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https://www.readbyqxmd.com/read/28480039/acute-mesenteric-ischemia-and-hepatic-infarction-after-treatment-of-ectopic-cushing-s-syndrome
#1
Shinobu Takayasu, Shingo Murasawa, Satoshi Yamagata, Kazunori Kageyama, Takeshi Nigawara, Yutaka Watanuki, Daisuke Kimura, Takao Tsushima, Yoshiyuki Sakamoto, Kenichi Hakamada, Ken Terui, Makoto Daimon
SUMMARY: Patients with Cushing's syndrome and excess exogenous glucocorticoids have an increased risk for venous thromboembolism, as well as arterial thrombi. The patients are at high risk of thromboembolic events, especially during active disease and even in cases of remission and after surgery in Cushing's syndrome and withdrawal state in glucocorticoid users. We present a case of Cushing's syndrome caused by adrenocorticotropic hormone-secreting lung carcinoid tumor. Our patient developed acute mesenteric ischemia after video-assisted thoracoscopic surgery despite administration of sufficient glucocorticoid and thromboprophylaxis in the perioperative period...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28377460/diagnostic-tests-for-cushing-s-syndrome-differ-from-published-guidelines-data-from-ercusyn
#2
MULTICENTER STUDY
Elena Valassi, Holger Franz, Thierry Brue, Richard A Feelders, Romana Netea-Maier, Stylianos Tsagarakis, Susan M Webb, Maria Yaneva, Martin Reincke, Michael Droste, Irina Komerdus, Dominique Maiter, Darko Kastelan, Philippe Chanson, Marija Pfeifer, Christian J Strasburger, Miklós Tóth, Olivier Chabre, Antoine Tabarin, Michal Krsek, Carmen Fajardo, Marek Bolanowski, Alicia Santos, John A H Wass, Peter J Trainer
OBJECTIVE: To evaluate which tests are performed to diagnose hypercortisolism in patients included in the European Registry on Cushing's syndrome (ERCUSYN), and to examine if their use differs from the current guidelines. PATIENTS AND METHODS: We analyzed data on the diagnostic tests performed in 1341 patients with Cushing's syndrome (CS) who have been entered into the ERCUSYN database between January 1, 2000 and January 31, 2016 from 57 centers in 26 European countries...
May 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28294570/how-does-obesity-affect-the-endocrine-system-a-narrative-review
#3
REVIEW
M Poddar, Y Chetty, V T Chetty
Obesity is a chronic, relapsing medical condition that results from an imbalance of energy expenditure and consumption. It is a leading cause of preventable illness, disability and premature death. The causes of obesity are multifactorial and include behavioural, socioeconomic, genetic, environmental and psychosocial factors. Rarely are endocrine diseases, e.g., hypothyroidism or Cushing's syndrome, the cause of obesity. What is less understood is how obesity affects the endocrine system. In this review, we will discuss the impact of obesity on multiple endocrine systems, including the hypothalamic-pituitary axis, changes in vitamin D homeostasis, gender steroids and thyroid hormones...
March 15, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28275992/follow-up-intervals-in-patients-with-cushing-s-disease-recommendations-from-a-panel-of-experienced-pituitary-clinicians
#4
Eliza B Geer, Alejandro Ayala, Vivien Bonert, John D Carmichael, Murray B Gordon, Laurence Katznelson, Ekaterina Manuylova, Ismat Shafiq, Vijaya Surampudi, Ronald S Swerdloff, Michael S Broder, Dasha Cherepanov, Marianne Eagan, Jackie Lee, Qayyim Said, Maureen P Neary, Beverly M K Biller
PURPOSE: Follow-up guidelines are needed to assess quality of care and to ensure best long-term outcomes for patients with Cushing's disease (CD). The purpose of this study was to assess agreement by experts on recommended follow-up intervals for CD patients at different phases in their treatment course. METHODS: The RAND/UCLA modified Delphi process was used to assess expert consensus. Eleven clinicians who regularly manage CD patients rated 79 hypothetical patient scenarios before and after ("second round") an in-person panel discussion to clarify definitions...
