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Cushing disease

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https://www.readbyqxmd.com/read/28422946/pediatric-cushing-disease-disparities-in-disease-severity-and-outcomes-in-the-hispanic-and-african-american-populations
#1
Alexandra Gkourogianni, Ninet Sinaii, Sharon H Jackson, Alexander S Karageorgiadis, Charalampos Lyssikatos, Elena Belyavskaya, Margaret F Keil, Mihail Zilbermint, Prashant Chittiboina, Constantine A Stratakis, Maya B Lodish
BACKGROUND: Little is known about the contribution of racial and socioeconomic disparities to severity and outcomes for children with Cushing disease (CD). METHODS: 129 children with CD, 45 Hispanic/Latino or African American (HI/AA) and 84 non-Hispanic White (non-HW), are included. A 10-point index for rating severity (CD-severity) incorporated degree of hypercortisolemia, glucose tolerance, hypertension, anthropomorphic measurements, disease duration, and tumor characteristics...
April 19, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28420444/case-report-acth-secreting-pituitary-carcinoma-metastatic-to-the-liver-in-a-patient-with-a-history-of-atypical-pituitary-adenoma-and-cushing-s-disease
#2
Amy S Joehlin-Price, Douglas A Hardesty, Christina A Arnold, Lawrence S Kirschner, Daniel M Prevedello, Norman L Lehman
BACKGROUND: Pituitary carcinoma is a rare entity requiring the presence of metastasis to confirm its malignant potential. We report a case of pituitary carcinoma and discuss the diagnosis and management of this lesion in relation to the existing literature. CASE PRESENTATION: The patient is a 51-year-old woman with Cushing's disease and intact adrenal glands who was diagnosed with metastatic pituitary carcinoma to the liver, 29 months after initial resection of an ACTH-secreting primary atypical pituitary adenoma (APA)...
April 18, 2017: Diagnostic Pathology
https://www.readbyqxmd.com/read/28418764/disease-surveillance-of-california-ground-squirrels-spermophilus-beecheyi-in-a-drive-through-zoo-in-oregon-usa
#3
Julia Ter Beest, Andrew Cushing, Modesto McClean, Wendy Hsu, Robert Bildfell
Rodents and other small wild mammals are often considered to be pests and vectors for disease in zoos that house small populations of valuable threatened and endangered animals. In 2005, three nonhuman primates at a drive-through zoo in Oregon, USA, acquired tularemia from an unknown source. Due to an abundance of California ground squirrels ( Spermophilus beecheyi ) on zoo grounds, we instituted serosurveillance of this species from July through September 2008 to determine the prevalence of antibodies against pathogens considered to be potentially transmissible to collection animals...
April 18, 2017: Journal of Wildlife Diseases
https://www.readbyqxmd.com/read/28413388/a-case-report-of-cushing-s-disease-presenting-as-hair-loss
#4
Emily G Lefkowitz, Jack P Cossman, John B Fournier
Cushing's syndrome is a rare endocrine disorder that comprises a large group of signs and symptoms resulting from chronic exposure to excess corticosteroids. Most cases of Cushing's syndrome are due to increased adrenocorticotropic hormone production from a pituitary adenoma, which is referred to as Cushing's disease. Most of the signs and symptoms are nonspecific and common in the general population, making a diagnosis often challenging. However, several dermatological manifestations, such as fragile skin, easy bruising, and reddish purple striae, are more discriminatory...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28412706/endocrine-comorbidities-in-patients-with-psoriatic-arthritis-a-population-based-case-controlled-study
#5
Amir Haddad, Ron Ilan Ashkenazi, Haim Bitterman, Ilan Feldhamer, Sari Greenberg-Dotan, Idit Lavi, Erez Batat, Irina Bergman, Arnon Dov Cohen, Devy Zisman
OBJECTIVE: To investigate endocrine comorbidities in patients with psoriatic arthritis (PsA). METHODS: A retrospective, cross-sectional study was performed with the database of Clalit Health Services, the largest healthcare provider in Israel, between 2002 and 2014. Patients with PsA were identified and matched by age and sex to healthy controls. The following morbidities were analyzed: hypo/hyperthyroidism, hypo/hyperparathyroidism, hyperprolactinemia, Cushing disease, Addison disease, diabetes insipidus, diabetes mellitus (DM), pituitary adenoma, acromegaly, and osteoporosis...
