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https://www.readbyqxmd.com/read/29781519/assessment-of-vertebral-microarchitecture-in-overt-and-mild-cushing-s-syndrome-using-trabecular-bone-score
#1
Helene Vinolas, Virginie Grouthier, Nadia Mehsen-Cetre, Amandine Boisson, Renaud Winzenrieth, Thierry Schaeverbeke, Charles Mesguich, Laurence Bordenave, Antoine Tabarin
OBJECTIVE: Osteoporotic fractures associated with Cushing's syndrome (CS) may occur despite normal bone mineral density (BMD). Few studies have described alterations in vertebral microarchitecture in glucocorticoid-treated patients and during CS. Trabecular bone score (TBS) estimates trabecular microarchitecture from dual-energy X-ray absorptiometry acquisitions. Our aim was to compare vertebral BMD and TBS in patients with overt CS and mild autonomous cortisol secretion (MACE), and following cure of overt CS...
May 21, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29779837/-hypertension-associated-with-paraparesis-of-the-lower-limbs-revealing-an-adrenal-adenoma
#2
E Tabti, A Benmekki, M H Bestaoui, M Messad, M A Ghembaza, A Lounici
Cushing's syndrome is a rare cause of high blood pressure. The originally adrenal cause is found in 15% of cases. We describe the case of a patient with hypertension associated with paraparesis of the lower limbs revealing a Cushing syndrome due to a left adrenal adenoma. A 23-year-old man consults for a paraparesis of the lower limbs. The highlighting of an arterial high blood pressure led to the realization of complementary examinations. Computed tomography of the abdomen shows a left adrenal mass. Chirurgical excision of the mass was performed and histological examination concluded with adrenal adenoma...
May 17, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29766359/two-types-of-ectopic-cushing-syndrome-or-a-continuum-review
#3
REVIEW
Marta Araujo Castro, Mónica Marazuela Azpiroz
BACKGROUND: Two types of ectopic Cushing syndrome (ECS) are described: ECS associated with aggressive neoplasms, and ECS with indolent and occult tumors, however, there is a lack of studies that thoroughly review their characteristics. METHODS: A systematic review was carried out on PUBMED of all the papers about the ECS, in order to better define the types of this subcategory of Cushing's syndrome, highlighting the differential aspects between these subgroups. RESULTS: It was found that in 50% of cases the prototypic "aggressive" ECS is caused by small cell lung carcinomas (SCLC)...
May 15, 2018: Pituitary
https://www.readbyqxmd.com/read/29760304/metyrapone-responsive-ectopic-acth-secreting-pheochromocytoma-with-a-vicious-cycle-via-a-glucocorticoid-driven-positive-feedback-mechanism
#4
Minako Inoue, Ken Okamura, Chie Kitaoka, Fumio Kinoshita, Ryo Namitome, Udai Nakamura, Masaki Shiota, Kenichi Goto, Toshio Ohtsubo, Kiyoshi Matsumura, Yoshinao Oda, Masatoshi Eto, Takanari Kitazono
In ectopic ACTH-secreting pheochromocytoma, combined ACTH-driven hypercortisolemia and hyper-catecholaminemia are serious conditions, which can be fatal if not diagnosed and managed appropriately, especially when glucocorticoid-driven positive feedback is suggested with a high ACTH/cortisol ratio. A 46-year-old man presented with headache, rapid weight loss, hyperhidrosis, severe hypertension and hyperglycemia without typical Cushingoid appearance. Endocrinological examinations demonstrated elevated plasma and urine catecholamines, serum cortisol and plasma ACTH...
May 15, 2018: Endocrine Journal
https://www.readbyqxmd.com/read/29757946/role-of-venous-sampling-in-the-diagnosis-of-endocrine-disorders
#5
REVIEW
Ryan W England, Eliza B Geer, Amy R Deipolyi
Venous sampling is the gold standard for localizing abnormal hormone secretion in several endocrine disorders. The most common indication for venous sampling is in the workup of primary aldosteronism, adrenocorticotropic hormone-dependent Cushing's syndrome, and hyperparathyroidism. In experienced hands, venous sampling is safe and accurate. This review discusses the role of venous sampling in the workup of endocrine disease, describing the underlying anatomy and pathophysiology, as an understanding of these concepts is essential for technical and clinical success...
May 14, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29754645/cushing-s-syndrome-2018-best-practices-and-looking-ahead
#6
EDITORIAL
Adriana G Ioachimescu
No abstract text is available yet for this article.
