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Diagnosis of Cushing

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https://www.readbyqxmd.com/read/29927501/children-with-men1-gene-mutations-may-present-first-and-at-a-young-age-with-cushing-disease
#1
Angeliki Makri, Maria Belen Bonella, Margaret F Keil, Laura Hernandez-Ramirez, Gabriella Paluch, Amit Tirosh, Carolina Saldarriaga, Prashant Chitiboina, Stephen J Marx, Constantine A Stratakis, Maya Lodish
OBJECTIVE: Cushing disease (CD) is a rare entity caused by ACTH-secreting pituitary tumors, leading to prolonged hypercortisolism. Most cases are sporadic but can rarely occur in the context of familial predisposition, due to germline mutations in genes such as MEN1, leading to multiple endocrine neoplasia type 1, MEN1. We have reported previously that CD can be the first and only presenting manifestation of MEN1. In this report, we describe a cohort of pediatric patients who presented with CD as the first manifestation of MEN1...
June 21, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29925743/tsh-ratio-as-a-novel-diagnostic-method-for-cushing-s-syndrome
#2
Daisuke Tamada, Tetsuhiro Kitamura, Mitsuyoshi Takahara, Toshihisa Tanaka, Masatoshi Takeda, Michio Otsuki, Iichiro Shimomura
Circadian variations impact thyrotropin (TSH) secretion; in Cushing's syndrome (CS) patients, the nocturnal serum TSH surge is abolished. The aim of this prospective study is to examine whether serum TSH surge may be a useful diagnostic method for CS. This prospective study recruited 136 inpatients for differential diagnosis of CS or subclinical CS (SCS), and 21 inpatients with depression at Osaka University Hospital. Serum TSH surge was assessed by the midnight-to-morning serum TSH ratio (2300-2400 h to 0800-0900 h)...
June 19, 2018: Endocrine Journal
https://www.readbyqxmd.com/read/29909407/familial-forms-of-cushing-syndrome-in-primary-pigmented-nodular-adrenocortical-disease-presenting-with-short-stature-and-insidious-symptoms-a-clinical-series
#3
Constanza Navarro Moreno, Amaury Delestienne, Etienne Marbaix, Selda Aydin, Konstanze Hörtnagel, Sarah Lechner, Yves Sznajer, Véronique Beauloye, Dominique Maiter, Philippe A Lysy
Cushing syndrome (CS) is a rare disease in children, frequently associated with subtle or periodic symptoms that may delay its diagnosis. Weight gain and growth failure, the hallmarks of hypercortisolism in pediatrics, may be inconsistent, especially in ACTH-independent forms of CS. Primary pigmented nodular adrenocortical disease (PPNAD) is the rarest form of ACTH-independent CS, and can be associated with endocrine and nonendocrine tumors, forming the Carney complex (CNC). Recently, phenotype/genotype correlations have been described with particular forms of CNC where PPNAD is isolated or associated only with skin lesions...
June 15, 2018: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/29900762/pituitary-pars-intermedia-dysfunction-equine-cushing-s-disease-in-nondomestic-equids-at-marwell-wildlife-a-case-series-one-chapman-s-zebra-equus-quagga-chapmani-and-five-przewalski-s-horses-equus-ferus-przewalskii
#4
Justine C R Shotton, William S M Justice, Francisco J Salguero, Alan Stevens, Barbara Bacci
  Pituitary pars intermedia dysfunction (PPID), also known as equine Cushing's disease, is widely reported in middle-aged to older domestic equids but to date reported in only one nondomestic equid, the onager ( Equus hemionus onager). This case series reports clinical, hematological, and pathological findings consistent with PPID in two further equid species: one Chapman's zebra ( Equus quagga chapmani) and five Przewalski's horses ( Equus ferus przewalskii). The case series reports basal adrenocorticotropic hormone (ACTH) testing as a method to diagnose and monitor PPID in zoological equids and the use of pergolide mesylate to reduce basal ACTH concentration and reduce clinical signs associated with PPID...
June 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29884527/cushing-s-disease-with-pulmonary-cryptococcus-neoformans-infection-in-a-single-center-in-beijing-china-a-retrospective-study-and-literature-review
#5
Lin Lu, Yu Yue Zhao, Hong Bo Yang, Xin Lun Tian, Zuo Jun Xu, Zhao Lin Lu
BACKGROUND: Patients with Cushing's disease (CD) with hypercortisolism have an increased risk of opportunistic infection. However, most CD patients exposed to infections are diagnostic latency, leading to a poor prognosis. METHODS: Six patients in our hospital and an additional six patients in the literature were included in this study. Clinical information of CD patients with pulmonary Cryptococcus neoformans are reviewed. RESULTS: The average baseline total cortisol and ACTH in serum at 8 am of all the patients was 44...
