Thromboprophylaxis in atrial fibrillation: correct interpretation and effective use of CHA2DS2-VASc and HAS-BLED scores

Thromboprophylaxis is one of the most important aspects of atrial fibrillation (AF) management as irregular atrial contractions foster formation of blood clots that may result in ischemic stroke. Strokes caused by AF are relatively large and often lead to death or sever disability, but they may be avoided with appropriate anticoagulation therapy. Unfortunately, the risk factors for stroke overlap with risk factors for bleeding, creating a genuine challenge for clinicians seeking to strike a balance in preventing these two types of complications. This is why risk assessment scores CHA2DS2-VASc and HAS-BLED have been developed. While their role to optimize the anticoagulation therapy was confirmed in multiple studies, the misinterpretation of the criteria within these scores and their inappropriate application can result in suboptimal treatment and needlessly expose patients to the risk of stroke, hemorrhage, or both. This review aims to present appropriate interpretation of CHA2DS2-VASc and HAS-BLED scores and discuss how anticoagulation therapy of AF patients should be guided by those two scores

Relationship of serum leptin with parameters of nutritional status and body composition among patients with stable course of cardiovascular disorders

Background: Blood leptin concentration is related to fat mass, adipose cell and leptin receptor function, and comorbidities. The aim of this study is to determine the relationships between blood leptin concentration and nutritional status assessment among inpatients with stable cardiovascular disorders.   Materials and Methods: Blood leptin concentration and nutritional risk and status assessments using clinical, anthropometric and biochemical parameters, as well bioelectrical impedance (BIA), were determined in 160 consecutive inpatients with mild exacerbation of cardiovascular diseases cardiovascular disorders undergoing non-urgent hospitalization.   Results: Patients with lower values of Minimal Nutritional Assessment score had lower blood leptin concentration and lower value of leptin to CRP ratio. Compared to patients with leptin concentration in the upper quartiles, individuals in the lowest quartile had a lower BMI and fat mass, thinner skinfolds, greater skeletal muscle mass and handgrip strength. In comparison with the values for leptin-to-CRP ratio, albumin, albumin-to-CRP ratio and lymphocyte count, leptin explained a greater part of the variance in the majority of parameters of nutritional status and body composition. Contrasting associations of leptin with ideal (negative) and current (positive) body mass were found.   Conclusions: Leptin was associated with parameters of nutritional status assessments more strongly than other biochemical parameters usually used. However, the use of leptin as a biomarker of nutritional status should be approached carefully and needs further evaluation, especially in the context of its strong association with both current and ideal body mass, the importance of receptors’ resistance to leptin, and leptin’s negative relationships with muscle mass and strength

Thromboprophylaxis in atrial fibrillation: correct interpretation and effective use of CHA2DS2-VASc and HAS-BLED scores

Thromboprophylaxis is one of the most important aspects of atrial fibrillation (AF) management as irregular atrial contractions foster formation of blood clots that may result in ischemic stroke. Strokes caused by AF are relatively large and often lead to death or sever disability, but they may be avoided with appropriate anticoagulation therapy. Unfortunately, the risk factors for stroke overlap with risk factors for bleeding, creating a genuine challenge for clinicians seeking to strike a balance in preventing these two types of complications. This is why risk assessment scores CHA2DS2-VASc and HAS-BLED have been developed. While their role to optimize the anticoagulation therapy was confirmed in multiple studies, the misinterpretation of the criteria within these scores and their inappropriate application can result in suboptimal treatment and needlessly expose patients to the risk of stroke, hemorrhage, or both. This review aims to present appropriate interpretation of CHA2DS2-VASc and HAS-BLED scores and discuss how anticoagulation therapy of AF patients should be guided by those two scores

Interesterificación de fosfatidilcolina de yema de huevo y aceites vegetales catalizada por lipasas

The incorporation of polyunsaturated fatty acids into the sn-1 position of egg-yolk phosphatidylcholine (PC) in the process of lipase-catalyzed interesterification was investigated. For this purpose plant oils containing these acids in the triacylglycerol (TAG) form were used as acyl donors and three commercially available immobilized lipases were examined as biocatalysts. In all the experiments the best results were obtained using Novozym 435. After 72 h of the reaction of PC with linseed oil the maximum incorporation of α-linolenic acid into PC was 34%. The result of this reaction was also a reduction in the n-6/n-3 ratio in egg-yolk PC from 24.5 to 0.7. The highest incorporation n-6 PUFAs into PC were obtained with evening primrose oil as the acyl donor, and in this case, 50.7% of n-6 PUFA as the sum of linoleic and γ-linolenic was achieved. The highest content of γ-linolenic acid in modified PC (7.3%) was achieved in the reaction of PC with borage oil.Se ha investigado la incorporación de ácidos grasos poliinsaturados en la posición sn-1 de fosfatidilcolina de yema de huevo (PC) en el proceso de interesterificación catalizado por lipasas. Para lograr este propósito, fueron examinados aceites vegetales que contienen estos ácidos en la forma de triacilgliceroles (TAG) como donadores de acilo y tres lipasas inmovilizadas disponibles comercialmente. En todos los experimentos los mejores resultados se obtuvieron para Novozym 435. La incorporación máxima de ácido α-linolénico en PC fue del 34% después de 72h de la reacción de PC con aceite de linaza. El resultado de esta reacción fue también la reducción de la relación de n-6/n-3 en PC de yema de huevo de 24.5 a 0.7. La incorporación más alta de n-6 PUFAs en PC se logró para el aceite de onagra como donador de acilo, en este caso se alcanzó el 50.7% de n-6 PUFA, como suma de los ácidos linoleico y γ-linolénico. El mayor contenido de ácido γ-linolénico en PC modificado (7.3%) se logró en la reacción de PC con aceite de borraja

Wpływ wybranych czynników na wyniki badania nasiąkliwości betonu

In spite of the fact that common concrete absorption tests are technically simple, the correctness of received  results is still very disputable. The lack of unequivocal procedures makes it impossible to compare the results obtained in various laboratories. The paper presents the research results  received in 5 series of concrete  with three different cements and various w/c ratios. The investigations were conducted on cube specimens with dimensions of 10cm and 15cm, all cubes were soaked and dryed in long terms. The object of the research was to identify the effect of  specimens dimensions and soaking time on the concrete absorption. Soaking time applied to investigations vastly exeeds the common soaking time described in standards concerning precast concrete elements.Badanie nasiąkliwości betonu, pomimo że jest oznaczeniem prostym technicznie budzi jednak dyskusje ze względu na poprawność uzyskiwanych wyników. Brak jednoznacznego opisu procedury badania powoduje, że wyniki uzyskiwane w różnych laboratoriach mogą nie być porównywalne. W referacie przedstawiono wyniki badania nasiąkliwości 5 serii betonów wykonanych z trzema różnymi cementami, o trzech różnych stosunkach W/C. Badania prowadzono na kostkach sześciennych o boku 10 i 15 cm, które były długotrwale nasycane i suszone. Z przeprowadzonych badań wynika, że decydujący wpływ na wyniki oznaczeń nasiakliwości wagowej ma wielkość badanej próbki oraz czas suszenia próbek, który znacznie przekracza minimalny czas określony w normie dla prefabrykatów betonowych