Difficulties in the Modeling of E. coli Spreading from Various Sources in a Coastal Marine Area.

Coastal and transitional waters are often used as bathing waters. In many regions, such activities play an important economic role. According to the European Union Bathing Water Directive (2006/7/EC) (BWD) the concentration of Escherichia coli in bathing water exceeding 500 CFU·100 mL-1 poses a high risk for bathers' health. In order to safeguard public health, microbiological environmental monitoring is carried out, which has recently been supported or replaced by mathematical models detailing the spread of sanitary contamination. This study focuses on the problems and limitations that can be encountered in the process of constructing a mathematical model describing the spread of biological contamination by E. coli bacteria in coastal seawater. This and other studies point to the following problems occurring during the process of building and validating a model: the lack of data on loads of sanitary contamination (often connected with multiple sources of biological contamination inflow) makes the model more complex; E. coli concentrations higher than 250 CFU·100 mL-1 (low hazard for health) are observed very rarely, and are associated with great uncertainty; the impossibility of predicting the time and intensity of precipitation as well as stronger winds and rougher sea, which may be a significant source of E. coli. However, there is universal agreement that such models will be useful in managing bathing water quality and protecting public health, especially during big failures of the wastewater network.

Late ventricular remodeling in non-reperfused acute myocardial infarction in humans is predicted by angiotensin II type 1 receptor density on blood platelets.

BACKGROUND: Ventricular remodeling after myocardial infarction (MI) is largely dependent on renin-angiotensin system activity, which is determined by angiotensin II concentration and angiotensin II type 1 receptor (AT(1)R) density in target tissues. We have recently shown that AT(1)R density in the acute phase of MI determines post-MI ventricular remodeling at discharge (8 days). The aim of this study was to test whether this correlation is retained in a longer follow-up (6 months), in the same group of patients. METHODS: In 48 patients with first acute MI who did not undergo reperfusion therapy, angiotensin AT(1)R density on blood platelets (a presumable marker of cardiovascular AT(1)R density) was assessed 13+/-5 h after the onset of MI, using radioligand binding assay. Echocardiographic indices of left ventricular function and dimensions were used as measures of ventricular remodeling. RESULTS: 6 months after the infarction patients who at baseline had AT(1)R density above median (N=17) as compared to those with AT(1)R density below median (N=20) had higher left ventricular end-systolic volume index (LVESVI, 41.3+/-2.7 vs. 33.2+/-2.3) and lower ejection fraction (LVEF 48.1+/-1.8 vs. 54.7+/-2.0). Moreover LVESVI positively and LVEF negatively correlated with AT(1)R density although the strength of these correlations was weaker than at discharge. Infarct size as reflected by a single troponin T measurement and post-MI therapy did not differ between high- and low-AT(1)R groups: over 85% patients received ACE-inhibitor, beta-blocker and statin. CONCLUSIONS: High AT(1)R density on blood platelets (a presumable marker of cardiovascular AT(1)R density) drawn in the acute phase of MI predicts poorer left ventricular systolic function in 6-month follow up. This suggests that modern therapy offers suboptimal blockade of renin-angiotensin system activity in the setting of MI.

Heart rate turbulence in children--age and heart rate relationships.

Heart rate turbulence (HRT) is a chronotropic response of the sinus heart rhythm to ventricular premature beat (VPB). Children show decreasing heart rate together with the maturation of the autonomic nervous system. The aim of the research was to assess the relationship between HRT parameters, age, and heart rate and time domain heart rate variability (HRV) parameters in healthy children. Twenty-four-hour ECG Holter recording was performed on 398 healthy children. The mean RR interval preceding VPB, number of VPBs, and HRT parameters-turbulence onset (TO) and turbulence slope (TS)-were determined. We observed significant correlation among TS and mean RR and age. Children with prepubertal status have lower values of TS compared with those during puberty. According to given quartiles, upper for TO was > or =-0.8%, lower for TS was < or =4.56 ms/RR, 13 patients (3%) obtained abnormal both TO and TS. The correlations between HRT and HRV parameters were observed among the youngest children. Age and heart rate preceding VPB have no effect on HRT onset in children, whereas HRT slope is highly dependent on these variables. Our results support hypothesis that in older children HRT is dependent on autonomic tone and also determined by other intrinsic modulators.

