The most common long-term complications observed in children after CDH repair are recurrent infections of the respiratory tract, lung hypoplasia, pathological GER, somatic growth abnormalities, and skeletal deformations. Children operated for CDH should be followed up regularly for many years by a multispecialty medical team. Diagnostics and/or follow-up of the above complications require detailed clinical examination, lung perfusion scintigraphy, spirometry, and 24-hour pH-metry.
Objective: To evaluate general health condition of children operated for esophageal atresia, including complications from gastrointestinal tract and skeletal defects. Methods:Between 1990 and 2005, 77 patients were operated for esophageal atresia in the Polish Mother's Health Memorial Hospital. The study was based on retrospective analysis of medical case records of all children with esophageal atresia. All living patients (n=51) were invited for follow-up studies.Results: Pathological gastroesophageal reflux was found in 46.7% of children. Scoliosis was diagnosed in 20 patients. Chest deformations were observed in 43.3% children Conclusion:The absence of clinical symptoms does not exclude the presence of gastroesophageal reflux in children operated for esophageal atresia. Children operated for esophageal atresia should be followed up regularly by a multispecialistic medical team.
Pulmonary torsion is a severe, life-threatening event, rarely occurring in children. We present a case of atypical postoperative complication of esophageal atresia repair in the form of pulmonary torsion comprising the middle lobe of the right lung. Clinical deterioration in the face of normal arterial blood gases should rise a high index of suspicion for pulmonary torsion. Early diagnosis is crucial, treatment is surgical, detorsion if possible, or if the lobe is not viable—resection.
The article presents the analysis of contemporary office work environment in Cracow. The aim is to examine architectural and ergonomic standards of office buildings that are recently being completed. Cracow is the second biggest city in Poland. Its rentable office stock estimated at level of 519 400 sqm makes it the biggest regional office market (except Warsaw). Referring to Knight Frank's recent data on office area at the construction stage (about 114 500 sqm), and vacancy rate (only 3,1%), it is also called to be the most mature and promising one. Moreover, it is expected to grow constantly with its IT sector prospering well and being now the biggest BPO center in Poland. Due to this permanent, impressive stock increase, Cracow could certainly be a leading example of the modern office architecture (exterior and interior), designed and raised nowadays in Poland. Thereat it is a valuable case to analyze. To carry through the researches there was a practical method of visitation undertaken. Several office buildings has been chosen and some of the most significant tenants selected to visit their office, so that both the edifice and interior can be rated. The purpose is to collect set of particular information that can be later compared and analyzed. Therefore there is a questionnaire prepared to be filled each time. It covers many different aspects. All the topics to explore were assigned to one of the main two categories: architecture and structural aspects with all the technical equipment, or interior arrangement. The building part of questionnaire contains of such information as: category, building location, accessibility, area and building space, materials and construction solutions, technical equipment, additional facilities, ecological solutions. Researches of interiors to examine are: interior arrangement, design, interior microclimate (insulation, ventilation, heating), comfort and ergonomics of individual office work stand (size, density, privacy), social and recreation facilities. The aim of the research is to define pattern of office work environment in Cracow. Data collected, analyzed and supplemented with publications on the subject are to be compared with the European standard.
Postoperative hydrocele (PH) is the most common and important complication of surgical treatment of varicocele. It may form many years after procedure performed in adolescent boys. Among procedure modifications aiming at prevention of PH the authors describe formation of a 'window' in tunica vaginalis and lymphatic vessels sparing. the aim of the study was determination of true PH occurrence in long term results and evaluation of implemented modifications of surgical treatment aimed at decreasing the occurrence of this complication. material and methods. The analysis comprised 289 boys operated using the Palomo method between 1991-2007. Initially no modification aiming at PH prevention was used, between 2003-2005 a 'window' was created in tunica vaginalis and since 2005 the standard has become dyeing of the lymphatic vessels which enabled sparing of these vessels during surgery. We evaluated the frequency of PH formation basing on direct postoperative and long term results in our operated patients. Results. Out-patient records of 289 boys who had undergone primary varicelectomy between 1999-2007 were retrospectively reviewed. In the group of 237 patients operated using the standard method PH was diagnosed in 26 cases (10.98%). The results were not improved by introduction of a modification -creation of a 'window' in tunica vaginalis. Hydrocele formed in 4 out of 27 patients (14.82%). In 25 boys treated with modified method -lymphatic vessels dyeing and sparing -in early postoperative period there were no cases of PH. The analysis of 122 adult men treated in childhood, who had been followed for on average 8 years and 8 months after surgery, showed that the frequency of PH after standard Palomo procedure without any preventive modifications was 27.9% (34 out of 122 operated cases). conclusions. 1. Postoperative hydrocele is the most common complication of surgical treatment of varicocele, however comparison of results from different centres requires uniform diagnostic criteria. 2. Early evaluation of this complication after procedures without preventive modifications may not be reliable, as PH may form many years after operation (11% based on records from early postoperative period, 27.8% based on long term results). 3. Among the modifications aimed at prevention of PH formation lymphatic vessels sparing seems most effective (in 25 patients operated using this method no PH in early postoperative period was seen), however long term results must be taken into account.
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