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    Transarterial embolization of a hyperfunctioning aldosteronoma in a patient with bilateral adrenal nodules.
    Radiol Case Rep 2017 Mar 29;12(1):87-91. Epub 2016 Nov 29.
    Department of Vascular and Interventional Radiology, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL 33136-1005, USA.
    Primary hyperaldosteronism often results in resistant hypertension and hypokalemia, which may lead to cardiovascular and cerebrovascular complications. Although surgery is first line treatment for unilateral functioning aldosteronomas, minimally invasive therapies may be first line for certain patients such as those who cannot tolerate surgery. We present a case of transarterial embolization (TAE) of an aldosteronoma. Read More

    NP-59 test for preoperative localization of primary hyperaldosteronism.
    Langenbecks Arch Surg 2017 Feb 21. Epub 2017 Feb 21.
    University Hospital La Princesa, Madrid, Spain.
    Purpose: Adrenal venous sampling is generally considered the gold standard to identify unilateral hormone production in cases of primary hyperaldosteronism. The aim of this study is to evaluate whether the iodine-131-6-β-iodomethyl-19-norcholesterol (NP-59) test may represent an alternative in selected cases.

    Methods: Patients submitted to laparoscopic adrenalectomy for suspected primary hyperaldosteronism (n = 27) were retrospectively reviewed. Read More

    Low dose-eplerenone treatment decreases aortic stiffness in patients with resistant hypertension.
    J Clin Hypertens (Greenwich) 2017 Feb 17. Epub 2017 Feb 17.
    Divisions of Nephrology and Intensive Care Medicine, Department of Internal Medicine, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
    Vascular damage is aggravated in animal models of hypertension with mineralocorticoid (MR) excess and in hypertensive patients with primary hyperaldosteronism. MR antagonism has shown to provide effective blood pressure (BP)-control in patients with treatment resistant hypertension (TRH), but the concurrent effects on the vasculature have not been examined. In a randomized, double-blinded, placebo-controlled parallel-group study, 51 patients with TRH received either eplerenone 50 mg or placebo for 6 months together with additional antihypertensives titrated to achieve a BP target of <140/90 mm Hg. Read More

    Adrenocortical neoplasms in adulthood and childhood: distinct presentation. Review of the clinical, pathological, and imaging characteristics.
    J Pediatr Endocrinol Metab 2017 Feb 7. Epub 2017 Feb 7.
    Adrenocortical tumors (ACT) in adulthood and childhood vary in clinical, histopathological, molecular, prognostic, and imaging aspects. ACT are relatively common in adults, as adenomas are often found incidentally on imaging. ACT are rare in children, though they have a significantly higher prevalence in the south and southeast regions of Brazil. Read More

    Anatomical Variations of the Right Adrenal Vein: Concordance Between Multidetector Computed Tomography and Catheter Venography.
    Hypertension 2017 Mar 30;69(3):428-434. Epub 2017 Jan 30.
    From the Department of Diagnostic Radiology (K.O., H.O., Y.T., T.M., K.S., K.T.), Department of Urology (Y.A.), and Division of Nephrology, Endocrinology, and Vascular Medicine (R.M., F.S.), Tohoku University Hospital, Sendai, Japan.
    Adrenal venous sampling is the most reliable diagnostic procedure to determine surgical indications in primary aldosteronism. Because guidelines recommend multidetector computed tomography (CT) to evaluate the adrenal gland, some past reports used multidetector CT as a guide for adrenal venous sampling. However, the detailed anatomy of the right adrenal vein and its relationship with an accessory hepatic vein remains uncertain. Read More

    Assessment of the Aldosteronona resolution score as a predictive resolution score of hypertension after adrenalectomy for aldosteronoma in French patients.
    Langenbecks Arch Surg 2017 Jan 22. Epub 2017 Jan 22.
    Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), CHU Hôtel-Dieu, 1 place Alexis Ricordeau, 44093, Nantes cedex 1, France.
    Purpose: Aldosteronoma Resolution Score (ARS) is a predictive score for cure of hypertension after adrenalectomy for hyperaldosteronism and has been validated in American patients. The aim of the study was to validate this score in a French population.

