Adrenal: • Images of Adrenal
Glands • ERK phosphorylation in the adrenal gland in response
to chronic ACTH treatment
Pituitary: • Bilateral Inferior Petrosal Sinuses Sampling in the Routine Investigation of Cushing's Syndrome: A Comparison with MRI • A Novel Nuclear Receptor Cofactor Modulates Glucocorticoid- Responsive Gene Expression • Corticotroph Tumor Progression after
Adrenalectomy in Cushing’s Disease: A Reappraisal of Nelson’s
Syndrome • Early Assessment of
Hypothalamic-Pituitary- Gonadal Function in Patients with
Congenital
Hypothyroidism of Central Origin • Pituitary: small gland with a big job • Eight on faculty receive DSPs, Named Chairs
Cortisol: • Adults Who Go to Bed Lonely Get Stress Hormone Boost
Next Morning • Purge Protection • Post Traumatic Stress Disorder • Stress can affect overall well-being
• Newest site features: bios, Helpful Doctors • US Postage Stamps for
Cushing's Awareness • Order Cushing's Awareness
Silicone Bands for yourself, a family member or donate to a Cushing's
patient at NIH • Upcoming Meetings:
Washington, DC and Toronto ENDO 2007.
Also on the website:
Pictures from Past Meetings: April 8, 2007, Petitions on the message boards to have April 8 be declared as Cushing's Awareness Day again this year. This date was chosen because it was Dr. Harvey Cushing's Birthday. More info here
Pictures from the Pittsburgh, PA Christmas Dinner, December 13, 2006 Click here
Pictures from the April 5-8, 2006
CUSH Cushing's Awareness Day Medical Forum, held in Oklahoma City, OK Click here
Upcoming Meetings: MAGIC Foundation (Growth Hormone) 3rd Adult Educational Convention, February 9 to 11, 2007, Las Vegas, NV More info here or call 708.383.0808 for details. June 2-5, 2007, ENDO 2007, Toronto, Canada, Metro Toronto Center.
News: The message boards now number over 5,500 participants.
Search Tool. Use this tool to search this site, PubMed, NIH Clinical Trials or any other website. More sites to be added soon.
CUSH Cuisine! $10.00 each, including shipping. More info Guest Transcripts
Sue was a very special friend to Cushies world-wide. We will
remember her always.
To
light a candle or post a tribute for Sue, please
click here
To
read more about Sue's journey, please
click here
Happy New Year to all!
May the New year be filled with peace and contentment for all. I hope that you find what you seek...and that this year brings warmth, love, good health and may your Cushing's symptoms be a thing of the past.
Welcome to the Cushing's Help and Support Newsletters!
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sure you continue to receive Cushing's e-mail in your
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please add CushingsSupport@aol.com to your address
book.
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information appears at the bottom of this, and every,
newsletter.
CUSH Cookbooks are here!
The CUSH Cookbooks are only $10.00 each including
shipping and handling.
Any profits will go to help bring awareness for
Cushings. Thank you!
The
cookbooks have about 169 recipes, so it isn't a huge cookbook, but one
that includes contributions from many Cushing's message board
members.
To purchase a cookbook send a check to: CUSH PO Box 1843 Florence, AL. 35631-1843 please
indicate on your check "Cookbook" or include a note with payment.
You can also purchase
cookbooks through Paypal. Please indicate that
the payment is for "cookbook."
Be sure that your correct mailing address is included
with payment along with a contact phone number in case we have questions
concerning your order.
If
anyone has any questions concerning cookbook payments please contact CUSH
Treasurer Cathy Gifford at CUSHOrg@aol.com
Coming Soon! What would you like to hear in a Cushing's Podcast?
Bios, possibly told by the person whose story it is?
Cushing's news?
Interviews with patients?
Interviews with doctors?
Would you be willing to interview your doctor/surgeon?
Listener comments?
Other ideas?
Submit your opinions and see what others have said on the Message Boards.
updated medical records. Anyone who goes for
surgery needs to have a back-up set of records with them. Some doctors
like a list all of labs on a spreadsheet with dates, results, ect. on
them to make it easier for them to go through. However, Most doctors
want to see the actual test results. Have both forms, if possible.
nightgowns
robe,
slippers
extra
pillow, if needed
microfleece blanket
book or
magazines Adrenal people: you may
have trouble resting things like books on your stomach post-op so
magazines or paperbacks are a better choice than hard cover
Sudoku
/ crossword puzzles
shampoo, conditioner
comb,
brush
toothbrush, toothpaste, deoderant
lip
balm
lotion
Puffs
Plus with lotion
underwear
maxi
pad/tampons
cool
max sports injury gel pack
medications Note: Check with your doctor - the
hospital may not allow you to take meds from outside.
Crisis
letter
medic
alert bracelet
an
iPod/charger or some CD's and small player pants with a loose elastic
waist are good, or a long, loose dress.
cell
phone and charger Note: Check with
the hospital. Many do not allow the use of cellphones.
list of
cell phone numbers of people to call from the hospital
change
of clothes to wear home. Adrenal
people: pants with a loose elastic waist are good, or a long,
loose dress.
digital
recorder so that you can record any instructions if need be after
surgery
huge,
cuddly teddy bear
mints
for dry mouth
Buy a COOL GEL SPORTS INJURY PACK (Walmart or
Walgreens) and wrap it around your head and back of your neck when you
have a head-ache or are feeling bad. The cool settles your tummy,
relieves the pain and swelling in the tissue around the head and neck
that is irritated from surgery.
