The Experts below are selected from a list of 69 Experts worldwide ranked by ideXlab platform
Aparna Pal - One of the best experts on this subject based on the ideXlab platform.
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Plurihormonal Pit-1 lineage adenoma presenting as Meningitis with recurrence after somatostatin analogue.
Endocrinology diabetes & metabolism case reports, 2019Co-Authors: Yoko Olmedilla, Shoaib Khan, Victoria Young, Robin Joseph, Simon Cudlip, Olaf Ansgorge, Ashley Grossman, Aparna PalAbstract:A 21 year-old woman was found to have a pituitary macroadenoma following an episode of Haemophilus Meningitis. Biochemical TSH and GH excess was noted, although with no clear clinical correlates. She was treated with a somatostatin analogue (SSA), which restored the euthyroid state and controlled GH hypersecretion, but she re-presented with a further episode of cerebrospinal fluid (CSF) leak and recurrent Meningitis. Histology following transsphenoidal adenomectomy revealed a Pit-1 lineage plurihormonal adenoma expressing GH, TSH and PRL. Such plurihormonal pituitary tumours are uncommon and even more unusual to present with spontaneous bacterial Meningitis. The second episode of CSF leak and Meningitis appears to have been due to SSA therapy-induced tumour shrinkage, which is not a well-described phenomenon in the literature for this type of tumour. Learning points: Pit-1 lineage GH/TSH/PRL-expressing plurihormonal pituitary adenomas are uncommon. Moreover, this case is unique as the patient first presented with bacterial Meningitis. Inmunohistochemical plurihormonality of pituitary adenomas does not necessarily correlate with biochemical and clinical features of hormonal hypersecretion. Given that plurihormonal Pit-1 lineage adenomas may behave more aggressively than classical pituitary adenomas, accurate pathological characterization of these tumours has an increasing prognostic relevance. Although unusual, a CSF leak and Meningitis may be precipitated by SSA therapy of a pituitary macroadenoma via tumour shrinkage. Background Plurihormonal Pit-1 lineage adenomas expressing growth hormone (GH), thyrotrophin (TSH) and prolactin (PRL) are rare (1, 2). Clinical expression of these plurihormonal tumours varies, as immunohistochemical staining, hormonal hypersecretion and associated clinical features may not necessarily align. Furthermore, bacterial Meningitis as first presentation of a pituitary adenoma is also highly uncommon (3). Although transsphenoidal adenomectomy is still considered the first therapeutic approach in patients with these plurihormonal adenomas (1), the role of somatostatin analogues (SSA) as primary medical therapy in selected cases appears promising (4, 5). In contrast to the treatment of invasive prolactinomas with dopamine agonists, therapy with SSAs is seldom associated with the development of a cerebrospinal fluid (CSF) leak and/or Meningitis (6). We report a case of a Pit-1 lineage plurihormonal (GH/TSH/PRL) pituitary adenoma initially presenting with Meningitis. On initiation of subsequent SSA therapy, this patient developed a CSF leak and a second episode of Meningitis.
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Plurihormonal Pit-1 lineage adenoma presenting as Meningitis with recurrence after somatostatin analogue
Bioscientifica, 2019Co-Authors: Yoko Olmedilla, Shoaib Khan, Victoria Young, Robin Joseph, Simon Cudlip, Olaf Ansgorge, Ashley Grossman, Aparna PalAbstract:A 21 year-old woman was found to have a pituitary macroadenoma following an episode of Haemophilus Meningitis. Biochemical TSH and GH excess was noted, although with no clear clinical correlates. She was treated with a somatostatin analogue (SSA), which restored the euthyroid state and controlled GH hypersecretion, but she re-presented with a further episode of cerebrospinal fluid (CSF) leak and recurrent Meningitis. Histology following transsphenoidal adenomectomy revealed a Pit-1 lineage plurihormonal adenoma expressing GH, TSH and PRL. Such plurihormonal pituitary tumours are uncommon and even more unusual to present with spontaneous bacterial Meningitis. The second episode of CSF leak and Meningitis appears to have been due to SSA therapy-induced tumour shrinkage, which is not a well-described phenomenon in the literature for this type of tumour
Yoko Olmedilla - One of the best experts on this subject based on the ideXlab platform.
