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https://www.readbyqxmd.com/read/28933807/recognizing-and-managing-adrenal-disorders-in-the-emergency-department-digest
#1
Amy Cutright, Stephen Ducey, Claudia L Barthold, Jeremy Kim
Primary and secondary adrenal insufficiency are underrecognized conditions among emergency department patients, affecting an estimated 10% to 20% of critically ill patients. The signs and symptoms of cortisol deficit can be nonspecific and wide-ranging, and identification and swift treatment with stress-dosing of hydrocortisone is vital to avoid life-threatening adrenal crisis. Laboratory evaluation focuses on identification of electrolyte abnormalities typical of adrenal insufficiency, and while additional testing may depend on the type and severity of symptoms, it should not delay corticosteroid replacement...
September 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28929663/-effect-of-aca%C3%A3-euterpe-oleracea-on-biological-expression-characteristics-of-deficiency-heat-and-deficiency-cold-rats
#2
Lin-Yuan Wang, Jian-Jun Zhang, Chun Wang, Ying-Li Zhu, Zi-Chen Wang, Cheng He, Yan Qu, Sha Wang
To study the effects of Acaí on biological expression characteristics in rats with deficiency-heat and deficiency-cold syndromes, SD rats were divided into blank group, deficiency-heat model group, deficiency-heat+Phellodendri Chinensis Cortex group, deficiency-heat+Acaí high dose and low dose groups, deficiency-cold model group, deficiency-cold+Cinnamomi Cortex group, deficiency-cold+Acaí high dose and low dose groups. The rats were treated with intramuscular injection of hydrocortisone (20 mg•kg⁻¹) or dexamethasone sodium phosphate (0...
October 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28925895/cardiovascular-drug-therapy-for-human-newborn-review-of-pharmacodynamic-data
#3
Ebru Ergenekon, Héctor Rojas-Anaya, María Carmen Bravo, Charalampos Kotidis, Liam Mahoney, Heike Rabe
BACKGROUND: Circulatory failure in preterm and term newborn infants is commonly treated with inotropes or vasoactive medications. In this structured literature review, the available data on pharmacodynamic effects of the inotropes adrenaline, dobutamine, dopamine, levosimendan, milrinone, noradrenaline, and the vasoactive drugs vasopressin and hydrocortisone are presented. METHODS: Structured searches were conducted to identify relevant articles according to pre-defined inclusion criteria which were human clinical trials published after 2000...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28916121/controversies-in-corticosteroid-use-for-sepsis
#4
Brit Long, Alex Koyfman
BACKGROUND: Severe sepsis and septic shock are potentially deadly conditions managed in the emergency department (ED). Management centers on source control, fluid resuscitation, broad-spectrum antimicrobials, and vasopressors as needed. The use of corticosteroids is controversial. OBJECTIVE: To evaluate the evidence behind corticosteroid therapy in patients with septic shock. DISCUSSION: Septic shock is associated with severe mortality and morbidity...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28904371/acute-interaction-between-hydrocortisone-and-insulin-alters-the-plasma-metabolome-in-humans
#5
Mohammad A Alwashih, Roland H Stimson, Ruth Andrew, Brian R Walker, David G Watson
With the aim of identifying biomarkers of glucocorticoid action and their relationship with biomarkers of insulin action, metabolomic profiling was carried out in plasma samples from twenty healthy men who were administered either a low or medium dose insulin infusion (n = 10 each group). In addition, all subjects were given metyrapone (to inhibit adrenal cortisol secretion) + /- hydrocortisone (HC) in a randomised crossover design to produce low, medium and high glucocorticoid levels. The clearest effects of insulin were to reduce plasma levels of the branched chain amino acids (BCAs) leucine/isoleucine and their deaminated metabolites, and lowered free fatty acids and acylcarnitines...
