Effects of different antihypertensive medication groups on cognitive function in older patients: A systematic review.

BACKGROUND: Chronic hypertension has been associated with an increased risk of cognitive decline. Although a link between hypertension and cognitive decline has been established, there is less evidence supported by systematic reviews. The main aim was to compare different antihypertensive drug groups in relation to their effect on cognition in older patients without established dementia using a systematic review. METHOD: A systematic search in Medline and Embase through to January 2017 was used to identify randomized controlled clinical trials (RCTs) studying the impact of different antihypertensives on cognition in older patients without dementia. Angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACE-Is), beta-blockers (BBs), diuretics, and calcium channel blockers (CCBs) were included in this review. RESULTS: The systematic search identified 358 studies. The full text of 31 RCTs was reviewed and a total of 15 RCTs were included in the review. Most studies reported an improvement in episodic memory in patients treated with ARBs versus placebo or other types of antihypertensive drugs. No study showed an improvement in cognition in patients who received diuretics, BBs, or CCBs. Heterogeneity was high in most trials (predominantly in the blinding of participants and investigators). CONCLUSION: This review suggests that ARBs can improve cognitive functions in the elderly, especially episodic memory. ACE-Is, diuretics, BBs and CCBs did not seem to improve cognitive function in the elderly but were similarly effective in blood pressure lowering as ARBs.

Age-related pharmacotherapy of attention deficit hyperactivity disorder in Slovenia in children and adolescents: A population-based study.

BACKGROUND: There are no data on age-related pharmacotherapy for Attention Deficit Hyperactivity Disorder (ADHD) medication in children and adolescents in the most European countries. The main aim of this paper was to obtain that data for children and adolescents in Slovenia. METHOD: The number of ADHD drug prescriptions per patient was obtained from the health claims data on prescription drugs of the Health Insurance Institute of Slovenia for the study period (2003-2015). Three age groups were analyzed: 2-5 years, 6-12 years, and 13-17 years. Only immediate-release methylphenidate (IR-MPH), methylphenidate-osmotic release oral delivery system (OROS-MPH), and atomoxetine (ATX) were available and included in this study. RESULTS: Less than 50% of patients in Slovenia were treated with medication. The number of patients treated with MPH in the 6-12 age group remained approximately the same between 2007 and 2015 (604-729 patients). In the 13-17 age group, however that number increased 2-fold between 2003 and 2015, from 288 to 555. The number of patients treated with ATX in the 6-12 age group age group increased from 20 to 163 between 2007 and 2015. The number was similar in the 13-17 age group, increasing from 10 to 165 in the same period. In 2015, 21% of the patients from all age groups in this study were treated with ATX. CONCLUSIONS: The number of patients treated for ADHD increased rapidly in all age groups. Patients under the age of six are prescribed medication in Slovenia, which should be avoided.

Separation of two-electron photoexcited atomic processes near the inner-shell threshold.

By means of a high resolution resonant inelastic x-ray scattering spectroscopy, we have for the first time separated spectral features pertaining to different two-electron atomic processes in the vicinity of an inner-shell threshold. Contributions of shakeoff, shakeup, and resonant 1s3p double excitations were extracted from the Ar KM-M{2,3}M x-ray satellite line intensity measured as a function of photon energy from [1s3p] double excitation threshold to saturation. The isolated [1s3p]nln'l' excitation spectrum is critically compared to the outcome of the multiconfiguration Dirac-Fock model with relaxation.

Harmonization of individual dosimetry quality control within metrology system of a small country.

A programme of harmonization of individual dosimetry quality control organized in the framework of a distributed metrology system is presented as seen from the experiences gained in Slovenia. As a part of the programme intercomparison of dosimetry services was organized and basic characteristics of dosimetry systems compared. Results are discussed with suggestions for further improvements of quality assurance.

Intercomparison of dosimetry systems based on CaF2:Mn TL detectors.

