Wysoko czułe białko C-reaktywne w moczu pacjentów z pęcherzem neurogennym po operacji przepukliny oponowo-rdzeniowej

Introduction. Neurogenic bladder (NB) is specific condition caused by disturbed bladder innervation and the most often complication of meningomyelocele (MMC). It is known that incorrect bladder function causes renal damage. Condition of  NB is worsened by urinary tract infections, detrusor overactivity, dysfunctional voiding and/or irregular catheterization. hs-CRP plays an important role in inflammatory process and can predict kidney function. The aim of this study was the estimation of urinary hs-CRP level in association with neurogenic bladder function based on urodynamics and renal function based on eGFR in MMC patients with various activity states and with different levels of lesion.Material and methods. 33 children and adolescents with urodynamically  confirmed neurogenic bladder and 20 healthy individuals were enrolled into the study. Patients were divided according to Hoffer’s scale and level of lesion. Urinary hs-CRP were evaluated in all individuals using ELISA methods. Urinary hs-CRP results were adjusted to the creatinine and expressed as hs-CRP/creatinine ratio. Nonparametric tests were used for statistical analysis.Results. When compared to the reference group, MMC patients showed increased urinary hs-CRP. There were no differences in the studied parameter between boys and girls, non- and catheterized, and with different urodynamic diagnosed children. We found positive correlations between Hoffer’s scale assessing physical activity and level of lesion and between GFR and urinary hs-CRP/crea.Conclusion. Urinary hs-CRP level is elevated in MMC patients compared to reference group and could be considered as a very early marker of glomerular hyperfiltration.Wstęp. Pęcherz neurogenny jest to specyficzny stan spowodowany zaburzonym unerwieniem pęcherza i jest jednym z najczęstszych powikłań przepukliny oponowo rdzeniowej. Znany jest fakt uszkodzenia funkcji nerek w następstwie pęcherza neurogennego. Czynność pęcherza neurogennego pogarszana jest poprzez zakażenia układu moczowego, nadczynność wypieracza, dysfunkcyjną mikcję i/lub nieregularne cewnikowanie. Wysoko czułe białko C-reaktywne (hs-CRP) odgrywa istotną rolę w procesach zapalnych, jak również może być czynnikiem predykcyjnym funkcji nerek. Celem pracy była ocena hsCRP w moczu w powiązaniu z czynnością pęcherza neurogennego ocenianą w badaniu urodynamicznym oraz funkcją nerek w oparciu o GFR u pacjentów z przepuklina oponowo-rdzeniową w zależności  od aktywności fizycznej i poziomu uszkodzenia.Materiał i metody. Do badania włączono 33 dzieci z potwierdzonym pęcherzem neurogennym i 20 zdrowych  jako grupę referencyjną. Pacjenci zostali podzieleni zgodnie z poziomem uszkodzenia i ze skalą aktywności fizycznej Hoffera. Stężenie hs-CRP w moczu oceniono metodą ELISA u wszystkich uczestników badania. Stężenie hs-CRP odniesiono do stężenia kreatyniny i przestawiono jako wskaźnik hs-CRP/kreatynina. Do analizy statystycznej użyto testów nieparametrycznych.Wyniki. U pacjentów z przepukliną oponowo-rdze-niową wykazano podwyższony hs-CRP w moczu w porów-naniu do grupy kontrolnej. Nie było różnic w badanych parametrach pomiędzy chłopcami i dziewczynkami, pacjentami cewnikowanymi i nie cewnikowanymi, i po-między pacjentami z różnymi rozpoznaniami urody-namicznymi. Wykazano pozytywne korelacje pomiędzy GFR i wskaźnikiem hsCRP/kreatynina a skalą Hoffera oceniającą aktywność fizyczną i poziomem uszkodzenia.Wniosek. Stężenie hs-CRP w moczu jest pod-wyższone u pacjentów z pęcherzem neurogennym po przepuklinie oponowo rdzeniowej w porównaniu do dzieci zdrowych i może być rozważany jako wczesny marker hyperfiltracji

Normative data on the Bonn Risk Index for calcium oxalate crystallization in healthy children