Take advantage of the moisture-ventilator that
they give you in ICU and be sure to request or demand that they let you
keep it after you get to your room. It releived the dry pain that my
nose had and made the whole thing WAY less painful than others have said
it was for them. ALSO...if you buy one of those $30 cool water
humidifiers from Walmart/Target for you upon your return home...you will
LOVE the moisture it gives you and it will make your nose feel MUCH
better, MUCH faster!
Optional, if
used:
nightguard for teeth
cpap
and oracle mask
Growth
hormone and supplies
camera
deck of
cards
Updated Pages on the
Website:
• Testimonialshttp://www.cushings-help.com/testimonials.htm I am very thankful that you chose to make this site as for I believe whole heartedly that everyone needs to make informed decisions about their doctors based on both sides, the good and the bad. This is private and keeps you protected! I am truely greatful to you!
Thank you so much for all of your help. You have done such an awsome job with these boards. I can not tell you how much of an inpact they have made on my life! For that alone I THANK YOU!
The amount of
info here is amazing. When I started doing searches online for Cushing's I
kept finding the same articles over and over again, just placed on
different sites and it was all just the definition of. So it was great to
find a place with real stories, more information on what to expect,
testing, etc.
By the way, thank you so much. Thank you for all that you do and thank you
for this website. It truly has saved my life!
Mary O YOU are a present to all of us. You very
well may have SAVED my life - and remember what Schindler said, "To save
one life, is to save all of mankind".
Heartfelt thanks for the site Mary, without it
& YOU, I wouldn't even know about NIH. I wouldn't have hope, & my
daughter wouldn't have a future.
Words just aren't enough Mary, look forward to
meeting you.
• Barb
(barbj222222 on the boards) posted this link to a fantastic (too long to post
here!) article: http://www.medstudents.com.br/endoc/endoc7.htm Cushing' Syndrome
Laboratorial Diagnosis
Cushing’s Syndrome may be defined as a persistent and
continuous state of endogenous cortisol overproduction, not being in
accordance with ordinary circadian rhythm patterns (It was first fully
clinically described by Harvey Cushing in 1912.). As a consequence, it
leads to various symptoms and signs, namely: Obesity (90%)* Hypertension
(85%) Diminished Glucose Intolerance (80%) Sexual and menstrual dysfunction (76%) Hirsutism and acne (72%) *
The main Cushing’s obesity feature is centripetal, but generalized obesity
can occur - often to children.
Apart from that, the finding of violet estriae,
associated or not with the above characteristics, raises the suspicious of
the syndrome. Also, it must be stressed out that the term "Cushing’s
Disease" is a specific type of Cushing’s Syndrome whose ethiology is
Pituitary Adenoma ACTH producer (generally it is due to microadenoma). The
other types of Cushing Syndrome are classified according to the
following... http://www.medstudents.com.br/endoc/endoc7.htm
Adrenal:
• Gina (da89165 on the boards)
found this great site that shows images of different glands/organs. She
writes: "This one really helped me to see 3 sets of adrenal glands....
1) atrophied from
Addisons 2) normal 3)
hyperplasia from cushings"
The pair of adrenals in the
center are normal. Those at the top come from a patient with adrenal
atrophy (with either Addison's disease or long-term corticosteroid
therapy). The adrenals at the bottom represent bilateral cortical
hyperplasia. This could be due to a pituitary adenoma secreting ACTH
(Cushing's disease), or Cushing's syndrome from ectopic ACTH production,
or idiopathic adrenal hyperplasia.
Increased ERK phosphorylation in the adrenal gland in
response to chronic ACTH treatment Jorge G
Ferreira1,3, Célia D Cruz2,3, Delminda Neves1,3 and Duarte
Pignatelli1,3 1Laboratory of Molecular Cell
Biology, Faculty of Medicine of Porto, Porto, Portugal 2Institute of Histology and Embryology, Faculty of
Medicine of Porto, Porto, Portugal 3Instituto de
Biologia Molecular e Celular (IBMC), Porto, Portugal
(Requests for offprints
should be addressed to D Pignatelli)
(Current address of D pignatelli is at IPATIMUP,
Porto, Portugal)
Abstract ACTH released from
the pituitary acts through activation of cAMP/PKA in adrenocortical cells
stimulating steroidogenesis. Although ACTH was originally thought to have
anti-proliferative effects on the adrenal, recently it has been described
that it could also have proliferative effects acting via other signalling
cascades. This is also relevant in humans given the increased levels of
ACTH occurring together with adrenal cortex hyperplasia observed in
Cushing's disease (CD) and possibly in other situations such as chronic
stress. One of the signalling pathways regulating cell proliferation is
the ERKs pathway. ERKs are members of the MAPK family of cascades. They
are activated by extracellular stimuli such as growth factors and
mitogens, become phosphorylated via MEK1/2 and regulate a diversity of
cellular processes such as proliferation and differentiation. Until now no
study addressed the effects of chronic ACTH administration on the
activation of ERKs in vivo.
