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  1. Book: Endocrine hypertension

    Bravo, Emmanuel L.

    (Endocrinology and metabolism clinics of North America ; 23,2)

    1994  

    Author's details Emmanuel L. Bravo, guest ed
    Series title Endocrinology and metabolism clinics of North America ; 23,2
    Collection
    Keywords Hypertension / complications ; Endocrine Diseases / complications ; Hypertonie ; Endokrinologie
    Subject Arterielle Hypertonie ; Arterieller Hochdruck ; Bluthochdruck ; Hochdruck ; Hypertension ; Hypertonus
    Language English
    Size VIII S., S. 235 - 449 : Ill., graph. Darst.
    Publisher Saunders
    Publishing place Philadelphia u.a.
    Publishing country United States
    Document type Book
    HBZ-ID HT006322266
    Database Catalogue ZB MED Medicine, Health

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  2. Article ; Online: Aldosterone breakthrough during angiotensin receptor blocker use: more questions than answers?

    Navaneethan, Sankar D / Bravo, Emmanuel L

    Clinical journal of the American Society of Nephrology : CJASN

    2013  Volume 8, Issue 10, Page(s) 1637–1639

    MeSH term(s) Aldosterone/blood ; Angiotensin Receptor Antagonists/therapeutic use ; Diabetes Mellitus, Type 2/complications ; Diabetic Nephropathies/drug therapy ; Female ; Humans ; Male
    Chemical Substances Angiotensin Receptor Antagonists ; Aldosterone (4964P6T9RB)
    Language English
    Publishing date 2013-08-08
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.07370713
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  3. Article: Pheochromocytoma: current perspectives in the pathogenesis, diagnosis, and management.

    Bravo, Emmanuel L

    Arquivos brasileiros de endocrinologia e metabologia

    2005  Volume 48, Issue 5, Page(s) 746–750

    Abstract: Pheochromocytomas (pheo) cause the most dramatic, life-threatening crises in all of endocrinology. A proper screening for pheo must be performed in any patient who has: 1) episodic headaches, tachycardia, and diaphoresis; 2) family history of pheo or ... ...

    Abstract Pheochromocytomas (pheo) cause the most dramatic, life-threatening crises in all of endocrinology. A proper screening for pheo must be performed in any patient who has: 1) episodic headaches, tachycardia, and diaphoresis; 2) family history of pheo or multiple endocrine neoplasia; 3) incidental suprarenal mass; 4) paroxysms of tachyarrhythmias or hypertension; 5) adverse cardiovascular responses to anesthetic agents, histamine, phenothiazine, tricyclic antidepressants, etc); and 6) spells occurring during exercise, straining, etc. The key to diagnosing pheo is to suspect it, then to confirm it. Early recognition of its presence is critical to avoiding significant morbidity and mortality. Once suspected, the diagnosis can be confirmed with biochemical testing in virtually all patients. The combination of resting plasma catecholamines > or =2000 pg/mL and urinary metanephrines > or =1.8 mg/24 h has a diagnostic accuracy of 98% in both sporadic and hereditary pheos. When available, measurement of plasma free metanephrines should be performed especially in hereditary pheos. Provocative (glucagon) and suppression tests (clonidine) may be necessary when baseline measurements are inconclusive. CT and MRI are equally sensitive for localization (98% and 100%, respectively), but have lower specificities (70% and 67%). MIBG is 100% specific, but less sensitive (78%). The availability of various medical (selective alpha-1- and beta-adrenergic receptor antagonists, calcium channel blockers) and surgical modalities have made successful management more promising than ever before.
    MeSH term(s) Adrenal Gland Neoplasms/diagnosis ; Adrenal Gland Neoplasms/etiology ; Adrenal Gland Neoplasms/therapy ; Humans ; Pheochromocytoma/diagnosis ; Pheochromocytoma/etiology ; Pheochromocytoma/therapy
    Language English
    Publishing date 2005-03-07
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 603919-4
    ISSN 1677-9487 ; 0004-2730
    ISSN (online) 1677-9487
    ISSN 0004-2730
    DOI 10.1590/s0004-27302004000500021
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  4. Article ; Online: New insight into the role of aldosterone/renin ratio in elevated peripheral and central blood pressure.

