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1.
Pol Merkur Lekarski ; 48(285): 188-194, 2020 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-32564045

RESUMO

The standard pharmacotherapy of benign prostatic hyperplasia (BPH) may also alleviate potential kidney dysfunction resulting from the development of obstructive uropathy in the course of BPH. AIM: The aim of study was to evaluate the effect of treatment with α-1- adrenolytic agent (tamsulosin) and 5-α-reductase inhibitor (finasteride) on renal function in rats. MATERIALS AND METHODS: Four groups of rats were studied: 1 - controls, 2 - rats with metoclopramide-induced hyperprolactinemia BPH model, 3 - rats with BPH treated with tamsulosin, 4 - rats with BPH treated with finasteride. BPH presence was verified by histopathological examination. The renal function was assessed by histopathological examination, and the laboratory assessment of the classic nitrogen parameters and new kidney function markers (cystatin C; CysC, kidney injury molecule-1; KIM-1). RESULTS: In group 2, BPH development was confirmed by histopathological examination, without simultaneous significant kidney disturbances. Compared to the controls, BPH animals exhibited significant proteinuria, and increased concentration and daily urinary excretion of CysC and KIM- 1. Treatment with tamsulosin significantly improved the histopathological image of the prostate without affecting renal structure and led to reduced blood urea and proteinuria. Treatment with finasteride also significantly reduced the histopathological signs of BPH without changing the image of the kidneys, and reduced CysC concentration and daily CysC excretion with urine compared to group 2 individuals. CONCLUSIONS: In the course of experimental hyperprolactinemiainduced BPH, kidney tubulopathy developed, which was indicated by KIM-1 and CysC disturbances in urine. The administration of finasteride reduced renal dysfunction to a higher degree, bringing the concentration and daily excretion of CysC back to normal.


Assuntos
Inibidores de 5-alfa Redutase , Hiperprolactinemia , Hiperplasia Prostática , Inibidores de 5-alfa Redutase/uso terapêutico , Animais , Hiperprolactinemia/tratamento farmacológico , Masculino , Modelos Teóricos , Oxirredutases , Hiperplasia Prostática/tratamento farmacológico , Ratos
3.
Pan Afr Med J ; 35: 2, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32117518

RESUMO

Hyperprolactinemia is responsible for 20 to 25% of consultations of secondary amenorrhea and 17% for female infertility. Dopamine agonists are the gold standard treatment of hyperprolactinemia. Although they are associated with various adverse effects, cabergoline is generally preferred due to better compliance, limited side effects and good therapeutic response. However, bromocriptine is widely and satisfactorily used in a context of limited availability of cabergoline. We sought to describe clinical manifestations of hyperprolactinemia and response to cabergoline in a sub Saharan Africa (SSA) setting. We describe the profile of all patients with a diagnosis of hyperprolactinaemia from 1st July 2012 to 15th May 2014 at the Endocrinology Department of Yaoundé Central Hospital. Patients with physiological hyperprolactinemia were not considered. All patients were routinely started on cabergoline at 0.5mg/week or at 1mg/week in case of macroprolactinoma or desire to become pregnant. The duration of follow up was 8-16 months. After three months of treatment, 8 of 10 patients with amenorrhea had menses and serum prolactin levels decreased significantly at month 2-3 (p = 0.025). In conclusion, our study suggests that cabergoline yields an excellent therapeutic response in a short period of time and may thus be cost saving in sub Saharan context despite its unit price.


Assuntos
Cabergolina/uso terapêutico , Agonistas de Dopamina/uso terapêutico , Hiperprolactinemia/tratamento farmacológico , Adulto , Camarões , Estudos Transversais , Feminino , Seguimentos , Humanos , Hiperprolactinemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
4.
Sheng Li Xue Bao ; 72(1): 125-132, 2020 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-32099990

RESUMO

In recent years, it has been found that kisspeptin plays some key roles in the physiological processes of the brain, such as gender differentiation, positive and negative feedback of sex hormones, onset of puberty, and transduction of energy signals in the body, which suggests that kisspeptin may be a key molecule for the maturation and regulation of female reproductive function. In addition to the systemic roles of the kisspeptin, its local roles in reproductive organs are constantly being discovered. With the discovery that kisspeptin is involved in the pathological process of reproductive endocrine diseases such as isolated hypogonadotropic hypogonadism (IHH), polycystic ovary syndrome (PCOS), premature ovarian failure (POF) and pathological hyperprolactinemia, exogenous application of kisspeptin to solve reproductive problems has become a new hot topic. The review focuses on the research progress of kisspeptin in the female reproductive system, especially on its application in assisted reproduction.


