A condition caused by prolonged exposure to excess levels of cortisol (HYDROCORTISONE) or other GLUCOCORTICOIDS from endogenous or exogenous sources. It is characterized by upper body OBESITY; OSTEOPOROSIS; HYPERTENSION; DIABETES MELLITUS; HIRSUTISM; AMENORRHEA; and excess body fluid. Endogenous Cushing syndrome or spontaneous hypercortisolism is divided into two groups, those due to an excess of ADRENOCORTICOTROPIN and those that are ACTH-independent.
Pathological processes of the ADRENAL CORTEX.
Pathological processes of the ADRENAL GLANDS.
A disease of the PITUITARY GLAND characterized by the excess amount of ADRENOCORTICOTROPIC HORMONE secreted. This leads to hypersecretion of cortisol (HYDROCORTISONE) by the ADRENAL GLANDS resulting in CUSHING SYNDROME.
Autosomal dominant syndrome characterized by cardiac and cutaneous MYXOMAS; LENTIGINOSIS (spotty pigmentation of the skin), and endocrinopathy and its associated endocrine tumors. The cardiac myxomas may lead to SUDDEN CARDIAC DEATH and other complications in Carney complex patients. The gene coding for the PRKAR1A protein is one of the causative genetic loci (type 1). A second locus is at chromosome 2p16 (type 2).
A group of hydroxycorticosteroids bearing a hydroxy group at the 17-position. Urinary excretion of these compounds is used as an index of adrenal function. They are used systemically in the free alcohol form, but with esterification of the hydroxy groups, topical effectiveness is increased.
An anterior pituitary hormone that stimulates the ADRENAL CORTEX and its production of CORTICOSTEROIDS. ACTH is a 39-amino acid polypeptide of which the N-terminal 24-amino acid segment is identical in all species and contains the adrenocorticotrophic activity. Upon further tissue-specific processing, ACTH can yield ALPHA-MSH and corticotrophin-like intermediate lobe peptide (CLIP).
A characteristic symptom complex.
Excision of one or both adrenal glands. (From Dorland, 28th ed)
Tumors or cancer of the ADRENAL GLANDS.
Examinations that evaluate and monitor hormone production in the adrenal cortex.
A malignant olfactory neuroblastoma arising from the olfactory epithelium of the superior nasal cavity and cribriform plate. It is uncommon (3% of nasal tumors) and rarely is associated with the production of excess hormones (e.g., SIADH, Cushing Syndrome). It has a high propensity for multiple local recurrences and bony metastases. (From Holland et al., Cancer Medicine, 3rd ed, p1245; J Laryngol Otol 1998 Jul;112(7):628-33)
Tumors or cancers of the ADRENAL CORTEX.
Neoplasms which arise from or metastasize to the PITUITARY GLAND. The majority of pituitary neoplasms are adenomas, which are divided into non-secreting and secreting forms. Hormone producing forms are further classified by the type of hormone they secrete. Pituitary adenomas may also be characterized by their staining properties (see ADENOMA, BASOPHIL; ADENOMA, ACIDOPHIL; and ADENOMA, CHROMOPHOBE). Pituitary tumors may compress adjacent structures, including the HYPOTHALAMUS, several CRANIAL NERVES, and the OPTIC CHIASM. Chiasmal compression may result in bitemporal HEMIANOPSIA.
A type I cAMP-dependent protein kinase regulatory subunit that plays a role in confering CYCLIC AMP activation of protein kinase activity. It has a lower affinity for cAMP than the CYCLIC-AMP-DEPENDENT PROTEIN KINASE RIBETA SUBUNIT.
The main glucocorticoid secreted by the ADRENAL CORTEX. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions.
Examinations that evaluate functions of the pituitary gland.
A benign neoplasm of the ADRENAL CORTEX. It is characterized by a well-defined nodular lesion, usually less than 2.5 cm. Most adrenocortical adenomas are nonfunctional. The functional ones are yellow and contain LIPIDS. Depending on the cell type or cortical zone involved, they may produce ALDOSTERONE; HYDROCORTISONE; DEHYDROEPIANDROSTERONE; and/or ANDROSTENEDIONE.
A pair of glands located at the cranial pole of each of the two KIDNEYS. Each adrenal gland is composed of two distinct endocrine tissues with separate embryonic origins, the ADRENAL CORTEX producing STEROIDS and the ADRENAL MEDULLA producing NEUROTRANSMITTERS.
Symptom complex due to ACTH production by non-pituitary neoplasms.
Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment.
Surgical removal or destruction of the hypophysis, or pituitary gland. (Dorland, 28th ed)
A benign epithelial tumor with a glandular organization.
The outer layer of the adrenal gland. It is derived from MESODERM and comprised of three zones (outer ZONA GLOMERULOSA, middle ZONA FASCICULATA, and inner ZONA RETICULARIS) with each producing various steroids preferentially, such as ALDOSTERONE; HYDROCORTISONE; DEHYDROEPIANDROSTERONE; and ANDROSTENEDIONE. Adrenal cortex function is regulated by pituitary ADRENOCORTICOTROPIN.
A peptide of about 41 amino acids that stimulates the release of ADRENOCORTICOTROPIC HORMONE. CRH is synthesized by neurons in the PARAVENTRICULAR NUCLEUS of the HYPOTHALAMUS. After being released into the pituitary portal circulation, CRH stimulates the release of ACTH from the PITUITARY GLAND. CRH can also be synthesized in other tissues, such as PLACENTA; ADRENAL MEDULLA; and TESTIS.
Fatty tissue in the region of the ABDOMEN. It includes the ABDOMINAL SUBCUTANEOUS FAT and the INTRA-ABDOMINAL FAT.
A condition of having excess fat in the abdomen. Abdominal obesity is typically defined as waist circumferences of 40 inches or more in men and 35 inches or more in women. Abdominal obesity raises the risk of developing disorders, such as diabetes, hypertension and METABOLIC SYNDROME X.
A pituitary adenoma which secretes ADRENOCORTICOTROPIN, leading to CUSHING DISEASE.
Radiation therapy used to treat the PITUITARY GLAND.
A chromosome disorder associated either with an extra chromosome 21 or an effective trisomy for chromosome 21. Clinical manifestations include hypotonia, short stature, brachycephaly, upslanting palpebral fissures, epicanthus, Brushfield spots on the iris, protruding tongue, small ears, short, broad hands, fifth finger clinodactyly, Simian crease, and moderate to severe INTELLECTUAL DISABILITY. Cardiac and gastrointestinal malformations, a marked increase in the incidence of LEUKEMIA, and the early onset of ALZHEIMER DISEASE are also associated with this condition. Pathologic features include the development of NEUROFIBRILLARY TANGLES in neurons and the deposition of AMYLOID BETA-PROTEIN, similar to the pathology of ALZHEIMER DISEASE. (Menkes, Textbook of Child Neurology, 5th ed, p213)
A cluster of metabolic risk factors for CARDIOVASCULAR DISEASES and TYPE 2 DIABETES MELLITUS. The major components of metabolic syndrome X include excess ABDOMINAL FAT; atherogenic DYSLIPIDEMIA; HYPERTENSION; HYPERGLYCEMIA; INSULIN RESISTANCE; a proinflammatory state; and a prothrombotic (THROMBOSIS) state. (from AHA/NHLBI/ADA Conference Proceedings, Circulation 2004; 109:551-556)
A relatively rare, usually benign neoplasm originating in the chemoreceptor tissue of the CAROTID BODY; GLOMUS JUGULARE; GLOMUS TYMPANICUM; AORTIC BODIES; and the female genital tract. It consists histologically of rounded or ovoid hyperchromatic cells that tend to be grouped in an alveolus-like pattern within a scant to moderate amount of fibrous stroma and a few large thin-walled vascular channels. (From Stedman, 27th ed)
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
A visual impairment characterized by the accumulation of fluid under the retina through a defect in the retinal pigment epithelium.
A condition characterized by severe PROTEINURIA, greater than 3.5 g/day in an average adult. The substantial loss of protein in the urine results in complications such as HYPOPROTEINEMIA; generalized EDEMA; HYPERTENSION; and HYPERLIPIDEMIAS. Diseases associated with nephrotic syndrome generally cause chronic kidney dysfunction.
An irregularly shaped venous space in the dura mater at either side of the sphenoid bone.
Chronic inflammatory and autoimmune disease in which the salivary and lacrimal glands undergo progressive destruction by lymphocytes and plasma cells resulting in decreased production of saliva and tears. The primary form, often called sicca syndrome, involves both KERATOCONJUNCTIVITIS SICCA and XEROSTOMIA. The secondary form includes, in addition, the presence of a connective tissue disease, usually rheumatoid arthritis.

