L'adhésion thérapeutique dans l'hypertension artérielle résistante

peer reviewe

The impact of war on the development and progression of arterial hypertension and cardiovascular disease: protocol of a prospective study among Ukrainian female refugees.

Growing evidence supports the impact of psychological factors such as traumatic experiences and Post Traumatic Stress Disorder (PTSD) on the incidence of arterial hypertension (HTN) and cardiovascular diseases (CVD). The war in Ukraine is exposing million inhabitants to traumatic experiences and severe stress. Part of Ukrainians (mostly women and children) left the country to escape war. We report the protocol of a prospective study aiming at the assessment of the impact of war-induced stress on HTN and CVD in women Ukrainian refugees who moved to Poland. The study will be conducted in 3 stages. Stage 1 will assess the prevalence of HTN and PTSD among Ukrainian refugees and will estimate the impact of war-related trauma exposure on these parameters. Data on office blood pressure (BP) will be compared to data already collected in STEPS data 2019 and May Measurement Month 2021 in Ukraine, matched for age and sex. Stage 2 will involve subjects diagnosed with HTN and/or PTSD referred for management and follow-up of these conditions. Psychologic targeted therapies will be offered to subjects with confirmed PTSD, with a periodical reassessment of the severity of PTSD-associated symptoms and of its impact on HTN and cardiovascular health. Clinical history and characteristics will be compared among three groups: subjects with HTN and PTSD, with HTN without PTSD, with PTSD but without HTN. Stage 3 will involve a subgroup among those screened in Stage 1, with the objective of investigating the biological mechanisms underlying the relation between HTN and trauma exposure, identifying early signs of subclinical target organ damage in subjects with HTN with/without PTSD. This study will test the hypothesis that trauma exposure and psychological stress contribute to BP elevation and progression of CVD in this population. It will provide new evidence on the effect of an integrated management, including psychological therapy, on BP and cardiovascular risk. Such approach may be further tested and extrapolated to other populations exposed to war and chronic violence, migrants and refugees around the world. number 2022/45/P/NZ5/02812

RESEARCHES ON THE PROTECTION OF VINEYARDS AND ORCHARDS AGAINST SPRING FROSTS USING HEAT AND SMOKE AND USING THE RESULTING ASH AS SOIL AMENDMENT

Orchards and vineyards can be exposed to climatic phenomena with unfavorable effects on tree growth and fruiting, such as: winter frosts, frosts and late spring frosts, hail, icing, etc. Smoke and heat are a valuable ally of fruit and vine growers, often intervening in preventing and limiting the negative effects of frosts and frosts on fruit trees and vines during the periods of budding, flowering and fruit binding. The accident is due to the freezing of water in the cellular structure of the vegetative organs (flower buds, buds, flowers, leaves). The paper presents a method of the protection for orchards and vineyards against hoar and late frosts as well as the possibility to use the resulting ash as soil amendment

INFLUENCE ON QUALITY AND ENERGY INDICES FOR A REVERSIBLE PLOW EQUIPPED WITH ELECTRIC VIBRATORS

The qualitative indices of the tillage as well as the exploitation energy indices represent two relevant factors in the exploitation of the agricultural equipments, these being the main barometer of the quality of the used equipment. The paper presents a comparative study of qualitative work indices, respectively energy indices, performed on two reversible plows with three troops, one used in the classical system and one optimized by implementing electrical systems for generating vibrations, located on each of the three active troops during operatio

INTELLIGENT MONITORING OF DISEASED PLANTS USING DRONES

Plant diseases are one of the grand challenges that face the agriculture sector world-wide. In the United States, crop diseases cause losses of one-third of crop production annually. Despite the importance, crop disease diagnosis is challenging for limited-resources farmers if performed through optical observation of plant leaves’ symptoms. Therefore, there is an urgent need for markedly improved detection, monitoring, and prediction of crop diseases to reduce crop agriculture losses. Advanced imaging technologies can detect such changes, and can, therefore, be used as noninvasive crop monitoring methods. Furthermore, novel methods of treatment precision application are required. Both sensing and actuation technologies can be mounted on equipment moving through fields (e.g., irrigation equipment), on (un)manned driving vehicles, and on small drones

