Search

Mikołaj Dopierała, Krzysztof Schwermer, Krzysztof Hoppe, Małgorzata Kupczyk, Krzysztof Pawlaczyk Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poznan, PolandCorrespondence: Krzysztof Pawlaczyk, Email kpawlac@ump.edu.plIntroduction: Chronic kidney disease is a widespread medical problem that leads to higher morbidity, mortality, and a decrease in the overall well-being of the general population. This is especially expressed in patients with end-stage renal disease (ESRD) undergoing maintenance haemodialysis. Several variables could be used to evaluate those patients’ well-being and mortality risk. One of them is the presence of residual urine output.Materials and Methods: The study was conducted on 485 patients treated with maintenance haemodialysis. After enrollment in the study, which consisted of medical history, physical examination, hydration assessment, and blood sampling, each patient was followed up for 24 months. We used residual urine output (RUO) as a measure of residual renal function (RRF). The entire cohort was divided into 4 subgroups based on the daily urinary output ( 100mL to 500mL to 1000mL).Results: The data show that the mortality rate was significantly higher in groups with lower RUO, which was caused mainly by cardiovascular events. Also, patients with higher RUO achieved better sodium, potassium, calcium, and phosphate balance. They were also less prone to overhydration and had a better nutritional status. Preserved RRF also had a positive impact on markers of cardiovascular damage, such as NT-proBNP as well as TnT.Conclusion: In conclusion, preserving residual urine output in ESRD patients undergoing maintenance haemodialysis is invaluable in reducing their morbidity and mortality rates and enhancing other favourable parameters of those patients.Keywords: end stage renal disease, haemodialysis, residual urine output, cardiovascular risk, mortality

Abstract Background The coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) produced a pandemic since March 2020 by affecting more than 243 million people with more than 5 million deaths globally. SARS-CoV-2 infection is produced by binding to angiotensin-converting enzyme, which among other sites is highly expressed in the endothelial cells of the blood vessels, pericytes and the heart, as well as in renal podocytes and proximal tubular epithelial cells. SARS-CoV-2 and cardiovascular disease (CVD) are interconnected by risk factors association with an increased incidence of the disease and by determining de novo cardiac complications. At the same time, COVID-19 disease can lead to acute kidney injury directly, or due to sepsis, multi-organ failure and shock. Therefore, the pre-existence of both CVD and chronic kidney disease (CKD) is linked with a higher risk of severe disease and worse prognosis. Methods The main aim of this study is to assess the CV risk in a CKD (stage 3 to 5), dialysis and kidney transplanted population, following SARS-CoV-2 infection, with focus on the endothelial dysfunction as compared to a control group of matched patients. By using clinical evaluation, flow-mediated dilatation, carotid-femoral pulse wave velocity, intima-media thickness, echocardiographic parameters, lung ultrasound, bioimpedance spectroscopy and a series of novel biomarkers, the investigators will determine the long-term impact of this disease on CV and renal outcomes. Discussion This study will address the challenges and implications in long-term CV sequeale of COVID-19 and focus on a better understanding of the underlying mechanisms and possible therapeutic options. Trial registration Patient enrolment in the trial started in January 2021 and is expected to finish at the end of 2022. The study can be found on ClinicalTrials.gov database with NCT05125913 identifier. Registered on 18 November 2021 - Retrospectively registered.