June 5, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29875286/surviving-ectopic-cushing-s-syndrome-quality-of-life-cardiovascular-and-metabolic-outcomes-in-comparison-to-cushing-s-disease-during-long-term-follow-up
#6
Andrea Osswald, Timo Deutschbein, Christina Maria Berr, Eva Plomer, Anne Mickisch, Katrin Ritzel, Jochen Schopohl, Felix Beuschlein, Martin Fassnacht, Stefanie Hahner, Martin Reincke
OBJECTIVE Aim of our study was to analyze long-term outcome of patients with the ectopic Cushing's syndrome (ECS) compared to patients with Cushing's disease (CD) regarding cardiovascular, metabolic, musculoskeletal and psychiatric co-morbidities. DESIGN Cross-sectional study in patients with ECS and CD in two German academic tertiary-care centers. METHODS Standardized clinical follow-up examination was performed including health-related quality of life (QoL) in 21 ECS patients in long-term remission (≥ 18 months since successful surgery)...
June 6, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29850940/pituitary-adenomas-in-children-and-young-adults
#7
Kara Leigh Krajewski, Roman Rotermund, Jörg Flitsch
PURPOSE: Pituitary adenomas are rare in the pediatric population. We present a recent cohort of children operated transsphenoidally on pituitary adenoma from a single center. METHODS: Inclusion criteria were age < 21 years and histopathological diagnosis of adenoma after transsphenoidal surgery. The electronic file was used for prospective and retrospective data collection on symptoms, pituitary function before/after surgical intervention, and surgical complications...
May 30, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29846662/diverticular-perforation-a-fatal-complication-to-forestall-in-cushing-s-syndrome
#8
Zahraa Abdul Sater, Smita Jha, Raven McGlotten, Iris Hartley, Mustapha El Lakis, Katherine Araque Triana, Lynnette K Nieman
Context: Patients taking exogenous glucocorticoids are at risk of gastrointestinal (GI) complications including peptic ulcer disease with perforation, and gastric bleeding. However, little is known about the GI co-morbidity in patients with endogenous hypercortisolemia. Case descriptions: We describe six patients with endogenous Cushing's Syndrome (CS) who developed sudden perforation of colonic diverticula requiring urgent exploratory laparotomy. Most of these patients shared the following features of Cushing's syndrome: significant skin thinning, severe hypercortisolemia (24-hour urine free cortisol ≥10X the upper limit of normal), ectopic secretion of ACTH, and severe hypokalemia...
May 28, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29799347/detection-of-microbleeds-associated-with-sentinel-headache-using-mri-quantitative-susceptibility-mapping-pilot-study
#9
Daichi Nakagawa, Kohsuke Kudo, Olatilewa Awe, Mario Zanaty, Yasunori Nagahama, Cameron Cushing, Vincent Magnotta, Minako Hayakawa, Lauren Allan, Jeremy Greenlee, Issam A Awad, Timothy Carroll, James Torner, Madhavan L Raghavan, David M Hasan
OBJECT Sentinel headaches (SHs) associated with cerebral aneurysms (CAs) could be due to microbleeds, which are considered a sign that an aneurysm is unstable. Despite the prognostic importance of these microbleeds, they remain difficult to detect using routine imaging studies. The objective of this pilot study is to detect microbleeds associated with SH using a magnetic resonance imaging (MRI) quantitative susceptibility mapping (QSM) sequence and then evaluate the morphological characteristics of unstable aneurysms with microbleeds...
May 25, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29791181/-cyclic-cushings-syndrome-a-case-study-and-overview
#10
Jana Kollerová, Ján Malina, Andrej Šteňo, Pavol Povinec, Juraj Payer
Cushings syndrome and especially Cushing´s disease represent diagnostically and therapeutically complicated medical situations. In some patients, cyclic changes in cortisol production additionally hamper the diagnosis in terms of source identification and management of hormone overproduction. It may not be clear, whether the patient is cured or not even years after the treatment. It is a rare disorder variant, but we assume that it is underdiagnosed and it´s incidence is actually higher. The article deals with a complicated course of diagnosis and treatment in a patient with cyclic Cushings syndrome...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29790808/comparison-of-time-to-engraftment-between-autologous-patients-receiving-washed-versus-non-washed-cryopreserved-peripheral-blood-stem-cell-products
#11
Ronit Reich-Slotky, Sarah S Makhani, Ljiljana V Vasovic, Roger N Pearse, Adriana Rossi, Adrianne Philips, Melissa M Cushing, Amrita D Singh, Koen van-Besien
Washing cryopreserved peripheral blood stem cell (PBSC) products can decrease infusion-related adverse reactions but can also result in cell loss and reduced cell viability. To assess the risk and benefit of washing products, we compared the time to neutrophil and platelet engraftment between autologous patients that received washed products (n = 201) and non-washed products (n = 89). The effect of the other variables, including age, gender, diagnosis, transplant dose, method of stem cell mobilization, and growth factor support regimen post-transplant, was assessed...
