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"Adrenal Insufficiency"

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https://www.readbyqxmd.com/read/29147134/the-clinical-course-after-glucocorticoid-treatment-in-patients-with-inflammatory-bowel-disease-is-linked-to-suppression-of-the-hypothalamic-pituitary-adrenal-axis-a-retrospective-observational-study
#1
Aghil Ibrahim, Per Dahlqvist, Tommy Olsson, David Lundgren, Mårten Werner, Ole B Suhr, Pontus Karling
Background: Adrenal insufficiency (AI) secondary to treatment with glucocorticoids (GCs) is common in patients with inflammatory bowel disease (IBD), but little is known about the relationship between AI and the clinical course in IBD. The aim of the study was to compare the clinical course in IBD patients with normal adrenal function versus patients with subnormal adrenal function. Methods: A retrospective observational study on 63 patients with IBD who had performed a low-dose short Synacthen test (LDSST) (1 μg) immediately (1-7 days) after a standard course of GCs...
November 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29146725/rare-cause-of-adrenal-insufficiency
#2
Justin Ws Hii, Michael M Page, Andrew Wesseldine
A 72-year-old man presented with weight loss, night sweats and haemoptysis and was hypotensive. CT imaging showed rapidly enlarging bilateral adrenal masses, and he was found to have primary adrenal insufficiency. An adrenal gland biopsy revealed the rare diagnosis of primary adrenal lymphoma. This unique case highlights possible rare causes of adrenal masses and adrenal insufficiency, their investigation and management principles.
November 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29137961/adrenal-insufficiency-in-critical-patients-new-ethiopathogenic-concepts-and-therapeutic-implications
#3
Laura Mateos Moreno, Nuria Palacios García, Francisco Javier Estrada García
Recently, there have been advances in understanding of the changes that occur in the hypothalamic-pituitary-adrenal axis during the different stages of critical disease. Such advances have led to a paradigm change, so that the aforementioned adaptations are no longer considered the result of adrenal axis activation, but a consequence of decreased cortisol metabolism illness. Knowledge of this new pathophysiological bases should lead to reconsider the diagnosis and treatment of adrenal insufficiency in critically ill patients, a condition poorly understood to date...
November 11, 2017: Endocrinología, diabetes y nutrición
https://www.readbyqxmd.com/read/29129244/the-risk-for-hypoglycemia-during-ramadan-fasting-in-patients-with-adrenal-insufficiency
#4
Melika Chihaoui, Wafa Grira, Jihene Bettaieb, Meriem Yazidi, Fatma Chaker, Ons Rejeb, Ibtissem Oueslati, Moncef Feki, Naziha Kaabachi, Hedia Slimane
OBJECTIVES: The risk for hypoglycemia during Ramadan fasting in patients with adrenal insufficiency (AI) is not fully known. The aims of this study were to evaluate this risk objectively and to determine the associated factors. METHODS: This prospective case-crossover study included 25 women and 5 men with known and treated AI and a median age of 38.5 y. Patients underwent clinical examination and a fasting blood sample was collected to measure glucose, urea, creatinine, sodium, potassium, cortisol, growth hormone and free thyroxine...
January 2018: Nutrition
https://www.readbyqxmd.com/read/29127765/high-aldosterone-and-cortisol-levels-in-salt-wasting-congenital-adrenal-hyperplasia-a-clinical-conundrum
#5
Sirisha Kusuma Boddu, Sheeja Madhavan
BACKGROUND: Salt wasting syndrome (hyponatremia, hyperkalemia, dehydration, metabolic acidosis) in early infancy could be caused by either mineralocorticoid deficiency as in congenital adrenal hyperplasia (CAH) and adrenal insufficiency or mineralocorticoid resistance as in pseudohypoaldosteronism (PHA). In salt wasting CAH, serum aldosterone and cortisol levels are expected to be low. Cross reactivity between high levels of adrenal steroid precursors and aldosterone has recently been reported resulting in elevated aldosterone levels in CAH, leading to difficulty in differentiating between CAH and PHA...
