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https://www.readbyqxmd.com/read/28106911/positron-emission-tomography-computed-tomography-imaging-of-adrenocorticotropic-hormone-producing-small-cell-neuroendocrine-carcinoma-of-the-cervix
#1
Vien X Nguyen, Ba D Nguyen, Dora M Lam-Himlin
Ectopic ACTH-dependent Cushing syndrome-inducing small-cell neuroendocrine carcinoma of the cervix, undiagnosed by computed tomography and whole-body octreotide scintigraphy, was identified using F-18 FDG PET/CT imaging. This article is protected by copyright. All rights reserved.
January 20, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28104732/iatrogenic-cushing-s-syndrome-due-to-topical-ocular-glucocorticoid-treatment
#2
Daisuke Fukuhara, Toshihiko Takiura, Hiroshi Keino, Annabelle A Okada, Kunimasa Yan
Iatrogenic Cushing's syndrome (CS) is a severe adverse effect of systemic glucocorticoid (GC) therapy in children, but is extremely rare in the setting of topical ocular GC therapy. In this article, we report the case of a 9-year-old girl suffering from idiopathic uveitis who developed CS due to topical ocular GC treatment. She was referred to the ophthalmology department with a complaint of painful eyes, at which time she was diagnosed with bilateral iridocyclitis and started on a treatment of betamethasone sodium phosphate eye drops...
January 19, 2017: Pediatrics
https://www.readbyqxmd.com/read/28102935/ectopic-cushing-syndrome-in-small-cell-lung-cancer-a-case-report-and-literature-review
#3
Hang-Yu Zhang, Jun Zhao
Small cell lung cancer (SCLC) is a neuroendocrine tumor with the potential to secrete various peptides or hormones that can lead to paraneoplastic syndromes, such as Ectopic Cushing syndrome (ECS). Because of the aggressive nature of the syndrome and its atypical features, ECS in small-cell lung cancer is difficult to diagnose and has a poor prognosis. We report a case of a 74-year-old male patient who presented with severe hypokalemia, proximal muscle weakness, peripheral edema, metabolic alkalosis, and worsening hyperglycemia...
November 8, 2016: Thoracic Cancer
https://www.readbyqxmd.com/read/28102088/hyperandrogenism-in-a-postmenopausal-woman-a-rare-case-of-ectopic-adrenal-cortical-gland
#4
Antonella Guarino, Luisa Di Benedetto, Valentina Giovanale, Gian Luca Rampioni Vinciguerra, Antonella Stoppacciaro, Filippo Bellati, Donatella Caserta
Most frequent causes of androgenic manifestation are Cushing's syndrome, PCO, benign and malignant androgen-secreting non adrenal tumors and iatrogenic hirsutism. Hyperplasia or neoplasms of ectopic adrenocortical gland are rare. We report a case of a 63-year old female with hirsutism and alopecia. Laboratory data highlighted increased levels of androgens. Diagnostic imaging revealed normal morphology of adrenocortical gland and ovaries. In view of the clinical picture and suspected diagnosis of extra-adrenal cause, she underwent bilateral salpingo-oophorectomy...
January 19, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28098665/source-of-ectopic-acth-secretion-easily-identified-by-68ga-dotanoc-pet-ct
#5
Sofiullah Abubakar, Yaw Ampem Amoako, Tessa Kotze, Naima Tag
Malignant tumors account for most sources of ectopic ACTH Cushing syndrome (EA-CS). Early localization of the source and complete removal can be curative and also prevent metastasis. Diagnostic CT is known to perform better than PET/CT (low dose) in characterizing lung pathologies. However, bronchial carcinoids, a common source of EA-CS, may be difficult to detect on chest CT scan especially when it is small and located close to the hilar region. We present a case of EA-CS due to bronchial carcinoid, which was easily seen on Ga DOTANOC PET/CT after a diagnostic chest CT was reported as normal...
