Rates of hospitalizations for migraines and other cephalic algias syndromes is children between 2014 and 2020

Introduction: Migraine is the most common chronic headache in childhood, however, it is still little diagnosed in the pediatric group. Early crises can be very early, at 6 months of age. It may present in different ways according to the age group of the child and may or may not resemble the clinical picture of the associated manifestations that may aid in diagnosis. Methods and Objectives: The study used data available on the DataSus, in the category of hospitalization by the CID-10, in the group of less than 1 year, between 1 and 4 years, 5 and 9 years and 10 and 14 years, in the period from 2014 to 2020, to discuss the diagnosis of migraines and compare the prevalence of hospitalizations among children . Results: Between 2014 and 2020, the age group with the highest rate of hospitalization for migraine and other cephalic pain syndromes was 10-14 years, with an average of 57,13%, followed by 5-9 years (32,75%), 1-4 years (8,95%) and below 1 year (1,57%). Conclusion: Migraine has a semiological aspect that makes it difficult to identify in the pediatric group: symptoms. How diagnosis depends on a subjective report, children, especially the younger ones, become underdiagnosed. This can justify the higher incidence of hospitalizations among older children, with greater communication skills and a better description. Another factor is the absence of skilled professionals. Adaptation is necessary to assist in diagnosis, such as: associated clinical manifestations; Note; use of semi-structured interrogation and playful scales to spread the pain.

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Clinical and radiological changes in acute hydrocarbon exposure in children

Romanian Journal of Medical Practice ◽

10.37897/rjmp.2021.s4.17 ◽

2021 ◽

Vol 16 (S4) ◽

pp. 76-80

Author(s):

Gabriela Viorela NIȚESCU ◽

◽

Dora Andreea BOGHIȚOIU ◽

Anca Angela SIMIONESCU ◽

Roxana NEMEŞ ◽

...

Keyword(s):

Clinical Picture ◽

Pediatric Population ◽

Clinical Manifestations ◽

The Body ◽

Age Group ◽

Asymptomatic Patients ◽

Medical Documents ◽

Radiological Changes ◽

Route Of Exposure ◽

Poisoning In Children

Acute chemical poisoning is an important cause of morbidity and mortality for the pediatric population, with hydrocarbon exposure accounting for a significant share. The route of exposure but especially the type of hydrocarbons are responsible for the effect that these substances exert on the body and implicitly the clinical picture and an understanding of them is used in the care of the patient exposed to hydrocarbons. Objectives. Outlining the clinical and radiological profile of accidental acute hydrocarbon poisoning in children. Material and method. Medical documents of patients hospitalized in the Pediatric Antitoxic Center with a diagnosis of acute hydrocarbon intoxication over a period of 2 years were retrospectively analyzed, taking into consideration demographic characteristics, type of hydrocarbons, clinical manifestations and radiological changes. Results. 25 cases of acute hydrocarbon poisoning were identified in children. Exposure was only accidental by ingestion, with males and the 1-5 age group occupying the largest share. The main clinical manifestations were respiratory, gastrointestinal and nervous system and radiological changes were associated in only 20% of cases. Conclusions. Acute hydrocarbon poisoning in children are frequently asymptomatic or causes mild symptoms, dominated by gastrointestinal, respiratory and neurological manifestations. Pulmonary radiography is mandatory in paraclinical diagnoses but there is no correlation between the severity of the clinical picture and the radiological aspects. There may be situations in which symptomatic patients do not have radiological changes or situations with pathological radiological aspects in asymptomatic patients.

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DYNAMICS OF PHENOTYPIC MANIFESTATIONS OF CONNECTIVE TISSUE DYSPLASIA IN CHILDREN WITH UROANDROLOGICAL PATHOLOGY IN THE AGE ASPECT

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2019-23-4-188-192 ◽

2019 ◽

Vol 23 (4) ◽

pp. 188-192

Author(s):

I. G. Vasilyeva ◽

S. M. Sharkov ◽

B. G. Safronov ◽

I. E. Volkov ◽

I. S. Burov ◽

...

