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S. Eggert, S. Kreger, K. Paliga, A. Weidemann The Alzheimer`s disease amyloid protein precursor APP ; gene is part of a multi-gene super-family from which sixteen homologous amyloidprecursor-like proteins APLP ; and APP species homologues are known. Comparison of exon structure including the uncharacterised APL-1 gene ; , construction of phylogenetic trees, and analysis of the protein sequence alignment of known homologues of the APP super-family were performed to reconstruct the evolution of the family and to assess the functional significance of conserved protein sequences between homologues. This analysis supports an adhesion function for all members of the APP super family, with specificity determined by those sequences which are not conserved between APLP lineages, and provides evidence for an increasingly complex APP superfamily during evolution. The analysis also suggests that Drosophila APPL and Caenorhabditis elegans APL-1 may be a fourth APLP lineage indicating that these proteins, while not functional homologues of human APP, are similarly likely to regulate cell adhesion. Furthermore, the A sequence is highly conserved only in APP orthologues, strongly suggesting this sequence is of significant functional importance in this lineage.
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This procedure is based on information provided in Croner's Substances Hazardous to Health - Emergency Spillage Guide 1995 ; for dealing with aldehyde spillages. In the event of a spillage the following actions should be taken immediately: Eliminate all possible sources of ignition aldehydes may produce flammable vapours ; . Instruct others to keep at a safe distance well away from the spillage. Where possible open windows and close doors on way out.
Nicotine replacement therapy. These events have been observed in both patients with and without evidence of preexisting hypertension. Data from a comparative study of ZYBAN, nicotine transdermal system NTS ; , the combination of sustained-release bupropion plus NTS, and placebo as an aid to smoking cessation suggest a higher incidence of treatment-emergent hypertension in patients treated with the combination of ZYBAN and NTS. In this study, 6.1% of patients treated with the combination of ZYBAN and NTS had treatment-emergent hypertension compared to 2.5%, 1.6%, and 3.1% of patients treated with ZYBAN, NTS, and placebo, respectively. The majority of these patients had evidence of preexisting hypertension. Three patients 1.2% ; treated with the combination of ZYBAN and NTS and one patient 0.4% ; treated with NTS had study medication discontinued due to hypertension compared to none of the patients treated with ZYBAN or placebo. Monitoring of blood pressure is recommended in patients who receive the combination of bupropion and nicotine replacement. There is no clinical experience establishing the safety of ZYBAN in patients with a recent history of myocardial infarction or unstable heart disease. Therefore, care should be exercised if it is used in these groups. Bupropion was well tolerated in depressed patients who had previously developed orthostatic hypotension while receiving tricyclic antidepressants, and was also generally well tolerated in a group of 36 depressed inpatients with stable congestive heart failure CHF ; . However, bupropion was associated with a rise in supine blood pressure in the study of patients with CHF, resulting in discontinuation of treatment in 2 patients for exacerbation of baseline hypertension. Hepatic Impairment: ZYBAN should be used with extreme caution in patients with severe hepatic cirrhosis. In these patients, a reduced frequency of dosing is required. ZYBAN should be used with caution in patients with hepatic impairment including mild to moderate hepatic cirrhosis ; and reduced frequency of dosing should be considered in patients with mild to moderate hepatic cirrhosis. All patients with hepatic impairment should be closely monitored for possible adverse effects that could indicate high drug and metabolite levels see CLINICAL PHARMACOLOGY, WARNINGS, and DOSAGE AND ADMINISTRATION ; . Renal Impairment: No studies have been conducted in patients with renal impairment. Bupropion is extensively metabolized in the liver to active metabolites, which are further metabolized and excreted by the kidneys. ZYBAN should be used with caution in patients with renal impairment and a reduced frequency of dosing should be considered as bupropion and its metabolites may accumulate in such patients to a greater extent than usual. The patient should be closely monitored for possible adverse effects that could indicate high drug or metabolite levels. Information for Patients: Although ZYBAN is not indicated for treatment of depression, it contains the same active ingredient as the antidepressant medications WELLBUTRIN, WELLBUTRIN SR, and WELLBUTRIN XL. Prescribers or other health professionals should inform patients, their families, and their caregivers about the benefits and risks associated with treatment with ZYBAN and should counsel them in its appropriate use. A patient Medication.
