scholarly journals PREVALENCE AND TIME OF DEVELOPMENT OF SYSTEMIC ARTERIAL HYPERTENSION IN PATIENTS AFTER LIVER TRANSPLANTATION

2021 ◽  
Vol 58 (1) ◽  
pp. 77-81
Author(s):  
Bianca de Oliveira LEMOS ◽  
Rita de Cássia Martins Alves SILVA ◽  
Renato Ferreira da SILVA
Keyword(s):  
Metabolic Syndrome ◽  
Liver Transplantation ◽  
Arterial Hypertension ◽  
Calcineurin Inhibitors ◽  
Immunosuppressive Drugs ◽  
Immunosuppressive Drug ◽  
University Hospital ◽  
Post Transplantation ◽  
Systemic Arterial Hypertension ◽  
High Prevalence

ABSTRACT BACKGROUND: The use of immunosuppressive drugs after liver transplantation (LT) is associated with the development of systemic arterial hypertension (SAH), in addition to other comorbidities of metabolic syndrome. OBJECTIVE: Therefore, the purpose of this study was to analyze the time after use immunosuppressive drugs the patient progresses to SAH, as well as to identify its prevalence and the factors that may be correlated to it. METHODS: A retrospective and longitudinal study was conducted, based on the analysis of medical records of 72 normotensive patients, attended in the transplant unit of a university hospital, between 2016 and 2019. RESULTS: It was observed, on average, 9±6.98 months after immunosuppressive use, the patients were diagnosed with hypertension, and the prevalence of transplanted patients who evolved to SAH in this study was 59.64% (41 patients). In addition, there was a correlation between serum dosage of tacrolimus and the development of SAH (P=0.0067), which shows that tacrolimus has a significant role in the development of SAH. Finally, it was noticed that the development of post-transplantation hypertension indicates a higher risk of the patient presenting the other parameters of metabolic syndrome, as well as a higher impairment in its renal function (P=0.0061). CONCLUSION: This study shows that the patients evolved to SAH in an average of 9±6.98 months after immunosuppressive drug use. We have also found high prevalence of systemic arterial hypertension (59.64%) in patients after liver transplantation, who used calcineurin inhibitors, especially when associated with the use of tacrolimus.

Evaluation of the first immunosuppressive drug assay available on a fully automated LC-MS/MS-based clinical analyzer suggests a new era in laboratory medicine

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Sebastian Hörber ◽  
Andreas Peter ◽  
Rainer Lehmann ◽  
Miriam Hoene
Keyword(s):  
High Specificity ◽  
Turnaround Time ◽  
Immunosuppressive Drugs ◽  
Immunosuppressive Drug ◽  
Ease Of Use ◽  
Analytical Performance ◽  
University Hospital ◽  
Therapeutic Monitoring ◽  
Mean Deviation ◽  
Liquid Chromatography Tandem Mass

AbstractObjectivesDue to its high specificity, liquid chromatography-tandem mass spectrometry (LC-MS/MS) is considered the gold standard in diagnostic areas such as therapeutic monitoring of immunosuppressive drugs (ISDs). However, many laboratories still rely on immunoassays for ISD quantification in a tradeoff between analytical performance and the advantages of fully automated analyzers – shorter turnaround times, greater ease of use, and 24/7 availability.MethodsThe LC-MS/MS-based Thermo Scientific™ Cascadion™ SM Immunosuppressant Panel was evaluated for >6 months in the routine laboratory of a university hospital. We assessed the analytical performance of the panel and compared it to conventional LC-MS/MS as well as to immunoassays (cyclosporine A, sirolimus, tacrolimus (Siemens) and everolimus (Thermo Fisher)). In addition, both ISD panel and Cascadion analyzer were scrutinized with regards to, e.g., turnaround time, usability, and robustness.ResultsAll ISDs showed high linearity and precision (CV≤6%) and a good correlation with conventional LC-MS/MS. The mean deviation to the immunoassays was 17–19% and negative for all ISDs except everolimus with a positive 19% bias. No weak points were revealed when challenging assay and system with, e.g., high haematocrit, sedimented whole blood or priority samples. The Cascadion integrated well into our 24/7 routine and could easily be operated simultaneously with several other analyzers by technical staff without LC-MS experience.ConclusionsThe ISD panel showed excellent analytical performance and demonstrated that a fully automated LC-MS-based analysis starting from primary samples is feasible, suggesting that LC-MS could become an integral part of 24/7 diagnostics in the near future.

scholarly journals The Impact of Metabolic Syndrome and Its Components on Female Sexual Dysfunction: A Narrative Mini-Review

2018 ◽  
Vol 12 (2) ◽  
pp. 57-63
Author(s):  
Simona Di Francesco ◽  
Marika Caruso ◽  
Iole Robuffo ◽  
Andrea Militello ◽  
Elena Toniato
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Sexual Dysfunction ◽  
Arterial Hypertension ◽  
Sexual Function ◽  
Sexual Desire ◽  
Female Sexual Dysfunction ◽  
Systemic Arterial Hypertension ◽  
The Metabolic Syndrome ◽  
The Impact

