9 research outputs found
Advances in the Imaging of Pituitary Tumors
© 2020 Elsevier Inc. In most patients with pituitary adenomas magnetic resonance imaging (MRI) is essential to guide effective decision-making. T1- and T2-weighted sequences allow the majority of adenomas to be readily identified. Supplementary MR sequences (e.g. FLAIR; MR angiography) may also help inform surgery. However, in some patients MRI findings are ânegativeâ or equivocal (e.g. with failure to reliably identify a microadenoma or to distinguish postoperative change from residual/recurrent disease). Molecular imaging [e.g. 11C-methionine PET/CT coregistered with volumetric MRI (Met-PET/MRCR)] may allow accurate localisation of the site of de novo or persistent disease to guide definitive treatment (e.g. surgery or radiosurgery)
Patient satisfaction with radioiodine treatment and telephone follow-up for the management of thyrotoxicosis
Waiel A Bashari, Rebecca L Coates, Shahbaz Nazir, Naomi E Riddel, Oluwaseyi O Lawanson, Ahmed M Mohamed, Samson O Oyibo Department of Diabetes and Endocrinology, Peterborough City Hospital, Peterborough, UK Background and objective: Patient satisfaction is of paramount importance when delivering a patient-centered service. Our hospital has been a center for the use of radioiodine to treat thyrotoxicosis for several years, but we began carrying out patient satisfaction surveys and implementing changes after 2008. The aim of the project reported here was to assess patient satisfaction with our radioiodine treatment and telephone follow-up service, and to compare results with our previous surveys.Patients and methods: Anonymous patient satisfaction questionnaires were sent to all patients who received radioiodine treatment for thyrotoxicosis between January 2012 and December 2013. Patients were asked to answer four questions concerning informed consenting, treatment, and telephone follow-up using a four-point Likert scale, and post back the questionnaires. A suggestion box was included for comments and suggestions for improvement.Results: A total of 56 questionnaires were posted out (to 44 females and 12 males) and 34 questionnaires were returned (60.8% response rate). Between 94% and 100% of the responders, depending on the question asked, were satisfied with the service they received. Patients also put useful comments and suggestions in the suggestion box provided.Conclusion: Patients with thyrotoxicosis were satisfied with our radioiodine treatment and telephone follow-up service. This survey has revealed areas for service improvement, and highlights the importance of patient satisfaction when assessing a patient-centered service. Keywords: service improvement, patient-centered service, patient satisfaction survey, informed consentin
Soyghurt Potentially Controls the Level of sFlt1 and PLGF in Preeclampsia Maternal Serum-Induced Placental Trophoblast Cell in vitro
Astrid Feinisa Khairani,1 Uci Ary Lantika,2 Julia Ramadhanti,1 Muhammad Hasan Bashari,1,3 Widad Aghnia Shalannandia,1 Tenny Putri Wikayani,4 Achadiyani Achadiyani,1 Mulyanusa Amarullah Ritonga5 1Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Jatinangor, West Java, Indonesia; 2Department of Biomedical Sciences, Faculty of Medicine, Universitas Islam Bandung, Bandung, West Java, Indonesia; 3Research Centre of Oncology and Stem Cell, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 4Culture and Cytogenetic Laboratory, Universitas Padjadjaran, Bandung, West Java, Indonesia; 5Department of Obstetrics and Gynecology, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, IndonesiaCorrespondence: Astrid Feinisa Khairani, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Jalan Raya Bandung â Sumedang Km 21, Jatinangor, West Java, 45363, Indonesia, Tel +62-22-779559445363, Email [email protected]: To observe the effect of soya yoghurt (Soyghurt), which is high in flavonoid substance, on the expression of preeclampsia biomarkers (sFLT-1 and PLGF) on preeclampsia serum-induced trophoblast primary cell culture isolated from placental tissue.Methods: The trophoblast primary culture was induced by preeclampsia serum (10%). The Soyghurt treatment was performed with 2.5%, 5%, and 7.5% Soyghurt supernatant concentrations in culture media. The expression of preeclampsia markers, sFLT-1 and PLGF, were evaluated using ELISA.Results: Expression of sFLT-1 on preeclampsia-induced cell culture treated with Soyghurt was significantly lowered compared to the untreated group (p 0.05).Conclusion: This study demonstrates the potential effect of Soyghurtâs in balancing preeclampsia marker expression by inhibiting the expression of sFLT-1 in preeclampsia serum -induced trophoblast cells.Keywords: preeclampsia, PLGF, sFLT-1, soya yoghurt, trophoblas
Modern imaging in Cushing's disease.
