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Sample records for children diagnosis treatment

  1. DIAGNOSIS AND TREATMENT OF CHILDREN ECHINOCOCCOSIS

    Directory of Open Access Journals (Sweden)

    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. Psychosis in children: diagnosis and treatment

    OpenAIRE

    Courvoisie, Helen; Labellarte, Michael J.; Riddle, Mark A.

    2001-01-01

    The diagnosis of childhood psychosis raises a host of unresolved problems, despite the Diagnostic and Statistical Manual Of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) giving identical symptoms and definitions for children, adolescents, and adults. The fantasy lives of children, and issues of developing language and cognition (including retardation), all impair diagnostic accuracy, particularly when differentiating between childhood-onset schizophrenia (COS) (≤12 years), bipolar ...

  3. Pathological fractures in children: Diagnosis and treatment options.

    Science.gov (United States)

    Canavese, F; Samba, A; Rousset, M

    2016-02-01

    A fracture is defined as pathological when it arises in a bone tissue that has been modified and reshaped by a local or systemic pathological process. In children, pathological fractures can be secondary to several conditions, ranging from metabolic diseases to tumors, infections or neuromuscular pathologies. History, clinical examination and radiologic assessment are essential to making a diagnosis, to identifying the underlying cause and to planning the right treatment of a pathological fracture. Treatment must be tailored to both the fracture and the underlying cause. The objective of this work is to present the diagnostic approach and the course to follow when a child presents with a pathological fracture. The most common causes of pathological fractures, as well as their characteristics, will be described. Pathological fractures occurring in osteogenesis imperfecta and in abused children as well as stress fractures will not be discussed. PMID:26774903

  4. Diagnosis and Treatment of Gastroesophageal Reflux in Infants and Children.

    Science.gov (United States)

    Baird, Drew C; Harker, Dausen J; Karmes, Aaron S

    2015-10-15

    Gastroesophageal reflux is defined as the passage of stomach contents into the esophagus with or without accompanied regurgitation (spitting up) and vomiting. It is a normal physiologic process that occurs throughout the day in infants and less often in children and adolescents. Gastroesophageal reflux disease (GERD) is reflux that causes troublesome symptoms or leads to medical complications. The diagnoses of gastroesophageal reflux and GERD are based on the history and physical examination. Diagnostic tests, such as endoscopy, barium study, multiple intraluminal impedance, and pH monitoring, are reserved for when there are atypical symptoms, warning signs, doubts about the diagnosis, or suspected complications or treatment failure. In infants, most regurgitation resolves by 12 months of age and does not require treatment. Reflux in infants may be treated with body position changes while awake, lower-volume feedings, thickening agents (i.e., rice cereal), antiregurgitant formula, extensively hydrolyzed or amino acid formulas, and, in breastfed infants, eliminating cow's milk and eggs from the mother's diet. Lifestyle changes to treat reflux in children and adolescents include sleeping position changes; weight loss; and avoiding smoking, alcohol, and late evening meals. Histamine H2 receptor antagonists and proton pump inhibitors are the principal medical therapies for GERD. They are effective in infants, based on low-quality evidence, and in children and adolescents, based on low- to moderate-quality evidence. Surgical treatment is available, but should be considered only when medical therapy is unsuccessful or is not tolerated. PMID:26554410

  5. Short stature in children and adolescence. Causes, diagnosis and treatment.

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    Hussimy Marchena Morera

    2008-12-01

    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.

  6. Iron deficiency anemia from diagnosis to treatment in children.

    Science.gov (United States)

    Özdemir, Nihal

    2015-03-01

    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. Short stature in children and adolescence. Causes, diagnosis and treatment.

    OpenAIRE

    Hussimy Marchena Morera; Alina Ester González Hermida; Jorge Luis Irizar Hernández; Greyci Cuervo-Arango Bernia; Inés Martínez Fernández; Alberto Roteta Dorado

    2008-01-01

    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 s...

