Effects of short-term exercise-training on aortic systolic pressure augmentation in overweight and obese individuals

To determine whether exercise training-induced decreases in blood pressure (BP) can be explained by decreases in aortic systolic pressure augmentation in overweight or obese individuals. Thirty-five sedentary or recreationally active men and women (30–57 years) who were either overweight (40 %) or obese (60 %) completed 6 weeks of exercise training (≥3 days/week; stationary bike and/or treadmill) either preceded (n = 19) or followed (n = 16) by a 6-week control period of no exercise. Aortic augmentation pressure (AP), aortic and peripheral augmentation indices (AIx), and central aortic BP (SphygmoCor) were determined before and after exercise training and a control period. Peak oxygen consumption increased (p = 0.0001) from 27.0 ± 5.1 to 28.8 ± 5.8 mL/(kg min) after 6 weeks of exercise. Exercise training decreased brachial systolic (SBP) and diastolic BP from 142 ± 8/94 ± 8 to 134 ± 11/86 ± 11 mmHg (p < 0.005/p < 0.005); whereas no changes were observed after the control period (141 ± 11/91 ± 9 mmHg, p = 0.81/p = 0.34). Neither AP (baseline: 9.2 ± 4.2 mmHg; after 6 weeks training: 8.7 ± 6.1 mmHg), aortic AIx (baseline: 24.6 ± 11.0 %; after 6 weeks training: 22.7 ± 11.1 %), nor peripheral AIx (baseline: 81.4 ± 16.7 mmHg; after 6 weeks training: 76.4 ± 16.5 mmHg) were modified by exercise training. Although aortic SBP decreased after exercise (132 ± 8 to 124 ± 12 mmHg, p < 0.002), these changes were accounted for by decreases in mean arterial pressure. In overweight or obese individuals, although short-term aerobic exercise training, which improved cardiorespiratory fitness, may produce marked decreases in aortic and brachial BP; these effects are not attributed to alterations in aortic systolic pressure augmentation.     

How to check whether a blood pressure monitor has been properly validated for accuracy

Hypertension guidelines recommend that blood pressure (BP) should be measured using a monitor that has passed validation testing for accuracy. BP monitors that have not undergone rigorous validation testing can still be cleared by regulatory authorities for marketing and sale. This is the situation for most BP monitors worldwide. Thus, consumers (patients, health professionals, procurement officers, and general public) may unwittingly purchase BP monitors that are non‐validated and more likely to be inaccurate. Without prior knowledge of these issues, it is extremely difficult for consumers to distinguish validated from non‐validated BP monitors. For the above reasons, the aim of this paper is to provide consumers guidance on how to check whether a BP monitor has been properly validated for accuracy. The process involves making an online search of listings of BP monitors that have been assessed for validation status. Only those monitors that have been properly validated are recommended for BP measurement. There are numerous different online listings of BP monitors, several are country‐specific and two are general (international) listings. Because monitors can be marketed using alternative model names in different countries, if a monitor is not found on one listing, it may be worthwhile cross‐checking with a different listing. This information is widely relevant to anyone seeking to purchase a home, clinic, or ambulatory BP monitor, including individual consumers for use personally or policy makers and those procuring monitors for use in healthcare systems, and retailers looking to stock only validated BP monitors.     

D-dimer relates positively with increased blood pressure in black South Africans: The SABPA study

Introduction

Hypertension is highly prevalent in black South Africans in which morbidity and mortality from stroke are on the increase. Elevated blood pressure and haemostatic markers can induce changes in blood rheology and endothelial function which could result in a procoagulant state that increases the risk for cerebrovascular disease. Information about the coagulation and fibrinolytic systems of people from African descent are limited. We therefore, investigated the haemostatic profile and its relationships with blood pressure in black South Africans.

Materials and methods

We measured ambulatory blood pressure and haemostatic markers of 201 black and 208 white school teachers. The haemostatic markers included measurements representing coagulation and fibrinolysis (von Willebrand factor, fibrinogen, plasminogen activator inhibitor-1, fibrin D-dimer and clot lysis time).

