Effects of telmisartan and ramipril on adiponectin and blood pressure in patients with type 2 diabetes

<b>Background:</b> Adiponectin is secreted by adipose tissue and may play a role in cardiovascular disease. We examined adiponectin levels in patients with type 2 diabetes who participated in the Telmisartan vs. Ramipril in Renal Endothelial Dysfunction (TRENDY) study. <b>Methods</b> A total of 87 patients were assessed at baseline and following 9 weeks treatment with the angiotensin-receptor blocker telmisartan (final dose, 80 mg; n = 45) or the angiotensin-converting enzyme inhibitor ramipril (final dose, 10 mg; n = 42). Adiponectin levels were measured in plasma by radioimmunoassay. <b>Results:</b> Adiponectin levels were inversely correlated with systolic (SBP; r = -0.240, P < 0.05) and diastolic (DBP; r = -0.227, P < 0.05) blood pressure at baseline and following treatment with telmisartan or ramipril (SBP: r = -0.228, P < 0.05; DBP: r = -0.286, P < 0.05). Changes in adiponectin levels were related to changes in SBP (r = -0.357, P < 0.01) and DBP (r = -0.286, P < 0.01). There was a significant increase in adiponectin levels in the telmisartan (0.68 (95% confidence interval (CI), 0.27 to 1.10) <sup>µ</sup>g/ml, P < 0.01) but not in the ramipril group (0.17 (95% CI, -0.56 to 0.90) <sup>µ</sup>g/ml, P = 0.67). Blood pressure reduction in the telmisartan group (DeltaSBP: -13.5 (95% CI, -17.0 to -10.0) mm Hg; ΔDBP: -7.6 (95% CI, -9.8 to -5.3) mm Hg, each P < 0.001) was significantly (P less than or equal to 0.01 for SBP and P < 0.01 for DBP) greater than in the ramipril group (ΔSBP: -6.1 (95% CI, -6.2 to -2.0) mm Hg; ΔDBP: -2.7 (95% CI, -5.0 to -0.5) mm Hg; P < 0.01 and P < 0.05, respectively). <b>Conclusion:</b> Adiponectin is correlated with blood pressure in patients with type 2 diabetes. Whether increased adiponectin contributes to the blood pressure–lowering effect of telmisartan needs further study

Biosensing platform combining label-free and labelled analysis using Bloch surface waves

Bloch surface waves (BSW) propagating at the boundary of truncated photonic crystals (1D-PC) have emerged as an attractive approach for label-free sensing in plasmon-like sensor configurations. Due to the very low losses in such dielectric thin film stacks, BSW feature very low angular resonance widths compared to the surface plasmon resonance (SPR) case. Besides label-free operation, the large field enhancement and the absence of quenching allow utilizing BSW coupled fluorescence detection to additionally sense the presence of fluorescent labels. This approach can be adapted to the case of angularly resolved resonance detection, thus giving rise to a combined label-free / labelled biosensor platform. It features a parallel analysis of multiple spots arranged as a one-dimensional array inside a microfluidic channel of a disposable chip. Application of such a combined biosensing approach to the detection of the Angiopoietin-2 cancer biomarker in buffer solutions is reported

Hyperdiffusion as a Mechanism for Solar Coronal Heating

A theory for the heating of coronal magnetic flux ropes is developed. The dissipated magnetic energy has two distinct contributions: (1) energy injected into the corona as a result of granule-scale, random footpoint motions, and (2) energy from the large-scale, nonpotential magnetic field of the flux rope. The second type of dissipation can be described in term of hyperdiffusion, a type of magnetic diffusion in which the helicity of the mean magnetic field is conserved. The associated heating rate depends on the gradient of the torsion parameter of the mean magnetic field. A simple model of an active region containing a coronal flux rope is constructed. We find that the temperature and density on the axis of the flux rope are lower than in the local surroundings, consistent with observations of coronal cavities. The model requires that the magnetic field in the flux rope is stochastic in nature, with a perpendicular length scale of the magnetic fluctuations of order 1000 km.Comment: 9 pages (emulateapj style), 4 figures, ApJ, in press (v. 679; June 1, 2008

Reduction in Basal Nitric Oxide Activity Causes Albuminuria

OBJECTIVE-The barrier function of the glomerular filter has been studied for decades. Albuminuria reflects a malfunction of this barrier, and in animals dysfunctional endothelial nitric-oxide (NO) synthase results in albuminuria. We aimed to analyze the importance of NO for the glomerular barrier function in humans. RESEARCH DESIGN AND METHODS-To assess the effect of endothelial dysfunction on albuminuria, we measured the urine albumin-to-creatinine ratio (UACR) both before and after the blockade of NO synthases (NOSs) with systemic infusion of N-G-monomethyl-L-arginine (L-NMMA) in two distinct study populations. In population A, 62 hypertensive patients with type 2 diabetes and, in population B, 22 patients with hypercholesterolemia but without hypertension or type 2 diabetes were examined. All subjects had normal renal function. RESULTS-There was a significant increase in the UACR in response to NOS inhibition with L-NMMA in hypertensive patients with type 2 diabetes (study population A) and in patients with hypercholesterolemia (study population B). Linear regression analyses revealed that the change in mean arterial presssure in response to L-NMMA was not related to the increase in the UACR in response to L-NMMA in either population, even after adjusting for filtration fraction. CONCLUSIONS-NOS inhibition provokes albuminuria that is unrelated to changes in blood pressure. It is noteworthy that this finding was evident in patient groups prone to endothelial dysfunction and albuminuria. Thus, acute deterioration of endothelial function by reducing NO activity causes an increase in albuminuria. Diabetes 60:572-576, 201

Hypertension and atrial fibrillation: diagnostic approach, prevention and treatment. Position paper of the Working Group 'Hypertension Arrhythmias and Thrombosis' of the European Society of Hypertension.

