Medición, control y conocimiento de la presión arterial: Iniciativa Mayo Mes de la Medición Colombia 2017 / Measurement, monitoring and knowledge of blood pressure: May Measurement Month, Colombia 2017

Objetivo: Describir los hallazgos de la implementación de la iniciativa Mayo Mes de la Medición 2017 aplicada a población colombiana adulta con el objetivo de crear conciencia sobre la importancia de la medición, conocimiento y control de la presión arterial. Materiales y métodos: Mayo Mes de la Medición es una encuesta transversal que sigue las directrices de la Sociedad Internacional de Hipertensión y la Liga Mundial de Hipertensión, que recoge información de factores de riesgo cardiovascular y mediciones de presión arterial. En Colombia su implementación fue liderada por la Fundación Oftalmológica de Santander (FOSCAL) y la Sociedad Latinoamericana de Hipertensión (LASH) con el apoyo de la Red Colombiana para la Prevención de las Enfermedades Cardiovasculares y Diabetes (RECARDI). Resultados: Se recolectaron datos en 11 departamentos de 21.797 personas, siendo el 58,7% mujeres, la edad promedio fue de 40,5±17,7 años. La prevalencia global de hipertensión arterial (HTA) fue del 20,8% (autorreporte de tratamiento antihipertensivo o toma de presión arterial sistólica [≥140mmHg]). El 46,5% del total de hipertensos tuvieron cifras de presión arterial sistólica que les clasifica como no controlados (presión arterial sistólica<140mmHg) y el 26,4% no conocían su condición de hipertensos, los cuales en el presente reporte son considerados como los casos nuevos de HTA. Conclusión: La prevalencia de presión arterial es alta en esta población adulta joven, en la cual el desconocimiento de la condición de HTA es también alta, y en aquellos que conocen su condición existe un porcentaje bajo de control de la HTA, resultados que demuestran la necesidad de implementar programas eficaces de detección de pacientes hipertensos y de establecer tratamientos estandarizados para mejorar el control de la HTA como una estrategia para la reducción de eventos cardiovasculares

Aim: To describe the findings of implementing May Measurement Month 2017 in the adult Colombian population to raise awareness of the importance of blood pressure measuring, monitoring, and awareness. Materials and methods: May Measurement Month is a cross-sectional survey that follows the directives of the International Society of Hypertension and the World Hypertension League, which gathers information on cardiovascular risk factors and blood pressure readings. Its implementation in Colombia was lead by the Santander Ophthalmological Foundation (FOSCAL) and the Latin American Society of Hypertension (LASH) with the support of the Colombian Network for the Prevention of Cardiovascular Diseases and Diabetes (RECARDI). Results: Data was collected from 11 departments on 21,797 people, 58.7% of whom were female, with an average age of 40.5±17.7 years. The overall prevalence of high blood pressure (HBP) was 20.8% (self-reported antihypertensive treatment or systolic blood pressure reading [systolic blood pressure≥140mmHg]). Of the total number of hypertensives, 46.5% had systolic blood pressure readings classified as uncontrolled (systolic blood pressure<140mmHg), and 26.4% were unaware that they were hypertensive who, in this report, we consider to be new cases of HBP. Conclusion: The prevalence of (elevated) blood pressure is high in this young adult population, whose lack of awareness of HBP is also high, and HBP in those aware of their condition is poorly controlled. These results highlight the need to implement effective detection programmes for hypertensive patients and to establish standardised treatments to improve HBP control as a strategy to reduce cardiovascular events

[Measurement, monitoring and knowledge of blood pressure: May Measurement Month, Colombia 2017]. / Medición, control y conocimiento de la presión arterial: Iniciativa Mayo Mes de la Medición Colombia 2017.

