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Book ; Conference proceedings: Influence of organic matter soil properties

Powlson, David S. / Neal, Andrew L.

by how much can organic carbon be increased in arable soils and can changes be measured? ; paper presented to the International Fertiliser Society at a conference in Cambridge, UK, on 9th December 2021

(Proceedings / International Fertiliser Society ; 862)

2021

Author's details	by David S. Powlson and Andrew L. Neal
Series title	Proceedings / International Fertiliser Society ; 862 Proceedings / the International Fertiliser Society
Collection	Proceedings / the International Fertiliser Society
Language	English
Size	32 Seiten, Illustrationen, Duagramme
Publisher	International Fertiliser Society
Publishing place	Colchester
Publishing country	Great Britain
Document type	Book ; Conference proceedings
Note	Literaturverzeichnis: Seite 23-28
HBZ-ID	HT021214210
ISBN	978-0-85310-499-5 ; 0-85310-499-9
Database	Catalogue ZB MED Nutrition, Environment, Agriculture

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Article ; Online: Cardiovascular Disease and Sleep-Disordered Breathing in Acromegaly.

Powlson, Andrew S / Gurnell, Mark

Neuroendocrinology

2016 Volume 103, Issue 1, Page(s) 75–85

Abstract: Treatment goals in acromegaly include symptom relief, tumour control and reversal of the excess morbidity and mortality associated with the disorder. Cardiovascular complications include concentric biventricular hypertrophy and cardiomyopathy, ... ...

Abstract	Treatment goals in acromegaly include symptom relief, tumour control and reversal of the excess morbidity and mortality associated with the disorder. Cardiovascular complications include concentric biventricular hypertrophy and cardiomyopathy, hypertension, valvular heart disease and arrhythmias, while metabolic disturbance (insulin resistance/diabetes mellitus, dyslipidaemia) further increases the risk of cardiovascular and cerebrovascular events. Sleep-disordered breathing (in the form of sleep apnoea) is also common in patients with acromegaly and may exacerbate cardiovascular dysfunction, in addition to contributing to impaired quality of life. Accordingly, and in keeping with evidence that cardiorespiratory complications in acromegaly are not automatically reversed/ameliorated simply through the attainment of 'safe' growth hormone and insulin-like growth factor 1 levels, recent guidelines have emphasised the need not only to achieve stringent biochemical control, but also to identify and independently treat these comorbidities. It is important, therefore, that patients with acromegaly are systematically screened at diagnosis, and periodically thereafter, for the common cardiovascular and respiratory manifestations and that biochemical targets do not become the only treatment goal.
MeSH term(s)	Acromegaly ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/drug therapy ; Heart Diseases/complications ; Heart Diseases/drug therapy ; Human Growth Hormone/secretion ; Humans ; Respiration ; Sleep Apnea Syndromes/complications ; Sleep Apnea Syndromes/drug therapy
Chemical Substances	Human Growth Hormone (12629-01-5)
Language	English
Publishing date	2016
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	123303-8
ISSN	1423-0194 ; 0028-3835
ISSN (online)	1423-0194
ISSN	0028-3835
DOI	10.1159/000438903
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Article ; Online: Real-world experience with 11C-methionine positron emission tomography in the management of acromegaly.

Haberbosch, Linus / MacFarlane, James / Koulouri, Olympia / Gillett, Daniel / Powlson, Andrew S / Oddy, Sue / Halsall, David J / Huynh, Kevin A / Jones, Jonathan / Cheow, Heok K / Spranger, Joachim / Mai, Knut / Strasburger, Christian J / Mannion, Richard J / Gurnell, Mark

European journal of endocrinology

2024 Volume 190, Issue 4, Page(s) 307–313

Abstract: Background: L-[methyl-11C]-methionine-positron emission tomography (Met-PET) is a potentially important imaging adjunct in the diagnostic workup of pituitary adenomas, including somatotroph tumors. Met-PET can identify residual or occult disease and ... ...

