scholarly journals Potential Diagnostic and Prognostic Biomarkers for Adenovirus Respiratory Infection in Children and Young Adults

Viruses ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1885
Author(s):  
Giovanni Battista Biserni ◽  
Sara Scarpini ◽  
Arianna Dondi ◽  
Carlotta Biagi ◽  
Luca Pierantoni ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Clinical Presentation ◽  
Inflammatory Responses ◽  
Early Recognition ◽  
Hospital Setting ◽  
Diagnostic Tools ◽  
Inappropriate Use ◽  
Airway Infections ◽  
Lymphocyte Cultures ◽  
Children And Young Adults

Human Adenoviruses (HAdV) are known to be potentially associated with strong inflammatory responses and morbidity in pediatric patients. Although most of the primary infections are self-limiting, the severity of clinical presentation, the elevation of the white blood cell count and inflammatory markers often mimic a bacterial infection and lead to an inappropriate use of antibiotics. In infections caused by HAdV, rapid antigen detection kits are advisable but not employed routinely; costs and feasibility of rapid syndromic molecular diagnosis may limit its use in the in-hospital setting; lymphocyte cultures and two-sampled serology are time consuming and impractical when considering the use of antibiotics. In this review, we aim to describe the principal diagnostic tools and the immune response in HAdV infections and evaluate whether markers based on the response of the host may help early recognition of HAdV and avoid inappropriate antimicrobial prescriptions in acute airway infections.

The desperate plea of women with the nutcracker syndrome

Phlebologie ◽  
2010 ◽  
Vol 39 (02) ◽  
pp. 104-111
Author(s):  
J. L. Villavicencio
Keyword(s):  
Renal Vein ◽  
Imaging Techniques ◽  
Left Renal Vein ◽  
Diagnostic Tools ◽  
Nutcracker Syndrome ◽  
Treatment Techniques ◽  
Children And Young Adults ◽  
Good Number ◽  
Pelvic Congestion

Summary Objective: To increase awareness on the severe impact of the nutcracker syndrome in women with undiagnosed disease. Patients and methods: We reviewed the medical literature and analyzed six representative series with 73 patients with nutcracker syndrome. Women with left flank pain, dyspareunia, dysuria, dysmenorrhea, micro- or macrohaematuria and pelvic congestion symptoms, should be carefully investigated for evidence of meso aortic left renal vein compression. A good number of our colleagues do not believe in the existence of the nutcracker syndrome and send these patients in a long pilgrimage in search of someone who can help them to get relief to their pain. New and improved imaging techniques can assist in the diagnosis but retrograde reno-gonadal phlebography and renocaval gradient are the most reliable diagnostic tools. Results: Among an assortment of treatment techniques, renal vein transposition and endovenous stenting were the two most commonly used procedures. There are no long term studies on renal vein stenting in children and young adults. Its use in these cases should be carefully considered. The nutcracker syndrome may present with pelvic congestion symptoms and its diagnosis missed. The patient's age, severity of symptoms and haemo dynamic renal studies should guide the treatment. Conclusion: An increased awareness of the existence of the nutcracker syndrome may prevent many unfortunate undiagnosed women from spending many months and often years of suffering.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

scholarly journals Multi-detector computed tomography (MDCT) as a diagnostic tool in assessment of thoracic aortic anomalies in pediatric patients

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Dawlat Nader Eltatawy ◽  
Fatma Anas Elsharawy ◽  
Aly Aly Elbarbary ◽  
Raghda Ghonimy Elsheikh ◽  
Manal Ezzat Badawy
Keyword(s):  
Computed Tomography ◽  
Aortic Arch ◽  
Pediatric Patients ◽  
Interrupted Aortic Arch ◽  
Diagnostic Tools ◽  
Non Invasive ◽  
Branching Patterns ◽  
Anatomic Variants ◽  
Multi Detector Computed Tomography

Abstract Background A wide variety of congenital thoracic aortic variants and pathological anomalies could be assessed recently in diagnostic and interventional radiology. Multi-detector computed tomography (MDCT) is one of the most important non-invasive diagnostic tools for their detection. The aim of the study was to evaluate role of MDCT scanning for diagnosis of thoracic aortic anatomic variants and diseases in pediatric patients. Results Thirty patients (15 male and 15 female), mean age (8.49 ± 20.29 months) were diagnosed with different thoracic aortic anomalies by MDCT then confirmed by surgical results. MDCT was more sensitive than echocardiography in detection of hypo plastic arch, vascular rings, interrupted aortic arch anomalies, and aortic coarctation. Both MDCT and echocardiography showed 100% sensitivity in their detection of TGA, TOF, and PDA. MDCT detected 6 cases of right-sided aortic arch while echo missed 2 cases. Different aortic arch branching patterns and coronary origin were better demonstrated by MDCT. Conclusion 320-Multi-detector computed tomography is a reliable tool for optimal detection of thoracic aortic anomalies and preoperative planning.

