Revisiting the combined approach of Yaşargil for microsurgical removal of intra-extraventricular and pure intraventricular craniopharyngiomas.

Objective: Craniopharyngiomas originate from squamous epithelium in the pituitary stalk, tend to expand into surrounding tissues, and have high recurrence rates when residual tumor remains. Therefore, gross total resection should be the goal at initial surgery. Yaşargil described the combined approach, involving both anterior interhemispheric transcallosal transforaminal and pterional transsylvian approaches in the same session for intra-extraventricular and pure intraventricular craniopharyngiomas.

Approach to the Patient: Hirsutism.

Hirsutism affects approximately 10% of women globally, with significant economic and quality of life impact. Facial and body terminal hair growth in a male-like pattern is determined by a number of factors, including circulating androgens, and tissue androgen receptor, 5α-reductase, 3α- and 17β-hydroxysteroid dehydrogenase, and ornithine decarboxylase content. The presence of hirsutism is usually determined by the modified Ferriman Gallwey (mFG) visual scale, assessing the amount of terminal hair at nine body sites (upper lip, chin, chest, upper and lower back, upper and lower abdomen, upper arms and thighs).

Rathke's cleft cyst: From history to molecular genetics.

A Rathke's cleft cyst (RCC) is a remnant of the embryologic Rathke's pouch and a common pituitary lesion. A true RCC is lined with ciliated cuboidal or columnar epithelia with occasional goblet cells and squamous metaplasia. A RCC is frequently diagnosed incidentally through magnetic resonance imaging and computed tomography of the brain or pituitary gland.

Sheehan syndrome: a current approach to a dormant disease.

Sheehan syndrome (SS) is postpartum pituitary necrosis leading to severe hypopituitarism. Severe bleeding during delivery and postpartum period results in ischemic necrosis of the enlarged pituitary gland during pregnancy. The improved obstetrical care decreased the incidence of SS significantly, however SS should always be kept in mind in the etiologies of hypopitutarism in women which can be easily recognized by medical history of the patient.

Hypoprolactinemia, a neglected endocrine disorder.

This special issue of Reviews in Endocrine and Metabolic Disorders is dedicated to hypoprolactinemia. Prolactin is known for its actions on the mammary gland including development, preparation for postpartum lactation, as well as synthesis and maintenance of milk secretion. However, prolactin has many other physiological effects on reproduction, embryonic and fetal development, homeostasis, neuroprotection, behavior, and immunoregulation.

Can Salivary Cortisol be Used in Diagnosing Adrenal Insufficiency During the Acute and Subacute Phases of Traumatic Brain Injury?

Introduction: The diagnosis of adrenal insufficiency (AI) related to traumatic brain injury (TBI) remains a challenge. We investigated the basal and low-dose adrenocorticotropic hormone (ACTH)-stimulated serum cortisol and salivary cortisol (SaC) levels and the diagnostic utility of SaC levels during 28 days following TBI.

Materials And Methods: Blood samples were collected for basal levels [sequentially from day 1 (D1) to D7 and on D28)] and for peak serum cortisol and SaC responses to the low-dose ACTH stimulation test (on D1, D7, and D28).

Drug induced hypoprolactinemia.

Prolactin levels can be influenced by multiple medications primarily through the interaction with dopamine receptors which regulate its secretion. Unlike hyperprolactinemia which has a well-defined clinical phenotype, the effects of hypoprolactinemia beyond inability to lactate are incompletely understood. Recent studies have raised concerns regarding detrimental changes in glucose metabolism, sexual function and psychological profile in patients with low prolactin levels.

Evaluation and follow-up of patients diagnosed with hypophysitis: a cohort study.

Objective: Primary hypophysitis might be challenging to diagnose, and there is a lack of evidence regarding optimal treatment strategies due to rarity of the disease. We aim to investigate the clinical features and compare the outcomes of different management strategies of primary hypophysitis in a large group of patients recruited on a nationwide basis.

Design: A retrospective observational study.

The comprehensive evaluation of oral and fecal microbiota in patients with acromegaly.

Purpose: The alteration of the microbiota in the mouth and gut could potentially play a role in the pathogenesis of various diseases, and conversely, these diseases may have an influence on the composition of the gut microbiota. Acromegaly disease can potentially affect physiological processes in the mouth and gut. The present study was designed to investigate the relationship between acromegaly and the oral and gut microbiota, as data on this topic are scarce.

Evaluation of growth hormone deficiency in women with unexplained infertility.

