen : Temozolomide is an alkylating chemotherapeutic agent used in malignant neuroendocrine neoplasia, melanoma, brain metastases and an essential component of adjuvant therapy in the treatment of glioblastoma multiforme and anaplastic astrocytoma. Since 2006, it has been used for the treatment of pituitary carcinomas and aggressive pituitary adenomas. Here, we discuss the current indications and results of temozolomide therapy in pituitary tumors, as well as frequently asked questions regarding temozolomide treatment, duration of therapy, dosage, tumor recurrence and resistance. Mención de responsabilidad : Luis V Syro, Fabio Rotondo, Leon D Ortiz, Kalman Kovacs Referencia : Endocr Relat Cancer. 2018 Aug;25(8):T159-T169. DOI (Digital Object Identifier) : 10.1530/ERC-18-0015 PMID : 29535142 En línea : https://erc.bioscientifica.com/view/journals/erc/25/8/ERC-18-0015.xml Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4186 65 YEARS OF THE DOUBLE HELIX: Treatment of pituitary tumors with temozolomide: an update [documento electrónico] / Luis Vicente Syro Moreno, . - 2018.
Obra : Endocrine Related Cancer
Idioma : Inglés (eng)
Palabras clave : Chemotherapy neoplasms neuroendocrine tumors pituitary temozolomide Resumen : Temozolomide is an alkylating chemotherapeutic agent used in malignant neuroendocrine neoplasia, melanoma, brain metastases and an essential component of adjuvant therapy in the treatment of glioblastoma multiforme and anaplastic astrocytoma. Since 2006, it has been used for the treatment of pituitary carcinomas and aggressive pituitary adenomas. Here, we discuss the current indications and results of temozolomide therapy in pituitary tumors, as well as frequently asked questions regarding temozolomide treatment, duration of therapy, dosage, tumor recurrence and resistance. Mención de responsabilidad : Luis V Syro, Fabio Rotondo, Leon D Ortiz, Kalman Kovacs Referencia : Endocr Relat Cancer. 2018 Aug;25(8):T159-T169. DOI (Digital Object Identifier) : 10.1530/ERC-18-0015 PMID : 29535142 En línea : https://erc.bioscientifica.com/view/journals/erc/25/8/ERC-18-0015.xml Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4186 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000800 AC-2018-087 Archivo digital Producción Científica Artículos científicos Disponible
Título : Temozolomide and pituitary tumors: current understanding, unresolved Issues, and future directions Tipo de documento : documento electrónico Autores : Luis Vicente Syro Moreno, Fecha de publicación : 2018 Títulos uniformes : Frontiers in Endocrinology Idioma : Inglés (eng) Palabras clave : Alkylating agents chemotherapy DNA repair neoplasms neuroendocrine tumors O(6)-Methylguanine-DNA Methyltransferase pituitary temozolomide Resumen : Temozolomide, an alkylating agent, initially used in the treatment of gliomas was expanded to include pituitary tumors in 2006. After 12 years of use, temozolomide has shown a notable advancement in pituitary tumor treatment with a remarkable improvement rate in the 5-year overall survival and 5-year progression-free survival in both aggressive pituitary adenomas and pituitary carcinomas. In this paper, we review the mechanism of action of temozolomide as alkylating agent, its interaction with deoxyribonucleic acid repair systems, therapeutic effects in pituitary tumors, unresolved issues, and future directions relating to new possibilities of targeted therapy. Mención de responsabilidad : Luis V Syro, Fabio Rotondo, Mauricio Camargo, Leon D Ortiz, Carlos A Serna, Kalman Kovacs Referencia : Front Endocrinol (Lausanne). 2018 Jun 15;9:318 DOI (Digital Object Identifier) : 10.3389/fendo.2018.00318 PMID : 29963012 En línea : https://www.frontiersin.org/articles/10.3389/fendo.2018.00318/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4163 Temozolomide and pituitary tumors: current understanding, unresolved Issues, and future directions [documento electrónico] / Luis Vicente Syro Moreno, . - 2018.
