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Medical management pathways for Cushing's disease in pituitary tumors centers of excellence (PTCOEs).
Pituitary
January 2025
Division of Endocrinology, Santiago de Compostela University and Ciber OBN, Santiago, Spain.
Purpose: A recent update of consensus guidelines for the management of Cushing's disease (CD) included indications for medical therapy. However, there is limited evidence regarding their implementation in clinical practice. This study aimed to evaluate current medical therapy approaches by expert pituitary centers through an audit conducted to validate the criteria of Pituitary Tumors Centers of Excellence (PTCOEs) and provide an initial standard of medical care for CD.
View Article and Find Full Text PDFDevelopment of a Genetic Test Indicating Increased AVP/V1b Signalling in Patients with Acute Depression.
Pharmacopsychiatry
January 2025
Max Planck Institute of Psychiatry, Munich, Germany.
A subgroup of patients with acute depression show an impaired regulation of the hypothalamic-pituitary-adrenocortical axis, which can be sensitively diagnosed with the combined dexamethasone (dex)/corticotropin releasing hormone (CRH)-test. This neuropathological alteration is assumed to be a result of hyperactive AVP/V1b signalling. Given the complicated procedure of the dex/CRH-test, this study aimed to develop a genetic variants-based alternative approach to predict the outcome of the dex/CRH-test in acute depression.
View Article and Find Full Text PDFComparison of two strategies of glucocorticoid withdrawal in patients with rheumatoid arthritis in low disease activity (STAR): a randomised, placebo- controlled, double-blind trial.
Ann Rheum Dis
January 2025
Rheumatology Center, Toulouse University Hospital, Toulouse, France.
Objectives: To compare two strategies-a hydrocortisone replacement strategy and a prednisone tapering strategy-for their success in glucocorticoid discontinuation in patients with rheumatoid arthritis (RA) with low disease activity (LDA).
Methods: The Strategies for glucocorticoid TApering in Rheumatoid arthritis (STAR) study was a double- blind, double-placebo randomised controlled trial including patients with RA receiving a stable dose of glucocorticoid 5 mg/day for ≥3 months and were in LDA for ≥3 months. Patients were randomly assigned in a 1:1 ratio to either replace prednisone with 20 mg/day of hydrocortisone for 3 months, then reduce to 10 mg/day for 3 months before discontinuation or to taper prednisone by 1 mg/day every month until complete discontinuation, contingent on maintaining LDA.
Pulsatile dexamethasone in patients with Infantile Spasms: A retrospective analysis of a unique therapy regime.
Neuropediatrics
January 2025
Pediatric Neurology, Jena University Hospital, Jena, Germany.
Objective Infantile Spasms (IS) are an age-specific epilepsy syndrome associated with poor outcome. Sustained and early spasm-control remains the main goal of therapy. We aimed to evaluate a unique pulsatile dexamethasone therapy regime in children with IS, applying a prolonged first pulse in cases of insufficient spasm-control.
View Article and Find Full Text PDFHER2 positive primary breast squamous cell carcinoma with good prognosis: a case report.
AME Case Rep
November 2024
Department of Clinical Laboratory Diagnosis, Shijiazhuang Pingan Hospital, Hebei Medical University, Shijiazhuang, China.
Background: Primary breast squamous cell carcinoma (PBSCC) is a unique histopathological type of breast cancer. The majority of current case reports of PBSCC are triple-negative tumors with poor prognosis. Due to its heterogeneous clinical course, no unified management is achieved.
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