Enjoy following the posts of these outstandingly brave Cushies as they attempt to post a blog post each day for the month of April
Amber http://amber-mulnix.blogspot.com/
Christina http://christinapay.blogspot.com/Cristina (Portugese language) http://cristinagoncalves1973.blogspot.pt/Danielle http://lifewithcushings.blogspot.com/DawnGrace C http://adayinthelifeofatrainwreck.blogspot.com/Judy DKay http://cushiemama.blogspot.com Lisa DMalia KMary BMaryO http://www.cushie.info/blog/Melissa AMelissa SMissaf http://blogforacushiecure.blogspot.com/Molli http://livingwithstripes.blogspot.com/Nancy J http://cushielife.multiply.com/Rene B http://missdiagnosis-rene.blogspot.com/Robin S survivethejourney.blogspot.comSarah C http://sarahsstupiddisease.wordpress.com/Sharon SShermaineStanley LStephanie Y cushiesteph.blogspot.comTrishaVanessa http://www.blogger.com/profile/05094821916178382160
Enjoy!
What's this about? More info here.
- , , , , , , , , , ,
- Maria P. Foschini, MD
Summary
It is difficult to evaluate the recurrence and progression potential of pituitary adenomas at presentation. The World Health Organization classification of endocrine tumors suggests that invasion of the surrounding structures, size at presentation, an elevated mitotic index, a Ki-67 labeling index higher than 3%, and extensive p53 expression are indicators of aggressive behavior.
Nevertheless, Ki-67 and p53 labeling index evaluation is subject to interobserver variability, and their cutoff values are controversial. In the present study, the prognostic value of Ki-67 and p53 protein labeling indices and their correlation with clinical and radiologic parameters were evaluated using digital image analysis in a series of 166 pituitary adenomas in patients having undergone a follow-up of at least 6 years to evaluate the impact on the recurrence and progression potential of pituitary adenomas.
The data were analyzed using the receiver operating characteristic curve and classification and regression tree analysis. The results showed that, in the unstratified data set, the commonly used threshold of the Ki-67 index of 3% has a high specificity (89.5%) but a low sensitivity (53.8%).
Unsatisfactory performance results were obtained by performing receiver operating characteristic curve analysis on the p53 labeling index. On the contrary, the classification and regression tree analysis–derived tree demonstrated that each pituitary adenoma subtype has specific prognostic factors.
Specifically, the Ki-67 labeling index is a useful prognostic factor in nonfunctioning, adrenocorticotropin, and prolactin adenomas, but with different thresholds. In conclusion, our study emphasizes that the term pituitary adenomas includes different types of tumors, each one having specific prognostic factors.
Access the entire article here: http://www.humanpathol.com/article/PIIS0046817711004965/abstract?rss=yes
Only 3 days (counting today) until the Cushing's Awareness Challenge begins. At night, when I'm supposed to be sleeping, ideas for posts keep swarming through my head. Sometimes, they form into fully-written posts. Then, when I wake up, the posts are gone.
I plan to follow the suggestions to some extent and have a few ideas of my own. Over the years, I've posted lots on several blogs but I don't know if I can get 30 days of Cushing's stuff together!
At the moment, there are 26 participants in this challenge and growing. Please follow their blogs. The list is here and is constantly updated as new URLs come in.
If you want to join us, its not too late. Directions and suggestions for posts can be found here: http://cushie-blogger.blogspot.com/2012/03/cushing-awareness-challenge.html
If you have ideas for what you'd like to read about (Cushing's related, of course), please feel free to put it in the comments area.
PharmaForm announced that Corcept Therapeutics Inc. has chosen PharmaForm as their primary commercial manufacturer for their newly approved drug product, Korlym™. The U.S. Food and Drug Administration approved Corcept's Korlym™ on February 17th, 2012 for patients with endogenous Cushing's syndrome.
PharmaForm, a full-service contract provider of development and manufacturing for the pharmaceutical and biotech industry, has worked with Corcept for several years as a contract provider for services in the development, optimization and validation of the manufacturing process for Corcept's Korlym™.
