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4. Accuracy of the 10 mg desmopressin test for differential diagnosis of Cushing syndrome: a systematic review and meta-analysis.

Author

Rosa Giampietro, Rodrigo, Gama Cabral, Marcos Vinicius, Gomes Pereira, Elizandra, Carlos Machado, Marcio, Vilar, Lucio, and dos Santos Nunes-Nogueira, Vania

Subjects
CUSHING'S syndrome, DESMOPRESSIN, DIFFERENTIAL diagnosis, CONFIDENCE intervals, SENSITIVITY & specificity (Statistics)
Abstract

We evaluated the accuracy of the 10 mg desmopressin test in differentiating Cushing disease (CD) from non-neoplastic hypercortisolism (NNH) and ectopic ACTH syndrome (EAS). A systematic review of studies on diagnostic test accuracy in patients with CD, NNH, or EAS subjected to the desmopressin test obtained from LILACS, PubMed, EMBASE, and CENTRAL databases was performed. Two reviewers independently selected the studies, assessed the risk of bias, and extracted the data. Hierarchical and bivariate models on Stata software were used for meta-analytical summaries. The certainty of evidence was measured using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation Working Group) approach. In total, 14 studies were included: 3 studies on differentiated CD versus NNH and 11 studies on differentiated CD versus EAS. Considering DACTH in 8 studies involving 429 patients, the pooled sensitivity for distinguishing CD from EAS was 0.85 (95% confidence interval [CI]: 0.80-0.89, I2 = 17.6%) and specificity was 0.64 (95% CI: 0.49-0.76, I2 = 9.46%). Regarding Dcortisol in 6 studies involving 233 participants, the sensitivity for distinguishing CD from EAS was 0.81 (95% CI: 0.74-0.87, I2 = 7.98%) and specificity was 0.80 (95% CI: 0.61-0.91, I2 = 12.89%). The sensitivity and specificity of the combination of DACTH > 35% and Dcortisol > 20% in 5 studies involving 511 participants were 0.88 (95% CI: 0.79-0.93, I2 = 35%) and 0.74 (95% CI: 0.55-0.87, I2 = 27%), respectively. The pooled sensitivity for distinguishing CD from NNH in 3 studies involving 170 participants was 0.88 (95% CI: 0.79-0.93) and the specificity was 0.94 (95% CI: 0.86-0.97). Based on the desmopressin test for differentiating CD from EAS, considering DACTH, Dcortisol, or both percent increments, 15%, 19%, or 20% of patients with CD, respectively, would be incorrectly classified as having EAS. For CD versus NNH, 11% of patients with CD would be falsely diagnosed as having NNH, whereas 7% of patients with NNH would be falsely diagnosed as having CD. However, in all hierarchical plots, the prediction intervals were considerably wider than the confidence intervals. This indicates low confidence in the estimated accuracy, and the true accuracy is likely to be different. [ABSTRACT FROM AUTHOR]

Published
2024
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5. AVALIAÇÃO DA RESISTÊNCIA INSULÍNICA EM INDIVÍDUOS COM OBESIDADE GRAVE CANDIDATOS À CIRURGIA BARIÁTRICA.

Author

Alves Almeida, Vivian Cristhyna, Sernizon Guimarães, Nathália, Araújo Tavares de Sá, Cristiane Maria, da Cunha Costa, Manoel, Pessoa de Araújo Burgos, Maria Goretti, Vilar, Lucio, and Lima Vieira, Renata Adrielle

Subjects
MORBID obesity, INSULIN resistance, BARIATRIC surgery
Abstract

Copyright of Revista Brasileira de Obesidade, Nutrição e Emagrecimento is the property of Instituto Brasileiro de Pesquisa e Ensino em Fisiologia do Exercicio and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2023

7. Challenges in the diagnosis and management of acromegaly: a focus on comorbidities

Author

Abreu, Alin, Tovar, Alejandro Pinzón, Castellanos, Rafael, Valenzuela, Alex, Giraldo, Claudia Milena Gómez, Pinedo, Alejandro Castellanos, Guerrero, Doly Pantoja, Barrera, Carlos Alfonso Builes, Franco, Humberto Ignacio, Ribeiro-Oliveira, Jr., Antônio, Vilar, Lucio, Jallad, Raquel S., Duarte, Felipe Gaia, Gadelha, Mônica, Boguszewski, Cesar Luiz, Abucham, Julio, Naves, Luciana A., Musolino, Nina Rosa C., de Faria, Maria Estela Justamante, Rossato, Ciliana, and Bronstein, Marcello D.

