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https://www.readbyqxmd.com/read/28339659/the-use-of-guideline-recommended-beta-blocker-therapy-in-primary-prevention-implantable-cardioverter-defibrillator-patients-insight-from-danish-nationwide-registers
#1
Anne-Christine Ruwald, Gunnar Hilmar Gislason, Michael Vinther, Jens Brock Johansen, Jens Cosedis Nielsen, Helen Høgh Petersen, Christian Torp-Pedersen, Sam Riahi, Christian Jøns
Aims: We aimed to examine the use of guideline recommended beta-blocker therapy prior to and after primary prevention implantable cardioverter defibrillator (ICD) implantation in a 'real-life' setting. Methods and results: From the Danish Pacemaker and ICD Registry we identified all 1st-time primary prevention ICD and cardiac resynchronization therapy defibrillator (CRT-D) implantations in Denmark from 2007-12 (n = 2935). Use of beta-blocker, type and dose was acquired through the Danish Prescription Registry...
February 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28327653/association-of-aldosterone-excess-and-apnea-hypopnea-index-in-patients-with-resistant-hypertension
#2
Xiao Ke, Wenyu Guo, Hu Peng, Chengheng Hu, Henghong Zhang, Changnong Peng, Xiaoqing Wang
The present study was to investigate the association of aldosterone excess and apnea-hypopnea index (AHI) in patients with resistant hypertension. Patients with resistant hypertension were enrolled and baseline characteristics including plasma aldosterone concentration (PAC) and 24 h-urine aldosterone levels were collected and compared between groups with different degrees of AHI as assessed by polysomnography. Association of key variables and AHI was then evaluated by univariate and multiple linear regression analysis...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28321305/occupational-mercury-vapour-poisoning-with-a-respiratory-failure-pneumomediastinum-and-severe-quadriparesis
#3
Jakub Smiechowicz, Anna Skoczynska, Agata Nieckula-Szwarc, Katarzyna Kulpa, Andrzej Kübler
OBJECTIVES: Despite restrictions, mercury continues to pose a health concern. Mercury has the ability to deposit in most parts of the body and can cause a wide range of unspecific symptoms leading to diagnostic mistakes. METHODS AND RESULTS: We report the case of severe mercury vapour poisoning after occupational exposure in a chloralkali plant worker that resulted in life-threatening respiratory failure, pneumomediastinum and quadriparesis. CONCLUSIONS: Prolonged mechanical ventilation and treatment with penicillamine and spironolactone was used with successful outcome...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28320863/rac1-gtpase-regulates-11%C3%AE-hydroxysteroid-dehydrogenase-type-2-and-fibrotic-remodeling
#4
Daniel Lavall, Pia Schuster, Nadine Jacobs, Andrey Kazakov, Michael Böhm, Ulrich Laufs
The aim of the study was to characterize the role of Rac1 GTPase for the mineralocorticoid receptor (MR) mediated pro-fibrotic remodeling. Transgenic mice with cardiac overexpression of constitutively active Rac1 (RacET) develop an age-dependent phenotype with atrial dilatation, fibrosis and atrial fibrillation. Expression of MR was similar in RacET and wild-type (WT) mice. The expression of 11β hydroxysteroid dehydrogenase type 2 (11β-HSD2) was age-dependently upregulated in the atria and the left ventricles of RacET mice on mRNA and protein level...
March 20, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28275946/a-network-meta-analysis-of-clinical-management-strategies-for-treatment-resistant-hypertension-making-optimal-use-of-the-evidence
#5
Peter Makai, Joanna IntHout, Jaap Deinum, Kevin Jenniskens, Gert Jan van der Wilt
BACKGROUND: With the addition of surgical interventions to current medicinal treatments, it is increasingly challenging for clinicians to rationally choose among the various options for treating patients with apparent treatment-resistant hypertension (ATRHTN). This study aims to establish the comparative effectiveness of mineralocorticoid receptor antagonists (MRA), renal denervation (RDN), darusentan and central arteriovenous anastomosis (CAA) for patients with ATRHTN by performing a network meta-analysis...
