Lesions In Target Organs Research Articles

Ochratoxin A in Poultry Supply Chain: Overview of Feed Occurrence, Carry-Over, and Pathognomonic Lesions in Target Organs to Promote Food Safety.

Ochratoxin A (OTA) is a mycotoxin produced by fungi species belonging to the genera Aspergillus spp. and Penicillium spp. The proliferation of OTA-producing fungal species may occur due to inadequate practices during both the pre-harvest and post-harvest stages of feed. Consequently, poultry species may be exposed to high concentrations of this mycotoxin that can be transferred to animal tissues due to its carry-over, reaching dangerous concentrations in meat and meat products. Therefore, this review aims to propose a comprehensive overview of the effects of OTA on human health, along with data from global studies on the prevalence and concentrations of this mycotoxin in avian feeds, as well as in poultry meat, edible offal, and eggs. Moreover, the review examines significant gross and histopathological lesions in the kidneys and livers of poultry linked to OTA exposure. Finally, the key methods for OTA prevention and decontamination of feed are described.

P122 EXPLORING CARDIOVASCULAR RISK ENHANCERS IN WOMEN: EYE-OPENING FINDINGS TO RETHINK ASSESSMENT

Background and Objectives. Traditional cardiovascular risk (CVR) stratification does not consider CVR enhancers (CVRE). Women present under-recognized CVR factors that may lead to developing subclinical vascular lesions such as arterial stiffness (AS). AS is associated with long-term cardiovascular events and can be determined by carotid-femoral pulse wave velocity (cf-PWV). Our objective was to determine cf-PWV in women with low 10-years CVR (10yCVR) with a CVRE and to compare them with a control group. Methods. Multicentric cross-sectional study, carried out in 2023 in Argentina. Group-1: women, 18-59 years-old, office-BP <140/90 mmHg, low (<5%) 10-yCVR using WHO's Calculator for Argentina, with a CVRE: history of gestational hypertension/preeclampsia; previous oncological treatment in current complete remission; autoimmune hematological or rheumatic disease in clinical remission; history of abortions/preterm births; early menopause/menarche; anxiety/depression disorder. Patients with cardiovascular event, chronic renal disease, diabetes, chronic hypertension, target organ lesion, 10-yCVR≥5%, and those on antihypertensive, statins, or aspirin treatment were excluded. Group-2: healthy women who attended routine control. Consecutive sampling. Office-BP were obtained with Omron-M3. cf-PWV was measured non-invasively through Aortic. AS was defined if cf-PWV exceeded 95% confidence interval (95%CI) upper limit for healthy Argentine population. Institutional Research Committee's approval and informed consent were obtained. Data was analyzed using SPSS for Windows. Results. Included 199 women: Group-1 (N=119); Group-2 (N=80). No differences were found between groups concerning age, weight, height, body mass index and heart rate. Group-1 showed higher cf-PWV: 6.89±1.08 vs. 5.56±0.65 (p<0.0001) and higher AS frequency: 57.1% vs. 2.5% (p<0.0001). In multivariate analysis only CVRE maintain related with AS (p<0.0001). A sub-analysis was performed excluding subjects with high-normal office-BP (27.6% of sample): 144 women remained, 77 (53.5%) in Group-1 and 67 (46.5%) in Group-2. Central (aortic) systolic-BP was <121 mmHg in all cases. Group-1 showed higher cf-PWV: 6.62±0.88 vs. 5.59±0.62 (p<0.0001) and AS: 51.9% vs. 1.4% (p<0.0001). Conclusions. Women with CVRE showed greater cf-PWV and higher proportion of AS.

Establishment and characterization of salivary gland-specific injury in transgenic mice model.

Many mouse models for autoimmune diseases also have lesions in non-target organs, which may make it difficult to determine whether the target organ lesion is primary or secondary. Hyposalivation has conventionally been studied using genetically modified mouse models for Sjogren's syndrome as well as spontaneous autoimmune mice with systemic lesions, none of which has salivary gland-specific injury. In this study, we established a salivary gland-specific injury mouse model using the TRECK system by gene modification with the transgene composed of the 5' untranslated region of human salivary mucin gene MUC7 (highly expressed specifically in human salivary gland) inserted at the upstream of hHB-EGF (diphtheria toxin receptor) in the TRECK vector. In this transgenic mouse model, we confirmed salivary gland-specific expression of hHB-EGF gene, and hyposalivation after treatment with diphtheria toxin. Histological assessment of the salivary gland from these mice showed granular convoluted tubule epithelial cells destruction at the same position as a positivity in TUNEL assay. This transgenic mouse model may become a useful tool for elucidating the mechanisms involved in hyposalivation and for developing pharmaceuticals and tissue regenerative medical products for this condition.