AIM: To describe the findings of implementing May Measurement Month 2017 in the adult Colombian population to raise awareness of the importance of blood pressure measuring, monitoring, and awareness. MATERIALS AND METHODS: May Measurement Month is a cross-sectional survey that follows the directives of the International Society of Hypertension and the World Hypertension League, which gathers information on cardiovascular risk factors and blood pressure readings. Its implementation in Colombia was lead by the Santander Ophthalmological Foundation (FOSCAL) and the Latin American Society of Hypertension (LASH) with the support of the Colombian Network for the Prevention of Cardiovascular Diseases and Diabetes (RECARDI). RESULTS: Data was collected from 11 departments on 21,797 people, 58.7% of whom were female, with an average age of 40.5±17.7 years. The overall prevalence of high blood pressure (HBP) was 20.8% (self-reported antihypertensive treatment or systolic blood pressure reading [systolic blood pressure≥140mmHg]). Of the total number of hypertensives, 46.5% had systolic blood pressure readings classified as uncontrolled (systolic blood pressure<140mmHg), and 26.4% were unaware that they were hypertensive who, in this report, we consider to be new cases of HBP. CONCLUSION: The prevalence of (elevated) blood pressure is high in this young adult population, whose lack of awareness of HBP is also high, and HBP in those aware of their condition is poorly controlled. These results highlight the need to implement effective detection programmes for hypertensive patients and to establish standardised treatments to improve HBP control as a strategy to reduce cardiovascular events.

Biofiltration of hydrogen sulfide by Sulfolobus metallicus at high temperatures.

Biofiltration of reduced sulfur compounds such as hydrogen sulfide has been mainly applied to emissions at mild temperatures (25 to 35 °C). However, an important number of industrial gaseous emission containing sulfur compounds, from diverse industrial sectors (petroleum refinery, cellulose production, smelting, rendering plants and food industries) are emitted at temperatures over 50 °C. Most of the studies on thermophilic systems report that a higher elimination capacity can be obtained at elevated temperature, allowing the design of smaller equipment for the same loading rate than that required for removing the same load under mesophilic conditions. A biotrickling filter inoculated with Sulfolobus metallicus, which operates at three different residence times, 60, 80 and 120 s, and two different temperatures (45 and 55 °C) for treating H(2)S is reported. The input loads of H(2)S were progressively increased from 0 to 100 gS/m(3). The aim of this study was to determine the capacity and ability of S. metallicus to oxidize H(2)S at high temperatures. The better removal capacity of H(2)S obtained was 37.1 ± 1.7 gS/m(3) h at 55 °C for a residence time of 120 s. The difference of the removal capacity of H(2)S between the two temperatures was 4 g/m(3) h on average of sulfur removal for the different residence times.

Angiogenic imbalance and plasma lipid alterations in women with preeclampsia from a developing country.

BACKGROUND: An imbalance between anti-angiogenic factors (e.g. soluble vascular endothelial growth factor receptor-1 (s-FLT1) and soluble endoglin (s-Eng)) and pro-angiogenic factors (e.g. placental growth factor (PlGF)) as well as increased oxidized low-density lipoprotein (ox-LDL) concentrations have been associated with preeclampsia (PE). Risk factors associated with the development of PE, however, are known to be different between developed and developing countries. The aim of the study was to determine the levels of s-FLT1, s-Eng, PIGF, and ox-LDL in women with PE from a developing country. METHODS: A multi-center case-control study was conducted. One hundred and forty three women with PE were matched by age and parity with 143 healthy pregnant women without cardiovascular or endocrine diseases. Before delivery, blood samples were taken and serum was stored until analysis. RESULTS: Women with PE had lower concentrations of PIGF (p<0.0001) and higher concentrations of s-Eng (p=0.001) than healthy pregnant women. There were no differences between the groups regarding ox-LDL or s-FLT1. Women with early onset PE had higher s-FLT1 concentrations (p=0.0004) and lower PIGF concentrations (p<0.0001) than their healthy pregnant controls. Women with late onset PE had higher concentrations of s-Eng (p=0.005). Women with severe PE had higher concentrations of s-Eng (p=0.0008) and ox-LDL (p=0.01), and lower concentrations of PIGF (p<0.0001). CONCLUSIONS: Women with PE from a developing country demonstrated an angiogenic imbalance and an increased rate of LDL oxidation. Findings from this study support the theory that PE is a multifactorial disease, and understanding differences in these subpopulations may provide a better target to approach future therapies.

Efficacy and safety of enteric-coated mycophenolate sodium in combination with two glucocorticoid regimens for the treatment of active lupus nephritis.

