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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/28915848/anemia-in-severe-heart-failure-patients-does-it-predict-prognosis
#2
Tamrat Befekadu Abebe, Eyob Alemayehu Gebreyohannes, Akshaya Srikanth Bhagavathula, Yonas Getaye Tefera, Tadesse Melaku Abegaz
BACKGROUND: Anemia is highly prevalent in heart failure (HF) patients. However, the prevalence, clinical impact and prognostic factor of anemia in heart failure patients is widely varies. The aim of this study was to evaluate the prevalence of anemia in patients with HF, to compare baseline clinical characteristic and outcomes of severe HF patients with and without anemia admitted to Gondar University Referral Hospital (GURH), Gondar, Ethiopia. METHOD: A retrospective cohort study was conducted and we assessed medical records of heart failure patients who were admitted Gondar University Referral Hospital in the period between December 02, 2010 and November 30, 2016...
September 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28912358/combined-oral-contraceptives-plus-spironolactone-compared-with-metformin-in-women-with-polycystic-ovary-syndrome-a-one-year-randomized-clinical-trial
#3
Macarena Alpañés, Francisco Álvarez-Blasco, Elena Fernández-Durán, Manuel Luque-Ramírez, Héctor F Escobar-Morreale
OBJECTIVE: We aimed to compare a combined oral contraceptive (COC) plus the antiandrogen spironolactone with the insulin sensitizer metformin in women with polycystic ovary syndrome (PCOS). DESIGN: We conducted a randomized, parallel, open-label, clinical trial comparing COC (30 μg of ethinylestradiol and 150 μg of desogestrel) plus spironolactone (100 mg/day) with metformin (850 mg b.i.d.) for one year in women with PCOS (EudraCT2008-004531-38). METHODS: The composite primary outcome included efficacy (amelioration of hirsutism, androgen excess and menstrual dysfunction) and cardiometabolic safety (changes in the frequencies of disorders of glucose tolerance, dyslipidemia and hypertension)...
November 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28905546/-hypertension-in-people-of-african-descent
#4
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/28900153/genetic-ablation-of-fgf23-or-klotho-does-not-modulate-experimental-heart-hypertrophy-induced-by-pressure-overload
#5
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/28898436/letter-to-liu-et%C3%A2-al-2017-article
#6
Richard S Legro
I was intrigued to see the recent trial of Liu et al(1) reporting the benefits of exenatide over metformin in terms of weight loss and pregnancy rate in women with polycystic ovary syndrome. I am writing to clarify the discrepancies between the trial as registered and the trial as reported in the manuscript. According to the trial registration on the Chinese Clinical Trial Registration Site (ChiCTR-IIR-16008084) the trial was a three armed trial for exenatide, metformin, or spironolactone. This article is protected by copyright...
