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https://www.readbyqxmd.com/read/29149336/military-neurosurgery-socioeconomic-data-benefits-challenges-and-opportunities
#1
Richard Menger, J Will Robbins, Randy Bell
Military conflict and neurosurgery date back to antiquity. Neurosurgery's development is intimately linked with Harvey Cushing's military experience. Previous papers highlighted unique opportunities and socioeconomic challenges facing military neurosurgeons. Here, we provide objective data from military neurosurgeons surrounding these issues.Internet survey responses were solicited from current, separated, and retired military neurosurgeons regarding workforce issues and their perception of military neurosurgery...
November 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29148866/drugs-of-abuse-and-novel-psychoactive-substances-at-outdoor-music-festivals-in-colorado
#2
Jacob Fox, Alexis Smith, Alexander Yale, Christopher Chow, Elsa Alaswad, Tracy Cushing, Andrew A Monte
BACKGROUND: Drugs of abuse (DOA) are widely used in the United States and are ubiquitous at outdoor music festivals. Attendees at music festivals are at high-risk for novel psychoactive substance (NPS) use, which is becoming more prevalent worldwide. No U.S. studies have employed an qualitative approach to investigate the etiologies of both traditional DOA and NPS use amongst music festival attendees. OBJECTIVES: The objective of this study was to improve understanding of the knowledge, attitudes, beliefs, and practices of festival attendees using NPS and DOA...
November 17, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/29147440/rare-presentation-of-adrenocortical-carcinoma-in-a-4-month-old-boy
#3
Sonali Malhotra, Apoorva R Waikar, Prabhsimranjot Singh, Ludovico Guarini, Elka Jacobson-Dickman, Roja Motaghedi, Irina Kazachkova
Adrenocortical carcinoma (ACC) is a rare malignancy and even rarer in infancy. Most of these tumors in pediatric age group are hormonally active and predominantly present with virilization. Cortisol hypersecretion presenting as Cushing syndrome is extremely rare and seen in older age groups. We report a 4-month-old infant who presented with linear growth arrest and excessive weight gain in early infancy, consequently diagnosed with ACC. On long-term follow-up for 7 years, he remained metastasis free following surgical resection and was not treated with chemotherapy...
June 2017: World Journal of Oncology
https://www.readbyqxmd.com/read/29145000/proopiomelanocortin-processing-and-prohormone-convertase-1-level-in-dogs-with-pituitary-corticotroph-tumors
#4
G Benchekroun, P de Fornel-Thibaud, D Rosenberg
Preliminary data suggest that prohormone convertase 1 (PC1/3) protein expression and proopiomelanocortin (POMC) processing are altered in large corticotroph tumors. The aim of this study was to characterize the levels of ACTH precursors and PC1/3 protein in small and large corticotroph tumors of dogs with Cushing's disease. Pituitary tumors of dogs with Cushing's disease were collected postmortem 30 min to 12h after natural death or euthanasia, and classified as small or large. POMC, pro-ACTH, and PC1/3 were detected by Western blotting...
October 13, 2017: Domestic Animal Endocrinology
https://www.readbyqxmd.com/read/29144801/utility-of-a-single-late-night-plasma-cortisol-and-acth-for-the-diagnosis-of-cushing-s-syndrome
#5
Kush Dev Singh Jarial, Anil Bhansali, Kanchan K Mukherjee, Rimesh Pal, Akhilesh Sharma, Rakesh K Vashishtha, Suja P Sukumar, Naresh Sachdeva, Rama Walia
OBJECTIVE: To evaluate the diagnostic efficacy of various screening tests for the diagnosis of Cushing's syndrome (CS). METHODS: 35 patients of Cushing's syndrome and 16 patients of pseudo-Cushing's syndrome were enrolled. Assessment of 24h urinary free cortisol (UFC), late night salivary cortisol (LNSC), over night dexamethasone suppression test (ONDST), late night plasma cortisol (LNPC) and ACTH on outpatient basis, and during sleep as well as in awake state after 48 hours of hospital admission...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29143885/consensus-driven-in-hospital-cortisol-assessment-after-acth-secreting-pituitary-adenoma-resection
#6
Yana Stolyarov, James Mirocha, Adam N Mamelak, Anat Ben-Shlomo
PURPOSE: Remission from Cushing disease (CD) after pituitary adenoma resection may be predicted by a postoperative reduction in serum cortisol level. A 2008 consensus statement recommends assessing morning cortisol levels during the first postoperative week, and replacing glucocorticoid (GC) if cortisol nadir of < 2 or < 5 µg/dL is achieved. We sought to evaluate adherence to consensus recommendations following adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma resection at our tertiary medical center, and assess time to cortisol nadir to better define the window for assessment and intervention...
