Primary treatment of macroprolactinomas with Parlodel LAR®

1988 ◽  
Vol 119 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Johanna W. van 't Verlaat ◽  
Ioana Lancranjan ◽  
Martin J. Hendriks ◽  
Ronald J. M. Croughs
Keyword(s):  
Oral Treatment ◽  
Tumour Size ◽  
Primary Treatment ◽  
Plasma Prolactin ◽  
Normal Range ◽  
Basal Plasma ◽  
Nerve Dysfunction ◽  
Long Acting ◽  
Bitemporal Hemianopia ◽  
Tumour Reduction

Abstract. Five patients, 3 women and 2 men, with macroprolactinomas characterized by extrasellar extension and basal plasma prolactin levels ranging from 4.6 to 102 U/I received six monthly injections of 50–100 mg Parlodel LAR®, an injectable long-acting repeatable form of bromocriptine. The following observations were made: 1. Plasma prolactin levels fell dramatically in all patients and values in the normal range were obtained in 3 patients. 2. In all patients, the onset of tumour reduction was visible on CT scans made one week after the first Parlodel LAR injection. After six Parlodel LAR injections, tumour size was reduced by more than 75% in 3 patients and by 50–75% in two patients. 3. Diminished visual acuity (one patient), bitemporal hemianopia (2 patients), and oculomotor and trochlear nerve dysfunction (one patient) were restored to normal after the first Parlodel LAR injection. 4. Hypogonadism normalized in 2 patients and improved in one patient, whereas plasma gonadotropins remained low in the 2 postmenopausal women. In one patient with hypothyroidism and hypocorticism, thyroid and adrenal functions normalized. It is concluded that bromocriptine retard (50–100 mg monthly) is a useful alternative for oral treatment of patients with prolactinomas, especially in those patients with compliance problems on oral bromocriptine therapy.

Bromocriptine treatment of prolactin secreting macroadenomas: a radiological, ophthalmological and endocrinological study

1986 ◽  
Vol 112 (4) ◽  
pp. 487-493 ◽  
Author(s):  
Johanna W. van 't Verlaat ◽  
Ronald J. M. Croughs ◽  
Martin J. Hendriks ◽  
Nicolaas J. Bosma ◽  
Johan W. R. Nortier ◽  
...  
Keyword(s):  
Tumour Size ◽  
Empty Sella ◽  
List Type ◽  
Plasma Prolactin ◽  
Oculomotor Palsy ◽  
Normal Range ◽  
Plasma Prolactin Level ◽  
Basal Plasma ◽  
Bitemporal Hemianopia ◽  
Tumour Reduction

Abstract. Twelve patients, six women and six men, with macroprolactinomas characterized by extrasellar extension and basal plasma prolactin levels >6 U/l were treated with 10–20 mg bromocriptine daily in four divided doses for a mean period of 2.4 years (range 0.5–3.5 years). The following observations were made: Plasma prolactin levels fell dramatically in all patients and values in the low normal range were obtained in 10 patients. Tumour size was reduced by more than 75% in 11 patients and by 50–75% in one patient. Tumour-reduction was associated with the development of a partial empty sella in eight cases. In four cases the pituitary became visible. Diminished visual acuity (three patients), bitemporal hemianopia (three patients), unilateral or bilateral central scotomas (three patients) and oculomotor palsy (two patients) restored to normal. Hypogonadism (all patients), hypothyroidism (six patients) and hypocorticism (three patients) improved or normalized in most cases. It is concluded that in the medical treatment of macroprolactinomas 10–20 mg bromocriptine in four divided doses effectively reduces both plasma prolactin level and tumour size.

scholarly journals Results of Primary Treatment with Bromocriptine of Prolactinomas with Extrasellar Extension