Assuntos
Kisspeptinas/fisiologia , Técnicas de Reprodução Assistida , Feminino , Hormônios Esteroides Gonadais/fisiologia , Humanos , Hiperprolactinemia/fisiopatologia , Hipogonadismo/fisiopatologia , Kisspeptinas/farmacologia , Síndrome do Ovário Policístico/fisiopatologia , Gravidez , Insuficiência Ovariana Primária/fisiopatologia
5.
Arq Neuropsiquiatr ; 78(1): 28-33, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32074187

RESUMO

METHODS: Prolactin (PRL) secreting adenomas are associated with high incidence of headache. The role of hyperprolactinemia in the headache context is not clear, nor is the effect of its treatment on headache. The present longitudinal study evaluated hyperprolactinemic patients (69), in terms of presence and characteristics of headache before and after hyperprolactinemia treatment. RESULTS: Headache was reported by 45 (65.2%) patients, independent of the etiology of hyperprolactinemia. The migraine phenotype was the most prevalent (66.6%). Medications used in the treatment of headache not changed during the study. The first line of treatment of hyperprolactinemia was dopaminergic agonists. In the last reevaluation, PRL level under treatment was within the reference range in 54.7% of the cases, and it was observed complete or partial resolution of the headache in 75% of the cases. The median PRL at this time in patients with complete headache resolution was 17 ng/mL, in those who reported partial recovery was 21 ng/mL, and in those in whom the headache did not change was 66 ng/mL, with a significant difference between the group with complete headache resolution vs. the group with unchanged headache (p=0.022). In the cases with complete headache resolution, the median fall on PRL levels was 89% and in those cases with partial headache resolution 86%, both significantly different (p<0.001) from the fall in the cases with an unchanged headache. CONCLUSION: Data allow us to conclude that, in this series, in the majority of cases the reduction in the level of PRL was followe3d by cessation or relief of the pain.


Assuntos
Cefaleia/sangue , Cefaleia/prevenção & controle , Hiperprolactinemia/terapia , Prolactina/sangue , Adenoma/complicações , Adenoma/terapia , Adulto , Análise de Variância , Agonistas de Dopamina/uso terapêutico , Feminino , Cefaleia/etiologia , Humanos , Hiperprolactinemia/complicações , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/terapia , Valores de Referência , Estatísticas não Paramétricas , Resultado do Tratamento
6.
PLoS One ; 15(2): e0228648, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32017792

RESUMO

BACKGROUND: Antipsychotic medication, stress, gender, and age are factors that influence prolactin levels in patients with psychosis. The aim of the study was to investigate the level of prolactin response to antipsychotic treatment in acute patients, taking into account the total duration of psychosis. METHODS AND FINDINGS: The study was conducted on 170 acute patients with schizophrenia spectrum disorders and bipolar disorder. Subjects were divided into three subgroups according to the duration of the psychosis (less than 5 years, between 5 and 10 years and more than 10 years of disorder duration). The initial prolactin response under antipsychotic treatment was measured, while the severity of the psychiatric symptoms was assessed with the BPRS (Brief Psychiatric Rating Scale). Hyperprolactinemia was found in 120 (70.6%) patients, amongst which 80 (66.7%) were females and 40 (33.3%) were males. The average increase in prolactinemia was 2.46 times the maximum value in women, and 1.59 times in men. Gender (ß = 0.27, p<0.0001), type of antipsychotic medication according to potency of inducing hyperprolactinemia (ß = -0.23, p<0.003), and the duration of psychosis over 10 years (ß = -0.15, p = 0.04) significantly predicted prolactin levels, when age, diagnosis, antipsychotic category (conventional/atypical/combinations of antipsychotics), and BPRS total scores were controlled for. CONCLUSIONS AND RELEVANCE: Prolactin levels in patients treated with antipsychotic medication appeared to depend on patients' gender, on the type of antipsychotic medication according to potency of inducing hyperprolactinemia, and on the duration of the psychosis. An increase in prolactin levels was associated with female gender, while the use of prolactin sparing antipsychotics and a duration of psychosis over 10 years were associated with lower prolactin levels.


