Computed Tomography and Adrenal Venous Sampling in the Diagnosis of Unilateral Primary Aldosteronism

Unilateral primary aldosteronism is the most common surgically correctable form of endocrine hypertension and is usually differentiated from bilateral forms by adrenal venous sampling (AVS) or computed tomography (CT). Our objective was to compare clinical and biochemical postsurgical outcomes of patients with unilateral primary aldosteronism diagnosed by CT or AVS and identify predictors of surgical outcomes. Patient data were obtained from 18 internationally distributed centers and retrospectively analyzed for clinical and biochemical outcomes of adrenalectomy of patients with surgical management based on CT (n=235 patients, diagnosed from 1994-2016) or AVS (526 patients, diagnosed from 1994-2015) using the standardized PASO (Primary Aldosteronism Surgical Outcome) criteria. Biochemical outcomes were highly different according to surgical management approach with a smaller proportion in the CT group achieving complete biochemical success (188 of 235 [80%] patients versus 491 of 526 [93%], P<0.001) and a greater proportion with absent biochemical success (29 of 235 [12%] versus 10 of 526 [2%], P<0.001). A diagnosis by CT was associated with a decreased likelihood of complete biochemical success compared with AVS (odds ratio, 0.28; 0.16-0.50; P<0.001). Clinical outcomes were not significantly different, but the absence of a postsurgical elevated aldosterone-to-renin ratio was a strong marker of complete clinical success (odds ratio, 14.81; 1.76-124.53; P=0.013) in the CT but not in the AVS group. In conclusion, patients diagnosed by CT have a decreased likelihood of achieving complete biochemical success compared with a diagnosis by AVS

Primary aldosteronism: A Japanese perspective

Primary aldosteronism (PA) is the most common cause of secondary hypertension, accounting for 10% of all hypertension. Far from being benign, hypertension due to PA is associated with high cardiovascular morbidity and mortality. However, PA is still underdiagnosed in general practice. Recent reports strongly recommend that identifying patients with PA is cost-beneficial based on improved cardiovascular outcomes afforded by specific surgical and medical treatment. This review provides an update of PA including controversial aspects of diagnosis and treatment

Responding to globalisation: The case of elite artistic gymnastics in China

This paper was accepted for publication in the journal International Review for the Sociology of Sport and the definitive published version is available at https://doi.org/10.1177/1012690217730679.This article explores a non-Western nation’s responses to globalisation through an in-depth analysis of elite artistic gymnastics in China over a lengthy time span. The concept of globalisation and patterns of ‘reach’ and ‘response’ act as the heuristic devices underpinning the analysis. Data were collected from a range of documents and fromand six semi-structured interviews. The trajectory of Chinese elite artistic gymnastics’ responses to globalisation can be characterised as a passive response in the 1950s, a participative response in the first half of the 1960s, a conflictual response from 1966 to the early 1970s, a participative response from the early 1970s to the 2012 Olympic Games, and a passive response, once again, during the Rio Olympiad (post-London 2012). In this way, a nation’s responses to globalisation are seen as dynamic rather than rigid or static. The ever-expanding reach of the international federation-led global system fundamentally demarcates the activities of member states. However, any nation-state has a degree of autonomy when responding to globalisation and in deciding the detailed pathways whereby to pursue success within this system, although in extreme cases, a nation-state can choose to resist this globalising context, largely depending on a government’s attitude towards globalisation and the value the government attaches to it

THE BELT AND ROAD INITIATIVE AND ITS IMPACT ON EUROPE

this paper analyses the possible impacts of Belt and Road Initiative on Europe looking at trade, investments and infrastructures