Volume 1 Issue 1

Review Article: Bioactive Vitamin D Therapy to Treat Secondary Hyperparathyroidism in Pre-Dialysis Chronic Kidney Disease: A Systematic Review

Jason J. Bucci, Abigail C. Staples and Karen E. Hansen

Background: Chronic kidney disease affects one in five adults =65 years old, over half of whom develop secondary hyperparathyroidism. In observational studies, secondary hyperparathyroidism is associated with low bone mineral density and excess vascular calcification, presumably leading to surplus fractures, more cardiovascular events and shortened lifespan. Several bioactive vitamin D analogs are FDA approved to treat secondary hyperparathyroidism and published algorithms direct their clinical use. However, whether such therapy improves patient outcomes is uncertain. The purpose of this review is to summarize evidence derived from clinical trials describing the benefits of treating secondary hyperparathyroidism in patients with pre-dialysis chronic kidney disease.
Methods: We performed a systematic review of the literature to identify trials using bioactive vitamin D (calcitriol, alfacalcidol, paricalcitol and doxercalciferol) to treat secondary hyperparathyroidism in chronic kidney disease patients. We focused on changes in bone mineral density, fractures, falls, vascular events and lifespan, resulting from treatment of secondary hyperparathyroidism.
Results: We found weak evidence that treating secondary hyperparathyroidism improved bone mineral density, based on two studies recruiting only 62 subjects. However, neither trial required baseline secondary hyperparathyroidism or followed published treatment algorithms. We found no randomized, placebo-controlled trials that tested the effect of treating secondary hyperparathyroidism on the risk of fractures, falls, vascular events or death.
Conclusions: Randomized, double-blind, placebo-controlled trials are needed to evaluate the potential harms and benefits of treating secondary hyperparathyroidism in pre-dialysis chronic kidney disease patients.
Keywords: Bone mineral density; Chronic kidney disease; Falls; Secondary hyperparathyroidism; Survival, Vitamin D

Cite this Article: Bucci JJ, Staples AC, Hansen KE. Bioactive Vitamin D Therapy to Treat Secondary Hyperparathyroidism in Pre-Dialysis Chronic Kidney Disease: A Systematic Review. Int J Clin Endocrinol. 2017;1(1): 025-032.

Published: 19 August 2017

Research Article: Role of BNP as a Screening Tool to Identify Asymptomatic Cardiac Disease in Chronic Type 2 DM Patients

SM. Rajendran*, R. Senthinathan, EN. Vedhashri, S. Abinaya and Jayashri

Aim: To study the value of BNP as a screening tool to identify silent ischemia and diastolic dysfunction in asymptomatic type II diabetic patients.
Objectives: The objective of the study is how far BNP value will be useful in early detection of LV dysfunction and ischemia without subjecting the patient to treadmill test and ECHO, as both are even though specific but not sensitive. Our effort is to identify a simple blood test which is highly sensitive in identifying them.
Study population: This study was conducted in the in the Department of Medicine and Department of cardiology Sree Balaji Medical College, Chennai, Tamil Nadu during the period of August 2010 to August 2011. Total number of patients included in this study was 77 out of which 22 were males and 55 were females' patients ranging from 30 years to 70 years.

Cite this Article: Rajendran SM, Senthinathan R, Vedhashri EN, Abinaya S, Jayashri. Role of BNP as a Screening Tool to Identify Asymptomatic Cardiac Disease in Chronic Type 2 DM Patients. Int J Clin Endocrinol. 2017;1(1): 020-024.

Published: 14 July 2017

Case Report: Adrenal Vein Sampling for Primary Hyperaldosteronism

Ana L. Campos Arbulu*, Patricio Mendez, Juan M. Fernandez Vila and Norberto Aristides Mezzadri

Primary hyperaldosteronism is characterized by an increase in the adrenal production of aldosterone. It is critical for its treatment to determine whether it is caused by unilateral or bilateral overproduction of aldosterone. When imaging studies are ambiguous, adrenal venous sampling is the choice to confirm lateralization. It consists in dosing plasma aldosterone and cortisol in both adrenal veins simultaneously with the femoral vein, and establishing the aldosterone/cortisol ratio. On the affected side this ratio is at least 2 times higher than the femoral vein's.

