Review
Biochemistry & Molecular Biology
Maria Francesca Birtolo, Simone Antonini, Andrea Saladino, Benedetta Zampetti, Elisabetta Lavezzi, Iacopo Chiodini, Gherardo Mazziotti, Andrea G. A. Lania, Renato Cozzi
Summary: Secondary Adrenal Insufficiency (SAI) is a condition characterized by low ACTH secretion due to hypothalamus or pituitary disease or injury. The evaluation of SAI is challenging due to non-specific symptoms, rarity, and pitfalls associated with laboratory tests. The gold standard test for assessing the HPA axis is the insulin tolerance test, but the ACTH stimulation test is safer and well-tolerated, although its diagnostic accuracy varies.
Article
Endocrinology & Metabolism
Lucyna Papierska, Michal Rabijewski, Bartosz Migda, Dorota Leszczynska, Karolina Nowak, Agnieszka Lebek-Szatanska, Piotr Glinicki, Wojciech Zgliczynski
Summary: The study aimed to determine whether a single measurement of ACTH is sufficient to confirm or rule out secondary adrenal insufficiency in the short Metyrapone test. The results showed that the readily available plasma ACTH assay cannot replace the measurement of 11-deoxycortisol concentrations for evaluating the results of the Metyrapone test.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Review
Endocrinology & Metabolism
Nada Younes, Isabelle Bourdeau, Andre Lacroix
Summary: Primary adrenal insufficiency is a rare but potentially fatal disease characterized by destruction of the adrenal cortex leading to hormone deficiencies. Patients often present with fatigue, weight loss, melanoderma, and hypotension. Diagnosis requires testing hormone levels and concentrations.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Review
Endocrinology & Metabolism
Filippo Ceccato, Mattia Barbot, Alessandro Mondin, Marco Boscaro, Maria Fleseriu, Carla Scaroni
Summary: This study aimed to evaluate the diagnostic accuracy of the CRH test, desmopressin test, and HDDST for the differential diagnosis of CD and EAS. The CRH test showed the highest sensitivity for detecting CD and the highest specificity for detecting EAS, while the diagnostic accuracy of HDDST and desmopressin test was lower.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Review
Gastroenterology & Hepatology
Brian J. Wentworth, Matthew Schliep, Wendy Novicoff, Helmy M. Siragy, Calvin X. Geng, Zachary H. Henry
Summary: This study found that relative adrenal insufficiency is highly prevalent in non-critically ill patients with cirrhosis and is associated with increased mortality. Despite the multifactorial pathogenesis proposed, there have been no studies to date investigating therapeutic interventions in this specific population.
LIVER INTERNATIONAL
(2023)
Review
Medicine, General & Internal
Nikola Gligorijevic, Marija Kaljevic, Natasa Radovanovic, Filip Jovanovic, Bojan Joksimovic, Sandra Singh, Igor Dumic
Summary: Objective: To summarize the existing knowledge about adrenal gland abscesses, including etiology, clinical presentation, common laboratory and imaging findings, management and overall morbidity and mortality. Results: Adrenal abscesses are usually caused by fungal pathogens, with Histoplasma capsulatum being the most common. The majority of the adrenal infections occur through secondary dissemination from other primary sources of infection. Long-term adrenal insufficiency develops in 46% of patients, and mortality is about 7%, with thrombocytopenia associated with worse prognosis.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Otorhinolaryngology
Gianluca Sampieri, Amirpouyan Namavarian, John J. W. Lee, Amr F. Hamour, John M. Lee
Summary: The meta-analysis showed that the use of INCS carries a low risk for AI, with differences in risk depending on the duration and type of steroids used. It is important to inform patients of these risks for the treatment of chronic sinonasal conditions.