September 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28893233/clinical-characteristics-of-adrenal-crisis-in-adult-population-with-and-without-predisposing-chronic-adrenal-insufficiency-a-retrospective-cohort-study
#6
Masahiro Iwasaku, Maki Shinzawa, Shiro Tanaka, Kimihiko Kimachi, Koji Kawakami
BACKGROUND: Adrenal crisis (AC) occurs in various clinical conditions but previous epidemiological studies in AC are limited to chronic adrenal insufficiency (AI) and sepsis. The aim of this study was to investigate characteristics of AC patients, including predisposing diseases and to describe candidate risk factors for AC such as comorbidities and glucocorticoid (GC) therapy. METHODS: We conducted a retrospective cohort study using a claims database on 7.4 million patients from 145 acute care hospitals between January 1, 2003 and April 30, 2014...
September 11, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28887465/host-immune-status-specific-production-of-gliotoxin-and-bis-methyl-gliotoxin-during-invasive-aspergillosis-in-mice
#7
Janyce A Sugui, Stacey R Rose, Glenn Nardone, Muthulekha Swamydas, Chyi-Chia R Lee, Kyung J Kwon-Chung, Michail S Lionakis
Delayed diagnosis in invasive aspergillosis (IA) contributes to its high mortality. Gliotoxin (GT) and bis-methyl-gliotoxin (bmGT) are secondary metabolites produced by Aspergillus during invasive, hyphal growth and may prove diagnostically useful. Because IA pathophysiology and GT's role in virulence vary depending on the underlying host immune status, we hypothesized that GT and bmGT production in vivo may differ in three mouse models of IA that mimic human disease. We defined temporal kinetics of GT and bmGT in serum, bronchoalveolar lavage fluid (BALF) and lungs of A...
September 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28880260/barriers-to-enrollment-in-a-randomized-controlled-trial-of-hydrocortisone-for-cardiovascular-insufficiency-in-term-and-late-preterm-newborn-infants
#8
K L Watterberg, E Fernandez, M C Walsh, W E Truog, B J Stoll, G M Sokol, K A Kennedy, M V Fraga, S S Beauman, B Carper, A Das, A F Duncan, W F Buss, C Gauldin, C B Lacy, P J Sanchez, S Chawla, S Lakshminrusimha, C M Cotten, K P Van Meurs, B B Poindexter, E F Bell, W A Carlo, U Devaskar, M H Wyckoff, R D Higgins
OBJECTIVE: To analyze reasons for low enrollment in a randomized controlled trial (RCT) of the effect of hydrocortisone for cardiovascular insufficiency on survival without neurodevelopmental impairment (NDI) in term/late preterm newborns. STUDY DESIGN: The original study was a multicenter RCT. Eligibility: ⩾34 weeks' gestation, <72 h old, mechanically ventilated, receiving inotrope. Primary outcome was NDI at 2 years; infants with diagnoses at high risk for NDI were excluded...
September 7, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28874192/plasma-metabolomic-study-in-chinese-patients-with-wet-age-related-macular-degeneration
#9
Dan Luo, Tingting Deng, Wei Yuan, Hui Deng, Ming Jin
BACKGROUND: Age-related macular degeneration (AMD) is a leading disease associated with blindness. It has a high incidence and complex pathogenesis. We aimed to study the metabolomic characteristics in Chinese patients with wet AMD by analyzing the morning plasma of 20 healthy controls and 20 wet AMD patients for metabolic differences. METHODS: We used ultra-high-pressure liquid chromatography and quadrupole-time-of-flight mass spectrometry for this analysis. The relationship of these differences with AMD pathophysiology was also assessed...
September 6, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28859501/is-there-a-hormonal-regulation-of-phagocytosis-at-unicellular-and-multicellular-levels-a-critical-review
#10
György Csaba
Phagocytosis is an ancient cell function, which is similar at unicellular and multicellular levels. Unicells synthesize, store, and secrete multicellular (mammalian) hormones, which influence their phagocytosis. Amino acid hormones, such as histamine, serotonin, epinephrine, and melatonin stimulate phagocytosis, whereas peptide hormones, such as adrenocorticotropic hormone (ACTH), insulin, opioids, arginine vasopressin, and atrial natriuretic peptide decreased it, independently on their chemical structure or function in multicellulars...
