232 research outputs found
Effect of eprosartan-based therapy on systolic blood pressure and total cardiovascular risk in a large international population: preliminary report of the observational POWER study
No full textAssen Goudev,1 Jean-Pascal Berrou,2 Atul Pathak3 On behalf of the POWER Investigators1Department of Cardiology, Queen Giovanna University Hospital, Sofia, Bulgaria; 2Strategic Medical Affairs, CardioMetabolic Established Products, Abbott Products Operations AG, Allschwil, Switzerland; 3Faculte´ de Médecine et CHU Toulouse, Unité de Pharmacologie Cardiovasculaire et Autonome, Service de Pharmacologie et Cardiologie, INSERM U 1048, Université Paul Sabatier, Toulouse, FranceBackground: Estimation of total cardiovascular risk is useful for developing preventive strategies for individual patients. The POWER (Physicians' Observational Work on Patient Education According to their Vascular Risk) survey, a 6-month, open-label, multinational, post-marketing observational evaluation of eprosartan, an angiotensin II receptor blocker, was undertaken to assess the efficacy and safety of eprosartan-based therapy in the treatment of high arterial blood pressure in a large population recruited from 16 countries with varying degrees of baseline cardiovascular risk, and the effect of eprosartan-based therapy on total cardiovascular risk, as represented by the SCORE® (Systematic Coronary Risk Assessment) or Framingham risk equations.Methods: Participating physicians recruited > 29,000 hypertensive patients whom they considered to be candidates (according to specified criteria) for treatment with eprosartan 600 mg/day, with other drugs added at the discretion of the physician.Results: During treatment, systolic blood pressure decreased by 25.8 ± 14.4 mmHg to 134.6 ± 11.4 mmHg (P < 0.001), mean diastolic blood pressure fell by 12.6 ± 9.5 mmHg to 81.1 ± 7.6 mmHg, and pulse pressure fell by 13.2 ± 13.5 mmHg to 53.6 ± 11.4 mmHg (both P < 0.01). Calculated total cardiovascular risk declined in parallel with the reduction in blood pressure.Conclusion: The POWER study has demonstrated, in a large and nonselected population, the feasibility and practicability of reducing total cardiovascular risk through systematic management of high blood pressure.Keywords: hypertension, SCORE®, Framingham, eprosartan, cardiovascular ris
Assen Ignatov: The Theomachist and the God-Seeker
No full textAssen Ignatov: The Theomachist and the God-Seeker
This article aims to trace the evolution of Assen Ignatov’s attitude towards religion and to outline the main features of this change – from an intellectual whose worldview was initially Marxist to being a dissident philosopher known also for his respect for Christianity. The first part of the study is devoted to the early professional stages of Assen Ignatov’s life (as a lecturer at Sofia University), when he attacked the “Bourgeois” philosophy for its affinity to religion. Gradually, these initial attitudes were seriously shaken, partly because he was one of the very few erudite thinkers in Bulgaria during the “socialist” period who witnessed the dogmatism and narrow interests of the Party philosophers. In addition, his escape to Western Europe was a radical break with the past, specifically with regard to religion. Assen Ignatov interpreted communism as a pseudo-religion from the viewpoint of Christian personalism and existentialism. The author concludes that the radical change of Ignatov’s attitude towards religion shows the measure of his general change of worldview.
Asen Ignatow – w walce przeciw Bogu i w poszukiwaniu Boga
Celem artykułu jest prześledzenie ewolucji stosunku do religii Asena Ignatowa: od intelektualisty, którego światopogląd był początkowo marksistowski, do filozofa-dysydenta, znanego również z jego szacunku dla chrześcijaństwa. W pierwszej części zaprezentowane są początkowe etapy w jego życiu zawodowym, kiedy jako wykładowca na Uniwersytecie w Sofii atakował filozofię burżuazyjną z powodu jej pokrewieństwa z religią. Stopniowo postawy te uległy poważnemu zachwianiu (również dlatego, że był on jednym z niewielu bardzo dobrze wykształconych myślicieli w Bułgarii okresu „socjalistycznego”, który obserwował dogmatyzm i wąskie interesy partyjnych filozofów), a jego ucieczka do Europy Zachodniej oznaczała zerwanie z przeszłością, szczególnie w odniesieniu do religii. Asen Ignatow interpretował komunizm jako pseudoreligię z punktu widzenia chrześcijańskiego personalizmu i egzystencjalizmu. Autorka konkluduje, że radykalny zwrot w postawie Ignatowa wobec religii jest wyrazem głębszych zmian o charakterze światopoglądowym
Public Outreach in the Drents Museum in Assen (NL)
No full textThe author of this article works as a museum teacher at the educational department of the Drents Museum and is an active member of the living history group Byfrost. Part of my job as museum teacher at the Drents Museum in Assen is attending to the all the groups that visit our museum. This includes the great number of children, both elementary school and high school students, that visit our museum. A lot of children think of a museum as a boring place where there is nothing to do but look at old paintings. Many only go to the museum if their parents or teachers make them go
Early Detection and Prediction of Cardiotoxicity - Biomarker and Echocardiographic Evaluation
No full textNon
Sleep disorders in patients with acute and exacerbated chronic heart failure
No full textHeart failure is often accompanied by sleep disorders. Continuous Positive Airway Pressure (CPAP) therapy has proven in the treatment of obstructive sleep apnea, but the benefits associated with comorbid patients and patients with heart failure is still under research. On the other hand, central sleep apnea is also with high frequency in these patients and more difficult to treat. The aim of the current publication is to make a brief review of acute and exacerbated chronic heart failure in patients with sleep disorders – frequency, severity, and types to treat
Influence of atrial fibrillation on efficacy and safety of omecamtiv mecarbil in heart failure: the GALACTIC-HF trial
No full textAims:
In GALACTIC-HF, the cardiac myosin activator omecamtiv mecarbil compared with placebo reduced the risk of heart failure events or cardiovascular death in patients with heart failure with reduced ejection fraction. We explored the influence of atrial fibrillation or flutter (AFF) on the effectiveness of omecamtiv mecarbil.