November 16, 2017: Pituitary
https://www.readbyqxmd.com/read/29143179/diagnostic-work-up-in-steroid-myopathy
#7
REVIEW
Marco Alessandro Minetto, Valentina D'Angelo, Emanuela Arvat, Santosh Kesari
INTRODUCTION: Steroid myopathy is a well-known sign of endogenous Cushing's syndrome as well as a side effect of glucocorticoid administration. The clinical finding of muscle weakness and the clinical inspection of the muscle size are the most commonly used diagnostic tools, sometimes in combination with needle electromyography, but there are no means to detect the myopathy before the appearance of clinical or electrodiagnostic signs. Until now, no guidelines have been produced for a disease-specific evaluation of muscle impairment in patients with Cushing's syndrome...
November 15, 2017: Endocrine
https://www.readbyqxmd.com/read/29142029/routine-use-of-quantitative-disease-activity-measurements-among-us-rheumatologists-implications-for-treat-to-target-management-strategies-in-rheumatoid-arthritis
#8
Jeffrey R Curtis, Lang Chen, Maria I Danila, Kenneth G Saag, Kathy L Parham, John J Cush
OBJECTIVE: The aim of our study was to examine why real-world practices and attitudes regarding quantitative measurements of rheumatoid arthritis (RA) have received limited attention. METHODS: An e-mail survey asked US rheumatologists to self-report on their use of quantitative measurements (metric). RESULTS: Among 439 respondents, metric rheumatologists (58%) were more likely to be in group practice and to use tumor necrosis factor inhibitors...
November 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/29141926/ectopic-acth-syndrome-complicated-by-multiple-opportunistic-infections-treated-with-percutaneous-ablation-of-the-adrenal-glands
#9
Chrystal Chan, James Mark Roberts
Ectopic adrenocorticotropic hormone (ACTH)-related Cushing's syndrome can lead to multiple complications including severe immunosuppression. If the ACTH-secreting tumour cannot be found, definitive treatment is surgical adrenalectomy, typically followed by glucocorticoid replacement. Here, we present a case of fulminant respiratory failure secondary to coinfection with Pneumocystis jirovecii and cytomegalovirus in a patient with ectopic ACTH-dependent Cushing's syndrome with occult primary. Due to significant deconditioning, she was unable to undergo definitive adrenalectomy and instead underwent percutaneous microwave ablation of the adrenal glands...
November 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29141379/-clinical-value-of-tumor-size-in-the-evaluation-of-adrenal-incidentalomas
#10
L L Li, L Zhao, J T Dou, G Q Yang, W J Gu, Z H Lü, J M Ba, Y M Mu, J M Lu, C Y Pan
Objective: To investigate the clinical value of tumor size in the evaluation of endocrinological and histological natures regarding adrenal incidentaloma (AI) patients. Methods: A total of 1 941 AI patients who were hospitalized in Department of Endocrinology, Chinese PLA General Hospital between January 1997 and December 2016 were retrospectively reviewed. The demographics of patients, imaging features, functional status and histological results were analyzed. Results: Of 1 941 patients, 984 (50.70%) were males, and 957 (49...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29136718/-a-case-report-of-cushing-s-syndrome-in-pregnancy
#11
J L Chen, Q Ren, J Q Li
No abstract text is available yet for this article.