Purpose: To evaluate changes in drug utilization pattern of antidiabetic drugs on prospective follow-up of new and recently diagnosed type 2 diabetes mellitus patients along with their 10-year cardiovascular risk assessment. Methods: A prospective observational hospital-based study was conducted among new and recently diagnosed (≤ 6 months) type 2 diabetes patients attending the medicine outpatient department (OPD) at tertiary care teaching hospital, Raipur, after taking written informed consent. Antidiabetic drug prescription and socio-demographic characteristics were noted in the Case Record Form. Recruited patients were followed up at 3, 6, and 9 months. Ten-year cardiovascular risk was determined using the QRISK®3 risk calculator. Result: A total of 90 patients, 48 (53.33%) new and 42 (46.67%) recently diagnosed type 2 diabetes patients, were recruited. An average number of antidiabetic drugs prescribed in patients was 2.1 at the final visit. The average daily dose of antidiabetic drugs was assessed against the WHO/ATC-defined daily dose (DDD). It was decreased for metformin and other antidiabetic drugs, except for glimepiride. More than one-third of patients had a QRISK3 score >10% at each visit. Conclusion: This study highlighted that patient education and periodic review of prescription of new and recently diagnosed diabetic patients play a vital role in managing type 2 diabetes mellitus by tailoring treatment regimen. The present study revealed overtreatment of low-risk groups and under-treatment of high-risk groups based on QRISK3 score and statins. This observation signifies that risk stratification is essential for preventing CVD risks in new diabetic patients. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) produced a pandemic since March 2020 by affecting more than 243 million people with more than 5 million deaths globally. SARS-CoV-2 infection is produced by binding to angiotensin-converting enzyme, which among other sites is highly expressed in the endothelial cells of the blood vessels, pericytes and the heart, as well as in renal podocytes and proximal tubular epithelial cells. SARS-CoV-2 and cardiovascular disease (CVD) are interconnected by risk factors association with an increased incidence of the disease and by determining de novo cardiac complications. At the same time, COVID-19 disease can lead to acute kidney injury directly, or due to sepsis, multi-organ failure and shock. Therefore, the pre-existence of both CVD and chronic kidney disease (CKD) is linked with a higher risk of severe disease and worse prognosis.Methods: The main aim of this study is to assess the CV risk in a CKD (stage 3 to 5), dialysis and kidney transplanted population, following SARS-CoV-2 infection, with focus on the endothelial dysfunction as compared to a control group of matched patients. By using clinical evaluation, flow-mediated dilatation, carotid-femoral pulse wave velocity, intima-media thickness, echocardiographic parameters, lung ultrasound, bioimpedance spectroscopy and a series of novel biomarkers, the investigators will determine the long-term impact of this disease on CV and renal outcomes.Discussion: This study will address the challenges and implications in long-term CV sequeale of COVID-19 and focus on a better understanding of the underlying mechanisms and possible therapeutic options.Trial Registration: Patient enrolment in the trial started in January 2021 and is expected to finish at the end of 2022. The study can be found on ClinicalTrials.gov database with NCT05125913 identifier. Registered on 18 November 2021 - Retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is the single largest cause for mortality and morbidity in the world and also in India. The prevalence of CVD risk factors in India is steadily increasing moreover CVD in Indians has been shown to occur prematurely. The study was designed to estimate the 10-year cardiovascular risk using region specific WHO/ISH risk prediction chart among unskilled workers of a tertiary care teaching hospital and to determine factors associated with risk. Material and methods: It were a hospital based cross sectional study. Based on the calculated sample size, 250 eligible workers were selected by simple random sampling. Using structured questionnaire, life style related risk factors namely, average daily consumption of fruits and vegetables, physical activity, perceived stress, tobacco and alcohol use was collected. BMI and BP were measured using standard protocol and classified following standard guidelines. Bio-chemical parameters were also measured. Results: Among 250 workers 37.2% and 10% consumed daily minimal recommended level of vegetables and fruits respectively, 21.1% was current tobacco user, 17.2% was alcohol drinkers, 50.4% were obese, 18.8% had high blood pressure, 6% had elevated cholesterol levels. Among the workers 46.7 % had

Dapagliflozin has been demonstrated to improve glycemic control, blood pressure, and body weight in type 2 diabetes mellitus (T2D); indeed, it can also reduce the risk of progression to renal failure, of hospitalization for heart failure and of cardiovascular death. We aim to investigate the acute effect of Dapagliflozin on kidney function in the common clinical practice in T2D. This is a study including 1402 patients with T2D recruited from 11 centers in Lombardia, Italy, who were evaluated at baseline and after 6 months of treatment with Dapagliflozin 10 mg per day. The primary outcome of the study was the change in HbA1c, while the secondary outcomes were modification of weight, BMI, systolic and diastolic pressure, creatinine, eGFR and albuminuria status. After 24 weeks of treatment with Dapagliflozin, a reduction in Hb1Ac was observed (−0.6 ± 1.8%) as well as in BMI (−1.5 ± 5.2 kg/m2). Statistically significant changes were also found for systolic and diastolic blood pressure, cholesterol and triglycerides. Interestingly, a statistically significant acute improvement of kidney function was evident. Our analyses confirm the beneficial effects of dapagliflozin after 6 months of therapy, with improvements of glycemic and lipid profiles, blood pressure, BMI. Finally, an acute positive effect on albuminuria and KIDGO classes was observed during a 6 months treatment with dapagliflozin in patients with T2D.

