Chronic venous disease has been pathology of great interest over time. With its large prevalence among the world population (10-33% adult woman and 10-20% of men) through profound socio-professional implications that affect the quality of life of patients, chronic venous disease is a real public health problem, being an important cause of morbidity and disability, a permanent area of research in the medical-pharmaceutical field. Special attention is now given to identifying the mechanisms and stages of disease development. From studies that have highlighted the importance of venous hypertension as an essential element in the development of the disease, to this day it has come up to demonstrating the fundamental role of the venous endothelium and glycocalyx in triggering and progressing of chronic venous disease. Biochemical, immunohistochemical, and functional investigations have allowed the evaluation of changes that occur in cellular metabolism and evidence of some immune-vascular factors responsible for vascular alterations in chronic venous disease: specialized receptors, adhesion molecules, cytokines, matrix and metalloproteinases. The analysis of the pathophysiology of chronic venous disease is still a vast area open to scientific research.
Two major trials, EMPA-REG OUTCOME trial (with Empagliflozin) and CANVAS trial (with Canagliflozin) have demonstrated the beneficial effects of SGLT2 inhibitors in patients with type 2 diabetes at risk for heart failure. SGLT2 inhibitors possess a unique pharmacological profile and have shown a significant reduction of hospitalization for heart failure in diabetic patients, immediately after treatment commencement. It seems that their effects are beneficial both in heart failure with reduced ejection fraction and heart failure with preserved ejection fraction. SGLT2 inhibitors reduce cardiovascular endpoints in patients with diabetes and high cardiovascular risk, most likely through a reduction of heart failure-related events. Empagliflozin treatment exerts beneficial effects on vascular function and central haemodynamics. Various mechanisms seem to contribute to the beneficial effects of SGLT2 inhibitors in heart failure. Taking into consideration their cardiovascular benefits and the number of ongoing trials with these drugs, there is a possibility to expand their indication to nondiabetic patients with heart failure. This review focuses on the newest insights into the beneficial effects of SGLT2 inhibitors on the cardiovascular system.
In the past, finding out the chemical resistance of the barrier materials designated for the production of individual protective equipment ofthe protection forces (policemen, firefighters, soldiers) was based on the need to respond to protection against weapons of mass destruction. Simple chemical methods based on indicating the colorimetric reactions were used. It was necessary to switch to more universal methods due to a change in the security of the environment and the need to focus on toxic industrial materials. The universality is due to using sensitive QCM sensors equipped with a special detection layer and some special carbon electrodes. The paper deals with new methods that are used to determine the chemical resistance of the barrier materials against the permeation of toxic substances, primarily in field conditions. However, they can also be used in stationary chemical laboratory conditions.
Systemic lupus erythematosus (SLE) is a complex autoimmune condition, which often evolves with severe complications. In SLE, autoantibodies appear, with systemic inflammation and multiple tissue destructions. SLE is the most common form of lupus and is considered more severe than other forms. SLE can affect many parts of the body, including the kidneys, heart, lungs, brain, blood, and skin. Symptoms vary among patients. SLE can follow an unpredictable pattern of remissions (symptoms improve) and flares (symptoms worsen). Renal involvement is one of the most severe complications in SLE patients. The process of depositing the immune complexes in the kidneys could lead to the appearance of lupus nephritis. If the treatment is early and treat-to-target, it can change the course of the renal disease.
Heart failure is the final stage of evolution of a large number of cardiovascular diseases and represents a health problem worldwide, due to increased prevalence of cardiovascular diseases. The patients with heart failure with preserved ejection fraction (HFpEF) represent about a half of the patients with heart failure and the prevalence of HFpEF is on the rise. HFpEF is mainly a disease of the elderly patients, who have numerous cardiovascular diseases – hypertension, myocardial ischaemia, atrial fibrillation, valvular disease, and also non-cardiovascular comorbidities, such as obesity, diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease, and obstructive sleep apnoea. HFpEF is more prevalent in women than in men, but women have a better prognosis than men. The pathophysiological changes that appear in HFpEF are: ventricular stiffening, cardiomyocite hypertrophy and hypercontractility, myocardial fibrosis and inflammation, which lead to abnormal diastolic function with delayed relaxation and inappropriate filling, in the presence of a normal systolic function of the left ventricle. The diagnosis of HFpEF is based on clinical, echocardiographic and biological criteria. In contrast to HFrEF, there is no effective treatment for HFpEF. The treatment of HFpEF includes diuretics for clinical improvement and treatment of comorbidities. The prognosis of patients with HFpEF is similar with those with HFrEF. Currently, the main objectives of the treatment in patients with HFpEF are to improve clinical status and decrease hospitalizations. Further studies are needed to establish an effective treatment to increase survival in these patients. Therefore, HFpEF continues to be a challenge for clinicians regarding the optimal therapy..
