Studied Group Research Articles

Hepatic Epithelioid Hemangioendothelioma: A Rare Disease With Favorable Outcomes After Liver Transplantation

BackgroundHepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular tumor with indolent behavior in terms of malignancy. The treatment of choice is either resection in the case of resectable lesions or liver transplantation (LT) for the disseminated intrahepatic form. The aim of this study was to investigate the outcomes of patients with HEHE treated by LT. Material and MethodsThere were 18 patients with HEHE who underwent LT between 2002 and 2018 included in this retrospective study. The study group was comprised of young recipients (median age of 39 years) and mainly women (15 of 18; 83.3%). Two recipients had concomitant tumors of epithelioid hemangioendothelioma in the liver and lungs prior to LT. The survival probability was calculated using the Kaplan-Meier estimator. ResultsAccording to histopathological data, none of the patients had a macrovascular invasion. In 4 patients (22.2%), the disease had spread to the hilar lymph nodes. The maximum diameter of the tumor in the studied group was 18 cm. The survival probability after 1, 5, and 15 years was 94.0%, 82.6%, and 41.3%, respectively. No disease recurrence was observed during a median follow-up of 65.9 months. ConclusionLiver transplantation provides favorable outcomes for selected patients with a hepatic form of epithelioid hemangioendothelioma.

Correlation of Echocardiographic Variables with Exercise Capacity in Patients with Pulmonary Hypertension due to Congenital Heart Diseases

Abstract Background Pulmonary arterial hypertension (PAH) is a disease of the pulmonary circulation with resultant effects on the right heart. Conceptually, left heart anatomy and function should be normal in patients with PAH. However, the RV and left ventricle (LV) do not function in isolation, sharing a common pericardial sac and inter-ventricular septum which in turn refers to the significance of assessment of both ventricles which has implications for patient prognosis with PAH. Aim Study the correlation between echocardiographic hemodynamic parameters and functional capacity in patients with pulmonary hypertension due to congenital heart disease and detection which parameter is the most independent predictor of functional capacity in patients with PAH-CHD. Methodology The study was conducted in the period from November 2016 to September 2017 including 34 patients who had been diagnosed with pulmonary arterial hypertension associated with congenital heart diseases (PAH-CHD). All of them were recruited from the congenital heart diseases unit at Ain Shams University hospital. The studied group was divided into two groups in a cross-sectional study: Group I: This included 21 patients with functional capacity according the 6MWT less than 330 m as an average for all subjects. Group II: This included 13 patients with functional capacity more than 330 m. Patients’ participation was voluntary and the subject had the right to withdraw from the study at any time without affecting his/her further medical care. Results The whole study population was divided according to the 6MW distance into two groups less than 330 and more than or equal 330 m. Comparing the 6MWD of each patient with the different Echocardiographic variables of systolic & diastolic dysfunction revealed that the group of shorter 6MW distance had higher RVSP, MPAP, E/e’ ratio, LVMPI and RVMPI, while they had lower LV e’ TDI, LV GRS, RV FAC and RV GLS (less negative value). Multivariate analysis of these Echocardiographic variables revealed that MPAP is independent predictor of 6MWD & thus an independent predictor of functional capacity in PAH-CHD patients. Conclusion Assessment of RV and LV function in PAH-CHD patients is important. Strain measurement by STE provides valuable information on the quantitative RV and LV functional assessment in the setting of volume and pressure overload. The MPAP and saturation were found to be the most independent predictors affecting the functional capacity of the patients with PAH-CHD. Recommendations Assessment of functional capacity in patients with PH using the 6MWT is recommended as a routine investigation from diagnosis and during follow-up and correlated with the echocardiographic variables, it has been shown to be practical and feasible and provides an easy and not expensive tool for clinical and prognostic assessment.

