[INTRODUCTION - The primary aim of the study was to investigate the possibility of a teratogenic effect of vaginal metronidazole treatment during pregnancy. MATERIALS AND METHODS - Various congenital abnormalities and all (1-3) their matched controls were analysed in the population-based database of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996. The study group comprised 38 151 pregnant women who had newborns without any congenital abnormalities (control group) and 22 843 pregnant women who had newborns or fetuses with congenital abnormalities. Main outcome measures were analysed in 22 congenital abnormalities groups. The use of metronidazole during the second and third trimesters being common, the secondary objective of the study was to analyse the effect of vaginal metronidazole treatment (500 mg of Klion) on gestational age and birth weight in the control group without congenital abnormalities. RESULTS - The prevalence of vaginal metronidazole treatment during pregnancy was 1.7% in the case group (n=388) and 1.5% in the control group (n=570) (odds ratio (OR), 1.1, 95% confidence interval (CI): 1.0-1.3). Comparisons of cases and their matched controls showed an association between vaginal metronidazole treatment during the second and third months of gestation and congenital hydrocephaly (adjusted OR with 95% CI, 10.7, 1.1-104.5), but this was only based on five cases. The analysis of metronidazole treatment reported by the physicians did not confirm this association. After metronidazole use the mean gestational age was slightly shorter (by 0.1 week) and the mean birth weight was also slightly lower (by 40g) in the treated group. CONCLUSION - This finding should only be regarded as an indication for a possible association between vaginal treatment with metronidazole during pregnancy and congenital hydrocephalus. The results showed that vaginal metronidazole treatment alone was not able to prevent a possible vaginal infection that is associated with preterm birth, and that the prevalence of low birth weight was higher among treated women. The protective effect of metronidazole on preterm birth and low birth weight was not confirmed.]

[INTRODUCTION - The congenital absence of celiac trunk and it’s subtotal stenosis are rare abnormalities and often recognised only during digital substraction angiography (DSA). This anomaly is significant when there is a need to perform local intraarterial chemoperfusion or chemoembolisation of malignant hepatic tumours. In these cases the liver is supplied with arterial blood through the superior mesenteric artery and the gastroduodenal arch. The direction of blood flow in the common hepatic artery is changed ensuring the flow to the splenic and left gastric artery. In such circumstances it is not possible to obtain local chemotherapy. CASE REPORT - Two male patients (61 and 75 years old) are reported. Both patients were candidates for chemotherapy due to hepatocellular carcinoma (HCC). In these two cases the planned therapy was impossible because of a stenosis of the celiac trunk in one, and atresia of the celiac trunk in the other. CONCLUSION - The recognition of vascular anomaly prior to endovascular intervention significantly affects the planning of the therapy.]

[This consensus document is intended to provide guidance for the effective and efficient treatment of asymptomatic individuals with high uric acid levels and gout patients.]