Diagnostic Value of Thyrotropin Releasing Hormone Test in 129 Patients with Suspected Tumoral Hyperprolactinemia

In 129 hyperprolactinemic (PRL 100ng/mL) and 100 normoprolactinemic patients (PRL 0–25 ng/mL), max. PRL (the difference between maximal prolactin (PRL) after thyrotropin releasing hormone (TRH) injection and basal value) was compared with basal PRL and computed tomography (CT) of the sellar region. In 122 hyperprolactinemic patients max. PRL was <100%, while tumor was found in 106 of them. In the remainder seven hyperprolactinemic patients max. PRL was 100% and CT showed no tumor. A significant difference in max. PRL between hyperprolactinemic patients without and those with verified adenoma was found and showed a significant negative correlation with basal PRL. Between 122 hyperprolactinemic patients with max. PRL <100%, mean basal PRL and duration of clinical symptoms were significantly lower in 16 patients with normal CT compared to 106 patients with tumor. All normoprolactinemic patients showed max. PRL 100% and no tumor on CT. PRL stimulation disturbance precedes tumor visualization and represents a decisive diagnostic parameter in hyperprolactinemic patients with no tumor signs

Lymphocytic Adenohypophysitis Simulating a Pituitary Adenoma in a Pregnant Woman

The lymphocytic hypophysitis, appearing in women during the third trimester of pregnancy or early post-partum period, is a rare cause of hypopituitarism and pituitary enlargement. A 39 year-old woman presented in the 37th week of pregnancy with bilateral heteronymous quadrantanopsia, CT indicative of tumorous mass and symptoms of hypopituitarism with decreased thyroid hormone and thyrotrophin levels, and low normal level of cortisol. After the birth of a healthy male child the patient breastfed for 10 days, sight disturbances disappeared, but amenorrhea persisted. Upon admittance the visual field showed no abnormalities. MR of the sellar region confirmed previous CT findings. Endocrinological testing confirmed secondary hypothyroidism and cortisol deficiency, normal levels of prolactin with satisfactory reaction to thyroliberin. Histology showed mononuclear infiltration, and immunohistochemistry revealed T-cells (CD3) at the borders, and B-cells (CD20) in the follicular center. Due to enlargement of the pituitary associated with hypopituitarism, an incorrect diagnosis of a tumor could be mad

Chiasma Syndrome in Acromegalic Patients – Correlation of Neuroradiologic and Neuroophthalmologic Findings

The study evaluated neuroophthalmologic and computerized tomography (CT) findings in 100 patients with somatotrophic adenoma and clinical picture of acromegaly, who underwent transsphenoidal adenomectomy. Prior to the surgery, visual field was normal in 77 patients. The diameter of adenoma in these patients ranged from 8 to 30 mm on CT, and the average value was 13.5 mm. Various kinds of visual field disturbances were present in 23 patients. The diameter of their adenomas ranged between 18 to 35 mm, with the average of 24.7 mm. Compared to visual field defects, CT findings of suprasellar adenoma extension were better correlated with chiasma syndrome (p < 0.001). All patients with suprasellar mass greater than 10 mm had chiasma syndrome. Degenerative adenoma changes (hemorrhagic necrosis), which precipitate abrupt increase in size of the tumor, were more frequently seen in patients with chiasma syndrome. The incidence of chiasma syndrome directly correlates with the degree of suprasellar extension of the tumor

A systematic review of the energy and climate impacts of teleworking

Information and communication technologies (ICTs) increasingly enable employees to work from home and other locations (‘teleworking’). This study explores the extent to which teleworking reduces the need to travel to work and the consequent impacts on economy-wide energy consumption. Methods/Design: The paper provides a systematic review of the current state of knowledge of the energy impacts of teleworking. This includes the energy savings from reduced commuter travel and the indirect impacts on energy consumption associated with changes in non-work travel and home energy consumption. The aim is to identify the conditions under which teleworking leads to a net reduction in economy-wide energy consumption, and the circumstances where benefits may be outweighed by unintended impacts. The paper synthesises the results of 39 empirical studies, identified through a comprehensive search of 9,000 published articles. Review results/Synthesis: Twenty six of the 39 studies suggest that teleworking reduces energy use, and only eight studies suggest that teleworking increases, or has a neutral impact on energy use. However, differences in the methodology, scope and assumptions of the different studies make it difficult to estimate ‘average’ energy savings. The main source of savings is the reduced distance travelled for commuting, potentially with an additional contribution from lower office energy consumption. However, the more rigorous studies that include a wider range of impacts (e.g. non-work travel or home energy use) generally find smaller savings. Discussion: Despite the generally positive verdict on teleworking as an energy-saving practice, there are numerous uncertainties and ambiguities about its actual or potential benefits. These relate to the extent to which teleworking may lead to unpredictable increases in non-work travel and home energy use that may outweigh the gains from reduced work travel. The available evidence suggests that economy-wide energy savings are typically modest, and in many circumstances could be negative or non-existent

Extending the life history of a clonal aquatic plant: dispersal potential of sexual and asexual propagules of Zostera noltii

The dispersal potential of sexual and asexual propagules of Zostera noltii was experimentally quantified in still water and under different currents in microcosm and mesocosm facilities. We estimated sinking rates of seeds and changes over time in shoot buoyancy, shoot viability, fragment breakage, shoot growth rate and spathe release rate of floating fragments. The fast sinking rates of detached Z. noltii seeds suggest a small spatial scale of dispersal insufficient to connect fragmented populations, whereas the traits of floating fragments, particularly shoot buoyancy and shoot survival (>55 d), suggest a potential for long distance dispersal (>2300 km) that could connect distant patches and allow colonization of new areas. We showed that the Z. noltii vegetative and reproductive fragments have the potential to extend the dispersal achieved by detached seeds alone