Advances in the treatment of prolactinomas

Prolactinomas account for approximately 40% of all pituitary adenomas and are an important cause of hypogonadism and infertility. The ultimate goal of therapy for prolactinomas is restoration or achievement of eugonadism through the normalization of hyperprolactinemia and control of tumor mass. Medical therapy with dopamine agonists is highly effective in the majority of cases and represents the mainstay of therapy. Recent data indicating successful withdrawal of these agents in a subset of patients challenge the previously held concept that medical therapy is a lifelong requirement. Complicated situations, such as those encountered in resistance to dopamine agonists, pregnancy, and giant or malignant prolactinomas, may require multimodal therapy involving surgery, radiotherapy, or both. Progress in elucidating the mechanisms underlying the pathogenesis of prolactinomas may enable future development of novel molecular therapies for treatment-resistant cases. This review provides a critical analysis of the efficacy and safety of the various modes of therapy available for the treatment of patients with prolactinomas with an emphasis on challenging situations, a discussion of the data regarding withdrawal of medical therapy, and a foreshadowing of novel approaches to therapy that may become available in the future

W.D. Chadick report concerning the prospects for freed persons in Ohio, 1858

Reverend W.D. Chadick was engaged by S.D. Cabaniss to travel to Ohio to research the attitudes of the white population towards freed persons and to evaluate the prospects of settling the Townsend heirs in that area. Wesley Townsend, the oldest of the Townsend heirs and the first to be manumitted, accompanied Chadick on his journey. Though Chadick found the disposition of Ohioans towards freed persons generally unfavorable, he recommended both the Athens district and the area surrounding Xenia, Ohio, as suitable places for the Townsend heirs to relocate