The Experts below are selected from a list of 15 Experts worldwide ranked by ideXlab platform
Adomas Bunevicius - One of the best experts on this subject based on the ideXlab platform.
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Stereotactic radiosurgery before bilateral adrenalectomy is associated with lowered risk of Nelson’s Syndrome in refractory Cushing’s disease patients
Acta Neurochirurgica, 2021Co-Authors: Adomas Bunevicius, Karen Lavezzo, Philip W. Smith, Mary Lee Vance, Jason SheehanAbstract:Background Nelson’s Syndrome is a rare but challenging sequelae of Cushing’s disease (CD) after bilateral adrenalectomy (BLA). We sought to determine if stereotactic radiosurgery (SRS) of residual pituitary adenoma performed before BLA can decrease the risk of Nelson’s Syndrome. Methods Consecutive patients with CD who underwent BLA after non-curative resection of ACTH secreting pituitary adenoma and had at least one follow-up visit after BLA were studied. Nelson’s Syndrome was diagnosed based on the combination of rising ACTH levels, increasing volume of the pituitary adenoma and/or hyperpigmentation. Results Fifty patients underwent BLA for refractory CD, and 43 patients (7 men and 36 women) had at least one follow-up visit after BAL. Median endocrine, imaging, and clinical follow-up were 66 months, 69 months, and 80 months, respectively. Nine patients (22%) were diagnosed with the Nelson’s Syndrome at median time after BLA at 24 months (range: 0.6–119.4 months). SRS before BLA was associated with reduced risk of the Nelson’s Syndrome (HR = 0.126; 95%CI [0.022–0.714], p =0.019), while elevated ACTH level within 6 months after BLA was associated with increased risk for the Nelson’s Syndrome (HR = 9.053; 95%CI [2.076–39.472], p =0.003). Conclusions SRS before BLA can reduce the risk for the Nelson’s Syndrome in refractory CD patients requiring BLA and should be considered before proceeding to BLA. Elevated ACTH concentration within 6 months after BLA is associated with greater risk of the Nelsons’ Syndrome. When no prior SRS is administered, those with a high ACTH level shortly after BLA may benefit from early SRS.
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Stereotactic radiosurgery before bilateral adrenalectomy is associated with lowered risk of Nelson's Syndrome in refractory Cushing's disease patients.
Acta neurochirurgica, 2021Co-Authors: Adomas Bunevicius, Karen Lavezzo, Philip W. Smith, Mary Lee Vance, Jason P. SheehanAbstract:Background Nelson's Syndrome is a rare but challenging sequelae of Cushing's disease (CD) after bilateral adrenalectomy (BLA). We sought to determine if stereotactic radiosurgery (SRS) of residual pituitary adenoma performed before BLA can decrease the risk of Nelson's Syndrome. Methods Consecutive patients with CD who underwent BLA after non-curative resection of ACTH secreting pituitary adenoma and had at least one follow-up visit after BLA were studied. Nelson's Syndrome was diagnosed based on the combination of rising ACTH levels, increasing volume of the pituitary adenoma and/or hyperpigmentation. Results Fifty patients underwent BLA for refractory CD, and 43 patients (7 men and 36 women) had at least one follow-up visit after BAL. Median endocrine, imaging, and clinical follow-up were 66 months, 69 months, and 80 months, respectively. Nine patients (22%) were diagnosed with the Nelson's Syndrome at median time after BLA at 24 months (range: 0.6-119.4 months). SRS before BLA was associated with reduced risk of the Nelson's Syndrome (HR = 0.126; 95%CI [0.022-0.714], p=0.019), while elevated ACTH level within 6 months after BLA was associated with increased risk for the Nelson's Syndrome (HR = 9.053; 95%CI [2.076-39.472], p=0.003). Conclusions SRS before BLA can reduce the risk for the Nelson's Syndrome in refractory CD patients requiring BLA and should be considered before proceeding to BLA. Elevated ACTH concentration within 6 months after BLA is associated with greater risk of the Nelsons' Syndrome. When no prior SRS is administered, those with a high ACTH level shortly after BLA may benefit from early SRS.