Methods and results:
GALACTIC-HF enrolled patients with New York Heart Association (NYHA) Class II–IV heart failure, left ventricular ejection fraction ≤35%, and elevated natriuretic peptides. We assessed whether the presence or absence of AFF, a pre-specified subgroup, modified the treatment effect for the primary and secondary outcomes, and additionally explored effect modification in patients who were or were not receiving digoxin. Patients with AFF (n = 2245, 27%) were older, more likely to be randomized as an inpatient, less likely to have a history of ischaemic aetiology or myocardial infarction, had a worse NYHA class, worse quality of life, lower estimated glomerular filtration rate, and higher N-terminal pro-B-type natriuretic peptide. The treatment effect of omecamtiv mecarbil was modified by baseline AFF (interaction P = 0.012), with patients without AFF at baseline deriving greater benefit. The worsening of the treatment effect by baseline AFF was significantly more pronounced in digoxin users than in non-users (interaction P = 0.007); there was minimal evidence of effect modification in those patients not using digoxin (P = 0.47) or in digoxin users not in AFF.
Conclusion:
Patients in AFF at baseline were less likely to benefit from omecamtiv mecarbil than patients without AFF, although the attenuation of the treatment effect was disproportionally concentrated in patients with AFF who were also receiving digoxin.
Clinical Trial Registration: NCT02929329
Safety management within Task Force Uruzgan: A report of working with Unmanned Aerial Vehicles
No full textIn this paper we present a conceptualization of safety management that is based on the cybernetic concepts of “controllability” and “control capacity”. In particular, we explore what this conceptualization means for safety management of the Dutch Army’s UAV unit that was part of Task Force Uruzgan (TFU) in the years 2006–2007 and 2008–2009. In this research we applied a qualitative research strategy. We conducted 20 interviews, 13 with employees of the UAV unit and 7 with key TFU-partners with whom the unit had to cooperate. We analyzed the interviews by means of the concepts developed in the theoretical framework. By going back and forth between theory and practice, we show that it was rather problematic for the unit to develop controllability and operate safely. We conclude with a reflection on a safety management strategy for this particular unit and the relevance of our conceptualization for other organizations.Values and TechnologyTechnology, Policy and Managemen
Cardiac amyloidosis – an underestimated etiology for heart failure with preserved ejection fraction. A literary review
No full textСърдечната амилоидоза, доскоро приемана за рядко заболяване, е сериозна и прогресираща кардиомиопатия, отличаваща се с екстрацелуларно натрупване на неправилно нагънати протеини в камерния миокард. Диагностицирането на сърдечната амилоидоза в ранен етап е ключово за прогнозата на пациентите, предоставяйки именно тогава широк спектър от терапевтични възможности, свързани с подобряване на прогнозата и/или предотвратяване на потенциално необратима загуба на физическа функция и качеството на живот, като съвременните данни сочат, че по-голямата част от пациентите не получават навременна диагноза. Пациентите със сърдечна амилоидоза в ранен етап не показват редукция на левокамерната глобална систолна функция, но могат да развият симптоми на сърдечна недостатъчност със запазена фракция на изтласкване (HFpEF), като СА се счита за една от пренебрегваните етиологии на HFpEF при възрастни. Сърдечната амилоидоза е прогресивно заболяване с лоша прогноза, ако се остави без лечение. Средната продължителност на живот на нелекуваните пациенти с AL-сърдечна амилоидоза е по-малка от 6 месеца, а тази на пациентите с ATTR-CA е 2.5-3.5 години. Следователно ранната клинична идентификация е от съществено значение. Cardiac amyloidosis, once considered a rare disease, is a severe and progressive cardiomyopathy characterized by extracellular deposition of misfolded proteins in the ventricular myocardium. Early diagnosis of cardiac amyloidosis is essential for improving patient prognosis, as it allows for a broader range of therapeutic options that can enhance outcomes and/or prevent potentially irreversible loss of physical function and quality of life. Current data suggest that a majority of patients do not get a timely diagnosis. Patients with early-stage CA do not exhibit reduced global left ventricular systolic function but may develop symptoms of heart failure with preserved ejection fraction (HFpEF), with CA considered as one of the overlooked etiologies of HFpEF in the elderly. Cardiac amyloidosis is a progressive disease with a poor prognosis if left untreated. The average life expectancy of untreated patients with AL cardiac amyloidosis is less than 6 months, while that of patients with ATTR-CA is 2.5-3.5 years. Therefore, early clinical identifi cation is essential
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