Published
2016
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10. Withdrawal of dopamine agonist treatment in patients with hyperprolactinaemia:A systematic review and meta-analysis

Author

Andersen, Ida B., Sørensen, Marie G.R., Dogansen, Sema C., Ku, Cheol R., Vilar, Lucio, Feldt-Rasmussen, Ulla, Krogh, Jesper, Andersen, Ida B., Sørensen, Marie G.R., Dogansen, Sema C., Ku, Cheol R., Vilar, Lucio, Feldt-Rasmussen, Ulla, and Krogh, Jesper

Abstract

Objective: To estimate the proportion of patients with persistent normoprolactinaemia following dopamine agonist (DA) withdrawal and to identify predictors of successful withdrawal in patients with hyperprolactinaemia. Design, patients, and measurements: A systematic review of observational eligible studies were identified by searching PubMed and Embase. The primary outcome was the proportion of patients with normoprolactinaemia after cessation of DA treatment. Secondary outcome included the proportion of patients with normoprolactinaemia after DA withdrawal using individual patient data. Risk of bias was assessed by using Newcastle-Ottawa Scale. Pooled proportions were estimated using a random effects model in case I2 ≤ 75% or by reporting range of effects if I2 > 75%. Results: Thirty-two observational studies enroling 1563 patients were included. The proportion of patients with persistent normoprolactinaemia ranged from 0% to 75% (I2 = 84%). Heterogeneity was partly explained by age with more successful withdrawal in patients of higher age. Individual patient data analyses suggested that the proportion of patients with persistent normoprolactinaemia 6 months after DA withdrawal with a low maintenance dose and full regression of the prolactinoma was 87.7% (95% confidence interval [CI] = 60.7–97.1; I2 = 0%) and 58.4% (95% CI = 23.8–86.3; I2 = 75%) for microadenomas and macroadenomas, respectively. Conclusions: The proportion of patients with persistent normoprolactinaemia following DA withdrawal treatment varied greatly, partly explained by the mean age of participants of the individual studies. Individual patient data analysis suggested that successful withdrawal was likely in patients with full regression of prolactinomas using a low maintenance dose before cessation.

Published
2022

15. Thyroid cancer in patients with acromegaly: a case–control study

Author

dos Santos, Maíra Cristina Carvalho, Nascimento, Gilvan Cortês, Nascimento, Ana Gisélia Cortês, Carvalho, Viviane Chaves, Lopes, Maria Honorina Cordeiro, Montenegro, Renan, Montenegro, Jr., Renan, Vilar, Lucio, Albano, Mônica Fiterman, Alves, Alice Regina Vasconcelos, Parente, Conceição Veiga, and dos Santos Faria, Manuel

Published
2013
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16. gsp Mutation Is Not a Molecular Biomarker of Long-Term Response to First-Generation Somatostatin Receptor Ligands in Acromegaly

Author

Wildemberg, Luiz Eduardo, primary, Henriques, Daniel, additional, Elias, Paula C. L., additional, Lima, Carlos Henrique de A., additional, Musolino, Nina R. de Castro, additional, Camacho, Aline Helen Silva, additional, Faria, Olivia, additional, Nazato, Debora, additional, Abucham, Julio, additional, Vilar, Lucio, additional, Mota, Jose Italo, additional, Huayllas, Martha Katherine P., additional, Chimelli, Leila, additional, Castro, Margaret de, additional, Kasuki, Leandro, additional, and Gadelha, Mônica R., additional

Published
2021
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19. Management of prolactinomas in Brazil: an electronic survey

Author

Vilar, Lucio, Naves, Luciana Ansaneli, Casulari, Luiz Augusto, Azevedo, Monalisa Ferreira, Albuquerque, José Luciano, Serfaty, Fabiano Marcel, Pinho Barbosa, Flavia R., de Oliveira, Jr., Antonio Ribeiro, Montenegro, Renan Magalhães, Montenegro, Jr., Renan Magalhães, Ramos, Alberto José Santos, dos Santos Faria, Manuel, Musolino, Nina Rosa C., Gadelha, Monica R., Boguszewski, Cesar Luiz, and Bronstein, Marcello D.

