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41. Guideline on the management of premature ovarian insufficiency

) antibodies should be performed in women with POI of unknown cause or if an immune disorder is suspected. In patients with a positive TPO-Ab test, thyroid stimulating hormone (TSH) should be measured every year. C 10 There is insufficient evidence to recommend routinely screening POI women for diabetes. D There is no indication for infection screening in women with POI. D The possibility of POI being a consequence of a medical or surgical intervention should be discussed with women as part (...) for at least 4 months, and ? an elevated FSH level > 25 IU/l on two occasions > 4 weeks apart. GPP What are the known causes of POI and how should they be investigated? Chromosomal analysis should be performed in all women with non-iatrogenic Premature Ovarian Insufficiency. C Gonadectomy should be recommended for all women with detectable Y chromosomal material. C Fragile-X premutation testing is indicated in POI women. B The implications of the fragile-X premutation should be discussed before the test

2015 European Society of Human Reproduction and Embryology

42. Adjustment to Cancer: Anxiety and Distress (PDQ®): Health Professional Version

is adjusting.[ ] Self-Report Screening Instruments Studies have tested the ability of single-item measures to accurately identify patients in distress.[ - ] In general, these ultrashort screening methods, such as the Distress Thermometer (DT), have demonstrated only modest overall accuracy. They are best for ruling out—but performed poorly at confirming—distress, anxiety, and depression. The Distress Thermometer (DT) The DT, the National Comprehensive Cancer Network (NCCN) single-item and rapid-screening (...) instrument, asks patients to rate their distress on a scale of 0 to 10, with 10 being extreme distress. On an accompanying problem checklist, patients are asked to indicate what has been a problem for them in the past week.[ ] Although many screening instruments have been tested with cancer patients, the DT has been the most widely investigated. The psychometric properties of the DT—a 0-to-10 visual analog scale in the form of a thermometer labeled No distress at 0 and Extreme distress at 10—have been

2018 PDQ - NCI's Comprehensive Cancer Database

43. Late Effects of Treatment for Childhood Cancer (PDQ®): Health Professional Version

of cardiac, pulmonary, and metabolic late effects.[ - ] Access to risk-based survivor care Most childhood cancer survivors do not receive recommended risk-based care. The CCSS observed the following: 88.8% of survivors reported receiving some form of medical care.[ ] 31.5% reported receiving care that focused on their previous cancer (survivor-focused care).[ ] 17.8% reported receiving survivor-focused care that included advice about risk reduction and discussion or ordering of screening tests (...) .[ - ] Treatment of childhood HL with higher cumulative doses of alkylating agents and ovarian radiation of 5 Gy or higher (exposures predisposing to premature menopause) have been correlated with reductions in breast cancer risk, underscoring the potential contribution of hormonal stimulation on breast carcinogenesis.[ , , ] Most data describing the risk of radiation-associated breast cancer are based on patients treated for HL, with doses ranging from 15 Gy to 50 Gy. However, the risk of breast cancer

2018 PDQ - NCI's Comprehensive Cancer Database

44. Revised ATA guidelines for the management of medullary thyroid carcinoma

to the neck 52 591–592 [T] Evaluation of patients with distant metastases 592 [T-1] Role of open or laparoscopic evaluation of the liver and selective venous catheterization with measurement of hepatic and peripheral vein stimulated Ctn levels 53, 54 592 [U] Diagnosis and treatment of patients with clinically evident metastatic disease 592 [U-1] Brain metastases 55 592–593 [U-2] Bone metastases 56–58 593 [U-3] Lung and mediastinal metastases 59 593 [U-4] Hepatic metastases 60 593 [U-5] Cutaneous (...) Carcinoembryonic antigen CLA Cutaneous lichen amyloidosis CRH Corticotropin-releasing hormone CT Computed tomography (tomographic) Ctn Calcitonin EBRT a External beam radiation therapy EMA European Medicines Agency FDA U.S. Food and Drug Administration FDG-PET 2-[Fluorine-18]?uoro-2-deoxy-D-glucose- positron emission tomography F-DOPA 18 F-dihydroxyphenylalanine FMTC Familial medullary thyroid cancer FNA Fine-needle aspiration FTC Follicular thyroid carcinoma HD Hirschsprung’s disease HIPAA Health Insurance