Background: The impact of metabolic syndrome on female sexual dysfunction received modest consideration in clinical practice. The aim of the research was to analyze the international literature to determine the relationship between the metabolic syndrome, its components and female sexual disorders. Methods: We identified relevant full-length papers by electronic databases as Index Medicus/Medline, Scopus, Life Science Journals, from 2005 to the present. Studies were searched using the following as search query: metabolic syndrome, female sexual dysfunction, obesity, systemic arterial hypertension, diabetes mellitus, dyslipidemia. Results: Women with metabolic syndrome showed higher prevalence of sexual inactivity and low sexual desire, orgasm and satisfaction respect to women without metabolic syndrome. Particularly metabolic components as diabetes mellitus, dy-slipidemia, systemic arterial hypertension were strongly associated with lower sexual desire, activity and Female Sexual Function Index total score. In contrast, other studies showed no relationship. Conclusion: Our study showed that in the clinical evaluation of women with metabolic syndrome routine inquiring about female sexual dysfunction should be recommended to ameliorate sexual function and quality of life. However more prospective and longitudinal studies on the sexual effects of metabolic syndrome should also be suggested to know the factors related to women's sexuality better.

scholarly journals The Role of mTOR Inhibitors in Liver Transplantation: Reviewing the Evidence

2014 ◽  
Vol 2014 ◽  
pp. 1-45 ◽  
Author(s):  
Goran B. Klintmalm ◽  
Björn Nashan
Keyword(s):  
Metabolic Syndrome ◽  
Liver Transplantation ◽  
Renal Function ◽  
De Novo ◽  
Immunosuppressive Agents ◽  
Mammalian Target Of Rapamycin ◽  
Calcineurin Inhibitors ◽  
Mtor Inhibitors

Despite the success of liver transplantation, long-term complications remain, includingde novomalignancies, metabolic syndrome, and the recurrence of hepatitis C virus (HCV) and hepatocellular carcinoma (HCC). The current mainstay of treatment, calcineurin inhibitors (CNIs), can also worsen posttransplant renal dysfunction, neurotoxicity, and diabetes. Clearly there is a need for better immunosuppressive agents that maintain similar rates of efficacy and renal function whilst minimizing adverse effects. The mammalian target of rapamycin (mTOR) inhibitors with a mechanism of action that is different from other immunosuppressive agents has the potential to address some of these issues. In this review we surveyed the literature for reports of the use of mTOR inhibitors in adult liver transplantation with respect to renal function, efficacy, safety, neurological symptoms,de novotumors, and the recurrence of HCC and HCV. The results of our review indicate that mTOR inhibitors are associated with efficacy comparable to CNIs while having benefits on renal function in liver transplantation. We also consider newer dosing schedules that may limit side effects. Finally, we discuss evidence that mTOR inhibitors may have benefits in the oncology setting and in relation to HCV-related allograft fibrosis, metabolic syndrome, and neurotoxicity.

scholarly journals High prevalence of arterial hypertension in a Brazilian Northeast population of low education and income level, and its association with obesity and metabolic syndrome

2012 ◽  
Vol 58 (2) ◽  
pp. 209-214 ◽  
Author(s):  
Ruy Lyra ◽  
Rosilda dos Santos Silva ◽  
Renan Magalhães Montenegro Junior ◽  
Marcus Vinicius Cardoso Matos ◽  
Nathalia Joanne Bispo Cézar ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Arterial Hypertension ◽  
Income Level ◽  
High Prevalence ◽  
Low Education ◽  
Brazilian Northeast

scholarly journals High prevalence of arterial hypertension in a Brazilian Northeast population of low education and income level, and its association with obesity and metabolic syndrome

2012 ◽  
Vol 58 (2) ◽  
pp. 209-214 ◽  
Author(s):  
Ruy Lyra ◽  
Rosilda dos Santos Silva ◽  
Renan Magalhães Montenegro Junior ◽  
Marcus Vinicius Cardoso Matos ◽  
Nathalia Joanne Bispo Cézar ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Arterial Hypertension ◽  
Income Level ◽  
High Prevalence ◽  
Low Education ◽  
Brazilian Northeast

Drug therapy and nutritional management of metabolic syndrome associated with hyperadrenocorticism in a dog – case report

2017 ◽  
Vol XXII (131) ◽  
pp. 38-46
Author(s):  
Viviani De Marco ◽  
Elidia Zotelli dos Santos
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Arterial Hypertension ◽  
Systemic Arterial Hypertension ◽  
The Metabolic Syndrome ◽  
Generic Term ◽  
High Concentrations ◽  
Stable Control ◽  
Biochemical Abnormalities

