A5011217365- Pituitary Gland Disorders and Treatments
- Adrenal Hormones and Disorders
- Growth Hormone and Insulin-like Growth Factors
- Adrenal and Paraganglionic Tumors
- Glioma Diagnosis and Treatment
- Meningioma and schwannoma management
- Neuroendocrine Tumor Research Advances
- Myasthenia Gravis and Thymoma
- Regulation of Appetite and Obesity
- Cancer, Hypoxia, and Metabolism
- Hormonal Regulation and Hypertension
- Adipose Tissue and Metabolism
- Ophthalmology and Eye Disorders
- Adipokines, Inflammation, and Metabolic Diseases
- Head and Neck Surgical Oncology
- Stress Responses and Cortisol
- Cancer Treatment and Pharmacology
- Enhanced Recovery After Surgery
- Ovarian function and disorders
- Erythrocyte Function and Pathophysiology
- Cardiac, Anesthesia and Surgical Outcomes
- Neurofibromatosis and Schwannoma Cases
- Management of metastatic bone disease
- Hypothalamic control of reproductive hormones
- Receptor Mechanisms and Signaling
Memorial Sloan Kettering Cancer Center
2016-2025
CancerCare
2022-2024
Cornell University
2021
Icahn School of Medicine at Mount Sinai
2009-2019
Mount Sinai Hospital
2016
Mount Sinai Medical Center
2013-2015
Mount Sinai Hospital
2015
Mount Sinai Hospital
2008-2014
New York Proton Center
2013
St. Luke's-Roosevelt Hospital Center
2010
Abstract Purpose The 14th Acromegaly Consensus Conference was convened to consider biochemical criteria for acromegaly diagnosis and evaluation of therapeutic efficacy. Methods Fifty-six experts from 16 countries reviewed discussed current evidence focused on assays; the role imaging, pathology, clinical assessments; consequences diagnostic delay; remission recommendations follow up; value assessment monitoring in defining disease progression, selecting appropriate treatments, maximizing...
Active Cushing's disease (CD) confers a 4-fold increase in mortality and is associated with significant morbidities. Although excess risk may persist even after CD treatment, predictors of treated are not well understood.To identify mortality, cardiovascular (CV) disease, recurrence long-term follow-up among patients CD.A retrospective chart review was conducted to evaluate who underwent transsphenoidal adenectomy single surgeon.Patients were categorized based on response initial treatment....
Abstract Context Pituitary carcinoma is a rare and aggressive malignancy with poor prognosis few effective treatment options. Case A 35-year-old woman presented an ACTH-secreting pituitary adenoma that initially responded to concurrent temozolomide capecitabine prior metastasizing the liver. Following ipilimumab nivolumab, tumor volume of dominant liver metastasis reduced by 92%, recurrent intracranial disease regressed 59%. Simultaneously, her plasma ACTH level decreased from 45,550 pg/mL...
Abstract Pituitary neuroendocrine tumors (PitNETs) exhibiting aggressive, treatment-refractory behavior are the rare subset that progress after surgery, conventional medical therapies, and an initial course of radiation characterized by unrelenting growth and/or metastatic dissemination. Two groups patients with PitNETs were sequenced: a prospective group ( n = 66) who consented to sequencing prior surgery retrospective 26) comprised aggressive/higher risk PitNETs. A higher mutational burden...
Because the exact etiology of functional, or idiopathic, hypothalamic amenorrhea (FHA) is still unknown, FHA remains a diagnosis exclusion. The disorder may be stress induced. However, mounting evidence points to metabolic/nutritional insult that primary causal factor. We explored thyroid, hormonal, dietary, behavior, and leptin changes occur in FHA, as they provide clue this disorder. Fourteen cycling control amenorrheic nonathletic subjects were matched for age, weight, height. denied...
GH and IGF-I are important regulators of metabolism body composition. In acromegaly, a state excess, the lipolytic insulin antagonistic effects may alter adipose tissue (AT) distribution.Our objective was to test hypothesis that in acromegaly whole-body AT mass is less examine for first time relationship between GH/IGF-I excess intermuscular (IMAT), an depot associated with resistance other populations.We conducted cross-sectional study 24 adults active compared predicted models developed...
