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A Study of Adrenal Incidentaloma-Related Hormonal Assays After First Integration of the Diagnosis Within Primary Healthcare.

BACKGROUND: Adrenal incidentalomas are detected in various medical and surgical healthcare departments, including primary healthcare. One up to three out of ten individuals confirmed with nonfunctioning adrenal incidentalomas (NFAs) actually present a mild autonomous cortisol secretion (MACS), which is distinct from Cushing's syndrome. OBJECTIVE: We aimed to assess the cortisol secretion in newly detected adrenal incidentalomas in patients who were referred by their primary healthcare physician upon accidental detection of an adrenal tumor at abdominal computed tomography (CT) scan that was p

An Interesting Case of Hepatic Adrenocortical Carcinoma.

Adrenocortical carcinoma (ACC) is a rare solid tumor with an incidence of 0.5 to 2 cases per million per year. It affects women more commonly than men with a ratio of 1.5:1. Ectopic ACC are considered to be extremely rare with no exact incidence data yet. We report an interesting case of hepatic ACC in a young woman with clinical signs of virilization.A-21-year old Sundanese woman visited our endocrine clinic with progressive hirsutism over the face, body, and extremities starting 14 years previously. She had irregular, heavy periods when she was 7 years old. She also experienced pubertal deve

Functional pituitary adenoma imaging.

High-resolution pituitary MRI localises most pituitary neuroendocrine tumours (PitNETs), yet clinically important subgroups remain challenging: (i) very small functioning tumours, particularly corticotroph microadenomas, and (ii) post-operative remnants where scar, gland and tumour cannot be reliably separated. Functional imaging, specifically PET has matured into a problem-solving modality when conventional imaging is equivocal, provided it is used selectively and interpreted within a physiology-led framework. This review proposes an MRI-first, tiered imaging strategy and a pragmatic approach

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… ’s syndrome. … Usefulness of 68 Ga-Pentixafor PET/CT on diagnosis and management of Cushing syndrome. Clin Nucl Med. 2022;47(8):669–76. 10.1097/RLU.0000000000004244. 59. Wu Y, Wu Y, Yao B, Ren S, Wu S, Rui W, et al. …

Насколько общим является гиперкортизолизм у пациентов с гипертензией? Факторы риска, эпидемиология и диагностика.

Эндогенный гиперкортизолизм (ЭГК) является недооцененным и клинически значительным фактором гипертонии, особенно резистентной гипертонии. После того, как EHC считается редким субъектом, он теперь воспринимается как спектр избытка кортизола, связанного с неблагоприятными кардиометаболическими результатами и ущербом, причиненным мишени. Недавно проведенные широкомасштабные исследования свидетельствуют о значительном увеличении распространенности ЭГК среди пациентов с устойчивой гипертонией и трудноконтролируемым диабетом, зачастую в отсутствие классических особенностей кушингоида. В настоящем об

Pamidronate-induced irreversible symptomatic hypocalcemia in a dog with hypercalcemia after glucocorticoid withdrawal: a case report.

BACKGROUND: Pamidronate is used for the treatment of hypercalcemia. However, a rare but potential adverse event of pamidronate treatment is hypocalcemia. This report describes an unusual case of severe, irreversible hypocalcemia after a single injection of pamidronate for the treatment of hypercalcemia due to glucocorticoid withdrawal in a dog. CASE PRESENTATION: An 11-year-old castrated male Maltese dog presented with anorexia, vomiting, and diarrhea (day 0). The patient had calcinosis cutis throughout the body, calcification of intraabdominal organs, mild azotemia, and severe hypercalcemia.

Treating Primary Aldosteronism-Induced Hypertension: Novel Approaches and Future Outlooks.

Primary aldosteronism (PA) is the most common cause of secondary hypertension and is associated with increased morbidity and mortality when compared with blood pressure-matched cases of primary hypertension. Current limitations in patient care stem from delayed recognition of the condition, limited access to key diagnostic procedures, and lack of a definitive therapy option for nonsurgical candidates. However, several recent advances have the potential to address these barriers to optimal care. From a diagnostic perspective, machine-learning algorithms have shown promise in the prediction of P

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… “Connshing's syndrome” was not associated with overt hypercortisolism/features of overt Cushing syndrome and patients demonstrating this metabolomic profile neither failed screening for Cushing syndrome with the overnight dexamethasone suppression test, nor did they demonstrate the typically suppressed … adrenocorticotropin (ACTH) level associated with adrenal Cushing syndrome. …

Recent advances in development of CDK7 inhibitors and their clinical trials: a narrative review.

