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https://www.readbyqxmd.com/read/28719376/stability-of-spironolactone-oral-suspension-in-pcca-base-suspendit
#1
Richard Graves, Kelly V Phan, Levon A Bostanian, Tarun K Mandal, Yashoda V Pramar
Spironolactone (Aldactone) is a potassium-sparing diuretic used to treat hypertension and heart failure and may also be used to treat edema resulting from kidney disease, low potassium levels, or excess aldosterone. No commercial liquid dosage form of spironolactone exists. An extemporaneously compounded suspension from pure drug powder or commercial tablets would provide an alternative option to meet unique patient needs. The purpose of this study was to determine the physicochemical stability of spironolactone in the PCCA base SuspendIt...
July 2017: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28712591/normalizing-ovulation-rate-by-preferential-reduction-of-hepato-visceral-fat-in-adolescent-girls-with-polycystic-ovary-syndrome
#2
Lourdes Ibáñez, Luis Del Río, Marta Díaz, Giorgia Sebastiani, Óscar J Pozo, Abel López-Bermejo, Francis de Zegher
PURPOSE: Polycystic ovary syndrome (PCOS) is an increasingly prevalent disorder in adolescent girls, commonly presenting with hirsutism/oligomenorrhea, commonly treated with an oral contraceptive (OC), and commonly followed by oligoanovulatory subfertility. We tested whether an intervention targeting the reduction of hepato-visceral adiposity is followed by a higher ovulation rate than OC treatment. METHODS: This randomized, open-label, single-center, pilot proof-of-concept study (12 months on treatment, then 12 months off) was performed in adolescent girls with hirsutism and oligomenorrhea (PCOS by National Institutes of Health; no sexual activity; N = 36; mean age 16 years, body mass index 23...
July 13, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28710615/aldosterone-antagonist-therapy-and-its-relationship-with-inflammation-fibrosis-thrombosis-mineral-bone-disorder-and-cardiovascular-complications-in-peritoneal-dialysis-pd-patients
#3
Rafał Donderski, Paweł Stróżecki, Beata Sulikowska, Magdalena Grajewska, Ilona Miśkowiec, Anna Stefańska, Joanna Siódmiak, Grażyna Odrowąż-Sypniewska, Jacek Manitius
BACKGROUND: High aldosterone level may contribute to pathogenesis of hypertension, vessels damage and cardiovascular system deterioration in chronic kidney disease patients. Besides its classical action via mineralocorticoid receptor, aldosterone is also involved in cell growth, inflammation, oxidative stress, endothelial dysfunction and exerts fibroproliferative effects. The aim of the study was to assess whether aldosterone antagonist treatment may influence serum level of inflammatory, fibrosis, thrombosis and mineral-bone metabolism markers in peritoneal dialysis (PD) patients and blood pressure, aortic stiffness, echocardiographic indices after 12 months of treatment...
July 14, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28700781/efficacy-and-safety-of-spironolactone-in-acute-heart-failure-the-athena-hf-randomized-clinical-trial
#4
Javed Butler, Kevin J Anstrom, G Michael Felker, Michael M Givertz, Andreas P Kalogeropoulos, Marvin A Konstam, Douglas L Mann, Kenneth B Margulies, Steven E McNulty, Robert J Mentz, Margaret M Redfield, W H Wilson Tang, David J Whellan, Monica Shah, Patrice Desvigne-Nickens, Adrian F Hernandez, Eugene Braunwald
Importance: Persistent congestion is associated with worse outcomes in acute heart failure (AHF). Mineralocorticoid receptor antagonists administered at high doses may relieve congestion, overcome diuretic resistance, and mitigate the effects of adverse neurohormonal activation in AHF. Objective: To assess the effect of high-dose spironolactone and usual care on N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels compared with usual care alone. Design, Setting, and Participants: This double-blind and placebo (or low-dose)-controlled randomized clinical trial was conducted in 22 US acute care hospitals among patients with AHF who were previously receiving no or low-dose (12...