Seroepidemiology of Toxoplasma gondii Infection in Drivers Involved in Road Traffic Accidents in Baghdad City

In this study, a total of (200) people (170 men and 30 women), aged (20-60) years were enrolled during a period of 10 months in Baghdad city. The informed consent of the studied groups was first taken and the blood alcohol levels after accidents showed negative results. The control group consisted of 100 individuals (60 men and 40 women), residents of the same region and in the same age group with no clinical signs and symptoms of toxoplasmosis. The commercial IgG and IgM ELISA kits were used to examine the collected serum samples. The serological test results of the studied group (SG) showed that 92(21.90%) were IgG positive, 75(17.85%) were IgM positive when compared with the control group (CG) who showed 11(2.61%) IgG positive and 33(7.857%) IgM positive. We can conclude that there is a high traffic accident risk to the drivers because of the high seroprevalence of latent toxoplasmosis. Prospective studies are still recommended and latent toxoplasmosis of the car drivers should be considered while strategies are being designed to prevent traffic road accidents in Baghdad.

CORRECTION OF ALBENDAZOLE DOSAGE AFTER LIVER ECHINOCOCCTOMY

Purpose. To improve the quality of treatment of patients with liver echinococcosis by optimizing postoperative chemotherapy. Material and methods. 226 patients with liver echinococcosis were admitted to the surgical department of the 2nd Clinic of the Samarkand State Medical Institute in 2009-2017. Patients were divided into two groups. In 2009-2012, 112 (49.5%) patients were operated on and were included into a control group. In 2013-2017, 114 (50.5%) patients were followed -up and were included into a study group. In the control group, postoperative chemotherapy was made by the standard protocol. In the studied group, Albendazole dosage was corrected according to the initial functional state of the liver. Due to positive findings in the experimental group, Albendazole was used at the dosage 5 mg / kg / day in patients with verified chronic liver disease and if liver enzymes were elevated before surgery. Results. Adverse reactions of Albendazole chemotherapy, by clinical and laboratory parameters, could develop in 52.7% - due to the preparation toxic effect and concomitant chronic diffuse liver pathology- while under dose correction, this figure is reduced to 18.3%. Conclusion. The proposed dose correction in patients with signs of liver insufficiency normalizes biochemical parameters and reduces toxic manifestations during chemotherapy. Of these 144 patients, long-term observations revealed echinococcosis relapse in 6 (4.2%) patients.

Determination of thallium in urine, blood, and hair in illicit opioid users in Iran

Heavy metals, including thallium and lead, are introduced to illicit drug users' body as a result of using drugs such as cocaine and heroin. This study aimed to determine urine, blood, and hair thallium (Tl) concentrations in illicit opioid users along with the relevant clinical signs and symptoms consistent with thallotoxicosis and to compare them with the corresponding variables in the control non-opioid user group. This case-control study was conducted on 50 illicit opioid users who had abused opioids continuously for more than a year, referred to Amirie Drug Abuse Treatment Clinic in Kashan, Iran. The control group included 50 non-opioid users. Thallium concentrations in urine, blood, and hair were assessed in both groups (n = 100) using electrothermal (graphite furnace) atomic absorption spectrometry (ET AAS, GF AAS). In the studied group, the median (interquartile range) concentrations of thallium in urine, blood, and hair were 54.8 ± 79.9 μg/L, 14.5 ± 11.1 μg/L, and 5.4 ± 3.7 µg/g, respectively; these values were 4.8 ± 5.2 μg/L, 2.5 ± 2.4 μg/L, and 1.4 ± 1.1 µg/g, respectively, in the control group. There were significant differences in urine, blood, and hair thallium concentrations between the study group and the control group (p < 0.001). There were significant correlations between duration of illicit opioid use and urine thallium concentrations (r = 0.394, p = 0.005) and hair thallium concentrations (r = 0.293, p = 0.039), but not with blood thallium concentrations (r = 0.246, p = 0.085). Urine and blood thallium concentrations of illicit opioid users with clinical signs and symptoms consistent with thallotoxicosis of weakness (p = 0.01), depression (p = 0.03), and headache (p = 0.03) were higher than users without these problems. The results of the study showed that thallium concentrations in urine, blood, and hair in illicit opioid users were significantly higher than the comparable concentrations in the control group. This can be due to the use of illicit opioids adulterated with thallium. Also, this study showed long-term illicit opioid use may lead to thallium exposure. In addition, cigarette smoking was associated with increased thallium exposure.