1990 ◽  
Vol 17 (1) ◽  
pp. 71-73 ◽  
Author(s):  
Johanna W. van't Verlaat ◽  
Ronald J.M. Croughs ◽  
Martin J. Hendriks ◽  
Nicolaas J. Bosma
Keyword(s):  
Tumor Size ◽  
Primary Treatment ◽  
Empty Sella ◽  
Fixed Dose ◽  
Plasma Prolactin ◽  
Oculomotor Palsy ◽  
Normal Range ◽  
Tumor Reduction ◽  
Continued Use ◽  
Bitemporal Hemianopia

ABSTRACT:Nineteen patients, seven women and twelve men, with macroprolactinomas characterized by extrasellar extension and basal prolactin levels above 6 U/I were treated with 10-20 mg bromocriptine daily in four divided doses for a mean period of 3.4 years (range 1.5-5.5 years). Plasma prolactin levels fell dramatically in all patients and values in the low normal range were obtained in sixteen patients. Tumor size was reduced by more than 75% in seventeen patients and by 50-75% in two patients. Tumor reduction was associated with the development of a partial empty sella in fourteen cases. In seventeen cases the pituitary became visible. Diminished visual acuity (six patients), bitemporal hemianopia (nine patients), unilateral and bilateral central scotomas (three patients) and oculomotor palsy (two patients) improved or normalized in all cases. Hypogonadism (all patients), hypothyroidism (nine patients) and hypocorticism (four patients) improved or normalized in most cases. It is concluded that in the medical treatment of macroprolactinomas 10-20 mg bromocriptine in four divided doses effectively reduces both plasma prolactin level and tumor size. The good results in this study may be related to the continued use of a fixed dose regimen of bromocriptine regardless of the plasma prolactin lowering effect.

Correlation between the number of thyroliberin binding sites, the tumour size and the plasma prolactin level in human prolactin-secreting adenomas

1985 ◽  
Vol 108 (4) ◽  
pp. 464-467 ◽  
Author(s):  
M. Le Dafniet ◽  
P. Pagesy ◽  
A. M. Brandi ◽  
J. Racadot ◽  
F. Peillon
Keyword(s):  
Binding Sites ◽  
Tumour Size ◽  
High Plasma ◽  
Plasma Prolactin ◽  
Lower Plasma ◽  
Basal Plasma ◽  
Grade Ii ◽  
Plasma Prl ◽  
Grade Iii ◽  
Trh Receptors

Abstract. Basal plasma prolactin (Prl) level, tumour size and [3H]thyroliberin (TRH) binding to tumour membranes were studied in 18 patients bearing Prl-secreting adenomas. Big tumours (grade III) were associated with high plasma Prl levels (median value: 1929 (range: 207–3570) ng/ml) and possessed numerous membrane TRH receptors (median value: 508 (range: 0–1200) fmol/mg of protein). By contrast, smaller tumours (grade II and I) were associated with lower plasma Prl levels (median values: 1085 (range: 40–1890) and 295 (range: 98–788) ng/ml, respectively) and possessed fewer membrane TRH receptors (median values 122 (range: 11–328) and 13 (range: 0–52) fmol/mg of protein, respectively). A direct positive correlation was demonstrated between the plasma Prl level and the number of [3H]TRH binding sites (ϱ: 0.729 P < 0.001). That the higher number of TRH receptors is associated with the largest tumours may be of importance in hyperprolactinaemia and should be taken in account when speculating on the pathogenesis of human Prl-secreting adenomas.

Chronic treatment with long-acting bromocriptine does not affect duration of the breeding season, voluntary food intake, body weight, or wool growth in the Scottish blackface ewe

1991 ◽  
Vol 3 (1) ◽  
pp. 25 ◽  
Author(s):  
JD Curlewis ◽  
AM Sibbald ◽  
JA Milne ◽  
AS McNeilly
Keyword(s):  
Body Weight ◽  
Food Intake ◽  
Chronic Treatment ◽  
Vehicle Group ◽  
Plasma Prolactin ◽  
Wool Growth ◽  
Long Acting ◽  
Group B ◽  
Group D ◽  
Voluntary Food Intake

