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Corticotropin Stimulation Test

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61. Dehydroepiandrosterone sulfate and dehydroepiandrosterone sulfate/cortisol ratio in cirrhotic patients with septic shock: another sign of hepatoadrenal syndrome? (PubMed)

cirrhosis and septic shock.We recruited 46 cirrhotic patients with septic shock, and 46 noncirrhotic counterparts matched by age and sex. We evaluated adrenal function using the short corticotropin stimulation test and analyzed the relation between DHEAS and cortisol.While the nonsurvivors in the cirrhotic group had significantly lower baseline DHEAS, lower baseline DHEAS/cortisol ratio, and reduced increments of both DHEAS and cortisol upon corticotropin stimulation, the survivors had lower baseline (...) Dehydroepiandrosterone sulfate and dehydroepiandrosterone sulfate/cortisol ratio in cirrhotic patients with septic shock: another sign of hepatoadrenal syndrome? Cirrhotic patients are susceptible to sepsis and critical illness-related corticosteroid insufficiency (CIRCI). Dehydroepiandrosterone sulfate (DHEAS) is a corticotropin-dependent adrenal androgen, which has immunostimulating and antiglucocorticoid effects. Considering the synchronized synthesis of cortisol and DHEAS and their opposing

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2017 Critical Care

62. Methamphetamine Induces TET1- and TET3-Dependent DNA Hydroxymethylation of Crh and Avp Genes in the Rat Nucleus Accumbens (PubMed)

Methamphetamine Induces TET1- and TET3-Dependent DNA Hydroxymethylation of Crh and Avp Genes in the Rat Nucleus Accumbens Methamphetamine (METH) addiction is a biopsychosocial disorder that is accompanied by multiple relapses even after prolonged abstinence, suggesting the possibilities of long-lasting maladaptive epigenetic changes in the brain. Here, we show that METH administration produced time-dependent increases in the expression of corticotropin-releasing hormone (Crh/Crf), arginine (...) and at intragenic Avp sites. In addition, METH increased the protein expression of ten-eleven-translocation enzymes that catalyze DNA hydroxymethylation. Importantly, METH increased TET1 binding at the Crh promoter and increased TET3 binding at Avp intragenic regions. We further tested the role of TET enzymes in METH-induced changes in gene expression by using the TET inhibitor, 1,5-isoquinolinediol (IQD), and found that IQD blocked METH-induced increases in Crh and Avp mRNA expression. Together, these results

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2017 Molecular neurobiology

63. Adaptive Changes in the Sensitivity of the Dorsal Raphe and Hypothalamic Paraventricular Nuclei to Acute Exercise, and Hippocampal Neurogenesis May Contribute to the Antidepressant Effect of Regular Treadmill Running in Rats (PubMed)

-HT) neurons in the central nervous system, and the hypothalamic paraventricular nucleus (PVN), in which corticotropin-releasing factor (CRF) neurons initiate the activation of the HPA axis, during one session of acute treadmill running at different speeds (0, 15, 25 m/min, 30 min) in male Wistar rats, using c-Fos immunohistochemistry. We also examined neurogenesis in the hippocampus using immunohistochemistry for doublecortin (DCX) and assessed depressive-like behavior using the forced swim test (...) including serotonergic transmission, activation of the hypothalamic-pituitary-adrenal (HPA) axis, and hippocampal neurogenesis, but few general concepts regarding the optimal exercise regimen for stimulating neural mechanisms involved in antidepressant properties have been developed. Here, we examined how 4 weeks of treadmill running at different intensities (0, 15, 25 m/min, 60 min/day, 5 times/week) alters neuronal activity in the dorsal raphe nucleus (DRN), which is the major source of serotonin (5

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2017 Frontiers in behavioral neuroscience

64. Neofordex - dexamethasone. To treat adults with multiple myeloma

II, or give the monohydrate. Form I, the more stable form, can only be generated from Form II at high temperature, but not from the hydrated forms. Intrinsic Dissolution Rates (IDR) of the different polymorphs were studied. The morphology of the active substance produced by the active ingredient manufacturer is determined and controlled by an XRPD method with a test and control limits included within the specification for the active substance. Specification The control tests comply (...) with the specification and test methods of the Ph. Eur. Monograph for dexamethasone acetate and additional test mentioned in the CEP. Additional specifications have also been set for particle size (laser diffraction) and polymorphism (XRPD). All additional methods have been adequately validated and described according to ICH Q2. Control limits for particle size distribution and morphology are justified in view of the characteristics of the batch of active substance used for the bioequivalence study. Batch analysis

