[Exercise tolerance in patients after acute lymphoblastic leukemia treatment in childhood]. / Wydolnosc wysilkowa pacjentów po leczeniu ostrej bialaczki limfoblastycznej w wieku dzieciecym.

The purpose of the presented study was to define the exercise tolerance in patients after acute lymphoblastic leukemia (ALL) treatment in childhood. Three groups of persons were examined: group A: 20 children, aged 7-19 years (mean 12.4 y), examined immediately after ALL therapy completion, with cumulative anthracycline (ATC) doses administered 155.8-300 mg/m2 and dexrazoxane, as cardioprotectant, group B: 36 patients, aged 12-24 years (mean 15.9), being 3-5 years after ALL treatment, who received ATC in cumulative doses 148.6-416.7 mg/m2, without cardioprotection, group C: 28 healthy volunteers, aged 9-25 years (mean 17.3), as controls. All the examined patients belonged to NYHA functional class I. In all subjects the exercise treadmill test was performed according to modified Bruce protocol. The parameters analysed were: MET--number of metabolic effort units achieved at the test, HRmax--maximal heart rate during exercise, %HRmax--percent of maximal HR for given patient's age achieved during the STdep--depression of ST segment in electrocardiography (ECG) immediately after the maximal exercise. During the exercise members of all 3 groups achieved the required HRmax without serious complaints and ECG abnormalities. Examined persons in group A,B and C presented with effort levels (MET), %HRmax, STdep that did not differ significantly. Only HRmax in groups A and C were higher than that achieved by members of group B.

[Non-invasive evaluation of cardiovascular system in patients after 3 to 5 years since the completion of acute lymphoblastic leukemia treatment]. / Nieinwazyjna ocena ukladu krazenia pacjentów po uplywie 3-5 lat od zakonczenia leczenia ostrej bialaczki limfoblastycznej w okresie dzieciecym.

In 34 patients, 25 males and 9 females, aged 12-24 years (mean 15.9) 3-5 years after the completion of acute lymphoblastic leukemia treatment the non-invasive evaluation of cardiovascular system was done with the use of electrocardiography, echocardiography and treadmill stress test. The cumulative anthracycline doses varied from 149 to 417 mg/m2, mean 250 mg/m2. The control group consisted of 28 healthy volunteers, 15 males and 13 females aged 9-25 years (mean 17.0). The history, physical examination and non-invasive tests' results did not revealed the cardiomyopathy signs, left ventricle contractility in the study and control groups did not differ significantly. Treadmill stress test showed lower maximal heart rate achieved and deeper ST segment depression in the study group. We conclude that the patients after leukemia treatment need further careful investigations.

[The usefulness of echocardiography in prospective heart function evaluation in children on maintenance haemodialysis]. / Przydatnosc echokardiografii w prospektywnej ocenie czynnosci serca u dzieci leczonych hemodializami.

Echocardiography evaluation of heart systolic and diastolic function is applied in monitoring of cardiovascular changes in end-stage renal disease children on maintenance haemodialysis. The aim of the study was the comparison of cardiac cavities diameters and heart walls thickness changes, as well as, indices of left ventricle (LV) function in 12 end-stage renal disease children before and after haemodialysis session, before (initial examination) and after half-year duration of maintenance haemodialysis treatment (control examination). In 5 dialysed children the comparison of above-mentioned parameters was done after 3 years of maintenance haemodialysis duration. In both examinations significant increase of relative wall thickness (RWT) of LV without the features of asymmetric hypertrophy and decrease of left atrium transverse diameter after haemodialysis session was noted. There was no progression of LV hypertrophy during the six months and three years of treatment. After 3 years of maintenance haemodialysis duration significant decrease of LV mass index was revealed in examined children. There was no significant change of cardiac cavity diameters and indices of LV function during the time of observation.

[Arterial hypertension in children aged 8-14 living in Zabrze]. / Nadcisnienie tetnicze u dzieci w wieku 8-14 lat zamieszkalych w Zabrzu.

In a group of 465 children (232 girls and 233 boys) aged 8-14 years, attending a primary school in Zabrze (Katowice District, southern Poland) arterial blood pressure was measured 3 times, body height and weight, once. A questionnaire collecting information about parents' education and hypertension, school performance and physical activity of the children was used. Among the studied children 417 (89.7%) presented with normal mean arterial pressure values, while 36 (7.7%) with arterial hypertension and 12 (2.6%) with borderline hypertension. The influence of children's obesity and parents' hypertension on the incidence of hypertension in children was proved, while physical activity, children's school performance as well as education of the parents did not show significant influence. The studied group revealed the highest frequency of arterial hypertension in Poland. Arterial blood pressure measurement is an important element of pediatric examination and treatment, constituting prophylaxis of cardiovascular morbidity in adulthood.

[Necrotizing vasculitis]. / Martwicze zapalenie naczyn (vasculitis necroticans).

We present a boy who had been under observation for 4 years, suffering since the age of nine from necrotizing vasculitis, which appeared during Proteus sp. sepsis. Complex treatment with antibiotics, large doses of steroids, antithrombotic and peripheral circulation improving drugs, as well as local drugs applied to the skin and oral cavity mucosa, resulted in a complete cure. This illness left some cosmetic skin defects on the face and extremities, a shortening of the tongue and malocclusion.