Prolactin Hormone Levels Research Articles

Enhancing oxytocin and prolactin levels to address oligogalactia through emotional management and massage in working mothers

Emotional management, combined with oxytocin massage and breast care, offers a comprehensive approach to boost prolactin release, enhance milk production, and improve breastfeeding outcomes. The aim of this study was to evaluate the effectiveness of combining emotional management with oxytocin massage and breast care in increasing oxytocin and prolactin hormone levels to address oligogalactia in working postpartum mothers. A quasi-experimental study was conducted at Kudus Community Health Center, Kudus Regency, Central Java, Indonesia, from January to March 2024. A total of 93 postpartum mothers were randomly assigned to three groups: (1) emotional management with oxytocin massage; (2) emotional management with breast care; and (3) lactation education only. Blood samples were collected before and after the interventions to measure oxytocin and prolactin levels. The present study found that emotional management combined with oxytocin massage significantly increased oxytocin levels from 505.0±264.0 pg/mL to 600.0±231.3 pg/mL (mean difference: 103 pg/mL; p=0.002) and prolactin levels from 191.0±67.3 ng/mL to 233.0±86.8 ng/mL (mean difference: 27 ng/mL; p=0.001). The emotional management and breast care group showed a smaller increase in oxytocin (362.0±175.1 pg/mL to 418.0±185.1 pg/mL; mean difference: 23 pg/mL; p=0.048) and a significant increase in prolactin (195.0±48.8 ng/mL to 255.0±82.3 ng/mL; mean difference: 38 ng/mL; p=0.049). In contrast, the lactation education group showed no significant changes in oxytocin (p=0.756) or prolactin levels (p=0.341). In conclusion, emotional management combined with oxytocin massage significantly increased both oxytocin and prolactin levels, suggesting that integrating emotional management and oxytocin massage may be an effective strategy for postpartum lactation support.

Research Note: Effect of different photoperiodic programs from rearing period on the reproductive performance and hormone secretion of White King pigeons

The photoperiod is an important factor during rearing and laying period that affects age and body weight at sexual maturation and reproductive performance in poultry; however relevant research on this factor in pigeons is still lacking. Thus, this study investigated the effects of different photoperiodic programs on the reproductive performance and hormonal profile in White King pigeons. From 101 d of age, the pigeons in the control group were exposed to a natural photoperiod until 160 d, and then to a photoperiod of 16 h (16 light [L]: 8 dark [D]) and lasted for 200 d. Pigeons in the 3 experimental groups were exposed to a short photoperiod of 8L: 16D until 160 d, and then to 14L: 10D, 16L: 8D, and 18L: 6D, respectively. The results showed that light-restriction (8L: 16D) during the rearing period and then 14L: 10D or 16L: 8D photostimulation delayed the age at first egg laying in pigeons. However, 16L: 8D after an 8L: 16D photoperiod during the breeding period ensured maximum photosensitivity, and significantly improved the reproductive performance (egg production and fertility rates) in pigeons. Moreover, the highest reproductive performance in group under16L: 8D after 8L: 16D photoperiodic program was accompanied by improved follicle-stimulating hormone and estradiol levels and reduced prolactin hormone levels. The results indicated that photoperiodic programs from rearing to laying period are closely related to the reproductive performance of White King pigeons. The results provide information that 8L: 16D during rearing period and 16L: 8D during laying period can be used to enhance reproductive performance in the pigeon industry.

