Sexual function in hypertensive patients receiving treatment

In many forms of erectile dysfunction (ED), cardiovascular risk factors, in particular arterial hypertension, seem to be extremely common. While causes for ED are related to a broad spectrum of diseases, a generalized vascular process seems to be the underlying mechanism in many patients, which in a large portion of clinical cases involves endothelial dysfunction, ie, inadequate vasodilation in response to endothelium-dependent stimuli, both in the systemic vasculature and the penile arteries. Due to this close association of cardiovascular disease and ED, patients with ED should be evaluated as to whether they may suffer from cardiovascular risk factors including hypertension, cardiovascular disease or silent myocardial ischemia. On the other hand, cardiovascular patients, seeking treatment of ED, must be evaluated in order to decide whether treatment of ED or sexual activity can be recommended without significantly increased cardiac risk. The guideline from the first and second Princeton Consensus Conference may be applied in this context. While consequent treatment of cardiovascular risk factors should be accomplished in these patients, many antihypertensive drugs may worsen sexual function as a drug specific side-effect. Importantly, effective treatment for arterial hypertension should not be discontinued as hypertension itself may contribute to altered sexual functioning; to the contrary, alternative antihypertensive regimes should be administered with individually tailored drug regimes with minimal side-effects on sexual function. When phosphodiesterase-5 inhibitors, such as sildenafil, tadalafil and vardenafil, are prescribed to hypertensive patients on antihypertensive drugs, these combinations of antihypertensive drugs and phosphodiesterase 5 are usually well tolerated, provided there is a baseline blood pressure of at least 90/60 mmHg. However, there are two exceptions: nitric oxide donors and α-adrenoceptor blockers. Any drug serving as a nitric oxide donor (nitrates) is absolutely contraindicated in combination with phosphodiesterase 5 inhibitors, due to significant, potentially life threatening hypotension. Also, α-adrenoceptor blockers, such as doxazosin, terazosin and tamsulosin, should only be combined with phosphodiesterase 5 inhibitors with special caution and close monitoring of blood pressure

Технология проведения очистки и диагностики магистрального нефтепровода "Восточная Сибирь-Тихий Океан" с использованием мобильных камер запуска-приема внутритрубных устройств

В выпускной квалификационной работе рассмотрена технология применения мобильных камер запуска-приема очистных устройств и диагностических снарядов на примере трубопровода "Восточная Сибирь - Тихий Океан. Рассчитана необходимая толщина стенки элементов камеры.In the final qualifying work, the technology of using mobile pig trap station was considered using the example of the "Eastern Siberia - Pacific Ocean" pipeline. The required thickness of the wall of the chamber elements was calculated

Проект установки водоподготовки в производстве метанола ООО «Сибметахим"

Объект исследования является система водоснабжения ООО «Сибметахим» г. Томск, которая включает очистку от взвешенных частиц, получение деминерализованной воды и турбинных конденсатов. Разрабатываемый проект стадии водоподготовки представляет собой комплекс сооружений, оборудования и трубопроводов обеспечивающих забор воды из реки Томь, очистку и ее обработку, транспортирование и подачу воды потребителю требуемых расходов и качества. Цель дипломного проекта является разработка усовершенствованной схемы очистки речной воды. Технологическая схема водоподготовительной установки включает механическую и физико-химическую очистку сточной воды. Основным аппаратом является ионообменные фильтры, размер и количество аппаратов было определенно исходя из материального баланса и аппаратурного расчета. Так же были проведены расчеты теплового баланса, гидравлического расчета, механического расчета. Экономическими показателями данного водоподготовительного цеха позволяет покрыть расходы на модернизацию в течении 95 месяцев.The object of study is the water supply system, OOO Sibmetahim" (Tomsk), which includes purification from suspended particles, obtaining demineralized water and turbine condensates. The project stage of water treatment is a complex of structures, equipment and pipelines to ensure water intake from the Tom river, cleaning and processing, transport and water supply of the required costs and quality. The goal of the graduation project is to develop an improved purification of river water. Technological scheme of water treatment plant includes the mechanical and physico-chemical treatment of waste water

Разработка и исследование автономной системы управления солнечной батареи

В данной работе выполнен анализ динамических характеристик системы ориентации солнечной батареи, осуществляющей слежение за перемещением солнца с использованием MatLab-моделирования. Отслеживание таких объектов возможно при условии знания его координат. Одним из требований, предъявляемых к следящему электроприводу, являются требования минимума статической и динамической ошибок позиционирования устройства. При эксплуатации систем слежения в удаленных местах так же появляется требование по сокращению потребления электроэнергии самой системы. Для снижения электропотребления необходимо уменьшать колебания антенны в режиме слежения.In this work, an analysis is made of the dynamic characteristics of a solar battery orientation system that monitors the movement of the sun using MatLab modeling. Tracking of such objects is possible under condition of knowledge of its coordinates. One of the requirements for a servomotor drive is the requirements of a minimum of static and dynamic device positioning errors. When operating tracking systems in remote locations, there is also a requirement to reduce the electricity consumption of the system itself. To reduce power consumption, it is necessary to reduce antenna oscillations in tracking mode