May 23, 2018: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/29787319/usefulness-of-multiple-electrode-aggregometry-as-a-screening-tool-for-bleeding-disorders-in-a-pediatric-hospital
#12
Thorsten Haas, Melissa M Cushing, Stephanie Varga, Séverine Gilloz, Markus Schmugge
Platelet function testing is a cornerstone in the diagnostic investigation of patients with a bleeding history. Multiple electrode aggregometry (MEA) has been shown to detect von Willebrand disease (VWD), platelet function disorders, and drug-induced bleeding disorders. However, there are few studies supporting its successful use in children. We have implemented and used MEA over 3 years in our hemostasis laboratory in order to study its usefulness to supplement and expedite diagnosis. This is a retrospective, single-center, cohort study of 109 hospitalized children who underwent a laboratory investigation of hemostasis and either had a reported bleeding history or an abnormal bleeding episode...
May 22, 2018: Platelets
https://www.readbyqxmd.com/read/29757946/role-of-venous-sampling-in-the-diagnosis-of-endocrine-disorders
#13
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/29754643/pregnancy-in-patients-with-cushing-s-syndrome
#14
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/29754641/the-ectopic-adrenocorticotropic-hormone-syndrome-rarely-easy-always-challenging
#15
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/29754634/mortality-in-patients-with-endogenous-cushing-s-syndrome
#16
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/29754631/diagnosis-of-cushing-s-syndrome-in-the-modern-era
#17
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/29749277/correlations-between-clinical-hormone-change-and-pathological-features-of-pituicytoma
#18
Ting-Wei Chang, Ching-Yi Lee, Shih-Ming Jung, Hung-Yi Lai, Chun-Ting Chen, Mun-Chun Yeap, Chi-Cheng Chuang, Peng-Wei Hsu, Chen-Nen Chang, Po-Hsun Tu, Shih-Tseng Lee
PURPOSE: Pituicytoma is a rare low-grade glioma arising from the pituicytes of the posterior pituitary. To date, the clinical and pathological correlates of pituicytoma have not been investigated. This study was thus designed to examine the correlation between pituicytoma and the normal pituitary gland. METHODS: The records of patients who underwent pituitary surgery at Chang Gung Memorial Hospital in Linkou, Taiwan between 2000 and 2016 were reviewed. Patients who received a pathological diagnosis of pituicytoma were included; however, those with inadequate specimens for pathological study were excluded...
May 11, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29748231/management-of-endocrine-disease-differential-diagnosis-investigation-and-therapy-of-bilateral-adrenal-incidentalomas
#19
Isabelle Bourdeau, Nada El Ghorayeb, Nadia Gagnon, Andre Lacroix
The investigation and management of unilateral adrenal incidentalomas have been extensively considered in the last decades. While bilateral adrenal incidentalomas represent about 15 percent of adrenal incidentalomas, they have been less frequently discussed. The differential diagnosis of bilateral incidentalomas includes metastasis, primary bilateral macronodular adrenal hyperplasia (BMAH) and bilateral cortical adenomas. Les frequent etiologies are bilateral pheochromocytomas, congenital adrenal hyperplasia, Cushing's disease or ectopic ACTH secretion with secondary bilateral adrenal hyperplasia, primary malignancies, myelolipomas, infections or hemorrhage...
May 10, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29718305/invasive-epithelial-ovarian-cancer-survival-by-histotype-and-disease-stage
#20
Lauren C Peres, Kara L Cushing-Haugen, Martin Köbel, Holly R Harris, Andrew Berchuck, Mary Anne Rossing, Joellen M Schildkraut, Jennifer A Doherty
Background: The understanding of ovarian cancer pathogenesis has recently shifted to recognize distinct changes in how ovarian cancer histotypes are defined. Using the 2014 World Health Organization (WHO) diagnostic guidelines, we classified ovarian cancer histotypes in Surveillance, Epidemiology, and End Results (SEER) cancer registry data and examined survival patterns by histotype and disease stage. Methods: We extracted data on 28 118 incident epithelial ovarian cancer cases diagnosed in 2004-2014 from SEER and defined histotype using the 2014 WHO guidelines (high-grade serous, low-grade serous, endometrioid, clear cell, mucinous, carcinosarcoma, and malignant Brenner tumors)...
April 28, 2018: Journal of the National Cancer Institute
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