Published
2010
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21. Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): A Pituitary Society Statement

Author

Casanueva, Felipe F, Barkan, Ariel L., Buchfelder, Michael, Klibanski, Anne, Laws, Edward R., Loeffler, Jay S., Melmed, Shlomo, Mortini, Pietro, Wass, John, Giustina, Andrea, Lomba, Alin Abreu, Abucham, Julio, Alvarez Escola, Cristina, Barkan, Ariel L, Beckers, Albert, Ben Shlomo, Anat, Bernabeu, Ignacio, Bidlingmaier, Martin, Biermasz, Nienke, Biller, Beverly, Boguszewski, Cesar Luiz, Bolanowski, Marek, Bollerslev, Jens, Bonert, Vivien, Bronstein, Marcello, Bruno, Oscar D., Carmichael, John D., Caron, Philippe, Chanson, Philippe, Casanueva, Felipe F., Clayton, Richard N., Colao, Annamaria, Cordido, Fernando, de Marinis, Laura, Fahlbusch, Rudolf, Fleseriu, Maria, Formenti, Anna Maria, Freda, Pamela U., Fukuoka, Hidenori, Ghigo, Ezio, Greenman, Yona, Grineva, Elena, Grossman, Ashley, Gurnell, Mark, Heaney, Anthony, Hoffman, Andrew R., Ilovayskaya, Irena, Johannsson, Gudmundur, Kadioglu, Pinar, Karavitaki, Niki, Katznelson, Laurence, Kelestimur, Fahrettin, Kelly, Daniel F., Ken, Ho, Krsek, Michal, Lacroix, Andre, Stevenloeffler, Jay, Losa, Marco, Jã¸rgensen, Jens Otto, Luger, Anton, Mallea Gil, Susana, Mamelak, Adam, Mazziotti, Gherardo, Mccormack, Ann, Mercado, Moises, Neggers, Sebastian, Ning, Guang, Oyesiku, Nelson M., Popovic, Vera, Petakov, Milan, Petersenn, Stephan, Pfeifer, Misa, Pico, Antonio, Domingo, Manuel Puig, Raverot, Gã©rald, Reincke, Martin, Gadelha, Monica Roberto, Salvatori, Roberto, Samson, Susan L., Shimatsu, Akira, Shimon, Ilan, Stewart, Paul, Strasburger, Christian, Swearingen, Brooke, Trainer, Peter, Tritos, Nicholas A., Tsagarakis, Stylianos, van der Lely, A. J., Vilar, Lucio, Villar Taibo, Rocio, Zatelli, Maria Chiara, Casanueva, Felipe F., Barkan, Ariel L., Buchfelder, Michael, Klibanski, Anne, Laws, Edward R., Loeffler, Jay S., Melmed, Shlomo, Mortini, Pietro, Wass, John, Giustina, Andrea, Lomba, Alin Abreu, Abucham, Julio, Alvarez-Escola, Cristina, Barkan, Ariel L, Beckers, Albert, Ben-Shlomo, Anat, Bernabeu, Ignacio, Bidlingmaier, Martin, Biermasz, Nienke, Biller, Beverly, Boguszewski, Cesar Luiz, Bolanowski, Marek, Bollerslev, Jen, Bonert, Vivien, Bronstein, Marcello, Bruno, Oscar D., Carmichael, John D., Caron, Philippe, Chanson, Philippe, Clayton, Richard N., Colao, Annamaria, Cordido, Fernando, De Marinis, Laura, Fahlbusch, Rudolf, Fleseriu, Maria, Formenti, Anna Maria, Freda, Pamela U., Fukuoka, Hidenori, Ghigo, Ezio, Greenman, Yona, Grineva, Elena, Grossman, Ashley, Gurnell, Mark, Heaney, Anthony, Hoffman, Andrew R., Ilovayskaya, Irena, Johannsson, Gudmundur, Kadioglu, Pinar, Karavitaki, Niki, Katznelson, Laurence, Kelestimur, Fahrettin, Kelly, Daniel F., Ken, Ho, Krsek, Michal, Lacroix, Andre, Stevenloeffler, Jay, Losa, Marco, Jørgensen, Jens Otto, Luger, Anton, Mallea-Gil, Susana, Mamelak, Adam, Mazziotti, Gherardo, Mccormack, Ann, Mercado, Moise, Neggers, Sebastian, Ning, Guang, Oyesiku, Nelson M., Popovic, Vera, Petakov, Milan, Petersenn, Stephan, Pfeifer, Misa, Pico, Antonio, Domingo, Manuel Puig, Raverot, Gérald, Reincke, Martin, Gadelha, Monica Roberto, Salvatori, Roberto, Samson, Susan L., Shimatsu, Akira, Shimon, Ilan, Stewart, Paul, Strasburger, Christian, Swearingen, Brooke, Trainer, Peter, Tritos, Nicholas A., Tsagarakis, Styliano, van der Lely, A. J., Vilar, Lucio, Villar-Taibo, Rocio, Zatelli, Maria Chiara, Gurnell, Mark [0000-0001-5745-6832], Apollo - University of Cambridge Repository, and Ho, Ken

