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Niemirska A.,The Childrens Memorial Health Institute
Hypertension | Year: 2013

Primary hypertension is associated with disturbed activity of the sympathetic nervous system and altered blood pressure rhythmicity. We analyzed changes in cardiovascular rhythmicity and its relation with target organ damage during 12 months of antihypertensive treatment in 50 boys with hypertension (median, 15.0 years). The following parameters were obtained before and after 12 months of antihypertensive treatment: 24-hour ambulatory blood pressure, left ventricular mass, carotid intima-media thickness, and MRI for visceral and subcutaneous adipose tissue. Amplitudes and acrophases of mean arterial pressure and heart rate rhythms were obtained for 24-, 12-, and 8-hour periods. After 1 year of treatment, 68% of patients were normotensive, and left ventricular mass and carotid intima-media thickness decreased in 60% and 62% of patients, respectively. Blood pressure and heart rate rhythmicity patterns did not change. Changes in blood pressure amplitude correlated with the decrease of waist circumference (P=0.035). Moreover, the decrease of visceral fat correlated with the decrease of 24-hour mean arterial pressure and heart rate acrophases (both P<0.05). There were no differences in changes of blood pressure and heart rate rhythms between patients who achieved or did not achieve normotension and regression of left ventricular mass and carotid intima-media thickness. It was concluded that abnormal cardiovascular rhythmicity persists in children with primary hypertension despite effective antihypertensive treatment, which suggests that it may be the primary abnormality. The correlation between changes in cardiovascular rhythmicity and visceral obesity may indicate that the visceral fat plays an important role in the sympathetic activity of adolescents with hypertension. Source


Kolodziejczyk E.,The Childrens Memorial Health Institute
Pancreas | Year: 2016

OBJECTIVES: To evaluate the diagnostic accuracy of magnetic resonance cholangiopancreatography (MRCP) in the detection of chronic pancreatitis (CP)–specific changes in the pediatric population. METHODS: The study included 48 children with pancreatic disorders subjected to both endoscopic retrograde cholangiopancreatography (ERCP) and MRCP within a 1- to 4-month interval. The sensitivity, specificity, positive predictive value, and negative predictive value of MRCP in the detection of CP-specific changes were determined using ERCP as a diagnostic standard. RESULTS: Diagnostic ERCP pancreatograms were obtained in 41 (85.4%) of 48 patients and diagnostic MRCP images in all 48 children. The sensitivity and positive predictive value of MRCP were 77.1% and 90%, respectively, and its specificity and negative predictive value amounted to 50% and 27.3%, respectively. The patients with consistent results of MRCP and ERCP (ie, true-positive and true-negative cases) and individuals with incompatible results of the tests (ie, false-positive and false-negative cases) differed in terms of their median age at MRCP (14.17 vs 10.33 years) and median CP stage according to the Cambridge Scale (4 vs 2). CONCLUSIONS: Magnetic resonance cholangiopancreatography provides diagnostic information equivalent to ERCP in a large percentage of pediatric patients with CP and should be used as the imaging method of choice, especially if the likelihood of therapeutic intervention is low. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Source


Gurzkowska B.,The Childrens Memorial Health Institute
Medycyna wieku rozwojowego | Year: 2011

To demonstrate differences in nutritional status of school-aged children and adolescents depending on school localization (urban/rural), school level (elementary/middle) and gender. Results of current health survey 'Elaboration of the reference range of arterial blood pressure for the population of children and adolescents in Poland' - PL0080 OLAF were used in the analysis. Data were analysed by SAS. 9.2 for Windows, EpiInfo 3.5.1 and LMSgrowth. The frequency and the Odds Ratio of underweight, overweight, obesity and normal weight were calculated by school localization, school level and gender. Data from 13 129 pupils were used in the analysis: 5 118 from elementary schools in urban areas, 3638 from elementary schools in rural areas, 2792 from middle schools in urban areas and 1581 from middle schools in rural areas. The frequency of normal weight was lower in urban compared with rural elementary schools (67.2% vs 70.0%; OR=0.88; p=0.005). The frequency of underweight, overweight and obesity was higher in urban compared with rural elementary schools, both boys and girls. The frequency of obesity was higher in urban middle schools than rural (3.0% vs 1.6%; OR=1.88; p=0.006). In the case of boys, statistically significant difference in frequency of overweight and obesity (together) was noted in urban middle schools compared to rural middle schools (16.7% vs 11.9%; OR=1.48; p=0.003). In the case of girls, the frequency of underweight was lower in urban compared with rural middle schools (12.7% vs 15.9%; OR= 0.77; p=0.032). Knowing differences in the nutritional status between pupils in urban and rural areas gives the opportunity to modify nutritional education programmes depending on needs identified in the particular type of area and target groups. In urban regions, in both elementary and middle schools, boys are a risk group for excess body weight, and require more attention in preventive undertakings. In rural areas, girls in middle schools should be targeted for preventive measures dealing with underweight. Source


Grajda A.,The Childrens Memorial Health Institute
Medycyna wieku rozwojowego | Year: 2011

The aim of the study was to compare the prevalence of overweight, obesity, and underweight in children and adolescents from different provinces in Poland. Data from the recent, large, population-representative sample of school-aged children and adolescents (N=17573) OLAF study: "Elaboration of the reference range of arterial blood pressure for the population of children and adolescents in Poland" - PL0080 OLAF were used in the analysis. The survey was conducted in all provinces of Poland (N=16). Data were analyzed using SAS 9.2, EpiInfo 3.5.1 and LMSgrowth software packages. The frequency of overweight, obesity, and underweight were determined. For overweight and obesity (jointly) and underweight the odds ratio (OR) was calculated for gender and voivodship of residence. The body mass index (BMI) was standardized and expressed as a z-score. The statistical significance of differences between BMI z-scores depending on voivodship of residence was assessed by the t-test. Significant differences were found in the occurrence of overweight and obesity among the analysed regions, and voivodships with a lower (małopolskie, świetokrzyskie, lubelskie, and podkarpackie) and higher (mazowieckie) risk of overweight and obesity were identified. In case of underweight, łódzkie and podkarpackie (<0.040) provinces were higher risk areas, while mazowieckie (<0.001) had lower risk. The prevalence of overweight (including obesity) was higher compared to the prevalence of underweight in the majority of provinces (15 out of 16). Analysis of regional differences in the prevalence of obesity, overweight and underweight in children and adolescents may point to the direction in which nationwide and local efforts should be made to reduce the inequalities stemming from nutritional status. Source


Rychlik M.P.,International Institute of Molecular and Cell Biology | Chon H.,U.S. National Institutes of Health | Cerritelli S.M.,U.S. National Institutes of Health | Klimek P.,International Institute of Molecular and Cell Biology | And 3 more authors.
Molecular Cell | Year: 2010

Two classes of RNase H hydrolyze RNA of RNA/DNA hybrids. In contrast to RNase H1 that requires four ribonucleotides for cleavage, RNase H2 can nick duplex DNAs containing a single ribonucleotide, suggesting different in vivo substrates. We report here the crystal structures of a type 2 RNase H in complex with substrates containing a (5′)RNA-DNA(3′) junction. They revealed a unique mechanism of recognition and substrate-assisted cleavage. A conserved tyrosine residue distorts the nucleic acid at the junction, allowing the substrate to function in catalysis by participating in coordination of the active site metal ion. The biochemical and structural properties of RNase H2 explain the preference of the enzyme for junction substrates and establish the structural and mechanistic differences with RNase H1. Junction recognition is important for the removal of RNA embedded in DNA and may play an important role in DNA replication and repair. © 2010 Elsevier Inc. Source

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