Pulse Wave Velocity: Retrospective Analysis in a Balkan Normotensive and Hypertensive Population: A Study of 9923 Patients.

We compared pulse wave velocity (PWV) between hypertensive patients and control patients to identify demographics and patient characteristics related to PWV. We retrospectively analyzed 9923 participants (3105 controls and 6818 hypertensive patients) from 5 outpatient hypertensive clinics (in Serbia and Greece). Pulse wave velocity had different distribution between controls and hypertensive patients ( P < .001). The magnitude of PWV increase was related to blood pressure (BP) category (from optimal to stage III hypertension; P < .001). Even in hypertensive patients with systolic BP (SBP) <140 and/or diastolic BP (DBP) <90 mm Hg, PWV was greater than in control patients ( P < .001). Pulse wave velocity was associated with almost all baseline characteristics of hypertensive patients (body mass index [BMI], gender, age, SBP, DBP, smoking status, and heart rate; P < .001). This association remained after adjustment of PWV confounders. There were 2231 (32.7%) hypertensive patients who had reached SBP <140 mm Hg and DBP <90 mm Hg. Pulse wave velocity was increased in hypertensive patients, and the degree of PWV increase was associated with baseline BP as well as with anthropometric parameters (eg, BMI, gender, age, heart rate, and smoking status).

Clinical case of neuroendocrine malignant tumor with unusual localization in the adrenal cortex.

The authors present unusual clinical case with atypical diagnostic work-up and histological result of adrenal neuroendocrine carcinoma.

Blood and plasma selenium levels and GSH-Px activities in patients with arterial hypertension and chronic heart disease.

The purpose of this study was to examine the relationship between arterial hypertension (HTN), chronic heart disease (CHD), and selenium (Se) status. Blood and plasma Se concentrations and Se-dependent GSH-Px activities were determined in 40 patients (HTN = 20; CHD = 20) and 17 healthy volunteers aged 41 to 66 years. Whole blood and plasma Se concentrations were significantly lower in the patients with HTN (19.1% and 26.3%, respectively) and CHD (33.1% and 29.4%, respectively) compared with the values obtained in the controls. The hypertensive patients had lower plasma Se-GSH-Px (26.7%), and those with CHD had both lower whole blood (19.5%) and plasma Se-GSH-Px activities (30.2%). A significant positive correlation between plasma Se-GSH-Px activity and ejection fraction (EF) was found in patients with CHD. There were significant correlations between plasma and whole blood Se concentration, plasma Se concentration and Se-GSH-Px activity, and whole blood Se and Se-GSH-Px activity. Our results showed that hypertensive patients and those with CHD had lower Se levels compared with controls. We conclude that low Se content might be a risk factor for development of HTN and CHD.

[Continuous ambulatory measurement of blood pressure in children--personal experience]. / Kontinuisano ambulatorno merenje krvnog pritiska kod dece--nasa iskustva.

