Аналіз адгезивної дисфункції ендотелію при резстентній артеріальній гіпертензії

Aim: To examine the antihypertensive activity of Telmisartan and Bisoprolol at resistant hypertension.To evaluate the features of resistant hypertension and endothelial vasomotor and adhesive dysfunction.Methods: The level of adhesion molecules s-ICAM-1, L-selectin and matrix metalloproteinase-9 was determined by ELISA with regard to vasoactive function of the brachial artery, which is determined through the flow-dependent vascular dilatation sample. Determination of Nitrogen oxide was conducted on data metabolites of total Nitrogen (NOx) by determination of Nitrite ion after colorimetric reaction with Griess reagent using SF-46 spectrometer (Russia).Results. The studies have shown that six-month treatment by Telmisartan and Bisoprolol in most patients (22 patients) was accompanied by target levels of blood pressure achievement, and was observed in 14 patients resistant to the treatment. The additional inclusion in complex treatment Aliskiren 150-300 mg per day was also accompanied by normalization of blood pressure.Conclusion.1. The function of endothelial adhesion and appearance of endothelial dysfunction occur prior to hypertension clinical and morphological signs.2. Induced hypertension increase of sICAM-1 and L-selectin and matrix metalloproteinase-9 is a marker of hypertension severity and the treatment efficiency.3. Telmisartan and Bisoprolol significantly reduce the adhesive endothelial dysfunction and contribute to the achievement of target blood pressure levelsПроведені досліджененя показали, що шестимісячна терапія телмісартаном і бісопрололом у більшості пацієнтів (22 хворих) супроводжувалась досягненням цільових рівнів артеріального тиску, а у 14 хворих відмічалась резистентність до проведеної терапії. Додаткове включення в комплекс лікування аліскірену 150–300 мг на добу супроводжувалось усуненням резистентност

Neurological Characteristics of Allgrove Syndrome: A Case Series

Purpose Allgrove syndrome, also known as “triple A” syndrome, is characterized by adrenal insufficiency, achalasia, and alacrimia. When neurological signs are also present, the condition is referred to as “4 A” syndrome. Methods We conducted a retrospective analysis of three patients with 4 A syndrome confirmed genetically. A complete neurological exam was carried out by an experimented neurologist. Results Herein, we describe the neurological characteristics often associated with this condition, through the clinical and electrophysiological analysis of three patients. All patients exhibited a mutation in AAAS, the gene coding for ALADIN. While these individuals presented with the classic features of triple-A syndrome, neurological symptoms were not prominent. Conclusion The neurological manifestations of Allgrove syndrome have historically been overlooked and inadequately explored. Due to the condition’s rarity and substantial phenotypic heterogeneity, only recently have a variety of symptoms been recognized and described

Leydig Cell Tumor Associated with Testicular Adrenal Rest Tumors in a Patient with Congenital Adrenal Hyperplasia due to 11β-Hydroxylase Deficiency

Congenital adrenal hyperplasia (CAH) describes a group of inherited autosomal recessive disorders characterized by enzyme defects in the steroidogenic pathways that lead to the biosynthesis of cortisol, aldosterone, and androgens. Chronic excessive adrenocorticotropic hormone (ACTH) stimulation may result in hyperplasia of ACTH-sensitive tissues in adrenal glands and other sites such as the testes, causing testicular masses known as testicular adrenal rest tumors (TARTs). Leydig cell tumors (LCTs) are make up a very small number of all testicular tumors and can be difficult to distinguish from TARTs. This distinction is interesting because LCTs and TARTs require different therapeutic approaches. Hereby, we present an unusual case of a 19-year-old patient with CAH due to 11β-hydroxylase deficiency, who presented with TARTs and an epididymal Leydig cell tumor

A year of genomic surveillance reveals how the SARS-CoV-2 pandemic unfolded in Africa.

