CONTEXT: Impaired diurnal blood pressure (BP) variability is related to higher cardiovascular risk. OBJECTIVE: To assess diurnal variability of BP and its relation to target organ damage (TOD) and catecholamine phenotype in a consecutive sample of pheochromocytoma/paraganglioma (PPGL). DESIGN: We included 179 patients with PPGL All patients underwent 24 hours of ambulatory BP monitoring to determine dipping status. Differences in plasma metanephrine or urine adrenaline were used to distinguish catecholamine biochemical phenotype. To evaluate TOD, renal functions, presence of left ventricle hypertrophy (LVH), and the subgroup (n = 111) carotid-femoral pulse wave velocity (PWV) were assessed. Structural equation modeling was used to find the relationship among nocturnal dipping, catecholamine phenotype, and TOD parameters. RESULTS: According to the nocturnal dipping, patients were divided into the three groups: dippers (28%), nondippers (40%), and reverse dippers (32%). Reverse dippers were older (P < 0.05), with a higher proportion of noradrenergic (NA) phenotype (P < 0.05), a higher prevalence of diabetes mellitus (P < 0.05), and sustained arterial hypertension (P < 0.01) and its duration (P < 0.05), as opposed to the other groups. All parameters of TOD were more pronounced only in reverse dippers compared with nondippers and dippers. The presence of NA phenotype (=absence of adrenaline production) was associated with reverse dipping and TOD (LVH and PWV). CONCLUSIONS: Patients with reverse dipping had more substantial TOD compared with other groups. The NA phenotype plays an important role, not only in impaired diurnal BP variability but also independently from dipping status in more pronounced TOD of heart and vessels.
- MeSH
- Adult MeSH
- Phenotype MeSH
- Pheochromocytoma complications metabolism physiopathology MeSH
- Catecholamines analysis metabolism MeSH
- Blood Pressure * MeSH
- Middle Aged MeSH
- Humans MeSH
- Blood Pressure Determination MeSH
- Adrenal Gland Neoplasms complications metabolism physiopathology MeSH
- Paraganglioma complications metabolism physiopathology MeSH
- Retrospective Studies MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
An unmodified boron-doped diamond (BDD) electrode was used in combination with square-wave voltammetry (SWV) in a simple, rapid and inexpensive method for the detection and determinativ of adrenaline. A low detection limit of 2•107 mol l1 attained on BDD electrode was due to a very high signal-to-noise (S/N) ratio. The proposed procedure was applied to analysis of human urine spiked with adrenaline giving good recovery values. Matrix effects did not present any significant interference. BDD electrode may be used as a sensitive drug sensor in clinical analysis of various biologically active compounds and may replace complex and expensive chromatographic and spectral methods. Howe¬ver, the usefulness of this method can be limited in clinical analysis in the presence of other drugs in urine, e.g. ascorbic acid and uric acid.
- MeSH
- Epinephrine * analogs & derivatives analysis urine MeSH
- Adrenergic alpha-Agonists MeSH
- Adrenergic beta-Agonists MeSH
- Chemistry, Analytic MeSH
- Urinalysis * methods trends utilization MeSH
- Boron MeSH
- Bronchodilator Agents MeSH
- Chemistry Techniques, Analytical methods utilization MeSH
- Chromatography, Ion Exchange methods utilization MeSH
- Diamond MeSH
- Electrochemical Techniques * methods instrumentation utilization MeSH
- Electrodes MeSH
- Electrophoresis, Capillary methods utilization MeSH
- Electrophysiological Phenomena MeSH
- Catecholamines analysis MeSH
- Humans MeSH
- Mydriatics MeSH
- Sympathomimetics MeSH
- Vasoconstrictor Agents MeSH
- Chromatography, High Pressure Liquid methods utilization MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
A capillary formed by connecting a 9.7 cm-long separation capillary with id 25 μm with an auxiliary 22.9 cm-long capillary with id 100 μm (coupled capillary) was tested for electrophoretic separation at high electric field intensities. The coupled capillary was placed in the cassette of a standard electrophoresis apparatus. It was used in the short-end injection mode for separation of a mixture of dopamine, noradrenaline, and adrenaline in a BGE of 20 mM citric acid/NaOH, pH 3.2. An intensity of 2.7 kV/cm was attained in the separation part of the capillary at a separation voltage of 30 kV, which is 2.9 times more than maximum intensity value attainable in a capillary with the same length with uniform id. At these high electric field intensities, the migration times of the tested neurotransmitters had values of 12.3-13.3 s and the attained separation efficiency was between 2350 and 2760 plates/s. It is thus demonstrated that an effective separation instrument - a coupled capillary - can be used for very rapid separation in combination with standard, commercially available instrumentation.