September 12, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28889825/enhancement-of-diuresis-with-metolazone-in-infant-paediatric-cardiac-intensive-care-patients
#7
Russell T Wise, Brady S Moffett, Ayse Akcan-Arikan, Marianne Galati, Natasha Afonso, Paul A Checchia
BACKGROUND: Few data are available regarding the use of metolazone in infants in cardiac intensive care. Researchers need to carry out further evaluation to characterise the effects of this treatment in this population. METHODS: This is a descriptive, retrospective study carried out in patients less than a year old. These infants had received metolazone over a 2-year period in the paediatric cardiac intensive care unit at our institution. The primary goal was to measure the change in urine output from 24 hours before the start of metolazone therapy to 24 hours after...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28888268/a-randomized-multicenter-open-label-blinded-end-point-trial-comparing-the-effects-of-spironolactone-to-chlorthalidone-on-left-ventricular-mass-in-patients-with-early-stage-chronic-kidney-disease-rationale-and-design-of-the-spiro-ckd-trial
#8
Manvir K Hayer, Nicola C Edwards, Gemma Slinn, William E Moody, Rick P Steeds, Charles J Ferro, Anna M Price, Cecilio Andujar, Mary Dutton, Rachel Webster, David J Webb, Scott Semple, Iain MacIntyre, Vanessa Melville, Ian B Wilkinson, Thomas F Hiemstra, David C Wheeler, Anna Herrey, Margaret Grant, Samir Mehta, Natalie Ives, Jonathan N Townend
BACKGROUND: Chronic kidney disease (CKD) is associated with increased left ventricular (LV) mass and arterial stiffness. In a previous trial, spironolactone improved these end points compared with placebo in subjects with early-stage CKD, but it is not known whether these effects were specific to the drug or secondary to blood pressure lowering. AIM: The aim was to investigate the hypothesis that spironolactone is superior to chlorthalidone in the reduction of LV mass while exerting similar effects on blood pressure...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28882798/modulatory-in-vitro-effect-of-stress-hormones-on-the-cytokine-response-of-rainbow-trout-and-gilthead-sea-bream-head-kidney-stimulated-with-vibrio-anguillarum-bacterin
#9
Ali Reza Khansari, David Parra, Felipe E Reyes-López, Lluís Tort
In fish, the stress response and their consequences in the immune system have been widely described. Recently, a differential cytokine regulation between rainbow trout (Oncorhynchus mykiss) and gilthead sea bream (Sparus aurata) was reported after treatment with stress hormones together with their receptor antagonists. Nevertheless, there is no evidence of whether antagonists for stress hormone receptors may influence the interaction between hormones and cytokines after bacterial administration. Thus, the aim of our study was to evaluate the cytokine expression in the presence of stress hormones (cortisol, ACTH, adrenaline), hormone receptor antagonists and inactivated Vibrio anguillarum bacterin in rainbow trout and gilthead sea bream head kidney primary cell culture (HKPCC)...
September 4, 2017: Fish & Shellfish Immunology
https://www.readbyqxmd.com/read/28880055/resistant-hypertension-an-overview
#10
Roberto Pedrinelli, Giulia Dell' Omo, Giuseppe Ambrosio, Matteo Cameli, Elisabetta Cerbai, Stefano Coiro, Michele Emdin, Riccardo Liga, Rossella Marcucci, Doralisa Morrone, Alberto Palazzuoli, Luigi Padeletti, Ketty Savino
Despite the availability of anti-hypertensive medications with proven efficacy and good tolerability, many hypertensive patients have blood pressure levels(BP) not at the goals set by international societies. Some of these patients are either non-adherent to the prescribed drugs or not optimally treated. However, a proportion, despite adequate treatment, has resistant hypertension(RH) defined as office BP above goal despite the use of ≥3 antihypertensive medications at maximally tolerated doses (one ideally being a diuretic)...
September 5, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28874460/citric-acid-metabolism-in-resistant-hypertension-underlying-mechanisms-and-metabolic-prediction-of-treatment-response
#11
Marta Martin-Lorenzo, Paula J Martinez, Montserrat Baldan-Martin, Gema Ruiz-Hurtado, Jose Carlos Prado, Julian Segura, Fernando de la Cuesta, Maria G Barderas, Fernando Vivanco, Luis Miguel Ruilope, Gloria Alvarez-Llamas
Resistant hypertension (RH) affects 9% to 12% of hypertensive adults. Prolonged exposure to suboptimal blood pressure control results in end-organ damage and cardiovascular risk. Spironolactone is the most effective drug for treatment, but not all patients respond and side effects are not negligible. Little is known on the mechanisms responsible for RH. We aimed to identify metabolic alterations in urine. In addition, a potential capacity of metabolites to predict response to spironolactone was investigated...
