scholarly journals Role of ultrasound in the diagnosis of cervical tuberculous lymphadenitis in children

Author(s):  
Tian-Zhuo Yu ◽  
Ying Zhang ◽  
Wen-Zhi Zhang ◽  
Gao‑Yi Yang

Abstract Background To describe sonographic characteristics of cervical tuberculous lymphadenitis (CTBL) in children, clinical information, and sonograms of 348 lymph nodes (LNs) from 57 children with CTBL were retrospectively analyzed in this study. Methods We retrospectively reviewed the clinical data and sonograms of 348 LNs from 31 boys and 26 girls with CTBL, who were confirmed by pathology or laboratory examination, at the Hangzhou Red Cross Hospital between June 2014 and December 2020. The age of the children ranged from 1 to 14 years (average 7.1 ± 2.9 years). Results Night sweats, fatigue and loss of appetite were the most common clinical symptoms observed in children with CTBL. Unilateral LN involvements were common. Occasionally, CTBL was found in healthy children with no symptoms. On sonography, the hilus was absent or unclear in all LNs. The short-to-long axis (S/L) ratio was ≥ 0.5, and the edges were unclear in most LNs. Other accompanying findings included necrosis (47.4%), an echogenic thin layer (36.8%), surrounding soft-tissue edema (38.5%), multiple intra-nodal strong echo (28.2%), sinus (22.7%) and abscess formation (6.9%). The Doppler ultrasound showed that the majority of vascularity patterns of CTBL were capsular or peripheral (33.3%). Conclusions Ultrasound is a recommended examination method for children from different age groups with cervical lymphadenitis. The ultrasonic signs of hilus absence, S/L ratio ≥ 0.5, unclear edge, necrosis, echogenic thin layer, strong echoes and capsular or peripheral vascularity may aid in the diagnosis of cervical tuberculous lymphadenitis.

2018 ◽  
Vol 75 (5) ◽  
pp. 516-520
Author(s):  
Gordana Kostic ◽  
Rasa Medovic ◽  
Slavica Markovic ◽  
Zorica Raskovic ◽  
Zoran Igrutinovic ◽  
...  

Introduction. After the contact with a patient suffering from tuberculosis (TB), previously healthy children have 1%?16% possibility to develop the disease. TB diagnosis in children is not easy to confirm so 15%?25% of cases remain undiagnosed. Case report. A 15-yearold- boy was hospitalized with productive cough, pain in the right flank area, fever, and fatigue, loss of appetite and night sweats. One of the boy's uncles was cured of tuberculosis, another uncle had active tuberculosis and both of them were in contact with the boy, but they did not live in the same household. During the physical examination, the child was febrile, with dyspnea, pale, with profuse sweating, debilitate. BCG (Bacillus Calmette ? Gu?rin) scar was present. The auscultatory findings of the lungs showed quiet breathing from the scapula to the right lung base and chest radiography suggested massive right sided pleuropneumonia. The parameters of the inflammation were high and Mycobacterium tuberculosis (MTB) was not found in the samples of sputum and gastric lavage. Pleural puncture revealed exudative nature in the aspirated fragment. Cytology was nonspecific, the MTB was not found and the planted surfaces on Lowenstein-Jensen remained sterile. Tuberculin skin test (TST) ? Mantoux was positive (+ 10 mm), Interferon Gamma Release Assay (QuantiFERON- TB GOLD In-Tube) was negative. The boy was unsuccessfully treated with broad spectrum antibiotics. By video-assisted thoracoscopy, the pleural tissue clip confirmed the benign chronic granulomatous process, while histochemical staining did not show MTB. The treatment with anti-TB medication led to clinical and radiographic recovery. The boy is now in good general condition, without consequences of the disease. Conclusion. This case report pointed out the importance of risk factors and difficulties in diagnosing TB in children.


