18 research outputs found

    A New Hand-Movement-Based Authentication Method Using Feature Importance Selection with the Hotelling’s Statistic

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    The growing amount of collected and processed data means that there is a need to control access to these resources. Very often, this type of control is carried out on the basis of biometric analysis. The article proposes a new user authentication method based on a spatial analysis of the movement of the finger’s position. This movement creates a sequence of data that is registered by a motion recording device. The presented approach combines spatial analysis of the position of all fingers at the time. The proposed method is able to use the specific, often different movements of fingers of each user. The experimental results confirm the effectiveness of the method in biometric applications. In this paper, we also introduce an effective method of feature selection, based on the Hotelling T2 statistic. This approach allows selecting the best distinctive features of each object from a set of all objects in the database. It is possible thanks to the appropriate preparation of the input data

    A nonspecific clinical picture and the course of Conn syndrome — current findings in the screening program for hypertensive patients

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    Conn syndrome (CS), next to bilateral adrenal hyperplasia, is one of the most common causes of primary hyperaldosteronism. It leads to potentially curable secondary hypertension. The 54-year-old woman underwent an abdominal computed tomography (CT) examination for symptomatic nephrolithiasis. A focal lesion of the left adrenal gland was found with a diameter of 16 mm and a density of 34 Hounsfield units (HU). The lesion was under observation, and the next magnetic resonance imaging (MRI) scans showed a slight enlargement of the lesion to a size of 18 x 12 mm. The lesion was interpreted as an atypical adenoma of the adrenal gland. According to the course, the patient was referred to the endocrinology clinic. The patient's symptoms included hypertension and paresthesia. During two separate hospitalizations, Conn syndrome was diagnosed using a specific laboratory test. The patient was successfully treated by surgical intervention, resulting in remission of all symptoms. This case illustrates the difficulties in diagnosing primary hyperaldosteronism. The symptoms of Conn syndrome may vary in severity or may be absent. Early diagnosis and appropriate treatment can save many ill individuals from cardiovascular, metabolic, or renal complications. The case underscores the need for screening hypertensive patients using the aldosterone-renin ratio (ARR)

    The use of modern telemedicine technologies in an innovative optimal cardiac rehabilitation program for patients after myocardial revascularization: Concept and design of RESTORE, a randomized clinical trial

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    Despite proven efficacy of cardiac rehabilitation (CR) in reducing the all-cause mortality in patients after myocardial revascularization, the penetration of CR, due to patient-related factors and referral rates remains limited. To improve the outcomes, home-based tele-rehabilitation (TR) has been proposed recently. In theory TR enhances the effects of standard CR procedures due to implementation of an intelligent monitoring system designed to ensure optimal training through on-demand transmission of vital signs, aimed at motivating the patients through daily schedule reminders, setting daily goals and creating a platform for mutual feedback. Several meta-analyses assessing various studies comparing these two methods (CR and TR) have proven that they are at least equally effective, with some of the research showing superiority of TR. Although there was a small sample size, lack of long-term follow-up, reporting effects of TR itself, no integration with tools designed for coaching, motivating and promoting a healthy lifestyle constitutes an important limitation. The latter carries a hopeful prognosis for improvement when utilizing a broad-spectrum approach, especially with use of dedicated technological solutions exploiting the fact of a large and yet rapidly increasing penetration of smartphones, mobile PCs and tablets in the population. The above-mentioned findings worked as the basis and rationale for commencing the RESTORE project aimed at developing and delivering state-of-the-art, comprehensive TR for patients after myocardial revascularization and evaluating its molecular aspect in view of how it influences the atherosclerosis progression attenuation. This paper presents the current state and rationale behind the project based on up-to-date TR efficacy data

    How Does Endothelial Permeability Affect the Development of Juvenile Idiopathic Arthritis? Vascular Endothelial Cadherin as a Promising New Tool Helpful in the Diagnostic Process