July 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28699986/diagnosis-and-management-of-primary-aldosteronism
#5
Leticia A P Vilela, Madson Q Almeida
Primary aldosteronism (PA) is the most common form of secondary hypertension (HTN), with an estimated prevalence of 4% of hypertensive patients in primary care and around 10% of referred patients. Patients with PA have higher cardiovascular morbidity and mortality than age- and sex-matched patients with essential HTN and the same degree of blood pressure elevation. PA is characterized by an autonomous aldosterone production causing sodium retention, plasma renin supression, HTN, cardiovascular damage, and increased potassium excretion, leading to variable degrees of hypokalemia...
May 2017: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28696223/white-coat-effect-is-uncommon-in-patients-with-refractory-hypertension
#6
Mohammed Siddiqui, Eric K Judd, Suzanne Oparil, David A Calhoun
Refractory hypertension is a recently described phenotype of antihypertensive treatment failure defined as uncontrolled blood pressure (BP) despite the use of ≥5 different antihypertensive agents, including chlorthalidone and spironolactone. Recent studies indicate that refractory hypertension is uncommon, with a prevalence of ≈5% to 10% of patients referred to a hypertension specialty clinic for uncontrolled hypertension. The prevalence of white coat effect, that is, uncontrolled automated office BP ≥135/85 mm Hg and controlled out-of-office BP <135/85 mm Hg, by awake ambulatory BP monitor in hypertensive patients overall is ≈30% to 40%...
July 10, 2017: Hypertension
https://www.readbyqxmd.com/read/28679982/pseudomelanosis-duodeni-a-case-report
#7
Masaya Iwamuro, Shohei Oka, Hiromitsu Kanzaki, Takehiro Tanaka, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada
An 83-year-old Japanese man underwent esophagogastroduodenoscopy for screening purposes. He had a medical history of hypertension, chronic kidney disease, chronic heart failure, and chronic myeloid leukemia, and he had been taking the following medications:ferrous citrate, furosemide, spironolactone, tolvaptan, bisoprolol, nicorandil, warfarin, nilotinib, febuxostat, esomeprazole, digestive enzyme complex, ambroxol, carbocysteine, and potassium L-aspartate. Esophagogastroduodenoscopy revealed a brownish speckled pigmentation in the duodenal bulb...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28676330/trends-in-prescribing-behavior-of-systemic-agents-used-in-the-treatment-of-acne-among-dermatologists-and-nondermatologists-a-retrospective-analysis-2004-2013
#8
John S Barbieri, William D James, David J Margolis
BACKGROUND: Despite recommendations to limit the use of oral antibiotics and increasing support for hormonal agents in the treatment of acne, it is unclear whether there have been any significant changes in practice patterns. OBJECTIVE: To characterize changes in prescribing behavior for systemic agents in the treatment of acne in the United States between 2004 and 2013. METHODS: We conducted a retrospective analysis using the OptumInsight Clinformatics DataMart (Optum, Eden Prairie, MN)...
July 1, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28674750/characteristics-of-hypertension-in-premature-infants-with-and-without-chronic-lung-disease-a-long-term-multi-center-study
#9
Randall D Jenkins, Julia K Aziz, Ladawna L Gievers, Harrison M Mooers, Nora Fino, David J Rozansky
BACKGROUND: Many causes for neonatal hypertension in premature infants have been described; however in some cases no etiology can be attributed. Our objectives are to describe such cases of unexplained hypertension and to compare hypertensive infants with and without chronic lung disease (CLD). METHODS: We reviewed all cases of hypertension in premature infants referred from 18 hospitals over 16 years. Inclusion criteria were hypertension occurring at <6 months of age and birth at <37 weeks gestation; the main exclusion criterion was known secondary hypertension...
July 3, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28666228/high-throughput-quantification-of-8-antihypertensive-drugs-and-active-metabolites-in-human-plasma-using-uplc-ms-ms
#10
Bart C H van der Nagel, Jorie Versmissen, Soma Bahmany, Teun van Gelder, Birgit C P Koch
BACKGROUND: To assess drug adherence of patients with hypertension, an analytical method was developed and validated using ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The method includes eight frequently prescribed antihypertensive drugs from four classes and their active metabolites: angiotensin converting enzyme inhibitors enalapril and perindopril (active metabolites respectively enalaprilate and perindoprilate), angiotensin II receptor blockers losartan (with the active metabolite losartan carboxylic acid) and valsartan, calcium channel blockers amlodipine and nifedipine and diuretics hydrochlorothiazide and spironolactone (with the active metabolite canrenone)...