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Plurihormonal Pit-1 lineage adenoma presenting as Meningitis with recurrence after somatostatin analogue.
Endocrinology diabetes & metabolism case reports, 2019Co-Authors: Yoko Olmedilla, Shoaib Khan, Victoria Young, Robin Joseph, Simon Cudlip, Olaf Ansgorge, Ashley Grossman, Aparna PalAbstract:A 21 year-old woman was found to have a pituitary macroadenoma following an episode of Haemophilus Meningitis. Biochemical TSH and GH excess was noted, although with no clear clinical correlates. She was treated with a somatostatin analogue (SSA), which restored the euthyroid state and controlled GH hypersecretion, but she re-presented with a further episode of cerebrospinal fluid (CSF) leak and recurrent Meningitis. Histology following transsphenoidal adenomectomy revealed a Pit-1 lineage plurihormonal adenoma expressing GH, TSH and PRL. Such plurihormonal pituitary tumours are uncommon and even more unusual to present with spontaneous bacterial Meningitis. The second episode of CSF leak and Meningitis appears to have been due to SSA therapy-induced tumour shrinkage, which is not a well-described phenomenon in the literature for this type of tumour. Learning points: Pit-1 lineage GH/TSH/PRL-expressing plurihormonal pituitary adenomas are uncommon. Moreover, this case is unique as the patient first presented with bacterial Meningitis. Inmunohistochemical plurihormonality of pituitary adenomas does not necessarily correlate with biochemical and clinical features of hormonal hypersecretion. Given that plurihormonal Pit-1 lineage adenomas may behave more aggressively than classical pituitary adenomas, accurate pathological characterization of these tumours has an increasing prognostic relevance. Although unusual, a CSF leak and Meningitis may be precipitated by SSA therapy of a pituitary macroadenoma via tumour shrinkage. Background Plurihormonal Pit-1 lineage adenomas expressing growth hormone (GH), thyrotrophin (TSH) and prolactin (PRL) are rare (1, 2). Clinical expression of these plurihormonal tumours varies, as immunohistochemical staining, hormonal hypersecretion and associated clinical features may not necessarily align. Furthermore, bacterial Meningitis as first presentation of a pituitary adenoma is also highly uncommon (3). Although transsphenoidal adenomectomy is still considered the first therapeutic approach in patients with these plurihormonal adenomas (1), the role of somatostatin analogues (SSA) as primary medical therapy in selected cases appears promising (4, 5). In contrast to the treatment of invasive prolactinomas with dopamine agonists, therapy with SSAs is seldom associated with the development of a cerebrospinal fluid (CSF) leak and/or Meningitis (6). We report a case of a Pit-1 lineage plurihormonal (GH/TSH/PRL) pituitary adenoma initially presenting with Meningitis. On initiation of subsequent SSA therapy, this patient developed a CSF leak and a second episode of Meningitis.
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Plurihormonal Pit-1 lineage adenoma presenting as Meningitis with recurrence after somatostatin analogue
Bioscientifica, 2019Co-Authors: Yoko Olmedilla, Shoaib Khan, Victoria Young, Robin Joseph, Simon Cudlip, Olaf Ansgorge, Ashley Grossman, Aparna PalAbstract:A 21 year-old woman was found to have a pituitary macroadenoma following an episode of Haemophilus Meningitis. Biochemical TSH and GH excess was noted, although with no clear clinical correlates. She was treated with a somatostatin analogue (SSA), which restored the euthyroid state and controlled GH hypersecretion, but she re-presented with a further episode of cerebrospinal fluid (CSF) leak and recurrent Meningitis. Histology following transsphenoidal adenomectomy revealed a Pit-1 lineage plurihormonal adenoma expressing GH, TSH and PRL. Such plurihormonal pituitary tumours are uncommon and even more unusual to present with spontaneous bacterial Meningitis. The second episode of CSF leak and Meningitis appears to have been due to SSA therapy-induced tumour shrinkage, which is not a well-described phenomenon in the literature for this type of tumour
Mvlml Cardoso - One of the best experts on this subject based on the ideXlab platform.
