DIAGNOSTIC ALGORITHM IN CHILDREN WITH ENURESIS NOCTURNA

Enuresis nocturna is a common disorder in childhood representing a serious medico-social problem. A series of organic, functional, familial, life-style, and psycho-social reasons are involved in wetting one's bed in children. The diagnostic algorithm in children with enuresis nocturna includes a detailed anamnesis and clinical examination, laboratory tests of urine, urea, creatinine, uric acid, ionogram, and echography of the urinary tract. The exclusion of an organic etiology requires purposeful search for psycho-social, familial, and life-style factors as well as consult examination by a psychiatrist or neurologist

DIAGNOSTIC AND THERAPEUTIC PROBLEMS OF ACUTE RENAL FAILURE IN CHILDHOOD

Acute renal failure (ACR) is a clinical-biological syndrome of sudden rapidly advancing, commonly reversible damage of renal function when a normal body homeostasis cannot be maintained. In the Department of Paediatrics, Medical University of Varna, 18 children with ACR were treated. The most common reasons for the ACR were the following: acute glomerulonephritis, haemolytic-uraemic syndrome, and severe malformations of the urinary tract. Blood urea, creatinine, ionogram,acid-base balance, and diuresis were dynamically monitored in all the children. Therapeutic behaviour was directed towards the correction of the dyselectrolytaemia and acid-alkaline profile. The elevated lethality rate still persisted. Three patients deceased

Non-surgical periodontal therapy in patients with periodontitis not suffering from common health disorders

Chronic periodontitis is a pathological condition of loss of tooth`s supporting surrounding tissues. The aim of this study is related to assessment of the efficiency of non-surgical periodontal treatment. Results and conclusions of researches published in the periodontal scientific literature are reviewed in our investigation. Chronic periodontitis significantly influences serum concentration of some inflammatory markers, including CRP. On the other hand, non-surgical periodontal therapy can result in decrease of the value of these inflammatory indicators and associates with improvement of all the periodontal clinical variables. The level of interleukin-6 is characterized with a tendency of reduction, parallel to improvement of periodontal state, as a consequence of performed non-surgical treatment procedures. Short-perspective nonsurgical treatment is effective in condition of slight and moderate degree of periodontitis. Non-surgical periodontal therapy and surgical periodontal treatment result in equal clinical results concerning reduction of depth of probing, clinical attachment level and intensity of bleeding, particularly in patients with periodontal pockets of 4 to 6 mm, suffering from moderate periodontitis. Investigations ascertain the thesis that non-surgical periodontal treatment is profitable, economic therapeutic method. In long-term there is a necessity of profound, detailed study of the considerable results, as well as accentuating upon the extent of patients` satisfaction

An integrated research tool for X-ray imaging simulation

This paper presents a software simulation package of the entire X-ray projection radiography process including beam generation, absorber structure and composition, irradiation set up, radiation transport through the absorbing medium, image formation and dose calculation. Phantoms are created as composite objects from geometrical or voxelized primitives and can be subjected to simulated irradiation process. The acquired projection images represent the two-dimensional spatial distribution of the energy absorbed in the detector and are formed at any geometry, taking into account energy spectrum, beam geometry and detector response. This software tool is the evolution of a previously presented system, with new functionalities, user interface and an expanded range of applications. This has been achieved mainly by the use of combinatorial geometry for phantom design and the implementation of a Monte Carlo code for the simulation of the radiation interaction at the absorber and the detector. © 2002 Published b

Measurement of Small Variations in Optical Properties of Turbid Inclusions with Respect to Surrounding Turbid Medium

Special optical system for non-invasive determination of small variations in the optical properties of homogeneous turbid inclusions embedded into large turbid medium is proposed and developed experimentally. Results for different choice of the optical parameters of both media are presented. The minimum detectable changes in the inclusion optical properties are estimated to be less than 5% with respect to the surrounding medium. It is shown that the output signals depend not only on the relative magnitude but also on the sign of the difference in optical properties of both media. The results could be used for developing techniques and algorithms for distinguishing of different kinds of abnormal formations

THE NEW FACE OF VITAMIN K - MORE THAN BLOOD CLOTTING FACTOR

Introduction: Twenty years ago, the metabolism of vitamin K was connected with its role in hemostasis. Since that time, it has been shown that vitamin K exerts multiple functions mediated by the Gla-proteins, having vitamin K as a cofactor. Numerous publications affirm that these Gla-proteins are related to physiological processes beyond coagulations, such as bone metabolism, vascular health and energy homeostasis.Aim: The aim of this research is to provide new data for the role of vitamin K in a myriad of physiological processes beyond blood clotting. Additionally, it aims to assess the potential new applications of vitamin K as a supplement for the prevention of bone and vascular diseases.Materials and Methods: Using the online databases Scopus, PubMed and Google Scholar, a search with the keywords: `vitamin K2`, `bone metabolism`, `cardiovascular diseases`, `osteocalcin` and `MGP` was conducted. Information regarding the effects of vitamin K on bone and vascular health was referred to in this work.Results: Vitamin K and vitamin K-dependent proteins play pivotal roles in the physiology of bone mineralization and in preventing ectopic calcification. Osteocalcin, a Gla protein located in bone and dentin, is important for bone mineralization. Following the posttranslational carboxylation of Glu-residues with a cofactor vitamin K2 (menaquinone), rather than vitamin K1 (phylloquinone), osteocalcin shows increased affinity for calcium. Osteocalcin is believed to be involved in osteoblast regulation and hydroxyapatite crystal growth. Matrix GLa-protein (MGP), sharing some sequences with osteocalcin, is a local inhibitor of arterial calcification. Vitamin K deficiency impairs the function of osteocalcin and MGP and, therefore, presumably contributes to bone demineralization and vascular calcification, the so-called calcium paradox.Conclusions: Vitamin K deficiencies, traditionally regarded as a cause for internal hemorrhages and blood clotting disorders, apparently can be linked to cardiovascular calcification and abnormal bone modelling. Appropriate treatment of vitamin K deficiency may improve bone and arterial health