  8. Traumatized refugee children: the case for individualized diagnosis and treatment.

    Science.gov (United States)

    Kinzie, J David; Cheng, Keith; Tsai, Jenny; Riley, Crystal

    2006-07-01

    The first 131 traumatized refugee children evaluated and treated in a child specialty clinic indicated a wide variety of trauma including war-related traumas (21%) for areas of recent conflict and domestic violence (28%) predominantly occurring in patients from Mexico and Latin America. Clinical diagnoses indicate PTSD was common (63%) in the war trauma group but was found less (25%) in the domestic violence group. Otherwise, the refugee clinic population showed a wide variety of diagnoses, including 20% having learning or cognitive disability or clear mental retardation. The traumatized refugee children had a similar prevalence of PTSD and depression to a comparable group of American child psychiatry patients. Refugee children have faced a variety of traumas and have a variety of diagnoses. All traumatized refugee children need an individualized evaluation and treatment plan. Trauma focused therapy is not appropriate for all refugee children. PMID:16840851

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

    Science.gov (United States)

    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

    Institute of Scientific and Technical Information of China (English)

    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. Diagnosis and Treatment of Obstructive Sleep Apnea Syndrome in Children.

    Science.gov (United States)

    Tsubomatsu, Chieko; Shintani, Tomoko; Abe, Ayumi; Yajima, Ryoto; Takahashi, Nozomi; Ito, Fumie; Takano, Kenichi; Himi, Tetsuo

    2016-01-01

    Sleep is important for children pertaining to their physical and mental growth. Obstructive sleep apnea syndrome (OSAS) in children has been shown to have different effects as compared to OSAS in adults, including deficits in cognition and neuropsychological functions, hyperactivity, ADHD, behavior problems, aggressive behavior, learning problems and nocturnal enuresis. Hypertrophy of the adenoids and tonsils is a major cause of OSAS in children; therefore, adenotonsillectomy may decrease the effects of OSAS pertaining to physical and mental growth. It is important to accurately diagnose and appropriately treat OSAS in children to prevent OSAS in their adulthood. PMID:27115764

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

    OpenAIRE

    Goran AJDINSKI; S. BOSNJAKOVSKA; L..UGRINOVSKA; M. DUKOVSKI; Cakar, M; L. BOGOEVSKA

    1997-01-01

    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 impr...

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

    CERN Document Server

    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.

  14. Iron deficiency anemia from diagnosis to treatment in children

    OpenAIRE

    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 toge...

  15. Radiologic diagnosis and treatment of biliary complications after hepatic transplantation in children

    International Nuclear Information System (INIS)

    The authors reviewed biliary complications that occurred in 20 of 58 pediatric hepatic transplant recipients, to assess the role of radiologic procedures in their diagnosis and treatment. Twelve transhepatic cholangiograms, 26 transheptic drainages, 11 balloon dilations, and one basketing procedures were done. Biliary obstruction occurred in 16 children and was most common with cholecystojejunostomies and choledochojejunostomies. Biliary leaks were identified in eight patients, four of whom also had obstruction. Three patients with bilomas underwent percutaneous catheter drainage. Biliary complications occur in approximately one-third of pediatric liver transplant recipients; aggressive radiologic techniques can be used in the diagnosis and treatment of these problems

  16. Sarcoidosis in children. Epidemiology in Danes, clinical features, diagnosis, treatment and prognosis.

    Science.gov (United States)

    Milman, N; Hoffmann, A L; Byg, K E

    1998-08-01

    This paper reviews current knowledge of childhood sarcoidosis with regard to the epidemiology in Danes, clinical presentation, diagnostic procedures, treatment and prognosis. Sarcoidosis is a granulomatous disease of unknown aetiology, with multiorgan involvement. The diagnosis is confirmed by the demonstration of epitheloid cell granulomas in tissue biopsy specimens. During the period 1980-92, three cases of childhood sarcoidosis were recorded in Copenhagen County, which has a total population of 610,000. The approximate incidence of clinically recognized sarcoidosis in Danish children younger than 15 y of age was 0.22-0.27/100,000 children per year, corresponding to approximately three new cases in Denmark each year. The true incidence is unknown, since the disease is often asymptomatic and resolves without a clinical diagnosis being made. In children younger than 5 y of age, the disease is characterized by involvement of skin, eyes and joints, whereas in older children involvement of lungs, lymph nodes and eyes predominate. The mainstay of treatment consists of oral corticosteroids. The risk/benefit ratio of using long-term corticosteroids needs to be evaluated in each individual patient. Some patients may benefit from additional therapy with methotrexate. The long-term prognosis is not well established, but it seems to be poorer in children younger than 5 y. Older children appear to have as favourable a prognosis as young adults. PMID:9736236

