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https://www.readbyqxmd.com/read/28225306/hydrocortisone-therapy-and-growth-trajectory-in-children-with-classical-congenital-adrenal-hyperplasia
#1
Carla Bizzarri, Nicola Improda, Chiara Maggioli, Donatella Capalbo, Silvia Roma, Ottavia Porzio, Mariacarolina Salerno, Marco Cappa
OBJECTIVE: Poor linear growth is one of the main concerns in children with congenital adrenal hyperplasia (CAH). We aimed to analyze factors affecting growth trajectory in children with classical CAH. METHODS: Clinical records of children followed from infancy up to the end of growth at two Italian tertiary referral hospitals were reviewed. Fifty-seven patients (31 males), treated with hydrocortisone and fludrocortisone only, were included. Clinical observations were divided into 3 groups: 0-2 years: 172 observations; from 2 years to puberty onset: 813 observations; after puberty onset: 527 observations...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28220108/adaptations-in-basal-and-hypothalamic-pituitary-adrenal-activated-deoxycorticosterone-responses-following-ethanol-self-administration-in-cynomolgus-monkeys
#2
Vanessa A Jimenez, Patrizia Porcu, A Leslie Morrow, Kathleen A Grant
Acute ethanol activates the hypothalamic-pituitary-adrenal (HPA) axis, while long-term exposure results in a blunted neuroendocrine state, particularly with regards to the primary endpoint, cortisol, the primary glucocorticoid produced in the adrenal cortex. However, it is unknown if this dampened neuroendocrine status also influences other adrenocortical steroids. Plasma concentration of the mineralocorticoid and neuroactive steroid precursor deoxycorticosterone (DOC) is altered by pharmacological challenges of the HPA axis in cynomolgus monkeys...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28211216/low-dose-eplerenone-treatment-decreases-aortic-stiffness-in-patients-with-resistant-hypertension
#3
Tatjana Kalizki, Bernhard M W Schmidt, Ulrike Raff, Annemarie Reinold, Thomas K Schwarz, Markus P Schneider, Roland E Schmieder, Andreas Schneider
Vascular damage is aggravated in animal models of hypertension with mineralocorticoid (MR) excess and in hypertensive patients with primary hyperaldosteronism. MR antagonism has shown to provide effective blood pressure (BP)-control in patients with treatment resistant hypertension (TRH), but the concurrent effects on the vasculature have not been examined. In a randomized, double-blinded, placebo-controlled parallel-group study, 51 patients with TRH received either eplerenone 50 mg or placebo for 6 months together with additional antihypertensives titrated to achieve a BP target of <140/90 mm Hg...
February 17, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28207417/adrenarche-unmasks-compound-heterozygous-3%C3%AE-hydroxysteroid-dehydrogenase-deficiency-c-244g-a-p-ala82thr-and-the-novel-931c-t-p-gln311-variant-in-a-non-salt-wasting-severely-undervirilised-46xy
#4
Stephanie Louise Teasdale, Adam Morton
3β-Hydroxysteroid dehydrogenase type II deficiency (3βHSD2) congenital adrenal hyperplasia is a rare cause of ambiguous genitalia, resulting in abnormal virilisation in both 46XY and 46XX. We describe a case of 46XY ambiguous genitalia that was misdiagnosed as androgen insensitivity syndrome. The correct diagnosis was made after adrenarche. Genotyping demonstrated compound heterozygosity in two alleles, the previously described c.244G>A (p.Ala82Thr), and a novel 931C>T(p.Gln311*) variant. We suggest that adrenarche unmasked the condition by driving cortisol production to rates that caused the mutant 3bHSD2 enzyme to become rate limiting for cortisol production...
February 16, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28196143/iron-restricted-pair-feeding-affects-renal-damage-in-rats-with-chronic-kidney-disease
#5
Yoshiro Naito, Aya Senchi, Hisashi Sawada, Makiko Oboshi, Tetsuo Horimatsu, Keisuke Okuno, Seiki Yasumura, Masaharu Ishihara, Tohru Masuyama
BACKGROUND: We have previously shown that dietary iron restriction prevents the development of renal damage in a rat model of chronic kidney disease (CKD). However, iron deficiency is associated with appetite loss. In addition, calorie restriction is reported to prevent the development of end-stage renal pathology in CKD rats. Thus, the beneficial effect of iron restriction on renal damage may depend on calorie restriction. Here, we investigate the effect of pair-feeding iron restriction on renal damage in a rat model of CKD...
2017: PloS One
https://www.readbyqxmd.com/read/28184100/clinical-question-in-congestive-heart-failure-patients-with-preserved-ejection-fraction-does-spironolactone-improve-cardiac-outcomes
#6
Leslie Williams, Cheyn Onarecker
CLINICAL QUESTION: In congestive heart failure patients with preserved ejection fraction, does spironolactone improve cardiac outcomes? ANSWER: No. A randomized controlled trial of patients with heart failure and an ejection fraction > 45% showed that spironolactone did not significantly reduce the incidence of the primary composite outcome of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for the management of heart failure. LEVEL OF EVIDENCE FOR THE ANSWER: A...