MANAGEMENT OF HYPERPROLACTINEMIA CAUSED PITUITARY MICROADENOMA

Hyperprolactinemia is an increase in fasting levels of the hormone prolactin above 20 ng/ml in menand above 25 ng/ml in women. Hyperprolactinemia occurs more often in women of reproductive age,with a percentage of 9 – 17%. The etiology of hyperprolactinemia can occur due to abnormal pituitarysecretions, systemic disease, use of drugs, damage to the hypothalamus-pituitary axis. A 33-year oldfemale patient came to the FER Polyclinic at M. Djamil Hospital with complaints of not menstruatingfor the past 2 months. Irregular menstruation since 15 years ago, menstruation 2-3 times in 6 months,irregular cycle for 7-8 days. The patient also complained of a fluid like breast milk coming out of thebreast for 5 years, initially the fluid came out in a trickle and then gradually reduced and now the fluidcomes out occasionally if the breast is squeezed. From the supporting examinations carried out, it wasfound that the prolactin hormone level in this patient was 134.53, and the results of the MRIexamination showed a mass measuring 1.05x1.12x0.5 mm, which was diagnosed as secondaryamenorrhea, hyperprolactinemia, and suspected pituitary microadenoma. The patient will bemonitored for general condition and vital signs, as well as consultations with colleagues involved, suchas consultations to the Internal Medicine section, Endocrinology, Metabolic and Diabetes Subdivision.

Increased Levels of The Hormone Prolactin Through Complementary Treatments (Breast Care) and Spiritual Approaches (Qur'anic Murottal)

Breast milk is the best natural nutrition for babies and is needed during the first six months of a baby's life. Breast care and Al-Quran Murottal are methods for increasing prolactin hormone levels, and can also reduce the release of stress hormones, which are very important when mothers are breastfeeding. Quasi-experimental (quasi-experiment) with the approach used is a pre-test post test control group design, namely, research that uses a control group to be used as a comparison between pretest and posttest. The sample was obtained using a purposive sampling technique with a total of 39 postpartum mothers divided into (13 postpartum mothers in the breast care group, 13 postpartum mothers in the Murottal Al-Quran group, and 13 postpartum mothers in the control group). Prolactin hormone levels were measured before and after treatment. Data were analyzed using paired t-test and linear regression. The results showed that the breast care group had a value of p= 0.007<0.05, the Al-Quran mental group had a value of p=0.011<0.05, and the control group had a value of p=0.154>0.05. showed that the breast care group and Al-Quran murotal had an influence on prolactin hormone levels, whereas the control group had no influence on prolactin hormone levels. In conclusion, Breast Care and Murottal Al-Quran can be used to increase prolactin hormone levels in postpartum mothers so that postpartum mothers do not need to be confused about how to increase breast milk production.

Effect of Hypnobreastfeeding on Milk Production in Stunting Prevention Efforts in North Tapanuli District

Indonesia is still facing nutrition problems that affect the quality of human resources. The problem of malnutrition is still quite high in Indonesia, especially the problem of stunting. Stunting can occur as a result of malnutrition, especially during 1000 HPK. The Lancet Breastfeeding 2016 states that breastfeeding can reduce infant mortality due to infection by 88%, besides that breastfeeding also contributes to reducing the risk of stunting in the future. Hypnobreastfeeding helps mothers ensure that they can continue to breastfeed, at least exclusively for the first six months. To prevent stunting, optimizing breastfeeding with Hypnobreastfeeding can reduce stunting rates in the North Tapanuli Regency so that the Sustainable Development Goals (SDGs) target in 2025 can be achieved by a 40% reduction. The study aims to determine the difference in prolactin hormone levels before and after the application of hypnobreastfeeding in breastfeeding mothers. The research was a quasi-experiment using pre and Post-tests with a control group design. The sampling technique used purposive sampling on postpartum mothers with a total sample of 30 people. This research was conducted in July-November. Statistical tests using the Wilcoxon test. To determine the difference in prolactin levels before and after hypnobreasfeeding, the p-value = 0.02, so that the p-value <0.05 can be concluded that there is a difference in prolactin hormone levels before and after the application of hypnobreastfeeding in nursing mothers. Based on the results of the study, hypnobreastfeeding can be an intervention for breastfeeding mothers to succeed in exclusive breastfeeding.