24 ; Mtinangi BL and Hainsworth R 1999 ; Effects of moderate exercise training on plasma volume, baroreceptor sensitivity and orthostatic tolerance in healthy subjects. Exp Physiol 84: 121-130. 25 ; Musgrave FS, Zechman FW, and Mains RC 1969 ; Changes in total leg volume during lower body negative pressure. Aerosp Med 40: 602-606. 26 ; Myhre LG, Brown DK, Hall FG, and Dill DB 1968 ; The use of carbon monoxide and T-1824 for determining blood volume. Clin Chem 14: 1197-1205. 27 ; Raven PB and Pawelczyk JA 1993 ; Chronic endurance exercise training: a condition of inadequate blood pressure regulation and reduced tolerance to LBNP. Med Sci Sports Exerc 25: 713-721. 28 ; Raven PB 1993 ; An overview of the problem: exercise training and orthostatic intolerance. Med Sci Sports Exerc 25: 702-704. 29 ; Savard GK and Stonehouse MA 1995 ; Cardiovascular response to orthostatic stress: effects of exercise training modality. Can J Appl Physiol 20: 240-254. 30 ; Shvartz E, Strydom NB, and Kotze H 1975 ; Orthostatism and heat acclimation. J Appl Physiol 39: 590-595. 31 ; Shvartz E 1996 ; Endurance fitness and orthostatic tolerance. Aviat Space Environ Med 67: 935-939. 32 ; Stegemann J, Framing HD, and Schiefeling M 1969 ; Der Einfluss einer 6-stndigen Immersion in thermo-indifferentem Wasser auf die Regulation des Kreislaufs und die Leistungsfhigkeit bei Trainierten und Un Trainierten. Pflgers Arch 312: 129-138. 33 ; Van Beaumont W, Greenleaf JE, Young HL, and Juhos L 1974 ; Plasma volume and blood constituent shifts during Z acceleraG tion after bedrest with exercise conditioning. Aerosp Med 45: 425-430. 34 ; Yamazaki F and Hamasaki K 2003 ; Heat acclimation increases skin vasodilation and sweating but not cardiac baroreflex responses in heat-stressed humans. J Appl Physiol 95: 1567-1574. 35 ; Zhang LF, Zheng J, Wang SY, Zhang ZY, and Liu C 1999 ; Effect of aerobic training on orthostatic tolerance, circulatory response, and heart rate dynamics. Aviat Space Environ Med 70: 975-982. Received 28 January 2005, and in revised form 18 April 2005, accepted 10 May 2005.
Remember use modifier "25" when billing for two 2 ; E&M codes. The "25" indicates a distinct and separate identifiable service. A common example is an office visit or preventive health visit with an immunization administration fee. The office visit must be submitted with modifier "25 and oxycodone.
Almost 56% of people with current asthma had used medication for their asthma in the last 2 weeks Figure 3.4 ; . The proportion of persons with current asthma who used pharmaceutical medication increased with age p trend 0.0001 ; . The lowest reported use.
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Sidiary. Under the CIA, which extends through May 2009, Pfizer agrees, among other things, to maintain a corporate compliance program meeting certain specifications and to notify the OIG within 30 days of any "reportable event"--i.e., a probable violation of criminal, civil, or administrative laws applicable to Medicare, Medicaid, or any other Federal health care program. Pfizer also will retain an Independent Review Organization IRO ; that periodically analyzes and reports to the OIG on Pfizer's compliance with the Medicaid rebate program with respect to all of its products, its product promotional activities vis--vis managed care customers, and its marketing activities with respect to off-label uses of all of its products.17.
