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Cushing’s syndrome is a set of symptoms and clinical signs caused by a prolonged exposure to excessive levels of cortisol or other glucocorticoids from endogenous or exogenous sources. It has a female predominance and usually affects adults between 20 and 50 years of age. The global incidence of endogenous Cushing’s syndrome is 0, 7 to 2, 4 cases per year. This is a severe condition associated with an elevated mortality rate which makes it important to treat. The goal of the treatment is to remove, if possible, the cause of hypercortisolism in order to normalize the cortisolemia, reverse the clinical picture and prevent comorbidities. The recent arrival on the market of drugs indicated for the treatment of Cushing’s syndrome now offers to the patients the chance to be treated while waiting to undergo surgery, in case of prior surgical failure or in case of unresectable, metastasic or occult tumor. The three most currently used oral drugs are ketoconazole, metyrapone, and mifepristone. The former two inhibit cortisol synthesis while the latter is a competitive glucocorticoid receptor (GR-II) antagonist. The aim of this thesis was to compare these three molecules in terms of efficacy and safety. It appears that all of them have advantages and disadvantages, and that not only should be the treatment be chosen considering the characteristics of these drugs but also according to those of the patients, such as their sex, the degree of hypercortisolism or the already existing complications. Le syndrome de Cushing est un ensemble de symptômes et de signes cliniques provoqués par une exposition prolongée à des taux excessifs de cortisol ou d'autres glucocorticoïdes de sources endogène ou exogène. Il a une prédominance féminine et touche généralement les adultes âgés de 20 à 50 ans. L'incidence mondiale du syndrome de Cushing endogène est de 0,7 à 2,4 cas par an. JI s'agit d'une affection sévère associée à une élévation du taux de mortalité, c'est pourquoi il est important de la traiter. Le but du traitement est de supprimer, si possible, la cause de l'hypercorticisme afin de normaliser la cortisolémie, d'inverser le tableau clinique et de prévenir les comorbidités. La mise sur le marché récente de traitements médicamenteux ayant pour indication le traitement du syndrome de Cushing offre désormais aux patients la possibilité d'être traités dans l'attente d'une opération chirurgicale, en cas d'échec d'une chirurgie antérieure ou encore lorsque l'on a affaire à une tumeur non résécable, métastatique ou occulte.Les trois traitements médicamenteux par voie orale les plus utilisés actuellement sont le kétoconazole, la métyrapone et la mifépristone. Les deux premiers sont des inhibiteurs de la synthèse du cortisol et le troisième est un antagoniste compétitif du récepteur aux glucocorticoïdes (GR-Il). Le but de ce mémoire était de comparer ces trois molécules en termes d'efficacité et de sécurité. Il en ressort que chacune d'entre elles possède des avantages et des inconvénients, et que le traitement ne doit pas être choisi uniquement vis-à-vis des caractéristiques de ces médicaments mais aussi en fonction des celles propres aux patients, telles que le sexe, le degré d'hypercorticisme ou encore les complications déjà existantes.

Ketoconazole --- Metyrapone --- Mifepristone --- Cushing Syndrome

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Cushing [Syndrome de ] --- Cushing"syndroom --- Cushing's syndrome --- Medische psychologie --- gezondheidspsychologie --- gezondheidspsychologie.

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Adrenalectomy --- Adrenal Gland Neoplasms --- Cushing Syndrome --- Pituitary Gland --- methods --- surgery --- surgery --- surgery

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Plusieurs problèmes affectent la balance énergétique chez le cheval âgé : parmi celles ci, nous allons nous concentrer sur le syndrome de cushing, le syndrome métabolique, et les affections dentaires. Après un rapide résumé des différentes maladies, une revue des différentes alimentations (fourrages, concentrés, compléments) pouvant être données et en quelles quantités sera vue dans une deuxième partie, et enfin une 3ème partie concernant un cas clinique illustratif sera développé

Nutrition, Dents, Cushing, Syndrome métabolique --- Sciences du vivant > Médecine vétérinaire & santé animale

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Neurological and psychiatric disorders can occur in endocrine diseases either in the setting of the clinical manifestations of the same (i.e., hyper- or hyposecretion of hormones or peptides from the endocrine glands) or as events secondary to the pathogenetic mechanisms of the endocrinopathy (i.e., autommunity affecting endocrine glands and the brain). Also the medical or surgical treatment of the endocrine disease can sometimes determine the occurrence of neurological or psychiatric abnormalities. Moreover some genetic alterations can lead to syndromes affecting both the endocrine and the nervous system with a variety of possible manifestations. In the last couple of decades a number of associations between dysfunctions of the endocrine system and neurological or psychiatric manifestations have appeared and only in the minority of the cases this link has been fully elucidated. Often the neurological or psychiatric alterations still represent a relevant challenge for clinicians with regard to the management of the patients. The complexity of the topic and the limited availability of laboratory research models for the study of the endocrine system-nervous system cross-interaction are making the scientific progresses intricate and, sometimes, slow. A dedicated focus to such broad and often still obscure topic might help and clarify the current state-of-the-art in the field and direct the goals of future research.

Neuroendocrinology. --- Psychoneuroendocrinology. --- Neuropsychiatry. --- Endocrine System Diseases --- physiopathology. --- Eating Disorders --- Polycystic Ovary Syndrome --- Obesity --- Exercise --- gender identity --- Acromegaly --- Quality of Life --- Cushing Syndrome --- Thyroid Surgery --- Hypogonadism