BACKGROUND: Patients who underwent surgery for aortic coarctation (COA) have an increased risk of arterial hypertension. We aimed at evaluating (1) differences between hypertensive and non-hypertensive patients and (2) the value of cardiopulmonary exercise testing (CPET) to predict the development or progression of hypertension. METHODS: Between 1999 and 2010, CPET was performed in 223 COA-patients of whom 122 had resting blood pressures of <140/90 mmHg without medication, and 101 were considered hypertensive. Comparative statistics were performed. Cox regression analysis was used to assess the relation between demographic, clinical and exercise variables and the development/progression of hypertension. RESULTS: At baseline, hypertensive patients were older (p=0.007), were more often male (p=0.004) and had repair at later age (p=0.008) when compared to normotensive patients. After 3.6 ± 1.2 years, 29/120 (25%) normotensive patients developed hypertension. In normotensives, VE/VCO2-slope (p=0.0016) and peak systolic blood pressure (SBP; p=0.049) were significantly related to the development of hypertension during follow-up. Cut-off points related to higher risk for hypertension, based on best sensitivity and specificity, were defined as VE/VCO2-slope ≥ 27 and peak SBP ≥ 220 mmHg. In the hypertensive group, antihypertensive medication was started/extended in 48/101 (48%) patients. Only age was associated with the need to start/extend antihypertensive therapy in this group (p=0.042). CONCLUSIONS: Higher VE/VCO2-slope and higher peak SBP are risk factors for the development of hypertension in adults with COA. Cardiopulmonary exercise testing may guide clinical decision making regarding close blood pressure control and preventive lifestyle recommendations.
Several models have been developed to predict prolonged stay in the intensive care unit (ICU) after cardiac surgery. However, no extensive quantitative validation of these models has yet been conducted. This study sought to identify and validate existing prediction models for prolonged ICU length of stay after cardiac surgery.
Even though mango productivity in Ethiopia is low due to moisture stress, there is no report on how such constraint could alleviate using Cocoon water-saving technology. Cocoon is small water reservoir technology which uses for plant growth in dry season. The objectives of this study were to introduce and evaluate effectiveness of water-saving techniques on mango seedlings survival and growth in Mihitsab-Azmati watershed, northern Ethiopia. In this experiment, five treatments of water-saving techniques with mango seedlings were evaluated. These were: Cocoon sprayed by tricel (T1), Cocoon painted by used engine oil (T2), Cocoon without tricel and oil (T3), manually irrigated seedlings (T4) and mango seedlings planted during rainy season (T5). The survival and growth performance of mango seedlings were recorded at six months and one-year after transplanting. Data on plant survival, height, number of leaves per plant, shoot length, stem diameter and crown width were subjected to analysis of variance and t-test. There were significant differences in the treatment effects on mango seedlings transplanted survival, plant height, number of leaves per plant, shoot length, stem diameter and crown width measured at six months and one-year after transplanting. The lowest survival rate (20 %) was found during both data collection time in T5. Six months after transplanting, the highest growth parameters were measured from T1 whereas the lowest was from T5. However, one-year after transplanting, the highest growth parameters were measured from T3. Plant heights increments between the two measurement periods for T3, T2, T1, T4 and T5 were 45.1, 38.5, 24.8, 9.8 and 7.0 cm, respectively; indicating that T3 performed better than the other treatments. The t-test on mean differences between the same growth parameter measured at 12 and six months after transplanting also showed significant differences. The Cocoon water-saving technology was superior in improving mango seedlings survival and growth in the study area. This study generalized that Cocoon seems promising, sustainable and highly scalable with mango seedlings at large-scale in the study area conditions. However, this technology should not be assumed to perform uniformly well in all environmental conditions and with all tree species before demonstrated on a pilot study.
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