Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Tuesday, November 8, 2016

The effect of growth hormone replacement in patients with hypopituitarism on pituitary tumor recurrence, secondary cancer, and stroke

Question for your doctor.
http://link.springer.com/article/10.1007/s12020-016-1156-6
  • Sina Jasim
  • Fares Alahdab
  • Ahmed T. Ahmed
  • Shrikant U. Tamhane
  • Anu Sharma
  • Diane Donegan
  • Todd B. Nippoldt
  • M. Hassan Murad
  • Sina Jasim
    • 1
  • Fares Alahdab
    • 2
  • Ahmed T. Ahmed
    • 2
  • Shrikant U. Tamhane
    • 1
  • Anu Sharma
    • 1
  • Diane Donegan
    • 1
  • Todd B. Nippoldt
    • 1
  • M. Hassan Murad
    • 2
  1. 1.Division of Endocrinology, Diabetes, Metabolism, & Nutrition, Mayo ClinicRochesterUSA
  2. 2.Mayo Clinic Evidence-Based Practice CenterRochesterUSA
Meta-Analysis
DOI: 10.1007/s12020-016-1156-6
Cite this article as:
Jasim, S., Alahdab, F., Ahmed, A.T. et al. Endocrine (2016). doi:10.1007/s12020-016-1156-6
  • 1 Downloads

Abstract

Growth hormone replacement therapy has benefits for patients with hypopituitarism. The safety profile in regard to tumor recurrence or progression, development of secondary malignancies, or cerebrovascular stroke is still an area of debate. A comprehensive search of multiple databases—MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus was conducted through August 2015. Eligible studies that evaluated long-term adverse events in adult patients with hypopituitarism treated with growth hormone replacement therapy and reported development of pituitary tumor recurrence or progression, secondary malignancies, or cerebrovascular stroke were selected following a predefined protocol. Reviewers, independently and in duplicate, extracted data and assessed the risk of bias. Random-effects meta-analysis was used to pool relative risks and 95 % confidence intervals. We included 15 studies (published 1995–2015) that reported on 46,148 patients. Compared to non-replacement, growth hormone replacement therapy in adults with hypopituitarism was not associated with statistically significant change in pituitary tumor progression or recurrence (relative risk, 0.77; 95 % confidence interval, 0.53–1.13) or development of secondary malignancy (relative risk, 0.99; 95 % confidence interval, 0.70–1.39). In two retrospective studies, there was higher risk of stroke in patients who did not receive replacement (relative risk, 2.07; 95 % confidence interval, 1.51–2.83). The quality of evidence is low due to study limitations and imprecision. This systematic review and meta-analysis supports the overall safety of growth hormone therapeutic use in adults with hypopituitarism with no clear evidence of increased risk of pituitary tumor recurrence, malignancy, or stroke.

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