  17. Diagnosis and treatment of Helicobacter pylori infection in children: a survey of WV primary care physicians.

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    Stevens, I W; Lawrence, Z; Elitsur, Y

    2001-01-01

    Helicobacter pylori infection has been implicated in the development of peptic ulcer disease in children. Although clinical protocols for the diagnosis and treatment of this infection in children are available, the implementation of those guidelines by primary physicians are insufficient. In this study, we surveyed the clinical practices of 409 primary physicians who practice in West Virginia and treat children with H. pylori infection. Results showed in contradiction with the recommendation, primary physicians are still using serology as the preferred diagnostic method for this disease. Most of the physicians treat this disease with a combination of two antibiotics and anti-acid medication (H2 blockers or PPI) for at least one week. We conclude that an increase in knowledge of those guidelines among primary physicians may improve physicians' compliance with H. pylori guidelines. PMID:11761653

  18. ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

    OpenAIRE

    2011-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood and can profoundly affect the academic achievement, well-being, and social interactions of children; the American Academy of Pediatrics first published clinical recommendations for the diagnosis and evaluation of ADHD in children in 2000; recommendations for treatment followed in 2001.

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

    Directory of Open Access Journals (Sweden)

    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

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

    OpenAIRE

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

    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 mo...

  1. Diagnosis and Treatment of Children with Reading and Writing Difficulties in Poland.

    Science.gov (United States)

    Bogdanowicz, Marta

    1989-01-01

    The history of specific difficulties in learning to read and write in Poland and multidisciplinary investigations in the field are discussed. A therapeutic care system including small correction-compensation groups, special grades, wards for dyslexic children, and individual outpatient treatment is currently in place, with research now focusing on…

  2. Maternal diagnosis and treatment of children's fever in an endemic malaria zone of Uganda: implications for the malaria control programme.

    Science.gov (United States)

    Lubanga, R G; Norman, S; Ewbank, D; Karamagi, C

    1997-10-14

    A mother's ability to suspect malaria in the presence of fever has important consequences for child survival in malaria-endemic areas. This paper presents results of a clinic-based study of mothers' abilities to suspect malaria in the event of recognizing fever and other physiological and behavioral changes associated with the disease. The study population consisted of all (439) women or mothers who had accompanied children 5 years and below to the Old Mulago Hospital, Kampala, Uganda over a 10 day period during the malaria season of 1992. The children were those who had fever as a major complaint at the time of the visit or those who had fever in the last 7 days and were visiting the clinic for the first time for the current illness. The children were physically examined and their blood tested for malaria parasites. Mothers' diagnosis was compared with clinical and laboratory diagnosis of malaria. Mothers associated the presence of fever with several types of illness and malaria was often not suspected. Only 40% of the mothers suspected malaria in their children. The mothers were poor at recognizing malaria when, in fact, it was present. The sensitivity of the mothers' diagnosis of malaria was found to be 37%; 63% of malaria cases were misclassified as other conditions. The doctors classified most (92%) of the cases presenting with fever as having malaria, but laboratory tests indicated that only 64% of the children really had malaria. The sensitivity of clinical diagnosis was 98%, but the specificity was only 18%. Ninety percent of the mothers gave some medicines before visiting the health centre; and, of these, 76% gave modern drugs exclusively, including antimalarials, antipyretics, antibiotics and other drugs. Among the modern drugs given to children suspected of having malaria, 50% were antimalarials. The most commonly used antimalarial was chloroquine tablets. Mothers indiscriminately administered antimalarials to children irrespective of the perceived cause

  3. 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

  4. 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%.

