Variation in Secondary Prevention of Coronary Heart Disease: The INTERASPIRE Study.

BACKGROUND AND AIMS: INTERASPIRE is an international study of coronary heart disease (CHD) patients, designed to measure if guideline standards for secondary prevention and cardiac rehabilitation are being achieved in a timely manner. METHODS: Between 2020-2023, adults hospitalized in the preceding 6-24 months with incident or recurrent CHD were sampled in 14 countries from all 6 World Health Organization regions and invited for a standardized interview and examination. Direct age and sex standardization was used for country-level prevalence estimation. RESULTS: Overall, 4548 (21.1% female) CHD patients were interviewed a median of 1.05 (interquartile range 0.76-1.45) years after index hospitalization. Among all participants, 24% were obese (40% centrally). Only 38.5% achieved a blood pressure (BP) <130/80 mmHg and 19.2% a low-density lipoprotein cholesterol (LDL-C) of <1.4 mmol/l. Of those smoking at hospitalization, 48% persisted at interview. Of those with known diabetes, 56% achieved glycated hemoglobin (HbA1c) of <7.0%. A further 9.8% had undetected diabetes and 26.9% impaired glucose tolerance. Females were less likely to achieve targets: BP (females 37.4% males 38.6%), LDL-C (females 13.7% males 18.6%) and HbA1c in diabetes (females 47.7% males 57.5%). Overall, just 9.0% (inter-country range 3.8%-20.0%) reported attending cardiac rehabilitation and 1.0% (inter-country range 0.0%-2.4%) achieved the study definition of optimal guideline adherence. CONCLUSIONS: INTERASPIRE demonstrates inadequate and heterogeneous international implementation of guideline standards for secondary prevention in the first year after CHD hospitalization, with geographic and sex disparity. Investment aimed at reducing between-country and between-individual variability in secondary prevention will promote equity in global efforts to reduce the burden of CHD.

Triglicerydes/high-density lipoprotein ratio as a risk factor of post-Covid-19 sinus tachycardia: A retrospective study.

Inappropriate sinus tachycardia (IST) is one of the manifestations of the post-COVID-19 syndrome (PCS), which pathogenesis remains largely unknown. This study aimed to identify potential risk factors for IST in individuals with PCS. The 1349 patients with PCS were included into the study. Clinical examination, 24H Holter ECG, 24H ambulatory blood pressure monitoring and biochemical tests were performed 12-16 weeks after the COVID-19 in all participants. IST was found in 69 (3.5%) individuals. In the clinical assessment IST patients were characterized by a higher age (p < 0.001) and lower prevalence of the diagnosed hypertension (p = 0.012), compared to remaining patients. Biochemical testing showed higher serum triglycerides (1.66 vs. 1.31 pmol/L, p = 0.007) and higher prevalence of a low high-density lipoprotein (HDL) cholesterol (24.6% vs. 15.2%, p = 0.035) in the IST group. Subsequently, the triglicerydes (TG)/HDL ratio, an indicator of insulin resistance, was significantly higher in the IST individuals (3.2 vs. 2.4, p = 0.005). 24H monitoring revealed a significantly higher minimum diastolic, maximum systolic and mean arterial blood pressure values in the IST group (p < 0.001 for all), suggesting a high prevalence of undiagnosed hypertension. A multivariate analysis confirmed the predictive value TG/HDL ratio >3 (OR 2.67, p < 0.001) as predictors of IST development. A receiver operating characteristic curve analysis of the relationship between the TG/HDL ratio and the IST risk showed that the predictive cut-off point for this parameter was 2.46 (area under the ROC curve = 0.600, p = 0.004). Based on these findings, one can conclude that insulin resistance seems to be a risk factor of IST, a common component of PCS.

The Critical Role of Community Pharmacists in Blood Pressure Monitoring.