INTERNATIONAL FORUM OF ALLERGY & RHINOLOGY
(2022)
Article
Endocrinology & Metabolism
Hasan Husni, Mohammed S. Abusamaan, Roshan Dinparastisaleh, Lori Sokoll, Roberto Salvatori, Amir H. Hamrahian
Summary: This study aimed to evaluate the appropriate cortisol values during the standard dose CST in patients with normal HPA axis when using the Roche Elecsys (R) Cortisol II assay. The results showed that the lowest cortisol levels at 30 and 60 minutes after cosyntropin administration were lower than the previously recommended cutoff values, suggesting the importance of considering the timing of cortisol draw after cosyntropin administration.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Li Zha, Jieli Li, Subhashree Mallika Krishnan, Michael R. Brennan, Yan Victoria Zhang, Patrick Povse, Rae Kerlin, Kevin Shively, Felicia Oleksik, JoAnna Williams, Elizabeth Sykes, Qian Sun
Summary: This study established the specific cutoffs for the level of cortisol in the Abbott Architect immunoassay by comparing it with other immunoassays. The results showed that the cortisol concentrations measured using the Abbott assay were similar to those measured using liquid chromatography-tandem mass spectrometry and the Roche Elecsys II assay but significantly lower than those measured using the Siemens assay. The recommended threshold for cortisol using the Abbott assay is 14.6 μg/dL at 60 minutes after ACTH stimulation.
ENDOCRINE PRACTICE
(2022)
Review
Medicine, General & Internal
Nasrin Amiri-Dashatan, Mehdi Koushki, Negin Parsamanesh, Hossein Chiti
Summary: This study reevaluated the association between cortisol level and severity of COVID-19 infection and found that higher cortisol levels are associated with severe COVID-19. This finding could be useful in identifying patients with poor prognosis at early stages of the disease, although age and sex may influence cortisol levels.
JOURNAL OF INVESTIGATIVE MEDICINE
(2022)
Review
Clinical Neurology
Shiqi Guang, Leilei Mao, Linxiu Zhong, Fangyun Liu, Zou Pan, Fei Yin, Jing Peng
Summary: The study compared the effectiveness and safety of hormonal therapy and corticosteroids for infantile spasms. It found that oral corticosteroids can be used as alternative options when ACTH is not applicable, and ACTH is more beneficial for patients without tuberous sclerosis complex. Low-dose ACTH therapy is recommended due to its comparative effectiveness and lower risk of adverse effects. However, due to the high heterogeneity of patients and treatment protocols, these findings should be interpreted cautiously. Further research with larger sample sizes and multicentric involvement is needed to evaluate the effectiveness of other alternative treatments.
FRONTIERS IN NEUROLOGY
(2022)
Review
Parasitology
Lachlan Fairley, Samuel Smith, Shalisa Maisrikrod, Lars Henning
Summary: This study analyzed the accuracy of various diagnostic tests in detecting Burkholderia pseudomallei infection. The results showed that immunofluorescence assay, polymerase chain reaction, and lateral flow immunoassay have moderate sensitivity and specificity. Serological tests have higher sensitivity but lower specificity compared to direct detection methods.
Review
Endocrinology & Metabolism
Antonella Al Refaie, Leonardo Baldassini, Michela De Vita, Stefano Gonnelli, Carla Caffarelli
Summary: Vitamin D plays an important role not only in phospho-calcium metabolism and skeletal disorders, but also in carcinogenesis, inflammation, autoimmunity, and endocrinopathies. There is evidence suggesting possible correlations between vitamin D and adrenal diseases, with common genetic pathways.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Review
Medicine, General & Internal
Salomi Shaikh, Lakshmi Nagendra, Shehla Shaikh, Joseph M. Pappachan
Summary: The diagnosis of adrenal insufficiency requires a high index of suspicion, detailed clinical assessment, and appropriate laboratory evaluation. The clinical characteristics vary depending on the cause and can range from insidious onset to a potentially life-threatening adrenal crisis. Testing the basal serum cortisol coupled with adrenocorticotrophin remains the initial tests of choice, while newer cortisol assays and salivary cortisol test are also being used. Testing the HPA axis, imaging, and ruling out systemic causes are necessary for the diagnosis, and cancer treatment with immune checkpoint inhibitors is an emerging cause that requires close follow up.