- MeSH
- Time Factors MeSH
- Models, Chemical MeSH
- Electrophoresis, Capillary instrumentation methods MeSH
- Sodium Hydroxide chemistry MeSH
- Catecholamines analysis chemistry isolation & purification MeSH
- Citric Acid chemistry MeSH
- Neurotransmitter Agents analysis chemistry isolation & purification MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Feochromocytomy a funkční paragangliomy jsou katecholaminy produkující nádory, které se projevují různými klinickými příznaky, nejčastěji bolestmi hlavy, pocením a hypertenzí. Biochemický screening feochromocytomu by měl být prováděn nejen u symptomatických pacientů nebo pacientů s náhodně zjištěnými tumory nadledviny, ale také u nosičů genů spojených s výskytem feochromocytomu a funkčního paragangliomu (mnohočetná endokrinní neoplazie 2, von Hippel-Lindauův syndrom, neurofibromatóza 1 a mutace sukcinátdehydrogenázy). Po biochemickém průkazu feochromocytomu používáme pro lokalizaci tumoru výpočetní tomografii, magnetickou rezonanci a funkční vyšetření s (123I)-metaiodobenzylguanidinem. Medikamentózní příprava je základním opatřením pro úspěšnou operaci, dnes většinou pomocí minimálně invazívní chirurgie. Dlouhodobé sledování je nutné i po úspěšném odstranění tumoru pro jeho možnou rekurenci.
Pheochromocytomas and functional paragangliomas are catecholamine-producing tumors presenting with various clinical symptoms, but mostly with headache, sweating, palpitations, and hypertension. Biochemical testing for pheochromocytoma should be performed not only in symptomatic subjects or in subjects with adrenal incidentaloma but also in subjects with a genetic predisposition for pheochromocytoma (multiple endocrine neoplasia type 2, von Hippel-Lindau syndrome, neurofibromatosis type 1 and mutations of succinate dehydrogenase genes). Once a pheochromocytoma is proven, computed tomography, magnetic resonance imaging and functional imaging with (123I)-metaiodobenzylguanidin may be used for tumor localization. Adequate medical pre-treatment is essential for successful operation which is performed in most cases by minimal invasive surgery. After tumor removal, further follow-up is necessary due to possible recurrence.