Arterial hypertension is the most important modifiable risk factor for cardiovascular morbidity and mortality. In some countries, pharmacists' patient-centered approach has become a common practice, and their role in supporting the management of cardiovascular disease has been successfully developed for years. In particular, recent findings have confirmed benefits of pharmacist-provided hypertension care. Current guidelines emphasize the need for regular BP measurements in subjects age 40 years and older, who are at increased risk of hypertension. A panel of experts in cardiology, hypertensiology, family medicine, and pharmacy presented a narrative review of implementing community pharmacy blood pressure (CPBP) measurements into Polish pharmacy practice to assist pharmacists in CPBP readings. The paper focuses on basic aspects of management of untreated patients with elevated blood pressure levels, as well as management of individuals diagnosed with hypertension, who should follow their primary care physicians' recommendations for anti-hypertensive therapy. The article also includes a few important aspects related to CPBP measurement, such as equipment and techniques. Development of ready-made schemes of procedures for patients with different results of blood pressure measurement could ensure a uniform standard of services provided by pharmacists. This gives an opportunity to provide such patients with medical care and initiate treatment, and facilitates effective maintenance of BP in hypertensive subjects. This article reviews the role of pharmacists in Poland in screening for hypertension by taking blood pressure measurements.

Anemia and iron metabolism disorders after single anastomosis sleeve ileal (SASI) bypass. Is it a real problem?

PURPOSE: SASI (single anastomosis sleeve ileal) bypass can lead to nutritional deficiencies, including disorders of iron metabolism and anemia. This study aims to evaluate the effect of SASI bypass on weight loss, anemia, and iron deficiency in patients with obesity during the follow-up period. METHODS: This study is a retrospective analysis of prospectively collected data from patients who underwent SASI bypass at our hospital between January 2020 and February 2022. RESULTS: The mean age of the patients was 42 years (range 22-58). The average duration of the follow-up period was 26 months. The mean percentage of excess weight loss (%EWL) was 90.1%, and total weight loss (%TWL) was 30.5%. During the postoperative observation period, anemia was identified in ten patients (25%), comprising 70% with normocytic anemia, 10% with microcytic anemia, and two macrocytic anemia cases (20%). Iron deficiency was observed in two patients (5%). CONCLUSION: SASI bypass is an effective bariatric procedure in weight loss outcomes. However, there may be an increased risk of anemia and iron metabolism disruptions associated with this procedure. The common limb length (250 vs. 300 cm) did not significantly impact hemoglobin, iron, TIBC, ferritin levels, or anemia incidence among patients undergoing SASI bypass. The decrease in postoperative ferritin levels signifies a depletion in tissue iron reserves, thereby emphasizing the necessity for surveillance of iron homeostasis parameters following SASI bypass.

May Measurement Month 2021: an analysis of blood pressure screening results from Poland.

May Measurement Month 2021 (MMM21) is the fourth edition of the global initiative in Poland initiated by the International Society of Hypertension (ISH) and aimed at raising awareness of hypertension and the need for blood pressure (BP) screening. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in 132 sites - between May and September 2021. Blood pressure was measured in 1699 subjects (mean age: 40.8 ± 17.0 years; 68.8% females). After multiple imputation, the age and sex standardized systolic and diastolic BP was 126.6/78.7 mmHg for the entire group, 133.8/81.9 mmHg in individuals on antihypertensive medication, and 125.4/78.6 mmHg in those not taking antihypertensive drugs. The proportion of subjects with high BP (≥140/90 mmHg) were: 30.9% for the entire group, 40.4% in subjects taking antihypertensive drugs, and 17.9% in those not taking antihypertensive drugs. Of all participants, 33.9% were in the age range of 18-29 years and we observed higher BP levels and more frequent BP elevation in males in this age group. These data provide unique insights into the hypertension rates during the COVID-19 pandemic. Due to the associated restrictions, only limited data could be obtained for older adults. Interestingly, among young Polish participants, the rate of hypertension and the level of BP were higher in males compared to females, suggestive perhaps of a higher susceptibility of males to experience a rise in BP during specific circumstances associated with a pandemic.

Burden of ischemic stroke in sub-Saharan African countries based on DALYs index - trend analysis and identification of risk factors. / Obciazenie panstw Afryki Subsaharyjskiej zwiazane z niedokrwiennym udarem mózgu na podstawie wskaznika DALY ­ analiza tendencji oraz identyfikacja czynników ryzyka.

