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https://www.readbyqxmd.com/read/29148144/systolic-blood-pressure-and-cardiovascular-outcomes-in-heart-failure-with-preserved-ejection-fraction-an-analysis-of-the-topcat-trial
#1
Senthil Selvaraj, Brian Claggett, Sanjiv J Shah, Inder Anand, Jean L Rouleau, Akshay S Desai, Eldrin F Lewis, Bertram Pitt, Nancy K Sweitzer, Marc A Pfeffer, Scott D Solomon
AIMS: Recent guidelines have advocated for stricter systolic blood pressure (SBP) control in heart failure with preserved ejection fraction (HFpEF), though data regarding the optimal SBP in HFpEF are sparse. METHODS AND RESULTS: We analysed participants from the Americas from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study with available baseline and 8-week visit SBP data (n = 1645). We related baseline SBP to several efficacy and safety outcomes...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29144822/testosterone-levels-achieved-by-medically-treated-transgender-women-in-a-united-states-endocrinology-clinic-cohort
#2
Jennifer J Liang, Divya Jolly, Kelly J Chan, Joshua D Safer
OBJECTIVE: Most transgender women depend on medical treatment alone to lower testosterone levels in order to align physical appearance with gender identity. The medical regimen in the United States typically includes spironolactone and estrogens. The purpose of this cross-sectional study was to assess the testosterone suppression achieved among transgender women treated with spironolactone and estrogens. METHODS: Testosterone and estradiol levels were extracted from the electronic medical records of 98 anonymized transgender women treated with oral spironolactone and oral estrogen therapy at the Endocrinology Clinic at Boston Medical Center...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29137066/a-coronary-artery-fistula-having-connection-between-2-coronary-arteries-and-the-left-ventricle-a-case-report
#3
Chang-Yeon Kim, Ji Yong Choi, Kee Sik Kim
RATIONALE: Cases of coronary artery fistula having a connection with the cardiac cavity are rare. Here, we report a case in which 2 coronary arteries empty into the left ventricular cavity together. PATIENT CONCERNS: A 63-year-old woman who was diagnosed as having hypertension 20 years prior presented with dyspnea. DIAGNOSES: The coronary angiography revealed coronary artery fistula. INTERVENTIONS: Chest X-ray showed pulmonary edema...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29132462/-familial-male-limited-precocious-puberty-due-to-asp578his-mutations-in-the-lhcgr-gene-clinical-characteristics-and-gene-analysis-in-an-infant
#4
Min Wang, Min Li, Yue-Sheng Liu, Si-Min Lei, Yan-Feng Xiao
The aim of the study was to provide a descriptive analysis of familial male-limited precocious puberty (FMPP), which is a rare inherited disease caused by heterozygous constitutively activating mutations of the luteinizing hormone/choriogonadotropin receptor gene (LHCGR). The patient was a ten-month-old boy, presenting with penile enlargement, pubic hair formation, and spontaneous erections. Based on the clinical manifestations and laboratory data, including sexual characteristics, serum testosterone levels, GnRH stimulation test, and bone age, this boy was diagnosed with peripheral precocious puberty...
November 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29126194/central-and-peripheral-slow-pressor-mechanisms-contributing-to
#5
Jiao Lu, Hong-Wei Wang, Monir Ahmad, Marzieh Keshtkar-Jahromi, Mordecai P Blaustein, John Hamlyn, Frans H H Leenen
Aims: High salt intake markedly enhances hypertension induced by angiotensin II (Ang II). We explored central and peripheral slow-pressor mechanisms which may be activated by Ang II and salt. Methods and Results: In Protocol I, Wistar rats were infused subcutaneously with low- dose Ang II (150 ng/kg/min) and fed regular (0.4%) or high salt (2%) diet for 14 days. In Protocol II, Ang II -high salt was combined with intracerebroventricular infusion of mineralocorticoid receptor (MR) blockers (eplerenone, spironolactone), epithelial sodium channel (ENaC) blocker (benzamil), angiotensin II type 1 receptor (AT1R) blocker (losartan) or vehicles...
