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https://www.readbyqxmd.com/read/28275992/follow-up-intervals-in-patients-with-cushing-s-disease-recommendations-from-a-panel-of-experienced-pituitary-clinicians
#1
Eliza B Geer, Alejandro Ayala, Vivien Bonert, John D Carmichael, Murray B Gordon, Laurence Katznelson, Ekaterina Manuylova, Ismat Shafiq, Vijaya Surampudi, Ronald S Swerdloff, Michael S Broder, Dasha Cherepanov, Marianne Eagan, Jackie Lee, Qayyim Said, Maureen P Neary, Beverly M K Biller
PURPOSE: Follow-up guidelines are needed to assess quality of care and to ensure best long-term outcomes for patients with Cushing's disease (CD). The purpose of this study was to assess agreement by experts on recommended follow-up intervals for CD patients at different phases in their treatment course. METHODS: The RAND/UCLA modified Delphi process was used to assess expert consensus. Eleven clinicians who regularly manage CD patients rated 79 hypothetical patient scenarios before and after ("second round") an in-person panel discussion to clarify definitions...
March 9, 2017: Pituitary
https://www.readbyqxmd.com/read/28226363/coagulation-profile-in-patients-with-different-etiologies-for-cushing-syndrome-a-prospective-observational-study
#2
Amit Tirosh, Maya Lodish, Charalampos Lyssikatos, Elena Belyavskaya, Richard A Feelders, Constantine A Stratakis
Previous studies reported a higher prevalence of venous-thromboembolic events among patients with Cushing disease (CD) compared to those with ACTH-independent Cushing syndrome (CS) from adrenal sources. The objective of the current study was to evaluate the coagulation profile of patients with CS from different etiologies. A prospective observational study was conducted at a clinical research center. The study included adult patients admitted for evaluation of suspected CS (n=85), that were divided into 3 groups: CD (n=22), ACTH-independent CS from an adrenal tumor/hyperplasia (adrenal CS, n=21), and a control group consisting of subjects with negative screening for CS (rule-out CS, n=42)...
February 22, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28149109/developing-cerebral-venous-infarct-presenting-with-seizure-occurring-after-lumbar-drain-placement-following-trans-sphenoidal-surgery-of-cushing-s-disease-review-of-literature
#3
Dattaraj Sawarkar, Guru Dutta Satyarthee, Pankaj Singh, Hitesh Gurjar, M M Singh, B S Sharma
No abstract text is available yet for this article.
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28079576/mixed-gangliocytoma-pituitary-adenoma-insights-on-the-pathogenesis-of-a-rare-sellar-tumor
#4
M Beatriz S Lopes, Emily Sloan, Julie Polder
Gangliocytomas originating in the sellar region are rare; most are tumors composed of gangliocytic and pituitary adenomatous elements, forming the so-called mixed gangliocytoma-pituitary adenoma. The majority of mixed gangliocytoma adenomas are associated with endocrinopathies, mainly acromegaly and less often Cushing disease and hyperprolactinemia. In the present study, 10 cases of mixed gangliocytoma and somatotroph adenomas were evaluated for patterns of cellular differentiation and expression of lineage-specific transcription factors...
January 10, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/27941732/glycosylated-hemoglobin-in-different-levels-of-bmi
#5
R K Das, A Nessa, M Asrin, M Z Huq, M F Husain, S Sufrin, R Zannat, T Tajkia
Body mass index is an inexpensive and easy method of screening for weight categories that may lead to health problems. Increased BMI in overweight and obese persons is directly associated with an increase in metabolic disease, such as type 2 diabetes mellitus. This Analytical cross sectional study was undertaken to assess the relation between increasing BMI and glycemic control of body through measuring glycosylated hemoglobin. This study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2011 to June 2012 on 180 equally divided male and female persons between the age of 25 to 55 years...
October 2016: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/27894193/currently-used-and-investigational-drugs-for-cushing%C3%A2-s-disease
#6
REVIEW
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...
January 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27882768/-adrenocortical-oncocytoma-presenting-as-cushing%C3%A2-s-syndrome-in-pregnancy-with-spontaneous-postpartum-uterine-rupture
#7
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/27869719/targeted-molecular-imaging-in-adrenal-disease-an-emerging-role-for-metomidate-pet-ct
#8
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/27828691/long-term-complete-remission-of-crooke-s-corticotropinoma-after-temozolomide-treatment
#9
Maria Kurowska, Jerzy S Tarach, Joanna Malicka, Grzegorz Zieliński, Maria Maksymowicz, Piotr Denew
INTRODUCTION: Crooke's corticotropinomas are the unique cause of Cushing's disease. The majority of them are aggressive macroadenomas, refractory to conventional therapy, with a high recurrence rate. The aim of the study was the presentation, in relation to data from the literature, of a case of a patient with ACTH-dependent Cushing's syndrome caused by recurrent Crooke's cells corticotropinoma, who achieved 33-month complete remission after treatment with temozolomide (TMZ). CASE REPORT: A 54-year-old man was diagnosed with Cushing's disease five years earlier on the basis of a typical clinical picture and hormonal tests...
