[Treatment of hyperprolactinemic amenorrhea with cabergoline]. / Tratamiento de amenorreas hiperprolactinémicas con cabergolina.

Cabergoline (CAB) is a long-acting dopamine agonist. In the first national study with CAB--as part of an international multicentric study--39 adult and adolescent females (16 to 44 years old) with hyperprolactinemic amenorrhea (18 microadenomas and 21 idiopathic hyperprolactinemias) were evaluated. CAB or bromocriptine (BEC) was administered for 24 weeks: over 8 weeks, treatment was given under double-blind conditions, and over the remaining 16 weeks (open period) 18 patients received CAB and 21 received BEC as a result of a random distribution. Maximum dosage: CAB = 1.5 mg in 2 or 3 weekly doses; BEC = up to 10 mg in 2 daily doses. Prolactin was measured at base line and 2, 4, 6, 8, 12, 14, 16, 20 and 24 weeks after the initiation of treatment. When vaginal bleeding was restored, progesterone was measured as an ovulation sign. The 4 adolescents continued with CAB treatment for 1 more year. Prolactin was statistically evaluated according to Man Whitney Test (general population) or Wilcoxon Test (adolescents). There were no significant differences between basal levels of prolactin (ng/ml) in patients treated with BEC or CAB: (173.86 +/- 28.23 and 152.11 +/- 14.06 respectively); at the fourth week of treatment the decrease was smaller (p = 0.005) in patients treated with BEC (36.36 +/- 5.71) than in those treated with CAB (14.06 +/- 3.60) and at 24 weeks differences disappeared: BEC = 19.88 +/- 4.48 and CAB = 9.63 +/- 2.62 (p = NS). The adolescents showed a marked decrease in prolactin with no significant differences between BEC and CAB: basal levels = 168.17 +/- 75.47 and 213 +/- 96.99 (p = NS); 4 weeks = 48.00 +/- 8.72 and 35.00 +/- 12.58 (p = NS); 24 weeks = 34.33 +/- 10.17 and 21.75 +/- 7.23 respectively. At 48 weeks (23.25 +/- 11.23) levels remained the same as those of week 24 (p = NS). Some patients treated with BEC had nausea, vomits and epigastralgia; these symptoms were not observed with CAB. All patients resumed menstrual cycles, except one treated with BEC; 6 patients treated with CAB became pregnant, and the 5 patients who continued under our control gave birth to healthy infants. It is concluded that CAB is a useful therapy. This is specially true for adolescents (an age group difficult to manage) because of its easy administration and the almost complete absence of side effects.

A new mask filter cartridge used to determine applicator inhalation exposure to an alachlor herbicide (Lasso) during normal spraying operations.

A filter cartridge with a low air-flow resistance was designed for use on a modified half-face respirator worn during the application of alachlor (Lasso) herbicide. The filter trapped large concentrations of alachlor while retaining the ability to trap small respirable droplets. Moreover, alachlor could be recovered from the disassembled cartridge and analyzed by conventional methods. The test cartridges were used in combination with conventional personal air samplers to determine whether the filters trapped more alachlor when compared with personal samplers and to determine accurately the amount of alachlor reaching the breathing zone. Farmers sprayed alachlor in the form of alachlor (N = 7) or alachlor mixed with other herbicides or surfactant (N = 15). An average of 4 x 10(-2) mg or 2 x 10(-4) mg/kg of applied alachlor reached the respirator filters. This concentration was 10-fold higher than the alachlor recovered from the personal samplers. The new filter cartridge is better for determining the amount of alachlor reaching the breathing zone, and there is a low potential for significant inhalation exposure to alachlor during normal spraying operations.

[The course of prolactinomas in adolescents]. / Evolución de prolactinomas en adolescentes.

