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Sample records for children diagnosis treatment

  1. DIAGNOSIS AND TREATMENT OF CHILDREN ECHINOCOCCOSIS

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    Veliyeva T.A.

    2015-05-01

    Full Text Available The problem of echinococcosis, despite the progress made in its diagnosis and treatment, currently remains poorly understood and highly relevant in pediatric Parasitology. Studies of many authors show that in recent years the number of patients with echinococcosis not only universally recognized endemic foci, but also among people in the European region, including in countries such as Romania, Germany, Austria. However, studies on the prevalence and structure of echinococcosis among children in Ukraine, are not held. Despite the large number of papers devoted to the treatment of echinococcosis, the problem of the treatment of this disease in children is still far from its final decision. Usually offered surgical treatment, which is not possible with multiple lesions of the liver or other organs. All this shows the relevance and importance for practical public health issues for further study of diagnosis and treatment of echinococcosis in children. The purpose of the study. A comparative analysis of the diagnostic efficacy of X-ray and ultrasound method in the diagnosis of echinococcosis in children. Material & methods. This work is based on a survey of 39 children with hepatic echinococcosis, were examined at the Department of Medical Parasitology and Tropical Diseases Kharkiv Medical Academy of Postgraduate Education from 2005 to 2015. Boys was 1.5 times greater (59.5% than girls - 40.5%. Children under five years of age accounted for only 4.0% of all patients, due to their limited contact with the environment when compared with older age. The greatest risk of disease was in the 10- 13 years of age, the number of children in the group reached 40.3% of the patients. The vast majority of patients (89.6% lived in rural areas. In this case, the parents of sick children from the village were engaged in farming, were in personal use livestock, dogs, which probably contributed to the invasion. Very often ill children pas¬tuhov, shepherds. 78% of

  2. Diagnosis and Treatment of Influenza in Children

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    M. S. Savenkova

    2016-01-01

    Full Text Available The article presents data on influenza epidemiology, pathogenesis, classification, clinical variants, diagnosis. Given the variety of antiviral drugs, highlighted the most relevant and used in pediatric patients, depending on age and mixed-flow options viral infections.

  3. Diagnosis and treatment of odontoid process fractures in children

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@Fractures of the odontoid process in children are rare but account for the majority of all the cervical spine injuries in the infantile and young juvenile groups. The initial radiographic evaluation is often difficult so that the diagnosis-making is delayed or the fractures are missed. The management of the odontoid fractures of adults has long been controversial and varies with different spinal surgeons. By contrast, the diagnosis and treatment of odontoid fractures in skeletally immature children have not been frequently documented and not in details. This paper reviews the clinical characteristics, diagnosis, treatment principles, and long-term outcome of the odontoid fractures in a consecutive series of patients aged 14years or younger.

  4. [Diagnosis and treatment of food allergies in preschool children].

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    Ferrari, G; Eng, P

    2012-04-01

    The prevalence of food allergies in preschool children has increased in the last few decades. Depending on the triggering allergen, children may outgrow many hypersensitivity reactions to food proteins by the age of 3 - 5 years. Despite improved diagnosis and knowledge, food allergies are still restricting the quality of life in affected subjects and their families. There is a wide spectrum of clinical manifestation from mild cutaneous symptoms to life-threatening anaphylactic reaction. Food proteins are the most frequent cause of anaphylactic reactions in childhood and adolescence. The task of primary care physicians includes identification of at-risk patients, early diagnosis and advice to family members concerning preventive measures and emergency treatment (e. g. adrenaline) in case of accidental ingestion of the culprit food. There is still no causal treatment of food allergy available. Therefore, strict avoidance of the causative food remains the most important measure to date.

  5. Management of bowel intussusception in children: from diagnosis to treatment

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    Anna Maria Caruso

    2017-02-01

    Full Text Available Introduction: Intussusception is the commonest cause of acute in­testinal obstruction in children. Failure of timely diagnosis and treatment results in a surgical emergency leading to fatal outcome. The classic triad of symptoms is seen in less than one-third of the children affected. Aim of this study was to evaluate the comprehensive management of intussusception in children, evaluating the outcome of conservative treatment with hydrostatic ultrasound reduction and surgery.Material and methods: A retrospective analysis was conducted including pediatric patients (up to 14 years old with diagnosis of bowel intussusception. The management and treatment depended on the patients’ situation: for children in good general conditions initial hydrostatic reduction under continuous ultrasonographic monitoring was attempted; if severe dehydration and/or septic shock was observed, the conservative treatment was contraindicated and direct surgical treatment was performed.Result: A total of 44 pediatric patients were included in the study. The most frequent symptoms observed were paroxysmal abdominal pain (100% of cases and vomiting (72%; only 29% of patients presented with the classic triad of symptoms (abdominal pain, palpable mass and blood stained stools. 28 patients (64% were managed conservatively with ultrasound hydrostatic reduction. 10 patients (23% required primary surgical intervention because of clinical conditions; 6 patients (14% were operated after failure of conservative approach. The total percentage of operated patients was 36%, with lead points identified in 12 cases.Conclusion: Our data confirm that hydrostatic reduction is a simple, real time procedure, free of radiations, non invasive and safe. Age had no impact on the reducibility whereas bloody stool, a prolonged duration of symptoms and the presence of lead point were risk factors of failure.

  6. Iron deficiency anemia from diagnosis to treatment in children

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    Özdemir, Nihal

    2015-01-01

    Iron deficiency is the most common nutritional deficiency worldwide and an important public health problem especially in developing countries. Since the most important indicator of iron deficieny is anemia, the terms “iron deficiency” and “iron deficiency anemia” are often used interchangeably. However, iron deficiency may develop in the absence of anemia and the tissues may be affected from this condition. The most common causes of iron deficiency in children include insufficient intake together with rapid growth, low birth weight and gastrointestinal losses related to excessive intake of cow’s milk. If insufficient intake can be excluded and there is insufficient response to oral iron treatment in patients with iron deficiency especially in older children, blood loss should be considered as the underlying cause. The main principles in management of iron deficiency anemia include investigation and elimination of the cause leading to iron deficiency, replacement of deficiency, improvement of nutrition and education of the patient and family. In this article, the practical approaches in the diagnosis and treatment of iron deficiency and the experience of our center have been reviewed. PMID:26078692

  7. The influence of underweight and obesity on the diagnosis and treatment of appendicitis in children

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    Timmerman, Marjolijn E W; Groen, Henk; Heineman, Erik; Broens, Paul M A

    2016-01-01

    PURPOSE: The impact of lower body mass index (BMI) on appendicitis has never been addressed. We investigated whether different BMIs affect the diagnosis and treatment of appendicitis in children. METHODS: The correlation between BMI and diagnosis accuracy and treatment quality was evaluated by retro

  8. Juvenile recurrent parotitis in children: diagnosis and treatment using sialography.

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    Narsimha Rao, Vanga V; Putta Buddi, Jai Shankar Homberhali; Kurthukoti, Ameet J

    2014-01-01

    Juvenile recurrent parotitis (JRP) is a nonobstructive, nonsuppurative parotid inflammation in young children. Causative factors are many such as allergy, infection, local autoimmune manifestations, and genetic inheritance have been suggested, but none have been proved. Parotid sialography is a hallmark in the diagnosis of JRP but newer modalities such as ultrasonography, computed tomography and magnetic resonance imaging-sialography are noninvasive investigative techniques. Recurrent attacks are often managed conservatively. Here we report a case of a 5-year-old child with JRP. Sailography can be used as both diagnostic and therapeutic modality.

  9. Overview of Diagnosis and Treatment of Psychological Trauma in Children.

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    Munson, Carlton E.

    1995-01-01

    Provides comprehensive definition of psychological trauma and offers guidance to practitioners who are increasingly needed to treat traumatized children. Key therapy considerations are organized around the role of dissociation and repetition compulsion in trauma. Presents treatments in connection with aloneness of trauma experience, dream and…

  10. DIAGNOSIS AND TREATMENT OF MEDIASTINAL ENTEROGENOUS CYSTS IN CHILDREN

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    Ke-ren Zhang; Hui-min Jia; En-yuan Pan; Lian-ying Wang

    2006-01-01

    Objective To investigate the diagnosis and therapy of mediastinal enterogenous cysts in children.Methods Clinical data of 17 cases with mediastinal enterogenous cysts within 19 years in our hospital were retrospectively analyzed.Results One case was intramural esophageal cyst and 16 cases were enteric cysts, two among which were complicated with abdominal enteric duplications. Most cases presented with symptoms of respiratory distress. Twelve cases were complicated with vertebral anomalies. Ultrasound of 12 cases and magnetic resonance imaging of 4 cases were helpful in confirming the cystic nature of these lesions. Eight cases had technetium-99m pertechnetate scintigraphy of posterior mediastinum.Conclusions Most patients present with symptoms of respiratory distress, complicated with vertebral anomalies. Ultrasonography and magnetic resonance imaging may be helpful in confirming the cystic nature of these lesions. Technetium-99m pertechnetate scintigraphy is the most effective method for differentiation of the disease from other mediastinal cysts.

  11. Talocalcaneal coalition combined with flatfoot in children: diagnosis and treatment: a review.

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    Zhou, Binghua; Tang, Kanglai; Hardy, Mark

    2014-01-01

    Talocalcaneal coalition often leads to a flatfoot deformity in children. Previous reports have uncovered many aspects of tarsal coalition and flatfoot respectively, including the etiology, clinical presentation, and diagnostic imaging, as well as treatment. However, the optimum surgical procedure for talocalcaneal coalition combined with flatfoot has not been definitively determined. The nonconformity of treatment options is due to our incomplete knowledge of biomechanics, diagnosis, and indication of treatment for talocalcaneal coalition with flatfoot. The objectives of this review are to provide an overview of the current knowledge about etiology, biomechanics, classification, diagnosis, and treatment options for talocalcaneal coalitions with flatfoot and highlight its therapies in children.

  12. Diagnosis and treatment of mental illness in mentally retarded children: a developmental model.

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    Dosen, A

    1989-01-01

    Attempts have been made in recent years to discover the roots of psychiatric disorders in mentally retarded children by employing a developmental approach in which the child, not the handicap, is brought more clearly into focus. This paper provides a brief overview of the developmental model that has proven useful for the author in the psychiatric diagnosis of mentally retarded children. Application of this model to the treatment of mentally ill-mentally retarded children is also addressed.

  13. MYCOPLASMA INFECTION IN CHILDREN: CURRENT DIAGNOSIS AND TREATMENT

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    F. S. Harlamova

    2016-01-01

    Full Text Available Presents literary and own data (52 patients on the role of mycoplasma infection. Mycoplasma infection is associated with long-term antigenemia in children, causes recurrent disease and autoimmunity. Among the 52 examined patients diagnosed with pneumonia in 17, bronchitis — from 19, rhinosinusitis  — at 11, StevensJohnson syndrome — in 2 children.  In half the cases mycoplasmosis occurs against the backdrop of persistent active herpes virus infection (in 27 children (52%. To optimize the causal and pathogenetic therapy mycoplasma requires correction of immune disorders.

  14. Controversies concerning the diagnosis and treatment of bipolar disorder in children

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    Johnston Josephine

    2010-03-01

    Full Text Available Abstract This commentary grows out of an interdisciplinary workshop focused on controversies surrounding the diagnosis and treatment of bipolar disorder (BP in children. Although debate about the occurrence and frequency of BP in children is more than 50 years old, it increased in the mid 1990s when researchers adapted the DSM account of bipolar symptoms to diagnose children. We offer a brief history of the debate from the mid 90s through the present, ending with current efforts to distinguish between a small number of children whose behaviors closely fit DSM criteria for BP, and a significantly larger number of children who have been receiving a BP diagnosis but whose behaviors do not closely fit those criteria. We agree with one emerging approach, which gives part or all of that larger number of children a new diagnosis called Severe Mood Dysregulation or Temper Dysregulation Disorder with Dysphoria. Three major concerns arose about interpreting the DSM criteria more loosely in children than in adults. If clinicians offer a treatment for disorder A, but the patient has disorder B, treatment may be compromised. Because DSM's diagnostic labels are meant to facilitate research, when they are applied inconsistently, such research is compromised. And because BP has a strong genetic component, the label can distract attention from the family or social context. Once a BP diagnosis is made, concerns remain regarding the primary, pharmacological mode of treatment: data supporting the efficacy of the often complex regimens are weak and side effects can be significant. However, more than is widely appreciated, data do support the efficacy of the psychosocial treatments that should accompany pharmacotherapy. Physicians, educators, and families should adopt a multimodal approach, which focuses as much on the child's context as on her body. If physicians are to fulfill their ethical obligation to facilitate truly informed consent, they must be forthcoming

  15. Using Stereoscopic 3D Technologies for the Diagnosis and Treatment of Amblyopia in Children

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    Gargantini, Angelo

    2011-01-01

    The 3D4Amb project aims at developing a system based on the stereoscopic 3D techonlogy, like the NVIDIA 3D Vision, for the diagnosis and treatment of amblyopia in young children. It exploits the active shutter technology to provide binocular vision, i.e. to show different images to the amblyotic (or lazy) and the normal eye. It would allow easy diagnosis of amblyopia and its treatment by means of interactive games or other entertainment activities. It should not suffer from the compliance problems of the classical treatment, it is suitable to domestic use, and it could at least partially substitute occlusion or patching of the normal eye.

  16. Diagnosis and treatment of severely malnourished children with diarrhea

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    Children with severe acute malnutrition complicated by diarrhoea require special care due to their unique physiological vulnerability and increased mortality risks. A systematic literature review (1950-2013) was conducted to identify the most effective diagnostic and therapeutic measures for the com...

  17. Talocalcaneal coalition combined with flatfoot in children: diagnosis and treatment: a review

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    Zhou, Binghua; Tang, Kanglai; Hardy, Mark

    2014-01-01

    Talocalcaneal coalition often leads to a flatfoot deformity in children. Previous reports have uncovered many aspects of tarsal coalition and flatfoot respectively, including the etiology, clinical presentation, and diagnostic imaging, as well as treatment. However, the optimum surgical procedure for talocalcaneal coalition combined with flatfoot has not been definitively determined. The nonconformity of treatment options is due to our incomplete knowledge of biomechanics, diagnosis, and indi...

  18. POSTTRAUMATIC SHOULDER INSTABILITY IN CHILDREN: CLINICAL PRESENTATION, DIAGNOSIS AND TREATMENT

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    Ярослав Николаевич Прощенко

    2014-09-01

    Full Text Available The article presents an analysis of the treatment of 15 patients with posttraumatic shoulder instability aged 11-17 years, as a result of primary traumatic dislocation and chronic instability. We identified the following causes of chronic shoulder instability: Bankart injury, SLAP-injury; Hill-Sachs defect; fracture of the glenoid, type 3 humeral head-glenoid relation, and retroversion of the humeral head, as well as defects in the treatment of primary shoulder dislocation. Surgical treatment is performed in 7 patients with chronic instability (7 joints. Unsatisfactory result was detected in 1 patient (1 joints, which is caused by a type 3 humeral head-glenoid relation.

  19. Diagnosis and treatment of nonorganic enuresis in children: Clinical practice guideline

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    Luis Guillermo Meave-Cueva; Rosalía Garza-Elizondo; Luisa Díaz-García

    2014-01-01

    Background: Bedwetting is an involuntary urination during sleep at the age of 5 years or older. Clinical Practice Guidelines (CPG) have been developed to improve decision-making strategies and standardize medical practice. The Ministry of health in Mexico developed the CPG diagnosis and treatment of non-organic enuresis at the first level of prevention in children. Its evidence is evaluated with the USPSTF (United States Preventive Services Task Force). Material and methods: Original articles...

  20. Focus on prevention, diagnosis and treatment of hypertension in children and adolescents

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    Spagnolo, Amedeo; Giussani, Marco; Ambruzzi, Amalia Maria; Bianchetti, Mario; Maringhini, Silvio; Matteucci, Maria Chiara; Menghetti, Ettore; Salice, Patrizia; Simionato, Loredana; Strambi, Mirella; Virdis, Raffaele; Genovesi, Simonetta

    2013-01-01

    The European Society of Hypertension has recently published its recommendations on prevention, diagnosis and treatment of high blood pressure in children and adolescents. Taking this contribution as a starting point the Study Group of Hypertension of the Italian Society of Pediatrics together with the Italian Society of Hypertension has conducted a reappraisal of the most recent literature on this subject. The present review does not claim to be an exhaustive description of hypertension in th...

  1. Time to move from presumptive malaria treatment to laboratory-confirmed diagnosis and treatment in African children with fever.

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    Valérie D'Acremont

    2009-01-01

    Full Text Available BACKGROUND TO THE DEBATE: Current guidelines recommend that all fever episodes in African children be treated presumptively with antimalarial drugs. But declining malarial transmission in parts of sub-Saharan Africa, declining proportions of fevers due to malaria, and the availability of rapid diagnostic tests mean it may be time for this policy to change. This debate examines whether enough evidence exists to support abandoning presumptive treatment and whether African health systems have the capacity to support a shift toward laboratory-confirmed rather than presumptive diagnosis and treatment of malaria in children under five.

  2. Focus on prevention, diagnosis and treatment of hypertension in children and adolescents.

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    Spagnolo, Amedeo; Giussani, Marco; Ambruzzi, Amalia Maria; Bianchetti, Mario; Maringhini, Silvio; Matteucci, Maria Chiara; Menghetti, Ettore; Salice, Patrizia; Simionato, Loredana; Strambi, Mirella; Virdis, Raffaele; Genovesi, Simonetta

    2013-03-19

    The European Society of Hypertension has recently published its recommendations on prevention, diagnosis and treatment of high blood pressure in children and adolescents. Taking this contribution as a starting point the Study Group of Hypertension of the Italian Society of Pediatrics together with the Italian Society of Hypertension has conducted a reappraisal of the most recent literature on this subject. The present review does not claim to be an exhaustive description of hypertension in the pediatric population but intends to provide Pediatricians with practical and updated indications in order to guide them in this often unappreciated problem. This document pays particular attention to the primary hypertension which represents a growing problem in children and adolescents. Subjects at elevated risk of hypertension are those overweight, with low birth weight and presenting a family history of hypertension. However, also children who do not present these risk factors may have elevated blood pressure levels. In pediatric age diagnosis of hypertension or high normal blood pressure is made with repeated office blood pressure measurements that show values exceeding the reference values. Blood pressure should be monitored at least once a year with adequate methods and instrumentation and the observed values have to be interpreted according to the most updated nomograms that are adjusted for children's gender, age and height. Currently other available methods such as ambulatory blood pressure monitoring and home blood pressure measurement are not yet adequately validated for use as diagnostic instruments. To diagnose primary hypertension it is necessary to exclude secondary forms. The probability of facing a secondary form of hypertension is inversely proportional to the child's age and directly proportional to blood pressure levels. Medical history, clinical data and blood tests may guide the differential diagnosis of primary versus secondary forms. The prevention of

  3. Testicular torsion: diagnosis, differential diagnosis, and treatment in children; Hodentorsion: Diagnose, Differenzialdiagnose und Therapie im Kindesalter

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    Guenther, P. [Chirurgische Universitaetsklinik Heidelberg (Germany)., Abt. Kinderchirurgie; Schenk, J.P. [Universitaetsklinikum Heidelberg (Germany). Paediatrische Radiologie

    2006-07-15

    Acute scrotum represents an emergency situation although testicular torsion is present in less than 20% of the cases. Sonography has meanwhile become the definitive modality for diagnosis. Its increasing use before surgical intervention has led to technical improvements in ultrasound diagnostics and critical assessment of ultrasound criteria to exclude testicular torsion as well as standardization of examination procedures. Central arterial and venous perfusion shown to be bilaterally equal on Doppler sonography is the most important criterion for excluding torsion. This article discusses other criteria such as the ''resistance index,'' comparison of parenchymal structure of both testes, evidence for spermatic cord torsion, or differences between the sides in perfusion of the testicular parenchyma and highlights the difficulties involved in partial and intermittent testicular torsion. Alternative investigative methods and the significance of sonography in the differential diagnosis of other underlying causes are addressed. In summary, the combination of interpreting B-mode imaging, color Doppler, and power Doppler sonography and analyzing Doppler flow curves after clinical examination results in successful and conclusive evaluation of the testes in cases of acute scrotum in boys. (orig.) [German] Das akute Skrotum ist eine Notfallsituation, wobei in weniger als 20% der Faelle eine Hodentorsion vorliegt. Inzwischen hat sich die Sonographie zur entscheidenden diagnostischen Untersuchungsmodalitaet entwickelt deren zunehmende Anwendung zu technischen Fortschritten der Ultraschalldiagnostik, zu einer kritischen Bewertung von Ultraschallkriterien zum Ausschluss einer Hodentorsion und zu einer Standardisierung der Untersuchungsablaeufe gefuehrt hat. Die in der Dopplersonographie dargestellte seitengleiche zentrale arterielle und venoese Perfusion ist hierbei das wichtigste Kriterium zum Ausschluss einer Torsion. Weitere Kriterien wie &apos

  4. A Practical Approach to the Diagnosis and Treatment of Vitiligo in Children.

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    Ezzedine, Khaled; Silverberg, Nanette

    2016-07-01

    Vitiligo is a common inflammatory skin disease with a worldwide prevalence of 0.5% to 2.0% of the population. In the pediatric population, the exact prevalence of vitiligo is unknown, although many studies state that most cases of vitiligo are acquired early in life. The disease is disfiguring, with a major psychological impact on children and their parents. Half of vitiligo cases have a childhood onset, needing thus a treatment approach that will minimize treatment side effects while avoiding psychological impacts. Management of vitiligo should take into account several factors, including extension, psychological impact, and possible associations with other autoimmune diseases. This review discusses the epidemiology of vitiligo and outlines the various clinical presentations associated with the disorder and their differential diagnosis. In addition, the pathophysiology and genetic determinants, the psychological impact of vitiligo, and management strategies are reviewed.

  5. EARLY DIAGNOSIS AS DETERMINATING FACTOR FOR PROFESSIONAL, RATIONAL AND EFFECTIVE TREATMENT OF CHILDREN WITH DEVELOPMENTAL DIFFICULTIES

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    Goran AJDINSKI

    1997-06-01

    Full Text Available Early diagnosis of children with developmental difficulties is one of the most important segments in the process of rehabilitation. It is not only an assessment and evaluation of the functional conditions, but also and detection of the possibilities for treatment and it’s improvement.In our presentation we give the first noticing for diagnostics of children with developmental difficulties in the Republic of Macedonia, the present capacities, possibilities, needs and suggestions for it’s improvement and advancement. Speaking about that we stress the need of multidisciplinary and complete professional team in the present institutions and solving out a number of problems that exist on that plan. It especially relates to the unique terminology, the procedure and involvement of defectologists in the diagnostic process.Having in mind the bio-psycho and social aspects of the personality of children with developmental difficulties, together with the need of a complex diagnostic procedure, we have tried to give the professional activities of all the profiles of professionals that take part in the diagnostic process. So, we give a review of the work of:· physician-pediatrician who is involved in the diagnostics of all children· audiologist who is involved in the diagnostics of children with damaged hearing from a medical point of view.· the clinical psychologist who works in the institute for medical rehabilitation and whose task is to prepare and realize all the necessary tests for the personality of the child with developmental difficulties.· physiologist for children with somatic damages.· neuropsychiatrist for children with psychological difficulties· specialist for eye diseases giving his report about the child’s damaged eyesight etc.We consider that we shouldn’t neglect the role of the defectologist, his examinations on psycho-motor status, speech, i. e. the functions of the individual in relation to the social aspect in a close

  6. EPIDEMIOLOGY, DIAGNOSIS AND TREATMENT OF ACUTE PROMYELOCYTIC LEUKEMIA IN CHILDREN: THE EXPERIENCE IN CHINA

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    Li Zhang

    2012-03-01

    Full Text Available The limited available data suggest that the rate of early mortality is high and that long-term survival is poor in many developing countries. Death from bleeding and infection during chemotherapy, relapse and treatment abandonment are among the main cause of treatment failure in APL children. The status of children APL treatment in China is not described in general.

  7. Screening, diagnosis and treatment of hypertension in obese children: an international policy comparison

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    A.J.G. Wirix; J. Verheul (Jelle); J. Groothoff (Jaap); J. Nauta (Jeroen); M.J.M. Chinapaw (Mai); J.E. Kist-Van Holthe (Joana)

    2017-01-01

    textabstractHypertension in obese children may require a different diagnostic and treatment approach from that for children with secondary hypertension, yet there is neither consensus nor a clear guideline. The aim of this study was to assess how obese children with hypertension are currently diagno

  8. Diagnosis and treatment of portal hypertension in children (Part II: treatment

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    Rafael Trinchet Soler

    2005-12-01

    Full Text Available The portal hypertension is the clinical syndrome characterized by the increase of pressure in portal system. Undoubtedly the gastrointestinal bleeding due to esopagheal and gastroesophageal varices, erosive gastritis and peptic ulcers constitute the most difficult and dangerous challenge for doctors and patients. Although most patients are treated by non-surgical methods, the surgical treatment correctly realized in chosen patients according to the current protocols is the most effective method to diminish the portal pressure definitively and can be carried out in more than 88% of patients smaller than 2 years old with a near elective mortality to 0% in some countries. We presented the Second Part of Good Clinical Practices Guideline for Portal hypertension (management, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.

  9. Post-traumatic stress disorder in children and adolescents: epidemiology, diagnosis and treatment options.

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    Donnelly, Craig L; Amaya-Jackson, Lisa

    2002-01-01

    Post-traumatic stress disorder (PTSD) is a common psychiatric condition in childhood and adolescence. Rates vary widely depending upon the type of trauma exposure. Interpersonal traumas, such as rape or physical abuse, are more likely to result in PTSD than exposure to natural or technological disaster. Clinical presentations are exceedingly complex and children with PTSD are at increased risk of having comorbid psychiatric diagnoses. Because of its complexity and frequent occurrence with other disorders, assessment of PTSD necessitates a broad-based evaluation utilizing multiple informations and structured instruments specific to the symptoms of PTSD in youth. Cognitive-behavioral therapy (CBT) is the treatment of first choice. Pharmacological agents for PTSD treatment have received little empirical investigation in childhood. Pharmacological treatment is used to target disabling symptoms of the disorder, which limit psychotherapy or life functioning, by helping children to tolerate working through distressful material in therapy and life. Pharmacological treatment should be based on a stepwise approach utilizing broad spectrum medications such as the selective serotonin reuptake inhibitors as first-line agents. Comorbid conditions should be identified and treated with appropriate medication or psychosocial interventions. Treatment algorithms are provided to guide rational medication strategies for children and adolescents with PTSD, subsyndromal PTSD, and in PTSD that is comorbid with other psychiatric conditions of childhood. Reduction in even one debilitating symptom of PTSD can improve a child's overall functioning across multiple domains.

  10. The usefulness of soluble transferrin receptor in the diagnosis and treatment of iron deficiency anemia in children

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    Yoon, Se Hoon; Kim, Dong Sup; Yu, Seung Taek; Shin, Sae Ron

    2015-01-01

    Purpose Soluble transferrin receptor (sTfR) is a truncated extracellular form of the membrane transferrin receptor produced by proteolysis. Concentrations of serum sTfR are related to iron status and erythropoiesis in the body. We investigated whether serum sTfR levels can aid in diagnosis and treatment of iron deficiency anemia (IDA) in children. Methods Ninety-eight patients with IDA were enrolled and were classified according to age at diagnosis. Group 1 comprised 78 children, aged 6-59 months, and group 2 comprised 20 adolescents, aged 12-16 years. Results In group 1, patients' serum sTfR levels correlated negatively with mean corpuscular volume; hemoglobin (Hb), ferritin, and serum iron levels; and transferrin saturation and positively with total iron binding capacity (TIBC) and red cell distribution width. In group 2, patients' serum sTfR levels did not correlate with ferritin levels and TIBC, but had a significant relationship with other iron indices. Hb and serum sTfR levels had a significant inverse relationship in both groups; however, in group 1, there was no correlation between Hb and serum ferritin levels. In 30 patients of group 1, serum sTfR levels were significantly decreased with an increase in Hb levels after iron supplementation for 1 month. Conclusion Serum sTfR levels significantly correlated with other diagnostic iron parameters of IDA and inversely correlated with an increase in Hb levels following iron supplementation. Therefore, serum sTfR levels can be a useful marker for the diagnosis and treatment of IDA in children. PMID:25729394

  11. EARLY DETECTION, DIAGNOSIS, TREATMENT AND PRE-SCHOOL EDUCATION OF CHILDREN WITH SIGHT DAMAGE

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    S. DIKIC

    1997-12-01

    Full Text Available Sight damages can appear in every period of the human life, from birth till very old age. The disorders of the sight function retard and hinder the possibility of learning, proper informing as well as recognizing the objects in reality. The possibility for rehabilitation and adaptation is bigger and the psychical consequences in the person development are smaller, if the person with damaged sight is younger and rehabilitation and correction of the incorrect sight function start at proper time, i.e., immediately after the detection of the damage.The developmental deviation with children with damaged sight can be recognized in the general physical development, in poorer fund of real ideas in the sensomotor development, in the space notion and space relations, in reduced motivation for certain activities and so on. However, these children have the same needs as the children with normal sight, such as: love, sympathies, care, discipline, learning, understanding, patience and so on. It should be taken into consideration that each child is an individual which means a special approach to the rehabilitation. In fact, more often we find children who, besides the sight damages, have other damages such as: cerebral paralysis, hearing damages, mental retardation, emotional disorders and so on.The preventive measures contribute to the decreasing number of children with more difficult psycho-physical anomalies and they mean obligation of the community to organize: Advisory Institutions for pregnant women, quick and prompt intervention of the ophthalmologists and other experts, increasing of the general culture of the population and so on, and the systematic sight check-ups of every child should be performed in the first, third and sixth year of their lives.The expert treatment of sight handicapped children should start from the very detection of the sight damage (blindness and low vision. For small blind and low vision children the Developmental Advisory

  12. New developments in diagnosis and treatment update: Schizophrenia/first episode psychosis in children and adolescents.

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    Lachman, Anusha

    2014-01-01

    Childhood onset schizophrenia (COS) is diagnosed before the age of 13 years, and early onset schizophrenia (EOS) is diagnosed before the age of 18 years. EOS is considered extremely rare and its prevalence in comparison to the worldwide prevalence of schizophrenia (1%) has not adequately been studied. Patients who experience the first episode of psychosis need to be treated early and optimally to lessen the morbidity and improve the outcome of the illness. Treatment needs to be a combination of both pharmacological and non-pharmacological modalities. Pharmacological intervention is necessary for remission, improvement of positive symptoms and to aid with the efficacy of psychosocial interventions. There is a lack of efficacy and safety data of the use of antipsychotic medication in children, with most of the information available being extrapolations of adult data. An increased use of atypical antipsychotic drugs in the treatment of EOS has been accompanied by growing concern about the appropriate use and associated side effects in children and adolescents. This update highlights new developments, concepts and treatment trends in EOS.

  13. Salmonella Diagnosis and Treatment

    Science.gov (United States)

    ... FDA) USDA Food Safety and Inspection Service Follow Salmonella RSS Diagnosis and Treatment Recommend on Facebook Tweet Share Compartir How Can Salmonella Infections Be Diagnosed? Diagnosing salmonellosis requires testing a ...

  14. PTSD: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Feature PTSD Symptoms, Diagnosis , Treatment Past Issues / Winter 2009 Table of Contents ... version of this page please turn Javascript on. Symptoms As with mild traumatic brain injury (TBI), PTSD ...

  15. Prevalence of diagnosis and direct treatment costs of back disorders in 644,773 children and youths in Germany

    Directory of Open Access Journals (Sweden)

    Ochsmann Elke B

    2010-08-01

    Full Text Available Abstract Background Many authors have reported about the high prevalence rates of self-reported back pain in children. Nevertheless, little is known about the diagnosis of back disorders - regardless of whether the diagnosis is associated with back pain or not. Therefore, the aim of this study was to analyse the prevalence rates and costs of diagnosis of back disorders in childhood and youth. Methods We conducted a secondary data analysis of a large, population based German data set (2,300,980 insurants of statutory health insurance funds which allowed for identification of prevalence rates of diagnoses of back disorders in children (age group 0-14 years and youths (age group 15-24 years using three digit ICD-10 codes for dorsopathies (M40 - M54: kyphosis and lordosis; scoliosis; spinal osteochondrosis; other deforming dorsopathies; ankylosing spondylitis; other inflammatory spondylopathies; spondylosis; other spondylopathies; spondylopathies in diseases classified elsewhere; cervical disc disorders; other intervertebral disc disorders; other dorsopathies, not elsewhere classified; dorsalgia. Direct treatment costs were calculated based on the real incurred costs for cases with a singular diagnosis of a back disorder. Wherever possible, the results of the random sample were extrapolated to all insurants of statutory health insurance funds (i. e., about 90% of the German population. Results We found prevalence rates for the diagnosis of back disorders to range between 0.01 - 12.5%. "Scoliosis" (M41 and "dorsalgia" (M54 were the most frequent diagnoses in both age groups. Based on these results, it was calculated that in 2002 alone, approximately 1.4 million children/youths in Germany were diagnosed with "dorsalgia" (M54, and that the direct costs for back disorders in childhood and youth accounted for at least 100 million Euros. Conclusions Instead of focusing on the individual, and self-reported disorder or disability, this analysis allowed for

  16. Diagnosis and treatment of sleep related breathing disorders in children: 2007 to 2011.

    LENUS (Irish Health Repository)

    Walsh, A

    2015-03-01

    Sleep related breathing disorders (SRBD) have historically been under-recognised and under-treated. Obstructive sleep apnoea (OSA) affects approximately 3% of children. In line with the increased recognition of SRBD there has been an increase in demand for diagnostic services. We determined the awareness of SRBD amongst Irish paediatricians, examined the provision of sleep services to children throughout the country between 2007 and 2011 and audited diagnostic sleep services in a tertiary centre in 2011. Amongst respondents there was an awareness of SRBD but a poor understanding of diagnostic evaluation with 31\\/46 (67) referring to inappropriate services. There has been a sharp increase in both diagnostic sleep tests (433-1793 [414]) and in the use of non-invasive ventilation (NIV) (31-186 [627]) for treatment of SRBD between 2007 and 2011. Paediatric sleep services are organized in an ad-hoc manner nationally with significant service variation. The use of domiciliary overnight oximetry reduced the requirement for more formal polysomnography by 70%.

  17. [Toxoplasmosis: Epidemiology, Diagnosis, Treatment].

    Science.gov (United States)

    Khryanin, A A; Reshetnikov, O V; Kuvshinova, I N

    2015-01-01

    The up-to-date literature and original data on the epidemiology, diagnosis and treatment of toxoplasmosis are presented. Particular attention is paid to the parasite infection during pregnancy. Spiramycin is the drug of choice for acute toxoplasmosis in pregnant women.

  18. [Urticaria: diagnosis and treatment].

    Science.gov (United States)

    Soria, A; Francès, C

    2014-09-01

    Urticaria is a common inflammatory skin disease. It is clinically defined as the occurrence of transient papular skin and/or mucosal lesions or subcutaneous lesions called angioedema. Chronic urticaria is defined as a clinical course over more than 6weeks. Different clinical forms of urticaria can coexist in the same patient. Urticaria results of mast cell activation. The diagnosis of urticaria is based on clinical examination. An allergic etiology for acute urticaria, although rare, is always to find and remove. Chronic urticaria is not allergic. Diagnosis is based on questioning and a careful clinical examination to rule out differential diagnoses. Few diagnostic tests are necessary for diagnosis and management, and are especially useful in case of doubtful diagnosis. The treatment of urticaria is symptomatic and based on anti-H1 second generation antihistamines as first-line therapy. In some chronic urticarial, antihistamines up dosing may be necessary. In the majority of patients, this treatment is sufficient to control chronic urticaria. In case of antihistamines failure, other treatment particularly immunomodulatory treatments can be offered in specialized departments.

  19. Advances in the Diagnosis and Treatment of Children with Serious Mental Illness.

    Science.gov (United States)

    Taylor, Edward H.

    1998-01-01

    Knowledge of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) criteria does not always help the family social worker identify children with neuropsychiatric disorders. Early onset schizophrenia, bipolar disorders, and severe depression can cause child behaviors that differ markedly from symptoms manifested by adults. This article…

  20. Hirsutism: diagnosis and treatment.

    Science.gov (United States)

    Hohl, Alexandre; Ronsoni, Marcelo Fernando; Oliveira, Mônica de

    2014-03-01

    Hirsutism is defined as excessive terminal hair growth in androgen-dependent areas of the body in women, which grows in a typical male distribution pattern. Hirsutism is a common clinical problem in women, and the treatment depends on the cause. The condition is often associated with a loss of self-esteem. Hirsutism reflects the interaction between circulating androgen concentrations, local androgen concentrations, and the sensitivity of the hair follicle to androgens. Polycystic ovary syndrome and idiopathic hirsutism are the most common causes of the condition. A woman's history and, physical examination are particularly important in evaluating excess hair growth. The vast majority of women with hirsutism have the idiopathic variety, and the diagnosis is made by exclusion. Serum testosterone level>200 ng/dL is highly suggestive of adrenal or ovarian tumor. Treatment of hirsutism should be based on the degree of excess hair growth presented by the patient and in the pathophysiology of the disorder. Treatment includes lifestyle therapies, androgen suppression, peripheral androgen blockage, and cosmetic treatments. The current review discusses definition, pathogenesis, physiopathology, differential diagnosis, diagnostic strategies, and treatment.

  1. Headache Symptoms, Diagnosis, and Treatment

    Science.gov (United States)

    ... Current Issue Past Issues Headaches and Migraines Headache Symptoms, Diagnosis, and Treatment Past Issues / Spring 2009 Table of ... symptoms and treatments. Migraine and Other Vascular Headaches—Symptoms and Diagnosis Migraine: The most common of vascular ...

  2. Uveitis in Children: Diagnosis and Management.

    Science.gov (United States)

    Gupta, Anju; Ramanan, A V

    2016-01-01

    Uveitis is a term used to describe inflammation of uvea, which is the middle layer of eye. It is an important cause of blindness in children in both developed and developing countries. Delayed diagnosis, inadequate treatment and risk of amblyopia are some of the factors that are unique to childhood uveitis and are responsible for significant morbidity seen with this disease.

  3. Diagnosis and treatment of impetigo.

    Science.gov (United States)

    Cole, Charles; Gazewood, John

    2007-03-15

    Impetigo is a highly contagious, superficial skin infection that most commonly affects children two to five years of age. The two types of impetigo are nonbullous impetigo (i.e., impetigo contagiosa) and bullous impetigo. The diagnosis usually is made clinically, but rarely a culture may be useful. Although impetigo usually heals spontaneously within two weeks without scarring, treatment helps relieve the discomfort, improve cosmetic appearance, and prevent the spread of an organism that may cause other illnesses (e.g., glomerulonephritis). There is no standard treatment for impetigo, and many options are available. The topical antibiotics mupirocin and fusidic acid are effective and may be superior to oral antibiotics. Oral antibiotics should be considered for patients with extensive disease. Oral penicillin V is seldom effective; otherwise there is no clear preference among antistaphylococcal penicillins, amoxicillin/clavulanate, cephalosporins, and macrolides, although resistance rates to erythromycin are rising. Topical disinfectants are not useful in the treatment of impetigo.

  4. Hyperthyroidism: Diagnosis and Treatment.

    Science.gov (United States)

    Kravets, Igor

    2016-03-01

    Hyperthyroidism is an excessive concentration of thyroid hormones in tissues caused by increased synthesis of thyroid hormones, excessive release of preformed thyroid hormones, or an endogenous or exogenous extrathyroidal source. The most common causes of an excessive production of thyroid hormones are Graves disease, toxic multinodular goiter, and toxic adenoma. The most common cause of an excessive passive release of thyroid hormones is painless (silent) thyroiditis, although its clinical presentation is the same as with other causes. Hyperthyroidism caused by overproduction of thyroid hormones can be treated with antithyroid medications (methimazole and propylthiouracil), radioactive iodine ablation of the thyroid gland, or surgical thyroidectomy. Radioactive iodine ablation is the most widely used treatment in the United States. The choice of treatment depends on the underlying diagnosis, the presence of contraindications to a particular treatment modality, the severity of hyperthyroidism, and the patient's preference.

  5. Diagnosis and surgical treatment of defects in the wall of the orbit of children and adults using demineralized bone allografts.

    Science.gov (United States)

    Ryabov, Alexey; Lekishvili, Mikhail

    2016-09-01

    Accuracy of diagnosis defines the quality of treatment in patients with traumatic damage to eyelet walls. In this area, complex functional and anatomical breaches are typical and require full characterization of pathological changes in bone and soft tissue structures. A new plastic material with a high degree level of demineralization called "Perfoost" can be used to treat defects in the bones of the face of children and adults. In the present study, 79 patients with fractured eyelet walls were treated between 1999 and 2006 by grafting the defect wall with demineralized bone allografts. Grafts were applied from 2 days to 18 months after trauma. Magnetic resonance computer CT was used to check the realignment of allografts every 6 months after the reconstructive operation. The post-operative period of the observation was from 6 months to 7 years after the operation. Good or satisfactory results were obtained for 97.47 % of patients.

  6. Arsenicosis: Diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Das Nilay

    2008-01-01

    Full Text Available Diagnosis of arsenicosis relies on both clinical and laboratory criteria, but principally it can be diagnosed on the basis of its cutaneous manifestations. Cutaneous manifestations (melanosis, keratosis, and cutaneous cancers are essential clues in the diagnosis, and trained dermatologists or arsenic experts are able to clinically confirm a case even without laboratory backup. Although systemic manifestations are not considered as diagnostic hallmarks, yet their presence serves as important telltale signs in arriving at the diagnosis. In countries where laboratory facilities are available, measuring the level of arsenic in drinking water (consumed in the last 6 months, urine, hair, and nails is of immense value. Newer biomarkers of arsenic exposure are being explored to provide early information about arsenic intoxication, of which urinary porphyrin level, blood metallothionein have shown promising results. Controlling the problem of arsenicosis depends on various factors, of which the most important is cessation of intake of arsenic-contaminated water. Deep wells, traditional dug wells, treatment of surface water, rainwater harvesting, and removing arsenic from the contaminated water by arsenic removal plant or arsenic treatment unit are the available options for providing arsenic-free drinking water. The role of nutrition and antioxidants in preventing the onset of symptoms of arsenicosis is also of importance. Nonspecific therapies (e.g., keratolytics for hyperkeratosis cannot also be ignored and serve as palliative measures. The persons affected need to be followed up at regular intervals to detect the onset of cancers (if any at the earliest. Role of counseling and education should never be underestimated since absence of public awareness can undermine all efforts of mitigation measures.

  7. 小儿脑型肺吸虫病的诊治%Diagnosis and treatment for children with cerebral paragonimiasis

    Institute of Scientific and Technical Information of China (English)

    翟碹; 梁平; 夏佐中; 李映良; 周渝冬; 李禄生

    2009-01-01

    Objective To explore the clinical features,diagnosis and treatment for children with cerebral paragonimiasis.Methods Among all the 59 patients,52 had a history of consuming raw crabs or drinking contaminated water,49 got intracranial hypertension,10 suffered hemiparalysis or hemiablepsia,19 had epileptic seizure,and 6 complicated with pulmonary symptoms.Forty-five got increased eosinophilic leukocytes in peripheral blood,36 had increased leucocytes.Skin test of Paragonimus westernami antigen was positive in 45 cases and ELISA test was positive in 15 cases.Intracerebral lesions were found in all the cases by CT or MRI examination.Results All patients underwent oral administration of Praziquantel.and 14 got craniotomy.Forty-one cases were cured and 18 cases partially recovered.Forty-three patients who were followed up for 6 months to 2 years had good prognosis.Conclusions Cerebral paragonimiasis in children has complex clinical manifestations,which is often misdiagnosed in the early stage.Epidemiology,increased eosinophilic leukocytes in peripheral blood.positive results of paragonimiasis immunology test and MRI contribute to early diagnosis.Drug or surgical treatment according to patient's different conditions can promise the good prognosis in children with cerebral cerebral paragonimiasis.%目的 探讨小儿脑型肺吸虫病的临床特点和诊治.方法 59例患儿中生食淡水蟹或饮用疫水52例,高颅压症状49例,肢体偏瘫19例,偏盲10例,癫痫发作19例,合并肺部症状6例;外周血嗜酸性粒细胞升高45例,白细胞升高36例;肺吸虫抗原皮试阳性55例,ELISA试验阳性15例.CT或MRI检查均发现脑内病灶.结果 所有病例均口服吡喹酮治疗,其中14例手术开颅切除病灶.痊愈41例,好转18例.43例患儿随访6~12个月预后良好.结论 小儿脑型肺吸虫病临床表现多样,早期易误诊.流行病学资料、外周血嗜酸性粒细胞升高、肺吸虫免疫学检查和MRI有助于早期诊断.根

  8. Malformations of the first ray of the foot in children: diagnosis, clinical picture, treatment

    Directory of Open Access Journals (Sweden)

    Михаил Павлович Конюхов

    2015-06-01

    Full Text Available Malformations of the first ray of the foot vary widely and are divided into simple and complex. Complex malformations include abnormality of development of the first metatarsal or the main phalanx and refer to atypical adducted foot deformity. They are also characterized by varus location of the first ray of varying severity. The cause of deformation is a damage of longitudinal epiphyseal growth plate area of the first metatarsal - “longitudinal epiphyseal bracket” or the so-called delta phalanx. Over the past five years, we treated 37 patients (53 feet aged from 6 months to 17 years old with developmental disabilities of the first ray of the foot. The spectrum of pathology is very diverse. In the majority of cases surgical treatment was multi-staged. It was revealed that the removal of deformity at the first stage of treatment should be complete, with maximum use of the bone to restore the length and shape of the affected bone. In treating combined deformities the good effect is guaranteed only with the removal of all the elements, including excision of the fibrous bridle along the inner surface of the first ray.

  9. Diagnosis and treatment of melamine-associated urinary calculus complicated with acute renal failure in infants and young children

    Institute of Scientific and Technical Information of China (English)

    SUN Ning; JIANG Ye-ping; FENG Dong-chuan; ZHANG Rui-feng; ZHU Xiao-yu; XIAO Hong-zhan; SHEN Ying; SUN Qiang; LI Xu-ran; JIA Li-qun; ZHANG Gui-ju; ZHANG Wei-ping; CHEN Zhi; FAN Jian-feng

    2009-01-01

    Background Infants in some areas of China developed urinary lithiasis after being fed with powdered milk that was tainted with melamine in 2008 and very small proportion of the infants developed acute renal failure caused by urinary tract calculus obstruction. The aim of this article was to summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus and acute renal failure developed after being fed with melamine tainted formula milk.Methods Data of infant patients with urinary calculus and acute renal failure due to melamine tainted formula milk admitted to the Beijing Children's Hospital Affiliated to the Capital Medical University and the Xuzhou Children's Hospital in 2008 were used to analyze the epidemiological characteristics, clinical manifestations, imaging features as well as effects of 4 types of therapies.Results All the 34 infants with urinary calculus were complicated with acute renal failure, their blood urea nitrogen (BUN) was (24.1±8.2) mmol/L and creatinine (CO was (384.2±901.2) μmol/L. The chemical analysis on the urinary calculus sampled from 15 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for the four types of therapies for returning Cr to normal was (3.5±1.9) days for cystoscopy group, (2.7±1.1) days for lithotomy group, (3.8±2.3) days for dialysis group, and (2.7±1.6) days for medical treatment group, which had no statistically significant difference (P=0.508). Renal failure of all the 34 infants was relieved within 1 to 7 days, averaging (3.00±1.78) days.Conclusions Melamine tainted formula milk may cause urinary calculus and obstructive acute renal failure. It is suggested that firstly the patients with urinary calculus complicated with acute renal failure should be treated with dialysis or medication to correct electrolyte disturbance, in particular hyperkalemia, and then relieve the obstruction with available medical and surgical methods as soon as

  10. Clinical Practice Experiences in Diagnosis and Treatment of Traumatic Brain Injury in Children: A Survey among Clinicians at 9 Large Hospitals in China.

    Science.gov (United States)

    Di, Fei; Gao, Qi; Xiang, Joe; Zhang, Di; Shi, Xiuquan; Yan, Xueqiang; Zhu, Huiping

    2015-01-01

    Proper diagnosis and treatment of traumatic brain injury (TBI) in children is becoming an increasingly problematic issue in China. This study investigated Chinese clinicians to provide information about their knowledge and experiences in diagnosis and treatment of pediatric TBI. We conducted a questionnaire survey among clinicians in the emergency departments and neurosurgery departments at 9 major hospitals in China. The questionnaire included demographic information, and knowledge and experiences regarding the diagnosis and treatment of pediatric TBI. A total of 235 clinicians completed questionnaires. 43.8% of the surveyed clinicians reported children with only scalp hematoma without any other signs and symptoms of concussion as TBI cases. Most clinicians (85.1%) reported no existing uniform diagnostic criteria for children with TBI in China. The majority of clinicians (91.9%) reported that CT scans were performed in all patients with suspected head injury as a routine procedure in their hospitals. Only 20.9% of clinicians believed that radiation from CT scanning may increase cancer risk in children. About 33.6% of the clinicians reported that they ordered CT scans to investigate suspected head injury due to the poor doctor-patient relationship in China, and to protect themselves against any medical lawsuits in the future. About 80% of the clinicians reported that there are no existing pediatric TBI treatment guidelines in China. Instead a senior doctor's advice is the most reported guidelines regarding treating pediatric TBI (66.0%). All of the surveyed clinicians reported that the lack of diagnosis and/or treatment standard is the biggest problem in effectively diagnosing and treating pediatric TBI in China. Developing guidelines for the diagnosis and treatment of children with TBI is a high priority in China. The extremely high usage of CT for pediatric TBI in China suggests that it is important to establish evidence-based clinical decision rules to help

  11. Diagnosis and treatment of standardization of rhinitis and sinusitis in children%儿童鼻-鼻窦炎诊疗规范化探讨

    Institute of Scientific and Technical Information of China (English)

    敬尚林; 林楠(综述); 陈继昌(审校)

    2014-01-01

    Rhinosinusitis is a common disease in children.Because of anatomical,physiological and immunological fac-tors in different ways,its clinical diagnosis and treatment procedures are obviously different from adults’.In this paper, literatures about standardization diagnosis and treatment of children with rhinosinusitis at home and abroad are reviewed.%鼻-鼻窦炎是儿童常见病,因解剖、生理及免疫等因素的不同,在临床诊断和治疗程序上与成人有明显区别,科学规范诊疗在临床上十分重要。复习国内外文献,探讨了儿童鼻-鼻窦炎规范化的诊疗程序。

  12. The diagnosis and treatment measures of children severe pneumonia%小儿重症肺炎的诊断和治疗措施

    Institute of Scientific and Technical Information of China (English)

    吴京晓

    2016-01-01

    Objective:To discuss the diagnosis and treatment measures of children severe pneumonia.Methods:34 children with severe pneumonia were selected.The diagnosis and treatment measures of children were summarized.Results:In 34 patients,26 cases(76.47%) were cured or improved discharge;3 cases(8.82%) were dead due to severe disease;5 cases(14.7%) were critically ill.There were many complications with interrupted treatment or transferred to the superior hospital for further treatment. Conclusion:Doing a good job in the early diagnosis of children severe pneumonia,and giving active and effective treatment can significantly improve the clinical treatment effect of patients,and improve the prognosis of patients.%目的:探讨小儿重症肺炎的诊断和治疗措施。方法:收治重症肺炎患儿34例,对患儿诊断和治疗措施进行总结。结果:34例患儿中治愈或好转出院26例(76.47%),因病情严重而死亡3例(8.82%),病情危重5例(14.7%),并发症多而中断治疗或转上级医院进一步治疗。结论:做好重症肺炎患儿早期诊断,并予以积极有效的治疗可明显提高患者临床治疗效果,改善患者预后。

  13. Improving the Diagnosis and Treatment of Urinary Tract Infection in Young Children in Primary Care: Results from the DUTY Prospective Diagnostic Cohort Study

    Science.gov (United States)

    Hay, Alastair D.; Sterne, Jonathan A. C.; Hood, Kerenza; Little, Paul; Delaney, Brendan; Hollingworth, William; Wootton, Mandy; Howe, Robin; MacGowan, Alasdair; Lawton, Michael; Busby, John; Pickles, Timothy; Birnie, Kate; O’Brien, Kathryn; Waldron, Cherry-Ann; Dudley, Jan; Van Der Voort, Judith; Downing, Harriet; Thomas-Jones, Emma; Harman, Kim; Lisles, Catherine; Rumsby, Kate; Durbaba, Stevo; Whiting, Penny; Butler, Christopher C.

    2016-01-01

    PURPOSE Up to 50% of urinary tract infections (UTIs) in young children are missed in primary care. Urine culture is essential for diagnosis, but urine collection is often difficult. Our aim was to derive and internally validate a 2-step clinical rule using (1) symptoms and signs to select children for urine collection; and (2) symptoms, signs, and dipstick testing to guide antibiotic treatment. METHODS We recruited acutely unwell children aged under 5 years from 233 primary care sites across England and Wales. Index tests were parent-reported symptoms, clinician-reported signs, urine dipstick results, and clinician opinion of UTI likelihood (clinical diagnosis before dipstick and culture). The reference standard was microbiologically confirmed UTI cultured from a clean-catch urine sample. We calculated sensitivity, specificity, and area under the receiver operator characteristic (AUROC) curve of coefficient-based (graded severity) and points-based (dichotomized) symptom/sign logistic regression models, and we then internally validated the AUROC using bootstrapping. RESULTS Three thousand thirty-six children provided urine samples, and culture results were available for 2,740 (90%). Of these results, 60 (2.2%) were positive: the clinical diagnosis was 46.6% sensitive, with an AUROC of 0.77. Previous UTI, increasing pain/crying on passing urine, increasingly smelly urine, absence of severe cough, increasing clinician impression of severe illness, abdominal tenderness on examination, and normal findings on ear examination were associated with UTI. The validated coefficient- and points-based model AUROCs were 0.87 and 0.86, respectively, increasing to 0.90 and 0.90, respectively, by adding dipstick nitrites, leukocytes, and blood. CONCLUSIONS A clinical rule based on symptoms and signs is superior to clinician diagnosis and performs well for identifying young children for noninvasive urine sampling. Dipstick results add further diagnostic value for empiric antibiotic

  14. Impetigo: diagnosis and treatment.

    Science.gov (United States)

    Hartman-Adams, Holly; Banvard, Christine; Juckett, Gregory

    2014-08-15

    Impetigo is the most common bacterial skin infection in children two to five years of age. There are two principal types: nonbullous (70% of cases) and bullous (30% of cases). Nonbullous impetigo, or impetigo contagiosa, is caused by Staphylococcus aureus or Streptococcus pyogenes, and is characterized by honey-colored crusts on the face and extremities. Impetigo primarily affects the skin or secondarily infects insect bites, eczema, or herpetic lesions. Bullous impetigo, which is caused exclusively by S. aureus, results in large, flaccid bullae and is more likely to affect intertriginous areas. Both types usually resolve within two to three weeks without scarring, and complications are rare, with the most serious being poststreptococcal glomerulonephritis. Treatment includes topical antibiotics such as mupirocin, retapamulin, and fusidic acid. Oral antibiotic therapy can be used for impetigo with large bullae or when topical therapy is impractical. Amoxicillin/clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, trimethoprim/sulfamethoxazole, and macrolides are options, but penicillin is not. Natural therapies such as tea tree oil; olive, garlic, and coconut oils; and Manuka honey have been anecdotally successful, but lack sufficient evidence to recommend or dismiss them as treatment options. Treatments under development include minocycline foam and Ozenoxacin, a topical quinolone. Topical disinfectants are inferior to antibiotics and should not be used. Empiric treatment considerations have changed with the increasing prevalence of antibiotic-resistant bacteria, with methicillin-resistant S. aureus, macrolide-resistant streptococcus, and mupirocin-resistant streptococcus all documented. Fusidic acid, mupirocin, and retapamulin cover methicillin-susceptible S. aureus and streptococcal infections. Clindamycin proves helpful in suspected methicillin-resistant S. aureus infections. Trimethoprim/sulfamethoxazole covers methicillin-resistant S

  15. Diagnosis and treatment of haemorrhoids

    DEFF Research Database (Denmark)

    Buntzen, Steen; Christensen, Peter Quist; Khalid, Ali;

    2013-01-01

    These guidelines provide a review of diagnosis, conservative and surgical treatment of haemorrhoids with primary focus on the surgical treatment. In symptomatic hemorrhoids it is recommended, that conservative treatment is used as basic treatment regardless of grading. The vast majority of grade II...

  16. 儿童功能性慢性腹痛的诊断与治疗%Diagnosis and treatment of functional chronic abdominal pain in children

    Institute of Scientific and Technical Information of China (English)

    江米足

    2014-01-01

    Functional chronic abdominal pain is very common in pediatrics,but the understanding of the diagnosis and treatment in clinics are to be strengthened.The diagnosis,differential diagnosis and treatment progress of 4 kinds of main functional chronic abdominal pain in children are reviewed such as functional dyspepsia,irritable bowel syndrome,functional abdominal pain and functional abdominal pain syndrome,abdominal migraine according to Rome Ⅲ diagnostic criteria of functional gastrointestinal diseases in children.%功能性慢性腹痛在儿科非常多见,但临床上对其诊断与治疗的认识尚有待加强.现结合功能性胃肠病罗马Ⅲ诊断标准,主要就4种儿童功能性慢性腹痛(如功能性消化不良、肠易激综合征、功能性腹痛和功能性腹痛综合征、腹型偏头痛)的诊断、鉴别诊断与治疗进展作一阐述.

  17. Hyperprolactinemia Diagnosis and Treatment

    Science.gov (United States)

    ... making tumor on the pituitary gland, called a prolactinoma . This tumor is almost always benign, meaning not ... women than men. Rarely, children and adolescents develop prolactinomas. Other brain tumors may also cause the pituitary ...

  18. Hipotireoidismo na criança: diagnóstico e tratamento Hypothyroidism in children: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Nuvarte Setian

    2007-11-01

    adolescents. SOURCES: Original and review articles and books containing relevant updated data. SUMMARY OF THE FINDINGS: This review addressed data on the etiopathogeny of hypothyroidism and on the importance of screening for congenital hypothyroidism to assure early diagnosis and treatment of the newborn. We point out the difficulties experienced in the handling of subclinical hypothyroidism; we also address the importance of diagnosing autoimmune Hashimoto's thyroiditis, the high incidence of the disease among adolescents, mainly females, and the occurrence of a severe neurological condition, Hashimoto's encephalopathy. We indicate situations in which severe hypothyroidism may lead to puberty disorders (precocious or delayed puberty and describe the importance of transcription factors in thyroid embryogenesis. Diagnostic and therapeutic criteria are also addressed. CONCLUSION: Thyroid hormones are necessary for normal growth and development since fetal life. Insufficient production or inadequate activity on the cellular or molecular level lead to hypothyroidism. These hormones are necessary for the development of the brain in the fetus and in the newborn infant. Neonatologists and pediatricians deal with child development issues in their practice, and many of these issues start during intrauterine life. Currently, with neonatal screening, neonatologists and pediatricians can prevent irreversible damage through early treatment. They should also be alert for dysfunctions such as subclinical hypothyroidism and Hashimoto's thyroiditis, which may provoke damage not only to growth, but also to the neurological and psychological development of these children and adolescents.

  19. [Symptoms diagnosis and treatment of dyscalulia].

    Science.gov (United States)

    Ise, Elena; Schulte-Körne, Gerd

    2013-07-01

    Children with dyscalculia show deficits in basic numerical processing which cause difficulties in the acquisition of mathematical skills. This article provides an overview of current research findings regarding the symptoms, cause, and prognosis of dyscalculia, and it summarizes recent developments in the diagnosis, early intervention, and treatment thereof. Diagnosis has improved recently because newly developed tests focus not only on the math curriculum, but also on basic skills found to be impaired in dyscalculia. A controversial debate continues with regard to IQ achievement discrepancy. International studies have demonstrated the effectiveness of specialized interventions. This article summarizes the research findings from intervention studies, describes different treatment approaches, and discusses implications for clinical practice.

  20. Dealing with Diagnosis of Cancer in Children

    Science.gov (United States)

    ... When Your Child Has Cancer Children Diagnosed With Cancer: Dealing With Diagnosis When a child or teen is diagnosed with ... How do parents usually react to a child’s cancer diagnosis? Ways to improve coping How can parents be ...

  1. Celiac Disease: Symptoms, Diagnosis & Treatment

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Celiac Disease Symptoms, Diagnosis & Treatment Past Issues / Spring 2015 ... Contents What are some of the symptoms of celiac disease? Some people with celiac disease may not ...

  2. Parkinson's Disease: Diagnosis and Treatment

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Parkinson's Disease Parkinson's Disease: Diagnosis and Treatment Past Issues / Winter 2014 Table of Contents Medications for Parkinson's disease can help many patients live productive lives and ...

  3. TBI Symptoms, Diagnosis, Treatment, Prevention

    Science.gov (United States)

    ... Past Issues Cover Story: Traumatic Brain Injury TBI Symptoms, Diagnosis, Treatment, Prevention Past Issues / Fall 2008 Table of ... turn Javascript on. Photo courtesy of ABC News Symptoms Mild: Person may remain conscious or be briefly ...

  4. Heart Disease: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 Table of Contents ... to view a larger version of the image Symptoms It is very important to learn the signs ...

  5. Colorectal Cancer: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Past Issues Special Section: Colorectal Cancer Colorectal Cancer: Symptoms, Diagnosis and Treatment Past Issues / Spring 2009 Table of ... version of this page please turn Javascript on. Symptoms Check with your healthcare provider if you have ...

  6. New advances in clinical diagnosis and treatment of children with bronchial pneumonia%小儿支气管肺炎的临床诊治新进展

    Institute of Scientific and Technical Information of China (English)

    余益萍

    2014-01-01

    支气管肺炎是儿童时期的常见病,如何有效地提升其临床疗效是目前广大儿科学工作者共同研究的课题。本文将比较临床上针对支气管肺炎采取西医治疗,或中医治疗,亦或是中西医结合治疗的效果,并论述小儿支气管肺炎临床诊治的新进展。%Bronchial pneumonia Chinese medicine to diagnose disease pneumonia cough is a common disease in children.How to effectively improve the clinical treatment effect of it is subject to jointly study the majority of workers of pediatrics at present. This paper will compare the present study for the bronchial pneumonia take western medicine treatment,or the treatment of traditional Chinese medicine,or the effect of combination of TCM and Western medicine treatment.And we discuss the recent progress in clinical diagnosis and treatment of children with bronchial pneumonia.

  7. The Diagnosis and Treatment of Cough Variant Asthma in Children%儿童咳嗽变异性哮喘的中医诊治探讨

    Institute of Scientific and Technical Information of China (English)

    宋景萍; 潘奕彤

    2015-01-01

    Pediatric cough variant asthma is a common disease in pediatrics, western medicine is the treatment of cough variant asthma main measures, but antibiotics abuse affects pediatric treatment effect and will produce the corresponding resistance, resulting in poor treatment effect. This paper is to explore the diagnosis and treatment of children cough variant asthma, so as to provide the reference for the treatment of children with cough variant asthma..%儿童咳嗽变异性哮喘是儿科常见疾病,西药是治疗咳嗽变异性哮喘主要措施,但抗生素的滥用影响了小儿的治疗效果,且会产生相应的耐药性,导致治疗效果不佳。本文对儿童咳嗽变异性哮喘的中医诊治展开相应探讨,以此为儿童咳嗽变异性哮喘的治疗提供必要参考。

  8. Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints

    Directory of Open Access Journals (Sweden)

    Stefan J. Friedrichsdorf

    2016-12-01

    Full Text Available Primary pain disorders (formerly “functional pain syndromes” are common, under-diagnosed and under-treated in children and teenagers. This manuscript reviews key aspects which support understanding the development of pediatric chronic pain, points to the current pediatric chronic pain terminology, addresses effective treatment strategies, and discusses the evidence-based use of pharmacology. Common symptoms of an underlying pain vulnerability present in the three most common chronic pain disorders in pediatrics: primary headaches, centrally mediated abdominal pain syndromes, and/or chronic/recurrent musculoskeletal and joint pain. A significant number of children with repeated acute nociceptive pain episodes develop chronic pain in addition to or as a result of their underlying medical condition “chronic-on-acute pain.” We provide description of the structure and process of our interdisciplinary, rehabilitative pain clinic in Minneapolis, Minnesota, USA with accompanying data in the treatment of chronic pain symptoms that persist beyond the expected time of healing. An interdisciplinary approach combining (1 rehabilitation; (2 integrative medicine/active mind-body techniques; (3 psychology; and (4 normalizing daily school attendance, sports, social life and sleep will be presented. As a result of restored function, pain improves and commonly resolves. Opioids are not indicated for primary pain disorders, and other medications, with few exceptions, are usually not first-line therapy.

  9. Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints.

    Science.gov (United States)

    Friedrichsdorf, Stefan J; Giordano, James; Desai Dakoji, Kavita; Warmuth, Andrew; Daughtry, Cyndee; Schulz, Craig A

    2016-12-10

    Primary pain disorders (formerly "functional pain syndromes") are common, under-diagnosed and under-treated in children and teenagers. This manuscript reviews key aspects which support understanding the development of pediatric chronic pain, points to the current pediatric chronic pain terminology, addresses effective treatment strategies, and discusses the evidence-based use of pharmacology. Common symptoms of an underlying pain vulnerability present in the three most common chronic pain disorders in pediatrics: primary headaches, centrally mediated abdominal pain syndromes, and/or chronic/recurrent musculoskeletal and joint pain. A significant number of children with repeated acute nociceptive pain episodes develop chronic pain in addition to or as a result of their underlying medical condition "chronic-on-acute pain." We provide description of the structure and process of our interdisciplinary, rehabilitative pain clinic in Minneapolis, Minnesota, USA with accompanying data in the treatment of chronic pain symptoms that persist beyond the expected time of healing. An interdisciplinary approach combining (1) rehabilitation; (2) integrative medicine/active mind-body techniques; (3) psychology; and (4) normalizing daily school attendance, sports, social life and sleep will be presented. As a result of restored function, pain improves and commonly resolves. Opioids are not indicated for primary pain disorders, and other medications, with few exceptions, are usually not first-line therapy.

  10. Glaucoma: Symptoms, Diagnosis & Treatment

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Glaucoma Symptoms, Treatment and Research Past Issues / Spring 2015 Table ... without any pain. Photo courtesy of NEI Glaucoma Symptoms At first, open-angle glaucoma has no symptoms. ...

  11. Clinical characteristics,diagnosis and treatment of children liver cirrhosis%小儿肝硬化临床特点及诊治

    Institute of Scientific and Technical Information of China (English)

    陆增强

    2015-01-01

    Objective:To explore the clinical characteristics,diagnosis and treatment of children liver cirrhosis.Methods:The etiology,clinical characteristic,treatment and outcome of 40 cases of children liver cirrhosis were summarized and analyzed,and they were compared with adult liver cirrhosis in the same period.Results:25 cases(62.5% ) were viral children liver cirrhosis, including 20 cases were hepatitis B.Followed by 6 cases(15%) were biliary cirrhosis,4 cases(10.0%) were prospective vein spongy degeneration.The main symptoms of patients with children liver cirrhosis were fatigue and edema.The main signs were liver and spleen ascites,enlargement,jaundice and so on.Conclusion:The laboratory examination has no specific diagnostic value in children liver cirrhosis.Combined with the physiological features of children,early diagnosis and treatment are the keys to prevent or reverse the disease.%目的:探究小儿肝硬化的临床特点及其诊治。方法:对40例小儿肝硬化的病因、临床特点、治疗和转归进行总结和分析,并与同时期的成人肝硬化进行对比。结果:病毒性小儿肝硬化25例(62.5%),其中乙型肝炎20例;其次是胆汁性肝硬化6例(15.0%),前瞻性静脉海绵样变性4例(10.0%)。小儿肝硬化患者的主要症状为乏力、浮肿,其主要体征为肝脾腹水、肿大、黄疸等。结论:实验室检查对小儿肝硬化并没有特异性的诊断价值;结合小儿的生理学特点,尽早诊断与治疗是防止和逆转该病的关键。

  12. [Cheilitis: Diagnosis and treatment].

