Diagnostic difficulties in the differentiation of urine retention and developmental anomalies in the pelvicalyceal system in the ultrasound examination of children

Ultrasound examination of the abdominal cavity is part of the baseline diagnostics of urinary tract diseases. Dilatation of the pelvicalyceal system is one of the most frequent findings. In ultrasonography of the urinary tract there are, however, some images of anatomical anomalies of the pelvicalyceal system which should not be consider as abnormal. In the study we analysed 920 ultrasound examinations of the urinary tract. Of all the ultrasound images only those with isolated dilatation of the renal pelvises and calices were selected (130 cases). Ampulla-shaped and/or external pelvises, isolated calices or both abnormalities were disclosed in 104, 46 and 20 cases, respectively. In about one-third of patients additional examinations (voiding cystography, intravenous urography, renal scyntygraphy) were performed which revealed normal anatomy of the urinary tract and disorders of urine flow in 80% and 20% of patients, respectively. In conclusion, the study implies that not all dilatation of the pelvicalyceal system structures signifies urine retention, although in the event of further doubt, there is a need for additional diagnostics

Polish 2010 growth references for school-aged children and adolescents

Growth references are useful in monitoring a child's growth, which is an essential part of child care. The aim of this paper was to provide updated growth references for Polish school-aged children and adolescents and show the prevalence of overweight and obesity among them. Growth references for height, weight, and body mass index (BMI) were constructed with the lambda, mu, sigma (LMS) method using data from a recent, large, population-representative sample of school-aged children and adolescents in Poland (n = 17,573). The prevalence of overweight and obesity according to the International Obesity Taskforce definition was determined with the use of LMSGrowth software. Updated growth references for Polish school-aged children and adolescents were compared with Polish growth references from the 1980s, the Warsaw 1996–1999 reference, German, and 2000 CDC references. A positive secular trend in height was observed in children and adolescents from 7 to 15 years of age. A significant shift of the upper tail of the BMI distribution occurred, especially in Polish boys at younger ages. The prevalence of overweight or obesity was 18.7% and 14.1% in school-aged boys and girls, respectively. The presented height, weight, and BMI references are based on a current, nationally representative sample of Polish children and adolescents without known disorders affecting growth. Changes in the body size of children and adolescents over the last three decades suggest an influence of the changing economical situation on anthropometric indices

Hypertension treatment preferences in long-term dialysed children in Poland : a survey of pediatric nephrologists

