Totally implantable venous ports in infants and children: a single-center retrospective study of indications and safety.

Introduction: Totally Implantable Venous Access Devices (TIVADs) contribute significantly to the treatment progress and comfort of patients requiring long-term therapy. However, the procedure for implanting TIVADs, as well as its very presence, may be associated with complications. Aim: This study evaluates the indications, safety, and complication rates of venous port implantations in pediatric patients. It also explores factors influencing the occurrence of early and late complications post-implantation. Materials and methods: The study included 383 pediatric patients treated at the Department of Pediatric Surgery, Traumatology, and Urology in Poznan between 2013 and 2020 who underwent 474 implantations of intravenous ports. Venous access was achieved using the Seldinger technique. Statistical analysis was performed using Statistica 13 with TIBCO and PQStat 1.8.2.156 with PQStat. Results: Venous ports were used in 345 oncology patients requiring chemotherapy (90% of the total group) and in 38 children (10%) with non-oncology indications. There were 36 early complications (7.6%) and 18 late complications (3.8%), excluding infectious complications. The most common early, non-infectious complications included pneumothorax (15 patients; 3%) and port pocket hematoma (12 patients; 2.5%). The most common late, non-infectious complications observed were venous catheter obstruction (8 children; 1.7%) and port system leakage (5 children; 1%). Infectious complications occurred in 129 cases (27.2%). Children with a diagnosis of non-Hodgkin's lymphoma, acute myeloid leukemia, and acute lymphoblastic leukemia had a significantly higher incidence of port infections. Venous ports equipped with a polyurethane catheter, compared to systems with a silicone catheter, functioned significantly shorter. Conclusions: The Seldinger method of port implantation is quick, minimally invasive, and safe. The type of port, including the material of the port's venous catheter, and the underlying disease have an impact on the durability of implantable intravenous systems. The experience of the surgeon is related to the frequency of complications associated with the procedure.

Endometriosis in Adolescents with Obstructive Anomalies of the Reproductive Tract.

BACKGROUND: This study aimed to assess the prevalence and course of endometriosis in adolescents with obstructive Müllerian anomalies. METHODS: The study group involved 50 adolescents undergoing surgeries (median age 13.5 (range 11.1-18.5)) for rare obstructive malformations of the genital tract: 15 girls had anomalies associated with cryptomenorrhea and 35 were menstruating. The median follow-up period was 2.4 (ranging from 0.1 to 9.5) years. RESULTS: We diagnosed endometriosis in 23 of the 50 subjects (46%), including 10 of the 23 patients (43.5%) with obstructed hemivagina ipsilateral renal anomaly syndrome (OHVIRAS), six of eight patients (75%) with a unicornuate uterus with a non-communicating functional horn, two of three patients (66.7%) with distal vaginal aplasia, and five of five patients (100%) with cervicovaginal aplasia. Persistent dysmenorrhea, following treatment, affected 14 of the 50 adolescents (28%), including 8 of the 17 subjects (47.1%) diagnosed with endometriosis at the time of surgical correction and six adolescents diagnosed with endometriosis during the follow-up. CONCLUSIONS: Endometriosis affects about half of young adolescents undergoing surgical treatment of obstructive Müllerian anomalies after menarche. The incidence of endometriosis is highest in girls with cervical aplasia. The risk of developing endometriosis decreases after surgical correction of obstruction but is still significant in patients with uterine anomalies.

Practical application of modified ASCCP 2019 algorithms in the diagnosis and early detection of cervical pathology.

OBJECTIVES: We assessed the risk for the high-grade precancerous CIN 2 (+) in women with HSIL and ASC-H depending on HPV status. MATERIAL AND METHODS: A retrospective analysis of results of cervical cancer screening following the current ASCCP recommendations by co-testing (LBC and molecular HPV DNA HR) performed between 2018 and 2022 in the Laboratory of Cervical Pathology, Obstetrics and Gynecology Hospital of Poznan University of Medical Sciences. Patient ages ranged from 22 to 72 years. RESULTS: The analysis of abnormal results of liquid-based cytology revealed the following: 1 suspicion of cervical carcinoma, 49 HSIL, 97 ASC-H, 95 LSIL, 92 ASCUS, and 4 AGC cases. Histopathological verification of the biopsy samples revealed a total of 288 abnormal results. CIN 2 (+) lesions were found in 127 women. ASC-H was the most common abnormal cytologic finding. Of the 338 molecular test results for HPV DNA HR, 85% were confirmed positive. A positive molecular signal confirming the presence of human papillomavirus on PAP smear was not homonymous with simultaneous histopathological diagnosis of cervical pathology. CONCLUSIONS: There is a high risk for CIN 2 (+) in patients with HSIL and HPV 16 (+) and/or HPV DNA HR (+), as well as ASC-H and HPV 16 (+). HSIL is rarely observed in women with HPV 16 (-). The risk for CIN 2 (+) in women with ASC-H and HPV (-) is low.

Long-Term Amnioinfusion through an Intrauterine Catheter in Preterm Premature Rupture of Membranes before 26 Weeks of Gestation: A Retrospective Multicenter Study.

INTRODUCTION: The objective of this study was to elucidate the efficacy of long-term amnioinfusion on perinatal outcomes in patients with preterm premature rupture of membranes (PPROM) before 26 weeks' gestation. MATERIAL: A total of 31 patients with PPROM at a periviable gestational age (21 + 0-25 + 0 weeks) were enrolled. Long-term amnioinfusion was performed in 22 patients, and 9 patients did not receive amnioinfusion. Data were collected retrospectively from 2 clinical sites between January 2017 and March 2019. RESULTS: In the medical management group, there was a significantly higher rate of chorioamnionitis compared to the long-term amnioinfusion group (89 vs. 15%, p = 0.001). The latency period between PPROM and delivery was higher in the amnioinfusion group (median, 5.5 vs. 3 weeks, p = 0.04). The frequency of bronchopulmonary dysplasia was higher in the control group compared to the amnioinfusion group (89 vs. 40%, p = 0.03). The rates of other neonatal complications were similar in both groups. CONCLUSIONS: Long-term amnioinfusion through an intrauterine catheter in PPROM before 26 weeks' gestation may improve pregnancy and newborn outcomes.