scholarly journals Splenomegaly in Children and Adolescents

2021 ◽  
Vol 9 ◽  
Author(s):  
Meinolf Suttorp ◽  
Carl Friedrich Classen
Keyword(s):  
Children And Adolescents ◽  
Correct Diagnosis ◽  
Lymphoid Tissues ◽  
White Pulp ◽  
Main Task ◽  
Morphological Alterations ◽  
Composition And Structure ◽  
Children And Young Adolescents ◽  
Altered Blood ◽  
Cellular Immune

In contrast to other lymphoid tissues making up the immune system, the spleen as its biggest organ is directly linked into the blood circulation. Beside its main task to filter out microorganism, proteins, and overaged or pathologically altered blood cells, also humoral and cellular immune responses are initiated in this organ. The spleen is not palpable during a physical examination in most but not all healthy patients. A correct diagnosis of splenomegaly in children and adolescents must take into account age-dependent size reference values. Ultrasound examination is nowadays used to measure the spleen size and to judge on reasons for morphological alterations in associated with an increase in organ size. An enormous amount of possible causes has to be put in consideration if splenomegaly is diagnosed. Among these are infectious agents, hematologic disorders, infiltrative diseases, hyperplasia of the white pulp, congestion, and changes in the composition and structure of the white pulp by immunologically mediated diseases. This review attempts to discuss a comprehensive list of differential diagnoses to be considered clinically in children and young adolescents.

scholarly journals Extracellular matrix of lymphoid tissues in the chick.

1989 ◽  
Vol 37 (5) ◽  
pp. 757-763 ◽  
Author(s):  
A Colombatti ◽  
A Poletti ◽  
A Carbone ◽  
D Volpin ◽  
G M Bressan
Keyword(s):  
Extracellular Matrix ◽  
Epithelial Cells ◽  
Basement Membrane ◽  
Basement Membranes ◽  
Intestinal Lumen ◽  
Lymphoid Tissues ◽  
White Pulp ◽  
Extracellular Matrix Components ◽  
Coarse Fibers ◽  
Distribution Of Components

We describe the immunohistochemical distribution of components of the extracellular matrix of the chick lymphoid system. In the thymus, basement membranes of epithelial cells bordering the lobules were intensely stained by laminin antibodies; fibronectin antibodies labeled the capsule and the septal matrix, and similar reactivity was seen with tropoelastin and gp 115 antibodies. No positivity was detected with any of the antibodies within the cortical parenchymal cells. Laminin was not detected in the medullary parenchyma, whereas fibronectin was present as coarse fibers. Tropoelastin and gp 115 appeared as a finer and more diffuse meshwork. In the bursa, laminin antibodies outlined the epithelial cells separating the cortex from the medulla. Fibronectin, tropoelastin, and gp 115 antibody stained the interfollicular septa and the cortical matrix, although to a different extent. Laminin was also detected in association with the interfollicular epithelium (IFE) basement membrane, whereas no staining was found underneath the follicle-associated epithelium (FAE). FAE cells not only lack a proper basement membrane but are also not separated from medullary lymphocytes by any of the other extracellular matrix components were investigated. Consequently, medullary lymphocytes are not sequestered, and can come easily into contact with antigens present in the intestinal lumen. All four antibodies stained the spleen capsule and spleen blood vessels, tropoelastin and gp 115 antibodies giving the strongest reactivity. A fine trabecular staining pattern was detected with gp 115 antibodies in the white pulp.

scholarly journals Primary lung neoplasms presenting as multiple synchronous lung nodules

2020 ◽  
Vol 29 (157) ◽  
pp. 190142
Author(s):  
Subha Ghosh ◽  
Atul C. Mehta ◽  
Sami Abuquyyas ◽  
Shine Raju ◽  
Carol Farver
Keyword(s):  
Lung Neoplasms ◽  
Correct Diagnosis ◽  
Ct Scanning ◽  
The Body ◽  
Lung Nodules ◽  
Lymphoid Tissues ◽  
Imaging Features ◽  
Primary Malignancy ◽  
Bilateral Lung ◽  
Diagnostic Work

Multiple synchronous lung nodules are frequently encountered on computed tomography (CT) scanning of the chest and are most commonly either non-neoplastic or metastases from a known primary malignancy. The finding may initiate a search for primary malignancy elsewhere in the body. An exception to this rule, however, is a class of rare primary lung neoplasms that originate from epithelial (pneumocytes and neuroendocrine), mesenchymal (vascular and meningothelial) and lymphoid tissues of the lung. While these rare neoplasms also present as multiple synchronous unilateral or bilateral lung nodules on chest CT, they are often overlooked in favour of more common causes of multiple lung nodules. The correct diagnosis may be suggested by a multidisciplinary team and established on biopsy, performed either as part of routine diagnostic work-up or staging for malignancy. In this review, we discuss clinical presentations, imaging features, pathology findings and subsequent management of these rare primary neoplasms of the lung.