November 8, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/29125879/spironolactone-is-effective-in-treating-hypokalemia-among-peritoneal-dialysis-patients
#6
Amit Langote, Swapnil Hiremath, Marcel Ruzicka, Brendan B McCormick
BACKGROUND: Hypokalemia is common in peritoneal dialysis (PD) patients and is associated with increased cardiovascular and all-cause mortality. The management approach for such patients routinely includes spironolactone at our centre. We undertook this study to assess the efficacy of spironolactone for the treatment of hypokalemia in PD patients. METHODS: Retrospective chart review of PD patients at a single centre. Serum potassium was compared prior to initiation of spironolactone and two months afterwards...
2017: PloS One
https://www.readbyqxmd.com/read/29122582/biorelevant-media-slows-the-solution-mediated-phase-transformation-of-amorphous-spironolactone
#7
Mary S Kleppe, Roy J Haskell, Robin H Bogner
Solution-mediated phase transformation (SMPT) can reduce the high drug concentration expected from amorphous formulations, eliminating the improvement in drug absorption one hoped to gain from this high energy drug state. The differences in SMPT of a supersaturating system were compared in biorelevant media (Fasted State Simulated Intestinal Fluid (FaSSIF) and Fed State Simulated Intestinal Fluid (FeSSIF)) and USP compendial medium, Simulated Intestinal Fluid without pancreatin (SIFsp). Amorphous spironolactone underwent SMPT to the same hydrate of spironolactone in all three media which was confirmed by the decrease in dissolution rates assessed in a flow-through dissolution apparatus, as well as by the appearance of crystals on the amorphous solid surface detected by polarized light microscopy...
November 6, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29121365/irvine-gass-macular-edema-responding-to-the-combination-of-oral-mineralocorticoid-receptor-antagonist-with-dexamethasone-drops
#8
Alexandre Matet, Alejandra Daruich, Francine Behar-Cohen
Long-lasting postoperative macular edema is a therapeutic challenge. The authors report an efficient combination therapy of oral mineralocorticoid receptor antagonists (eplerenone [Inspra; Pfizer, New York City, NY] or spironolactone, 25 mg/day to 50 mg/day) and topical dexamethasone (four times/day and progressive dose tapering) in three refractory cases following complex cataract or retinal detachment surgery. In Case 1, central macular thickness (CMT) decreased from 523 μm to 214 μm and visual acuity (VA) improved from 20/200 to 20/50 during a 6-month period...
November 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/29105635/clinical-efficacy-of-unani-medicine-renax-for-treatment-of-urolithiasis
#9
Mushtaq Ahmad, Ghazala Shaheen, Saeed Ahmad, Muhammad Akram, Syed Muhammad Ali Shah, Shahbaz Ahmad Zakki
Stone formation occurs most commonly in acute and chronic renal failure. A kidney stone is a solid lump made up of crystals that separate from the urine and build up on the inner surfaces of the kidney. The current study was conducted to investigate the clinical efficacy of Unani medicine Renax in comparison with allopathic medicine (Spironolactone + Furosemide) to treat urolithiasis. The study was conducted in District Dera Ghazi Khan, South Punjab region. This was case control, randomized, double blind clinical study...
September 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29100412/the-therapeutic-effect-of-bromocriptine-in-combination-with-spironolactone-in-patients-with-primary-aldosteronism-a-hypothesis-generating-pilot-study
#10
Vin-Cent Wu, Che-Hsiung Wu, Ya-Wen Yang, Kuo-How Huang, Chia-Hui Chang, Shao-Yu Yang, Yen-Hung Lin, Kwan-Dun Wu
Background: Dopamine D2-like receptors are attenuated in aldosterone producing adenoma, lead to overproduction of aldosterone in affected patients, and thus reported to serve as a potential treatment target for primary aldosteronism. The D2 dopamine receptor agonist bromocriptine has been used clinically for reducing tumor mass of pituitary adenomas of lactotroph origin. The aim of the present study was to assess the efficacy of adding bromocriptine to spironolactone in the biochemical control of primary aldosteronism...
