288 research outputs found
Somatostatin receptor ligands in the treatment of acromegaly
No full textFirst-generation somatostatin receptors ligands (SRL) are the mainstay in the medical treatment of acromegaly, however the percentage of patients controlled with these drugs significantly varies in the different studies. Many factors are involved in the resistance to SRL. In this review, we update the physiology of somatostatin and its receptors (sst), the use of SRL in the treatment of acromegaly and the factors involved in the response to these drugs. The SRL act through interaction with the sst, which up to now have been characterized as five subtypes. The first-generation SRL, octreotide and lanreotide, are considered sst2 specific and have biochemical response rates varying from 20 to 70%. Tumor volume reduction can be found in 36–75% of patients. Several factors may determine the response to these drugs, such as sst, AIP, E-cadherin, ZAC1, filamin A and β-arrestin expression in the somatotropinomas. In patients resistant to first-generation SRL, alternative medical treatment options include: SRL high dose regimens, SRL in combination with cabergoline or pegvisomant, or the use of pasireotide. Pasireotide is a next-generation SRL with a broader pattern of interaction with sst. In the light of the recent increase of treatment options in acromegaly and the deeper knowledge of the determinants of response to the current first-line therapy, a shift from a trial-and-error treatment to a personalized one could be possible
SAGIT(®): clinician-reported outcome instrument for managing acromegaly in clinical practice-development and results from a pilot study
No full textThe SAGIT instrument is a comprehensive clinician-reported outcome instrument assessing key features of acromegaly: signs and symptoms, associated comorbidities; growth hormone levels; insulin-like growth factor-1 levels; and tumor profile. The SAGIT instrument has been designed to assist endocrinologists managing acromegaly in practice. Here, we report on pre-testing (to assess ease of understanding and acceptability) and a pilot study (to assess relevance, ease of use, and utility in real-life conditions) (NCT02231593)
SAGIT(®): clinician-reported outcome instrument for managing acromegaly in clinical practice-development and results from a pilot study
No full textThe SAGIT instrument is a comprehensive clinician-reported outcome instrument assessing key features of acromegaly: signs and symptoms, associated comorbidities; growth hormone levels; insulin-like growth factor-1 levels; and tumor profile. The SAGIT instrument has been designed to assist endocrinologists managing acromegaly in practice. Here, we report on pre-testing (to assess ease of understanding and acceptability) and a pilot study (to assess relevance, ease of use, and utility in real-life conditions) (NCT02231593)
Semantic Information and the Trivialization of Logic: Floridi on the Scandal of Deduction
No full textIn this paper we discuss Floridi’s views concerning semantic information in the light of a recent contribution (in collaboration with the present author) [1] that defies the traditional view of deductive reasoning as “analytic” or “tautological” and construes it as an informative, albeit non-empirical, activity. We argue that this conception paves the way for a more realistic notion of semantic information where the “ideal agents” that are assumed by the standard view can be indefinitely approximated by real ones equipped with growing computational resources
Acromegaly: Molecular Expression of Somatostatin Receptor Subtypes and Treatment Outcome
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