Assuntos
Antipsicóticos/farmacologia , Hiperprolactinemia/etiologia , Prolactina/efeitos dos fármacos , Transtornos Psicóticos/tratamento farmacológico , Adulto , Antipsicóticos/uso terapêutico , Benzodiazepinas/efeitos adversos , Benzodiazepinas/uso terapêutico , Transtorno Bipolar/complicações , Transtorno Bipolar/tratamento farmacológico , Feminino , Humanos , Hiperprolactinemia/diagnóstico , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Olanzapina/efeitos adversos , Olanzapina/uso terapêutico , Prolactina/sangue , Transtornos Psicóticos/complicações , Risperidona/efeitos adversos , Risperidona/uso terapêutico , Esquizofrenia/complicações , Esquizofrenia/tratamento farmacológico , Fatores Sexuais , Fatores de Tempo
7.
Braz J Psychiatry ; 42(1): 33-39, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31314867

RESUMO

OBJECTIVE: To evaluate body dissatisfaction and distorted body self-image in women with prolactinoma. METHODS: Body dissatisfaction and distorted body self-image were evaluated in 80 women with prolactinoma. All patients were in menacme, 34% had normal body mass index (BMI), and 66% were overweight. Most patients (56.2%) had normal prolactin (PRL) levels and no hyperprolactinemia symptoms (52.5%). The Body Shape Questionnaire (BSQ) was used to assess the patients' dissatisfaction with and concern about their physical form, and the Stunkard Figure Rating Scale (FRS) was used to assess body dissatisfaction and distorted body self-image. The patients were divided according to PRL level (normal vs. elevated) and the presence or absence of prolactinoma symptoms. RESULTS: The normal and elevated PRL groups had similar incidences of body dissatisfaction and distorted body self-image. However, symptomatic patients reported a higher incidence of dissatisfaction than asymptomatic patients. Distorted body self-image was less common among symptomatic patients. CONCLUSION: Symptomatic patients showed higher body dissatisfaction, but lower body self-image distortion. The presence of symptoms may have been responsible for increased body awareness. The perception of body shape could have triggered feelings of dissatisfaction compared to an ideal lean body. Therefore, a distorted body self-image might not necessarily result in body dissatisfaction in women with prolactinomas.


Assuntos
Transtornos Dismórficos Corporais/psicologia , Hiperprolactinemia/psicologia , Neoplasias Hipofisárias/psicologia , Prolactinoma/psicologia , Adulto , Imagem Corporal/psicologia , Índice de Massa Corporal , Agonistas de Dopamina/uso terapêutico , Feminino , Humanos , Hiperprolactinemia/sangue , Hiperprolactinemia/tratamento farmacológico , Pessoa de Meia-Idade , Neoplasias Hipofisárias/sangue , Prolactina/sangue , Prolactinoma/sangue , Escalas de Graduação Psiquiátrica , Valores de Referência , Estatísticas não Paramétricas , Inquéritos e Questionários , Adulto Jovem
8.
Sultan Qaboos Univ Med J ; 19(2): e129-e134, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31538011

RESUMO

Objectives: This study aimed to evaluate the aetiologies of hyperprolactinaemia in the United Arab Emirates (UAE). Methods: This retrospective study used laboratory databases to identify all patients who underwent evaluation for prolactin at Tawam Hospital, Al Ain, UAE, between 2009 and 2015. Of those 2,280 patients, all patients with low or normal prolactin (n = 1,315) were excluded. Subsequently, charts of the remaining patients (n = 965) with hyperprolactinaemia were reviewed and those with incomplete work-ups or insufficient documentation of the hyperprolactinaemia's aetiology were excluded (n = 458). Results: A total of 507 patients were included in the study. The average age at prolactin evaluation was 36 ± 13.2 years and the majority (67.1%) of patients were female. The most common reasons for requesting prolactin were menstrual disorders (29.5%), infertility (18%), evaluation of sellar masses (14.3%), ruling out seizures (13.4 %) and monitoring while on psychiatric medications (8.7%). The most common causes of hyperprolactinaemia were prolactinoma (17%), transient hyperprolactinaemia (14.6%), drug-induced side effects (14.4%), polycystic ovarian syndrome (11.8%) and seizure disorder (7.7%). In females, common aetiologies were prolactinomas, transient and idiopathic hyperprolactinaemia, while sellar masses, seizures, chronic kidney disease and acute illnesses were common aetiologies of hyperprolactinaemia in males. The prolactin level varied between the different aetiologies and a level of >250 ng/mL was suggestive of macro-prolactinoma. Conclusion: A significant proportion of patients with hyperprolactinaemia have transient hyperprolactinaemia. Before further investigations are carried out, prolactin level assessment should be repeated, especially in patients with mild hyperprolactinaemia.


