Acromegaly : a guide to diagnosis and treatment / / Lewis S. Blevins, Manish K. Aghi, editors

• Pubblicazione: Cham, Switzerland : , : Springer, , [2022]; ©2022
• Descrizione fisica: 1 online resource (300 pages)
• Disciplina: 616.4
• Soggetto topico: Acromegaly; Acromegàlia
• Soggetto genere / forma: Llibres electrònics
• Persona (resp. second.): BlevinsLewis S., Jr.; AghiManish K.
• Nota di bibliografia: Includes bibliographical references and index.
• Nota di contenuto: Intro -- Preface -- Preface -- Contents -- Chapter 1: The Molecular Biology and Pathology of Acromegaly -- Introduction -- Physiological Features of GH and IGF1 -- GH Physiology -- IGF1 Physiology -- Pathogenesis of Somatotroph Adenomas -- Altered cAMP Signaling in Somatotroph Adenomas -- Epigenetic Gene Silencing in Somatotroph Adenomas -- Gene Overexpression in Somatotroph Adenomas -- The Impact of Histopathological Features in Somatotroph Adenoma Management -- Classification of Pituitary Adenomas -- Somatotroph Adenoma Behavior Based on Pathological Features -- Somatostatin Receptor Subtypes in Somatotroph Adenomas -- Densely Granulated Vs Sparsely Granulated Somatotroph Adenomas -- Dual-Staining Somatotroph Adenomas -- Conclusions -- References -- Chapter 2: Growth Hormone-Releasing Hormone-Secreting Neuroendocrine Tumors -- Introduction -- Causes of Ectopic GHRH Production -- Clinical Presentation of Ectopic GHRH Production -- Diagnostic Workup of Ectopic GHRH Syndrome -- Differential Diagnosis for NETs According to Site -- Treatment Options for NETs -- Prognosis -- References -- Chapter 3: Diagnosis of Acromegaly -- Introduction -- Physiology and Pathophysiology -- Clinical Evaluation -- Laboratory Testing -- Imaging Studies -- Approach to the Patient -- Summary and Future Directions -- References -- Chapter 4: Imaging in Acromegaly -- Anatomy -- Imaging of the Pituitary Gland -- Imaging of Tumors in the Gland -- Microadenoma (Fig. 4.2) -- Macroadenoma (Fig. 4.3) -- Mimics (Fig. 4.5) -- Systemic Findings of Acromegaly -- Advances in Imaging of the Pituitary Gland -- References -- Chapter 5: The Clinical Presentation of Acromegaly -- Background and Historical Perspective -- Signs and Symptoms Prompting Diagnosis -- Why Is There a Prolonged Delay in Diagnosis of Acromegaly, Given the Classic and Recognizable Clinical Features of this Disease?. ; What Are the Signs, Symptoms, and/or Reasons That Ultimately Lead to the Diagnosis? -- What Signs and Symptoms Are Present at the Time of Diagnosis of Acromegaly? -- Severity of the Disease -- Diseases or Conditions with Clinical Overlap That May Mimic Acromegaly -- Conclusions -- References -- Chapter 6: Sleep-Disordered Breathing in Acromegaly -- Introduction -- Obstructive Sleep Apnea -- Definition and Diagnosis -- Epidemiology -- Symptoms and Risk Factors -- Complications of Untreated Obstructive Sleep Apnea -- Treatment of Obstructive Sleep Apnea -- Central Sleep Apnea -- Conclusion -- References -- Chapter 7: Cardiovascular Pathology in Acromegaly -- Background -- Pathogenesis -- Acromegalic Cardiomyopathy -- Hypertension -- Coronary Arterial Disease -- Arrythmias -- Valvular Heart Disease -- Diagnostic Evaluation -- HTN -- Cardiomyopathy -- Arrythmias -- Atherosclerotic Arterial Disease -- Treatment of Cardiovascular Complications in Acromegaly -- Transsphenoidal Surgery -- Somatostatin Analogs -- GHR Antagonists -- Summary -- References -- Chapter 8: Diabetes Mellitus in Acromegaly -- Epidemiology -- Pathogenesis of Diabetes in Acromegaly -- Excess Growth Hormone Leads to Increased Lipolysis -- Increased Free Fatty Acids Interfere with Insulin Signaling Pathway -- Increased Free Fatty Acids Promote Gluconeogenesis and Inhibit Glycolysis -- Increased Expression of Pro-inflammatory Adipokines and Cytokines -- β-Cell Dysfunction -- Treatment -- Choice of Therapy for Acromegaly -- Treatment of Diabetes in Patients with Acromegaly -- References -- Chapter 9: Musculoskeletal Disorders of Acromegaly -- References -- Chapter 10: Acromegaly and Cancer -- Acromegaly and Cancer Mortality -- Disease Control and Cancer Mortality -- Evidence for Involvement of the GH/IGF Axis in Cancer Development -- Height and Cancer. ; GH/IGF-1 and Cancer in General Populations -- GH/IGF Receptor Signaling in Cancer -- Cancer Incidence