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Endo and Health News, 2007

Compiled From the Weekly Email Newsletters

Other Years 2008 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 |

For purposes of this list the year 2007 started with the April 18, 2007 newsletter. For New Items prior to that newsletter, please see the News Items and Research Forum of the message boards

Type Subject Date

Acromegaly

Growing feet could mean tumour

In more than 90 per cent of acromegaly cases the over-production of growth hormone is caused by a benign tumour on the pituitary gland....

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Manchester Evening News 4/17/2007
Acromegaly Masquerading as Polycystic Ovary Syndrome

Renner, Matthew MD., et al. – This case describes a growth hormone-prolactin, cosecreting pituitary microadenoma that presented with chronic, hyperandrogenic anovulation. A 37-year-old parous patient presented with 1 year of irregular cycles unresponsive to clomiphene citrate and a mildly elevated prolactin. Laboratory evaluation demonstrated hyperprolactinemia with an elevated, age-adjusted, insulin-like growth factor-1 level, and nonsuppressed growth hormone following glucose loading

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The Endocrinologist 4/13/2007

Adrenal

Dehydroepiandrosterone Induces a Neuroendocrine Phenotype in Nerve Growth Factor-Stimulated Chromaffin Pheochromocytoma PC12 Cells

In summary, our data show that DHEA influences cell survival and differentiation processes in PC12 cells, possibly by interacting with the ERK1/2 MAPK pathway. DHEA drives NGF-stimulated cells toward a neuroendocrine phenotype, suggesting that the interaction of intraadrenal steroids and growth factors is required for the maintenance of an intact adrenal medulla...

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Endo Journals December 21, 2007
Adrenal Insufficiency in Critical Illness

One of the more controversial areas in critical care in recent decades relates to the issue of adrenal insufficiency and its treatment in critically ill patients. There is no consensus on which patients to test for adrenal insufficiency, which tests to use and how to interpret them, whether to use corticosteroids, and, if so, who to treat and with what dose. This review illustrates the complexity and diversity of pathophysiological changes in glucocorticoid secretion, metabolism, and action and how these are affected by various types of illness. It will review adrenal function testing and give guidance on corticosteroid replacement regimens based on current published literature. There remain inherent difficulties in interpreting the effects of glucocorticoid replacement during critical illness because of the diversity of effects of glucocorticoids on various tissues. Investigation and treatment will depend on whether the likely cause of corticosteroid insufficiency is adrenal or central in origin.

Key Words: corticosteroids • hydrocortisone • cortisol • sepsis • adrenal insufficiency • Addison's disease

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Journal of Intensive Care Medicine November 30, 2007
Pheochromocytoma and Extraadrenal Abdominal Paraganglioma

Conclusion: Carbidopa enhances the sensitivity of 18F-DOPA PET for adrenal pheochromocytomas and extraadrenal abdominal paragangliomas by increasing the tumor-to-background ratio of tracer uptake. The sensitivity of 18F-DOPA PET for metastases of paraganglioma appears to be limited....

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Journal of Nuclear Medicine October 2, 2007
The Adrenal Glands

In some cases, an adrenal tumor can cause excess production of hormones. Patients may experience severe headaches, anxiety, palpitations, sweating, and a rapid heart rate. Overproduction of cortisol can lead to the development of Cushing's syndrome, a condition characterized by obesity, high blood pressure, high glucose levels, menstrual problems, fragile skin and stretch marks. Excess production of aldosterone can cause high blood pressure and low potassium levels...

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WSOCTV September 28, 2007
Bilateral Laparoscopic Adrenalectomy For Corticotropin-Dependent Cushing's Syndrome: A Review of the Mayo Clinic Experience

There has been a rapid shift from open to laparoscopic approaches in adrenal surgery, but the safety and efficacy of bilateral laparoscopic adrenalectomy (BLA) in patients with corticotropin (ACTH)-dependent Cushing's syndrome continues to be defined...

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Mayo Clinic September 27, 2007
Travel to India for Adrenal Surgery

This article describes about the Adrenal Surgery in India. Many patients travel across the globe to India to get low cost adrenal surgery; explore the need for patients to do so and what sets apart India as the Medical Hub of the World...

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Scribd September 27, 2007
An Update on the Diagnosis of Adrenal Insufficiency and the Use of Corticotherapy in Critical Illness

Recently, inaccuracies in measuring cortisol have been identified, making interpretation of cortisol concentrations difficult. A large-scale study failed to confirm a previously reported mortality benefit of corticotherapy in late ARDS, but preliminary data suggest a role for steroid treatment in early ARDS. Finally, a pilot study has found that hydrocortisone lowers morbidity and mortality in SCAP...

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theannals.com August 15, 2007
Improved Detection and Characterization of Adrenal Disease with PET-CT1

Abstract Positron emission tomography (PET)–computed tomography (CT) combines complementary modalities, thereby providing useful structural and functional information for the detection and characterization of a variety of conditions affecting the adrenal gland....

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RadioGraphics 5/16/2007
Reduced Final Height Outcome in Congenital Adrenal Hyperplasia under Prednisone Treatment: Deceleration of Growth Velocity during Puberty

Conclusion: Patients with CAH are able to achieve adequate FH with conventional therapy. Total pubertal growth is significantly decreased, and treatment with prednisone results in decreased FH. In addition to biochemical analysis, treatment should be adjusted to normal growth velocity, especially during puberty.

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Journal of Clinical Endocrinology & Metabolism 5/5/2007
Adrenalectomy In The Laparoscopic Era

There were 82 adrenalectomies performed over the 12 year period. Sixty-one were completed laparoscopically, 17 were performed open and four were converted from a laparoscopic to an open procedure. The indications for surgery included 30 phaeochromocytomas, 20 non-functioning cortical adenomas, 9 aldosteronomas, 6 cortisol-producing adenomas, 3 adrenocortical carcinomas, 3 pseudocysts, 3 cortical hyperplasias, 2 cortical cysts, and one each of heamangioma, angiolipoma, myelolipoma, haematoma, lymphoma and adrenal metastasis...

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ANZ Journal of Surgery 5/4/2007
Hospital's blunder left me in bed for a year

This is done to check how well a patient's adrenal glands, the part of the body which produces adrenaline, are working. When the test results were returned, ...

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York Press 4/19/2007
Researchers Identify Thousands With Curable High Blood Pressure

Adrenal venous sampling being performed on a patient with primary aldosteronism to distinguish unilateral (surgically correctable) from bilateral forms. ...

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University of Queensland 4/18/2007
Adrenal Gland Volume and Dexamethasone-Suppressed Cortisol Correlate with Total Daily Salivary Cortisol in African-American Women

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Journal of Clinical Endocrinology & Metabolism

4/15/2007

Cancer

Presence of Multiple Carcinoid Tumorlets in Lung Linked to Good Survival

The appearance of multiple carcinoid tumors -- or "tumorlets" -- on lung specimens is associated with "excellent" long-term survival and usually only mild airflow limitation, investigators report in the June issue of Chest. Dr. Marie-Christine Aubry and colleagues at the Mayo Clinic in Rochester, Minnesota, systematically analyzed the significance of multiple carcinoid tumors or tumorlets in a series of 294 patients being treated at the Mayo Clinic between 1987 and 2000. There were 28 patients with two or more tumors or tumorlets, and 26 of the 28 were women. Mean age was 65 years. Mean follow-up was 66 months. Seventeen patients had multiple nodules. Nine of the 17 had stable disease with no growth in residual small indeterminate nodules. Nearly half of patients with multiple nodules had respiratory problems. Two had Cushing's syndrome...

