Higher Arterial Blood Pressure Research Articles

The Effect of Melatonin Supplement on High Arterial Blood Pressure: An Overview from Clinicaltrials.gov.

Melatonin is a hormone produced by the pineal gland primarily at night. It has been suggested that melatonin may possess various cardiovascular benefits, including the potential to lower blood pressure. For this reason, we sought to identify and provide evidence of the effectiveness of melatonin on high arterial blood pressure in clinical trials. Using the search term "melatonin and hypertension", a search of the ClinicalTrials.gov database was performed on October 10th, 2023. I defined the exclusion and inclusion criteria to isolate appropriate clinical trials. Inclusion criteria for the search included hypertension that utilized melatonin as a treatment supplement; all non-related trials were omitted from the search. The data extractions, including study title, study type, study status, and intervention and outcome details, were compiled. Of the 13 clinical trials identified, only three focused on examining the effects of melatonin. The study titles, enrollment numbers, conditions, statuses, interventions, and outcome measures have been explained in depth. Information gathered from these clinical trials will assist us in identifying the possible risks and benefits of melatonin with respect to high arterial blood pressure. Melatonin has been shown to be an effective treatment for lowering blood pressure. More research is required to fully establish the potential benefits and risks and highlight the mechanisms through which melatonin may influence blood pressure regulation.

Ocular and systemic associations and heritability of retinal arterial wall-to-lumen ratios in a twin cohort.

To investigate ocular and systemic factors associated with the retinal arterial wall-to-lumen ratio (WLR) and to determine the relative contribution of genetic and environmental variation to WLR in healthy adults. This cross-sectional twin study included 78 monozygotic and 67 dizygotic same-sex twin pairs aged 58.4 ± 9.8 (mean ± SD) years. Lumen diameter (LD) and outer diameter (OD) of a superotemporal retinal artery were measured using adaptive optics fundus photography, and the WLR was calculated. Linear mixed model regression analysis of associations with WLR comprised the descriptive variables ocular axial length (AL), intraocular pressure (IOP), height, weight, body mass index (BMI), smoking, blood pressure, high density (HDL), low density (LDL) and very low density (VLDL) lipoproteins, total cholesterol and triglycerides. The relative influence of genes and environment on WLR was calculated through polygenetic modelling. Increasing age and arterial blood pressure were associated with a higher WLR, while increasing retinal artery OD and ocular AL were associated with a lower WLR. Sex, smoking status, BMI, IOP, cholesterol levels or triglycerides had no detectable impact on the WLR. Broad-sense heritability of WLR was 21% (95% CI: 1-41%), while environmental factors accounted for the remaining 79% of the interindividual variance (95% CI: 59-99%). Retinal artery wall thickness was closely linked to increasing age and higher arterial blood pressure, the latter being mediated by the environment over genes.

Prediction of Factors for Patients with Hypertension and Dyslipidemia Using Multilayer Feedforward Neural Networks and Ordered Logistic Regression Analysis: A Robust Hybrid Methodology

Background: Hypertension is characterized by abnormally high arterial blood pressure and is a public health problem with a high prevalence of 20%–30% worldwide. This research combined multiple logistic regression (MLR) and multilayer feedforward neural networks to construct and validate a model for evaluating the factors linked with hypertension in patients with dyslipidemia. Methods: A total of 1000 data entries from Hospital Universiti Sains Malaysia and advanced computational statistical modeling methodologies were used to evaluate seven traits associated with hypertension. R-Studio software was utilized. Each sample's statistics were calculated using a hybrid model that included bootstrapping. Results: Variable validation was performed by using the well-established bootstrap-integrated MLR technique. All variables affected the hazard ratio as follows: total cholesterol (β1: −0.00664; p < 0.25), diabetes status (β2: 0.62332; p < 0.25), diastolic reading (β3: 0.08160; p < 0.25), height measurement (β4: −0.05411; p < 0.25), coronary heart disease incidence (β5: 1.42544; p < 0.25), triglyceride reading (β6: 0.00616; p < 0.25), and waist reading (β7: −0.00158; p < 0.25). Conclusions: A hybrid approach was developed and extensively tested. The hybrid technique is superior to other standalone techniques and allows an improved understanding of the influence of variables on outcomes.