    Science.gov (United States)

    Samimi, Mahtab

    2016-02-01

    The whole examination of oral cavity, other mucosae and skin is required when managing a cheilitis. Irritants (climatic, mechanical, caustic agents...) constitute the main aetiological factors of cheilitis. Allergic contact cheilitis should be investigated with a detailed anamnesis in order to search any causative agent in contact with the oral mucosae. Patch testing is required to confirm the diagnosis of delayed hypersensivity. Chronic actinic cheilitis occurs mostly in middle-aged, fair-skinned men. It is a potentially malignant condition that requires biopsies to exclude severe dysplasia or carcinoma. Angular cheilitis can occur spontaneously but is frequently related with several precipitating factors, such as systemic immune suppression, local irritation and moisture, fungal and/or bacterial infection. Cheilitis can also be seen in various systemic conditions such as lichen planus, lupus, atopic dermatitis and nutritional deficiencies. Erosive and crusty cheilitis and bullous erosive stomatitis are the main oral features of erythema multiforme and Stevens-Johnson syndrome. Granulomatous macrocheilitis (cheilitis granulomatosa) presents with intermittent or permanent lip swelling. It should be confirmed by a biopsy. It can be either isolated (Miescher macrocheilitis) or associated with various systemic conditions.

  13. Timing of Autism Diagnosis Tied to Choice of Treatment

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_160279.html Timing of Autism Diagnosis Tied to Choice of Treatment Kids diagnosed ... Aug. 5, 2016 (HealthDay News) -- Children diagnosed with autism before age 4 are more likely to get ...

  14. 儿童泌尿系感染的诊治进展%Advances in diagnosis and treatment of urinary tract infection in children

    Institute of Scientific and Technical Information of China (English)

    张洪英

    2016-01-01

    Urinary tract infection is one of the common infectious diseases in pediatrics.Early recognition and treatment can effectively prevent the formation of renal scarring,which has important significance for the long-term prognosis of kidney.This paper summarizes the literature on children's urinary tract infections in recent years,and describes the status of domestic research on clinical manifestation,laboratory examination,diagnostic criteria and treatment,in order to provide reference and basis for clinical diagnosis and treatment of urinary tract infections in children.%泌尿系感染(urinary tract infection,UTI)是儿科常见的感染性疾病,早期识别和治疗可有效预防肾脏瘢痕形成,对肾脏远期预后具有重要意义.该文总结近年来儿童泌尿系感染相关文献,分别从临床表现、实验室检查、诊断标准和治疗等方面阐述国内外的研究现状,以期为儿童泌尿系感染的临床诊断和治疗提供参考.

  15. Accuracy of Urine Circulating Cathodic Antigen Test for the Diagnosis of Schistosoma mansoni in Preschool-Aged Children before and after Treatment

    Science.gov (United States)

    Coulibaly, Jean T.; N'Gbesso, Yves K.; Knopp, Stefanie; N'Guessan, Nicaise A.; Silué, Kigbafori D.; van Dam, Govert J.; N'Goran, Eliézer K.; Utzinger, Jürg

    2013-01-01

    Background The Kato-Katz technique is widely used for the diagnosis of Schistosoma mansoni, but shows low sensitivity in light-intensity infections. We assessed the accuracy of a commercially available point-of-care circulating cathodic antigen (POC-CCA) cassette test for the diagnosis of S. mansoni in preschool-aged children before and after praziquantel administration. Methodology A 3-week longitudinal survey with a treatment intervention was conducted in Azaguié, south Côte d'Ivoire. Overall, 242 preschoolers (age range: 2 months to 5.5 years) submitted two stool and two urine samples before praziquantel administration, and 86 individuals were followed-up posttreatment. Stool samples were examined with duplicate Kato-Katz thick smears for S. mansoni. Urine samples were subjected to POC-CCA cassette test for S. mansoni, and a filtration method for S. haematobium diagnosis. Principal Findings Before treatment, the prevalence of S. mansoni, as determined by quadruplicate Kato-Katz, single CCA considering ‘trace’ as negative (t−), and single CCA with ‘trace’ as positive (t+), was 23.1%, 34.3% and 64.5%, respectively. Using the combined results (i.e., four Kato-Katz and duplicate CCA(t−)) as diagnostic ‘gold’ standard, the sensitivity of a single Kato-Katz, a single CCA(t−) or CCA(t+) was 28.3%, 69.7% and 89.1%, respectively. Three weeks posttreatment, the sensitivity of a single Kato-Katz, single CCA(t−) and CCA(t+) was 4.0%, 80.0% and 84.0%, respectively. The intensity of the POC-CCA test band reaction was correlated with S. mansoni egg burden (odds ratio = 1.2, p = 0.04). Conclusions/Significance A single POC-CCA cassette test appears to be more sensitive than multiple Kato-Katz thick smears for the diagnosis of S. mansoni in preschool-aged children before and after praziquantel administration. The POC-CCA cassette test can be recommended for the rapid identification of S. mansoni infections before treatment. Additional studies are

  16. Accuracy of urine circulating cathodic antigen test for the diagnosis of Schistosoma mansoni in preschool-aged children before and after treatment.

    Directory of Open Access Journals (Sweden)

    Jean T Coulibaly

    Full Text Available BACKGROUND: The Kato-Katz technique is widely used for the diagnosis of Schistosoma mansoni, but shows low sensitivity in light-intensity infections. We assessed the accuracy of a commercially available point-of-care circulating cathodic antigen (POC-CCA cassette test for the diagnosis of S. mansoni in preschool-aged children before and after praziquantel administration. METHODOLOGY: A 3-week longitudinal survey with a treatment intervention was conducted in Azaguié, south Côte d'Ivoire. Overall, 242 preschoolers (age range: 2 months to 5.5 years submitted two stool and two urine samples before praziquantel administration, and 86 individuals were followed-up posttreatment. Stool samples were examined with duplicate Kato-Katz thick smears for S. mansoni. Urine samples were subjected to POC-CCA cassette test for S. mansoni, and a filtration method for S. haematobium diagnosis. PRINCIPAL FINDINGS: Before treatment, the prevalence of S. mansoni, as determined by quadruplicate Kato-Katz, single CCA considering 'trace' as negative (t-, and single CCA with 'trace' as positive (t+, was 23.1%, 34.3% and 64.5%, respectively. Using the combined results (i.e., four Kato-Katz and duplicate CCA(t- as diagnostic 'gold' standard, the sensitivity of a single Kato-Katz, a single CCA(t- or CCA(t+ was 28.3%, 69.7% and 89.1%, respectively. Three weeks posttreatment, the sensitivity of a single Kato-Katz, single CCA(t- and CCA(t+ was 4.0%, 80.0% and 84.0%, respectively. The intensity of the POC-CCA test band reaction was correlated with S. mansoni egg burden (odds ratio = 1.2, p = 0.04. CONCLUSIONS/SIGNIFICANCE: A single POC-CCA cassette test appears to be more sensitive than multiple Kato-Katz thick smears for the diagnosis of S. mansoni in preschool-aged children before and after praziquantel administration. The POC-CCA cassette test can be recommended for the rapid identification of S. mansoni infections before treatment. Additional studies are warranted

  17. Childhood Asthma: Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Wim M. van Aalderen

    2012-01-01

    Full Text Available Many children suffer from recurrent coughing, wheezing and chest tightness. In preschool children one third of all children have these symptoms before the age of six, but only 40% of these wheezing preschoolers will continue to have asthma. In older school-aged children the majority of the children have asthma. Quality of life is affected by asthma control. Sleep disruption and exercised induced airflow limitation have a negative impact on participation in sports and social activities, and may influence family life. The goal of asthma therapy is to achieve asthma control, but only a limited number of patients are able to reach total control. This may be due to an incorrect diagnosis, co-morbidities or poor inhalation technique, but in the majority of cases non-adherence is the main reason for therapy failures. However, partnership with the parents and the child is important in order to set individually chosen goals of therapy and may be of help to improve control. Non-pharmacological measures aim at avoiding tobacco smoke, and when a child is sensitised, to avoid allergens. In pharmacological management international guidelines such as the GINA guideline and the British Guideline on the Management of Asthma are leading.

  18. Childhood asthma: diagnosis and treatment.

    Science.gov (United States)

    van Aalderen, Wim M

    2012-01-01

    Many children suffer from recurrent coughing, wheezing and chest tightness. In preschool children one third of all children have these symptoms before the age of six, but only 40% of these wheezing preschoolers will continue to have asthma. In older school-aged children the majority of the children have asthma. Quality of life is affected by asthma control. Sleep disruption and exercised induced airflow limitation have a negative impact on participation in sports and social activities, and may influence family life. The goal of asthma therapy is to achieve asthma control, but only a limited number of patients are able to reach total control. This may be due to an incorrect diagnosis, co-morbidities or poor inhalation technique, but in the majority of cases non-adherence is the main reason for therapy failures. However, partnership with the parents and the child is important in order to set individually chosen goals of therapy and may be of help to improve control. Non-pharmacological measures aim at avoiding tobacco smoke, and when a child is sensitised, to avoid allergens. In pharmacological management international guidelines such as the GINA guideline and the British Guideline on the Management of Asthma are leading.

  19. Early Diagnosis and Treatment of Secretory Otitis Media in Children%小儿分泌性中耳炎的早期诊治与护理

    Institute of Scientific and Technical Information of China (English)

    许欢

    2015-01-01

    Objective To investigate the early diagnosis and treatment of secretory otitis media in children. Methods 100 children with secretory otitis media in our hospital from February 2013 to February 2015 were selected as the research object, and were randomly divided into two groups, the observation group of 50 cases, the control group of 50 cases. The control group in the treatment of children at the beginning of the nursing, the observation group at the time of admission to start nursing, observation and comparison of the two groups of nursing. Results The nursing satisfaction of the observation group was significantly better than the control group, the difference was statistically signiifcant (P<0.05). Conclusion Effective nursing care can achieve signiifcant clinical effect, improve nursing satisfaction.%目的:探讨小儿分泌性中耳炎的早期诊治与护理。方法选取我院2013年2月~2015年2月收治的100例小儿分泌性中耳炎患儿为研究对象,将其随机分为两组,观察组50例,对照组50例。对照组患儿在治疗开始时进行护理,观察组在患儿入院时就开始护理,观察比较两组的护理效果。结果观察组患儿的护理满意度优于对照组,差异有统计学意义(P<0.05)。结论在患儿入院时便对患儿进行有效护理能够取得较好的临床疗效,提高护理满意度。

  20. Progress in Diagnosis and Treatment of Occult Inguinal Hernias in Children%小儿隐匿性腹股沟斜疝的诊疗进展

    Institute of Scientific and Technical Information of China (English)

    汤明生; 李建宏; 张镟; 王广欢; 钟军; 段守兴; 唐水平; 蒋学武

    2012-01-01

    Occult inguinal hernia,also called occult hernia,is the special type of the indirect inguinal hernia in children. Due to the patent processus vaginalis or the smaller hernia sac,the intra - abdominal organs didn't protrude into the inguinal canal to form bump,therefore, the patients were asymptomatic clinically and prone to delayed treatment. Once symptomatic, the patient had to accept further operation, which could easily result in unnecessary medical disputes. Most occult hernias are confirmed by surgical operation in children, especially after widely - used laparoscopy. This review mainly summarize the recent advance about the diagnosis and treatment of occult hernia in children.%小儿隐匿性腹股沟斜疝又称为小儿隐性疝,是小儿腹股沟斜疝的一种特殊表现,由于鞘状突未闭或疝囊较小,腹腔内组织不能突入腹股沟管形成肿块,临床上无任何不适症状,因而易延误治疗.若不及时诊治,待发展到症状体征明显时被迫再次手术,易引起不必要的医疗纠纷.目前,绝大多数小儿隐匿性腹股沟斜疝是手术探查时发现的,尤其是在腹腔镜广泛应用之后.现主要从诊断与治疗方面对近年来小儿隐匿性腹股沟斜疝的研究进展作一综述.

  1. School Refusal: Clinical Features, Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Kayhan Bahali

    2010-12-01

    Full Text Available Children regularly and voluntarily go to school in order to fulfill the expectations of society from them to continue their education or schooling. School continuation has been made compulsory by laws. Nonetheless, contrary to popular belief, for some children it is distressing to go to school. These children have difficulty continuing school and/or refuse to go to school. Today school refusal is defined as a child’s inability to continue school for reasons, such as anxiety and depression. The prevalence of school refusal has been reported to be approximately 1% in school-age children and 5% in child psychiatry samples. The prevalence of school refusal is similar among boys and girls. School refusal can occur at any time throughout the child’s academic life and at all socio-economic levels. School refusal is considered a symptom rather than a clinical diagnosis and can manifest itself as a sign of many psychiatric disorders, with anxiety disorders predominant. Separation anxiety disorder, generalized anxiety disorder, social phobia, specific phobia, and adjustment disorder with anxiety symptoms are the most common disorders co-occurring with school refusal. While separation anxiety disorder is associated with school refusal in younger children, other anxiety disorders, especially phobias, are associated with school refusal in adolescents. Children who have parents with psychiatric disorders have a higher incidence of school refusal, and psychiatric disorders are more frequently seen in adult relatives of children with school refusal, which supports a significant role of genetic and environmental factors in th etiology of school refusal. School refusal is a emergency state for child mental health. As it leads to detrimental effects in the short term and the long term, it should be regarded as a serious problem. The long-lasting follow-up studies of school refusing children have revealed that these children have a higher incidence of

  2. Advanced Diagnosis and Treatment of Refractory Status Epilepticus in Children%儿童难治性癫(痫)持续状态诊疗进展

    Institute of Scientific and Technical Information of China (English)

    梁锦平; 徐祝菲

    2012-01-01

    难治性癫(痫)持续状态(RsE)是严重的儿童神经急症,预后极差.病情转归取决于潜在病因、治疗时机及方法.现重点阐述RSE的基本流行病学、病因、临床诊断与脑电图特征、治疗方法及研究进展,尤其是RSE不同时期的用药治疗指南,为癫(痫)发作及持续状态的治疗提供临床指导.%Refractory status epilepticus( RSE) is a severe neurological emergency of children with a poor prognosis. The outcome is mainly dependent on potential etiology, prompt time and method. This review covers epidemiology, common etiology, clinical diagnosis and therapeutic methods of RSE,particularly the treatment guidelines of in different stages,providing a clinical guidance for treatment of epileptic seizures and status epilepticue, prevention and treatment of RSE.

  3. Diagnosis and Treatment of Neurocysticercosis

    Directory of Open Access Journals (Sweden)

    Christina M. Coyle

    2009-01-01

    Full Text Available Neurocysticercosis, the infection caused by the larval form of the tapeworm Taenia solium, is the most common parasitic disease of the central nervous system and the most common cause of acquired epilepsy worldwide. This has primarily been a disease that remains endemic in low-socioeconomic countries, but because of increased migration neurocysticercosis is being diagnosed more frequently in high-income countries. During the past three decades improved diagnostics, imaging, and treatment have led to more accurate diagnosis and improved prognosis for patients. This article reviews the current literature on neurocysticercosis, including newer diagnostics and treatment developments.

  4. Audiologic guidelines for the diagnosis & treatment of otitis media in children%儿童中耳炎的临床诊断和治疗指导方案--美国听力学学会的白皮书

    Institute of Scientific and Technical Information of China (English)

    蒋涛; 邹凌

    2006-01-01

    @@ 美国听力学学会于2000年在其学会刊物上颁布了一个重要的检测和治疗因中耳炎造成的儿童听力损失的指导方案:Audiologic guidelines for the diagnosis & treatment of otitis media in children.

  5. Diagnosis of Urinary Tract Infections in Children

    Science.gov (United States)

    2016-01-01

    Urinary tract infections (UTIs) are a common occurrence in children. The management and laboratory diagnosis of these infections pose unique challenges that are not encountered in adults. Important factors, such as specimen collection, urinalysis interpretation, culture thresholds, and antimicrobial susceptibility testing, require special consideration in children and will be discussed in detail in the following review. PMID:27053673

  6. Diagnosis of Urinary Tract Infections in Children.

    Science.gov (United States)

    Doern, Christopher D; Richardson, Susan E

    2016-09-01

    Urinary tract infections (UTIs) are a common occurrence in children. The management and laboratory diagnosis of these infections pose unique challenges that are not encountered in adults. Important factors, such as specimen collection, urinalysis interpretation, culture thresholds, and antimicrobial susceptibility testing, require special consideration in children and will be discussed in detail in the following review.

  7. Diagnosis and treatment of congenital heart defects

    Energy Technology Data Exchange (ETDEWEB)

    Peuster, M.; Beerbaum, P.; Meyer, H. [Ruhr-Universitaet Bochum, Bad Oeyenhausen (Germany). Herz- und Diabeteszentrum NRW

    2004-07-01

    The Clinic for Congenital Heart Defects in Bad Oeynhausen, Germany, specializes in the interdisciplinary care of children and adolescents with congenital heart defects. The available expertise covers all aspects of diagnosis and treatment, as well as clinical research at the highest level. The clinic has a complete array of imaging systems, including a Philips Integris BV5000 Biplane cath lab system, Philips Gyroscan Intera CV MR system, ultrasound and PET systems. The range of available equipment makes it possible to select the most appropriate imaging modality for each situation, with particular reference to the need to minimize the overall radiation exposure. (orig.)

  8. [Depression: diagnosis, treatment and course].

    Science.gov (United States)

    Stuppäck, Christoph

    2011-12-01

    Depressions are very common mental diseases. The diagnosis is made by psychopathology criteria and the course of the disorder. There is a growing body to the knowledge about etiology and treatment of depression - neuro-imaging, neuroplasticity, CREB and BDNF are all modified by antidepressants treatment and/or psychotherapy. As differential diagnoses, depressive syndromes on the basis of organic diseases but also burn-out syndromes may play a role, different therapeutic efforts are necessary. The treatment of depression consists of psychopharmacological and psychotherapeutic strategies, combinations of both are useful. Many psychopharmacological substances with differing mechanisms of action are available - combinations of antidepressants with complementing mechanisms are possible. The course of depressions is mainly influenced by "working therapies". Comorbid somatic diseases and their successful treatment are of relevance for the long term course.

  9. Diagnosis, assessment, and treatment of hypersexuality.

    Science.gov (United States)

    Kaplan, Meg S; Krueger, Richard B

    2010-03-01

    This article reviews the current evidence base for the diagnosis, assessment, and treatment of hypersexual conditions. Controversy concerning this diagnosis is discussed. Terminology and diagnostic criteria, as well as psychological, psychopharmacological, and other treatment approaches, are presented.

  10. Childhood tuberculosis: epidemiology, diagnosis, treatment, and vaccination.

    Science.gov (United States)

    Tsai, Kuo-Sheng; Chang, Hsiao-Ling; Chien, Shun-Tien; Chen, Kwo-Liang; Chen, Kou-Huang; Mai, Ming-Hsin; Chen, Kow-Tong

    2013-10-01

    Despite the existence of a government-run tuberculosis (TB) control program, the current nationwide burden of TB continues to be a public health problem in Taiwan. Intense current and previous efforts into diagnostic, therapeutic, and preventive interventions have focused on TB in adults, but childhood TB has been relatively neglected. Children are particularly vulnerable to severe disease and death following infection, and children with latent infections become reservoirs for future transmission following disease reactivation in adulthood, thus fueling future epidemics. Additional research, understanding, and prevention of childhood TB are urgently needed. This review assesses the epidemiology, diagnosis, treatment, and relevant principles of TB vaccine development and presents efficacy data for the currently licensed vaccines.

  11. Diagnosis lost: Differences between children who had and who currently have an autism spectrum disorder diagnosis.

    Science.gov (United States)

    Blumberg, Stephen J; Zablotsky, Benjamin; Avila, Rosa M; Colpe, Lisa J; Pringle, Beverly A; Kogan, Michael D

    2016-10-01

    Autism spectrum disorder diagnoses sometimes change due to misdiagnosis, maturation, or treatment. This study uses a probability-based national survey-the Survey of Pathways to Diagnosis and Services-to compare currently diagnosed (n = 1420) and previously diagnosed (n = 187) children aged 6-17 years based on retrospective parental reports of early concerns about their children's development, responses to those concerns by doctors and other healthcare providers, the type of provider who made the first autism spectrum disorder diagnosis, and the autism spectrum disorder subtype diagnoses received (if any). Propensity score matching was used to control for differences between the groups on children's current level of functioning and other current characteristics that may have been related to diagnosis loss. Approximately 13% of the children ever diagnosed with autism spectrum disorder were estimated to have lost the diagnosis, and parents of 74% of them believed it was changed due to new information. Previously diagnosed children were less likely to have parents with early concerns about verbal skills, nonverbal communication, learning, and unusual gestures or movements. They were also less likely to have been referred to and diagnosed by a specialist. Previously diagnosed children were less likely to have ever received a diagnosis of Asperger's disorder or autistic disorder.

  12. B ultrasound in diagnosis and treatment of intussusception in children%小儿肠套叠的B超诊治价值

    Institute of Scientific and Technical Information of China (English)

    朱映红; 卜秋强; 林淑莲; 浦征宇

    2015-01-01

    Objective To explore the value and effect of color Doppler ultrasound in the diagnosis and treatment of children with intussusception.Methods 98 children with intussusception taking ultrasound and X-ray examination and conifrmed by surgery or enema were randomly divided into a control group and an observation group, 49 cases for each group. The control group were treated with air enema by X-ray, and the observation group were given ultrasonic monitoring pressure enema treatment. The clinical effects were compared between these two groups.Results 98 cases were correctly diagnosed by ultrasound, with a coincidence rate of 100.00%. The reduction success rate was signiifcantly higher in the observation group than in the control group (93.88% vs. 79.59%,P 0.05). The incidence of complications rate was obviously lower in the the observation group than in the control group (0.00% vs. 10.20%,P < 0.05). All the children were cured after active surgical treatment.Conclusions B ultrasound in the diagnosis of intussusception is highly accurate, simple, fast, noninvasive, and safe and has good curative effect and no radiation. B ultrasound can be used as a diagnosis method for intussusception and can be reset in real-time ultrasound image surveillance and has high reduction rate and fewer adverse reaction.%目的:探讨彩色多普勒超声在诊断小儿肠套叠(ITST)中的临床应用价值及对小儿肠套叠的治疗作用。方法将我院98例行B超及X线平片检查并经手术或灌肠确诊的ITST,按照数字表法随机分为两组,对照组49例给予X线下空气灌肠复位治疗;观察组49例给予超声监测下水压灌肠复位治疗,并比较两组的临床效果。结果 B超诊断正确98例,符合率100.00%;观察组的复位成功率为93.88%,明显高于对照组的79.59%(P<0.05),两组复位失败共13例占13.27%(13/98),后均行手术治疗成功;而观察组复位时间与对照组比较差异

  13. SARCOPENIA: DIAGNOSIS, STAGES AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Pasca Luminita Aurelia

    2015-02-01

    Full Text Available Sarcopenia is defined as the age-related loss of skeletal muscle mass and decline of function. The causes of sarcopenia are multi-factorial. The diagnosis of sarcopenia should be considered in all older patients who present with declines in physical function, because of potential consequences for the development of frailty and disability. There are numerous techniques to assess muscle mass, muscle strength and physical performance. Treatment consists of nutritional (macro- and micronutrients and physical activity (resistance exercise regimens adapted to person. There is an emerging role for testosterone and anabolic steroids in severe sarcopenia.

  14. Recent Advances in the Diagnosis and Treatment of Niemann-Pick Disease Type C in Children: A Guide to Early Diagnosis for the General Pediatrician

    Directory of Open Access Journals (Sweden)

    Hanna Alobaidy

    2015-01-01

    Full Text Available Niemann-Pick disease (NP-C is a lysosomal storage disease in which impaired intracellular lipid transport leads to accumulation of cholesterol and glycosphingolipids in various neurovisceral tissues. It is an autosomal recessive disorder, caused by mutations in the NPC1 or NPC2 genes. The clinical spectrum is grouped by the age of onset and onset of neurological manifestation: pre/perinatal; early infantile; late infantile; and juvenile periods. The NP-C Suspicion Index (SI screening tool was developed to identify suspected patients with this disease. It is especially good at recognizing the disease in patients older than four years of age. Biochemical tests involving genetic markers and Filipin staining of skin fibroblast are being employed to assist diagnosis. Therapy is mostly supportive and since 2009, the first specific therapy approved for use was Miglustat (Zavesca aimed at stabilizing the rate of progression of neurological manifestation. The prognosis correlates with age at onset of neurological signs; patients with early onset form progress faster. The NP-C disease has heterogeneous neurovisceral manifestations. A SI is a screening tool that helps in diagnostic process. Filipin staining test is a specific biomarker diagnostic test. Miglustat is the first disease-specific therapy.

  15. Piriformis syndrome, diagnosis and treatment.

    Science.gov (United States)

    Kirschner, Jonathan S; Foye, Patrick M; Cole, Jeffrey L

    2009-07-01

    Piriformis syndrome (PS) is an uncommon cause of sciatica that involves buttock pain referred to the leg. Diagnosis is often difficult, and it is one of exclusion due to few validated and standardized diagnostic tests. Treatment for PS has historically focused on stretching and physical therapy modalities, with refractory patients also receiving anesthetic and corticosteroid injections into the piriformis muscle origin, belly, muscle sheath, or sciatic nerve sheath. Recently, the use of botulinum toxin (BTX) to treat PS has gained popularity. Its use is aimed at relieving sciatic nerve compression and inherent muscle pain from a tight piriformis. BTX is being used increasingly for myofascial pain syndromes, and some studies have demonstrated superior efficacy to corticosteroid injection. The success of BTX in treating PS supports the prevailing pathoanatomic etiology of the condition and suggests a promising future for BTX in the treatment of other myofascial pain syndromes.

  16. Turco's injury: diagnosis and treatment.

    Science.gov (United States)

    da Silva, Ana Paula Simões; Shimba, Leandro Girardi; Ribas, Luiz Henrique Boraschi Vieira; de Almeida, Alexandre Simmonds; Naves, Vinicius; Duarte Júnior, Aires

    2014-01-01

    The aim of this study was to alert doctors to the existence of Turco's injury and discus the existing treatments that have been described in the worldwide literature. A bibliographic survey of Lisfranc's injury and Turco's injury covering from 1985 to 2013 was conducted in the SciELO and PubMed databases. Among the 193 articles, those relating to bone-ligament injuries of the Lisfranc joint and high-energy trauma were excluded, as were the case reports. The patients selected were professional or amateur athletes who solely presented a ligament injury to the Lisfranc joint (Turco's injury), which was diagnosed from the history, physical examination, radiographs and magnetic resonance images. Non-athletic patients and those with associated bone injuries were excluded (10). According to the injury classification, the patients were treated by means of either an open or a closed procedure and then a standard rehabilitation protocol. Out of the 10 patients, five underwent conservative treatment and five underwent surgical treatment using different techniques and synthesis materials. We obtained two poor results, one satisfactory, five good and two excellent. We conclude that the correct diagnosis has a direct influence on the treatment and on the final result obtained, and that lack of knowledge of this injury is the main factor responsible for underdiagnosing Turco's injury. There is a need for randomized prospective studies comparing the types of synthesis and evolution of treated cases, in order to define the best treatment for this injury.

  17. 儿童睡眠呼吸暂停的诊断及治疗进展%Diagnosis and treatment of children with sleep apnea

    Institute of Scientific and Technical Information of China (English)

    李淼(综述); 尚云晓(审校)

    2016-01-01

    Sleep apnea includes obstructive sleep apnea,central sleep apnea and mixed sleep apnea.Ob-structive sleep apnoea syndrome(OSAS)is affecting up to 5.7% of children,which hss adverse impact on growth,development cognitive and behavioral outcomes,and untreated OSAS increases cardiovascular risk,so paying closer attention to childhood OSAS early diagnosis and treatment seems more important.First-line treat-ment in OSAS children is adenotonsillectomy,although other treatment options available include continuous posi-tive airways pressure,anti-inflammatory therapies,airway adjuncts and orthodontic appliances.Central sleep ap-nea may be related to respiratory regulation center immaturity or dysplasia.Central sleep apnea may be hereditary or acquired.Therefore,the treatment of central sleep apnea should be focused on primariy etiology.%睡眠呼吸暂停包括阻塞性、中枢性及混合性睡眠呼吸暂停。目前有5.7%的儿童患有阻塞性睡眠呼吸暂停综合征,其危害包括影响生长、发育、认知及行为等方面,同时会增加心脏血管疾病的风险。因此关注阻塞性睡眠呼吸暂停综合征儿童早期的诊断及治疗更有意义。阻塞性睡眠呼吸暂停首选的治疗是扁桃体切除术,其他治疗包括连续的正压通气、抗炎治疗、气道调节器及咽腔矫正器等。中枢性睡眠呼吸紊乱与呼吸中枢不成熟及发育异常有关。中枢性呼吸暂停可能是遗传性的,或者是后天获得性的,因此中枢性呼吸暂停的治疗主要是病因学治疗。

  18. The diagnosis and treatment of strangulating small bowel obstruction in children%儿童绞窄性肠梗阻的诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    刘涛; 温哲; 梁奇峰; 梁鉴坤; 王哲; 夏慧敏

    2016-01-01

    目的:探讨儿童绞窄性肠梗阻的诊断和治疗。方法回顾性分析2013年8月至2014年7月我院收治的5例绞窄性肠梗阻患儿的临床资料,总结早期诊断和手术治疗的经验。结果5例均急诊手术证实为绞窄性肠梗阻,其中肠系膜裂孔疝并空肠坏死2例,美克尔憩室索带压迫并回肠坏死1例,回肠扭转并坏死2例。所有患儿均一期行坏死肠切除肠吻合术,无死亡病例,术后无短肠综合征发生;无休克复苏后脑损伤发生。随访2年所有患儿身高、体重等生长指标发育良好,无饮食障碍、排便障碍发生。结论详细的体格检查,及时的影像学检查以及常规的腹腔穿刺检查是明确绞窄性肠梗阻的充分依据;正确及时手术治疗是明确病因、祛除病灶的根本途径。%Objective To investigate the diagnosis and treatment of strangulating small bowel obstruction in children .Meth-ods The clinical data of 5 children with strangulating small bowel obstruction admitted between August 2013 and July 2014 at our de-partment were retrospectively analyzed to summarize the experience in its early diagnosis and surgical treatment .Results The all pa-tients were confirmed to suffer the disease by emergency surgery .There were 2 cases with mesenteric hiatal hernia and jejunal necrosis , 1 case with Meckel's diverticulum cord compression and ileal necrosis ,and 2 cases with volvulus of ileum and necrosis .The intestinal anastomosis was performed in all patients .There was no death ,no short bowel syndrome after operation ,and no brain injury after shock resuscitation.The patients were followed up for 2 years,and all of them recovered well .There were no postoperative complications such as digestive disorders and defecation disorders .Their growth indexes such as height and weight were well developed .Conclusion The detailed physical examination ,timely image examination and routine abdominal paracentesis are the basis

  19. Growth hormone treatment in children.

    Science.gov (United States)

    Gertner, J M

    1997-04-01

    GH therapy increases final height in GH-deficient children. Short-term growth acceleration is also seen in children with many other causes of shortness. This review covers the diagnosis of GH-deficiency (GHD) and the details of GH treatment and its long-term results in GH-deficient patients and in those with other conditions, including "idiopathic short stature" and Turner syndrome. The efficacy of GH in enhancing adult stature in children with diagnoses other than GHD and Turner syndrome has not been established, and the only other indication for which it is approved by the U.S. Food and Drug Administration is chronic renal insufficiency. Broadening of the indications for GH use in childhood can only occur if supported by the results of carefully performed clinical trials. (Trends Endocrinol Metab 1997;8:92-97). (c) 1997, Elsevier Science Inc.

  20. Diagnosis and Treatment of Renovascular Hypertension in Children%小儿肾血管性高血压的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    陶文芳; 王风兰; 马玉琳; 冯家钧; 高治中; 沈同举

    1985-01-01

    Renovascular hypertension is not rare in children.From 1972 to 1985,9 cases were treated in our hospital. The etiology in this series can be classified into:renal arteerial stenosis, tiny renal arteries with renal hypoplasia and congenital vascular deformity, There were 5 cases of renal arterial stenosis,4 of which underwent autotranspla ntation of the kidney and in one case nephrectomy was performed.Blood pressure returned normal after operation in all the cases.Kidney and renal artery hypoplasia was flound in 3 cases, in which nephrectomy was performed and postoperative blood pressure dropped down to norm al in 2 cases but the third died of heart failure.One patient had unilateral renal artery deformity and received nephrectomy because of failure of renal autotransplantation.Blood pressure became normal after surgery.Diagnosis and treatment of this condition in pediatric cases are discussed in this paper.%@@ 小儿肾血管性高血压较少见.我科自1972~1985年间共收治小儿肾血管性高血压9例,报告如下.

  1. Diagnosis and emergency treatment of convulsion in children%儿童惊厥的诊断与急救处理

    Institute of Scientific and Technical Information of China (English)

    钟建民

    2011-01-01

    Convulsion is a common pediatric emergency and the most frequent clinical feature among the diseases of nervous system in children.Convulsion emergencies are potèntially life-threatening events.Brief convulsions rarely produce lasting effects on the brain.Prolonged convulsions,especially status epilepticus,can lead to permanent neurologic damage.Airway management and timely termination of the convulsion are the initial priorities.Early recognition and accurate diagnosis are crucial for effective emergency treatment of convulsion.%惊厥是常见儿科急症,也是最常见的小儿神经系统症状,有些惊厥可能危及患儿生命.一般短暂的惊厥对大脑几乎没有明显影响,但长程惊厥尤其是癫(痫)持续状态则可能导致神经系统永久损害.气道管理和及时控制惊厥发作是最优先考虑的急救处理措施.小儿惊厥的早期识别和正确诊断是急诊治疗成功的关键.

  2. Characteristics of acute poisoning in children and advances in the diagnosis and treatment%小儿急性中毒的特点和诊治进展

    Institute of Scientific and Technical Information of China (English)

    钱素云

    2010-01-01

    Acute poisoning in children is closely related with the surrounding environment. In China,acute poisoning in children,mainly caused by wrong intake of pesticides,drugs and rodenticide,still leads to high mortality in severe acute poisoning cases. Particular emphasis on safe storage of drugs and toxic chemicals mentioned above may reduce poisoning accidents at the source. Of the suspected poisoning cases, besides the detailed medical history and physical examination, poison identification is the most direct and objective method to confirm the diagnosis and evaluate the poisoning severity. Timely diagnosis, appropriate antidote use, extensive application of blood purification therapy, and emphasis on supportive therapy remain critical for the successful treatment. Accurate and comprehensive clinical epidemiological data are considered to be of informative value to identifying poisoning of different regions, ages and sexes.%儿童急性中毒的发生与周围环境密切相关.我国儿童急性中毒以农药、药物和灭鼠药为主,主要因误服误食所致,重症急性中毒的病死率仍较高.加强对药物和上述毒物的管理,可以从源头减少中毒机会.对疑似中毒的患儿,除详细询问病史和查体外,多数情况下毒物鉴定是明确有元中毒和病情严重程度最直接、客观的方法.及时诊断、合理使用解毒药物、普及血液净化治疗技术、重视支持疗法是成功救治的关键.准确而全面的临床流行病学资料有助于对地区性、年龄阶段性及不同性别的中毒起到警示作用.

  3. Trigeminal neuralgia - diagnosis and treatment.

    Science.gov (United States)

    Maarbjerg, Stine; Di Stefano, Giulia; Bendtsen, Lars; Cruccu, Giorgio

    2017-01-01

    Introduction Trigeminal neuralgia (TN) is characterized by touch-evoked unilateral brief shock-like paroxysmal pain in one or more divisions of the trigeminal nerve. In addition to the paroxysmal pain, some patients also have continuous pain. TN is divided into classical TN (CTN) and secondary TN (STN). Etiology and pathophysiology Demyelination of primary sensory trigeminal afferents in the root entry zone is the predominant pathophysiological mechanism. Most likely, demyelination paves the way for generation of ectopic impulses and ephaptic crosstalk. In a significant proportion of the patients, the demyelination is caused by a neurovascular conflict with morphological changes such as compression of the trigeminal root. However, there are also other unknown etiological factors, as only half of the CTN patients have morphological changes. STN is caused by multiple sclerosis or a space-occupying lesion affecting the trigeminal nerve. Differential diagnosis and treatment Important differential diagnoses include trigeminal autonomic cephalalgias, posttraumatic or postherpetic pain and other facial pains. First line treatment is prophylactic medication with sodium channel blockers, and second line treatment is neurosurgical intervention. Future perspectives Future studies should focus on genetics, unexplored etiological factors, sensory function, the neurosurgical outcome and complications, combination and neuromodulation treatment as well as development of new drugs with better tolerability.

  4. Feature Hepatitis: Hepatitis Symptoms, Diagnosis, Treatment & Prevention

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Feature Hepatitis Hepatitis: Symptoms, Diagnosis, Treatment & Prevention Past Issues / Spring 2009 ... No appetite Fever Headaches Diagnosis To check for hepatitis viruses, your doctor will test your blood. You ...

  5. Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Glaucoma Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research Past Issues / Fall 2009 Table of Contents Symptoms and Diagnosis Glaucoma can develop in one or ...

  6. Angioedema: Diagnosis and treatment approaches

    Directory of Open Access Journals (Sweden)

    Ali Tahsin Güneş

    2013-03-01

    Full Text Available Angioedema (AE is defined as sudden, localized and transient swelling of the skin and/or mucous membranes. This swelling condition is a result of interstitial edema from vasoactive mediators increasing the permeability of postcapillary venules of the subcutaneous and submucosal tissues. When localized to the skin, it presents as asymmetric, nonpitting, nondependent, and occasionally painful edema. However, mucosal attacks, such as laryngeal edema and bowel involvement can produce severe discomfort and life-threatening symptoms. There are several forms including those involving dysfunction or depletion of the C1-inhibitor gene (classical hereditary AE types and acquired AE, allergic AE, drug-induced AE (nonsteroidal anti-inflammatory drug-induced AE, angiotensin converting enzyme inhibitor-induced AE, idiopathic and a recently described form, HAE type 3. These various forms of AE have overlapping symptoms, but some unique clinical and historical features as well as presence of accompanying urticaria can aid in the differential diagnosis. The key to successful management is to rule out conditions that masquerade as AE, detection and avoidance of triggers, early recognition of attacks, and aggressive airway management when warranted. In this article, common and rare forms as well as clinical symptoms, differential diagnosis, and treatment approaches for AE are reviewed.

  7. 儿童盖氏骨折样损伤的诊断及治疗%Diagnosis and treatment of galeazzi fracture like injury in children

    Institute of Scientific and Technical Information of China (English)

    董国章

    2015-01-01

    Objective:To investigate the diagnosis and treatment of galeazzi fracture like injury in children.Methods:7 cases of galeazzi fracture were selected from July 2008 to June 2014.There were no obvious signs of distal radioulnar dislocation,but there were symptoms of swelling and tenderness over the ulnar side.The children were given the closed reduction conservative treatment(4 cases) and minimally invasive percutaneous kirschner wire fixation(3 cases).And they were given the supination gypsum long arm cast immobilization after the operation.Results:All fractures were healed,and no dislocation of distal radioulnar joint performance.2 cases were given the treatment of soft tissue injury.They were given gypsum supination when review.The gypsum brake symptoms was improved.Conclusion:In the treatment of children's injury cover,we need to have a comprehensive understanding of the damage fracture.When we treated the fracture of radius,we also noticed the may cause injury of the ulnar side symptoms and related processing.In the treatment,we took manual reduction for simple fracture of radius.For the reset is not ideal fracture,we can combine with minimally invasive incision percutaneous K-wire fracture alignment fixed,and on the ulnar side of moderate reduction to avoid tendon Kan meal.%目的:探讨儿童盖氏骨折样损伤的诊断及治疗。方法:2008年7月-2014年6月收治儿童盖氏骨折患儿7例,均无明显下尺桡脱位征象,但尺侧存有肿胀压痛症状。患儿采取闭合复位保守治疗(4例)和微创经皮克氏针固定术(3例)。术后给予旋后位石膏长臂石膏固定。结果:所有骨折均愈合,无下尺桡关节脱位表现,2例患儿按照软组织损伤处理,复查时予以石膏旋后位,石膏制动症状改善。结论:治疗儿童盖氏骨折样损伤需要对该损伤有一个全面的认识,处理桡骨骨折同时注意到尺侧症状、损伤可能原因及相关处理,治疗方面对简单的

  8. EVALUTION OF THE COMMUNICATIVE BEHAVIOUR AS A BASE FOR DIAGNOSIS AND TREATMENT PLANNING OF COMMUNICATIONAL IMPAIRMENTS WITH CHILDREN WITH AUTISM

    Directory of Open Access Journals (Sweden)

    Nadica JOVANOVIKJ-SIMIKJ

    2000-12-01

    Full Text Available Communicational impairments in the framework of the autism syndrome are considered as main ones for understanding the nature of autism, both for the planning and carrying out the efficient programme of treatment. (Every child with autism need an individual approach. Therefore it is very important to have precise evaluation of the communicative behavior of each child personally.The evaluation procedure should be flexible enough to identify the individual differences and provide real information on the understanding of the language and the abilities for speech production, communicative and socio-interactive abilities, as well as the language-communicative abilities.

  9. [RARE DISEASES DTC: DIAGNOSIS, TREATMENT AND CARE].

    Science.gov (United States)

    Mendlovic, Joseph; Barash, Hila; Yardeni, Hadar; Banet-Levi, Yonit; Yonath, Hagith; Raas-Rothschild, Annick

    2016-04-01

    Rare diseases are chronic, progressive genetic disorders, which affect around 6-8% of the general population, mainly children. Therefore, in Israel approximately 500,000 people are probably affected by a rare disease. In this article, we review some of the issues pertaining to rare diseases, such as the need for accurate diagnosis which is necessary not only for specific care and treatment but also for informed family planning. In addition, we review the impact of the activities of patients' organizations on the awareness of rare diseases and their involvement in the creation of the Orphan Drug Act, which was the leading point on the way to drug development worldwide. During the last few years networks for reaching leading specialists' opinions on the way to proper diagnosis were created. Thereafter, the next generation genetic technologies, such as exome sequencing, have been a revolution in terms of options and hope for patients with rare undiagnosed diseases. Patients with rare diseases and their families are a challenge to the health care system, not only in terms of diagnosis and therapy, but also in terms of special needs. In addition, deciphering molecular pathways of rare diseases might be the key for understanding molecular events involved in common disorders. We emphasize the duty to ensure appropriate capacity and equal access to follow-up and clinical management of patients with rare diseases in Israel.

  10. Food Allergies: Symptoms, Diagnosis, Prevention and Treatment

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Food Allergies Food Allergies: Symptoms, Diagnosis, Prevention and Treatment Past Issues / ... available treatments only ease the symptoms. Preventing a food allergy reaction There are no drugs or treatments ...

  11. 小儿慢性肾脏病贫血的诊断与治疗%Diagnosis and treatment for anemia of chronic kidney disease in children

    Institute of Scientific and Technical Information of China (English)

    刘小荣

    2015-01-01

    小儿慢性肾脏病(CKD)贫血的产生存在多种原因,包括慢性肾功能不全导致的红细胞生成原料缺乏(铁、叶酸、维生素B12缺乏),红细胞寿命缩短和失血,以及尿毒素抑制骨髓红细胞生成等,但最主要的原因为慢性肾功能不全时肾脏促红细胞生成素生成减少.贫血影响组织氧的供应及利用和心排出量的增加,常表现疲倦、呼吸困难,导致心脏扩大、心室肥厚、心力衰竭、脑供血不全、认知功能下降、免疫功能损伤等一系列病理生理现象,影响患者的预后及生存质量.肾性贫血需要积极治疗,其与慢性肾衰竭患者的生存率及生活质量密切相关.现就小儿CKD肾性贫血的诊断,如何评估贫血、铁剂的治疗及红细胞生成刺激剂治疗的策略进行阐述.%There are many reasons for children with anemia of chronic kidney disease (CKD), such as chronic renal insufficiency due to lack of raw materies erythropoietin(iron,folic acid, vitamin B12 deficiency), shortening of the life of red blood cells and blood loss, bone marrow suppression by urine toxins such as erythropoietin.But the main reason is decreased production of renal erythropoietin accompanying chronic renal insufficiency.Anemia affects tissue's oxygen supply, utilization, and cardiac output, and patients often show a series of pathophysiology of immune dysfunction,such as fatigue, difficulty in breathing, enlargement of the hearts, ventricular hypertrophy, heart failure, cerebral insufficiency ,cognitive decline ,affecting the prognosis and quality of life of patients.Renal anemia requires aggressive treatment,which is closely related to the survival and quality of life in patients with chronic renal failure.This paper elaborates on the diagnosis of anemia in children with CKD, the evaluation strategies of anemia,iron therapy and erythropoiesis stimulating agents treatment.

  12. Alzheimer's Disease: Symptoms, Diagnosis and Treatment

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Alzheimer's Disease Symptoms, Diagnosis and Treatment Past Issues / Fall 2010 Table of Contents Symptoms Scientists believe that changes in the brain may ...

  13. Doença de Wilson em crianças e adolescentes: diagnóstico e tratamento Wilson's disease in children and adolescents: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Stephania de Andrade Sócio

    2010-06-01

    Full Text Available OBJETIVO: Descrever as formas de apresentação, as alterações laboratoriais ao diagnóstico e o tratamento de crianças e adolescentes com doença de Wilson. MÉTODOS: Estudo descritivo e retrospectivo de 17 crianças e adolescentes com doença de Wilson atendidos no Ambulatório de Hepatologia Pediátrica do Hospital das Clínicas da Universidade Federal de Minas Gerais no período de 1985 a 2008. Os dados foram coletados dos prontuários e durante as consultas ambulatoriais. RESULTADOS: A idade ao diagnóstico variou de 2,8 a 15,1 anos, com média de 8,8±0,9 anos. A forma de apresentação predominante foi hepática (53%, seguida por assintomáticos provenientes de triagem familiar. O anel de Kayser-Fleischer foi encontrado em 41% dos pacientes. A ceruloplasmina encontrava-se alterada em 15/17 pacientes e o cobre urinário variou de 24 a 1000mcg/24h (mediana: 184mcg/24h. O tratamento instituído foi a D-penicilamina. Observaram-se efeitos colaterais em cinco crianças, sem necessidade de interrupção ou troca da medicação. As respostas clínica e laboratorial, com níveis normais de aminotransferases, foram evidenciadas em 14 pacientes após mediana de 10,7 meses de tratamento. Três crianças morreram (uma por hepatite fulminante e duas com complicações da insuficiência hepática grave, apesar do tratamento. CONCLUSÕES: A doença de Wilson é rara na faixa etária pediátrica. A forma de apresentação predominante é a hepática. Seu diagnóstico se baseia principalmente em dosagem de ceruloplasmina baixa, cobre livre e cobre em urina de 24 horas elevados, mas exige alto grau de suspeição. Apresenta boa resposta e tolerância ao tratamento medicamentoso.OBJECTIVE: To describe clinical symptoms, laboratory findings at diagnosis and treatment of children and adolescents with Wilson's disease. METHODS: This is a descriptive and retrospective study of a series of 17 children and adolescents with Wilson's disease, assited at the

  14. Short stature in children and adolescence. Causes, diagnosis and treatment. Talla baja en niños y adolescentes: causas, diagnóstico y tratamiento.

    Directory of Open Access Journals (Sweden)

    Inés Martínez Fernández

    Full Text Available Growth is a biological and dynamic process that begins with fecundation and ends at the final stage of adolescence. Its development is complex and different factors intervene in it. Short stature is the most frequent growth disorder in the daily medical practice; furthermore, it is the entity that produces concern and dissent in the patient and his/her relatives. To recognize and to treat early this growth and development altered in our children and adolescence permits us to adopt diagnosis strategies and treatment that favor his/her recovery. A revision was performed with the aim to expose tools which permit health professionals to identify a patient with this disorder at early stage, and to develop behaviors for its correction in order to achieve a better life quality in pediatric patients.
    El crecimiento es un proceso biológico y dinámico que se inicia con la fecundación y termina al finalizar la adolescencia. Su evolución es compleja y en él intervienen diferentes factores. La talla baja es el trastorno del crecimiento más frecuente en la práctica médica diaria y además, es la entidad que más preocupación e inconformidad crea en el paciente y en sus familiares. Saber reconocer y tratar precozmente las alteraciones en el crecimiento y desarrollo de nuestros niños y adolescentes, permite adoptar estrategias de diagnóstico y tratamiento que favorezcan su recuperación. Se realizó una revisión con el objetivo de exponer herramientas que permitan a los profesionales de la salud identificar precozmente a un paciente con este trastorno y desarrollar conductas para su corrección y de esta forma lograr una mejor calidad de vida en los pacientes pediátricos.

  15. The Diagnosis and Treatment of Duplication of Kidney in Children%小儿肾重复畸形的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    王常林; 赵国贵; 王宪刚; 侯英

    1993-01-01

    Sixty-five children with duplication of the kidney were reported.The manifestations of this disease appeared as urinary infection,urinary stuttering,dysuria,and abdominal mass.The diagnosis depends on a series of examinations,among them,sonography is the best in showing the direct image,IVP has a lower rate of imaging due to damaged renal function,SPECT gives a clear image with a high sensativity in a duplication of the kidney with hydronephrosis.The treatment f duplication of the kidney with significant clinical symptoms of ureterocele or ectopic ureteric orifice,is mainly operation.Ureter transplantation is indicated in those with the function-normal kidney and ureters,but duplicative part of kidney should be resected in those with poor function and had infection.The prognosis is generally good.%65例小儿肾重复畸形,主要表现为泌尿系感染、尿淋漓、排尿困难及腹部包块.最后确诊靠影像学检查.B超不受肾功能限制;SPECT灵敏度高,积水型重肾也可显影.对有症状的重肾,应手术治疗,需切除重复的部分.如其肾功能近于正常,可行输尿管移植术.对其输尿管囊肿、开口异位的处理,除少数病例外,多不必切除.该病治疗效果满意.

  16. [Halitosis--diagnosis and treatment].

    Science.gov (United States)

    Chomyszyn-Gajewska, Maria; Skrzypek, Agata

    2013-01-01

    Halitosis (bad breath) applies to according to various authors--even 25-50% of the population. Volatile sulfur compounds are frequently encountered in the exhaled air. The article presents the most common causes of halitosis. It is believed that approximately 80-90% of the causes of halitosis are located in the head area (mouth, ear, nose, throat), whereas the remaining cases correspond to systemic illness, such as of the stomach and lung, certain medications or food. This paper describes different means to assess halitosis, which can be helpful in determining the diagnosis. The article describes ways to treat the symptoms and causes of halitosis associated with oral cavity. In patients who have had another source of halitosis, additional diagnostic procedures and appropriate treatment must be performed. Given the prevalence of the problem of the malodour and its impact on the quality of everyday life, halitosis is a phenomenon that should not be underestimated. The causes need to be detected and an appropriate therapy must be performed. Patients with diagnosed halitophobia should be directed to appropriate specialists.

  17. [Fascioliasis: diagnosis, epidemiology and treatment].

    Science.gov (United States)

    Carrada-Bravo, Teodoro

    2003-01-01

    Fascioliasis is a trematode, disease of liver and bile ducts of sheep, cattle, and other ruminants throughout the world that is caused by the fluke, Fasciola hepatica. Human infection has been reported in Mexico, Cuba, Puerto Rico, Chile, Peru, Uruguay, Brazil, Argentina, the US, Europe, eastern Africa, Japan and Australia. The parasite's miracidium invades one of the various Lymnaea water snail hosts. Infection results from ingestion of encysted metacercariae attached to raw watercress (Nasturtium officinale). Symptoms recorded from human cases included irregular fever, epigastric pain and abdominal tenderness, obstructive jaundice and leucocytosis with eosinophilea up to 60%. Specific diagnosis is based on recovery of the eggs in the patient's stool or from biliary tract drainage. Treatment is with emetine hydrochloride given intramusculary. Bithionol is given orally at a dosage of 30-50 mg/kg but on alternate days from 10 to 15 doses. Praziquantel is probably effective. Preventive measures include education of the public on mode of transmission of life cycle of the parasite, and dipping fresh watercress into boiling water for a few sec, or drying suspected watercress.

  18. Antibiotic consumption in children prior to diagnosis of asthma

    Directory of Open Access Journals (Sweden)

    FitzGerald Mark J

    2011-05-01

    Full Text Available ABSTRACT Background Asthma is difficult to diagnose in children and at times misdiagnosis of an infection can occur. However, little is known about the magnitude and patterns of antibiotic consumption in children with asthma relative to those without asthma. Methods Using population-based data, 128,872 children were identified with at least 6 years of follow-up. The adjusted rate-ratio (RR of antibiotics dispensed to asthmatic as compared to non-asthmatic children was determined. Results At age six, the RR of antibiotic consumption for asthmatics compared to non-asthmatics varied between, 1.66 to 2.32, depending on the year of asthma diagnosis. Of the 18,864 children with asthma at ages 2-8, 52% (n = 9,841 had antibiotics dispensed in the 6 months prior to their index date of asthma diagnosis. The RR of antibiotic consumption in the 1 month prior to asthma diagnosis compared to 5 months prior was 1.66 (95% CI 1.60-1.71. The RR was lower in males compared to females (1.58 vs 1.77, and lower in those who received antibiotics in the first year of life relative to those that did not (1.60 vs. 1.76. Conclusions There is higher antibiotic consumption in children with asthma compared to those without asthma. The pattern of antibiotic use suggests that diagnosis guidelines are difficult to follow in young children leading to misdiagnosis and over treatment with antibiotics.

  19. [Surgical treatment of children with hepatic tumours

    DEFF Research Database (Denmark)

    Rasmussen, A.; Kvist, N.; Kirkegaard, P.;

    2008-01-01

    INTRODUCTION: In this paper we review the results of surgical treatment of children with hepatic tumours. MATERIALS AND METHODS: The study comprises 33 children who have undergone lever resection or liver transplantation since 1990. 26 patients had hepatoblastoma, 3 had hepatocellular carcinoma, 2......%). There was no difference in survival dependent on the type of resection, and there was no impact of the extension of tumour growth at the time of diagnosis. CONCLUSION: The combination of neoadjuvant chemotherapy followed by liver resection or liver transplantation is the treatment of choice in all children...

  20. The impact of psychiatric diagnosis on treatment adherence and duration among victimized children and adolescents in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Sandra Scivoletto

    Full Text Available OBJECTIVE: Despite the high prevalence of substance abuse and mood disorders among victimized children and adolescents, few studies have investigated the association of these disorders with treatment adherence, represented by numbers of visits per month and treatment duration. We aimed to investigate the effects of substance abuse and mood disorders on treatment adherence and duration in a special program for victimized children in São Paulo, Brazil. METHODS: A total of 351 participants were evaluated for psychiatric disorders and classified into one of five groups: mood disorders alone; substance abuse disorders alone; mood and substance abuse disorders; other psychiatric disorders; no psychiatric disorders. The associations between diagnostic classification and adherence to treatment and the duration of program participation were tested with logistic regression and survival analysis, respectively. RESULTS: Children with mood disorders alone had the highest rate of adherence (79.5%; those with substance abuse disorders alone had the lowest (40%; and those with both disorders had an intermediate rate of adherence (50%. Those with other psychiatric disorders and no psychiatric disorders also had high rates of adherence (75.6% and 72.9%, respectively. Living with family significantly increased adherence for children with substance abuse disorders but decreased adherence for those with no psychiatric disorders. The diagnostic correlates of duration of participation were similar to those for adherence. CONCLUSIONS: Mood and substance abuse disorders were strong predictive factors for treatment adherence and duration, albeit in opposite directions. Living with family seems to have a positive effect on treatment adherence for patients with substance abuse disorders. More effective treatment is needed for victimized substance-abusing youth

  1. 儿童颈椎外伤的诊断及治疗%The diagnosis and treatment of cervical spine injuries in children

    Institute of Scientific and Technical Information of China (English)

    熊伟; 李锋; 郭风劲; 陈安民

    2008-01-01

    目的 探讨儿童颈椎外伤的临床特点、诊断、治疗方法及难点和要点.方法 回顾性分析我院1995年1月至2005年12月期间治疗的儿童颈椎外伤病例的临床资料,同时检索分析国内外关于儿童颈椎外伤的文献.结果 11例患儿纳入本研究,其中男8例,女3例;平均年龄(12.1±4.0)岁;受伤机制包括坠落伤(3例),运动伤(3例),车祸伤(2例),直接暴力伤(2例),因娱乐致伤(1例).受伤部位分布为C1-34例,C4-77例.4例合并神经系统症状,其中1例为无骨折脱位型脊髓损伤.4例接受手术治疗,7例行保守治疗.结论 儿童颈椎外伤相对少见,其在临床表现、影像学检查及治疗方法上均存在与年龄相关的特点.熟悉这些特点对儿童颈椎外伤患儿的诊断及治疗至关重要.%Objective To review our experience in diagnosis and treatment of pediatric cervical spine injuries. Methods From January 1995 to December 2005, 11 patients including 8 boys and 3 girls were recruited in this study. Their mean age was 12. 14 years, ranged from 5 to 17 years. The causes for injury included falls (3 cases), sports related injuries (3 cases), traffic accidents (2 cases), direct hit injuries (2 bcases), and entertainment related injuries (1 case). All patients underwent neurological and radiological examinations. The treatments were carried out according to the results of such examinations. Results The injury sites were C1-3 in 4 patients and C4-7 in 7 patients. Neurological function was evaluated according to Frankel score: 1 case of Frankel A, 1 case of Frankel B, 2 cases of Frankel C and 7 cases of Frankel E. One of the 11 patients was affected by spinal cord injury without radiographic abnormality. Seven patients were cured by conservative treatments. The other 4 patients underwent operations, 2 were anterior decompression and fusion operations and the other 2 were posterior approach operations. Among the 2 cases with posterior approach, 1 was

  2. 儿童先天性脑积水的诊治探讨%Diagnosis and treatment of congenital hydrocephalus in children

    Institute of Scientific and Technical Information of China (English)

    刘智强; 刘水源; 林志雄; 梅文忠; 龚清永; 何理盛; 康德智; 吴喜跃

    2013-01-01

    目的 探讨并总结儿童先天性脑积水的诊治经验. 方法 回顾性分析福建医科大学附属第一医院神经外科自2007年6月至2011年6月收治的29例儿童先天性脑积水患者的临床资料,其中合并神经系统畸形27例,包括胼胝体缺如或发育不全6例、导水管狭窄5例、脑膜膨出3例、脊膜膨出3例、Dandy-Walker畸形2例、Chiari 1型畸形1例、脑灰质异位并脑裂畸形1例、脑发育不全1例、脑裂畸形1例、神经纤维瘤病1型1例、第四脑室囊肿1例、枕大池囊肿1例、透明隔囊肿1例;伴其他脏器畸形4例,包括胸7半椎体脊柱侧弯并右足马蹄内翻足1例、乳糜漏1例、腹股沟斜疝1例、脐疝1例.26例患者行脑室腹腔分流术,3例行囊肿腹腔分流术,均应用可调压分流管. 结果 29例患者中有效26例,疗效不佳3例.术后出现并发症13例,其中分流管感染3例,分流管近端堵塞或引流不畅3例,分流管腹腔端堵塞或引流不畅3例,硬膜下积液1例,硬膜下积液并硬膜下血肿1例,腹腔囊肿1例,分流管人右侧阴囊并阴囊肿胀1例. 结论 儿童先天性脑积水常合并脏器发育畸形,应注意相关检查以明确,并针对性治疗,以改善预后.%Objective To summarize the diagnosis and treatment experience of congenital hydrocephalus in children.Methods The clinical data of 29 children with congenital hydrocephalus,admitted to our hospital from June 2007 to June 2011,were analyzed retrospectively; in these patients,27 had combined nervous system malformations,including corpus callosum agenesis or hypoplasia in 6,aqueduct stenosis in 5,meningocele in 3,spinal meningocele in 3,Dandy-Walker malformation in 2,Chiaril malformation in 1,Heterotopic gray matter combined with schizencephaly in 1,atelencephalia in 1,schizencephaly in 1,neurofibromatosis type 1 in 1,fourth ventricle cysts in 1,arachnoid cyst in cerebello-medullary cistern in 1 and septum pellucidum cysts in 1; 4 was

  3. 小儿贲门失弛缓症的外科诊治%Diagnosis and surgical treatment of cardiac achalasia in children

    Institute of Scientific and Technical Information of China (English)

    董泾青; 孙凯

    2012-01-01

    To investigate the diagnosis and treatment of cardiac achalasia in children. Methods: The clinical data of 34 pediatric patients with achalasia admitted between September 2001 and September 2011 were retrospectively analyzed. All patients presented with typical manifestations, such as dysphagia, vomiting after feeding and "bird's beak" narrowing of the distal esophagus on barium esophagogram. All patients underwent modified transabdominal Heller's myotomy plus Dor's fundoplication. Results: All the 34 patients were discharged from hospital 7 to 14 days after surgery and were able to tolerate semi-liquid diet before discharge. One patient was lost to follow-up while the other 33 patients were followed up for 2 months to 9 years and 7 months. The symptoms such as dysphagia, vomiting after feeding and gastroesophageal reflux were not present in any of the patients. The postoperative barium meal examination results showed that esophageal lumen in all patients were smooth, the narrow segment expanded and the barium passed easily into the stomach. Except for one child with trisomy 21, the growth and development of all the other cases were similar to their age-matched peers.Conclusion: Modified Heller's myotomy has noticeable effectiveness on cardiac achalasia in children, and the additional Dor's fundoplication is an important procedure for prevention of gastroesophageal reflux after esophagocardiomyotomy.%目的:探讨小儿贲门失弛缓症的诊疗方法.方法:回顾性分析2001年9月—2011年9月收治的34例贲门失弛缓症患儿的临床资料,患儿均有吞咽困难,进食后呕吐胃内容物,上消化道钡餐检查可见食管下端鸟嘴样狭窄等典型征象.患儿均经腹行改良Heller术和Dor胃底前壁折叠术.结果:34例均于手术后7~14 d顺利出院,出院前均可进半流食.1例失访,33例患儿随访2个月至9年7个月.均无吞咽困难、进食后呕吐和反流性食管炎的症状,术后上消化道钡餐复查,食管腔

  4. 61例儿童睾丸卵黄囊瘤的诊断与治疗%The diagnosis and treatment of testicular yolk sac tumors in children

    Institute of Scientific and Technical Information of China (English)

    魏仪; 温晟; 魏光辉; 吴盛德; 林涛; 何大维; 李旭良; 刘俊宏; 刘星华; 邁陆鹏; 张德迎

    2014-01-01

    目的:分析儿童睾丸卵黄囊瘤的诊断与治疗,以提高其临床诊治水平。方法回顾性分析本院1995年至2014年收治的61例儿童睾丸卵黄囊瘤患儿的临床资料。结果61例均以阴囊包块就诊,其中60例无痛;61例体查均有阴囊沉重感,透光试验均为阴性;3例提睾反射消失,6例误诊为鞘膜积液,4例初诊腹股沟疝,2例睾丸炎症,1例误诊为腺瘤。术前AFP值均增高,超声检查提示实性包块,CDFI提示84.8%睾丸肿块血流丰富。阴囊X线片均未见确切钙化影。60例行瘤睾高位切除术,1例行睾丸肿瘤剥除术,11例加行腹股沟区淋巴结清扫术。病理检查多见疏网状、腺泡样以及乳头样结构。2009年以前术后化疗采用博来霉素+长春新碱,近5年采用PEB(顺铂+足叶以带+博来霉素)方案、PVB(顺铂+长春新碱+博来霉素)方案或二者交替化疗。术后1~2个月随访AFP值多降至正常,无一例复发或死亡。结论儿童睾丸卵黄囊瘤多因无肿痛性肿块就诊,体查包块有沉重感,AFP值升高,超声检查可见实质性包块。胸片和腹部超声可协助肿瘤临床分期。手术方案主要为高位瘤睾切除术,术中冰冻切片能协助术者选择手术范围,术后配合化疗,患儿临床预后效果好。%Objetive To explore the diagnosis and treatment of testicular yolk sac tumors in children and improving our current diagnostic and treatment level. Methods The clinical data of 61 cases with testicu-lar yolk sac tumor from 1 995 to 201 4 in Chongqing medical university affiliated children ’s hospital. Results 61 cases presented with scrotal mass (60 painless、bearing down1 00%、cremasteric reflect posi-tive1 00%).6 cases were misdiagnosed as hydrocele,4 inguinal hernia,2 testicular inflammation and 1 adeno-ma.Serum AFP were all increased.The ultrasound presented solid mass .Rich blood flow reached 84.8% in CDFI

  5. [Practice guideline 'Prostate cancer: diagnosis and treatment'

    NARCIS (Netherlands)

    Reijke, T.M. de; Battermann, J.J.; Moorselaar, R.J.A. van; Jong, IJ de; Visser, A.P.; Burgers, J.S.

    2008-01-01

    --A national, multidisciplinary practice guideline was developed concerning diagnosis and treatment of patients with prostate cancer. Because of the lack of sufficient scientific evidence at this moment no practice guideline on screening is included. --The diagnosis of prostate cancer is made by tra

  6. 小儿中枢神经系统源性肺水肿12例诊治分析%Diagnosis and treatMent analysis of 12 children with central neurogenic pulMonary edeMa

    Institute of Scientific and Technical Information of China (English)

    邵启国

    2012-01-01

    目的探讨小儿中枢神经系统源性肺水肿(neurogenic pulMonary edeMa,NPE)的诊治方法,旨在为临床治疗该病提供参考。方法对2009年2月-2012年2月我院收治的12例小儿神经源性肺水肿患者的诊断、治疗方法进行回顾性分析。结果12例患儿经治疗后,痊愈4例,伤残3例,死亡5例,其中3例死于多器官功能衰竭,2例死于呼吸衰竭。结论早诊断、早治疗是降低小儿NPE病死率的关键。加强对NPE高危患儿的监护,在治疗原发病的基础上采取降低颅内压、呼吸支持、改善血液动力学等综合治疗,可以有效地提高小儿NPE的救治成功率。%Objective To explore the diagnosis and treatMent of central neurogenic pulMonary edeMa in children and provide a reference for the clinical treatMent of the disease.Methods Retrospective analysis the diagnosis and treatMent Methods of 12 children with central neurogenic pulMonary edeMa in ourhostipal froM Feb.2009 to Feb.2012.Results After treatMent,4 cases recovered,3 cases of disability,5 cases died,the fatality rate was 41.67%.3 cases died of Multiple organ failure,2 cases died of respiratory failure.Conclusion Early diagnosis and early treatMent is significant to reduce the Mortality of children NPE.To strengthen the custody ofhigh risk children for NPE,while treating the priMary disease,reducing intracranial pressure,iMproving breathing andheModynaMics can effectively iMprove the treatMent success rate of children NPE.