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754644/cushing-s-syndrome-in-pediatrics-an-update
#7
REVIEW
Maya B Lodish, Margaret F Keil, Constantine A Stratakis
Cushing syndrome (CS) is a multisystem disorder resulting from the prolonged exposure to excess glucocorticoids. In children, CS most commonly results from the exogenous administration of steroids and the typical presentation is height deceleration concomitant with weight gain. Endogenous and ectopic causes are rare. CS in children may be associated with distinct germline and somatic mutations. Clinical practice guidelines are available assist clinicians. Patients should be referred to multidisciplinary centers of excellence with experience in endocrinology and surgery...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754643/pregnancy-in-patients-with-cushing-s-syndrome
#8
REVIEW
Marcio Carlos Machado, Maria Candida Barisson Vilares Fragoso, Marcello Delano Bronstein
Progress in diagnosis and treatment of endocrine diseases has made pregnancy possible for women with endocrinopathies, including Cushing's syndrome (CS). The risk of maternal-fetal complications in patients who are not biochemically controlled, however, is substantial. Therefore, the surgical and/or medical control of hypercortisolism is mandatory prior to conceiving. A diagnosis of de novo CS during gestation is difficult due to changes in the hypothalamic-pituitary-adrenal axis during pregnancy, which may lead to some clinical features suggestive of CS along with abnormal laboratory tests...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754642/medical-therapy-for-cushing-s-syndrome-in-the-twenty-first-century
#9
REVIEW
Nicholas A Tritos, Beverly M K Biller
Medical therapy has a useful adjunctive role in many patients with Cushing's syndrome. Patients with pituitary corticotroph adenomas who have received radiation therapy to the sella require medical therapy until the effects of radiation therapy occur. In addition, patients with Cushing's syndrome who cannot undergo surgery promptly, including those who are acutely ill and cannot safely undergo tumor resection, may benefit from medical therapy as a bridge to surgery. Other possible candidates for medical therapy are those with unresectable tumors or those whose tumor location remains unknown despite adequate diagnostic evaluation...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754641/the-ectopic-adrenocorticotropic-hormone-syndrome-rarely-easy-always-challenging
#10
REVIEW
Aimee R Hayes, Ashley B Grossman
Despite modern imaging techniques, differentiating ectopic adrenocorticotropic hormone (ACTH) syndrome from pituitary-dependent Cushing's syndrome, Cushing's disease, is especially difficult when well-differentiated carcinoids are the source of ACTH secretion, particularly pulmonary carcinoid tumors. ACTH-secreting pulmonary carcinoids, like the corticotroph adenomas causing Cushing's disease, are often small and difficult to detect, and patients present with a gradual onset of the classical signs and symptoms of Cushing's syndrome, indistinguishable from the presentation of Cushing's disease...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754640/adrenocortical-carcinoma-with-hypercortisolism
#11
REVIEW
Soraya Puglisi, Paola Perotti, Anna Pia, Giuseppe Reimondo, Massimo Terzolo
Adrenocortical carcinoma (ACC) is a rare and aggressive tumor. ACC may be associated with different syndromes of hormone excess, most frequently Cushing's syndrome with or without hypersecretion of androgens. Recent data suggest that cortisol excess is a negative prognostic factor in advanced and localized ACC. Surgery with radical intent, when feasible, is the most effective treatment for ACC with hypercortisolism. Mitotane is the medical treatment of choice, both postoperatively and in inoperable or metastatic cases...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754639/adrenal-surgery-for-cushing-s-syndrome-an-update
#12
REVIEW
Guido Di Dalmazi, Martin Reincke
Recent advances in the molecular pathogenesis and the natural history of Cushing's syndrome have improved the understanding of the management of this disease. The long-term efficacy of several cortisol-lowering medical treatments is currently under evaluation. However, adrenalectomy is a safe option for the treatment of patients affected by Cushing's syndrome. Unilateral adrenalectomy is the gold standard for treatment of adrenocortical adenomas associated with hypercortisolism. Bilateral adrenalectomy has been widely used in the past as definitive treatment of bilateral macronodular hyperplasia and persistent or recurrent Cushing's disease...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754634/mortality-in-patients-with-endogenous-cushing-s-syndrome
#13
REVIEW
Pedram Javanmard, Daisy Duan, Eliza B Geer
Cushing's syndrome is associated with increased morbidity and mortality. Cardiovascular events, sepsis, and thromboembolism are the leading causes of mortality. Patient's with Cushing's due to a pituitary adenoma and those with Cushing's due to benign adrenal adenoma have relatively good survival outcomes often mirroring that of the general population. Persistent or recurrent disease is associated with high mortality risk. Ectopic Cushing's syndrome and Cushing's due to adrenocortical carcinoma confer the highest mortality risk among Cushing's etiologies...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754633/morbidity-of-cushing-s-syndrome-and-impact-of-treatment
