Diagnosis and Management of Endocrine Hypertension in Children and Adolescents

2020 ◽  
Vol 26 (43) ◽  
pp. 5591-5608
Author(s):  
Eleni P. Kotanidou ◽  
Styliani Giza ◽  
Vasiliki-Regina Tsinopoulou ◽  
Maria Vogiatzi ◽  
Assimina Galli-Tsinopoulou
Keyword(s):  
Treatment Options ◽  
Special Focus ◽  
Endocrine Disorders ◽  
Childhood And Adolescence ◽  
Endocrine Gland ◽  
Adrenal Hyperplasia ◽  
Endocrine Hypertension ◽  
Hypertension In Children ◽  
Diagnosis Of Hypertension

Hypertension in childhood and adolescence has increased in prevalence. Interest in the disease was raised after the 2017 clinical practice guidelines of the American Academy of Paediatrics on the definition and classification of paediatric hypertension. Among the secondary causes of paediatric hypertension, endocrine causes are relatively rare but important due to their unique treatment options. Excess of catecholamine, glucocorticoids and mineralocorticoids, congenital adrenal hyperplasia, hyperaldosteronism, hyperthyroidism and other rare syndromes with specific genetic defects are endocrine disorders leading to paediatric and adolescent hypertension. Adipose tissue is currently considered the major endocrine gland. Obesity-related hypertension constitutes a distinct clinical entity leading to an endocrine disorder. The dramatic increase in the rates of obesity during childhood has resulted in a rise in obesity-related hypertension among children, leading to increased cardiovascular risk and associated increased morbidity and mortality. This review presents an overview of pathophysiology and diagnosis of hypertension resulting from hormonal excess, as well as obesity-related hypertension during childhood and adolescence, with a special focus on management.

Hypertension First Seen as Facial Paralysis: Case Reports and Review of the Literature

PEDIATRICS ◽  
1991 ◽  
Vol 87 (3) ◽  
pp. 387-389
Author(s):  
RICHARD L. SIEGLER ◽  
EILEEN D. BREWER ◽  
HOWARD M. CORNELI ◽  
JOEL A. THOMPSON
Keyword(s):  
Facial Paralysis ◽  
Severe Hypertension ◽  
Case Reports ◽  
Review Of The Literature ◽  
Nerve Paralysis ◽  
Cranial Nerve Paralysis ◽  
Number Of Children ◽  
Seventh Cranial Nerve ◽  
Hypertension In Children ◽  
Diagnosis Of Hypertension

Facial paralysis was first described in a hypertensive patient by Moxon1 more than a century ago. Subsequently, there have been reports2-8 that have included a number of children, and facial palsy is mentioned in standard pediatric references9,10 as a rare feature of hypertension. Even so, practitioners may fail to recognize that facial (seventh cranial nerve) paralysis can be the initial feature of severe hypertension in children. To increase the level of awareness, we describe three severely hypertensive children who were first seen with facial paralysis between 1980 and 1988. In one of these children the diagnosis of hypertension was delayed.

scholarly journals PERIOPERATIVE CHEMOTHERAPY IN LOCALLY ADVANCED GASTRIC CANCER

2013 ◽  
Vol 50 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Thales Paulo BATISTA ◽  
Candice Amorim de Araujo Lima SANTOS ◽  
Gustavo Fernandes Godoy ALMEIDA
Keyword(s):  
Gastric Cancer ◽  
Therapeutic Strategy ◽  
Multimodal Therapy ◽  
Standard Treatment ◽  
Treatment Options ◽  
Locally Advanced ◽  
Special Focus ◽  
Perioperative Chemotherapy ◽  
Locally Advanced Gastric Cancer ◽  
Advanced Stages

Gastric cancer is one of the most common cancers and a main cause of cancer-related death worldwide, since the majority of patients suffering of this malignancy are usually faced with a poor prognosis due to diagnosis at later stages. In order to improve treatment outcomes, the association of surgery with chemo and/or radiotherapy (multimodal therapy) has become the standard treatment for locally advanced stages. However, despite several treatment options currently available for management of these tumors, perioperative chemotherapy has been mainly accepted for the comprehensive therapeutic strategy including an appropriated D2-gastrectomy. This manuscript presents a (nonsystematic) critical review about the use of perioperative chemotherapy, with a special focus on the drugs delivery.

scholarly journals Evolution of the framework for 21st century competencies

2013 ◽  
pp. 10-24
Keyword(s):  
Information And Communication Technologies ◽  
21St Century ◽  
International Organizations ◽  
Conceptual Models ◽  
Communication Technologies ◽  
Educational Policies ◽  
Special Focus ◽  
Information And Communication ◽  
Ict Competencies