Results

Black participants displayed significantly higher blood pressure, von Willebrand factor, fibrinogen, plasminogen activator inhibitor-1 and D-dimer levels and longer clot lysis times (p ≤ 0.001). Single, partial and multiple regression analyses showed that systolic (p ≤ 0.011) and diastolic blood pressure (p = 0.010) correlated positively with D-dimer in black participants, while systolic (p ≤ 0.001) and daytime diastolic blood pressure (p = 0.011) correlated negatively with clot lysis time in white participants.

Conclusion

The black population had a more prothrombotic profile, with higher levels of coagulation markers and inhibited fibrinolysis, than the white study participants. The positive association between blood pressure and elevated D-dimer in the blacks may contribute to the high prevalence of hypertension and related increased cardiovascular and cerebrovascular risk in this group.     

The Association of Measures of the Micro- and Macro-Vasculature with Selenium and GPx Activity in a Young Bi-Ethnic Population: The African-PREDICT Study

Abstract

Objective: Selenium plays an important physiological role as component for antioxidant selenoproteins such as glutathione peroxidase (GPx). Since oxidative stress contributes to hypertension development, it is likely that selenium deficiency may contribute to the burden of cardiovascular disease. To better understand the involvement of selenium and GPx in the early development of cardiovascular disease, we investigated in young, healthy black and white African men and women whether measures of the micro- and macrovasculature are related to selenium and GPx activity.

Methods: In young adults (N?=?394; aged 20–30?years) we determined serum selenium, GPx activity, microvascular measures (central retinal artery equivalent, central retinal vein equivalent, arteriolar-to-venular ratio [AVR], and estimated glomerular filtration rate [eGFR]), and macrovascular measures (pulse wave velocity, 24-hour pulse pressure [PP] and augmentation index [Aix]).

Results: In multivariable-adjusted regression analyses, there were vasculoprotective associations between serum selenium and a microvascular measure (AVR [β?=?0.23; p?=?0.036]) in black African women and with a macrovascular measure (24-hour PP [β = ?0.15; p?=?0.048]) in white African women. In turn, GPx activity also showed a protective association with a microvascular measure (eGFR) in white African men (β?=?0.23; p?=?0.035), as well as with macrovascular measures (AIx, PP) in the black (β = ?0.25; p?=?0.027) and white African men (β = ?0.22; p?=?0.035), and black African women (β = ?0.32; p?=?0.001).

Conclusions: Collectively the findings suggest a protective role for the micronutrient selenium and GPx on both the micro- and macrovasculature in a young, healthy bi-ethnic population.     

Burn prevention programmes for children: Are they effective?

A project was designed to evaluate fire safety knowledge in a population of 67 school children aged 8 to 13 yr, and how a lecture on burn and fire prevention affected this prior knowledge.The project consisted of four major parts: (a) a prelecture test presenting 9 questions related to important and frequently encountered situations occurring during burn accidents; (b) presentation of a multimedia lecture on burn and fire prevention the same day of the pre-lecture test; (c) a post-lecture test, using the same questions as the pre-lecture test, administered to the same student population one week after the lecture presentation; and (d) analysis and discussion of the results with the students and subsequent reinforcement of correct behaviours related to fire prevention.The results of the project demonstrated that prior knowledge and behaviour related to burn and fire prevention was deficient for this population and that the multimedia lecture was an efficient educational tool.However, the results also pointed out that some misinterpretations resulted from the lecture, as seen by inconsistent answers, mainly due to the common failure of safety education programmes to understand the child's point of view and his particular cognitive development.These results emphasize the necessity for the development of burn prevention programmes which take into account the child's perception of his world, his uniqueness and his cognitive and moral development; and, secondly, the absolute necessity for evaluating these programmes.     

