Explanipedia

Is It Time to Retire Aldosterone Suppression Testing? Open

Gregory Kline, Alexander A. C. Leung, Danny Orton, James MacFarlane, Mark Gurnell · 2025

Primary aldosteronism (PA) is the most common endocrine hypertension. For decades, PA diagnosis has required proving nonsuppressibility of aldosterone following maneuvers modulating the renin-angiotensin-aldosterone pathway. This includes …

Barriers and facilitators to following dietary recommendations for bone health: a qualitative study Open

Harleen Ghuttora, Lorena Kembel, Heidi Piovoso, A. Lynn Feasel, Julia MacLaren , et al. · 2025

Our findings indicate that adults with or at risk of osteoporosis face multiple barriers to adhering with dietary recommendations. Bone-focused Culinary Medicine programming merits further study as a possible method of overcoming these bar…

Incidence of Adrenal Masses Eventually Discovered in Patients Screened for Primary Aldosteronism Open

Gregory Kline, J.M. Low, Joshua Burkart, Leo Hu, Kaitlyn Mellor , et al. · 2025

Context Biochemical screening for endocrine hypertension may be complex; the known presence of an adrenal mass markedly increases the pretest probability for adrenal hypertension and may inform diagnostic efforts. Objective Model the poten…

Big data determination and validation of reference range for 24 hour urine cortisol by LCMS/MS Open

Gregory Kline, Erik Venos, Doris M. Campbell, Alexander A. C. Leung, Danny Orton · 2025

Objective 24-hour urine free cortisol(UFC) is a first line test for Cushing syndrome(CS). A new mass spectrometry assay for UFC requires a validated, relevant reference range appropriate to a screening population. Design Combined retrospec…

Discordance between adrenal vein sampling and imaging: the role of unilateral cortisol excess Open

Megan Grundy, Alexander A. C. Leung, Martin Hyrcza, Janice L. Pasieka, Denise Chan , et al. · 2025

Objective Adrenal vein sampling (AVS) is considered the gold-standard for identifying unilateral primary aldosteronism (PA), but is sensitive to any asymmetry in cortisol production. Subclinical autonomous cortisol production likely contri…

Use of Albumin-Adjusted Calcium Measurements in Clinical Practice Open

Noémie Desgagnés, James A. King, Gregory Kline, Isolde Seiden‐Long, Alexander A. C. Leung · 2025

Importance Using albumin-adjusted calcium is commonly recommended for for measuring calcium, but with little empirical evidence to support the practice. Objective To assess the correlation between total calcium measurements (with or withou…

P480: A novel MRTFB missense variant, c.479T>C p.(Leu160Pro), in a school-aged girl with neurodevelopmental disorder Open

Rebecca Nakles-Taylor, Michelle K. Paczosa, Shaochun Bai, Helena Kääriäinen, María Calvo , et al. · 2025

7454 Angiotensin AT1 Receptor Type 1 (AT1) Autoantibodies In Patients with Primary Aldosteronism Open

Jotinder K. Waraich, Gregory Kline, May Y. Choi, Ronald J. Sigal, Cori Caughlin , et al. · 2024

Disclosure: J.K. Waraich: None. G. Kline: None. M.Y. Choi: None. R.J. Sigal: None. C. Caughlin: None. S.J. Przybojewski: None. A. Leung: None. Background: Primary aldosteronism (PA) is a condition characterized by excessive aldosterone sec…

Understanding Elevated Vitamin D Measurements to Uncover Hypercalcemia Etiology Open

Umair Sajid, Dennis J. Orton, Martin Kaufmann, Glenville Jones, Gregory Kline · 2024

Subtype Identification of Surgically Curable Primary Aldosteronism During Treatment With Mineralocorticoid Receptor Blockade Open

Giovanni Pintus, Teresa Maria Seccia, Laurence Amar, Michel Azizi, Anna Riester , et al. · 2024

