Information for Cushing’s Patients on Korlym

Please note – On July 1st, Korlym will not be supplied by Curascript and Accredo any more.

Korlym will continue to be available, just through a different pharmacy called Centric Health Resources.  They are trying to reach all of you to introduce you to their program and enhanced services as well as set up your next shipment.

If you have not yet spoken with them, please call them at 866-758-7138.

For reference, their website is: http://www.centrichealthresources.com/

Upcoming Endocrinology Conferences

73rd Scientific Sessions (2013) of American Diabetes Association CME 
June 21-25, 2013 -Chicago, Illinois, United States

6th International Conference on Childrens Bone Health CME 
June 22-25, 2013 -Rotterdam, Netherlands

2013 Annual Meeting of the Society for Behavioral Neuroendocrinology CME 
June 23-26, 2013 -Atlanta, Georgia, United States

17th Annual Conference on Hypertension – Focus on Hypertension, Diabetes and Dyslipidemia CME 
June 28-30, 2013 -Charleston, South Carolina, United States

Bone Densitometry Comprehensive Exam Review CME 
August 3, 2013 -Houston, Texas, United States

4th World Congress on Diabetes & Metabolism CME 
August 14-16, 2013 -Skokie, Illinois, United States

Anti-Aging Medicine: Advances in Hormone Replacement CME 
August 17-18, 2013 -Chicago, Illinois, United States

World Congress on Endocrinology 2013 CME 
August 26-28, 2013 -Raleigh, North Carolina, United States

HBPR 2013: High Blood Pressure Research 2013 Scientific Sessions CME 
September 11-14, 2013 -New Orleans, Louisiana, United States

35th Annual British Andrology Society Meeting CME 
September 13-14, 2013 -Liverpool, United Kingdom

5th Florence-Utah Symposium on Genetics of Male Infertility 
September 19-21, 2013 -Florence, Italy

2013 Cardiometabolic Health Congress CME 
October 2-5, 2013 -Boston, Massachusetts, United States

Bone Densitometry: Principles and Procedures CME 
October 5-6, 2013 -Houston, Texas, United States

11th Annual Meeting of Androgen Excess & PCOS Society CME 
October 17-18, 2013 -Newport, Rhode Island, United States

AAES 2014 Annual Meeting CME 
April 27-29, 2014 -Boston, Massachusetts, United States

74th Scientific Sessions of American Diabetes Association CME 
June 13-17, 2014 -San Francisco, California, United States

50th EASD Annual Meeting CME 
September 15-19, 2014 -Vienna, Austria

84th Annual Meeting of the American Thyroid Association CME 
October 29 – November 2, 2014 -Coronado, California, United States

ENDO 2015 CME 
March 5-8, 2015 -San Diego, California, United States

AAES 2015 Annual Meeting CME 
May 17-19, 2015 -Nashville, Tennessee, United States

Research and Markets: Pituitary ACTH Hypersecretion (Cushing’s Disease) – Pipeline Review Report, H1 2013 Edition

Research and Markets(http://www.researchandmarkets.com/research/rdf6gm/pituitary_acth) has announced the addition of the “Pituitary ACTH Hypersecretion (Cushing’s Disease) – Pipeline Review, H1 2013” report to their offering.

‘Pituitary ACTH Hypersecretion (Cushing’s Disease) – Pipeline Review, H2 2013’, provides an overview of the indication’s therapeutic pipeline. This report provides information on the therapeutic development for Pituitary ACTH Hypersecretion (Cushing’s Disease), complete with latest updates, and special features on late-stage and discontinued projects. It also reviews key players involved in the therapeutic development for Pituitary ACTH Hypersecretion (Cushing’s Disease).

Scope

– A snapshot of the global therapeutic scenario for Pituitary ACTH Hypersecretion (Cushing’s Disease).

– A review of the Pituitary ACTH Hypersecretion (Cushing’s Disease) products under development by companies and universities/research institutes based on information derived from company and industry-specific sources.

– Coverage of products based on various stages of development ranging from discovery till registration stages.

– A feature on pipeline projects on the basis of monotherapy and combined therapeutics.

– Coverage of the Pituitary ACTH Hypersecretion (Cushing’s Disease) pipeline on the basis of route of administration and molecule type.

– Key discontinued pipeline projects.

– Latest news and deals relating to the products.

