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Cushings disease

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https://www.readbyqxmd.com/read/28730425/at-101-acts-as-anti-proliferative-and-hormone-suppressive-agent-in-mouse-pituitary-corticotroph-tumor-cells
#1
B S Yurekli, B Karaca, A Kisim, E Bozkurt, H Atmaca, S Cetinkalp, G Ozgen, C Yilmaz, S Uzunoglu, R Uslu, F Saygili
PURPOSE: Gossypol, a naturally occurring compound in cottonseeds, has anticancer effects against several tumor cell lines. It has been extensively studied in clinical trials and is well tolerated with a favorable safety profile. AT-101, a derivative of R (-)-gossypol, binds to Bcl-2 family proteins and induces apoptosis in vitro. Although transsphenoidal surgical excision of the pituitary corticotroph adenoma is the gold standard of care, it is not successful all the time. Medical therapy for Cushing's disease still remains a challenge for the clinicians...
July 20, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28721218/spontaneous-reossification-of-the-sella-in-transsphenoidal-reoperation-associated-with-strontium-ranelate
#2
Maria Mercedes Pineyro, Daiana Arrestia, Mariana Elhordoy, Ramiro Lima, Saul Wajskopf, Raul Pisabarro, Maria Pilar Serra
Spontaneous reossification of the sellar floor after transsphenoidal surgery has been rarely reported. Strontium ranelate, a divalent strontium salt, has been shown to increase bone formation, increasing osteoblast activity. We describe an unusual case of a young patient with Cushing's disease who was treated with strontium ranelate for low bone mass who experienced spontaneous sellar reossification after transsphenoidal surgery. A 21-year-old male presented with Cushing's features. His past medical history included delayed puberty diagnosed at 16 years, treated with testosterone for 3 years without further work-up...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28711536/the-outcomes-of-primary-transsphenoidal-surgery-in-cushing-s-disease-experience-of-a-tertiary-center
#3
Fatma Ela Keskin, Hande Mefkure Ozkaya, Murat Bolayirli, Secil Erden, Pınar Kadioglu, Necmettin Tanriover, Nurperi Gazioglu
BACKGROUND: To report the initial and long-term remission rates and related factors, secondary treatments, and outcomes of a series of patients with Cushing's disease (CD). METHODS: One hundred forty-seven consecutive adult patients with CD who underwent primary trans-sphenoidal surgery between 1998 and 2014 were included in this study. Eighty-two were followed up in Cerrahpasa Medical Faculty Endocrinology and Metabolism outpatient clinic. The patients were requested to attend a long-term remission assessment; 55 could be contacted and data for the remaining 27 patients' last visit to the outpatient clinics were reviewed for early and late remission...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710189/use-of-cabergoline-for-the-management-of-persistent-cushing-s-disease-in-pregnancy
#4
Kathleen Su-Yen Sek, Doddabele Srinivasa Deepak, Kok Onn Lee
Cushing's disease (CD) is rare during pregnancy and is associated with significant maternal and fetal complications. It is important to control hypercortisolism during pregnancy, either surgically or medically, for a successful maternal and fetal outcome. We report a patient with recurrent CD who was treated with low-dose cabergoline (CAB) for persistent hypercortisolism throughout pregnancy. A 36-year-old woman was diagnosed with CD at the age of 23. She underwent trans-sphenoidal surgery with initial complete remission...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28710116/expression-and-mutational-status-of-usp8-in-tumors-causing-ectopic-acth-secretion-syndrome
#5
Luis Gustavo Pérez-Rivas, Andrea Oßwald, Thomas Knösel, Kristin Lucia, Christian Schaaf, Michael Hristov, Julia Fazel, Thomas Kirchner, Felix Beuschlein, Martin Reincke, Marily Theodoropoulou
The ectopic ACTH secretion syndrome (EAS) is the clinical consequence of the paraneoplastic secretion of ACTH by non-pituitary tumors. The mechanisms responsible for the pathogenesis of these tumors are still unknown. Recently, we and others detected hotspot heterozygous driver mutations in the gene coding for the ubiquitin-specific protease 8 (USP8) in almost half of ACTH-secreting pituitary corticotroph tumors causing Cushing's disease. Mutant USP8 was also found to stimulate proopiomelanocortin (POMC) transcription and ACTH synthesis...