[Does autonomic diabetic neuropathy influence microcirculation reactivity in adolescents with diabetes type 1?]. / Czy autonomiczna neuropatia cukrzycowa wplywa na reaktywnosc mikrokrazenia u mlodziezy z cukrzyca typu 1?

INTRODUCTION: Microcirculation is known to be disturbed in many organs of diabetic patients. Retinopathy, nephropathy and neuropathy might be considered as the cause of the functional and morphological changes at the level of microcirculation. The aim of the study was to assess by means of dynamic capillaroscopy the influence of autonomic diabetic nephropathy (CAN) in adolescents with type 1 diabetes mellitus on capillary blood flow (CBV) in skin microcirculation. MATERIAL AND METHODS: The study group consisted of 18 patients with type 1 diabetes mellitus (mean age 15+/-2 years). In 9 of them the diagnosis of CAN was made on the basis of Ewing tests. The control group consisted of 10 healthy persons aged 15+/-1.5 years. CBV was measured in capillars of the nailfold of the fourth finger during rest and after 2 minutes of arterial occlusion (the occlusion pressure - above 20 mmHg systolic blood pressure - was obtained by the occlusion of brachial artery using sphygnomanometer cuff). RESULTS: The resting CBV did not differ between patients with CAN, without CAN and healthy controls (0.39+/-0.06, 0.41+0.05 i 0.42+/-0.07). The values of the peak CBV significantly differ between the examined groups (CAN: 0.75+0.1; without CAN: 0.86+/-0.11; control group: 0.98+/-0.09, p<0.01). CONCLUSIONS: The obtained results indicate that the presence of the autonomic diabetic neuropathy significantly influences the regulatory function of microcirculation, which may predispose to occurrence of different late diabetic complications.

[The assessment of 24-hour ambulatory blood pressure monitoring (ABPM), microalbuminuria and diabetic autonomous neuropathy in children with type 1 diabetes and hypertension]. / Ocena 24-godzinnego monitorowania cisnienia tetniczego, mikroalbuminurii oraz autonomicznej neuropatii cukrzycowej u dzieci z cukrzyca typu 1 i nadcisnieniem tetniczym.

INTRODUCTION: The late complications of diabetes consisted of autonomic neuropathy, nephropathy, which more often coexist with hypertension in children with type 1 diabetes mellitus. THE AIM OF THE STUDY was to assess the connections between changes in the autonomous nervous system, 24-hour ABPM and daily albumin excrection in children with hypertension and type 1 diabetes mellitus. MATERIAL: The group consisted of 72 patients with diabetes (diabetes duration time 6.5+/-1.5 years). 34 patients of that group have hypertension. The control group consisted of 30 healthy children matched according to age and sex. RESULTS: In children with hypertension we found significantly often occurrence of microalbuminuria (13/34 i 1/38, p<0.001). In 17 patients from the group with hypertension and 17 patients without hypertension we affirm signs of autonomic neuropathy. The values of heart rate variability (HRV) were significantly decreased in the group with hypertension as compared to the control group. A stepwise multiple regression analysis with hypertension as a dependent variable and diabetes duration time, microalbuminuria, HbA1c level, HRV parameters and a presence of autonomous neuropathy as predictors proved that hypertension is associated with higher HbA1c level (b=0.35), the presence of autonomous neuropathy (b=0.28), and lower HF values (b=0.41) (p<0.01). CONCLUSIONS: Hypertension in children with type 1 diabetes mellitus is correlated with the presence of autonomous neuropathy, higher HbA1c level and lowered values of heart rate variability parameters.

