Endocrinology, Metabolism and Clinical Nutrition

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Hershel Raff, PhD

Professor of Medicine, Surgery and Physiology
Director, Endocrine Research Laboratory
Aurora St. Luke's Medical Center
Aurora Research Institute

Training:

            PhD, Environmental Physiology
            Johns Hopkins University
            Post-doctoral Fellowship in Endocrinology
            University of California, San Francisco
 
Contact:
            Aurora St. Luke’s Medical Center
            2801 W KK River Pky, Suite 245
            Milwaukee WI 53215
            Phone: (414) 649-6411
            Fax: (414) 649-5747
            Email: hraff@mcw.edu or hershel.raff@aurora.org

Investigative Interests:

Cushing's syndrome, adrenal tumors, fetal and neonatal endocrinology and metabolism

Clinical Research:
My clinical research has two major areas of interest. The first is the development of new methods in the diagnosis and differential diagnosis of Cushing's syndrome. We have developed and championed the use of bedtime salivary cortisol measurement to diagnose endogenous hypercortisolism. The patients sample saliva at home using a special device and mail the samples back to our lab. There are now many major studies from all over the world demonstrating the accuracy and cost-effectiveness of this approach. My laboratory receives clinical samples (through ACL Reference Laboratories) from all over the US. My laboratory also helped develop the inferior petrosal sinus sampling for ACTH technique to differentiate pituitary from ectopic ACTH-dependent Cushing's syndrome. We also developed the method to verify catheter placement using prolactin measurements.

Laboratory Research: The major interest of my laboratory is to evaluate the endocrine and metabolic adaptations of the fetus, neonate, adolescent, and adult rat to perinatal hypoxia. We have studied the hypothalamic-pituitary-adrenal axis showing a non-ACTH mediated increase in steroidogenesis apparently mediated by a novel neural pathway to the adrenal cortex via sympathetic nerves. We have also demonstrated dramatic effects on the lipid profile (metabolome), hepatic, endocrine pancreatic, and gastrointestinal function, bone metabolism, growth and the growth hormone axis, and adipokine expression. We are currently studying the short- and long-term effects of spontaneous hypothermia during intermittent and continuous hypoxia on these humoral systems.


Selected Recent Publications:

Woods DL, Kovach CR, Raff H, Basmadjian A, Hegadoren KM. Using saliva to measure
            endogenous cortisol in nursing home residents with advanced dementia. Research in
            Nursing & Health 31:283-194, 2008.

Bruder ED, Lee JJ, Widmaier EP, Raff H. Microarray and real-time PCR analysis of adrenal gland
            gene expression in the 7-day-old rat: effects of hypoxia from birth. Physiol Genomics
            29:193-200, 2007.

Raff H. Brock S, Findling JW. Cosyntropin-stimulated salivary cortisol in hospitalized patients
            with hypoproteinemia. Endocrine 34:68-74, 2008.

Carroll T, Raff H, Findling JW. Late-night salivary cortisol measurement in the diagnosis of
            Cushing’s syndrome. Nature Clinical Practice Endocrinology & Metabolism 6:344-350, 2008.

Kovach CR, Woods DL, Logan BR, Raff H. Diurnal variation of cortisol in people with dementia:
            relationship to cognition and illness burden. American Journal of Alzheimers Disease & Other
            Dementias 26: 145-150, 2011.

Bruder ED, Kamer KJ, Guenther MA, Raff H. Adrenocorticotropic hormone and corticosterone
            responses to acute hypoxia in the neonatal rat: effects of body temperature maintenance.
            Am J Physiol Regul Integr Comp Physiol 300:R708-R715, 2011.

Raff H, Ettema SL, Eastwood DC, Woodson BT. Salivary cortisol in obstructive sleep apnea:
            the effect of CPAP. Endocrine 40:137-139, 2011.

Valentine AR, Raff H, Liu H, Ballesteros M, Rose JM, Jossart GH, Cirangle P, Bravata DM.
            Salivary cortisol increases after bariatric surgery in women. Horm Metab Res 43:587-590, 2011.

Sharma ST, Raff H, Nieman LK. Prolactin as a marker of successful catheterization during IPSS
            in patients with ACTH-dependent Cushing's Syndrome. J. Clin Endocrinol Metab 96:3687-3694, 2011.

Guenther MA, Bruder ED, Raff H. Effects of body temperature maintenance on glucose insulin, and
            corticosterone responses to acute hypoxia in the neonatal rat. Am J Physiol Regul Integr Comp Physiol
            302:R627-R633, 2012.

Raff H, Singh RJ. Measurement of late night salivary cortisol and cortisone by liquid chromatography-
            tandem mass spectrometry to assess pre-analytical sample contamination with topical hydrocortisone.
            Clinical Chemistry 58:947-948, 2012.

Recent Books:

            Widmaier EP, Raff H, Strang KT. Vander's HUMAN PHYSIOLOGY: The Mechanism's of Body Function
            12th Edition, McGraw-Hill, Boston, 2011, 754 pages.

Raff H, Levitzky M. MEDICAL PHYSIOLOGY: A SYSTEMS APPROACH. McGraw-Hill Medical,
            New York, 2011, 786 pages.

Recent Reviews and Chapters:

Carroll T, Raff H, Findling JW. Late-night salivary cortisol measurement in the diagnosis of Cushing's
            Syndrome. Nature Clinical Practice Endocrinology & Metabolism 6:344-350, 2008.

Raff H, Sluss PM. Pre-analytical issues for testosterone and estradiol assays. Steroids
            73:1297-1304, 2008.

Raff H. Utility of salivary cortisol measurements in Cushing's syndrome and adrenal insufficiency.
            J Clin Endocrinol Metab 94:3647-3655. 2009.

Raff H. Cushing's syndrome: diagnosis and surveillance using salivary cortisol. Pituitary 15: 64-70, 2012.

 

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