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Cushings disease

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https://www.readbyqxmd.com/read/28222414/urinary-steroid-metabolites-in-a-case-of-florid-ectopic-cushing-s-syndrome-and-clinical-correlations
#1
Angelos Kyriacou, Karolina G Stepien, Basil Issa
A 51-year old woman was admitted with multiple cerebral, pulmonary and intra-abdominal abscesses. The combination of apparent immunosuppression, obesity, diabetes mellitus, hypertension, hypokalaemia, osteoporotic fractures and bilateral shoulder avascular necrosis led to a clinical diagnosis of Cushing's syndrome (CS). This was biochemically confirmed as follows: midnight serum cortisol 4275 nmol/L (60-250), non-suppressed overnight dexamethasone suppression test, raised salivary cortisol 716 nmol/L (5-46) and ACTH 639 ng/L (0-46)...
October 2016: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28218067/melanocortin-4-receptor-gene-mutations-in-a-group-of-turkish-obese-children-and-adolescents
#2
Selma Tunç, Korcan Demir, Fatma Ajlan Tükün, Cihan Topal, Filiz Hazan, Burcu Sağlam, Özlem Nalbantoğlu, Melek Yıldız, Behzat Özkan
OBJECTIVE: Melanocortin-4 receptor (MC4R) mutations are the most common known cause of monogenic obesity but there is limited data regarding MC4R mutations in Turkish subjects. To determine the prevalence of MC4R mutations in a group of Turkish morbid obese children and adolescents. METHODS: MC4R was sequenced in 47 consecutive morbidly obese children and adolescents (28 girls and 19 boys, aged 1-18 years) who presented during a 1-year period. Inclusion criterion was a BMI ≥120% of the 95th percentile or ≥35 kg/m2...
February 20, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28210785/on-glioblastoma-and-the-search-for-a-cure-where-do-we-stand
#3
REVIEW
John Bianco, Chiara Bastiancich, Aleksander Jankovski, Anne des Rieux, Véronique Préat, Fabienne Danhier
Although brain tumours have been documented and recorded since the nineteenth century, 2016 marked 90 years since Percival Bailey and Harvey Cushing coined the term "glioblastoma multiforme". Since that time, although extensive developments in diagnosis and treatment have been made, relatively little improvement on prognosis has been achieved. The resilience of GBM thus makes treating this tumour one of the biggest challenges currently faced by neuro-oncology. Aggressive and robust development, coupled with difficulties of complete resection, drug delivery and therapeutic resistance to treatment are some of the main issues that this nemesis presents today...
February 17, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/28191290/loss-of-efficacy-of-pasireotide-after-its-re-administration-is-there-a-reason-why
#4
Stylianos Mandanas, Lemonia Mathiopoulou, Maria Boudina, Alexandra Chrisoulidou, Kalliopi Pazaitou-Panayiotou
Pasireotide is a recently approved medical treatment for persistent or recurrent Cushing's disease (CD). However, an escape from the initial successful response has not yet been described. A 42-year-old female presented with several symptoms indicative of hypercortisolism. Biochemical evaluation and imaging were consistent with CD due to a pituitary adenoma. Surgical excision of the adenoma was unsuccessful and gamma-knife radiosurgery was followed. Our patient remained hypercortisolemic thus treatment with pasireotide (900 mg subcutaneously twice daily) was decided...
