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https://www.readbyqxmd.com/read/27906551/ald1613-a-novel-long-acting-monoclonal-antibody-to-control-acth-driven-pharmacology
#1
Andrew L Feldhaus, Katie Anderson, Benjamin Dutzar, Ethan Ojala, Patricia Dianne McNeill, Pei Fan, Jenny Mulligan, Sam Marzolf, Charlie Karasek, Michelle Scalley-Kim, Erica Stewart, Jens Billgren, Vanessa Rubin, Kathleen Schneider, David Jurchen, Kathy Snow, Shaun Barnett, Barbara Bengtsson, Brian Baker, John A Latham, Dan Allison, Leon F Garcia-Martinez
ACTH is the primary regulator of adrenal glucocorticoid production. Elevated levels of ACTH play a critical role in disease progression in several indications including congenital adrenal hyperplasia and Cushing's disease. We have generated a specific, high affinity, neutralizing monoclonal antibody (ALD1613) to ACTH. In vitro, ALD1613 neutralizes ACTH-induced signaling via all five melanocortin receptors and inhibited ACTH-induced cAMP accumulation in a mouse adrenal cell line (Y1). ALD1613 administration to wild-type rats significantly reduced plasma corticosterone levels in a dose dependent manner...
December 1, 2016: Endocrinology
https://www.readbyqxmd.com/read/27903577/adrenal-cushing-syndrome-with-detectable-acth-from-an-unexpected-source
#2
Thinzar M Lwin, Nehal Galal, Shweta Gera, Jennifer L Marti
Mixed corticomedullary adrenal tumours (MCMT) are rare. We describe the second reported case of a male patient presenting with hypertension and Cushing syndrome with MCMT. A man aged 48 years presented with hypertension and signs of Cushing syndrome. 24-hour urine cortisol was elevated, with detectable adrenocorticotropic hormone (ACTH). A high-dose dexamethasone suppression test indicated an adrenal or ectopic Cushing syndrome. Plasma metanephrines were normal. A 3 cm left adrenal mass was identified without potential ectopic sources of ACTH on imaging...
November 30, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27901643/bilateral-testicular-tumors-resulting-in-recurrent-cushing-s-syndrome-after-bilateral-adrenalectomy
#3
Troy Puar, Manon Engels, Antonius E van Herwaarden, Fred C G J Sweep, Christina Hulsbergen-van de Kaa, Karin Kamphuis-van Ulzen, Vasileios Chortis, Wiebke Arlt, Nike Stikkelbroeck, Hedi L Claahsen-van der Grinten, Ad R M M Hermus
CONTEXT: Recurrence of hypercortisolism in patients after bilateral adrenalectomy for Cushing's disease is extremely rare. PATIENT: We present a rare case of a 27-year-old man who previously underwent bilateral adrenalectomy for Cushing's disease with complete clinical resolution. Cushingoid features recurred 12 years later, along with bilateral testicular enlargement. Hormonal tests confirmed ACTH-dependent Cushing's. Surgical resection of the testicular tumors led to clinical and biochemical remission...
November 30, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27898397/multicenter-performance-evaluation-of-a-second-generation-cortisol-assay
#4
Michael Vogeser, Jürgen Kratzsch, Yoon Ju Bae, Mathias Bruegel, Uta Ceglarek, Tom Fiers, Alexander Gaudl, Hedwig Kurka, Christoph Milczynski, Cristina Prat Knoll, Anna C Suhr, Daniel Teupser, Ingrid Zahn, Richard E Ostlund
BACKGROUND: Untreated disorders of the adrenocortical system, such as Cushing's or Addison's disease, can be fatal, and accurate quantification of a patient's cortisol levels is vital for diagnosis. The objective of this study was to assess the analytical performance of a new fully-automated Elecsys® Cortisol II assay (second generation) to measure cortisol levels in serum and saliva. METHODS: Four European investigational sites assessed the intermediate precision and reproducibility of the Cortisol II assay (Roche Diagnostics) under routine conditions...