Diagnostic Utility of Aldosterone/Direct Renin Concentration Ratio in Iraqi Patients with High Arterial Blood Pressure: A Pilot Study


 
 
 Objectives: Primary aldosteronism is a prevalent contributor to secondary hypertension, posing an elevated risk of morbidity and mortality. The initial step in diagnosing this condition involves screening individuals suspected of having it.
 Methods: In our study, we enrolled 50 patients who were suspected of having hyperaldosteronism. We provided specific recommendations and instructions to these patients concerning drug therapy and implemented measures to enhance testing accuracy. The tests were conducted using the Chemiluminescence Immunoassay (CLIA) system procedure, relying on plasma direct renin concentration rather than activity. Our findings were meticulously validated, compared, and aligned with the references from ARUP laboratories.
 Results: Among our participants, 4 patients (8%) were unequivocally diagnosed with primary aldosteronism based on the Aldosterone Direct Renin Concentration (ADRR) criteria. These patients exhibited the trifecta of hypokalemia, elevated aldosterone levels, and diminished renin levels, obviating the need for further confirmatory testing. Furthermore, 13 patients (26%) were deemed likely candidates for primary aldosteronism, given their plasma aldosterone levels exceeding 15 ng/dl and renin levels below 2.5 pg/ml. Additionally, 7 patients (14%) displayed strong indications of primary aldosteronism, characterized by plasma aldosterone levels surpassing 21 ng/dl and plasma renin concentrations below 2.5 pg/ml, accompanied by high ADRR values. However, both the "likely" and "strong indication" groups necessitated confirmatory testing. Notably, our results revealed no significant disparities in age, gender, personal or family history of atherosclerotic cardiovascular disease (ASCVD), or the presence of adrenal adenomas between patients diagnosed with primary aldosteronism and those in the non-aldosteronism group within the study.
 Conclusion: Primary aldosteronism is a prevalent health concern, warranting the screening of highly suspicious patients. Utilizing direct renin concentration, instead of renin activity, offers a straightforward, cost-effective, rapid, and reproducible method for diagnosis.
 
 

Abernethy malformation: A case report

Congenital portosystemic shunts are rare congenital vascular malformations characterized by a partial or complete portal blood diversion into the systemic circulation. Congenital extrahepatic portosystemic shunts, known as Abernethy malformations, pose a diagnostic challenge due to their low incidence and clinical presentations.
 A 15-year-old male with a history of chronic epigastric pain and nausea, high arterial blood pressure, recurrent nose bleeds, chest pain, dizziness, dyspnea, low exercise tolerance, hematochezia, and itching was diagnosed with Abernethy malformation type Ib. Imaging studies revealed a dilated portal vein conduit flowing into the inferior vena cava, bypassing the porta hepatis. Multiple liver nodules, heart chamber dilatation, myocardial hypertrophy, and pulmonary hypertension were also discovered. Following multidisciplinary panel meetings, liver transplantation was advised due to the severity of the patients symptoms and shunt anatomy.
 Furthermore, diagnostic algorithms and other treatment options are discussed.

