Kidney volume normative values in Central European children aged 0-19 years: a multicenter study.

BACKGROUND AND OBJECITVES: The currently available kidney volume normative values in children are restricted to small populations from single-centre studies not assessing kidney function and including none or only a small number of adolescents. This study aimed to obtain ultrasound-based kidney volume normative values derived from a large European White/Caucasian paediatric population with normal kidney function. METHODS: After recruitment of 1427 children aged 0-19 years, 1396 individuals with no history of kidney disease and normal estimated glomerular filtration rate were selected for the sonographic evaluation of kidney volume. Kidney volume was correlated with age, height, weight, body surface area and body mass index. Kidney volume curves and tables related to anthropometric parameters were generated using the LMS method. Kidney volume predictors were evaluated using multivariate regression analysis with collinearity checks. RESULTS: No clinically significant differences in kidney volume in relation to height were found between males and females, between supine and prone position and between left and right kidneys. Males had, however, larger age-related kidney volumes than females in most age categories. For the prediction of kidney volume, the highest coefficient correlation was observed for body surface area (r = 0.94), followed by weight (r = 0.92), height (r = 0.91), age (r = 0.91), and body mass index (r = 0.67; p < 0.001 for all). CONCLUSIONS: This study presents LMS-percentile curves and tables for kidney volume which can be used as reference values for children aged 0-19 years.

Life time use of illicit substances among adolescents and young people hospitalized in psychiatric hospital.

Adolescents are known to be particularly vulnerable, compared to children and adults, to initiation of substance use and progression to problematic use. This study aimed to examine the prevalence and type of illicit drug use in a population of adolescents and young adults who were hospitalized in a psychiatric hospital. The purpose of the study was also to find the link between age, sex, type of admission and particular mental disorders and using psychoactive substances at least once in a lifetime. A 12-month retrospective cross-sectional analysis of medical records compiled for adolescent and youth psychiatric patients who had been admitted to the Regional Psychiatric Hospital in Olsztyn, Poland, between October 1, 2018, and September 30, 2019, was conducted. After analyzing the available medical records, 506 cases were included and analyzed. Data for the study were collected in an Excel spreadsheet from discharge reports, including data from psychiatric examinations, especially anamnesis. Subsequently, statistical calculations were performed. Lifetime prevalence of any illicit substance use (34.0%) was common. The most frequently used drug was Cannabis (29.2%), the next New Psychoactive Substance-NPS (14.2%) and Amphetamine (13.0%). The higher number of people declaring to take illicit substances was proportional to the increasing age. Except for the group 10-15 years, the subject group was dominated by males. The highest, statistically significant percentage of patients who declared taking illicit substances in general, was found in people with diagnoses F20-F29 (schizophrenia, schizotypal and delusional disorders) (55%), additionally, we found a statistically significant association between NPS use and these diagnoses. Only in the group of patients diagnosed with eating disorders no one declared taking psychoactive substances. However, the correlation between taking illicit drugs and the subgroups with diagnosed psychiatric diseases should be treated with caution because of the small sample size in some cases. Our findings have shown the significant prevalence of the phenomenon in this population. These data highlight the need to explore this population at high risk carefully.

Kidney length normative values - new percentiles by age and body surface area in Central European children and adolescents.

BACKGROUND: Kidney size evaluation is an essential examination in pediatric nephrology. While body length/height is the best predictor of kidney length, age-based and body surface area (BSA)-based normative values may be useful in clinical practice or research. This study aimed to establish ultrasound-based kidney length lambda-mu-sigma (LMS) percentiles by age and BSA in healthy children. METHODS: In 1758 Polish and Lithuanian children (868 boys, 49%) aged 0-19 years, kidney length was measured using ultrasonography. In all participants, anthropometric measurements were taken and kidney function was evaluated based on serum creatinine concentration. Participants with chronic or kidney diseases, abnormal kidney function, or pathologies in sonographic examination were excluded from the analysis. RESULTS: Kidney length (median kidney length) increased progressively from infancy to the age of 18 years, from 60.1 to 114.2 mm in males, and from 57.3 to 105.2 mm in females. A gradual increase of kidney length (50th percentile) in relation to BSA (from 46.1 mm in infants with a BSA of 0-1.2 m2 to 118.3 mm in adolescents with a BSA of 2.6-2.8 m2) was also observed. LMS percentiles by age (stratified by sex) and BSA were determined and presented as graphs and tables of percentiles and LMS parameters by 1-year age intervals and 0.2 m2 of BSA, respectively. CONCLUSIONS: We present the first age- and BSA-based kidney length LMS normative values based on the largest pediatric cohort to date, which can be used in both clinical practice and research studies. A higher resolution version of the Graphical abstract is available as Supplementary information.

