Abstract：
:Unlike other pituitary hormones, PRL is under tonic inhibition by the hypothalamus by way of the PRL inhibitory factor, dopamine. GAP and GABA may also be inhibitory. PRL-releasing factors include TRH and VIP and possibly others. Circulating PRL is predominantly monomeric, although some patients with hyperprolactinemia appear to have increased quantities of the less biologically active polymeric forms. PRL is secreted episodically, with an increase in the amplitude of the secretory pulses with sleep. A transitory increase also occurs in response to the protein component of meals. Basal PRL levels increase in response to the hormonal milieu of pregnancy, and suckling postpartum triggers PRL release. Pathologic increases of PRL owing to hypothalamic dysregulation occur with a variety of medications, including the neuroleptics, metoclopramide, antidepressants, methyldopa, reserpine and verapamil, abuse of opiates and cocaine, renal insufficiency, cirrhosis, hypothyroidism, adrenal insufficiency, neurogenic stimulation, and idiopathically. Hyperprolactinemia also may occur from structural lesions of the stalk and hypothalamus, which cause disinhibition with or without maintenance of PRF activity, ectopic neoplasm production, and, most commonly, from prolactinomas. Diagnostic testing consists of routine chemistry and thyroid testing and imaging with MRI or CT. Dopamine agonists are the treatment of choice of prolactinomas of all sizes. Transsphenoidal surgery is an alternative for the patient who does not respond to medical therapy or who wishes definitive tumor removal, realizing that long-term cure is achieved in only 50% to 60% of patients with microadenomas and a much lower number in those with macroadenomas. Radiotherapy is reserved for patients who do respond to either medical or surgical treatment. Patients wishing to become pregnant usually are treated with bromocriptine, although prepregnancy surgical debulking may be advisable for those with large macroadenomas to reduce problems with tumor enlargement.
journal_name
Endocrinol Metab Clin North Amjournal_title
Endocrinology and metabolism clinics of North Americaauthors
Molitch MEsubject
Has Abstractpub_date
1992-12-01 00:00:00pages
877-901issue
4eissn
0889-8529issn
1558-4410journal_volume
21pub_type
杂志文章,评审abstract：:With building pressure for cost-containment of medical expenditures, the medical community is finding it increasingly necessary to justify its procedures and systems of care. The analysis of health care outcomes has been extensively applied to diabetes care as a means of determining the process by which optimal outcom...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70262-0
更新日期：1997-09-01 00:00:00
abstract：:To make a diagnosis of insulinoma, one must consider it. Neuroglycopenic symptoms are the most prominent and convincing, and the combination of hypoglycemia and endogenous hyperinsulinemia are diagnostic of insulinoma. A glucose level of approximately 40 mg/dL with a concomitant insulin level of 6 microU/mL, a C-pepti...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70087-6
更新日期：1999-09-01 00:00:00
abstract：:Based on the 2010 version, the 2017 World Health Organization (WHO 2017) classification is for pancreatic neuroendocrine neoplasms (PanNEN). The WHO 2017 classification introduces the novel well-differentiated neuroendocrine tumor of high grade (NET G3). A sharp distinction between NET and poorly differentiated neuroe...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2018.04.008
更新日期：2018-09-01 00:00:00
abstract：:This article links the understanding of developmental physiology of the adrenal cortex to adrenocortical tumor formation. Many molecular mechanisms that lead to formation of adrenocortical tumors have been discovered via next-generation sequencing approaches. The most frequently mutated genes in adrenocortical tumors ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2017.01.007
更新日期：2017-06-01 00:00:00
abstract：:Trabecular bone score (TBS) is a novel method that assesses skeletal texture from spine dual-energy X-ray absorptiometry (DXA) images. TBS improves fracture-risk prediction beyond that provided by DXA bone mineral density (BMD) and clinical risk factors, and can be incorporated to the Word Health Organization Fracture...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2016.09.005
更新日期：2017-03-01 00:00:00
abstract：:The degree of hyperglycemia may be an important predictor of morbidity and mortality among patients with MI or stroke, and in those undergoing surgical procedures including coronary artery bypass. Hyperglycemia should be aggressively controlled from the time of hospital admission regardless of the patient's primary me...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70162-6
更新日期：2000-12-01 00:00:00