The aim of this study was to determine whether suppression of the seasonal increase in prolactin concentrations by chronic treatment with the dopamine agonist bromocriptine would affect onset of anoestrus, voluntary food intake, body weight, and wool growth in a seasonal breed of sheep. Groups of eight Scottish Blackface ewes were injected i.m. each week with either the vehicle (Group A) or 2.0 mg (Group B), 6.0 mg (Group C), or 18.0 mg (Group D) of bromocriptine in a long-acting formulation, commencing on 18 January and terminating on 25 July (midwinter to midsummer in the northern hemisphere). Immediately before the bromocriptine injection, blood samples were taken for progesterone and prolactin determination. Voluntary food intakes were measured daily, and body weights were recorded every fortnight. Estimates of wool growth were made by weighing wool clipped from a measured area of skin once a month. Treatment had no effect on onset of anoestrus, voluntary food intake, body weight, or wool growth. Plasma prolactin concentrations increased significantly in all groups during the treatment period. From January to April, all doses of bromocriptine significantly reduced prolactin concentrations but later in the study (May and June) prolactin was significantly suppressed in Group D only, although even in this group prolactin concentrations increased between March and June. Pituitary prolactin content, measured at the end of the study in July, was also suppressed by bromocriptine. The gradual increase in prolactin concentrations in ewes receiving chronic bromocriptine was further investigated by treating a fifth group of ewes (Group E) with 18.0 mg of long-acting bromocriptine each week, commencing on 20 June.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Dopaminergic tone and obesity: an insight from prolactinomas treated with bromocriptine

2002 ◽  
pp. 77-84 ◽  
Author(s):  
M Doknic ◽  
S Pekic ◽  
M Zarkovic ◽  
M Medic-Stojanoska ◽  
C Dieguez ◽  
...  
Keyword(s):  
Body Weight ◽  
Dopamine Agonist ◽  
Repeated Measures ◽  
Analysis Of Covariance ◽  
Plasma Prolactin ◽  
Serum Leptin ◽  
Dopaminergic Tone ◽  
Male Patients ◽  
The Difference ◽  
Long Acting

OBJECTIVE: It has recently been shown that increased body weight is associated with prolactinomas and that weight loss occurs with normalization of prolactin levels. On the other hand, decreased dopaminergic tone in humans is well correlated with obesity. The objective of this study was to correlate changes in prolactin levels with leptin and body mass index (BMI) in patients with prolactinomas treated with the long-acting dopamine agonist bromocriptine (BC). METHODS: Eleven female and twelve male patients, aged 36.7+/-2.6 years with BMI in males of 30.4+/-1.7 kg/m(2) and in females of 24.4+/-1.2 kg/m(2), were evaluated after 1 and 6 months and 11 patients were further evaluated after 2 years of BC therapy. Plasma prolactin is presented as the mean of four samples taken daily. Serum leptin was determined in the pooled serum from three samples taken at 15-min intervals at 0800 h after an overnight fast. Multivariate linear regression and repeated measures analysis of covariance were used. RESULTS: In males, pretreatment prolactin levels were 71 362+/-29 912 mU/l while leptin levels were 14.9+/-1.8 microg/l. In females, pretreatment prolactin levels were 11 395+/-5839 mU/l and leptin levels were 16.7+/-2.5 microg/l. The sexual dimorphism of serum leptin levels at initial presentation was preserved after adjusting for BMI and prolactin-induced hypogonadism. After 1 month of therapy, prolactin levels significantly decreased (males: 17 618+/-8736 mU/l, females: 3686+/-2231; P<0.05), BMI did not change (males: 30.2+/-1.7 kg/m(2), females: 24.1+/-1.2 kg/m(2); P>0.05), while serum leptin levels decreased (males: 12.5+/-1.5 microg/l, females: 13.6+/-2.1 microg/l; P<0.05). After 6 months of treatment, prolactin further decreased (males: 3456+/-2101 mU/l, females: 677+/-360 mU/l; P<0.05) as did BMI (males: 28.6+/-1.6 kg/m(2), females 23.1+/-1.0 kg/m(2); P<0.05). The difference was more pronounced in male patients. Leptin levels were 12.8+/-2.8 microg/l in males and 12.9+/-1.8 microg/l in females (P<0.05). After 2 years of BC treatment, prolactin levels were near normal (males: 665+/-439 mU/l, females 447+/-130 mU/l; P<0.05) and BMI remained 26.5+/-1.9 kg/m(2) for males and 23.6+/-0.8 kg/m(2) for females (P<0.05). Leptin levels were 9.5+/-2.2 microg/l in males and 18.7+/-3.1 microg/l in females (P<0.05). There was a gradual increase in the gender difference in serum leptin levels over time. Changes in serum leptin levels significantly correlated with changes in BMI (r=0.844, P<0.001) but did not correlate with changes in plasma prolactin levels after 1 month (r=0.166), 6 months (r=0.313) and 2 years (r=0.234, P>0.05). CONCLUSION: The long-acting dopamine agonist BC, by increasing dopaminergic tone, may influence body weight and likely body composition by mechanisms in addition to reducing hyperprolactinemia in patients with prolactinomas.

