Przydatność tomografii komputerowej jamy brzusznej w różnicowaniu powikłań po przeszczepach nerek na podstawie przypadków klinicznych

Background: The aim of the study was to describe the diagnostic efficiency of computer tomography in the differentiation of urgent complications after renal transplants. The most common situation which needs to be explained using imaging diagnostics is acute abdominal pain in patients with renal grafts shortly after the operation (within a few weeks) in conditions of emergency. Most of the examinations were performed without contrast enhancement to avoid possible nephrotoxicity of the contrast media following the transplantology rule. The difference in the efficiency of the two methods with or without i.v. infusion contrast is emphasized. Material/Methods: Thirty-two CT's of 22 patients with complications after renal transplants were analyzed by comparing their clinical data. The images were compared with regard to size, parenchymal density, and homogeneity of the renal graft. Furthermore, contrast enhancement homogeneity with preservation of the cortical-medullar differentiation, width of the excretory system and the ureter, and presence of circumgraft fluid collection with a designation of its density and probabiliter specify (lymphocele, abscess, or hematoma) were also considered. When possible, the lumen of the renal vessels and the state of vessel anastomosis were recorded (CT angiography and some good-quality contrast examination). Also, other pathologies in the examined region were considered as a potential cause of the acute pain (e.g. multiplanar reconstruction was performed to obtain proper images of the lumbal spine). Results: CT of the abdomen explained clinical problems in 21 of the 22 patients (95%). Most examinations showed that the fluid collections were lymphocele, mainly small and without compression of adjoining structures, which are considered normal after transplants. Large fluid collections requiring decompression were found in 6 patients (including 2 hematoma and 1 with abscess). Causes unrelated to renal graft were found in 4 cases. Conclusions: Computer tomography, although it is not included in post-transplant monitoring procedures, appears to be a very useful method to enhance ultrasound imaging in cases of complication after renal transplant in a situation where MRI is not available. Its efficiency is increased to a great degree using contrast enhancement, which allows evaluation of excretory system morphology, the widths of walls, and the lumen of the ureter and renal vessels and, more specifically, to evaluate renal parenchyma

Effectiveness of cidofovir intralesional treatment in recurrent respiratory papillomatosis

To present the results of recurrent respiratory papillomatosis (RRP) treatment with surgical excision and adjuvant anti-viral cidofovir intralesional use and to examine the correlation between the cidofovir effectiveness and the patient previous history of multiple larynx procedures, age, extension of lesion and dose. 32 patients with laryngeal papillomas were treated with cidofovir in our Department between I.2009 and I.2011. The number of previous RRP debulking procedures ranged from 1 to 100. The intensity of papillomatosis differed from one anatomic site and moderate growth to four or five localizations with heavy extension. The number of injections per patient varied from 1 to 7, and the total volume of 5 mg/ml solution varied from 2 to 33 ml. The injections were combined with laser debulking of the lesions. In disperse papillomata, the injections were administered in particular anatomical sites in 4–6 weeks intervals, in massive lesions injections were repeated in the same anatomical site in 2–4 weeks. Complete remission was observed in 18 out of 32 patients. 13 patients showed remission in a place of cidofovir injection. One patient did not react to the drug. In four patients, new changes in injection places appeared. In two patients, hepatic toxic side effects were observed. Intralesional cidofovir injection has been shown to be an effective and safe therapy for laryngeal papillomatosis and should be considered in those patients who experienced disease relapse

The usefulness of the NBI – narrow band imaging for the larynx assessment

Narrow band imaging (NBI) by enhancing the contrast between the mucosal epithelium and submucosal vessels facilitates diagnosis of precancerous and cancerous lesions, as well as hypertrophic lesions such as laryngeal papillomatosis. Narrow band imaging (NBI) is an optical technique based on the modification of white light by the use of special optical filters. Every change in the microvascular architecture of the mucosa is classified according to Ni’s classification (2011). The use of NBI improves sensitivity and specificity of assessment of laryngeal lesions and allows more precise assessment of the status of surgical margins of early-stage and locally-advanced laryngeal cancers managed in endoscopic laser cordectomy

