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January

2

Highlights:

• Helpful Hints

• Latest Testimonials:

• First VOICE Chat

• Podcasts

• Adrenal Crisis Causes Death in Some People Who Were Treated With hGH

• New and updated bios and Helpful Doctors

• Upcoming Meetings: Austin, Texas; Pituitary Patient Education Day, Stanford, CA; UVA Pituitary Days; ENDO 08, San Francisco, CA; Endo 2009, Washington, DC; Endo 2010, San Diego, California and tentative meetings in the UK; Southern California Area and Minneapolis; Missouri; the Los Angeles area; the Midwest/midsouth (Missouri, Oklahoma, Arkansas); Virginia (Tidewater/Hampton Roads area)

• And much more...


30


Highlights:

• Cushing's Awareness Day, 2008

• Cushing's Voice Chats / Internet Talk Radio and Podcasts

• Classical Forms of Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency in Adults

• Evaluation of the Pituitary Function with Insulin Tolerance (Hypoglycaemia) Testing: Are There Any Differences Using Insulin Lispro Compared to Regular Insulin?

• RxTrials Institute Drug Pipeline Alert

• The Diagnosis of Polycystic Ovary Syndrome: The Criteria Are Insufficiently Robust for Clinical Research

• Hypothalamic-pituitary insufficiency following infectious diseases of the central nervous system

• Pediatric Pituitary Adenomas

• “Subclinical Cushing’s syndrome” is not subclinical: improvement after adrenalectomy in 9 patients

• Expression of vasopressin receptors in ACTH-independent macronodular bilateral adrenal hyperplasia causing Cushing's syndrome: molecular, immunohistochemical and pharmacological correlates

• C-Reactive Protein and Cushing's

• Pituitary adenoma

• FDA Accepts Samaritan's Cushing's SP-6300 IND and Clears Phase II Study

• Laparoscopic surgery is safe for large adrenal lesions

• New and updated bios and Helpful Doctors

• Upcoming Meetings: UVA Pituitary Days; ENDO 08, San Francisco, CA; Endo 2009, Washington, DC; Endo 2010, San Diego, California and tentative meetings in the UK; Southern California Area and Minneapolis; Missouri; the Los Angeles area; the Midwest/midsouth (Missouri, Oklahoma, Arkansas); Virginia (Tidewater/Hampton Roads area)

• And much more...


February

26

Highlights:

• This Week, Thursday February 28 at 7:30PM eastern. Jen will talk about Bilateral Adrenalectomies (BLAs) and answer your questions. The Call-In number for questions or comments is (646) 200-0162. http://www.blogtalkradio.com/CushingsHelp

• Podcasts

• Endo News

• Limitations of nocturnal salivary cortisol and urine free cortisol, in the diagnosis of mild Cushing’s syndrome Neither a normal UFC nor a normal NSC excludes mild Cushing's Syndrome. Multiple samples (urine/saliva) and DST are needed to make the diagnosis of mild CS...

• Update in Pituitary Disease--Cedars Sinaii Publication (UPDATE WITH FULL ARTICLE), new vistas....in unraveling the challenges of pituitary disease A recent paper, for the first time, proposed the aryl hydrocarbon receptor interacting protein (AIP) gene as predisposing to pituitary adenoma...

• Stress hormone impacts memory Cortisol production is controlled by the hypothalamic-pituitary axis (HPA), a hormone-producing system involving the hypothalamus and pituitary gland in the brain and the adrenal gland located near the kidney. People with poorly controlled diabetes often have an overactive HPA axis and excessive cortisol produced by the adrenal gland...

• A Neurosurgeons Perspective on Brain Tumors (Video) Neurosurgeons at NOHC are among the region's most experienced in caring for patients with brain tumors and other cranial disorders...

• Pituitary Brain Tumors - A Neurosurgeons Perspective (Video) Chicago Institute of Neurosurgery & Neuroresearch - Dr. Gail Rosseau, neurosurgeon at the Neurologic & Orthopedic Hospital of Chicago, provides an educational insight on pituitary tumors - the conditions and treatments for certain cases...