Circulating microRNA-21-3p in patients with arterial hypertension

Objective — to study changes in the blood plasma levels of microRNA‑21‑3p in patients with arterial hypertension (AH) and their relationship with the characteristics of the course of the disease.
 Materials and methods. Examinations involved 24 patients with hypertension stage II and degree 2—3 (11 men, 13 women) aged from 42 to 60 years. The control group consisted of 12 practically healthy individuals, age and gender matching. The examinations were carried out in the Department of Hypertension and Kidney Diseases of the GI «L. T. Mala National Therapy Institute of NAMS of Ukraine». The degree, stage of hypertension and the presence of risk factors for cardiovascular diseases (CVD), established CVD and kidney disease were assessed in accordance with current recommendations. All patients underwent general clinical laboratory and instrumental examinations. The blood plasma level of circulating microRNA‑21‑3p was determined by quantitative reverse transcriptase‑polymerase chain reaction (qRT‑PCR) using reagent kits for monitoring and analyzing microRNA expression «TaqMan microRNA Assay» (ThermoFisher Scientific, USA). Small nuclear RNA U6 was used as a reference. Relative expression was calculated in relative units (r.u.) using the ΔΔCt method. Statistical analysis of the obtained data was carried out using standard methods with application packages Microsoft Excel and SPSS 19.0.
 Results. A significant decrease in the plasma levels of microRNA‑21‑3p in patients with hypertension was established in comparison with practically healthy individuals. The most pronounced decrease in plasma microRNA‑21‑3p levels was observed in patients with the most severe hypertension (stage 3 AH) and in subjects, in whom antihypertensive therapy did not result in the achieving target levels of «office» blood pressure (BP). Significant negative correlations were found between the plasma microRNA‑21‑3p levels and hemodynamic parameters (BP levels) and the left ventricular myocardial mass index — an indicator of the severity of left ventricular hypertrophy, one of the key lesions of target organs. The obtained results indicate the presence in patients with hypertension of a significant deficiency in the production of microRNA‑21‑3p, which, according to the literature data, has pronounced antihypertensive and cardiovascular‑ and renoprotective properties.
 Conclusions. A significant decrease in the blood plasma levels of microRNA‑21‑3p, the endogenous regulator of gene expression with antihypertensive and organoprotective properties, was established in patients with hypertension in comparison with practically healthy subjects. The revealed decrease in the blood plasma levels of this microRNA was enhanced at severe and uncontrolled hypertension and associated with the degree of hypertensive heart damage. The data obtained indicate the important role of microRNA‑21‑3p in the hypertension pathogenesis and the prospects of finding methods for correcting its production.

Pediatric hypertension as an early manifestation of cardiovascular disease in children.

In adults, cardiovascular events associated with arterial hypertension (AH) have a major impact on morbidity and mortality. In light of recent findings, AH in children has been interpreted as early cardiovascular disease (CVD), while exposure to CV risk factors in children proves to be a predictor of subclinical CVD in adults. The American College of Cardiology/American Heart Association has recently updated the classifications for measuring blood pressure (BP) in adults and children. Primary AH in children is generally asymptomatic, and it is associated with a family history of AH, overweight/obesity, and normal morphofunctional characteristics of the urinary system. The younger the child and the higher the BP, the greater the likelihood of secondary AH. The investigation into the etiology of AH begins with a detailed anamnesis, which should include clinical information and details on the use of medication, smoking, and alcohol consumption from the perinatal period to the time of consultation. Modifying risk factors by reducing weight, decreasing alcohol consumption and increasing vegetable intake from childhood to adulthood has been associated with the resolution of AH in the childhood-adulthood transition, and with the reversal of cardiometabolic adverse effects in non-obese adult individuals. Pharmacological therapy should be initiated in cases of symptomatic AH, AH secondary to chronic kidney disease or diabetes mellitus, presence of target organ lesions, stage 2 AH with no modifiable cause and resistant AH unresponsive to lifestyle changes.

What are the Best Drugs and Combinations in Afro-Descendant Hypertensive Patients?