  5. Computed tomography in the diagnosis and treatment of mediastinal abnormalities in children

    International Nuclear Information System (INIS)

    Thirty-one children with mediastinal abnormalities - 14 malignant lymphomas, 4 other primary malignancies, one metastatic and 12 benign lesions - were examined one or several times using CT, which proved to be effective especially for cysts (5 patients), ductus arteriosus aneurysm (2 patients), and intrathoracic liver (one patient). It also supplied important diagnostic information regarding the extent of disease in malignant thymoma (one patient), in neurinoma (one patient), and in Hodgkin's lymphoma (5 patients). It was found to be useful in the monitoring of treatment of patients with lymphomas, in which a small residue, probably a fibrotic remnant, was invariably seen after completion of chemotherapy and irradiation. It was concluded that when the residue was enlarged, the possibility of relapse and even thymic hyperplasia should be considered. However, if CT was performed under general anaesthesia pseudo-widening of the anterior mediastinum could simulate recurrence. Surgical biopsy was found to be necessary in these cases because fine-needle aspiration biopsy was unsuccessful. (orig.)

  6. Diagnosis, Treatment and Follow-Up in Four Children with Biotinidase Deficiency from Pakistan

    International Nuclear Information System (INIS)

    Biotinidase deficiency is an inherited disorder in which the vitamin biotin is not recycled. If untreated, affected individuals develop neurological and cutaneous symptoms. Untreated individuals with biotinidase deficiency either succumb to disease or are left with significant morbidity. We describe clinical course and follow-up of 4 children from Pakistan. All 4 presented with classical symptoms of biotinidase deficiency and responded dramatically to oral biotin within days to weeks. Biotinidase deficiency is reported in Pakistani children from different part of world, however; there is no such report from Pakistan. This highlights lack of awareness of biotinidase deficiency among physicians in Pakistan. (author)

  7. Effect of Early Diagnosis and Treatment on the Prognosis of Children with Epilepsy Accompanied by Continuous Spikes and Waves during Slow Wave Sleep

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    Jiahua Ju

    2014-03-01

    Full Text Available Objective: To emphasize the importance of early diagnosis and treatment on the prognosis of children with epilepsy accompanied by continuous spikes and waves during slow wave sleep (CSCW. Methods: The clinical characteristics, electroencephalogram (ECG features, treatment and prognosis of 12 children with CSCW in our hospital were retrospectively analyzed, and the followup of 6 months to 4 years was given. Results: Imaging showed that 8 children suffered from brain lesions, while other 4 were normal. The initial onset of 10 children was at night, whereas 2 began with absence seizure in lucid interval, and they gradually appeared comprehensive brain function decline, meanwhile, ECG was characterized by continuous discharge during slow wave sleep. After 3 months of treatment with valproic acid, clonazepam, lamotrigine and hormones, the clinical symptoms and ECG of 10 children improved significantly, in which 3 ones recurred after 6 months of comprehensive treatment. Conclusion: The early manifestation of CSWS is untypical, and hence, early diagnosis and treatment can ameliorate the epileptic seizures of children, effectively inhibit epileptic electrical activity and has favorable prognosis.

  8. Effect of Early Diagnosis and Treatment on the Prognosis of Children with Epilepsy Accompanied by Continuous Spikes and Waves during Slow Wave Sleep

    Institute of Scientific and Technical Information of China (English)

    Ju Jiahua; Lu Weijuan

    2014-01-01

    Objective:To emphasize the importance of early diagnosis and treatment on the prognosis of children with epilepsy accompanied by continuous spikes and waves during slow wave sleep (CSCW). Methods:The clinical characteristics, electroencephalogram (ECG) features, treatment and prognosis of 12 children with CSCW in our hospital were retrospectively analyzed, and the follow-up of 6 months to 4 years was given. Results:Imaging showed that 8 children suffered from brain lesions, while other 4 were normal. The initial onset of 10 children was at night, whereas 2 began with absence seizure in lucid interval, and they gradually appeared comprehensive brain function decline, meanwhile, ECG was characterized by continuous discharge during slow wave sleep. After 3 months of treatment with valproic acid, clonazepam, lamotrigine and hormones, the clinical symptoms and ECG of 10 children improved signiifcantly, in which 3 ones recurred after 6 months of comprehensive treatment. Conclusion:The early manifestation of CSWS is untypical, and hence, early diagnosis and treatment can ameliorate the epileptic seizures of children, effectively inhibit epileptic electrical activity and has favorable prognosis.