Companies Involved in Pituitary ACTH Hypersecretion (Cushing’s Disease) Therapeutics Development

 

  • Isis Pharmaceuticals, Inc.
  • Ipsen S.A.
  • Novartis AG
  • HRA Pharma, SA
  • Cortendo Invest AB

 

Drug Profiles: Product Description, Mechanism of Action and R&D Progress

 

  • LCI-699
  • mifepristone
  • ISIS-GCCRRx
  • Inhibitors of ACTH receptor
  • ketoconazole
  • Next Generation Cortisol Inhibitor
  • pasireotide Long Acting Release

 

For more information visit http://www.researchandmarkets.com/research/rdf6gm/pituitary_acth

The Rare Disease Search Engine That Outperforms Google

A powerful new search engine designed to help diagnose rare diseases could prove a boon for both medics and the public.

In the late 1940s, a professor at the University of Maryland School of Medicine coined an unusual phrase to describe unexpected diagnoses. “When you hear hoofbeats behind you, don’t expect to see a zebra,” he said. The phrase stuck and today, medics commonly use the term “zebra” to describe a rare disease, usually defined as one that occurs in less than 1 in 2000 of the population.

Rare diseases are inherently hard to diagnose. According to the European Organisation for Rare Disease, 25 per cent of diagnoses are delayed by between 5 and 30 years.

So it’s no surprise that medics are looking for more effective ways to do the job. An increasingly common aid in this process is the search engine, typically Google.  This forms part of an iterative process in which a medic enter symptoms into a search engine, examines lists of potential diseases and then looks for further evidence of symptoms in the patient.

The problem, of course, is that  common-or-garden search engines are not optimised for this process. Google, for example, considers pages important if they are linked to by other important pages, the basis of its famous PageRank algorithm. However, rare diseases by definition are unlikely to have a high profile on the web. What’s more, searches are likely to be plagued with returns from all sorts of irrelevant sources.

Today, Radu Dragusin at the Technical University of Denmark and a few pals unveil an alternative. These guys have set up a bespoke search engine dedicated to the diagnosis of rare diseases called FindZebra, a name based on the common medical slang for a rare disease. After comparing the results from this engine against the same searches on Google, they show that it is significantly better at returning relevant results.

The magic sauce in FindZebra is the index it uses to hunt for results. These guys have created this index by crawling a specially selected set of curated  databases on rare diseases. These include the Online Mendelian Inheritance in Man database, the Genetic and Rare Diseases Information Center and Orphanet

They then use the open source information retrieval tool Indri  to search this index via a website with a conventional search engine interface. The result is FindZebra.

Finally, they compared the results of  searches on FindZebra against the same search on Google applied to the same limited dataset, a feature that is possible with advanced Google searches.  Dragusin and co say that the Google results are significantly worse than their own.

For example, on FindZebra the search query “Boy, normal birth, deformity of both big toes (missing joint), quick development of bone tumor near spine and osteogenesis at biopsy” returns the correct diagnosis “Fibrodysplasia ossificans progressiva” as the first result. However, this diagnosis does not appear at all in the results from any type of Google search.

This indicates that the PageRank algorithm, or at least the way Google has tweaked it, is not suited to this kind of search. “Our finding, that FindZebra outperforms Google overall for this task and especially when restricted to the sites of our collection (Google Restricted), suggests that Google ranking algorithm is suboptimal for the task at hand,” they conclude.

Although still a research project, Dragusin and co have made their rare disease search engine publicly available at www.findzebra.com. This could clearly become a valuable tool for the medical community.

What is less clear, however, is how this tool will be used by the general public. The site comes with the forlorn message: “Warning! FindZebra is a research project and it is to be used only by medical professionals” .

FindZebra could obviously be a hypochondriac’s charter. On the other hand, that’s true of any medical dictionary.

The informed public are increasingly visiting their doctors armed with detailed information downloaded form the internet.  Any move to improve the quality of this information must surely be of significant value.

Ref: arxiv.org/abs/1303.3229: FindZebra: A Search Engine For Rare Diseases

From TechnologyReview.com

A Subtle Case of Cushing’s

English: "Dr. Harvey Cushing," oil o...

English: “Dr. Harvey Cushing,” oil on canvas, by the American artist Edmund Tarbell. Courtesy of the Dittrick Medical History Center. (Photo credit: Wikipedia)

Synopsis: 36 year old male who presented with weight gain, proximal muscle weakness, and excessive sweating. Among multiple 24-hour urine free cortisol and midnight salivary tests, a minority were minimally elevated.

The diagnosis of Cushing’s disease was questioned over an eight month evaluation period.

The challenges of diagnosing Cushing’s disease are discussed.

