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Endoscopic endonasal management of sellar/suprasellar arachnoid cysts: tailored surgical strategies and systematic review.

INTRODUCTION: Sellar and suprasellar arachnoid cysts(SACs)are rare lesions that may cause headaches, visual impairment, and endocrine dysfun … ition. Headache improved in all patients, and visual function improved or stabilized in every case. Hyperprolactinemia resolved universally, while other pituitary deficits showed variable recovery. Two patients developed postoperative CSF rhinorrhea-both after extended fenestration-requiring revision. No vascular injuries or mortality occurred. One asymptomatic radi …

Clinical presentation, investigation findings, and outcomes of hypophysitis in sarcoidosis: a systematic review.

PURPOSE: Hypophysitis in sarcoidosis is a rare manifestation of neurosarcoidosis that may cause permanent endocrine dysfunction, visual impa … most common anterior pituitary abnormality (74.1%), followed by central hypothyroidism (63.6%) and hyperprolactinemia (58.1%). MRI most commonly demonstrated pituitary stalk thickening (43.1%) and sellar/suprasellar masses (36.4%). CSF analysis frequently showed elevated protein (68.9%) and pleocytosis (59.5%). Systemic involvement occurred in 80.3% of patients, pr …

Integrating machine learning with electronic health record data to facilitate detection of prolactin level and pharmacovigilance signals in olanzapine-treated patients.

BACKGROUND AND AIM: Available evidence suggests elevated serum prolactin (PRL) levels in olanzapine (OLZ)-treated patients with schizophreni … mean relative error of 11%. Risperidone and aripiprazole exhibited the strongest associations with hyperprolactinemia and decreased blood PRL according to the disproportionality analyses, and both were identified as co-administered drugs that influenced PRL levels during OLZ treatment by SHAP analyses. CONCLUSIONS: Multiple pathophysiological and pharmacological c …

Treatment persistence in patients with schizophrenia treated with lurasidone in Italian clinical practice.

BACKGROUND AND RATIONALE: Treatment persistence combines clinician and patient judgment of efficacy, tolerability and safety into a comprehe … experienced at least one adverse drug reaction: akathisia (7.32%), extrapyramidal disorder (4.88%), hyperprolactinemia (2.44%), restlessness (2.44%), and galactorrhea (2.44%). None were serious. CONCLUSIONS: Persistence to LUR in patients with schizophrenia was relatively high: 78% and 58% of patients were still on LUR after 6 and 18 months of treatment, respective …

The patterns and occupational distribution of hormonal abnormalities among men investigated for infertility in some centers in the southwest, Nigeria.

BACKGROUND AND AIM: Male factor infertility results from dysfunction at various levels of spermatogenesis, sex hormone abnormalities, and oc … 15/186 (8.1%) elevated LH levels, 07/186 (3.8%) hypergonadotropic-hypergonadism, and 05/186 (2.7%) hyperprolactinemia. Artisans (OR 1.2252 95%CI 0.367-2.472), workers in chemical related industries (OR 1.667, 95%CI 0.594-4.676), and businessmen (OR 1.200, 95%CI 0.110-3.49) are more likely to be predisposed to hormonal abnormalities. CONCLUSION: The patterns of hor …

Depression and Impulsivity Self-Assessment Tools to Identify Dopamine Agonist Side Effects in Patients With Pituitary Adenomas.

Background: Dopamine agonists (DA) are the first line therapy for prolactinoma and symptomatic hyperprolactinemia; use as an adjuvant treatment for acromegaly and Cushing's disease is rare. Some patients develop de novo psychiatric symptoms or have exacerbation of pre-existing conditions during DA therapy. A practical, clinically sensitive depression and impulse control disorders (ICD; particularly hypersexuality and gambling disorders) detection tool is important for identifying at risk patients. The Barratt Impulsivity Scale (BIS-11) and the 9-item Patient Health Questionnaire (PHQ-9) are se…

Pediatric prolactinoma: initial presentation, treatment, and long-term prognosis.