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29134965/depression-is-associated-with-more-aggressive-inflammatory-bowel-disease
#12
Bharati Kochar, Edward L Barnes, Millie D Long, Kelly C Cushing, Joseph Galanko, Christopher F Martin, Laura E Raffals, Robert S Sandler
OBJECTIVES: Depression is prevalent in inflammatory bowel disease (IBD) patients. The impact of depression on IBD is not well-studied. It is unknown how providers should assess depression. METHODS: We used data from the Sinai-Helmsley Alliance for Research Excellence cohort, to assess methods of diagnosing depression and effects of baseline depression on disease activity at follow-up. A patient health questionnaire (PHQ-8) score ≥5 was consistent with mild depression...
November 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29134558/development-of-hyperkalemia-following-treatment-with-dapagliflozin-dapa-in-a-patient-with-type-2-diabetes-after-bilateral-adrenalectomy
#13
Daichi Miyaoka, Akihiro Tsuda, Noriyuki Hayashi, Norikazu Toi, Akiyo Yamasaki, Yuki Nagata, Shinya Nakatani, Masafumi Kurajoh, Shinsuke Yamada, Tomoaki Morioka, Yasuo Imanishi, Masanori Emoto, Masaaki Inaba
Dapagliflozin (DAPA), a sodium-glucose co-transporter 2 (SGLT2) inhibitor, is known to have a beneficial diuretic effect, in addition to a glucose-lowering effect. Although SGLT2 inhibitor has been reported, the increase of hyperkalemia in patients treated with renin-angiotensin-aldosterone system (RAAS) inhibitors, their mechanism of action is unclear. We report the first case of a type 2 diabetes (T2DM) patient with potential mineralocorticoid deficiency who developed hyperkalemia after administration of DAPA...
November 13, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/29134170/effectiveness-of-bilateral-inferior-petrosal-sinuses-sampling-in-tumor-lateralization-intraoperative-findings-and-postoperative-results
#14
Pablo Harker, Oscar Feo-Lee, Manuel Giraldo-Grueso, Juan Carlos Puentes
Object  Diagnosis and treatment of Cushing's disease (CD) is a demanding endeavor. We evaluated the effectiveness of inferior petrosal sinus sampling (IPSS) in preoperative tumor lateralization and surgical outcomes. Methods  Fifty-two consecutive patients with CD and normal magnetic resonance imaging (MRI) were enrolled between 2009 and 2015. Selective catheterization of petrosal sinuses for IPSS was performed. All patients underwent microsurgical dissection, and if a lesion was found, underwent lesion resection...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29128555/combined-haploidentical-and-umbilical-cord-blood-allogeneic-stem-cell-transplantation-for-high-risk-lymphoma-and-cll
#15
Jingmei Hsu, Andrew Artz, Sebastian A Mayer, Danielle Guarner, Michael R Bishop, Ronit Reich-Slotky, Sonali M Smith, June Greenberg, Justin Kline, Rosanna Ferrante, Adrienne A Phillips, Usama Gergis, Hongtao Liu, Wendy Stock, Melissa Cushing, Tsiporah B Shore, Koen van Besien
Limited studies have reported on outcomes for lymphoid malignancy patients receiving alternative donor allogeneic stem cell transplants. We have previously described combining CD34-selected haploidentical grafts with umbilical cord blood (haplo-cord) to accelerate neutrophil and platelet engraftment. Here, we examine the outcome of patients with lymphoid malignancies undergoing haplo-cord transplantation at the University of Chicago and Weill Cornell Medical College. We analyzed 42 lymphoma and CLL patients who underwent haplo-cord allogeneic stem cell transplantation...