  7. 白血病与非白血病患儿重症肺炎临床诊治差异分析%Clinical Diagnosis and Treatment Research of Severe Pneumonia in Leukemia Children and Non - leukemia Children

    Institute of Scientific and Technical Information of China (English)

    杨少灵; 邹亚伟; 翟莺莺

    2016-01-01

    Objective To analyze the differences of clinical diagnosis and treatment of severe pneumonia in leukemia children and non - leukemia children,in order to improve the level of diagnosis and treatment of children with severe pneumonia and reduce mortality. Methods A retrospective study was made on the clinical data of 91 children with severe pneumonia who were admitted into the First Affiliated Hospital of Guangzhou Medical University from 2010 to 2013. According to whether leukemia existed,the children were divided into two groups:leukemia group( n = 30)and non - leukemia group( n = 61). General condition,high risk factors, clinical manifestations, complications, laboratory examination and treatment methods were observed. Results Children of leukemia group suffered from fever and shortness of breath as main symptoms,and most of the cases were absent of other symptoms and positive signs;complications were mainly stomatitis,intestinal infection,urinary tract infections,infectious shock,respiratory failure,heart failure and intracranial infection;pathogens were mainly pseudomonas aeruginosa,fungus and klebsiella pneumoniae;blood routine examination mostly revealed white blood cell count reduced,lack of granulocyte,CRP elevated;blood gas analysis and electrolyte analysis mostly revealed metabolic acidosis, respiratory acidosis,hypoxemia,hypokalemia,hyponatremia;there were 6 cases of type 1 respiratory failure and 6 cases of type 2 respiratory failure;chest imaging revealed multiple nodular high - density shadow. After treatment,20 cases were cured,and 8 cases had marked effect,with a total effective rate 93. 3% ;2 cases died,and the mortality rate was 6. 7% . Children of non -leukemia group suffered from cough, fever, shortness of breath, wheezing and had more positive signs and symptoms;complications were mainly pyothorax,septic shock,heart failure and respiratory failure;pathogens were mainly staphylococcus aureus,deputy flu bloodthirsty bacillus and mycoplasma

  8. Diagnosis and treatment of septic arthritis.

    Science.gov (United States)

    Morton, Alison J

    2005-12-01

    Septic arthritis (SA) is a common orthopedic condition encountered in horses that are presented to equine veterinarians. Successful out-come is dependent on prompt and thorough evaluation and treatment. This article briefly reviews the pathophysiology, outlines diagnostics, describes treatment options and prognostics, and discusses current research in diagnosis and treatment of SA.

  9. [Phyllodes tumor: diagnosis and treatment].

    Science.gov (United States)

    Uribe, A; Bravo, G; Uribe, A; Viada, R; Capetillo, M; Villarroel, T

    1995-01-01

    We reviewed 1.178 benign tumors treated between 1981/93 among which 39 appeared with a Phylodes Tumors diagnosis, disregarding 5 of them because they did not have a precise description and histologic classification, studying 34 proved cases which represented 2.89% of all benign tumors; if we add 89% cancers in these years, we have 2.074 and the relation becomes 1.64% of the total. We found 22 benign phylodes (64.7%) 7 border line (20.5%) and 5 malignant (14.8%) whose clinic, histologic and evolutive characteristics are presented in this paper.

  10. The role of bone marrow pathology in diagnosis and differential diagnosis of refractory cytopenia of children

    Institute of Scientific and Technical Information of China (English)

    李占琦

    2013-01-01

    Objective To explore the diagnosis and differential diagnosis of refractory cytopenia of children(RCC) according to WHO classification,and discuss the relationship between the cytology reviewed by hematologists and histology reviewed by pathologists. Methods

  11. Cognitive dysfunction in children with brain tumors at diagnosis

    Science.gov (United States)

    Studer, Martina; Ritter, Barbara Catherine; Steinlin, Maja; Leibundgut, Kurt; Heinks, Theda

    2015-01-01

    Background Survivors of brain tumors have a high risk for a wide range of cognitive problems. These dysfunctions are caused by the lesion itself and its surgical removal, as well as subsequent treatments (chemo‐ and/or radiation therapy). Multiple recent studies have indicated that children with brain tumors (BT) might already exhibit cognitive problems at diagnosis, i.e., before the start of any medical treatment. The aim of the present study was to investigate the baseline neuropsychological profile in children with BT compared to children with an oncological diagnosis not involving the central nervous system (CNS). Methods Twenty children with BT and 27 children with an oncological disease without involvement of the CNS (age range: 6.1–16.9 years) were evaluated with an extensive battery of neuropsychological tests tailored to the patient's age. Furthermore, the child and his/her parent(s) completed self‐report questionnaires about emotional functioning and quality of life. In both groups, tests were administered before any therapeutic intervention such as surgery, chemotherapy, or irradiation. Groups were comparable with regard to age, gender, and socioeconomic status. Results Compared to the control group, patients with BTs performed significantly worse in tests of working memory, verbal memory, and attention (effect sizes between 0.28 and 0.47). In contrast, the areas of perceptual reasoning, processing speed, and verbal comprehension were preserved at the time of measurement. Conclusion Our results highlight the need for cognitive interventions early in the treatment process in order to minimize or prevent academic difficulties as patients return to school. Pediatr Blood Cancer 2015;62:1805–1812. © 2015 The Authors. Pediatric Blood & Cancer, published by Wiley Periodicals, Inc. PMID:26053691

  12. Early and Periodic Screening, Diagnosis and Treatment

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who...

  13. 加拿大自闭症诊断和治疗现状%Diagnosis and treatment for children with autism spectrum disorder in Canada

    Institute of Scientific and Technical Information of China (English)

    赵晶

    2013-01-01

    This article provides a review of diagnostic progress of autism spectrum disorder (ASD) and treatment programs for children with ASD in British Columbia , Canada in order to give suggestions for China to develop ser-vices for children with ASD.%介绍自闭症在加拿大尤其是British Columbia(BC)省诊断和治疗的现状,包括诊断流程、诊断团队的组成、父母在诊断和治疗中的参与、自闭症的治疗方法等;希望可以起到一个抛砖引玉的作用,为中国自闭症诊断和治疗的发展提供一些可能的借鉴。

  14. The radiological diagnosis of pneumonia in children

    Directory of Open Access Journals (Sweden)

    Kerry-Ann F O'Grady

    2014-06-01

    Full Text Available Despite the importance of paediatric pneumonia as a cause of short and long-term morbidity and mortality worldwide, a reliable gold standard for its diagnosis remains elusive. The utility of clinical, microbiological and radiological diagnostic approaches varies widely within and between populations and is heavily dependent on the expertise and resources available in various settings. Here we review the role of radiology in the diagnosis of paediatric pneumonia. Chest radiographs (CXRs are the most widely employed test, however, they are not indicated in ambulatory settings, cannot distinguish between viral and bacterial infections and have a limited role in the ongoing management of disease. A standardised definition of alveolar pneumonia on a CXR exists for epidemiological studies targeting bacterial pneumonias but it should not be extrapolated to clinical settings. Radiography, computed tomography and to a lesser extent ultrasonography and magnetic resonance imaging play an important role in complicated pneumonias but there are limitations that preclude their use as routine diagnostic tools. Large population-based studies are needed in different populations to address many of the knowledge gaps in the radiological diagnosis of pneumonia in children, however, the feasibility of such studies is an important barrier.

  15. Diagnosis and treatment of 1 110 cases of premature children%早产儿1100例临床分析

    Institute of Scientific and Technical Information of China (English)

    尹华; 卜雷; 孙瑞君; 袁安香

    2011-01-01

    Objective To aralyze The prevalence of premature children, mortality and complications to related factors, discussed measures to reduce the premature children mortality. Methods From January 2003 to December 2006 and January 2007 January 2010 12 after 8 years in our hospital obstetric preterm children born in 1110 into the first 4 years of group and group 4 years after the two groups. Each group of children on the incidence of premature causes of death, complications were retrospectively analyzed. Results Preterm birth rate of first 4 years 2.85% to 3.67% after 4 years,the difference was statistically significant( P <0.05 ). Between the two groups the proportion of different age groups and the main types of diseases,no significant difference(P> 0.05). By comparison,the mortality of premature children dropped from the 12.06% to 2.36%, a significant difference before and after ( P < 0.01 ).Conclusion The prevention and treatment of premature children was still very trduous task, particularly in preventing complications of preterm children was very important to prevent the occurrence of lung disease.%目的 通过对早产儿患病率、病死率的相关因素分析,探讨降低早产儿病死率的措施。方法 对1 100例早产儿按时间前后分为两组(A组,B组)。对两组早产发生率、死亡原因、并发症发生情况进行回顾性对比分析。结果 早产发生率A组2.85%,B组3.67%,两组差异有统计学意义(P<0.05)。早产儿病死率A组12.06%,B组2.36%,差异有统计学意义(P<0.01)。结论 加强围生儿的监测和保健护理,可以降低早产儿的患病率和病死率。

  16. Diagnosis and treatment of sleep-disordered breathing in children%儿童睡眠呼吸障碍性疾病的诊断和治疗进展

    Institute of Scientific and Technical Information of China (English)

    苏苗赏; 李昌崇

    2009-01-01

    Sleep-disordered breathing has attracted wide attention from clinicians with the development of children's sleep medicine in recent years.This review will focus on the updated classification of sleep disorders in children and sleep staging,new rules for sleep respiratory events,etiological classification and epidemiological characteristics,and clinical diagnosis and treatment.%随着近年来儿童睡眠医学的快速发展,睡眠呼吸障碍已引起临床医师的广泛关注.本文将儿童睡眠障碍的最新分类和睡眠分期、睡眠呼吸事件的判读新规则、病因分类和流行病特点,以及临床诊断和治疗进展作一综述.

  17. [Diagnosis and treatment of tics].

    Science.gov (United States)

    Topka, H

    2007-05-21

    Tics are repetitive and sudden purposeless movements. Phenomenologically tics are differentiated as simple or complex, motor or vocal. Transient forms, which last less than 1 year, occur frequently in child hood. For Tourette syndrome, multiple simple and complex motor and vocal tics are present for more than one year. Frequently, additional symptoms of an obsessive-compulsive disorder or an attention deficit hyperactivity disorder are present. There is no therapy for the cause of tics. For minor symptoms or if a transient tic disorder is suspected, the use of medications should be avoided. Instead the patient and if necessary, the parents should be informed in detail and given advice. Particularly for children, it is important to exclude antiepileptic drugs as the cause of tics. For chronic tics and for pronounced symptoms, drug therapy with neuroleptic drugs or clonidine is a possibility. However, the efficacy of these substances is limited.

  18. [Sleep disorders: diagnosis and treatment].

    Science.gov (United States)

    Holsboer-Trachsler, E; Kocher, R

    1995-12-02

    Disturbed or inadequate sleep is a frequent complaint with a great impact on daily functions and an often chronic course requiring adequate treatment. To choose an appropriate therapy it is necessary to develop a useful, reliable, valid and specific diagnostic procedure. Primary care physicians can recognize and treat most sleep disorders. For special diagnostic cases sleep centers are recommended. Sleep disorders may be managed by adequate pharmacological as well as nonpharmacological treatment. Besides specific pharmacological means, education in sleep/wake physiology and hygiene and several psychotherapeutic strategies may be valuable.

  19. Diagnosis and treatment of obturator hernia

    Energy Technology Data Exchange (ETDEWEB)

    Nakayama, Takamori; Kobayashi, Seiji; Shiraishi, Kou; Nishiumi, Takao; Mori, Syunji; Isobe, Kiyoshi; Furuta, Yoshiaki [Shizuoka Red Cross Hospital (Japan)

    2002-09-01

    Obturator hernia is a rare type of hernia, but it is a significant cause of intestinal obstruction due to the associated anatomy. Correct diagnosis and treatment of obturator hernia is important, because delay can lead to high mortality. Twelve patients with obturator hernia were managed during a 11-year period, including 11 women and 1 man with a mean age of 82 years. We compared our experience with the previously published data to establish standards for the diagnosis and treatment of this hernia. All 12 patients presented with intestinal obstruction. The median interval from admission to operation was 2 days. The Howship-Romberg sign was positive in 5 patients. A correct diagnosis was made in all 8 patients who underwent pelvic CT scanning. Surgery was performed via an abdominal approach (n=7) or an inguinal approach (n=5). The hernial orifice was closed using the uterine fundus (n=6), a patch (n=5), and direct suture (n=1). Mean follow-up time was 33 months, and no recurrence has been detected. The poor physical condition of patients might have led to a delay in diagnosis and treatment. In troubled patients with nonspecific intestinal obstruction, CT scanning is useful for the early diagnosis of obturator hernia. Correct CT diagnosis of obturator hernia allows us to select the inguinal approach combined with patch repair, which is minimally invasive surgery. (author)

  20. Vulvodynia. Definition, diagnosis and treatment

    DEFF Research Database (Denmark)

    Petersen, Christina Damsted; Lundvall, Lene; Kristensen, Ellids

    2008-01-01

    Vulvodynia is a chronic painful disorder with an estimated prevalence of 9-12%. A rising incidence of the condition constitutes a growing problem. This has lead to an increased focus on etiology and treatment, while the definition also requires attention. Previous assumptions stating that the pro......Vulvodynia is a chronic painful disorder with an estimated prevalence of 9-12%. A rising incidence of the condition constitutes a growing problem. This has lead to an increased focus on etiology and treatment, while the definition also requires attention. Previous assumptions stating...... that the problem is solely a psychological disorder have been abandoned, because inflammatory mechanisms and genetic factors have been found to be involved in the pathogenesis as well as psychosexual contributors. This article describes the terminology and definition of the condition, theories on patho...

  1. Hodgkin Lymphoma: Diagnosis and Treatment.

    Science.gov (United States)

    Ansell, Stephen M

    2015-11-01

    Hodgkin lymphoma is a rare B-cell malignant neoplasm affecting approximately 9000 new patients annually. This disease represents approximately 11% of all lymphomas seen in the United States and comprises 2 discrete disease entities--classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Within the subcategorization of classical Hodgkin lymphoma are defined subgroups: nodular sclerosis, mixed cellularity, lymphocyte depletion, and lymphocyte-rich Hodgkin lymphoma. Staging of this disease is essential for the choice of optimal therapy. Prognostic models to identify patients at high or low risk for recurrence have been developed, and these models, along with positron emission tomography, are used to provide optimal therapy. The initial treatment for patients with Hodgkin lymphoma is based on the histologic characteristics of the disease, the stage at presentation, and the presence or absence of prognostic factors associated with poor outcome. Patients with early-stage Hodgkin lymphoma commonly receive combined-modality therapies that include abbreviated courses of chemotherapy followed by involved-field radiation treatment. In contrast, patients with advanced-stage Hodgkin lymphoma commonly receive a more prolonged course of combination chemotherapy, with radiation therapy used only in selected cases. For patients with relapse or refractory disease, salvage chemotherapy followed by high-dose treatment and an autologous stem cell transplant is the standard of care. For patients who are ineligible for this therapy or those in whom high-dose therapy and autologous stem cell transplant have failed, treatment with brentuximab vedotin is a standard approach. Additional options include palliative chemotherapy, immune checkpoint inhibitors, nonmyeloablative allogeneic stem cell transplant, or participation in a clinical trial testing novel agents.

  2. 儿童热性惊厥诊治进展%THE PROGRESS OF DIAGNOSIS AND TREATMENT OF CHILDREN'S FEBRILE SEIZURES

    Institute of Scientific and Technical Information of China (English)

    刘春枝; 马超

    2015-01-01

    热性惊厥( FS)是儿童常见神经系统疾病之一,也是近年来国内外研究的热点。其发病因素较为复杂,致病机理尚未明确。尽管大多数呈良性经过,预后良好,但目前仍有诸多问题亟待解决。除患儿家长过度紧张和焦虑外,对FS的临床特征缺乏足够的认识,不同程度地存在着过度检查和过度治疗,甚至过度解读个别检查结果。结合近年来对儿童热性惊厥的治疗经验,从临床实用角度出发,对目前国内外最新研究证据和临床情况进行分析,探讨国内外儿童热性惊厥的病因、发病机理、临床表现、治疗及预防等方面的研究进展。%Febrile seizures( FS) is one of the common diseases of the nervous system in children, and it's also a focus of research at home and abroad in recent years. Its etiological factor is relatively complicated,and the pathogenesis is not yet clear. Although most of the patients with FS are benign and the prognosis of it is good, there are still many problems to be solved at present. In addition to the parents of the children usually behave excessive tension and anxiety,the clinicians are lack of enough understanding about the clinical features of FS and the clinicials,There are excessive examination and treatment in different degrees,even read too much into individual test results. In combination with the treatment experience of FS for children in recent years,and from the angle of the clinical practical,the latest research evidence and clinical situations at home and abroad are analyzed. The research prosress of the etiology of FS in children at home and abroad,and its were reviewed in this paper pathogenesis, clinical manifestation,treatment and prevention.

  3. Early breast cancer: diagnosis, treatment and survivorship.

    LENUS (Irish Health Repository)

    Meade, Elizabeth

    2013-01-11

    Breast cancer is the most common female cancer and globally remains a major public health concern. The diagnosis and treatment of breast cancer continues to develop. Diagnosis is now more precise, surgery is less mutilating and women now have the option of breast conserving therapy with better cosmesis, and without sacrificing survival. Radiotherapy is more targeted and the selection of patients for adjuvant chemotherapy is based not only on prognostic and predictive factors, but also on newer molecular profiling that will ensure that chemotherapy is given to the patients who need and respond to it. These developments all provide a more tailored approach to the treatment of breast cancer. Management now involves a multidisciplinary team approach in order to provide the highest standard of care for patients throughout their cancer journey from diagnosis through treatment and into follow-up care.

  4. Symptoms and time to diagnosis in children with brain tumours

    DEFF Research Database (Denmark)

    Klitbo, Ditte Marie; Nielsen, Rine; Illum, Niels Ove;

    2011-01-01

    Clinical symptoms in brain tumours in children are variable at onset and diagnosis is often delayed. Symptoms were investigated with regard to brain tumour localisation, prediagnostic symptomatic intervals and malignancy.......Clinical symptoms in brain tumours in children are variable at onset and diagnosis is often delayed. Symptoms were investigated with regard to brain tumour localisation, prediagnostic symptomatic intervals and malignancy....

  5. UNDESCENDED TESTIS, DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Winarta Lesmana Handrea

    2013-05-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Undescended testis (UDT or cryptorchidism is one of the commonest abnormalities in male infants. In this anomaly, testes are not located normally in the scrotum. The incidence of UDT is 4-5% of term male infants, and 20-33% of premature male infants. The occurrence of abnormalities of hormones control or anatomy process that is required in the normal process of lowering the testes can cause UDT. UDT can be differentiated into palpable and nonpalpable. The diagnosis of UDT can be known through physical examination. However, if the testes are impalpable, laparoscopy can be done to determine the position of the testis. Hormonal therapy to overcome UDT is still under controversy. The action that often done is surgery, called orchidopexy. The most serious complication of orchidopexy is testicular atrophy. It occurs in a small percentage, which is about 5-10%. Infertility may occur in 1 to 3 of 4 adult males and the risk of occurrence of malignancies is increased by as much as 5-10 times higher in men with a history of UDT. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  6. DIAGNOSIS AND TREATMENT OF CESAREAN SCAR PREGNANCY

    Institute of Scientific and Technical Information of China (English)

    Lan-zhou Jiao; Jun Zhao; Xi-run Wan; Xin-yan Liu; Feng-zhi Feng; Tong Ren; Yang Xiang

    2008-01-01

    Objective To investigate the early diagnosis and treatment of cesarean sear pregnancy (CSP).Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the le-sion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed.Results CSP constituted 1.05% of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1:1 221. Themean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 weremisdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging (MRI). The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hyster-ectomy. The conservative treatment was successful in 24 eases. All of the 28 women were cured through individual ther-apies.Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP,and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.

  7. Neonatal candidiasis: diagnosis, prevention, and treatment.

    Science.gov (United States)

    Greenberg, Rachel G; Benjamin, Daniel K

    2014-11-01

    Infection with Candida species is associated with significant morbidity and mortality in infants. The incidence of Candida infection varies widely across centers, likely due to differences in practice related to modifiable risk factors such as exposure to empiric antibiotics and length of parenteral nutrition. Early diagnosis of Candida and prompt treatment with appropriate antifungal agents, such as fluconazole, amphotericin B deoxycholate, and micafungin, are critical for improved outcomes. This paper reviews the current literature relating to the prevention, diagnosis, and treatment of Candida infections in the neonatal intensive care unit.

  8. Diagnosis and treatment of croup.

    Science.gov (United States)

    Quan, L

    1992-09-01

    Croup is a common childhood disease that has no specific diagnostic test. It must be differentiated from life-threatening diseases, such as epiglottitis, that demand specific interventions. A high degree of toxicity, the presence of dysphagia and the absence of cough help distinguish epiglottitis from croup. The usefulness and safety of visualization of the epiglottis in patients with croup are controversial. Clinical recognition of respiratory distress and failure is vital. Hypoxia is common. Pulse oximetry is helpful in the assessment of hypoxia, but readings do not correlate with clinical status or respiratory failure. Although studies have not proved that mist therapy is beneficial, the efficacy of racemic epinephrine is well documented. High dose corticosteroids have proved effective in the treatment of croup. Outpatient use of racemic epinephrine and steroids remains controversial.

  9. Neck pain: causes, diagnosis, treatment

    Directory of Open Access Journals (Sweden)

    Aleksey Ivanovich Isaikin

    2011-01-01

    Full Text Available Neck pain is frequently encountered in clinical practice. In most cases, it is unassociated with a serious problem and ends with complete recovery. Nonspecific (mechanical, axial pain is most common; posttraumatic pain associated with whiplash injury is less frequently encountered; compression (radicular and myelopathic syndromes are much less frequent. Analysis of complaints and medical histories and neuroorthopedic and neurological examinations allow one to define the major source of pain. Additional studies are indicated in cases of suspected serious pathology, ineffective standard medical therapy, elective manual therapy or neurosurgery. Paracetamol, nonsteroidal anti-inflammatory agents, and myelorelaxants are the drugs of choice in treating acute pain. If these are ineffective, blocks with local anesthetics and glucocorticoids, including diprospan, are used. Early activation and manual therapy are effective. Psychotherapy, therapeutic exercises, manual therapy, and the use of antidepressants and anticonvulsants are indicated for chronic pain. Surgical treatment has limited indications.

  10. Diagnosis of invasive fungal infections in immunocompromised children.

    Science.gov (United States)

    Dornbusch, H J; Groll, A; Walsh, T J

    2010-09-01

    Early recognition and rapid initiation of effective treatment is a prerequisite for successful management of children with invasive fungal infections. The increasing diversity of fungal pathogens in high-risk patients, the differences in the antifungal spectra of available agents and the increasing rates of resistance call for identification of the infecting isolate at the species level and for information on drug resistance, in order to provide state-of-the-art patient care. Microscopy and culture of appropriate specimens remain the reference standard for mycological diagnosis, despite difficulties in obtaining appropriate and/or sufficient specimens, long durations of culture and false-negative results. Modern imaging studies and detection of circulating fungal cell wall components and DNA in blood and other body fluids or in affected tissues may improve the laboratory diagnosis of invasive mycoses.

  11. Neurosarcoidosis: Clinical manifestations, diagnosis and treatment.

    Science.gov (United States)

    Nozaki, Kenkichi; Judson, Marc A

    2012-06-01

    Sarcoidosis is an idiopathic granulomatous disease affecting multiple organs. Neurosarcoidosis, involving the central and/or peripheral nervous systems, is a relatively rare form of sarcoidosis. Its clinical manifestations include cranial neuropathies, meningitis, neuroendocrinological dysfunction, hydrocephalus, seizures, neuropsychiatric symptoms, myelopathy and neuropathies. The diagnosis is problematic, especially when occurring as an isolated form without other organ involvement. Distinguishing neurosarcoidosis from other granulomatous diseases and multiple sclerosis is especially important. Although biopsy of neural tissue is the gold standard for the diagnosis of neurosarcoidosis, this is often not practical and the diagnosis must be inferred though other tests, often coupled with biopsy of extraneural organs. Corticosteroids and other immuno-suppressants are frequently used for the treatment of neurosarcoidosis. This article reviews the epidemiology, pathogenesis, pathology, clinical features, diagnosis, diagnostic tests, diagnostic criteria, and therapy of neurosarcoidosis.

  12. Naegleria fowleri: Diagnosis, Pathophysiology of Brain Inflammation, and Antimicrobial Treatments.

    Science.gov (United States)

    Pugh, J Jeffrey; Levy, Rebecca A

    2016-09-21

    Primary amoebic meningoencephalitis (PAM) is a very rare disease with a high mortality rate. PAM is caused by Naegleria fowleri, an amoeba which resides in freshwater lakes and ponds and can survive in inadequately chlorinated pools ( Lopez, C.; Budge, P.; Chen, J., et al. Primary amebic meningoencephalitis: a case report and literature review . Pediatr. Emerg. Care 2012 , 28 , 272 - 276 ). In the past 50 years, there have been over 130 cases of Naegleria induced PAM in the United States with only three known survivors; one survivor was diagnosed and treated at Arkansas Children's Hospital. Successful treatment of PAM started with a rapid diagnosis, extensive antimicrobial therapy including an investigational medication miltefosine, supportive care, an intraventricular shunt, and hypothermia. These treatments address different aspects of the disease process. Increased understanding of the diagnosis and treatment of PAM is important especially for patients who present with meningitis-like findings during the summer months.

  13. Diagnosis and treatment of children with attention deficit hyperactivity disorder%儿童注意力缺陷多动障碍的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    马士薇

    2013-01-01

      儿童注意力缺陷多动障碍是一种影响终身的慢性神经精神疾病,儿童具有注意缺陷或多动、冲动等6条以上症状,至少已持续6个月方可诊断。诊断时注意与儿童其他疾病的鉴别。该病的治疗必须药物、行为矫治并重,对家长的培训和学校干预也应并重。%Attention deficit hyperactivity disorder of children is a chronic neuropsychiatric disease which affects lifelong. Children with attention deficit or hyperactivity, impulse and other six symptoms that last at least for six months can be diagnosed. When making diagnose, attention should be paid to distinguish other children’s diseases. Treatment should combine medication and behavior modification and parents’ training with school intervention.

  14. Portopulmonary hypertension: from diagnosis to treatment.

    Science.gov (United States)

    Giusca, Sorin; Jinga, Mariana; Jurcut, Ciprian; Jurcut, Ruxandra; Serban, Marinela; Ginghina, Carmen

    2011-10-01

    Portopulmonary hypertension is a form of pulmonary arterial hypertension that has gained interest in recent years with the development of liver transplantation techniques and new pulmonary vasodilator therapies. Portopulmonary hypertension is defined as pulmonary artery hypertension associated with portal hypertension with or without advanced hepatic disease. Echocardiography plays a major role in screening for portopulmonary hypertension but right heart catheterization remains the gold standard for diagnosis. The treatment of patients with portopulmonary hypertension consists of general measures that apply to all patients that carry the diagnosis of pulmonary hypertension and specific vasodilator therapies. These new therapies showed encouraging results in patients who would otherwise have a contraindication for liver transplantation. The review presents a summary of the current knowledge on the epidemiology, diagnosis, treatment and prognosis of patients with portopulmonary hypertension.

  15. Effect of Malnutrition at Diagnosis on Clinical Outcomes of Children With Acute Lymphoblastic Leukemia.

    Science.gov (United States)

    Yazbeck, Nadine; Samia, Loma; Saab, Raya; Abboud, Miguel R; Solh, Hassan; Muwakkit, Samar

    2016-03-01

    Acute lymphoblastic leukemia (ALL) is the most common malignancy among children. Although studies have shown that malnutrition can negatively affect treatment outcome, results are controversial. This retrospective study aims at determining the prevalence of malnutrition and its association with treatment outcome among children with ALL treated at the Children's Cancer Institute in Lebanon. A total of 103 patients diagnosed with ALL between April 2002 and May 2010 were enrolled. Anthropometric data were collected from medical records upon diagnosis, at 3 and 6 months, and at the end of treatment. Body mass index was calculated for children 2 years of age and older, whereas weight-for-height ratio was used for patients below 2 years. Patients were considered underweight, stunted, or wasted if their Z-scores were <-2 SD. The prevalence of malnourished children was 25.2% at diagnosis and remained almost the same at the end of treatment. The odds of having a poor outcome (death and relapse) was higher among malnourished children and more so among stunted children with an odds ratios=2.15; 95% confidence interval, 0.5-8.3 and odds ratio=2.63; 95% confidence interval, 0.6-11.5, respectively. Although there was a trend showing worse outcomes in malnourished children with ALL at diagnosis when compared with well-nourished children larger studies using additional tools like arm anthropometry need to be conducted to prove the association.

  16. Diagnosis and Treatment of Eating Disorders.

    Science.gov (United States)

    Neuman, Patricia; And Others

    This paper was designed to provide professional counselors with a comprehensive but concise method of accurately evaluting, interviewing, and planning for treatment of eating disorder clients. The paper is organized in five sections. The first section, Diagnosis, compares, contrasts, and offers clear explanations of the diagnostic criteria for…

  17. Diagnosis and treatment of Helicobacter pylori infection

    DEFF Research Database (Denmark)

    Bytzer, Peter; Dahlerup, Jens Frederik; Eriksen, Jens Ravn

    2011-01-01

    National Danish guidelines for the diagnosis and treatment of Helicobacter pylori (Hp) infection have been approved by the Danish Society for Gastroenterology. All patients with peptic ulcer disease, gastric cancer, and MALT lymphoma should be tested for Hp. We also recommend testing in first...

  18. Diagnosis and treatment of Helicobacter pylori infection

    DEFF Research Database (Denmark)

    Bytzer, Peter; Dahlerup, Jens Frederik; Eriksen, Jens Ravn;

    2011-01-01

    National Danish guidelines for the diagnosis and treatment of Helicobacter pylori (Hp) infection have been approved by the Danish Society for Gastroenterology. All patients with peptic ulcer disease, gastric cancer, and MALT lymphoma should be tested for Hp. We also recommend testing in first deg...

  19. Cervicogenic vertigo: etiology, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Elham Tavanai

    2013-07-01

    Full Text Available Background and Aim: Cervicogenic dizziness is induced by a specific neck position and the earth’s gravity has no effect on provoking of it. The precise incidence of cervicogenic dizziness is not certain but, 20-58% of patients following sudden head injuries experience its symptoms . In this article, the etiology, diagnosis and treatment of cervicogenic vertigo is discussed. Methods: At first, articles of cervicogenic dizziness from electronic databases of Google scholar , PubMed, Scopus, Ovid and CINAHL were searched from 1987 up to 2012. Then, the articles in them vertigo, disequilibrium or nystagmus were consistent with neck disorders were searched. Conclusion: Articles with title of cervicogenic vertigo (cervical vertigo were limited. Clinical researches about cervicogenic vertigo up to now implicate on several points; all signify that we cannot diagnose it certainly and there is not any specific single test for that. Recently, smooth pursuit neck torsion test (SPNTT has introduced for diagnosis of cervicogenic vertigo that is not valid yet. There is no protocol for diagnosis of cervicogenic vertigo and diagnosis is often based on limited clinical experiences of clinicians. Physiotherapy, medication and manual therapies are options for treatment but there is no distinct and effective treatment for it and in just one article, a combination of treatments for cervicogenic vertigo as a protocol has recommended.

  20. Differential Diagnosis and Treatment of Career Indecision.

    Science.gov (United States)

    Fuqua, Dale R.; Hartman, Bruce W.

    1983-01-01

    Discusses the need for a better diagnostic approach to career indecision. Suggests a model for differential diagnosis and treatment containing three career indecision types or perspectives, i.e., developmental tasks, acute situational reactions, and chronic psychological concerns. Discusses problems of diagnostic measurement. (WAS)

  1. [Differential infratentorial brain tumor diagnosis in children].

    Science.gov (United States)

    Warmuth-Metz, M; Kühl, J; Rutkowski, S; Krauss, J; Solymosi, L

    2003-11-01

    With the exception of the first year of life, infratentorial brain tumors are more frequent in the first decade than tumors in the supratentorial compartment. In particular these are cerebellar low-grade astrocytomas, medulloblastomas, brainstem gliomas and ependymomas of the fourth ventricle. The morphology on MRI and CT and the mode of dissemination permit differential diagnosis in many cases. To allow correct stratification into different treatments in possibly disseminating malignant brain tumors, knowledge of the status of dissemination is essential, and therefore not only cranial but also spinal MRI is indispensable for staging. If the spinal MRI is performed in the immediate postoperative period, knowledge of the normal non-specific purely postoperative changes, often seen as enhancement in the subdural spinal spaces, is necessary in order to avoid misinterpretation as meningial seeding. The differential diagnosis of pediatric infratentorial brain tumors and the morphology of subdural enhancement are illustrated with typical images. The natural history of the most frequent tumors and its importance for treatment decisions is discussed in light of the literature.

  2. Diagnosis and Treatment of 68 Cases of Children With Chronic Gastritis%68例小儿慢性胃炎诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    尹君平

    2016-01-01

    Objective To study the clinical characteristics and treatment of children with chronic gastritis.Methods 68 cases of children with chronic gastritis were analyzed, the use of serological identiifcation from Helicobacter pylori infection, symptomatic treatment of patients. Results Etiology survey: 68 patients, 45 cases of irregular diet, the partial eclipse phenomenon. 54 cases originated from Helicobacter pylori infection, 4 cases from bile reflux, 8 cases from poor diet, 2 cases of other reasons. Results Intermittent abdominal pain in 37 cases, 41 cases of 32 cases of anorexia, acid reflux, abdominal distension, weight loss and weak in 23 cases. According to different etiology, clinical symptoms and disease in children with progress, individualized treatment, clinical symptoms of 68 patients improved in 49 cases, gastric mucosal inlfammation reduced, clinical effective rate of 86.8%. And the positive rate of Hp was higher than that of Hp negative group.Conclusion Treatment should be based on the different causes, clinical symptoms and disease progression, to take personalized symptomatic treatment, in order to improve clinical symptoms, reduce gastric mucosal inlfammation, improve the clinical cure rate.%目的:研究小儿慢性胃炎临床特征以及对症治疗方法。方法对68例慢性胃炎的儿童进行发病原因分析,使用血清学鉴定是否源于幽门螺杆菌感染,对症治疗患者。结果发病原因调查:68例患者中,45例有不规律饮食、偏食现象。54例源于幽门螺杆菌感染,4例源于胆汁回流,8例源于不良饮食,2例其他原因。结果上腹间断痛37例,食欲不振41例,反酸、腹部胀32例,消瘦无力23例。根据患儿的不同病因、临床症状及病情进展情况,采取个性化治疗后,68例患者临床症状有明显改善者49例,胃黏膜炎症有所减轻,临床治疗有效率为86.8%。而Hp阳性有效率高于Hp阴性组。结论治疗时应根据患儿不

  3. Diagnosis and treatment of children with acute appendicitis with the performance of intestinal obstruction%以肠梗阻为表现的小儿急性阑尾炎的诊治

    Institute of Scientific and Technical Information of China (English)

    尚献会; 陈长梅; 王鑫; 金祝; 高明娟; 郑泽兵

    2016-01-01

    目的:分析表现为肠梗阻的小儿急性阑尾炎的临床诊治特点。方法:收治小儿急性阑尾患儿60例,分析患儿的临床资料。结果:60例患儿均出现了食欲不振,腹痛偶伴有腹泻,恶心,呕吐,少量患儿伴有发热等肠梗阻临床症状。入院后对患儿进行支持治疗。手术中明确急性阑尾炎导致肠梗阻发生。根据各患儿的病情进行针对性治疗。结论:提高对疾病的认识,做到早诊断、早治疗,这样大部分阑尾炎患者可以治愈,同时对患者认真探查,可有效减少并发症的产生。%Objective:To analyze the characteristics of clinical diagnosis and treatment of children with acute appendicitis with the performance of intestinal obstruction.Methods:60 children with acute appendicitis were selected.We analyzed the clinical data. Results:60 cases showed loss of appetite,abdominal pain occasionally accompanied by diarrhea,nausea and vomiting,a small amount of children with fever and other symptoms of intestinal obstruction.Support treatment for children after admission.In the operation,it was found the intestinal obstruction occurred due to acute appendicitis.According to the patient's condition for targeted treatment.Conclusion:Improve the understanding of the disease,make early diagnosis and early treatment,so that most of the patients with appendicitis can be cured,at the same time,serious exploration should be carried out for patients,which can effectively reduce the complications.

  4. [Tendinitis in athletes: etiology, diagnosis and treatment].

    Science.gov (United States)

    Gremion, G; Zufferey, P

    2015-03-11

    Tendinopathy is one of the most common diagnosis in sports. Knowledges about their etiology, the repair process to their diagnosis and their treatment have improved thanks to the development of imaging, especially ultra- sound. The disorder whose etiology could be mechanical or degenerative can cause long- term disability and sometimes the end of the sport carreer. The risk of reccurence is com- mon; this may lead to tendon rupture whose functional effects can be significative. The management should be early: it must respect the deadlines for tendon healing and pro- pose a gradual recovery efforts after elimina tion of the contributing factors involved.

  5. Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment

    Directory of Open Access Journals (Sweden)

    Enrico Bellato

    2012-01-01

    Full Text Available Fibromyalgia syndrome is mainly characterized by pain, fatigue, and sleep disruption. The etiology of fibromyalgia is still unclear: if central sensitization is considered to be the main mechanism involved, then many other factors, genetic, immunological, and hormonal, may play an important role. The diagnosis is typically clinical (there are no laboratory abnormalities and the physician must concentrate on pain and on its features. Additional symptoms (e.g., Raynaud’s phenomenon, irritable bowel disease, and heat and cold intolerance can be associated with this condition. A careful differential diagnosis is mandatory: fibromyalgia is not a diagnosis of exclusion. Since 1990, diagnosis has been principally based on the two major diagnostic criteria defined by the ACR. Recently, new criteria have been proposed. The main goals of the treatment are to alleviate pain, increase restorative sleep, and improve physical function. A multidisciplinary approach is optimal. While most nonsteroidal anti-inflammatory drugs and opioids have limited benefit, an important role is played by antidepressants and neuromodulating antiepileptics: currently duloxetine (NNT for a 30% pain reduction 7.2, milnacipran (NNT 19, and pregabalin (NNT 8.6 are the only drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. In addition, nonpharmacological treatments should be associated with drug therapy.

  6. ALZHEIMER’S DISEASE: DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    A. A. Naumenko

    2016-01-01

    Full Text Available Early diagnosis of Alzheimer's disease (AD is one of the most important tasks of modern medicine. Even before its obvious clinical symptoms develop, AD can be now identified from the data of functional neuroimaging, including that with the Pittsburgh compound, which can detect amyloid protein accumulation in the brain structures, and from those of an analysis of biomarkers in the cerebrospinal fluid. If there are clinical symptoms, a diagnosis can be established by the correct evaluation of mnestic disorders; the latter in BA are so-called hippocampal. Treatment for AD should be initiated as early as possible; methods for pathogenetic therapy are being actively developed. When treating AD, one should adhere to a comprehensive approach involving the use of drugs for basic symptomatic treatment and those enhancing its efficiency, and non-drug treatments (cognitive and motor training. It is important to timely identify and eliminate potentially reversible conditions and to work with caregivers and guardians.

  7. Diagnosis and Treatment Value of 64 Row CT in Children With Secretory Otitis Media%64排CT在儿童分泌性中耳炎诊疗中的作用

    Institute of Scientific and Technical Information of China (English)

    付高尚; 徐艳霞; 韩富根

    2015-01-01

    目的:探讨64排CT在儿童分泌性中耳炎诊断、治疗过程中的意义。方法对2012年8月~2014年8月在本院治疗的76例(131耳)分泌性中耳炎患儿的临床资料进行回顾性分析。结果76例(131耳)分泌性中耳炎患儿当中,其中部分患儿3月后复查CT乳突密度影降低,避免了不必要的手术。结论64排颞骨CT检查对儿童分泌性中耳炎病情严重程度准确诊断提供重要的参考价值。%Objective To investigate the 64 slice CT in the diagnosis of children with secretory otitis media,in the course of treatment significance.Methods From August 2012 to August 2014 in our hospital(76 cases(131 ears)of secretory otitis media in children with clinical data were retrospectively analyzed.Results 76 cases(131 ears)with secretory otitis media in children,including review of CT significantly decreased the mastoid density in march part of the children,to avoid unnecessary operation.Conclusion The diagnostic accuracy of 64 row CT scanning of temporal bone of children with secretory otitis media disease severity and provides an important reference value.

  8. Kidney diseases in children - early diagnosis and prevention.

    Science.gov (United States)

    Polenakovic, Momir; Gucev, Zoran; Tasic, Velibor

    2016-01-01

    Pediatric kidney diseases were in the focus of the World Kidney Day 2016. Macedonian pediatric nephrologists gave their contribution with public appearance in kindergartens, primary and secondary schools, with interactive lectures and discussion with the youngest about the kidney function, healthy life style and simple measures to prevent kidney and urinary tract diseases. Besides promotive appearance in the media, series of lectures were presented in front of the health professionals. The aim was to attract the attention of the professionals for early diagnosis and prevention of kidney disease. The action starts in utero, followed by early postnatal imaging and assessment, conservative treatment and in selected cases surgical treatment. The emphasis is on the multidisciplinary and comprehensive approach to children and adolescents with kidney diseases.

  9. Early Diagnosis and Treatment for Compartment Syndrome in Children%儿童间隔综合征的早期诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    曾裴; 戴祥麒; 张质彬

    1996-01-01

    通过对患间隔综合征的31例患儿复查,总结如何正确作出早期诊断和治疗的经验.31例患儿中,上肢病变16例,其中9例为肱骨髁上骨折(56%),下肢病变15例,其中7例为胫腓骨骨折(40%).25例行筋膜减张术,17例获得随访,平均随访时间为28个月,14例肢体功能恢复(82%).治疗成功的关键在于早期诊断和治疗,彻底的筋膜减张是预防神经、肌肉坏死唯一有效的方法.临床诊断间隔综合征的五大要点:疼痛是最早最常见的症状,感觉障碍是很早出现而易被忽视的体征,疼痛消失和麻痹是晚期标志,被动牵拉试验阳性是手术适应证,但不能作为唯一的确诊指标.%Thirty-one cases of compartment syndrome were reviewed.In 16 cases of upper limb involvement,9 cases(56%)resulted from supracondylar fracture of the humerus.In 15 cases of lower limb involvement,7(40%)resulted from fractures of the tibia and fibula.Of them,25 cases underwent fasciotomy,17 cases were followed up for an average of 28 months.Successful results were obtained in 14 (82%).It seems that early diagnosis and treatment are very important for good prognosis.Thorough fasciotomy is the only effective method to prevent nerve and muscle necrosis.The authors suggest the significanee of 5P signs:pain is the earliest and most common symptom,paresthesia appears early but is easily neglected,paralysis and painlessness are the late signs;pain aggravated by passive extension with a definite diagnosis is an indication of operation.

  10. Diagnosis and Treatment of Hemangioma of the Parotid Gland in Children%小儿腮腺血管瘤的诊断和治疗(附10例报告)

    Institute of Scientific and Technical Information of China (English)

    王赞尧

    1985-01-01

    10 cases of hemangiomas of the parotid gland in infancy and childhood are reported.8 were boys and 2 girls,aged from 10 days to 16 years.The tumors were found developed before the patients-reached the age of 4months in 8 cases.The diagnosis was mainly based upon typical syruptoms and noedle aspiration.The cases were divided into 3 age groups.Group I was composed of newborns and infants under 2;Group Ⅱ of children between 2 and 5,and Group Ⅲ of those over 5.Generally the tumors grew rapidly duringthe age between 4-8 months then they stopped growing and remained stationary for 8-10 months till they gradually decreased in size.At the age of 4-5 years,most tumors regressed almost completely.The author points out that the choice of treatment depends on the age.For Group Ⅰ,expectant treatment by observing for the spontaneous regression of the tumor was preferable.There were 3 children whose tumors regressed spontaneously till they disappeared.The parents of another two children refused the expectant treatment and requested some other therapy,therefore,irradiation of the tumors was given with good results.For Group Ⅱ,as the tumors had been decreasing in size for a certain period of time before the first visit,further observation for regression seemed proper.Surgical excision was suggested only for rapidly growing hemangiomas.For Grou p Ⅲ,generally,spontaneous regression was impossible,so operation was inevitable.%@@ 腮腺血管瘤是小儿腮腺肿瘤中常见的一种,约占腮腺良性肿瘤的32.40%(5).过去,不少小儿外科医师主张不论小儿年龄大小都采用手术切除.

  11. Laryngopharyngeal Reflux: Diagnosis, Treatment, and Latest Research

    Directory of Open Access Journals (Sweden)

    Campagnolo, Andrea Maria

    2014-01-01

    Full Text Available Introduction Laryngopharyngeal reflux (LPR is a highly prevalent disease and commonly encountered in the otolaryngologist's office. Objective To review the literature on the diagnosis and treatment of LPR. Data Synthesis LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Molecular studies have tried to identify biomarkers of reflux such as interleukins, carbonic anhydrase, E-cadherin, and mucin. Conclusion Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.

  12. Progress in diagnosis and treatment of children combined allergic rhinitis and asthma syndrome%儿童过敏性鼻炎-哮喘综合征诊治进展

    Institute of Scientific and Technical Information of China (English)

    郭茹茹

    2014-01-01

    过敏性鼻炎和支气管哮喘是儿童常见的呼吸道过敏性疾病,发病率逐年上升.既往认为两者是完全独立的疾病,而近年的研究表明两者从病因学、发病机制、病理学变化以及治疗方面高度相似,故提出“过敏性鼻炎-哮喘综合征”这一新的概念,是指同时发生临床或亚临床的过敏性鼻炎和支气管哮喘症状,二者需整体看待,进行联合诊断和治疗,从而极大程度减少了误诊,并减少药物的重复使用,提高临床疗效.该文就儿童过敏性鼻炎-哮喘综合征诊治进展作一综述.%Allergic rhinitis and bronchial asthma are two common respiratory allergic diseases in children and the incidence of the two diseases is increasing.They are regarded as mutually separate diseases,but recent studies suggest that there is a strong link between the two diseases,which is represented at the etiology,mechanisms,pathologic and therapeutic levels.So combined allergic rhinitis and asthma syndrome (CARAS),a new terminology has formally introduced to illustrate concurrent symptoms of allergic rhinitis and bronchial asthma.The diagnosis and treatment of CARAS need to be considered collectively.Therefore the incidence of misdiagnosis and repeated use of drugs can be significantly reduced,then improving the clinical efficacy.This article reviews progress of the diagnosis and treatment of CARAS in children.

  13. [Diagnosis and treatment of pediatric subglottic stenosis: experience in a tertiary care center].

    Science.gov (United States)

    Botto, Hugo Alberto; Pérez, Cinthia Giselle; Cocciaglia, Alejandro; Nieto, Mary; Rodríguez, Hugo Aníbal

    2015-08-01

    Subglottic stenosis is among the most common causes of airway obstruction in children, 90% of which resulting from endotracheal intubation. The diagnosis is based on the patient's clinical, radiologic evaluation, flexible laryngoscopy and rigid airway endoscopy under general anesthesia. It must be suspected in children with respiratory distress after extubation. The therapeutic approach depends on the severity of the subglottic stenosis and the patient's symptoms. We describe our experience with the subglottic stenosis etiologies, diagnosis, treatment and outcome of patients with this condition.

  14. Diagnosis and treatment of bronchopulmonary neuroendocrine tumours

    DEFF Research Database (Denmark)

    Tabaksblat, Elizaveta Mitkina; Langer, Seppo W; Knigge, Ulrich;

    2016-01-01

    Bronchopulmonary neuroendocrine tumours (BP-NET) are a heterogeneous population of neoplasms with different pathology, clinical behaviour and prognosis compared to the more common lung cancers. The management of BP-NET patients is largely based on studies with a low level of evidence and extrapol...... and extrapolation of data obtained from more common types of neuroendocrine tumours. This review reflects our view of the current state of the art of diagnosis and treatment of patients with BP-NET....

  15. Cervicogenic headache: Differential diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Aleksey Nikolayevich Barinov

    2012-01-01

    Full Text Available The paper discusses the issues of differential diagnosis of cervicocranialgia with tension headache and migraine with concomitant cervical myofascial syndrome. It considers the basic mechanisms of the pathogenesis of these nosological entities and common approaches to their treatment. The mechanisms of pathogenetic action of myorelaxants are shown in cervicocranialgia and myofascial pain syndromes. Methods for mini-invasive therapy for cervicogenic headache and other musculoskeletal disorders are presented.

  16. Diagnosis and treatment of gallbladder perforation

    Institute of Scientific and Technical Information of China (English)

    Hayrullah Derici; Cemal Kara; Ali Dogan Bozdag; Okay Nazli; Tugrul Tansug; Esra Akca

    2006-01-01

    AIM: To present our clinical experience with gallbladder perforation cases.METHODS: Records of 332 patients who received medical and/or surgical treatment with the diagnosis of acute cholecystitis in our clinic between 1997 and 2006 were reviewed retrospectively. Sixteen (4.8%) of those patients had gallbladder perforation. The parameters including age, gender, time from the onset of symptoms to the time of surgery, diagnostic procedures, surgical treatment, morbidity, and mortality were evaluated.RESULTS: Seven patients had type Ⅰ gallbladder perforation, 7 type Ⅱ gallbladder perforation, and 2 type Ⅲ gallbladder perforation according to Niemeier's classification. The patients underwent surgery after administration of intravenous electrolyte solutions, and were treated with analgesics and antibiotics within the first 36 h (mean 9 h) after admission. Two patients died of sepsis and multiple organ failure in the early postoperative period. Subhepatic abscess, pelvic abscess,pneumonia, pancreatitis, and acute renal failure were found in 6 patients.CONCLUSION: Early diagnosis and emergency surgical treatment of gallbladder perforation are of crucial importance. Upper abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation.

  17. Diagnosis and Treatment of Pityriasis Rubra Pilaris

    Directory of Open Access Journals (Sweden)

    Kubanov Alexey

    2014-12-01

    Full Text Available The article deals with clinical diagnosis and treatment of pityriasis rubra pilaris (PRP. The authors analyze the diagnostic errors, present literature review, and their own observations. The clinical study included 23 patients with pityriasis rubra pilaris: 18 women and 5 men, average age of 54 ± 7.2. The clinical diagnosis of all examined patients was subsequently confirmed by histological analysis of the skin. The primary clinical diagnosis was psoriasis in 15 (65.2% patients, 6 (26% patients received treatment for toxic exanthema, and only 2 (8.8% patients were presumptively diagnosed with pityriasis rubra pilaris. In conclusion, pityriasis rubra pilaris was initially misdiagnosed in 91.2% of patients. Considering the great number of diagnostic errors, we analyzed the main diagnostic and differential diagnostic features of PRP. The most effective of all synthetic retinoids in PRP treatment is acitretin. Although symptomatic improvement in PRP occurs within a month, substantial improvement, even clearing is possible within 4 - 6 months.

  18. Precision medicine for diagnosis and treatment of osteosarcoma

    Institute of Scientific and Technical Information of China (English)

    Rui Wang; Freddie H Fu; Bing Wang

    2016-01-01

    Osteosarcoma is one of the most common primary malignant bone tumors, most commonly afecting chil-dren and adolescents. With a low 5-year survival rate, osteosarcoma is among the most dangerous threats to the health and life of young people. In many cases, lung micro-metastases are detected at the time of osteosarcoma diagnosis, which makes it very dificult to save patients’ lives even with very radical treat-ments such as surgical amputation to remove the primary lesion. Patients with osteosarcoma often die of lung metastatic disease. The diagnosis of osteosarcoma at an early stage is therefore very important for disease prognosis. Osteosarcoma shows a remarkable variation in its pathologic presentation between its diferent pathologic sub-types and from patient to patient. Prior to displaying any abnormalities in celular morphology, molecular and biochemical metabolic changes may occur, leading to increases in abnormaly functioning oncoproteins. New evidence from molecular biological and genomic studies provides critical information about the occurrence, development, metastasis, and prognosis of osteosarcoma. The precision medicine approach, which alows for individualized treatment, has improved the prognosis and treatment outcomes for osteosarcoma. This review aims to comprehensively summarize the recent key discoveries in osteosarcoma and to highlight optimal strategies for diagnosis and treatment.

  19. Analysis of clinical diagnosis and treatment of mycoplasma pneumoniae pneumonia in children%小儿肺炎支原体肺炎的临床诊治分析

    Institute of Scientific and Technical Information of China (English)

    齐俊民

    2015-01-01

    Objective:To analyze the clinical characteristics of mycoplasma pneumoniae pneumonia in children,thereby enhancing children mycoplasma pneumonia clinical diagnosis and treatment.Methods:120 patients with mycoplasma pneumoniae pneumonia in children were selected from January to December 2013.The clinical data were retrospectively analyzed,and they were divided into the treatment group and the control group.Results:The effective rate of treatment group was significantly higher than the control group,and there was statistically significant(P<0.05);the treatment group in the mean time coughing subsided,the average time of fever and average hospitalization time were far less than that in control group(P<0.05).Conclusion:The treatment group and the control group for comparison,the efficacy of the treatment group is significant;the treatment time is short;it can save medical costs for patients;it is worth promoting.%目的:对小儿肺炎支原体肺炎的临床表现特点进行分析,从而提高小儿肺炎支原体肺炎的临床诊治水平。方法:2013年1-12月收治小儿肺炎支原体肺炎患者120例,对临床治疗资料进行回顾性分析,将对其,分为治疗组和对照组。结果:治疗组有效治疗率显著高于对照组,两组比较差异有统计学意义(P<0.05);治疗组患儿的咳嗽消退平均时间、退热平均时间以及住院平均时间均要远远短于对照组(P<0.05)。结论:治疗组和对照组相对比,治疗组疗效显著,而且治疗时间短,为患者节省医疗费用,值得临床推广应用。

  20. Diagnosis and treatment of type 2 diabetes in children and adolescents%儿童及青少年2型糖尿病的诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    赵莎; 马向华; 倪娟

    2013-01-01

    儿童及青少年糖尿病一直是威胁儿童及青少年健康成长的重要危险因素,目前儿童及青少年糖尿病中2型糖尿病占很大一部分.对儿童及青少年2型糖尿病的诊断主要是与1型糖尿病的鉴别.儿童及青少年2型糖尿病多伴有肥胖、多囊卵巢综合征(PCOS)、黑棘皮病等,可以通过临床症状、空腹血糖、口服葡萄糖耐量试验(OGTT)、胰岛素自身抗体和C肽水平来诊断儿童及青少年2型糖尿病.儿童及青少年2型糖尿病与1型糖尿病相比,更早、更易出现糖尿病微血管并发症.目前的治疗方案主要有糖尿病健康教育、饮食控制、运动疗法、口服药物和胰岛素治疗.%Diabetes has been an important risk factor which threats the health of children and adolescents.Type 2 diabetes accounted for a large part in the amount of children and adolescents with diabetes.Diag-nosis of type 2 diabetes in children and adolescents is mainly to identify from type 1 diabetes mellitus.Many children and adolescents with type 2 diabetes usually have problem with obesity,polycystic ovary syndrome (PCOS) or acanthosis nigricans,etc.The diagnosis of children and adolescents with type 2 diabetes can through the clinical symptoms,fasting glucose,oral glucose tolerance test (OGTT),insulin autoantibodies and C-peptide levels.Compared with type 1 diabetes,children and adolescents with type 2 diabetes develop micro-vascular complications more easily and earlier.The treatment of children and adolescents with type 2 diabetes includes diabetic health education,diet control,exercise,oral drugs and insulin.

  1. [Diagnosis and treatment of acute pancreatitis].

    Science.gov (United States)

    Dalgat, D M; Magomaev, M Sh; Medzhidov, R T; Kurbanov, K M

    1986-04-01

    In diagnosis of acute pancreatitis of special importance is determination of the activity of transamidinase, phospholipase A, lipase, concentration of copper, calcium and triglycerides in blood serum as well as laparoscopy with biopsy and local thermometry of the pancreas. The dosage of 5-fluoruracil in the complex treatment of patients should be differentiated corresponding to the form of the disease: 3 mg/kg in the endomatous form, 5 mg/kg in the destructive form. The general lethality was 1.4%. In conservative treatment there were no lethal outcomes.

  2. Cardiac Arrhythmias: Diagnosis, Symptoms, and Treatments.

    Science.gov (United States)

    Fu, Du-Guan

    2015-11-01

    The cardiac arrhythmia is characterized by irregular rhythm of heartbeat which could be either too slow (100 beats/min) and can happen at any age. The use of pacemaker and defibrillators devices has been suggested for heart arrhythmias patients. The antiarrhythmic medications have been reported for the treatment of cardiac arrhythmias or irregular heartbeats. The diagnosis, symptoms, and treatments of cardiac arrhythmias as well as the radiofrequency ablation, tachycardia, Brugada syndrome, arterial fibrillation, and recent research on the genetics of cardiac arrhythmias have been described here.

  3. Plantar fascia rupture: diagnosis and treatment.

    Science.gov (United States)

    Rolf, C; Guntner, P; Ericsäter, J; Turan, I

    1997-01-01

    Two patients with spontaneous medial plantar fascia rupture due to a definite injury with no prior symptoms, were referred to our institution. Clinically, there was a tender lump in the sole, and magnetic resonance imaging confirmed the diagnosis. Nonoperative treatment was sufficient in curing the acute total rupture. Endoscopic release was used on the partially ruptured plantar fascia, but it is probably more optimal in the acute phase. The literature provides no comparative data on operative or nonoperative treatment efficacy for this rare condition.

  4. Diagnosis and treatment of thyroid nodules in children%儿童甲状腺结节的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    李春睿; 徐书杭; 刘超; 蔡可英

    2013-01-01

    甲状腺结节较少发生于儿童和青少年,但其恶性风险更高,故鉴别其良、恶性非常重要.目前推荐使用的诊断方法主要有甲状腺超声、甲状腺细针穿刺细胞学检查等.儿童甲状腺良性结节的治疗相比成人更为保守,然而对于恶性结节,甲状腺全切术为首选.术后宜密切随访,并正规实施后续治疗.对甲状腺癌术后的患者,需要定期复查放射性碘全身扫描(WBS)、甲状腺球蛋白测定等.左旋甲状腺素的临床效果尚存争议.%Although pediatric thyroid masses are rare,they have a good chance of carcinoma.There-fore,it is important to assess the risk of malignancy.Appropriate diagnostic tests include thyroid ultrasound,thyroid fine needle aspiration technique and so on.Compared to aduLTs,treatment of benign thyroid nodules in children is more conservative,however,for malignant thyroid nodules,total thyroidectomy is the first choice.Moreover,whole body scan with radioactive iodine and thyroglobulin determination should be suggested after thyROidectomy.The clinical efficacv of L-thyroxin is still debated.

  5. 儿童缺铁性贫血诊疗进展%Diagnosis and treatment of iron deficiency anemia in children

    Institute of Scientific and Technical Information of China (English)

    蔡华菊(综述); 王宁玲(审校)

    2016-01-01

    缺铁性贫血(iron deficiency anemia,IDA)是因体内铁缺乏致使血红蛋白合成减少而引起的贫血。喂养不当、消化系统疾病、微量元素及维生素缺乏等仍然是导致儿童 IDA 的高危因素,高热惊厥与儿童 IDA 的关系尚有争议。研究表明,婴幼儿时期铁缺乏能够导致认知抑制控制功能不可逆减退,延迟结扎脐带等措施则可以有效预防儿童 IDA。间断补充铁剂等方法在治疗儿童 IDA 过程中亦能达到良好效果。%Iron deficiency could cause hemoglobin synthesis decrease,and then lead to iron deficiency a-nemia(IDA).The present study has found that incorrect feeding,gastrointestinal disease and deficiency of trace elements are high risks of IDA.Whether febrile seizure is associated with IDA is still controversial.Recent re-search has discovered that infant iron deficiency can lead to poor cognitive inhibitory control,while delayed cord clamping and other measures can effectively prevent IDA in children.Discontinuous complement iron agent can also achieve good effect on treatment.

  6. The diagnosis and treatment of dermatitis herpetiformis

    Directory of Open Access Journals (Sweden)

    Antiga E

    2015-05-01

    Full Text Available Emiliano Antiga, Marzia Caproni Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Florence, Italy Abstract: Dermatitis herpetiformis (DH is an inflammatory cutaneous disease with a chronic relapsing course, pruritic polymorphic lesions, and typical histopathological and immunopathological findings. According to several evidences, DH is considered the specific cutaneous manifestation of celiac disease, and the most recent guidelines of celiac disease have stated that, in celiac patients with a proven DH, a duodenal biopsy is unnecessary for the diagnosis. In this review, the most recent data about the diagnosis and the management of DH have been reported and discussed. In particular, in patients with clinical and/or histopathological findings suggestive for DH, the finding of granular IgA deposits along the dermal–epidermal junction or at the papillary tips by direct immunofluorescence (DIF assay, together with positive results for anti-tissue transglutaminase antibody testing, allows the diagnosis. Thereafter, a gluten-free diet should be started in association with drugs, such as dapsone, that are able to control the skin manifestations during the first phases of the diet. In conclusion, although DH is a rare autoimmune disease with specific immunopathological alterations at the skin level, its importance goes beyond the skin itself and may have a big impact on the general health status and the quality of life of the patients. Keywords: dermatitis herpetiformis, celiac disease, diagnosis, treatment, autoimmune disease, inflammatory cutaneous disease 

  7. MRI findings and differential diagnosis in children with cerebral paragonimiasis

    Directory of Open Access Journals (Sweden)

    Zhen Zeng

    2016-06-01

    Conclusions: The clinical manifestations of cerebral paragonimiasis are nonspecific in children while the MRI findings of cerebral paragonimiasis are characteristic, including irregular hemorrhage, ring-like enhancement and disproportionately large areas of surrounding edema. Brain MRI plays an important role in the diagnosis of cerebral paragonimiasis in children.

  8. Progress in diagnosis and treatment of children with neuropsychiatric systemic lupus erythematosus%儿童神经精神性狼疮的发病机制及诊治进展

    Institute of Scientific and Technical Information of China (English)

    官丽梅

    2016-01-01

    儿童神经精神性狼疮(neuropsychiatric systemic lupus erythematosus,NPSLE)是系统性红斑狼疮(systemic lupus erythematosus,SLE)的严重并发症,发生率高达95%.目前认为NPSLE发病机制是多种因素作用的结果,包括血脑屏障破坏、血管栓塞、神经内分泌功能紊乱、自身抗体的产生以及炎性介质的参与.临床表现复杂多样,主要表现为头痛、癫痫样发作及精神障碍.国际上尚无统一的诊断标准,必须综合应用免疫血清学、脑脊液检测、神经影像学和神经精神的评估,治疗主要应用免疫抑制剂、生物治疗和对症治疗,早期诊断和规范治疗有助于改善预后.%Neuropsychiatric systemic lupus erythematosus(NPSLE)of children is a serious complication of children with systemic lupus erythematosus (SLE),and the incidence is even up to 95 %.The pathogenic pathogenesis of NPSLE maybe result from participation of many factors including the blood-brain barrier damage,blood clots,neuroendocrine disorders,autoantibody production and inflammatory mediators.Its clinical manifestations are complexity and diversity.Headache,epilepsy,mental disorders are comom in children with NPSLE.There is no unified diagnosis for NPSLE,which must be evaluated by the general methods including immunoserological testing,cerebrospinal fluid testing,neuroimaging and neuropsychological assessments.The management of patients with NPSLE consists of immunosuppressive,biotherapy and symptomatic therapies.Early diagnosis and standard treatment may improve the prognosis of children with NPSLE.

  9. AD/HD: POSSIBLE DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Karl REICHELT

    2008-12-01

    Full Text Available The purpose of this paper is to show that a more exact diagnosis and dietary intervention in AD/HD (Attention Deficit/Hyperactivity Di­sor­der is possible and probable. The clinical symptom based diagnosis we suggest may be supplemented with physiological tests. A ge­netic and environmental inter-action is clearly involved and explainable using phenyl­ke­tonuria as a model.Method: Examining peer reviewed published papers on gut to blood, blood to brain inter­action and effect of interventions in AD/HD and our own studies in the field. The various treatment options are discussed.Results: It can be shown that a gut to brain activity is possible and probable, and dietary intervention is useful and probably safer than drugs. Preliminary data on a small five year follow up of dietary intervention is shown.

  10. Diagnosis, prevention, and treatment of scabies.

    Science.gov (United States)

    Shimose, Luis; Munoz-Price, L Silvia

    2013-10-01

    Scabies remains a public health problem, especially in developing countries, with a worldwide incidence of approximately 300 million cases each year. Prolonged skin-to-skin contact is necessary to allow the transmission of the causative mite, Sarcoptes scabiei. Classic scabies presents with burrows, erythematous papules, and generalized pruritus. Clinical variants include nodular scabies and crusted scabies, also called Norwegian scabies. The diagnosis is based mainly on history and physical examination, but definitive diagnosis depends on direct visualization of the mites under microscopy. Alternative diagnostic methods include the burrow ink test, video-dermatoscopy, newly serologic tests like PCR/ELISA, and specific IgE directed toward major mite components. Treatment of scabies consists of either topical permethrin or oral ivermectin, although the optimal regimen is still unclear.

  11. Psychosis in Parkinson's disease: diagnosis and treatment.

    Science.gov (United States)

    Doraiswamy, M; Martin, W; Metz, A; Deveaugh-Geiss, J

    1995-09-01

    1. This article reviews the prevalence, diagnosis, pathophysiology and management of psychosis in Parkinson's disease. 2. Psychosis in Parkinson's disease has been associated with all antiparkinsonian medications. The most common symptoms are vivid disturbing dreams, visual hallucinations and paranoid delusions. 3. The emergence of psychosis reduces the patient's functional capacity and increases caregiver burden. It also poses a therapeutic dilemma because effective treatment of psychotic symptoms may result in worsening of motor symptoms and vice versa. 4. Increased physician awareness is essential for proper diagnosis and management. Withdrawal of anticholinergic medications and amantadine followed by levodopa dose adjustment is effective in many patients. 5. Atypical neuroleptics, in low doses, may be successful when other measures have failed. However, these agents are not approved for treating Parkinsonian psychosis and must be considered as investigational therapies.

  12. [Peptic ulcer disease etiology, diagnosis and treatment].

    Science.gov (United States)

    Bak-Romaniszyn, Leokadia; Wojtuń, Stanisław; Gil, Jerzy; Płaneta-Małecka, Izabela

    2004-01-01

    Authors in this article present etiology, clinical manifestations, diagnostic procedures and treatment of peptic ulcer disease in children and adults. Increased gastric acid output, Helicobacter pylori, NSAIDs and stress are the basic risk factors in peptic ulcer disease. H. pylori infection is a widely known risk factor in peptic ulcer disease and influences diagnostic and treatment procedures. Primary ulcer disease concerns mainly duodenum and is accompanied by H. pylori infection. Gastroscopy and Helicobacter tests are the only reliable procedures to diagnose peptic ulcer disease. Nowadays the most important aim in peptic ulcer treatment is the H. pylori eradication. Therapy with two antibiotics and a protein pomp inhibitor eradicates the bacteria, treats the ulceration and lowers the number of ulcer recurrence. In non-infected H. pylori ulcers or in a long-term treatment protein pomp inhibitors and H2-inhibitors are effective as well in gastroprotective therapy.