Prevalence and clinical correlates and characteristics of “Super Fontan”

Super-Fontan (SF) is an excellent phenotype of patients with Fontan circulation and normal exercise capacity. This study aimed to clarify the prevalence and clinical correlates and characteristics of SF. We reviewed 404 Fontan patients who had undergone cardiopulmonary exercise testing, and the results were compared with clinical profiles. Seventy-seven (19%) patients had SF, and the postoperative prevalence at 5, 10, 15, 20, and ≥ 25 years was 16 (35%), 30 (39%), 18 (19%), 13 (14%), and 0 (0%), respectively. Compared with non-SF, SF patients were younger (P < .001) and were mostly men (P < .05). SF was characterized by a current high arterial blood pressure and oxygen saturation (SaO2), low systemic ventricle (SV) end-diastolic pressure, favorable body composition, superior pulmonary function, preserved hepatorenal and hemostatic functions, and better glucose tolerance (P < .05-.001). Pre-Fontan better SV function, low pulmonary artery resistance, and high SaO2 were associated with current SF (P < .05-.01). Furthermore, positive trajectory of exercise capacity and high daily activity during childhood were associated with current adult SF (P < .05). During the follow-up, 25 patients died, and 74 patients were unexpectedly hospitalized. There was no death in the SF group, and the rate of hospitalization was 67% lower than that of the non-SF group (P < .01-.001). The prevalence of SF gradually decreased over time. SF was characterized by preserved multi-end-organ function and an excellent prognosis. Pre-Fontan hemodynamics and post-Fontan childhood daily activity were associated with being adult SF.

OCCURRENCE OF ACUTE URIC ACID NEPHROPATY IN CLIMACTERIC PERIOD OF WOMEN

The presented article describes a typical clinical case of an overweight (body mass index - 32.4 kg/m2) climacteric patient, with periodic crises of high arterial blood pressure, treated with hestogenic drugs for a long time due to endometriosis, with advanced acute renal failure.It should be noted that the emergence of severe forms of acute uric acid nephropathy and the accompanying of this disease with acute renal failure rarely occur. However, it is appropriate to classify not only post-, but also premenopausal women who suffer from overweight, obesity and high blood pressure into the risk group due to urate damage to their kidneys and to take measures aimed at correcting metabolic disorders.

Role of arterial hypertension and angiotensin II in chronic kidney disease (Review).

Chronic kidney disease (CKD) is a major public health issue, due to its effect on the quality of life of patients and by the huge costs incurred in treating this disease. It is an irreversible process, characterized by the progressive loss of functional nephrons. CKD ultimately requires the support of renal function by dialysis or even renal transplantation. It has a multiple etiology, but the most common causes remain arterial hypertension and diabetes. High arterial blood pressure affects the target organs (kidneys) and this leads to a vicious circle involved in maintaining high blood pressure. Arterial hypertension is closely related to the renal pathology of CKD. The result of excessive activation of the renin angiotensin system (RAS) is increased angiotensin II (Ang II), which acts upon the systemic circulation and especially upon the kidneys. The outcome is high blood pressure and also the stimulation of proinflammatory and profibrotic effects in the kidneys. Collectively these ultimately lead to CKD. The aim of this review was to provide a brief overview of the pathophysiological associations between CKD, arterial hypertension, and Ang II.

Down syndrome patients with normal hearts: are they really normal?

Even though congenital heart disease is a common finding in down syndrome (DS) patients, some of them have anatomically normal hearts. However, the term "normal" might not be suitable, as these patients usually suffer from functional cardiac dysfunction. Several research highlighted that despite the absence of anatomical heart defects, subtle cardiac function derangements are present in DS patients. We aim to assess cardiac functions by Two-dimensional echocardiography and tissue Doppler imaging (TDI) in pediatric DS patients who have anatomically normal hearts. One hundred seventy-two patients with karyotyping confirmed DS with anatomically normal hearts and 165 healthy normal control children were enrolled in the current study. Their cardiac functions were assessed using both 2-dimensional echocardiography and TDI. Both patients and controls had structurally and anatomically normal hearts. In DS patients, the right side of the heart showed a significant reduction in both systolic and diastolic functions. Systolic dysfunction was evident by significantly decreased levels of Tricuspid annular plane systolic excursion and systolic wave by TDI. Diastolic dysfunction of the right ventricle was evident by prolonged deceleration time by conventional echocardiography and a significant decrease in annular tissue doppler velocity during early diastole/late diastole ratio by TDI. The E/De ratio was significantly increased. Even with anatomically normal hearts, DS patients should undergo cardiac function assessment by echocardiography & TDI. TDI is superior to conventional echocardiography in detecting subtle cardiac dysfunction especially left ventricular diastolic dysfunction in DS patients. TDI showed a significant decrease in the early/atrial ratio of mitral valve annulus and prolongation of left ventricle isometric relaxation time in DS children. Also, the left ventricle E/De ratio was prolonged denoting elevated filling pressures and diastolic dysfunction. This indicates that the TDI has higher sensitivity to detect diastolic dysfunction than conventional Echocardiography. Biventricular TDI-derived myocardial performance index was found to be significantly increased in DS children.