Hypertension in African descendants occurs early, with high rates of cardiovascular events compared to Caucasians. In addition, genetic influence, low levels of plasma renin activity, greater sensitivity to salt, low sodium secretion, and other mechanisms are involved and discussed in this article. For pharmacological treatment, several studies were evaluated, such as CREOLE, ALLHAT, CARDIA, JHS, REGARDS, AASK, ACCOMPLISH, review articles and meta-analyzes and some guidelines, such as European, American, Brazilian to compare treatment indication. Several pharmacological classes, such as calcium channel blockers, Β-blockers, renin angiotensin system inhibitors, aldosterone and diuretics were included in present review in order to compare utilization and indication for Afro-descendant hypertensive patients. We concluded that several relevant points should be considered in the pharmacological treatment of African descendants that include pathophysiological characteristics, early development of lesions in target organs, in addition to higher rates of cardiovascular and renal events. In addition to lifestyle changes, improved nutrition, combined treatment, probably as a first-line treatment, should be considered as an approach, and the drugs used should aim at blood pressure control and inhibition of the inflammatory process, which results in worse outcomes. It is important to highlight that the representativeness of the Afro-descendant population was unsatisfactory for a robust conclusion. in this population, we can infer from the initial pharmacological treatment the use of thiazide-like diuretics, or dihydropyridine calcium channel blocker should be considered, although the institution of fixed combinations with angiotensin enzyme conversion inhibitors or angiotensin receptor blockers are important in the protection of target organs that occurs earlier and more seriously.

Features of steroidogenesis and arterial hypertension in men in different types of "physiological" male hyperandrogenism

To reveal the peculiarities of steroidogenesis and arterial hypertension in «physiological» hyperandrogenism in men. One-stage simultaneous study. The groups of men with hyperandrogenism caused by increased total testosterone (n=34) and those with hyperandrogenism caused by increased dihydrotestosterone (DHT) (n=66) were compared. In determining the type of hyperandrogenism and allocating patients to groups, DHT and total testosterone levels were determined by enhanced chemiluminescence. Subgroups of men with and without arterial hypertension were compared in the group of patients with hyperandrogenism due to an increase in total testosterone. Body mass index, waist circumference, systolic and diastolic blood pressure, pulse, and LH, SBHG, estradiol, blood multisteroid levels by isotope dilution liquid chromatography/tandem mass spectrometry, glucose, blood lipid spectrum, uric acid, creatinine, renin, potassium, sodium, and blood chloride were assessed in all patients. Patients with arterial hypertension additionally underwent daily BP monitoring, albuminuria assessment, electrocardiography, ocular fundus examination. The baseline threshold level of significance was p<0.05. For multiple comparisons, the p significance level was calculated using the Bonferroni correction. Statistically significant differences were found in the levels of 17-hydroxypregnenolone, 17-hydroxyprogesterone, and androstenedione, which were higher in men with elevated levels of total testosterone. No statistically significant differences in other laboratory parameters were found. No cases of increased blood pressure were detected in the group of men with elevated DHT. In the group of men with elevated total testosterone, 23,5% of men with arterial hypertension without targetorgan lesions were identified, while hyperandrogenism was associated with 17,6% of cases. Arterial hypertension associated with hyperandrogenism was characterized by a rise in blood pressure in the early morning hours. Estradiol levels, while remaining within normal limits, were statistically significantly lower in patients with arterial hypertension compared with men with elevated testosterone but without hypertension. No cases of arterial hypertension were observed in «physiological» hyperandrogenism due to elevated DHT levels, whereas its incidence in «physiological» hyperandrogenism due to elevated total testosterone was 23,5%. The features of steroidogenesis were increased production of 17-hydroxypregnenolone, 17-hydroxyprogesterone, and androstenedione in men with testosterone hyperandrogenism and decreased estradiol production in patients with arterial hypertension compared with patients without testosterone hyperandrogenism.

Utility of postmortem bacterial culture of abdominal organs at autopsy of young calves.

Postmortem bacterial culture is controversial in human medicine, and veterinary-specific research in this area is lacking. To address this knowledge gap, we cultured liver, kidney, and spleen individually from on-farm calf mortalities to determine the number of bacterial species present, concordance between organ cultures, and agreement with gross and histologic findings. We hypothesized that the spleen, a filtering organ, would be the most useful organ with the least amount of postmortem contamination given that it does not have a direct conduit to a bacterial population. Fresh liver, kidney, and spleen were collected for culture from 30 calves 5-28-d-old with various causes of mortality. Bacterial growth of ≥2 species was observed in ~48% of cultures, with Escherichia coli and Streptococcus spp. being most frequent. One bacterial species was present in 20% of cultures, with E. coli predominating. No growth was observed in ~32% of cultures. In 43% of cases, there was agreement in the culture results for all 3 organs; however, the majority were mixed bacterial growth. The best agreement was observed when there were no gross and/or histologic septic lesions in target organs and no bacterial growth on culture. The spleen was not helpful in determining bacterial significance in comparison to kidney or liver.

