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.

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.

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.

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.

[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.