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Hiperaldosteronismo primario, una nueva perspectiva
Karen Gómez- Hernández,Chih Hao Chen-Ku
Acta Médica Costarricense , 2007,
Abstract: Hace cincuenta a os se describió por primera vez el hiperaldosteronismo primario que hasta hace poco se consideraba un síndrome infrecuente y una causa excepcional de hipertensión arterial. De cada 10 pacientes hipertensos habrá en promedio uno de ellos con este padecimiento, convirtiendo a tal grupo de enfermedades en la causa más frecuente de hipertensión potencialmente curable. Este incremento en la prevalencia se debe quizás al aumento en la sensibilidad de las pruebas de tamizaje utilizadas. Si bien es cierto, los nuevos hallazgos no implican necesariamente el tamizaje generalizado de la población de hipertensos; es importante que el médico que la controla esté familiarizado con el tema para que lo considere y lo sospeche en el manejo y seguimiento de sus pacientes. Primary aldosteronism was first described fifty years ago, and until recently it was considered uncommon and an exceptional cause of hypertension. Now we know that approximately one out of every 10 patients with hypertension will have some form of hyperaldosteronism, making this group of diseases the number one cause of potentially curable hypertension. This increase in prevalence is probably due to improved screening strategies. Although, these new findings do not necessarily imply the need to screen all the patients with hypertension, it is fundamental that physicians treating hypertensive patients be familiarized with primary hyperaldosteronism so that they consider this possibility as they manage and follow this individuals patients.
TITLE: Trial of the Century: Leopoldo Lugones Revisited. TíTULO: El juicio del siglo: Leopoldo Lugones revisitado.  [cached]
Miguel Dalmaroni
Castilla : Estudios de Literatura , 2010,
Abstract: ABSTRACT: In the form of an itinerary, this paper aims to review the current conditions of possibility for a rereading of the argentine poet Leopoldo Lugones (from their speeches and texts) revisited as a historical type of political writer. RESUMEN: Bajo la forma de un itinerario, este ensayo se propone revisar las condiciones actuales de posibilidad para una relectura del poeta argentino Leopoldo Lugones (de sus intervenciones y textos) revisitado como un tipo histórico de escritor político.
Falla cardiaca e hiperaldosteronismo primario: Presentación de un caso Heart failure and primary hyperaldosteronism: Case report
Juan M Camargo,Fernán del C Mendoza,Efraín A Gómez,Rubén D Luna
Revista Colombiana de Cardiología , 2012,
Abstract: La insuficiencia cardiaca es un síndrome asociado con alta morbilidad y mortalidad, principalmente debido a episodios de agudización o descompensación. La cardiopatía hipertensiva es una etiología de la insuficiencia cardiaca con alta prevalencia en el mundo. El hiperaldosteronismo primario es una causa de hipertensión con incidencia creciente, que, independiente de la hipertensión, puede desencadenar miocardiopatía con todas sus consecuencias. En este artículo se presenta el caso de un paciente de cincuenta a os con insuficiencia cardiaca agudizada con disfunción sistólica, asociada a hipertensión resistente y como patología de base un estado con hipersecreción de aldosterona (hiperaldosteronismo primario). Heart failure is a syndrome associated with high morbidity and mortality, mainly due to episodes of exacerbation or decompensation. Hypertensive heart disease is a cause of heart failure with a high prevalence in the world. Primary hyperaldosteronism is a cause of hypertension with increasing incidence, which, independent of hypertension, can lead to cardiomyopathy with all its consequences. This article presents the case of a fifty years old male patient with acute heart failure exacerbated with systolic dysfunction, associated with resistant hypertension and having as underlying pathology a condition of aldosterone hypersecretion (primary hyperaldosteronism).
Hiperaldosteronismo hiporreninémico supresible con glucocorticoides. Reporte de un caso y revisión de la literatura
Hugo Villarroel Abrego
Revista Costarricense de Cardiología , 2007,
Abstract: Se presenta el caso de un paciente de 57 a os de edad, hipertenso severo y refractario, tratado sin éxito con 4 drogas antihipertensivas. El cuadro se asociada a debilidad muscular, alcalosis metabólica, hipokalemia severa y kaliuresis aumentada. Después de un exhaustivo estudio y varios ensayos terapéuticos en secuencia, se concluyó que este caso de hiperaldosteronismo hiporreninémico correspondía a la rara patología genética conocida como hiperaldosteronismo supresible con glucocorticoides. Hasta donde el autor sabe este es el primer caso reportado en Centroamérica de esta entidad. Se hace una revisión sobre el tema. Glucocorticoid-supressible hyporeninemic hyperaldosteronism. A case report and literature review This case report is about a male 57-years patient, with severe and refractary arterial hypertension, treated unsuccesfully with four antihypertensive drugs. Besides there was muscular weakness, metabolic alkalosis, severe hypokalemia and inapropiate kaliuresis and a secundary cause of hypertension was considered. After a comprehensive workout and several sequential clinical assays, it was concluded that this state of hyporeninemic hyperaldosteronism was a case of the rare genetic disease known as a glucocorticoid-remediable hyperaldosteronism. As far as we know, this is the first case reported in El Salvador and Central America. A review of the subject has been made.
Rastreamento, Comprova o e Diferencia o Laboratorial do Hiperaldosteronismo Primário
Kater Claudio E.
