Macroprolactinemia in patients with hyperprolactinemia: an experience from a single tertiary center

Macroprolactinemia frequently causes misdiagnosis, unnecessary investigation and inappropriate treatment in hyperprolactinemic patients. Aim of this study is to investigate the prevalence and clinical characteristics of Thai patients with macroprolactinemia. We performed a cross-sectional study in 56 hyperprolactinemic patients (51 women and 5 men) whose sera were subsequently tested for the presence of macroprolactin. Recovery of less than 40% of serum prolactin after polyethylene glycol (PEG) precipitation was indicative of macroprolactinemia. Our study revealed 19.64% (11/56) of patients with hyperprolactinemia were found to have a preponderance of macroprolactin. All patients with macroprolactinemia were women, of which eight of them were initially diagnosed as idiopathic hyperprolactinemia and mistreated with dopamine agonist medications. Interestingly, neuroradiological abnormalities were reported in three patients with macroprolactinemia, 2 cases with prolactinoma and one case with stalk effect hyperprolactinemia. In conclusion, nearly one-fifth of our patients with hyperprolactinemia have macroprolactinemia. This finding suggests that the diagnostic algorithm of all patients with hyperprolactinemia should include the PEG precipitation test as the initial step

ADAPTIVE WEB CACHING WITH INTERPOLATION AND WEB USAGE PATTERNS

ABSTRACT The objective of this research increases efficiency of web cache memory. The Adaptive Web Caching with Interpolation and Web Usage Patterns (AWC-IWUP) simulation is investigated to solve for decision making about web objects replacement based on web usage and dynamic decision. More than 1,000,000 data sets of web usage between January 2013 and October 2013 from Walailak University are used for testing in this simulation. The AWC-IWUP simulation combines many mathematical statistics theories as follows: Expected value algorithm, Cubic spline technique, MarSpline technique, First Order Condition (FOC) and Bayesian algorithm. The experimental results of this research can conclude that the AWC-IWUP simulation is proposed replacement technique that the AWC-IWUP solves replacement problem of the web cache memory better than the LRU technique. The AWC-IWUP technique increases the hit ratios higher than the LRU technique approximately 25%