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Background: Hypothalamic-pituitary-adrenal (HPA) axis recovery after cessation of steroid therapy in children with nephrotic syndrome (NS) has hardly been studied in the literature.

Methods: This 22-month cross-sectional study recruited children (2-14 years) with NS, having received a minimum 3 months of prednisolone, now in remission, and off steroids for 1, 3, or 6 months. Serum cortisol-basal and stimulated (with long-acting intramuscular adrenocorticotropic hormone), and factors affecting them, were assessed.

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Introduction: 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.

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Article Synopsis
  • Non-neoplastic hypercortisolaemia, or pseudo-Cushing's syndrome (PCS), can occur due to various health conditions like depression, obesity, and diabetes, linked to overactivity of the hypothalamic-pituitary-adrenal axis.
  • A 66-year-old woman exhibited symptoms such as weakness, weight loss, and poorly controlled hypertension, which led to the discovery of pheochromocytoma, a tumor that causes hormone overproduction, upon further testing.
  • After undergoing surgery to remove the tumor and receiving supportive treatment, her symptoms improved significantly, confirming the diagnosis of PCS rather than traditional Cushing's syndrome.
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Background: The treatment of vitiligo is difficult and usually requires prolonged therapy. All exogenous glucocorticoid therapies can lead to the hypothalamic-pituitary-adrenal axis (HPA) suppression. Steroid therapy in the form of an intermittent pulse therapy is a much safer option than daily administration.

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Central Adrenal Insufficiency: Etiology and Diagnostic Approach.

J Clin Res Pediatr Endocrinol

December 2024

Department of Pediatric Endocrinology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.

Central adrenal insufficiency (CAI) occurs due to a pituitary gland disorder (secondary AI) or hypothalamic dysfunction (tertiary AI). It is a potentially life-threatening condition that has many congenital and acquired causes. Adrenocorticotropic hormone (ACTH) deficiency may be isolated or more commonly it can be accompanied by other pituitary hormone deficiencies or midline defects.

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