Undetectable urinary free cortisol concentrations in a case of Cushing's disease. (1/758)

Measurement of the 24-h urinary free cortisol is a valuable screening test of endogenous hypercortisolism and, although false positive results may occur in a few situations, for example endogenous depression, false negative results are unusual. We report a case of a 48-year-old lady with pituitary-dependent Cushing's disease, whose 24-h urinary free cortisol excretion was consistently undetectable in association with increased plasma and salivary cortisol concentrations and reduced dexamethasone suppressibility. The patient had chronic renal impairment (creatinine clearance 21 ml/min) as a consequence of hypertension, despite only modestly increased urea and creatinine concentrations. Urinary free cortisol measurements must be interpreted with caution in patients with renal impairment.  (+info)

Primary hepatic carcinoid in a renal transplant patient. (2/758)

There seems to be a world-wide increase in the incidence of tumors among immunosuppressed patients. Of 1350 renal allografts transplanted in the past 23 years at the Department of Transplantation and Surgery, 56 cases were malignant tumors. The case of a 58-year-old female patient is reported, with disseminated primary carcinoid in the liver detected 86 days after renal transplantation. According to the literature only 39 patients with primary liver carcinoids have been reported until 1997, but this is the first where the carcinoid developed in an immunosuppressed patient. The rapid progression of the carcinoid could be associated with the immunosuppression.  (+info)

The neuroendocrine protein 7B2 is required for peptide hormone processing in vivo and provides a novel mechanism for pituitary Cushing's disease. (3/758)

The neuroendocrine protein 7B2 has been implicated in activation of prohormone convertase 2 (PC2), an important neuroendocrine precursor processing endoprotease. To test this hypothesis, we created a null mutation in 7B2 employing a novel transposon-facilitated technique and compared the phenotypes of 7B2 and PC2 nulls. 7B2 null mice have no demonstrable PC2 activity, are deficient in processing islet hormones, and display hypoglycemia, hyperproinsulinemia, and hypoglucagonemia. In contrast to the PC2 null phenotype, these mice show markedly elevated circulating ACTH and corticosterone levels, with adrenocortical expansion. They die before 9 weeks of severe Cushing's syndrome arising from pituitary intermediate lobe ACTH hypersecretion. We conclude that 7B2 is indeed required for activation of PC2 in vivo but has additional important functions in regulating pituitary hormone secretion.  (+info)

Venous subarachnoid hemorrhage after inferior petrosal sinus sampling for adrenocorticotropic hormone. (4/758)

Neurologic complications associated with inferior petrosal sinus sampling for adrenocorticotropic hormone in the diagnosis of Cushing syndrome are rare. Previously reported complications include brain stem infarction and pontine hemorrhage. We report a case of venous subarachnoid hemorrhage with subsequent acute obstructive hydrocephalus occurring during inferior petrosal sinus sampling for Cushing syndrome.  (+info)

Natural killer cell activity in the peripheral blood of patients with Cushing's syndrome. (5/758)

BACKGROUND: Natural killer (NK) cells are CD3(-)CD16(+)CD56(+) bone-marrow-derived lymphocytes mediating first-line defence by direct cytotoxicity against various types of target cells without prior immunization. NK cell activity is positively regulated by immune interferon (IFN-gamma); among hormones, glucocorticoids are potent in vitro and in vivo inhibitors, whereas ACTH and beta-endorphin in many experimental circumstances enhance NK cytotoxicity. DESIGN: We measured NK cytotoxicity of peripheral blood mononuclear cells (PBMC) obtained at 0800h and 2000h from 26 patients with Cushing's syndrome (12 pituitary-dependent, 12 adrenal-dependent and two dependent on ectopic ACTH secretion). In vitro responsiveness to IFN-gamma or cortisol was also tested. METHODS: NK activity was measured in a 4-h direct cytotoxicity assay using K562 cells as targets. Plasma ACTH, serum and urinary free cortisol were concomitantly measured with commercially available kits. RESULTS: Spontaneous activity and responsiveness to IFN-gamma or cortisol were significantly greater in 15 age- and sex-matched controls than in Cushing's patients at 0800h. In pituitary-dependent Cushing's patients, plasma ACTH correlated positively with mean levels of spontaneous NK activity (r=0.64, P<0.05) and negatively with cortisol-dependent percentage inhibition (r=-0.69, P<0.02). In adrenal-dependent Cushing's patients, a negative correlation was observed between levels of spontaneous NK activity and urinary free cortisol (r=-0.67, P<0.02). CONCLUSIONS: Our data indicate that excess endogenous glucocorticoids affect spontaneous NK cell activity and responsiveness to exogenous IFN-gamma or cortisol. The differential patterns observed between pituitary-dependent and adrenal-dependent groups are compatible with a positive immunomodulatory role of pituitary pro-opiomelanocortin-derived peptides that effectively counterbalance, at least partially, glucocorticoid immunosuppression.  (+info)

Studies on the "low dose" suppressible Cushing's disease. (6/758)

Diagnosis of Cushing's disease in most cases can be established by the standard dexamethasone suppression test without difficulty. However, some cases were known to be normally suppressed by the standard low dose of dexamethasone (2 mg daily). The case we encountered recently was also normally suppressed by either the rapid (Nugent) or the standard (Liddle) method. This fact prompted us to study the usefulness of a single dose of 0.5 mg of dexamethasone to suppress the plasma cortisol in the normal. It was concluded that the single oral dose of 0.5 mg of dexamethasone given at 11 p.m. on the previous night suppressed the plasma cortisol efficiently the following morning in the normal, thus making the differentiation of particular cases of Cushing's disease from the normal possible. The disappearance of plasma dexamethasone did not differ significantly between the normal and the Cushing's disease.  (+info)

Pituitary tumours in the elderly: a 20 year experience. (7/758)

The proportion of the elderly in the population is increasing, and the appreciation and management of medical problems in this age group will therefore become more important. We therefore decided to determine the clinical features and types of pituitary tumour presenting in the elderly, and to examine the treatment and outcome in this group. We conducted a retrospective case-note review from a specialist endocrine and neurosurgical unit in a tertiary referral centre. Eighty-four patients aged 65 years and over on diagnosis of a pituitary tumour were referred to the unit between 1975 and 1996. There were 45 males and 39 females, and the mean age was 72.4 years (range 65-86). Over half of the pituitary lesions were non-functioning adenomas (NFAs) (60.7%). GH-secreting tumours were present in 11 (13.1%) and macroprolactinomas in 7 (8.1%). Four patients had microadenomas and 17 had miscellaneous pituitary-related lesions. Visual deterioration was the commonest mode of presentation in 33 (39.3%), but 54 (64.3%) had evidence of visual impairment on detailed examination. Despite the majority of patients (80.8%) having coexisting medical conditions, trans-sphenoidal surgery was performed in 60 (71.4%) and was well tolerated with a zero peri- and post-operative mortality rate, and post-operative complications in 11 (13.1%). Pituitary tumours in the elderly are most frequently NFAs that present with visual deterioration and hypopituitarism. The fact that 46.5% were pan-hypopituitary on diagnosis and that 64.3% of patients had visual impairment suggests a delay in diagnosis in this age group. Despite significant coexisting medical pathology in this large series of patients, surgery was safe and successful in the majority.  (+info)

The expression of inhibin/activin subunits in the human adrenal cortex and its tumours. (8/758)

Inhibins and activins are dimeric proteins of the transforming growth factor-beta superfamily which have been shown to be expressed in the adrenal cortex. Recent studies have suggested a role for these peptides in the pathogenesis and/or function of adrenal tumours. To investigate further their physiological and pathological roles, we have documented immunoreactivity for inhibin alpha, betaA and betaB subunits in normal adult and fetal human adrenals, in hyperplastic adrenals and in adrenal tumours. In the normal and hyperplastic adult gland, diffuse immunopositivity was demonstrated for beta subunits, suggesting that activins (beta beta dimers) can be expressed in all zones. Inhibin alpha was limited to the zona reticularis and the innermost zona fasciculata in the normal gland, extending centripetally into the zona fasciculata in hyperplasia, supporting a role for ACTH in the regulation of expression, and suggesting that expression of inhibins (alpha beta dimers) is restricted. Immunopositivity for all three subunits was seen in both fetal and definitive zones of the fetal cortex, indicating that both inhibins and activins could be expressed in both. Immunopositivity for all three subunits was seen in most adrenocortical tumours. Loss of immunopositivity for inhibin alpha in a subgroup of carcinomas might indicate a role in tumour progression. The greater intensity of staining for inhibin alpha in tumours associated with Cushing's syndrome again suggests a link with cortisol production.  (+info)

Cushing syndrome is a hormonal disorder that occurs when your body is exposed to high levels of the hormone cortisol for a long time. This can happen due to various reasons such as taking high doses of corticosteroid medications or tumors that produce cortisol or adrenocorticotropic hormone (ACTH).