2016 ◽  
Vol 7 (3) ◽  
pp. 35-41
Author(s):  
Irina B Ershova ◽  
Irina A Lokhmatova

Intestinal helminthic infections have various adverse effects on the health of children. Ascariasis is one of the most common intestinal helminthics. Long parasitism of the roundworm in the body of the child leads to the formation astheno-vegetative syndrome, lag in physical, mental and intellectual development.The aim of our study was to investigate the featuers of manifestations of asthenic syndrome in children of different age groups with intestinal stage of ascariasis. The results of 133 children observations (age from 1 to 18 years) with intestinal stage of ascariasis were presented in our research. Rate the overall status of children with identifying syndromes related to manifestations of worm infestations, particular attention was paid to the terms of clinical symptoms appearance of he disease. The study showed that the asthenic syndrome occurs in 3 times more often in children with intestinal stage of ascariasis, compared to the relatively healthy children (p < 0.01). The most characteristic symptoms of asthenic syndrome were slackness and fatigue (62.4%), irritability (64.66%), capriciousness and hysterical states (61.65%), decreased memory and attention (43.61%), emotional lability (34%) and headache (25.56%). In preschool children more frequently (p < 0.01) were recorded capriciousness and hysterical state (over 75%). Complaints about the deterioration of memory and attention deficits (55.56–76.47%) were observed in school-age children more frequently (p < 0.01). Young people significantly more common complainted on headaches (62.5%; p < 0.05). Slackness, fatigue and irritability occurred significantly more frequently (p < 0.01) among all age groups of children with ascariasis.


1976 ◽  
Vol 81 (2) ◽  
pp. 330-339 ◽  
Author(s):  
K. Parth ◽  
H. Zimprich ◽  
Roswitha Brunel

ABSTRACT An accurate and relatively simple radioimmunoassay for the determination of aldosterone concentration in peripheral plasma has been developed. 0.5–2.0 ml plasma with added [1,2-3H] aldosterone is extracted with dichloromethane. Purification of the extract is achieved by thin layer chromatography in the system benzene-acetone 1:1. Recovery of [1,2-3H] aldosterone is 58 ± 6 (sd) %. Bound and free fractions are separated by dextran-coated charcoal. The intra-assay reproducibility is 8.8 % and the inter-assay reproducibility varies from 11.4–16.1 %. The sensitivity of the assay for a 5 ml plasma sample can be put at 0.2 ng/100 ml. Normal values determined in 52 healthy children of different age groups are presented. Furthermore the aldosterone stimulating effect of low sodium diet (17 children), severe and prolonged vomiting (19 children) and synthetic ACTH (10 children) has been studied by our modified method.


Author(s):  
Anders Batman Mjelle ◽  
Anesa Mulabecirovic ◽  
Roald Flesland Havre ◽  
Edda Jonina Olafsdottir ◽  
Odd Helge Gilja ◽  
...  

Abstract Purpose Liver elastography is increasingly being applied in screening for and follow-up of pediatric liver disease, and has been shown to correlate well with fibrosis staging through liver biopsy. Because time is of the essence when examining children, we wanted to evaluate if a reliable result can be achieved with fewer acquisitions. Materials and Methods 243 healthy children aged 4–17 years were examined after three hours of fasting. Participants were divided into four age groups: 4–7 years; 8–11 years; 12–14 years and 15–17 years. Both two-dimensional shear wave elastography (2D-SWE; GE Logiq E9) and point shear wave elastography (pSWE; Samsung RS80A with Prestige) were performed in all participants, while transient elastography (TE, Fibroscan) was performed in a subset of 87 children aged 8–17 years. Median liver stiffness measurement (LSM) values of 3, 4, 5, 6, 7, and 8 acquisitions were compared with the median value of 10 acquisitions (reference standard). Comparison was performed for all participants together as well as within every specific age group. We investigated both the intraclass correlation coefficient (ICC) with absolute agreement and all outliers more than 10 %, 20 % or ≥ 0.5 or 1.0 kPa from the median of 10 acquisitions. Results For all three systems there was no significant difference between three and ten acquisitions, with ICCs ≥ 0.97. All systems needed 4 acquisitions to achieve no LSM deviating ≥ 1.0 kPa of a median of ten. To achieve no LSM deviating ≥ 20 % of a median of ten acquisitions, pSWE and TE needed 4 acquisitions, while 2D-SWE required 6 acquisitions. Conclusion Our results contradict recommendations of 10 acquisitions for pSWE and TE and only 3 for 2D-SWE.


