Reliability of palpation of the radial artery compared with auscultation of the brachial artery in measuring SBP.

Background: Systolic blood pressure contributes more to cardiovascular disease than DBP, especially in elderly persons. Palpation of the radial artery to assess SBP - Riva-Rocci's technique - may be an attractive alternative for auscultatory SBP in these patients. Therefore, we investigated the difference between SBP determined by palpation of the radial artery (pSBP) and SBP assessed by auscultation of the brachial artery (aSBP).

Severe malaria is associated with a deficiency of von Willebrand factor cleaving protease, ADAMTS13.

Severe falciparum malaria remains a major killer in tropical countries. Central in the pathophysiology is mechanical obstruction in the microcirculation caused by cytoadherence and sequestration of parasitized erythrocytes. However, the pathogenesis of many features complicating severe malaria, including coma, renal failure and thrombocytopenia, remains incompletely understood.

Rattling in the cage: ions as probes of sub-picosecond water network dynamics.

We present terahertz (THz) measurements of salt solutions that shed new light on the controversy over whether salts act as kosmotropes (structure makers) or chaotropes (structure breakers), which enhance or reduce the solvent order, respectively. We have carried out precise measurements of the concentration-dependent THz absorption coefficient of 15 solvated alkali halide salts around 85 cm(-1) (2.5 THz).

Value of retinal examination in hypertensive encephalopathy.

The presence of grade III or IV hypertensive retinopathy (HRP) is considered to distinguish hypertensive urgencies from emergencies. However, case-reports suggest that these retinal changes may be lacking in patients with hypertensive encephalopathy. To assess the frequency of grade III and IV retinopathy in this hypertensive emergency, we conducted a retrospective cohort study.

Solvation dynamics of model peptides probed by terahertz spectroscopy. Observation of the onset of collective network motions.

We have studied the solvation of model peptides at low hydration levels by terahertz absorption spectroscopy. We have recorded the concentration-dependent terahertz absorption coefficients of N-acetyl-glycine-amide (NAGA), N-acetyl-glycine-methylamide (NAGMA), N-acetyl-leucine-amide (NALA), N-acetyl-leucine-methylamide (NALMA), and N-acetyl-tryptophan-amide (NATA) in aqueous solution. We find a dramatic decrease in the THz absorption, if the number of water molecules per solute is less than 18-20.

The terahertz dance of water with the proteins: the effect of protein flexibility on the dynamical hydration shell of ubiquitin.

The role of water in the functioning of proteins has been a hot topic over the years. We use terahertz (THz) spectroscopy as an experimental tool to probe the protein-induced fast solvation dynamics of ubiquitin. In order to investigate the effect of protein flexibility on the changes in the solvation dynamics, we have measured the concentration-dependent THz absorption of several site-specific ubiquitin mutants.

Poor adherence to home blood pressure measurement schedule.

Background: Consensus dictates that devices used for home blood pressure (BP) measurement should be equipped with a memory to store readings, rather than trusting patients' logbooks. However, data entered in the memory rely on patients' adherence to measurement schedules. We investigated the number and relevance of deviations from the requested measurement schedule.

Educational inequalities in metabolic syndrome vary by ethnic group: evidence from the SUNSET study.

Background: Compared with Whites, many ethnic minority groups have higher prevalence of metabolic syndrome. The reasons for these ethnic inequalities in health are incompletely understood. The main objective was to examine whether socio-economic position (SEP) as measured by education was related to the prevalence of metabolic syndrome in different ethnic groups in Amsterdam, The Netherlands.

Reversible posterior leucoencephalopathy syndrome associated with bortezomib in a patient with relapsed multiple myeloma.

Reversible posterior leucoencephalopathy syndrome (RPLS) is a potentially fatal but reversible clinico-radiological syndrome with symptoms of headache, altered mental functioning, visual changes and seizures in association with typical posterior cerebral white matter lesions. RPLS is associated with the use of cytotoxic drugs, usually in combination with high blood pressure. We report a case of RPLS that we believe is associated with bortezomib, a proteasome inhibitor with proapoptotic and antiangiogenic properties approved for the treatment of relapsed multiple myeloma, and speculate about the possible mechanisms leading to RPLS.

Gender disparities in hypertension among different ethnic groups in Amsterdam, The Netherlands: the SUNSET study.

Background: Studies have consistently shown a lower prevalence of hypertension in women than in men. Obesity is an important risk factor for hypertension, and the rate of obesity is particularly high among ethnic minority women. It is therefore questionable whether the lower prevalence of hypertension in women is also true among specific ethnic minority groups in Europe.

Cerebral hemodynamics during treatment with sodium nitroprusside versus labetalol in malignant hypertension.