Read the entire article here: http://www.marketwatch.com/story/pharmaform-announces-commercial-manufacturing-contract-for-corcepts-korlym-2012-03-26
Do you blog? Want to get started?
Since April 8 is Cushing's Awareness Day, several people got their heads together to create this blogging challenge.
All you have to do is blog about something Cushing's related for the 30 days of April. Robin designed 3 versions of our "official logo" to put on your blogs.
Please note that these are thumbnails - the actual image is larger than shown here. Click on the images to view actual size.
If your blog wants you to upload an image from your desktop, right-click on the image above and choose "save-as". Remember where you saved it to!
In all cases, the URL for the site is http://www.cushings-help.com
[[posterous-content:pid___0]]Small. If your blog asks you to enter the URL, use this:
Medium. If your blog asks you to enter the URL, use this:
Large. If your blog asks you to enter the URL, use this:
Please let me know the URL to your blog and I will list it on CushieBloggers ( http://cushie-blogger.blogspot.com/ ) The more people who participate, the more the word will get out about Cushing's.
Suggested topics - or add your own!
- In what ways have Cushing's made you a better person?
- What have you learned about the medical community since you have become sick?
- If you had one chance to speak to an endocrinologist association meeting, what would you tell them about Cushing's patients?
- What would you tell the friends and family of another Cushing's patient in order to garner more emotional support for your friend? challenge with Cushing's? How have you overcome challenges? Stuff like that.
- I have Cushing's Disease....(personal synopsis)
- How I found out I have Cushing's
- What is Cushing's Disease/Syndrome? (Personal variation, i.e. adrenal or pituitary or ectopic, etc.)
- My challenges with Cushing's
- Overcoming challenges with Cushing's (could include any challenges)
- If I could speak to an endocrinologist organization, I would tell them....
- What would I tell others trying to be diagnosed? What would I tell families of those who are sick with Cushing's?
- Treatments I've gone through to try to be cured/treatments I may have to go through to be cured.
- What will happen if I'm not cured?
- I write about my health because…
- 10 Things I Couldn’t Live Without.
- My Dream Day.
- What I learned the hard way
- Miracle Cure. (Write a news-style article on a miracle cure. What’s the cure? How do you get the cure? Be sure to include a disclaimer)
- Health Madlib Poem. Go to : http://languageisavirus.com/cgi-bin/madlibs.pl and fill in the parts of speech and the site will generate a poem for you.
- The Things We Forget. Visit http://thingsweforget.blogspot.com/ and make your own version of a short memo reminder. Where would you post it?
- Give yourself, your condition, or your health focus a mascot. Is it a real person? Fictional? Mythical being? Describe them. Bonus points if you provide a visual!
- 5 Challenges & 5 Small Victories.
- The First Time I…
- Make a word cloud or tree with a list of words that come to mind when you think about your blog, health, or interests. Use a thesaurus to make it branch more.
- How much money have you spent on cushing's, or, How did Cushing's impact your life financially?
- Why do you think Cushing's may not be as rare as doctors believe?
- What is your theory about what causes Cushing's?
- How has Cushing's altered the trajectory of your life? What would you have done? Who would you have been?
- What three things has Cushing's stolen from you? What do you miss the most? What can you do in your Cushing's life to still achieve any of those goals? What new goals did Cushing's bring to you?
- How do you cope?
- What do you do to improve your quality of life as you fight Cushing's?
- Your thoughts...?
Do you blog? Want to get started?
Since April 8 is Cushing's Awareness Day, several people got their heads together to create this blogging challenge.
All you have to do is blog about something Cushing's related for the 30 days of April. Robin designed 3 versions of our "official logo" to put on your blogs.
Please note that these are thumbnails - the actual image is larger than shown here. Click on the images to view actual size.
If your blog wants you to upload an image from your desktop, right-click on the image above and choose "save-as". Remember where you saved it to!
In all cases, the URL for the site is http://www.cushings-help.com
Small. If your blog asks you to enter the URL, use this:
Medium. If your blog asks you to enter the URL, use this:
Large. If your blog asks you to enter the URL, use this:
Please let me know the URL to your blog and I will list it on CushieBloggers ( http://cushie-blogger.blogspot.com/ ) The more people who participate, the more the word will get out about Cushing's.