Keyword(s):

Connective Tissue ◽

Oral Cavity ◽

Clinical Symptoms ◽

Age Groups ◽

Clinical Manifestations ◽

Preschool Age ◽

Urogenital System ◽

Age Group ◽

Older Children ◽

Connective Tissue Dysplasia

Introduction. The article includes a comparative study of phenotypic manifestations of undifferentiated connective tissue dysplasia in children of different age groups with urological and andrological pathology. Material and methods. The trial performed included 214 children aged from 1 month to 17 years with clinical manifestations of undifferentiated connective tissue dysplasia who were treated in the children’s uroandrological department for congenital malformations of the urogenital system. The generally accepted table of external phenotypic markers in scores was used in establishing undifferentiated connective tissue dysplasia . Results. In infants, the most frequent disorders were in ears and skin. In the preschool age, in the majority of cases, craniocephalic abnormalities, pathology of osteo-articular system and ears were met. The trail has revealed that the rate of ocular abnormalities increases with age. Moreover, two or more ocular problems were most common in older children. Anomalies of the oral cavity were diagnosed only in a quarter of infants and were manifested in them by a single sign. In older age groups, oral cavity anomalies were in more than half of the patients, and often they were not isolated. During the survey of senior schoolchildren, it was noted that all children of this age group had this or that disorder in their osteo-articular system, and almost always they were multiple. Conclusion. Somatic manifestations of undifferentiated connective tissue dysplasia are often multiorganic and often have non-specific clinical symptoms. Identification of patterns of formation of uroandrological pathology in patients of different age groups with connective tissue insufficiency will ensure timely prevention and correction of visceral manifestations of dysplasia in children.

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Clinical-anamnestic analysis of the course and treatment of benign and borderline epithelial ovarian tumors

HEALTH OF WOMAN ◽

10.15574/hw.2016.115.86 ◽

2016 ◽

pp. 86-93

Author(s):

M.Yu. Yegorov ◽

◽

A.A. Sukhanova ◽

Keyword(s):

Varicose Veins ◽

Clinical Manifestations ◽

Abnormal Uterine Bleeding ◽

Abdominal Distension ◽

Ovarian Tumors ◽

Lower Limbs ◽

Benign Tumors ◽

Age Group ◽

Venous Disorders ◽

Serous Tumors

The objective: study the features of gynecological, physical history, diagnosis and treatment of patients with benign epithelial ovarian tumors (BeEOT) and borderline epithelial ovarian tumors (BEOT), determining the frequency of recurrence of ovarian tumors in the postoperative period. Patients and methods. According to a retrospective analysis of case histories of 112 women with epithelial ovarian tumors (EOT) underwent conservative or radical surgical treatment in a hospital, two groups were formed: I group – patients with benign epithelial ovarian tumors (BeEOT), which amounted to 85 (75.9%) women, and group II – patients with borderline epithelial ovarian tumors (BEOT), which amounted to 27 (24.1%) women. It was found that the main complaints of patients with EOT were pain (49.1%), abdominal distension (17%), and abnormal uterine bleeding (12.5%). The highest incidence of BeEOT (31.8%) observed in the age group of 41–50 years, while the peak incidence of BEOT (44.4%) corresponds to the age group of 51–60 years. Results. In BEOT endocrine pathology occurs significantly more frequently (p<0.05) than in BeEOT – 25.9% vs. 9.4%, respectively. Pathology of pancreatic-hepatobiliary system occurs significantly more frequently (p<0.05) in patients with BEOT compared with BeEOT – 81.5% versus 57.6%, respectively. Venous disorders (varicose veins of the pelvic organs, lower limbs, haemorrhoids) observed in BEOT significantly more frequently (p<0.05) than in BeEOT – 18.5% vs. 5.9%, respectively. EOT most often diagnosed in the period from 1 to 6 months after the first clinical manifestations with an average uptake of medical care 4.6±0.57 months. In assessing of peritoneal exudate cytogram the mesothelium cells are significantly more common for BeEOT (p<0.01) than BEOT – 79.4% versus 40.9%, respectively. Cervicitis is more likely significantly to occur in BeEOT (p<0.01) than in BEOT – 29.4% vs. 7.4%, respectively. The most common histological type among the benign tumors of the ovaries are endometriomas, which occurred in 48.2% of all BeEOT cases, and among the borderline tumors – serous tumors, which accounted for 59.3% of all BEOTs. Conclusion. The use of organ sparing surgery in EOT increases the risk of recurrence, especially in the case of endometrial histology or borderline variant of tumor. Key words: benign and borderline epithelial ovarian tumors, clinical-anamnestic analysis, diagnosis, treatment.