The relationship between rheumatoid arthritis disease and hearing loss

Background Rheumatoid arthritis (RA) is one of the most common systemic autoimmune diseases, characterized by chronic persistent and progressive erosive polyarthritis, leading to irreversible joint disability and increased mortality. It is a disease that affects 1% of the population. The auditory system may be involved during the course of disease; however, the association of RA and hearing impairment (HI) has not been clearly defined. Aim The aim of this work was to evaluate the pattern of HI in patients with RA and to examine the possible associations between RA and hearing loss. Patients and methods A total of 55 patients with RA (mean age of 42.10±11.80 years; female sex: 100%) and 55 healthy controls (mean age of 40.92±8.70 years; female sex: 100%) were included in this study. The two groups were matched for age and sex (P&gt;0.05). The mean RA duration is 88.10±27.39 months. Otoscopic examination was normal in all participants. HI was evaluated by pure tone audiometry and tympanometry including the static compliance and acoustic reflex threshold test. Complete medical history and thorough physical examination were taken along with full investigation (including rheumatoid factor, erythrocyte sedimentation rate, C-reactive protein, and the presence of anticyclic citrullinated peptide antibodies). Results Both groups were comparable regarding age and sex. However, there was a significant increase of HI in the studied group when compared with control group (36.7 vs 3.3%, respectively). Audiometric tests revealed significant increase in the hearing threshold and increased air bone gap. The immitancemetry revealed decrease of static compliance and significant increase of average acoustic reflex in the study group when compared with the control group. Conclusion Hearing loss is statistically increased in RA, and disease activity is usually associated with HI.

Assessment of Changes in the Hemoglobin Level under the Influence of Comprehensive Spa Therapy Using Therapeutic Radon-Sulfur Waters and Its Correlation with Free Radical Reactions.

Introduction Hemoglobin is a protein present in erythrocytes of higher organisms. Its main function is to transport oxygen from the lungs to tissues and carbon dioxide from tissues to the lungs. Hemoglobin contains Fe2+, catalyzes free radical reactions, and may initiate oxidation reactions by enzymatic and nonenzymatic degradation. The aim of the study was to evaluate the effect of balneophysiotherapy on the hemoglobin level in osteoarthritis patients and to try to assess the association of those metabolic changes with free radical reactions. Materials and Methods The study was conducted in Przerzeczyn-Zdrój spa resort. It included patients receiving spa treatment over 21-day sessions. The studied group consisted of n = 122 patients with joint and back pain due to osteoarthritis or disc herniation. Their age ranged between 32 and 67 years with a mean age of 53.5. Blood samples were collected before treatment and after 21 days at the spa. Standard tests were used. The results were statistically analyzed using the sign test and the Wilcoxon test. Results In the study group, we observed a drop in the hemoglobin level following spa treatment. Before treatment, the mean hemoglobin level was 14.1549 g%, and after treatment, it was 14.0008 g%. Conclusions (1) In the study, we concluded that balneophysiotherapy in osteoarthritis patients resulted in a decrease in the mean hemoglobin level. (2) The decrease in the mean hemoglobin level in osteoarthritis patients treated at the spa resort may indicate an association with free radical reactions. This trial was registered with NCT03405350.

Research of empathy and positive thinking of a dentist as a condition of professional competence

A professionally oriented approach in modern dentistry requires the formation of communication skills of the dentist and the ability to establish favorable psycho-emotional contact with the patient, since the fear of dental treatment in many patients is too strong. The relaxed and trusting relationship between the doctor and the patient improves the outcome of the treatment. Patients who feel calm with the doctor, tolerate dental interventions easier, need lower doses of sedatives and anesthetics. The patient’s great excitement or fear makes him consciously or unconsciously resist the doctor’s actions, which results in unpleasant sensations both in the patient and the doctor, and the likelihood of developing complications of a general nature (fainting, hypertensive crisis, collapse, etc.) increases. The aim — to study the empathy and positive thinking of dentists, teachers of clinical departments of the faculty of dentistry of Altay State Medical University (AGMU). These qualities are invariant components of the personality and important conditions for the formation of professional competence. Materials and methods. A study of 38 dentists who are the teachers of the clinical departments of the Faculty of Dentistry of the AGMU was conducted. The levels of empathy and the severity of the various channels of empathy in dentists were evaluated according to the method of V.V. Boyko. To identify the level of positive thinking style in doctors, the method of L.M. Rudina. Results. The general indicator of the level of empathy in the study group of dentists in general corresponds to a level above the average. The results of the optimism test showed that doctors in 75% of cases formed a positive thinking style. Conclusions. These indicators demonstrate that representatives of the studied group of medical workers do not have trouble in establishing psycho-emotional contact with patients.

