Kinesitherapy for Patients on Hemodialysis

Introduction: Chronic kidney disease (CKD) is a huge challenge for GPs and nephrologists. Physiotherapists are increasingly included in the multidisciplinary teams dealing with CKD around the world to improve the quality of life and prevent a number of complications of patients undergoing the most common treatment for CKD, namely hemodialysis.Aim: The aim of this article is to present the possibilities for optimizing and supporting the motor activity of hemodialysis patients.Materials and Methods: Review of medical literature from the last 10 years, published in the scientific databases: Pubmed, Google Scholar, PubMed Central, and ScienceDirect, has been conducted.Results: Numerous independent studies have shown that kinesitherapy is a reliable aid in the prevention of cardiovascular diseases and in improving the overall condition of patients with CKD on hemodialysis. The implementation of specialized devices for kinesitherapy during hemodialysis and the selection of appropriate exercises to practice at home also show a significant improvement in mental health (motivation for a better and more active life) of hemodialysis patients.Conclusion: The inclusion of kinesitherapy during hemodialysis and acquainting chronically ill patients with the opportunities for improving their physical activities would lead to improved health status and quality of life of these patients

Childhood obesity, renal injury and future disease risk

INTRODUCTION: Evidence associates obesity with glomerular hyperfiltration. Concurrent inflammation, hypertension, dyslipidemia, and insulin resistance represent further established risks to renal health in both children and adults. Our aim was to investigate the relationship between childhood obesity and the risk of renal impairment.MATERIALS AND METHODS: A total of 114 obese but otherwise healthy children, who were investigated in 2013, were included in the study (mean age 11.5±3.6). Auxology was measured using standard procedures. The pubertal status was defined applying the Tanner scale. Blood and urine tests were performed after overnight fast. Kidney size was measured by standard abdominal ultrasound; kidney volume and estimated glomerular filtration rate were calculated.RESULTS: Microalbuminuria was detected in 8.5% of the children, and 40.2% of all patients were with high systolic blood pressure (BP). Close to half of the children (43.4%) showed insulin resistance (assessed by HOMA-IR) and 95.4% displayed hyperinsulinism. Kidney volume correlated with waist circumference (WC) (left r=0.636, p<0.001; right r=0.532, p<0.001), as well as with weight and elevated systolic BP. Children with hyperfiltration (9.6% of all) at this stage all had elevated total cholesterol and triglycerides. In further 14.3% of the children (all pubertal) the glomerular filtration rate was low, and they had significantly larger kidney volume (left p<0.001; right p=0.004), HOMA-IR (p=0.001), WC and BMI (p<0.001) compared to those with normal and hyperfiltration rate.CONCLUSION: To summarize, childhood obesity showed an association with established risk factors for renal toxicity. Whether kidney volume in obese children has an independent predictive value of future chronic kidney disease remains to be investigated

A review of career devoted to biophotonics-in memoriam to Ekaterina Borisova (1978-2021)

Regretfully, because of her sudden demise, Assoc. Prof. Ekaterina Borisova is no longer amongst us. COVID-19 pulled away a brilliant scientist during the peak of her scientific career (see Fig. 1). All authors would like to express deepest condolences and sincere support to her family, friends, relatives and colleagues! We, therefore, rightfully commemorate her dedicated and devoted contribution to biophotonics, her readiness to always support, help, motivate and inspire all her colleagues and collaborators

Diagnosing rheumatoid arthritis in outpatient care

Rheumatoid arthritis (RA) is a chronic, progressive systemic immune-mediated inflammatory disease of the connective tissue engaging mainly the peripheral joints. Its course is mainly as a symmetric erosive polyarthritis. In patients with persisting inflammation due to delay of diagnosis or due to inadequate therapy behaviour, the probability of disability is increased, the cardiovascular risk is increased, and the survival rate is reduced. There is more than enough scientific evidence that the earlier the patients with RA are diagnosed and treated, the better their prognosis is. There is a growing number of medicines, including biological ones, that are relatively safe and highly efficient in the control of synovial inflammation, especially when therapy with them is started early. Irrespective of this, the studies analysing the time from the onset of the symptoms until the start of the disease modifying anti-rheumatic drug (DMARD) therapy show that there are significant delays that vary from 6 to 57 months, depending on the geographic region. The review examines the main reasons for the diagnostic delay and the consequences from it. The emphasis is on the role of the GP in the strategy for early diagnosis of RA. The suggested recommendation for early referral is an instrument of the doctors in the outpatient care to identify the potential patients with an active RA at the beginning of the disease. The early referral to a rheumatologist for a final diagnosis and early treatment with DMARD should improve the long-term outcome of RA

Femtosecond laser fabrication of engineered functional surfaces based on biodegradable polymer and biopolymer/ceramic composite thin films

Surface functionalization introduced by precisely-defined surface structures depended on the surface texture and quality. Laser treatment is an advanced, non-contact technique for improving the biomaterials surface characteristics. In this study, femtosecond laser modification was applied to fabricate diverse structures on biodegradable polymer thin films and their ceramic blends. The influences of key laser processing parameters like laser energy and a number of applied laser pulses (N) over laser-treated surfaces were investigated. The modification of surface roughness was determined by atomic force microscopy (AFM). The surface roughness (R-rms) increased from approximately 0.5 to nearly 3 mu m. The roughness changed with increasing laser energy and a number of applied laser pulses (N). The induced morphologies with different laser parameters were compared via Scanning electron microscopy (SEM) and confocal microscopy analysis. The chemical composition of exposed surfaces was examined by FTIR, X-ray photoelectron spectroscopy (XPS), and XRD analysis. This work illustrates the capacity of the laser microstructuring method for surface functionalization with possible applications in improvement of cellular attachment and orientation. Cells exhibited an extended shape along laser-modified surface zones compared to non-structured areas and demonstrated parallel alignment to the created structures. We examined laser-material interaction, microstructural outgrowth, and surface-treatment effect. By comparing the experimental results, it can be summarized that considerable processing quality can be obtained with femtosecond laser structuring

Defined nano-structuring with ultrashort pulses in gelatin biopolymer films for tissue-engineering

We compare the morphological modifications in gelatin films, induced with an 800nm femtosecond amplifier, in subject of the number of input pulses and the input pulse duration. Foam is formed in all cases, but only under certain conditions the desirable structures that mimic the native subcellular matrix are formed. The number of input pulses significantly changes the foam structure, allowing a well-defined nano-structuring for optimal tissue-engineering

Defined nano-structuring with ultrashort pulses in gelatin biopolymer films for tissue-engineering

We compare the morphological modifications in gelatin films, induced with an 800nm femtosecond amplifier, in subject of the number of input pulses and the input pulse duration. Foam is formed in all cases, but only under certain conditions the desirable structures that mimic the native subcellular matrix are formed. The number of input pulses significantly changes the foam structure, allowing a well-defined nano-structuring for optimal tissue-engineering

Defined nano-structuring with ultrashort pulses in gelatin biopolymer films for tissue-engineering

We compare the morphological modifications in gelatin films, induced with an 800nm femtosecond amplifier, in subject of the number of input pulses and the input pulse duration. Foam is formed in all cases, but only under certain conditions the desirable structures that mimic the native subcellular matrix are formed. The number of input pulses significantly changes the foam structure, allowing a well-defined nano-structuring for optimal tissue-engineering