Dr Eric Daiter has served Monmouth and Middlesex Counties of New Jersey as an infertility expert for the past 20 years. Dr. Daiter is happy to offer second opinions (at the office or over the telephone) or new patient appointments. It is easy, just call us at 908 226 0250 to set up an appointment (leave a message with your name and number if we are unable to get to the phone and someone will call you back).
"I always try to be available for my patients since I do understand the pain and frustration associated with fertility problems or endometriosis."
"I understand that the economy is very tough and insurance companies do not cover a lot of the services that might help you. I always try to minimize your out of pocket cost while encouraging the most successful and effective treatments available."
Cushing's syndrome is the result of chronic exposure to high concentrations
of circulating cortisol (a glucocorticosteroid produced in the
adrenal gland), either due to exogenous administration of ACTH
or glucocorticoids or due to endogenous increased secretion of
ACTH or cortisol. About 85% of endogenous Cushing's syndrome is
caused by excessive ACTH. About 80% of the ACTH dependent Cushing's
syndromes are caused by pituitary oversecretion of ACTH (Cushing's
disease) and 20% caused by ectopic ACTH. ACTH independent Cushing's
syndrome can be due to a benign cortisol secreting adrenal adenoma
or an adrenocortical carcinoma.
The clinical appearance of Cushing's syndrome is a result of the
increased circulating levels of the steroid hormone cortisol.
The Cushingoid appearance includes
* rounded face (moon facies), truncal obesity (fat
especially around the waist), "buffalo hump" (increased
fatty tissue in the supraclavicular region)
* muscle weakness (especially involving the proximal
muscles that makes it difficult to stand from a squat) and fatigue
* purple striae (linear streaks) on the skin
* easy bruisability and low fracture threshold for
the ribs and vertebrae
* carbohydrate intolerance or frank diabetes mellitus
The diagnostic tests to confirm hypercortisolism may include either
the 24 hour urine free cortisol concentration or the single 1
mg overnight dexamethasone suppression test. The 24 hour urine
test is generally the preferred screening test since there are
virtually no false negative results. With either test, positive
results must be confirmed and then the cause for the excess cortisol
determined. There is a complex multitest regimen that is suggested
to determine the cause whenever the initial testing is positive.
Identification of this syndrome and treatment is important to
avoid some of the clinical consequences of chronic exposure to