April 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28404594/health-related-quality-of-life-of-patients-with-hypothalamic-pituitary-adrenal-axis-dysregulations-a-cohort-study
#6
Charlotte De Bucy, Laurence Guignat, Tanya Niati, Jerome Bertherat, Joel Coste
OBJECTIVE: Health-related quality of life (HrQoL) is increasingly considered to be an important outcome of care for hypothalamic-pituitary-adrenal (HPA) axis dysregulation. The objective of this study was to assess the influence of type of HPA axis dysregulation and cortisol status on HrQOL and its evolution with time and treatment. DESIGN: Prospective cohort study. METHODS: Between September 2007 and April 2014, HrQoL questionnaires were administered during routine management to all patients with HPA axis dysregulation hospitalized in a single department and this was repeated after 6- 12-, 24- and 36-month during standard follow-up...
April 12, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28391254/primary-pigmented-nodular-adrenocortical-disease-literature-review-and-case-report-of-a-6-year-old-boy
#7
Dragan Katanić, Dejan Kafka, Mirjana Živojinov, Jovan Vlaški, Zorana Budakov, Marija Knežević Pogančev, Ivana Vorgučin, Tomislav Ćuk
Cushing's syndrome is rare in childhood and is usually caused by a pituitary adenoma. Primary hyperfunction of adrenal glands is less frequent, particularly primary pigmented nodular adrenocortical disease (PPNAD). It occurs usually in children and adolescents, with female preponderance, while Cushing's disease has increased frequency in prepubertal males. A case of a 6-year-old boy is presented with isolated non-familiar PPNAD. The clinical pattern involved Cushingoid appearance, hypertension, virilization and depressive mood...
April 10, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28382019/transcriptome-analysis-showed-a-differential-signature-between-invasive-and-non-invasive-corticotrophinomas
#8
Leonardo Jose Tadeu de Araújo, Antonio Marcondes Lerario, Margaret de Castro, Clarissa Silva Martins, Marcello Delano Bronstein, Marcio Carlos Machado, Ericka Barbosa Trarbach, Maria Candida Barisson Villares Fragoso
ACTH-dependent hypercortisolism caused by a pituitary adenoma [Cushing's disease (CD)] is the most common cause of endogenous Cushing's syndrome. CD is often associated with several morbidities, including hypertension, diabetes, osteoporosis/bone fractures, secondary infections, and increased cardiovascular mortality. While the majority (≈80%) of the corticotrophinomas visible on pituitary magnetic resonance imaging are microadenomas (MICs, <10 mm of diameter), some tumors are macroadenomas (MACs, ≥10 mm) with increased growth potential and invasiveness, exceptionally exhibiting malignant demeanor...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28380523/genomewide-association-study-reveals-a-risk-locus-for-equine-metabolic-syndrome-in-the-arabian-horse
#9
S L Lewis, H M Holl, C Streeter, C Posbergh, B J Schanbacher, N J Place, M F Mallicote, M T Long, S A Brooks
Equine obesity can cause life-threatening secondary chronic conditions, similar to those in humans and other animal species. Equine metabolic syndrome (EMS), primarily characterized by hyperinsulinemia, is often present in obese horses and ponies. Due to clinical similarities to conditions such as pituitary pars intermedia dysfunction (formerly equine Cushing's disease), conclusive diagnosis of EMS often proves challenging. Aside from changes in diet and exercise, few targeted treatments are available for EMS, emphasizing the need for early identification of at-risk individuals to enable implementation of preventative measures...