Results of treatment and long and short-term follow up of 13 patients (8 girls, 5 boys), aged 14-20 years (x:16.5) with prolactinomas, were assessed. Most frequent initial symptoms were: cephalea, puberty arrest or delay, galactorrhea and visual impairment. Pre-treatment evaluation showed variable and discordant responses of LH and FSH to LR-RH test, while results of TRH (TSH) test were normal in 8/9 patients (one girl had a primary hypothyroidism). Basal prolactin (PRL) levels were high in all patients (77 and 1150 ng/ml; mean +/- SD: 378 +/- 285), without further increase of TRH (mean: 25%). Eight patients had initially been operated; 7 remained hyperprolactinemic, requiring bromocriptine (BEC) after surgery. Five patients received BEC initially; CT scanning showed the absence of a substantial reduction of tumor size in 4 patients and there was no change in 1 girl. They all underwent surgery. Follow-up of 11 patients lasted between 2 and 12 years. Of those initially operated, 1 had a spontaneous return to normal gonadal function, and 5 patients required concomitant treatment. Of the 5 patients initially treated with BEC, 1 girl spontaneously resumed her cycles and became pregnant 10 months later, 1 girl completed her puberal development and at present she menstruates normally; 1 girl required concomitant progesterone treatment and the boy resumed his gonadal function. The secondarily operated girl remains normoprolactinemic, although without menstruation.(ABSTRACT TRUNCATED AT 250 WORDS)

Evolucion de prolactinomas en adolescentes / The course of prolactinomas in adolescents

Se presentan los resultados del tratamiento y seguimiento a mediano y largo plazo en 13 pacientes (8 niñas y 5 varones) de 14.2 a 20 años (x:16,5) portadores de prolactinoma. En el momento de la consulta los signos clínicos, más frecuentes fueron: cefaleas, detención o retraso de la pubertad, galactorrea y alteraciones visuales. La evaluación pretratamiento mostró respsuestas variables y discordantes de LH y FSH al ensayo de LH-RH, mientras que la prueba de TRH (TSH) resultó normal en 8/9 casos (una joven mostró un hipotiroidismo primario asociado). Los niveles de prolactina (PRL) basales estaban elevados en todos los casos entre 77 y 1150 ng/ml (x ñ SD : 378 ñ 285), sin incremento luego del TRH (x : 25%). En 8 casos, la cirugía constituyó el tratamiento inicial; 7 de ellos persistieron hiperprolactinémicos y requirieron bromocriptina (BEC) postquirúrgica. Cinco enfermos recibieron BEC como tratamiento primario; la TC mostró desaparición o importante reducción tumoral en 4 y ausencia de modificaciones en 1 niña por lo que se indicó cirugía secundariamente. La evolución pudo seguirse en 11 pacientes entre 2 y 12 años. De los operados inicialmente, 1 recuperó espontáneamente la función gonadal y 5 casos requirieron tratamiento complementario. De los 5 casos tratados primariamente con BEC, una recuperó ciclos espontáneamente logrado embarazo a los 10 meses, una completó el desarrollo puberal y presenta sangrados periódicos, una requirió tratamiento complementario con progesterona y el varón recuperó la función gonadal. La niña que fue secundariamente operada persiste normoprolactinémia sin recuperar sus ciclos. Concluimos que: 1) la PRL basal, junto con la evaluación radiológica, constituyen los elementos fundamentales en el diagnóstico de prolactinoma; 2) las evidencias clínicas y radiológicas abonarían en favor de una mayor rapidez evolutiva en los varones; 3) la BEC constituye un recurso valioso en el tratamiento primario o complementario de los prolactinomas en pacientes infantojuveniles

Evolución de prolactinomas en adolescentes. / [The course of prolactinomas in adolescents]

Results of treatment and long and short-term follow up of 13 patients (8 girls, 5 boys), aged 14-20 years (x:16.5) with prolactinomas, were assessed. Most frequent initial symptoms were: cephalea, puberty arrest or delay, galactorrhea and visual impairment. Pre-treatment evaluation showed variable and discordant responses of LH and FSH to LR-RH test, while results of TRH (TSH) test were normal in 8/9 patients (one girl had a primary hypothyroidism). Basal prolactin (PRL) levels were high in all patients (77 and 1150 ng/ml; mean +/- SD: 378 +/- 285), without further increase of TRH (mean: 25

