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Cosyntropin

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https://www.readbyqxmd.com/read/27888772/adrenocortical-sensitivity-moderated-by-ongoing-stress-predicts-drinking-intensity-in-alcohol-dependent-men
#1
Bryon Adinoff, David Leonard, Julianne Price, Martin A Javors, Robrina Walker, E Sherwood Brown, Hong Xiao, Uma Rao
Allostatic load from both environmental stressors and persistent glucocorticoid secretion has been associated with disease severity in alcohol dependence. Heightened relapse risk and/or drinking severity, in particular, may be a reaction to alcohol- and withdrawal-induced changes in physiological stress response systems coupled with ongoing life stress, although their shared contributions upon drinking severity have not been assessed. To investigate the combined contribution of hypothalamic-pituitary-adrenal (HPA) reactivity and environmental stressors (e...
November 5, 2016: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/27878800/a-single-center-experience-of-the-implementation-of-adrenal-vein-sampling-procedure-impact-on-the-diagnostic-work-up-in-primary-aldosteronism
#2
Jacek Kądziela, Aleksander Prejbisz, Ilona Michałowska, Sylwia Kołodziejczyk-Kruk, Leo Schultze Kool, Marek Kabat, Hanna Janaszek-Sitkowska, Sadegh Toutounchi, Zbigniew Gałązka, Urszula Ambroziak, Tomasz Bednarczuk, Magdalena Januszewicz, Dorota Ptasińska-Wnuk, Michał Hoffmann, Andrzej Januszewicz, Adam Witkowski
BACKGROUND AND AIM: Primary aldosteronism (PA) is one of the most common causes of secondary hypertension. Adrenal vein sampling (AVS) remains a "gold standard" procedure in differentiation between unilateral (adenoma) and bilateral (hyperplasia) disease. We present our single-center experience in establishing and implementation of the AVS procedure. METHODS: All patients had primary aldosteronism confirmed in salt-infusion test. Adrenal vein sampling was performed sequentially during a continuous intravenous infusion of cosyntropin and was preceded by multislice contrast-enhanced computed tomography (CT) examination of adrenal glands performed few weeks before AVS in majority of patients...
November 23, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27861246/adrenal-venous-sampling-in-primary-aldosteronism-multinomial-regression-modeling-to-detect-aldosterone-secretion-lateralization-when-right-adrenal-sampling-is-missing
#3
Camille Durivage, Rémi Blanchette, Gilles Soulez, Miguel Chagnon, Patrick Gilbert, Marie-France Giroux, Isabelle Bourdeau, Vincent L Oliva, André Lacroix, Eric Therasse
OBJECTIVE: Difficulty to recognize or canulate the right adrenal vein is the most frequent cause of adrenal venous sampling (AVS) failure. We aimed to assess multinomial regression modeling (MRM) of peripheral and left adrenal vein samplings to detect lateralization of aldosterone secretion when the right AVS is missing. METHODS: Simultaneous bilateral AVS samplings were performed before (basal) and after intravenous cosyntropin injection in 188 consecutive patients between December 1989 and September 2015...
November 16, 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27852811/adrenal-function-in-cats-with-cholestatic-liver-disease
#4
Faith I Buckley, Orla Mahony, Cynthia R L Webster
Cats with cholestatic liver disease experience significant morbidity and mortality when they undergo invasive procedures under anesthesia. Although inadequate adrenal response might account for these outcomes, adrenal function in cats with cholestatic liver disease has not been documented, to our knowledge. The goal of our study was to describe adrenal function in these cats. Twenty-seven cats with a serum bilirubin >230 µmol/L (3 mg/dL) and serum alanine aminotransferase >2 times the upper limit of normal had pre- and 60-min post-adrenocorticotropic hormone (ACTH) cortisol analysis after administration of 5 µg/kg cosyntropin intravenously...
November 15, 2016: Journal of Veterinary Diagnostic Investigation
https://www.readbyqxmd.com/read/27798546/evaluation-of-early-corticosteroid-therapy-in-management-of-pediatric-septic-shock-in-pediatric-intensive-care-patients-a-randomized-clinical-study
#5
Ahmed El-Nawawy, Doaa Khater, Heba Omar, Yasser Wali
BACKGROUND: Septic shock is a major healthcare problem. Adrenal insufficiency in children with septic shock is a recognized complication, yet is controversial regarding its management and effect on mortality. According to the current guidelines, children with risk factors for adrenal insufficiency should receive a stress dose of steroids in step 3 of treatment. This study aimed to evaluate and compare early corticosteroid therapy with the traditional use of steroids among pediatric septic shock patients...
