Well: Think Like a Doctor: Red Herrings Solved!

Readers solve the case of a 29-year-old woman with an injured groin, a swollen foot and long list of other abnormalities.    
Source: NYT - Category: American Health Authors: Tags: Cushing's Syndrome Doctors Hormones Think Like a Doctor ACTH (Adrenocorticotropic Hormone) Featured Cortisol (Hormone) Source Type: news

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Authors: Chrisoulidou A, Rakitzi P, Boudina M, Apostolidou-Kiouti F, Poimenidou E, Papanikolaou A, Devlioti A, Rallis G, Pazaitou-Panayiotou K Abstract OBJECTIVE: During follow-up in cancer patients, adrenal lesions are frequently found by computer tomography imaging. In these patients, the frequency of subclinical Cushing's syndrome (SCS) has not been fully explored. The aim of the present study was to investigate the presence of SCS in cancer patients with adrenal lesions in comparison to patients with true adrenal incidentalomas. DESIGN: We studied 95 patients with adrenal lesions: 57 patients (group A, 20 m...
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research
Conclusions: After laparoscopic adrenalectomy, the probability of AI is small in patients with adrenal SCS, and the symptoms of AI were mild. Meanwhile, the HPA axis rapidly recovered. Therefore, prophylactic steroid treatment is not mandatory. Given that AI is more frequent in patients with higher cut-offs of 1 mg-DST, a more precise definition of SCS is necessary to better manage these patients.
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Original Articles Source Type: research
Authors: Braun J, Grinshpun A, Atlan K, Sachar S, Knigen A, Yosha-Orpaz L, Grozinsky-Glasberg S, Khoury T, Nachman D Abstract PMID: 30685911 [PubMed - in process]
Source: The Israel Medical Association Journal - Category: General Medicine Tags: Isr Med Assoc J Source Type: research
Jeffrey Wagner, Fabienne Langlois, Dawn Shao Ting Lim, Shirley McCartney, Maria Fleseriu
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Authors: Tsurutani Y, Miyoshi K, Inoue K, Takiguchi T, Saito J, Omura M, Nishikawa T Abstract Adrenal Cushing's syndrome (CS) is caused by cortisol-producing adrenal adenoma and is frequently accompanied by glucose metabolism disorders, which are characterized by increased insulin resistance and insufficient β-cell compensation. However, considering the rarity of CS, few studies have assessed whether the glucose metabolism disorders could be ameliorated by surgical treatment. In this case series, we evaluated glucose metabolism before and after surgery in 11 patients (10 women and 1 man) who underwent unilater...
Source: Endocrine Journal - Category: Endocrinology Tags: Endocr J Source Type: research
Purpose: To investigate subfoveal choroidal thickness and pachychoroid and their correlation with hormone level in patients with endogenous Cushing syndrome (CS). Methods: We enrolled a consecutive series of patients with CS and healthy controls. All participants had swept-source optical coherence tomography. All patients with CS had hormone test including morning plasma-free cortisol, 24-hour urine-free cortisol (24UFC), and plasma adrenocorticotropic hormone. We compared subfoveal choroidal thickness and pachychoroid changes between two groups. We performed univariate and multivariate analysis to study correlation b...
Source: RETINA - Category: Opthalmology Tags: Original Study Source Type: research
Conclusions: Our results demonstrate that patients successfully treated for CS could develop autoimmune diseases. Therefore, after treatment, CS patients need to be strictly monitored in order to evaluate the possible onset of autoimmune diseases. PMID: 30662460 [PubMed]
Source: International Journal of Endocrinology - Category: Endocrinology Tags: Int J Endocrinol Source Type: research
CONCLUSIONS: Laparoscopic adrenalectomy is safe and feasible in obese patients affected with Cushing's disease and it can lead to the resolution of the related symptoms. PMID: 30663461 [PubMed - as supplied by publisher]
Source: Minimally Invasive Therapy and Allied Technologies - Category: Surgery Tags: Minim Invasive Ther Allied Technol Source Type: research
In this study, using clinical samples from patients with Cushing's syndrome and adipocyte-specific Gr knockout mice (AGRKO), we investigated the roles of adipocyte GR and its clinical relevance in Cushing's syndrome. Under chronic treatment with corticosterone, AGRKO underwent healthy adipose expansion with diminished ectopic lipid deposition and improved insulin sensitivity. These changes were associated with Atgl-mediated lipolysis through novel intronic glucocorticoid-responsive element. In addition, integrated analysis with RNA-Seq of AGRKO and clinical samples revealed that healthy adipose expansion associated with dy...
Source: Endocrinology - Category: Endocrinology Authors: Tags: Endocrinology Source Type: research
Since the first description of laparoscopic adrenalectomy (LA) for pheochromocytoma and Cushing syndrome in 1992, the utilization of and indications for a minimally invasive approach to the adrenal gland have vastly expanded. Although minimally invasive adrenalectomy has been established as the preferred approach for patients with benign tumors of the adrenal gland, minimally invasive adrenalectomy for cancer remains controversial. In this article, the authors review the indications for minimally invasive adrenalectomy for adrenal nodules suspicious for, or established to represent, a primary malignancy or a site of metastatic cancer.
Source: Surgical Oncology Clinics of North America - Category: Surgery Authors: Source Type: research
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