BIOARCHAEOLOGY OF CHILDREN AND ADOLESCENTS OF THE EARLY BRONZE AGE ON THE BASIS OF MATERIALS FROM THE BURIAL GROUNDS OF THE VOLGOGRAD REGION

The paper studies the burials and anthropological materials of children (Early Bronze Age; Yamna culture), originating from the burial complexes of the Lower Volga using the method of paleopathological examination of skeletal remains and through the interpretation of the archaeological material. The skeletal remains of seven indi-viduals whose age did not exceed 15–16 years were examined. The bone material exhibited varying degrees of preservation. In 6 skeletal remains, only fragments of the cranium were examined, whereas in 5 individuals it was possible to examine the postcranial remains along with the skull bones. In this study, we applied a procedure for studying pathological abnormalities in the human skeleton developed by A.P. Buzhilova [1998]. Different me-thodological recommendations were used when recording bone porosis [Ortner, Ericksen, 1997; Ortner, Putschar, 1981; Lukacs, et al., 2001; Brown, Ortner, 2011; Maclellan, 2011]. The analysis of anthropological series helped to assess the incidence of porotic hyperostosis of eye sockets (cribra orbitalia) and cranial roof bones; to detect the signs of inflammatory processes in the bones of the postcranial skeleton in the form of periostitis, inflamma-tion on the inner surface of the bones of the cranial vault, as well as the pathological conditions of the dental sys-tem [Hegen, 1971; Stuart-Macadam, 1992; Waldron et al., 2009; Walker et al., 2009; Suby, 2014; Zuckerman et al., 2014]. The analysis of archaeological materials from children's burials of the Early Bronze Age revealed that almost all burials of children and adolescents are inlet, i.e. they do not have their individual barrows. The collec-tion of items is extremely small and is primarily represented by ceramics of very poor quality. A low proportion of children's burials attributed to the Yamna culture is observed in the Lower Volga burial grounds. As a rule, chil-dren are buried together with adults, so separate burials are very rare. Two of the seven studied individuals were 4 to 7 years old, while the remaining five individuals were buried at the age of 8–16. The reason for the small number of children's burials of the Yamna culture is associated with the low social status of the immature part of the population, which, in turn, may suggest some special, poorly fixed archaeologically, burial ritual for the bulk of children, given that subsequently the number of children's individual burials increased quite significantly on the same territory. Nevertheless, their design and accompanying items are not much different from those of adult burials. Young individuals of the Early Bronze Age are characterised by markers of episodic stress that occurred during various periods of childhood, predominantly from 2 to 4 years old. The stress can be associated with the transition from the dairy diet to the solid food diet. The widespread occurrence of tartar in immature individuals can indicate the specificity of their diet, which was based on soft and, possibly, fatty food. In addition, it may indi-cate a lack of oral hygiene, which is quite natural for the historical period. Vitamin deficiency recorded in the stu-died group results either from exposure to negative factors during the late transition from breastfeeding to solid food or from chronic hunger. Young people of the Early Bronze Age had non-specific inflammations, which, most likely, were not systematic, but occurred sporadically. We can presume that children and adolescents of the stu-died age lived peacefully and participated in the economic activities of the social groups. Being exposed to epi-sodic stresses, immature individuals of the pit culture successfully adapted to environmental factors.

