Last Build Date: Tue, 22 Mar 2016 08:30:34 +0100
Sat, 19 Mar 2016 00:00:00 +0100The report by Golekoh et al1 examined the prevalence of adrenal insufficiency in children with eosinophilic esophagitis treated with swallowed fluticasone propionate (FP) or budesonide and found that all patients on budesonide had normal testing. This contrasts with our study,2 in which we documented an adrenal insufficiency prevalence of 43% with budesonide. They consequently explain these contrasting results by suggesting that our study population was treated concomitantly with inhaled corticosteroids for asthma. (Source: The Journal of Pediatrics)
Fri, 18 Mar 2016 23:15:02 +0100Authors: Hirayama Y, Kudo T, Kasai N Abstract Rathke's cleft cysts are known to cause hormone-related abnormalities. However, the natural history of this disorder is obscure, so it is rarely associated with acute adrenal insufficiency. We herein describe a case of Rathke's cleft cyst associated with acute adrenal insufficiency in a 27-year-old man. The patient experienced severe headaches due to acute adrenal insufficiency without changes in the size of the cyst. Glucocorticoid administration improved these symptoms, and the cyst spontaneously shrank before operation. This case led us to conclude that Rathke's cleft cysts should be considered in the differential diagnosis of patients who present with adrenal insufficiency, and that the cysts can be reduced by glucocorticoids. ...
Fri, 18 Mar 2016 00:00:00 +0100CONCLUSIONS: Hopefully, these studies will lead to a simplified protocol with fewer samples for the measurement of salivary cortisone that can reliably assess the adequacy of hydrocortisone replacement in patients with adrenal insufficiency. This protocol has to be cost-effective and be feasible to obtain timed salivary samples accurately at home. It would be a significant advance to be able to monitor hydrocortisone replacement therapy with as few as one or two salivary cortisone measurements. PMID: 26990943 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Thu, 17 Mar 2016 00:00:00 +0100Conclusions Sustained hypercalcaemia affects 1 in 500 children in a general hospital setting. The frequency was highest in neonates and underlying aetiology differed markedly with age. All children with sustained hypercalcaemia require thorough investigation to determine the underlying aetiology to ensure appropriate management. (Source: Archives of Disease in Childhood)
Wed, 16 Mar 2016 00:00:00 +0100To investigate whether steroid replacement therapy improved hemodynamics in infants after surgery for congenital heart disease only when they develop adrenal insufficiency. The authors retrospectively investigated adrenal function and evaluated hemodynamic responses to steroid replacement therapy in infants after surgery for congenital heart disease. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Tue, 15 Mar 2016 18:34:09 +0100Conclusions: Cecal ligation and puncture–induced murine sepsis induces a strong inflammatory response in the adrenal glands, which is accompanied by cell death and hemorrhage. Our data suggest that mortality and adrenal incapacitation are associated with the degree of adrenal inflammation, thereby underscoring the importance of adrenal function on survival. (Source: Critical Care Medicine)
Mon, 14 Mar 2016 16:44:04 +0100Authors: Addison M, Wilkinson DG Abstract The subdivision of tissues into sharply demarcated regions with distinct and homogenous identity is an essential aspect of embryonic development. Along the anteroposterior axis of the vertebrate nervous system, this involves signaling which induces spatially restricted expression of transcription factors that specify regional identity. The spatial expression of such transcription factors is initially imprecise, with overlapping expression of genes that specify distinct identities, and a ragged border at the interface of adjacent regions. This pattern becomes sharpened by establishment of mutually exclusive expression of transcription factors, and by cell segregation that underlies formation of a straight border. In this review, we discuss s...
Sat, 12 Mar 2016 00:00:00 +0100Publication date: Available online 11 March 2016 Source:Evaluation and Program Planning Author(s): J. Jay Miller, Erlene Grise-Owens, Donia Addison, Midaya Marshall, Donna Trabue, Laura Escobar-Ratliff Increasingly, organizations in general, and social service organizations, specifically, are recognizing the importance of planning and evaluating organizational wellness initiatives. Yet, few participatory models for carrying out these aims exist. For this study, researchers utilized concept mapping (CM) to explicate a conceptual framework for planning, and subsequently evaluating, a wellness initiative at a multi-state social service organization. CM is a participatory approach that analyzes qualitative data via multi-dimensional scaling and hierarchical cluster analyses. Outputs in...
Fri, 11 Mar 2016 03:03:03 +0100ConclusionPhysical activity is decreased in patients with Addison′s disease, combined with a reduced subjective health related QoL and increased fatigue.This article is protected by copyright. All rights reserved. (Source: Clinical Endocrinology)
Thu, 10 Mar 2016 20:03:02 +0100CONCLUSION: PARTO is technically feasible, safe, and effective for gastric variceal hemorrhage in patients with portal hypertension. PMID: 26957908 [PubMed - in process] (Source: Korean Journal of Radiology)
Thu, 10 Mar 2016 00:00:00 +0100ConclusionsApplying a SHI database comprising more than 9 million individuals, we identified robust data about the risk of AC in different groups of patients with AI. Our data confirm and extend the clinical observation that patients with APS are at highest risk for AC. Approximately 1 of 8 patients with primary AI and type 1 diabetes suffers from an AC each year. Specific targeting of efforts aiming at the prevention of AC is necessary. (Source: Clinical Endocrinology)
Wed, 09 Mar 2016 00:00:00 +0100The aim of this systematic literature review was to summarise the current knowledge regarding the prevalence of, time to recovery from, and influence of glucocorticoid dose and duration on glucocorticoid-induced adrenal insufficiency (AI). (Source: Seminars in Arthritis and Rheumatism)
Wed, 09 Mar 2016 00:00:00 +0100Adrenal crisis is a life‐threatening emergency that causes significant excess mortality in patients with adrenal insufficiency. Delayed recognition by medical staff of an impending adrenal crisis and failure to give timely hydrocortisone therapy within the emergency department continue to be commonly encountered, even in metropolitan teaching hospitals. Within the authors’ institutions, several cases of poorly handled adrenal crises have occurred over the last 2 years. Anecdotal accounts from members of the Addison's support group suggest that these issues are common in Australia. This manuscript is a timely reminder for clinical staff on the critical importance of the recognition, treatment and prevention of adrenal crisis. The manuscript: (i) outlines a case and the clinical outcome ...