#14
REVIEW
Susan M Webb, Elena Valassi
Cortisol excess in Cushing's syndrome is associated with metabolic, cardiovascular, and cognitive alterations, only partially reversible after resolution of hypercortisolism. Elevated cardiovascular risk may persist after eucortisolism has been achieved. Fractures and low bone mineral density are also described in Cushing's syndrome in remission. Hypercortisolism may induce irreversible structural and functional changes in the brain, leading to neuropsychiatric disorders in the active phase of the disease, which persist...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754632/genetics-of-cushing-s-syndrome
#15
REVIEW
Laura C Hernández-Ramírez, Constantine A Stratakis
The knowledge on the molecular and genetic causes of Cushing's syndrome (CS) has greatly increased in the recent years. Somatic mutations leading to overactive 3',5'-cyclic adenosine monophosphate/protein kinase A and wingless-type MMTV integration site family/beta-catenin pathways are the main molecular mechanisms underlying adrenocortical tumorigenesis. Corticotropinomas are characterized by resistance to glucocorticoid negative feedback, impaired cell cycle control and overexpression of pathways sustaining ACTH secretion...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754631/diagnosis-of-cushing-s-syndrome-in-the-modern-era
#16
REVIEW
Lynnette Kaye Nieman
Four challenges complicate the evaluation for Cushing syndrome. These challenges include increasing global prevalence of obesity and diabetes; increasing use of exogenous glucocorticoids, which cause a Cushing syndrome phenotype; the confusion caused by nonpathologic hypercortisolism not associated with Cushing syndrome, which may present with symptoms consistent with Cushing syndrome; and difficulty identifying pathologic hypercortisolism when it is extremely mild or cyclic or in renal failure, incidental adrenal masses, and pregnancy...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29749880/adrenal-insufficiency-due-to-ritonavir-triamcinolone-drug-drug-interaction-without-preceding-cushing-s-syndrome
#17
S Noe, H Jaeger, S Heldwein
We present the case of a 58-year-old HIV-infected patient with adrenal insufficiency after local injection of triamcinolone, most likely due to drug-drug interaction with his ritonavir-boosted antiretroviral therapy (ART). This is the first case of adrenal insufficiency occurring without prior symptoms of Cushing's syndrome in a patient on a booster-containing ART. We want to draw attention to this seemingly rare, but potentially life-threatening medical condition that can occur even in short-term use of glucocorticoids in low doses in patients on booster-containing ART and summarize some considerations for management...
January 1, 2018: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/29746308/structural-brain-abnormalities-in-cushing-s-syndrome
#18
Stephanie E E C Bauduin, Nic J A van der Wee, Steven J A van der Werff
PURPOSE OF REVIEW: Alongside various physical symptoms, patients with Cushing's disease and Cushing's syndrome display a wide variety of neuropsychiatric and cognitive symptoms, which are indicative of involvement of the central nervous system. The aim of this review is to provide an overview of the structural brain abnormalities that are associated with Cushing's disease and Cushing's syndrome and their relation to behavioral and cognitive symptomatology. RECENT FINDINGS: In this review, we discuss the gray matter structural abnormalities found in patients with active Cushing's disease and Cushing's syndrome, the reversibility and persistence of these changes and the white matter structural changes related to Cushing's syndrome...
May 8, 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29744071/etomidate-in-the-control-of-severe-cushing-s-syndrome-by-neuroendocrine-carcinoma
#19
Alfredo Adolfo Reza-Albarrán, Gerson Geovany Andino Ríos, Laura Gabriela Gómez Herrera
Etomidate is a very effective drug in severe Cushing's syndrome that is refractory to ketoconazol. Control of the serum cortisol levels in ectopic Cushing's syndrome can be obtained with infusion rates much lower than those used in anesthesia, without respiratory side effects.
May 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29738970/a-novel-derivatives-of-thiazol-4-5h-one-and-their-activity-in-the-inhibition-of-11%C3%AE-hydroxysteroid-dehydrogenase-type-1
#20
Renata Studzińska, Renata Kołodziejska, Daria Kupczyk, Wojciech Płaziński, Tomasz Kosmalski
11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) is an enzyme that catalyzes the conversion of inactive cortisone into physiologically active cortisol. Inhibiting the activity of this enzyme plays a key role in the treatment of Cushing's syndrome, metabolic syndrome and type 2 diabetes. Therefore, new compounds that are selective inhibitors of this enzyme are constantly being looked for. In this work we present the synthesis of 2-(allylamino)thiazol-4(5H)-one derivatives by the reaction of N-allylthiourea with appropriate α-bromoesters...
April 30, 2018: Bioorganic Chemistry
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