The neuropsychiatric complications of glucocorticoid use: steroid psychosis revisited.

Background: Glucocorticoids are widely prescribed for a variety of diseases and are known to cause neuropsychiatric as well as somatic side effects.

Objective: This article will review the incidence, clinical characteristics, course, and treatment of neuropsychiatric effects of glucocorticoids.

Methods: We performed a literature review of the neuropsychiatric complications of glucocorticoids using the PubMed database.

Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline.

Objective: The aim is to provide guidelines for the evaluation and management of adults with hypoglycemic disorders, including those with diabetes mellitus.

Evidence: Using the recommendations of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, the quality of evidence is graded very low (plus sign in circle ooo), low (plus sign in circle plus sign in circle oo), moderate (plus sign in circle plus sign in circle plus sign in circle o), or high (plus sign in circle plus sign in circle plus sign in circle plus sign in circle).

Conclusions: We recommend evaluation and management of hypoglycemia only in patients in whom Whipple's triad--symptoms, signs, or both consistent with hypoglycemia, a low plasma glucose concentration, and resolution of those symptoms or signs after the plasma glucose concentration is raised--is documented.

Improved contemporary surgical management of insulinomas: a 25-year experience at the Massachusetts General Hospital.

Objective: To determine changes in the management strategy of patients with insulinomas and identify critical factors in patient outcome.

Background: Pancreatic insulinomas are rare neoplasms that are present in various ways. The optimal approach to localization, operative management, and follow-up of insulinomas is undetermined.

Perioperative management of patients treated with glucocorticoids.

HPA suppression is a common consequence of glucocorticoid therapy, whereas overt secondary adrenal insufficiency is a rare but life-threatening condition. Prolonged hypotension and a response to adequate doses of a glucocorticoid agent are not reliable ways to assess adrenocortical function. One must also demonstrate plasma cortisol levels that are inappropriately low for the clinical situation.