Leigh syndrome (LS), subacute necrotizing encephalomyelopathy is caused by various genetic defects, including m.9185T>C MTATP6 variant. Mechanism of LS development remains unknown. We report on the acid-base status of three patients with m.9185T>C related LS. At the onset, it showed respiratory alkalosis, reflecting excessive respiration effort (hyperventilation with low pCO2). In patient 1, the deterioration occurred in temporal relation to passive oxygen therapy. To the contrary, on the recovery, she demonstrated a relatively low respiratory drive, suggesting that a "hypoventilation" might be beneficial for m.9185T>C carriers. As long as circumstances of the development of LS have not been fully explained, we recommend to counteract hyperventilation and carefully dose oxygen in patients with m.9185T>C related LS.
Hyperventilation/genetics , Leigh Disease/genetics , Mitochondrial Proton-Translocating ATPases/genetics , Mutation/genetics , Adult , Alkalosis, Respiratory/genetics , Child , Child, Preschool , Humans , Hyperventilation/diagnosis , Leigh Disease/diagnosis
OBJECTIVES: Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. METHODS AND RESULTS: We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. RESULTS: Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% - emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b-TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization - in 30.7%, mRS of 0-2 - in 31.4% and mRS of 6 in 22% of cases. CONCLUSION: Our results can help harmonize standards for MT in Poland according to international guidelines.
Stroke/surgery , Thrombectomy/methods , Humans , Poland , Retrospective Studies
Spontaneous torsion of the greater omentum is a rare cause of the acute abdomen or pain complaints of the pelvis minor. It can imitate an severe inflammatory conditions rolling in the peritoneal cavity like e.g. appendicitis. At the work a case of omental torsion at the patient after the caesarean section with pain problems in the right iliac fossa was presented. Problems of the preoperative diagnostic testing and a possible differential diagnosis were discussed.
Cesarean Section/adverse effects , Omentum/injuries , Peritoneal Diseases/etiology , Peritoneal Diseases/therapy , Torsion Abnormality/etiology , Torsion Abnormality/therapy , Adult , Female , Humans , Peritoneal Diseases/diagnosis , Poland , Pregnancy
UNLABELLED: Contemporary care of the woman, especially in the postmenopausal period is based not only on gynaecological periodic inspections, but also on the routine evaluation of the pelvis minorwith the ultrasound examination. Based on this examination we can manytimes initially diversify causes of wrong manifestations, so like, e.g., urinary incontinence, of social pathologies coming into existence in the result rolling within the pelvis minor. Urinary incontinence is a complaint which is changing the quality of life. Three-dimensional sonography (3D USG) supplies us more information than traditional two-dimensional sonography. It let us to make dynamic representation of examining structures and let us to observe them in any angle we need. The best way for sonographic examination of lower pelvis minor is translabial sonography, because it doesn't change mutual relationship of any parts in lower pelvic area, just like transrectal ortransvaginal probes can make. For good treatment of symptoms of urinary incontinence we have to perform not only functional examination of lower urinary tract, but also make very accurate rate of the static of female genital organs and pelvic floor. BACKGROUND: The aim of study was to rate the angle between both puborectal muscles measurements using translabial three-dimensional sonography in women with stress urinary incontinence without descension of the female genital tract. MATERIAL AND METHODS: Studied group included 100 patients who were examined with GE Kretz Voluson 730 (GE, Austria) scaner equipped 6-9 MHztranslabial probe. First group with stress urinary incontinence comprised 50 women in the mean age 56.22 (+/- 10.43) years old and the second without symptoms--50 women in the mean age 49.0 (+/- 13.22) years old. All cases of urinary stress incontinence in first group was confirm with urodynamic examination. Women in both groups were in similar body mass index, means (+/-SD): 26.88 (+/- 2.02) and 26.20 (+/- 4.14), respectively. Menopausal status in both groups was not statistically significant and aggregate 7.21 (+/- 8.71) in group of women with stress urinary incontinence and 4.70 (+/- 6.32) in group of women without symptoms. Means (+/- SD) quantity of deliveries was significantly higher in group of women with stress urinary incontinence than in control group and amount to 2.40 (+/- 1.03) and 1.56 (+/- 1.34), respectively. In all cases 3D USG coronal view of pelvic diaphragm was obtained and the angle between both puborectal muscles were measured. All women had about 200 ml urine in the bladder. RESULTS: Means (+/-SD) of this angle in these groups were 65.48 +/- 9.22 and 58.64 +/- 9.17 degrees, respectively. The differences between both groups in all measurements were statistically significant (p<0.0015). CONCLUSION: Stated during translabial three-dimensional ultrasound examination considerably different values of the angle between puborectal muscles at women with and without the urinary incontinence can be more helpful in a accurate diagnosing of the type of the urinary incontinence.
