Philippe Lecomte

CONTEXT: Familial pituitary adenomas occur rarely in the absence of multiple endocrine neoplasia type 1 (MEN1) and Carney complex (CNC). OBJECTIVE: Our objective was to characterize the clinical and genealogical features of non-MEN1/CNC familial isolated pituitary adenomas (FIPA). DESIGN AND SETTING: We conducted a retrospective study of clinical and genealogical characteristics of FIPA cases and performed a comparison with a sporadic population at 22 university hospitals in Belgium, Italy, France, and The Netherlands. RESULTS: Sixty-four FIPA families including 138 affected individuals were identified [55 prolactinomas, 47 somatotropinomas, 28 nonsecreting adenomas (NS), and eight ACTH-secreting tumors]. Cases were MEN1/PRKAR1A-mutation negative. First-degree relationships predominated (75.6%) among affected individuals. A single tumor phenotype occurred in 30 families (homogeneous), and heterogeneous phenotypes occurred in 34 families. FIPA cases were younger at diagnosis than sporadic cases (P = 0.015); tumors were diagnosed earlier in the first vs. the second generation of multigenerational families. Macroadenomas were more frequent in heterogeneous vs. homogeneous FIPA families (P = 0.036). Prolactinomas from heterogeneous families were larger and had more frequent suprasellar extension (P = 0.004) than sporadic cases. Somatotropinomas occurred as isolated familial somatotropinoma cases and within heterogeneous FIPA families; isolated familial somatotropinoma cases represented 18% of FIPA cases and were younger at diagnosis than patients with sporadic somatotropinomas. Familial NS cases were younger at diagnosis (P = 0.03) and had more frequently invasive tumors (P = 0.024) than sporadic cases. CONCLUSIONS: Homogeneous and heterogeneous expression of prolactinomas, somatotropinomas, NS, and Cushing's disease can occur within families in the absence of MEN1/CNC. FIPA and sporadic cases have differing clinical characteristics. FIPA may represent a novel endocrine neoplasia classification that requires further genetic characterization.

BACKGROUND AND DESIGN: The skin properties of 98 postmenopausal women with hormone replacement therapy (oestradiol gel or patches) or without hormone replacement therapy were studied using non-invasive techniques: skin thickness with skin echography, skin hydration with a dryness score and measurement of capacitance, skin surface lipids with a Sebumeter and microtopography with image analysis of cutaneous replicas. RESULTS: In this open study we demonstrated an increase in skin thickness and sebum in the treated group in comparison to the untreated group (7-15% according to area for skin thickness, 35% for sebum). Hydration and microtopography were not different in the two groups. CONCLUSIONS: Postmenopausal women who were receiving hormonal substitution have a greater thickness and casual level than untreated women. We therefore suggest that hormonal aging exists and that cutaneous atrophy can be prevented with hormone replacement therapy.

The book provides critical information and knowledge on the importance of livestock in the global effort to alleviate poverty and promote human health. It describes and evaluates case studies, examines theoretical frameworks, and discusses key global policy development issues, challenges and constraints related to smallholder livestock-production systems around the globe. The book is written for academic professionals, industry experts, government officials and other scholars interested in the facts and issues concerning the contribution of livestock to the social and economic progress of developing countries.