Subacute toxicity and endocrine-disrupting effects of Fe2O3, ZnO, and CeO2 nanoparticles on amphibian metamorphosis.

This study evaluated the potential toxic and endocrine-disrupting effects of sublethal concentrations of Fe2O3, CeO2 and ZnO nanoparticles (NPs) on amphibian metamorphosis. Tadpoles were exposed to several NPs concentrations, reaching a maximum of 1000 µg/L, for up to 21 days according to the amphibian metamorphosis assay (AMA). Some standard morphological parameters, such as developmental stage (DS), hind limb length (HLL), snout-to-vent length (SVL), wet body weight (WBW), and as well as post-exposure lethality were recorded in exposed organisms on days 7 and 21 of the bioassay. Furthermore, triiodothyronine (T3), thyroxine (T4) and malondialdehyde (MDA) levels and the activities of glutathione S-transferases (GST), glutathione reductase (GR), catalase (CAT), carboxylesterase (CaE), and acetylcholinesterase (AChE) were determined in exposed tadpoles as biomarkers. The results indicate that short-term exposure to Fe2O3 NPs leads to toxic effects, both exposure periods cause toxic effects and growth inhibition for ZnO NPs, while short-term exposure to CeO2 NPs results in toxic effects and long-term exposure causes endocrine-disrupting effects. The responses observed after exposure to the tested NPs during amphibian metamorphosis suggest that they may have ecotoxicological effects and their effects should be monitored through field studies.

Haemophagocytic lymphohistiocytosis in a patient with left ventricular assist device.

Left ventricular assist devices provide circulatory support to heart failure patients while awaiting a suitable donor heart. However, with their increased duration of therapy, complications are seen frequently. Although coagulation disorders (bleeding and thrombosis) are the most common complications, infection is also a major complication associated with significant morbidity. We report a case of a 53-year-old male with a left ventricular assist device who presented with driveline infection. He subsequently developed pancytopenia and was diagnosed with haemophagocytosis. Immediate treatment with intravenous immunoglobulin and methylprednisolone was started. His blood cell count returned to normal levels and the patient became eligible for heart transplantation again. Our case represents the rare occurrence of haemophagocytosis in a patient, which, if unnoticed, could lead to fatal consequences.

Morbidity and mortality risk among patients with screening-detected severe hypertension in the Malmö Preventive Project.

OBJECTIVE: Screening of hypertension has been advocated for early detection and treatment. Severe hypertension (grade 3 hypertension) is a strong predictor for cardiovascular disease. This study aimed to evaluate not only the risk factors for developing severe hypertension, but also the prospective morbidity and mortality risk associated with severe hypertension in a population-based screening and intervention programme. RESEARCH DESIGN AND METHODS: In all, 18,200 individuals from a population-based cohort underwent a baseline examination in 1972-1992 and were re-examined in 2002-2006 in Malmö, Sweden. In total, 300 (1.6%) patients with severe hypertension were identified at re-examination, and predictive risk factors from baseline were calculated. Total and cause-specific morbidity and mortality were followed in national registers in all severe hypertension patients, as well as in age and sex-matched normotensive controls. Cox analyses for hazard ratios were used. RESULTS: Men developing severe hypertension differed from matched controls in baseline variables associated with the metabolic syndrome, as well as paternal history of hypertension (P < 0.001). Women with later severe hypertension were characterized by elevated BMI and a positive maternal history for hypertension at baseline. The risk of mortality, coronary events, stroke and diabetes during follow-up was higher among severe hypertension patients compared to controls. For coronary events, the risk remained elevated adjusted for other risk factors [hazard ratio 2.31, 95% confidence interval (CI) 1.22-4.40, P = 0.011]. CONCLUSION: Family history and variables associated with metabolic syndrome are predictors for severe hypertension after a long-term follow-up. Severe hypertension is associated with increased mortality, cardiovascular morbidity and incident diabetes in spite of treatment. This calls for improved risk factor control in patients with severe hypertension.

Monitoring treatment adherence in hypertension.

Hypertension is associated with high mortality and morbidity that will increase if hypertension is left untreated. Treatment adherence is crucial in blood pressure control, and monitoring patient adherence is essential to the successful management of hypertension, since nonadherence is associated with poor prognosis. There are both direct and indirect methods to monitor adherence. Direct methods can be defined as assessment of treatment response or level of drug or its metabolite in blood, urine and body fluids without any intermediate or agent. Indirect methods require several instruments, such as questionnaires, reports, devices, and monitors. Certain methods may be advantageous in specific clinical and research settings. Advances in technology (new tools, devices, laboratory methods), and new approaches to reporting will not only help patients control high blood pressure but decrease hypertension-related mortality and morbidity.

Hypertension in women--pathophysiological and clinical aspects.

Hypertension is the most important risk factor, responsible for cardiovascular morbidity and mortality worldwide, both in men and women. Cardiovascular disorders in women are still underestimated, due to lower absolute risk calculations and the underdetection of classical risk factors. In recent years the differences in pathophysiology and the clinical presentation and treatment of cardiac diseases in women have become fields of interest and research. Several studies have examined gender-related differences in the pathophysiology of hypertension, its prevalence and control. The influence of menopause, obesity and salt-sensitivity on the pathogenesis of hypertension in women has been widely investigated. This article presents current data on differences in prevalence, control and mechanisms of hypertension in women.

7th meeting on hypertension and atherosclerosis.

The 7th Meeting on Hypertension and Atherosclerosis was organized in collaboration with the Society of Hypertension and Atherosclerosis and endorsed by the European Society of Hypertension. From basic sciences to clinical aspects, the congress covered the wide spectrum of cardiovascular health, providing a venue for the conversation of scientists from all around the world. At the end of the 5 days, participants had the opportunity discuss the main topics and updates on hypertension and atherosclerosis.

What we have learned from risk charts?

Evaluation of: Sehestedt T, Jeppesen J, Hansen TW et al.: Risk stratification with the risk chart from the European Society of Hypertension compared with SCORE in the general population. J. Hypertens. 27, 2351-2357 (2009). Risk factor assessment is an important issue in preventing and treating cardiovascular diseases. Three widely used risk charts: the Framingham, Systemic Coronary Risk Evaluation and the European Society of Hypertension/European Society of Cardiology charts, are discussed, and a recent study by Sehestedt et al. comparing systemic coronary risk evaluation and the European Society of Hypertension/European Society of Cardiology chart, is also evaluated in this article.

[Unmet needs in hypertension]. / Hipertansiyonda karsilanmamis gereksinimler.

Hypertension is considered one of the world's most important health problems. Approximately one billion people are affected in the world. Almost for 50 years, effective medical treatment in reducing blood pressure are among the tools of cardiovascular medical treatment. However, control rates of hypertension is not at an acceptable level. One of the main causes of the difficulty to take hypertension under control is that this disease is a chronic disease. Control of hypertension and the goal of optimum blood pressure is of crucial importance because of the association between arterial hypertension and organ damage in terms of cardiac, vascular and renal functions. An important part of research on hypertension has concentrated on renin angiotensin system (RAS), as a basic mechanism in regulating acute and chronic blood pressure. Today, what is expected from new antihypertensive drugs and direct renin inhibitors in particular is to provide significantly more effective blood pressure control as well as preventing target organ damage, by acting on the RAS which has an important role in the etiology of hypertension.