November 11, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29125476/adrenalectomy-was-recommended-for-patients-with-subclinical-cushing-s-syndrome-due-to-adrenal-incidentaloma
#6
Dong Wang, Zhi-Gang Ji, Han-Zhong Li, Yu-Shi Zhang
OBJECTIVE: To assess whether adrenalectomy may improve biochemical and metabolic impairment for patients with subclinical Cushing syndrome (SCS) due to adrenal incidentaloma (AI) compared with conservative management. METHODS: A total of 87 patients with SCS due to AI in Peking Union Medical College Hospital between September 2011 and January 2016 have been treated. Forty-eight patients underwent laparoscopic adrenalectomy (operative group), whereas 39 were managed conservatively (control group)...
October 31, 2017: Cancer Biomarkers: Section A of Disease Markers
https://www.readbyqxmd.com/read/29121431/outcomes-of-oral-lichen-planus-and-oral-lichenoid-lesions-treated-with-topical-corticosteroid
#7
M A Gonzalez-Moles, J A Gil-Montoya, L Gonzalez-Ruiz, P Ramos, M Bravo
OBJECTIVE: To determine corticosteroid treatment effectiveness in patients with Oral Lichen Planus/Oral Lichenoid Lesions (OLP/OLL). MATERIAL AND METHODS: Twenty-one OLP and eighty-one OLL patients received 0.05% clobetasol propionate (CP) or 0.05% triamcinolone acetonide (TA) in aqueous solution (AS) or orabase (OB), evaluating responses to treatment and follow-up compliance. RESULTS: Lesions were atrophic (72/102; 70.6%), extensive (58/100; 58%), producing eating difficulties (62/102; 60...
November 9, 2017: Oral Diseases
https://www.readbyqxmd.com/read/29119207/anesthesia-in-a%C3%A2-child-with-suspected-peroxisomal-disorder
#8
J S Englbrecht, M Maas
We present the case of an 8‑year-old female child with suspected peroxisomal disorder requiring general anesthesia for adenotomy, paracentesis and brainstem-evoked response audiometry. Peroxisomes are small intracellular organelles that catalyse key metabolic reactions. Peroxisomal disorders are a heterogeneous group of rare genetic diseases. Anesthesia can be challenging as adrenal insufficiency, mental retardation, muscle weakness, risk of pulmonary aspiration, airway complications, seizure disorders and altered pharmacokinetics and pharmacodynamics can occur in these patients but guidelines for anesthesia do not exist due to the heterogeneity and rarity of these diseases and case reports are rare...
November 8, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29118985/acute-development-of-cushing-syndrome-in-an-hiv-infected-child-on-atazanavir-ritonavir-based-antiretroviral-therapy
#9
Gueorgui Dubrocq, Andrea Estrada, Shannon Kelly, Natella Rakhmanina
An 11-year-old male with perinatally acquired human immune deficiency virus (HIV) infection on antiretroviral regimen, which included abacavir plus lamivudine (Epzicom), didanosine, ritonavir and atazanavir presented with bilateral axillary striae, increased appetite, fatigue, facial swelling and acute weight gain. Two months prior to presentation, the patient had received a diagnostic and therapeutic intra-articular triamcinolone injection in the knee for pain relief and subsequently became progressively swollen in the face, developed striae bilaterally at the axillae, experienced increased appetite, fatigue and an 8 pound weight gain...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29116030/management-of-x-linked-adrenoleukodystrophy-in-morocco-actual-situation
#10
F Z Madani Benjelloun, Y Kriouile, D Cheillan, H Daoud-Tetouani, L Chabraoui
OBJECTIVES: X-linked adrenoleukodystrophy is a neurodegenerative disorder caused by mutations in the ABCD1 gene. Adrenomyeloneuropathy and childhood cerebral Adrenoleukodystrophy are the most common phenotypes. This paper focuses on a descriptive study of the first program of diagnosis, treatment, and follow-up of this disease in Morocco. RESULTS: We developed three protocols of X-linked Adrenoleukodystrophy management: general protocol, asymptomatic protocol, and heterozygous protocol...