Patients provided a medical history, and underwent physical and laboratory evaluations that included stool microscopy and culture for B. hominis and colonoscopy. The 95 cases 51 males and 44 females ; had a mean + - SD age of 37.8 + - 13.2 years. Stool microscopy was positive for B. hominis in 32% 30 of 95 ; of the cases and 7% 4 of 55 ; the controls P 0.001 ; . Stool culture was positive in 46% 44 of 95 ; of the cases and 7% 4 of 55 ; the controls P 0.001 ; . Stool culture for B. hominis in IBS was more sensitive than microscopy P 0.001 ; . Blastocystis hominis was frequently demonstrated in the stool samples of IBS patients; however, its significance in IBS still needs to be investigated. Stool culture has a higher positive yield for B. hominis than stool microscopy. 6. Role of peripheral CRF signalling pathways in stressrelated alterations of gut motility and mucosal function. Tache Y, Perdue MH Neurogastroenterology and motility: the official journal of the European Gastrointestinal Motility Society, 2004, 16 Suppl 1, 137-42. Central corticotrophin releasing-factor CRF ; signalling pathways are involved in the endocrine, behavioural and visceral responses to stress. Recent studies indicate that peripheral CRF-related mechanisms also contribute to stress-induced changes in gut motility and intestinal mucosal function. Peripheral injection of CRF or urocortin inhibits gastric emptying and motility through interaction with CRF2 receptors and stimulates colonic transit, motility, Fos expression in myenteric neurones and defecation through activation of CRF1 receptors. With regard to intestinal epithelial cell function, intraperitoneal CRF increases ion secretion and mucosal permeability to macromolecules. The motility and mucosal changes induced by peripheral CRF mimic those induced by acute stress. In addition, CRF receptor antagonists given peripherally prevent acute restraint and water avoidance stress-induced delayed gastric emptying, stimulation of colonic motor function and mucosal permeability. Similarly, early trauma enhanced intestinal mucosal dysfunction to an acute stressor in adult rats and the response is prevented by peripheral injection of CRF antagonist. Chronic psychological stress results in reduced host defence and initiates intestinal inflammation through mast celldependent mechanisms. These findings provide convergent evidence that activation of peripheral CRF receptors and mast cells are important mechanisms involved in stressrelated alterations of gut physiology and paxil.
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In his second poster he evaluated muscle fatigue by single fibre emg, and abnormal findings were not shown p de becker brussels ; compared exercise capacity in healthy sedentary females with that in females with cfs and penicillin.
Ombregt L, Ter Veer HJ. Treatment of the lumbar spine. In Ombregt L, Bisschop P, Ter Veer HJ et al eds ; . A System of Orthopaedic Medicine. W B Saunders, London, 1995, pp 633-688. Ciocon JO, Galindo-Clocon D, Amarnath L et al. Caudal epidural blocks for elderly patients with lumbar canal stenosis. J Geriatr Soc 1994; 42: 593596. Manchikanti L, Pakanati RR, Pampati V. Comparison of three routes of epidural steroid injections in low back pain. Pain Digest 1999; 9: 277-285. Beyer W. Das zervikale and lumbale Bandscheibensyndrom und seind Behandlung mit NovocainPrednisolon-Injectionen an die Nervenwurzeln. Munch Med Wschr 1960; 102: 1164-1165. Lindhal O, Rexed B. Histologic changes in spinal nerve roots of operated cases of sciatica. Acta Orthop Scand 1951; 20: 215-225. Mount HTR. Epidural injection of hydrocortisone for the management of the acute lumbar disc protrusion. In Morley TP ed ; . Current Controversies in Neurosurgery. WB Saunders, Philadelphia, 1976, pp 67-72. Sharma RK. Indications, technique and results of caudal epidural injection for lumbar disc retropulsion. Postgrad Med J 1977; 53: 1-6. Gordon J. Caudal extradural injection for the treatment of low back pain. Anaesthesia 1980; 35: 515516. Revel M, Auleley GR, Alaoui S et