Hypertension is the most common cardiovascular disorder and atrial fibrillation is the most common clinically significant arrhythmia. Both these conditions frequently coexist and their prevalence increases rapidly with aging. There are different risk factors and clinical conditions predisposing to the development of atrial fibrillation, but due its high prevalence, hypertension is still the main risk factor for the development of atrial fibrillation. Several pathophysiologic mechanisms (such as structural changes, neurohormonal activation, fibrosis, atherosclerosis, etc.) have been advocated to explain the onset of atrial fibrillation. The presence of atrial fibrillation per se increases the risk of stroke but its coexistence with high blood pressure leads to an abrupt increase of cardiovascular complications. Different risk models are available for the risk stratification and the prevention of thromboembolism in patients with atrial fibrillation. In all of them hypertension is present and is an important risk factor. Antihypertensive treatment may contribute to reduce this risk, and it seems some classes are superior to others in the prevention of new-onset atrial fibrillation and prevention of stroke. Antithrombotic treatment with warfarin is effective in the prevention of thromboembolic events, although quite recently, new classes of anticoagulants that do not require international normalized ratio monitoring have been introduced with promising results

New strategies to improve clinical outcomes for diabetic kidney disease

BACKGROUND: Diabetic kidney disease (DKD), the most common cause of kidney failure and end-stage kidney disease worldwide, will develop in almost half of all people with type 2 diabetes. With the incidence of type 2 diabetes continuing to increase, early detection and management of DKD is of great clinical importance. MAIN BODY: This review provides a comprehensive clinical update for DKD in people with type 2 diabetes, with a special focus on new treatment modalities. The traditional strategies for prevention and treatment of DKD, i.e., glycemic control and blood pressure management, have only modest effects on minimizing glomerular filtration rate decline or progression to end-stage kidney disease. While cardiovascular outcome trials of SGLT-2i show a positive effect of SGLT-2i on several kidney disease-related endpoints, the effect of GLP-1 RA on kidney-disease endpoints other than reduced albuminuria remain to be established. Non-steroidal mineralocorticoid receptor antagonists also evoke cardiovascular and kidney protective effects. CONCLUSION: With these new agents and the promise of additional agents under clinical development, clinicians will be more able to personalize treatment of DKD in patients with type 2 diabetes

The BNL EBIS Program: Status and plans

Recently an Electron Beam Ion Source (EBIS), on long term loan from Sandia National Laboratories, has been put into operation at Brookhaven National Laboratory. This source is being primarily used as a test device to answer questions relevant to the eventual design of an EBIS-based heavy ion preinjector for RHIC; a secondary objective is to determine parameters of an EBIS capable of delivering fully stripped light ions up to neon for medical applications. Such a source can easily produce all ions in charge states as needed, but the challenge lies in reaching intensities of interest to RHIC (2--3 {times} 10{sup 9} particles/pulse). The source studies are planned to address issues such as scaling of the electron beam current in stages up to 10 A, possible onset and control of instabilities, external ion injection, parametric studies of the ion yield, charge state distributions and emittance of the extracted ion beam, ion cooling in the trap, and other technical and physics issues

QED Calculation of E1M1 and E1E2 Transition Probabilities in One-Electron Ions with Arbitrary Nuclear Charge

The quantum electrodynamical theory of the two-photon transitions in hydrogenlike ions is presented. The emission probability for 2s1/2 -> 2E1+1s1/2 transitions is calculated and compared to the results of the previous calculations. The emission probabilities 2p12 -> E1E2+1s1/2 and 2p1/2 -> E1M1+1s1/2 are also calculated for the nuclear charge Z values 1-100. This is the first calculation of the two latter probabilities. The results are given in two different gauges.Comment: 14 pages, 4 tables, 1 figur

Multiwavelength Study on Solar and Interplanetary Origins of the Strongest Geomagnetic Storm of Solar Cycle 23

We study the solar sources of an intense geomagnetic storm of solar cycle 23 that occurred on 20 November 2003, based on ground- and space-based multiwavelength observations. The coronal mass ejections (CMEs) responsible for the above geomagnetic storm originated from the super-active region NOAA 10501. We investigate the H-alpha observations of the flare events made with a 15 cm solar tower telescope at ARIES, Nainital, India. The propagation characteristics of the CMEs have been derived from the three-dimensional images of the solar wind (i.e., density and speed) obtained from the interplanetary scintillation data, supplemented with other ground- and space-based measurements. The TRACE, SXI and H-alpha observations revealed two successive ejections (of speeds ~350 and ~100 km/s), originating from the same filament channel, which were associated with two high speed CMEs (~1223 and ~1660 km/s, respectively). These two ejections generated propagating fast shock waves (i.e., fast drifting type II radio bursts) in the corona. The interaction of these CMEs along the Sun-Earth line has led to the severity of the storm. According to our investigation, the interplanetary medium consisted of two merging magnetic clouds (MCs) that preserved their identity during their propagation. These magnetic clouds made the interplanetary magnetic field (IMF) southward for a long time, which reconnected with the geomagnetic field, resulting the super-storm (Dst_peak=-472 nT) on the Earth.Comment: 24 pages, 16 figures, Accepted for publication in Solar Physic