Laparoscopic Ovarian-Sparing Surgery for the Management of Benign Ovarian Lesions in Pediatric Patients: A Retrospective Analysis.

INTRODUCTION: Laparoscopic ovarian-sparing surgery (OSS) is safe and effective management approach for benign ovarian lesions in pediatric patients. This study evaluates the outcomes of females younger than 18 years who underwent the OSS procedure between December 2013 and November 2022 at a single institution. MATERIAL AND METHODS: We conducted a retrospective analysis of records from 82 females who underwent OSS for ovarian lesions. OSS was performed based on diagnostic imaging that suggested the benign nature of the lesion. RESULTS: Of the 82 patients studied, 78 had unilateral lesions and 4 had bilateral synchronous lesions. The mean age was 14 years. The majority (62 cases) of the surgeries were laparoscopic, with 20 requiring conversion to open surgery due to factors such as indistinguishable edges and large size of the lesion. We identified 8 cases of ovarian torsion. The surgical specimens revealed that 46 were ovarian teratomas, 2 were granulosa cell tumors, 15 were cystadenomas, and 23 were functional cysts. There were no intraoperative complications. Two recurrences were observed in patients who were initially treated for bilateral ovarian teratomas. One patient developed a pelvic abscess. Additionally, three patients had metachronous ovarian tumors during the follow-up period. In patients followed with ultrasound imaging, the viable ovary was visualized in 83.6% of the cases (61 out of 73). CONCLUSION: Our findings demonstrate the effectiveness of laparoscopic OSS in preserving ovarian function and providing clinical benefits in patients with benign ovarian lesions. We recommend regular follow-up with ultrasound to exclude metachronous lesions or recurrence. LEVEL OF EVIDENCE: III.

The Problem of Selecting the Parameters of the Numerical Model of the Heating Process with a Point Heat Source and Its Experimental Verification.

The paper presents an analysis of the problem of selecting the parameters of the model describing the heating process. Heating is treated as a part of the process of heat treatment of elements such as axles and shafts using a heat source in the form of an electric arc. For this purpose, an experimental stand was made and research was carried out to analyse the temperature in the control node. Cylindrical specimens with a constant cross-section made of medium carbon steel AISI 1045 were used as the test objects. A device using TIG technology was used as the heat source. Due to the heating of the element-its rotational movement-it was necessary to use a non-contact measuring device. The construction of the research stand is a representation of the developed industrial stand. In addition, calibrations of the non-contact measuring system were performed using a thermocouple system. Comparing the results obtained from the experiment and the numerical model showed a fairly high convergence of the adopted numerical parameters (the difference between the experiment and the numerical model did not exceed 6.5%). In addition, an analysis of the surface of the samples was performed for the occurrence of remelting by determining its roughness and waviness.

Algorithm for Determining Time Series of Phase Transformations in the Solid State Using Long-Short-Term Memory Neural Network.

In the numerical analysis of manufacturing processes of metal parts, many material properties depending on, for example, the temperature or stress state, must be taken into account. Often these data are dependent on the temperature changes over time. Strongly non-linear material property relationships are usually represented using diagrams. In numerical calculations, these diagrams are analyzed in order to take into account the coupling between the properties. An example of these types of material properties is the dependence of the kinetics of phase transformations in the solid state on the rate and history of temperature change. In literature, these data are visualized Continuous Heating Transformation (CHT) and Continuous Cooling Transformation (CCT) diagrams. Therefore, it can be concluded that time series analysis is important in numerical modeling. This analysis can also be performed using neural networks. This work presents a new approach to storing and analyzing the data contained in the discussed CCT diagrams. The application of Long-Short-Term Memory (LSTM) neural networks and their architecture to determine the correct values of phase fractions depending on the history of temperature change was analyzed. Moreover, an area of research was elements that determine what type of information should be stored by LSTM network coefficients, e.g., whether the network should store information about changes of single phase transformations, or whether it would be better to extract data from differences between several networks with similar architecture. The purpose of the studied network is strongly different from typical applications of artificial neural networks. The main goal of the network was to store information (even by overfitting the network) rather than some form of generalization that allows computation for unknown cases. Therefore, the authors primarily investigated in the ability of the layer-based LSTM network to store nonlinear time series data. The analyses presented in this paper are an extension of the issues presented in the paper entitled "Model of the Austenite Decomposition during Cooling of the Medium Carbon Steel Using LSTM Recurrent Neural Network".

Percutaneous Internal Ring Suturing (PIRS) - The Benefits of Laparoscopic Inguinal Hernia Repair.

