Therapeutical inertia in hypertension patients treated by general practitioners and cardiologists in Poland

Wstęp W Polsce realizowane były dotychczas 3 dużeprogramy populacyjne mające na celu scharakteryzowanieproblemu nadciśnienia tętniczego: Pol-MONICA, NATPOL i WOBASZ. Pozwoliło to naoszacowanie odsetka pacjentów z prawidłowo leczonymnadciśnieniem, który wynosił 12% w 2002 rokui wzrósł do 26% w 2011 roku.Materiał i metody Badanie dotyczące problemuinercji terapeutycznej w leczeniu nadciśnienia tętniczegowśród lekarzy rodzinnych i kardiologóww Polsce prowadzone było w latach 2009–2010. Uczestniczyłow nim 4195 osób w wieku 18–92 lat (śr. 47,9± 11,01 lat), w tym 42,4% kobiet i 57,6% mężczyzn.U każdego pacjenta przeprowadzono 3 wizyty.W badaniu wzięło udział 246 lekarzy. Odsetek osóbz dobrze kontrolowanym nadciśnieniem tętniczymzdefiniowano jako stosunek osób aktualnie leczonychz powodu nadciśnienia, u których uzyskanonormalizację ciśnienia tętniczego (<140/90 mm Hg),do ogółu osób, u których w czasie badania stwierdzononadciśnienie tętnicze.Wyniki Odsetek pacjentów z wartościami ciśnienia skurczowego powyżej górnej granicy normy, to znaczypowyżej 140 mm Hg wynosił w kolejnych trzechwizytach odpowiednio 84,4%, 57,5% i 38,6%, a z wartościamiciśnienia rozkurczowego powyżej górnejgranicy normy, to znaczy 90 mm Hg, odpowiednio74,6%, 43,0% i 30,5%. W odniesieniu do tych pacjentówterapia uległa zmianie podczas kolejnych wizyt,odpowiednio w 82,4%, 58% i 40,3% przypadków.Wnioski Do czynników mogących pozytywnie wpłynąćna zjawisko inercji terapeutycznej należą: poprawawykształcenia lekarzy w zakresie leczenianadciśnienia tętniczego i znajomości obowiązującychzaleceń, stosowanie preparatów złożonych,ograniczona liczba wizyt lekarskich w danej jednostceczasu, współistnienie innych chorób układu sercowo-naczyniowego oraz możliwość telefonicznegolub radiowego raportowania zmierzonych wartościciśnienia przez pacjentów.Background There were three large population-based programscarried out in Poland to characterize the problem ofarterial hypertension- Pol-MONICA, NATPOL andWOBASZ. It was possible to estimate the percentage ofproperly treated hypertension patients, which increasedfrom 12% in 2002 to 26% in 2011.Material and methods Study concerning therapeutic inertiain hypertension treatment among general practitionersand cardiologists in Poland was carried out in 2009-10. Itwas attended by 4195 people aged 18-92 years (mean47.9±11.01 years), including 42.4% women and 57.6%men. Every patient had three visits. In the study took part246 physicians. The percentage of patients with well-controlledhypertension was defined as the ratio of patientscurrently treated for hypertension who achieved a goalblood pressure (< 140/90 mmHg) and the total number ofparticipating hypertension patients.Results The percentage of patients with systolic blood pressurevalues above 140 mm Hg was during following threevisits, respectively 84.4%, 53.9% and 26.8%, and withdiastolic blood pressure values above 90 mm Hg, respectively74.1%, 38.1% and 19.1%. In these patients, treatmentwas changed during subsequent visits, respectively in82.4%, 58% and 40.3% of cases.Conclusions The factors that can positively influencetherapeutical inertia are: improvement of physician educationconcerning arterial hypertension treatment and currentguidelines knowledge, hypertension treatment usingcombination drugs, coexistence of other cardiovascular system’sdiseases, patient’s possibility to do phone or radioreports of his blood pressure value

Agrimonia – biological activity and perspectives for medicinal application. Part I

The menopause-related alteration in a woman’s body may include a variety of disorders, such as obesity,metabolic syndrome, changes in immune response or haemostatic parameters, and oxidative stress. Some plantderivedsubstances have been used for many years as an alternative for oestrogen therapy in the treatment ofvarious menopausal symptoms. Among these compounds, the best known are isoflavones. However, also otherbiologically active compounds, that are present in herbs, should be taken into account as potential therapeuticagents. The growing number of reports has confirmed favourable effects of plants belonging to the Agrimoniagenus. Three species of them occur in Poland: Agrimonia eupatoria L., Agrimonia pilosa Ledeb., and Agrimoniaprocera Wallr. In the present review, the available data and recent findings on the potential use of differentplants from Agrimonia genus in prevention and therapy of various disturbances of the inflammatory systemand cardiovascular disorders are described. One of the most important aspects of the medicinal application ofAgrimonia plants is their possible role in the protection of the cardiovascular system against changes associatedwith menopause

CO Oxidation over Pd Catalyst Supported on Porous TiO2 Prepared by Plasma Electrolytic Oxidation (PEO) of a Ti Metallic Carrier

