Cushing syndrome occurs when your body has too much of the hormone cortisol over time. This can result from taking oral corticosteroid medication. Or your body might produce too much cortisol.
Too much cortisol can cause some of the hallmark signs of Cushing syndrome — a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome can also result in high blood pressure, bone loss and, on occasion, type 2 diabetes.
Treatments for Cushing syndrome can return your body's cortisol levels to normal and improve your symptoms. The earlier treatment begins, the better your chances for recovery.
The prevalence of well-documented, permanent adrenal insufficiency is 5 in 10,000 in the general population. Hypothalamic-pituitary origin of disease is most frequent, with a prevalence of 3 in 10,000, whereas primary adrenal insufficiency has a prevalence of 2 in 10,000. Approximately one-half of the latter cases are acquired, mostly caused by autoimmune destruction of the adrenal glands; the other one-half are genetic, most commonly caused by distinct enzymatic blocks in adrenal steroidogenesis affecting glucocorticoid synthesis (i.e. congenital adrenal hyperplasia.)
Adrenal insufficiency arising from suppression of the HPA axis as a consequence of exogenous glucocorticoid treatment is much more common, occurring in 0.5–2% of the population in developed countries.
Hyperparathyroidism is medical condition where overactivity of one or more of the body's four parathyroid glands leads to excess of parathyroid hormone in the bloodstream.
The prevalence of well-documented, permanent adrenal insufficiency is 5 in 10,000 in the general population. Hypothalamic-pituitary origin of disease is most frequent, with a prevalence of 3 in 10,000, whereas primary adrenal insufficiency has a prevalence of 2 in 10,000. Approximately one-half of the latter cases are acquired, mostly caused by autoimmune destruction of the adrenal glands; the other one-half are genetic, most commonly caused by distinct enzymatic blocks in adrenal steroidogenesis affecting glucocorticoid synthesis (i.e. congenital adrenal hyperplasia.)
Adrenal insufficiency arising from suppression of the HPA axis as a consequence of exogenous glucocorticoid treatment is much more common, occurring in 0.5–2% of the population in developed countries.
Hyperparathyroidism is medical condition where overactivity of one or more of the body's four parathyroid glands leads to excess of parathyroid hormone in the bloodstream.
This lecture talk about the disturbance of adrenal gland hormones and how it affect health. it also discuss in brief how to manage such condition in your dental clinic
A case report of Adrenal cushing's syndrome , presented with a typical dermatological lesions , seen in endocrinology outpatient clinic in zagazig university hospitals, Egypt
Postpartum Hemorrhage (PPH) is a significant and potentially life-threatening medical condition that occurs after childbirth. It is characterised by excessive loss of blood, typically defined as blood loss exceeding 500 millilitres for a vaginal delivery or 1000 millilitres for a cesarean section. PPH is a critical concern due to its capacity to lead to severe maternal morbidity and even mortality.
Keratitis is an inflammatory condition that affects the cornea of your eye.
The cornea is the clear part that covers both the iris and the pupil.
Keratitis can be caused by an infection or injury to the eye.
Keratitis is a common condition.
People who wear contact lenses may experience keratitis more frequently than people who don’t wear contacts. In either case, you can take steps to help prevent this condition.
If you do develop keratitis, see your doctor right away.
Central and Peripheral Vision & their DiseasesHuzaifa Zahoor
The act or power of seeing
The special sense by which the qualities of an object (such as color, luminosity, shape, and size) constituting its appearance are perceived through a process in which light rays entering the eye are transformed by the retina into electrical signals that are transmitted to the brain via the optic nerve.
Types of Vision
Central Vision
Peripheral Vision
Disease of Vision
Central Vision Loss
Peripheral Vision Loss
Quality sexual health education (SHE) provides students with the knowledge and skills to help them be healthy and avoid human immunodeficiency virus (HIV), sexually transmitted diseases (STD), and unintended pregnancy.