Tue, 08 Mar 2016 00:00:00 +0100Publication date: Available online 6 March 2016 Source:The Journal of Steroid Biochemistry and Molecular Biology Author(s): Walter L. Miller Steroidogenesis begins with cellular internalization of low-density lipoprotein particles and subsequent intracellular processing of cholesterol. Disorders in these steps include Adrenoleukodystrophy, Wolman Disease and its milder variant Cholesterol Ester Storage Disease, and Niemann-Pick Type C Disease, all of which may present with adrenal insufficiency. The means by which cholesterol is directed to steroidogenic mitochondria remains incompletely understood. Once cholesterol reaches the outer mitochondrial membrane, its delivery to the inner mitochondrial membrane is regulated by the steroidogenic acute regulatory protein (StAR). Severe StAR mut...
Mon, 07 Mar 2016 00:00:00 +0100Abstract Spontaneous hypoglycemia is a puzzling clinical problem and an important reason for referral to endocrinologists. Several clinical conditions such as insulinomas, non-insulinoma pancreatogenous hypoglycemia syndrome, insulin autoimmune syndrome, postprandial hypoglycemia (reactive hypoglycemia), non-islet cell tumor hypoglycemia, primary adrenal insufficiency, hypopituitarism, and critical illness can be associated with spontaneous hypoglycemia. Rarely, in patients with mental health issues, factious hypoglycemia from extrinsic insulin use or ingestion of oral hypoglycemic agents can obfuscate the clinical picture for clinicians trying to identify an organic cause. In those presenting with Whipple’s triad (symptoms ± signs of hypoglycemia, low plasma glucose, and res...
Thu, 03 Mar 2016 01:05:52 +0100Authors: Francis NA, Ridd MJ, Thomas-Jones E, Shepherd V, Butler CC, Hood K, Huang C, Addison K, Longo M, Marwick C, Wootton M, Howe R, Roberts A, Inaam-ul Huq M, Madhok V, Sullivan F on behalf of the CREAM team. (Source: NIHR Journals Library)
Tue, 01 Mar 2016 06:00:00 +0100Hyponatremia is one of the most common electrolyte imbalances in HIV patients. The differential diagnosis may include hypovolemic hyponatremia, syndrome of inappropriate antidiuretic hormone secretion (SIADH), and adrenal insufficiency. Here, we describe a case of hyponatremia secondary to cerebral salt wasting syndrome (CSWS) in an HIV patient with cryptococcal meningitis. A 52-year-old man with a history of diabetes and HIV was admitted for headache and found to have cryptococcal meningitis. He was also found to have asymptomatic hyponatremia. He had signs of hypovolemia, such as orthostatic hypotension, dry mucosa, decreased skin turgor, hemoconcentration, contraction alkalosis, and high BUN/Cr ratio. The laboratory findings revealed sodium of 125 mmol/L, potassium of 5.5 mmol/L, urine ...
Tue, 01 Mar 2016 06:00:00 +0100Abstract: The insulin tolerance test (ITT) is the gold standard for diagnosing adrenal insufficiency (AI) after pituitary surgery. The ITT is unpleasant for patients, requires close medical supervision and is contraindicated in several comorbidities. The aim of this study was to analyze whether tumor size, remission rate, preoperative, and early postoperative baseline hormone concentrations could serve as predictors of AI in order to increase the diagnostic accuracy of morning serum cortisol. This prospective study enrolled 70 consecutive patients with newly diagnosed pituitary adenomas. Thirty-seven patients had nonfunctioning pituitary adenomas (NPA), 28 had prolactinomas and 5 had somatotropinomas. Thyroxin (T4), thyrotropin (TSH), prolactin, follicle-stimulating hormone (FSH), luteini...
Tue, 01 Mar 2016 06:00:00 +0100We report the case of an 82-year-old patient who was admitted to our hospital with clinical symptoms and laboratory findings of hyponatremia. Following the diagnostic algorithm of hyponatremia we reached the diagnosis of AI. Clinician's attention must focus on the underlying cause of AI which in this case was hidden in a miscommunication between hypothalamus and pituitary due to an ectopic posterior pituitary lobe and became apparent by a pituitary magnetic resonance imaging (MRI) scan. Treatment with oral hydrocortisone resulted in full clinical recovery and electrolyte balance, which was maintained after 7 months of follow-up. Secondary AI is related with hyponatremia through increased ADH secretion. Although a hyponatremic episode may be the first presentation of AI, clinical suspicion...
Tue, 01 Mar 2016 00:00:00 +0100ConclusionResults from our study show that approximately 1 in 6 patients with SAI recover adrenal function, even up to 5 years after diagnosis. We recommend that patients with SAI undergo regular testing to assess recovery in order to prevent unnecessary glucocorticoid therapy.This article is protected by copyright. All rights reserved. (Source: Clinical Endocrinology)
Tue, 01 Mar 2016 00:00:00 +0100(Source: QJM)
Tue, 01 Mar 2016 00:00:00 +0100(Source: QJM)
Mon, 29 Feb 2016 00:00:00 +0100Hyponatremia is the most common clinical electrolyte disorder. Once thought to be asymptomatic in response to adaptation by the brain, recent evidence suggests that chronic hyponatremia may be linked to attention deficits, gait disturbances, risk of falls, and cognitive impairments. Such neurologic defects are associated with a reduction in quality of life and may be a significant cause of mortality. However, because underlying diseases such as adrenal insufficiency, heart failure, liver cirrhosis, and cancer may also affect brain function, the contribution of hyponatremia alone to neurologic manifestations and the underlying mechanisms remain unclear. Using a syndrome of inappropriate secretion of antidiuretic hormone rat model, we show here that sustained reduction of serum sodium ion co...