January 16, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28079576/mixed-gangliocytoma-pituitary-adenoma-insights-on-the-pathogenesis-of-a-rare-sellar-tumor
#6
M Beatriz S Lopes, Emily Sloan, Julie Polder
Gangliocytomas originating in the sellar region are rare; most are tumors composed of gangliocytic and pituitary adenomatous elements, forming the so-called mixed gangliocytoma-pituitary adenoma. The majority of mixed gangliocytoma adenomas are associated with endocrinopathies, mainly acromegaly and less often Cushing disease and hyperprolactinemia. In the present study, 10 cases of mixed gangliocytoma and somatotroph adenomas were evaluated for patterns of cellular differentiation and expression of lineage-specific transcription factors...
January 10, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28069628/cushing-s-syndrome-a-practical-approach-to-diagnosis-and-differential-diagnoses
#7
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...
January 9, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28068878/long-term-control-of-hypercortisolism-by-vandetanib-in-a-medullary-thyroid-carcinoma-with-a-somatic-ret-mutation
#8
Anne-Cécile Paepegaey, Beatrix Cochand-Priollet, Estelle Louiset, Pierre Olivier Sarfati, Marco Alifano, Nelly Burnichon, Marie Bienvenu-Perrard, Najiba Lahlou, Léopoldine Bricaire, Lionel Groussin
CONTEXT: Medullary thyroid carcinomas (MTCs) complicated by ectopic Cushing's syndrome have a poor prognosis, partially due to the difficulties to control hypercortisolism by adrenal blocking drugs. Recent reports (including the initial follow-up of this patient) have suggested that tyrosine kinase inhibitors (TKIs) may be a therapeutic option due to an antisecretory action on ACTH. However, there is a lack of long-term follow-up studies. CASE DESCRIPTION: We report the case of a 58 year-old man with a MTC-related Cushing's syndrome resistant to a combination of several anticortisolic drugs...
January 9, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28068807/annals-express-measuring-cortisol-in-serum-urine-and-saliva-are-our-assays-good-enough
#9
Nadia El-Farhan, D Aled Rees, Carol Evans
Cortisol is a steroid hormone produced in response to stress. It is essential for maintaining health and well-being; and leads to significant morbidity when deficient or present in excess. It is lipophillic and is transported bound to cortisol-binding globulin (CBG) and albumin; a small fraction (~10%) of total serum cortisol is unbound and biologically active. Serum cortisol assays measure total cortisol and their results can be misleading in patients with altered serum protein concentrations. Automated immunoassays are used to measure cortisol but lack specificity and show significant interassay differences...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28068682/cushing-s-syndrome-managed-by-endoscopic-ultrasound-guided-radiofrequency-ablation-of-adrenal-gland-adenoma
#10
Sun-Ho Lee, Dong Wan Seo, Dongwook Oh, Tae Jun Song, Do Hyun Park, Sang Soo Lee, Myung-Hwan Kim
No abstract text is available yet for this article.
February 2017: Endoscopy
https://www.readbyqxmd.com/read/28065244/advances-in-evaluation-of-cognitive-impairment-in-patients-with-cushing-s-disease
#11
Wei-Yu Mao, Hui You, Bing Xing, Hui-Juan Zhu, Feng Feng
Cushing's disease (CD) is a relatively rare disease,characterized by pathological hypercortisolism secondary to excessive adrenocorticotrophic hormone that is secreted by pituitary adrenocorticotrophic hormone adenoma or hyperplasia. In addition to the typical clinical symptoms such as moon face,buffalo hump,and central obesity,the CD patients may also experience mental disorders and cognitive dysfunction. This review mainly focuses on the cognitive state of CD patients,the mechanisms of cognitive impairment caused by high cortisol levels,and the imaging findings (especially magnetic resonance imaging) for the evaluation of cognitive functions...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28062892/a-bifurcation-theorem-for-evolutionary-matrix-models-with-multiple-traits
#12
J M Cushing, F Martins, A A Pinto, Amy Veprauskas
One fundamental question in biology is population extinction and persistence, i.e., stability/instability of the extinction equilibrium and of non-extinction equilibria. In the case of nonlinear matrix models for structured populations, a bifurcation theorem answers this question when the projection matrix is primitive by showing the existence of a continuum of positive equilibria that bifurcates from the extinction equilibrium as the inherent population growth rate passes through 1. This theorem also characterizes the stability properties of the bifurcating equilibria by relating them to the direction of bifurcation, which is forward (backward) if, near the bifurcation point, the positive equilibria exist for inherent growth rates greater (less) than 1...
