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[PMID]: 28939282 [Au] Autor: Cuervo D; Loli C; Fernández-Álvarez M; Muñoz G; Carreras D [Ad] Endereço: Laboratorio de Control del Dopaje, Agencia Española de Protección de la Salud en el Deporte, Ministerio de Educación, Cultura y Deporte, Gobierno de España, c/El Greco s/n, 28040, Madrid, Spain. Electronic address: dario.cuervo@aepsad.gob.es. [Ti] Título: Determination of doping peptides via solid-phase microelution and accurate-mass quadrupole time-of-flight LC-MS. [So] Source: J Chromatogr B Analyt Technol Biomed Life Sci;1065-1066:134-144, 2017 Oct 15. [Is] ISSN: 1873-376X [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: A complete analytical protocol for the determination of 25 doping-related peptidic drugs and 3 metabolites in urine was developed by means of accurate-mass quadrupole time-of-flight (Q-TOF) LC-MS analysis following solid-phase extraction (SPE) on microplates and conventional SPE pre-treatment for initial testing and confirmation, respectively. These substances included growth hormone releasing factors, gonadotropin releasing factors and anti-diuretic hormones, with molecular weights ranging from 540 to 1320Da. Optimal experimental conditions were stablished after investigation of different parameters concerning sample preparation and instrumental analysis. Weak cation exchange SPE followed by C18 HPLC chromatography and accurate mass detection provided the required sensitivity and selectivity for all the target peptides under study. 2mg SPE on 96-well microplates can be used in combination with full scan MS detection for the initial testing, thus providing a fast, cost-effective and high-throughput protocol for the processing of a large batch of samples simultaneously. On the other hand, extraction on 30mg SPE cartridges and subsequent target MS/MS determination was the protocol of choice for confirmatory purposes. The methodology was validated in terms of selectivity, recovery, matrix effect, precision, sensitivity (limit of detection, LOD), cross contamination, carryover, robustness and stability. Recoveries ranged from 6 to 70% (microplates) and 17-95% (cartridges), with LODs from 0.1 to 1ng/mL. The suitability of the method was assessed by analyzing different spiked or excreted urines containing some of the target substances. [Mh] Termos MeSH primário: Doping nos Esportes Peptídeos/urina Extração em Fase Sólida/métodos Espectrometria de Massas em Tandem/métodos [Mh] Termos MeSH secundário: Antidiuréticos/isolamento & purificação Antidiuréticos/urina Cromatografia Líquida de Alta Pressão/métodos Hormônio Liberador de Gonadotropina/isolamento & purificação Hormônio Liberador de Gonadotropina/urina Hormônio Liberador de Hormônio do Crescimento/isolamento & purificação Hormônio Liberador de Hormônio do Crescimento/urina Seres Humanos Limite de Detecção Peptídeos/isolamento & purificação Reprodutibilidade dos Testes [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antidiuretic Agents); 0 (Peptides); 33515-09-2 (Gonadotropin-Releasing Hormone); 9034-39-3 (Growth Hormone-Releasing Hormone) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171030 [Lr] Data última revisão: 171030 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170924 [St] Status: MEDLINE

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[PMID]: 28502212 [Au] Autor: Jermendy G; Kiss Z; Rokszin G; Abonyi-Tóth Z; Wittmann I; Kempler P [Ad] Endereço: Bajcsy-Zsilinszky Kórház Budapest, Maglódi út 89-91., 1106. [Ti] Título: [Trends in antidiabetic treatment prescribed for patients with type 2 diabetes in Hungary between 2001 and 2014 - results from the database analysis of the National Health Insurance Fund]. [Ti] Título: A 2-es típusú diabetes antihyperglykaemiás kezelésének alakulása Magyarországon 2001­2014 között ­ az Országos Egészségbiztosítási Pénztár adatbázis-elemzésének eredményei.. [So] Source: Orv Hetil;158(20):770-778, 2017 May. [Is] ISSN: 0030-6002 [Cp] País de publicação: Hungary [La] Idioma: hun [Ab] Resumo: In the last couple of years, significant