The hemodynamic patterns in hypertensive men and women of different age.

Aging is associated with cardiovascular remodeling, which can be accelerated in arterial hypertension (AH). The aim of this study was to evaluate the relation between hemodynamic profile and age, as well as to identify the role of sex in hemodynamic patterns of aging in AH. The study comprised 326 patients with AH (mean age: 44.3 years). Two-dimensional echocardiography was performed to evaluate, that is, left ventricular diastolic dysfunction (LVDD) and ejection fraction (LVEF), and ICG to evaluate, that is, acceleration time index (ACI), velocity index (VI), total arterial compliance (TAC), systemic vascular resistance index (SVRI) and thoracic fluid content (TFC). The statistical analysis included interquartile comparison in subgroups of age <19-37 years (Q1), 38-44 years (Q2), 45-51 years (Q3) and 52-68 years (Q4). Aging was associated with: (1) higher prevalence of LVDD (Q1 vs Q4: 11.0% vs 24.7%, P=0.023); (2) altered LV systolic performance-ACI (81.4 vs 64.0 1/100 Ω s(-2), P=0.0001), VI (50.5 vs 42.8 1/1000 Ω s(-1), P=0.006), LVEF (65.4% vs 67.0%, NS); and (3) increased afterload-TAC (2.25 vs 1.87 ml mm Hg(-1), P=0.0001), SVRI (2182 vs 2407 dyn s m(2) cm(-)(5); P=0.045). The 'U-shaped' relation to age was observed for TFC. The above-mentioned hemodynamic trends were more pronounced in men, whereas females presented the 'middle-aged delay'. The influence of aging on cardiovascular system shows in progressive arterial stiffness and impaired left ventricular function. Thoracic fluid reduction may be compensatory to vasoconstriction but its efficiency declines with age. The patterns of cardiovascular aging are different in men and women.

Sex determines cardiovascular hemodynamics in hypertension.

The aim of this study was to evaluate the influence of sex on cardiovascular hemodynamics and heart remodeling in 144 patients with arterial hypertension that underwent: (1) echocardiography (that is, indices of left ventricular diastolic function: e', E/e'), (2) impedance cardiography (that is, systemic vascular resistance (SVR), total artery compliance (TAC) and Heather index (HI)) and (3) applanation tonometry (augmentation index (AI), central systolic and diastolic blood pressure (CSBP, CDBP), central pulse pressure (CPP)). Women, in comparison with men, revealed to have: (1) stiffer arteries--lower TAC (1.93±0.55 vs 2.16±0.59 ml per mm Hg; P=0.025), higher CSBP (128.7±14.9 vs 123.4±13.2 mm Hg; P=0.036), CPP (39.9±9.5 vs 33.8±9.0 mm Hg; P=0.0002), AI (31.5±8.7 vs 17.5±12.7%; P<0.00001), SVR (1257.6±305.6 vs 1091.2±240.7 dyn × s × cm(-)(5); P=0.002) and (2) higher left ventricular performance--HI (16.3±4.3 vs 11.7±3.2 Ohm × s(2); P<0.00001). In women CSBP, CPP and AI were more clearly associated with left ventricular filling pressure (e') (r=-0.39, r=-0.45, r=-0.44, P<0.01; respectively). These relations were remarkably weaker in men. Hypertensive women characterized with lower large artery compliance, more pronounced augmentation of central blood pressure and more distinctive association of central blood pressure with left ventricular diastolic function. Sex differences in cardiovascular function can impact the individualized management of arterial hypertension.

Biliary complications after orthotopic liver transplantation: a 5-year experience.