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Clinical manifestations, diagnosis and treatment of HIV infection of stage 4 (severely symptomatic stage) in the practice of a health professional

Terapevt (General Physician) ◽

10.33920/med-12-2005-04 ◽

2020 ◽

pp. 27-34

Author(s):

A. Nikitina ◽

A. Rusanova ◽

A. Zhilenkova

Keyword(s):

Hiv Infection ◽

Health Professional ◽

Clinical Picture ◽

Clinical Manifestations ◽

Significant Problem ◽

Diagnosis And Treatment ◽

Modern World ◽

Infected People ◽

Stage 4 ◽

Future Practice

HIV infection is a significant problem in the modern world, because there are more and more infected people every year. This article will consider: the clinical picture, diagnosis and treatment of this disease in different countries. Based on these data, the following conclusions will be made to help doctors in their future practice correctly approach the diagnosis and treatment of patients with this disease.

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SAT0651-HPR BARRIERS IN DIAGNOSING RHEUMATOID ARTHRITIS – A FOCUS GROUP STUDY ON THE GENERAL PRACTITIONERS’ PERSPECTIVES

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4387 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1284.1-1285

Author(s):

A. S. Lundberg ◽

B. A. Esbensen ◽

E. M. Hauge ◽

A. De Thurah

Keyword(s):

Rheumatoid Arthritis ◽

General Practice ◽

Focus Group ◽

General Practitioners ◽

Clinical Picture ◽

Clinical Manifestations ◽

University Hospital ◽

Text Book ◽

Clear Cut ◽

Initial Symptoms

Background:Early treatment, before three months from symptom onset of rheumatoid arthritis (RA), is essential to increase the likelihood of remission and to prevent permanent joint damage (1). However, it has been shown that only 20% of the patients are seen within the first three months, and the median delay in general practice has been estimated to 4 months (range 2–9) (2).Objectives:To explore the barriers in diagnosing RA from the general practitioners’ (GPs) perspective.Methods:We conducted a qualitative study based on focus group interviews. We recorded the interviews digitally and transcribed verbatim. The transcribed interviews were analyzed based on content analysis (3), by using Nivo 12. Sample size was determined by thematic saturation.Results:In total ten GPs participated in three different focus groups. 40 % were female, mean age was 53 years (range 37-64), and mean year since specialist authorization as GP was 16 years (range 5-23). 60 % of the GPs worked in a practice located within the referral area of a university hospital; the remaining within the referral area of a regional hospital.Four themes emerged in the analysis: 1) When the patient is not a text book example, referring to the difficulty of identifying relevant symptoms among all clinical manifestations from the joints as described by the patients, 2)The importance of maintaining the gatekeeper function, referring to the societal perspective, and the GPs responsibility to refer the right patients to secondary care, 3)Difficulties in referral of patients to the rheumatologist,referring to perceived differences in the collaboration with rheumatologists. The GPs experienced that it was sometimes difficult to be assisted by rheumatologists, especially when the clinical picture was not ‘clear cut’. Finally, (4)Para-clinical testing, can it be trusted?referring to challenges on the evaluation of especially biomarkers.The overarching theme was:Like finding a needle in a haystack, covering the GPs difficulties in detecting RA among the many patients in general practice who appear to be well and at the same time have symptoms very similar to RA.Conclusion:The GPs experienced that RA was a difficult diagnosis to make. The immediate challenge was that RA patient’s initial symptoms often resembled those of more common and less serious conditions, and that investigative findings such as biomarkers can be negative at the early state of the disease. At the same time, the collaboration with rheumatologists was sometimes seen as a hurdle, when the clinical picture was not ‘clear cut’.In order to facilitate earlier diagnosis of RA in general practice, the GPs and rheumatologists need to focus on these barriers by strengthening mutual information and collaboration.Physicians should remain vigilant to patients who have conditions that do not resolve as expected with treatment, who have symptoms that persist, or who do not look well despite negative investigative findings.References:[1]Aletaha D, et al. JAMA, Oct 2018.[2]Kiely P, et al. Rheumatology, Jan 2009.[3]Braun V. Qualitative research in psychology. 2006, 3(2), 77-101Disclosure of Interests:Anne Sofie Lundberg: None declared, Bente Appel Esbensen: None declared, Ellen-Margrethe Hauge Speakers bureau: Fees for speaking/consulting: MSD, AbbVie, UCB and Sobi; research funding to Aarhus University Hospital: Roche and Novartis (not related to the submitted work)., Annette de Thurah Grant/research support from: Novartis (not relevant for the present study)., Speakers bureau: Lily (not relevant for the present study).