2016: Endokrynologia Polska
https://www.readbyqxmd.com/read/27782371/a-pharmacokinetic-model-of-a-tissue-implantable-cortisol-sensor
#10
Michael A Lee, Naveed Bakh, Gili Bisker, Emery N Brown, Michael S Strano
Cortisol is an important glucocorticoid hormone whose biochemistry influences numerous physiological and pathological processes. Moreover, it is a biomarker of interest for a number of conditions, including posttraumatic stress disorder, Cushing's syndrome, Addison's disease, and others. An implantable biosensor capable of real time monitoring of cortisol concentrations in adipose tissue may revolutionize the diagnosis and treatment of these disorders, as well as provide an invaluable research tool. Toward this end, a mathematical model, informed by the physiological literature, is developed to predict dynamic cortisol concentrations in adipose, muscle, and brain tissues, where a significant number of important processes with cortisol occur...
December 2016: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/27662440/the-desmopressin-test-predicts-better-than-basal-cortisol-the-long-term-surgical-outcome-of-cushing-s-disease
#11
D A Vassiliadi, M Balomenaki, A Asimakopoulou, E Botoula, M Tzanela, S Tsagarakis
CONTEXT: Cushing's disease (CD) has a significant relapse rate after successful transsphenoidal surgery (TSS). Many CD patients respond aberrantly to the desmopressin test (DT). Disappearance of this response after surgery may suggest complete removal of abnormal corticotrophs and a lower possibility of recurrence. OBJECTIVE: The utility of postoperative DT to predict long-term outcome compared to the widely used postoperative cortisol level. DESIGN: Retrospective analysis...
December 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27633717/idiopathic-intracranial-hypertension-after-surgical-treatment-of-cushing-disease-case-report-and-review-of-management-strategies
#12
Jeffrey Wagner, Cara M Fleseriu, Aly Ibrahim, Justin S Cetas
BACKGROUND: Idiopathic intracranial hypertension (IIH) in patients with Cushing disease (CD), after treatment, is rarely described, in adults. The cause is believed to be multifactorial, potentially related to a relative decrease in cortisol after surgical resection or medical treatment of a corticotroph pituitary adenoma. We investigate our center's CD database (140 surgically and 60 medically [primary or adjunct] treated patients) for cases of IIH, describe our center's experience with symptomatic IIH, and review treatment strategies in adults with CD after transsphenoidal resection...
September 12, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27552540/vascular-health-in-patients-in-remission-of-cushing-s-syndrome-is-comparable-to-that-in-bmi-matched-controls
#13
Maem Wagenmakers, Shpp Roerink, Tha Schreuder, T S Plantinga, S Holewijn, Dhj Thijssen, J W Smit, G A Rongen, A M Pereira, Ajm Wagenmakers, R T Netea-Maier, Armm Hermus
CONTEXT: In active Cushing's syndrome (CS), patients suffer from endothelial dysfunction and premature atherosclerosis. However, it is uncertain to what extent vascular health recovers after long-term remission. This is highly relevant as this topic relates to future development of cardiovascular disease. OBJECTIVE: To investigate whether micro- and macrovascular health is impaired after long-term remission of CS, in patients with no or adequately treated co-morbidities...
August 23, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27517036/advancing-treatment-of-pituitary-adenomas-through-targeted-molecular-therapies-the-acromegaly-and-cushing-disease-paradigms
#14
REVIEW
Michael A Mooney, Elias D Simon, Andrew S Little
The current treatment of pituitary adenomas requires a balance of conservative management, surgical resection, and in select tumor types, molecular therapy. Acromegaly treatment is an evolving field where our understanding of molecular targets and drug therapies has improved treatment options for patients with excess growth hormone levels. We highlight the use of molecular therapies in this disease process and advances in this field, which may represent a paradigm shift for the future of pituitary adenoma treatment...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27464539/-comparison-of-efficacy-between-the-serum-cortisol-and-24-hour-urine-free-cortisol-in-combined-dexamethasone-suppression-test-in-the-diagnosis-of-cushing-syndrome
#15
COMPARATIVE STUDY
L Lu, J H Chen, H J Zhu, A L Song, M Li, S Chen, H Pan, F Y Gong, R Z Wang, B Xing, Y Yao, M Feng, Z L Lu
OBJECTIVE: To compare the sensitivity and specificity between the 24 hour urine free cortisol (24 h UFC) and serum cortisol in dexamethasone suppression test (DST) in the diagnosis of Cushing syndrome (CS). METHODS: Combined low dose DST (LDDST) and high dose DST (HDDST) were carried out in 67 cases of CS with surgically confirmed cases in recent 3 years(from January 2011 to November 2015). The serum cortisol and 24 h UFC were collected simultaneously for each subject and the sensitivity and specificity of serum cortisol and 24 h UFC were compared...