abstract：:The last 2 decades have seen tremendous growth in understanding the clinical characteristics of various childhood bone disorders, their mechanisms and natural histories, and their responses to treatment. In this review, the authors describe advances in bone assessment techniques for children. In addition, they provide...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2020.07.005
更新日期：2020-12-01 00:00:00
abstract：:Glucose intolerance and diabetes are common complications of cystic fibrosis (CF), affecting up to 75% of the adult population. This article discusses the prevalence and pathophysiology of glucose tolerance abnormalities in CF, and reviews recent recommendations for diagnosis, screening, and management of CF-related d...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70102-x
更新日期：1999-12-01 00:00:00
abstract：:The development of vaccines is arguably the most significant achievement in medicine to date. The practice of innoculation with the fluid from a sore to protect from a disease actually dates back to ancient China; however, with the introduction of Jenner's smallpox vaccine, and greater understanding of the immune syst...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(01)00021-4
更新日期：2002-06-01 00:00:00
abstract：:An approach to the diagnosis and follow-up of patients with osteoporosis is described. A system of classification of vertebral fractures is outlined, and the relative merits of different techniques for bone mineral density are discussed. The importance of identifying factors that accelerate bone loss is stressed. The ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1988-09-01 00:00:00
abstract：:This article discusses congenital adrenal hyperplasia (CAH) caused by a deficiency of 21-hydroxylase, which represents 90% of all cases of CAH. As in other genetic disorders of metabolism, the symptoms of CAH are related to both the decrease of the final products of metabolism and the accumulation of precursors that a...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-06-01 00:00:00
abstract：:Duplex/color Doppler sonography (US) is the imaging modality of choice for the evaluation of patients with primary amenorrhea. Careful correlation with clinical history, physical examination and laboratory findings significantly narrows the diagnostic possibilities thus allowing for a more precise diagnosis. This arti...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2009.09.002
更新日期：2009-12-01 00:00:00
abstract：:Women who cannot or choose not to take estrogens do have alternatives; however, the options are few and unproven in longterm clinical trials with respect to safety and efficacy. Many available alternative treatments may alleviate the symptoms of the menopause, but do not convey long-term protection against osteoporosi...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70253-x
更新日期：1997-06-01 00:00:00
abstract：:This review provides an overview of the safety of growth hormone replacement therapy in individuals previously treated for cancer. The review focuses on the risk of disease recurrence and second neoplasm occurrence with special attention to data on childhood cancer survivors. ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2012.07.002
更新日期：2012-12-01 00:00:00
abstract：:Familial benign hypercalcemia, or hypocalciuric hypercalcemia, may be defined as a dominantly inherited disorder of calcium and magnesium metabolism, characterized by lifelong hypercalcemia and hypermagnesemia (both of variable degree), that usually is not associated with any symptoms, physical signs, reduced vitality...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-09-01 00:00:00
abstract：:This article summarizes the effects of catecholamines and vasopressin on the cardiovascular system, focusing on their metabolic and immunologic properties. Particular attention is dedicated to the septic shock condition. ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2006.09.012
更新日期：2006-12-01 00:00:00
abstract：:The presence of vitamin D receptors in diverse tissues like immune cells, beta-cells in the pancreas, and cardiac myocytes has prompted research to evaluate the impact of vitamin D deficiency on the occurrence of immune diseases, diabetes, and cardiovascular disease (CVD). The expression of receptors not only in norma...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2012.05.004
更新日期：2012-09-01 00:00:00
abstract：:Both somatostatin analogues, which bind to the somatostatin receptor subtypes 2 and 5, and dopamine agonists, which are specific for the D2 receptor, have been used to treat acromegaly. Each of these classes of drugs contains several compounds that vary in duration of action, efficacy, and side effect profile. Althoug...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70062-1
更新日期：1999-03-01 00:00:00
