European Journal of Endocrinology,
Год журнала:
2024,
Номер
unknown
Опубликована: Янв. 1, 2024
Abstract
Appropriate
management
of
adrenal
insufficiency
in
pregnancy
is
challenging
due
to
the
rarity
both
primary,
secondary
and
tertiary
forms
disease
as
well
lack
evidence-based
recommendations
guide
clinicians
glucocorticoid
sometimes
also
mineralocorticoid
dosage
adjustments.
Debut
during
requires
immediate
diagnosis
it
can
lead
crisis,
intrauterine
growth
restriction
foetal
demise.
Diagnosis
difficult
overlap
symptoms
its
crisis
with
those
pregnancy.
Adrenal
stable
replacement
treatment
needs
careful
monitoring
adapt
physiological
changes
requirement
hormones.
This
hampered
because
diagnostic
threshold
most
adrenocortical
hormones
not
applicable
The
frequent
use
assisted
reproduction
technology
controlled
ovarian
hyperstimulation
these
patient
groups
induced
low
fertility
has
created
an
unrecognised
risk
crises
accelerated
oestrogen
stimulation
increased
even
be
life-threatening
complications
for
woman
foetus.
area
consensus
between
gynaecologists
endocrinologists
referral
centres
alleviate
such
gestational
risk.
Patient
partner
education,
EU
emergency
card
contribute
better
outcomes.
There
a
strong
need
more
research
on
e.g.
improvement
treatment,
biomarkers
optimisation
this
field,
which
suffers
from
rare
nature
diseases
poor
funding.
Archives of Disease in Childhood,
Год журнала:
2023,
Номер
108(11), С. 871 - 878
Опубликована: Апрель 12, 2023
Adrenal
insufficiency
(AI)
is
characterised
by
lack
of
cortisol
production
from
the
adrenal
glands.
This
can
be
a
primary
disorder
or
secondary
to
adrenocorticotropic
hormone
deficiency
suppression
exogenous
glucocorticoids.
Symptoms
AI
in
children
may
initially
non-specific
and
include
growth
faltering,
lethargy,
poor
feeding,
weight
loss,
abdominal
pain,
vomiting
lingering
illnesses.
treated
with
replacement
doses
hydrocortisone.
At
times
physiological
stress
such
as
illness,
trauma
surgery,
there
an
increased
requirement
for
glucocorticoids,
which
if
untreated
lead
crisis
death.
There
are
no
unified
guidelines
those
<18
years
old
UK,
leading
substantial
variation
management
AI.
paper
sets
out
guidance
intercurrent
medical,
dental
surgical
procedures
allow
timely
appropriate
recognition
treatment
young
people.
International Journal of Pharmaceutics,
Год журнала:
2022,
Номер
630, С. 122466 - 122466
Опубликована: Дек. 6, 2022
The
standard
of
care
for
patients
with
Adrenal
Insufficiency
(AI)
is
suboptimal.
Administration
hydrocortisone
three
times
a
day
produces
plasma
cortisol
fluctuations
associated
negative
health
outcomes.
Furthermore,
there
high
inter-individual
variability
in
need,
necessitating
personalized
approach.
It
hypothesized
that
personalized,
sustained
release
formulation
would
enhance
the
pharmacotherapy
by
mimicking
physiological
concentration
at
higher
level.
Therefore,
novel
24
h
3D
printed
(3DP)
has
been
developed
(M3DICORT)
coupling
hot-melt
extrusion
fused
deposition
modeling.
A
uniform
drug
distribution
3DP
tablets
demonstrated
content
101.66
±
1.60
%
an
acceptance
value
4.01.
had
stable
dissolution
profile
where
intra-batch
deviation
was
2.8
and
inter-batch
6.8
%.
Tablet
height
were
correlated
(R2
=
0.996),
providing
tool
easy
dose
personalization.
Tablets
maintained
critical
quality
attributes,
such
as
(f2
>
60)
uniformity
after
process
transfer
from
single-screw
extruder
to
twin-screw
extruder.
Impurities
observed
final
product
which
should
be
mitigated
before
clinical
assessment.
To
our
knowledge,
M3DICORT
first
specifically
AI.
Expert Opinion on Investigational Drugs,
Год журнала:
2024,
Номер
33(2), С. 115 - 126
Опубликована: Янв. 29, 2024
Adrenal
insufficiency
currently
affects
over
300/million
population,
with
higher
morbidity
and
mortality
compared
to
the
general
population.
