Causes of hyperprolactinaemia in the primary care setting: How to optimise hyperprolactinaemia management.

BACKGROUND AND PURPOSE: To analyse the causes of hyperprolactinaemia in patients with symptoms compatible with hyperprolactinaemia evaluated in a primary care setting. PATIENTS AND METHODS: A retrospective study of all patients tested for serum prolactin levels between 2019 and 2020 in 20 primary care centres at the Hospital Ramón y Cajal in Madrid. Hyperprolactinaemia is defined as a serum prolactin>19.4ng/ml in men and >26.5ng/ml in women. Aetiology is grouped into physiological (pregnancy, lactation, inadequate venipuncture, macroprolactinaemia), pharmacological, pathological (hypothalamic and/or pituitary diseases, chronic renal failure, primary hypothyroidism), and idiopathic. RESULTS: In 1630 patients tested for serum prolactin, 30.7% (n=501) had hyperprolactinaemia. Of these 501 patients, 89.6% were females. 149 patients were referred to the Endocrinology Department and 164 to the Gynaecology Department. Aetiological diagnosis of hyperprolactinaemia was achieved in 411 out of 501 cases. The most frequent cause of hyperprolactinaemia was pharmacological, in 39.1%. The second more frequent cause was idiopathic (29%) and less common were inadequate venipuncture extraction (13.4%), tumour (8.5%) and macroprolactinaemia (3.9%). Patients with tumoural hyperprolactinaemia presented higher serum prolactin levels (87.0±80.19 vs 49.7±39.62ng/ml, P=0.010). In addition, symptoms, such as galactorrhoea (33.3% vs 16.5%, P=0.018), and headache (25.7% vs 13.3%, P=0.045), were more frequent than in patients of the other aetiological groups. CONCLUSION: Hyperprolactinaemia is common among patients evaluated in a primary care setting with symptoms of hyperprolactinaemia, but more than 50% of cases are due to pharmacological treatments or improper sample extraction. It is necessary to establish referral protocols to specialised medicine to optimise healthcare resources and avoid unnecessary studies.

Translation and validation of Baron Cohen’s face test in a general population from Spain.

Facial emotion recognition is considered the foundation of effective social functioning, but it has been found impaired in several clinical populations. How- ever, there are few validated tests to measure the ability. To the best of our knowledge, there is no validated measure in a Spanish population. We translated and validated Baron Cohen’s Face Test in a general Spanish population.

Traducción y validación del test de caras de Baron Cohen en población española / Translation and validation of Baron Cohen’s face test in a general population from Spain

Introducción: El reconocimiento facial de emociones esesencial en el funcionamiento social adecuado. Se han encontrado déficits en muchas poblaciones clínicas. Hay pocostests validados que midan esta habilidad y ninguno en población española. En este trabajo, tradujimos y validamos elTest de Caras de Baron Cohen en población general española.Métodos. El test fue administrado a 211 personas (63,3 %mujeres) sanas de entre 19 y 70 años de edad. Usamos matricestetracóricas para obtener la fiabilidad test-retest y la consistencia interna. Se realizó un análisis factorial confirmatorio paracomprobar la unidimensionalidad del test. Utilizamos correlaciones de Pearson para examinar asociaciones entre variables.Resultados. La media en el estudio fue de 18 (DE = 1,38).Se obtuvo un alfa de Cronbach de 0,75. Calculamos los índices Guttman Lambda 3 para cada ítem. 17 de 20 ítems obtuvieron una estabilidad test-retest excelente. No encontramosasociaciones entre el rendimiento y el género, la edad o elnivel académico. El test presentó una estructura unidimensional (CFI = 0,889; TLI = 0,873 y RMSEA = 0,047).Conclusiones. El Test de Caras de Baron Cohen puede serútil como instrumento de medida a pesar de no ser sensibleal género y a la edad. Puesto que presenta un efecto techo,no resulta un instrumento adecuado para obtener medidasprecisas del funcionamiento superior de esta habilidad. (AU)

Introduction: Facial emotion recognition is consideredthe foundation of effective social functioning, but it hasbeen found impaired in several clinical populations. However, there are few validated tests to measure the ability. Tothe best of our knowledge, there is no validated measurein a Spanish population. We translated and validated BaronCohen’s Face Test in a general Spanish population.Methods. The test was administered to 211 (63.3% female) healthy volunteers between 19 and 70 years of age. Weused tetrachoric matrices to obtain item per item test-retestreliability and internal consistency. We used confirmatoryfactor analysis to test for unidimensionality. We used Pearson correlations to examine associations between variables.Results. The mean score was 18 (SD=1.38). Cronbach’salfa was 0.75. Guttman Lambda 3 indexes yielded 17 outof 20 items to have excellent test-retest reliability. Gender or age differences in performance were not found. Thetest seems to comply with a one-dimensional structure:CFI=0.889; TLI=0.873 and RMSEA=0.047.Conclusions. Baron Cohen’s Face Test could be a validmeasure of FER, although it is not sensitive to age or gender.Because it presents a certain ceiling effect, it could not beappropriate to detect excelling performance. (AU)