In a prospective, double-blind, intraindividual, cross-over, placebo-controlled multicenter study, clinical and biochemical effects of once daily postprandial dose regimens of 50, 100, and 200 mg spironolactone were investigated in 45 outpatients with primary hypertension, WHO (World Health Organization) Stage I-II. Each of the three active therapy periods, which were randomly allocated to patients, were of 2 months' duration, with intervening placebo periods, Clinical and biochemical parameters, including furosemide-stimulated plasma renin activity (PRA), were recorded at regular intervals. All three spironolactone doses resulted in statistically significant blood pressure (BP) reductions independent of initial pretreatment levels and yielded satisfactory BP control in more than half of the patients. The 200 mg daily dose of spironolactone was found to be more effective than 50 but not 100 mg. When, correlating blood pressure response (delta MAP) to PRA, the profiling for positive spironolactone responders was characterized by high age and low PRA, irrespective of sex. Spironolactone therapy resulted in decreased serum sodium and magnesium values; potassium, creatinine, urate, and triglyceride levels were increased. However, all treatment values were within normal ranges. Side effects were infrequent and mainly of endocrine nature.
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http://dx.doi.org/10.1161/01.hyp.2.5.672 | DOI Listing |
J Eval Clin Pract
February 2025
Pitești University Centre, National University of Science and Technology Politehnica Bucharest, Pitești, Romania.
This article identifies and offers a response to several problems that affect the quality of both clinical education and health care services. These matters are: that in clinical training and practice, health, as lived by patients (persons), is not properly considered, and is equated reductively with treating diseases/disorders; that health is seen through disease, and as restricted to a single model defined by an organism's meeting (or being returned to) biochemical or functional standards; that intellectual assumptions instilled in schools of Medicine and Psychology about realities pertaining to healthcare determine an understanding of chronic illness or life with chronic challenges focused on impairment and suffering, and not on the fuller experience of living with illness, disability or neuropsychological challenges that patients have as persons; that arts-based education reflects the same focus in understanding 'illness', and thus neglects giving attention to the creation of personal health states of those living with challenging or debilitating long-term conditions; that, consequently, the arts are instrumentalized to serve these predefined educational purposes, rather than allowed to inform clinical training through that which is intrinsic or more specific to them. As a way out of these limitations and as an illustration of how things could be done differently, Vincent Van Gogh's paintings of the Sunflowers are used as visual inspiration for how we could change the way we see, and construct new mental representations of 'health', 'chronic illness' or 'chronic challenges', 'patient as person' or even 'person as non-patient', 'the clinician's role' and 'the identity of clinical practice'.
View Article and Find Full Text PDFJBMR Plus
February 2025
Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki 00014, Finland.
Hypophosphatemic rickets is a rare bone disease characterized by short stature, bone deformities, impaired bone mineralization, and dental problems. Most commonly, hypophosphatemic rickets is caused by pathogenic variants in the X-chromosomal gene, but autosomal dominant and recessive forms also exist. We investigated a Finnish family in which the son (index, 29 yr) and mother (56 yr) had hypophosphatemia since childhood.
View Article and Find Full Text PDFBJUI Compass
January 2025
OncoAssure Ltd, NovaUCD Dublin Ireland.
Objectives: This study aimed to clinically validate the six-gene prognostic molecular clinical risk score (MCRS) for the prediction of aggressive prostate cancer in diagnostic biopsy tissue.
Methods: MCRS was evaluated in prostate biopsy tissue from a Swedish cohort of men with prostate cancer (UPCA, = 100). The primary outcome of adverse pathology and secondary outcomes of high primary Gleason (≥G4) and high pathological T-stage (≥T3) were assessed by likelihood ratio statistics and area under the receiver operating characteristic curves from logistic regression models; time to biochemical recurrence was assessed by likelihood ratio statistics and C-indexes from Cox proportional hazard regression models.
Niger Med J
January 2025
Department Of Medical Oncology, Indira Gandhi Institute of Medical Sciences, Patna, India.
Background: Bone marrow (BM) in addition to being the origin of primary hematological malignancies is also commonly involved in metastatic solid tumors. Bone marrow examination includes aspiration and biopsy, and it is a well-known procedure not only to diagnose hematological malignancies but also for staging and prognosis of various solid tumors. The presence of metastasis in the bone marrow is of grave prognostic significance and it is imperative to rule out marrow involvement in any malignancy where curative treatment is considered.
View Article and Find Full Text PDFNiger Med J
January 2025
Department of Obstetrics and Gynaecology, AIIMS, Bilaspur, Himachal Pradesh, India.
Autosomal hypophosphatemic rickets though a rare genetic disorder can lead to significant discomfort to the patient resulting in clinical deterioration and a poor quality of life. We describe a case of a 33-year-old woman G2P1001 at 6 weeks of gestation with complaints of myalgia and bony pains. Keeping her history of bony pains and fractures in mind, she was further evaluated.
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