Wstęp Przewlekła choroba nerek prowadzi do rozwoju nadciśnienia tętniczego u większości chorych. Leczenie nadciśnienia towarzyszącego niewydolności nerek jest utrudnione przez ograniczenia w stosowaniu wielu preparatów i brak wystarczających doświadczeń klinicznych, a ponadto istniejące obecnie rekomendacje nie obejmują w ogóle chorych ze schyłkową niewydolnością nerek. Wybór terapii hipotensyjnej ogranicza też młody wiek chorych, gdyż wielu leków nie można stosować u dzieci. Celem badania była analiza jakości leczenia przeciwnadciśnieniowego u dzieci ze schyłkową niewydolnością nerek poddawanych przewlekłej dializoterapii. Materiał i metody Analizą objęto wszystkie dzieci dializowane w Polsce w dniu 30 listopada 2004 roku (n = 134). Uzyskano informacje dotyczące grup stosowanych leków oraz dawek preparatów, a także opinie lekarzy na temat doboru leków stosowanych przy nagłym wzroście ciśnienia tętniczego oraz tych, których dzieciom dializowanym nie powinno się podawać. Wyniki Nadciśnienie tętnicze stwierdzono u 74 (55%) dzieci (47 chłopców, 27 dziewczynek). Najczęstszą przyczyną niewydolności nerek w grupie dzieci z nadciśnieniem było kłębuszkowe zapalenie nerek (27/74). W badanej grupie 65% dzieci leczono za pomocą kilku leków hipotensyjnych, 32% za pomocą jednego leku, a 3% jedynie metodami niefarmakologicznymi. Mimo aktywnego leczenia, zaledwie u 58% dializowanych dzieci prowadziło ono do obniżenia wartości ciśnienia tętniczego poniżej 95 percentyla dla wzrostu i wieku. Najmniejszą skuteczność kontroli ciśnienia tętniczego obserwowano w przypadku leczenia skojarzonego, zwłaszcza wielolekowego. Najczęściej stosowanymi lekami byli antagoniści wapnia, które podawano u ogółem 73% dzieci, w tym u 43/48 w politerapii, a 11/24 w monoterapii. Inhibitory konwertazy angiotensyny były najczęściej stosowane w monoterapii (50%). Mimo znanych kontrowersji, przy nagłym wzroście ciśnienia tętniczego stosowano najczęściej nifedipinę. Wnioski Badanie wykazało, że w Polsce odsetek dializowanych dzieci wymagających leczenia nadciśnieniowego sięga 55%, w tym większość z nich wymaga podawania kilku leków. Pomimo że zasady leczenia są podobne we wszystkich ośrodkach, skuteczność leczenia pozostaje niezadowalająca (58%).Background Chronic kidney disease is associated with the development of arterial hypertension in a vast majority of patients. The treatment of hypertension in these subjects is difficult and challenging due to a limited clinical experience with most drugs and no widely recognised recommendations for patients with end-stage renal disease. A choice of antihypertensive drugs is further narrowed by the young age of the patients since almost all drugs are not recommended in children with renal failure. The aim of this nationwide retrospective analysis was to assess the hypertension treatment patterns in the population of children with chronic kidney diseases (CKD) undergoing hemodialysis or peritoneal dialysis in Poland. Material and methods Among all 134 children dialysed on 30th November 2004 in 13 pediatric dialysis centres in Poland seventy four (55%; 47M, 27F) children were hypertensive. For each patients the treating physicians filled a questionnaire that allowed to collect the following data: the primary kidney disease, chronic dialysis treatment, diagnostic criteria of hypertension and present antihypertensive medication if any. Additionally we asked of the doctors’ preference for a therapy for the acute rise in blood pressure and suggestions which drugs, in their opinion, should not be used in dialysed children. Results In the hypertensive dialysed patients the most frequent causes of chronic kidney disease were chronic glomerulopathies (27/74). Thirty two percent of children were on monotherapy whereas 65% required combined treatment. The therapy was adequate only in 58% of subjects. The lowest rate of efficacy was detected in patients requiring a combined antihypertensive therapy. Among antihypertensive drug classes calcium channel blockers were administered most frequently (in 73% of children, in 11/24 cases in monotherapy and in 43/48 patients in combination). Angiotensin converting enzyme inhibitors were most frequently administered in monotheraphy (50%). Nifedipine was preferred in acute blood pressure rise in children. Conclusion We conclude that incidence of hypertension in dialysed children in Poland is relatively high. The pattern of the treatment was quite uniform, although the efficacy was relatively low (58%)

Hypertension treatment preferences in long-term dialysed children in Poland - a survey of pediatric nephrologists