A SHE curriculum includes medically accurate, developmentally appropriate, and culturally relevant content and skills that target key behavioral outcomes and promote healthy sexual development.
The curriculum is age-appropriate and planned across grade levels to provide information about health risk behaviors and experiences.
Sexual health education should be consistent with scientific research and best practices; reflect the diversity of student experiences and identities; and align with school, family, and community priorities.
The diaphragm is a dome-shaped muscular barrier between the chest and abdominal cavities. It separates your heart and lungs from your abdominal organs (stomach, intestines, spleen, and liver).
A diaphragmatic hernia occurs when one or more of your abdominal organs move upward into your chest through a defect (opening) in the diaphragm. This kind of defect can be present at birth or acquired later in life. It’s always a medical emergency and requires prompt surgery to correct.
Cryotherapy is the use of extreme cold to freeze and remove abnormal tissue.
Doctors use it to treat many skin conditions (including warts and skin tags) and some cancers, including prostate, cervical, and liver cancer.
This treatment is also called cryoablation.
Surgery is the branch of medicine that deals with the physical manipulation of a bodily structure to diagnose, prevent, or cure an ailment.
Ambroise Paré, a 16th-century French surgeon, stated that to perform surgery is, "To eliminate that which is superfluous, restore that which has been dislocated, separate that which has been united, join that which has been divided and repair the defects of nature.“
Patent ductus arteriosus (PDA) is a persistent opening between the two major blood vessels leading from the heart. The opening (ductus arteriosus) is a normal part of a baby's circulatory system in the womb that usually closes shortly after birth. If it remains open, it's called a patent ductus arteriosus.
A small patent ductus arteriosus often doesn't cause problems and might never need treatment. However, a large patent ductus arteriosus left untreated can allow poorly oxygenated blood to flow in the wrong direction, weakening the heart muscle and causing heart failure and other complications.
Treatment options for a patent ductus arteriosus include monitoring, medications, and closure by cardiac catheterization or surgery.
Diet therapy is a broad term for the alteration or adoption of a diet to prevent or treat a disease or to simply promote optimum health.
In some cases, an alternative dietary lifestyle plan may be developed to eliminate certain foods to reclaim health.
An incorrect diet can cause not only weight gain and skin conditions but may promote exhaustion and fatigue.
Depending on the disease, if you do not follow the diet advised to you by a specialist it may have serious consequences on your health.
A good diet can prevent various diseases.
Traditional medicine (also known as indigenous or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies before the era of modern medicine.
Rheumatic fever (acute rheumatic fever) is a disease that can affect the heart, joints, brain, and skin.
Rheumatic fever can develop if strep throat and scarlet fever infections are not treated properly.
Early diagnosis of these infections and treatment with antibiotics is key to preventing rheumatic fever.
Avicenna, an Iranian philosopher and physician of the tenth and eleventh centuries (4th and 5th century A.H.) is without doubt one of the eminent scientists and talented scholars of his own age.
His scientific fame and influence was not only spread in Iran and the Islamic world, but also extended to the whole world.
He is still known as a universal scientist in particular in medicine in the views of the researchers and historians of science history.
Greece the territory of beginning of practice of healingHuzaifa Zahoor
Greek civilization emerged around 700 B.C.E. and continued until around 600 C.E. Greek doctors used rational thinking when dealing with medicine. This approach continues to influence medicine today.
The history & development of traditional chinese medicineHuzaifa Zahoor
Traditional Chinese medicine is system of medicine at least 23 centuries old that aims to prevent or heal disease by maintaining or restoring yinyang balance.
China has one of the world’s oldest medical systems.
Acupuncture and Chinese herbal remedies date back at least 2,200 years, although the earliest known written record of Chinese medicine is the Huangdi neijing (The Yellow Emperor’s Inner Classic) from the 3rd century BCE.
MODY is the name given to a collection of different types of inherited forms of diabetes that usually develop in adolescence or early adulthood.
MODY stands for “Maturity-onset diabetes of the young” and was given that name in the past because it acted more like the adult type of diabetes (Type 2 Diabetes) but was found in young people.