Https://doi.org/10.32921/2225-9929-2023-2-51-4-

Purpose of the study: To study the development characteristics of metabolic syndrome and risk factors in civil servants of Astana city.Methods. The study was conducted in Astana with two groups of study, main group and control group. These groups were consist of 475 people working in civil service and people working in other fields of service aged 18 to 63.Results. To conduct the study we selected people with metabolic syndrome in accordance with the criteria of the International Diabetes Federation (IDF 2009), we also reviewed the case with prevalence of metabolic syndrome in people of studied groups. In the main group, the incidence of metabolic syndrome was 10.6% lower than in the control group and it was found that the majority of them were 53.5% men. The differences between metabolic syndrome components compared to the control group, in men: triglycerides, blood glucose level, high arterial blood pressure (p&lt;0.05), and in women: triglycerides, high-density lipoproteins, high arterial blood pressure (p&lt;0.05). It was noticed, that the combination of the metabolic syndrome components in both groups occurs mainly in the form of waist + glucose + triglyceride circumference. In addition, high arterial blood pressure, triglyceride and smoking were identified as the leading risk factors of this pathological condition among the respondents.Conclusions. There is a characteristic tendency of spreading the metabolic syndrome, the course of components and the accompanying situation among civil servants. It is based on risk factors that influenced. In this way, the given study results can be used as a basis for the formation of preventive measures of metabolic syndrome among civil servants.Keywords: metabolic syndrome, civil servants, prevalence characteristics, risk factors

Sars-Cov2 Induced Biochemical Mechanisms in Liver Damage and Intestinal Lesions.

The online version contains supplementary material available at 10.1007/s12291-022-01089-x.

Impact of hyperoxia and phenylephrine on cerebral oxygenation: An experimental clinical study.

Oxygen supply to the brain is of special importance during intracranial surgery because it may be compromised by intracranial pathology. A high arterial blood pressure (mean arterial pressure above 80 mmHg) and a high arterial oxygen tension (PaO2 above 12 kPa) is therefore often targeted in these patients, when for example intracranial pressure is increased or when a mass effect on brain tissue from a tumour is present, and it is pursued by administering vasopressors such as phenylephrine and by increasing inspiratory oxygen fraction (FiO2 ). However, whether these interventions increase cerebral oxygenation remains uncertain. We aimed to investigate the effect of hyperoxia and phenylephrine on brain tissue oxygen tension (PbtO2 ) in patients undergoing craniotomy. In this experimental study, we included 17 adult patients scheduled for elective craniotomy. After securing a stable baseline of the oxygen probe, PbtO2 was measured in white matter peripherally in the surgical field during general anaesthesia. Primary comparisons were PbtO2 before versus after an increase in FiO2 from 0.30 to 0.80 as well as before versus after a bolus dose of phenylephrine (0.1-0.2mg depending on patient haemodynamics). Data were analysed with the Wilcoxon signed rank test. We obtained complete data sets in 11 patients undergoing the FiO2 increase and six patients receiving the phenylephrine bolus. PbtO2 was 22 (median; 5%-95% range, 4.6-54) mmHg during 30% oxygen, 68 (8.4-99) mmHg during 80% oxygen (p=.004 compared to 30% oxygen), 21 (4.5-81) mmHg before phenylephrine, and 19 (4.2-56) mmHg after phenylephrine (p=.56 compared to before phenylephrine). In patients undergoing craniotomy under general anaesthesia, brain tissue oxygen tension increased with a high inspiratory oxygen fraction but remained unchanged after a bolus dose of phenylephrine.