Fri, 26 Feb 2016 00:00:00 +0100Conclusions: The present study represents an important contribution to the literature in that it appears to be the first to empirically investigate the link between GSS and CVD prevalence among African American men and women. (Source: Circulation: Cardiovascular Quality and Outcomes)
Fri, 26 Feb 2016 00:00:00 +0100(Source: Circulation: Heart Failure)
Wed, 24 Feb 2016 00:00:00 +0100We present a summary of lectures and commentaries from the attendees to serve as an example that other similarly motivated groups can model and share their experiences. It is our hope that these presentations will result in comments, feedback and suggestions from all those researchers interested in this important area. (Source: Journal of Bone Oncology)
Wed, 24 Feb 2016 00:00:00 +0100The aim of this study was to assess the effect of continuous propofol sedation plus prolonged mechanical ventilation on adrenal insufficiency (AI) in patients with traumatic brain injury (TBI). Eighty-five adult patients diagnosed with moderate TBI (Glasgow Coma Scale (GCS) score 9–13) from October 2011 to October 2012 were included in this prospective study. The patients comprised three groups: no mechanical ventilation and sedation (n=27), mechanical ventilation alone (n=24) and mechanical ventilation plus sedation (n=34). The low-dose short Synacthen test was performed at 8:00 on the first, third, and fifth days after TBI. Logistic regression analysis was performed to identify factors affecting the use of mechanical ventilation and sedation, and the incidence of AI. On the fifth d...
Tue, 23 Feb 2016 00:00:00 +0100Conclusions Patients with higher values of QFT-G (>1.5) are more likely to have treatment success with ATT. In our model, steroid sparing immunosuppressive agents reduced the chances of success in both ATT and non-ATT-treated patients. It is unclear whether this effect reflects the intrinsic underlying severity of disease (ie, study bias), or whether steroid sparing immunosuppressive agents mitigate against successful ATT. (Source: British Journal of Ophthalmology)
Mon, 22 Feb 2016 05:06:15 +0100Journal of the American Chemical SocietyDOI: 10.1021/jacs.5b11744 (Source: Journal of the American Chemical Society)
Sun, 21 Feb 2016 10:23:07 +0100ConclusionsApplying a SHI database comprising more than 9 million individuals, we identified robust data about the risk of AC in different groups of patients with AI. Our data confirm and extend the clinical observation, that patients with APS are at highest risk for AC. Approximately 1 of 8 patients with primary AI and type 1 diabetes suffers from an AC each year. Specific targeting of efforts aiming at the prevention of AC is necessary.This article is protected by copyright. All rights reserved. (Source: Clinical Endocrinology)
Sat, 20 Feb 2016 00:00:00 +0100Conclusion The GST correctly classified GHD using GH cut-points of 1 ng/ml for FD-GST and 2 ng/ml for WB-GST, hence using 3 ng/ml as the GH cut-point will misclassify some GH-sufficient adults. The GST may also be an acceptable alternative to the ITT for evaluating the HPA axis utilizing cortisol cut-points of 9 µg/dL for FD-GST and 11 µg/dL for WB-GST. (Source: Pituitary)
Thu, 18 Feb 2016 19:22:02 +0100Conclusions. Admission for medical problems in CAH children declines with age. An AC was recorded in 6.5% of the admissions, with the majority of ACs occurring in the 1 to 5 years age group and there were no deaths. PMID: 26880914 [PubMed] (Source: International Journal of Endocrinology)
Thu, 18 Feb 2016 00:00:00 +0100CONCLUSIONS: Acquired lipodystrophy is known to be associated with autoimmune disorders. To our knowledge, however, this is the first time when acquired generalized lipodystrophy has been identified in association with APS1. PMID: 26891119 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Thu, 18 Feb 2016 00:00:00 +0100Breast cancer most commonly metastasizes to bone where metastases cause the potentiation of the vicious cycle. During this process, breast cancer bone metastases inhibit osteoblasts from forming new bone, while also activating osteoclasts to degrade bone. This in turn causes release of bone-matrix bound growth factors which propagate tumor growth. The overall net bone destruction can lead to significant adverse clinical consequences for patients including fractures or substantial pain. While agents such as bisphosphonates or the monoclonal antibody to RANKL denosumab, both of which inhibit the osteolytic activity of osteoclasts, are currently used in breast cancer bone metastatic patients to alleviate these adverse clinical outcomes, they have not been associated with increased patient sur...
Thu, 18 Feb 2016 00:00:00 +0100Invasive lobular carcinoma (ILC) is the second most common type of breast cancer. Classic type ILC is generally regarded as indolent in nature with its favourable biologic characteristics such as low grade, ER positivity and luminal A subtype. Despite this, patients with ILC can develop significant distant recurrence or metastases. Thus the ability to identify those patients at highest risk of recurrence or metastasis, and identification of novel therapies for ILC are urgently required. To this end, we recently profiled the miRNA expression in primary surgical ILC specimens from patients who went on to have metastatic disease compared to those who remained tumor free long term. As miRNA are stable in formalin fixed paraffin embedded tissues1, we speculated they could be robust biomarkers. ...