September 2016: Journal of the Oklahoma State Medical Association
https://www.readbyqxmd.com/read/28181634/mineralocorticoid-receptor-antagonists-in-elderly-patients-with-heart-failure-a-systematic-review-and-meta-analysis
#7
Deepa Japp, Anoop Shah, Sheila Fisken, Martin Denvir, Susan Shenkin, Alan Japp
No abstract text is available yet for this article.
January 9, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28176630/novel-drugs-for-hypertension-and-heart-failure-struggling-for-a-place-under-the-sun
#8
Charles Faselis, Chrysoula Boutari, Michael Doumas, Konstantinos Imprialos, Konstantinos Stavropoulos, Peter Kokkinos
BACKGOUND: Current drug therapy for the management of arterial hypertension and heart failure has provided substantial benefits but has also some limitations. LCZ696, a dual inhibitor of angiotensin receptor blockers and neprilysin, and finerenone, a non-steroidal mineralocorticoid receptor antagonist, are two recently developed novel agents for the management of these conditions. METHODS: This review aims to present the pathophysiological basis for the use of these two novel drugs, critically discuss available clinical data, and provide future perspectives...
February 6, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28170340/adrenocortical-neoplasms-in-adulthood-and-childhood-distinct-presentation-review-of-the-clinical-pathological-and-imaging-characteristics
#9
Andréa Farias de Melo-Leite, Paula Condé Lamparelli Elias, Sara Reis Teixeira, Silvio Tucci, Gyl Eanes Barros, Sonir R Antonini, Valdair Francisco Muglia, Jorge Elias
Adrenocortical tumors (ACT) in adulthood and childhood vary in clinical, histopathological, molecular, prognostic, and imaging aspects. ACT are relatively common in adults, as adenomas are often found incidentally on imaging. ACT are rare in children, though they have a significantly higher prevalence in the south and southeast regions of Brazil. In clinical manifestation, adults with ACT present more frequently with glucocorticoid overproduction (Cushing syndrome), mineralocorticoid syndromes (Conn syndrome), or the excess of androgens in women...
February 7, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28155610/mineralocorticoid-antagonists-in-esrd-an-overview-of-their-efficacy-and-safety
#10
Panagiotis I Georgianos, Vasilios Vaios, Theodoros Eleftheriadis, Pantelis Zebekakis, Vassilios Liakopoulos
Add-on mineralocorticoid-receptor-antagonists (MRAs) spironolactone and eplerenone can enhance the cardioprotective action of angiotensin-converting-enzyme-inhibitors (ACEIs), angiotensin-receptor-blockers (ARBs) and/or β-blockers in non-dialysis patients with congestive heart failure (CHF) and reduced left ventricular (LV) ejection fraction. The efficacy and safety of MRAs among patients on chronic dialysis is less well studied. A growing body of evidence derived from small randomized studies suggests that MRA therapy may improve a number of surrogate cardiovascular (CV) risk factors (i...
February 1, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28148579/liquorice-induced-apparent-mineralocorticoid-excess-presenting-in-the-emergency-department
#11
Stuart Declan Gallacher, Georgios Tsokolas, Ioannis Dimitropoulos
A 65-year-old woman with a background of myalgic encephalitis, who was taking alternative medicines and dietary supplements, presented with hypokalaemia and hypertension. After a thorough history it became apparent that this was most likely secondary to regular consumption of liquorice tea. The patient was advised to discontinue drinking this tea and was discharged. Follow-up showed normalising blood pressure and hypokalaemia, with a normal aldosterone:renin ratio.
February 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28144958/population-pharmacokinetics-of-ly2623091-in-patients-with-hypertension-and-chronic-kidney-disease
#12
Evan B Wang, Archana Chaudhary, Timothy H Waterhouse, Gemma L Dickinson
LY2623091 is a selective, orally active, nonsteroidal, competitive mineralocorticoid receptor antagonist that blocks the actions of aldosterone and other mineralocorticoid receptor ligands at the receptor level. The aim of this work was to explore and establish a population pharmacokinetic model, quantify the degree of interindividual variability, and identify significant disease-, patient-, and study-specific covariates that alter the disposition of LY2623091. The data included concentrations from 294 healthy subjects and patients with hypertension and/or chronic kidney disease (CKD), sampled in 5 phase 1 and 2 studies...
February 1, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28131750/efficacy-of-eplerenone-in-the-management-of-mineralocorticoid-excess-in-men-with-metastatic-castration-resistant-prostate-cancer-treated-with-abiraterone-without-prednisone
#13
David Gill, David Gaston, Erin Bailey, Andrew Hahn, Sumati Gupta, Julia Batten, Anitha Alex, Kenneth Boucher, David Stenehjem, Neeraj Agarwal
BACKGROUND: Abiraterone acetate has been approved for metastatic castration-resistant prostate cancer (mCRPC). Coadministration with prednisone has been recommended to prevent the toxicity from secondary mineralocorticoid excess, such as hypertension, hypokalemia, and edema. However, the use of prednisone is often not desired by patients because of the potential for detrimental effects of long-term therapy with corticosteroids, especially in those with comorbidities such as diabetes or who have received previous immunotherapeutic agents...