Wstęp Przewlekła choroba nerek prowadzi do rozwoju nadciśnienia tętniczego u większości chorych. Leczenie nadciśnienia towarzyszącego niewydolności nerek jest utrudnione przez ograniczenia w stosowaniu wielu preparatów i brak wystarczających doświadczeń klinicznych, a ponadto istniejące obecnie rekomendacje nie obejmują w ogóle chorych ze schyłkową niewydolnością nerek. Wybór terapii hipotensyjnej ogranicza też młody wiek chorych, gdyż wielu leków nie można stosować u dzieci. Celem badania była analiza jakości leczenia przeciwnadciśnieniowego u dzieci ze schyłkową niewydolnością nerek poddawanych przewlekłej dializoterapii. Materiał i metody Analizą objęto wszystkie dzieci dializowane w Polsce w dniu 30 listopada 2004 roku (n = 134). Uzyskano informacje dotyczące grup stosowanych leków oraz dawek preparatów, a także opinie lekarzy na temat doboru leków stosowanych przy nagłym wzroście ciśnienia tętniczego oraz tych, których dzieciom dializowanym nie powinno się podawać. Wyniki Nadciśnienie tętnicze stwierdzono u 74 (55%) dzieci (47 chłopców, 27 dziewczynek). Najczęstszą przyczyną niewydolności nerek w grupie dzieci z nadciśnieniem było kłębuszkowe zapalenie nerek (27/74). W badanej grupie 65% dzieci leczono za pomocą kilku leków hipotensyjnych, 32% za pomocą jednego leku, a 3% jedynie metodami niefarmakologicznymi. Mimo aktywnego leczenia, zaledwie u 58% dializowanych dzieci prowadziło ono do obniżenia wartości ciśnienia tętniczego poniżej 95 percentyla dla wzrostu i wieku. Najmniejszą skuteczność kontroli ciśnienia tętniczego obserwowano w przypadku leczenia skojarzonego, zwłaszcza wielolekowego. Najczęściej stosowanymi lekami byli antagoniści wapnia, które podawano u ogółem 73% dzieci, w tym u 43/48 w politerapii, a 11/24 w monoterapii. Inhibitory konwertazy angiotensyny były najczęściej stosowane w monoterapii (50%). Mimo znanych kontrowersji, przy nagłym wzroście ciśnienia tętniczego stosowano najczęściej nifedipinę. Wnioski Badanie wykazało, że w Polsce odsetek dializowanych dzieci wymagających leczenia nadciśnieniowego sięga 55%, w tym większość z nich wymaga podawania kilku leków. Pomimo że zasady leczenia są podobne we wszystkich ośrodkach, skuteczność leczenia pozostaje niezadowalająca (58%).Background Chronic kidney disease is associated with the development of arterial hypertension in a vast majority of patients. The treatment of hypertension in these subjects is difficult and challenging due to a limited clinical experience with most drugs and no widely recognised recommendations for patients with end-stage renal disease. A choice of antihypertensive drugs is further narrowed by the young age of the patients since almost all drugs are not recommended in children with renal failure. The aim of this nationwide retrospective analysis was to assess the hypertension treatment patterns in the population of children with chronic kidney diseases (CKD) undergoing hemodialysis or peritoneal dialysis in Poland. Material and methods Among all 134 children dialysed on 30th November 2004 in 13 pediatric dialysis centres in Poland seventy four (55%; 47M, 27F) children were hypertensive. For each patients the treating physicians filled a questionnaire that allowed to collect the following data: the primary kidney disease, chronic dialysis treatment, diagnostic criteria of hypertension and present antihypertensive medication if any. Additionally we asked of the doctors’ preference for a therapy for the acute rise in blood pressure and suggestions which drugs, in their opinion, should not be used in dialysed children. Results In the hypertensive dialysed patients the most frequent causes of chronic kidney disease were chronic glomerulopathies (27/74). Thirty two percent of children were on monotherapy whereas 65% required combined treatment. The therapy was adequate only in 58% of subjects. The lowest rate of efficacy was detected in patients requiring a combined antihypertensive therapy. Among antihypertensive drug classes calcium channel blockers were administered most frequently (in 73% of children, in 11/24 cases in monotherapy and in 43/48 patients in combination). Angiotensin converting enzyme inhibitors were most frequently administered in monotheraphy (50%). Nifedipine was preferred in acute blood pressure rise in children. Conclusion We conclude that incidence of hypertension in dialysed children in Poland is relatively high. The pattern of the treatment was quite uniform, although the efficacy was relatively low (58%)

Applying the time-lapse imaging technique for the studies of stem gravitropic kinetics in the changed gravimorphic conditions