Jason Sheehan - One of the best experts on this subject based on the ideXlab platform.
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Stereotactic radiosurgery before bilateral adrenalectomy is associated with lowered risk of Nelson’s Syndrome in refractory Cushing’s disease patients
Acta Neurochirurgica, 2021Co-Authors: Adomas Bunevicius, Karen Lavezzo, Philip W. Smith, Mary Lee Vance, Jason SheehanAbstract:Background Nelson’s Syndrome is a rare but challenging sequelae of Cushing’s disease (CD) after bilateral adrenalectomy (BLA). We sought to determine if stereotactic radiosurgery (SRS) of residual pituitary adenoma performed before BLA can decrease the risk of Nelson’s Syndrome. Methods Consecutive patients with CD who underwent BLA after non-curative resection of ACTH secreting pituitary adenoma and had at least one follow-up visit after BLA were studied. Nelson’s Syndrome was diagnosed based on the combination of rising ACTH levels, increasing volume of the pituitary adenoma and/or hyperpigmentation. Results Fifty patients underwent BLA for refractory CD, and 43 patients (7 men and 36 women) had at least one follow-up visit after BAL. Median endocrine, imaging, and clinical follow-up were 66 months, 69 months, and 80 months, respectively. Nine patients (22%) were diagnosed with the Nelson’s Syndrome at median time after BLA at 24 months (range: 0.6–119.4 months). SRS before BLA was associated with reduced risk of the Nelson’s Syndrome (HR = 0.126; 95%CI [0.022–0.714], p =0.019), while elevated ACTH level within 6 months after BLA was associated with increased risk for the Nelson’s Syndrome (HR = 9.053; 95%CI [2.076–39.472], p =0.003). Conclusions SRS before BLA can reduce the risk for the Nelson’s Syndrome in refractory CD patients requiring BLA and should be considered before proceeding to BLA. Elevated ACTH concentration within 6 months after BLA is associated with greater risk of the Nelsons’ Syndrome. When no prior SRS is administered, those with a high ACTH level shortly after BLA may benefit from early SRS.
Jason P. Sheehan - One of the best experts on this subject based on the ideXlab platform.
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Stereotactic radiosurgery before bilateral adrenalectomy is associated with lowered risk of Nelson's Syndrome in refractory Cushing's disease patients.
Acta neurochirurgica, 2021Co-Authors: Adomas Bunevicius, Karen Lavezzo, Philip W. Smith, Mary Lee Vance, Jason P. SheehanAbstract:Background Nelson's Syndrome is a rare but challenging sequelae of Cushing's disease (CD) after bilateral adrenalectomy (BLA). We sought to determine if stereotactic radiosurgery (SRS) of residual pituitary adenoma performed before BLA can decrease the risk of Nelson's Syndrome. Methods Consecutive patients with CD who underwent BLA after non-curative resection of ACTH secreting pituitary adenoma and had at least one follow-up visit after BLA were studied. Nelson's Syndrome was diagnosed based on the combination of rising ACTH levels, increasing volume of the pituitary adenoma and/or hyperpigmentation. Results Fifty patients underwent BLA for refractory CD, and 43 patients (7 men and 36 women) had at least one follow-up visit after BAL. Median endocrine, imaging, and clinical follow-up were 66 months, 69 months, and 80 months, respectively. Nine patients (22%) were diagnosed with the Nelson's Syndrome at median time after BLA at 24 months (range: 0.6-119.4 months). SRS before BLA was associated with reduced risk of the Nelson's Syndrome (HR = 0.126; 95%CI [0.022-0.714], p=0.019), while elevated ACTH level within 6 months after BLA was associated with increased risk for the Nelson's Syndrome (HR = 9.053; 95%CI [2.076-39.472], p=0.003). Conclusions SRS before BLA can reduce the risk for the Nelson's Syndrome in refractory CD patients requiring BLA and should be considered before proceeding to BLA. Elevated ACTH concentration within 6 months after BLA is associated with greater risk of the Nelsons' Syndrome. When no prior SRS is administered, those with a high ACTH level shortly after BLA may benefit from early SRS.
