Knowledge of blood pressure self-control principles in hospitalized patients with hypertension

Wstęp. Nadciśnienie tętnicze (HTN) stanowi główną przyczynę zgonów na świecie. Podstawą jego kontroli są domowe pomiary ciśnienia tętniczego. Ważną rolę w rozpoznawaniu HTN oraz leczeniu go odgrywają gabinetowe pomiary ciśnienia tętniczego oraz całodobowe monitorowanie ciśnienia. Głównym celem pracy jest ocena znajomości zasad pomiaru ciśnienia tętniczego, a także wiedzy na temat choroby u hospitalizowanych chorych z HTN. Materiał i metody. Badaniem ankietowym objęto grupę 126 pacjentów z rozpoznanym i leczonym HTN hospitalizowanych w I Klinice Kardiologii i Elektroterapii Świętokrzyskiego Centrum Kardiologii w Kielcach. Narzędziem badawczym była ankieta złożona z 23 pytań zamkniętych oraz 3 pytań otwartych. Oceniano dane demograficzne, czas trwania HTN, styl życia oraz obecność schorzeń współistniejących. Część pytań dotyczyła znajomości zasad samokontroli ciśnienia tętniczego oraz sposobu wykonywania pomiarów ciśnienia. Wyniki. Badana grupa 126 chorych z HTN obejmowała 58 kobiet (46%) oraz 68 mężczyzn (54%). Jedynie u 26 osób (20,6%) w całej badanej grupie stwierdzono prawidłową masę ciała. Średni czas trwania HTN wynosił 11 lat. W badanej grupie 118 chorych (93,7%) wykonywało domowe pomiary ciśnienia tętniczego. Spośród respondentów 43 osoby (34,1%) posługiwały się ciśnieniomierzem nadgarstkowym. Wśród badanych chorych 107 osób (85%) znało prawidłowe wartości ciśnienia tętniczego, z kolei 19 chorych (15%) nie wiedziało, jakie to wartości. Oceniono styl życia hospitalizowanych chorych z HTN. Zmianę diety oraz eliminację niekorzystnych nawyków żywieniowych od czasu rozpoznania HTN deklarowało 48 osób (38,1%), pozostałe 78 (61,9%) nie dokonało zmian w swoich nawykach żywieniowych w związku z występowaniem HTN. Większość chorych z badanej grupy, tj. 95 osób (75,3%), miało świadomość konsekwencji, które wynikają z nieleczenia lub niewłaściwego leczenia HTN. Pozostali ankietowani, tj. 31 osób (24,6%), nie mieli wiedzy na ten temat. Oceniając swój poziom wiedzy, jedynie 10 osób (7,9%) określiło go jako dobry. Wnioski. Wiedza dotycząca samokontroli HTN u chorych leczonych hipotensyjnie jest niewystarczająca. Konieczna jest systematyczna edukacja chorych, dotycząca głównie mieszkańców wsi oraz osób w wieku emerytalnym.Introduction. Hypertension (HTN) is the main cause of mortality worldwide. Control of HTN is based on home blood pressure measurements. An important role in the diagnosis of HTN plays an ambulatory blood pressure measurement. The main aim of the study was to assess the knowledge of blood pressure measurements, as well as the assessment of knowledge about the disease in hospitalized patients with hypertension. Materials and methods. The study involved a group of 126 patients with diagnosed and treated HTN hospitalized in the First Clinical Department of Cardiology in Świętokrzyskie Cardiology Centre in Kielce. Questionnaire consisted of 23 closed questions and 3 open questions was a study tool. It assessed demographic data, duration of HTN, lifestyle and the presence of comorbidities. Some of the questions concerned the knowledge of the principles of self-control of blood pressure and how to perform blood pressure measurements. Results. Studied group of 126 patients with hypertension included 58 women (46%) and 68 men (54%). Only 26 patients (20.6%) in the whole group had normal body weight. The average duration of HTN was 11 years. One hundred and eighteen patients (93.7%) measured their blood pressure at home. Forty-three respondents (34.1%), used wrist sphygmomanometer. Among studied patients, 107 (85%) knew the correct blood pressure. Nineteen (15%) patients did not know the correct blood pressure values. Lifestyle of hospitalized patients with hypertension was also assessed. Healthy diet and eliminating risk factors since the diagnosis HTN were declared by 48 patients (38.1%), the remaining 78 patients (61.9%) did not make changes in their eating habits despite the occurrence of HTN. Most patients in the study group (95 patients, 75.3%) were aware of the consequences of untreated or inadequately treated HTN. The remaining 31 respondents (24.6%) had no knowledge of the subject. Assessing their level of knowledge, only 10 (7.9%) respondents defined it as good. Conclusions. Knowledge of self-control of HTN in patients treated with antihypertensive drugs is insufficient. Systematic education is still necessary, mainly for country dwellers in old age