Wed, 17 Feb 2016 14:25:02 +0100CONCLUSIONS: Choroidal involvement in presumed ocular tuberculosis can present with a variable spectrum. Treatment failure rates were equivalent between ATT and non-ATT treated groups. PMID: 26807675 [PubMed - as supplied by publisher] (Source: Ocular Immunology and Inflammation)
Wed, 17 Feb 2016 14:22:02 +0100In conclusion, the study reveals an association between AAD and IL2 locus. It confirms specific 21OH-directed reactivity of the peripheral AAD lymphocytes, which display increased synthesis of interleukin-2 and sIL2Ra. PMID: 25347332 [PubMed - indexed for MEDLINE] (Source: Autoimmunity)
Wed, 17 Feb 2016 14:22:02 +0100Authors: Seminog OO, Seminog AB, Yeates D, Goldacre MJ Abstract There are reports suggesting that people with Klinefelter's syndrome (KS) may be at increased risk of some autoimmune diseases, but the evidence is not substantial. We wanted to add to the evidence by systematically assessing the risk of autoimmune diseases in a national cohort of people with KS. We selected records of all people with KS in a record-linked dataset of all hospital day cases and inpatient admissions in England, 1999-2011; and we followed them up by electronic record linkage to identify the occurrence of autoimmune diseases. We compared their occurrence in the KS cohort with a control cohort, studied in the same way, and expressed the results as rate ratios (RR). Of 30 autoimmune diseases studied in peopl...
Tue, 16 Feb 2016 00:00:00 +0100ConclusionLong‐term use of budesonide nasal irrigations is generally safe, but asymptomatic HPAA suppression may occur in selected patients. Concomitant use of both nasal steroid sprays and pulmonary steroid inhalers while using daily budesonide nasal irrigations is associated with an increased risk. Rhinologists should be alerted to the potential risks of long‐term use of budesonide nasal irrigations, and monitoring for HPAA suppression may be warranted in patients receiving long‐term budesonide irrigation therapy. (Source: International Forum of Allergy and Rhinology)
Fri, 12 Feb 2016 12:00:00 +0100New guideline details diagnosis and treatment of Addison's Disease. Endocrinology Advisor (Source: Society for Endocrinology)
Thu, 11 Feb 2016 00:00:00 +0100Horm Metab ResDOI: 10.1055/s-0035-1565183Autoimmune adrenalitis (AA) and congenital adrenal hyperplasia (CAH) are the most common reasons for acquired and monogenetic primary adrenal insufficiency. Both concern women in their fertile years. The aim of the work was to examine fertility rates, pregnancy outcome, and children’s characteristics in AA and CAH patients in 2 German endocrine centers. One hundred and fifty-eight women were contacted. Thirty-nine patients with CAH due to 21-hydroxlase deficiency and 54 AA patients agreed and were included. Information about course and outcome of pregnancies was obtained by questionnaire and telephone interview. Fertility rates were calculated and compared to expected values from the German general population. Twelve CAH patients (30.8%) had 25 pr...
Thu, 11 Feb 2016 00:00:00 +0100CONCLUSIONS: Pemphigus is associated with increased mortality likely through its association with numerous comorbid health conditions. Patients with pemphigus require improved access to dermatologic care and increased screening for the myriad comorbidities. This article is protected by copyright. All rights reserved. PMID: 26864457 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)
Wed, 10 Feb 2016 00:00:00 +0100(Source: Clinical Pediatrics)
Fri, 05 Feb 2016 15:47:27 +0100LONDON, Feb 5 (Reuters) - A sixth sperm whale has died on a British beach, the latest of nearly 30 to have become stranded in shallow waters on the coastline of Europe's North Sea over the past month. As marine pathologists cut samples from the whale's carcass on the windswept expanse of sand at low tide, scientists said it was too early to know exactly why so many whales had taken a wrong turn into the North Sea. Since mid-January, 29 sperm whales have died on beaches in the Netherlands, France, Germany and Britain. They are thought by experts to be members of the same pod, a group of young males migrating south from sub-polar waters. "What we've got here is a bunch of teenagers out having a good time but taking a wrong turning into the North Sea," said British Divers Marine Life Rescue o...
Thu, 04 Feb 2016 01:16:02 +0100Authors: Perry BI PMID: 26835171 [PubMed] (Source: The Primary Care Companion for CNS Disorders)
Tue, 02 Feb 2016 05:00:00 +0100Updated Date: Feb 2, 2016 EST (Source: DailyMed Drug Label Updates)
Tue, 02 Feb 2016 00:00:00 +0100
Fri, 29 Jan 2016 00:00:00 +0100This study explores how dietary fat intake in high-risk midlife adults living in the rural south is influenced by three behavior s... (Source: BMC Public Health)
Thu, 28 Jan 2016 00:00:00 +0100Publication date: Available online 28 January 2016 Source:Biochemical Engineering Journal Author(s): Amanda Hildebrand, J.Bennett Addison, Takao Kasuga, Zhiliang Fan End-product inhibition by cellobiose and glucose is a rate-limiting factor in cellulose hydrolysis by cellulases. While cellobiose and glucose inhibition have been extensively investigated, cellobionate inhibition has been minimally studied despite the discovery that accessory proteins such as cellobiose dehydrogenase (CDH) work synergistically with cellulases to form aldonic acids. The fraction of equilibrated cellobionate in the cellobiono-δ-lactone form was determined by NMR over the range of pH 4 to 8. To better improve the understanding of cellobiono-δ-lactone and cellobionate inhibition of cellulases, we investig...