Efficacy of Commercial Infectious Bronchitis Vaccines against Canadian Delmarva (DMV/1639) Infectious Bronchitis Virus Infection in Layers.

Vaccination is the most important way to control infectious bronchitis (IB) in chickens. Since the end of 2015, the Delmarva (DMV)/1639 strain of infectious bronchitis virus (IBV) has caused significant damage to the layer flocks in Eastern Canada. The efficacy of a combination of existing IB vaccines licensed in Canada was assessed against experimental challenge with this IBV strain. The layer pullets were vaccinated during the rearing phase with live attenuated IB vaccines of Massachusetts (Mass) + Connecticut (Conn) types followed by an inactivated IB vaccine of Mass + Arkansas (Ark) types and then challenged with the Canadian IBV DMV/1639 strain at 30 weeks of age. Protection was evaluated based on the egg laying performance, immune responses, viral shedding, and viral genome loads and lesions in IBV target organs. The vaccinated challenged hens were protected from the drop in egg production observed in the non-vaccinated challenged hens. Early (5 dpi) anamnestic serum antibody response was measured in the vaccinated challenged hens as well as a significant level of antibodies was detected in the oviduct washes (14 dpi). In contrast, hens in the non-vaccinated challenged group showed delayed (12 dpi) and significantly lower serum antibody response. Viral RNA loads were reduced in the respiratory, alimentary, and reproductive tissues of the vaccinated challenged hens compared to the non-vaccinated challenged hens. Compared to the control groups, the vaccinated challenged hens had less marked microscopic lesions in the trachea, kidney, magnum, and uterus. Our experimental model demonstrated inconclusive results for cell-mediated immune responses and viral shedding. Overall, the vaccination program used in this study minimized viral replication and histopathological changes in most IBV target organs and protected challenged hens against drop in egg production.

Comparison of Blood Pressure Variability between 24 h Ambulatory Monitoring and Office Blood Pressure in Diabetics and Nondiabetic Patients: A Cross-Sectional Study.

Background Evidence regarding blood pressure (BP) variability (BPV) and its independent association with adverse outcomes has grown. Diabetic patients might have increased BPV, but there is still an evidence gap regarding relation between BPV and type 2 diabetes beyond mean values of BP. Objective To examine the relationship between 24 h ambulatory BP monitoring (ABPM, short-term variability) and visit-to-visit in-office BPV (OBP, long-term variability), in diabetics (D) and nondiabetics (ND), and to explore BPV relation with estimated glomerular filtration rate (eGFR), and pulse wave velocity (PWV) as indicators of target organ lesion. Materials and Methods We conducted a single-center cross-sectional study in an outpatient BP unit, including adult patients consecutively admitted from 1999 to 2019. Multivariate was performed to compare BPV between D and ND adjusted for clinical variables. Pearson's correlation was performed to evaluate relation of BPV with eGFR and PWV. Results A total of 1123 patients with ABPM and OBP measurements were included. Values of eGFR and PWV were worse in D than in ND. Measurements of OBPV did not differ between groups. Of ABPM BPV, the coefficient of variation and standard deviation for daytime systolic BP were higher in D compared to ND, but only in ND did BPV correlated with both eGFR and PWV. Conclusion We found that diabetes is associated with higher variability of daytime BP than nondiabetics along with worse damage of vascular and renal function. However, in contrast to nondiabetics, in diabetics eGFR and PWV may not be dependent on BP variability, suggesting that other mechanisms might explain more rigorously the greater damage of target organ lesion markers.

ROLE OF ESTIMATING PULSE WAVE VELOCITY IN COMMUNITY PHARMACIES IN SPAIN COMPARED TO SCORE

Objective: European Guidelines clearly state the need to estimate cardiovascular (CV) risk using tables validated for this purpose. However, they also recommend assessing subclinical organ damage to improve stratification, since target organ lesions, such as arterial stiffness, estimated by brachial oscillometry, have an independent and additional prognostic value. Previous studies have shown that Community Pharmacies are able to correctly measure arterial stiffness.The objective of this study is to assess whether the estimation of arterial stiffness can improve CV risk stratification according to SCORE in Community Pharmacies. Design and method: This is an observational prospective epidemiological study in which everyone who enters the participating Community Pharmacies will be offered a voluntary measurement of blood pressure and arterial stiffness to compare the stratification of their CV risk according to SCORE with or without considering pulse wave velocity. The expected duration of the study is 12 months. Results: In the first month of recruitment, data from 275 patients (173 women, 102 men) were collected. Five of 39 (12.8%) patients under 40 years of age and 42 of 109 (38.5%) over 65 years of age presented pathological stiffness and could be classified as high risk even though being out of the age-range of SCORE. Of the 133 (48.4%) who were capable of calculating SCORE, the cholesterol value was available only in 69 patients (51.9%). Among them, according to SCORE, 18 patients (26.0%) were at low risk, 50 (72.5%) at moderate risk and only 1 (1.5%) at high risk, while 28 patients (21.1%) presented pathological arterial stiffness. Conclusions: Almost half of the people who randomly enter a community pharmacy had ages that make it impossible to calculate the CV risk by SCORE. Among them, arterial damage was detected in a third. Of the other half, one in five presented arterial damage and, therefore, high CV risk, when SCORE only detected it in a single patient. Therefore, estimating arterial stiffness in community pharmacies markedly improves detection of high CV risk compared to SCORE.

