Endocrinology - Bankstown Hospital - Grand Rounds - Further Reading - LibGuides at South Western Sydney Local Health District

Introduction

Welcome to the Grand Rounds Further Reading List, Endocrinology edition, brought to you by the Clinical Library, on Level 4, next to the Auditorium.

This library guide is to help support you in your professional development. Please give us feedback so we can improve this list in the future.

If you have any questions, please contact the Clinical Library on 9722 8250 or email SWSLHD-BankstownLibrary@health.nsw.gov.au or visit us Monday to Fridays, 8.30am - 5.00pm.

THIS WEEK'S TOPIC

"Acromegaly and Pregnancy"

Journal Articles

Bandeira, D. B., et al. (2022). "Acromegaly and pregnancy: a systematic review and meta-analysis." Pituitary 25(3): 352-362 MEDLINE https://access.ovid.com/custom/redirector/ciap.html?dest=https://acs.hcn.com.au/?acc=36422&url=https://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med21&DO=10.1007%2fs11102-022-01208-0

PURPOSE: To evaluate the association between acromegaly and pregnancy in terms of disease activity, maternal and fetal outcomes.

METHODS: This systematic review was conducted according to the Joanna Briggs Institute methodology for systematic reviews of etiology and risk. We focused on observational studies that included pregnant women with acromegaly. The outcomes were acromegaly activity, preterm birth, gestational diabetes, hypertension, eclampsia/preeclampsia, miscarriage, perinatal mortality, low birthweight, small for gestational age, and congenital malformations. Embase, Medline, LILACS, and CENTRAL were our source databases. To perform proportional meta-analyses, we used Stata Statistical Software 17.

RESULTS: Nineteen studies were included encompassing a total of 273 pregnancies in 211 women with acromegaly. The overall frequency of control of acromegaly during pregnancy was 62%, and of tumor growth was 9%. No fetal or maternal deaths were reported. The overall frequency of worsening of previous diabetes or development of gestational diabetes was 9%, and of previous hypertension or preeclampsia/eclampsia was 6%. The overall frequency of premature labor was 9% [from 17 studies of 263 pregnancies; 95% confidence interval (CI), 5-13%]; of spontaneous miscarriage was 4% (from 19 studies of 273 pregnancies; 95% CI, 2-11%); of small for gestational age was 5% (from 15 studies of 216 newborns; 95% CI, 3-9%); and of congenital malformations was 1% (from 18 studies of 240 newborns; 95% CI, 0-7%).

CONCLUSION: Pregnancy in women with acromegaly is frequently associated with disease control and is safe in relation to fetal and maternal outcomes, as in women without acromegaly.

Caron, P. (2011). "Acromegaly and pregnancy." Annales d Endocrinologie 72(4): 282-286 MEDLINE https://access.ovid.com/custom/redirector/ciap.html?dest=https://acs.hcn.com.au/?acc=36422&url=https://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med8&DO=10.1016%2fj.ando.2011.07.002

In women with acromegaly due to growth hormone (GH)-secreting pituitary adenomas, the occurrence of pregnancy warrants consideration of: (1) the consequences of pregnancy on the pituitary adenoma including the tumor syndrome and GH/IGF-1 secretion, (2) the consequence of GH/IGF-1 hypersecretion on the pregnant woman and the fetus, (3) the consequences of pituitary surgery and medical treatment (dopamine agonists, somatostatin analogs, GH receptor antagonist) on the pregnant woman and the developing fetus.

Jallad, R. S., et al. (2018). "Outcome of pregnancies in a large cohort of women with acromegaly." Clinical Endocrinology 88(6): 896-907 MEDLINE https://access.ovid.com/custom/redirector/ciap.html?dest=https://acs.hcn.com.au/?acc=36422&url=https://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med15&DO=10.1111%2fcen.13599

OBJECTIVE: To assess the outcome of pregnancies in a large cohort of women with acromegaly.

DESIGN AND METHODS: This is a retrospective analysis of 31 pregnancies in 20 patients with acromegaly.

RESULTS: Twenty-seven pregnancies resulted in healthy offspring, and 4 resulted in abortion. Three patients underwent transsphenoidal surgery during pregnancy. IGF-1 levels remained elevated during pregnancy in 4 pregnancies and normalized in 23 cases. Fifteen cases were followed during pregnancy without any medical or surgical treatment, and 13 of these exhibited normal IGF-1 levels. Before or during pregnancy, somatostatin receptor ligands usage was not associated with higher risk for adverse outcomes. Arterial hypertension worsening (45%) and impairment of glucose levels (32%) were the most common complications during pregnancies. There were no maternal or neonatal deaths. One woman delivered twins. Two cases of congenital malformations and one with foetal macrosomia were observed. Caesarean delivery was performed in sixteen cases.