  9. 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…

  10. Diagnosis and treatment of non-parasitic splenic cysts in children

    International Nuclear Information System (INIS)

    Splenic cysts of various types are rare surgical abnormalities. The diagnostic and therapeutic procedures are discussed with special reference to the author's clinical material consisting of six children with non-parasitic cysts. Sonography and, in special cases, CT are the most important methods of examination. The desirability of conserving the spleen, while removing the cyst, is stressed. (orig.)

  11. Gastro-esophageal reflux in children:Symptoms, diagnosis and treatment

    OpenAIRE

    Vandenplas, Yvan; Hauser, Bruno; Devreker, Thierry; MAHLER, Tania; Degreef, Elisabeth; Veereman-Wauters, Gigi

    2011-01-01

    Gastroesophageal reflux (GER) is the passage of gastric contents into the esophagus and is a normal physiologic process occurring several times per day in healthy individuals. In infants and toddlers, no symptoms allow to diagnose GERD or to predict response to therapy. In older children and adolescents, history and physical examination may be sufficient to diagnose GERD. Endoscopically visible breaks in the distal esophageal mucosa are the most reliable evidence of reflux esophagitis. Eso...

  12. Urinary tract infections in children younger than 5 years of age: epidemiology, diagnosis, treatment, outcomes and prevention.

    Science.gov (United States)

    Schlager, T A

    2001-01-01

    Although the true incidence of urinary tract infections (UTIs) in children is difficult to estimate, they are one of the most common bacterial infections seen by clinicians who care for young children. Except for the first 8 to 12 weeks of life, when infection of the urinary tact may be secondary to a haematogenous source, UTI is believed to arise by the ascending route after entry of bacteria via the urethra. Enterobacteriaceae are the most common organisms isolated from uncomplicated UTI. Infection with Staphylococcus aureus is rare in children without in-dwelling catheters or other sources of infection, and coagulase-negative staphylococci and Candida spp. are associated with infections after instrumentation of the urinary tract. The diagnosis of UTI in young children is important as it is a marker for urinary tract abnormalities and, in the newborn, may be associated with bacteraemia. Early diagnosis is critical to preserve renal function of the growing kidney. A urine specimen for culture is necessary to document a UTI in a young child. Prior to culture, urinalysis may be useful to detect findings supporting a presumptive diagnosis of UTI. The goals of the management of UTI in a young child are: (i) prompt diagnosis of concomitant bacteraemia or meningitis, particularly in the infant; (ii) prevention of progressive renal disease by prompt eradication of the bacterial pathogen, identification of abnormalities of the urinary tract and prevention of recurrent infections; and (iii) resolution of the acute symptoms of the infection. Delay in initiation of the antibacterial therapy is associated with an increased risk of renal scarring. The initial choice of antibacterial therapy is based on the knowledge of the predominant pathogens in the patient's age group, antibacterial sensitivity patterns in the practice area, the clinical status of the patient and the opportunity for close follow-up. Imaging studies to detect congenital or acquired abnormalities are

  13. The development of procedures of diagnosis and treatment of Hodgkin's disease in children

    International Nuclear Information System (INIS)

    A retrospective analysis of the results of treatment of 467 cases of primary Hodgkin's disease (aged under 15) (1968-1992) has been undertaken. As such invasive diagnostic procedures as lower direct lymphography and laparotomy with splenectomy were being abandoned, polychemotherapy plus irradiation of zones of involvement alone at all stages were introduced. Although generalized forms of tumor (stage 3-4 tumors in 69% of cases) were in evidence and risk-adapted therapy procedures were used, the 5-year survival for 1988-1992 was 88%, the recurrence-free survival rate in the treated cases being 67%

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

    Directory of Open Access Journals (Sweden)

    Mikhail Pavlovich Konyukhov

    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.

  15. [Pheochromocytoma: diagnosis and treatment].