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Chest July 14, 2007

Cortisol

Does Stress Cause Disease? It Doesn't Help, Reviewers Say

Cortisol, the primary effector of HPA activation in humans, regulates a broad range of physiological processes, including anti-inflammatory responses; metabolism of carbohydrates, fats, and proteins; and gluconeogenesis...

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MedPage Today October 11, 2007
Measurement of Salivary Cortisol Concentration in the Assessment of Adrenal Function in Critically Ill Subjects: A Surrogate Marker of the Circulating Free Cortisol

Conclusions: Salivary cortisol measurements are simple to obtain, easy to measure in most laboratories, and provide an indirect yet reliable and practical assessment of the serum free cortisol concentrations during critical illnesses. The concentrations of the two measures of unbound cortisol determined in two different body fluids correlated very well, regardless of the serum protein concentrations. Measurements of salivary cortisol can serve as a surrogate marker for the free cortisol in the circulation...

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Journal of Clinical Endocrinology & Metabolism August 7, 2007
Associations of Salivary Cortisol With Cognitive Function in the Baltimore Memory Study

Conclusions Elevated cortisol was associated with poorer cognitive function across a range of domains in this large population-based study. We believe the findings are consistent with the hypothesis that hypothalamic-pituitary-adrenal axis dysregulation may be a risk factor for poorer cognitive performance in older persons...

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Arch Gen Psychiatry July 4, 2007
Ketoconozole: Experimental Drug Improves Glycemic Control, Lipids in Type 2 Diabetes: Presented at ENDO

Dr. Welles noted that ketoconazole, a racemic combination of two enantiomers, has been used to treat cortisol excess in patients with Cushing's syndrome, the results of which have led to improved insulin resistance, glycemic control, lipid measures, and blood pressure...

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Endo 2007 June 4, 2007
Mother's stress harms foetus, research shows

Cortisol in Pregnancy

Scientists sampled blood from the mother and amniotic fluid from around the foetus in the womb and found that, at a gestational age of 17 weeks or greater, higher cortisol levels in the mother's blood were reflected in higher levels in the amniotic fluid. Amniotic fluid is mainly produced by the foetus and is a good indicator of its exposure to a range of substances, including hormones...

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Guardian Unlimited May 31, 2007
The Use of Cortisol as an Early Marker for Acute Myocardial Infarction in an Emergency Department Setting

Conclusions

Cortisol levels were found to be high in patients with cardiac chest pain, and significantly elevated in patients diagnosed with MI. This suggests that cortisol may be a valuable predictor of cardiac disease and could potentially serve as a cardiac marker for MI in the emergency setting.

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Society for Academic Emergency Medicine 4/28/2007
Scientists Unravel Clue in Cortisol Production

When a person's under stress or injured, the adrenal gland releases cortisol to help restore the body's functions to normal. But the hormone's effects are many and varied, lowering the activity of the immune system, helping create memories with short-term exposure, while impairing learning if there's too much for too long. Given the variety of its effects, understanding how cortisol is made is essential to producing medications that can alter its production...

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NIH and Georgia Tech 4/24/2007

Cortisone

DuoCort AB: DuoCort announces Phase I Data Presentation at the European Congress of Endocrinology

About dual-release hydrocortisone

DuoCort's dual-release 5 mg and 20 mg hydrocortisone tablets for patients with chronic adrenal insufficiency were granted an Orphan Medicinal Product Designation in the European Union in May 2006. DuoCort's objective is to improve today's glucocorticoid replacement therapy with a once-daily tablet which is more convenient than current treatment and capable of improving patient compliance. In addition, by combining rapid release and extended release characteristics, DuoCort's new tablet also delivers a more physiological dose of hydrocortisone, better mimicking the body's natural cortisol serum profile.

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DuoCort 4/28/2007

Cushing's

Samaritan Pharmaceuticals Begins Trading On OTC Bulletin Board Under Ticker Symbol SPHC

Samaritan has partnered its Phase II/III oral HIV viral-entry inhibitor drug. Its promising memory-restoring Alzheimer's drug Caprospinol expects to enter a Phase I clinical trial after acute toxicity study and its High Stress Cortisol drug to counteract Cushing's disease expects to enter Phase II clinical trials...

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CNN Money December 18, 2007
A ‘smart’ type of Cushing's syndrome

Cushing's syndrome results from lengthy and inappropriate exposure to excessive concentrations of either endogenous or exogenous glucocorticoids. This case report describes a patient with a novel type of Cushing's syndrome due to the use of party drugs. A 35-year-old woman had gained 8 kg body weight in 5 months and complained of anxiety. She showed a Cushing-like appearance and mild hypertension (blood pressure, BP 150/95 mmHg). She reported daily use of increasing doses of {gamma}-hydroxybutyric acid (GHB), a popular party drug. ACTH plasma levels were in the upper normal range (41 ng/l), with normal plasma cortisol (0.36 µmol/l). She showed an abnormal overnight 1 mg dexamethasone suppression test (cortisol 0.38 µmol/l). The urinary excretion of free cortisol in 24 h was also increased (0.47 µmol/24 h). CT scanning of the abdomen showed normal adrenals. After stopping GHB intake she lost 7 kg body weight and her BP normalized (BP 135/80 mmHg). GHB is a popular party drug in the Netherlands, but it is also used as a narcotic and for the treatment of narcolepsy. We hypothesize that GHB may bind to the pituitary gland {gamma}-aminobutyric acid-B receptors leading to ACTH overproduction.

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European Journal of Endocrinology December 17, 2007
False-positive inferior petrosal sinus sampling in the diagnosis of Cushing's disease

Inferior petrosal sinus sampling (IPSS) for adrenocorticotropic hormone (ACTH) levels in patients with Cushing’s syndrome has become a useful method to distinguish ACTH-secreting pituitary tumors (Cushing’s disease) from other causes of the syndrome, principally ectopic adrenocorticotropin secretion by an occult tumor. Although the test is generally regarded as highly specific, the authors recently encountered two patients whose IPSS measurements were falsepositive for Cushing’s disease. The results of IPSS suggested a pituitary origin of ACTH secretion in both patients, but transsphenoidal surgery failed to disclose a pituitary adenoma or to improve postoperative plasma cortisol levels. Both patients subsequently were found to have an ACTH-secreting carcinoid tumor of the lung. The false-positive IPSS studies were due to periodic hormonogenesis. The patients must be hypercortisolemic at the time IPSS is performed for the study to be valid.