Background and objectiveCDK7, a member of the CDK-activating kinase (CAK) family, plays a key role in cell cycle, transcriptional regulation and in regulating the proliferation and apoptosis of tumor cells. Some evidence suggests that CDK7 is a promising target for cancer treatments, so it is of great significance to develop an efficient and highly selective CDK7 inhibitor. CDK7 inhibitors have not yet been marketed. This review focuses on some selective CDK7 inhibitors currently in clinical research, and introduces their targets, indications, and the latest clinical trial progress in detail.M

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… syndrome | Phase II | NCT03774446 ( 45 ) | Recruiting | NSC-701554 | | Cushing syndrome | Phase II | NCT02160730 ( 46 ) | Terminated | | | Cystic fibrosis | Phase II | NCT02649751 ( 47 ) | Terminated | | | Rheumatoid arthritis | Phase I/II | ISRCTN36667085 ( 48 ) | Completed | | | | SCLC … Currently in phase II clinical development for pituitary cushing syndrome ( NCT03774446 ) ( 45 ), the compound also shows therapeutic potential for abnormal cell proliferation disorders including rheumatoid arthritis, advanced solid tumors, and BRCA-mutated cancers ( 50 ). …

Irish Endocrine Society 44th Annual Meeting.

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Prevalence of low alkaline phosphatase activity in laboratory assessment: Is hypophosphatasia an underdiagnosed disease?

BackgroundTissue-nonspecific alkaline phosphatase (TNSALP) encoded by the ALPL gene is of particular importance for bone mineralization. Mutation in the ALPL gene can lead to persistent low ALP activity resulting in the rare disease Hypophosphatasia (HPP) that is characterized by disturbed bone and dental mineralization. While severe forms are extremely rare with an estimated prevalence of 1/100.000, recent studies suggest that moderate form caused by heterozygous mutations are much more frequent with an estimated prevalence of 1/508. The purpose of this study was to estimate the prevalence of

Adrenocortical Carcinoma: A Challenging Diagnosis.

Adrenocortical carcinoma (ACC) is a rare malignancy with aggressive behaviour and a poor prognosis. Patients can present with adrenal hormonal excess or with nonspecific symptoms driven by the presence of an abdominal mass or metastatic disease. Many are completely asymptomatic and diagnosed incidentally. ACC can cause considerable morbidity and mortality, mostly due to its ability to invade surrounding tissues, produce hormones, and spread to distant organs. The authors describe a case of a 62-year-old woman who presented with subacute dorso-lumbar pain. A computed tomography (CT) scan reveal

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… Patients can exhibit adrenal hormonal excess, with either hypercortisolism presenting with Cushing syndrome features or hyperandrogenism resulting in male pattern baldness, virilization, hirsutism, menstrual abnormalities, or both. …

Историческое развитие иммуноэндокринных концепций психических расстройств и их терапии.

Отношения между центральной нервной, иммунной и эндокринной системами являются предметом психиатрических исследований, особенно в области депрессии и шизофрения. У поля длинные предтечи. Наблюдаемые явления, связанные с этими отношениями, восходят к неолитической эпохе. Теории иммуноэндокринной системы в самом широком смысле записаны в древности. В 19th Крепелин и Вагнер-Джаурег сообщили о первых клинических наблюдениях у пациентов психиатрических учреждений. Von Bestow, Эддисон и Кушинг описали психические симптомы у пациентов, страдающих эндокринными заболеваниями. :: 20th откровение века с

The Glucocorticoid Receptor: Isoforms, Functions, and Contribution to Glucocorticoid Sensitivity.

Glucocorticoids exert pleiotropic effects on all tissues to regulate cellular and metabolic homeostasis. Synthetic forms are used therapeutically in a wide range of conditions for their anti-inflammatory benefits, at the cost of dose and duration-dependent side effects. Significant variability occurs between tissues, disease states, and individuals with regard to both the beneficial and deleterious effects. The glucocorticoid receptor (GR) is the site of action for these hormones and a vast body of work has been conducted understanding its function. Traditionally, it was thought that the anti-

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… In patients with Cushing syndrome compared to healthy controls, the relative expression of GRβ mRNA was higher in hypercortisolism and declined after successful treatment. … syndrome ( 292 ). …

Do payers value rarity? An analysis of the relationship between disease rarity and orphan drug prices in Europe.

Background and Objective: Orphan drugs have been a highlight of discussions due to their higher prices than non-orphan drugs. There is currently no European consensus on the method of value assessment for orphan drugs. This study assessed the relationship between the prevalence of rare diseases and the annual treatment cost of orphan drugs in France, Germany, Italy, Norway, Spain, Sweden, and UK. Methods: Approved orphan drugs and prevalence data were extracted from the European Medicines Agency website. Annual treatment costs were calculated using ex-factory price. Simple regression was used

Idiopathic osteoporosis, Ehlers-Danlos syndrome, postural orthostatic tachycardia syndrome, and mast cell activation disorder in a 27-year-old male patient: A unique case presentation.

A young male patient presents with widespread pain and varying chronic inflammatory symptoms for three years and idiopathic low bone density for more than ten years. Based on the patient's clinical history, the patient has been diagnosed with an hypermobile Ehlers-Danlos syndrome, postural orthostatic tachycardia syndrome, and mast cell activation disorder trifecta with affiliated inflammation-induced osteoporosis.

Metabolic Syndrome and Cardiovascular Disease after Hematopoietic Cell Transplantation: Screening and Preventive Practice Recommendations from the CIBMTR and EBMT.

Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus, and all-cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with an estimated prevalence of MetS of 31% to 49% among HCT recipients. Although MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and

Reducing diagnostic delay in hypophosphatasia: a case series of 14 patients presenting to general rheumatology.

OBJECTIVES: Hypophosphatasia (HPP) is a rare genetic metabolic bone disease that can cause chronic pain and fractures. Its hallmark is a persistently low serum ALP. HPP is now recognised by many osteoporosis specialists, but other specialists, such as rheumatologists and primary care physicians, may be less aware of this condition, causing diagnostic delay and possible harm to these patients. Our objective was to highlight features that can reduce this delay. METHODS: We retrospectively analysed 14 patients that presented with musculoskeletal pain to general rheumatology clinic at St. George'

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… Table 2 Other causes of low serum ALP adapted from [ 6 ] Persistent causes Transient causes Celiac disease Cardiac bypass surgery Cushing syndrome Clofibrate therapy Hypothyroidism Improperly collected blood (oxalate, ethylenediaminetetraacetic acid) Inappropriate reference range Massive transfusion … syndrome | Clofibrate therapy Hypothyroidism | Improperly collected blood (oxalate, ethylenediaminetetraacetic acid) Inappropriate reference range | Massive transfusion Multiple myeloma | Milk-alkali syndrome Osteogenesis imperfecta, type 2 | Profound anaemia Pernicious anaemia | Starvation Radioactive …

Pituitary metastasis: a rare condition.

Tumor metastasis to the pituitary gland is a rare, not well-documented and life-threatening condition associated with a shortened life span. A better understanding of its clinical manifestations could lead to earlier diagnosis, appropriate therapy and potentially improving quality of life. Therefore, we retrospectively studied the charts of patients with pituitary metastases who were treated at the City of Hope National Medical Center (Duarte, CA) from 1984 to 2018. We reviewed and analyzed tumor origin, primary pituitary clinical manifestation, duration between primary tumor diagnosis and pit

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… Differential diagnosis in Cushing syndrome. Use of corticotropin-releasing hormone. Medicine 1995. 74 74–82. ( 10.1097/00005792-199503000-00002) 3. Teears RJ, Silverman EM. Clinicopathologic review of 88 cases of carcinoma metastatic to the pituitary gland. Cancer 1975. 36 216–220. 4. … Case of small cell lung cancer complicated with diabetes insipidus and Cushing syndrome due to ectopic adrenocorticotropic hormone secretion. Nihon Kokyuki Gakkai Zasshi 2007. 45 793–798. 129. …

Long-Term Health Effects of Curative Therapies on Heart, Lungs, and Kidneys for Individuals with Sickle Cell Disease Compared to Those with Hematologic Malignancies.

The goal of curing children and adults with sickle cell disease (SCD) is to maximize benefits and minimize intermediate and long-term adverse outcomes so that individuals can live an average life span with a high quality of life. While greater than 2000 individuals with SCD have been treated with curative therapy, systematic studies have not been performed to evaluate the long-term health effects of hematopoietic stem cell transplant (HSCT) in this population. Individuals with SCD suffer progressive heart, lung, and kidney disease prior to curative therapy. In adults, these sequalae are associ

A Case of Autoimmune Hepatitis Initially Manifesting as Hepatic Encephalopathy.

Autoimmune hepatitis (AIH) is a T-cell-mediated liver disease characterized by elevated transaminases, circulating autoantibodies, hypergammaglobulinemia, and interface hepatitis. A 66-year-old female patient visited our department due to recurrent episodes of altered consciousness, sleep-wake inversion, and asterixis, indicating hepatic encephalopathy (HE). Her liver biopsy results clearly demonstrated interface hepatitis. The patient's severe HE does not parallel her relatively stable liver function and was attributed to a wide retroperitoneal collateral vein shunting blood directly into the

Bone Metabolic Markers in Patients with Obstructive Sleep Apnea Syndrome.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is prevalent in obesity and is associated with many metabolic abnormalities. The relationship between OSAS and bone metabolism is still unclear. The aim of this study was to investigate the relationship between the severity of OSAS and bone metabolic markers. METHODS: A total of 119 obese males were enrolled in this study in spring months from 2015 to 2017. All candidates underwent polysomnography, and their bone mineral density (BMD) and the serum levels of total procollagen type 1 N-terminal propeptide (t-P1NP), N-terminal midfragment of o

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… syndrome, hypogonadism, hypopituitarism, growth hormone deficiency, acromegaly, gastrointestinal diseases, chronic renal disease, multiple myeloma, malignancy, bone metastasis, Paget's disease, rheumatologic disorders, stroke, paraplegia, hemiplegia, dementia, schizophrenia, depression, or a history … We also excluded the patients with diseases and drugs that affect bone metabolic markers, such as thyroid and parathyroid diseases, Cushing syndrome, growth hormone deficiency, acromegaly, gastrointestinal diseases, chronic renal disease, multiple myeloma, malignancy, bone metastasis, and Paget's disease …