A Randomized Prospective Comparison of Oral versus Intraperitoneal Ciprofloxacin as the Primary Treatment of Peritonitis Complicating Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 351-354 ◽  
Author(s):  
I.K.P. Cheng ◽  
C.Y. Chan ◽  
W.T. Wong ◽  
S.W. Cheng ◽  
C.W. Ritchie ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Treatment Group ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Bacterial Resistance ◽  
Oral Treatment ◽  
Prospective Trial ◽  
Primary Treatment ◽  
Drug Levels ◽  
Bacterial Peritonitis ◽  
Prospective Comparison

The present study compared oral versus Intraperitoneal (ip) ciprofioxacin (ciproxin) as primary treatment of bacterial peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD) In a randomized, prospective trial. A total of 54 episodes In 46 patients were recruited for study. After excluding nonbacterial episodes and those not treated according to protocol, 48 episodes evenly divided between the two treatment arms were eligible for analysis. The primary cure rate was 41.7% and 66.7%, respectively, In the oral and Ip treatment group. Half of those who tailed or relapsed were due to Infection with resistant, mostly grampositive bacteria, which accounted for 79% of culture-positive episodes. Of the gram-positive Isolates 42.3% were either resistant or Intermediately susceptible to ciproxin compared to 16.7% of gram-negative Isolates. The high level of bacterial resistance to ciproxin and treatment failure rate were related to the previous exposure to fluoroquinolones. Inadequate trough peritoneal drug levels also accounted for the failures in the Ip but not the oral treatment group. We conclude that oral ciproxin is ineffective as a primary treatment of CAPD peritonitis in patients previously exposed to fluoroquinolones and that when administered Ip, a dose of 50 mg/L Instead of 25 mg/L of ciproxin should be used as maintenance In order to achieve adequate trough peritoneal drug levels.

Antipsychotic injectable treatment in patients with involuntary ambulatory treatment

2011 ◽  
Vol 26 (S2) ◽  
pp. 1230-1230
Author(s):  
L. Borreda Belda ◽  
L. Borreda ◽  
R. Maravall ◽  
J.F. Perez ◽  
M. Grau ◽  
...  
Keyword(s):  
Oral Treatment ◽  
Demographic Variables ◽  
Antipsychotic Treatment ◽  
Adherence To Treatment ◽  
Ambulatory Treatment ◽  
Injectable Treatment ◽  
Psychiatric Outpatient Clinic ◽  
Schizophrenic Patients ◽  
Long Acting ◽  
Seriously Ill Patients