KEY WORDS • Cushing’s syndrome • Cushing’s disease • inferior petrosal sinus sampling • carcinoid tumor

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Journal of Neurosurgery December 17, 2007
Food-dependent Cushing's syndrome: from molecular characterization to therapeutical results N M Albiger, G Occhi, B Mariniello, M Iacobone1, G Favia1, A Fassina2, D Faggian3, F Mantero and C Scaroni

Department of Medical and Surgical Sciences Endocrinology Unit, University of Padua, via Ospedale 105, 35128 Padua, Italy, Departments of 1 Endocrine Surgery, 2 Pathology and 3 Laboratory Medicine,, University of Padua, 1-3: Giustiniani, 35128. Padua, Italy

(Correspondence should be addressed to N M Albiger; Email: nalbiger@yahoo.com)

Abstract

Objective: Cortisol secretion in ACTH-independent macronodular adrenal hyperplasia (AIMAH) may be regulated by the aberrant expression of several G-protein-coupled receptors. Bilateral adrenalectomy is the treatment of choice in most cases. We searched for aberrant receptor expression in a patient with AIMAH and evaluated the response to medical and surgical treatment.

Patient: A 35-year-old woman with amenorrhea, hirsutism, and hypertension presented ACTH-independent cortisol secretion with high androgen levels. Abdominal computed tomography showed bilateral adrenal macronodules (4.5 cm right and 1.0 cm left). Scintigraphy with I131-norcholesterol showed bilateral uptake, prevalent on the right side. Several in vivo stimulation tests were assessed before and after treatment and in vitro studies were performed after unilateral adrenalectomy.

Results: Plasma cortisol increased after a standard meal test (60%) and oral glucose loading (147%), and the response was blunted by pretreatment with 100 µg s.c. octreotide. The therapy with long-acting release octreotide (octreotide-LAR) showed an improvement in urinary free cortisol (UFC) levels. Unilateral adrenalectomy was performed and histopathology revealed macronodular AIMAH. Cortisol and androgens increased after perifusion of tumoral tissue with glucose-dependent insulinotropic polypeptide (GIP), and GIP and LH-receptor overexpression was found in both the adrenal nodules and the adjacent cortex. After surgery, UFC and androgen levels normalized followed by clinical improvement.

Conclusions: GIP and LH-receptor expression may coexist in AIMAH, influencing the functional and morphological phenotype. Aberrant hormone receptor expression enables specific pharmacological treatment, but long-term studies are needed to evaluate its real efficacy. Unilateral adrenalectomy may be a safe initial option, particularly for asymmetric bilateral adrenal enlargements.

European Journal of Endocrinology December 11, 2007
Patients With Mild Cushing Syndrome May Benefit From Adrenalectomy Researchers at UT Southwestern Medical Center have found that patients with a mild form of Cushing syndrome, a metabolic disorder caused by adrenal tumors, demonstrate substantial clinical improvement after adrenalectomy.

The study, appearing in the December issue of the journal Surgery, is the largest series of surgical outcomes reported in patients with subclinical Cushing syndrome to date, said Dr. Richard Auchus, associate professor of internal medicine at UT Southwestern and co-author of the study.

"We don't have enough data to come out with a definitive statement that everyone with an adrenal tumor and mild cortisol excess should have the adrenal tumor removed," Dr. Auchus said. "We can say, however, that there are many people with large adrenal tumors who, while not meeting classical criteria for Cushing syndrome, nonetheless suffer from the hormonal disorder and will benefit from surgery."

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medicalnewstoday.com December 10, 2007
Cushing's syndrome in women with polycystic ovaries and hyperandrogenism

A 41-year-old woman presented to an endocrinology–gynecology clinic having been diagnosed 7 years earlier with polycystic ovarian syndrome on account of hirsutism, subfertility, greasy skin, acne and multiple ovarian cysts. Ovulation induction had led to a successful pregnancy. Subfertility recurred, however, and persisted alongside a new diagnosis of hypertension and progressive weight gain. Upon examination, the patient was hypertensive with facial plethora, rounded facies and violaceous abdominal striae...

This article in PDF format

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Nature Clinical Practice Endocrinology & Metabolism (2007) November 28, 2007
Open Mouths, Open Minds

It's not difficult to find serious grievances from fat patients. On one new blog, First, Do No Harm, a woman with Cushing's Syndrome, a muscle-wasting disease that turns muscle to fat, says she was told that she just needed to go on a diet....

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Valley Advocate November 1, 2007
Articles from The Journal of Neurosurgery, September 2007 Volume 23, Number 3
  • Brain atrophy and cognitive deficits in Cushing's disease by Chirag G. Patil, M.D., Shivanand P. Lad, M.D., Ph.D., Laurence Katznelson, M.D., and Edward R. Laws Jr., M.D.
  • Current state of the art in the diagnosis and surgical treatment of Cushing disease: early experience with a purely endoscopic endonasal technique by Amir R. Dehdashti, M.D. and Fred Gentili, M.D., F.R.C.S.C.
  • Cushing disease: use of perioperative serum cortisol measurements in early determination of success following pituitary surgery by Armand Krikorian, M.D., Dima Abdelmannan, M.D., Warren R Selman, M.D., and Baha M Arafah, M.D.
  • Cyclic Cushing syndrome: definitions and treatment implications by Dennis A. Velez, M.D., Marc R. Mayberg, M.D., and William H. Ludlam, M.D., Ph.D.
  • Diagnosis and Management of Cushing Disease by William T. Couldwell, M.D., Ph.D.
  • Diagnostic approach to Cushing disease by Bradley A. Gross, B.S., Stefan A. Mindea, M.D., Anthony J. Pick, M.D., James P. Chandler, M.D., and H. Hunt Batjer, M.D.
  • Evaluation and management of Cushing syndrome in cases of negative sellar magnetic resonance imaging by Jay Jagannathan, M.D., Jason P. Sheehan, M.D., Ph.D., and John A. Jane Jr., M.D.
  • Medical management of Cushing disease by Bradley A. Gross, B.S., Stefan A. Mindea, M.D., Anthony J. Pick, M.D., James P. Chandler, M.D., and H. Hunt Batjer, M.D.
  • National trends, complications, and outcomes following transsphenoidal surgery for Cushing's disease from 1993 to 2002 by Chirag G. Patil, M.D., Shivanand P. Lad, M.D., Ph.D., Griffith R. Harsh, M.D., Edward R. Laws Jr., M.D., and Maxwell Boakye, M.D.
  • Nelson syndrome: comprehensive review of pathophysiology, diagnosis, and management by Magdalena J. Banasiak, M.D. and Ali R. Malek, M.D.
  • Nelson syndrome: historical perspectives and current concepts by Mark Hornyak, M.D., Martin H. Weiss, M.D., Don H. Nelson, M.D., and William T. Couldwell, M.D., Ph.D.
  • The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease
  • Transsphenoidal surgery for Cushing's disease: a review of success rates, remission predictors, management of failed surgery, and Nelson's Syndrome by Daniel F. Kelly, M.D.
  • Treatment options for Cushing disease after unsuccessful transsphenoidal surgery by James K. Liu, M.D., Maria Fleseriu, M.D., Johnny B. Delashaw Jr., M.D., Ivan S. Ciric, M.D., William T. Couldwell, M.D., and Ph.D.

