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Article ; Online: Licorice-induced hypertension: a case of pseudohyperaldosteronism due to jelly bean ingestion.

Foster, Christopher A / Church, Kristen S / Poddar, Megha / Van Uum, Stan H M / Spaic, Tamara

2017 Volume 129, Issue 3, Page(s) 329–331

Abstract: Hypertension is one of the most common problems encountered in the primary care setting. Numerous secondary causes of hypertension exist and are potentially reversible. The ability to screen for such causes and manage them effectively may spare patients ... ...

Abstract	Hypertension is one of the most common problems encountered in the primary care setting. Numerous secondary causes of hypertension exist and are potentially reversible. The ability to screen for such causes and manage them effectively may spare patients from prolonged medical therapy and hypertensive complications. Licorice can cause hypertension and hypokalemia due its effects on cortisol metabolism. We report a case of jelly bean ingestion that highlights the presentation, pathophysiology and management of licorice-induced hypertension.
MeSH term(s)	Glycyrrhiza/adverse effects ; Glycyrrhiza/metabolism ; Humans ; Hyperaldosteronism/chemically induced ; Hypertension/chemically induced ; Hypokalemia/chemically induced ; Male ; Middle Aged
Language	English
Publishing date	2017-04
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	410138-8
ISSN	1941-9260 ; 0032-5481
ISSN (online)	1941-9260
ISSN	0032-5481
DOI	10.1080/00325481.2017.1291062
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Article: Liquorice and hypertension.

van Uum, S H

The Netherlands journal of medicine

2005 Volume 63, Issue 4, Page(s) 119–120

Abstract: Glycyrrhetinic acid, the active constituent of liquorice, inhibits renal IIbeta-hydroxysteroid dehydrogenase. This allows cortisol to stimulate mineralocorticoid receptors, which can result in hypertension and hypokalaemia. Treatment options are based on ...

Abstract	Glycyrrhetinic acid, the active constituent of liquorice, inhibits renal IIbeta-hydroxysteroid dehydrogenase. This allows cortisol to stimulate mineralocorticoid receptors, which can result in hypertension and hypokalaemia. Treatment options are based on pathophysiological understanding.
MeSH term(s)	11-beta-Hydroxysteroid Dehydrogenases/antagonists & inhibitors ; Candy/toxicity ; Glycyrrhetinic Acid/toxicity ; Glycyrrhiza/chemistry ; Glycyrrhiza/toxicity ; Humans ; Hypertension/chemically induced ; Hypertension/enzymology ; Hypokalemia/chemically induced ; Hypokalemia/enzymology ; Receptors, Mineralocorticoid/drug effects
Chemical Substances	Receptors, Mineralocorticoid ; 11-beta-Hydroxysteroid Dehydrogenases (EC 1.1.1.146) ; Glycyrrhetinic Acid (P540XA09DR)
Language	English
Publishing date	2005-04
Publishing country	Netherlands
Document type	Editorial
ZDB-ID	193149-0
ISSN	1872-9061 ; 0300-2977
ISSN (online)	1872-9061
ISSN	0300-2977
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Zs.A 576: Show issues

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Article: Regional Variation across Canadian Centers in Radioiodine Administration for Thyroid Remnant Ablation in Well-Differentiated Thyroid Cancer Diagnosed in 2000-2010.

Rachinsky, I / Rajaraman, M / Leslie, W D / Zahedi, A / Jefford, C / McGibbon, A / Young, J E M / Pathak, K A / Badreddine, M / De Brabandere, S / Fong, H / Van Uum, S

Journal of thyroid research

2016 Volume 2016, Page(s) 2867916

Abstract: ... ...

Abstract	Background
Language	English
Publishing date	2016-11-29
Publishing country	United States
Document type	Journal Article
ISSN	2090-8067
ISSN	2090-8067
DOI	10.1155/2016/2867916
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Article ; Online: A pediatric patient with Cushing syndrome caused by ectopic ACTH syndrome and concomitant pituitary incidentalomas.

Goldberg, Alyse S / Stein, Robert / Merritt, Neil H / Inculet, Richard / Van Uum, Stan

Journal of pediatric endocrinology & metabolism : JPEM

2014 Volume 27, Issue 1-2, Page(s) 123–128

Abstract: Ectopic ACTH syndrome is a rare but important cause of pediatric Cushing syndrome, for which management by a multidisciplinary team is required. Although diagnostic evaluation is similar to that in adults, the variation in epidemiology may sway ... ...