Analytically confirmed presence of psychoactive substances, especially new psychoactive substances in a group of patients hospitalized with mental and behavioural disorders due to the use of psychoactive substances diagnosis.

OBJECTIVES: The study assessed the presence of new psychoactive substances (NPS) in comparison to "classic" drugs in the group of newly admitted patients with mental and behavioral disorders due to the use of psychoactive substances diagnosis (section F11-19 according to ICD-10). MATERIAL AND METHODS: Data from anamnesis and the blood and urine samples were collected from 116 patients diagnosed with mental and behavioral disorders due to psychoactive substance use. All of them expressed written informed consent. Analytical confirmation was obtained by highperformance liquid chromatography coupled to tandem mass spectrometry (LC/MS/MS). Liquid-liquid extraction was used for sample preparation. RESULTS: In the sample, 108 (93%) of 116 were positive for psychoactive substances (including 96 cases where >1 substance was found), 69% of individuals were tested positive for opioids and 67% for benzodiazepines. Eleven (9%) of 116 patient samples were positive for NPS. We detected 7 different substances. Six of them were synthetic cannabinoids: PB-22, MDMB-CHMICA, MMB-CHMICA, AB-CHMINACA, MMB-FUBINACA, THJ-2201 and one synthetic cathinone 3-CMC. CONCLUSIONS: The prevalence and NPS profile (the predominance of synthetic cannabinoids) are similar in the group of people with addiction to psychoactive substances as in populations of people taking recreational drugs and the overdose patients admitted to the hospital. Int J Occup Med Environ Health. 2022;35(4):485-95.

Kidney length normative values in children aged 0-19 years - a multicenter study.

BACKGROUND: Currently used pediatric kidney length normative values are based on small single-center studies, do not include kidney function assessment, and focus mostly on newborns and infants. We aimed to develop ultrasound-based kidney length normative values derived from a large group of European Caucasian children with normal kidney function. METHODS: Out of 1,782 children aged 0-19 years, 1,758 individuals with no present or past kidney disease and normal estimated glomerular filtration rate had sonographic assessment of kidney length. The results were correlated with anthropometric parameters and estimated glomerular filtration rate. Kidney length was correlated with age, height, body surface area, and body mass index. Height-related kidney length curves and table were generated using the LMS method. Multivariate regression analysis with collinearity checks was used to evaluate kidney length predictors. RESULTS: There was no significant difference in kidney size in relation to height between boys and girls. We found significant (p < 0.001), but clinically unimportant (Cohen's D effect size = 0.04 and 0.06) differences between prone vs. supine position (mean paired difference = 0.64 mm, 95% CI = 0.49-0.77) and left vs. right kidneys (mean paired difference = 1.03 mm, 95% CI = 0.83-1.21), respectively. For kidney length prediction, the highest coefficient correlation was observed with height (adjusted R2 = 0.87, p < 0.0001). CONCLUSIONS: We present height-related LMS-percentile curves and tables of kidney length which may serve as normative values for kidney length in children from birth to 19 years of age. The most significant predictor of kidney length was statural height.

A computational method to differentiate rheumatoid arthritis patients using thermography data.

BACKGROUND: The traditional rheumatoid arthritis (RA) diagnosis is very complicated because it uses many clinical and image data. Therefore, there is a need to develop a new method for diagnosing RA using a consolidated set of blood analysis and thermography data. OBJECTIVE: The following issues related to RA are discussed: 1) Which clinical data are significant in the primary diagnosis of RA? 2) What parameters from thermograms should be used to differentiate patients with RA from the healthy? 3) Can artificial neural networks (ANN) differentiate patients with RA from the healthy? METHODS: The dataset was composed of clinical and thermal data from 65 randomly selected patients with RA and 104 healthy subjects. Firstly, the univariate logistic regression model was proposed in order to find significant predictors. Next, the feedforward neural network model was used. The dataset was divided into the training set (75% of data) and the test set (25% of data). The Broyden-Fletcher-Goldfarb-Shanno (BFGS) and non-linear logistic function to transformation nodes in the output layer were used for training. Finally, the 10 fold Cross-Validation was used to assess the predictive performance of the ANN model and to judge how it performs. RESULT: The training set consisted of the temperature of all fingers, patient age, BMI, erythrocyte sedimentation rate, C-reactive protein and White Blood Cells (10 parameters in total). High level of sensitivity and specificity was obtained at 81.25% and 100%, respectively. The accuracy was 92.86%. CONCLUSIONS: This methodology suggests that the thermography data can be considered in addition to the currently available tools for screening, diagnosis, monitoring of disease progression.