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Preventable newborn deaths: analysis of the newborn infection component in Brazil from 2007 to 2017
European Journal of Public Health, 2020Co-Authors: E S Oliveira, A F Di Moura, Tamires Rebeca Forte Viana, N R Oliveira, Lorena Pinheiro Barbosa, Paulo César De Almeida, Mvlml CardosoAbstract:Abstract The Universal Agenda 2030 was developed by representatives of all countries as an action plan covering the three dimensions of sustainable development: economic, social and environmental. 17 objectives were agreed upon, highlighting objective 03, which aims to ensure a healthy life and promote well-being for all at all ages, having as one of the established goals to end preventable deaths of newborns by 2030. Infections neonatal care reflects deficits in health care, covering the entire perinatal period, and it is necessary to understand its causes in order to promote quality preventive and health promotion actions. The question is: what are the causes that make up the indicator of early neonatal mortality, due to preventable causes in Brazil between 2007 to 2017? Retrospective study carried out between September and October 2019 using secondary data collection from Department of Informatics of the Unified Health System - SUS (DATASUS). The outcome variable was early neonatal mortality from preventable causes and the independent variable was the infections component of the newborn). Twelve preventable causes of death have been identified in this category: congenital rubella syndrome; congenital syphilis; neonatal tetanus; diphtheria; Haemophilus and non-Haemophilus Meningitis; human immunodeficiency virus diseases; neonatal infections; pneumonia; acute infections of lower airways; bacterial diseases and intestinal infectious diseases. The main cause of preventable death was infections from the neonatal period, which include congenital viral diseases (cytomegalovirus and herpes simplex); newborn bacterial septicemia; congenital parasitic diseases; omphalitis of newborn with or without mild hemorrhage; intra-amniotic infection of the fetus, neonatal infection of the urinary tract and/or skin. There is a need for more effective public health actions to modify the neonatal mortality situation, as well as health surveillance actions. Key messages Warn about causes of perinatal mortality that can be avoided. Strengthen the fulfillment of objective 3 of the 2030 Agenda to ensure and promote health in the perinatal period.
K.p. Klugman - One of the best experts on this subject based on the ideXlab platform.
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Pneumococcal and Haemophilus influenzae Meningitis in a children's hospital in Ethiopia : serotypes and susceptibility patterns
Tropical medicine & international health : TM & IH, 1999Co-Authors: Lulu Muhe, K.p. KlugmanAbstract:This study describes the serotypes and susceptibility pattern of two organisms (Streptococcus pneumoniae and Haemophilus influenzae) causing Meningitis in Ethiopian children. The study was conducted in the Ethio-Swedish Childrens Hospital in Addis Ababa from 1993 to 1995. Subjects had had clinical symptoms for more than 4 weeks and a positive CSF culture growing either S. pneumoniae or H. influenzae. Resistance of S. pneumoniae and H. influenzae to penicillin and chloramphenicol has already been reported globally; this resistance has been related to specific serotypes of S. pneumoniae or to beta-lactamase-producing H. influenzae strains. Results showed that of 7294 patients there were 74 Haemophilus Meningitis and 46 pneumococcal Meningitis cases. 19 children died from pneumococcal Meningitis and 28 from Haemophilus Meningitis. The mortality rate was higher for penicillin-resistant pneumococcal Meningitis (50%) than for penicillin-susceptible pneumococcal Meningitis (39%). Common serotypes accounting for 76% of S. pneumoniae were type 14 19F 20 1 18 and 5 whereas 97% of the H. influenzae cases were type b and only 2 cases were beta-lactamase-producing. 76% of S. pneumoniae isolates belong to serotypes preventable by a 9-valent vaccine. The data did not show any difference between the two organisms causing Meningitis with regard to clinical presentation or outcome although alterations in levels of consciousness occurred more frequently in the S. pneumoniae group.