Mycophenolic acid, in combination with glucocorticoids, has been shown in a series of trials to be safe and effective for treatment of lupus nephritis. Regimens that permit glucocorticoid dose reduction without loss of efficacy would be advantageous. MyLupus was a 24-week, multicentre, open-label, study in patients with active proliferative lupus nephritis treated with enteric-coated mycophenolate sodium (EC-MPS), randomized to standard-dose (n = 42) or reduced-dose (n = 39) glucocorticoids. Complete response at week 24, the primary endpoint, was achieved in 19.8% (16/81) of patients (19.0% standard-dose, 20.5% reduced-dose; lower limit of 97.5% CI for the difference -15.9%, p = 0.098, i.e. non-inferiority was not shown). Partial response occurred in 42.0% of patients (34/81). From baseline to week 24, the mean global British Isles Lupus Assessment Group (BILAG) score decreased from 14.0 ± 5.4 to 5.0 ± 3.8 (p < 0.001). The incidence of adverse events was 80.2% (65/81), most frequently gastrointestinal complications (31/81, 38.3%). Infections were reported in 57.1% and 35.9% of standard- and reduced-dose glucocorticoid patients, respectively (p = 0.056), with herpes zoster in 16.7% and 0% (p = 0.012). Three patients discontinued study medication due to adverse events. This exploratory study suggests that EC-MPS may facilitate glucocorticoid reduction without loss of efficacy in patients with active lupus nephritis, but results require confirmation in a controlled, longer-term study versus the current standard of care.

Removal of hydrogen sulfide and ammonia from gas mixtures by co-immobilized cells using a new configuration of two biotrickling filters.

The simultaneous removal of H(2)S and NH(3) was investigated using two biotrickling filters packed with polyurethane foam cubes. One biotrickling filter was inoculated with Thiobacillus thioparus ATCC 23645 for the removal of H(2)S (BTT) and the other filter with Nitrosomonas europaea ATCC 19718 for the removal of NH(3) (BNE). Three different configurations were studied by modification of the gas line and recirculation medium line. The best results were obtained with the BNE biotrickling filter after the co-immobilization of the two bacteria. A removal efficiency of 100% for 230 ppmv of NH(3) and 129 ppmv of H(2)S was reached at an EBRT of 60 seconds. The results obtained show that it is possible to co-immobilize both microorganisms using the same recirculation medium and remove successfully H(2)S and NH(3) from a gas mixture.

A double-blind, controlled, multicenter, randomized study comparing the antihypertensive effectiveness and tolerance of a daily dose of two nifedipine formulations: nifedipine microgranules versus nifedipine osmotic pump.

INTRODUCTION: Controlled clinical studies have clearly established the advantages of blood pressure (BP) reduction. However, optimal control of BP in the population is still not adequate. Monotherapy is ineffective in the majority of hypertensive patients, and multidrug therapy increases costs. OBJECTIVE: The objective of the study was to assess to what extent and how uniformly BP can be controlled with two different 24-hour drug-releasing formulations of nifedipine, used as monotherapy. METHODS: One hundred ninety-two patients of both genders, aged 18 to 65 years, with mild to moderate (Stage 1 and 2) essential hypertension with systolic BP <200 mm Hg and diastolic BP between 90 and 115 mm Hg were randomized in a double-blind, double-dummy fashion to receive sustained-release formulations of 30 mg nifedipine/day either as microgranules (NMG) or via osmotic pump (NOP) for 8 weeks. Office BP was measured at baseline (after 2 weeks of placebo) and after the third to fourth week of treatment. If at the third to fourth week the systolic BP/diastolic BP did not reach values of <140/<90 mm Hg, the dose was doubled to 60 mg/day. Monotherapy that did not yield these BP values at 8 weeks was considered a failure. Ambulatory monitoring of blood pressure (AMBP) was also performed after the placebo period and at the end of treatment. Smoothness index (SI) and trough/peak ratio (T/P) were calculated and their correlation was checked. RESULTS: The initial systolic/diastolic BP values were similar at baseline and decreased significantly after the third to fourth week of treatment, with no difference between the groups. The proportions of patients reaching the goal BP (<140/<90 mm Hg) were similar in the two groups: NMG, 71%, and NOP, 78% (P = 0.12). There were no changes in the heart rate in either group. There was no difference between groups in the reduction in mean arterial pressure measured by AMBP. The frequency of SI values >1.4 and T/P ratios of >0.5 was similar in both groups. An important correlation was found between the SI and T/P values. The incidence of adverse effects was low and similar in both groups. CONCLUSIONS: Target BP was reached in more than 70% of patients receiving monotherapy with either formulation. Both formulations were tolerated well.

Operational and microbiological aspects of a bioaugmented two-stage biotrickling filter removing hydrogen sulfide and dimethyl sulfide.

