The Prevalence of Obstructive Sleep Apnea in Patients With Primary Aldosteronism.

CONTEXT: Investigating the co-occurrence of obstructive sleep apnea (OSA) and primary aldosteronism (PA) is crucial for understanding their interrelation. OBJECTIVE: This work aimed to evaluate the prevalence of OSA in individuals diagnosed with PA and to assess the prevalence of PA within the OSA population, with a specific focus on hypertensive individuals. METHODS: An exhaustive search was performed across PubMed, Embase, CINAHL, Scopus, and Web of Science up to September 2023, without restrictions on language or publication date. Studies were selected based on their focus on the prevalence of OSA in PA patients and vice versa, specifically in hypertensive individuals. Data were extracted using standard guidelines, focusing on patient characteristics, prevalence rates, and other relevant clinical parameters. RESULTS: Proportional meta-analysis using a random-effects model revealed a 59.8% prevalence of OSA in hypertensive PA patients, with 45.4% exhibiting moderate-to-severe OSA. Meta-regression showed no significant effect of age, sex, body mass index, antihypertensive medication, systolic blood pressure, diastolic blood pressure, or serum potassium on OSA prevalence. However, a significant positive association was found with the glomerular filtration rate (GFR) (P < .001). Subgroup analysis also revealed that a hyperfiltration rate (GFR ≥ 100 mL/min per 1.73 m2) may be associated with a higher prevalence of OSA (71%, P value for interaction < .01). Among hypertensive OSA patients, 11.2% had PA. CONCLUSION: A substantial prevalence of OSA in individuals with PA was identified, demonstrating a complex interplay between these conditions in hypertensive patients. Notably, the prevalence of OSA was significantly associated with kidney hyperfiltration.

Estimated glomerular filtration rate-dip after medical target therapy associated with increased mortality and cardiovascular events in patients with primary aldosteronism.

OBJECTIVES: The correlation of the changes of estimated glomerular filtration rate (eGFR) with long-term cardiovascular complications in patients with primary aldosteronism (PA) following mineralocorticoid receptor antagonists (MRA) treatment remains ambiguous. This prospective study aims to determine factors associated with all-cause mortality and de novo cardiovascular events of PA patients against the eGFR-dip. METHODS: A total of 208 newly diagnosed PA patients were enrolled from January 2017 to January 2019. MRA was administered with at least a 6-month follow-up. The 'eGFR-dip' was defined as the difference between eGFR at 6 months after MRA treatment and respective baseline eGFR divided by the baseline eGFR. RESULTS: After a mean 5.7 years follow-up, an eGFR-dip more than 12%, which was detected in 99 (47.6%) of the 208 patients, was a significant independent risk factor predicting composite outcomes (all-cause mortality, de-novo three-point major adverse cardiovascular events, and/or congestive heart failure). Multivariable logistic regression showed that age [odds ratio (OR), 0.94; P = 0.003], pretreatment plasma aldosterone concentration (PAC; OR, 0.98; P  = 0.004), and initial eGFR (OR, 0.97; P  < 0.001) had a positive linkage with the eGFR-dip more than 12%. CONCLUSIONS: Nearly half of PA patients had an eGFR-dip more than 12% after 6 months of MRA treatment. They had a higher incidence of all-cause mortality and de novo cardiovascular events. Elder age, higher pretreatment PAC, or higher initial eGFR could be associated with an elevated risk of an eGFR-dip more than 12%.

Water quality during development and apportionment of pollution from rivers in Tapeng Lagoon, Taiwan.

This work investigated water samples collected from Tapeng Lagoon, Taiwan. Factor analysis was conducted to explain the characteristics and the variation in the quality of water during the disassembly of oyster frames and fishery boxes. The result shows that the most important latent factors in Tapeng Lagoon are the ocean factor, primary productivity factor, and the fishery pollution factor. Canonical discriminant analysis is applied to identify the source of pollution in neighboring rivers outside Tapeng Lagoon. The two constructed discriminant functions (CDFs) showed markedly contribution to all discriminant variables, and that total nitrogen, algae, dissolved oxygen and total phosphate, combined in the nutrient effect factor. The recognition capacities in these two CDFs were 95.6%, 4.4%, respectively. The water quality in the Kaoping river most strongly determined that in the Tapeng Lagoon the best is. And disassembling the oyster frames and fishery boxes improves the water quality markedly. However, environmental topographic conditions indicate that strengthening stream pollution prevention and to constructing another entrance to the ocean are the best approaches for improving the quality of water in Tapeng Lagoon, especially by reducing eutrophication. These approaches and results yield useful information concerning habitat recovery and water resource management.

Synthesis and antimycobacterial evaluation of certain fluoroquinolone derivatives.

A number of fluoroquinolone derivatives were synthesized and evaluated for antimycobacterial activity. Preliminary results are (1) for 1-aryl fluoroquinolones, 1-(4-nitrophenyl) derivatives were inactive while their 1-(2-fluoro-4-nitrophenyl) counterparts were active anti-TB agents (3a vs 4a; 3b vs 4b) indicated the fluoro substituent at C-2 position is important. For the 1-(2-fluoro-4-nitrophenyl)quinolones, 7-piperidinyl derivative 4a and 7-(3,5-dimethylpiperazinyl) derivative 4e, which exhibited 97% and 98% inhibition, respectively, were more active than their 7-morpholinyl, 7-(4-methylpiperazinyl) and 7-piperazinyl congeners, 4b,4c and 4d, respectively. In addition, 7-[4-(8-hydroxyquinolin-2-ylmethyl)piperazin-1-yl] derivative 9d exhibited 44% inhibition on the growth of Mycobacterium tuberculosis while its 7-(4-methylpiperazin-1-yl) counterpart 3c was inactive implied the metal-chelating 8-hydroxyquinoline moiety was capable of enhancing the anti-TB activity, (2) for the bifunctional fluoroquinolone-hydroxyquinoline complexes, ciprofloxacin and ofloxacine derivatives, which exhibited the same anti-TB activity (98% inhibition), are more potent than norfloxacin counterpart, which in turn is more potent than 1-aryl congeners (9b, 9c>9a>9d, 9e).