Abstract P234: Arterial Hypertension, Insulin Resistance And Depressive-like Behavior In Crtc1 -deficient Mice

Background: Epidemiological evidence has demonstrated a link between cardiovascular disease, metabolic syndrome and depression. Whether this association is causal and what mechanisms may be involved is still unknown. Studies in humans and mice suggest that alterations of the CREB-BDNF pathway can contribute to the development of both, eating disorders and major depressive disorders. Mice deficient in the CREB-regulated transcriptional coactivator 1 (Crtc1) have been shown to become overweight and display depressive-like behavior. Here, we investigated whether Crtc1 -deficient mice concomitantly exhibit a hypertensive, insulin resistant and depression-like phenotype. Methods: Mean arterial blood pressure and heart rate were measured by radiotelemetry in unrestrained Crtc1 -deficient mice (KO) and wildtype littermates (WT). Renal renin expression was quantified by qPCR. Insulin resistance was determined by the i.p. glucose tolerance test, and depressive-like behavior was assessed by the soiled bedding preference test. Results: Crtc1 -deficient mice had higher arterial blood pressures (dark: KO 117±2 mm Hg, WT 107±2 mm Hg, p&lt;0.05; light: KO 102±2 mm Hg, WT 94±2 mm Hg, p&lt;0.05, 1-way ANOVA, n=8-11) and heart rates (dark: KO 593±11 bpm, WT 596±7 bpm; light: KO 529±12 bpm, WT 494±8 bpm, p&lt;0.05, 1-way ANOVA, n=8-11). Relative renin mRNA expression was not different between genotypes (KO 0.86±0.07, WT 1.00±0.10, n=10). Glucose tolerance was significantly impaired in Crtc1 -deficient mice (maximum plasma glucose concentrations KO 423±27 mg/dl, WT 295±27 mg/dl, p&lt;0.0001, 2-way ANOVA, n=9). In the soiled bedding preference test, male Crtc1 -deficient mice exhibited a lack of preference for female-soiled bedding over clean bedding (female vs. clean KO 75.3±11.2 s vs 79.0±11.0 s, WT 119.5±13.5 s vs. 51.5±10.5 s, n=2-3). Conclusions: Crtc1 might be a molecular component of a pathway that connects arterial hypertension, metabolic syndrome and depression.

Influence of a new stimulator of soluble guanylate cyclase on platelet aggregation and vascular endothelial function in experimental ischemic stroke against the background of arterial hypertension