    Method: Data concerning patients operated from 2002 to 2015 in 7 French University Hospitals were retrospectively collected. Read More

    Evacetrapib: Another CETP Inhibitor for Dyslipidemia With No Clinical Benefit.
    Cardiol Rev 2017 Mar/Apr;25(2):43-52
    From the *Department of Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA; and †Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.
    Evacetrapib is a cholesteryl ester transfer protein (CETP) inhibitor that has been recently studied as a cholesterol modifying agent to reduce cardiovascular risk and mortality in high risk cardiovascular disease patients. Evacetrapib acts to decrease lipid exchange through CETP inhibition. CETP acts to transfer cholesteryl esters from high-density lipoprotein-cholesterol (HDL-C) to low-density lipoprotein cholesterol (LDL-C) and very-low-density lipoprotein (VLDL-C). Read More

    Novel Approach to Establishing an Aldosterone: Renin Ratio Cutoff for Primary Aldosteronism.
    Hypertension 2017 Mar 9;69(3):450-456. Epub 2017 Jan 9.
    From the Division of Endocrinology and Metabolism, Department of Medicine (A.A.L., G.A.K.) and Calgary Laboratory Services, Department of Pathology and Laboratory Medicine, Section of Clinical Biochemistry (D.J.O., A.C., H.S.), University of Calgary, Alberta, Canada.
    Direct renin concentration is replacing plasma renin activity in many laboratories for the investigation of primary aldosteronism, which may have a significant impact on the resulting aldosterone:renin ratios. We sought to develop a population-based approach to establishing an aldosterone:renin ratio cutoff when transitioning between assays. A population-based study was performed in Calgary, Alberta, Canada of 4301 individuals who received testing from January 2012 to November 2015. Read More

    Synthetic approaches towards the multi target drug spironolactone and its potent analogues/derivatives.
    Steroids 2017 Feb 29;118:76-92. Epub 2016 Dec 29.
    Department of Chemistry, Quaid-i-Azam University, 45320 Islamabad, Pakistan.
    Spironolactone is a well-known multi-target drug and is specifically used for the treatment of high blood pressure and heart failure. It is also used for the treatment of edema, cirrhosis of the liver, malignant, pediatric, nephrosis and primary hyperaldosteronism. Spironolactone in association with thiazide diuretics treats hypertension and in association with furosemide treats bronchopulmonary dyspepsia. Read More

    A novel mutation of CLCNKB in a Korean patient of mixed phenotype of Bartter-Gitelman syndrome.
    Korean J Pediatr 2016 Nov 30;59(Suppl 1):S103-S106. Epub 2016 Nov 30.
    Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
    Bartter syndrome (BS) is an inherited renal tubular disorder characterized by low or normal blood pressure, hypokalemic metabolic alkalosis, and hyperreninemic hyperaldosteronism. Type III BS is caused by loss-of-function mutations in CLCNKB encoding basolateral ClC-Kb. The clinical phenotype of patients with CLCNKB mutations has been known to be highly variable, and cases that are difficult to categorize as type III BS or other hereditary tubulopathies, such as Gitelman syndrome, have been rarely reported. Read More

    Hypertension: The role of biochemistry in the diagnosis and management.
    Clin Chim Acta 2017 Feb 19;465:131-143. Epub 2016 Dec 19.
    Dept. of Clinical Biochemistry & Diagnostic Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland.
    Hypertension is defined as a persistently elevated blood pressure ≥140/90mmHg. It is an important treatable risk factor for cardiovascular disease, with a high prevalence in the general population. The most common cause, essential hypertension, is a widespread disease - however, secondary hypertension is under investigated and under diagnosed. Read More

    Improvement of Bone Turnover Markers and Bone Mineral Density following treatment of Primary Aldosteronism.
    Minerva Endocrinol 2016 Dec 20. Epub 2016 Dec 20.
    Endocrine Unit, Department of Medicine, University Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia -
    Background: Recent studies showed association between hyperaldosteronism and low bone density among patients with primary aldosteronism (PA) due to secondary hyperparathyroidism. Our objective is to assess bone turnover markers (BTM) and bone mineral density (BMD) of PA patients compared to essential hypertension.

