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Tatiana V Novoselova, Peter J King, Leonardo Guasti, Louise A Metherell, Adrian J L Clark, and Li F Chan

have a negative feedback on the release of CRH and AVP at the hypothalamus and ACTH at the pituitary, thus providing tight regulation of cortisol production. ACTH receptor/melanocortin-2-receptor The ACTH receptor (also known as the melanocortin

Open access

Kathrin R Frey, Tina Kienitz, Julia Schulz, Manfred Ventz, Kathrin Zopf, and Marcus Quinkler

of GCs in PAI and CAH still tends to be more than the total daily endogenous cortisol secretion seen in healthy subjects (5–10 mg of cortisol/m 2 of body surface area/day) ( 1 ) possibly triggering long-term morbidities such as osteoporosis. GC

Open access

Anastasia P Athanasoulia-Kaspar, Matthias K Auer, Günter K Stalla, and Mira Jakovcevski

hypercortisolism ( 36 ). Furthermore, TL has been evaluated in other conditions with increased endogenous cortisol such as chronic stress exposure and post-traumatic stress disorder ( 37 ). Shorter TL has been reported for both neuropsychiatric conditions

Open access

Carla Scaroni, Nora M Albiger, Serena Palmieri, Davide Iacuaniello, Chiara Graziadio, Luca Damiani, Marialuisa Zilio, Antonio Stigliano, Annamaria Colao, Rosario Pivonello, and the Altogether to Beat Cushing’s Syndrome (ABC) study group

cortisol at 08:00 h (29 µg/dL; n.v. 5–25), and high urinary free cortisol (UFC) (280 µg/24 h; n.v. 36–137), while ACTH levels at 08:00 h were in the normal range (26 pg/mL; n.v. 10–50). The patient’s diabetes was poorly controlled (HbA1c 8%). The

Open access

Jesper Krogh, Peter Plomgaard, Ruth Frikke-Schmidt, Sten Velschow, Jesper Johannesen, Linda Maria Hilsted, Malene Schrøder, and Ulla Feldt-Rasmussen

Repeated blood sampling is required in certain clinical and research settings, which is currently performed by drawing blood from venous catheters requiring manual handling of each sample at time of collection. A novel body-worn device for repeated serial samples, Fluispotter®, with automated extraction, collection and storage of up to 20 venous dried blood spot samples over the course of 20 hours may overcome problems with current methods for serial sampling. The purpose of this study was to assess the performance and safety of Fluispotter for the first time in healthy subjects. Fluispotter consists of a cartridge with tubing, reservoir for flushing solution, pumps and filter-paper and a multi-lumen catheter placed in the brachial vein. We recruited healthy subjects for testing in an in-hospital setting. Fluispotter was attached by an anesthesiologist to 22 healthy subjects of which 9/22 (40.9 %) participants had all 20 samples taken, which was lower than the goal of complete sampling in 80 % of the subjects (p = 0.02). The main reason for sample failure was clogging of blood flow which was observed in 11/22 (50 %) of the participants. No serious adverse events occurred, and the participants rated the pain from insertion and removal of catheter as very low. A cortisol profile showed nadir values at midnight and highest values at 5 a.m. Although full sampling was not successful in all participants, the Fluispotter technology proved safe and highly acceptable to the participants producing the expected cortisol profile without the requirement of staff during sample collection.

Open access

Prachi Bansal, Anurag Lila, Manjunath Goroshi, Swati Jadhav, Nilesh Lomte, Kunal Thakkar, Atul Goel, Abhidha Shah, Shilpa Sankhe, Naina Goel, Neelam Jaguste, Tushar Bandgar, and Nalini Shah

Introduction Cushing’s disease (CD) is a state of cortisol excess, caused by an ACTH-secreting pituitary adenoma. Although a rare disease with an annual incidence of 1.5 patients/million ( 1 ), it is associated with significant morbidity and

Open access

C E Higham, A Olsson-Brown, P Carroll, T Cooksley, J Larkin, P Lorigan, D Morganstein, P J Trainer, and the Society for Endocrinology Clinical Committee

screening. CTCAE grade 1–2. Other important considerations; hypophysitis and maintenance glucocorticoid therapy. Management of a life-threateningly unwell patient (CTCAE grade 3–4) Cortisol Features of acute cortisol

Open access

Greta B Raglan, Louis A Schmidt, and Jay Schulkin

glucocorticoid levels and high anxiety. Despite this, individuals with PTSD also have higher levels of CRH in the cerebral spinal fluid ( 27 ) and appear to have similar cortisol reactivity to individuals without the disorder ( 28 ). Based on these findings, it

Open access

Filippo Ceccato, Diego Cecchin, Michele Gregianin, Giacomo Ricci, Cristina Campi, Filippo Crimì, Marta Bergamo, Annibale Versari, Carmelo Lacognata, Federico Rea, Mattia Barbot, and Carla Scaroni

Introduction Cushing’s syndrome (CS), characterized by excessive endogenous cortisol secretion, is in most cases ACTH-dependent. Corticotropin (ACTH) secretion arises from a pituitary adenoma (Cushing’s disease) or, less frequently, from a non

Open access

Wiebke Arlt and the Society for Endocrinology Clinical Committee

Introduction Acute adrenal insufficiency , also termed adrenal crisis , is a life-threatening endocrine emergency brought about by a lack of production of the adrenal hormone cortisol, the major glucocorticoid. Identifying patients at risk