Subjects
Male, Pituitary disorder, Pituitary Diseases, Thyrotropinomas, Endocrinology, Diabetes and Metabolism, Pituitary Disease, Pituitary neoplasm, Session (web analytics), Task (project management), 0302 clinical medicine, Endocrinology, Medicine, Pituitary Neoplasm, Societies, Medical, media_common, Gonadotropin, Cushing’s disease, Cushing’s disease, 3. Good health, Diabetes and Metabolism, Treatment Outcome, Work (electrical), Pituitary Gland, Female, Cushing's disease, Human, United State, medicine.medical_specialty, media_common.quotation_subject, Thyrotropinoma, 030209 endocrinology & metabolism, NO, Pituitary radiotherapy, 03 medical and health sciences, Excellence, Medical, Acromegaly, Gonadotropins, Transsphenoidal surgery, Humans, Pituitary ACTH Hypersecretion, Pituitary Neoplasms, United States, Medical education, business.industry, Pituitary ACTH hypersecretion, Pituitary tumors, Correction, medicine.disease, Surgery, Societies, business, 030217 neurology & neurosurgery
Abstract

Introduction: With the goal of generate uniform criteria among centers dealing with pituitary tumors and to enhance patient care, the Pituitary Society decided to generate criteria for developing Pituitary Tumors Centers of Excellence (PTCOE). Methods: To develop that task, a group of ten experts served as a Task Force and through two years of iterative work an initial draft was elaborated. This draft was discussed, modified and finally approved by the Board of Directors of the Pituitary Society. Such document was presented and debated at a specific session of the Congress of the Pituitary Society, Orlando 2017, and suggestions were incorporated. Finally the document was distributed to a large group of global experts that introduced further modifications with final endorsement. Results: After five years of iterative work a document with the ideal criteria for a PTCOE is presented. Conclusions: Acknowledging that very few centers in the world, if any, likely fulfill the requirements here presented, the document may be a tool to guide improvements of care delivery to patients with pituitary disorders. All these criteria must be accommodated to the regulations and organization of Health of a given country.

Published
2017
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23. Machine Learning-based Prediction Model for Treatment of Acromegaly With First-generation Somatostatin Receptor Ligands

Author

Wildemberg, Luiz Eduardo, primary, da Silva Camacho, Aline Helen, additional, Miranda, Renan Lyra, additional, Elias, Paula C L, additional, de Castro Musolino, Nina R, additional, Nazato, Debora, additional, Jallad, Raquel, additional, Huayllas, Martha K P, additional, Mota, Jose Italo S, additional, Almeida, Tobias, additional, Portes, Evandro, additional, Ribeiro-Oliveira, Antonio, additional, Vilar, Lucio, additional, Boguszewski, Cesar Luiz, additional, Winter Tavares, Ana Beatriz, additional, Nunes-Nogueira, Vania S, additional, Mazzuco, Tânia Longo, additional, Rech, Carolina Garcia Soares Leães, additional, Marques, Nelma Veronica, additional, Chimelli, Leila, additional, Czepielewski, Mauro, additional, Bronstein, Marcello D, additional, Abucham, Julio, additional, de Castro, Margaret, additional, Kasuki, Leandro, additional, and Gadelha, Mônica, additional