October 25, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27797844/bilateral-primary-adrenal-lymphoma-with-adrenal-insufficiency
#6
Aishah Ekhzaimy, Ahmad Mujamammi
Primary adrenal lymphoma is an extremely rare condition. We describe a case of bilateral adrenal lymphoma in a man aged 55 years who was admitted to our hospital. He had a 3-month history of left flank pain, nausea and vomiting with weight loss. A CT scan at a private hospital revealed bilateral large adrenal masses; the patient was referred to our centre based on these findings. He was evaluated for pheochromocytoma by an endocrinology team; however, all findings were negative. In addition, a cosyntropin stimulation test indicated adrenal insufficiency...
October 26, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27779350/adrenal-insufficiency-in-neonates-after-cardiac-surgery-with-cardiopulmonary-bypass
#7
Jack H Crawford, Matthew S Hull, Santiago Borasino, Brad L Steenwyk, Kristal M Hock, Kevin Wall, Jeffrey A Alten
BACKGROUND: Cardiopulmonary bypass (CPB) may lead to adrenal insufficiency (AI). Emerging evidence supports association of AI with morbidity after cardiac surgery. AIMS: The aim of this study was to define AI incidence in neonates undergoing complex cardiac surgery with CPB and its association with intraoperative post-CPB outcomes. METHODS: Forty subjects enrolled in a prior randomized control trial who received preoperative methylprednisolone as part of our institutional neonatal bypass protocol were included...
October 25, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27631398/myxedema-coma-secondary-to-central-hypothyroidism-a-rare-but-real-cause-of-altered-mental-status-in-pediatrics
#8
Michael D Thompson, Rohan K Henry
BACKGROUND: Myxedema coma (MC), a medical emergency defined as severe hypothyroidism leading to altered mental status, is more common in older women with hypothyroidism. METHODS/RESULTS: A 7-year-old Caucasian male with chromosome 1q deletion presented with altered mental status preceded by milestone regression. His presenting labs results were: thyroid-stimulating hormone (TSH) 0.501 μIU/ml and free thyroxine (T4) <0.5 ng/dl. His morning cortisol level was 8...
September 16, 2016: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/27537994/adrenal-suppression-with-chronic-topical-corticosteroid-use-in-psoriasis-patients
#9
Lisa H Lam, Jeffrey L Sugarman
BACKGROUND: Topical corticosteroids (TCS) are typically used for extended periods of time for chronic skin conditions, including psoriasis. Chronic TCS use may result in side effects similar to those of systemic corticosteroids. Patients may have subclinical adrenal suppression and be unaware of their risk in the case of serious trauma.<BR /> OBJECTIVE: The objective of this study was to investigate the real world effects of chronic TCS use and its effects on adrenal suppression in a chronic disease such as psoriasis...
August 1, 2016: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/27474252/reassessment-of-the-cosyntropin-stimulation-test-in-the-confirmatory-diagnosis-and-subtype-classification-of-primary-aldosteronism
#10
Hironobu Umakoshi, Yang Xiaomei, Takamasa Ichijo, Kohei Kamemura, Yuichi Matsuda, Yuichi Fujii, Tatsuya Kai, Tomikazu Fukuoka, Ryuichi Sakamoto, Atsushi Ogo, Tomoko Suzuki, Tatsuki Ogasawara, Mika Tsuiki, Mitsuhide Naruse
OBJECTIVE: Although corticotropin is a representative secretagogue of aldosterone, the utility of the cosyntropin stimulation test (C-ST) in diagnosing primary aldosteronism (PA) has not been elucidated. Aim of the study was to evaluate the clinical utility of C-ST for confirmatory testing and subtype classification of PA. DESIGN, SETTING AND PATIENTS: In this retrospective study, we identified patients with hypertension and positive case-detection results for PA who underwent C-ST and saline infusion testing (SIT) between 2006 and 2013 at eight referral centres in Japan...