Elicitation of allergic asthma by immunoglobulin free light chains

The observation that only 50% of patients with adult asthma manifest atopy indicates that other inflammatory mechanisms are likely involved in producing the characteristic features of this disorder; namely reversible airway obstruction, hyperresponsiveness, and pulmonary inflammation. Our recent discovery that antigen-specific Ig free light chains (LCs) mediate hypersensitivity-like responses suggests that these molecules may be of import in the pathophysiology of asthma. Using a murine experimental model of nonatopic asthma, we now have shown that an LC antagonist, the 9-mer peptide F991, can abrogate the development of airway obstruction, hyperresponsiveness, and pulmonary inflammation. Further, passive immunization with antigen-specific LCs and subsequent airway challenge can elicit a mast cell-dependent reaction leading to acute bronchoconstriction. These findings, and the demonstration that the concentration of free kappa LCs in the sera of patients with adult asthma were significantly increased (as compared with age-matched nonasthmatic individuals), provide previously undescribed insight into the pathogenesis of asthma. In addition, the ability to inhibit pharmacologically LC-induced mast cell activation provides a therapeutic means to prevent or ameliorate the adverse bronchopulmonary manifestations of this incapacitating disorder.     

Cardiovascular effects of oral Supplementation of vitamin C, E and folic acid in young healthy males

Numerous observational studies showed associations of antioxidants (vitamins C and E) and folate intake with a reduced risk of cardiovascular disease, but randomized controlled clinical trials have generally not supported this hypothesis. The objective of this study was to investigate the effects of a daily dosage of 1000 mg vitamin C, 800 mg vitamin E, and 10 mg folate on markers of vascular function in 31 young healthy male adults. Cardiovascular values after a 12-week vitamin (14 subjects) or placebo (17 subjects) intervention were compared to baseline values. Cardiovascular parameters (blood pressure, stroke volume, heart rate, cardiac output, vascular resistance, arterial compliance) were measured continuously after an overnight fast under controlled circumstances with a Finometer device. Our main finding was a significant decrease (p = 0.03) in systolic blood pressure in the experimental group. No statistically significant changes were observed within other cardiovascular variables of the experimental group, but possible beneficial decreases in diastolic blood pressure and increases in arterial compliance after 12 weeks of vitamin supplementation were indicated. In conclusion, beneficial effects of antioxidants and folate were observed probably because the supplementation was used by young healthy subjects under carefully controlled conditions.     

Application of difference circular dichroism (CD) spectroscopy for determination of pharmaceutical compounds. Analysis of stereoisomers by the HPLC-CD/UV method

Circular dichroism (CD) spectroscopy is gaining an increasing importance in pharmaceutical analysis. One of the main advantages of the CD spectroscopic method is its inherent selectivity, which provides the selective analysis of chiral molecules possessing optically active absorbance bands. In addition to direct CD spectroscopic methods, several new procedures have been developed based on CD spectroscopy for the analysis and determination of pharmaceutical compounds in the past few years. One of the most progressive fields of chiroptical analysis is the combination of high performance liquid chromatographic separation and CD spectroscopy and the application of simultaneous dual CD/UV detection. The aim of our research work was to work out new procedures based on CD and CD related techniques and to investigate the application of these methods in pharmaceutical analysis. This work presents a new, selective and sensitive difference CD spectroscopic method based on oxime formation of the keto group for the determination of delta 4-3-ketosteroids and 6-keto-morphinans. Molar CD and UV spectral parameters of E and Z oxime isomers, produced in the course of oxime formation reaction, have been determined by HPLC separation and simultaneous dual CD and UV detection, without isolation of the isomers. The stereochemistry of spirocyclic pyridopyridazine compounds has been investigated by simultaneous dual CD and UV spectroscopy following HPLC separation. The enantiomeric relationship of the pyridopyridazine stereoisomers has been proved by the application of ellipticity-absorbance ratio spectra in a novel way.     

Experimental verification and validation of a computer model for light–tissue interaction

Laser light is frequently used in both diagnostics and treatment of patients. For any laser treatment to be effective it is important to deliver the correct dose at the treatment site. Human skin scatters and absorbs laser light in the visible wavelength region, which results in a decrease in fluence some distance into the skin. Computer simulations can be used to predict the fluence at the treatment site. Liquid and solid phantoms were prepared and the optical properties were measured. These values were then used as input values to a commercial software package simulating the different layers of skin representing phantoms. The transmission and reflected fractions of the different phantoms were measured with an integrating sphere and compared with the computer simulations. The results showed very good agreement with the measured values and the model can therefore be used with confidence to predict fluence at any treatment site inside the skin.