Evaluation of the activity and medical nutrition therapy types used by nutrition support teams in hospitals in the Greater Poland voivodeship.

INTRODUCTION: Nutrition therapy is medical treatment that includes assessment of patients' nutritional status, their nutrient requirements, supply of nutritional products in appropriate quantities, and monitoring all of these processes. The nutrition support team is responsible for the organization of the nutrition therapy. AIM: To evaluate the activity of nutrition support teams in hospitals in the Greater Poland voivodeship. MATERIAL AND METHODS: An evaluation of nutrition support teams' activity and the types of nutrition therapy used in hospitals in the Greater Poland voivodeship was made. In order to collect all the necessary data, a questionnaire with closed-ended questions was sent to all hospitals registered in the voivodeship. RESULTS: Out of 25 hospitals that returned the completed questionnaire, 15 (60.0%) confirmed the presence of a nutrition support team in their structures. In previous reports it was 17 centres (68.0%) that had such team, but sometimes the team was not working to its full extent. 73.0% of hospitals were satisfied with both the presence of the team and its activity concerning proper fulfilment of entrusted tasks. The activity of nutrition support teams in the Greater Poland voivodeship correlated closely with the size of the hospital. CONCLUSIONS: Nutrition support teams function in the majority of hospitals in the Greater Poland voivodeship. Nutrition teams are more common in larger hospitals. In order to provide proper medical nutrition therapy, the legal obligation to appoint nutrition support teams in the hospitals should be restored.

Isolated endobronchial juvenile xanthogranuloma: a case report.

Juvenile xanthogranuloma (JXG) is a rare non-Langerhans cell tumour usually diagnosed during infancy. The lesion is typically located in the skin; however, extracutaneous lesions have been described. The symptoms vary depending on the location and size of the lesion. Presented here is a case of 13-year-old girl with this type of tumour located within the bronchus. She reported chest discomfort, difficulty breathing, and cough. A month prior to admission she had suffered from a respiratory tract infection. Prolonged surgical treatment was required due to the tumour's atypical location and recurrence of the tumour following initial resection. Isolated pulmonary JXG is an extremely rare finding, which requires accurate diagnosis and careful planning of therapeutic treatment. Severe pulmonary symptoms, inconclusive histopathological examination, malignancy risk, and large tumour size are indications for radical surgical resection of the tumour. Non-surgical treatment with chemotherapy is useful in cases of inoperable tumours.

Vaginoscopic Resection for Vaginal Rhabdomyosarcoma during Early Infancy: A Case Report.

Embryonal rhabdomyosarcoma, a malignant soft tissue neoplasm, is 1 of the most common pediatric tumors of the vagina. Although radical surgery has been replaced with radiation therapy, chemotherapy, and conservative surgery, the use of vaginoscopy is still uncommon. We present the case of an infant who underwent vaginoscopic resection because of botryoid sarcoma at 9 months of age.

Are there any factors influencing the course of multistage treatment in Hirschsprung's disease?

INTRODUCTION: Surgical treatment of Hirschsprung's disease may be performed in a single step, or in stages with a temporary stoma. The therapy depends on the clinical condition of the patient and the severity of symptoms. Planned multistage treatment is carried out in two or three steps. AIM: To analyse our 15 years of experience with multistage surgery for the treatment of Hirschsprung's disease, to identify multistage-related factors influencing the course of surgery and hospitalisation, and to evaluate the probability of complications during multistage treatment. MATERIAL AND METHODS: The study material was collected on the basis of documentation of patients treated during the years 2000 to 2014. The parameters concerning surgery and hospitalisation were statistically analysed. RESULTS: Twenty nine patients were treated with multistage surgery using the following methods: Duhamel-Martin and Transanal Endorectal Pull-Through (TEPT). There were significant correlations (p < 0.05) between length of resected intestine and operative time. Classification and Regression Tree (CRT) was used to classify the operated children depending on the presentence of complications after surgery. CONCLUSIONS: The incidence of complications during multistage treatment for both methods was comparable. It is difficult to objectively compare the Duhamel-Martin and TEPT techniques because of the different indicators for their use in multistage surgery. Intestinal adhesions were the most common complication after definitive surgery. Younger age of the operated patients was associated with greater risk of adhesion formation.

A 15-Year Experience with the One-Stage Surgery for Treatment of Hirschsprung's Disease in Newborns, Infants, and Young Children.

The treatment of Hirschsprung's disease has changed over the past several years. Significant modifications occurred after the implementation of surgery without laparotomy, using transanal access. The type of this surgery depends on the condition and the age of a child. The aim of the study was to summarize our 15-year experience with one-stage surgery for the treatment of Hirschsprung's disease in the wider context of current clinical practice and to identify transanal endorectal pull-through-related factors influencing the surgery and hospitalization. The retrospective analysis of newborns, infants, and young children was performed between 2000 and 2014. Four girls and 29 boys were operated on. The parameters describing the surgery and the hospitalization were analyzed. The number of patients treated using transanal endorectal pull-through technique was 30, and Duhamel-Martin, 3. There were significant correlations (p < 0.05) between necessity of blood transfusion, length of resected intestine, operative time, the number of intraoperative histopathological assessments, and length of hospitalization. The time of one-step surgery is extended because of waiting for repeated intraoperative histopathological assessment of the level of resection. More extended bowel resection is connected with longer length of hospitalization and, more often, necessity of blood transfusion.