2016 European Medicines Agency - EPARs

65. Alcohol-induced Cushing syndrome. Hypercortisolism caused by alcohol abuse. (PubMed)

. Studies using corticotropin-releasing hormone stimulation and tests after ethanol ingestion revealed inconclusive results.There is no clear definition for the alcohol-induced pseudo-Cushing state, and hitherto studies fail to provide clues to differentiate between pseudo-Cushing and Cushing's syndrome. Only cessation of alcohol can normalise biochemical abnormalities and regress hypercortisolic symptoms. (...) the severity of the changes varied widely. The most frequently occurring abnormalities were: insufficient suppression after low-dose dexamethasone or increased 24-hour urinary free cortisol (UFC). After alcohol withdrawal, cortisol decreased and dexamethasone-induced suppression of cortisol increased. No differences were noted between alcoholic and control subjects after an ACTH stimulation test, insulin tolerance test or metyrapone test. Differences were found after a naloxone test and hexarelin test

2017 Netherlands Journal of Medicine

66. Manipulating the sleep-wake cycle and circadian rhythms to improve clinical management of major depression

in mice indicate the extent to which the coordination of key behavioral factors is dis- turbed. For example, mice with a point mutation in the CLOCK gene display: (i) hyperactivity over the light/dark cycle;, (ii) reduced depression-like behavior in rodent testing paradigms;, and, (iii) an increase in reward value in response to self-stimulation tests [73-75]. Alterations of clock genes also increase dopamine release, enhance sensitivity to dopamine receptor agonists, and alter the relative (...) Manipulating the sleep-wake cycle and circadian rhythms to improve clinical management of major depression OPINION Open Access Manipulating the sleep-wake cycle and circadian rhythms to improve clinical management of major depression Ian B Hickie 1* , Sharon L Naismith 1 , Rébecca Robillard 1 , Elizabeth M Scott 1,2 and Daniel F Hermens 1 Abstract Background: Clinical psychiatry has always been limited by the lack of objective tests to substantiate diagnoses and a lack of specific treatments

2013 Clinical Practice Guidelines Portal

67. Overexpression of CRF in the BNST diminishes dysphoria but not anxiety-like behavior in nicotine withdrawing rats (PubMed)

-releasing factor (CRF) in the bed nucleus of the stria terminalis (BNST) diminishes nicotine withdrawal symptoms in rats. The effect of nicotine withdrawal on brain reward function was investigated with an intracranial self-stimulation (ICSS) procedure. Anxiety-like behavior was investigated in the elevated plus maze test and a large open field. An adeno-associated virus (AAV) pseudotype 2/5 vector was used to overexpress CRF in the lateral BNST and nicotine dependence was induced using minipumps (...) Overexpression of CRF in the BNST diminishes dysphoria but not anxiety-like behavior in nicotine withdrawing rats Smoking cessation leads to dysphoria and anxiety, which both increase the risk for relapse. This negative affective state is partly mediated by an increase in activity in brain stress systems. Recent studies indicate that prolonged viral vector-mediated overexpression of stress peptides diminishes stress sensitivity. Here we investigated whether the overexpression of corticotropin

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2016 European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology

68. The effect of sex and irritable bowel syndrome on HPA axis response and peripheral glucocorticoid receptor expression (PubMed)

to corticotropin-releasing factor (CRF) and adrenocorticotropic hormone (ACTH), and on GR mRNA expression in peripheral blood mononuclear cells (PBMCs).Rome III+ IBS patients and healthy controls underwent CRF (1μg/kg ovine) and ACTH (250μg) stimulation tests with serial plasma ACTH and cortisol levels measured (n=116). GR mRNA levels were measured using quantitative PCR (n=143). Area under the curve (AUC) and linear mixed effects models were used to compare ACTH and cortisol response measured across time

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2016 Psychoneuroendocrinology