abstract：:All organisms must adapt to changing nutrient availability, with nutrient surplus promoting glucose metabolism and nutrient deficit promoting alternative fuels (in mammals, mainly free fatty acids). A major function of glucose-sensing neurons in the hypothalamus is to regulate blood glucose. When these neurons sense g...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2012.11.007
更新日期：2013-03-01 00:00:00
abstract：:The actions of the vitamin D hormone 1,25-dihydroxyvitamin D(3) (1,25(OH)(2)D(3)) are mediated by the vitamin D receptor (VDR), a ligand-activated transcription factor that functions to control gene expression. After ligand activation, the VDR binds directly to specific sequences located near promoters and recruits a ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2010.02.007
更新日期：2010-06-01 00:00:00
abstract：:Weight gain can be a significant barrier to the treatment of diabetes. Insulin detemir is a basal insulin analog that can help patients move safely toward glycemic targets with less weight gain. This review discusses the potential adverse effects of, and hypothesis for, weight gain resulting from intensive insulin man...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(07)80006-5
更新日期：2007-08-01 00:00:00
abstract：:Morbid obesity has reached epidemic proportions in the United States. Unfortunately, medical interventions have been largely ineffective in this growing population. Currently bariatric surgery is the most effective intervention in managing morbid obesity and its comorbidities. As more patients become eligible for and ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(03)00002-1
更新日期：2003-06-01 00:00:00
abstract：:Physiologic regulation of bone cell function is achieved by the combined actions of some circulating hormones and several locally produced cytokines. Interactions among these agents are important, and the regulated generation of proteolytic activities is likely to play a major role in determining net effects on bone c...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-12-01 00:00:00
abstract：:Nelson's syndrome (NS) is a condition which may develop in patients with Cushing's disease after bilateral adrenalectomy. Although there is no formal consensus on what defines NS, corticotroph tumor growth and/or gradually increasing ACTH levels are important diagnostic elements. Pathogenesis is unclear and well-estab...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2020.05.004
更新日期：2020-09-01 00:00:00
abstract：:Hypertension is an important and modifiable risk factor for the macrovascular and microvascular complications of diabetes. Prior literature outlines the significance of lowering blood pressure and subsequent cardiovascular and microvascular benefits. Blood pressure targets of less than 140/90 mm Hg are recommended in ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2017.10.008
更新日期：2018-03-01 00:00:00
abstract：:The study of genetic syndromes associated with adrenocortical tumors (Beckwith-Wiedemann, Li-Fraumeni, McCune-Albright, Carney, and multiple endocrine neoplasia type 1) has shed light on the molecular basis of tumorigenesis. Abnormalities at the 11p15 locus appear as crucial and frequent events found specifically in m...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70112-2
更新日期：2000-03-01 00:00:00
abstract：:The immune system, through a complex interplay of highly specialized cells and a seemingly endless number of soluble mediators, works to ensure protection from the potentially harmful pathogens that we encounter in our lifetime. The development of the immune system is a compromise between the necessity to recognize fo...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(01)00016-0
更新日期：2002-06-01 00:00:00
abstract：:More than 80% of women experience psychologic or physical symptoms in the late reproductive years, with varying degrees of severity and disruption in their lives. Patients and clinicians have misconceptions about what changes are considered "normal" or"abnormal" during this period. Of importance to clinicians, large-s...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2004.07.003
更新日期：2004-12-01 00:00:00
abstract：:Acute hyperkalemia can be a life-threatening consequence of a variety of pathologic, pharmacologic, and iatrogenic disorders. Recognition and prompt therapy often reverse the electrophysiologic complications within minutes. Therefore, physicians must have a thorough understanding of potassium homeostasis. The causes o...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-09-01 00:00:00
abstract：:A consensus conference of the American Association of Clinical Endocrinologists and American College of Endocrinology held in February 2016 advocated expanding the use of continuous glucose monitoring (CGM) in the management of diabetes. Based on the data described in this paper, CGM use is shown to improve glucose co...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2016.06.003
更新日期：2016-12-01 00:00:00