The Effectiveness of Kenikir Extract (Cosmos Caudatus) To Increase The Hormone Prolactin In Puerperal Mothers

Failure of exclusive breastfeeding still occurs due to insufficient milk production. Kenikir or Cosmos Caudatus has active compounds that may increase breast milk, but there has been no further research on kenikir in breast milk production. Analyzing the effectiveness of kenikir extract in increasing prolactin hormone levels in puerperal mothers. This type of research is a true experiment with pretest posttest control group design. The independent variable is nikir extract. The dependent variable is the hormone prolactin. The sample of 40 postpartum mothers was divided into 20 mothers in the control group and 20 mothers in the intervention group. The analysis used the Paired T Test and Wilcoxon to determine the differences before and after the intervention in each group. Then Mann Whitney's analysis was carried out on differences between groups. Administration of 300 mg of kenikir extract for 14 days can increase the hormone prolactin with an average of 44.70 ng / ml p value 0.0001. Giving kenikir extract is effective in increasing the hormone prolactin in postpartum mothers.

Normal intellectual ability and hyperprolactinemia as unique clinical manifestations of congenital hypothyroidism: A case report and review of hypotheses.

Congenital hypothyroidism is the deficiency of thyroid hormone in infants and hyperprolactinemia is frequently observed. Previously reported cases typically involve intellectual disability, highlighting this particular unique case report to the first reported patient demonstrating normal intellectual ability despite experiencing growth and gonad dysfunction. This study aims to present a case and review medical hypotheses related to the patient's condition. A 19-year-old female presented with a chief complaint of irregular menstruation for up to 40 days or not occurring at all. The patient experienced the first menstruation at the age of 16 years old. The patient's height was 133 cm, body weight 40 kg, and body mass index 22.61 kg/m2; other family members were normal. Physical examination showed no abnormalities, and laboratory examination showed suppressed serum free T4 (FT4) level (6.41 pmol/L), elevated thyroid stimulating hormone (TSH) level (333.700 µIU/mL), and elevated prolactin hormone level (32.03 ng/mL). Ultrasound of the thyroid gland found hypoplasia of the left and right thyroid glands. The patient was a college student enrolled in a public national university and had never complained about academic performance throughout the patient's education. The patient was diagnosed with congenital hypothyroidism and hyperprolactinemia. The patient was administered up to 100 µg daily of oral levothyroxine, which improved the patient's menstrual cycles. The patient's delayed diagnosis may be attributed to central congenital hypothyroidism being underdiagnosed. We hypothesized that thyroid-releasing hormone receptor (TRHR) gene mutation might contribute to the underlying cause of hyperprolactinemia and normal intellectual ability of the patient. Further study on the significance of TRHR gene mutations in congenital hypothyroidism is required to improve diagnosis and treatment.

Effect of Covid-19 Vaccine on Women's Fertility Hormones

The coronavirus disease 2019 (COVID-19), as a result of the modern intense respiratory syndrome coronavirus 2, caused an unexpected fundamental global raise in the admission to hospitals for lung and other organ diseases. COVID-19 vaccination has increased and accelerated in a conscionable progress. More than 184 nominee vaccines are being tested in preclinical use and 104 in clinical stages of development. The current study aimed to know the impact of the COVID-19 vaccine on female fertility hormones. The results obtained from the current study showed a slight increase in FSH and LH hormones for women infected with Covid-19 virus and for women who received the vaccine to prevent covid-19 virus compared to healthy, uninfected and unvaccinated groups (FSH 10.26±3.86 ,15.32±2.04 LH 15.41±2.76, 10.40±1.58 respectively), with non-significant differences (P>0.05), while the prolactin hormone levels showed a highly significant increase (P<0.01) in infected women who took the vaccine in comparison with its levels in healthy women who did not receive the vaccine and not infected (32.32±6.48, 19.62±4.04, 10.27±6.88 respectively). Conclusions: Covid- 19 vaccine affected the female hormones in one way or another.

Effect of COVID-19 infection on the erectile function.

