A5054986806- Adrenal and Paraganglionic Tumors
- Hormonal Regulation and Hypertension
- Pituitary Gland Disorders and Treatments
- Adrenal Hormones and Disorders
- Cancer, Hypoxia, and Metabolism
- Ovarian cancer diagnosis and treatment
- Bone health and osteoporosis research
- Parathyroid Disorders and Treatments
- Thyroid Cancer Diagnosis and Treatment
- Grief, Bereavement, and Mental Health
- Testicular diseases and treatments
- Blood donation and transfusion practices
- Sarcoidosis and Beryllium Toxicity Research
- Infectious Encephalopathies and Encephalitis
- Dysphagia Assessment and Management
- Pathogenesis and Treatment of Hiccups
- Bone health and treatments
- Vitamin D Research Studies
- Electroconvulsive Therapy Studies
- Liver Diseases and Immunity
- Bone fractures and treatments
- Gallbladder and Bile Duct Disorders
- Bone and Joint Diseases
- Frailty in Older Adults
- Homelessness and Social Issues
Henry Ford Health System
2021-2024
Mayo Clinic in Arizona
2019-2022
Mayo Clinic in Florida
2021
Mayo Clinic
2019-2020
WinnMed
2019-2020
Providence Hospital
2015
North Middlesex Hospital
2008
Middlesex University
2008
The Royal Free Hospital
2007-2008
University College London
2007-2008
Frailty, characterized by multi-system decline, increases vulnerability to adverse health outcomes and can be measured using Frailty Index (FI). We aimed assess the prevalence of frailty in patients with adrenal disorders (based on hormonal sub-type) examine association between FI performance-based measures physical function.
Increased visceral fat and sarcopenia are cardiovascular risk factors that may explain increased morbidity frailty in patients with adrenal adenomas. Our objective was to compare body composition measurement of adenomas referent subjects without disease.Cross-sectional study, 2014-2018.Participants were adults nonfunctioning tumor (NFAT), mild autonomous cortisol secretion (MACS), Cushing syndrome (CS) age, sex, BMI 1:1 matched disorders. Main outcome measures measurements calculated from...
Incidentally discovered adrenal tumors are reported in ~ 5% of adults undergoing cross‐sectional imaging. Mild autonomous cortisol secretion ( MACS ) from the mass is demonstrated 5–48% patients with tumors. The diagnosis represents a challenge due to limitations currently used diagnostic tests, differences definitions clinically relevant , and heterogeneity an individual's susceptibility abnormal mass. Patients present increased risk cardiovascular factors, events, metabolic bone disease,...
Parathyroid adenomas weighing more than 3.5 g are reported variously as “atypical”, “large” or “giant” parathyroid adenomas. All such rare variants accounting for no 1.5% of all Large often associated with severe form the disease, including osteitis fibrosa cystica (OFC) and share many biochemical, histological, molecular features both benign malignant neoplasms, considered a distinct clinical entity. However, pathogenesis oversized often-associated skeletal phenotype remains unclear. We...
Abstract Context Several studies have reported increased risk of fragility fractures in patients with mild autonomous cortisol secretion (MACS), discordant to the degree bone density deterioration. Objective To evaluate effect MACS on metabolism adrenal adenomas. Design Cross-sectional study prospective enrollment, 2014-2019 Setting Referral center. Patients 213 adenomas: 22 Cushing syndrome (CS), 92 and 99 nonfunctioning tumors (NFAT). Main Outcome Measures Osteocalcin, procollagen I intact...
Abstract Context Interpretation of dexamethasone suppression test (DST) may be influenced by absorption and metabolism the altered cortisol binding. Objective We aimed to determine normal ranges free during DST in participants without adrenal disorders identify population patients where post-DST measurements add value diagnostic workup. Design Setting Cross-sectional study conducted a tertiary medical center. Participants Adult volunteers (n = 168; 47 women on oral contraceptive therapy...
Guidelines suggest performing urine steroid profiling in patients with indeterminate adrenal tumors to make a noninvasive diagnosis of adrenocortical carcinoma (ACC). However, is not widely available.
