The importance of postoperative control: adrenal insufficiency after unilateral adrenalectomy for Conn’s syndrome. A case study

According to the current guidelines of the Polish Society of Hypertension on the management of primary aldosteronism (PA) associated with aldosterone-producing adenoma, the treatment of choice is unilateral laparoscopic adrenalectomy. Isolated deficiency of aldosterone after adrenalectomy for Conn’s syndrome is rare. The literature finds few reports on postoperative hypoaldosteronism requiring mineralocorticoid replacement. In this case study we present a patient who developed postoperative hypoaldosteronism

Associations of the –344T>C polymorphism of CYP11B2 gene with 24-hour blood pressure profiles in middle-aged women with essential hypertension

Background In this cross-sectional study, we assessed the impact of –344T>C polymorphism of the CYP11B2 gene which encodes aldosterone synthase on 24-hour blood pressure patterns.Material and methods The study was performed in 137 females with essential hypertension aged 42−60 years. We measured plasma aldosterone level and renin activity (PRA), fasting glucose, lipid profiles and 24-hour urinary sodium and potassium excretion. Based on 24-hour blood pressure monitoring we identified cases with dipping and non-dipping patterns of blood pressure.Results Mean PRA and aldosterone levels and aldosterone-to-renin ratio (ARR) were within normal range. Non-dipping hypertension was found in 54.3% of patients. Genotype frequencies of TT, CC and CT were 27%, 27% and 46%, respectively. Carriers of the C allele had significantly lower nocturnal blood pressure reduction (P = 0.004) and higher nocturnal systolic (P = 0.02) and diastolic blood pressure (P = 0.044), frequency of non-dipping profile (P = 0.001), and 24-hour urinary potassium excretion (P = 0.047). Urinary sodium excretion was positively correlated with a decrease in nocturnal blood pressure (R = 0.202; P = 0.037). In a multiple regression analysis, ARR and presence of the C allele adjusted for confounding variables were inversely associated with the nocturnal blood pressure decline (b = −0.348; P = 0.022 and b = −0.222; P = 0.018, respectively).Conclusions In conclusion, in middle-aged females with essential hypertension carrying the C allele we found higher nocturnal blood pressure, lower nocturnal blood pressure reduction, and higher prevalence of non-dipping hypertension than in TT carriers.Background In this cross-sectional study, we assessed the impact of –344T>C polymorphism of the CYP11B2 gene which encodes aldosterone synthase on 24-hour blood pressure patterns.Material and methods The study was performed in 137 females with essential hypertension aged 42−60 years. We measured plasma aldosterone level and renin activity (PRA), fasting glucose, lipid profiles and 24-hour urinary sodium and potassium excretion. Based on 24-hour blood pressure monitoring we identified cases with dipping and non-dipping patterns of blood pressure.Results Mean PRA and aldosterone levels and aldosterone-to-renin ratio (ARR) were within normal range. Non-dipping hypertension was found in 54.3% of patients. Genotype frequencies of TT, CC and CT were 27%, 27% and 46%, respectively. Carriers of the C allele had significantly lower nocturnal blood pressure reduction (P = 0.004) and higher nocturnal systolic (P = 0.02) and diastolic blood pressure (P = 0.044), frequency of non-dipping profile (P = 0.001), and 24-hour urinary potassium excretion (P = 0.047). Urinary sodium excretion was positively correlated with a decrease in nocturnal blood pressure (R = 0.202; P = 0.037). In a multiple regression analysis, ARR and presence of the C allele adjusted for confounding variables were inversely associated with the nocturnal blood pressure decline (b = −0.348; P = 0.022 and b = −0.222; P = 0.018, respectively).Conclusions In conclusion, in middle-aged females with essential hypertension carrying the C allele we found higher nocturnal blood pressure, lower nocturnal blood pressure reduction, and higher prevalence of non-dipping hypertension than in TT carriers

Anaerobic motor skills of players aged 9–15 covered by the program of polish soccer skills

