Presentation
We report a 44-year-old Caucasian female who presented with hypoglycemia and hypotension. The patient had a basal cortisol of 1.6 ug/dl and a peak serum cortisol of 23.3 ug/dl after 250 ug of cosyntropin. [ncbi.nlm.nih.gov]
In these clinical settings, the patient presents with a persistent systemic inflammation state, a hyperdynamic cardiovascular response, and vasopressor dependent shock. [dx.doi.org]
Entire Body System
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Intravenous Administration
Plasma cortisol and ACTH were measured at baseline and at intervals over a one hour period following intravenous administration of 1μg of cosyntropin. [ncbi.nlm.nih.gov]
This prospective, randomized, multi-center study hypothesized no difference in efficacy of EBP and the intravenous administration of the ACTH analogue, cosyntropin, in the treatment of PDPH. [academic.oup.com]
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Acutely Ill Patient
We recommend that clinicians managing acutely ill patients have a low threshold for initiating glucocorticoid replacement in the presence of hypoglycemia and shock regardless of the peak cortisol values. [ncbi.nlm.nih.gov]
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Cushingoid
Other: hypersensitivity reactions, cushingoid symptoms. Effects on lab test results • May increase serum glucose and sodium levels. May decrease potassium and calcium levels. [glowm.com]
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Pseudotumor
Adverse reactions CNS: seizures, dizziness, vertigo, increased intracranial pressure with papilledema, pseudotumor cerebri. CV: flushing. EENT: cataracts, glaucoma. [glowm.com]
Neurologic
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Papilledema
Adverse reactions CNS: seizures, dizziness, vertigo, increased intracranial pressure with papilledema, pseudotumor cerebri. CV: flushing. EENT: cataracts, glaucoma. [glowm.com]
Workup
Initial adrenal workups involve cortisol testing and ACTH stimulation. [arupconsult.com]
Treatment
Dogs received each treatment once with a 2-week interval between treatments. Blood samples were assayed for cortisol, progesterone, 17-hydroxyprogesterone, androstenedione, and estradiol concentrations. [dx.doi.org]
Current treatments consist primarily of non-invasive treatment with intravenous fluids and caffeine therapy and invasive treatment by Epidural Blood Patch. Efficacy of Caffeine 300mg IV BID x 1d doses is approximately 70% (2). [druglib.com]
Current treatments consist primarily of non-invasive treatment with intravenous fluids and caffeine therapy and invasive treatment by Epidural Blood Patch. Efficacy of Caffeine 300mg IV bis in die (BID) x 1d doses is approximately 70% (2). [clinicaltrials.gov]
Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002; 288:862-71. [books.google.com]
Prognosis
A cosyntropin adrenal stimulation test was administered to each patient and the response was correlated with the past transplant course and their subsequent prognosis. [ncbi.nlm.nih.gov]
In this latter setting, which is the par excellence model for ischemia/reperfusion, nonresponse to the CST is correlated with longer ischemia duration and poorer prognosis (28). [journals.lww.com]
Etiology
The book is designed to supplement standard textbooks that provide detailed information on etiology, pathogenesis and therapeutic controversies in pediatric clinical neuroscience. [books.google.it]
Etiology and ecology. Arch Inten Med 1962; 110:845–847. 11. Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 1993; 270 24:2957–2963. 12. [journals.lww.com]
Pathophysiology
These findings confirm that adrenal sensitivity to corticotropin (ACTH) is enhanced in MDD and suggest that this endocrine abnormality may be related pathophysiologically to the resistance of cortisol secretion to dexamethasone suppression. [ncbi.nlm.nih.gov]
This Second Edition has been thoroughly updated with the latest information on pathophysiology, treatment, and drug dosing. New chapters cover obesity, vitamin D deficiency, autoimmune polyendocrine syndromes, and endocrine disorders in HIV/AIDS. [books.google.com]
[…] biochemistry of nutrition 180 Nutritional disorders and their management 200 Clinical biochemistry of the gastrointestinal tract 214 Assessment of hepatic function and investigation of jaundice 231 Acute and chronic liver disease 250 Glucose metabolism and the pathophysiology [books.google.it]
Graves, Physiology, Pathophysiology, and Anesthetic Management of Patients with Gastrointestinal and Endocrine Disease, Veterinary Anesthesia and Analgesia, (639-677), (2017). E. Gunn, R. E. Shiel and C. T. [doi.org]
Pathophysiology of free cortisol in plasma. Ann N Y Acad Sci 1988;538:130–6. Google Scholar 17. Vogeser M, Mohnle P, Briegel J. Free serum cortisol: quantification applying equilibrium dialysis or ultrafiltration and an automated immunoassay system. [degruyter.com]
Prevention
CONCLUSIONS: LD cosyntropin stimulation testing results should be interpreted cautiously when used alone to prevent unnecessary long-term treatment. [ncbi.nlm.nih.gov]
This thoroughly updated edition includes an introduction to risk assessment and screening and results of recent clinical trials and their implications for treatment and prevention. [books.google.com]