Image quality evaluation of breast tomosynthesis with synchrotron radiation

Purpose: This study investigates the image quality of tomosynthesis slices obtained from several acquisition sets with synchrotron radiation using a breast phantom incorporating details that mimic various breast lesions, in a heterogeneous background. Methods: A complex Breast phantom (MAMMAX) with a heterogeneous background and thickness that corresponds to 4.5 cm compressed breast with an average composition of 50% adipose and 50% glandular tissue was assembled using two commercial phantoms. Projection images using acquisition arcs of 24\ub0, 32\ub0, 40\ub0, 48\ub0, and 56\ub0 at incident energy of 17 keV were obtained from the phantom with the synchrotron radiation for medical physics beamline at ELETTRA Synchrotron Light Laboratory. The total mean glandular dose was set equal to 2.5 mGy. Tomograms were reconstructed with simple multiple projection algorithm (MPA) and filtered MPA. In the latter case, a median filter, a sinc filter, and a combination of those two filters were applied on the experimental data prior to MPA reconstruction. Visual inspection, contrast to noise ratio, contrast, and artifact spread function were the figures of merit used in the evaluation of the visualisation and detection of low- and high-contrast breast features, as a function of the reconstruction algorithm and acquisition arc. To study the benefits of using monochromatic beams, single projection images at incident energies ranging from 14 to 27 keV were acquired with the same phantom and weighted to synthesize polychromatic images at a typical incident x-ray spectrum with W target. Results: Filters were optimised to reconstruct features with different attenuation characteristics and dimensions. In the case of 6 mm low-contrast details, improved visual appearance as well as higher contrast to noise ratio and contrast values were observed for the two filtered MPA algorithms that exploit the sinc filter. These features are better visualized at extended arc length, as the acquisition arc of 56\ub0 with 15 projection images demonstrates the highest image reconstruction quality. For microcalcifications, filtered MPA implemented with a combination of median and sinc filters indicates better feature appearance due to efficient suppression of background tissue. The image quality of these features is less sensitive to the acquisition arc. Calcifications with size ranging from 170 to 500 \u3bcm, like the ones presently studied, are well identified and visualized for all arcs used. The comparison of single projection images obtained under different beam conditions showed that the use of monochromatic beam can produce an image with higher contrast and contrast to noise ratio compared to an image corresponding to a polychromatic beam even when the latter is acquired with double incident exposure. Conclusions: Filter optimization in respect to the type of feature characteristics is important before the reconstruction. The MPA combined with median and sinc filters results in improved reconstruction of microcalcifications and low-contrast features. The latter are better visualized at extended arc length, while microcalcifications are less sensitive to this acquisition parameter. Use of monochromatic beams may result in tomographic images with higher contrast acquired at lower incident exposures. \ua9 2012 American Association of Physicists in Medicin

The Napoli-Varna-Davis project for virtual clinical trials in X-ray breast imaging

Virtual clinical trials (VCTs) have been proposed to overcome the limitations of clinical trials using a patient population. VCTs are in-silico reproductions of medical examinations using digital models of the patients and simulated imaging devices. In this work, we present a VCT framework for imaging and dosimetry in breast computed tomography (BCT), digital breast tomosynthesis (DBT) and 2D digital mammography (DM), realized by Univ. Napoli Federico II in collaboration with the medical physics teams at Univ. California Davis and the Medical University of Varna, Bulgaria. Computational phantoms of the uncompressed (pendant) breast were generated by clinical BCT scans acquired at UC Davis. A dataset of digital breast phantoms was produced by means of voxel classification of the uncompressed breast CT images. The voxels were classified as air, skin, adipose and glandular tissue using a semi-automatic algorithm. A software compression algorithm (developed at U. Varna) applied to the 3D phantoms produces compressed breast digital phantoms for virtual DM and DBT investigations using a clinical scanners' technical specifications and geometry as inputs. Monte Carlo simulations, based on Geant4, were used to provide in-silico reproductions of real scans of a given patient breast model. The software permits the estimation of mean glandular dose (MGD) in 2D and 3D imaging as well as the 3D dose distribution. The platform produces breast projection images which are then reconstructed using analytical or iterative algorithms. Patient-specific MGD estimations, as well as simulated BCT volume data sets were compared with the clinical BCT scans. The VCT platform reported herein will be used for scanner optimization and for virtual trials comparing BCT against mammography and DBT, in terms of image quality and glandular dose distributions. In addition to in-silico evaluation, 3D printing methods were used to produce compressed and uncompressed anthropomorphic breast phantoms from the patient image-derived digital breast phantoms for the purpose of experimental validation