The symptoms of Cushing syndrome may include:

* Obesity, particularly around the trunk and upper body
* Thinning of the skin, easy bruising, and purple or red stretch marks on the abdomen, thighs, breasts, and arms
* Weakened bones, leading to fractures
* High blood pressure
* High blood sugar
* Mental changes such as depression, anxiety, and irritability
* Increased fatigue and weakness
* Menstrual irregularities in women
* Decreased fertility in men

Cushing syndrome can be diagnosed through various tests, including urine and blood tests to measure cortisol levels, saliva tests, and imaging tests to locate any tumors. Treatment depends on the cause of the condition but may include surgery, radiation therapy, chemotherapy, or adjusting medication dosages.

Adrenal cortex diseases refer to a group of conditions that affect the adrenal glands, which are small glands located on top of the kidneys. The adrenal glands consist of two parts: the outer adrenal cortex and the inner medulla. The adrenal cortex is responsible for producing hormones such as cortisol, aldosterone, and androgens that regulate various bodily functions, including metabolism, blood pressure, and sexual development.

Diseases of the adrenal cortex can result from an overproduction or underproduction of these hormones. Some common adrenal cortex diseases include:

1. Addison's disease: a condition characterized by insufficient production of hormones by the adrenal glands, leading to symptoms such as fatigue, weight loss, low blood pressure, and darkening of the skin.
2. Cushing's syndrome: a condition caused by an excess of cortisol in the body, which can result from taking high doses of corticosteroid medications or from a tumor in the pituitary gland or adrenal glands. Symptoms include weight gain, particularly around the trunk and face, thinning of the skin, easy bruising, muscle weakness, and mood changes.
3. Congenital adrenal hyperplasia: a group of inherited disorders that affect the production of hormones by the adrenal glands. Depending on the specific type of congenital adrenal hyperplasia, symptoms can range from ambiguous genitalia in newborns to precocious puberty, short stature, and infertility in older children and adults.
4. Adrenal tumors: benign or cancerous growths that develop in the adrenal glands and can cause hormonal imbalances. Symptoms depend on the type of tumor and the hormones it produces.

Treatment for adrenal cortex diseases depends on the specific condition and its underlying cause. Treatment options may include medication, surgery, or radiation therapy.

Adrenal gland diseases refer to a group of medical conditions that affect the function or structure of the adrenal glands. The adrenal glands are small, triangular-shaped glands located on top of each kidney. They are responsible for producing several essential hormones, including cortisol, aldosterone, and adrenaline (epinephrine).

There are various types of adrenal gland diseases, some of which include:

1. Adrenal Insufficiency: A condition where the adrenal glands do not produce enough hormones, particularly cortisol and aldosterone. This can lead to symptoms such as fatigue, weight loss, low blood pressure, and skin hyperpigmentation.
2. Cushing's Syndrome: A condition characterized by an excess of cortisol in the body. It can be caused by a tumor in the pituitary gland or adrenal glands, or it can result from long-term use of steroid medications.
3. Adrenal Cancer: A rare type of cancer that affects the adrenal glands. Symptoms may include abdominal pain, weight loss, and high blood pressure.
4. Pheochromocytoma: A tumor that develops in the adrenal glands and causes an overproduction of adrenaline (epinephrine) and noradrenaline (norepinephrine). Symptoms may include high blood pressure, headaches, sweating, and anxiety.
5. Adrenal Hemorrhage: A condition where bleeding occurs in the adrenal glands, often as a result of severe trauma or infection. This can lead to adrenal insufficiency and other complications.
6. Congenital Adrenal Hyperplasia: An inherited disorder that affects the production of cortisol and other hormones in the adrenal glands. Symptoms may include ambiguous genitalia, precocious puberty, and short stature.

Treatment for adrenal gland diseases varies depending on the specific condition and its severity. Treatment options may include medication, surgery, or radiation therapy.

Pituitary ACTH hypersecretion, also known as Cushing's disease, is a condition characterized by the excessive production of adrenocorticotropic hormone (ACTH) from the pituitary gland. This results in an overproduction of cortisol, a steroid hormone produced by the adrenal glands, leading to a constellation of symptoms known as Cushing's syndrome.

In Cushing's disease, a benign tumor called an adenoma develops on the pituitary gland, causing it to release excess ACTH. This in turn stimulates the adrenal glands to produce more cortisol than necessary. The resulting high levels of cortisol can cause various symptoms such as weight gain, particularly around the trunk and face (central obesity), thinning of the skin, bruising, weakness, fatigue, mood changes, high blood pressure, and an increased risk of infections.

It is important to distinguish Cushing's disease from other causes of Cushing's syndrome, such as cortisol-producing adrenal tumors or exogenous sources of corticosteroid use, as the treatment approach may differ. Treatment for Cushing's disease typically involves surgical removal of the pituitary tumor, with additional medical management and/or radiation therapy in some cases.

Carney Complex is a rare genetic disorder characterized by the development of various types of tumors and pigmented spots on the skin. It is caused by mutations in the PRKAR1A gene, which regulates the activity of enzymes involved in cell growth and division. The condition is typically inherited in an autosomal dominant manner, meaning that a child has a 50% chance of inheriting the disorder if one parent has it.

The tumors associated with Carney Complex can develop in various parts of the body, including the heart, endocrine glands, and skin. Some common types of tumors include:

* Myxomas: benign tumors that typically develop in the heart, but can also occur in other parts of the body
* Pigmented nodular adrenocortical disease (PNAD): benign tumors that develop in the adrenal glands and produce excess hormones
* Thyroid tumors: benign or malignant tumors that develop in the thyroid gland
* Breast tumors: benign or malignant tumors that develop in the breast
* Skin tumors: including pigmented spots, skin tags, and growths

People with Carney Complex may also experience other symptoms such as Cushing's syndrome (a hormonal disorder caused by excess cortisol), acromegaly (a hormonal disorder caused by excess growth hormone), and various endocrine disorders.

Treatment for Carney Complex typically involves surgical removal of tumors when necessary, as well as monitoring for the development of new tumors and other symptoms. Regular follow-up with a healthcare provider is important to manage the condition and prevent complications.

17-Hydroxycorticosteroids are a class of steroid hormones that are produced in the adrenal gland. They are formed from the metabolism of cortisol, which is a hormone that helps regulate metabolism, immune response, and stress response. 17-Hydroxycorticosteroids include compounds such as cortisone and corticosterone.

These hormones have various functions in the body, including:

* Regulation of carbohydrate, fat, and protein metabolism
* Suppression of the immune system
* Modulation of the stress response
* Influence on blood pressure and electrolyte balance

Abnormal levels of 17-hydroxycorticosteroids can indicate problems with the adrenal gland or pituitary gland, which regulates adrenal function. They are often measured in urine or blood tests to help diagnose conditions such as Cushing's syndrome (overproduction of cortisol) and Addison's disease (underproduction of cortisol).

Adrenocorticotropic Hormone (ACTH) is a hormone produced and released by the anterior pituitary gland, a small endocrine gland located at the base of the brain. ACTH plays a crucial role in the regulation of the body's stress response and has significant effects on various physiological processes.

The primary function of ACTH is to stimulate the adrenal glands, which are triangular-shaped glands situated on top of the kidneys. The adrenal glands consist of two parts: the outer cortex and the inner medulla. ACTH specifically targets the adrenal cortex, where it binds to specific receptors and initiates a series of biochemical reactions leading to the production and release of steroid hormones, primarily cortisol (a glucocorticoid) and aldosterone (a mineralocorticoid).

Cortisol is involved in various metabolic processes, such as regulating blood sugar levels, modulating the immune response, and helping the body respond to stress. Aldosterone plays a vital role in maintaining electrolyte and fluid balance by promoting sodium reabsorption and potassium excretion in the kidneys.

ACTH release is controlled by the hypothalamus, another part of the brain, which produces corticotropin-releasing hormone (CRH). CRH stimulates the anterior pituitary gland to secrete ACTH, which in turn triggers cortisol production in the adrenal glands. This complex feedback system helps maintain homeostasis and ensures that appropriate amounts of cortisol are released in response to various physiological and psychological stressors.

Disorders related to ACTH can lead to hormonal imbalances, resulting in conditions such as Cushing's syndrome (excessive cortisol production) or Addison's disease (insufficient cortisol production). Proper diagnosis and management of these disorders typically involve assessing the function of the hypothalamic-pituitary-adrenal axis and addressing any underlying issues affecting ACTH secretion.

