The δ18O and δD isoscapes of recent groundwater in Poland

Considering the country’s development and quality of life, recognition of the water cycle mechanism is of great importance. A significant contribution to this comes from the isotopic composition of particular elements of the water cycle. However, a weak point is that in Poland only one element of the water cycle, precipitation, is sampled and measured over more than 312 thousands km2 at a single station. It is therefore necessary to seek extension of or alternatives for these rare data. Such an alternative is the sampling of groundwater containing tritium in the national monitoring network of groundwater bodies that is maintained by the Polish Geological Institute. Based on such data we have constructed δ18O and δD isoscapes (i.e., maps of δ18O and δD values) of recent groundwater. These data provide spatial distribution of δ18O and δD values which can be used as input to hydrogeological models

Cardiovascular risk management in type 2 diabetes of more than 10-year duration: Results of Polish ARETAEUS2-Grupa Study

Background: ARETAEUS 1 study showed that a great majority of patients with type 2 dia­betes mellitus (T2DM) of short duration did not meet all of the treatment goals. Since then the treatment goals in T2DM have been changed. The aim of the ARETAEUS 2-Grupa Study was to assess cardiovascular (CV) risk management and meeting treatment goals in the population of T2DM of more than 10-year duration. Methods: ARETAEUS2-Grupa was a cross-sectional questionnaire-based study conducted in Poland in 2012. Randomly selected physicians recruited 1,740 patients with T2DM diag­nosed more than 10 years before the study. Results: Lipid treatment goals were met respectively: for total cholesterol in 34.5% of all patients, triglycerides in 53.8%, low density lipoprotein cholesterol (LDL-C) in 26.5% and high density lipoprotein cholesterol (HDL-C) in 38.2%. Most of patients with and without coronary artery disease were receiving aspirin (90.3% and 60%, respectively) and statins (84.4% and 67.7%, respectively). The current blood pressure (BP) goal (140/90 mm Hg) was met in 43.5% of pa­tients and the previous goal (< 130/80 mm Hg) in 12.4%. The patients were mainly treated with ≥ 3 antihypertensive drugs. All treatment goals (for HbA1c, BP and LDL-C) were reached only by 8.2% of patients, any two goals by 26.3% of patients, one goal by 39.8% of patients, none by 25.6% of patients. Conclusions: The new less restrictive treatment goals are reached more frequently but still much is to be done in the field of clinical practice guidelines implementation and CV prevention in T2DM population

Relationship between mitral leaflets angles, left ventricular geometry and mitral deformation indices in patients with ischemic mitral regurgitation: imaging by echocardiography and cardiac magnetic resonance

Chronic ischemic mitral regurgitation (IMR) is associated with a markedly worse prognosis after myocardial infarction (MI).The study aimed to evaluate the relationship between anterior and posterior mitral leaflet angle (MLA) values, left ventricle remodeling and severity of ischaemic mitral regurgitation (IMR). Methods: Forty-two patients (age 63.5 ± 9.7 years, 36 men) with chronic IMR (regurgitant volume, RV > 20 ml; >6 months after MI) underwent transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR) imaging. Anterior and posterior MLA, determined by echocardiography, were correlated with indices of LV remodeling, mitral apparatus deformation and IMR severity by CMR. The anterior and posterior MLA was 25.41 ± 4.28 and 38.37 ± 8.89° (mean ± SD). In 5 patients (11.9%) the posterior MLA was ≥45°. There was a significant correlation between anterior MLA and RV (r = 0.74, P = 0.01). For patients with RV > 30 ml this correlation was stronger (r = 0.97, P = 0.005) and, in addition, there was a correlation between the RV and posterior MLA (r = 0.90, P = 0.037), between tenting area and posterior MLA (r = 0.90, P = 0.04), and between tenting area and anterior MLA (r = 0.82, P = 0.08). With regard to LV remodeling parameters, there was weaker but significant correlation between posterior MLA and LV end-diastolic volume index (r = 0.35, P = 0.031), LV end-systolic volume index (r = 0.37, P = 0.021), stroke volume (r = 0.35, P = 0.03), sphericity index (r = 0.33, P = 0.041). Anterior MLA correlated with wall motion score index (r = 0.41, P = 0.019). Besides, there was a correlation between posterior MLA and left atrial volume (r = 0.41, P = 0.012). Measurement of anterior and posterior MLA may play an important role in evaluating patients with IMR

Management and treatment goals in Polish patients with type 2 diabetes of more than ten years’ duration — results of ARETAEUS2-Grupa Study

