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Topic: Hypercortisolism

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	Cushing Diease and Nelson Syndrome (Site not responding. Last check: 2007-10-26)
		The tissue effects of chronic hypercortisolism that result in Cushing's syndrome may be caused by adrenal tumors, ectopic secretion of adrenocorticotropic hormone (ACTH) or corticotropin releasing hormone (CRH), severe depression, exogenous administration of glucocorticoids, or pituitary hypersecretion of ACTH.
		Nelson's syndrome differs from Cushing's disease in that the hypercortisolism cannot occur because of the adrenalectomy and, by definition, a pituitary tumour is known to be present.
		ACTH-secreting nonpituitary neoplasms that cause secondary hypercortisolism (ectopic Cushing's syndrome) and the adrenal disorder causing primary hypercortisolism (adrenal Cushing's syndrome) are responsible for approximately equal proportions of the majority of remaining cases of spontaneous Cushing's syndrome.
	www.pituitaryadenomas.com /cushing.htm (4379 words)

	Diagnosis of hypercortisolism
		First-line tests to screen for hypercortisolism include measurement of 24 h urinary cortisol excretion, cortisol diurnal rhythm, a 1 mg overnight dexamethasone suppression test and, since recently available, midnight salivary cortisol concentrations.
		In case of ACTH-independent hypercortisolism, imaging of the adrenals is performed to examine for adenoma, hyperplasia or carcinoma.
		When ACTH-dependent hypercortisolism is present, the work-up will be continued with pituitary imaging, eventually followed by bilateral sinus petrosus inferior sampling, since this form of Cushing’s syndrome is most frequently caused by a pituitary adenoma.
	www.endocrine-abstracts.org /ea/0011/ea0011s88.htm (263 words)

	Grant-funded Project Nr. 077/1999/C/1.LF - Final Report (Site not responding. Last check: 2007-10-26)
		Hypercortisolism, both endogenous as well as induced by the treatment with glucocorticoids, is known to fasten atherosclerotic process.
		Besides, it is possible to speculate that even the lack of growth hormone may participate on the development of atherosclerotic changes in hypercortisolism.
		was suggested, that hypercortisolism leaves behind the permanent metabolic changes leading to accelerated atherosclerosis even after cortisol normalisation.
	www1.cuni.cz /cuni/ruk/gauk/zz2001/077_99-e.htm (366 words)

	Medical Dictionary: Hypercortisolism - CureResearch.com
		Hypercortisolism (condition): Cushing's syndrome is a disorder of the adrenal glands leading to excess cortisol secretion.
		Hypercortisolism: Cushing's syndrome is a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol.
		Sometimes called "hypercortisolism," it is relatively rare and most commonly affects adults aged 20 to 50.
	www.cureresearch.com /medical/hypercortisolism_printer.htm (200 words)

	[No title]
		The hypercortisolism of pseudo-Cushing's states is believed to be mediated through increased hypothalamic secretion of corticotropin-releasing hormone (CRH) in the context of a hypothalamic-pituitary-adrenal axis that is otherwise appropriately restrained by negative cortisol feedback.
		In contrast, hypothalamic CRH secretion is suppressed by the hypercortisolism of true Cushing's syndrome, which is less responsive to the negative feedback of exogenous glucocorticoid [8].
		The diagnosis of hypercortisolism: biochemical criteria differentiating patients from lean and obese normal subjects and from females on oral contraceptives.
	dspace.dial.pipex.com /town/estate/aquc35/book/yanovski.txt (4644 words)

	RedOrbit - Health - Bilateral Adrenal Enlargement and Non-Suppressible Hypercortisolism As a Presenting Feature of ... (Site not responding. Last check: 2007-10-26)
		In the majority of cases of malignancy-associated hypercortisolism, it might be expected that the presence of malignant disease would be clinically apparent, thus rendering a detailed endocrinological evaluation of the HPA axis unnecessary.
		However, in the present case we describe a patient with occult malignancy presenting with bilateral adrenocortical enlargement and non-suppressible hypercortisolism that was not due to the ectopic ACTH syndrome.
		The ectopic ACTH syndrome is a classical cause of non-suppressible hypercortisolism in malignant disease but is rare outside the context of small cell lung cancer.7 In contrast, adrenal enlargement, cither due to diffuse non-metastatic hyperplasia or metastatic deposits, occurs more frequently.
	www.redorbit.com /news/display?id=110401 (1641 words)

