Diverse pathological lesions of primary aldosteronism and their clinical significance

AbstractPrimary aldosteronism (PA) is mainly clinically classified as unilateral aldosterone-producing adenoma (APA) or bilateral idiopathic hyperaldosteronism. Immunohistochemistry for aldosterone synthase reveals a diverse PA pathology, including pathological APA and aldosterone-producing cell clusters. The relationship between PA pathology and adrenalectomy outcomes was examined herein. Data from 219 unilaterally adrenalectomized PA cases were analyzed. Pathological analyses revealed diverse putative aldosterone-producing lesions. Postoperative biochemical outcomes in 114 cases (test cohort) were classified as complete success (n = 85), partial success (n = 19), and absent success (n = 10). Outcomes in the large and small PA lesion groups, rather than between PA lesion types, were compared at five threshold values for PA lesion sizes (2–6 mm with 1-mm increments) to streamline the results. The proportion of complete success was significantly higher in the large PA lesion group than in the small PA lesion group at the 5-mm threshold only. The proportion of absent success was significantly higher in the small PA lesion group than in the large PA lesion group at all thresholds. Univariate and multivariate analyses of the test cohort identified serum K as an independent predictive factor for the small PA lesion group, which was confirmed in the 105-case validation cohort. Chi-squared automatic interaction detector analysis revealed that the best threshold of serum K for predicting large PA lesions was 2.82 mEq/L. These results will be beneficial for treating PA in clinical settings because patients with low serum K levels and apparent adrenal masses on CT may be subjected to adrenalectomy even if the adrenal venous sampling test is unavailable.

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Statistical Analysis of the Relationship Between Antioxidant Activity and the Structure of Flavonoid Compounds

Revista de Chimie ◽

10.37358/rc.19.9.7497 ◽

2019 ◽

Vol 70 (9) ◽

pp. 3103-3107 ◽

Cited By ~ 7

Author(s):

Ioana Glevitzky ◽

Gabriela Alina Dumitrel ◽

Mirel Glevitzky ◽

Bianca Pasca ◽

Pavel Otrisal ◽

...

Keyword(s):

Antioxidant Activity ◽

Antioxidant Activities ◽

Basic Structure ◽

Oh Groups ◽

Flavonoid Compounds ◽

Chi Squared ◽

Potential Link ◽

Van Der Waals Surface ◽

The Relationship ◽

Phenolic Oh Groups

Using different methods of statistics, this paper aims to highlight the potential link between the antioxidant activity of flavonoids and the corresponding molecular descriptors. By calculating the descriptors (van der Waals surface (A), molar volume (V), partition coefficient (LogP), refractivity (R), polarizability (a), forming heat (Hformation), hydration energy (Ehidr), the dipole moment (mt)), together with antioxidant activities (RSA) calculated or taken from the literature, number of phenolic -OH groups and the presence (2) or absence (1) of C2=C3 double bond) for 29 flavonoid compounds and by intercorrelation between the studied parameters, the link between the number of phenolic groups grafted to the basic structure of flavonoids and their antioxidant activity was confirmed. Simultaneously, by using the chi-squared test and the intercorrelations matrix, a satisfactorily correlation coefficient (r2=0.5678; r=0.7536) between the structure of the flavonoids and their activity was obtained, fact that confirms the correlation of the antioxidant activity with the number of -OH phenolic groups.

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Advances of ECG Sensors from Hardware, Software and Format Interoperability Perspectives

Electronics ◽

10.3390/electronics10020105 ◽

2021 ◽

Vol 10 (2) ◽

pp. 105

Author(s):

Khaleel Husain ◽

Mohd Soperi Mohd Zahid ◽

Shahab Ul Hassan ◽

Sumayyah Hasbullah ◽

Satria Mandala

Keyword(s):

Machine Learning ◽

Heart Attack ◽

Privacy Preservation ◽

Causes Of Death ◽

Clinical Settings ◽

Data Format ◽

Medical Institutions ◽

Comprehensive Survey ◽

Electrocardiogram Ecg ◽

The Relationship

It is well-known that cardiovascular disease is one of the major causes of death worldwide nowadays. Electrocardiogram (ECG) sensor is one of the tools commonly used by cardiologists to diagnose and detect signs of heart disease with their patients. Since fast, prompt and accurate interpretation and decision is important in saving the life of patients from sudden heart attack or cardiac arrest, many innovations have been made to ECG sensors. However, the use of traditional ECG sensors is still prevalent in the clinical settings of many medical institutions. This article provides a comprehensive survey on ECG sensors from hardware, software and data format interoperability perspectives. The hardware perspective outlines a general hardware architecture of an ECG sensor along with the description of its hardware components. The software perspective describes various techniques (denoising, machine learning, deep learning, and privacy preservation) and other computer paradigms used in the software development and deployment for ECG sensors. Finally, the format interoperability perspective offers a detailed taxonomy of current ECG formats and the relationship among these formats. The intention is to help researchers towards the development of modern ECG sensors that are suitable and approved for adoption in real clinical settings.