UNLABELLED: Prolactinoma is a rare pituitary adenoma secreting prolactin. Studies on diagnostics, treatment, and prognosis in pediatric prol … d with other sellar masses (n = 235). CONCLUSION: In pediatric prolactinoma, diagnosis is based on hyperprolactinemia and imaging. Dopamine agonist treatment is effective and safe. Overall survival and functional capacity as a measure of quality of survival were not impaired, indicating an optimistic prognosis. Surgery should be considered only in emergency situati …

Clinical experiences and success rates of acromegaly treatment: the single center results of 62 patients.

BACKGROUND: This study aimed to report the clinical and outcome data from a large cohort of patients diagnosed with acromegaly and treated a … hism were the most prominent (92%). The number of patients with diabetes mellitus, hypertension and hyperprolactinemia were 22 (35%), 13 (21%) and 13 (21%), respectively. Microadenomas and macroadenomas were found in eight and 54 patients, respectively. A significant correlation was found between the initial tumor diameters and GH levels (p = 0.002). The mean GH and …

Multiple pituitary hormone abnormalities, fever, behavioral problems, seizures and apnoic spells in a 6-year old girl.

UNLABELLED: A 6-year old girl was examined having two years previously presented a transient Cushing's syndrome, followed by recurrent hypon … eak GH levels: 3.1 and 2.9 ng/ml (normal>10). Moreover, thyrotropin (TSH) deficiency and persistent hyperprolactinemia were detected. She was started on hGH and thyroxine. She was also put on fluid restriction and increased sodium intake for her SIADH. She was advised to use O2 administration by mask in case of apnoeas. The child died at age 6 6/12 years as a result …

[Antipsychotics and hyperpolactinaemia: pathophysiology, clinical relevance, diagnosis and therapy].

Hyperprolactinaemia is a frequent but often neglected side effect of typical, but also of many atypical antipsychotics such as amisulpiride, risperidone or ziprasidone. Besides galactorrhoea, potential consequences are suppression of the hypothalamic-pituitary-gonadal axis with hypogonadism, sexual dysfunction, infertility and in women also irregularities of the menstrual cycle and amenorrhoea. Potential long term consequences are mainly osteopenia and osteoporosis with an enhanced risk of fractures. Hyperprolactinaemia, if not clearly caused by a prolactin inducing antipsychotic, should alway

Psychoneuroimmunology and its relationship to the differential diagnosis of temporomandibular disorders.

Psychoneuroimmunology (PNI) is a field of medicine which joins immunology and neurobiology. It focuses on the relationship of stress upon the hypothalamic-adrenal-pituitary (HPA) axis. Depletion of hormones and neurotransmitters within the HPA-axis, as a result of stress, can lead to a multitude of diseases and disorders. Therefore, it is necessary for the dentist to be familiar with PNI and the HPA-axis in order to make an accurate diagnosis of TMD.

Serum testosterone levels are related to cognitive function in men with schizophrenia.

BACKGROUND: Sex steroids such as oestrogen and testosterone are potent neurodevelopmental hormones that also play a role in neuromodulation and neuroprotection of the mature brain. Sex steroid hormones may also be involved in the pathophysiology of schizophrenia as reduced circulating sex steroid levels and changes in brain sex steroid receptors are found in people with schizophrenia compared to controls. In men with schizophrenia, recent studies have documented an inverse correlation between serum testosterone and negative symptoms. Our study sought to confirm whether men with schizophrenia h

Giant prolactinomas in women.

OBJECTIVE: To characterise distinctive clinical features of giant prolactinomas in women. DESIGN: A multicentre, retrospective case series and literature review. METHODS: We collected data from 15 female patients with a pituitary tumour larger than 4 cm and prolactin levels above 1000 μg/l and identified 19 similar cases from the literature; a gender-based comparison of the frequency and age distribution was obtained from a literature review. RESULTS: The initial PubMed search using the term 'giant prolactinomas' identified 125 patients (13 women) responding to the inclusion criteria. The f

Application of new homologous in vitro bioassays for human lactogens to assess the actual bioactivity of human prolactin isoforms in hyperprolactinaemic patients.