    Methods: This was an open-label, prospective, case-controlled study, conducted over 12 months. Read More

    The Resting-State Functional Connectivity of the Default Mode Networks in Patients With Obstructive Sleep Apnea-Hypopnea Syndrome.
    CNS Neurol Disord Drug Targets 2016 Dec 19. Epub 2016 Dec 19.
    Department of Radiology, Children`s Hospital of Nanjing Medical University, Nanjing 210008, PRC, China.
    Obstructive sleep apnea-hypopnea syndrome (OSAHS) is normally linked to cognitive and functional dysfunctions. In this study, we explored the resting-state functional connectivity (rsFC) in the default mode network (DMN) to show the mechanism of neurophysiology in patients with OSAHS. Resting-state structural and functional Magnetic Resonance Imaging data were obtained from sixteen male moderate-to- severe patients with untreated OSAHS and 15 male matched healthy control subjects. Read More

    Consequences of morbid obesity on the kidney. Where are we going?
    Clin Kidney J 2016 Dec 20;9(6):782-787. Epub 2016 Sep 20.
    Department of Nephrology, Hospital Universitari Germans Trias i Pujol, Universitat, Autònoma de Barcelona, Esfera UAB, Badalona, Spain.
    Obesity and morbid obesity are modifiable risk factors for the development and progression of kidney disease. Obesity has reached epidemic proportions and is currently an important health problem in Europe, so it is necessary to develop therapeutic and preventive strategies. The obesity-related glomerulopathy has been defined as a secondary form of focal segmental glomerulosclerosis, and its most characteristic feature is glomerulomegaly. Read More

    The Triad of Sleep Apnea, Hypertension, and Chronic Kidney Disease: A Spectrum of Common Pathology.
    Cardiorenal Med 2016 Nov 5;7(1):74-82. Epub 2016 Nov 5.
    Division of Nephrology, University of Missouri Health Science Center, Columbia, MO, USA; Nephrology Section, Harry S. Truman Veterans' Hospital, Columbia, MO, USA.
    Obstructive sleep apnea (OSA), hypertension, and chronic kidney disease (CKD) are different entities and are generally managed individually most of the time. However, CKD, OSA, and hypertension share many common risk factors and it is not uncommon to see this complex triad together. In fact, they share similar pathophysiology and have been interlinked with each other. Read More

    Is Laparoendoscopic Single-Site Adrenalectomy a Feasible Alternative in Treating Aldosterone-Producing Adenoma?
    Biomed Res Int 2016 16;2016:6894381. Epub 2016 Nov 16.
    Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan; Department of Urology, Tzu Chi University, Medical College, Hualien, Taiwan.
    Objective. To compare laparoendoscopic single-site (LESS) and conventional multiport adrenalectomy in patients with aldosterone-producing adenoma (APA). Material and Methods. Read More

    Histopathological classification of cross-sectional image negative hyperaldosteronism.
    J Clin Endocrinol Metab 2016 Dec 14:jc20162986. Epub 2016 Dec 14.
    1 Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan.
    Context: Approximately half of primary aldosteronism (PA) have clinically evident disease according to clinical (hypertension) and/or laboratory (aldosterone and renin levels) findings but do not have nodules detectable in routine cross-sectional imaging. However, the detailed histopathologic, steroidogenic and pathobiological features of cross-sectional image negative PA have not been well characterized.

    Objective: Examine histopathology, steroidogenic enzyme expression and somatic mutation status of aldosterone-driver genes in adrenals from cross-sectional image negative hyperaldosteronism. Read More

    Genetic characterization of a mouse line with primary aldosteronism.
    J Mol Endocrinol 2017 Feb 13;58(2):67-78. Epub 2016 Dec 13.
    Medizinische Klinik und Poliklinik IVEndocrine Research Unit, Klinikum der Universität München, LMU, Munich, Germany.
    In an attempt to define novel genetic loci involved in the pathophysiology of primary aldosteronism, a mutagenesis screen after treatment with the alkylating agent N-ethyl-N-nitrosourea was established for the parameter aldosterone. One of the generated mouse lines with hyperaldosteronism was phenotypically and genetically characterized. This mouse line had high aldosterone levels but normal creatinine and urea values. Read More

    A Novel Method of Adrenal Venous Sampling via an Antecubital Approach.
    Cardiovasc Intervent Radiol 2017 Mar 8;40(3):388-393. Epub 2016 Dec 8.
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing, 100037, China.
    Purpose: Currently, almost all adrenal venous sampling (AVS) procedures are performed by femoral vein access. The purpose of this study was to establish the technique of AVS via an antecubital approach and evaluate its safety and feasibility.