A syndrome, in medical terms, is a set of symptoms that collectively indicate or characterize a disease, disorder, or underlying pathological process. It's essentially a collection of signs and/or symptoms that frequently occur together and can suggest a particular cause or condition, even though the exact physiological mechanisms might not be fully understood.

For example, Down syndrome is characterized by specific physical features, cognitive delays, and other developmental issues resulting from an extra copy of chromosome 21. Similarly, metabolic syndromes like diabetes mellitus type 2 involve a group of risk factors such as obesity, high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that collectively increase the risk of heart disease, stroke, and diabetes.

It's important to note that a syndrome is not a specific diagnosis; rather, it's a pattern of symptoms that can help guide further diagnostic evaluation and management.

Adrenalectomy is a surgical procedure in which one or both adrenal glands are removed. The adrenal glands are small, triangular-shaped glands located on top of each kidney that produce hormones such as cortisol, aldosterone, and adrenaline (epinephrine).

There are several reasons why an adrenalectomy may be necessary. For example, the procedure may be performed to treat tumors or growths on the adrenal glands, such as pheochromocytomas, which can cause high blood pressure and other symptoms. Adrenalectomy may also be recommended for patients with Cushing's syndrome, a condition in which the body is exposed to too much cortisol, or for those with adrenal cancer.

During an adrenalectomy, the surgeon makes an incision in the abdomen or back and removes the affected gland or glands. In some cases, laparoscopic surgery may be used, which involves making several small incisions and using specialized instruments to remove the gland. After the procedure, patients may need to take hormone replacement therapy to compensate for the loss of adrenal gland function.

Adrenal gland neoplasms refer to abnormal growths or tumors in the adrenal glands. These glands are located on top of each kidney and are responsible for producing hormones that regulate various bodily functions such as metabolism, blood pressure, and stress response. Adrenal gland neoplasms can be benign (non-cancerous) or malignant (cancerous).

Benign adrenal tumors are called adenomas and are usually small and asymptomatic. However, some adenomas may produce excessive amounts of hormones, leading to symptoms such as high blood pressure, weight gain, and mood changes.

Malignant adrenal tumors are called adrenocortical carcinomas and are rare but aggressive cancers that can spread to other parts of the body. Symptoms of adrenocortical carcinoma may include abdominal pain, weight loss, and hormonal imbalances.

It is important to diagnose and treat adrenal gland neoplasms early to prevent complications and improve outcomes. Diagnostic tests may include imaging studies such as CT scans or MRIs, as well as hormone level testing and biopsy. Treatment options may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.

Adrenal cortex function tests are a group of diagnostic tests that evaluate the proper functioning of the adrenal cortex, which is the outer layer of the adrenal glands. These glands are located on top of each kidney and are responsible for producing several essential hormones. The adrenal cortex produces hormones such as cortisol, aldosterone, and androgens.

There are several types of adrenal cortex function tests, including:

1. Cortisol testing: This test measures the levels of cortisol in the blood or urine to determine if the adrenal glands are producing adequate amounts of this hormone. Cortisol helps regulate metabolism, immune response, and stress response.
2. ACTH (adrenocorticotropic hormone) stimulation test: This test measures the adrenal gland's response to ACTH, a hormone produced by the pituitary gland that stimulates the adrenal glands to produce cortisol. The test involves administering synthetic ACTH and measuring cortisol levels before and after administration.
3. Aldosterone testing: This test measures the levels of aldosterone in the blood or urine to determine if the adrenal glands are producing adequate amounts of this hormone. Aldosterone helps regulate electrolyte balance and blood pressure.
4. Dexamethasone suppression test: This test involves administering dexamethasone, a synthetic corticosteroid, to suppress cortisol production. The test measures cortisol levels before and after administration to determine if the adrenal glands are overproducing cortisol.
5. Androgen testing: This test measures the levels of androgens, such as testosterone and dehydroepiandrosterone (DHEA), in the blood or urine to determine if the adrenal glands are producing excessive amounts of these hormones.

Abnormal results from adrenal cortex function tests may indicate conditions such as Addison's disease, Cushing's syndrome, congenital adrenal hyperplasia, and pheochromocytoma.

Esthesioneuroblastoma, also known as olfactory neuroblastoma, is a rare type of malignant tumor that develops in the upper part of the nasal cavity, near the area responsible for the sense of smell (olfaction). It arises from the olfactory nerve cells and typically affects adults between 20 to 50 years old, although it can occur at any age.

Esthesioneuroblastomas are characterized by their aggressive growth and potential to spread to other parts of the head and neck, as well as distant organs such as the lungs, bones, and bone marrow. Symptoms may include nasal congestion, nosebleeds, loss of smell, facial pain or numbness, bulging eyes, and visual disturbances.

Diagnosis is usually made through a combination of clinical examination, imaging studies (such as MRI or CT scans), and biopsy. Treatment typically involves surgical resection of the tumor, followed by radiation therapy and/or chemotherapy to reduce the risk of recurrence. Regular follow-up care is essential due to the possibility of late relapse.

Overall, prognosis varies depending on factors such as the stage of the disease at diagnosis, the patient's age, and the effectiveness of treatment. While some individuals may experience long-term survival or even cure, others may face more aggressive tumor behavior and a higher risk of recurrence.

Adrenal cortex neoplasms refer to abnormal growths (tumors) in the adrenal gland's outer layer, known as the adrenal cortex. These neoplasms can be benign or malignant (cancerous). Benign tumors are called adrenal adenomas, while cancerous tumors are called adrenocortical carcinomas.

Adrenal cortex neoplasms can produce various hormones, leading to different clinical presentations. For instance, they may cause Cushing's syndrome (characterized by excessive cortisol production), Conn's syndrome (caused by aldosterone excess), or virilization (due to androgen excess). Some tumors may not produce any hormones and are discovered incidentally during imaging studies for unrelated conditions.

The diagnosis of adrenal cortex neoplasms typically involves a combination of imaging techniques, such as CT or MRI scans, and hormonal assessments to determine if the tumor is functional or non-functional. In some cases, a biopsy may be necessary to confirm the diagnosis and differentiate between benign and malignant tumors. Treatment options depend on the type, size, location, and hormonal activity of the neoplasm and may include surgical excision, radiation therapy, chemotherapy, or a combination of these approaches.

Pituitary neoplasms refer to abnormal growths or tumors in the pituitary gland, a small endocrine gland located at the base of the brain. These neoplasms can be benign (non-cancerous) or malignant (cancerous), with most being benign. They can vary in size and may cause various symptoms depending on their location, size, and hormonal activity.

Pituitary neoplasms can produce and secrete excess hormones, leading to a variety of endocrine disorders such as Cushing's disease (caused by excessive ACTH production), acromegaly (caused by excessive GH production), or prolactinoma (caused by excessive PRL production). They can also cause local compression symptoms due to their size, leading to headaches, vision problems, and cranial nerve palsies.

The exact causes of pituitary neoplasms are not fully understood, but genetic factors, radiation exposure, and certain inherited conditions may increase the risk of developing these tumors. Treatment options for pituitary neoplasms include surgical removal, radiation therapy, and medical management with drugs that can help control hormonal imbalances.

Cyclic AMP-dependent protein kinase RIα subunit, also known as PKA RIα or PRKAR1A, is a type of regulatory subunit of the cyclic AMP (cAMP)-dependent protein kinase (PKA) enzyme. PKA is a key enzyme in many cellular signaling pathways and is composed of two regulatory subunits and two catalytic subunits. The RIα subunit is one of the four different regulatory subunits (RIα, RIβ, RIIα, and RIIβ) that regulate PKA activity by binding to cAMP, which leads to the release and activation of the catalytic subunits.

The RIα subunit is encoded by the PRKAR1A gene and is primarily expressed in many tissues, including the brain, heart, and adrenal glands. Mutations in the PRKAR1A gene have been associated with several genetic disorders, such as Carney Complex, a rare autosomal dominant disorder characterized by multiple tumors and endocrine overactivity. The RIα subunit plays an essential role in regulating various cellular processes, including metabolism, differentiation, proliferation, and apoptosis.

Hydrocortisone is a synthetic glucocorticoid, which is a class of steroid hormones. It is identical to the naturally occurring cortisol, a hormone produced by the adrenal gland that helps regulate metabolism and helps your body respond to stress. Hydrocortisone has anti-inflammatory effects and is used to treat various inflammatory conditions such as allergies, skin disorders, and autoimmune diseases. It works by suppressing the immune system's response to reduce swelling, redness, itching, and other symptoms caused by inflammation.

Hydrocortisone is available in different forms, including oral tablets, topical creams, lotions, gels, and ointments, as well as injectable solutions. The specific use and dosage depend on the condition being treated and the individual patient's medical history and current health status.

