Maïa® trapeziometacarpal joint arthroplasty: Survival and clinical outcomes at 5 years' follow-up.

We sought to report the clinical and radiological outcomes and the survival of Maïa® trapeziometacarpal joint arthroplasty retrospectively at a mean 5 years' follow-up. We evaluated the implant survival and the clinical outcomes of 93 patients (113 prostheses). Patients were examined during a consultation and their mobility, key pinch strength and satisfaction were recorded. Patients also completed a QuickDASH evaluation. The 5-year survival rate was 92.2%. The mean QuickDASH Score was 26.7. The complication rate was 31% and the revision rate was 12.4%. The most common complication was dislocation and the most frequent cause of surgical revision was periprosthetic ossification. We identified two cases of aseptic loosening. This study shows the Maïa® prosthesis provides satisfactory medium-term results and has an excellent 5-year survival. However, the high complication and revision rates are still a major concern.

[Two years experience of laparoscopic management of the deep posterior vaginal endometriosis]. / Dwuletnie doswiadczenia wlasne w laparoskopowych operacjach endometriozy przegrody odbytniczo-pochwowej.

Our three year experiences of laparoscopic operations recto-vaginal endometriosis is presented here. We treated 15 patients. The main symptom was severe dyspaurenia. Laparoscopic (n = 14) and laparotomic (n = 1) excision of endometriotic nodules resulted in considerable pain relief. The surgical techniques was excision with scissors and bipolar coagulation. In all the procedures the anterior rectum was freed to the loose areolar tissue of the recto-vaginal septum, prior to excising deep fibrotic endometriosis. Operation time was average 135 minutes and intraoperative blood loss was minimal. Postoperative hospital stay was average 4.8 days. Fourteen patients were free from the preoperative symptoms at six month follow-up. Laparoscopic surgery for deep recto-vaginal endometriosis is an effective treatment and offers significant symptom relief.

[Congenital toxoplasmosis in own studies]. / Toksoplazmoza wrodzona w badaniach wlasnych.

Clinical picture of congenital Toxoplasma gondii has been presented in 20 children. The infection was diagnosed in 18 children in the first and in 2 children in the sixth month of life. Clinical symptoms were observed in as many as 12 children. The most frequent symptoms were those concerning central nervous system, organ of vision in the form of hydrocephalus, spastic paresis, epilepsy, intracranial calcification, choroiditis, retinitis and vision impairment. The presented analysis indicates an urgent need of introduction of screening in pregnant women and infants and widespreading of prophylactic activity aiming at raising awareness of the existing threat of T. gondii infection.

[Immunologic disorders in children with Lyme borreliosis]. / Zaburzenia ukladu odpornosciowego w przebiegu boreliozy u dzieci.

In this study we present evaluation of some immune parameters in children with borreliosis. We examined subsets of blood lymphocyte (CD3, CD4, CD8, CD19, CD3 HLA DR) and NK cells using monoclonal antibodies and flow cytometry in 14 children age from 3 to 16 years. We observed an altered lymphocyte phenotypes and NK cells in infected children compare to healthy control. We conclude that the changes in host immune response may play an important role in the pathogenesis of borreliosis and their monitoring may be helpful for the prognosis the course of the disease.

[Possibility of using saliva for therapeutic monitoring of digoxin]. / Mozliwosc zastosowania sliny do terapii monitorowanej digoksyny.

Digoxin in salvia and blood serum of 24 patients obtained Bemecor was determined by the method of FPIA (IMx-ABBOT). Mixed saliva was collected by three different types of Salivette (Sarstedt) given in order: normal Salivette with cotton wool swab, Slivette with polyester wool and Salivette with citric acid as a stimulator. It was found, that the correletio between the digoxin concentrations in saliva and serum and saliva/serum rations depended on the type of Salivette. The highest correlation was obtained with the Salivette with polyester wool (r = 0.892), but low concentrations of this drug in serum were good reflected in all samples of saliva, independent on kind of Salivette.

[Effect of low-dose recombinant humane erythropoietin therapy on the quality of life in patients with anemia in the course of end-stage renal failure treated with dialysis]. / Wplyw malych dawek ludzkiej rekombinowanej erytropoetyny na jakosc zycia chorych z niedokrwistoscia w przebiegu schylkowej niewydolnosci nerek leczonych dializami pozaustrojowymi.

The aim of the study was to assess the efficacy of low-dose subcutaneous recombinant human erythropoietin (rHuEpo) therapy in hemodialysis patients with particular emphasis on their quality of life. Twenty five anemic (Ht25%) patients (14 males and 11 females, age 39-13 years) with end-stage renal disease were given rHuEpo (initial dose: 52.5 +/- 2.5 IU/kg/week; maintenance dose: 67.0-10.5 IU/kg/week) once or twice weekly for 12 months. Quality of life, assessed by self-administered questionnaire (1-3 scale), was measured every month. Additionally, sexual functions (-1 up to 3 scale, basal level 0), including libido and sexual satisfaction, and serum sex hormones (testosterone, LH, FSH, prolactin) were evaluated every 6 months. During first 4 months of the therapy there was a significant increase of Ht (21.1 +/- 0.5% vs 28.5 +/- 0.6%; p < 0.0001), which was maintained for the whole study period. From the 3rd month in majority of patients a marked (p < 0.01) improvement in their physical fitness, mood and cold tolerance was noted. Despite a substantial increase in sexual satisfaction (p < 0.01) and libido (p < 0.001), no significant changes in serum sex hormones profile, except transient rise in serum prolactin level, were observed. It is concluded that low-dose rHuEpo therapy for the renal anemia of hemodialysis patients is associated with a sustained significant improvement in their quality of life and sexual functions, despite no significant changes in sex hormones serum levels.