    Materials And Methods: From January 2012 to June 2015, 194 consecutive patients diagnosed as primary aldosteronism underwent AVS via an antecubital approach without ACTH simulation. Read More

    Adrenocortical carcinoma, an unusual cause of secondary hypertension.
    BMJ Case Rep 2016 Dec 7;2016. Epub 2016 Dec 7.
    Department of Endocrinology, Hospital Regional Licenciado Adolfo Lopez Mateos, Ciudad de Mexico, Mexico.
    We present the case of a female patient aged 39 years who was admitted to our hospital due to hypertension, severe hypokalaemia and metabolic alkalosis; physical examination was remarkable for plethoric moon face, centripetal obesity and bilateral lower extremity oedema. She was admitted for intravenous potassium replacement and further assessment of hypertension and associated clinical findings. Laboratory testing showed increased levels of aldosterone, renin, cortisol, testosterone and androstenedione. Read More

    Plasma adrenocorticotropic hormone but not aldosterone is correlated with blood pressure in patients with aldosterone-producing adenomas.
    J Clin Hypertens (Greenwich) 2016 Dec 5. Epub 2016 Dec 5.
    Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
    Although plasma aldosterone concentration (PAC) varies depending on primary aldosteronism (PA) subtypes, patients with different subtypes may have similar blood pressure (BP). The authors hypothesized that hormones other than aldosterone might influence BP in PA patients. A total of 73 PA cases, including 30 cases of aldosterone-producing adenomas (APAs), 29 cases of bilateral hyperaldosteronism, and 24 control cases of essential hypertension were enrolled retrospectively. Read More

    Bartter's and Gitelman's syndrome.
    Curr Opin Pediatr 2016 Nov 30. Epub 2016 Nov 30.
    Center of Pediatrics and Adolescent Medicine at Philipps University Marburg, Marburg, Germany.
    Purpose Of Review: The clinical presentations of Bartter's syndrome and Gitelman's syndrome will be reviewed including two most recently described hypokalemic salt-losing tubulopathies. By taking the quite heterogeneous presentations and the apparently different pathophysiologies as the basis, the applicability of the physiologic classification has been tested.

    Recent Findings: According to the physiologic approach, salt-losing tubulopathies can be divided into two major groups (with completely different tubular defects): first, disorders of the thick ascending limb of Henle's loop (loop disorders); second, disorders of the distal convolute tubule (DCT disorders). Read More

    Hypertension Cure Following Laparoscopic Adrenalectomy for Hyperaldosteronism is not Universal: Trends Over Two Decades.
    World J Surg 2016 Nov 21. Epub 2016 Nov 21.
    Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
    Background: Laparoscopic adrenalectomy has been established as a standard surgical method for unilateral primary aldosteronism. Meanwhile, the background characteristics of the patients undergoing adrenalectomy have changed over the last 20 years. The aim of this study was to investigate the changes in hypertension cure rates after laparoscopic adrenalectomy during the last two decades. Read More

    Preclinical and Early Clinical Profile of a Highly Selective and Potent Oral Inhibitor of Aldosterone Synthase (CYP11B2).
    Hypertension 2017 Jan 21;69(1):189-196. Epub 2016 Nov 21.
    From the Clinical Pharmacology (K.B., D.S., M.-L.D.), Biostatistics (G.P.), Discovery (K.A.), Pharmaceutical Sciences (S.M., M.C.D.V.M.), and Translational Medicine, Cardiovascular Diseases (P.F.), Pharma Research and Early Development, Roche Innovation Center Basel, Switzerland; and Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, United Kingdom (M.J.B).
    Primary hyperaldosteronism is a common cause of resistant hypertension. Aldosterone is produced in the adrenal by aldosterone synthase (AS, encoded by the gene CYP11B2). AS shares 93% homology to 11β-hydroxylase (encoded by the gene CYP11B1), responsible for cortisol production. Read More

    Resistant Hypertension.
    Adv Exp Med Biol 2016 Nov 19. Epub 2016 Nov 19.
    Lankenau Medical Center, Lancaster Avenue, Suite 130, Wynnewood, PA, USA, 19096.
    Conservatively, ten million people in the USA alone may suffer from RH and may be similarly prevalent elsewhere. Given the strong linear correlation between hypertension and cardiovascular outcomes, better control is paramount. We favor a multi-pronged approach. Read More

    Scoring system for the diagnosis of bilateral primary aldosteronism in the outpatient setting before adrenal venous sampling.
    Clin Endocrinol (Oxf) 2016 Nov 8. Epub 2016 Nov 8.
    Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
    Objective: The only reliable method for subtyping primary aldosteronism (PA) is adrenal venous sampling (AVS), which is costly and time-consuming. Considering the limited availability of AVS, it would be helpful to obtain information on the diagnosis of bilateral hyperaldosteronism (BHA) from routine tests. We aimed to establish new, simple criteria for outpatients to diagnose BHA from PA before AVS. Read More