Abstract	Background: L-[methyl-11C]-methionine-positron emission tomography (Met-PET) is a potentially important imaging adjunct in the diagnostic workup of pituitary adenomas, including somatotroph tumors. Met-PET can identify residual or occult disease and make definitive therapies accessible to a subgroup of patients who would otherwise require lifelong medical therapy. However, existing data on its use are still limited to small case series. Here, we report the largest single-center experience (n = 61) in acromegaly. Methods: A total of 189 cases of acromegaly were referred to our national Met-PET service in the last 12 years. For this analysis, we have reviewed outcomes in those 61 patients managed exclusively by our multidisciplinary team (single center, single surgeon). Referral indications were as follows: indeterminate magnetic resonance imaging (MRI; n = 38, 62.3%), occult residual (n = 14, 23.0%), (radio-)surgical planning (n = 6, 9.8%), and occult de novo tumor (n = 3, 4.9%). Results: A total of 33/61 patients (54.1%) underwent PET-guided surgery. Twenty-four of 33 patients (72.7%) achieved complete biochemical remission following (re-)surgery. Insulin-like growth factor 1 levels were reduced to <2 × upper limit of normal (ULN) in 6 of the remaining 9 cases, 3 of whom achieved levels of <1.1 × ULN compared with mean preoperative levels of 2.4 × ULN (SD 0.8) for n = 9. Only 3 patients developed single new hormonal deficits (gonadotropic/thyrotropic insufficiency). There were no neurovascular complications after surgery. Conclusion: In patients with persistent/recurrent acromegaly or occult tumors, Met-PET can facilitate further targeted intervention (surgery/radiosurgery). This led to complete remission in most cases (24/33) or significant improvement with comparatively low risk of complications. L-[methyl-11C]-methionine-positron emission tomography should therefore be considered in all patients who are potential candidates for further surgical intervention but present no clear target on MRI.
MeSH term(s)	Humans ; Acromegaly/diagnostic imaging ; Acromegaly/etiology ; Acromegaly/therapy ; Carbon Radioisotopes ; Positron-Emission Tomography/methods ; Adenoma/diagnostic imaging ; Adenoma/surgery ; Methionine ; Magnetic Resonance Imaging/methods ; Racemethionine
Chemical Substances	Carbon-11 ; Carbon Radioisotopes ; carbon-11 methionine (58576-49-1) ; Methionine (AE28F7PNPL) ; Racemethionine (73JWT2K6T3)
Language	English
Publishing date	2024-04-17
Publishing country	England
Document type	Journal Article
ZDB-ID	1183856-5
ISSN	1479-683X ; 0804-4643
ISSN (online)	1479-683X
ISSN	0804-4643
DOI	10.1093/ejendo/lvae028
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Article ; Online: High prevalence of severe sleep cycle disruption in de novo acromegaly and underdiagnosis by common clinical screening tools: A prospective, observational, cross-sectional study.

Powlson, Andrew S / Annamalai, Anand K / Moir, Samantha / Webb, Alison J / Bala, Laksha / Graggaber, Johann / Kandasamy, Narayanan / Koulouri, Olympia / Halsall, David J / Shneerson, John M / Gurnell, Mark

Clinical endocrinology

2023 Volume 100, Issue 3, Page(s) 251–259

Abstract: Context: Although sleep disordered breathing (SDB) is well-recognised in acromegaly, most studies have reported heterogeneous, often heavily treated, groups and few have performed detailed sleep phenotyping at presentation.: Objective: To study SDB ... ...