June 19, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28664677/comparative-evaluation-of-torasemide-and-spironolactone-on-adverse-cardiac-remodeling-in-a-rat-model-of-dilated-cardiomyopathy
#11
Somasundaram Arumugam, Remya Sreedhar, Vengadeshprabhu Karuppagounder, Meilei Harima, Masahiko Nakamura, Hiroshi Suzuki, Hirohito Sone, Kenichi Watanabe
BACKGROUND: Chronic heart failure (CHF) involves fluid retention and volume overload, leading to impaired cardiac function. In these conditions, diuretic agents are most commonly used to treat edema and thereby reducing the volume load on the failing heart. There are several other beneficial effects of diuretics apart from their action on urinary excretion. METHODS: In order to identify the effects of diuretic agents on adverse cardiac remodeling in CHF, the present study was carried out, where we have compared the effects of torasemide and spironolactone in a rat model of dilated cardiomyopathy induced by porcine cardiac myosin mediated experimental autoimmune myocarditis...
June 30, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28652798/combined-aquaretic-and-diuretic-therapy-in-acute-heart-failure
#12
Michael Goyfman, Paul Zamudio, Kristine Jang, Jennifer Chee, Catherine Miranda, Javed Butler, Nand K Wadhwa
INTRODUCTION: Acute heart failure (AHF) is a leading cause of hospitalization and readmission in the US. The present study evaluated maximum diuresis while minimizing electrolyte imbalances, hemodynamic instability, and kidney dysfunction, to achieve a euvolemic state safely in a shorter period of time. METHODS AND RESULTS: A protocol of combined therapy with furosemide, metolazone, and spironolactone, with or without tolvaptan and acetazolamide, was used in 17 hospitalized patients with AHF...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28647918/designing-future-clinical-trials-in-heart-failure-with-preserved-ejection-fraction-lessons-from-topcat
#13
REVIEW
Ravi B Patel, Sanjiv J Shah, Gregg C Fonarow, Javed Butler, Muthiah Vaduganathan
PURPOSE OF REVIEW: Spironolactone did not demonstrate benefit with respect to the primary composite endpoint in the global TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial in patients with chronic heart failure with preserved ejection fraction (HFpEF). We identify key lessons from the TOPCAT experience that can be applied to future HFpEF trials. RECENT FINDINGS: Subsequent analyses of TOPCAT have revealed marked regional heterogeneity in patient profiles, event rates, drug adherence, and treatment effects...
June 24, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28634082/cytokine-modulation-by-stress-hormones-and-antagonist-specific-hormonal-inhibition-in-rainbow-trout-oncorhynchus-mykiss-and-gilthead-sea-bream-sparus-aurata-head-kidney-primary-cell-culture
#14
Ali Reza Khansari, David Parra, Felipe E Reyes-López, Lluís Tort
A tight interaction between endocrine and immune systems takes place mainly due to the key role of head kidney in both hormone and cytokine secretion, particularly under stress situations in which the physiological response promotes the synthesis and release of stress hormones which may lead into immunomodulation as side effect. Although such interaction has been previously investigated, this study evaluated for the first time the effect of stress-associated hormones together with their receptor antagonists on the expression of cytokine genes in head kidney primary cell culture (HKPCC) of the freshwater rainbow trout (Oncorhynchus mykiss) and the seawater gilthead sea bream (Sparus aurata)...
June 19, 2017: General and Comparative Endocrinology
https://www.readbyqxmd.com/read/28626417/spironolactone-as-an-adjunctive-treatment-in-neovascular-age-related-macular-degeneration
#15
Kapil G Kapoor, Jennifer Sim
Neovascular age-related macular degeneration (AMD) is a potentially sight-threatening condition. The current standard-of-care treatment regimen is serial intravitreal antivascular endothelial growth factor injections. While these typically have great success, they do carry exceptional treatment burden on the patient, cost burden due to their required frequency of use, and the risk of endophthalmitis, which can be devastating. This case report explores an alternative potential option as a treatment adjunct for neovascular AMD (nAMD), and identifies some of the overlap between nAMD and central serous chorioretionpathy...