July 14, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/28700464/cryptococcal-meningitis-after-transnasal-transsphenoidal-pituitary-microsurgery-of-acth-secreting-pituitary-adenoma-a-case-report
#6
Yang Liu, Ming Feng, Yong Yao, Kan Deng, Xinjie Bao, Xiaohai Liu, Renzhi Wang
RATIONALE: Microbial infection should be regarded in the differential diagnosis of neurosurgical complications after transnasal transsphenoidal pituitary microsurgery, albeit cryptococcal meningitis is rare. This article will discuss the risk factors of cryptococcal meningitis in patients underwent transnasal transsphenoidal pituitary microsurgery, and summary the potential origins of infection. PATIENT CONCERNS AND DIAGNOSIS: Here, we report a case of 37-year-old male who had cryptococcal meningitis after transnasal transsphenoidal pituitary microsurgery of a relapsing ACTH-secreting pituitary adenoma...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28691036/detection-of-secondary-causes-and-coexisting-diseases-in-hypertensive-patients-osa-and-pa-are-the-common-causes-associated-with-hypertension
#7
Lei Wang, Nanfang Li, Xiaoguang Yao, Guijuan Chang, Delian Zhang, Mulalibieke Heizhati, Menghui Wang, Qin Luo, Jianqiong Kong
BACKGROUND: Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients. METHODS: Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol. RESULTS: Detection rate of secondary causes and coexisting diseases of hypertension was 39...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28689311/frequency-of-familial-pituitary-adenoma-syndromes-among-patients-with-functioning-pituitary-adenomas-in-a-reference-outpatient-clinic
#8
N V Marques, L Kasuki, M C Coelho, C H A Lima, L E Wildemberg, M R Gadelha
INTRODUCTION: Pituitary adenomas (PA) occur mainly as sporadic disease, but familial syndromes are found in approximately 5% of cases. Identification of these syndromes is important in order to diagnose individuals at risk at an earlier stage. AIMS: To evaluate the frequency of familial PA in a reference outpatient clinic devoted to PA treatment and to identify family members suspected to have pituitary disease. METHODS: Patients with PA were interviewed with respect to the presence of family members with diagnosis of PA or with signs or symptoms suggestive of them...
July 8, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28688648/nationwide-review-of-hormonally-active-adrenal-tumors-highlights-high-morbidity-in-pheochromocytoma
#9
Punam P Parikh, Gustavo A Rubio, Josefina C Farra, John I Lew
BACKGROUND: Adrenal adenomas are benign tumors often discovered incidentally, and >70% are hormonally inactive. The remaining subset may produce excess aldosterone, cortisol, or catecholamine. Perioperative outcomes after adrenalectomy for such "hormonally active" tumors remain unclear. This study examines in-hospital outcomes after unilateral adrenalectomy for hormonally active tumors. METHODS: A retrospective review was performed using the Nationwide Inpatient Sample (2006-2011) to identify patients undergoing unilateral adrenalectomy for hormonally active or inactive tumors...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28685507/recent-progress-in-the-medical-therapy-of-pituitary-tumors
#10
REVIEW
Fabienne Langlois, Shirley McCartney, Maria Fleseriu
Management of pituitary tumors is multidisciplinary, with medical therapy playing an increasingly important role. With the exception of prolactin-secreting tumors, surgery is still considered the first-line treatment for the majority of pituitary adenomas. However, medical/pharmacological therapy plays an important role in controlling hormone-producing pituitary adenomas, especially for patients with acromegaly and Cushing disease (CD). In the case of non-functioning pituitary adenomas (NFAs), pharmacological therapy plays a minor role, the main objective of which is to reduce tumor growth, but this role requires further studies...
