9,303 results match your criteria spironolactone


Analysis of the physiological and pathological factors of hospitalized patients taking warfarin and the correlation between drug interactions and warfarin efficacy.

Ann Palliat Med 2021 May;10(5):5400-5406

Department of Pharmacy, Shenzhen Hospital of Southern Medical University, Shenzhen, China.

Background: To study the various factors affecting the anticoagulant effect of warfarin, and to promote the rational use of warfarin.

Methods: We collected the medical records of 125 hospitalized patients who used warfarin from January 2018 to December 2019. Statistical analysis was performed on characteristics such as gender, age, treatment, diabetes, hyperlipidemia, hyperthyroidism, hypothyroidism, hepatitis, renal insufficiency, and nephritis; along with other pathological factors, such as aspirin, clopidogrel, spironolactone, amiodarone, amlodipine, trimetazidine, bisoprolol, isosorbide, atorvastatin, furosemide, digoxin, metoprolol, acarbose, levamlodipine, enoxaparin, moxifloxacin, levofloxacin, other drug interactions, and comorbidities. Read More

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Hypertension and heart failure with preserved ejection fraction: position paper by the European Society of Hypertension.

J Hypertens 2021 Jun 16. Epub 2021 Jun 16.

First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy Internal Medicine Department, ICMID, Hospital Clínic, University of Barcelona, Barcelona, Spain Cardiology, Geneva University Hospitals, Geneva, Switzerland King's College London British Heart Foundation Centre, London, UK Université de Lorraine, Centre d'Investigations Cliniques Plurithématique Inserm 1433 CHRU de Nancy, Inserm U1116 FCRIN INI-CRCT, Nancy, France University Medical Centre Ljubljana, Hypertension Department, Medical University Ljubljana, Ljubljana, Slovenia Department of Hypertension, National Institute of Cardiology, Warsaw, Poland Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Stockholm, Sweden Cardiology Department, Asklepeion General Hospital, Athens, Greece Cardiology Department, Klinikum Wels-Grieskirchen, Wels, Austria Økern Heart Centre Institute for Surgical Research and Department of Cardiology, Oslo University Hospital, Rikshospitalet, and University of Oslo Department of Cardiology, Oslo University Hospital Institute of Clinical Medicine, Medical Faculty, University of Oslo, and Departments of Cardiology and Nephrology, Oslo University Hospital, Ullevaal, Oslo, Norway Università Milano-Bicocca, Milan; Policlinico di Monza, Monza, Italy Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Berlin, Germany.

Hypertension constitutes a major risk factor for heart failure with preserved ejection fraction (HFpEF). HFpEF is a prevalent clinical syndrome with increased cardiovascular morbidity and mortality. Specific guideline-directed medical therapy (GDMT) for HFpEF is not established due to lack of positive outcome data from randomized controlled trials (RCTs) and limitations of available studies. Read More

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Three week compared to seven week run-in period length and the assessment of pre-randomization adherence: A study within a trial.

Contemp Clin Trials 2021 Jun 5;107:106466. Epub 2021 Jun 5.

Population Health Research Institute, Hamilton, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Canada; Department of Medicine, McMaster University, Canada.

Background/aims: To examine how measuring adherence at 3 weeks by self-report and pill counts compares to measurements at 7 weeks in a pre-randomization run-in period.

Methods: Study within a trial of an international parallel group randomized controlled trial (RCT) that compares spironolactone to placebo. Adults receiving dialysis enter an 8-week active run-in period with spironolactone. Read More

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Polymeric micelle mediated follicular delivery of spironolactone: Targeting the mineralocorticoid receptor to prevent glucocorticoid-induced activation and delayed cutaneous wound healing.

Int J Pharm 2021 Jun 4;604:120773. Epub 2021 Jun 4.

School of Pharmaceutical Sciences, University of Geneva, CMU - 1 rue Michel Servet, 1211 Geneva 4, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU - 1 rue Michel Servet, 1211 Geneva 4, Switzerland. Electronic address:

Impaired wound healing in patients receiving glucocorticoid therapy is a serious clinical concern: mineralocorticoid receptor (MR) antagonists can counter glucocorticoid-induced off-target activation of MR receptors. The aim of this study was to investigate the cutaneous delivery of the potent MR antagonist, spironolactone (SPL), from polymeric micelle nanocarriers, prepared using a biodegradable copolymer, methoxy-poly(ethylene glycol)-di-hexyl-substituted-poly(lactic acid). Immunofluorescent labelling of the MR showed that it was principally located in the pilosebaceous unit (PSU), justifying the study rationale since polymeric micelles accumulate preferentially in appendageal structures. Read More

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The expanding class of mineralocorticoid receptor modulators: New ligands for kidney, cardiac, vascular, systemic and behavioral selective actions.