2015 Pediatric Endocrine Society

45. Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers

and 24 h later NR NR Mean VPT at 1 mo: Org low: 2.9, Org high: 1.1, PL: 3.7 Mean VPT at 4-12 mo: Org low: 3.6, Org high: 2.0, PL: 4.8 Note: No formal test for significance conducted Mean sum scores for patient reported neurological signs and symptoms at 1 mo: Org low: 6.3, Org high: 0.0, PL: 6.3 Mean sum scores for patient reported neurological signs and symptoms at 4-12 mo: Org low: 4.5, Org high: 3.5, PL: 5.7 Note: No formal test for significance conducted Oxycarbazepine (OXC) Argyriou 2006a (...) by toxicities such as nausea, vomiting, and light-headedness. A phase II trial randomly assigned 117 patients with solid tumors receiving treatment with carboplatin/paclitaxel to low-dose (2 μg/kg) or high-dose (4 μg/kg) recombinant human leukemia inhibitory factor (rhuLIF) or placebo. This study was convincingly negative, with no differences between the groups in standardized composite peripheral nerve electrophysiology (CPNE) scores, the primary end point, or other secondary neurological testing variables

2014 American Society of Clinical Oncology Guidelines

46. Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline

Education and Research, Inc.® 3 AUA/SUFU Guideline Overactive Bladder catheterization if necessary. Standard Option (Evidence Strength Grade B C) 18. Clinicians may offer peripheral tibial nerve stimulation (PTNS) as third line treatment in a carefully selected patient population. Recommendation (Evidence Strength Grade C) 19. Clinicians may offer sacral neuromodulation (SNS) as third line treatment in a carefully selected patient population characterized by severe refractory OAB symptoms or patients (...) information regarding use of neuromodulation therapies, including sacral neuromodulation (SNS) and peripheral tibial nerve stimulation (PTNS) (also known as posterior tibial nerve stimulation) and limited information regarding the use of intravesical onabotulinumtoxinA to treat non-neurogenic OAB patients, additional searches were performed to capture this literature and relevant data were added to the database. The AUA update literature review process, in which an additional systematic review

2014 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction

47. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: AUA/SUFU Guideline

OAB treatments. The patient must be able and willing to return for frequent post-void residual evaluation and able and willing to perform self-catheterization if necessary. Standard Option (Evidence Strength Grade B C ) 18. Clinicians may offer peripheral tibial nerve stimulation (PTNS) as third line treatment in a carefully selected patient population. Recommendation (Evidence Strength Grade C) 19. Clinicians may offer sacral neuromodulation (SNS) as third line treatment in a carefully selected (...) neuromodulation (SNS) and peripheral tibial nerve stimulation (PTNS) (also known as posterior tibial nerve stimulation) and limited information regarding the use of intravesical onabotulinumtoxinA to treat non-neurogenic OAB patients, additional searches were performed to capture this literature and relevant data were added to the database. The AUA update literature review process, in which an additional systematic review is conducted periodically to maintain guideline currency with newly-published relevant

2014 American Urological Association

48. Primary Ovarian Insufficiency in Adolescents and Young Women

, it is acceptable to test for thyroid disease every 1–2 years. Patients with primary ovarian insufficiency also have a 50% chance of developing adrenal insufficiency if they have adrenal autoimmunity. Patients should be tested for adrenal anti-bodies and if results are positive, should undergo yearly corticotropin stimulation testing. Data are lacking on the follow-up of patients with negative test results (1). Diabetes mellitus, pernicious anemia, myasthenia gravis, rheumatoid arthritis, systemic lupus (...) insufficiency Menstrual irregularity for at least 3 consecutive months Follicle-stimulating hormone and estradiol levels (two random tests at least 1 month apart) Prolactin and thyroid function test If diagnosis is confirmed: Karyotype FMR1 permutation Adrenal antibodies — 21-hydroxylase (CYP21) by immunoprecipitation or — Indirect immunofluorescence Pelvic ultrasonography Data from Nelson LM. Clinical practice. Primary ovarian insufficiency. . Initial laboratory evaluation for suspected primary ovarian