Objectives: Using rats submitted to different ACTH
dosages as well as variable durations, we determined if ACTH induced ERKs
activation and by establishing a parallelism with Proliferating Cell
Nuclear Antigen (PCNA) expression we aimed to demonstrate a role of ACTH
induced ERKs activation in cell proliferation. Blood was collected for
hormonal analysis and the role of ACTH induced ERKS activation in the
stimulation of steroidogenesis was also studied. We confirmed that ACTH
increased adrenal weight and Corticosterone levels when compared with
Control or Dexamethasone-treated animals. We also demonstrated that ACTH
increases ERKs activation and PCNA expression in a time- and
dose-dependent manner. When ERKs activation was blocked by the use of a
specific MEK inhibitor (PD98059), there was a decrease in ACTH-induced
Corticosterone release and PCNA expression. We conclude that chronic ACTH
induces ERKs activation and that this plays an important role in the
induction of cell proliferation as well as steroidogenesis.
Description of Invention:
Nuclear receptors are ligand-activated transcription factors that regulate a wide range of biological processes and dysfunction of these receptors can lead to proliferative, reproductive and metabolic diseases, such as cancer, infertility, obesity and diabetes. Nuclear receptors are the second largest class of drug targets and the market for nuclear receptor targeted drugs is estimated to be almost 15% of the $400 billion global pharmaceutical market. Researchers at the National Institute of Diabetes and Digestive and Kidney Disease have isolated a novel protein termed STAMP (SRC-1 and TIF-2 Associated Modulatory Protein) that interacts with the biologically active domains of the coactivators TIF-2 and SRC-1 (J. Biol. Chem. (2002) 51,49256-66) and present data which support a role for STAMP as an important new factor in the glucocorticoid regulatory network. There remains a need for novel therapeutics that specifically block or enhance specific genes and an emerging therapeutic goal is the discovery of agents that modulate co-activators or co-repressors in a tissue specific manner.
The invention is a novel protein that plays a key role in modulating transcriptional properties of glucocorticoid receptor (GR)-steroid complexes during both gene induction and gene repression, and is likely to modulate the transcriptional properties of all the steroid receptors including androgen, mineralocorticoid and progesterone receptors. The inventors have shown that ectopically expressed STAMP protein both modulates the EC50 of glucocorticoid receptor-agonist complexes for induced genes and increases glucocorticoid receptor-repressive activity of suppressed genes in a manner that is inhibited by specific siRNAs under physiologically relevant conditions. The modulation of STAMP levels at the cell or organism level could possibly be used as a therapeutic able to modify inappropriate gene expression that occurs in certain diseases or as a result of long-term steroid treatment.
Available for licensing are claims directed to compositions which are capable of modulating the GR gene expression in a mammalian cell using DNA, siRNA or antibodies and to methods of shifting a steroid dose-response curve, where less of the steroid needs to be administered because the composition contains the STAMP polypeptide. The novel STAMP functional sequence can be used in a composition of matter claim or as a target that could be regulated by an antibody or perhaps other modulator that would vary the ability of STAMP to either induce or repress the activity of glucocorticoid receptors. Diseases that could be treated include: hypertension, diabetes, cardiovascular disease, osteoporosis, Cushing's Disease as well as any disease requiring chronic steroid treatment such as Rheumatoid Arthritis, Asthma, inflammatory and auto-immune diseases. The present invention provides a broad, flexible IP platform that should be of interest to companies which focus on nuclear receptors as drug target and lead discovery generators, as well as to companies which have the capability to develop STAMP's potential as a therapeutic.
Inventors:
S. Stoney Simons and Yuanzheng He (NIDDK)
Patent Status:
DHHS Reference No. E-056-2004/0 --
U.S. Provisional Application No. 60/548,039 filed 26 Feb 2004
PCT Application No. PCT/US2005/006393 filed 25 Feb 2005, which published as WO 2005/082935 on 09 Sep 2005
Licensing Status:
In addition to licensing, the technology is available for further development through collaborative research with the inventors via a Cooperative Research and Development Agreement (CRADA).
Portfolios:
Internal Medicine
Internal Medicine-Therapeutics-Cardiology-Other
Internal Medicine-Therapeutics
Internal Medicine-Other
For Additional Information Please Contact:
Susan Carson D.Phil.
NIH Office of Technology Transfer
6011 Executive Blvd, Suite 325
Rockville, MD 20852-3804
Phone: (301) 435-5020
Email: carsonsu@mail.nih.gov
Fax: (301) 402-0220
Early Assessment of Hypothalamic-Pituitary-Gonadal
Function in Patients with Congenital Hypothyroidism of Central Origin
David A. van Tijn, Eelco J. Schroor, Henriette A.
Delemarre-van de Waal, Jan J. M. de Vijlder and Thomas Vulsma
Department of Pediatric Endocrinology (D.A.v.T.,
J.J.M.d.V., T.V.), Emma Children’s Hospital, Academic Medical Center,
University of Amsterdam, 1100 DE Amsterdam, The Netherlands; and
Department of Pediatrics (E.J.S., H.A.D.v.d.W.), Subdivision
Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The
Netherlands
Address all correspondence and requests for reprints
to: David A. van Tijn, M.D., Department of Pediatric Endocrinology, Emma
Children’s Hospital, G8-205, Academic Medical Center, University of
Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. E-mail:
tijn1@planet.nl
.
Context: Early recognition of gonadotropic
dysfunction couldenable well-timed growth
and maturation and prevent damage togonads and external genitalia. The adaptation of the Dutch
neonatalscreening program for congenital
hypothyroidism in the mid 1990sresulted
in enhanced detection of congenital hypothyroidismof central origin (CH-C), with high likelihood
of multiple pituitaryhormone deficiency,
including gonadotropin (Gn) deficiency.