developments in antidiabetic treatment have influenced the pharmacological treatment of type 2 diabetes mellitus (T2DM). The aim of this study was to analyze the changes in prescribing patterns of glucose-lowering drugs for T2DM patients in Hungary between 2001 and 2014. The number of patients with newly diagnosed T2DM decreased from 75,700 (2001) to 33,700 (2014), while prevalent T2DM cases continuously increased and plateaued in 2014 with a number of registered patients of 727,000. Sulfonylurea-monotherapy decreased from 64% to 35% while metformin-monotherapy increased from 19% to 42% in this period. The most frequently used drug at first treatment initiation was metformin (66%) and sulfonylurea (16%) as monotherapy in 2014. DPP4-inhibitors were newly administered in 20,362 cases while GLP1-mimetics were newly used by 4,996 patients in 2014. Five years later after initiating sulfonylurea therapy between 2010 and 2014, metformin was more frequently used as second drug (39%) than sulfonylurea in patients with previous metformin treatment (22.9%). The prescribing patterns of glucose-lowering drugs have changed over time in accordance with new guidelines. Further changes in prescribing habits can be expected in the near future. Orv Hetil. 2017; 158(20): 770-778. [Mh] Termos MeSH primário: Antidiuréticos/uso terapêutico Diabetes Mellitus/tratamento farmacológico Diabetes Mellitus/epidemiologia Hipoglicemiantes/uso terapêutico [Mh] Termos MeSH secundário: Bases de Dados Factuais Feminino Seres Humanos Hungria/epidemiologia Masculino Metformina/uso terapêutico Programas Nacionais de Saúde Prevalência Estudos Retrospectivos Compostos de Sulfonilureia/uso terapêutico [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antidiuretic Agents); 0 (Hypoglycemic Agents); 0 (Sulfonylurea Compounds); 9100L32L2N (Metformin) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170928 [Lr] Data última revisão: 170928 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170516 [St] Status: MEDLINE [do] DOI: 10.1556/650.2017.30769

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[PMID]: 28332265 [Au] Autor: Kazi RN; Sattar MA; Johns EJ [Ad] Endereço: College of Applied Medical Science, Prince Sattam Bin Abdul-Aziz University, Wadi Ad Dawaser, Saudi Arabia. [Ti] Título: Antidiuretic and antinatriuretic response to high salt load in normotensive Wistar-Kyoto rats: Role of alpha-1A-adrenoreceptors. [So] Source: Auton Autacoid Pharmacol;37(1):13-18, 2017 Jan. [Is] ISSN: 1474-8673 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Altered renal adrenergic responses have been recognized as pathophysiological responses to high salt intake. This study aims to investigate the influence of 6 weeks of high salt diet on α -adrenoceptor regulation of renal tubular antinatriuretic and antidiuretic response in normal Wistar Kyoto rats. To achieve the above objective, antinatriuretic and antidiuretic response to phenylephrine was measured in the absence and presence of 5-methylurapidil (5-MeU) using the inulin clearance method. Systemic mean arterial blood pressure and renal haemodynamics were also measured simultaneously. Six weeks of high salt intake in Wistar-Kyoto (WKY) rats did not bring any significant increase in mean arterial blood pressure. WKY rat on high salt diet (WKYHNa) showed an exaggerated increase in absolute and fractional sodium excretion. There was a significant involvement of α -adrenoceptor in carrying out renal tubular antinatriuretic and antidiuretic response in Wistar Kyoto rats on normal sodium diet (WKYNNa). However, α -adrenoceptor played a minimal role in handling the tubular reabsorptive response in WKY rats on high salt diet. [Mh] Termos MeSH primário: Antidiuréticos/farmacologia Natriuréticos/farmacologia Receptores Adrenérgicos alfa 1/efeitos dos fármacos Cloreto de Sódio na Dieta/farmacologia [Mh] Termos MeSH secundário: Animais Pressão Arterial/efeitos dos fármacos Insulina/metabolismo Masculino Fenilefrina/farmacologia Piperazinas/farmacologia Ratos Ratos Endogâmicos WKY Circulação Renal [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antidiuretic Agents); 0 (Insulin); 0 (Natriuretic Agents); 0 (Piperazines); 0 (Receptors, Adrenergic, alpha-1); 0 (Sodium Chloride, Dietary); 1HLS600135 (5-methylurapidil); 1WS297W6MV (Phenylephrine) [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170718 [Lr] Data última revisão: 170718 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170324 [St] Status: MEDLINE [do] DOI: 10.1111/aap.12053