As with any medication, hydrocortisone can have side effects, especially when used in high doses or for extended periods. Common side effects include increased appetite, weight gain, mood changes, insomnia, and skin thinning. Long-term use of hydrocortisone may also increase the risk of developing osteoporosis, diabetes, cataracts, and other health problems. Therefore, it is essential to follow your healthcare provider's instructions carefully when using this medication.

Pituitary function tests are a group of diagnostic exams that evaluate the proper functioning of the pituitary gland, a small endocrine gland located at the base of the brain. The pituitary gland is responsible for producing and releasing several essential hormones that regulate various bodily functions, including growth, metabolism, stress response, reproduction, and lactation.

These tests typically involve measuring the levels of different hormones in the blood, stimulating or suppressing the pituitary gland with specific medications, and assessing the body's response to these challenges. Some common pituitary function tests include:

1. Growth hormone (GH) testing: Measures GH levels in the blood, often after a provocative test using substances like insulin, arginine, clonidine, or glucagon to stimulate GH release.
2. Thyroid-stimulating hormone (TSH) and free thyroxine (FT4) testing: Assesses the function of the thyroid gland by measuring TSH and FT4 levels in response to TRH (thyrotropin-releasing hormone) stimulation.
3. Adrenocorticotropic hormone (ACTH) and cortisol testing: Evaluates the hypothalamic-pituitary-adrenal axis by measuring ACTH and cortisol levels after a CRH (corticotropin-releasing hormone) stimulation test or an insulin tolerance test.
4. Prolactin (PRL) testing: Measures PRL levels in the blood, which can be elevated due to pituitary tumors or other conditions affecting the hypothalamus.
5. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) testing: Assesses reproductive function by measuring FSH and LH levels, often in conjunction with estradiol or testosterone levels.
6. Gonadotropin-releasing hormone (GnRH) stimulation test: Evaluates gonadal function by measuring FSH and LH levels after GnRH administration.
7. Growth hormone (GH) testing: Measures GH levels in response to various stimuli, such as insulin-like growth factor-1 (IGF-1), glucagon, or arginine.
8. Vasopressin (ADH) testing: Assesses the posterior pituitary function by measuring ADH levels and performing a water deprivation test.

These tests can help diagnose various pituitary disorders, such as hypopituitarism, hyperpituitarism, or pituitary tumors, and guide appropriate treatment strategies.

An adrenocortical adenoma is a benign tumor that arises from the cells of the adrenal cortex, which is the outer layer of the adrenal gland. These tumors can produce and release various hormones, such as cortisol, aldosterone, or androgens, depending on the type of cells they originate from.

Most adrenocortical adenomas are nonfunctioning, meaning that they do not secrete excess hormones and may not cause any symptoms. However, some functioning adenomas can produce excessive amounts of hormones, leading to a variety of clinical manifestations. For example:

* Cortisol-secreting adenomas can result in Cushing's syndrome, characterized by weight gain, muscle wasting, thin skin, easy bruising, and mood changes.
* Aldosterone-producing adenomas can cause Conn's syndrome, marked by hypertension (high blood pressure), hypokalemia (low potassium levels), and metabolic alkalosis.
* Androgen-secreting adenomas may lead to hirsutism (excessive hair growth) or virilization (development of male secondary sexual characteristics) in women.

The diagnosis of an adrenocortical adenoma typically involves imaging tests, such as CT or MRI scans, and hormonal evaluations to determine if the tumor is functioning or not. Treatment usually consists of surgical removal of the tumor, especially if it is causing hormonal imbalances or growing in size.

The adrenal glands are a pair of endocrine glands that are located on top of the kidneys. Each gland has two parts: the outer cortex and the inner medulla. The adrenal cortex produces hormones such as cortisol, aldosterone, and androgens, which regulate metabolism, blood pressure, and other vital functions. The adrenal medulla produces catecholamines, including epinephrine (adrenaline) and norepinephrine (noradrenaline), which help the body respond to stress by increasing heart rate, blood pressure, and alertness.

Ectopic ACTH syndrome is a medical condition characterized by the excessive production of adrenocorticotropic hormone (ACTH) from a source outside of the pituitary gland, typically from a tumor in another part of the body. The most common sources of ectopic ACTH are small-cell lung carcinomas, but it can also occur with other types of tumors such as thymic carcinoids, pancreatic islet cell tumors, and bronchial carcinoids.

The excessive production of ACTH leads to an overproduction of cortisol from the adrenal glands, resulting in a constellation of symptoms known as Cushing's syndrome. These symptoms can include weight gain, muscle weakness, thinning of the skin, easy bruising, mood changes, and high blood pressure, among others.

Ectopic ACTH syndrome is typically more severe than pituitary-dependent Cushing's syndrome, and it may be more difficult to diagnose and treat due to the underlying tumor causing the excessive ACTH production. Treatment usually involves removing the tumor or controlling its growth, as well as managing the symptoms of Cushing's syndrome with medications that block cortisol production or action.

Iatrogenic disease refers to any condition or illness that is caused, directly or indirectly, by medical treatment or intervention. This can include adverse reactions to medications, infections acquired during hospitalization, complications from surgical procedures, or injuries caused by medical equipment. It's important to note that iatrogenic diseases are unintended and often preventable with proper care and precautions.

Hypophysectomy is a surgical procedure that involves the removal or partial removal of the pituitary gland, also known as the hypophysis. The pituitary gland is a small endocrine gland located at the base of the brain, just above the nasal cavity, and is responsible for producing and secreting several important hormones that regulate various bodily functions.

Hypophysectomy may be performed for therapeutic or diagnostic purposes. In some cases, it may be used to treat pituitary tumors or other conditions that affect the function of the pituitary gland. It may also be performed as a research procedure in animal models to study the effects of pituitary hormone deficiency on various physiological processes.

The surgical approach for hypophysectomy may vary depending on the specific indication and the patient's individual anatomy. In general, however, the procedure involves making an incision in the skull and exposing the pituitary gland through a small opening in the bone. The gland is then carefully dissected and removed or partially removed as necessary.

Potential complications of hypophysectomy include damage to surrounding structures such as the optic nerves, which can lead to vision loss, and cerebrospinal fluid leaks. Additionally, removal of the pituitary gland can result in hormonal imbalances that may require long-term management with hormone replacement therapy.

An adenoma is a benign (noncancerous) tumor that develops from glandular epithelial cells. These types of cells are responsible for producing and releasing fluids, such as hormones or digestive enzymes, into the surrounding tissues. Adenomas can occur in various organs and glands throughout the body, including the thyroid, pituitary, adrenal, and digestive systems.

Depending on their location, adenomas may cause different symptoms or remain asymptomatic. Some common examples of adenomas include:

1. Colorectal adenoma (also known as a polyp): These growths occur in the lining of the colon or rectum and can develop into colorectal cancer if left untreated. Regular screenings, such as colonoscopies, are essential for early detection and removal of these polyps.
2. Thyroid adenoma: This type of adenoma affects the thyroid gland and may result in an overproduction or underproduction of hormones, leading to conditions like hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid).
3. Pituitary adenoma: These growths occur in the pituitary gland, which is located at the base of the brain and controls various hormonal functions. Depending on their size and location, pituitary adenomas can cause vision problems, headaches, or hormonal imbalances that affect growth, reproduction, and metabolism.
4. Liver adenoma: These rare benign tumors develop in the liver and may not cause any symptoms unless they become large enough to press on surrounding organs or structures. In some cases, liver adenomas can rupture and cause internal bleeding.
5. Adrenal adenoma: These growths occur in the adrenal glands, which are located above the kidneys and produce hormones that regulate stress responses, metabolism, and blood pressure. Most adrenal adenomas are nonfunctioning, meaning they do not secrete excess hormones. However, functioning adrenal adenomas can lead to conditions like Cushing's syndrome or Conn's syndrome, depending on the type of hormone being overproduced.

It is essential to monitor and manage benign tumors like adenomas to prevent potential complications, such as rupture, bleeding, or hormonal imbalances. Treatment options may include surveillance with imaging studies, medication to manage hormonal issues, or surgical removal of the tumor in certain cases.

The adrenal cortex is the outer portion of the adrenal gland, which is located on top of the kidneys. It plays a crucial role in producing hormones that are essential for various bodily functions. The adrenal cortex is divided into three zones:

1. Zona glomerulosa: This outermost zone produces mineralocorticoids, primarily aldosterone. Aldosterone helps regulate sodium and potassium balance and thus influences blood pressure by controlling the amount of fluid in the body.
2. Zona fasciculata: The middle layer is responsible for producing glucocorticoids, with cortisol being the most important one. Cortisol regulates metabolism, helps manage stress responses, and has anti-inflammatory properties. It also plays a role in blood sugar regulation and maintaining the body's response to injury and illness.
3. Zona reticularis: The innermost zone produces androgens, primarily dehydroepiandrosterone (DHEA) and its sulfate form (DHEAS). These androgens are weak compared to those produced by the gonads (ovaries or testes), but they can be converted into more potent androgens or estrogens in peripheral tissues.