Zastosowanie NBI – wąskopasmowej endoskopii lupowej do oceny krtani

Wąskopasmowa endoskopia lupowa (NBI) poprzez wizualizację naczyń nabłonka ułatwia wykrywanie zmian przednowotworowych, nowotworowych i przerostowych, np. brodawczaków krtani. Technologia NBI oparta jest na modyfikacji światła białego przy użyciu odpowiednich filtrów optycznych. Dla każdego typu patologii jest dokładnie scharakteryzowany wzór unaczynienia (opracowany w 2011 roku), znany jako klasyfikacja Ni. NBI w połączeniu z klasyczną endoskopią poprawia czułość i specyficzność oceny zmian w krtani, ale także zwiększa dokładność oceny marginesów powierzchniowych resekcji podczas chordektomii laserowej we wczesnych i średniozaawansowanych rakach krtani

The usefulness of the NBI – narrow band imaging for the larynx assessment

Narrow band imaging (NBI) by enhancing the contrast between the mucosal epithelium and submucosal vessels facilitates diagnosis of precancerous and cancerous lesions, as well as hypertrophic lesions such as laryngeal papillomatosis. Narrow band imaging (NBI) is an optical technique based on the modification of white light by the use of special optical filters. Every change in the microvascular architecture of the mucosa is classified according to Ni’s classification (2011). The use of NBI improves sensitivity and specificity of assessment of laryngeal lesions and allows more precise assessment of the status of surgical margins of early-stage and locally-advanced laryngeal cancers managed in endoscopic laser cordectomy

Uczucia oraz stosunek dzieci względem kontaktów z ochroną zdrowia

Introduction and purpose Medical procedures can be physically harmful and cause psychological trauma among young children, possibly resulting in certain lifelong aversion. The aim of the study was to evaluate children's feelings while undergoing minor medical procedures depending on age, gender and previous experience and to compare it with university students. Material and methods We conducted a survey among 382 primary school children, as well as 334 university students. Questions concerned the frame of mind at the moment of examination, during dentist and general physician appointment, vaccination, hospitalization and condition of sore throat. Results The experience of hospital stay resulted in better feelings about possible future hospitalization in both groups, and about dentist appointment in the group of children. Girls and women declared lower mood during general physician appointment. Interestingly, in the group of children boys felt worse at the moment of survey, while in the group of students women felt so. The current frame of mind correlated with an appraisal of all other situations among students, whereas only with physician appointment and vaccination among children. All of above were statistically significant. For both groups, the most unpleasant condition was sore throat. However, in regards to medical procedures exclusively, vaccination appeared to be the most traumatic for children and hospitalization for students. Conclusion Earlier experience and gender of children can affect their feelings about medical procedures. Presented analysis suggests that every medical should do their best to provide pleasant atmosphere for every child during medical contacts.Wprowadzenie i cel pracy Procedury medyczne mogą być nieprzyjemne fizycznie oraz powodować uraz psychiczny wśród dzieci, potencjalnie skutkując niechęcią do nich w przyszłości. Celem pracy była ocena uczcuć dzieci podczas poddawania się podstawowym procedurom medycznym w zależności od wieku, płci i osobistego doświadczenia, a także porównanie z grupą studentów uczelni wyższych. Materiał i metoda Przeprowadzono ankietę wśród 382 dzieci ze szkół podstawowych oraz wśród 334 studentów uczelni wyższych. Pytania dotyczyły samopoczucia podczas przeprowadzania ankiety, podczas wizyty u lekarza podstawowej opieki zdrowotnej, podczas wizyty u dentysty, podczas szczepienia, podczas hospitalizacji oraz w przypadku bólu gardła. Wyniki Doświadczenie hospitalizacji skutkowało lepszym wyobrażeniem odnośnie potencjalnej hostpitalizacji w przyszłości w obu grupach. Dziewczynki oraz kobiety deklarowały gorsze samopoczucie podczas wizyty u lekarza podstawowej opieki zdrowotnej. Co ciekawe, w grupie dzieci, chłopcy czuli się gorzej w momencie badania, natomiast w grupie studentów - kobiety. Obecne samopoczucie korelowało z oceną wszystkich innych sytuacji w grupie studentów, podczas gdy w grupie dzieci jedynie z oceną wizyty u lekarza podstawowej opieki zdrowotnej oraz szczepienia. Wszystkie powyższe wyniki były istotne statycznie. Dla obu grup najbardziej nieprzyjemną sytuacją był ból gardła. Jednak, biorąc pod uwagę procedury medyczne, w grupie dzieci najbardziej traumatyzującym okazało się szczepienie, a w grupie studentów hospitalizacja.  Wnioski Wcześniejsze doświadczenia oraz płeć dzieci mogą wpływać na uczucia dzieci związane z procedurami medycznymi. W związku z tym każda osoba zaangażowana w ochronę zdrowia powinna dbać o jak najwyższą jakość kontaktów z dziećmi