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Producer: Aspose.Pdf for .NET 10.1.0; modified using iTextSharp™ 5.4.0 ©2000-2012 1T3XT BVBA (AGPL-version) CreationDate: Wed Jun 19 15:43:56 2019 CEST ModDate: Thu Jul 4 11:35:07 2019 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 8 Encrypted: no Page size: 600.05 x 800 pts Page rot: 0 File size: 824746 bytes Optimized: no PDF version: 1.4 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MinionPro-Regular CID Type 0C Identity-H yes no yes 413 0 JANNGF+MinionPro-It Type 1C Custom yes yes yes 65 0 JANNGG+Minion-Black Type 1C WinAnsi yes yes no 31 0 JANNKF+minionblackadditional3 Type 1C WinAnsi yes yes no 414 0 JANODD+MinionPro-Regular2 Type 1C Custom yes yes yes 29 0 JANODE+MinionMath-Regular Type 1C Custom yes yes yes 30 0 JANODF+MinionMath-Capt Type 1C Custom yes yes yes 32 0 REVTWK+MinionPro-Regular CID TrueType Identity-H yes yes yes 1 0 JANOGF+minionregularadditional Type 1C Custom yes yes no 33 0 MinionPro-Regular3 Type 1C Custom yes no yes 81 0 JANOOE+MinionPro-Capt Type 1C WinAnsi yes yes no 97 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2022-03-23 02:25:55 CET RepresentationInformation: 223898.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-03-22 10:31:18 CET Size: 824746 Format: PDF Version: 1.4 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf Profile: ISO PDF/A-1, Level B PDFMetadata: Objects: 477 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Info: Title: Keywords: Creator: Aspose Ltd. Producer: Aspose.Pdf for .NET 10.1.0; modified using iTextSharp™ 5.4.0 ©2000-2012 1T3XT BVBA (AGPL-version) CreationDate: Wed Jun 19 15:43:56 CEST 2019 ModDate: Thu Jul 04 11:35:07 CEST 2019 ID: 0x55e1790284e2274c390216338c2d62b7, 0x8a67c4361411a00fc77cc6d412245bea Filters: FilterPipeline: FlateDecode Fonts: Type0: Font: BaseFont: REVTWK+MinionPro-Regular Encoding: Identity-H ToUnicode: true Font: BaseFont: MinionPro-Regular Encoding: Identity-H ToUnicode: true Type1: Font: BaseFont: JANODF+MinionMath-Capt FontSubset: true FirstChar: 2 LastChar: 179 FontDescriptor: FontName: JANODF+MinionMath-Capt Flags: Symbolic FontBBox: 23, -257, 610, 710 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: JANNGF+MinionPro-It FontSubset: true FirstChar: 2 LastChar: 182 FontDescriptor: FontName: JANNGF+MinionPro-It Flags: Serif, Symbolic, Italic FontBBox: -201, -360, 1684, 1002 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: JANOGF+minionregularadditional FontSubset: true FirstChar: 2 LastChar: 4 FontDescriptor: FontName: JANOGF+minionregularadditional Flags: Symbolic FontBBox: -279, -257, 1011, 896 FontFile3: true EncodingDictionary: Differences: true Font: BaseFont: MinionPro-Regular3 FirstChar: 2 LastChar: 121 FontDescriptor: FontName: MinionPro-Regular3 Flags: Serif, Symbolic FontBBox: -290, -360, 1684, 989 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: JANOOE+MinionPro-Capt FontSubset: true FirstChar: 32 LastChar: 102 FontDescriptor: FontName: JANOOE+MinionPro-Capt Flags: Nonsymbolic FontBBox: -304, -369, 1712, 1007 FontFile3: true Encoding: WinAnsiEncoding Font: BaseFont: JANODD+MinionPro-Regular2 FontSubset: true FirstChar: 2 LastChar: 182 FontDescriptor: FontName: JANODD+MinionPro-Regular2 Flags: Serif, Symbolic FontBBox: -290, -360, 1684, 989 