November 17, 2016: Rare Tumors
https://www.readbyqxmd.com/read/28183578/a-case-of-central-diabetes-insipidus-after-ketamine-infusion-during-an-external-to-internal-carotid-artery-bypass
#5
Sharib Gaffar, Jonathan P Eskander, Burton D Beakley, Brian P McClure, Peter Amenta, Nakeisha Pierre
STUDY OBJECTIVE: We report the first teenage case of ketamine-induced transient central diabetes insipidus. CASE SUMMARY: The patient was an 18-year-old woman with moyamoya disease undergoing an external carotid to internal carotid bypass and given a low-dose ketamine infusion. After approximately 2 hours in the supine position, with 0.5 Minimum Alveolar Concentration (MAC) of sevoflurane, a propofol infusion at 50 μg/kg/min, a remifentanil infusion at 0.5 μg/kg/min, and a ketamine infusion at a dose of 10 μg/kg/min, this patient had an excessive urine output...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183144/rapid-deterioration-of-latent-hbv-hepatitis-during-cushing-disease-and-posttraumatic-stress-disorder-after-earthquake
#6
Ryosuke Tashiro, Yoshikazu Ogawa, Teiji Tominaga
Reactivation of the hepatitis B virus (HBV) is a risk in the 350 million HBV carriers worldwide. HBV reactivation may cause hepatocellular carcinoma, cirrhosis, and fulminant hepatitis, and HBV reactivation accompanied with malignant tumor and/or chemotherapy is a critical problem for patients with chronic HBV infection. Multiple risk factors causing an immunosuppressive state can also induce HBV reactivation.We present a case of HBV reactivation during an immunosuppressive state caused by Cushing disease and physical and psychological stress after a disaster...
February 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28179451/cushing-s-syndrome-in-children-and-adolescents-a-danish-nationwide-population-based-cohort-study
#7
Johanne Marie Holst, Erzsébet Horváth-Puhó, Rb Jensen, Mariane Rix, Niels Thomas Hertel, Olaf Dekkers, Henrik Toft Sørensen, Anders Juul, Jens Otto L Jorgensen
OBJECTIVE: Cushing's syndrome (CS) affects all age groups, but epidemiologic data in young pa-tients are very limited. We therefore examined the incidence, prevalence, and hospital morbidity of CS in children and adolescents. DESIGN: In a nationwide cohort study we included all Danish citizens aged 0-20 years from 1977 to 2012. Data were obtained from the Danish National Patient Registry using the International Classi-fication of Diseases (ICD) codes and the Danish Civil Registration System...
February 8, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28179447/diagnosis-of-endocrine-disease-differentiation-of-pathologic-neoplastic-hypercortisolism-cushing-syndrome-from-physiologic-non-neoplastic-hypercortisolism-formerly-known-as-pseudo-cushing-syndrome
#8
James Findling, Hershel Raff
Endogenous hypercortisolism (Cushing syndrome) usually implies the presence of a pathologic condition caused by either an ACTH-secreting neoplasm or autonomous cortisol secretion from a benign or malignant adrenal neoplasm. However, sustained or intermittent hypercortisolism may also accompany many medical disorders that stimulate physiologic/non-neoplastic activation of the HPA axis (formerly known as pseudo-Cushing syndrome); these two entities may share indistinguishable clinical and biochemical features...
February 8, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28175424/213%C3%A2-histone-deacetylase-inhibitor-vorinostat-is-a-novel-promising-treatment-for-cushing-disease
#9
Prashant Chittiboina, Jie Lu, Xiang Wang, Martin G Piazza, Zhengping Zhuang
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28170483/diagnosis-and-treatment-of-pituitary-adenomas-a-review
#10
Mark E Molitch
Importance: Pituitary adenomas may hypersecrete hormones or cause mass effects. Therefore, early diagnosis and treatment are important. Observations: Prevalence of pituitary adenomas ranges from 1 in 865 adults to 1 in 2688 adults. Approximately 50% are microadenomas (<10 mm); the remainder are macroadenomas (≥10 mm). Mass effects cause headache, hypopituitarism, and visual field defects. Treatments include transsphenoidal surgery, medical therapies, and radiotherapy...