INTRODUCTION: The laparoscopic inguinal hernia repair in children using the PIRS technique is a well-established method. However, there are still opinions that this method does not bring more benefits than open surgery. PURPOSE: The study aims to demonstrate the benefits of laparoscopic technique over conventional, open techniques. PATIENTS AND METHODS: We conducted a retrospective study that included children aged 0-18 treated using the PIRS technique in 2008-2016. The control group consisted of patients treated with the traditional, open method of inguinal hernia repair. A total of 276 children were qualified for laparoscopic surgery, and there were 274 patients in the control group. A full laparoscopic procedure was performed on 247 patients. Assessment of the pathology of the internal inguinal ring was done in all patients during the laparoscopic procedure. Intraoperatively 79 children had bilateral inguinal hernia diagnosed, 133 right-sided inguinal herniae, and 57 left-sided inguinal herniae. The occurrence of hernia was not confirmed in 7 children, whereas 53 patients had open contralateral patent processus vaginalis. In a case of contralateral patent processus vaginalis, the repair was performed using the PIRS method. RESULTS: The recurrence of the inguinal hernia was observed in 10 children in the laparoscopic group and in 5 cases in control group. The duration of the procedure was noted and compared to open inguinal hernia repair. There was a statistically shorter duration of the laparoscopic method. In the control group, there were 16 patients with a metachronous contralateral inguinal hernia. CONCLUSION: The laparoscopic inguinal hernia repair was associated with a better assessment of hernia pathology, shorter operative time, and lower risk of contralateral hernia repair.

Social Attitude to COVID-19 and Influenza Vaccinations after the Influenza Vaccination Season and between the Second and Third COVID-19 Wave in Poland, Lithuania, and Ukraine.

The SARS-CoV-2 pandemic affected the entire world and contributed to severe health and economic consequences. A safe and effective vaccine is a tool allowing the pandemic to be controlled. Hence, we aimed to conduct a survey on vaccinations against seasonal influenza and COVID-19 in Poland, Lithuania, and Ukraine. We also evaluated societal attitudes towards influenza and COVID-19 vaccinations. MATERIALS AND METHODS: We conducted the study between December 2020 and May 2021. At the time, the countries subject to the research were between the second and third waves of the COVID-19 pandemic. We used an anonymous and self-designed questionnaire comprised of eleven closed-ended questions and a short socio-demographic section. The questionnaire was administered by direct contact or mainly (due to the COVID-19 pandemic) by e-mail or Facebook. Finally, we included 2753 answers from Poland, 1852 from Ukraine, and 213 from Lithuania. RESULTS: Between 61% (Poland) and 72.9% (Ukraine) of the study participants have never been vaccinated against influenza (p < 0.05). Totals of 67.6% of the respondents in Poland, 73.71% in Lithuania, and 29.5% in Ukraine responded that they want to be vaccinated against COVID-19 (p < 0.05). Vaccine hesitancy was mainly related to worries about its side effects. There were also vaccine non-adopters in the study. In Ukraine, 67% of the respondents were clearly opposed to mandatory COVID-19 vaccines, compared to 41.7% in Poland and 30.99% in Lithuania (p < 0.05). CONCLUSIONS: There are still many people who present vaccine hesitancy or are opposed to vaccines. Thus, societal education about vaccination and the pandemic is crucial. Vaccine hesitancy or refusal might be related to vaccine origin. Shortages of influenza vaccines made it impossible to vaccinate those who were determined to be vaccinated. There is room for discussion of mandatory COVID-19 vaccinations.

Model of the Austenite Decomposition during Cooling of the Medium Carbon Steel Using LSTM Recurrent Neural Network.

The motivation of the presented paper is the desire to create a universal tool to analyse the process of austenite decomposition during the cooling process of various steel grades. The presented analysis concerns the application of Recurrent Artificial Neural Networks (RANN) of the Long Short-Term Memory (LSTM) type for the analysis of the transition path of the cooling curve. This type of network was selected due to its ability to predict events in time sequences. The proposed generalisation allows for the determination of the austenite transformation during the continuous cooling process for various cooling curves. As training data for the neural network, values determined from the macroscopic model based on the analysis of Continuous Cooling Transformation (CCT) diagrams were used. All relations and analyses used to build training/testing or validation sets are presented in the paper. The modelling with the use of LSTM network gives the possibility to determine the incremental changes of phase transformation (in a given time step) with the assumed changes of temperature resulting from the considered cooling rate.

The role of Staphylococcus aureus in atopic dermatitis: microbiological and immunological implications.