al. Forceful epidural injections for the treatment of lumbosciatic pain with post-operative lumbar spinal fibrosis. Rev Rhum Engl Ed 1996; 63: 270-277. Cuckler JM, Bernini PA, Wiesel SW et al. The use of epidural steroid in the treatment of radicular pain. J Bone Joint Surg 1985; 67: 63-66. Dilke TFW, Burry HC, Grahame R. Extradural corticosteroid injection in the management of lumbar nerve root compression. Br Med J 1973; 2: 635-637. Helliwell M, Robertson JC, Ellia RM. Outpatient treatment of low back pain and sciatica by a single extradural corticosteroid injection. Br J Clin Pract 1985; 39: 228-231. Klenerman L, Greenwood R, Davenport HT et al. Lumbar epidural injections in the treatment of sciatica. Br J Rheumatol 1984; 23: 35-38. Ridley MG, Kingsley GH, Gibson T et al. Outpatient lumbar epidural corticosteroid injection in the management of sciatica. Br J Rheumatol 1988; 27: 10031007. Rocco AG, Frank E, Kaul AF et al. Epidural steroids, epidural morphine and epidural steroids combined with morphine in the treatment of post-laminectomy syndrome. Pain 1989; 36: 297-303. Serrao JM, Marks RL, Morley SJ et al. Intrathecal midazolam for the treatment of chronic mechanical low back pain: A controlled comparison with epidural steroid in a pilot study. Pain 1992; 48: 5-12.
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Product in Holland and the price elsewhere in the European Union to make importation of the product profitable. The products where such a differential exists must, by definition, be those whose price will have been lowered by the imposition of the WGP. As such it is not surprising that parallel-distribution declined after this was introduced. Products that were imported from Southern Europe may not have been affected so severely; it has been suggested that there were actually some price rises as firms raised the price to the average, resulting in opportunities to distribute products where the margin had been too small, for example, evra ortho patch.
ENZON PHARMACEUTICALS, INC. AND SUBSIDIARIES Notes to Consolidated Financial Statements -- Continued ; The Company has determined that there were no other-than-temporary declines in the fair values of its marketable securities and short-term investments as of December 31, 2006. The following table shows the gross unrealized losses and fair values of the Company's available-for-sale securities both short-term and long-term ; aggregated by investment category and length of time that individual securities have been in a continuous loss position at December 31, 2006 in thousands and phenergan.
3. TCA Subclasses: TCAs are divided into two subclasses: tertiary and secondary. Although efficacy between these two subclasses is equivalent, a noticeable difference in adverse effect profile exists. A. Tertiary Tricyclic Antidepressants 1. Overview: The tertiary TCAs are equally efficacious in equivalent doses.18-21 The four tertiary TCAs amitriptyline, doxepin, imipramine and trimipramine ; exert more sedation, anticholinergic effects, orthostatic hypotension and serotonin blocking activity than the secondary TCAs. Tertiary amine antidepressants are demethylated in vivo to secondary amines that are relatively selective for norepinephrine reuptake inhibition over tertiary TCAs.18-21 2. Safety: The following table illustrates the adverse effect profile of the tertiary TCAs. According to this table, all four agents are associated with moderate to high severity for most of the adverse effects.19 Agent Anticholinerg ic Effects# + + + + Sedatio n + + Orthostati c Hypotensi on + + Distres s 0 0 Cardiac Arrhythmi as.
TABLE I. Thermal analysis of the glass transition of ortho- and meta-toluidine. ortho-toluidine Thermal rate Glass trans. temperature Thermal rate Glass trans. temperature 10 K min upon heating T1 T2 T3 189 191 193 K min upon heating T1 T2 T3 187 189.5 192 meta-toluidine 10 K min upon heating T1 T2 T3 189 192 193 K min upon heating T1 T2 T3 187 188.5 191 K min upon freezing T1 T2 T3 192 187 182.5 K min upon freezing T1 T2 T3 193.5 188 182 and plavix.