The value of topotecan in the second-line treatment of small-cell lung cancer. Preliminary report

Introduction: Small cell lung cancer (SCLC) is an aggressive malignancy with high propensity for early regional and distant metastases. Response rate to first-line chemotherapy is high but typically short-therm. All patients with extensive disease and majority with limited disease have recurrence of disease. The choice of second-line chemotherapy in case of progression depends on many factors, including type of first-line chemotherapy, response to treatment, progression-free survival and patients’ performance status. No standard second-line treatment has been established until recently. Monotherapy with topotecan is widely used in second-line treatment especially in patients in poor performance status. Material and methods: The aim of the study was to evaluate the results of monotherapy with topotecan. We also determined the predictive markers which could affect the therapeutic effect of topotecan. The examined group consisted of 42 patients with extensive stage of SCLC. Cox regression model was used to establish adverse factors, which were prognostic for overall survival of our patients divided into two groups according to administrated chemotherapy: 21 topotecan-treated and 21 standard chemotherapy-treated. Six variables that gave a maximum hazard ratio (HR) were used in the final model, e.g.: the age above 65 (HR = 2.35), anemia (HR = 1.83) and poor performance status (HR = 1.51). These variables scored the points according to their prognostic significance and HR. Results: In Kaplan-Meier analysis, in the group of patients treated with topotecan, the higher survival probability was noted for patients scored below 10 points than for patients scored above 10 points. The prognostic scale was not useful for patients with other scheme of chemotherapy. Five partial responses (24%) in topotecan-treated patients were noted. Conclusions: Precise qualification of patients to topotecan monotherapy in second-line treatment may be effective to prolong survival and increase the percentage of SCLC patients with objective response.Wstęp: Drobnokomórkowy rak płuca (DRP) jest nowotworem złośliwym o dużej agresywności oraz wysokim potencjale wzrostu i tworzenia przerzutów. Odpowiedź na leczenie pierwszej linii uzyskuje się często, lecz jest ona zwykle krótkotrwała. Nawrót choroby występuje u niemal wszystkich chorych w stadium choroby rozległej i u większości chorych w stadium choroby ograniczonej. Wybór chemioterapii drugiej linii zależy od wielu czynników, w tym od pierwotnie zastosowanych leków i uzyskanej odpowiedzi, czasu od zakończenia pierwszego leczenia do progresji oraz stanu sprawności chorego. Najczęściej w leczeniu drugiej linii stosuje się schemat chemioterapii, za pomocą którego uzyskano długotrwałą remisję w pierwszej linii leczenia. Coraz częściej w leczeniu drugiej linii wykorzystuje się monoterapię topotekanem, szczególnie u chorych w złym stanie sprawności. Materiał i metody: Celem autorów pracy była ocena wyników monoterapii topotekanem oraz określenie wpływu czynników predykcyjno-rokowniczych na skuteczność terapii. Badaniami objęto 42 chorych na DRP w uogólnionym stadium. W grupie 21 chorych stosowano monoterapię topotekanem, natomiast u pozostałych chorych inne schematy chemioterapii. Za pomocą testu względnego ryzyka według Coxa udowodniono, że największy wpływ na skrócenie całkowitego przeżycia mają między innymi: wiek powyżej 65 lat (HR = 2,35), wystąpienie niedokrwistości (HR = 1,83) oraz zły stan sprawności (HR = 1,51). Stworzono skalę predykcyjno-rokowniczą, która objęła 6 czynników wypunktowanych w zależności od wartości ryzyka względnego. Wyniki: Prawdopodobieństwo przeżycia chorych leczonych topotekanem było nieistotnie wyższe (p = 0,097) w grupie chorych, którzy uzyskali mniej niż 10 punktów w porównaniu z grupą chorych z punktacją 10 i więcej punktów według zaproponowanej skali. Skala ta okazała się nieprzydatna w prognozowaniu przebiegu DRP u chorych otrzymujących inną chemioterapię. Obiektywną odpowiedź na leczenie topotekanem uzyskano u 5 chorych (24%). Wnioski: Precyzyjna kwalifikacja do monoterapii topotekanem może przynieść wydłużenie czasu życia i umożliwić uzyskanie wyższego odsetka odpowiedzi wśród leczonych chorych