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Age-Dependency of Total Tau in the Cerebrospinal Fluid Is Corrected by Amyloid-β 1–40: A Correlational Study in Healthy Adults

Journal of Alzheimer s Disease ◽

10.3233/jad-210286 ◽

2021 ◽

pp. 1-8

Author(s):

Paul Theo Zebhauser ◽

Achim Berthele ◽

Marie-Sophie Franz ◽

Oliver Goldhardt ◽

Janine Diehl-Schmid ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Amyloid Β ◽

Healthy Adults ◽

Tau Proteins ◽

Clinical Settings ◽

Inclusion Criteria ◽

Total Tau ◽

Potential Marker ◽

Wide Range ◽

The Relationship

Background: Tau proteins are established biomarkers of neuroaxonal damage in a wide range of neurodegenerative conditions. Although measurement of total-Tau in the cerebrospinal fluid is widely used in research and clinical settings, the relationship between age and total-Tau in the cerebrospinal fluid is yet to be fully understood. While past studies reported a correlation between age and total-Tau in the cerebrospinal fluid of healthy adults, in clinical practice the same cut-off value is used independently of patient’s age. Objective: To further explore the relationship between age and total-Tau and to disentangle neurodegenerative from drainage-dependent effects. Methods: We analyzed cerebrospinal fluid samples of 76 carefully selected cognitively healthy adults and included amyloid-β 1–40 as a potential marker of drainage from the brain’s interstitial system. Results: We found a significant correlation of total-Tau and age, which was no longer present when correcting total-Tau for amyloid-β 1–40 concentrations. These findings were replicated under varied inclusion criteria. Conclusion: Results call into question the association of age and total-Tau in the cerebrospinal fluid. Furthermore, they suggest diagnostic utility of amyloid-β 1–40 as a possible proxy for drainage-mechanisms into the cerebrospinal fluid when interpreting biomarker concentrations for neurodegenerative diseases.

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Exceptional patients: Narratives of connections

Palliative & Supportive Care ◽

10.1017/s147895151300014x ◽

2013 ◽

Vol 12 (4) ◽

pp. 269-276 ◽

Cited By ~ 4

Author(s):

Joan C. Engebretson ◽

Noemi E. Peterson ◽

Moshe Frenkel

Keyword(s):

Well Being ◽

Decision Making Process ◽

Clinical Settings ◽

Crucial Importance ◽

Higher Power ◽

Personal Connections ◽

External Connections ◽

The Relationship ◽

Health And Well Being ◽

Provided Examples

AbstractObjective:This study sought to better understand the patient s perspective of the experience of recovery from cancer that appeared to defy medical prognoses.Methods:Fourteen cases of medically verified exceptional outcomes were identified. A qualitative approach, employing long narrative interviews was used. Data was analyzed using a cross case thematic analytic approach.Results:The major overarching theme was connections, both internal and external. Internal included connections with God or a higher power and with oneself. The external connections, the focus of this paper, included 1) personal connections with friends and family, 2) connections with the medical system: the physician, nurses and other staff, and 3) connections with other patients. They described the nature of these relationships and the importance of frequent contact with family and friends as providing significant emotional and instrumental support. They expressed confidence in receiving care from a reputable clinic, and with very little probing illustrated the importance of the relationship with their providers. They articulated the significance of the compassionate qualities of the physician and identified communication attributes of their physician that were important in establishing this connection. These attributes were demeanor, availability, honesty, sensitivity in the decision making process. They provided examples of positive connections with nurses and other staff as well as with other patients through their illness process.Significance of results:The importance of connections in these illness narratives was richly illustrated. These issues often are overlooked in clinical settings; yet they are of crucial importance to the health and well-being of the patients.