    Science.gov (United States)

    Widimský, J; Zelinka, T; Petrák, O; Strauch, B; Rosa, J; Michalský, M; Kasalický, M; Safarík, L; Vranková, A; Holaj, R

    2009-01-01

    Pheochromocytoma (pheo) is adrenal or less frequently extraadrenal tumour of chromafine tissue. Pheos are rare, but cardiovascular and metabolic abnormalities are common. Unrecognised pheo may lead to fatal hypertensive crisis during anesthesia or other stresses. Proper diagnosis of pheo is thus of utmost importance. 24-h blood pressure (BP) monitoring may contribute to the diagnosis of pheo due to increased BP variability and absence of night BP decline. Pheo contains large amount of enzyme catechol-O-methyl transpherase (COMT) with subsequent excessive production of COMT metabolites like metanephrines. Measurement of plasma free metanephrines or urinary fraccionated metanephrines has usually higher sensivitivity and specificity compared with plasma or urinary catecholamines. Morphological diagnosis of adrenal/extraadrenal pheo is based on CT/MR visualisation and 123I-metaiodobenzylguanidin (MIBG) or PET 18F-fluorodeoxyglucose scan. Genetic analysis should be performed in all confirmed pheo cases, especially in younger subjects below 50 years of age in order to detect mutations of following genes: von Hippel-Lindau (VHL), RET- protooncogen, genes encoding B, C and D subunit of mitochondrial sukcinat dehydrogenaze (SDHB, SDHC, SDHD) and neurofibromatosis type I gene. Pharmacological treatment is based on alpha blockers with subsequent (after 24-48 hours) administration of beta-blockers/especially in patients with tendency to tachycardia/. Following this therapy normalisation of BP is common and laparoscopic excision of pheo tumour can be realised. Malignant pheos are difficult to treat due to early occurrence of metastasis and lack of response to chemotherapy or iradiation in most cases. PMID:19899721

  16. 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

  17. 儿童脊柱结核诊疗现状及进展%Current status and progress in diagnosis and treatment for children with spinal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    李晋; 宋文慧

    2015-01-01

    通过分析最近几年关于儿童脊柱结核诊疗方面的相关文献,从诊断和治疗两方面探讨儿童脊柱结核的特点;并评估各种诊疗手段的临床应用价值。目前认为早期诊断、及时解除压迫症状、维持脊柱的稳定、预防晚期脊柱畸形进一步加重是儿童脊柱结核诊疗的重点。在抗结核药物治疗基础上,采用个体化的手术干预及支具制动策略,可良好地缓解症状,控制疾病的进展,减少并发症的发生,提高患儿生存质量。基因诊断及微创治疗为儿童脊柱结核的诊疗提供了新的思路。%Through the analysis of literatures about the diagnosis and treatment of children's spinal tuberculosis in recent years, from two aspects of diagnosis and treatment to study the characteristics of spinal tuberculosis in children, and evaluate the clinical value of various diagnostic methods. Early diagnosis and timely removement of oppression symptoms, maintaining the stability of the spine, preventing further advanced spinal deformity are considered to be the key in diagnosis and treatment of children's spinal tuberculosis. On the basis of anti-tuberculosis drugs treatment, adopting the strategy of individualized operation and braking can be good to relieve symptoms, control the progress of the disease, reduce complications and improve the quality of life in children. Genetic diagnosis and minimally surgical treatment offer new ways for the diagnosis and treatment of spinal tuberculosis in children.

  18. 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

  19. Hyperprolactinemia Diagnosis and Treatment

    Science.gov (United States)

    ... may receive treatment with estrogen (for women) or testosterone (for men). Hypothyroidism. An underactive thyroid most often needs treatment with synthetic (laboratory- made) thyroid hormone. Most often this treatment ...

  20. 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.

  1. Cystic Fibrosis: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... please turn Javascript on. Feature: Steady Advances Against Cystic Fibrosis Symptoms, Diagnosis, Treatment Past Issues / Fall 2012 Table ... both of the baby's CFTR genes are normal. Cystic Fibrosis Carrier Testing People who have one normal and ...

  2. 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 Table ... Contents What are some of the symptoms of celiac disease? Some people with celiac disease may not feel ...

  3. TBI Symptoms, Diagnosis, Treatment, Prevention

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Cover Story: Traumatic Brain Injury TBI Symptoms, Diagnosis, Treatment, ... Prevention (CDC) urge people to always: Wear a seat belt when driving or riding in a car ...