Abstract	Ectopic ACTH syndrome is a rare but important cause of pediatric Cushing syndrome, for which management by a multidisciplinary team is required. Although diagnostic evaluation is similar to that in adults, the variation in epidemiology may sway investigations, leading to inappropriate and/or incomplete diagnostic interventions. We present a case of 15-year-old girl with symptoms of severe ACTH-dependent Cushing syndrome and two pituitary adenomas. The ectopic source of ACTH production was confirmed after petrosal venous sampling was performed. Diagnostics and perioperative management of a pulmonary carcinoid tumor producing ectopic ACTH is reviewed. In pediatric patients, as in adult patients, a pituitary lesion <6 mm on MRI is not sufficient confirmation of Cushing's disease, and appropriate diagnostic work-up should be performed to assess the source of the ACTH overproduction.
MeSH term(s)	ACTH Syndrome, Ectopic/complications ; Adolescent ; Carcinoid Tumor/complications ; Carcinoid Tumor/diagnosis ; Carcinoid Tumor/pathology ; Cushing Syndrome/etiology ; Female ; Humans ; Incidental Findings ; Lung Neoplasms/complications ; Lung Neoplasms/diagnosis ; Lung Neoplasms/pathology ; Pituitary Neoplasms/complications ; Pituitary Neoplasms/diagnosis ; Pituitary Neoplasms/secondary
Language	English
Publishing date	2014-01
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	1231070-0
ISSN	2191-0251 ; 0334-018X
ISSN (online)	2191-0251
ISSN	0334-018X
DOI	10.1515/jpem-2013-0070
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Zs.A 2258: Show issues

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Article ; Online: Hormone phase influences sympathetic responses to high levels of lower body negative pressure in young healthy women.

Usselman, Charlotte W / Nielson, Chantelle A / Luchyshyn, Torri A / Gimon, Tamara I / Coverdale, Nicole S / Van Uum, Stan H M / Shoemaker, J Kevin

American journal of physiology. Regulatory, integrative and comparative physiology

2016 Volume 311, Issue 5, Page(s) R957–R963

Abstract: We tested the hypothesis that sympathetic responses to baroreceptor unloading may be affected by circulating sex hormones. During lower body negative pressure at -30, -60, and -80 mmHg, muscle sympathetic nerve activity (MSNA), heart rate, and blood ... ...

Abstract	We tested the hypothesis that sympathetic responses to baroreceptor unloading may be affected by circulating sex hormones. During lower body negative pressure at -30, -60, and -80 mmHg, muscle sympathetic nerve activity (MSNA), heart rate, and blood pressure were recorded in women who were taking (n = 8) or not taking (n = 9) hormonal contraceptives. All women were tested twice, once during the low-hormone phase (i.e., the early follicular phase of the menstrual cycle and the placebo phase of hormonal contraceptive use), and again during the high-hormone phase (i.e., the midluteal phase of the menstrual cycle and active phase of contraceptive use). During baroreceptor unloading, the reductions in stroke volume and resultant increases in MSNA and total peripheral resistance were greater in high-hormone than low-hormone phases in both groups. When normalized to the fall in stroke volume, increases in MSNA were no longer different between hormone phases. While stroke volume and sympathetic responses were similar between women taking and not taking hormonal contraceptives, mean arterial pressure was maintained during baroreceptor unloading in women not taking hormonal contraceptives but not in women using hormonal contraceptives. These data suggest that differences in sympathetic activation between hormone phases, as elicited by lower body negative pressure, are the result of hormonally mediated changes in the hemodynamic consequences of negative pressure, rather than centrally driven alterations to sympathetic regulation.
MeSH term(s)	Adult ; Blood Pressure/drug effects ; Blood Pressure/physiology ; Contraceptives, Oral, Hormonal/administration & dosage ; Contraceptives, Oral, Hormonal/pharmacology ; Female ; Follicular Phase/drug effects ; Follicular Phase/physiology ; Gonadal Steroid Hormones/blood ; Heart Rate/drug effects ; Heart Rate/physiology ; Humans ; Lower Body Negative Pressure ; Luteal Phase/drug effects ; Luteal Phase/physiology ; Pressoreceptors/drug effects ; Pressoreceptors/physiology ; Sympathetic Nervous System/diagnostic imaging ; Sympathetic Nervous System/physiology
Chemical Substances	Contraceptives, Oral, Hormonal ; Gonadal Steroid Hormones
Language	English
Publishing date	2016-10-12
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.00190.2016
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Uc I Zs.89: Show issues

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Article ; Online: Ciprofloxacin and rifampin have opposite effects on levothyroxine absorption.