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    Introduction. Vascular endothelial cadherin (VE-cadherin) is a calcium-dependent protein essential for stabilization of the adherens junctions of the endothelial cells. Through vasculogenic mimicry, VE-cadherin may influence angiogenesis in synovial fibroblast-like cells. The soluble extracellular domain of VE-cadherin may be considered an indicator of endothelial dysfunction. Its potential as a diagnostic biomarker in rheumatic diseases, including juvenile idiopathic arthritis (JIA), needs to be investigated. Materials and Methods. The study group included 80 patients diagnosed with JIA. In 53 individuals, blood samples were obtained twice with an average interval of 102.4±4.6 days. Results from the study group were compared to 29 age- and sex-matched healthy children. Results. Serum levels of VE-cadherin were significantly higher in JIA patients than in healthy controls. In such comparison, VE-cadherin had 87.5% sensitivity and 69.0% specificity for the cutoff level 4.36 ng/ml (Youden index 0.56, area under the curve 0.724). VE-cadherin concentrations negatively correlated with the disease activity score. However, such finding may be a false result because of the downregulation of VE-cadherin induced by glucocorticosteroids. Conclusions. VE-cadherin may become a promising diagnostic biomarker of early stages of JIA. Its predictive significance may be decreased by utilization of glucocorticosteroids. A multicentre study including patients with other arthritides is recommended for further evaluation of this protein

    A Granulocyte-Specific Protein S100A12 as a Potential Prognostic Factor Affecting Aggressiveness of Therapy in Patients with Juvenile Idiopathic Arthritis

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    Background. Defining new prognostic biomarkers has become one of the most promising perspectives for the long-term care of patients with juvenile idiopathic arthritis (JIA). The new efficient indicators of disease activity and potential response to treatment are crucial in establishing new therapeutic plans in accordance with the “treat to target” strategy. One of the most studied proteins is called S100A12, which is an alarmin specific for granulocytes, considered as a marker of their activity. Materials and Methods. Study involved 80 patients diagnosed with JIA. Children with systemic subtype were not included in the study. In 53 cases, blood samples were obtained in two time points. Results from the study group were compared to 29 age- and sex-matched healthy individuals. Results. Serum S100A12 levels were higher in JIA than in healthy controls at the study baseline (11.67 ± 6.59 vs. 6.01 ± 2.33 ng/ml). There were no significant differences in S100A12 values between assessed subtypes of JIA. The highest concentrations were observed in patients within a disease flare. S100A12 levels were not dependent from using glucocorticosteroids. The studied protein appeared to be an efficient biomarker for JIA patients: 100% specificity as a diagnostic marker (cut-off level: 10.73 ng/ml) and 100% sensitivity as an indicator of exacerbations within a 3-month observation (cut-off level: 5.48 ng/ml). Conclusions. S100A12 may become an important factor influencing decisions on aggressiveness of JIA therapy. Further elaboration on the clinical algorithm is necessary for that protein to be included in everyday practice

    The Potential Importance of MicroRNAs as Novel Indicators How to Manage Patients with Juvenile Idiopathic Arthritis More Effectively

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    Small, noncoding sequences of ribonucleic acid called microRNAs (miRNAs, miR) are functioning as posttranscriptional regulators of gene expression. As they draw increasing attention of rheumatologists, there is a growing body of evidence concerning specific molecules that may affect the long-term care of patients with inflammatory arthritides. Findings involving children with juvenile idiopathic arthritis (JIA) are still limited though. The aim of the study was to browse the available data on microRNAs which may be utilized as potential biomarkers helpful in diagnosing and monitoring JIA patients. The review contains a brief summary on the most studied sequences: miR-16, miR-125a-5p, miR-146a, miR-155, and miR-223. It is complemented with other miRNAs possibly relevant for JIA (miR-145, miR-23b, miR-27a, and miR-204) and discussion on challenges for using miRNAs in pediatric rheumatology (particularly, issues regarding specificity of biomarkers and measurements involving synovial fluid)

    Disturbances of discriminative sensation in patients after ischemic and haemorrhagic stroke, illustrated with example of area of innervation of median nerve and radial nerve

