PMC:4143611 / 6134-7422
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/4143611","sourcedb":"PMC","sourceid":"4143611","source_url":"https://www.ncbi.nlm.nih.gov/pmc/4143611","text":"This is further complicated by the fact that several circumstances can influence serum cortisol levels. Prophylactic medical treatments are often used prior to or during surgery to control cortisol levels in patients with CD. Since successful pituitary adenomectomy typically results in adrenal insufficiency, glucocorticoids are commonly administered peri- and/or pre-operatively [5]. On the other hand, because invasive surgery is a stressful procedure that elevates cortisol levels [18, 19], some centers attempt to mitigate such elevations in patients with CD, who are already hypercortisolemic as a result of the disease, prior to TSS [3, 20]. Steroidogenesis inhibitors, such as ketoconazole and metyrapone, may be administered for several weeks preceding adenomectomy [12, 21]. While the practice considers the patient’s best interest, pre-operative administration of these drugs often delays surgery and can pose challenges to the evaluation of remission status immediately following surgery. It is possible that adrenal insufficiency might be exaggerated by the action of these drugs and potentially falsely identifies some cases as surgical successes. It is therefore important for clinicians to time preoperative treatment discontinuation in order to avoid mistaking remission.","tracks":[{"project":"2_test","denotations":[{"id":"24980037-20556520-63233417","span":{"begin":382,"end":383},"obj":"20556520"},{"id":"24980037-5427262-63233418","span":{"begin":486,"end":488},"obj":"5427262"},{"id":"24980037-15951937-63233419","span":{"begin":490,"end":492},"obj":"15951937"},{"id":"24980037-18413427-63233420","span":{"begin":641,"end":642},"obj":"18413427"},{"id":"24980037-16698415-63233421","span":{"begin":644,"end":646},"obj":"16698415"},{"id":"24980037-16474220-63233422","span":{"begin":776,"end":778},"obj":"16474220"},{"id":"24980037-22533782-63233423","span":{"begin":780,"end":782},"obj":"22533782"}],"attributes":[{"subj":"24980037-20556520-63233417","pred":"source","obj":"2_test"},{"subj":"24980037-5427262-63233418","pred":"source","obj":"2_test"},{"subj":"24980037-15951937-63233419","pred":"source","obj":"2_test"},{"subj":"24980037-18413427-63233420","pred":"source","obj":"2_test"},{"subj":"24980037-16698415-63233421","pred":"source","obj":"2_test"},{"subj":"24980037-16474220-63233422","pred":"source","obj":"2_test"},{"subj":"24980037-22533782-63233423","pred":"source","obj":"2_test"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"2_test","color":"#93cbec","default":true}]}]}}