MODY limits the body’s ability to produce insulin, but is different than the juvenile type of diabetes (Type 1 Diabetes).
When our bodies don’t produce enough insulin, it can increase blood glucose levels. High blood glucose levels lead to diabetes.
Steatohepatitis is a type of fatty liver disease, characterized by inflammation of the liver with concurrent fat accumulation in the liver.
Mere deposition of fat in the liver is termed steatosis, and together these constitute fatty liver changes.
The word is from steato-, meaning "fat“ and hepatitis, meaning "inflammation of the liver".
Ultrasonography of Heart or Cardiac ultrasonography or Echocardiogram or ultrasound of the heart is the production of two-dimensional cross-sectional images of intracardiac anatomy by stop-action compound scan pulse-echo ultrasound.
The images show the size and shape of the cardiac chambers in systole and diastole, the appearance of heart valves, and the orientation of the great vessels.
The stop-action display is created by repetitively activating the recording oscilloscope for a selected short segment of each cardiac cycle.
The activating signal is timed by the patient's electrocardiogram.
The asynchronous motion of the scanner accumulates additional echoes with each cycle.
As a non-invasive technique, it is without risk or morbidity.
The right equipment is essential for a clinic that provides physical therapy, and choosing the right medical gear for your business is rarely simple.
High-quality systems often command high prices, and ensuring you have the tools you need to help patients with both occupational health development and recovery is essential.
You don’t have to break the bank to acquire the best physical therapy equipment, but you do need to be sure that your equipment is made of sturdy material that can withstand regular use by patients with a variety of different needs and body types.
The ability to understand the routes of infection, conduct epidemiology studies and to implement effective infection control procedures are crucial to hospital hygiene management.
Prolonged patient stays lead to increased morbidity and mortality rates in many cases.
Therefore, Healthcare-Associated Infections (HAI) represent a significant cost to hospitals and hinder patient care.
Advanced microbial strain typing, hospital hygiene and infection control solutions are improving the way hospitals deal with HAI.
The vas deferens, also called ductus deferens, is part of the male reproductive system of many vertebrates; these ducts transport sperm from the epididymis to the ejaculatory ducts in anticipation of ejaculation. It is a partially coiled tube that exits the abdominal cavity through the inguinal canal.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
2. Cushing syndrome occurs when your body has too much of
the hormone cortisol over time. This can result from taking
oral corticosteroid medication. Or your body might
produce too much cortisol.
Too much cortisol can cause some of the hallmark signs of
Cushing syndrome — a fatty hump between your
shoulders, a rounded face, and pink or purple stretch
marks on your skin. Cushing syndrome can also result in
high blood pressure, bone loss and, on occasion, type 2
diabetes.
Treatments for Cushing syndrome can return your body's
cortisol levels to normal and improve your symptoms. The
earlier treatment begins, the better your chances for
recovery.
3.
4. There are two main etiologies of Cushing syndrome:
Endogenous hypercortisolism
Endogenous Cushing syndrome results from excessive production
of cortisol by adrenal glands and can be ACTH-dependent and
ACTH-independent.
exogenous hypercortisolism.
Exogenous hypercortisolism, the most common cause of Cushing
syndrome, is mostly iatrogenic and results from the prolonged use
of glucocorticoids.
ACTH-secreting pituitary adenomas (Cushing disease) and
ectopic ACTH secretion by neoplasms are responsible for
ACTH-dependent Cushing. Adrenal hyperplasia, adenoma,
and carcinoma are major causes of ACTH-independent
Cushing syndrome.
5. When stimulated by ACTH, the adrenal gland secretes cortisol
and other steroid hormones.
ACTH is produced by the pituitary gland and released into the
petrosal venous sinuses in response to stimulation by
corticotropin-releasing hormone (CRH) from the
hypothalamus (according to image on next slide).