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: JANODE+MinionMath-Regular FontSubset: true FirstChar: 2 LastChar: 179 FontDescriptor: FontName: JANODE+MinionMath-Regular Flags: Symbolic FontBBox: 19, -261, 600, 712 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: JANNKF+minionblackadditional3 FontSubset: true FirstChar: 32 LastChar: 45 FontDescriptor: FontName: JANNKF+minionblackadditional3 Flags: Nonsymbolic FontBBox: 6, -284, 854, 763 FontFile3: true Encoding: WinAnsiEncoding Font: BaseFont: JANNGG+Minion-Black FontSubset: true FirstChar: 32 LastChar: 243 FontDescriptor: FontName: JANNGG+Minion-Black Flags: Serif, Nonsymbolic, ForceBold FontBBox: -133, -250, 1120, 827 FontFile3: true Encoding: WinAnsiEncoding CIDFontType0: Font: BaseFont: MinionPro-Regular CIDSystemInfo: Registry: Adobe Registry: Identity Supplement: 0 FontDescriptor: FontName: MinionPro-Regular Flags: Nonsymbolic FontBBox: -290, -360, 1684, 989 FontFile3: true CIDFontType2: Font: BaseFont: REVTWK+MinionPro-Regular CIDSystemInfo: Registry: Adobe Registry: Identity Supplement: 0 FontDescriptor: FontName: REVTWK+MinionPro-Regular Flags: Nonsymbolic FontBBox: -289, -360, 1684, 917 FontFile2: true XMP: application/pdfSalivary Cortisol Determination in ACTH Stimulation Test to Diagnose Adrenal Insufficiency in Patients with Liver CirrhosisAlbert, LaraProfitós, JoaquímSánchez-Delgado, JordiCapel, IsmaelGonzález-Clemente, José MiguelSubías, DavidCano, AlbertBerlanga, EugenioEspinal, AnnaHurtado, MartaPareja, RocíoRigla, MercedesDalmau, BlaiVergara, MercedesMiquel, MireiaCasas, MeritxellGiménez-Palop, OlgaPurpose. The prevalence of adrenal insufficiency (AI) in patients with decompensated liver cirrhosis is unknown. Because these patients have lower levels of cortisol-binding carrier proteins, their total serum cortisol (TSC) correlates poorly with free serum cortisol (FC). Salivary cortisol (SaC) correlates better with FC. We aimed to establish SaC thresholds for AI for the 250 μg intravenous ACTH test and to estimate the prevalence of AI in noncritically ill cirrhotic patients. Methods. We included 39 patients with decompensated cirrhosis, 39 patients with known AI, and 45 healthy volunteers. After subjects fasted ≥8 hours, serum and saliva samples were collected for determinations of TSC and SaC at baseline 0’(T0) and at 30-minute intervals after intravenous administration of 250 μg ACTH [30’(T30), 60’(T60), and 90’(T90)]. Results. Based on the findings in healthy subjects and patients with known AI, we defined AI in cirrhotic patients as SaC-T0< 0.08 μg/dL (2.2 nmol/L), SaC-T60 < 1.43 μg/dl (39.5 nmol/L), or ΔSaC<1 μg/dl (27.6 nmol/L). We compared AI determination in cirrhotic patients with the ACTH test using these SaC thresholds versus established TSC thresholds (TSC-T0< 9 μg/dl [248 nmol/L], TSC-T60 < 18 μg/dl [497 nmol/L], or ΔTSC<9 μg/dl [248 nmol/L]). SaC correlated well with TSC. The prevalence of AI in cirrhotic patients was higher when determined by TSC (48.7%) than by SaC (30.8%); however, this difference did not reach statistical significance. AI was associated with sex, cirrhosis etiology, and Child-Pugh classification. Conclusions. Measuring SaC was more accurate than TSC in the ACTH stimulation test. 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