  13. Diagnosis and treatment of invasive pulmonary aspergillosis in 21 children with non-hematologic diseases%非血液病患儿侵袭性肺曲霉病21例的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    张晓艳; 赵顺英; 钱素云; 胡英慧; 曾津津; 江载芳

    2009-01-01

    Objective To explore diagnosis and treatments of invasive pulmonary aspergillosis (IPA) in children with non-hematologic diseases. Method Twenty one patients without hematological malignancy were diagnosed with proven or possible IPA from July 2002 to June 2008. The risk factors, clinical manifestations, chest radiographic findings, microbiological and histopathological evidence, diagnostic procedures, treatment and prognosis were retrospectively reviewed. Result Five children had proven IPA, and 16 patients had possible IPA. Thirteen children were classified as having acute invasive pulmonary asergillosis (AIPA), eight children as having chronic necrotizing pulmonary aspergillosis (CNPA). Definitive diagnosis of primary immunodeficiency (PID) was made in 6 children (4 with chronic granulomatous disease, 2 with cellular immunodeficiency); three children were suspected of having PID. Corticosteroids and multiple broad-spectrum antibiotics had been administered in 5 patients (3 of these 5 patients also had invasive mechanical ventilation). Two children had underlying pulmonary disease. Three patients had unknown risk factors. Among these three patients, two had history of environmental exposure. Fever and cough were present in all the children. Fine rales were found in nineteen children. Six children had hepatosplenomegaly. The common roentgenographic feature of AIPA in 13 patients was nodular or mass-like consolidation with multiple cavity. "air-crescent" was seen in 10 of patients with AIPA. Lobar consolidation with cavity and adjacent pleural thickening was found in all children with CNPA. The positive rate of sputum and/or BALF culture in MPA and CNFA were 72.1% and 22.4%, respectively. A large number of septate hyphae on wet smear were found in all of the children whose sputum and/or BALF culture were positive. Lung biopsy was performed in 3 children with CNPA, and necrosis, granulomatous inflammation, as well as septate, branching hyphae were observed on

  14. Analysis on clinical diagnosis and treatment of Mycoplasma pneumoniae pneumonia in children%小儿肺炎支原体肺炎的临床诊治分析

    Institute of Scientific and Technical Information of China (English)

    闫文芳

    2012-01-01

    目的:探讨小儿肺炎支原体肺炎的临床特点,提高小儿肺炎诊治水平.方法:回顾性分析该院在2011年5月~2012年5月收治并经过临床确诊的120例患者的临床资料.结果:120例患儿经过3~5天临床治疗后有99例患儿体温明显下降,咳嗽明显减轻.治疗7~9天后有18例患儿体温平稳,咳嗽明显减轻,其中有3例患儿合并军团菌感染高热持续11天后体温才恢复正常,临床对于合并其他的细菌感染18例患者给予头孢类或美洛西林治疗,对该组患儿临床经过12天治疗后经过复查X线胸片好转后出院进行随访,经1个月随访,所有患儿全部治愈.结论:小儿肺炎支原体肺炎是临床常见的疾病,临床表现为除呼吸道疾病外,常合并肺外多系统的损害,咽拭子支原体DNA检测阳性可以作为临床早期诊断的重要手段,对于小儿肺炎支原体肺炎临床采用阿奇霉素和红霉素治疗效果好.%Objective; To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia in children, and improve the diagnostic level and curative level. Methods: The clinical data of 120 children who were diagnosed as Mycoplasma pneumoniae pneumonia definitely and treated in the hospital from May 2011 to May 2012 were analyzed retrospectively. Results; At 3 - 5 days after clinical treatment, body temperature of 99 children decreased significantly, cough was relieved obviously. At 7 -9 days after treatment, the body temperature of 18 children maintained stable, cough was relieved obviously, and the body temperature of 3 children with Legionella,infection combined with hyperpyrexia returned to normal after 11 days. Eighteen children with other bacterial infection were treated with cephalosporin and mezlocillin for 12 days, then they left the hospital after improvement of X - ray chest radiography reexamination, the children were followed up for more than one month, all the children were cured. Conclusion: Pediatric Mycoplasma

  15. 非肝炎病毒感染性肝炎患儿临床诊治分析%Clinical diagnosis and treatment of children with non-hepatitis virus infection

    Institute of Scientific and Technical Information of China (English)

    潘秋芳; 宋存红; 周立锐

    2015-01-01

    目的:探讨儿童发生非肝炎病毒感染相关性肝炎的诊断及治疗效果,对临床发生非肝炎病毒感染性肝炎患儿的诊断和治疗提供指导。方法采用回顾性分析方法对2009年1月-2012年8月在感染科住院治疗的143例患儿,非肝炎病毒感染性肝炎的临床特征及诊断和治疗结果。结果143例非肝炎病毒感染相关性肝炎患儿的临床症状主要表现为发热占61.54%、纳差占46.35%、腹泻腹胀占32.17%、咳嗽占31.47%、恶心呕吐占29.37%;患儿的临床体征主要表现为肝脏肿大占30.77%、扁桃体肿大占28.67%、淋巴结肿大占23.08%、脾大占18.18%;入院时指标谷丙转氨酶(ALT)、谷草转氨酶(AST)异常分布率最高,分别为92.13%、88.11%,出院时分别为6.99%、5.59%;治疗前143例患儿的ALT、AST水平分别为(365.67±38.44)IU/L、(268.93±36.72)IU/L,治疗后分别为(159.53±26.74)IU/L、(84.92±9.33)IU/L,治疗后ALT、AST均明显的下降且治疗前后差异有统计学意义(P<0.05)。结论儿童非肝炎病毒感染相关性肝炎的临床表现与病毒感染相关性肝炎的临床表现非常相似,要综合实验室各种指标及病原学检查,并进行综合治疗。%OBJECTIVE To explore the diagnosis of the children with viral infection‐associated hepatitis and observe the therapeutic effect so as to provide guidance for clinical diagnosis and treatment of the children with hepatitis vi‐rus infections .METHODS A total of 143 children with hepatitis virus infections who were hospitalized the infection control department from Jan 2009 to Aug 2012 were enrolled in the study ,then the clinical characteristics and the results of diagnosis and treatment of the participants were retrospectively analyzed .RESULTS Of the 143 children presenting various clinical manifestations ,61 .54% had fever ,46 .35

  16. Diagnosis and treatment of penetrating anorectal wounds

    Institute of Scientific and Technical Information of China (English)

    LIU Xin-sheng; HUI Xi-zeng; ZHANG Yang-de; LI Kun

    2006-01-01

    Objective:To research the diagnosis and effective treatment of penetrating anorectal wounds.Methods: Retrospective analysis was done in 16 cases of penetrating anorectal wounds from 1985 to 2004.Debridement and suture of anorectal and vesical wounds,effective diversion of fecal and urinary stream and sufficient presacral drainage were performed in all cases.Results: All the 16 cases were cured. Among them, 2cases with infection in presacral space were cured by sufficient drainage after operation, one case was cured by secondary repair after anal sphincter was repaired unsuccessfully and one case with rectovesical fistula was cured with conservative treatment. None of them suffered from complications such as anal stenosis, dysuria or importence etc.Conclusions: For penetrating anorectal wound, to master early recognition of concomitant injures, to select appropriate surgical intervention and to strengthen perioperative treatment are the keys to improve the curative effects.

  17. Tuberculosis: current trends in diagnosis and treatment.

    Science.gov (United States)

    Bello, A K; Njoku, C H; Njoku, A K

    2005-12-01

    Among communicable diseases, tuberculosis (TB) is the second leading cause of death worldwide, killing nearly 2 million people each year. It is estimated that about one-third of the world population are infected with TB (2 billion people) and about 10% of this figure will progress to disease state. Most cases are in the less-developed countries of the world. Tuberculosis incidence has been on the increase in Africa, mainly as a result of the burden of HIV infection. Definitive diagnosis of tuberculosis remains based on culture for Mycobacterium tuberculosis, but rapid diagnosis of infectious tuberculosis by simple sputum smear for acid fast bacilli remains an important tool, as more rapid molecular techniques are being developed. Treatment with several drugs for 6 months or more can cure more than 95% of patients. Direct observation of treatment, a component of the recommended five-element DOTS strategy, is judged to be the standard of care by most authorities. Currently only a third of cases worldwide are treated using this approach. There may be need to modify the treatment modalities especially with the choice of drugs and duration of therapy when TB infection occurs in special situation like pregnancy, liver disease, renal failure or even in coexistence with HlV/AIDS or the drug resistant state.

  18. Avian luxations: occurrence, diagnosis and treatment.

    Science.gov (United States)

    Azmanis, Panagiotis N; Wernick, Morena B; Hatt, Jean-Michel

    2014-01-01

    Whereas the treatment of fractures in birds has been a matter of multiple studies and reviews, comparatively little information is available for the treatment of luxations in birds. In this article, we review the current knowledge regarding the frequency, etiology, clinical presentation, diagnosis, and treatment of luxations in birds, aiming to guide the clinician in private practice as well as future research. The type, the localization, and the frequency of luxation do not follow a concrete pattern. In general, pet and aviary birds are more susceptible to leg and spinal luxations while in wild birds wing luxations are more frequently observed. Diagnosis is made on the basis of detailed orthopedic and radiographic examinations. Conservative management and coaptation has been successfully used in carpal, minor elbow, shoulder, coracoid, and metatarsophalangeal luxations. Surgical management is recommended in palatine bone, metacarpophalangeal, severe elbow, coxofemoral, stifle, and intertarsal joint luxations. The techniques, which have been applied, include arthrodesis, femoral head osteotomy, polymer rods, bone plates, and internal and external fixation in various combinations. Currently, there are no controlled studies, which underline the advantages and disadvantages of each technique.

  19. Diagnosis and treatment of prostatic abscess

    Directory of Open Access Journals (Sweden)

    Paulo Oliveira

    2003-02-01

    Full Text Available OBJECTIVES: Present and discuss the pathogenesis, diagnostic methods and treatment of the prostatic abscess. MATERIALS AND METHODS: We have retrospectively studied the medical records of 9 patients diagnosed and treated for prostatic abscess, between March 1998 and December 2000, assessing age, context, associated diseases, and diagnostic and therapeutic methods. We have compared the data found with those described in literature, based on Medline data. RESULTS: Mean age was 52.6 years. Three patients had previous diabetes mellitus diagnosis, and one was infected by HIV virus. Transrectal ultrasound of the prostate confirmed the diagnosis of prostatic abscess in all 7 cases in which it was performed. All cases received antibiotic treatment, and 77.8% needed concomitant surgical treatment. Two cases of microabscess were treated only with antibiotics. Four patients were submitted to perineal catheter drainage, 2 were submitted to transurethral resection of the prostate (TURP, and one patient required both procedures. Mean hospitalization time was 11.2 days, and most frequent bacterial agent was S. aureus. All patients were discharged from the hospital, and there was no death in this series. CONCLUSIONS: Prostatic abscess should be treated with broad-spectrum antibiotics and surgical drainage (perineal puncture or TURP. Microabscess may heal without surgery.

  20. Pediatric insomnia: clinical, diagnosis, and treatment.

    Science.gov (United States)

    Miano, Silvia; Peraita-Adrados, Rosa

    2014-01-01

    Pediatric insomnia is an extrinsic sleep disorder subdivided into two categories: behavioral insomnia and insomnia related to medical, neurological, and psychiatric diseases. This review will cover several types of insomnia, comorbidities and specific pediatric therapies according to clinical characteristics and age. Behavioral insomnia should be differentiated from pediatric insomnia due to medical conditions, mostly occurring during the first year of life. Multiple night awakenings and diurnal hypersomnolence are strong indicators of insomnia due to medical conditions. Insomnia during adolescence and pediatric insomnia associated with psychiatric comorbidity, cognitive disabilities and epilepsy, will be discussed in terms of diagnosis, clinical features and implications for treatment.

  1. Cerebral salt wasting: pathophysiology, diagnosis, and treatment.

    Science.gov (United States)

    Yee, Alan H; Burns, Joseph D; Wijdicks, Eelco F M

    2010-04-01

    Cerebral salt wasting (CSW) is a syndrome of hypovolemic hyponatremia caused by natriuresis and diuresis. The mechanisms underlying CSW have not been precisely delineated, although existing evidence strongly implicates abnormal elevations in circulating natriuretic peptides. The key in diagnosis of CSW lies in distinguishing it from the more common syndrome of inappropriate secretion of antidiuretic hormone. Volume status, but not serum and urine electrolytes and osmolality, is crucial for making this distinction. Volume and sodium repletion are the goals of treatment of patients with CSW, and this can be performed using some combination of isotonic saline, hypertonic saline, and mineralocorticoids.

  2. Photographic-assisted diagnosis and treatment planning.

    Science.gov (United States)

    Goodlin, Ron

    2011-04-01

    The advent of digital photography allows the practitioner to show the patient the photographs immediately, to co-diagnose, and to work with the patient chairside or in a consult room while showing the patient some simple imaging techniques, such as whitening the teeth, making the teeth look longer, and showing the effects of orthodontics or veneers to get better alignment and other factors of smile design and esthetic dentistry. This article describes recommended digital dental photographic equipment, how to produce the standard series of diagnostic dental photographs, photographic assisted diagnosis and treatment planning including a discussion of anthropometrics and cephalometrics, and digital imaging techniques.

  3. Application of electronic bronchoscopy in the diagnosis and treatment of children with lobar pneumonia%电子支气管镜应用于儿童大叶性肺炎的疗效观察

    Institute of Scientific and Technical Information of China (English)

    李虎; 张玲; 刘青; 华亚军

    2015-01-01

    Objective To evaluate the value of electronic bronchoscopy and bronchoalveolar lavage on pathogen diagnosis and treatment for children with lobar pneumonia. Methods The clinical data of 128 children with lobar pneumonia was retrospectively analyzed. The data about electronic bronchoscopy and bronchoalveolar lavage of these children was collected, and the efficacy of electronic bronchoscope treatment and non-electronic bronchoscope treatment was compared. Results The total fever course, time of improvement of the symptoms and signs, time of C-reactive protein level back to normal and duration of hospital stay were obviously shorter in the lavage group than in the control group (all P<0. 05). The efficiency of the lavage group was 100%, and 94. 3% of the control group (χ2=10. 395, P=0. 006). The positive observation of FQ-MP-DNA by BALF pathogen detection took up 46. 6%, and the positive observation of bacterial culture accounted for 27. 6%. Conclusion The early application of electronic bronchoscope in diagnosis and treatment can effectively promote lung recruitment and absorption of inflammation, de-fine the pathogens and shorten the course of disease, which could achieve the dual benefits of diagnosis and treat-ment.%目的 观察评估电子支气管镜检查和肺泡灌洗术对儿童大叶性肺炎的诊治效果. 方法 回顾性分析本院明确诊断为大叶性肺炎的128例患儿的临床资料,收集患儿电子支气管镜检查及支气管肺泡灌洗术资料,并对比电子支气管镜治疗与非电子支气管镜治疗的临床疗效. 结果 灌洗组患儿总热程、症状好转时间、体征消失时间、CRP恢复时间及住院天数均低于对照组( P均<0. 05 ) ,灌洗组患儿有效率100%;对照组有效率94. 3%,两组疗效比较,具有明显统计学差异(χ2 =10. 395,P=0. 006). 患儿BALF病原学检查FQ-MP-DNA检测阳性者占46. 6%,细菌培养阳性结果占27. 6%. 结论 早期进行电子支气管镜诊治,能够明确病

  4. [Short bowel syndrome in children: a diagnosis and management update].

    Science.gov (United States)

    Valdovinos, D; Cadena, J; Montijo, E; Zárate, F; Cazares, M; Toro, E; Cervantes, R; Ramírez-Mayans, J

    2012-01-01

    Short bowel syndrome (SBS) refers to the sum of the functional alterations that are the result of a critical reduction in the length of the intestine, which in the absence of adequate treatment, presents as chronic diarrhea, chronic dehydration, malnutrition, weight loss, nutriment and electrolyte deficiency, along with a failure to grow that is present with greater frequency during the neonatal period. The aim was to carry out a review of the literature encompassing the definition and the most frequent causes of SBS, together with an understanding of its physiopathology, prognostic factors, and treatment. An Internet search of PubMed articles was carried out for the existing information published over the last 20 years on SBS in children, using the keywords "short bowel syndrome". From a total of 784 potential articles, 82 articles were chosen for the literature review. The treatment of patients presenting with SBS is quite a challenge and therefore it is necessary to establish multidisciplinary management with a focus on maintaining optimal nutritional support that covers the necessities of growth and development and at the same time provides a maximum reduction of short, medium, and long-term complications. The diagnosis and treatment of a child with SBS require a team of professionals that are experts in gastroenterologic, pediatric, and nutritional management. The outcome for the child will be directly related to opportune management, as well as to the length of the intestinal resection and the presence or absence of the ileocecal valve.

  5. Mialgias: Approaches to differential diagnosis, treatment

    Directory of Open Access Journals (Sweden)

    Nadezhda Aleksandrovna Shostak

    2013-01-01

    Full Text Available Differential diagnosis in muscle pains often presents great difficulties so all existing signs of the disease should be carefully considered to make its diagnosis and to prescribe adequate therapy. The paper considers the causes of muscle pains, laboratory and instrumental studies (immunological tests, determination of the level of specific muscular enzymes, primarily creatine phosphokinase – CPK, etc., and the main reasons for enhanced plasma CPK activity. It also describes acute and chronic mialgias associated with enhanced plasma CPK activity, as well as diseases in which mialgias are related to the normal level of CPK, myofascial syndrome (MFS and fibromyalgia (FM in particular. The characteristic features of MFS are given in its diagnostic criteria. It is stated that a differential diagnosis should be made between MFS and major muscle pain-associated abnormalities, such as polymyalgia rheumatica, FM, etc. Diagnosticcriteria for polymyalgia rheumatica are given. A MFS treatment algorithm is presented. Local exposure methods applied to altered musculoligamentous structures in combination with myorelaxants and non-steroidal anti-inflammatory drugs assume paramount importance in MFS.

  6. Diagnosis and treatment of gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Raul; Badillo; Dawn; Francis

    2014-01-01

    Gastroesophageal reflux disease(GERD) is a common disease with a prevalence as high as 10%-20% in the western world. The disease can manifest in various symptoms which can be grouped into typical,atypi-cal and extra-esophageal symptoms. Those with the highest specificity for GERD are acid regurgitation and heartburn. In the absence of alarm symptoms,these symptoms can allow one to make a presumptive diagnosis and initiate empiric therapy. In certain situations,further diagnostic testing is needed to confirm the diagnosis as well as to assess for complications or alternate causes for the symptoms. GERD complications include erosive esophagitis,peptic stricture,Barrett’s esophagus,esophageal adenocarcinoma and pulmonary disease. Management of GERD may involve lifestyle modification,medical therapy and surgical therapy. Life-style modifications including weight loss and/or head of bed elevation have been shown to improve esophageal pH and/or GERD symptoms. Medical therapy involves acid suppression which can be achieved with antacids,histamine-receptor antagonists or proton-pump inhibitors. Whereas most patients can be effectively managed with medical therapy,others may go on to require anti-reflux surgery after undergoing a proper pre-operative evaluation. The purpose of this review is to discuss the current approach to the diagnosis and treatment of gas-troesophageal reflux disease.

  7. A PROPOSITION FOR THE DIAGNOSIS AND TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE IN CHILDREN - A REPORT FROM A WORKING GROUP ON GASTROESOPHAGEAL REFLUX DISEASE

    NARCIS (Netherlands)

    VANDENPLAS, Y; ASHKENAZI, A; BELLI, D; BOIGE, N; BOUQUET, J; CADRANEL, S; CEZARD, JP; CUCCHIARA, S; DUPONT, C; GEBOES, K; GOTTRAND, F; HEYMANS, HSA; JASINSKI, C; KNEEPKENS, CMF; KOLETZKO, S; MILLA, P; MOUGENOT, JF; NUSSLE, D; NAVARRO, J; NEWELL, SJ; OLAFSDOTTIR, E; PEETERS, S; RAVELLI, A; POLANCO, [No Value; SANDHU, BK; TOLBOOM, J

    1993-01-01

    In this paper, a Working Group on Gastro-Oesophageal Reflux discusses recommendations for the first line diagnostic and therapeutic approach of gastro-oesophageal reflux disease in infants and children. All members of the Working Group agreed that infants with uncomplicated gastro-oesophageal reflux

  8. A proposition for the diagnosis and treatment of gastro-oesophageal reflux disease in children: A report from a working group on gastro-oesophageal reflux disease

    NARCIS (Netherlands)

    Y. Vandenplas (Yvan); A. Ashkenazi (A.); D. Belli (D.); N. Boige (N.); J. Bouquet (Jan); S. Cadranel (S.); J.P. Cezard (J.); S. Cucchiara (S.); C. Dupont (C.); K. Geboes (K.); F. Gottrand; H.S.A. Heymans (Hugo); C. Jasinski (C.); C.M.F. Kneepkens (Frank); S. Koletzko (Sybille); P. Milla (Peter); J.F. Mougenot (J.); D. Nusslé (D.); J. Navarro (J.); S.J. Newell (S.); E. Olafsdottir (E.); S. Peeters (S.); A. Ravelli (A.); I. Polanco (I.); B. Sandhu; J.J. Tolboom (Jules)

    1993-01-01

    textabstractIn this paper, a Working Group on Gastro-Oesophageal Reflux discusses recommendations for the first line diagnostic and therapeutic approach of gastro-oesophageal reflux disease in infants and children. All members of the Working Group agreed that infants with uncomplicated gastro-oesoph

  9. Diagnosis and treatment of odontoid fracture in children%儿童齿状突骨折的诊治探讨

    Institute of Scientific and Technical Information of China (English)

    陈建松; 吴伟良; 朱建; 舒强

    2015-01-01

    目的 探讨儿童齿状突骨折的临床特点及治疗策略.方法 回顾性分析我院收治的7例齿状突骨折患儿,其中男5例,女2例;年龄3~12岁,平均5.6岁.致伤原因:2例为车祸伤,5例为高处坠落伤.根据Anderson-D' Alonzo分型,均为Ⅱ型骨折(5例为骨骺分离,2例为真性骨折).2例患儿合并脊髓损伤,其中1例单侧肢体麻痹,另1例高位截瘫.5例患儿行Minerva石膏技术治疗,1例大龄儿童行颈后路寰枢椎螺钉固定融合术,另1例合并肢体麻痹者行颈后路寰枢椎临时固定术.结果 高位截瘫患儿行Minerva石膏固定后,齿状突复位良好,但因肺部严重感染于伤后1个月死亡.余6例患儿均获随访,随访时间7~84个月(平均34个月),均达骨性愈合,愈合时间为2~4个月(平均2.6个月).Minerva石膏治疗的4例患儿颈部伸屈及旋转活动均正常,其中2例出现腋窝皮肤压疮.手术治疗的2例患儿,行寰枢椎融合术者,颈部左、右旋转仅30°,行寰枢椎临时固定者,颈部左右旋转约65°,该患儿于术后3个月神经功能完全恢复.结论 儿童齿状突骨折常表现为齿状突骨骺分离.复位及Minerva石膏固定是一种方便、有效的方法,可作为儿童齿状突骨折的首选治疗方法,后路内固定易引起颈部活动障碍,仅适用于少部分患儿,骨折愈合后需及时拆除内固定.%Objective To explore the clinical characteristics and treatment strategies of odontoid fractures in children.Methods A total of 7 pediatric patients with odontoid fractures were analyzed retrospectively.There were 5 males and 2 females with an average age of 5.6 (3-12) years.The causes were traffic accident (n =2) and fall (n =5).All of them belonged to type Ⅱ fracture according to the Anderson-DAlonzo classification.And the factures were synchondrosis (n =5) and real (n =2).Two patients had neurologic involvements of unilateral extremity paresthesia (n =1) and high paraplegia (n =1).Five patients

  10. [Diagnosis and treatment of patellar chondroblastoma].

    Science.gov (United States)

    Cheng, Qiang; Huang, Wei

    2013-12-01

    Chondroblastoma of the patella, rare occurred in patellar,is a kind of an uncommon benign bone tumor. Compared with giant cell tumor, the morbidity of chondroblastoma is lower. Meanwhile, its clinical manifestations are various, and images are very complicated. Therefore, the understanding of this kind of tumors may be limited even to the orthopedist. The differences of patellar chondroblastoma between other tumor in X-ray, CT and MRI is a spot in recent years. Sometimes patellar chondroblastoma coexists with aneurysmal bone cyst, which is a challenge to obtain an accurate pathological and radiological diagnosis. For the treatment, curettage and bone grafting is one the most popular method, but whether to perform a biopsy before surgery still remain controversy. Some new technique still has an unknown prospect for the treatment such as radiofrequency ablation.

  11. [Causes, diagnosis and treatment of suicidality].

    Science.gov (United States)

    Althaus, D; Hegerl, U

    2004-11-01

    In Germany, each year more than 11,000 people commit suicide. Rates of attempted suicide are estimated to be tenfold higher. Psychosocial as well as biological causes play an important role in the etiology of suicidality. Patients suffering from affective disorders, alcohol and drug abuse, and psychotic disorders are considered to be the most important high-risk groups. Careful diagnosis of suicidality is a precondition for successful therapy. Acute treatment is based on psychopharmacological as well as on psychotherapeutic strategies. In the case of acute danger, short-term goals consist in gaining time and actively providing direct support. In the long run, treatment of the underlying psychiatric disorder and stabilisation of the daily life situation become more important. There is no scientific evidence for the hypothesis that selective serotonin reuptake inhibitors (SSRIs) increase the risk of suicide.

  12. Estimation of children's radiation dose from cardiac catheterisations, performed for the diagnosis or the treatment of a congenital heart disease using TLD dosimetry and Monte Carlo simulation

    Energy Technology Data Exchange (ETDEWEB)

    Yakoumakis, E N; Gialousis, G I; Papadopoulou, Despina; Makri, Triantafillia; Pappouli, Zografia; Yakoumakis, Nikolaos; Papagiannis, Panayotis; Georgiou, Evangelos [Medical Physics Department, University of Athens, 75 Mikras Asias Street, Athens 11527 (Greece)], E-mail: gialousis@med.uoa.gr

    2009-06-15

    Entrance surface radiation doses were measured with thermoluminescent dosimeters for 98 children who were referred to a cardiology department for the diagnosis or the treatment of a congenital heart disease. Additionally, all the radiographic parameters were recorded and Monte Carlo simulations were performed for the estimation of entrance surface dose to effective dose conversion factors, in order to further calculate the effective dose for each child. For diagnostic catheterisations the values ranged from 0.16 to 14.44 mSv, with average 3.71 mSv, and for therapeutic catheterisations the values ranged from 0.38 to 25.01 mSv, with average value 5 mSv. Effective doses were estimated for diagnostic procedures and interventional procedures performed for the treatment of five different heart diseases: (a) atrial septal defect (ASD), (b) ventricular septal defect (VSD), (c) patent ductus arteriosus (PDA), (d) aorta coarctation and (e) pulmonary stenosis. The high levels of radiation exposure are, however, balanced with the advantages of cardiac catheterisations such as the avoidance of surgical closure and the necessity of shorter or even no hospitalisation.

  13. Laparoscopic diagnosis and treatment of nonpalpable testis

    Directory of Open Access Journals (Sweden)

    Francisco T. Denes

    2008-06-01

    Full Text Available INTRODUCTION: Treatment of the cryptorchid testicle is justified due to the increased risk of infertility and malignancy as well as the risk of testicular trauma and psychological stigma on patients and their parents. Approximately 20% of cryptorchid testicles are nonpalpable. In these cases, the videolaparoscopic technique is a useful alternative method for diagnosis and treatment. MATERIALS AND METHODS: We present data concerning 90 patients submitted to diagnostic laparoscopy for impalpable testicles. Forty-six patients (51.1% had intra-abdominal gonads. In 25 testicles of 19 patients, we performed a two stage laparoscopic Fowler-Stephens orchiopexy. The other 27 patients underwent primary laparoscopic orchiopexy, in a total of 29 testicles. RESULTS: We obtained an overall 88% success rate with the 2 stage Fowler-Stephens approach and only 33% rate success using one stage Fowler-Stephens surgery with primary vascular ligature. There was no intraoperative complication in our group of patients. In the laparoscopic procedures, the cosmetic aspect is remarkably more favorable as compared to open surgeries. Hospital stay and convalescence were brief. CONCLUSIONS: In pediatric age group, the laparoscopic approach is safe and feasible. Furthermore, the laparoscopic orchiopexy presents excellent results in terms of diagnosis and therapy of the impalpable testis, which is why this technique has been routinely incorporated in our Department.

  14. Diagnosis and treatment of hepatocellular carcinoma: Anupdate

    Institute of Scientific and Technical Information of China (English)

    Javier Tejeda-Maldonado; Ignacio García-Juárez; Jonathan Aguirre-Valadez; Adrián González-Aguirre; Mario Vilatobá-Chapa; Alejandra Armengol-Alonso; Francisco Escobar-Penagos; Aldo Torre; Juan Francisco Sánchez-ávila; Diego Luis Carrillo-Pérez

    2015-01-01

    Hepatocellular carcinoma (HCC) is one of the mostcommon malignancies leading to high mortality ratesin the general population; in cirrhotic patients, it isthe primary cause of death. The diagnosis is usuallydelayed in spite of at-risk population screening recommendations,i.e., patients infected with hepatitis B or Cvirus. Hepatocarcinogenesis hinges on a great numberof genetic and molecular abnormalities that lead totumor angiogenesis and foster their disseminationpotential. The diagnosis is mainly based on imagingstudies such as computed tomography and magneticresonance, in which lesions present a characteristicclassical pattern of early arterial enhancement followedby contrast medium "washout" in late venous phase.On occasion, when imaging studies are not conclusive,biopsy of the lesion must be performed to establish thediagnosis. The Barcelona Clinic Liver Cancer stagingmethod is the most frequently used worldwide andrecommended by the international guidelines of HCCmanagement. Currently available treatments includetumor resection, liver transplant, sorafenib and locoregionaltherapies (alcoholization, radiofrequencyablation, chemoembolization). The prognosis of hepatocarcinomais determined according to the lesion's stageand in cirrhotic patients, on residual liver function.Curative treatments, such as liver transplant, aresought in patients diagnosed in early stages; patients inmore advanced stages, were not greatly benefitted bychemotherapy in terms of survival until the advent oftarget molecules such as sorafenib.

  15. 5. Diagnosis and Treatment of Lyme Arthritis

    Science.gov (United States)

    Arvikar, Sheila L.; Steere, Allen C.

    2015-01-01

    SYNOPSIS In the United States, Lyme arthritis is the most common feature of late stage infection with the tick-borne spirochete, Borrelia burgdorferi, usually beginning months after the initial tick bite. However, in some patients, including most of those seen today, the earlier phases of the infection are asymptomatic and arthritis is the presenting manifestation of the disease. Patients with Lyme arthritis have intermittent or persistent attacks of joint swelling and pain in one or a few large joints, especially the knee, usually over a period of several years, without prominent systemic manifestations. Serologic testing is the mainstay of diagnosis. Synovial fluid PCR testing for B. burgdorferi DNA is often positive prior to treatment, but it is not a reliable marker of spirochetal eradication after antibiotic therapy. Responses to oral or intravenous antibiotic treatment are generally excellent, although a small percentage of patients have persistent synovitis after 2-3 months of oral and IV antibiotics, which usually then responds to anti-inflammatory therapies, disease modifying anti-rheumatic drugs (DMARDs), or synovectomy. This chapter reviews the clinical manifestations, diagnosis, and management of Lyme arthritis. PMID:25999223

  16. [Diagnosis and treatment of mixed dementia].

    Science.gov (United States)

    Hanyu, Haruo

    2012-09-01

    Vascular dementia (VaD)--secondary to cerebrovascular disease (CVD)--has been traditionally distinguished from Alzheimer's disease (AD), which is a purely neurodegenerative form of dementia. However, CVDs such as lacunes and white matter lesions are common in patients with AD, whereas certain pathological changes of AD, including senile plaques and tangles, are observed in elderly patients with VaD. These findings indicate that mixed vascular-degenerative dementia (MD) is the most common cause of dementia in the elderly. In the treatment and prevention of dementia, the accurate diagnosis of each individual type of dementia is vital. However, recognizing the distinction between these diseases can be difficult in clinical practice. This article provides an overview of MD, including the incidence, diagnosis, and treatment. In particular, we emphasize that functional brain imaging, including perfusion single photon emission computed tomography and benzodiazepine receptor binding measurement, in combination with morphological imaging (such as magnetic resonance imaging) is useful for distinguishing AD, VaD and MD. In addition to antiplatelet medications, cholinesterase inhibitors and N-methyl-D-aspartic acid antagonists may be effective in treating MD. Moreover the vascular risk factors also should be treated appropriately. The article describes the need for further studies to develop a better understanding of MD.

  17. 门冬酰胺酶相关儿童急性胰腺炎诊治研究进展%Progress of diagnosis and treatment of asparaginase associated pancreatitis in children

    Institute of Scientific and Technical Information of China (English)

    石苇

    2016-01-01

    门冬酰胺酶(ASP)是儿童急性淋巴细胞白血病和非霍奇金淋巴瘤联合化疗方案中的关键药物之一.ASP相关急性胰腺炎(AAP)是ASP的主要严重不良反应.现通过复习有关儿童AAP的近年国内外文献和我国《培门冬酶治疗急性淋巴细胞白血病和恶性淋巴瘤的专家共识》,以及对网络收集的历年来我国儿童AAP报道资料进行归纳与统计分析,参照国际AAP诊断标准,提出儿童AAP流行病学、临床表现、早期诊断和有效治疗要点,以及左旋门冬酰胺酶和培门冬酶的AAP临床对比.全文资料数据详尽,分析归纳依据充分,相关经验的临床可操作性强,对临床有效诊治儿童AAP具有较大的参考价值.%Asparaginase(ASP) is an important drug in the treatment of childhood acute lymphoblastic leukemia and non-Hodgkin lymphoma.Asparaginase associated pancreatitis (AAP) is the main treatment-adverse events of asparaginase.After reviewing the recent foreign literatures about AAP and the Chinese expert about polyethylene glycol conjugated asparaginase (PEG-ASP) in the treatment of acute lymphoblastic leukemia and malignant lymphoma with asparaginase,conclude and analysis the data about childhood AAP and show the epidemiology,clinical features,early diagnosis and effective treatment of children with AAP.Make clinical compare of L-asparaginase and PEG-ASP.Based on the full grasp of the relevant data,analyzing,introducing and integrating,this may be helpful to the diagnosis and treatment of childhood AAP.

  18. Diagnosis and treatment in acute scrotal problems in children%小儿阴囊急症的临床诊治经验

    Institute of Scientific and Technical Information of China (English)

    李骥; 杨艳芳; 毕建朋; 李梁斌; 樊宏杰; 陈小朋; 侯广军; 王家祥

    2015-01-01

    mergered with mumps,whose color doppler ultrasound showed testicular blood flow was rich,and one 12 years old case,whose ultrasound showed 4cm × 3cm × 2cm heterogeneity echo of mass and testicular like tissue instead of the normal testis.The sheath membrane inflammation was found in 17 cases,including newborn in 4 cases,1 m-1 y in 6 cases,1 y1 m-4 y in 7 cases.Thirteen cases existed diarrhea before onset and the onset time were more than 24 hours.The ultrasound in 14 cases showed that testicular blood flow were unclear.Testicular sheath membrane hemorrhage was diagnosed in 3 cases,which were all the newborn.Unilateral scrotum showed blue color.Ultrasound showed densely dotted echo and heterogeneity mass.Results In 63 cases of TT,54 cases were received unilateral testis resection and opposite side proceeded fixation due to the esticular necrosis.Six cases were received the testis reversion and bilateral fixation whose onset time were from 4 hours to 11 hours.One case appeared testicular atrophy.In 130 cases with TAT,82 cases were underwent testicular appendage resection,48 cases adopted conservative treatment of oral antibiotics.Forty-nine cases of epididymitis which proceeded testicular exploration and testicular membrane decompression,the rest of 50 cases received oral or intravenous antibiotics therapy and topical analgesic anti-inflammatory ointment treatment.1 case with orchitis was given conservative treatment and the other underwent necrotic tissue removed.In 17 cases with sheath membrane inflammation,14 cases,whose ultrasound showed vague blood flow,were underwent testicular membrane decompression and other 3 cases received anti-infection conservative treatment.1 case with sheath within membrane hemorrhage was given hemostatic conservative treatment and other 2 cases accepted evacuation of hematoma.Conclusion TAT was the commonest cause of acute scrotum disease in children,whose onset peak ranged from 7 to 13 years old.TT was the most urgent type,in which left

  19. Tuberculous Meningitis: Diagnosis and Treatment Overview

    Directory of Open Access Journals (Sweden)

    Grace E. Marx

    2011-01-01

    Full Text Available Tuberculous meningitis (TBM is the most common form of central nervous system tuberculosis (TB and has very high morbidity and mortality. TBM is typically a subacute disease with symptoms that may persist for weeks before diagnosis. Characteristic cerebrospinal fluid (CSF findings of TBM include a lymphocytic-predominant pleiocytosis, elevated protein, and low glucose. CSF acid-fast smear and culture have relatively low sensitivity but yield is increased with multiple, large volume samples. Nucleic acid amplification of the CSF by PCR is highly specific but suboptimal sensitivity precludes ruling out TBM with a negative test. Treatment for TBM should be initiated as soon as clinical suspicion is supported by initial CSF studies. Empiric treatment should include at least four first-line drugs, preferably isoniazid, rifampin, pyrazinamide, and streptomycin or ethambutol; the role of fluoroquinolones remains to be determined. Adjunctive treatment with corticosteroids has been shown to improve mortality with TBM. In HIV-positive individuals with TBM, important treatment considerations include drug interactions, development of immune reconstitution inflammatory syndrome, unclear benefit of adjunctive corticosteroids, and higher rates of drug-resistant TB. Testing the efficacy of second-line and new anti-TB drugs in animal models of experimental TBM is needed to help determine the optimal regimen for drug-resistant TB.

  20. Hearing Loss in Children: Screening and Diagnosis

    Science.gov (United States)

    ... Form Controls NCBDDD Cancel Submit Search The CDC Hearing Loss in Children Note: Javascript is disabled or is ... message, please visit this page: About CDC.gov . Hearing Loss Homepage Facts Noise-Induced Hearing Loss Genetics of ...

  1. Metabolic syndrome in children and adolescents - criteria for diagnosis

    Directory of Open Access Journals (Sweden)

    Mancini Marcio C

    2009-10-01

    Full Text Available Abstract In recent years, there has been a greater concern about the presence of obesity and metabolic syndrome in children and adolescents. However, there is no consensus regarding the diagnosis of metabolic syndrome in children and adolescents. It is evident that each component of the syndrome must be identified as early as possible in order to prevent definitive lesions. The question is how to do this and which cut-offs must be adopted for this diagnosis. For a matter of convenience, the definition chosen as the most appropriate is the one proposed by the IDF, with cut-offs fixed for pressure, lipids and glycemia, and abdominal circumference points assessed by percentile. Although on the one hand this definition could fail to include some children in the diagnosis of Metabolic Syndrome, on the other hand, it would be of easier acceptance as it does not use multiple tables to assess several anthropometric and metabolic criteria.

  2. Sonographic diagnosis of "acute abdomen" in children and adults

    Science.gov (United States)

    Vauth, Christoph; Englert, Heike; Fischer, Thomas; Kulp, Werner; Greiner, Wolfgang; Willich, Stephan N.; Stroever, Brigitte; Graf von der Schulenburg, Johann-Matthias

    2005-01-01

    Introduction The acute abdomen is the main term for an at first unclear emergency situation of the abdominal cavity. The acute abdomen belongs to the three most important reasons for the admission of patients into the emergency room. Further, this illness ranks 40% of all consultations in the ambulant care sector. The acute abdomen requires an early and direct diagnosis because of its potential of having a life threatening differential diagnosis. This HTA report aimed to assess the ultrasound diagnosis of the acute abdomen considering children and adults. This will be done from a medical and economic perspective. The differential diagnosis respectively the cause of the acute abdomen binds high direct treatment costs, especially in the stationary sector. Ultrasound diagnosis is a procedure that plays a big part in the differential diagnosis process and it is widely used in practise. Other research methods of diagnosing acute abdominal illness are: clinical examinations with inspection and palpation, surgical exploration and laparocopy as well as computer tomography and x-ray examination. Objectives The main objective of this HTA report is to assess what significance sonography should have within the examination strategy of the acute abdomen from the medical and economical view. Second, this HTA report will evaluate under which circumstances the ultrasonographic diagnosis of the acute abdomen, considering medical and economical quality classifications, is the alternative of choice to comparable diagnostic measures. Methods The target population this HTA report is aimed at are children and adults with acute abdomen or embedded differential diagnosis. A systematic literature search was conducted covering all relevant medical and HTA-databases. Furthermore, handsearch was conducted inside of the known data bases of HTA-institutions as well as from medical and economical journals. The following databases were searched in cooperation with DIMDI to identify relevant

  3. Pathogenesis, Diagnosis and Treatment of Hemochromatosis.

    Science.gov (United States)

    Zoller, Heinz; Henninger, Benjamin

    2016-01-01

    Hemochromatosis is a common cause of chronic liver disease and HFE genotyping allows decisive and non-invasive diagnosis. Molecular and clinical genetic studies have led to the identification of genes other than HFE in patients with inherited diseases associated with increased hepatic iron storage that can cause hemochromatosis, which adds complexity to a diagnostic approach to patients with suspected hemochromatosis. Despite major advances in genetics, hepatic iron quantification by non-invasive methods therefore remains the key to the diagnosis of hemochromatosis. Although associated with homozygosity for the C282Y polymorphism in the HFE gene in >80% of patients, hemochromatosis is a complex genetic disease with strong environmental disease modifiers. Testing for mutations in the non-HFE hemochromatosis genes transferrin receptor 2, hemojuvelin, HAMP and SLC40A1 is complex, costly and time-consuming. Demonstration of hepatic iron overload by liver biopsy or MRI is therefore required before such complex tests are carried out. The pathogenesis of chronic liver disease in hemochromatosis is mainly attributed to the redox potential of tissue iron, and only the more recent studies have focused on the toxic properties of circulating iron. Considering the fact that an increased saturation of transferrin and high iron in plasma are the hallmark of all hemochromatosis forms, an alternative view would be that toxic iron in the circulation is involved in the pathogenesis of hemochromatosis. Recent studies have shown an increased concentration of redox-active iron in plasma in patients with increased transferrin saturation. This finding supports the hypothesis that tissue iron may be the 'smoking gun' of iron-induced organ damage. Taken together, caring for patients with suspected or established hemochromatosis still remains a challenge, where understanding the genetics, biochemistry and cell biology of hemochromatosis will aid better diagnosis and treatment of affected

  4. 纤维支气管镜在小儿难治性肺炎诊断与治疗中的应用%Role of flexible bronchoscopy in the diagnosis and treatment of refractory pneumonia in children

    Institute of Scientific and Technical Information of China (English)

    安淑华; 王萌萌; 李金英; 郑博娟; 王艳艳; 赵清娟; 王宁

    2011-01-01

    Objective To evaluate the effectiveness of the flexible bronchoscopy in the diagnosis and treatment of refractory pneumonia among children.Methods Sixty children with refractory pneumonia were randomly divided into two groups: lavage and control (n = 30 each).The control group received conventional medical treatment.The lavage group was given flexible bronchoscopy besides conventional medical treatment.The therapeutic effects were compared between the two groups.The results of bacterial culture and detection of antibodies against Mycoplasma pneumoniae in bronchoalveolar lavage fluid (BALF) were observed.Results The coincidence of bacterial culture results between BALF and sputum samples was 63.3%, and there were no significant differences in the positive bacterial culture results between them.The coincidence of PCR test for antibodies against Mycoplasma pneumoniae between BALF and serum samples was 73.3%.The results of Fisher's exact test showed the positive rate of Mycoplasma pneumoniae antibodies of BALF was higher than that of serum ( P < 0.05 ).The effective rate in the lavage group was significantly higher than that in the control group ( 97% vs 73%; P < 0.01 ).Conclusions The flexible bronchoscopy is useful for the diagnosis and treatment of refractory pneumonia in children.%目的 探讨纤维支气管镜(简称纤支镜)在小儿难治性肺炎诊治中的作用.方法 60例确诊为难治性肺炎的住院患儿,随机分为灌洗组和对照组,每组30例.灌洗组在给予常规治疗基础上行纤支镜治疗,对照组给予常规治疗.观察并分析两组疗效及灌洗组病原学检查结果.结果 肺泡灌洗液(BALF)培养与痰培养比较符合率为63.3%,两者阳性检出率差异无统计学意义.BALF支原体PCR检测与血清支原体抗体检测阳性率比较符合率为73.3%,BALF支原体PCR检测阳性率高于血清支原体抗体检测,差异有统计学意义(P<0.05).灌洗组有效率为97%,

  5. Allergy Diagnosis and Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... this page please turn Javascript on. Feature: Managing Allergies Allergy Diagnosis and Treatment Past Issues / Spring 2013 Table of Contents Diagnosis Testing for Allergies Knowing exactly what you are allergic to can ...

  6. Haemophilus influenzae Disease (Including Hib) Diagnosis and Treatment

    Science.gov (United States)

    ... Search The CDC Cancel Submit Search The CDC Haemophilus influenzae Disease (Including Hib) Note: Javascript is disabled or ... Compartir On this Page Diagnosis Treatment Complications Diagnosis Haemophilus influenzae , including Hib, disease is usually diagnosed with one ...

  7. Osteoarthritis: Symptoms, Diagnosis & Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Osteoarthritis Osteoarthritis: Symptoms, Diagnosis & Treatment Past Issues / Winter 2013 Table of Contents ... about possible other causes, such as rheumatoid arthritis. Diagnosis A combination of the following methods are used ...

  8. Diagnosis and treatment of disseminated intravascular coagulation.

    Science.gov (United States)

    Levi, M

    2014-06-01

    Disseminated intravascular coagulation (DIC) is a condition in which systemic activation of coagulation without a specific localization occurs, resulting in extensive formation of intravascular fibrin, particularly in small and midsize vessels. Disseminated intravascular coagulation may lead to several altered coagulation parameters, including a low platelet count, abnormal global clotting assays, low levels of physiological anticoagulant proteases, or increased fibrin degradation products. Also, more complex assays for activation of coagulation factors or pathways may indicate involvement of these molecules in DIC. None of these tests alone, however, can accurately ascertain or rebuff a diagnosis of DIC. Nonetheless, a combination of readily available routine assays may be instrumental in establishing a diagnosis of DIC and can also be useful to point to a subset of patients with DIC that may need definite, often costly, interventions in the hemostatic system. Current insights on relevant etiological pathways that may contribute to the occurrence of DIC have led to innovative therapeutic and adjunctive approaches to patient with DIC. Management options directed at the amelioration of hemostatic activation may tentatively be indicated and were found to be advantageous in experimental and clinical investigations. These treatments encompass elimination of tissue factor-mediated thrombin generation or restitution of normal anticoagulant function.

  9. Adrenal Insufficiency - Aetiology, Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Nazma Akter

    2015-03-01

    Full Text Available Adrenal insufficiency is caused by either primary adrenal failure or by hypothalamic-pituitary impairment of the corticotropic axis. Adrenal insufficiency, first codified in 1855 by Thomas Addison, remains relevant in 2014 because of its lethal nature. Though, it is a rare disease but is life threatening when overlooked. Main presenting symptoms such as fatigue, anorexia and weight loss are nonspecific, thus diagnosis is often delayed. The diagnostic work-up is well established but some pitfalls remain. The diagnosis is adequately established by the 250 μg ACTH (adrenocorticotropic hormone stimulation test in most cases. Glucocorticoids provide life saving treatment but long-term quality of life is impaired, perhaps because therapy is not given in a physiologic way. Dehydroepiandrosterone-replacement therapy has been introduced that could help to restore quality of life. It may be useful in pubertal girls, but not in adults. Monitoring of glucocorticoid-replacement is difficult due to lack of objective methods of assessment and is therefore largely based on clinical grounds. Thus, long-term management of patients with adrenal insufficiency remains a challenge, requiring an experienced specialist.

  10. Metabolic syndrome in children and adolescents - criteria for diagnosis

    OpenAIRE

    Mancini Marcio C

    2009-01-01

    Abstract In recent years, there has been a greater concern about the presence of obesity and metabolic syndrome in children and adolescents. However, there is no consensus regarding the diagnosis of metabolic syndrome in children and adolescents. It is evident that each component of the syndrome must be identified as early as possible in order to prevent definitive lesions. The question is how to do this and which cut-offs must be adopted for this diagnosis. For a matter of convenience, the d...

  11. Diagnosis and treatment of acute bronchitis.

    Science.gov (United States)

    Albert, Ross H

    2010-12-01

    Cough is the most common symptom bringing patients to the primary care physician's office, and acute bronchitis is usually the diagnosis in these patients. Acute bronchitis should be differentiated from other common diagnoses, such as pneumonia and asthma, because these conditions may need specific therapies not indicated for bronchitis. Symptoms of bronchitis typically last about three weeks. The presence or absence of colored (e.g., green) sputum does not reliably differentiate between bacterial and viral lower respiratory tract infections. Viruses are responsible for more than 90 percent of acute bronchitis infections. Antibiotics are generally not indicated for bronchitis, and should be used only if pertussis is suspected to reduce transmission or if the patient is at increased risk of developing pneumonia (e.g., patients 65 years or older). The typical therapies for managing acute bronchitis symptoms have been shown to be ineffective, and the U.S. Food and Drug Administration recommends against using cough and cold preparations in children younger than six years. The supplement pelargonium may help reduce symptom severity in adults. As patient expectations for antibiotics and therapies for symptom management differ from evidence-based recommendations, effective communication strategies are necessary to provide the safest therapies available while maintaining patient satisfaction.

  12. [Burnout syndrome: diagnosis, principles of treatment, prophylaxis].

    Science.gov (United States)

    Ovchinnikov, Yu V; Palchenkova, M V; Kalachev, O V

    2015-07-01

    Burnout syndrome is a socio-psychological phenomenon of emotional, motivational, and physical exhaustion as a result of chronic occupational stress. It is manifested as long-term emotional exhaustion, depersonalization and diminished personal and professional achievements. Burnout syndrome is common among health care workers, 'due to their high dedication, empathy for suffering patients, and decision-making related to life and health of patients. Personal, role and organizational factors influence on development of burnout. The clinical picture of burnout is multifactorial and can be described as a set of psychosomatic and somatic disorders, symptoms of social dysfunction. Diversity and non-specific symptoms of burnout syndrome determine the need for an interdisciplinary approach to its diagnosis. The leading role in solving problems related to stress and emotional burnout plays psychotherapy. The paper presents diagnostic criteria, risk factors, and methods of prevention and treatment of emotional burnout.

  13. Milk Fistula: Diagnosis, Prevention, and Treatment.

    Science.gov (United States)

    Larson, Kelsey E; Valente, Stephanie A

    2016-01-01

    Milk fistula is an uncommon condition which occurs when there is an abnormal connection that forms between the skin surface and the duct in the breast of a lactating woman, resulting in spontaneous and often constant drainage of milk from this path of least resistance. A milk fistula is usually a complication that results from a needle biopsy or surgical intervention in a lactating patient. Here, the authors present an unusual case of a spontaneous milk fistula which developed from an abscess in the breast of a lactating woman. The patient initially presented to the office with a large open wound on her breast, formed from skin breakdown, within which milk was pooling. She was treated with local wound care and cessation of breastfeeding, with appropriate healing of the wound and closure of the fistula with 6 weeks. Diagnosis, prevention, and treatment of milk fistula were reviewed.

  14. Food addiction-diagnosis and treatment.

    Science.gov (United States)

    Dimitrijević, Ivan; Popović, Nada; Sabljak, Vera; Škodrić-Trifunović, Vesna; Dimitrijević, Nina

    2015-03-01

    In this article we summarized the recent research of the food addiction, diagnosis, treatment and prevention, which is carried out in this area. The concept of food addiction is new and complex, but proven to be very important for understanding and solving the problem of obesity. First part of this paper emphasizes the neurological studies, whose results indicate the similarity of brain processes that are being activated during drug abuse and during eating certain types of food. In this context, different authors speak of "hyper-palatable", industrial food, saturated with salt, fat and sugar, which favor an addiction. In the section on diagnostic and instruments constructed for assessing the degree of dependence, main diagnostic tool is standardized Yale Food Addiction Scale constructed by Ashley Gearhardt, and her associates. Since 2009, when it was first published, this scale is used in almost all researches in this area and has been translated into several languages. Finally, distinguish between prevention and treatment of food addiction was made. Given that there were similarities with other forms of addictive behavior, the researchers recommend the application of traditional addiction treatment.

  15. Diagnosis and treatment of neurotransmitter disorders.

    Science.gov (United States)

    Pearl, Phillip L; Hartka, Thomas R; Taylor, Jacob

    2006-11-01

    The neurotransmitter disorders represent an enigmatic and enlarging group of neurometabolic conditions caused by abnormal neurotransmitter metabolism or transport. A high index of clinical suspicion is important, given the availability of therapeutic strategies. This article covers disorders of monoamine (catecholamine and serotonin) synthesis, glycine catabolism, pyridoxine dependency, and gamma-aminobutyric acid (GABA) metabolism. The technological aspects of appropriate cerebrospinal fluid (CSF) collection, shipment, study, and interpretation merit special consideration. Diagnosis of disorders of monoamines requires analysis of CSF homovanillic acid, 5-hydroxyindoleacetic acid, ortho-methyldopa, BH4, and neopterin. The delineation of new disorders with important therapeutic implications, such as cerebral folate deficiency and PNPO deficiency, serves to highlight the value of measuring CSF neurotransmitter precursors and metabolites. The impressive responsiveness of Segawa fluctuating dystonia to levodopa is a hallmark feature of previously unrecognized neurologic morbidity becoming treatable at any age. Aromatic amino acid decarboxylase and tyrosine hydroxylase deficiency have more severe phenotypes and show variable responsiveness to levodopa. Glycine encephalopathy usually has a poor outcome; benzoate therapy may be helpful in less affected cases. Pyridoxine-dependent seizures are a refractory but treatable group of neonatal and infantile seizures; rare cases require pyridoxal-5-phosphate. Succinic semialdehyde dehydrogenase deficiency is relatively common in comparison to the remainder of this group of disorders. Treatment directed at the metabolic defect with vigabatrin has been disappointing, and multiple therapies are targeted toward specific but protean symptoms. Other disorders of GABA metabolism, as is true of the wide spectrum of neurotransmitter disorders, will require increasing use of CSF analysis for diagnosis, and ultimately, treatment.

  16. Celiac disease: Prevalence, diagnosis, pathogenesis and treatment

    Institute of Scientific and Technical Information of China (English)

    Naiyana Gujral; Hugh J Freeman; Alan BR Thomson

    2012-01-01

    Celiac disease (CD) is one of the most common diseases,resulting from both environmental (gluten) and genetic factors [human leukocyte antigen (HLA) and nonHLA genes].The prevalence of CD has been estimated to approximate 0.5%-1% in different parts of the world.However,the population with diabetes,autoimmune disorder or relatives of CD individuals have even higher risk for the development of CD,at least in part,because of shared HLA typing.Gliadin gains access to the basal surface of the epithelium,and interact directly with the immune system,via both bans-and para-cellular routes.From a diagnostic perspective,symptoms may be viewed as either "typical" or "atypical'; In both positive serological screening results suggestive of CD,should lead to small bowel biopsy followed by a favourable clinical and serological response to the gluten-free diet (GFD) to confirm the diagnosis.Positive anti-tissue transglutaminase antibody or antiendomysial antibody during the clinical course helps to confirm the diagnosis of CD because of their over 99% specificities when small bowel villous atrophy is present on biopsy.Currently,the only treatment available for CD individuals is a strict life-long GFD.A greater understanding of the pathogenesis of CD allows alternative future CD treatments to hydrolyse toxic gliadin peptide,prevent toxic gliadin peptide absorption,blockage of selective deamidation of specific glutamine residues by tissue,restore immune tolerance towards gluten,modulation of immune response to dietary gliadin,and restoration of intestinal architecture.

  17. Current Diagnosis and Treatment of Halitosis

    Directory of Open Access Journals (Sweden)

    Mehmet Mustafa Kılıçkaya

    2015-11-01

    Full Text Available Halitosis or oral malodor is not a diagnosis, but is symptom. Halitosis, that we frequently encounter in ear, nose and throat practice can be the harbinger of some serious underlying disease. Therefore, diagnosis and to find the cause of the halitosis are important. Also halitosis treatment is necessary due to the social and psychological effects. Breath contains hundreds of volatile organic compounds that are by-products of our metabolism. Certain diseases such as nasopharynx cancer, larynx cancer ve lung cancer alter the mix of gases. Thus, the analysis of exhaled air has gained importance. New technologies lead to the development of new devices. And with these called electronic noses the analysis of exhaled air has becomes an important non-invasive diagnostic method. In the literature, halitosis and bad breath which is used as synonymus with oral malodor is the emission of unpleasant odor from mouth and nasal passage. It occurs in 25% of the population, approximately and it has a significant social and economic impact. Halitosis is classified as true halitosis (physiologic halitosis and pathologic halitosis, pseudohalitosis and halitophobia. The most common cause is intra-oral diseases. Among all these factors, the most important etiologic factor are the coating tongue. Other ear, nose and throat diseases such as rhinitis and sinusitis are seen among the most common extraoral causes. Treponema denticola, Porphyromonas gingivalis, Tanneralla forsythia, Fusobacterium nucleatum, Prevotella intermedia, Prevotella nigrescens, Actinobacilli and Solobacterium moorei are the bacteria which are commonly isolated from patients with halitosis and they are volatile sulfur compounds (VSCs producing ones as well. The treatment of halitosis should be carried out according to the etiology. In the physiologic halitosis tooth brushing, use of dental floss, tongue cleaning and chlorhexidine, cetylpyridinium chloride and zinc containing antimicrobial mouthwashes

  18. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available Oncofertility Consortium Children Procedures and Treatment Share My Story Share my story! Children Procedures and Treatment Is ovarian tissue cryopreservation available to girls under 18? How can ...

  19. The diagnosis and treatment of plastic bronchitis in children with status asthmaticus%儿童哮喘持续状态下的塑型性支气管炎

    Institute of Scientific and Technical Information of China (English)

    梁金鑫; 张琪; 胡凤华

    2012-01-01

    目的 研究哮喘持续状态患儿中塑型性支气管炎的发病特点,探讨其诊断和治疗方法.方法 从2008年1月至2011年5月收治4例哮喘持续状态合并塑型性支气管炎的患儿,回顾性分析其发病病因、临床特点、病原学、治疗过程及治疗效果.结果 4例患儿中行急诊纤维支气管镜检查3例,所有取出异物行病理检查,诊断为塑型性支气管炎,这4例患儿经气管插管、呼吸支持、纤维支气管镜灌洗、呼吸道管理及抗感染治疗,均痊愈出院.结论 确诊塑型性支气管炎需依靠支气管镜检查和病理组织学检查.哮喘持续状态患儿要高度警觉塑型性支气管炎的发生.%Objective To investigate the clinical characteristics, diagnosis and therapeutic approaches of plastic bronchitis in children with status asthmaticus. Methods The clinical profiles of 4 children with plastic bronchitis and plastic bronchitis admitted to Capital Institute of Pediatrics from Jan 2008 to May 2011 were retrospectively analyzed. Results Of 4 patients with plastic bronchitis, three received bronchoseope inspection, and all of them were confirmed plastic bronchitis by histopathology, and cured after mechanical ventdation, airway management and anti-infection treatment. Conclusion Plastic bronchitis diagnosis depends on bronchial endoscopy and histopathology. The occurrence of plastic bronchitis in patients with status asthmaticus should be alerted.

  20. Clinical practice. Diagnosis and treatment of cow's milk allergy

    NARCIS (Netherlands)

    Kneepkens, C. M. Frank; Meijer, Yolanda

    2009-01-01

    Introduction Cow's milk allergy (CMA) is thought to affect 2-3% of infants. The signs and symptoms are nonspecific and may be difficult to objectify, and as the diagnosis requires cow's milk elimination followed by challenge, often, children are considered cow's milk allergic without proven diagnosi

  1. Diagnosis and emergency treatment of headache in children%儿童头痛的诊断与急救处理

    Institute of Scientific and Technical Information of China (English)

    杨光; 邹丽萍

    2011-01-01

    Headache is a common complaint in children and adolescents.While the majority of headaches are self-limited and benign,headaches occasionally herald a life-threatening illness such as meningitis,intracranial hemorrhage,brain tumor or hydrocephalus.The primary objective of the emergency department pediatrician is to diagnose and manage any acute life-threatening cause of headache.For the non-emergency headache,the goal is to relieve the pain and the associated symptoms.%头痛是儿科急诊最常见的主诉之一,多为良性、自限性,但也可能是多种严重疾病如脑膜炎、颅内出血、颅内占位病变或脑积水的首发症状.小儿头痛的急诊处理原则主要是识别和处理危及生命的头痛病因,其次为缓解疼痛及处理伴随症状.

  2. Periodontal risk assessment, diagnosis and treatment planning.

    Science.gov (United States)

    Pihlstrom, B L

    2001-01-01

    The prevention and treatment of the periodontal diseases is based on accurate diagnosis, reduction or elimination of causative agents, risk management and correction of the harmful effects of disease. Prominent and confirmed risk factors or risk predictors for periodontitis in adults include smoking, diabetes, race, P. gingivalis, P. intermedia, low education, infrequent dental attendance and genetic influences. Several other specific periodontal bacteria, herpesviruses, increased age, male, sex, depression, race, traumatic occlusion and female osteoporosis in the presence of heavy dental calculus have been shown to be associated with loss of periodontal support and can be considered to be risk indicators of periodontitis. The presence of furcation involvement, tooth mobility, and a parafunctional habit without the use of a biteguard are associated with a poorer periodontal prognosis following periodontal therapy. An accurate diagnosis can only be made by a thorough evaluation of data that have been systematically collected by: 1) patient interview, 2) medical consultation as indicated, 3) clinical periodontal examination, 4) radiographic examination, and 5) laboratory tests as needed. Clinical signs of periodontal disease such as pocket depth, loss of clinical attachment and bone loss are cumulative measures of past disease. They do not provide the dentist with a current assessment of disease activity. In an attempt to improve the ability to predict future disease progression, several types of diagnostic tests have been studied, including host inflammatory products and mediators, enzymes, tissue breakdown products and subgingival temperature. In general, the usefulness of these tests for predicting future disease activity remains to be established in terms of sensitivity, specificity and predictive value. Although microbiological analysis of subgingival plaque is not necessary to diagnose and treat most patients with periodontitis, it is helpful when treating

  3. Diagnosis and treatment of irritable bowel syndrome.

    Science.gov (United States)

    Suares, Nicole C; Ford, Alexander C

    2011-05-01

    Irritable bowel syndrome (IBS) is a chronic functional disorder of the gastrointestinal tract. The exact cause is unknown. The diagnosis should be made on clinical grounds, using symptom-based criteria such as the Manning or Rome criteria, unless symptoms are thought to be atypical. Excluding celiac disease in all patients consulting with symptoms suggestive of IBS is worthwhile, but evidence for performing other investigations to exclude organic disease is not convincing. No medical therapy for IBS has been shown to alter the disease course, and treatment has traditionally been directed towards symptom relief. The aim should be to improve the predominant symptom reported by the patient. Fiber, peppermint oil, or antispasmodic agents are beneficial as first-line therapies in some patients. Where these fail, emerging data have confirmed the efficacy of antidepressants, drugs acting on the 5-hydroxytryptamine receptor, and probiotics in the short-term treatment of IBS. There are a number of novel therapies under development that show promise, including non-absorbable antibiotics, lubiprostone, and linaclotide. This article will provide a summary of diagnostic criteria for IBS, evidence to support investigations to exclude organic disease, and current and emerging therapies in this field.

  4. Soft-tissue rheumatism: diagnosis and treatment.

    Science.gov (United States)

    Reveille, J D

    1997-01-27

    Soft tissue rheumatism is one of the most common and most misunderstood categories of disorders facing the primary care physician. Among the more common types are subacromial bursitis, epicondylitis, trochanteric bursitis, anserine bursitis, and fibromyalgia. The keys to the diagnosis of soft-tissue rheumatism are the history and, more importantly, the physical examination. Extensive laboratory testing and radiographs are not as helpful in evaluating patients with these complaints. Treatment consists of nonsteroidal anti-inflammatory drugs (NSAIDs) and nonnarcotic analgesics. Especially in patients with localized disorders, intralesional injections of corticosteroids are particularly effective and safe and should be part of the armamentarium of the primary care practitioner. Fibromyalgia is a particularly challenging form of nonarticular rheumatism. The clinical presentation is rather characteristic, with the patient typically being a woman 30-60 years of age who presents with diffuse somatic pain. Patients often give a history of sleep disturbance, may be depressed, and show characteristic tender areas, or trigger points. Laboratory findings are normal. Management includes reassurance, correction of the underlying sleep disturbance with low doses of a tricyclic antidepressant, treatment with muscle relaxants and nonnarcotic analgesics or NSAIDs, and an exercise program with a strong aerobic component.

  5. [Borderline personality disorders: diagnosis and treatment].

    Science.gov (United States)

    Allilaire, Jean-François

    2012-10-01

    Borderline personality disorders are complex clinical states with highly polymorphic symptoms and signs, leading to delays in their diagnosis and treatment. All international classifications emphasize certain clinical criteria such as unstable identity and interpersonal relationships, feelings of emptiness or boredom, and pathological impulsiveness. The prevalence is about 2%, with a female-male sex ratio of 2 or 3 to 1. Both adolescents and adults may be affected There is a high risk of suicide, addictive behaviors, eating disorders, and criminality. These individuals frequently have a history of trauma in early childhood, such as separation, loss, physical or sexual abuse, or affective privation. Subjective signs and symptoms are particularly important in the diagnostic and therapeutic evaluation, and this requires an empathic and subtle approach. Standardized and semi-structured interviews may help to identify comorbidities such as thymic disorders, anxiety, addiction, eating disorders, and, in some cases, psychotic symptoms. The psychiatric bio-psycho-social model takes into account multiple pathogenic factors, such as trauma during early development, temperamental instability and other emotional disorders, as well as psychosocial, neurobiological (5HT etc.) and genetic vulnerabilities. Treatment requires optimal integration of psychotherapeutic and pharmacotherapeutic approaches. Emergency intervention must be available in case of delirious or suicidal behavior The clinical course is often lengthy and complex, but outcome may be favorable, provided the principal risk--suicide--is correctly managed,

  6. Diagnosis and treatment of chondroblastoma: Our experience

    Directory of Open Access Journals (Sweden)

    Slavković Slobodan

    2006-01-01

    Full Text Available The paper presented the results of diagnostics and treatment of patients with diagnosis of chondroblastoma, treated at the Institute of Orthopedic Surgery "Banjica", Belgrade. A total of 30 patients were analyzed, involving the period from 1975-2004. All important data were obtained using the complete medical documentation, physical examination, radiographic findings and available additional diagnostic procedures. The proximal part of tibia, the proximal part of humerus and the distal part of femur were the most common sites of tumor, accounting for 63% of cases. Higher incidence of chondroblastoma was found in male patients, especially in the second decade of life. Pathohistological tumor verification was done in all patients. The patients were then treated by different surgical procedures, both on account of primary lesion and recurrence. Curettage and osteoplasty using the auto- and homograft were carried out in 21 patients, wide resection in nine cases, and amputation was performed in three cases. One patient had radiotherapy due to recurrence of lesion, nevertheless malignant transformation of chondroblastoma occurred in time. Seven patients manifested local recurrence, and one of them even had relapse on two occasions and malignant transformation of chondroblastoma. Malignant lesions were found in three cases (10% of patients; one lesion was diagnosed as primary while other two malignancies were detected only after recurrence, and the treatment was completed by lower leg amputation.

  7. [Vestibular neuronitis: pathophysiology, diagnosis and treatment].

    Science.gov (United States)

    Zaper, Dinka; Adamec, Ivan; Gabelić, Tereza; Krbot, Magdalena; Isgum, Velimir; Hajnsek, Sanja; Habek, Mario

    2012-01-01

    Vestibular neuritis (VN) is one of the most common causes of peripheral vertigo. Caloric testing has been the traditional gold standard for detecting a peripheral vestibular deficit, but some recently developed bedside tests (head thrust, head heave, head shake and vibration test) were evaluated as a good alternative with similar sensitivity and specificity. These tests have shown both diagnostic value in the short term and prognostic value in the long term, and have availability and ease of use as an advantage. As an addition to clinical examination, vestibular evoked myogenic potentials can differentiate between involvement of superior and inferior branch of the vestibular nerve, but also between peripheral and central lesions. Although glucocorticoids are currently widely used in the treatment of VN, there is a lack of evidence for the validity of their administration. There are a number of high quality clinical trials that suggest vestibular rehabilitation exercises, which are based on the mechanisms of vestibular compensation, in the managment of VN. This review will focus on the latest developments in the pathophysiology, diagnosis and treatment of patients with VN.

