Birth Weight Is Associated With Kidney Size in Middle-Aged Women.

INTRODUCTION: Low birth weight (LBW) is associated with increased risk of kidney disease due to lower nephron endowment leading to hyperfiltration and subsequent nephron loss. Kidney size is commonly used as a proxy for nephron number. We compared kidney volume measured by magnetic resonance imaging (MRI) with measured glomerular filtration rate (mGFR) in adults with either normal birth weight (NBW) or low birth weight (LBW). METHODS: Healthy individuals aged 42 to 52 years with LBW (1100-2300 g) and NBW (3500 -4000 g) were invited to participate. The GFR was measured using plasma clearance of iohexol. Kidney volume was measured on magnetic resonance images using axial T2 images and coronal T1 images with fat saturation without contrast enhancement; calculations were performed according to the ellipsoid formula π/6 × length × width × depth. RESULTS: We included 102 individuals (54 LBW and 48 NBW). Total kidney volume was 302 ± 51 ml for female NBW vs 258 ± 48 ml for female LBW individuals (P = 0.002). For male individuals, total kidney volume was 347 ± 51 ml vs. 340 ± 65 ml (P = 0.7). The mGFR was significantly associated with kidney volume, with r = 0.52 (P < 0.001) for women and r = 0.39 (P = 0.007) for men. A mediation analysis showed that the association between birth weight and mGFR (significant in total sample and women) was mediated by kidney volume. CONCLUSION: Healthy female individuals born with LBW have smaller kidneys than healthy females born with NBW. The previously shown associations between LBW and lower mGFR in adult women might be explained by smaller kidney volume.

Internal Hernia in Pregnant Woman after Roux-en-Y Gastric Bypass Surgery.

Laparoscopic Roux-en-Y gastric bypass has become the most common obesity surgery procedure worldwide over the last two decades. Many patients undergoing the procedure are women of reproductive age. This carries a risk for developing gastric bypass-related complications during pregnancy. One of the potentially serious risks is an internal hernia. We present a patient in the third trimester of pregnancy with an internal hernia following a laparoscopic Roux-en-Y gastric bypass for morbid obesity. We discuss the importance of computed tomography (CT) in the diagnosis of an internal hernia and review key CT findings including compression of the superior mesenteric vein, which proved to be crucial in diagnosing the internal hernia in this patient.

[64-slice computer tomography for diagnostics of the small bowel: computer tomography enteroclysis]. / Mozliwosci 64-warstwowej tomografii komputerowej w diagnostyce jelita cienkiego--enterokliza tomografii komputerowej.

INTRODUCTION: Radiologic imaging of the small bowel is the method of choice because other methods are of limited availability. Computer tomography (CT) enteroclysis is the leading modern method for diagnostic imaging of the small intestine. It combines the advantages of conventional small bowel infusion with those of abdominal CT and can serve to disclose a wide range of small bowel pathologies. MATERIAL AND METHODS: 101 patients underwent CT enteroclysis at the Department of Diagnostic Imaging and Interventional Radiology, Pomeranian Medical University in Szczecin. The procedure of CT enteroclysis is described starting from patient preparation and infusion technique to the scanning protocols. RESULTS: The results served to characterize the patients, establish indications and contraindications to CT enteroclysis, and reveal common errors of the method. CONCLUSIONS: Preliminary findings bring to light the considerable usefulness of CT enteroclysis. Other methods like ultrasound, MRI, conventional enteroclysis, or capsule endoscopy can be complementary in special cases.

[Venous sinus thrombosis which occurred during treatment of a 15-years old girl with t cell non-Hodgkin lymphoma - case report]. / Zakrzepica zatok zylnych mózgu w przebiegu leczenia 15-letniej pacjentki z nieziarniczym chloniakiem zlosliwym t-komórkowym-opis przypadku.

Venous thrombosis (VT) is a rare condition in childhood, being usually associated with congenital predisposition or acquired risk factors. The incidence of VT among children with cancer is between 1 and 36%. The highest incidence is among children with acute lymphoblastic leukaemia, followed by those with lymphoma and solid tumours. Malignancy and/or chemotherapy complications are considered as triggering factors. We report a case of a 15-year-old girl with non-Hodgkin lymphoma who developed generalized seizures during chemotherapy. Head computed tomography revealed right transverse and sagittal sinus thrombosis. Anticoagulation treatment using heparin as well as thrombolytic treatment with recombinant human tissue plasminogen activator (rhtPA) were introduced. The immediate application of rhtPA resulted in recanalisation of initially involved vessels which led to recovery with no neurological deficits. The reported case of severe venous thrombosis suggests that systemic treatment with rhtPA is effective and safe in children with cerebral venous sinus thrombosis.