scholarly journals Hyperaldosteronism: types, clinical characteristics, and treatment

2021 ◽  
Author(s):  
Areej M. Alsyamy ◽  
Amnah T. Kashkari ◽  
Fawaz A. Alazdi ◽  
Abdulmonem T. Dalati ◽  
Mohammed M. Alawadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Literature Review ◽  
Medical Treatment ◽  
Perioperative Care ◽  
Clinical Characteristics ◽  
Clinical Phenotypes ◽  
Diagnostic Approaches ◽  
Secondary Hyperaldosteronism

Cases with hyperaldosteronism might be asymptomatic in many events. Therefore, the diagnosis can be missed. However, the usual presentation for many patients has been reported to be a refractory elevation in the blood pressure which might be mild to severe. Based on the type of hyperaldosteronism and the diagnosis, the treatment of these conditions should be established. Therefore, it can be concluded that the treatment is specific to the management of the underlying etiology, and managing the clinical characteristics and associated complications. This present literature review aims to provide evidence regarding the types, clinical characteristics, and treatment of aldosterone based on data from the current investigations in the literature. Different clinical phenotypes have been reported for the condition. Nevertheless, the disease can be broadly classified into primary and secondary hyperaldosteronism based on the pathophysiology and etiology of the condition. Clinical characteristics might not be diagnostic since they are very non-specific, despite being common in these patients, as hypokalemia and hypertension. Therefore, clinicians should be aware of conducting the necessary diagnostic approaches before establishing the diagnosis. Management of these patients requires the integration of different approaches, including surgical and medical treatment. Perioperative care is important because it may lead to unfavorable consequences if neglected.

Empirical and long-term therapy for endometriosis-associated pelvic pain

2021 ◽  
pp. 8-12
Author(s):  
I. V. Kuznetsova
Keyword(s):  
Literature Review ◽  
Medical Treatment ◽  
Pelvic Pain ◽  
Clinical Characteristics ◽  
Current Data ◽  
Diagnosis And Treatment ◽  
Term Therapy ◽  
Common Disease ◽  
Long Term Therapy

Endometriosis is a common disease, the diagnosis and treatment of which is still a matter of debate. One of the main symptoms of endometriosis -pelvic pain is a particular problem due to the difficulties in identifying the cause and the lack of sufficient effect from surgical and medical treatment. The literature review presents current data on the prevalence, clinical characteristics and methods of individualized therapy in patients with pelvic pain established or presumably associated with endometriosis.

Prevalence, Biochemical and Clinical Characteristics of Resistant Hypertension

2018 ◽  
Vol 69 (10) ◽  
pp. 2845-2849
Author(s):  
Daniela Gurgus ◽  
Elena Ardeleanu ◽  
Carmen Gadau ◽  
Roxana Folescu ◽  
Ioan Tilea ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Resistant Hypertension ◽  
Clinical Characteristics ◽  
Salt Intake ◽  
Target Organ Damage ◽  
Multivariate Logistic Regression Analysis ◽  
Organ Damage ◽  
Left Ventricular ◽  
High Salt Intake

The objectives of the present study were to evaluate the prevalence of resistant hypertension (RH) in primary care setting and to analyse its biochemical and clinical characteristics. After 3 months of treatment and evaluation, 721 (14.01%) of 5,146 patients with hypertension did not reach target office blood pressure of [ 140/90 mmHg. After exclusion of �white-coat effect� with ambulatory blood pressure, of secondary and pseudo- resistant hypertension, prevalence of RH was 6.74%. Lifestyle factors associated with RH were physical inactivity, obesity, high salt intake, smoking and excessive alcohol ingestion. Compared to controlled hypertension, RH patients presented higher incidence of family history of cardiovascular disease (38.90% vs 25.94%), diabetes mellitus (34.87% vs 19.01%), impaired fasting glucose (21.91% vs 19.07%), target organ damage (29.1% vs 15.95%), and cardiovascular disease (27.09% vs 17.06%). Dyslipidaemia (52.90% vs 42.03%), fasting plasma glucose (116.10�38.9 vs 107.80�37.2), HbA1c (6.41�1.42 vs 5.96�0.94), serum creatinine (1.09�0.27 vs 1.03�0.24) and microalbuminuria (21.90% vs 10.95%) were significantly higher in RH. Predictors of RH, determined by a multivariate logistic regression analysis were left ventricular hypertrophy (OD 2.14, 95% CI 1.32-3.69), renal impairment expressed as eGFR [ 60 ml/min/1.73m2 (OD 1.62, 95% CI 1.21-2.21) and the presence of cardiovascular disease (OD 1.48, 95% CI 1.02-2.16).

