Ambulatory blood pressure monitoring and renal functions in children with a solitary kidney

The aim of this study is to investigate the blood pressure (BP) profile, microalbuminuria, renal functions, and relations with remaining normal kidney size in children with unilateral functioning solitary kidney (UFSK). Sixty-six children with UFSK were equally divided into three groups: unilateral renal agenesis (URA), unilateral atrophic kidney (UAK), and unilateral nephrectomy (UNP). Twenty-two age-, weight-, and height-matched healthy children were considered as a control group. The serum creatinine level and first-morning urine microalbumin and creatinine concentrations were determined by the standard methods. Also, the BP profile was determined by ambulatory blood pressure monitoring (ABPM). We found that the serum creatinine level was higher and creatinine clearance was lower in each patient groups compared to those of the control group (p < 0.05). Compared with the controls, each group of patients had mean office, 24-h, daytime, and night-time systolic and diastolic BP values similar to those of the controls (p > 0.05). An inverse correlation was found between the renal size standard deviation scores (SDS) of normal kidneys and 24-h systolic and diastolic BP load SDS in all of the patients (p < 0.05; r = −0.372, r = −0.295, respectively). The observed relationship between renal size SDS and 24-h mean arterial pressure (MAP), systolic and diastolic BP load SDS suggests that children with UFSK should be evaluated by using ABPM for the risk of hypertension

Segregated Algorithms for the Numerical Simulation of Cardiac Electromechanics in the Left Human Ventricle

We propose and numerically assess three segregated ( partitioned) algorithms for the numerical solution of the coupled electromechanics problem for the left human ventricle. We split the coupled problem into its core mathematical models and we proceed to their numerical approximation. Space and time discretizations of the core problems are carried out by means of the Finite Element Method and Backward Differentiation Formulas, respectively. In our mathematical model, electrophysiology is represented by the monodomain equation while the Holzapfel-Ogden strain energy function is used for the passive characterization of tissue mechanics. A transmurally variable active strain model is used for the active deformation of the fibers of the myocardium to couple the electrophysiology and the mechanics in the framework of the active strain model. In this work, we focus on the numerical strategy to deal with the solution of the coupled model, which is based on novel segregated algorithms that we propose. These also allow using different time discretization schemes for the core submodels, thus leading to the formulation of staggered algorithms, a feature that we systematically exploit to increase the efficiency of the overall computational procedure. By means of numerical tests we show that these staggered algorithms feature (at least) first order of accuracy. We take advantage of the efficiency of the segregated schemes to solve, in a High Performance Computing framework, the cardiac electromechanics problem for the human left ventricle, for both idealized and subject-specific configurations