BACKGROUND: Prolactin (PRL) plays a central role in mammary gland development and lactation. Due to its molecular heterogeneity, measurement of PRL immunoreactivity does not necessarily reflect its intrinsic bioactivity. For many years the Nb2 rat lymphoma cell bioassay has been the only reference bioassay for human lactogens. This bioassay, however, does not always correlate with the clinical features found in some patients exhibiting normal or elevated immunoreactive serum PRL concentrations. OBJECTIVES: (1) To determine the concentrations of bioactive PRL in serum samples from individuals

Comparison of quetiapine and risperidone in the treatment of schizophrenia: A randomized, double-blind, flexible-dose, 8-week study.

OBJECTIVE: To compare the efficacy and tolerability of quetiapine and risperidone in the treatment of schizophrenia. METHOD: In this 8-week, double-blind, multicenter, flexible-dose study, patients with schizophrenia (DSM-IV diagnosis) were randomly assigned to quetiapine (200-800 mg/day) or risperidone (2-8 mg/day). The primary hypothesis was that quetiapine was not inferior to risperidone. The primary efficacy measure was change from baseline in Positive and Negative Syndrome Scale (PANSS) total scores; secondary outcomes included response rate (> or = 40% reduction in PANSS scores), Clinic

Cystic lesions of the pituitary: clinicopathological features distinguishing craniopharyngioma, Rathke's cleft cyst, and arachnoid cyst.

The distinction among craniopharyngioma (CR), Rathke's cleft cyst (RCC), and intrasellar arachnoid cyst (AC) remains a difficult preoperativ … duration was 70 +/- 13 months. Patients with CR presented with hypopituitarism in 95% of cases and hyperprolactinemia in 38%. These patients also had more preoperative neurological deficits (67%), ophthalmological complaints (67%), and significantly higher psychiatric manifestations (33%; P = 0.003) than those with RCC or AC. Patients with AC presented with headach …

Endocrine paraneoplastic syndromes in lung cancer: A call for clinical vigilance (Review).

Endocrine paraneoplastic syndromes (PNS) are uncommon but clinically impactful manifestations associated with malignancies, particularly lung cancer, most notably small-cell lung cancer. These syndromes arise from ectopic hormone production by malignant cells, causing systemic effects that are independent of direct tumor invasion or metastasis. Their presentation often precedes or signals recurrence of the primary cancer, underscoring the importance of early recognition and targeted intervention. Common endocrine PNS in lung cancer include syndrome of inappropriate antidiuretic hormone secreti

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… The clinical presentation of hyperprolactinemia results from suppression of the hypothalamic-pituitary-gonadal axis and varies depending on the patient's sex and age. … In women, hyperprolactinemia may present with oligomenorrhea, amenorrhea, galactorrhea, decreased libido, infertility, and, in prolonged cases, possible osteopenia. …

Hyperprolactinaemia with amisulpride.

Psychopharmaca are used in treatment of psychiatric illnesses and disorders, among other therapeutic possibilities. The choice of the psychopharmaca is determined by the specific psychopathology of the patient, within the diagnostic categories, according to the current classification of diseases and disorders. With the advances in pharmaco industry, the range of drugs used in the everyday clinical practice is occurring at a very rapid pace. Antipsychotic medications are used in treatment of mainly psychotic disorders. However, the new generation of antipsychotics, due to their specific recepto

Antipsychotic agents: a clinical update.

Antipsychotic agents have many indications and are frequently used. All physicians, regardless of their subspecialty, will most likely treat patients who receive these drugs. This article is designed to help nonpsychiatric physicians use antipsychotics appropriately. The indications, recommended dosages, side effects, and drug interactions of antipsychotic medications are reviewed. Receptor binding data are used to help predict the side-effect profile of these agents. Knowledge of these side effects and of the patient's medical condition helps the physician select a drug that the patient can t