Abstract	Context: Although sleep disordered breathing (SDB) is well-recognised in acromegaly, most studies have reported heterogeneous, often heavily treated, groups and few have performed detailed sleep phenotyping at presentation. Objective: To study SDB using the gold standard of polysomnography, in the largest group of newly-diagnosed, treatment-naïve patients with acromegaly. Setting and patients: 40 patients [22 males, 18 females; mean age 54 years (range 23-78)], were studied to: (i) establish the prevalence and severity of SDB (ii) assess the reliability of commonly employed screening tools [Epworth Sleepiness Scale (ESS) and overnight oxygen desaturation index (DI)] to detect SDB (iii) determine the extent to which sleep architecture is disrupted. Results: Obstructive sleep apnoea (OSA), defined by the apnoea-hypopnoea index (AHI), was present in 79% of subjects (mild, n = 12; moderate, n = 5; severe, n = 14). However, in these individuals with OSA by AHI criteria, ESS (positive in 35% [n = 11]) and DI (positive in 71%: mild, n = 11; moderate, n = 6; severe, n = 5) markedly underestimated its prevalence/extent. Seventy-eight percent of patients exhibited increased arousal, with marked disruption of the sleep cycle, despite most (82%) having normal total time asleep. Fourteen patients spent longer in stage 1 sleep. Deeper sleep stages were severely attenuated in many subjects (reduced stage 2, n = 18; reduced slow wave sleep, n = 24; reduced rapid eye movement sleep, n = 32). Conclusion: Our study provides strong support for clinical guidelines that recommend screening for sleep apnoea syndrome in patients with newly-diagnosed acromegaly. Importantly, however, it highlights shortcomings in commonly recommended screening tools (questionnaires, desaturation index) and demonstrates the added value of polysomnography to allow timely detection of obstructive sleep apnoea and associated sleep cycle disruption.
MeSH term(s)	Male ; Female ; Humans ; Young Adult ; Adult ; Middle Aged ; Aged ; Cross-Sectional Studies ; Prevalence ; Prospective Studies ; Acromegaly/diagnosis ; Acromegaly/epidemiology ; Reproducibility of Results ; Sleep Apnea, Obstructive/diagnosis ; Sleep Apnea, Obstructive/epidemiology ; Sleep
Language	English
Publishing date	2023-12-21
Publishing country	England
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	121745-8
ISSN	1365-2265 ; 0300-0664
ISSN (online)	1365-2265
ISSN	0300-0664
DOI	10.1111/cen.14994
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Article ; Online: Nuclear imaging in the diagnosis of primary aldosteronism.

Powlson, Andrew S / Gurnell, Mark / Brown, Morris J

Current opinion in endocrinology, diabetes, and obesity

2015 Volume 22, Issue 3, Page(s) 150–156

Abstract: Purpose of review: Primary aldosteronism is increasingly recognized as a common secondary cause of hypertension. Successful demonstration of a unilateral cause (e.g. a classical 'Conn's adenoma') offers the potential for curative adrenalectomy. Adrenal ... ...

Abstract	Purpose of review: Primary aldosteronism is increasingly recognized as a common secondary cause of hypertension. Successful demonstration of a unilateral cause (e.g. a classical 'Conn's adenoma') offers the potential for curative adrenalectomy. Adrenal vein sampling (AVS), in conjunction with cross-sectional imaging, remains the 'gold standard' for distinguishing unilateral and bilateral disease, but is technically demanding and frequently unsuccessful or inconclusive. As such, alternative strategies for lateralization, including nuclear medicine techniques, are being developed and brought into clinical practice. Recent findings: Metomidate, a potent ligand of CYP11B1 and CYP11B2, can be C11H3-labelled as a PET tracer and has been shown to offer a rapid noninvasive alternative to AVS for localizing unilateral aldosterone-producing adenomas. Summary: Increasing experience with 11C-metomidate PET-CT supports its use as an adjunct to AVS when this has failed, is ambiguous, or cannot be undertaken.
MeSH term(s)	Etomidate/analogs & derivatives ; Humans ; Hyperaldosteronism/diagnostic imaging ; Positron-Emission Tomography/methods
Chemical Substances	metomidate (Z18ZYL8Y51) ; Etomidate (Z22628B598)
Language	English
Publishing date	2015-04-02
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2272017-0
ISSN	1752-2978 ; 1752-296X
ISSN (online)	1752-2978
ISSN	1752-296X
DOI	10.1097/MED.0000000000000148
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Article: Cardiovascular Disease and Sleep-Disordered Breathing in Acromegaly

