Characterization of tuberculosis in children and adolescents in underdeveloped country

Objective To associate the territory of identity with the production of care within a PCC focusing on children and adolescents with drug abuse and their institutional identity. Method We used the “ process tracing methodology” in four research categories: focus groups, characterization of professionals, observing the everyday and interviewing two members of emblematic cases of the service. Results territory of identity of the institution, which operates the production of care is crossed by the difficulty of dealing with the complexity brought by the users and the performance of the PCC network. This paper is also permeated by different conceptions of care and small problematization of these issues in collective spaces of service. Conclusion The discussion in focus groups and other devices can be powerful resources to reframe the meaning of care and identity of collective service.

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Accuracy of shear wave elastography in characterization of thyroid nodules in children and adolescents

Insights into Imaging ◽

10.1186/s13244-021-01074-7 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Mohammed Hazem ◽

Ossama M. Zakaria ◽

Mohamed Yasser Ibrahim Daoud ◽

Ibrahim Khalid Al Jabr ◽

Abdulwahab A. AlYahya ◽

...

Keyword(s):

Children And Adolescents ◽

Shear Wave ◽

Diagnostic Performance ◽

Thyroid Nodules ◽

Shear Wave Elastography ◽

Invasive Technique ◽

Predictive Values ◽

Patients Âgés ◽

Non Invasive

Abstract Background Thyroid nodules are an important health problem in children and adolescents. They possess a higher risk of malignancy in comparison to adults. This fact forms a great dilemma for clinicians. The aim of this study was to evaluate the reliability of shear wave elastography (SWE) as a non-invasive technique in the characterization of thyroid nodules in children and adolescents. Methods This prospective study included 56 patients with thyroid nodules. All the patients underwent clinical assessment, laboratory investigations, ultrasound, and Doppler examination, followed by an SWE assessment. Statistical analysis was performed and the best cut-off value to differentiate benign from malignant nodules was determined using the ROC curve and AUC. Results Seventy-two nodules were detected in the examined patients (ages ranged from 11 to 19 years, with mean age of 14.89 ± 2.3 years). Fifty-eight nodules (80.6%) were benign, and fourteen nodules (19.4%) were malignant (histopathologically proved). Highly suspicious criteria for prediction of malignancy by ultrasound and Doppler were hypoechoic echopattern, internal or internal and peripheral vascularity, microcalcifications, taller-than-wide dimensions, irregular outlines, and absence of halo (p < 0.05). The diagnostic performance for their summation was 70.69% sensitivity, 82.8% specificity, 80.45% accuracy, a 63.79% positive predictive value (PPV), and 87.9% negative predictive values (NPV). Regarding SWE, our results showed that 42.2 kPa was the best cut-off value, with AUC = 0.921 to differentiate malignant from benign nodules; the diagnostic performance was 85.71% sensitivity, 94.83% specificity, 93.06% accuracy, 76.9% PPV, and 93.2% NPV. Conclusion Shear wave elastography is a non-invasive technique that can assist in the diagnosis of malignant thyroid nodules among children and adolescents.

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DETECTION AND DIFFERENTIAL DIAGNOSTICS OF TUBERCULOSIS IN CHILDREN AND ADOLESCENTS

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2017-95-9-34-39 ◽

2017 ◽

Vol 95 (6) ◽

pp. 34-39 ◽

Cited By ~ 1

Author(s):

L. A. Bаryshnikovа ◽

◽

V. A. Аksenovа ◽

N. I. Klevno ◽

◽

...

Keyword(s):

Children And Adolescents ◽

Differential Diagnostics ◽

Tuberculosis In Children

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THE TREATMENT OF PRIMARY TUBERCULOSIS IN CHILDHOOD

PEDIATRICS ◽

10.1542/peds.26.4.641 ◽

1960 ◽

Vol 26 (4) ◽

pp. 641-653

Author(s):

A. Lotte ◽

H. Noufflard ◽

Robert Debrá ◽

H. E. Brissaud

Keyword(s):

Children And Adolescents ◽

Acquired Resistance ◽

Age Groups ◽

Primary Tuberculosis ◽

Definite Answer ◽

Spontaneous Course ◽

Resistant Strains ◽

Statistical Survey ◽

Tuberculosis In Children

A preliminary inquiry of the Institut National d'Hygiéne (France), based on the follow-up of 5,526 cases of primary tuberculosis in children and adolescents, is reported; 1,425 cases were seen before 1955 and included in the statistical survey concluded in June, 1956. The spontaneous course of 895 patients who received no treatment is analyzed; special emphasis is placed on complications and their relative incidence in the different age groups and forms of primary tuberculosis. Comparative studies of treated and untreated cases were possible only in patients under 15 years of age and in clinically manifest forms of tuberculosis (Types II, III, and IV). These cases represent a total of 1,061 cases; 564 patients received treatment, 497 received no treatment. Findings in the different age groups are analyzed. A bacteriologic inquiry was also made on the problem of contamination with streptomycin- and isoniazid-resistant strains of M. tuberculosis and on secondarily acquired resistance to isoniazid in treated patients. A decrease of more than 80% in the incidence of complications led to the conclusion that routine chemotherapy should be resorted to in clinically manifest primary tuberculosis in children and adolescents. In the case of completely latent primary tuberculosis, however, a definite answer cannot be given as yet. It is the purpose of the future development of the trial to try to answer that question.

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