Influence of genetic factors on early hypertensive complications

Choroby układu krążenia są główną przyczyną zachorowalności, zgonów i inwalidztwa w rozwiniętych krajach świata. Najważniejszym czynnikiem ryzyka prowadzącym do rozwoju powikłań narządowych jest nadciśnienie tętnicze. Niniejszy artykuł jest poświęcony głównie powikłaniom naczyniowym (zaburzenia funkcji śródbłonka i przebudowa ściany tętnic) oraz mikroalbuminurii. W pracy opisano aktualny stan wiedzy o wpływie wybranych czynników genetycznych na predyspozycję do rozwoju powikłań nadciśnienia tętniczego. Czynniki te obejmują warianty polimorficzne genów kandydatów, zaangażowanych między innymi w regulację ciśnienia krwi, hemostazę, stres oksydacyjny i proces zapalny. Stwierdzenie predyspozycji genetycznej do rozwoju wczesnych powikłań sercowo-naczyniowych jest niezwykle istotnym czynnikiem ryzyka wystąpienia poważniejszych powikłań — zawału serca czy udaru mózgu — i może zrewolucjonizować metody diagnostyki chorób, oceny ryzyka i prognozowania oraz wyboru terapii. Nadciśnienie Tętnicze 2011, tom 15, nr 2, strony 125–142.Hypertension is the most prevalent risk factor for cardiovascular disease (CVD), the leading cause of death worldwide, especially in developed countries. Genetic and environmental determinants play important roles in hypertension and its complications. This publication gives a short introduction to the pathogenesis of CVD and summarizes the current findings of the genetic factors involved. This review focuses on a better understanding of the role of candidate genes polymorphisms that play a crucial role in blood pressure regulation, hemostatic processes, oxidative stress and inflammatory responses leading to endothelial damage, and as a result, to vascular remodeling and microalbuminuria. Those gene variants could contribute to inter-individual differences in susceptibility to and outcome of essential hypertension. Therefore, the major challenge in cardiovascular medicine is to find a way of predicting the risk of hypertension complications by genetic markers that, used with imaging techniques, could lead to the development of new and better diagnostic and therapeutic methods. Arterial Hypertension 2011, vol. 15, no 2, pages 125–142

Epilepsy and hypertension: The possible link for sudden unexpected death in epilepsy?

Epilepsy affects about 50 million people worldwide. Sudden unexpected death in epilepsy (SUDEP) is the main cause of death in epilepsy accounting for up to 17% of all deaths in epileptic patients, and therefore remains a major public health problem. SUDEP likely arises from a combination and interaction of multiple risk factors (such as being male, drug resistance, frequent generalized tonic-clonic seizures) making risk prediction and mitigation challenging. While there is a general understanding of the physiopathology of SUDEP, mechanistic hypotheses linking risk factors with a risk of SUDEP are still lacking. Identifying cross-talk between biological systems implicated in SUDEP may facilitate the development of improved models for SUDEP risk assessment, treatment and clinical management. In this review, the aim was to explore an overlap between the pathophysiology of hypertension, cardiovascular disease and epilepsy, and discuss its implication for SUDEP. Presented herein, evidence in literature in support of a cross-talk between the renin–angiotensin system (RAS) and sympathetic nervous system, both known to be involved in the development of hypertension and cardiovascular disease, and as one of the underlying mechanisms of SUDEP. This article also provides a brief description of local RAS in brain neuroinflammation and the role of centrally acting RAS inhibitors in epileptic seizure alleviation

System wieloaspektowej analizy ksiąg urodzeń, małżeństw i zgonów (na przykładzie parafii Osieczna, lata 1794 – 1874)

Pozna

Robotic observation pipeline for small bodies in the solar system based on open-source software and commercially available telescope hardware