[Serum levels of matrix metaloproteinase 2 (MMP-2), matrix metaloproteinase 9 (MMP-9) and tissue inhibitor of metaloproteinase 2 (TIMP-2) in children and adolescents with growth hormone deficiency]. / Ocena stezenia metaloproteinazy macierzy pozakomorkowej 2 (MMP-2), metaloproteinazy macierzy pozakomorkowej 9 (MMP-9) i tkankowego inhibitora metaloproteinazy 2 (TIMP-2) u dzieci i mlodziezy z niedoborem hormonu wzrostu.

INTRODUCTION: Matrix metaloproteinases (MMPs) have been implicated in various pathological processes including inflammatory response, atherosclerosis and cardiovascular disease. Growth hormone deficiency (GHD) is associated with prematury atherosclerosis and cardiovascular disease. Circulating levels of matrix metaloproteinases and their tissue inhibitors (TIMPs) so far have not been assessed in children and adolescents with GHD. MATERIAL AND METHODS: Serum levels of matrix metaloproteinase 2 (MMP-2), matrix metaloproteinase 9 (MMP-9) and tissue inhibitor of metaloproteinase 2 (TIMP-2) were measured in 44 (11 girls and 33 boys) children and adolescents with newly diagnosed GHD [age (mean+/-SD) 12.5+/-2.7 years, height 1.3+/-0.1 m, body surface area (BSA) 1.1+/-0.2 m(2) and body mass index (BMI) 17.4+/-2.2 kg/m(2)] and in 32 (11 girls and 21 boys) healthy children and adolescents (age 12.4+/-2.9 years, height 1.6+/-0.2 m, BSA 1.4+/-0.3 m(2) and BMI 18.7+/-2.6 kg/m(2)). Human MMP-2, MMP-9 and TIMP-2 measurements were carried out with the use of ELISA kits. RESULTS: Patients with GHD had significantly higher concentrations of MMP-2 (287.2+/-60.5 vs. 235.8+/-41.3 ng/ml, p<0.0001) and TIMP-2 (81.4+/-14.9 vs. 62.7+/-15.9 ng/ml, p<0.0001) levels than the control healthy group. There was no difference in MMP-9 levels (338.5+/-197.9 vs. 276.3+/-121.7 ng/ml, p=0.12) between patients with GHD and controls. CONCLUSIONS: Children and adolescents with GHD have elevated serum concentrations of MMPs-2 and TIMP-2.

Heart rate variability and left ventricular mass in slim children and young adults with hypertension.

INTRODUCTION: Uncontrolled arterial hypertension brings direct and long-term sequelae in adult age, such as stroke, ischaemic heart disease with myocardial infarction, left ventricular hypertrophy or cardiac arrhythmia. AIM: To assess heart rate variability (HRV) spectral parameters and left ventricular mass in slim children with arterial hypertension, and to search for correlations between these two parameters. METHODS: 35 children aged 14.4+/-3.1 with idiopathic untreated arterial hypertension were enrolled. The control group included 30 age- and gender-matched healthy children (aged 14.1+/-2.9 years). In all analysed subjects an analysis of HRV parameters (high frequency (HF) and low frequency (LF) components) during 10-minute waking state and sleeping time was performed and left ventricular mass (LVM) as well as the left ventricular mass index (LVMI, g/m) were assessed based on echocardiographic measurements. RESULTS: There was no difference in LF during the waking state and sleep HF between the two groups, whereas HF values during the waking state were significantly lower (p<0.05) in children with hypertension. The LF/HF index from both registration intervals was significantly higher in the group of children with hypertension. In children with hypertension, LVM and LVMI correlated significantly with LF (r=0.32, p<0.05 and r=0.39, p<0.01). LVM and LVMI correlated positively with the LF/HF index during night hours (r=0.45, p<0.004 and r=0.49, p<0.002). No significant correlations were found between the analysed parameters in children from the control group. CONCLUSIONS: The increase of sympathetic activity during sleep correlates significantly with left ventricular mass and corrected left ventricular mass index in children with arterial hypertension.

[Usefulness of continuous glucose monitoring system (CGMS) in monitoring glycaemic profile in small children with diabetes type 1]. / Przydatnosc zastosowania systemu ciaglego monitorowania glikemii (CGMS) w ocenie i monitorowaniu profilu glikemii u malych dzieci chorych na cukrzyce typu 1.

