The Experts below are selected from a list of 9 Experts worldwide ranked by ideXlab platform
Orsolya Nemes - One of the best experts on this subject based on the ideXlab platform.
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Treatment of pituitary adenomas
Orvosi hetilap, 2009Co-Authors: Emese Mezosi, Orsolya NemesAbstract:According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are "incidentalomas". The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, Hypophysis Apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3-5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing's disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors.
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A Hypophysisadenomák kezelése = Treatment of pituitary adenomas
2009Co-Authors: Emese Mezősi, Orsolya NemesAbstract:Az agyalapi mirigy terfoglalo folyamatainak prevalenciaja epidemiologiai vizsgalatok alapjan 16,5%, tulnyomo tobbseguk „incidentaloma”. A Hypophysisbetegsegek klinikai tunetei gyakran nem specifikusak, felismeresuk a Hypophysis hormontermelesenek zavara, kompresszios tunetek, Hypophysisapoplexia kapcsan vagy veletlen leletkent tortenik. A laboratoriumi diagnosztika elter a periferias endokrin szerv betegsegeiben megszokott algoritmustol. A prolactinomak ellatasaban a dopaminagonista kezeles jelenti az első vonalbeli terapiat, a kezeles celja a prolaktinszint normalizalasa, reproduktiv korban a fertilitas visszaallitasa, a tumortomeg megkisebbitese, a rezidualis Hypophysisműkodes megőrzese vagy javitasa es a betegseg kiujulasanak gatlasa. A dopaminagonista keszitmenyek kozul hazankban a bromocriptin es a quinagolid erhető el. A kezelesre jol reagalo tumoroknal 3–5 ev mulva a gyogyszer elhagyhato, ezen betegek ketharmadanal recidivara nem kell szamitani. A GH-, ACTH- es TSH-termelő, valamint hormonalisan inaktiv tumoroknal prioritasa van az idegsebeszeti megoldasnak. Az idegsebeszeti technikak jelentősen fejlődtek az elmult evtizedekben, a műteti mortalitas csokkent. A műtettel nem gyogyithato acromegalias betegek kezeleseben lenyeges haladast hoztak a szomatosztatinanalogok, es kezdeti tapasztalatok vannak a GH-receptor-antagonista pegvisomant alkalmazasaval. A Cushing-kor gyogyszeres kezelese tovabbra is a mellekvese-műkodes gatlasan alapszik, klinikai vizsgalat fazisaban van egy uj szomatosztatinanalog, a pasireotid. A ritka TSH-termelő adenomak dopaminagonista es szomatosztatinanalog kezelesre egyarant reagalhatnak. A Hypophysistumorok hagyomanyos irradiacios kezelese hatterbe szorult, invaziv, inoperabilis vagy malignus tumoroknal jon szoba. A sugarsebeszet es a frakcionalt stereotaxias sugarkezeles helye a Hypophysistumorok ellatasaban meg tovabbi vizsgalatokat igenyel. | According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are “incidentalomas”. The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, Hypophysis Apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3–5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing’s disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors.
Nemes Orsolya - One of the best experts on this subject based on the ideXlab platform.