Suggested topics - or add your own!
- In what ways have Cushing's made you a better person?
- What have you learned about the medical community since you have become sick?
- If you had one chance to speak to an endocrinologist association meeting, what would you tell them about Cushing's patients?
- What would you tell the friends and family of another Cushing's patient in order to garner more emotional support for your friend? challenge with Cushing's? How have you overcome challenges? Stuff like that.
- I have Cushing's Disease....(personal synopsis)
- How I found out I have Cushing's
- What is Cushing's Disease/Syndrome? (Personal variation, i.e. adrenal or pituitary or ectopic, etc.)
- My challenges with Cushing's
- Overcoming challenges with Cushing's (could include any challenges)
- If I could speak to an endocrinologist organization, I would tell them....
- What would I tell others trying to be diagnosed? What would I tell families of those who are sick with Cushing's?
- Treatments I've gone through to try to be cured/treatments I may have to go through to be cured.
- What will happen if I'm not cured?
- I write about my health because…
- 10 Things I Couldn’t Live Without.
- My Dream Day.
- What I learned the hard way
- Miracle Cure. (Write a news-style article on a miracle cure. What’s the cure? How do you get the cure? Be sure to include a disclaimer)
- Health Madlib Poem. Go to : http://languageisavirus.com/cgi-bin/madlibs.pl and fill in the parts of speech and the site will generate a poem for you.
- The Things We Forget. Visit http://thingsweforget.blogspot.com/ and make your own version of a short memo reminder. Where would you post it?
- Give yourself, your condition, or your health focus a mascot. Is it a real person? Fictional? Mythical being? Describe them. Bonus points if you provide a visual!
- 5 Challenges & 5 Small Victories.
- The First Time I…
- Make a word cloud or tree with a list of words that come to mind when you think about your blog, health, or interests. Use a thesaurus to make it branch more.
- How much money have you spent on cushing's, or, How did Cushing's impact your life financially?
- Why do you think Cushing's may not be as rare as doctors believe?
- What is your theory about what causes Cushing's?
- How has Cushing's altered the trajectory of your life? What would you have done? Who would you have been?
- What three things has Cushing's stolen from you? What do you miss the most? What can you do in your Cushing's life to still achieve any of those goals? What new goals did Cushing's bring to you?
- How do you cope?
- What do you do to improve your quality of life as you fight Cushing's?
- Your thoughts...?
Ask Dr. Theodore Friedman.
Read Dr. Friedman's Second Guest Chat, March 2, 2004.
Listen to Dr. Friedman Second Live Voice Interview, March 12, 2009.
Listen to Dr. Friedman Third Live Voice Interview, February 13, 2011.
Listen to Dr. Friedman Fourth Live Voice Interview, March 12, 2012.
Óscar Vidal, Emiliano Astudillo, Mauro Valentini, Cesar Ginestà, Juan C. García-Valdecasas and Laureano Fernandez-Cruz
Abstract
Background
Laparoscopic adrenalectomy via three or four trocars is a well-established procedure. This report describes the initial experience with single-incision laparoscopic surgery (SILS) using the transperitoneal approach for left adrenalectomy.
Methods
Between April 2010 and August 2011, all consecutive patients with adrenal masses, including Conn’s syndrome, Cushing’s adenoma, and nonfunctional adrenal tumors, who agreed to undergo SILS adrenalectomy were included in a prospective study. The left 2.5-cm subcostal incision was the sole point of entry. Data of patients who underwent SILS adrenalectomy were compared with those from an uncontrolled group of patients who underwent conventional laparoscopic adrenalectomy during the same study period.
Results
There were 20 patients in each study group (20 men, 20 women; mean age [SD] = 50 [6.5] years). SILS was successfully performed and none of the patients required conversion to an open procedure. In one case of SILS procedure, an additional lateral 5-mm port was needed for retraction of the kidney. The mean (SD) duration of the operation was 95 (20) min in the SILS group and 80 (8) min in the conventional laparoscopic adrenalectomy group (p = 0.052). There were no intraoperative or postoperative complications. There were no differences between the two study groups with respect to postoperative pain, number of patients who resumed oral intake within the first 24 h, final pathologic diagnosis, and length of hospital stay.
