Navegando por Palavras-chave "Adrenal insufficiency"

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    Adrenal fatigue does not exist: a systematic review
    (Biomed Central Ltd, 2016) Cadegiani, Flavio A. [UNIFESP]; Kater, Claudio E. [UNIFESP]
    Background: The term "adrenal fatigue" ("AF") has been used by some doctors, healthcare providers, and the general media to describe an alleged condition caused by chronic exposure to stressful situations. Despite this, "AF" has not been recognized by any Endocrinology society, who claim there is no hard evidence for the existence. The aim of this systematic review is to verify whether there is substantiation for "AF". Methods: A systematic search was performed at PUBMED, MEDLINE (Ebsco) and Cochrane databases, from the beginning of the data until April 22nd, 2016. Searched key words were: "adrenal" + "fatigue", "adrenal" + "burnout", "adrenal" + "exhaustion", "hypoadrenia", "burnout" + "cortisol", "fatigue" + "cortisol", "clinical" + "burnout", "cortisol" + "vitalility", "adrenal" + "vitality", and "cortisol" + "exhaustion". Eligibility criteria were: (1) articles written in English, (2) cortisol profile and fatigue or energy status as the primary outcome, (3) performed tests for evaluating the adrenal axis, (4) absence of influence of corticosteroid therapy, and (5) absence of confounding diseases. Type of questionnaire to distinct fatigued subjects, population studied, tests performed of selected studies were analyzed. Results: From 3,470 articles found, 58 studies fulfilled the criteria: 33 were carried in healthy individuals, and 25 in symptomatic patients. The most assessed exams were "Direct Awakening Cortisol" (n = 29), "Cortisol Awakening Response" (n = 27) and "Salivary Cortisol Rhythm" (n = 26). Discussion: We found an almost systematic finding of conflicting results derived from most of the studies methods utilized, regardless of the validation and the quality of performed tests. Some limitations of the review include: (1) heterogeneity of the study design
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    Corticosteróides sistêmicos na prática dermatológica. Parte I: Principais efeitos adversos
    (Sociedade Brasileira de Dermatologia, 2007-02-01) Freitas, Thais Helena Proença De [UNIFESP]; Souza, Daniella Abbruzzini Ferreira De; Universidade Federal de São Paulo (UNIFESP); Hospital Central da Santa Casa de São Paulo Departamento de Clínica Médica Serviço de Dermatologia; Hospital Central da Santa Casa de São Paulo Clínica de Dermatologia
    Systemic corticosteroids have been used in dermatological practice for approximately 60 years due to their anti-inflammatory and immunosuppressive effects. The challenge of corticosteroid therapy is to counterbalance the desirable actions and undesirable pharmacological effects. Unfortunately, advanced understanding of the mechanisms of action of corticosteroids has not resulted in the development of minimal toxicity regimens. In this article, we report the main pharmacological properties of systemic corticosteroids, their major indications in clinical practice and the adverse effects of high doses and/or prolonged administration.
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    Insuficiência adrenal primária no adulto: 150 anos depois de Addison
    (Sociedade Brasileira de Endocrinologia e Metabologia, 2004-10-01) Silva, Regina do Carmo [UNIFESP]; Castro, Margaret de; Kater, Claudio Elias [UNIFESP]; Cunha, Andréa Aparecida; Moraes, Andréia M. de; Alvarenga, Daniela B. de; Moreira, Ayrton C.; Elias, Lucila L.k.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    Thomas Addison first described, 150 years ago, a clinical syndrome characterized by salt-wasting and skin hyperpigmentation, associated with a destruction of the adrenal gland. Even today, over a century after Addison's report, primary adrenal insufficiency can present as a life-threatening condition, since it frequently goes unrecognized in its early stages. In the 1850 s, tuberculous adrenalitis was present in the majority of patients, but nowadays, autoimmune Addison's disease is the most common cause of primary adrenal insufficiency. In the present report, we show the prevalence of different etiologies, clinical manifestations and laboratorial findings, including the adrenal cortex autoantibody, and 21-hydroxylase antibody in a Brazilian series of patients with primary adrenal insufficiency followed at Divisão de Endocrinologia da Universidade Federal de São Paulo (UNIFESP) and at Faculdade de Medicina de Ribeirão Preto - USP (FMRP-USP).