BACKGROUND: Stroke burden, measured by DALYs, reveals a growing concern in sub-Saharan Africa. Ischemic stroke, exacerbated by modifiable risk factors like hypertension and household air pollution, poses a significant health challenge. Regional disparities, economic development, and healthcare inefficiencies underscore the need for targeted interventions and further research. OBJECTIVE: This study aims to analyze trends in the burden of ischemic stroke across specific regions in sub-Saharan Africa from 2000 to 2019. The objective is to identify key changes in stroke burden progression and highlight modifiable risk factors. MATERIAL AND METHODS: Utilizing World Health Organization (WHO) data from 2000 and 2019, national estimates of ischemic stroke DALYs in 49 sub-Saharan African countries were collected. DALYs were calculated per 100,000 population to reduce the impact of population size. Statistical analyses and visual representations using MapChart were employed to interpret the trends. RESULTS: The study reveals wide variations in ischemic stroke DALYs changes across sub-Saharan African countries from 2000 to 2019. Predominantly, countries in the Eastern and Southern regions experienced adverse increases, while those in the Central and West regions mostly exhibited declines in DALYs. Countries such as Lesotho, Zimbabwe, and Mauritius, saw the most significant DALYs increases, whereas Rwanda, Malawi, and Equatorial Guinea experienced the most favorable changes. CONCLUSIONS: Stroke is a pressing health concern in sub-Saharan Africa. Modifiable risk factors like hypertension and household air pollution necessitate targeted interventions. Tailored healthcare policies, reinforced health systems and comprehensive research into region-specific risk factors are crucial to alleviate stroke-related morbidity and mortality in the region. Addressing these challenges is vital to mitigate the increasing burden of stroke in the particular regions of sub-Saharan Africa.

Clinical and electrocardiographic correlates of myocardial dysfunction after COVID-19 in nonhospitalised patients in long-term follow-up. Data from the polish long-covid cardiovascular study.

Clinical evidence indicates that COVID-19 is a multiorgan disease that significantly impacts the cardiovascular system. However, little is known about the predictors of myocardial dysfunction after SARS-CoV-2 infection. Therefore, this research aimed to evaluate the clinical and electrocardiographic correlates of myocardial dysfunction after SARS-CoV-2 infection in nonhospitalised patients without previously diagnosed cardiovascular disease. This observational study included 448 patients selected from the database of 4142 patients in the Polish Long-Covid Cardiovascular study. All patients underwent a 12-lead electrocardiogram (ECG); 24-h Holter ECG monitoring, 24/7 ambulatory blood pressure monitoring, echocardiography, and cardiac magnetic resonance imaging. According to the results of diagnostic tests, patients were divided into two groups depending on the occurrence of myocardial dysfunction after COVID-19. Group 1-without myocardial dysfunction after COVID-19-consisted of 419 patients, with a mean age of 48.82 (SD ± 11.91), and Group 2 (29 patients)-with myocardial dysfunction after COVID-19, with a mean age of 51.45 (SD ± 12.92). When comparing the analysed groups, there were significantly more men in Group 2 (p = 0.006). QRS (corresponds to the time of ventricular contraction in an electrocardiographic examination) fragmentation (p = 0.031), arrhythmias (atrial fibrillation, supraventricular extrasystole, ventricular extrasystole) (p = 0.008), and male gender (p = 0.007) were independently associated with myocardial dysfunction after COVID-19. The study showed that myocardial damage after COVID-19 affects men more often and is independent of typical clinical factors and the severity of the disease course. The QRS fragmentation and arrhythmias observed in the ECG indicate the possibility of myocardial dysfunction in patients after COVID-19, which may be a valuable marker for physicians.

OAGB with shortened excluded ileal loop as an effective treatment for type 2 diabetes mellitus in the cases of Caucasian men and women with obesity of the first degree (BMI 30-35 kg/m2).

INTRODUCTION: The aim of the study is to assess the effect of shortening the excluded loop of the small intestine to 150 cm on the effectiveness of one anastomosis gastric bypass (OAGB) in remission of type 2 diabetes with Io obesity. MATERIAL AND METHODS: The study included 25 patients with a body mass index (BMI) 30-35 kg/m2, with a diagnosis of diabetes mellitus type 2 (T2DM), and undergoing OAGB with excluded 150 cm of the small intestine. RESULTS: There were no deaths in the study group, bleeding during the postoperative period requiring reoperation, anastomotic leakage/leakage throught mechanical stitching. The mean a glycated haemoglobin (HbA1C) level 12 months after surgery was 6.16 ± 0.96%, corresponding to a 2.29 ± 3.3% decrease. In more than 85% of the patients taking insulin before surgery, the insulin was discontinued in the postoperative period. Additionally, the level of glycaemia was assessed in patients on the day of surgery (163 ± 58 mg/dl) and on the day of discharge from the hospital (4.7 ± 1.3 days)-it was lower by over 18% (133 ± 39.2 mg). Over the period of 12 months following OAGB, there was a reduction in the mean BMI value from 33.5 ± 2 to 25.5 ± 2.5 kg/m2 and improvement in lipid parameters and mean values of blood pressure. CONCLUSION: OAGB with excluded 150 cm of the small intestine has beneficial effect on the remission of T2DM in patients with a BMI of 30-35kg/m2 and is associated with an acceptable level of complications. The achieved weight loss after surgery is satisfactory.

