Abstract:
:In recent years, the short Synacthen test (SS) has become the most widely used test to assess adrenal reserve. Despite its frequent use, there are still several areas related to the short Synacthen test (SST), which have no consensus including the optimum sampling times, that is, whether a 60 min post-Synacthen administration cortisol is necessary or not. METHODOLOGY:We performed a retrospective data analysis of 492 SSTs performed on adult patients in a tertiary referral teaching hospital in Ireland. The SSTs were performed in the inpatient and outpatient setting and included patients across all medical disciplines and not exclusively to the endocrinology department. RESULTS:313 patients had 0, 30 and 60 min samples available for analysis. A total of 270/313 (82%) were deemed to pass the test, that is, cortisol ≥500 nmol/L at both 30 and 60 min. Of the 313 patients, 19 (6%) patients had an indeterminate response, cortisol <500 nmol/L at 30 min, but rising to ≥500 nmol/L on the 60 min sample. Of these 19 patients, only 9/19 patients had a serum cortisol level at 30 min <450 nmol/L, requiring clinical treatment with glucocorticoid replacement. All 24/313 (8%) patients who had insufficient responses at 60 min were also insufficient at 30 min sampling. No individuals passed (≥500 nmol/L) at 30 min and then failed (<500 nmol/L) at 60 min. CONCLUSION:Using the 30 min cortisol sample post-Synacthen administration alone identifies clinically relevant adrenal insufficiency in the majority of cases. A small subset of patients have a suboptimal response at 30 min but have a 60 min cortisol concentration above the threshold for a pass. Data regarding the long-term outcomes and management of such patients are lacking and require further study.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Dineen R,Mohamed A,Gunness A,Rakovac A,Cullen E,Barnwell N,Neary C,Behan LA,Boran G,Gibney J,Sherlock Mdoi
10.1136/postgradmedj-2019-136669subject
Has Abstractpub_date
2020-02-01 00:00:00pages
67-72issue
1132eissn
0032-5473issn
1469-0756pii
postgradmedj-2019-136669journal_volume
96pub_type
杂志文章abstract::The first case of the Zollinger-Ellison syndrome treated from the outset continuously for more than a year with the histamine H2-receptor antagonist cimetidine is reported. Symptomatic response has been dramatic and sustained, marked endoscopic improvement has been observed with healing of oesophageal, gastric and sto...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.626.749
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journal_title:Postgraduate medical journal
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journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.861.386
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pub_type: 杂志文章
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
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journal_title:Postgraduate medical journal
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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journal_title:Postgraduate medical journal
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journal_title:Postgraduate medical journal
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journal_title:Postgraduate medical journal
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journal_title:Postgraduate medical journal
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journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1979-01-01 00:00:00
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journal_title:Postgraduate medical journal
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2004.020164
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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更新日期:2007-03-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.778.672
更新日期:1990-08-01 00:00:00
abstract:PURPOSE OF THE STUDY:Genome-wide association studies have revealed an association of ADAMTS7 polymorphisms with the risk of cardiovascular diseases. Nonetheless, the role of ADAMTS7 polymorphisms on myocardial infarction (MI) risk remains poorly understood. Here, we aim to evaluate the effect of ADAMTS7 tag single nucl...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
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abstract::There is overwhelming evidence for the clinical efficacy of the influenza vaccine, especially in the elderly with chronic disease, reducing mortality and hospital admissions. There is also evidence to suggest that the influenza vaccine may be beneficial in the healthy elderly. There is some evidence to suggest that th...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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更新日期:1996-06-01 00:00:00