Bonn Risk Index (BRI) is being used for the assessment of urinary calcium oxalate (CaOx) crystallization. There are no published data regarding BRI during growth. The objective of this study was to establish age- and sex-dependent BRI values in healthy children and adolescents. A total of 1,050 Caucasian subjects aged 3–18 years (525 males, 525 females) without a history of kidney stone disease were enrolled in the cross-sectional study. The study group was divided into 15 ranges according to age, each comprising 70 subjects. Urinary ionized calcium [Ca(2+)] was measured using a selective electrode while the onset of spontaneous crystallization was determined using a photometer and titrating with 40 mmol/L ammonium oxalate (Ox(2−)). The calculation of BRI value was based on the ratio of [Ca(2+)] to the required amount of ammonium oxalate added to 200 ml of urine to induce crystallization. The median BRI was 0.26 1/L and the values of the 5th and 95th percentiles were 0.06 1/L and 1.93 1/L, respectively. BRI correlated positively with body-area-related BRI (1/L × 1.73 m(2)) (R = 0.18; P < 0.05), whereas a negative correlation was found between BRI and body weight (1/L × kg) (R = −0.85; P < 0.05). Neither sex nor age differences were detected in BRI across studied children and adolescents. The values of Bonn Risk Index were constant during growth and there was a limited influence of age and sex on BRI in children over 3 years of age. The BRI may be valuable in the evaluation of pediatric patients at risk for kidney stones, particularly if the BRI from stone formers is demonstrated to be higher than in normal children

The role of selected parental and perinatal factors in the future mobility of children with myelomeningocele

Background. Myelomenigocele (MMC) is the most severe form of spina bifida, caused by genetic and environmental components; it has many serious complications in a patient’s future life, where dysfunctional mobility is one of the most troublesome. Objectives. The aim of our study was to explore the role of selected factors: parental and perinatal in children with myelomenigocele and correlate them with their future motor function. Material and methods. This retrospective analysis was based on 95 births that occurred from 1985 to 2013. Clinical data were collected using medical records and supplemented by a questionnaire for parents. Standard deviation of WHO scores (Z-scores) for weight, length, and body mass index (BMI) at birth were calculated. Hoffer’s scale was used to assess MMC children’s motor function. Results . There were no statistically significant differences between 53 girls and 42 boys who were enrolled in the study, excluding the month of conception. The tested parameters did not vary substantially according to maternal age. Maternal age correlated positively with paternal age at conception, birth order, and stillbirth rate. Mode of delivery was strongly associated with Apgar scale and birth weight. Apgar score, birth length, and thus WHO Z-score for length-for-age had positive correlations with future mobility of MMC children. Conclusions . 1. Perinatal factors have a significant effect on children’s physical activity. 2. There is no clinical evidence that cesarean section improves early neurological outcome of MMC infants. 3. Parental factors, particularly maternal age, do not determine the future mobility of children with myelomeningocele

The role of selected parental and perinatal factors in the future mobility of children with myelomeningocele

Background. Myelomenigocele (MMC) is the most severe form of spina bifida, caused by genetic and environmental components; it has many serious complications in a patient’s future life, where dysfunctional mobility is one of the most troublesome. Objectives. The aim of our study was to explore the role of selected factors: parental and perinatal in children with myelomenigocele and correlate them with their future motor function. Material and methods. This retrospective analysis was based on 95 births that occurred from 1985 to 2013. Clinical data were collected using medical records and supplemented by a questionnaire for parents. Standard deviation of WHO scores (Z-scores) for weight, length, and body mass index (BMI) at birth were calculated. Hoffer’s scale was used to assess MMC children’s motor function. Results . There were no statistically significant differences between 53 girls and 42 boys who were enrolled in the study, excluding the month of conception. The tested parameters did not vary substantially according to maternal age. Maternal age correlated positively with paternal age at conception, birth order, and stillbirth rate. Mode of delivery was strongly associated with Apgar scale and birth weight. Apgar score, birth length, and thus WHO Z-score for length-for-age had positive correlations with future mobility of MMC children. Conclusions . 1. Perinatal factors have a significant effect on children’s physical activity. 2. There is no clinical evidence that cesarean section improves early neurological outcome of MMC infants. 3. Parental factors, particularly maternal age, do not determine the future mobility of children with myelomeningocele

Glutathione reductase activity correlates with concentration of extracellular matrix degradation products in synovial fluid from patients with joint diseases

The mechanisms underlying cartilage matrix degradation in joint diseases is not fully understood but reactive oxygen species are implicated as main causative factors. Comparative studies of glutathione reductase (GR) activity in synovial fluid from patients with rheumatoid arthritis (RA), reactive arthritis (ReA) and osteoarthritis (OA) as well as correlations between GR activity and concentration of the major cartilage components in synovial fluid are presented in this study. We found significantly higher activity of GR in RA (about three-fold) and ReA (about two-fold) than in OA. In RA and ReA patients, GR activity in synovial fluid correlates negatively with the concentrations of collagen and degradation products of sulfated glycosaminoglycans. In OA patients the activity of GR was significantly lower than in RA and ReA, which positively correlated with the concentration of collagen and showed a tendency for positive correlation with the degradation products of sulfated glycosaminoglycans. Our results suggest that in RA and ReA patients increased activity of GR does not prevent the increased degradation of collagen and proteoglycans by ROS