Assuntos
Hiperprolactinemia/etiologia , Adulto , Feminino , Humanos , Hiperprolactinemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prolactina/análise , Prolactina/sangue , Prolactinoma/complicações , Prolactinoma/epidemiologia , Estudos Retrospectivos , Centros de Atenção Terciária/organização & administração , Centros de Atenção Terciária/estatística & dados numéricos , Emirados Árabes Unidos/epidemiologia
9.
Metab Brain Dis ; 34(6): 1679-1687, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31422510

RESUMO

First-episode psychosis (FEP) patients are more sensitive to neuroleptic side-effects such as hyperprolactinemia. We examined the prolactin levels of previously minimally treated patients with first episode schizophrenia over their first year of treatment with flupenthixol decanoate and the relationship between prolactin levels, gender and clinical features of schizophrenia. Prolactin levels were assessed at three monthly intervals in 126 patients with first-episode schizophrenia in a single-site study conducted over 12 months during treatment with flupenthixol decanoate according to a fixed protocol. The mean prolactin level for the total sample was 11.91 ng/ml (standard deviation [SD]15.52) at baseline. Women had higher levels of prolactin than men at month 3, 6 and 12, reaching statistical significance at month 12 (p = 0.02). At 12 months more women than men had hyperprolactinemia (defined as more than 20 ng/ml for males, and as more than 25 ng/ml for females (p = 0.007). Using a mixed effect model, there was a significant association between prolactin change scores over 12 months and gender (p = 0.025) as well as Positive and Negative Syndrome Scale (PANSS) total scores (p = 0.001). In addition female gender (p = 0.04) and age (p = 0.02) correlated with the risk of hyperprolactinemia as categorical variable. In this study treatment with flupenthixol decanoate was associated with relatively low levels of hyperprolactinemia, likely owing to flupenthixol's relatively atypical mode of action, as well as to the low doses used in our study. We found an inverse correlation between total PANSS scores and prolactin levels, which could support the suggested theory of prolactin having antipsychotic properties. Our study confirms the importance of gender on the prolactin raising effects of antipsychotic treatment.


Assuntos
Flupentixol/análogos & derivados , Hiperprolactinemia/induzido quimicamente , Propafenona/sangue , Esquizofrenia/tratamento farmacológico , Tranquilizantes/uso terapêutico , Adolescente , Adulto , Fatores Etários , Feminino , Flupentixol/efeitos adversos , Flupentixol/uso terapêutico , Humanos , Masculino , Esquizofrenia/sangue , Fatores Sexuais , Tranquilizantes/efeitos adversos , Resultado do Tratamento , Adulto Jovem
10.
Am J Cardiol ; 124(8): 1207-1212, 2019 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-31409451

RESUMO

Premenopausal women with macroprolactinemia are characterized by increased cardiometabolic risk. No previous study has investigated the impact of any lipid-lowering agent on circulating levels of cardiometabolic risk factors in patients with elevated macroprolactin content. We studied 2 groups of women matched for age, body mass index, plasma lipids, and blood pressure: 12 women with macroprolactinemia and 14 women with prolactin levels within the reference range. Because of coexistent isolated hypercholesterolemia, all subjects were then treated with atorvastatin (20 mg daily). Glucose homeostasis markers, plasma lipids, as well as circulating levels of uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, and 25-hydroxyvitamin D were measured before entering the study and 6 months later. The treatment arms differed in baseline values of hsCRP and 25-hydroxyvitamin D, as well as in insulin sensitivity. Atorvastatin decreased total and low-density lipoprotein cholesterol levels stronger in women without than in women with macroprolactinemia. In normoprolactinemic women, atorvastatin decreased circulating levels of uric acid, hsCRP, fibrinogen, homocysteine, and increased concentrations of 25-hydroxyvitamin D, whereas in women with macroprolactinemia the drug decreased levels of hsCRP and homocysteine, as well as impaired insulin sensitivity. Both study groups differed in post-treatment insulin sensitivity and post-treatment values of prolactin before polyethylene glycol precipitation, macroprolactin, total cholesterol, low-density lipoprotein cholesterol, glycated hemoglobin, uric acid, hsCRP, fibrinogen, homocysteine, and 25-hydroxyvitamin D. In conclusion, the obtained results suggest that macroprolactinemia may attenuate cardiometabolic effects of atorvastatin.