Wed, 27 Jan 2016 00:00:00 +0100This article is protected by copyright. All rights reserved. (Source: American Journal of Transplantation)
Wed, 27 Jan 2016 00:00:00 +0100Conclusions Pituitary apoplexy should be taken into consideration during a sudden isolated oculomotor nerve palsy. Immediate transsphenoidal pituitary decompression is a potentially effective method of the treatment. In the setting of a little expanding lesion an oculomotor nerve function may be restored without any surgical intervention. (Source: Polish Annals of Medicine)
Tue, 26 Jan 2016 00:00:00 +0100Conclusions: The possibility of growth hormone (GH) treatment can be considered in cases of documented GH deficiency in patients with Costello syndrome, but only under close oncologic and cardiologic supervision. (Source: Italian Journal of Pediatrics)
Mon, 25 Jan 2016 12:00:00 +0100The Endocrine Society has issued a Clinical Practice Guideline (CPG) on diagnosis and treatment of primary adrenal insufficiency. Guidelines (Source: Society for Endocrinology)
Sat, 23 Jan 2016 00:00:00 +0100The design and synthesis of polymeric coordination compounds of 3d transition metals are of great interest in the search for functional materials. The coordination chemistry of the copper(II) ion is of interest currently due to potential applications in the areas of molecular biology and magnetochemistry. A novel coordination polymer of CuII with bridging N,N′-bis(2-hydroxyphenyl)-2,2-dimethylpropane-1,3-diamine (H2L-DM) and dicyanamide (dca) ligands, catena-poly[[[μ2-2,2-dimethyl-N,N′-bis(2-oxidobenzylidene)propane-1,3-diamine-1:2κ6O,N,N′,O′:O,O′]dicopper(II)]-di-μ-dicyanamido-1:2′κ2N1:N5;2:1′κ2N1:N5], [Cu2(C19H20N2O2)(C2N3)2]n, has been synthesized and characterized by CHN elemental analysis, IR spectroscopy, thermal analysis and X-ray single-crystal diffraction analys...
Fri, 22 Jan 2016 00:00:00 +0100This study also provided the first in vivo evidence for enhanced β-oxidation during HCV infection because HCV-infected SCID/Alb-uPA mice accumulated higher plasma ketones while fasting than did control mice. Overall, this study highlights the reprogramming of hepatocellular lipid metabolism and bioenergetics during HCV infection, which are predicted to impact both the HCV life cycle and pathogenesis. (Source: Journal of Biological Chemistry)
Thu, 21 Jan 2016 15:10:02 +0100In conclusion, this study identified Arg109 as a critical residue in the HESX1 protein and extends our understanding of the phenotypic features, molecular mechanism, and developmental course associated with mutations in HESX1. When multiple genes need to be analyzed for mutations simultaneously, targeted sequence analysis of interesting genomic regions is an attractive approach. PMID: 26781211 [PubMed - as supplied by publisher] (Source: Endocrine Journal)
Thu, 21 Jan 2016 13:55:30 +0100The first-ever Endocrine Society clinical-practice guidelines on diagnosis and management of primary adrenal insufficiency in adults and children stress the urgency of treating adrenal crisis. Medscape Medical News (Source: Medscape Diabetes Headlines)
Thu, 21 Jan 2016 00:00:00 +0100ConclusionsEndodontic access cavity preparation modified the critical defect population of the all‐ceramic restorative materials investigated. The strength of a predominantly glassy ceramic following endodontic access can be maintained if adhesive cementation was used; however, the beneficial effects of adhesive cementation on ceramic reinforcement were lost on leucite‐reinforced ceramics following access cavity preparation. Replacement restoration for these materials would be recommended clinically following endodontic access as opposed to repair of the access cavity using a direct restorative material. (Source: International Endodontic Journal)
Thu, 21 Jan 2016 00:00:00 +0100This clinical report describes the use of an “atraumatic” vertical extraction system to facilitate the restorative treatment of a tooth that would otherwise be considered unrestorable because of subgingival caries. Minimally invasive surgical root extrusion was undertaken using the Benex extraction system, which can provide controlled tooth extrusion with minimal deformation of the bone socket. A carious endodontically treated mandibular premolar was extruded to provide routine restorative treatment and endodontic retreatment. (Source: Journal of Prosthetic Dentistry)
Tue, 19 Jan 2016 00:00:00 +0100Abstract Corticosteroid agents (CA) are widely used in the treatment of metastatic castration-resistant prostate cancer (mCRPC) either as concomitant treatment with active agents such as docetaxel, cabazitaxel and abiraterone or in a palliative setting, predominantly due to their anti-inflammatory activity. However, the chronic use of CA has numerous side effects, especially in case of steroid-induced adrenal insufficiency. Furthermore, the latest clinical and preclinical data demonstrate that CA themselves are likely to promote tumour progression in certain populations of patients with mCRPC. Therefore, the role of CA in advanced disease should be carefully weighed for each patient and their withdrawal should be considered in some patients. This is necessary, especially in cl...
Sun, 17 Jan 2016 18:44:02 +0100CONCLUSION: Rapid and effective preoperative preparation of patients with Graves' disease is achievable with Lugol's solution, dexamethasone and a beta-blocker. The risk of temporary hypothalamic-pituitary-adrenal axis suppression has to be taken into account. PMID: 26765838 [PubMed - in process] (Source: Swiss Medical Weekly)
Thu, 14 Jan 2016 00:00:00 +0100Publication date: Available online 12 January 2016 Source:Micron Author(s): Malik Arshman Khan, Owen Addison, Alison James, Christian J. Hendriksz, Maisoon Al-Jawad Mucopolysaccharidosis (MPS) is an inherited metabolic disorder that can affect the tooth structure leading to defects. Synchrotron x-ray diffraction being a state of the art technique has been used to determine the enamel crystallite orientation in deciduous enamel affected by Mucopolysaccharidosis Type I and Mucopolysaccharidosis Type IVA and comparing these with that of healthy deciduous enamel. Using this technique it was observed that there is a loss of texture in deciduous enamel affected by Mucopolysaccharidosis Type I and Mucopolysaccharidosis Type IVA when compared to the healthy deciduous enamel. Generally it wa...
