A case report of hyponatremia after surgery for Conn's adenoma

Primary aldosteronism (PA), also known as Conn's syndrome, is a frequent cause of secondary hypertension. If PA is due to a documented unilateral adrenal adenoma, adrenalectomy is the treatment of choice. Endocrine Society guidelines suggest monitoring potassium after adrenalectomy, while there is no mention of sodium disorders after surgery. Here we report the case of a patient with Conn's syndrome who developed hyponatremia after surgery. This was an unexpected event in the course of the treatment, which sheds light on the fact that low levels of aldosterone strongly influence sodium concentration, and advises clinicians to monitor sodium after adrenalectomy

Gait and Apathy as Relevant Symptoms of Subcortical Vascular Dementia

Background: Subcortical vascular dementia relates to small-vessel disease and hypoperfusion, resulting in focal and diffuse ischemic white matter lesions. The main target of the disease are the frontal subcortical neural networks. There is no clinical standard definition of the pathology, on the contrary, everyday clinical practice suggests dominant behavioral alterations and dysexecutive syndrome. Methods: The aim of this study was to investigate gait disorders, behavioral alteration, and drug intake of a subcortical population with dementia (n \ubc 1155). A complete neuropsychological examination was conducted at baseline and every 6 months, and the results were compared. Results: Our data suggest that there is a significant increment in apathy levels and a dramatic decrease in gait and equilibrium control in the patients examined during follow-up. Conclusion: Subcortical vascular dementia may be associated with gait and balance alteration and apathy per se; we suggest to implement clinical data with these major aspects

Relationship between aortic valve stenosis and the hemodynamic pattern in the renal circulation, and restoration of the flow wave profile after correction of the valvular defect

Objective The index of maximal systolic acceleration ([AImax]: maximal systolic acceleration of the Doppler waveform divided by peak systolic velocity) shows diagnostic accuracy in screening of renal artery stenosis. This study aimed to determine whether an upstream factor of resistance, such as aortic valve stenosis (AVS), can affect Doppler parameters detected in the peripheral arteries. Methods In this prospective study, we measured the AImax in non-stenotic renal interlobar arteries of 62 patients with AVS. Patients were divided into three groups on the basis of severity of valvulopathy as follows: mild-to-moderate AVS (M-AVS; n\u2009=\u200924), intermediate AVS (I-AVS; n\u2009=\u200915), and severe AVS (S-AVS; n\u2009=\u200923) based on Nishimura\u2019s criteria. Results The AImax in the renal parenchymal arteries was significantly lower in the S-AVS group (8.9\u2009\ub1\u20093.6 s 121) than in the M-AVS (15.3\u2009\ub1\u20093.8 s 121) and I-AVS groups (16.7\u2009\ub1\u20095.2 s 121). The AImax was positively correlated with the aortic valve area and inversely correlated with the tranvalvular aortic pressure gradient. After aortic valve replacement, the AImax significantly increased from 10.7\u2009\ub1\u20094.0 s 121 at baseline to 19.3\u2009\ub1\u20094.4 s 121. Conclusions Proximal resistance can lead to diagnostic bias of Doppler parameters that are applied in the diagnosis of peripheral vasculopathies, particularly in renal artery stenosis