It has been understood that COVID-19, which has become a global pandemic in a short time, is a disease affecting multiple organs and systems. Some of the organs and systems affected by the disease also play a role in the pathophysiology of erectile dysfunction (ED), which led us to consider the possible effects of the disease on the erectile function. In this study, we aimed to evaluate changes in the erectile functions of patients with COVID-19 among those that had previously diagnosed with mild and moderate ED in our urology outpatient clinic. Eighty-one patients aged 18-65 years who were confirmed to have COVID-19 were included in the study. According to disease severity, these patients were divided into two groups as mild (non-hospitalized, n=60) and moderate (hospitalized but did not require intensive care, n=21). The patients' pre- and post-disease scores in the five-item International Index of Erectile Function (IIEF-5) ​​and hormone panel results were compared. The changes in the IIEF-5 scores of the patients from the pre-disease to the post-disease period were statistically significant for both the mild and moderate groups (p<0.05). When these changes were compared between the mild and moderate groups, the difference was not statistically significant (p=0.156). There was also no statistically significant change in the testosterone, follicle-stimulating, luteinizing, and prolactin hormone levels before and after the disease. In this study, we determined that SARS-CoV-2 infection caused deterioration in existing ED in sexually active male individuals, regardless of the severity of the disease.

Drink combination made from Fenugreek seeds and Phoenix dac-tylifera to increase prolactin hormone levels in postpartum mothers and its impact on baby weight

Background: Breast milk is the best leading food for the growth and development of the baby; however, the production of breast milk produced by breastfeeding mothers is still lacking and impacts the baby's weight. One of the efforts is consuming a combination drink of Fenugreek seeds and Phoenix dactylifera containing galactagogue, which has never been done in this study before, to see an increase in breast milk production from indicators of prolactin hormone levels and its impact on baby weight.Purpose: Knowing the effect of giving drinks a combination of Fenugreek seeds and Phoenix dactylifera on the hormone prolactin and its impact on baby weight.Methods: This is an experimental study with a combination design, pretest-posttest, and posttest-only design. Respondents totaled 32 breastfeeding mothers, 16 were given drinks combination of Fenugreek seeds and Phoenix dactylifera, and 16 were given Phoenix dactylifera drinks. The intervention was given for 14 days, and the Mann-Whitney test analyzed prolactin hormone and baby weight using the Independent T-test.Results: Mean levels of the hormone prolactin in the intervention group were higher (279.52 ng/ml) than in the control group (263.31 ng/ml) with p&gt;0.05. The average increase in body weight of infants of the intervention group (606.25 g) was higher than the control group (381.25 g) with a p&lt;0.05.Conclusion: A drink combination made from Fenugreek seeds and Phoenix dactylifera can increase hormone prolactin. However, it is not statistically meaningful, and mothers who consume drinks have babies weighing higher than mothers who only give Phoenix dactylifera drinks.

PENINGKATAN PRODUKSI ASI PADA IBU POST PARTUM MELALUI PIJAT EFFLEURAGE DI KLINIK LMT SIREGAR

Exclusive breastfeeding has a significant effect on the quality of the baby's health. The fact is that only 1 in 2 babies under 6 months are getting exclusive breastfeeding. One way that can affect the increase in breast milk production is by means of massage techniques. This study aims to determine the effectiveness of effleurage massage on breast milk production in post partum mothers This type of research is a quantitative study in the form of a quasi-experimental design with a two-group pretest-posttest design. The population of this study was all post partum mothers who gave birth at LMT Siregar Clinic as many as 14 people and the research sample using accidental sampling technique was 14 people who were divided into 2 groups, intervention and control. Collecting data using observation sheets which were analyzed using the Wilcoxon test. The results showed a p-value of 0.038 in the intervention group and a p-value of 0.083 in the control group. The conclusion is the difference in the production of post partum mother's milk before and after the effleurage massage in the intervention group but there is no difference in the production of breast milk in the control group. For this reason is expected to provide health education on how to increase milk production with effleurage massage techniques and the need to provide support to families to carry out complementary therapy with effleurage massage techniques to increase prolactin hormone levels.