March 2017: Journal of Animal Science
https://www.readbyqxmd.com/read/28377801/current-best-practice-in-the-management-of-patients-after-pituitary-surgery
#10
REVIEW
Alessandro Prete, Salvatore Maria Corsello, Roberto Salvatori
Sellar and parasellar masses are a common finding, and most of them are treated surgically via transsphenoidal approach. This type of surgery has revolutionized the approach to several hypothalamic-pituitary diseases and is usually effective, and well-tolerated by the patient. However, given the complex anatomy and high density of glandular, neurological and vascular structures in a confined space, transsphenoidal surgery harbors a substantial risk of complications. Hypopituitarism is one of the most frequent sequelae, with central adrenal insufficiency being the deficit that requires a timely diagnosis and treatment...
March 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28364356/diabetes-in-cushing-disease
#11
REVIEW
G Mazziotti, A M Formenti, S Frara, F Maffezzoni, M Doga, A Giustina
PURPOSE OF REVIEW: This review focuses on the pathophysiological and clinical aspects of diabetes mellitus occurring in patients with Cushing disease (CD). RECENT FINDINGS: Insulin resistance and impairment in insulin secretion are both involved in the pathogenesis of glucocorticoid-induced diabetes. Correction of glucocorticoid excess does not always resolve abnormalities of glucose homeostasis, and correction of hyperglycaemia is specifically required. In fact, insulin resistance may persist even after correction of glucocorticoid excess and diabetes needs to be treated for long term...
May 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28356253/adrenocortical-carcinoma-masquerading-as-cushing-s-disease
#12
Kush Dev Jarial, Rama Walia, Santosh Kumar, Anil Bhansali
Cushing's syndrome (CS) can be classified as adrenocorticotropic hormone (ACTH)-dependent or ACTH-independent depending on the ACTH levels. However, 30% of the patients with CS have ACTH levels in the 'grey zone' (5-20 pg/mL), thereby posing a challenge in establishing the aetiological diagnosis. In a patient with full-blown features of Cushing's syndrome with equivocal ACTH levels, and a pituitary microadenoma on contrast-enhanced MRI sella, can falsely lead to a diagnosis of Cushing's disease. Pituitary microadenoma, if <6 mm in size, may be an incidental finding (incidentaloma) in this scenario and can be present in ∼3-27% of the healthy population...
March 29, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28355719/-a-clinical-analysis-of-123-cases-of-primary-empty-sella
#13
J Li, H W Jia, C L Wang, R Zhang, M Y Qu, W Li, M H Yuan, J Cui, Q He, H Y Wei, T H Zhu, Z S Ma, W Liu, Z L Dong, Z G Gao
Objective: This study was conducted to analyze the clinical characteristics and pituitary function of patients with primary empty sella (PES). Methods: The clinical data from 123 hospitalized adult patients with PES from January 2010 to May 2016 were retrospectively studied. Results: (1) The average age of the 123 (male 43, female 80) PES patients was (59.2±13.6) years (ranging 24-92 years), among whom 61% patients were in the age group between 50-69 years. (2) The symptoms of the patients included fatigue (56...
April 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28351913/management-of-endocrine-disease-quality-of-life-tools-for-the-management-of-pituitary-disease
#14
Susan M Webb, Iris Crespo, Alicia Santos, Eugenia Resmini, Anna Aulinas, Elena Valassi
In the last years, quality of life (QoL) has become an outcome measure in patients with pituitary diseases. OBJECTIVE: Describe available data on QoL impairment evaluated with questionnaires in patients with pituitary diseases. DESIGN: Critical review of the pertinent literature and pragmatic discussion of available information. METHODS: Selection of relevant literature from PubMed and WOK, especially from the last 5 years and comprehensive analysis...
March 28, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28343156/ectopic-acth-producing-large-cell-neuroendocrine-pancoast-tumour-presenting-as-horner-syndrome
#15
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/28332877/pentraxin-3-as-a-new-cardiovascular-marker-in-adrenal-adenomas
#16
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
#17
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
#18
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/28329436/prospective-evaluation-of-a-week-one-overnight-metyrapone-test-with-subsequent-dynamic-assessments-of-hypothalamic-pituitary-adrenal-axis-function-after-pituitary-surgery
#19
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/28323961/normalized-early-post-operative-cortisol-and-acth-values-predict-nonremission-after-surgery-for-cushing-s-disease
#20
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
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