BACKGROUND: Improved methods of diabetes therapy result in a near normoglycaemic state in many patients. This leads however unfortunately to more frequent hypoglycaemic incidents. Particularly small children, whose nervous system is not fully mature, are at high risk of central nervous system damage in case of hypoglycaemia. A new method of detail monitoring of glycaemia provides CGMS system. OBJECTIVES: The aim of the study was to compare the glycaemic profile, with high attention to hypoglycaemia in groups of young and older children with diabetes type 1, using CGMS and routine glucose meter. MATERIAL AND METHODS: We studied 32 children with diabetes type 1. Children were divided into groups: group I--small children, n=17 (<7 yrs of age), mean age 5,8 years, with disease duration--2,46 years, with mean HbA1c level--7,22%, and group II--older children, n=15 (>10 years of age), mean age--12 years, with disease duration--3 years, with HbA1c level--7,21%. Continuous glucose monitoring system (CGMS), by MiniMed, was applied in outpatient or hospital conditions, after short training of patient and parents; together with routine glucose meter measurements, 4-8 times/24 hours. In 9 patients from small children group CGMS was repeated after 2 months. RESULTS: Hypoglycaemic incidents detected with CGMS were similar in both groups: 4,6 in I group vs. 4,2 in II group (ns). Hypoglycaemic incidents found with meter were lower in I group--1,6 vs. 2,3 in II group (ns). Mean hypoglycaemic time/24 hour was longer in small children group: 101 min vs. 74 min in group II (p<00,05). In I group we found higher number of hypoglycaemic incidents during the night compared to group II--1,7 vs. 0,8 (p<00,05) and longer duration of night hypoglycaemia: in I group--56 min vs. 32 min in group II (p<00,05). Repeated CGMS study in 9 children from I group revealed decreased mean time of hypoglycaemia/24 hours from 134 min/24 h to 90 min/24 h (p<00,05) and decreased time of night hypoglycaemia from 65 min to 40 min (p<00,05), with a comparable number of hypoglycaemic incidents. Hypoglycaemic incidents found with routine meter measurements in small children were 1,6 vs. 4,6 hypoglycaemia found with CGMS (p<00,05), in the older children group routine measurement found 2,3 hypoglycaemia vs. 4,2 detected with CGMS (ns). CONCLUSIONS: 1. CGMS can be particularly usefull in monitoring glucose profile and detecting hypoglycaemia incidents, mainly nocturnal in small children. 2. CGMS allows to verify meal dose of insulin and to decrease postprandial hyperglycaemia. 3. Modification of insulin therapy on the base of CGMS helps to decrease the time of hypoglycaemia and hyperglycemia, particularly during the night.

[Proinflammatory cytokines (IL-6, TNF-alpha) and cardiac troponin I (cTnI) in serum of young people with ventricular arrhythmias]. / Cytokiny prozapalne (IL-6, TNF-alpha) i sercowa troponina I (cTnI) w surowicy mlodych osób z komorowymi zaburzeniami rytmu serca.

UNLABELLED: In the most cases the origin of ventricular arrhythmias is ischaemic, necrosis focus or presence of the connective tissue in cardiac muscle. The aim of the study was to evaluate troponin I (cTnI), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) vs in young subject with ventricular arrhythmias. Into the study group included young people without organic heart diseases, dyselectrolitemia, with normal ECG which has not elevated levels of C-reactive protein (55 persons). The control group consisted of 22 healthy persons. The values of cTnI were not increased. The TNF-alpha concentrations were elevated in persons with ventricular arrhythmias (92 +/- 232 pg/mL vs. 2 +/- 1 pg/mL, p < 0.001). The IL-6 concentrations were slightly elevated without statistical significance (1.5 +/- 4.5 pg/mL i 0.1 +/- 0.04 pg/mL, p = 0.06). CONCLUSIONS: There was no evidence of myocardial injury in young people with ventricular arrhythmias (cTnI). We noted increase levels of proinflammatory cytokines. It might suggest that the background of ventricular arrhythmias is inflammation.