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https://www.readbyqxmd.com/read/28343156/ectopic-acth-producing-large-cell-neuroendocrine-pancoast-tumour-presenting-as-horner-syndrome
#1
Rajanshu Verma, Alexandra Lambert, Harold H Katz, Scott J Benson
We present an interesting case where a patient is presented with a droopy left eyelid (as part of Horner syndrome) and Cushingoid features which were a result of a Pancoast tumour (apical lung tumour in superior pulmonary sulcus) involving the left lung. This tumour was secreting ectopic adrenocorticotropic hormone (ACTH), a paraneoplastic endocrine phenomenon, which resulted in Cushing syndrome symptomatology. Though most ectopic ACTH-producing lung cancers are either small cell or carcinoid tumours, this was in fact a large cell neuroendocrine cancer (LCNEC)...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28337175/effects-of-chronic-acth-excess-on-human-adrenal-cortex
#2
REVIEW
Xavier Bertagna
Chronic ACTH excess leads to chronic cortisol excess, without escape phenomenon, resulting in Cushing's syndrome. Excess adrenal androgens also occur: in females, they will overcompensate the gonadotrophic loss, inducing high testosterone; in males, they will not compensate it, inducing low testosterone. Chronic ACTH excess leads to chronic adrenal mineralocorticoid excess and low aldosterone levels: after an acute rise, aldosterone plasma levels resume low values after a few days when ACTH is prolonged. Two other mineralocorticoids in man, cortisol and 11 deoxycorticosterone (DOC), at the zona fasciculata, will not escape the long-term effect of chronic ACTH excess and their secretion rates will remain elevated in parallel...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28332877/pentraxin-3-as-a-new-cardiovascular-marker-in-adrenal-adenomas
#3
Muhammed Kizilgul, Selvihan Beysel, Ozgur Ozcelik, Seyfullah Kan, Mahmut Apaydin, Mustafa Caliskan, Bekir Ucan, Erkam Sencar, Seyda Ozdemir, Erman Cakal
BACKGROUND: Pentraxin 3 (PTX3) is an acute-phase glycoprotein, which is increased in patients with cardiovascular disease (CVD) and considered as a predictor of CVD in the general population. Both functional and nonfunctional adrenal tumors are associated with a higher risk of cardiovascular events and mortality. We aimed to investigate plasma PTX3 levels in patients with functioning and nonfunctioning adrenal tumors and to determine its relationship with cardiovascular risk factors. MATERIAL AND METHODS: Twenty-one patients with functional adrenal tumors (11 pheochromocytomas, 9 Cushing's Syndrome and 1 primary hyperaldosteronism), 28 patients with non-functional adrenal incidentilomas, and 40 healthy controls were enrolled in the study...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28332874/long-term-outcome-of-the-different-treatment-alternatives-for-recurrent-and-persistent-cushing-s-disease
#4
Ana Laura Espinosa-de-Los-Monteros, Ernesto Sosa-Eroza, Etual Espinosa, Victoria Mendoza, Rocio Arreola, Moises Mercado
BACKGROUND: Treatment alternatives for persistent and recurrent Cushing's disease (CD) include pituitary surgical reintervention, radiotherapy, pharmacotherapy and bilateral adrenalectomy (BA). The decision of which of these alternatives is better suited for the individual patient rests on clinical judgment and the availability of resources. OBJECTIVE: To evaluate the long-term efficacy of the different secondary interventions for persistent and recurrent Cushing's disease...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28332512/a-lack-of-day-by-day-variability-in-blood-pressure-in-a-cushing-s-disease-patient
#5
K Eguchi, H Kurita, E Matsumoto, M Hashimoto, K Kario
No abstract text is available yet for this article.