Introduction. The key element of the footballer’s training is the preparation of the physical performance. Long-term observations have shown tracks in the development of motor skills. In football, anaerobic abilities play a special role in athletic training. It can be assumed that only adequately measured motor skills are a guarantee of dynamic growth. Aim of the study. The aim of this study is to assess the motor skills in the course of biological development of players aged 9–15 taking part in the Polish Soccer Skills programe and their numerical characteristics. Material and methods. The study included 1131 players at the age of 9 (n = 189), 10 (n = 170), 11 (n = 183), 12 (n = 194), 13 (n = 124), 14 (n = 151), 15 (n = 120). The respondents participated in the Polish Soccer Skills programe and had varied professional experience. The starting speed over a distance of 5 meters, run over a distance of 20 meters, power of the lower limbs, agility run and growth were measured. The average descriptive statistics: (X), the minimum (min), maximum (max) and standard deviation (SD) were measured. The study was conducted in July and August 2014 in towns of Spała, Kleszczów and Wałcz. Results and Conclusions. The study concluded that the level of anaerobic abilities are changing with the development of biological development of players taking part in the program of Polish Soccer Skills. The differences in the anaerobic abilities were observed across all age groups

Management of hypertension in selected acute conditions associated with an increased activation of the sympathetic nervous system

Autonomiczny układ nerwowy odgrywa kluczową rolę w utrzymaniu homeostazy układu krążenia poprzez wpływ na obwodowy opór naczyniowy, pojemność minutową serca, funkcję nerek. Dysfunkcja w obszarze autonomicznego układu nerwowego, objawiająca się chroniczną wzmożoną aktywacją współczulną, pełni istotną rolę w patogenezie nadciśnienia tętniczego i jego powikłań narządowych. Stany nagłego wzmożenia aktywności współczulnej, przebiegające z natychmiastowym wzrostem ciśnienia tętniczego, mogą stanowić bezpośrednie zagrożenia życia. W obecnej pracy przedstawiono wskazówki dotyczące postępowania z nadciśnieniem tętniczym w wybranych przypadkach przebiegających ze wzmożoną aktywnością współczulną — guza chromochłonnego, nagłego odstawienia klonidyny, narkomanii oraz stresu okołooperacyjnego.The autonomic nervous system plays a key role in cardiovascular homeostasis by affecting the peripheral vascular resistance, cardiac output, renal function. Dysfunction in the autonomic nervous system, manifested by chronic increased sympathetic activation, plays an important role in the pathogenesis of hypertension and target organ damage. Sudden conditions of enhancement sympathetic activity, running with an immediate increase in arterial pressure, may pose a direct threat to life. The present work provides guidelines for the management of hypertension in some selected cases associated with an increased activity of the sympathetic — pheochromocytoma, sudden clonidine withdrawal, drug addiction, perioperative stress

Comparison of selected cardiovascular risk factors in women and men over 75 years of age with hypertension