Prognostic value of low ankle-brachial index in patients with resistant hypertension

In the presence of resistant hypertension, patients have a significantly higher risk of stroke, myocardial infarction, kidney disease, heart failure, and death than patients with elevated blood pressure. Increased arterial stiffness is an important factor in determining cardiovascular risk. Peripheral artery damage is a target organ lesion, and its presence puts the patient at high or very high risk. The simplest non-invasive method of detecting peripheral vascular damage in patients is to determine the ankle-brachial index (ABI). Aim. To detect the frequency of damage to the lower extremity peripheral arteries by determining the ankle-brachial index and its impact on the subsequent prognosis in patients of older age (>55 years) with resistant hypertension using automatic blood pressure monitors. Materials and methods. The object of the study were patients with hypertension aged 55 years – 150 people with elevated blood pressure of the 3rd degree and 20 healthy people of the same age. The study included only those patients who did not have clinical symptoms of peripheral vascular disease, type 2 diabetes mellitus. Determination of the ABI was performed by an automatic device. Results. The frequency of femoral artery lesions detection by measuring blood pressure on the brachial and legs in asymptomatic patients with resistant hypertension was 14.0 %. For a detailed analysis, we divided all patients with hypertension depending on the value of the ABI into two subgroups: subgroup A included patients (n = 129) with an ABI value >0.9, subgroup B (n = 21) – with the value of ≤0.9. In patients with resistant hypertension and peripheral arterial disease, the more common factors were: longer duration of hypertension, the presence of isolated systolic hypertension and a lower level of glomerular filtration rate. Decreased ABI (≤0.9) in patients with resistant hypertension was associated with a 1.4-fold increased risk of adverse cardiovascular complications and a 1.9-fold increased risk of all-cause mortality. Conclusions. In patients with resistant hypertension, a reduced ankle-brachial index was associated with a 1.4-fold increased risk of adverse cardiovascular complications and a 1.9-fold increased risk of all-cause mortality.

Amentoflavone attenuates Listeria monocytogenes pathogenicity through an LLO-dependent mechanism.

L. monocytogenes remain a leading cause of foodborne infection. Listeriolysin O (LLO), an indispensable virulence determinant involved in diverse pathogenic mechanisms of L. monocytogenes infection, represents a promising therapeutic target. In this study, we sought to identify an effective inhibitor of LLO pore formation and its mechanism of action in the treatment of L. monocytogenes infection. Haemolysis assays were carried out to screen an effective LLO inhibitor. The interaction between candidate and LLO was investigated using surface plasmon resonance and molecular docking. The effect of candidate on LLO-mediated cytotoxicity, barrier disruption and immune response were investigated. Finally, the in vivo effect of candidate on mice challenged with L. monocytogenes was examined. Amentoflavone, a natural flavone present in traditional Chinese herbs, effectively inhibited LLO pore formation by engaging the residues Lys93, Asp416, Tyr469 and Lys505 in LLO. Amentoflavone dose-dependently reduced L. monocytogenes-induced cell injury in an LLO-dependent manner. In the Caco-2 monolayer model, amentoflavone maintained the integrity of the epithelial barrier exposed to LLO. Amentoflavone inhibited the inflammatory response evoked by L. monocytogenes in an LLO-dependent manner, and inhibition was attributed to ability to block perforation-associated K+ efflux and Ca2+ influx. In the mouse infection model, amentoflavone treatment significantly reduced bacterial burden and pathological lesions in target organs, with a significant increase in survival rate. Amentoflavone reduced the pathogenicity of L. monocytogenes by specifically inhibiting LLO pore formation, and this may represent a potential treatment for L. monocytogenes infection.