September 1, 2017: Acta Microbiologica et Immunologica Hungarica
https://www.readbyqxmd.com/read/28840698/-effect-of-a%C3%A3-a%C3%A3-euterpe-oleracea-on-lipid-metabolism-immune-substances-and-endocrine-hormone-in-rats-with-deficiency-heat-and-deficiency-cold-syndrome
#11
Zi-Chen Wang, Jian-Jun Zhang, Ying-Li Zhu, Yan Qu, Wen-Ting Fei, Sha Wang, Jing-Xia Wang, Lin-Yuan Wang
To study the effects of AÇaí(Euterpe oleracea) on lipid metabolism, immune substances and endocrine hormone level in rats with deficiency-heat and deficiency-cold syndrome. SD rats were divided into blank control group, deficiency-heat model group, deficiency-heat & Phellodendri Cortex group, deficiency-heat & AÇaí high dose and low dose groups, deficiency-cold model group, deficiency-cold & Cinnamomi Cortex group, deficiency-cold & AÇaí high dose and low dose groups. The rats received intramuscular injection of dexamethasone sodium phosphate (0...
July 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28837521/premedication-use-in-preventing-acute-infliximab-infusion-reactions-in-patients-with-inflammatory-bowel-disease-a-single-center-cohort-study
#12
Stephanie L Gold, Shirley Cohen-Mekelburg, Yecheskel Schneider, Nicole Shen, Alec Faggen, Amanda Rupert, Ellen J Scherl, Brian Bosworth, Adam Steinlauf
BACKGROUND: Infliximab (IFX) is commonly used in patients with inflammatory bowel disease. One common side effect of IFX is an acute infusion reaction. Despite the lack of evidence supporting their use, clinicians use various premedications to prevent acute reactions. We evaluated the effectiveness of premedications in the prevention of acute IFX infusion reactions. METHODS: A retrospective cohort study was performed identifying patients with a diagnosis of inflammatory bowel disease who received IFX at our institution...
August 22, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28835258/acute-hypopituitarism-associated-with-periorbital-swelling-and-cardiac-dysfunction-in-a-patient-with-pituitary-tumor-apoplexy-a-case-report
#13
Nobumasa Ohara, Yuichiro Yoneoka, Yasuhiro Seki, Katsuhiko Akiyama, Masataka Arita, Kazumasa Ohashi, Kazuo Suzuki, Toshinori Takada
BACKGROUND: Pituitary tumor apoplexy is a rare clinical syndrome caused by acute hemorrhage or infarction in a preexisting pituitary adenoma. It typically manifests as an acute episode of headache, visual disturbance, mental status changes, cranial nerve palsy, and endocrine pituitary dysfunction. However, not all patients present with classical symptoms, so it is pertinent to appreciate the clinical spectrum of pituitary tumor apoplexy presentation. We report an unusual case of a patient with pituitary tumor apoplexy who presented with periorbital edema associated with hypopituitarism...
August 24, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28832260/development-of-chitosan-gelatin-keratin-composite-containing-hydrocortisone-sodium-succinate-as-a-buccal-mucoadhesive-patch-to-treat-desquamative-gingivitis
#14
Zahra Davoudi, Mohammad Rabiee, Behzad Houshmand, Niloofar Eslahi, Kimia Khoshroo, Morteza Rasoulianboroujeni, Mohammadreza Tahriri, Lobat Tayebi
The aim of this research was to develop chitosan/gelatin/keratin composite containing hydrocortisone sodium succinate as a buccal mucoadhesive patch to treat desquamative gingivitis, which was fabricated through an environmental friendly process. Mucoadhesive films increase the advantage of higher efficiency and drug localization in the affected region. In this research, mucoadhesive films, for the release of hydrocortisone sodium succinate, were prepared using different ratios of chitosan, gelatin and keratin...
August 23, 2017: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/28831558/importance-of-adhesiolysis-in-revision-surgery-for-vibrant-soundbridge-device-failures-at-the-short-incus-process
#15
Yoon Ah Park, Tae Hoon Kong, Jin Soon Chang, Young Joon Seo
The objectives of the study were to report a vibrant soundbridge (VSB) implant revision surgical method involving adhesiolysis at the short incus process under local anesthesia and demonstrate successful hearing performance after surgery. Three cases of VSB surgery, performed in 2016, were enrolled. All cases had diagnoses of device failure. This 'seven-incision line' exposed the floating mass transducer directly, after which the three steps (adhesiolysis, curettage, and hydrocortisone injection) were performed...
