Clinical factors affecting lower limb torsional deformities treatment with the Ilizarov method.

INTRODUCTION: One of the many uses of the Ilizarov fixator is for torsional deformities correction. Rotational and translational bone displacement related to torsional deformities correction includes the additional tension stresses, which affect the biology of the regenerated bone. Understanding the clinical factors will assist in designing the optimal treatment strategy, thus possibly improving the outcomes. PATIENTS AND METHODS: It was case series retrospective study. The study examined 56 patients. The mean follow-up time was 5 years and 6 months. The mean age at the start of treatment was 19 years and 10 months. Patients underwent derotational corticotomies of distal metaphysis of the femur or proximal metaphysis of the tibia using the Ilizarov method. In these patients, following derotational corticotomies with the Ilizarov method, numerous variables were defined and their effect evaluated: the selected treatment strategy, the rate, size, type, and level of derotation on complications, the alignment index, the correction coefficient, the elongation index, and deformation correction factor. RESULTS: The differences in the values of alignment index and deformation correction factor in this study subgroups were not statistically significant. We found differences in the elongation index and correction coefficient in a number of subgroups. DISCUSSION: In the case of correcting torsional deformation without significant elongation, acute correction and with a value of >30° does not significantly affect the results. Treatment strategy, type and level of derotation had no major influence on torsional deformities treatment. LEVEL OF EVIDENCE: Case-control study III.

[The effect of one-year treatment with captopril on exercise tolerance and myocardial ischemia in patients with myocardial infarction ]. / Wplyw jednorocznego leczenia kaptoprylem na wydolnosc wysilkowa i niedokrwienie miesnia sercowego u chorych z zawalem serca.

The aim of the study was to assess the effect of 1-year captopril therapy initiated 1-4 days (mean: 21-24 h) after beginning of AMI on exercise performance and myocardial ischemia during cycle ergometer test. 93 pts with first documented Q-wave AMI, aged L 70 years were qualified for the study. 50 of the pts were randomly included to the captopril group, 43 to the control group. In both groups pts with inferior AMI (accordingly 66% and 72%) and normal LV function (EF > or = 40% in ECHO) were prevailed in the study. Captopril therapy was initiated with the dose of 3.125 mg, then every 8 hours the dose of 6.25 mg was administered in Ist and IInd day, 12.5 mg--in III day and 25 mg from IV day on. Exercise cycle ergometer tests (ExT) were performed in every pt at 14 day, and 1, 3, 6 and 12 months after AMI. The ExT began at 25 W of power and was increased at 2-minute intervals by 25 W until fatigue or other typical cause of termination of the test. In the captopril group duration of ExT lengthened significantly in comparison with initial test (on 14 day) after 3 (6.4 +/- 1.47 vs 5.3 +/- 1.54 min; p < 0.01), 6 (6.7 +/- 1.59 vs 5.3 +/- 1.54 min; p < 0.001) and 12 months (7.0 +/- 1.22 vs 5.3 +/- 1.54 min; p < 0.001). In the control group exercise time was longer after 6 and 12 months compared to initial examination (accordingly 6.4 +/- 1.43 and 6.5 +/- 1.26 vs 4.8 +/- 1.47 min; p < 0.001). However, the differences regarding this time between the captopril and control group were not significant on consecutive control stages. The final result of the test (positive, negative, doubtful) did not differ significantly in both groups on consecutive examination stages. Captopril administered during 1-year period after AMI slightly improved physical working capacity (accelerated the improvement) and had no effect on ischemia during estimated cycle ergometer test. These results may depend on inclusion to the study predominantly pts with normal LV function and interior MI.

[Palatine tonsil lymphoma in ENT department in Belchatów for the of 1987-1998]. / Chloniaki zlosliwe migdalka podniebiennego w materiale Oddzialu Laryngologicznego Szpitala Rejonowego w Belchatowie w latach 1987-1998 r.

The authors present 10 cases of malignant lymphomas of the head and neck hospitalized in ENT Department of Regional Hospital in Belchatów. The two cases of tonsil lymphomas were described in detail calling attention to diagnostic difficulties. The false result of aspiration biopsy caused prolongation of diagnostic procedure.