March 9, 2017: Pituitary
https://www.readbyqxmd.com/read/28069628/cushing-s-syndrome-a-practical-approach-to-diagnosis-and-differential-diagnoses
#5
REVIEW
Joseph M Pappachan, Christian Hariman, Mahamood Edavalath, Julian Waldron, Fahmy W Hanna
Diagnosis of Cushing's syndrome (CS) and identification of the aetiology of hypercortisolism can be challenging. The Endocrine Society clinical practice guidelines recommends one of the four tests for initial screening of CS, namely, urinary-free cortisol, late night salivary cortisol, overnight dexamethasone suppression test or a longer low-dose dexamethasone suppression test, for 48 hours. Confirmation and localisation of CS requires additional biochemical and radiological tests. Radiological evaluation involves different imaging modalities including MRI with or without different radio-nuclear imaging techniques...
April 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27974908/cushing-s-disease-a-multidisciplinary-overview-of-the-clinical-features-diagnosis-and-treatment
#6
REVIEW
A Buliman, L G Tataranu, D L Paun, A Mirica, C Dumitrache
Cushing's disease is considered a rare condition characterized by the hypersecretion of the adrenocorticotropic hormone (ACTH) due to a pituitary adenoma that ultimately causes endogenous hypercortisolism by stimulating the adrenal glands. The clinical signs suggesting Cushing's disease, such as obesity, moon face, hirsutism, and facial plethora are already present on presentation. Endogenous hypercortisolism is associated with an increased risk of cardiovascular and metabolic manifestations, as well as respiratory disorders, psychiatric complications, osteoporosis and infections, leading to high rates of morbidity and mortality...
January 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27936531/endocrinology-update-hirsutism
#7
Joel J Heidelbaugh
Hirsutism is defined as excessive terminal hair growth, such as coarse sexual or secondary hair, that typically appears in a male growth pattern in androgen-dependent areas of the female body. It can occur in men and women. Common etiologies include polycystic ovary syndrome, idiopathic hyperandrogenemia, idiopathic hirsutism, adrenal hyperplasia due to 21-hydroxylase deficiency, androgen-secreting tumors, iatrogenic hirsutism, acromegaly, Cushing syndrome, hyperprolactinemia, and hypo- or hyperthyroidism. Diagnostic guidelines are predominantly aimed at premenopausal women but an appropriate evaluation for underlying endocrinopathies in postmenopausal women and men may be required...
December 2016: FP Essentials
https://www.readbyqxmd.com/read/27743452/the-combination-of-vestibular-impairment-and-congenital-sensorineural-hearing-loss-predisposes-patients-to-ocular-anomalies-including-usher-syndrome
#8
Stephanie Kletke, Vaishnavi Batmanabane, Tianyang Dai, Ajoy Vincent, Shuning Li, Karen A Gordon, Blake C Papsin, Sharon L Cushing, Elise Héon
The co-occurrence of hearing impairment and visual dysfunction is devastating. Most deaf-blind etiologies are genetically determined, the commonest being Usher syndrome (USH). While studies of the congenitally deaf population reveal a variable degree of visual problems, there are no effective ophthalmic screening guidelines. We hypothesized that children with congenital sensorineural hearing loss (SNHL) and vestibular impairment were at an increased risk of having Usher syndrome. A retrospective chart review of 33 cochlear implants recipients for severe to profound SNHL and measured vestibular dysfunction was done to determine the ocular phenotype...
October 15, 2016: Clinical Genetics
https://www.readbyqxmd.com/read/27729065/symptomatic-cushing-s-syndrome-and-hyperandrogenemia-in-a-steroid-cell-ovarian-neoplasm-a-case-report
#9
Ramy Sedhom, Sophia Hu, Anupam Ohri, Dorian Infantino, Sara Lubitz
BACKGROUND: Malignant steroid cell tumors of the ovary are rare and frequently associated with hormonal abnormalities. There are no guidelines on how to treat rapidly progressive Cushing's syndrome, a medical emergency. CASE PRESENTATION: A 67-year-old white woman presented to our hospital with rapidly developing signs and symptoms of Cushing's syndrome secondary to a steroid-secreting tumor. Her physical and biochemical manifestations of Cushing's syndrome progressed, and she was not amenable to undergoing conventional chemotherapy secondary to the debilitating effects of high cortisol...
October 12, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27662258/towards-a-universally-accepted-definition-of-subclinical-cushing-s-syndrome-subclinical-autonomous-hypercortisolism
#10
Warrick J Inder
No abstract text is available yet for this article.