• Treatment 'could cut out steroids' Extended use of steroids may result in Cushing's syndrome, a condition marked by rapid weight gain, muscle weakness and skin problems which may lead to high blood pressure, diabetes and heart disease. In some cases, it can shorten life...

• Surgical Treatment of Orthopedic Trauma Derived from Harvey Cushing's remarkable personal collection in the Brain Tumor Registry, “The Legacy of Harvey Cushing: Profiles of Patient Care,” by Aaron A. Cohen-Gadol, MD and Dennis D. Spencer, MD, is a stunning historical account of Cushing's surgical cases and research from 1905 to 1930. The book showcases the extraordinary contribution that Cushing made to the advancement of neurological surgery in the twentieth century. The perfectly preserved material, that was housed at the Yale University Library for over 60 years, is the oldest catalog of neurological and neuropathological disease. In particular, the book features extraordinary photographs of patients which were painstakingly digitized from glass slides...

• Diagnosis of adult GH deficiency The current guidelines for the diagnosis of adult GHD are mainly based on the statements from the GH Research Society Consensus from Port Stevens in 1997. It is stated that diagnosis of adult GHD must be shown biochemically by provocative tests within the appropriate clinical context. The insulin tolerance test (ITT) was indicated as that of choice and severe GHD defined by a GH peak lower than 3 ?g/L...

• Warning over illegal skin bleach, illegal skin bleach caused Cushing's Doctors diagnosed her with Cushing's syndrome, which is caused by high levels of steroid hormones such as cortisol in the blood. It is usually caused by a problem with the adrenal glands, which make the hormones, or with the pituitary gland sending too high a signal to the adrenal glands. But blood tests on the patient showed very low levels of cortisol and of corticotropin, the signalling hormone in the pituitary gland...

• Life's hard times are an important part of who Linda Miller is today. (pituitary tumor) At that time, it was a healing thing for me," said Miller, who suffered through a year of painful symptoms before doctors discovered that she had a tumor on her pituitary gland, and Cushing's disease as a result of that...

• The girl, 10, who could die from shock just by watching a scary film ~ Polyglandular Addison's disease/Jenny's Pennies Jennifer is one of just six known sufferers of polyglandular Addison's disease, which causes her to become ill whenever she is surprised or shocked. The condition means she is unable to produce adrenaline in response to alarm or any sudden form of emotional or physical stress...

• New and updated bios

• Upcoming Meetings: Santa Monica, CA; Charlotte, NC; Seattle, WA; Philadelphia, PA; Charlotte, NC; Greenwood, Indiana; Santa Monica, CA; ENDO 08, San Francisco, CA; Endo 2009, Washington, DC; Endo 2010, San Diego, California and tentative meetings in the UK; Southern California Area; Minneapolis; Missouri; the Los Angeles area; the Midwest/midsouth (Missouri, Oklahoma, Arkansas); Virginia (Tidewater/Hampton Roads area)

• And much more...


March

26

Highlights:

• This Week, Thursday March 27 at 7:30PM eastern. Monica (Monicaroni) and Crystal (Vinesqueen), March 27, 2008. The Call-In number for questions or comments is (646) 200-0162. http://www.blogtalkradio.com/CushingsHelp

• Podcasts

• Endo News

• Cyclical Cushing's Syndrome Due to Bronchial Carcinoid: Early Diagnosis and Prompt Treatment. We hereby describe a patient with cyclical Cushing's syndrome due to ectopic production of adrenocorticotropic hormone (ACTH) by a bronchial carcinoid tumor, accurately diagnosed and treated within a short period of time. In addition we describe for the first time careful assessment of cortisol levels in the postoperative period without hormone replacement demonstrating limited need for steroid replacement...

• High prevalence of central adrenal insufficiency in patients with Prader-Willi syndrome Strikingly, 60% of our PWS patients had central adrenal insufficiency. The high percentage of CAI in PWS patients might explain the high rate of sudden death in these patients, particularly during infection-related stress. Based on our data, one should consider treatment with hydrocortisone during acute illness in PWS patients, unless CAI has recently been ruled out with a metyrapone test...