INTRODUCTION: Atopic dermatitis (AD) is an inflammatory disease characterised by chronic and recurrent course. Its predominant symptom is skin pruritus. Therefore, many AD patients have recurrent skin infections and are susceptible to the colonisation of apparently healthy skin and nasal vestibule by Staphylococcus aureus (S. aureus). Some S. aureus strains are capable of producing exotoxins. AIM: To assess the relation between the total IgE (tIgE) and asIgE targeted against SEA (SEA-sIgE) and SEB (SEB-sIgE), as indicators of the severity of the course of AD, and the presence of S. aureus on apparently healthy skin, in skin lesions and in the nasal vestibule. MATERIAL AND METHODS: The research was performed in a population of 134 AD patients (61 men and 73 women) aged 2-86 years. Three smears were collected for microbiological investigations: from the nasal vestibule, from the skin where lesions appeared at the moment of investigations and from the skin which was free from the eczema. On collection the material was cultured on solid and broth mediums. After incubation each medium was thoroughly analysed for the presence of S. aureus. RESULTS: There was a statistically significant correlation between healthy skin colonisation by S. aureus and increased SEA-sIgE. The same correlation was proved between healthy skin colonisation by S. aureus and increased SEB-sIgE. There was a statistically significant correlation between colonisation of the nasal vestibule by S. aureus and the SEA-sIgE and SEB-sIgE serum concentration. CONCLUSIONS: It seems that the colonisation of the lesioned skin, healthy skin and the anterior nares by S. aureus is related with higher tIgE serum concentration, which translates to more severe course of the disease. Significantly increased SEA-IgE and SEB-IgE concentrations were observed in the patients whose tIgE serum concentration was statistically higher.

Skin and nasal vestibule colonisation by Staphylococcus aureus and its susceptibility to drugs in atopic dermatitis patients.

INTRODUCTION: Atopic dermatitis (AD) is a chronic and recurrent disease with an inflammatory background. Genetic and environmental factors are responsible for the occurrence and development of this dermatosis. OBJECTIVE: The aim of the study was to assess the frequency of colonisation of the nasal vestibule and apparently healthy skin by S. aureus, and to assess dermal lesions for superinfection with S. aureus in AD patients. MATERIAL AND METHODS: The research was performed on a population of 100 AD patients. Three smears were collected for microbiological investigations: from the anterior nares, from apparently healthy skin and from lesioned skin. On collection, the material was cultured on mediums provided by the bioMerieux and Argenta companies. The strains were identified and their sensitivity to antibiotics assessed by means of the Vitek2 system (bioMerieux). RESULTS: S. aureus was present in at least one location in 90%. 44% presented S. aureus colonization of apparently healthy skin and within skin lesions. In the case of 23%, this particular pathogen was detected only in skin lesions, whereas 6% had a positive result within the area of apparently healthy skin. In total, S. aureus was detected in the skin of 73%. In 61%, apparently healthy skin had been colonized with S. aureus, whereas in 81% colonization was proved within the skin lesions. S. aureus was detected in the nasal vestibule of 85%. Among the group with S. aureus in their anterior nares, the pathogen was also found on the skin surface of 77%. CONCLUSIONS: S. aureus colonises skin in most AD patients. Most AD patients carry S. aureus in their nasal vestibules. S. aureus does not seem to colonise healthy skin as often as skin lesions in young people. The vast majority of S. aureus strains were sensitive to local antibiotics. Most S. aureus strains produced penicillinase.

Protocol versus Nonprotocol Dosing of Vancomycin in Neonates: A Single Center Evaluation of Steady State Trough Levels.

Objective This study aims to assess the need for modification of the current vancomycin dosing protocol at a single institution by conducting a comparison of dosing per protocol versus off protocol and the resulting first troughs in neonates. Secondary outcomes include comparison of time to first therapeutic steady-state trough, dose at first therapeutic steady-state trough, and success of the consult-to-pharmacy service. Study Design This single center retrospective chart review analyzed patients at a level-IIIb neonatal intensive care unit who received vancomycin and had at least one appropriately drawn trough level documented from 2013 to 2014. Effectiveness of each dosing strategy was evaluated by assessing troughs. Results Approximately 30% of first vancomycin trough levels obtained are within the desired range of 15 to 20 µg/mL and patients achieve therapeutic steady-state trough levels after 3.6 days, regardless of the initial dosing strategy. The current protocol reflects the therapeutic steady state dosing only 22% of the time. The vancomycin consult-to-pharmacy service improves the achievement of goal trough ranges. Conclusion An assessment of doses that achieved a goal vancomycin trough of 15 to 20 µg/mL revealed that a dose of 12.5 mg/kg at the same intervals and age ranges specified in the current protocol would enable the achievement of this higher goal trough.

