Publications by authors named "A Ben-Shlomo"
Opioid-induced adrenal insufficiency: diagnostic and management considerations.
Front Endocrinol (Lausanne)
March 2024
The dramatic rise in opioid use over the last two decades has led to a surge in their harmful health effects. Lesser known among clinicians is the impact of opioids on the endocrine system, especially with regard to cortisol. Opioids can suppress the hypothalamus-pituitary-adrenal (HPA) axis and may result in clinically significant adrenal insufficiency, especially in those treated at higher doses and for a longer time.
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- Current research indicates that cortisol-secreting adrenocortical carcinoma has a poorer prognosis compared to non-secreting types, but the impact of other secretory subtypes was unclear prior to this study.
- The study analyzed data from 807 patients with adrenocortical carcinoma over 23 years, showing different overall survival rates based on secretory subtype, with cortisol-secreting patients having a median survival of 36 months and non-secreting patients 115 months.
- Mixed cortisol/androgen secreting tumors were linked to worse overall survival, while the type of secretion did not significantly affect survival outcomes in patients who underwent complete resection (R0).
Article Synopsis
- MEN1 is an autosomal dominant disorder linked to mutations in the MEN1 tumor suppressor gene, leading to various endocrine/neuroendocrine tumors.
- Researchers created an isogenic control line and a homozygous double mutant line using CRISPR/Cas technology from induced pluripotent stem cells (iPSCs) of a patient with a specific MEN1 mutation (c.1273C>T).
- These newly developed cell lines aim to help understand the underlying mechanisms of MEN1 and assist in identifying possible therapeutic targets for treatment.
Purpose: Treatment-refractory pituitary tumors demonstrate characteristics resembling those of highly aggressive tumors, in which the local tumor microenvironment (TME) plays a dominant role in promoting aggressiveness and refractoriness. However, role of the TME in pituitary tumors is not well studied.
Methods: Literature on the TME and development of refractory pituitary tumors was reviewed RESULTS: TME harbors tumorigenic immune cells, cancer-associated fibroblasts (CAF), extracellular matrix, and other factors that have been shown to affect behavior of tumor tissue.
Context: Postoperative hyponatremia leads to prolonged hospital length of stay and readmission within 30 days.
Objective: To assess 3 strategies for reducing rates of postoperative hyponatremia and analyze risk factors for hyponatremia.
Design: Two retrospective analyses and 1 prospective study.