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Diagnosis of Cushing

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https://www.readbyqxmd.com/read/29034650/a-complicated-case-of-resistant-hypertension
#1
Mauro Chiarito, Andrea Scotti, Carlo A Pivato, Giuseppe Cottone, Carlo Ballarotto, Cosmo Godino, Alberto Margonato
A 47-year-old woman presented with a history of resistant arterial hypertension, associated with disabling headache. She was subjected to an enormous number of tests in order to identify an underlying cause of secondary hypertension, such as pheochromocytoma or Cushing syndrome, but all the most common causes of secondary hypertension were investigated and gradually excluded. Factitious use of amphetamine or cocaine was excluded, and therapy compliance was verified by witnessed ingestion of drug therapy, in order to rule out Munchausen syndrome...
August 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29032459/predictors-of-silent-corticotroph-adenoma-recurrence-a-large-retrospective-single-center-study-and-systematic-literature-review
#2
Fabienne Langlois, Dawn Shao Ting Lim, Chris G Yedinak, Isabelle Cetas, Shirley McCartney, Justin Cetas, Aclan Dogan, Maria Fleseriu
PURPOSE: Silent corticotroph adenomas (SCAs) are clinically silent and non-secreting, but exhibit positive adrenocorticotropic hormone (ACTH) immunostaining. We characterized a single center cohort of SCA patients, compared the SCAs to silent gonadotroph adenomas (SGAs), identified predictors of recurrence, and reviewed and compared the cohort to previously published SCAs cases. METHODS: Retrospective review of SCA and SGA surgically resected patients over 10 years and 6 years, respectively...
October 14, 2017: Pituitary
https://www.readbyqxmd.com/read/29032119/a-systematic-review-of-safety-and-efficacy-of-systemic-corticosteroids-in-atopic-dermatitis
#3
Sherry Yu, Aaron M Drucker, Mark Lebwohl, Jonathan I Silverberg
BACKGROUND: Systemic corticosteroids are often used to treat atopic dermatitis (AD). However, few studies assessed the safety and efficacy of systemic corticosteroids in AD. OBJECTIVE: To systematically review the literature on efficacy and safety of systemic corticosteroid use (oral, intramuscular, intravenous) in AD. METHODS: PubMed, Embase, Medline, Scopus, Web of Science, and Cochrane Library were searched. We included systematic reviews, guidelines and treatment reviews of systemic corticosteroid use among patients of all ages with a diagnosis of AD (52 reviews and 12 studies)...
October 12, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29027854/long-term-outcomes-of-tissue-based-acth-antibody-assay-guided-transsphenoidal-resection-of-pituitary-adenomas-in-cushing-disease
#4
J Mark Erfe, Avital Perry, John McClaskey, Silvio E Inzucchi, Whitney Sheen James, Tore Eid, Richard A Bronen, Amit Mahajan, Anita Huttner, Florecita Santos, Dennis Spencer
OBJECTIVE Cushing disease is caused by a pituitary micro- or macroadenoma that hypersecretes adrenocorticotropic hormone (ACTH), resulting in hypercortisolemia. For decades, transsphenoidal resection (TSR) has been an efficacious treatment but with certain limitations, namely precise tumor localization and complete excision. The authors evaluated the novel use of a double-antibody sandwich assay for the real-time quantitation of ACTH in resected pituitary specimens with the goals of augmenting pathological diagnosis and ultimately improving long-term patient outcome...
October 13, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28994151/negative-hepatic-computed-tomographic-attenuation-pattern-in-a-dog-with-vacuolar-hepatopathy-and-hepatic-fat-accumulation-secondary-to-cushing-s-syndrome
#5
Andrea Carloni, Michaela Paninarova, Damiano Cavina, Mariarita Romanucci, Leonardo Della Salda, Simone Teodori, Massimo Vignoli
This report describes an unusual computed tomographic (CT) hepatic pattern, characterized by negative attenuation values (from -19.59 to -28.85 Hounsfield Units, HU) in a canine patient with severe Cushing's syndrome. Attenuation values of the splenic parenchyma (63.26 HU) and abdominal fat (-118.34 HU) were within normal limits. The negative hepatic attenuation values allowed a CT diagnosis of severe hepatic fatty infiltration that was subsequently confirmed by tissue-core biopsy and histopathological examination...