January 5, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28126566/rapid-actions-of-aldosterone-revisited-receptors-in-the-limelight
#14
Martin Wehling
Steroid hormones like aldosterone have been conclusively shown to elicit both late genomic and rapid, nongenomically initiated responses. Aldosterone was among the first for which rapid, clinically relevant effects were even shown in humans. Yet, after over 30 years of research, the nature of receptors involved in rapid actions of aldosterone is still unclear. Such effects may be assigned to the classical, intracellular steroid receptors, in this case mineralocorticoid receptors (MR, class IIa action Mannheim classification)...
January 23, 2017: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/28126345/regulation-of-plasma-glucose-and-sulfate-excretion-in-pacific-hagfish-eptatretus-stoutii-is-not-mediated-by-11-deoxycortisol
#15
Alexander M Clifford, Nicolas R Bury, Aaron G Schultz, James D Ede, Brendan L Goss, Greg G Goss
The goal of this study was to identify whether Pacific hagfish (Eptatretus stoutii) possess glucocorticoid and mineralocorticoid responses and to examine the potential role(s) of four key steroids in these responses. Pacific hagfish were injected with varying amounts of cortisol, corticosterone or 11-deoxycorticosterone (DOC) using coconut oil implants and plasma glucose and gill total-ATPase activity were monitored as indices of glucocorticoid and mineralocorticoid responses. Furthermore, we also monitored plasma glucose and 11-deoxycortisol (11-DOC) levels following exhaustive stress (30 min of agitation) or following repeated infusion with SO4(2-)...
January 23, 2017: General and Comparative Endocrinology
https://www.readbyqxmd.com/read/28121843/apparent-mineralocorticoid-excess-caused-by-a-novel-mutation-in-11%C3%AE-hydroxysteroid-dehydrogenase-type-2-gene
#16
Yue Wang, Linqiang Ma, Xiaoyu Shu, Jiayu Li, Jinbo Hu, Kai P Law, Ting Luo, Richa Goswami, Shumin Yang, Suhua Zhang, Qifu Li
No abstract text is available yet for this article.
March 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28118280/low-dose-eplerenone-decreases-left-ventricular-mass-in-treatment-resistant-hypertension
#17
Andreas Schneider, Johannes Schwab, Marina V Karg, Tatjana Kalizki, Annemarie Reinold, Ingrid Bär, Markus P Schneider, Roland E Schmieder, Bernhard M W Schmidt
BACKGROUND: Mineralocorticoid receptor antagonists are increasingly used in patients with treatment-resistant hypertension (TRH). There is experimental evidence for blood pressure (BP) independent effects of mineralocorticoid receptor blockade on cardiovascular target organ damage. We hypothesized that low-dose eplerenone (50 mg) will reduce left ventricular mass (LVM) beyond its BP-lowering effects. METHODS: We performed a randomized, double-blind, placebo-controlled, parallel group study in 51 patients with TRH...
January 23, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28115063/mineralocorticoid-receptor-blockade-for-prevention-of-acute-kidney-injury-an-elusive-target
#18
EDITORIAL
Daphna Bar-Nur, Bertrand L Jaber
No abstract text is available yet for this article.
February 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28110567/-hungarian-heart-failure-registry-2015-2016-preliminary-results
#19
Noémi Nyolczas, Krisztina Heltai, Attila Borbély, Tamás Habon, Zoltán Járai, Erzsébet Sziliczei, Péter Stadler, Réka Faludi, Béla Herczeg, Előd Papp, Ferenc Lakatos, Katalin Nagy, András Katona, Imre Kovács, János Tomcsányi, András Nagy, Róbert Sepp
Heart failure is associated with a poor prognosis despite significant advances in the pharmacological and device therapy and incurs very high cost because of frequent hospitalizations. Therefore, professional high-quality care is essential for both patients and the healthcare system. The best way to evaluate the quality of care for a particular disease is the use of disease-specific registries. Until now, there has not been a registry evaluating characteristics and management of heart failure patients in Hungary...
January 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28107779/effects-of-mineralocorticoid-receptor-antagonists-on-the-progression-of-diabetic-nephropathy
#20
Li-Jing Sun, Yan-Ni Sun, Jian-Ping Shan, Geng-Ru Jiang
AIMS: We aimed to evaluate the potential benefits and adverse effects of adding a mineralocorticoid receptor antagonist (MRA) to angiotensin converting enzyme inhibitors (ACEI) and/or angiotensin receptor blockers (ARB), as standard treatment in patients with DN. MATERIALS AND METHODS: We scanned the Embase, PubMed, and Cochrane Central Register of Controlled Trials databases for human clinical trials published in English until June 2016, evaluating renal outcomes in patients with DN...
January 20, 2017: Journal of Diabetes Investigation
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