June 2017: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28683237/late-night-salivary-cortisol-is-unaltered-in-patients-with-polycystic-ovarian-syndrome-pcos-irrespective-of-disease-phenotype-and-in-obese-women-irrespective-of-the-presence-of-pcos
#11
Hande Mefkure Ozkaya, Fatma Ela Keskin, Abdullah Tuten, Ebru Korkmaz, Hulya Zeynep Oktay, Pinar Kadioglu
OBJECTIVE: To determine cut-off values of late-night salivary cortisol (LNSC) using an electrochemiluminescent immunoassay (ECLIA) and to investigate whether the diagnostic performance of the assay was influenced by the presence of obesity or polycystic ovary syndrome (PCOS). METHODS: A total of 124 subjects comprising 25 patients with Cushing's syndrome (CS), 44 with PCOS (22 nonobese and 22 obese), 21 with constitutional obesity (CO), and 34 healthy subjects (HS) were included in the study...
July 6, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28680643/a-rare-case-of-an-acth-crh-co-secreting-midgut-neuroendocrine-tumor-mimicking-cushing-s-disease
#12
Regina Streuli, Ina Krull, Michael Brändle, Walter Kolb, Günter Stalla, Marily Theodoropoulou, Annette Enzler-Tschudy, Stefan Bilz
Ectopic ACTH/CRH co-secreting tumors are a very rare cause of Cushing's syndrome and only a few cases have been reported in the literature. Differentiating between Cushing's disease and ectopic Cushing's syndrome may be particularly difficult if predominant ectopic CRH secretion leads to pituitary corticotroph hyperplasia that may mimic Cushing's disease during dynamic testing with both dexamethasone and CRH as well as bilateral inferior petrosal sinus sampling (BIPSS). We present the case of a 24-year-old man diagnosed with ACTH-dependent Cushing's syndrome caused by an ACTH/CRH co-secreting midgut NET...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#13
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28667008/a-case-of-acute-confusion-cushing-s-syndrome-presenting-with-primary-hyperparathyroidism
#14
Esmee Irvine, Yew Wen Yap, Tej Purewal, Esmee Irvine
Cushing's syndrome is a rare disease. Cushing's syndrome presenting as acute psychosis is an exceptional occurrence. We present the case of a 37-year-old woman who was admitted with acute confusion associated with mild hypercalcaemia and was subsequently diagnosed with parathyroid and adrenal adenomas. Our hospital sees approximately 6000 endocrine patients per year, with an incidence of around four Cushing's cases annually. This is the first such case to occur in our hospital and one of few described in the literature...
June 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28665508/a-polymorphism-in-the-cyp17a1-gene-influences-the-therapeutic-response-to-steroidogenesis-inhibitors-in-cushing-s-syndrome
#15
Elena Valassi, Anna Aulinas, Camilla Am Glad, Gudmundur Johannsson, Oskar Ragnarsson, Susan M Webb
CONTEXT: Steroidogenesis inhibitors, such as ketoconazole (KTZ) and metyrapone (MTP) are used to lower hypercortisolism in patients with Cushing's syndrome (CS). Cortisol normalization is not reached in all patients taking these medications. OBJECTIVE: To test the hypothesis that variants in genes affecting steroidogenesis contribute to different responses to KTZ and/or MTP in patients with CS. PATIENTS AND METHODS: Fifty-four CS patients [46 women; mean (±SD) age, 39...