    Anterior Chamber Non-Hodgkin Lymphoma of the Iris Masquerading as Uveitis-Glaucoma-Hyphema Syndrome.
    Ocul Oncol Pathol 2016 Oct 12;2(4):230-233. Epub 2016 May 12.
    Department of Ophthalmology and Visual Science, New Haven, Conn., USA; Department of Ophthalmic Oncology, Smilow Cancer Hospital, New Haven, Conn., USA.
    Purpose: To report a case of iris non-Hodgkin lymphoma initially thought to be uveitis-glaucoma-hyphema (UGH) syndrome.

    Methods: We reviewed the clinical, radiographic, and histopathologic findings in a patient with recurrent hyphemas and increased ocular pressure who eventually was found to have a rapidly growing iris mass.

    Results: An 89-year-old man with a history of cataract extraction and mantle cell lymphoma developed recurrent hyphema, which was subsequently revealed to be due to an iris mass. Read More

    Adrenal vein sampling in primary aldosteronism: concordance of simultaneous vs sequential sampling.
    Eur J Endocrinol 2017 Feb 11;176(2):159-167. Epub 2016 Nov 11.
    Department of RadiologyCentre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada
    Objective: Many investigators believe that basal adrenal venous sampling (AVS) should be done simultaneously, whereas others opt for sequential AVS for simplicity and reduced cost. This study aimed to evaluate the concordance of sequential and simultaneous AVS methods.

    Design And Methods: Between 1989 and 2015, bilateral simultaneous sets of basal AVS were obtained twice within 5 min, in 188 consecutive patients (59 women and 129 men; mean age: 53. Read More

    Cardiac Dysfunction in Association with Increased Inflammatory Markers in Primary Aldosteronism.
    Endocrinol Metab (Seoul) 2016 Dec 3;31(4):567-576. Epub 2016 Nov 3.
    Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
    Background: Oxidative stress in primary aldosteronism (PA) is thought to worsen aldosterone-induced damage by activating proinflammatory processes. Therefore, we investigated whether inflammatory markers associated with oxidative stress is increased with negative impacts on heart function as evaluated by echocardiography in patients with PA.

    Methods: Thirty-two subjects (mean age, 50. Read More

    Galectin-3 Blockade Reduces Renal Fibrosis in Two Normotensive Experimental Models of Renal Damage.
    PLoS One 2016 9;11(11):e0166272. Epub 2016 Nov 9.
    Cardiovascular Translational Research. Navarrabiomed (Miguel Servet Foundation), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
    Background: Galectin-3 (Gal-3), a β-galactoside-binding lectin, is increased in kidney injury and its pharmacological blockade reduces renal damage in acute kidney injury, hyperaldosteronism or hypertensive nephropathy. We herein investigated the effects of pharmacological Gal-3 inhibition by modified citrus pectin (MCP) in early renal damage associated with obesity and aortic stenosis (AS).

    Results: Gal-3 was upregulated in kidneys from high fat diet (HFD) rats and in animals with partial occlusion of ascending aorta (AS). Read More

    Identification of Two Heritable Cross-Disorder Endophenotypes for Tourette Syndrome.
    Am J Psychiatry 2016 Nov 4:appiajp201616020240. Epub 2016 Nov 4.
    From the Department of Psychiatry, University of California, San Francisco; the Department of Medicine, Vanderbilt University Medical Center, Nashville; the Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston; the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore; the Department of Psychiatry and University Health Network, University of Toronto, Toronto; the Youthdale Treatment Centres, Toronto; the Department of Psychiatry, University of Montreal, Montreal; the Yale Child Study Center and the Department of Genetics, Yale University School of Medicine, New Haven, Conn.; the Feinstein Institute for Medical Research, North Shore/Long Island Jewish Health System, Manhasset, N.Y.; the Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands; the Stanley Institute for Cognitive Genomics, Cold Spring Harbor Laboratory, Cold Spring Harbor, N.Y.; the Department of Psychology, University of Denver, Denver; the Department of Psychiatry, University of Utah, Salt Lake City; the Department of Behavioral Health, Tripler Army Medical Center, Honolulu; the Departments of Neurology, Brigham and Women's Hospital and Massachusetts General Hospital,, Boston; and the Department of Psychiatry, University of Florida, Gainesville.
    Objective: Phenotypic heterogeneity in Tourette syndrome is partly due to complex genetic relationships among Tourette syndrome, obsessive-compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD). Identifying symptom-based endophenotypes across diagnoses may aid gene-finding efforts.