2014 American College of Obstetricians and Gynecologists

49. Adrenal Suppression in Infants Treated with Topical Ocular Glucocorticoids. (PubMed)

to collect data on results and timing of a standard corticotropin (adrenocorticotropic hormone [ACTH]) stimulation test and GC dose per kilogram body weight.Incidence of adrenal suppression in children tested on GC treatment. Glucocorticoid dose per kilogram body weight.Among 26 consecutive infants, 15 (58%) were tested while they were still on GC treatment. Ten of these 15 infants (67%) had adrenal suppression, 2 of whom had obvious clinical signs of Cushing's syndrome and 1 of whom had signs (...) of Addisonian crises during general anesthesia. Eleven of the 26 infants (42%) were tested at a median time of 21 days (range, 6-89) after treatment cessation, and they all had normal test results. Children with suppressed adrenal function had received cumulative GC doses per body weight that were significantly higher the last 5 days before testing compared with children with normal test results. Infants with adrenal suppression were treated with hydrocortisone replacement therapy. Adrenal function

2018 Ophthalmology

50. Spontaneous adrenocorticotropic hormone (ACTH) normalisation due to tumour regression induced by metyrapone in a patient with ectopic ACTH syndrome: case report and literature review. (PubMed)

lung. There was no adrenal gland enlargement. Tumour markers were not significantly elevated; ACTH levels were not suppressed by 8-mg dexamethasone. A corticotropin-releasing hormone stimulation test revealed blunted ACTH response (basal ACTH, 204.6 pg/mL; highest ACTH level during the 120-min stimulation test, 214.0 pg/mL). She was diagnosed with EAS due to a lung lesion. MTP treatment was started to reduce cortisol production. ACTH levels and cortisol and UFC levels were normalised and the ACTH

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2018 BMC Endocrine Disorders

51. Clinical Trial to Investigate CT38 in the Treatment of Myalgic Encephalomyelitis / Chronic Fatigue Syndrome

Identifier: NCT03613129 Recruitment Status : Recruiting First Posted : August 2, 2018 Last Update Posted : August 2, 2018 See Sponsor: LUCINDA BATEMAN, MD Information provided by (Responsible Party): LUCINDA BATEMAN, MD, Bateman Horne Center Study Details Study Description Go to Brief Summary: This study seeks to examine the effect of a subcutaneous infusion of CT38, an experimental peptide, on cardio-pulmonary exercise test (CPET) performance and CPET-induced changes in functional capacity and symptom (...) levels (assessed by, Fitbit monitoring, DANA cognitive testing and patient-reported outcome measures) in ME/CFS. Condition or disease Intervention/treatment Phase Myalgic Encephalomyelitis Chronic Fatigue Syndrome Drug: CT38 Phase 1 Phase 2 Detailed Description: Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) is a complex disorder that may be triggered by infection or other stressors (e.g., emotional or physical trauma, immune activation, chemical exposures). Its hallmark is a reduced

2018 Clinical Trials

52. Adrenocorticotropic Hormone (ACTH) for Post-op Inflammation in Proliferative Vitreoretinopathy (PVR)

. It stimulates the adrenal cortex to produce and secrete glucocorticoids. ACTH is available for clinical usage as an injectable gel (H.P. Acthar®). Other Names: H.P. Acthar Gel Repository Corticotropin Injection Outcome Measures Go to Primary Outcome Measures : Change in mean aqueous levels of albumin in post-operative PVR patients receiving subcutaneous injections of H.P. Acthar® [ Time Frame: Baseline, 1 day after surgery, 1 week after surgery, 8 weeks after surgery ] The levels of albumin in the aqueous (...) , with higher scores corresponding to better visual acuity (a score of 100 corresponding to a Snellen visual acuity of 20/10). Percentage of post-operative PVR patients receiving subcutaneous injections of H.P. Acthar® who develop recurrent retinal detachment [ Time Frame: 12 weeks after surgery ] Recurrent retinal detachment is a common complication of PVR. It will be diagnosed based on clinical exam and supporting information from diagnostic tests such as Optical Coherence Tomography. Percentage of post

