Congenital diaphragmatic hernia: pathogenesis, prenatal diagnosis and management — literature review

Congenital diaphragmatic hernia (CDH) is a developmental discontinuity of the diaphragm. It allows abdominal viscera to herniate into the chest and leads to lung hypoplasia. Congenital diaphragmatic hernia is one of the most severe birth defects, with extremely high neonatal mortality. This paper presents a review of the available literature on prenatal diagnosis, management and treatment options for CDH. In selected cases, a prenatal procedure to improve neonatal survival is possible. The authors of this manuscript believe their work might contribute to a better understanding of congenital diaphragmatic hernia and patient selection for the FETO (fetal endoscopic tracheal occlusion) surgery or expectant management

Rola prawa krajowego w międzynarodowych sporach inwestycyjnych

The author of the article deals with the issue of how important the laws and regulations of the host state really are, when it comes to international investment disputes. To answer the aforementioned question, the reader is fi rst given a short introduction to the idea of foreign direct investment within international trade, along with the major legal agreements governing them. The fi rst main part of the article brings closer the notion of international investment law and tries to explain its complex nature, together with some historical context. The second and the main part is divided into smaller divisions, in order to refl ect the stages of FDI from its commencement up to a possible outcome of a legal dispute before an international arbitration tribunal, and to present how the applicability and signifi cance of the host state law changes, along with the shift of those stages. The most important deliberations on the host state law within the article consider: its complimentary character to public international law and the investment treaties, its infl uence on the issue of jurisdiction of the arbitration tribunals in international investment disputes and its applicability during the merits stage of such disputes. Another feature worth mentioning is the presentation of the new form of clauses incorporated into modern investment contracts, i.e. – the choice of law and stabilization clauses. The author based his conclusions on a vast selection of international arbitration awards and decisions, as well as the modern treaty practice of the states, by virtue of researching model BIT’s of the biggest traders in the world, e.g. Germany, China, France and United Kingdom of Great Britain and Northern Irelan

Diaphragmatic hernia as an early ultrasound manifestation of Apert syndrome

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Współczesne farmakologiczne możliwości zwiększania stężeń cholesterolu frakcji HDL

Miażdżyca i jej powikłania są podstawowym czynnikiem ryzyka chorób układu sercowo-naczyniowego oraz główną przyczyną zgonów w krajach ekonomicznie rozwiniętych, a kontrola profilu lipidowego i leczenie dyslipidemii stanowią podstawę prewencji zdarzeń sercowo-naczyniowych. Prawidłowe stężenie lipoprotein o wysokiej gęstości (HDL, high-density lipoprotein, czyli cholesterolu frakcji HDL) znacznie zmniejsza ryzyko dalszego rozwoju miażdżycy oraz zapobiega wystąpieniu incydentów sercowo-naczyniowych, co wielokrotnie udowodniono w badaniach epidemiologicznych. Istnieją również dane wskazujące, że interwencja terapeutyczna zwiększająca stężenie cholesterolu frakcji HDL przekłada się na poprawę rokowania pacjentów z grup podwyższonego ryzyka sercowo-naczyniowego (np. Veterans Affairs High-Density Lipoprotein Intervention Trial [VA-HIT] z zastosowaniem gemfibrozilu). W niniejszym artykule podsumowano w zarysie obecną farmakoterapię zaburzeń lipidowych ze szczególnym zwróceniem uwagi na frakcję HDL cholesterolu jako główny cel terapeutyczny

Diagnosis and treatment of post-traumatic hypothermia in hospitals : a pilot study

Background: An unintentional drop in core body temperature of trauma victims is associated with increased mortality. Thermoregulation is impaired in these patients, especially when treated with opioids or anesthetics. Careful thermal insulation and active warming are necessary to maintain normothermia. The aim of the study was to assess the equipment and procedures for diagnosing and managing post-traumatic hypothermia in Polish hospitals. Methods: Survey forms regarding equipment and procedures on monitoring of core temperature (Tc) and active warming were distributed to every hospital that admits trauma victims in the Holy Cross Province. Questionnaires were addressed to surgery departments, intensive care units (ICUs), and operating rooms (ORs). Results: 92% of surgery departments did not have equipment to measure core body temperature and 85% did not have equipment to rewarm patients. Every ICU had equipment to measure Tc and 83% had active warming devices. In 50% of ICUs, there were no rewarming protocols based on Tc and the initiation of rewarming was left to the physician’s discretion. In 58% of ORs, Tc was not monitored and in 33% the patients were not actively warmed. Conclusions: The majority of surveyed ICUs and ORs are adequately equipped to identify and treat hypothermia, however the criteria for initiating Tc monitoring and rewarming remain unstandardized. Surgery departments are not prepared to manage post-traumatic hypothermia

Reference values for placental growth factor (PlGF) concentration and uterine artery Doppler pulsatility index (PI) at 11–13+6 weeks of gestation in the Polish population

Objectives: The aim of the study was to determine placental growth factor (PlGF) concentration and uterine artery (UtA) Doppler pulsatility index (PI) at 11–13+6 weeks of gestation in the Polish population. Material and methods: A prospective study was performed in pregnant women who underwent routine ultrasound scan at 11–13+6 weeks of gestation. All participants completed a questionnaire about their medical history, demographicsand current pregnancy. Mean arterial pressure (MAP) was calculated. Gestational age was confirmed by CRL and mean UtA PI was calculated. Blood samples were taken to measure beta HCG, PAPP-A and PlGF concentrations. Results: Out of the 577 analyzed participants, 60 (10.4%) were found to have abnormal placentation disorders (20 – hypertensive disorders and 40 – IUGR). The patients were subdivided into two groups, depending on pregnancy utcome: unaffected (n=517) and affected (n=60). The study did not confirm the anticipated correlation between maternal BMI and PlGF, but the concentration of PlGF was significantly increased in smokers. UtA PI values were not statistically significantly different depending on maternal age, BMI, method of conception, smoking or parity. The study confirms that both, UtA PI and PlGF concentrations are CRL-dependent. Median MoM values for PlGF and UtA PI were obtained for each set of CRL measurements. Median PIGF MoM was decreased in pregnancies complicated by hypertensive disorders and IUGR as compared to the unaffected group. Conclusions: The established reference ranges for UtA PI and PlGF at 11–13+6 weeks of gestation may be of clinical value in predicting placenta-associated diseases in early stages of pregnancy in the Polish population

Management of hypertension in pregnancy — prevention, diagnosis, treatment and long-term prognosis. A position statement of the Polish Society of Hypertension, Polish Cardiac Society and Polish Society of Gynaecologists and Obstetricians

ADDITIONAL INFORMATION This article has been co‑published in Kardiologia Polska (doi:10.33963/KP.14904), Arterial Hypertension (doi:10.5603/AH.a2019.0011), and Ginekologia Polska (doi:10.5603/GP.2019.0074). The articles in Kardiologia Polska, Arterial Hypertension, and Ginekologia Polska are identical except for minor stylistic and spelling differences in keeping with each journal’s style. Any citation can be used when citing this article