Relationship between sociodemographic factors and depression symptoms and level of diabetes acceptance

&lt;b&gt;Introduction:&lt;/b&gt; Diabetes is a disease whose course is strongly determined by self-monitoring and self-care. Ensuring metabolic control of diabetes is not only important for the current state of health, it also allows to maintain the body in the best condition despite the existing chronic disease. &lt;br&gt;&lt;b&gt;Purpose:&lt;/b&gt; To assess the relationship between sociodemographic factors and depression symptoms and the level of disease acceptance in diabetes. &lt;br&gt;&lt;b&gt;Materials and methods:&lt;/b&gt; The study used a diagnostic survey method with a questionnaire, the Beck Depression Inventory, and the Acceptance of Illness Scale. The study group consisted of 43 women (51%) and 41 men (49%). A total of 67% of respondents had diagnosed type 2 diabetes, 24% type 1 diabetes, and 6% LADA. Average disease duration was 15 years. &lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; In the studied group, 15% of patients had diagnosed symptoms of depression; while according to the Beck Depression Inventory, depressive episodes occurred more often in mild (30%) and moderate (23%) severity. They were observed more often in people over 50 years old. Depression symptoms were significantly more common in the group of overweight and obese people (p=0.022, r(X,Y)=0.2490). &lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; The problem of depression increases with disease duration. People diagnosed with type 2 diabetes have lower levels of disease acceptance. Disease acceptance is a factor that eliminates the occurrence of depressive disorders of varying severity.

Diagnosis of the Mathematical Skills of Children from Polish Kindergartens and Its Importance for Geometric Shape Recognition

The objective of this research was to diagnose mathematical abilities in preschool children aged 5 to 7 on the basis of geometry and, subject to the results obtained, to recommend targeted pedagogical interventions with respect to the preschoolers found to have deficits in knowledge and skills. The research was conducted in the Biala Podlaska Laboratory of Psycho-Motor Skills in Poland in June 2018. A SensoMotoric Instrument eye-tracking device and the i ViewX platform registering data with a frame rate of 250 Hz was used. Using a special measurement system, the device can track and record the eye movements of an analysed person in a sequence and at a specific speed. The analysis of the data was performed with the application of the BeGaze 3.4 software. To demonstrate the differences between the correctness of task performance and the age and gender of the children, a Pearson’s Chi squared test was performed. To analyse the time that children from the study group needed to perform specific tasks, Student’s t test was employed. In all analysed cases, the significance level p = .05 was assumed. The results of the research involving the studied group of children (N = 176) demonstrated differences in the level of geometric skills. Regarding biological variables, such as gender and age, statistically significant differences were observed with respect to the age of the studied group. Distinguishing between plane shapes did not cause any problems in comparison with the tasks which required analytical thinking. The most evident distinctions were observed between children aged 5 and older children (6 and 7 years old). The level of difficulty of the tasks was a factor that affected the time needed to provide answers irrespective of gender. The level of geometric performance of the majority of the studied children was normal. Nonetheless, individual targeted interventions should be considered with respect to certain children with mathematical problems in order to improve their geometric skills before they start school education. The development of pedagogical interventions should be preceded by a targeted diagnosis of unsatisfactory performance and progress with respect to elementary mathematical skill acquisition. Teachers should be inspired to use innovative methods and techniques in their didactic practise in order to motivate children to study geometry.

Clinical and Biological Profile of Patients with Non-Valvular Atrial Fibrillation and Hemodynamic Significant Valvular Heart Disease

The non-valvular AF, beyond the guidelines, include 2 types of patients. We aimed to analyze the clinical and biological profile of patients with non-valvular atrial fibrillation (AF)andhemodynamicsignificantvalvular heart disease. We includedretrospectively 513 patients admitted in our hospitalwithnon-valvular AF, and we divided into:study group(333 patients; 64.9%) andcontrole group(180 patients; 35.1%) hemodynamic significant valvular heart disease. From the studied group 5.5% of patients associated all four valvular heart disease, 26.7% ofpatients associated mitral, aortic and tricuspid regurgitation and 71.9%of patients associated two valvular heart disease: 32.7% with mitral and aortic, 31.4% with mitral and tricuspid, 4.5% with tricuspid and pulmonary, and3.3% withtricuspid and aortic. Dyslipidemia (higher cholesterol and trygliceride levels) was present in 14.5% of patients, statistic significantly more frequently in patients from the control group (11.4% vs 18.3%, P= 0.033). Dyslipidemia showed a significantly higher estimated risk for AF (RR=1.25; IC95%: 0.99-1.56), as well as diabetes mellitus (RR=1.36; IC95%: 1.12-1.64)and coronary heart disease (RR=3.70; IC95%: 1.83-7.46). Therefore patients with non-valvular AF and hemodynamic significant valvular heart disease, beyond the curent guidelines, could has a completely different profile and prognosis.