Prenyl Ammonium Salts – New Carriers for Gene Delivery: A B16-F10 Mouse Melanoma Model

Purpose Prenyl ammonium iodides (Amino-Prenols, APs), semi-synthetic polyprenol derivatives were studied as prospective novel gene transfer agents. Methods AP-7, -8, -11 and -15 (aminoprenols composed of 7, 8, 11 or 15 isoprene units, respectively)were examined for their capacity to form complexes with pDNA, for cytotoxicity and ability to transfect genes to cells. Results All the carriers were able to complex DNA. The highest, comparable to commercial reagents, transfection efficiency was observed for AP-15. Simultaneously, AP-15 exhibited the lowest negative impact on cell viability and proliferation—considerably lower than that of commercial agents. AP-15/DOPE complexes were also efficient to introduce pDNA to cells, without much effect on cell viability. Transfection with AP-15/DOPE complexes influenced the expression of a very few among 44 tested genes involved in cellular lipid metabolism. Furthermore, complexes containing AP-15 and therapeutic plasmid, encoding the TIMP metallopeptidase inhibitor 2 (TIMP2), introduced the TIMP2 gene with high efficiency to B16-F10 melanoma cells but not to B16-F10 melanoma tumors in C57BL/6 mice, as confirmed by TIMP2 protein level determination. Conclusion Obtained results indicate that APs have a potential as non-viral vectors for cell transfection

Pregnancy-related cardiac non-elective hospitalizations and pregnancy outcomes. A tertiary referral cardiac center experience

Background: Pregnant women with cardiovascular diseases (CVD) and their offspring are at higher risk of morbidity and mortality.Aims: To provide data on pregnancy outcomes among women with different types of CVD requiring non-elective cardiac hospitalization in a tertiary referral cardiac center.Methods: We identified all records of non-elective hospitalizations of pregnant women hospitalized between January 2009 through March 2018, at our institution — a tertiary referral cardiac center. The incidence and types of cardiac complications during pregnancy, as well as the pregnancy and offspring outcomes, were determined.Results: One hundred and sixty-one out of 328 pregnancy-related hospitalizations in 140 pregnancies were non-elective. Cardiac complications occurred in 62 (44%) pregnancies, with the most frequent being episodes of arrhythmia (22.1% pregnancies), followed by heart failure exacerbations (6.4% pregnancies). Maternal mortality reached 2.1% and affected only women with primary cardiomyopathies (CMP). Offspring mortality was 2.8%. Newborns of mothers with cardiac complications had significantly lower Apgar scores and gestational age at delivery, compared to mothers without cardiac complications.Conclusions: In our series mortality and morbidity among pregnant women with CVD hospitalizations were high. An unfavorable maternal outcome mainly affected women with CMP. Offspring of mothers with cardiovascular complications are prone to have a lower gestational age and Apgar score