Intorduction: Aldosterone is known to play important role in developing cardiovascular, metabolic, renal damage in hypertensive patients. Aim: Aim of study was to evaluate parameters obtained by eco-color Doppler study, as non-invasive and easly performed method in asyntomatic patients with Essential Hypertension (EH) and Primary Aldosteronism (PA), without overt organ damage. Methods: From April 2019 to March 2020 we consecutively enrolled 73 hypertensive subjects (48 males, 25 women), distinguished in two groups: 30 EH patients (mean age 49.5 ± 18.7 years) and 43 PA patients (mean age 53.1 ± 11.6 years)] [23 with aldosterone-secreting adrenal adenoma (APA), 20 with idiopathic aldosteronism (IHA)]. Results: PA group showed higher renal filtration rate and 24-h urinary excretion of albumin respect to EH; moreover, in PA we found higher Pulsatility Index, altered percentage of Renale Resistance Index, Atrophy Index, and reducted parietal thickness than EH. The correlation study showed that plasma aldosterone were positively correlated with pulsatility index in PA group (right r = 0.35; p < 0.05; left r = 0.36; p < 0.05). Conclusion: parameters obtained through the intra-renal eco-color Doppler examination, easly performed and non-invasive, can be useful in the early-stage identification of subclinical microvascular alterations, especially in PA, condition characterized by increased risk of cardio-vascular remodelling and metabolic alterations. [ABSTRACT FROM AUTHOR]

Aim: The present study was conducted to assess liver involvement in subjects with type 2 diabetes mellitus and to find the correlation between different cardiovascular parameters and non-alcoholic fatty liver disease in these subjects. Methods: The present prospective clinical study included 75 subjects showing fatty liver changes on ultrasound and type 2 diabetes mellitus where correlation with cardiovascular changes was assessed. Results: Highest prevalence of LVDD in subjects with HbA1c of 7.1-8, hypertension is significantly higher in subjects with fatty liver compared to subjects without fatty liver and based on diabetes duration, LVDD, and ischemic changes on ECG is seen in majority subjects of diabetes with 5-10 years. Hypertension grade 0 was seen in 13.33% (n=10) study subjects, Grade 1 hypertension in 45.33% (n=34) study subjects, and Grade 2 hypertension in 20% (n=15) study subjects, in total of 78.66% (n=59) study subjects. In subjects with nonfatty liver, Grade 0, 1, 2, and 3 hypertension was seen in 10.66% (n=8), 10.66% (n=8), and 0 study subjects respectively, and in total of 21.33% (n=16) study subjects. This difference was statistically significant with p<0.0001 Conclusion: The present study concludes that left ventricular diastolic dysfunction was mainlyseen abnormality on echocardiographic examination in subjects with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

The coronavirus 2019 (COVID-19) pandemic has caused global health, social and economic system challenges. Adults with cardiovascular disease may be at a higher risk of mortality with COVID-19. Low ankle–brachial index (ABI) indicates a diagnosis of peripheral artery disease (PAD) and is associated with increased risk of cardiovascular disease events. The aim of the study was to investigate the relationship between PAB and the consequences of COVID-19. Patients and Methods: 160 patients were analyzed, and 33 (20.6%) (mean age 41.33 years, 72.7% women) of them had COVID-19. Results: The majority of patients studied who recovered from COVID-19 showed normal ABI values. Conclusions: Normal ABI values showing low cardiovascular risk are associated with a better prognosis and successful recovery from COVID-19. [ABSTRACT FROM AUTHOR]

Copyright of Heart & Vascular Diseases / Choroby Serca & Naczyn is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim. To investigate arterial stiffness parameters in middle-aged patients with stage II grade 1-2 essential arterial hypertension (HT) and evaluate their changes after treatment with single pill combinations (SPC) of antihypertensive drugs.Methods. At the first phase of the study, according to the medical records data, a group of untreated patients with stage II grade 1-2 HT (n=100, 47 men, mean age 51.9±6.5 years), and a group of healthy controls with normal blood pressure (BP) (n=86; 28 men; mean age 48.8±5.8 years) were formed. The analysis of arterial stiffness was performed by the volumetric sphygmography technique using VaSera VS-1500N device (Fukuda Denshi Co., Ltd, Japan). All the subjects underwent ambulatory BP monitoring (BPLab, BP2005-01.04.00.2540, Petr Telegin, Russia) as well as a routine BP measurement by the Korotkov method. At the second stage of the study, a group of HT patients (n=90) was formed according to the medical history data. These patients thanks to antihypertensive treatment with SPC (perindopril arginine/indapamide or valsartan/amlodipine) achieved the target BP level (

