: 500 Other signs include increased urination (and accompanying increased thirst), persistent high blood pressure (due to cortisols enhancement of epinephrines vasoconstrictive effect) and insulin resistance (especially common with ACTH production outside the pituitary), leading to high blood sugar and insulin resistance which can lead to diabetes mellitus. Insulin resistance is accompanied by skin changes such as acanthosis nigricans in the axilla and around the neck, as well as skin tags in the axilla. Untreated Cushings syndrome can lead to heart disease and increased mortality. Cortisol can also exhibit mineralocorticoid activity in high concentrations, worsening the hypertension and leading to hypokalemia (common in ectopic ACTH secretion) and hypernatremia (increased Na+ ions concentration in plasma). Furthermore, excessive cortisol may lead to gastrointestinal disturbances, opportunistic infections, and impaired wound healing related to cortisols suppression of the immune and inflammatory responses. Osteoporosis is also an issue in Cushings syndrome since osteoblast activity is inhibited. Additionally, Cushings syndrome may cause sore and aching joints, particularly in the hip, shoulders, and lower back.Brain changes such as cerebral atrophy may occur. This atrophy is associated with areas of high glucocorticoid receptor concentrations such as the hippocampus and correlates highly with psychopathological personality changes. Rapid weight gain
Moodiness, irritability, or depression
Muscle and bone weakness
Memory and attention dysfunction
Osteoporosis
Diabetes mellitus
Hypertension
Immune suppression
Sleep disturbances
Menstrual disorders such as amenorrhea in women
Infertility in women
Impotence in men
Hirsutism
Baldness
Hypercholesterolemia

Hyperpigmentation
Cushings syndrome due to excess ACTH may also result in hyperpigmentation. This is due to melanocyte-stimulating hormone production as a byproduct of ACTH synthesis from pro-opiomelanocortin (POMC).
Statistics
Many of those affected during a thunderstorm asthma outbreak may have never experienced an asthma attack before.It has been found 95% of those that were affected by thunderstorm asthma had a history of hayfever, and 96% of those people had tested positive to grass pollen allergies, particularly rye grass. A rye grass pollen grain can hold up to 700 tiny starch granules, measuring 0.6 to 2.5 μm, small enough to reach the lower airways in the lung. Prevention
Patients with a history of grass allergies should be tested for asthma and treated for the grass allergies and asthma if also present. Patients with known asthma should be treated and counseled on the importance of adherence to preventative medication protocols. Preventative treatment found useful for severe asthma includes Allergen immunotherapy (AIT) particularly sublingual immunotherapy (SLIT). Significant events
6 July 1983 (1983-07-06) – 7 July 1983 (1983-07-07): Birmingham, England
8 November 1987 (1987-11-08): Melbourne, Australia
29 November 1989 (1989-11-29) – 30 November 1989 (1989-11-30): Melbourne, Australia
24 July 1994 (1994-07-24) – 25 July 1994 (1994-07-25): London, England
30 October 1997 (1997-10-30): Wagga Wagga, Australia
4 June 2004 (2004-06-04): Naples, Italy
25 November 2010 (2010-11-25): Melbourne, Australia
2 November 2013 (2013-11-02): Ahvaz, Iran
21 November 2016 (2016-11-21): Melbourne, Australia
1 December 2016 (2016-12-01): Kuwait and Riyadh, Saudi Arabia


== References ==