). Eight patients had initially been operated; 7 remained hyperprolactinemic, requiring bromocriptine (BEC) after surgery. Five patients received BEC initially; CT scanning showed the absence of a substantial reduction of tumor size in 4 patients and there was no change in 1 girl. They all underwent surgery. Follow-up of 11 patients lasted between 2 and 12 years. Of those initially operated, 1 had a spontaneous return to normal gonadal function, and 5 patients required concomitant treatment. Of the 5 patients initially treated with BEC, 1 girl spontaneously resumed her cycles and became pregnant 10 months later, 1 girl completed her puberal development and at present she menstruates normally; 1 girl required concomitant progesterone treatment and the boy resumed his gonadal function. The secondarily operated girl remains normoprolactinemic, although without menstruation.(ABSTRACT TRUNCATED AT 250 WORDS)

Evolucion de prolactinomas en adolescentes / The course of prolactinomas in adolescents

Se presentan los resultados del tratamiento y seguimiento a mediano y largo plazo en 13 pacientes (8 niñas y 5 varones) de 14.2 a 20 años (x:16,5) portadores de prolactinoma. En el momento de la consulta los signos clínicos, más frecuentes fueron: cefaleas, detención o retraso de la pubertad, galactorrea y alteraciones visuales. La evaluación pretratamiento mostró respsuestas variables y discordantes de LH y FSH al ensayo de LH-RH, mientras que la prueba de TRH (TSH) resultó normal en 8/9 casos (una joven mostró un hipotiroidismo primario asociado). Los niveles de prolactina (PRL) basales estaban elevados en todos los casos entre 77 y 1150 ng/ml (x ñ SD : 378 ñ 285), sin incremento luego del TRH (x : 25%). En 8 casos, la cirugía constituyó el tratamiento inicial; 7 de ellos persistieron hiperprolactinémicos y requirieron bromocriptina (BEC) postquirúrgica. Cinco enfermos recibieron BEC como tratamiento primario; la TC mostró desaparición o importante reducción tumoral en 4 y ausencia de modificaciones en 1 niña por lo que se indicó cirugía secundariamente. La evolución pudo seguirse en 11 pacientes entre 2 y 12 años. De los operados inicialmente, 1 recuperó espontáneamente la función gonadal y 5 casos requirieron tratamiento complementario. De los 5 casos tratados primariamente con BEC, una recuperó ciclos espontáneamente logrado embarazo a los 10 meses, una completó el desarrollo puberal y presenta sangrados periódicos, una requirió tratamiento complementario con progesterona y el varón recuperó la función gonadal. La niña que fue secundariamente operada persiste normoprolactinémia sin recuperar sus ciclos. Concluimos que: 1) la PRL basal, junto con la evaluación radiológica, constituyen los elementos fundamentales en el diagnóstico de prolactinoma; 2) las evidencias clínicas y radiológicas abonarían en favor de una mayor rapidez evolutiva en los varones; 3) la BEC constituye un recurso valioso en el tratamiento primario o complementario de los prolactinomas en pacientes infantojuveniles (AU)

Technetium-99m complexes of dimethylaminomethylene diphosphonate (DMAD)--II. Biological distributions of 99mTc-DMAD components isolated by anion exchange HPLC.

HPLC isolated components of 99mTc(NaBH4)-DMAD mixtures exhibit significantly different biological properties than do analogous components of 99mTc(NaBH4)-MDP and 99mTc(NaBH4)-HEDP mixtures. Most importantly, 99mTc-DMAD components desorb from normal bone whereas analogous 99mTc-MDP and 99mTc-HEDP components do not. However, within an osteogenic rat model, an HPLC isolated 99mTc-DMAD component does not exhibit an unusually high abnormal/normal tibia uptake ratio.

Technetium-99m complexes of dimethylaminomethylene diphosphonate (DMAD)--I. Anion exchange HPLC characterization of 99mTc(NaBH4)-DMAD mixtures.

Radiopharmaceutical analogs prepared by sodium borohydride reduction of 99mTcO4- in the presence of DMAD have been characterized by anion exchange HPLC (high performance liquid chromatography) separation of the resulting mixture into component 99mTc-DMAD complexes. The distribution of complexes within a radiopharmaceutical formulation can be manipulated by controlling technetium concentration, pH, presence or absence of air, and time post reaction.