Biomedical subjects

J Calaf-Alsina

Publications and source records attributed to J Calaf-Alsina.

4 recordsLinked to original sources

PubMed1994

Long-acting repeatable bromocriptine in the treatment of patients with microprolactinoma intolerant or resistant to oral dopaminergics.

OBJECTIVE: To study the efficacy of long-acting repeatable bromocriptine in suppressing abnormal PRL secretion in microprolactinoma patients. To assess the incidence and nature of side effects induced by the product. DESIGN: Longitudinal, open label, noncontrolled. SETTING: Human hyperprolactinemic volunteers in an academic clinical research environment. PATIENTS: Ten patients with radiologically proven microademonas resistant or intolerant to oral bromocriptine were included. INTERVENTIONS: The patients were treated with 50 to 150 mg of long-acting bromocriptine monthly during 6 months. MAIN OUTCOME MEASURE: The serum PRL concentrations and the side-effects were assessed before and after each new injection. RESULTS: Serum PRL levels decreased during the first cycle to normal values in four patients. At the end of the study the PRL levels were normalized in five cases and were only slightly increased in three. One patient was resistant to the treatment. Two among four infertile women became pregnant. In nine patients the accompanying symptoms disappeared after the 2nd month. Adverse events were mild or moderate and circumscribed to the 1st month of treatment. CONCLUSION: The long-acting bromocriptine is both effective and well tolerated and is a good alternative to the oral approach in the management of microprolactinoma patients.

Administration, Oral↗

PubMed1992

Outcome and long-term effects of pregnancy in women with hyperprolactinaemia.

Twenty-four women with high circulating prolactin became pregnant on 39 occasions, of which 32 ended in delivery. Sixteen patients showed radiological evidence of pituitary tumour, 6 exhibited a normal CT and 2 had an empty sella. The pregnancies were induced in 4 patients after successful pituitary surgery, in 3 after surgery and medical treatment, and in the rest by bromocriptine (16) long-acting repeatable bromocriptine (1) and methergoline (1). No major complications related to hyperprolactinaemia or its treatment were observed during pregnancy in the patients or offspring. Prolactin after pregnancy was lower than before (basal 95 micrograms/l, after 1st pregnancy 38 micrograms/l P < 0.002, after 2nd pregnancy 24 micrograms/l P < 0.005 compared to basal prolactin); this prolactin reduction tended to be greater in the 9 multiparous patients, but did not attain statistical significance, probably because the number of multiparous patients was too small. A new empty sella developed after delivery in 4 women and persisted in another 2, all of which were medically treated; prolactin fell in all 6 cases normalizing in 3; 4 of these patients had undergone two or more pregnancies. The mean period of follow-up from the last pregnancy was 41.6 months (8-101). These data suggest that pregnancy may hasten a tendency to spontaneous improvement of hyperprolactinaemia, and multiparity may be beneficial in this way.

Adenoma↗

PubMed1992

Computerized tomography versus magnetic resonance imaging: a comparative study in hypothalamic-pituitary and parasellar pathology.

OBJECTIVE: We wished to analyse the relative value of computerized tomography and magnetic resonance in patients referred for evaluation of pituitary and parasellar lesions. DESIGN: We performed a separate evaluation by two independent neuroradiologists of computerized tomography and magnetic resonance images ordered numerically and anonymously, with no clinical data available. PATIENTS: We studied 40 patients submitted for hypothalamic-pituitary study; 31 were carried out preoperatively, of which histological confirmation later became available in 14. The remaining nine patients were evaluated postoperatively. MEASUREMENTS: Over 40 parameters relating to the bony margins, cavernous sinuses, carotid arteries, optic chiasm, suprasellar cisterns, pituitary, pituitary stalk and extension of the lesion were evaluated. These reports were compared with the initial ones offered when the scans were ordered, and with the final diagnosis. RESULTS: Concordance between initial computerized tomography and magnetic resonance was observed in 27 cases (67.5%); among the discordant cases computerized tomography showed the lesion in two, magnetic resonance in 10, while in the remaining case reported to harbour a microadenoma on computerized tomography the differential diagnosis between a true TSH-secreting microadenoma and pituitary resistance to thyroid hormones is still unclear. Both neuroradiologists coincided in their reports in 32 patients (80%); when the initial report was compared with those of the neuroradiologists, concordance was observed with at least one of them in 34 instances (85%). Discordant results were observed principally in microadenomas secreting ACTH or PRL and in delayed puberty. In the eight patients with Cushing's disease (histologically confirmed in six) magnetic resonance was positive in five and computerized tomography in two; the abnormal image correctly identified the side of the lesion at surgery. CONCLUSIONS: In patients referred for evaluation of Cushing's syndrome or hyperprolactinaemia (due to microadenomas) or after surgery, magnetic resonance is clearly preferable to computerized tomography. In macroadenomas both scans are equally diagnostic but magnetic resonance offers more information on pituitary morphology and neighbouring structures. Nevertheless, there are cases in which the results of computerized tomography and magnetic resonance will complement each other, since different parameters are analysed with each examination and discordant results are encountered.

Adenoma↗

PubMed1987

Effects of a cyproterone-containing oral contraceptive on hormonal levels in polycystic ovarian disease.

The management of polycystic ovarian disease in women not desiring pregnancy is controversial. To avoid the progressive androgenic effects on peripheral target organs, some advocate the use of oral contraceptives. This study reports the effects of a preparation with 50 micrograms ethinyl estradiol and 2 mg cyproterone acetate on gonadotropins, prolactin, testosterone, sex hormone binding globulin (SHBG), androstenedione, and calculated free testosterone index before and after six months of treatment. Gonadotropins, testosterone, and androstenedione levels decreased, prolactin did not change, and sex hormone binding globulin increased as the result of the treatment. This led to a net decrease in the calculated free testosterone.

Contraceptives, Oral, Hormonal↗