• Woman Beats Rare Disease Cushing's disease (CD) is rare in the paediatric age range, but may present a difficult therapeutic challenge. Most paediatric endocrinologists have limited experience managing children or adolescents with CD and thus benefit from close consultation with adult colleagues. Prior to definitive treatment, a diagnostic protocol for investigation is required which broadly follows the model for adult patients. Treatment strategies for CD are described and critically appraised. The management of paediatric CD patients after cure also presents challenges for optimizing growth, bone health, reproduction and body composition from childhood into and during adult life...

• 40% of patients with CD will have a normal MRI Forty percent of patients with CD will have a normal pituitary magnetic resonance image, whereas conversely there is a 10% prevalence of pituitary incidentalomas in the age range in which CD typically presents (1). It is, therefore, clear that magnetic resonance imaging of the pituitary cannot be relied on and weight should be given to the biochemical evaluation of a given patient...

• Three years prospective investigation of anterior pituitary function after traumatic brain injury: a pilot study GH deficiency is the most common pituitary deficit 1 and 3 years after TBI (traumatic brain injury). In patients with mild and moderate TBI, pituitary function improves over time in a considerable number of patients, but it may also worsen rarely over the 3-year period. In patients with severe TBI, ACTH and GH deficiencies at 1st year evaluation persist at 3rd year...

• Advances in the Management of Paediatric Cushing's Disease Cushing's disease (CD) is rare in the paediatric age range, but may present a difficult therapeutic challenge. Most paediatric endocrinologists have limited experience managing children or adolescents with CD and thus benefit from close consultation with adult colleagues. Prior to definitive treatment, a diagnostic protocol for investigation is required which broadly follows the model for adult patients. Treatment strategies for CD are described and critically appraised. The management of paediatric CD patients after cure also presents challenges for optimizing growth, bone health, reproduction and body composition from childhood into and during adult life...

• The Diagnosis of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline After excluding exogenous glucocorticoid use, we recommend testing for Cushing's syndrome in (a) patients with multiple and progressive features compatible with the syndrome, particularly those with a high discriminatory value, and (b) patients with adrenal incidentaloma. We recommend initial use of one test with high diagnostic accuracy (urine cortisol, late night salivary cortisol, 1-mg overnight or 2-mg 48-hour dexamethasone suppression test). We recommend that patients with an abnormal result see an endocrinologist and undergo a second test, either one of the above or, in some cases, a serum midnight cortisol or dexamethasone-CRH test. Patients with concordant abnormal results should undergo testing for the cause of Cushing's syndrome. Patients with concordant normal results should not undergo further evaluation. We recommend additional testing in patients with (a) discordant results, (b) normal responses suspected of cyclic hypercortisolism, or (c) initially normal responses who accumulate additional features over time...

• DHEAS Levels Linked to Cognitive Function in Women "Possible explanations for our findings include direct actions of DHEA/DHEAS via a putative DHEA receptor, via the androgen receptor, or as neurosteroids and endogenous ligands for sigma-1 receptors," Dr. Davis' team suggests. DHEAS may also be a "marker of overall potential for tissue intracrine androgen and estrogen production in women but not the actual mediator of the effect."

• Pituitary Disease / Disorder Affects 1 In 5 = 20% Of The U.S. Population "1 in 5 individuals may have an abnormal growth on their pituitary gland, causing significant health complications. If left undiagnosed and untreated, this can impair normal hormone function resulting in a reduced lifespan," explains Dr. Shereen Ezzat, Professor of Medicine, University of Toronto and member of the Board of Directors of the Pituitary Network Association...

• The Role of Sex Steroids in Controlling Pubertal Growth In summary, there is ample evidence to suggest that sex steroids, particularly, oestrogen play a vital role in modulating linear growth through the systemic GH-IGF-I axis, as well as, at the level of the growth plate. Clinical disorders of sex steroid synthesis and action lead to an abnormal pattern of growth. An improved understanding of this effect of sex steroids on growth requires a combination of clinical and basic experimental studies...