Thu, 14 Jan 2016 00:00:00 +0100Conclusions We found that viral factors were the dominant factors in determining the interferon treatment outcomes in chimeric mice. Host factors, such as pre-treatment liver interferon-stimulated gene expression and single nucleotide polymorphisms near interleukin 28B and interferon lambda 4 coding regions, were less important determinants of the response to interferon in the chimeric mice than they were in patients. Our results also suggest that a complete immune system as seen in patients may be required for host factors such as single nucleotide polymorphisms near interleukin 28B / interferon lambda 4 and pre-treatment liver interferon-stimulated gene upregulation to have an effect on the interferon response. (Source: PLoS One)
Thu, 14 Jan 2016 00:00:00 +0100Publication date: 1 March 2016 Source:Physiology & Behavior, Volume 155 Author(s): Michelle Henry, Pedro S.A. Wolf, Ian L. Ross, Kevin G.F. Thomas (Source: Physiology and Behavior)
Wed, 13 Jan 2016 15:35:05 +0100A Clinical Practice Guideline (CPG) has been issued on the diagnosis and treatment of primary adrenal insufficiency, a condition commonly known as Addison's disease that occurs when the body produces too little of the hormone cortisol. (Source: ScienceDaily Headlines)
Wed, 13 Jan 2016 00:00:00 +0100CONCLUSIONS: We recommend diagnostic tests for the exclusion of primary adrenal insufficiency in all patients with indicative clinical symptoms or signs. In particular, we suggest a low diagnostic (and therapeutic) threshold in acutely ill patients, as well as in patients with predisposing factors. This is also recommended for pregnant women with unexplained persistent nausea, fatigue, and hypotension. We recommend a short corticotropin test (250 μg) as the "gold standard" diagnostic tool to establish the diagnosis. If a short corticotropin test is not possible in the first instance, we recommend an initial screening procedure comprising the measurement of morning plasma ACTH and cortisol levels. Diagnosis of the underlying cause should include a validated assay of autoantibodies against ...
Tue, 12 Jan 2016 18:00:36 +0100ConclusionsEndodontic access cavity preparation modified the critical defect population of all‐ceramic restorative materials. The strength of a predominantly glassy ceramic following endodontic access can be maintained if adhesive‐cementation was used, however, the beneficial effects of adhesive cementation on ceramic reinforcement were lost on leucite‐reinforced ceramics following access cavity preparation. Replacement restoration for these materials would be recommended clinically following endodontic access as opposed to repair of the access cavity using a direct restorative material. (Source: International Endodontic Journal)
Tue, 12 Jan 2016 05:00:18 +0100Having a well-stocked kitchen can be the difference between preparing a healthy a meal and blasting through your daily calorie count by giving up and ordering in. To stay healthy, knowing your kitchen is set up with the all right tools can be especially important. In partnership with Tropicana, we talked to a few of our favorite health-food bloggers and health nuts to find out what goes into stocking the perfect kitchen. 1. It Starts With Great Knives It’s hard to describe why it feels so good to slice through a tomato with a razor-sharp edge or chop herbs with a perfectly balanced knife -- it just does, and a great set of steel in the kitchen can change the way we view dinner time. "My kitchen knife has had the biggest influence on the way I cook!" says Sonja Overhiser, one half of the ...
Tue, 12 Jan 2016 00:00:00 +0100GFER-related mitochondrial encephalomyopathy has been previously described only in 3 siblings of a consanguineous Moroccan family. Their phenotype included congenital cataracts, hypotonia, developmental delay, and sensorineural hearing loss. Multiple mitochondrial respiratory chain complex deficiencies were identified on muscle biopsy. We describe a now-19-year-old woman with adrenal insufficiency, lactic acidosis, congenital cataracts, and respiratory insufficiency secondary to mitochondrial disorder, who was reported by North et al (1996) as a toddler. Compound heterozygous GFER mutations c.373C>T (Q125X) and c.581G>A (R194 H) were recently discovered in this patient. The purpose of this report is (1) to expand the phenotype this ultra-rare disorder and (2) to provide a review of t...
Fri, 08 Jan 2016 00:00:00 +0100Conclusions SS is associated with increased SaC, but decreased cFC levels when baseline STC is assumed to be sufficient. When STC level is assumed to be insufficient, SaC levels remain unchanged, but cFC levels are decreased. Lower STC levels is not associated with increased mortality in patients with SS. More data are needed in order to suggest the use of SaC and cFC instead of STC. Trial registration ClinicalTrials.gov No: NCT02589431 (Source: Journal of Intensive Care)
Wed, 06 Jan 2016 00:00:00 +0100Patients with end-stage renal disease (ESRD) regardless of diabetes status are at increased risk of hypoglycemia with a resultant array of adverse clinical outcomes. Therefore, hypoglycemia should be thoroughly evaluated in ESRD patients. In diabetic dialysis patients, hypoglycemic agents and nutritional alterations can trigger hypoglycemia in the background of diminished gluconeogenesis, reduced insulin clearance by the kidney and improved insulin sensitivity following initiation of renal replacement therapy. Detailed evaluation of antidiabetic regimen and nutritional patterns, patient education on self-monitoring of blood glucose and/or referral to a diabetes specialist may reduce risk of subsequent hypoglycemia. In certain situations, it is important to recognize the possibility of non-...
Wed, 06 Jan 2016 00:00:00 +0100This article is protected by copyright. All rights reserved. (Source: Clinical Endocrinology)
Mon, 04 Jan 2016 00:00:00 +0100Abstract Invasive lobular carcinoma (ILC) of the breast is the second most common type of invasive breast carcinoma accounting for 8–14% of all breast cancers. Traditional management of ILC has followed similar paradigms as that for invasive ductal carcinoma (IDC). However, ILC represents a pathologically, clinically and biologically unique variant of breast cancer with particular management challenges. These challenges are seen in both the loco‐regional management of ILC; where ILC tumors tend to avoid detection and hence present as more clinically advanced and surgically challenging carcinomas, and the systemic management with a unique response pattern to standard systemic therapies. Because of these challenges, the outcome for patients with ILC has likely lagged behind the continued...