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Abstract 211: Variation of NEDD4L is Associated with Hypertension in Chinese Hans Chronic Kidney Disease Patients

Hypertension ◽

10.1161/hyp.62.suppl_1.a211 ◽

2013 ◽

Vol 62 (suppl_1) ◽

Author(s):

Cheng Wang ◽

Jun Zhang ◽

Cuicui Li ◽

Wenyu Gong ◽

Tanqi Lou

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Logistic Regression ◽

Kidney Disease ◽

Blood Pressure Monitoring ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Functional Studies ◽

Chi Squared ◽

The Relationship

Background: Neural precursor cell expressed developmentally down-regulated 4-like (NEDD4L) is a candidate gene for hypertension, and carriers of an intact NEDD4L C2-domain,encoded by the NEDD4L rs4149601 (G/A) GG genotype, together with the C-allele of the NEDD4L rs2288774 (C/T) polymorphism have been found be associated with hypertension both in African Americans and whites. However, there is no data on the relationship between polymorphism of NEDD4L rs4149601 and rs2288774 and hypertension in Chinese chronic kidney disease (CKD) patients. The purpose of the current study was to investigate the relationship between the variation of NEDD4L rs4149601, rs2288774 and hypertension in CKD patients. Methods: A total of 546 Chines Hans CKD patients were enrolled in our study. The SNPs were genotyped using PCR-based techniques. All patients underwent ambulatory blood pressure monitoring, and clinical data were also collected. Multivariate logistic regression analysis was used to identify the relationship between polymorphisms and hypertension. Results: 506 patients carried GG/GA genotype and 30 carried AA genotype. Rs4149601 AA genotype carriers had significantly higher rate of hypertension (68.3% vs 46.2%, P = 0.022) than GG/GA genotype carriers by Chi-squared test. AA genotype carriers also had a higher day-time and bedtime systolic blood pressure (142±16 vs 135±23, P=0.036; 137±18 vs 127±13, P=0.022, respectively) when compared with GG/GA genotype carriers. AA genotype [OR= 3.08, 95% CI (1.06-9.80)], lowever eGFR [OR=0.98, 95% CI (0.97-0.99)], older age [OR=1.03, 95% CI (1.01-1.05)] were independently associated with hypertension in CKD patients by multivariate logistic regression. However, No difference was found in blood pressure with rs2288774 TT/TC/CC genotypes, and no difference was found in the incidence of hypertension among patients with three genotypes. Conclusions: Our results suggested 4149601AA genotype of NEDD4L may be associated with hypertension in CKD patients, and further genetic and functional studies are required to understand its role in the manifestation of hypertension in Chinese CKD patients.

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Family Caregiving for Individuals With Heart Failure: A Scientific Statement From the American Heart Association

Circulation ◽

10.1161/cir.0000000000000768 ◽

2020 ◽

Vol 141 (22) ◽

Cited By ~ 1

Author(s):

Lisa Kitko ◽

Colleen K. McIlvennan ◽

Julie T. Bidwell ◽

J. Nicholas Dionne-Odom ◽

Shannon M. Dunlay ◽

...

Keyword(s):

Heart Failure ◽

Family Caregiving ◽

Heart Association ◽

Well Being ◽

Clinical Settings ◽

Financial Health ◽

Future Directions ◽

Scientific Statement ◽

The Relationship ◽

Health And Well Being

Many individuals living with heart failure (HF) rely on unpaid support from their partners, family members, friends, or neighbors as caregivers to help manage their chronic disease. Given the advancements in treatments and devices for patients with HF, caregiving responsibilities have expanded in recent decades to include more intensive care for increasingly precarious patients with HF—tasks that would previously have been undertaken by healthcare professionals in clinical settings. The specific tasks of caregivers of patients with HF vary widely based on the patient’s symptoms and comorbidities, the relationship between patient and caregiver, and the complexity of the treatment regimen. Effects of caregiving on the caregiver and patient range from physical and psychological to financial. Therefore, it is critically important to understand the needs of caregivers to support the increasingly complex medical care they provide to patients living with HF. This scientific statement synthesizes the evidence pertaining to caregiving of adult individuals with HF in order to (1) characterize the HF caregiving role and how it changes with illness trajectory; (2) describe the financial, health, and well-being implications of caregiving in HF; (3) evaluate HF caregiving interventions to support caregiver and patient outcomes; (4) summarize existing policies and resources that support HF caregivers; and (5) identify knowledge gaps and future directions for providers, investigators, health systems, and policymakers.