scholarly journals SAT0267 ROLE OF AGGRESSIVE IMMUNOSUPPRESSION ON SUBGLOTTIC STENOSIS IN GRANULOMATOSIS WITH POLYANGIITIS: RETROSPECTIVE ANALYSIS OF A MONOCENTRIC COHORT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1076.1-1077
Author(s):  
L. Moroni ◽  
L. Giudice ◽  
G. A. Ramirez ◽  
S. Sartorelli ◽  
A. Cariddi ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Clinical Characteristics ◽  
Granulomatosis With Polyangiitis ◽  
Balloon Catheter ◽  
Subglottic Stenosis ◽  
Damage Accrual ◽  
The Mean ◽  
The One

Background:Subglottic stenosis (SGS) is defined as airway narrowing below the vocal cords and is a common and potentially life-threatening manifestation of Granulomatosis with Polyangiitis (GPA), with an estimated prevalence of 16-23% (1). Balloon catheter dilation is effective in GPA-related SGS, but relapses are frequent. Little is known about the role of immunosuppression in this setting.Objectives:to analyse the clinical characteristics of a monocentric GPA cohort, describe phenotype differences among patients with and without SGS and investigate the role of surgical and medical treatments on relapse risk and general outcome.Methods:Biopsy-proven patients with SGS were identified by review of medical charts among a cohort of patients with GPA, classified according to the algorithm of the European Medicine Agency (2). The clinical characteristics of patients with SGS were retrospectively collected over a median follow-up time of 15.9 years and compared to those of patients without SGS.Results:Fourteen patients with SGS-GPA were identified, with a female to male ratio of 1:1 and a prevalence of 29.2% among the cohort. The mean ± SD age at GPA onset was 30.8 ± 14.4 years, with a mean time from GPA diagnosis to SGS onset of 4.7 ± 4.2 years. ANCA were positive in 78.6% (54.0% anti-PR3, 18.1% anti-MPO and 27.9% IFI only). The mean Birmingham Vasculitis Activity Score (BVAS) at onset was 10.0 ± 5.6. The main clinical manifestations associated with SGS were crusty rhinitis (100%), sinusitis (78%), pulmonary disease (72.7%), otitis/mastoiditis (50%), glomerulonephritis (42.9%), orbital pseudotumor (28.6%). Six patients (42.9%) received medical treatment only, other six (42.9%) had one to three balloon dilations and two (14.2%) underwent four or more procedures. Eight patients had no SGS relapse (maximum one dilation) and they all received immunosuppression with rituximab (RTX), cyclophosphamide (CYC) or azathioprine (AZA). All patients who received no immunosuppression, methotrexate (MTX) or mycophenolate (MMF) had at least one relapse. Patients treated with MTX or MMF had a mean relapse-free survival of 13.1 months, which was comparable to the one of patients not receiving medical treatment (40.2 months; p=NS) and shorter than the one of patients receiving CYC or RTX (153.2 months; p=0.032). CYC use also inversely correlated with the number of surgical procedures (r=-0.691, p=0.006). Compared to patients without SGS (31 consecutive patients with at least 4 years of follow-up), patients with SGS-GPA had an earlier disease onset (mean age 30.8 vs 50.4 years; p<0.001), but with lower BVAS (mean 10.0 vs 15.3; p=0.013) and showed a higher prevalence of crusty rhinitis (100% vs 67.7%; p=0.019). No difference was observed in damage accrual over time between the two groups.Conclusion:Subglottic stenosis is highly prevalent in patients with GPA and may define a milder disease subset occurring more frequently in younger patients. MTX and MMF might be insufficient to prevent SGS relapses requiring balloon dilation. Aggressive immunosuppression (CYC or RTX) might have a non-redundant role in this setting and reduce the risk of relapses.References:[1]Quinn KA, et al. Subglottic stenosis and endobronchial disease in granulomatosis with polyangiitis. Rheumatology 2019; 58 (12), 2203-2211.[2]Watts R, et al. Development and validation of a consensus methodology for the classification of the ANCA associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis 2007; 66: 222-7.Disclosure of Interests:Luca Moroni: None declared, Laura Giudice: None declared, Giuseppe Alvise Ramirez: None declared, Silvia Sartorelli: None declared, adriana cariddi: None declared, Angelo Carretta: None declared, Enrica Bozzolo: None declared, Lorenzo Dagna Grant/research support from: The Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR) received unresctricted research/educational grants from Abbvie, Bristol-Myers Squibb, Celgene, Janssen, Merk Sharp & Dohme, Mundipharma Pharmaceuticals, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI., Consultant of: Prof Lorenzo Dagna received consultation honoraria from Abbvie, Amgen, Biogen, Bristol-Myers Squibb, Celltrion, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI.