UNLABELLED: Ambulatory blood pressure monitoring (ABPM) during normal daily activities and during night, when the patient is asleep, is a new method of measuring blood pressure (BP) in children, used for better diagnosis and treatment of hypertension. Compared to casual BP measurements, it documents normal daily BP variations, BP during sleep, the influence of emotional and physical stress on BP and is a better predictor of hypertension associated with end-organ damage. However, the experience in ABPM in children is still limited. In our country ABPM has been used since recently, and first results are referred to children with end-stage renal failure. SUBJECTS AND METHODS: ABPM was performed in two groups of children: group A consisted of 61 children, aged 14.3 +/- 2.9 (mean +/- SD) yrs in whom intermittent outpatient BP measurements (for at least 3 months) suggested the diagnosis of hypertension (according to the data of Second Task Force); group B consisted of 52 patients (pts), aged 12.8 +/- 4.6 yr with renal disease. Four pts from group A (6.6%) and 20 pts from group B (38.5%) received antihypertensive therapy (captopril, nifedipine, furosemide and propranolol ). All children from group A and half of the children from group B had normal renal function. Eighteen pts from group B were on chronic haemodialysis (34.6%). Blood pressure was recorded during a 24-hour period except in haemodialyzed pts (48 h) (Table 1). Results of BP measurements are presented as the mean values of BP during a 24-hour period, during normal daily activities and during sleep. We used the age- and gender-appropriate 95th percentile from the Task Force Study as the daytime upper-limit of normal and 10% lower for the upper-limit at night. According to BP load (the percentage of BPs exceeding the upper limits of normal for age), children were assumed to have mild-to-moderate hypertension (BP load between 20% and 40%) or severe hypertension (BP load more than 40%). The success of antihypertensive therapy was evaluated after 1-3 months in 11 pts (twice in 10 pts and three times in one pt). RESULTS: In group A 39.4% of pts were normotensive and 36.1% were without antihypertensive therapy, 58.4% of normotensive and 40.5% of hypertensive pts had blunted circadian BP rhythm (nocturnal BP reduction of less than 10% of diurnal values) (Graph. 1). In group B 38.5% of pts were normotensive and 27% were without antihypertensive therapy. In the group of normotensive pts alteration of circadian BP rhythm was found in 40% of pts with normal renal function, 80% of pts with chronic renal failure and in 100% of pts with terminal renal failure, while in the hypertensive group, altered circadian BP rhythm had 68%, 100% and 92% of pts, respectively (Graph 2). Mild-to-moderate hypertension had 54% of hypertensive pts from group A and 37.5% of hypertensive pts from group B. Severe hypertension was more frequent in group B (62.5%) comparing to group A (46%). The effectiveness of antihypertensive therapy was assessed in 11 pts. In 69.2% of pts BP became normal or was significantly decreased, in 23.1% of pts BP was not changed and 7.7% of pts had higher values of BP. DISCUSSION: ABPM is very useful for diagnosing white coat hypertension. Like other authors, we have pointed out that more than one third of pts who were hypertensive according to usual BP measurements had normal 24-hour BP and we classified them as white coat hypertensives. More than a half of the pts had blunted circadian BP rhythm, and as it is not certain whether they will become hypertensive in adulthood they should be periodically controlled. There are several proofs that results of ABPM have a better correlation with hypertensive end-organ damage; therefore ABPM is used for assessing the severity of hypertension. In our former work, we showed excellent correlation of BP with left ventricular mass index in children with end-stage renal failure. (ABSTRACT TRUNCATED)

[Continuous blood pressure monitoring over a 24-hour period in children with terminal renal failure treated with hemodialysis]. / Kontinuisano pracenje krvnog pritiska u toku 24 sata kod dece s terminalnom insuficijencijom bubrega, lecenih hronicnim hemodijalizama.

Recent evidence suggests that circadian blood pressure changes are common in patients with impaired renal function and has excellent correlation with end-organ damage. The aim of this paper was to: 1) evaluate if children with end-stage renal failure have altered circadian blood pressure rhythm; 2) assess whether pre- or postdialytic blood pressure is representative for the average interdialytic blood pressure; 3) assess whether pre- or postdialytic blood pressure is representative for the average interdialytic blood pressure; 3) determine influence of pre-, post and interdialytic blood pressure. Ambulatory blood pressure monitoring was performed in two groups of patients: group A-13 children with end-stage renal failure, aged 15.15 +/- 5.58 years, on chronic haemodialysis from 2 to 156 (mean 45.3) months, 4 of whom were hypertensive and 9 normotensive; group B-19 children with chronic hypertension (essential or renal hypertension) aged 15.28 +/- 2.27 years. 84.62% of children from group A and 31.58% from group B (p = 0.0037) had blunted circadian blood pressure rhythm (a nocturnal reduction of blood pressure is less than 10% of daytime values). Pre- and postdialytic systolic, diastolic and mean arterial blood pressure did not differ significantly and were in correlation with interdialytic blood pressure (r = 0.9; p < 0.01). Pre-, post- and interdialytic blood pressures correlated well with left ventricular mass index (r = 0.6; p < 0.05), but were not in correlation with the degree of hypervolemia (p < 0.05).

Osteomesopycnosis.

The radiographic findings in two children with osteomesopycnosis are described. This is the first report in the Australian literature of this uncommon, recently described entity.

[Effect of various technological processes on the feeding properties of extracted sunflower meal]. / Einfluss von verschiedenen techologischen Prozessen auf die Fütterungseigenschaften von Sonnenblumenextraktionsschrot

The extracted sunflower meal with low cellulose content that was obtained by a new technological procedure exhibited better feeding properties than the sunflower meal produced by the old procedure. This is due to reduced protein denaturation and restricted deterioration of lysine but other biological factors may also be involved in this. The extracted sunflower meal with low cellulose content produced nearly identical results compared with those of extracted soya bean meal, and even a somewhat more efficient rate of gain. This is probably due to the higher methionine content of the meal, a fact which was also pointed out by other authors doing experimental work with extracted meals. It is a matter of great economic importance that the expensive soya bean meal which has to be, for the most part, imported to Bulgaria, can be replaced by this type of extracted sunflower meal. On the basis of the new technological procedure it has become possible to produce an extracted meal with low cellulose content from an ordinary extracted meal by using a fairly simple procedure (removal of seed husks).