January 6, 2017: Journal of Mathematical Biology
https://www.readbyqxmd.com/read/28060049/ritonavir-and-topical-ocular-corticosteroid-induced-cushing-s-syndrome-in-an-adolescent-with-hiv-1-infection
#13
Paul G Rainsbury, Jessica Sharp, Alison Tappin, Martin Hussey, Alexandra Lenko, Caroline Foster
Cushing's syndrome following topical ocular corticosteroid use is extremely rare. We describe a case of symptomatic Cushing's syndrome in an adolescent male with sight-threatening vernal keratoconjunctivitis on antiretroviral therapy for HIV-1 infection that included ritonavir, a potent cytochrome p450 CYP3A4 inhibitor. CYP3A4 inhibition reduces the metabolism of exogenous corticosteroids leading to suppression of endogenous steroid production and Cushing's syndrome.
January 3, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28059655/norman-m-dott-master-of-hypothalamic-craniopharyngioma-surgery-the-decisive-mentoring-of-harvey-cushing-and-percival-bailey-at-peter-bent-brigham-hospital
#14
Ruth Prieto, José M Pascual
Norman McOmish Dott (1897-1973) developed surgical neurology in Edinburgh, Scotland, and was a scholar of worldwide renown. One of Dott's most notable contributions to neurosurgery was his understanding of hypothalamic physiology, mostly acquired through the comprehensive study of patients with lesions involving this region of the diencephalon, particularly craniopharyngiomas (CPs). Recognition of symptoms caused by hypothalamic disturbances allowed him to predict the accurate anatomical relationships between CPs and the hypothalamus, despite the rudimentary radiological methods available during the 1930s...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28058099/adenomatoid-tumor-of-the-adrenal-gland-in-young-woman-from-clinical-and-radiological-to-pathological-study
#15
Brankica Krstevska, Sasha Jovanovska Mishevska, Rubens Jovanovic
Adenomatoid tumors are neoplasms of mesothelial origin, usually occurring in the male and female genital tracts. Extragenital localization sites such as adrenal glands are rare but have been reported. When found in the adrenals, they represent great clinical, radiological and pathological diagnostic challenge, with wide range of differential diagnoses to be considered. We present a case of a 30 years old female, with incidental ultrasound finding of unilateral tumor in the right adrenal gland. Multi slices CT scan was of value in localizing this tumor, but not in the precise diagnosis...
November 17, 2016: Rare Tumors
https://www.readbyqxmd.com/read/28033218/avascular-necrosis-of-the-hips-with-increased-activity-on-68ga-dotatate-pet-ct
#16
Georgios Z Papadakis, Corina Millo, Apostolos H Karantanas, Ulas Bagci, Nicholas J Patronas
Prolonged exposure to cortisol is one of the major causes of avascular bone necrosis (AVN). We report on a case of a woman with Cushing syndrome attributed to ectopic adrenocorticotropic hormone-secreting tumor who was evaluated with whole-body PET/CT study using Ga-DOTATATE. The scan showed increased activity by both femoral heads, corresponding to the margins of bilateral AVN seen on MRI. The presented data suggests AVN-induced reactive inflammatory alterations adjacent to the necrotic segment of the bone, which can be effectively targeted using radiolabeled somatostatin (SST) analogs...