Primary Trombocythemia in Children and Adolescents Includes Different Subtypes Compared to Adult Essential Thrombocythemia

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1865-1865
Author(s):  
Fiorina Giona ◽  
Marica Laurino ◽  
Luciana Teofili ◽  
Sara Capodimonti ◽  
Maurizio Martini ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Essential Thrombocythemia ◽  
Conflicts Of Interest ◽  
Correct Diagnosis ◽  
Young Patients ◽  
Antiplatelet Agents ◽  
Wild Type ◽  
Primary Thrombocythemia ◽  
Calr Mutations

Abstract The recent discovery of various mutations of the CALR gene that are mutually exclusive with JAK2 and MPL mutations has allowed a correct diagnosis in about 90% of adult cases of essential thrombocythemia (ET). Moreover, the mutation status of JAK2 and CARL defines subtypes of ET in adults with a substantially different clinical course and outcome. Based on our experience, we suggested that primary thrombocythemia (PT) in children is characterized by subtypes that differ from those found in adult ET. The present study was carried out in children and adolescents with PT in order to (a) characterize the various subtypes of the disease and (b) analyze their clinical and biologic features, treatment approach and outcome. PT patients aged <20 years (yrs) at diagnosis (dx) were evaluated for mutations of JAK2, thrombopoietin (TPO) and its receptor (MPL) and CALR genes, and for clonal hematopoiesis (females). The presence of MPLS505A (confirmed on DNA from buccal swabs) defined a hereditary thrombocytosis (HT). ET was diagnosed according to WHO 2008 criteria. For wild type patients, an additional inclusion criteria was a follow-up >24 months. Among 58 PT patients (males: 23; females: 35; median age at dx: 14.4 yrs), 21 (36%) had HT due to MPLS505A, 14 were JAK2V617F-mutated (24%), 9 (16%) harbored CALR mutations and 14 (24%) were wild type for JAK2, CALR and MPL (Fig 1). JAK2- and CALR-mutated were older than those with wild type ET or with HT (median age, 17.6 and 16.1 vs 10.4 and 13.7 yrs, p .028). As to the hematologic findings, HT patients showed both hematocrit values (median, 36.3%) and leukocytes counts (median, 9.53 x109/L) significantly lower than ET patients, whatever the subtypes (median, 41.2% and 11.2 x109/L, p .006 and p .029, respectively). No differences were found with regard to platelets both between HT and ET and among the different ET subtypes. JAK2-mutated patients exhibited more frequently symptoms (69%) compared to CALR-mutated (22%), wild-type ET (14%) and HT (14%) patients (p. 0057). Splenomegaly at diagnosis was recorded more frequently in JAK2-mutated than in CALR-mutated or wild type-ET or HT (50%, 33% 21% and 14% , respectively, p .122). Antiplatelet agents, mostly acetylsalicylic acid (ASA), were started less frequently in HT than in ET patients, irrespective of the subtypes (57% vs 81%, p .05). The use of ASA progressively decreased over the time; at the last follow-up, 2 patients with HT, 2 CALR-mutated and 1 JAK2-mutated patients were still receiving ASA, while no wild type ET patient was on treatment. Cytoreductive agents, hydroxyurea and/or interferon and/or anagrelide, were used in a minority of HT patients (19%) in comparison with ET patients (65%), p .001, mainly with those wild-type (78%, p <.001). At the last observation, one HT patient was still receiving cytoreductive agents compared to 30% of ET patients whatever the subtypes (p .024). After a median follow-up of 196 months (similar in the different subtypes), all patients are alive. On the whole, 5 thrombotic events were recorded in 3 patients with HT and in 2 ET patients (1 JAK2-mutated and 1 JAK2 and CALR wild-type), without any significant thrombophilic abnormalities during treatment with ASA and/or cytoreductive agents. A progressive splenomegaly was recorded in 9 (15%) patients (2 HT, 4 JAK2-mutated, 3 CALR-mutated) and it was combined with grade ≥2 medullar fibrosis in 2/4 JAK2-mutated and in 2/3 CALR-mutated patients. None of the JAK2 and CALR wild-type patients had spleen enlargement or reticulin fibrosis (p .022). Two untreated patients (1 HT and JAK2 and CALR wild-type) developed malignancies. On the whole, these data emphasize that in young patients with PT, hereditary forms can be frequently observed. Thrombotic events, recorded mainly in HT patients despite treatment with ASA, were probably due to a MRP4 protein overexpression that was found in our MPLS505A HT. Moreover, our observations highlight that, in contrast to adult ET, more than one third of young ET patients have no JAK2 or CALR mutations. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals The Role of Physical Aerobic Activity in Controlling Exercise-Induced Bronchoconstriction in Children and Adolescents with Asthma