Comparing the efficacy of lacosamide(LCM) and levetiracetam (LEV)monotherapy in children with focal epilepsy

The purpose of this study is to evaluate efficacy, tolerability and safety of two antiepileptic drugs (AEDs), LEV and LCM in children with focal epilepsy. The studied group consisted of 55 children, 30 boys and 25 girls, aged between 10 to 17 years, with different types of focal epilepsy. The present study was carried out for two years and our study group was divided into two subgroups one treated with LEV in dose of 2000mg per day (29 patients), the other with LCM in dose of 200mg per day (26 patients). Dosages were stable during a whole period of study. The focal epilepsy seizures prevalence (ILAE, 2017) was: 33 patients with motor onset seizures with impaired awareness, 14 patients with focal onset non-motor seizures with impaired awareness, 8 patients with focal onset seizures with preserved awareness and motor onset. Effect of AEDs was estimated with statistical methods. Mean number of seizures decreased significantly after two years in children treated with both AEDs. For patients treated with LCM it was 34% of patients with no seizures during treatment and 42% of patients with 50% reduction of seizure frequency. For patients treated with LEV it was 13% of patients with no seizures during treatment and 41% of patients with 50% reduction of seizure frequency. Assesing the safety of both drugs, we observed psychiatric side-effects (depression and aggressiveness) in 3 patients treated with levetiracetam. Our study suggests that LCM therapy in focal seizures is more effective and safe than LEV therapy.

Distribution of Cardiovascular Risk Factors in Patients with Psoriasis

Psoriasis is a chronic inflammatory systemic disorder that associates many cardiovascular comorbidities. The association between psoriasis and cardiovascular disease is a complex one, which implies many risk factors, such as age, gender, heredity, smoking, alcohol and stress. The prognosis of patients with psoriasis may be improved by identifying and reduction of these cardiovascular risk factors. The objective of our study was to determine the prevalence of cardiovascular risk factors among patients with psoriasis from Bucharest and Ilfov county, Romania. 634 individuals from the general population were initially included. From these individuals, 208 patients with psoriasis have been selected for inclusion in our observational study. The patients were selected from Elias Emergency Hospital of Bucharest, Romania, and through the family doctors praxis, between 2010-2017. Of the 634 individuals from the general population, 208 patients (33%) were identified as patients with a diagnosis of vulgar psoriasis, confirmed by the dermatologist, forming the study group. The presence of risk factors is consistent with the presence of cardiovascular disease (23%) in the studied group. Patients with psoriasis, without cardiovascular diseases, have an increased risk of developing them throughout their lives. Patients with psoriasis have a very high risk of developing life-long cardiovascular disease, because of a multitude of risk factors associated with psoriasis. Intervention on modifiable risk factors for cardiovascular disease can be mediated by a family doctor, who can monitor the development over time and may also intervene early when appropriate.

Evaluation of the Degree of Dental Anxiety in a Lot of Patients Altered in Young Adults

The study aims at identifying and highlighting dental anxiety in a group of young adults, analyzing patients� concerns about the main dental treatment procedures, and establishing statistical relationships between anxiety and gender, the background, level of education, socio-economic status and knowledge of habits of care and hygiene of oral cavity characteristic of the studied group. The study group consists of 150 female (50%) and male (50%) patients , aged between 20 and 40 years. The inclusion criteria in the batch were those related to the age range of 20 to 40 years.Two respondents (Corah�s Dental Anxiety Scale, Revised (DAS-R)) were given two questionnaires ( Corah�s Dental Anxiety Scale, DAS-R), and the second questionnaire contained 7 questions about the habits dental care). Most patients� concerns about the main procedures of dental treatment / other concerns are: dental extraction, material expenses, possibility of treatments and shame she felt oppressed health of the oral cavity. Regardless of the level of dental anxiety, the oral cavity hygiene habits are not properly performed by patients, with an increased tendency for them to be disregarded by patients with severe dental anxiety.

