LIVIVO - Search results -

Search results

Result 1 - 10 of total 143

Search options

Article ; Online: Septic Shock: A Disruptor of the Hypothalamic-Adrenal Axis as We Know It.

Nieman, Lynnette K

2022 Volume 163, Issue 5

MeSH term(s)	Humans ; Hypothalamo-Hypophyseal System ; Hypothalamus ; Pituitary-Adrenal System ; Shock, Septic
Language	English
Publishing date	2022-02-08
Publishing country	United States
Document type	Editorial ; Research Support, N.I.H., Intramural ; Comment
ZDB-ID	427856-2
ISSN	1945-7170 ; 0013-7227
ISSN (online)	1945-7170
ISSN	0013-7227
DOI	10.1210/endocr/bqac010
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Uh III Zs.72: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Selective progesterone receptor modulators and reproductive health.

Nieman, Lynnette K

Current opinion in endocrinology, diabetes, and obesity

2022 Volume 29, Issue 4, Page(s) 406–412

Abstract: Purpose of review: This review is intended to provide perspective on the history of selective progesterone receptor modulators (SPRMs) and progesterone antagonists, their current availability, therapeutic promise and safety concerns.: Recent findings!# ...

Abstract	Purpose of review: This review is intended to provide perspective on the history of selective progesterone receptor modulators (SPRMs) and progesterone antagonists, their current availability, therapeutic promise and safety concerns. Recent findings: Despite keen interest in synthesis of these compounds, only a handful have had clinical test results allowing for commercialization. Mifepristone is well tolerated and effective for single dose first trimester at-home pregnancy termination and is available in much of the world. Ulipristal acetate, at single doses, is well tolerated and effective for emergency contraception, with less availability. Chronic use of these agents has been associated with abnormal liver enzymes, and rarely, with hepatic failure; causality is not understood. Summary: SPRMs and progesterone antagonists have great therapeutic promise for use in other reproductive disorders, including breast cancer, endometriosis, adenomyosis, estrogen-free contraception and cervical ripening but require additional study. Alternative formulations, whether local (topical breast or intrauterine) or extended-release may reduce the incidence of liver function abnormalities and should be explored.
MeSH term(s)	Female ; Hormone Antagonists/adverse effects ; Humans ; Mifepristone/adverse effects ; Pregnancy ; Progesterone ; Receptors, Progesterone ; Reproductive Health
Chemical Substances	Hormone Antagonists ; Receptors, Progesterone ; Mifepristone (320T6RNW1F) ; Progesterone (4G7DS2Q64Y)
Language	English
Publishing date	2022-07-02
Publishing country	England
Document type	Journal Article ; Review ; Research Support, N.I.H., Intramural
ZDB-ID	2272017-0
ISSN	1752-2978 ; 1752-296X
ISSN (online)	1752-2978
ISSN	1752-296X
DOI	10.1097/MED.0000000000000753
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Se 1363: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Molecular Derangements and the Diagnosis of ACTH-Dependent Cushing's Syndrome.

Nieman, Lynnette K

Endocrine reviews

2021 Volume 43, Issue 5, Page(s) 852–877

Abstract: Endogenous Cushing's syndrome (CS) is associated with morbidities (diabetes, hypertension, clotting disorders) and shortens life because of infections, pulmonary thromboembolism, and cardiovascular disease. Its clinical presentation is immensely variable, ...

Abstract	Endogenous Cushing's syndrome (CS) is associated with morbidities (diabetes, hypertension, clotting disorders) and shortens life because of infections, pulmonary thromboembolism, and cardiovascular disease. Its clinical presentation is immensely variable, and diagnosis and treatment are often delayed. Thus, there are many opportunities for basic and clinical research leading to better tests, faster diagnosis, and optimized medical treatments. This review focuses on CS caused by excessive adrenocorticotropin (ACTH) production. It describes current concepts of the regulation of ACTH synthesis and secretion by normal corticotropes and mechanisms by which dysregulation occurs in corticotrope (termed "Cushing's disease") and noncorticotrope (so-called ectopic) ACTH-producing tumors. ACTH causes adrenal gland synthesis and pulsatile release of cortisol; the excess ACTH in these forms of CS leads to the hypercortisolism of endogenous CS. Again, the differences between healthy individuals and those with CS are highlighted. The clinical presentations and their use in the interpretation of CS screening tests are described. The tests used for screening and differential diagnosis of CS are presented, along with their relationship to cortisol dynamics, pathophysiology, and negative glucocorticoid feedback regulation in the two forms of ACTH-dependent CS. Finally, several gaps in current understanding are highlighted in the hope of stimulating additional research into this challenging disorder.
MeSH term(s)	Adrenal Glands ; Adrenocorticotropic Hormone ; Cushing Syndrome/diagnosis ; Diagnosis, Differential ; Glucocorticoids/therapeutic use ; Humans ; Hydrocortisone
Chemical Substances	Glucocorticoids ; Adrenocorticotropic Hormone (9002-60-2) ; Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2021-11-25
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, N.I.H., Intramural
ZDB-ID	603096-8
ISSN	1945-7189 ; 0163-769X
ISSN (online)	1945-7189
ISSN	0163-769X
DOI	10.1210/endrev/bnab046
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 1562: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Is it Time for a New Approach to the Differential Diagnosis of ACTH-Dependent Cushing Syndrome?

