P. Korohoda

Correlation between fat mass and blood pressure in healthy children

Obesity is a well-known risk factor for arterial hypertension. The aim of this study was to analyze which surrogate marker of adiposity, i.e., body mass index (BMI) or fat mass (FM), as measured by bioimpedance analysis (BIA), best correlated with blood pressure in healthy children. Body weight, height, and casual blood pressure (BP) were measured in 193 healthy children (103 boys), aged 8–16xa0years. Body composition was determined by BIA. The correlation between BMI and age was linear, whereas the correlation between percentage of FM and age was nonlinear and it was different in boys and girls. Blood pressure standard deviation scores (SDS) correlated with FM SDS (BIA) over the entire normal range (systolic: ru2009=u20090.26, pu2009=u20090.002; diastolic: ru2009=u20090.33, pu2009<u20090.01). An evaluation of the children based on BP (three groups: BP < 50th percentile, 50th < BP > 95th percentile; BP > 95th percentile) revealed that hypertensive children had a higher BMI (17.6 vs. 19.4 vs. 26.2xa0kg/m2, respectively) and a greater FM (14.0 vs. 16.8 vs. 30.2%, respectively). In conclusion, the divergence in FM in healthy boys and girls can be determined by BIA but not by BMI. In healthy children, BP within the entire normal range correlated with FM, children with established hypertension presented with a significantly higher FM. The study points to FM as an important determinant of BP pressure in obese and non-obese children.

Fast filtering by generalized convolution related to discrete trigonometric transforms

The authors show that for a family of discrete trigonometric transforms (the set of 16 transforms), filters, which are typically defined and computed in the transform domain by means of static but dense multiplications, can be realized directly in the primary domain using the so-called generalized convolution. This concept is based on the generalized convolution matrices, which are distinct for each transform. These matrices are either sparse or can be made sparse at the cost of some slight and usually fully acceptable approximation. It is shown that filtering with the generalized convolution matrices may require less computations than typical filtering procedures performed in the transform domain, even if fast algorithms for the forward and for the inverse transformations are used. The theoretical results are illustrated and verified with examples of half-band low-pass filters.

Acute kidney injury in a single pediatric intensive care unit in Poland: a retrospective study.

Background/Aims: The recent improvements of management of patients in pediatric intensive care units (PICU) are associated with improved outcome. However, this decrease in mortality is associated with an increased number of children with acute kidney injury (AKI), especially in patients with multiorgan failure. Methods: The report presents a retrospective analysis of 25 cases of AKI (assessed based on the pRIFLE criteria) in PICU within 7 years. Results: AKI was diagnosed in 1.24% of all hospitalized children. AKI percentage duration (as compared to the total hospitalization time) in the children who died vs. the survivors was 79.55% vs. 46.19%, respectively (p<0.05). The mortality rate of AKI patients was 40% which was 4.4-times higher as compared to the total mortality rate in PICU. The final cumulative survival ratio (FCSR) of patients meeting the oliguria criterion (which was met in 48% of AKI patients) was 37% vs. 49% in non-oliguric children. Averaged urine output values in the first week of hospitalization in the deceased vs. survivors were 1.49 vs. 2.57 ml/kg/h, respectively (p<0.05). Conclusions: Oliguria should not be considered as a sensitive parameter for AKI diagnosing in children below one year of age. A decreased mean urine output in the first week of PICU hospitalization (less than 1.4 ml/kg/h) should be considered as a poor prognostic factor. In many cases AKI was diagnosed too infrequently and too late.

Can We Further Improve the Quality of Nephro-Urological Care in Children with Myelomeningocele?