Goldberg, Alyse S / Tirona, Rommel G / Asher, Linda J / Kim, Richard B / Van Uum, Stan H M

Thyroid : official journal of the American Thyroid Association

2013 Volume 23, Issue 11, Page(s) 1374–1378

Abstract: Background: Levothyroxine (L-T4) absorption varies between individuals, and can be affected by various concomitantly administered drugs. Case reports have indicated an association between cotreatment with ciprofloxacin or rifampin and hypothyroidism in ... ...

Abstract	Background: Levothyroxine (L-T4) absorption varies between individuals, and can be affected by various concomitantly administered drugs. Case reports have indicated an association between cotreatment with ciprofloxacin or rifampin and hypothyroidism in patients on a stable L-T4 dose. Methods: The effects of two antibiotics on T4 absorption were prospectively assessed in a double-blind, randomized, crossover fashion. Eight healthy volunteers received 1000 μg L-T4 combined with placebo, ciprofloxacin 750 mg, or rifampin 600 mg as single doses. We measured total plasma thyroxine (T4) concentrations over a 6-hour period after dosing using liquid chromatography-tandem mass spectrometry. For each study arm, areas under the T4 plasma concentration-time curve (T4 AUCs) were compared. Results: Coadministration of ciprofloxacin significantly decreased the T4 AUC by 39% (p = 0.035), while, surprisingly, rifampin significantly increased T4 AUC by 25% (p = 0.003). Conclusion: Intestinal absorption of L-T4 is differentially affected by acute coadministration of ciprofloxacin or rifampin. Mechanistic studies focused on intestinal and possibly hepatic thyroid hormone transporters are required to explain the observed drug interactions with L-T4.
MeSH term(s)	Absorption ; Administration, Oral ; Adolescent ; Adult ; Area Under Curve ; Ciprofloxacin/pharmacology ; Cross-Over Studies ; Double-Blind Method ; Drug Interactions ; Female ; Humans ; Hypothyroidism/chemically induced ; Intestinal Absorption/drug effects ; Liver/metabolism ; Male ; Prospective Studies ; Rifampin/pharmacology ; Thyroid Hormones/metabolism ; Thyroxine/administration & dosage ; Thyroxine/pharmacokinetics ; Time Factors ; Young Adult
Chemical Substances	Thyroid Hormones ; Ciprofloxacin (5E8K9I0O4U) ; Thyroxine (Q51BO43MG4) ; Rifampin (VJT6J7R4TR)
Language	English
Publishing date	2013-11
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1086044-7
ISSN	1557-9077 ; 1050-7256
ISSN (online)	1557-9077
ISSN	1050-7256
DOI	10.1089/thy.2013.0014
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Zs.A 3307: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 106: Show issues

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Article ; Online: Stress and reward: long term cortisol exposure predicts the strength of sexual preference.

Chumbley, J R / Hulme, O / Köchli, H / Russell, E / Van Uum, S / A Pizzagalli, D / Fehr, E

Physiology & behavior

2014 Volume 131, Page(s) 33–40

Abstract: Healthy individuals tend to consume available rewards like food and sex. This tendency is attenuated or amplified in most stress-related psychiatric conditions, so we asked if it depends on endogenous levels of the 'canonical stress hormone' cortisol. We ...

