The eLitMed.hu medical portal uses computer cookies for convenient operation. Detailed information can be found in the Cookie-policy.
Hypertension and nephrology - 2014;18(03-04)
Content
Hypertension and nephrology
SEPTEMBER 20, 2014
[Visualization of glomerular filtration in animals in vivo - significant filtration in afferent arteriola. Regulation of endothelial permeability]
[Recently we have in vivo visualized glomerular filtration and fluid flow from the JGA portion of afferent arteriole into JGA using intravital multiphoton microscopy. Fluorescence of the extracellular fluid marker lucifer yellow appeared in the interstitium around the distal portion of afferent arteriole before the filtration into Bowman's capsule. In isolated microperfused JGA we demonstrated fluid movement from the glomerulus into the MD tubule. All these prove that there is a significant and dynamic fluid flow exists in the JGA. Angiotensin II similar to VEGF plays a role in regulation of permeability/fenestration formation. Angiotensin II acts through AT1 receptor and PV-1 protein synthesis.]
Hypertension and nephrology
SEPTEMBER 20, 2014
[Signaling pathways in renal fibrosis]
[Myofibroblasts are the main effector cells of tissue fibrosis in chronic kidney disease. These cells are the main source of collagen rich extracellular matrix in the fibrous tissue. Recent hypotheses suggest that pericytes are the major progenitors of myofibroblasts. Platelet derived growth factor, transforming growth factor β and Wingless/Int signaling pathways play important role in pericyte activation. There are experimental evidences that blocking this pathways inhibits tissue fibrosis, therefore they might be targets for the development of antifibrotic drugs in the future.]
Hypertension and nephrology
SEPTEMBER 20, 2014
[Local importance of Hantavirus infections in mirror of the latest virological, epidemiological and clinical results]
[Hantaviruses are widespread infectious agents carried by different rodent species. The majority of them belongs to viral zoonotic pathogens, sometimes causing severe human infections. Hantaviruses inflict hemorrhagic fever with renal syndrome in Eurasia and supposedly in Africa, and hantavirus cardio-pulmonary syndrome in the Americas. The relationship between the virus and its host species is a result of a several million year co-evolution. Although virus replication is most intense in the infected rodents' lungs, these animals do not develop disease, instead they carry and spread the pathogens throughout their lifetime by body fluids. In the majority of infections, the virus gets into the human body by vaporization of rodent body fluids or by direct contact. In Europe, Puumala (PUUV) and Dobrava-Belgrade (DOBV) hantaviruses are the most abundant hantaviral infectious agents. There are numerous studies described the presence of different genotipes of hantaviruses circulating in Hungary. Although the number of clinical and epidemiolgical studies are limited, the medical importance - especially in a high risk population - of these viruses are unqustionable. There are a variety of methods to identify hantaviral infections. Molecular biological methods (RT-PCR) - also enabling genotyping - and virus neutralization tests proved to be the most reliable tools. The latter technique requires virus culturing, which can only be carried out in high-containment laboratories.]
Hypertension and nephrology
SEPTEMBER 20, 2014
[Importance of Reynolds-score system on cardiovascular risk assessment]
[The author summarizes knowledge about Reynolds risk assessment system based on data of references and own experiences. The first part of article is about how the results of study of pathogenesis of atherosclerosis were converted into new risk assessment systems. One result of this process is the Reynolds system wich is consisted of traditional riks factors, high sensitive C-reactive protein and the patients’ family medical history. He demonstrates essence of Reynolds system and process of it’s validity. The author deals with comparison of Reynolds system with other traditional risk assessment systems. The practical issues of application of Reynolds system are detailed in the conclusion of the article.]
Hypertension and nephrology
SEPTEMBER 20, 2014
Hypertension and nephrology
SEPTEMBER 20, 2014
[Serum uric acid in primary hypertension: cause or consequence? - Data from SEPHAR II Survey]
[Objectives: To evaluate a possible link between serum uric acid (SUA) levels, arterial stiffness and atherogenic index of plasma on one hand and renal function on the other and to test the role of SUA in the assessment of total cardiovascular risk. Materials and methods: We studied serum uric acid levels (SUA) in 1975 subjects included in SEPHAR II survey. We measured arterial stiffness parameters, calculated atherogenic index of plasma and estimated glomerular filtration rate (eGFR) by MDRD and CKD-EPI formulae and assessed total cardiovascular risk according to current ESH-ESC risk stratification chart. Results: The highest SUA values were recorded in subjects with grade III HT and were correlated with increased arterial stiffness and with increased atherogenic index of plasma. The lowest eGRF values, assessed by both MDRD and CKD-EPI, were observed among subjects with hyperuricemia and a significant indirect correlation between SUA and eGFR was evidenced. A proportional correlation between SUA values and total CV risk was also obtained. Conclusions: The study supports SUA implication in the pathogenesis of elevated blood pressure and the role of uric acid as a cardiovascular risk factor, particularly for the development of hypertension and renal disease.]