Moderate alcohol use has a positive effect on the clinical expression of atherosclerosis by increasing HDL-C levels, inhibiting platelets' aggregation and increasing fibrinolytic activity. The purpose of this study was to analyze the prevalence of alcohol consumption by gender and age between 18-60 years, based on a questionnaire method. The analysis of the results showed the presence of a high proportion of male/daily users of alcohol in higher doses and predominantly concentrated beverages. The relationship between increased alcohol consumption and increased cardiovascular risk calculated by SCORE was confirmed. [ABSTRACT FROM AUTHOR]

Despite the prophylactic medicine achievements through the past decade, tobacco smoking remains one of the main risk factors of appearance and progression of diseases, which are accompanied by the high population mortality. Aim: development of the new approaches of complications prediction, prophylaxis and treatment in patients with high and very high total cardiovascular risk, which are based on the heart rhythm turbulence evaluation. Materials and Methods: 603 patients were chosen for the research. All patients were divided into tree groups. The first – patients with IHD without concomitant risk factors, such as smoking, obesity, metabolic syndrome. The second – patients, who smoke for more than 2 years (people with very high cardiovascular risk by SCORE scale). The third group – patients with metabolic syndrome without IHD or hypertension (patients with high cardiovascular risk). Control group included 149 patients. Holter monitoring of the heart rhythm was performed in patients with high and very high cardiovascular risk by the SCORE scale with myocardial infarction to study the specifications of the heart rhythm turbulence. Plasma calcium and magnesium levels were measured to establish the correlation between appearance and progression of ventricular arrhythmia and increase of the heart rhythm turbulence phenomenon. Results. The prevalence of ventricular and supraventricular arrhythmia is reliably higher among the smokers than among healthy persons. The highest percentage of the ventricular extrasystoles both the early appearing extrasystoles and the group extrasystoles is observed among smokers. Among healthy people every fourth person has deviations in heart rhythm turbulence indices, and every seventeenth has significant deviations and high risk of cardiac sudden death. Smokers have reliable decrease of calcium and increase of magnesium plasma levels. People with heart rhythm turbulence, metabolic syndrome and hypertension have reliable increased in calcium plasma concentration compared with people with metabolic syndrome but without hypertension. Conclusions. 1) Smoking contributes to increase the polytopic extrasystoles prevalence. 2) Smokers have higher acceleration and deceleration levels of the heart rhythm turbulence. 3) Changes of calcium and magnesium plasma levels in smokers do not cause the ventricular extrasystole. 4) Studying of the heart rhythm turbulence is available marker of fatal arrhythmias occurrence predicting.

Object of assessment is patients following kidney transplantation.Objective. We defined the grade of myocardial remodeling in patients after transplantation during the 1-year period.Materials and Methods. We analyzed 125 patients prior to transplantation, in 6 months and in 1 year postoperatively. The comparative assessment of cardiovascular system remodeling indicators was carried out. Conclusion. In the analyzed population, frequency and myocardial hypertrophy of the left ventricle evidence showed tendency to decrease after kidney transplantation that was defined by targeted levels of arterial pressure achievement and improved indicators of the glomerular filtration.

Aim. Assessment and quality of diagnostics of treatment of patients with arterial hypertension (AH) and their conformity with international and national recommendations on AH.Material and methods. The poll among physicians of Volgograd and Volgograd region, who took part in the regional conference, devoted to the problems of AH, was carried out in April 2004. The questionnaire included 13 questions about peculiarities of AH patients’ management 128 physicians took part in the poll, from them 90 thetapeutists (general physicians), 24 cardiologists, and 14 physicians of different therapeutic specializations.Results. Variability of conceptions of physicians on some principals of diagnostics and treatment of AH patients is revealed. Insufficient knowledge of criteria for division patients according to the risk category of cardiovascular complications. The same is observed for definition of AH grade according to the blood pressure level, and of the main approaches AH patients treatment. From all the questioned physicians only 25.2% correctly evaluated the risk level of cardiovascular diseases, 21% of physicians wrongly assessed the AH grade according to the blood pressure Level.Conclusion. Results, show that real practice of diagnostics and treatment of AH significantly deviates from international and national recommendations on AH.