Assuntos
Atorvastatina/administração & dosagem , Doenças Cardiovasculares/prevenção & controle , LDL-Colesterol/sangue , Hipercolesterolemia/tratamento farmacológico , Hiperprolactinemia/sangue , Prolactina/sangue , Adulto , Idoso , Anticolesterolemiantes/administração & dosagem , Biomarcadores/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Feminino , Seguimentos , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/complicações , Hiperprolactinemia/complicações , Hiperprolactinemia/dietoterapia , Incidência , Resistência à Insulina , Pessoa de Meia-Idade , Polônia/epidemiologia , Fatores de Risco
11.
Am Fam Physician ; 100(3): 168-175, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31361105

RESUMO

Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. Although many conditions can lead to hirsutism, polycystic ovary syndrome and idiopathic hyperandrogenism account for more than 85% of cases. Less common causes include idiopathic hirsutism, nonclassic congenital adrenal hyperplasia, androgen-secreting tumors, medications, hyperprolactinemia, thyroid disorders, and Cushing syndrome. Women with an abnormal hirsutism score based on the Ferriman-Gallwey scoring system should be evaluated for elevated androgen levels. Women with rapid onset of hirsutism over a few months or signs of virilization are at high risk of having an androgen-secreting tumor. Hirsutism may be treated with pharmacologic agents and/or hair removal. Recommended pharmacologic therapies include combined oral contraceptives, finasteride, spironolactone, and topical eflornithine. Because of the length of the hair growth cycle, therapies should be tried for at least six months before switching treatments. Hair removal methods such as shaving, waxing, and plucking may be effective, but their effects are temporary. Photoepilation and electrolysis are somewhat effective for long-term hair removal but are expensive.


Assuntos
Hiperplasia Suprarrenal Congênita/complicações , Síndrome de Cushing/complicações , Hirsutismo/etiologia , Hiperandrogenismo/complicações , Hiperprolactinemia/complicações , Neoplasias/complicações , Síndrome do Ovário Policístico/complicações , Doenças da Glândula Tireoide/complicações , Hiperplasia Suprarrenal Congênita/diagnóstico , Hiperplasia Suprarrenal Congênita/terapia , Antagonistas de Androgênios/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Anticoncepcionais Orais Hormonais/uso terapêutico , Síndrome de Cushing/diagnóstico , Síndrome de Cushing/terapia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Eflornitina/uso terapêutico , Feminino , Glucocorticoides/uso terapêutico , Hormônio Liberador de Gonadotropina/agonistas , Remoção de Cabelo , Hirsutismo/diagnóstico , Hirsutismo/terapia , Humanos , Hiperandrogenismo/diagnóstico , Hiperandrogenismo/terapia , Hiperprolactinemia/diagnóstico , Hiperprolactinemia/terapia , Leuprolida/uso terapêutico , Antagonistas de Receptores de Mineralocorticoides/uso terapêutico , Neoplasias/diagnóstico , Neoplasias/terapia , Inibidores da Ornitina Descarboxilase/uso terapêutico , Síndrome do Ovário Policístico/diagnóstico , Síndrome do Ovário Policístico/terapia , Espironolactona/uso terapêutico , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/terapia
12.
Best Pract Res Clin Endocrinol Metab ; 33(2): 101290, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31326373

