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  1. Article ; Online: The Overnight Low-Dose Dexamethasone Suppression Test Can Be Used to Evaluate Patients With Chronic Kidney Disease.

    Raff, Hershel

    Journal of the Endocrine Society

    2024  Volume 8, Issue 3, Page(s) bvae007

    Language English
    Publishing date 2024-01-29
    Publishing country United States
    Document type Journal Article ; Comment
    ISSN 2472-1972
    ISSN (online) 2472-1972
    DOI 10.1210/jendso/bvae007
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  2. Article ; Online: Salivary cortisol and cortisone measurement improves ACTH stimulation testing in women taking oral contraceptives.

    Raff, Hershel

    The Journal of clinical endocrinology and metabolism

    2024  

    Language English
    Publishing date 2024-01-12
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 3029-6
    ISSN 1945-7197 ; 0021-972X
    ISSN (online) 1945-7197
    ISSN 0021-972X
    DOI 10.1210/clinem/dgae027
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  3. Article ; Online: Late Night Salivary Cortisol in the diagnosis of neoplastic hypercortisolism (including cyclic Cushing's syndrome).

    Raff, Hershel

    Pituitary

    2022  Volume 25, Issue 5, Page(s) 698–700

    Abstract: Late night salivary cortisol (LNSC) is a mainstay in the diagnosis of neoplastic hypercortisolism (Cushing's syndrome) with a sensitivity and specificity of > 90% in patients with syndromic signs and symptoms. Intermittent hormonogenesis (day to day ... ...

    Abstract Late night salivary cortisol (LNSC) is a mainstay in the diagnosis of neoplastic hypercortisolism (Cushing's syndrome) with a sensitivity and specificity of > 90% in patients with syndromic signs and symptoms. Intermittent hormonogenesis (day to day variation) is common in milder Cushing's disease whereas true cyclic Cushing's syndrome (weeks to months of tumor quiescence) is unusual. In both cases, LNSC is useful as a sensitive evaluative diagnostic tool, although its lower specificity may lead to false positive results in patients without Cushing's disease. Furthermore, intermittent hormonogenesis may lead to false negative LNSC results in patients with mild Cushing's disease. Finally, LNSC is useful as an approach to follow patients after pituitary surgery to detect a recurrence even many years after a full remission.
    MeSH term(s) Humans ; Cushing Syndrome/diagnosis ; Hydrocortisone ; Saliva ; Pituitary ACTH Hypersecretion ; Sensitivity and Specificity
    Chemical Substances Hydrocortisone (WI4X0X7BPJ)
    Language English
    Publishing date 2022-03-25
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1385151-2
    ISSN 1573-7403 ; 1386-341X
    ISSN (online) 1573-7403
    ISSN 1386-341X
    DOI 10.1007/s11102-022-01214-2
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  4. Article ; Online: A New Approach - Home Waking Salivary Cortisone to Screen for Adrenal Insufficiency.

    Raff, Hershel / Zhang, Catherine D

    NEJM evidence

    2023  Volume 2, Issue 2, Page(s) EVIDe2200306

    Abstract: Adrenal insufficiency is a common and potentially life-threatening endocrine disorder that can be drug induced or endogenous and of adrenal (primary) or pituitary/hypothalamic (secondary/tertiary) origin. ...

    Abstract Adrenal insufficiency is a common and potentially life-threatening endocrine disorder that can be drug induced or endogenous and of adrenal (primary) or pituitary/hypothalamic (secondary/tertiary) origin.
    MeSH term(s) Humans ; Hydrocortisone ; Cortisone ; Adrenal Insufficiency ; Adrenocorticotropic Hormone ; Glucocorticoids
    Chemical Substances Hydrocortisone (WI4X0X7BPJ) ; Cortisone (V27W9254FZ) ; Adrenocorticotropic Hormone (9002-60-2) ; Glucocorticoids
    Language English
    Publishing date 2023-01-24
    Publishing country United States
    Document type Editorial
    ISSN 2766-5526
    ISSN (online) 2766-5526
    DOI 10.1056/EVIDe2200306
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  5. Article ; Online: Recognition of Nonneoplastic Hypercortisolism in the Evaluation of Patients With Cushing Syndrome.

    Findling, James W / Raff, Hershel

    Journal of the Endocrine Society

    2023  Volume 7, Issue 8, Page(s) bvad087

    Abstract: The evaluation of suspected hypercortisolism is one of the most challenging problems in medicine. The signs and symptoms described by Dr Harvey Cushing are common and often create diagnostic confusion to even experienced endocrinologists. Cushing ... ...

    Abstract The evaluation of suspected hypercortisolism is one of the most challenging problems in medicine. The signs and symptoms described by Dr Harvey Cushing are common and often create diagnostic confusion to even experienced endocrinologists. Cushing syndrome is classically defined as neoplastic hypercortisolism resulting from an ACTH-secreting tumor or from autonomous secretion of excess cortisol associated with benign or malignant adrenal neoplasia. The increasing recognition of the negative cardiometabolic effects of mild cortisol excess without overt physical signs of Cushing syndrome has led to more screening for endogenous hypercortisolism in patients with adrenal nodular disease, osteoporosis, and the metabolic syndrome. However, sustained or intermittent activation of the dynamic hypothalamic-pituitary-adrenal axis caused by chemical (alcohol), inflammatory (chronic kidney disease), psychologic (major depression), and physical (starvation/chronic intense exercise) stimuli can result in clinical and/or biochemical features indistinguishable from neoplastic hypercortisolism. Nonneoplastic hypercortisolism (formerly known as pseudo-Cushing syndrome) has been recognized for more than 50 years and often causes diagnostic uncertainty. This expert consultation describes two patients with features of Cushing syndrome who were referred for inferior petrosal sinus sampling for the differential diagnosis of ACTH-dependent hypercortisolism. Both patients were discovered to have nonneoplastic hypercortisolism: one from a covert alcohol use disorder and the other to chronic kidney disease. This consultation emphasizes the value of a good history and physical examination, appropriate laboratory testing, and the desmopressin acetate stimulation test to aid in distinguishing neoplastic from nonneoplastic hypercortisolism.
    Language English
    Publishing date 2023-06-23
    Publishing country United States
    Document type Journal Article
    ISSN 2472-1972
    ISSN (online) 2472-1972
    DOI 10.1210/jendso/bvad087
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  6. Article ; Online: Periodic hypoxia, intermittent pain, and caffeine in male and female neonatal rats: corticosterone, insulin resistance, and hepatic gene expression.