Hypertension and nephrology
SEPTEMBER 20, 2014
Hypertension and nephrology
SEPTEMBER 20, 2014
[The measurement of blood pressure variability with „visit-to-visit” method in the OPAL study]
[Authors reanalysed the 2 years-data of OPAL study for evaluation of change in blood pressure variability. The visit-to-visit form of long term measurement method was selected for characterization of the variability. The decrease of blood pressure fluctuation due to antihypertensive treatment was measured with the standard deviation of mean values and the variation koefficient. According to our observation the combined ACE inhibitor + amlodipine therapy was effective not only in the respect of systolic and diastolic target pressure, but - with continuous reduction - the BPV indices reached the level of normotensive subjects in the end of first year of treatment.]
Hypertension and nephrology
SEPTEMBER 20, 2014
Hypertension and nephrology
SEPTEMBER 20, 2014
[Changes in prescribing practice of diuretics in the treatment of hypertension between 2007 and 2013 in the mirror of insurance data]
[Amongst diuretics, thiazides are the most commonly used antihypertensive agents. Due to their long-term effect, they are ideal for treatment of hypertension. Indapamide is a long-acting (half-life 14-16 hours) thiazide-like diuretic, which is effective in very small doses (1.25 to 5 mg). Indapamide mainly provides a forceful blood pressure lowering effect, by decreasing arteriolar and peripheral resistance due to its vasodilatative effect. Even in hypertensive, diabetic patients, indapamide does not affect the lipid metabolism or the carbohydrate metabolism. As an antihypertensive medicine, thiazide-type diuretics (only in small doses - 6.25- 12.5 mg hypothiazide, 12.5 mg chlorthalidone, 5 mg clopamide) can be the first choice, when dealing with essential hypertension disease without complications. They may also be used in monotherapy. When dealing with hypertension associated with old age or with isolated systolic hypertension, these products are recommended with “A” type evidence. For the treatment of left ventricular hypertrophy and post-stroke conditions associated with the treatment of hypertension, it is recommended to use indapamide in case of diabetes, furosemide and thiazide in case of a left ventricular dysfunction and heart failure, or a combination of these. When reviewing the national sales of mono-component diuretics between 2007 and 2013 in the National Health Insurance (OEP) database, we could see that the sales of hydrochlorothiazide, clopamide, and chlorthalidone decreased. In 2013 however, the sales of the latter experienced a turnover, which might indicate the activity of the followers of the new guideline. The use of diuretics with indapamide as their active substance increased. The prescription of diuretics used in a combination increased continuously between 2007 and 2010 and reached a monthly one million prescribed boxes. During the time in question, the use of products combined with hydrochlorothiazide (most products contain this agent) was the most dominant, but its share fell from 88% to 66% due to the growth of combinations containing the active ingredient indapamide. This is interesting because this combination is “unique” (perindopril + indapamide). During the period in question, only the prescription of this combination increased steadily. The use of diuretics is very important in antihypertensive therapy. If we compare the diuretics and their combinations to the recommendations, we can state that the treatment is done along the guidelines, or in other words the use of the metabolic neutral combination therapy is increasing.]
Hypertension and nephrology
SEPTEMBER 20, 2014
[Treatment of high blood pressure in praxis and beyond. Hypertension praxis model]
[Author presents a hypertension care model in the general praxis. Hypertensive patients and those with diabetes, hyperlipidemia and obesity, OSAS and the therapeutic results with these care model system for three years was analysed. The target blood pressure was achieved in a great rate in all patient’s groups. the elements of therapeutic success was analysed.]
Hypertension and nephrology
SEPTEMBER 20, 2014
Hypertension and nephrology
SEPTEMBER 20, 2014
Hypertension and nephrology
SEPTEMBER 20, 2014
Hypertension and nephrology
SEPTEMBER 20, 2014
1.
Clinical Neuroscience
[Headache registry in Szeged: Experiences regarding to migraine patients]
21. MAY
2.
Clinical Neuroscience
[The new target population of stroke awareness campaign: Kindergarten students ]
21. MAY
3.
Clinical Neuroscience
Is there any difference in mortality rates of atrial fibrillation detected before or after ischemic stroke?
27. NOV
4.
Clinical Neuroscience
Factors influencing the level of stigma in Parkinson’s disease in western Turkey
27. SEP
5.
Clinical Neuroscience
[The effects of demographic and clinical factors on the severity of poststroke aphasia]
18. JUL
1.
2.
Clinical Oncology
[Pancreatic cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up]
29. AUG
3.
Clinical Oncology
[Pharmacovigilance landscape – Lessons from the past and opportunities for future]
29. AUG
4.
5.