July 30, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27425787/comparison-of-2-doses-for-acth-stimulation-testing-in-dogs-suspected-of-or-treated-for-hyperadrenocorticism
#11
C Aldridge, E N Behrend, R J Kemppainen, T M Lee-Fowler, L G Martin, C R Ward, D Bruyette, J Pannu, P Gaillard, H P Lee
BACKGROUND: Lowering the cosyntropin dose needed for ACTH stimulation would make the test more economical. OBJECTIVES: To compare the cortisol response to 1 and 5 μg/kg cosyntropin IV in dogs being screened for hyperadrenocorticism (HAC) and in dogs receiving trilostane or mitotane for pituitary-dependent HAC. ANIMALS: Healthy dogs (n = 10); client-owned dogs suspected of having HAC (n = 39) or being treated for pituitary-dependent HAC with mitotane (n = 12) or trilostane (n = 15)...
July 18, 2016: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/27259503/enhanced-cosyntropin-stimulation-test-performance-enabled-by-electronic-medical-record
#12
Anat Ben-Shlomo, Joseph Guzman, James Mirocha
PURPOSE: To improve performance of the cosyntropin stimulation test (CST) used for diagnosis of adrenal-cortisol insufficiency by implementing an electronic medical record (EMR) system protocol. METHODS: We implemented a SmartForm protocol of the validated CST in our EMR system (CS-Link™, EPIC) system and compared medical staff test performance before and after protocol implementation. RESULTS: Correct performance of the CST improved significantly after EMR implementation...
October 2016: Pituitary
https://www.readbyqxmd.com/read/27119749/diagnostic-criteria-for-adrenal-venous-sampling
#13
Olivier Steichen, Laurence Amar
PURPOSE OF REVIEW: Primary aldosteronism accounts for 3 to 5% of all hypertension cases. Unilateral aldosterone hypersecretion can be treated with adrenalectomy. Guidelines for primary aldosteronism management recommend adrenal vein sampling (AVS) to ascertain unilateral primary aldosteronism before surgery. Many different protocols are used to perform AVS and for the interpretation of its results, but without hard evidence of why one should be given preference. Experts have proposed recommendations to guide clinical practice and the grounds for future research to address this situation...
June 2016: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/27015690/intravenous-cosyntropin-versus-epidural-blood-patch-for-treatment-of-postdural-puncture-headache
#14
Steven R Hanling, Joseph E Lagrew, Derrick H Colmenar, Albin S Quiko, Carol A Drastol
OBJECTIVE: This study evaluated the efficacy of IV cosyntropin as an alternative to epidural blood patch (EBP) for refractory or severe post-dural puncture headache (PDPH). METHODS: Twenty-eight patients were randomized to receive EBP or intravenous cosyntropin after diagnosis with post-dural puncture headache. Efficacy was evaluated immediately after treatment and at 1 day, 3 days, and 7 days following treatment using self-reported verbal reported scores for pain and function related to their headache on a 10-point scale using two-way repeated measures analysis of variance (ANOVA) with multiple comparisons...
March 25, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/26975712/adrenal-venous-sampling-in-patients-with-positive-screening-but-negative-confirmatory-testing-for-primary-aldosteronism
#15
MULTICENTER STUDY
Hironobu Umakoshi, Mitsuhide Naruse, Norio Wada, Takamasa Ichijo, Kohei Kamemura, Yuichi Matsuda, Yuichi Fujii, Tatsuya Kai, Tomikazu Fukuoka, Ryuichi Sakamoto, Atsushi Ogo, Tomoko Suzuki, Kazutaka Nanba, Mika Tsuiki
Adrenal venous sampling is considered to be the most reliable diagnostic procedure to lateralize aldosterone excess in primary aldosteronism (PA). However, normative criteria have not been established partially because of a lack of data in non-PA hypertensive patients. The aim of the study was to investigate aldosterone concentration and its gradient in the adrenal vein of non-PA hypertensive patients. We retrospectively studied the results of cosyntropin-stimulated adrenal venous sampling in 40 hypertensive patients who showed positive screening testing but negative results in 2 confirmatory tests/captopril challenge test and saline infusion test...