Methicillin-resistant Staphylococcus aureus in patients with congenital heart disease in the pediatric intensive care unit.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) colonization has been recognized as a significant problem among hospitalized patients. Available data about prevalence of MRSA among children with congenital heart disease (CHD) are minimal. The aim of the study was to determine the prevalence of MRSA colonization and to identify risk factors for MRSA colonization among children <19 years old with CHD admitted to a pediatric intensive care unit (PICU). METHODS: Admission and weekly MRSA nasal surveillance testing was performed, and patients were stratified into six risk groups based on the Risk Adjustment for Congenital Heart Surgery-1 Method. The MRSA-colonized children were compared to the MRSA noncolonized children. RESULTS: During the 3-year study period, there were 372 admissions of children with CHD to the PICU. Of the 372, 72 (19.4%) had no surveillance cultures performed or had no prior history of MRSA and were excluded from further analysis. Of the remaining 300 admissions, 29 (9.7%) (263 individual children) were found to be colonized. The mean age of the 263 children when first admitted to the PICU was 3.29 years (range 0.03-18.30, median 0.66). Age distribution was not significantly different between the colonized and noncolonized groups (P = .236). Gender (P = .667), race (P = .837), and CHD complexity (P = .395) were not significantly associated with colonization. The odds of being colonized if previously hospitalized were 4.42 times greater than if not previously hospitalized (95% confidence interval 1.89, 10.34). CONCLUSION: Routine MRSA surveillance should be performed in patients with CHD to identify colonized patients.

[Tobacco smoking and frequency of arterial hypertension in students of Poznan universities]. / Palenie tytoniu i wystepowanie nadcisnienia tetniczego wsród studentów poznanskich uczelni.

The aim of the study was to assess the tobacco smoking among students of three Poznan universities and its effect on the students' blood pressure. Into the consideration were taken the frequency and duration of tobacco smoking, and the number of cigarettes smoked daily. The study involved 700 students. An appropriate questionnaire was used to collect the data, and blood pressure measurements were taken. The results were statistically analyzed using t-Student and chi2 tests. The results show that the gender and type of the university attended influence the prevalence of tobacco smoking. The percentage of smoking men was significantly higher than the percentage of smoking women. The lowest percentage of smokers was found among the students of the Medical Sciences University as compared with other universities. In addition, some positive correlation between tobacco smoking and the occurrence of arterial hypertension was observed.

[Anaemia from religious reasons as a distant effect of husband's alcoholism]. / Niedokrwistosc z przyczyn religijnych jako odlegly skutek alkoholizmu meza.

Chronic nutrition deficiencies, economic or cultural in their nature are one of the most often reason ofanaemia. From the other hand various diet restrictions may lead to different nutrition deficiencies. The occurrence of anaemia caused by diet restrictions is relatively rare among Catholics in Poland. We present a case of 51 years old woman with severe anaemia (Hgb 2.48 mmol/l), occasionally diagnosed. Anaemia occurred 20 years after she took a pledge never to eat meat. The aim of her oath was the begging for grace and quitting alcoholism by her husband, a habitual alcoholic. The iron and vitamin B12 supplementation led to quick improvement of hematological parameters.

[The activity of angiotensin converting enzyme in vascular mesenteric bed of rats poisoned with lead and cadmium]. / Dzialanie enzymu konwertujacego angiotensyne i (ACE) w naczyniach krezkowych szczurów zatruwanych olowiem i kadmem.

Heavy metals can increase the arterial blood pressure by influencing the endothelial renin-angiotensin system. The aim of this study was to determine the effect of single and combined exposure to lead and cadmium at hypertensive doses on the tissue renin-angiotensin system in rats. An attempt was made to assay the induced synthesis of angiotensin II (AII) in the isolated mesenteric rat bed, as well as the reactivity of vessels to AII and norepinephrine used before and after infusion of angiotensin receptor blocker. Angiotensin converting enzyme (ACE), used in infusion, induced slight increase in perfusion pressure only in mesenteric vessels of cadmium poisoned rats. In this group, AII given during ACE infusion induced slightly stronger vasoconstriction than in other groups of rats, and losartan, used in infusion totally eliminated the pressor effect of AII. Therefore, the share of endothelial renin-angiotensin system in the regulation of vessel resistance was greater than in mesenteric bed of lead-poisoned rats or controls. It is likely that the effect of ACE inhibitors and blockers of the AII receptors may be slightly stronger in persons with arterial hypertension exposed to cadmium than in non-exposed patients.