in Acromegaly -- Specific Cancer Incidence -- Colon Cancer and Acromegaly -- Thyroid Cancer and Acromegaly -- Breast Cancer and Acromegaly -- Prostate Cancer and Acromegaly -- Other Cancers and Acromegaly -- Summary of Cancer Incidence -- Diabetes and Cancer Incidence in Acromegaly -- Conclusion -- References -- Chapter 11: Mortality in Acromegaly -- Introduction -- GH and IGF-1 Levels as Predictors of Mortality -- Hypopituitarism and Mortality -- Radiotherapy and Mortality -- Cancer Incidence, Mortality, and Acromegaly -- Other Causes of Mortality -- Cardiovascular Disease -- Sleep Apnea -- Diabetes -- Conclusions -- References -- Chapter 12: An Overview of the Approach to the Management of Acromegaly -- References -- Chapter 13: Transsphenoidal Surgery for Acromegaly -- Introduction -- Diagnosis and Referral -- Preoperative Management -- Preoperative Imaging -- Premedication -- Operative Details: Transsphenoidal Surgery -- Technique -- Anesthetic Considerations -- Positioning -- Typical Surgical Steps -- Morbidity of Transsphenoidal Surgery for Acromegaly -- Vascular Complications -- CSF Leak -- Adenohypophysis Hormonal Deficits -- Diabetes Insipidus and SIADH -- Biochemical Outcomes and Management of Residual Tumor -- References -- Chapter 14: Stereotactic Radiosurgery and Radiation Therapy for Acromegaly -- Introduction -- Historical Perspective -- Stereotactic Radiosurgery for Acromegaly -- Patient Selection and Pre-SRS Evaluation -- SRS Procedure -- Endocrine Control -- Complications from SRS -- Repeated GKRS -- Brief Cessation of Antisecretory Medication around the Time of SRS -- Fractionated Radiation Therapy for Acromegaly -- Endocrine Control -- Complications Following FRT -- Proton Beam Irradiation -- Conclusions -- References -- Untitled. ; Chapter 15: Challenging Questions in the Management of Acromegaly in the Young -- Introduction -- Case Presentation -- Challenging Clinical Management Questions -- Conclusions -- References -- Chapter 16: Somatostatin Analogues in the Management of Patients with Acromegaly -- References -- Chapter 17: Use of Dopamine Agonists for Acromegaly -- History of Acromegaly Treatment and Use of Dopamine Agonists -- Mechanism of Action of Dopamine Agonists in Acromegaly -- Acromegaly Treatment Algorithm -- Dopamine Agonist Dosing in Acromegaly -- Dopamine Agonists as Monotherapy -- Dopamine Agonists as Combination Therapy -- Dopamine Agonists and Somatostatin Analogues -- Dopamine Agonists and Growth Hormone Receptor Antagonists -- Side Effects of Dopamine Agonists -- Summary -- References -- Chapter 18: Pegvisomant: Lessons Learned After 20 Years and Practical Recommendations of Its Use for the Treatment of Acromegaly -- Introduction -- Data from Clinical Studies of Pegvisomant -- When to Consider Pegvisomant Therapy in Patients with Acromegaly -- Initiation, Titration, and Maintenance of Pegvisomant Therapy -- Precautions When Using Pegvisomant -- Cost Considerations When Using Pegvisomant -- Conclusion -- References -- Chapter 19: Perspectives on Combination Medical Therapy in the Treatment of Acromegaly -- Introduction -- Somatostatin Receptor Ligand and Dopamine Agonist Combination Treatment -- Adverse Effects -- Somatostatin Receptor Ligand and Growth Hormone Receptor Antagonist Combined Treatment -- Long-Acting First-Generation Somatostatin Receptor Ligands and Pegvisomant (SRL-PEG) -- Primary Efficacy Endpoints -- Secondary Efficacy Endpoints -- Adverse Effects -- Pasireotide Long-Acting Release and Pegvisomant (PAS-PEG) -- Primary Efficacy Endpoints -- Secondary Efficacy Endpoints -- Adverse Effects -- Cabergoline and Pegvisomant Combination Treatment. ; Conclusion -- References -- Chapter 20: Long-Term Follow-up of Patients with Acromegaly -- References -- Chapter 21: Acromegaly from the Perspective of a Patient -- A Perspective -- The Diagnosis Story -- The Surgery and Treatment -- Pituitary World News -- The Work and the Learning Continues -- About Insights -- On Family and Genetics -- How Awareness Works: One Story -- References -- Index.
• Titolo autorizzato: Acromegaly
• ISBN: 3-031-16258-7
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Lingua di pubblicazione: Inglese
• Record Nr.: 9910629290103321
• Lo trovi qui: Univ. Federico II
• Serie: Contemporary endocrinology.