Published
2021
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24. Normal Sensorineural Hearing, and Peripheral/Central Nervous Auditory System Transmission in Acromegalic Patients under Treatment (Evaluated by Brainstem Auditory Evoked Potentials and Pure Tone Audiometry)

Author

Carvalho, Marcelo A, primary, Freitas, Marcos R, additional, Albano, Monica F, additional, Fernandes, Virginia O, additional, Quidute, Ana R, additional, Vilar, Lucio, additional, Montengro, Renan, additional, and Mendonca, Alessandra TB, additional

Published
2011
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25. Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism

Author

Garmes, Heraldo Mendes, primary, Boguszewski, César Luiz, additional, Miranda, Paulo Augusto Carvalho, additional, Martins, Manoel Ricardo Alves, additional, Silva, Silvia Regina Correa da, additional, Abucham, Julio Zaki, additional, Musolino, Nina Rosa de Castro, additional, Vilar, Lucio, additional, Portari, Luiz Henrique Corrêa, additional, Gadelha, Mônica Roberto, additional, Kasuki, Leandro, additional, Naves, Luciana Ansaneli, additional, Czepielewski, Mauro Antônio, additional, Almeida, Tobias Skrebsky de, additional, Duarte, Felipe Henning Gaia, additional, Glezer, Andrea, additional, and Bronstein, Marcello Delano, additional

Published
2021
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26. Guia Prático em Neuroendocrinologia

Author

Castillo, Alejandro Rosell, primary, Lopes, Aline Alves, additional, Latronico, Ana Claudia, additional, Hoff, Ana Oliveira, additional, Quidute, Ana Rosa Pinto, additional, Guasti, André, additional, Glezer, Andrea, additional, Moreira, Ayrton Custódio, additional, Rocha, Beatriz Santana Soares, additional, Simões, Carla Raquel Oliveira, additional, Soares, Carlos Eduardo Lopes, additional, Martins, Clarissa Silva, additional, Lourenço Junior, Delmar Muniz, additional, Wittmann, Denise Engelbrecht Zantut, additional, Pardini, Dolores, additional, Santos, Elenilde Gomes, additional, Leão, Felipe Augusto Azevedo, additional, Machado, Hélio Rubens, additional, Inácio, Ícaro Sampaio, additional, Mota, José Ítalo Soares, additional, Marques, Júlia Vieira Oberger, additional, Drummond, Juliana Beaudette, additional, Abucham Filho, Júlio Zaki, additional, Schweizer, Júnia Ribeiro de Oliveira Longo, additional, Daniel, Karla Borges, additional, Kasuki, Leandro, additional, Czepielewski, Letícia Sanguinetti, additional, Naves, Luciana Ansaneli, additional, Albuquerque, Luciano, additional, Vilar, Lucio, additional, Oliveira-Neto, Luís Alves, additional, Martins, Manoel Ricardo Alves, additional, Aguiar-Oliveira, Manuel Hermínio, additional, Bronstein, Marcello Delano, additional, Natal, Marcelo Ricardo Canuto, additional, Machado, Márcio Carlos, additional, Boguszewski, Margaret Cristina da Silva, additional, Castro, Margaret de, additional, Felippe, Marilia Bortolotto, additional, Czepielewski, Mauro Antônio, additional, Gadelha, Mônica R., additional, Musolino, Nina Rosa de Castro, additional, Elias, Paula Condé Lamparelli, additional, Miranda, Paulo Augusto Carvalho, additional, Niemeyer Filho, Paulo, additional, Batista, Rafael Loch, additional, Jallad, Raquel S., additional, Silva, Silvia Regina Correa da, additional, Antonini, Sonir R., additional, Luciano, Thais Milioni, additional, Almeida, Tobias Skrebsky de, additional, Nogueira, Vania dos Santos Nunes, additional, and Brito, Vinicius Nahime, additional

Published
2020
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30. ASSOCIATION BETWEEN FOOD INTAKE, BOTH BODY COMPOSITION AND LIFESTYLE IN PATIENTS UNDERGOING BARIATRIC SURGERY.