A porous TiO2 layer was prepared with the plasma electrolytic oxidation (PEO) of Ti. In a further step, Pd was deposited on the TiO2 surface layer using the adsorption method. The activity of the Pd/TiO2/Ti catalyst was investigated during the oxidation of CO to CO2 in a mixture of air with 5% CO. The structure of the catalytic active layer was studied using a scanning electron microscope equipped with an energy dispersive spectrometer (SEM-EDS), time-of-flight secondary ion mass spectrometry (TOF-SIMS), inductively coupled plasma mass spectrometry (ICP-MS), and X-ray diffraction (XRD). The PEO process provided a porous TiO2 layer with a uniform thickness in the range of 5–10 µm, which is desirable for the production of Pd-supported catalysts. A TOF-SIMS analysis showed the formation of Pd nanoparticles after the adsorption treatment. The conversion of CO to CO2 in all samples was achieved at 150–280 °C, depending on the concentration of Pd. The composition of Pd/ TiO2/Ti was determined using ICP-MS. The optimum concentration of Pd on the surface of the catalyst was approximately 0.14% wt. This concentration was obtained when a 0.4% PdCl2 solution was used in the adsorption process. Increasing the concentration of PdCl2 did not lead to a further improvement in the activity of Pd/ TiO2/Ti

Enhancing biogas plant production using pig manure and corn silage by adding wheat straw processed with liquid hot water and steam explosion

Abstract Background Pig manure utilization and valorization is an important topic with tightening regulations focused on ecological and safety issues. By itself pig manure is a poor substrate for biogas production because of its excessive nitrogen content relative to available organic carbon. Such substrate is alkaline, and methanogenesis can be suppressed, and so additional substrates with high organic carbon must be added. The most promising is straw, which is available from adjacent biogas plant cultures. However, the abundant lignocellulosic biomass of wheat straw undergoes slow decomposition, and only a fraction of the chemical energy can be converted into biogas; thus economical methods for pretreatment increasing bioavailability are sought. Results A method was investigated to increase the methane yield in a full-scale plant for co-fermenting pig manure with corn silage, which was the default substrate in the original source reactors. Increased lignocellulosic bioavailability of wheat straw was achieved by combining liquid hot water (LHW) and steam explosion (SE). According to FT-IR analysis, the treatment resulted in hemicellulose hydrolysis, partial cellulose depolymerization, and lignin bond destruction. Low-mass polysaccharides (0.6 × 103 g mol−1) had significantly higher concentration in the leachate of LHW-SE wheat straw than raw wheat straw. The methanogenic potential was evaluated using inoculum from two different biogas plants to study the influence of microorganism consortia. The yield was 24–34% higher after the pretreatment process. In a full-scale biogas plant, the optimal conditions were ~ 165 °C, ~ 2.33 MPa, and 10 min in LHW and ~ 65 °C and ~ 0.1 MPa for SE. The processes did not generate detectable inhibitors according to GC–MS analysis, such as furfural and 5-hydroxymethylfurfural. Conclusions The LHW-SE combined pretreatment process increases the bioavailability of carbohydrates from wheat straw. The LHW-SE treated wheat straw gave similar biogas yields to corn silage, thus enables at least partial replacement of corn silage and is good for diversification of substrates. Surprisingly, microorganisms consortia from other biogas plant fed with other substrates may have higher efficiency in utilization of tested substrate. Thus, methanogenic consortia may be considered in the process of optimization at industrial scale. The efficiency was calculated, and the LHW-SE may be profitable at full industrial scale and further optimization is proposed

Zn Modification of Pd/TiO2/Ti Catalyst for CO Oxidation

The main goal of this study was to modify the activity of Pd/TiO2/Ti catalyst in the reaction of CO oxidation by the addition of Zn. Plasma electrolytic oxidation (PEO) of Ti wire was conducted to produce a uniform porous layer of TiO2. A mixture of Pd and Zn was then introduced by means of adsorption. After reduction treatment, the activity of the samples was examined by oxidation of 5% CO in a temperature range from 80–350 °C. Model catalysts with sufficient amounts of the metals for physico-chemical investigation were prepared to further investigate the reaction between Pd and Zn during CO oxidation. The structures and compositions of the samples were investigated using scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS), time-of-flight secondary ion mass spectrometry (TOF-SIMS), inductively coupled plasma mass spectrometry (ICP-MS), Fourier transform infrared (FTIR), and X-ray diffraction (XRD). Modification of Pd/TiO2/Ti catalyst by Zn with a Pd:Zn atomic ratio of 2:1 decreased the temperature of complete CO oxidation from 220 °C for Pd/TiO2/Ti to 180 °C for Pd-Zn/TiO2/Ti. The temperature of 50% CO conversion on Pd-Zn(2:1)/TiO2/Ti was around 55 °C lower than in the reaction on monometallic Pd catalyst. The addition of Zn to the Pd catalyst lowered the binding energy of CO on the surface and improved the dissociative adsorption of oxygen, facilitating the oxidation of CO. FTIR showed that the bridging form of adsorbed CO is preferred on bimetallic systems. Analysis of the surface compositions of the samples (SEM-EDS, TOF-SIMS) showed higher amounts of oxygen on the bimetallic systems