43 research outputs found
Absence of D147E mutation of CYP11B2 gene in hypertensive patients with increased corticosterone and aldosterone production.
No full textAbsence of D147E mutation of CYP11B2 gene in hypertensive patients with increased corticosterone and aldosterone production.
Mulatero P1, Glorioso N, Fallo F, Soro A, Morra di Cella S, Carra R, Filigheddu F, Veglio F.
Author information
Abstract
OBJECTIVE:
11beta-Hydroxylase and aldosterone synthase are two highly homologous genes involved in different forms of human hypertension and in different animal models of hypertension. It has been shown that the conservative substitution D147E in the human CYP11B2 gene results in an increased production of corticosterone and aldosterone in vitro. A gene conversion between the CYP11B1 and CYP11B2 genes could be responsible for such a substitution.
METHODS:
In this study we investigated the presence of the mutation D147E of CYP11B2 in a group of 128 patients with primary aldosteronism, 68 patients with essential hypertension and increased corticosterone production and in 48 normal volunteers.
RESULTS AND CONCLUSIONS:
We did not identify any patient carrying this mutation, indicating that if it exists it is very rare and so has no relevance in determining the increased steroid excretion seen in some subtypes of human hypertension
The importance of materiality analysis and stakeholder engagement in determining corporate purpose: A case study from the aviation industry
No full textThe conventional emphasis on shareholder value has given way to a more expansive understanding of corporate purpose in recent years, encompassing social and environmental responsibilities. A new approach to management, known as the stakeholder view, prioritises a balance between the interests of all stakeholders and challenges Friedman’s shareholder-centric model, which places shareholders at the centre of corporate strategy. Despite growing support for this broader perspective, certain critics advise that the business’s identity and competitiveness may be weakened by the lack of a clear purpose, making it more susceptible to pressure from external actors and power groups like top management. Moreover, the increasing importance of sustainability has made companies need to incorporate social and environmental goals into their governance, frequently expressed as corporate purpose. This business purpose is not always explicitly defined, and done so leads to the notion of an implicit business purpose, which can be inferred from sustainability actions, strategies, and practices. Using Geasar S.p.A., an operator of an airport management company based in Olbia (Sardinia, Italy), as a case study, our contribution investigates how materiality analysis and stakeholder interaction may be used to identify and strengthen the implicit corporate purpose. The case study demonstrates how the Company, through an implicit statement of purpose, can manifest a solid commitment to environmental and social sustainability and the improvement of the territory in which it operates. The analysis reveals how Geasar S.p.A. has integrated the values of social responsibility into corporate governance and strategies, evolving from a traditional CSR approach to a more sophisticated ESG model based on a solid corporate purpose actively promoting the economic and social development of Sardinia through a strong link with the territory
Blood pressure circadian rhythm alterations in alpha-synucleinopathies
No full textIntroduction: We sought to analyze the blood pressure (BP) circadian rhythm in Parkinson's disease (PD), multiple system atrophy (MSA), and pure autonomic failure (PAF) and to evaluate the effect of vasoactive and dopaminergic medications on BP fluctuations during activities of daily living.Methods: We analyzed data from patients with PD (n=72), MSA (n=18), and PAF (n=17) evaluated with 24-h ambulatory BP monitoring (ABPM) at our Center between 1996 and 2015. Comparisons between groups were performed according to (a) clinical diagnosis and (b) pharmacological treatment. ABPM parameters included 24-h BP variability, BP load, nocturnal dipping, and awakening hypotension.Results: The average BP was 12114/72 +/- 8 mmHg during daytime and 133 +/- 20/76 +/- 13 mmHg during nighttime (p<0.01), with BP load of 24 +/- 22/15 +/- 16% (daytime) vs. 61 +/- 36/52 +/- 36% (nighttime) (p<0.01). In-office BP measurements were consistent with OH in 95 patients (89%) and SH in 63 (59%). ABPM demonstrated increased BP variability in 67 patients (63%), awakening hypotension in 63 (59%), "reverse dipping" in 85 (79.4%), "reduced dipping" in 13 (12.1%), and "normal dipping" in 9 (8.4%). No differences were observed between PD, MSA, and PAF, but a sub-analysis of PD patients revealed two distinct patterns of BP alterations. No significant differences were observed in relation to the use of vasoactive or dopaminergic medications.Conclusion: Regardless of the neurological diagnosis and pharmacological treatment, patients with alpha-synucleinopathies showed a BP circadian rhythm characterized by increased BP variability, reverse dipping, increased BP load, and awakening hypotension