July 19, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27394707/cabergoline-treatment-for-recurrent-cushing-s-disease-during-pregnancy
#16
Afif Nakhleh, Leonard Saiegh, Maria Reut, Mohammad Sheikh Ahmad, Irit Wirsansky Pearl, Carmela Shechner
OBJECTIVE: Cushing's disease during pregnancy is associated with an increased risk for maternal and fetal complications. In recurrent Cushing`s disease following transsphenoidal surgery, and when re-operation is not feasible, medical treatment is usually considered. Cabergoline was found to be effective in reducing hypercortisolism in Cushing's disease. Evolving data concerning the safety of cabergoline use during pregnancy show no significant increase in the rate of complications during pregnancy or the postnatal period...
July 2016: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27363699/negative-correlation-between-tumour-size-and-cortisol-acth-ratios-in-patients-with-cushing-s-disease-harbouring-microadenomas-or-macroadenomas
#17
M C Machado, A E E Alcantara, A C L Pereira, V A S Cescato, N R Castro Musolino, B B de Mendonça, M D Bronstein, M C B V Fragoso
PURPOSE: Pituitary macroadenomas (MACs) represent 10-30 % of Cushing's disease (CD) cases. The aim of this study was to report the clinical, laboratorial and imaging features and postsurgical outcomes of microadenoma (MIC) and MAC patients. METHODS: Retrospective study with 317 CD patients (median 32 years old, range 9-71 years) admitted between 1990 and 2014, 74 (23.3 %) of whom had MAC. RESULTS: Hirsutism, plethora facial, muscular weakness and muscular atrophy were more frequent in the MIC patients...
December 2016: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/27252864/spontaneous-resolution-of-avascular-necrosis-of-femoral-heads-following-cure-of-cushing-s-syndrome
#18
A Pazderska, S Crowther, P Govender, K C Conlon, M Sherlock, J Gibney
UNLABELLED: Avascular necrosis (AVN) is a rare presenting feature of endogenous hypercortisolism. If left untreated, complete collapse of the femoral head may ensue, necessitating hip replacement in up to 70% of patients. The majority of the described patients with AVN due to endogenous hypercortisolaemia required surgical intervention. A 36-year-old female, investigated for right leg pain, reported rapid weight gain, bruising and secondary amenorrhoea. She had abdominal adiposity with violaceous striae, facial plethora and hirsutism, atrophic skin, ecchymosis and proximal myopathy...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27214296/venous-sampling-for-cushing-disease-comparison-of-internal-jugular-vein-and-inferior-petrosal-sinus-sampling
#19
Martin G Radvany, Alfredo Quinones-Hinojosa, Gary L Gallia, Gary S Wand, Roberto Salvatori
OBJECTIVE: Because magnetic resonance imaging (MRI) fails to detect many adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas, inferior petrosal sinus sampling (IPSS) is considered the gold standard to differentiate Cushing disease (CD) from ectopic ACTH secretion syndrome (EAS). Some authors have suggested internal jugular vein sampling (IJVS) as an alternative to IPSS. METHODS: We simultaneously compared IJVS to IPSS in 30 consecutive patients referred for ACTH-dependent Cushing syndrome and equivocal MRI exams...
September 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27027905/health-related-quality-of-life-and-parental-stress-in-children-with-fecal-incontinence-a-normative-comparison
#20
Christopher C Cushing, Bruno Martinez-Leo, Andrea Bischoff, Jennifer Hall, Michael Helmrath, Belinda H Dickie, Marc A Levitt, Alberto Peña, Meg H Zeller, Jason S Frischer
OBJECTIVE: The aim of the present study was to describe the quality of life and parenting stress associated with a child with fecal incontinence (FI). METHODS: Female caregivers (n = 170) of children of 3 to 12 years age with FI completed a broad and general measure of quality of life and a measure of parenting stress. Results were compared with proxy reports for a normative sample of healthy children. RESULTS: Caregivers of children with FI reported significantly impaired quality of life for their children and increased parenting stress in all of the respective domains relative to healthy controls...
December 2016: Journal of Pediatric Gastroenterology and Nutrition
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