March 8, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28274925/salt-supplementation-ameliorates-developmental-kidney-defects-in-cox-2-mice
#6
Patrick Slattery, Stefanie Frölich, Itamar Goren, Rolf Michael Nüsing
Deficiency of cyclooxygenase-2 (COX-2) activity in the early postnatal time course causes impairment of kidney development leading to kidney insufficiency. We hypothesize that impaired NaCl reabsorption during the first days of life is a substantial cause for nephrogenic defects observed in COX-2-/- mice and that salt supplementation corrects these defects. Daily injections of 0.8 mg/g/d NaCl for the first 10 days after birth ameliorated impaired kidney development in COX-2-/- pups resulting in an increase in glomerular size and reduction of immature superficial glomeruli...
March 8, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28274354/hormonal-therapies-for-acne
#7
Brittany Barros, Diane Thiboutot
Acne is a common, worldwide problem that is usually multifactorial in etiology, but androgens may play a pivotal role in the development and severity of acne. Endocrinopathies, such as polycystic ovarian syndrome, ovarian tumors, or adrenal hyperplasia or tumors, may be detected in some patients with acne, especially if acne is sudden in onset, associated with hirsutism or menstrual irregularities, or associated with cushingoid facies, acanthosis nigricans, patterned hair loss, or deepened voice. In these instances, serum-free and total testosterone, dehydroepiandrosterone, luteinizing hormone, and follicle stimulating hormone should be tested...
March 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/28257818/novel-alternating-current-electrospinning-of-hydroxypropylmethylcellulose-acetate-succinate-hpmcas-nanofibers-for-dissolution-enhancement-the-importance-of-solution-conductivity
#8
Attila Balogh, Balázs Farkas, Ádám Pálvölgyi, András Domokos, Balázs Démuth, György Marosi, Zsombor Kristóf Nagy
Novel high-yield alternating current electrospinning (ACES) as well as direct current (DCES) methods were investigated to prepare high quality hydroxypropylmethylcellulose acetate succinate (HPMCAS) fibers for the dissolution enhancement of poorly soluble spironolactone (SPIR). Although HPMCAS is of great pharmaceutical importance as a carrier of marketed solid dispersion-based products, it was found to be unprocessable using electrospinning. Addition of small amounts of polyethylene oxide as aid polymer provided smooth fibers with DCES but strongly beaded products with ACES...
February 28, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28254387/colectomy-induces-an-aldosterone-mediated-increase-in-jejunal-glucose-uptake-in-rats
#9
Maha Khachab, Amjad Kanaan, Dania Awad, Elie Deeba, Samira Osman, Camille F Nassar
AIMS: The main function of the colon is water and electrolyte absorption. Total colectomy eliminates this colonic function and may alter the absorptive capacity of the small intestine for nutrients. This study examines the effect of total colectomy on jejunal glucose absorption and investigates the potential role of aldosterone in mediating the alterations in glucose uptake post-colectomy using the aldosterone antagonist spironolactone. MAIN METHODS: Total colectomy with ileo-rectal anastomosis was performed on anesthetized rats...
February 27, 2017: Life Sciences
https://www.readbyqxmd.com/read/28253402/the-relationship-between-the-renin-angiotensin-aldosterone-system-and-nmda-receptor-mediated-signal-and-the-prevention-of-retinal-ganglion-cell-death
#10
Mamoru Kobayashi, Kazuyuki Hirooka, Aoi Ono, Yuki Nakano, Akira Nishiyama, Akitaka Tsujikawa
Purpose: Excitotoxicity, which is due to glutamate-induced toxic effects on the retinal ganglion cell (RGC), is one of several mechanisms of RGC loss. The renin-angiotensin-aldosterone system (RAAS) has also been implicated in RGC death. Therefore, it is important to determine the exact relationship between the RAAS and N-methyl-d-aspartate (NMDA) receptor-mediated signal in order to prevent RGC death. Methods: N-methyl-d-aspartate or aldosterone was injected into the vitreous body...