Antihypertensive Bridge Therapy by Continuous Drug Infusion With an Elastomeric Pump in Device-Resistant Hypertension
No full textAbstract not availabl
Detection of orthostatic hypotension with ambulatory blood pressure monitoring in parkinson’s disease
No full textWe sought to test the accuracy of 24-hours ambulatory blood pressure (BP) monitoring (ABPM) for the detection of orthostatic hypotension (OH) in Parkinson's disease (PD). A total of 113 patients referred for autonomic testing between January 2015 and June 2017 underwent ABPM and office BP measurements in supine and standing positions. The study population consisted of 81 males and 32 females with PD duration of 6.5 +/- 4.1 years and Hoehn and Yahr staging of 1 (13.3%), 1.5 (20.4%), 2 (27.4%), 2.5 (23.9%), 3 (13.3%), and 4 (1.8%). Motor fluctuations were present in 44% of patients. The data from office BP recordings were compared to selected ABPM parameters, and the results showed an association between OH and (a) ABPM-detected hypotensive episodes (Hypo-ep) and (b) ABPM-detected awakening hypotension (Hypo-aw). Having 2 or more Hypo-ep episodes <= 15 mmHg (systolic) compared to average 24-h systolic BP (Hypo-ep(Delta 15/24h)) yielded 75% diagnostic accuracy for OH, while the presence of at least one Hypo-ep(Delta 15/24h) within 90 min after getting up (Hypo-aw(Delta 15/24h)) yielded 93% specificity for OH. A diagnostic accuracy of 87.6% was achieved when including daytime and nighttime ABPM values, weighted BP variability, systolic and diastolic BP loads, nocturnal dipping, and postprandial hypotension in a computerized prediction algorithm. In conclusion, our findings suggest that selected ABPM parameters, such as the number of hypotensive episodes and the presence of awakening hypotension, may be used to screen patients for OH, while using a computerized prediction algorithm that includes all ABPM parameters provides the greatest diagnostic accuracy
Machine learning applied to ambulatory blood pressure monitoring: a new tool to diagnose autonomic failure?
No full textBACKGROUND: Autonomic failure (AF) complicates Parkinson’s disease (PD) in one-third of cases, resulting in complex blood pressure (BP) abnormalities. While autonomic testing represents the diagnostic gold standard for AF, accessibility to this examination remains limited to a few tertiary referral centers. OBJECTIVE: The present study sought to investigate the accuracy of a machine learning algorithm applied to 24-h ambulatory BP monitoring (ABPM) as a tool to facilitate the diagnosis of AF in patients with PD. METHODS: Consecutive PD patients naïve to vasoactive medications underwent 24 h-ABPM and autonomic testing. The diagnostic accuracy of a Linear Discriminant Analysis (LDA) model exploiting ABPM parameters was compared to autonomic testing (as per a modified version of the Composite Autonomic Symptom Score not including the sudomotor score) in the diagnosis of AF. RESULTS: The study population consisted of n = 80 PD patients (33% female) with a mean age of 64 ± 10 years old and disease duration of 6.2 ± 4 years. The prevalence of AF at the autonomic testing was 36%. The LDA model showed 91.3% accuracy (98.0% specificity, 79.3% sensitivity) in predicting AF, significantly higher than any of the ABPM variables considered individually (hypotensive episodes = 82%; reverse dipping = 79%; awakening hypotension = 74%). CONCLUSION: LDA model based on 24-h ABPM parameters can effectively predict AF, allowing greater accessibility to an accurate and easy to administer test for AF. Potential applications range from systematic AF screening to monitoring and treating blood pressure dysregulation caused by PD and other neurodegenerative disorders
Roasting and chlorine leaching of gold-bearing refractory concentrate: Experimental and process analysis
No full textThis paper deals with gold extraction from a refractory concentrate by chlorine leaching. The process considers a pre-treatment of refractory materials by low temperature oxidation carried out with low oxygen concentration. The oxidized material is treated by leaching with brine. After gold adsorption/reduction onto activated carbon, iron and base metals can be precipitated by NaOH. Roasting tests show the necessity to carry out a thermal pre-treatment at least at 550 C to obtain a reduction of sulfur and mercury in the material (50% and 90%, respectively). Highest gold extraction yield (around 93%) is obtained in the leaching test performed with material sample treated at 650 C. This result confirms the necessity to optimize the thermal pre-treatment to improve Au recovery and to reduce chlorine consumption. A comparison with conventional cyanidation confirms that chlorination could be an useful alternative: in fact, gold extraction yield is quite low: 57% in non-pre-treated material and 25% in pre-treatment material. © 2013 Published by Elsevier B.V. on behalf of China University of Mining & Technology