Nieman, Lynnette K

The Journal of clinical endocrinology and metabolism

2020 Volume 105, Issue 12

MeSH term(s)	Adrenocorticotropic Hormone ; Cushing Syndrome/diagnosis ; Diagnosis, Differential ; Humans ; Petrosal Sinus Sampling
Chemical Substances	Adrenocorticotropic Hormone (9002-60-2)
Language	English
Publishing date	2020-10-03
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Intramural ; Comment
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgaa493
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Uh III Zs.134: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Hypercoagulability in Cushing's syndrome: incidence, pathogenesis and need for thromboprophylaxis protocols.

Feelders, Richard A / Nieman, Lynnette K

Pituitary

2022 Volume 25, Issue 5, Page(s) 746–749

Abstract: Cushing's syndrome (CS) is associated with a hypercoagulable state resulting in an increased risk on venous thromboembolism (VTE). In patients with untreated active CS VTE incidence is up to 18-fold higher compared to the general population, whereas ... ...

Abstract	Cushing's syndrome (CS) is associated with a hypercoagulable state resulting in an increased risk on venous thromboembolism (VTE). In patients with untreated active CS VTE incidence is up to 18-fold higher compared to the general population, whereas after pituitary and adrenal surgery a postoperative VTE risk between 2.6 and 5.6% has been reported. Interestingly, after surgery the VTE risk is not only increased in the first week but also during several months postoperatively. The hypercoagulable state in CS is thought to be caused, at least in part, by an imbalance between activity of pro- and anticoagulant pathways. However, changes in activated partial thromboplastin time and plasma concentrations of pro-and anticoagulant factors are not observed in every CS patient. Only retrospective studies have shown that thromboprophylaxis lowers VTE risk in CS. Future prospective studies should asses the optimal timing, duration and type of thromboprophylaxis in CS to improve VTE-related morbidity and mortality.
MeSH term(s)	Humans ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology ; Venous Thromboembolism/prevention & control ; Cushing Syndrome/complications ; Cushing Syndrome/surgery ; Incidence ; Anticoagulants/therapeutic use ; Retrospective Studies ; Prospective Studies ; Thrombophilia/drug therapy ; Thrombophilia/complications
Chemical Substances	Anticoagulants
Language	English
Publishing date	2022-07-26
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/s11102-022-01261-9
Database	MEDical Literature Analysis and Retrieval System OnLINE

Full text online

Accessible to users with ZB MED library card

In stock of ZB MED Cologne/Königswinter

Zs.A 6139: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾

Article ; Online: Hypertension and Cardiovascular Mortality in Patients with Cushing Syndrome.

Nieman, Lynnette K

Endocrinology and metabolism clinics of North America

2019 Volume 48, Issue 4, Page(s) 717–725

Abstract: Patients with Cushing syndrome have an increased mortality rate, primarily due to increased cardiovascular death, which is driven by hypertension, diabetes, obesity, and dyslipidemia. These should be evaluated before and after active hypercortisolism, ... ...

Abstract	Patients with Cushing syndrome have an increased mortality rate, primarily due to increased cardiovascular death, which is driven by hypertension, diabetes, obesity, and dyslipidemia. These should be evaluated before and after active hypercortisolism, and each should be treated specifically. Antihypertensives may be chosen based on probable pathophysiology. Thus, inhibitors of the renin-angiotensinogen system are recommended. Mineralocorticoid antagonists are helpful in hypokalemic patients. Other agents are often needed to normalize blood pressure. If medical treatment of Cushing syndrome is chosen, the goal should be to normalize cortisol (or its clinical action); if this is not achieved, it is more difficult to treat comorbidities.
MeSH term(s)	Cardiovascular Diseases/etiology ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/therapy ; Cushing Syndrome/complications ; Cushing Syndrome/mortality ; Cushing Syndrome/therapy ; Humans ; Hypertension/etiology ; Hypertension/mortality ; Hypertension/physiopathology ; Hypertension/therapy
Language	English
Publishing date	2019-09-19
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Intramural ; Review
ZDB-ID	92116-6
ISSN	1558-4410 ; 0889-8529
ISSN (online)	1558-4410
ISSN	0889-8529
DOI	10.1016/j.ecl.2019.08.005
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Se 148: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Ovine CRH Stimulation and 8 mg Dexamethasone Suppression Tests in 323 Patients With ACTH-Dependent Cushing's Syndrome.

