Glucocorticoids in the context of "Alcoholic hepatitis"

Cushing's syndrome is a collection of signs and symptoms due to prolonged exposure to glucocorticoids such as cortisol. Signs and symptoms may include high blood pressure, abdominal obesity but with thin arms and legs, reddish stretch marks, a round red face due to facial plethora, a fat lump between the shoulders, weak muscles, weak bones, acne, and fragile skin that heals poorly. Women may have more hair and irregular menstruation or loss of menses, with the exact mechanisms of why still unknown. Occasionally there may be changes in mood, headaches, and a chronic feeling of tiredness.

Cushing's syndrome is caused by either excessive cortisol-like medication, such as prednisone, or a tumor that either produces or results in the production of excessive cortisol by the adrenal glands. Cases due to a pituitary adenoma are known as Cushing's disease, which is the second most common cause of Cushing's syndrome after medication. A number of other tumors, often referred to as ectopic due to their placement outside the pituitary, may also cause Cushing's. Some of these are associated with inherited disorders such as multiple endocrine neoplasia type 1 and Carney complex. Diagnosis requires a number of steps. The first step is to check the medications a person takes. The second step is to measure levels of cortisol in the urine, saliva or in the blood after taking dexamethasone. If this test is abnormal, the cortisol may be measured late at night. If the cortisol remains high, a blood test for ACTH may be done.

Cognitive impairment is an inclusive term to describe any characteristic that acts as a barrier to the cognition process or different areas of cognition. Cognition, also known as cognitive function, refers to the mental processes of how a person gains knowledge, uses existing knowledge, and understands things that are happening around them using their thoughts and senses. Cognitive impairment can be in different domains or aspects of a person's cognitive function including memory, attention span, planning, reasoning, decision-making, language (comprehension, writing, speech), executive functioning, and visuospatial functioning. The term cognitive impairment covers many different diseases and conditions and may also be symptom or manifestation of a different underlying condition. Examples include impairments in overall intelligence (as with intellectual disabilities), specific and restricted impairments in cognitive abilities (such as in learning disorders like dyslexia), neuropsychological impairments (such as in attention, working memory or executive function), or it may describe drug-induced impairment in cognition and memory (such as that seen with alcohol, glucocorticoids, and the benzodiazepines.). Cognitive impairments may be short-term, progressive (gets worse over time), or permanent.

There are different approaches to assessing or diagnosing a cognitive impairment including neuropsychological testing using various different tests that consider the different domains of cognition. Examples of shorter assessment clinical tools include the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). There are many different syndromes and pathologies that cause cognitive impairment including dementia, mild neurocognitive disorder, and Alzheimer's disease.

The zona fasciculata (sometimes, fascicular or fasciculate zone) constitutes the middle and also the widest zone of the adrenal cortex, sitting directly beneath the zona glomerulosa. Constituent cells are organized into bundles or "fascicles".

The zona fasciculata chiefly produces glucocorticoids (mainly cortisol in humans), which regulate the metabolism of glucose. Glucocorticoid production is stimulated by adrenocorticotropic hormone (ACTH), which is released from the anterior pituitary, especially in times of stress as part of the fight-or-flight response. The zona fasciculata also generates a small amount of weak androgens (e.g., dehydroepiandrosterone). The main source of androgens will come from the zona reticularis region. In certain animals such as rodents, the lack of 17alpha-hydroxylase results in the synthesis of corticosterone instead of cortisol.