May 2016: Hypertension
https://www.readbyqxmd.com/read/26879335/safety-analysis-of-long-term-budesonide-nasal-irrigations-in-patients-with-chronic-rhinosinusitis-post-endoscopic-sinus-surgery
#16
Ethan Soudry, Jane Wang, Reza Vaezeafshar, Laurence Katznelson, Peter H Hwang
BACKGROUND: Although the safety of topical nasal steroids is well established for nasal spray forms, data regarding the safety of steroid irrigations is limited. We studied the effect of long-term budesonide nasal irrigations (>6 months) on hypothalamic-pituitary-adrenal axis (HPAA) function and intraocular pressure (IOP) in patients post-endoscopic sinus surgery. METHODS: This was retrospective case series. Adrenal function was assessed by using the high-dose cosyntropin stimulation test...
June 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/26865584/adrenal-derived-11-oxygenated-19-carbon-steroids-are-the-dominant-androgens-in-classic-21-hydroxylase-deficiency
#17
Adina F Turcu, Aya T Nanba, Robert Chomic, Sunil K Upadhyay, Thomas J Giordano, James J Shields, Deborah P Merke, William E Rainey, Richard J Auchus
OBJECTIVE: To comprehensively characterize androgens and androgen precursors in classic 21-hydroxylase deficiency (21OHD) and to gain insights into the mechanisms of their formation. DESIGN: Serum samples were obtained from 38 patients (19 men) with classic 21OHD, aged 3-59, and 38 sex- and age-matched controls; 3 patients with 11β-hydroxylase deficiency; 4 patients with adrenal insufficiency; and 16 patients (8 men) undergoing adrenal vein sampling. Paraffin-embedded normal (n = 5) and 21OHD adrenal tissues (n = 3) were used for immunohistochemical studies...
May 2016: European Journal of Endocrinology
https://www.readbyqxmd.com/read/26839091/evaluation-of-the-glucocorticoid-mineralocorticoid-and-adrenal-androgen-secretion-dynamics-in-a-large-cohort-of-patients-aged-6-18%C3%A2-years-with-transfusion-dependent-%C3%AE-thalassemia-major-with-an-emphasis-on-the-impact-of-cardiac-iron-load
#18
Ahmet Uçar, Nergiz Öner, Gülcihan Özek, Mehmet Güli Çetinçakmak, Mahmut Abuhandan, Ali Yıldırım, Cemil Kaya, Sena Ünverdi, Hamdi Cihan Emeksiz, Yasin Yılmaz, Aylin Yetim
The variable presence of adrenal insufficiency (AI) due to hypocortisolemia (HC) in patients with thalassemia is well established; however, the prevalence of adrenocortical hypofunction (ACH) in the zona glomerulosa and zona reticularis of the adrenal cortex is unknown. To establish the prevalence of ACH, we examined the cortisol response to 1-µg and 250-µg ACTH tests, plasma aldosterone (A)/plasma renin activity (PRA) ratio, and serum dehydroepiandrosterone sulfate (DHEAS) levels in a large cohort of patients with thalassemia, and to investigate the impact of total body iron load (TBIL) on adrenocortical function...
July 2016: Endocrine
https://www.readbyqxmd.com/read/26647150/cosyntropin-stimulated-serum-free-cortisol-in-healthy-adrenally-insufficient-and-mildly-cirrhotic-populations
#19
Mitra Rauschecker, Smita Baid Abraham, Brent S Abel, Robert Wesley, Elizabeth Saverino, Apurva Trivedi, Theo Heller, Lynnette K Nieman
CONTEXT: Serum free cortisol (SFF) responses to cosyntropin simulation test (CST) may more accurately assess adrenal function than total cortisol (TF). OBJECTIVE: The objective of the study was to evaluate the diagnostic utility of SFF responses during a 250-μg CST. DESIGN: We recruited healthy volunteers (HV; n = 27), patients with primary and secondary adrenal insufficiency (n = 19 and n = 24, respectively), and subjects with Child-Pugh class A cirrhosis (CH; n = 15)...
March 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/26436215/a-rare-mechanism-of-hyponatremia-in-hiv-disease
#20
Hector Madariaga, Aswini Kumar, Apurv Khanna
BACKGROUND: Hyponatremia is the most common disorder of body fluid and electrolyte balance in clinical practice. It is associated with increased morbidity, mortality, and length of hospital stay. Little is known about the relationship between hyponatremia and HIV disease. It is thought that hyponatremia in HIV is associated with a syndrome of inappropriate ADH secretion (SIADH), volume depletion, and adrenal insufficiency. Another common association is with Pneumocystis jirovecii (PCP)...
2015: American Journal of Case Reports
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