Arquivos Brasileiros de Endocrinologia & Metabologia , 2002,
Abstract: Hiperaldosteronismo primário (HAP), antes considerado uma causa rara de hipertens o, pode corresponder, em séries recentes, a 5-10% da popula o de hipertensos. Embora alguns considerem o HAP como a principal causa de hipertens o secundária, outros recomendam cautela na análise desta recente "epidemia". As manifesta es clássicas do excesso de aldosterona n o est o sempre presentes no HAP, determinando como base para o seu rastreamento a rela o aldosterona: renina plasmática (ng/dl:ng/ml/h). Hipertensos com valor desta rela o > ou = 25 (e aldosterona >14ng/dl) devem prosseguir numa avalia o que inclui testes de supress o da aldosterona plasmática ou urinária (infus o de salina, administra o de fludrocortisona ou dieta hipersódica). A ausência de supress o caracteriza autonomia da secre o de aldosterona e HAP, cujas principais etiologias s o o adenoma adrenal (APA) e a hiperplasia bilateral ou hiperaldosteronismo idiopático (HAI). A diferencia o entre APA e HAI - obrigatória para direcionar a interven o terapêutica -, fundamenta-se na ausência de resposta da aldosterona aos testes de estímulo da renina (teste postural, diuréticos ou dieta hipossódica) no primeiro e na hiperresposta, no último. A complementa o diagnóstica inclui a avalia o por TC e, se necessário, cateterismo venoso bilateral com dosagem de aldosterona dos efluentes adrenais para confirmar a origem de seu excesso.
Hipertensión arterial maligna e hiperaldosteronismo hiperreninémico: reporte de un caso
Hugo Villarroel-ábrego,Marcella Rivas,David Sotello,Denis Sorto
Revista Costarricense de Cardiología , 2011,
Abstract: Se presenta el caso de una mujer de 28 a os de edad, hospitalizada por hipertensión arterial severa, edema pulmonar e hipokalemia. Se encontró hiperaldosteronismo hiperrreninémico e imagen de una lesión nodular en la glándula suprarrenal izquierda, la cual fue extirpada mediante cirugía laparoscópica El estudio histológico demostró hiperplasia macronodular cortical y en el postoperatorio, hubo retorno progresivo de la hipertensión e hipokalemia. Malignant Arterial Hypertension and Hyperreninemic Hyperaldosteronism: a Case Report The case of a 28-year old female hospitalized because of severe arterial hypertension, pulmonary edema and hypokalemia is presented. Hyperreninemia, hyperaldosteronism and the presence of a nodular lesion in the left adrenal gland were detected. Laparoscopic adrenalectomy was performed and histology showed macronodular cortical hyperplasia. In the postoperative period, there was a progressive recurrence of hypertension and hypokalemia.
Hiperaldosteronismo Primario
Pe?a Ibá?ez,Pascual; García Pérez,Aída; Sánchez Ortiz,Pilar;
Revista Clínica de Medicina de Familia , 2010, DOI: 10.4321/S1699-695X2010000300016
Abstract: primary hyperaldosteronism is characterised by an excessive production of aldosterone by the adrenal gland, with suppression of plasma renin activity. clinical findings are not very specific and in some patients it is asymptomatic although in almost all cases there is moderately to severely high blood pressure that is difficult to control and neuromuscular symptoms such as asthenia and paresthesia. we present the case of a 33 year old patient who came to the emergency department due to chest pain and symptoms related to the parasympathetic nervous system.
Hiperaldosteronismo primario
Fardella,Carlos E; Mosso,Lorena M; Carvajal,Cristian A;
Revista médica de Chile , 2008, DOI: 10.4067/S0034-98872008000700014
Abstract: primary aldosteronism (pa) is a known cause of hypertension. in the kidney, aldosterone promotes sodium and water reabsorption, increasing the intravascular volume and blood pressure (bp). in the cardiovascular system, aldosterone modifies endothelial and smooth muscle cell response, increasing cardiovascular risk in a blood pressure-independent way. recently a high prevalence of pa (near to 10%) in hypertensive population, has been detected measuring plasma aldosterone/renin activity ratio (arr) as screening test. this ratio increases along with the severity ofthe hypertensive disease. the diagnostic work up of pa should confirm the autonomy of aldosterone secretion from the renin-angiotensin system and should differentiate the clinical subtypes of the disease. these are idiopathic aldosteronism (ia) and aldosterone-producing adenoma (apa). other causes are familial hyperaldosteronism (fh) type i (glucocorticoid-remediable aldosteronism), fh-ii (non glucocorticoid-remediable aldosteronism), primary adrenal hyperplasia and adrenal carcinoma. this article reviews the prevalence, diagnosis and treatment of pa and also the clinical, biochemical and genetic characteristics ofits different subtypes
Pessoa Revisitado  [cached]
Jo?o Décio
Alfa : Revista de Linguística , 2001,
Abstract:
Hiperaldosteronismo primario Primary aldosteronism
Carlos E Fardella,Lorena M Mosso,Cristian A Carvajal
Revista médica de Chile , 2008,
Abstract: Primary aldosteronism (PA) is a known cause of hypertension. In the kidney, aldosterone promotes sodium and water reabsorption, increasing the intravascular volume and blood pressure (BP). In the cardiovascular system, aldosterone modifies endothelial and smooth muscle cell response, increasing cardiovascular risk in a blood pressure-independent way. Recently a high prevalence of PA (near to 10%) in hypertensive population, has been detected measuring plasma aldosterone/renin activity ratio (ARR) as screening test. This ratio increases along with the severity ofthe hypertensive disease. The diagnostic work up of PA should confirm the autonomy of aldosterone secretion from the renin-angiotensin system and should differentiate the clinical subtypes of the disease. These are idiopathic aldosteronism (IA) and aldosterone-producing adenoma (APA). Other causes are familial hyperaldosteronism (FH) type I (glucocorticoid-remediable aldosteronism), FH-II (non glucocorticoid-remediable aldosteronism), primary adrenal hyperplasia and adrenal carcinoma. This article reviews the prevalence, diagnosis and treatment of PA and also the clinical, biochemical and genetic characteristics ofits different subtypes
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