000			03615nam a22005897a 4500
008			170428s20172017 xxu||||| |||| 00| 0 eng d
022			_a0021-972X
040			_aOvid MEDLINE(R)
099			_a28323961
245			_aNormalized early post-operative cortisol and ACTH values predict nonremission after surgery for Cushing's disease.
251			_aJournal of Clinical Endocrinology & Metabolism. 102(7):2179-2187, 2017 Jul 01
252			_aJ Clin Endocrinol Metab. 102(7):2179-2187, 2017 Jul 01
253			_aThe Journal of clinical endocrinology and metabolism
260			_c2017
260			_fFY2018
266			_d2017-05-06
501			_aAvailable online through MWHC library: 1999- June 2013, Available in print through MWHC library: 1999 - 2006
520			_aConclusions: NEPV for cortisol and ACTH predict non-remission after TSS for CD.
520			_aContext: Perioperative increases in adrenocorticotropic hormone (ACTH) and cortisol mimic corticotropin releasing hormone (CRH) stimulation testing. This phenomenon may help identify patients with residual adenoma after transsphenoidal surgery (TSS) for Cushing's disease (CD).
520			_aDesign: Retrospective case control study of patients treated at a single center from December 2003 till July 2016. Early and medium-term remission were assessed at 10 days and 11 months.
520			_aInterventions: Normalized early post-operative values (NEPV) for cortisol and ACTH were calculated as immediate post-operative cortisol or ACTH minus preoperative post-CRH stimulation test levels.
520			_aMain Outcome Measures: Prediction of early non-remission was evaluated using logistic regression. Prediction of medium-term remission was assessed using Cox regression. Predictive ability was quantified by areas under the receiver operating characteristic curve (AUROC).
520			_aObjective: To predict non-remission after TSS for CD.
520			_aPatients: 291 consecutive TSS cases from 257 patients with biochemical evidence of CD.
520			_aResults: NEPV for cortisol and ACTH predicted early non-remission (adjusted OR 1.1, 95% CI 1.0 - 1.1, P = 0.016; and adjusted OR 1.0, 95% CI 1.0 - 1.0, P = 0.048 respectively). AUROC for NEPV cortisol was 0.78, 95% CI 0.61 - 0.95; and for NEPV ACTH was 0.80, 95% CI 0.61 - 0.98. NEPV for both cortisol and ACTH predicted medium-term non-remission (hazard ratios (HR) 1.1, 95% CI 1.0 - 1.1, P = 0.023; and HR 1.0, 95% CI 1.0 - 1.0, P = 0.025 respectively).
520			_aSetting: Clinical Center.
546			_aEnglish
650			_a*Adrenocorticotropic Hormone/bl [Blood]
650			_a*Hydrocortisone/bl [Blood]
650			_a*Pituitary ACTH Hypersecretion/su [Surgery]
650			_aAdult
650			_aAge Factors
650			_aBiomarkers/bl [Blood]
650			_aFemale
650			_aHumans
650			_aMale
650			_aPituitary ACTH Hypersecretion/bl [Blood]
650			_aPostoperative Period
650			_aPredictive Value of Tests
650			_aPrognosis
650			_aReference Values
650			_aRemission Induction
650			_aRetrospective Studies
650			_aSex Factors
651			_aMedStar Washington Hospital Center
656			_aMedicine/Endocrinology
657			_aJournal Article
700			_aSharma, Susmeeta T
790			_aAsuzu D, Benzo S, Beri A, Chatain GP, Chittiboina P, Hayes C, Keil M, Lodish M, Lonser RR, McGlotten R, Nieman L, Oldfield EH, Sharma ST, Stratakis C
856			_uhttps://dx.doi.org/10.1210/jc.2016-3908 _zhttps://dx.doi.org/10.1210/jc.2016-3908
942			_cART _dArticle
999			_c2742 _d2742