June 30, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28660991/insulin-resistance-in-endocrine-disorders-treatment-options
#16
Anita Rogowicz-Frontczak, Anna Majchrzak, Dorota Zozulińska-Ziółkiewicz
Changes in sensitivity to insulin occur in the course of a number of endocrine disorders. Most of the hormones through their antagonistic action to insulin lead to increased hepatic glucose output and its decreased utilisation in peripheral tissues. Carbohydrate disorders observed in endocrine diseases result from the phenomenon of insulin resistance, and in some cases also a reduction in insulin secretion is present. Abnormalities of glucose metabolism are observed in acromegaly, but also in growth hormone deficiency, hypercortisolism in the course of Cushing's syndrome, hyper- or hypothyroidism, primary hyperparathyroidism, aldosteronism, pheochromocytoma, congenital hypertrophy of the adrenal glands, polycystic ovaries syndrome, hypogonadism, or other hormonally active neuroendocrine tumours...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28645354/-acromegaly-and-cushing-s-disease-persistence-of-comorbidities-after-the-control-of-hypersecretion
#17
C Rochette, F Castinetti, T Brue
Acromegaly and Cushing's disease lead to common and distinct comorbidities. Currently available treatments lead to the control of hyper secretion in the majority of cases. However, the prevalence of the comorbidities does not always go back to the one of the normal population after remission. For instance, about 1/3 of acromegalic patients with diabetes and half of patients with Cushing's disease and diabetes will have normal blood glucose values after remission. In contrast, high blood pressure frequently recovers after remission in both diseases...
October 2016: Annales D'endocrinologie
https://www.readbyqxmd.com/read/28642375/acquired-resistance-to-corticotropin-therapy-in-nephrotic-syndrome-role-of-de-novo-neutralizing-antibody
#18
Pei Wang, Yan Zhang, Yu Wang, Andrew S Brem, Zhangsuo Liu, Rujun Gong
There is increasing evidence supporting the use of corticotropin as an alternative treatment of refractory proteinuric glomerulopathies. The efficacy of short-acting corticotropin, however, remains unknown and was tested here in an adolescent with steroid-dependent nephrotic syndrome caused by minimal change disease. After developing Cushing syndrome and recently being afflicted with severe cellulitis, the patient was weaned off all immunosuppressants, including corticosteroids. This resulted in a relapse of generalized anasarca, associated with massive proteinuria and hypoalbuminemia...
June 22, 2017: Pediatrics
https://www.readbyqxmd.com/read/28639924/cushing-syndrome-diagnostic-workup-and-imaging-features-with-clinical-and-pathologic-correlation
#19
Nicolaus A Wagner-Bartak, Ali Baiomy, Mouhammed Amir Habra, Shalini V Mukhi, Ajaykumar C Morani, Brinda R Korivi, Steven G Waguespack, Khaled M Elsayes
OBJECTIVE: Cushing syndrome (CS) is a constellation of clinical signs and symptoms resulting from chronic exposure to excess cortisol, either exogenous or endogenous. Exogenous CS is most commonly caused by administration of glucocorticoids. Endogenous CS is subdivided into two types: adrenocorticotropic hormone (ACTH) dependent and ACTH independent. CONCLUSION: Cushing disease, which is caused by a pituitary adenoma, is the most common cause of ACTH-dependent CS for which pituitary MRI can be diagnostic, with bilateral inferior petrosal sinus sampling useful in equivocal cases...
July 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28639759/-diabetes-mellitus-secondary-to-an-endocrine-pathology-when-to-think-about-it
#20
Nathalie Rouiller, François R Jornayvaz
An endocrine disease can be associated with glucose intolerance or diabetes mellitus, and the latter can falsely be considered as type 2 diabetes. Glycemic imbalance can be a direct or indirect consequence of excessive hormone production. Endocrine diseases such as acromegaly, Cushing's syndrome and pheochromocytoma can increase glucose production and cause insulin resistance. Hyperthyroidism, hyperaldosteronism, glucagonoma and somatostatinoma lead to hyperglycemia by other physiopathological mechanisms detailed in this article...
May 31, 2017: Revue Médicale Suisse
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