BACKGROUND: Current guidelines and consensus documents recommend withdrawal of mineralocorticoid receptor antagonists (MRAs) before primary aldosteronism (PA) subtyping by adrenal vein sampling (AVS), but this practice can cause severe hyp…

Multiple radiologist review of adrenal CT still frequently misses lateralized surgical primary aldosteronism Open

Darren Mah, Mark Kneteman, Stefan Przybojewski, Vamshi Kotha, Gregory Kline , et al. · 2023

Patients with primary aldosteronism (PA) have increased morbidity and mortality compared to those with essential hypertension. Accurate detection of lateralized PA is important so that affected patients can receive potentially curative adr…

Subclinical Primary Aldosteronism and Cardiovascular Health: A Population-Based Cohort Study Open

Gregory L. Hundemer, Mohsen Agharazii, François Madore, Anand Vaidya, Jenifer M. Brown , et al. · 2023

BACKGROUND: Primary aldosteronism, characterized by overt renin-independent aldosterone production, is a common but underrecognized form of hypertension and cardiovascular disease. Growing evidence suggests that milder and subclinical form…

THU593 Unilaterally Selective Adrenal Vein Sampling For Identification Of Surgically Curable Primary Aldosteronism Open

Gian Paolo Rossi, Domenico Bagordo, Laurence Amar, Michel Azizi, Anna Riester , et al. · 2023

Disclosure: G. Rossi: None. D. Bagordo: None. L. Amar: None. M. Azizi: None. A. Riester: None. M. Reincke: None. C. Degenhart: None. J. Widimský: None. M. Naruse: None. J. Deinum: None. T. Kocjan: None. A. Negro: None. E. Rossi: None. G. K…

Biomarkers to Guide Medical Therapy in Primary Aldosteronism Open

Gregory L. Hundemer, Alexander A. C. Leung, Gregory Kline, Jenifer M. Brown, Adina F. Turcu , et al. · 2023

Primary aldosteronism (PA) is an endocrinopathy characterized by dysregulated aldosterone production that occurs despite suppression of renin and angiotensin II, and that is non-suppressible by volume and sodium loading. The effectiveness …

Multiple Spontaneous Vertebral Fractures in a Younger Post-menopausal Woman Upon Stopping Denosumab Therapy Open

Leo Hu, William D. Leslie, Gregory Kline · 2023

Denosumab is a widely used medication for the treatment of osteoporosis. It has been observed in recent years that abruptly stopping denosumab leads to an increase in bone turnover markers, a decrease in bone mineral density, and a higher …

Poorly Controlled Blood Pressure: The Virus and the Elephant Open

Gregory Kline · 2023

General Comorbidity Indicators Contribute to Fracture Risk Independent of FRAX: Registry-Based Cohort Study Open

Gregory Kline, Suzanne N. Morin, Lisa M. Lix, Eugène McCloskey, Helena Johansson , et al. · 2022

Context FRAX® estimates 10-year fracture probability from osteoporosis-specific risk factors. Medical comorbidity indicators are associated with fracture risk but whether these are independent from those in FRAX is uncertain. Objective We …

Performance of Confirmatory Tests for Diagnosing Primary Aldosteronism: a Systematic Review and Meta-Analysis Open

Alexander A. C. Leung, Christopher Symonds, Gregory L. Hundemer, Paul E. Ronksley, Diane Lorenzetti , et al. · 2022

Background: Confirmatory tests are recommended for diagnosing primary aldosteronism, but the supporting evidence is unclear. Methods: We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials. Studies evaluating a…

A retrospective review of the community medicine needs from osteoporosis services in Canada Open

Gregory Kline, Christopher Symonds, Emma O. Billington · 2022

Apparent “Rapid Loss” After Short-Interval Bone Density Testing in Menopausal Women Is Usually a Measurement Artifact Open