Lifestyle Intervention for Reducing Leg Cramps among Pregnant Women

Background: Leg cramps are a common discomfort during pregnancy account 30-50% of pregnant women. Lifestyle intervention help in reducing symptoms and discomfort associated with leg cramps. Aim: Was to study the effectiveness of lifestyle intervention for reducing leg cramps among pregnant women. Research Design: A quasi-experimental design was used. Setting: This study was conducted in Outpatient Clinic at Obstetric and Gynecological Department affiliated at Benha Teaching Hospital. Sampling: A purposive sample of 212 pregnant women having leg cramps and divided into study and control group. Tools: Three tools were used for collecting data; 1) A structured interviewing questionnaire; it includes four parts personal characteristics of studied women, past and current obstetric history, leg cramps history, and studied women's knowledge. 2) Modified Healthy Life Style Assessment Scale. 3) Visual analogue Scale. Results: showed that the mean age in the studied group and control group were 27.06±6.45 & 26.98±7.43 respectively. And secondary education is the education level of the large proportion of both study and control group 49.1% & 57.5% respectively, there was highly significant differences between two groups in all items related to their knowledge pConclusion: implementation of lifestyle intervention was effective in improving pregnant women's Lifestyle, through improving their knowledge and decreasing the severity and frequency of leg cramps. Recommendation: The nurses should provide all pregnant women at antenatal clinics with a self-care guideline about lifestyle intervention for reducing leg cramps during pregnancy to improve their awareness.

Metabolic syndrome in overweight or obese children and adolescents based on own material.

AimTo assess the prevalence of metabolic syndrome (MS) components in overweight or obese children and adolescents, as well as analyze the risk factors of its occurrence.Material and methodsThe study was conducted in a group of 70 children and adolescents aged 5-18 hospitalized in the Department of Gastroenterology, Allergology and Pediatrics, Polish Mother’s Memorial Hospital – Research Institute in Lodz (Poland) based on the results of medical histories, physical examination, biochemical investigation, and calculation of the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index.ResultsMS was diagnosed in 14 children (20%). The most common abnormalities besides obesity included: decreased High Density Lipoprotein Cholesterol (HDL-C) levels (n=13, 92.9%), increased triglycerides (TG) concentrations (n=10, 71.4%) and arterial hypertension (n=10, 71,4%). Among all the children, insulin resistance was diagnosed in 29 subjects (41.4%). The results of univariate logistic regression showed that the occurrence of lipid disorders, obesity, hypertension and diabetes in their parents, as well as the duration of pregnancy, birth weight, or breastfeeding were not associated with the risk of MS development in the subjects (p>0.05). However, in the study group, 92.9% of subjects had one or more particular risk factor for MS development.ConclusionsBesides visceral obesity, lipid disorders were the most frequently observed components of MS in the subjects analyzed, which may have prognostic significance. The occurrence of one or more MS risk factors in almost all of the children studied indicates the increased risk of cardiovascular diseases in the studied group in the future.

Skin microvascular circulation is not affected by diabetes duration in young patients with non-complicated type 1 diabetes mellitus.

Skin microcirculation is recognized as an appropriate model to use when investigating the relationship between cardiovascular risk factors and microvascular function. It is currently amatter of debate whether studies on skin microcirculation in young type 1 diabetic patients without existing microangiopathy may be helpful in identifying subjects with impaired endothelial function. To evaluate the potential changes in skin microcirculation of patients up age of 18 years using capillaroscopy, post reactive hyperaemia (PORH) and venous occlusion (VO) tests, and to establish the relationship between those changes and disease duration and metabolic control in patients with type 1 diabetes. Study group consisted of 112 pediatric patients aged 8.4-18.0 years, with amedian age of 14.95 years. The median diabetes duration and age at onset were 5 years and 9.6 years, respectively. The median HbA1c in the studied group was 7.6% at the time when the microcirculation was being examined. Capillaroscopy studies were focused on type 1 diabetic patients and employed non-selective stimuli such as the PORH and VO tests. The relative area covered by capillaries (coverage) was measured before the testing and again after the PORH and VO tests. The analysis revealed that none of the skin microcirculation indices correlated significantly with patient age, diabetes duration or metabolic control. In young patients with uncomplicated type 1 diabetes mellitus skin microcirculation function is not dependent on age, disease duration or metabolic control.