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[PMID]: 28258576 [Au] Autor: Lu HA [Ad] Endereço: Program in Membrane Biology, Division of Nephrology, Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Boston, MA, 02114, USA. halu@partners.org. [Ti] Título: Diabetes Insipidus. [So] Source: Adv Exp Med Biol;969:213-225, 2017. [Is] ISSN: 0065-2598 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Disruption of water and electrolyte balance is frequently encountered in clinical medicine. Regulating water metabolism is critically important. Diabetes insipidus (DI) presented with excessive water loss from the kidney is a major disorder of water metabolism. To understand the molecular and cellular mechanisms and pathophysiology of DI and rationales of clinical management of DI is important for both research and clinical practice. This chapter will first review various forms of DI focusing on central diabetes insipidus (CDI) and nephrogenic diabetes insipidus (NDI ) . This is followed by a discussion of regulatory mechanisms underlying CDI and NDI , with a focus on the regulatory axis of vasopressin, vasopressin receptor 2 (V2R ) and the water channel molecule, aquaporin 2 (AQP2 ). The clinical manifestation, diagnosis and management of various forms of DI will also be discussed with highlights of some of the latest therapeutic strategies that are developed from in vitro experiments and animal studies. [Mh] Termos MeSH primário: Aquaporina 2/metabolismo Diabetes Insípido/metabolismo Receptores de Vasopressinas/metabolismo Vasopressinas/metabolismo Água/metabolismo [Mh] Termos MeSH secundário: Animais Anti-Inflamatórios não Esteroides/uso terapêutico Antidiuréticos/uso terapêutico Aquaporina 2/genética Desamino Arginina Vasopressina/uso terapêutico Diabetes Insípido/tratamento farmacológico Diabetes Insípido/genética Diabetes Insípido/patologia Modelos Animais de Doenças Regulação da Expressão Gênica Seres Humanos Rim/efeitos dos fármacos Rim/metabolismo Rim/patologia Inibidores de Fosfodiesterase/uso terapêutico Isoformas de Proteínas/genética Isoformas de Proteínas/metabolismo Receptores de Vasopressinas/genética Vasopressinas/genética Vasopressinas/uso terapêutico Equilíbrio Hidroeletrolítico [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (AQP2 protein, human); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Antidiuretic Agents); 0 (Aquaporin 2); 0 (Phosphodiesterase Inhibitors); 0 (Protein Isoforms); 0 (Receptors, Vasopressin); 059QF0KO0R (Water); 11000-17-2 (Vasopressins); ENR1LLB0FP (Deamino Arginine Vasopressin) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170907 [Lr] Data última revisão: 170907 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170305 [St] Status: MEDLINE [do] DOI: 10.1007/978-94-024-1057-0_14

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[PMID]: 28223002 [Au] Autor: Andreoli DC; Whittier WL [Ad] Endereço: Section of Nephrology, Division of Nephrology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL. [Ti] Título: Reset Osmostat: The Result of Chronic Desmopressin Abuse? [So] Source: Am J Kidney Dis;69(6):853-857, 2017 Jun. [Is] ISSN: 1523-6838 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: A reset osmostat as a cause of hyponatremia can be found in a variety of clinical settings, including pulmonary and neurologic diseases, as well as in physiologic circumstances such as pregnancy. This teaching case describes a 72-year-old white man with a long-standing history of self-medicating with desmopressin acetate (DDAVP) who presented with profound hyponatremia. On discontinuation of DDAVP treatment, he was found to