March 23, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28332051/white-matter-involvement-on-dti-mri-in-cushing-s-syndrome-relates-to-mood-disturbances-and-processing-speed-a-case-control-study
#6
Patricia Pires, Alicia Santos, Yolanda Vives-Gilabert, Susan M Webb, Aitor Sainz-Ruiz, Eugenia Resmini, Iris Crespo, Manel de Juan-Delago, Beatriz Gómez-Anson
PURPOSE: Cushing's syndrome (CS) is an endocrine disorder due to prolonged exposure to cortisol. Recently, microstructural white matter (WM) alterations detected by diffusion tensor imaging (DTI) have been reported in CS patients, and related to depression, but other functional significances. remain otherwise unclear. We aimed at investigating in more depth mood symptoms in CS patients, and how these relate to cognition (information processing speed), and to WM alterations on DTI. METHODS: The sample comprised 35 CS patients and 35 healthy controls...
March 22, 2017: Pituitary
https://www.readbyqxmd.com/read/28329633/comorbidities-of-hospitalized-pemphigus-patients-in-the-united-states
#7
Derek Y Hsu Y Hsu
We sought to determine the comorbid health conditions and inpatient mortality associated with pemphigus in a U.S. inpatient cohort. The 2002-2012 Nationwide Inpatient Sample, which contains a representative 20% stratified sample of all inpatient hospitalizations in the US, was analyzed. Comorbidities were determined through ICD-9-CM codes. Survey weighted multivariate logistic regression models controlling for demographic factors were constructed to determine the association of pemphigus with various comorbidities...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329436/prospective-evaluation-of-a-week-one-overnight-metyrapone-test-with-subsequent-dynamic-assessments-of-hypothalamic-pituitary-adrenal-axis-function-after-pituitary-surgery
#8
Katherine English, Warrick J Inder, Zara Weedon, Goce Dimeski, Jane Sorbello, Anthony W Russell, Emma L Duncan, Ross Cuneo
OBJECTIVE: To determine if an overnight metyrapone test (OMT) within the first week post pituitary surgery can definitively assess the hypothalamic-pituitary-adrenal (HPA) axis, compared with subsequent dynamic tests and glucocorticoid requirement at 6 months. DESIGN: Prospective study measuring morning cortisol levels on day 3 and 4 post-operatively, OMT day 5-7 and week 6, 250μg short Synacthen test (SST) week 6 and insulin tolerance test (ITT) week 7. PATIENTS AND MEASUREMENTS: Forty participants who underwent pituitary surgery at a single centre (Cushing's disease excluded) and were followed for at least 6 months...
March 22, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28328532/cushing-s-syndrome-in-infancy-due-to-ectopic-acth-secretion-by-a-sacro-coccygeal-teratoma
#9
Marta Rydzewska, Maryna Krawczuk-Rybak, Adrianna Zajkowska, Natalia Jurczuk, Dariusz Polnik, Mieczysław Szalecki, Elżbieta Moszczyńska, Martin O Savage, Artur Bossowski
BACKGROUND: Adenocorticotropic hormone (ACTH)-dependent Cushing's syndrome in infancy is extremely rare. We describe the case of a sacro-coccygeal ectopic ACTH-secreting immature teratoma in an infant who also presented the triad of defects characteristic of Currarino syndrome. CASE PRESENTATION: A girl was born with a large immature teratoma in the sacro-coccygeal region associated with anal atresia. At the age of 7 days, the concentration of α-fetoprotein (AFP) was above the age-specific normal range...
March 22, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28325824/persistence-of-myopathy-in-cushing-s-syndrome-evaluation-of-the-german-cushing-s-registry
#10
Christina Maria Berr, Mareike R Stieg, Timo Deutschbein, Marcus Quinkler, Ralf Schmidmaier, Andrea Osswald, Nicole Reisch, Katrin Ritzel, Christina Dimopoulou, Julia Fazel, Stefanie Hahner, Gunter K Stalla, Felix Beuschlein, Martin Reincke
BACKGROUND: Cushing's syndrome (CS) is characterized by an excessive secretion of glucocorticoids that results in a characteristic clinical phenotype. One feature of clinical hypercortisolism is breakdown of protein metabolism translating into clinical consequences including glucocorticoid induced myopathy. While surgery is effective in control of cortisol excess, the effect of biochemical remission on muscular function is yet unclear. METHODS: In a cross-sectional study we analyzed 47 patients with CS during the florid phase (ActiveCS)...