Cushing's Disease (CD) alters fat distribution, muscle mass, adipokine profile, and cardiovascular risk factors. It is not known whether remission entirely reverses these changes.Our objective was to determine the adverse body composition profile in CD change after remission.Fourteen patients were studied prospectively: before surgery (active disease) again postoperatively 6 months discontinuing oral glucocorticoids (remission). Whole-body magnetic resonance imaging used examine lean tissue...
Summary Objective Chronic hypercortisolemia due to Cushing’s disease (CD) results in abnormal adipose tissue (AT) distribution. Whole‐body magnetic resonance imaging (MRI) was used examine lean and AT distribution female patients with CD further understand the role of glucocorticoid excess development obesity. Design Cross‐sectional case–control study. Patients Fifteen women 12 healthy controls. Measurements Mass skeletal muscle (SM) visceral (VAT), subcutaneous (SAT), intermuscular (IMAT)...
Pasireotide long-acting release is a somatostatin analog that indicated for treatment of patients with acromegaly. This analysis documents the safety pasireotide in acromegaly enrolled ACCESS trial (ClinicalTrials.gov identifier: NCT01995734). an open-label, multicenter, single-arm, expanded-treatment protocol designed to provide access pending regulatory approval. Patients received 40 mg administered intramuscularly every 28 days. The primary outcome was proportion having treatment-emergent...
Abstract Context Pituitary corticotroph adenomas are rare tumors that can be associated with excess adrenocorticotropin (ACTH) and adrenal cortisol production, resulting in the clinically debilitating endocrine condition Cushing disease. A subset of behave aggressively, genomic drivers behind development these largely unknown. Objective To investigate at risk for aggressive behavior. Design Whole-exome sequencing patient-matched tumor normal deoxyribonucleic acid (DNA) from a patient cohort...
Context: GH and IGF-I are nitrogen retaining anabolic, but the impact of long-term exposure to supraphysiological IGF-I, either from endogenous overproduction in acromegaly or exogenous sources, on skeletal muscle (SM) mass is not clear. Objectives: The objectives study were assess SM by whole-body magnetic resonance imaging (MRI) test hypothesis that dual-energy x-ray absorptiometry (DXA) lean tissue mass-derived estimates accurately estimate true mass. Design, Setting, Patients: design was...
Although epidemiological studies have found that GH and IGF-1 normalization reduce the excess mortality of active acromegaly to expected rates, cross-sectional data report some cardiovascular (CV) risk markers be less favorable in remission than acromegaly.The objective study was test hypothesis after surgical therapy increases weight adiposity CV these changes are paralleled by a rise ghrelin.Forty-two adults with untreated, were studied prospectively. Changes outcome measures from before...
The proper clinical evaluation of pituitary and adrenal disorders depends on the accurate measurement plasma ACTH. modern two-site sandwich ACTH immunoassay is a great improvement compared with older methods but still has potential for interferences such as heterophile antibodies pro-opiomelanocortin (POMC) fragments. We report cases five patients in whom diagnosis or differential Cushing syndrome was confounded by erroneously elevated results from Siemens Immulite assay [ACTH(Immulite)]...
Abstract Context Aggressive pituitary tumors that have progressed following temozolomide limited treatment options. Peptide receptor radionuclide therapy and immunotherapy may a complementary role in the management of these tumors. Methods We provide follow-up data on previously reported patient with hypermutated recurrent tumor. The this report provided written informed consent for tumor sequencing review medical records an institutional board–approved research protocol (NCT01775072)....
This extended evaluation (EE) of the SONICS study assessed effects levoketoconazole for an additional 6 months following open-label, 6-month maintenance treatment in endogenous Cushing's syndrome.SONICS included dose-titration (150-600 mg BID), maintenance, and EE phases. Exploratory efficacy assessments were performed at 9 12 (relative to start maintenance). For pituitary MRI patients with disease, a threshold ≥2 mm denoted change from baseline largest tumor diameter.Sixty entered month 6;...
Abstract Cushing syndrome (CS) in pregnancy is a rare disorder with challenging diagnostic and therapeutic considerations. For patients medically managed CS planning pregnancy, bilateral adrenalectomy advised before conception. To our knowledge, no case of disease (CD) treated throughout cortisol synthesis inhibition has been described. We present 2 cases CD metyrapone, non-Food Drug Administration-approved drug for pregnancy. The first involves 31-year-old woman recurrent who conceived...