  8. Diagnosis and emergency treatment of intracranial hypotension syndrome in children%儿童低颅压综合征的诊断与急救处理

    Institute of Scientific and Technical Information of China (English)

    王华; 李明磊

    2011-01-01

    儿童低颅压综合征是容易被忽视的问题,但临床上确实时有发生,应该引起广大医务工作者的注意.原发性低颅压综合征多与自身脑血管功能障碍、感染有关;继发性低颅压综合征多与医源性、继发于其他疾病以及外伤有关.低颅压综合征的主要临床症状是体位相关性头痛,一般通过脑脊液测压即可诊断.多数患儿经过体位调整后临床症状消失,重者可通过饮水、静脉滴注低渗(0.5%)或生理盐水给予纠正.儿童低颅压综合征重在预防,预后良好.%Intracranial hypotension syndrome is easily underestimated by doctors and patients,but its occurrence is not infrequent.Primary intracranial hypotension is usually associated with cerebral blood vessel disturbance and infections.Secondary intracranial hypotension is usually secondary to iatrogenic and other diseases or trauma.The main manifestation of intracranial hypotension syndrome is postural headache which may be diagnosed by cerebrospinal fluid pressure measurement during lumber puncture.The headache can disappear by posture adjustment in most children,or by water intake or intravenous administration of hypotonic (0.5%)or saline in serious case.Prognosis is good and precaution is most important for all.

  9. Advances in the diagnosis and treatment of children with plastic bronchitis%儿童塑型性支气管炎诊疗进展

    Institute of Scientific and Technical Information of China (English)

    张雪

    2013-01-01

    儿童塑型性支气管炎是一种较罕见的疾病,病因不明,起病隐匿,进展快,症状重,诊断和治疗难度大,病死率高.儿童塑型支气管炎被认为与某些疾病包括支气管哮喘、囊性纤维病、伴发急性胸部综合征的镰状细胞病、先天性心脏病以及各种呼吸道细菌性和病毒性感染有一定关系.关于儿童塑型性支气管炎的诊断和治疗目前仍较困难,临床医生应该警惕该病,做到早期诊断、早期治疗.%Children with plastic bronchitis,characterized by unknown origin,insidious onset,rapid progress,severe symptom and high mortality,is a relatively rare disease.Also,it is difficult to diagnose and treat with plastic bronchitis characterized by marked airway obstruction,via the formation of large gelatinous or rigid airway cast.It is associated with certain diseases including bronchial asthma,cystic fibrosis,accompanied with acute chest syndrome with sickle cell disease,congenital heart disease and bacterial and viral respiratory infection.Clinicians should be aware of this disease,and early bronchoscopy should be intervened.

  10. Diagnosis and Treatment of W(o)lffian Duct Torsion in Children%儿童午菲管扭转的诊治

    Institute of Scientific and Technical Information of China (English)

    胡文全; 魏文辉; 侯波; 商忠良; 宋澄; 戴向晨; 杨志强; 薛璇英

    1997-01-01

    目的:对儿童午菲管扭转病因、诊断及早期手术治疗进行分析总结.临床资料:本组7例均有剧烈运动或直接暴力损伤史.特征为以附睾头部为中心整个附睾肿胀,其与睾丸相连处明显触痛伴阴囊红肿.术中发现午菲管扭转并获病理证实.复查睾丸正常.结果:7例均做午菲管切除.术后输通脉液及抗生素,10天后炎症消退,疗效优于非手术治疗.结论:午菲管扭转须与睾丸及睾丸附件扭转和睾丸炎相鉴别.早期手术治疗有利于睾丸及附睾炎症吸收和功能恢复.%Seven children with W(o)lffian duet torsion had a history of strenuous exercise or direct violent injury.Swelling appeared in the epididymis,especially the head of epididymis.The scrotum became red and swollen.During operation,the torsional W(o)lffian duct was resected.Intravenous low molecular weight dextrose and antibiotics were given postoperatively.Torsion of W(o)lffian duct was related to the anatomical abnormality.strenuous exercise and direct violent injury.It should be differentiated from the torsion of testis and the orchitis.It is suggested that an early exploration would be beneficial to the resolution of inflammation and the restoration of the testicular function.

  11. Aortic stenosis: From diagnosis to optimal treatment

    Directory of Open Access Journals (Sweden)

    Tavčiovski Dragan

    2008-01-01

    Full Text Available Aortic stenosis is the most frequent valvular heart disease. Aortic sclerosis is the first characteristic lesion of the cusps, which is considered today as the process similar to atherosclerosis. Progression of the disease is an active process leading to forming of bone matrix and heavily calcified stiff cusps by inflammatory cells and osteopontin. It is a chronic, progressive disease which can remain asymptomatic for a long time even in the presence of severe aortic stenosis. Proper physical examination remains an essential diagnostic tool in aortic stenosis. Recognition of characteristic systolic murmur draws attention and guides further diagnosis in the right direction. Doppler echocardiography is an ideal tool to confirm diagnosis. It is well known that exercise tests help in stratification risk of asymptomatic aortic stenosis. Serial measurements of brain natriuretic peptide during a follow-up period may help to identify the optimal time for surgery. Heart catheterization is mostly restricted to preoperative evaluation of coronary arteries rather than to evaluation of the valve lesion itself. Currently, there is no ideal medical treatment for slowing down the disease progression. The first results about the effect of ACE inhibitors and statins in aortic sclerosis and stenosis are encouraging, but there is still not enough evidence. Onset symptoms based on current ACC/AHA/ESC recommendations are I class indication for aortic valve replacement. Aortic valve can be replaced with a biological or prosthetic valve. There is a possibility of percutaneous aortic valve implantation and transapical operation for patients that are contraindicated for standard cardiac surgery.

  12. Diagnosis and Treatment of Polycystic Ovary Syndrome.

    Science.gov (United States)

    Williams, Tracy; Mortada, Rami; Porter, Samuel

    2016-07-15

    Polycystic ovary syndrome is the most common endocrinopathy among reproductive-aged women in the United States, affecting approximately 7% of female patients. Although the pathophysiology of the syndrome is complex and there is no single defect from which it is known to result, it is hypothesized that insulin resistance is a key factor. Metabolic syndrome is twice as common in patients with polycystic ovary syndrome compared with the general population, and patients with polycystic ovary syndrome are four times more likely than the general population to develop type 2 diabetes mellitus. Patient presentation is variable, ranging from asymptomatic to having multiple gynecologic, dermatologic, or metabolic manifestations. Guidelines from the Endocrine Society recommend using the Rotterdam criteria for diagnosis, which mandate the presence of two of the following three findings- hyperandrogenism, ovulatory dysfunction, and polycystic ovaries-plus the exclusion of other diagnoses that could result in hyperandrogenism or ovulatory dysfunction. It is reasonable to delay evaluation for polycystic ovary syndrome in adolescent patients until two years after menarche. For this age group, it is also recommended that all three Rotterdam criteria be met before the diagnosis is made. Patients who have marked virilization or rapid onset of symptoms require immediate evaluation for a potential androgen-secreting tumor. Treatment of polycystic ovary syndrome is individualized based on the patient's presentation and desire for pregnancy. For patients who are overweight, weight loss is recommended. Clomiphene and letrozole are first-line medications for infertility. Metformin is the first-line medication for metabolic manifestations, such as hyperglycemia. Hormonal contraceptives are first-line therapy for irregular menses and dermatologic manifestations.

  13. Diagnosis and management of upper gastrointestinal bleeding in children.

    Science.gov (United States)

    Owensby, Susan; Taylor, Kellee; Wilkins, Thad

    2015-01-01

    Upper gastrointestinal bleeding is an uncommon but potentially serious, life-threatening condition in children. Rapid assessment, stabilization, and resuscitation should precede all diagnostic modalities in unstable children. The diagnostic approach includes history, examination, laboratory evaluation, endoscopic procedures, and imaging studies. The clinician needs to determine carefully whether any blood or possible blood reported by a child or adult represents true upper gastrointestinal bleeding because most children with true upper gastrointestinal bleeding require admission to a pediatric intensive care unit. After the diagnosis is established, the physician should start a proton pump inhibitor or histamine 2 receptor antagonist in children with upper gastrointestinal bleeding. Consideration should also be given to the initiation of vasoactive drugs in all children in whom variceal bleeding is suspected. An endoscopy should be performed once the child is hemodynamically stable.

  14. Diagnosis of Spontaneous Bacterial Peritonitis in Children by Reagent Strips

    Directory of Open Access Journals (Sweden)

    Fatemeh Farahmand

    2013-02-01

    Full Text Available This study was aimed to evaluate the efficacy of dipstick tests (leukocyte esterase and nitrite in diagnosis of spontaneous bacterial peritonitis (SBP in cirrhotic patients. Forty six children with ascites hospitalized between 2009 and 2010 in Children Medical Center were enrolled in this study. Reagent strip assays for leukocyte esterase and nitrite were performed on ascetic fluid and the results were compared to manual cell counting and ascitic fluid culture. SBP was defined as having a polymorphonuclear ascites count of ≥ 250/mm3. Twenty children were female and twenty six were male with mean age of 3±3.9 years. The sensitivity specificity, positive and negative predictive values of the leukocyte esterase reagent strips were all 100%. The sensitivity, specificity, positive and negative predictive value of the nitrite reagent strip test were 100%, 97%, 90% and 100% respectively. Leukocyte esterase reagent strips may provide a rapid, bedside diagnostic test for the diagnosis of SBP.

  15. Diagnosis and treatment of adolescent idiopathic scoliosis.

    Science.gov (United States)

    Burton, Monique S

    2013-11-01

    Scoliosis is defined as a lateral curvature of the spine greater than 10 degrees on radiography that is typically associated with trunk rotation. The three major types of scoliosis are congenital, idiopathic, and neuromuscular. Idiopathic scoliosis is divided into three subcategories based on the age of onset. Infantile idiopathic scoliosis affects patients younger than 3 years, juvenile idiopathic scoliosis appears in children between 3 and 10 years, and adolescent idiopathic scoliosis (AIS) occurs in skeletally immature patients older than 10 years. AIS is the most common form of idiopathic scoliosis. Approximately 2% to 4% of children aged 10 to 16 years have some degree of spinal curvature. Although some researchers view routine screening for AIS as controversial, well-child examinations and sports physicals are an optimal time to evaluate for AIS in the clinical setting. In 2008, the American Academy of Orthopaedic Surgeons, the Scoliosis Research Society, the Pediatric Orthopaedic Society of North America, and the American Academy of Pediatrics convened a task force to review the issues related to scoliosis screening and issued an information statement concluding that although screening has limitations, the potential benefits that patients with idiopathic scoliosis receive from early treatment can be substantial. Recommendations are now that females are screened twice, at age 10 and 12 years, and males once at age 13 or 14 years. Screening during routine well-child examinations and/or school-based evaluations will help identify patients who need ongoing monitoring. The evaluation of curvatures in conjunction with the level of skeletal maturity will help to guide the management of the curvature.

  16. 数字减影血管造影低剂量技术在儿童介入诊疗中的应用%Low-dose technology in the diagnosis and treatment of children interventional applications

    Institute of Scientific and Technical Information of China (English)

    刘晓晗; 王子军

    2015-01-01

    目的:通过对儿童心血管介入诊疗中X射线辐射剂量的统计与分析,探讨数字减影血管造影(DSA)低剂量技术在儿童辐射防护中的应用。方法:回顾性分析收治的18岁以下300例患者,3种常见的儿童介入操作的近两年的患者辐射水平与两年前相同操作患者辐射水平的技术分析。其中,房间隔缺损封堵术患者60例,室间隔缺损封堵术患者90例,动脉导管未闭封堵术患者150例。采用DSA机自动调节曝光条件,对入射有效剂量(ED)、剂量面积乘积(DAP)以及透视时间(F)进行测定。结果:两组结果在透视时间、入射ED存在显著性差异。近两年的统计数据显示患儿所受到的辐射剂量明显减少,入射ED与透视时间两者之间存在显著线性关系。不同心血管介入操作的DAP存在显著性差异,室间隔缺损封堵术的DAP仍较大。结论:低剂量技术有效减少了儿童辐射剂量,值得推广。%Objective:Cardiovascular interventional therapy for children Statistics and Analysis of X-ray radiation dose to explore low-dose technology in the protection of children. Methods:The hospital nearly two years the use of low-dose technology in the interventional diagnosis and treatment of children, a retrospective analysis of 18 patients under the age of three kinds of treated me institutes common childhood intervention operations radiation levels were nearly two years and two years ago the same operation of the radiation levels in patients with technical analysis, a total of 300 cases. Among them, 60 cases of atrial septal defect occlusion in patients with ventricular septal defect occlusion in patients with 90 cases, patent ductus arteriosus occlusion in patients with 150 cases. Using digital subtraction angiography machine automatically adjusts the exposure conditions. Including entrance dose ED(mGy), dose area product DAP and fluoroscopy time F were measured. Results:The two groups

  17. The diagnosis and treatment of focal fibrocartilaginous dysplasia in children%儿童骨骼局灶性纤维软骨发育不良的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    梅海波; 赫荣国; 朱光辉; 叶卫华; 唐进; 刘昆; 伍江雁; 胡欣; 谭谦

    2011-01-01

    目的 描述儿童骨骼局灶性纤维软骨发育不良(FFCD)的临床与X线特征,探讨其自然病程与治疗方法的选择.方法 2004年至2009年期间收治的4例儿童FFCD,男3例,女1例,发病年龄8个月~1岁9个月,就诊年龄为1岁~2岁1个月;病变位于胫骨近端2例、股骨远端1例、尺骨远端1例.4例均手术治疗.结果 2例(股骨与尺骨病变)经手术病灶切除、截骨矫形或骨痂牵伸延长,经过18个月和66个月随访观察,发现成角畸形或短缩畸形得到完全矫正;另2例胫骨近端病变因成角畸形>20°,患儿年龄≤2岁,采取单纯病灶切除,术后6个月和12个月的X线片,显示其成角畸形呈现进行性减少,但仍需继续观察.4例病理结果均为FFCD.结论 儿童胫骨FFCD具有自然矫正的潜力,特别是2岁以下者允许临床观察,但股骨、尺骨和肱骨FFCD因自然矫正潜力很小,常需要手术治疗.%Objective To review the clinic presentation, radiographic and MRI appearance of Focal Fibrocartilaginous Dysplasia(FFCD)in children. Methods We retrospectively assessed the radiological and MRI characteristics of FFCD in 4 children. The operative indications and methods were evaluated. Results We reported 4 children with FFCD which have been confirmed by pathology, of which distal femur was involved in one case and distal ulna in one child and proximal tibia in the remaining two infants. The cases involved in distal ulna and distal femur were treated with excision of the lesion, correction osteotomy or femur lengthening with Ilizarov techenique. The two infants with proximal tibia involvement underwent simple excision of the lesion in order to accelerate the correction and to confirm the diagnosis histologically, The. results of the two patients involved distal ulna and distal femur were satisfactory. The angular deformity were completely corrected and normal length was restored at follow-up 66 months and 18 months post-operatively. The proximal

  18. [Current diagnosis and treatment of acromegaly].

    Science.gov (United States)

    Melgar, Virgilio; Espinosa, Etual; Cuenca, Dalia; Valle, Vanessa; Mercado, Moisés

    2015-01-01

    Acromegaly is a rare condition characterized by the excessive secretion of growth hormone (GH), usually by a pituitary adenoma. The clinical manifestations of acromegaly include enlarged hands, feet and face, headaches, arthralgias, fatigue and hyperhydrosis. This condition is also associated with comorbidities such as hypertension and diabetes in a significant proportion of patients and frequently compromises life quality and life expectancy. The biochemical diagnosis of acromegaly rests on the demonstration of an autonomous secretion of GH by means of the measurement of glucose-suppressed GH levels and the serum concentration of insulin like growth factor type 1 (IGF-1). The localizing method of choice is magnetic resonance image of the selar area, which in 70 % of the cases reveals the presence of a macroadenoma. Even though the primary treatment is usually the transsphenoidal resection of the adenoma, the majority of patients require a multimodal intervention that includes radiotherapy, as well as pharmacological therapy with somatostatin analogs and dopamine agonists. The latter approach has resulted in a significant reduction in mortality and in an improvement in the quality of life.

  19. HIV Diagnosis and Treatment through Advanced Technologies

    Science.gov (United States)

    Zulfiqar, Hafiza Fizzah; Javed, Aneeqa; Sumbal; Afroze, Bakht; Ali, Qurban; Akbar, Khadija; Nadeem, Tariq; Rana, Muhammad Adeel; Nazar, Zaheer Ahmad; Nasir, Idrees Ahmad; Husnain, Tayyab

    2017-01-01

    Human immunodeficiency virus (HIV) is the chief contributor to global burden of disease. In 2010, HIV was the fifth leading cause of disability-adjusted life years in people of all ages and leading cause for people aged 30–44 years. It is classified as a member of the family Retroviridae and genus Lentivirus based on the biological, morphological, and genetic properties. It infects different cells of the immune system, such as CD4+ T cells (T-helper cells), dendritic cells, and macrophages. HIV has two subtypes: HIV-1 and HIV-2. Among these strains, HIV-1 is the most virulent and pathogenic. Advanced diagnostic methods are exploring new ways of treatment and contributing in the reduction of HIV cases. The diagnostic techniques like PCR, rapid test, EIA, p24 antigen, and western blot have markedly upgraded the diagnosis of HIV. Antiretroviral therapy and vaccines are promising candidates in providing therapeutic and preventive regimes, respectively. Invention of CRISPR/Cas9 is a breakthrough in the field of HIV disease management. PMID:28326304

  20. Naegleria fowleri: pathogenesis, diagnosis, and treatment options.

    Science.gov (United States)

    Grace, Eddie; Asbill, Scott; Virga, Kris

    2015-11-01

    Naegleria fowleri has generated tremendous media attention over the last 5 years due to several high-profile cases. Several of these cases were followed very closely by the general public. N. fowleri is a eukaryotic, free-living amoeba belonging to the phylum Percolozoa. Naegleria amoebae are ubiquitous in the environment, being found in soil and bodies of freshwater, and feed on bacteria found in those locations. While N. fowleri infection appears to be quite rare compared to other diseases, the clinical manifestations of primary amoebic meningoencephalitis are devastating and nearly always fatal. Due to the rarity of N. fowleri infections in humans, there are no clinical trials to date that assess the efficacy of one treatment regimen over another. Most of the information regarding medication efficacy is based on either case reports or in vitro studies. This review will discuss the pathogenesis, diagnosis, pharmacotherapy, and prevention of N. fowleri infections in humans, including a brief review of all survivor cases in North America.

  1. Narcolepsy: etiology, clinical features, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Jolanta B. Zawilska

    2012-10-01

    Full Text Available [u][/u] Narcolepsy is a chronic hypersomnia characterized by excessive daytime sleepiness (EDS and manifestations of disrupted rapid eye movement sleep stage (cataplexy, sleep paralysis, and hypnagogic/hypnopompic hallucinations. Mechanisms underlying narcolepsy are not fully understood. Experimental data indicate that the disease is caused by a loss of hypocretin neurons in the hypothalamus, likely due to an autoimmune process triggered by environmental factors in susceptible individuals. Most patients with narcolepsy and cataplexy have very low hypocretin-1 levels in the cerebrospinal fluid. An appropriate clinical history, polysomnogram, and multiple sleep latency test are necessary for diagnosis of the disease. Additionally, two biological markers, i.e., cerebrospinal fluid hypocretin-1 levels and expression of the DQB1*0602 gene, are used. The treatment of narcolepsy is aimed at the different symptoms that the patient manifests. Excessive daytime sleepiness is treated with psychostimulants (amphetamine-like, modafinil and armodafinil. Cataplexy is treated with sodium oxybate (GHB, tricyclic antidepressants, or selective serotonin and noradrenaline reuptake inhibitors. Sleep paralysis, hallucinations, and fragmented sleep may be treated with sodium oxybate. Patients with narcolepsy should follow proper sleep hygiene and avoid strong emotions.

  2. Pathogen diagnosis of children sepsis by LAMP technology

    Institute of Scientific and Technical Information of China (English)

    Yu-Cai Zhang

    2013-01-01

    Objective:To explore a rapid diagnostic method in neonatal sepsis and bacterial meningitis. Methods:The primers were designed and synthesized based on16S rRNA gene of Staphylococcus aureus.Four specimens ofStaphylococcus aureus,16 specimens of coagulase-negativeStaphylococci,2 specimens ofEnterococci,3 specimens ofStreptococcus,1 specimen ofMicrococcus,3 specimens ofEscherichia coli,4 specimens ofKlebsiella pneumoniae,3 specimens ofPseudomonas aeruginosa,2 specimens ofEnterobacter cloacae, and5 specimens of Acinetobacterwere tested by loop-mediated isothermal amplification(LAMP) assay.A total of118 clinical specimens of sepsis and non-sepsis were collected and detected with bothLAMP assay and blood culture.Results:By designing primers specific forStaphylococcus aureus, specimens containing different kinds of pathogens were carried out byLAMP assay, and our data showed LAMP technology for the specific detection ofStaphylococcus aureus in samples was successfully established.All clinical specimens of sepsis and non-sepsis were tested by both blood cultures andLAMP, and our data showed that compared wit blood culture method, theLAMP technology showed significantly high detection rate(P <0.01).Conclusions:As a quick and easy detection ofStaphylococcus aureus, theLAMP technology was successfully established, laid the foundation for the diagnosis and treatment of childrenStaphylococcus aureus sepsis, and showed great promotion and application value.

  3. Advances in the Diagnosis and Treatment of Acanthamoeba Keratitis

    Directory of Open Access Journals (Sweden)

    Benjamin Clarke

    2012-01-01

    Full Text Available This paper aims to review the recent literature describing Acanthamoeba keratitis and outline current thoughts on pathogenesis, diagnosis, and treatment as well as currently emerging diagnostic and treatment modalities.

  4. PSORIATIC ARTHRITIS: CLASSIFICATION, CLINICAL PRESENTATION, DIAGNOSIS, TREATMENT

    Directory of Open Access Journals (Sweden)

    T. V. Korotaeva

    2014-01-01

    Full Text Available The lecture gives basic information about psoriatic arthritis (PsA, a chronic inflammatory disease of the joints, spine, and enthesises from a group of spondyloarthritis. It describes the epidemiology of the disease and considers current ideas on its pathogenesis and factors influencing the development of PsA in psoriatic patients. The classification and clinical forms of PsA are presented. The major clinical manifestations of the disease are indicated to include peripheral arthritis, enthesitis, dactylitis, and spondylitis. The diagnosis of the disease is noted to be established on the basis of its detected typical clinical and radiological signs, by applying the CASPAR criteria. A dermatologist, rheumatologist, and general practitioner screen PsA, by actively detecting complaints, characteristic clinical and radiological signs of damage to the joints, and/or spine, and/or enthesises and by using screening questionnaires. There are data that patients with PsA are observed to be at higher risk for a number of diseases type 2 diabetes mellitus hypertension, coronary heart disease, obesity, metabolic syndrome, inflammatory bowel diseases, etc. The aim of current pharmacotherapy for PsA is to achieve remission or minimal activity of clinical manifestations of the disease, to delay or prevent its X-ray progression, to increase survival, to improve quality of life in patients, and to reduce the risk of comorbidities. The paper considers groups of medicines used to treat the disease, among other issues, information about biological agents (BA registered in the Russian Federation for the treatment of PsA. Most patients are mentioned to show a good response to this therapy option just 3–6 months after treatment initiation; however, some of them develop primary inefficiency. In this case, switching one BA to another is recommended. Some patients using a BA develop secondary treatment inefficiency, which is firstly due to the appearance of

  5. Dual diagnosis clients' treatment satisfaction - a systematic review

    OpenAIRE

    Schulte, S. J.; Meier, P.S.; Stirling, J.

    2011-01-01

    Abstract Background The aim of this systematic review is to synthesize existing evidence about treatment satisfaction among clients with substance misuse and mental health co-morbidity (dual diagnoses, DD). Methods We examined satisfaction with treatment received, variations in satisfaction levels by type of treatment intervention and by diagnosis (i.e. DD clients vs. single diagnosis clients), and the influence of factors other than treatment type on satisfaction. Peer-reviewed studies publi...

  6. Diagnosis, treatment, and prevention of gout.

    Science.gov (United States)

    Hainer, Barry L; Matheson, Eric; Wilkes, R Travis

    2014-12-15

    Gout is characterized by painful joint inflammation, most commonly in the first metatarsophalangeal joint, resulting from precipitation of monosodium urate crystals in a joint space. Gout is typically diagnosed using clinical criteria from the American College of Rheumatology. Diagnosis may be confirmed by identification of monosodium urate crystals in synovial fluid of the affected joint. Acute gout may be treated with nonsteroidal anti-inflammatory drugs, corticosteroids, or colchicine. To reduce the likelihood of recurrent flares, patients should limit their consumption of certain purine-rich foods (e.g., organ meats, shellfish) and avoid alcoholic drinks (especially beer) and beverages sweetened with high-fructose corn syrup. Consumption of vegetables and low-fat or nonfat dairy products should be encouraged. The use of loop and thiazide diuretics can increase uric acid levels, whereas the use of the angiotensin receptor blocker losartan increases urinary excretion of uric acid. Reduction of uric acid levels is key to avoiding gout flares. Allopurinol and febuxostat are first-line medications for the prevention of recurrent gout, and colchicine and/or probenecid are reserved for patients who cannot tolerate first-line agents or in whom first-line agents are ineffective. Patients receiving urate-lowering medications should be treated concurrently with nonsteroidal anti-inflammatory drugs, colchicine, or low-dose corticosteroids to prevent flares. Treatment should continue for at least three months after uric acid levels fall below the target goal in those without tophi, and for six months in those with a history of tophi.

  7. 小儿血液病治疗相关性大脑后部可逆性脑病的诊治%Diagnosis and treatment of therapy-related posterior reversible encephalopathy syndrome in children with hematologic disease

    Institute of Scientific and Technical Information of China (English)

    刘四喜; 文飞球; 王缨; 石红松; 麦惠容; 袁秀丽; 陈森敏; 李长钢

    2015-01-01

    目的:对治疗阶段并发大脑后部可逆性脑病综合征(PRES)的血液病患儿的临床资料进行分析,以提高对该病的认识。方法对我院3例血液病患儿治疗过程中并发PRES的发病时间、临床表现、影像特征及治疗转归等进行回顾性分析。结果2例急性淋巴细胞白血病患儿在诱导化疗阶段发生PRES,1例重型β地中海贫血患儿在亲缘性HLA全相合外周血造血干细胞移植术后4个月发生PRES。3例患儿的临床表现均为头痛、视觉障碍、高血压、痫性发作、精神异常及昏迷。3例患儿头颅MRI均显示顶枕叶对称性受累,其中1例患儿的MRI示双侧额颞部亦广泛受累。2例患儿脑病症状均短期内缓解,随访亦无神经系统异常表现;1例经多种抗癫痫药物治疗,随访2年仍有频繁癫痫发作。结论化疗药物和高血压是本组PRES病例发病的重要因素;PRES并不完全可逆,部分可见难治性癫痫等后遗症;及时行头颅MRI检查以早期诊治,也许能够避免永久性脑损伤。%Objective To analyze the clinical data of therapy-related posterior reversible encephalopathy syndrome (PRES) in three children with hematologic disease to understand this disease ulteriorly. Methods Retrospectively analyzed the clinical manifestations,magnetic resonance imaging (MRI) scanning of the brain and neurological outcomes of three cases of PRES at our hospital. Results Two children got PRES during acute lymphoblastic leukemia induction chemotherapy,and one children with majorβ-thalassemia got PRES after hematopoietic stem cell transplantation. All cases had headache,visual distur-bance,hypertension,seizures,mental anomaly and coma.The cranial MRI results showed all three cases were bilateral symmetri-cal in parietal and occipital lobes,and one case with extensive involvement in bilateral fontotemporal lobe in addition. Two cases showed complete recovery after symptomatic treatment during

  8. [Causes of late diagnosis of appendicitis in children].

    Science.gov (United States)

    Zlámal, Z

    1996-07-01

    The author evaluates the case-history of 51 children with perforated appendicitis treated during 1984-1995 at the First Surgical Clinic of the Faculty Hospital Olomouc. The purpose was to find an answer to the problem why in these children the diagnosis was delayed and whose was the fault of the substantial deterioration of the health status. In the evaluation four groups of causal responsibility are differentiated: a very rapid development of appendicitis-parents, arriving late in the surgery-paediatricians-surgeons. The authors discuss circumstances associated with the diagnostic error and delay.

  9. MRI diagnosis of bone marrow relapse in children with ALL

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H.; Hernanz-Schulman, Marta [Vanderbilt University, Department of Radiology and Radiological Sciences, Vanderbilt Children' s Hospital, Nashville, TN (United States); Frangoul, Haydar A. [Vanderbilt University, Department of Pediatric Hematology-Oncology, Vanderbilt Children' s Hospital, Nashville, TN (United States); Connolly, Susan A. [Harvard Medical School, Department of Radiology, Boston Children' s Hospital, Boston, MA (United States)

    2008-01-15

    Diffuse marrow replacement in acute leukemia is well known, but there are few reports describing the MRI features of pediatric leukemic relapse. Our purpose was to describe the MRI appearance of pediatric leukemic relapse. A total of 53 consecutive children with a history of ALL were referred for musculoskeletal MRI from 1 January 1998 to 28 February 2007 at one center, and from 1 January 2000 to 2 May 2007 at a second center. From this group, 14 children seen at initial diagnosis of leukemia and 2 children who underwent MRI after therapy for relapse were excluded. The remaining 37 children, 8 with relapse and 29 in remission, were studied. Images of patients with relapse and in remission were reviewed for type and configuration of marrow infiltration; coexisting marrow alterations including osteonecrosis or stress reaction were also reviewed. All eight children with relapse demonstrated nodular lesions with well-defined margins. Coexisting osteonecrosis was present in three children (38%) and pathologic fracture in one. Among the 29 children in remission, 9 showed stress reaction/fracture, 14 showed osteonecrosis and 9 showed ill-defined nodules, and in 5 the marrow was completely normal. Well-defined nodules in all patients with leukemic relapse suggest that this appearance is characteristic and distinct from the published findings of diffuse marrow replacement in acute leukemia. (orig.)

  10. 儿童急性胰腺炎的诊断、治疗及病因分析%The diagnosis, pathogenesis, and treatment of acute pancreatitis in children

    Institute of Scientific and Technical Information of China (English)

    王晓晔; 谢艺; 崔华雷

    2012-01-01

    Objective To analyze the characteristics of the clinical presentations,etiologies,diagnosis,and treatment of pediatric pancreatitis.Methods Sixty-three patients (39 males and 24 females) with diagnosis of pancreatitis were studied from March 2007 to March 2010.All patients were treated by abrosia,gastrointestinal decompression and intravenous hydration therapy,ulinastatin and octreotide acetate were also used to inhibit pancreatic enzyme secretion.Only 5 cases underwent abdominal cavity drainage.Results The morbidity of acute pancreatitis increased with age,especially from 9 to 14 years old.And the obese children were also susceptible to acute pancreatitis.The antibiotic therapy and the inhibition of pancreatic enzymes were effective for children with acute pancreatitis.All patients were cured.Conclusions The implement of antibiotic therapy and the inhibition of pancreatic enzymes in early phage are very important,surgical therapy should be adopted in severe cases.%目的 通过对63例确诊为急性胰腺炎患儿诊治过程的总结,分析近年来儿童急性胰腺炎的疾病特点,总结治疗经验.方法 2007年3月至2010年3月我院收治63例急性胰腺炎患儿,男39例,女24例,分析致病因素,经症状体征、化验检查、影像学检查确诊后,均予禁食、胃肠减压,静脉补液抗感染,应用抑制胰酶分泌药物(醋酸奥曲肽)及抗炎抑酶药物(乌司他丁)治疗,58例患儿经保守治疗痊愈,5例重症患儿经保守治疗无效行开腹腹腔引流术后治愈.结果 急性胰腺炎发病率逐年增高,年龄集中在9~14岁,肥胖儿发病率增高,全身抗感染结合抑制胰酶分泌治疗有效,63例患儿均治愈,其中5例急性重症患儿保守治疗无效后经手术治疗治愈.结论 及时应用抗生素及胰酶抑制剂治疗小儿急性胰腺炎有良好的治疗效果,急性重症胰腺炎应积极手术治疗,为防治疾病应做好健康宣教.

  11. 不完全性川崎病的临床特征、早期诊断及治疗%Clinical Features,Early Diagnosis and Treatment of Incomplete Kawasaki Disease in Children

    Institute of Scientific and Technical Information of China (English)

    余莉; 王一斌; 乔莉娜; 华益民; 朱琦; 石晓青; 周开宇; 刘瀚旻

    2015-01-01

    Objective To explore the clinical features, early diagnosis and treatment of incomplete Kawasaki disease ( iKD) in children in order to early recognition and diagnosis of iKDs. Methods Retrospectively study on children with KD( Ka-wasaki disease)including 174 cases of iKD patients and 317 cases of cKD(complete Kawasaki disease)patients admitted in the West China Second University hospital from May,2011 to April,2014. The sex,age,clinical features,laboratory tests in acute phase,IVIG( intravenous immunoglobulin) treatment and CALs( coronary artery lesions) were analysed between the iKDsand cKDs, respectively. Results ①There were no significant differences in sex and age between iKDs and cKDs(P>0. 05),but the inci-dences of exanthema,bilateral bulbar conjunctival injection,oral and pharyngeal hyperemia,strawberry tongue,erythema of palms and soles,cervical lymphadenopathy in iKDs were lower than in cKDs(P 0. 05).③The time of diagnosis in iKDswere later than in cKDs. There were no significant difference in the incidence of CALs,response of IVIG and duration of fever betweeniKDs and cKDs(P>0. 05). Conclusion The incidences of typical clinical symptoms of KD in iKDswere lower than in cKDs. These la-boratory tests including WBC,Hct,ESR,AST,ALT,PA,HDL,sterile pyuria are help for diagnosis of iKDs. The CALs caused by iKDs were decreased by using of IVIG within 10 days after initial fever.%目的:探讨不完全性川崎病的临床特征、诊断及治疗,为临床医生识别和早期诊断提供依据。方法回顾性分析2011年4月至2014年3月在我医院住院治疗的川崎病( Kawasaki disease,KD)患者临床资料,对174例不完全性川崎病( incomplete Kawasaki disease,iKD)及317例完全性川崎病( complete Kawasaki disease,cKD)的性别、发病年龄、临床表现、急性期实验室检查、IVIG( intravenous immunoglobulin)治疗及冠状动脉损伤( coronary artery lesions,CALs)进行比较。结果①iKD与cKD患者性别及年

  12. [The diagnosis of insulin dependent diabetes in children and teenagers].

    Science.gov (United States)

    Rocaboy, Claudette; Lebrun, Charlotte

    2016-01-01

    The conditions of the announcement of the diagnosis of diabetes in children and teenagers are key to helping them live as best as possible with the constraints of this chronic disease. The psychologist works as a mediator in order that the suffering of the child and their family is listened to and contained within the nursing team. This support facilitates the adaptation and reorganisation of their day-to-day life.

  13. Clinical practice: the diagnosis of imported malaria in children.

    Science.gov (United States)

    Maltha, Jessica; Jacobs, Jan

    2011-07-01

    The present paper reviews the diagnosis of imported malaria in children. Malaria is caused by a parasite called Plasmodium and occurs in over 100 countries worldwide. Children account for 10-15% of all patients with imported malaria and are at risk to develop severe and life-threatening complications especially when infected with Plasmodium falciparum. Case-fatality ratios vary between 0.2% and 0.4%. Children visiting friends and relatives in malaria endemic areas and immigrants and refugees account for the vast majority of cases. Symptoms are non-specific and delayed infections (more than 3 months after return from an endemic country) may occur. Microscopic analysis of the thick blood film is the cornerstone of laboratory diagnosis. For pragmatic reasons, EDTA-anticoagulated blood is accepted, provided that slides are prepared within 1 h after collection. Information about the Plasmodium species (in particular P. falciparum versus the non-falciparum species) and the parasite density is essential for patient management. Molecular methods in reference settings are an adjunct for species differentiation. Signals generated by automated hematology analyzers may trigger the diagnosis of malaria in non-suspected cases. Malaria rapid diagnostic tests are reliable in the diagnosis of P. falciparum but not for the detection of the non-falciparum species. They do not provide information about parasite density and should be used as an adjunct (and not a substitute) to microscopy. In case of persistent suspicion and negative microscopy results, repeat testing every 8-12 h for at least three consecutive samplings is recommended. A high index of suspicion and a close interaction with the laboratory may assure timely diagnosis of imported malaria.

  14. Diagnosis and treatmendt of non-organic cenuresis in children: Clínical Practice Guidelines

    OpenAIRE

    Meave Cueva Luis Guillermo; Díaz García Luisa; Garza Elizondo Rosalía

    2014-01-01

    Background: Bedwetting is an involuntary urination during sleep at the age of 5 years or older. Clinical Practice Guidelines (CPG) have been developed to improve decision-making strategies and standardize medical practice. The Ministry of health in Mexico developed the CPG diagnosis and treatment of non- organic enuresis at the first level of prevention in children. Its evidence is evaluated with the USPSTF (United States Preventive Services Task Force). Material and methods: Original arti...

  15. Diagnosis and treatment of 64 children with viral encephalitis complicated with respiratory failure%儿童病毒性脑炎合并呼吸衰竭64例诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    吴波; 张玉琴; 王晓敏; 雷梅芳; 刘晓军

    2016-01-01

    Objective To summarize the clinical features of children with viral encephalitis accompa-nied with respiratory failure,and to improve the early diagnosis and treatment. Methods The clinical data of 64 cases with viral encephalitis combined with respiratory failure in our unit from May 2005 to May 2015 were analyzed retrospectively. Results All children were characterized by sudden onset. Among them, 60 cases (93. 7%) had fever,50 cases(78. 1%) had convulsion onset,46 cases(71. 8%) had consciousness disorders, 30 cases(46. 8%) had positive pathological signs. Most of them developed respiratory failure in acute stage. Total 56 cases occurred central respiratory failure,6 cases occurred central respiratory failure with peripheral respiratory failure,2 cases occurred respiratory and circulatory failure. Total 46 cases underwent cerebrospinal fluid examination. Routine biochemical test found 32 abnormal cases,of which 10 cases had intracranial hyper-tension and 19 cases had leukocytosis,and 17 cases had increased protein content. Ten cases were positive in cerebrospinal fluid etiology examination,including herpes simplex virus positive in 8 cases,EB virus positive in 1 case,and coxsackie virus positive in 1 case. There were 6 of 64 cases with abnormal CT scans and 29 of 34 cases with abnormal MRI. The results of EEG examination were abnormal in all patients for the first time. The EEG of 48 cases showed diffuse slow waves-δ activity. EEG examination showed generalized discharges or focal discharges during treatment in 22 cases. Five cases of electrophysiological examination showed cervical spinal cord anterior horn injury. Total 24 cases were complicated with stress ulcer,4 cases with liver damage,6 cases with heart damage,4 cases with renal damage,1 case with lung damage. All cases underwent mechanical ventilation for 2-50 days. Total 33 cases(51. 5%) improved and discharged,14 cases died during hospitaliza-tion,17 cases were given up treatment. Total 25 cases had

  16. DIAGNOSIS AND TREATMENT OF THE PITUITARY METASTASES

    Institute of Scientific and Technical Information of China (English)

    连伟; 任祖渊; 苏长保

    2004-01-01

    Thee cases of pituitary metastases were reported. They all had operations and the pathological examination confirming the diagnosis. The clinical features of diabetes insipidus and extraocular nerve palsy were presented. In two cases, the original tumors were bronchioloalveolar carcinoma; in the other one, the original tumor was unknown. All three cases had poor outcome. These cases illustrate the fact that a pituitary metastasis can closely mimic a pituitary benign tumor, such as pituitary adenoma. Especially in the presence of suggestive symptoms such as diabetes insipidus and/or cranical nerve paralysis, the possibility of metastatic disease in the differential diagnosis of a pituitary mass should always be considered.

  17. Diagnosis and new treatments in genetic neuropathies.

    Science.gov (United States)

    Reilly, M M; Shy, M E

    2009-12-01

    The genetic neuropathies are a clinically and genetically heterogeneous group of diseases of which the most common types are Charcot-Marie-Tooth disease (CMT), the hereditary sensory and autonomic neuropathies and the distal hereditary motor neuropathies. More than 30 causative genes have been described, making an accurate genetic diagnosis increasingly possible. Although no specific therapies are yet available, research into their pathogenesis has revolutionised our understanding of the peripheral nervous system and allowed the development of rational approaches to therapy. The first therapeutic trials in CMT are currently underway. This review will suggest an approach to the diagnosis of these disorders and provide an update on new therapies.

  18. Treatment approaches for dual diagnosis clients in England

    OpenAIRE

    Schulte, S.; Meier, P.S.; Stirling, J.; Berry, M

    2008-01-01

    Introduction - Dual diagnosis (DD, co-occurrence of substance use and mental health problems) prevalence data in England are limited to specific regions and reported rates vary widely. Reliable information on actual service provision for dual diagnosis clients has not been collated. Thus a national survey was carried out to estimate dual diagnosis prevalence in treatment populations and describe the service provision available for this client population in drug/alcohol (DAS) and mental health...

  19. How Much are Emergency Medicine Specialists’ Decisions Reliable in the Diagnosis and Treatment of Pediatric Fractures?

    Directory of Open Access Journals (Sweden)

    Mohsen Mardani-Kivi

    2016-01-01

    Full Text Available Background: Considering the importance of an early diagnosis and proper decision-making in regards to the treatment of pediatric distal radius and elbow fractures, this study examines emergency medicine specialists’ accuracy in the diagnosis and treatment of these patients. Methods: From 2012 and 2013, children less than 14 years old who were referred to an academic hospital emergency department with elbow or distal radius fractures were enrolled. Initially, patients were examined by an emergency medicine specialist and then they were referred to an orthopedic surgeon. Type of fracture and the proposed treatment of two specialists were compared. Results: In total, there were 108 patients (54 patients in each group with a mean age of 8.1+3.3 years. Identical diagnosis in 48 cases (88.9% of distal radius and 36 cases (66.7% of elbow trauma were observed. We found a difference between diagnosis of the two specialists in diagnosing lateral condyle of the humerus fracture in the elbow group and growth plate fracture in the distal radius fracture group, but the differences were not significant. Among 108 patients, 70 patients (64.8% received identical treatment. Conclusion: Although the emergency medicine specialists responded similarly to the orthopedic specialists in the diagnosis of pediatric distal radius and elbow fractures, diagnosis of more complicated fractures such as lateral condylar humoral fractures, distal radius growth plate and for choosing the proper treatment option, merits further education.

  20. Diagnosis and treatment of inflammatory intestinovesical fistulas.

    Science.gov (United States)

    Szentgyörgyi, E; Kondás, J; Szöke, D; Balogh, A; Orbán, L

    1989-01-01

    The histories of 3 patients operated for inflammatory intestinovesical fistulas are reviewed. Two of them were treated for colovesical, one for ileovesical fistula. The questions concerning the development, diagnostics and surgical management are discussed in detail. The importance of cystoscopy in diagnosis is emphasized. In all three patients one-session operations were performed with good results.

  1. 支气管镜在儿童支气管黏液表皮样癌诊治中的应用%Application of bronchoscope in diagnosis and treatment of bronchial mucoepidermoid carcinoma in children

    Institute of Scientific and Technical Information of China (English)

    焦安夏; 刘玺诚; 饶小春; 马渝燕; 潘跃娜; 孟辰芳; 刘芳; 周春菊; 冯雪莉

    2015-01-01

    目的 探讨支气管镜在儿童支气管黏液表皮样癌诊断及介入治疗中的应用.方法 回顾性分析2013年4月至2015年6月首都医科大学附属北京儿童医院介入肺科经病理确诊的4例儿童支气管黏液表皮样癌的临床资料,分析其临床特征、胸部CT及支气管镜表现.结果 3例为低度恶性支气管黏液表皮样癌,1例为中度恶性(中分化)支气管黏液表皮样癌.发病年龄4岁11个月~10岁9个月.患儿均无特征性临床表现,以咳嗽、喘息、运动耐受不良为主要症状,2例伴咯血,术前误诊为肺炎、支气管哮喘、支气管异物等.胸部CT提示呼吸道内类圆形肿物,2例发生于左主支气管,1例发生于右支气管中间段,1例发生于右中叶支气管,有阻塞性肺不张或肺气肿.4例患儿均在全身麻醉下行支气管镜下病灶活检,3例行支气管镜下介入治疗切除肿物,1例行肺叶切除+支气管重建术.结论 儿童黏液表皮样癌无特征性表现,常出现咳嗽、喘息等呼吸道症状.支气管镜下组织活检对确诊有重要作用,对不能手术切除的肿瘤,支气管镜下介入治疗是一种有效的姑息治疗方法.%Objective To explore the application of bronchoscope in diagnosis and treatment of bronchial mucoepidermoid carcinoma in children.Methods The clinical data of 4 cases of bronchial mucoepidermoid carcinoma treated in Department of Interventional Pulmonology,Beijing Children's Hospital Affiliated to Capital Medical University from April 2013 to June 2015,were retrospectively analyzed,and their clinical manifestations,chest computed tomography(CT),bronchoscopic manifestations were analyzed.Results Among the 4 cases of bronchial mucoepidermoid carcinoma,3 cases were low-grade bronchial mucoepidermoid carcinoma,and 1 case was intermediate grade malignant.Onset of clinical manifestations occurred from the ages of 4 years and 11 months old to 10 years and 9 months old.All patients had no

  2. Alopecia areata in children : treatment with diphencyprone

    NARCIS (Netherlands)

    Schuttelaar, M L; Hamstra, J J; Plinck, E P; Peereboom-Wynia, J D; Vuzevski, V D; Mulder, P G; Oranje, A P

    1996-01-01

    We assessed the efficacy of diphencyprone (DPCP) treatment in a total of 26 children with alopecia areata (AA). Sixteen children had alopecia areata totalis (AAT) and 10 had alopecia areata localis (AAL). DPCP is an absolute contact sensitizer. Twenty-five children could be sensitized with a 2% DPCP

  3. Diagnosis and Treatment of Hypophyseal Cushing’s Syndrome

    OpenAIRE

    Kirilyuk, M.L.

    2014-01-01

    The paper deals with the questions on etiology, pathogenesis and diagnosis of hypophyseal Cushing’s syndrome. There are described the clinical picture of Cushing’s syndrome as well as the conditions associated with hypercorticoidism in the absence of Cushing’s syndrome. There are dwelt the principles of laboratory and instrumental diagnosis and treatment of this syndrome.

  4. Treatment of obesity-related hypertension in children and adolescents.

    Science.gov (United States)

    Halbach, Susan M; Flynn, Joseph

    2013-06-01

    The obesity epidemic has become a common concern among pediatricians, with an estimated 32 % of US children and adolescents classified as overweight and 18 % as obese. Along with the increase in obesity, a growing body of evidence demonstrates that chronic diseases, such as Type 2 diabetes, primary hypertension, and hyperlipidemia, once thought to be confined solely to adulthood, are commonly seen among the obese in childhood. Following a brief summary of the diagnosis and evaluation of hypertension in obese children and adolescents, this review will highlight recent research on the treatment of obesity-related hypertension. Pharmacologic and non-pharmacologic treatment will be discussed. Additionally, current and emerging therapies for the primary treatment of obesity in children and adolescents, which have been gaining in popularity, will be reviewed.

  5. Diagnosis and Treatment: Contemporary Practices in Special Education.

    Science.gov (United States)

    Ellis, Herbert G.

    The author reviews current practices in the educational diagnosis of exceptional children and proposes a model for more effective identification, screening, and evaluation of students with special needs. Problems and benefits of models in current use (multidisciplinary team approach, the training based model, and the psychometric approach) are…

  6. NEW INTERNATIONAL RECOMMENDATIONS FOR THE DIAGNOSIS AND TREATMENT OF GOUT

    Directory of Open Access Journals (Sweden)

    M. S. Eliseev

    2014-01-01

    Full Text Available The article is devoted to the discussion of the new recommendations for the diagnosis and treatment of gout, which were developed within the international program «3e Initiative».

  7. Nursing diagnosis Noncompliance to treatment in men with hypertension

    Directory of Open Access Journals (Sweden)

    Talliton Uchôa de Araújo

    2016-01-01

    Full Text Available Objective : to identify the frequency of occurrence of nursing diagnosis Noncompliance of treatment in men with high blood pressure, its defining characteristics, and related factors. Methods : a Cross-sectional study involving 44 men with hypertension by applying a validated instrument for identification of nursing diagnosis. Results : the diagnosis frequency of occurrence was 56.8%, the most present defining characteristics were the inadequate management of nonpharmacological treatment (p=0.000 and adherence failure of indicative behavior (p=0.000. The most common related factors were deficient knowledge for the monitor of the non- drug treatment regimen (p=0.000 and insufficient teaching ability of health staff (p=0.002. Conclusion : it was found a high frequency of diagnosis in men and the data point to the need for training of health professionals for the development of skills in promoting adherence of men to the treatment of hypertension.

  8. Hypothyroidism:Symptoms,Diagnosis and Treatment | NIH Medlineplus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Hypothyroidism Hypothyroidism: Symptoms, Diagnosis & Treatment Past Issues / Spring 2012 Table ... of its symptoms are seen in other diseases, hypothyroidism usually cannot be diagnosed based on symptoms alone. ...

  9. Treatment of membranous nephropathy in children.

    Science.gov (United States)

    Makker, Sudesh P

    2003-07-01

    Membranous nephropathy (MN) is not a common pediatric glomerular disease and not a common cause of idiopathic nephrotic syndrome (NS) in children. Because of the rarity of the disease, there is only a limited amount of uncontrolled data and no controlled data available in children regarding the treatment of MN. Older uncontrolled data indicate that nearly a quarter of children with NS, whether untreated or treated with various immunosuppressive agents, develop chronic renal failure. Current recommendations for treatment both for children presenting with or without NS therefore are based on controlled data obtained in adults with MN. All children should receive angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs). Children with NS may be treated initially with corticosteroids. If a satisfactory response is not obtained with corticosteroids, then treatment with cyclosporine or chlorambucil can be tried. The protocols of treatment with these drugs are described in this article.

  10. Haglund's Syndrome: Diagnosis and Treatment Using Sonography

    OpenAIRE

    Sofka, Carolyn M.; Adler, Ronald S.; Positano, Rock; Pavlov, Helene; Luchs, Jonathan S.

    2006-01-01

    Haglund's syndrome is a cause of retrocalcaneal pain. The clinical diagnosis of Haglund's syndrome is often confusing as the clinical picture may mimic other causes of hindfoot pain such as isolated retrocalcaneal bursitis or hindfoot involvement from more systemic arthropathies such as Reiter's syndrome or rheumatoid arthritis. With the increasing frequency of employing sonography as a diagnostic tool in the evaluation of foot and ankle pathology, recognition of the sonographic appearance of...

  11. Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment

    OpenAIRE

    Enrico Bellato; Eleonora Marini; Filippo Castoldi; Nicola Barbasetti; Lorenzo Mattei; Davide Edoardo Bonasia; Davide Blonna

    2012-01-01

    Fibromyalgia syndrome is mainly characterized by pain, fatigue, and sleep disruption. The etiology of fibromyalgia is still unclear: if central sensitization is considered to be the main mechanism involved, then many other factors, genetic, immunological, and hormonal, may play an important role. The diagnosis is typically clinical (there are no laboratory abnormalities) and the physician must concentrate on pain and on its features. Additional symptoms (e.g., Raynaud’s phenomenon, irritable ...

  12. Implant periapical lesion: diagnosis and treatment

    OpenAIRE

    Peñarrocha Diago, María; Maestre Ferrín, Laura; Cervera Ballester, Juan; Peñarrocha Oltra, David

    2012-01-01

    The implant periapical lesion is the infectious-inflammatory process of the tissues surrounding the implant apex. It may be caused by different factors: contamination of the implant surface, overheating of bone during drilling, preparation of a longer implant bed than the implant itself, and pre-existing bone disease. Diagnosis is achieved by studying the presence of symptoms and signs such us pain, swelling, suppuration or fistula; in the radiograph an implant periapical radiolucency may app...

  13. Lymphomas: diagnosis, treatment. Cancergram CT05

    Energy Technology Data Exchange (ETDEWEB)

    1985-01-01

    The scope of this Cancergram includes Hodgkin's disease, adenolymphoma, Burkitt's lymphoma, lymphosarcoma, lymphoblastoma, lymphocytoma, reticulum cell sarcoma, mycosis fungoides, and any not otherwise specified lymphoma. Abstracts are included which concern all clinical aspects of the various forms of lymphoma, such as diagnosis and staging, supportive care, evaluation, and therapy. Animal models, tissue culture experiments, carcinogenesis and other preclinical studies are generally excluded, except for those considered to have direct clinical relevance.

  14. Diagnosis and treatment of protein plugs of the common channel in children with congenital biliary dilatation%先天性胆管扩张症合并共同管内蛋白栓的诊断和处理

    Institute of Scientific and Technical Information of China (English)

    李龙; 张金山; 孙海林; 袁新宇; 刘树立; 刁美; 张军

    2009-01-01

    目的 探讨先天性胆管扩张症合并共同管蛋白栓的诊断和清除方法.方法 2001年6月至2009年1月,在收治的先天性胆管扩张症203例患儿中,经手术前超声、CT、MRCP和术中胆道造影检查发现22例合并胰胆合流异常患儿的共同管内有蛋白栓存在,年龄1岁8个月至12岁,平均6.1岁.对其临床表现、影像学特点及手术中蛋白栓的清除方法进行分析,并对其术后症状、生化检测和胆道改变进行随访.结果 22例患儿均以腹痛症状为主,并发呕吐,其中13例患儿合并黄疸,2例囊肿穿孔.19例患儿腹痛的发作期,血和尿中的胰淀粉酶升高.术中胆道造影22例均发现共同管内充盈缺损和扩张,胰管显影,其中9例合并胰管扩张.采用插管和尿道镜冲洗清除后,共同管的直径回缩,胰管不再显影.蛋白栓非常脆软,很容易被水流的冲力破碎成较小的颗粒.经再次共同管造影证实,蛋白栓清除干净.其中8例经小儿尿道镜直视下证实蛋白栓清除干净.患儿随访3个月至8年,22例患儿经血生化和超声检查,无胰淀粉酶升高和再发共同管和胰管内结石者.结论 1岁以上先天性胆管扩张症患儿,以腹痛为主,发作时血和尿中的胰淀粉酶升高,影像学共同管充盈缺损和扩张者,应怀疑共同管内蛋白栓.术中胆道造影是可靠的诊断方法.插管冲洗或尿道镜下清除蚩白栓安全有效,远期预后好.%Objective To investigate the method of diagnosis and removal for protein plugs in the common channel in children with congenital biliary dilatation.Methods The clinical presentation,radiological features and surgical treatment of 22 cases with congenital biliary dilatation(CBD) with protein plugs of the common channel were analyzed.The postoperative symptoms,laboratory examination and bile duct changes were evaluated during follow-up term.Results The 22 children had an average age of 6.1 years,ranging from 1 year 8 months to 12

  15. 漏斗胸合并肺部疾病的诊断和治疗%The diagnosis and treatment of pectus excavatum associated with congenital pulmonary disease in children

    Institute of Scientific and Technical Information of China (English)

    张娜; 曾骐; 陈诚豪; 于洁

    2011-01-01

    Objective To summarize the experience of diagnosis and treatment of pectus excavatum associated with congenital pulmonary disease in children.Methods The data of 91 patients with pectus excavatum associated with congenital pulmonary disease was collected from July 2002 to August 2010 in Beijing Children's Hospital.There were 64 males and 27 females.30 patients with pectus excavatum associated with congenital pulmonary cyst,congenital cystic adenomatoid malformation,pulmonary sequestration,and some severe cases of congenital lobar emphysema received the Nuss surgery and lobectomy simultaneously.Results 30 cases with pectus excavatum asseeiated with congenital pulmonary disease received simultaneous Nuss procedure and lobectomy.All cases were confirmed by pathology and recovered uneventfully.Conclusion Chest CT scan is an effective way to evaluate pectus excavatum associated with pulmonary diseases.Whether surgery is needed for the pulmonary disease depend on the specific types of disease,age and other various factors.Simultaneous surgery for pectus excavatum and pulmonary disease can lower the risk of the multiple operations,and reduce the financial burden of famihes.%目的 回顾先天性漏斗胸合并肺部疾病的病例,探讨诊断方法及治疗原则.方法 2002年7月至2011年8月回顾性分析91例合并肺部疾病漏斗胸患儿的临床资料.其中男64例,女27例.术前常规行胸部X线平片和CT检查,其中影像学证实的漏斗胸同时合并先天性肺囊肿、先天性肺囊性腺瘤样畸形、肺隔离症、肺大疱及部分较严重的肺气肿患儿30例,均同期行漏斗胸Nuss手术和开胸肺叶切除手术.结果 30例病例均顺利完成同期漏斗胸Nuss手术及肺叶切除手术,且最终均通过病理诊断证实.术后随访效果良好.结论 胸部CT扫描检查是诊断先天性漏斗胸合并肺部疾病的有效方法.微创Nuss手术给同期行肺叶切除手术带来了可能.同期手术减少了患儿多

  16. Congenital Heart Disease: Causes, Diagnosis, Symptoms, and Treatments.

    Science.gov (United States)

    Sun, RongRong; Liu, Min; Lu, Lei; Zheng, Yi; Zhang, Peiying

    2015-07-01

    The congenital heart disease includes abnormalities in heart structure that occur before birth. Such defects occur in the fetus while it is developing in the uterus during pregnancy. About 500,000 adults have congenital heart disease in USA (WebMD, Congenital heart defects medications, www.WebMD.com/heart-disease/tc/congenital-heart-defects-medications , 2014). 1 in every 100 children has defects in their heart due to genetic or chromosomal abnormalities, such as Down syndrome. The excessive alcohol consumption during pregnancy and use of medications, maternal viral infection, such as Rubella virus, measles (German), in the first trimester of pregnancy, all these are risk factors for congenital heart disease in children, and the risk increases if parent or sibling has a congenital heart defect. These are heart valves defects, atrial and ventricular septa defects, stenosis, the heart muscle abnormalities, and a hole inside wall of the heart which causes defect in blood circulation, heart failure, and eventual death. There are no particular symptoms of congenital heart disease, but shortness of breath and limited ability to do exercise, fatigue, abnormal sound of heart as heart murmur, which is diagnosed by a physician while listening to the heart beats. The echocardiogram or transesophageal echocardiogram, electrocardiogram, chest X-ray, cardiac catheterization, and MRI methods are used to detect congenital heart disease. Several medications are given depending on the severity of this disease, and catheter method and surgery are required for serious cases to repair heart valves or heart transplantation as in endocarditis. For genetic study, first DNA is extracted from blood followed by DNA sequence analysis and any defect in nucleotide sequence of DNA is determined. For congenital heart disease, genes in chromosome 1 show some defects in nucleotide sequence. In this review the causes, diagnosis, symptoms, and treatments of congenital heart disease are described.

  17. Clinical features and experience of diagnosis and treatment of thyroid neoplasm in children%儿童甲状腺肿瘤的临床特征及诊治体会

    Institute of Scientific and Technical Information of China (English)

    常实; 邓桢翰; 董超; 张志鹏; 廖辉军; 王志明

    2011-01-01

    Objective To study the clinical features, diagnosis and therapy of thyroid neoplasm in children. Methods A retrospective study was performed on 32 children with thyroid nodular who were underwent operation in Xiangya Hospital between January 2002 and December 2010. Results Of the 32 cases, there were 23 girls and 9 boys. Six cases were diagnosed as nodular Goiter adenoma and 26 cases were diagnosed as thyroid papillary carcinoma. B-ultrasonic examination showed a 100% accurate rate for the diagnosis of thyroid carcinoma. Fourteen children (44%,) were proven to have concurrent Hashimoto's thyroiditis. Twenty-two (69% ) children with thyroid carcinoma were found to have lymph metastasis in the lateral neck. The children younger than 10 years showed a high rate of metastasis than those older one (94% vs 56% , P < 0.05 ). All 32 children received a surgical therapy. Subtotal thyroidectomy was performed on the 6 children with nodular Goiter adenoma. Total thyroidectomy (17 cases) or ipsilateral thyroidectomy (9 cases) was performed according to the stage of thyroid carcinoma. The surgical outcomes were followed up for 3 months to 9 years and no recurrence or death occurred. The development and growth were normal in the children. Conclusions Childhood thyroid nodular attacks girls more than boys, and the frequency of malignancy is high. Hashimoto's thyroiditis is a common concurrent disease. The incidence of local lymph metastasis is high in those younger than 10 years. The surgical therapy for thyroid neoplasm may lead satisfactory outcomes in children.%目的 探讨儿童甲状腺肿瘤的临床特征及诊断与治疗.方法 回顾性分析2002年1月至2010年12月中南大学湘雅医院经手术治疗的32例甲状腺肿瘤患儿的临床资料.结果 32例患儿中,女性23例,男性9例.经病理证实良性肿瘤6例,恶性26例.良性病例均诊断为腺瘤性结节性甲状腺肿,恶性均为甲状腺乳头状癌.B超对甲状腺

  18. [Diagnosis and treatment of rheumatoid arthritis].

    Science.gov (United States)

    Krüger, K

    2014-09-01

    Rheumatoid arthritis today is still not curable but satisfactory treatable. Treatment targets include clinical remission (or at least low disease activity), lack of radiological destructions and functional disability as well as acceptable life quality and unimpaired working ability. Diagnosing and adequately treating the disease as early as possible is essential for a favourable long-term outcome. Treatment to target with validation and if necessary modification at least every three months until target is achieved ensures good results. Predominantly treatment starts with a combination of methotrexate and glucocorticoids followed by a conventional DMARD combination and then addition of a biologic DMARD in case of failing target. Presence of adverse risk factors and/or high disease activity a cDMARD/bDMARD combination might be used already after starting treatment failure. Additional treatment options such as physiotherapy should be added. Altogether with current treatment possibilities burden of disease declined dramatically in recent years.

  19. Evaluation of GnRH analogue testing in diagnosis and management of children with pubertal disorders

    Directory of Open Access Journals (Sweden)

    Hemchand K Prasad

    2012-01-01

    Full Text Available Context: Gonadotrophin releasing hormone (GnRH stimulation test is pivotal in the assessment of children with pubertal disorders. However, lack of availability and high cost often result in the test falling into disfavor. We routinely use the GnRH analogue stimulation test as an alternative at our center. Aim: To present the data on children with endocrine disorders who underwent GnRH agonist stimulation test in pediatric endocrine clinic of a tertiary care referral hospital. Setting and Design: Pediatric endocrine clinic of a tertiary care referral hospital. Retrospective analysis of case records. Materials and Methods: The details pertaining to clinical and radiological parameters and hormonal tests were retrieved from case records of 15 children who underwent GnRH agonist stimulation test from May 2010 to April 2011. Results: Indications for testing with GnRH analogue were evaluation of delayed puberty, diagnosis of precocious puberty, assessment of hormonal suppression in treatment of precocious puberty and micropenis in two, nine, three and one cases, respectively. The results of the test and clinical and radiological parameters were in concordance. The test was also crucial in diagnosing the onset of central precocious puberty in two children with congenital adrenal hyperplasia. Conclusion: GnRH agonist test is a convenient, safe test that can be performed on an out-patient basis and can help the clinicians in the correct diagnosis and appropriate treatment of various puberty-related disorders.

  20. Electrophysiology in ADHD Diagnosis, predictions, and treatment

    OpenAIRE

    Øgrim, Geir

    2014-01-01

    Study 1: The theta/beta ratio (TBR) study Significantly elevated levels of power in the QEEG theta band or the theta/beta ratio (TBR) were found in 26% of the ADHD patients compared with 2.5% of controls. Excess theta was correlated with inattention and executive problems. Finding excess theta or TBR in a patient strengthens the hypothesis that ADHD is a correct diagnosis, as this pattern is not associated with common comorbid diagnoses in child psychiatry. Our findings were in...

  1. [Optic neuritis: diagnosis, treatment and clinical implications].

    Science.gov (United States)

    Steffen, Heimo; Tabibian, David

    2015-12-16

    Optic neuritis is one of the most important causes of visual loss in young and middle aged adults. The prognosis in terms of functional outcome is good. The diagnosis of optic neuritis is a clinical one. Steroids can shorten the recovery time but do not change the long term functional outcome. The MRI is the most important investiga- tion to assess an associated risk of multiple sclerosis. Optic cohe- rence tomography (OCT) contribute additional details to course and functional outcome of optic neuritis. In the future the OCT may additionally contribute to the relationship between optic neuritis and possible associated multiple sclerosis.

  2. Male hypogonadism: Causes, genetics, diagnosis and treatment.

    Directory of Open Access Journals (Sweden)

    William Jubiz

    2009-11-01

    Full Text Available Male hypogonadism represents an altered testicular function with infertility and decreased testosterone production. It can be caused by an intrinsic testicular damage, hypothalamic-pituitary dysfunction, or decreased end organ response to testosterone. Signs include hair loss, decreased sexual function, voice changes, eunuchoidal habitus and gynecomastia. The testes are small and osteoporosis may be present. The diagnosis is suspected clinically and is confirmed with decreased circulating testosterone concentrations. FSH and LH are increased in patients with testicular damage (primary hypogonadism and decreased in those with hypothalamic–pituitary dysfunction. Testosterone is available for intramuscular injection, transdermic patches, gel or pellets and by absorption by the oral mucosa.

  3. Diagnosis and management of cutaneous vasculitis in children.

    Science.gov (United States)

    Ting, Tracy V

    2014-04-01

    Cutaneous vasculitis in children is rare. Causes of cutaneous vasculitis are varied and are typically differentiated by the affected vessel size. A skin biopsy remains the gold standard for diagnosis but other causes for vasculitis, including systemic conditions, should be considered. This article discusses the childhood conditions commonly presenting with cutaneous vasculitis (leukocytoclastic vasculitis, cutaneous polyarteritis nodosa), biopsy recommendations and findings, and management and potential differential diagnoses, and includes a brief summary of other diseases that may include cutaneous symptoms as a constellation of other systemic findings.

  4. The prevention, diagnosis and management of central venous line infections in children.

    Science.gov (United States)

    Chesshyre, Emily; Goff, Zoy; Bowen, Asha; Carapetis, Jonathan

    2015-06-01

    With advancing paediatric healthcare, the use of central venous lines has become a fundamental part of management of neonates and children. Uses include haemodynamic monitoring and the delivery of lifesaving treatments such as intravenous fluids, blood products, antibiotics, chemotherapy, haemodialysis and total parenteral nutrition (TPN). Despite preventative measures, central venous catheter-related infections are common, with rates of 0.5-2.8/1000 catheter days in children and 0.6-2.5/1000 catheter days in neonates. Central line infections in children are associated with increased mortality, increased length of hospital and intensive care unit stay, treatment interruptions, and increased complications. Prevention is paramount, using a variety of measures including tunnelling of long-term devices, chlorhexidine antisepsis, maximum sterile barriers, aseptic non-touch technique, minimal line accessing, and evidence-based care bundles. Diagnosis of central line infections in children is challenging. Available samples are often limited to a single central line blood culture, as clinicians are reluctant to perform painful venepuncture on children with a central, pain-free, access device. With the advancing evidence basis for antibiotic lock therapy for treatment, paediatricians are pushing the boundaries of line retention if safe to do so, due to among other reasons, often limited venous access sites. This review evaluates the available paediatric studies on management of central venous line infections and refers to consensus guidelines such as those of the Infectious Diseases Society of America (IDSA).