Karen Lavezzo - One of the best experts on this subject based on the ideXlab platform.
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Stereotactic radiosurgery before bilateral adrenalectomy is associated with lowered risk of Nelson’s Syndrome in refractory Cushing’s disease patients
Acta Neurochirurgica, 2021Co-Authors: Adomas Bunevicius, Karen Lavezzo, Philip W. Smith, Mary Lee Vance, Jason SheehanAbstract:Background Nelson’s Syndrome is a rare but challenging sequelae of Cushing’s disease (CD) after bilateral adrenalectomy (BLA). We sought to determine if stereotactic radiosurgery (SRS) of residual pituitary adenoma performed before BLA can decrease the risk of Nelson’s Syndrome. Methods Consecutive patients with CD who underwent BLA after non-curative resection of ACTH secreting pituitary adenoma and had at least one follow-up visit after BLA were studied. Nelson’s Syndrome was diagnosed based on the combination of rising ACTH levels, increasing volume of the pituitary adenoma and/or hyperpigmentation. Results Fifty patients underwent BLA for refractory CD, and 43 patients (7 men and 36 women) had at least one follow-up visit after BAL. Median endocrine, imaging, and clinical follow-up were 66 months, 69 months, and 80 months, respectively. Nine patients (22%) were diagnosed with the Nelson’s Syndrome at median time after BLA at 24 months (range: 0.6–119.4 months). SRS before BLA was associated with reduced risk of the Nelson’s Syndrome (HR = 0.126; 95%CI [0.022–0.714], p =0.019), while elevated ACTH level within 6 months after BLA was associated with increased risk for the Nelson’s Syndrome (HR = 9.053; 95%CI [2.076–39.472], p =0.003). Conclusions SRS before BLA can reduce the risk for the Nelson’s Syndrome in refractory CD patients requiring BLA and should be considered before proceeding to BLA. Elevated ACTH concentration within 6 months after BLA is associated with greater risk of the Nelsons’ Syndrome. When no prior SRS is administered, those with a high ACTH level shortly after BLA may benefit from early SRS.
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Stereotactic radiosurgery before bilateral adrenalectomy is associated with lowered risk of Nelson's Syndrome in refractory Cushing's disease patients.
Acta neurochirurgica, 2021Co-Authors: Adomas Bunevicius, Karen Lavezzo, Philip W. Smith, Mary Lee Vance, Jason P. SheehanAbstract:Background Nelson's Syndrome is a rare but challenging sequelae of Cushing's disease (CD) after bilateral adrenalectomy (BLA). We sought to determine if stereotactic radiosurgery (SRS) of residual pituitary adenoma performed before BLA can decrease the risk of Nelson's Syndrome. Methods Consecutive patients with CD who underwent BLA after non-curative resection of ACTH secreting pituitary adenoma and had at least one follow-up visit after BLA were studied. Nelson's Syndrome was diagnosed based on the combination of rising ACTH levels, increasing volume of the pituitary adenoma and/or hyperpigmentation. Results Fifty patients underwent BLA for refractory CD, and 43 patients (7 men and 36 women) had at least one follow-up visit after BAL. Median endocrine, imaging, and clinical follow-up were 66 months, 69 months, and 80 months, respectively. Nine patients (22%) were diagnosed with the Nelson's Syndrome at median time after BLA at 24 months (range: 0.6-119.4 months). SRS before BLA was associated with reduced risk of the Nelson's Syndrome (HR = 0.126; 95%CI [0.022-0.714], p=0.019), while elevated ACTH level within 6 months after BLA was associated with increased risk for the Nelson's Syndrome (HR = 9.053; 95%CI [2.076-39.472], p=0.003). Conclusions SRS before BLA can reduce the risk for the Nelson's Syndrome in refractory CD patients requiring BLA and should be considered before proceeding to BLA. Elevated ACTH concentration within 6 months after BLA is associated with greater risk of the Nelsons' Syndrome. When no prior SRS is administered, those with a high ACTH level shortly after BLA may benefit from early SRS.