Purpose: Growth hormone (GH) has been recognized to play a regulatory role in female reproduction. It has been reported that infertile GH deficient patients regained fertility after GH replacement. The frequency of GH deficiency is not established in patients diagnosed with unexplained infertility.

Alterations in Serum miR-126-3p Levels over Time: A Marker of Pituitary Insufficiency following Head Trauma.

Introduction: Traumatic brain injuries (TBIs) pose a high risk of pituitary insufficiency development in patients. We have previously reported alterations in miR-126-3p levels in sera from patients with TBI-induced pituitary deficiency.

Methods: To investigate why TBI-induced pituitary deficiency develops only in some patients and to reveal the relationship between miR-126-3p with hormone axes, we used mice that were epigenetically modified with miR-126-3p at the embryonic stage.

Hypoprolactinemia. Does it matter? Redefining the hypopituitarism and return from a mumpsimus : "Absence of proof is not the proof of absence".

Prolactin (PRL) is secreted by the lactotroph cells in the anterior pituitary gland which is under inhibitory control of dopamine. The mature human PRL has more than 300 physiological actions including lactation, reproduction, homeostasis, neuroprotection, behavior, water and electrolyte balance, immunoregulation and embryonic and fetal development. PRL is involved in the growth and development of mammary gland, preparation of the breast for lactation in the postpartum period, synthesis of milk, and maintenance of milk secretion.

Hypothalamic-Pituitary Axis Function and Adrenal Insufficiency in COVID-19 Patients.

The outbreak of COVID-19 has affected more than half a billion people worldwide and caused more than 6 million deaths since 2019. The responsible virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily affects the lungs, but it has multisystemic effects. It is well known that dysfunction of multiple endocrine organs may occur during or after COVID-19.

Idiopathic hirsutism: Is it really idiopathic or is it misnomer?

Hirsutism, which is characterized by excessive growth of terminal hair in a male pattern, may result from various causes including polycystic ovary syndrome (PCOS), non-classic congenital adrenal hyperplasia, adrenal or ovarian tumors or it may be idiopathic. Idiopathic hirsutism is currently defined as hirsutism associated with normal ovulatory function, normal serum androgen levels and normal ovarian morphology, however, the pathogenesis of idiopathic hirsutism is not clear. The androgens are the main hormones to stimulate growth of body hair, therefore, there should be any form of increased androgen effect irrespective of normal serum androgen levels in any patient with hirsutism.

The Role of Apoptosis and Autophagy in the Hypothalamic-Pituitary-Adrenal (HPA) Axis after Traumatic Brain Injury (TBI).

Traumatic brain injury (TBI) is a major health problem affecting millions of people worldwide and leading to death or permanent damage. TBI affects the hypothalamic-pituitary-adrenal (HPA) axis either by primary injury to the hypothalamic-hypophyseal region or by secondary vascular damage, brain, and/or pituitary edema, vasospasm, and inflammation. Neuroendocrine dysfunctions after TBI have been clinically described in all hypothalamic-pituitary axes.

Prediabetes and mild hepatosteatosis are associated with blunted cortisol response to glucagon but not to growth hormone.

Background: Although there is a close relationship between cortisol and growth hormone (GH) levels, glucose intolerance and hepatosteatosis, changes in GH and the hypothalamo-pituitary-adrenal (HPA) axis were not previously studied in prediabetes. The main purpose of the present study was to assess changes in GH and HPA axis and their relationship with hepatosteatosis in prediabetic patients.

Methods: Forty prediabetic patients, with body-mass index (BMI) 25-35kg/m, and 23 healthy individuals, with normal glucose tolerance and similar age and BMI, were included.

Differentiating Polycystic Ovary Syndrome from Adrenal Disorders.

Although polycystic ovary syndrome (PCOS) is primarily considered a hyperandrogenic disorder in women characterized by hirsutism, menstrual irregularity, and polycystic ovarian morphology, an endocrinological investigation should be performed to rule out other hyperandrogenic disorders (e.g., virilizing tumors, non-classical congenital adrenal hyperplasia (NCAH), hyperprolactinemia, and Cushing's syndrome) to make a certain diagnosis.

Acromegaly is associated with a distinct oral and gut microbiota.

Purpose: Our aim was to investigate the changes in the composition of oral and gut microbiota in patients with newly diagnosed acromegaly and their relationship with IGF-1 levels.

Methods: Oral and fecal samples were collected from patients with newly diagnosed acromegaly without comorbidities and from healthy controls. The composition of the microbiota was analyzed.