• New and updated bios

• Upcoming Meetings: Seattle, WA; Philadelphia, PA; Charlotte, NC; Greenwood, Indiana; Santa Monica, CA; ENDO 08, San Francisco, CA; Endo 2009, Washington, DC; Endo 2010, San Diego, California and tentative meetings in the UK; Southern California Area; Minneapolis; Missouri; the Los Angeles area; the Midwest/midsouth (Missouri, Oklahoma, Arkansas); Virginia (Tidewater/Hampton Roads area)

• And much more...

April

May

June / July

2

Highlights:

• No Interview this week due to the US Holiday. This newsletter includes 39 new and updated bios, 1 new helpful doctor, 3 Cushing's clinical trials and 19 userful endocrine news summaries.

• Podcasts

• Endo News

Endo News July 2
Work-up and management of paediatric Cushing's syndrome
Early diagnosis and treatment of Cushing's syndrome is vital for long-term outcome. The overall prognosis for Cushing's syndrome is good but challenges remain to ensure normal postcure growth and body composition...

Endo News July 2
Diagnosis‑°Addison’s Disease Secondary to Tuberculosis of the Adrenal Glands
In 1855, Thomas Addison described autopsy findings of six patients with adrenal tuberculosis, which continues to be one of the most common causes of adrenal insufficiency in the developing world...

Endo News June 30
Adaptive Responses of the Maternal Hypothalamic-Pituitary-Adrenal Axis during Pregnancy and Lactation
The extent of the global adaptations in the HPA axis has been revealed and the underlying mechanisms investigated within the last 20 years. Both basal, including the circadian rhythm, and stress-induced adrenocorticotrophic hormone and glucocorticoid secretory patterns are altered...

Endo News June 29
Complications of Diabetes Insipidus: The Significance of Headache
Causes of deficient amounts of ADH secretion include: (a) a malfunctioning hypothalamus or pituitary gland, (cool.gif damage to the hypothalamus or pituitary gland during surgery...

Endo News June 28
Measurement of urinary free cortisol by tandem mass spectrometry and comparison with results obtained by gas chromatography-mass spectrometry and two commercial immunoassays
The interference of cortisol ring-A metabolites in immunoassays contribute to overestimation of UFC concentrations. The LC-MS/MS procedure had the sensitivity, specificity, linearity, precision and accuracy for the determination of UFC concentrations. The method is suitable for routine use provided that method-dependant reference values are established...

Endo News June 26
Failure of partial hypophysectomy as definitive treatment in cushing’s disease owing to nodular corticotrope hyperpiasia; report of four cases
We conclude that although our patients appear to have inadequate suppression with high-dose dexamethasone, there is no way to diagnose this pathology presurgically, and that total hypophysectomy, bilateral adrenalectomy, and irradiation are the only alternatives for definitive treatment. A CRH-secreting ectopic tumor could not be found in our patients either before or after surgery in the follow-up period...

Endo News June 24
Role for postoperative cortisol response to desmopressin in predicting the risk for recurrent Cushing's disease
In the early postoperative period of Cushing's disease patients, desmopressin may stimulate ACTH secretion in the remnant corticotrophic tumour, but not in nontumour suppressed cells...

Endo News June 23
The Startling Truth About Doctors and Diagnostic Errors
Despite all of the talk about medical errors and patient safety, almost no one likes to talk about diagnostic errors. Yet doctors misdiagnose patients more often than we would like to think. Sometimes they diagnose patients with illnesses they don't have. Other times, the true condition is missed. All in all, diagnostic errors account for 17 percent of adverse events in hospitals, according to the Harvard Medical Practice Study, a landmark study that looks at medical errors...

Endo News June 23
The adrenal cortex in ectopic adrenocorticotropic hormone syndrome: A morphological study with histology, transmission and scanning electron microscopy, flow cytometry, and image analysis
The surgically removed adrenal glands of an 83-year-old woman with ectopic adrenocorticotropic hormone syndrome were studied by light microscopy, transmission and scanning electron microscopy, and flow-cytometric and image analyses for DNA ploidy. Light microscopy revealed marked adrenocortical hyperplasia...

