Późny efekt proarytmiczny w trakcie terapii sotalolem wywołany stresem emocjonalnym

We present a case of significant QTc prolongation with torsade de pointes in a female patient with a DDD pacemaker, who had been treated with an established dose of sotalol for two years. The most probable trigger factor of this adverse event was a strong emotional stress. The discontinuation of treatment with sotalol resulted in clinical recovery and QTc normalisation. Kardiol Pol 2011; 69, 7: 721–72

Ramipril z amlodipiną — nowy lek złożony w terapii hipotensyjnej

Złożone leki hipotensyjne zdobywają coraz większą popularność w terapii nadciśnienia tętniczego ze względu na dodatkowe korzyści, jakie przynoszą w zakresie wytrwałości terapeutycznej i poprawy współpracy pacjenta z lekarzem. W nadciśnieniu tętniczym II stopnia są podstawową opcją terapeutyczną. Ramipril z amlodipiną to nowe połączenia leków hipotensyjnych w preparacie złożonym dostępne na rynku farmaceutycznym w Polsce. W tym wypadku mamy do dyspozycji skojarzenie w jednej kapsułce wszechstronnie przebadanego inhibitora konwertazy angiotensyny z najpopularniejszym dihydropirydynowym antagonistą wapnia. Oba leki cechują korzystne wyniki dużych prób klinicznych z ich udziałem, zarówno w nadciśnieniu niepowikłanym, jak i w przypadku powikłań sercowo-naczyniowych.W badaniu oceniającym bezpośrednio preparat złożony ramipril–amlodipina wykazano jego wysoką skuteczność w obniżaniu ciśnienia tętniczego ocenianego metodą 24-godzinnego ABPM oraz w po miarach gabinetowych, a także ograniczenie występowania obrzęków kostek typowych dla amlodipiny. Leczenie było bardzo dobrze tolerowane przez 95% pacjentów.Naturalne wskazanie dla połączenia ramiprilu z amlodipiną to nadciśnienie tętnicze niepowikłane II stopnia niezależnie od ryzyka sercowo-naczyniowego, szczególnie pacjenci z towarzyszącym zespołem metabolicznym i/lub cukrzycą. W nadciśnieniu tętniczym powikłanym chorobą niedokrwienną serca, po przebytym incydencie wieńcowym połączenie ramiprilu z amlodipiną może być z powodzeniem stosowane łącznie z beta-adrenolitykiem, szczególnie w razie konieczności intensyfikacji leczenia hipotensyjnego lub przeciwdławicowego za pomocą 3 leków. Wydaje się, że połączenie ramiprilu z amlodipiną może być ciekawe z punktu widzenia chronoterapii w nadciśnieniu tętniczym z możliwością jego zastosowania w porze wieczornej u pacjentów typu nondipper

Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%

Effect of Dimer Structure and Inhomogeneous Broadening of Energy Levels on the Action of Flavomononucleotide in Rigid Polyvinyl Alcohol Films

The results of time-resolved fluorescence measurements of flavin mononucleotide (FMN) in rigid polyvinyl alcohol films (PVA) demonstrate that fluorescence intensity decays are strongly accelerated in the presence of fluorescent dimers and nonradiative energy transfer processes. The fluorescence decay originating both from H and J dimer states of FMN was experimentally observed for the first time. The mean fluorescence lifetimes for FMN dimers were obtained: τfl = 2.66 ns (at λexc = 445 nm) and τfl = 2.02 (at λexc = 487 nm) at λobs = 600 nm and T = 253 K from H and J state of dimers, respectively. We show that inhomogeneous orientational broadening of energy levels (IOBEL) affects the shape of the fluorescence decay and leads to the dependence of the average monomer fluorescence lifetime on excitation wavelength. IOBEL affected the nonradiative energy transfer and indicated that different flavin positioning in the protein pocket could (1) change the spectroscopic properties of flavins due to the existence of “blue” and “red” fluorescence centers, and (2) diminish the effectiveness of energy transfer between FMN molecules

Physiological and Biochemical Parameters of Common Duckweed Lemna minor after the Exposure to Tetracycline and the Recovery from This Stress

In this study, the ability of Lemna minor L. to recover to normal growth, after being degraded in a tetracycline-containing medium, was extensively investigated. The plants were exposed to tetracycline (TC) at concentrations of 1, 2.5, and 10 mM. Subsequently, their physiological status was analysed against the following criteria: rate of plant growth; free radical accumulation; antioxidant enzyme activity; chlorophyll content; HSP70 protein content; cell membrane permeability, and mitochondrial activity. The study showed that duckweed can considerably recover from the damage caused by antibiotics, within a week of cessation of stress. Of the plant properties analysed, mitochondrial activity was the most sensitive to antibiotic-induced disturbances. After transferring the plants to a tetracycline-free medium, all plant parameters improved significantly, except for the mitochondrial activity in the plants grown on the medium containing the highest dose of tetracycline. In the plants treated with this antibiotic at the concentration of 10 mM, the proportion of dead mitochondria increased and was as high as 93% after one week from the beginning of the recovery phase, even after the transfer to the tetracycline-free medium

Steady state and time resolved fluorescence studies of azadioxatriangulenium (ADOTA) fluorophore in silica and PVA thin films

A cationic azadioxatriangulenium (ADOTA) dye was entrapped in silica thin films obtained by the sol-gel process and in poly (vinyl) alcohol (PVA) thin films. Azadioxatriangulenium is a red emitting fluorophore with a long fluorescence lifetime of ~20 ns. The fluorescent properties of azadioxatriangulenium in silica thin films and PVA films were studied by means of steady–state and time resolved fluorescence techniques. We have found that the azadioxatriangulenium entrapped in silica thin film has a wider fluorescence lifetime distribution (Lorentzian distribution), lower fluorescence efficiencies, shorter lifetimes compared to Azadioxatriangulenium in a PVA film. The local environment of azadioxatriangulenium molecules in the silica thin film is rich with water and ethanol, which creates the possibility of forming excited state aggregates due to high concentration of dye within a small confined area. In contrast to the PVA matrices, the porous silica films allow restricted rotations of Azadioxatriangulenium molecules, which result in faster and complex fluorescence anisotropy decays suggesting energy migration among dye molecules