Disorders related to the adrenal cortex can lead to hormonal imbalances, affecting various bodily functions. Examples include Addison's disease (insufficient adrenal cortical hormone production) and Cushing's syndrome (excessive glucocorticoid levels).

Corticotropin-Releasing Hormone (CRH) is a hormone that is produced and released by the hypothalamus, a small gland located in the brain. CRH plays a critical role in the body's stress response system.

When the body experiences stress, the hypothalamus releases CRH, which then travels to the pituitary gland, another small gland located at the base of the brain. Once there, CRH stimulates the release of adrenocorticotropic hormone (ACTH) from the pituitary gland.

ACTH then travels through the bloodstream to the adrenal glands, which are located on top of the kidneys. ACTH stimulates the adrenal glands to produce and release cortisol, a hormone that helps the body respond to stress by regulating metabolism, immune function, and blood pressure, among other things.

Overall, CRH is an important part of the hypothalamic-pituitary-adrenal (HPA) axis, which regulates many bodily functions related to stress response, mood, and cognition. Dysregulation of the HPA axis and abnormal levels of CRH have been implicated in various psychiatric and medical conditions, including depression, anxiety disorders, post-traumatic stress disorder (PTSD), and Cushing's syndrome.

Abdominal fat, also known as visceral fat, is the fat that is stored in the abdominal cavity and surrounds the internal organs such as the liver, pancreas, and intestines. It is different from subcutaneous fat, which is the fat located just under the skin, and is often measured using techniques such as CT scans or MRI to assess health risks. Excess abdominal fat has been linked to an increased risk of various health conditions, including type 2 diabetes, heart disease, and stroke.

Abdominal obesity is a type of obesity that is defined by an excessive accumulation of fat in the abdominal region. It is often assessed through the measurement of waist circumference or the waist-to-hip ratio. Abdominal obesity has been linked to an increased risk of various health conditions, including type 2 diabetes, cardiovascular disease, and certain types of cancer.

In medical terms, abdominal obesity is also known as central obesity or visceral obesity. It is characterized by the accumulation of fat around internal organs in the abdomen, such as the liver and pancreas, rather than just beneath the skin (subcutaneous fat). This type of fat distribution is thought to be more harmful to health than the accumulation of fat in other areas of the body.

Abdominal obesity can be caused by a variety of factors, including genetics, lifestyle choices, and certain medical conditions. Treatment typically involves making lifestyle changes, such as eating a healthy diet and getting regular exercise, as well as addressing any underlying medical conditions that may be contributing to the problem. In some cases, medication or surgery may also be recommended.

An ACTH-secreting pituitary adenoma is a type of tumor that develops in the pituitary gland, a small gland located at the base of the brain. This type of tumor is also known as Cushing's disease.

ACTH stands for adrenocorticotropic hormone, which is a hormone produced and released by the pituitary gland. ACTH stimulates the adrenal glands (small glands located on top of the kidneys) to produce cortisol, a steroid hormone that helps regulate metabolism, helps the body respond to stress, and suppresses inflammation.

In an ACTH-secreting pituitary adenoma, the tumor cells produce and release excessive amounts of ACTH, leading to overproduction of cortisol by the adrenal glands. This can result in a constellation of symptoms known as Cushing's syndrome, which may include weight gain (especially around the trunk), fatigue, muscle weakness, mood changes, thinning of the skin, easy bruising, and increased susceptibility to infections.

Treatment for an ACTH-secreting pituitary adenoma typically involves surgical removal of the tumor, followed by medications to manage cortisol levels if necessary. Radiation therapy may also be used in some cases.

Pituitary irradiation is a medical procedure that involves the use of targeted radiation therapy to treat conditions affecting the pituitary gland, a small endocrine gland located at the base of the brain. The pituitary gland controls various hormonal functions in the body, and any abnormalities or tumors in this area can lead to hormonal imbalances and other related health issues.

In pituitary irradiation, a radiation oncologist uses external beam radiation therapy (EBRT) to deliver precise and focused doses of high-energy radiation to the pituitary gland. The goal is to destroy or shrink the tumor while minimizing damage to surrounding healthy tissues. This procedure can be used as a primary treatment option, an adjuvant therapy following surgery, or in cases where surgical intervention is not feasible or has been unsuccessful.

The effects of pituitary irradiation on hormone production may take months or even years to manifest fully. Patients will typically require regular follow-ups with their healthcare team to monitor hormonal levels and manage any potential side effects, which can include fatigue, headaches, vision changes, and cognitive impairment. In some cases, hormone replacement therapy might be necessary to address hormonal deficiencies resulting from the treatment.

Down syndrome is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is characterized by intellectual and developmental disabilities, distinctive facial features, and sometimes physical growth delays and health problems. The condition affects approximately one in every 700 babies born in the United States.

Individuals with Down syndrome have varying degrees of cognitive impairment, ranging from mild to moderate or severe. They may also have delayed development, including late walking and talking, and may require additional support and education services throughout their lives.

People with Down syndrome are at increased risk for certain health conditions, such as congenital heart defects, respiratory infections, hearing loss, vision problems, gastrointestinal issues, and thyroid disorders. However, many individuals with Down syndrome live healthy and fulfilling lives with appropriate medical care and support.

The condition is named after John Langdon Down, an English physician who first described the syndrome in 1866.

Metabolic syndrome, also known as Syndrome X, is a cluster of conditions that increase the risk of heart disease, stroke, and diabetes. It is not a single disease but a group of risk factors that often co-occur. According to the American Heart Association and the National Heart, Lung, and Blood Institute, a person has metabolic syndrome if they have any three of the following five conditions:

1. Abdominal obesity (waist circumference of 40 inches or more in men, and 35 inches or more in women)
2. Triglyceride level of 150 milligrams per deciliter of blood (mg/dL) or greater
3. HDL cholesterol level of less than 40 mg/dL in men or less than 50 mg/dL in women
4. Systolic blood pressure of 130 millimeters of mercury (mmHg) or greater, or diastolic blood pressure of 85 mmHg or greater
5. Fasting glucose level of 100 mg/dL or greater

Metabolic syndrome is thought to be caused by a combination of genetic and lifestyle factors, such as physical inactivity and a diet high in refined carbohydrates and unhealthy fats. Treatment typically involves making lifestyle changes, such as eating a healthy diet, getting regular exercise, and losing weight if necessary. In some cases, medication may also be needed to manage individual components of the syndrome, such as high blood pressure or high cholesterol.

Paraganglioma, extra-adrenal, is a type of rare tumor that develops in the nervous system's paraganglia, which are groups of specialized cells that are responsible for regulating blood pressure and other bodily functions. Unlike adrenal paragangliomas, which form in the adrenal glands located on top of the kidneys, extra-adrenal paragangliomas develop outside of the adrenal glands, in various locations along the sympathetic and parasympathetic nervous systems. These tumors can be functional or nonfunctional, meaning they may or may not produce hormones such as catecholamines (epinephrine, norepinephrine, and dopamine). Functional extra-adrenal paragangliomas can cause symptoms related to excessive hormone production, including hypertension, sweating, headaches, and rapid heartbeat. Treatment typically involves surgical removal of the tumor, along with preoperative preparation to manage potential hormonal imbalances.

Follow-up studies are a type of longitudinal research that involve repeated observations or measurements of the same variables over a period of time, in order to understand their long-term effects or outcomes. In medical context, follow-up studies are often used to evaluate the safety and efficacy of medical treatments, interventions, or procedures.

In a typical follow-up study, a group of individuals (called a cohort) who have received a particular treatment or intervention are identified and then followed over time through periodic assessments or data collection. The data collected may include information on clinical outcomes, adverse events, changes in symptoms or functional status, and other relevant measures.

The results of follow-up studies can provide important insights into the long-term benefits and risks of medical interventions, as well as help to identify factors that may influence treatment effectiveness or patient outcomes. However, it is important to note that follow-up studies can be subject to various biases and limitations, such as loss to follow-up, recall bias, and changes in clinical practice over time, which must be carefully considered when interpreting the results.

Central serous chorioretinopathy (CSC) is a medical condition that affects the eye, specifically the retina and the choroid. The choroid is the layer of blood vessels that supplies oxygen and nutrients to the retina. In CSC, there is a buildup of fluid under the retina, leading to distortion or loss of vision.