March 21, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28323961/normalized-early-post-operative-cortisol-and-acth-values-predict-nonremission-after-surgery-for-cushing-s-disease
#11
David Asuzu, Grégoire P Chatain, Christina Hayes, Sarah Benzo, Raven McGlotten, Meg Keil, Andrea Beri, Susmeeta T Sharma, Lynnette Nieman, Maya Lodish, Constantine Stratakis, Russell R Lonser, Edward H Oldfield, Prashant Chittiboina
Context: Perioperative increases in adrenocorticotropic hormone (ACTH) and cortisol mimic corticotropin releasing hormone (CRH) stimulation testing. This phenomenon may help identify patients with residual adenoma after transsphenoidal surgery (TSS) for Cushing's disease (CD). Objective: To predict non-remission after TSS for CD. Design: Retrospective case control study of patients treated at a single center from December 2003 till July 2016...
March 15, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28321371/anatomic-variations-in-pituitary-endocrinopathies-implications-for-the-surgical-corridor
#12
Edward C Kuan, Frederick Yoo, Won Kim, Karam W Badran, Thomas E Heineman, Ali R Sepahdari, Marvin Bergsneider, Marilene B Wang
Objectives/Hypotheses Functioning pituitary adenomas may produce endocrinopathies such as acromegaly and Cushing syndrome. Both conditions lead to characteristic anatomic variations as a result of hormonally induced abnormal soft tissue deposition. We evaluate the anatomic differences between acromegalics and Cushing disease patients and compare these dimensions to controls. Design Radiographic review of preoperative magnetic resonance images (MRI) of the pituitary gland. Setting Tertiary academic medical center...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28319239/mobile-health-interventions-for-improving-health-outcomes-in-youth-a-meta-analysis
#13
David A Fedele, Christopher C Cushing, Alyssa Fritz, Christina M Amaro, Adrian Ortega
Importance: Mobile health interventions are increasingly popular in pediatrics; however, it is unclear how effective these interventions are in changing health outcomes. Objective: To determine the effectiveness of mobile health interventions for improving health outcomes in youth 18 years or younger. Data Sources: Studies published through November 30, 2016, were collected through PubMed, Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Center, and PsychINFO...
March 20, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28317048/acth-producing-neuroendocrine-tumor-of-the-pancreas-a-case-report-and-literature-review
#14
Justin Byun, Sung Hyun Kim, Hyang Sook Jeong, Yumie Rhee, Woo Jung Lee, Chang Moo Kang
Tumors that arise from the endocrine pancreas, or the islets of pancreas, are called pancreatic neuroendocrine tumors (NETs). Pancreatic NET have an incidence of <0.1 per one million persons, and can lead to secretion of ectopic adrenocorticotropic hormone (ACTH). Herein, we presented a case of patient with Cushing's syndrome as a result of ACTH-producing pancreatic NET, who underwent successful laparoscopic distal pancreatosplenectomy. A 40-year-old Korean female patient with ophthalmologic discomfort, osteoporosis, and unexplained hypokalemia was admitted to our hospital...
February 2017: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28315152/bilateral-robotic-transabdominal-adrenalectomy-in-a-patient-with-intestinal-malrotation
#15
Zuliang Feng, Carmen C Solórzano
Bilateral adrenalectomy is the preferred surgical approach for patients with failed treatments for pituitary-based Cushing's syndrome. Intestinal malrotation (IM) is a rare congenital anatomic variant that rarely affects adults. The abnormal abdominal anatomy is concerning to surgeons planning elective procedures in such patients. Here, we describe a bilateral robotic transabdominal adrenalectomy (RTA) in a patient with IM. A 29-year-old female presented with refractory pituitary-based Cushing's syndrome and was found to have IM on preoperative CT scan...