2021 ◽  
Vol 11 (4) ◽  
pp. 484-487
Author(s):  
Walid Abdelbasset ◽  
Abbas Elsayed
Keyword(s):  
Physical Activity ◽  
Aerobic Exercise ◽  
Children And Adolescents ◽  
Life Quality ◽  
Aerobic Exercise Training ◽  
Moderate Intensity ◽  
Aerobic Activity ◽  
Children And Young Adolescents ◽  
Exercise Induced

Asthma, one of the major widespread chronic disorders among children and adolescents, has become more prevalent recently. The common manifestations of this disorder are caused by inflammatory airways that lead to airway restriction and lung hypersensitivity causing dry coughing, wheezing, and shortness of breath, all of which are combined with sleep disturbance, impaired physical activity, and reduced quality of life. The main goal of this brief review was to identify the associated variables that affect the management of asthma disease in children and young adolescents and to identify the role of physical aerobic exercise in the treatment of asthmatic children. The current review was based on prior research published in English databases such as Google Scholar, PubMed, and Embase in scientific articles published between January 2010 and October 2021 with the keywords "asthma," "children," "adolescents," "breathing episodes," "physical activity," and "physical exercise." Regular physical aerobic exercise training with moderate intensity has been shown to improve pulmonary functions, life quality, psychological conditions, and reduce asthma symptoms and EIB in children and adolescents with bronchial asthma.

scholarly journals INFLAMMATION-RELATED MORPHOLOGICAL ALTERATIONS IN THE MICROVASCULATURE

2021 ◽  
Vol 21 (1) ◽  
pp. 155-159
Author(s):  
S.М. Bilash ◽  
M.M. Koptev ◽  
N.I. Vynnyk ◽  
O.М. Pronina ◽  
L.M. Shylkina
Keyword(s):  
Time Course ◽  
Microvascular Dysfunction ◽  
Functional System ◽  
Tissue Fluid ◽  
Scientific Publications ◽  
Morphological Alterations ◽  
Small Vessels ◽  
Complex Structural ◽  
Altered Blood ◽  
Main Components

Microvasculature is a complex structural and functional system that regulates blood supply of body organs, provides transcapillary exchange of fluid and supports the tissue homeostasis. The human microvasculature is represented by the system of small vessels: arterioles, capillaries, venules and arteriolovenular anastomoses. The vessels of this complex become flexible in the altered blood flow; they can deposit the blood corpuscles, get affected by spasms and pass plasma only, change their permeability for tissue fluid. Microvasculature is extremely sensitive to the insults of various factors. Microvascular dysfunction coexists or precedes the macrovascular diseases probably due to joint mechanisms of damage to vessels such as oxidative stress and inflammation. Disorders of microcirculation are one of the main components of inflammation. This article is aimed at the analysis of the scientific publications on the study of morphological alterations in the microvasculature in response to inflammation. The bibliosemantic method was used. The findings of current publications on the morphological alterations that occur in the microcirculation in response to inflammation have been investigated. The analysis has shown significant morphological alterations in the microvessels in response to the proinflammatory factors. Inflammatory processes are accompanied by the events of microvascular dysfunction, associated with hyperpermeability of capillaries, destruction of microvascular endothelial barrier, loss of antiadhesive function of endothelium, etc. In response to inflammation, the marked morphofunctional alterations in the microvasculature of the various organs are observed that are dependent on the time course of inflammation. Early onset is manifested mainly by the spasm of the vascular resistance and dilatation of the capacitance vessels. Disorders of blood rheological properties are manifested by stasis, sludge, microthrombosis.

scholarly journals Anorexia nervosa: an increasing problem in children and adolescents

2009 ◽  
Vol 11 (1) ◽  
pp. 100-103 ◽  
Keyword(s):  
Anorexia Nervosa ◽  
Risk Factor ◽  
Eating Disorder ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Early Recognition ◽  
Major Risk Factor ◽  
Family Treatment ◽  
Young Adolescents ◽  
Children And Young Adolescents

Information from eating disorder clinics across five continents suggests that anorexia nervosa is becoming an increasing problem in children and young adolescents. There is some indication that anxiety disorders in childhood may be a major risk factor for the development of anorexia nervosa. Early recognition and family treatment for this disorder are essential to prevent chronic impairment.

scholarly journals The Psychological and Biological Impact of “In-Person” vs. “Virtual” Choir Singing in Children and Adolescents: A Pilot Study Before and After the Acute Phase of the COVID-19 Outbreak in Austria

