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https://www.readbyqxmd.com/read/28918446/favorable-surgical-outcomes-of-aldosterone-producing-adenoma-based-on-lateralization-by-ct-imaging-and-hypokalemia-a-non-avs-based-strategy
#1
Hai Li, Jianbin Liu, Xiujuan Feng, Liehua Liu, Guohong Wei, Xiaopei Cao, Yanbing Li
PURPOSE: To test the efficacy of a strategy based on CT imaging and clinical characteristics on lateralizing origin of excess aldosterone secretion in primary aldosteronism. PATIENTS AND METHODS: Consecutive patients with diagnosed primary hyperaldosteronism from June 2006 to July 2012 in our center underwent adrenal surgeries without pre-operational adrenal venous sampling (AVS) if all the three criteria were met: (1) round- or oval-shaped occupational lesion of low density after contrast enhancement with diameter >1 cm on CT scan was located in one adrenal gland; (2) unequivocally normal contralateral adrenal gland; (3) serum potassium level lower than 3...
September 16, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28918310/effect-of-eplerenone-on-markers-of-bone-turnover-in-patients-with-primary-hyperparathyroidism-the-randomized-placebo-controlled-epath-trial
#2
Nicolas Verheyen, Martin R Grübler, Andreas Meinitzer, Christian Trummer, Verena Schwetz, Karin Amrein, Hans P Dimai, Winfried März, Cristiana Catena, Dirk von Lewinski, Jakob Voelkl, Ioana Alesutan, Astrid Fahrleitner-Pammer, Helmut Brussee, Stefan Pilz, Andreas Tomaschitz
Mineralocorticoid receptor (MR) antagonism may affect bone turnover via direct and indirect pathways involving parathyroid hormone, but randomized controlled trials are lacking. In a pre-specified analysis of the "Eplerenone in primary hyperparathyroidism" placebo-controlled, randomized trial (ISRCTN 33941607), effects of eight weeks MR-blockade with eplerenone on bone turnover markers in 97 patients with primary hyperparathyroidism were tested. Mean age was 67.5±9.5years, and 76 (78.4%) were females. In analysis of covariance with adjustment for baseline values, eplerenone had no significant effect on isoform 5b of the tartrate-resistant acid phosphatase (TRAP), beta-crosslaps, N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin and bone-specific alkaline phosphatase...
September 13, 2017: Bone
https://www.readbyqxmd.com/read/28915854/medical-therapy-following-hospitalization-for-heart-failure-with-reduced-ejection-fraction-and-association-with-discharge-to-long-term-care-a-cross-sectional-analysis-of-the-reasons-for-geographic-and-racial-differences-in-stroke-regards-population
#3
Emily B Levitan, Melissa K Van Dyke, Ligong Chen, Raegan W Durant, Todd M Brown, J David Rhodes, Olusola Olubowale, Oluwole Muyiwa Adegbala, Meredith L Kilgore, Justin Blackburn, Karen C Albright, Monika M Safford
BACKGROUND: Less intensive treatment for heart failure with reduced ejection fraction (HFrEF) may be appropriate for patients in long-term care settings because of limited life expectancy, frailty, comorbidities, and emphasis on quality of life. METHODS: We compared treatment patterns between REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants discharged to long-term care versus home following HFrEF hospitalizations. We examined medical records and Medicare pharmacy claims for 147 HFrEF hospitalizations among 80 participants to obtain information about discharge disposition and medication prescriptions and fills...
September 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28915330/impact-of-adrenal-steroids-on-regulation-of-adipose-tissue
#4
Marco Infante, Andrea Armani, Caterina Mammi, Andrea Fabbri, Massimiliano Caprio
Corticosteroids are secreted by the adrenal glands and control the functions of adipose tissue via the activation of mineralocorticoid receptor (MR) and glucocorticoid receptor (GR). In turn, adipocytes release a large variety of adipokines into the bloodstream, regulating the function of several organs and tissues, including the adrenal glands, hereby controlling corticosteroid production. In adipose tissue, the activation of the MR by glucocorticoids (GC) and aldosterone affects important processes such as adipocyte differentiation, oxidative stress, autophagic flux, adipokine expression as well as local production of GC through upregulation of the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1)...
