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https://www.readbyqxmd.com/read/29767448/development-and-validation-of-a-fast-and-sensitive-uhplc-esi-ms-method-for-the-simultaneous-quantification-of-spironolactone-and-its-metabolites-in-ocular-tissues
#1
Naoual Dahmana, Doris Gabriel, Robert Gurny, Yogeshvar N Kalia
Glucocorticoids are a mainstay for the treatment of immune-mediated conditions and inflammatory diseases. However, their chronic use causes numerous side-effects including delays in corneal and cutaneous wound healing. This is attributed to off-target agonism of the mineralocorticoid receptor, which can be reduced by co-administration of a mineralocorticoid receptor antagonist such as spironolactone. The aim of this study was to develop a fast, selective and sensitive UHPLC-ESI-MS method for the simultaneous quantification of spironolactone, its active metabolites - 7α-thiomethylspironolactone and canrenone, the latter's water-soluble prodrug potassium canrenoate, and the synthetic glucocorticoid, dexamethasone, in corneal samples (17α-methyltestosterone served as an internal standard)...
May 16, 2018: Biomedical Chromatography: BMC
https://www.readbyqxmd.com/read/29756046/hormonal-treatment-of-transgender-women-with-oral-estradiol
#2
Matthew C Leinung, Paul J Feustel, Jalaja Joseph
Purpose: Maintaining cross-sex hormone levels in the normal physiologic range for the desired gender is the cornerstone of transgender hormonal therapy, but there are limited data on how to achieve this. We investigated the effectiveness of oral estradiol therapy in achieving this goal. Methods: We analyzed data on all transgender females seen in our clinic since 2008 treated with oral estradiol. We looked at the success of achieving serum levels of testosterone and 17-β estradiol in the normal range on various doses of estradiol (with and without antiandrogens spironolactone and finasteride)...
2018: Transgender Health
https://www.readbyqxmd.com/read/29753419/severe-renal-failure-and-thrombotic-microangiopathy-induced-by-malignant-hypertension-successfully-treated-with-spironolactone
#3
H M Villafuerte Ledesma, J M Peña Porta, P Iñigo Gil, P Martin Azara, J E Ruiz Lalglesia, A Tomás LaTorre, A Martínez Burillo, P Vernet Perna, R Álvarez Lipe
Malignant hypertension can cause thrombotic microangiopathy (TMA) characterized by hemolytic anemia and thrombocytopenia. On the other hand, severe hypertension is sometimes associated with hemolytic uremic syndrome (HUS) or thrombotic thrombocytopenic purpura (TTP). Distinguishing these entities is important because of therapeutic implications. Plasmapheresis should be initiated as soon as possible if we are dealing with TTP. We describe the case of a 30-year-old man referred to our hospital with malignant hypertension, severe renal failure and TMA: haemoglobin=9g/dL, total bilirubin=0...
May 9, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29753370/effects-of-different-doses-of-irbesartan-combined-with-spironolactone-on-urinary-albumin-excretion-rate-in-elderly-patients-with-early-type-2-diabetic-nephropathy
#4
Yingying Chen, Peng Liu, Xia Chen, Yanan Li, Fengmei Zhang, Yangang Wang
BACKGROUND: There is a lack of research on the effect of low dose of angiotensin receptor blockers combined with spironolactone, and the effect of high dose of angiotensin receptor blockers alone on the urinary albumin excretion rate (UAER) in elderly patients with early type 2 diabetic nephropathy (DN). METHODS: We conducted a prospective, randomized, open-label, parallel-controlled study that included 244 elderly patients with early DN and mild-to-moderate essential hypertension...
May 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29752945/evaluation-of-spironolactone-solid-dispersions-prepared-by-co-spray-drying-with-soluplus-%C3%A2-and-pvp-and-influence-of-tableting-on-drug-release
#5
Nizar Al-Zoubi, Faten Odah, Wasfy Obeidat, Ahmad Al-Jaberi, Ioannis Partheniadis, Ioannis Nikolakakis
Solid dispersions of spironolactone with Soluplus® and PVP were prepared by spray drying according to a mixture experimental design and evaluated for moisture content, particle size, drug solubility, crystallinity (PXRD and DSC) and physicochemical interactions (FTIR, Raman). In vitro dissolution was evaluated for the spray dried product itself and after compression into tablets and prediction models were derived using multiple linear regression analysis. The spray dried products consisted of amorphous drug, indicated by the absence of crystalline PXRD peaks...