Elenius, Henrik / McGlotten, Raven / Nieman, Lynnette K

The Journal of clinical endocrinology and metabolism

2023 Volume 109, Issue 1, Page(s) e182–e189

Abstract: Context: Determining the etiology of adrenocorticotropin (ACTH)-dependent Cushing's syndrome (CS) is often difficult. The gold standard test, inferior petrosal sinus sampling (IPSS), is expensive and not widely available.: Objective: Evaluate the ... ...

Abstract	Context: Determining the etiology of adrenocorticotropin (ACTH)-dependent Cushing's syndrome (CS) is often difficult. The gold standard test, inferior petrosal sinus sampling (IPSS), is expensive and not widely available. Objective: Evaluate the performance of the corticotropin-releasing hormone stimulation test (CRH-ST) and the 8 mg high-dose dexamethasone suppression test (HDDST) in distinguishing Cushing's disease (CD) from ectopic ACTH syndrome (EAS). Methods: Retrospective review in a tertiary referral center. A total of 323 patients with CD or EAS (n = 78) confirmed by pathology or biochemical cure (n = 15) in 96% underwent CRH-ST and HDDST performed between 1986 and 2019. We calculated test sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value, and diagnostic accuracy (DA) for the diagnosis of CD, and determined optimal response criteria for each test, alone and in combination. Results: The CRH-ST performed better than the HDDST (DA 91%, 95% CI 87-94% vs 75%, 95% CI 69-79%). Optimal response criteria were a ≥40% increase of ACTH and/or cortisol during the CRH test and a ≥69% suppression of cortisol during the HDDST. A ≥40% cortisol increase during the CRH test was the most specific measure, PPV 99%. Seventy-four percent of subjects had concordant positive CRH test and HDDST results, yielding Se 93%, Sp 98%, DA 95%, and PPV 99%, with a pretest likelihood of 85%. A proposed algorithm diagnosed 64% of patients with CD with near perfect accuracy (99%), obviating the need for IPSS. Conclusion: CRH is a valuable tool to correctly diagnose the etiology of ACTH-dependent CS. Its current worldwide unavailability impedes optimal management of these patients.
MeSH term(s)	Humans ; Animals ; Sheep ; Cushing Syndrome/diagnosis ; Cushing Syndrome/etiology ; Adrenocorticotropic Hormone ; Corticotropin-Releasing Hormone/pharmacology ; Hydrocortisone ; Diagnosis, Differential ; ACTH Syndrome, Ectopic/diagnosis ; Pituitary ACTH Hypersecretion/diagnosis ; Pituitary ACTH Hypersecretion/complications ; Dexamethasone/pharmacology
Chemical Substances	Adrenocorticotropic Hormone (9002-60-2) ; Corticotropin-Releasing Hormone (9015-71-8) ; Hydrocortisone (WI4X0X7BPJ) ; Dexamethasone (7S5I7G3JQL)
Language	English
Publishing date	2023-08-04
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/clinem/dgad454
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Uh III Zs.134: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article: Recent Updates on the Diagnosis and Management of Cushing's Syndrome.

Nieman, Lynnette K

Endocrinology and metabolism (Seoul, Korea)

2018 Volume 33, Issue 2, Page(s) 139–146

Abstract: Cushing's syndrome, a potentially lethal disorder characterized by endogenous hypercortisolism, may be difficult to recognize, especially when it is mild and the presenting features are common in the general population. However, there is a need to ... ...

Abstract	Cushing's syndrome, a potentially lethal disorder characterized by endogenous hypercortisolism, may be difficult to recognize, especially when it is mild and the presenting features are common in the general population. However, there is a need to identify the condition at an early stage, as it tends to progress, accruing additional morbidity and increasing mortality rates. Once a clinical suspicion is raised, screening tests involve timed measurement of urine, serum or salivary cortisol at baseline or after administration of dexamethasone, 1 mg. Each test has caveats, so that the choice of tests must be individualized for each patient. Once the diagnosis is established, and the cause is determined, surgical resection of abnormal tumor/tissue is the optimal treatment. When this cannot be achieved, medical treatment (or bilateral adrenalectomy) must be used to normalize cortisol production. Recent updates in screening for and treating Cushing's syndrome are reviewed here.
Language	English
Publishing date	2018-06
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	2802452-7
ISSN	2093-5978 ; 2093-596X
ISSN (online)	2093-5978
ISSN	2093-596X
DOI	10.3803/EnM.2018.33.2.139
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Update on subclinical Cushing's syndrome.

