Pitfalls in the Diagnostic Evaluation of Hyperprolactinemia

An appropriate diagnostic evaluation is essential for the most appropriate treatment to be performed. Currently, macroprolactinemia is the third most frequent cause of non-physiological hyperprolactinemia after drugs and prolactinomas. Up to 40% of macroprolactinemic patients may present with hypogonadism symptoms, infertility and/or galactorrhea. Thus, the screening for macroprolactin is indicated not only for asymptomatic subjects but also for those without an obvious cause for their prolactin (PRL) elevation. Before submitting patients to macroprolactin screening and pituitary magnetic resonance imaging (MRI), one should rule out pregnancy, drug-induced hyperprolactinemia, primary hypothyroidism, and renal failure. The magnitude of PRL elevation can be useful in determining the etiology of hyperprolactinemia. PRL values>250 ng/mL are highly suggestive of prolactinomas and virtually exclude non-functioning pituitary adenomas (NFPAs) and other sellar masses as the etiology of hyperprolactinemia. However, they can also be found in subjects with macroprolactinemia, drug-induced hyperprolactinemia or chronic renal failure. By contrast, most patients with NFPAs, drug-induced hyperprolactinemia, macroprolactinemia or systemic diseases present with PRL levels
Source: Neuroendocrinology - Category: Endocrinology Source Type: research

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Authors: Baghcheghi Y, Mansouri S, Beheshti F, Shafei MN, Salmani H, Reisi P, Anaeigoudari A, Bideskan AE, Hosseini M Abstract Protective effects of vitamin E (Vit E) on long term potentiation (LTP) impairment, neuronal apoptosis and increase of nitric oxide (NO) metabolites in the hippocampus of juvenile rats were examined. The rats were grouped (n=13) as: (1) control; (2) hypothyroid (Hypo) and (3) Hypo-Vit E. Propylthiouracil (PTU) was given in drinking water (0.05%) during 6 weeks. Vit E (20 mg/ kg) was daily injected (IP). To evaluate synaptic plasticity, LTP from the CA1 area of the hippocampus followed by h...
Source: International Journal for Vitamin and Nutrition Research - Category: Nutrition Tags: Int J Vitam Nutr Res Source Type: research
We present the case of a patient with an incidental ultrasonographic finding of bilateral aneurysm of the internal iliac arteries, both with indications for surgery. The patient was successfully treated with endovascular techniques, first repairing the right internal iliac with a branched iliac stent graft, preserving patency, then embolizing the left internal iliac artery. Knowledge of the various different techniques and devices and their limitations is fundamental to adequate planning of endovascular treatment, even in rare cases.
Source: Jornal Vascular Brasileiro - Category: Surgery Source Type: research
Download the flyer UCLA statement on measles case1. What is measles?Measles is a highly contagious disease that is caused by a virus that lives in the nose and throat. The symptoms of measles include:Fever   (101°F or higher)CoughRunny noseRed watery eyesRash of red spots. Some are slightly raised. Typically starts on the face or hairline and spreads to the rest of the body.Measles can lead to serious illnesses, hospitalization, and even death. Serious illnesses include:DiarrheaEar InfectionBrain Damage        Pregnant women, infants, young children, and persons with a weakened i...
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
The very large economic and social burdens of fracture-related complications make rapid fracture healing a major public health goal. The role of parathyroid hormone (PTH) in treating osteoporosis is generally accepted, but the effect of PTH on fracture healing is controversial. This meta-analysis was designed to investigate the efficacy and safety of PTH in fracture healing. The EMBASE, PubMed, and Cochrane Library databases were systematically searched from the inception dates to April 26, 2018. The primary randomized clinical trials comparing PTH treatment for fracture healing with placebo or no treatment were identified...
Source: Clinics - Category: General Medicine Source Type: research
By Margarite Nathe, Principal Editor/Writer, IntraHealth InternationalApril 25, 2019It takes tenacity to work in global health and development. These folks have it.I ’m going to go out on a limb and guess that if you work in global health or international development, you might know what frustration feels like.Maybe the project funding cycle gets you down. Maybe you ’ve struggled with a public policy that hurts more people than it helps. It could be that you’ve grappled with shoddy data sets, or corrupt officials, or the fickle winds of politics that so often blow our efforts off course.You ne...
Source: IntraHealth International - Category: International Medicine & Public Health Authors: Tags: SwitchPoint Source Type: news
Authors: Akinsete A, Oyenusi E, Odugbemi B, Odugbemi T, Temiye E Abstract Thyroid disorders have been described in an adult population but are underreported in the pediatric population. The aim of this study was to determine the prevalence and describe the spectrum of thyroid abnormalities among HIV infected children on Highly Active Antiretroviral Therapy (HAART) in Lagos, Nigeria. This was a cross-sectional study carried out at a teaching hospital with an antiretroviral therapy (ART) center. Serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) were analyzed in 8...
Source: Journal of Thyroid Research - Category: Endocrinology Tags: J Thyroid Res Source Type: research
This study was approved by the Animal Experimental Ethics Committee of Southern Medical University, Guangzhou, China (2014-024). All experiments were performed under protocols to meet the requirements of the Association for Assessment and Accreditation of Laboratory Animal Care International and the Experimental Animal Center of Southern Medical University. Male cynomolgus monkeys (Macaca fascicularis) were used, preliminary power analysis being performed to get the proper sample size for three groups (G∗Power 3.1, Heinrich-Heine-Universität Düsseldorf, Germany; alpha = 0.05, power = 0.95; total N = 20 hem...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
M. Piasecki1*, A. Ireland2, J. Piasecki3, H. Degens2,4, D. W. Stashuk5, A. Swiecicka6, M. K. Rutter6,7, D. A. Jones2 and J. S. McPhee8,9* 1Clinical, Metabolic and Molecular Physiology, MRC-ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom 2School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom 3Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Tre...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
The objective of the present study was to investigate the immediate and delayed effects of moderate, clinically-relevant HB on cardiorespiratory control in preterm lambs. Two groups of five preterm lambs, namely control and HB, were studied. At day five of life, moderate HB (150–250 μmol/L) was induced and maintained during 17 h in the HB group while control lambs received a placebo solution. Six hours after HB onset, 7-h polysomnographic recordings with electrocardiogram (ECG) and respiratory (RESP) signals were performed to assess the immediate effects of HB on heart rate variability (HRV), respiratory rate vari...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
ConclusionThis case report describes a patient with a paravertebral giant cell tumor who was successfully treated by preoperative denosumab injection followed by total en bloc spondylectomy.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
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