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Journal of Neurosurgery October 31, 2007
Genetics of Adrenal Tumors Associated With Cushing's Syndrome: A New Classification for Bilateral Adrenocortical Hyperplasias

Adrenocortical causes of Cushing's syndrome include isolated and sporadic adenoma causes as well as rare carcinoma causes and bilateral hyperplasias. The classification of various forms of adrenal hyperplasias can be based on histologic, biochemical, and genetic features...
MedScape October 26, 2007
Cyclical Cushing's syndrome: an update

Summary: Cyclical Cushing's syndrome is a pattern of hypercortisolism in which the biochemistry of cortisol production fluctuates rhythmically. This syndrome is often associated with fluctuating symptoms and signs. This type of case was initially thought to be rare. It has, however, recently been recognized as occurring much more frequently. The phenomenon is important because it can, if not recognized, lead to errors in diagnosis and differential diagnosis of the syndrome and in assessment of therapeutic outcomes. All of these can have very serious clinical consequences. Clinical researchers, including ourselves, have developed criteria, protocols and dynamic biochemical tools to detect cycling in patients with hypercortisolism. Unfortunately, the mechanisms causing the abnormal pathophysiology have not been well elucidated but some recent insights have been gained. The review discusses strateges for diagnosing and managing this important subgroup of patients with hypercortisolism...

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Current Opinion in Endocrinology, Diabetes and Obesity October 8, 2007
PDE11A as a Novel Therapeutic Target for Inherited Form of Cushing Syndrome and Endocrine Tumors

Cushing Syndrome, a disorder associated with excess production of a steroid hormone, cortisol, affects up to 10 per 15 million people every year. Cushing Syndrome may be caused by several reasons such as cortisol-producing endocrine tumors and can be inherited in some instances. Surgery of the adrenal tumor is the most common method of treatment. New diagnostic and therapeutic approaches need to be developed for successful management of the disease...

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NIH October 6, 2007
Alopecia or Why People Go Bald

Among women the cause of hair loss can be an hyper-sensitivity to male hormones or their increased amount in the body because of the following diseases: polycystic ovaries, congenital dysfunction of cortex of adrenal glands, Cushing syndrome, tumours of adrenal glands and ovaries...

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EditorsChoice October 2, 2007
Steroid withdrawal syndrome after successful treatment of Cushing's syndrome: a reminder

Steroid withdrawal syndrome (SWS) usually refers to relapse of the disease being treated after withdrawal of glucocorticoid therapy, or the symptoms of adrenal insufficiency which occur when glucocorticoids are rapidly reduced or stopped. A less well-recognised form of SWS is that which develops when patients experience a symptom complex similar to that of adrenal insufficiency despite acceptable cortisol levels. We describe three patients who presented with this form of SWS following surgical treatment for endogenous Cushing's syndrome...

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Department of Endocrinology, Manchester Royal Infirmary September 20, 2007
Cushing's Syndrome - Definition, Causes, Symptoms and Treatment

Cushing's syndrome is a rare endocrine disorder caused by high levels of cortisol in the blood. Sometimes called "hypercortisolism. It is relatively rare and most commonly affects person aged 20 to 50. An estimated 10 to15 of every million people are affected each year. Cushing's syndrome occurs when the body's tissues are exposed to excessive levels of cortisol for long periods of time. Many people suffer the symptoms of Cushing's syndrome because they take glucocorticoid hormones such as prednisone for asthma, rheumatoid arthritis, lupus and other inflammatory diseases, or for immunosuppression after transplantation...

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ArticlesBase.com August 14, 2007
11th Doctor Sees 'Ghost'

The endocrinologist said he was fairly sure Silverman had Cushing's disease, a rare disorder that strikes about one in 500,000 Americans. Cushing's results in the overproduction of the stress hormone cortisol, which can wreak havoc with multiple organ systems.

Silverman, Lipson recalled, had the round "moon face" that characterizes patients with Cushing's or those on high doses of corticosteroids. Many of her other symptoms were classic manifestations of the disease. The usual cause is a nonmalignant tumor on the pituitary gland at the base of the brain...

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Washington Post August 14, 2007
CORLUX for the treatment of Cushing's Syndrome, orphan drug designation

Corcept is still determining its development plan for Corlux for evaluating the use of Corlux for the treatment of Cushing's Syndrome. However, an Investigational New Drug (IND) application will be submitted to the FDA in the near future, a necessary step to begin clinical trials. While the market opportunity for Cushing's Syndrome may be small compared with that of psychotic depression, and may not be realized for several years, the granting of Orphan Drug status from the FDA provides reason to believe that Corlux may have significant value beyond PMD...

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Journal of Clinical Endocrinology & Metabolism August 14, 2007
Dexamethasone-Suppressed Corticotropin-Releasing Hormone Stimulation Test for Diagnosis of Mild Hypercortisolism

Conclusions: Our results differ from previous studies because our data suggest that when using the combined dexamethasone-suppressed CRH stimulation test, a 15-min post-CRH ACTH value greater than 27 pg/ml (5.9 pmol/liter) had the highest diagnostic accuracy for the detection of CS. However, the sensitivity and specificity for this test were not statistically different from the sensitivity and specificity of other tests, such as those measuring post-CRH stimulated ACTH levels or post-CRH cortisol levels at other time points. Therefore, clinicians should be cautious about interpretation of suppression and stimulation tests in the diverse population of patients with hypercortisolism...

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Journal of Clinical Endocrinology & Metabolism August 9, 2007
Georgetown University and Samaritan Sign Exclusive Licensing Agreement for Novel Treatment of Cushing's Syndrome

Samaritan Pharmaceuticals, Inc. (AMEX:LIV), a developer of innovative drugs, announced today that it has entered into an exclusive licensing agreement with Georgetown University for a new innovative drug SP-6300 to treat Cushing's syndrome...

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Georgetown University August 9, 2007
Preliminary Experience with 3-Tesla MRI and Cushing's Disease

Because radiographic visualization of a pituitary microadenoma is frequently difficult, we hypothesized that microadenomas associated with Cushing's disease may be better resolved and localized via acquisition with 3-Tesla (3T) compared with standard 1.5-Tesla (1.5T) magnetic resonance imaging (MRI)...

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Thieme Medical Publishers, Inc. August 8, 2007
Updated info: Screening Of Cushing's Syndrome In Adult Patients Newly Diagnosed To Have Diabetes Mellitus

Conclusions: The results of the present study support the view that unknown CS is not rare among patients with diabetes mellitus. This is the first demonstration that screening for CS may be feasible at the clinical onset of diabetes in an unselected cohort of patients. Therefore, early diagnosis and treatment of CS may give the opportunity to improve the prognosis of diabetes.

Full Text PDF (73 KB) (Subscription)

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Clinical Endocrinology August, 2007
Doug's fight for veterans of nuclear testing

Doug himself, who spent a year on Christmas Island, suffers from bone spurs and in 1977 lost daughter Gill when she was just 13 to a rare form of cancer called Cushing's Syndrome, something he believes was passed directly down through his genes....