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Primary aldosteronism in Klinefelter’s syndrome: two cases

Endocrinology Diabetes and Metabolism Case Reports ◽

10.1530/edm-19-0126 ◽

2019 ◽

Vol 2019 ◽

Author(s):

Yasufumi Seki ◽

Satoshi Morimoto ◽

Naohiro Yoshida ◽

Kanako Bokuda ◽

Nobukazu Sasaki ◽

...

Keyword(s):

Luteinizing Hormone ◽

Primary Aldosteronism ◽

Luteinizing Hormone Receptor ◽

List Type ◽

Klinefelter’S Syndrome ◽

Klinefelter's Syndrome ◽

Plasma Aldosterone Concentration ◽

Lh Receptor ◽

Serum Lh ◽

Aldosterone Producing Adenoma

Summary Primary aldosteronism (PA) is more common than expected. Aberrant adrenal expression of luteinizing hormone (LH) receptor in patients with PA has been reported; however, its physiological role on the development of PA is still unknown. Herein, we report two unique cases of PA in patients with untreated Klinefelter’s syndrome, characterized as increased serum LH, suggesting a possible contribution of the syndrome to PA development. Case 1 was a 39-year-old man with obesity and hypertension since his 20s. His plasma aldosterone concentration (PAC) and renin activity (PRA) were 220 pg/mL and 0.4 ng/mL/h, respectively. He was diagnosed as having bilateral PA by confirmatory tests and adrenal venous sampling (AVS). Klinefelter’s syndrome was suspected as he showed gynecomastia and small testes, and it was confirmed on the basis of a low serum total testosterone level (57.3 ng/dL), high serum LH level (50.9 mIU/mL), and chromosome analysis. Case 2 was a 28-year-old man who had untreated Klinefelter’s syndrome diagnosed in his childhood and a 2-year history of hypertension and hypokalemia. PAC and PRA were 247 pg/mL and 0.3 ng/mL/h, respectively. He was diagnosed as having a 10 mm-sized aldosterone-producing adenoma (APA) by AVS. In the APA, immunohistochemical analysis showed co-expression of LH receptor and CYP11B2. Our cases of untreated Klinefelter’s syndrome complicated with PA suggest that increased serum LH levels and adipose tissues, caused by primary hypogonadism, could contribute to PA development. The possible complication of PA in hypertensive patients with Klinefelter’s syndrome should be carefully considered. Learning points: The pathogenesis of primary aldosteronism is still unclear. Expression of luteinizing hormone receptor has been reported in aldosterone-producing adenoma. Serum luteinizing hormone, which is increased in patients with Klinefelter’s syndrome, might contribute to the development of primary aldosteronism.

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Determination of Climate and Social Community Factors in Coronavirus Disease-19 Spread Distribution

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6932 ◽

2021 ◽

Vol 9 (E) ◽

pp. 1434-1442

Author(s):

Faradiba Faradiba ◽

Lodewik Zet

Keyword(s):

Growth Rate ◽

Analysis Method ◽

Daily Growth ◽

Social Community ◽

Community Factors ◽

Chi Squared ◽

The Government ◽

Automatic Interaction Detector

BACKGROUND: Coronavirus Disease-2019 (COVID-19) is very shocking to the world. Until mid-2020, this virus has not yet found a vaccine that can be produced and can be applied en mass across the country. The spread of COVID-19 differs between regions which implie that regional characteristics have an influence on the rate of growth. Regional and social climate factors are thought to have a role in the growth rate of COVID-19. AIM: This study aims to find the role of climate and social society on the spread of COVID-19. METHODS: This research uses OLS regression analysis method, and then continued with Chi-squared Automatic Interaction Detector analysis to find the segmentation of the role of climate and social factors on the daily growth rate of COVID-19 in positive and deceased patients. RESULTS: The results of this study state that all independent variables of the study have a significant effect on the spread of COVID-19, with R-squared values in positive and deceased patients, respectively 61.1% and 70.0%. Strategic steps are needed to carry out policies that are targeted, effective and efficient. CONCLUSION: The results of this study can be a reference for the government in determining policies to reduce the growth rate of COVID-19, by focusing on areas that have poor sanitary environment and area are on Java Island.

