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New aspects in the treatment of hypertension

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Hypertension is currently the leading cause of cardiovascular complications (heart attack, stroke) and the resulting deaths of patients. Reduced morbidity and mortality from cardiovascular complications is the main goal of treating patients suffering from high blood pressure (BP). To achieve target BP levels in the arsenal of physicians are five major classes of antihypertensive drugs: angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, β-blockers, diuretics. The choice of antihypertensive drug in concrete clinical situation often complicated and determined by complex factors. Among these presence of risk factors; target organ damage; associated clinical conditions, metabolic syndrome, diabetes, comorbidities; possible individual patient response to antihypertensive drugs of different classes in history; the likelihood of drug interactions; socio-economic factors, including the cost of treatment of hypertension. Promising is the use of angiotensin II receptor blockers - drugs with pleiotropic pharmacological properties that have a multicomponent antihypertensive efficacy, good tolerability, diverse organoprotection that are safe, able to enhance remote prognosis for patients with hypertension. Azilsartan medoxomil is a competitive reversible angiotensin II type 1 receptor antagonist. Azilsartan developing hypotensive effect faster, prolonged and pronounced compared to other sartans (valsartan, candesartan and olmesartan). In addition to antihypertensive action azilsartan medoxomil shows a number of additional pleiotropic effects. These include antithrombotic, antiproliferative and antyfibrotic action. It demonstrates the improvement in glucose tolerance and tissue insulin sensitivity, improves endothelial function, reduces the progression of albuminuria, proteinuria.
Annually, hunters shoot millions of birds with lead ammunition. Many studies indicate diverse and often very high lead levels in the edible parts of game. Considering the number of hunters, the determined levels may pose a public health risk. Shotgun pellets are the main source of lead contamination of game animal tissues. Despite numerous studies indicating lead contamination in game birds, no significant reasons for diverse contamination of tissues with this toxic metal have been reported. The personal analysis presented in this paper suggests that the explanation for diverse levels of contamination of game animal tissues should be sought in physical phenomena generated by a projectile in damaged animal tissues. The projectile penetrating a target generates a multi-phase medium from destroyed tissues and simultaneously changes the shape of its front part. This movement of projectile is an example of a turbulent flow. The interpretation of the interaction between a projectile and damaged tissues indicate that the variable and unpredictable parameters of a projectile for each shot and the medium created by a projectile make it, impossible to determine, the degree of this interaction. The phenomenon of a temporary cavity created by a shot seems to determine the magnitude of lead transfer into tissues surrounding the path of a wound. Fluid mechanics also explains the relatively high lead levels in game birds in comparison with the levels determined in big game animals. In view of the unpredictability of projectile-animal body interactions, it should be assumed that game bird shot with lead pellets contains the lead levels dangerous to human health. Therefore, the use of lead pellets for bird shooting should be banned.
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The new retiolitid graptolite Kirkigraptus inexpectans gen. et sp. nov., from the Neodiversograptus nilssoni Biozone of the Bartoszyce borehole, Poland is described. It is unique among the retiolitids not having a preserved virgella or ancora. Instead the most proximal structures are two round proxi−lateral lists, joining the two genicular lists of the first thecae, connecting the two sides of the rhabdosome. The lists are interpreted as a possible homologue of the distal edge of the ancora umbrella in typical retiolitids. The size of rhabdosome with large proximal lateral orifices, and the ventral panels of thecae with mid−ventral lists, are similar to those of Plectograptus, whereas the two ancora sleeve panels consisting of spaced horizontal lists only, resemble those of Valentinagraptus. It is possible that the new retiolitid may represent a new pattern of development of the proximal end of the rhabdosome, different from that in all other retiolitids.
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