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Spalding Today June 13, 2007
The Application of the Combined Corticotropin-Releasing Hormone plus Desmopressin Stimulation during Petrosal Sinus Sampling Is Both Sensitive and Specific in Differentiating Patients with Cushing's Disease from Patients with the Occult Ectopic Adrenocorticotropin Syndrome

Conclusions: The application of a combined stimulation with CRH plus desmopressin during BIPSS is associated with a high sensitivity but no loss of specificity.

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Journal of Clinical Endocrinology & Metabolism June 7, 2007
7 medical reasons you may be gaining weight

3. Cushing's syndrome What is it? Also known as hypercortisolism, this rare condition means there is too much of the hormone cortisol in the adrenal glands. Cortisol normally helps regulate blood pressure and metabolism. While weight gain is a big red flag, tiredness and troubles with the skin (bruises last longer than usual, for example) are also signs. While both children and adults can develop hypercortisolism, it's more common in women aged 25 to 45 years.

The gain explained: The weight gain tends to occur in the upper body and particularly around the face and neck area, similar to if you were receiving corticosteroid injections, says Watson. "A roundish face, an apple-shaped upper body, that's where the gain would come in," she says.

What now: There are a variety of reasons for too much cortisol in the body - you may have been taking medications for another condition, such as asthma, or there could be a noncancerous tumour causing the oversecretion. So treatment will vary and may include surgery, radiation or taking cortisol-inhibiting drugs. This levelling out will help regulate symptoms; losing the weight comes down to hard work. "There are no drugs that you can just give to counter the weight-gain effects," says Dornan. Instead, it's incorporating healthful meal choices - lean proteins, whole grains, fresh produce - and increasing your activity options whenever you can. Check out Health Canada's website (www.hc-sc.gc.ca) for easy activities you can do at home, work or outside. ...

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Homemakers.com June 2, 2007
"Miraculous Miranda"

"Donna Renfro was living a parent's nightmare. Her five year old daughter was going to die without a medical breakthrough to save her from a rare disease. Desperate and distraught, Donna started keeping a diary which chronicled her uphill journey.

That was eight years ago. Today, her daughter is a healthy teenager, and this East Tennessee mom is compelled to share her story with anyone who doesn't know God or have hope.

When Miranda Renfro was five years old, she routinely suffered from random blindness, paralysis, headaches, and rapid weight gain. Cushings Disease caused her body to produce exceptionally high levels of cortisol, and the genetic hormonal imbalance was going to kill her if doctors couldn't find the root of her disease.

"So we were looking for a tumor that you couldn't see, and if they didn't take it out, she was going to die," Renfro said.

Miranda has the intermittent form of Cushings Disease, which proved difficult for doctors to find the cause. Her Cushings cycles didn't last long enough to gather the proper test results."

There are two parts to this story...you can watch both on volunteertv.com

New Cushing's Book: Miraculous Miranda Medical Nightmare to Medical Miracle

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VolunteerTV 5/23/2007
Reaching out to children carers

The family, from Crawcrook, Gateshead, have suffered a string of medical setbacks over the past few years - Jenny was struck with Cushing's syndrome, which caused excessive weight gain and diabetes, had a brain tumour removed in 2000 and cannot walk very far due to arthritis in her leg....

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icNewcastle 5/21/2007
ACTH-independant macronodular adrenal hyperplasia: imaging findings of a rare condition : A case report.

Endogenous Cushing's syndrome is a relatively rare disease. Most cases being ACTH-dependent, ACTH-independent Cushing's syndrome (AICS) is an even rarer condition [15%-20%]. In more than 95% cases the cause of AICS is unilateral adrenal enlargement caused by adenoma or carcinoma. Bilateral adrenal disease is caused by primary pigmented nodular adrenal dysplasia (PPNAD) and ACTH-independent macro nodular hyperplasia (AIMAH). Only few case reports of the latter condition exist in the radiology literature, PPNAD being the commoner of two as the cause for AICS.

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SpringerLink 5/18/2007
Sugar Hill mom educates about Cushing's syndrome

The mean basal plasma ACTH and FCI were higher and CBG was lower in thyrotoxic patients in comparison with controls. The peak cortisol was less than 18 µg/dl in 10 of 29 and 14 of 29 on 250 and 1 µg ACTH1–24 stimulation. Peak FCI was subnormal only in three of 27 (11.1%) and two of 21 (7.4%) on 250 and 1 µg ACTH1–24 stimulation, respectively. The mean plasma ACTH, basal FCI, and subnormal peak FCI (two of the three) normalized after euthyroidism. Plasma ACTH and FCI did not correlate with severity of thyrotoxicosis...

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Triple Crown Media, Inc 5/16/2007
What's Wrong with Doctors

He describes, for example, Thomas, a previously fit seventy-two-year-old man, who one day was found to have a cancer in his left kidney. The tumor was removed surgically but, instead of Thomas's recovering, his entire body began to swell. Eventually, he was diagnosed with Cushing's syndrome, a condition in which the adrenal glands overproduce steroid hormone. No matter what his doctors did, they could not stop the hormone from pouring into his bloodstream. Thomas became sicker and sicker. He could not walk and he had recurrent episodes of pneumonia.

By the time Thomas got to see Atul Gawande, there was only one option left—to remove the source of the offending hormone. Although the operation to take out his adrenal glands carried its own dangers, Gawande told Thomas that his only chance of a normal life was to accept the risk. The operation went well. But Thomas suffered a series of terrible complications, culminating in four months of intensive care, a tracheostomy, and incarceration in a long-term care facility. When he last saw Gawande, he could hardly lift his head. All he could do to express himself was to cry. Gawande implies that this was one operation that should have been avoided....

Buy the book: What's Wrong with Doctors

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New York Review of Books 5/11/2007
Prom night gives these seriously ill teens a huge lift

Hospitalized for more than a month last summer, she's been diagnosed with Cushing's syndrome, a condition that causes weight gain, fatigue, depression and mood swings, among other symptoms...

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SeattlePi 5/4/2007
Family's despair over rare disease

THE family of a Chippenham man who died of a rare hormonal disorder have told of the despair his illness caused before it was diagnosed....

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Wiltshire News 4/29/2007
Improved Quality of Life After Bilateral Laparoscopic Adrenalectomy for Cushing's Disease: A 10-Year Experience.

Conclusions: Laparoscopic bilateral adrenalectomy for symptomatic Cushing's disease is a safe and effective treatment option. The majority of patients experience considerable improvement in their Cushing's disease symptoms, and their quality of life equals that of patients initially cured by transsphenoidal pituitary tumor resection.

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Annals of Surgery 4/28/2007
Adrenocorticotropic hormone-independent Cushing's syndrome

Summary: A better understanding of molecular mechanisms involved in adrenocortical tumors and hyperplasias may lead to improved diagnostic and prognostic markers and treatment strategies to assist clinicians in the management of corticotropin-independent Cushing's syndrome.