Wstęp: W poprzednich badaniach wykazano niewystarczającą kontrolę choroby u chorych na cukrzycę. Polskie Towarzystwo Diabetologiczne zmieniło wartości docelowe HbA1c i ciśnienia tętniczego u chorych na cukrzycę w wytycznych z 2011 roku, które zostały utrzymane w kolejnych edycjach wytycznych. Badanie przeprowadzono w celu oceny leczenia cukrzycy i wyboru metod leczenia u chorych na cukrzycę typu 2 o czasie trwania > 10 lat oraz określenia stopnia spełniania kryteriów kontroli cukrzycy zalecanych w wytycznych Polskiego Towarzystwa Diabetologicznego z 2012 roku.Materiał i metody: Badanie ARETAEUS2-Grupa było przekrojowym badaniem kwestionariuszowym przeprowadzonym w Polsce w 2012 roku (kwiecień–czerwiec). Badaniem objęto 1740 chorych na cukrzycę typu 2 w każdym wieku i obu płci rozpoznaną ponad 10 lat przed rozpoczęciem badania, włączonych do badania przez losowo wybranych lekarzy.Wyniki: Wszyscy chorzy otrzymywali leczenie farmakologiczne, większość — leczenie skojarzone lub insulinę w monoterapii. 40% chorych spełniło kryterium kontroli HbA1c (≤ 7%), a mediana odsetka HbA1c była powyżej zalecanej wartości (7,2%). W całej populacji jedynie 8% chorych spełniło wszystkie kryteria kontroli choroby (HbA1c, ciśnienie tętnicze i profil lipidowy), 26% — dwa z tych kryteriów, 40%— jedno z tych kryteriów. Ponad 25% chorych nie spełniło żadnego z tych kryteriów.Wnioski: Zaobserwowano duże odstępstwa od celów leczenia zalecanych w aktualnych wytycznych postępowania u chorych na cukrzycę typu 2 o czasie trwania > 10 lat. Częstość występowania sercowo-naczyniowych czynników ryzyka i późnych powikłań cukrzycy była duża, a stosunkowo duży odsetek chorych nie był badany w kierunku późnych powikłań cukrzycy.Introduction: Previous studies have shown insufficient diabetes control in patients with type 2 diabetes (T2DM). Diabetes Poland changed the target HbA1c and blood pressure (BP) values in diabetic patients in their practice guidelines in 2011, that were further sustained. To assess the management and treatment choices in T2DM of more than ten years’ duration and the degree to which diabetic control criteria recommended by the Diabetes Poland clinical practice guidelines 2012 are being met.Material and methods: ARETAEUS2-Grupa was a cross-sectional questionnaire-based study conducted in Poland in 2012 (April–June). It involved 1,740 patients of any age and both genders, with T2DM diagnosed more than ten years before the study, and recruited by randomly selected physicians.Results: All patients received pharmacological treatment, most of them combination therapy or insulin in monotherapy. 40% of patients met the goal for HbA1c control (≤ 7%) and the median value of HbA1c was above the recommended threshold (7.2%). Only 8% of thetotal population met all three goals (HbA1c, BP and lipid levels), 26% — two goals, and 40% — only one goal. Over 25% of patients did not meet any of the treatment goals.Conclusions: We observed considerable deviations from treatment targets recommended by current clinical practice guidelines for patients with T2DM of more than ten years’ duration. The frequency of cardiovascular risk factors and late diabetes complications was high, while a relatively high percentage of patients was not examined for late diabetes complications

Relativistic Effects in the Scalar Meson Dynamics

A separable potential formalism is used to describe the $\pi\pi$ and $K\overline{K}$ interactions in the scalar-isoscalar states in the energy range from the $\pi\pi$ threshold up to 1.4 GeV. Introduction of relativistic propagators into a system of Lippmann-Schwinger equations leads to a very good description of the data ($\chi^{2}=0.93$ per one degree of freedom). Three poles are found in this energy region: fo(500) ($M=506\pm 10$ MeV, $\Gamma=494\pm 5$ MeV), fo(975) ($M=973\pm 2$ MeV, $\Gamma=29\pm 2$ MeV) and fo(1400) ($M=1430\pm 5$ MeV, $\Gamma=145\pm 25$ MeV). The fo(975) state can be interpreted as a $K\overline{K}$ bound state. The fo(500) state may be associated with the often postulated very broad scalar resonance under the $K\overline{K}$ threshold (sometimes called $\sigma$ or $\epsilon$ meson). The scattering lengths in the $\pi\pi$ and $K\overline{K}$ channels have also been obtained. The relativistic approach provides qualitatively new results (e.g. the appearance of the fo(500)) in comparison with previously used nonrelativistic approach.Comment: 30 pages in LaTeX + 5 figures available on request. Preprint Orsay No IPNO/TH 93-3