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    INTRODUCTION One of the basic functions of the nervous system is sensation, which enables the recognition and, as a conse-quence, appropriate reaction to various stimuli from external and internal environments. Sensation disturbances of a central origin were essential to this study. The purpose of this study was to assess the disturbances of sensa-tion in the paretic upper limb and determination of the dependence between the kind of stroke and the degree of tactile sensation impairment. MATERIAL AND METHODS The study was conducted among patients hospitalized at the neurological department. A total of 40 patients (22 women and 18 men) after ischemic and haemorrhagic stroke were enrolled in the study. The mean age was 58 years. Two methods were employed in the area of innervation of the median and radial nerves: Weber’s two-point discrimination test and an aesthesiometer. RESULTS The research has shown that regardless of the kind of stroke suffered, there is always an occurrence of tactile sensation disturbances within the area of paresis. The disturbances of sensation were found to be more serious in patients after haemorrhagic stroke. A correlation was found between disturbances of discriminative sensation and disturbances of skin sensation. As a result of the applied therapy, gradual improvement of both skin and discriminative sensation was observed in both research groups. CONCLUSIONS Both methods have confirmed that patients after haemorrhagic stroke suffer from more serious disturbances of skin and discriminative sensation than patients after ischemic stroke.W S T ĘP Jedną z podstawowych funkcji układu nerwowego jest czucie pozwalające na rozpoznawanie, a w konsekwencji na prawidłowe reagowanie na różne bodźce ze świata zewnętrznego i wewnętrznego. Niniejsza praca dotyczy zaburzeń czucia pochodzenia ośrodkowego. Celem pracy była ocena zaburzeń czucia w obrębie kończyny górnej niedowładnej oraz określenie zależności między rodzajem udaru a stopniem upośledzenia czucia. MATERIAŁ I METODY Badania przeprowadzono wśród pacjentów hospitalizowanych na oddziale neurologii. Objęto nimi 40 pacjentów (22 kobiety i 18 mężczyzn) po przebytym udarze niedokrwiennym i krwotocznym mózgu. Średnia wieku całej grupy badanej wynosiła 58 lat. Każda grupa została przebadana za pomocą dwóch metod badawczych: cyrkla Webera oraz estezjometru włókienkowego. Badania odbywały się na określonych wcześniej dwóch obszarach unerwienia nerwu pośrodkowego i promieniowego. W Y N I K I Analiza wyników pozwoliła stwierdzić, iż bez względu na rodzaj dokonanego udaru mózgu, zawsze dochodzi do upośledzenia czucia w obrębie niedowładu lub porażenia. Wykazano, iż u pacjentów po udarze krwotocznym zaburzenia te są większe. Zanotowano istotną korelację między zaburzeniami czucia dyskryminacyjnego a zaburzeniami czucia skórnego. Terapia w obu grupach badawczych przyniosła stopniowę poprawę czucia zarówno skórnego, jak i dyskryminacyjnego. U pacjentów krwotocznych była ona mniejsza i przebiegała wolniej, często pozostawiając duże ubytki. W N I O S K I Obie metody badawcze potwierdziły, że pacjenci po przebytym udarze krwotocznym cierpią na zaburzenia czucia dyskryminacyjnego i czucia skórnego w większym stopniu i z większym nasileniem niż pacjenci po przebytym udarze niedokrwiennym

    When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease – a review of Lyme arthritis in children

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    Abstract The Lyme arthritis is a common manifestation of infection with Borrelia burgdorferi spirochete. Despite its infectious background, the inflammation clinically and histopatologically resembles juvenile idiopathic arthritis. As it affects a considerable number of Lyme disease patients, it should be routinely considered in differential diagnosis. Development of arthritis is partially dependent on spirochetal factors, including the ribosomal spacer type and the sequence of outer surface protein C. Immunological background involves Th1-related response, but IL-17 provides an additional route of developing arthritis. Autoimmune mechanisms may lead to antibiotic-refractory arthritis. The current diagnostic standard is based on a 2-step testing: ELISA screening and immunoblot confirmation. Other suggested methods contain modified two-tier test with C6 ELISA instead of immunoblot. An initial 28-day course of oral antibiotics (doxycycline, cefuroxime axetil or amoxicillin) is a recommended treatment. Severe cases require further anti-inflammatory management. Precise investigation of new diagnostic and therapeutic approaches is advisable