The observation of small bodies in the Space Environment is an ongoing important task in astronomy. While nowadays new objects are mostly detected in larger sky surveys, several follow-up observations are usually needed for each object to improve the accuracy of orbit determination. In particular objects orbiting close to Earth, so called Near-Earth Objects (NEOs) are of special concern as a small but not negligible fraction of them can have a non-zero impact probability with Earth. Additionally, the observation of manmade space debris and tracking of satellites falls in the same class measurements. Telescopes for these follow-up observations are mainly in a aperture class between 1 m down to approximately 25 cm. These telescopes are often hosted by amateur observatories or dedicated companies like 6ROADS specialized on this type of observation. With upcoming new NEO search campaigns by very wide field of view telescopes, like the Vera C. Rubin Observatory, NASA’s NEO surveyor space mission and ESA’s Flyeye telescopes, the number of NEO discoveries will increase dramatically. This will require an increasing number of useful telescopes for follow-up observations at different geographical locations. While well-equipped amateur astronomers often host instruments which might be capable of creating useful measurements, both observation planning and scheduling, and also analysis are still a major challenge for many observers. In this work we present a fully robotic planning, scheduling and observation pipeline that extends the widely used open-source cross-platform software KStars/Ekos for Instrument Neutral Distributed Interface (INDI) devices. The method consists of algorithms which automatically select NEO candidates with priority according to ESA’s Near-Earth Object Coordination Centre (NEOCC). It then analyses detectable objects (based on limiting magnitudes, geographical position, and time) with preliminary ephemeris from the Minor Planet Center (MPC). Optimal observing slots during the night are calculated and scheduled. Immediately before the measurement the accurate position of the minor body is recalculated and finally the images are taken. Besides the detailed description of all components, we will show a complete robotic hard- and software solution based on our methods.TS-R acknowledges funding from the NEO-MAPP project (H2020-EU-2-1-6/870377). This work was (partially) funded by the Spanish MICIN/AEI/10.13039/501100011033 and by “ERDF A way of making Europe” by the “European Union” through grant RTI2018-095076-B-C21, and the Institute of Cosmos Sciences University of Barcelona (ICCUB, Unidad de Excelencia “María de Maeztu”) through grant CEX2019-000918-M

C-reactive protein is not related to ambulatory blood pressure or target organ damage in treated hypertensives

Background Publication of the JUPITER trial has renewed the interest in the use of CRP in cardiovascular risk prediction. The aim of the study was to assess the relationship between CRP, ambulatory blood pressure and target organ damage in a cohort of treated hypertensive males without overt cardiovascular disease.Materials and methods The studied group consisted of 299 male hypertensive patients. Patients were stratified into low (≤ 2 mg/L), intermediate (2–5 mg/L), and high (> 5 mg/L) CRP groups. We measured ambulatory blood pressure, pulse wave velocity, left ventricular function and structure, carotid intima media thickness and ankle-brachial index.Results Twenty-six percent of the patients had CRP in the range of 2 to 5 mg/L, and 12% had CRP levels exceeding 5 mg/L. Ambulatory blood pressure and heart rate were not different across the three groups. Patients with high CRP had lower HDL cholesterol levels and higher plasma fibrinogen levels. Carotid femoral pulse wave velocity, carotid intima media thickness and ankle-brachial index were not different across the three groups. Echocardiographic data were also not related to the CRP level.Conclusions1. Elevated levels of CRP are frequently observed among treated patients with hypertension.2. CRP elevation is associated with higher fibrinogen and glucose levels, and lower HDL cholesterol independently of obesity and smoking status.3. Elevated CRP levels are not related to ambulatory blood pressure profile or target organ damage severity.4. Our findings are consistent with the concept that CRP measurement is of limited value in cardiovascular assessment.Background Publication of the JUPITER trial has renewed the interest in the use of CRP in cardiovascular risk prediction. The aim of the study was to assess the relationship between CRP, ambulatory blood pressure and target organ damage in a cohort of treated hypertensive males without overt cardiovascular disease.Materials and methods The studied group consisted of 299 male hypertensive patients. Patients were stratified into low (≤ 2 mg/L), intermediate (2–5 mg/L), and high (> 5 mg/L) CRP groups. We measured ambulatory blood pressure, pulse wave velocity, left ventricular function and structure, carotid intima media thickness and ankle-brachial index.Results Twenty-six percent of the patients had CRP in the range of 2 to 5 mg/L, and 12% had CRP levels exceeding 5 mg/L. Ambulatory blood pressure and heart rate were not different across the three groups. Patients with high CRP had lower HDL cholesterol levels and higher plasma fibrinogen levels. Carotid femoral pulse wave velocity, carotid intima media thickness and ankle-brachial index were not different across the three groups. Echocardiographic data were also not related to the CRP level.Conclusions1. Elevated levels of CRP are frequently observed among treated patients with hypertension.2. CRP elevation is associated with higher fibrinogen and glucose levels, and lower HDL cholesterol independently of obesity and smoking status.3. Elevated CRP levels are not related to ambulatory blood pressure profile or target organ damage severity.4. Our findings are consistent with the concept that CRP measurement is of limited value in cardiovascular assessment