March 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28247180/registry-based-pragmatic-trials-in-heart-failure-current-experience-and-future-directions
#11
REVIEW
Lars H Lund, Jonas Oldgren, Stefan James
PURPOSE OF REVIEW: Randomized controlled trials (RCTs) in heart failure (HF) are becoming increasingly complex and expensive to conduct and if positive deliver expensive therapy tested only in selected populations. RECENT FINDINGS: Electronic health records and clinical cardiovascular quality registries are providing opportunities for pragmatic and registry-based prospective randomized clinical trials (RRCTs). Simplified regulatory, ethics, and consent procedures; recruitment integrated into real-world care; and simplified or automated baseline and outcome collection allow assessment of study power and feasibility, fast and efficient recruitment, delivery of generalizable findings at low cost, and potentially evidence-based and novel use of generic drugs with low costs to society...
April 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28247089/bullous-pemphigoid-a-review-of-its-diagnosis-associations-and-treatment
#12
REVIEW
Philippe Bernard, Frank Antonicelli
Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease in Western countries, and typically affects the elderly. BP is immunologically characterized by tissue-bound and circulating autoantibodies directed against either the BP antigen 180 (BP180, or BPAG2) or the BP antigen 230 (BP230, or BPAG1e), or even both, which are components of hemidesmosomes involved in the dermal-epidermal cohesion. Risk factors for BP include old age, neurologic diseases (dementia, Parkinson's disease, cerebrovascular disease), and some particular drugs, including loop diuretics, spironolactone and neuroleptics...
February 28, 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/28245473/anti-fibrosis-effect-of-relaxin-and-spironolactone-combined-on-isoprenaline-induced-myocardial-fibrosis-in-rats-via-inhibition-of-endothelial-mesenchymal-transition
#13
Jiejie Cai, Xiao Chen, Xingxing Chen, Lingzhi Chen, Gaoshu Zheng, Xi Zhou, Hao Zhou
BACKGROUND: The effect of relaxin and spironolactone combined on myocardial fibrosis has not been reported. Thus, we investigated the effect of the combined therapy on isoprenaline-induced myocardial fibrosis and the mechanism. METHODS: Rats were injected subcutaneously with isoprenaline to induce myocardial fibrosis and underwent subcutaneous injection with relaxin (2 µg·kg-1·d-1) and given a gavage of spironolactone (30 mg·kg-1·d-1) alone or combined for 14 days...
March 1, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28245343/eplerenone-for-hypertension
#14
REVIEW
Tina Sc Tam, May Hy Wu, Sarah C Masson, Matthew P Tsang, Sarah N Stabler, Angus Kinkade, Anthony Tung, Aaron M Tejani
BACKGROUND: Eplerenone is an aldosterone receptor blocker that is chemically derived from spironolactone. In Canada, it is indicated for use as adjunctive therapy to reduce mortality for heart failure patients with New York Heart Association (NYHA) class II systolic chronic heart failure and left ventricular systolic dysfunction. It is also used as adjunctive therapy for patients with heart failure following myocardial infarction. Additionally, it is indicated for the treatment of mild and moderate essential hypertension for patients who cannot be treated adequately with other agents...
February 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28239828/the-relation-of-the-serum-aldosterone-level-and-central-serous-chorioretinopathy-a-pilot-study
#15
Q Gong, X-H Sun, S-T Yuan, Q-H Liu
OBJECTIVE: The aim of this study was to investigate the serum aldosterone level and abnormal levels of mineral corticoid in patients with the central serous chorioretinopathy (CSC). PATIENTS AND METHODS: All recruited patients with CSC received fundus fluorescein angiography (FFA), enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) and serum aldosterone assay. The patients were classified into spontaneously resolved group and unresolved group according to a 3-months follow-up of Optical Coherence Tomography (OCT) examination...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28236585/the-importance-of-genetic-counseling-and-genetic-screening-a-case-report-of-a-16-year-old-boy-with-resistant-hypertension-and-severe-hypokalemia
#16
Ze-Min Kuang, Ying Wang, Jia-Jie Wang, Jing-Hua Liu, Rong Zeng, Qi Zhou, Zhen-Qiu Yu, Long Jiang
Liddle's syndrome, an autosomal dominant form of monogenic hypertension, is characterized by salt-sensitive hypertension with early penetrance, hypokalemia, metabolic alkalosis, suppression of plasma rennin activity and aldosterone secretion, and a clear-cut response to epithelial sodium channel blockers but not spironolactone therapy. Here, we describe the case of a 16-year-old boy patient with resistant hypertension (maintain 170-180/100-110 mm Hg after administration four kinds of antiypertensive drugs) and severe hypokalemia...