Background. Correction of endothelial dysfunction during arterial hypertension (AH) is an important measure in preventing cerebrovascular stroke. Drugs activating soluble guanylate cyclase (sGC) and 3’,5’-guanosine monophosphate (cGMP) production independently of nitric oxide (NO) were shown to be therapeutically useful in reducing the risk of stroke. The present work aims to study the antiaggregant and endothelium-protective activity of a new sGC stimulator, an indolinone derivative (2-[2-[(5RS)-5-(hydroxymethyl)-3-methyl-1,3-oxazolidine-2- yliden]-2-cyanoethylidene]-1H-indole-3(2H)-one (codename — GRS) in a model of ischemic stroke with AH. Prior studies have shown that GRS compound inhibits platelet aggregation, lowers blood pressure (BP) in spontaneouslyhypertensive SHR rats, prevents vascular occlusion in models of arterial and venous thrombosis. Antiplatelet drug clopidogrel, a P2Y12 receptor inhibitor, included in the standard of care for secondary prevention of ischemic stroke, was used as the reference drug.Objective. To assess the antiaggregant and endothelium-protective activity of a new indolinone derivative GRS, an sGC stimulator, compared to clopidogrel in a model of ischemic stroke concomitant with high arterial BP in spontaneously-hypertensive SHR rats.Design and methods. Focal brain ischemia/reperfusion was modelled in spontaneously-hypertensive SHR rats (n = 78). GRS in 10 mg/kg dose and clopidogrel in 10 mg/kg dose were administered orally once daily 3 days before modelling ischemia/reperfusion and for 5 days afterwards. Platelet aggregation and functioning of vascular endothelium were monitored.Results. Focal brain ischemia/reperfusion in SHR rats resulted in increased platelet aggregation and the development of endothelial dysfunction and disruption of vasodilatory function of endothelium. GRS compound and clopidogrel in repeated administration have prevented an increase in platelet aggregation (p &lt; 0,05), GRS compound also alleviated endothelial dysfunction (p &lt; 0,05).Conclusions. The indolinone derivative GRS, an sGC stimulator, inhibits increased platelet aggregation and prevents endothelial dysfunction in rats after focal brain ischemia/ reperfusion; the endothelium-protective effects of GRS aren’t related to its antiaggregant activity.

Effect of season and diet on heart rate and blood pressure in female red deer (Cervus elaphus) anaesthetised with medetomidine-tiletamine-zolazepam.

Temperate zone ungulates like red deer (Cervus elaphus) show pronounced seasonal acclimatisation. Hypometabolism during winter is associated with cardiovascular changes, including a reduction in heart rate (fH) and temporal peripheral vasoconstriction. How anaesthesia with vasoactive substances such as medetomidine affect the seasonally acclimatised cardiovascular system is not yet known. We anaesthetised eleven healthy female red deer with medetomidine (0.1 mg/kg) and tiletamine/zolazepam (3 mg/kg) twice in winter (ad libitum and restricted feed) and in summer (ad libitum and restricted feed), with a two-week washout-period in-between, to test for the effect of season, food availability and supplementation with omega-3 or omega-6 polyunsaturated fatty acid (PUFA) on fH and arterial blood pressure (ABP) during anaesthesia. Six animals received pellets enriched with omega-6 fatty acids (FA), and five animals with omega-3 FA. Anaesthesia significantly decreased fH in summer but not in winter and ABP was lower in winter (p < 0.05). The combination of omega-6 FA enriched pellets and food restriction resulted in a lower fH and higher ABP during anaesthesia with more pronounced changes in winter (p < 0.001). Our results demonstrate that season, food availability and type of PUFA supplementation in red deer affect the cardiovascular system during anaesthesia.

Monocrotaline‐induced Pulmonary Hypertension Impairs Diaphragm Vasomotor Function

