The national incidence and outcomes of gastroschisis repairs.

The birth prevalence of gastroschisis worldwide has increased over the past decades. We aim to determine the Irish national incidence of gastroschisis repairs (NIGR) over a 5 year period (2007- 2011) and clinical outcomes by a retrospective cohort review of cases admitted to all Irish paediatric surgical units. Seventy patients were identified. The NIGR per 10,000 live births was 1.96 (SD 0.51) per year. Fifty eight (82%) were antenatally detected. Twenty eight (40%) had primary repair day 1 with the remaining repaired in a median of 3(2-5.75) days. Thirty three (47%) experienced a central catheter related infection. Duration of stay was significantly correlated with decreasing gestational age (p = 0.016), decreasing birthweight (p = 0.005), increasing numbers of blood transfusions (p < 0.001) and co-morbidity or complication (p < 0.001). This study provides individual centres with patient outcomes and national data that can be provided to parents and clinical staff regarding the clinical course of gastroschisis.

[Experience with conducting transcutaneous kidney biopsy in a cardiology clinic]. / Opyt provedeniia chreskozhnoi biopsii pochek v kardiologicheskoi klinike

The analysis of 450 closed puncture biopsies of the kidneys permits to conclude that the employment of this method in a cardiological hospital provides rather valuable information on the state of the renal tissue in cases of various diseases entailing the arterial hypertension syndrome. The incidations for kidney biopsy include arterial hypertension, developing against the background of the nephrotic syndrome of varying genesis, clinically distinct glomerulonephritis (to precise its morphological variant), various forms of renovascular hypertension, and in some cases -- hypertensive form of pyelonephritis. Important complications such as macrohematuria and pararenal haematoma were observed in 25 cases. The employment of kidney biopsy in a cardiological clinic helped to make the diagnosis of the lesion underlying arterial hypertension, to choose the adequate method of treatment and to improve the prognosis of the disease.

[Renal factor in the early stages of hypertension]. / O pochechnom faktore v rannikh stadiiakh gipertonicheskoi bolezni

The paper deals with a study into the state of renal-pressor humoral factors and morphological changes in the kidneys at early stages of inception and formation of hypertensive disease. By applying the radioimmunological method of determining renin in patients with the IIA and IIB stages of the disease--two groups among them, with normal or an elevated renin activity and with its low level were recognized. In analyzing morphological features of renal tissue obtained through biopsy it was found that in 2/3 of patients with the IB and IIA stages of hypertensive disease no changes in the kidneys were demonstrable. In 1/3 of the patients there were in evidence organic alterations in the form of arteriolohyalinosis, proliferation and fibrosis of the intima, myoelastosis, myoelastofibrosis involving the media of intrarenal arteries of diverse calibre, dystrophic changes in the tubular system, partial glomerular hyalinosis, hypertrophy and hyperplasia of the juxtaglomerular apparatus.

[Lesions of target organs in arterial hypertension]. / Porazhenie organov-myshenei pri arterial'noi gipertonii.

A total of 530 patients with a variety of hypertensive conditions, including 476 patients with labile and stable essential hypertension, 40 with hypertensive chronic diffuse glomerulonephritis and hypertensive chronic pyelonephritis, and 14 with vasorenal hypertension, were investigated. Structure and function of target organs (the heart and the kidneys) were assessed by means of echocardiography (530) and intravital morphologic studies of renal biopsy specimens (89). A heterogeneous nature of hypertrophic developments associated with essential hypertension was demonstrated, with adequate, inadequate, disproportionate and excessive hypertrophy identified, while no correlation could be found between the kind of hypertension and the degree and nature of hypertrophy. Renal morphologic changes were also shown to be heterogeneous in labile and stable arterial hypertension, and early involvement of the renal mechanism presenting as structural changes was found to be possible.

[Diagnosis of latent forms of symptomatic arterial hypertension in young patients]. / O diagnostike skryto protekaiushchikh form simptomaticheskoi arterial'noi gipertonii u bol'nykh molodogo vozrasta.

A study of 174 patients has established that renal biopsy is of principal value for differential diagnosis in 70 per cent of cases where the origin of high and stable arterial hypertension of young patients is difficult to establish, and the results of a preliminary investigation fail to suggest a reliable diagnosis. In 73 per cent of the patients with the given clinical symptoms, arterial hypertension was symptomatic and associated with latent renal disease. Morphological investigation of biopsy specimens established the nature of the process resulting in the development of arterial hypertension as well as its pattern and activity in the absence of pathognomonic clinical and laboratory signs.

[Hypertensive disease and renal hypertension (structural and functional studies of the kidneys using dynamic computerized tomography)]. / Gipertonicheskaia bolezn' i pochechnye gipertonii (strukturnoe i funktsional'noe issledovanie pochek s ispol'zovaniem dinamicheskoi kompiuternoi tomografii).