CONCLUSION: Our study confirms the impact of gestation on IGF-1 levels. However, it also indicates that acromegaly still holds an increased risk for worsening of comorbidities, especially in uncontrolled patients.

Motivala, S., et al. (2011). "Pituitary disorders during pregnancy." Endocrinology & Metabolism Clinics of North America 40(4): 827-836 MEDLINE https://access.ovid.com/custom/redirector/ciap.html?dest=https://acs.hcn.com.au/?acc=36422&url=https://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med8&DO=10.1016%2fj.ecl.2011.08.007

The pituitary gland undergoes much anatomic and physiologic variation during pregnancy. Pituitary disease may have a significant impact on a patient prior to conception as well as throughout her pregnancy. It is imperative to provide care to patients affected by pituitary disease with a multidisciplinary approach involving endocrinologists, obstetricians and, when appropriate, neurosurgical care, as this group of disorders can represent a substantial level of morbidity and mortality for both mother and fetus.

Wiesli, P., et al. (2006). "Pregnancy-induced changes in insulin-like growth factor I (IGF-I), insulin-like growth factor binding protein 3 (IGFBP-3), and acid-labile subunit (ALS) in patients with growth hormone (GH) deficiency and excess." Acta Obstetricia et Gynecologica Scandinavica 85(8): 900-905 MEDLINE https://access.ovid.com/custom/redirector/ciap.html?dest=https://acs.hcn.com.au/?acc=36422&url=https://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&DO=10.1080%2f00016340600676532

BACKGROUND: Under most circumstances with altered growth hormone (GH) secretion, the changes of insulin-like growth factor I (IGF-I), insulin-like growth factor binding protein 3 (IGFBP-3), and acid-labile subunit (ALS) are in parallel. The aim of the present study was to compare the effects of pregnancy in a hypopituitary patient with those of pregnancy in an acromegalic patient on IGF-I, IGFBP-3, and ALS.

METHODS AND RESULTS: IGF-I and ALS were low before pregnancy in the hypopituitary patient under glucocorticoid and thyroxine treatment. Gonadotropin treatment allowed her to become pregnant; IGF-I and ALS levels rose in the second half of pregnancy and fell again after delivery. IGF-I concentrations were elevated in the patient with persistent acromegaly before and dropped into the normal range during the first half of pregnancy. In the second half of pregnancy and following delivery, IGF-I levels increased again. IGFBP-3 levels (as assessed by immunoblot analysis as well as by 125I-IGF II ligand blotting) decreased markedly during pregnancy in both patients, suggesting that the placenta rather than pituitary GH regulates IGFBP-3 proteolysis in human pregnancy. The increase of IGF-I (and ALS) during the second half of pregnancy in the individual with pituitary GH deficiency may be attributed to placental GH. The fall of IGF-I (and ALS) into the normal range in the acromegalic patient during the first trimester of pregnancy may be related to decreased production or decreased half-life of these proteins.

CONCLUSION: Our data suggest that measures to continuously replace GH or to suppress GH secretion during pregnancy in patients with GH deficiency or excess, respectively, may not be warranted.

