Wstep Nerki są organem szczegolnie narazonym na upośledzenie ich funkcji oraz wystepowanie powikl... more Wstep Nerki są organem szczegolnie narazonym na upośledzenie ich funkcji oraz wystepowanie powiklan w czasie leczenia i po zakonczonym leczeniu ostrej bialaczki limfoblastycznej (OBL), ktore w sposob istotny mogą wplywac na komfort i dlugośc zycia pacjentow. Cel pracy Celem pracy byla ocena wielkości i funkcji nerek u dzieci, oraz określenie czynnikow mających wplyw na wystepowanie nieprawidlowości w ich funkcjonowaniu po zakonczonym leczeniu OBL za pomocą wybranych badan klinicznych, biochemicznych i obrazowych. Material i metody Badaniami objeto grupe 48 dzieci, w tym 29 (60%) chlopcow i 19 (40%) dziewczynek, w wieku 79–275 miesiecy (średnia 159 miesiecy; SD 49 miesiecy), u ktorych w latach 1989–2001 ustalono rozpoznanie OBL. Wyniki i wnioski Wykazano, ze stosowany program chemioterapii i czas obserwacji dluzszy niz 5 lat po zakonczenia leczenia w sposob istotny wplywaly na obnizenie wartości GFR, wystepowanie blizn w nerkach oraz zmniejszenie objetości i dlugości nerek. Dlatego konieczne wydaje sie objecie okresową opieką nefrologiczną pacjentow po zakonczeniu leczenia OBL.
The case of a 70-year-old female with asymptotic parathyroid cyst is presented. It was not possib... more The case of a 70-year-old female with asymptotic parathyroid cyst is presented. It was not possible to make a proper diagnosis preoperatively. The correct diagnosis was based on the result of the postoperative microscopic examination of the resected tissues. The diagnostic difficulties are discussed.
Pomeranian Medical University in Szczecin: a Students’ Scientific Circle in Department of Diagno ... more Pomeranian Medical University in Szczecin: a Students’ Scientific Circle in Department of Diagno stic Imaging and Interventional Radiology, Polish p rogram b Department of Diagnostic Imaging and Interventional R diology, Autonomous Public Clinical Hospital No. 1 c Department of Diagnostic Imaging and Interventional R diology Pomorski Uniwersytet Medyczny w Szczecinie: a Studenckie Koło Naukowe przy Zakładzie Diagnostyki Obrazowej i Radiologii Interwencyjnej, dla studentó w polskojęzycznych b Zakład Diagnostyki Obrazowej i Radiologii Interwenc yjnej, Samodzielny Publiczny Szpital Kliniczny Nr 1 d Zakład Diagnostyki Obrazowej i Radiologii Interwen cyjnej
The presence of a tumour, poor general condition, features of anaemia, increased erythrocyte sedi... more The presence of a tumour, poor general condition, features of anaemia, increased erythrocyte sedimentation rates and imaging suggesting malignancy were the common features in 4 different tumour-like abdominal conditions that are extremely rare in childhood. These conditions included: extensive retroperitoneal tumour with rib involvement that turned out to be an inflammatory lesion caused by Actinomyces in a 12-year-old girl; multi-loculated tumour of the mesentery/ovary caused by mesenteric lymphadenopathy in the course of a Salmonella enteritidis infection in a 2.5-year-old girl; tumour of the VII - VIII hepatic segments that turned out to be the focus of granuloma in the course of lambliasis in a 5.5-year-old boy with a history of purulent neck lymphadenopathy and a final suspicion of immunocompromise; and a multi-loculated tumour of the small pelvis and inguinal area that turned out to be an abscess of the iliopsoas muscle in a 16-year-old boy. Apart from the imaging, the lesions required cytological examination of the material harvested by fine-needle biopsies (liver tumour) or histopathological investigations (retroperitoneal tumour, mesenteric/ovarian tumour, liver tumour and--on second surgery--the pelvic tumour) and/or bacteriological examination (all cases), serological examination (liver tumour and mesenteric/ovarian tumour), protozoal investigation (liver tumour), and measurement of AFP levels (mesenteric/ovarian tumour). Surgical treatment (retroperitoneal tumour, mesenteric/ovarian tumour and tumour of the small pelvis) and guided antibiotic therapy (all cases including 15 weeks of antibiotics in the first case) allowed complete recovery in 3 patients (actinomycosis, mesenteric lymphadenopathy, abscess of the iliopsoas muscle). Antibiotic and antiprotozoal therapy cured the granulomatous hepatitis; however this patient tended to develop severe right-sided pleural/pulmonary changes (the child was referred for further diagnosis with suspicion of immunocompromise).
