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Corticotropin Stimulation Test

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61. Normalized early post-operative cortisol and ACTH values predict nonremission after surgery for Cushing's disease. (PubMed)

Normalized early post-operative cortisol and ACTH values predict nonremission after surgery for Cushing's disease. Perioperative increases in adrenocorticotropic hormone (ACTH) and cortisol mimic results of corticotropin-releasing hormone (CRH) stimulation testing. This phenomenon may help identify patients with residual adenoma after transsphenoidal surgery (TSS) for Cushing disease (CD).To predict nonremission after TSS for CD.Retrospective case-control study of patients treated at a single (...) center from December 2003 until July 2016. Early and medium-term remission were assessed at 10 days and 11 months.Two hundred and ninety-one consecutive TSS cases from 257 patients with biochemical evidence of CD seen at a clinical center.Normalized early postoperative values (NEPVs) for cortisol and ACTH were calculated as immediate postoperative cortisol or ACTH levels minus preoperative post-CRH-stimulation test levels.Prediction of early nonremission was evaluated using logistic regression

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2017 Journal of Clinical Endocrinology and Metabolism

62. Hormonal Mechanisms of Sleep Restriction

. This scale will be used to assess changes in sleepiness throughout the day and through 4 nights of sleep restriction. Two card gambling task [ Time Frame: 5 days ] Computerized neurobehavioral testing to determine how 4 nights of sleep restriction affects participants' decision making. The end point is discriminability index, d'. Modified Sternberg working memory test [ Time Frame: 5 days ] Computerized neurobehavioral testing to determine how 4 nights of sleep restriction affects reaction time (...) injury or of learning disability - Vision or hearing impairment unless corrected back to normal Anemia (Hct <38%) History of psychiatric illness Clinically significant abnormalities in blood and urine, and free of traces of drugs Other endocrine abnormalities including hypothyroidism or adrenal failure; primary gonadal disease as indicated by serum LH (luteinizing hormone) or FSH (follicle stimulating hormone) concentration >10 or >15 IU/L, respectively, hyperprolactinemia indicated by prolactin

2017 Clinical Trials

63. Don’t stress about CRF: Assessing the translational failures of CRF1 antagonists (PubMed)

Don’t stress about CRF: Assessing the translational failures of CRF1 antagonists Dr. Athina Markou sought treatments for a common neural substrate shared by depression and drug dependence. Antagonists of corticotropin-releasing factor (CRF) receptors, a target of interest to her, have not reached the clinic despite strong preclinical rationale and sustained translational efforts.We explore potential causes for the failure of CRF1 antagonists and review recent findings concerning CRF-CRF1 (...) systems in psychopathology.Potential causes for negative outcomes include (1) poor safety and efficacy of initial drug candidates due to bad pharmacokinetic and physicochemical properties, (2) specificity problems with preclinical screens, (3) the acute nature of screens vs. late-presenting patients, (4) positive preclinical results limited to certain models and conditions with dynamic CRF-CRF1 activation not homologous to tested patients, (5) repeated CRF1 activation-induced plasticity that reduces

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2017 Psychopharmacology

64. 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

65. 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

66. 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

67. 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

68. 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

69. 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

70. 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

71. 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

72. 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

73. 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

74. 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

75. 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

76. 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

77. 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

78. 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

79. 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

80. 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

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