69. An Atraumatic Symphysiolysis with a Unilateral Injured Sacroiliac Joint in a Patient with Cushing's Disease: A Loss of Pelvic Stability Related to Ligamentous Insufficiency? (PubMed)

and adrenocorticotropic hormone levels were measured and subsequent corticotropin-releasing hormone stimulation, dexamethasone suppression test, and petrosal sinus sampling verified the diagnosis of adrenocorticotropic hormone-dependent Cushing's disease. The combination of adrenocorticotropic hormone-dependent Cushing's disease and the additional application of exogenous glucocorticoids is the most probable cause of a rare atraumatic rotational pelvic instability in a premenopausal patient. To the authors' knowledge

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2016 Case reports in orthopedics

70. CRF-R1 activation in the anterior-dorsal BNST induces maternal neglect in lactating rats via an HPA axis-independent central mechanism (PubMed)

CRF-R1 activation in the anterior-dorsal BNST induces maternal neglect in lactating rats via an HPA axis-independent central mechanism Adequate maternal behavior in rats requires minimal corticotropin-releasing factor receptor (CRF-R) activation in the medial-posterior bed nucleus of the stria terminalis (mpBNST). Based on the architectural heterogeneity of the BNST and its distinct inter-neural connectivity, we tested whether CRF-R manipulation in another functional part, the anterior-dorsal (...) manipulation. Furthermore, under basal and stress conditions, activation of adBNST CRF-R1 increased plasma ACTH and corticosterone concentrations, whereas stimulation of adBNST CRF-R2 increased basal plasma ACTH and corticosterone concentrations, but blocked the stress-induced increase in plasma corticosterone secretion. Moreover, both the CRF-R1 and -R2 antagonists prevented the stress-induced increase in plasma corticosterone secretion. Importantly, elevated levels of circulating corticosterone induced

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2016 Psychoneuroendocrinology

71. Pituitary Adenoma

if asymptomatic and pituitary mass incidentally found on brain imaging Obtain Brain imaging (MRI preferred) If Pituitary Adenoma is suspected Ophthalmology and Endocrine referrals as below Suspected Pituitary Adenoma Consult ophthalmology for macroadenoma even if no visual changes are readily evident Detailed visual field testing Detailed XII. Management Management directed by endocrinology Consult prior to starting management and in completing evaluation once Pituitary Adenoma is identified Prolactinoma (...) daily (or depot 20 mg every 4 weeks) Lanreotide ( tuline) 90 mg SQ every 4 weeks antagonists (reduce IGF-1 and associated symptoms) Pegvisomant ( vert) 15-20 mg daily Non-Functioning Pituitary Adenoma Obtain ophthalmology for Visual field testing and complete Indicated for Non-functioning Pituitary Macroadenoma (>1 cm) Neurosurgery indications Abnormal ophthalmology examination (especially visual field deficit) Neurologic symptoms (e.g. ) Lesion increasing in size to abut the or growth to >1 cm

2018 FP Notebook

72. Skin Exposure to Ultraviolet B Rapidly Activates Systemic Neuroendocrine and Immunosuppressive Responses (PubMed)

Skin Exposure to Ultraviolet B Rapidly Activates Systemic Neuroendocrine and Immunosuppressive Responses The back skin of C57BL/6 mice was exposed to a single 400 mJ cm-2 dose of ultraviolet B (UVB), and parameters of hypothalamic-pituitary-adrenal (HPA) axis in relation to immune activity were tested after 30-90 min following irradiation. Levels of brain and/or plasma corticotropin-releasing hormone (CRH), β-endorphin, ACTH and corticosterone (CORT) were enhanced by UVB. Hypophysectomy had (...) mice suppressed T-cell mitogen-induced IFNγ production as compared to sera from sham-treated mice. IFNγ production was inhibited in splenocytes isolated from UVB-treated animals with intact pituitary, while stimulated in splenocytes from UVB-treated hypophysectomized mice. Thus, cutaneous exposure to UVB rapidly stimulates systemic CRH, ACTH, β-endorphin and CORT production accompanied by rapid immunosuppressive effects in splenocytes that appear to be independent of the HPA axis.© 2016

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2016 Photochemistry and photobiology