INTRODUCTION: Biliary complications, particularly bile duct stenosis or leak, remain the "Achilles' heel" of orthotopic liver transplantation (OLT), significantly increasing the risk of graft loss and recipient death. The aim of the study was to retrospectively analyze biliary complications over a 5-year experience seeking to identify risk factors for these complications. MATERIAL AND METHODS: Eighty-seven OLT performed in 84 recipients were included in the analysis. In all cases but one, we performed an end-to-end hepatic duct anastomosis with a 7-0 running suture under 2.5× magnification. RESULTS: Biliary complications developed after 17.2% OLT: anastomosis site stenosis (10.3%), multiple stenoses (5.7%), or bile duct necrosis (1.1%). A bile leak was not observed. Two recipients died from biliary sepsis. Among the patients with biliary complications, there was an higher rate of hepatic artery problems (33.3% vs 2.7%; P<.01), and a longer anhepatic phase (85 vs 72 minutes; P<.01). We performed endoscopic treatment in 73% and percutaneous drainage in 6.6% of recipients. Good treatment results were achieved in 36.4% of cases with biliary complications whereas they were satisfactory in 27.3%. Five patients with biliary complications required re-transplantation. CONCLUSIONS: A bile duct anastomosis performed end-to-end with a running suture under magnification decreased the risk of bile leakage after OLT. A prolonged anhepatic phase or an hepatic artery thrombosis or stenosis increased the risk of biliary complications after OLT.

The multinational birth cohort of EuroPrevall: background, aims and methods.

BACKGROUND/AIM: The true prevalence and risk factors of food allergies in children are not known because estimates were based predominantly on subjective assessments and skin or serum tests of allergic sensitization to food. The diagnostic gold standard, a double-blind placebo-controlled food provocation test, was not performed consistently to confirm suspected allergic reactions in previous population studies in children. This protocol describes the specific aims and diagnostic protocol of a birth cohort study examining prevalence patterns and influential factors of confirmed food allergies in European children from different regions. METHODS: Within the collaborative translational research project EuroPrevall, we started a multi-center birth cohort study, recruiting a total of over 12 000 newborns in nine countries across Europe in 2005-2009. In addition to three telephone interviews during the first 30 months, parents were asked to immediately inform the centers about possible allergic reactions to food at any time during the follow-up period. RESULTS: All children with suspected food allergy symptoms were clinically evaluated including double-blind placebo-controlled food challenge tests. We assessed sensitization to different food allergens by measurements of specific serum immunoglobulin E and skin prick tests, collect blood, saliva or buccal swabs for genetic tests, breast milk for measurement of food proteins/cytokines, and evaluate quality-of-life and economic burden of families with food allergic children. CONCLUSIONS: This birth cohort provides unique data on prevalence, risk factors, quality-of-life, and costs of food allergies in Europe, leading to the development of more informed and integrated preventative and treatment strategies for children with food allergies.

[Frequency of antibodies against Trichinella spiralis and Echinococcus ssp. appearance in children with atopic diseases]. / Czestosc wystepowania przeciwcial przeciwko Trichinella spiralis i Echinococcus spp. wsród dzieci z chorobami atopowymi.

Parasitic infestation and atopic diseases have common features. The aim of our study was to evaluate the occurrence of Trichinella and Echinococcus seropositivity in children with atopic diseases. The study group involved 72 children aged from 2,5 to 18 years with asthma and allergic rhinitis. The control group comprised 30 children without allergic diseases. In 12 children with atopic diseases the serological tests were positive for Trichinella spiralis, in II for Echinococcus spp. and in 5 both for Trichinella and Echinococcus. In control group the serological tests were positive in 3, 6 and 3 children respectively. There were no differences in occurrence of positive results of serological tests in children with atopy and children without allergic diseases.

[AIDS syndrome in an eight-month-old infant]. / Zespól AIDS u 8-miesiecznego niemowlecia.

The paper presents multiorgan manifestations of AIDS syndrome in an infant at the age of 8 months. The child was admitted to the Clinic with enteric disorder, anaemia, hepatosplenomegaly and pneumonia. The diagnosis of those anomalies and the treatment of pneumonia took much time. Infection with CMV was recognized but, despite the treatment and elimination of the virus, the child's condition did not improve and general emaciation progressed. The diagnosis of AIDS syndrome was based upon indicator illnesses: chronic recurrent pneumonia, cytomegaly and emaciation syndrome as well as upon the results of additional examinations, first of all including the presence of p24 antigen in the serum. In children with chronic diseases and manifesting non-specific multiorgan symptoms we should take into consideration AIDS syndrome in the differential diagnosis.

