Cat Scratch Disease in a 1.5-year-old girl - Case report.

INTRODUCTION: The paper is a case report presenting Cat Scratch Disease (CSD) in a 1.5-year- old girl. Bartoneloses, including CSD, are a group of infectious diseases which are rarely detected, therefore there are no statistical data concerning the aetiology, and the incidence of CSD noted in Poland is low in comparison with other European countries. OBJECTIVE: The purpose of the paper is to discuss several problems related to CSD. MATERIAL AND METHODS: A 1.5-year-old girl who was seen in hospital for the sparing use of her left arm when crawling. X-rays showed osteolytic lesions which radiologists described as multi-ocular cyst or infection. As neither clinical examination nor laboratory investigations found pathological signs, the patient was followed-up on an ambulant basis. Repeated x-ray taken 4 weeks later showed increased periosteal proliferation accompanied by pain. The baby was admitted to the Clinic but additional investigations found no pathologies. The baby was consulted by a rheumatologist and haematologist; however, they did not facilitate a definitive diagnosis. As the baby developed, because of a thickening of the soft tissues on the dorsal side of the distal epiphisis in the forearm the doctors decided to inspect the condition operatively. Macroscopic examination found brownish granulated tissue. Suction drainage was inserted and a tissue sample was tested for aerobic and anaerobic bacteria, tuberculosis and borelliosis. The test results were negative. The baby was in good condition, was not pyrexial and suffered from less pain. The diagnostics was further expanded and the baby tested for yersinia, chlamydia, tuberculosis and bartonella, i.e. CSD. The postoperative wound healed soon and radiological bony lesions began to resolve. After a month, we received a positive bartonella test result, the baby tested positively for Bartonella henselae IgG class, which confirmed past or active infection of CSD. A repeated test for B. henselae taken 6 months later showed a lower level of antibodies. CONCLUSIONS: It should be remembered that CSD, which is an extremely rare infection, can be diagnosed despite mediocre clinical and radiological manifestations. Thus, in the case of infections of unexplained aetiology and mediocre manifestations diagnostics should include testing for Bartonella henselae.

Influence of urbanization level and Gross Domestic Product on the prevalence of adolescent obesity in Poland.

INTRODUCTION: Obesity is considered as a major disease of twenty-first century civilization. Its occurrence in Poland and worldwide has been increasing steadily for many years. Several factors play an important role in the development of overweight and obesity. In addition to the genetic factors and those associated with diseases of the endocrine system and nervous system, the rapidly growing number of obese people is due to improper nutrition. OBJECTIVES: In this paper, authors attempt to justify the prevalence of obesity in Poland among the population of adolescent and young adults aged 15 - 29 years of age, depending on the urbanization level and Gross Domestic Product (GDP) per capita of voivodeships. METHODS: Voivodeships, as an entity of regional autonomy, were divided into two groups according to urbanization level and GDP per capita. From the total population of each voivodeship population, groups of overweight and obese people aged 15-29 were selected. The population group aged 15-29 was divided into male and female subgroups. Each subgroup was compared in the different voivodeships, depending on the urbanization level and GDP per capita. RESULTS: The study shows that there is a strong linear relationship between the prevalence of obesity and GDP per capita of each examined region. During the study, the correlation between the level of prevalence of obesity and urbanization level produced a negative result. CONCLUSION: The high level of regional economic development in the economic transformation states has a significant impact on the increase in the percentage of people with overweight and obesity in the population aged 15-29. Gender and place of residence (urban or rural areas) did not show significant correlation with the occurrence of overweight and obesity in the study group of the population.

Retrospective epidemiological study of supracondylar fractures of the humeral bone in children from urban and rural areas of the Lublin region in eastern Poland.

INTRODUCTION: Supracondylar fractures of the humeral bone are frequent injuries in children. It has been affirmed that supracondylar fractures have an excellent prognosis when proper treatment is applied. OBJECTIVE: Present of the statistical relationships between fractures occurring and patient's development period; the relation between development period and site of the fracture and statistical relationship between development period and gender of the patients. Also indicated are the place of residence of the hospitalized patients and time of admission to the Clinic after injury. MATERIALS AND METHOD: Research was based on the data of paediatric patients treated in the Clinic for Paediatric Surgery, Traumatology and Paaediatric Orthopaedics, and Rehabilitation Clinic of the Medical University in Lublin, Poland, between 1986- 2010. An independent Chi-square Test was used for statistical analysis (χ²). RESULTS: The majority of patients were admitted to the Clinic on the day of injury. Of these patients, 71% lived in the urban area of the Lublin region where all the children received medical care in hospital directly after trauma; 29% of children came from the rural areas of the Lublin region, and 10% of them were admitted to hospital 24 or more hours after the injury. CONCLUSION: 71% of patients lived in the urban areas of the Lublin region and the main cause of injury was a fall from a higher level onto an outstretched upper left limb. Most supracondylar fractures of the humeral bone concerned children at school and adolescent age. Despite the fact that some of the hospitalised children lived in the rural areas of the Lublin region, the majority were admitted to the Clinic directly after trauma and received timely treatment.

Computer aided modelling of spastic hip joint based on CT date.

BACKGROUND: The main subject of the paper is development of three-dimensional numerical modelling method of children's hip joint. Anatomically correct as well as deformed due to cerebral palsy joints were taken into consideration. MATERIALS AND METHODS: The modelling process was carried out on data obtained from X-ray computer tomography. Specialized software was used to develop three-dimensional models of particular objects (e.g. pelvis, thigh bone) of hip joint. RESULTS: The CT-data of two patients from Clinic of Children Orthopaedics and Rehabilitation of Lublin Medical University was used to perform three - dimensional geometrical models of hip joints. Finite element models were prepared also taking into account inhomogeneity of the bone tissue. CONCLUSIONS: RESULTS of our researches clearly show that three-dimensional, computer modelling of the children hip joint can be performed based on CT-data. Use of these methods will enable us to gain a better understanding of children hip joint deformation process and facilitate planning of therapy.

[Congenital disorders of hemostasis in children with Perthes disease]. / Wrodzone zaburzenia ukladu hemostazy u dzieci z choroba Perthesa.

The level of selected parameters of the coagulation system and fibrynolysis (prothrombin time, partial thromboplastin time, fibrinogen level, albumin C system, V Leiden factor and III antithrombin level) in 25 children who had been treated with Perthes disease was evaluated. In three children prolonged prothrombin time occurred; in one child anomalous protein C system was noted. The remaining parameters were normal in all children. The investigation results reveal that congenital disturbances of the haemostasis system were not the cause of Perthes disease in 24 children.