RESUMO

Prevalence and incidence of prolactinomas are approximately 50 per 100,000 and 3-5 new cases/100,000/year. The pathophysiological mechanism of hyperprolactinemia-induced gonadotropic failure involves kisspeptin neurons. Prolactinomas in males are larger, more invasive and less sensitive to dopamine agonists (DAs). Macroprolactin, responsible for pseudohyperprolactinemia is a frequent pitfall of prolactin assay. DAs still represent the primary therapy for most prolactinomas, but neurosurgery has regained interest, due to progress in surgical techniques and a high success rate in microprolactinoma, as well as to some underestimated side effects of long-term DA treatment, such as impulse control disorders or impaired quality of life. Recent data show that the suspected effects of DAs on cardiac valves in patients with prolactinomas are reassuring. Finally, temozolomide has emerged as a valuable treatment for rare cases of aggressive and malignant prolactinomas that do not respond to all other conventional treatments.


Assuntos
Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/epidemiologia , Neoplasias Hipofisárias/terapia , Prolactinoma/diagnóstico , Prolactinoma/epidemiologia , Prolactinoma/terapia , Agonistas de Dopamina/uso terapêutico , Feminino , Humanos , Hiperprolactinemia/diagnóstico , Hiperprolactinemia/epidemiologia , Hiperprolactinemia/etiologia , Hiperprolactinemia/terapia , Incidência , Kisspeptinas/metabolismo , Masculino , Neurônios/metabolismo , Neurônios/patologia , Neoplasias Hipofisárias/complicações , Prevalência , Prolactina/análise , Prolactina/sangue , Prolactinoma/complicações , Qualidade de Vida
14.
Psychiatr Danub ; 31(Suppl 2): 148-152, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31158115

RESUMO

BACKGROUND: Hyperprolactinemia is associated with side effect of antipsychotics in people suffering from psychotic disorders. However, increased prolactin levels (mlU/L) were found in patients suffering from the first psychotic episode who were not receiving antipsychotic therapy. The assumption of this study is that the abnormality in the level of prolactin is associated with the effect and influence of the disease, not the therapy that is carried out. SUBJECTS AND METHODS: Study involved 54 female patients hospitalized in Psychiatric hospital "Sveti Ivan", whose average age was 33.9 years. All patients had been diagnosed with a psychotic disorder (according to MKB-10, F20-F29). 18 patients had their first psychotic episode, while 36 patients had relapses of psychotic disorder. The methods used were: PANSS scale and measurement of prolactin concentration (Immunoanalyzer ACCESS 2, CLIA method). Arithmetic mean, standard deviations, correlation coefficient, Mann Whitney U test and the chi-squared test were used. RESULTS: 75.5% of patients had prolactin values above the reference values (min 121, max 4192 ml/L). In a sample of patients with first psychotic episode, 77.8% had elevated prolactin levels, while among re-hospitalized patients, elevated levels had 74.2%. Statistically significant results were obtained: patients with higher pronounced symptoms had higher prolactin values, especially particles on PANSS: P1 (delusions), N4 (Apathy), G15 (preoccupation) and G16 (active avoidance). CONCLUSION: Elevated prolactin in patients has been demonstrated regardless of antipsychotic therapy, therefore the question of etiology of hyperprolactinemia in psychotic disorders is questionable. The association of hyperprolactinemia with the severity of the clinical picture has also been demonstrated, higher prolactin values indicating a stronger clinical picture, which calls into question the protective role of prolactin in psychotic disorders.


Assuntos
Antipsicóticos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Hiperprolactinemia , Transtornos Psicóticos , Adulto , Antipsicóticos/efeitos adversos , Feminino , Humanos , Hiperprolactinemia/induzido quimicamente , Prolactina , Transtornos Psicóticos/tratamento farmacológico
16.
Psychiatry Res ; 276: 218-222, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31112855

RESUMO

Recent studies have found hyperprolactinemia in first episode psychotic patients that had not previously received antipsychotic treatment (drug-naïve). Our goal was to learn whether there were differences in baseline prolactin concentrations between drug-naïve psychotic patients and healthy controls, as well as to study possible gender differences in the prolactin elevation. A cross-sectional study was conducted that included 61 drug-naïve psychosis patients and 45 healthy controls (aged between 14-55 years old). A blood sample was extracted between 8 and 10 a.m. Prolactin levels and TSH were determined. The Perceived Stress Scale (PSS) was conducted across the sample. This study showed significantly higher levels of prolactin in drug-naïve patients compared to healthy controls. These results were maintained after controlling prolactin levels for sex, age, THC consumption, baseline TSH, and PSS. A significant correlation between prolactin and PSS was not observed. Significant differences in prolactin levels between men and women were not observed. These results are clinically important because if elevated baseline prolactin levels are detected in these patients, it will be necessary to initiate neuroleptics that do not increase this hormone. There was no evidence that stress was related to an increase in prolactin at the onset of psychosis.


