The Mayo Clinic

There are many tell-tale signs a person will present that will not even have an endocrinologist question if he or she has Cushing’s syndrome. A predominant symptom of the disorder is a red, rounded face (also known as “moon face”). Another externally visual sign is excess weight gain, particularly in the abdominal region. The patient may not distribute fat properly and can have fat-loss in their extremities. These people typically take on the apple body type. Muscle, back, and bone pain are also common complaints (Nieman, 2015).

fat, specially if associated with cystitis that could be incorrectly identified as tumor invasion. Vascular hyperaemia adjacent to the tumor could cause these abnormal signals

“Mayo Clinic has established arrangements with several different types of health care insurers” (n.d., Mayo Clinic). It is important to review information and resources relevant to your health care coverage prior to setting up your appointment. Mayo clinic also has resources available to assist patients with the insurance process including pre-authorizations and pre-certifications from their insurance company. Mayo clinic accepts coverage from several contracted insurance plans. Mayo clinic may not offer the highest benefit level or participate in every product offering from the every health plan listed; benefit coverage is determined solely by the insurance provider. A few of health care providers contracted with Mayo Clinic

In 2004 Mayo Collaborative Services and Mayo Clinic Rochester (Mayo) announced that they would be releasing a diagnostic test that utilizes thiopurine drugs to treat autoimmune diseases. Mayo’s announcement came after they had purchased and utilized similar diagnostic tests based on Prometheus Laboratories, Inc. (Prometheus) patents. After Mayo’s Prometheus sued Mayo claiming patent infringement. This paper will examine the Mayo Collaborative Services v Prometheus Laboratories, Inc. case that refers to the patent infringement law. We will examine both sides of the case by exploring Diamond v. Diehr, Mackay Radio & Telegraph Co. v. Radio Corp. of America, Bilski v. Kappos, and Parker v. Flook’s relationship with the case. This paper will ultimately conclude in favor of Mayo because Prometheus’ patents effectively claim natural laws and are therefore not patent eligible.

It is important to distinguish between Cushing disease and Cushing syndrome. While both are based on high levels of cortisol circulating in the body, Cushing disease is specifically caused by a generally benign tumor of the pituitary gland which secretes excess levels of adrenocorticotropic hormone (ACTH), leading to overproduction of cortisol in the adrenal glands. Cushing syndrome, on the other hand, refers to the symptoms caused by elevated levels of cortisol in the body due to any cause, and is also called hypercortisolism or hyperadrenocorticism. In addition to the Cushing disease promoting pituitary tumor, a number of additional circumstances may lead to the development of Cushing Syndrome. Elevated levels of cortisol often are a result of a prolonged use of corticosteroids, which may be prescribed for the treatment of allergies, asthma, or autoimmune diseases. However, elevated cortisol levels may also occur with cancerous or benign tumors of the ACTH-producing lungs, pancreas, or thyroid stimulating an excess production of cortisol. Cushing syndrome is fairly rare, affecting 10 -15

The name often refers to just the cancerous ones rather than all such tumors. Symptoms may include enlarged lymph nodes, fever, drenching sweat, weight loss, itching, and feeling tired. The enlarged lymph nodes are usually painless. The sweats are most common at night.

R.M. is a 74-year-old Caucasian male with a history of stage IV neuroendocrine tumor with metastasis who was admitted from the ER with a fever of unknown cause and sudden onset of bilateral lower extremity weakness. Brain cancer due to metastasis will first be discussed along with etiology, signs, symptoms, diagnosis, and treatment methods. The patient’s comorbidity of chronic anemia will then be discussed and related to the diagnosis of cancer. The suspected diagnosis of cauda equina syndrome will then be related to the patient's sudden onset of weakness and diagnosis of brain cancer. Finally, the patient’s admitting diagnosis of fever will be discussed, along with the suspected diagnosis of urinary tract infection (UTI).