Author

Lima Vieira, Renata Adrielle, Araújo Tavares de Sá, Cristiane Maria, da Cunha Costa, Manoel, Pessoa de Araújo Burgos, Maria Goretti, and Vilar, Lucio

Subjects
FOOD consumption, BODY composition, BARIATRIC surgery, ALCOHOLIC beverages, BONE density
Abstract

The number of bariatric surgeries performed in Brazil increased with 85% between 2011 and 2018. Aim: The aim of the present study was to evaluate associations between food intake and both body composition and lifestyle in the preoperative period of bariatric surgery. Methods: A cross-sectional study was conducted with adults scheduled for bariatric surgery at a university hospital in the city of Recife, Brazil. Data were collected on anthropometric characteristics, body composition determined using dual emission x-ray absorptiometry (DXA), lifestyle and food intake. Results: Sixty patients participated in this study (78.3% women; mean age: 38.8 ± 9.6 years). Regarding lifestyle, 31.7% sedentary lifestyle, 33.3% consumed alcoholic beverages and 83.3% never smoked. Absolute values of trunk fat, lean mass and bone mineral density were 26.84 ± 5.34 kg, 55.85 ± 10.19 kg and 11.1 ± 0.08 g/cm², respectively. The association tests revealed that a lower amount of trunk fat was associated with a greater intake of carbohydrates, sedentary individuals consumed more carbohydrates and non-smokers consumed more fruits, vegetables and olive oil. Conclusions: A greater sedentary lifestyle was associated with consumption of carbohydrates. Moreover, not smoking in the preoperative period of bariatric surgery was associated with greater consumption of healthy eating markers. [ABSTRACT FROM AUTHOR]

Published
2021
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31. Brazilian multicenter study on pegvisomant treatment in acromegaly

Author

Boguszewski, Cesar L., primary, Huayllas, Martha Katherine P, additional, Vilar, Lucio, additional, Naves, Luciana Ansaneli, additional, Ribeiro-Oliveira, Antonio, additional, Soares, Beatriz Santana, additional, Czepielewski, Mauro Antonio, additional, Abucham, Julio, additional, Correa-Silva, Silvia Regina, additional, Bronstein, Marcello Delano, additional, Jallad, Raquel Soares, additional, Duarte, Felipe Gaia, additional, Musolino, Nina Rosa, additional, Kasuki, Leandro, additional, and Gadelha, Monica Roberto, additional

Published
2019
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35. SUN-445 A Brazilian Multicentric Study Evaluating Pregnancies Induced by Cabergoline in Patients Harboring Prolactinomas

Author

Sant Anna, Beatriz, primary, Musolino, Nina, additional, Gadelha, Monica, additional, Castro, Margareth, additional, Vilar, Lucio, additional, Martins, Manoel, additional, Abucham, Julio, additional, Garmes, Heraldo, additional, Boguszewski, Cesar, additional, Bueno, Cristina, additional, Czepielewski, Mauro, additional, Portes, Evandro, additional, Nunes, Vania, additional, Ribeiro-Oliveira, Antonio, additional, Francisco, Rossana Pulcineli, additional, Bronstein, Marcello, additional, and Glezer, Andrea, additional

Published
2019
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36. Controversial issues in the management of hyperprolactinemia and prolactinomas : an overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism

Author

Vilar, Lucio, Czepielewski, Mauro Antonio, Viecceli, Camila, and Bronstein, Marcello D.