November 7, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29109870/acute-onset-panhypopituitarism-nearly-missed-by-initial-cosyntropin-testing
#11
Claudine A Blum, Daniel Schneeberger, Matthias Lang, Janko Rakic, Marc Philippe Michot, Beat Müller
Introduction: Diagnosis of adrenal crisis and panhypopituitarism in patients with septic shock is difficult but crucial for outcome. Case: A 66-year-old woman with metastasized breast cancer presented to the ED with respiratory insufficiency and septic shock after a 2-day history of the flu. After transfer to the ICU, corticosteroids were started in addition to antibiotics, as the patient was vasopressor-nonresponsive. Diabetes insipidus was diagnosed due to polyuria and treated with 4 mg desmopressin...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29108822/the-immunobiology-and-clinical-features-of-type-1-autoimmune-polyglandular-syndrome-aps-1
#12
REVIEW
Can-Jie Guo, Patrick S C Leung, Weici Zhang, Xiong Ma, M Eric Gershwin
Autoimmune Polyglandular Syndrome type 1 (APS-1) is a subtype of the autoimmune polyendocrine syndrome characterized by the simultaneous or sequential dysfunction of multiple endocrine or non-endocrine glands. A clinical diagnosis of APS-1 is typically based on the presence of at least two of three following criteria: chronic mucocutaneous candidiasis, hypoparathyroidism and adrenal insufficiency. The first identified causative mutated gene for APS-1 is autoimmune regulator (AIRE) encoding a critical transcription factor, which is primarily expressed in the medullary thymic epithelial cells (mTECs) for generating central immune tolerance...
November 3, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29106702/hypothalamic-pituitary-adrenal-hpa-axis-suppression-after-treatment-with-glucocorticoid-therapy-for-childhood-acute-lymphoblastic-leukaemia
#13
REVIEW
Niki Rensen, Reinoud Jbj Gemke, Elvira C van Dalen, Joost Rotteveel, Gertjan Jl Kaspers
BACKGROUND: Glucocorticoids play a major role in the treatment of acute lymphoblastic leukaemia (ALL). However, supraphysiological doses can suppress the hypothalamic-pituitary-adrenal (HPA) axis. HPA axis suppression resulting in reduced cortisol response may cause an impaired stress response and an inadequate host defence against infection, which remain a cause of morbidity and death. Suppression commonly occurs in the first days after cessation of glucocorticoid therapy, but the exact duration is unclear...
November 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29097858/serum-cortisol-level-in-indian-patients-with-severe-sepsis-septic-shock
#14
Ragavendra Suresh, Naveet Wig, Prasan Kumar Panda, V P Jyotsna, P K Chaturvedi, R M Pandey
Background: The relationship between cortisol level and sepsis is not known in Indian patients of severe sepsis/septic shock. Aims: The study was done to determine the optimal range of cortisol levels, defining the adrenocortical response, and predicting the mortality, if possible, in the above type of patients. Settings and Designs: The study was a single-centered prospective cohort study, conducted in a tertiary referral center, North India...
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29093678/immune-related-adverse-events-associated-with-anti-pd-1-pd-l1-treatment-for-malignancies-a-meta-analysis
#15
Peng-Fei Wang, Yang Chen, Si-Ying Song, Ting-Jian Wang, Wen-Jun Ji, Shou-Wei Li, Ning Liu, Chang-Xiang Yan
Background: Treatment of cancers with programmed cell death protein 1 (PD-1) pathway inhibitors can lead to immune-related adverse events (irAEs), which could be serious and even fetal. Therefore, clinicians should be aware of the characteristics of irAEs associated with the use of such drugs. Methods: The MEDLINE, EMBASE, and Cochrane databases were searched to find potential studies using the following strategies: anti-PD-1/PD-L1 treatment; irAEs; and cancer. R© package Meta was used to pool incidence. Results: Forty-six studies representing 12,808 oncologic patients treated with anti-PD-1/PD-L1 agents were included in the meta-analysis...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29089364/primary-adrenal-insufficiency-in-adult-population-a-portuguese-multicentre-study-by-the-adrenal-tumours-study-group
#16
Lia Ferreira, Joao Silva, Susana Garrido, Carlos Bello, Diana Oliveira, Hélder Simões, Isabel Paiva, Joana Guimarães, Marta Ferreira, Maria Teresa Pereira, Rita Bettencourt-Silva, Ana Filipa Martins, Tiago Silva, Vera Fernandes, Maria Ferreira
INTRODUCTION: Primary adrenal insufficiency (PAI) is a rare but severe and potentially life-threatening condition. No previous studies have characterized Portuguese patients with PAI. AIMS: To characterize the clinical presentation, diagnostic workup, treatment and follow-up of Portuguese patients with confirmed PAI. METHODS: This multicentre retrospective study examined PAI patients in 12 Portuguese hospitals. RESULTS: We investigated 278 patients with PAI (55...