October 9, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28982703/somatic-usp8-mutations-are-frequent-events-in-corticotroph-tumor-progression-causing-nelson-s-tumor
#6
Luis G Perez-Rivas, Marily Theodoropoulou, Troy H Puar, Julia Fazel, Mareike R Stieg, Francesco Ferrau, Guillaume Assie, Monica R Gadelha, Timo Deutschbein, Maria C Fragoso, Benno Kusters, Wolfgang Saeger, Juergen Honegger, Michael Buchfelder, Marta Korbonits, Jerome Bertherat, Gunter K Stalla, Ad Hermus, Felix Beuschlein, Martin Reincke
Objective Somatic mutations in the ubiquitin-specific protease 8 (USP8) gene are frequent in corticotroph tumors causing Cushing's disease. Corticotroph tumor progression, the so-called Nelson's syndrome, is a potentially life-threatening complication of bilateral adrenalectomy in patients with refractory Cushing's disease that is caused by the development of an ACTH-secreting tumor of the pituitary gland. Whether USP8 alterations are also present in progressive Nelson's tumors has not been studied in detail so far...
October 5, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28981236/-adrenal-disease-diagnosis-management-of-adrenal-incidentaloma
#7
A S Azzi, N Driessens
Adrenal glands are specialized in biosynthesis of several hormones correlated to different clinical phenotypes in case of excess or lack of production. In addition to secretion disorders, tumors, secreting or not, can take place in adrenal glands. Incidentalomas are the most common adrenal diseases in clinical practice. The challenge of the management is to determine whether the lesion is benign or malignant and secreting or not in order to direct therapeutic management towards surgical option, pharmacotherapy or clinical follow-up...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28951275/diagnosis-and-outcomes-of-341-patients-with-cushing-s-disease-following-transsphenoid-surgery-a-single-center-experience
#8
Ming Feng, Ziyuan Liu, Xiaohai Liu, Xinjie Bao, Yong Yao, Kan Deng, Bing Xing, Wei Lian, Huijuan Zhu, Lin Lu, Renzhi Wang
OBJECTIVE: Transsphenoid surgery (TSS) is a standard treatment modality for Cushing's disease (CD). However, postoperative remission and recurrence rates vary among studies. Here we analyze the diagnosis and outcomes of 341 patients with preoperative diagnosis of CD undergoing TSS in a single center over 3 years. PATIENTS AND METHODS: 341 patients were enrolled. Clinical manifestations, imaging, laboratory workups, results of inferior petrosal sinus sampling (IPSS) were obtained...
September 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28938458/corticotroph-pituitary-carcinoma-in-a-patient-with-lynch-syndrome-ls-and-pituitary-tumors-in-a-nationwide-ls-cohort
#9
Daniel Bengtsson, Patrick Joost, Christos Aravidis, Marie Askmalm Stenmark, Ann-Sofie Backman, Beatrice Melin, Jenny von Salomé, Theofanis Zagoras, Samuel Gebre-Medhin, Pia Burman
Context: Lynch syndrome is a cancer predisposing syndrome caused by germline mutations in genes involved in DNA mismatch repair (MMR). Patients are at high risk for several types of cancer, but pituitary tumors have not previously been reported. Case: A 51-year old man with LS (MSH2 mutation) and a history of colon carcinoma presented with severe Cushing's disease and a locally aggressive pituitary tumor. The tumor harbored a mutation consistent with the patient's germline mutation, and displayed defect MMR function...
August 18, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28937294/hypertensive-crisis-in-pregnancy-due-to-a-metamorphosing-pheochromocytoma-with-postdelivery-cushing-s-syndrome
#10
Katharina Langton, Matthias Gruber, Jimmy Masjkur, Charlotte Steenblock, Mirko Peitzsch, Jörn Meinel, Jacques Lenders, Stefan Bornstein, Graeme Eisenhofer
Pheochromocytomas in pregnancy are rare but potentially lethal. Even rarer is the combination of pheochromocytoma in pregnancy with subsequent development of ectopic Cushing's syndrome. We report a 36-year-old woman, previously diagnosed with essential hypertension, who developed severe hypertension in pregnancy complicated by insulin-dependent gestational diabetes. A cesarean section was performed at 32 weeks following a hypertensive crisis after routine administration of betamethasone. Postnatal persistence of signs and symptoms of catecholamine excess led to the diagnosis of a left adrenal pheochromocytoma...
