A Metabolomic Profile of Seminal Fluid in Extremely Severe Oligozoopermia Suggesting an Epididymal Involvement.

Male infertility has increased in the last decade. Pathophysiologic mechanisms behind extreme oligospermia (EO) are not yet fully understood. In new “omics” approaches, metabolomic can offer new information and help elucidate these mechanisms.

Metabolomic signature of the seminal plasma in men with severe oligoasthenospermia.

Background: Male factor is incriminated in approximately 50% of cases of infertility. The metabolomic approach has recently been used in the assessment of sperm quality and male fertility.

Materials And Methods: We analyzed the metabolomic signatures of the seminal plasma in 20 men with severe oligoasthenospermia (prewash total motile sperm count < 5.

Assessment of SARS-CoV-2 serological tests for the diagnosis of COVID-19 through the evaluation of three immunoassays: Two automated immunoassays (Euroimmun and Abbott) and one rapid lateral flow immunoassay (NG Biotech).

Background: The emergence of new SARS-CoV-2 has promoted the development of new serological tests that could be complementary to RT-PCR. Nevertheless, the assessment of clinical performances of available tests is urgently required as their use has just been initiated for diagnose.

Objectives: The aim of this study was to assess the performance of three immunoassays for the detection of SARS-CoV-2 antibodies.

The role of diabetes in acromegaly associated neoplasia.

Background: The risk and mortality due to cancer in patients with acromegaly have been previously investigated. Although GH/IGF-1 excess provides a probable pathophysiological explanation, the degree of IGF-1 excess and the role in acromegaly-associated neoplasms of diabetes, a common comorbidity in acromegaly with known association with cancer, remains unclear.

Methods: Acromegalic patients treated in three Canadian referral centers (Toronto, Montreal, Edmonton) were included.

Pasireotide LAR maintains inhibition of GH and IGF-1 in patients with acromegaly for up to 25 months: results from the blinded extension phase of a randomized, double-blind, multicenter, Phase III study.

Purpose: A large, randomized, double-blind, Phase III core study demonstrated that pasireotide LAR was significantly superior to octreotide LAR at providing GH <2.5 μg/L and normalized IGF-1 after 12 months' treatment in patients with acromegaly. We report the efficacy and safety of pasireotide LAR and octreotide LAR after up to 26 months' treatment.

Pharmacokinetics, pharmacodynamics, and safety of pasireotide LAR in patients with acromegaly: a randomized, multicenter, open-label, phase I study.

Pasireotide (SOM230), a multireceptor-targeted somatostatin analogue, has exhibited favorable safety/tolerability in several clinical studies. A long-acting-release (LAR) formulation of pasireotide may offer advantages over the subcutaneous formulation. This randomized, open-label, Phase I study evaluated the safety, PK, and PD of pasireotide LAR 20, 40, or 60 mg/month in patients with acromegaly.

Metabolic glucose status and pituitary pathology portend therapeutic outcomes in acromegaly.

Introduction: Acromegaly is frequently associated with impaired glucose tolerance and/or diabetes. To evaluate the relationship between glucose metabolism and acromegaly disease, we evaluated 269 consecutive patients from two referral centres.

Methods: Clinical presentation, pituitary tumor size and invasiveness, and pituitary pathology were captured in a dedicated database.

Iatrogenic Cushing syndrome in patients receiving inhaled budesonide and itraconazole or ritonavir: two cases and literature review.

Objective: To present two cases of iatrogenic Cushing syndrome caused by the interaction of budesonide, an inhaled glucocorticoid, with ritonavir and itraconazole.

Methods: We present the clinical and biochemical data of two patients in whom diagnosis of Cushing syndrome was caused by this interaction. We also reviewed the pertinent literature and management options.

Emerging trends in the diagnosis and treatment of acromegaly in Canada.

Objective: To evaluate demographic data and quality of care of patients with acromegaly in Canada and their evolution over time and secondly, to evaluate predictors of co-morbidities and treatment outcomes.

Design And Patients: Retrospective analyses of clinical, biochemical and treatment outcome data of 649 patients with acromegaly (males: 50·7%) followed from 1980 to 2010 (mean 10·2 years, SD 13·7) in eight tertiary care centres from six Canadian provinces.

Results: In comparison to 1980-1994, the number of patients referred with acromegaly in the last 15 years was higher with female preponderance (52·8% vs 41·4%, P = 0·01) and an older age at diagnosis (46·4 ± 14 vs 41·3 ± 12 years, P < 0·0001).

Apoplexy of a microprolactinoma during pregnancy: case report and review of literature.

Objective: To report a rare case of apoplexy in a microprolactinoma during pregnancy.

Methods: We present the initial clinical manifestations, laboratory results, radiologic findings, and management in a patient who had pituitary apoplexy during early pregnancy. The pertinent literature and management options are also reviewed.

Oral estroprogestin: an alternative low cost therapy for women with postoperative persistent acromegaly?

Oral estrogens reduce GH-induced IGF-1 production and preliminary studies have shown that adjuvant estroprogestin (EP) therapy with octreotide LAR may control disease activity in some female patients who are partially responsive to octreotide LAR. Our aim was to verify if EP alone or in combination with octreotide LAR can achieve remission of acromegaly in selected cases of patients uncontrolled by surgery. Eleven women with persistent active acromegaly following surgery participated in this unblinded open label pilot study.

Failure of temozolomide and conventional doses of pegvisomant to attain biochemical control in a severe case of acromegaly.