Urinary risk factors for calcium oxalate urolithiasis in children with monosymptomatic enuresis

Introduction: A disturbed calcium-phosphate balance is an important issue for kidney stone formation in nephrolithiasis. Hypercalciuria (HC) has been proposed as an essential etiology of monosymptomatic nocturnal enuresis (MNE). Objectives: We may suspect that patients with MNE may be at risk of stone formation hence the objective of this paper was to assess the risk in MNE children using Bonn Risk Index (BRI). Patients and Methods: The urinary work-up of 204 children (83 with MNE and 121 controls) included urinary calcium (Ca), magnesium (Mg) and sodium (Na) excretion, Ca/creatinine ratio, BRI, ionized calcium (Ca2+), Mg/creatinine and Ca/citrate ratios, urinary citrates and oxalates (Ox). Results: Ca/creatinine and Mg/creat ratios were higher in the MNE group. There were no differences in Mg and Ca amount in urine and Mg/Ca ratio between MNE and the reference group. Both groups differed in Mg and Ca excretion per kg of body mass. MNE children differed from controls regarding BRI, Ox and urinary Ca2+. No differences in urinary citrate excretion nor Ca/citrate ratio between MNE and the controls were found. Correlations between factors important in the crystallization process in MNE children were recorded. Conclusion: MNE patients may be at risk of oxalate nephrolithiasis. Further studies to assess the role of the BRI and Ca/citrate ratio in predicting stone formation in MNE children are needed

Semiconductor nitride light sources: 2014 Nobel prize in physics to Isamu Akasaki, Hiroshi Amano and Shuji Nakamura

Podstawy fizyczne działania półprzewodnikowych przyrządów emitujących światło, tzn. diod laserowych i elektroluminescencyjnych zostały omówione w zwięzły sposób. Historyczny rozwój badań nad zastosowaniem półprzewodnikowych źródeł światła, w tym źródeł światła czerwonego został zarysowany. Trudności i rozwój półprzewodnikowych źródeł światła w ostatnim półwieczu został omówiony. Przełomowy wkład Isamu Aksaki, Hiroshi Amano i Shuji Nakamuro w rozwój badan i technologii diod opartych o azotki metali grupy III, który doprowadził do powstania źródeł światła niebieskiego, zielonego i fioletowego w latach 90. XX w., i został uhonorowany Nagrodą Nobla z fizyki w 2014 r., został szczegółowo opisany. Dalszy rozwój dziedziny do chwili obecnej i jej perspektywy zostały zarysowane. Rola polskich ośrodków naukowych w tej dziedzinie, znacząca w skali światowej, została również lakonicznie omówiona.Physical foundations of semiconductor light emitting devices, i.e. laser diodes (LDs) and light emitting diodes (LEDs), and history of studies concerning application of semiconductor light sources, including sources of red light, are shortly outlined. The seminal contributions of Isamu Akasaki, Hiroshi Amano and Shuji Nakamura to the investigations and applications of the group III metal nitrides that led to emergence of blue, green and violet light sources in the last decade of XX century, honored by 2014 Nobel Prize in Physics, are presented in detail. Further developments in this area up to the present day and future perspectives, including the important role played therein by Polish research institutions, are also sketched

Localization Effects in InGaN/GaN Double Heterostructure Laser Diode Structures Grown on Bulk GaN Crystals.

International audienceWe demonstrate a double heterostructure (DH) nitride laser diode (LD) with an untypically wide 9.5 nm InGaN active region instead of the commonly used narrow InGaN quantum wells. Structures were grown on bulk GaN, which ensures low dislocation densities and therefore low concentrations of nonradiative recombination centers. The efficient screening of polarization induced electric fields in the structures under investigation, which contained heavily (1×1019 cm-3) Si doped barriers, was demonstrated by means of hydrostatic pressure dependent photoluminescence measurements on a simplified sample with identical active region. Since the detrimental separation of carriers by electric fields becomes more pronounced for wider InGaN active regions, efficient screening of polarization induced electric fields is essential for the investigated heterostructures. Optical and electrical parameters of this LD were comparable to those of comparable devices with typical QWs of ~4 nm as active region. We observed a high thermal stability of the photoluminescence intensity and, via time-resolved photoluminescence, a relatively temperature-independent radiative decay time. These observations support the significance of carrier localization phenomena for the radiative recombination processes of the investigated structure. The implications of these results for DH LD structures are discussed