Hyperadrenocorticism (HAC) is a generic term that refers to clinical and biochemical abnormalities resulting from persistently high concentrations of glucocorticoids in the bloodstream, which may occur spontaneously or iatrogenically. Chronic hypercortisolism may promote abdominal obesity, dyslipidemia, systemic arterial hypertension and insulin resistance, abnormalities associated with the metabolic syndrome (MS). The present study aims to report the presence of MS in a dog with spontaneous HAC, and its satisfactory long-term therapeutic resolution. The animal presented marked alterations in addition to the classic symptoms of HAC: discrete hyperglycemia, insulin resistance, hyperlipidemia, arterial hypertension and obesity. Complete resolution of MS and stable control of HAC were observed after five months of treatment.

scholarly journals Renal Dysfunction in Liver Transplantation: The Problem and Preventive Strategies

2004 ◽  
Vol 18 (suppl c) ◽  
pp. 27C-40C ◽  
Author(s):  
Marcelo Cantarovich
Keyword(s):  
Liver Transplantation ◽  
Adverse Effects ◽  
Renal Dysfunction ◽  
Calcineurin Inhibitors ◽  
Immunosuppressive Drugs ◽  
Therapeutic Monitoring ◽  
Wide Range ◽  
Nephrotoxic Drugs ◽  
Poor Outcomes

Ongoing improvements in survival following liver transplantation have necessitated a re-evaluation of immunosuppression protocols. Corticosteroids and calcineurin inhibitors (CNIs) are the most frequently used immunosuppressive drugs for liver transplantation but are associated with a wide range of adverse effects, such as hypertension, hyperlipidemia and nephrotoxicity. The need for hemodialysis after liver transplantation is associated with poor outcomes. Renal dysfunction in this setting may be caused by pre-existing renal disease, hepatorenal syndrome and/or post-transplant factors, including the use of nephrotoxic drugs, most notably CNIs such as cyclosporine and tacrolimus. The methods that address this problem include the diligent control of metabolic factors (eg, hypertension and hyperlipidemia), therapeutic monitoring of CNIs and withdrawal or reduction of the dosage of CNIs, combined with the use of newer non-nephrotoxic agents. Although there is no clear consensus about the most effective strategy, the optimal long-term immunosuppressive regimen would prevent rejection without causing nephrotoxicity or other significant adverse effects. Recent evidence suggests that the liver is a tolerogenic organ and that some patients may need little, if any, long-term immunosuppression.

scholarly journals High prevalence of arterial hypertension in a Brazilian Northeast population of low education and income level, and its association with obesity and metabolic syndrome

2012 ◽  
Vol 58 (2) ◽  
pp. 209-214 ◽  
Author(s):  
Ruy Lyra ◽  
Rosilda dos Santos Silva ◽  
Renan Magalhães Montenegro Junior ◽  
Marcus Vinicius Cardoso Matos ◽  
Nathalia Joanne Bispo Cézar ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Arterial Hypertension ◽  
Income Level ◽  
High Prevalence ◽  
Low Education ◽  
Brazilian Northeast

scholarly journals Nutritional indicators among patients with liver transplantation: A cross sectional study

2021 ◽  
Vol 11 (1) ◽  
pp. 78
Author(s):  
Ateya Megahed Ibrahim ◽  
Shereen Ahmed A. Qalawa
Keyword(s):  
Liver Transplantation ◽  
Dietary Habits ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Military Hospital ◽  
Sociodemographic Characteristics ◽  
Hospital Data ◽  
Post Transplantation ◽  
Nutritional Disorder ◽  
Cross Sectional

Background and objective: The trouble of nutritional state is considered as a prophet of morbidity and mortality in patients with advanced liver disease. The severity of nutritional disorder increases with diminished liver function. The aim of this study was to explore the nutritional indicators among patients with liver transplantation patients in Egypt.Methods: Outlined is a descriptive cross-sectional research design using a convenience sampling of 210 patients following liver transplantation from the outpatient of transplantation centre the Mansura university Hospital, Wady el-Nile Hospital, International Military Medical centre, Almady Military Hospital. Data were collected using an adapted four parts tool that gathered sociodemographic data of patients; data about patient dietary habits and dietary balance and an assessment of patients physical and anthropometric measurements as nutritional predictor’s.Results: There is a highly significant relation between nutritional status, gender and sociodemographic characteristics among patients with liver transplantation. As well, educational levels and occupation point to difference between physical and nutritional indicators parameter and sociodemographic characteristics. As well, high body mass indicators (BMI) vary between physical and nutritional indicator parameters.Conclusions: There are noticeable needs for instructional schemes to be offered on simple media to increase awareness of patient’s nutritional requirements post transplantation. Implications for Nursing and Health policy: There is a growing demand for strategies and programs that take into consideration all the needs of liver transplantation patients. Efforts should be carried out to design and implement interventions that suit the patients following liver transplantation using simple media and suitable language.

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