Assuntos
Hiperprolactinemia/psicologia , Prolactina/sangue , Transtornos Psicóticos/sangue , Fatores Sexuais , Adolescente , Adulto , Antipsicóticos/uso terapêutico , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Hiperprolactinemia/sangue , Masculino , Pessoa de Meia-Idade , Transtornos Psicóticos/complicações , Adulto Jovem
17.
World Neurosurg ; 128: e522-e530, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31048050

RESUMO

OBJECTIVE: Rathke's cleft cysts (RCCs) may have various anatomic, clinical, and radiologic characteristics, which may be related to their differences in texture or consistency. The purpose of the study was to investigate RCCs based on consistency. METHODS: We retrospectively reviewed 25 cases of patients with RCCs who underwent endoscopic endonasal transsphenoidal surgery between 2008 and 2018. Cases were divided into 3 types based on cyst consistency: fluid (serous) or type A (n = 4); semi-fluid (mucoid) or type B (n = 17); and non-fluid (caseous) or type C (n = 4). Demographic, clinical, radiologic, and surgical characteristics for each group were analyzed. RESULTS: All type A RCCs (100%) had visual impairment. The mean age (42.8 ± 13 years) and cyst volume (2442.5 ± 533.6 mm3) were higher in these patients. T1-weighted images were hypointense and T2-weighted images were hyperintense on magnetic resonance imaging. Type B RCCs were more frequently encountered (68%). Although headache was the most common (82.3%) symptom, endocrine disorders were also prevalent (52.9%). T1-weighted images were typically isointense or hyperintense on magnetic resonance imaging. Type C RCCs had the youngest patient population (30.3 ± 10.2 years) and T2-weighted images were predominantly hypointense in this group. CONCLUSIONS: The proposed novel consistency classification of RCCs will provide a practical tool for more accurately estimating the nature of the pathology, because each type has its own specific characteristics. Furthermore, the new classification of RCCs may aid in planning a consistency-specific surgery.


Assuntos
Cistos do Sistema Nervoso Central/diagnóstico por imagem , Cistos do Sistema Nervoso Central/patologia , Adolescente , Adulto , Idoso , Cistos do Sistema Nervoso Central/classificação , Cistos do Sistema Nervoso Central/complicações , Feminino , Cefaleia/etiologia , Humanos , Hidrocortisona/deficiência , Hiperprolactinemia/etiologia , Hipogonadismo/etiologia , Hipotireoidismo/etiologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Transtornos da Visão/etiologia , Adulto Jovem
18.
Hinyokika Kiyo ; 65(2): 55-59, 2019 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-31067844

RESUMO

A 41-year-old male with the chief complaint of infertility was referred to our hospital. He presented withmild erectile dysfunction and reduced shaving frequency. Semen analysis indicated a decreased semen volume in addition to a low sperm count and motility. Hormone evaluation revealed the following details : follicle stimulating hormone (FSH) 1.7 mIU/ml (range 2.0-8.3 mIU/ml), luteinizing hormone (LH) 0.9 mIU/ml (range 0.8-5.7 mIU/ml), testosterone 86.6 ng/dl (range 225.0-1,039 ng/dl), and prolactin (PRL) 242.0 ng/ml (range 3.6-12.8 ng/ml). Magnetic resonance imaging (MRI) of the patient's head showed empty sella turcica. He was diagnosed with acquired hypogonadotropic hypogonadism due to hyperprolactinemia. We suspected that the hyperprolactinemia was due to the pituitary lesion, although the possibility of coexisting pituitary microadenoma could not be discarded. Based on the diagnosis, cabergoline therapy was started. Four months after initiation of cabergoline therapy, the patient's hormone levels and semen parameters normalized, followed by improvement in his clinical symptoms. Furthermore, his wife spontaneously conceived.