    Gehrand, Ashley L / Phillips, Jonathan M / Raff, Hershel

    American journal of physiology. Regulatory, integrative and comparative physiology

    2023  Volume 324, Issue 6, Page(s) R708–R719

    Abstract: Preterm infants experience multiple stressors including periodic neonatal hypoxia, maternal/caregiver separation, and acute pain from clinical procedures. Although neonatal hypoxia or interventional pain are associated with sexually dimorphic effects ... ...

    Abstract Preterm infants experience multiple stressors including periodic neonatal hypoxia, maternal/caregiver separation, and acute pain from clinical procedures. Although neonatal hypoxia or interventional pain are associated with sexually dimorphic effects that may last into adulthood, the interaction of these common preterm stressors and caffeine pretreatment remains unknown. We hypothesize that an interaction of acute neonatal hypoxia, isolation, and pain modeling the experience of the preterm infant will augment the acute stress response and that caffeine routinely given to preterm infants will alter this response. Male and female rat pups were isolated and exposed to six cycles of periodic hypoxia (10% O
    MeSH term(s) Infant, Newborn ; Animals ; Rats ; Female ; Male ; Humans ; Animals, Newborn ; Insulin Resistance ; Rats, Sprague-Dawley ; Corticosterone ; Adrenocorticotropic Hormone/pharmacology ; Caffeine/pharmacology ; Glucocorticoids/metabolism ; Acute Pain/metabolism ; Hypothalamo-Hypophyseal System/metabolism ; Infant, Premature ; Hypoxia/metabolism ; Insulin ; Liver/metabolism ; Gene Expression
    Chemical Substances Corticosterone (W980KJ009P) ; Adrenocorticotropic Hormone (9002-60-2) ; Caffeine (3G6A5W338E) ; Glucocorticoids ; Insulin
    Language English
    Publishing date 2023-03-13
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 603839-6
    ISSN 1522-1490 ; 0363-6119
    ISSN (online) 1522-1490
    ISSN 0363-6119
    DOI 10.1152/ajpregu.00316.2022
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  7. Article ; Online: CORT, Cort, B, Corticosterone, and now Cortistatin: Enough Already!

    Raff, Hershel

    Endocrinology

    2016  Volume 157, Issue 9, Page(s) 3307–3308

    Language English
    Publishing date 2016-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 427856-2
    ISSN 1945-7170 ; 0013-7227
    ISSN (online) 1945-7170
    ISSN 0013-7227
    DOI 10.1210/en.2016-1500
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  8. Article ; Online: Do the Effects of the Triorganotin Tributyltin on the Hypothalamic-Pituitary-Adrenal Axis In Vivo Contribute to Its Environmental Toxicity?

    Raff, Hershel

    Endocrinology

    2016  Volume 157, Issue 8, Page(s) 2996–2998

    Language English
    Publishing date 2016-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 427856-2
    ISSN 1945-7170 ; 0013-7227
    ISSN (online) 1945-7170
    ISSN 0013-7227
    DOI 10.1210/en.2016-1400
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  9. Article ; Online: Comment on Grover et al.

    Medda, Rituparna / Raff, Hershel / Shaker, Joseph / Guda, Nalini

    The American journal of gastroenterology

    2022  Volume 117, Issue 5, Page(s) 813–814

    MeSH term(s) Humans ; Bone Density ; Liver Cirrhosis ; Dietary Supplements ; Vitamin D
    Chemical Substances Vitamin D (1406-16-2)
    Language English
    Publishing date 2022-01-25
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000001636
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  10. Article ; Online: Measurement of Salivary Cortisone to Assess the Adequacy of Hydrocortisone Replacement.

    Raff, Hershel

    The Journal of clinical endocrinology and metabolism

    2016  Volume 101, Issue 4, Page(s) 1350–1352

    Abstract: This Commentary discusses the study of Debono et al that suggests that measuring salivary cortisone may be useful in the assessment of proper hydrocortisone therapy. ...

    Abstract This Commentary discusses the study of Debono et al that suggests that measuring salivary cortisone may be useful in the assessment of proper hydrocortisone therapy.
    MeSH term(s) Chromatography, Liquid ; Cortisone/analysis ; Humans ; Hydrocortisone/metabolism ; Saliva/chemistry ; Salivary Glands/metabolism ; Salivary Glands/pathology ; Tandem Mass Spectrometry
    Chemical Substances Cortisone (V27W9254FZ) ; Hydrocortisone (WI4X0X7BPJ)
    Language English
    Publishing date 2016-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3029-6
    ISSN 1945-7197 ; 0021-972X
    ISSN (online) 1945-7197
    ISSN 0021-972X
    DOI 10.1210/jc.2016-1228
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