September 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/29095358/comparison-of-short-term-efficacy-between-oral-spironolactone-treatment-and-photodynamic-therapy-for-the-treatment-of-nonresolving-central-serous-chorioretinopathy
#11
Ji Hwan Lee, Sung Chul Lee, Hyesun Kim, Christopher Seungkyu Lee
PURPOSE: To compare the short-term therapeutic efficacy of oral spironolactone treatment with that of half-dose photodynamic therapy (PDT) in patients with nonresolving central serous chorioretinopathy. METHODS: This retrospective, interventional, comparative study included 41 patients with nonresolving central serous chorioretinopathy who exhibited subretinal fluid accumulation for more than 3 months. Of the 41 patients, 18 (18 eyes) received oral spironolactone treatment and 23 (23 eyes) received half-dose PDT...
October 30, 2017: Retina
https://www.readbyqxmd.com/read/29092740/preoperative-aldosterone-receptor-blockade-and-outcomes-of-cardiac-surgery-in-patients-with-chronic-kidney-disease%C3%A2
#12
Linda Shavit, Shuli Silberman, Rachel Tauber, Ofer Merin, Daniel Bitran, Daniel Fink
BACKGROUND AND AIMS: Recent clinical evidence demonstrates that chronic low-dose mineralocorticoid receptor antagonists (MRA), when added to optimal treatment, result in reductions in cardiovascular mortality. However, continuation of MRAs before cardiac surgery in patients with CKD has never been evaluated and its potential benefit or harm in this specific clinical setting is largely unknown. MATERIALS AND METHODS: This is an observational study that included adult CKD patients undergoing cardiac surgery...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29089356/spironolactone-versus-observation-in-the-treatment-of-acute-central-serous-chorioretinopathy
#13
Xinghong Sun, Yuanlu Shuai, Wangyi Fang, Jia Li, Weizhong Ge, Songtao Yuan, Qinghuai Liu
PURPOSE: To evaluate the efficacy of oral spironolactone in patients with acute central serous chorioretinopathy (CSC). METHODS: This is a prospective, randomised controlled clinical study. Thirty patients with acute CSC were the participants, including 18 patients who were treated with spironolactone (40 mg orally, twice daily) for 2 months in the experimental group and 12 patients who received observation in the control group. Main outcome measures included the proportion of eyes achieving complete resolution of subretinal fluid (SRF), changes in central macular thickness (CMT), the height of SRF (SRFH), best corrected visual acuity (BCVA) and subfoveal choroidal thickness (SFCT)...
October 31, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29081661/managing-resistant-hypertension-focus-on-mineralocorticoid-receptor-antagonists
#14
REVIEW
Juan Carlos Yugar-Toledo, Rodrigo Modolo, Ana Paula de Faria, Heitor Moreno
Mineralocorticoid-receptor antagonists (MRAs) have proven to be effective in some types of hypertension, especially in resistant hypertension (RHTN). In this phenotype of hypertension, the renin-angiotensin-aldosterone pathway plays an important role, with MRAs being especially effective in reducing blood pressure. In this review, we show the relevance of aldosterone in RHTN, as well as some clinical characteristics of this condition and the main concepts involving its pathophysiology and cardiovascular damage...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29066763/urotensin-ii-exerts-pressor-effects-by-stimulating-renin-and-aldosterone-synthase-gene-expression
#15
Brasilina Caroccia, Mirko Menegolo, Teresa M Seccia, Lucia Petrelli, Michele Antonello, Alice Limena, Andrea Porzionato, Raffaele De Caro, Marko Poglitsch, Gian Paolo Rossi
We investigated the in vivo pressor effects of the potent vasoconstrictor Urotensin II (UII). We randomized normotensive Sprague-Dawley rats into 4 groups that received a 7-day UII infusion (cases) or vehicle (controls). Group 1 received normal sodium intake; Group 2 underwent unilateral nephrectomy and salt loading; Group 3 received spironolactone, besides unilateral nephrectomy and salt loading; Group 4 only received spironolactone. UII raised BP transiently after a lag phase of 12-36 hours in Group 1, and progressively over the week in Group 2...