2022 ◽  
Vol 12 ◽  
Author(s):  
Katarzyna Grebosz-Haring ◽  
Anna K. Schuchter-Wiegand ◽  
Anja C. Feneberg ◽  
Nadine Skoluda ◽  
Urs M. Nater ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Chronic Stress ◽  
Positive Impact ◽  
Moderate Increase ◽  
Social Contacts ◽  
Choral Singing ◽  
Stress Levels ◽  
Before And After ◽  
Children And Young Adolescents ◽  
Age Range

Psychobiological responses to music have been examined previously in various naturalistic settings in adults. Choir singing seems to be associated with positive psychobiological outcomes in adults. However, evidence on the effectiveness of singing in children and adolescents is sparse. The COVID-19 outbreak is significantly affecting society now and in the future, including how individuals engage with music. The COVID-19 pandemic is occurring at a time when virtual participation in musical experiences such as singing in a virtual choir has become more prevalent. However, it remains unclear whether virtual singing leads to different responses in comparison with in-person singing. We evaluated the psychobiological effects of in-person choral singing (7 weeks, from January to March 2020, before the COVID-19 outbreak) in comparison with the effects of virtual choral singing (7 weeks, from May to July 2020, after schools partly re-opened in Austria) in a naturalistic pilot within-subject study. A group of children and young adolescents (N = 5, age range 10–13, female = 2) from a school in Salzburg, Austria were recruited to take part in the study. Subjective measures (momentary mood, stress) were taken pre- and post-singing sessions once a week. Additionally, salivary biomarkers (cortisol and alpha-amylase) and quantity of social contacts were assessed pre- and post-singing sessions every second week. Psychological stability, self-esteem, emotional competences, and chronic stress levels were measured at the beginning of in-person singing as well as at the beginning and the end of the virtual singing. We observed a positive impact on mood after both in-person and virtual singing. Over time, in-person singing showed a pre-post decrease in salivary cortisol, while virtual singing showed a moderate increase. Moreover, a greater reduction in stress, positive change in calmness, and higher values of social contacts could be observed for the in-person setting compared to the virtual one. In addition, we observed positive changes in psychological stability, maladaptive emotional competences, chronic stress levels, hair cortisol, self-contingency and quality of life. Our preliminary findings suggest that group singing may provide benefits for children and adolescents. In-person singing in particular seems to have a stronger psychobiological effect.

scholarly journals Salivary Gland Disorders in Children and Adolescents: A 15-year Experience

2020 ◽  
Vol 24 (01) ◽  
pp. e31-e37
Author(s):  
Donata Gellrich ◽  
Moritz Bichler ◽  
Christoph A. Reichel ◽  
Florian Schrötzlmair ◽  
Pamela Zengel
Keyword(s):  
Salivary Gland ◽  
Children And Adolescents ◽  
Correct Diagnosis ◽  
Retrospective Chart Review ◽  
Diagnostic Procedures ◽  
Correct Treatment ◽  
Salivary Gland Diseases ◽  
Juvenile Recurrent Parotitis ◽  
Long Term Follow Up ◽  
First Occurrence

Abstract Introduction Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections. Objective To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years. Methods A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016. Results Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolaryngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties – resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improvements in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis. Conclusions Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unnecessarily long period of suffering despite a favorable outcome following the correct treatment.

PHYSICAL EDUCATION AS AN ESSENTIAL COMPONENT OF A HEALTHY LIFESTYLE

2021 ◽  
pp. 65-69
Author(s):  
TATIANA I. PCHELNIKOVA ◽  
ALEKSANDR M. CHASTIHIN
Keyword(s):  
Physical Education ◽  
Motor Activity ◽  
Children And Adolescents ◽  
Normal Development ◽  
Healthy Lifestyle ◽  
After School ◽  
Main Task ◽  
Mental Performance ◽  
Responsible Attitude ◽  
Level Of Knowledge

Relevance: normal physical education and upbringing also contributes to the normal development of such qualities as memory, attention, high levels of stability, perception, observation, and mental performance. In physical education classes, the student learns rational and safe methods of life activity, rational actions, rules of personal and public hygiene, hardening, etc., which positively affects mental development, the process of mental education, and intelligence. The modern Russian school does not provide all the necessary conditions that would allow it to become a place for the formation of the health of schoolchildren. It is necessary to continue physical education after school, to form among children and adolescents the skills and abilities of a healthy lifestyle, a conscious and responsible attitude to the preservation and promotion of health. The main task is to develop and consolidate a conscious attitude to health, personal and public safety among children and adolescents for the entire life cycle. The reasons for the increased attention to the health of students are the following: insufficient motor activity, low level of knowledge, skills and abilities in the field of motor activity, as well as insufficient awareness of the formation of a healthy lifestyle of adolescents.

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