have a reset osmostat. The mild hyponatremia persisted on follow-up. We theorize that the reset osmostat may have developed secondary to long-standing DDAVP use. [Mh] Termos MeSH primário: Antidiuréticos/efeitos adversos Desamino Arginina Vasopressina/efeitos adversos Hiponatremia/induzido quimicamente Poliúria/tratamento farmacológico [Mh] Termos MeSH secundário: Idoso Fibrilação Atrial Seres Humanos Hipotálamo Masculino Concentração Osmolar Automedicação Urinálise [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antidiuretic Agents); ENR1LLB0FP (Deamino Arginine Vasopressin) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170814 [Lr] Data última revisão: 170814 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170223 [St] Status: MEDLINE

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[PMID]: 28052875 [Au] Autor: Su W; Huang SZ; Gao M; Kong XM; Gustafsson JÅ; Xu SJ; Wang B; Zheng F; Chen LH; Wang NP; Guan YF; Zhang XY [Ad] Endereço: AstraZeneca-Shenzhen University Joint Institute of Nephrology, Shenzhen University Health Science Center, Shenzhen University, Shenzhen, China. [Ti] Título: Liver X receptor ß increases aquaporin 2 protein level via a posttranscriptional mechanism in renal collecting ducts. [So] Source: Am J Physiol Renal Physiol;312(4):F619-F628, 2017 Apr 01. [Is] ISSN: 1522-1466 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Liver X receptors (LXRs) including LXRα and LXRß are nuclear receptor transcription factors and play an important role in lipid and glucose metabolism. It has been previously reported that mice lacking LXRß but not LXRα develop a severe urine concentrating defect, likely via a central mechanism. Here we provide evidence that LXRß regulates water homeostasis through increasing aquaporin 2 (AQP2) protein levels in renal collecting ducts. LXRß mice exhibited a reduced response to desmopressin (dDAVP) stimulation, suggesting that the diabetes insipidus phenotype is of both central and nephrogenic origin. AQP2 protein abundance in the renal inner medulla was significantly reduced in LXRß mice but with little change in AQP2 mRNA levels. In vitro studies showed that AQP2 protein levels were elevated upon LXR agonist treatment in both primary cultured mouse inner medullary duct cells (mIMCD) and the mIMCD3 cell line with stably expressed AQP2. In addition, LXR agonists including TO901317 and GW3965 failed to induce AQP2 gene transcription but diminished its protein ubiquitination in primary cultured mIMCD cells, thereby inhibiting its degradation. Moreover, LXR activation-induced AQP2 protein expression was abolished by the protease inhibitor MG132 and the ubiquitination-deficient AQP2 (K270R). Taken together, the present study demonstrates that activation of LXRß increases AQP2 protein levels in the renal collecting ducts via a posttranscriptional mechanism. As such, LXRß represents a key regulator of body water homeostasis. [Mh] Termos MeSH primário: Aquaporina 2/metabolismo Túbulos Renais Coletores/metabolismo Receptores X do Fígado/metabolismo Processamento de Proteína Pós-Traducional [Mh] Termos MeSH secundário: Animais Antidiuréticos/farmacologia Aquaporina 2/genética Linhagem Celular Desamino Arginina Vasopressina/farmacologia Genótipo Capacidade de Concentração Renal Túbulos Renais Coletores/efeitos dos fármacos Receptores X do Fígado/deficiência Receptores X do Fígado/efeitos dos fármacos Receptores X do Fígado/genética Camundongos Endogâmicos C57BL Camundongos Knockout Fenótipo Complexo de Endopeptidases do Proteassoma/metabolismo Estabilidade Proteica Proteólise Fatores de Tempo Transfecção Ubiquitinação Regulação para Cima [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antidiuretic Agents); 0 (Aqp2 protein, mouse); 0 (Aquaporin 2); 0 (Liver X Receptors); 0 (Nr1h2 protein, mouse); EC 3.4.25.1 (Proteasome Endopeptidase Complex); ENR1LLB0FP (Deamino Arginine Vasopressin) [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170713 [Lr] Data última revisão: 170713 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170106 [St] Status: MEDLINE [do] DOI: 10.1152/ajprenal.00564.2016