Background: To determine whether the use of hydrophilic guidewires has increased the technical su... more Background: To determine whether the use of hydrophilic guidewires has increased the technical success rate of peripheral percutaneous transluminal angioplasty (PTA). Material/methods: We performed 125 procedures and analyzed the technical success rates of PTA using the conventional guidewire first and then if needed, the hydrophilic guidewire for iliac and SFA stenoses or occlusions. Angioplasty was performed on 25 stenosed, 25 occluded iliac arteries and 25 stenosed, 50 occluded femoral arteries. The result was defined as technical success when the lesion was crossed by a guidewire and balloon, then it was dilated with restoration of vessel lumen and less than 30% residual stenosis and the rise in ABI values was at least 0.15 after 24 hours. Results: The technical success rate after PTA of stenosed iliac arteries was achieved in 96% (24/25) using conventional wires and 100% using hydrophilic guidewire; in iliac occlusions, the rates were 60% (15/25) and 96%, respectively; in femoral stenosis - 84% (21/25) and 100%; in occlusions in the first group: lesions <10 cm -64% (16/25) and 96%, in the second group: lesions >10 cm -48% (12/25) and 88%. In the iliac group, there was no significant difference in the success of iliac stenosis PTA. However, there were significant changes in the success rates of PTA performed for SFA stenosis and iliac and SFA occlusions. Conclusions: In summary, we report an overall improvement and high technical success rate for peripherial PTA. The use of hydrophilic guidewires made significant difference to the technical success rate of PTA, especially in occlusion and more complicated lesions.
The aim of this study was to examine the correlation between age and clinical course of spontaneo... more The aim of this study was to examine the correlation between age and clinical course of spontaneous intracerebral haemorrhage (SICH) in its acute phase (within 30 days), including severity of neurological deficit, characteristics and frequency of medical complications as well as 30-day mortality. We also attempted to determine independent predictors of early mortality. This study comprised 153 patients with SICH admitted within 24 hours after SICH onset who were treated pharmacologically and had complete clinical data. The analysis concerned the correlation between age and neurological deficit on admission and on discharge, assessed with NIHSS score; the types and the frequency of general complications that occurred in the acute phase of SICH; characteristics of head CT images; early mortality; and survival time. Multiple logistic regression analysis was used to determine independent predictors of early mortality. Age of patients correlated with NIHSS score on admission (p = 0.000003) and on discharge (p = 0.02); 35.2% of patients developed medical complications, presumably infectious ones, and the age of patients who developed complications was significantly higher (p = 0.004). Patients who died (21.5%) were significantly older (p = 0.0001). Predictors of death were: age (OR 1.1, 95% CI 1.02-1.19, p = 0.002) and severity of neurological deficit on admission (OR 1.3, 95% CI 1.1-1.6, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). In elderly patients with SICH, the neurological deficit and risk of medical complications are more evident. Greater neurological deficit in these patients may result from coincidence of SICH with earlier brain lesions. Age and greater neurological deficit on admission constitute predictors of early mortality in elderly patients with SICH.
Wstep Nerki są organem szczegolnie narazonym na upośledzenie ich funkcji oraz wystepowanie powikl... more Wstep Nerki są organem szczegolnie narazonym na upośledzenie ich funkcji oraz wystepowanie powiklan w czasie leczenia i po zakonczonym leczeniu ostrej bialaczki limfoblastycznej (OBL), ktore w sposob istotny mogą wplywac na komfort i dlugośc zycia pacjentow. Cel pracy Celem pracy byla ocena wielkości i funkcji nerek u dzieci, oraz określenie czynnikow mających wplyw na wystepowanie nieprawidlowości w ich funkcjonowaniu po zakonczonym leczeniu OBL za pomocą wybranych badan klinicznych, biochemicznych i obrazowych. Material i metody Badaniami objeto grupe 48 dzieci, w tym 29 (60%) chlopcow i 19 (40%) dziewczynek, w wieku 79–275 miesiecy (średnia 159 miesiecy; SD 49 miesiecy), u ktorych w latach 1989–2001 ustalono rozpoznanie OBL. Wyniki i wnioski Wykazano, ze stosowany program chemioterapii i czas obserwacji dluzszy niz 5 lat po zakonczenia leczenia w sposob istotny wplywaly na obnizenie wartości GFR, wystepowanie blizn w nerkach oraz zmniejszenie objetości i dlugości nerek. Dlatego konieczne wydaje sie objecie okresową opieką nefrologiczną pacjentow po zakonczeniu leczenia OBL.
The case of a 70-year-old female with asymptotic parathyroid cyst is presented. It was not possib... more The case of a 70-year-old female with asymptotic parathyroid cyst is presented. It was not possible to make a proper diagnosis preoperatively. The correct diagnosis was based on the result of the postoperative microscopic examination of the resected tissues. The diagnostic difficulties are discussed.
