Wartości uzyskane w całodobowym automatycznym pomiarze ciśnienia tętniczego odpowiadające wartości ciśnienia tętniczego zmierzonej w gabinecie lekarskim wynoszącej 130/80 mm Hg

Background: 24 hour ambulatory blood pressure monitoring (ABPM) values for patients who have office BP of 130/80 mm Hghave not been clearly reported.Aim: The determination of ABPM values in treated hypertensive subjects corresponding to a mean office BP of 130/80 mm Hg.Methods: BP measurement in subjects 40–70 years old, by ABPM and mercury sphygmomanometer. The inclusion criteria were:mean office BP systolic (SBP) 128–132 mm Hg and diastolic (DBP) 78–82 mm Hg. Seventy six subjects met all study inclusion criteria.Results: Mean office BP: SBP 129.5 ± 1.1 mm Hg, DBP 79.9 ± 1.3 mm Hg. Mean 24 hour BP: SBP 121.9 ± 2.0 mm Hg,DBP 73.1 ± 1.9 mm Hg. Mean awake BP: SBP 124.9 ± 2.4 mm Hg, DBP 75.5 ± 2.2 mm Hg. Mean asleep BP: SBP109.1 ± 3.9 mm Hg, DBP 63.3 ± 4.0 mm Hg.Conclusions: The target values of ABPM identified in this study can be used in clinical practice and will contribute to riskstratification and treatment of hypertension.Wstęp: Dotychczas nie przedstawiono danych dotyczących wartości uzyskanych w całodobowym automatycznym pomiarzeciśnienia tętniczego (ABPM) u chorych, u których ciśnienie tętnicze zmierzone w gabinecie lekarskim wynosiło 130/80 mm Hg.Cel: Celem badania było ustalenie, jakie wartości ciśnienia tętniczego w ABPM u chorych z nadciśnieniem tętniczym stosującychleki przeciwnadciśnieniowe odpowiadają wynikowi pomiaru gabinetowego wynoszącego 130/80 mm Hg.Metody: Przeprowadzono pomiary ciśnienia tętniczego u osób w wieku 40–70 lat, stosując ABPM i gabinetowy pomiarsfigmomanometrem rtęciowym. Kryterium włączenia do badania było uzyskanie w pomiarze gabinetowym średniej wartościciśnienia skurczowego (SBP) 128–132 mm Hg i rozkurczowego (DBP) 78–82 mm Hg. Kryteria włączenia spełniło 76 osób.Wyniki: Średnie wartości w gabinetowych pomiarach ciśnienia tętniczego wynosiły: SBP 129,5 ± 1,1 mm Hg, DBP79,9 ± 1,3 mm Hg. W pomiarach za pomocą ABPM uzyskano następujące wartości: SBP 121,9 ± 2,0 mm Hg, DBP73,1 ± 1,9 mm Hg. Średnie ciśnienie tętnicze w porze aktywności dziennej wynosiło: SBP 124,9 ± 2,4 mm Hg, DBP75,5 ± 2,2 mm Hg, a w porze nocnej — SBP 109,1 ± 3,9 mm Hg, DBP 63,3 ± 4,0 mm Hg.Wnioski: Uzyskane w niniejszym badaniu wartości ciśnienia tętniczego zmierzone w ABPM mogą być użyteczne w praktyceklinicznej i przyczynią się do poprawy stratyfikacji ryzyka oraz leczenia nadciśnienia tętniczego

Gluten ataxia is better classified as non-celiac gluten sensitivity than as celiac disease: a comparative clinical study

Gluten ataxia (GA) has customarily been considered to be the main neurological manifestation of celiac disease (CD). In recent years, the condition of non-celiac gluten sensitivity (NCGS) has been defined, which includes some patients who are not considered "true celiacs." We performed a comparative clinicopathological study of these three entities. We studied 31 GA, 48 CD and 37 NCGS patients, prospectively in the same center for a period of 7 years. The protocol study included two serological determinations for gluten sensitivity [anti-gliadin IgA and IgG (AGA) and anti-tissue transglutaminase IgA (TG) antibodies], HLA-DQ2 typing, and duodenal histological assessment. Demographics and investigative findings were compared. Females were 55 % in GA, 75 % in CD (p < 0.001), and 47 % in NCGS (N.S.). GA patients were older (59 \ub1 14 years) than CD (43 \ub1 13 years) and NCGS (41 \ub1 8 years) groups (p < 0.001). AGA positivity was higher in GA (100 %) than in CD (48 %) groups (p < 0.001), but similar to NCGS patients (89 %; N.S.); TG positivity was lower in GA (3.2 %) than in CD (33.3 %; p < 0.001), but similar to NCGS (2.7 %; N.S.). DQ2 (+) was lower in GA (32.2 %) than in CD (89.6 %; p < 0.001), but similar to NCGS (29.7 %; N.S.). Lymphocytic enteritis (Marsh type 1) was lower in GA (9.6 %) than in CD (66.7 %; p < 0.001), but similar to NCGS (10.8 %; N.S.). The other gluten sensitivity-related characteristics measured were different to CD patients, but very close to NCGS. We conclude that GA patients are better classified within the NCGS group, than within CD