February 3, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28224249/signal-enhancement-in-the-hplc-esi-ms-ms-analysis-of-spironolactone-and-its-metabolites-using-hfip-and-nh4f-as-eluent-additives
#17
Kalev Takkis, Rudolf Aro, Lenne-Triin Kõrgvee, Heili Varendi, Jana Lass, Koit Herodes, Karin Kipper
This paper describes an LC-MS/MS method to determine the concentration of spironolactone and its metabolites 7-alpha-methylthiospironolactone and canrenone in blood plasma samples. The resulting assay is simple (using protein precipitation for sample preparation) and sensitive (the lower limit of quantification is close to 0.5 ng/ml) while requiring only 50 μl of plasma, making it especially suitable for analyzing samples obtained from pediatric and neonatal patients where sample sizes are limited. The sensitivity is achieved by using ammonium fluoride as an eluent additive, which in our case amplifies the signal from our analytes in the plasma solution on average about 70 times...
February 21, 2017: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/28219198/-effects-and-mechanisms-of-ursodeoxycholic-acid-on-isoprenaline-induced-myocardial-fibrosis-in-mice
#18
X Li, K Q Han, Y N Shi, S Z Men, S Li, M H Sun, H Dong, J J Lu, L J Ma, M Zhao, D Li, W Liu
Objective: To investigate the effects and possible mechanisms of ursodeoxycholic acid (UDCA) on myocardial fibrosis in mice. Method: To observe the expression of transforming growth factor(TGF) -β1, CTGF, MMPs and the degree of myocardial fibrosis, 61 male Kunming mice were randomly divided into normal group, low dose UDCA group, high dose of UDCA group, spironolactone group, and the control group.Isoproterenol (ISO) injection was given subcutaneously (30 d) to make the model of myocardial fibrosis.Corresponding anti-fibrosis drugs (UDCA or spironolactone) were given by gavage...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28202884/neurohumoral-modulation-during-waon-therapy-in-chronic-heart-failure%C3%A3-subanalysis-of-waon-chf-study
#19
Tomoko Ichiki, John C Burnett, Christopher G Scott, Denise M Heublein, Masaaki Miyata, Koichiro Kinugawa, Teruo Inoue, Chuwa Tei
BACKGROUND: Heart failure (HF) is a disease of neurohumoral dysfunction and current pharmacological therapies for HF have not improved mortality rates, thus requiring additional new strategies. Waon therapy for HF patients may be a complementary strategy with peripheral vasodilation via nitric oxide. We hypothesized that Waon therapy would improve neurohumoral factors, such as natriuretic peptides (NP) and the renin-angiotensin-aldosterone system (RAAS) in HF.Methods and Results:Plasma samples were collected from patients enrolled in the WAON-CHF Study (Waon therapy (n=77) or control (n=73)) before and after the treatment...
February 16, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28184100/clinical-question-in-congestive-heart-failure-patients-with-preserved-ejection-fraction-does-spironolactone-improve-cardiac-outcomes
#20
Leslie Williams, Cheyn Onarecker
CLINICAL QUESTION: In congestive heart failure patients with preserved ejection fraction, does spironolactone improve cardiac outcomes? ANSWER: No. A randomized controlled trial of patients with heart failure and an ejection fraction > 45% showed that spironolactone did not significantly reduce the incidence of the primary composite outcome of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for the management of heart failure. LEVEL OF EVIDENCE FOR THE ANSWER: A...
September 2016: Journal of the Oklahoma State Medical Association
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