Aim. To assess cumulative cardio-vascular (CV) risk and elasticity of big-to-middle size arteries in hypertensive patients depending on age, sex and enalapril (Enap, Dr. Reddy’s) effects on these features.Material and methods. 143 patients with arterial hypertension of 1-2 stages were split in 3 groups: 1st – patients younger than 55 y.o. (17 men, 27 women before menopause); 2nd – patients aged 55-65 y.o. (16 men, 38 women); 3rd – elder than 65 y.o. (11 men, 34 women). Fatal CV risk according to SCORE scale and cumulative risk of acute coronary disease (CAD) events according to PRCAM program was assessed before and after 4 weeks of enalapril therapy (5-30 mg/d). Besides the speed of pulse wave spread (SPWS) was determined by method of volume sphygmography.Results. Normal SPWS in elastic arteries was observed in women under 55 y.o. SPWS disturbances were detected in elderly patients. Lower blood pressure (BP) levels and better plasma lipid profile was found in women of young and middle age in comparison with these in men of the same age. More than 80% of hypertensive patients have high CV risk, especially in elderly ones. Enam improved SPWS in elastic arteries, reduced BP and cumulative CV risk.Conclusion. There are gender and age differences between BP levels, SPWS indices, plasma lipid profiles and cumulative CV risks in hypertensive patients. Enalapril improves these characteristics.

Postoperative arterial fibrillation (AF) is one of the most common complication after cardiac surgery . POAF affect the length of hospital stay, incidence of postoperative stroke and mortality. The main factors of postoperative AF include age, gender, left atrial size, presence of AF before surgery. The most effective drugs to prevent POAF are beta-blockers and amiodarone. In many cases statins, blockers of the renin -angiotensin system are prescribed. Clinical management of patients with POFP and urgency of restoring sinus rhythm are determined by hemodynamic parameters. In unstable hemodynamic condition electrical cardioversion is performed.

Aim: to evaluate the main parameters of the microcirculatory blood flow and to determine its reserve capacity in patients with arterial hypertension (AH) and different degrees of cardiovascular risk (CVR).Subjects and methods. We examined 64 subjects aged 47-58 years, of which 27 were healthy volunteers and 37 patients with 1st and 2nd degree arterial hypertension, with medium, high and very high CVR (the antihypertensive therapy was cancelled for 2 weeks before the study). In all subjects laser Doppler flowmetry (LDF) with studing initial perfusion parameters, 2 constrictor and 3 dilatator tests waky perfomed. To assess the status of the tone-shaping «active» and «passive» parts of microcirculatory modulation, analysis of the amplitude and frequency spectrum of LDF- grams was carried out.Results. A significant increase in the rate of «base perfusion» in all hypertensive groups compared with the control group was found. The amplitude of respiratory oscillations was one-third higher in high and very high CVR groups in comparison with the control, the amplitude of the myogenic and neurogenic oscillations were maximal and reached significant values in very high CVR group. A reduction in constrictor response in hypertensive patients with middle and high CVR and its increase in the very high CVR group was shown during constrictor functional tests. The power of perfusion increase was reduced in response to all kinds of dilatator stimulus in hypertensive patients group.Conclusion. The findings indicate a progressive increase in the level of «base perfusion», worsening of venous congestion symptoms in hypertensive patients with the progression in CVR severity. High and very high CVR patients showed a reduction in myogenic tone of microvessels when compared with those with normotension. Dilatator functional tests showed a tendency to lower capillary blood flow reserve in hypertensive patients compared with the control group.

Aim: assessment of arterial stiffness (AS) in patients with abdominal obesity (AO) without arterial hypertension and low cardio-vascular risk (CVR), the analysis of AS correlation with the markers of target organ remodeling, determination of threshold values AS, combined with a high probability target organ damage. Subjects and methods. 95 normotensive patients with AO were examined (mean age 44,9±5,1 years, 72 men) by following methods: lipid and glucose level, carotid artery ultrasound with intima/media thickness estimation, echocardiography, 24-hour monitoring of blood pressure (BP) with arterial stiffness assessment, obtained by the portable recorder BPLab. Results. Subclinical arterial lesion was revealed in 37,9%, mean pulse wave velocity (PWV) was 7,6±0,6 m/s, maximum PWV – 10 m/s. PWV and central BP in aorta were higher in patients with subclinical carotid atherosclerosis (8,0±0,5 m/s vs 7,5±0,6 m/s, р