Objective: We analyzed GnRH test results and
baseline Gn andsex hormone measurements
in 15 infants with CH-C to examinethese
diagnostic tools for assessment of the integrity of thehypothalamus-pituitary-gonad axis in young
infants.
Design: In a nationwide prospective study
(1994–1996),patients were referred to our
department if neonatal CH screeningresults were indicative of CH-C. When CH-C was confirmed, GnRHtests and baseline Gn and sex hormone
measurements took placeat the age of 3
months, when euthyroid status had been accomplishedby T4
supplementation, and if necessary, cortisol supplementationwas installed.
Setting: The study took place at the
Department of PediatricEndocrinology,
Emma Children’s Hospital, Academic MedicalCenter, University of Amsterdam (referral center).
Patients: The study included 15 neonates
(five girls and 10boys) with CH-C,
detected by neonatal screening, in whom investigationof the hypothalamus-pituitary-gonad axis could
be performedat 3 months of age.
Main
Outcome Measures: Results of GnRH tests and baseline Gnand sex hormone measurements were
assessed.
Results: GnRH tests at 3 months of age
showed a pattern indicativeof endogenous
GnRH stimulation in nine infants and a bluntedresponse in six. Baseline Gn and sex hormone concentrationsexcept estradiol (P = 0.053) were significantly different
betweenresponders and nonresponders.
Conclusions: The GnRH test and baseline
measurements of Gn andsex hormone serum
concentrations at 3 months of age are promisingoptions in the assessment of hypothalamic-pituitary-gonadalfunction in infants with CH-C of both
sexes.
• Robin (staticnrg on the boards) posted this from http://www.ajronline.org/cgi/content/abstract/187/2/562
1 Department of Radiology, Evangelismos General Hospital, 11 Amasias St., Athens, Greece 11634.
2 Second Department of Radiology, University of Athens, Athens, Greece.
3 Department of Endocrinology, Evangelismos General Hospital, Athens, Greece.
OBJECTIVE: Identifying the cause of Cushing's syndrome (CS) is a perplexing issue. Bilateral inferior petrosal sinuses sampling (BIPSS) is an invasive and elaborate but established procedure in distinguishing Cushing's disease (CD) from ectopic adrenocorticotropic hormone (ACTH) syndrome. We compare the diagnostic performance of BIPSS and MRI in detecting an ACTH-secreting source, and we suggest the diagnostic protocol that we found beneficial for the management of patients with CS.
MATERIALS AND METHODS: Seventy-eight consecutive patients with CS were included. All patients underwent biochemical investigation and pituitary MRI. Consequently, patients were routinely referred for BIPSS; 25 received stimulation with corticotropin-releasing hormone (CRH) and 53 with CRH and desmopressin. The diagnosis of CD was established on the basis of complementary biochemical, imaging, and BIPSS criteria. The diagnostic performances of BIPSS and MRI were calculated for patients with final diagnosis.
RESULTS: A final diagnosis was available for 54 patients (46 CD confirmed, five ectopic confirmed, three adrenals). No (known) patient was misclassified based on our suggested diagnostic criteria. MRI rendered 25 false-negatives and two false-positives (incidentalomas). Successful BIPSS yielded two false-negatives and three false-positives (adrenals). The calculated accuracy for detecting a pituitary source of ACTH was 50% and 88% for MRI and successful BIPSS, respectively.
CONCLUSION: MRI is of only limited diagnostic performance, while BIPSS is the most accurate way to establish the diagnosis of CD. The routine use of a multimodality diagnostic approach including BIPSS, MRI, and biochemical tests is suggested to avoid the risk of mismanagement for patients with CS.
Departments of Endocrinology (G.A., F.K., J.B.,
X.B.), Biophysics and Hormonology (M.-A.D.), and Digestive and Endocrine
Surgery (B.D.), Cochin Hospital, Faculté René Descartes, Paris 5
University, Centre de Référence des Maladies Rares de la Surrénale, and
Department of Radiology A (H.B., S.S., P.L.), Statistics and Medical
Informatics (J.C.), and Department of Endocrinology-Metabolism-Cancer
(G.A., J.B., X.B.), Institut National de la Santé et de la Recherche
Médicale U567 and Centre National de la Recherche Scientifique Unité Mixte
de Recherche 8104, Cochin Institute, 75014 Paris, France; and Department
of Neuropathology (M.K.), Laboratoire R. Escourolle, Pitié Salpétrière
Hospital, Paris 6 University, 75013 Paris, France
Address all correspondence and requests for reprints
to: Xavier Bertagna, Department of Endocrinology, Cochin Hospital, 27, rue
du Fg St. Jacques, 75014 Paris, France. E-mail: xavier.bertagna@cch.aphp.fr
.
Context: Adrenalectomy is a radical
treatment for hypercortisolismin
Cushing’s disease. However, it may lead to Nelson’ssyndrome, originally defined by the
association of a pituitarymacroadenoma
and high plasma ACTH concentrations, a much fearedcomplication.
Objective: The objective of the study was to
reconsider Nelson’ssyndrome by
investigating corticotroph tumor progression basedon pituitary magnetic resonance imaging scan
and search forpredictive factors.
Design: This was a retrospective cohort
study.
Setting: The complete medical records of
Cushing’s diseasepatients at Cochin
Hospital were studied.