    Method: Assessments for Tourette syndrome, OCD, and ADHD symptoms were conducted in a discovery sample of 3,494 individuals recruited for genetic studies. Read More

    A Novel Phenotype of Familial Hyperaldosteronism Type III: Concurrence of Aldosteronism and Cushing's Syndrome.
    J Clin Endocrinol Metab 2016 Nov 12;101(11):4290-4297. Epub 2016 Jul 12.
    Department of Endocrinology (A.T., F.W.), Key Laboratory of Endocrinology, Ministry of Health, and Departments of Urology (G.L., Y.Z.) and Clinical Laboratory (D.Z.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; The Key Laboratory of Genome Sciences and Information (J.J.), Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; Department of Endocrinology (Z.Y.), Affiliated Hospital of the Inner Mongolia Medical University, Hohhot 010050, China; and Hypertension Center (J.C.), Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
    Context: To date, all the familial hyperaldosteronism type III (FH-III) patients reported presenting with typical primary aldosteronism (PA), without showing other adrenal hormone abnormalities.

    Objective: This study characterized a novel phenotype of FH-III and explored the possible pathogenesis.

    Patients And Methods: A male patient presented with severe hypertension and hypokalemia at the age of 2 years and developed Cushing's syndrome at 20 years. Read More

    Successful treatment of severe hypokalemia in a dog with acute kidney injury caused by leptospirosis.
    J Vet Emerg Crit Care (San Antonio) 2016 Nov 4;26(6):837-843. Epub 2015 Dec 4.
    Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL, 32608.
    Objective: To report the case management of a patient with severe hypokalemia resulting in cardiopulmonary arrest caused by infection with leptospirosis.

    Case Summary: A 3-year-old intact female Dachshund presented for polyuria, polydipsia, and refractory hypokalemia, which progressed to flaccid paralysis and cardiorespiratory arrest. Following successful resuscitation, the dog was apneic and managed with mechanical ventilation while volume status and electrolytes were corrected. Read More

    NLRP3 Inflammasome Mediates Aldosterone-Induced Vascular Damage.
    Circulation 2016 Dec 1;134(23):1866-1880. Epub 2016 Nov 1.
    From Department of Pharmacology (T.B.-N., N.S.F., C.Z.Z., F.R., I.O.P., V.C.O., K.B.N., R.A.-L., E.C., F.L.M., D.P., J.P.M.L., J.C.A.F., R.C.T.), Department of Physiology (C.A.A.S., R.F.), Department of Biochemistry and Immunology (D.C.), Department of Clinical Medicine, Division of Endocrinology (P.C.E., A.C.M.), and Department of Cell and Molecular Biology (D.S.Z.), Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Immunology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil (F.V.P., T.B., N.O.); and Department of Pharmacology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (S.B.C.).
    Background: Inflammation is a key feature of aldosterone-induced vascular damage and dysfunction, but molecular mechanisms by which aldosterone triggers inflammation remain unclear. The NLRP3 inflammasome is a pivotal immune sensor that recognizes endogenous danger signals triggering sterile inflammation.

    Methods: We analyzed vascular function and inflammatory profile of wild-type (WT), NLRP3 knockout (NLRP3(-/-)), caspase-1 knockout (Casp-1(-/-)), and interleukin-1 receptor knockout (IL-1R(-/-)) mice treated with vehicle or aldosterone (600 µg·kg(-1)·d(-1) for 14 days through osmotic mini-pump) while receiving 1% saline to drink. Read More

    Disordered zonal and cellular CYP11B2 enzyme expression in familial hyperaldosteronism type 3.
    Mol Cell Endocrinol 2017 Jan 25;439:74-80. Epub 2016 Oct 25.
    Division of Endocrinology, Henry Ford Health System, Detroit, MI, United States.
    Three forms of familial primary aldosteronism have been recognized. Familial Hyperaldosteronism type 1 (FH1) or dexamethasone suppressible hyperaldosteronism, FH2, the most common form of as yet unknown cause(s), and FH3. FH3 is due to activating mutations of the potassium channel gene KCNJ5 that increase constitutive and angiotensin II-induced aldosterone synthesis. Read More