This article presents the successive changes and evolution of the frameworks for 21st century competencies, since the appearance of the first conceptual models during the final years of the last century, and also it is a review of the competencies that are needed in the 21st century with a special focus on the Information and Communication Technologies (ICT) competencies. The included frameworks have been elaborated by diverse institutions such as international organizations, private consortia and also governments as a guideline for educational policies in elementary and secondary schools. Later, the frameworks are compared and analyzed according to a classification of the competencies into general categories, in order to visualize some trends and obtain some insights about the direction they are heading. Finally, it provides some suggestions for the conception of future frameworks.

scholarly journals Predictors of arterial hypertension in children (A Review)

2020 ◽  
Vol 27 (6) ◽  
pp. 123-135
Author(s):  
A. V. Burlutskaya ◽  
O. G. Korobkina
Keyword(s):  
Arterial Hypertension ◽  
Systemic Inflammation ◽  
Network Formation ◽  
Current Knowledge ◽  
Blood Cholesterol ◽  
Childhood And Adolescence ◽  
Bacterial Strains ◽  
Taxonomic Profile ◽  
The Impact ◽  
Hypertension In Children

Background. Arterial hypertension poses a relevant problem and roots in early childhood. Today, arterial hypertension in children and adolescents is considered rather common and should be controlled and prevented as early as possible, which warrants further research into its pathogenesis and effective correction.Objectives. To generalize current knowledge of microbiota in the development of arterial hypertension in children.Methods. National and foreign published sources were surveyed in the eLibrary, Web of Science and PubMed databases. Keyword queries were: gut microbiota, arterial hypertension [артериальная гипертензия], children [дети], chronic systemic inflammation [хроническое системное воспаление], probiotics [пробиотики]. All sources have a publication depth of 7 years. The study used content analysis and descriptive analytics.Results. Arterial hypertension remains a problem of high economic, medical and social importance as a major cause of brain disorders and coronary heart disease. Hypertension is shown to emerge early in childhood and adolescence during the regulatory network formation. Manifold evidence is accumulated on the involvement of human microbiota in pathogenesis of arterial hypertension. Infant microbiota is more unstable than in adults. Its taxonomic profile is viewed important for sustaining health, with imbalances in intestinal microbiota potentially entailing serious consequences. The impact of microbiota on chronic systemic inflammation, lipid metabolism, development and progression of atherosclerosis has been reported. Certain bacterial strains are known to exert benign effect on arterial hypertension and blood cholesterol. Selected mechanisms of the microbiota-mediated regulation of blood pressure have been identified. Improved methods for microbial community correction are being developed and include diet, antibiotic, prebiotic and probiotic regimens, faecal microbiota transplant.Conclusion. Current achievements promise the emergence of novel approaches for arterial hypertension control early in childhood to avoid incorrigible adult complications.

Molecular Pathology of Breast Cancer: The Journey From Traditional Practice Toward Embracing the Complexity of a Molecular Classification

2011 ◽  
Vol 135 (5) ◽  
pp. 544-557 ◽  
Author(s):  
Aaron M. Gruver ◽  
Bryce P. Portier ◽  
Raymond R. Tubbs
Keyword(s):  
Molecular Diagnostics ◽  
Treatment Options ◽  
Molecular Classification ◽  
Published Data ◽  
Breast Carcinomas ◽  
Developing Regions ◽  
Traditional Practice ◽  
The Moment

Abstract Context.—Adenocarcinoma of the breast is the most frequent cancer affecting women in both developed and developing regions of the world. From the moment of clinical presentation until the time of pathologic diagnosis, patients affected by this disease will face daunting questions related to prognosis and treatment options. While improvements in targeted therapies have led to increased patient survival, these same advances have created the imperative to accurately stratify patients to achieve maximum therapeutic efficacy while minimizing side effects. In this evolving era of personalized medicine, there is an ever-increasing need to overcome the limitations of traditional diagnostic practice. Objective.—To summarize the molecular diagnostics traditionally used to guide prognostication and treatment of breast carcinomas, to highlight published data on the molecular classification of these tumors, and to showcase molecular assays that will supplement traditional methods of categorizing the disease. Data Sources.—A review of the literature covering the molecular diagnostics of breast carcinomas with a focus on the gene expression and array studies used to characterize the molecular signatures of the disease. Special emphasis is placed on summarizing evolving technologies useful in the diagnosis and characterization of breast carcinoma. Conclusions.—Available and emerging molecular resources will allow pathologists to provide superior diagnostic, prognostic, and predictive information about individual breast carcinomas. These advances should translate into earlier identification and tailored therapy and should ultimately improve outcome for patients affected by this disease.

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