Background: Cyclooxygenase-2 inhibitors (COX-2-Is) have recently been concerned in the occurrence of adverse cardiovascular (CV) events. Rofecoxib and valdecoxib has been withdrawn from the market, but celecoxib, etoricoxib and parecoxib continues to be used. Other nonsteroidal anti-inf lammatory drugs (NSAIDs) may also increase the risk of CV events. However, clinical trial databases for COX-2-Is had created lots of controversies regarding cardiovascular safety of selective and nonselective cyclooxygenase inhibitors (COX-Is). This study was, conducted to assess and compare the CV risk of COX-Is in arthritic patients over a period of time. Materials and Methods: In this prospective cohort study adult arthritics of either sex those were freshly diagnosed or taking COX-Is for < 3 months; were included. Patients were grouped into nonselective and selective COX-2-I groups with reference to treatment they received. The CV risk factors like blood pressure (BP), blood sugar level (BSL), lipid profile, body mass index (BMI) were assessed and compared; demography of CV risk factors was also studied. Data obtained was analysed using Student's 't'-test of OpenEpi statistical software. Results: Study clearly revealed that all NSAIDs exhibit variable CV risk; however, selective COX-2-Is found to exhibit more CV risk. BMI, BP and lipid profile; the potential CV risk factors, showed significant impairment in selective COX-2-Is group; P < 0.01, P < 0.001 and P < 0.05, respectively, compared to baseline and P < 0.05 vs. nonselective COX-Is for BMI. Conclusions: This study portrays the potential CV risk of selective COX-2-Is; confirms and re-evaluate the results of earlier studies in this regard. [ABSTRACT FROM AUTHOR]

The aim of this paper was to review studies that examine the association between volume and pattern of objectively measured sedentary behaviour and markers of cardio-metabolic risk in youth. A search for relevant articles was conducted in PubMed and SportDiscus, and the following inclusion criteria were applied: (i) youth participants (age range 6-19); (ii) accelerometer-measured volume and/or pattern of sedentary behaviour and its association with ≥1 cardio-metabolic outcome; and (iii) published, in press or accepted in an English language peer-reviewed journal between January 2000 and October 2013. A total of 45 articles met the a priori criteria and, thus, were considered eligible for inclusion. Although youth accumulate approximately 6 to 8 h of daily sedentary behaviour, little evidence supports an association with individual and clustered cardio-metabolic risk when adjusted for moderate-to-vigorous physical activity (MVPA). Conclusion: We suggest that youth should be encouraged to engage in recommended levels of MVPA and reduce excessive time spent in screen-based sedentary behaviour. Future studies should examine the association between volume and pattern of objectively measured sedentary behaviour and cardio-metabolic risk independent of time spent in MVPA. [ABSTRACT FROM AUTHOR]

Allogeneic red blood cell (RBC) transfusions have been shown to be associated with considerable risks. While their efficiency in many clinical situations has not been proven, the number of studies finding adverse outcomes in terms of morbidity (e.g. postoperative infections) and mortality continues to rise. In view of these facts, physicians involved in transfusion medicine have to be as restrictive as possible with RBC transfusions. Only a thorough knowledge of the physiology and pathophysiology of oxygen transport can be a solid base for meaningful transfusion decisions. Therefore, the goal of this article is to review the basics of oxygen transport and normovolaemic anaemia. [ABSTRACT FROM AUTHOR]

Strong epidemiological evidence supports a causal relationship between dyslipidemia and atherosclerotic cardio-vascular disease, which remains the leading cause of death and morbidity worldwide. A lipid profile (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides) is recommended at the initial evaluation for the assessment of the cardio-vascular risk. A commentary of the lipid profile for the clinician and mostly for the patient should be stated on the lab report. Quantifying the cardio-vascular risk using the SCORE (systematic coronary risk estimation) system, as recommended by the Haute autorité de santé (HAS), is the starting point to establish therapeutic goals and treatment strategies. It may be important to emphasize therapeutic goals in lipid reports in order to better monitor lipid profiles at appropriate intervals to assess compliance and therapeutic efficacy for patients on lipid lowering therapy.

A cross-sectional analytical epidemiologic study was undertaken in the community setting, on 1080 army personnel in a field formation, to study the association between waist/hip ratio (WHR) and certain physiological and biochemical parameters of cardiovascular risk. The study revealed that Junior Commissioned Officers, personnel aged 35 years and above, and personnel from Services had an increased probability of having higher WHR. WHR was consistently, linearly and significantly associated with increasing mean values of serum cholesterol, blood sugar and blood pressure. The optimum cut-off point of WHR from the findings of this study seems to be 0.91 and above. Beyond this value of WHR, the cardiovascular risk increases significantly and becomes more dramatic at WHR values of 0.96 and above.