In patients with malignant hypertension, immediate blood pressure reduction is indicated to prevent further organ damage. Because cerebral autoregulatory capacity is impaired in these patients, a pharmacologically induced decline of blood pressure reduces cerebral blood flow with the danger of cerebral hypoperfusion. We compared the reduction in transcranial Doppler-determined middle cerebral artery blood velocity during blood pressure lowering with sodium nitroprusside with that of labetalol.

Association between thrombotic microangiopathy and reduced ADAMTS13 activity in malignant hypertension.

The thrombotic microangiopathy observed in malignant hypertension is similar to that of thrombotic thrombocytopenic purpura, which is associated with a deficiency of ADAMTS13, a von Willebrand factor (VWF)-cleaving protease that cleaves large prothrombogenic multimers. We hypothesized that ADAMTS13 is deficient in malignant hypertension and that the severity of thrombotic microangiopathy is associated with decreased ADAMTS13 activity. We included 20 patients with malignant and 20 patients with severe hypertension, and 20 matched normotensive individuals served as control subjects.

[Severe anaemia caused by Human Parvovirus B19 infection in a patient with autoimmune haemolytic anaemia and a B-cell non-Hodgkin lymphoma].

A 65-year-old man with a 15-year history of 'leukemicised' low-grade lymphocytic B-cell non-Hodgkin lymphoma with a low-titre of IgM kappa paraprotein was admitted with severe anaemia and reticulocytopenia. Treatment with prednisone and chlorambucil had been started two weeks earlier because of a recently diagnosed Coombs-positive haemolytic anaemia. He also received a blood transfusion at that time.

Prevalence of microalbuminuria and its association with pulse pressure in a multi-ethnic population in Amsterdam, the Netherlands. The SUNSET Study.

Background: Microalbuminuria is related to renal disease, and is an important risk factor for cardiovascular disease. Wide pulse pressure (PP) has recently been linked to microalbuminuria. Studies on ethnic differences in microalbuminuria have shown inconsistent results.

Prevalence and determinants of prehypertension among African Surinamese, Hindustani Surinamese, and White Dutch in Amsterdam, the Netherlands: the SUNSET study.

Background: Evidence suggests that prehypertension is associated with increased risk of cardiovascular mortality. Little is known about ethnic differences in prehypertension in Europe. We aimed to assess these ethnic differences and to determine the factors associated with prehypertension in Amsterdam, the Netherlands.

The M235T polymorphism in the angiotensinogen gene is associated with the risk of malignant hypertension in white patients.

Background: Malignant hypertension can be considered an extreme phenotype of renin-mediated hypertension. Therefore, we compared the allelic frequencies of the angiotensinogen (AGT) M235T, angiotensin-converting enzyme insertion/deletion (ACE I/D) and angiotensin II-type I receptor (AT1R) A1166C polymorphisms in malignant hypertensive patients with hypertensive and normotensive controls.

Methods: A total of 101 consecutive patients between 1995 and 2005 admitted to a large university hospital fulfilled the criteria for malignant hypertension.

The renin-angiotensin system in malignant hypertension revisited: plasma renin activity, microangiopathic hemolysis, and renal failure in malignant hypertension.

Background: Malignant hypertension is a renin-dependent form of hypertension. However, the variations in renin-angiotensin system (RAS) activation in malignant hypertension are not completely understood. A proposed mechanism for ongoing RAS activation is the presence of microangiopathic hemolysis resulting in renovascular ischemia.

Ethnic disparities in the incidence, presentation and complications of malignant hypertension.

Background: The incidence of malignant hypertension has declined after the introduction of antihypertensive agents. However, previous reports have suggested that malignant hypertension may be relatively common in multi-ethnic populations. The aim of this study was to compare ethnic disparities in the incidence, clinical characteristics and complications of malignant hypertension.

[Clinical reasoning and decision making in practice. A 39-year-old woman with somnolence, hypertension and haemolysis].

A 39-year-old woman was admitted with somnolence, severe hypertension and thrombotic microangiopathy. Both malignant hypertension and thrombotic thrombocytopenic purpura (TTP) were considered. Immediate therapy was instituted to treat both diseases because of severe clinical deterioration.

[Atenolol or metoprolol as beta-blocker in the treatment of hypertension].

Recently the guideline committee of the Dutch College of General Practitioners advocated the use of metoprolol instead of atenolol in patients with an indication for beta-blockers. This recommendation was based on a recent meta-analysis in The Lancet in which no effect was observed in favour ofatenolol compared with placebo on all-cause mortality, cardiovascular mortality and myocardial infarction. Atenolol also had a higher total mortality and stroke risk compared with other antihypertensive agents.