Observations of the Time Domain Sampler receiver from the Radio and Plasma Wave instrument during the Solar Orbiter Earth flyby

International audienceOn November 27, 2021, Solar Orbiter completed its only flyby of Earth on its way to the following Sun's encounter in March 2022. Although this fast flyby was performed primarily to decrease the spacecraft's velocity and change orbit to get closer to the Sun, the Radio and Plasma Wave (RPW) instrument had the opportunity to perform high cadence measurements in the Earth's magnetosphere. We review the main observation of the Time Domain Sampler (TDS) receiver, a part of the RPW instrument, made during this flyby at frequencies below 200 kHz. The TDS receiver operated in a high cadence mode providing us with the regular waveform snapshot with 62 ms length every ten seconds for two electric components. Besides the regular captures, we have got more than five hundred onboard classified snapshots and the statistical products with a sixteen-second cadence. Before entering the terrestrial magnetosphere around 02:30UT, the spacecraft wandered through the foreshock region, registering intense bursts of Langmuir waves. After the bowshock crossing, Solar Orbiter was for more than two hours in the morning sector of the magnetosphere, recording various plasma wave modes. The closest approach was reached at 04:30UT above North Africa at an altitude of 460 km. Then the spacecraft continued into the Earth's tail and entered the magnetosheath around 13:00UT. After 15:00UT, the Solar Orbiter crossed the bowshock, and bursts of Langmuir waves were detected again pointing out to the deep downstream foreshock region. Further from the Earth, intense Auroral Kilometric Radiation (AKR) at frequencies above 100 kHz was also detected

Reduced Radiation Exposure Protocol during Computer Tomography of the Left Atrium Prior to Catheter Ablation in Patients with Atrial Fibrillation

(1) Background: Computer tomography (CT) is an imaging modality used in the pre-planning of radiofrequency catheter ablation (RFA) procedure in patients with cardiac arrhythmias. However, it is associated with a considerable ionizing radiation dose for patients. This study aims to develop and validate low-dose CT scanning protocols of the left atrium (LA) for RFA guidance. (2) Methods: 68 patients scheduled for RFA of atrial fibrillation were sequentially assigned to four groups of ECG-gated scanning protocols, based on the set tube current (TC): Group A (n = 20, TC = 33 mAs), Group B (n = 18, TC = 67 mAs), Group C (n = 10, TC = 135 mAs), and control Group D (n = 20, TC = 600 mAs). We used a 256-row multidetector CT with body weight-dependent tube voltage of 80 kVp (&lt;70 kg), 100 kVp (70&ndash;90 kg), and 120 kVp (&gt;90 kg). We evaluated scanning parameters including radiation dose, total scanning procedure time and signal-to-noise ratio (SNR). (3) Results: The average effective radiation dose (ED) was lower in Group A in comparison to Group B, C and D (0.83 (0.76&ndash;1.10), 1.55 (1.36&ndash;1.67), 2.91 (2.32&ndash;2.96) and 9.35 (8.00&ndash;10.04) mSv, p &lt; 0.05). The total amount of contrast media was not significantly different between groups. The mean SNR was 6.5 (5.8&ndash;7.3), 7.1 (5.7&ndash;8.2), 10.8 (10.1&ndash;11.3), and 12.2 (9.9&ndash;15.7) for Group A, B, C and D, respectively. The comparisons of SNR in group A vs. B and C vs. D were without significant differences. (4) Conclusions: Optimized pre-ablation CT scanning protocols of the LA can reduce an average ED by 88.7%. Three dimensional (3D) models created with the lowest radiation protocol are useful for the integration of electro-anatomic-guided RFA procedures