It has been suggested that treatment with adequate dose titration of pegvisomant, a GH antagonist, up to a maximum of 40 mg daily, can achieve IGF-1 normalisation in virtually all patients with acromegaly. On the other hand, temozolomide (TMZ), an alkylating cytostatic agent, has been reported to reduce pituitary tumour size and hormone hypersecretion in a small number of aggressive pituitary macroadenomas. In this paper we report the case of a patient resistant to very high doses of pegvisomant used in combination with somatostatin analogs (SSA) and to TMZ therapy.

Cabergoline therapy for prolactinomas: is valvular heart disease a real safety concern?

Dopamine agonists (DAs) are the first-line therapy for the treatment of hyperprolactinemia, with cabergoline, an ergot-derived selective D(2)-receptor agonist, being the preferred and most widely used drug. Recent studies reported cardiac valve regurgitations in patients with Parkinson's disease treated with high doses of DA, raising concerns about the safety of cabergoline in patients with hyperprolactinemia. To date, seven case-control studies have examined the potential association between cardiac valvular abnormalities and cabergoline therapy in patients with hyperprolactinemia.

A Canadian multi-centre, open-label long-term study of Pegvisomant treatment in refractory acromegaly.

Purpose: Acromegaly is a rarely diagnosed condition with potentially serious complications including accelerated heart disease and reduced survival. After a mean interval of nearly 9 years from onset of disease, a significant proportion of patients are diagnosed with invasive adenomas precluding complete surgical resection. Furthermore, strict normalization of the growth hormone (GH) target insulin-like growth factor I (IGF-I) cannot always be achieved by adjunctive medical therapy with somatostatin analogues.

Octreotide LAR for the treatment of acromegaly.

Background: Somatostatin analogs previously considered as adjuvant therapy in acromegaly are increasingly used as a first-line therapy in selected cases.

Objective: To review the octreotide LAR pharmacological and clinical data, and discuss the impact of this agent on current treatment regimens.

Methods: We reviewed PubMed publications since the first use of octreotide LAR in acromegaly, and historical articles related to the discovery and development of this molecule.

Long-term cabergoline therapy is not associated with valvular heart disease in patients with prolactinomas.

Ergot-derived dopamine receptor agonists, especially pergolide and cabergoline, have been associated with an increased risk of valvular heart disease in patients treated for Parkinson's disease. Cabergoline at lower doses than those employed in Parkinson's disease is widely used in patients with prolactinomas, because of its high efficacy and tolerability; however, its safety with regard to cardiac valve disease is unknown. In order to assess the prevalence of cardiac valve regurgitation in patients with prolactinomas treated with long-term cabergoline, we performed a prospective and multicentric study including four university centers in the province of Quebec.

Serum markers of cardiovascular risk in patients with acromegaly before and after six months of treatment with octreotide LAR.

Acromegaly is associated with increased morbidity and mortality from cardiovascular disease. Inflammatory markers, such as C-reactive protein and leucocyte count, haemostatic markers, such as fibrinogen and factor VIII and cardiac hypertrophy marker, B-type natriuretic peptide, have emerged as important cardiovascular risk markers in the general population. The objective of this study was to assess the serum levels of conventional, inflammatory, haemostatic markers and NT-pro BNP in mostly non-diabetic normotensive patients with acromegaly, as well as the effect of 6 months of octreotide LAR therapy on these markers.

An unusual association of a sellar gangliocytoma with a prolactinoma.

The simultaneous occurrence of a hypothalamic and sellar gangliocytoma with a pituitary prolactinoma is very rare. The explanation for such an association is not known. We describe the case of a woman who had a coexisting adjacent pituitary prolactinoma and gangliocytoma within the same sellar mass.

Canadian guidelines for the management of adult growth hormone deficiency.

Purpose: To develop guidelines for the management of growth hormone (GH) deficiency in Canadian adults to facilitate rational use of GH in appropriate indications.

Methods: The guidelines were developed by group of endocrinologists and an endocrine specialist nurse with an interest in neuroendocrine disorders, representing all regions of Canada and practicing in a variety of settings. A steering committee with broad expertise undertook a systematic review of the evidence relating to adult GHD and GH replacement.

The influences of hyperprolactinemia and obesity on cardiovascular risk markers: effects of cabergoline therapy.

Objective: In view of the association of hyperprolactinaemia with insulin resistance, we hypothesized that patients with hyperprolactinaemia may present increased cardiovascular risk markers.

Design: Descriptive clinical trial.

Methods: Serum glucose, insulin, insulin resistance, lipids, high sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, tumour necrosis factor (TNF)-alpha and soluble E-selectin (sELAM-1) serum levels were determined in 15 patients with hyperprolactinaemia at baseline (compared with 20 healthy subjects) and after 12 weeks of cabergoline therapy (0.

Canadian consensus guidelines for the diagnosis and management of acromegaly.

Acromegaly is a chronic condition associated with considerably increased morbidity and mortality if left unchecked. In December 2004, a national meeting was held to discuss the diversity in clinical practice across the country in diagnosing and treating patients with acromegaly, as well as to seek consensus on a number of management principles. The group reviewed recent guidelines and discussed issues of diagnosis, treatment, monitoring and treating comorbidities to seek a Canadian consensus on the management of this rare disorder.

Enhanced lipoprotein lipase secretion and foam cell formation by macrophages of patients with growth hormone deficiency: possible contribution to increased risk of atherogenesis?

GH deficiency is associated with increased prevalence of atherosclerosis, and recent data indicate a proatherogenic role for macrophage lipoprotein lipase (LPL) in the arterial wall. In this pilot study, we determined LPL expression and foam cell formation in monocyte-derived macrophages of 12 control subjects and nine patients with GH deficiency without GH replacement therapy. LPL mRNA levels, mass, and activity were increased in macrophages of patients with GH deficiency.