January 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/27569751/levels-of-evidence-for-foot-and-ankle-questions-on-the-orthopaedic-in-training-examination-15-year-trends
#11
Cory T Walsh, Louis C Grandizio, Joel C Klena, John M Parenti, Gerard J Cush
BACKGROUND: The foot and ankle (FA) content domain is a component of the orthopaedic in-training examination (OITE). Levels of evidence (LoE) have been infrequently studied on the OITE. The purpose of this study is to determine if LoE for primary journal articles referenced for FA questions increased over a 15-year period. We also aim to determine if reference characteristics and question taxonomy have changed during this period. METHODS: All 132 questions and 261 references in the FA content domain from 1995 to 1997 and from 2010 to 2012 were included...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27390704/a-survey-of-clinical-practice-patterns-in-diagnosis-and-management-of-cushing-s-disease-in-iran
#12
Mojtaba Malek, Fatemeh Esfehanian, Atieh Amouzegar, Farzaneh Sarvghadi, Zohreh Moossavi, Mohammad R Mohajeri-Tehrani, Mohammad E Khamseh, Alireza Amirbaigloo, Ameneh Ebrahim Valojerdi
BACKGROUND: Cushing's disease is the most prevalent cause of endogenous adrenocorticotrophic hormone hypersecretion. The aim of this study was to document the current clinical practice pattern in the management of Cushing's disease by Iranian Endocrinologists to determine their opinions and compare them with the current clinical practice guidelines. METHODS: An eight-item questionnaire dealing with diagnosis, treatment and follow up of patients with Cushing's disease was developed, piloted, and sent to the members of Iranian Endocrinology Society...
2016: Medical Journal of the Islamic Republic of Iran
https://www.readbyqxmd.com/read/27390021/management-of-adrenal-incidentalomas-european-society-of-endocrinology-clinical-practice-guideline-in-collaboration-with-the-european-network-for-the-study-of-adrenal-tumors
#13
Martin Fassnacht, Wiebke Arlt, Irina Bancos, Henning Dralle, John Newell-Price, Anju Sahdev, Antoine Tabarin, Massimo Terzolo, Stylianos Tsagarakis, Olaf M Dekkers
: By definition, an adrenal incidentaloma is an asymptomatic adrenal mass detected on imaging not performed for suspected adrenal disease. In most cases, adrenal incidentalomas are nonfunctioning adrenocortical adenomas, but may also represent conditions requiring therapeutic intervention (e.g. adrenocortical carcinoma, pheochromocytoma, hormone-producing adenoma or metastasis). The purpose of this guideline is to provide clinicians with best possible evidence-based recommendations for clinical management of patients with adrenal incidentalomas based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system...
August 2016: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27217765/ectopic-adrenocorticotropic-hormone-syndrome-caused-by-neuroendocrine-tumors-of-the-thymus-30-year-experience-with-16-patients-at-a-single-institute-in-the-people-s-republic-of-china
#14
Ye-Ye Chen, Shan-Qing Li, Hong-Sheng Liu, Ying-Zhi Qin, Li Li, Cheng Huang, Ya-Lan Bi, Yun-Xiao Meng, Jia He, Xiao-Yun Zhou, Dong-Jie Ma
BACKGROUND AND PURPOSE: Thymic neuroendocrine carcinomas (TNECs) are extremely uncommon. Certain cases of TNECs can produce the adrenocorticotropic hormone (ACTH) and cause ectopic ACTH syndrome (EAS). The current literature on this topic consists mainly of case reports, and therapeutic guidelines are lacking. The aim of this study was to discuss the diagnosis, surgical management, and prognosis of EAS caused by TNECs to improve clinical experience with this rare disease. METHODS: From June 1984 to June 2014, at the Peking Union Medical College Hospital, the surgical interventions and follow-up outcomes of 16 consecutive patients (eight men and eight women) with EAS caused by TNECs were retrospectively analyzed...