Cite this Article: Campos Arbulu AL, Patricio M, Fernandez Vila JM, Mezzadri NA. Adrenal Vein Sampling for Primary Hyperaldosteronism. Int J Clin Endocrinol. 2017;1(1): 018-019.

Published: 14 June 2017

Review Article: Selenium: Properties and Clinical Applications. A Systematic Review

Giovanni Ragozzino1*, Vittoria Tanzilli1, Nadia MV. Cristiano1, Giuseppina Guarino2 and Edi Mattera2

Selenium (Se), which is commonly found in nature, is one of the essential trace elements necessary for the normal development of human and animal organisms. Selenium participates in the protection of cells against ROS, in heavy metal detoxification, and regulation of the immune and reproductive systems. Selenium was first defined in 1818 by the Swedish chemist Berzelius in sulfuric acid residues. At the end of 1960s, the role of selenium in human health began to attract attention and human diseases that resembled animal diseases responding to selenium was started to be investigated. Nowadays Selenium is used in the prevention and/or treatment of different disorders including chronic autoimmune thyroiditis, Graves' disease, hypothyroidism, cancer, human infertility, cardiovascular disease, diabetes, osteoarthritis, rheumatoid arthritis, AIDS and depression. In these cases Selenium supplementation is increasingly becoming a valid therapeutic solution.
Keywords: Selenium; Supplementation; Antioxidant; Disease; Thyroid; Cancer; Infertility; Depression

Cite this Article: Ragozzino G, Tanzilli V, Cristiano NMV, Guarino G, Mattera E. Selenium: Properties and Clinical Applications. A Systematic Review. Int J Clin Endocrinol. 2017;1(1): 008-017.

Published: 08 May 2017

Research Article: Association between Depression, Anxiety and Stress Symptoms and Glycemic Control in Diabetes Mellitus Patients

Abdulbari Bener, Mustafa Ozturk and Erol Yildirim

Background: There are very a few studies on psychiatric symptoms in patients with Diabetes Mellitus (DM) patients and assessing glycemic controls.
Aim: To describe the level of glycemic control, complications and psychosocial functioning among DM patients using the Depression Anxiety Stress Scales (DASS-21) instrument and its predictors among diabetic Turkish population.
Subject and Methods: A cross-sectional study conducted from February 2016 to January 2017. Of the total 1,600 diabetic patients approached, 1,147 (71.6%) gave their consent. Data analysis included, sociodemographic, blood pressure and glycated hemoglobin (HbA1c) and the Depression Anxiety Stress Scales (DASS)-21 and Beck Depression Inventory (BDI-II) scale to assess the validity of DASS-21.
Results: Most of the studied diabetic cases were with HbA1c ≥ 8 glycemic in the age group above 40 years old. There were statistically significant differences between two groups regarding occupation (p = 0.025), income (p = 0.001), place of residence (p = 0.014) and consanguinity marriages (p = 0.026). The most significant difference were oberved for parameters such as family history of Diabetes Mellitus, physical activities, high blood pressure, stroke and macro vascular complications. The depression, anxiety and stress scores were significantly higher and more frequent in diabetic HbA1c ≥ 8 cases compared to HbA1c < 8. The multivariable logistic regression analysis revealed that high blood pressure, BDI-II depression, DASS21 stress, physical exercise, DASS21 depression, income, family history of diabetes, DASS21 anxiety and sleeping disturbance were the major significant contributors after adjusting for age, gender and other variables. The distribution depression, anxiety and stress scores in DM patients were higher in HbA1c ≥ 8 compared to HbA1c < 8.
Conclusion: The current study suggests that there is relationship between DM and depression, anxiety and stress symptoms in Turkish population. DM is very complex disease and it management requires significant self-control and increasing access to psychological support.
Keywords: Diabetes mellitus; DASS21; Depression; Anxiety; Stress; Predictors; Turkey

Cite this Article: Bener A, Ozturk M, Yildirim E. Association between Depression, Anxiety and Stress Symptoms and Glycemic Control in Diabetes Mellitus Patients. Int J Clin Endocrinol. 2017;1(1): 001-007.

Published: 04 April 2017

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