Hipoglikemia u pacjentów poddanych chirurgii metabolicznej — przegląd literatury

Bariatric surgery is currently the most effective method of obesity treatment, regardless of the method used. Compared to non-surgical methods, it ensures greater weight reduction and better control of comorbidities, especially type 2 diabetes. The complication of bariatric surgery, both with and without type 2 diabetes, is the presence of a significant decrease in blood glucose level — hypoglycaemia. In the early postoperative phase, it is mainly hypoglycaemia associated with the so-called ‘dumping syndrome’. Later (months or years after the surgery), it is mainly caused by endogenous hyperinsulinism (PBSH, post-bariatric surgery hypoglycaemia). The incidence of PBSH varies considerably, from 0.1–50% depending on the adopted criteria. The pathomechanism of this phenomenon is multifactorial and based, among others, on inadequate incretins secretion, in particular glucagon-like peptide 1, in response to a meal, modified hepatic glucose metabolism or reduction in ghrelin concentration. Due to incomplete understanding about the pathophysiology of this phenomenon, there are no treatment algorithms. Nevertheless, three therapeutic options can be distinguished: diet modification, pharmacotherapy, and surgical treatment.Chirurgia bariatryczna jest obecnie najbardziej skuteczną metodą leczenia otyłości, niezależnie od zastosowanej metody, ponieważ w porównaniu z metodami niechirurgicznymi zapewnia większą redukcję masy ciała oraz kontrolę nad chorobami współtowarzyszącymi, przede wszystkim cukrzycą typu 2. Istotnym powikłaniem zabiegów chirurgii metabolicznej, zarówno u chorych na cukrzycę typu 2, jak i u osób bez cukrzycy, jest występowanie hipoglikemii — we wczesnej fazie pooperacyjnej najczęściej związanej z tak zwanym zespołem poposiłkowym, później (kilka miesięcy lub lat po operacji) spowodowanej endogennym hiperinsulinizmem (PBSH, hipoglikemia występująca po zabiegach bariatrycznych). Częstość występowania PBSH znacznie się waha, wynosząc 0,1–50%, zależnie od przyjętych kryteriów. Patomechanizm tego zjawiska jest wieloczynnikowy i oparty między innymi na nieadekwatnym wydzielaniu inkretyn, w tym przede wszystkim glukagonopodobnego peptyd typu 1, w odpowiedzi na posiłek, zmodyfikowany metabolizm wątrobowy glukozy czy obniżenie stężenia greliny. W związku z brakiem dokładnej wiedzy na temat patofizjologii tego zjawiska brakuje jednoznacznych algorytmów leczenia. Niemniej można wyróżnić trzy opcje terapeutyczne: modyfikację diety, farmakoterapię i leczenie chirurgiczne

