IntroductionAbdominal ultrasonography has replaced barium studies in establishing the diagnosis in difficult cases of infantile hypertrophic pyloric stenosis (IHPS). The aim of this retrospective study was to establish sonographic criteria of qualification for surgical treatment in children with IHPS.Material and methodsHundred and fifteen infants (98 boys and 17 girls) with suspected IHPS were treated between 2000 and 2009. Pyloric muscle thickness, pyloric diameter and pyloric length were measured in US scans in all patients. Results were compared with US results of 19 infants with negative diagnosis and 29 children of the reference group.ResultsDiagnosis of IHPS was confirmed by US examination in 96 children (83.5%). There were 86 boys in the group with male prevalence 8.6 : 1. The remaining 19 infants (16.5%) had a negative ultrasound. The mean PL (20.89 vs. 12.73), PMT (5.41 vs. 2.24), and PD (14.1 vs. 7.42) differed significantly between patients with and without pyloric stenosis (p < 0.0001). The mean PL (12.34), PMT (2.2), and PD (7.48) in the reference group did not differ statistically from values obtained in patients with negative IHPS diagnosis and were significantly lower than in children from the IHPS group (p < 0.0001). US imaging had a sensitivity of 98%, specificity of 100%, with a positive and negative predictive value of 100% and 90% respectively.ConclusionsThis study confirmed that ultrasonography is the first choice of diagnostic method in an infant with suspected hypertrophic pyloric stenosis. In cases with an uncertain clinical diagnosis of IHPS the examination can be easily repeated.
the aim of the study. To decide on the accurate way of treatment and to establish criteria for operation in boys with pubertal epididymal cysts (ECs). Material and methods. Results of scrotal ultrasound of 363 boys and adolescents, aged 2 months to 18 years, were reviewed retrospectively. Results. of all 363 patients with scrotal ultrasound 59 (16.2%) at mean age of 14.03 yrs had ECs. The EC incidence increased with age and 42 out of 124 boys (33.8%) older than 14 yrs had cysts (chi 2 =27.627, p=0.000). out of 59 patients, in 30 (50.8%) cysts were diagnosed incidentally at the time of scrotal US, 29 boys (49.2%) presented with scrotal mass and/or pain. 31 patients with ECs (52.5%) underwent elective surgery and the remaining 28 boys (47.5%) received conservative treatment. The age of boys with ECs who underwent surgery ranged from 8 to 18 years (mean 14.32). The age range of patients treated conservatively was 7-18 (mean 13.71). There was no statistical difference in age between boys treated surgically and conservatively (t=0.924, p=0.36). ECs resolved in 17 patients out of 28 boys treated conservatively, in remaining 11 boys the size of cysts was stabile and they remain asymptomatic. Clinical and ultrasonographic follow-up were carried out from 11 months to 5 years. Conclusions. ECs are more common in older boys (over 14 years). Management of ECs smaller than 10 mm should be conservative with clinical and ultrasound controls, leaving surgery for cysts increasing in size over 10 mm which did not involute with time.
This work deals with electromyography (EMG) signal processing for the diagnosis and therapy of different muscles. Because the correct muscle activity measurement of strongly noised EMG signals is the major hurdle in medical applications, a raw measured EMG signal should be cleaned of different factors like power network interference and ECG heartbeat. Unfortunately, there are no completed studies showing full multistage signal processing of EMG recordings. In this article, the authors propose an original algorithm to perform muscle activity measurements based on raw measurements. The effectiveness of the proposed algorithm for EMG signal measurement was validated by a portable EMG system developed as a part of the EU research project and EMG raw measurement sets. Examples of removing the parasitic interferences are presented for each stage of signal processing. Finally, it is shown that the proposed processing of EMG signals enables cleaning of the EMG signal with minimal loss of the diagnostic content.
The use of UT and EIT technologies gives the opportunity to develop new, effective, minimally invasive diagnostic methods for urology. The introduction of new diagnostic methods into medicine requires the development of new tools for collecting, processing and analysing the data obtained from them. Such system might be seen as a part of the electronic health record EHR system. The digital medical data management platform must provide the infrastructure that will make medical activity possible and effective in the presented scope. The solution presented in this article was implemented using the newest computer technologies to obtain advantages such as mobility, versatility, flexibility and scalability. The architecture of the developed platform, technological stack proposals, database structure and user interface are presented. In the course of this study, an analysis of known and available standards such as Hl7, RIM, DICOM, and tools for collecting medical data was performed, and the results obtained using them are also presented. The developed digital platform also falls into an innovative path of creating a network of sensors communicating with each other in the digital space, resulting in the implementation of the IoT (Internet of Things) vision. The issues of building software based on the architecture of microservices were discussed emphasizing the role of message brokers. The selected message brokers were also analysed in terms of available features and message transmission time.
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