  5. Weight-based nutritional diagnosis of Mexican children and adolescents with neuromotor disabilities

    Directory of Open Access Journals (Sweden)

    Vega-Sanchez Rodrigo

    2012-07-01

    Full Text Available Abstract Background Nutrition related problems are increasing worldwide but they have scarcely been evaluated in people with neuromotor disabilities, particularly in developing countries. In this study our aim was to describe the weight-based nutritional diagnoses of children and adolescents with neuromotor disabilities who attended a private rehabilitation center in Mexico City. Methods Data from the first visit’s clinical records of 410 patients who attended the Nutrition department at the Teleton Center for Children Rehabilitation, between 1999 and 2008, were analyzed. Sex, age, weight and height, length or segmental length data were collected and used to obtain the nutritional diagnosis based on international growth charts, as well as disability-specific charts. Weight for height was considered the main indicator. Results Cerebral palsy was the most frequent diagnosis, followed by spina bifida, muscular dystrophy, and Down’s syndrome. Children with cerebral palsy showed a higher risk of presenting low weight/undernutrition (LW/UN than children with other disabilities, which was three times higher in females. In contrast, children with spina bifida, particularly males, were more likely to be overweight/obese (OW/OB, especially after the age of 6 and even more after 11. Patients with muscular dystrophy showed a significantly lower risk of LW/UN than patients with other disabilities. In patients with Down’s syndrome neither LW/UN nor OW/OB were different between age and sex. Conclusions This is the first study that provides evidence of the nutritional situation of children and adolescents with neuromotor disabilities in Mexico, based on their weight status. Low weight and obesity affect a large number of these patients due to their disability, age and sex. Early nutritional diagnosis must be considered an essential component in the treatment of these patients to prevent obesity and malnutrition, and improve their quality of life.

  6. Cerebrovascular Disease in Children: Recent Advances in Diagnosis and Management

    Science.gov (United States)

    Bowers, Karen J.; deVeber, Gabrielle A.; Ferriero, Donna M.; Roach, E. Steve; Vexler, Zinaida S.; Maria, Bernard L.

    2017-01-01

    Cerebrovascular disease in children manifests in many forms, all of which have devastating and long-lasting effects. Recent advances in diagnostic imaging have revealed that this condition is much more common in the pediatric population than previously believed, affecting as many as 1 in 1500 neonates and 1 in 3000 children. The underlying mechanisms that cause stroke—ischemic stroke, sinovenous thrombosis, and hemorrhagic stroke—are only beginning to be understood; however, progress has been made toward better understanding the mechanisms of disease, particularly in the fields of genetics, inflammation, and thrombus formation. Furthermore, new imaging techniques, and better understanding of how to use imaging in managing stroke, have enabled practitioners to more quickly and accurately identify cerebrovascular disease type in children, which is key to mitigation of negative outcomes. The 2010 Neurobiology of Disease in Children symposium, held in conjunction with the 39th annual meeting of the Child Neurology Society, aimed to (1) describe clinical issues surrounding childhood stroke, including diagnosis and acute care; (2) discuss recent advances in the understanding of the pathogenesis of childhood stroke; (3) review current management of and therapies for childhood stroke, including controversial therapies; and (4) establish research directions for investigators. This article summarizes the speakers’ presentations and includes an edited transcript of question-and-answer sessions. PMID:21778188

  7. Epidemiology, diagnosis, and treatment of temporomandibular disorders.

    Science.gov (United States)

    Liu, Frederick; Steinkeler, Andrew

    2013-07-01

    Temporomandibular disorder (TMD) is a multifactorial disease process caused by muscle hyperfunction or parafunction, traumatic injuries, hormonal influences, and articular changes. Symptoms of TMD include decreased mandibular range of motion, muscle and joint pain, joint crepitus, and functional limitation or deviation of jaw opening. Only after failure of noninvasive options should more invasive and nonreversible treatments be initiated. Treatment can be divided into noninvasive, minimally invasive, and invasive options. Temporomandibular joint replacement is reserved for severely damaged joints with end-stage disease that has failed all other more conservative treatment modalities.

  8. Diagnosis and treatment of sexual addiction.

    Science.gov (United States)

    Goodman, A

    1993-01-01

    Following a brief introduction to the concept of addiction, the definition of and diagnostic criteria for sexual addiction are presented. A theoretical framework for treatment of sexual addiction is then outlined, based on an understanding of the underlying addictive process: the compulsive dependence on external actions as a means of regulating one's internal states. Effective treatment addresses both addictive behavior and the addictive process. Addictive sexual behavior is addressed through behavioral symptom management, which includes relapse prevention and other cognitive-behavioral techniques. The addictive process is addressed by enhancing self-regulatory functions through individual psychotherapy, therapeutic group experience, and pharmacotherapy (medication treatment, when indicated). An integrated system for treatment of sexual addiction, which brings together these therapeutic methods in one theoretically coherent, clinically unified approach, is outlined.

  9. Anorexia nervosa--diagnosis, aetiology, and treatment.

    Science.gov (United States)

    Hartman, D

    1995-12-01

    The aetiology, assessment and treatment of anorexia nervosa are reviewed in the light of the classical accounts of Morton, Lasègue and Gull. The core symptoms are deliberate weight loss, disturbed body image and amenorrhoea, and complications may include cardiac failure, electrolyte disturbances, hypothermia and osteoporosis. Common clinical findings are described. Disturbed brain serotonin activity is implicated in the aetiology of anorexia nervosa, but there is little support for the use of pharmacological treatments. Psychological theories of aetiology are discussed with reference to Bruch, Crisp, Palazzoli and Minuchin: the common theme is the reaction of the patient and her family to the physical and social changes of puberty. Individual and/or family psychotherapy is seen as central to the treatment of anorexia nervosa, and the relevant clinical research is reviewed. The roles of general practitioners, general psychiatrists and eating disorder specialists are discussed in the light of recent consensus treatment guidelines.

  10. [Diagnosis and early treatment of juvenile delinquency].

    Science.gov (United States)

    Barbagallo, A; Bellia, A; Benvenuto, G; Cosentino, F; Riggio, T M

    1975-09-12

    Longitudinal research has shown that social failure to adjust can be prevented by early removal of ambiental factors encouraging pathological development of the Ego, and the detection and treatment of psychological tendencies towards the acquisition of deviant stimuli.

  11. Dual diagnosis clients' treatment satisfaction - a systematic review

    Directory of Open Access Journals (Sweden)

    Stirling John

    2011-04-01

    Full Text Available Abstract Background The aim of this systematic review is to synthesize existing evidence about treatment satisfaction among clients with substance misuse and mental health co-morbidity (dual diagnoses, DD. Methods We examined satisfaction with treatment received, variations in satisfaction levels by type of treatment intervention and by diagnosis (i.e. DD clients vs. single diagnosis clients, and the influence of factors other than treatment type on satisfaction. Peer-reviewed studies published in English since 1970 were identified by searching electronic databases using pre-defined search strings. Results Across the 27 studies that met inclusion criteria, high average satisfaction scores were found. In most studies, integrated DD treatment yielded greater client satisfaction than standard treatment without explicit DD focus. In standard treatment without DD focus, DD clients tended to be less satisfied than single diagnosis clients. Whilst the evidence base on client and treatment variables related to satisfaction is small, it suggested client demographics and symptom severity to be unrelated to treatment satisfaction. However, satisfaction tended to be linked to other treatment process and outcome variables. Findings are limited in that many studies had very small sample sizes, did not use validated satisfaction instruments and may not have controlled for potential confounders. A framework for further research in this important area is discussed. Conclusions High satisfaction levels with current treatment provision, especially among those in integrated treatment, should enhance therapeutic optimism among practitioners dealing with DD clients.

  12. Diagnosis and Treatment of Thyroid Disorders

    OpenAIRE

    磯崎, 収; ISOZAKI, Osamu

    2004-01-01

    The incidence of thyroid disorders including subclinical diseases is compatible with that of diabetes mellitus, one of the most epidemic metabolic disorders causing social problems. Graves' disease accounts for more than 90% thyrotoxicosis in Japan. However painless thyroiditis, which is self-limiting, should be ruled out before treatment. One of the important issues for the treatment of Graves' disease with antithyroid drugs is how to manage the agranulocytosis, one of the most serious side ...

  13. Enteropathic Spondyloarthritis: From Diagnosis to Treatment

    Directory of Open Access Journals (Sweden)

    Rosario Peluso

    2013-01-01

    Full Text Available Enteropathic arthritis (EA is a spondyloarthritis (SpA which occurs in patients with inflammatory bowel diseases (IBDs and other gastrointestinal diseases. Diagnosis is generally established on the medical history and physical examination. It was, generally, made according to the European Spondyloarthropathy Study Group (ESSG criteria. Rheumatic manifestations are the most frequent extraintestinal findings of IBD with a prevalence between 17% and 39%, and IBD is associated, less frequently, with other rheumatic disease such as rheumatoid arthritis, Sjogren syndrome, Takayasu arteritis, and fibromyalgia. Although the pathogenesis of EA has not been plainly clarified, the most popular theory supposes that joint inflammation occurs in genetically predisposed subjects with bacterial gut infections, provided an important evidence for a possible relationship between inflammation of the gut mucosa and arthritis. The management of patients with EA requires an active cooperation between the gastroenterologist and rheumatologist.

  14. Clinical manifestations, diagnosis, and treatment of neurocysticercosis.

    Science.gov (United States)

    Sotelo, Julio

    2011-12-01

    Neurocysticercosis (NCC) is the most frequent parasitic disease of the human brain. Modern imaging studies, CT and MRI, have defined the diagnosis and characterization of the disease. Through these studies the therapeutic approach for each case may be individualized with the aid of antihelmintics, steroids, symptomatic medicines, or surgery. The use of one or various therapeutic measures largely depends on the peculiar combination of number, location, and biological stage of lesions as well as the degree of inflammatory response to the parasites. Although there is not a typical clinical picture of NCC, epilepsy is the most frequent manifestation of parenchymal NCC, whereas hydrocephalus is the most frequent manifestation of meningeal NCC. Eradication of cysticercosis is an attainable goal by public education and sanitary improvement in endemic areas.

  15. Diagnosis and treatment of temporomandibular disorders.

    Science.gov (United States)

    Gauer, Robert L; Semidey, Michael J

    2015-03-15

    Temporomandibular disorders (TMD) are a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint complex, and surrounding musculature and osseous components. TMD affects up to 15% of adults, with a peak incidence at 20 to 40 years of age. TMD is classified as intra-articular or extra-articular. Common symptoms include jaw pain or dysfunction, earache, headache, and facial pain. The etiology of TMD is multifactorial and includes biologic, environmental, social, emotional, and cognitive triggers. Diagnosis is most often based on history and physical examination. Diagnostic imaging may be beneficial when malocclusion or intra-articular abnormalities are suspected. Most patients improve with a combination of noninvasive therapies, including patient education, self-care, cognitive behavior therapy, pharmacotherapy, physical therapy, and occlusal devices. Nonsteroidal anti-inflammatory drugs and muscle relaxants are recommended initially, and benzodiazepines or antidepressants may be added for chronic cases. Referral to an oral and maxillofacial surgeon is indicated for refractory cases.

  16. Diagnosis and treatment of molar incisor hypomineralization.

    Science.gov (United States)

    Mathu-Muju, Kavita; Wright, J Timothy

    2006-11-01

    Molar incisor hypomineralization (MIH) is a relatively common condition that varies in clinical severity and can result in early loss of the permanent 6-year molars. The etiology of MIH remains unclear, and the diagnosis can be confused with more generalized enamel defects such as those that occur in amelogenesis imperfecta. The management of MIH depends largely on the severity of the enamel defect. Degrees of hypomineralization can range from mild enamel opacities to enamel that readily abrades from the tooth as it emerges into the oral cavity. Usually, severely affected molars are extremely hypersensitive, prone to rapid caries development, and can be difficult to manage in young patients. The purpose of this article is to review approaches to diagnosing and treating MIH.

  17. Differential diagnosis and treatment of vestibular vertigo

    Directory of Open Access Journals (Sweden)

    Vladimir Anatolyevich Parfenov

    2010-01-01

    Full Text Available Vertigo is a common complaint that leads patients to visit physicians of various specialties. Diseases resulting in vestibular vertigo are very diverse and may be caused by lesion of both the central parts of the vestibular system and the peripheral vestibular apparatus. In many cases, its diagnosis can be made from complaints and a history of disease and special bedside tests requiring no sophisticated equipment. Management of vestibular vertigo should aim at treating the underlying disease; vestibular dilators as symptomatic therapy can be effective for several days. Vestibular exercises the efficiency of which can be enhanced by betahistine and other drugs accelerating vestibular compensation should be further needed. Data on the efficacy of betaver (betahistine in patients with vestibular vertigo are given.

  18. Prenatal Depression: Best Practice Guidelines for Diagnosis and Treatment

    Science.gov (United States)

    Choate, Laura H.; Gintner, Gary G.

    2011-01-01

    The purpose of this article is to provide counselors with an overview of best practices for the treatment of women who experience prenatal depression (PND). The authors first discuss issues in the screening and diagnosis of PND. Next, the 2 most common treatments, antidepressants and psychotherapy, are reviewed and discussed in relation to current…

  19. Epidemiology, diagnosis, and treatment of neck pain.

    Science.gov (United States)

    Cohen, Steven P

    2015-02-01

    Neck pain is the fourth leading cause of disability, with an annual prevalence rate exceeding 30%. Most episodes of acute neck pain will resolve with or without treatment, but nearly 50% of individuals will continue to experience some degree of pain or frequent occurrences. History and physical examination can provide important clues as to whether the pain is neuropathic or mechanical and can also be used to identify "red flags" that may signify serious pathology, such as myelopathy, atlantoaxial subluxation, and metastases. Magnetic resonance imaging is characterized by a high prevalence of abnormal findings in asymptomatic individuals but should be considered for cases involving focal neurologic symptoms, pain refractory to conventional treatment, and when referring a patient for interventional treatment. Few clinical trials have evaluated treatments for neck pain. Exercise treatment appears to be beneficial in patients with neck pain. There is some evidence to support muscle relaxants in acute neck pain associated with muscle spasm, conflicting evidence for epidural corticosteroid injections for radiculopathy, and weak positive evidence for cervical facet joint radiofrequency denervation. In patients with radiculopathy or myelopathy, surgery appears to be more effective than nonsurgical therapy in the short term but not in the long term for most people.

  20. Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies.

    Science.gov (United States)

    Saha, Manish; Allon, Michael

    2017-02-07

    Given the high comorbidity in patients on hemodialysis and the complexity of the dialysis treatment, it is remarkable how rarely a life-threatening complication occurs during dialysis. The low rate of dialysis emergencies can be attributed to numerous safety features in modern dialysis machines; meticulous treatment and testing of the dialysate solution to prevent exposure to trace elements, toxins, and pathogens; adherence to detailed treatment protocols; and extensive training of dialysis staff to handle medical emergencies. Most hemodialysis emergencies can be attributed to human error. A smaller number are due to rare idiosyncratic reactions. In this review, we highlight major emergencies that may occur during hemodialysis treatments, describe their pathogenesis, offer measures to minimize them, and provide specific interventions to prevent catastrophic consequences on the rare occasions when such emergencies arise. These emergencies include dialysis disequilibrium syndrome, venous air embolism, hemolysis, venous needle dislodgement, vascular access hemorrhage, major allergic reactions to the dialyzer or treatment medications, and disruption or contamination of the dialysis water system. Finally, we describe root cause analysis after a dialysis emergency has occurred to prevent a future recurrence.

  1. Diagnosis as the First Critical Point in the Treatment Trajectory

    DEFF Research Database (Denmark)

    Missel, Malene; Pedersen, Jesper H; Hendriksen, Carsten

    2015-01-01

    of patients with operable lung cancer in order to identify their needs for care interventions from the point of diagnosis to hospitalization. METHODS: We investigated patients' lived experiences from a longitudinal perspective at 4 critical time points during the treatment trajectory; we present here...... the patient to face a new life situation, and demands one-on-one supportive care. CONCLUSIONS: Diagnosis is the first critical point for patients with operable lung cancer and disrupts their daily life. Patients need psychosocial support during the period from diagnosis to surgical intervention and patient...... the findings from the first time point, diagnosis. Data were collected through interviews conducted 7 to 10 days following diagnosis of lung cancer. Data from 19 patients are included, and the analysis is based on Ricoeur's interpretation theory. The study framework is inspired by Schutz's phenomenological...

  2. Acute kidney injury in children: Enhancing diagnosis with novel biomarkers

    Directory of Open Access Journals (Sweden)

    Samuel Nkachukwu Uwaezuoke

    2016-07-01

    Full Text Available This narrative review aims to appraise the sensitivity and specificity of novel biomarkers in identifying acute kidney injury (AKI in children. Serum creatinine represents a poor traditional biomarker for AKI due to some limitations. Although alternative reliable biomarkers that would better identify individuals at high risk for developing AKI, identify AKI early enough, monitor its progression and patients' recovery, as well as identify those patients at higher risk for poor outcomes are not yet available in renal care, the search-light has recently been focused on various novel biomarkers, some of which could provide this information in time ahead. Several studies have established their predictive value. However, none of them could solely fulfill all the criteria of the ideal biomarker. Therefore, to increase their sensitivity and specificity and enhance the diagnosis of AKI, constellations of different biomarkers with specific features are probably required. In future, the diagnostic evaluation of AKI in intensive care units will have to undergo a paradigm shift from serum creatinine as the traditional biomarker to tissue-specific injury biomarkers. A panel of these novel biomarkers employed at the bedside setting will ultimately revolutionize the diagnosis and prognostication of AKI in children.

  3. Acromioclavicular joint injuries: anatomy, diagnosis, and treatment.

    Science.gov (United States)

    Willimon, S Clifton; Gaskill, Trevor R; Millett, Peter J

    2011-02-01

    Acromioclavicular (AC) joint injuries are common in athletic populations and account for 40% to 50% of shoulder injuries in many contact sports, including lacrosse, hockey, rugby and football. The AC joint is stabilized by static and dynamic restraints, including the coracoclavicular (CC) ligaments. Knowledge of these supporting structures is important when identifying injury and directing treatment. Management of AC injuries should be guided by severity of injury, duration of injury and symptoms, and individual patient factors. These help determine how best to guide management, and whether patients should be treated surgically or nonsurgically. Treatment options for AC injuries continue to expand, and include arthroscopic-assisted anatomic reconstruction of the CC ligaments. The purpose of this article is to review the anatomy, diagnostic methods, and treatment options for AC joint injuries. In addition, the authors' preferred reconstruction technique and outcomes are presented.

  4. Clinical symptoms, diagnosis, and treatment of neurocysticercosis.

    Science.gov (United States)

    Garcia, Hector H; Nash, Theodore E; Del Brutto, Oscar H

    2014-12-01

    The infection of the nervous system by the cystic larvae of Taenia solium (neurocysticercosis) is a frequent cause of seizure disorders. Neurocysticercosis is endemic or presumed to be endemic in many low-income countries. The lifecycle of the worm and the clinical manifestations of neurocysticercosis are well established, and CT and MRI have substantially improved knowledge of the disease course. Improvements in immunodiagnosis have further advanced comprehension of the pathophysiology of this disease. This knowledge has led to individualised treatment approaches that account for the involvement of parenchymal or extraparenchymal spaces, the number and form of parasites, and the extent of degeneration and associated inflammation. Clinical investigations are focused on development of effective treatments and reduction of side-effects induced by treatment, such as seizures, hydrocephalus, infarcts, and neuroinjury.

  5. Mozart ear: diagnosis, treatment, and literature review.

    Science.gov (United States)

    Yamashita, Ken; Yotsuyanagi, Takatoshi; Saito, Tamotsu; Isogai, Noritaka; Mori, Hiromasa; Itani, Yoshihito

    2011-11-01

    Mozart ear is a congenital auricular deformity, which is mainly characterized by a bulging appearance of the anterosuperior portion of the auricle, a convexly protruded cavum conchae, and a slit-like narrowing of the orifice of the external auditory meatus. It is said to be uncommon, and because no one has yet fully described neither the disease nor the treatment, the concept of Mozart ear has not been unified. This report describes a case of a 13-year-old girl presented with an unusual congenital deformity which showed the features of Mozart ear. It is an extremely rare deformity that only about 4 clinical cases have been reported in medical literature thereby a treatment method has not been fully discussed. For surgical correction of our cases, we excised deformed conchal cartilage, turned it over, regrafted, and maintained a cosmetically positive result. We also reviewed and described the origin, current concept, and treatment method of Mozart ear.

  6. Recurrent respiratory papillomatosis : From diagnosis to treatment

    NARCIS (Netherlands)

    Tjon-Pian-Gi, Robin Edward Adrianus

    2016-01-01

    Recurrent respiratory papillomatosis (RRP) is a rare, benign, recurrent disease of the airway. Its warty lesions are associated with the Human papilloma virus (HPV) types 6 and 11, with a predisposition in the larynx. Because no curative treatment exists, some patients may require more than 100 surg

  7. Crohn disease: pathophysiology, diagnosis, and treatment.

    Science.gov (United States)

    Mazal, Jonathan

    2014-01-01

    Crohn disease (often seen in the literature as "Crohn's disease"), an autoimmune disease with debilitating gastrointestinal and extragastrointestinal manifestations, is on the rise in the United States and Europe. This article discusses the disease process, clinical presentation, diagnostic tools, and treatment options for Crohn disease. Statistics regarding disease prevalence and epidemiology also are reported.

  8. Spontaneous Ureteral Rupture Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    E. Pampana

    2013-01-01

    Full Text Available Rupture of the urinary collecting system associated with perinephric or retroperitoneal extravasation of the urine is an unusual condition and it is commonly associated with renal obstructing disease. Perforation could occur at any level from the calix to the bladder but it is usually seen at the fornices and upper ureter. It may lead to several serious consequences including urinoma, abscess formation, urosepsis, infection, and subsequent irreversible renal impairment. We report a case of a 69-year-old woman who presented at the emergency department of our institution with severe abdominal pain. Due to symptomatology worsening, complete laboratory evaluation was performed and the patient underwent abdominal contrast enhanced computed tomography (CT evaluation which showed contrast agent extravasation outside the excretory system without any evidence of renal calculi at basal acquisition. It was decided to perform a double-J stent placement which was followed by complete healing of the ureter and its removal was performed 8 weeks later. Diagnosis and therapeutic approaches are discussed.

  9. Tic disorders in the differential diagnosis of chronic cough in children in relation to four cases.

    Science.gov (United States)

    Karakaya, Işık; Şişmanlar, Şahika Gülen

    2015-09-01

    Chronic cough is a frequent reason for medical referrals in childhood. In patients who do not have signs or symptoms of an underlying respiratory system disease and who do not respond to experimental treatment, psychogenic cough should be considered. In this paper, four patients who were referred to our department with a prediagnosis of psychogenic cough, found to have tic disorder as a result of the assessments performed and improved with antipsychotic medication are presented. The differantial diagnosis of chronic cough in children should include tic disorders as well as psychogenic cough. Tic disorders can be diagnosed easily with detailed history and their response to medical treatment is rather satisfactory. Recognition of these disorders by pediatricians will minimize erroneous diagnoses and inappropriate therapies in children with a complaint of chronic cough.

  10. Moral Distress: Recognition, Diagnosis, and Treatment.

    Science.gov (United States)

    Trautmann, Jennifer

    2015-01-01

    Infusion nursing is a unique hybrid of inpatient and ambulatory nursing. The subspecialty of nurses cares for patients requiring treatment over long periods, including cancer patients receiving chemotherapy and patients who require short bursts of treatment, such as those with multiple sclerosis, Crohn's disease, and rheumatoid arthritis. Infusion nurses are exposed to many of the common root causes of moral distress in their practice, similar to nurses caring for terminally ill or critically ill patients. The specific aims of this article are to (1) define moral distress, moral residue, and the crescendo effect; (2) describe ethical stressors that can be confused with moral distress; (3) review the effects of moral distress on different health care providers; and (4) provide strategies to manage moral distress in the workplace using a case example.

  11. [Subclinical hyperthyroidism: from diagnosis to treatment].

    Science.gov (United States)

    Corvilain, B

    2012-09-01

    Subclinical hyperthyroidism is a common clinical entity. Subclinical hyperthyroidism is defined as a serum TSH below the reference range but a normal T4 and T3 level in an asymptomatic patient. Whether or not subclinical hyperthyroidism should be treated remains a matter of debate. Cross-sectional studies and longitudinal population-based studies demonstrate association between subclinical hyperthyroidism and risk of atrial fibrillation, osteoporosis and cardiovascular and global mortality. However, there are no randomized clinical trials answering the question whether long term-health outcomes are improved by the treatment of subclinical hyperthyroidism. Therefore in the absence of evidence for or against treatment of subclinical hyperthyroidism, it seems appropriate to follow algorithms that consider the level of TSH and the presence of risks factors (age > 65 years, osteoporosis, post menopause and cardiac disease).

  12. [Differential diagnosis and treatment of cramps].

    Science.gov (United States)

    Diener, H C; Westphal, K

    2013-10-10

    Cramps are painful sensations caused by intense involuntary contractions of skeletal muscles, mostly in the calves, usually lasting from a few seconds to several minutes. Although cramps are mostly idiopathic, theycan bea symptom of other forms of myalgia, restless legs syndrome or spasticity. Especially nocturnal cramps can cause considerable distress for patients requiring fast pain reduction and effective prophylaxis. Stretching the calf muscles helps preventing nocturnal cramps. Pharmacological treatment of leg cramps includes magnesium and quinine.

  13. Uterine fibroid tumors: diagnosis and treatment.

    Science.gov (United States)

    Evans, Patricia; Brunsell, Susan

    2007-05-15

    The incidence of uterine fibroid tumors increases as women grow older, and they may occur in more than 30 percent of women 40 to 60 years of age. Risk factors include nulliparity, obesity, family history, black race, and hypertension. Many tumors are asymptomatic and may be diagnosed incidentally. Although a causal relationship has not been established, fibroid tumors are associated with menorrhagia, pelvic pain, pelvic or urinary obstructive symptoms, infertility, and pregnancy loss. Transvaginal ultrasonography, magnetic resonance imaging, sonohysterography, and hysteroscopy are available to evaluate the size and position of tumors. Ultrasonography should be used initially because it is the least invasive and most cost-effective investigation. Treatment options include hysterectomy, myomectomy, uterine artery embolization, myolysis, and medical therapy. Treatment must be individualized based on such considerations as the presence and severity of symptoms, the patient's desire for definitive treatment, the desire to preserve childbearing capacity, the importance of uterine preservation, infertility related to uterine cavity distortions, and previous pregnancy complications related to fibroid tumors.

  14. Diagnosis and treatment of lichen planus.

    Science.gov (United States)

    Usatine, Richard P; Tinitigan, Michelle

    2011-07-01

    Lichen planus is a chronic, inflammatory, autoimmune disease that affects the skin, oral mucosa, genital mucosa, scalp, and nails. Lichen planus lesions are described using the six P's (planar [flat-topped], purple, polygonal, pruritic, papules, plaques). Onset is usually acute, affecting the flexor surfaces of the wrists, forearms, and legs. The lesions are often covered by lacy, reticular, white lines known as Wickham striae. Classic cases of lichen planus may be diagnosed clinically, but a 4-mm punch biopsy is often helpful and is required for more atypical cases. High-potency topical corticosteroids are first-line therapy for all forms of lichen planus, including cutaneous, genital, and mucosal erosive lesions. In addition to clobetasol, topical tacrolimus appears to be an effective treatment for vulvovaginal lichen planus. Topical corticosteroids are also first-line therapy for mucosal erosive lichen planus. Systemic corticosteroids should be considered for severe, widespread lichen planus involving oral, cutaneous, or genital sites. Referral to a dermatologist for systemic therapy with acitretin (an expensive and toxic oral retinoid) or an oral immunosuppressant should be considered for patients with severe lichen planus that does not respond to topical treatment. Lichen planus may resolve spontaneously within one to two years, although recurrences are common. However, lichen planus on mucous membranes may be more persistent and resistant to treatment.

  15. [Toxoplasmosis in pregnancy: prevention, prenatal diagnosis and treatment].

    Science.gov (United States)

    Hohlfeld, P; Biedermann, K; Extermann, P; Gyr, T

    1995-01-01

    Maternal infection with Toxoplasma gondii acquired during pregnancy occurs in more than 500 women per year in Switzerland. Systematic screening at the beginning of pregnancy allows the introduction of health education programs. The screening during pregnancy is performed to diagnose primary maternal infections and to propose prenatal diagnosis and treatment. The administration of specific antibiotherapy during pregnancy (spiramycine or the association of pyrimethamine and sulfonamides) significantly reduces the risk of fetal infection. Prenatal diagnosis of congenital toxoplasmosis is possible and reliable. It avoids unnecessary termination of pregnancy when the fetus is not infected and specific therapy in case of infection (association of pyrimethamine and sulfonamides). Prenatal treatment may be proposed without prenatal diagnosis as of the 16th week of gestation. In any case, prenatal treatment seems to reduce the incidence of severe congenital toxoplasmosis.

  16. Diagnosis and treatment of pulmonary embolism: a multidisciplinary approach.

    Science.gov (United States)

    Lavorini, Federico; Di Bello, Vitantonio; De Rimini, Maria Luisa; Lucignani, Giovanni; Marconi, Letizia; Palareti, Gualtiero; Pesavento, Raffaele; Prisco, Domenico; Santini, Massimo; Sverzellati, Nicola; Palla, Antonio; Pistolesi, Massimo

    2013-12-19

    The diagnosis of pulmonary embolism (PE) is frequently considered in patients presenting to the emergency department or when hospitalized. Although early treatment is highly effective, PE is underdiagnosed and, therefore, the disease remains a major health problem. Since symptoms and signs are non specific and the consequences of anticoagulant treatment are considerable, objective tests to either establish or refute the diagnosis have become a standard of care. Diagnostic strategy should be based on clinical evaluation of the probability of PE. The accuracy of diagnostic tests for PE are high when the results are concordant with the clinical assessment. Additional testing is necessary when the test results are inconsistent with clinical probability. The present review article represents the consensus-based recommendations of the Interdisciplinary Association for Research in Lung Disease (AIMAR) multidisciplinary Task Force for diagnosis and treatment of PE. The aim of this review is to provide clinicians a practical diagnostic and therapeutic management approach using evidence from the literature.

  17. The diagnosis and treatment of arthritis in horses.

    Science.gov (United States)

    Rose, R J

    1983-01-01

    In this paper on the diagnosis and treatment of arthritis in horses, both degenerative arthritis and septic arthritis are considered. Diagnosis should be made on the combination of clinical examination together with the use of diagnostic aids such as radiology, intra-articular local anaesthesia and synovial fluid analysis. Intra-articular therapy appears to be the most effective in the treatment of degenerative arthritis. Excellent responses to therapy have been reported with corticosteroids, sodium hyaluronate, orgotein and synovial fluid transfer, where joints showed an absence of degenerative changes on radiographs. In septic arthritis, systemic treatment with the appropriate antibiotic, following bacterial culture and sensitivity testing, can produce good results if prompt diagnosis is made.

  18. Diagnosis, treatment, and prevention of cerebral palsy.

    Science.gov (United States)

    O'Shea, Thomas Michael

    2008-12-01

    Cerebral palsy is the most prevalent cause of persisting motor function impairment with a frequency of about 1/500 births. In developed countries, the prevalence rose after introduction of neonatal intensive care, but in the past decade, this trend has reversed. A recent international workshop defined cerebral palsy as "a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain." In a majority of cases, the predominant motor abnormality is spasticity; other forms of cerebral palsy include dyskinetic (dystonia or choreo-athetosis) and ataxic cerebral palsy. In preterm infants, about one-half of the cases have neuroimaging abnormalities, such as echolucency in the periventricular white matter or ventricular enlargement on cranial ultrasound. Among children born at or near term, about two-thirds have neuroimaging abnormalities, including focal infarction, brain malformations, and periventricular leukomalacia. In addition to the motor impairment, individuals with cerebral palsy may have sensory impairments, cognitive impairment, and epilepsy. Ambulation status, intelligence quotient, quality of speech, and hand function together are predictive of employment status. Mortality risk increases incrementally with increasing number of impairments, including intellectual, limb function, hearing, and vision. The care of individuals with cerebral palsy should include the provision of a primary care medical home for care coordination and support; diagnostic evaluations to identify brain abnormalities, severity of neurologic and functional abnormalities, and associated impairments; management of spasticity; and care for associated problems such as nutritional deficiencies, pain, dental care, bowel and bladder continence, and orthopedic complications. Current strategies to decrease the risk of cerebral palsy include interventions to

  19. [Lipids composition diet in phenylketonuric children with early diagnosis].

    Science.gov (United States)

    Cornejo, Verónica; Concha, Miluska; Cabello, Juan Francisco; Raimann, Erna

    2005-12-01

    Phenylketonuria (PKU) is a genetic disorder caused by a partial or complete mutation of the enzyme phenylalanine hydroxylase (PHA), fact that produces high levels of phenylalanine in blood resulting in mental retardation if not diagnosed during the neonatal period. Treatment consists of a phenylalanine (Phe) restricted diet. Several studies have shown that due to restriction of animal protein, this diet is deficient in fatty acids such as alfalinolenic acid (ALA) and provides high levels of linoleic acid (LA). The objective of this study was to determine the lipid composition of the diet consumed by children with early-diagnosed PKU. Lipid composition of the Phenylalanine restricted diet consumed by 29 children with PKU and in follow-up at INTA, University of Chile, were analyzed. Children were paired by sex and age with a control group. A twenty-four hour dietary recall was performed for 3 consecutive days and total fatty acid intake, including saturated, monounsaturated, polyunsaturated, LA and ALA, were calculated. In the restricted diet of children with PKU, 31.8% of total calories are from fat, 13% of which are LA and 0.2% ALA, showing significant differences as compared to the control group. The ratio of saturated:monounsaturated:polyunsaturated fatty acids was 1:1.7:3.9 and the ratio of LA:ALA was ten-fold higher than the recommended ratio of 115:1. It is concluded that the Phenyalanine restricted diet of Chilean children with PKU is high in LA and low in ALA.

  20. Diagnosis and treatment of rare complications of pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    Zhao-Wen Zong; Quan-wei Bao; Hua-Yu Liu; Yue Shen; Yu-Feng Zhao; Xiang Hua; Qing-Shan Guo

    2016-01-01

    Purpose:To enhance the awareness of rare complications of pelvic fracture and describe the correct diagnosis and effective treatment.Methods:A total of 188 cases of pelvic fractures were retrospectively reviewed,and four patients who suffered from four types of rare pelvic fracture complications were described,namely ureteral obstruction caused by retroperitoneal hematoma-induced abdominal compartment syndrome (ACS),bowel entrapment,external iliac artery injury,and open scrotal sac injury.Results:We demonstrated that combined measures should be employed to prevent the occurrence of ACS following major pelvic fractures.Ureteral catheter support may be a good option at an early stage when ACS occurred.Contrasted computed tomography examination and sufficient awareness are keys to a correct diagnosis of bowel entrapment following pelvic fractures.Recognition of risk factors,early diagnosis,and prompt treatment of suspected injury of the external iliac artery are keys to patient survival and to avoid limb loss.Scrotal and/or testicular injury complicated by pelvic fractures should be carefully treated to maintain normal gonad function.Additionally, establishment of a sophisticated trauma care system and multi-disdplinary coordination are important for correct diagnosis and treatment of rare complications in pelvic fractures.Conclusions:Rare complications of pelvic fractures are difficult to diagnose and negatively impact outcome.Recognition of risk factors and sufficient awareness are essential for correct diagnosis and prompt treatment.

  1. 儿童夹腿综合征70例诊治分析%Diagnosis and Treatment of Restless Leg Syndrome in Children:Analysis of 70 Cases

    Institute of Scientific and Technical Information of China (English)

    邢小芬; 乔书花; 刘琳

    2011-01-01

    目的 总结分析儿童夹腿综合征的病因、诱因、实验室检查及治疗方法.方法 回顾性分析70例夹腿综合征患儿的临床表现、诱因、实验室检查结果、治疗及效果.结果 儿童夹腿综合征患儿中外阴阴道炎占31.4%;长期处于单调生活环境者占21.4%,农村及城郊患儿多于城市患儿,激素水平无明显异常改变.经外阴局部抗感染治疗效果较好.结论 外阴阴道炎症以及单调的生活方式是夹腿综合征的主要诱因,通过对炎症的治疗、行为的干预以及必要的药物治疗能够达到完全治愈,且对儿童发育无影响.%Objective To summarize the causes, laboratory examinations, and treatment of restless leg syndrome in children. Methods The clinical manifestations, causes, laboratory examination results, treatment and outcomes of 70 children with restless leg syndrome were retrospectively analyzed. Results Of these 70 children, 22 ( 31. 4% ) had genital inflammations. A notable proportion ( 21. 4% ) of children was living in monotonous environment. More pediatric patients were living in rural or suburban regions. Their sex hormone levels showed no remarkable changes. Local anti - infection therapy could achieve good effectiveness. Conclusion Genital inflammation and monotonous environment living environment are the major causes of restless leg syndrome in children. Anti - inflammation treatment, behavior intervention, and necessary medication often can effectively manage the syndrome, without leaving a further impact on child's development.

  2. Update on idiopathic hirsutism: diagnosis and treatment.

    Science.gov (United States)

    Erem, C

    2013-01-01

    Idiopathic hirsutism (IH) is defined as hirsutism in conjunction with normal ovulatory function and normal serum androgen levels. The pathogenesis of IH is still not clear. Increased peripheral 5alpha-reductase enzyme activity and abnormalities of androgen receptor gene polymorphisms have been postulated to explain the pathogenesis of this disorder. It is diagnosed in women who have hirsutism, normal ovulatory function, and normal levels of serum total or free testosterone. Combination treatment of IH, including androgen suppression, peripheral androgen blockade and cosmetic methods is most effective.

  3. Hepatocellular carcinoma: From diagnosis to treatment

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Hepatocellular carcinoma (HCC) is the sixth mostprevalent malignancy worldwide and is a rising causeof cancer related mortality. Risk factors for HCC arewell documented and effective surveillance and earlydiagnosis allow for curative therapies. The majority ofHCC appears to be caused by cirrhosis from chronichepatitis B and hepatitis C virus. Preventive strategiesinclude vaccination programs and anti-viral treatments.Surveillance with ultrasonography detects early stagedisease and improves survival rates. Many treatmentoptions exist for individuals with HCC and are determinedby stage of presentation. Liver transplantation is offeredto patients who are within the Milan criteria and arenot candidates for hepatic resection. In patients withadvanced stage disease, sorafenib shows some survivalbenefit.

  4. Diagnosis and treatment of fistulising Crohn's disease

    DEFF Research Database (Denmark)

    Hvas, Christian Lodberg; Dahlerup, Jens Frederik; Jacobsen, Bent Ascanius

    2011-01-01

    A fistula is defined as a pathological connection between the intestine and an inner (bladder or other intestine) or outer (vagina or skin) epithelial surface. Fistulas are discovered in up to 25% of all Crohn's disease patients during long-term follow-up examinations. Most are perianal fistulas....../MRI for complete anatomical definition. Any abscess should be drained, and the disease extent throughout the entire gastrointestinal tract should be evaluated. Treatment goals for perianal fistulas include reduced fistula secretion or none, evaluated by clinical examination; the absence of abscesses; and patient...

  5. SCABIES – PRACTICAL RECOMMENDATIONS FOR DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Mónica Tavares

    2017-01-01

    Conclusions: This article aims to summarize the pathogenesis of infection by Sarcoptes scabiei var. hominis in children focusing special attention on symptoms and treatment. Although there are no randomized controlled trials with sulfur precipitated in scabies treatment to prove its effi cacy and safety, it seems to be one of the most recommended drugs in this age group.

  6. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available ... approach the subject of fertility preservation with their cancer-stricken child? How is the Oncofertility Consortium addressing the fertility preservation needs of children? How do cancer and cancer treatment affect a child's fertility? Why ...

  7. Predictive indices of empirical clinical diagnosis of malaria among under-five febrile children attending paediatric outpatient clinic

    Directory of Open Access Journals (Sweden)

    Hassan A Elechi

    2015-01-01

    Full Text Available Background: Malaria has remained an important public health problem in Nigeria with children under 5 years of age bearing the greatest burden. Accurate and prompt diagnosis of malaria is an important element in the fight against the scourge. Due to the several limitations of microscopy, diagnosis of malaria has continued to be made based on clinical ground against several World Health Organization (WHO recommendations. Thus, we aim to assess the performance of empirical clinical diagnosis among febrile children under 5 years of age in a busy pediatric outpatient clinic. Materials and Methods: The study was a cross-sectional study. Children aged <5 years with fever or 72 h history of fever were recruited. Children on antimalarial prophylaxis or on treatment for malaria were excluded. Relevant information was obtained from the caregiver and clinical note of the child using interviewer administered questionnaire. Two thick and two thin films were made, stained, and read for each recruited child. Data was analysed using SPSS version 16. Results: Of the 433 children studied, 98 (22.6% were empirically diagnosed as having malaria and antimalarial drug prescribed. Twenty-three (23.5% of these children were confirmed by microscopy to have malaria parasitemia, while 75 (76.5% were negative for malaria parasitemia. Empirical clinical diagnosis show poor predictive indices with sensitivity of 19.2%, specificity of 76.0%, positive predictive value of 23.5% and negative predictive value of 71%. Conclusion and Recommendations: Empirical clinical diagnosis of malaria among the under-five children with symptoms suggestive of acute malaria is highly not reliable and hence the need to strengthen parasitological diagnosis.

  8. Liquid biopsies: tumor diagnosis and treatment monitoring

    Directory of Open Access Journals (Sweden)

    Binh Thanh Vu

    2016-08-01

    Full Text Available Cancer is a disease with high evolutionary, i.e., malignant, characteristics that change under selective pressure from therapy. Characterization based on molecular or primary tumor properties or clinicopathological staging does not fully reflect the state of cancer, especially when cancer cells metastasize. This is the major reason for failure of cancer treatment. Currently, there is an urgent need for new approaches that allow more effective, but less invasive, monitoring of cancer status, thereby improving the efficacy of treatments. With recent technological advances, and ldquo;liquid biopsies, and rdquo; the isolation of intact cells or analysis of components that are secreted from cells, such as nucleic acids or exosomes, could be implemented easily. This approach would facilitate real-time monitoring and accurate measurement of critical biomarkers. In this review, we summarize the recent progress in the identification of circulating tumor cells using new high-resolution approaches and discuss new circulating tumor nucleic acid- and exosome-based approaches. The information obtained through liquid biopsies could be used to gain a better understanding of cancer cell invasiveness and metastatic competence, which would then benefit translational applications such as personalized medicine. [Biomed Res Ther 2016; 3(8.000: 745-756

  9. Primary bronchiolar disorders: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Georgios Patsourakis

    2010-01-01

    Full Text Available SUMMARY. Bronchiolitis is a generic term applied to a variety of inflammatory diseases that affect the bronchioles, sparing a considerable portion of the other parenchymal structures, in which both inflammatory cells and mesenchymal tissue are present. Bronchiolitis occurs in a variety of clinical settings and may be associated with large airway disease and parenchymal disease. The symptoms and signs of bronchiolitis are nonspecific and polymorphous. The course is usually chronic, but it may be acute or subacute. The advent of high resolution computerized tomography scan (HRCT has enabled the identification of more specific patterns that correlate with the involvement of the small airways, and it is clinically useful for confirmation of suspected bronchiolar lesions. Recently, improvement has been noted in the prognosis and clinical outcome of the disease mainly as a result of the application of macrolide treatment. Currently many clinical trials are in progress aimed at the identification of the most appropriate treatment for each specific type of bronchiolitis. Pneumon 2010, 23(1:48-79.

  10. Hepatitis C virus: Virology, diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    More than twenty years of study has provided abetter understanding of hepatitis C virus (HCV) lifecycle, including the general properties of viral RNAand proteins. This effort facilitates the developmentof sensitive diagnostic tools and effective antiviraltreatments. At present, serologic screening test isrecommended to perform on individuals in the highrisk groups and nucleic acid tests are recommendedto confirm the active HCV infections. Quantization andgenotyping of HCV RNAs are important to determinethe optimal duration of anti-viral therapy and predictthe likelihood of response. In the early 2000s, pegylatedinterferon plus ribavirin became the standard anti-HCV treatment. However, this therapy is not ideal. To2014, boceprevir, telaprevir, simeprevir, sofosbuvir andHarvoni are approved by Food and Drug Administrationfor the treat of HCV infections. It is likely that thenew all-oral, interferon-free, pan-genotyping anti-HCVtherapy will be available within the next few years.Majority of HCV infections will be cured by these antiviraltreatments. However, not all patients are expectedto be cured due to viral resistance and the high costof antiviral treatments. Thus, an efficient prophylacticvaccine will be the next challenge in the fight againstHCV infection.

  11. Hepatitis E in Europe: Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Charlotte M. Nijskens

    2015-12-01

    Full Text Available Hepatitis E virus (HEV is a single-stranded, non-enveloped, positive-stranded RNA virus that can be classified into four genotypes with distinct geographical distributions. Several reservoirs and transmission routes have been identified. The clinical symptoms of acute hepatitis caused by the different genotypes cannot be distinguished from each other and are similar to those caused by other types of hepatitis. In developed countries, fulminant hepatitis can develop in patients with underlying (liver disease. Chronic HEV infections are reported in immunocompromised patients and can eventually result in fibrosis and even cirrhosis. Due to the nonspecific presentation, HEV infection is often misdiagnosed. Extrahepatic manifestations, mainly neurological syndromes and renal injury, have been reported. HEV infection can be diagnosed either by serological testing or by detecting HEV RNA in serum or faeces. Acute infections normally do not require treatment, but chronic infections should be treated by reducing immunosuppressive drugs, if possible, and/or using antiviral therapy. Recently, the efficacy and safety of an HEV vaccine has been studied. This review gives an overview of the current knowledge about the virus as well as the different clinical presentations, differential diagnoses, diagnostic strategies, and treatments of this infection.

  12. Disclosing HIV diagnosis to children in Odi district, South Africa: Reasons for disclosure and non-disclosure

    Directory of Open Access Journals (Sweden)

    Johanna M. Mahloko

    2012-02-01

    Full Text Available Background: The increasing access to antiretroviral therapy (ART and survival of HIV- infected children has posed challenges to caregivers on disclosing the HIV diagnosis to children. Objectives: The objectives of this study was to determine the reasons of caregivers for the disclosure and non-disclosure of the HIV diagnosis to children on ART and to determine the caregivers’ perceptions of children’s reaction to disclosure. Method: A cross-sectional study was conducted amongst 149 caregivers of children between 4–17 years who receive ART from a district hospital in South Africa. Descriptive and inferential statistics were used in the analysis of data. Results: The prevalence of disclosure was 40% and the mean age of disclosure was 9.3 years. Reasons for disclosure included that the child was not adhering to treatment (n = 59; 39%; the child was consistently asking questions about the treatment and nature of the disease (n = 59; 39%. Reasons for non-disclosure were that the child was too young (n = 90; 72%; the child would tell others about diagnosis (n = 90; 21.1%; the child would be socially rejected (n = 90; 18.6%; fear of negative consequences for the child (n = 90; 13.3%; and caregivers do not know how to tell or approach disclosure (n = 90; 8.9%. Conclusion: Caregivers disclosed the diagnosis so that their child would adhere to ART medication; non-disclosing caregivers delayed disclosure because their children were too young to understand the HIV diagnosis. Disclosure of HIV to children should be integrated into regular discussions with caregivers of children in ART settings to improve their knowledge and skills to manage disclosure.

  13. The diagnosis and treatment of severe cerebral fat embolism

    Institute of Scientific and Technical Information of China (English)

    周东生; 王甫; 王伯珉; 王鲁博; 李连欣; 许世宏; 穆卫东

    2003-01-01

    Objective: To improve the diagnosis and treatment of severe cerebral fat embolism (SCFE).Methods: The data of nine patients with SCFE were retrospectively analyzed. The manifestations of the central nerve system, respiratory system and hemorrhage were recorded, at the same time, accessory examination including arterial oxygen, fat macroglobules in venous blood and image examination was adapted. The patients were treated with exopexy, pharmocotherapy and oxygentherapy.Results: Two of the nine patients died of severe complications, the other seven recovered without severe sequela.Conclusions: Gurd standard should be improved for early diagnosis of SCFE. If svere complications can be prevented, patients who receive early treatment will have favourable prognosis.

  14. Research Progress of Exosomes in Lung Cancer Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Hongbo ZOU

    2016-11-01

    Full Text Available As the leading cause of morbidity and cancer related-death worldwide, lung cancer has a serious threat to human health. Exosomes are nanoscale lipid membrane vesicles derived from multivesicles, which containing active biomolecules including proteins, lipids, nucleic acids and etc. Exosomes play important roles in lung cancer initiation and progression by promoting the formation of tumor microenvironment, enhancing tumor invasive and metastasis capability, leading to immunosuppression and resistance to chemoradiotherapy, and also have the application value in early diagnosis and treatment. This review summarizes the research progress of exosomes in tumor initiation and progression, and its roles in diagnosis and treatment of lung cancer.

  15. [Diagnosis and treatment of warfarin resistance].

    Science.gov (United States)

    Tan, Shenglan; Zhou, Xinmin; Li, Zhi; Zhang, Wei; Liu, Zhaoqian; Zhou, Honghao

    2013-03-01

    Warfarin resistance is a phenomenon that patients need to take much higher than normally prescribed dosage of warfarin to maintain the target therapeutic international normalized ratio (INR) range, or even fail to reach the target INR. Warfarin resistance can be categorized in etiologic terms as hereditary vs acquired, or in pharmacologic terms as pharmacokinetic vs pharmacodynamic. Once warfarin resistance is diagnosed, the type of resistance should be determined as soon as possible so that treatment could be oriented toward the causes. Poor compliance, genetic mutations, concurrent medications that could decrease the absorption or increase the clearance of warfarin, and consumption of diet rich in vitamin K are the major reasons for warfarin resistance. Educating patients, increasing warfarin dosage and switching to other anticoagulants would be effective for warfarin resistance.

  16. DIAGNOSIS AND TREATMENT OF MULTIPLE PRIMARY CARCINOMAS

    Institute of Scientific and Technical Information of China (English)

    Zhang Shuangmin; Ma Songzhang; Yang Dalai; Chen Shuguang; Yang Chunming; Song Huafeng

    1998-01-01

    32 cases of double primary cancer had been treated in our hospital from January, 1984 to March, 1994.Among them, 21 cases in male and 11 cases in female, the ratio of male and female is 1.9:1, the age ranged from 37to 84 years old, the median age was 60 years old. 8 of them were synchronous carcinoma and 23 were metachronous carcinoma, the period from first to second cancer ranged 8 months to 8 years and 3 months. 26 of the 32 patients were performed radical resection and radiotherapy and/or chemotherapy treatment. The postoperative survival rate of 1, 3 and 5 year's were 100.0%, 65.3% and 42.3% respectively. 2 patients survived over 10 years with no tumor. The other 6patients were later stage when fund the second primary cancer, palliative operations were only performed for them and they survived ranging from 5 to 15 months.

  17. DIAGNOSIS AND SURGICAL TREATMENT OF BRONCHOGENIC CYSTS

    Institute of Scientific and Technical Information of China (English)

    戈烽; 廖泉; 肖蜀梅; 任华; 张志庸; 李泽坚

    1995-01-01

    Between 1974 and 1993, 22 patients with bronchogenic cysts were operated on in our hospital; there were 14 men and 8 women, ranging in age from 11 to 62 years, The cyst locations were mediastinal in 13 (59.1%) and intrapulmonary in 9 (40.9%). There were symptoms (chest pain and recurrent bronehiolits) in 20 patients (91%). The preoperative complications included infection in the lung and in the cyst and dysphagia due to esophageal eornpression. Chest pain was the main symptom in mediastinal cyst and recurrent infection of lung in intrapulmonary cyst. Plain chest radiograms showed that a rousd shadow, occasional air-fluid levels, and peripheral calcification may be found in cysts. An operation is the best treatment for cysts. All cysts were completely excised. No postoperative complieations, late complica-tions, or recurrence developed in our patients.

  18. Positioning diagnosis and surgical treatment of the recurrent clubfoot in children%儿童复发性马蹄内翻足的定位诊断与外科治疗的选择

    Institute of Scientific and Technical Information of China (English)

    梅海波; 赫荣国; 刘昆; 唐进; 伍江雁; 叶卫华; 胡欣; 谭谦; 易银芝

    2010-01-01

    目的 探讨复发性马蹄内翻足的定位诊断问题,为选择针对性的矫形手术方法提供依据.方法 回顾性分析自2002年以来治疗的复发性马蹄内翻足18例26足,按Davidson方法分成三组:A组为单纯性前足内收畸形(8例10足);B组为前足内收并中足旋后复合畸形(蚕豆足畸形,8例13足);C组为后足内翻合并前足内收畸形(2例3足).A组畸形采用胫前肌腱外移术或胫前肌腱外移术+骰骨外侧闭合性楔形截骨术矫形,B组畸形采用中跗骨联合截骨矫形,C组畸形采用跟骨外移截骨+软组织松解+胫前肌腱外移,或加Ilizarov外固定器逐渐矫形.结果 本组18例26足术后平均随访时间为30个月(18~70个月),其中随访时间超过2年为16例23足.按照国际马蹄内翻足研究会评定标准(ICFSG)评价手术效果,优8例10足,良6例10足,可1例2足,差1例1足.其中评定为可和差的2例3足均为C组病例,虽然其后足内翻合并前足内收畸形获得比较满意的矫正,但距骨滑车畸形引起的胫距、距下关节僵硬并未解决,是导致评分过低的主要因素.结论 儿童复发性马蹄内翻足的术前定位诊断与矫形结果有较强的相关性.依照术前定位诊断确定的畸形类型,选择针对性的矫形手术方法,才能实现满意的矫形效果.%Objective To investigate the positioning diagnose and the efficacy of surgical treatment of the recurrent clubfoot in children.Methods Since 2002,18 patients with 26 recurrent clubfeet were treated at this center.Patients were grouped into 3 groups according to the Davidson's method of clubfoot classification criteria:Group A was simple forefoot adduction (8 cases,10 feet);Group B was stiffness of the midfoot supination and forefoot adduction,which was also called bean-shape foot (8 cases,13 feet);Group C was rigidity deformity of the hindfoot inversion and plantar flexion,and forefoot adduction (2 cases,3 feet).The group A patients underwent anterior

  19. Current status of diagnosis and treatment of hepatic echinococcosis

    Science.gov (United States)

    Mihmanli, Memmet; Idiz, Ufuk Oguz; Kaya, Cemal; Demir, Uygar; Bostanci, Ozgur; Omeroglu, Sinan; Bozkurt, Emre

    2016-01-01

    Echinococcus granulosus (E. granulosus) and Echinococcus multilocularis (E. multilocularis) infections are the most common parasitic diseases that affect the liver. The disease course is typically slow and the patients tend to remain asymptomatic for many years. Often the diagnosis is incidental. Right upper quadrant abdominal pain, hepatitis, cholangitis, and anaphylaxis due to dissemination of the cyst are the main presenting symptoms. Ultrasonography is important in diagnosis. The World Health Organization classification, based on ultrasonographic findings, is used for staging of the disease and treatment selection. In addition to the imaging methods, immunological investigations are used to support the diagnosis. The available treatment options for E. granulosus infection include open surgery, percutaneous interventions, and pharmacotherapy. Aggressive surgery is the first-choice treatment for E. multilocularis infection, while pharmacotherapy is used as an adjunct to surgery. Due to a paucity of clinical studies, empirical evidence on the treatment of E. granulosus and E. multilocularis infections is largely lacking; there are no prominent and widely accepted clinical algorithms yet. In this article, we review the diagnosis and treatment of E. granulosus and E. multilocularis infections in the light of recent evidence. PMID:27729953

  20. Update on the diagnosis and treatment of autoimmune pancreatitis.

    Science.gov (United States)

    Ghazale, Amaar H; Chari, Suresh T; Vege, Santhi Swaroop

    2008-04-01

    Autoimmune pancreatitis (AIP) is the pancreatic manifestation of a systemic fibroinflammatory disease (IgG4-related systemic disease) in which affected organs demonstrate dense lymphoplasmacytic infiltration with abundant IgG4-positive cells. The diagnosis of AIP and its differentiation from pancreatic cancer, its main differential diagnosis, remains a clinical challenge. The five cardinal features of AIP are characteristic histology, imaging, and serology; other organ involvement; and response to steroid therapy. Recent advances in our understanding of these features have resulted in enhanced recognition and diagnosis of this benign disease. This in turn has resulted in the avoidance of unnecessary surgical procedures for suspected malignancy. This article reviews recent updates in the diagnosis and treatment of autoimmune pancreatitis.

  1. Treatment of Palm Burns in Children

    OpenAIRE

    Argirova, M.; Hadzhiyski, O.

    2005-01-01

    The timing and methods of treatment of palm burns in children vary widely. From January 2002 to November 2004, 492 children with burns - 125 of them with hand burns or other body burns - were hospitalized and treated at the N.I. Pirogov Clinic for Burns and Plastic Surgery in Bulgaria. Fifty-four children (for a total of 73 burned hands) presented isolated palm burns.Twenty-two hands were operated on. In this review we present the incidence, causes, treatment methods, functional results, and ...

  2. Diagnosis and treatment of chronic insomnia

    Directory of Open Access Journals (Sweden)

    Saddichha Sahoo

    2010-01-01

    Full Text Available Insomnia is a disorder characterized by inability to sleep or a total lack of sleep, prevalence of which ranges from 10 to 15% among the general population with increased rates seen among older ages, female gender, White population and presence of medical or psychiatric illness. Yet this condition is still under-recognized, under-diagnosed, and under-treated. This article aims to review the operational definitions and management of chronic insomnia. A computerized search on PubMed carried from 1980 to January 2009 led to the summarization of the results. There are several strategies to manage chronic insomnia. To initiate treatment, it is necessary to define it and differentiate it from other co-morbid psychiatric disorders. Non-pharmacologic strategies such as stimulus control therapy and relaxation and cognitive therapies have the best effect sizes followed by sleep restriction, paradoxical intention and sleep hygiene education which have modest to less than modest effect sizes. Among pharmacotherapeutic agents, non-benzodiazepine hypnotics are the first line of management followed by benzodiazepines, amitryptiline and antihistaminics. However, adequate trials of combined behavior therapy and pharmacotherapy are the best course of management.

  3. [Current diagnosis and treatment of hyperprolactinemia].

    Science.gov (United States)

    Melgar, Virgilio; Espinosa, Etual; Sosa, Ernesto; Rangel, María José; Cuenca, Dalia; Ramírez, Claudia; Mercado, Moisés

    2016-01-01

    Hyperprolactinemia is a frequent neuroendocrinological condition that should be approached in an orderly and integral fashion, starting with a complete clinical history. Once physiological causes such as pregnancy, systemic disorders such as primary hypothyroidism and the use of drugs with dopamine antagonistic actions such as metochlopramide have been ruled out, the most common cause of hyperprolactinemia is a PRL-secreting pituitary adenoma or prolactinoma. Prolactinomas are usually classified as microprolactinomas (less than 1 cm) or macroprolactinomas (larger than 1 cm), which can either be confined or invasive. The hormonal consequence of hypeprolactinemia is hypogonadism; in women, this is manifested as amenorrhea/oligomenorreha, anovulation and galactorrhea, whereas in men the main complaints are a diminished libido and erectile dysfunction. Macroprolactinomas can also present with symptoms and signs resulting form mass effect of the tumor, such as headaches and visual field defects. Other structural causes of hyperprolactinemia include non-functioning pituitary adenomas and infiltrative disorders, which can interrupt the inhibitory, descending dopaminergic tone. The primary treatment of prolactinomas is pharmacological with dopamine agonists such as cabergoline.

  4. Dysthymia and Apathy: Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Junko Ishizaki

    2011-01-01

    Full Text Available Dysthymia is a depressive mood disorder characterized by chronic and persistent but mild depression. It is often difficult to be distinguished from major depression, specifically in its partially remitted state because “loss of interest” or “apathy” tends to prevail both in dysthymia, and remitted depression. Apathy may also occur in various psychiatric and neurological disorders, including schizophrenia, stroke, Parkinson's disease, progressive supranuclear palsy, Huntington's disease, and dementias such as Alzheimer's disease, vascular dementia, and frontotemporal dementia. It is symptomatologically important that apathy is related to, but different from, major depression from the viewpoint of its causes and treatment. Antidepressants, especially noradrenergic agents, are useful for depression-related apathy. However, selective serotonin reuptake inhibitors (SSRIs may be less effective for apathy in depressed elderly patients and have even been reported to worsen apathy. Dopaminergic agonists seem to be effective for apathy. Acetylcholine esterase inhibitors, methylphenidate, atypical antipsychotics, nicergoline, and cilostazol are another choice. Medication choice should be determined according to the background and underlying etiology of the targeting disease.

  5. Diagnosis and treatment of venous ulcers.

    Science.gov (United States)

    Collins, Lauren; Seraj, Samina

    2010-04-15

    Venous ulcer, also known as stasis ulcer, is the most common etiology of lower extremity ulceration, affecting approximately 1 percent of the U.S. population. Possible causes of venous ulcers include inflammatory processes resulting in leukocyte activation, endothelial damage, platelet aggregation, and intracellular edema. The primary risk factors for venous ulcer development are older age, obesity, previous leg injuries, deep venous thrombosis, and phlebitis. On physical examination, venous ulcers are generally irregular, shallow, and located over bony prominences. Granulation tissue and fibrin are typically present in the ulcer base. Associated findings include lower extremity varicosities, edema, venous dermatitis, and lipodermatosclerosis. Venous ulcers are usually recurrent, and an open ulcer can persist for weeks to many years. Severe complications include cellulitis, osteomyelitis, and malignant change. Poor prognostic factors include large ulcer size and prolonged duration. Evidence-based treatment options for venous ulcers include leg elevation, compression therapy, dressings, pentoxifylline, and aspirin therapy. Surgical management may be considered for ulcers that are large in size, of prolonged duration, or refractory to conservative measures.

  6. The Importance of Early Diagnosis and Treatment in Congenital Scoliosis

    Directory of Open Access Journals (Sweden)

    Safak Ekinci

    2011-08-01

    Full Text Available SUMMARY AIM: this study evaluates how early diagnosis of congenital scoliosis affects results and complication rates of of surgical treatment. METHOD: We have evaluated the efficiency and effectivity of modern posterior spinal instrumentation methods in congenital scoliosis cases who were diagnosed and treated in Gulhane Military Medical Academy Orthopaedics and Traumatology Department. We have evaluated 53 patients (13 male,29 female who were operated for congenital scoliosis between 1995 and 2009. Patients were divided into two groups according to the time of diagnosis to evaluate fusion levels, numbers of surgery, surgery methods, reduction rate, intraspinous and other system abnormalities and complications. RESULTS: 9 of 24 patients with diagnosis age before 5 and 11 of 29 patients with diagnosis age after 5 treated with single operation. Correction of main curve was %35.4 and compensatory curve was %13. Main curve correction of patients under 5 age was %36,3 and main curve correction of older group was %34,8 (p>0.05. Average number of fused levels in first group was 2,3±2,1 and in the older group 7,5±3,1. CONCLUSION: In patients before 5 age less invasive surgeries were needed to accomplish succesful treatment and early diagnosis of congenital scoliosis is the most important part of the treatment. KEY WORDS: Congenital ,Scoliosis, Posterior, Instrumentation [TAF Prev Med Bull 2011; 10(4.000: 441-446

  7. Prescription of respiratory medication without an asthma diagnosis in children : a population based study

    NARCIS (Netherlands)

    Zuidgeest, Mira Gp; van Dijk, Liset; Smit, Henriette A.; van der Wouden, Johannes C.; Brunekreef, Bert; Leufkens, Hubert G. M.; Bracke, Madelon

    2008-01-01

    Background: In pre-school children a diagnosis of asthma is not easily made and only a minority of wheezing children will develop persistent atopic asthma. According to the general consensus a diagnosis of asthma becomes more certain with increasing age. Therefore the congruence between asthma medic

  8. Prescription of respiratory medication without an asthma diagnosis in children: a population based study.

    NARCIS (Netherlands)

    Zuidgeest, M.G.P.; Dijk, L. van; Smit, H.A.; Wouden, J.C. van der; Brunekreef, B.; Leufkens, H.G.M.; Bracke, M.

    2008-01-01

    BACKGROUND: In pre-school children a diagnosis of asthma is not easily made and only a minority of wheezing children will develop persistent atopic asthma. According to the general consensus a diagnosis of asthma becomes more certain with increasing age. Therefore the congruence between asthma medic

  9. [Hypertension and pregnancy. Diagnosis, physiopathology and treatment].

    Science.gov (United States)

    Fournier, A; Fievet, P; el Esper, I; el Esper, N; Vaillant, P; Gondry, J

    1995-11-25

    This review on hypertension in pregnancy focuses mainly on the pathophysiology and prevention of pregnancy induced hypertension which, when associated with proteinuria, is usually called preeclampsia. Rather than a genuine hypertensive disease, preeclampsia is mainly a systemic endothelial disease causing activation of platelets and diffuse ischemic disorders whose most obvious clinical manifestations involve the kidney (hence the proteinuria, edema and hyperuricemia), the liver (hence the hemolytic elevated liver enzymes and low platelets, or HELLP syndrome), and the brain (hence eclamptic convulsions). Hypertension is explained by increased vascular reactivity rather than by an imbalance between vasoconstrictive and vasodilating circulating hormones. This increased reactivity is due to endothelial dysfunction with imbalance between prostacyclin and thromboxane A2 and possibly dysfunction of NO and endothelin synthesis. The aggressive substances for endothelium are thought to be of placentar origin and the cause of their release is explained by placentar ischemia related to a defect of trophoblastic invasion of the spiral arteries. The etiology of this latter defect is unknown but involves immunologic mechanisms with genetic predisposition. The only effective treatment for PIH is extraction of the baby with the whole placenta. The decision for extraction is often a very delicate obstetric problem. Antihypertensive drugs are mainly indicated in severe hypertension (> 160-100 mm Hg), with the aim of preventing cerebral hemorrhage in the mother, but have not been shown to improve fetal morbidity or mortality. Eclamptic seizures can be prevented and treated more effectively with magnesium sulfate than with diazepam or phenytoin. Prevention of preeclampsia remains the main challenge. Whereas antihypertensive drugs are ineffective, calcium supplementation and low dose aspirin have proven effective but mainly in selected populations with a relatively high incidence of

  10. 图形翻转视觉诱发电位诊治儿童屈光不正性弱视%Pattern reversal visual-evoked potential for the diagnosis and treatment of ametropic amblyopia in children

    Institute of Scientific and Technical Information of China (English)

    周红梅; 项道满; 胡兰香

    2012-01-01

    Objective To compare the features of pattern reversal visual-evoked potential (PRVEP) in children with myopic,hypermetropic and astigmatical amblyopia and the effect of treatment on PRVEP.Methods Ninty children (180 eyes) with amblyopia at 6 to 7 years of age were recruited from Guangzhou Women and Children' s Medical Center between May 2009 and May 2011 and were assigned to myopic (n=30,60 eyes),hypermetropic (n=30,60 eyes) and astigmatical (n=30,60 eyes) amblyopia group respectively.Thirty normal healthy children (60 eyes) were served as normal controls.PR-VEP examination was undertaken for comparison on the latency period of P100 and changes in amplitude of P wave piror to and after treatment.Results Children with amblyopia were associated with prolonged latency period of P100 for PR-VEP and reduced amplitude of P wave as compared with normal controls.Children with myopic amblyopia possessed the longest latency period of P100 and the lowest amplitude of P wave (both P<0.05),followed by those with hypermetropic and astigmatical amblyopia (P>0.05 for between-group comparison).Shortened latency period of P100 and increased amplitude of P wave were noted after the treatment in children with amblyopia.The differences in pre-and post-treatment latency period of P100 and amplitude of P wave reached statistical significance among the three groups [for the difference in latency period:(2.640±0.009 ms vs (5.590±0.576)ms vs (6.989±2.229)ms,for the difference in amplitude of P wave:(0.929 ± 0.611) μV vs (2.595 ± 0.464) μV vs (2.575 ± 0.211) μV,all P<0.05].Children with myopic amblyopia were featured by the lowest difference in latency period and amplitude.Conclusion The fact that children with myopic amblyopia have the lowest difference in latency period and amplitude proves the refactory treatment.Asessment of PR-VEP is clinically important to the treatment of amblyopia.%目的 对比近视性、远视性、散光性弱视患儿治疗前后的图形翻转

  11. [Diagnosis and management of ankyloglossia in young children].

