[Diabetic foot--an attempt at defining the risk factors for amputation]. / Stopa cukrzycowa--próba okreslenia czynników ryzyka amputacji.

The study included 65 patients--42 males and 23 females aged 67 +/- 17 with the diabetic foot syndrome. They were divided into 2 groups: those who underwent amputation (25 patients) and 40 who were treated conservatively. Amputations were preceded most frequently by ulceration (17 cases), phlegmona (5 cases) or dry necrosis (3 cases). The high percentage of amputations in the studied patients could be explained, at least in part, by poor general condition and advanced local changes. In the group of patients, who underwent amputation--in relation to those treated conservatively a decrease in filtration function was found (46.0 +/- 24.3 vs 89.5 +/- 26.2) and a higher percentage in the prevalence of microalbuminuria or proteinuria (80% vs 45%) as well as a higher percentage of cigarettes smokers in this group (72% vs 40%). The majority of the studied patients was characterized by poor education, lack of self-control of glycaemia, no efficient metabolic control of diabetes, measured by glycated haemoglobin and the presence of neuropathy and retinopathy. In addition, in 4 patients among the whole studied group (including 1 patient who underwent amputation), diabetes was newly diagnosed. These results indicate the necessity of improving education, early diagnosis of insulin independent diabetes, more frequent foot examinations and the elimination of amputation risk factors. Prophylaxis of diabetes foot associated with the proper treatment of diabetes is a necessary condition for decreasing of the amputation rate according to St. Vincent Declaration.

[Estimate of clinical dynamic in periventricular leukomalacia]. / Ocena dynamiki objawów klinicznych w przypadkach okolokomorowej leukomalacji.

Clinical observations of 68 preterm and term newborns with ultrasonographically diagnosed PVL treated in the Infant Department of the Child Health Center in Warsaw from January 1985 to December 1990 are presented. The most frequent clinical sign in newborns was hypotonia of the lower extremities. Tremors were significantly more frequent in preterms. During the infant period, more clinical signs occurred in connection with cerebral atrophy (ventriculomegaly and subdural space enlargement). Observations were carried from the neonatal period to the age of 6 years. Development of 42 (61.8%) children was normal. In 26 (38.2%) infants from 6 to 12 months old, cerebral palsy (most frequently diplegia) was diagnosed. No significant differences in the frequency of cerebral palsy between terms and preterms were found. Epilepsy and minimal brain dysfunctions were also present.

[A case of Galen's vein aneurysm in an infant treated by combined transtorcular/transfemoral embolization]. / Przypadek tetniaka zyly Galena u niemowlecia, leczony embolizacja transtorkularna i transfemoralna.

We present a case of an aneurysm of Galen vein in an infant with concomitant large hydrocephalus, treated by ventriculoperitoneal shunting and combined transtorcular-transfemoral embolization with a good clinical outcome. The technical aspect of the procedure is described in detail; current concepts concerning the pathophysiology and data in the available literature are reviewed.

[Preliminary evaluation of the usefulness of passage time along the alimentary tract in the diagnosis of constipation in children]. / Ocena wstepna przydatnosci czasu pasazu przez przewód pokarmowy w diagnostyce zaparc u dzieci.

In children with constipation the usefulness of passage time along the large bowel was assessed, limiting the number of performed rectal enemas. The preliminary results suggest that it is possible to answer the clinician's questions - whether the passage time is prolonged, and if so, to determine in what segment of the large bowel. This method may be treated as a screening test in the diagnosis of constipation in children.

Incidence of hepatic hamartomas in tuberous sclerosis.

Hepatic hamartomas were thought to be a rare finding in patients with tuberous sclerosis. The purpose of this study was to assess their incidence in children with tuberous sclerosis and to review the literature. During 1984-90 we examined 51 children by ultrasonography; there were 25 boys and 26 girls. Their age ranged from 3 months to 18 years. Liver hamartomas were seen in 12 (23.5%) of the children, more often in girls than boys (5:1). Their incidence increased with age reaching 45% in children over the age of 10. They did not produce any symptoms of hepatic dysfunction. Our study and review of reported cases prove that hepatic hamartomas are a common finding in patients with tuberous sclerosis and may be very helpful in providing a more accurate diagnosis and consequently help in genetic counselling.