Endogenous Cushing’s syndrome results when the high levels of cortisol originate from within the body. The most common causes of endogenous Cushing’s syndrome are adrenal, pituitary or ectopic tumours. These tumours lead to a disruption of the normal functioning of the HPA axis. Exogenous Cushing’s syndrome results when the high levels of cortisol in the blood is a direct result of some factor outside of the body, such as the administration of therapeutic steroids (Bronstein 2011). The endogenous component of Cushing’s syndrome can be further broken down into ACTH dependent and ACTH independent. ACTH-dependent causes account for the majority of cases (80%) (Bronstein 2011). Pituitary adenomas account for 80% of ACTH-dependent causes, with the remaining 20% resulting from ectopic tumours. These ectopic tumours are generally small-cell carcinomas of the lungs, but may also result from endocrine tumours on a variety of organs (Newell-Price et al. 2006). ACTH-independent causes typically result from various tumours on the adrenal glands, resulting in the direct secretion of cortisol into the blood. In extremely rare cases, ACTH-independent Cushing’s syndrome can be caused by corticotropin-independent macronodular adrenal disease and McCune-Albright syndrome (Newell-Price et al. 2006).

The disease can strike suddenly and be hard to diagnose while patients who are exposed to the drugs associated with high cortisol levels are usually screened for the syndrome when symptoms emerge. In one patient, Chondra Hungerford, it struck her when she was in the peak physical condition of her whole life. She was an amateur body builder and fitness enthusiast who could clean and jerk 200 pounds and bench press 185, but in a matter of months, she went from a 5 foot 6 inch, 120-pound muscle machine to 176 pounds and desperately ill (Dador, 2013). Fortunately for Chondra, doctors were able to identify the disease and remove a tumor at the base of the skull where the pituitary gland is positioned. Within four months Chondra had

Throughout the paper author Mark E. Molitch, a medical doctor, discusses the formation of pituitary tumors and the impact they have on the body. He describes how these adenomas form, what symptoms they cause, how they are diagnosed, and how they are treated. In the paper he addresses specific tumors such as Prolactinoma, which encompasses around half of all pituitary adenomas and causes an elevation in prolactin levels, as well as Acromegaly, a growth hormone secreting tumor, and Cushing disease which causes the overproduction of cortisol.

Hyperpituitarism is the over production of pituitary hormones caused by a benign tumor in the pituitary gland that can interfere with other pituitary hormone functions, resulting in target organ hormone deficiencies.1 Hyperpituitarism has two sub forms called Acromegaly and Gigantism.7

• Imaging techniques, such as computed tomography (CT) scans or magnetic resonance imaging (MRI) scans of the pituitary are used to locate the tumor that causes the GH overproduction.

Signs or symptoms could include lumps in the abdomen, bone pain, bulging eyes, dark circles around the eyes, swollen stomach, trouble breathing, weakness or paralysis. Once neuroblastoma has been diagnosed, it has usually metastasized to the lymph nodes, bones, bone marrow, and liver (NIH, n.d.).

The practice of co-branding is a relatively new technique utilized in the health care industry, which applies when one organization markets its name alongside another brand name. In this example of co-branding, the government of Vietnam wants to create an affiliation with Stanford Medical Center and its major national hospital in Saigon. This venture would include sending clinicians over to Vietnam to monitor, train and help and monitor its quality programs. In this situation, the Vietnamese hospital is looking to gain benefit from the Stanford Medical Center in what can be termed the “halo of affection” that belongs belong to the well-know and well-respected academic medical center. The Stanford Medical Center brand managers should be

Apporoximately 100 cases of JGCT have been reported in English literature. It was first described by Robertson et al in 1967 and was given this name by Kihara in 1968 (1, 2). It is seen predominantly in females in second and third decades of life (3-5). Although some cases have been reported in patients who are more than 40 years old (4) as well as in children of less than 10 years age. Most of the symptoms are attributed to hypertension, hypokalemia, hyperaldosteronism and increased renin activity due to secretion by the tumor. These non-specific symptoms are headaches, retinopathy , double vision, dizziness, nausea, vomiting, polyuria and proteinuria (3, 6). Hypertension is mostly present for several years before the diagnosis of reninoma is made. No correlation has been reported of degree or duration of hypertension with tumor size. Three clinical variants have been reported so far: ‘typical variant’ presenting with hypertension, hypokalemia, increased plasma renin secretion and hyperaldosteronism; ‘atypical variant’ presenting with hypertension but without hypokalemia; ‘non-functioning variant’ presenting without hypertension (12). Endoh et al reported a case of non-functioning variant which was discovered incidentally (7). Our patient presented with hypertension, headaches and hypokalemia and increased plasma renin