Multicystic dysplastic kidney represents a disorder in the fetus development presented prenatally of postnatally, this deserving special attention due to a risk of additional anomalies in children ...with this disorder. The aim of this study was to determine the incidence and type of common anomalies of the urinary system in the prenatal diagnosis of unilateral multicystic dysplastic kidney, and point out the necessity of postnatal diagnostic procedures in order to evaluate the state of the urinary system.
This retrospective-prospective study encompassed 38 cases of prenatally diagnosed unilateral fetal multicystic dysplastic kidney, presented to the Council for Fetal Anomalies from the Institute for Gynecology and Obstetrics of the Clinical Centre of Serbia and the University Children's Clinic within a three-year period. Associated anomalies were revealed by autopsy findings when pregnancy was terminated, ie resumed with clinical and operative findings of born children.
In every case of terminated pregnancy and death after birth the autopsy revealed additional renal or exstrarenal anomaly which were not prenataly detected. Postnatal evaluation of survived children with unilateral multicistic disease revealed that 31.4% of them have an anomaly of the contralateral kidney, 26.3% anomaly of the ipsilateral side, 13.2% anomaly of the lower portions of the urinary system and the same percent an additional extrarenal anomaly. The surgery was performed in 73.6% of children, more than half of the interventions were related to extrarenal anomaly. In 17% of children the kidney function was deteriorated after surgery.
Children suffering from unilateral multicystic dysplastic kidney have a greater chance of exhibiting an anomaly of the contralateral kidney and the urinary system in general. Therefore, they require thorough examination, both prenatally and postnatally. We propose obligatory serial professional prenatal ultrasound examinations, followed by postnatal ultrasound, isotope scan, and we especially emphasize the need for performing urinary cystouretherography, bearing in mind the high incidence of the vesicoureteral reflux of the contralateral kidney. In addition to nephrectomy, cytoscopy and colposcopy also need to be performed for the purpose of discovering possible hidden anomalies of the urogenital system.
Congenital fetal anomalies are the great problem and one of the main causes of increased perinatal mortality and morbidity. The aim of this study is to determine the outcome of prenataly detected ...multicystic dysplastic kidney and to point to the necessity of postnatal diagnostic procedures.
The retrospective-prospective study encompasses 38 cases of the prenatally diagnosed unilateral fetal multicystic dysplastic kidney. The associated anomalies were revealed either by autopsy findings when the pregnancy was terminated, or when the pregnancy continued, by clinical and operative findings the newborns.
The autopsy finding revealed bilateral multicystic displastic kidney or unilateral mylticystic displastic kidney and the agenesis of the contralateral kidney. The postnatal evaluation of the newborns with unilateral multicistic disease revealed that 84.3% of them had some concomitant anomaly of the urinary tract, most of them had an anomaly of the contralateral kidney (31.4%). The surgery was performed in 73.6% of children, in 17% of children the kidney function deteriorated after the surgery.
The findings of bilateral multicystic kidney disease and unilateral multicystic kidney disease and amnion are the indication to terminate the pregnancy. The finding of an isolated unilateral multicystic dysplastic kidney require thorough examination, both prenatally and postnatally. We propose obligatory serial prenatal ultrasound examinations, followed by postnatal ultrasound, isotope scan, and urinary cystourethography.
In this paper, we derived an analytical expression for the throughput efficiency in a GBN ARQ telecommunication scheme with the xor packet combining. The analysis was based on retransmission cycles. ...Results show that including the xor packet combining leads to better performance compared to the ordinary single copy GBN ARQ scheme.
The aim of this open study was to make a preliminary estimate of the efficacy and tolerability of intravenously administered magnesium sulfate (1 g) in comparison to subcutaneously administered ...sumatriptan in the treatment of severe migraine attacks. The study comprised 22 consecutive patients whose attacks were treated with magnesium sulfate (5 ml of a 20% solution), and the results were compared with those of another group of 14 consecutive patients whose attacks were treated with sumatriptan (6 mg). Immediately before and 10, 20 and 30 minutes after injections, patients reported pain intensity on a verbal 0-10 scale. Pain disappearance or pain relief >50% were considered significant. Efficacy of sumatriptan was superior that of to magnesium sulfate 20 minutes after the injections (p<0.05) and comparable after 30 minutes (magnesium therapy was successful in 68% in comparison to 79% of patients treated with sumatriptan). After only 10 minutes, 3 patients treated with magnesium sulfate were pain free, with the same effect in 5 (22.5%) and 10 (45%) patients after 20 and 30 minutes, respectively. The rate of headache recurrence was low and no major adverse effects were recorded. In conclusion, magnesium sulfate may be a well-tolerated pharmacological alternative for the treatment of severe migraine attacks.PUBLICATION ABSTRACT
Fibrinolytic activity in the acute stroke was examined by monitoring the level of plasminogen activator inhibitor-1 (PAI-1), as one of the indicators of fibrinolytic activity. Given the role of PAI-1 ...in the processes of atherogenesis and thrombogenesis, plasma PAI-1 level was measured in 59 patients (up to 50 years of age) with atherothrombotic stroke (verified by computed tomography scanning or magnetic resonance imaging of brain) in the period from 12 to 24 hours (I analysis) and 30 days after the onset of stroke (II analysis); then, it was correlated with plasma PAI-1 level in the control group (57 healthy subjects), which was 2.86 +/- 0.70 U/ml. It was found that PAI-1 level was significantly higher in the acute stroke (I analysis: PAI-1 = 4.10 +/- 1.40 U/ml, p < 0.001; II analysis: PAI-1 = 3.64 +/- 0.90 U/ml, p < 0.001), while fibrinolytic activity was lower, especially on the first day from the stroke that was not completely increased even after 30 days. There was no difference in PAI-1 levels between the subgroups of patients with infarction and lacunar cerebral ischemia (p > 0.05), as well as between females and males (p > 0.05). Along with significantly increased fibrinogen level (4.65 +/- 1 g/l, in the controls--2.83 +/- 0.64 g/l, p < 0.001), significantly higher triglycerides (2.04 +/- 0.76 mmol/l, in the controls--1.38 +/- 0.54 mmol/l, p < 0.001) and lipoproteins(a) (0.405 +/- 0.29 g/l, in the controls--0.172 +/- 0.14 g/l, p < 0.001) were found, correlating with higher plasma PAI-1 level in these patients. The increased plasma level of PAI-1 pointed to possibility of decreased fibrinolytic activity in pathogenesis of ischemic stroke, as well as, risk of reinsult, which had been the greatest after the onset of stroke and declined gradually within several weeks.
