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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.

The presence of false negatives in the evaluation of patients with short stature and the variability of 24 hour growth hormone (GH) physiological studies in the normal population are well known. Therefore the reproducibility of two widely used pharmacological test was studied in normal children. Forty prepuberal children were evaluated (34 boys and 6 girls), with chronological ages ranging from 2 years 11 months to 12 years 11 months (mean: 9 years 1 month), bone ages from 3 years 2 months to 12 years 6 months (mean: 8 years 4 months) and with normal stature and growth velocity (SDS > -2) and normal body mass index (BMI < 25). Clonidine test was performed (100 micrograms/m2 surface) measuring GH (ng/ml) 0,06 and 90 min in 20 patients (Group I). Exercise-Propranolol test was performed (0,5 mg/kg weight) with basal and post-exercise GH measurements in 20 patients (Groups II). The tests were repeated at one week intervals and each child was his own control. Group I showed (mean +/- SD): 1st test: B = 1.78 +/- 1.59, Max Resp = 13.16 +/- 8.34; 2nd test: B = 1.17 +/- 0.51, Max Resp = 15.12 +/- 8.09. Group II showed (mean +/- SD): 1st test: B = 1.38 +/- 0.58, Max Resp 16.97 +/- 9.69; 2nd test: B = 1.54 +/- 1.16, Max Resp = 13.49 +/- 7.81. Wilcoxon's test did not show significant differences when comparing B vs B and Max Resp vs Max Resp in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

A reduction of circulating testosterone has been reported in lung, stomach and pancreatic carcinoma. In order to evaluate the concentration of this hormone in patients with colorectal cancer, we studied 58 men with histologically confirmed disease. Seric testosterone, estradiol and carcinoembryogenic antigen were simultaneously measured in 24 patients under pre-surgical evaluation (group I) and in 34 patients after surgical resection (group II). The results were compared with a control group carrying benign gastrointestinal pathologies. According to the Kruskal-Wallis test, the testosterone level in cancer groups was significantly lower than in the control group (p < 0.0001). We have also observed a statistical significance between subgroups I and II compared to the control group (p < 0.001), while no conspicuous differences were perceived in estradiol concentrations between benign and cancer groups. Decreased serum levels of testosterone were found in 69% of patients with colon or rectal carcinoma and 56.9% of them had raised levels of carcinoembryonic antigen. The combined determination of both biomarkers increase to 86.2% the sensitivity of tumor screening compared with a single detection. Our results suggest that the combination of testosterone and carcinoembryonic antigen enhances the efficiency of tumor screening. We conclude that the evaluation of circulating testosterone could be a new and more sensitive assay for diagnosis and follow-up of colorectal carcinoma in males, specially in patients with normal levels of carcinoembryonic antigen.

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)