Very early onset inflammatory bowel disease (VEO-IBD); spectrum of clinical presentation, diagnostic tools and outcome in children

2021 ◽  
Vol 71 (10) ◽  
pp. 2350-2354
Author(s):  
Huma Arshad Cheema ◽  
Nadia Waheed ◽  
Anjum Saeed ◽  
Zafar Fayyaz ◽  
Muhammad Nadeem Anjum ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Early Onset ◽  
Clinical Presentation ◽  
Association Studies ◽  
Diagnostic Tools ◽  
Genome Wide Association Studies ◽  
Genome Wide ◽  
Basic Work ◽  
Inflammatory Bowel

Background: Very early-onset inflammatory bowel disease (VEO-IBD) is defined as diagnosis of Ulcerative Colitis (UC) or Crohn’s Disease (CD) in children under six years of age. Genome wide association studies have linked a strong genetic component responsible for VEO-IBD. Approximately, 30-40% children of VEO-IBD have underlying immunodeficiency states. We aimed to study the spectrum of presentation, underlying monogenetic defects and outcome in VEO-IBD. Methods: This is a prospective, observational study conducted at division of Gastroenterology, the Children's Hospital & the Institute of Child Health, Lahore, over 2 years. Children developing features of IBD under six-years of age were included. Data included demography, clinical presentation, diagnostic tools and outcome. Gastroscopy and colonoscopy were performed in all patients in addition to basic work up done for associatedimmunodeficiency states and molecular genetics.  SPSS version 21 was used for analysis. Continuous...

CHRONIC LEAD ENCEPHALOPATHY

PEDIATRICS ◽  
1960 ◽  
Vol 25 (2) ◽  
pp. 309-315
Author(s):  
Harry H. White ◽  
Fred D. Fowler
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pediatric Patients ◽  
Early Recognition ◽  
Central Nervous System Involvement ◽  
Fast Screening ◽  
The Central Nervous System ◽  
Lead Encephalopathy ◽  
Urinary Coproporphyrin

Chronic lead encephalopathy must be considered in the differential diagnosis of pediatric patients who present with manifestations of schizophrenia, behavior disorders or degenerative diseases of the central nervous system. Determination of urinary coproporphyrin is a simple, fast screening procedure applicable to office practice. The prognosis for normal mental development following encephalopathy is poor. It is hoped that early recognition of the more subtle signs of central nervous system involvement will allow treatment to be instituted soon enough to prevent the crippling mental deterioration which is so often a sequela of lead poisoning.

Placental Mesenchymal Dysplasia

2007 ◽  
Vol 131 (1) ◽  
pp. 131-137 ◽  
Author(s):  
Zahida Parveen ◽  
Jane Elaine Tongson-Ignacio ◽  
Cory R. Fraser ◽  
Jeffery L. Killeen ◽  
Karen S. Thompson
Keyword(s):  
Differential Diagnosis ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Data Sources ◽  
Molar Pregnancy ◽  
Close Attention ◽  
Normal Fetus ◽  
Fetal Complications ◽  
Microscopic Features ◽  
Placental Mesenchymal Dysplasia

Abstract Context.—Placental mesenchymal dysplasia is characterized by placentomegaly and may be mistaken for molar pregnancy both clinically and macroscopically because of the presence of “grapelike vesicles.” It may be associated with a completely normal fetus, a fetus with growth restriction, or a fetus with features of Beckwith-Wiedemann syndrome. Objective.—To review the etiology, molecular pathology, gross and microscopic features, clinical presentation, complications, and differential diagnosis of placental mesenchymal dysplasia. Data Sources.—The PubMed and the Medline databases were systematically searched for articles between 1970 and 2006. The following keywords were used: placental mesenchymal dysplasia, mesenchymal hyperplasia, molar pregnancy, pseudomolar pregnancy, Beckwith-Wiedemann syndrome, and placentomegaly. Relevant references from review articles were also searched. Conclusions.—Placental mesenchymal dysplasia should be considered in the differential diagnosis when the ultrasonographic findings show a cystic placenta. Close attention should be paid to fetal morphology for early recognition of fetal complications and to prevent unnecessary termination of pregnancy in cases associated with a normal fetus.

Immune Reconstitution Inflammatory Syndrome

2011 ◽  
Vol 23 (1) ◽  
pp. 90-96 ◽  
Author(s):  
A.R. Tappuni
Keyword(s):  
Antiretroviral Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
T Regulatory Cells ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Clinical Intervention ◽  
Suppressor Cell ◽  
Life Threatening ◽  
Inflammatory Syndrome

Immune reconstitution inflammatory syndrome (IRIS) is a phenomenon observed in patients recovering from immunodeficiency. The clinical presentation of IRIS involves the unmasking of covert infections or the worsening of overt conditions. Several causes and pathways have been suggested, most recognizing an inflammatory flare component occurring in the context of rapid immune reconstitution. In HIV-infected patients, IRIS inadvertently occurs as the consequence of successful antiretroviral therapy, and it is affiliated with improvement of the immune function, complicating the course of the disease and presenting treatment challenges to clinicians. The pathogenesis of IRIS is poorly understood, but in recovering HIV patients, its initiation and progression seem to be primarily linked to an increase in CD4+ T-helper and CD8+ T-suppressor cell count and a reduction in T-regulatory cells, all endorsed by exaggerated cytokine release and activity. The clinical presentation of IRIS is usually atypical. The manifestations depend on the trigger antigen, which can be an infective agent (viable or nonviable), a host antigen, or a tumor antigen. Most IRIS cases are self-limiting, but a few cases can be overwhelming and life-threatening; hence, early recognition is important. In most cases, there is no need to discontinue the antiretroviral therapy, although in the more severe cases, other clinical intervention may be necessary.

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