White willow (Salix alba L.) dormant shoots were collected in March and cut into 30 cm segments. The basal ends were placed in containers with sand and kept in dispersed sunlight and the halogen light after dark. To induce the gravimorphic reaction the segments were oriented at the angle of 30 degrees with respect to horizontal line (stage I). After two weeks of culture the segments were turned at the angle of 150 degrees in such a way that the segments were in horizontal position and the newly formed lateral shoots were oriented according to the gravity vector (fig. 1). They were kept in such position for another 2 weeks (stage II). The growth kinetics of newly formed shoots was studied using time lapse technique. It was found that during stage I the most intensive development of lateral buds growth occurred on the upper side at apical part of the shoot segment. During stage II, the newly formed shoots started to reorient opposite to the gravity vector. The latateral shoots close to the apical end responded faster as compared to the shoots located at farther distances. The site of gravitropic response during 2−week−long experiment was moving and located always below apical part of the lateral shoot in the non−lignified zone. Microscopic observations of the newly formed lateral shoots revealed formation of secondary xylem typical for willow and in some regions the structure newly formed xylem was similar to that of tension wood. The possibility of application of 3D digital Image Correlation method for the studies of growth trajectory was tested in the preliminary experiment performed on the seedlings of Cucumis sativus (fig. 2). The preliminary results (fig. 3) indicate that the method could be applied also for the of growth trajectory of woody plants

Cognitive underpinnings of irony understanding in children.

We examined the relationship between irony interpretation and Theory of Mind measures (Strange Stories, Happé, 1994) and the Theory of Mind Inventory (ToMI, Hutchins et al., 2012), as well as working memory, set shifting and inhibitory control, whilst controlling for non-verbal IQ. We also examined different types of irony interpretation. All previous studies have used simple forms of irony, where the hearer can see from the real world context that the literal meaning cannot be true (see (1)). We included a complex irony condition, where the non-literal interpretation cannot be inferred from the visual context (see (2)). (1) Tom and Sally wanted to go for a picnic. It has just started to rain. Sally: It's a perfect day for a picnic. (2) Tom: I have been invited to a party by the most beautiful girl in my class. Sally: Yeah, and I have been invited to the Queen's party. We presented children (N=51; aged 6;01 - 9;01) with 5 videos, in both simple and complex irony conditions. After each short dialogue as in (1) and (2), participants answered an open-ended question, then a forced-choice (out of three) question about the speakers meaning. Children selected above chance for simple irony (M = 76% correct) but significantly below chance for complex (M = 25% correct) irony. Regression analyses showed that when controlling for age, nonverbal IQ and formal language, ToM measures related to simple irony interpretation. There was no relationship found between the EF and ToM measures and complex irony interpretation

Diversity of needles structure of the selected Polish populations of Pinus sylvestris L. on the experimental plots in the Forest Experimental Station in Rogów

The anatomical and morphological diversity of Scots pine (Pinus sylvestris L.) needles was investigated in nine Polish populations grown on the experimental plots at the Forest Experimental Station of the Warsaw University of Life Sciences – SGGW (Rogów, Central Poland). The experiment started in 1966 and the needle samples were collected from the trees cut down during the thinning treatment in 2016. The following needle traits were measured: (1) length, (2) width, (3) thickness, (4) cross−sectional area of the transfusion tissue, (5) epidermis thickness, (6) width to thickness of the needle cross section ratio, (7) distance between the vascular bundles, (8) number of resin ducts, and (9) length of the needle scales. The results showed that trees from the provenances differ with respect to the studied needle features, however, the differences, for individual traits, are relatively small and in most cases are statistically insignificant as measured by the Kruskal−Wallis test. Statistically significant differences (p<0.05) were found only in case of such features as the number of resin ducts and the length of needle scales. The results may suggest that the environmental conditions of the Polish lowland are not sufficiently diversified to induce clear differences between the individual morphological and anatomical traits of pine needles. However, despite the relatively small differences between the studied populations regarding individual traits, the use of the UPGMA (Unweighted Pair Group Method with Arithmetic mean) dendrogram, taking into consideration the combined effect of all the examined traits of needles, allowed to separate geographically the tested Polish provenances into three groups: I – mid−western (Rogów, Bolewice, Spała, Karsko, Gubin, Tabórz), II – north−eastern (Rospuda, Starzyna) and III – south−eastern (Janów Lubelski). It is suggested that this may be related both to the ability of Scots pine to adapt to local conditions as well as the possibility that the geographical groups of tested populations originated from three different main glacial refugia