73. Repeated restraint stress lowers the threshold for response to third ventricle CRF administration (PubMed)

Repeated restraint stress lowers the threshold for response to third ventricle CRF administration Rats and mice exposed to repeated stress or a single severe stress exhibit a sustained increase in energetic, endocrine, and behavioral response to subsequent novel mild stress. This study tested whether the hyper-responsiveness was due to a lowered threshold of response to corticotropin releasing factor (CRF) or an exaggerated response to a standard dose of CRF. Male Sprague-Dawley rats were (...) subjected to 3h of restraint on each of 3 consecutive days (RRS) or were non-restrained controls. RRS caused a temporary hypophagia but a sustained reduction in body weight. Eight days after the end of restraint, rats received increasing third ventricle doses of CRF (0-3.0μg). The lowest dose of CRF (0.25μg) increased corticosterone release in RRS, but not control rats. Higher doses caused the same stimulation of corticosterone in the two groups of rats. Fifteen days after the end of restraint, rats

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2016 Hormones and behavior

74. LW-AFC, a new formula derived from Liuwei Dihuang decoction, ameliorates behavioral and pathological deterioration via modulating the neuroendocrine-immune system in PrP-hAβPPswe/PS1ΔE9 transgenic mice (PubMed)

alleviated the neuron loss in the hippocampus, suppressed Aβ deposition in the brain, and reduced the concentration of Aβ1-42 in the hippocampus and plasma of APP/PS1 mice. LW-AFC treatment also significantly decreased the secretion of corticotropin-releasing hormone and gonadotropin-releasing hormone in the hypothalamus, and adrenocorticotropic hormone, luteinizing hormone, and follicle-stimulating hormone in the pituitary. Moreover, LW-AFC increased CD8+CD28+ T cells, and reduced CD4+CD25+Foxp3+ T (...) were compared using a Student's t test. Comparison of the data from multiple groups against one group was performed using a one-way analysis of variance (ANOVA) followed by a Dunnett's post hoc test or a two-way repeated-measures analysis of variance with a Tukey multiple comparisons test.LW-AFC ameliorated the cognitive impairment observed in APP/PS1 mice, including the impairment of object recognition memory, spatial learning and memory, and active and passive avoidance. In addition, LW-AFC

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2016 Alzheimer's research & therapy

75. Adrenocortical Sensitivity, Moderated by Ongoing Stress, Predicts Drinking Intensity in Alcohol-Dependent Men (PubMed)

corticotropin releasing factor (oCRH) and cosyntropin]. Following treatment discharge, drinking outcomes (primary outcome: drinks per drinking day (DDD); secondary outcomes: total drinks and drinking days) were assessed weekly and ongoing life stress was assessed biweekly for 24 weeks following treatment discharge. Generalized estimating equation models of drinking severity were fit with basal and stimulated ACTH and cortisol concentrations as predictors and ongoing life stress as the moderator. Greater (...) contributions upon drinking severity have not been assessed. To investigate the combined contribution of hypothalamic-pituitary-adrenal (HPA) reactivity and environmental stressors (e.g., ongoing life stress) to relapse severity in alcohol-dependent men following treatment, plasma adrenocorticotropin (ACTH) and cortisol were obtained in 4-6 weeks abstinent alcohol-dependent men (n=41) following a psychosocial stressor [the Trier Social Stress Test (TSST)] and two pharmacological provocations [ovine

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2016 Psychoneuroendocrinology

76. Ketoconazole HRA

2.8. Risk Management Plan 79 2.9. Product information 84 3. Benefit-Risk Balance 85 Benefits 85 Risks 86 Benefit-risk balance 88 4. Recommendations 89 Ketoconazole HRA Assessment report EMA/CHMP/534845/2014 Page 3/115 List of abbreviations ACTH Adrenocorticotrophin Hormone AE Adverse events AGT Aminoglutethimide AI Adrenal insufficiency ALT Alanine transaminase AP Alkaline phosphatase AST Aspartate transaminase AUC Area under the curve b.i.d Twice a day CD Cushing’s disease CRH Corticotropin (...) applied for the following indication: Treatment of Cushing’s syndrome. The legal basis for this application refers to: Article 10(a) of Directive 2001/83/EC – relating to applications relying on well-established medicinal use supported by bibliographic literature. The application submitted is composed of administrative information, complete quality data, non-clinical and clinical data based on bibliographic literature substituting all non-clinical tests and clinical studies together

