Abstract:Traumatic brain injury (TBI) is the most common cause of death and disability in young adults. Post-TBI neuroendocrine disorders have been increasingly acknowledged in recent years due to their potential contribution to morbidity and, probably, to mortality after trauma. Marked alterations of the hypothalamic-pituitary axis during the post-TBI acute and chronic phases have been reported. Prospective and longitudinal studies have shown that some abnormalities are transitory. On the other hand, there is a high f… Show more
“…Entre essas deficiências, o hipogonadismo é reconhecido hoje como frequente complicação secundária ao TCE, contribuindo para a alta morbidade observada nesses pacientes. Hohl et al, 16 analisando 30 pacientes, sendo 22 homens, com intervalo médio da avaliação laboratorial entre o TCE e o os exames laboratoriais, encontraram 10% dos pacientes (66,7% homens) com níveis de FSH abaixo do normal e 3,3% deles com nível baixo de LH. No grupo masculino, 9,1% apresentavam níveis de testosterona abaixo do valor de referência.…”
“…Entre essas deficiências, o hipogonadismo é reconhecido hoje como frequente complicação secundária ao TCE, contribuindo para a alta morbidade observada nesses pacientes. Hohl et al, 16 analisando 30 pacientes, sendo 22 homens, com intervalo médio da avaliação laboratorial entre o TCE e o os exames laboratoriais, encontraram 10% dos pacientes (66,7% homens) com níveis de FSH abaixo do normal e 3,3% deles com nível baixo de LH. No grupo masculino, 9,1% apresentavam níveis de testosterona abaixo do valor de referência.…”
“…34 Much of the recently published literature established and confirmed the association of TBI with pituitary dysfunction. [38][39][40][41] Studies show that posttraumatic hypogonadism is common in the acute post-TBI phase, with most patients recovering within 1 year. However, in 10 to 17% of survivors, hypogonadism persists.…”
Male infertility is a condition that affects approximately 50% of infertile couples and about 30% of those couples have only male factor infertility identified. There has been speculation that male military service members may have an even greater lifetime prevalence of infertility as compared to the general population, but very few scientific publications focus on male factor infertility in the military population specifically. This review will discuss many of the unique considerations regarding male infertility in the military and highlight future opportunities for research. The military/federal health system has the potential to serve as a leader in both the delivery of health care for male factor infertility and in the clinical investigation into the etiologies of and treatments for male factor infertility.
“…Described in 1918 ( 8 ), partial or complete hypopituitarism is a potential consequence of TBI ( 9 , 10 ). There are several mechanisms by which TBI can cause hypothalamus-pituitary dysfunction, including hypoxic insult or direct mechanical injury to the hypothalamus, pituitary stalk or the gland itself, compression from hemorrhage, edema or increased intracranial pressure, and vascular injury to the hypothalamus or the pituitary gland ( 10 – 13 ).…”
Section: Chronic Hypopituitarism and Tbimentioning
Traumatic brain injury (TBI) is a worldwide core public health problem affecting mostly young male subjects. An alarming increase in incidence has turned TBI into a leading cause of morbidity and mortality in young adults as well as a tremendous resource burden on the health and welfare sector. Hormone dysfunction is highly prevalent during the acute phase of severe TBI. In particular, investigation of the luteinizing hormone (LH) and testosterone levels during the acute phase of severe TBI in male has identified a high incidence of low testosterone levels in male patients (36.5–100%) but the prognostic significance of which remains controversial. Two independent studies showed that normal or elevated levels of LH levels earlier during hospitalization are significantly associated with higher mortality/morbidity. The association between LH levels and prognosis was independent of other predictive variables such as neuroimaging, admission Glasgow coma scale, and pupillary reaction. The possible mechanisms underlying this association and further research directions in this field are discussed. Overall, current data suggest that LH levels during the acute phase of TBI might contribute to accurate prognostication and further prospective multicentric studies are required to develop more sophisticated predictive models incorporating biomarkers such as LH in the quest for accurate outcome prediction following TBI. Moreover, the potential therapeutic benefits of modulating LH during the acute phase of TBI warrant investigation.
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