Authors:
E Bădilă

Acta Endocrinol (Buchar) 2020 Oct-Dec;16(4):487-496

"Carol Davila" University of Medicine and Pharmacy, Clinical Emergency Hospital, Bucharest, Romania.

This paper reviews the class of mineralocorticoid receptor (MR) modulators, especially new nonsteroidal antagonists. MR is a nuclear receptor expressed in many tissues and cell types. Aldosterone, the most important mineralocorticoid hormone and MR agonist, has many unfavorable effects, especially on the heart, blood vessels, and kidneys, by promoting fibrosis and tissue remodelling. Read More

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Management of endocrine disease: Optimal feminizing hormone treatment in transgender people.

Eur J Endocrinol 2021 Jun 1. Epub 2021 Jun 1.

M Andersen, Endocrinology, Odense University Hospital, Odense, Denmark.

Transgender women are assigned male at birth, but identify as women. The incidence of gender dysphoria is estimated to be around 1% of the population. Gender dysphoria may be associated with depression and low quality of life, which in most cases improves during gender affirming hormonal treatment (GAHT). Read More

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Optic Pit Maculopathy: Adjunctive Treatment Using Oral Spironolactone and Topical Dorzolamide.

Int Med Case Rep J 2021 26;14:357-360. Epub 2021 May 26.

Department of Ophthalmology, Hôpital du Saint-Sacrement, Centre Hospitalier Universitaire de Québec - Université Laval, Québec City, Québec, Canada.

Purpose: There is no consensus for the treatment of optic disc pit maculopathy (ODPM). We describe a case of ODPM refractory to vitrectomy that was successfully treated with systemic spironolactone and topical dorzolamide 2%.

Methods: Case report. Read More

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Radiofrequency catheter ablation combined with spironolactone in the treatment of atrial fibrillation: A single-center randomized controlled study.

Clin Cardiol 2021 Jun 2. Epub 2021 Jun 2.

Department of Cardiology, Fujian Medical University Union Hospital & Fujian Provincial Institute of Coronary Disease, Fuzhou, China.

At present, the question of whether radiofrequency ablation (RFA) combined with spironolactone can reduce the levels of plasma angiotensin II (AngII) and aldosterone (ALD) in patients with atrial fibrillation (AF) and reduce the recurrence of AF has not been reported. HYPOTHESIS: The present study evaluates the effect of spironolactone as an ALD antagonist on the short-term and long-term recurrence of AF after RFA. A total of 203 patients were enrolled in the present study, with 102 patients in the spironolactone therapy group (Group PVI/SP) and 101 patients in the control group (Group PVI alone). Read More

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Treated Hypertensive Patients Assessed by Home Blood Pressure Telemonitoring. TeleMRPA Study.

Arq Bras Cardiol 2021 May 31. Epub 2021 May 31.

Centro Universitário CESMAC - Hospital do Coração, Maceió, AL - Brasil.

Background: Hypertensive patients undergoing treatment and assessed only by casual blood pressure (BP) measurement may be subject to mistaken decisions.

Objective: To assess BP behavior by measuring its levels at the office (casual) and at home (HBPM), the behavior of different classes of antihypertensive drugs, and the prevalence of uncontrolled white-coat hypertension (UCWCH) and uncontrolled masked hypertension (UCMH).

Methods: Cross-sectional study assessing patients who underwent BP monitoring in the TeleMRPA platform between 2017 and 2019. Read More

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OPALS: A New Osimertinib Adjunctive Treatment of Lung Adenocarcinoma or Glioblastoma Using Five Repurposed Drugs.

Cells 2021 May 10;10(5). Epub 2021 May 10.

Dr. Rosell Oncology Institute (IOR), Quirón-Dexeus University Institute, 08028 Barcelona, Spain.

Background: Pharmacological targeting aberrant activation of epidermal growth factor receptor tyrosine kinase signaling is an established approach to treating lung adenocarcinoma. Osimertinib is a tyrosine kinase approved and effective in treating lung adenocarcinomas that have one of several common activating mutations in epidermal growth factor receptor. The emergence of resistance to osimertinib after a year or two is the rule. Read More

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Nonsteroidal Mineralocorticoid Receptor Antagonists: Exploring Role in Cardiovascular Disease.