INTRODUCTIONPulmonary hypertension (PH) is a chronic and progressive disease characterized by high arterial blood pressure and compensatory vascular remodeling in the pulmonary circulation. Mounting evidence suggests that the effects of PH extend beyond the pulmonary circulation. In humans and animals, PH induces diaphragm contractile dysfunction and diaphragm muscle atrophy. While the mechanistic bases for the PH‐induced diaphragm dysfunction is relatively unknown, alterations in the vasomotor control of the diaphragm resistance vasculature (i.e. arterioles) may play a key role. Therefore, we tested the hypothesis that PH increases the vasoconstrictor responsiveness and impairs the vasorelaxation of diaphragm arterioles.METHODSAdult female Sprague‐Dawley rats (n=8) were divided into healthy control (HC; n=2), ovariectomized (OVX; n=3), and PH + OVX (n=3). PH + OVX animals were given a single intraperitoneal injection of monocrotaline (MCT; 50mg/kg) to induce PH. Disease progression was then monitored via echocardiography. Once animals developed PH (~3 weeks post injection), the diaphragm was removed and first‐order arterioles (1A) from the medial costal diaphragm were isolated, cannulated, and pressurized at 90 cmH2O. After a 60 min equilibration period and spontaneous tone development, vasoconstrictor responses to potassium chloride (KCl) (10‐100 mM) and endothelium‐dependent and ‐independent vasorelaxation responses to cumulative doses of acetylcholine (ACh) and sodium nitroprusside (SNP) (10‐9 to 10‐4 M) were determined.RESULTSSpontaneous tone (%) development was not different across all three groups (HC: 36 ± 9%; OVX: 33 ± 9%; PH + OVX: 39 ± 2%; P&gt;0.05). Compared to control vessels, maximal percent vasoconstriction with KCl was decreased with OVX (67 ± 2 versus 50 ± 1%; P&lt;0.05). Maximal vasoconstriction (%) was reduced with PH + OVX (36 ± 4%) compared to vessels from both healthy control and OVX groups (P&lt;0.05). Ovariectomy had no effect on endothelium‐dependent vasodilation responses to ACh versus intact control animals (P&gt;0.05). The maximal ACh‐mediated vasodilation with PH + OVX (29 ± 9%) was decreased versus both healthy (45 ± 6%; P&lt;0.05) and OVX animals (41 ± 4%; P&lt;0.05). Across all three groups, there were no differences in percent relaxation with SNP (P&gt;0.05).CONCLUSIONThese findings suggest that estrogen plays a role in the maintenance of K+ channel activity and/or the contribution of K+ channels to diaphragm vasomotor tone, and that PH further disrupts K+ channel function in diaphragm arterioles. In addition, the absence of estrogen in OVX animals had no effect on endothelial function whereas PH + OVX impaired endothelium‐dependent vasorelaxation of diaphragm resistance vessels. These findings suggest that PH, at least in the rodent model utilized herein, elicits endothelial dysfunction in the diaphragm vasculature and provide a potential mechanism for the impaired diaphragm contractile dysfunction in PH patients.

Introducing multi-component cardiovascular health screening into existing Abdominal Aortic Aneurysm (AAA) screening programmes in the UK: a qualitative study of programme staff views

BackgroundCardiovascular disease is a major contributor to poor health in the UK and the leading cause of death in England. Peripheral arterial disease and high blood pressure are conditions that identify individuals at high cardiovascular disease risk, likely to benefit from cardiovascular risk management. Both conditions remain considerably underdiagnosed and untreated. The National Health Service abdominal aortic aneurysm (AAA) screening programmes represent an opportunity to screen for these conditions with potentially minimal additional effort or cost. We explored AAA screening programme staff views on the proposed introduction of such additional screening within AAA screening.MethodsNine focus groups and seven follow-on interviews were undertaken with 38 AAA screening staff. Our study methods were oriented broadly towards a grounded theory methodology, and data were analysed using thematic analysis.ResultsThree themes were identified: (i) ‘Perceptions of patient experience and health-related outcomes’, (ii) ‘Opportunities and challenges for programme staff’, and (iii) ‘Maintaining and improving programme standards’. Staff talked about the high uptake of AAA screening, staff experience and skills in their role, and the programme’s high quality standards as both opportunities and potential challenges linked to the proposed additions to AAA screening. While positive about the potential to improve patients’ health outcomes, participants had questions about the practicalities of incorporating additional procedures within their time- and resource-constrained context, and how this may reconfigure work processes, roles and relationships.ConclusionsThe proposed additions to the programme require taking staff’s views into account. Key areas that need to be addressed relate to ensuring follow-up support for patients, clarity around staff responsibilities, and availability of sufficient resources for the programme.