Fri, 01 Jan 2016 00:00:00 +0100ConclusionsPemphigus is associated with increased mortality likely through its association with numerous comorbid health conditions. Patients with pemphigus require improved access to dermatologic care and increased screening for the myriad comorbidities.This article is protected by copyright. All rights reserved. (Source: British Journal of Dermatology)
Fri, 25 Dec 2015 09:26:08 +0100CONCLUSIONS: The intervention was effective in changing home environments and reducing energy intake. PMID: 26696290 [PubMed - in process] (Source: American Journal of Public Health)
Fri, 25 Dec 2015 08:26:13 +0100We report a case of a patient with metastatic melanoma presenting with signs and symptoms of Addison's disease. PMID: 26688417 [PubMed - in process] (Source: Annals of the Royal College of Surgeons of England)
Fri, 25 Dec 2015 00:00:00 +0100Conclusion We describe a potential method for assessing the structural integrity of growing rods using ultrasonic structural health monitoring. These preliminary data demonstrate the ability of periodic rod assessment to detect structural changes in cycled growing rods, which appear to correspond to subclinical rod fatigue before rod fracture. (Source: Spine Deformity)
Wed, 23 Dec 2015 00:00:00 +0100Publication date: Available online 22 December 2015 Source:The Journal of Steroid Biochemistry and Molecular Biology Author(s): Brian R. Stolze, Verena Gounden, Jianghong Gu, Elizabeth A. Elliott, Likhona S. Masika, Brent S. Abel, Deborah P. Merke, Monica C. Skarulis, Steven J. Soldin Our goals were to (1) develop an improved micro-method usable for neonates for steroid profile measurements and a method to measure androsterone, a key steroid in the recently described androgen backdoor pathway together, with dehydroepiandrosterone and (2) to assess if dehydroepiandrosterone diurnal concentration fluctuations exist potentially necessitating strict adherence to time of blood sample draw and requirement of separate time-dependent reference intervals. Liquid chromatography-tandem mas...
Tue, 22 Dec 2015 10:46:46 +0100CONCLUSION: This study establishes a quality benchmark for readmission rates after transsphenoidal surgery for pituitary lesions and identifies delayed hyponatremia as the primary cause. Implementation of an outpatient care pathway for managing hyponatremia may improve readmission rates. ABBREVIATIONS: CMS, Centers for Medicare and Medicaid Services DI, diabetes insipidus SIADH, syndrome of inappropriate antidiuretic hormone (Source: Neurosurgery)
Mon, 21 Dec 2015 00:58:11 +0100Authors: Mallappa A, Debono M Abstract Since the first use of cortisone in patients around 65 years ago, the use of synthetic glucocorticoids has made a crucial impact on the treatment of several diseases in medicine. Although significant reductions in morbidity and mortality have occurred in patients suffering from cortisol deficiency, conventional hydrocortisone replacement treatment is still inadequate. A major limitation is that it fails to replace cortisol in a physiological manner. Cortisol has a distinct circadian rhythm and acts as a secondary messenger synchronizing the central to peripheral clocks, hence playing a key role in biological processes and the circadian timing system. Circadian misalignment has been associated with ill-health and so nonphysiological glucocortic...
Mon, 21 Dec 2015 00:00:00 +0100Conclusions Maternal S-cortisol was higher during vaginal delivery compared to elective cesarean section, indicating higher stress levels. A reduction in the hydrocortisone dose at childbirth in women with adrenal insufficiency should be considered, particularly in women undergoing an elective cesarean section. (Source: Archives of Gynecology and Obstetrics)
Mon, 21 Dec 2015 00:00:00 +0100Authors: Pavey CR, Addison J, Brandle R, Dickman CR, McDonald PJ, Moseby KE, Young LI Abstract Irruptive population dynamics are characteristic of a wide range of fauna in the world's arid (dryland) regions. Recent evidence indicates that regional persistence of irruptive species, particularly small mammals, during the extensive dry periods of unpredictable length that occur between resource pulses in drylands occurs as a result of the presence of refuge habitats or refuge patches into which populations contract during dry (bust) periods. These small dry-period populations act as a source of animals when recolonisation of the surrounding habitat occurs during and after subsequent resource pulses (booms). The refuges used by irruptive dryland fauna differ in temporal and spatial sca...