Books

Endocrine Physiology, Sixth Edition by Patricia E. Molina
Call Number: BANKSTOWN Medical Library WK 102/MOL/6
ISBN: 9781264278459
Publication Date: 2023
Master the aspects of endocrine physiology required in clinical medicine and ace the USMLE Endocrine Physiology delivers unmatched coverage of the fundamental concepts of hormone biological actions--providing the foundation you need to understand the physiologic mechanisms involved in neuroendocrine regulation of organ function. The first chapter walks you through organization of the endocrine system, as well as general concepts of hormone production and release, transport and metabolic rate, and cellular mechanisms of action. Emphasizing must-know principles, Endocrine Physiology is essential for residents and fellows and is the single-best endocrine review available for the USMLE® Step 1. Features Boxed case studies show how to apply principles to real-world clinical situations Bulleted objectives, key concepts, study questions, suggested readings, and diagrams encapsulating key concepts Pedagogical throughout
Oxford Desk Reference: Endocrinology by Helen E. Turner (Editor); Richard Eastell (Editor); Ashley Grossman (Editor)
Call Number: BANKSTOWN Medical Library WK 39/END/1
ISBN: 9780199672837
Publication Date: 2018
Oxford Desk Reference: Endocrinology provides easy access to evidence-based materials for quick consultation but also provides an in-depth expert reference for clinical practice. It covers the process of diagnosis, investigation, and management, as well as information for patients. Internationally-renowned experts have brought together evidence, guidelines and their clinical expertise to put trustworthy support at your fingertips. The vast spectrum of endocrine disorders are clearly laid out in self-contained topics for easy reference. Chapters build bridges between pathogenesis, clinical presentation, differential diagnosis and investigation to aid understanding. Careful consideration is given to establishing a diagnosis including the recognition, investigation and management of the rarer diagnoses. The practical treatment of everyday endocrine disorders and the management of life-long conditions are outlined in clear protocols. Chapters are organised by endocrine glands, disorders and syndromes and there are sections on the involvement of hormones in other specialities including endocrine oncology. The continuity from childhood to adolescent and adult endocrinology as well as the needs of older patients is explored in specific sections. Dedicated chapters cover the important roles endocrine specialist nurses play in patient management, and dietetic advice. The editors have included a wealth of practical resources including: DT A speedy reference section, which provides summaries and quick direction DT A patient advice and reference section, which supports face-to-face discussion with patients DT A medicolegal chapter, which outlines risk and DVLA regulations Oxford Desk Reference: Endocrinology is the ideal companion for consultants, registrars associate specialists and clinical assistants as well as those from other disciplines who share endocrine clinics including endocrine surgeons, oncologists, gynaecologists and paediatricians.

e-Books

The Diabetes in Pregnancy Dilemma by Oded Langer (Editor)
Call Number: ProQuest E-Book Central database (login required
ISBN: 9781607951827
Publication Date: 2015-01-01
Diabetes mellitus is approaching epidemic proportions worldwide, and the effects and treatment of diabetes in pregnancy are not well enough understood by many doctors who see pregnant women in their practices. The goal of this book is to provide much-needed information to clinicians about pregestational and gestational diabetes in pregnancy and help them develop the tools and skills to improve the outcome of these pregnancies. This is the second edition of a highly regarded book on diabetes in pregnancy, strongly recommended in JAMA to anyone involved in the care of pregnant women with diabetes mellitus. Th
Pituitary Disorders by Edward R. Laws (Editor); Shereen Ezzat (Editor); Sylvia L. Asa (Editor); Linda M. Rio (Editor); Lorin Michel (Editor); Robert Knutzen (Editor)
Call Number: ProQuest E-Book Central database (login required
ISBN: 9780470672013
Publication Date: 2013-05-06
Providing a full analysis of pituitary disorder management from acromegaly to Addison's Disease; from Cushing's Disease to hypopituitarism; from hormone disorders to hormone replacement. Well-illustrated throughout, and with contributions from leading specialists in pituitary disease, inside you'll find comprehensive and expert coverage, including: Diagnosing pituitary disease Management options for each disorder Complications that can occur Psychological and psychosocial effects of pituitary disease What outcomes you and your patients can expect over the long term Current research and clinical trials related to pituitary disease Pituitary Disorders: Diagnosis and Management is the perfect clinical tool for physicians and health care providers from many related disciplines, and an essential companion for the best quality management of pituitary patients.
Pancreatic Neuroendocrine Neoplasms by Stefano La Rosa (Editor); Fausto Sessa (Editor)
Call Number: ProQuest E-Book Central database (login required
ISBN: 9783319172347
Publication Date: 2015
This book provides a broad overview of pancreatic neuroendocrine neoplasms, focusing on the most important developments in the technologies used to diagnose, classify and treat them. After a historical and epidemiological overview, the opening chapters examine the various diagnostic approaches (radiology, nuclear medicine, endocrinology, cytology and immunohistochemistry) and discuss the WHO classification. The functioning and nonfunctioning tumor types are then fully discussed, covering epidemiology, diagnosis, morphology and prognosis of each entity. Careful consideration is given to the molecular features that have contributed in understanding the pathogenesis of such neoplasms and may have potential implications for the diagnostic and therapeutic pathways. The final chapters consider the surgical and medical approaches to therapy, providing a practical and analytical overview of the available options. The book is written by a multidisciplinary team of worldwide-recognized experts and is addressed to radiologists, nuclear medicine physicians, endocrinologists, pathologists, surgeons and oncologists.