Фактори, що впливають на контроль артеріального тиску в пацієнтів з ренопаренхімною та есенціальною артеріальною гіпертензією

Метою нашого дослідження було порівняти контроль артеріального тиску (АТ) у широкій українській популяції пацієнтів з есенціальною та ренопаренхімною артеріальною гіпертензією (АГ) та оцінити фактори, що асоціюються з недосягненням цільового АТ протягом тримісячного антигіпертензивного лікування, окремо в кожній групі. В аналіз було включено дані 9259 пацієнтів. Усі пацієнти залежно від причини АГ були розподілені на дві групи. У першу групу увійшло 2197 (23,7 %) осіб з ренопаренхімною АГ, у другу групу — 7062 (76,3 %) особи з есенціальною АГ. 531 лікар на свій розсуд призначав антигіпертензивні препарати в дозах, які вважав потрібними. Контроль ефективності лікування відбувався під час 4 візитів протягом 3 місяців. Пацієнтам на візитах вимірювали офісний АТ, проводили електрокардіографію, оцінку прихильності до лікування за допомогою стандартної анкети, оцінку серцево-судинного ризику та опитування згідно з розробленою авторами дослідження анкетою. Мультифакторний регресійний аналіз застосовували для виявлення незалежних предикторів недостатньої ефективності терапії. Виявлено, що ренопаренхімна АГ порівняно із есенціальною АГ асоціювалася з більшою частотою ускладнень (серцева недостатність, інсульт), супутніх станів (ішемічна хвороба серця, цукровий діабет), факторів ризику (дисліпідемія, вік, ожиріння, обтяжена спадковість, високий рівень систолічного АТ), і в таких хворих більш частим було ураження органів-мішеней (гіпертрофія лівого шлуночка, порушення функції нирок). Цільовий АТ (< 140/90 мм рт.ст.) було досягнуто в 53,9 % пацієнтів першої групи та 60,7 % (Р < 0,001) пацієнтів другої групи. При цьому порівняно з другою групою середня кількість препаратів, які отримували хворі з ренопаренхімною АГ, та частота застосування комбінованої терапії були достовірно більшими — 2,20 ± 0,02 проти 2,04 ± 0,01 (Р < 0,001) та 64 проти 57,1 % (Р < 0,001) відповідно. В обох групах на початку дослідження лише незначна кількість пацієнтів мала високу прихильність до лікування —20,1 та 23,5 % відповідно в першій та другій групах (Р < 0,001). Покращення прихильності хворих до лікування спостерігалося в обох групах: достовірно зменшилася частка пацієнтів із низькою прихильністю та збільшилася частка із високою та помірною. Проте в кінці дослідження більше осіб з ренопаренхімною АГ, ніж із есенціальною, характеризувалися як пацієнти з низькою прихильністю. В обох групах поганий контроль АТ асоціювався з початковим рівнем систолічного та діастолічного артеріального тиску. Більш висока прихильність до лікування в кінці дослідження (а не на початку) та вживання свіжих овочів і фруктів зменшували ймовірність поганого контролю АТ також в обох групах. В осіб з ренопаренхімною АГ більш старший вік та більша кількість препаратів асоціювалися із недосягненням цільового АТ, тоді як додаткова фізична активність, навпаки, збільшувала шанси на успішне лікування. Наявність серцевої недостатності та інфаркту міокарда в анамнезі збільшувала ймовірність недосягнення цільового АТ лише в осіб другої групи. Наявність вищої освіти та робочий статус зменшували ймовірність недосягнення цільового АТ лише в групі хворих з есенціальною АГ. Отже, пацієнти з ренопаренхімною АГ були більш тяжкою категорією хворих з АГ, і вони потребують більшої уваги та більш агресивного ведення й корекції інших факторів ризику, а не тільки АТ. Виявлені спільні та відмінні фактори, що асоціювалися з відсутністю досягнення цільового АТ, необхідно враховувати для більш ефективного ведення пацієнтів з АГ різної етіології.

Spoligotype-specific risk of finding lesions in tissues from cattle infected by Mycobacterium bovis