Management of a pregnant woman with fibromuscular dysplasia

No abstract available

EXPERIMENTAL RESEARCH ON DETERMINATION OF DEFORMATIONS IN THE CUTTING PROCESS IN WET SANDY SOILS

The active parts of tillage equipment must be checked for wear resistance, under different conditions working with the soil, so that the average life span should be determined wear resistance, to ensure timely changes of parts. Research in the field has shown that there are at least two main forces acting on the active parts: impact and friction, the action of these forces causes wear. In order to test the tillage knives in laboratory conditions, was used a stand made by INMA Bucharest. With the help of this stand, the deformations in the cutting process were determined in different working conditions: at a certain working speed and at a certain humidity of the sandy soil

A European Renal Association (ERA) synopsis for nephrology practice of the 2023 European Society of Hypertension (ESH) Guidelines for the Management of Arterial Hypertension.

In June 2023, the European Society of Hypertension (ESH) presented and published the new 2023 ESH Guidelines for the Management of Arterial Hypertension, a document that was endorsed by the European Renal Association (ERA). Following the evolution of evidence in recent years, several novel recommendations relevant to the management of hypertension in patients with chronic kidney disease (CKD) appeared in these Guidelines. These include recommendations for target office blood pressure (BP) <130/80 mmHg in most and against target office BP <120/70 mmHg in all patients with CKD; recommendations for use of spironolactone or chlorthalidone for patients with resistant hypertension with estimated glomerular filtration rate (eGFR) higher or lower than 30 mL/min/1.73 m2, respectively; use of a sodium-glucose cotransporter 2 inhibitor for patients with CKD and estimated eGFR ≥20 mL/min/1.73 m2; use of finerenone for patients with CKD, type 2 diabetes mellitus, albuminuria, eGFR ≥25 mL/min/1.73 m2 and serum potassium <5.0 mmol/L; and revascularization in patients with atherosclerotic renovascular disease and secondary hypertension or high-risk phenotypes if stenosis ≥70% is present. The present report is a synopsis of sections of the ESH Guidelines that are relevant to the daily clinical practice of nephrologists, prepared by experts from ESH and ERA. The sections summarized are those referring to the role of CKD in hypertension staging and cardiovascular risk stratification, the evaluation of hypertension-mediated kidney damage and the overall management of hypertension in patients with CKD

CONSTRUCTION TYPES OF TECHNICAL EQUIPMENT FOR DOSING, WEIGHING, PACKAGING AND PROCEDURES USED IN MILLING UNITS

The paper presents several types of technical equipment for dosing, weighing, packaging and the procedures used in the milling units. The weighing systems take into account several important criteria for their design, namely: how the weight or mass of the load is offset and how the result is transferred

Blood pressure changes after renal denervation at 10 European expert centers

We did a subject-level meta-analysis of the changes (Δ) in blood pressure (BP) observed 3 and 6 months after renal denervation (RDN) at 10 European centers. Recruited patients (n=109; 46.8% women; mean age 58.2 years) had essential hypertension confirmed by ambulatory BP. From baseline to 6 months, treatment score declined slightly from 4.7 to 4.4 drugs per day. Systolic/diastolic BP fell by 17.6/7.1 mm Hg for office BP, and by 5.9/3.5, 6.2/3.4, and 4.4/2.5 mm Hg for 24-h, daytime and nighttime BP (P0.03 for all). In 47 patients with 3- and 6-month ambulatory measurements, systolic BP did not change between these two time points (P0.08). Normalization was a systolic BP of <140 mm Hg on office measurement or <130 mm Hg on 24-h monitoring and improvement was a fall of 10 mm Hg, irrespective of measurement technique. For office BP, at 6 months, normalization, improvement or no decrease occurred in 22.9, 59.6 and 22.9% of patients, respectively; for 24-h BP, these proportions were 14.7, 31.2 and 34.9%, respectively. Higher baseline BP predicted greater BP fall at follow-up; higher baseline serum creatinine was associated with lower probability of improvement of 24-h BP (odds ratio for 20-μmol l(-1) increase, 0.60; P=0.05) and higher probability of experiencing no BP decrease (OR, 1.66; P=0.01). In conclusion, BP responses to RDN include regression-to-the-mean and remain to be consolidated in randomized trials based on ambulatory BP monitoring. For now, RDN should remain the last resort in patients in whom all other ways to control BP failed, and it must be cautiously used in patients with renal impairment