Renal functional and structural studies were performed in 46 patients with arterial hypertension: out of them 12 had hypertensive disease, 13, chronic pyelonephritis, 21, a hypertensive type of chronic glomerulonephritis. In each case, the clinical diagnosis was evidenced by one of the invasive techniques. Dynamic computed tomography was conducted by the original methods; the findings were analyzed by taking into account time-density curves which made it possible to gain an insight into the status of blood flow and filtration in each individual kidney. Computed tomography and dynamic computed tomography revealed that hypertensive disease was characterized-by normal volume and thickness of the renal cortical layer and symmetric time-density curves, whereas a hypertensive type of chronic glomerulonephritis featured lower renal cortical layer thickness, reduced renal volume, symmetrically decrease amplitudes of the first and second peaks of the time-density curve, chronic pyelonephritis showed asymmetric time-density diagrams due to the lower density areas in the afflicted kidney.

[Value of puncture biopsy of the kidneys on the side of the stenosis in renovascular hypertension. I]. / Znachenie punktsionnoi biopsii pochek pri vazorenal'noi giptertonii na storone stenoza. Soobshchenie 1.

The morphological picture of bioptic renal tissue was studied in 23 patients with different forms of vasorenal hypertension, among whom 12 had fibromuscular dysplasia of the renal arteries, 8 had atherosclerotic stenosis, and 3 had panarteritis of the aorta and its branches with involvement of the renal arteries. The syndrome of malignant hypertension was encountered in 13 patients and stable arterial hypertension with high blood pressure levels in 10 patients. Analysis of the bioptic material allowed it to be divided into two groups: the 1st was marked by a picture of "Selye's kidney" and the 2nd by a combination of stenosis of the renal arteries and parenchymatous diseases of the kidneys. The significance of examining the morphological picture of renal bioptates, both with regard to the study of the pathogenesis of vasorenal hypertension and the diagnosis of concomitant parenchymatous process is shown.

[Characteristics of left ventricular hypertrophy in patients with different forms of arterial hypertension based on echocardiographic data]. / Kharakteristika gipertrofii levogo zheludka u bol'nykh s razlichnymi formami arterial'noi gipertonii po dannym ékhokardiografii.

Echocardiographic investigation of 110 patients with different forms of stable arterial hypertension demonstrated a moderately close correlation between left-ventricular myocardial weight, and systolic and diastolic arterial blood pressure in patients with essential hypertension and chronic diffuse glomerulonephritis, and a weak correlation between left-ventricular myocardial weight and systolic pressure in patients with renovascular hypertension and chronic unilateral or predominantly unilateral pyelonephritis. Inadequate left-ventricular hypertrophy has similar incidence (15-20%) in patients with different forms of arterial hypertension, whereas excessive hypertrophy only occurs in patients with essential hypertension. The frequency of asymmetrical hypertrophy differs in the two groups.

[Fluorescein angiographic studies of the fundus oculi in the malignant arterial hypertension syndrome]. / Fliuorestsein-angiograficheskie issledovaniia glaznogo dna pri sindrome zlokachestvennoi arterial'noi gipertonii.

Fluorescein-angiographic examination of fundus oculi in 33 patients with the syndrome of malignant hypertension made it possible to recognize for the first time changes in the choriocapillary layer, which in 29 patients were displayed by choroidal retention; ischemic zones were seen in 20 patients. It is suggested that the discovery of ischemic zones in the choriocapillary layer may be an early diagnostic criterion of malignant hypertension.

[Comparative effectiveness of the combined outpatient-hospital and outpatient treatments of hypertension patients with high and stable arterial pressure indices]. / Sravnitel'naia éffektivnost' kompleksnogo ambulatorno-statsionarnogo i ambulatornogo lecheniia bol'nykh gipertonicheskoi bolezn'iu, protekaiushchei s vysokimi i stoikimi urovniami arterial'nogo davleniia.

The paper is concerned with an analysis of the effectiveness of the outpatient and hospital stages in the treatment of patients with essential hypertension with stable and high AP indices. The absence of significant changes in the time course of AP, the number and nature of complications and the number of days of temporary disability was shown in 197 patients treated in the groups of outpatient and outpatient-hospital therapy.

[Long-term observation (8-10 years) of patients with mild forms of arterial hypertension]. / Dlitel'noe nabliudenie (8-10 let) za bol'nymi s "miagkimi" formami arterial'noi gipertonii.

The nature of a course of "mild" arterial hypertension was studied in 126 patients for 8-10 yrs. It was shown that in 13.2% of the cases arterial pressure returned to normal values during a "natural" course of disease; border-line arterial hypertension was revealed in 9.4%. Stage II hypertension was diagnosed in 77.4% of the cases after 7-10 yrs. Progression of arterial hypertension was noted in this group in 1/3 of the cases (30.2%). Aggravated heredity and an initial morphological state of the kidneys (according to the results of intravital morphological investigation) were shown to be predictors of prognosis of arterial hypertension. The initial picture of the fundus of the eye and electrocardiographic signs of myocardial hypertrophy reflected the nature of a course of hypertension being not factors determining prognosis of arterial hypertension stabilization.