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Current Opinion in Endocrinology, Diabetes & Obesity 4/27/2007
Novartis Expands Late-stage Oncology Pipeline With AS1404, a Novel Agent Shown to Break Down Blood Vessels That Support Tumor Growth

In addition to AS1404, other compounds include RAD001 (multiple tumors) SOM230 (Cushing's disease/refractory carcinoid tumors, acromegaly), LBH589 (chronic ...

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Novartis 4/19/2007

Diabetes

Both slow-release and regular-form metformin improve glycemic control without altering plasma visfatin level in patients with type 2 diabetes mellitus

Both slow-release (SR) and regular-release (RR) metformin were effective in the treatment of type 2 diabetes mellitus. We compare the efficacy, safety, and effects on serum adipocytokines and inflammatory markers of both regimens in patients with type 2 diabetes mellitus. A prospective, randomized, double-blind study enrolled 55 patients with type 2 diabetes mellitus, which were randomly assigned to receive either metformin SR or RR (at a maximal dosage of 2000 mg/d for 12 weeks). Glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose, adipocytokines, C-reactive protein, and insulin resistance and pancreatic beta-cell function were measured before and after treatment. Significant decreases (P < .001) in mean HbA1c and fasting plasma glucose levels were observed in each group. However, the mean changes in HbA1c from baseline to end point in the 2 groups were not significantly different. Changes in metabolic parameters were similar except that a decreased total cholesterol level was observed in the metformin RR group. Neither regimen treatment had any influence on insulin resistance, but metformin RR improved beta-cell function. Neither regimen had an effect on serum adipocytokines or inflammatory markers. Once-daily metformin SR was as safe and effective as metformin RR in type 2 diabetic patients. Neither dosage form affected serum adipocytokines and inflammatory markers.

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Metabolism July 16, 2007
Primary Aldosteronism Common in Patients With Type 2 Diabetes and Resistant Hypertension

According to the authors of the current study, 20 million people in the United States have diabetes and another 50 million have hypertension, and diabetes and hypertension coexist in 40% to 60% of patients with type 2 diabetes with a 1.5- to 3-times increase in prevalence vs patients without diabetes. Furthermore, 50% of patients with diabetes have hypertension at the time of diagnosis. The American Diabetes Association has recommended a blood pressure goal of 130/80 mm Hg or lower for adults with diabetes, and 10% to 30% of individuals with diabetes are believed to have resistant hypertension...

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Medscape July 4, 2007
Study shows Diachrome improves blood sugar control in people with type 2 diabetes, Patented combo of Chromium Picolinate and Biotin

Uncontrolled, obese and overweight type 2 diabetes patients present an ongoing clinical challenge to health professionals. Prescribing another anti-diabetic medication can increase the risk of unwanted side effects, including weight gain or hypoglycemic events, and could place an added financial burden on the patient,” said Cesar Albarracin, MD, lead investigator and a leader in the field of nutritional management of type 2 diabetes. “This study shows that adding Diachrome to anti-diabetic medications can help patients reach their blood sugar goal simply, effectively and safely...

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EurekAlert June 4, 2007
Congress Briefed on Self-Management of Chronic Illness Research

More than 45 percent of adults struggle with a chronic health condition that affects their daily activities. From diabetes to asthma, heart disease, depression, obesity, and AIDS, more and more Americans are living with chronic illnesses. More than 90 million Americans live with one or more chronic illness; at least 22 million live with three chronic illnesses. Coping with a complex chronic illness such as diabetes affects the individual as well as family members throughout the entire lifespan...

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Coalition for the Advancement of Health Through Behavioral and Social Science Research (CAHT-BSSR) 5/26/2007
Screening Of Cushing's Syndrome In Adult Patients Newly Diagnosed To Have Diabetes Mellitus
 

Conclusions: The results of the present study support the view that unknown CS is not rare among patients with diabetes mellitus. This is the first demonstration that screening for CS may be feasible at the clinical onset of diabetes in an unselected cohort of patients. Therefore, early diagnosis and treatment of CS may give the opportunity to improve the prognosis of diabetes.

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Clinical Endocrinology 4/12/2007

Growth Hormone

Growth hormone replacement throughout life: Insights into age-related responses to treatment

The adult growth hormone deficiency (GHD) syndrome is a well-defined clinical entity. Although the symptoms of GHD are not age specific, their relative importance differs depending on the patient’s age, and the impact of GHD varies throughout adult life...

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Growth Hormone & IGF Research October 1, 2007
Clinical Implications of Residual Growth Hormone (GH) Response to Provocative Testing in Adults with Severe GH Deficiency

Conclusions: This study provides further observational data of substitution therapy in GH-deficient adults with pituitary adenomas. Comparing long-term surgical results, we found no evidence that GH substitution should be withheld in deficient patients. Even residual tumour does not constitute a contraindication to GH replacement. However, since pituitary tumours are slow growing, an observational period of 5 years may not have been long enough to verify any absolute influence on recurrence potential...

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European Journal of Endocrinology July 31, 2007
Clinical Implications of Residual Growth Hormone (GH) Response to Provocative Testing in Adults with Severe GH Deficiency

Even in adult severe GHD, GH release appears to be regulated by factors defined to play an important role in normal GH secretion. The impact of very low GH release on IGF-I and lipid parameters indicates a persistent physiological role of low GH concentrations in severely affected patients with GHD...

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Shreveport Times July 16, 2007
The Diagnosis of Partial Growth Hormone Deficiency in Adults with a Putative Insult to the Hypothalamo-Pituitary Axis

Conclusion: The diagnosis of GHI in an individual is extremely difficult because the patients rarely exhibit additional pituitary hormone deficits, and levels of GH-dependent proteins are normal in the majority. Diagnosis relies heavily on GH stimulation tests and requires two tests in all patients to define GHI; obesity when present is potentially a major confounder.

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Journal of Clinical Endocrinology & Metabolism 5/2/2007
Aging: Disease or Business Opportunity?

Medical research has tended to support the view that growth hormone's risks outweigh any potential anti-aging benefits. Under federal law, the substance is illegal to use except for treating childhood growth disorders, AIDS and a rare adult hormone deficiency. But Dr. Klatz and Dr. Goldman have argued that aging is a disease that causes the pituitary gland to gradually produce less growth hormone. Therefore, they say in books, articles and speeches that hormone replacement therapy at low doses is legal and beneficial in “properly diagnosed deficient adults.”

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New York Times 4/15/2007

Hirsuitism

Female facial hair can be hormone-related

Rarer causes of hirsuitism include adrenal gland overactivity, tumors of the adrenal gland or ovary, pituitary gland tumors and some prescription medicines...

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TimesFreePress July 4, 2007

Hormones

Samuel L. Leonard, Hormone Researcher

Dr. Leonard was still a graduate student when he began his studies of sex hormones, produced at the base of the brain in the pituitary gland.

In the 1930s, in the infancy of endocrinology, it was known that the anterior pituitary had a general role in stimulating the ovaries and the testes. Dr. Leonard, then a doctoral student at the University of Wisconsin, working with F. L. Hisaw, his thesis adviser, and H. L. Fevold, determined that the pituitary actually produces two hormones with distinct effects on the sexual organs.