Infectious complications in children treated for hodgkin and non-hodgkin lymphomas in polish pediatric leukemia/lymphoma study group: incidence, epidemiology and etiology

The objective of this nation-wide study was to evaluate the epidemiology and profile of bacterial (BI), viral (VI), and invasive fungal disease (IFD) in patients treated for non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) between the years 2013–2015. In the analyzed period of time, within the studied group of 328 children diagnosed and treated for lymphomas, at least one infectious complication (IC) was diagnosed i.e. 39.3% children. In these patients there were 350 episodes of IC, therein 80.6% episodes of BI, 11.1% episodes of VI, and 8.3% episodes of IFD. In both groups, NHL and HL patients, a stable level of bacterial infections, with an increase in resistance rates, and increased levels of viral and fungal infections were observed. Profile of BI does not depend on lymphoma type, with predominance of Gram-negative bacteria and higher prevalence of MDR pathogens. The overall survival of lymphoma patients with IC was comparable for different types of infections.

Congenital Heart Defects Coexisting with Omphalocele - the Important Prognostic Factor

Abstract Introduction: The aim of this study was to evaluate the following parameters of fetuses and neonates with omphalocele: the prevalence of coexisting congenital heart defects (CHD), abnormalities in heart function and the impact of coexisting CHD on fetal and neonatal survival. Material and methods: The study group consisted of 69 fetuses with omphalocele diagnosed and monitored at the Department of Prenatal Cardiology in our Institute in the years 2007-2017. The retrospective analisis of patients' data was performed. For statistical analysis we used Chi-square test, t-Student test and U Mann-Whitney test.. Results: In the studied group omphalocele was an isolated defect in 31.9% of the cases (22/69), in 68.1% (47/69) coexisting defects were present, in 49.3% (34/69) the coexisting defect was CHD. The most common CHD coexisting with omphalocele were ventricular septal defect (VSD), double outlet right ventricle (DORV) and atrio-ventricular septal defect (AVSD). Abnormalities of heart function were present in 43.5% (30/69) of fetuses with omphalocele: 23.5% (8/34) with normal heart anatomy and in 62.9% (22/35) with CHD. Statistically significant differences between the group with normal heart anatomy and the group with CHD regarded: Cardiovascular Profile Score (CVPS) (median 10 points vs median 9 points, U Mann-Whitney test p=0.034), neonatal birth weight(mean 3253 g vs median 2700 g, U Mann-Whitney test p=0.003), Apgar score (median 8 vs median 7, U Mann-Whitney test p=0.038) and survival rate until discharge from hospital (85% vs 52.9%, Chi-square test p=0.034). The comparison of data from 2007-2017 with data obtained from similar analysis performed in our center in 1999-2006, revealed significant improvement in the early detection of omphalocele (median 14.5 weeks of gestation vs mean 25.4 weeks of gestation), gestational age of delivery (mean 38 weeks of gestation vs mean 34 weeks of gestation) and survival rate until discharge both in neonates with normal heart anatomy and coexisting CHD (85% and 52.9% vs 70% and 23% respectively) . Conclusions: 1. The presence of coexisting CHD is an important prognostic factor in fetuses and neonates with omphalocele, so early fetal echocardiography should be performed in every case of omphalocele. 2. During the last decade (2007-2017), in contrast to years 1999-2006, we observed significant improvement in early and complete prenatal diagnosis of omphalocele. 3. We observed improvement in strategy of obstetrical management resulting in delivering neonates in a more advanced gestational age both in the group with normal heart anatomy and the group with coexisting CHD.