    Science.gov (United States)

    Veyssiere, A; Kun-Darbois, J D; Paulus, C; Chatellier, A; Caillot, A; Bénateau, H

    2015-09-01

    Ankyloglossia is a common condition. Its prevalence is between 3.2% and 4.8% depending on the series and is largely underestimated given the fact of non-diagnosis when the symptoms are limited. It is defined as a short lingual frenulum resulting in a limitation of the lingual mobility. It is due to a defect in cellular apoptosis embryogenesis between the floor of the mouth and tongue. The result is a fibrous and short lingual frenulum. Several classifications were used to make the diagnosis. However, these are the clinical implications, particularly on food and primarily breastfeeding in the baby and phonation in older children that will motivate the management. This is surgical and different techniques are available: infants before the age of 6 months and when the lingual frenulum is still a fine cellular membrane, frenotomy is recommended. Frenectomy with or without frenoplasty is indicated for the older child. The surgery is simple, the results are good and rapidly improving grievances. Complications are rare. Finally, speech therapy is important when there are implications for phonation.

  12. Treatment of Autism Spectrum Disorder in Children and Adolescents.

    Science.gov (United States)

    DeFilippis, Melissa; Wagner, Karen Dineen

    2016-08-15

    Autism spectrum disorder is a diagnosis that includes significant social communication deficits/delays along with restricted patterns of interests and behaviors. The prevalence of this diagnosis has increased over the past few decades, and it is unclear whether this is solely attributable to the increased awareness of milder forms of the disorder among medical providers. The current treatment options for the core symptoms of autism are limited to psychosocial therapies, such as applied behavior analysis. Medications have been most effective in treating the associated behavioral symptoms of autism, though studies have examined potential benefits in some of the core symptoms of autism with certain medications, especially the repetitive behaviors often seen with this diagnosis. Risperidone and aripiprazole are currently the only medications FDA approved for symptoms associated with autism spectrum disorders, targeting the irritability often seen with this diagnosis. Children and adolescents with autism spectrum disorder appear to be more susceptible to adverse effects with medications; therefore, initiation with low doses and titrating very slowly is recommended. Some complementary alternative treatments have been researched as possible treatments in autism, though evidence supporting many of these is very limited.

  13. Treatment of Autism Spectrum Disorder in Children and Adolescents

    Science.gov (United States)

    DeFilippis, Melissa; Wagner, Karen Dineen

    2016-01-01

    Autism spectrum disorder is a diagnosis that includes significant social communication deficits/delays along with restricted patterns of interests and behaviors. The prevalence of this diagnosis has increased over the past few decades, and it is unclear whether this is solely attributable to the increased awareness of milder forms of the disorder among medical providers. The current treatment options for the core symptoms of autism are limited to psychosocial therapies, such as applied behavior analysis. Medications have been most effective in treating the associated behavioral symptoms of autism, though studies have examined potential benefits in some of the core symptoms of autism with certain medications, especially the repetitive behaviors often seen with this diagnosis. Risperidone and aripiprazole are currently the only medications FDA approved for symptoms associated with autism spectrum disorders, targeting the irritability often seen with this diagnosis. Children and adolescents with autism spectrum disorder appear to be more susceptible to adverse effects with medications; therefore, initiation with low doses and titrating very slowly is recommended. Some complementary alternative treatments have been researched as possible treatments in autism, though evidence supporting many of these is very limited. PMID:27738378

  14. Incorporating diagnosis and treatment of hyperhidrosis into clinical practice.

    Science.gov (United States)

    Pariser, David M

    2014-10-01

    Proper billing and coding are essential to document the diagnosis of hyperhidrosis and to assure proper reimbursement for treatment. Providers should become familiar with the payment policies of local health plans to streamline the preauthorization process that is often needed for many treatments commonly used for hyperhidrosis. Having a preprinted letter of medical necessity and patient intake forms that record the necessary historical information about the disease, previous treatments, and other pertinent information will help increase the speed of the office flow. This article presents algorithms for treatment of the various forms of primary focal hyperhidrosis.

  15. Osteomyelitis of the foot and ankle: diagnosis, epidemiology, and treatment.

    Science.gov (United States)

    Lindbloom, Benjamin J; James, Eric R; McGarvey, William C

    2014-09-01

    Osteomyelitis of the foot and ankle is a common, potentially devastating condition with diagnostic and treatment challenges. Understanding the epidemiology and pathogenesis of osteomyelitis can raise clinical suspicion and guide testing and treatments. History and physical examination, laboratory studies, vascular studies, histologic and microbiologic analyses, and various imaging modalities contribute to diagnosis and treatment. Treatment including empiric broad-spectrum antibiotics and surgery should take a multidisciplinary approach to optimize patient factors, ensure eradication of the infection, and restore function. Optimization of vascular status, soft tissues, limb biomechanics, and physiologic state of the patient must be considered to accelerate and ensure healing.

  16. Hip osteoarthrosis: clinical presentation, diagnosis, approaches to treatment

    Directory of Open Access Journals (Sweden)

    Marina Stanislavovna Svetlova

    2013-01-01

    Full Text Available The paper characterizes the specific features of the anatomy and physiology of the hip joint, the clinical presentation of coxarthrosis and presents current methods for the diagnosis and treatment of the disease. It gives the results of a trial evaluating the impact of long-term (one-year theraflex therapy on the symptoms of hip osteoarthrosis.

  17. Future opportunities for the diagnosis and treatment of prostate cancer

    NARCIS (Netherlands)

    Watson, R.W.; Schalken, J.A.

    2004-01-01

    Despite recent advances, current diagnostic tests and treatment of prostate cancer have limitations. In the last few years, numerous biomolecules have been investigated with the aim of improving diagnosis, including kallikrein-like proteases, growth factors and neuroendocrine markers. Analysis of su

  18. The elbow: diagnosis and treatment of common injuries.

    Science.gov (United States)

    Sellards, Robb; Kuebrich, Chris

    2005-03-01

    This article deals with common injuries to the elbow. Elbow anatomy is reviewed. Diagnosis and treatment of pronator syndrome,lateral epicondylitis (tennis elbow), radial tunnel syndrome, posterior interosseous nerve syndrome, medial epicondylitis (golfer's elbow), ulnar collateral ligament injury, cubital tunnel syndrome,posterolateral rotatory instability, distal biceps injuries, tricepstendon injuries, and posterior elbow impingement are discussed.

  19. Helicobacter pylori in childhood : aspects of prevalence, diagnosis and treatment

    NARCIS (Netherlands)

    Mourad-Baars, Petronella Elisabeth Cornelia

    2012-01-01

    In this dissertation we present the results of our research on Helicobacter pylori infections in childhood, focusing on the prevalence, diagnosis and treatment of the infection. Our studies were conducted in the Netherlands, Europe and Indonesia. We discuss diagnostic tests, therapeutic regimens, re

  20. Conjunctival tumors in children: histopathologic diagnosis in 165 cases

    Directory of Open Access Journals (Sweden)

    Martin A. Zimmermann-Paiz

    2015-12-01

    Full Text Available ABSTRACT Purpose: Conjunctival tissue tumors have a varied presentation, and few series studies on pediatric patients have been published. The objective of this paper is to report the histopathologic diagnoses (spanning over 1988-2013 of conjunctival tumors in children younger than 14 years. Methods: We conducted a retrospective, descriptive, and observational study by reviewing the database of all children in whom a conjunctival tumor was surgically removed at Hospital de Ojos y Oídos "Dr. Rodolfo Robles V.," Benemérito Comité Pro Ciegos y Sordos de Guatemala. The data pertaining to gender, age, and histopathologic diagnosis of all cases was collected. The same ocular pathologist made all diagnoses. Results: One hundred sixty-five cases were found, with a mean age of 7.88 years, being 91 (55.15% male subjects. Melanocytic lesions were the most common tumors found (30.91% of cases, with only one case (0.60% being malignant. Conclusions: Melanocytic lesions were the most common tumors found, and of all the cases, only one was malignant; this was in a patient with xeroderma pigmentosum. These findings are consistent with those reported in other studies regarding the frequencies of the histopathology of conjunctival tumors in the pediatric population.

  1. Birth of healthy children after preimplantation diagnosis of β-thalassemia

    Institute of Scientific and Technical Information of China (English)

    焦泽旭; 庄广伦; 周灿权; 舒益民; 李洁; 梁晓燕

    2004-01-01

    Background Clinical programs for preventing β-thalassemia are presently based on prospective carrier screening and prenatal diagnosis. This paper report an achievement of a pregnancy with unaffected embryos using in vitro fertilization and embryo transfer (IVF-ET), in combination with preimplantation genetic diagnosis (PGD), for a couple at risk of having children with β-thalassemia.Methods A couple carrying different thalassemia mutations, both a codon 41-42 mutation and the IVS Ⅱ 654 mutation, received standard IVF treatment, with intracytoplasmic sperm injection, embryo biopsiy, single cell polymerase chain reaction (PCR) and DNA analysis. Only unaffected or carrier embryos were transferred to the uterine cavity. After confirmation of pregnancy, a prenatal diagnosis was performed.Results Of a total of 13 embryos analyzed for β-globin mutations, PGD indicated that 2 were normal,3 were affected, and 6 were carriers. Diagnosis could not be made in the other 2 embryos. Three embryos were transferred to the uterus on the third day after oocyte retrieval. Ultrasonography revealed a twin pregnancy with one blighted ovum. The prenatal genetic diagnosis revealed that both fetuses were unaffected, and two healthy boys were born, confirming the results of PGD.Conclusions We developed a single-cell based primer extension preamplification (PEP)-PCR assay for the detection of β-thalassemia mutations. The assays were efficient and accurate at all stages of the procedure, and resulted in the birth of PGD-confirmed β-thalassemia free children in China. PEP was used here in PGD for β-thalassemia.

  2. Ultrasonographic diagnosis of urinary calculus caused by melamine in children

    Institute of Scientific and Technical Information of China (English)

    JIA Li-qun; SHEN Ying; WANG Xiao-man; HE Le-jian; XIN Yue; HU Yan-xiu

    2009-01-01

    Background Intake of melamine can cause renal and ureteral lithiasis in infants and children. The present study aimed to understand the value of ultrasonography in the diagnosis of renal and ureteral lithiasis in infants and young children caused by melamine, and the characteristics of ultrasonograms of melamine-associated calculi.Methods Ultrasonographic examination on the urinary system was performed for 28 332 children who ingested milk powder that was possibly tainted with melamine; 395 of the children were diagnosed by ultrasonography as having urinary calculus, and 231 cases had lump-like calculi and 164 cases had sand gravel-like calculi. The features of the calculi, the sites of obstruction and the status of hydronephrosis and hydroureterosis were analyzed. Ultrasonographic reexamination was performed for 116 patients and the findings were compared with those of the first ultrasonography, and the short-term expulsion of the calculi was evaluated.Results Most of the 395 patients with urinary lithiasis, except for those who developed renal failure, had no symptoms. The whole profile of the calculi could be seen in most of the cases, because the echogenicity of the calculi with no sharp or absent acoustical shadowing, was weaker as compared with those from calcium-containing calculi. Comet tail sign could be seen behind the echogenicity of single gravel calculus. The rate of diagnostic consistency of ureteral lithiasis between the ultrasound and the results of clinical observation (including stones expelled spontaneously or after cystoscopic intervention) in 51 cases for 76 ureters was 100%. Percutaneous renal biopsy was performed for one case, and histopathological examination showed flocculent, fine strip-like, ellipse and circular deeply stained sand gravel-like material in the renal tubules, and the circular calculi were found to be attached to the walls of the tubules. Chemical analysis of the calculi expelled from 12 cases showed that the main contents

  3. The value of family history in the diagnosis of hypersensitivity pneumonitis in children

    Directory of Open Access Journals (Sweden)

    Joana Cardoso

    2014-04-01

    Full Text Available Hypersensitivity pneumonitis (HP, or extrinsic allergic alveolitis, is an immunologically mediated disease resulting from the inhalation of organic substances that trigger an inflammatory response in the alveolar wall, bronchioles, and interstitium in susceptible individuals. Although HP is predominantly an occupational disease, seen in adulthood, cases in children have been described. The diagnosis of HP requires a high degree of suspicion. The treatment consists in avoiding contact with the antigen, and, in some cases, systemic corticosteroids might be necessary in order to prevent its progression to pulmonary fibrosis. We report the clinical cases of three children with a history of contact with birds and a family history of HP. All three patients presented with cough and dyspnea on exertion. The disease was diagnosed on the basis of the clinical history and ancillary diagnostic test results consistent with the diagnosis, including a predominance of lymphocytes (> 60%, CD8+ T lymphocytes in particular in bronchoalveolar lavage fluid and a ground-glass pattern seen on HRCT of the chest. Early diagnosis is crucial in order to prevent HP from progressing to pulmonary fibrosis. Hereditary factors seem to influence the onset of the disease.

  4. Intravenous immunoglobulin treatment of children with autism.

    Science.gov (United States)

    Plioplys, A V

    1998-02-01

    Since autism has been associated with immunologic abnormalities suggesting an autoimmune cause of autistic symptoms in a subset of patients, this study was undertaken to investigate whether intravenous immunoglobulin (i.v.Ig) would improve autistic symptoms. Ten autistic children with immunologic abnormalities, demonstrated on blood tests, were enrolled in this study. Their ages ranged from 4 to 17 years, with two girls and eight boys. Eight children (1 female and 7 male) historically had undergone autistic regression. Intravenous immunoglobulin, 200 to 400 mg/kg, was administered every 6 weeks for an intended treatment program of four infusions. In five children, there was no detectable change in behavior during the treatment program. In four children, there was a mild improvement noted in attention span and hyperactivity. In none of these children did the parents feel that the improvement was sufficient to warrant further continuation of the infusions beyond the termination of the program. Only in one child was there a very significant improvement, with almost total amelioration of autistic symptoms over the time period of the four infusions. Once the treatment program was completed, this child gradually deteriorated over a 5-month time period and fully reverted to his previous autistic state. In this treatment program, five children had no response to intravenous immunoglobulin. In the four children who showed mild improvements, those improvements may simply have been due to nonspecific effects of physician intervention and parental expectation (ie, placebo effect). However, in one child there was a very significant amelioration of autistic symptoms. There were no distinguishing historic or laboratory features in this child who improved. Given a positive response rate of only 10% in this study, along with the high economic costs of the immunologic evaluations and the intravenous immunoglobulin treatments, the use of intravenous immunoglobulin to treat autistic

  5. Diagnosis and treatment of the Pierre Robin sequence: results of a retrospective clinical study and review of the literature.

    NARCIS (Netherlands)

    Elzen, A. van der; Semmekrot, B.A.; Bongers, M.H.F.; Huygen, P.L.M.; Marres, H.A.M.

    2001-01-01

    We performed a retrospective study of all children with Pierre Robin sequence (PRS), admitted to our hospital from 1981-1998 in order to evaluate diagnosis, treatment and prognosis. Patients were divided into two categories: isolated PRS (group 1) and PRS plus, i.e. PRS as part of a more complex syn

  6. Results of the dental treatment in children with bruxism

    Directory of Open Access Journals (Sweden)

    Kirenia Pieri Silva

    2015-02-01

    Full Text Available Background: bruxism is a habit associated to stress and to occlusal disturbances which can be solved applying an odontological treatment. Objective: to evaluate the effectiveness of the odotological treatment in students from 5 to 11 years with bruxism. Methods: a study of cuasiexperimental intervention design of type before and after in all the children with bruxim (52, with ages of 5 to 11 elderly years, belonging to Health Area II. Cienfuegos. An oral exam to each child was made; parents and teachers were interviewed as well. Studied variables were: Age, sex, the bruxism's grade of affectation, psychological diagnosis and symptoms and the bruxism's signs. The results present itself in draw of numbers and percentages. Results: the bigger affectation predominated in the female sex from 6 to 11 elderly years and the psychological diagnosis of severe disorders. When examining the signs and symptoms of bruxism before the intervention, the more frequent were the dental squeaking and the dental squeezing. After applying the treatment, more than the half of the children improved his symptomatology in relation to the initial status, and an improvement of over the 70 % in the event of the muscular pain was achieved. Conclusion: the effectiveness of the dental treatment in the improvement of the signs and symptoms of the bruxism was demonstrated.

  7. Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management.

    Science.gov (United States)

    Kaditis, Athanasios G; Alonso Alvarez, Maria Luz; Boudewyns, An; Alexopoulos, Emmanouel I; Ersu, Refika; Joosten, Koen; Larramona, Helena; Miano, Silvia; Narang, Indra; Trang, Ha; Tsaoussoglou, Marina; Vandenbussche, Nele; Villa, Maria Pia; Van Waardenburg, Dick; Weber, Silke; Verhulst, Stijn

    2016-01-01

    This document summarises the conclusions of a European Respiratory Society Task Force on the diagnosis and management of obstructive sleep disordered breathing (SDB) in childhood and refers to children aged 2-18 years. Prospective cohort studies describing the natural history of SDB or randomised, double-blind, placebo-controlled trials regarding its management are scarce. Selected evidence (362 articles) can be consolidated into seven management steps. SDB is suspected when symptoms or abnormalities related to upper airway obstruction are present (step 1). Central nervous or cardiovascular system morbidity, growth failure or enuresis and predictors of SDB persistence in the long-term are recognised (steps 2 and 3), and SDB severity is determined objectively preferably using polysomnography (step 4). Children with an apnoea-hypopnoea index (AHI) >5 episodes·h(-1), those with an AHI of 1-5 episodes·h(-1) and the presence of morbidity or factors predicting SDB persistence, and children with complex conditions (e.g. Down syndrome and Prader-Willi syndrome) all appear to benefit from treatment (step 5). Treatment interventions are usually implemented in a stepwise fashion addressing all abnormalities that predispose to SDB (step 6) with re-evaluation after each intervention to detect residual disease and to determine the need for additional treatment (step 7).

  8. Diagnosis and treatment of arterial-ureteric fistula.

    Science.gov (United States)

    Bietz, Gabriel; House, Aaron; Erickson, Deborah; Endean, Eric D

    2014-06-01

    A 45-year-old woman presented with gross hematuria. She had previously undergone an aortobifemoral bypass that subsequently became infected. The infected graft was removed and replaced with homograft. An arterioureteric fistula was identified with angiography and the patient was treated with an iCast stent graft. Diagnosis of arterioureteric fistula should be suspected in patients with gross hematuria and associated risk factors. We would recommend angiography for diagnosis and simultaneous treatment with a stent graft, although the long-term durability and outcome is unknown.

  9. Diagnosis and treatment of 34 cases of blunt duodenal injuries

    Institute of Scientific and Technical Information of China (English)

    BAO Shi-ting; WANG San-ming

    2007-01-01

    Objective: To summarize the experience on diagnosis and treatment of blunt duodenal injuries, and thus to improve the therapeutic skills. Methods: Clinical data of 34 cases of blunt duodenal injuries admitted to our hospital from 1990 to 2006 were retrospectively analyzed. Results: Among them, 28 cases were cured, 20 cases presented with complications, and 6 cases died. The causes of death were: duodenal or pancreatic fistula in 2 cases, intra- and retroperitoneal infection complicating septicopyemia in 2, disseminated intravascular coagulation in 1 and multiple organ failure in 1. Conclusions: Misdiagnosis and missed diagnosis predispose to happen for blunt duodenal injuries. Early recognition and surgical intervention are critical to a successful rescue.

  10. Amyloidotic cardiomyopathy: multidisciplinary approach to diagnosis and treatment.

    Science.gov (United States)

    Seldin, David C; Berk, John L; Sam, Flora; Sanchorawala, Vaishali

    2011-07-01

    Amyloidotic cardiomyopathy (ACMP) occurs in the setting of rare genetic diseases, blood dyscrasias, chronic infection and inflammation, and advanced age. Cardiologists are on the front lines of diagnosis of ACMP when evaluating patients with unexplained dyspnea, congestive heart failure, or arrhythmias. Noninvasive detection of diastolic cardiac dysfunction and unexplained left ventricular hypertrophy should be followed by biopsy to demonstrate the presence of amyloid deposits and appropriate genetic, biochemical, and immunologic testing to accurately define the type of amyloid. Growing numbers of treatment options exist for these diseases, and timely diagnosis and institution of therapy is essential for preservation of cardiac function.

  11. Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo

    Directory of Open Access Journals (Sweden)

    Muhammed Dagkiran

    2015-12-01

    Full Text Available Benign paroxysmal positional vertigo is the cause of peripheral vertigo, which only takes seconds posed by certain head and body position and led to severe attacks of vertigo. Therefore, it is a disturbance that causes a continuous fear of fall and anxiety in some patients. Although benign paroxysmal positional vertigo is the most common cause of peripheral vertigo, it may cause unnecessary tests, treatment costs and the loss of labor due to the result of the delay in the diagnosis and treatment stages. Diagnosis and treatment of this disease is easy. High success rates can be achieved with appropriate repositioning maneuvers after taking a detailed medical history and accurate assessment of accompanying nystagmus. The aim of this paper was to review the updated information about benign paroxysmal positional vertigo. [Archives Medical Review Journal 2015; 24(4.000: 555-564

  12. Psychological effects of diagnosis and treatment of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Frederiksen, Maria Eiholm; Njor, Sisse; Lynge, Elsebeth

    2015-01-01

    BACKGROUND: Treatment of cervical intraepithelial neoplasia (CIN) is a common minor surgical procedure to prevent uterine cervical cancer. However, news of an abnormality detected at screening for cancer might cause the woman to worry. OBJECTIVES: To investigate the psychological consequences...... psychological outcomes in women with a histological diagnosis or treatment of CIN, and in women having an outcome other than CIN at cervical screening. DATA COLLECTION AND ANALYSIS: We abstracted the data using a pre-specified list of study characteristics and measured outcomes. For studies not reporting...... statistical testing, we estimated the statistical significance of the differences between the compared groups using unpaired t tests. MAIN RESULTS: From 5099 retrieved abstracts, 16 studies were included. Diagnosis and treatment of CIN were associated with worse psychological outcomes than normal cytology...

  13. Advances in diagnosis and treatment of cerebral venous system diseases

    Directory of Open Access Journals (Sweden)

    Xiao-yun LIU

    2016-11-01

    Full Text Available Cerebral venous system diseases include cerebral venous thrombosis (CVT, venous sinus stenosis, carotid cavernous fistula (CCF, intracranial arteriovenous malformation (AVM and so on. In recent years, due to the rapid development of neuroimaging and interventional technology, more and more cerebral venous system diseases have been timely diagnosed and treated, such as magnetic resonance black-blood thrombus imaging (MRBTI in the diagnosis of CVT, stenting in the treatment of venous sinus stenosis, micro coil plus Onyx glue or covered stents in the treatment of CCF, which allow us to make a deeper recognition of cerebral venous system diseases. Therefore, this paper will introduce the latest diagnosis and treatment of cerebral venous system diseases. DOI: 10.3969/j.issn.1672-6731.2016.11.006

  14. Pathogenesis, diagnosis and treatment of cerebral fat embolism

    Institute of Scientific and Technical Information of China (English)

    Yihua Zhou; Ying Yuan; Chahua Huang; Lihua Hu; Xiaoshu Cheng

    2015-01-01

    In this study, we analyzed two cases of pure cerebral fat embolism and reviewed related literatures to explore the pathogenesis, clinical manifestations, diagnosis and treatment of cerebral fat embolism, improve the treatment efficiency and reduce the misdiagnosis rate.In our cases, patients fully returned to consciousness at the different times with good prognosis, normal vital signs and without obvious sequelae.For patients with the limb fractures, who developed coma without chest distress, dyspnea or other pulmonary symptoms 12 or 24 h post injury, cerebral fat embolism should be highly suspected, except for those with intracranial lesions, such as delayed traumatic intracerebral hemorrhage, etc.The early diagnosis and comprehensive treatment can improve prognosis.

  15. Pulmonary hypertension in children with congenital heart disease (PAH-CHD, PPHVD-CHD). Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK.

    Science.gov (United States)

    Kozlik-Feldmann, Rainer; Hansmann, Georg; Bonnet, Damien; Schranz, Dietmar; Apitz, Christian; Michel-Behnke, Ina

    2016-05-01

    Pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is a complex disease that presents with a broad spectrum of morphological and haemodynamic findings of varying severity. Recently, the aspect of paediatric pulmonary hypertensive vascular disease (PPHVD) has been introduced to expand the understanding of the full spectrum of pulmonary hypertension and increased pulmonary vascular resistance. Evaluation and treatment of PAH-CHD/PPHVD-CHD can be divided into in different topics. First, defining criteria for operability and initiation of advanced therapies preoperatively and postoperatively is an unresolved issue. Second, management of Eisenmenger syndrome is still an important question, with recent evidence on the severity of the disease and a more rapidly progressive course than previously described. Third, the Fontan circulation with no subpulmonary ventricle requires a distinct discussion, definition and classification since even a mild rise in pulmonary vascular resistance may lead to the so-called failing Fontan situation. Patients with CHD and single-ventricle physiology (Fontan/total cavopulmonary anastomosis) require a particularly stepwise and individualised approach. This consensus statement is on the current evidence for the most accurate evaluation and treatment of increased pulmonary artery pressure and resistance, as well as ventricular dysfunction, in children with congenital heart defects, and provides according practical recommendations. To optimise preoperative and postoperative management in patients with PAH-CHD, diagnostic and treatment algorithms are provided.

  16. How to improve the early diagnosis of Trypanosoma cruzi infection: relationship between validated conventional diagnosis and quantitative DNA amplification in congenitally infected children.

    Directory of Open Access Journals (Sweden)

    Jacqueline Bua

    Full Text Available BACKGROUND: According to the Chagas congenital transmission guides, the diagnosis of infants, born to Trypanosoma cruzi infected mothers, relies on the detection of parasites by INP micromethod, and/or the persistence of T. cruzi specific antibody titers at 10-12 months of age. METHODOLOGY AND PRINCIPAL FINDINGS: Parasitemia levels were quantified by PCR in T. cruzi-infected children, grouped according to the results of one-year follow-up diagnosis: A Neonates that were diagnosed in the first month after delivery by microscopic blood examination (INP micromethod (n = 19 had a median parasitemia of 1,700 Pe/mL (equivalent amounts of parasite DNA per mL; B Infants that required a second parasitological diagnosis at six months of age (n = 10 showed a median parasitemia of around 20 Pe/mL and 500 Pe/mL at 1 and 6 months old, respectively, and C babies with undetectable parasitemia by three blood microscopic observations but diagnosed by specific anti - T. cruzi serology at around 1 year old, (n = 22, exhibited a parasitemia of around 5 Pe/mL, 800 Pe/mL and 20 Pe/mL 1, 6 and 12 month after delivery, respectively. T. cruzi parasites were isolated by hemoculture from 19 congenitally infected children, 18 of which were genotypified as DTU TcV, (former lineage TcIId and only one as TcI. SIGNIFICANCE: This report is the first to quantify parasitemia levels in more than 50 children congenitally infected with T. cruzi, at three different diagnostic controls during one-year follow-up after delivery. Our results show that the parasite burden in some children (22 out of 51 is below the detection limit of the INP micromethod. As the current trypanocidal treatment proved to be very effective to cure T. cruzi - infected children, more sensitive parasitological methods should be developed to assure an early T. cruzi congenital diagnosis.

  17. [Treatment of pain in children burns].

    Science.gov (United States)

    Latarjet, J; Pommier, C; Robert, A; Comparin, J P; Foyatier, J L

    1997-03-01

    Burn injury is considered by children as one of the most painful traumas (just after bone factures). Burn pain in children can and must be controlled as well as for adult patients, with almost identical techniques. Continuous pain from injury and intermittent pain caused by therapeutic procedures must be evaluated and treated separately. Due to very high levels of nociception, satisfactory management of procedural pain requires the use of opioid therapy. Non pharmacological methods are meaningless if pharmacological treatment is not optimal.

  18. African American families on autism diagnosis and treatment: the influence of culture.

    Science.gov (United States)

    Burkett, Karen; Morris, Edith; Manning-Courtney, Patricia; Anthony, Jean; Shambley-Ebron, Donna

    2015-10-01

    Cultural factors such as health care access and autism spectrum disorder (ASD) symptom interpretations have been proposed as impacting delayed diagnosis and treatment for African American children with ASD. A qualitative study of urban African American families caring for their child with autism was conducted with 24 family members and 28 ASD professionals. Cultural caring meant families protected their child from harm including potential or actual distrustful encounters, and took action for their child and community to optimize their child's health and address the knowledge deficits of ASD within their community. Families and professionals believed cultural influences delayed families' receiving and seeking appropriate health care for the African American child with ASD affecting timely autism diagnosis and treatment.

  19. [Ankle joint arthritis--etiology, diagnosis and treatment].

    Science.gov (United States)

    Uri, Ofir; Haim, Amir

    2008-11-01

    Ankle joint arthritis causes functional limitation and affects the quality of life many patients. It follows traumatic injuries, inflammatory joint arthritis, primary osteoarthritis, hemochromatosis and infections. Understanding the unique anatomy and biomechanics of the ankle is important for diagnosis and treatment of ankle joint pathology. The treatment of ankle joint arthritis has advanced considerably in recent years and it is still a surgical challenge. Total ankle replacement seems to be a promising form of treatment, even though current data does not demonstrate advantages over ankle joint arthrodesis.

  20. Essentiality of early diagnosis of molar incisor hypomineralization in children and review of its clinical presentation, etiology and management.

    Science.gov (United States)

    Garg, Nishita; Jain, Abhay Kumar; Saha, Sonali; Singh, Jaspal

    2012-09-01

    Molar incisor hypomineralization (MIH) is a common developmental condition resulting in enamel defects in first permanent molars and permanent incisors. It presents at eruption of these teeth. One to four molars, and often also the incisors, could be affected. Since first recognized, the condition has been puzzling and interpreted as a distinct phenomenon unlike other enamel disturbances. Early diagnosis is essential since, rapid breakdown of tooth structure may occur, giving rise to acute symptoms and complicated treatment. The purpose of this article is to review MIH and illustrate its diagnosis and clinical management in young children. How to cite this article: Garg N, Jain AK, Saha S, Singh J. Essentiality of Early Diagnosis of Molar Incisor Hypomineralization in Children and Review of its Clinical Presentation, Etiology and Management. Int J Clin Pediatr Dent 2012;5(3):190-196.

  1. Diagnosis and treatment of hereditary tyrosinemia in Japan.

    Science.gov (United States)

    Nakamura, Kimitoshi; Matsumoto, Shirou; Mitsubuchi, Hiroshi; Endo, Fumio

    2015-01-01

    Hereditary tyrosinemia is an autosomal recessive inherited disease that manifests as three types (types I-III). We conducted a nationwide survey of this disease in Japan, and here review the results in relation to prevalence, clinical characteristics, and treatment and diagnosis. A definitive diagnosis of tyrosinemia type I is difficult to obtain based only on blood tyrosine level. Detection of succinylacetone using dried blood spots or urinary organic acid analysis, however, is useful for diagnosis. In tyrosinemia type I, dietary therapy and nitisinone (Orfandin®) are effective. Prognosis is greatly affected by the complications of liver cancer and hypophosphatemic rickets; even patients that are treated early with nitisinone may develop liver cancer. Long-term survival can be expected in type I if nitisinone therapy is effective. Prognosis in types II and III is relatively good.

  2. DIAGNOSIS AND TREATMENT OF INSIDIOUS RECURRENT SMALL INTESTINAL HEMORRHAGE

    Institute of Scientific and Technical Information of China (English)

    何小东; 陶蔚; 郑朝纪; 张振寰

    2000-01-01

    Objective. To improve the localized diagnosis of insidious recurrent small intestinal hemorrhage. Methods. This retrospective analysis include 64 cases of such diseases, which were admitted from 1988 to 1998 toour hospital. Result. Ultrasonography, CT, small bowel pneumobariunlgraphy, diluted barium enema, isetopic examination, DSA and intraoperafive small-bowel endoscopy were used for diagnosis of hemonrrhagic site, and 37 cases got a defirfite location before operation, while 10 cases were confirmed the diagnosis during the operation. Forty-seven cases were treated surgically, while the other 17 cases had non-surgical treatment. Of the 47 cases,39 cases underwent partial en-terectomy, 5 cases had suture and ligature of vascular deformity, 2 cases had Whipple's operation, and one patient had ectomy of the end of ileum and right colon. Conclusion. DSA, Isotopic examination and intraoperafive enteroscopy are of considerable importance for the lo-cation judgement of recurrent small intestinal hemorrhage.

  3. Asthma in elite athletes: pathogenesis, diagnosis, differential diagnoses, and treatment

    DEFF Research Database (Denmark)

    Pedersen, Lars; Elers, Jimmi; Backer, Vibeke

    2011-01-01

    Elite athletes have a high prevalence of asthma and exercise-induced bronchoconstriction. Although respiratory symptoms can be suggestive of asthma, the diagnosis of asthma in elite athletes cannot be based solely on the presence or absence of symptoms; diagnosis should be based on objective...... measurements, such as the eucapnic voluntary hyperpnea test or exercise test. When considering that not all respiratory symptoms are due to asthma, other diagnoses should be considered. Certain regulations apply to elite athletes who require asthma medication for asthma. Knowledge of these regulations...... is essential when treating elite athletes. This article is aimed at physicians who diagnose and treat athletes with respiratory symptoms. It focuses on the pathogenesis of asthma and exercise-induced bronchoconstriction in elite athletes and how the diagnosis can be made. Furthermore, treatment of elite...

  4. Biomarkers in the diagnosis and treatment of postural tachycardia syndrome in children%分子标志物在儿童体位性心动过速综合征诊治中的应用

    Institute of Scientific and Technical Information of China (English)

    金红芳; 李红霞

    2016-01-01

    Postural tachycardia syndrome (POTS)is one common type of orthostatic intolerance (OI)in chil-dren.POTS is characterized by OI symptoms and excessively increased heart rate from supine to upright position.Main treatments for POTS are physical training,automatic function exercise and medications including α-receptor agonists,β-receptor blockers and oral rehydration salts.This review aimed to summarize the biomarkers in the diagnosis and treatment of POTS.%体位性心动过速综合征(POTS)是儿童直立不耐受的主要类型之一。POTS 患儿在临床上以直立不耐受的症状为主要表现,且直立后心率较基础状态下过度增快。目前对 POTS 的治疗方法有健康教育、自主神经功能锻炼及药物应用(α受体激动剂、β受体阻滞剂及口服补液盐)等。现主要就生物标志物在 POTS 诊疗过程中的应用进行综述。

  5. Non-classical phenotypes of autoimmune hepatitis and advances in diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    Albert J Czaja; Yusuf Bayraktar

    2009-01-01

    Non-classical manifestations of autoimmune hepatitis can delay diagnosis and treatment. Our aims were to describe the clinical phenotypes that can confound the diagnosis, detail scoring systems that can ensure their recognition, and outline advances in treatment that can improve their outcome. Prime source and review articles in English were selected through Medline from 1970-2008 and assimilated into personal libraries spanning 32 years. Acute severe or asymptomatic presentations and atypical histological findings,including centrilobular zone 3 necrosis and concurrent bile duct changes, are compatible with the diagnosis.Cholangiographic abnormalities may be present in children and adults with the disease, and autoimmune hepatitis must be considered in patients without autoantibodies or with antimitochondrial antibodies and no other cholestatic features. Asymptomatic patients frequently become symptomatic; mild disease can progress; and there are no confident indices that justify withholding treatment. Two diagnostic scoring systems with complementary virtues have been developed to evaluate patients with confusing features. Normal liver tests and tissue constitute the optimal end point of treatment, and the first relapse is an indication for longterm azathioprine therapy. Cyclosporine, tacrolimus and mycophenolate mofetil are promising salvage therapies, and budesonide with azathioprine may be a superior frontline treatment. We conclude that the non-classical phenotypes of autoimmune hepatitis can be recognized promptly, diagnosed accurately, and treated effectively.

  6. Diagnosis and treatment of scabies in 2002: rapid diagnosis and proper management limit the risk of spread.

    Science.gov (United States)

    2002-10-01

    (1) Scabies is due to a parasite, Sarcoptes scabiei hominis, that colonises the human epidermis. It can affect people of all ages, regardless of their socioeconomic status. (2) Common scabies in adults causes sometimes intense pruritus and skin lesions with a characteristic aspect and distribution. The lesions are often more extensive in children. (3) Crusted (hyperkeratotic) scabies, a severe and highly contagious form, mainly occurs in immunocompromised patients. (4) Scabies lesions are often atypical in elderly patients. (5) The diagnosis of common scabies is generally based on clinical findings. Atypical forms can be diagnosed by direct examination of skin scrapings for parasites. (6) Topical treatment is based on insecticides. 5% permethrin is recommended in reference textbooks. Benzyl benzoate (possibly combined with sulfiram) is poorly evaluated. (7) Scabies can be treated more easily with ivermectin, an oral antiparasitic agent.

  7. Improved diagnosis in children with partial epilepsy using a multivariable prediction model based on EEG network characteristics.

    Directory of Open Access Journals (Sweden)

    Eric van Diessen

    Full Text Available BACKGROUND: Electroencephalogram (EEG acquisition is routinely performed to support an epileptic origin of paroxysmal events in patients referred with a possible diagnosis of epilepsy. However, in children with partial epilepsies the interictal EEGs are often normal. We aimed to develop a multivariable diagnostic prediction model based on electroencephalogram functional network characteristics. METHODOLOGY/PRINCIPAL FINDINGS: Routinely performed interictal EEG recordings at first presentation of 35 children diagnosed with partial epilepsies, and of 35 children in whom the diagnosis epilepsy was excluded (control group, were used to develop the prediction model. Children with partial epilepsy were individually matched on age and gender with children from the control group. Periods of resting-state EEG, free of abnormal slowing or epileptiform activity, were selected to construct functional networks of correlated activity. We calculated multiple network characteristics previously used in functional network epilepsy studies and used these measures to build a robust, decision tree based, prediction model. Based on epileptiform EEG activity only, EEG results supported the diagnosis of with a sensitivity and specificity of 0.77 and 0.91 respectively. In contrast, the prediction model had a sensitivity of 0.96 [95% confidence interval: 0.78-1.00] and specificity of 0.95 [95% confidence interval: 0.76-1.00] in correctly differentiating patients from controls. The overall discriminative power, quantified as the area under the receiver operating characteristic curve, was 0.89, defined as an excellent model performance. The need of a multivariable network analysis to improve diagnostic accuracy was emphasized by the lack of discriminatory power using single network characteristics or EEG's power spectral density. CONCLUSIONS/SIGNIFICANCE: Diagnostic accuracy in children with partial epilepsy is substantially improved with a model combining functional

  8. Emerging fungal infections among children: A review on its clinical manifestations, diagnosis, and prevention.

    Science.gov (United States)

    Jain, Akansha; Jain, Shubham; Rawat, Swati

    2010-10-01

    The incidence of fungal infections is increasing at an alarming rate, presenting an enormous challenge to healthcare professionals. This increase is directly related to the growing population of immunocompromised individuals especially children resulting from changes in medical practice such as the use of intensive chemotherapy and immunosuppressive drugs. Although healthy children have strong natural immunity against fungal infections, then also fungal infection among children are increasing very fast. Virtually not all fungi are pathogenic and their infection is opportunistic. Fungi can occur in the form of yeast, mould, and dimorph. In children fungi can cause superficial infection, i.e., on skin, nails, and hair like oral thrush, candida diaper rash, tinea infections, etc., are various types of superficial fungal infections, subcutaneous fungal infection in tissues under the skin and lastly it causes systemic infection in deeper tissues. Most superficial and subcutaneous fungal infections are easily diagnosed and readily amenable to treatment. Opportunistic fungal infections are those that cause diseases exclusively in immunocompromised individuals, e.g., aspergillosis, zygomycosis, etc. Systemic infections can be life-threatening and are associated with high morbidity and mortality. Because diagnosis is difficult and the causative agent is often confirmed only at autopsy, the exact incidence of systemic infections is difficult to determine. The most frequently encountered pathogens are Candida albicans and Aspergillus spp. But other fungi such as non-albicans Candida spp. are increasingly important.

  9. Emerging fungal infections among children: A review on its clinical manifestations, diagnosis, and prevention

    Directory of Open Access Journals (Sweden)

    Akansha Jain

    2010-01-01

    Full Text Available The incidence of fungal infections is increasing at an alarming rate, presenting an enormous challenge to healthcare professionals. This increase is directly related to the growing population of immunocompromised individuals especially children resulting from changes in medical practice such as the use of intensive chemotherapy and immunosuppressive drugs. Although healthy children have strong natural immunity against fungal infections, then also fungal infection among children are increasing very fast. Virtually not all fungi are pathogenic and their infection is opportunistic. Fungi can occur in the form of yeast, mould, and dimorph. In children fungi can cause superficial infection, i.e., on skin, nails, and hair like oral thrush, candida diaper rash, tinea infections, etc., are various types of superficial fungal infections, subcutaneous fungal infection in tissues under the skin and lastly it causes systemic infection in deeper tissues. Most superficial and subcutaneous fungal infections are easily diagnosed and readily amenable to treatment. Opportunistic fungal infections are those that cause diseases exclusively in immunocompromised individuals, e.g., aspergillosis, zygomycosis, etc. Systemic infections can be life-threatening and are associated with high morbidity and mortality. Because diagnosis is difficult and the causative agent is often confirmed only at autopsy, the exact incidence of systemic infections is difficult to determine. The most frequently encountered pathogens are Candida albicans and Aspergillus spp. But other fungi such as non-albicans Candida spp. are increasingly important.

  10. [Dual diagnosis in anxiety disorders: pharmacologic treatment recommendations].

    Science.gov (United States)

    Sáiz Martínez, Pilar Alejandra; Jimenez Treviño, Luis; Díaz Mesa, Eva M; García-Portilla González, M Paz; Marina González, Pedro; Al-Halabí, Susana; Szerman, Néstor; Bobes García, Julio; Ruiz, Pedro

    2014-01-01

    Anxiety disorders and substance use disorders are highly comorbid (between 18% and 37%), and such comorbidity complicates treatment and worsens prognosis (including higher suicide risk). There are not many research works on the specific pharmacologic treatment of dual comorbid anxiety disorders. Most authors recommend a simultaneous approach of both, anxiety and substance use, disorders. Research data on pharmacotherapy suggest that psychotropics used in the treatment of anxiety disorders are also effective in dual diagnosis. SSRIs are considered first-line therapy in the treatment of dual anxiety while benzodiacepines should be avoided. New generation antiepileptic have shown efficacy in case series and open label studies in the latest years, thus being a promising treatment option for dual comorbid anxiety disorders, specially pregabalin in generalized anxiety disorder.

  11. OVERVIEW FOR THE DIAGNOSIS AND TREATMENT OF GALLBLADDER CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    何小东; 肖毅; 郑朝纪; 张振寰; 张建希

    2000-01-01

    Objective. To improve the recognition of diagnosis and treatment of gallbladder cancer. Methods. Retrospective analysis of 52 cases of gallbladder carcinoma in our hospital from 1988 to 1998. Results. Preoperative diagnostic rate was 90.3%, of which 12 cases (23%) were early stage of carcinoma. The total operation resection rate was 55.8%, for which only 17.8% were advance stage of carcinoma. Conclution. The early diagnosis is the key factor of increasing treatment successful rate. The following are the symptoms that raise our special attention to carcinoma of gallbladder: ( 1 ) Age over 50 have recurrent eholecysfitis and with past history of gallstone; (2) Congenital malformation of bile duct; (3) Local thickening and irregularity of gallbladder,gall; (4) Polypoid lesion larger than lem inside gallbladder; (5) Atrophic gallbladder; (6) Intraluminal stone of gallbladder does not move when change in body position; (7) Regional lymph node enlargement.

  12. Diagnosis and Treatment of Pseudo-Class III Malocclusion

    OpenAIRE

    Ariel Reyes; Luis Serret; Marcos Peguero; Orlando Tanaka

    2014-01-01

    Pseudo-Class III malocclusion is characterized by the presence of an anterior crossbite due to a forward functional displacement of the mandible; in most cases, the maxillary incisors present some degree of retroclination, and the mandibular incisors are proclined. Various types of appliances have been described in the literature for the early treatment of pseudo-Class III malocclusion. The objectives of this paper are to demonstrate the importance of making the differential diagnosis between...

  13. Diagnosis of septic arthritis and initial antibiotic treatment

    OpenAIRE

    Bombaci, Hasan; Canbora, Kerem; Onur, Gokhan; Gorgec, Mucahit; Dosoglu, Nilgun

    2004-01-01

    Objectives: This study was designed to determine the similarities and differences in clinical, laboratory and radiographic presentation of septic arthritis in childhood and at adult ages, to find out its etiological profile, and to establish an antibiotic treatment protocol for the initial period and for patients in whom the causative agent could not be identified. Methods: Thirty-four patients (age range 15 months to 85 years) who underwent surgery with a diagnosis of septic arthritis wer...

  14. A consensus on the diagnosis and treatment of acromegaly complications

    OpenAIRE

    Melmed, S; Casanueva, F.F.; Klibanski, A; Bronstein, M. D.; Chanson, P.; Lamberts, S. W.; Strasburger, C. J.; Wass, J. A. H.; Giustina, A

    2012-01-01

    In March 2011, the Acromegaly Consensus Group met to revise and update the guidelines on the diagnosis and treatment of acromegaly complications. The meeting was sponsored by the Pituitary Society and the European Neuroendocrinology Association and included experts skilled in the management of acromegaly. Complications considered included cardiovascular, endocrine and metabolic, sleep apnea, bone diseases, and mortality. Outcomes in selected, related clinical conditions were also considered, ...

  15. Prevalence, etiology, diagnosis, treatment and complications of supernumerary teeth

    OpenAIRE

    Ata-Ali Mahmud, Fadi; Ata-Ali Mahmud, Francisco Javier; Peñarrocha Oltra, David; Peñarrocha Diago, Miguel

    2014-01-01

    The aim of this article was to review the literature on supernumerary teeth, analyzing their prevalence, etiology, diagnosis, treatment and possible complications. An electronic search was made in the Pubmed-Medline database up to January 2014 using the key search terms “multiple supernumerary teeth” (n=279), “prevalence supernumerary teeth” (n=361), and “supernumerary teeth” (n=2412). In addition to the articles initially identified, others were included in the review proceeding from a manua...

  16. 儿童咳嗽变异性哮喘的中医诊治探讨%The Discussion of Diagnosis and Treatment of Traditional Chinese Medicine of Children Cough Variant Asthma

    Institute of Scientific and Technical Information of China (English)

    高艳

    2012-01-01

    [Objective] To discuss the question that children cough variant asthma should be diagnosed and treated in accordance with what disease in Traditional Chinese Medicine. [Methods] Using two rounds of questionnaire survey method. In the questionnaires, average, unimportant percentage, grading, coefficient of variation are calculated to statistically analyze the extent and level of coordination of experts' opinion of various indexes. [Results] There is little difference in the statistical results of "asthma" and "cough", but the extent and level of importance and coordination of experts' opinions in asthma are slightly higher than the cough. [Conclusion] More experts agreed that children cough variant asthma should be diagnosed and treated in accordance with asthma in Traditional Chinese Medicine and a standardized treatment is necessary.%[目的]探讨儿童咳嗽变异性哮喘应按中医何病进行诊治.[方法]进行两轮专家问卷调查,对每轮问卷中专家意见的集中程度与协调程度,采用计算均数、不重要百分比、等级和变异系数的方式进行统计分析.[结果]“哮喘”、“咳嗽”两个选项的统计结果差别不大,其中哮喘的重要性与专家协调程度均略高于咳嗽.[结论]更多专家赞同儿童咳嗽变异性哮喘应按中医哮喘进行辨证论治,与哮喘一样要进行全程规范的治疗.

  17. Why Tell Children: A Synthesis of the Global Literature on Reasons for Disclosing or Not Disclosing an HIV Diagnosis to Children 12 and under

    Science.gov (United States)

    Krauss, Beatrice J.; Letteney, Susan; Okoro, Chioma N.

    2016-01-01

    While the psychological and health benefits of knowing one’s HIV diagnosis have been documented for adults and adolescents, practice is still in development for younger children. Moderating conditions for whether or not to tell a child he/she has HIV vary by region and local context. They include accessibility of treatment, consideration of HIV as a stigmatizing condition, prevalence of HIV, and an accompanying presumption that any illness is HIV-related, parent or caregiver concerns about child reactions, child’s worsening health, assumptions about childhood and child readiness to know a diagnosis, and lack of policies such as those that would prevent bullying of affected children in schools. In this systematic review of the global literature, we summarize the reasons caregivers give for telling or not telling children 12 and under their HIV diagnosis. We also include articles in which children reflect on their desires for being told. While a broad number of reasons are given for telling a child – e.g., to aid in prevention, adaptation to illness (e.g., primarily to promote treatment adherence), understanding social reactions, and maintaining the child–adult relationship – a narrower range of reasons, often related to immediate child or caregiver well-being or discomfort, are given for not telling. Recommendations are made to improve the context for disclosure by providing supports before, during, and after disclosure and to advance the research agenda by broadening samples and refining approaches. PMID:27660752

  18. Why tell children: A synthesis of the global literature on reasons for disclosing or not disclosing an HIV diagnosis to children 12 and under

    Directory of Open Access Journals (Sweden)

    Beatrice J. Krauss

    2016-09-01

    Full Text Available While the psychological and health benefits of knowing one’s HIV diagnosis have been documented for adults and adolescents, practice is still in development for younger children. Moderating conditions for whether or not to tell a child he/she has HIV vary by region and local context. They include accessibility of treatment, consideration of HIV as a stigmatizing condition, prevalence of HIV and an accompanying presumption that any illness is HIV-related, parent or caregiver concerns about child reactions, child’s worsening health, assumptions about childhood and child readiness to know a diagnosis, and lack of policies such as those that would prevent bullying of affected children in schools. In this systematic review of the global literature, we summarize the reasons caregivers give for telling or not telling children 12 and under their HIV diagnosis. We also include articles in which children reflect on their desires for being told. While a broad number of reasons are given for telling a child—e.g., to aid in prevention, adaptation to illness (e.g., primarily to promote treatment adherence, understanding social reactions, and maintaining the child-adult relationship—a narrower range of reasons, often related to immediate child or caregiver well-being or discomfort, are given for not telling. Recommendations are made to improve the context for disclosure by providing supports before, during and after disclosure and to advance the research agenda by broadening samples and refining approaches.

  19. Diagnosis and treatment of chronic acquired demyelinating polyneuropathies.

    Science.gov (United States)

    Latov, Norman

    2014-08-01

    Chronic neuropathies are operationally classified as primarily demyelinating or axonal, on the basis of electrodiagnostic or pathological criteria. Demyelinating neuropathies are further classified as hereditary or acquired-this distinction is important, because the acquired neuropathies are immune-mediated and, thus, amenable to treatment. The acquired chronic demyelinating neuropathies include chronic inflammatory demyelinating polyneuropathy (CIDP), neuropathy associated with monoclonal IgM antibodies to myelin-associated glycoprotein (MAG; anti-MAG neuropathy), multifocal motor neuropathy (MMN), and POEMS syndrome. They have characteristic--though overlapping--clinical presentations, are mediated by distinct immune mechanisms, and respond to different therapies. CIDP is the default diagnosis if the neuropathy is demyelinating and no other cause is found. Anti-MAG neuropathy is diagnosed on the basis of the presence of anti-MAG antibodies, MMN is characterized by multifocal weakness and motor conduction blocks, and POEMS syndrome is associated with IgG or IgA λ-type monoclonal gammopathy and osteosclerotic myeloma. The correct diagnosis, however, can be difficult to make in patients with atypical or overlapping presentations, or nondefinitive laboratory studies. First-line treatments include intravenous immunoglobulin (IVIg), corticosteroids or plasmapheresis for CIDP; IVIg for MMN; rituximab for anti-MAG neuropathy; and irradiation or chemotherapy for POEMS syndrome. A correct diagnosis is required for choosing the appropriate treatment, with the aim of preventing progressive neuropathy.

  20. [Analysis of children with a presumptive diagnosis of toxocariasis in Santa Fe, Argentina].

    Science.gov (United States)

    Martín, Ubaldo O; Machuca, Pía B; Demonte, Miguel A; Contini, Liliana

    2008-01-01

    Human toxocariasis is a parasitic disease found worldwide. The most important etiological agent is Toxocara canis, a dog parasite. Humans are infected by the ingestion of their eggs; the eggs hatch in the small intestine and the larvae migrate through the capillaries, taking up residence in different tissues. Clinical manifestations are associated with mechanical and/or reaction damage caused by these parasites larvae. Clinical diagnosis is difficult. The method applied in this work is the demonstration of antibodies against the helminth in the blood of children, target host population of this parasitic disease. An ELISA test was performed using T. canis larval excretory-secretory products as antigen. A total of 100 children presumptively diagnosed of toxocariasis that had been derived from different services of the Regional Children's Hospital for complementary studies, were included in the analysis. The test detected two different populations: infected (59) and non-infected (41). The statistical analysis showed a non significant association between infection and sex (p = 0.279). Infected subjects tended to be older than the non infected (p = 0.009). Eosinophilia was detected in 100% of seropositive children and in 85.2% of the seronegative. There was no significant association between infection and leucocytosis (p = 0.950). The association of these two parameters was significantly higher among infected patients (R = 0.918). Respiratory symptoms and signs were more frequently detected in the positive population (p = 0.05). Dogs tenancy was as frequent among infected as in the non infected homes (p = 0.53). According to these results, prevention, early diagnosis and opportune treatment for toxocariasis should be considered as priority health activities in this region.

  1. The Role of Clinical Symptoms in the Diagnosis of Intrathoracic Tuberculosis in Young Children

    Science.gov (United States)

    Tameris, Michele D.; Luabeya, Kany Kany A.; Geldenhuys, Hennie; Scriba, Thomas J.; Hussey, Gregory D.; Mahomed, Hassan; Landry, Bernard S.; Hanekom, Willem A.; McShane, Helen; Hatherill, Mark

    2015-01-01

    Background: Childhood tuberculosis (TB) is usually Mycobacterium tuberculosis (MTB) culture negative. Furthermore, clinical presentation may be altered by active case finding, isoniazid prophylaxis and early treatment. We aimed to establish the value of presenting symptoms for intrathoracic TB case diagnosis among young children. Methods: Healthy, HIV-uninfected, South African infants in an efficacy trial of a novel TB vaccine (MVA85A) were followed for 2 years for suspected TB. When suspected, investigation followed a standardized algorithm comprising symptom history, QuantiFERON Gold-in-Tube, chest radiography (CXR), MTB culture and Xpert MTB/RIF from paired gastric lavage and induced sputa. Adjusted odds ratios and 95% confidence intervals describe the associations between symptoms and positive MTB culture or Xpert MTB/RIF, and CXR compatible with intrathoracic TB. Results: Persistent cough was present in 172/1017 (16.9%) of the children investigated for TB. MTB culture/Xpert MTB/RIF was positive in 38/1017 children (3.7%); and CXR was positive, that is, compatible with intrathoracic TB, in 131/1017 children (12.9%). Children with persistent cough had more than triple the odds of a positive MTB culture/Xpert MTB/RIF (adjusted odds ratios: 3.3, 95% confidence interval: 1.5–7.0) and positive CXR (adjusted odds ratios: 3.5, 95% confidence interval: 2.2–5.5). Persistent cough was the only symptom that differentiated children with severe (56.5%) from nonsevere intrathoracic TB disease (28.2%; P = 0.001). Conclusion: Persistent cough was the cardinal diagnostic symptom associated with microbiologic and radiologic evidence, and disease severity, of intrathoracic TB. Symptom-based definitions of TB disease for diagnostic, preventive and therapeutic studies should prioritize persistent cough above other symptoms compatible with childhood TB. PMID:26226446

  2. History of music therapy treatment interventions for children with autism.

    Science.gov (United States)

    Reschke-Hernández, Alaine E

    2011-01-01

    The purpose of this paper is to provide a systematic review of the history of music therapy research and treatment of children with autism. Understanding such history is important in order to improve clinical efficacy and inform future research. This paper includes a history of autism diagnosis, reviews strengths and limitations of music therapy practice with children with autism from 1940-2009, and suggests direction for future music therapy research and clinical practice with this population. Literature was limited to the English language and obtained with the following search terms: autism, autistic, (early) infantile autism, child, therapeutic music, musical therapy, and music therapy. Table of contents from music therapy journals were searched, and reference lists from obtained articles were perused for additional articles. This historical review focused primarily on journal articles, however, books and book chapters that appeared to hold particular historical significance were also included.

  3. Diagnosis and treatment of enthesitis-related arthritis

    Directory of Open Access Journals (Sweden)

    Weiss PF

    2012-06-01

    Full Text Available Pamela F WeissDivision of Rheumatology and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Departments of Pediatrics and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, USAAbstract: Juvenile idiopathic arthritis (JIA is a chronic, inflammatory disease of unknown etiology. The enthesitis-related arthritis (ERA JIA category describes a clinically heterogeneous group of children including some who have predominately enthesitis, enthesitis and arthritis, juvenile ankylosing spondylitis, or inflammatory bowel disease-associated arthropathy. ERA accounts for 10%–20% of JIA. Common clinical manifestations of ERA include arthritis, enthesitis, and acute anterior uveitis. Axial disease is also common in children with established ERA. Treatment regimens for ERA, many of them based on adults with rheumatoid arthritis and ankylosing spondylitis, include the use of nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and biologic agents either individually or in combination.Keywords: juvenile arthritis, enthesitis, sacroillitis, epidemiology, therapy

  4. Basic problems in the diagnosis and treatment of vestibular vertigo

    Directory of Open Access Journals (Sweden)

    Maksim Valeryevich Zamergrad

    2010-01-01

    Full Text Available The paper describes the basic problems in the diagnosis and treatment of diseases accompanied by vertigo. In particular, it discusses the specific features of vertigo terminology, the overestimation of the value of cerebrovascular diseases and degenerative cervical spine changes in the development of vertigo and the underestimation of a role of peripheral vestibular diseases and psychogenic disorders in the genesis of different forms of vertigo. Emphasis is placed on the importance of vestibular exercises in the complex treatment of diseases manifesting themselves as vertigo. In addition, the possibilities of drug-induced stimulation of vestibular compensation are discussed.

  5. Update on diagnosis and treatment of idiopathic pulmonary fibrosis

    Science.gov (United States)

    Baddini-Martinez, José; Baldi, Bruno Guedes; da Costa, Cláudia Henrique; Jezler, Sérgio; Lima, Mariana Silva; Rufino, Rogério

    2015-01-01

    Idiopathic pulmonary fibrosis is a type of chronic fibrosing interstitial pneumonia, of unknown etiology, which is associated with a progressive decrease in pulmonary function and with high mortality rates. Interest in and knowledge of this disorder have grown substantially in recent years. In this review article, we broadly discuss distinct aspects related to the diagnosis and treatment of idiopathic pulmonary fibrosis. We list the current diagnostic criteria and describe the therapeutic approaches currently available, symptomatic treatments, the action of new drugs that are effective in slowing the decline in pulmonary function, and indications for lung transplantation. PMID:26578138

  6. Challenges With the Diagnosis and Treatment of Cerebral Radiation Necrosis

    Energy Technology Data Exchange (ETDEWEB)

    Chao, Samuel T., E-mail: chaos@ccf.org [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Ahluwalia, Manmeet S. [Department of Medical Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Barnett, Gene H. [Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Stevens, Glen H.J. [Department of Neurology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Murphy, Erin S. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Stockham, Abigail L. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Shiue, Kevin [Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Suh, John H. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States)

    2013-11-01

    The incidence of radiation necrosis has increased secondary to greater use of combined modality therapy for brain tumors and stereotactic radiosurgery. Given that its characteristics on standard imaging are no different that tumor recurrence, it is difficult to diagnose without use of more sophisticated imaging and nuclear medicine scans, although the accuracy of such scans is controversial. Historically, treatment had been limited to steroids, hyperbaric oxygen, anticoagulants, and surgical resection. A recent prospective randomized study has confirmed the efficacy of bevacizumab in treating radiation necrosis. Novel therapies include using focused interstitial laser thermal therapy. This article will review the diagnosis and treatment of radiation necrosis.

  7. Vertigo and dizziness in childhood - update on diagnosis and treatment.

    Science.gov (United States)

    Jahn, K; Langhagen, T; Schroeder, A S; Heinen, F

    2011-08-01

    Vertigo and balance disorders are not uncommon in children. The prevalence of vestibular vertigo in 10-year-Dolds is estimated to be 5.7%. The most common cause is vestibular migraine which accounts for almost 40% of the diagnoses. In adolescents, the incidence of somatoform vertigo syndromes increases. Vestibular function can be reliably evaluated at the bedside by the head-impulse test for vestibulo-ocular reflex function, ocular motor testing of the central vestibular system, and balance tests for vestibulo-spinal function. Vestibular migraine is treated by behavioural and drug therapies. Somatoform vertigo improves if information about the disorder and behavioual advice are provided. Sometimes psychotherapy is useful; drug therapy is recommended in severe cases. Other common vestibular disorders in children include benign positioning nystagmus and labyrinthitis. In summary, the underlying causes of vertigo and dizziness in children can be diagnosed on the basis of patient history and clinical bedside testing. Reponses to caloric irrigation of the ears, rotational chair testing, posturography, and video-oculography can be used to ascertain the diagnosis. Brain imaging is indicated in patients presenting with subacute central vestibular signs. The majority of syndromes have a favourable prognosis and can be successfully treated.

  8. Neurological Manifestations, Diagnosis, and Treatment of Celiac Disease: A Comprehensive Review

    Directory of Open Access Journals (Sweden)

    Shahriar Nikpour

    2012-01-01

    Full Text Available Celiac disease or gluten sensitivity may initially present asone or more neurological signs and/or symptoms. On the other hand, it may be associated with or complicated by neurological manifestations. Neurological presentations are rare in children but as many as 36% of adult patients present with neurological changes. With severe malnutrition after progression of celiac disease, different vitamin deficiencies may develop. Such problems can in turn overlap with previous neurological abnormalities including ataxia,epilepsy, neuropathy, dementia, and cognitive disorders. Inthis study, we aimed to review the neurological aspects of celiac disease. Early diagnosis and treatment could prevent related disability in patients with celiac disease.

  9. Treatment of primary headache in children: a multicenter hospital-based study in France.

    Science.gov (United States)

    Cuvellier, Jean-Christophe; Donnet, Anne; Guégan-Massardier, Evelyne; Nachit-Ouinekh, Fatima; Parain, Dominique; Vallée, Louis

    2009-12-01

    The aim of this 6-month, prospective, multicenter study of 398 children and adolescents with primary headaches was to collect data on headache treatment in neuropediatric departments. Treatments were compared before and after consultation. Prior to consultation, the acute treatments that had been prescribed most frequently were paracetamol (82.2% of children) and non-steroidal anti-inflammatory drugs treatment (53.5%); 10.3% had received a prophylactic treatment. No differences in either acute or prophylactic treatment with respect to headache diagnosis were observed. After the neuropediatric consultation, paracetamol was replaced by a non-steroidal anti-inflammatory drug in about three-quarters of cases and by triptan in about one-quarter of cases. The number of children prescribed a prophylactic treatment nearly doubled, whereas there was a 5-fold and 23-fold increase in psychotherapy and relaxation training, respectively, between pre-referral and referral. We conclude that specific treatments were underused for primary headache.

  10. Children Procedures and Treatment (Fertility Issues)

    Science.gov (United States)

    ... approach the subject of fertility preservation with their cancer-stricken child? How is the Oncofertility Consortium addressing the fertility preservation needs of children? How do cancer and cancer treatment affect a child's fertility? Why should fertility preservation be a priority ...

  11. Developments and challenges in the diagnosis and treatment of ADHD

    Directory of Open Access Journals (Sweden)

    Taciana G. Costa Dias

    2013-01-01

    Full Text Available Attention-deficit/hyperactivity disorder (ADHD is a prevalent neurodevelopmental disorder, often associated with other psychiatric comorbidities, functional impairments, and poor long-term outcomes. The objective of this selected review is to describe current advances and challenges in the diagnosis and treatment of ADHD. The disorder is associated with neurobiological underpinnings and is highly heterogeneous in various aspects, such as symptom profiles, cognitive impairments, and neurobiological and genetic features. The efficacy and safety of short-term pharmacological treatments across the life cycle is well studied, but further research investigating long-term treatment, impact of treatment in preschoolers, and non-pharmacological interventions is needed. Future research is also needed to better characterize the neurodevelopmental pathways of the disorder, linking clinical and neurobiological information, less investigated populations, and new interventions.

  12. Diagnosis and treatment of hepatic angiomyolipoma in 26 cases

    Institute of Scientific and Technical Information of China (English)

    Ning Ren; Lun-Xiu Qin; Zhao-You Tang; Zhi-Quan Wu; Jia Fan

    2003-01-01

    AIM: To summarize the experience of the diagnosis and treatment of hepatic angiomyolipoma (HAML).METHODS: The clinical, imaging and pathological features,and treatment strategies of 26 patients with HAML treated at the authors′institute between October 1998 and January 2003 were retrospectively analyzed. All the patients received liver resection and were followed up till the study.Immunohistochemical assays were performed with a panel of antibodies.RESULTS: There was an obvious female predominance (21:5), and most of the patients (18/26) had no symptoms.Heterogeneous high echo was found in ultrasonography and punctiform or filiform vascular distribution pattern was found in color Doppler-sonography in most of the lesions (21/26).All of the 5 lesions further enhanced with Levovist showed early and prolonged enhancement. At contrast-enhanced spiral CT, the soft-tissue components of 24 lesions were markedly enhanced in the arterial phase and 18 lesions remained enhanced in the portal venous phase. MRI was performed in 9 patients, and showed hypointensity or hyperintensity on T1-weighted images and heterogeneous hyperintensity on T2-weighted images. Histopathologically,all lesions were composed of adipose tissues, smooth muscle and blood vessels with different proportions. Most lesions showed positive immunohistochemical staining for HMB45(26/26), A103 (24/26) and SMA (24/26). All of the 26 patients showed a benign course with no sign of recurrence.CONCLUSION: Preoperative radiological diagnosis of HAML is possible. The demonstration of intratumoral fat and central vessels is helpful in the diagnosis. HMB45, A103 and SMA are promising markers for pathologic diagnosis of HAML,and surgical resection is effective for the treatment of HAML.

  13. Diagnosis and treatment of traumatic carotid cavernous fistula

    Institute of Scientific and Technical Information of China (English)

    杨东虹; 何奇元; 邹咏文; 许民辉

    2002-01-01

    Objective: To discuss the diagnosis and managementof traumatic carotid cavernous fistula (TCCF).Methods: In all 15 patients with TCCF confirmed byangiography, 8 patients got early diagnosis and cure. WithSeldinger technique adpoted in the puncture of femoralartery, Magic 3 F-1.8 F BD catheters combining withballoon were used to embolize the fistula or the internalcarotid artery.Results: Early diagnosis and cure were achieved in 8patients within one week and no sequelae occurred. Sevenpatients with delayed diagnosis who were cured beyond oneweek had some sequelae such as hypopsia in 5 cases,incomplete oculomotor paralyses in 3 and incompleteabducent paralyses in 2. Among all the 15 cases, theinternal carotid artery was preserved in 12 cases acountingfor 80%. Occluding the fistula with sacrifice of the internalcarotid artery was performed in 3 cases and no repatency of the fistula occurred by following up beyond three months.Conclusions: The preferred therapy for TCCF is toocclude the fistula using detachable balloon. The diagnosisand treatment for TCCF can significantly reduce occurrencerate of the complications and sequelae.