October 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29043663/nephrotoxicity-induced-by-cisplatin-intake-in-experimental-rats-and-therapeutic-approach-of-using-mesenchymal-stem-cells-and-spironolactone
#16
Mohamed M Elseweidy, Mervat E Askar, Sahar E Elswefy, Mohamed Shawky
Chronic kidney disease may lead to subsequent tissue fibrosis. However, many factors can combat injurious stimuli in these tissues aiming to repair, heal, and alleviate any disturbance. Chemokines release, migration of inflammatory cells to the affected site, and activation of fibroblasts for the production of extracellular matrix are commonly observed in this disease. In the last years, many studies have focused on spironolactone (SPL), a mineralocorticoid receptor antagonist, and its pharmacological effects...
October 17, 2017: Applied Biochemistry and Biotechnology
https://www.readbyqxmd.com/read/29039622/quality-of-vitamin-k-antagonist-oral-anticoagulation-in-322-patients-with-atrial-fibrillation-real-life-data-from-a-survey-in-eastern-switzerland
#17
Micha Tobias Maeder, Tabea König, Sanja Bogdanovic, Irene Schneider, Werner Eugster, Peter Ammann, Marius König, Jürg Beer, Hans Rickli
AIM OF THE STUDY: To better appreciate the role of the non-vitamin K oral anticoagulants (NOACs) for patients with non-valvular atrial fibrillation in Switzerland we aimed to assess the quality of vitamin K antagonist (VKA) anticoagulation in daily practice. METHODS: In a cross-sectional study, clinically stable patients on VKA treatment for non-valvular atrial fibrillation for at least 6 months, documentation of international normalised ratio (INR) values for at least 3 months and with at least two INR values were included...
October 17, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29037584/fungal-biotransformation-of-diuretic-and-antihypertensive-drug-spironolactone-with-gibberella-fujikuroi-curvularia-lunata-fusarium-lini-and-aspergillus-alliaceus
#18
Amal Al-Aboudi, Belal Muneeb Kana'an, Musa Abu Zarga, Saira Bano, Atia-Tul-Wahab, Kulsoom Javed, M Iqbal Choudhary
Derivatives of spironolactone (1), a diuretic and antihypertensive drug, were synthesized by using fungal cells for the first time. Ten different fungi were screened for their ability to biotransform 1, four of which were able to produce metabolites 2-8. Gibberella fujikuroi produced canrenone (2), 1-dehydrocanrenone (3), Curvularia lunuta provided compound 2, and 7α-thio-spironolactone (4), Fusarium lini yielded compounds 2, 3, 1β-hydroxycanrenone (5), 1α-hydroxycanrenone (6), 1-dehydro-15α-hydroxycanrenone (7), and 15α-hydroxycanrenone (8), while Aspergillus alliaceus was able to produce all the seven metabolites...
October 14, 2017: Steroids
https://www.readbyqxmd.com/read/29036418/spironolactone-induced-degradation-of-the-tfiih-core-complex-xpb-subunit-suppresses-nf-%C3%AE%C2%BAb-and-ap-1-signaling
#19
Jason M Elinoff, Li-Yuan Chen, Edward J Dougherty, Keytam S Awad, Shuibang Wang, Angelique Biancotto, Afsheen H Siddiqui, Nargues A Weir, Rongman Cai, Junfeng Sun, Ioana R Preston, Michael A Solomon, Robert L Danner
No abstract text is available yet for this article.
September 27, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/29034087/spironolactone-in-cardiovascular-disease-an-expanding-universe
#20
REVIEW
John W Funder
Spironolactone has been marketed for over half a century as a 'potassium-sparing diuretic', used primarily in patients with ascites. With the realization that primary aldosteronism is the most common (5-13%) form of secondary hypertension, it has become widely used as a mineralocorticoid receptor antagonist. More recently, in the wake of the RALES trial, spironolactone in addition to standard therapy has been shown to be very beneficial in heart failure with a reduced ejection fraction. Despite the failure of the TOPCAT trial, spironolactone is being increasingly used in diastolic heart failure (i...
2017: F1000Research
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