The term "central" in CSC refers to the fact that the fluid accumulation occurs in the central part of the retina, called the macula, which is responsible for sharp, detailed vision. The term "serous" indicates that the fluid accumulation is made up of serum, the clear portion of blood.

CSC is more common in middle-aged men and can be associated with stress, corticosteroid use, and certain medical conditions such as hypertension and sleep apnea. In many cases, CSC resolves on its own within a few months without treatment. However, some people may experience recurrent episodes or develop chronic CSC, which can lead to permanent vision loss if left untreated. Treatment options for CSC include laser therapy, photodynamic therapy, and medication.

Nephrotic syndrome is a group of symptoms that indicate kidney damage, specifically damage to the glomeruli—the tiny blood vessel clusters in the kidneys that filter waste and excess fluids from the blood. The main features of nephrotic syndrome are:

1. Proteinuria (excess protein in urine): Large amounts of a protein called albumin leak into the urine due to damaged glomeruli, which can't properly filter proteins. This leads to low levels of albumin in the blood, causing fluid buildup and swelling.
2. Hypoalbuminemia (low blood albumin levels): As albumin leaks into the urine, the concentration of albumin in the blood decreases, leading to hypoalbuminemia. This can cause edema (swelling), particularly in the legs, ankles, and feet.
3. Edema (fluid retention and swelling): With low levels of albumin in the blood, fluids move into the surrounding tissues, causing swelling or puffiness. The swelling is most noticeable around the eyes, face, hands, feet, and abdomen.
4. Hyperlipidemia (high lipid/cholesterol levels): The kidneys play a role in regulating lipid metabolism. Damage to the glomeruli can lead to increased lipid production and high cholesterol levels in the blood.

Nephrotic syndrome can result from various underlying kidney diseases, such as minimal change disease, membranous nephropathy, or focal segmental glomerulosclerosis. Treatment depends on the underlying cause and may include medications to control inflammation, manage high blood pressure, and reduce proteinuria. In some cases, dietary modifications and lifestyle changes are also recommended.

The cavernous sinus is a venous structure located in the middle cranial fossa, which is a depression in the skull that houses several important nerves and blood vessels. The cavernous sinus is situated on either side of the sphenoid bone, near the base of the skull, and it contains several important structures:

* The internal carotid artery, which supplies oxygenated blood to the brain
* The abducens nerve (cranial nerve VI), which controls lateral movement of the eye
* The oculomotor nerve (cranial nerve III), which controls most of the muscles that move the eye
* The trochlear nerve (cranial nerve IV), which controls one of the muscles that moves the eye
* The ophthalmic and maxillary divisions of the trigeminal nerve (cranial nerve V), which transmit sensory information from the face and head

The cavernous sinus is an important structure because it serves as a conduit for several critical nerves and blood vessels. However, it is also vulnerable to various pathological conditions such as thrombosis (blood clots), infection, tumors, or aneurysms, which can lead to serious neurological deficits or even death.

Sjögren's syndrome is a chronic autoimmune disorder in which the body's immune system mistakenly attacks its own moisture-producing glands, particularly the tear and salivary glands. This can lead to symptoms such as dry eyes, dry mouth, and dryness in other areas of the body. In some cases, it may also affect other organs, leading to a variety of complications.

There are two types of Sjögren's syndrome: primary and secondary. Primary Sjögren's syndrome occurs when the condition develops on its own, while secondary Sjögren's syndrome occurs when it develops in conjunction with another autoimmune disease, such as rheumatoid arthritis or lupus.

The exact cause of Sjögren's syndrome is not fully understood, but it is believed to involve a combination of genetic and environmental factors. Treatment typically focuses on relieving symptoms and may include artificial tears, saliva substitutes, medications to stimulate saliva production, and immunosuppressive drugs in more severe cases.