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[PMID]: 27922286 [Au] Autor: Sánchez-Ferrer ML; Prieto-Sánchez MT; Orozco-Fernández R; Machado-Linde F; Nieto-Diaz A [Ad] Endereço: a Obstetrics and Gynaecology Department , Virgen de la Arrixaca Clinical Hospital, University of Murcia , Murcia , Spain. [Ti] Título: Central pontine myelinolysis during pregnancy: Pathogenesis, diagnosis and management. [So] Source: J Obstet Gynaecol;37(3):273-279, 2017 Apr. [Is] ISSN: 1364-6893 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Central pontine myelinolysis (CPM) is a rare condition usually caused by rapid sodium correction in hyponatraemia after a severe neurological syndrome. Only few cases have been reported during pregnancy, most of which were reported in patients with hyperemesis. We describe the successful management of the first case of twin pregnancy in a patient who presented with CPM after treatment for premature labour and then review the literature on CPM in pregnancy (aetiology, diagnosis and management). Our patient required emergency delivery to achieve electrolyte and fluid balance. At six months, the twins remained asymptomatic and the mother had minor sequelae. The aetiology is not clear, and there is no evidence regarding the optimal treatment or prognosis of CPM. In our patient, desmopressin-contaminated atosiban showed a certain probability in the Karch-Lasagne algorithm of a causality relationship between hyponatraemia and the drug. To our knowledge, this is the first case of myelinolysis reported in a twin pregnancy possibly related to desmopressin-contaminated atosiban. [Mh] Termos MeSH primário: Antidiuréticos/envenenamento Desamino Arginina Vasopressina/envenenamento Hiponatremia/induzido quimicamente Mielinólise Central da Ponte/diagnóstico Tocolíticos/efeitos adversos Vasotocina/análogos & derivados [Mh] Termos MeSH secundário: Adulto Antieméticos/administração & dosagem Encéfalo/diagnóstico por imagem Cesárea Dexametasona/administração & dosagem Contaminação de Medicamentos Feminino Seres Humanos Hiponatremia/diagnóstico Hiponatremia/tratamento farmacológico Recém-Nascido Imagem por Ressonância Magnética Mielinólise Central da Ponte/etiologia Mielinólise Central da Ponte/terapia Trabalho de Parto Prematuro/tratamento farmacológico Gravidez Gravidez de Gêmeos Tocolíticos/administração & dosagem Ultrassonografia Pré-Natal Vasotocina/administração & dosagem Vasotocina/efeitos adversos Equilíbrio Hidroeletrolítico [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Antidiuretic Agents); 0 (Antiemetics); 0 (Tocolytic Agents); 081D12SI0Z (atosiban); 7S5I7G3JQL (Dexamethasone); ENR1LLB0FP (Deamino Arginine Vasopressin); W6S6URY8OF (Vasotocin) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171016 [Lr] Data última revisão: 171016 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161207 [St] Status: MEDLINE [do] DOI: 10.1080/01443615.2016.1244808

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[PMID]: 27862898 [Au] Autor: Juul KV; Malmberg A; van der Meulen E; Walle JV; Nørgaard JP [Ad] Endereço: Clinical R&D, Ferring Pharmaceuticals A/S, Copenhagen, Denmark. [Ti] Título: Low-dose desmopressin combined with serum sodium monitoring can prevent clinically significant hyponatraemia in patients treated for nocturia. [So] Source: BJU Int;119(5):776-784, 2017 May. [Is] ISSN: 1464-410X [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To explore risk factors for desmopressin-induced hyponatraemia and evaluate the impact of a serum sodium monitoring plan. SUBJECTS AND METHODS: This was a meta-analysis of data from three clinical trials of desmopressin in nocturia. Patients received placebo or desmopressin orally disintegrating tablet (ODT; 10-100 µg). The incidence of serum sodium <130 mmol/L was recorded by age, sex and dose. Potential predictors of clinically significant hyponatraemia were identified using multivariate analysis in a Cox proportional hazards model. RESULTS: Dose, age, baseline serum sodium level and kidney function, according