RESUMEN

During a 6 years' period (2 years of control, 2 years of risk group and 2 years of routine screening) the authors examined the effect of different diagnostical methods on the frequency of detected renal developmental anomalies. The incidence of documented renal malformations was 1.1% during the use of classical diagnostical methods, 8.3% during the application of intrauterine routine and postnatal risk group screening, and 10.3% after the introduction of postnatal routine screening in 2 years' periods. The advantage of both postnatal risk group and postnatal routine screening was that the greatest part of renal anomalies could have been diagnosed before the appearance of the symptoms of urinary infection. On the basis of effectivity of postnatal routine screening and decrease of uncertainty of postnatal risk group screening authors suggested the introduction of the postnatal routine screening as general practice under our own circumstances.

Asunto(s)

RESUMEN

By analysing their newborn patients of 15 years the authors confirm the earlier observation, that the subcapsular haematoma is a common finding at postmortem examination of the newborns dying during neonatal period. The association of the pathological symptoms of hypoxic origin of the other organs observed at autopsy and the decreasing incidence of subcapsular haematoma as a results of obstetrical and neonatal intensive care make this disease of hypoxic origin probable. In spite of common subcapsular haematoma the haemorrhage of liver causing haemascos is relatively uncommon. In their five patients suffering from liver rupture they observed two types of this (immediate and delayed rupture of liver's capsule), which also differed from one another in their clinical picture. They are drawing attention to general use of ultrasound in diagnostics which means a new chance to diagnosis in alive of both types.

Asunto(s)

RESUMEN

During a six-month period the authors have been diagnosing 25 neonatal adrenal haemorrhage by 870 ultrasound screening examinations. This frequency (28.7%) is surprisingly high in comparison with earlier postmortem estimated literature data (1.7-6.0%). In 24 survived neonates the adrenal haemorrhage was absorbed between 6 weeks and 4 months, no disturbances in the electrolyte levels were found, and the haemorrhage did not require any treatment. However, the authors observed pathological neurological symptoms or intracranial haemorrhage as more than 30% of the newborn infants suffering from adrenal haemorrhage. On the basis of ultrasound signs of adrenal haemorrhages the authors distinguish three groups, namely, cortical, medullar and apoplectiform haemorrhages. By analysing the history, clinical symptoms and follow up study of adrenal haemorrhages in the newborn period the authors conclude that infants born as "large for date babies", suffered from intrauterine asphyxia, forceps or vacuum extractions can be taken the risk of adrenal haemorrhage.

Asunto(s)

RESUMEN

The authors diagnosed 40 renal malformations during 2 years investigated and 2 years control period. On the basis of analysing their patients they came to the conclusion that after the introduction of intrauterine routine ultrasound examinations and screening of childhood risk group the number of recognised renal malformations increased significantly (32 in the investigated and only 8 in the control period). Furthermore the age of patients at the time of diagnosing shifted to the early postnatal period, and the number of patients diagnosed on the basis of the positive urinary investigations decreased significantly. But the intrauterine routine ultrasound investigation at presently applied examination system can consider only one-third of fetal renal malformations. And also an important fact that the increased number of considered patients came from the increasing of patients who have needed operation and did not increase the number of infants who have needed only conservative therapy. According to the small surgical complications they concluded that the risk of the early surgical intervention does not seem to be higher than in case of postponed ones. On the basis of clinical observation with childhood risk group arising the necessarity of the non invasive postnatal routine screening.

Asunto(s)

Asunto(s)

RESUMEN

The authors have twice observed undesirable effects of adrenaline during the demonstration of malignant renal tumours. Following adrenaline there was less flow of contrast medium into the tumour vessels than during angiography without the drug. In their opinion, this is due to the fact that constriction of the inter-lobar arteries occludes the vessels supplying the tumour, and that in some cases the new-formed vessels react strongly to adrenaline. In a third case, the tumour vessels reacted much more strikingly to adrenaline than would have been expected from previous experience. They therefore doubt whether pharmaco-angiography with adrenaline is always indicated for demonstrating malignant renal tumours; adrenaline may be expected to produce a positive result only in these cases in which there is a central origin of the artery supplying the tumour. They therefore suggest a change to some other, more suitable drug.

Asunto(s)

Asunto(s)