J Cardiovasc Pharmacol 2021 Jun;77(6):685-698

Department of Pharmacy, Penn State Health Milton S. Hershey Medical Center, Hershey, PA.

Abstract: Aldosterone, a mineralocorticoid hormone, plays a role in the pathophysiology of many cardiovascular disease states. Mineralocorticoid receptor antagonists (MRAs) have been shown to improve clinical outcomes in select patient populations. However, use of available steroidal receptor antagonists, eplerenone and spironolactone, is often limited by the risk or development of hyperkalemia. Read More

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The Role of Finerenone in the Management of Diabetic Nephropathy.

Diabetes Ther 2021 May 29. Epub 2021 May 29.

First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi street, 54636, Thessaloniki, Greece.

Diabetic nephropathy (DN) is the leading cause of chronic kidney disease. Even though mineralocorticoid receptor antagonists (MRA) induce incremental reductions in urine albumin excretion when added to angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, this combination is infrequently used because of an increased risk of hyperkalemia. In this context, finerenone, a novel selective MRA that appears to be associated with lower risk for hyperkalemia compared with other MRAs (spironolactone and eplerenone), might represent a useful tool in patients with DN. Read More

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The role of the mineralocorticoid receptor and mineralocorticoid-receptor-directed therapies in heart failure.

Endocrinology 2021 May 29. Epub 2021 May 29.

Baker Heart and Diabetes Institute, Cardiovascular Endocrinology Laboratory, Prahran, Australia.

Mineralocorticoid receptor (MR) antagonists (MRA), also referred to as aldosterone blockers, are now well recognised for their clinical benefit in patients with heart failure with reduced ejection fraction (HFrEF). Recent studies have also shown MRA can improve outcomes in patients with 'HFpEF', where the ejection fraction is preserved but left ventriclar filling is reduced. While the MR is a steroid hormone receptor best known for anti-natriuretic actions on electrolyte homeostasis in the distal nephron, it is now estalished that the MR has many physiological and pathophysiological roles in the heart, vasculature and other non-epithelial tissue types. Read More

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Clinical efficacy of a benazepril and spironolactone combination in dogs with congestive heart failure due to myxomatous mitral valve disease: The BEnazepril Spironolactone STudy (BESST).

J Vet Intern Med 2021 May 24. Epub 2021 May 24.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.

Background: The renin-angiotensin-aldosterone system (RAAS), when chronically activated, is harmful and RAAS-suppressive drugs are beneficial in the treatment of congestive heart failure (CHF). Mineralocorticoid receptor antagonists are widely used in the treatment of CHF in people.

Hypothesis/objectives: To determine if a mineralocorticoid receptor antagonist (spironolactone) is beneficial and safe in CHF due to myxomatous mitral valve disease (MMVD) of varying severity, we hypothesized that, when combined with furosemide, a combination product (S+BNZ) containing the ACE inhibitor (ACE-I), benazepril, and spironolactone, would be superior to benazepril alone. Read More

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Deep-Learning Models for the Echocardiographic Assessment of Diastolic Dysfunction.

JACC Cardiovasc Imaging 2021 May 12. Epub 2021 May 12.

Center for Clinical Innovation, Division of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia, USA. Electronic address:

Objectives: The authors explored a deep neural network (DeepNN) model that integrates multidimensional echocardiographic data to identify distinct patient subgroups with heart failure with preserved ejection fraction (HFpEF).

Background: The clinical algorithms for phenotyping the severity of diastolic dysfunction in HFpEF remain imprecise.

Methods: The authors developed a DeepNN model to predict high- and low-risk phenogroups in a derivation cohort (n = 1,242). Read More

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Arterial hypertension.

Lancet 2021 May 18. Epub 2021 May 18.

Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Houston, TX, USA.

Arterial hypertension is the most important contributor to the global burden of disease; however, disease control remains poor. Although the diagnosis of hypertension is still based on office blood pressure, confirmation with out-of-office blood pressure measurements (ie, ambulatory or home monitoring) is strongly recommended. The definition of hypertension differs throughout various guidelines, but the indications for antihypertensive therapy are relatively similar. Read More

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Serum potassium changes due to concomitant ACEI/ARB and spironolactone therapy: A systematic review and meta-analysis.

Am J Health Syst Pharm 2021 May 20. Epub 2021 May 20.

College of Pharmacy, L.S. Skaggs Research Institute, University of Utah, Salt Lake City, UT, USA.