August 22, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28822384/clinical-characteristics-of-trauma-patients-requiring-hydrocortisone-treatment-for-refractory-hypotension
#16
Gina Kim, Jeffrey Young
Corticosteroids play an important role in responding to physiologic stress in the human body. However, its application in critical care remains heavily debated. The purpose of this study was to identify patient characteristics associated with receiving stress-dose steroids during the intensive care unit stay after traumatic injury and its effect on in-hospital mortality. Patients admitted to the University of Virginia trauma center between January 1, 2011, and December 31, 2015, were identified using our Trauma Registry...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28822218/locally-produced-xenin-and-the-neurotensinergic-system-in-pancreatic-islet-function-and-%C3%AE-cell-survival
#17
Dawood Khan, Srividya Vasu, R Charlotte Moffett, Victor A Gault, Peter R Flatt, Nigel Irwin
Modulation of neuropeptide receptors is important for pancreatic β-cell function. Here, islet distribution and effects of the neurotensin (NT) receptor modulators, xenin and NT, was examined. Xenin, but not NT, significantly improved glucose disposal and insulin secretion, in mice. However, both peptides stimulated insulin secretion from rodent β-cells at 5.6 mM glucose, with xenin having similar insulinotropic actions at 16.7 mM glucose. In contrast, NT inhibited glucose-induced insulin secretion. Similar observations were made in human 1...
August 28, 2017: Biological Chemistry
https://www.readbyqxmd.com/read/28820232/recognizing-and-managing-adrenal-disorders-in-the-emergency-department
#18
Amy Cutright, Stephen Ducey, Claudia L. Barthold
Primary and secondary adrenal insufficiency are underrecognized conditions among emergency department patients, affecting an estimated 10% to 20% of critically ill patients. The signs and symptoms of cortisol deficit can be nonspecific and wide-ranging, and identification and swift treatment with stress-dosing of hydrocortisone is vital to avoid life-threatening adrenal crisis. Laboratory evaluation focuses on identification of electrolyte abnormalities typical of adrenal insufficiency, and while additional testing may depend on the type and severity of symptoms, it should not delay corticosteroid replacement...
September 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28819949/addison-s-disease-concomitant-with-corticotropin-deficiency-and-pituitary-crh-resistance-a-case-report
#19
Krzysztof C Lewandowski, Katarzyna Malicka, Katarzyna Dąbrowska, Andrzej Lewiński
A 36-year-old woman was found to have a low morning ACTH concentration despite a history of Addison's disease. Past medical history: At the age of 23 years the subject developed Graves's disease, which was treated with radioiodine. At about the same time, she claimed to have two episodes of pancreatitis treated with cholecystectomy. About seven months later she was euthyroid on L-thyroxine (TSH 1.51 mIU/mL) but was admitted with hypotension, hyponatraemia (sodium 109 mmol/L), and low morning cortisol (119 nmol/L)...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28817507/comparison-of-consent-models-in-a-randomized-trial-of-corticosteroids-in-pediatric-septic-shock
#20
Kusum Menon, Katharine O'Hearn, James Dayre McNally, Anand Acharya, Hector R Wong, Margaret Lawson, Tim Ramsay, Lauralyn McIntyre, Elaine Gilfoyle, Marisa Tucci, David Wensley, Ronald Gottesman, Gavin Morrison, Karen Choong
OBJECTIVES: To describe the use of deferred and prior informed consent models in the context of a low additional risk to standard of care, placebo-controlled randomized controlled trial of corticosteroids in pediatric septic shock. DESIGN: An observational substudy of consent processes in a randomized controlled trial of hydrocortisone versus placebo. SETTING: Seven tertiary level PICUs in Canada. PATIENTS: Children newborn to 17 years inclusive admitted to PICU with suspected septic shock between July 2014 and March 2016...
August 16, 2017: Pediatric Critical Care Medicine
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