Patients: Patients included 53 Cushing’s
disease patientstreated by adrenalectomy
between 1991 and 2002, without previouspituitary irradiation.
Measurements: Clinical data, pituitary
magnetic resonance imagingdata, and
plasma ACTH concentrations for all patients and pituitarygland pathology data for 25 patients were
recorded. Corticotrophtumor
progression-free survival was studied by Kaplan-Meier,and the influence of recorded parameters was
studied by Coxregression.
Intervention: There was no intervention.
Results: Corticotroph tumor progression
ultimately occurredin half the patients,
generally within 3 yr after adrenalectomy.A shorter duration of Cushing’s disease (adjusted hazardratio: 0.884/yr), and a high plasma ACTH
concentration in theyear after
adrenalectomy [adjusted hazard ratio per 100 pg/ml(22 pmol/liter): 1.069] were predictive of
corticotroph tumorprogression. In one
case, corticotroph tumor progression wascomplicated by transitory oculomotor nerve palsy. During
follow-up,corticotroph tumor progression
was associated with the increaseof
corresponding ACTH concentrations (odds ratio per 100 pg/mlof ACTH variation: 1.055).
Dear Dr. Donohue: A close friend of mine has been
diagnosed with hypopituitarism. What can you tell me about this disease? I
found little information at the library. -- T.K.
Dear
T.K.: The pituitary gland is one of the body's smallest glands, but it
has some of the most important functions for health.
It's attached to the
underside of the brain, just a little way in from the bridge of the
nose.
The pituitary
orchestrates the way many other glands function. Its hormones turn on
those other glands. ACTH, adrenocorticotropic hormone, prods the adrenal
glands to make cortisone and hormones that regulate salt retention and
blood pressure. Cortisone is involved in the production of glucose, the
cells' fuel, and in controlling inflammation.
The pituitary also makes hormones that direct the
function of the ovaries, testes and thyroid gland. It's the source of
growth hormone and the hormone that promotes milk production.
Another important pituitary
hormone prevents too much body water from being lost into the urine.
With hypopituitarism, the
gland puts out too little or none of its hormones. Weakness, weight loss,
a drop in blood pressure, excessive urination and a profound change in
menstrual periods are some of the consequences. If the condition isn't
treated, death is the eventual result.
Treatment consists of supplying the missing
hormones.
The causes of
hypopituitarism are many. Brain tumors, infections of the gland,
interruption of its blood supply and head trauma are some of the things
that bring about gland failure.
______
Dr. Donohue is unable to answer individual letters,
but he will incorporate them into his column whenever possible. Readers
may write him at P.O. Box 536475, Orlando, FL 32853-6475.
• Denney found an article (too long to post!). She
writes: "I came across this in the middle of December when I was looking
for a connection between my family's problems with blood vessel
malformations and the fact that we also have a higher incidence of
endocrine / tumors. I don't print a lot of things that catch my eye (I do
however have a zillion bookmarked pages), but I did this.
I am on my 3rd read now and
keep picking up on things that seem to help explain some of the things you
read here on the board. For example, several board members have associated
birth control hormones with the start of their symptoms. The article also
makes some hypothesises about why some Pituitary tumors are recurring.
This is from 2003 so there
may be progress on some of the questions asked throughout the article by
now."
Three members of the University faculty have been
named distinguished service professors, while five other faculty members
have received named professorships.
The
three faculty members who have received distinguished service
professorships are: James Chandler, the Barbara E. and Richard J. Franke
Professor in English Language & Literature, and the College; Martha
Roth, Professor in the Oriental Institute and the College; and Richard
Strier, the Frank L. Sulzberger Professor in English Language &
Literature, and the College.
The
one that may be of interest to us...
Roy Weiss,
Professor in Medicine, has been named the first Rabbi Morris I. Esformes
Professor. Esformes, a grateful patient and friend of the University, gave
$2.5 million to support the professorship, which will benefit
endocrinology, pediatric surgery, gastroenterology, and radiation and
oncology.
Roy Weiss
An
authority on the genetics, biology and treatment of diseases of the
thyroid and the pituitary, Weiss, along with colleague Samuel Refetoff,
has described several genetic diseases of the thyroid. Together, they run
one of the largest referral centers for genetic thyroid disease in the
world. Weiss also leads one of the largest
programs in the Midwest in the diagnosis and treatment of Cushing’s
disease, a pituitary disorder.
Weiss serves on the editorial board of several
journals and is an associate editor of the journal, Thyroid and of the Encyclopedia of Hormones. He has won many honors,
including national awards from the March of Dimes and the National
Institutes of Health as well as several teaching awards.
He
completed his internship, residency and endocrine fellowship at Chicago
and joined the faculty in 1990. Weiss rose quickly through the ranks,
becoming a professor and program director of the Clinical Research Center
in 2003 and chief of endocrinology in 2006.
He
earned his B.Sc. in zoology from Duke University in 1975, his Ph.D. in
cell biology from the University of South Carolina in 1978 and his M.D.
from Sackler Medical School in Tel Aviv, Israel, in 1985.
Cortisol:
Adults Who Go to Bed Lonely Get Stress Hormone Boost
Next Morning A new study that takes a rare look at the physiological,
social and emotional dynamics of day-to-day experiences in real-life
settings shows that when older adults go to bed lonely, sad or
overwhelmed, they have elevated levels of cortisol shortly after waking
the next morning.