Abstract Context SDHB mutations are found in an increasing number of neoplasms, most notably paragangliomas and pheochromocytomas (PPGLs). SDHB-PPGLs slow-growing tumors, but ∼50% them may develop metastasis. The molecular basis metastasis these tumors is a long-standing unresolved problem. Thus, better understanding the biology needed. Objective This study aimed to identify gene methylation changes relevant for metastatic SDHB-PPGLs. Design We performed genome-wide profiling DNA diverse...
An older woman presented to the hospital with abdominal pain and subsequently had three episodes of melaena, requiring blood transfusions. She was known suffer severe depression on high-dose fluoxetine. Gastroscopy colonoscopy failed reveal an underlying cause for gastrointestinal (GI) bleeding. Possibility selective serotonin reuptake inhibitors causing GI bleed raised. Fluoxetine discontinued patient commenced mirtazapine. The no further bleeding significant improvement in haemoglobin.
Adrenal hemorrhage is an under-recognized condition often found incidentally on imaging in acutely ill patients. Unilateral adrenal usually clinically silent however bilateral can cause acute primary insufficiency which be life threatening. This a case of secondary to hemorrhage.
Abstract Disclosure: E. Davydov: None. D. Severson: S. Athimulam: Introduction: Medullary thyroid cancer (MTC) accounts for less than 5% of all cancers. In 1% these patients, cushing syndrome (CS) due to ectopic ACTH secretion can develop. Selpercatinib is a selective RET kinase inhibitor approved in 2020 treatment advanced medullary with mutations. We present case patient MTC complicated by CS that resolved after Selpercatinib. Case: A 38-year old male presented the ED progressive left...
Abstract Disclosure: K. Yu: None. S. Athimulam: J. Saini: R. Kaur: R.J. Singh: S.K. Grebe: Q. Xue: I. Bancos: Advisory Board Member; Self; AstraZeneca, Corcept, Novo Nordisk, HRA Pharmaceuticals, Neurocrine, Diurnal, Recordati, Sparrow, Xeris, Spruce, Adrenas. Research Investigator; Recordati. Context: Early diagnosis is essential to assure a better prognosis in patients with adrenocortical carcinoma (ACC). Guidelines suggested performing urine steroid profiling indeterminate adrenal tumors...
Abstract Disclosure: R. Nakdali: None. S. Athimulam: Introduction: Ovarian steroid cell tumors are a rare subtype of sex-cord stromal tumors. Leydig is sex-stromal that found in < 1% all ovarian They typically benign, unilateral, and secrete androgens which causes virilization. Below we present the case postmenopausal woman who presented with signs virilization was diagnosed an tumor. Case: A 62-year-old woman, history partial hysterectomy right oophorectomy to Endocrinology clinic...
Abstract Disclosure: R. Nakdali: None. S. Athimulam: Introduction: Ovarian steroid cell tumors are a rare subtype of sex-cord stromal tumors. Leydig is sex-stromal that found in < 1% all ovarian They typically benign, unilateral, and secrete androgens which causes virilization. Below we present the case postmenopausal woman who presented with signs virilization was diagnosed an tumor. Case: A 62-year-old woman, history partial hysterectomy right oophorectomy to Endocrinology clinic...
Background: Several studies reported high prevalence of bone disease (osteoporosis/osteopenia) in patients with mild autonomous cortisol secretion (MACS), discordant to the degree density deterioration. Bone turnover marker (BTM) measurements can potentially elucidate underlying mechanism MACS-related disease. Objective: To describe relationship between BTMs and glucocorticoid autonomy adrenal adenomas Methods: Patients were prospectively enrolled from clinics over 3 years. Inclusion...
Introduction: Acquired tracheoesophageal fistula (TEF) is a rare condition that can impair respiratory and digestive functions. Morbidity mortality high with malignancy being the most common etiology. Other less etiologies occur secondary to infection, ruptured diverticula trauma. Methods: 85-year-old female extensive medical history presented hospital from rehabilitation facility distress. She recently had an admission at different institution stroke required ventilator support percutaneous...
Introduction: Secondary sclerosing cholangitis (SSC) is a rare disease; the infrequency of its presentation poses diagnostic challenge and highlights importance identifying causative factors. Typical causes SSC include intraductal stones, surgical trauma, recurrent pancreatitis, intra-hepatic chemotherapy. There have been no reported cases systemic chemotherapy resulting in SSC. Methods: 64-year old woman presented to hospital with 2-week history worsening right upper quadrant pain, jaundice...