    Bravo, Emmanuel L / Rafey, Mohammed A

    Journal of the American College of Cardiology

    2010  Volume 55, Issue 19, Page(s) 2181–2182

    MeSH term(s) Aldosterone/blood ; Biomarkers/blood ; Humans ; Hyperaldosteronism/complications ; Hypertension/diagnosis ; Hypertension/etiology ; Hypertension/therapy ; Renin/blood ; Renin-Angiotensin System/physiology
    Chemical Substances Biomarkers ; Aldosterone (4964P6T9RB) ; Renin (EC 3.4.23.15)
    Language English
    Publishing date 2010-05-11
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2010.02.020
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  5. Article: Aldosterone and specific aldosterone receptor antagonists in hypertension and cardiovascular disease.

    Bravo, Emmanuel L

    Current hypertension reports

    2003  Volume 5, Issue 2, Page(s) 122–125

    Abstract: Recent preclinical and clinical studies indicate that aldosterone, independent of angiotensin II and elevated blood pressure, may play a role in health and disease. In addition to its role in fluid and electrolyte balance and circulatory homeostasis, ... ...

    Abstract Recent preclinical and clinical studies indicate that aldosterone, independent of angiotensin II and elevated blood pressure, may play a role in health and disease. In addition to its role in fluid and electrolyte balance and circulatory homeostasis, more recent studies have identified aldosterone as a critical mediator of vascular damage. In animal studies, aldosterone is implicated in cardiac and vascular fibrosis, renal disease, and cerebrovascular damage. These lesions are prevented by specific aldosterone receptor blockade. In clinical studies, aldosterone receptor antagonism is associated with decreased hospitalization, symptomatology, and mortality, and improvement of endothelial dysfunction in patients with chronic heart failure. A better understanding of aldosterone's actions in nonepithelial tissues should pave the way to better protection of organs at risk such as the kidneys, heart, and brain.
    MeSH term(s) Aldosterone/physiology ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Animals ; Cardiovascular Diseases/drug therapy ; Cardiovascular Diseases/physiopathology ; Endothelium, Vascular/physiopathology ; Humans ; Hypertension/drug therapy ; Hypertension/physiopathology ; Mineralocorticoid Receptor Antagonists/therapeutic use
    Chemical Substances Angiotensin-Converting Enzyme Inhibitors ; Mineralocorticoid Receptor Antagonists ; Aldosterone (4964P6T9RB)
    Language English
    Publishing date 2003-11-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057367-4
    ISSN 1522-6417
    ISSN 1522-6417
    DOI 10.1007/s11906-003-0068-z
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  6. Article: What is the best diagnostic approach when pheochromocytoma is suspected?

    Bravo, Emmanuel L

    Cleveland Clinic journal of medicine

    2001  Volume 69, Issue 3, Page(s) 257–258

    MeSH term(s) Adrenal Gland Neoplasms/diagnosis ; Catecholamines/blood ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Metanephrine/urine ; Pheochromocytoma/diagnosis
    Chemical Substances Catecholamines ; Metanephrine (5001-33-2)
    Language English
    Publishing date 2001-09-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639116-3
    ISSN 0891-1150
    ISSN 0891-1150
    DOI 10.3949/ccjm.69.3.257
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  7. Article ; Online: Risk factors for infections caused by carbapenem-resistant Enterobacterales: an international matched case-control-control study (EURECA).