BackgroundAlthough the pathogenic effect of members of the Mycobacterium tuberculosis complex in susceptible hosts is well known, differences in clinical signs and pathological findings observed in infected animals have been reported, likely due to a combination of host and pathogen-related factors. Here, we investigated whether Mycobacterium bovis strains belonging to different spoligotypes were associated with a higher risk of occurrence of visible/more severe lesions in target organs (lungs and/or lymph nodes) from infected animals. A large collection of 8889 samples belonging to cattle were classified depending on the presence/absence of tuberculosis-like lesions and its degree of severity. All samples were subjected to culture irrespective of the presence of lesions, and isolates retrieved were identified and subjected to spoligotyping. The association between the presence/severity of the lesions and the isolation of strains from a given spoligotype was assessed using non-parametric tests and Bayesian mixed multivariable logistic regression models that accounted for origin (region and herd) effects.ResultsResults suggested a difference in severity in lesioned samples depending on the strain’s spoligotype. An association between specific spoligotypes and presence of lesions was observed, with a higher risk of finding lesions in animals infected with strains with spoligotypes SB0120, SB0295 and SB1142 compared with SB0121, and in those coming from certain regions in Spain.ConclusionsOur results suggest that strains belonging to certain spoligotypes may be associated with a higher probability in the occurrence of gross/macroscopic lesions in infected cattle, although these observational findings should be confirmed in further studies that allow accounting for the effect of other possible confounders not considered here, and ultimately through experimental studies.

Association of 3 single nucleotide polymorphisms of the eighth chromosome with remodeling of the myocardium and carotid arteries in the Kazakh population.

Cardiovascular diseases are one of the key health issues in Kazakhstan. According to the WHO, the prevalence of arterial hypertension (AH) was 28% in males and 25% in females in 2015, which puts up vastly to premature mortality from non-communicable diseases.The search for genetic features of target organ lesions processes in AH is relevant. The goal of this study was to search for the genetic markers of myocardial remodeling (MR) and carotid artery remodeling (CAR).A total of 866 hypertensive individuals were recruited in Nur-Sultan, Kazakhstan. Their blood was genotyped for 9 single nucleotide polymorphisms (SNPs) of the eighth chromosome to find an association with remodeling. The analysis was carried out in the group pairs (control and CAR, control and MR, and control and CAR and MR). The genotype–phenotype association was assessed using 5 different inheritance models: dominant, codominant, recessive, overdominant, and log-additive.Statistically significant results were found for 3 SNPs (rs2407103, rs11775334, rs2071518) which minor alleles enlarged risks of MR and CAR in AH in the studied population. Three polymorphisms have previously been associated with АН and some other traits like pulse pressure and blood glucose in other ethnic populations: rs2407103 – in Afro-American population, rs11775334 – in the European population, rs2071518 is well studied in various ethnic populations (European, South Asian, Afro-American, Hispanic, East Asian).

Cardio-ankle vascular index (CAVI) in diagnostics, risk and severity evaluation of magistral vessels lesion in patients with cardio-vascular diseases and type 2 diabetes

Assesment of arterial stiffness the substantional prognostic factor for evaluating complications of cardiovascular diseases (CVD) in patients with atherosclerosis, hypertension and type 2 diabetes, may be performed using different parameters, including cardio-ankle vascular index (CAVI). The main purpose of this review is to analyze data from studies where CAVI is used to test the arterial wall stiffness in magistral vessels. CAVI measurement is non-invasive and performed by portable devices which makes it comfortable for ambulatory use in patients who come for a check-up and also in those who already are hospitalized. It does not require any special knowledge from investigator and the test lasts a couple of minutes long. CAVI does not depend on blood pressure changes and is more specific in structural changes of arterial wall assessment than brachial-ankle pulse wave velocity (baPWV). CAVI shows considerable correlation with markers of CVD like atherosclerotic plaques in vessels, diastolic disfunction of left ventricle and angina pectoris. CAVI may be used for early monitoring and assessing the lesions of target organs in patients with atherosclerosis, chronic hypertension and type 2 diabetes. Establishing CAVI as a standart parameter in assessing patients who are at risk of CVD can help to improve complications prevention, reduce mortality and prolong their lifespan.

Preoperative Preparation Of Elderly Patients With Concomitant Hypertension In The Practice Of Ophthalmic Surgery

Background: The relevance of the problem of arterial hypertension (AH) is determined by its high frequency in the population, the influence on the state of health, working capacity and longevity of the population. Persons of old and old age, as a rule, have a significant amount of risk factors for cardiovascular diseases, very often there are lesions of target organs and associated clinical conditions, therefore, the majority of painful AHs of these age-related categories belong to high and very high-risk groups. Purpose of the research: To optimize the existing methods of managing elderly and senile patients with hypertension during cataract extraction, including preoperative assessment of patients' condition and preparation, intraoperative protection. Materials and methods: Clinical observations cover 150 patients aged 60 to 89 years (74.7 ± 0.5), who were required for surgical treatment for age-related cataracts in the department of ophthalmology at the Sam clinic. Depending on the method of anesthesiology, all patients were divided into 2 groups. Results: All patients with hypertension on the background of an antihypertensive therapy have clinically achieved the target numbers for arterial pressure. . Arterial hypertension before surgery in patients of the II group testified to a pressurized reaction of the cardiovascular system (CCC) in response to psycho-emotional irritation and a short-term associated with it. After the operative period, indicators of the functional state of the CVS improved, however, tachycardia of the heart rate of 85.4 ± 1.4 use of antihypertensive and pain-relieving drugs. In patients of the I-group, the SAD stabilized at 87.7 ± 3.7 mm Hg, heart rate 66.2 ± 3.4 beats. in minutes at the I-stage already after premedication. Conclusion. The results of the study suggest that conducting adequate antihypertensive therapy in combination with drugs that reduce mental and emotional stress in the preoperative period, exclusion of eye contact, psychoemotional stress through sedation and neuroleptanalgesia in waiting rooms allows to stabilized the clinical state of patients, clearly correlating with an improvement in hemodynamic parameters.