Assuntos
Síndrome da Sela Vazia , Hiperprolactinemia , Hipogonadismo , Infertilidade Masculina , Adulto , Síndrome da Sela Vazia/complicações , Humanos , Hiperprolactinemia/complicações , Infertilidade Masculina/etiologia , Hormônio Luteinizante , Masculino , Testosterona
19.
J Obstet Gynaecol Res ; 45(7): 1236-1244, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30932283

RESUMO

AIM: To investigate whether treated hyperprolactinemia has an impact on pregnancy outcomes in in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). METHODS: A retrospective cohort study was conducted on 535 women who underwent IVF/ICSI-ET between January 2012 and December 2016, of which 123 had treated hyperprolactinemia (case group), 369 were matched controls. Besides, 43 remained hyperprolactinemic after treatment consisted of abnormal group. Cumulative live birth rate (CLBR) after one oocyte retrieval cycle was taken as the primary outcome. A time-to-event analysis using Fine and Gray's test was used to compare CLBR between case and control groups. RESULTS: The median prolactin level was 80.00 ng/mL before dopamine agonist treatment in case group, and it reduced to 14.80 ng/mL after the treatment, similar to the level of control group (15.17 ng/mL, P = 0.316). No significant differences in baseline characteristics were found between case and control groups. The CLBR after one oocyte retrieval cycle were 69.1% (85/123) and 66.4% (245/369) in the case group and control group, respectively (P = 0.580). No significant differences were found between case and control groups in perinatal outcomes. Pregnancy and perinatal outcomes of abnormal group were similar to those of case and control groups. CONCLUSION: Impact of treated hyperprolactinemia on CLBR and perinatal outcomes in IVF-ET was not evident.


Assuntos
Transferência Embrionária/estatística & dados numéricos , Fertilização In Vitro/estatística & dados numéricos , Hiperprolactinemia/fisiopatologia , Recuperação de Oócitos/estatística & dados numéricos , Injeções de Esperma Intracitoplásmicas/estatística & dados numéricos , Adulto , Coeficiente de Natalidade , Estudos de Casos e Controles , Agonistas de Dopamina/uso terapêutico , Feminino , Humanos , Hiperprolactinemia/tratamento farmacológico , Nascimento Vivo , Parto , Gravidez , Estudos Retrospectivos , Estudos de Tempo e Movimento , Resultado do Tratamento
20.
Horm Cancer ; 10(2-3): 120-127, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31001736

RESUMO

Natural course of prolactinomas after menopause is not fully elucidated. The aim of this study was to compare recurrence rate after cabergoline withdrawal in premenopausal vs. postmenopausal women with microprolactinoma. Sixty-two women with microprolactinoma treated with cabergoline for at least 1 year and followed for 2 years after drug withdrawal were retrospectively selected. Patients were divided into two groups: 48 patients stopped cabergoline before menopause ("PRE" group), while 14 after menopause ("POST" group). Recurrence was defined by prolactin levels above normal, confirmed on two occasions. Overall, 39/62 women relapsed. Patients who relapsed apparently had higher prolactin before withdrawal (median 216.2, range 21.2-464.3 mIU/L) compared with those in long-term remission (94.3, 29.7-402.8 mIU/L; p < 0.05), and the risk of recurrence seemed lower in POST women (4/14, 29%) than in PRE ones (35/48, 73%, p < 0.005, OR 0.149, 95% CI 0.040-0.558). However, none of the factors (prolactin before withdrawal, menopausal status, treatment duration, complete adenoma regression) showed a correlation with recurrence risk in multivariate analysis. The best strategy able to optimize CBG treatment and withdrawal's outcomes is still to be defined in microprolactinomas. Postmenopausal status cannot reliably predict long-term remission, and follow-up is needed also in women of this age.


Assuntos
Cabergolina/administração & dosagem , Neoplasias Hipofisárias/tratamento farmacológico , Pós-Menopausa , Pré-Menopausa , Prolactinoma/tratamento farmacológico , Adenoma/metabolismo , Adolescente , Adulto , Agonistas de Dopamina/administração & dosagem , Feminino , Humanos , Hiperprolactinemia/tratamento farmacológico , Pessoa de Meia-Idade , Prolactina/biossíntese , Recidiva , Indução de Remissão , Estudos Retrospectivos , Risco , Resultado do Tratamento , Adulto Jovem
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