Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK
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patients take prednisolone as early as possible upon wakening. Other studies are trialling glucocorticoid pump replacement therapy to mimic circadian rhythms; however, there is limited evidence for their use so far ( 24 , 25 ). The importance of pulsatile
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taking the dose on waking in the morning. MRHC has delayed release and sustained absorption was called Chronocort during development and has been shown to mimic the normal circadian rhythm of cortisol ( 13 , 14 ). MRHC is taken twice daily, at bedtime
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profiles in adult patients with 21-hydroxylase deficiency have shown a substantial circadian rhythm highly influenced by glucocorticoid replacement ( 6 ). Most recent clinical guideline from the US Endocrine Society suggests levels of androstenedione and 17
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Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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circadian rhythm of cortisol secretion whereby, in the evening, cortisol secretion is higher in CS patients than in normal subjects ( 4 ). Therefore, assessment of LNSC, without the impracticality of hospitalisation and disruption of a normal routine, would
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Department and Graduate Institute of Forensic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
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appearance, unilateral abnormality, and bilateral abnormalities. AVS All AVS procedures were performed by an interventional radiologist with 15 years of experience and in the morning to avoid bias resulting from the circadian rhythms of aldosterone
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Morise T & Takimoto H . Circadian rhythm of plasma aldosterone and time dependent alterations of aldosterone regulators . Journal of Steroid Biochemistry 1984 20 321 – 323 . ( https://doi.org/10.1016/0022-4731(8490225-5 ) 11 Bornstein SR
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; problems with the oral mucosa or saliva; current pregnancy; abnormal circadian rhythm (not sleeping at night between 00:30 and 05:00 h). The study was approved by the local ethics committee in Umeå (Dnr 2018-162-31M). Written informed consent was obtained
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the form of immediate-release hydrocortisone fails to replicate the physiological cortisol circadian rhythm, and together with the uncertainties of GC dose adjustment and the absence of reliable biomarkers, patients receiving GC therapy may be over- or