May 9, 2018: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29749461/upregulation-of-allograft-inflammatory-factor%C3%A2-1-expression-and-secretion-by-macrophages-stimulated-with-aldosterone-promotes-renal-fibroblasts-to-a-profibrotic-phenotype
#6
Yushu Li, Xingzhi Wang, Lei Zhang, Xueying Yuan, Jianbing Hao, Jie Ni, Lirong Hao
Macrophages have been identified as a key cell type in the pathogenesis of renal interstitial fibrosis (RIF). However, the mechanism through which macrophages drive fibrosis remains unclear. The current study focuses on the effects and possible underlying mechanism of allograft inflammatory factor‑1 (AIF‑1), an inflammation‑responsive scaffold protein expressed and secreted by macrophages, in promoting fibroblasts to a profibrotic phenotype. In vivo experiments indicated that AIF‑1, CD68 and α‑smooth muscle actin (α‑SMA) were upregulated in kidney tissues of mice subjected to unilateral ureteric obstruction, while their expressions were inhibited by an aldosterone receptor antagonist, spironolactone...
May 10, 2018: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29743456/-short-term-sustained-virological-response-in-a-patient-with-liver-cirrhosis-hepatitis-c-and-declining-hepatic-spare-ability-during-treatment-with-direct-acting-antivirals
#7
Hitoshi Mori, Hiroaki Takaya, Tadashi Namisaki, Ryuichi Noguchi, Junichi Hanatani, Miki Kaneko, Kenichiro Seki, Yasushi Okura, Mitsuteru Kitade, Akira Mitoro, Junichi Yamao, Hitoshi Yoshiji
A 75-year-old female patient with liver cirrhosis and hepatitis C was treated with direct-acting antivirals (DAA) (Sofosbuvir+Ledipasvir). The hepatitis C virus (HCV) -RNA level decreased to negative 4 weeks after the start of the treatment. Six weeks later, she developed ascites and showed declining hepatic spare ability. Accordingly, DAA treatment was stopped. She was started on furosemide 20mg/day and spironolactone 50mg/day. After 7 days, she started taking tolvaptan 7.5mg/day because furosemide and spironolactone proved to be ineffective...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/29724188/the-effect-of-spironolactone-on-calcineurin-inhibitor-induced-nephrotoxicity-a-multicenter-randomized-double-blind-clinical-trial-the-spiren-trial
#8
Line Aas Mortensen, Helle C Thiesson, Birgitte Tougaard, Martin Egfjord, Anne Sophie Lind Fischer, Claus Bistrup
BACKGROUND: Calcineurin inhibitor induced nephrotoxicity contributes to late allograft failure in kidney transplant patients. Evidence points towards aldosterone to play a role in the development of fibrosis in multiple organs. Animal studies have indicated a beneficial effect of mineralocorticoid receptor antagonists preventing calcineurin inhibitor induced nephrotoxicity. Only few studies have explored this effect in humans. The objective of this study is to evaluate the effect of spironolactone on glomerular filtration rate and fibrosis in kidney transplant patients...
May 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29709099/biomarker-based-phenotyping-of-myocardial-fibrosis-identifies-patients-with-heart-failure-with-preserved-ejection-fraction-resistant-to-the-beneficial-effects-of-spironolactone-results-from-the-aldo-dhf-trial
#9
Susana Ravassa, Tobias Trippel, Doris Bach, Diana Bachran, Arantxa González, Begoña López, Rolf Wachter, Gerd Hasenfuss, Christian Delles, Anna F Dominiczak, Burkert Pieske, Javier Díez, Frank Edelmann
BACKGROUND: Myocardial fibrosis is characterized by excessive cross-linking and deposition of collagen type I and is involved in left ventricular stiffening and left ventricular diastolic dysfunction (LVDD). We investigated whether the effect of spironolactone on LVDD in patients with heart failure with preserved ejection fraction (HFpEF) depends on its effects on collagen cross-linking and/or deposition. METHODS AND RESULTS: We investigated 381 HFpEF patients from the multicentre, randomized, placebo-controlled Aldo-DHF trial with measures of the E:e' ratio...
April 30, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29708436/prolactin-levels-do-not-rise-among-transgender-women-treated-with-estradiol-and-spironolactone
#10
Jason R Bisson, Kelly J Chan, Joshua D Safer
CONTEXT: Existing transgender treatment guidelines suggest that for transfeminine hormone treatment there is a need to monitor prolactin levels. Also, recent studies suggest that use of cyproterone acetate as an adjunctive anti-androgen during transgender hormone treatment may elevate serum prolactin. OBJECTIVE: We sought to determine whether the reported relationship between transfeminine estradiol treatment and hyperprolactinemia would be evident when the regimen used spironolactone as the adjunctive anti-androgen...