A two-stage biotrickling filter was developed for removing dimethyl sulfide (DMS) and hydrogen sulfide (H2S). The first biotrickling filter (ABF) was inoculated with Acidithiobacillus thiooxidans and operated without pH control, while the second biotrickling filter (HBF) was inoculated with Hyphomicrobium VS and operated at neutral pH. High DMS elimination capacities were observed in the HBF (8.2 g DMS m(-3) h(-1) at 90% removal efficiency) after 2 days. Maximal observed elimination capacities were 83 g H2S m(-3) h(-1) (100% removal efficiency) and 58 g DMS m(-3) h(-1) (88% removal efficiency) for the ABF and the HBF, respectively. The influence of a decreasing empty bed residence time (120 down to 30 sec) and the robustness of the HBF towards changing operational parameters (low pH, starvation, and DMS and H2S peak loadings) were investigated. Suboptimal operational conditions rapidly resulted in lower DMS removal efficiencies, but recovery of the HBF was mostly obtained within a few days. The H2S removal efficiency in the ABF, however, was not influenced by varying operational conditions. In both reactors, microbial community dynamics of the biofilm and the suspended bacteria were investigated, using denaturing gradient gel electrophoresis (DGGE). After a period of gradual change, a stable microbial community was observed in the HBF after 60 days, although Hyphomicrobium VS was not the dominant microorganism. In contrast, the ABF biofilm community was stable from the first day and only a limited bacterial diversity was observed. The planktonic microbial community in the HBF was very different from that in the biofilm.

The influence of pH in the hydrolytic stage of anaerobic digestion of the organic fraction of urban solid waste.

The influence of the pH in the first stage, the hydrolytic stage, of the anaerobic digestion of the organic fraction of urban solid waste in a two phase anaerobic reactor was studied. The reactor was fed with a solution of the organic fraction of urban solid residues containing 5 to 7% solids. Four reactors with a working volume of 3 L were used, the experiments were done at three controlled pHs; 6, 7, and 8, and one with free pH, the temperature was keep at 37 degrees C in all the experiments. The higher degradation of TSS and VSS was obtained in the reactors operated at pH 7 and 8; 75% degradation of TSS and 85% degradation of VSS. The volatile fatty acids were determined at the different pH conditions, no significant differences were found, and as was expected, the acetic acid was found at the higher value among them (from 25 to 29 g/L). According to the results obtained it is possible to conclude that in the case of the hydrolytic stage of the anaerobic digestion of the organic fraction of urban solid waste it is not necessary to control the pH, the pH is kept stable by the buffer effect of the protein residues and other macromolecules present in the residue.

Efficacy and safety of two different formulations of nifedipine (GITS) vs. slow release microgranules in patients with mild and moderate hypertension.

The objective of this study was to compare the safety and efficacy of nifedipine in two different formulations (osmotic pump and slow release microgranules) in patients with essential hypertension. A total of 91 patients with mild and moderate essential hypertension were recruited in a randomised, double-blinded trial, to receive a daily dose of 30 mg of nifedipine GITS or nifedipine slow release microgranules for 8 weeks. Patients who did not respond to the above-mentioned dose at week 4 of treatment received an increased dose of 60 mg per day of either drug for the remaining trial period. The primary end point of this study was the variation in mean sitting diastolic blood pressure (SDBP) from baseline values to the ones found at week 4 of treatment. The secondary end point was the variation in mean sitting systolic blood pressure (SSBP). Drug tolerability was measured according to incidence of side effects. The results were that both presentations reduced the mean SDBP and SSBP with similar efficacy. Drug side effects were also similar in both formulations. In conclusion nifedipine in slow release microgranules (NMG) is as effective as osmotic pump nifedipine (GITS) in reducing blood pressure with a similar tolerability profile.

Solid substrate fermentation of leached beet pulp withTrichoderma aureoviride.

Optimum production of cellulases on leached beet pulp by native and mutant strains ofTrichoderma aureoviride in column-type, solid-substrate fermenters, at controlled temperature and aeration rate, was with a mutant strain, that produced 11 and 29 filter paper units of activity/g solids on raw and acid pre-treated leached beet pulp, respectively. The former value was 40% higher than in the native strain and 70% higher than in the reference strain. protein enrichment of residual solid was significant in all cases, with values up to 40% of total dry weight. Results are suitable for scale-up to pilot level.