Monday, June 30, 2008

Monday's News

First System for Treatment of Vertigo Wins Approval


According to Portland Business Journal, Vesticon Corp. out of Portland, Oregon just received FDA approval for the first device to diagnose and help treat people experiencing benign paroxysmal positional vertigo (BPPV).
For more information, click on the title. (Many people with Cushing's Disease suffer from this.)




Case Report Endocrinologist. 18(3):117-120, May/June 2008.Guadalix, Sonsoles MD; Jodar, Esbeban MD, PhD; Azriel, Sharona MD, PhD; Calatayud, Maria MD; Tejero, Ana Isabel MD

Abstract: Topical and inhaled corticoids are considered to be safe even though some reports point out the risks, especially in children. We describe 2 adults in whom the chronic use of topical steroids led to Cushing syndrome. Patients treated with potent topical corticoids should be informed about the possibility of developing Cushing syndrome. Adrenal reserve should be monitored in those patients treated with glucocorticoids for long periods, regardless of the administration route.


Case Report Endocrinologist. 18(3):121-123, May/June 2008.Petidis, Konstantinos MD; Douma, Stella MD; Doumas, Michael MD; Papaefthimiou, Panagiota MD; Kartali, Nikoletta MD; Vogiatzis, Konstantinos MD; Zamboulis, Chrysanthos MD
Abstract: Pheochromocytoma is a tumor of the adrenal medulla that secretes catecholamines (noradrenaline and adrenaline). The clinical presentation is characterized by paroxysmal hypertension, tachycardia, headache, and sweating. Pheochromocytoma is associated with neurofibromatosis type 1. We report the case of a woman with neurofibromatosis type 1 and bilateral adrenal pheochromocytomas who presented with thrombosis of the portal vein, thrombocytosis, hepatic infarct, and stenosis of celiac artery. To our knowledge this is the first report of this constellation of findings as the presenting clinical picture of pheochromocytoma.
(C) 2008 Lippincott Williams & Wilkins, Inc.



Unraveling the molecular basis of micronodular adrenal hyperplasia.

Adrenal cortex Current Opinion in Endocrinology, Diabetes & Obesity. 15(3):227-233, June 2008.Horvath, Anelia; Stratakis, Constantine A

Abstract: Purpose of review: The present review discusses the molecular basis of micronodular adrenal hyperplasia. It focuses on the role of genetic defects in cyclic-AMP (cAMP) signaling-related molecules, namely PRKAR1A, GNAS, PDE11A, and PDE8B in the predisposition to tumor formation. This review also discusses the involvement of cAMP signaling and related pathways and their impact on the adrenocortical tumor formation.

Recent findings: Molecular abnormalities in the phosphodiesterases family are the most recently discovered genetic abnormalities that predispose individuals to various adrenocortical tumors. In contrast to GNAS and PRKAR1A, defects in phosphodiesterases are associated more frequently with incomplete penetrance.

Summary: Recent findings indicate the importance of cAMP signaling for normal adrenocortical functioning and the sensitivity of the adrenal gland to subtle alterations in cAMP levels. The identification of low-penetrance mutations in more than one phosphodiesterase in patients with adrenocortical hyperplasia is suggestive for a complementary role of the different phosphodiesterases in adrenal gland abnormalities and possible involvement of other members of this pathway in adrenocortical tumor defects.



Pharmacological treatment of hypercortisolism.
Adrenal cortex Current Opinion in Endocrinology, Diabetes & Obesity. 15(3):234-238, June 2008.Shalet, Stephen a; Mukherjee, Annice b
Abstract: Purpose of review: To consider the current status and types of drug therapy aimed at restoring eucortisolaemia in patients with Cushing's syndrome.

Recent findings: Advances such as laparoscopic adrenalectomy modify the exact placing of drug therapy among the wide variety of therapies available to treat patients with Cushing's syndrome because of different causes; nonetheless, it is now clear that hypercortisolism, per se, if present for any length of time, modifies the future prognosis of the patient, even after cure of the Cushing's syndrome. Thus, early diagnosis and restoration of eucortisolsm are critical. There are three main types of drug therapy: steroidogenesis inhibitors, glucocorticoid antagonists and neuromodulatory compounds. Currently, steroidogenesis inhibitors such as metyrapone and ketaconazole are most commonly the first choice if drug therapy is to be used, but at least for the most common form of Cushing's syndrome, Cushing's disease, the neuromodulatory compounds such as cabergoline show potential.

Summary: Pharmacological therapy for Cushing's syndrome remains critically important for normalizing cortisol levels while awaiting the impact of more definitive treatment.



Testosterone Replacement May Lower Risk of Heart Disease, Diabetes, Death, but Long-Term Effects Unclear
By Kathleen Doheny, WebMD Medical News

June 18, 2008 — Testosterone replacement therapy can help older men deficient in the hormone reduce their risks of heart disease, diabetes, and death, according to new research presented this week at ENDO 08, the annual meeting of The Endocrine Society. (to read complete article, click here)

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