Conclusion
SILS left adrenalectomy is a technically feasible and safe procedure in carefully selected patients. The definitive clinical, aesthetic and functional advantages of this technique require further analysis.
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From http://www.springerlink.com/content/h60075322750m0x0/
I don't have permission yet to post any details but suffice it to say, losing even one Cushing's patient is one too many.
We have a list of those that we know about here http://www.cushie.info/index.php?option=com_content&view=category&id=... and I'm sure that there are many more that we never hear about.
Cushing's can be fatal.
"Cushing's disease is a rare disorder, with three to five cases per million people. It can affect all ages and both genders but is most common in otherwise healthy young women," says Beverly M.K. Biller, MD, of the Massachusetts General Hospital Neuroendocrine Unit, senior author of the study. "Often misdiagnosed, Cushing's is associated with a broad range of health problems – causing physical changes, metabolic abnormalities and emotional difficulties – and if not controlled, significantly increases patients' risk of dying much younger than expected."
If you think you have Cushing's, please keep fighting as long as you need to to get help. We don't need any more names on the In Memory list!
Retroperitoneal Adrenal-Sparing Surgery for the Treatment of Cushing's Syndrome Caused by Adrenocortical Adenoma: 8-Year Experience With 87 Patients
Hong-chao He, Jun Dai, Zhou-jun Shen, Yu Zhu, Fu-kang Sun, Yuan Shao, Rong-ming Zhang, Hao-fei Wang, Wen-bin Rui and Shan Zhong
Abstract
Background
The objective of this study was to present our 8-year experience with partial adrenalectomy via the retroperitoneal approach for the treatment of Cushing’s adenoma.
Methods
A total of 93 patients who underwent adrenal surgery for Cushing’s adenoma from March 2003 to December 2010 were enrolled in this study. Preoperative, intraoperative, and postoperative variables were reviewed from the database. Student’s t test was used to analyze the continuous data, and the χ2 test was used to analyze the categoric data. A value of p < 0.05 was considered statistically significant.
Results
Adrenal-sparing surgery was performed in 87 cases (31 by open surgery, 56 by retroperitoneal laparoscopy). Six patients underwent open/laparoscopic total adrenalectomy because of recurrent disease or a large size. The cure rate in our series was 97.8%. Hypertension resolved in 34 of 64 patients (53.1%), diabetes in 7 of 27 patients (25.9%) and obesity in 28 of 48 patients (58.3%). One patient died during the postoperative period. The intraoperative complication rate for the open surgery group was significantly higher than that for the retroperitoneal laparoscopy group (9.1 vs. 1.7%).
Conclusions
The retroperitoneal approach is reliable and safe for treating Cushing’s syndrome. The laparoscopic technique can decrease the prevalence of intraoperative complications. Retroperitoneal laparoscopic partial adrenalectomy can be performed with extremely low morbidity and achieves an excellent outcome, although death may occur during the postoperative period in high-risk patients. Postoperative management plays an important role in the surgical treatment of Cushing’s syndrome.
Jun Dai is listed as co-first author.