Powlson, Andrew S. / Gurnell, Mark

Neuroendocrinology

2015 Volume 103, Issue 1, Page(s) 75–85

Institution	Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, UK
Abstract	Treatment goals in acromegaly include symptom relief, tumour control and reversal of the excess morbidity and mortality associated with the disorder. Cardiovascular complications include concentric biventricular hypertrophy and cardiomyopathy, hypertension, valvular heart disease and arrhythmias, while metabolic disturbance (insulin resistance/diabetes mellitus, dyslipidaemia) further increases the risk of cardiovascular and cerebrovascular events. Sleep-disordered breathing (in the form of sleep apnoea) is also common in patients with acromegaly and may exacerbate cardiovascular dysfunction, in addition to contributing to impaired quality of life. Accordingly, and in keeping with evidence that cardiorespiratory complications in acromegaly are not automatically reversed/ameliorated simply through the attainment of ‘safe' growth hormone and insulin-like growth factor 1 levels, recent guidelines have emphasised the need not only to achieve stringent biochemical control, but also to identify and independently treat these comorbidities. It is important, therefore, that patients with acromegaly are systematically screened at diagnosis, and periodically thereafter, for the common cardiovascular and respiratory manifestations and that biochemical targets do not become the only treatment goal.
Keywords	Acromegaly ; Cardiovascular disease ; Hypertension ; Cardiomyopathy ; Sleep apnoea
Language	English
Publishing date	2015-07-28
Publisher	S. Karger AG
Publishing place	Basel, Switzerland
Document type	Article
Note	At the Cutting Edge
ZDB-ID	123303-8
ISBN	978-3-318-05837-6 ; 978-3-318-05838-3 ; 3-318-05837-8 ; 3-318-05838-6
ISSN	1423-0194 ; 0028-3835
ISSN (online)	1423-0194
ISSN	0028-3835
DOI	10.1159/000438903
Database	Karger publisher's database

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Article: Development of a bespoke phantom to optimize molecular PET imaging of pituitary tumors.

EJNMMI physics

2023 Volume 10, Issue 1, Page(s) 34

Abstract: Background: Image optimization is a key step in clinical nuclear medicine, and phantoms play an essential role in this process. However, most phantoms do not accurately reflect the complexity of human anatomy, and this presents a particular challenge ... ...

Abstract	Background: Image optimization is a key step in clinical nuclear medicine, and phantoms play an essential role in this process. However, most phantoms do not accurately reflect the complexity of human anatomy, and this presents a particular challenge when imaging endocrine glands to detect small (often subcentimeter) tumors. To address this, we developed a novel phantom for optimization of positron emission tomography (PET) imaging of the human pituitary gland. Using radioactive 3D printing, phantoms were created which mimicked the distribution of Results: The phantom enabled us to replicate pituitary glands harboring tumors of varying sizes (2, 4 and 6 mm diameters) and differing radioactive concentrations (2 ×, 5 × and 8 × the normal gland). The anatomical phantom successfully approximated the attenuation properties of surrounding bone and soft tissue. Two iterative reconstruction algorithms [ordered subset expectation maximization (OSEM); Bayesian penalized likelihood (BPL)] with a range of reconstruction parameters (e.g., 3, 5, 7 and 9 OSEM iterations with 24 subsets; BPL regularization parameter (β) from 50 to 1000) were tested. Images were analyzed quantitatively and qualitatively by eight expert readers. Quantitatively, signal was the highest using BPL with β = 50; noise was the lowest using BPL with β = 1000; contrast was the highest using BPL with β = 100. The qualitative review found that accuracy and confidence were the highest when using BPL with β = 400. Conclusions: The development of a bespoke phantom has allowed the identification of optimal parameters for molecular pituitary imaging: BPL reconstruction with TOF, PSF correction and a β value of 400; in addition, for small (< 4 mm) tumors with low contrast (2:1 or 5:1), sensitivity may be improved using a β value of 100. Together, these findings should increase tumor detection and confidence in reporting scans.
Language	English
Publishing date	2023-06-01
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2768912-8
ISSN	2197-7364
ISSN	2197-7364
DOI	10.1186/s40658-023-00552-9
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Article ; Online: Arginine or Hypertonic Saline-Stimulated Copeptin to Diagnose AVP Deficiency.