Review
Gastroenterology & Hepatology
Saravana Ruban Gurusamy, Ayesha Shah, Nicholas J. Talley, Natasha Koloski, Michael P. Jones, Marjorie M. Walker, Mark Morrison, Gerald Holtmann
Summary: This systematic review and meta-analysis found a significant association between functional dyspepsia (FD) and small intestinal bacterial overgrowth (SIBO), with SIBO prevalence higher in FD patients compared to controls. The quality of evidence was low due to heterogeneity in breath test types and clinical factors. Further well-designed studies are needed to confirm the link between SIBO and FD.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2021)
Article
Medicine, General & Internal
Zhen Wang, Fares Alahdab, Magdoleen Farah, Mohamed Seisa, Mohammed Firwana, Rami Rajjoub, Samer Saadi, Tabinda Jawaid, Tarek Nayfeh, Mohammad Hassan Murad
Summary: This meta-epidemiological study found that lack of blinding of patients and study personnel was associated with a larger treatment effect in randomized controlled trials evaluating therapies for chronic medical conditions. However, there was no statistically significant association with other risk of bias indicators.
BMJ EVIDENCE-BASED MEDICINE
(2022)
Editorial Material
Medicine, General & Internal
Ryan S. D'Souza, Lubna Daraz, W. Michael Hooten, Gordon Guyatt, Mohammad Hassan Murad
BMJ EVIDENCE-BASED MEDICINE
(2022)
Editorial Material
Medicine, General & Internal
Ryan S. D'Souza, Lubna Daraz, W. Michael Hooten, Gordon Guyatt, Mohammad Hassan Murad
BMJ EVIDENCE-BASED MEDICINE
(2022)
Article
Public, Environmental & Occupational Health
Robin G. Molella, Angela L. Murad, Meaghan Sherden, Derrick J. Fritz, Emily N. Sadecki, Graham Briggs, Zhen Wang, M. Hassan Murad
Summary: This study compared the health outcomes of community residents before and after the pandemic through a mid-cycle survey. The results showed a decrease in well-being, an increase in substance use, and financial stress among community residents since the beginning of the pandemic.
AMERICAN JOURNAL OF PREVENTIVE MEDICINE
(2022)
Article
Medicine, General & Internal
Mohammad Hassan Murad, Abdalla Kara Balla, Muhammad Shahzeb Khan, Asim Shaikh, Samer Saadi, Zhen Wang
Summary: The fragility index (FI) is a useful measure for assessing the robustness of statistically significant results. This study identified a range of FI values (19-22) that can indicate the precision of treatment effects, providing a rule of thumb for evaluating the stability of treatment outcomes.
BMJ EVIDENCE-BASED MEDICINE
(2023)
Article
Pharmacology & Pharmacy
Yaqi Jing, Mohammad Hassan Murad, Lifeng Lin
Summary: This article proposes a Bayesian hierarchical model to synthesize different types of study results. The Bayesian method generally produces more accurate results compared to the conventional conversion method. However, the Bayesian method relies on the normality assumption for continuous measures and may lead to biases for non-normal data.