Fulltext Preview
From http://www.springerlink.com/content/034754537j7586k2/
The Adrenal Vein Sampling International Study (AVIS) for Identifying the Major Subtypes of Primary Aldosteronism
- Gian Paolo Rossi,
- Marlena Barisa,
- Bruno Allolio,
- Richard J. Auchus,
- Laurence Amar,
- Debbie Cohen,
- Christoph Degenhart,
- Jaap Deinum,
- Evelyn Fischer,
- Richard Gordon,
- Ralph Kickuth,
- Gregory Kline,
- Andre Lacroix,
- Steven Magill,
- Diego Miotto,
- Mitsuhide Naruse,
- Tetsuo Nishikawa,
- Masao Omura,
- Eduardo Pimenta,
- Pierre-François Plouin,
- Marcus Quinkler,
- Martin Reincke,
- Ermanno Rossi,
- Lars Christian Rump,
- Fumitoshi Satoh,
- Leo Schultze Kool,
- Teresa Maria Seccia,
- Michael Stowasser,
- Akiyo Tanabe,
- Scott Trerotola,
- Oliver Vonend,
- Jiri Widimsky Jr.,
- Kwan-Dun Wu,
- Vin-Cent Wu and
- Achille Cesare Pessina
-Author Affiliations
- University of Padova (G.P.R., M.B., T.M.S., A.C.P.), Department of Medicine (DIMED) Internal Medicine 4, Padova, 35128 Italy; University Hospital Würzburg (B.A.), Department of Internal Medicine I, Endocrine and Diabetes Unit, Würzburg, 97080 Germany; University of Texas (R.J.A.), Southwestern Medical Center at Dallas, Dallas, Texas 75390; Hôpital Européen Georges Pompidou (L.A., P.-F.P.), Hypertension Unit, Paris, 75908 France; Hospital of The University of Pennsylvania (D.C.), Department of Internal Medicine, Philadelphia, Pennsylvania 19104; University Hospital Innenstadt (C.D.), Department of Clinical Radiology, Munich, 80336 Germany; Radboud University Nijmegen (J.D.), Department of Internal Medicine, Nijmegen, 6225GA Netherlands; University Hospital Innenstadt (E.F., M.R.), Department of Endocrinology, Munich, Germany; University of Queensland School of Medicine (R.G., E.P., M.S.), Greenslopes Hospital, Endocrine Hypertension Research Centre, Brisbane, 4120 Australia; University Hospital Würzburg (R.K.), Institute of Radiology, Würzburg, Germany; University of Calgary (G.K.), Foothills Medical Centre, Calgary, T2N4J8 Canada; Centre hospitalier de l'Université de Montréal (A.L.), Department of Medicine, Montreal, H2W 1T8 Canada; Medical College of Wisconsin (S.M.), Endocrinology Clinic Community Memorial Medical Commons, Menomonee Falls, Wisconsin 53051; University of Padova (D.M.), Department of Medicine (DIMED) Radiology, Padova, Italy; National Hospital Organization Kyoto Medical Center (M.N.), Department of Endocrinology Clinical Research Institute, Kyoto, 612-8555 Japan; Yokohama Rosai Hospital (T.N., M.O.), Department of Endocrinology and Metabolism, Yokohama City, 222-0036 Japan; Clinical Endocrinology (M.Q.), Charité Campus Mitte, Charité University Medicine Berlin, Berlin, 10117 Germany; Azienda Ospedaliera Santa Maria Nuova (E.R.), Department of Internal Medicine, Reggio Emilia, 42123 Italy; Department of Nephrology (L.C.R., O.V.), Heinrich-Heine-University Düsseldorf, Düsseldorf, 40225 Germany; Tohoku University Hospital (F.S.), Department of Nephrology, Endocrinology and Vascular Medicine, Sendai, 980-8574 Japan; Department of Radiology (L.S.K.), Radboud University Nijmegen Medical Center, Nijmegen, Netherlands; Institute of Clinical Endocrinology (A.T.), Tokyo Women's Medical University, Tokyo, 162-8666 Japan; Hospital of The University of Pennsylvania (S.T.), Department of Radiology, Philadelphia, Pennsylvania; Charles University in Prague (J.W.), General Faculty Hospital, Third Department of Medicine, Prague, 12808 Czech Republic; and National Taiwan University Hospital (K.-D.W., V.-C.W.), Department of Internal Medicine, Taipei, 10048 Taiwan
- Address all correspondence and requests for reprints to: Prof. Gian Paolo Rossi, M.D., FACC, FAHA, Department of Medicine, Internal Medicine 4, University Hospital via Giustiniani, 2, 35126 Padova, Italy. E-mail: gianpaolo.rossi@unipd.it.
Abstract
Context: In patients who seek surgical cure of primary aldosteronism (PA), The Endocrine Society Guidelines recommend the use of adrenal vein sampling (AVS), which is invasive, technically challenging, difficult to interpret, and commonly held to be risky.
Objective: The aim of this study was to determine the complication rate of AVS and the ways in which it is performed and interpreted at major referral centers.