Subjects
Hyperprolactinemia, Hipófise, Hiperprolactinemia, Dopamine agonists, Sociedade Brasileira de Endocrinologia e Metabologia, Temozolomide, Prolactinoma, Prolactina, Agonistas de dopamina, Hook-effect, Pseudoprolactinomas, Pituitary surgery, Macroprolactin
Abstract

Prolactinomas are the most common pituitary adenomas (approximately 40% of cases), and they represent an important cause of hypogonadism and infertility in both sexes. The magnitude of prolactin (PRL) elevation can be useful in determining the etiology of hyperprolactinemia. Indeed, PRL levels > 250 ng/mL are highly suggestive of the presence of a prolactinoma. In contrast, most patients with stalk dysfunction, drug-induced hyperprolactinemia or systemic diseases present with PRL levels < 100 ng/mL. However, exceptions to these rules are not rare. On the other hand, among patients with macroprolactinomas (MACs), artificially low PRL levels may result from the so-called “hook effect”. Patients harboring cystic MACs may also present with a mild PRL elevation. The screening for macroprolactin is mostly indicated for asymptomatic patients and those with apparent idiopathic hyperprolactinemia. Dopamine agonists (DAs) are the treatment of choice for prolactinomas, particularly cabergoline, which is more effective and better tolerated than bromocriptine. After 2 years of successful treatment, DA withdrawal should be considered in all cases of microprolactinomas and in selected cases of MACs. In this publication, the goal of the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism (SBEM) is to provide a review of the diagnosis and treatment of hyperprolactinemia and prolactinomas, emphasizing controversial issues regarding these topics. This review is based on data published in the literature and the authors’ experience.

Published
2018

37. Serum levels of vitamin A, visual function and ocular surface after bariatric surgery

Author

BRANDÃO, Luana Paula Nogueira de Araújo, VILAR, Lucio, CAVALCANTI, Bernardo Menelau, BRANDÃO, Pedro Henrique Amorim, ARANTES, Tiago Eugênio Faria e, and CAMPOS, Josemberg Marins

Subjects
Bariatric surgery, Cegueira noturna, genetic structures, Cirurgia bariátrica, Vitamin A deficiency, Night blindness, Xerophthalmia, Xeroftalmia, eye diseases, Deficiência de vitamina A
Abstract

BACKGROUND Bariatric surgery is the most effective treatment for severe obesity, but the surgery increases the risk of developing nutritional deficiencies, such as vitamin A deficiency. In human metabolism, vitamin A plays a role in vision. OBJECTIVE To evaluate serum vitamin A, visual function and ocular surface of patients undergoing bariatric surgery. METHODS A cross-sectional and analytical study was conduced with 28 patients undergoing bariatric surgery for at least 6 months. Ophthalmologic evaluation was done through color vision test, contrast sensitivity test, ocular surface tests and confocal microscopy, as well as vitamin A serum measurement. RESULTS Vertical sleeve gastrectomy was performed in seven (25.0%) patients and Roux -en-Y gastric by-pass in 21 (75.0%). Mean serum vitamin A level was 1.7±0.5 µmoL/L. Most patients (60.7%) had symptoms of dry eye. Five (17.9%) patients had contrast sensitivity impairment and 18 (64.3%) color vision changes. In the group of patients undergoing Roux -en-Y gastric by-pass , mean vitamin A levels were 1.8±0.6 µmoL/L, whereas they were 1.7±0.5 µmoL/L in patients submitted to the restrictive technique vertical sleeve gastrectomy . The analysis of the influence of serum levels of vitamin A in the visual function and ocular surface was performed by Pearson correlation test and there was no significant correlation between any of the variables and vitamin A. CONCLUSION There was no influence of the bariatric surgery technique used on serum vitamin A levels, on the visual function or on the ocular surface. Moreover, there was no correlation between serum levels of vitamin A and the visual function or the ocular surface changes. RESUMO CONTEXTO A cirurgia bariátrica é o tratamento mais efetivo para obesidade grave, entretanto aumenta o risco de desenvolvimento de deficiência de nutrientes, como vitamina A. No metabolismo humano, a vitamina A exerce função importante na visão. OBJETIVO Avaliar níveis séricos de vitamina A, função visual e superfície ocular de pacientes submetidos à cirurgia bariátrica. MÉTODOS Estudo transversal e analítico. População de 28 pacientes submetidos à cirurgia bariátrica há pelo menos 6 meses. Foi feita avaliação oftalmológica por meio de teste de visão de cores, teste de sensibilidade ao contraste, acuidade visual com correção, testes de superfície ocular e microscopia confocal, além da dosagem de vitamina A sérica. RESULTADOS Sete (25,0%) pacientes foram submetidos à gastrectomia vertical e 21 (75,0%), à derivação gástrica em Y de Roux. A média do valor sérico de vitamina A foi de 1,7±0,5 µmoL/L. A maioria dos pacientes (60,7%) apresentavam sintomas de olho seco. Cinco (17,9%) pacientes apresentaram alteração da sensibilidade ao contraste e 18 (64,3%) alteração da visão de cores. Quando considerados apenas os pacientes submetidos à derivação gástrica em Y de Roux, a média de vitamina A foi de 1,8±0,6 µmoL/L, enquanto os submetidos à técnica gastrectomia vertical tiveram média de 1,7±0,5 µmoL/L. A análise da influência dos níveis séricos de vitamina A na função visual e na superfície ocular foi realizada pelo teste de correlação de Pearson e não houve correlação significativa. CONCLUSÃO Não houve influência do tipo de técnica de cirurgia bariátrica utilizada nos níveis séricos de vitamina A, na função visual, nem na superfície ocular. Da mesma forma, não houve correlação dos níveis séricos de vitamina A com a função visual nem com as alterações de superfície ocular.