Elevated levels of cortisol -- a stress hormone
linked to depression, obesity and other health problems when chronic --
actually cue the body on a day-to-day basis that it is time to rev up to
deal with loneliness and other negative experiences, according to
Northwestern University’s Emma K. Adam, the lead investigator of the
study.
The study,
“Day-to-day experience-cortisol dynamics,” was published online the week
of Oct. 30 by the Proceedings of the National
Academy of Sciences (PNAS).
“You’ve gone to bed with loneliness, sadness,
feelings of being overwhelmed, then along comes a boost of hormones in the
morning to give you the energy you need to meet the demands of the day,”
said Adam, assistant professor of education and social policy and faculty
fellow at the Institute for Policy Research.
The morning cortisol boost could help adults who went
to bed with troubled or overwhelming feelings go out in the world the next
day and have the types of positive social experiences that help regulate
hormone levels, she said.
Adam also is a faculty fellow at C2S: The Center on
Social Disparities and Health. C2S is a new center within the Institute
for Policy Research that is reaching across Northwestern’s two campuses
and a number of social, life and biomedical disciplines to offer a 21st
century look at how biological, social and cultural dynamics intersect and
affect health throughout the life span.
Cortisol is often characterized as a negative hormone
because of evidence, mostly in animal models, that long-term elevations
could be potentially harmful to physical health. But in the short term the
stress hormone is adaptive and helpful, according to Adam.
“Cortisol helps us respond
to stressful experiences and do something about them,” she said. “It is
necessary for survival -- fluctuations in this hormone assist us in
meeting the changing demands we face in our daily lives.”
The first of its type, the
study shows that it is not just on average that people who have more
negative emotions have higher levels of cortisol. Rather, with its
detailed and intricate methodology, the study shows a sensitive day-to-day
dance between experience and cortisol. Experience influences stress
hormones, and stress hormones influence experience, the study shows.
“Cortisol responds to and
interacts with our daily experiences in subtle and important ways,” Adam
concluded.
Cortisol
levels are generally high immediately upon waking, increase in the first
30 minutes after waking and then decline to low values at bedtime.
Adam, with her colleagues
John T. Cacioppo and Louise C. Hawkley at the University of Chicago, and
Brigitte M. Kudielka from the University of Trier, Germany, showed that
changes in this pattern from one day to the next are closely interwoven
with changes in our daily experiences.
The study, based on data from the Chicago Health,
Aging, and Social Relations Study (CHASRS) at the University of Chicago
includes 156 older adults living in Cook County who were born between 1935
and 1952 and represent a range of socioeconomic classes. Their cortisol
levels were measured from small samples of saliva provided three times a
day for three consecutive days. Study participants reported their feelings
each night in a diary, and researchers looked at whether cortisol levels
on a particular day were predicted by experiences the day before or were
predictive of experiences that same day.
In addition to noting that loneliness the night
before predicted higher cortisol the next morning, Adam and colleagues
found that people who experience anger throughout the day have higher
bedtime levels of cortisol and flatter overall levels of the stress
hormone, typically considered a risk factor for disorder. “High levels of
cortisol in the evening are a kind of biological signature of a bad day,”
Adam noted.
The study
also provided evidence that, in addition to simply being at the mercy of
your daily experiences, cortisol also plays a role in influencing them.
Individuals with lower levels of cortisol in the morning experienced
greater fatigue during the day, a result with potential implications for
understanding chronic fatigue.
In all of her work, Adam is interested in how
people’s changing social environments get under the skin to influence
their biology and health. “Stress systems are designed to translate social
experience into biological action,” she said. “They are designed to be a
conduit from the outside world to our internal worlds so that we can
better respond to our social context. The overarching question of my
studies of these systems in a variety of contexts is whether overuse of
these systems plays a role in disease outcomes.”
In reference to Mr. Mehan's
article on the Fairfax County Library's ruthless purging of texts -- I am
a lifelong resident of Annandale, Virginia and use the library system
regularly and have watched as books have disappeared from the catalog.
One of my favorite books is
Harvey Cushing's brilliant life of Sir William
Osler -- a book for which Cushing, a distinguished neurosurgeon, won the
Pullitzer Prize (1925). One copy of this book was available in the Fairfax
County system -- and I tried to check it out once in a while to make sure
that it stayed in the system. I neglected my duties for the past few years
and the book is now gone -- shame on me.
Librarians, when not chatting about their pets, like
to talk about a thing called "serendipitous browsing" that occurs when a
patron wandering the stacks comes across a title by accident and is
enlightened. Some of my favorite books have come to me in this way --
especially Cushing's Life of
Osler.
One has
to wonder what the content of those stacks would be like if they were only
to be filled with books people have checked out over the previous two
years. If we are to judge by the quality of the television shows they
watch, the music they listen to, the news services they revere and the
politicians they elect, someday soon I may have to browse my old Mad magazines for pith. -- Joseph Provenzano Fairfax County Librarian Patron Annandale, Virginia
Brief
Report Effects of Parental PTSD (Post Traumatic Stress Disorder) on the
Cortisol Response to Dexamethasone Administration in Their Adult
OffspringRachel Yehuda, Ph.D.,
William Blair, B.A., Ellen Labinsky, Ph.D. and Linda M. Bierer, M.D.
OBJECTIVE: The authors used a low-dose
dexamethasone suppressiontest to examine the effect of a PTSD risk factor,
parental PTSD,on cortisol negative feedback inhibition in adult
offspringof Holocaust survivors with PTSD (N=13) versus without PTSD(N=12)
as well as a comparison group of offspring whose parentshad no Holocaust
exposure (N=16).