Influence of postural changes on haemodynamics in internal carotid artery bifurcation aneurysm using numerical methods

Cerebral intracranial aneurysms are serious problems that can lead to stroke, coma, and even death. The effect of blood flow on cerebral aneurysms and their relationship with rupture are unknown. In addition, postural changes and their relevance to haemodynamics of blood flow are difficult to measure in vivo using clinical imaging alone. Computational simulations investigating the detailed haemodynamics in cerebral aneurysms have been developed in recent times not only to understand the progression and rupture but also for clinical evaluation and treatment. In the present study, the haemodynamics of a patient-specific case of a large aneurysm on the left side internal carotid bifurcation (LICA) and no aneurysm on the right side internal carotid bifurcation (RICA) was investigated. The simulation of these patient-specific models using fluid–structure interaction provides a valuable comparison of flow behavior between normal and aneurysm models. The influences of postural changes were investigated during standing, sleeping, and head-down (HD) position. Significant changes in flow were observed during the HD position and quit high arterial blood pressure in the internal carotid artery (ICA) aneurysm model was established when compared to the normal ICA model. The velocity increased abruptly during the HD position by more than four times (LICA and RICA) and wall shear stress by four times (LICA) to ten times (RICA). The complex spiral flow and higher pressures prevailing within the dome increase the risk of aneurysm rupture.

Cortisol is not enough: A complex stress reaction in tethered goats

AbstractThe purpose of this study was to assess the diversity of physiological stress responses elicited by tethering versus loose holding in the Swedish domestic goat (Capra hircus). Eight goats were randomly divided into two groups and the experiment was performed in a crossover design. Six goats had implanted transmitters that registered heart rate and arterial blood pressure telemetrically and blood samples were taken on separate days. Heart rate increased around feeding both when the goats were held loose in pairs, and when they were tied up. When the goats were tethered, the heart rates and blood pressures were higher, and the concentrations of ß-endorphin and oxytocin lower, compared to when held loose in pairs. In conclusion, housing and the company of another animal affect arterial blood pressure, heart rate, and the concentrations of ß-endorphin and oxytocin in goats, but the cortisol and vasopressin concentrations did not differ between the treatments. The higher arterial blood pressure and heart rate, and lower concentrations of ß-endorphin and oxytocin in tethered goats indicate that being tied up may be more stressful for the goats compared to being held loose. The use of single measures, eg cortisol concentrations, was not sufficient to give an accurate picture of the animals’ response to the management system. This study demonstrates the importance of using a wide variety of physiological measures when evaluating stress in animal welfare research.

A case-control study of hypertension and associated risk factor on kidney Volume

Introduction: Hypertension (or HTN) or high blood pressure is defined as abnormally high arterial blood pressure. According to the Joint National Committee 8 (JNC8), normal blood pressure is a systolic BP &lt; 120 mmHg and diastolic BP &lt; 80 mm Hg. Hypertension is defined as systolic BP level of ≥140 mmHg and/or diastolic BP level ≥ 90 mmHg. Material and Methods: This is a prospective, descriptive, cross sectional and observational study conducted at Department of Physiology, General Medicine and Radiology, Index Medical College, Hospital and Research center Indore. Period of the study from January 2020 December 2021. Using ultrasonographic methods, absolute renal size, relative renal size (renal length/body length), renal volume (length × width × depth × 0.52), and renal shape (width/length) were calculated. Results: The case group Mean Systolic Blood Pressure is 147.45 ± 5.87 mm of Hg (Mean±SD) and control group Mean Systolic Blood Pressure of 117.35 ± 5.67 mm of Hg (Mean±SD). However, this reduction in Systolic Blood Pressure is statistically significant. (P value &lt; 0.05). The case group Mean Diastolic Blood Pressure is 97.03 ± 5.824 mm of Hg (Mean±SD) and Mean Diastolic Blood Pressure is 76.93 ± 5.688 mm of Hg (Mean±SD). This reduction in Diastolic Blood Pressure is however statistically significant. (P value &lt; 0.05). Conclusion: The data presented in this work showed that renal size and volume were more than in hypertensive than normotensive subjects. The cortical size for both kidneys was greater in our study group compared to cortical size in normotensive subjects.