- MeSH
- Survival Analysis MeSH
- Drug Therapy methods MeSH
- Pheochromocytoma diagnosis etiology therapy MeSH
- Financing, Organized MeSH
- Hypertension etiology MeSH
- Cardiovascular Diseases etiology complications MeSH
- Catecholamines analysis diagnostic use secretion MeSH
- Clinical Laboratory Techniques classification utilization MeSH
- Humans MeSH
- Magnetic Resonance Imaging utilization MeSH
- Minimally Invasive Surgical Procedures methods utilization MeSH
- Mutation genetics MeSH
- Paraganglioma diagnosis etiology therapy MeSH
- Prognosis MeSH
- Recurrence MeSH
- Tomography utilization MeSH
- Check Tag
- Humans MeSH
Stresové hormóny sa zaraďujú medzi predpokladané patogenetické činitele pri rozvoji viacerých psychických porúch a zmeny sekrécie hormónov môžu zohrávať dôležitú úlohu aj pri ich liečbe. Napriek tomu je len málo informácií o interakcii psychofarmák so stresovými hormónmi počas stresu u človeka. V našich sledovaniach sme sa zamerali na látky zo skupiny novších antiepileptík a tymoprofylaktík. V randomizovanej, placebom kontrolovanej, dvojito slepej štúdii sme ukázali, že podanie lamotrigínu moduluje sekréciu viacerých stresových hormónov počas mentálneho stresu (Makatsori a spol., 2004). Z tradičného pohľadu sa stavy s vysokou anxietou spájajú s hyperaktivitou stresových hormónov. Údaje získané u pacientov s úzkostnými poruchami sú však rôznorodé. Rozhodli sme sa preto preveriť hypotézu, že vysoká anxieta je sprevádzaná zvýšenou aktiváciou hormónov počas stresu. Vyšetrili sme vybranú skupinu zdravých dobrovoľníkov, ktorí boli buď nad hornou (úzkostní) alebo pod dolnou (neúzkostní) hranicou normálneho rozmedzia úzkostnosti v slovenskej populácii podľa dotazníka STAI-T (Spielberger State and Trait Anxiety Inventory). Ako stresovú situáciu sme zvolili model psychosociálneho stresu založený na verejnom prejave. Počas stresu mali úzkostní jedinci v súlade s vyslovenou hypotézou väčší vzostup srdcovej frekvencie. Avšak hladiny kortizolu neboli u úzkostných subjektov vyššie, ale boli v porovnaní s neúzkostnými jedincami naopak znížené. Tento nález sa potvrdil pri meraní plazmatického aj salivárneho kortizolu. Podobne, v skupine úzkostných ľudí sme zistili nižšie hladiny plazmatických katecholamínov, teda adrenalínu a noradrenalínu počas psychosociálneho stresu. Naše výsledky dokazujú, že vysoká úzkostnosť nie je spojená s nadmernou stresovou odpoveďou (Ježová a spol., 2004), čo je v protiklade s tradičným názorom.
Stress hormones belong to suspected pathogenetic factors related to the development and course of several mental disorders. Nevertheless, little information is available on the interaction between psychotropic drugs and stress hormones in humans. Our attention was put to newer drugs used in the treatment of epilepsy and bipolar disorder. We showed in an randomized, placebo controlled double blind study that single treatment with lamotrigine modulates secretion of several hormones during mental stress (Makatsori a spol., 2004). From the traditional view, states with high anxiety are associated with a hyperactivity of stress hormones. Studies in patients with anxiety disorders have provided conflicting results. We decided to verify the hypothesis that high trait anxiety is accompanied by increased hormone release during stress. We investigated selected groups of healthy subjects at the upper (anxious) and lower (non-anxious) limits of the normal range of the trait scale in the Spielberger State and Trait Anxiety Inventory (STAI-T). A model of psychosocial stress based on public speech was used. In consistence with the hypothesis proposed, increases in the heart rate were significantly higher in anxious subjects compared to those in non-anxious individuals. However, the levels of both plasma and salivary cortisol were not increased, but they were decreased in subjects with high anxiety. Similarly, plasma levels of adrenaline and noradrenaline were significantly lower in the group of anxious volunteers. Obtained results provide evidence that high anxiety is not associated with an exaggerated stress response (Ježová a spol. 2004), which is in contrast to the traditional view.
- MeSH
- Antidepressive Agents pharmacology MeSH
- Research Support as Topic MeSH
- Hydrocortisone analysis pharmacology secretion MeSH
- Catecholamines analysis pharmacology secretion MeSH
- Humans MeSH
- Stress, Psychological metabolism MeSH
- Anxiety metabolism MeSH
- Check Tag
- Humans MeSH
- Publication type
- Randomized Controlled Trial MeSH
- MeSH
- Research Support as Topic MeSH
- Catecholamines analysis metabolism MeSH
- Humans MeSH
- Maprotiline administration & dosage MeSH
- Anorexia Nervosa metabolism physiopathology MeSH
- Microdialysis methods utilization MeSH
- Adolescent MeSH
- Adipose Tissue metabolism MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Female MeSH
- Publication type
- Comparative Study MeSH