September 12, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/28913500/neuroendocrine-stress-response-implications-for-cardiac-surgery-associated-acute-kidney-injury
#5
REVIEW
J Mauricio Del Rio, Alina Nicoara, Madhav Swaminathan
Surgical stress causes biochemical and physiologic perturbations of every homeostatic axis. These alterations include volume/baroreceptor regulation, sympathetic activation, parasympathetic suppression, neuroendocrine activation, acute phase response protein synthesis and secretion, immune response modulation and long-term behavioral adaptation. The kidney is central to the stress response because of its main role in the maintenance of water, electrolyte balance and hence, intracellular and extracellular compartments, including the intravascular volume...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28905546/-hypertension-in-people-of-african-descent
#6
Fabien Cane, Sofia Zisimopoulou, Antoinette Pechère-Bertschi
Hypertension in people of African descent presents an increased prevalence, an earlier and more severe target organ damage and is harder to control compared to other ethnicities. Preeclampsia and gestational hypertension are more frequent in black women. The physiological phenomenon of night time blood pressure dipping is often blunted. The low renin hypertension phenotype seems to be caused by an increase in sodium retention at renal level. The treatment of choice is calcium channel blockers and thiazide diuretics along with a renin-angiotensin-aldosterone blocker for kidney protection...
September 13, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28904869/high-glucose-stimulates-expression-of-aldosterone-synthase-cyp11b2-and-secretion-of-aldosterone-in-human-adrenal-cells
#7
Hiroki Shimada, Naotaka Kogure, Erika Noro, Masataka Kudo, Kaori Sugawara, Ikuko Sato, Kyoko Shimizu, Makoto Kobayashi, Dai Suzuki, Rehana Parvin, Takako Saito-Ito, Akira Uruno, Akiko Saito-Hakoda, William E Rainey, Sadayoshi Ito, Atsushi Yokoyama, Akira Sugawara
Aldosterone synthase is the key rate-limiting enzyme in adrenal aldosterone production, and induction of its gene (CYP11B2) results in the progression of hypertension. As hypertension is a frequent complication among patients with diabetes, we set out to elucidate the link between diabetes mellitus and hypertension. We examined the effects of high glucose on CYP11B2 expression and aldosterone production using human adrenal H295R cells and a stable H295R cell line expressing a CYP11B2 5'-flanking region/luciferase cDNA chimeric construct...
September 2017: FEBS Open Bio
https://www.readbyqxmd.com/read/28904081/variable-setpoint-as-a-relaxing-component-in-physiological-control
#8
Geir B Risvoll, Kristian Thorsen, Peter Ruoff, Tormod Drengstig
Setpoints in physiology have been a puzzle for decades, and especially the notion of fixed or variable setpoints have received much attention. In this paper, we show how previously presented homeostatic controller motifs, extended with saturable signaling kinetics, can be described as variable setpoint controllers. The benefit of a variable setpoint controller is that an observed change in the concentration of the regulated biochemical species (the controlled variable) is fully characterized, and is not considered a deviation from a fixed setpoint...
September 2017: Physiological Reports
https://www.readbyqxmd.com/read/28904009/diagnosis-of-endocrine-disease-18-oxocortisol-and-18-hydroxycortisol-is-there-clinical-utility-of-these-steroids
#9
Jacques Lenders, Tracy A Williams, Martin Reincke, Celso E Gomez-Sanchez
Since the early nineteen eighties 18-hydroxycortisol and 18-oxocortisol have attracted attention when it was shown that the urinary excretion of these hybrid steroids was increased in primary aldosteronism. The development and more widespread use of specific assays has improved the understanding of their role in the (patho)physiology of adrenal disorders. The adrenal site of synthesis is not fully understood although it is clear that for the synthesis of 18-hydroxycortisol and 18-oxocortisol the action of both aldosterone synthase (zona glomerulosa) and 17α-hydroxylase (zona fasciculata) is required with cortisol as main substrate...
September 13, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28902663/aldosterone-induces-left-ventricular-subclinical-systolic-dysfunction-a-strain-imaging-study
#10
Zheng-Wei Chen, Kuan-Chih Huang, Jen-Kuang Lee, Lung-Chun Lin, Ching-Way Chen, Yi-Yao Chang, Che-Wei Liao, Vin-Cent Wu, Chi-Shen Hung, Yen-Hung Lin
BACKGROUND: Primary aldosteronism is associated with a higher incidence of left ventricular (LV) hypertrophy and diastolic dysfunction than essential hypertension. However, systolic function via endocardial measurements is similar between patients with primary aldosteronism and essential hypertension. Speckle-tracking echocardiography is a sensitive tool which can detect subclinical impairments in systolic function. The aim of this study was to investigate aldosterone-induced subclinical impairments in systolic function...