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On the nanogram scale but also provide the impetus to employ integrated microfluidics chips to generalize, accelerate, diversify and lower the cost in the preparation of radiolabeled imaging probes. MEDI 455 Structure-activity relationship study of IMPY derivatives as candidate radioligands for amyloid Lisheng Cai1, Lisa Nichols2, Jessica Cuevas1, Sebastian Temme1, Mary M. Herman3, Robert B. Innis2, and Victor W. Pike1. 1 ; PET Radiopharmaceutical Sciences, Molecular Imaging Branch, National Institute of Mental Health, 10 Center Drive, Bldg 10, B3C346, Bethesda, MD 20892, Fax: 301-480-5112, cail intra.nimh.nih.gov, 2 ; Molecular Imaging Branch, National Institute of Mental Health, 3 ; Clinical Brain Disorders Branch, National Institute of Mental Health We have evaluated the tertiary amines, [18F]FEM-IMPY [N- 2-fluoroethyl ; -4- 6-iodo-H-imidazo [1, 2-a]pyridin-2-yl ; -N-methylbenzeneamine] and its 3-fluoropropyl analog, [18F]FPM-IMPY, as beta-amyloid radioligands [1]. However, metabolism is rapid via de-alkylation of the tertiary aromatic amino group, culminating in defluoridation and high uptake of radioactivity in bone. With a view to avoiding rapid defluoridation, we decided to make use of 'isosteric' and 'isoelectronic' effects in the design of further analogs of IMPY. One set of analogs are secondary amines in which a methyl group is 'shifted' from the tertiary amine nitrogen to the nearest orrtho ring position. The second set have a thiol ether instead of iodine in the 6position. The third set combines both strategies. Through this in vitro evaluation, promising candidates have been identified as potential PET radioligands. The SAR study identifies that the binding site typical of 6-OH-BTA-1 PIB ; is a relatively small site, with only the 6-position in IMPY derivatives tolerating substantial structural change.
A special type of health summary for patients with diabetes is available the Diabetes Standard Summary. There are several ways to display the Diabetes Standard Summary for a patient with diabetes. At the main Diabetes Management System menu, select HS Health Summary. When prompted for a health summary type, enter DIABETES STANDARD. The Health Summary will be printed in a standard format. If you plan to review the Health Summary on the terminal screen, you may choose the menu option BHS Browse Health Summary and select a health summary type of DIABETES STANDARD. This option permits the user to use the -, + and keys to scroll through the Health Summary or to return to review various items of interest. This Health Summary is similar to the Adult Regular Summary except that it includes a Diabetes Flow Sheet at the end of the report as well as a Diabetes Patient Care Summary. The Flow Sheet contains those items that have been identified for provider review at each Diabetic Clinic visit. In addition, the Diabetes Standard Summary includes a Diabetes Patient Care Summary which provides an overview of all IHS Diabetes Standards of Care for that patient. Both the Diabetic Flow Sheet and the Diabetes Patient Care Summary are triggered by the presence of a problem of Diabetes on the Active Problem list or a diagnosis of Diabetes in the last year by a primary provider. The Diabetes Standard Health Summary should be routinely printed by Health Records staff for all diabetic clinic visits. An option may be set to automatically print the Diabetes Standard Health Summary for patients with Diabetes regardless of when or where the health summary is printed. The option, Update Health Summary Site Parameters, is included under the Health Summary Maintenance Menu. Instructions for setting up this feature are provided below. 1. In the Health Summary Maintenance Menu, select HSSP Update Health Summary Site parameters 2. Identify the name of your facility and plendil.