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Abstract 12591: Impact of Aldosterone Producing Adenoma on Endothelial Function and Rho-Associated Kinase Activity in Patients With Primary Aldosteronism

Circulation ◽

10.1161/circ.130.suppl_2.12591 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Takeshi Matsumoto ◽

Yukihito Higashi ◽

Nozomu Oda ◽

Akimichi Iwamoto ◽

Yumiko Iwamoto ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Primary Aldosteronism ◽

Vascular Function ◽

Cardiovascular Events ◽

Plasma Renin ◽

Secondary Hypertension ◽

Plasma Aldosterone Concentration ◽

Significant Difference ◽

Aldosterone Producing Adenoma ◽

Rock Activity

Background: Hypertension is associated with endothelial dysfunction and activated Rho-associated kinases (ROCKs) activity. Primary aldosteronism (PA) is a most common cause of secondary hypertension. Recent studies have shown that risk of cardiovascular events is higher in patients with PA than in patients with essential hypertension (EH). However, there is little information on the relationship between subtype of PA and the grade of atherosclerosis. The purpose of this study was to evaluate the vascular function and ROCK activity in patients with PA. Methods: Vascular function, including flow-mediated vasodilation (FMD) and nitroglycerin-induced vasodilation, and ROCK activity in peripheral leukocytes were evaluated in 21 patients with aldosterone producing adenoma (APA) group (50.7±14.3 years, 9 males), 23 patients with idiopathic hyperaldosteronism (IHA) group (55.8±9.9 years, 12 males), and 33 age-, gender-, and blood pressure-matched EH group (54.9 ± 10.7 years, 18 males). Results: FMD was significantly lower in the APA group than in the IHA group and EH group (3.2±2.0% vs. 4.6±2.3% and 4.4±2.2%, P<0.05, respectively), whereas there was no significant difference in FMD between the IHA group and EH group. There was no significant difference in the response of nitroglycerine in three groups. ROCK activity was significantly higher in the APA group than in the IHA group and EH group (1.29±0.57 vs. 1.00±0.46 and 0.81±0.36, P<0.05 and P<0.001, respectively), whereas there was no significant difference in ROCK activity between the IHA group and EH group. FMD correlated with age (r=-0.31, P<0.01), brachial arterial diameter (r=-0.44, P<0.01), plasma aldosterone concentration (PAC) (r=-0.35, P<0.01) and plasma renin activity ratio (ARR) (r=-0.34, P<0.01). ROCK activity correlated with age (r=-0.24, P=0.04), PAC (r=0.33, P<0.01) and ARR (r=0.46, P<0.01). Conclusions: APA was associated with both endothelial dysfunction and increased ROCK activity compared with those in IHA and EH. These findings suggest that APA may have a higher risk of future cardiovascular events.

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Evaluating Perceived Emergency Preparedness and Household Preparedness Behaviors: Results from a CASPER Survey in Fairfax, Virginia

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2019.48 ◽

2019 ◽

Vol 14 (2) ◽

pp. 222-228

Author(s):

Rennie W. Ferguson ◽

Shawn Kiernan ◽

Ernst W. Spannhake ◽

Benjamin Schwartz

Keyword(s):

Public Health ◽

Emergency Preparedness ◽

Large Scale ◽

Household Level ◽

Perceived Preparedness ◽

Chi Squared ◽

Public Health Emergency Response ◽

Household Preparedness ◽

Using Data ◽

The Relationship

ABSTRACTObjectives:Using data collected from a Community Assessment for Public Health Emergency Response (CASPER) conducted in Fairfax Health District, Virginia, in 2016, we sought to assess the relationship between household-level perceived preparedness and self-reported preparedness behaviors.Methods:Weighted population estimates and 95% confidence intervals were reported, and Pearson’s chi-squared test was used to investigate differences by group.Results:Examining responses to how prepared respondents felt their household was to handle a large-scale emergency or disaster, an estimated 7.4% of respondents (95% CI: 4.3–12.3) reported that their household was “completely prepared,” 37.3% (95% CI: 31.4–43.7) were “moderately prepared,” 38.2% (95% CI: 31.6–45.2) were “somewhat prepared,” and 14.4% (95% CI: 10.2–20.0) were “unprepared.” A greater proportion of respondents who said that their household was “completely” or “moderately” prepared for an emergency reported engaging in several behaviors related to preparedness. However, for several preparedness behaviors, there were gaps between perceived preparedness and self-reported readiness.Conclusions:Community assessments for public health preparedness can provide valuable data about groups who may be at risk during an emergency due to a lack of planning and practice, despite feeling prepared to handle a large-scale emergency or disaster.

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