September 11, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28902380/-organ-interactions-heart-and-kidney
#11
Daniel Salleck, Stefan John
The interactions between heart and kidney are various and of clinical relevance. Worsening of one organ often influences the function of the other. With NYHA and KDIGO we have classification systems for heart and kidney failure and those should be used for cardiorenal systems as well. Furthermore there is a useful classification system for cardiorenal syndromes itself. Cardiorenal syndrome is a complex illness which should be treated by interdisciplinary medical teams. A key roll in pathophysiology is the renin-angiotensin-aldosteron-system (RAAS)...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28900153/genetic-ablation-of-fgf23-or-klotho-does-not-modulate-experimental-heart-hypertrophy-induced-by-pressure-overload
#12
Svetlana Slavic, Kristopher Ford, Magalie Modert, Amarela Becirovic, Stephan Handschuh, Andreas Baierl, Nejla Katica, Ute Zeitz, Reinhold G Erben, Olena Andrukhova
Left ventricular hypertrophy (LVH) ultimately leads to heart failure in conditions of increased cardiac pre- or afterload. The bone-derived phosphaturic and sodium-conserving hormone fibroblast growth factor-23 (FGF23) and its co-receptor Klotho have been implicated in the development of uremic LVH. Using transverse aortic constriction (TAC) in gene-targeted mouse models, we examine the role of Fgf23 and Klotho in cardiac hypertrophy and dysfunction induced by pressure overload. TAC profoundly increases serum intact Fgf23 due to increased cardiac and bony Fgf23 transcription and downregulation of Fgf23 cleavage...
September 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28900121/dominance-of-the-hypothalamus-pituitary-adrenal-axis-over-the-renin-angiotensin-aldosterone-system-is-a-risk-factor-for-decreased-insulin-secretion
#13
Makoto Daimon, Aya Kamba, Hiroshi Murakami, Satoru Mizushiri, Sho Osonoi, Kota Matsuki, Eri Sato, Jutaro Tanabe, Shinobu Takayasu, Yuki Matsuhashi, Miyuki Yanagimachi, Ken Terui, Kazunori Kageyama, Itoyo Tokuda, Shizuka Kurauchi, Shigeyuki Nakaji
How the association between the hypothalamus-pituitary-adrenal (HPA) axis and the renin-angiotensin-aldosterone system (RAAS) affects glucose metabolism were not well examined in a general population. Participants of the population-based 2015 Iwaki study were enrolled (n: 1,016; age: 54.4 ± 15.1 years). Principal component (PC) analysis identified two PCs: PC1 represented levels of the HPA axis (serum cortisol) and the RAAS (plasma aldosterone) as a whole, and PC2 represented the HPA axis relative to the RAAS (HPA axis dominance)...
September 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28894201/cortisol-overproduction-results-from-dna-methylation-of-cyp11b1-in-hypercortisolemia
#14
Mitsuhiro Kometani, Takashi Yoneda, Masashi Demura, Hiroshi Koide, Koshiro Nishimoto, Kuniaki Mukai, Celso E Gomez-Sanchez, Tadayuki Akagi, Takashi Yokota, Shin-Ichi Horike, Shigehiro Karashima, Isamu Miyamori, Masakazu Yamagishi, Yoshiyu Takeda
Adrenocortical hormone excess, due to primary aldosteronism (PA) or hypercortisolemia, causes hypertension and cardiovascular complications. In PA, hypomethylation of aldosterone synthase (CYP11B2) is associated with aldosterone overproduction. However, in hypercortisolemia, the role of DNA methylation of 11β-hydroxylase (CYP11B1), which catalyzes cortisol biosynthesis and is highly homologous to CYP11B2, is unclear. The aims of our study were to determine whether the CYP11B1 expression was regulated through DNA methylation in hypercortisolemia with cortisol-producing adenoma (CPA), and to investigate a possible relationship between DNA methylation and somatic mutations identified in CPA...