Abstract	Healthy individuals tend to consume available rewards like food and sex. This tendency is attenuated or amplified in most stress-related psychiatric conditions, so we asked if it depends on endogenous levels of the 'canonical stress hormone' cortisol. We unobtrusively quantified how hard healthy heterosexual men would work to consume erotic images of women versus men and also measured their exposure to endogenous cortisol in the prior two months. We used linear models to predict the strength of sexual preference from cortisol level, after accounting for other potential explanations. Heterosexual preference declines with self-reported anhedonia but increases with long term exposure to endogenous cortisol. These results suggest that cortisol may affect reward-related behavior in healthy adults.
MeSH term(s)	Adolescent ; Adult ; Anhedonia/physiology ; Hair/chemistry ; Humans ; Hydrocortisone/metabolism ; Linear Models ; Male ; Neuropsychological Tests ; Photic Stimulation ; Reward ; Sexual Behavior/physiology ; Visual Perception/physiology ; Young Adult
Chemical Substances	Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2014-05-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3907-x
ISSN	1873-507X ; 0031-9384
ISSN (online)	1873-507X
ISSN	0031-9384
DOI	10.1016/j.physbeh.2014.04.013
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Zs.A 747: Show issues

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Article ; Online: Menstrual cycle and sex effects on sympathetic responses to acute chemoreflex stress.

Usselman, Charlotte W / Gimon, Tamara I / Nielson, Chantelle A / Luchyshyn, Torri A / Coverdale, Nicole S / Van Uum, Stan H M / Shoemaker, J Kevin

American journal of physiology. Heart and circulatory physiology

2014 Volume 308, Issue 6, Page(s) H664–71

Abstract: This study aimed to examine the effects of sex (males vs. females) and sex hormones (menstrual cycle phases in women) on sympathetic responsiveness to severe chemoreflex activation in young, healthy individuals. Muscle sympathetic nerve activity (MSNA) ... ...

Abstract	This study aimed to examine the effects of sex (males vs. females) and sex hormones (menstrual cycle phases in women) on sympathetic responsiveness to severe chemoreflex activation in young, healthy individuals. Muscle sympathetic nerve activity (MSNA) was measured at baseline and during rebreathing followed by a maximal end-inspiratory apnea. In women, baseline MSNA was greater in the midluteal (ML) than early-follicular (EF) phase of the menstrual cycle. Baseline MSNA burst incidence was greater in men than women, while burst frequency and total MSNA were similar between men and women only in the ML phase. Chemoreflex activation evoked graded increases in MSNA burst frequency, amplitude, and total activity in all participants. In women, this sympathoexcitation was greater in the EF than ML phase. The sympathoexcitatory response to chemoreflex stimulation of the EF phase in women was also greater than in men. Nonetheless, changes in total peripheral resistance were similar between sexes and menstrual cycle phases. This indicates that neurovascular transduction was attenuated during the EF phase during chemoreflex activation, thereby offsetting the exaggerated sympathoexcitation. Chemoreflex-induced increases in mean arterial pressure were similar across sexes and menstrual cycle phases. During acute chemoreflex stimulation, reduced neurovascular transduction could provide a mechanism by which apnea-associated morbidity might be attenuated in women relative to men.
MeSH term(s)	Action Potentials ; Adult ; Biomarkers/blood ; Chemoreceptor Cells/metabolism ; Female ; Hemodynamics ; Humans ; Hypercapnia/blood ; Hypercapnia/metabolism ; Hypercapnia/physiopathology ; Hypoxia/blood ; Hypoxia/metabolism ; Hypoxia/physiopathology ; Male ; Menstrual Cycle/blood ; Menstrual Cycle/metabolism ; Muscle, Skeletal/innervation ; Reflex ; Sex Factors ; Stress, Physiological ; Sympathetic Nervous System/physiopathology ; Time Factors ; Young Adult
Chemical Substances	Biomarkers
Keywords	covid19
Language	English
Publishing date	2014-12-19
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603838-4
ISSN	1522-1539 ; 0363-6135
ISSN (online)	1522-1539
ISSN	0363-6135
DOI	10.1152/ajpheart.00345.2014
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Uc I Zs.89: Show issues

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Article: Effect of omalizumab for autoimmune progesterone dermatitis refractory to bilateral oophorectomy: a case report.

Varghese, Akshay / Paul, Terri / Kim, Harold / Van Uum, Stan / Vadas, Peter / Azzola, Alescia

Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

2021 Volume 17, Issue 1, Page(s) 58

Abstract: Background: Autoimmune progesterone dermatitis (APD) is a rare skin condition caused by sensitivity to high levels of progesterone secreted during the luteal phase of the menstrual cycle. This may be due to various pathophysiological mechanisms ... ...