2018 Clinical Trials

53. Secondary adrenal insufficiency and pituitary dysfunction in oral/transdermal opioid users with non-cancer pain (PubMed)

collected prior to 0900 h. Further testing with corticotropin (250 µg IV) and metyrapone (30 mg/kg) stimulation tests was undertaken on participants with serum cortisol <250 nmol/L. Validated questionnaires completed to assess QoL, fatigue and sexual function. Results Secondary adrenal insufficiency (SAI) was identified on the basis of a failed stimulation test in 22.5% of opioid users vs no controls (P = 0.01). Opioid users with SAI had a higher median morphine-equivalent daily dose (MEDD), P = 0.037

2018 European Journal of Endocrinology

54. Pembrolizumab and Pelareorep in Treating Patients With Advanced Pancreatic Cancer

anticoagulant therapy. For patients on anticoagulant therapy, PT/INR must be within therapeutic range. Activated partial thromboplastin time (aPTT) =< 1.5 x ULN unless subject is receiving anticoagulant therapy. For patients on anticoagulant therapy, PT/INR must be within therapeutic range Thyroid-stimulating hormone (TSH), thyroxine (T4) and corticotropin (ACTH) within normal range (prior to registration). Proteinuria within institutional normal or =< grade 1 OR urinary protein < 1 g/24 hours (hr) (prior (...) markers [ Time Frame: Up to 2 years ] Will be assessed for change using paired statistical methods such as paired t-tests or signed rank tests. Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below

2018 Clinical Trials

55. Multicenter Study of Seliciclib (R-roscovitine) for Cushing Disease

and >3 after corticotropin-releasing hormone (CRH) stimulation Recurrent or persistent Cushing disease defined as pathologically confirmed resected pituitary ACTH-secreting tumor, and 24 hour UFC above the upper limit of normal reference range beyond post-surgical week 6 Patients on medical treatment for Cushing disease. Washout periods must be completed before screening assessments are performed. Exclusion criteria: Patients with compromised visual fields, and not stable for at least 6 months (...) or the evaluation of its results, such as History of immunocompromise, including a positive HIV test result (ELISA and Western blot). An HIV test will not be required, however, previous medical history will be reviewed Presence of active or suspected acute or chronic uncontrolled infection History of, or current alcohol misuse/abuse in the 12 month period prior to screening Female patients who are pregnant or lactating, or are of childbearing potential and not practicing a medically acceptable method of birth

2018 Clinical Trials

56. Sex differences in the ACTH and cortisol response to pharmacological probes are stressor-specific and occur regardless of alcohol dependence history. (PubMed)

and may involve both central and peripheral mechanisms regulating the limbic-hypothalamic-pituitary-adrenal axis. In the present randomized, double blind, placebo-controlled, triple-dummy crossover study, we juxtaposed a centrally-acting, citalopram (2 mg/unit BMI) neuroendocrine stimulation test with a peripherally-acting, dexamethasone (Dex) (1.5 mg)/corticotropin-releasing factor (CRF) (1 μg/kg) test in euthymic women (N = 38) and men (N = 44) with (54%) and without histories of alcohol dependence (...) /CRF test than they did the citalopram test while men exhibited the opposite pattern of results. Women also had more robust ACTH, cortisol and body temperature responses to Dex/CRF than men, and exhibited a shift in their adrenal glands' sensitivity to ACTH as measured by the cortisol/log (ACTH) ratio during that session in contrast to the other test days. Our findings indicate that central serotonergic and peripheral mechanisms both play roles in mediating sexually dimorphic, stressor-specific