Short-Term Soil Flushing with Tannic Acid and Its Effect on Metal Mobilization and Selected Properties of Calcareous Soil.

Cadmium, Cu, Ni, Pb, and Zn removal via soil flushing with tannic acid (TA) as a plant biosurfactant was studied. The soil was treated for 30 h in a column reactor at a constant TA concentration and pH (3%, pH 4) and at variable TA flow rates (0.5 mL/min or 1 mL/min). In the soil leachates, pH, electrical conductivity (EC), total dissolved organic carbon, and metal concentrations were monitored. Before and after flushing, soil pH, EC, organic matter content, and cation exchange capacity (CEC) were determined. To analyze the organic matter composition, pyrolysis as well as thermally assisted hydrolysis and methylation coupled with gas chromatography-mass spectrometry were used. Metal fractionation in unflushed and flushed soil was analyzed using a modified sequential extraction method. The data on cumulative metal removal were analyzed using OriginPro 8.0 software (OriginLab Corporation, Northampton, MA, USA) and were fitted to 4-parameter logistic sigmoidal model. It was found that flushing time had a stronger influence on metal removal than flow rate. The overall efficiency of metal removal (expressed as the ratio between flushed metal concentration and total metal concentration in soil) at the higher flow rate decreased in this order: Cd (86%) > Ni (44%) > Cu (29%) ≈ Zn (26%) > Pb (15%). Metals were removed from the exchangeable fraction and redistributed into the reducible fraction. After flushing, the soil had a lower pH, EC, and CEC; a higher organic matter content; the composition of the organic matter had changed (incorporation of TA structures). Our results prove that soil flushing with TA is a promising approach to decrease metal concentration in soil and to facilitate carbon sequestration in soil.

Characteristics of psychiatric inpatients diagnosed with mental and behavioral disorders caused by psychoactive substances (F11-19 block), with a focus on NPS and psychiatric co-morbidities.

OBJECTIVES: This study analyzed the prevalence of new psychoactive substance (NPS) use in the analyzed group and compared demographic features and psychoactive substance profiles between the 2 subgroups (NPS users, non-NPS users). The secondary measure was used to determine the prevalence of psychiatric comorbidities in study group and to compare demographic features and psychoactive substance profiles between 2 subgroups (the F11-19 only diagnosed group and the F11-19 group with psychiatric comorbidities according to ICD-10). MATERIAL AND METHODS: A 12-month retrospective cross-sectional analysis of medical records compiled for adult psychiatric patients who had been admitted to the Regional Psychiatric Hospital in Olsztyn, Poland, in October 1, 2016 - September 30, 2017 was conducted. After analyzing the available medical records, 157 cases were included and analyzed. Data for the study were collected in a specially designed monitoring card from discharge reports, including data from psychiatric examinations, especially anamnesis. RESULTS: The most commonly declared psychoactive substances were amphetamine (AMF) - 54% and cannabinoids - 46%. The prevalence of NPS use in the study group was 34%. Inpatients taking NPS, as compared with non-NPS users, were younger and more often admitted to hospital through the Emergency Department. It was also found that NPS users more often took AMF or cannabinoids, and less frequently benzodiazepines (BDZ) or opioids. However, the taking of AMF, cannabinoids and BDZ was also age-dependent. CONCLUSIONS: The prevalence of psychiatric comorbidities in the study group was 9%. Inpatients with psychiatric comorbidities were older and took BDZ significantly more often than AMF. In addition, NPS use affects different groups, including a specific group as the analyzed sample, which shows a similar NPS use profile as different groups described in the literature. Int J Occup Med Environ Health. 2020;33(2):125-36.

Infrared Thermography Sensor for Disease Activity Detection in Rheumatoid Arthritis Patients.

A recent review of thermography studies in rheumatoid arthritis shows limited data about disease activity and mostly focuses on differences between the thermography of rheumatoid arthritis patients and typical subjects. A retrospective study compared patients with high disease activity (n = 50), moderate disease activity (n = 16), and healthy participants (n = 42), taking into account demographic, clinical, laboratory, and thermography parameters. We applied an infrared thermography sensor and a fingers examination protocol. Outcomes included the mean temperature of five fingers of a hand: In static, post-cooling, post-rewarming, the total change in mean temperature of fingers due to cold provocation, the total change in mean temperature of fingers due to rewarming, the area under the cooling curve, the area under the heating curve, the difference between the area under the rewarming and the cooling curve, and temperature intensity distribution maps. For patients with high disease activity, a lower area under the heating curve and a lower difference between the area under the rewarming curve and the cooling curve were observed, as well as a smaller total change in mean temperature due to rewarming, compared to patients with moderate disease activity (p < 0.05). Our study findings could be helpful in patients with an equivocal clinical examination.