March 17, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28300138/reduced-dna-methylation-and-psychopathology-following-endogenous-hypercortisolism-a-genome-wide-study
#16
Camilla A M Glad, Johanna C Andersson-Assarsson, Peter Berglund, Ragnhildur Bergthorsdottir, Oskar Ragnarsson, Gudmundur Johannsson
Patients with Cushing's Syndrome (CS) in remission were used as a model to test the hypothesis that long-standing excessive cortisol exposure induces changes in DNA methylation that are associated with persisting neuropsychological consequences. Genome-wide DNA methylation was assessed in 48 women with CS in long-term remission (cases) and 16 controls matched for age, gender and education. The Fatigue impact scale and the comprehensive psychopathological rating scale were used to evaluate fatigue, depression and anxiety...
March 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28298353/simultaneous-assay-of-cortisol-and-dexamethasone-improved-diagnostic-accuracy-of-the-dexamethasone-suppression-test
#17
Grethe Åstrøm Ueland, Paal Methlie, Ralf Kellmann, Marit R Bjørgaas, Bjorn O Asvold, Ketil Thorstensen, Oskar Kelp, Hrafnkell B Thordarson, Gunnar Mellgren, Kristian Løvås, Eystein Sverre Husebye
OBJECTIVES: The overnight dexamethasone (DXM)-suppression test (DST) has high sensitivity, but moderate specificity, for diagnosing hypercortisolism. We have evaluated if simultaneous measurement of S-DXM may correct for variable DXM bioavailability and increase diagnostic performance of DST, and if saliva (sa) is a feasible adjunct or alternative to serum. DESIGN AND METHODS: Prospective study of DST in suspected Cushing's syndrome (CS) (n= 49), incidentaloma (n= 152), and controls (n= 101)...
March 15, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28298034/a-protocol-for-postoperative-admission-of-elective-craniotomy-patients-to-a-non-icu-or-step-down-setting
#18
Jeffrey E Florman, Deborah Cushing, Lynne A Keller, Anand I Rughani
OBJECTIVE Selecting the appropriate patients undergoing craniotomy who can safely forgo postoperative intensive care unit (ICU) monitoring remains a source of debate. Through a multidisciplinary work group, the authors redefined their institutional care process for postoperative monitoring of patients undergoing elective craniotomy to include transfer from the postanesthesia care unit (PACU) to the neurosurgical floor. The hypothesis was that an appropriately selected group of patients undergoing craniotomy could be safely managed outside the ICU in the postoperative period...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28294570/how-does-obesity-affect-the-endocrine-system-a-narrative-review
#19
REVIEW
M Poddar, Y Chetty, V T Chetty
Obesity is a chronic, relapsing medical condition that results from an imbalance of energy expenditure and consumption. It is a leading cause of preventable illness, disability and premature death. The causes of obesity are multifactorial and include behavioural, socioeconomic, genetic, environmental and psychosocial factors. Rarely are endocrine diseases, e.g., hypothyroidism or Cushing's syndrome, the cause of obesity. What is less understood is how obesity affects the endocrine system. In this review, we will discuss the impact of obesity on multiple endocrine systems, including the hypothalamic-pituitary axis, changes in vitamin D homeostasis, gender steroids and thyroid hormones...
March 15, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28290967/the-brief-military-career-of-dr-william-h-welch
#20
James K Gilman
INTRODUCTION: The purpose of this article is to examine the Army service of Dr. William H. Welch during World War I. MATERIALS AND METHODS: Archival research utilizing prime source documents in the William H. Welch Collection of the Alan M. Chesney Medical Archives for the Johns Hopkins Medical Institutions. RESULTS: Welch joined the Army at the age of 67 after serving as one of the principal transformational forces for reforming medical education in the United States and founding the first academic institution for educating public health professionals in the United States, the Johns Hopkins School of Public Health and Hygiene...
March 2017: Military Medicine
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