ReviewReviews in endocrine & metabolic disorders2021
Investigation of the Hypothalamo-pituitary-adrenal (HPA) axis: a contemporary synthesis.
Review in Reviews in endocrine & metabolic disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 69 citations in OpenAlex.
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- Bibliometric and visual analysis in the field of electroacupuncture's analgesia and regulation on negative emotion from 2014 to 2024.Frontiers in neurology · 2025Pooled it
- [European journal of nuclear medicine and molecular imaging · 2026Article
- Endoplasmic Reticulum Stress Induced by Turbulence of Mitochondrial Fusion and Fission Was Involved in Isoproterenol-Induced H9c2 Cell Injury.International journal of molecular sciences · 2026Article
- Defining a serum cortisol cutoff level post-CRH stimulation for diagnosing ACTH deficiency: A retrospective study validated by a nationwide registry.Frontiers in endocrinology · 2026Article
- Comparison of Glucagon Stimulation Test and Insulin Tolerance Test for Assessment of an Anterior Pituitary Function-A Cross-Over Study.Journal of clinical medicine · 2025Article
- Investigating the role of transposable elements in shaping abdominal fat and egg production phenotypic traits in geese.BMC genomics · 2025Article
- Exploring the use of traditional Chinese medicine exercises for cancer patients from the perspective of bibliometrics.Discover oncology · 2025Article
- Evaluation of the impact Of ChatGPT support on acromegaly management and patient education.Endocrine · 2025Article
- Comprehensive safety assessment of Qiwei Tiexie Pill: integrating histopathological, biochemical, and metabolomic analyses in a rat model.Frontiers in pharmacology · 2025Article
- Hypoprolactinemia. Does it matter? Redefining the hypopituitarism and return from a mumpsimus : "Absence of proof is not the proof of absence".Reviews in endocrine & metabolic disorders · 2024Review
- An evidence-based nursing practice affects stress state, coagulation, complications and quality of life in patients with upper gastrointestinal bleeding in the emergency department: a retrospective observational study.BMC gastroenterology · 2024Observational
- Mechanisms of Heat Stress on Neuroendocrine and Organ Damage and Nutritional Measures of Prevention and Treatment in Poultry.Biology · 2024Review
- Review
- Basal cortisol in relation to metyrapone confirmation in predicting adrenal insufficiency after pituitary surgery.Pituitary · 2024Article
- Continuous Glucose Monitoring: A Possible Aid for Detecting Hypoglycemic Events during Insulin Tolerance Tests.Sensors (Basel, Switzerland) · 2023Article
- Molecular and Epigenetic Control of Aldosterone Synthase, CYP11B2 and 11-Hydroxylase, CYP11B1.International journal of molecular sciences · 2023Review
- Cardiovascular disease and depression: a narrative review.Frontiers in cardiovascular medicine · 2023Review
- Isolated anterior pituitary dysfunction in adulthood.Frontiers in endocrinology · 2023Review
- Opioid-induced adrenal insufficiency: diagnostic and management considerations.Frontiers in endocrinology · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The hypothalamo-pituitary-adrenal (HPA) axis is one of the main components of the stress system. Maintenance of normal physiological events, which include stress responses to internal or external stimuli in the body, depends on appropriate HPA axis function. In the case of severe cortisol deficiency, especially when there is a triggering factor, the patient may develop a life-threatening adrenal crisis which may result in death unless early diagnosis and adequate treatment are carried out. The maintenance of normal physiology and survival depend upon a sufficient level of cortisol in the circulation. Life-long glucocorticoid replacement therapy, in most cases meeting but not exceeding the need of the patient, is essential for normal life expectancy and maintenance of the quality of life. To enable this, the initial step should be the correct diagnosis of adrenal insufficiency (AI) which requires careful evaluation of the HPA axis, a highly dynamic endocrine system. The diagnosis of AI in patients with frank manifestations is not challenging. These patients do not need dynamic tests, and basal cortisol is usually enough to give a correct diagnosis. However, most cases of secondary adrenal insufficiency (SAI) take place in a gray zone when clinical manifestations are mild. In this situation, more complicated methods that can simulate the response of the HPA axis to a major stress are required. Numerous studies in the assessment of HPA axis have been published in the world literature. In this review, the tests used in the diagnosis of secondary AI or in the investigation of suspected HPA axis insufficiency are discussed in detail, and in the light of this, various recommendations are made.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.