Novel techniques for a wireless motion capture system for the monitoring and rehabilitation of disabled persons for application in smart buildings.

BACKGROUND: Due to the problem of aging societies, there is a need for smart buildings to monitor and support people with various disabilities, including rheumatoid arthritis. OBJECTIVE: The aim of this paper is to elaborate on novel techniques for wireless motion capture systems for the monitoring and rehabilitation of disabled people for application in smart buildings. METHODS: The proposed techniques are based on cross-verification of distance measurements between markers and transponders in an environment with highly variable parameters. To their verification, algorithms that enable comprehensive investigation of a system with different numbers of transponders and varying ambient parameters (temperature and noise) were developed. In the estimation of the real positions of markers, various linear and nonlinear filters were used. Several thousand tests were carried out for various system parameters and different marker locations. RESULTS: The results show that localization error may be reduced by as much as 90%. It was observed that repetition of measurements reduces localization error by as much as one order of magnitude. CONCLUSIONS: The proposed system, based on wireless techniques, offers a high commercial potential. However, it requires extensive cooperation between teams, including hardware and software design, system modelling, and architectural design.

Interleukin-17 inhibitors. A new era in treatment of psoriasis and other skin diseases.

Psoriasis is a chronic skin disease caused by the excessive secretion of inflammatory cytokines. Available therapeutic options include biologic drugs such as tumor necrosis factor alpha inhibitors and interleukin 12/23 (IL-12/23) inhibitors. The recent discovery of IL-17, which contributes to development of psoriasis, opened new possibilities for further treatment modalities. Currently, one anti-IL17 biological agent is approved for the treatment - a fully human monoclonal antibody that targets IL-17A (secukinumab). Further clinical trials, including a humanized IgG4 specific for IL-17 (ixekizumab) and a fully human antibody that targets the IL-17 receptor A (brodalumab).

Acne inversa goes an extra mile than hidradenitis suppurativa.

Acne inversa (AI, hidradenitis suppurativa, Velpeau's disease, Verneuil's disease) is a severe, chronic inflammatory dermatosis of unknown etiology, detected on the basis of clinical symptoms more frequently in women than in men. Purulent lesions in the form of nodules and inflammatory tumors, fistulas and scars are present in the areas with hair follicles and apocrine glands, most commonly on the armpits, groin, around the anus and pubic region. Acne inversa can lead to physical and mental disorders. Unfortunately, it is often misdiagnosed and ineffectively treated. The paper presents a case of a 46-year-old patient who was successfully treated surgically for AI around the anus and buttocks by excision of the changes and closure of the wound with local flaps and split-thickness skin grafts, taken with dermatome from the rear surface of the thighs. Surgical treatment is the method of choice in the treatment of severe AI.

Synthesis of polycyclic aminocyclobutane systems by the rearrangement of N-(ortho-vinylphenyl) 2-azabicyclo[3.1.0]hexane derivatives.

The acid-catalysed thermal rearrangements of a family of N-aryl 2-azabicyclo[3.1.0]hexanes is described. These substrates, designed in such a way that the aromatic system is conjugated with an alkene group located at the ortho position relative to the nitrogen atom, have been prepared by using an intramolecular Kulinkovich-de Meijere reaction. The rearrangements can then be conducted either under standard thermal conditions or with microwave activation. Depending on the conditions applied and the substitution pattern, dihydroquinoline or polycyclic aminocyclobutane derivatives can be obtained. A mechanistic discussion is provided, with the proposition of the initial protonation of the aminocyclopropane moiety to give an iminium intermediate. By analogy with related intermolecular reactions, the involvement of electrocyclic reactions among the series of elementary steps that follow is put forward.

Inflammatory bowel disease - is there something new in the immunological background?

In the present paper we correlate clinical data, as well as histopathological, immunohistochemical and molecular biology methods, with the occurrence of both forms of inflammatory bowel disease (IBD) i.e. ulcerative colitis and Crohn's disease. We found that patients with a history of Epstein-Barr virus (EBV) or cytomegalovirus (CMV) infections, as well as steroid treatment, had increased susceptibility to the development of IBD. The diagnosis of IBD was confirmed by histopathology. Previous infections by EBV and CMV, as well as M. tuberculosis, were proved by PCR-based techniques and in situ hybridization. We found PCR-proved latent viral infections in 30-50% of the IBD patients we studied. However, we were unable to prove the presence of viral antigens by immunohistochemistry for EBV or CMV. We found positive correlations between the presence of anti-CMV IgG, as well as PCR-positive results for M. tuberculosis with an ulcerative colitis diagnosis. Additionally, up to 80% of IBD patients used steroids, which was found to be correlated with a diagnosis of Crohn's disease. Our data may support the theory that IBD could be related to previous viral infections and the use of steroids.