Pomeranian Medical University in Szczecin: a Students’ Scientific Circle in Department of Diagno ... more Pomeranian Medical University in Szczecin: a Students’ Scientific Circle in Department of Diagno stic Imaging and Interventional Radiology, Polish p rogram b Department of Diagnostic Imaging and Interventional R diology, Autonomous Public Clinical Hospital No. 1 c Department of Diagnostic Imaging and Interventional R diology Pomorski Uniwersytet Medyczny w Szczecinie: a Studenckie Koło Naukowe przy Zakładzie Diagnostyki Obrazowej i Radiologii Interwencyjnej, dla studentó w polskojęzycznych b Zakład Diagnostyki Obrazowej i Radiologii Interwenc yjnej, Samodzielny Publiczny Szpital Kliniczny Nr 1 d Zakład Diagnostyki Obrazowej i Radiologii Interwen cyjnej
The presence of a tumour, poor general condition, features of anaemia, increased erythrocyte sedi... more The presence of a tumour, poor general condition, features of anaemia, increased erythrocyte sedimentation rates and imaging suggesting malignancy were the common features in 4 different tumour-like abdominal conditions that are extremely rare in childhood. These conditions included: extensive retroperitoneal tumour with rib involvement that turned out to be an inflammatory lesion caused by Actinomyces in a 12-year-old girl; multi-loculated tumour of the mesentery/ovary caused by mesenteric lymphadenopathy in the course of a Salmonella enteritidis infection in a 2.5-year-old girl; tumour of the VII - VIII hepatic segments that turned out to be the focus of granuloma in the course of lambliasis in a 5.5-year-old boy with a history of purulent neck lymphadenopathy and a final suspicion of immunocompromise; and a multi-loculated tumour of the small pelvis and inguinal area that turned out to be an abscess of the iliopsoas muscle in a 16-year-old boy. Apart from the imaging, the lesions required cytological examination of the material harvested by fine-needle biopsies (liver tumour) or histopathological investigations (retroperitoneal tumour, mesenteric/ovarian tumour, liver tumour and--on second surgery--the pelvic tumour) and/or bacteriological examination (all cases), serological examination (liver tumour and mesenteric/ovarian tumour), protozoal investigation (liver tumour), and measurement of AFP levels (mesenteric/ovarian tumour). Surgical treatment (retroperitoneal tumour, mesenteric/ovarian tumour and tumour of the small pelvis) and guided antibiotic therapy (all cases including 15 weeks of antibiotics in the first case) allowed complete recovery in 3 patients (actinomycosis, mesenteric lymphadenopathy, abscess of the iliopsoas muscle). Antibiotic and antiprotozoal therapy cured the granulomatous hepatitis; however this patient tended to develop severe right-sided pleural/pulmonary changes (the child was referred for further diagnosis with suspicion of immunocompromise).
Background: To determine whether the use of hydrophilic guidewires has increased the technical su... more Background: To determine whether the use of hydrophilic guidewires has increased the technical success rate of peripheral percutaneous transluminal angioplasty (PTA). Material/methods: We performed 125 procedures and analyzed the technical success rates of PTA using the conventional guidewire first and then if needed, the hydrophilic guidewire for iliac and SFA stenoses or occlusions. Angioplasty was performed on 25 stenosed, 25 occluded iliac arteries and 25 stenosed, 50 occluded femoral arteries. The result was defined as technical success when the lesion was crossed by a guidewire and balloon, then it was dilated with restoration of vessel lumen and less than 30% residual stenosis and the rise in ABI values was at least 0.15 after 24 hours. Results: The technical success rate after PTA of stenosed iliac arteries was achieved in 96% (24/25) using conventional wires and 100% using hydrophilic guidewire; in iliac occlusions, the rates were 60% (15/25) and 96%, respectively; in femoral stenosis - 84% (21/25) and 100%; in occlusions in the first group: lesions <10 cm -64% (16/25) and 96%, in the second group: lesions >10 cm -48% (12/25) and 88%. In the iliac group, there was no significant difference in the success of iliac stenosis PTA. However, there were significant changes in the success rates of PTA performed for SFA stenosis and iliac and SFA occlusions. Conclusions: In summary, we report an overall improvement and high technical success rate for peripherial PTA. The use of hydrophilic guidewires made significant difference to the technical success rate of PTA, especially in occlusion and more complicated lesions.
The aim of this study was to examine the correlation between age and clinical course of spontaneo... more The aim of this study was to examine the correlation between age and clinical course of spontaneous intracerebral haemorrhage (SICH) in its acute phase (within 30 days), including severity of neurological deficit, characteristics and frequency of medical complications as well as 30-day mortality. We also attempted to determine independent predictors of early mortality. This study comprised 153 patients with SICH admitted within 24 hours after SICH onset who were treated pharmacologically and had complete clinical data. The analysis concerned the correlation between age and neurological deficit on admission and on discharge, assessed with NIHSS score; the types and the frequency of general complications that occurred in the acute phase of SICH; characteristics of head CT images; early mortality; and survival time. Multiple logistic regression analysis was used to determine independent predictors of early mortality. Age of patients correlated with NIHSS score on admission (p = 0.000003) and on discharge (p = 0.02); 35.2% of patients developed medical complications, presumably infectious ones, and the age of patients who developed complications was significantly higher (p = 0.004). Patients who died (21.5%) were significantly older (p = 0.0001). Predictors of death were: age (OR 1.1, 95% CI 1.02-1.19, p = 0.002) and severity of neurological deficit on admission (OR 1.3, 95% CI 1.1-1.6, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). In elderly patients with SICH, the neurological deficit and risk of medical complications are more evident. Greater neurological deficit in these patients may result from coincidence of SICH with earlier brain lesions. Age and greater neurological deficit on admission constitute predictors of early mortality in elderly patients with SICH.
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