2916. Cushing's syndrome.
作者: André Lacroix.;Richard A Feelders.;Constantine A Stratakis.;Lynnette K Nieman.
来源: Lancet. 2015年386卷9996期913-27页
Chronic exposure to excess glucorticoids results in diverse manifestations of Cushing's syndrome, including debilitating morbidities and increased mortality. Genetic and molecular mechanisms responsible for excess cortisol secretion by primary adrenal lesions and adrenocorticotropic hormone (ACTH) secretion from corticotroph or ectopic tumours have been identified. New biochemical and imaging diagnostic approaches and progress in surgical and radiotherapy techniques have improved the management of patients. The therapeutic goal is to normalise tissue exposure to cortisol to reverse increased morbidity and mortality. Optimum treatment consisting of selective and complete resection of the causative tumour is necessay to allow eventual normalisation of the hypothalamic-pituitary-adrenal axis, maintenance of pituitary function, and avoidance of tumour recurrence. The development of new drugs offers clinicians several choices to treat patients with residual cortisol excess. However, for patients affected by this challenging syndrome, the long-term effects and comorbidities associated with hypercortisolism need ongoing care.
2918. Mortality risk attributable to high and low ambient temperature: a multicountry observational study.
作者: Antonio Gasparrini.;Yuming Guo.;Masahiro Hashizume.;Eric Lavigne.;Antonella Zanobetti.;Joel Schwartz.;Aurelio Tobias.;Shilu Tong.;Joacim Rocklöv.;Bertil Forsberg.;Michela Leone.;Manuela De Sario.;Michelle L Bell.;Yue-Liang Leon Guo.;Chang-fu Wu.;Haidong Kan.;Seung-Muk Yi.;Micheline de Sousa Zanotti Stagliorio Coelho.;Paulo Hilario Nascimento Saldiva.;Yasushi Honda.;Ho Kim.;Ben Armstrong.
来源: Lancet. 2015年386卷9991期369-75页
Although studies have provided estimates of premature deaths attributable to either heat or cold in selected countries, none has so far offered a systematic assessment across the whole temperature range in populations exposed to different climates. We aimed to quantify the total mortality burden attributable to non-optimum ambient temperature, and the relative contributions from heat and cold and from moderate and extreme temperatures.
2919. Long-term effects of lithium on renal, thyroid, and parathyroid function: a retrospective analysis of laboratory data.
作者: Brian Shine.;Rebecca F McKnight.;Laurence Leaver.;John R Geddes.
来源: Lancet. 2015年386卷9992期461-8页
Lithium is a widely used and highly effective treatment for mood disorders, but causes poorly characterised adverse effects in kidney and endocrine systems. We aimed to analyse laboratory information system data to determine the incidence of renal, thyroid, and parathyroid dysfunction associated with lithium use.
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