1,721,253 research outputs found
Prevalence of primary aldosteronism (PA) nationwide in Italy in newly diagnosed hypertensive patients
No full text
Effects of long-term treatment with human pure FSH on seminal parameters and sperm cells ultrastructure in idiopathic oligo-asthenozoospermia.
No full textTen subfertile men affected by idiopathic oligoteratoasthenozoospermia and exhibiting normal serum hormone levels received a long-term treatment with human pure follicle-stimulating hormone (hp-FSH) (150 IU, intramuscularly, three times per week for 6 months). Semen parameters and ultrastructural features of spermatozoa were evaluated before and after therapy. The results showed an increase in sperm cell concentration and, more interestingly, motility. Electron microscopic examination revealed an improved fine architectural pattern, mainly involving acrosome, head and chromatin and middle-piece, in accordance with the positive changes of functional data. No significant changes of hp-FSH treatment on serum hormone levels were observed, since the latter were found to be substantially unchanged after 6 months of therapy. The present data suggest: (i) the benefit of hp-FSH administration in idiopathic oligoteratoasthenozoospermia, when hormone parameters support a substantial integrity of spermatogenetic micro-environment and (ii) an optimal effect after long-term (6 months) therapy
Monogenic Forms of Hypertension
No full textEssential hypertension is a highly prevalent disease in the general population. Secondary hypertension is characterized by a specific and potentially reversible cause of increased blood pressure levels. Some secondary endocrine forms of hypertension are common (caused by uncontrolled cortisol, aldosterone, or catecholamines production). This article describes rare monogenic forms of hypertension, characterized by electrolyte disorders and suppressed renin-aldosterone axis. They represent simple models for the physiology of renal control of sodium levels and plasma volume, thus reaching a high scientific interest. Furthermore, they could explain some features closer to the essential phenotype of hypertension, suggesting a mechanistically driven personalized treatment
Body composition and metabolic features in women with adrenal incidentaloma or Cushing's syndrome
No full textThe aim of this study was to evaluate body composition and metabolic features in women with nonhypersecretory adrenal cortical incidentaloma (AI) and women with Cushing's syndrome (CS) compared with healthy control (C) women matched for age, menopausal status, and body mass index. We examined 15 females with CS, 22 with AI, and 20 C. We evaluated anthropometric, hormonal, and metabolic parameters in all subjects. Body composition was measured by dual-energy x-ray absorptiometry for total body (TB); in addition, abdominal fat was measured between L2 and L4 vertebrae. Women with CS and AI were overweight; waist to hip ratio mean values showed that women with CS and AI had a central fat distribution. TB fat was significantly higher in CS than in C women, however, AI women also had high fat values. Abdominal fat was significantly more increased in CS than in AI and C women. Eighty percent of CS women and 50% of AI women were hypertensive. High density lipoprotein cholesterol levels were lower and triglyceride levels were higher in CS and AI women than in C. The area under the curve for glucose after oral glucose tolerance test was significantly higher in CS and AI than in C. AI had urinary free cortisol values slightly higher than C and than the normal range. In conclusion, these data indicate that AI are at an intermediate state between normal and pathological. These alterations suggest that a subtle cortisol hypersecretion is probably present in AI and it may be the factor promoting alterations of body composition and metabolic parameters
Analysis of screening and confirmatory tests in the diagnosis of primary aldosteronism: need for a standardized protocol
No full text
Primary aldosteronism (Conn's syndrome)
No full textIdiopathic (essential) hypertension is the most common cause of elevated blood pressure (BP) levels in a patient. However, up to 5%–10% of patients with elevated BP are affected by a specific and potentially reversible cause that is known as secondary hypertension. Primary aldosteronism (PA) is the most common form of endocrine hypertension. The diagnostic and therapeutic pathways for PA consist of few important steps: screening tests in high-risk population, identification of PA subtype, and treatment (surgery in case of unilateral adenoma, and if not for surgery, treatment with a mineralcorticoid receptor antagonist). Aldosterone-to-renin ratio is recommended as the initial test to screen for PA; it should be performed after giving adequate wash-out time for several interfering drugs. Confirmatory tests including captopril challenge test and saline infusion test are used if clinical conditions such as spontaneous hypokalemia and increased aldosterone levels are not sufficient to confirm PA. Before surgery, adrenal venous sampling is suggested to ensure accurate lateralization of aldosterone production
- …