The association of serum testosterone levels and ventricular repolarization

It is assumed that testosterone is an important regulator of gender-related differences in ventricular repolarization. Therefore, our aim was to study whether serum levels of testosterone are associated with QTc, QT and RR interval variation. Setting: two independent population-based cohort studies. Participants: 445 male participants (≥55 years) from the Rotterdam study cohort and 1,428 male participants from the study of health in Pomerania (SHIP) with an electrocardiogram who were randomly sampled for assessment of serum testosterone at baseline, after exclusion of participants with testosterone altering drugs, QTc prolonging drugs or dig(it)oxin, left ventricular hypertrophy and left and right bundle branch block. Endpoints: length of the QTc, QT and RR intervals. Analysis: linear regression model, adjusted for the two individual studies and a pooled analysis of both studies. The pooled analysis of the Rotterdam study and SHIP showed that the QTc interval gradually decreased among the tertiles (P value for trend 0.024). The third tertile of serum testosterone was associated with a lower QTc interval compared to the first tertile [−3.4 ms (−6.5; −0.3)]. However, the third tertile of serum testosterone was not associated with a lower QT interval compared to the first tertile [−0.7 ms (−3.1; 1.8)]. The RR interval gradually increased among the tertiles (P value for trend 0.002) and the third tertile of serum testosterone showed an increased RR interval compared to the first tertile [33.5 ms (12.2; 54.8)]. In the pooled analysis of two population-based studies, serum testosterone levels were not associated with the QT interval, which could be due to a lack of power. Lower QTc intervals in men with higher serum testosterone levels could be due to the association of serum testosterone with prolongation of the RR interval

Abdominal aortic aneurysm is associated with a variant in low-density lipoprotein receptor-related protein 1

Abdominal aortic aneurysm (AAA) is a common cause of morbidity and mortality and has a significant heritability. We carried out a genome-wide association discovery study of 1866 patients with AAA and 5435 controls and replication of promising signals (lead SNP with a p value < 1 × 10-5) in 2871 additional cases and 32,687 controls and performed further follow-up in 1491 AAA and 11,060 controls. In the discovery study, nine loci demonstrated association with AAA (p < 1 × 10-5). In the replication sample, the lead SNP at one of these loci, rs1466535, located within intron 1 of low-density-lipoprotein receptor-related protein 1 (LRP1) demonstrated significant association (p = 0.0042). We confirmed the association of rs1466535 and AAA in our follow-up study (p = 0.035). In a combined analysis (6228 AAA and 49182 controls), rs1466535 had a consistent effect size and direction in all sample sets (combined p = 4.52 × 10-10, odds ratio 1.15 [1.10-1.21]). No associations were seen for either rs1466535 or the 12q13.3 locus in independent association studies of coronary artery disease, blood pressure, diabetes, or hyperlipidaemia, suggesting that this locus is specific to AAA. Gene-expression studies demonstrated a trend toward increased LRP1 expression for the rs1466535 CC genotype in arterial tissues; there was a significant (p = 0.029) 1.19-fold (1.04-1.36) increase in LRP1 expression in CC homozygotes compared to TT homozygotes in aortic adventitia. Functional studies demonstrated that rs1466535 might alter a SREBP-1 binding site and influence enhancer activity at the locus. In conclusion, this study has identified a biologically plausible genetic variant associated specifically with AAA, and we suggest that this variant has a possible functional role in LRP1 expression

Genetic associations at 53 loci highlight cell types and biological pathways relevant for kidney function.

Reduced glomerular filtration rate defines chronic kidney disease and is associated with cardiovascular and all-cause mortality. We conducted a meta-analysis of genome-wide association studies for estimated glomerular filtration rate (eGFR), combining data across 133,413 individuals with replication in up to 42,166 individuals. We identify 24 new and confirm 29 previously identified loci. Of these 53 loci, 19 associate with eGFR among individuals with diabetes. Using bioinformatics, we show that identified genes at eGFR loci are enriched for expression in kidney tissues and in pathways relevant for kidney development and transmembrane transporter activity, kidney structure, and regulation of glucose metabolism. Chromatin state mapping and DNase I hypersensitivity analyses across adult tissues demonstrate preferential mapping of associated variants to regulatory regions in kidney but not extra-renal tissues. These findings suggest that genetic determinants of eGFR are mediated largely through direct effects within the kidney and highlight important cell types and biological pathways