November 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29125476/adrenalectomy-was-recommended-for-patients-with-subclinical-cushing-s-syndrome-due-to-adrenal-incidentaloma
#16
Dong Wang, Zhi-Gang Ji, Han-Zhong Li, Yu-Shi Zhang
OBJECTIVE: To assess whether adrenalectomy may improve biochemical and metabolic impairment for patients with subclinical Cushing syndrome (SCS) due to adrenal incidentaloma (AI) compared with conservative management. METHODS: A total of 87 patients with SCS due to AI in Peking Union Medical College Hospital between September 2011 and January 2016 have been treated. Forty-eight patients underwent laparoscopic adrenalectomy (operative group), whereas 39 were managed conservatively (control group)...
October 31, 2017: Cancer Biomarkers: Section A of Disease Markers
https://www.readbyqxmd.com/read/29123215/observer-s-anxiety-facilitates-magnocellular-processing-of-clear-facial-threat-cues-but-impairs-parvocellular-processing-of-ambiguous-facial-threat-cues
#17
Hee Yeon Im, Reginald B Adams, Jasmine Boshyan, Noreen Ward, Cody A Cushing, Kestutis Kveraga
Facial expression and eye gaze provide a shared signal about threats. While a fear expression with averted gaze clearly points to the source of threat, direct-gaze fear renders the source of threat ambiguous. Separable routes have been proposed to mediate these processes, with preferential attunement of the magnocellular (M) pathway to clear threat, and of the parvocellular (P) pathway to threat ambiguity. Here we investigated how observers' trait anxiety modulates M- and P-pathway processing of clear and ambiguous threat cues...
November 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29122730/cerebral-venous-sinus-thrombosis-following-second-transsphenoidal-surgery-report-of-a-rare-complication-and-review-of-literature
#18
Zhuangzhuang Miao, Zhuo Zhang, Juan Chen, Junwen Wang, Huaqiu Zhang, Ting Lei
BACKGROUND: Cushing's disease, induced by pituitary adrenocorticotropic hormone (ACTH) secreting adenomas, is associated with high risk factors of stroke. At present, transsphenoidal surgery remains the first line of therapy. Cerebral venous sinus thrombosis (CVST) is an uncommon form of stroke with variable presentations but, to date, there have been no reports of its occurrence in Cushing's disease patients following surgery. CASE DESCRIPTION: We herein report a Cushing's disease case who suffered CVST a few days after a second transsphenoidal surgery...
November 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29119040/giant-mucopyocele-associated-with-intracranial-hypertension-case-report-and-literature-review
#19
Maick Willen Fernandes Neves, Luis Otavio Carneiro Pontelli, Luiz Gustavo de Abreu Mattos, Mariana Mazzuia Guimarães, Telmo Augusto Barba Belsuzarri, Tiago Fernandes Gonçales, Wolnei Marques Zeviani, Paulo Henrique Pires de Aguiar, João Flavio Mattos Araújo
Background: Mucoceles are epithelial lined sacs that contain mucous. Eventually, they can be infected and so called mucopyoceles, which are usually slow growing lesions with common bone destruction located in the facial sinus. Mucoceles show multivariate etiology and occur between the fourth and seventh decade of life. Case Description: Patient, 55-year-old, female, was referred unconscious with Cushing's triad to our department; she had fever since four days. The findings of skull computer tomography highlighted a large bifrontal lesion with an invasion of the rear wall of the frontal sinus, compression of the frontal lobes, and midline deviation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29118985/acute-development-of-cushing-syndrome-in-an-hiv-infected-child-on-atazanavir-ritonavir-based-antiretroviral-therapy
#20
Gueorgui Dubrocq, Andrea Estrada, Shannon Kelly, Natella Rakhmanina
An 11-year-old male with perinatally acquired human immune deficiency virus (HIV) infection on antiretroviral regimen, which included abacavir plus lamivudine (Epzicom), didanosine, ritonavir and atazanavir presented with bilateral axillary striae, increased appetite, fatigue, facial swelling and acute weight gain. Two months prior to presentation, the patient had received a diagnostic and therapeutic intra-articular triamcinolone injection in the knee for pain relief and subsequently became progressively swollen in the face, developed striae bilaterally at the axillae, experienced increased appetite, fatigue and an 8 pound weight gain...
2017: Endocrinology, Diabetes & Metabolism Case Reports
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