    Vertetrac system performance analysis regarding BMI

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    BACKGROUND Performing symmetrical or asymmetrical lumbar spine traction using the Vertetrac system allows relief of pinched ligaments and nerve roots in the case of herniated nucleus pulposus. The aim of the study was to analyze the effectiveness of Vertetrac in lumbar disc herniation due to the weight of the patient. METHODS Using the Vertetrac targeted traction system, 68 patients with lumbar spine pain were treated. According to their BMI, the patients were divided into three groups: M1, M2, M3. After a thorough interview and testing, the pa-tient was fastened to the Vertetrac device where traction was increased or reduced, depending on the patient's feeling of pain. The rehabilitation was carried out twice a week until the pain subsided. RESULTS Our findings are presented according to the three division groups, depending on BMI, analyzed pain reduction after the first treatment session and after the therapeutic series; the number of treatment sessions required to reduce pain and return of pain. Analyzing the difference between all the tests, examinations and symptoms, the highest average improvement of positive reactions was observed in the M2 group – overweight people -14.83 with a standard deviation of 8.75. The weakest average was obtained by the M3 group – obese people – 9.17 with a standard deviation of 5.15. CONCLUSIONS BMI has the influence of lowering the degree of pain after the first treatment session. The people with the correct weight recorded the largest decrease in feelings of pain, while the group of obese people has the weakest improvement in pain sensation. In the period up to 3 years after the end of therapy, in the vast majority of patients treated with Vertetrac targeted traction, the pain does not return.WSTĘP Wykonanie trakcji symetrycznej lub asymetrycznej kręgosłupa lędźwiowego za pomocą systemu Vertetrac umożliwia odciążenie uciśniętego więzadła i korzenia nerwu w przypadku przepukliny jądra miażdżystego. Celem pracy była analiza skuteczności działania systemu Vertetrac w dyskopatii lędźwiowej ze względu na wagę pacjenta. M E T O D Y Leczeniu za pomocą systemu trakcji celowanej Vertetrac poddano 68 pacjentów z bólem odcinka lędźwiowego kręgosłupa. Ze względu na wskaźnik masy ciała BMI (body mass index), badanych podzielono na trzy grupy: M1, M2, M3. Badany po przeprowadzeniu szczegółowego wywiadu i przeprowadzonych testach – zapinany był w urządzeniu Vertetrac, gdzie zwiększano lub zmniejszano trakcję, w zależności od odczuć bólowych badanego. Rehabilitację prowadzono dwa razy w tygodniu do czasu zniwelowania bólu. W Y N I K I Wyniki badań własnych zostały przedstawione zgodnie z trzema podziałami grupowymi, zależnie od wskaźnika masy ciała BMI (body mass index) , przean a- lizowano redukcję bólu po pierwszej sesji terapeutycznej i po zakończeniu serii terapeutycznej, liczbę sesji terapeutycznych koniecznych do zredukowania bólu, powrót dolegliwości bólowych. Analizując różnicę między wszystkimi testami, badaniami i objawami, najwy ż- szą średnią poprawy reakcji dodatnich odnotowano w grupie M2 – osób z nadwagą 14,83, przy odchyleniu standardowym 8,75. Najsłabszą średnią osiągnęła grupa osób z otyłością M3 – 9,17, przy odchyleniu standardowym 5,15. W N I O S K I 1. BMI ma wpływ na obniżenie stopnia bólu po pierwszej sesji terapeutycznej. 2. U osób z poprawną wagą odnotowuje się największy spadek odczuć bólowych, natomiast grupę osób otyłych cechuje najsłabsza poprawa odczuć bólowych. 3. W okresie do 3 lat od zakończenia terapii u znacznej większości osób leczonych trakcją celowaną Vertetrac dolegliwości bólowe nie powracają

    What Each Clinical Anatomist Has to Know about Left Renal Vein Entrapment Syndrome (Nutcracker Syndrome): A Review of the Most Important Findings

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    Nutcracker syndrome (NCS) is the most common term for compression of the left renal vein between the superior mesenteric artery and the abdominal aorta. The development of NCS is associated with the formation of the left renal vein (LRV) from the aortic collar during the sixth to eighth week of gestation and abnormal angulation of the superior mesenteric artery from the aorta. Collateralization of venous circulation is the most significant effect of NCS. It includes mainly the left gonadal vein and the communicating lumbar vein. Undiagnosed NCS may affect retroperitoneal surgery and other radiological and vascular procedures. The clinical symptoms of NCS may generally be described as renal presentation when symptoms like haematuria, left flank pain, and proteinuria occur, but urologic presentation is also possible. Radiological methods of confirming NCS include Doppler ultrasonography as a primary test, retrograde venography, which can measure the renocaval pressure gradient, computed tomography angiography, which is faster and less traumatic, intravascular ultrasound, and magnetic resonance angiography. Treatment can be conservative or surgical, depending on the severity of symptoms and degree of LRV occlusion. Nutcracker syndrome is worth considering especially in differential diagnosis of haematuria of unknown origin
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