ANALYSIS OF FACTORS ASSOCIATED WITH FRAILTY SYNDROME IN PATIENTS WITH HEART FAILURE.

OBJECTIVE: Aim: Determination of factors associated with frailty syndrome (FS) in patients with heart failure (HF). PATIENTS AND METHODS: Materials and methods: Consecutive patients hospitalized in the department were assessed for the presence of FS using L. Fried criteria, Edmonton Frail Scale (EFS) and Tilburg Frailty Indicator (TFI). Presence of arterial hypertension, diabetes, obesity, chronic obstructive pulmonary disease (COPD), and heart failure was included in the analysis based on patients' medical history and findings from current hospitalization. Patients were assessed for the presence of depression using Beck's Depression Inventory (BDI). Physical capacity was assessed using NYHA classification. RESULTS: Results: 87 patients (mean age 81.4±6.7; 57 women; 11 HFrEF, mean NYHA 2.36±1.21; 11 HFmrEF, mean NYHA 2.18±1.08; 65 HFpEF mean NYHA 1.94±1.09) were included in the analysis. Multivariable analysis showed significant relationship between FS assessed with EFS and age (ß=0.316, SE=0.08; p=0.0001), arterial hypertension (ß=-0.194, SE=0.08; p=0.0173), COPD (ß=0.176, SE=0.08; p=0.0300) and depression (ß=0.565, SE=0.08; p=0.0000). FS assessed with L. Fried criteria was significantly related to age (ß=0.359, SE=0.09; p= 0.0001), NYHA classification (ß= 0.336, SE=0.09; p=0.0002) and depression (ß=0.297, SE=0.09; p=0.0010). Age (ß=0.251, SE=0.10; p=0.0114) and depression (ß=0.375, SE=0.1; p=0.0002) were significantly related to FS assessed using TFI. In multivariable analysis HF phenotype was not significantly related to FS. CONCLUSION: Conclusions: Age and depression assessed with BDI are related to FS in patients with HF. Arterial hypertension and COPD are linked to FS assessed using EFS, whereas NYHA classification is linked to FS assessed with L. Fried criteria. No statistically significant relationship was found between FS and HF phenotype.

Longer Hospitalizations and Higher In-Hospital Mortality for Acute Heart Failure during the COVID-19 Pandemic in Larger vs. Smaller Cardiology Departments: Subanalysis of the COV-HF-SIRIO 6 Multicenter Study.

Background: The coronavirus disease-2019 (COVID-19) pandemic is surging across Poland, leading to many direct deaths and underestimated collateral damage. We aimed to compare the influence of the COVID-19 pandemic on hospital admissions and in-hospital mortality in larger vs. smaller cardiology departments (i.e., with ≥ 2000 vs. < 2000 hospitalizations per year in 2019). Methods: We performed a subanalysis of the COV-HF-SIRIO 6 multicenter retrospective study including all patients hospitalized in 24 cardiology departments in Poland between January 1, 2019 and December 31, 2020, focusing on patients with acute heart failure (AHF) and COVID-19. Results: Total number of hospitalizations was reduced by 29.2% in larger cardiology departments and by 27.3% in smaller cardiology departments in 2020 vs. 2019. While hospitalizations for AHF were reduced by 21.8% and 25.1%, respectively. The length of hospital stay due to AHF in 2020 was 9.6 days in larger cardiology departments and 6.6 days in smaller departments (p < 0.001). In-hospital mortality for AHF during the COVID-19 pandemic was significantly higher in larger vs. smaller cardiology departments (10.7% vs. 3.2%; p < 0.001). In-hospital mortality for concomitant AHF and COVID-19 was extremely high in larger and smaller cardiology departments accounting for 31.3% vs. 31.6%, respectively. Conclusions: During the COVID-19 pandemic longer hospitalizations and higher in-hospital mortality for AHF were observed in larger vs. smaller cardiology departments. Reduced hospital admissions and extremely high in-hospital mortality for concomitant AHF and COVID-19 were noted regardless of department size.