Current
glucocorticoid
replacement
therapy
is
limited
by
a
lack
of
reliable
biomarkers
guide
dosing,
inter-patient
variation
in
metabolism
narrow
therapeutic
window.
Increased
may
relate
unappreciated
under-
or
over-exposure
glucocorticoids
impaired
cortisol
circadian
rhythm.
New
agents
are
required
emulate
physiological
secretion
individualize
dosing.
Endocrine Connections,
Год журнала:
2023,
Номер
12(4)
Опубликована: Янв. 30, 2023
Background
Information
on
clinical
outcomes
of
coronavirus
disease
19
(COVID-19)
infection
in
patients
with
adrenal
disorders
is
scarce.
Methods
A
collaboration
between
the
European
Society
Endocrinology
(ESE)
Rare
Disease
Committee
and
Reference
Network
Endocrine
Conditions
via
Registries
for
allowed
collection
data
64
cases
(57
insufficiency
(AI),
7
Cushing’s
syndrome)
that
had
been
reported
by
12
centres
8
countries
January
2020
December
2021.
Results
Of
all
patients,
23
were
males
41
females
(13
those
children)
a
median
age
37
51
years.
In
45/57
(95%)
AI
cases,
COVID-19
was
confirmed
testing.
Primary
present
patients;
affected
Addison’s
disease,
congenital
hyperplasia
primary
(PAI)
due
to
other
causes.
The
most
relevant
comorbidities
hypertension
(12%),
obesity
(
n
=
14%)
diabetes
mellitus
(9%).
An
increase
2.0
(IQR
1.4)
times
daily
replacement
dose
42
(74%)
patients.
Two
administered
i.m.
injection
100
mg
hydrocortisone,
11/64
admitted
hospital.
be
transferred
intensive
care
unit,
one
fatal
outcome.
Four
persistent
SARS-CoV-2
infection,
others
complete
remission.
Conclusion
This
multicentre
questionnaire
first
collect
outcome
gland
disorders.
It
suggests
good
case
duly
adjustments
emphasizes
importance
patient
education
sick
day
rules.
Cancers,
Год журнала:
2023,
Номер
15(24), С. 5786 - 5786
Опубликована: Дек. 10, 2023
Malignant
neoplasms
are
currently
one
of
the
leading
causes
morbidity
and
mortality
worldwide,
posing
a
major
public
health
challenge.
However,
recent
advances
in
research
cancer
biology
immunity
have
led
to
development
immunotherapy,
which
is
now
used
on
an
everyday
basis
treatment
addition
surgical
treatment,
classical
cytostatics,
radiotherapy.
The
efficacy
immunotherapy
has
promoted
great
popularity
this
among
patients,
as
well
significant
interest.
increasing
number
patients
being
treated
with
not
only
reassures
physicians
technique
but
also
shows
wide
spectrum
side
effects
therapy,
been
considered
before.
Immune-related
adverse
events
may
affect
many
systems
organs,
such
digestive,
cardiovascular,
respiratory,
skin,
or
endocrine
organs.
Most
complications
mild
moderate
course,
there
life-threatening
manifestations
that
essential
be
aware
because
if
they
properly
diagnosed
time,
can
fatal
consequences.
purpose
paper
was
present
results
literature
review
current
state
knowledge
(such
adrenal
crisis,
thyroid
storm,
myxoedema
diabetic
ketoacidosis,
severe
hypocalcaemia)
immune
checkpoint
inhibitors
provide
information
symptoms,
diagnostics,
management
strategies.
European Journal of Endocrinology,
Год журнала:
2024,
Номер
190(4), С. 275 - 283
Опубликована: Март 30, 2024
Abstract
Objective
Patients
with
congenital
adrenal
hyperplasia
(CAH)
require
life-long
glucocorticoid
replacement,
including
stress
dosing
(SD).
This
study
prospectively
assessed
crisis
(AC)
incidence,
frequency,
and
details
of
SD
disease
knowledge
in
adult
paediatric
patients
their
parents.
Design
Prospective,
observational
study.
Methods
Data
on
AC
were
collected
via
a
patient
diary.
In
case
AC,
medical
records
reviewed
interviews
conducted.
Adherence
to
sick
day
rules
the
German
Society
Endocrinology
(DGE)
using
version
CAH
assessment
questionnaire
(CAHKAQ)
assessed.
Results
187
patients,
incidence
was
8.4
per
100
years
(py)
5.1
py
38
children.
adults,
195.4
episodes
recorded,
children
169.7
py.
72.3%
adults
34.8%,
performed
according
recommendations.