Gregory Kline, Suzanne N. Morin, Lisa M. Lix, William D. Leslie · 2022

Context Medication may be considered when bone mineral density (BMD) loss is reported as “excessive.” Objective We hypothesized that the rate of BMD change between 2 serial tests demonstrates higher random variability at shorter vs longer …

Divergent Patterns of Antifracture Medication Use Following Fracture on Therapy: A Population-Based Cohort Study Open

Gregory Kline, Suzanne N. Morin, Lisa M. Lix, William D. Leslie · 2021

Context Fracture on therapy should motivate better antifracture medication adherence. Objective This study aimed to describe osteoporosis medication adherence in women before and following a fracture. Methods This retrospective cohort anal…

Carbamazepine drug effect simulating biochemical central hypothyroidism in a patient with Bardet-Biedl syndrome Open

David Kishlyansky, Gregory Kline · 2021

Carbamazepine (CBZ) is a medication used commonly in epilepsy. Decreases in free T4 levels simulating central hypothyroidism have been reported, although the clinical significance is still unclear. We present a 24-year-old man with Bardet-…

Response Letter to the Editor from Zhu et al: “Performance of the Aldosterone-to-Renin Ratio as a Screening Test for Primary Aldosteronism: A Systematic Review and Meta-Analysis” Open

Gregory L. Hundemer, Gregory Kline, Alexander A. C. Leung · 2021

Performance of the Aldosterone to Renin Ratio as a Screening Test for Primary Aldosteronism Open

Annie Hung, Sumaiya Ahmed, Ankur Gupta, Alexandra Davis, Gregory Kline , et al. · 2021

Context The aldosterone to renin ratio (ARR) is the guideline-recommended screening test for primary aldosteronism. However, there are limited data in regard to the diagnostic performance of the ARR. Objective To evaluate the sensitivity a…

External Validation of Prediction Models for Unilateral Primary Aldosteronism Open

Davis Sam, Gregory Kline, Benny So, Janice L. Pasieka, Adrian Harvey , et al. · 2021

Primary aldosteronism (PA) is the most common cause of remediable hypertension. Treatment is informed by establishing whether disease is unilateral (localized to one adrenal gland) or bilateral. Adrenalectomy is the guideline-recommended t…

Author response for "Patient Outcomes in the Years After a DXA-BMD Treatment Monitoring Test: Improved Medication Adherence in Some, But Too Little Too Late" Open

Gregory Kline, Lisa M. Lix, William D. Leslie · 2021

Growth hormone deficiency testing and treatment following mild traumatic brain injury Open

Leah J. Mercier, N. Krüger, Quoc Thang Le, Tak Fung, Gregory Kline , et al. · 2021

Properly Collected Plasma Metanephrines Excludes PPGL After False-Positive Screening Tests Open

Gregory Kline, Jessica M. Boyd, Brenda Polzin, Adrian Harvey, Janice L. Pasieka , et al. · 2021

Context False-positive results are common for pheochromocytoma/paraganglioma (PPGL) real-world screening. Objective Determine the correlation between screening urine and seated plasma metanephrines in outpatients where PPGL was absent, com…

Comparison of 2 fracture risk estimation processes in Alberta: a cross-sectional chart review Open

Shivraj Riar, A. Lynn Feasel, Fariba Aghajafari, Dean Frohlich, Christopher Symonds , et al. · 2021

Fracture risk estimates on BMD reports (using the CAROC tool) and those calculated in the clinical setting (using FRAX) frequently result in different risk classification. Osteoporosis treatment decisions may differ in up to half of patien…

Outcomes of a Specialized Clinic on Rates of Investigation and Treatment of Primary Aldosteronism Open

Yuan-yuan Liu, James A. King, Gregory Kline, Raj Padwal, Janice L. Pasieka , et al. · 2021

In this cohort, less than 1% of patients expected to have PA were ever formally diagnosed and treated. These findings suggest that a system-level approach to assist with investigation and treatment of PA may be highly effective in closing …

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