Design and Settings: The Adrenal Vein Sampling International Study is an observational, retrospective, multicenter study conducted at major referral centers for endocrine hypertension worldwide.
Participants: Eligible centers were identified from those that had published on PA and/or AVS in the last decade.
Main Outcome Measure: The protocols, interpretation, and costs of AVS were measured, as well as the rate of adrenal vein rupture and the rate of use of AVS.
Results: Twenty of 24 eligible centers from Asia, Australia, North America, and Europe participated and provided information on 2604 AVS studies over a 6-yr period. The percentage of PA patients systematically submitted to AVS was 77% (median; 19–100%, range). Thirteen of the 20 centers used sequential catheterization, and seven used bilaterally simultaneous catheterization; cosyntropin stimulation was used in 11 centers. The overall rate of adrenal vein rupture was 0.61%. It correlated directly with the number of AVS performed at a particular center (P = 0.002) and inversely with the number of AVS performed by each radiologist (P = 0.007).
Conclusions: Despite carrying a minimal risk of adrenal vein rupture and at variance with the guidelines, AVS is not used systematically at major referral centers worldwide. These findings represent an argument for defining guidelines for this clinically important but technically demanding procedure.
- Received October 14, 2011.
- Accepted January 31, 2012.
- Copyright © 2012 by The Endocrine Society
From http://jcem.endojournals.org/content/early/2012/03/01/jc.2011-2830.abstract?rss=1
Tosoh introduces the ST AIA-PACK DHEA-S Assay for use on Tosoh Automated Immunoassay Analyzers
South San Francisco, CA (PRWEB) March 06, 2012
Tosoh Bioscience, Inc. introduces the ST AIA-PACK DHEA-S assay for use on Tosoh automated immunoassay analyzers including the AIA-360, AIA-600 II, AIA-1800, AIA-2000 and the new AIA-900.
Utilizing Tosoh's unit dose test cup reagent technology, ST AIA-PACK DHEA-S has an assay time of approximately 20 minutes. Single, unitized test cups require no pre-mixing, no pre-measuring and no on-board refrigeration. Dry reagent format ensures 90 day calibration stability for minimal waste and cost effective testing. Test cups are bar-coded for easy identification and inventory management.
ST AIA-PACK DHEA-S is designed for In Vitro Diagnostic Use Only for the quantitative measurement of dehydroepiandrosterone sulfate (DHEA-S) in human serum, heparinized or EDTA plasma. DHEA-S is used for the diagnosis of various diseases of the adrenal cortex, and is especially useful for the differential diagnosis of Cushing's syndrome.
Concentrations of DHEA-S are often measured, along with other hormones such as FSH, LH, prolactin, estrogen, and testosterone, to help diagnose polycystic ovarian syndrome (PCOS) and to help rule out other causes of infertility, amenorrhea, and hirsutism. DHEA-S levels may be ordered to investigate and diagnose the cause of virilization in young girls and early (precocious) puberty in young boys.
ST AIA-PACK DHEA-S has been designed for a variety of clinical diagnostic applications including: Pediatric/Children's Hospitals, Endocrinologist, GP, Reproductive and Metabolic Clinics.
Tosoh Bioscience, Inc. (TBI) provides highly sophisticated diagnostic systems for immunoassay and HPLC testing to doctor's offices, hospitals and reference laboratories throughout the Americas. Based in South San Francisco, CA, TBI is a U.S. subsidiary of Tosoh Corporation which is headquartered in Tokyo, Japan. TBI is part of Tosoh Corporation's Bioscience Division.
For the original version on PRWeb visit: www.prweb.com/releases/prwebTosoh/DHEAS/prweb9248342.htm
Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/g/a/2012/03/06/prweb9248342.DTL#ixzz1oTaQcBBoABC’s World News Tonight is doing a story on Cushing’s syndrome.
We are very excited in that it has a chance to raise awareness of Cushing’s among the millions of viewers and potentially reach some people who haven’t yet been diagnosed.
A physician who is going to be interviewed for the segment, which is planned to air tomorrow, March 6, 2012!
Be sure to tune in... and record the segment?