    CACNA1H Mutations Are Associated With Different Forms of Primary Aldosteronism.
    EBioMedicine 2016 Nov 4;13:225-236. Epub 2016 Oct 4.
    INSERM, UMRS_970, Paris Cardiovascular Research Center, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France. Electronic address:
    Primary aldosteronism (PA) is the most common form of secondary hypertension. Mutations in KCNJ5, ATP1A1, ATP2B3 and CACNA1D are found in aldosterone producing adenoma (APA) and familial hyperaldosteronism (FH). A recurrent mutation in CACNA1H (coding for Cav3. Read More

    Work up of incidental adrenal mass: state of the art.
    Urologia 2016 Nov 23;83(4):179-185. Epub 2016 Jun 23.
    Department of Urology, ASL2 Abruzzo, Chieti - Italy.
    Due to the increasing use of radiological investigations, the detection of incidental adrenal masses has become even more frequent. Therefore, it is crucial to identify the nature of the adrenal mass in order to decide the type of treatment that should be undertaken. Toward this goal, biochemical tests are useful in order to assess catecholamines levels for the presence of a pheochromocytoma or cortisol excess in case of Cushing's syndrome. Read More

    Transcriptome Pathway Analysis of Pathological and Physiological Aldosterone-Producing Human Tissues.
    Hypertension 2016 Dec 24;68(6):1424-1431. Epub 2016 Oct 24.
    From the Centre for Clinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, United Kingdom (J.Z., M.J.B.); Clinical Pharmacology Unit, Department of Medicine, University of Cambridge (J.Z.), University of Cambridge Metabolic Research Laboratories, Wellcome Trust MRC Institute of Metabolic Science (B.L., G.S.H.Y.), Cambridge University Hospitals NHS Foundation Trust (S.G.N.), Addenbrooke's Hospital, United Kingdom; and Department of Medicine, Faculty of Medicine, The National University of Malaysia (UKM) Medical Centre, Kuala Lumpur (E.A.B.A.).
    Primary aldosteronism is present in ≈10% of hypertensives. We previously performed a microarray assay on aldosterone-producing adenomas and their paired zona glomerulosa and fasciculata. Confirmation of top genes validated the study design and functional experiments of zona glomerulosa selective genes established the role of the encoded proteins in aldosterone regulation. Read More

    Primary Aldosteronism: Diagnosis and Management.
    Am J Med Sci 2016 Oct 1;352(4):391-398. Epub 2016 Jul 1.
    Department of Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee.
    Primary aldosteronism (PA) is an important and commonly unrecognized cause of secondary hypertension. Idiopathic hyperaldosteronism and aldosterone-producing adenomas account for more than 95% of PA and are characterized, respectively, by bilateral or unilateral involvement of the adrenal glands. When there is suspicion for the presence of PA, a plasma aldosterone to renin ratio should be obtained initially. Read More

    [Primary hyperaldosteronism due to unilateral adrenal hyperplasia with surgical resolution].
    Hipertens Riesgo Vasc 2016 Oct - Dec;33(4):155-158. Epub 2016 Apr 15.
    Servicio de Endocrinología y Nutrición, Hospital Universitario Doctor Peset, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, España.
    Unilateral adrenal hyperplasia is a rare cause of primary hyperaldosteronism (around a 3%) that has surgical treatment. A case of a patient with hypertension resistant to conventional therapy in treatment with 7 drugs who presented with primary hyperaldosteronism due to unilateral adrenal hyperplasia is presented. A left adrenalectomy was performed, and the patient had a good clinical response, with no need of any drug after 2 years of surgery. Read More

    Adrenal disorders: Is there Any role for vitamin D?
    Rev Endocr Metab Disord 2016 Oct 20. Epub 2016 Oct 20.
    Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy.
    An emerging branch of research is examining the linkage between Vitamin D and nonskeletal disorders, including endocrine diseases. In this regard, a still little studied aspect concerns the involvement of vitamin D in adrenal gland disorders. Adrenal gland disorders, which might be theoretically affected by vitamin D unbalance, include adrenal insufficiency, Cushing's syndrome, adrenocortical tumors and hyperaldosteronism. Read More

    Risk factors for renal impairment revealed after unilateral adrenalectomy in patients with primary aldosteronism.
    Medicine (Baltimore) 2016 Jul;95(27):e3930
    aDepartment of Medicine, Division of Nephrology bBiostatistics and Clinical Epidemiology Center cDepartment of Surgery dDepartment of Medicine, Division of Endocrinology, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
    Primary aldosteronism (PA) may induce significant decline of renal function and structural damage of kidney. However, it is difficult to evaluate accurate renal function in patients with PA, because glomerular hyperfiltration and aldosterone escape can conceal renal impairment. In this retrospective cohort study, we compared changes in renal function after unilateral adrenalectomy between patients with PA and patients with other adrenal diseases. Read More