Philip W. Smith - One of the best experts on this subject based on the ideXlab platform.
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Stereotactic radiosurgery before bilateral adrenalectomy is associated with lowered risk of Nelson’s Syndrome in refractory Cushing’s disease patients
Acta Neurochirurgica, 2021Co-Authors: Adomas Bunevicius, Karen Lavezzo, Philip W. Smith, Mary Lee Vance, Jason SheehanAbstract:Background Nelson’s Syndrome is a rare but challenging sequelae of Cushing’s disease (CD) after bilateral adrenalectomy (BLA). We sought to determine if stereotactic radiosurgery (SRS) of residual pituitary adenoma performed before BLA can decrease the risk of Nelson’s Syndrome. Methods Consecutive patients with CD who underwent BLA after non-curative resection of ACTH secreting pituitary adenoma and had at least one follow-up visit after BLA were studied. Nelson’s Syndrome was diagnosed based on the combination of rising ACTH levels, increasing volume of the pituitary adenoma and/or hyperpigmentation. Results Fifty patients underwent BLA for refractory CD, and 43 patients (7 men and 36 women) had at least one follow-up visit after BAL. Median endocrine, imaging, and clinical follow-up were 66 months, 69 months, and 80 months, respectively. Nine patients (22%) were diagnosed with the Nelson’s Syndrome at median time after BLA at 24 months (range: 0.6–119.4 months). SRS before BLA was associated with reduced risk of the Nelson’s Syndrome (HR = 0.126; 95%CI [0.022–0.714], p =0.019), while elevated ACTH level within 6 months after BLA was associated with increased risk for the Nelson’s Syndrome (HR = 9.053; 95%CI [2.076–39.472], p =0.003). Conclusions SRS before BLA can reduce the risk for the Nelson’s Syndrome in refractory CD patients requiring BLA and should be considered before proceeding to BLA. Elevated ACTH concentration within 6 months after BLA is associated with greater risk of the Nelsons’ Syndrome. When no prior SRS is administered, those with a high ACTH level shortly after BLA may benefit from early SRS.
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Stereotactic radiosurgery before bilateral adrenalectomy is associated with lowered risk of Nelson's Syndrome in refractory Cushing's disease patients.
Acta neurochirurgica, 2021Co-Authors: Adomas Bunevicius, Karen Lavezzo, Philip W. Smith, Mary Lee Vance, Jason P. SheehanAbstract:Background Nelson's Syndrome is a rare but challenging sequelae of Cushing's disease (CD) after bilateral adrenalectomy (BLA). We sought to determine if stereotactic radiosurgery (SRS) of residual pituitary adenoma performed before BLA can decrease the risk of Nelson's Syndrome. Methods Consecutive patients with CD who underwent BLA after non-curative resection of ACTH secreting pituitary adenoma and had at least one follow-up visit after BLA were studied. Nelson's Syndrome was diagnosed based on the combination of rising ACTH levels, increasing volume of the pituitary adenoma and/or hyperpigmentation. Results Fifty patients underwent BLA for refractory CD, and 43 patients (7 men and 36 women) had at least one follow-up visit after BAL. Median endocrine, imaging, and clinical follow-up were 66 months, 69 months, and 80 months, respectively. Nine patients (22%) were diagnosed with the Nelson's Syndrome at median time after BLA at 24 months (range: 0.6-119.4 months). SRS before BLA was associated with reduced risk of the Nelson's Syndrome (HR = 0.126; 95%CI [0.022-0.714], p=0.019), while elevated ACTH level within 6 months after BLA was associated with increased risk for the Nelson's Syndrome (HR = 9.053; 95%CI [2.076-39.472], p=0.003). Conclusions SRS before BLA can reduce the risk for the Nelson's Syndrome in refractory CD patients requiring BLA and should be considered before proceeding to BLA. Elevated ACTH concentration within 6 months after BLA is associated with greater risk of the Nelsons' Syndrome. When no prior SRS is administered, those with a high ACTH level shortly after BLA may benefit from early SRS.