November 29, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27894193/currently-used-and-investigational-drugs-for-cushing%C3%A2-s-disease
#5
Denis Ciato, Aizhar G Mumbach, Marcelo Paez-Pereda, Günter K Stalla
Cushing's disease (CD) is caused by a corticotroph adenoma of the pituitary gland that secretes excess adrenocorticotropic hormone (ACTH) causing increased morbidity and mortality. Surgery is the treatment of choice, but is not always successful. Alternatives include radiotherapy, adrenal surgery, and pharmaceutical therapy. The latter is increasingly gaining momentum due to the recent development of compounds that reduce hypercortisolaemia or its symptoms, acting through different mechanisms. Areas covered: In this article, the authors provide a complete overview of the treatment options for Cushing´s disease, including adrenal-directed, tumor-targeted, and peripheral therapies that are currently used or in development, and discuss their potential advantages and limitations...
November 29, 2016: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27886397/telomerase-and-n-cadherin-differential-importance-in-adrenocortical-cancers-and-adenomas
#6
Sofia S Pereira, Valdemar Máximo, Ricardo Coelho, Rui Batista, Paula Soares, Susana G Guerreiro, Manuel Sobrinho-Simões, Mariana P Monteiro, Duarte Pignatelli
Adrenocortical carcinomas (ACC) are most frequently highly aggressive tumors. We assessed the telomerase reverse transcriptase (TERT) and N-cadherin role in the biology of ACC and their potential utility as molecular biomarkers, in different types of tumoral adrenocortical tissue. A total of 48 adrenal cortex samples (39 tumoral and 9 normal adrenal glands) were studied. TERT promoter mutations were searched by PCR and Sanger sequencing in two hotspots positions (-124 and -146). Also, telomerase and N-cadherin expression were evaluated by immunohistochemistry...
November 25, 2016: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/27885975/hearing-benefit-and-rated-satisfaction-in-children-with-unilateral-conductive-hearing-loss-using-a-transcutaneous-magnetic-coupled-bone-conduction-hearing-aid
#7
Melissa J Polonenko, Lora Carinci, Karen A Gordon, Blake C Papsin, Sharon L Cushing
BACKGROUND: Bilateral hearing is important for learning, development, and function in complex everyday environments. Children with conductive and mixed hearing loss (HL) have been treated for years with percutaneous coupling through an abutment, which achieves powerful output, but the implant site is susceptible to skin reactions and trauma. To overcome these complications, transcutaneous magnetic coupling systems were recently introduced. PURPOSE: The purpose of the study was to evaluate whether the new transcutaneous magnetic coupling is an effective coupling paradigm for bone-conduction hearing aids (BCHAs)...
November 2016: Journal of the American Academy of Audiology
https://www.readbyqxmd.com/read/27882768/-adrenocortical-oncocytoma-presenting-as-cushing%C3%A2-s-syndrome-in-pregnancy-with-spontaneous-postpartum-uterine-rupture
#8
M Kotoulová, I Mikysková, J Dušková, J Vláčil, M Dvořák, M Halaška
OBJECTIVE: The description of rare case of the Cushings syndrome in pregnancy resulting in the spontaneous rupture of uterus. DESIGNS: A case report. SETTING: Department of Gynecology and Obstetrics, 1st Medical Faculty of Charles University and Hospital Na Bulovce. CASE REPORT: The authors report the case of a 33 year old woman, who was admitted to the clinic in 30th week of pregnancy for elevated blood pressure and hypokalemia...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27880049/understanding-clinicians-attitudes-toward-a-mobile-health-strategy-to-childhood-asthma-management-a-qualitative-study
#9
Jessica P Hollenbach, Anna Cushing, Emilie Melvin, Bryanna McGowan, Michelle M Cloutier, Melissa Manice
OBJECTIVES: Mobile technology for childhood asthma can provide real-time data to enhance care. What real-time adherence information clinicians want, how they may use it, and if the data meet their clinical needs has not been fully explored. Our goal was to determine whether pediatric primary care and pulmonary clinicians believe a sensor-based mobile intervention is useful in caring for patients with asthma. METHODS: We recruited participants from 3 urban, primary care and 1 pulmonary practice from July to September 2015 in Hartford, CT...