Nieman, Lynnette K

Current opinion in endocrinology, diabetes, and obesity

2015 Volume 22, Issue 3, Page(s) 180–184

Abstract: Purpose of review: The present review summarizes recent findings in the diagnosis and treatment of subclinical Cushing's syndrome, a condition of subtle cortisol dysregulation with a spectrum of clinical and biochemical abnormalities.: Recent findings! ...

Abstract	Purpose of review: The present review summarizes recent findings in the diagnosis and treatment of subclinical Cushing's syndrome, a condition of subtle cortisol dysregulation with a spectrum of clinical and biochemical abnormalities. Recent findings: The diagnosis of subclinical Cushing's syndrome is suggested by abnormal suppression to dexamethasone in a patient with an adrenal mass. The natural history of this disorder includes progression in a minority of cases, and increased cardiovascular disease in patients with more severe and progressive disease, much as is found in overt Cushing's syndrome. In patients with an abnormal response to dexamethasone, additional biochemical and metabolic features increase confidence in the ability of adrenalectomy to reverse clinical abnormalities. In addition, bilateral masses and larger masses are more likely to be associated with hypercortisolism. Summary: We review the recent literature on subclinical cortisol secretion and suggest that additional studies are needed to define optimal diagnostic and therapeutic approaches.
MeSH term(s)	Cushing Syndrome/diagnosis ; Cushing Syndrome/metabolism ; Cushing Syndrome/therapy ; Humans ; Hydrocortisone/metabolism
Chemical Substances	Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2015-06
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2272017-0
ISSN	1752-2978 ; 1752-296X
ISSN (online)	1752-2978
ISSN	1752-296X
DOI	10.1097/MED.0000000000000159
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Se 1363: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Cushing's syndrome: update on signs, symptoms and biochemical screening.

Nieman, Lynnette K

European journal of endocrinology

2015 Volume 173, Issue 4, Page(s) M33–8

Abstract: Endogenous pathologic hypercortisolism, or Cushing's syndrome, is associated with poor quality of life, morbidity, and increased mortality. Early diagnosis may mitigate against this natural history of the disorder. The clinical presentation of Cushing's ... ...

Abstract	Endogenous pathologic hypercortisolism, or Cushing's syndrome, is associated with poor quality of life, morbidity, and increased mortality. Early diagnosis may mitigate against this natural history of the disorder. The clinical presentation of Cushing's syndrome varies, in part related to the extent and duration of cortisol excess. When hypercortisolism is severe, its signs and symptoms are unmistakable. However, most of the signs and symptoms of Cushing's syndrome are common in the general population (e.g., hypertension and weight gain) and not all are present in every patient. In addition to classical features of glucocorticoid excess, such as proximal muscle weakness and wide purple striae, patients may present with the associated comorbidities that are caused by hypercortisolism. These include cardiovascular disease, thromboembolic disease, psychiatric and cognitive deficits, and infections. As a result, internists and generalists must consider Cushing's syndrome as a cause, and endocrinologists should search for and treat these comorbidities. Recommended tests to screen for Cushing's syndrome include 1 mg dexamethasone suppression, urine free cortisol, and late night salivary cortisol. These may be slightly elevated in patients with physiologic hypercortisolism, which should be excluded, along with exogenous glucocorticoid use. Each screening test has caveats and the choice of tests should be individualized based on each patient's characteristics and lifestyle. The objective of this review is to update the readership on the clinical and biochemical features of Cushing's syndrome that are useful when evaluating patients for this diagnosis.
MeSH term(s)	Body Fat Distribution ; Cushing Syndrome/complications ; Cushing Syndrome/diagnosis ; Dexamethasone ; Glucocorticoids ; Humans ; Hydrocortisone/analysis ; Hydrocortisone/urine ; Hypertension/etiology ; Muscle Weakness/etiology ; Obesity/etiology ; Saliva/chemistry ; Striae Distensae/etiology
Chemical Substances	Glucocorticoids ; Dexamethasone (7S5I7G3JQL) ; Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2015-07-08
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	1183856-5
ISSN	1479-683X ; 0804-4643
ISSN (online)	1479-683X
ISSN	0804-4643
DOI	10.1530/EJE-15-0464
Database	MEDical Literature Analysis and Retrieval System OnLINE

Full text online

Accessible to users with ZB MED library card

In stock of ZB MED Cologne/Königswinter

Uh III Zs.147: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾

To top

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito