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Randomised, placebo-controlled, double-blinded, four-way crossover trial to demonstrate the comparative pharmacodynamic equivalence of a non-invasive diagnostic test for adrenal insufficiency in a healthy population: the STARLIT-2 study protocol.
BMJ Open
December 2024
Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
Introduction: Cortisol is an essential stress hormone and failure of its production, known as adrenal insufficiency (AI), is associated with significant mortality due to adrenal crisis. The Short Synacthen Test (SST) is the current diagnostic test of choice for AI, but it is both invasive and resource intensive. Globally, there is an unmet need for a non-invasive, cost-effective test.
View Article and Find Full Text PDFImpact of Surreptitious Glucocorticoids in Over-the-Counter Arthritis Supplements.
J Endocr Soc
January 2025
Division of Endocrinology and Diabetes, Keck Medicine of USC, Los Angeles, CA 90033, USA.
Adrenal dysfunction due to over-the-counter (OTC) health supplements containing unlabeled glucocorticoids has been previously reported. Here, we present a case series of 12 patients at an urban safety net medical center evaluated by endocrinology for iatrogenic adrenal dysfunction, Cushing syndrome (CS) and/or adrenal insufficiency (AI), associated with use of OTC arthritis supplements surreptitiously containing glucocorticoids. There were 12 patients using OTC arthritis supplements (Artri King [n = 8], Ardosons [n = 3], Ajo Rey [n = 1]) included.
View Article and Find Full Text PDFACTH-like Peptides Compensate Rat Brain Gene Expression Profile Disrupted by Ischemia a Day After Experimental Stroke.
Biomedicines
December 2024
Laboratory of Human Molecular Genetics, National Research Center "Kurchatov Institute", Kurchatov Sq. 2, 123182 Moscow, Russia.
Ischemic stroke results from a disruption of cerebral blood flow. Adrenocorticotropic hormone (ACTH) serves as the basis for the creation of synthetic peptides as neuroprotective agents for stroke therapy. Previously, using RNA-Seq we first revealed differential expressed genes (DEGs) associated with ACTH(4-7)PGP (Semax) and ACTH(6-9)PGP peptides under cerebral ischemia conditions.
View Article and Find Full Text PDFIntroduction: Consensus regarding the diagnostic cutoff values for cortisol responses to low-dose Cosyntropin testing (LDT) and its specific advantages over standard (high) dose test (HDT) in assessing the pituitary-adrenal axis in children is lacking.
Methods: In a retrospective study, patients who underwent sequential LDT and HDT were classified into two groups depending on the reason for testing: prolonged systemic glucocorticoid exposure (Group 1) or suspected hypothalamic-pituitary dysfunction (Group 2). Sensitivity and specificity analysis of varying cortisol levels during LDT in diagnosing ACTH deficiency (ACTHD) were calculated via the receiver operating characteristic curve (ROC) analysis against the reference diagnostic test HDT.
Effect of Corticosteroid Premedication on Adrenal Vein Sampling in Patients with Primary Aldosteronism and Iodinated Contrast Allergy.
J Vasc Interv Radiol
December 2024
Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Purpose: To evaluate the impact of corticosteroid premedication on the performance of adrenal vein sampling (AVS) in patients with primary aldosteronism (PA) and allergy to iodinated contrast media (ICM).
Materials And Methods: Patients who underwent AVS for PA, between September 1990 and October 2023, were retrospectively identified. Patients with ICM allergy who received corticosteroid pre-medication were matched 1:1 with patients without contrast allergy.
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