November 23, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27879325/cushing-syndrome-in-a-child-due-to-pro-opiomelanocortin-pomc-secretion-from-a-yolk-sac-tumor
#10
Evelien Gevers, Suzanne Meredith, Pratik Shah, John Torpiano, Catherine Peters, Neil Sebire, Olga Slater, Anne White, Mehul Datani
CONTEXT: Pituitary microadenomas and adrenal tumours are the most common causes for endogenous Cushing syndrome (CS) in children. CASE DESCRIPTION: We describe a two-year old girl with Cushing syndrome due to ectopic pro-opiomelanocortin (POMC) production from an abdominal yolk sac tumor. Cortisol concentrations were elevated but adrenocorticotropic hormone (ACTH) concentrations were equivocal. The use of antibodies specifically detecting ACTH precursors revealed that plasma ACTH precursors were elevated...
November 22, 2016: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27875378/cushing-syndrome-in-carney-complex-clinical-pathologic-and-molecular-genetic-findings-in-the-17-affected-mayo-clinic-patients
#11
Kathleen M Lowe, William F Young, Charalampos Lyssikatos, Constantine A Stratakis, J Aidan Carney
Carney complex (CNC) is a rare dominantly inherited multiorgan tumoral disorder that includes Cushing syndrome (CS). To establish the Mayo Clinic experience with the CS component, including its clinical, laboratory, and pathologic findings, we performed a retrospective search of the patient and pathologic databases of Mayo Clinic in Rochester, MN, for patients with CNC and clinical or laboratory findings of CS. Thirty-seven patients with CNC were identified. Twenty-nine had clinical, pathologic, or laboratory evidence of an adrenocortical disorder...
November 21, 2016: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/27873108/flushing-in-neuro-endocrinology
#12
REVIEW
Fady Hannah-Shmouni, Constantine A Stratakis, Christian A Koch
Cutaneous flushing is a common presenting complaint in endocrine disorders. The pathophysiology of flushing involves changes in cutaneous blood flow triggered by multiple intrinsic factors that are either related to physiology or disease. Flushing can be divided into episodic or persistent causes. Episodic flushing is mediated by the release of endogenous vasoactive mediators or medications, while persistent flushing results in a fixed facial erythema with telangiectasia and cyanosis due to slow-flowing deoxygenated blood in large cutaneous blood vessels...
November 21, 2016: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/27870568/morbidity-and-mortality-differences-between-hematopoietic-cell-transplantation-survivors-and-other-cancer-survivors
#13
Eric J Chow, Kara L Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Nandita Khera, Stephanie J Lee, Wendy M Leisenring, Paul J Martin, Beth A Mueller, Stephen M Schwartz, K Scott Baker
Purpose To compare the risks of serious health outcomes among hematopoietic cell transplantation (HCT) survivors versus a matched population of patients with cancer who did not undergo HCT, where the primary difference may be exposure to HCT. Methods Two-year HCT survivors treated at a comprehensive cancer center from 1992 through 2009 who were Washington State residents (n = 1,792; 52% allogeneic and 90% hematologic malignancies) were frequency matched by demographic characteristics and underlying cancer diagnosis (as applicable) to non-HCT 2-year cancer survivors, using the state cancer registry (n = 5,455) and the general population (n = 16,340) using driver's license files...
November 21, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27869874/-pharmacological-treatment-in-adrenal-cushing-s-syndrome
#14
Antonio Stigliano, Lidia Cerquetti, Vincenzo Toscano
ACTH-independent adrenal Cushing's syndrome is the least common form of endogenous hypercortisolism. Recently, advances in genetics have allowed the description of several forms different to pathogenetic etiology, morphostructural characteristics and evolution towards the hypercortisolism. Alongside these, the adrenocortical carcinoma is also frequently responsible of a hypercortisolism clinical picture. The availability of steroidogenesis inhibitors, such as metyrapone and ketoconazole, provides to endocrinologist a therapeutic chance against different metabolic disorders sustained by hypercortisolism...