[The evaluation of respiratory function in children with chronic allergic rhinitis]. / Ocena czynnosci oddechowej dzieci z przewleklym alergicznym zapaleniem blony sluzowej nosa.

The aim of the paper is to assess respiratory functions in children with chronic allergic rhinitis. Multiple spirometric measurements were performed during oral and nasal ventilation and after nasal provocation with histamin and allergen. We find that spirometric measurements during nasal ventilation are very useful because they objectivize the degree of nasal patency disturbances. We have also noted the occurrence of bronchospastic reactions after nasal provocations.

Arylamine N-acetyltransferase (NAT2) gene mutations in children with allergic diseases.

The overrepresentation of phenotypically slow acetylators among patients with atopic allergy has been reported in previous studies. The N-acetyltransferase coding gene has not yet been investigated in allergic diseases. This study was designed to determine the differences in the distribution of mutation frequency and genotypes that encode normal and defective activity of N-acetyltransferase in children with atopic allergies compared with healthy children. In 56 children with documented inhalational, food, or mixed allergies and in 100 healthy control children with no clinical or laboratory signs of allergy, the genotype coding for N-acetyltransferase was identified by means of the polymerase chain reaction followed by analysis of restriction fragment length polymorphism. Nucleotide transitions in the following positions were investigated: 481 C-->T, 590 G-->A, 803 A-->G, and 857 G-->A, which enabled the identification of six genotypes, including the wild-type (wt) allele, and 16 genotypes, including mutated alleles (homozygotic and herterozygotic). The statistical analysis showed significant differences in the distribution of the frequency of the occurrence of mutated alleles and genotypes between the two groups of children. In 51 children (91%) with allergy, genotypes that encode acetylation defect were found; genotypes that code for normal N-acetyltransferase were observed in only five allergic children (9%). In the control group the distribution of genotypes coding for normal and defective N-acetyltransferase activity is 38% and 62%, respectively. Thus study enabled the conclusion that the slow acetylation genotype is a genetic marker of predisposition to atopy.

[Evaluation of the respiratory system function in girls from the Textile Technical College in Lódz (II)]. / Ocena czynnosci ukladu oddechowego dziewczat z Technikum Wlókienniczego w Lodzi (Czesc II).

The work in textile industry is a risk factor of the development of chronic non-specific diseases of the respiratory tract. Thus the vocational selection for the posts in this industry should particularly take into account the health status of the applying youths. The subjects of the study were 35 girls from Textile Technical College and 42 girls from Grammar School (control group). The girls were examined three times in the succeeding school years. Anthropometric and spirometric examinations were performed. No significant differences between the values of ventilation parameters in both the groups were observed, which indicates that the selection of pupils admitted to the Technical College was proper. During the period of professional training no adverse effects of the industrial environment on the respiratory function could be found either.

[Evaluation of somatic development, physical fitness and motor skills of girls from the Textile Technical College in Lódz (I)]. / Ocena rozwoju somatycznego, wydolnosci fizycznej i sprawnosci motorycznej dziewczat z technikum wlókienniczego w Lodzi.

Thirty-five girls from a technical college (TC) and forty-five from a grammar school (GS) (a control group) were included in a long-term examination. Somatic traits have been investigated for 4 years, while aerobic capacity and motor efficiency have been studied for 3 years. The preliminary selection was noticed in girls--candidates to technical college and grammar school. These two groups of girls differed in respect of social factors and somatic predisposition. At the beginning of the examination the girls from the technical college revealed a considerably lower motor efficiency as compared to those from the GS. After 3 or 4 years of learning traits of the body length were still weaker in the girls from the technical college. However, they had a more massive skeleton, stronger trunk muscles and stronger hands. In addition, these girls were characterized by a remarkable improvement of general physical efficiency, particularly endurance, speed and nimbleness. In the final stage of the study in all girls from both TC and GS aged 18 lower aerobic capacity in comparison with data from the previous year was found, which could results from inefficient physical activity during the educational process. This fact may be especially unfavourable for the girls from TC as far as their future profession is concerned.