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Endocrine Disorders, Contraception, and Hormone Therapy during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Insufficient ACTH secretion by the pituitary may cause adrenal corticosteroid insufficiency, insufficient adrenal secretion of corticosteroids, or inadequate steroid replacement therapy. Adrenal atrophy secondary to autoimmune disease occurs in about three quarters of diagnosed cases. Addison’s disease diagnosis in pregnancy may be difficult because the signs and symptoms (weakness, fatigue, anorexia, nervousness, increased skin pigmentation) parallel those observed in a normal pregnancy. Addison’s disease can follow a chronic, indolent course, or progress into a true acute medical emergency characterized by an “Addisonian crisis” (severe nausea, vomiting, diarrhea, abdominal pain hypotension). Pregnancy is known to aggravate Addison’s disease. Addison’s disease does apparently not affect spontaneous abortion rate, prematurity rate, and neonatal outcome (Brent, 1950; Satterfield and Williamson, 1976). Chronic adrenal insufficiency requires adequate adrenal replacement in the form of cortisone acetate or prednisone and 9-alpha-fluoro-hydrocortisone. During labor, delivery, and the first few days postpartum, the mother should be monitored closely, ensuring a good state of hydration with normal saline and adequate cortisol hemisuccinate replacement. It is common for women with adrenal insufficiency to be diagnosed for the first time during the puerperium when they develop adrenal crisis (Brent, 1950). Treatment involves replacement steroids during an Addisonian crisis including cortisol hemisuccinate (Solu-Cortef), with fluid replacement as isotonic saline, and glucose administration.
Heterocyclic Drug Design and Development
Published in Rohit Dutt, Anil K. Sharma, Raj K. Keservani, Vandana Garg, Promising Drug Molecules of Natural Origin, 2020
Garima Verma, Mohammad Shaquiquzzaman, Mohammad Mumtaz Alam
Addison’s disease is a long term endocrine disorder characterized by insufficient production of steroid hormones. Symptoms of the disease include fatigue, sores in mouth, weight loss, darkened skin color, depression, fainting spells, decreased heart rate, etc. (Macon and Yu, 2016). Treatment includes administration of glucocorticoids. Drugs obtained from plants intended for the treatment of Addison’s disease are given in Table 9.16.
Practice exam 4: Answers
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
Appropriate investigations for this patient are chromosomal analysis, thyroid function tests, fasting blood sugar, and autoimmune screen for polyendocrinopathy. If Addison’s disease is suspected, the adrenocorticotrophic hormone stimulation test is performed. A dual X-ray absorptiometry scan may be performed to estimate bone mineral density (5).
Recent developments in wearable & non-wearable point-of-care biosensors for cortisol detection
Published in Expert Review of Molecular Diagnostics, 2023
Simran Kaur, Niharika Gupta, Bansi D. Malhotra
Cortisol, as a potential biomarker for stress-related disorders and other conditions like Cushing’s syndrome and Addison’s disease, is being extensively researched. With a wide range of sampling methods available, the research and development of biosensing devices for cortisol detection considerably increased. The most viable and explored sampling techniques are sweat and saliva. PoC devices may prove crucial for stress management as well as the prevention of associated complications. Both saliva and sweat have been employed in various devices to detect cortisol; however, sweat has the highest number of PoC devices, especially mobile integrated devices for cortisol detection and stress monitoring. Other biofluids currently have very limited PoC applications, due to difficulty of reach, invasive procedures, and contamination chances. Hence, researchers have focused more on saliva and sweat to develop PoC devices. Wearable sensors are developed to cater sweat-based detection, whereas non-wearable sensors are developed to detect through saliva. Electrochemical PoC devices have lower limits of detection, and hence offer more sensitivity and accuracy as well as good reproducibility and reliability. It is essential to construct prototypes of products that can be easily and cost-effectively used to estimate cartisolin desired specimens.
A case of recurrent pigmented macules in Laugier-Hunziker syndrome treated using a Q-switched Nd-YAG laser
Published in Journal of Cosmetic and Laser Therapy, 2019
Myoung Eun Choi, Chang Jin Jung, Woo Jin Lee, Chong Hyun Won, Sung Eun Chang, Mi Woo Lee, Jee Ho Choi, Seung Hwan Paik
The differential diagnosis of multiple mucosal pigmentations includes Peutz-Jeghers syndrome, Addison’s disease, McCune-Albright syndrome and neurofibromatosis (1). A variety of drugs such as minocycline, phenothiazines, ketoconazole, oral contraceptives, zidovudine and chemotherapeutic agents can induce hyperpigmentation in the oral cavity (1,2). Ruling out Peutz-Jeghers syndrome requires STK11 gene testing or a gastrointestinal endoscopy since patients with this condition are at a high risk of gastrointestinal cancer (1). The pigmentation associated with Peutz-Jehgers syndrome typically occurs in childhood and nail involvement is rare. Addison’s disease is associated with a low production of cortisol and aldosterone and can be ruled out by measuring the serum levels of cortisol and ACTH in addition to assessing clinical symptoms including fatigue, weakness, loss of weight, and gastrointestinal disturbances. McCune-Albright syndrome is characterized by unilateral café au lait spots, precocious puberty and polyostotic fibrous dysplasia (2).
Everyday managing and living with autoimmune Addison’s disease: Exploring experiences using photovoice methods
Published in Scandinavian Journal of Occupational Therapy, 2018
Emelie Mälstam, Sophie Bensing, Eric Asaba
One of the most common topics during the PVG discussions was the dual view of AAD and the information that existed about the disease and its impact on everyday life. There was a consensus in the group that healthcare professionals in different settings had repeatedly informed them that: ‘Addison’s disease is just a matter of taking some pills and everything will be alright.’ This general picture of the disease did not match the members own lived experiences. Often during the PVG discussions, the members noted: ‘That’s not really how it is.’ (Alice). On the contrary, the majority of the members described everyday life with AAD as complex, involving negotiations and feelings of insecurity regarding the everyday management of the disease. Several aspects could act as barriers to wellbeing, including increased sensitivity to stress and infections, reduced strength and energy, difficulty recovering after strain, and an increased need for rest due to both physical and mental fatigue. There was also a shared experience related to the fact that the disease was an invisible one; it was a challenge to look healthy, tanned, and alert on the outside, while the inside told a different story. The photograph in Figure 2 represents the dual view of the disease in that everyday life with AAD was not always how it seemed to be from the outside looking in.