While all Cushing's disease gives Cushing's syndrome, not all Cushing's syndrome is due to Cushing's disease. Several possible ... Cushing's syndrome was first described by American neurosurgeon Harvey Cushing in 1932. Cushing's syndrome may also occur in ... "Cushing syndrome". mayoclinic.org. Mayo Clinic. Retrieved June 5, 2022. "Cushing's Syndrome". National Endocrine and Metabolic ... This is also known as Cushing's disease and is responsible for 70% of endogenous Cushing's syndrome. In adrenal Cushing's, ...
... and abnormal cortisol levels seen in Cushing's syndrome. However, pseudo-Cushing's syndrome is not caused by a problem with the ... excluding Cushing's Another cause for Cushing's syndrome is adrenocortical carcinoma. This is a rare form of cancer with an ... "The diagnosis and differential diagnosis of Cushing's syndrome and pseudo-Cushing's states". Endocrine Reviews. 19 (5): 647-72 ... Pseudo-Cushing's syndrome or non-neoplastic hypercortisolism is a medical condition in which patients display the signs, ...
The symptoms of Cushing's disease are similar to those seen in other causes of Cushing's syndrome. Patients with Cushing's ... The difference between Cushing's disease and other forms of Cushing's syndrome "The burden of Cushing's disease (CD): clinical ... Pituitary adenomas are responsible for 80% of endogenous Cushing's syndrome, when excluding Cushing's syndrome from exogenously ... it is hard to differentiate true Cushing's from pseudo-Cushing's (non-neoplastic hypercortisolism). Once Cushing's syndrome has ...
"Cushing's Syndrome". The Lecturio Medical Concept Library. Retrieved 11 July 2021. "Cushing's Syndrome". National Endocrine and ... Cushing's syndrome): excessive levels of cortisol Secondary hypercortisolism (pituitary tumor resulting in Cushing's disease, ... pseudo-Cushing's syndrome) Primary hypocortisolism (Addison's disease, Nelson's syndrome): insufficient levels of cortisol ... This form of the syndrome, known as Cushing's disease Forbis P (2005). Stedman's medical eponyms (2nd ed.). Baltimore, Md.: ...
"Cushing's Syndrome". www.niddk.nih.gov. Retrieved 2015-08-25. Laws, Edward; Ezzat, Shereen; Asa, Sylvia; Rio, Linda (2013-02-21 ... For Cushing's disease there is surgery to extract the tumor; after surgery, the gland may slowly start to work again, though ... Cushing's disease diagnosis is done with a physical examination, laboratory tests and X rays of the pituitary glands (to locate ... MedlinePlus Encyclopedia: Cushing disease Handbook of Medical-surgical Nursing. Lippincott Williams & Wilkins. 2006-01-01. ISBN ...
Extensive granuloma formations may occur in patients with immune deficiencies (e.g. Cushing syndrome). Immunodeficient neonates ...
Cushing's syndrome Nephrotic syndrome has many causes and may either be the result of a glomerular disease that can be either ... "Cushing's Syndrome". The Lecturio Medical Concept Library. Retrieved 11 July 2021. "Ascites". The Lecturio Medical Concept ... A broad classification of nephrotic syndrome based on underlying cause: Nephrotic syndrome is often classified histologically: ... called secondary nephrotic syndrome. Primary causes of nephrotic syndrome are usually described by their histology: Minimal ...
"Cushing's Syndrome". The Lecturio Medical Concept Library. Retrieved 28 September 2021. PDQ Adult Treatment Editorial Board ( ... There may be associated atypical carcinoid syndrome, acromegaly, Cushing disease, other endocrine disorders, telangiectasia, or ... that can cause Cushing's syndrome. Occasionally, haemorrhage or the effects of tumor bulk are the presenting symptoms. Bowel ... and Cushing's syndrome. Some are asymptomatic.[citation needed]Animal neuroendocrine tumors include neuroendocrine cancer of ...
Several mutations in PRKACA have been found in patients with Cushing's syndrome that result in an increase in the ability of ... Lacroix A, Feelders RA, Stratakis CA, Nieman LK (Aug 2015). "Cushing's syndrome". Lancet. 386 (9996): 913-27. doi:10.1016/S0140 ... specifically Long QT syndrome. This results in irregular heartbeats that can cause sudden death. Mutations in the PRKACA gene ...
179-. ISBN 978-94-015-7190-6. D. T. Krieger (2012). Cushing's Syndrome. Springer Science & Business Media. pp. 200-201. ISBN ... Cushing's syndrome, breast cancer, and prostate cancer, among other indications. It has also been used by bodybuilders, ... anticonvulsant in the treatment of petit mal epilepsy and as a steroidogenesis inhibitor in the treatment of Cushing's syndrome ... ISBN 978-1-60327-829-4. Gross BA, Mindea SA, Pick AJ, Chandler JP, Batjer HH (2007). "Medical management of Cushing disease". ...
It is also called von Rokitansky-Cushing syndrome. Apart from the stomach, ulcers may also develop in the proximal duodenum and ... A Cushing ulcer, named after Harvey Cushing, is a gastric ulcer associated with elevated intracranial pressure. ... As Cushing ulcers have a higher incidence of developing after shock, sepsis or trauma, diagnosis should include recent medical ... Most episodes of Cushing ulceration resolve on medical intervention, consisting primarily of rinsing the area with saline and ...
The advice does not affect topical ketoconazole products, and the oral use of the drug for Cushing's syndrome. Cautions Avoid ... "Cushing syndrome - Symptoms and causes". Mayo Clinic. Retrieved 2022-04-23. "Polyenes - an overview , ScienceDirect Topics". ...
She was later diagnosed with Cushing's Syndrome, a side effect from her medication. On November 30, 2019, she returned to ... "Janine Berdin develops vocal nodules; gets treated for Cushing's Syndrome". YahooNews. November 3, 2019. Retrieved December 3, ... "Janine Berdin is being treated for Cushing's Syndrome". YahooNews. October 31, 2019. Retrieved December 3, 2019. "Janine Berdin ...
Coagulopathy can be caused by thinning of the skin (Cushing's syndrome), such that the skin is weakened and is bruised easily ... Douglas H (April 1949). "Cushing' Syndrome and Thymic Carcinoma". QJM: An International Journal of Medicine. 18 (2): 133-147. ... Rare examples are Bernard-Soulier syndrome, Wiskott-Aldrich syndrome and Glanzmann's thrombasthenia. Gene therapy treatments ... such as in Cushing's syndrome.[citation needed] Some people lack genes that typically produce the protein coagulation factors ...
Most common cause of ACTH-independent Cushing's syndrome Hyperplasia Adrenal tumor Cushing's syndrome Conn's syndrome ... "ACTH-dependent Cushing's syndrome" caused by pituitary adenomas. In contrast, "Cushing's syndrome" refers specifically to " ... "Cushing's syndrome" differs from the "Cushing's disease" even though both conditions are induced by hypercortisolism. The term ... and ACTH-independent Cushing's Syndrome to improve the available diagnostic and prognostic markers that can assist clinicians ...
Eckstein N, Haas B, Hass MD, Pfeifer V (Aug 2014). "Systemic therapy of Cushing's syndrome". Orphanet Journal of Rare Diseases ... mifepristone is investigated for its therapeutical potential in indications like Cushing's syndrome, Alzheimer's disease or ...
Facial plethora may be a sign of Cushing's syndrome, superior vena cava syndrome, carcinoid syndrome, polycythemia vera, and ... Facial plethora is an excessive blood flow to the face and is a hallmark sign of Cushing's syndrome. The blood flow is to the ... Stratakis, CA (September 2016). "Skin manifestations of Cushing's syndrome". Reviews in Endocrine & Metabolic Disorders. 17 (3 ... a hallmark sign of Cushing's syndrome. Pulmonary plethora is an increased pulmonary perfusion seen on chest X-rays. A plethora ...
Merrin PK, Alexander WD (August 1990). "Cushing's syndrome induced by medroxyprogesterone". BMJ. 301 (6747): 345. doi:10.1136/ ... "Progesterone for outpatient treatment of Pickwickian syndrome". Annals of Internal Medicine. 83 (4): 476-479. doi:10.7326/0003- ...
"Cushing syndrome - Diagnosis and treatment - Mayo Clinic". www.mayoclinic.org. Retrieved 2023-03-28. "Are people with Cushing's ... known as pseudo-Cushing's syndrome (PCS). Therefore, it is important to understand the cause of the syndrome to differentiate ... Cushing's Syndrome Archived 2011-04-10 at the Wayback Machine at The National Endocrine and Metabolic Diseases Information ... When the body is exposed to an excess level of cortisol, generalized symptoms that are referred to as Cushing's syndrome appear ...
... and the most common cause of exogenous Cushing's Syndrome. Clinical features of Cushing's Syndrome is inclusive of many adverse ... Iatrogenic Cushing's Syndrome is a direct complication of glucocorticoid therapy, ... Hopkins RL, Leinung MC (June 2005). "Exogenous Cushing's syndrome and glucocorticoid withdrawal". Endocrinology and Metabolism ... Serious side effects include iatrogenic Cushing's Syndrome, hypertension, osteoporosis, diabetes, infection, and skin atrophy. ...
... is also used to treat Cushing's disease (pituitary-dependent Cushing's syndrome) in dogs. The medication is used in ... The drug is also sometimes used in the treatment of Cushing's syndrome. The use of mitotane is unfortunately limited by side ... 697-. ISBN 978-3-88763-075-1. Canine Cushing's Syndrome: Diagnosis and Treatment Archived 2007-10-21 at the Wayback Machine V. ... Marcello D. Bronstein (1 October 2010). Cushing's Syndrome: Pathophysiology, Diagnosis and Treatment. Springer Science & ...
Measuring ACTH will confirm that the cause of the patients Cushing's syndrome is ACTH independent. The nature of Cushing's ... leading to an increased fracture risk in people with Cushing's syndrome. PPNAD is unique as it often causes Cushing's at a ... The effects of PPNAD can often be cyclical so the symptoms of Cushing's syndrome will not always be as severe, which may ... The classic symptoms of Cushing's syndrome include rapid central weight gain, a puffy red face and a buffalo hump at the back ...
They have been used to inhibit corticosteroid synthesis in the treatment of Cushing's syndrome and adrenocortical carcinoma, ... Marcello D. Bronstein (1 October 2010). Cushing's Syndrome: Pathophysiology, Diagnosis and Treatment. Springer Science & ... "Updates on the role of adrenal steroidogenesis inhibitors in Cushing's syndrome: a focus on novel therapies". Pituitary. 19 (6 ... and trilostane was formerly used to inhibit corticosteroid synthesis in the treatment of Cushing's syndrome. 17α-Hydroxylase/17 ...
Ledger T, Tong W, Rimmer J (August 2019). "Iatrogenic Cushing's syndrome with inhaled fluticasone". Australian Prescriber. 42 ( ...
... resulting in endocrine disorders such as Cushing's syndrome, Conn's syndrome (hyperaldosteronism), virilization of females, or ... 2021-02-22). "Circulating microRNA Expression in Cushing's Syndrome". Frontiers in Endocrinology. 12: 620012. doi:10.3389/fendo ... under 3 cm are generally considered benign and are only treated if there are grounds for a diagnosis of Cushing's syndrome or ... Pheochromocytomas occur in patients of all ages, and may be sporadic, or associated with a hereditary cancer syndrome, such as ...
Cushing Syndrome and Primary Adrenal Disorders. Meeting Abstracts. Endocrine Society. Bergthorsdottir R, Leonsson-Zachrisson M ... such as in the Triple-A or Allgrove syndrome). DAX-1 mutations may cluster in a syndrome with glycerol kinase deficiency with a ... in Waterhouse-Friderichsen syndrome or antiphospholipid syndrome), particular infections (tuberculosis, histoplasmosis, ... "Autoimmune polyglandular syndrome type 1 , Genetic and Rare Diseases Information Center (GARD) - an NCATS Program". ...
Sonino, N (2001). "Psychiatric disorders associated with Cushing's syndrome. Epidemiology, pathophysiology and treatment". CNS ... Restless legs syndrome (RLS), also known as Wittmaack-Ekbom's syndrome, is characterized by an irresistible urge to move one's ... CDC - Chronic Fatigue Syndrome Jul 1, 2010 ... CDC Centers for Disease Control and Prevention Chronic Fatigue Syndrome.[7] ... Cushing's Syndrome, also known as hypercortisolism, is an endocrine disorder characterized by an excess of cortisol. In the ...
Páez-Pereda, Marcelo; Arzt, Eduardo; Stalla, Günter K (2002). "Cushing's syndrome: Drug targets and therapeutic options". ... spanish) Prueban con éxito una terapia para la enfermedad de Cushing, Diario La Nación (Argentina), 10/13/2006. Arzt E ( ... September 2006). "Retinoic acid as a novel medical therapy for Cushing's disease in dogs". Endocrinology. 147 (9): 4438-44. doi ...
They are used to treat Cushing's syndrome. Antiglucocorticoids could be effective antidepressants for a subset of specific mood ...
Johnson, Philip J. (2002). "The equine metabolic syndrome peripheral Cushing's syndrome". Vet. Clin. North Am. Equine Pract. 18 ... It also favors the development of equine Cushing's disease, and causes a drop in stallion fertility. The horse body mass is ... It also favors the onset of equine Cushing's disease, usually around eleven to thirteen years of age. Overweight stallions tend ... Equine obesity has been implicated in the increase in cases of insulin resistance, known as equine metabolic syndrome, a ...

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