April 30, 2018: Endocrine Practice
https://www.readbyqxmd.com/read/29700011/an-investigation-of-drug-drug-interaction-alert-overrides-at-a-pediatric-hospital
#11
Kate Humphrey, Maria Jorina, Marvin Harper, Brenda Dodson, Seung-Yeon Kim, Al Ozonoff
OBJECTIVES: Drug-drug interactions (DDIs) can result in patient harm. DDI alerts are intended to help prevent harm; when the majority of alerts presented to providers are being overridden, their value is diminished. Our objective was to evaluate the overall rates of DDI alert overrides and how rates varied by specialty, clinician type, and patient complexity. METHODS: A retrospective study of DDI alert overrides that occurred during 2012 and 2013 within the inpatient setting described at the medication-, hospital-, provider-, and patient encounter-specific levels was performed at an urban, quaternary-care, pediatric hospital...
May 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29695512/individual-participant-data-analysis-of-two-trials-on-aldosterone-blockade-in-myocardial-infarction
#12
Farzin Beygui, Eric Van Belle, Patrick Ecollan, Jacques Machecourt, Christian W Hamm, Estaeban Lopez De Sa, Marcus Flather, Freek W A Verheugt, Eric Vicaut, Faiez Zannad, Bertram Pitt, Gilles Montalescot
BACKGROUND: Two recent randomised trials studied the benefit of mineralocorticoid receptor antagonists (MRAs) in ST-segment elevation myocardial infarction (STEMI) irrespective or in absence of heart failure. The studies were both undersized to assess hard clinical endpoints. A pooled analysis was preplanned by the steering committees. METHODS: We conducted a prespecified meta-analysis of patient-level data of patients with STEMI recruited in two multicentre superiority trials, randomised within 72 hours after symptom onset...
April 25, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29692992/tolvaptan-for-primary-aldosteronism-and-autosomal-dominant-polycystic-kidney-disease-a-case-report
#13
Kyohei Kunizawa, Junichi Hoshino, Hiroki Mizuno, Tatsuya Suwabe, Keiichi Sumida, Masahiro Kawada, Masayuki Yamanouchi, Akinari Sekine, Noriko Hayami, Rikako Hiramatsu, Eiko Hasegawa, Naoki Sawa, Kenmei Takaichi, Shigeru Shibata, Yoshifumi Ubara
A 59-year-old Japanese woman was admitted for evaluation of muscle weakness. Autosomal dominant polycystic kidney disease had been diagnosed at the age of 47 years, followed by primary aldosteronism at 53 years. At the age of 58, tolvaptan was started (60 mg/day) to treat her renal disease. After 8 months of tolvaptan therapy, hypokalemia-related muscle weakness became prominent, and hypertension became refractory. Finally, treatment with low-dose tolvaptan (30 mg/day) and high-dose spironolactone (100 mg/day) normalized serum potassium and the blood pressure...
January 2018: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/29674401/licorice-induced-apparent-mineralocorticoid-excess-compounded-by-excessive-use-of-terbutaline-and-high-water-intake
#14
Laust Frisenberg Buhl, Frederik Nørregaard Pedersen, Marianne Skovsager Andersen, Dorte Glintborg
This case highlights the clinical course of a 54-year-old male patient presenting with hypertension and long-term refractory hypokalaemia. He reported long-term malaise, fatigue and physical discomfort. Diarrhoea, vomiting, over-the-counter drugs, dietary supplements and any kind of medical abuse were all denied. Physical examination was normal. Suppressed plasma renin activity along with a low aldosterone level and elevated urinary cortisone/cortisol metabolite excretion ratio raised the suspicion of apparent mineralocorticoid excess (AME)...
April 19, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29669139/diuretic-or-sodium-restricted-diet-for-obstructive-sleep-apnea-a-randomized-trial
#15
Cintia Zappe Fiori, Denis Martinez, Carolina Caruccio Montanari, Pedro Lopez, Rodrigo Camargo, Lauren Sezerá, Sandro Cadaval Gonçalves, Flavio Danni Fuchs
Study Objectives: Interventions that decrease leg fluid retention reduce obstructive sleep apnea (OSA) severity in nonrandomized experiments. We aimed to investigate in a randomized trial the effect of interventions that reduce fluid volume on OSA severity. Methods: Men diagnosed with severe OSA were randomized to receive daily spironolactone 100 mg + furosemide 20 mg or nutritional counseling to sodium-restricted diet plus placebo pill or placebo pill. All participants underwent home sleep apnea testing at baseline and after 1 week follow-up...