to estimated GFR clearance, were significant risk factors for hyponatraemia in both sexes; similar to the known risk factors associated with hyponatraemia in the general population. In men, arthritis and use of drugs for bone disease were also predictive of hyponatraemia, while in women, raised monocytes and absence of lipid-modifying drugs increased the risk of hyponatraemia. Use of the proposed monitoring scheme and the minimum effective dose would have omitted all patients with clinically significant hyponatraemia from further treatment. CONCLUSIONS: The incidence of hyponatraemia can be reduced by using minimum effective gender-specific dosing with the ODT formulation of desmopressin (25 µg in women, 50 µg in men). A sodium monitoring plan is proposed whereby baseline sodium must be ≥135 mmol/L (especially important in the elderly), with additional monitoring at week 1 and month 1 for those at elevated risk because they are aged ≥65 years or receiving concomitant medication associated with hyponatraemia. This monitoring plan would help to prevent some at-risk patients developing hyponatraemia; retrospective application of the monitoring plan showed that, once at-risk patients were appropriately screened out, only mild, non-clinically significant hyponatraemia was observed, within ranges of other drugs associated with hyponatraemia and similar to the background prevalence in the treatment population. [Mh] Termos MeSH primário: Antidiuréticos/administração & dosagem Desamino Arginina Vasopressina/administração & dosagem Monitoramento de Medicamentos Hiponatremia/sangue Hiponatremia/prevenção & controle Noctúria/sangue Noctúria/tratamento farmacológico Sódio/sangue [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Antidiuréticos/efeitos adversos Desamino Arginina Vasopressina/efeitos adversos Método Duplo-Cego Feminino Seres Humanos Hiponatremia/induzido quimicamente Masculino Meia-Idade Metanálise em Rede Estudos Retrospectivos Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Antidiuretic Agents); 9NEZ333N27 (Sodium); ENR1LLB0FP (Deamino Arginine Vasopressin) [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170630 [Lr] Data última revisão: 170630 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161119 [St] Status: MEDLINE [do] DOI: 10.1111/bju.13718

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[PMID]: 27401397 [Au] Autor: Miwa K [Ad] Endereço: Miwa Naika Clinic, Toyama, Japan. Electronic address: info@miwa-naika.com. [Ti] Título: Down-regulation of renin-aldosterone and antidiuretic hormone systems in patients with myalgic encephalomyelitis/chronic fatigue syndrome. [So] Source: J Cardiol;69(4):684-688, 2017 04. [Is] ISSN: 1876-4738 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: BACKGROUND: Central nervous system dysfunction associated with myalgic encephalomyelitis (ME) has been postulated as the cause of chronic fatigue syndrome (CFS). A small heart or reduced left ventricular volume with reduced cardiac output has been reported to be common in patients with ME. The main circulatory blood volume regulators may be down-regulated. METHODS: Plasma levels of the neurohumoral factors that regulate circulatory blood volume were determined in 18 patients with ME and 15 healthy subjects (Controls). RESULTS: The echocardiographic examination revealed that the mean values for the left ventricular end-diastolic diameters, stroke volume index, and cardiac index as well as the mean blood pressure were all significantly smaller in the ME group than in the Controls. The mean plasma renin activity (1.6±1.0ng/ml/h vs. 2.5±1.5ng/ml/h, p=0.06) was considerably lower in the ME group than in the Controls. Both the mean plasma aldosterone (104±37pg/ml vs. 157±67pg/ml, p=0.004) and antidiuretic hormone (ADH) (2.2±1.0pg/ml vs. 3.3±1.5pg/ml, p=0.02) concentrations were significantly lower in the ME group than in the Controls. Desmopressin (120µg), a synthetic version of arginine vasopressin, was orally administered for five successive days to 10 patients with ME. In five patients (50%), the symptoms