Imaging, Three-Dimensional/methods , Muscle, Skeletal/diagnostic imaging , Pelvic Floor/diagnostic imaging , Urinary Incontinence, Stress/diagnostic imaging , Female , Humans , Middle Aged , Pelvic Floor/pathology , Ultrasonography
In this article a new abilities of lower urinary tract diagnosis in three-dimensional sonography were shown. The examination's components, which allow us to estimate anatomical changes in patients with urinary incontinence were described.
Imaging, Three-Dimensional/methods , Postmenopause , Urinary Incontinence/diagnostic imaging , Female , Humans , Ultrasonography , Urinary Tract/diagnostic imaging
In this paper authors describe classification, preliminary diagnosis of urinary incontinence. They also show ways of pharmacological therapy and kinds of available medicines, which are administer in treatment of women with urinary incontinence symptoms of neurologic descent and overactive bladder.
Urinary Incontinence/diagnosis , Urinary Incontinence/drug therapy , Aged , Female , Humans , Middle Aged , Physical Therapy Modalities , Urinary Bladder, Overactive/diagnosis , Urinary Bladder, Overactive/drug therapy , Urinary Bladder, Overactive/rehabilitation , Urinary Incontinence/classification , Urinary Incontinence/rehabilitation , Urinary Incontinence, Stress/diagnosis , Urinary Incontinence, Stress/drug therapy , Urinary Incontinence, Stress/rehabilitation
UNLABELLED: Three-dimensional sonography has been used for about 15 years, not only to examine the female genital organs, but also the lower urinary tract and pelvic floor. Three-dimensional sonography offers more information than traditional two-dimensional sonography allowing for a dynamic representation of the examined structures and observation at any angle necessary. Translabial sonography is the best way of a sonographic examination of the lower urinary tract, because it does not affect the mutual relationship of any parts in the lower pelvic area, contrary to the transrectal or transvaginal probes. In order to establish proper treatment of the urinary incontinence symptoms, not only a functional examination of the lower urinary tract, but also a very accurate assessment of the statics of the female genital organs and pelvic floor need to be performed. BACKGROUND: The aim of the study was to rate the area and diameters of the limbs of the levator ani muscle using a three-dimensional (3D) translabial sonography in women with stress urinary incontinence without the female genital tract prolapse. MATERIAL AND METHODS: The study group included 100 patients who were examined with the GE Kretz Voluson 730 (GE, Austria), equipped with 6-9 MHz translabial probe. The first group with stress urinary incontinence consisted of 50 women (mean age 56.22 (+/- 10.43) years) and the second group included 50 women without symptoms (mean age 49.40 (+/- 13.22) years). All cases of urinary stress incontinence in the first group were confirm by means of a urodynamic examination. Women in both groups had similar body weight (kilograms), mean (+/- SD): 26.88 (+/- 2.02) and 26.20 (+/- 4,14), respectively. Menopausal status in both groups was not statistically significant and amounted to 7.21 (+/- 8.71) in the group of women with stress urinary incontinence and 4.70 (+/- 6.32) in the group without symptoms. Mean (+/- SD) number of deliveries was significantly higher in the group of women with stress urinary incontinence than in the control group (2.40 (+/- 1.03) and 1.56 (+/- 1.34), respectively). In all cases 3D coronal view of the pelvic diaphragm was obtained and the area and thickness of limbs of the levator ani muscle were measured. All women had about 200 ml urine in the bladder. RESULTS: The results are presented as means +/- SD. Mean measurements of this area in both groups were 8.54 +/- 1.62 cm2 and 10.57 +/- 1.29 cm2, respectively. Mean thickness of the limbs in the groups were: 8.72 +/- 0.64mm and 10.85 +/- 0.89mm on the left side and 8.85 +/- 0.67mm and 10.89 +/- 0.87mm on right side, respectively. The differences between both groups in all measurements were statistically significant (p < 0.001). CONCLUSIONS: There are some differences involving measurements of the thickness and the area of the limbs of the levator ani muscle in women with and without stress urinary incontinence and without the genital tract prolapse in both groups. The observed differences could have implications in physiotherapy of the pelvic floor muscles in women without statics abnormalities.
Muscle Fibers, Skeletal/diagnostic imaging , Pelvic Floor/diagnostic imaging , Pelvic Organ Prolapse/diagnostic imaging , Severity of Illness Index , Adult , Aged , Cohort Studies , Female , Humans , Imaging, Three-Dimensional , Magnetic Resonance Imaging , Middle Aged , Muscle Fibers, Skeletal/pathology , Observer Variation , Pelvic Organ Prolapse/pathology , Ultrasonography , Urodynamics
This article presents suitability of two-dimensional sonography in lower urinary tract diagnostics. Examination components, allowing for a detailed evaluation of anatomical changes in patients with urinary incontinence, were described.
Postmenopause , Urinary Incontinence/diagnostic imaging , Female , Humans , Ultrasonography , Urinary Tract/diagnostic imaging