Review of our experience in 2004: The most notable change for this year was the installation of the Electronic Medical Record, Medifile in June 2004. We then had a busy month of training sessions for all staff. The scheduling program is new so receptionists had to be trained; the billing program was new so administrative staff had to be trained; the medical staff had never used an electronic medical chart before so their training was extensive. We also moved the Health Promotion staff to their new quarters where our old meeting room had been. They are now more accessible and not right in the middle of a busy clinical area. Their offices can now be used for clinical services. CFRT, the Campus First Response Team were all trained and providing services by the end of the 2004 school year Medical Visits We had 36, 506 visits to doctors in 2003-04, an increase of almost 10, 000 visits in the past 5 years. Nurses performed 9, 433 nursing procedures such as immunizations , dressings and other injections, as well as counselling and telephone advice referrals, prescriptions Our travel clinic experienced an increase of 50% more consultations in 2003-04 and 1874 travel injections were administered. October 2004 the Health Service collaborated with the VACCESS Corporation to offer the third meningicoccal vaccine clinic for students Birth Control Dispensing: More than 25, 000 packages of Oral Contraceptive Pills were dispensed in 2003-004. The following contraceptive products are for sale at our cashier window at reduced cost. Alesse, Brevicon, Cyclen, Demulen, Marvelon, Ortho, Select, Synphasic, TriCyclen, Triphasil and Triquilar. Emergency Contraceptives available are Yuzpe Protocol and Plan B. We stock Vaginal Contraceptive Film, Depo Provera and Diane 35. 450 free condoms are distributed each week by the Health Service. Regular condoms and female condoms are supplied free of charge, when available from Public Health. Monitoring programs: We monitor and follow patients with abnormal Pap tests and offer a biweekly colposcopy clinic to further investigate patients with abnormalities. 3, 221 Pap tests were done in 2003-04 and 252 patients were seen at the Colposcopy Clinic. We carefully monitor patients with latent TB and Hepatitis B and C carriers Health Promotion: Our Health Promotion team now consists of the Health Promotion Nurse, the Community Health Co-ordinator who is shared with the Psychiatry Service and the large group of students who they supervise.
Surance copayment, whereby the insured bears part of the cost of his injury. Copayments limit moral hazard, but unless the copayment is 100 percent, 67 it cannot eliminate it. Thus, even if, as the incommensurability thesis would suggest, people have private incentives to take every reasonable measure to reduce their emotional distress, the mitigation principle still would play an important 68 role in establishing the proper level of damages. Moral hazard, like most microeconomic theories, 69 is based on the idea of substitutability. People derive utility from a combination of things, such as physical health, economic prosperity, and emotional tranquility. One can maintain one's original level of utility after losing some of any of these elements by gaining more of some other ele and potassium and ortho, for example, texas orthopedics.
W Strategy #1: Create a drug-testing marketing initiative to businesses. The initiative would include approaching businesses and providing speakers and testimonials about the benefits of creating a drug-free work environment. We would also provide information about how to develop policies when an employee needs treatment. Creating a drug-free workforce needs to include a second chance for those who are in recovery. Job training and job mentoring programs could help increase the numbers of eligible employees and provide a muchneeded opportunity. Rewarding positive behavior produces better results than punishing negative behavior, so we are recommending a reward program be established for.
In patients with diabetes mellitus can accelerate atherosclerosis and heart failure due to spasm of the effect of exposure to light and judging the reliability and reputations of the world, indigenous medical practices have been widely criticized for overprescribing drugs such as bursitis and tendonitis and pravachol.
Bacterial adherence and the glycocalyx and their role in musculoskeletal infection. Orthop Clin North 1984; 15 3 ; : 517-535. Hedlundh U, Karlsson M, Ringsberg K, Besjakov J, Fredin H. Muscular and neurologic function in patients with recurrent dislocation after total hip arthroplasty: a matched controlled study of 65 patients using dual-energy X-ray absorptiometry and postural stability tests. J Arthroplasty 1999; 14 3 ; : 319-325. Judge A, Chard J, Learmonth I, Dieppe P. The effects of surgical volumes and training centre status on outcomes following total joint replacement: analysis of the Hospital Episode Statistics for England. J Public Health 2006; 28 2 ; : 116-124.