ACTH is released in a diurnal pattern that is independent of
circulating cortisol levels: peak release occurs just before
awakening, and ACTH levels then decline throughout the day.
Control of CRH and ACTH release is maintained through
negative feedback by cortisol at the hypothalamic and pituitary
levels.
Neuronal input at the hypothalamic level can also stimulate CRH
release.
6.
7. Although the adenomas of Cushing's disease secrete
excessive amounts of ACTH, they generally retain some
negative feedback responsiveness to high doses of
glucocorticoids.
Ectopic sources of ACTH, usually in the form of
extracranial neoplasms, are generally not responsive to
negative feedback with high doses of glucocorticoids.
However, some overlap exists in the response to negative
feedback between pituitary and ectopic sources of excessive
ACTH.
Cushing's syndrome is categorized as ACTH dependent or
ACTH independent (according to table on next slide).
This division is convenient for organizing the work-up of
patients with suspected hypercortisolism.
8. ACTH Dependent ACTH Independent
Cushing's disease Iatrogenic
Ectopic ACTH syndrome Adrenal adenoma
Ectopic corticotropin-releasing
hormone syndrome*
Micronodular hyperplasia*
Macronodular hyperplasia*
ACTH = adrenocorticotropin hormone.
*—Accounts for 1 percent or less of cases.
9. Depression, alcoholism, medications, eating disorders
and other conditions can cause mild clinical and
laboratory findings, similar to those in Cushing's
syndrome, termed “pseudo-Cushing's syndrome.”
The laboratory and clinical findings of
hypercortisolism disappear if the primary process is
successfully treated.
Dexamethasone, an exogenous glucocorticoid, is used
to test for Cushing's syndrome.
This gluococorticoid does not interfere with cortisol
assays but induces similar physiologic responses.
10. The most common symptoms of this condition are:
weight gain
fatty deposits, especially in the midsection, the face
(causing a round, moon-shaped face), and between the
shoulders and the upper back (causing a buffalo hump)
purple stretch marks on the breasts, arms, abdomen,
and thighs
thinning skin that bruises easily
skin injuries that are slow to heal
acne
Fatigue
muscle weakness
11.
12.
13. In addition to the common symptoms above, there are other
symptoms that may sometimes be observed in people with
Cushing’s syndrome.
These can include:
high blood sugar
increased thirst
increased urination
osteoporosis
high blood pressure (hypertension)
a headache
mood swings
anxiety
irritability
depression
an increased incidence of infections
14.
15. Cushing’s syndrome can be particularly difficult to
diagnose. This is because many of the symptoms, like
weight gain or fatigue, can have other causes.
Additionally, Cushing’s syndrome itself can have many
different causes.
Your healthcare provider will review your medical
history. They’ll ask questions about symptoms, any
health conditions you may have, and any medications
you may be prescribed.
They’ll also perform a physical exam where they’ll look
for signs like buffalo hump, and stretch marks and
bruises.
16. The doctor may order laboratory tests, including:
24-hour urinary free cortisol test
For this test, you’ll be asked to collect your urine over a 24-hour
period. The levels of cortisol will then be tested.
Salivary cortisol measurement
In people without Cushing’s syndrome, cortisol levels drop in the
evening. This test measures the level of cortisol in a saliva sample
that’s been collected late at night to see if cortisol levels are too
high.
Low-dose dexamethasone suppression test
For this test, you’ll be given a dose of dexamethasone late in the
evening. Your blood will be tested for cortisol levels in the morning.
Normally, dexamethasone causes cortisol levels to drop. If you have
Cushing’s syndrome, this won’t occur.
17. Imaging tests
CT or MRI scans can provide images of your pituitary and adrenal
glands to detect abnormalities, such as tumors.
Petrosal sinus sampling
This test can help determine whether the cause of Cushing
syndrome is rooted in the pituitary or somewhere else. For the test,
blood samples are taken from the veins that drain the pituitary
gland (petrosal sinuses).
