Navegando por Palavras-chave "dopamine agonists"

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    Controversial issues in the management of hyperprolactinemia and prolactinomas - An overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism
    (Sbem-Soc Brasil Endocrinologia & Metabologia, 2018) Vilar, Lucio; Abucham, Julio [UNIFESP]; Albuquerque, Jose Luciano; Araujo, Luiz Antonio; Azevedo, Monalisa F.; Boguszewski, Cesar Luiz; Casulari, Luiz Augusto; Cunha Neto, Malebranche B. C.; Czepielewski, Mauro A.; Duarte, Felipe H. G.; Faria, Manuel dos S.; Gadelha, Monica R.; Garmes, Heraldo M.; Glezer, Andrea; Gurgel, Maria Helane; Jallad, Raquel S.; Martins, Manoel; Miranda, Paulo A. C.; Montenegro, Renan M.; Musolino, Nina R. C.; Naves, Luciana A.; Ribeiro-Oliveira Junior, Antonio; Silva, Cintia M. S.; Viecceli, Camila; Bronstein, Marcello D.
    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.
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    Síndrome das pernas inquietas: diagnóstico e tratamento. Opinião de especialistas brasileiros
    (Assoc Arquivos Neuro- Psiquiatria, 2007-09-01) Aloe, Flávio; Alves, Rosana S Cardoso; Andrade, Luiz Augusto Franco [UNIFESP]; Assis,Márcia; Bacelar, Andrea; Bezerra, Márcio; Cardoso, Francisco [UNIFESP]; Ferraz, Henrique Ballalai [UNIFESP]; Fonseca, Ronaldo Guimarães; Horta, Wagner; Haddad, Mônica Santoro; Hasan, Rosa; Mattos, James Pitágoras; Prado, Gilmar Fernandes do [UNIFESP]; Rizzo, Geraldo; Rodrigues, Nonato; Silva, Ademir Batista da [UNIFESP]; Silva, Delson Jose; Teive, Helio Afonso Ghizoni; Grupo Brasileiro de Estudos em Síndrome das Pernas Inquietas (GBE-SPI); Universidade de São Paulo (USP); Hosp Israelita Albert Einstein; Pratica privada; Practica Privada; Universidade Federal de Minas Gerais (UFMG); Universidade Federal de São Paulo (UNIFESP); UFCE; Universidade Federal de Goiás (UFG)
    This article contains the conclusions of the November 17-18, 2006 meeting of the Brazilian Study Group of Restless Legs Syndrome (GBE-SPI) about diagnosis and management of restless legs syndrome (RLS). RLS is characterized by abnormal sensations mostly but not exclusively in the legs which worsen in the evening and are improved by motion of the affected body part. its diagnosis is solely based on clinical findings. Therapeutic agents with efficacy supported by Class I studies are dopamine agonists, levodopa and gabapentine. Class 11 studies support the use of slow release valproic acid, clonazepan and oxycoclone. The GBE-SPI recommendations for management of SPI are sleep hygiene, withdrawal of medications capable of worsening the condition, treatment of comorbidities and pharmacological agents. The first choice agents are dopaminergic drugs, second choice are gabapentine or oxycodone, and the third choice are clonazepan or slow release valproic acid.