IntroductionInvoluntary Ambulatory Treatment (IAT) is a judicial measure existing in Spain. Its aim is to ensure the adherence to treatment of seriously ill patients, with poor insight and repeated hospitalization. This is done by means of the regular and involuntary administration of antipsychotic intramuscular medication.ObjectivesTo assess the treatment used in patients undergoing IAT in a local clinic, to assess the type of medicaments and their dosage and to verify adherence to treatment and evolution.Material and methodA revision was made of the clinical backgrounds of all the patients of a psychiatric outpatient clinic who have been submitted to IAT (n = 37). A note was made of socio-demographic variables as well as psychiatric diagnoses according to DSM-IV-TR criteria and the number of hospitalizations and treatments used.ResultsAll but one patient had been hospitalized and average of 3.53 times before IAT. Since undergoing IAT only 6 patients have been admitted (16%). Four of them relapsed having abandoned treatment.In seven cases (19%) the patients gained insight and the antipsychotic treatment was changed from injectable to oral treatment at the patients’ request. In these cases IAT was ceased.The antipsychotic prescribed in 59% of the cases was Long-Acting Injectable Risperidone. This percentage was higher in non- schizophrenic patients (84%).ConclusionsIn our environment IAT could be an effective tool for severe patients with nil insight, since it can bring about an improvement in treatment adherence and evolution, as well as insight.

Short- and long-term fluctuations in plasma prolactin concentration in normal subjects

1981 ◽  
Vol 97 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Henning Djursing ◽  
Claus Hagen ◽  
Jan Møller ◽  
Claus Christiansen
Keyword(s):  
Plasma Concentration ◽  
Menstrual Cycle ◽  
Normal Subjects ◽  
Plasma Prolactin ◽  
Menopausal Women ◽  
Normal Menstrual Cycle ◽  
Basal Plasma ◽  
Short And Long Term ◽  
Post Menopausal

Abstract. The physiological changes in plasma prolactin concentration were studied in 447 normal subjects, including 65 men, 75 pre-menopausal women and 307 post-menopausal women. The within-day and day-to-day variation as well as the circadian and circannual rhythm of plasma prolactin levels were determined. Furthermore, the relationship between changes in prolactin and oestradiol-17β levels during the normal menstrual cycle and in the climacteric was studied. Pre-menopausal women had significantly (P<0.01) higher basal plasma prolactin concentration than men and post-menopausal women. Furthermore, they had significantly (P < 0.01) higher day-to-day variation than men. This suggests that prolactin in women is secreted in a pulsatile fashion. Only small seasonal variations in both sexes were seen. The levels of plasma prolactin during the ovulatory and the luteal phase in the cycle were significantly (P < 0.02) higher than that of the follicular phase, and a positive correlation between changes in plasma concentration of oestradiol-17β and prolactin was found. Also in post-menopausal women a relationship between plasma concentration of prolactin and oestradiol-17β was seen. It is concluded that the assessment of prolactin concentration in blood is dependent on the physiological variation recorded during sleep in both sexes. However, only in women day-to-day changes and the changes related to the menstrual cycle and the climacteric are of importance.

Validation of CA-125 concentration nadir within the normal range following primary treatment as a predictor of survival for epithelial ovarian cancer (EOC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16007-16007
Author(s):  
A. Prat ◽  
J. Del Campo ◽  
S. Peralta ◽  
S. Cedres ◽  
A. Perez ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Cox Model ◽  
Primary Treatment ◽  
Cox Proportional Hazards ◽  
University Hospital ◽  
Stage Iii ◽  
Ca 125 ◽  
Rank Test ◽  
Normal Range