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Infant Acute Myeloid Leukemia: A Unique Clinical and Biological Entity

Cancers ◽

10.3390/cancers13040777 ◽

2021 ◽

Vol 13 (4) ◽

pp. 777

Author(s):

Charlotte Calvo ◽

Odile Fenneteau ◽

Guy Leverger ◽

Arnaud Petit ◽

André Baruchel ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Myeloid Leukemia ◽

Lymphoblastic Leukemia ◽

Age Groups ◽

Study Groups ◽

Biological Entity ◽

Age Group ◽

Older Children ◽

Megakaryoblastic Leukemia ◽

Acute Myeloid

Infant acute myeloid leukemia (AML) is a rare subgroup of AML of children <2 years of age. It is as frequent as infant acute lymphoblastic leukemia (ALL) but not clearly distinguished by study groups. However, infant AML demonstrates peculiar clinical and biological characteristics, and its prognosis differs from AML in older children. Acute megakaryoblastic leukemia (AMKL) is very frequent in this age group and has raised growing interest. Thus, AMKL is a dominant topic in this review. Recent genomic sequencing has contributed to our understanding of infant AML. These data demonstrated striking features of infant AML: fusion genes are able to induce AML transformation without additional cooperation, and unlike AML in older age groups there is a paucity of associated mutations. Mice modeling of these fusions showed the essential role of ontogeny in the infant leukemia phenotype compared to older children and adults. Understanding leukemogenesis may help in developing new targeted treatments to improve outcomes that are often very poor in this age group. A specific diagnostic and therapeutic approach for this age group should be investigated.

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Surgical treatment of bilateral temporal lobe pharmacoresistant epilepsy

Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery) ◽

10.33920/med-01-2008-06 ◽

2020 ◽

pp. 60-82

Author(s):

Igor Sergeevich Trifonov ◽

Mikhail Vladimirovich Sinkin ◽

Elena Vladimirovna Grigoryeva ◽

Rashid Abdurakhmanovich Navruzov

Keyword(s):

Surgical Treatment ◽

Temporal Lobe ◽

Clinical Picture ◽

Clinical Manifestations ◽

Epileptogenic Zone ◽

Pharmacoresistant Epilepsy ◽

Modern Methods ◽

Selection For ◽

Selection Of Patients ◽

Selection Of

Surgical treatment of bilateral temporal lobe pharmacoresistant epilepsy is associated with some difficulties: particularly, the lack of stereotypical clinical picture in the same patient and controversial data on modern methods of diagnostics — all these statements make identifying epileptogenic zone more difficult and lack of clear criteria for the selection of patients for surgical treatment. In this review, issues of aetiology, pathogenesis, clinical manifestations and criteria for the selection for surgical treatment suggested by different authors are presented.

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POLYNEURITIS IN CHILDREN

PEDIATRICS ◽

10.1542/peds.22.5.972 ◽

1958 ◽

Vol 22 (5) ◽

pp. 972-990

Author(s):

Niels L. Low ◽

Julia Schneider ◽

Sidney Carter

Keyword(s):

Clinical Picture ◽

Cranial Nerve ◽

Clinical Manifestations ◽

Signs And Symptoms ◽

Severity Of The Disease ◽

Clinical Records

Polyneuritis in children is becoming more common. The clinical picture is variable; it may be manifested by motor and sensory findings, or by a combination of peripheral and cranial nerve signs and symptoms. The etiology is usually obscure. The pathologic picture varies with the severity of the disease and differs according to the stage at which the patient dies, but all fatal cases show the same main characteristic changes. Clinical records of 30 cases, 17 boys and 13 girls from 17 months to 16 years of age, are reviewed. The clinical manifestations, course and treatment are described.

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LOWER URINARY TRACT SYNDROME IN ELDERLY AND SENILE PEOPLE WITH COMBINED PATHOLOGY OF THE PROSTATE AND LUMBAR SPINE

Успехи геронтологии ◽

10.34922/ae.2020.33.5.013 ◽

2021 ◽

pp. 921-926

Author(s):

В. В. Третьяков ◽

В. С. Мякотных

Keyword(s):