February 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28155129/drug-interaction-potential-of-osilodrostat-lci699-based-on-its-effect-on-the-pharmacokinetics-of-probe-drugs-of-cytochrome-p450-enzymes-in-healthy-adults
#11
Sara Armani, Lillian Ting, Nicholas Sauter, Christelle Darstein, Anadya Prakash Tripathi, Lai Wang, Bing Zhu, Helen Gu, Dung Yu Chun, Heidi J Einolf, Swarupa Kulkarni
BACKGROUND AND OBJECTIVES: Osilodrostat (LCI699) is an adrenal steroidogenesis inhibitor currently in late-phase clinical development as a potential treatment for Cushing's disease. This study evaluated the inhibitory effect of osilodrostat on the pharmacokinetics of probe substrates of the cytochrome P450 (CYP) enzymes CYP1A2, CYP2C19, CYP2D6, and CYP3A4. METHODS: Healthy adult volunteers received single-dose cocktail probe substrates [caffeine (100 mg), omeprazole (20 mg), dextromethorphan (30 mg), and midazolam (2 mg)] followed by a 6-day washout...
February 2, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28149109/developing-cerebral-venous-infarct-presenting-with-seizure-occurring-after-lumbar-drain-placement-following-trans-sphenoidal-surgery-of-cushing-s-disease-review-of-literature
#12
Dattaraj Sawarkar, Guru Dutta Satyarthee, Pankaj Singh, Hitesh Gurjar, M M Singh, B S Sharma
No abstract text is available yet for this article.
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28146078/metabolomic-biomarkers-in-urine-of-cushing-s-syndrome-patients
#13
Alicja Kotłowska, Tomasz Puzyn, Krzysztof Sworczak, Piotr Stepnowski, Piotr Szefer
Cushing's syndrome (CS) is a disease which results from excessive levels of cortisol in the human body. The disorder is associated with various signs and symptoms which are also common for the general population not suffering from compound hypersecretion. Thus, more sensitive and selective methods are required for the diagnosis of CS. This follow-up study was conducted to determine which steroid metabolites could serve as potential indicators of CS and possible subclinical hypercortisolism in patients diagnosed with so called non-functioning adrenal incidentalomas (AIs)...
January 29, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28140540/sequential-high-and-low-dose-systemic-corticosteroid-therapy-for-severe-childhood-alopecia-areata
#14
Karin Jahn-Bassler, Wolfgang Michael Bauer, Franz Karlhofer, Matthias G Vossen, Georg Stingl
BACKGROUND: Given the limited number of therapeutic options, severe childhood alopecia areata (AA) poses a clinical challenge. The best and most rapid response rates can be achieved with high-dose systemic corticosteroids, however, relapse following treatment discontinuation is inevitable. Due to systemic side effects, long-term high-dose corticosteroid regimens are not feasible. Following initial pulse therapy, continuation of corticosteroid therapy at a dose below the Cushing threshold might be able to suppress disease activity without causing severe side effects...
January 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28110235/relationship-between-expression-of-vascular-endothelial-growth-factor-and-the-proliferation-of-prolactinomas
#15
Nan Li Ya, ZhiQuan Jiang
OBJECTIVE: Prolactinomas are the most common functional hormone-producing pituitary lesions, accounting for 30-40% of all pituitary tumors, while in autopsy series their incidence reaches 50%. However, patients with prolactinoma had a higher recurrence percentage and rate than patients with acromegaly or Cushing's disease. Furthermore, prolactinomas have the highest rate of recurrence post-surgery as compared with other pituitary adenomas. At present, this behavior of prolactinoma is largely unexplained, but may be related to definition of cure, or to more frequent microscopic tumor infiltration into normal pituitary tissue, which is not removed at surgery...
February 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28079576/mixed-gangliocytoma-pituitary-adenoma-insights-on-the-pathogenesis-of-a-rare-sellar-tumor
#16
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/28068807/annals-express-measuring-cortisol-in-serum-urine-and-saliva-are-our-assays-good-enough
#17
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/28065244/advances-in-evaluation-of-cognitive-impairment-in-patients-with-cushing-s-disease
#18
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/28029519/adrenocorticotropic-hormone-levels-before-treatment-predict-recurrence-of-cushing-s-disease
#19
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/28018289/choroidal-and-retinal-abnormalities-by-optical-coherence-tomography-in-endogenous-cushing-s-syndrome
#20
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
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