Association between the ACCN1 Gene and Multiple Sclerosis in Central East Sardinia

Multiple genome screens have been performed to identify regions in linkage or association with Multiple Sclerosis (MS, OMIM 126200), but little overlap has been found among them. This may be, in part, due to a low statistical power to detect small genetic effects and to genetic heterogeneity within and among the studied populations. Motivated by these considerations, we studied a very special population, namely that of Nuoro, Sardinia, Italy. This is an isolated, old, and genetically homogeneous population with high prevalence of MS. Our study sample includes both nuclear families and unrelated cases and controls. A multi-stage study design was adopted. In the first stage, microsatellites were typed in the 17q11.2 region, previously independently found to be in linkage with MS. One significant association was found at microsatellite D17S798. Next, a bioinformatic screening of the region surrounding this marker highlighted an interesting candidate MS susceptibility gene: the Amiloride-sensitive Cation Channel Neuronal 1 (ACCN1) gene. In the second stage of the study, we resequenced the exons and the 3′ untranslated (UTR) region of ACCN1, and investigated the MS association of Single Nucleotide Polymorphisms (SNPs) identified in that region. For this purpose, we developed a method of analysis where complete, phase-solved, posterior-weighted haplotype assignments are imputed for each study individual from incomplete, multi-locus, genotyping data. The imputed assignments provide an input to a number of proposed procedures for testing association at a microsatellite level or of a sequence of SNPs. These include a Mantel-Haenszel type test based on expected frequencies of pseudocase/pseudocontrol haplotypes, as well as permutation based tests, including a combination of permutation and weighted logistic regression analysis. Application of these methods allowed us to find a significant association between MS and the SNP rs28936 located in the 3′ UTR segment of ACCN1 with p = 0.0004 (p = 0.002, after adjusting for multiple testing). This result is in tune with several recent experimental findings which suggest that ACCN1 may play an important role in the pathogenesis of MS

GWAS of Suicide Attempt in Psychiatric Disorders Identifies Association With Major Depression Polygenic Risk Scores

Objective: Over 90% of suicide attempters have a psychiatric diagnosis, however twin and family studies suggest that the genetic etiology of suicide attempt (SA) is partially distinct from that of the psychiatric disorders themselves. Here, we present the largest genome-wide association study (GWAS) on suicide attempt using major depressive disorder (MDD), bipolar disorder (BIP) and schizophrenia (SCZ) cohorts from the Psychiatric Genomics Consortium. Method: Samples comprise 1622 suicide attempters and 8786 non-attempters with MDD, 3264 attempters and 5500 non-attempters with BIP and 1683 attempters and 2946 non-attempters with SCZ. SA GWAS were performed by comparing attempters to non-attempters in each disorder followed by meta-analyses across disorders. Polygenic risk scoring was used to investigate the genetic relationship between SA and the psychiatric disorders. Results: Three genome-wide significant loci for SA were found: one associated with SA in MDD, one in BIP, and one in the meta-analysis of SA in mood disorders. These associations were not replicated in independent mood disorder cohorts from the UK Biobank and iPSYCH. No significant associations were found in the meta-analysis of all three disorders. Polygenic risk scores for major depression were significantly associated with SA in MDD (R2=0.25%, P=0.0006), BIP (R2=0.24%, P=0.0002) and SCZ (R2=0.40%, P=0.0006). Conclusions: This study provides new information on genetic associations and demonstrates that genetic liability for major depression increases risk for suicide attempt across psychiatric disorders. Further collaborative efforts to increase sample size hold potential to robustly identify genetic associations and gain biological insights into the etiology of suicide attempt