Funder: Wellcome Trust Institutional Strategic Support Fund, University of CambridgeManagement of Cushing's disease is informed by dedicated imaging of the sella and parasellar regions. Although magnetic resonance imaging (MRI) remains the investigation of choice, a significant proportion (30-50%) of corticotroph tumours are so small as to render MRI indeterminate or negative when using standard clinical sequences. In this context, alternative MR protocols [e.g. 3D gradient (recalled) echo, with acquisition of volumetric data] may allow detection of tumors that have not been previously visualized. The use of hybrid molecular imaging (e.g. 11C-methionine positron emission tomography coregistered with volumetric MRI) has also been proposed as an additional modality for localizing microadenomas
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Novel imaging techniques in refractory pituitary adenomas.
Accurate localization of the site(s) of active disease is key to informing decision-making in the management of refractory pituitary adenomas when autonomous hormone secretion and/or continued tumor growth challenge conventional therapeutic approaches. In this context, the use of non-standard MR sequences, alternative post-acquisition image processing, or molecular (functional) imaging may provide valuable additional information to inform patient management
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Novel imaging techniques in refractory pituitary adenomas
Funder: Erasmus+; doi: http://dx.doi.org/10.13039/501100010790Funder: Wellcome Trust Institutional Strategic Support Fund, University of CambridgeAccurate localization of the site(s) of active disease is key to informing decision-making in the management of refractory pituitary adenomas when autonomous hormone secretion and/or continued tumor growth challenge conventional therapeutic approaches. In this context, the use of non-standard MR sequences, alternative post-acquisition image processing, or molecular (functional) imaging may provide valuable additional information to inform patient management
11C-methionine PET aids localization of microprolactinomas in patients with intolerance or resistance to dopamine agonist therapy.
PURPOSE: To assess the potential for 11C-methionine PET (Met-PET) coregistered with volumetric magnetic resonance imaging (Met-PET/MRCR) to inform clinical decision making in patients with poorly visualized or occult microprolactinomas and dopamine agonist intolerance or resistance. PATIENTS AND METHODS: Thirteen patients with pituitary microprolactinomas, and who were intolerant (nâ=â11) or resistant (nâ=â2) to dopamine agonist therapy, were referred to our specialist pituitary centre for Met-PET/MRCR between 2016 and 2020. All patients had persistent hyperprolactinemia and were being considered for surgical intervention, but standard clinical MRI had shown either no visible adenoma or equivocal appearances. RESULTS: In all 13 patients Met-PET/MRCR demonstrated a single focus of avid tracer uptake. This was localized either to the right or left side of the sella in 12 subjects. In one patient, who had previously undergone surgery for a left-sided adenoma, recurrent tumor was unexpectedly identified in the left cavernous sinus. Five patients underwent endoscopic transsphenoidal selective adenomectomy, with subsequent complete remission of hyperprolactinaemia and normalization of other pituitary function; three patients are awaiting surgery. In the patient with inoperable cavernous sinus disease PET-guided stereotactic radiosurgery (SRS) was performed with subsequent near-normalization of serum prolactin. Two patients elected for a further trial of medical therapy, while two declined surgery or radiotherapy and chose to remain off medical treatment. CONCLUSIONS: In patients with dopamine agonist intolerance or resistance, and indeterminate pituitary MRI, molecular (functional) imaging with Met-PET/MRCR can allow precise localization of a microprolactinoma to facilitate selective surgical adenomectomy or SRS.Cambridge NIHR Biomedical Research Centre (BRC-1215-20014