Accuracy of sonographic criteria in the decision for surgical treatment in infantile hypertrophic pyloric stenosis.

INTRODUCTION: Abdominal ultrasonography has replaced barium studies in establishing the diagnosis in difficult cases of infantile hypertrophic pyloric stenosis (IHPS). The aim of this retrospective study was to establish sonographic criteria of qualification for surgical treatment in children with IHPS. MATERIAL AND METHODS: Hundred and fifteen infants (98 boys and 17 girls) with suspected IHPS were treated between 2000 and 2009. Pyloric muscle thickness, pyloric diameter and pyloric length were measured in US scans in all patients. Results were compared with US results of 19 infants with negative diagnosis and 29 children of the reference group. RESULTS: Diagnosis of IHPS was confirmed by US examination in 96 children (83.5%). There were 86 boys in the group with male prevalence 8.6 : 1. The remaining 19 infants (16.5%) had a negative ultrasound. The mean PL (20.89 vs. 12.73), PMT (5.41 vs. 2.24), and PD (14.1 vs. 7.42) differed significantly between patients with and without pyloric stenosis (p < 0.0001). The mean PL (12.34), PMT (2.2), and PD (7.48) in the reference group did not differ statistically from values obtained in patients with negative IHPS diagnosis and were significantly lower than in children from the IHPS group (p < 0.0001). US imaging had a sensitivity of 98%, specificity of 100%, with a positive and negative predictive value of 100% and 90% respectively. CONCLUSIONS: This study confirmed that ultrasonography is the first choice of diagnostic method in an infant with suspected hypertrophic pyloric stenosis. In cases with an uncertain clinical diagnosis of IHPS the examination can be easily repeated.

A boy with severe craniodiaphyseal dysplasia and apparently normal mother.

We describe a boy and his mother affected with craniodiaphyseal dysplasia (CDD). The boy had a very severe form of the disease with extensive osteosclerosis already at birth. Facial diplegia, bilateral hearing loss and optic nerve atrophy were early, severe complications of the disease. At age 7 years progressive genu valgum and unusual epimetaphyseal radiographic appearances suggested hyperparathyroidism. This was confirmed by biochemical tests. Because of some facial similarity between the asymptomatic mother and the propositus, a limited skeletal survey of the mother was performed. It demonstrated cranial osteosclerosis and hyperostosis. It is possible that the mother has somatic mosaicism for a mutation of the genes causing CDD.

Left atrial approach to close the atrial septal defect type II in case of right lung agenesis with extreme dextroversion.

This paper presents a case of a rare combination of right lung agenesis and atrial septal defect type II (ASD II). Successful surgical repair of ASD II was performed at the age of six years with total circulatory arrest (TCA) and deep hypothermia, because of difficult approach. Computed tomography and intraoperative findings are described. From patho-embryological consideration, defects in the primitive respiratory apparatus in embryo stages were presumably responsible for agenesis of the lung. The patient was found to have a very short stump of the right pulmonary artery, but this malformation seems to be secondary.

[Pseudoatrophic macules as a additional skin sign of neurofibromatosis]. / Pseudozanikowe plamy jako dodatkowy objaw skórny nerwiakowlókniakowatosci.

Pseudoatrophic macules are the infrequently mentioned skin symptom of neurofibromatosis. It may be the important diagnostic sign, especially, when other symptoms are absent or puerlly expressed.

[Natural history of fetal/newborn ovarian cyst]. / Historia naturalna plodowych/noworodkowych torbieli jajnika.

OBJECTIVE: Fetal and neonatal ovarian cysts are detected freguently by ultrasonography. Prenatal ovarian cysts have a follicular or luteal origin. Their natural history is a spontaneous involution. Pre- and postnatal changes in the sonographic aspects allow to choose the appropriate therapeutical indications: conservative approach, surgery, or percutaneous aspiration. MATERIALALS AND METHODS: In retrospective review from 1992-2004 authors present 26 patients with ovarian cysts. RESULTS: Fifteen patients were diagnosed by prenatal ultrasonography carried out between 33 and 39 weeks of gestation. Postnatally 14 were observed only and their cysts regressed, 10 with cysts larger than 4 cm, had surgical exploration, 2 patients with cysts between 2 to 4 cm were candidates for percutaneous aspiration. CONCLUSION: 1. The conservative treatment and clinical observation using ultrasonography is recommended when the ovari cystic is 40 mm in diameter. 2. When the ovari cystic is bigger then 40 mm in diameter it is recommended to perform puncture and fluid aspiration from the cystis under ultrasonography control. 3. The surgical intervention was planned when the ovari cystis was heterogenous and has been growing for a few months.

[Contraceptive practices among students]. / Metody zapobiegania niepozadanej ciazy wsród studentów.

Research has shown that university students tend to have specific sexual behaviour. It is worth mentioning that not much attention has been paid to pregnancy prevention practices among medical students nor has any survey been conducted in this matter. The purpose of this survey was to ascertain the frequency of contraceptive usage among students at Medical University of Warsaw. Specially designed questionnaires were anonymously self-administered by 634 female and 354 male medical students. 52.2% of the female students and 67.2% of the male students were sexually active at the time. 43.4% of the survey participants used condoms, while 26.3% used oral contraception pill (OCP) as contraceptive methods. Only 0.5% of those participants used intrauterine device. The survey result indicates an apparent dichotomy between the male and female students in terms of (appropriate) choice of the following contraceptive methods: condom, OCP, withdrawal, basal body temperature and Billings' methods.

[Oral contraceptive practices among female medical students of the University of Warsaw]. / Stosowanie doustnych srodków antykoncepcy jnych wsród studentek Akademii Medycznej w Warszawie.

DESIGN: Apparently no researches have been conducted regarding oral contraceptive usage among female medical students in Poland. In the last ten years, all over the world, only five publications have dealt with this topic. OBJECTIVES: The purpose of the research reported in this article was to establish the types, choices and frequency of usage of oral contraceptive pills among female medical students of the University of Warsaw. MATERIAL AND METHODS: 634 female students responded to a specially designed questionnaire. RESULTS: Data collected indicated that, 52.2% of the students have been involved in sexual intercourse. 167 of them used Oral Contraceptive Pills (OCP). Two third survey participants used OCP following a doctors recommendations. CONCLUSIONS: 1.30.5% of the sexually active students used OCP. 2.31.9% of this group of students believed the use of OCP was the most effective of all the contraceptive methods. 3.65.0% of the respondents used OCP following a doctors recommendations. 22.7% of the survey participants used OCP in order to regulate their menstrual cycles. 4. The respondents who reported customary use of OCP cited the most frequently used OCP as: Cilest-28.0%, Mercilon-19.2% and Minulet-13.2%.