September 22, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28910955/-the-localization-diagnosis-of-patients-with-adrenocorticotropic-hormone-dependent-cushing-s-syndrome-in-adolescence
#11
S Chen, Z X Pan, L Lu, A L Tong, H Pan, H J Zhu, Y Yao, M Feng, R Z Wang, Z L Lu
Objective: To elucidate the clinical characteristics and localization diagnosis of patients with adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS) in adolescence. Methods: The clinical data, laboratory examination and localization diagnosis from 35 patients aged less than 18 years old with adolescent CS who were treated at Peking Union Medical College Hospital between January 1990 and March 2012 were analyzed. Results: There were 29 cases of Cushing's disease (CD) and 6 cases of ectopic ACTH syndrome (EAS)...
September 12, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28906379/accessory-ovarian-steroid-cell-tumor-producing-testosterone-and-cortisol-a-case-report
#12
Li Zang, Mingxia Ye, Guoqing Yang, Jinlong Li, Mei Liu, Jin Du, Weijun Gu, Nan Jin, Lijuan Yang, Jianming Ba, Jingtao Dou, Wensheng Fan, Yiming Mu, Yuanguang Meng, Zhaohui Lyu
RATIONALE: An accessory ovary is a rare structure containing normal ovarian tissue, which has a direct or ligamentous connection with a normal and eutopic ovary. PATIENT CONCERNS: In the study, we reported a 46-year-old woman presented with secondary amenorrhea and virilization symptoms for 1 year. DIAGNOSES: Endocrine evaluation revealed slightly elevated serum cortisol, extremely elevated 24-hour urinary-free cortisol and serum testosterone...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28895465/paraneoplastic-cushing-syndrome-case-series-and-review-of-the-literature
#13
Annelies Deldycke, Christel Haenebalcke, Youri Taes
OBJECTIVES: Paraneoplastic Cushing syndrome is a rare condition, representing a small fraction of the adrenocorticotropic hormone (ACTH)-dependent cases of Cushing syndrome Methods: Four case descriptions and literature review, highlighting the diagnostic challenges and treatment options are presented. RESULTS: Different tumor types can be associated with ectopic ACTH secretion. The most common types are bronchial carcinoids and small cell lung carcinoma (SCLC)...
September 12, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28887280/transsphenoidal-surgery-for-mixed-pituitary-gangliocytoma-adenomas
#14
Matthew J Shepard, Mohamed A Elzoghby, Daffer Ghanim, M Beatriz S Lopes, John A Jane
OBJECTIVE: Most sellar gangliocytomas are discovered with a concurrent pituitary adenoma, also known as a mixed gangliocytoma-adenoma (MGA). MGAs are rare with less than 100 cases reported in the literature and only one previously documented surgical series. As MGAs are radiologically indistinguishable from pituitary adenomas, their diagnosis is often made following surgery. This, combined with the paucity of clinical outcome data for these tumors, makes their diagnosis and management challenging...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28880607/mind-body-therapy-for-military-veterans-with-post-traumatic-stress-disorder-a-systematic-review
#15
Robin E Cushing, Kathryn L Braun
OBJECTIVE: About a third of service members returning from post-9/11 deployment in Afghanistan and Iraq report combat-related mental health conditions, but many do not seek conventional treatment. Mind-body therapies have been offered as alternative approaches to decreasing post-traumatic stress disorder (PTSD), but no review of studies with veterans of post-9/11 operations was found. The objective of this study was to fill that gap. DESIGN: A systematic literature review was conducted following the preferred items for systematic reviews and meta-analyses (PRISMA) guidelines...