EMTALA: Screening Can Satisfy EMTALA, Despite Misdiagnosis

2003 ◽  
Vol 31 (1) ◽  
pp. 169-170 ◽  
Author(s):  
Hemanth Gundavaram
Keyword(s):  
Blood Pressure ◽  
Medical Treatment ◽  
Emergency Room ◽  
Urinary Retention ◽  
Court Of Appeals ◽  
Statutory Duty ◽  
Active Labor ◽  
Summary Judgment ◽  
De Medicina ◽  
The U.S

In Del Carmen Guadalupe v. Agosto, the U.S. Court of Appeals for the First Circuit held that a hospital fulfills its statutory duty to screen patiens in is emergency room if it provides for a “screening examination reasonably calculated to identify critical medical conditions” that may be afflicting symptomatic patients and if it “provides that level of screening uniformly to all those who present substantially similar complaints.” The First Circuit affirmed the lower court's decision to grant summary judgment to the hospital in a claim raised under the Emergency Medical Treatment and Active Labor Act (EMTALA).Maria del Carmen Guadalupe brought her husband, Narciso Figueroa, to the Hospital Interamericano De Medicina Avanzada, Inc., (HIMA) on October 3, 1998, with symptoms of urinary retention, edema in the legs, high blood pressure, pain, increased respiratory difficulty, a dry cough, fever, and drowsiness.

Ameloblastic fibro-odontoma in a child patient: case report and literature review

2021 ◽  
Vol 10 (2) ◽  
pp. e26610212430
Author(s):  
Gustavo Zanna Ferreira ◽  
Carolina Ferrairo Danieletto-Zanna ◽  
Liogi Iwaki Filho ◽  
Rômulo Maciel Lustosa ◽  
Willian Pecin Jacomacci ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Bone Regeneration ◽  
Clinical Characteristics ◽  
Patient Case ◽  
Lesion Pattern ◽  
Local Bone ◽  
Ameloblastic Fibroma ◽  
Child Patient

The ameloblastic fibro-odontoma (AFO) is a mixed odontogenic tumor, with characteristics of ameloblastic fibroma, presenting enamel and dentin, which occurs more frequently in individuals aged 5 to 17 years. This paper reports na extensive case of ameloblastic fibro-odontoma in the mandible of a 3-year-old patient, discussed in comparison to cases selected from a brief literature review on the clinical characteristics, Evolution and therapeutic options for this lesion. In the last years, there was no consensus in the literature concerning its etiopathogenesis and classification, yet recently the AFO was classified as a developing odontoma. This case is in accordance with the 7 cases reported in the literature of AFO in the mandible of children aged 10 years or younger, especially concerning the lesion pattern and evolution and treatment adopted. The patient did not present relapse and exhibited local bone regeneration at the 3-year follow-up.

scholarly journals Effects of eplerenone on resistance to antihypertensive medication in patients with primary or secondary hyperaldosteronism

2017 ◽  
Vol 5 (2) ◽  
pp. 93-99 ◽  
Author(s):  
J. David Spence ◽  
Chrysi Bogiatzi ◽  
Mariya Kuk ◽  
George K. Dresser ◽  
Daniel G. Hackam
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Concomitant Medication ◽  
Antihypertensive Medication ◽  
Pressure Control ◽  
Blinded Study ◽  
History Of ◽  
Secondary Hyperaldosteronism ◽  
One Year ◽  
Resistance Score