Epidemiology of hypertensive crisis in the Buea Regional Hospital, Cameroon.

Hypertensive crisis (HC) includes hypertensive urgency (HU) and hypertensive emergency (HE). There is scarcity of data on the epidemiology of patients presenting with HC in Cameroon. The aim of this study was to determine the prevalence, clinical characteristics, and outcome of HU and HE. We conducted a cross-sectional study from June 2018 until June 2019. The criteria to define a hypertensive crisis were systolic and/or diastolic blood pressure ≥180/110mmHg. We compared HU vs HE. Out of the 1536 patients admitted, 95(6.2%) had a HC. There were 49(51.6%) men and 56 (58.9%) had a HE. The mean age was 51.1±14.9years. A history of hypertension was found in 75.3% of the patients but only 24.2% were on treatment. 33.7% consumed alcohol and 24.2% had chronic kidney disease. Headache (34.7%), dyspnea (34.7%), and neurological deficit (23.2%) were the most common symptoms. Patients with HE had higher systolic and diastolic blood pressures though the difference was not significant. The most frequent forms of HE were acute left ventricular failure with pulmonary edema (44.6%), intracerebral hemorrhage (21.4%), and cerebral infarction (16.1%). The most commonly prescribed medication was labetalol (44.2%). Mean length of hospital stay was 8.4days. Patients with HE had a longer hospital stay (9.8 vs 6.3days, P<.001). In-hospital case fatality was 6.3%. Hypertensive crisis accounted for 6.2% of admissions in the medical unit with HE being more common than HU. Acute left ventricular failure with pulmonary edema and stroke were the most frequent target organ lesions in HE.

Cardiovascular risk in petrochemical workers

Introduction. The high prevalence of diseases of the circulatory system of workers in various sectors of the economy, the lack of data on the effects of harmful production factors on the formation of cardiovascular diseases in petrochemical industry workers justify the importance of conducting special studies on these petrochemical complex plants with the aim of assessing cardiovascular risk with the subsequent development of preventive measures. Material and methods. The objects of the study were workers in the production of monomers (ethylene, propylene, ethylbenzene, isoprene, divinyl) of petrochemical enterprises. Hygienic studies of the working conditions of workers included an assessment of the factors of the working environment and the labor process using generally accepted methods. Comprehensive clinical examination of workers included periodic examinations (n = 2634) with calculation of total and relative cardiovascular risk using the SCORE system, using questionnaire data, a Reeder L questionnaire and an in-depth clinical diagnostic medical examination (n = 101) with the definition total cardiovascular risk. Results. The most significant occupational factors of the labor process for workers in the main profession - panmen were established to include the combination of a chemical factor with the occupational noise and labor intensity, with an overall assessment of working conditions 3.2. The class of working conditions of workers of the comparison group (locksmith in instrumentation and automation corresponds to the permissible). There were revealed a high prevalence of arterial hypertension and other factors of cardiovascular risk. A higher dependence of the arterial hypertension level on age and length of service in the group of panmen was established when compared to the mechanicians of instrumentation and automation. Using mathematical models of multiple regression, the likely dynamics of the level of arterial hypertension and the left ventricular myocardial mass index were calculated under the influence of increasing age and other risk predictors. Conclusion. The results of a clinical study showed workers with severe arterial hypertension, a high and very high risk of death from cardiovascular disease on the SCORE scale, a high and very high overall cardiovascular risk, signs of dyslipidemia, obesity, high stress levels to require close attention. It is important to timely diagnose lesions of target organs, to conduct rational prevention aimed at reducing risk factors. According to the results of the study, there were developed preventive measures aimed at reducing cardiovascular morbidity and cardiovascular risk, prolonging the longevity of workers in petrochemical industries.