The New England journal of medicine

2023 Volume 389, Issue 20, Page(s) 1877–1887

Abstract: Background: Distinguishing between arginine vasopressin (AVP) deficiency and primary polydipsia is challenging. Hypertonic saline-stimulated copeptin has been used to diagnose AVP deficiency with high accuracy but requires close sodium monitoring. ... ...

Abstract	Background: Distinguishing between arginine vasopressin (AVP) deficiency and primary polydipsia is challenging. Hypertonic saline-stimulated copeptin has been used to diagnose AVP deficiency with high accuracy but requires close sodium monitoring. Arginine-stimulated copeptin has shown similar diagnostic accuracy but with a simpler test protocol. However, data are lacking from a head-to-head comparison between arginine-stimulated copeptin and hypertonic saline-stimulated copeptin in the diagnosis of AVP deficiency. Methods: In this international, noninferiority trial, we assigned adult patients with polydipsia and hypotonic polyuria or a known diagnosis of AVP deficiency to undergo diagnostic evaluation with hypertonic-saline stimulation on one day and with arginine stimulation on another day. Two endocrinologists independently made the final diagnosis of AVP deficiency or primary polydipsia with use of clinical information, treatment response, and the hypertonic-saline test results. The primary outcome was the overall diagnostic accuracy according to prespecified copeptin cutoff values of 3.8 pmol per liter after 60 minutes for arginine and 4.9 pmol per liter once the sodium level was more than 149 mmol per liter for hypertonic saline. Results: Of the 158 patients who underwent the two tests, 69 (44%) received the diagnosis of AVP deficiency and 89 (56%) received the diagnosis of primary polydipsia. The diagnostic accuracy was 74.4% (95% confidence interval [CI], 67.0 to 80.6) for arginine-stimulated copeptin and 95.6% (95% CI, 91.1 to 97.8) for hypertonic saline-stimulated copeptin (estimated difference, -21.2 percentage points; 95% CI, -28.7 to -14.3). Adverse events were generally mild with the two tests. A total of 72% of the patients preferred testing with arginine as compared with hypertonic saline. Arginine-stimulated copeptin at a value of 3.0 pmol per liter or less led to a diagnosis of AVP deficiency with a specificity of 90.9% (95% CI, 81.7 to 95.7), whereas levels of more than 5.2 pmol per liter led to a diagnosis of primary polydipsia with a specificity of 91.4% (95% CI, 83.7 to 95.6). Conclusions: Among adult patients with polyuria polydipsia syndrome, AVP deficiency was more accurately diagnosed with hypertonic saline-stimulated copeptin than with arginine-stimulated copeptin. (Funded by the Swiss National Science Foundation; CARGOx ClinicalTrials.gov number, NCT03572166.).
MeSH term(s)	Adult ; Humans ; Arginine/administration & dosage ; Arginine Vasopressin/deficiency ; Diagnosis, Differential ; Glycopeptides/analysis ; Polydipsia/diagnosis ; Polydipsia/etiology ; Polydipsia, Psychogenic/diagnosis ; Polydipsia, Psychogenic/etiology ; Polyuria/etiology ; Saline Solution, Hypertonic/administration & dosage ; Sodium/analysis ; Deficiency Diseases/diagnosis ; Deficiency Diseases/etiology
Chemical Substances	Arginine (94ZLA3W45F) ; Arginine Vasopressin (113-79-1) ; copeptins ; Glycopeptides ; Saline Solution, Hypertonic ; Sodium (9NEZ333N27)
Language	English
Publishing date	2023-11-15
Publishing country	United States
Document type	Equivalence Trial ; Journal Article
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMoa2306263
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Article: Localization of TSH-secreting pituitary adenoma using 11C-methionine image subtraction.