	Hypercortisolism
		Hypercortisolism is a condition that results from an excess of cortisol, a hormone produced by the adrenal glands.
		Hypercortisolism can be caused by a tumor of the pituitary gland, a tumor of the adrenal gland, a tumor somewhere other than the pituitary or adrenal glands (ectopic Hypercortisolism), or by long-term use of corticosteroids (drugs commonly used to treat conditions, such as rheumatoid arthritis and asthma).
		Because Hypercortisolism is a rare but serious disorder, it is very important to carefully exclude (rule out) other disorders and then separate the different types, leading eventually to a specific cause that can be treated.
	arthritis-symptom.com /h-l/hypercortisolism.htm (1447 words)

	Medical Dictionary: Hypercortisolism - WrongDiagnosis.com - WrongDiagnosis.com
		Hypercortisolism (medical condition): Cushing's syndrome is a disorder of the adrenal glands leading to excess cortisol secretion.
		Hypercortisolism is listed as a "rare disease" by the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH).
		This means that Hypercortisolism, or a subtype of Hypercortisolism, affects less than 200,000 people in the US population.
	www.wrongdiagnosis.com /medical/hypercortisolism_printer.htm (371 words)

	HIV & AIDS - Pathogenesis of human suppression in hypercatabolic diseases: AIDS, septicaemia, toxic shock syndrome and ...
		The above describes events during persistent catabolic displacement in metabolism due to hypercortisolism: persistent B-cell activation and hypergammaglobulinaemia, which is characteristic of latent and active autoimmune disease.(10) As already mentioned, the main physiological function of cytotoxic T-cells is to dispose of "altered-self" structures, ie.
		Prevention and treatment of the latter is limited to disposal of "altered-self" structures, by removing hypercortisolism and by strengthening anabolic metabolism.
		Enduring hypercortisolism due to a persistent displacement in the cytokine profile towards Th2 is also associated with a selective decline in CD4 cells, with CD8 cells remaining constant.
	www.virusmyth.net /aids/data/ahpathogen.htm (3638 words)

	Endotext.com - CARNEY'S COMPLEX (Site not responding. Last check: 2007-10-26)
		Hypercortisolism is caused by multiple autonomously functioning pigmented adrenocortical nodules ranging in size from submicroscopic to 10 mm in diameter; the adrenal gland is usually of normal weight.
		Hypercortisolism was established by increases in urinary free cortisol (UFC) and 17-hydroxycorticosteroids above the upper limit of normal.
		Making the diagnosis of hypercortisolism in PPNAD can be difficult, because it usually develops slowly over several years and the clinical manifestations of Cushing's syndrome are often subtle.
	www.endotext.org /adrenal/adrenal21/adrenal21.htm (3938 words)

	Cushing's Syndrome
		Cushing's syndrome, also called hypercortisolism, is a rare endocrine disorder characterized by a variety of symptoms and physical abnormalities.
		It may be caused by either prolonged exposure of the body's tissues to high levels of the hormone cortisol or by the overproduction of cortisol in the body.
		The aim of treatment is to cure the hypercortisolism and to eliminate any tumor that threatens the individual's health, while minimizing the chance of endocrine deficiency or long-term dependence on medications.
	healthlink.mcw.edu /article/921724441.html (292 words)

	Hypercortisolism (Site not responding. Last check: 2007-10-26)
		Hypercortisolism news vertical portal can now be syndicated quickly and easily using our new Really Simple Syndication feeds.
		Cleveland Jewish News, OH -Cushing s syndrome, or hypercortisolism, is a hormonal disorder caused by the body...
		For any further understanding that could lead to the prevention, treatment, and/or cure of the disorders, we recommend that affected individuals seek the advice or counsel of his or her own personal physician(s).
	hypercortisolism.diseasemap.com /section_1470_1.html (311 words)