Effect of Relaxation Therapy on Anxiety Level and Breast Milk Production in Pregnant and Postpartum Mothers: Systematic Literature Review

Anxiety in pregnant and postpartum women can affect the condition of the mother and baby. Psychological stress can influence the hypothalamus and pituitary gland to secrete Adrenocorticotropic Hormone to produce cortisol. The amount of cortisol is high, resulting in inhibited milk production. Relaxation therapy is able to stimulate the milk ejection reflex more efficiently than standard practice in health care facilities which only focus on optimizing body functions, without involving the mind and soul. This review conducted a systematic review to evaluate the effect of interventions using Relaxation Therapy in increasing breast milk production. A literature search was conducted using the PRISMA guidelines including studies of relaxation therapy interventions during the pregnancy and postpartum period. Using a literature keyword search strategy, 718 studies related to relaxation therapy in pregnant and postpartum women were found and 25 studies were eligible for inclusion in the analysis. A total of 10 studies on anxiety in pregnant women, 5 studies on anxiety in postpartum mothers, 3 studies on cortisol hormone levels, 5 studies on breast milk production and 2 studies on prolactin hormone levels. These studies were conducted in Malaysia, France, England, Greece, Korea, Turkey, America, Taiwan, Iran, Indonesia, Spain, Denmark and India. The samples analyzed were 1,608 pregnant women and 1227 postpartum women. Based on the results of a review, Relaxation Therapy in the form of Hypnobreastfeeding and Music Therapy is effective in stimulating the production of breast milk and prolactin hormones in postpartum mothers. Hypnosis, Music Therapy and Benson's relaxation technique were associated with a significant reduction in anxiety levels as indicated by an increase in PSS scores and a decrease in salivary cortisol.

Effect of Relaxation Therapy on Anxiety Level and Breast Milk Production in Pregnant and Postpartum Mothers: Systematic Literature Review

Anxiety in pregnant and postpartum women can affect the condition of the mother and baby. Psychological stress can influence the hypothalamus and pituitary gland to secrete Adrenocorticotropic Hormone to produce cortisol. The amount of cortisol is high, resulting in inhibited milk production. Relaxation therapy is able to stimulate the milk ejection reflex more efficiently than standard practice in health care facilities which only focus on optimizing body functions, without involving the mind and soul. This review conducted a systematic review to evaluate the effect of interventions using Relaxation Therapy in increasing breast milk production. A literature search was conducted using the PRISMA guidelines including studies of relaxation therapy interventions during the pregnancy and postpartum period. Using a literature keyword search strategy, 718 studies related to relaxation therapy in pregnant and postpartum women were found and 25 studies were eligible for inclusion in the analysis. A total of 10 studies on anxiety in pregnant women, 5 studies on anxiety in postpartum mothers, 3 studies on cortisol hormone levels, 5 studies on breast milk production and 2 studies on prolactin hormone levels. These studies were conducted in Malaysia, France, England, Greece, Korea, Turkey, America, Taiwan, Iran, Indonesia, Spain, Denmark and India. The samples analyzed were 1,608 pregnant women and 1227 postpartum women. Based on the results of a review, Relaxation Therapy in the form of Hypnobreastfeeding and Music Therapy is effective in stimulating the production of breast milk and prolactin hormones in postpartum mothers. Hypnosis, Music Therapy and Benson's relaxation technique were associated with a significant reduction in anxiety levels as indicated by an increase in PSS scores and a decrease in salivary cortisol.

Dynamics of endocrine and metabolic changes among patients with coronary artery disease, type 2 diabetes mellitus and metabolic syndrome while treating with telmisartan

Dynamics of endocrine and metabolic changes among patients with coronary artery disease, type 2 diabetes mellitus and metabolic syndrome while treating with telmisartan

Pengaruh pemberian minuman campuran daun katuk, daun pepaya, dan kacang hijau terhadap produksi ASI dan berat badan bayi mencit

Foodstuffs rich in lactogogum are very useful in increasing milk production, especially in postpartum mothers. This study studied the effect of a mixed drink of katuk leaves, papaya leaves, and green beans on increasing breast milk production and weight growth of baby mice. This type of research is an experimental RAL with four treatments and three repetitions on female mice of the DDY strain aged 2,5–3 months, a total of 32 mice with six mice each. Mice were divided into four groups, two treatment groups and two control groups. Its treatment for 12 days postpartum. Data analysis used ANOVA and continued with the Duncan test at a 5% confidence interval. The study results found that there was a significant difference in the average milk production of the mother mice in the four groups (p= 0,003); there was no difference in the average total weight gain of mice during the four groups (p= 0,187). In conclusion, giving a functional drink a mixture of katuk leaves, papaya leaves, and green beans has the same potential as commercial katuk leaf extract but has not increased breast milk production in mice. Suggestion, further research is needed to measure prolactin hormone levels and milk quality