Abstract	Background: Autoimmune progesterone dermatitis (APD) is a rare skin condition caused by sensitivity to high levels of progesterone secreted during the luteal phase of the menstrual cycle. This may be due to various pathophysiological mechanisms including a Type I and Type IV hypersensitivity reaction. Here we present the case of a patient with APD whose episodic flares were controlled by the addition of omalizumab, after a bilateral oophorectomy failed to resolve her symptoms. Case presentation: A 34-year-old female presented to our Endocrine clinic with marked Cushingoid features secondary to high-dose oral prednisone prescribed for APD diagnosed 6 years earlier. She first developed a pruritic maculopapular rash on her arms and legs just after the birth of her second child in 2009. The rash was also associated with headaches and diffuse angioedema. Symptoms occurred for 1-2 weeks, in a cyclical fashion, during the luteal phase of each menstrual cycle and subsided within a few days after menses. The severity of symptoms increased as time went on, and flare-ups began to also include dyspnea, nausea, vomiting and abdominal pain. Her symptoms improved with administration of oral prednisone, but she continued to experience breakthrough symptoms. After multiple failed treatment modalities, she elected bilateral oophorectomy in 2018. However, her symptoms of APD persisted and she still required high-dose oral prednisone. Her condition was further complicated by vasomotor menopausal symptoms and progressive iatrogenic Cushing's syndrome. She eventually was started on Omalizumab, which suppressed further recurrences of APD symptoms and allowed her to wean off prednisone. Vasomotor menopausal symptoms responded well to the addition of conjugated estrogens with bazedoxifene. However, her symptoms of diffuse bony pain and arthralgias which started whilst on prednisone have persisted in spite of discontinuing prednisone. Conclusions: To our knowledge, this is only the third case of APD which was successfully treated with Omalizumab and the first case where a bilateral oophorectomy failed to resolve symptoms of APD in the literature. This case also demonstrates the complications of vasomotor menopausal symptoms secondary to a bilateral oophorectomy, as well as the adverse effects of long-term glucocorticoid therapy.
Language	English
Publishing date	2021-06-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2434973-2
ISSN	1710-1492 ; 1710-1484
ISSN (online)	1710-1492
ISSN	1710-1484
DOI	10.1186/s13223-021-00561-2
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Article: Dehydroepiandrosterone administration in humans: evidence based?

Bovenberg, S A / van Uum, S H M / Hermus, A R M M

The Netherlands journal of medicine

2005 Volume 63, Issue 8, Page(s) 300–304

Abstract: Dehydroepiandrosterone (DHEA) and its ester dehydroepiandrosterone sulphate (DHEAS) are produced by the adrenal glands. These hormones are inactive precursors that are transformed into active sex steroids in peripheral target tissues. After a peak in ... ...

Abstract	Dehydroepiandrosterone (DHEA) and its ester dehydroepiandrosterone sulphate (DHEAS) are produced by the adrenal glands. These hormones are inactive precursors that are transformed into active sex steroids in peripheral target tissues. After a peak in early adulthood, there is a marked decrease in plasma concentrations throughout adult life. These hormones are thought to affect mood and well-being, have neurosteroid effects and may influence the immune system. Animal experiments suggest that DHEA has many other effects, including anticancer, immune-enhancing, neurotropic and general antiageing effects, but information based on studies in humans is limited. In female patients with adrenal insufficiency, treatment with DHEA replacement doses of 20 to 50 mg results in improvements in mood, quality of life and libido. These studies usually lasted only a few months, so the effect of chronic DHEA treatment or its effectiveness in male patients is not known. Some studies suggest a favourable effect of pharmacological doses of DHEA in the treatment of depression. DHEA may have a very limited effect on cognitive function in elderly people, and some studies suggest a beneficial immunomodulatory effect of DHEA in patients with autoimmune diseases, but further studies are warranted before introducing DHEA for these indications in clinical practice.
MeSH term(s)	Adrenal Insufficiency ; Affect/drug effects ; Age Factors ; Autoimmune Diseases/drug therapy ; Cognition/drug effects ; Dehydroepiandrosterone/administration & dosage ; Dehydroepiandrosterone/secretion ; Evidence-Based Medicine ; Female ; Humans ; Male ; Postmenopause/drug effects
Chemical Substances	Dehydroepiandrosterone (459AG36T1B)
Language	English
Publishing date	2005-09
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	193149-0
ISSN	1872-9061 ; 0300-2977
ISSN (online)	1872-9061
ISSN	0300-2977
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