December 28, 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28029519/adrenocorticotropic-hormone-levels-before-treatment-predict-recurrence-of-cushing-s-disease
#17
Chun-Heng Kuo, Shyang-Rong Shih, Hung-Yuan Li, Szu-Chi Chen, Po-Ju Hung, Fen-Yu Tseng, Tien-Chun Chang
BACKGROUND/PURPOSE: Cushing's disease (CD) is the most common cause of endogenous Cushing's syndrome. Transsphenoidal surgery (TSS) is the first choice of treatment. Predicting prognosis after treatment can benefit further strategies of management, but currently there is no convenient predictor. This study aims to investigate characteristic changes after treatment and to identify potential prognostic predictors. METHODS: We retrospectively studied the records of CD patients presenting to the National Taiwan University Hospital, Taipei, Taiwan between 1992 and 2011...
October 28, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28029028/the-recovery-of-hypothalamic-pituitary-adrenal-axis-is-rapid-in-subclinical-cushing-syndrome
#18
Hee Kyung Kim, Jee Hee Yoon, Yun Ah Jeong, Ho Cheol Kang
BACKGROUND: In subclinical Cushing syndrome (SC), it is assumed that glucocorticoid production is insufficient to cause a clinically recognizable syndrome. Differences in hormonal levels or recovery time of the hypothalamic-pituitary-adrenocortical (HPA) axis after adrenalectomy between patients with overt Cushing syndrome (OC) and SC remain unknown. METHODS: Thirty-six patients (10 with OC and 26 with SC) with adrenal Cushing syndrome who underwent adrenalectomy from 2004 to 2014 were reviewed retrospectively...
December 2016: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28018289/choroidal-and-retinal-abnormalities-by-optical-coherence-tomography-in-endogenous-cushing-s-syndrome
#19
Maria Fernanda Abalem, Marcio Carlos Machado, Helen Nazareth Veloso Dos Santos, Rafael Garcia, John Helal, Pedro Carlos Carricondo, Sérgio Luis Gianotti Pimentel, Mario Luiz Ribeiro Monteiro, Cynthia X Qian, Marcello Delano Bronstein, Maria Cândida Villares Barisson Fragoso
CONTEXT: Cortisol has been suggested as a risk factor for choroidal thickening, which may lead to retinal changes. OBJECTIVE: To compare choroidal thickness measurements using optical coherence tomography (OCT) in patients with endogenous active Cushing's syndrome (CS) and to evaluate the occurrence of retinal abnormalities in the same group of patients. DESIGN: Cross-sectional study. SETTING: Outpatient clinic. PATIENTS: Eleven female patients with CS in hypercortisolism state as determined by the presence of at least two abnormal measurements from urinary cortisol 24 h, no suppression of cortisol with low dose dexamethasone suppression test, and nocturnal salivary cortisol levels and 12 healthy controls...
2016: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28017223/parent-vessel-occlusion-for-treatment-of-cerebral-aneurysms-is-there-still-an-indication-a-series-of-17-patients
#20
Nishant Ganesh Kumar, Travis R Ladner, Imad S Kahn, Scott L Zuckerman, Christopher B Baker, Marybess Skaletsky, Deborah Cushing, Matthew R Sanborn, J Mocco, Robert D Ecker
INTRODUCTION/PURPOSE: Flow diversion has allowed cerebrovascular neurosurgeons and neurointerventionalists to treat complex, large aneurysms, previously treated with trapping, bypass, and/or parent vessel sacrifice. However, a minority of aneurysms remain that cannot be treated endovascularly, and microsurgical treatment is too dangerous. However, balloon test occlusion (macro and micro), micro WADA testing, ICG, intra-angiography and intra-operative monitoring are all available to clinically test the hypothesis that vessel sacrifice is safe...
January 15, 2017: Journal of the Neurological Sciences
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