Myelomeningocele (MMC) results from a failure of normal neural tube fusion in early fetal development. Retrospective, observational study of medical data of 54 children treated in Pediatric Nephrology and Urology Clinics for five years was performed. The following data were analyzed: serum creatinine, eGFR, urine analysis, renal scintigraphy (RS), renal ultrasound, and urodynamics. Mean age of studied population: 12.3 years, median of eGFR at the beginning and at the end of survey was 110.25 and 116.5 mL/min/1.73 m2 accordingly. Median of frequency of urinary tract infections (fUTI): 1.2 episodes/year. In 24 children: low-pressure, in 30 children: high-pressure bladder was noted. Vesicouretral reflux (VUR) was noted in 23 children (42.6%). fUTI were more common in high-grade VUR group. High-grade VURs were more common in group of patients with severe renal damage. At the end of the survey 11.1% children were qualified to higher stages of chronic kidney disease. Renal parenchyma damage progression in RS was noted in 22.2% children. Positive VUR history, febrile recurrent UTIs, bladder wall trabeculation, and older age of the patients constitute risk factors of abnormal renal scans. More than 2.0 febrile, symptomatic UTIs annually increase by 5.6-fold the risk of severe renal parenchyma damage after five years.

Time-frequency analysis of accelerometry data for seizure detection

Abstract This article presents an algorithm based on a short-time Fourier transform for reliable detection of epileptic seizures measured with three-dimensional (3D) accelerometry. The objective of the described work is to provide basic technical information to create useful alarm models for epileptic seizure detection using a mobile phone. The presented material is based on experimental measurements. Finally, the possibility of increasing smartphone detection capability by attaching a triaxial piezoelectric accelerometer to the patient’s wrist is suggested.

Filter Size Not the Anticoagulation Method is the Decisive Factor in Continuous Renal Replacement Therapy Circuit Survival

Background/Aim: As continuous renal replacement therapy (CRRT) has emerged as a standard therapy in pediatric intensive care units (PICU), many related issues that may have an impact on circuit survival have gained in importance. Objective of the study was an evaluation of factors associated with circuit survival, including anticoagulation (ACG). Methods: Retrospective study that included 40 patients, who in total received 7636 hours of CRRT during 150 sessions (84 filters, 4260 hours with heparin anticoagulation (Hep-ACG); 66 filters, 3376 hours with regional citrate anticoagulation (RCA)). Results: The Kaplan-Meier analysis of the total circuit survival time depending on the type of ACG did not demonstrate a significant difference between Hep-ACG and RCA. The percentage of clotted filters was significantly higher in case of smaller filters (HF20: 58.8%; ST60: 29.5%; ST100: 15.8%), and their lifetime was significantly lower regardless of ACG (the mean and median lifetime for HF20: 38.7/27.0 h; for ST60: 54.1/72.0 h., for ST100: 62.1/72.0 h, respectively). Conclusions: Irrespectively of filter size, filter clotting occurs within the first 24 hours after the initiation of CRRT. Most commonly, clotting affects small filters, and their lifetime is significantly shorter as compared to larger filters regardless of the type of the ACG.

Should the Lopot-Plot Be Used in Daily Practice to Optimise Hemodialysis Treatment?

ABSTRACT The paper presents an application of the Lopot-plot, which compares the timeaveraged concentration (TAC) and the time-averaged deviation (TAD) of the weekly dialysis cycle, to comprise the results of intensive computational study. The presented case is based on 420 one-week-cycle simulations to verify the consequences implied by the change of the treatments schedule from nonuniformly to uniformly distributed over the week. The concept of steady state is explained and utilized to obtain periodical runs of the urea concentration. The presented graphs encouragingly indicate the potential of such plots in presenting results of multivariable intensive computations that should be advisably performed during the planning process of hemodialysis treatment.

Video processing for modelling of temperature changes in the initially cooled forearm of the hemodialyzed person

In the paper a problem of precise compensation of the original object motion in front of the infrared camera is discussed. The block matching techniques from stereovision and video coding have been adopted to this peculiar task after top-hat preprocessing of the sequence. The pixels are described with the original temperature values instead of colour parameters. The motion detection and compensation processes have been followed carefully with help of adequate images and graphs. It has been proved that proper video processing may compensate for lack of strong restrictions during thermogram sequence acquisition.