The responses of readings by the TL dosimetry system MR200 TL developed in-house and used at JSI and the TOLEDO TL system used at RBI are compared. Ten measurements at different doses ranging from 0.01 mSv to 5 Sv were carried out. A set of 36 dosemeters with three pellets of CaF2:Mn were irradiated in radiation fields of 137Cs and 60Co. Analysis of the measured results shows that at doses below 0.1 Sv, readers' outputs do not differ >5% from each other. At doses >1 Sv, the results obtained by the MR200 reader must be corrected with a known factor. Finally, the reproducibility of the results from the MR200 was tested.

Comparative study of LiF:Mg,Cu,Na,Si and Li2B4O7:Cu,Ag,P TL detectors.

Recently, two new types of 'tissue equivalent' thermoluminescent detectors (TLDs) have aroused attention: LiF:Mg,Cu,Na,Si and Li2B4O7:Cu,Ag,P. In this work the characteristics of both detectors were compared with the characteristics of the well-known type LiF:Mg,Ti detector, TLD-100. The following properties were investigated: the glow curve structures, relative sensitivity, batch homogeneity and uniformity, detection threshold, reproducibility of the response, linearity in the wide dose range and fading. Also, the energy dependence for medium and low energy X rays was determined in the range of mean energies between 33 and 116 keV. The results confirmed 'tissue equivalency' of both new types in the investigated range of photon energies. LiF:Mg,Cu,Na,Si detector has very high sensitivity (approximately 75 times higher than that of TLD-100) and is convenient for use in a very low range of doses. Li2B4O7:Cu,Ag,P detector shows some improvements in comparison with the previously prepared types of lithium borate. The most important is the five times higher sensitivity than that of TLD-100. This detector is also very promising, especially in medical dosimetry.

Quality assurance of environmental gamma radiation monitoring in Slovenia.

Environmental gamma radiation monitoring established in Slovenia consists of a network of multifunctional gamma monitors (MFMs) based on pairs of Geiger-Müller counters and a network of measuring sites with high-sensitive thermoluminiscence dosemeters. The measuring points are evenly spread across Slovenia, located at the meteorological stations and more densely on additional locations around the Krsko NPP. The MFM network has a 2-fold function with one sensor used for the purpose of early warning system in near surroundings of the NPP and the other, more sensitive, for natural radiation monitoring. The paper summarises activities to establish quality assurance of the environmental gamma radiation measurements in Slovenia, with a critical view of the results in comparison with the international standards and recommendations. While the results of linearity and energy dependence tests were satisfying, on-field intercomparison showed that the inherent signal of one of the monitors (MFM) has to be taken into account in the range of environmental background radiation.

Energy dependence of new thermoluminescent detectors in terms of HP(10) values.

The aim of this work was to determine energy dependence characteristics in terms of values of the personal dose equivalent, HP(10). The following types of thermoluminescent detectors (TLDs) were investigated: (a) two new types based on lithium borate, Li2B4O7:Cu,In and Li2B4O7:Cu,In,Ag; (b) two types based on the highly sensitive material LiF:Mg,Cu,P, TLD-700H and GR 200A; (c) two well-known types of LiF:Mg,Ti detector, TLD-100 and TLD-700 and (d) highly sensitive Al2O3:C detectors. TLDs previously calibrated with 137Cs gamma rays were simultaneously irradiated with X ray beams in the range of mean energies between 33 and 116 keV. The irradiations were performed with detectors in polymethyl methacrylate (PMMA) holders placed on a 30 cm x 30 cm x 15 cm water phantom with PMMA walls (ISO phantom). Measured energy responses were compared with calculated data for HP(10) values. The results confirmed the satisfactory tissue equivalent characteristics of all investigated TLDs except Al2O3:C, which (due to its large energy dependence) is suitable for personal dosimetry only with an appropriate filter.

Development of a quality assurance programme for external personal dosimetry in Slovenia.

In order to improve the quality of individual monitoring and to achieve harmonisation with the new international standards, important components of a quality assurance system are considered and are presented as a result of cooperation of different institutions. The components are quality assurance and routine quality control of monitoring systems, and the creation of a central state dose register of workers.