Disclaimer: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Read More

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A Rare Case of Reversible Cardiac Dysfunction Associated with Tegafur/Gimeracil/Oteracil (S-1) Therapy.

Int Heart J 2021 May 15;62(3):700-705. Epub 2021 May 15.

Department of Onco-Cardiology/Cardiovascular Medicine, The Cancer Institute Hospital, Japanese Foundation for Cancer Research.

For the past 20 years, S-1 has been used in the treatment of many types of cancer. However, the clinical importance of myocardial dysfunction attributed to S-1 remains to be unclear. Thus, in this study, we report on a patient with myocardial dysfunction associated with S-1. Read More

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Dietary nitrate prevents progression of carotid subclinical atherosclerosis through blood pressure-independent mechanisms in patients with or at risk of type 2 diabetes mellitus.

Br J Clin Pharmacol 2021 May 13. Epub 2021 May 13.

Department of Clinical Pharmacology, King's College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, UK.

Aims: To test if 6 months' intervention with dietary nitrate and spironolactone could affect carotid subclinical atherosclerosis and stiffness, respectively, vs. placebo/doxazosin, to control for blood pressure (BP).

Methods: A subgroup of participants in our double-blind, randomized-controlled, factorial VaSera trial had carotid imaging. Read More

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Non-thiazide diuretics and hospitalization due to hyponatraemia: A population-based case-control study.

Clin Endocrinol (Oxf) 2021 May 12. Epub 2021 May 12.

Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Objective: Diuretics are often implicated in hyponatraemia. While thiazides constitute one of the most common causes of hyponatraemia, data on loop diuretics and potassium-sparing agents are limited and partly conflicting. The objective of this investigation was to study the association between use of different types of non-thiazide diuretics and hospitalization due to hyponatraemia. Read More

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Pachychoroid Neovasculopathy Disguising as Age-Related Macular Degeneration Treated by Spironolactone and Anti-VEGF Combination Therapy.

Case Rep Ophthalmol 2021 Jan-Apr;12(1):116-123. Epub 2021 Apr 9.

Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.

Nonresponse of neovascular age-related macular degeneration (nAMD) to anti-vascular endothelial growth factor (anti-VEGF) therapy can often be attributed to misdiagnosis, and pathologies mimicking AMD might require different therapeutic concepts. In the following, we want to outline a case of presumed nAMD which revealed to be pachychoroid neovasculopathy (PNV) and was successfully treated by the addition of spironolactone. A 67-year-old female patient was referred for nonresponse of nAMD on her left eye after 29 intravitreal injections of aflibercept with no complete resolution of subretinal fluid. Read More

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Risk factors for recurrence of atrial fibrillation.

Anatol J Cardiol 2021 May;25(5):338-345

First Department of Internal Medicine, Medical University Varna; Varna-Bulgaria.

Objective: Atrial fibrillation (AF) is a progressive disease, associated with increased risk of mortality, stroke, heart failure, and worsens quality of life. There is a high incidence of AF recurrence despite the treatment. The aim of the study was to assess the time to recurrence of AF after sinus rhythm restoration with electrical or pharmacological cardioversion and to identify the risk factors. Read More

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Estrogen-induced gallstone pancreatitis in a transgender female.

Am J Health Syst Pharm 2021 May 5. Epub 2021 May 5.

University of Missouri Hospitals, Columbia, MO, USA.

Disclaimer: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Read More

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Predictors of fatal outcomes among hospitalized COVID-19 patients with pre-existing hypertension in China.

Clin Respir J 2021 May 3. Epub 2021 May 3.

State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Background: Coronavirus disease 2019 (COVID-19) is an emerging, rapidly evolving pandemic, hypertension is one of the most common co-existing chronic conditions and a risk factor for mortality. Nearly one-third of the adult population is hypertensive worldwide, it is urgent to identify the factors that determine the clinical course and outcomes of COVID-19 patients with hypertension.

Methods And Results: 148 COVID-19 patients with pre-existing hypertension with clarified outcomes (discharge or deceased) from a national cohort in China were included in this study, of whom 103 were discharged and 45 died in hospital. Read More

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Hypokalaemic paralysis and metabolic alkalosis in a patient with Sjögren syndrome: a case report and literature review.

BMC Nephrol 2021 Apr 30;22(1):159. Epub 2021 Apr 30.

General medicine, National Hospital of Sri Lanka, Colombo, Sri Lanka.