September 7, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28879648/is-there-any-difference-in-acromegaly-and-other-chronic-disease-in-quality-of-life-and-psychiatric-morbidity
#16
Dorota Maria Szcześniak, Aleksandra Jawiarczyk-Przybyłowska, Łukasz Matusiak, Anna Bolanowska, Julian Maciaszek, Małgorzata Siemińska, Joanna Rymaszewska, Marek Bolanowski
INTRODUCTION: The study aimed to evaluate the psychological profile of patients with acromegaly in comparison to other chronic diseases such as non-functioning pituitary adenomas, Cushing disease, plaque psoriasis, and to the healthy control group. MATERIALS AND METHODS: A total sample of 153 participants in clinical groups underwent a cross-sectional assessment including the quality of life (AcroQoL, WHOQoL-BREF), psychiatric morbidity (GHQ-28) and the acceptance of illness (AIS) and 65 participants in the healthy control group...
September 7, 2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28877721/a-case-of-adrenocoricotrophic-hormone-independent-bilateral-adrenocortical-macronodular-hyperplasia-concomitant-with-primary-aldosteronism
#17
Mao Tokumoto, Naoyoshi Onoda, Yukie Tauchi, Shinichiro Kashiwagi, Satoru Noda, Norikazu Toi, Masahumi Kurajoh, Masahiko Ohsawa, Yuto Yamazaki, Hironobu Sasano, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: Adrenocoricotrophic hormone (ACTH) - independent bilateral adrenocortical macronodular hyperplasia (AIMAH) is a rare cause of Cushing's syndrome, and is characterized by bilateral adrenal hyperplasia. However, Primary aldosteronism (PA) is a relatively common adrenal disease. CASE PRESENTATION: A 56-year-old man who has been treated hypertension and diabetes mellitus was detected low plasma potassium level with an elevated level of plasma aldosterone concentration and bilateral adrenal swelling...
September 6, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28874240/-review-of-online-prescriptions-of-topical-steroids-for-an-obese-boy-with-iatrogenic-cushing-s-syndrome
#18
Sina Dalby, Inge Østergaard
A 14-year-old boy with obesity developed iatrogenic Cushing's syndrome after having received topical steroid therapy for psoriasis. The diagnosis was suspected when he developed striae, moon face and stunted growth. A review of the Danish online registration of prescriptions: Shared Medicine Card, revealed that an amount of 5.1 kg topical steroids had been prescribed during a period of twelve months. Blood tests showed stunted cortisol release. Primary obesity in children is associated with increased growth...
August 28, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28871375/walter-e-dandy-his-contributions-to-pituitary-surgery-in-the-context-of-the-overall-johns-hopkins-hospital-experience
#19
Andrea Corsello, Giulia Di Dalmazi, Fabiana Pani, Paulina Chalan, Roberto Salvatori, Patrizio Caturegli
BACKGROUND: Walter E. Dandy (1886-1946) was an outstanding neurosurgeon who spent his entire career at the Johns Hopkins Hospital. After graduating from medical school in 1910, he completed a research fellowship in the Hunterian laboratory with Harvey Cushing and then joined the Department of Surgery as resident, rising to the rank professor in 1931. Dandy made several contributions that helped building the neurosurgical specialty, most famously the introduction of pneumo-ventriculography to image brain lesions for which he received a Nobel prize nomination...
September 4, 2017: Pituitary
https://www.readbyqxmd.com/read/28870984/optimal-follow-up-strategies-for-adrenal-incidentalomas-reappraisal-of-the-2016-ese-ensat-guidelines-in-real-clinical-practice
#20
A Ram Hong, Jung Hee Kim, Kyeong Seon Park, Kyong Young Kim, Ji Hyun Lee, Sung Hye Kong, Seo Young Lee, Chan Soo Shin, Sang Wan Kim, Seong-Yeon Kim
OBJECTIVE: Recently, the European Society of Endocrinology (ESE), in collaboration with the European Network for the Study of Adrenal Tumors (ENSAT), asserted that adrenal incidentalomas (AIs) <4 cm and ≤10 Hounsfield units (HU) do not require further follow-up imaging. In order to validate the clinical application of the follow-up strategies suggested by the 2016 ESE-ENSAT guidelines, we explored the clinical characteristics and natural course of AIs in a single center over 13 years...
September 4, 2017: European Journal of Endocrinology
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