Gonadotoxic effect of tramadol administration: A prospective controlled study

ABSTRACT Objective To detect the possible gonadotoxic effects of tramadol dependence on seminal fluid parameters, and prolactin and testosterone hormone levels. Patients, Subjects, and Methods There were 94 participants who were divided into a tramadol-dependent group (T-group; 56 patients) and a control group (C-group; 38 healthy volunteers). The following variables were evaluated: testosterone level, prolactin level, erectile function, libido, semen parameters, and effect of tramadol dose and dependence duration. Results There was a significant increase in erectile dysfunction (ED) and decreased libido in the T-group vs C-group. Also, the serum testosterone level was lower in the T-group vs the C-group, while the serum prolactin level was significantly higher in the T-group vs the C-group. All semen parameters were low in the T-group except for abnormal forms, which were high. As the dose of tramadol increased there was a more negative effect on the previous parameter, while ED, libido, semen volume and concentration showed no significant changes. When comparing tramadol doses of 400–1000 mg/day to >1000 mg/day, the tramadol blood level increased with high doses, while serum testosterone level decreased when the dose increased and the prolactin level increased when the dose increased. Progressive motility of the sperm decreased and abnormal forms increased. Also increased duration of tramadol administration was also accompanied by a more negative effect on these parameters Conclusion Tramadol administration has a negative effect on hormone levels, libido, erectile function, and semen characters.Abbreviations:ED: erectile dysfunction; EF: erectile function

Plurihormonal pituitary macroadenoma:\xa0 a case report

BackgroundPlurihormonal pituitary adenomas are a unique type of pituitary adenomas that secrete two or more pituitary hormones normally associated with separate cell types that have different immunocytochemical and ultrastructural features. Although they represent 10–15% of all pituitary tumors, only a small fraction of plurihormonal pituitary adenomas clinically secrete multiple hormones. The most common hormone combinations secreted by plurihormonal pituitary adenomas are growth hormone, prolactin, and one or more glycoprotein hormones. The most common hormonal symptom is acromegaly (50%). The aim of this case report is to bring awareness about this rare type of pituitary adenomas and to describe the unique presentation of our patient, even though plurihormonal pituitary adenomas are known mostly as a clinically silent tumors.Case presentationHerein, we describe an unusual case of plurihormonal pituitary adenoma with triple-positive staining for adrenocorticotropic hormone, growth hormone, and prolactin. The patient is a 65-year-old Egyptian woman who presented with mass effect symptoms of the pituitary tumor, which primarily manifested as severe headache and visual field defects. She also presented with some cushingoid features, and further analysis confirmed Cushing’s disease; slightly high prolactin and normal growth hormone levels were observed. She underwent transsphenoidal surgery and has been in remission thus far. Only a few cases have been reported in the literature, but none has exhibited silent acromegaly or mass effect symptoms as the initial presentation.ConclusionThis case highlights an unusual plurihormonal pituitary adenoma case with a rare combination of secreted hormones; mass effect symptoms were dominant, as were uncommon visual field defects. Our case further proves that immunohistochemical analyses of all pituitary hormones are needed to ensure correct diagnosis and to alert clinicians to the need for more rigorous follow-up due to the higher morbidity of these patients. Our case report approval number Federal Wide Assurance NIH, USA is FWA00018774 IRB registration number with OHRP/NIH is IRB00010471.

Efficacy of Gamma Knife radiosurgery in the management of pituitary prolactinoma.