Investigation of the Associations of Novel Inflammatory Biomarkers-Systemic Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI)-With the Severity of Coronary Artery Disease and Acute Coronary Syndrome Occurrence.

Atherosclerosis, the underlying cause of coronary artery disease (CAD), has a significant inflammatory component. White blood cell count is an affordable and accessible way to assess the systemic immune response, as it comprises many subgroups with distinct and complex functions. Considering their multidirectional effect on atherosclerosis, new biomarkers integrating various leukocyte subgroups, the Systemic Inflammatory Index (SII) and the Systemic Inflammatory Response Index (SIRI), were recently devised to describe the balance between inflammation and immune reaction. This research aimed to evaluate the relationship of the intensity of inflammation measured by these biomarkers with the severity of CAD assessed with coronary angiography and with the diagnosis of acute coronary syndrome (ACS) or stable CAD in 699 patients. SIRI, but not SII, was associated with the diagnosis, having the highest values for patients with ACS (STEMI), significantly higher than in patients with stable CAD (p < 0.01). The highest SII and SIRI values were observed in patients with three-vessel CAD. SII and SIRI require further in-depth and well-designed research to evaluate their potential in a clinical setting.

Critical Role of Functional Groups Containing N, S, and O on Graphene Surface for Stable and Fast Charging Li-S Batteries.

Lithium-sulfur (Li-S) batteries are considered one of the most promising energy storage technologies, possibly replacing the state-of-the-art lithium-ion (Li-ion) batteries owing to their high energy density, low cost, and eco-compatibility. However, the migration of high-order lithium polysulfides (LiPs) to the lithium surface and the sluggish electrochemical kinetics pose challenges to their commercialization. The interactions between the cathode and LiPs can be enhanced by the doping of the carbon host with heteroatoms, however with relatively low doping content (<10%) in the bulk of the carbon, which can hardly interact with LiPs at the host surface. In this study, the grafting of versatile functional groups with designable properties (e.g., catalytic effects) directly on the surface of the carbon host is proposed to enhance interactions with LiPs. As model systems, benzene groups containing N/O and S/O atoms are vertically grafted and uniformly distributed on the surface of expanded reduced graphene oxide, fostering a stable interface between the cathode and LiPs. The combination of experiments and density functional theory calculations demonstrate improvements in chemical interactions between graphene and LiPs, with an enhancement in the electrochemical kinetics, power, and energy densities.

Boosting Rechargeable Batteries R&D by Multiscale Modeling: Myth or Reality?

This review addresses concepts, approaches, tools, and outcomes of multiscale modeling used to design and optimize the current and next generation rechargeable battery cells. Different kinds of multiscale models are discussed and demystified with a particular emphasis on methodological aspects. The outcome is compared both to results of other modeling strategies as well as to the vast pool of experimental data available. Finally, the main challenges remaining and future developments are discussed.

May Measurement Month 2019: an analysis of blood pressure screening results from Poland.

May Measurement Month 2019 is the third edition of a global initiative organized by the International Society of Hypertension aimed at raising awareness of hypertension and the need for blood pressure (BP) screening. We present data analysis from Poland. To evaluate the potential of opportunistic BP measurements as a tool for cardiovascular disease prevention programmes. To collect new country data for further annual comparisons. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in 201 sites in May 2019. BP was measured in 7072 subjects (mean age: 54 ± 15 years; 62.3% females). After multiple imputation, the age- and sex-standardized systolic BP (SBP) and diastolic BP (DBP) was 125.4/78.5 mmHg in the whole group, 133.3/82.8 mmHg in individuals on antihypertensive medication and 123.3/77.7 mmHg in those not taking antihypertensive drugs. The proportion of subjects with high BP (≥140/90 mmHg) were 41.8% in subjects taking antihypertensive drugs, and 19.6% in those not taking any antihypertensive drugs. Overall, hypertension was present in 55.4% of participants (3917 out of 7072), of whom 83.0% were aware of their diagnosis. 80.4% of hypertensives were taking antihypertensive medication. 46.7% of all hypertensives had BP controlled to target (<140/90 mmHg). Higher BP correlated with body mass index and age but not tobacco smoking. SBP but not DBP was higher in diabetic participants. These data provide evidence on the current epidemiology of hypertension and may serve as a source of information to introduce primary and secondary prevention programmes to reduce cardiovascular risk in Poland.

May Measurement Month 2018: an analysis of blood pressure screening campaign results from Poland.