Published
2017

44. Efficacy and tolerability of cabergoline in a cohort of 160 prolactinomas at weekly doses of up to 9 mg

Author

Vilar, Lucio, primary, Vilar, Clarice, additional, Albuquerque, Luciano, additional, The, Ana Carolina, additional, Trovao, Erik, additional, Gadelha, Patricia, additional, Sampaio, Icaro, additional, Gomes, Barbara, additional, Ferreira, Liana, additional, Aroucha, Priscila, additional, Lyra, Raissa, additional, Fonseca, Maira, additional, and Lyra, Ruy, additional

Published
2018
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45. The importance of routine screening for macroprolactin in symptomatic patients with idiopathic hyperprolactinemia

Author

Vilar, Lucio, primary, Vilar, Clarice, additional, Albuquerque, José Luciano, additional, Thé, Ana Carolina, additional, Gadelha, Patricia, additional, Borges, Thaíse, additional, Cardoso, Izabela, additional, Ferreira, Liana, additional, Sampaio, Icaro, additional, Melo, Maíra, additional, Diniz, Erik, additional, and Lyra, Ruy, additional

Published
2018
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46. Controversial issues in the management of hyperprolactinemia and prolactinomas – An overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism

Author

Vilar, Lucio, primary, Abucham, Julio, additional, Albuquerque, José Luciano, additional, Araujo, Luiz Antônio, additional, Azevedo, Monalisa F., additional, Boguszewski, Cesar Luiz, additional, Casulari, Luiz Augusto, additional, Cunha, Malebranche B. C., additional, Czepielewski, Mauro A., additional, Duarte, Felipe H. G., additional, Faria, Manuel dos S., additional, Gadelha, Monica R., additional, Garmes, Heraldo M., additional, Glezer, Andrea, additional, Gurgel, Maria Helane, additional, Jallad, Raquel S., additional, Martins, Manoel, additional, Miranda, Paulo A. C., additional, Montenegro, Renan M., additional, Musolino, Nina R. C., additional, Naves, Luciana A., additional, Ribeiro-Oliveira, Antônio, additional, Silva, Cíntia M. S., additional, Viecceli, Camila, additional, and Bronstein, Marcello D., additional

Published
2018
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47. A review of Cushing's disease treatment by the Department of Neuroendocrinology of the Brazilian Society of Endocrinology and Metabolism

Author

Machado, Márcio Carlos, primary, Fragoso, Maria Candida Barisson Vilares, additional, Moreira, Ayrton Custódio, additional, Boguszewski, César Luiz, additional, Vieira, Leonardo, additional, Naves, Luciana A., additional, Vilar, Lucio, additional, Araújo, Luiz Antônio de, additional, Musolino, Nina Rosa Castro, additional, Miranda, Paulo Augusto C., additional, Czepielewski, Mauro A., additional, Gadelha, Monica R., additional, Bronstein, Marcello Delano, additional, and Ribeiro-Oliveira, Antônio, additional

Published
2018
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