Gillett, Daniel / Senanayake, Russell / MacFarlane, James / van der Meulen, Merel / Koulouri, Olympia / Powlson, Andrew S / Crawford, Rosy / Gillett, Bethany / Bird, Nick / Heard, Sarah / Kolias, Angelos / Mannion, Richard / Aloj, Luigi / Mendichovszky, Iosif A / Cheow, Heok / Bashari, Waiel A / Gurnell, Mark

EJNMMI research

2022 Volume 12, Issue 1, Page(s) 26

Abstract: Background: Pituitary adenomas (PA) affect ~ 1:1200 of the population and can cause a wide range of symptoms due to hormone over-secretion, loss of normal pituitary gland function and/or compression of visual pathways, resulting in significantly ... ...

Abstract	Background: Pituitary adenomas (PA) affect ~ 1:1200 of the population and can cause a wide range of symptoms due to hormone over-secretion, loss of normal pituitary gland function and/or compression of visual pathways, resulting in significantly impaired quality of life. Surgery is potentially curative if the location of the adenoma can be determined. However, standard structural (anatomical) imaging, in the form of MRI, is unable to locate all tumors, especially microadenomas (< 1 cm diameter). In such cases, functional imaging [ Results: We found that the mean percentage differences in maximum pituitary uptake between two Met-PET scans in healthy volunteers were 2.4% for (SUVr) [cerebellum], 8.8% for SUVr [pons], 5.2% for SUVr [gray matter] and 23.1% for the SUVbw [no region]. Laterality, as measured by contrast-noise ratio (CNR), indicated the correct location of the adenoma in all three image types with mean CNR values of 6.2, 8.1 and 11.1 for SUVbw, SUVbwSub and SUVrSub [cerebellum], respectively. Subtraction imaging improved CNR in 60% and 100% of patients when using images generated from SUVbw [no region] and SUVr [cerebellum] scans compared to standard clinical SUVbw imaging. Conclusions: Met-PET scans should be normalized to the cerebellum to minimize the effects of physiological variation in pituitary gland uptake of 11C-methionine, especially when comparing serial imaging. Subtraction imaging following endocrine suppression of tumor function improved lateralization of PA when compared with single time point clinical Met-PET but, importantly, only if the images were normalized to the cerebellum prior to subtraction.
Language	English
Publishing date	2022-05-07
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2619892-7
ISSN	2191-219X
ISSN	2191-219X
DOI	10.1186/s13550-022-00899-7
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Article ; Online: Using Molecular Imaging to Enhance Decision Making in the Management of Pituitary Adenomas.

Bashari, Waiel A / Senanayake, Russell / MacFarlane, James / Gillett, Daniel / Powlson, Andrew S / Kolias, Angelos / Mannion, Richard J / Koulouri, Olympia / Gurnell, Mark

Journal of nuclear medicine : official publication, Society of Nuclear Medicine

2021 Volume 62, Issue Suppl 2, Page(s) 57S–62S

Abstract: ... is limited by the inability of MRI to accurately localize the site(s) of de novo, persistent, or ...

Abstract	In most patients with suspected or confirmed pituitary adenomas (PAs), MRI, performed using T1- (with or without gadolinium enhancement) and T2-weighted sequences, provides sufficient information to guide effective clinical decision making. In other patients, additional MR sequences (e.g., gradient recalled echo, fluid-attenuation inversion recovery, MR elastography, or MR angiography) may be deployed to improve adenoma detection, assess tumoral consistency, or aid distinction from other sellar/parasellar lesions (e.g., aneurysm, meningioma). However, there remains a small but important subgroup of patients in whom primary or secondary intervention (e.g., first or redo transsphenoidal surgery, stereotactic radiosurgery) is limited by the inability of MRI to accurately localize the site(s) of de novo, persistent, or recurrent PA. Emerging evidence indicates that hybrid imaging, which combines molecular (e.g.
MeSH term(s)	Gadolinium ; Humans ; Middle Aged ; Pituitary Neoplasms
Chemical Substances	Gadolinium (AU0V1LM3JT)
Language	English
Publishing date	2021-06-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80272-4
ISSN	1535-5667 ; 0097-9058 ; 0161-5505 ; 0022-3123
ISSN (online)	1535-5667
ISSN	0097-9058 ; 0161-5505 ; 0022-3123
DOI	10.2967/jnumed.120.251546
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