	098 : The use of saliva cortisol measurements for the diagnosis of hypercortisolism (Site not responding. Last check: 2007-10-26)
		Purpose: The measurement of saliva cortisol for the diagnosis of hypercortisolism is becoming more widely accepted, based upon results of small patient numbers.
		We found a high sensitivity for the detection of hypercortisolism at the 10: 00 p.m.
		On the one hand this method is less time consuming and less expensive than blood sampling, on the other hand it is a reliable screening method for the diagnosis of hypercortisolism and follow-up after surgery.
	www.thieme.de /abstracts/eced/abstracts2003/daten/098.html (442 words)

	Adrenalectomy for hypercortisolism
		Aim of the study: to analyze surgical outcome in patients who underwent unilateral or bilateral adrenalectomy for hypercortisolism.
		Results: adrenalectomies for hypercortisolism were performed in 18 patients (5 males, 13 females, mean age 43.6±16.1 years).
		Except for the patients who died, resolution of the symptoms of hypercortisolism was complete.
	www.endocrine-abstracts.org /ea/0010/ea0010p85.htm (326 words)

	Cushing's Disease: Clinical Manifestations and Diagnostic Evaluation - September 1, 2000 - American Family Physician
		If the findings of the history and physical examination suggest hypercortisolism and an iatrogenic cause (i.e., corticosteroid use) is not apparent, laboratory evaluation is warranted.
		In this instance, the hypercortisolism of pseudo-Cushing's syndrome should correct spontaneously if treatment of the underlying process is successful.
		Ketoconazole (Nizoral) and aminoglutethimide (Cytadren), which are inhibitors of adrenal steroid biosynthesis, may be used in the perioperative period to decrease the clinical effects of hypercortisolism.
	www.aafp.org /afp/20000901/1119.html (3625 words)

	Clinical Trial: Long Term Post Operative Follow-Up of Cushing Syndrome
		Although most patients with hypercortisolism can be diagnosed and treated the long-term effects of hypercortisolism and its treatment are unknown.
		However, it is well established that hypercortisolism weakens bones (decreased bone density), causes secondary hypogonadism, increases levels of fat in the blood (hyperlipidemia), and decreases thyroid function (hypothyroidism).
		Although most patients with hypercortisolism now can be diagnosed correctly and successfully treated, the long-term sequelae of hypercortisolism and its treatment are unknown.
	clinicaltrials.gov /ct/gui/show/NCT00029952;jsessionid=B908C68509DF1... (774 words)

	Cushing’s Syndrome - Endocrine Cancers - Stanford Comprehensive Cancer Center
		Elevated levels of cortisol are also referred to as hypercortisolism.
		The bones are weakened due to osteoporosis from the hypercortisolism, and routine activities such as bending, lifting or rising from a chair may lead to backaches, rib and spinal column fractures.
		Once hypercortisolism is confirmed, the next step is to determine the cause.
	cancer.stanford.edu /endocrine/cushings.html (831 words)

	NEJM -- Responses to corticotropin-releasing hormone in the hypercortisolism of depression and Cushing's disease. ... (Site not responding. Last check: 2007-10-26)
		Primary depression can be associated with substantial hypercortisolism, thus prompting some researchers to suggest that depression shares pathophysiologic features with Cushing's disease.
		The purpose of this study was to evaluate whether the pituitary-adrenal responses to ovine corticotropin-releasing hormone could help to clarify the mechanism of hypercortisolism in depression and in Cushing's disease and to assist in the differential diagnosis of these disorders.
		We conclude that the pathophysiologic features of hypercortisolism in depression and Cushing's disease are distinct in each of the disorders and that the ovine corticotropin-releasing hormone stimulation test can be helpful in their differential diagnosis.
	content.nejm.org.cob-web.org:8888 /cgi/content/extract/314/21/1329 (1228 words)

