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Related Concept Videos

Spare Receptors01:30

Spare Receptors

Some receptors remain unoccupied even when an agonist produces a maximal response. Such empty ones are called spare receptors. In presence of spare receptors the maximum effect of an agonist drug is achieved with fewer than 100% of the receptors being occupied. To determine the presence of spare receptors, scientists often compare the concentration of the drug needed to produce 50% of the maximum effect (EC50) with the concentration of the drug needed to occupy 50% of the receptors (Kd). If the...
Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Pancreatic Juice and Secretion01:26

Pancreatic Juice and Secretion

Pancreatic juice is a clear fluid produced by the pancreas, containing water, salts, sodium bicarbonate, and enzymes vital for digestion in the small intestine. It helps break down large molecules, facilitating nutrient absorption.
When acidic chyme from the stomach enters the duodenum, it triggers the release of secretin, a hormone that prompts pancreatic juice secretion. After a fatty meal, cholecystokinin, another hormone, stimulates gallbladder contraction and enhances enzyme-rich...
Gastritis-II: Pathophysiology01:17

Gastritis-II: Pathophysiology

Gastritis is marked by disruption of the mucosal barrier that usually protects the stomach tissue from digestive juices and manifests in acute and chronic forms.
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
Esophageal Achalasia01:27

Esophageal Achalasia

Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...

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Corrigendum to "Effects of modified release hydrocortisone on restoration of early morning cortisol, quality of life, and fatigue in adrenal insufficiency (The CHAMPAIN study): a randomised, double-blind, double-dummy, cross-over study comparing Chronocort and Plenadren"[eClinical Medicine 91(2026); 103714].

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Adrenal insufficiency.

Wiebke Arlt1, Bruno Allolio

  • 1Division of Medical Sciences, University of Birmingham, Birmingham, UK.

Lancet (London, England)
|June 6, 2003
PubMed
Summary

Adrenal insufficiency, a rare but life-threatening condition, presents with non-specific symptoms leading to delayed diagnosis. Effective management requires specialist care, though acute cases need prompt recognition by all physicians.

Area of Science:

  • Endocrinology
  • Internal Medicine

Background:

  • Adrenal insufficiency stems from primary adrenal failure or hypothalamic-pituitary dysfunction.
  • It is a rare, potentially fatal condition often diagnosed late due to nonspecific symptoms like fatigue and weight loss.

Purpose of the Study:

  • To review the diagnosis and management of adrenal insufficiency.
  • To highlight challenges in identifying secondary adrenal insufficiency and assessing treatment quality.

Main Methods:

  • Review of diagnostic work-up for adrenal insufficiency.
  • Discussion of current glucocorticoid and mineralocorticoid replacement therapies.
  • Exploration of dehydroepiandrosterone replacement and quality of life impacts.

Main Results:

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  • Diagnostic pitfalls persist, especially for secondary adrenal insufficiency.
  • Quality of life is significantly impaired despite optimized replacement therapy.
  • Objective assessment of glucocorticoid replacement quality remains challenging.

Conclusions:

  • Long-term management of adrenal insufficiency is complex and requires specialist expertise.
  • Prompt recognition and management of acute adrenal failure are crucial for all doctors.
  • Dehydroepiandrosterone therapy may improve quality of life.