The prevalence of primary aldosteronism (PA) in a group of 350 hypertensive patients

Background Hypertension is one of the commonest diseases worldwide. Its prevalence is estimated to approximately 25% of the population. In addition, hypertension is an important risk factor for increased cardiovascular events. In most cases it is of idiopathic origin, but may also be due to another disease, e.g. endocrine dysfunction. Primary aldosteronism (PA) is a common cause of resistant hypertension; its proper diagnosis determines further therapy.The aim of this study was to evaluate the prevalence of PA in a group of 350 patients (240 women and 110 men) with hypertension.Material and methods All patients underwent hormonal tests including assessment of the levels of: ACTH, cortisol (baseline and in dexamethasone suppression test), DHEA-S, chromogranin A, VMA urine excretion, aldosterone and active renin. Afterwards, an intravenous load test with 0.9% neutral saline solution was performed. Abdominal ultrasound was performed in all patients, and abdominal computed tomography only in patients with abnormal hormonal tests. Other forms of secondary hypertension were previously excluded.Results Primary aldosteronism was diagnosed in 58 patients (16.6%) — 38 women and 20 men. Adrenal adenoma was found in 20 patients (34.5%), and idiopathic hyperaldosteronism in 38 patients (65.5%). Hypokalaemia occurred in 25 patients (43.1%). Moreover, it was found that the aldosterone-renin ratio above 8.25 supports the diagnosis of PA.Conclusion We conclude that the diagnosis of PA should not be limited only to the hypertensive patient with hypokalaemia. PA is an important cause of hypertension, especially among patients with difficulties in normalization of blood pressure with standard pharmacological treatment.Background Hypertension is one of the commonest diseases worldwide. Its prevalence is estimated to approximately 25% of the population. In addition, hypertension is an important risk factor for increased cardiovascular events. In most cases it is of idiopathic origin, but may also be due to another disease, e.g. endocrine dysfunction. Primary aldosteronism (PA) is a common cause of resistant hypertension; its proper diagnosis determines further therapy.The aim of this study was to evaluate the prevalence of PA in a group of 350 patients (240 women and 110 men) with hypertension.Material and methods All patients underwent hormonal tests including assessment of the levels of: ACTH, cortisol (baseline and in dexamethasone suppression test), DHEA-S, chromogranin A, VMA urine excretion, aldosterone and active renin. Afterwards, an intravenous load test with 0.9% neutral saline solution was performed. Abdominal ultrasound was performed in all patients, and abdominal computed tomography only in patients with abnormal hormonal tests. Other forms of secondary hypertension were previously excluded.Results Primary aldosteronism was diagnosed in 58 patients (16.6%) — 38 women and 20 men. Adrenal adenoma was found in 20 patients (34.5%), and idiopathic hyperaldosteronism in 38 patients (65.5%). Hypokalaemia occurred in 25 patients (43.1%). Moreover, it was found that the aldosterone-renin ratio above 8.25 supports the diagnosis of PA.Conclusion We conclude that the diagnosis of PA should not be limited only to the hypertensive patient with hypokalaemia. PA is an important cause of hypertension, especially among patients with difficulties in normalization of blood pressure with standard pharmacological treatment

The prevalence of high blood pressure as one of cardiovascular risk factors among women with polycystic ovary syndrome

Background Polycystic ovary syndrome (PCOS) is one of the commonest endocrinopathy diagnosed among women mainly at reproductive age. For the first time it was described by Stein and Leventhal in 1935 and defined by two of the three findings: irregular menses (oligo-/amenorrhoea), hyperandrogenism or polycystic ovaries appearance on ultrasound, provided that other causes of androgen excess and dysovulation are excluded. PCOS is very often associated with infertility, endometrium cancer, obesity, insulin resistance, impaired glucose metabolism, higher risk for type 2 diabetes, high blood pressure, impaired lipid profile, mental illnesses and non-alcoholic liver steatosis. The presence of some of mentioned conditions may exacerbate the risk of cardiovascular events in women with PCOS [1, 2].The main goal of our study was to assess the frequency of hypertension among women with PCOS.Material and methods Retrospective analysis of medical records of 213 women, age 17–42 (mean 25 ± 6 years).Results Twenty-two women (10%) in examined group suffered from hypertension. The incidence of elevated blood pressure was higher among women with insulin resistance (p = 0.006). Prevalence odds ratio (OR) of arterial hypertension in the group with hyperprolactinaemia was 0.15 (confidence interval [CI] 0.06–0.37) and in the group with insulin resistance (OR) 1.05 (CI 0.61–1.83).Conclusion The prevalence of hypertension among women with PCOS is higher when compared with healthy women at the same age. Thus, due to the young age of enrolled patients, it seems reasonable to recommend extension of the diagnostics of PCOS with blood pressure assessment.Background Polycystic ovary syndrome (PCOS) is one of the commonest endocrinopathy diagnosed among women mainly at reproductive age. For the first time it was described by Stein and Leventhal in 1935 and defined by two of the three findings: irregular menses (oligo-/amenorrhoea), hyperandrogenism or polycystic ovaries appearance on ultrasound, provided that other causes of androgen excess and dysovulation are excluded. PCOS is very often associated with infertility, endometrium cancer, obesity, insulin resistance, impaired glucose metabolism, higher risk for type 2 diabetes, high blood pressure, impaired lipid profile, mental illnesses and non-alcoholic liver steatosis. The presence of some of mentioned conditions may exacerbate the risk of cardiovascular events in women with PCOS [1, 2].The main goal of our study was to assess the frequency of hypertension among women with PCOS.Material and methods Retrospective analysis of medical records of 213 women, age 17–42 (mean 25 ± 6 years).Results Twenty-two women (10%) in examined group suffered from hypertension. The incidence of elevated blood pressure was higher among women with insulin resistance (p = 0.006). Prevalence odds ratio (OR) of arterial hypertension in the group with hyperprolactinaemia was 0.15 (confidence interval [CI] 0.06–0.37) and in the group with insulin resistance (OR) 1.05 (CI 0.61–1.83).Conclusion The prevalence of hypertension among women with PCOS is higher when compared with healthy women at the same age. Thus, due to the young age of enrolled patients, it seems reasonable to recommend extension of the diagnostics of PCOS with blood pressure assessment