Hypertension remains the most important cardiovascular risk factor in Poland. May Measurement Month is a global initiative organized by the International Society of Hypertension aimed at raising awareness of hypertension and the need for blood pressure (BP) screening and demonstrating the potential of the opportunistic BP measurements. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in 146 sites in May 2018. Blood pressure was measured in 6450 subjects (mean age: 41 ± 15 years; 59% females). After multiple imputation, the age and sex standardized systolic and diastolic BP was 126.7/78.4 mmHg in the whole analysed group, 132.8/81.3 mmHg in subjects taking antihypertensive drugs, and 125.7/78.0 mmHg in those not taking any antihypertensive drugs. After multiple imputation, the proportions of subjects with high BP (systolic ≥140 mmHg or diastolic ≥90 mmHg or on treatment for raised BP) were 22.2% in the whole analysed group, 39.2% in subjects taking antihypertensive drugs, and 18.6% those not taking any antihypertensive drugs. Overall, hypertension was present in 32.8% of participants, among them 38.7% were not aware of the disease, 53.1% were taking antihypertensive drugs, and 32.3% had BP controlled to target (<140/90 mmHg). Blood pressure was increasing with increasing body mass index and alcohol intake. Smokers and project participants with diabetes had increased average BP. In conclusion, this project provides additional evidence for a considerable potential for further reduction of cardiovascular risk through improvement in detection and treatment of hypertension in Poland.

Multi-Electron Reactions Enabled by Anion-Based Redox Chemistry for High-Energy Multivalent Rechargeable Batteries.

The development of multivalent metal (such as Mg and Ca) based battery systems is hindered by lack of suitable cathode chemistry that shows reversible multi-electron redox reactions. Cationic redox centres in the classical cathodes can only afford stepwise single-electron transfer, which are not ideal for multivalent-ion storage. The charge imbalance during multivalent ion insertion might lead to an additional kinetic barrier for ion mobility. Therefore, multivalent battery cathodes only exhibit slope-like voltage profiles with insertion/extraction redox of less than one electron. Taking VS4 as a model material, reversible two-electron redox with cationic-anionic contributions is verified in both rechargeable Mg batteries (RMBs) and rechargeable Ca batteries (RCBs). The corresponding cells exhibit high capacities of >300 mAh g-1 at a current density of 100 mA g-1 in both RMBs and RCBs, resulting in a high energy density of >300 Wh kg-1 for RMBs and >500 Wh kg-1 for RCBs. Mechanistic studies reveal a unique redox activity mainly at anionic sulfides moieties and fast Mg2+ ion diffusion kinetics enabled by the soft structure and flexible electron configuration of VS4 .

Do we know more about hypertension in Poland after the May Measurement Month 2017?-Europe.

Elevated blood pressure (BP) is a worldwide burden, leading to over 10 million deaths yearly. May Measurement Month (MMM) is a global initiative organized by the International Society of Hypertension aimed at raising awareness of hypertension and the need for BP screening. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017. BP measurement, the definition of hypertension and statistical analysis followed the globally approved MMM17 Study Protocol. In Poland 5834 (98.9%, Caucasian) individuals were screened. After multiple imputation, 2601 (35.3%) had hypertension. Of individuals not receiving anti-hypertensive medication, 976 (20.6%) were hypertensive. Of individuals receiving anti-hypertensive medication, 532 (49.1%) had uncontrolled BP. In the crude screened group, 81.4% declared to not receive any anti-hypertensive treatment, while the remaining 18.6% were on such medications. In overweight and obese patients both systolic and diastolic BP were significantly higher than in normal weight and underweight subjects. In addition, BP measured on Sundays was significantly lower than on Mondays. MMM17 was one of the largest recent BP screening campaigns in Poland. We found that over 1/3 of participants were hypertensive. Almost half of the treated subjects had uncontrolled BP. These results suggest that opportunistic screening can identify substantial numbers with raised BP.

Relationship between Blood and Induced Sputum Eosinophils, Bronchial Hyperresponsiveness and Reversibility of Airway Obstruction in Mild-to-Moderate Chronic Obstructive Pulmonary Disease.