April 1, 2018: Sleep
https://www.readbyqxmd.com/read/29668634/spironolactone-is-superior-to-hydrochlorothiazide-for-blood-pressure-control-and-arterial-stiffness-improvement-a-prospective-study
#16
RANDOMIZED CONTROLLED TRIAL
Yan Liu, Siping Dai, Lin Liu, Huocheng Liao, Chun Xiao
The present study is to investigate whether spironolactone is better than hydrochlorothiazide (HCTZ) for blood pressure (BP) control and arterial stiffness improvement. Five-hundred-sixty-six uncontrolled hypertensive patients with 2 different classes of antihypertensive medications treatment were enrolled. Spironolactone or HCTZ was randomly prescribed for 4 weeks. Carotid-femoral pulse wave velocity (cf-PWV) was measured at baseline and after 4 weeks' of spironolactone or HCTZ treatment. Between-group differences were evaluated, and logistic regression analysis was performed to evaluate the association of cf-PWV increase and incident resistant hypertension...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29668577/the-use-of-a-novel-non-steroidal-mineralocorticoid-receptor-antagonist-finerenone-for-the-treatment-of-chronic-heart-failure-a-systematic-review-and-meta-analysis
#17
Hui Pei, Wei Wang, Di Zhao, Lei Wang, Guo-Hai Su, Zhuo Zhao
BACKGROUND: The non-steroidal mineralocorticoid receptor antagonist finerenone (BAY 94-8862) has been used to treat chronic heart failure (CHF) with reduced ejection fraction (HFrEF). However, conflicting results were reported for its efficacy and safety. The study aimed to compare the efficacy and safety of finerenone versus spironolactone or eplerenone in patients with chronic heart failure. METHODS: Electronic databases including MEDLINE, EMBASE, and CENTRAL were searched from inception to December 2017 for randomized controlled trials assessing finerenone treatment in patients with chronic heart failure...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29664406/racial-differences-in-characteristics-and-outcomes-of-patients-with-heart-failure-and-preserved-ejection-fraction-in-the-treatment-of-preserved-cardiac-function-heart-failure-trial
#18
Eldrin F Lewis, Brian Claggett, Amil M Shah, Jiankang Liu, Sanjiv J Shah, Inder Anand, Eileen O'Meara, Nancy K Sweitzer, Jean L Rouleau, James C Fang, Akshay S Desai, Tamrat M Retta, Scott D Solomon, John F Heitner, Thomas D Stamos, Robin Boineau, Bertram Pitt, Marc A Pfeffer
BACKGROUND: Black patients have been shown to have different baseline characteristics and outcomes compared with nonblack patients in cohort studies. However, few studies have focused on heart failure (HF) with preserved ejection fraction (HFpEF) patients. We aimed to determine the difference in cardiovascular outcomes in black and nonblack patients with HFpEF and to determine the relative efficacy and safety of spironolactone in black and nonblack patients. METHODS AND RESULTS: Patients with HFpEF, randomized to spironolactone versus placebo in the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) in North and South America, were grouped according to self-described black and nonblack race...
March 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29656764/prescribing-habits-for-androgenic-alopecia-among-dermatologists-in-spain-in-2017-a-cross-sectional-study
#19
C Pindado-Ortega, D Saceda-Corralo, D Buendía-Castaño, P Fernández-González, Ó M Moreno-Arrones, P Fonda-Pascual, A Alegre-Sánchez, A R Rodrigues-Barata, S Vañó-Galván
BACKGROUND: Topical minoxidil and oral finasteride are the only drugs approved for the treatment of androgenetic alopecia (AGA) in Spain. However, the management of this condition is highly variable because numerous treatments are used off-label. The main aim of this study was to describe the prescribing habits of dermatologists in Spain for male AGA (MAGA) and female AGA (FAGA). MATERIAL AND METHODS: Descriptive cross-sectional study using online questionnaires completed by dermatologists working in Spain...
April 12, 2018: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/29655877/endocrine-and-haemodynamic-changes-in-resistant-hypertension-and-blood-pressure-responses-to-spironolactone-or-amiloride-the-pathway-2-mechanisms-substudies
#20
Bryan Williams, Thomas M MacDonald, Steve V Morant, David J Webb, Peter Sever, Gordon T McInnes, Ian Ford, J Kennedy Cruickshank, Mark J Caulfield, Sandosh Padmanabhan, Isla S Mackenzie, Jackie Salsbury, Morris J Brown
BACKGROUND: In the PATHWAY-2 study of resistant hypertension, spironolactone reduced blood pressure substantially more than conventional antihypertensive drugs. We did three substudies to assess the mechanisms underlying this superiority and the pathogenesis of resistant hypertension. METHODS: PATHWAY-2 was a randomised, double-blind crossover trial done at 14 UK primary and secondary care sites in 314 patients with resistant hypertension. Patients were given 12 weeks of once daily treatment with each of placebo, spironolactone 25-50 mg, bisoprolol 5-10 mg, and doxazosin 4-8 mg and the change in home systolic blood pressure was assessed as the primary outcome...
April 11, 2018: Lancet Diabetes & Endocrinology
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