    Hypomethylation of CYP11B2 in Aldosterone-Producing Adenoma.
    Hypertension 2016 Dec 17;68(6):1432-1437. Epub 2016 Oct 17.
    From the Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan (Y.Y., K.O., H.O., K.I., K.K., M.Y.); and Division of Endocrinology, G.V. (Sonny) Montgomery VA Medical Center, University of Mississippi Medical Center, Jackson (C.E.G.-S.).
    The purpose of this study was to evaluate the DNA methylation levels of steroidogenic enzyme genes in aldosterone-producing adenoma (APA) and the effects of gene mutations in APA on the DNA methylation levels. DNA methylation array analysis was conducted using nonfunctioning adrenocortical adenoma (n=12) and APA (n=35) samples, including some with a KCNJ5 mutation (n=21), an ATP1A1 mutation (n=5), and without the known mutations (n=9). The quantitative polymerase chain reaction assay was performed for the detection of CYP11B2 and CYP11B1 expression levels in nonfunctioning adrenocortical adenoma and APA. Read More

    OS 35-09 LONG-TERM OUTCOME OF SURGICALLY- AND MEDICALLY-TREATED PATIENTS OF THE PRIMARY ALDOSTERONISM PREVALENCE IN HYPERTENSIVES (PAPY) STUDY.
    J Hypertens 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e401
    Department of Medicine, University of Padova, Italy.
    Objective: PA causes excess cardiovascular (CV) damage, but whether it worsens prognosis remained uncertain as there are no prospective studies. To compare long-term outcome of the 1125 patients recruited in the PAPY study.

    Design And Method: 11. Read More

    OS 33-02 IN PATIENTS WITH RESISTANT HYPERTENSION INCREASED 24-H URINARY CORTISOL LEVEL PREDICT INCREASED BODY MASS INDEX.
    J Hypertens 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e393
    Department of Medicine, University of Alabama at Birmingham, U.S.A.
    Objective: Obesity is associated with a high risk of hypertension and is characterized by hyperaldosteronism and hypercortisolism. We have previously reported that patients with resistant hypertension (RHTN), defined as blood pressure (BP) that remains above goal in spite of the concurrent use of 3 antihypertensive agents of different classes, have a high prevalence of hyperaldosteronism that is positively correlated with body mass index (BMI). Experimental studies indicate that adipocytes secrete a as yet undetermined factor that stimulates aldosterone and cortisol release. Read More

    SY 15-4 ROLE OF HISTONE DEACETYLASES IN REGULATING ENDOTHELIAL AND VASCULAR FUNCTION.
    J Hypertens 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e371-e372
    Kyungpook National University School of Medicine, Korea, Republic of.
    Histone deacetylases (HDACs) act as co-repressors in gene transcription by erasing the acetylation of histones, resulting in epigenetic gene silencing. Recent studies revealed that HDAC inhibitors attenuated blood pressure of several hypertensive animal models such as spontaneously hypertensive rats, hyperaldosteronism rats, angiotensin II-induced hypertensive rats and pulmonary hypertensive rats. Unexpectedly, microarray studies uncovered that administration of HDAC inhibitors decreased expression of some genes for example extracellular matrix proteins, oxidative stress-related proteins, cytokines, chemokines and ion transporters, mostly targets of corticoid receptors. Read More

    SY 14-3 PRIMARY ALDOSTERONISM IN RESISTANT HYPERTENSION.
    J Hypertens 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e369
    University of Alabama at Birmingham, U.S.A.
    : Resistant hypertension refers to patients with difficult-to-treat hypertension, generally defined as needing three or more medications of different classes, including, if tolerated, a diuretic. Observational studies indicate that the prevalence of resistant hypertension based on the preceding definition of needing 3 or medications for blood pressure (BP) control is approximately 15-20% of patients being treated for hypertension. However, causes of pseudoresistance are common, including poor BP technique, poor adherence, white coat effects, and under-treatment, all of which must be identified in order to distinguish apparent resistance from true treatment resistance. Read More

    BR 04-1MANAGEMENT OF TREATMENT-RESISTANT HYPERTENSION.
    J Hypertens 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e198
    University of Edinburgh, United Kingdom.
    Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Read More

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