Blood eosinophilia has been proposed as a surrogate marker for airway eosinophilia and as a predictor of treatment response in chronic obstructive pulmonary disease (COPD). The aim of the study was to assess the relationship between blood and sputum eosinophils and to investigate the association between blood and sputum eosinophil count and clinical features of mild-to-moderate COPD. We performed a retrospective analysis of blood and sputum eosinophil count, as well as demographic and lung function data in a cohort of 90 stable, steroid-naive (Global Initiative for Chronic Obstructive Lung Disease 1 or 2) COPD patients and 20 control subjects. Blood and sputum eosinophil count did not correlate both in patients with COPD (r = -0.04 p = 0.705) and in controls (r = 0.05, p = 0.838). Sputum eosinophilia (≥3%) was present in 40% of COPD patients. The median blood eosinophil count in patients with COPD was 180 (interquartile range 90-270)/µL; patients with low blood eosinophils (<180/µL) did not differ from those with high blood eosinophils (≥180/µL) in terms of forced expiratory volume in 1 second, bronchial reversibility or hyperresponsiveness. This was also the case when COPD patients with and without sputum eosinophilia were compared. At the same time, positive bronchial reversibility and positive bronchial hyperresponsiveness were observed in 2 (11%) COPD patients with high blood eosinophils and in 1 (5%) patient with sputum eosinophilia. There was a weak, albeit significant correlation (r = 0.22 p = 0.041) between blood eosinophil count and age in patients with COPD. Peripheral eosinophil count poorly reflects sputum eosinophils and lung function in stable steroid-naive mild-to-moderate COPD patients.

[Control of cardiovascular risk factors in patients after myocardial infarction].

Despite significant improvements in the diagnosis and treatment of cardiovascular diseases that have occurred in recent years, they remain the main cause of morbidity and mortality in the population. In many European countries, the incidence of coronary heart disease is currently 50% lower than it was in the early 1980s, which is the result of cardiovascular prevention. A special group of patients are people after myocardial infarction with very high cardiovascular risk. They should definitely implement activities at the individual level e. g. work on improving the unhealthy lifestyle and pharmacologically control other risk factors. A diet low in saturated fats should be recommended, i.e. mainly containing whole grains, vegetables, fruits and fish, recommend regular physical exercise: 150 min / week of moderate, aerobic physical activity, reducing the supply of calories in order to get rid of overweight or obesity. Help in quitting tobacco addiction should take place through the minimal nicotine intervention and, if necessary, pharmacological therapy. Another thing is the control of other risk factors, i. e. the appropriate treatment of dyslipidemia (the primary target is LDL cholesterol <1.8 mmol/l or reduction by ≥ 50%, if the initial concentration is between 1.8 and 3.5 mmol/l, treatment hypertension (target arterial pressure for most people aged 18-65 is in the range: 120-130/70-79 mmHg, if it is well tolerated, while for older people it is in the range: 130-139/70-79mmHg, if it is well tolerated), optimal diabetes therapy (target glycated hemoglobin <7%) and appropriate antiplatelet therapy (in most patients double antiplatelet therapy is recommended for 12 months after acute coronary syndrome). These activities lead to a significant improvement in quality of life and a decrease in mortality due to cardiovascular diseases.

Fully quantum calculation of the second and third virial coefficients of water and its isotopologues from ab initio potentials.

Path-Integral Monte Carlo methods were applied to calculate the second, B(T), and the third, C(T), virial coefficients for water. A fully quantum approach and state-of-the-art flexible-monomer pair and three-body potentials were used. Flexible-monomer potentials allow calculations for any isotopologue; we performed calculations for both H2O and D2O. For B(T) of H2O, the quantum effect contributes 25% of the value at 300 K and is not entirely negligible even at 1000 K, in accordance with recent literature findings. The effect of monomer flexibility, while not as large as some claims in the literature, is significant compared to the experimental uncertainty. It is of opposite sign to the quantum effect, smaller in magnitude than the latter below 500 K, and varies from 2% at 300 K to 10% at 700 K. When monomer flexibility is accounted for, results from the CCpol-8sf pair potential are in excellent agreement with the available experimental data and provide reliable B(T) values at temperatures outside the range of experimental data. The flexible-monomer MB-pol pair potential yields B(T) values that are slightly too high compared to experiment. For C(T), our calculations confirm earlier findings that the use of three-body potential is necessary for meaningful predictions. However, due to various uncertainties of the potentials used, especially the three-body ones, we were not able to establish benchmark values of C(T), although our results are in qualitative agreement with available experimental data. The quantum effect, never before included for water, reduces the magnitude of the classical value for H2O by a factor of 2.5 at 300 K and is not entirely negligible even at 1000 K.