Beta cell replacement therapy

Beta cell replacement therapy is currently the only treatment method that allows restoration of physiological endogenous insulin secretion in the amounts corresponding to the current body requirements. Beta cell replacement options available for highly selected patients with brittle type 1 diabetes include solid- -organ pancreas and islet transplantation. Beta cell replacement therapy may be offered to patients with both good kidney function and renal failure. In progressive renal failure, beta cell transplantation may be performed simultaneously with kidney transplantation or afterwards. Islet autotransplantation is offered to patients submitted to total pancreatectomy. In patients with brittle type 1 diabetes who continue to experience life threatening severe hypoglycaemia episodes despite optimized insulin therapy, beta cell replacement helps improve hypoglycaemia awareness, thus reducing the risk of severe hypoglycaemia episodes, facilitates blood glucose control with normalization of haemoglobin A1c (HbA1c) level, and reduces microvascular disease progression. In patients undergoing total pancreatectomy, infusion of the patient’s own islets isolated from the removed pancreas prevents blood glucose level excursions and reduces the risk of surgically- -induced diabetes. In this article, we review the current indications and contraindications to beta cell replacement, expected benefits, and possible complications of beta cell transplantation.Beta cell replacement therapy is currently the only treatment method that allows restoration of physiological endogenous insulin secretion in the amounts corresponding to the current body requirements. Beta cell replacement options available for highly selected patients with brittle type 1 diabetes include solid- -organ pancreas and islet transplantation. Beta cell replacement therapy may be offered to patients with both good kidney function and renal failure. In progressive renal failure, beta cell transplantation may be performed simultaneously with kidney transplantation or afterwards. Islet autotransplantation is offered to patients submitted to total pancreatectomy. In patients with brittle type 1 diabetes who continue to experience life threatening severe hypoglycaemia episodes despite optimized insulin therapy, beta cell replacement helps improve hypoglycaemia awareness, thus reducing the risk of severe hypoglycaemia episodes, facilitates blood glucose control with normalization of haemoglobin A1c (HbA1c) level, and reduces microvascular disease progression. In patients undergoing total pancreatectomy, infusion of the patient’s own islets isolated from the removed pancreas prevents blood glucose level excursions and reduces the risk of surgically- -induced diabetes. In this article, we review the current indications and contraindications to beta cell replacement, expected benefits, and possible complications of beta cell transplantation

The importance of blood pressure measurements at the emergency department in detection of arterial hypertension

Background: Arterial hypertension (AH) is the most important modifiable risk factor for cardiovascular diseases in Poland and around the world. Unfortunately, despite its potentially catastrophic consequences, more than 30% of hypertensive patients in Poland remain undiagnosed. Therefore, emergency department (ED) triage may play a role in screening of a significant proportion of the population. The present study aimed to assess the prevalence of hypertension in patients reporting to the ED by verifying ad hoc measurements with ambulatory blood pressure monitoring (ABPM). Methods: The study included 78,274 patients admitted to the ED of the University Clinical Center in Gdansk from 01.01.2019 to 31.12.2020, with elevated blood pressure values (systolic blood pressure [SBP] > 140 mmHg and/or diastolic blood pressure [DBP] > 90 mmHg) during triage according to the inclusion and exclusion criteria. Results: Out of 34,597 patients with SBP > 140 mmHg and/or DBP > 90 mmHg, 27,896 patients (80.6% of patients) had previously been diagnosed with AH. Finally, a group of 6701 patients with elevated values of arterial blood pressure in triage, who had not yet been diagnosed with AH, was identified. This accounted for 8.6% of patients admitted to the ED. Ultimately, 58 patients (26 women and 36 men) agreed to undergo ABPM. Based on the analysis, AH 32 patients were diagnosed with AH (55.2%). Conclusions: The ED plays an essential role in diagnosing hypertension among people reporting to the ED for various reasons. There is a high probability of a diagnosis of AH in a group of patients who have elevated blood pressure values during triage and have not yet been diagnosed with hypertension

Comparison of composition of ultra-thin silicon oxynitride layers’ fabricated by PECVD and ultrashallow rf plasma ion implantation, Journal of Telecommunications and Information Technology, 2007, nr 3

In this paper differences in chemical composition of ultra-thin silicon oxynitride layers fabricated in planar rf plasma reactor are studied. The ultra-thin dielectric layers were obtained in the same reactor by two different methods: ultrashallow nitrogen implantation followed by plasma oxidation and plasma enhanced chemical vapour deposition (PECVD). Chemical composition of silicon oxynitride layers was investigated by means of X-ray photoelectron spectroscopy (XPS) and secondary ion mass spectrometry (SIMS). The spectroscopic ellipsometry was used to determine both the thickness and refractive index of the obtained layers. The XPS measurements show considerable differences between the composition of the fabricated layers using each of the above mentioned methods. The SIMS analysis confirms XPS results and indicates differences in nitrogen distribution