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Chapter 2. Pituitary and Adrenal Disorders of Pregnancy 144 ; Guilhaume B, Sanson ML, Billaud L, et al. Cushing's syndrome and pregnancy: aetiologies and prognosis in twenty-two patients. Eur J Med 1: 83, 1992. ; Wallace C, Toth EL, Lewanczuk RZ, Siminoski K: Pregnancy-induced Cushing's syndrome in multiple pregnancies. J Clin Endocrinol Metab 81: 15, 1996. ; Kasperlik-Zaluska AA, Szczupacka I, Leszczynska-Bystrzanowska J, Drus-Przybyszewska G: Pregnancy-dependent Cushing's syndrome in three pregnancies. Br J Obstet Gynaecol 107: 810, 2000. ; Nolten WE, Lindheimer MD, Rueckert PA, et al. Diurnal patterns and regulation of cortisol secretion in pregnancy. J Clin Endocrinol Metab 51: 466, 1980. ; Pinette MG, Pan YQ, Oppenheim D, et al. Bilateral inferior petrosal sinus corticotropin sampling with corticotropin-releasing hormone stimulation in a pregnant patient with Cushing's syndrome. J Obstet Gynecol 171: 563, 1994. ; Kreines K, DeVaux WD. Neonatal adrenal insufficiency associated with maternal Cushings syndrome. Pediatrics 47: 516, 1971. ; Amado JA, Pesquera C, Gonzalez EM, et al: Successful treatment with ketoconazole of Cushing's syndrome in pregnancy. Postgrad Med J 66: 221, 1990. ; Berwaerts J, Verhelst J, Mahler C, Abs R: Cushing's syndrome in pregnancy treated by ketoconazole: case report and review of the literature. Gynecol Endocrinol 13: 175, 1999. ; Mellor A, Harvey RD, Pobereskin LH, Sneyd JR: Cushing's disease treated by trans-sphenoidal selective adenomectomy in mid-pregnancy. Br J Anaesth 80: 850, 1998. ; Madhun ZT, Aron DC: Cushing's disease in pregnancy. In: Bronstein MD, editor. Pituitary tumors and pregnancy. Norwell MA ; : Kluwer Academic Publishers, p. 149172, 2001. 154 ; Hana V, Dokoupilova M, Marek J, Plavka R: Recurrent ACTH-independent Cushing's syndrome in multiple pregnancies and its treatment with metyrapone. Clin Endocrinol Oxf ; 54: 277, 2001. ; Lindsay JR, Jonklaas J, Oldfield EH, Nieman LK: Cushing's syndrome during pregnancy: personal experience and review of the literature. J Clin Endocrinol Metab 90: 3077, 2005. ; Lindsay JR, Nieman LK: The hypothalamic-pituitary-adrenal axis in pregnancy: challenges in disease detection and treatment. Endocrine Reviews 26: 775, 2005 ; Tajika T, Shinozaki T, Watanabe H, Yangawa T, Takagishi K: Case report of a Cushing's syndrome patient with multiple pathologic fractures during pregnancy. J Orthop Sci 7: 498, 2002. ; Putignano P, Toja P, Dubini A, et al: Midnight salivary cortisol versus urinary free and midnight serum cortisol as screening tests for Cushing's syndrome. J Clin Endocrinol Metab 88: 4153, 2003. ; Magiakou MA, Mastorakos G, Rabin D, et al: The maternal hypothalamic-pituitary-adrenal axis in the third trimester of human pregnancy. Clin Endocrinol Oxf ; 44: 419, 1996. ; Connell JM, Cordiner J, Davies DL, et al: Pregnancy complicated by Cushing's syndrome: potential hazard of metyrapone therapy: case report. Br J Obstet Gynaecol 92: 1192, 1985. ; Close CF, Mann MC, Watts JF, et al: ACTH-independent Cushing's syndrome in pregnancy with spontaneous resolution after delivery: control of the hypercortisolism with metyrapone. Clin Endocrinol Oxf ; 39: 375, 1993. ; Gormley MJ, Hadden DR, Kennedy TL, et al: Cushing's syndrome in pregnancy--treatment with metyrapone. Clin Endocrinol Oxf ; 16: 283, 1982.
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