of orthostatic intolerance during a 10min active standing test were ameliorated in association with a significant increase in urinary osmotic pressure and decrease in heart rate. Furthermore, in five patients (50%), the performance status scores for the activities of daily living were improved. CONCLUSIONS: Both the renin-aldosterone and ADH systems were down-regulated despite the existence of reduction in cardiac preload and output in patients with ME. Desmopressin improved symptoms in half of the patients. [Mh] Termos MeSH primário: Aldosterona/metabolismo Regulação para Baixo Síndrome de Fadiga Crônica/metabolismo Renina/metabolismo Vasopressinas/metabolismo [Mh] Termos MeSH secundário: Adolescente Adulto Antidiuréticos/uso terapêutico Pressão Sanguínea Débito Cardíaco Estudos de Casos e Controles Desamino Arginina Vasopressina/uso terapêutico Ecocardiografia Síndrome de Fadiga Crônica/tratamento farmacológico Feminino Ventrículos do Coração/diagnóstico por imagem Seres Humanos Masculino Meia-Idade [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (Antidiuretic Agents); 11000-17-2 (Vasopressins); 4964P6T9RB (Aldosterone); EC 3.4.23.15 (Renin); ENR1LLB0FP (Deamino Arginine Vasopressin) [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 171106 [Lr] Data última revisão: 171106 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160713 [St] Status: MEDLINE

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[PMID]: 27164325 [Au] Autor: Denys MA; Bruneel E; Van Laecke S; Nørgaard JP; Everaert K [Ad] Endereço: a Department of Urology , Ghent University Hospital , Ghent , Belgium. [Ti] Título: Pitfalls and opportunities in multidisciplinary research about nocturia in adults. [So] Source: Acta Clin Belg;72(1):2-5, 2017 Feb. [Is] ISSN: 2295-3337 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: OBJECTIVES: Describe current shortcomings in clinical research on the treatment of nocturia in adults, and suggest new directions for future studies in this field. METHODS: A literature search was conducted using the keywords 'nocturia,' 'nocturnal polyuria,' 'sleep,' and 'hypertension.' RESULTS: Nocturia, or waking up at night to void, is a highly prevalent and bothersome lower urinary tract symptom (LUTS) affecting up to 40% of adults. Since the majority of patients are diagnosed with nocturnal polyuria (NP) as one of the underlying causes, it is not surprising that the effect of treatments for overactive bladder (OAB) and bladder outlet obstruction (BOO) are disappointing with regard to nocturia. Therefore, we suggest to conduct studies in which nocturic patients are treated according to the underlying pathophysiology: (1) antimuscarinics or ß3-agonists for OAB symptoms, (2) α-blockers or 5α-reductase inhibitors in men with BOO caused by enlarged prostates, (3) desmopressin or diuretics for NP, (4) continuous positive airway pressure in nocturic patients with obstructive sleep apnea, and (5) all its combinations in case of combined pathophysiology. Not only the effect on treatment efficacy or side effects needs to be assessed, but also the impact on related comorbidities such as sleep disorders, hypertension, and endocrine functions such as blood glucose regulation. CONCLUSION: Future research needs to subtype nocturic patients in order to adapt treatment according to the underlying cause. [Mh] Termos MeSH primário: Antidiuréticos/uso terapêutico Desamino Arginina Vasopressina/uso terapêutico Diuréticos/uso terapêutico Noctúria/tratamento farmacológico [Mh] Termos MeSH secundário: Protocolos Clínicos Seres Humanos Hipertensão/complicações Comunicação Interdisciplinar Noctúria/etiologia Privação do Sono/etiologia [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Antidiuretic Agents); 0 (Diuretics); ENR1LLB0FP (Deamino Arginine Vasopressin) [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170706 [Lr] Data última revisão: 170706 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160511 [St] Status: MEDLINE [do] DOI: 10.1080/17843286.2016.1177276

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