Small vessel disease (SVD) is associated with traditional vascular risk factors (RF). The aim of our study was to determine whether different SVD types, single lacunar infarction (LI) and multiple LI ...(MLI) with or without white matter lesions (WML), have different RF profiles.
Forty RF parameters were analysed in 201 consecutive patients with magnetic resonance imaging finding of SVD.
History of arterial hypertension, higher systolic and mean blood pressure (BP) but also hypotension, and higher plasma homocysteine levels were more frequent in MLI compared to single LI patients (
p
<
0.05). Patients with one LI were younger, more frequently had clinically evident stroke and family history of cardiovascular disease (CVD) (
p
<
0.05). Significant difference between groups was found only in these RF, indicating that similar pathological processes led to both types of SVD.
Positive correlation with age and family history of CVD necessitates further analyses of other factors, predominantly genetic, as the key to the answer why patients develop different lesions in SVD.
The aim of this paper is to examine the subjection of the embryo and the newborn to lead and cadmium as well as the effects of these metals upon the kidney function in the children newly born on ...time. The hypothetical framework of the paper was that lead and cadmium that are trans placental transmitted to the embryo organism lead to the change of the kidney function in the sence of damages done to the tubular system and to the interstitium along with changes in the urine sediment and in the levels of urea and creatinine in the serum; thus induced effects can be detected in the first week of life of the newborn babies.The examination was done in 1995 at Gynecological and Obstetric Clinic in Niš. The examined and the control group consisted of 30 newborns on time. The clinic examination was done on all the newborns. Regarding the kidney function examination, on the forth day of life all the newborn children were subjected to the determination of the value of urea and creatinine in the vein blood, the urine examination, the physical and physical-chemical features of the urine (outlook, specific weight, color, pH), the chemical status of the urine, the microscopic examination of the urine sediment, the ultrasonic examination of the kidneys. On the basis of the carried out examination and obtained results we came to the following conclusions:The lead concentration in the air at the localities related to the examined group is above G VI while for the control one below GVI. The cadmium concentration in the air from the examined localities in both the groups are above GVI. The lead and cadmium concentrations in the sediment materials at the localities related to the examined and control group are below GVI.The lead concentration in the umbilical cord blood is higher in the control group with respect to the examined one though without statistic significance. The lead concentration in the human milk is higher in the control group than in the examined one though without statistic significance. The average values of lead in the placenta tissue are higher in the examined than in the control group though without statistic significance. In the material in which lead was determined there was a correlation established between mothers smoking during the pregnancy and the lead concentration in the placenta tissue of the control group.The average values of cadmium in the umbilical cord blood, human milk and placenta tissue are higher in the control group than in the examined one without statistically significant difference. The determined cadmium values in the human milk in both the groups are smaller than MDK for cadmium in the human milk. In the material in which cadmium was determined, there was a correlation established between mother's smoking during the pregnancy and the cadmium concentration in the human milk in the control group.The determined concentrations of lead and cadmium in the examined material are higher in the control one than in the examined group (except for lead concentration in the placenta tissue) which lead us to conclude that, beside the air, there are other, more important ways of introducing lead and cadmium into the pregnant woman's organism.The estimation of the urea and creatinine level in the serum as well as the proteinuria estimate did not establish any toxic effects of the examined heavy metals upon the kidney function.The research carried out with the babies born on time in the first seven days of life did not confirm the working hypothesis.
Unexpected rapid maternal death after delivery due to HELLP syndrome is rarely encountered and may become the subject of forensic expertise. Unexpectedness, suddenness, and fulminant course of this ...syndrome as well as absence of classical signs of pre-eclampsia can confuse physicians and lead to diagnostic delay. A definitive post-mortem diagnosis of HELLP syndrome in questionable cases of maternal death should be based on accepted laboratory criteria and characteristic histopathological alterations. We present a case of acute postpartum HELLP syndrome complicated by disseminated intravascular coagulation and acute renal failure which caused rapid maternal death only 20 hours after a caesarean section following an uncomplicated pregnancy.
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