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A Hypophysisadenomák kezelése = Treatment of pituitary adenomas
'Akademiai Kiado Zrt.', 2029Co-Authors: Mezősi Emese, Nemes OrsolyaAbstract:Az agyalapi mirigy térfoglaló folyamatainak prevalenciája epidemiológiai vizsgálatok alapján 16,5%, túlnyomó többségük „incidentaloma”. A Hypophysisbetegségek klinikai tünetei gyakran nem specifikusak, felismerésük a Hypophysis hormontermelésének zavara, kompressziós tünetek, Hypophysisapoplexia kapcsán vagy véletlen leletként történik. A laboratóriumi diagnosztika eltér a perifériás endokrin szerv betegségeiben megszokott algoritmustól. A prolactinomák ellátásában a dopaminagonista kezelés jelenti az első vonalbeli terápiát, a kezelés célja a prolaktinszint normalizálása, reproduktív korban a fertilitás visszaállítása, a tumortömeg megkisebbítése, a reziduális Hypophysisműködés megőrzése vagy javítása és a betegség kiújulásának gátlása. A dopaminagonista készítmények közül hazánkban a bromocriptin és a quinagolid érhető el. A kezelésre jól reagáló tumoroknál 3–5 év múlva a gyógyszer elhagyható, ezen betegek kétharmadánál recidívára nem kell számítani. A GH-, ACTH- és TSH-termelő, valamint hormonálisan inaktív tumoroknál prioritása van az idegsebészeti megoldásnak. Az idegsebészeti technikák jelentősen fejlődtek az elmúlt évtizedekben, a műtéti mortalitás csökkent. A műtéttel nem gyógyítható acromegaliás betegek kezelésében lényeges haladást hoztak a szomatosztatinanalógok, és kezdeti tapasztalatok vannak a GH-receptor-antagonista pegvisomant alkalmazásával. A Cushing-kór gyógyszeres kezelése továbbra is a mellékvese-működés gátlásán alapszik, klinikai vizsgálat fázisában van egy új szomatosztatinanalóg, a pasireotid. A ritka TSH-termelő adenomák dopaminagonista és szomatosztatinanalóg kezelésre egyaránt reagálhatnak. A Hypophysistumorok hagyományos irradiációs kezelése háttérbe szorult, invazív, inoperábilis vagy malignus tumoroknál jön szóba. A sugársebészet és a frakcionált stereotaxiás sugárkezelés helye a Hypophysistumorok ellátásában még további vizsgálatokat igényel. | According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are “incidentalomas”. The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, Hypophysis Apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3–5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing’s disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors
Mezősi Emese - One of the best experts on this subject based on the ideXlab platform.
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A Hypophysisadenomák kezelése = Treatment of pituitary adenomas
'Akademiai Kiado Zrt.', 2029Co-Authors: Mezősi Emese, Nemes OrsolyaAbstract:Az agyalapi mirigy térfoglaló folyamatainak prevalenciája epidemiológiai vizsgálatok alapján 16,5%, túlnyomó többségük „incidentaloma”. A Hypophysisbetegségek klinikai tünetei gyakran nem specifikusak, felismerésük a Hypophysis hormontermelésének zavara, kompressziós tünetek, Hypophysisapoplexia kapcsán vagy véletlen leletként történik. A laboratóriumi diagnosztika eltér a perifériás endokrin szerv betegségeiben megszokott algoritmustól. A prolactinomák ellátásában a dopaminagonista kezelés jelenti az első vonalbeli terápiát, a kezelés célja a prolaktinszint normalizálása, reproduktív korban a fertilitás visszaállítása, a tumortömeg megkisebbítése, a reziduális Hypophysisműködés megőrzése vagy javítása és a betegség kiújulásának gátlása. A dopaminagonista készítmények közül hazánkban a bromocriptin és a quinagolid érhető el. A kezelésre jól reagáló tumoroknál 3–5 év múlva a gyógyszer elhagyható, ezen betegek kétharmadánál recidívára nem kell számítani. A GH-, ACTH- és TSH-termelő, valamint hormonálisan inaktív tumoroknál prioritása van az idegsebészeti megoldásnak. Az idegsebészeti technikák jelentősen fejlődtek az elmúlt évtizedekben, a műtéti mortalitás csökkent. A műtéttel nem gyógyítható acromegaliás betegek kezelésében lényeges haladást hoztak a szomatosztatinanalógok, és kezdeti tapasztalatok vannak a GH-receptor-antagonista pegvisomant alkalmazásával. A Cushing-kór gyógyszeres kezelése továbbra is a mellékvese-működés gátlásán alapszik, klinikai vizsgálat fázisában van egy új szomatosztatinanalóg, a pasireotid. A ritka TSH-termelő adenomák dopaminagonista és szomatosztatinanalóg kezelésre egyaránt reagálhatnak. A Hypophysistumorok hagyományos irradiációs kezelése háttérbe szorult, invazív, inoperábilis vagy malignus tumoroknál jön szóba. A sugársebészet és a frakcionált stereotaxiás sugárkezelés helye a Hypophysistumorok ellátásában még további vizsgálatokat igényel. | According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are “incidentalomas”. The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, Hypophysis Apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3–5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing’s disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors
Emese Mezősi - One of the best experts on this subject based on the ideXlab platform.