Wstęp Choroby sercowo-naczyniowe (CVD) są wiodącą przyczyną zgonów w Polsce, stanowiąc około 46% wszystkich zgonów w populacji. W konsekwencji zmian demograficznych, związanych ze starzejącym się społeczeństwem, umieralność sercowo-naczyniowa stanowi istotny, wzrastający problem powszechnej opieki zdrowotnej. Według aktualnych danych CVD stanowią większe zagrożenie życia mężczyzn. Umieralność mężczyzn w Polsce jest wyższa niż przeciętna w krajach UE we wszystkich grupach wiekowych. Wobec tych danych zasadne wydaje się być poszukiwanie tych parametrów ryzyka sercowo-naczyniowego, które w sposób istotny różnią kobiety od mężczyzn. Od 2003 roku wytyczne ESH/ESC oraz PTNT sugerują pomiar IMT w tętnicach szyjnych jako wskaźnik uszkodzeń narządowych w przebiegu nadciśnienia tętniczego, uwzględniany w ocenie ryzyka sercowo-naczyniowego. Celem pracy było porównanie wybranych czynników ryzyka sercowo-naczyniowego u pacjentów powyżej 75 roku życia z nadciśnieniem tętniczym oraz porównanie wybranych czynników ryzyka sercowo-naczyniowego u osób po 75 roku życia, chorujących na nadciśnienie tętnicze z IMT ≤ 0,9 mm w porównaniu z pacjentami z IMT > 0,9 mm. Materiał i metody Badanie przeprowadzono w populacji dorosłych pacjentów jednego z miejscowych niepublicznych zakładów podstawowej opieki zdrowotnej. Do badania zakwalifikowano pacjentów z rozpoznanym i leczonym nadciśnieniem tętniczym, powyżej 75 roku życia. Łącznie do analizy włączono 119 pacjentów. Wnioski W ocenie wybranych parametrów ryzyka sercowo-naczyniowego wykazano istotne różnice dla płci w zakresie parametrów nerkowych, lipidowych, zapalnych oraz grubości błony wewnętrznej i środkowej. Osoby z IMT ≤ 0,9 mm były młodsze, wykazywały niższe parametry przerostu lewej komory serca w badaniu echokardiograficznym, niższe wartości skurczowego ciśnienia tętniczego oraz niższe wartości ciśnienia tętna. W badaniu zaobserwowano dodatnie korelacje między IMT a wiekiem badanych i wskazano na istotny związek grubości IMT z przerostem mięśnia sercowego. Uzyskane wyniki przemawiają za przydatnością oceny grubości IMT w szacowaniu globalnego ryzyka sercowo-naczyniowego także u osób w podeszłym wieku, przy małej przydatności szacunkowej oceny ryzyka sercowo-naczyniowego w tej grupie chorych.Background Cardiovascular diseases (CVD) are the leading cause of death in Poland, representing approximately 46% of all deaths in the population. As a result of demographic changes related to the aging population, cardiovascular mortality is a significant, growing problem of universal health care. According to current data CVD pose a greater threat to the lives of men. The mortality rate for men in Poland is higher than the average in the EU countries in all age groups. In view of these data it seems reasonable to be searching for these parameters of cardiovascular risk, which significantly differ women than men. Since 2003 Guidelines of ESH/ESC and PTNT suggest measuring carotid IMT as an indicator of organ damage in the course of hypertension, included in the evaluation of cardiovascular risk. The aim of the study was to compare some factors of cardiovascular risk in patients over 75 years of age with hypertension and comparison of selected risk factors for cardio-vascular event in people over 75 years of age, suffering from hypertension with IMT ≤ 0.9 mm compared with patients with IMT > 0.9 mm. Material and methods The study was conducted in the adult population, patients of one of the local non-public primary health care. The study enrolled patients with diagnosed and treated hypertension, over 75 years of age. For analysis included 119 patients. Conclusions The evaluation of selected parameters of cardiovascular risk demonstrated significant differences for sex, in terms of kidney, lipid, inflammatory parameters and thickness of intima and media. Patients with IMT ≤ 0.9 mm were younger, had lower parameters of left ventricular hypertrophy on echocardiography, lower systolic blood pressure and lower pulse pressure. In the study, we observed a positive correlation between IMT and age of the respondents and indicated a significant association with IMT and myocardial hypertrophy. The results speak for usability evaluation of IMT in the estimation of global cardiovascular risk in the elderly, with little appreciation of the usefulness of cardiovascular risk in this group of patients

Testosterone assocition with blood pressure profile and left ventricular mass in a young hypertensive population

Sex hormones not only regulate the gonads function, but also may affect the cardiovascular system, although their role is still not clear. Testosterone influence on arterial pressure and left ventricular hypertrophy were widely reported. A number of factors have been implicated as the underlying cause of the relation between testosterone and blood pressure, including sex and age as most important ones. In present findings, a 24-hour ABPM revealed that 33.9% of patients had an altered pattern of blood pressure with no significant differences between sexes. In the whole studied sample, positive correlation has been found between testosterone and 24-hour systolic blood pressure, daytime BP, sodium and potassium levels in the 24-hour urine collection, and left ventricular mass index. In conclusion, testosterone association with blood pressure profile and left ventricular mass in a young hypertensive population seems to be probable, but further analysis is necessary

The Analysis of Fiber and CO

The aim of the conducted research was to compare the functional properties and the cutting accuracy of items produced using Fiber lasers in comparison with CO2 lasers. The object of 6 mm thick sheet plates made of S235JR steel cut with the two different laser types were analyzed. The tests covered dimensional accuracy (in accordance with the PN EN 22768-fH standard) and the surface after cutting (in accordance with the PN-EN ISO 9013: 2017-04). The results of the analysis have demonstrated that for the same welding linear energy, more accurate cutting surface is obtained using Fiber laser cutting