    Pérez-Galera, Salvador / Bravo-Ferrer, Jose M / Paniagua, María / Kostyanev, Tomislav / de Kraker, Marlieke E A / Feifel, Jan / Sojo-Dorado, Jesús / Schotsman, Joost / Cantón, Rafael / Daikos, George L / Carevic, Biljana / Dragovac, Gorana / Tan, Lionel K / Raka, Lul / Hristea, Adriana / Viale, Pierluigi / Akova, Murat / Reguera, Jose María / Valiente de Santis, Lucía /
    Torre-Cisneros, Julián / Cano, Ángela / Roilides, Emmanuel / Radulovic, Lili / Kirakli, Cenk / Shaw, Evelyn / Falagas, Matthew E / Pintado, Vicente / Goossens, Herman / Bonten, Marc J / Gutiérrez-Gutiérrez, Belén / Rodriguez-Baño, Jesús

    EClinicalMedicine

    2023  Volume 57, Page(s) 101871

    Abstract: Background: Data on risk factors for carbapenem-resistant Enterobacterales (CRE) with wider applicability are needed to inform preventive measures and efficient design of randomised trials.: Methods: An international matched case-control-control ... ...

    Abstract Background: Data on risk factors for carbapenem-resistant Enterobacterales (CRE) with wider applicability are needed to inform preventive measures and efficient design of randomised trials.
    Methods: An international matched case-control-control study was performed in 50 hospitals with high CRE incidence from March 2016 to November 2018 to investigate different aspects of infections caused by CRE (NCT02709408). Cases were patients with complicated urinary tract infection (cUTI), complicated intraabdominal (cIAI), pneumonia or bacteraemia from other sources (BSI-OS) due to CRE; control groups were patients with infection caused by carbapenem-susceptible Enterobacterales (CSE), and by non-infected patients, respectively. Matching criteria included type of infection for CSE group, ward and duration of hospital admission. Conditional logistic regression was used to identify risk factors.
    Findings: Overall, 235 CRE case patients, 235 CSE controls and 705 non-infected controls were included. The CRE infections were cUTI (133, 56.7%), pneumonia (44, 18.7%), cIAI and BSI-OS (29, 12.3% each). Carbapenemase genes were found in 228 isolates: OXA-48/like, 112 (47.6%), KPC, 84 (35.7%), and metallo-β-lactamases, 44 (18.7%); 13 produced two. The risk factors for CRE infection in both type of controls were (adjusted OR for CSE controls; 95% CI; p value) previous colonisation/infection by CRE (6.94; 2.74-15.53; <0.001), urinary catheter (1.78; 1.03-3.07; 0.038) and exposure to broad spectrum antibiotics, as categorical (2.20; 1.25-3.88; 0.006) and time-dependent (1.04 per day; 1.00-1.07; 0.014); chronic renal failure (2.81; 1.40-5.64; 0.004) and admission from home (0.44; 0.23-0.85; 0.014) were significant only for CSE controls. Subgroup analyses provided similar results.
    Interpretation: The main risk factors for CRE infections in hospitals with high incidence included previous colonization, urinary catheter and exposure to broad spectrum antibiotics.
    Funding: The study was funded by the Innovative Medicines Initiative Joint Undertaking (https://www.imi.europa.eu/) under Grant Agreement No. 115620 (COMBACTE-CARE).
    Language English
    Publishing date 2023-02-27
    Publishing country England
    Document type Journal Article
    ISSN 2589-5370
    ISSN (online) 2589-5370
    DOI 10.1016/j.eclinm.2023.101871
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  8. Article: Pheochromocytoma: an approach to antihypertensive management.

    Bravo, Emmanuel L

    Annals of the New York Academy of Sciences

    2002  Volume 970, Page(s) 1–10

    Abstract: Pheochromocytoma and paragangliomas are rare tumors of chromaffin tissue that secrete catecholamines either intermittently or continuously, producing hypertension with a constellation of symptoms and signs that can be frightening to the patient and that ... ...