Background: Acquired Gitelman syndrome is a very rare disorder reported in association with autoimmune disorders, mostly Sjögren syndrome. It is characterized by the presence of hypokalaemic metabolic alkalosis, hypocalciuria, hypomagnesaemia and hyper-reninaemia, in the absence of typical genetic mutations associated with inherited Gitelman syndrome.

Case Presentation: A 20 year old woman who was previously diagnosed with primary Sjögren syndrome and autoimmune thyroiditis presented with two week history of lower limb weakness and salt craving. Read More

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Efficacy of Spironolactone Treatment in Murine Models of Cutaneous and Visceral Leishmaniasis.

Front Pharmacol 2021 13;12:636265. Epub 2021 Apr 13.

Laboratorio de Bioquímica de Tripanosomatídeos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.

Translational studies involving the reuse and association of drugs are approaches that can result in higher success rates in the discovery and development of drugs for serious public health problems, including leishmaniasis. If we consider the number of pathogenic species in relation to therapeutic options, this arsenal is still small, and each drug possesses a disadvantage in terms of toxicity, efficacy, price, or treatment regimen. In the search for new drugs, we performed a drug screening of promastigotes and intracellular amastigotes of fifty available drugs belonging to several classes according to their pharmacophoric group. Read More

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Mineralocorticoid Receptor Antagonists Eplerenone and Spironolactone Modify Adrenal Cortex Morphology and Physiology.

Biomedicines 2021 Apr 20;9(4). Epub 2021 Apr 20.

Department of Experimental Biology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.

Mineralocorticoid receptor antagonists (MRAs) are a class of anti-hypertensive drugs that act by blocking aldosterone action. The aim of this study was to evaluate whether the MRAs spironolactone and eplerenone influence adrenal cortical physiology and morphology. Spontaneous hypertensive rats (SHR, = 18) and normotensive rats (WKY, = 18) were randomly exposed to a daily dose of spironolactone ( = 6), eplerenone ( = 6), or no drug ( = 6) over 28 days. Read More

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Cutaneous and hepatic vascular lesions due to a recurrent somatic mutation reveal a pathway for vascular malformation.

HGG Adv 2021 Apr 1;2(2). Epub 2021 Mar 1.

Department of Dermatology, School of Medicine, Yale University, New Haven, CT 06510, USA.

The term "cavernous hemangioma" has been used to describe vascular anomalies with histology featuring dilated vascular spaces, vessel walls consisting mainly of fibrous stromal bands lined by a layer of flattened endothelial cells, and an irregular outer rim of interrupted smooth muscle cells. Hepatic hemangiomas (HHs) and cutaneous venous malformations (VMs) share this histologic pattern, and we examined lesions in both tissues to identify genetic drivers. Paired whole-exome sequencing (WES) of lesional tissue and normal liver in HH subjects revealed a recurrent c. Read More

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High-dose spironolactone lacks effectiveness in treatment of fibromyalgia (RCT).

Eur J Pain 2021 Apr 28. Epub 2021 Apr 28.

Clinic for Anesthesiology, University Medical Center Schleswig-Holstein, Kiel, Germany.

Background: Spironolactone (SPL) is a reversible mineralocorticoid receptor (MR) and androgen receptor (AR) antagonist which attracts pharmacotherapeutic interest not only because of its beneficial effects in heart failure but also because of the pathogenetic roles of MR and AR activities in neuropsychiatric diseases. Recently, beneficial and rapid-onset effects of SPL have been documented in a case series of women with fibromyalgia syndrome (FMS). To reaffirm this observation, we performed a double-blind placebo-controlled randomized clinical trial (RCT). Read More

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Anti-stress effects of combined block of glucocorticoid and mineralocorticoid receptors in the paraventricular nucleus of the hypothalamus.

Br J Pharmacol 2021 Apr 27. Epub 2021 Apr 27.

Department of Pharmacology, Peking University, School of Basic Medical Science, Beijing, China.

Background And Purpose: Mineralocorticoid receptors (MRs), glucocorticoid receptors (GRs) and corticotropin-releasing factor (CRF) in the paraventricular nucleus of hypothalamus (PVN) are involved in the response to stress. The present study investigated the role of GRs and MRs in the PVN in regulating depressive and anxiety-like behaviours.

Experimental Approach: To model chronic stress, rats were exposed to corticosterone treatment via drinking water for 21 days, and GR antagonist RU486 and MR antagonist spironolactone, alone and combined, were directly injected in the PVN daily for the last 7 days of corticosterone treatment. Read More

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