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A Hypophysisadenomák kezelése = Treatment of pituitary adenomas
2009Co-Authors: Emese Mezősi, Orsolya NemesAbstract:Az agyalapi mirigy terfoglalo folyamatainak prevalenciaja epidemiologiai vizsgalatok alapjan 16,5%, tulnyomo tobbseguk „incidentaloma”. A Hypophysisbetegsegek klinikai tunetei gyakran nem specifikusak, felismeresuk a Hypophysis hormontermelesenek zavara, kompresszios tunetek, Hypophysisapoplexia kapcsan vagy veletlen leletkent tortenik. A laboratoriumi diagnosztika elter a periferias endokrin szerv betegsegeiben megszokott algoritmustol. A prolactinomak ellatasaban a dopaminagonista kezeles jelenti az első vonalbeli terapiat, a kezeles celja a prolaktinszint normalizalasa, reproduktiv korban a fertilitas visszaallitasa, a tumortomeg megkisebbitese, a rezidualis Hypophysisműkodes megőrzese vagy javitasa es a betegseg kiujulasanak gatlasa. A dopaminagonista keszitmenyek kozul hazankban a bromocriptin es a quinagolid erhető el. A kezelesre jol reagalo tumoroknal 3–5 ev mulva a gyogyszer elhagyhato, ezen betegek ketharmadanal recidivara nem kell szamitani. A GH-, ACTH- es TSH-termelő, valamint hormonalisan inaktiv tumoroknal prioritasa van az idegsebeszeti megoldasnak. Az idegsebeszeti technikak jelentősen fejlődtek az elmult evtizedekben, a műteti mortalitas csokkent. A műtettel nem gyogyithato acromegalias betegek kezeleseben lenyeges haladast hoztak a szomatosztatinanalogok, es kezdeti tapasztalatok vannak a GH-receptor-antagonista pegvisomant alkalmazasaval. A Cushing-kor gyogyszeres kezelese tovabbra is a mellekvese-műkodes gatlasan alapszik, klinikai vizsgalat fazisaban van egy uj szomatosztatinanalog, a pasireotid. A ritka TSH-termelő adenomak dopaminagonista es szomatosztatinanalog kezelesre egyarant reagalhatnak. A Hypophysistumorok hagyomanyos irradiacios kezelese hatterbe szorult, invaziv, inoperabilis vagy malignus tumoroknal jon szoba. A sugarsebeszet es a frakcionalt stereotaxias sugarkezeles helye a Hypophysistumorok ellatasaban meg tovabbi vizsgalatokat igenyel. | According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are “incidentalomas”. The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, Hypophysis Apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3–5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing’s disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors.
Emese Mezosi - One of the best experts on this subject based on the ideXlab platform.
-
Treatment of pituitary adenomas
Orvosi hetilap, 2009Co-Authors: Emese Mezosi, Orsolya NemesAbstract:According to epidemiological studies, the prevalence of pituitary adenomas is 16.5% and the majority of them are "incidentalomas". The symptoms of pituitary disorders are often non-specific; disturbances of pituitary function, compression symptoms, Hypophysis Apoplexy or accidental findings may help the diagnosis. The hormonal evaluation of pituitary adenomas is different from the algorithm used in the disorders of peripheral endocrine organs. The first-line therapy of prolactinomas are the dopamine agonists, and the aims of the treatment are to normalize the prolactin level, restore fertility in child-bearing age, decrease tumor mass, save or improve the residual pituitary function and inhibit the relapse of the disease. The available dopamine agonists in Hungary are bromocriptine and quinagolide. In case of tumors with good therapeutic response, medical therapy can be withdrawn after 3-5 years; hyperprolactinemia will not recur in 2/3 of these patients. Neurosurgery is the primary therapy of GH-, ACTH-, TSH-producing and inactive adenomas. In the last decades, significant improvement has been reached in surgical procedures, resulting in low mortality rates. Acromegalic patients with unresectable tumors have a great benefit from somatostatin analog treatment. The growth hormone receptor antagonist pegvisomant is the newest modality for the treatment of acromegaly. The medical therapy of Cushing's disease is still based on the inhibition of steroid production. A new, promising somatostatin analog, pasireotide is evaluated in clinical trials. The rare TSH-producing tumor can respond to both dopamine agonist and somatostatin analog therapy. The application of conventional radiotherapy has decreased; radiotherapy is mainly used in the treatment of invasive, incurable or malignant tumors. Further studies are needed to elucidate the exact role of radiosurgery and fractionated stereotaxic irradiation in the treatment of pituitary tumors.