The progression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Africa has so far been heterogeneous, and the full impact is not yet well understood. In this study, we describe the genomic epidemiology using a dataset of 8746 genomes from 33 African countries and two overseas territories. We show that the epidemics in most countries were initiated by importations predominantly from Europe, which diminished after the early introduction of international travel restrictions. As the pandemic progressed, ongoing transmission in many countries and increasing mobility led to the emergence and spread within the continent of many variants of concern and interest, such as B.1.351, B.1.525, A.23.1, and C.1.1. Although distorted by low sampling numbers and blind spots, the findings highlight that Africa must not be left behind in the global pandemic response, otherwise it could become a source for new variants

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Changes in heart rate variability in patients with hypertension under outpatient stage treatment

Actuality of the heart rate variability study in patients with hypertension is underlined with high risk of hypertension complications development and the influence of the autonomic nervous system that changes the tone, affects not only the course of the disease but also increases the risk of death. The aim was to study heart rate variability with conventional methods, in order to increase the efficiency of the hypertension treatment with telmisartan and bisoprolol in 35 patients suffering from high blood pressure with degree I and II in an ambulatory care clinic. Results. It has been proven that the treatment with bisoprolol and telmisartan in patients with hypertension degree I and II is accompanied by a significant reduction of the sympathetic division activity of the autonomic nervous system, indicating positive change of the autonomic imbalance and increased activity of the parasympathetic system, therefore accompanied by significant reduction in the low frequency spectrum of the sympathetic nervous system in relation with the cardiac activity and the confirmed indicators LF / HF

Зміни варіабельності ритму серця у хворих на артеріальну гіпертензію у процесі амбулаторного лікування

Actuality of the heart rate variability study in patients with hypertension is underlined with high risk of hypertension complications development and the influence of the autonomic nervous system that changes the tone, affects not only the course of the disease but also increases the risk of death.The aim was to study heart rate variability with conventional methods, in order to increase the efficiency of the hypertension treatment with telmisartan and bisoprolol in 35 patients suffering from high blood pressure with degree I and II in an ambulatory care clinic.Results. It has been proven that the treatment with bisoprolol and telmisartan in patients with hypertension degree I and II is accompanied by a significant reduction of the sympathetic division activity of the autonomic nervous system, indicating positive change of the autonomic imbalance and increased activity of the parasympathetic system, therefore accompanied by significant reduction in the low frequency spectrum of the sympathetic nervous system in relation with the cardiac activity and the confirmed indicators LF / HF.Актуальность исследования вариабельности сердечного ритма у больных АГ обусловлена высоким риском развития осложнений АГ и особенностями влияния вегетативной нервной системы, поскольку изменения её тонуса не только неблагоприятно влияют на течение заболевания, но и повышают риск летальных исходов.С целью повышения эффективности лечения АГ телмисартаном и бисопрололом у 35 пациентов с артериальной гипертензией I и II степени в амбулаторних условиях было проведено исследование вариабельности сердечного ритма общепринятыми методами.Установлено, что у больных АГ I и II степени лечение бисопрололом и тел-мисартаном сопровождалось существенным снижением активности симпатического отдела вегетативной нервной системы, что свидетельствовало о положительной коррекции вегетативного дисбаланса и повышении активности парасимпатического её отдела и, как следствие, сопровождалось существенным снижением мощности спектра низких частот симпатического отдела вегетативной нервной системы в отношении сердечной деятельности и подтверждалось показателем LF/HF, что также свидетельствовало о снижении тонуса симпатического звена вегетативной нервной системы на деятельность сердца и уровень АД.Актуальність дослідження варіабельності серцевого ритму у хворих на АГ є зумовленою високим ризиком розвитку ускладнень АГ та особливостями впливу вегетативної нервової системи, оскільки зміни її тонусу не тільки несприятливо впливають на перебіг захворювання, але й підвищують ризик летальних наслідків.З метою підвищення ефективності лікування телмісартаном і бісопрололом хворих на АГ у 35 хворих на артеріальну гіпертензію І та ІІ ступенів в амбулаторних умовах дослідили варіабельність серцевого ритму загальноприйнятими методами.Встановили, що у хворих на АГ І та ІІ ступенів лікування бісопрололом і телмісартаном супроводжувалось істотним зниженням активності симпатичного відділу вегетативної нервової системи, що свідчило про позитивну корекцію вегетативного дисбалансу та підвищення активності парасимпатичного її відділу і, як наслідок, супроводжувалось істотним зниженням потужності спектра низьких частот симпатичного відділу вегетативної нервової системи стосовно серцевої діяльності та підтверджувалось показником LF/HF, що також свідчило про зниження впливу симпатичної ланки вегетативної нервової системи на діяльність серця та рівень АТ

An MDE-based approach for self-adaptive RTES model generation

International audienc