New standards in hypertension and cardiovascular risk management: focus on telmisartan

Blockade of the renin–angiotensin system is an important approach in managing high blood pressure, and has increasingly been shown to affect cardiovascular disease processes mediated by angiotensin II throughout the cardiovascular and renal continua. Telmisartan is an angiotensin II receptor blocker (ARB) displaying unique pharmacologic properties, including a longer half life than any other ARB, that result in large and sustained reductions of blood pressure. In patients with mild-to-moderate hypertension, telmisartan has proved superior to other antihypertensive agents (valsartan, losartan, ramipril, perindopril, and atenolol) in controlling blood pressure particularly towards the end of the dosing interval. There is also clinical evidence that telmisartan reduces left ventricular hypertrophy, reduces arterial stiffness and the recurrence of atrial fibrillation, and confers renoprotection. The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET®) study has demonstrated that telmisartan has similar cardiovascular protective effects to ramipril in a large, high-risk patient population but was better tolerated. The powerful and sustained blood pressure control apparent in clinical trials, together with cardiovascular protection and tolerability demonstrated in ONTARGET® means that telmisartan may be a preferred option for patients with hypertension

a practical guide

Funding Information: We are grateful to all staff composing the?Imaging Department, the Colorectal Cancer Unit, and The Pathology Department of the Champalimaud Foundation. We would also like to thank Nuno Lou??o from Philips Healthcare (R) for the outstanding technical support. Publisher Copyright: © 2021, The Author(s).In the past nearly 20 years, organ-sparing when no apparent viable tumour is present after neoadjuvant therapy has taken an increasingly relevant role in the therapeutic management of locally-advanced rectal cancer patients. The decision to include a patient or not in a “Watch-and-Wait” program relies mainly on endoscopic assessment by skilled surgeons, and MR imaging by experienced radiologists. Strict surveillance using the same modalities is required, given the chance of a local regrowth is of approximately 25–30%, almost always surgically salvageable if caught early. Local regrowths occur at the endoluminal aspect of the primary tumour bed in almost 90% of patients, but the rest are deep within it or outside the rectal wall, in which case detection relies solely on MR Imaging. In this educational review, we provide a practical guide for radiologists who are, or intend to be, involved in the re-staging and follow-up of rectal cancer patients in institutions with an established “Watch-and-Wait” program. First, we discuss patient preparation and MR imaging acquisition technique. Second, we focus on the re-staging MR imaging examination and review the imaging findings that allow us to assess response. Third, we focus on follow-up assessments of patients who defer surgery and confer about the early signs that may indicate a sustained/non-sustained complete response, a rectal/extra-rectal regrowth, and the particular prognosis of the “near-complete” responders. Finally, we discuss our proposed report template.publishersversionpublishe

Cavity-ring-down Doppler-broadening primary thermometry

A step forward in Doppler-broadening thermometry is demonstrated using a comb-assisted cavity-ring-down spectroscopic approach applied to an isolated near-infrared line of carbon dioxide at thermodynamic equilibrium. Specifically, the line-shape of the Pe(12) line of the (30012)â\u86\u90(00001) band of CO2 at 1.578 μm is accurately measured and its Doppler width extracted from a refined multispectrum fitting procedure accounting for the speed dependence of the relaxation rates, which were found to play a role even at the very low pressures explored, from 1 to 7 Pa. The thermodynamic gas temperature is retrieved with relative uncertainties of 8Ã\u9710-6 (type A) and 11Ã\u9710-6 (type B), which ranks the system at the first place among optical methods. Thanks to a measurement time of only â\u89\u885h, the technique represents a promising pathway toward the optical determination of the thermodynamic temperature with a global uncertainty at the 10-6 level

Absolute frequency measurements of CHF3 Doppler-free ro-vibrational transitions at 8.6 μm

We report on absolute measurements of saturated-absorption line-center frequencies of room-temperature trifluoromethane using a quantum cascade laser at 8.6 μm and the frequency modulation spectroscopy method. Absolute calibration of the laser frequency is obtained by direct comparison with a mid-infrared optical frequency comb synthesizer referenced to a radio-frequency Rb standard. Several sub-Doppler transitions falling in the v5 vibrational band are investigated at around 1158.9 cm-1 with a fractional frequency precision of 8.6·10-12 at 1-s integration time, limited by the Rb-clock stability. The demonstrated frequency uncertainty of 6.6·10-11 is mainly limited by the reproducibility of the frequency measurements

HIF-transcribed p53 chaperones HIF-1α

Chronic hypoxia is associated with a variety of physiological conditions such as rheumatoid arthritis, ischemia/reperfusion injury, stroke, diabetic vasculopathy, epilepsy and cancer. At the molecular level, hypoxia manifests its effects via activation of HIF-dependent transcription. On the other hand, an important transcription factor p53, which controls a myriad of biological functions, is rendered transcriptionally inactive under hypoxic conditions. p53 and HIF-1α are known to share a mysterious relationship and play an ambiguous role in the regulation of hypoxia-induced cellular changes. Here we demonstrate a novel pathway where HIF-1α transcriptionally upregulates both WT and MT p53 by binding to five response elements in p53 promoter. In hypoxic cells, this HIF-1α-induced p53 is transcriptionally inefficient but is abundantly available for protein-protein interactions. Further, both WT and MT p53 proteins bind and chaperone HIF-1α to stabilize its binding at its downstream DNA response elements. This p53-induced chaperoning of HIF-1α increases synthesis of HIF-regulated genes and thus the efficiency of hypoxia-induced molecular changes. This basic biology finding has important implications not only in the design of anti-cancer strategies but also for other physiological conditions where hypoxia results in disease manifestation

BriXs ultra high fluxinverse compton source based on modified push-pull energy recovery linacs

We present a conceptual design for a compact X-ray Source BriXS (Bright and compact X-ray Source). BriXS, the first stage of the Marix project, is an Inverse Compton Source (ICS) of X-ray based on superconducting cavities technology for the electron beam with energy recirculation and on a laser system in Fabry-Pérot cavity at a repetition rate of 100 MHz, producing 20–180 keV monochromatic X-Rays devoted mainly to medical applications. An energy recovery scheme based on a modified folded push-pull CW-SC twin Energy Recovery Linac (ERL) ensemble allows us to sustain an MW-class beam power with almost one hundred kW active power dissipation/consumption

Mechanical Response of Short Fiber Reinforced Fly Ash Based Geopolymer Composites

The requirement for environmentally friendly construction materials for sustainable development is nowadays an important issue and the geopolymer technology provides a good solution to replace, as binder, the ordinary cement materials for green building. Fly ash, an industrial by-product currently disposed of as waste, can be used as feedstock for geopolymers with an excellent greenness. In order to preserve the eco-friendly nature of the fly ash based geopolymer and enhance the mechanical properties that represent a weak point of the cementitious materials, limiting their application fields, a new fly ash based geopolymer composite was introduced. For this purpose, inorganic, organic and natural short fibers, i.e. Eglass, aramid and hemp respectively, were considered as reinforcement. The mechanical response of these composites under quasi-static and dynamic load conditions was investigated and compared to plain geopolymers, drawing the attention to the hemp reinforced ones, because of their low coast and eco-friendly nature