  4. Early Diagnosis, Timely Treatment

    Medline Plus

    Full Text Available ... have a very good chance of receiving proper treatment and care to the point where vision loss ... eye examinations. Announcer: Today's most frequently prescribed glaucoma treatment contains a beta blocker to reduce the pressure. ...

  5. Diagnosis and management of ADHD in children.

    Science.gov (United States)

    Felt, Barbara T; Biermann, Bernard; Christner, Jennifer G; Kochhar, Param; Harrison, Richard Van

    2014-10-01

    Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in children, and the prevalence is increasing. Physicians should evaluate for ADHD in children with behavioral concerns (e.g., inattention, hyperactivity, impulsivity, oppositionality) or poor academic progress using validated assessment tools with observers from several settings (home, school, community) and self-observation, if possible. Physicians who inherit a patient with a previous ADHD diagnosis should review the diagnostic process, and current symptoms and treatment needs. Coexisting conditions (e.g., anxiety, learning, mood, or sleep disorders) should be identified and treated. Behavioral treatments are recommended for preschool-aged children and may be helpful at older ages. Effective behavioral therapies include parent training, classroom management, and peer interventions. Medications are recommended as first-line therapy for older children. Psychostimulants, such as methylphenidate and dextroamphetamine, are most effective for the treatment of core ADHD symptoms and have generally acceptable adverse effect profiles. There are fewer supporting studies for atomoxetine, guanfacine, and clonidine, and they are less effective than the psychostimulants. Height, weight, heart rate, blood pressure, symptoms, mood, and treatment adherence should be recorded at follow-up visits. PMID:25369623

  6. Diagnosis and treatment of haemorrhoids

    DEFF Research Database (Denmark)

    Buntzen, Steen; Christensen, Peter Quist; Khalid, Ali; Ljungmann, Ken; Lindholt, Jan; Lundby, Lilli; Walker, Line Rossell; Raahave, Dennis; Qvist, Niels

    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...... haemorrhoids are treated conservatively, but surgery may be considered in a few cases with pronounced symptoms. In these cases chirurgia minor, Doppler guided dearterilization procedures or stapled haemorrhoidopexy are recommended. In grade III and IV Doppler guided dearterilization procedures, stapled...

  7. Early Diagnosis, Timely Treatment

    Medline Plus

    Full Text Available ... proper treatment and care to the point where vision loss is minimized. Your chances of going blind ... he's been able to keep about half his vision level. Kermit: Well, I can see everything here. ...

  8. Early Diagnosis, Timely Treatment

    Medline Plus

    Full Text Available ... able to read. Announcer: Kermit has also undergone laser treatments and microsurgery, common procedures which help to ... There's no cure for glaucoma. The goal of therapy is to delay the progression of the disease ...

  9. 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

    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。%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..

  10. Early Diagnosis, Timely Treatment

    Medline Plus

    Full Text Available ... been able to keep about half his vision level. Kermit: Well, I can see everything here. I can see everything. But I wouldn't be able to read. Announcer: Kermit has also undergone laser treatments and microsurgery, common procedures which help to ...

  11. Early Diagnosis, Timely Treatment

    Medline Plus

    Full Text Available ... see everything. But I wouldn't be able to read. Announcer: Kermit has also undergone laser treatments and microsurgery, common procedures which help to relieve the pressure. His vision loss has stabilized and he's been able to maintain nearly ...

  12. Early Diagnosis, Timely Treatment

    Medline Plus

    Full Text Available ... very good chance of receiving proper treatment and care to the point where vision loss is minimized. Your chances of going blind are very low if you're responsible and you take your medications faithfully and you come in for ...