Background: Gamma Knife radiosurgery (GKR) has been widely used in the management of a variety of intracranial tumors, including pituitary adenomas. Pituitary prolactinoma (Prs) is one of the most common types of these adenomas.Methods: This prospective study included 50 patients with pituitary Prs over a period from June 2017 to June 2018 at the Neurosciences Hospital, Baghdad/Iraq. The GKR procedure was performed using the Leksell Gamma Knife® Perfexion™, 192 beams of Cobalt 60 radiation were delivered through the intact skull to the pituitary Prs.Results: There is a significant female predominance 32 (72%). The results after 6 months of GKR showed significant improvement regarding the size of adenoma, prolactin hormone level, contrast enhancement on MRI, and medical treatment.Conclusion: The study showed that the GKR is a safe and effective modality of treatment in the management of pituitary Prs.

Relationships between avian malaria resilience and corticosterone, testosterone and prolactin in a Hawaiian songbird

Glucocorticoids, androgens, and prolactin regulate metabolism and reproduction, but they also play critical roles in immunomodulation. Since the introduction of avian malaria to Hawaii a century ago, low elevation populations of the Hawaii Amakihi (Chlorodrepanis virens) that have experienced strong selection by avian malaria have evolved increased resilience (the ability to recover from infection), while high elevation populations that have undergone weak selection remain less resilient. We investigated how variation in malaria selection has affected corticosterone, testosterone, and prolactin hormone levels in Amakihi during the breeding season. We predicted that baseline corticosterone and testosterone (which have immunosuppressive functions) would be reduced in low elevation and malaria-infected birds, while stress-induced corticosterone and prolactin (which have immunostimulatory functions) would be greater in low elevation and malaria-infected birds. As predicted, prolactin was significantly higher in malaria-infected than uninfected females (although more robust sample sizes would help to confirm this relationship), while testosterone trended higher in malaria-infected than uninfected males and, surprisingly, neither baseline nor stress-induced CORT varied with malaria infection. Contrary to our predictions, stress-induced corticosterone was significantly lower in low than high elevation birds while testosterone in males and prolactin in females did not vary by elevation, suggesting that Amakihi hormone modulation across elevation is determined by variables other than disease selection (e.g., timing of breeding, energetic challenges). Our results shed new light on relationships between introduced disease and hormone modulation, and they raise new questions that could be explored in experimental settings.

Surgical Outcome of Endoscopic Transsphenoidal Surgery for Giant Pituitary Adenoma

Background: Pituitary adenomas are benign neoplasms representing 10 to 15% of intracranial lesions. Giant pituitary adenomas describe tumors more than 4 cm in maximum diameter and represent 6-10% of pituitary tumors. The introduction oftruly ‘extended endonasal’ approaches has enabled thepituitary surgeon to achieve a more radical resection safely. The aim of the work: Evaluation of efficacy of the endoscopic endonasal approach in managing giant pituitary adenoma. Patients and methods: Fifteenpatients with giant pituitary adenomas were enrolled. They were submitted to full clinical examination, radiological, visual, and hormonal assessment in the pre and postoperative period. A purely endoscopic endonasal approach was used as the primary surgical management for all the patients. The collected data included preoperative data, tumor characteristics, resection rate, clinical outcome, recurrence rate, and need for adjuvant radiotherapy Results: The mean age was 40.7 [range 16-57] years, with a male predominance [60%]. Visual affection was reported in [86.6%] with pituitary hormonal hypersecretion in 53.3%. There was an improvement in 80% of patients with visual field defects and 83.3% of patients with diminished visual acuity. Prolactin hormone levels normalized in 40%, while growth hormone normalized in 33.3%. Follow-up MRI revealed gross total resection [GTR] in 41.6% of patients with suprasellar extension, subtotal removal [about 80% of the tumor] in 50% of patients, partial tumor resection in one patient [8.4%]. In para-sellar extension, subtotal resection achieved [in 66.6%], and partial resection in 33.3%. Postoperative CSF leak occurred in 13.3% due to uncomplete reconstruction of the sella. They were reoperated for sella repair and augmentation. Three patients [20%] had transient [for 3 weeks] postoperative diabetes insipidus [DI] in the early postoperative period. Conclusion: Endoscopic endonasal approach is an effective and safe approach for managing giant pituitary adenomas.