Sun, 20 Dec 2015 23:44:52 +0100This article also includes a brief update on diabetes mellitus types 1 and 2, obesity, and polycystic ovarian syndrome; new thoughts and controversies about vitamin D and current management of the common thyroid disorders; adrenal insufficiency; and concerns with disorders of puberty in adolescents. PMID: 23705521 [PubMed - indexed for MEDLINE] (Source: Adolescent Medicine: State of the Art Reviews)
Sun, 20 Dec 2015 21:07:04 +0100Authors: Dave P, Bhosle D, Dharme M, Deshmukh D, Patel J Abstract A 46 years old female, presented with severe fatigue, nypotension ana hyperpigmentation. Her basal serum cortisol level at 8 a.m. was < 1.0 μg/dl which suggested a diagnosis of Addison's disease. An association with latent autoimmune diabetes of adult and autoimmune hypothyroidism led to a diagnosis of Polyglandular Autoimmune Syndrome type II (PAS II). She also had alopecia universalis and hypoparathyroidism which are very rare in PAS type II syndrome. On treatment with hydrocortisone and fludrocortisone there was drastic improvement in the clinical features. PMID: 26591178 [PubMed - in process] (Source: Journal of the Association of Physicians of India)
Sun, 20 Dec 2015 14:41:55 +0100CONCLUSIONS: The case focuses attention on the risk of psychosis connected with the treatment of the adrenal crisis with high doses of Hydrocortisone. Because of the risk of psychiatric complications, the patients treated with high doses of corticosteroids, require an evaluation of risk factors for mental disturbances, and safety precautions in cooperation of endocrinologist and psychiatrist. PMID: 26488344 [PubMed - as supplied by publisher] (Source: Psychiatria Polska)
Fri, 18 Dec 2015 02:48:03 +0100This report intends to highlight this novel association of macular amyloidosis and macroprolactinoma. (Endokrynol Pol 2015; 66 (6): 555-558). PMID: 26662655 [PubMed - in process] (Source: Endokrynologia Polska)
Fri, 18 Dec 2015 00:00:00 +0100(Source: Annals of Clinical Biochemistry)
Tue, 15 Dec 2015 17:59:00 +0100Today, the U.S. Department of Justice entered a consent decree of permanent injunction in the District of Vermont against the Correia Family Limited Partnership, doing business as Wynsum Holsteins, a dairy farm located in West Addison, Vermont, and its partners, Anthony Correia, Barbara Correia and Stephen Correia. The decree accompanies a complaint filed at the request of the U.S. Food and Drug Administration. (Source: Food and Drug Administration)
Tue, 15 Dec 2015 14:31:48 +0100Inorganic ChemistryDOI: 10.1021/acs.inorgchem.5b02703 (Source: Inorganic Chemistry)
Tue, 15 Dec 2015 12:00:00 +0100Both low-dose and high-dose adrenocorticotropic hormone stimulation tests have similar diagnostic accuracy in identifying adrenal insufficiency; however, the tests have limitations and cannot necessarily rule out the condition, according to research in The Journal of Clinical Endocrinology & Metabolism. Healio (Source: Society for Endocrinology)
Mon, 14 Dec 2015 12:00:00 +0100The diagnosis of adrenal insufficiency may be made using the serum free cortisol response to cosyntropin as an alternative to serum total cortisol, according to recent findings reported in The Journal of Clinical Endocrinology and Metabolism. Healio (Source: Society for Endocrinology)
Sun, 13 Dec 2015 00:00:00 +0100Conclusions Based on the disease's progress, the clinical signs and biochemical aspects between the two siblings, we demonstrate that there is no correlation genotype-phenotype. (Source: Clinica Chimica Acta)
Sat, 12 Dec 2015 20:53:12 +0100CONCLUSION: Development of acute parkinsonism after rapid correction of hyponatremia may indicate the occurrence of EPM and underlying adrenal insufficiency should be excluded in these patients. PMID: 26106753 [PubMed - indexed for MEDLINE] (Source: Acta Neurologica Taiwanica)
Sat, 12 Dec 2015 17:05:33 +0100Authors: Veltri KT, Mason C Abstract A potassium deficiency can impair metabolic functions, and medications cause hypokalemia through a variety of mechanisms. The authors report on a 58-year-old female suffering from fatigue and weakness after a recent diagnosis of adrenal insufficiency. PMID: 25798039 [PubMed] (Source: P and T)
Sat, 12 Dec 2015 02:20:35 +0100Authors: Razavi Z, Sanginabadi M Abstract Prolonged potent topical glucocorticoid therapy in infants can cause iatrogenic Cushing's syndrome. This case highlights the rarity of poor weight gain in iatrogenic Cushing's syndrome. A 17-month-old boy was referred to outpatients pediatric endocrine clinic for evaluation of growth failure. On presentation his weight was 9.7kg (5th percentile) and height was 72cm (-3.6 SD below mean for age and sex). Systemic examination revealed grossly moon-like face, hypertrichosis and thin skin in the genital area. His mother reported using local clobetasol for the previous seven months for his diaper dermatitis. Baseline plasma cortisol was low (0.3ng/ml, normal range: 60 to 280ng/ml). During standard dose of synthetic adrenocorticotropic hormone tes...
Sat, 12 Dec 2015 02:16:22 +0100CONCLUSION: Adrenocortical insufficiency is common in persons with HIV infection, occurring in about 34.8% of patients studied. Clinically evident adrenocortical insufficiency is uncommon in persons with HIV. PMID: 24669022 [PubMed - indexed for MEDLINE] (Source: Ghana Medical Journal)
Fri, 11 Dec 2015 00:00:00 +0100CONCLUSIONS: Based on the disease's progress, the clinical signs and biochemical aspects between the two siblings, we demonstrate that there is no correlation genotype-phenotype. PMID: 26686776 [PubMed - as supplied by publisher] (Source: International Journal of Clinical Chemistry)
Thu, 10 Dec 2015 00:00:00 +0100In conclusion, EPO seems to reverse sepsis-induced vasoplegia to NE through the preservation of α1D adrenoceptor mRNA/protein expression, inhibition of GRK2-mediated desensitization, and attenuation of NO overproduction in the mouse aorta. (Source: Journal of Cardiovascular Pharmacology and Therapeutics)
Thu, 10 Dec 2015 00:00:00 +0100To establish the prevalence of adrenal insufficiency (AI) in children with eosinophilic esophagitis treated with swallowed fluticasone propionate (FP) or budesonide. (Source: The Journal of Pediatrics)
Wed, 09 Dec 2015 16:25:24 +0100Conclusions: We recommend genetic testing for patients who have negative anti-adrenal antibodies or suggestive family history. Diagnosing a genetic etiology can provide information about prognosis and treatment, and is therefore beneficial for patients. Our high proportion of patients with nonclassic lipoid congenital adrenal hyperplasia likely represents a founder effect.Horm Res Paediatr (Source: Hormone Research in Paediatrics)