November 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/27869719/targeted-molecular-imaging-in-adrenal-disease-an-emerging-role-for-metomidate-pet-ct
#15
REVIEW
Iosif A Mendichovszky, Andrew S Powlson, Roido Manavaki, Franklin I Aigbirhio, Heok Cheow, John R Buscombe, Mark Gurnell, Fiona J Gilbert
Adrenal lesions present a significant diagnostic burden for both radiologists and endocrinologists, especially with the increasing number of adrenal 'incidentalomas' detected on modern computed tomography (CT) or magnetic resonance imaging (MRI). A key objective is the reliable distinction of benign disease from either primary adrenal malignancy (e.g., adrenocortical carcinoma or malignant forms of pheochromocytoma/paraganglioma (PPGL)) or metastases (e.g., bronchial, renal). Benign lesions may still be associated with adverse sequelae through autonomous hormone hypersecretion (e...
November 18, 2016: Diagnostics
https://www.readbyqxmd.com/read/27868204/bioengineering-pediatric-scaffold-free-auricular-cartilaginous-constructs
#16
Pedram Akbari, Stephen D Waldman, Sharon L Cushing, Blake C Papsin, Evan J Propst, Joanna F Weber, Herman Yeger, Walid A Farhat
OBJECTIVE: The use of exogenous materials as scaffolds in cartilage tissue engineering has limited the clinical application of resultant constructs due to the risk of postoperative complications. In an effort to minimize such complications, we aim to generate human, scaffold-free auricular cartilaginous constructs. STUDY DESIGN: Laboratory study using pediatric auricular cartilage. METHODS: Remnant, normal pediatric auricular cartilage samples that would have otherwise been discarded were collected and digested to free cells...
November 21, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27865872/thymic-hyperplasia-after-treatment-of-acth-dependent-cushing-s-syndrome-can-be-mistaken-for-a-thymic-epithelial-tumor
#17
Jaydira Del Rivero, Chul Kim, Mary Eid, Mark A Ahlman, Lynnette Nieman, Arun Rajan
No abstract text is available yet for this article.
November 16, 2016: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/27865591/outcome-of-adrenalectomy-for-subclinical-hypercortisolism-and-cushing-syndrome
#18
Marco Raffaelli, Carmela De Crea, Gerardo D'Amato, Pierpaolo Gallucci, Celestino P Lombardi, Rocco Bellantone
BACKGROUND: We compared operative and metabolic outcomes in patients with subclinical Cushing syndrome and Cushing syndrome caused by unilateral adrenal lesion, aiming to clarify the role of glucocorticoid replacement treatment in patients with subclinical Cushing syndrome after adrenalectomy. METHODS: The medical records of all the patients who underwent unilateral adrenalectomy for subclinical Cushing syndrome or Cushing syndrome were reviewed. Diagnostic criteria for subclinical Cushing syndrome were a pathologic dexamethasone suppression test plus 2 additional criteria...
November 16, 2016: Surgery
https://www.readbyqxmd.com/read/27864805/endocrine-hypertension-a-practical-approach
#19
REVIEW
Joseph M Pappachan, Harit N Buch
Elevated blood pressure resulting from few endocrine disorders (endocrine hypertension) accounts for a high proportion of cases of secondary hypertension. Although some features may be suggestive, many cases of endocrine hypertension remain silent until worked up for the disease. A majority of cases result from primary aldosteronism. Other conditions that can cause endocrine hypertension are: congenital adrenal hyperplasia, Liddle syndrome, pheochromocytomas, Cushing's syndrome, acromegaly, thyroid diseases, primary hyperparathyroidism and iatrogenic hormone manipulation...
November 19, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27859451/altered-spontaneous-brain-activity-in-cushing-s-disease-a-resting-state-functional-mri-study
#20
Hong Jiang, Na-Ying He, Yu-Hao Sun, Fang-Fang Jian, Liu-Guan Bian, Jian-Kang Shen, Fu-Hua Yan, Si-Jian Pan, Qing-Fang Sun
CONTEXT AND OBJECTIVE: Cushing's disease (CD) provides a unique and naturalist model for studying the influence of hypercortisolism on the human brain and the reversibility of these effects after resolution of the condition. This cross-sectional study used resting state fMRI (rs-fMRI) to investigate the altered spontaneous brain activity in CD patients and the trends for potential reversibility after the resolution of the hypercortisolism. We also aim to determine the relationship of these changes with clinical characteristics and cortisol levels...
November 8, 2016: Clinical Endocrinology
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