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2018 Psychoneuroendocrinology Controlled trial quality: uncertain

57. Late Effects of Treatment for Childhood Cancer (PDQ®): Health Professional Version

of cardiac, pulmonary, and metabolic late effects.[ - ] Access to risk-based survivor care Most childhood cancer survivors do not receive recommended risk-based care. The CCSS observed the following: 88.8% of survivors reported receiving some form of medical care.[ ] 31.5% reported receiving care that focused on their previous cancer (survivor-focused care).[ ] 17.8% reported receiving survivor-focused care that included advice about risk reduction and discussion or ordering of screening tests (...) .[ - ] Treatment of childhood HL with higher cumulative doses of alkylating agents and ovarian radiation of 5 Gy or higher (exposures predisposing to premature menopause) have been correlated with reductions in breast cancer risk, underscoring the potential contribution of hormonal stimulation on breast carcinogenesis.[ , , ] Most data describing the risk of radiation-associated breast cancer are based on patients treated for HL, with doses ranging from 15 Gy to 50 Gy. However, the risk of breast cancer

2016 PDQ - NCI's Comprehensive Cancer Database

58. Addison's disease

if adrenal insufficiency is suspected. Admission to hospital may be required depending on the clinical picture and clinical judgement. The diagnosis of Addison's disease is usually confirmed in secondary care. An adrenocorticotrophic hormone stimulation (Synacthen®) test should be done. Treatment for Addison's disease is usually initiated and adjusted by a specialist endocrinologist, but repeat prescriptions may be provided in primary care under a shared care arrangement. Hydrocortisone is usually used (...) to the recommendations on corticosteroid dosing during intercurrent illness, and it is now recommended that an adrenocorticotrophic hormone stimulation (Synacthen®) test should be carried out in secondary care. Previous changes Previous changes May 2014 — minor update. Change to the section on choice of hydrocortisone preparation for the treatment of adrenal crisis. October 2010 — minor update. Text regarding DHEA replacement therapy (unlicensed) reworded to reflect that this may be prescribed by some specialists

2016 NICE Clinical Knowledge Summaries

59. Chronic primary adrenal insufficiency after unilateral adrenonephrectomy: A case report. (PubMed)

) and a mildly decreased morning serum cortisol level (6.4 mg/mL, normal: 7-28 mg/mL). In addition to the patient's clinical symptoms and laboratory results, the results from ACTH and corticotropin-releasing hormone stimulation tests were used to make a diagnosis of primary adrenal insufficiency.Treatment was initiated using oral prednisolone (20 mg), which rapidly resolved his symptoms. At the 1-year follow-up, the patient had a markedly decreased serum cortisol level (2.0 mg/mL) with an ACTH level

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2017 Medicine

60. Apparent Hypothalamic-Pituitary-Adrenal Axis Suppression via Reduction of Interleukin-6 by Glucocorticoid Therapy in Systemic Autoimmune Diseases. (PubMed)

(28 women) who were starting prednisolone therapy according to our standard regimens were prospectively observed. Patients were classified into high-dose and low-dose groups depending on the dose of prednisolone administered as indicated for their diseases. Plasma adrenocorticotropic hormone (ACTH) and serum cortisol levels were measured by electrochemiluminescence immunoassay. The corticotropin-releasing hormone (CRH) test was performed at baseline and second and forth weeks after starting (...) glucocorticoid therapy. The increased levels of ACTH (ΔACTH) and cortisol (Δcortisol) were investigated. Serum levels of 10 proinflammatory cytokines were measured simultaneously by a multi-spot assay system.In the high-dose group, both basal and stimulated levels of ACTH and cortisol were significantly decreased by glucocorticoid therapy. In the low-dose group, basal ACTH and cortisol levels were also significantly decreased by glucocorticoid therapy, but ΔACTH and Δcortisol were unchanged. Among 10

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2016 PLoS ONE

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