[Evaluation of treating anemia in patients undergoing chronic dialysis with small doses of human recombinant erythropoietin]. / Ocena leczenia niedokrwistosci u chorych przewlekle dializowanych malymi dawkami ludzkiej rekombinowanej erytropoetyny.

The aim of the study was to assess the efficacy of low dose subcutaneous (sc) recombinant human erythropoietin (rHuEpo) therapy in hemodialysis (hd) patients, with particular emphasis on their quality of life. 25 anemic (Ht < 25%) hd patients with end-stage renal disease were given small sc doses of rHuEpo once or twice weekly for 12 months. During first 4 months of the therapy there was a significant increase of Ht (21.1 +/- 0.5 vs 28.5 +/- 0.6%; p < 0.0001) and serum hb (6.68 +/- 0.12 vs 8.51 +/- 0.18 g/dl; p < 0.0001) at mean induction dose of 52.5 +/- 2.5 IU/kg/week and this was maintained with a mean dose 67.0 +/- 10.5 IU/kg/week. RHuEpo was effective in 24 patients; all of them required no blood transfusions after starting the therapy. In majority of patients an substantial (p < 0.01) improvements in exercise tolerance, well-being, cold tolerance, sexual satisfaction and libido were observed, although sexual hormones profile revealed no significant changes during the treatment. Within first 6 months of the study cardiac index decreased substantially (p < 0.01), mainly because of stroke volume reduction, but after one year this hemodynamic improvement was noted only in patients who maintained a stable blood pressure. Hypertension worsened in 31% of patients. Low-dose s.c. rHuEpo: (1) is effective and safe treatment for anemia in hds patients, sufficient to abolish blood transfusion requirements; (2) produces significant improvements in quality of life; and (3) allows for 50% costs reduction.

[Evaluation of a method for determining ACTH concentration in samples of serum obtained by catheterization of inferior petrosal sinuses in diagnosis of Cushing's disease]. / Wartosc metody oznaczania poziomu hormonu ACTH w próbkach krwi uzyskanych poprzez cewnikowanie zatok skalistych dolnych w diagnostyce choroby Cushinga.

A method consisting in the catheterization of lower petrosal sinuses aimed at obtaining blood samples for the determination of ACTH concentration has been applied in diagnostically difficult cases of Cushing's disease. The appearance of ACTH concentration gradient between the blood originating from the immediate vicinity of pituitary and the peripheral venous blood confirmed the hypophyseal etiology of hypercortisolemia. The gradient of ACTH concentration between the two petrosal sinuses made possible the localization of a microadenoma in the anterior lobe of pituitary. The diagnostic conclusions obtained by the above method have been confirmed during the surgery.

[Changes in laboratory parameters of thyroid function in children with simple goiter from the Mazovia region]. / Zmiany laboratoryjnych wskaznikow czynnosci tarczycy u dzieci z wolem obojetnym z regionu Mazowsza.

Endocrinological Out-Patients Clinic at Children's Hospital in Dziekanów Lesny takes care of the children from Mazovia region. Hormonal findings in children with simple goiter were analyzed in several groups of patients. In all those patients preferential T3-secretion and decreased T4 production was found. These findings allow to conclude, that in Mazovia region there is iodine deficiency, which is probably the main cause of goiter development.

Changes in serum T4, T3 and TSH concentrations in newborns and infants with congenital goiter from the Mazovia region.

Thyroid function was investigated in a group of 61 newborns with congenital goiter before starting the therapy with thyroid hormones. The group included 19 girls and 42 boys, of which 27 were of age not exceeding one week (group I), 19 were between the first and the second week (group II), and 15 were between the second week and the third month of life (group III). The concentrations of the thyroid hormones were determined by radioimmunoassay. The values obtained have been compared with the local reference range obtained for the newborns of the Mazovia region. The values remaining outside the reference range were found in 47.5% of the newborns studied. The elevated values of TSH were observed mainly in group I newborns (12 from 27); among group II newborns there was only one with the elevated values, and none among the newborns of group III. thyroxine (T4) values were lowered in 14 among 27 newborns of group I, and in 2 among 19 newborns of group II; all T4 values were normal in group III. The percentage of the elevated values of triiodothyronine (T3) was higher in older newborns (group III). The elevated level of T3 accompanied by the lowered level of T4 with the normal or moderately elevated level of TSH is characteristic for the adaptation to the deficiency of iodine. There is preferential secretion of T3 aimed at maintaining euthyreosis. The elevated levels of T3 found in 30% of newborns with untreated goiter suggest an intrauterine deficit of iodine as a cause of the goiter appearance.(ABSTRACT TRUNCATED AT 250 WORDS)

[Ferritin (tumor marker) in patients with laryngeal cancer and precancerous conditions]. / Ferrytyna (marker nowotworowy) u chorych na raka krtani w stanach przedrakowych.

Evaluation of the ferritin as a neoplasm marker was performed in laryngeal cancer patients. In 35 laryngeal cancer patients and in 21 laryngeal leucoplakia patients the ferritin serum level and the blastic transformation of leucocytes were tested. In both groups the high ferritin level was discovered. It is the sign of low specificity of ferritin as a neoplasm marker. There was no correlation between the ferritin serum level and the degree of the blastic changes of leucocytes.