September 5, 2017: Hypertension
https://www.readbyqxmd.com/read/28868032/spironolactone-for-secondary-central-serous-chorioretinopathy-a-challenge-rechallenge-case
#12
Kapil G Kapoor, Jennifer Sim
Central serous chorioretinopathy (CSCR) is potentially sight-threatening and has been associated with corticosteroid use. CSCR secondary to steroid use can sometimes be challenging to treat, especially if continuing steroid use is medically necessary. In this case report we demonstrate the efficacy of spironolactone as an effective agent in countering CSCR secondary to steroid use. This challenge-rechallenge case may be helpful to clinicians in delineating a treatment paradigm for these patients.
May 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28862134/adult-female-acne-treated-with-spironolactone-a-retrospective-data-review-of-70-cases
#13
Anne Isvy-Joubert, Jean-Michel Nguyen, Aurélie Gaultier, Mélanie Saint-Jean, Marie Le Moigne, Elodie Boisrobert, Amir Khammari, Brigitte Dreno
The prevalence of acne in the adult population is increasing, particularly in women. Spironolactone regulates sebaceous gland activity by blocking androgen receptor. To evaluate retrospectively the efficacy of spironolactone in women with acne. Data from 70 women of at least 20 years, treated for their acne between 2010 and 2015 with low-dose spironolactone (≤150 mg/day), were analysed. Remission was defined by the number of retentional lesions inferior or equal to five and inflammatory lesions inferior or equal to two on the face...
August 1, 2017: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/28844072/update-in-diagnosis-and-management-of-primary-aldosteronism
#14
REVIEW
Sofia M Dick, Marina Queiroz, Bárbara L Bernardi, Angélica Dall'Agnol, Letícia A Brondani, Sandra P Silveiro
Primary aldosteronism (PA) is a group of disorders in which aldosterone is excessively produced. These disorders can lead to hypertension, hypokalemia, hypervolemia and metabolic alkalosis. The prevalence of PA ranges from 5% to 12% around the globe, and the most common causes are adrenal adenoma and adrenal hyperplasia. The importance of PA recognition arises from the fact that it can have a remarkably adverse cardiovascular and renal impact, which can even result in death. The aldosterone-to-renin ratio (ARR) is the election test for screening PA, and one of the confirmatory tests, such as oral sodium loading (OSL) or saline infusion test (SIT), is in general necessary to confirm the diagnosis...
August 28, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28839438/efficacy-of-tolvaptan-for-the-patients-with-advanced-hepatocellular-carcinoma
#15
Masayuki Miyazaki, Masayoshi Yada, Kosuke Tanaka, Takeshi Senjyu, Takeshi Goya, Kenta Motomura, Motoyuki Kohjima, Masaki Kato, Akihide Masumoto, Kazuhiro Kotoh
AIM: To investigate the factors influenced the efficacy of tolvaptan (TLV) in liver cirrhosis. METHODS: We retrospectively enrolled 61 consecutive patients with refractory hepatic ascites. All of them had been treated with furosemide and spironolactone before admission, and treated with TLV for 7 d in our hospital. The effect of TLV was defined by the rate of body weight loss, and the factors that influenced TLV efficacy were analyzed using multiple regression. RESULTS: Coexistent hepatocellular carcinoma (HCC) was the only significant predictive variable that attenuated the efficacy of TLV...
August 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28822828/targeted-lowering-of-central-blood-pressure-in-patients-with-hypertension-baseline-recruitment-rationale-and-design-of-a-randomized-controlled-trial-the-low-cbp-study
#16
James E Sharman, Tony Stanton, Christopher M Reid, Anthony Keech, Philip Roberts-Thomson, Simon Stewart, Robert Greenough, Michael Stowasser, Walter P Abhayaratna
BACKGROUND: High blood pressure (BP) is the most common modifiable cause of death from cardiovascular disease. Lowering BP with medication improves patient outcomes, but even in populations with normal upper arm (brachial) BP there remains considerable residual risk for cardiovascular disease and this may be due to persistently elevated central BP. There has never been a trial to determine the value of targeted central BP lowering among patients with hypertension, and this was the aim of this study...