Obra : Frontiers in Endocrinology
Idioma : Inglés (eng)
Palabras clave : Alkylating agents chemotherapy DNA repair neoplasms neuroendocrine tumors O(6)-Methylguanine-DNA Methyltransferase pituitary temozolomide Resumen : Temozolomide, an alkylating agent, initially used in the treatment of gliomas was expanded to include pituitary tumors in 2006. After 12 years of use, temozolomide has shown a notable advancement in pituitary tumor treatment with a remarkable improvement rate in the 5-year overall survival and 5-year progression-free survival in both aggressive pituitary adenomas and pituitary carcinomas. In this paper, we review the mechanism of action of temozolomide as alkylating agent, its interaction with deoxyribonucleic acid repair systems, therapeutic effects in pituitary tumors, unresolved issues, and future directions relating to new possibilities of targeted therapy. Mención de responsabilidad : Luis V Syro, Fabio Rotondo, Mauricio Camargo, Leon D Ortiz, Carlos A Serna, Kalman Kovacs Referencia : Front Endocrinol (Lausanne). 2018 Jun 15;9:318 DOI (Digital Object Identifier) : 10.3389/fendo.2018.00318 PMID : 29963012 En línea : https://www.frontiersin.org/articles/10.3389/fendo.2018.00318/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4163 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000777 AC-2018-064 Archivo digital Producción Científica Artículos científicos Disponible
Título : Alpha subunit in clinically non-functioning pituitary adenomas: An immunohistochemical study Tipo de documento : documento electrónico Autores : Luis Vicente Syro Moreno, Fecha de publicación : 2017 Títulos uniformes : Pathology, Research and Practice Idioma : Inglés (eng) Palabras clave : α-Subunit Glycoprotein hormones Pituitary Pituitary hormones Pituitary tumors Resumen : Pituitary adenomas may be classified as either functioning or non-functioning, depending on whether excess hormone secretion can be clinically identified. Of the six hormones produced in the anterior pituitary, TSH, FSH and LH are known as glycoproteins and contain two subunits (α and β). While α-subunit is identical within all of them, each β-subunit is unique and biologically specific. Independently, the α- and β-subunits are inactive and only induce a hormonal response when they are non-covalently associated. Studies have shown that in certain cases, pituitary adenomas may abnormally secrete only α-subunit, detectable in the serum or through immunohistochemical analysis. In the present study, we examined α-subunit immunoexpression in surgically removed non-functioning pituitary adenomas and analyzed its prognostic value. Results showed that expression of α-subunit in clinically non-functioning pituitary adenomas is not a rare occurrence. While there were no age/gender differences between tumors that expressed α-subunit and those that did not, α-subunit immunonegative adenomas presented with suprasellar extension more frequently and had an Ki67 proliferation greater than 3%. The use of immunohistochemical techniques to determine the presence of α-subunit may provide information on tumor cell proliferation and biologic behavior. To fully understand the role of α-subunit in pituitary adenomas more work is needed. Mención de responsabilidad : Michael Solarski, Fabio Rotondo, Luis V Syro, Michael D Cusimano, Kalman Kovacs Referencia : Pathol Res Pract. 2017 Sep;213(9):1130-1133. DOI (Digital Object Identifier) : 10.1016/j.prp.2017.07.010 PMID : 28780083 En línea : https://linkinghub.elsevier.com/retrieve/pii/S034403381730626X Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4032 Alpha subunit in clinically non-functioning pituitary adenomas: An immunohistochemical study [documento electrónico] / Luis Vicente Syro Moreno, . - 2017.
Obra : Pathology, Research and Practice
Idioma : Inglés (eng)
Palabras clave : α-Subunit Glycoprotein hormones Pituitary Pituitary hormones Pituitary tumors Resumen : Pituitary adenomas may be classified as either functioning or non-functioning, depending on whether excess hormone secretion can be clinically identified. Of the six hormones produced in the anterior pituitary, TSH, FSH and LH are known as glycoproteins and contain two subunits (α and β). While α-subunit is identical within all of them, each β-subunit is unique and biologically specific. Independently, the α- and β-subunits are inactive and only induce a hormonal response when they are non-covalently associated. Studies have shown that in certain cases, pituitary adenomas may abnormally secrete only α-subunit, detectable in the serum or through immunohistochemical analysis. In the present study, we examined α-subunit immunoexpression in surgically removed non-functioning pituitary adenomas and analyzed its prognostic value. Results showed that expression of α-subunit in clinically non-functioning pituitary adenomas is not a rare occurrence. While there were no age/gender differences between tumors that expressed α-subunit and those that did not, α-subunit immunonegative adenomas presented with suprasellar extension more frequently and had an Ki67 proliferation greater than 3%. The use of immunohistochemical techniques to determine the presence of α-subunit may provide information on tumor cell proliferation and biologic behavior. To fully understand the role of α-subunit in pituitary adenomas more work is needed. Mención de responsabilidad : Michael Solarski, Fabio Rotondo, Luis V Syro, Michael D Cusimano, Kalman Kovacs Referencia : Pathol Res Pract. 2017 Sep;213(9):1130-1133. DOI (Digital Object Identifier) : 10.1016/j.prp.2017.07.010 PMID : 28780083 En línea : https://linkinghub.elsevier.com/retrieve/pii/S034403381730626X Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4032 Reserva
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