September 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28893861/adrenal-venous-sampling-for-primary-aldosteronism-laboratory-medicine-best-practice
#15
Gregory Kline, Daniel T Holmes
Primary aldosteronism (PA) is the most common form of secondary hypertension and is critical to identify because when caused by an aldosterone-producing adenoma (APA) or another unilateral form, it is potentially curable, and even when caused by bilateral disease, antihypertensives more specific to PA treatment can be employed (ie, aldosterone antagonists). Identification of unilateral forms is not generally accomplished with imaging because APAs may be small and elude detection, and coincidental identification of a non-functioning incidentaloma contralateral to an APA may lead to removal of an incorrect gland...
September 11, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28892958/correlation-of-serum-prolactin-level-to-child-pugh-scoring-system-in-cirrhosis-of-liver
#16
Chaitanya H Balakrishnan, H Rajeev
INTRODUCTION: With the growing incidence of liver cirrhosis among Asians, the use of a biomarker such as prolactin, indicates the severity of the disease, its complications and serves as a tool for early intervention. AIM: To compare the efficacy of serum prolactin to the Child Pugh scoring system in cirrhosis of the liver and establish that serum prolactin is an early marker for complications of cirrhosis of the liver. MATERIALS AND METHODS: This was a comparative study on 60 patients admitted to the Department of General Medicine, KIMS from June 2014 to November 2015...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28889455/management-of-primary-aldosteronism-in-patients-with-adrenal-hemorrhage-following-adrenal-vein-sampling-a-brief-review-with-illustrative-cases
#17
REVIEW
Fady Hannah-Shmouni, Andrew Demidowich, Beatriz Rizkallah Alves, Gabriela Dockhorn Paluch, Dionysiou Margarita, Charalampos Lysikatos, Elena Belyavskaya, Richard Chang, Constantine A Stratakis
The authors describe the clinical investigation of two cases of primary aldosteronism with adrenal hemorrhage (AH) following adrenal vein sampling. A literature review was conducted regarding the medical management of primary aldosteronism in patients with AH following adrenal vein sampling. Guidelines on the management of primary aldosteronism with AH following adrenal vein sampling are lacking. The two patients were followed with serial imaging to document resolution of AH and treated medically with excellent blood pressure response...
September 9, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28887369/genetic-mechanisms-of-human-hypertension-and-their-implications-for-blood-pressure-physiology
#18
Eric Seidel, Ute I Scholl
Hypertension, or elevated blood pressure, constitutes a major public health burden that affects more than 1 billion people worldwide and contributes to about 9 million deaths annually. Hereditary factors are thought to contribute to up to 50% of interindividual blood pressure variability. Blood pressure in the general population approximately shows a normal distribution and is thought to be a polygenic trait. In rare cases, early-onset hypertension or hypotension are inherited as Mendelian traits. The identification of the underlying Mendelian genes and variants has contributed to our understanding of the physiology of blood pressure regulation, emphasizing renal salt handling and the renin angiotensin aldosterone system as players in the determination of blood pressure...
September 8, 2017: Physiological Genomics
https://www.readbyqxmd.com/read/28883863/the-evolution-of-natriuretic-peptide-augmentation-in-management-of-heart-failure-and-the-role-of-sacubitril-valsartan
#19
Srikanth Yandrapalli, Wilbert S Aronow, Pratik Mondal, David R Chabbott
Heart failure (HF) is one of the leading causes of morbidity, mortality, and health care expenditures in the US and worldwide. For three decades, the pillars of treatment of HF with reduced ejection fraction (HFrEF) were medications that targeted the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone system (RAAS). Prior attempts to augment the natriuretic peptide system (NPS) for the management of HF failed either due to lack of significant clinical benefit or due to the unacceptable side effect profile...
August 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28879651/preliminary-studies-on-the-differential-expression-of-adrenocorticotropic-hormone-receptor-in-adrenal-adenomas
#20
Dongliang Hu, Tongzu Liu, Xinghuan Wang
INTRODUCTION: The ACTH receptor (ACTHR) is primarily expressed in the adrenal cortex. Previous studies focused on the regulatory function of ACTHR in glucocorticoid secretion, but research on adrenal tumours is rare. The aim of this study was to evaluate ACTHR expression in common adrenal adenomas and investigate its influence on adrenal tumorigenesis using adrenocortical H295R cells. MATERIALS AND M: ETHODS: Real-time polymerase chain reaction and western blot were used to detect the expression of ACTHR in 18 aldosterone-producing adenomas, 16 cortisol-producing adenomas, nine non-functional adenomas, and 12 normal adrenal samples...
September 7, 2017: Endokrynologia Polska
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