16007 Background: Recent studies suggest that the CA-125 nadir within the normal range after surgery and chemotherapy treatment is a predictor of survival (Crawford, ASCO 2004; Crawford, Ann Oncol 2005) and relapse (Markman, J Clin Oncol 2006). In order to validate these previous findings, we have conducted a retrospective analysis of patients (pts) treated in our institution for EOC. Methods: Between March 1, 1997, and October 30, 2005, all pts treated for EOC at Vall d'Hebron University Hospital were identified from the tumor registry database and screened retrospectively for their standard prognostic factors (age at diagnosis (=65 vs. >65), stage (III-IV vs. IC-II), and suboptimal vs. optimal cytorreduction). Inclusion criteria: an elevated CA-125 at time of diagnosis (>35 U/mL); primary treatment (PT) that consisted in surgery and intravenous carboplatin/paclitaxel for a maximum of 6–9 cycles; complete clinical and radiological response to initial treatment with normalization of CA-125 (=35 U/mL); and disease status at the time of last follow-up. Standard Kaplan-Meier methods were used to plot the progression-free survival (PFS) of members of each of the nadir groups. The relative contribution of the different potential correlates of prognosis was assessed by the Cox proportional hazards method. Results: 123 pts were identified: 64 Group A (=10 U/mL), 42 Group B (11–20 U/mL), 17 Group C (21–35 U/mL). Median age: 56. Stage IC 25%, II 13%, III 52%, IV 10%. Median follow-up 39.2 months (m). Median PFS was 69.7 m, 27.7 m, and 15.8 m for A, B and C, respectively (p< .0001, log-rank test). The Cox model showed a highly-significant impact on PFS in relation to CA-125 nadir levels, residual tumor after surgery and stage. Hazard ratios (HR) for PFS (95% CI) of B vs. A, C vs. B, and C vs. A were 1.98 (p= .034), 2.35 (p= .02), and 4.67 (p< .001), respectively. HR for PFS (95% CI) of suboptimal vs. optimal cytorreduction and stage III-IV vs. IC-II were 1.84 (p= .058) and 3.2 (p= .002), respectively. Conclusions: The CA-125 nadir in the normal range following PT for EOC is a reproducible predictor of PFS in stage IC-IV. Prospective studies of maintenance-consolidation therapies or different approaches in selected pts based on CA-125 nadir seem warranted. No significant financial relationships to disclose.

Awkward movements: Extrapyramidal symptoms in a group of patients treated with aripiprazole long acting injectable

2016 ◽  
Vol 33 (S1) ◽  
pp. S552-S553
Author(s):  
C. Victor ◽  
S. Berta ◽  
T. Ivan ◽  
O. Silvia ◽  
C. Sandra ◽  
...  
Keyword(s):  
Side Effects ◽  
Oral Treatment ◽  
Care Center ◽  
Extrapyramidal Symptoms ◽  
Average Score ◽  
Health Care Center ◽  
Normal Limits ◽  
Competing Interest ◽  
Long Acting

IntroductionExtrapyramidal symptoms are well known as side effects in therapy with antipsychotics. Explore this side effects is mandatory because they normally are a cause of treatment discontinuation or assess a change in medication. Some studies notice how long acting injectable antipsychotic cause less extrapyramidal symptoms than oral treatment, others does not find differences.ObjectiveThe aim of this study is to analyze the extrapyramidal symptoms presented on a group of patients treated with aripiprazole long acting injectable (ALAI) follow-up in a mental health care center.MethodsDescriptive study of a group of patients treated with ALAI. To assess the possible extrapyramidal symptoms due to treatment we have used the Simpson-Angus Scale (SAS). The follow up was 3 months after initiation of treatment.ResultsSix patients were included in the study, 2 women (33.3%) and 4 men (66.7%). The mean age of the sample was 37 years old. The different diagnoses of the group were 4 patients with psychotic disorder (66.7%; 2 schizophrenia, 1 schizoaffective disorder and 1 delusional chronic disorder) and the other 2 had an affective disorder (33.3%; both bipolar disorder). The average score for the SAS was 1.2 meaning normal results and therefore no significant extrapyramidal symptoms.ConclusionsIn our sample the average of the results obtained by applying the SAS is considered within normal limits. In our case as to extrapyramidal effects ALAI treatment has been well tolerated. A larger sample would be needed to obtain more reliable results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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