Clinical History

Pre-Operative Imaging

Operative Findings

Surgical Pathology

Post-Operative Course

Discussion, Part 1

Discussion, Part 2


References

Nieman LK, Biller BM, Findling JW, Newell-Price J, Savage MO, Stewart PM, Montori VM. The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008 May;93(5):1526-40.

Mantero F, Terzolo M, Arnaldi G, Osella G, Masini AM, Alì A, Giovagnetti M, Opocher G, Angeli A. A survey on adrenal incidentaloma in Italy. Study Group on Adrenal Tumors of the Italian Society of Endocrinology. J Clin Endocrinol Metab. 2000 Feb;85(2):637-44.

Catargi B, Rigalleau V, Poussin A, Ronci-Chaix N, Bex V, Vergnot V, Gin H, Roger P, Tabarin A. Occult Cushing’s syndrome in type-2 diabetes. J Clin Endocrinol Metab. 2003 Dec;88(12):5808- 13.

Reimondo G, Pia A, Allasino B, Tassone F, Bovio S, Borretta G, Angeli A, Terzolo M. Screening of Cushing’s syndrome in adult patients with newly diagnosed diabetes mellitus. Clin Endocrinol (Oxf). 2007 Aug;67(2):225-9.

Omura M, Saito J, Yamaguchi K, Kakuta Y, Nishikawa T. Prospective study on the prevalence of secondary hypertension among hypertensive patients visiting a general outpatient clinic in Japan. Hypertens Res. 2004 Mar;27(3):193-202.

Chiodini I, Mascia ML, Muscarella S, Battista C, Minisola S, Arosio M, Santini SA, Guglielmi G, Carnevale V, Scillitani A. Subclinical hypercortisolism among outpatients referred for osteoporosis. Ann Intern Med. 2007 Oct 16;147(8):541-8.

Cushing H, Bull Johns Hopkins Hospital, 1932; 50:137-195

Ross EJ, Linch DC. Cushing’s syndrome–killing disease: discriminatory value of signs and symptoms aiding early diagnosis. Lancet. 1982 Sep 18;2(8299):646-9.

Plotz CM, Knowlton AI, Ragan C. The natural history of Cushing’s syndrome. Am J Med. 1952 Nov;13(5):597-614.

Lindholm J, Juul S, Jørgensen JO, Astrup J, Bjerre P, Feldt-Rasmussen U, Hagen C, Jørgensen J, Kosteljanetz M, Kristensen L, Laurberg P, Schmidt K, Weeke J. Incidence and late prognosis of cushing’s syndrome: a population-based study. J Clin Endocrinol Metab. 2001 Jan;86(1):117-23.

Newell-Price J, Bertagna X, Grossman AB, Nieman LK. Cushing’s syndrome. Lancet. 2006 May 13;367(9522):1605-17.

Nieman LK, Biller BM, Findling JW, Newell-Price J, Savage MO, Stewart PM, Montori VM. The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008 May;93(5):1526-40. Epub 2008 Mar 11.

Liu H, Bravata DM, Cabaccan J, Raff H, Ryzen E. Elevated late- night salivary cortisol levels in elderly male type 2 diabetic veterans. Clin Endocrinol (Oxf). 2005 Dec;63(6):642- 9.

Qureshi AC, Bahri A, Breen LA, Barnes SC, Powrie JK, Thomas SM, Carroll PV. The influence of the route of oestrogen administration on serum levels of cortisol-binding globulin and total cortisol. Clin Endocrinol (Oxf). 2007 May;66(5):632-5.

Newell-Price J, Trainer P, Perry L, Wass J, Grossman A, Besser M. A single sleeping midnight cortisol has 100% sensitivity for the diagnosis of Cushing’s syndrome. Clin Endocrinol (Oxf). 1995 Nov;43(5):545-50.

Papanicolaou DA, Yanovski JA, Cutler GB Jr, Chrousos GP, Nieman LK. A single midnight serum cortisol measurement distinguishes Cushing’s syndrome from pseudo-Cushing states. J Clin Endocrinol Metab. 1998 Apr;83(4):1163-7.

Pecori Giraldi F, Ambrogio AG, De Martin M, Fatti LM, Scacchi M, Cavagnini F. Specificity of first-line tests for the diagnosis of Cushing’s syndrome: assessment in a large series. J Clin Endocrinol Metab. 2007 Nov;92(11):4123-9. Epub 2007 Aug 14.

From UCLA Pituitary Tumor Program

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