JOURNAL OF BIOPHARMACEUTICAL STATISTICS
(2023)
Editorial Material
Medicine, General & Internal
Madelin R. Siedler, M. Hassan Murad, Rebecca L. Morgan, Yngve Falck-Ytter, Reem A. Mustafa, Shahnaz Sultan, Philipp Dahm
BMJ EVIDENCE-BASED MEDICINE
(2023)
Review
Endocrinology & Metabolism
Ghada El-Hajj Fuleihan, Gregory A. Clines, Mimi Hu, Claudio Marcocci, M. Hassan Murad, Thomas Piggott, Catherine Van Poznak, Joy Y. Wu, Matthew T. Drake
Summary: Hypercalcemia of malignancy (HCM) is a common complication of malignancies, but its incidence may be decreasing. Despite the availability of effective medications, there are no evidence-based recommendations for managing HCM. A panel of experts developed guidelines for the treatment of adults with HCM, recommending the use of denosumab or intravenous bisphosphonate. Treatment of the primary malignancy is crucial for controlling HCM.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Article
Endocrinology & Metabolism
Anthony L. McCall, David C. Lieb, Roma Gianchandani, Heidemarie MacMaster, Gregory A. Maynard, M. Hassan Murad, Elizabeth Seaquist, Joseph Wolfsdorf, Robin Fein Wright, Wojtek Wiercioch
Summary: This study reviewed and updated the management of hypoglycemia in people with diabetes, aiming to reduce and prevent it. A multidisciplinary panel of experts identified 10 clinical questions and made 10 recommendations. These recommendations can be used to inform clinical practice and improve healthcare systems, as hypoglycemia is an important complication for people with diabetes.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Editorial Material
Medicine, General & Internal
M. Hassan Murad, Melanie D. Swift, Raymund R. Razonable, Aaron J. Tande, John W. Wilson, Mary J. Kasten, Irene G. Sia, Jennifer N. Matey, Greg Vanichkachorn, Natalie A. Caine, Vijay Shah, Jack O'Horo, Molly J. Destro Borgen, Clayton T. Cowl, Elie F. Berbari
MAYO CLINIC PROCEEDINGS
(2023)
Article
Medicine, General & Internal
Zhen Wang, Muayad A. Alzuabi, Rebecca L. Morgan, Reem A. Mustafa, Yngve Falck-Ytter, Philipp Dahm, Shahnaz Sultan, Mohammad Hassan Murad
Summary: This study empirically evaluated five commonly used meta-analysis methods and their impact on imprecision judgements about effect estimates. The results showed that different pooling methods led to different conclusions about the precision of effect estimates, particularly when the number of studies was small and statistical heterogeneity was substantial. Therefore, sensitivity analyses using multiple methods may be necessary in these two scenarios.
BMJ EVIDENCE-BASED MEDICINE
(2023)
Article
Medicine, General & Internal
M. Hassan Murad, Zhen Wang, Ye Zhu, Samer Saadi, Haitao Chu, Lifeng Lin
Summary: Trading off benefits and harms requires knowledge of the absolute risk reduction or risk difference, making risk difference a critical measure for decision making. However, estimating risk difference is not straightforward and the available methods have various limitations. This article discusses four methods for estimating risk difference and provides recommendations on when to use each approach.
BMJ-BRITISH MEDICAL JOURNAL
(2023)
Review
Medicine, General & Internal
Mohammad Hassan Murad, Zhen Wang, Haitao Chu, Lifeng Lin, Ibrahim K. El Mikati, Joanne Khabsa, Elie Akl, Robby Nieuwlaat, Holger J. Schuenemann, Irbaz Bin Riaz
Summary: Living systematic reviews (LSRs) are continuously updated reviews that incorporate new evidence as it becomes available. It is important to determine when to retire LSRs from the living mode, and we propose triggers for making that decision. The first trigger is retiring LSRs when there is conclusive evidence for decision-making. The second trigger is retiring LSRs when the question becomes less pertinent for decision-making or when resources are unavailable.
BMJ EVIDENCE-BASED MEDICINE
(2023)
Article
Health Care Sciences & Services
M. Hassan Murad, Jos Verbeek, Lukas Schwingshackl, Tommaso Filippini, Marco Vinceti, Elie A. Akl, Rebecca L. Morgan, Reem A. Mustafa, Dena Zeraatkar, Emily Senerth, Renee Street, Lifeng Lin, Yngve Falck-Ytter, Gordon Guyatt, Holger J. Schunemann
Summary: This article discusses the impact of dose-response gradients on the certainty of evidence in intervention and exposure studies. By determining the credibility of the gradient and applying the gradient domain, ratings can be increased.
JOURNAL OF CLINICAL EPIDEMIOLOGY
(2023)
Review
Infectious Diseases
Matteo Passerini, Julian Maamari, Tarek Nayfeh, Leslie C. Hassett, Aaron J. Tande, Mohammad H. Murad, Zelalem Temesgen, Elie F. Berbari
Summary: This study assessed the efficacy of an early switch to oral therapy in bacterial native vertebral osteomyelitis and found that the current evidence is insufficient to support routine recommendation of early switch.
JOURNAL OF BONE AND JOINT INFECTION
(2022)
