PurposeTo systematically review the effectiveness of medical treatment for Cushing’s syndrome in clinical practice, regarding cortisol secretion, clinical symptom improvement, and quality of life. To assess the occurrence of side effects of these medical therapies.MethodsEight electronic databases were searched in March 2017 to identify potentially relevant articles. Randomized controlled trials and cohort studies assessing the effectiveness of medical treatment in patients with Cushing’s syndrome, were eligible. Pooled proportions were reported including 95% confidence intervals.ResultsWe included 35 articles with in total 1520 patients in this meta-analysis. Most included patients had Cushing’s disease. Pooled reported percentage of patients with normalization of cortisol ranged from 35.7% for cabergoline to 81.8% for mitotane in Cushing’s disease. Patients using medication monotherapy showed a lower percentage of cortisol normalization compared to use of multiple medical agents (49.4 vs. 65.7%); this was even higher for patients with concurrent or previous radiotherapy (83.6%). Mild side effects were reported in 39.9%, and severe side effects were seen in 15.2% of patients after medical treatment. No meta-analyses were performed for clinical symptom improvement or quality of life due to lack of sufficient data.ConclusionsThis meta-analysis shows that medication induces cortisol normalization effectively in a large percentage of patients. Medical treatment for Cushing’s disease patients is thus a reasonable option in case of a contraindication for surgery, a recurrence, or in patients choosing not to have surgery. When experiencing side effects or no treatment effect, an alternate medical therapy or combination therapy can be considered.Electronic supplementary materialThe online version of this article (10.1007/s11102-018-0897-z) contains supplementary material, which is available to authorized users.
Patterned semiconductors are essential for the fabrication of nearly all electronic devices. Over the last two decades, semiconducting polymers (SPs) have received enormous attention due to their potential for creating low‐cost flexible electronic devices, while development of scalable patterning methods capable of producing sub‐μm feature sizes has lagged. A novel method for patterning SPs termed Projection Photothermal Lithography (PPL) is presented. A lab scale PPL microscope is built and it is demonstrated that rapid (≈4 cm2 h−1) and large single exposure area (≈0.69 mm2) sub‐μm patterns can be obtained optically. Polymer domains are selectively removed via a photo‐induced temperature gradient that enables dissolution. It is hypothesized that commercial‐scale patterning with a throughput of ≈5 m2 h−1 and resolution of <1 μm could be realized through optimization of optical components.
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