Simon Cudlip - One of the best experts on this subject based on the ideXlab platform.
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Plurihormonal Pit-1 lineage adenoma presenting as Meningitis with recurrence after somatostatin analogue.
Endocrinology diabetes & metabolism case reports, 2019Co-Authors: Yoko Olmedilla, Shoaib Khan, Victoria Young, Robin Joseph, Simon Cudlip, Olaf Ansgorge, Ashley Grossman, Aparna PalAbstract:A 21 year-old woman was found to have a pituitary macroadenoma following an episode of Haemophilus Meningitis. Biochemical TSH and GH excess was noted, although with no clear clinical correlates. She was treated with a somatostatin analogue (SSA), which restored the euthyroid state and controlled GH hypersecretion, but she re-presented with a further episode of cerebrospinal fluid (CSF) leak and recurrent Meningitis. Histology following transsphenoidal adenomectomy revealed a Pit-1 lineage plurihormonal adenoma expressing GH, TSH and PRL. Such plurihormonal pituitary tumours are uncommon and even more unusual to present with spontaneous bacterial Meningitis. The second episode of CSF leak and Meningitis appears to have been due to SSA therapy-induced tumour shrinkage, which is not a well-described phenomenon in the literature for this type of tumour. Learning points: Pit-1 lineage GH/TSH/PRL-expressing plurihormonal pituitary adenomas are uncommon. Moreover, this case is unique as the patient first presented with bacterial Meningitis. Inmunohistochemical plurihormonality of pituitary adenomas does not necessarily correlate with biochemical and clinical features of hormonal hypersecretion. Given that plurihormonal Pit-1 lineage adenomas may behave more aggressively than classical pituitary adenomas, accurate pathological characterization of these tumours has an increasing prognostic relevance. Although unusual, a CSF leak and Meningitis may be precipitated by SSA therapy of a pituitary macroadenoma via tumour shrinkage. Background Plurihormonal Pit-1 lineage adenomas expressing growth hormone (GH), thyrotrophin (TSH) and prolactin (PRL) are rare (1, 2). Clinical expression of these plurihormonal tumours varies, as immunohistochemical staining, hormonal hypersecretion and associated clinical features may not necessarily align. Furthermore, bacterial Meningitis as first presentation of a pituitary adenoma is also highly uncommon (3). Although transsphenoidal adenomectomy is still considered the first therapeutic approach in patients with these plurihormonal adenomas (1), the role of somatostatin analogues (SSA) as primary medical therapy in selected cases appears promising (4, 5). In contrast to the treatment of invasive prolactinomas with dopamine agonists, therapy with SSAs is seldom associated with the development of a cerebrospinal fluid (CSF) leak and/or Meningitis (6). We report a case of a Pit-1 lineage plurihormonal (GH/TSH/PRL) pituitary adenoma initially presenting with Meningitis. On initiation of subsequent SSA therapy, this patient developed a CSF leak and a second episode of Meningitis.
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Plurihormonal Pit-1 lineage adenoma presenting as Meningitis with recurrence after somatostatin analogue
Bioscientifica, 2019Co-Authors: Yoko Olmedilla, Shoaib Khan, Victoria Young, Robin Joseph, Simon Cudlip, Olaf Ansgorge, Ashley Grossman, Aparna PalAbstract:A 21 year-old woman was found to have a pituitary macroadenoma following an episode of Haemophilus Meningitis. Biochemical TSH and GH excess was noted, although with no clear clinical correlates. She was treated with a somatostatin analogue (SSA), which restored the euthyroid state and controlled GH hypersecretion, but she re-presented with a further episode of cerebrospinal fluid (CSF) leak and recurrent Meningitis. Histology following transsphenoidal adenomectomy revealed a Pit-1 lineage plurihormonal adenoma expressing GH, TSH and PRL. Such plurihormonal pituitary tumours are uncommon and even more unusual to present with spontaneous bacterial Meningitis. The second episode of CSF leak and Meningitis appears to have been due to SSA therapy-induced tumour shrinkage, which is not a well-described phenomenon in the literature for this type of tumour