METHOD: Blood samples wereobtained at 8:00 a.m.
for the determination of baseline cortisol.Participants ingested 0.5 mg of
dexamethasone at 11:00 p.m.,and blood samples were obtained again at 8:00
a.m. the followingday.
RESULTS: Enhanced
cortisol suppression in response to dexamethasonewas associated primarily
with parental PTSD status, with minimalcontribution of subjects’ own
trauma-related symptoms.
CONCLUSIONS: Enhanced
cortisol negative feedback inhibitionmay be associated with PTSD because
it is related to the PTSDrisk factor of parental PTSD.
General
Health:
• Herbs, Vitamins and
Minerals.
From another message board I'm on. It's for
kidney cancer, but some of this info is good, just the same...
I am always worried/concerned about
everything we think of doing in addition to standard dr. prescribed
treatments. So as usual I research everything. In my research of the
mushroom supplements I found the following website. Since this is
Memorial-Sloan Kettering and is not a marketing ploy of any type. I
thought I would post to the list. When people recommend you should take
this vitamin or herb for this or that, this may be a good place to start
to get informed without having to go through all of the sales sites
promising a natural cure for everything. And as always, verify
everything you want to take prior to with your doctor. http://www.mskcc.org/mskcc/html/11570.cfm?search=&x=16&y16
Day after day brings a new, seemingly endless list of
responsibilities.
You
have shopping to do, meals to prepare, homework to help with and bills to
pay; then, there’s work and keeping your loved ones happy. There’s so much
to do, and it seems there are just not enough hours in the day to get it
done.
And, to top it off,
you begin to feel sick and come down with a cold. A coincidence? Probably
not.
Approximately 43
percent of adults suffer adverse health side effects due to stress,
according to the National Stress Institute. Stress, and its side effects,
may result in up to half of the 550 million missed days of work
annually.
Stress is
difficult to define because everyone reacts to stressful situations
differently. What is stressful for one person may have little effect on
another. But stress is more than simply a feeling, more than just tight
muscles and feeling tense and worn out.
“Pretty much everyone, no matter how laid back, has
some stress in their lives,” said Becky Wolter, exercise physiologist and
manager of the Decatur Memorial Hospital Wellness Center. “Telltale signs
that stress is starting to consume your life include gaining or losing
excessive amount of weight, losing sleep and other signs of depression.
Signs of depression often run parallel to overabundance of stress.”
When under extreme stress,
our bodies release large amounts of cortisol, adrenaline, which can affect
blood pressure, and other stress-related hormones, according to the
American Institute of Stress.
Certain types of chronic stress are associated with
immune system resistance to disorders ranging from the common cold to
cancer.
Stress levels can
affect nearly every area of the body, including metabolism, the
cardiovascular system, the brain and even the health of your skin and
hair, according to the institute.
“Stress is very devastating and can lead to all types
of chronic diseases, especially long-term stress,” said Mike King,
president of Mari-Mann Herb Co. Inc. “It can lead to headaches, depletion
of minerals in the body, ulcers, stomach problems and mental and emotional
dysfunction. I believe that high, intensive stress is toxic to the immune
system. A little bit of stress is OK, but it’s how we respond to it that
is the problem.”
While
some stress is beneficial, such as pushing yourself when on deadline, many
people don’t realize just how negatively stress can affect overall well
being, said Susan Rasar, a registered nurse with the Wellness Center.
“Some people become so
negative toward themselves when they are under stress,” she said, “it
causes irritability, nervousness, apathy, low self-esteem and a rapid
heartbeat, which can cause poor circulation. I’ve heard of nurses who take
an aspirin at a certain stoplight every day because they know what’s
coming.”
Surprisingly,
our bodies are better adapted to acute stress, such as a car accident,
than the day-to-day chronic stress that many endure continually. Many
parents and individuals turn to exercise, friends and even meditation to
combat or prevent stress.
“When you start worrying about the future, you get
overwhelmed,” said Cat RunningElk, a national motivational speaker and
certified Reiki Master. “Take a break from the treadmill and from your
shopping list, and take a minute to appreciate everything around you.”
RunningElk said she
recommends taking 15 minutes each day for “quiet time,” such as a walk in
the park.
“Your breath is
also really important,” she said. “Take a deep breath in, tense your body
and release after 10 seconds. Instead of fighting the tension, bring it
all in, and then blow it out and let it all go. It can really make a
difference doing that for 60 seconds, especially if you are waiting in
line or in traffic.”
Although stress usually comes from outside sources,
your mental state is very important, King said.
“Your emotions are not
attached to you; you can change the way you feel and address your
environment differently,” he said. “If you can learn to cope with it to
where it’s not damaging your body, there you go -- you can sit there and
deal with it. But sometimes you may have to make lifestyle changes. The
important thing is you’ve got to enjoy life.”
DEAR DR. DONOHUE: I am 18 and into
bodybuilding, which I've been doing for three years. I have achieved some
success, but not the success I want and not the success I see others have
gotten. I know many of them are on steroids.
I am
considering trying them too. I don't think I will ever get the size I want
without them. I would like the truth. Are they really dangerous? Do they
really work? -- D.F.
ANSWER: The word ''steroid'' creates
confusion. One class of steroids is the cortisone drug family. Prednisone
is a much-used member of this family. These steroids have a place in
medicine to fight inflammation.