Interpretacja elektrokardiogramu u sportowców wyczynowych

Background: The Ministry of Health in Poland recommends electrocardiogram (ECG)-based cardiovascular screening in athletes, but so far there has been a lack of guidelines on preparticipation assessment. We compared different criteria of ECG screening assessment in a group of top-level athletes. Aim: The aims were to evaluate the prevalence of ECG changes in athletes that necessitate further cardiological work-up according to three criteria in various age groups as well as to identify factors determining the occurrence of changes related and unrelated to the training. Methods: 262 high-dynamic, high-static Polish athletes (rowers, cyclists, canoeists) were divided into two age categories: young (≤ 18 years of age; n = 177, mean age 16.9 ± 0.8; 15–18 years) and elite (> 18 years of age; n = 85, mean age 22.9 ± 3.4; 19–34 years). All sports persons had a 12-lead ECG performed and evaluated according to 2010 European Society of Cardiology (ESC) recommendations, 2012 Seattle criteria, and 2014 Refined criteria. Results: The Refined criteria reduced (p < 0.001) the number of training-unrelated ECG findings to 8.0% vs. 12.6% (Seattle criteria) and 30.5% (ESC recommendations). All three criteria revealed more training-related changes in the group of older athletes (76.5% vs. 55.9%, p = 0.001). Predictors that significantly (p < 0.005) affected the occurrence of adaptive changes were the age of the athlete, training duration (in years), and male gender. Conclusions: 1. The ESC criteria identified a group of athletes that was unacceptably large, as for the screening test, requiring verification with other methods (every fourth athlete). 2. The use of the Refined criteria helps to significantly reduce the frequency and necessity for additional tests. 3. The dependence of adaptive changes on training duration and athletes’ age confirms the benign nature of those ECG findings.  Wstęp: Ministerstwo Zdrowia w Polsce rekomenduje wykonywanie elektrokardiograficznych (EKG) badań przesiewowych u sportowców, wciąż jednak brakuje wytycznych na temat tego, które kryteria powinno się stosować w ocenie EKG sportowca. Porównano zatem różne kryteria oceny EKG u polskich sportowców trenujących w wymiarze wyczynowym. Cel: Celem pracy była ocena częstości występowania zmian w EKG niezwiązanych z treningiem, wymagających dalszej diagnostyki zgodnie z trzema wybranymi kryteriami oceny EKG w dwóch grupach wiekowych. Ponadto podjęto próbę zidentyfikowania czynników determinujących występowanie zmian związanych i niezwiązanych z treningiem. Metody: 262 polskich sportowców obciążonych największym wysiłkiem dynamicznym i statycznym (wioślarze, kolarze, kajakarze) zostało podzielonych na dwie grupy wg wieku: młodzi (≤ 18 rż.; n = 177, średnia wieku 16,9 ± 0,8 roku; 15–18 lat) oraz dojrzali (> 18 rż.; n = 85, średnia wieku 22,9 ± 3,4 roku; 19–34 lat). U wszystkich sportowców wykonano 12-odprowadzeniowe EKG, które ocenione wg wzorców zawartych w rekomendacjach Europejskiego Towarzystwa Kardiologicznego (ESC) z 2010 r., kryteriów Seattle z 2012 r. oraz kryteriów Refined z 2014 r. Wyniki: Kryteria Refined obniżyły (p < 0,001) liczbę zmian niezwiązanych z treningiem do 8,0% vs. 12,6% (kryteria Seattle) oraz 30,5% (rekomendacje ESC). Wszystkie trzy kryteria pokazały, że zmiany związane z treningiem występują częściej w grupie starszych sportowców (76,5% vs. 55,9%; p = 0,001). Czynnikami wpływającymi (p < 0,005) na występowanie zmian związanych z treningiem w EKG okazały się: wiek sportowca, czas trwania treningu (w latach) i płeć męska. Wnioski: 1. Ocena wg kryteriów ESC pozwoliła na zidentyfikowanie nieakceptowalnie dużej grupy sportowców wymagających dalszej diagnostyki kardiologicznej (co czwarty badany sportowiec). 2. Zastosowanie kryteriów Refined istotnie zmniejszyło częstość i konieczność wykonywania dodatkowych badań. 3. Zależność częstości występowania zmian związanych z treningiem od czasu trwania treningu oraz od wieku sportowca potwierdza łagodny charakter tych zmian w EKG.

Universal Dependencies 2.3

Universal Dependencies is a project that seeks to develop cross-linguistically consistent treebank annotation for many languages, with the goal of facilitating multilingual parser development, cross-lingual learning, and parsing research from a language typology perspective. The annotation scheme is based on (universal) Stanford dependencies (de Marneffe et al., 2006, 2008, 2014), Google universal part-of-speech tags (Petrov et al., 2012), and the Interset interlingua for morphosyntactic tagsets (Zeman, 2008)