	Cushing's Syndrome
		Radiographic examinations of the sella turcica or adrenal glands are not useful screening tests in the initial evaluation of hypercortisolism.
		Rarely, patients with hypercortisolism will have a false-negative test result because of delayed metabolism of dexamethasone, which results in markedly increased plasma dexamethasone levels compared with those usually obtained.
		The elevated dexamethasone levels may then cause adrenal suppression in some patients with hypercortisolism, particularly in those with Cushing disease.
	members.tripod.com /~enotes/cushing.htm (945 words)

	Bone involvement in patients with adrenal incidentalomas: role of subclinical hypercortisolism (via CobWeb/3.1 ... (Site not responding. Last check: 2007-10-26)
		Previous studies suggest that in patients with adrenal incidentalomas (AI) subclinical hypercortisolism (SH) exerts a deleterious effect on bone mineral density (BMD), but scarce data are available about vertebral fractures.
		The patients were subdivided into two groups: with or without subclinical hypercortisolism (SH+/SH−).
		The diagnosis of SH was made on the presence of 2 of the following 3 alterations in the pituitary-adrenal axis: urinary free cortisol (UFC) levels higher than 70 mcg/24 hrs, serum cortisol levels after a 1-mg overnight dexamethasone suppression test (F after Dex) higher than 3.0 mcg/dL, and ACTH levels lower than 10 pg/mL.
	www.endocrine-abstracts.org.cob-web.org:8888 /ea/0011/ea0011oc53.htm (250 words)

	Cushing's Syndrome Information Page: National Institute of Neurological Disorders and Stroke (NINDS)
		hypercortisolism, is a rare endocrine disorder caused by chronic exposure of the body's tissues to excess levels of cortisol - a hormone naturally produced by the adrenal gland.
		Surgery, radiotherapy, chemotherapy, immunotherapy, or a combination of these may be used to treat ectopic ACTH syndrome.
		The aim of surgical treatment is to cure hypercortisolism by removing the tumor while minimizing the chance of endocrine deficiency or long-term dependence on medications.
	www.ninds.nih.gov /disorders/cushings/cushings.htm (466 words)

	Cushing' Syndrome Laboratorial Diagnosis - Endocrinology - MEDSTUDENTS
		There are various diagnostic screening tests for hypercortisolism, but they vary with their specificity, sensitivity, dosing laboratorial methods and other variables.
		The hypercortisolism diagnosis is established when the level of evening cortisol is higher than 50% of the morning level.
		It is important to notice that dexamethasone, characterized for its high potency, is used in the laboratorial tests for hypercortisolism, because it does not interfere with dosing of endogenous cortisol unlike other corticoids.
	www.medstudents.com.br /endoc/endoc7.htm (2699 words)

	Medical Policy LAB.00017 \| Salivary Hormone Tests (Site not responding. Last check: 2007-10-26)
		Clinical features such as weight gain, depression, hypertension, and menstrual irregularities, although common in the general population, may raise the possibility of Cushing’s syndrome. Thus, because it may be difficult to identify those patients with endogenous hypercortisolism on the basis of clinical features, confirmatory tests must be used to assure proper diagnosis.
		Cushing's syndrome: also referred to as hypercortisolism, is an endocrine disorder caused by excessive levels of the endogenous hormone cortisol.
		No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, or otherwise, without permission from the health plan.
	medpolicy.unicare.com /policies/LAB/salivary_hormone_tests.html (957 words)

	eMedicine - Cushing Syndrome : Article by Gail Adler, MD, PhD
		Endogenous glucocorticoid overproduction or hypercortisolism that is independent of adrenocorticotropic hormone (ACTH) usually is due to a primary adrenocortical neoplasm (usually an adenoma but rarely a carcinoma).
		When surgery is not successful or cannot be used, as often occurs with ectopic ACTH or metastatic adrenal carcinoma, control of hypercortisolism may be attempted with medication.
		If this agent is ineffective at controlling hypercortisolism, the dose may be maintained while another steroid enzyme inhibitor, typically metyrapone, is initiated.
	www.emedicine.com /emerg/topic117.htm (5418 words)

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