Endo News June 19
PPH and more After Five Years on Fen-Phen
In 2000, Shannon went in to the hospital for a hysterectomy. "I came out of the hospital having been diagnosed with high blood pressure, diabetes, and Cushing's disease, in addition to having the hysterectomy," she said...

Endo News June 19
Predicting Recurrence
Fifty-seven Cushing's disease patients submitted to pituitary surgery and desmopressin stimulation in the early postoperative with a long-term follow-up (20‑°161 months) were studied...

Endo News June 18
The Burning Question ‑° What Causes High Blood Pressure?
Miscellaneous health issues such as kidney disease, adrenal problems like Cushing's disease, diabetes, aortic malformations and even sleep apnea are contributors to what causes high blood pressure...

Endo News June 18
Phaeochromocytoma combined with subclinical Cushing's syndrome & pituitary microadenoma
Phaeochromocytoma (PHEO) occasionally associates with pathological lesions of the adrenal cortex. The coexistence of PHEO and pre-clinical Cushing's syndrome (PCS) of the same adrenal gland has rarely been reported. We report a case of PHEO and PCS originating from the same adrenal gland and discuss the peculiar diagnostic aspects of this entity...

Endo News June 17
Obesity can be rooted in medical problems
Another disease related to weight gain is Cushing's syndrome. Cushing's syndrome is a hormonal disorder caused by prolonged exposure of tissue to the hormone cortisol. Not only does it cause excessive weight gain, but it can also cause severe fatigue, weak muscles and high blood pressure. Irritability, anxiety, and depression are common, as well. Women experience excessive hair growth along with these other symptoms...

Endo News June 17
The Other Side of Obesity as Disease Debate
A further conceptual problem arises when obesity occurs in a disease such as Cushing's Syndrome. Obesity is one of the components or signs of that syndrome. Is the obesity which is a sign of Cushing's disease, itself a separate disease?...

Endo News June 13
A Swift Kick in the ASP
Another example is Cushing's disease, which is a small tumor on the pituitary. The net effect of Cushing's disease is that it causes the body to have high levels of the hormone cortisol. I had a friend with Cushing's disease. He ran five miles every day, and by any measure ate a healthy diet, yet continued to gain weight. Why? Increased cortisol (from the sympathetic endocrine system) can cause compensatory secretion of insulin (from the opposing parasympathetic endocrine system). Chronically high insulin will make you fat no matter how much you exercise or how little you eat. Keep insulin high, and you can literally starve to death while remaining obese...

Endo News June 12
Pituitary Hyperplasia
Pituitary cell hyperplasia can be a source of hyperprolactinemia, gigantism, and Cushing's disease. Indeed, up to 18% of Cushing's disease and some of the nonremissions following successful removal of corticotroph ademona could be attributable to corticotroph hyperplasia...

Endo News May 20
Feds to Offer Free Health Care to People With Very Rare Diseases
The new mystery-disease program is aimed at people with the rarest of the rare diseases ‑± even those with truly brand-new ailments ‑± who otherwise would be turned away because there are no studies, yet, for their conditions or a researcher specifically tracking their symptoms. It doesn't promise a diagnosis, but the chance to be reevaluated by a team of renowned specialists...

• New and updated bios

• Upcoming Meetings: Seattle, WA; Philadelphia, PA; Charlotte, NC; Greenwood, Indiana; Santa Monica, CA; ENDO 08, San Francisco, CA; Endo 2009, Washington, DC; Endo 2010, San Diego, California and tentative meetings in the UK; Southern California Area; Minneapolis; Missouri; the Los Angeles area; the Midwest/midsouth (Missouri, Oklahoma, Arkansas); Virginia (Tidewater/Hampton Roads area)

• And much more...


Note! The News Items are now available through the bi-weekly Newsletters and the News Items and Research Forum of the message boards. To subscribe to the newsletters, please click here.
Archives are avaliable here.

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