2019 ◽  
Vol 1 (8) ◽  
pp. 42-50
Author(s):  
A. V. Budkevich ◽  
L. B. Ivanov ◽  
G. R. Novikova ◽  
G. M. Dzhanumova

According to the authors, rationing the age-related EEG parameters in children should be based on personal psychical characteristics. A comparative analysis of personal psychical characteristics and electroencephalographic data was carried out in 300 apparently healthy children aged 3-15 years. According to this principle, two subgroups of conditionally healthy children in each age group were singled out: 1) with an immature attention function and 2) with an increased anxious background that do not reach the pathological level. Registration and analysis of EEG was performed by the Neurokariograf computer complex (MBN, Moscow) using mathematical processing methods.The EEG interpretation was based on the principle of assessing the functional state of a child's brain using a three-component model according to: 1) wakefulness level and its dissociation, 2) severity of signs of the EEG neurotic pattern, 3) directionality of formation of traits of the system-functional brain organization (severity of signs functional hypofrontality).lt was found the presence of EEG signs was indicative of a lower level of wakefulness in children with an immature function of attention in all age groups, compared with the indicators of the average population of group and children with an increased background of anxiety. Children with an increased background of anxiety have a tendency to prevalence and excessive spatial synchronization of the alpha rhythm. ln healthy children, the fact of a decrease in wakefulness and the presence of signs of anxiety in the clinic and in EEG patterns indicates individual personalities and should not be considered as pathology.


2021 ◽  
Vol 7 (1) ◽  
pp. 18
Author(s):  
Christiane Auray-Blais ◽  
Michel Boutin ◽  
Pamela Lavoie ◽  
Bruno Maranda

The Quebec Neonatal Urine Screening Program was initiated in 1971 with overall screening inception of newborns in 1973. Forty-seven years later, over 3.5 million babies have been screened for up to 25 inborn errors of metabolism divided into two groups: (1) urea cycle disorders and organic acidurias; and (2) disorders of amino acid metabolism and transport. The main goal of this preventive genetic medicine program is the detection of treatable diseases before the onset of clinical symptoms. Urine specimens from 21-day-old babies are collected and dried on filter paper by parents at home. The participation is voluntary with a high compliance rate over the years (~90%). Specimens are analyzed by thin layer chromatography (TLC). The main objective of this evaluative research project was to assess the feasibility of a technological upgrade towards mass spectrometry. A 2.85-min flow injection method was devised, normal values established, and abnormal profiles confirmed using second-tier tests. The validated assays are sensitive, specific, and suitable for populational screening, as well as for high-risk screening laboratories. Triple H syndrome, which would not be detected in newborns by blood screening at two days of age was found to be positive in the urine of an affected patient.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044208
Author(s):  
Amalie Lykkemark Moeller ◽  
Elisabeth Helen Anna Mills ◽  
Helle Collatz Christensen ◽  
Filip Gnesin ◽  
Stig Nikolaj Fasmer Nikolaj Blomberg ◽  
...  

ObjectiveCurrently effective symptom-based screening of patients suspected of COVID-19 is limited. We aimed to investigate age-related differences in symptom presentations of patients tested positive and negative for SARS-CoV-2.DesignSettingCalls to the medical helpline (1-8-1-3) and emergency number (1-1-2) in Copenhagen, Denmark. At both medical services all calls are recorded.ParticipantsWe included calls for patients who called for help/guidance at the medical helpline or emergency number prior to receiving a test for SARS-CoV-2 between April 1st and 20th 2020 (8423 patients). Among these calls, we randomly sampled recorded calls from 350 patients who later tested positive and 250 patients tested negative and registered symptoms described in the call.OutcomeResultsAfter exclusions, 544 calls (312 SARS-CoV-2 positive and 232 negative) were included in the analysis. Fever and cough remained the two most common of COVID-19 symptoms across all age groups and approximately 42% of SARS-CoV-2 positive and 20% of negative presented with both fever and cough. Symptoms including nasal congestion, irritation/pain in throat, muscle/joint pain, loss of taste and smell, and headache were common symptoms of COVID-19 for patients younger than 60 years; whereas loss of appetite and feeling unwell were more commonly seen among patients over 60 years. Headache and loss of taste and smell were rare symptoms of COVID-19 among patients over 60 years.ConclusionOur study identified age-related differences in symptom presentations of SARS-CoV-2-positive patients calling for help or medical advice. The specific symptoms of loss of smell or taste almost exclusively reported by patients younger than 60 years. Differences in symptom presentation across age groups must be considered when screening for COVID-19.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Geraldine Landon ◽  
Isabelle Denjoy ◽  
Enora Clero ◽  
Aleksandr Silenok ◽  
Irina Kurnosova ◽  
...  