Use of a novel transfer function to reduce repolarization

Abstract Background Cardiac repolarization is assessed by the QT interval on the surface electrocardiogram and varies with the heart rate. Standard QT corrections (QTc) do not account for the lag in QT change following a change in heart rate (QT hysteresis). Our group has developed and tested a transfer function (TRF) model to assess the effectiveness of a dynamic model of QT/RR coupling in eliminating hysteresis. Methods We studied three groups: group I, healthy volunteers (n=23, 41±17 years); group II, hypertensive patients (n=25, 45±11 years); and group III, patients in a predominately paced rhythm (n=5, 75±6 years). To vary the heart rate, either exercise bicycling in the supine position (groups I and II) or manipulation of the pacemaker parameters (group III) was done. We then compared a dynamic TRF model with a model based on weighted averages of previous RR intervals. Two parameters were tested: root mean square (RMS) of the error signal between measured and computed QT and the elimination of hysteretic loops. Results TRF-based measurements eliminated hysteresis in 22/23 (95%) group I patients, 21/25 (84%) group II patients, and 4/5 (80%) group III patients. When hysteresis elimination was not complete, the QT drift that followed RR intervals was different before and after bicycling (100 ms). In these patients, the corresponding QT interval did not significantly change during this period. The TRF model was found superior to the other tested models with respect to both analyzed parameters (RMS and hysteresis elimination). Conclusion The TRF model limited QT hysteresis in healthy, hypertensive, and pacemaker-dependent patients. In addition, an important finding of QT drift in patients with hypertension was identified. With further study in these and other diseased states, the TRF model may improve our ability to measure accurately cardiac repolarization and to determine arrhythmia risk

Dynamic coupling between heart rate and ventricular repolarisation

A novel model for the coupling between ventricular repolarisation and heart rate (QT/RR) is presented. It is based upon a transfer function (TRF) formulism which describes the static as well as the dynamic properties of this coupling, i.e. the behavior after a sudden change of heart rate. Different TRF models have been analyzed by comparing their capability of describing experimental data collected with 19 healthy volunteers and several protocols of RR stimulation: i) rest with deep breathing at 0.1 Hz; ii) tilt with controlled breathing at 0.1 Hz and 0.33 Hz; and iii) cycling. The search for the best TRF leads to unambiguous identification of a three-parameter model as the most suitable descriptor of the QT/RR coupling. Compared with established static models (linear, or power-law), our model predictions are substantially closer to the experimental results, with errors &#61566;50% smaller. The shape of frequency and step responses of our transfer functions is essentially the same for all subjects and protocols. Moreover, each transfer function may be uniquely identified by three parameters, obtained from the step response, which are believed to be of physiological relevance: (i) gain for slow RR variability; (ii) gain for fast RR variability; and (iii) time during which QT attains 90% of its steady state value. The transfer function successfully describes the behavior of the RR control following an abrupt change of the RR interval, and its parameters may offer a tool for detecting pharmacologically induced changes, particularly those leading to increased arrhythmogenic risk. Key words —QT/RR coupling, transfer functio

Benthic Communities of Low-Order Streams Affected by Acid Mine Drainages: A Case Study from Central Europe

Only little attention has been paid to the impact of acid mine drainages (AMD) on aquatic ecosystems in Central Europe. In this study, we investigate the physico-chemical properties of low-order streams and the response of benthic invertebrates to AMD pollution in the Banská Štiavnica mining region (Slovakia). The studied streams showed typical signs of mine drainage pollution: higher conductivity, elevated iron, aluminum, zinc and copper loads and accumulations of ferric precipitates. Electric conductivity correlated strongly with most of the investigated elements (weighted mean absolute correlation = 0.95) and, therefore, can be recommended as a good proxy indicator for rapid AMD pollution assessments. The diversity and composition of invertebrate assemblages was related to water chemistry. Taxa richness decreased significantly along an AMD-intensity gradient. While moderately affected sites supported relatively rich assemblages, the harshest environmental conditions (pH &lt; 2.5) were typical for the presence of a limited number of very tolerant taxa, such as Oligochaeta and some Diptera (Limnophyes, Forcipomyiinae). The trophic guild structure correlated significantly with AMD chemistry, whereby predators completely disappeared under the most severe AMD conditions. We also provide a brief review of the AMD literature and outline the needs for future detailed studies involving functional descriptors of the impact of AMD on aquatic ecosystems