Children
scored
higher
CAHKAQ
than
(18.0
[1.0]
vs
16.0
[4.0];
P
=
.001).
there
positive
correlation
frequency
(r
.235,
.011)
score
.233,
.014),
between
.193,
.026).
Conclusion
The
are
high.
contrast
cohort,
majority
not
accordance
DGE
recommendations,
underlining
need
for
structured
repeated
education
particular
focus
transition.
Endocrine,
Год журнала:
2022,
Номер
77(1), С. 1 - 10
Опубликована: Май 18, 2022
Abstract
Purpose
Review
the
literature
concerning
adrenal
insufficiency
(AI)
and
crisis
(AC)
in
adolescents
young
adults.
Methods
Searches
of
PubMed
identifying
relevant
reports
up
to
March
2022.
Results
AI
is
rare
disorder
that
requires
lifelong
glucocorticoid
replacement
therapy
associated
with
substantial
morbidity
occasional
mortality
among
Aetiologies
this
age
group
are
more
commonly
congenital,
acquired
causes,
resulting
from
tumours
hypothalamic-pituitary
area
autoimmune
adrenalitis
others,
increasing
age.
All
patients
at
risk
AC,
which
have
an
estimated
incidence
6
8
ACs/100
patient
years.
Prevention
ACs
includes
use
educational
interventions
achieve
competency
dose
escalation
parenteral
administration
during
times
physiological
stress,
such
as
intercurrent
infection.
While
AI/AC
children
adults
has
been
documented,
there
few
studies
focussed
on
AC
occurrence
AI.
This
despite
range
developmental,
psychosocial,
structural
changes
can
interfere
chronic
disease
management
important
period
growth
development.
Conclusion
In
review,
we
examine
current
state
knowledge
epidemiology
emerging
adults;
causes
group;
suggest
areas
for
further
investigation
aimed
reducing
health
impact
these
patients.
Scandinavian Journal of Immunology,
Год журнала:
2024,
Номер
99(3)
Опубликована: Янв. 19, 2024
Group
2
innate
lymphoid
cells
(ILC2s)
are
a
type
of
immune
that
produce
large
amount
IL-5
and
IL-13
two
cytokines
crucial
for
various
processes
such
as
allergic
airway
inflammation,
tissue
repair
homeostasis.
It
is
known
damaged
epithelial-derived
alarmins,
IL-33,
IL-25
thymic
stromal
lymphopoietin
(TSLP),
the
predominant
ILC2
activators
mediate
production
cytokines.
In
recent
years,
abundant
studies
have
found
many
factors
can
regulate
development
function.
Hormones
synthesized
by
body's
endocrine
glands
or
play
an
important
role
in
response.
Notably,
ILC2s
express
hormone
receptors
their
proliferation
function
be
modulated
multiple
hormones
during
inflammation.
Here,
we
summarize
effects
on
ILC2-driven
inflammation
discuss
underlying
mechanisms
potential
therapeutic
significance.
INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine),
Год журнала:
2025,
Номер
20(8), С. 573 - 579
Опубликована: Янв. 4, 2025
War
destroys
normal
life
and
is
the
main
factor
of
human
psychological
physical
vulnerability.
The
stress
war
most
powerful
pathogenic
in
emergence,
detection
exacerbation
somatic,
mental
behavioral
disorders.
Trauma
can
affect
functioning
hypothalamus
pituitary
gland,
as
well
hypothalamic-pituitary-adrenal
axis.
One
these
strong
types
gunshot
injury
and,
consequently,
surgical
intervention
resulting
metabolic
physiological
disturbances.
During
stress,
an
excessive
amount
cortisol
produced,
but
when
body
exhausted,
level
this
hormone
decreases,
then
adrenal
insufficiency
occurs.
article
considered
secondary
that
develop
a
result
after
combat
trauma
with
massive
blood
loss,
which
be
objectively
characterized
acute
male
combatants.
It
important
to
pay
attention
recognition
early
prevention
hypoglycemia
insufficiency.
So,
continuous
glucose
monitoring
should
used.
Although
test
quite
safe,
it
desirable
have
simpler
diagnostic
marker
obtained
without
administration
adrenocorticotropic
hormone.
also
recommended
study
serum,
deficiency
sex
hormones.
Measurement
dehydroepiandrosterone
sulfate
included
laboratory
assessment
hypothalamic-pituitary-adrenal
axis
function.
Dynamic
measurements
proven
increase
accuracy
diagnosing
Thus,
cause
non-specific
symptoms
person
who
has
stress.
Early
testing
based
on
clinical
suspicion
prevent
further
development
crisis.