AbstractBetween 2009 and 2013, a large cross-sectional study on the health consequences of the Chernobyl nuclear accident was performed in the contaminated and uncontaminated territories of the Bryansk Oblast (Russian Federation). The objective of this work was to confirm or refute a possible association between childhood cardiac arrhythmia and a chronic exposure to caesium-137. As part of this study, a large number of electrocardiographic and cardiac ultrasound parameters were collected from 18,152 children aged 2–18 years including 12,512 healthy ones not contaminated with caesium-137. It seemed therefore relevant for us to share in a second publication these medical data based on healthy and uncontaminated children with the scientific community because of the large quantities and the limited availability of such kind of data. In the present study, relating to electrocardiographic parameters, the measurements performed fully reflect the expected evolution of the paediatric electrocardiogram between 5 and 18 years of age. Thus, the median values were generally quite close to those available in the literature. In contrast, differences in the 2nd and 98th percentiles were notable and could be explained in particular by the type of equipment used, the number of subjects included in the study and racial disparities. As for echocardiographic parameters, the evolution of the measured values in age groups is consistent with what was expected considering factors such as growth. In comparison with other scientific studies that have investigated these echocardiographic parameters, some differences by age groups have been identified. The ethnic factor truly appears to be a relevant feature to consider. In view of the results, it appeared essential to the authors to approach the methodological conditions of the scientific studies already published on the topic to be truly comparable and thus to provide a reliable answer on a topic for which real expectations in terms of medical care are required.


PEDIATRICS ◽  
1956 ◽  
Vol 18 (1) ◽  
pp. 31-38
Author(s):  
Paul R. Patterson ◽  
Earle L. Lipton ◽  
Klaus R. Unna ◽  
Kurt Glaser

The susceptibility of healthy children to neostigmine by hypodermic injection was studied in controlled experiments on 45 children ranging in age from 1 month to 12 years. Minimum effective doses (MED) of neostigmine were determined by their effect in stimulating salivary and sweat glands, and in increasing gastrointestinal motility. The MED of neostigmine for stimulation of salivation is in all age groups smaller (by 6 to 38 per cent) than the MED increasing gastrointestinal motility. The average MED either for glandular (.025 to .036 mg./kg.) or gastrointestinal (.036 to .045 mg./kg.) activity fails to show significant differences among the various age groups when expressed in terms of body weight. Exceptions were found exclusively in children weighing more than 30 kg. The findings do not support the view that a physiologic vagotonia is present in infants.


PEDIATRICS ◽  
1967 ◽  
Vol 39 (2) ◽  
pp. 252-257
Author(s):  
Mary L. Voorhess

There is increase in the daily urinary excretion of dopamine (DA), norepinephrine (NE), epinephrine (E), and 3-methoxy-4-hydroxymandelic acid (VMA) with age. The mean output in micrograms per 24 hours for various age groups is as follows: birth to 1 year-DA 60.9 (± 24.3), NE 10.6 (± 3.4), E 1.3 (± 1.2), VMA 569 (± 309); 1 through 5 years—DA 124.1 (± 40.7), NE (18.8 ± 7.0), E 3.2 (± 2.7), VMA 1348 (± 433); 6 through 15 years—DA 169.3 (± 72.6), NE 37.4 (± 16.6), E 4.8 (± 2.4), VMA 2373 (± 698); over 15 years—DA 249.1 (± 74.9), NE 50.7 (± 15.7), E 7.1 (± 3.3), VMA 3192 (± 699). The studies suggest that the daily output of these compounds in the various age groups is similar when related to body surface area after infancy.


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