The
steroids you're talking about are muscle-building (anabolic) steroids,
male hormones. They have a limited place in medicine but no place in
athletics. They really do work. They produce rapid gains in muscle
growth.
They are
dangerous. They cause breast growth in men and breast shrinkage in women.
They shrivel the testicles. They might enlarge the prostate gland. They
cause acne and hair loss. They can weaken tendons. They're reputed to
cause heartbeat abnormalities.
They lead
to cardiovascular problems. Recently, it was shown that a group of
muscle-building-steroid users, at young ages, had a buildup of calcium in
their heart arteries. Calcium buildup in arteries is a signal that those
arteries are likely to clog up and obstruct blood flow to heart
muscle.
Nicole is not
yet diagnosed with Cushing's but has a long history of many
Cushing's symptoms. Nicole has been diagnosed so far with PCOS and
Fibromyalgia. A dynamic MRI suggests a pituitary microadenoma but
she is not diagnosed with pituitary disease or Cushing's yet. She
suspects steroid-induced Cushing's due to meds she has taken
throughout her short life. Nicole has two areas on MySpace: a bio at
http://www.myspace.com/labellavitabrasil and an area for Cushies at http://groups.myspace.com/cushingssurvivors.
Stasia is not
yet diagnosed with Cushing's but has a PCOS diagnosis. Her urine and
cortisol is elevated so she will see an endocrinologist in March
2007. A doctor mentioned ectopic Cushing's.
Teraleann was
diagnosed with secondary adrenal insufficiency and hypothyroidism.
She has also been diagnosed with a rare intracellular bacterial
disease known as brucellosis or undulant fever and had mononuclosis
at 3 months.
Tracy is not
yet been diagnosed but she has been suffering with bizarre symptoms
for 12 years. She took a lot of steroids before her hysterectomy due
to endometriosis. She has also been told that she has interstial
cysitis.
Brook's final
diagnosis was confirmed at the NIH *National Institutes of Health)
and Brook will have surgery on February 14th 2007 to remove the
tumor on the right side of her pituitary. She has a page on
myspace.
Jean had
unsuccessful pituitary surgery May 14, 2003. Her second surgery will
be with Dr. Kassam in Pittsburgh.
Erie, PA
JoAnn (on the boards mrsjones91730 is JoAnn's
daughter)
Dr. Friedman diagnosed JoAnn and confirmed
that her Cushing's was caused by a pituitary tumor. Her surgery was
January 3rd, 2004. JoAnn also had adrenal surgery August of 2005 and
Gamma Knife in April 06. She died of
congestive heart failure September 2006.
Mary Jo had a
pituitary tumor removed at the Mayo Clinic in Rochester in September
of 1992. She is now Addisonian and will take prednisone for the rest
of her life. She would like to hear from others who have had
Cushings and may now be Addisonian.
Peggy was
first diagnosed with a (pituitary) prolactinoma, but now has some
Cushing's symptoms. She has taken bromocriptine and cabergoline to
help control the overproduction of prolactin.
Denise is
looking for information for her father. He was diagnosed with
cushings disease about four months ago. The endo told him it was
from the prolonged use of cortisone injections that his other Dr.
was giving him every three weeks for the last thirteen months for a
disease he has called Pyronies. Another doctor has put him back on
low-dose steroids and he has many Cushing's symptoms.
Dr. Elaine Wong West Los Angeles, VA Facilities 11301 Wilshire Blvd. Los Angeles, CA 90073 phone: 3102683754
Endocrinologist She's a resident doctor that's been treating me
for the prolactinoma. I have been going to see her every three
months for the last year and three months. She is probably good but
I don't feel she has answered my questions. I would like to get a
second opinio but for that I am probably going to have to go to a
different hospital.
West Los Angeles, CA
Dr. Daniella Mittan
2120 Exchange Street
Suite 200
Astoria, OR 97103
Phone: 5033255360
Fax: 5033259373
Dr. Maria
Fleseriu Oregon Health & Science
University 3181 S.W. Sam Jackson Park Rd,
BTE472 Portland, OR 97239
Pituitary, Adrenal,
Endocrinologist, Prolactinoma
Portland,
OR
Dr. James
Neifing The Portland (OR) Diabetic And
Endocrinology Clinic which is very close to Good Samaritan Hospital
phone: 503-274-4884
Dr. Neifing has taken care of e since my
adrenalectomy in 2000. He is very thourough and listens to how I
feel as well as being very thourough. I feel he is very accessible
in person as well as by phone. That is important to me since I live
3.5 hours away from Portland. I though it would be helpful to have
another endo who knows cushings since Dr. L is moving from
Portlland. Lynn in Oregon
Portland,
OR
Dr. Anne LaRochelle 333 State Street Erie,
Pa 16507 phone: 8144548886 fax: 8144564609
Endocrinologist She is a very nice dr...never had any problems
with her... seems to know alot about Cushing's... she has diagnosed
about 15 cases of Cushing's that I know of since she's been in
practice... worth seeing if you don't live too far from
Erie...
• If you've been diagnosed
with Cushing's, please participate in the Cushing's Register
The information you provide will be used to create a
register and will be shared with the medical world. It would not be used
for other purposes without your expressed permission. Note: This information will not be sold or shared
with other companies.
Lynne Clemens, President of
CUSH Orgis be the person
responsible for the creation of this register.