2014 European Medicines Agency - EPARs

77. Reduced cortisol metabolism during critical illness. (PubMed)

Reduced cortisol metabolism during critical illness. Critical illness is often accompanied by hypercortisolemia, which has been attributed to stress-induced activation of the hypothalamic-pituitary-adrenal axis. However, low corticotropin levels have also been reported in critically ill patients, which may be due to reduced cortisol metabolism.In a total of 158 patients in the intensive care unit and 64 matched controls, we tested five aspects of cortisol metabolism: daily levels (...) comparisons). Cortisol production was 83% higher in the patients (P=0.02). There was a reduction of more than 50% in cortisol clearance during tracer infusion and after the administration of 100 mg of hydrocortisone in the patients (P≤0.03 for both comparisons). All these factors accounted for an increase by a factor of 3.5 in plasma cortisol levels in the patients, as compared with controls (P<0.001). Impaired cortisol clearance also correlated with a lower cortisol response to corticotropin stimulation

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2013 NEJM

78. Congenital Adrenal Hyperplasia Due to Steroid 21-hydroxylase Deficiency

will discuss only 21-hydroxylase deficiency here. The cortisol synthetic block leads to corticotropin stimulation of the adrenal cortex, with accumulation of cortisol precursors that are diverted to sex hormone biosynthesis ( ). A cardinal feature of classic or severe virilizing CAH in newborn females is genital ambiguity. If the disorder is not recognized and treated, both girls and boys undergo rapid postnatal growth and sexual precocity or, in the case of severe enzyme deficiency, neonatal salt loss (...) for hormonal diagnosis of CAH is a cosyntropin stimulation test ( ), it may be difficult to perform on an urgent basis in many clinical settings. Treatment of infants with positive screens and obvious electrolyte abnormalities or circulatory instability should never be delayed for cosyntropin stimulation testing; in such infants, the adrenal cortex is highly stimulated anyway, and baseline steroids will be markedly elevated. Extant norms are for tests employing a pharmacological dose of 0.125–0.25 mg

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2010 The Endocrine Society

79. Androgen Reduction in Congenital Adrenal Hyperplasia, Phase 1

is a cytochrome P450 enzyme located in the endoplasmic reticulum. It catalyzes conversion of 17-hydroxyprogesterone (17-OHP) to 11-deoxycortisol, a precursor for cortisol, and progesterone to deoxycorticosterone, a precursor for aldosterone. Aldosterone deficiency may lead to salt wasting with consequent failure to thrive, hypovolemia, shock and if untreated, death in the first few weeks of life. Because patients cannot synthesize cortisol efficiently, the adrenal cortex is stimulated by corticotropin (ACTH (...) Concentration (Cmax) [ Time Frame: 7 days ] Sparse PK will be derived from peak and trough abiraterone levels. Number of adverse events [ Time Frame: 7 days ] Safety monitoring in Phase 1 will include liver function tests (AST, ALT, bilirubin) and possible mineralocorticoid effects (blood pressure, plasma renin). 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

2015 Clinical Trials

80. Androgen Reduction in Congenital Adrenal Hyperplasia

-OHP) to 11-deoxycortisol, a precursor for cortisol, and progesterone to deoxycorticosterone, a precursor for aldosterone. Aldosterone deficiency may lead to salt wasting with consequent failure to thrive, hypovolemia, shock and if untreated, death in the first few weeks of life. Because patients cannot synthesize cortisol efficiently, the adrenal cortex is stimulated by corticotropin (ACTH) and overproduces cortisol precursors. Some of these precursors are diverted to sex hormone biosynthesis (...) . Abnormal liver function tests (transaminases>3X ULN). Abnormal renal function tests (BUN or creatinine >1.5 ULN). Significant anemia (hemoglobin < 12 g/dl). Clinically significant ECG abnormality A history of a malabsorption syndrome. Evidence of active malignancy. Co-existent disease that may interfere with linear growth or that requires concomitant therapy that is likely to interfere with study procedures or results. Treatment with potentially hepatotoxic medications, CYP2D6, strong inhibitors

2015 Clinical Trials

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