August 16, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28814143/ly3045697-results-from-two-randomized-clinical-trials-of-a-novel-inhibitor-of-aldosterone-synthase
#17
Joanne Sloan-Lancaster, Eyas Raddad, Amy Flynt, Yan Jin, James Voelker, Jeffrey W Miller
INTRODUCTION: LY3045697 is a potent and selective aldosterone synthase (CYP11B2) inhibitor that was developed as a safer alternative to mineralocorticoid receptor antagonists. Effects of LY3045697 on aldosterone and cortisol synthesis, as well as potassium ion homeostasis, were evaluated in two clinical studies in healthy subjects. MATERIALS AND METHODS: Two incomplete, placebo-controlled crossover-design clinical studies examined safety, pharmacodynamics, and pharmacokinetics under single and repeated dose conditions in healthy subjects...
July 2017: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/28811691/association-of-prooxidant-antioxidant-balance-with-clinical-and-laboratory-parameters-and-its-relation-to-different-drug-regimens-in-polycystic-ovary-syndrome-women-with-normal-bmi
#18
Niloofar Heshmati, Shoaleh Shahgheibi, Bahram Nikkhoo, Sabrieh Amini, Mohammad Abdi
Polycystic ovarian syndrome is one of the most common hormonally leading cause infertility disorders. The effect of oxidant-antioxidant imbalance on disease progression has been studied in many disorders. The present study was aimed to evaluate prooxidant-antioxidant balance (PAB) in patients with polycystic ovarian syndrome compared to healthy subjects. We also studied the possible effect of treatment with available drugs on serum PAB. In this case-control study 100 polycystic ovary syndrome (PCOS) patients and 100 healthy individuals were enrolled in the study...
July 2017: Indian Journal of Clinical Biochemistry: IJCB
https://www.readbyqxmd.com/read/28801620/a-novel-aldosterone-antagonist-limits-renal-injury-in-5-6-nephrectomy
#19
Clarice K Fujihara, M C Kowala, M D Breyer, Claudia R Sena, Mariliza V Rodrigues, Simone C A Arias, Camilla Fanelli, Denise M Malheiros, P K Jadhav, Chahrzad Montrose-Rafizadeh, Jose E Krieger, Roberto Zatz
Aldosterone antagonists slow the progression of chronic kidney disease (CKD), but their use is limited by hyperkalemia, especially when associated with RAS inhibitors. We examined the renoprotective effects of Ly, a novel non-steroidal mineralocorticoid receptor (MR) blocker, through two experimental protocols: In Protocol 1, male Munich-Wistar rats underwent 5/6 renal ablation (Nx), being divided into: Nx+V, receiving vehicle, Nx+Eple, given eplerenone, 150 mg/kg/day, and Nx+Ly, given Ly, 20 mg/kg/day...
August 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28797006/amiloride-is-effective-in-the-management-of-abiraterone-induced-mineralocorticoid-excess-syndrome-without-interfering-with-its-antineoplastic-activity
#20
Francesca Bedussi, Diego Galli, Martina Fragni, Francesca Valcamonico, Elisa Rossini, Alberto Dalla Volta, Sara Vezzoli, Elisa Roca, Vittorio Ferrari, Barbara Lazzari, Maurizio Memo, Sandra Sigala, Alfredo Berruti
BACKGROUND: The administration of abiraterone acetate (abiraterone) leads to an adrenocorticotropic hormone (ACTH)-driven increase in mineralocorticoid hormones, requiring glucocorticoid supplementation that may stimulate the growth of prostate cancer (PCa). Amiloride is a drug that selectively reduces the aldosterone-sensitive Na+/K+ exchange and could be effective in the management of mineralocorticoid excess syndrome (MCES). METHODS: The efficacy of amiloride + hydrochlorothiazide (HCT) in the clinical management of abiraterone-induced MCES was assessed in 5 consecutive patients with castration-resistant PCa (CRPC)...
August 11, 2017: Pharmacology
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