A thin tube is inserted into your upper thigh or groin area while
you're sedated and is threaded to the petrosal sinuses. Levels
of ACTH are measured from the petrosal sinuses and from a blood
sample taken from the forearm.
If the ACTH level is higher in the sinus sample, the problem stems
from the pituitary. If the ACTH levels are similar between the
sinuses and forearm, the root of the problem lies outside of the
pituitary gland.
18. Most cases of Cushingoid symptoms are caused by corticosteroid
medications, such as those used for asthma, arthritis, eczema and other
inflammatory conditions.
Consequently, most patients are effectively treated by carefully
tapering off (and eventually stopping) the medication that causes the
symptoms.
If an adrenal adenoma is identified, it may be removed by surgery.
An ACTH-secreting corticotrophic pituitary adenoma should be
removed after diagnosis.
Regardless of the adenoma's location, most patients require steroid
replacement postoperatively at least in the interim, as long-term
suppression of pituitary ACTH and normal adrenal tissue does not
recover immediately.
Clearly, if both adrenals are removed, replacement with hydrocortisone
or prednisolone is imperative.
19. In those patients not suited for or unwilling to undergo surgery, several drugs have been
found to inhibit cortisol synthesis (e.g. ketoconazole, metyrapone) but they are of
limited efficacy.
Mifepristone is a powerful glucocorticoid type II receptor antagonist and, since it does
not interfere with normal cortisol homeostasis type I receptor transmission, may be
especially useful for treating the cognitive effects of Cushing's syndrome.
However, the medication faces considerable controversy due to its use as an abortifacient.
In February 2012, the FDA approved mifepristone to control high blood sugar levels
(hyperglycemia) in adult patients who are not candidates for surgery, or who did not
respond to prior surgery, with the warning that mifepristone should never be used by
pregnant women.
In March 2020, Isturisa (osilodrostat) oral tablets a 11-beta-hydroxylase enzyme inhibitor
was approved by FDA for treating those patients who cannot undergo pituitary surgery or
for patients who underwent surgery but continue to have the disease.
Removal of the adrenals in the absence of a known tumor is occasionally performed to
eliminate the production of excess cortisol.
In some occasions, this removes negative feedback from a previously occult pituitary
adenoma, which starts growing rapidly and produces extreme levels of ACTH, leading to
hyperpigmentation.
This clinical situation is known as Nelson's syndrome.
21. Diet
Although dietary changes won’t cure your condition, they can help to keep
your cortisol levels from rising even more or help to prevent some
complications.
22. Some dietary tips for those with Cushing’s syndrome include:
Monitor your calorie intake
Keeping track of your calorie intake is important since weight gain is one of the
main symptoms of Cushing’s syndrome.
Try to avoid drinking alcohol.
Alcohol consumption has been linked with a rise in cortisol levels, particularly in
heavy drinkersTrusted Source, according to a 2007 study.
Watch your blood sugar.
Cushing’s syndrome can lead to high blood glucose, so try not to eat foods that
can cause a rise in blood sugar. Examples of foods to focus on eating include
vegetables, fruits, whole grains, and fish.
Cut back on sodium.
Cushing’s syndrome is also associated with high blood pressure (hypertension).
Because of this, try to limit your sodium intake. Some easy ways to do this
include not adding salt to food and carefully reading food labels to check sodium
content.
Make sure to get enough calcium and vitamin D.
Cushing’s syndrome can weaken your bones, making you prone to fractures.
Both calcium and vitamin D can help to strengthen your bones.
23. Cushing’s Syndrome: Signs, Causes, and Treatment
(healthline.com)
Cushing's Disease: Clinical Manifestations and Diagnostic
Evaluation - American Family Physician (aafp.org)
Cushing’s Syndrome/Disease – Causes, Symptoms,
Diagnosis and Treatments (aans.org)
Cushing syndrome - Symptoms and causes - Mayo Clinic
Cushing Syndrome - StatPearls - NCBI Bookshelf (nih.gov)
Diagnostic Approach to Cushing Disease (medscape.com)
