Timing of cortisol replacement therapy affects cognitive performance

According to a trial, published inPNAS, timing cortisol replacement therapy to more closely match the usual ultradian rhythm can improve cognitive function in patients with adrenal insufficiency.Medical Xpress
Source: Society for Endocrinology - Category: Endocrinology Source Type: news

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Authors: Grassi G, Morelli V, Ceriotti F, Polledri E, Fustinoni S, D'Agostino S, Mantovani G, Chiodini I, Arosio M Abstract PURPOSE: The current cut-offs for the diagnosis of adrenal insufficiency (AI) have been established using outdated immunoassays. We compared the cortisol concentrations measured with Roche Cortisol I (R1), the newly available Roche Cortisol II (R2), and liquid chromatography tandem mass spectrometry (LC-MS/MS), the gold standard procedure to measure steroids in patients undergoing the corticotropin (ACTH) test. METHODS: We enrolled 30 patients (age 47 ± 21 years) ...
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research
Condition:   Adrenal Insufficiency, Congenital Interventions:   Other: Continuous blood glucose measurement;   Other: Measurement of capillary blood glucose Sponsor:   Assistance Publique - Hôpitaux de Paris Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
To keep patients with adrenal insufficiency safe during the COVID-19 crisis NHSE&I have agreed it is appropriate to release theNHS Emergency Steroid Card as a PDF that patients can download themselves.Guidance related to the release of the new NHS Emergency Steroid Card is almost ready for publication but the COVID-19 crisis has taken precedence.The card can be downloaded from ouradrenal crisis webpage, where you will also find additional emergency adrenal insufficiency management information and COVID-19 guidance.   
Source: Society for Endocrinology - Category: Endocrinology Source Type: news
CONCLUSIONS: There are currently limited trials comparing the efficacy and safety of different glucocorticoid replacement regimens for treating 21-hydroxylase deficiency CAH in children and adults and we were unable to draw any firm conclusions based on the evidence that was presented in the included trials. No trials included long-term outcomes such as quality of life, prevention of adrenal crisis, presence of osteopenia, presence of testicular or ovarian adrenal rest tumours, subfertility and final adult height. There were no trials examining a modified-release formulation of HC or use of 24-hour circadian continuous sub...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Primary adrenal insufficiency, a potentially life-threatening disease, often runs an insidious course mandating a strong clinical suspicion for a prompt diagnosis.1 A 65-year-old farmer presented with a one-month history of fatigue and dizziness reporting episodes of loss of consciousness. On clinical examination, he appeared cachectic, with skin and mucosal hyperpigmentation. Chest computed tomography, subsequent to a chest X-ray showing a “coin” lesion, demonstrated a 2.4 × 2cm nodule of the posterior right upper lobe and small lymph-nodes in the mediastinum.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: CLINICAL COMMUNICATION TO THE EDITOR Source Type: research
In conclusion, the incidence of AI among NSCLC patients treated with anti-PD-1 antibodies was similar to previous studies. Corticosteroid replacement improved PS, symptoms, and laboratory data of patients with AI and suspicious of AI. Corticosteroid replacement may contribute to continuation of anti-PD-1 antibodies and survival outcome was preferable in patients with AI and suspicious of AI receiving corticosteroid treatment.
Source: Medical Oncology - Category: Cancer & Oncology Source Type: research
The spring issue of the Society’s quarterly magazineThe Endocrinologist is now available online.  This issue, with the theme,'Exercise: It's good to move it, move it' examines multiple benefits of staying active, including maintaining a healthy metabolism, improving bone health and staying well during aging and pregnancy.In Society News, find out all you ever wanted to know about your new Society President, Raj Thakker, learn about the Society's new Undergraduate Video Award, and read new Society guidance on peri-operative management of adrenal insufficiency.Browse this latest issue, an...
Source: Society for Endocrinology - Category: Endocrinology Source Type: news
Isabelle Bourdeau Mitotane is a steroidogenesis inhibitor and adrenolytic drug used for treatment of adrenocortical cancer (ACC). Mitotane therapy causes adrenal insufficiency requiring glucocorticoid replacement in all patients. However, it is unclear whether chronic therapy with mitotane induces complete destruction of zona fasciculata and whether hypothalamic-pituitary-adrenal (HPA) axis can recover after treatment cessation. Our objective was to assess the HPA axis recovery in a cohort of patients after cessation of adjuvant mitotane therapy for ACC. We retrospectively reviewed patient files with stage I-II-III ...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
Nature Reviews Endocrinology, Published online: 09 March 2020; doi:10.1038/s41574-020-0342-zCurrent recommendations for perioperative doses of hydrocortisone in patients with adrenal insufficiency undergoing major surgery with general anaesthesia have been examined in a new paper. Compared with current guidelines, lower doses of hydrocortisone, tapered quickly back to baseline levels of glucocorticoids, were found to be effective and safe.
Source: Nature Reviews Endocrinology - Category: Endocrinology Authors: Source Type: research
Abstract Synthetic glucocorticoids are widely prescribed for the treatment of numerous inflammatory and autoimmune diseases and they can also affect the way the adrenal gland produces endogenous glucocorticoids. Indeed, patients undergoing synthetic glucocorticoid treatment can develop adrenal insufficiency, a condition characterised by reduced responsiveness of the adrenal to ACTH stimulation or stressors (e.g. surgical or inflammatory stress). To better elucidate the long-term effect of synthetic glucocorticoids treatment and withdrawal on adrenal function, we have investigated the effects of prolonged treatment...
Source: Brain, Behavior, and Immunity - Category: Neurology Authors: Tags: Brain Behav Immun Source Type: research
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