    Abstract Pheochromocytoma and paragangliomas are rare tumors of chromaffin tissue that secrete catecholamines either intermittently or continuously, producing hypertension with a constellation of symptoms and signs that can be frightening to the patient and that continue to provide perplexing problems for clinicians. With surgical treatment, symptoms will be relieved and hypertension normalized or ameliorated for patients who do not have malignant tumors. Appropriate antihypertensive drugs are used to manage hypertension, to control associated cardiovascular symptoms, and to prepare patients for operation. The question debated most often regarding medical therapy of pheochromocytoma is whether antihypertensive treatment regimens other than nonspecific alpha-blockade are just as effective and safe. Understanding the pathophysiologic mechanisms that sustain the hypertension and the pharmacology of antihypertensive agents allows better selection of antihypertensive therapy.
    MeSH term(s) Adrenal Gland Neoplasms/complications ; Adrenal Gland Neoplasms/therapy ; Adrenergic alpha-Antagonists/therapeutic use ; Adrenergic beta-Antagonists/therapeutic use ; Antihypertensive Agents/therapeutic use ; Blood Pressure/physiology ; Calcium Channel Blockers/therapeutic use ; Catecholamines/blood ; Clonidine/therapeutic use ; Hemodynamics ; Humans ; Hypertension/drug therapy ; Hypertension/etiology ; Neuropeptide Y/blood ; Phenoxybenzamine/therapeutic use ; Pheochromocytoma/complications ; Pheochromocytoma/therapy
    Chemical Substances Adrenergic alpha-Antagonists ; Adrenergic beta-Antagonists ; Antihypertensive Agents ; Calcium Channel Blockers ; Catecholamines ; Neuropeptide Y ; Phenoxybenzamine (0TTZ664R7Z) ; Clonidine (MN3L5RMN02)
    Language English
    Publishing date 2002-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 211003-9
    ISSN 1749-6632 ; 0077-8923
    ISSN (online) 1749-6632
    ISSN 0077-8923
    DOI 10.1111/j.1749-6632.2002.tb04408.x
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  9. Article: Pheochromocytoma.

    Bravo, Emmanuel L

    Cardiology in review

    2001  Volume 10, Issue 1, Page(s) 44–50

    Abstract: Pheochromocytomas cause the most dramatic, life-threatening crises in all of endocrinology. Pheochromocytoma is an explosive clinical syndrome characterized by severe hypertension associated with cardiac complications, hypotension, or even shock and ... ...

    Abstract Pheochromocytomas cause the most dramatic, life-threatening crises in all of endocrinology. Pheochromocytoma is an explosive clinical syndrome characterized by severe hypertension associated with cardiac complications, hypotension, or even shock and sudden death. The key to diagnosing pheochromocytoma is to suspect it, then confirm it. The cases reported in this review illustrate how the diagnosis can be easily missed and definitive treatment delayed. An appreciation of the wide range of clinical manifestations, based on clear understanding of the mechanisms of catecholamine action and the pathophysiology of pheochromocytoma, and the availability of simple and accurate diagnostic tests should lead to earlier detection of these tumors. Advances in localization techniques and availability of various treatment modalities have made successful management more promising than ever before.
    MeSH term(s) Adrenal Gland Neoplasms/complications ; Adrenal Gland Neoplasms/diagnosis ; Adrenal Gland Neoplasms/drug therapy ; Adrenergic alpha-Antagonists/therapeutic use ; Adult ; Calcium Channel Blockers/therapeutic use ; Catecholamines/blood ; Female ; Humans ; Hypertension/etiology ; Labetalol/therapeutic use ; Male ; Metanephrine/urine ; Pheochromocytoma/complications ; Pheochromocytoma/diagnosis ; Pheochromocytoma/drug therapy ; Prazosin/therapeutic use
    Chemical Substances Adrenergic alpha-Antagonists ; Calcium Channel Blockers ; Catecholamines ; Metanephrine (5001-33-2) ; Labetalol (R5H8897N95) ; Prazosin (XM03YJ541D)
    Language English
    Publishing date 2001-12-06
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 1294965-6
    ISSN 1061-5377
    ISSN 1061-5377
    DOI 10.1097/00045415-200201000-00009
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  10. Article ; Online: Renal denervation for resistant hypertension.

    Bravo, Emmanuel L / Rafey, Mohammed A / Nally, Joseph V

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2009  Volume 54, Issue 5, Page(s) 795–797

    Language English
    Publishing date 2009-11
    Publishing country United States
    Document type Comment ; Journal Article
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2009.07.005
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