Chronic Pain ◽

Urinary Tract ◽

Lumbar Spine ◽

Clinical Picture ◽

Lower Urinary Tract ◽

Lumbar Region ◽

Urination Disorders ◽

Pain Syndromes ◽

Chronic Pain Syndromes ◽

Lower Urinary

Для определения места и роли дегенеративных изменений поясничного отдела позвоночника в патогенезе синдрома нижних мочевых путей и успешности проведения лечебных мер наблюдали 106 мужчин пожилого и старческого возраста, страдающих доброкачественной гиперплазией предстательной железы и патологией позвоночника. Длительные хронические боли в пояснице испытывали 48 (45,3 %) пациентов, у 93,8 % из них отмечали никтурию, у 75 % - затруднения при мочеиспускании, у 60,4 % - ложные позывы на мочеиспускание, что мотивировало обращение к урологу. Выявленные с помощью опросника IPSS различия, соответственно 21,78±4,33 и 16,33±4,61 балла, указывали на негативное значение хронического болевого синдрома в формировании общей клинической картины урологической патологии. У лиц старческого возраста болевой синдром и симптомы раздражения мочевых путей были менее выраженными, чем у лиц пожилого возраста, а обструктивные симптомы, наоборот, более отчетливыми. Хронические болевые синдромы в поясничной области значительно чаще ( р <0,001)регистрировали у 67 пациентов с удовлетворительными и неудовлетворительными результатами лечения по поводу расстройств мочеиспускания, чем у 39 с наилучшей эффективностью. Таким образом, патология поясничного отдела позвоночника и связанные с ней хронические болевые синдромы вносят существенный вклад в патогенез и клиническую картину синдрома нижних мочевых путей и в результативность лечения расстройств мочеиспускания. Выявленные особенности следует учитывать в процессе диагностики и лечения комбинированной патологии. In order to determine the place and role of degenerative changes in the lumbar spine in the pathogenesis of lower urinary tract syndrome and the success of treatment measures, 106 elderly and senile male patients suffering from benign prostatic hyperplasia and spinal pathology were observed. Long-term chronic lower back pain was experienced by 48 (45,3 %) patients, 93,8 % of them had night urination, 75 % had difﬁculty urinating, and 60,4 % had false urge to urinate, which motivated them to contact a urologist.The differences identiﬁed using the IPSS questionnaire, respectively 21,78±4,33 and 16,33±4,61 points, indicated a negative value of chronic pain syndrome in the formation of the overall clinical picture of urological pathology. Among the senile patients, pain and urinary tract irritation symptoms were less pronounced than among the elderly patients, and obstructive symptoms, on the contrary, were more pronounced. Chronic pain syndromes in the lumbar region were signiﬁcantly more frequent ( p <0,001) among 67 patients with satisfactory and unsatisfactory results of treatment for urination disorders than among 39 with the best efﬁciency. Thus, the pathology of the lumbar spine and associated chronic pain syndromes make a signiﬁcant contribution to the pathogenesis and clinical picture of the lower urinary tract syndrome and to the effectiveness of treatment of urination disorders. The identiﬁed features should be taken into account in the process of diagnosis and treatment of combined pathology.

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A Five Years Old Child with Failure To Thrive and Vomiting Presenting as a Diagnostic Dilemma: A Case Report

Journal of Nepal Medical Association ◽

10.31729/jnma.5134 ◽

2020 ◽

Vol 58 (228) ◽

Author(s):

Anita Lamichhane ◽

Rupesh Sharma ◽

Ramana Rajkarnikar ◽

Rubee Awale ◽

Prapti Shrestha ◽

...

Keyword(s):

Failure To Thrive ◽

Exploratory Laparotomy ◽

Age Group ◽

Older Children ◽

Diagnostic Challenge ◽

High Resolution Computed Tomography ◽

Diagnostic Dilemma ◽

Recurrent Vomiting ◽

Colicky Pain ◽

Band Failure

Vomiting with failure to thrive in older children is a diagnostic challenge due to the diversity in the diagnosis. We report a case of a five-years-old girl with failure to thrive, history of recurrent vomiting and intermittent colicky pain abdomen since 45 days of life. Intestinal malrotation with Ladd’s band was diagnosed based on clinical acumen, high- resolution computed tomography, barium follow through and intraoperative findings. Exploratory laparotomy with Ladd’s procedure was performed under general anesthesia which showed malrotation at the duodenojejunal junction with a short route of mesentery with floating caecum with Ladd’s band. Failure to thrive with malrotation of the gut in the older age group is rare in itself. As there are very few cases reported in this age group, so we undertook to report this case to increase the awareness of knowledge concerning the diagnosis and timely management to prevent the comorbidity of this condition.

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