May 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28611786/spironolactone-treatment-and-effect-on-survival-in-chronic-heart-failure-patients-with-reduced-renal-function-a-propensity-matched-study
#16
Viera Stubnova, Ingrid Os, Morten Grundtvig, Dan Atar, Bård Waldum-Grevbo
BACKGROUND/AIMS: Spironolactone may be hazardous in heart failure (HF) patients with renal dysfunction due to risk of hyperkalemia and worsened renal function. We aimed to evaluate the effect of spironolactone on all-cause mortality in HF outpatients with renal dysfunction in a propensity-score-matched study. METHODS: A total of 2,077 patients from the Norwegian Heart Failure Registry with renal dysfunction (eGFR <60 mL/min/1.73 m(2)) not treated with spironolactone at the first visit at the HF clinic were eligible for the study...
February 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28579091/characteristics-and-outcomes-of-heart-failure-hospitalization-before-implementation-of-a-heart-failure-clinic-the-precic-study
#17
Irene Marques, Sara Abreu, Manuela V Bertão, Betânia Ferreira, Raquel Lopes Ramos, Juliana Lopes, Sandra Nunes, Denisa Mendonça, Laetitia Teixeira
OBJECTIVE: This study aims to characterize patients hospitalized for acute heart failure (HF) in an internal medicine department and their one-year mortality and rate of rehospitalization for decompensated HF. METHODS: This retrospective observational study enrolled all patients discharged in 2012 after hospitalization for acute HF. Discharge summaries, clinical records and telephone interviews were analysed. The data reports to the year before implementation of a heart failure clinic...
May 31, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28577743/renin-angiotensin-system-blockade-finerenone
#18
REVIEW
Luis M Ruilope, Juan Tamargo
Finerenone is a novel selective nonsteroidal mineralocorticoid receptor antagonist. Results in preclinical studies showed that lower doses of finerenone were needed to achieve similar cardiorenal protective effects compared to both spironolactone and eplerenone and phase II studies in finerenone in patients with heart failure, type-2 diabetes mellitus and/or chronic kidney disease are encouraging as the drug is effective and safe in patients on renin-angiotensin system inhibitors (significant reduction in albuminuria and a low rate of hyperkalemia), but the primary end points were "soft" end points (serum potassium, estimated glomerular filtration rate, albuminuria, N-terminal prohormone B-type natriuretic peptide levels)...
April 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28577687/true-rate-of-mineralocorticoid-receptor-antagonists-related-hyperkalemia-in-placebo-controlled-trials-a-meta-analysis
#19
Davor Vukadinović, Daniel Lavall, Aleksandra Nikolovska Vukadinović, Bertram Pitt, Stefan Wagenpfeil, Michael Böhm
BACKGROUND: Mineralocorticoid receptor antagonists (MRA) improve survival in heart failure with reduced ejection fraction but are often underused, mostly due to concerns of hyperkalemia. Because hyperkalemia occurs also on placebo, we aimed to determine the truly MRA-related rate of hyperkalemia. METHODS: We performed a meta-analysis including randomized, placebo-controlled trials reporting hyperkalemia on MRAs in patients after myocardial infarction or with chronic heart failure...
June 2017: American Heart Journal
https://www.readbyqxmd.com/read/28577676/clinical-and-prognostic-value-of-spot-urinary-creatinine-in-chronic-heart-failure-an-analysis-from-gissi-hf
#20
Jozine M Ter Maaten, Aldo Pietro Maggioni, Roberto Latini, Serge Masson, Gianni Tognoni, Luigi Tavazzi, Stefano Signorini, Adriaan A Voors, Kevin Damman
OBJECTIVES: This study aimed to identify patient characteristics associated with low urinary creatinine in morning spot urine and investigate its association with clinical outcome. BACKGROUND: Twenty-four-hour creatinine excretion is an established marker of muscle mass in heart failure and other populations. Spot urine creatinine might be an easy obtainable, cheap marker of muscle wasting and prognosis in heart failure (HF) patients. METHODS: Spot urine creatinine concentration was measured in 2130 patients included in the GISSI-HF trial...
June 2017: American Heart Journal
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