  14. Comparison of ambulatory electroencephagraphy in the diagnosis of epilepsy in children with sleep-derivation electroencephalogram

    Institute of Scientific and Technical Information of China (English)

    Ying Yang

    2016-01-01

    Objective:To compare the value of aEEG with sdEEG in the diagnosis of epilepsy in children, improve diagnostic accuracy.Methods:204 suspected epilepsy children were dedected by MRI, rEEG and aEEG, sdEEG, routine examination results as the gold standard computing aEEG, sdEEG diagnostic accuracy, and analyze the impact aEEG, factors sdEEG test results. Results:204 cases of suspected epileptic children diagnosed with epilepsy routine 189 cases, aEEG diagnostic sensitivity, specificity, positive predictive value, negative predictive value of 94.18%, 93.33%, 99.44%, 56.00%, sensitivity sdEEG diagnosis, specificity, positive predictive value, negative predictive value of 91.01%, 73.33%, 97.73%, 39.29%; aEEG epileptic discharge detection rate of 62.54%, higher than 51.95% sdEEG of; sdEEG in 1 to 3 years old suffering children epileptiform discharges detected positive rate accounted for 69.81%, higher than the 4 to 7 years old and > years the proportion of children, and in three age aEEG epileptiform discharge detection rate more balanced.Conclusions:aEEG inspection sensitivity, specificity for the diagnosis of epilepsy in children is higher than sdEEG, and for the diagnosis of all ages of children, and sdEEG use more flexible, suitable for children under 3 years of diagnosis.

  15. TREATMENT OF BRACHIMETATARSIA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    N. A. Kovalenko-Klychkova

    2014-01-01

    Full Text Available Brachimetatarsia is a malformation of one or more of the metatarsal bones, characterized by its shortening. Abnormal anatomy of the forefoot leads to the convergence of epiphyses of adjacent metatarsals, deformation of the forefeet, including the formation of hallux valgus, pain and cosmetic defects. The authors have conducted the surgical treatment (lengthening the shortened metatarsal bones in 18 female patients (28 feet, 32 metatarsal bones and determined the optimal method of surgical correction. Depending on the severity of metatarsal bone shortening 3 methods of surgical treatment were applied: in shortening of less than 1,2 cm -the slide osteotomy; in shortening up to 1.8 cm - a one-staged lengthening of metatarsal bone with autograft; more than 1.8 cm - the distraction osteosynthesis. Due to existing disorders it is advisable to perform restoration of the shortened toe length according to the type of the metatarsal parabola, inherent to the patient. The optimal method of surgical treatment is a one-staged lengthening of the shortened metatarsal bone with the use of autograft from the iliac wing borrowed by means of “window-form” method without damage to the integrity of the apophysis.

  16. Predict Value of Serum B-Cell Activating Factor on Treatment Effectiveness of Children with Idiopathic Thrombocytopenic Purpura in Diagnosis%血清B淋巴细胞激活因子水平对初诊特发性血小板减少性紫癜患儿疗效的预测价值

    Institute of Scientific and Technical Information of China (English)

    葛小丽; 韩志君; 过毅; 陈洪敏

    2012-01-01

    目的 评价血小板减少性紫癜(ITP)患儿初诊时血清B淋巴细胞激活因子(BAFF)对其疗效的预测价值.方法 采用ELISA法检测初诊37例ITP患儿与37例隐睾及腹股沟疝患儿(对照组)血清BAFF水平,分析ITP患儿血清BAFF水平与其血小板计数、治疗效果的关系.采用受试者工作曲线法(ROC)分析血清BAFF水平对治疗效果的预测价值.结果 ITP患儿血清BAFF水平较对照组增高(P=0.02),且与血小板计数呈负相关(R2=0.39,P<0.01).初诊时血清BAFF水平较低的患儿,其治疗效果相对较好(P<0.01).采用初诊血清BAFF水平预测患儿治疗效果,其曲线下面积(AUC)为0.85(95% CI0.72 ~0.97,P<0.01),当血清BAFF值为850 ng·L-1时,预测敏感性为0.71(95% CI 0.48 ~0.89),特异性为0.88(95% CI 0.62 ~0.98).结论 初诊血清BAFF水平有助于ITP患儿最终治疗效果的预测.%Objective To evaluate the predictive efficiency of serum B - cell activating factor (BAFF) on the treatment effectiveness in children with idiopathic thrombocytopenic purpura (ITP) in diagnosis. Methods Serum BAFF level of 37 children with ITP and controls ( consisted of cryptorchidism and inguinal hernia) were detected by enzyme - linked immunosorbent assay (ELISA). The correlations between serum BAFF and platelet count and treatment effectiveness were analyzed. The predictive efficiency of BAFF on ITP patients' treatment effectiveness was evaluated by receiver operating characteristics (ROC) curve analysis. Results Increased serum BAFF, which negatively correlated with platelet count, was observed in children with ITP. Higher serum BAFF at diagnosis was associated with worse treatment effectiveness, and vice versa. For treatment effectiveness predicting, the area under curve (AUC) for serum BAFF level was 0. 85 (95%CI0.72 -0.97, P<0.01). At the cut-off value of 850 ng·L-1 , the sensitivity and specificity for serum BAFF level were 0.71 (95%CI 0.48 -0. 88) and 0. 88 (95% CI0.62 - 0

  17. LABORATORY DIAGNOSIS OF OPPORTUNISTIC INFECTIONS AT LONG-SUBFEBRILITES AND OBSTRUCTIVE BRONCHITIS IN CHILDREN WITH MIXED INFECTION

    Directory of Open Access Journals (Sweden)

    T. N. Rybalkina

    2013-01-01

    Full Text Available The article discusses the role of agents of opportunistic infections (OI in the etiology of children’s infectious diseases illustrated by the long-subfebrilites and obstructivebronchitis. When children without expressed immunity disorders are infected with mixed infections OI have more pronounced manifestations, which requires appropriate treatment. At the same time, the similarity of the clinical manifestations does not mean that an etiological diagnosis can be determined without laboratory diagnostic methods. The importance of routine pediatrics monitoring of children with latent forms of OI is emphasized.

  18. [Surgical treatment of chiasmal gliomas in children].

    Science.gov (United States)

    Helcl, F

    1997-03-01

    Chiasmal gliomas are rare brain tumors occurring especially in children. Their proper treatment is still controversial and consists of surgery, radiotherapy and chemotherapy. Surgical removal of these tumors can usually be only partial or subtotal and radiotherapy frequently follows. There are supporters of surgical approach, as well as its enemies. The author has been engaged in problems of optimal treatment of this entity for more than 10 years. He is offering a review of knowledge from the literature concerning surgical treatment of this disease in children. The great majority of articles in the literature are dealing with retrospective analysis of relatively small series of patients usually treated in single neurosurgical department and the surgical treatment is enclosed like a part of combined therapy. Articles dealing only with surgical treatment of chiasmal gliomas are few and reviews determining the contemporary role of surgery of this entity are also lacking. This was the main impulse for writing this compilation. The short history of surgical therapy is reviewed. Some new trends of this therapy are also mentioned (microsurgery, Cavitron Ultrasonic Surgical Aspirator and peroperative use of visual evoked potentials). Up to date criteria for surgical treatment of chiasmal gliomas in children are given-exploration of chiasmal region and performing a biopsy in all cases, radical surgery only in extrinsic gliomas of the chiasmal region and conservative surgical approach to intrinsic chiasmal gliomas. It is emphasized that the significance of obstructive hydrocephalus in this entity has not been fully estimated till now, as well as the role of shunting procedures. Surgical treatment remains, nevertheless, an important armamentarium in the management of chiasmal gliomas in children. (Ref. 20.)

  19. Diagnosis and treatment of hepatocellular carcinoma: An update

    Science.gov (United States)

    Tejeda-Maldonado, Javier; García-Juárez, Ignacio; Aguirre-Valadez, Jonathan; González-Aguirre, Adrián; Vilatobá-Chapa, Mario; Armengol-Alonso, Alejandra; Escobar-Penagos, Francisco; Torre, Aldo; Sánchez-Ávila, Juan Francisco; Carrillo-Pérez, Diego Luis

    2015-01-01

    Hepatocellular carcinoma (HCC) is one of the most common malignancies leading to high mortality rates in the general population; in cirrhotic patients, it is the primary cause of death. The diagnosis is usually delayed in spite of at-risk population screening recommendations, i.e., patients infected with hepatitis B or C virus. Hepatocarcinogenesis hinges on a great number of genetic and molecular abnormalities that lead to tumor angiogenesis and foster their dissemination potential. The diagnosis is mainly based on imaging studies such as computed tomography and magnetic resonance, in which lesions present a characteristic classical pattern of early arterial enhancement followed by contrast medium “washout” in late venous phase. On occasion, when imaging studies are not conclusive, biopsy of the lesion must be performed to establish the diagnosis. The Barcelona Clinic Liver Cancer staging method is the most frequently used worldwide and recommended by the international guidelines of HCC management. Currently available treatments include tumor resection, liver transplant, sorafenib and loco-regional therapies (alcoholization, radiofrequency ablation, chemoembolization). The prognosis of hepatocarcinoma is determined according to the lesion’s stage and in cirrhotic patients, on residual liver function. Curative treatments, such as liver transplant, are sought in patients diagnosed in early stages; patients in more advanced stages, were not greatly benefitted by chemotherapy in terms of survival until the advent of target molecules such as sorafenib. PMID:25848464

  20. Challenges in the diagnosis and treatment of pulmonary arterial hypertension.

    LENUS (Irish Health Repository)

    2012-12-01

    Advances in the diagnosis and management of pulmonary arterial hypertension (PAH) have resulted in significant improvements in outcomes for patients with this devastating and progressive disease. However, because of the non-specific nature of its symptoms, and the low level of suspicion among clinicians, prompt and accurate diagnosis of PAH as a rare disease remains a challenge. This article explains some of the issues that need to be addressed when faced with a patient with suspected PAH and describes how noninvasive and invasive techniques can be used effectively to ensure an accurate diagnosis. The availability of PAH-specific therapy means that once diagnosed, patients have a much greater chance of survival than they would have had in the past. However, despite improved survival, mortality is still high and, therefore, there is still room for improvement. It is currently recommended that patients with an inadequate clinical response to treatment receive sequential combination therapy; however, supportive data are still scarce. Although there is no clear explanation, these findings may be explained by the design and end-points chosen in clinical trials, the changing population of PAH and a need to improve the management strategy in this disease. Indeed, there is a clear need for randomised controlled studies that investigate whether adopting individualised treatment strategies, including upfront combination therapy, could help to optimise long-term management of patients with PAH.

  1. Surgical treatment options for septic arthritis of the hip in children

    Directory of Open Access Journals (Sweden)

    Gang Xu

    2016-01-01

    Full Text Available Septic arthritis is the result of bacterial infection of the hip joint and is often found in infants and toddlers. It is the most common septic joint condition during growth and may cause the most devastating complications without prompt and proper treatment. Early diagnosis and intervention are required to avoid irreversible complications. This review documents the systematic approach to diagnosis and management of septic arthritis in children.

  2. Surgical treatment options for septic arthritis of the hip in children.

    Science.gov (United States)

    Xu, Gang; Spoerri, Muriel; Rutz, Erich

    2016-01-01

    Septic arthritis is the result of bacterial infection of the hip joint and is often found in infants and toddlers. It is the most common septic joint condition during growth and may cause the most devastating complications without prompt and proper treatment. Early diagnosis and intervention are required to avoid irreversible complications. This review documents the systematic approach to diagnosis and management of septic arthritis in children.

  3. Inherited copper transport disorders: biochemical mechanisms, diagnosis, and treatment.

    Science.gov (United States)

    Kodama, Hiroko; Fujisawa, Chie; Bhadhprasit, Wattanaporn

    2012-03-01

    Copper is an essential trace element required by all living organisms. Excess amounts of copper, however, results in cellular damage. Disruptions to normal copper homeostasis are hallmarks of three genetic disorders: Menkes disease, occipital horn syndrome, and Wilson's disease. Menkes disease and occipital horn syndrome are characterized by copper deficiency. Typical features of Menkes disease result from low copper-dependent enzyme activity. Standard treatment involves parenteral administration of copper-histidine. If treatment is initiated before 2 months of age, neurodegeneration can be prevented, while delayed treatment is utterly ineffective. Thus, neonatal mass screening should be implemented. Meanwhile, connective tissue disorders cannot be improved by copper-histidine treatment. Combination therapy with copper-histidine injections and oral administration of disulfiram is being investigated. Occipital horn syndrome characterized by connective tissue abnormalities is the mildest form of Menkes disease. Treatment has not been conducted for this syndrome. Wilson's disease is characterized by copper toxicity that typically affects the hepatic and nervous systems severely. Various other symptoms are observed as well, yet its early diagnosis is sometimes difficult. Chelating agents and zinc are effective treatments, but are inefficient in most patients with fulminant hepatic failure. In addition, some patients with neurological Wilson's disease worsen or show poor response to chelating agents. Since early treatment is critical, a screening system for Wilson's disease should be implemented in infants. Patients with Wilson's disease may be at risk of developing hepatocellular carcinoma. Understanding the link between Wilson's disease and hepatocellular carcinoma will be beneficial for disease treatment and prevention.

  4. Oral lichen planus: A look from diagnosis to treatment.

    Directory of Open Access Journals (Sweden)

    Pablo Córdova

    2014-03-01

    Full Text Available Oral lichen planus (OLP is a chronic mucocutaneous disease of unknown etiology. Its pathogenesis is multifactorial and it may affect the oral mucosa, skin and other mucous membranes. Diagnosis is based on clinic and histopathology; direct immunofluorescence techniques can also be of use. It affects about one to two percent of the population, mainly women between the fifth and sixth decades of life. In the mouth, the most affected area is the buccal mucosa, followed by the gums, tongue and/or palate. Its three most representative clinical forms are reticular, erythematous and erosive; evolution depends on the type it is. Lesion treatment is determined by the clinical form and, since no fully effective treatment has been found yet, it is directed towards controlling the disease. The treatment of choice involves topical or systemic corticosteroids, but other drugs may also be used.The aim of this paper is to gather current and relevant information about oral lichen planus: its pathogenesis, diagnosis, treatment and management.

  5. Treatment Preferences for CAM in Children with Chronic Pain

    Directory of Open Access Journals (Sweden)

    Jennie C. I. Tsao

    2007-01-01

    Full Text Available CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls (mean age = 14.5 years ± 2.4; range = 8–18 years presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80% were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy, pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities.

  6. Treatment Preferences for CAM in children with chronic pain.

    Science.gov (United States)

    Tsao, Jennie C I; Meldrum, Marcia; Kim, Su C; Jacob, Margaret C; Zeltzer, Lonnie K

    2007-09-01

    CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls) (mean age = 14.5 years +/- 2.4; range = 8-18 years) presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80%) were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy), pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities.

  7. Guidelines for diagnosis and treatment of Hunter Syndrome for clinicians in Latin America

    Directory of Open Access Journals (Sweden)

    Roberto Giugliani

    2014-06-01

    Full Text Available This review aims to provide clinicians in Latin America with the most current information on the clinical aspects, diagnosis, and management of Hunter syndrome, a serious and progressive disease for which specific treatment is available. Hunter syndrome is a genetic disorder where iduronate-2-sulfatase (I2S, an enzyme that degrades glycosaminoglycans, is absent or deficient. Clinical manifestations vary widely in severity and involve multiple organs and tissues. An attenuated and a severe phenotype are recognized depending on the degree of cognitive impairment. Early diagnosis is vital for disease management. Clinical signs common to children with Hunter syndrome include inguinal hernia, frequent ear and respiratory infections, facial dysmorphisms, macrocephaly, bone dysplasia, short stature, sleep apnea, and behavior problems. Diagnosis is based on screening urinary glycosaminoglycans and confirmation by measuring I2S activity and analyzing I2S gene mutations. Idursulfase (recombinant I2S (Elaprase®, Shire enzyme replacement therapy (ERT, designed to address the underlying enzyme deficiency, is approved treatment and improves walking capacity and respiratory function, and reduces spleen and liver size and urinary glycosaminoglycan levels. Additional measures, responding to the multi-organ manifestations, such as abdominal/inguinal hernia repair, carpal tunnel surgery, and cardiac valve replacement, should also be considered. Investigational treatment options such as intrathecal ERT are active areas of research, and bone marrow transplantation is in clinical practice. Communication among care providers, social workers, patients and families is essential to inform and guide their decisions, establish realistic expectations, and assess patients' responses.

  8. Guidelines for diagnosis and treatment of Hunter Syndrome for clinicians in Latin America

    Science.gov (United States)

    Giugliani, Roberto; Villarreal, Martha Luz Solano; Valdez, C. Araceli Arellano; Hawilou, Antonieta Mahfoud; Guelbert, Norberto; Garzón, Luz Norela Correa; Martins, Ana Maria; Acosta, Angelina; Cabello, Juan Francisco; Lemes, Aída; Santos, Mara Lucia Schmitz Ferreira; Amartino, Hernán

    2014-01-01

    This review aims to provide clinicians in Latin America with the most current information on the clinical aspects, diagnosis, and management of Hunter syndrome, a serious and progressive disease for which specific treatment is available. Hunter syndrome is a genetic disorder where iduronate-2-sulfatase (I2S), an enzyme that degrades glycosaminoglycans, is absent or deficient. Clinical manifestations vary widely in severity and involve multiple organs and tissues. An attenuated and a severe phenotype are recognized depending on the degree of cognitive impairment. Early diagnosis is vital for disease management. Clinical signs common to children with Hunter syndrome include inguinal hernia, frequent ear and respiratory infections, facial dysmorphisms, macrocephaly, bone dysplasia, short stature, sleep apnea, and behavior problems. Diagnosis is based on screening urinary glycosaminoglycans and confirmation by measuring I2S activity and analyzing I2S gene mutations. Idursulfase (recombinant I2S) (Elaprase®, Shire) enzyme replacement therapy (ERT), designed to address the underlying enzyme deficiency, is approved treatment and improves walking capacity and respiratory function, and reduces spleen and liver size and urinary glycosaminoglycan levels. Additional measures, responding to the multi-organ manifestations, such as abdominal/inguinal hernia repair, carpal tunnel surgery, and cardiac valve replacement, should also be considered. Investigational treatment options such as intrathecal ERT are active areas of research, and bone marrow transplantation is in clinical practice. Communication among care providers, social workers, patients and families is essential to inform and guide their decisions, establish realistic expectations, and assess patients’ responses. PMID:25071396

  9. Novel medical imaging technologies for disease diagnosis and treatment

    Science.gov (United States)

    Olego, Diego

    2009-03-01

    New clinical approaches for disease diagnosis, treatment and monitoring will rely on the ability of simultaneously obtaining anatomical, functional and biological information. Medical imaging technologies in combination with targeted contrast agents play a key role in delivering with ever increasing temporal and spatial resolution structural and functional information about conditions and pathologies in cardiology, oncology and neurology fields among others. This presentation will review the clinical motivations and physics challenges in on-going developments of new medical imaging techniques and the associated contrast agents. Examples to be discussed are: *The enrichment of computer tomography with spectral sensitivity for the diagnosis of vulnerable sclerotic plaque. *Time of flight positron emission tomography for improved resolution in metabolic characterization of pathologies. *Magnetic particle imaging -a novel imaging modality based on in-vivo measurement of the local concentration of iron oxide nano-particles - for blood perfusion measurement with better sensitivity, spatial resolution and 3D real time acquisition. *Focused ultrasound for therapy delivery.

  10. DIAGNOSIS AND TREATMENT OF INSIDIOUS RECURRENT SMALL INTESTINAL HEMORRHAGE

    Institute of Scientific and Technical Information of China (English)

    何小东; 陶蔚; 郑朝纪; 张振寰

    2000-01-01

    Objective. To improve the localized diagn osis of insidious recurrent small intestinal hemorrhage. Methods. This retrospective analysis include 64 cases of such diseases, which were admitted from 1988 to 1998 to our hospital. Result. Ultrasonography, CT, small bowel pneumobariumgraphy, diluted barium enema, isotopic examination, DSA and intraoperative small-bowel endoscopy were used for diagnosis of hemorrhagic site, and 37 cases got a definite location before operation, while 10 cases were confirmed the diagnosis during the operation. Forty-seven cases were treated surgically, while the other 17 cases had non-surgical treatment. Of the 47 cases,39 cases underwent partual en terectomy, 5 cases had suture and ligature of vascular deformity, 2 cases had Whipple' s operation, and one patient had ectomy of the end of ileum and right colon. Conclusion. DSA, Isotopic examination and intraoperative enteroscopy are of considerable importance for the lo cation judgement of recurrent small intestinal hemorrhage.

  11. Headache and facial pain: differential diagnosis and treatment.

    Science.gov (United States)

    Bernstein, Jonathan A; Fox, Roger W; Martin, Vincent T; Lockey, Richard F

    2013-01-01

    Headaches affect 90% of the population sometime during their life. Most are benign and fleeting, some are serious and life-threatening, and others require ongoing medical consultation and treatment. A careful history and physical is necessary to establish a differential diagnosis and to guide the choice of testing to make an accurate diagnosis. The most common types of headaches are discussed in this review. They are divided into primary and secondary headache disorders as classified by the International Headache Society. Primary headache disorders include migraine without and with aura, cluster and tension-type headaches. Secondary headaches are those that occur as a result of some other disorder and include brain tumors, rhinosinusitis, diseases of intracranial and extracranial vasculature, and temporomandibular joint disease.

  12. Diagnosis and Treatment of Refractory Gastroesophageal Reflux Disease (GERD

    Directory of Open Access Journals (Sweden)

    Selfie

    2015-12-01

    Full Text Available Gastroesophageal reflux disease (GERD was a damage in mucosal layer caused by gastric acid reflux. GERD was found about 10-20% in Western Countries and less in Asia, about 2,6-6,7%. Among different type of GERD, refractory GERD was a problem found in daily clinical practice. This terminology was used in patients with regurgitation and heartburn symptoms which is not responsive to 8 weeks proton pump inhibitor (PPI therapy. There were several mechanisms underlying the etiology and pathophysiology of refractory GERD. In general, refractory GERD diagnosis was based on clinical findings, objective endoscopic examination, ambulatory reflux monitoring, and response to antiacid-secretion therapy. Reevaluation of patients compliance should be the first step in refractory GERD management. A further treatment strategies could be started, consist of medical and surgical therapies. A basic clinical knowledge of refractory GERD would help clinician in deciding the best approach for diagnosis and therapy.

  13. Diagnosis and treatment of SAPHO syndrome: A case report.

    Science.gov (United States)

    Song, Xinghua; Sun, Wenwen; Meng, Zhaowei; Gong, Lu; Tan, Jian; Jia, Qiang; Yu, Chunshui; Yu, Tielian

    2014-08-01

    The present study reports a rare case of synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome in an adult male. The 42-year-old man complained of skin lesions, chest pain and lumbago. Laboratory evaluations demonstrated an elevated erythrocyte sedimentation rate and increased levels of C-reactive protein. Computerized tomography, bone scintigraphy and magnetic resonance imaging revealed multiple bone lesions. A diagnosis of SAPHO syndrome was made. Non-steroidal anti-inflammatory drugs, alendronate sodium and steroids were administered, which resulted in clinical improvement. The current case study demonstrates that skin manifestation and multiple imaging modalities are important in generating a definite diagnosis of SAPHO syndrome, and that early treatment is vital for a positive outcome.

  14. Diagnosis and treatment of cold agglutinin mediated autoimmune hemolytic anemia.

    Science.gov (United States)

    Berentsen, Sigbjørn; Tjønnfjord, Geir E

    2012-05-01

    Exact diagnosis of the subtype has essential therapeutic consequences in autoimmune hemolytic anemia. Cold-antibody types include primary chronic cold agglutinin disease (CAD) and rare cases of cold agglutinin syndrome (CAS) secondary to cancer or acute infection. Primary CAD is a clonal lymphoproliferative disorder. Not all patients require pharmacological therapy, but treatment seems indicated more often than previously thought. Corticosteroids should not be used to treat primary CAD. Half of the patients respond to rituximab monotherapy; median response duration is 11 months. The most efficient treatment to date is fludarabine and rituximab in combination, resulting in responses in 75%, complete responses in 20% and median response duration of more than 66 months. Toxicity may be a concern, and an individualized approach is discussed. Erythrocyte transfusions can be given provided specific precautions are undertaken. No evidence-based therapy exists in secondary CAS, but optimal treatment of the underlying disorder is essential when feasible.

  15. [Diagnosis and treatment of recurrent hemarthrosis after total knee arthroplasty].

    Science.gov (United States)

    Li, Y; Tian, H; Zhang, K

    2016-12-01

    Recurrent hemarthrosis is a relatively rare complication after total knee arthroplasty with the incidence estimated between 0.3% and 1.6%. There are various causes of this complication which can be broadly divided into general and local reasons. If the blood coagulation function was normal, the most common reason of hemarthrosis is the impingement of proliferative synovium between the articulating components of the knee prosthesis. However, some causes are not well understood which make diagnosis and treatment more difficult. Conservative therapy is the preferred treatment including rest, cooling, aspiration, and elevation. If conservative treatment is not successful, as next step an angiography and angiographic embolization of the source of bleeding is indicated. If embolization is unsuccessful, open synovectomy or arthroscopic is the next step. If these approaches are unsuccessful, the previously mentioned steps should be repeated until the cause of recurrent hemarthrosis become clear and the bleeding have been stopped.

  16. Hypersensitivity to biological agents-updated diagnosis, management, and treatment.

    Science.gov (United States)

    Galvão, Violeta Régnier; Castells, Mariana C

    2015-01-01

    Biological agents are used in the treatment of neoplastic, autoimmune, and inflammatory diseases and their clinical applications are becoming broader. Following their increased utilization, hypersensitivity reactions linked to these drugs have become more frequent, sometimes preventing the use of first-line therapies. The clinical presentation of hypersensitivity reactions to biological agents ranges from mild cutaneous manifestations to life-threatening reactions. In this scenario, rapid desensitization is a groundbreaking procedure that enables selected patients to receive the full treatment dose in a safe way, in spite of their immediate hypersensitivity reaction to the drug, and protects them against anaphylaxis. The aim of this review is to update and discuss some of the main biological agents used in clinical practice (rituximab, trastuzumab, cetuximab, ofatumumab, tocilizumab, brentuximab, omalizumab, and tumor necrosis factor alpha inhibitor agents) and their associated hypersensitivity reactions, including clinical presentations, diagnosis, and treatment in the acute setting. In addition, novel management options with rapid desensitization are presented.

  17. New Insights in the Diagnosis and Treatment of Heart Failure

    Science.gov (United States)

    Agnetti, Giulio; Piepoli, Massimo F.; Siniscalchi, Giuseppe; Nicolini, Francesco

    2015-01-01

    Cardiovascular disease is the leading cause of mortality in the US and in westernized countries with ischemic heart disease accounting for the majority of these deaths. Paradoxically, the improvements in the medical and surgical treatments of acute coronary syndrome are leading to an increasing number of “survivors” who are then developing heart failure. Despite considerable advances in its management, the gold standard for the treatment of end-stage heart failure patients remains heart transplantation. Nevertheless, this procedure can be offered only to a small percentage of patients who could benefit from a new heart due to the limited availability of donor organs. The aim of this review is to evaluate the safety and efficacy of innovative approaches in the diagnosis and treatment of patients refractory to standard medical therapy and excluded from cardiac transplantation lists. PMID:26634204

  18. [Errors and difficulties in the diagnosis and management of acute and chronic abdomen in children].

    Science.gov (United States)

    Sabetay, C; Singer, I; Zavate, A; Ciobanu, O; Cârstoiu, E; Stoica, A; Maloş, Anca; Farcaş, I; Kamel, J; Hams, I; Kastrati, A

    2002-01-01

    The authors are reviewing on a lot of 2844 cases between 1996 and 2000 the difficult problems of differential diagnosis between acute surgical abdomen in children and intestinal tuberculosis, abdominal tumors and inflammatory diseases such as acute osteomielitis. They are presenting 13 particular cases in which the acute abdomen diagnosis was difficult or even omitted.

  19. The differential diagnosis of children with joint hypermobility: a review of the literature

    OpenAIRE

    Elliott Elizabeth J; Tofts Louise J; Munns Craig; Pacey Verity; Sillence David O

    2009-01-01

    Abstract Background In this study we aimed to identify and review publications relating to the diagnosis of joint hypermobility and instability and develop an evidence based approach to the diagnosis of children presenting with joint hypermobility and related symptoms. Methods We searched Medline for papers with an emphasis on the diagnosis of joint hypermobility, including Heritable Disorders of Connective Tissue (HDCT). Results 3330 papers were identified: 1534 pertained to instability of a...

  20. Advances in diagnosis and treatment of metastatic cervical cancer.

    Science.gov (United States)

    Li, Haoran; Wu, Xiaohua; Cheng, Xi

    2016-07-01

    Cervical cancer is one of the most common cancers in women worldwide. The outcome of patients with metastatic cervical cancer is poor. We reviewed the relevant literature concerning the treatment and diagnosis of metastatic cervical cancer. There are two types of metastasis related to different treatments and survival rates: hematogenous metastasis and lymphatic metastasis. Patients with hematogenous metastasis have a higher risk of death than those with lymphatic metastasis. In terms of diagnosis, fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and PET-computed tomography are effective tools for the evaluation of distant metastasis. Concurrent chemoradiotherapy and subsequent chemotherapy are well-tolerated and efficient for lymphatic metastasis. As for lung metastasis, chemotherapy and/or surgery are valuable treatments for resistant, recurrent metastatic cervical cancer and chemoradiotherapy may be the optimal choice for stage IVB cervical cancer. Chemotherapy and bone irradiation are promising for bone metastasis. A better survival is achieved with multimodal therapy. Craniotomy or stereotactic radiosurgery is an optimal choice combined with radiotherapy for solitary brain metastases. Chemotherapy and palliative brain radiation may be considered for multiple brain metastases and other organ metastases.

  1. Calcium renal lithiasis: metabolic diagnosis and medical treatment

    Directory of Open Access Journals (Sweden)

    Miguel Angel Arrabal-Polo

    Full Text Available Calcium renal lithiasis is a frequent condition that affects the worldwide population and has a high recurrence rate. Different metabolic changes may trigger the onset of calcium stone disorders, such as hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia and others. There are also other very prevalent disorders that are associated with calcium calculi, such as arterial hypertension, obesity and loss of bone mineral density. A correct diagnosis needs to be obtained through examining the serum and urinary parameters of mineral metabolism in order to carry out adequate prevention and treatment of this condition. Once the metabolic diagnosis is known, it is possible to establish dietary and pharmacological treatment that may enable monitoring of the disease and prevent recurrence of stone formation. Some advances in treating this pathological condition have been made, and these include use of sodium alendronate in patients with calcium renal lithiasis and osteopenia/osteoporosis, or use of a combination of a thiazide with a bisphosphonate. In summary, calcium renal lithiasis often requires multidrug treatment with strict control and follow-up of patients.

  2. Calcium renal lithiasis: metabolic diagnosis and medical treatment.

    Science.gov (United States)

    Arrabal-Polo, Miguel Angel; Arrabal-Martin, Miguel; Garrido-Gomez, Juan

    2013-01-01

    Calcium renal lithiasis is a frequent condition that affects the worldwide population and has a high recurrence rate. Different metabolic changes may trigger the onset of calcium stone disorders, such as hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia and others. There are also other very prevalent disorders that are associated with calcium calculi, such as arterial hypertension, obesity and loss of bone mineral density. A correct diagnosis needs to be obtained through examining the serum and urinary parameters of mineral metabolism in order to carry out adequate prevention and treatment of this condition. Once the metabolic diagnosis is known, it is possible to establish dietary and pharmacological treatment that may enable monitoring of the disease and prevent recurrence of stone formation. Some advances in treating this pathological condition have been made, and these include use of sodium alendronate in patients with calcium renal lithiasis and osteopenia/osteoporosis, or use of a combination of a thiazide with a bisphosphonate. In summary, calcium renal lithiasis often requires multidrug treatment with strict control and follow-up of patients.

  3. Candidiasis: predisposing factors, prevention, diagnosis and alternative treatment.

    Science.gov (United States)

    Martins, Natália; Ferreira, Isabel C F R; Barros, Lillian; Silva, Sónia; Henriques, Mariana

    2014-06-01

    Candidiasis is the most common opportunistic yeast infection. Candida species and other microorganisms are involved in this complicated fungal infection, but Candida albicans continues to be the most prevalent. In the past two decades, it has been observed an abnormal overgrowth in the gastrointestinal, urinary and respiratory tracts, not only in immunocompromised patients, but also related to nosocomial infections and even in healthy individuals. There is a widely variety of causal factors that contribute to yeast infection which means that candidiasis is a good example of a multifactorial syndrome. Due to rapid increase in the incidence in these infections, this is the subject of numerous studies. Recently, the focus of attention is the treatment and, above all, the prevention of those complications. The diagnosis of candidiasis could become quite complicated. Prevention is the most effective "treatment," much more than eradication of the yeast with antifungal agents. There are several aspects to consider in the daily routine that can provide a strength protection. However, a therapeutic approach is necessary when the infection is established, and therefore, other alternatives should be explored. This review provides an overview on predisposition factors, prevention and diagnosis of candidiasis, highlighting alternative approaches for candidiasis treatment.

  4. Children with fever without apparent source: diagnosis and dilemmas

    NARCIS (Netherlands)

    S.E. Bleeker (Sacha)

    2002-01-01

    textabstractTills thesis describes the results of diagnostic research in young children presenting with fever without apparent source at the emergency department. The study was conducted at the Sophia Children's University Hospital in Rotterdam and the Juliana Children's Hospital in The Hague, both

  5. Epidemiology, diagnosis and management of functional abdominal pain in children: A look beyond the belly

    NARCIS (Netherlands)

    Korterink, J.J.

    2015-01-01

    Chronic abdominal pain represents a common problem in children. In almost 90% of children presenting with chronic abdominal pain, no organic cause is found and a diagnosis of functional abdominal pain is made. Initially this condition was referred to as ‘recurrent abdominal pain’ by Apley and Naish

  6. Resolution of the Diagnosis and Maternal Sensitivity among Mothers of Children with Intellectual Disability

    Science.gov (United States)

    Feniger-Schaal, Rinat; Oppenheim, David

    2013-01-01

    We examined mothers' resolution of their children's diagnosis of Intellectual Disability (ID) and its link to maternal sensitivity, and we hypnotized that mothers' who are "resolved" will show more sensitivity during their interactions with their children than "unresolved" mothers. We assessed maternal resolution using the Reaction to Diagnosis…

  7. Transitional cell carcinoma of the bladder in children: radiologic appearance and differential diagnosis.

    Science.gov (United States)

    Quillin, S P; McAlister, W H

    1991-01-01

    Primary epithelial tumors of the bladder are rare in children. We report a case of transitional cell carcinoma (TCCa) of the bladder in a 10-year-old boy who was evaluated with intravenous urography, ultrasonography, and computed tomography (CT). The radiographic appearance and a differential diagnosis are discussed. The literature of TCCa of the bladder in children is reviewed.

  8. Children and Youth with Fetal Alcohol Spectrum Disorders: Summary of Intervention Recommendations after Clinical Diagnosis

    Science.gov (United States)

    Jirikowic, Tracy; Gelo, Julie; Astley, Susan

    2010-01-01

    Children with fetal alcohol spectrum disorders (FASDs) present with a wide range of developmental disabilities; however, clinical standards of care after a diagnosis are not well established. This retrospective review summarizes the types of intervention recommendations generated by an interdisciplinary FASD diagnostic team for 120 children ages…

  9. Ewing sarcoma in adolescents and young adults: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Davis LE

    2014-09-01

    Full Text Available Lara E Davis,1,2 Suman Malempati2 1Department of Medicine, 2Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA Abstract: Ewing sarcoma (ES is a rare tumor that most often occurs in adolescents and young adults. This review discusses the diagnosis, prognosis, and treatment of localized and metastatic ES, with an emphasis on the care of adolescent and young adult patients. The pathobiology is reviewed. Particular attention is given to recent and current clinical trials, and an introduction to future directions for therapy of ES is provided. Keywords: Ewing, sarcoma, primitive neuroectodermal tumor, PNET

  10. Update in diagnosis and treatment of diabetic foot infections.

    Science.gov (United States)

    Miller, Andy O; Henry, Michael

    2009-11-01

    Foot infections are a major cause of morbidity and mortality in diabetics. Evaluation of diabetic foot infections often requires clinical, radiologic, laboratory, and microbiologic assessment. Osteomyelitis has a profound impact on the prognosis and management of these infections, and diagnosis can be difficult; the gold standard remains bone biopsy. Despite a panoply of studies, the optimal management of diabetic foot infections remains poorly understood. Antibiotics, surgery, rehabilitation and/or off-loading, and glycemic control remain the cornerstones of treatment; alternative therapies remain largely unproven.

  11. [Lactose intolerance: pathophysiology, clinical symptoms, diagnosis and treatment].

    Science.gov (United States)

    Hutyra, Tomasz; Iwańczak, Barbara

    2009-02-01

    Lactose malabsorption and milk products intolerance symptoms are the most common alimentary tract disorders. Lactose intolerance is a result of lactase deficiency or lack of lactase and lactose malabsorption. Three types of lactase deficiency were distinguished: congenital, late-onset lactase deficiency and secondary lactase deficiency. Lactose intolerance means the appearance of clinical gastrointestinal symptoms after ingestion of lactose. To the clinical symptoms of lactose intolerance belongs: nausea, vomiting, abdominal distension, cramps, flatulence, flatus, diarrhea and abdominal pain. The diagnosis of lactose intolerance is based on the breath hydrogen test and analysis of lactase activity in the small intestine mucosa. Dietary treatment eliminates clinical symptoms.

  12. Concerns on diagnosis and treatment of breast cancer in China

    Institute of Scientific and Technical Information of China (English)

    WANG Shen-ming

    2007-01-01

    @@ Breast cancer is one of the neoplasms that have greatest negative psychological impact on the sufferers. Although China is among the low morbidity country of breast cancer, its yearly increasing rate in China is 1%-2% higher than the average rate of the word.1 Due to its largest population in the word, China tops the world in its breast cancer cases but general medical care for the patients still lags behind the developed countries. These issues are related to the diagnosis and treatment of breast cancer in China.

  13. Epidemiology, etiology, diagnosis and treatment of prostate cancer.

    Science.gov (United States)

    Daniyal, Muhammad; Siddiqui, Zamir Ali; Akram, Muhammad; Asif, H M; Sultana, Sabira; Khan, Asmatullah

    2014-01-01

    Prostate cancer is more common in men over the age of 65 years. There are 15% cases with positive family history of prostate cancer Worldwide. Prostate cancer is the second leading cause of death among the U.S. men. Prostate cancer incidence is strongly related to age with the highest rates in older man. Globally millions of people are suffering from this disease. This study aims to provide awareness about prostate cancer as well as an updated knowledge about the epidemiology, etiology, diagnosis and treatment of prostate cancer.

  14. Early Diagnosis and Treatment of Traumatic Vestibulopathy and Postconcussive Dizziness.

    Science.gov (United States)

    Hoffer, Michael E; Schubert, Michael C; Balaban, Carey D

    2015-08-01

    Mild traumatic brain injury (mTBI) is a common health condition in amateur and professional sports and in military operations but can occur in everyday life. Dizziness is the most common disorder seen after mTBI followed closely by headache. This article examines the diagnosis and treatment of vestibular disorders after mTBI. Data are included from the literature, and conclusions are drawn from the literature review and the experience of the authors. Much of what is known about this disorder comes from recent military experience, but the link to more common civilian injuries is detailed in this article.

  15. Advances in Diagnosis and Treatment of Hepatic Steatosis

    Institute of Scientific and Technical Information of China (English)

    赵晓威

    2004-01-01

    @@ Hepatic steatosis is not a nosologic entity, but a kind of fatty degeneration of the liver caused mainly by obesity and alcoholism, followed by nutritional disorder, diabetes, drug intoxication, pregnancy and heredity. The incidence of hepatic steatosis in Chinese adults is about 15-20%. It can affect the liver function, and develops into hepatitis, fibrosis and cirrhosis of the liver. As more than 25% patients are asymptomatic or with nonspecific symptoms, a timely and correct diagnosis and treatment is very important in clinical practice.

  16. When is facial paralysis Bell palsy? Current diagnosis and treatment.

    Science.gov (United States)

    Ahmed, Anwar

    2005-05-01

    Bell palsy is largely a diagnosis of exclusion, but certain features in the history and physical examination help distinguish it from facial paralysis due to other conditions: eg, abrupt onset with complete, unilateral facial weakness at 24 to 72 hours, and, on the affected side, numbness or pain around the ear, a reduction in taste, and hypersensitivity to sounds. Corticosteroids and antivirals given within 10 days of onset have been shown to help. But Bell palsy resolves spontaneously without treatment in most patients within 6 months.

  17. Diagnosis and Treatment of Pseudo-Class III Malocclusion.

    Science.gov (United States)

    Reyes, Ariel; Serret, Luis; Peguero, Marcos; Tanaka, Orlando

    2014-01-01

    Pseudo-Class III malocclusion is characterized by the presence of an anterior crossbite due to a forward functional displacement of the mandible; in most cases, the maxillary incisors present some degree of retroclination, and the mandibular incisors are proclined. Various types of appliances have been described in the literature for the early treatment of pseudo-Class III malocclusion. The objectives of this paper are to demonstrate the importance of making the differential diagnosis between a skeletal and a pseudo-Class III malocclusion and to describe the correction of an anterior crossbite. The association of maxillary expansion and a 2 × 4 appliance can successfully be used to correct anterior crossbites.

  18. Outcome of one-stage treatment of developmental dysplasia of hip in older children

    Directory of Open Access Journals (Sweden)

    Basant Kumar Bhuyan

    2012-01-01

    Conclusions: Young children having DDH can safely be treated with an extensive one-stage triple procedure of open reduction, femoral shortening derotation, and Salter′s osteotomy, without increasing the risk of AVN. Early diagnosis and intervention is the successful treatment of patients suffering from DDH.

  19. Posttraumatic Stress Disorder in Children and Adolescents: A Review of Psychopharmacological Treatment

    Science.gov (United States)

    Huemer, J.; Erhart, F.; Steiner, H.

    2010-01-01

    PTSD in children and adolescents differs from the adult disease. Therapeutic approaches involve both psychotherapy and psychopharmacotherapy. Objectives: The current paper aims at reviewing studies on psychopharmacological treatment of childhood and adolescent PTSD. Additionally, developmental frameworks for PTSD diagnosis and research along with…

  20. New developments in the diagnosis and treatment of impotence.

    Science.gov (United States)

    De Palma, R G

    1996-01-01

    New developments in the diagnosis and treatment of impotence or erectile dysfunction are increasingly based on better understanding of the erectile process. In 1978 it was thought that the failure of arterial inflow was the main cause of male erectile dysfunction. Emphasis was placed on methods of corpus cavernosal revascularization. In recent years, interest has shifted to abnormal cavernosal smooth muscle function. An understanding of the erectile process was greatly enhanced by intracavernosal administration of vasoactive agents in 1982 and, more recently, the use of prostaglandin E1. These agents promote erection by causing smooth muscle to relax. The intracavernosal administration of vasoactive agents is now used in diagnosis and in therapy. Standard approaches to diagnosis and therapy still vary, but more rational steps are evolving. Considerable progress has been made in quantifying penile blood flow. Increasingly effective therapies are available for an estimated 10 million American men suffering from erectile dysfunction. Therapies include the use of drugs, administering vasoactive agents intracavernosally, vacuum constrictor devices, and vascular interventions in highly selected cases of arterial or venous disease. These procedures are being carefully reevaluated. Critical analysis of recent results suggests that about 7% of men are amendable to vascular interventions, with success rates approximating 70% when supplemental therapy is used. PMID:8779203

  1. [Clinical Pathological Diagnosis, and Treatment for Pleural Mesothelioma].

    Science.gov (United States)

    Kishimoto, Takumi; Fujimoto, Nobukazu; Nishi, Hideyuki

    2016-05-01

    For the differential diagnosis between fibrous pleuritis and other malignancies such as lung cancer, multiple immunostaining is essential to diagnose pleural mesothelioma. For cytological diagnosis of pleural effusions, differentiation between mesothelioma cells and reactive mesothelial cells is very difficult. Therefore, histological diagnoses of tumor tissues obtained via biopsy are essential. To diagnose epthelioid mesothelioma, more than 2 positive and negative markers must be consistent with those known for mesothelioma. To diagnose sarcomatoid mesothelioma, keratin is usually positive, differentiating the diagnosis from that for real sarcoma. For surgical treatment for pleural mesothelioma, extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D) are usually performed. The proportion of P/D increases because of the low death rates with surgery and similar survivals. However, a trimodal approach, such as EPP with chemotherapy and radiotherapy, is best for longer survival and expected to be curative. For chemotherapy, only cisplatin (CDDP) combined with pemetrexed (PEM) is effective, and no other agents have been identified for this disease. Nowadays, clinical immunotherapy trials start with phase II study.

  2. Exosomes and Their Signiifcance in Diagnosis and Treatment of Tumors

    Institute of Scientific and Technical Information of China (English)

    WANG Jian; LI Chao; LI Wei

    2015-01-01

    In the research field of biological markers for tumor diagnosis, the appearance of exosomes has resolved the problem that RNA molecules can be easily degraded. Exosomes carry various RNAs and can protect them from being degraded. They are deifned as polymorphism vesicle-like corpuscles (diameter: 30-100 nm) derived from late endosome or multi-vesicular endosomes in cellular endocytosis system, which contain abundant biological information, including multiple lipids, proteins and nucleic acids, etc. Exosomes are extracellular nanoscale vesicae formed in a series of regulating process of cellular “endocytosis-fusion-excretion”, and they carry proteins and transport RNAs, thus playing an important role in the intercellular material and informational transduction. There are still large amount of mRNAs and miRNAs in exosomes. Exosomes can not only protect in-vitro RNA stability, but also transfer RNA to speciifc target cells as effective carriers so as to play their regulatory function. Exosomes realize their biological information exchanges and transition via endocrine, paracrine and autocrine, and regulate cellular biological activities through direct action on superficial signal molecules or extracellular release and membrane fusion of biological active ingredients. They can directly act on tumors to impact tumor progression, or improve tumor angiogenesis and metastasis by regulating immunological function. Additionally, they can also be used for tumor diagnosis. Therefore, this study mainly summarized the biological characteristics of exosomes and their application in the regulation, diagnosis and treatment of tumors, hoping to provide references for the application of exosomes in tumors.

  3. [Thrombocytopenia induced by heparin. Diagnosis, treatment, physiopathology: current concepts].

    Science.gov (United States)

    Gruel, Y; Drouet, L

    1986-01-01

    Iatrogenic thrombocytopenia is a rare, but severe complication of treatments with heparin and heparinoids. Mean temporary thrombocytopenia failing to show any complications are usually diagnosed as quite different from acute and delayed thrombocytopenia of which severity depends mainly on thrombotic symptoms demonstrated in 65 p. 100 of cases; the initial evolution of an average thrombocytopenia is not easy to diagnose; it may as well exist a connection between the two diseases, from a physiopathogenic point of view. The diagnosis of severe thrombocytopenia depends:--clinically, on the initial data, delayed as compared with the heparin treatment beginning and existence of arterial and/or venous thrombosis;--biologically, by demonstrating an aggregating activity for platelets in presence of heparin, in the patient plasma. Such an activity requires the suppression of standard heparinotherapy as well as the choice of substitutive anticoagulant treatment in case of evolutive thrombosis. Low molecular weight heparins are prescribed only if in vitro tests of platelet aggregation with the patient's plasma are negative. Antivitamins K are to be used as soon as possible alone or combined with heparin fractions. Antiaggregants are prescribed alone, above all in case of isolated thrombocytopenia and combined with AVK. Treatment of thrombotic complications depends on surgical disobstruction if arterial thrombosis, and use of fibrinolytics if pulmonary embolisms. The acute reaction of some thrombocytopenia to heparin as well as therapeutic difficulties demonstrate the efficiency of an early diagnosis performed thanks to systematic platelet numerations during the first 15 days of a treatment with heparin, as well as to the prevention along with systematic association with aspirin, especially if replaced with AVK.

  4. 恩施地区儿童癫痫诊治及管理存在的问题(附225例分析)%Issues in Diagnosis, Treatment and Management of Epileptic Children in Enshi (A Retrospective Study of 225 Cases)

    Institute of Scientific and Technical Information of China (English)

    杨倩; 王芳

    2015-01-01

    目的:了解恩施地区儿童癫痫诊治及管理中存在的问题,以提高儿童癫痫的诊治水平。方法对2011年1—12月在我院儿科以癫痫收治患儿225例的诊治情况、癫痫综合征分类、随访及预后情况进行回顾性分析。结果本组中142例(63.1%)曾在外院诊断为癫痫,仅5例(3.5%)进行癫痫综合征分类;46例(32.4%)误漏诊,其中22例癫痫误诊为其他疾病,24例非癫痫误诊为癫痫。116例(81.7%)首诊治疗不正规,92例首次治疗使用2种抗癫痫药物(AEDs),其中农村患儿84例,24例用药剂量不足。来我院后,确诊癫痫201例,仅21例(10.4%)不能进行综合征归类,余180例均按照2010年国际抗癫痫联盟的癫痫分类诊断标准进行分型诊断,22例(10.9%)暂未应用AEDs 治疗,单一AEDs 治疗135例(67.2%),联用2种AEDs 治疗33例(16.4%),联用3种AEDs 治疗11例(5.5%)。随访率79.6%,服药1年内112例(55.7%)擅自减量或停药,农村患儿占44.3%。经治疗症状完全控制121例(60.2%),显效及有效59例(29.4%),无效21例(10.4%)。另24例经相关检查排除癫痫诊断,10例脑性瘫痪治疗后症状好转,余14例治愈。结论对于儿童癫痫的诊断,首先要确定发作类型,再明确癫痫综合征分类,然后按照规范、个体化原则选择疗效确切、依从性好的AEDs 进行治疗。尤其要加强农村癫痫患儿治疗期间的随访跟踪管理。%Objective To discuss diagnosis, treatment and management of epileptic children in Enshi in order to im-prove the levels of diagnosis and treatment. Methods A Retrospective analysis of diagnosis and treatment, classifications and prognosis were made on 225 cases of epileptic children in the department of pediatrics of our hospital during January and De-cember 2011. Results 142 cases (63. 1%) were diagnosed as epilepsy in other hospitals and only 5 cases (3. 5%) were classified as epilepsy syndrome;46 cases (32. 4%) were misdiagnosed, among which, 22 epileptic children

  5. COMPARATIVE STUDY OF RDTS v/s MICROSCOPY FOR THE DIAGNOSIS OF MALARIA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Rajesh Kumar

    2014-05-01

    Full Text Available Malaria presents a diagnostic challenge in most tropical countries. Rapid detection of the malaria parasite and early treatment of infection still remain the most important goals of disease management. Therefore, performance characteristics of the indigenous RDTs was determined among children with suspected malaria fever attending pediatrics OPD or admitted in indoor of UP RIMS n R Saifai central India, to assess whether this rapid diagnostic test (RDT could be used for diagnosis of malaria and results were compared with Gold Standard microscopy test. We also assessed the logical utilization of RDTs to monitor treatment outcome. MATERIALS AND METHODS: 03 months to 12 years old children who were presented with acute fever without any focus to the OPD or IPD of our department from May 2011 to April 2013 were selected for the study. A finger prick blood sample was collected from each clinically suspected case of malaria to prepare blood smear and for testing with the RDT after taking informed consent. The blood smears were read by an experienced microscopist blinded to the RDT results and clinical status of the subjects. The figures for specificity, sensitivity, accuracy and predictive values were calculated using microscopy as gold standard. RESULTS: Analysis revealed that overall sensitivity, specificity and accuracy of the RDT were approx. 90%, while RDT is useful to confirm the diagnosis of new symptomatic cases of suspected malaria infection, the persistence of parasite antigen leading to false positives even after clearance of asexual Parasitaemia has limited its utility as a prognostic tool. The study showed that RDTs was easy to use, reliable and cheap for diagnosing new malaria cases, and is an appropriate test for the use in the fields and remote areas.

  6. Prevalence of and risk factors for late diagnosis of HIV infection in Brazilian infants and children

    Directory of Open Access Journals (Sweden)

    Lígia Mara Dolce de Lemos

    2015-06-01

    Full Text Available INTRODUCTION: Late human immunodeficiency virus (HIV diagnosis is an important cause of HIV-related morbidity and mortality in infants and children. METHODS: This retrospective cohort study of HIV-infected children diagnosed in Sergipe, in northeastern Brazil, between 2002 and 2011 aimed to determine the prevalence of and risk factors for late HIV diagnosis. RESULTS: Of 55 infants and children with confirmed infection, 42 (76.5% were diagnosed at ≥ 12 months old. No antiretroviral prophylaxis during delivery (OR 5.48, 95% CI 1.11-32.34 was associated with late diagnosis. CONCLUSIONS: More than 75% of cases were diagnosed late. Efforts are needed to improve early HIV diagnosis in infants.

  7. Serving and Supporting Young Children with a Dual Diagnosis of Hearing Loss and Autism: The Stories of Four Families

    Science.gov (United States)

    Myck-Wayne, Janice; Robinson, Suzanne; Henson, Erica

    2011-01-01

    The research on young children with a dual diagnosis of hearing loss and autism spectrum disorder (ASD) is meager and scattered. Pockets of research on this population of children suggest that it is difficult to make the diagnosis of ASD in children with hearing loss. A case study design was used to examine the diagnostic process for young…

  8. Children acceptance of laser dental treatment

    Science.gov (United States)

    Lazea, Andreea; Todea, Carmen

    2016-03-01

    Objectives: To evaluate the dental anxiety level and the degree of acceptance of laser assisted pedodontic treatments from the children part. Also, we want to underline the advantages of laser use in pediatric dentistry, to make this technology widely used in treating dental problems of our children patients. Methods: Thirty pediatric dental patients presented in the Department of Pedodontics, University of Medicine and Pharmacy "Victor Babeş", Timişoara were evaluated using the Wong-Baker pain rating scale, wich was administered postoperatory to all patients, to assess their level of laser therapy acceptance. Results: Wong-Baker faces pain rating scale (WBFPS) has good validity and high specificity; generally it's easy for children to use, easy to compare and has good feasibility. Laser treatment has been accepted and tolerated by pediatric patients for its ability to reduce or eliminate pain. Around 70% of the total sample showed an excellent acceptance of laser dental treatment. Conclusions: Laser technology is useful and effective in many clinical situations encountered in pediatric dentistry and a good level of pacient acceptance is reported during all laser procedures on hard and soft tissues.

  9. Hemosuccus pancreaticus: Problems and pitfalls in diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    Yoshikazu Toyoki; Kenichi Hakamada; Shunji Narumi; Masaki Nara; Keinosuke Ishido; Mutsuo Sasaki

    2008-01-01

    Hemosuccus pancreaticus is a rare cause of intermittent upper gastrointestinal bleeding.We report two cases of hemosuccus pancreaticus with multiple episodes of upper gastrointestinal bleeding.The causes of hemorrhage were rupture of pseudoaneurysm of the splenic artery and bleeding from the wall of pancreatic pseudocyst.Interventional radiology is the first modality for early diagnosis and possible treatment of hemosuccus pancreaticus.When angiography shows no abnormal findings or interventional radiological therapy can not be successful,surgery should be considered without delay.Our patients herein underwent surgery without recurrence or sequelae.Intraoperative ultrasonography and pancreatoscopy were helpful modalities for confirming the source of hemorrhage and determining the cutting line of the pancreas.When we encounter intermittent upper gastrointestinal bleeding with an obscure source,hemosuccus pancreaticus should be included in differential diagnoses especially in patients with chronic pancreatitis,which would lead to a prompt and proper treatment.

  10. Diagnosis and treatment of chronic cerebrovascular disease, use of pentoxifylline

    Directory of Open Access Journals (Sweden)

    V. A. Parfenov

    2016-01-01

    Full Text Available Chronic cerebrovascular disease (CCVD is one of the most common  iagnoses in Russian neurology, by which is meant vascular cognitive impairment (VCI in modern foreign literature. There are data available in the literature on the diagnosis and treatment of CCVD (VCI. Theresults of the author’s studies show that CCVD often masks other diseases (anxiety and depressive disorders, primary headache, peripheral vestibulopathy, and Alzheimer's disease that are unfortunately poorly diagnosed in our country, so patients do not receive effective treatment. To modify risk factors for stroke (smoking and alcohol cessation, sufficient exercise, to normalize blood pressure (the use of antihypertensivemedications, to reduce blood cholesterol levels (statins, to perform antithrombotic therapy (antiplatelet agents and anticoagulants, and to use cognitive enhancers are of key importance when treating patients with CCVD (VCI. There are data on the use of pentoxifylline in patients with CCVD, vascular dementia.

  11. Diagnosis and treatment of fetal anemia due to isoimmunization.

    Science.gov (United States)

    Plöckinger, B; Strümpflen, I; Deutinger, J; Bernaschek, G

    1994-01-01

    45 pregnant women affected by rhesus incompatibility were treated at the Department of Prenatal Diagnosis and Therapy, Vienna, between January 1992 and March 1993. 32 patients had a cordocentesis and on 21 fetuses, anemia requiring treatment was diagnosed. A total of 71 intravascular transfusions via the umbilical vein was given. The mean number of transfusions per fetus was 3.4 (range 1-11). Of the 7 fetuses who had already developed hydrops when therapy was started (hematocrit < 13%), 5 (71%) survived. The survival rate of non-hydropic anemic fetuses was 93% (13/14). By using intravascular transfusion for treatment of severe fetal anemia, a success rate of 86% (18/21) was achieved.

  12. Infection after total knee replacement: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Lucio Honorio de Carvalho Junior

    2013-09-01

    Full Text Available Infection after total knee replacement (IATJ is a rare complication. It is associated with increased morbidity and mortality increasing the final costs. Gram positive coccus and Staphylococcus coagulase-negative and Staphylococcus aureus are the most common isolated germs (>50% of the cases. Conditions related to the patient, to the surgical procedure and even to the post op have been identified as risk factors to IATJ. Many complementary methods together with clinical symptoms are useful to a proper diagnosis. Treatment for IATJ must be individualized but generally is a combination of systemic antibiotic therapy and surgical treatment. Prosthesis exchange in one or two stages is the first choice procedure. Debridement with prosthesis retention is an option in acute cases with stable implants and antibiotic sensible germs.

  13. Diagnosis and treatment of diffuse axonal injury in 169 patients

    Institute of Scientific and Technical Information of China (English)

    YANG Jia-yong; YANG Zhen-jiu; FENG Cheng-xuan; LI Hong-wei; LI Wei-ping; ZHANG Jun; ZHANG Hong

    2005-01-01

    Objective: To evaluate current diagnosis and therapeutic effect and outcome of diffuse axonal injury (DAI) in 169 patients.Methods: The data of 169 DAI patients treated in the Second, Sixth, Eighth and Ninth Hospitals of Shenzhen and Shekou Hospital from January 2001 to January 2005 were collected. The imaging features, classification, GCS (Glasgow coma scale), treatment and outcome of the 169patients were retrospectively analyzed.Results: The simpler the imaging features, the closer the focus of DAI to the periphery of hemisphere and the higher the GCS score, the better the prognoses of DAI patients will be.Conclusions: The prognoses of DAI patients are closely related to the imaging features and classification,GCS and clinical treatment.

  14. Osteoradionecrosis of the mandible: Etiology, prevention, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Rayatt Sukh

    2007-12-01

    Full Text Available The treatment of head and neck cancer remains a challenge. Despite advances in surgical reconstructive techniques, most patients will require adjuvant therapy in the form of radiotherapy or chemo-radiotherapy to improve locoregional control. The short- and long term side effects of radiotherapy can be difficult to treat. In this review the causative effects and pathogenesis of osteoradionecrosis of the mandible will be highlighted. In addition, preventive measures and clinical features of radiotherapy induced damage will be presented. Finally, medical and surgical management of osteoradionecrosis, as well as, reconstructive surgery of the mandible will be discussed. At the end of this paper the reader should have up to date knowledge concerning the etiology, prevention, diagnosis and treatment of patients with osteoradionecrosis of the mandible.

  15. Management of Cerebral Cavernous Malformations: From Diagnosis to Treatment

    Directory of Open Access Journals (Sweden)

    Nikolaos Mouchtouris

    2015-01-01

    Full Text Available Cerebral cavernous malformations are the most common vascular malformations and can be found in many locations in the brain. If left untreated, cavernomas may lead to intracerebral hemorrhage, seizures, focal neurological deficits, or headaches. As they are angiographically occult, their diagnosis relies on various MR imaging techniques, which detect different characteristics of the lesions as well as aiding in planning the surgical treatment. The clinical presentation and the location of the lesion are the most important factors involved in determining the optimal course of treatment of cavernomas. We concisely review the literature and discuss the advantages and limitations of each of the three available methods of treatment—microsurgical resection, stereotactic radiosurgery, and conservative management—depending on the lesion characteristics.

  16. Еctopic ACTH syndrome: clinical picture, diagnosis, treatment

    Directory of Open Access Journals (Sweden)

    N S Kuznetsov

    2012-03-01

    Full Text Available Diagnosis and treatment of ectopic ACTH-syndrome currently is one of the most challenging problems among other forms of endogenous hypercorticism. This syndrome is associated with presence of extrapituitary tumors characterized with different histogenesis and localization, which produce adrenocorticotropic hormone (ACTH, or – rarely – corticotrophin-releasing hormone. In most cases the ectopic synthesis of ACTH is performed in bronchial carcinoid tumors (36–46%, oat cell cancer (18–20%, medullary thyroid cancer (3–7%, pheochromocytoma (9–23%, other sites are infrequent (pancreas, thymus, parotid gland, ovaries, uterus, prostate, colon, stomach, esophagus, etc.. Much of these tumors are aggressive and are characterized with propensity to metastasize and relapse. Currently there are few contradictory data on the comparative evaluation of the effectiveness of methods of topical diagnosis of the source of ectopic ACTH-secretion, and therefore there is an urgent need to develop an optimal and most efficient algorithm for diagnostic procedures to determine the extent of the tumor in patients with ectopic ACTH-syndrome. Indications for surgery, timing and extent of surgical intervention, the effectiveness of the operation, the causes and frequency of relapses are still discussed.The present difficulties of diagnosis, as well as the lack of a unified approach to the treatment of this disease in the complex, often lead to the progression and development of a large number of serious complications functions of up to disability, which in turn does not lead to significant improvement of quality of life. Thus further research is necessary to study of this disease

  17. Treatment of Helicobacter Pylori in Children

    Directory of Open Access Journals (Sweden)

    F Famouri

    2014-04-01

    Full Text Available Childrenwith Helicobacter infection need treatment. The aim of treatment is elimination of H.Pylori. Most patients with this infection are asymptomatic and without peptic disease. Treatment and management of these patients are controversy. Conventional Treatment: The best treatment for H. pylori eradication regimens should have cure rates of at least 80%, be without major side effects, and induce minimal bacterial resistance. Antibiotics alone have not achieved this. Luminal acidity influences both the effectiveness of some antimicrobial agents and the survival of the bacteri; thus antibiotics have been combined with acid suppression such as proton pump inhibitors (PPIs, bismuth, or H2 antagonists. The “classic” regimen is treatment twice daily for 7 days with a PPI and clarithromycin plus either amoxicillin or metronidazole Bismuth has been used in the treatment of peptic ulcer disease and 1 part o quadruple therapy for H.Pylori but compliance of children for it is low.   Sequential Therapy  Sequential therapyinvolves dual therapy with a PPI and amoxicillin for 5 days followed sequentially by clarithromycin, Tinidazole and omeperazole for 5 days or other triple therapy for 7 days. This treatment has had 97% efficacy.   Adjunctive Therapies A number of studies have showed the potential benefits of probiotic therapy in H. pylori treatment regimens.Consumption of these drugs accompanied with other medications increase H.Pylori eradication.    

  18. Chromoblastomycosis: an overview of clinical manifestations, diagnosis and treatment.

    Science.gov (United States)

    Queiroz-Telles, Flavio; Esterre, Phillippe; Perez-Blanco, Maigualida; Vitale, Roxana G; Salgado, Claudio Guedes; Bonifaz, Alexandro

    2009-02-01

    Chromoblastomycosis is one of the most frequent infections caused by melanized fungi. It is a subcutaneous fungal infection, usually an occupational related disease, mainly affecting individuals in tropical and temperate regions. Although several species are etiologic agents, Fonsecaea pedrosoi and Cladophialophora carrionii are prevalent in the endemic areas. Chromoblastomycosis lesions are polymorphic and must be differentiated from those associated with many clinical conditions. Diagnosis is confirmed by the observation of muriform cells in tissue and the isolation and the identification of the causal agent in culture. Chromoblastomycosis still is a therapeutic challenge for clinicians due to the recalcitrant nature of the disease, especially in the severe clinical forms. There are three treatment modalities, i.e., physical treatment, chemotherapy and combination therapy but their success is related to the causative agent, the clinical form and severity of the chromoblastomycosis lesions. There is no treatment of choice for this neglected mycosis, but rather several treatment options. Most of the patients can be treated with itraconazole, terbinafine or a combination of both. It is also important to evaluate the patient's individual tolerance of the drugs and whether the antifungal will be provided for free or purchased, since antifungal therapy must be maintained in long-term regimens. In general, treatment should be guided according to clinical, mycological and histopathological criteria.

  19. [Female sexual dysfunction: classification, epidemiology, diagnosis and treatment].

    Science.gov (United States)

    Luria, Mijal; Hochner-Celnikier, Drorit; Mock, Moshe

    2004-11-01

    The successful pharmacological treatment of erectile dysfunction in males has led to increasing interest in the sexual problems of women. Yet in recent years there has been growing consensus regarding the differences between male and female sexuality. William Masters and Virginia Johnson's model of sexual response, revised by Helen Singer Kaplan, has been generally accepted for many decades. This model consists of 4 successive phases: desire, excitement (arousal), orgasm and resolution. Rosemary Basson has suggested a different model, valid especially in long-term relationships. According to Basson, a woman may decide to seek a stimuli necessary to ignite sexual desire, for reasons which are not sexual (such as the need for intimacy or emotional bonding). The desire develops at a latter stage, as a consequence and not as a cause. As the understanding of the sexual response grows, new methods of classification and treatment are being developed. Female sexual dysfunction is common, frequently neglected and has a significant impact on the lives of women. It has a diverse etiology including anatomical, physiological, medical as well as psychological and social factors. The assessment of these disorders incorporates both medical and psychological evaluation. The treatment includes education, improvement of inter-personal communication, behavioral treatment and the solution of medical problems. Different medications are being developed but most have yet to be proven effective. This review presents the female sexual response as it is understood today and the different methods of classification, diagnosis and treatment of female sexual dysfunction.

  20. Nutritional status at diagnosis in children with cancer. 2. An assessment by arm anthropometry.

    Science.gov (United States)

    Barr, Ronald; Collins, Laura; Nayiager, Trishana; Doring, Nancy; Kennedy, Charlene; Halton, Jacqueline; Walker, Scott; Sala, Alessandra; Webber, Colin

    2011-04-01

    Assessment of nutritional status in children with cancer is important but measures based on weight can be problematic at diagnosis, especially in those with advanced disease. Likewise, dual energy x-ray absorptiometry may be confounded by other radiological procedures and is not commonly available in low-income countries where most children with cancer live. Arm anthropometry is not subject to these constraints. In a study sample of 99 Canadian patients with cancer at diagnosis, mid-upper arm circumference correlated well with lean body mass as measured by dual energy x-ray absorptiometry but triceps skin fold thickness was a poor predictor of fat mass. Arm anthropometry can be a useful tool for the measurement of nutritional status in children with cancer. However, further studies, particularly in low-income countries and in children with solid tumors at diagnosis, are required to determine the full extent of its utility.