Abstract Background and Objectives Resistant hypertension is an important problem; nearly half of diagnosed hypertensives are not controlled to target blood pressure levels, and approximately 90% of strokes occur among patients with resistant hypertension. Primary aldosteronism accounts for approximately 20% of resistant hypertension, but the role of secondary hyperaldosteronism in resistant hypertension is seldom considered. We assessed the effects of eplerenone in patients with hypertension and either primary or secondary hyperaldosteronism. Methods Patients with a history of resistant hypertension and a supine plasma aldosterone level ≥ 360 pmol/L were randomized to eplerenone versus placebo in a fully blinded study for one year. A medication intensity score was developed to assess the resistance of hypertension to medication (blood pressure × medication intensity). We assessed the effects of eplerenone on blood pressure and on resistance to concomitant medication. Results Final results were available in 37 patients (19 on eplerenone and 18 on placebo). Resistance to medication, as assessed by the intensity of concomitant medication required to maintain blood pressure control, was markedly reduced by eplerenone: medication intensity scores declined by –0.50 ± 1.04 (SD) on placebo versus –2.11 ± 1.45 with eplerenone (P = 0.0001), the Systolic Resistance Score declined by –80.00 ± 122.93 on placebo versus –334.05 ± 21.73 on eplerenone (P = 0.0001), and the Diastolic Resistance Score increased by 1.28 ± 31.65 on placebo and declined by –40.74 ± 57.08 on eplerenone (P = 0.009). Conclusions Eplerenone significantly reduced resistance to concomitant antihypertensive medication in both primary and secondary hyperaldosteronism.

scholarly journals American Heart Association High Blood Pressure Protocol 2017: A Literature Review

Cureus ◽  
2018 ◽  
Author(s):  
Asad Ali ◽  
Muhammad Abu Zar ◽  
Ahmad Kamal ◽  
Amber E Faquih ◽  
Chandur Bhan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Literature Review ◽  
High Blood Pressure ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association

scholarly journals Uterine Prolapse in Pregnancy: Two Cases Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Chunyan Zeng ◽  
Feng Yang ◽  
Chunhua Wu ◽  
Junlin Zhu ◽  
Xiaoming Guan ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Conservative Treatment ◽  
Literature Review ◽  
Vaginal Delivery ◽  
Clinical Characteristics ◽  
Uterine Prolapse ◽  
The Other ◽  
Gestational Period ◽  
In Pregnancy

Uterine prolapse complicating pregnancy is rare. Two cases are presented here: one patient had uterine prolapse at both her second and third pregnancy, and the other developed only once prolapse during pregnancy. This report will analyze etiology, clinical characteristics, complication, and treatment of uterine prolapse in pregnancy. Routine gynecologic examination should be carried out during pregnancy. If uterine prolapse occurred, conservative treatment could be used to prolong the gestational period as far as possible. Vaginal delivery is possible, but caesarean section seems a better alternative when prolapsed uterus cannot resolve during childbirth.

scholarly journals METODE MASSAGE TERHADAP TEKANAN DARAH PADA PENDERITA HIPERTENSI: A LITERATUR REVIEW

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Ardiansyah . ◽  
Titih Huriah
Keyword(s):  
Blood Pressure ◽  
Literature Review ◽  
Massage Therapy ◽  
Whole Body ◽  
Scalp Massage ◽  
Back Massage

Terapi non farmakologi saat ini digunakan untuk hipertensi adalah mssage. pijat (massage) memberikan rangsangan akan menimbulkan efek relaksasi (pelemasan) otot-otot kaku sertaakibat vasodilatasi umum akan menurunkan tekanan darah secara stabil. Tujuan penelitian ini untuk mengetahui efektifitas beberapa metode massage terhadap tekanan darah pada penderita hipertensi. Metode Literature review ini menggunakan database Science Direct, Proquest, Goggle Scholar.Pada tahap awal pencarian dengan keywords: “Therapy Massage, Blood Pressure, Hypertension” didapatkan hasil 17 jurnal internasional dari rentang tahun  2013 sampai 2017 yang sesuai dengan kriteria inklusi dan eksklusi. Hasil yang diperoleh dari 17 jurnal yang diperoleh, 9 penelitian dilakukan pada responden per­empuan, 8 penelitian pada responden laki-laki dan perempuan. Mengungkapkan hasil bahwa ada perbedaan penurunan efek secara signifikan antara tekanan darah sistolik dan tekanan darah diastolik  setelah dilakukan bebrapa jenis metode swedish massage, aroma massage, massage therapy, acupoint massage, scalp massage, without massage, back massage, classic massage, singel session massage, mechanical massage, foot massage, dan whole body massage. Kesimpulan tinjauan literatur review ini mendapatkan hasil bahwa ada pengaruh efek signifikan pemberian dari beberapa jenis metode massage. Metode massage adalah salah satu terapi pijat yang paling efektif untuk menurunkan atau menstabilkan tekanan darah khususnya pada penderita hipertensi. 

Sign in / Sign up

Export Citation Format

Share Document