October 31, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/29089175/comparison-of-c26-0-carnitine-and-c26-0-lysophosphatidylcholine-as-diagnostic-markers-in-dried-blood-spots-from-newborns-and-patients-with-adrenoleukodystrophy
#17
Irene C Huffnagel, Malu-Clair van de Beek, Amanda L Showers, Joseph J Orsini, Femke C C Klouwer, Inge M E Dijkstra, Peter C Schielen, Henk van Lenthe, Ronald J A Wanders, Frédéric M Vaz, Mark A Morrissey, Marc Engelen, Stephan Kemp
X-linked adrenoleukodystrophy (ALD) is the most common leukodystrophy with a birth incidence of 1:14,700 live births. The disease is caused by mutations in ABCD1 and characterized by very long-chain fatty acids (VLCFA) accumulation. In childhood, male patients are at high-risk to develop adrenal insufficiency and/or cerebral demyelination. Timely diagnosis is essential. Untreated adrenal insufficiency can be life-threatening and hematopoietic stem cell transplantation is curative for cerebral ALD provided the procedure is performed in an early stage of the disease...
October 28, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/29076676/adrenal-insufficiency-in-pakistani-hiv-infected-patients
#18
Bahjat Afreen, Khurshid Ahmed Khan, Amna Riaz
BACKGROUND: Adrenal insufficiency (AI) is the most common endocrine complication among patients with AIDS/HIV infection and there are number of causes of AI in HIV patients. Human immunodeficiency virus directly as well as indirectly destroys adrenal glands. The estimates of its prevalence and severity vary. AI is the most life threatening but readily correctable endocrine complication that occurs in persons with HIV infection. This study was carried out to determine the frequency of Adrenal Insufficiency in HIV patients and their clinical features as proper diagnosis and timely treatment have been shown to improve quality of life and long-term mortality in AIDS patients...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29067249/serum-dehydroepiandrosterone-sulfate-in-assessing-the-integrity-of-the-hypothalamic-pituitary-adrenal-axis
#19
Suranut Charoensri, Laor Chailurkit, Dittapol Muntham, Pongamorn Bunnag
OBJECTIVE: To evaluate the relationship between age- and gender-adjusted dehydroepiandrosterone sulfate (DHEA-S) levels and low-dose adrenocorticotropic hormone (ACTH) stimulation in assessing the integrity of the hypothalamic-pituitary-adrenal (HPA) axis, in patients who were at risk of HPA insufficiency, including those currently being treated with glucocorticoids. METHODS: Forty-six participants with a suspicion of secondary adrenal insufficiency were recruited from the Diabetes and Endocrinology Clinic at Ramathibodi Hospital, Mahidol University, Bangkok...
March 2017: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29067215/nivolumab-induced-hypothyroidism-and-selective-pituitary-insufficiency-in-a-patient-with-lung-adenocarcinoma-a-case-report-and-review-of-the-literature
#20
Myrto Kastrisiou, Fereniki-Lida Kostadima, Aristides Kefas, George Zarkavelis, Nikos Kapodistrias, Evangelos Ntouvelis, Dimitrios Petrakis, Alexandra Papadaki, Amalia Vassou, George Pentheroudakis
Immune checkpoint blockade including programmed cell death 1 pathway inhibition with agents such as nivolumab is gaining ground in a wide array of malignancies, so far demonstrating significantly improved survival rates even in metastatic, often multiply pretreated settings. Although targeted in nature and generally well-tolerated compared with conventional anticancer treatments, these agents are often linked to a newly emerged group of adverse reactions, referred to as immune-related adverse events, which can also affect endocrine organs...
2017: ESMO Open
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