The researchers labeled the first hormone FSH, or follicle-stimulating hormone; the second they called LH, or luteinizing hormone, which is critical in the production of testosterone in men and can help trigger ovulation in women....

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New York Times November 23, 2007
When hormones go haywire, life can be hell

The majority of our hormones are produced in the 11 glands dotted about the body. These regulate everything from sex drive to hair growth. The symptoms of glandular disorders are wide-ranging, which means the true cause of the patient's illness can often go undiagnosed. Here we offer a guide to the most common conditions, their causes and treatment...

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Daily News, UK August 8, 2007

Menopause

Abnormal Uterine Bleeding May Be Best Evaluated by Menopausal Status

Menorrhagia is reported in women with subclinical or overt hypothyroidism and Cushing's syndrome. Uterine causes for abnormal uterine bleeding include ...

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Medscape 4/17/2007

Osteoporosis

Seven Common Myths About Osteoporosis

"Certain kidney diseases, vitamin D deficiency, some hormonal diseases such as some thyroid disorders, Cushing's syndrome, individuals who are treated with steroids for certain medical conditions, and certain types of cancer can contribute to osteoporosis," she says...

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University of Michigan 5/8/2007

PCOS

Lower Levels of Urinary 2-Hydroxyestrogens in Polycystic Ovary Syndrome

Conclusions: Urinary 2-hydroxyestrogen is decreased in subjects with PCOS, which could be due in part to increased ovarian expression of COMT. Further studies are needed to ascertain the role of estrogen metabolism in PCOS before this information can be used in clinical settings...

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Journal of Clinical Endocrinology & Metabolism August 8, 2007
Cedars-Sinai endocrine researchers to discuss gene that may be linked to polycystic ovary syndrome (PCOS)

Women with PCOS have many small cysts on the periphery of the ovaries and suffer from symptoms that include menstrual irregularities, excess weight, skin problems and an excess of male-type hair growth called hirsutism. These women also are often found to have insulin resistance, a condition that allows high levels of insulin to circulate in the blood, which increases risk of developing type 2 diabetes, hypertension and heart disease...

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SpiritIndia June 2, 2007
Acromegaly Masquerading as Polycystic Ovary Syndrome

Renner, Matthew MD., et al. – This case describes a growth hormone-prolactin, cosecreting pituitary microadenoma that presented with chronic, hyperandrogenic anovulation. A 37-year-old parous patient presented with 1 year of irregular cycles unresponsive to clomiphene citrate and a mildly elevated prolactin. Laboratory evaluation demonstrated hyperprolactinemia with an elevated, age-adjusted, insulin-like growth factor-1 level, and nonsuppressed growth hormone following glucose loading

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The Endocrinologist 4/13/2007

Pituitary Tumor

Patient's Symptoms Of Cushing's Disease Beginning To Abate After Endoscopic Pituitary Cure

BrendaW wrotes: "This is an excellent article that not only describes this type of surgery (endoscopic) and its seemingly effortless recovery, but offers fairly clear explanations of several areas of concern for Cushing's patients. For example, the difference between Cushing's Disease and Cushing's Syndrome, why the levels of Cortisol in our bodies can mean a rise or fall in aches and pains, and a brief description/recommendation of LA's prestigious Cedars-Sinai Medical Center..."

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medicalnewstoday.com November 29, 2007
No Scalpel In Hand, (UVa) Surgeons Treat Gamma Knife Patient

Gingras, who resides in Johnson City, TN, suffers from a pituitary tumor that has caused him to develop Cushing's disease, a rare disorder that over-stimulates hormone production in the adrenal gland. When surgery and conventional radiation therapy failed to eradicate his tumor, doctors recommended Gamma Knife treatment...

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University of Virginia Health System November 28, 2007
Pulling Out Tumors Through Your Nose

Brain surgery involves actually cracking open skulls, which often leads to post-op complications and a lengthy recovery. But Amin Kassam, chairman of the department of neurological surgery at the University of Pittsburgh Medical Center and director of its Minimally Invasive Endoneurosurgery Center, has found a way to leave your melon intact: He performs brain surgery through the nose...

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Popular Science October 11, 2007
Woman without pituitary gland, gives birth to healthy baby

A 25-year-old woman whose pituitary gland had been removed through surgery following detection of a tumour, has given birth to a girl child after conceiving through intra-uterine insemination at a city hospital. Describing it as a "rarest of the rare case", Dr V Sunitha of Vikram Hospital said today that a patient who had undergone pituitary tumour surgery, conceiving and having a normal gestation and delivering a healthy baby was a rarity...

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ZeeNews October 1, 2007
Pituitary Tumors in Children

In rare cases, children may develop tumors on the pituitary gland. Such tumors are usually benign (non-cancerous) and do not spread to other parts of the body. But, because the pituitary gland is very important in helping to regulate the hormones of the body, even a small disruption can have serious effects on mood, on the ability to focus and concentrate, as well as on growth and overall maturation...

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Services of Health September 30, 2007
The efficacy of fractionated radiotherapy and stereotactic radiosurgery for pituitary adenomas: long-term results of 125 consecutive patients treated in a single institution

BACKGROUND: The objective of this retrospective cohort study was to define the efficacy and safety of fractionated radiotherapy (FRT) and stereotactic radiosurgery (SRS) for the treatment of patients with pituitary adenoma...

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Scottsdale Healthcare, Scottsdale, AZ September 29, 2007
Pituitary macroadenomas: are combination antiplatelet and anticoagulant therapy contraindicated? A case report

A 57-year-old female with a known pituitary macroadenoma was treated for suspected acute coronary syndrome with aspirin, clopidogrel and full dose enoxaparin. She developed a severe and sudden headache, nausea and vomiting and visual deterioration. A CT scan showed haemorrhage into the pituitary macroadenoma. She underwent neurosurgical decompression. Post-operatively her visual fields and acuity returned to baseline. She was continued on hydrocortisone and thyroxine replacement on discharge.....

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Journal of Medical Case Reports September 18, 2007
Pituitiary [sic] Tumor

Cushings Disease: This syndrome is caused by tumors on the ACTH (Adrenal Corticotrophin Hormone) secreting cells of the pituitary gland. Patients with this problem develop fat deposits in strange places (Moon face, Buffalo hump on the back of the neck), spontaneous scarring of the skin along the belly that look striated, pimples in adults, high blood pressure and elevated body temperature. These tumors are usually so small that the surgeon might have a difficult time finding the little "bad pearl" in the gland during surgery. This is the one time when small can be bad, especially if the surgeon is unable to locate and remove the tumor! ACTH secreting tumors, although small and troublesome, are readily cured by surgery alone....

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Brain Surgery Journal September 9, 2007
Our Own Denise (radtraveler) in the news!

Denise Potter, who works at the Christus Schumpert Highland Hospital as a mammographer, has Cushing's disease which affects the performance of the pituitary gland....

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Shreveport Times July 16, 2007
Second-line treatment for Cushing's disease when initial pituitary surgery is unsuccessful.