2016: OncoTargets and Therapy
https://www.readbyqxmd.com/read/27211887/cushing-s-syndrome-where-and-how-to-find-it
#15
Miguel Debono, John D Newell-Price
The diagnosis of Cushing's syndrome is challenging to endocrinologists as patients often present with an insidious history, together with subtle external clinical features. Moreover, complications of endogenous hypercortisolism, such as visceral obesity, diabetes, hypertension and osteoporosis, are conditions commonly found in the population, and discerning whether these are truly a consequence of hypercortisolism is not straightforward. To avoid misdiagnosis, a careful investigative approach is essential. The investigation of Cushing's syndrome is a three-step process...
2016: Frontiers of Hormone Research
https://www.readbyqxmd.com/read/27185359/cryoprecipitate-indications-and-patterns-of-use-in-the-pediatric-intensive-care-unit-inappropriate-transfusions-and-lack-of-standardization
#16
Robert A DeSimone, Marianne E Nellis, Ruchika Goel, Thorsten Haas, Ljiljana Vasovic, Melissa M Cushing
BACKGROUND: The dosage and indications for cryoprecipitate are not well studied for any patient population. Prior observational studies have suggested that 24% to 62% of cryoprecipitate transfusions are inappropriate, and there is limited information on patterns of cryoprecipitate use in children. The purpose of this retrospective study was to explore the indications and appropriateness of the use of cryoprecipitate in critically ill children. STUDY DESIGN AND METHODS: We retrospectively reviewed the electronic medical records for cryoprecipitate ordering and utilization in the pediatric intensive care unit at a large tertiary care center during a 4...
August 2016: Transfusion
https://www.readbyqxmd.com/read/27160717/cushing-s-syndrome-screening-and-diagnosis
#17
REVIEW
Filippo Ceccato, Marco Boscaro
Endogenous Cushing's syndrome (CS) is a rare disease, and usually characterized by hypertension, diabetes, obesity, osteoporosis, facial rounding, dorsocervical fat pad, thin skin, purple striae, hirsutism, and mood disorders. Efficient diagnostic and screening strategies lead to the diagnosis of a significantly higher number of cases of CS. As a screening test for CS, the Endocrine Society's Clinical Practice Guidelines recommend a single test with a high diagnostic accuracy, among the 1-mg dexamethasone suppression test (1-mg DST), late night salivary cortisol (LNSC), and 24 h urinary free cortisol (UFC)...
September 2016: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/27061040/wilderness-medical-society-practice-guidelines-for-the-prevention-and-treatment-of-drowning
#18
Andrew C Schmidt, Justin R Sempsrott, Seth C Hawkins, Ali S Arastu, Tracy A Cushing, Paul S Auerbach
The Wilderness Medical Society convened a panel to review available evidence supporting practices for the prevention and acute management of drowning in out-of-hospital and emergency medical care settings. Literature about definition and terminology, epidemiology, rescue, resuscitation, acute clinical management, disposition, and drowning prevention was reviewed. The panel graded evidence supporting practices according to the American College of Chest Physicians criteria, then made recommendations based on that evidence...
June 2016: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/26905474/italian-society-for-the-study-of-diabetes-sid-italian-endocrinological-society-sie-guidelines-on-the-treatment-of-hyperglycemia-in-cushing-s-syndrome-and-acromegaly
#19
REVIEW
M G Baroni, F Giorgino, V Pezzino, C Scaroni, A Avogaro
BACKGROUND: Hyperglycemia is a common feature associated with states of increased growth hormone secretion and glucocorticoid levels. AIMS: The purpose of these guidelines is to assist clinicians and other health care providers to take evidence-based therapeutic decisions for the treatment of hyperglycemia in patients with growth hormone and corticosteroid excess. METHODOLOGY: Both the SID and SIE appointed members to represent each society and to collaborate in Guidelines writing...
February 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/26830928/analysis-of-orthopedic-resident-ability-to-apply-levels-of-evidence-criteria-to-scientific-articles
#20
Louis C Grandizio, Stephanie S Shim, Jove Graham, Callista Costopoulos, Gerard Cush, Joel C Klena
OBJECTIVE: In the era of evidence-based medicine, understanding study design and levels of evidence (LoE) criteria is an important component of resident education and aids practicing surgeons in making informed clinical decisions. The purpose of this study is to analyze the ability of orthopedic residents to accurately determine LoE criteria for published articles compared with medical students. DESIGN: Basic science article. SETTING: Geisinger Medical Center (Danville, PA), tertiary referral center...
May 2016: Journal of Surgical Education
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