Proinflammatory cytokines and IL-10 in inflammatory bowel disease and colorectal cancer patients.

INTRODUCTION: The aim of the study was to describe the levels of circulating monocyte/macrophage pro-inflammatory cytokines (TNF-alpha, IL-1beta IL-6, and IL-8) and an anti-inflammatory cytokine (IL-10) in inflammatory bowel disease (IBD) and colorectal cancer (CRC) patients and healthy controls. MATERIALS AND METHODS: The study was conducted on 15 healthy individuals, 20 patients with ulcerative colitis (UC), 12 with Crohn's disease (CD), and 15 with CRC (Dukes' stage B). Blood serum cytokine levels were measured by ELISA. RESULTS: The patients with UC had significantly higher levels of the pro-inflammatory cytokines and of circulating IL-10 than the healthy controls. The patients with CD and CRC had the same specific pattern of serum cytokines of significantly elevated levels of the pro-inflammatory cytokines, but the IL-10 levels were within the range found in the healthy individuals. CONCLUSIONS: Thus our results demonstrate that both IBD and CRC are linked with an intensified production of a wide array of monocyte/macrophage pro-inflammatory cytokines which is not accompanied by elevated levels of circulating IL-10, except for its insufficiently inhibitory elevation in UC patients.

[Mycobacterium avium subsp. paratuberculosis in inflammatory bowel diseases]. / Mycobacterium avium subsp. paratuberculosis w nieswoistych chorobach zapalnych jelit.

In the paper results were presented of a study on manifestation of infection with Mycobacterium avium subsp.paratuberculosis in 16 patients aged 15-42 years with Lesniowski-Crohn disease (group 1), in 20 patients aged 21-50 years with ulcerative colitis (group 2) and in 12 healthy individuals aged 23-60 years (group 3, control). All the ill patients were subjected to surgery, involving partial or total resection of large intestine, while individuals in group 3 (control) were subjected to colonoscopy with sampling of large intestine. Using mechanical/enzymatic technique DNA was extracted from the tissue material and was identified using PCR-ELISA technique (Mycobacterium paratuberculosis PCR; Institut Pourquier-France). Colour reaction was evoked using the TMB substrate. In the studies presence of Mycobacterium avium subsp. paratuberculosis was noted in 10 (62.5%) patients with Lesniowski-Crohn disease, in 5 (25%) patients with ulcerative colitis and in 1 patient 1 (8.3%) patient of the control group. The obtained results permit to suggest that Mycobacterium avium subsp. paratuberculosis bacteria participate in etiopathogenesis of Lesniowski-Crohn disease.

Is there any relationship between lipids and vitamin B levels in persons with elevated risk of atherosclerosis?

BACKGROUND: There is increasing evidence that plasma homocysteine level is an independent risk factor for atherosclerosis. Low levels of serum folates, cobalamin and pyridoxine are associated with increased risk of cardiovascular disease. Most dietary products contain cholesterol as well as methionine, so hyperlipidemia could be associated with a higher level of homocysteine and inversely with lower levels of B vitamins. The aim of this study was to investigate the differences in levels of lipids and vitamins affecting homocysteine metabolism in different groups of patients. MATERIAL/METHODS: We examined 38 healthy persons, 55 patients hospitalised for cardiac surgery, and 62 patients without clinical evidence of atherosclerosis but with one of the atherosclerosis risk factors (hypercholesterolemia, NIDDM or chronic renal insufficiency). The levels of total cholesterol, triglycerides, vitamin B12, folic acid and vitamin B6 index in serum were determined using routine laboratory methods. RESULTS: We found no association between lipids and B vitamins in any examined group. There were significant differences between concentrations of analysed parameters in all groups of patients as compared to controls. CONCLUSIONS: The lack of correlation between the levels of lipid parameters and B vitamins in serum indicates that these may be independent, additional risk factors for atherosclerosis. Higher vitamin B6 deficiency in dialysis patients is probably caused by low intake combined with the increased requirements of uremic patients. Permanent monitoring of B vitamins in serum is necessary in patients with elevated risk of atherosclerosis, as well as long-term education, careful diet planning and supplementation.