Adenectomy via transsphenoidal surgery is considered the treatment of choice for Cushing's disease. It is successful in about 80% of patients in the hands of an experienced surgeon. When transsphenoidal surgery fails or is contraindicated, a second-line treatment must be chosen. The review focuses on second-line treatment options...

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Current Opinion in Endocrinology, Diabetes & Obesity August, 2007
Coburn has surgery for benign tumor

U.S. Sen. Tom Coburn's office revealed Wednesday that Coburn had undergone surgery to remove a "benign pituitary tumor."...

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Tulsa World June 14, 2007
Cedars-Sinai researchers present new endocrine findings at 2 international conferences

At The Endocrine Society meeting, Shlomo Melmed, M.D., director of the Burns and Allen Research Institute at Cedars-Sinai Medical Center and one of the world's experts on human growth hormone and the pituitary gland, will be presenting “The Year in Pituitary,” an overview of new research in the field including innovative insights linking the pituitary gland to the understanding of systemic illness, mental disorders and the aging process, advances in subcellular mechanisms in the pathogenesis of pituitary disorders, and the publication of new data reflecting long term medical treatment outcomes in patients with acromegaly. Melmed, who is president and founding member of the Pituitary Society and president of the International Society of Endocrinology, will also highlight challenges scientists continue to face continue to face as they advance the diagnosis, treatment and understanding of endocrine disorders....

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Cedars-Sinai June 7, 2007
Endoscopic Removal Of Brain Tumor Through Nose - A Breakthrough In Neuro Surgery

Patients who suffer from brain tumor usually need surgery as part of overall management.Conventional approach to brain tumors has been through a craniotomy (making a window on the skull).This form allows the neurosurgeon to adequately visualize the tumor and manipulate the surrounding structures ensuring safe removal. With the advent of minimal access surgery in other parts of the body, there is an increasing tendency to minimize the size of the skull opening or incision.

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Wockhardt Hospitals 5/23/2007
Pheochromocytoma - An Analysis Of 123 Patients

The family, from Crawcrook, Gateshead, have suffered a string of medical setbacks over the past few years - Jenny was struck with Cushing's syndrome, which caused excessive weight gain and diabetes, had a brain tumour removed in 2000 and cannot walk very far due to arthritis in her leg....

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Blackwell Publishing 5/22/2007
Medical Marvels

An article about neurosurgeon Dr Hae-Dong Jho in Pittsburgh Magazine: Medical Marvels.

Jho is famous for his "Band-Aid" techniques used in minimally invasive surgery - whether it's the brain, the neck or the spine. Most patients go home the next day, often sporting a single Band-Aid over a small incision. Jho is known, too, for his patients' hospital accommodations. They don't go to the intensive-care unit after an operation; they go to a private room. "I don't care if my patient is poor, indigent, homeless or rich, he deserves decent care in a private room," Jho says. He also insists his patients eat "healthy food" from the dietitian and nurses who provide "compassionate, loving care." "He's a complete gentleman" outside the operating room, Angle has observed, and "a drill sergeant" inside.

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Pittsburgh Magazine 5/17/2007
Selective bilateral blood sampling from the inferior petrosal sinus in Cushing's disease: Effects of corticotropin-releasing factor and thyrotropin-releasing hormone on pituitary secretion

Abstract We sought to enhance the sensitivity of selective bilateral blood sampling to determine adrenocorticotropin (ACTH) and prolactin levels in the inferior petrosal sinus (IPS) by administering two stimulatory agents—corticotropin-releasing factor (CRF) and thyrotropin-releasing hormone (TRH). We then determined the ACTH and prolactin levels in the IPS of 10 patients with Cushing's disease. After peripheral administration of both CRF and TRH, ACTH levels were significantly higher on the tumor side in all patients. The prolactin level was significantly higher on the tumor side when CRF or TRH was used to stimulate pituitary secretion. Postsurgical immunohistochemistry studies revealed production of both ACTH and prolactin in tumor cells, explaining the abnormal secretion pattern of the pituitary adenoma. The use of CRF and TRH may therefore improve the reliability of selective blood sampling and tests from the IPS in those cases of Cushing's disease for which noninvasive methods have otherwide failed to clarify the diagnosis.

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Springer New York 5/16/2007
Kickboxing Causes Damage To Hormone Producing Area In Brain

Abstract
New research shows for the first time that kickboxing can cause brain damage. Head injuries in kickboxing can cause damage to an area of the brain called the pituitary, resulting in decreased production of hormones, which affect the body's metabolism and response to stress.

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Clinical Endocrinology  
ECT in Patients With Intracranial Masses

Journal of Neuropsychiatry (subscription) - USA
No deviation of the pituitary stalk or significant deformity of the diaphragma sellae was noted. She received 10 treatments without complications and with ...
Journal of Neuropsychiatry  

Thyroid

Plasma Adrenocorticotropin (ACTH) Values and Cortisol Response to 250 and 1 µg ACTH Stimulation in Patients with Hyperthyroidism before and after Carbimazole Therapy: Case-Control Comparative Study

The mean basal plasma ACTH and FCI were higher and CBG was lower in thyrotoxic patients in comparison with controls. The peak cortisol was less than 18 µg/dl in 10 of 29 and 14 of 29 on 250 and 1 µg ACTH1–24 stimulation. Peak FCI was subnormal only in three of 27 (11.1%) and two of 21 (7.4%) on 250 and 1 µg ACTH1–24 stimulation, respectively. The mean plasma ACTH, basal FCI, and subnormal peak FCI (two of the three) normalized after euthyroidism. Plasma ACTH and FCI did not correlate with severity of thyrotoxicosis...

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Journal of Clinical Endocrinology & Metabolism 5/15/2007
Verbal Memory Retrieval Deficits Associated With Untreated Hypothyroidism

The effects of inadequate thyroid hormone availability to the brain on adult cognitive function are poorly understood. This study assessed the effects of hypothyroidism on cognitive function using a standard neuropsychological battery in 14 patients suffering from untreated hypothyroidism and complaining of subjective cognitive difficulties in comparison with 10 age-matched healthy comparison subjects. Significant differences between groups were limited to verbal memory retrieval as measured by the California Verbal Learning Test (CVLT). On short delay free recall, long delay free recall, and long delay cued recall, significant differences remained between groups despite the limited statistical power of this study. There were no significant results found between groups on attentional or nonverbal tasks. Results suggest that hypothyroid-related memory deficits are not attributable to an attentional deficit but rather to specific retrieval deficits.

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J Neuropsychiatry Clin Neurosci 4/18/2007
 

Note: These articles are provided in furtherance of the mission of Cushing's Help and Support to help people with Cushing's or other endocrine problems, their friends and families through research, education, support, and advocacy. These news items are intended to serve as background concerning its subject for patient-physician discussions and discussions among Cushing's Help and Support Message Board Members.

These articles contain information by authors and publishers that is subject to the Copyright Act of 1976, and "fair use doctrine" therein, effective on January 1, 1978 (17 U.S.C. § 101 et seq.). Cushing's Help and Support makes no representation that the information and any of the views or comments contained in these articles are completely accurate or current. Cushing's Help and Support takes no responsibility for any of the content.

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