  13. Osteoporosis: diagnosis and treatment

    International Nuclear Information System (INIS)

    Osteoporosis represents an important problem in Public Health. It is defined a decrease in bone mass with changes in its microstructure and increased rich of fracture. This bone mass is under the influence of genetic, ethnic, nutrition environment and cultural factors. Usually, osteoporosis is asymptomatic until the occurrence of fracture that are the main morbidity element. Its study implies conventional radiologic methods, bone densitometry, bone remodelation markers and bone biopsy. The importance of prevention must be noted, as well as its treatment on the basis of exercise, calcium and hormonal substitution in the post menopause woman. Other drugs are vitamin D, bifosfonates, calcitonin and fluorine; the factors involved in bone growth on the course of experimentation

  14. 儿童胆道系统感染的诊断与治疗%Diagnosis and treatment of biliary infection in children

    Institute of Scientific and Technical Information of China (English)

    黄志华; 刘圣烜; 董琛

    2011-01-01

    儿童胆道系统感染包括急、慢性胆囊炎和胆管炎.急性胆囊炎主要表现为右上腹疼痛,呈持续性胀痛,Murphy征阳性,伴恶心、呕吐,部分患儿有高热、寒战、黄疸,重症者发生昏迷.急性胆管炎发病急骤,以腹痛、寒战、高热和黄疸三联征为临床特征,少数患儿以感染性休克为主要表现,病死率高.本文介绍儿童胆道系统感染的诊断与治疗.%Biliary infection in children includes acute and chronic cholecystitis and cholangitis.The main dinical manifestations of acute cholecystitis are right upper-quadrant abdominal pain which is persistent with nausea and vomiting,Murphy's sign positive.Some of patients have high fever,chills,jaundice,and some severe patients have coma.Acute cholangitis has rapid onset.The most common manifestations are abdominal pain,fever,chills and jaundice which are known as Charcot's triad.A few children's main manifestation is septic shock which has a high mortality.This article described the diagnosis and treatment of biliary inflammation in children.

  15. [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. PMID:23782565

  16. Hyperprolactinemia: causes, diagnosis, and treatment

    International Nuclear Information System (INIS)

    The basic data on hyperprolactinemia (i.e. an excess of PRL above a reference laboratory's upper limits), the most common endocrine disorder of the hypothalamic-pituitary axis are given in this review. The following issues are discussed: regulation of prolactin (Prl) secretion, definition of hyperprolactinemia, its etiology and pathogenesis as well as its symptoms, diagnosis, and treatment (including medical and surgical therapy). It should be stressed that finding of elevated PRL serum concentrations constitute the beginning of diagnostic procedure and, after exclusion of physiologic, pharmacologic, and other organic causes of increased PRL levels, should be followed by detailed diagnosis including MRI. In patients in whom hyperprolactinemia has been confirmed the treatment with dopamine agonists (with prevalence of cabergoline, followed by quinagoline) is currently considered first-choice therapy. Surgery should be performed only in the patients resistant or intolerant to these agents, or in patients who refuse long-term therapy. (author)

  17. 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

  18. Porphyria: Pathophysiology, diagnosis, and treatment.

    Science.gov (United States)

    Gasson, Tracy; Klein, Kathleen

    2015-08-15

    Porphyrias are inherited metabolic disorders that involve alterations in enzymes utilized in the heme biosynthetic pathway. Most of these conditions are inherited; however, some are believed to be acquired through environmental exposures. Patients with porhyrias often present with a wide range of clinical symptoms, making it difficult to diagnose. Treatments vary depending on clinical presentation. A thorough and detailed history is essential and key to discovering a porphyria diagnosis. PMID:26180905

  19. SARCOPENIA: DIAGNOSIS, STAGES AND TREATMENT

    OpenAIRE

    Pasca Luminita Aurelia; Dogaru Gabriela; Donca Valer

    2015-01-01

    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)...

  20. Atypical parkinsonism: diagnosis and treatment.

    Science.gov (United States)

    Stamelou, Maria; Bhatia, Kailash P

    2015-02-01

    Atypical parkinsonism comprises typically progressive supranuclear palsy, corticobasal degeneration, and mutilple system atrophy, which are distinct pathologic entities; despite ongoing research, their cause and pathophysiology are still unknown, and there are no biomarkers or effective treatments available. The expanding phenotypic spectrum of these disorders as well as the expanding pathologic spectrum of their classic phenotypes makes the early differential diagnosis challenging for the clinician. Here, clinical features and investigations that may help to diagnose these conditions and the existing limited treatment options are discussed. PMID:25432722

  1. 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.

  2. Mania: diagnosis and treatment recommendations.

    Science.gov (United States)

    Malhi, Gin S; Tanious, Michelle; Berk, Michael

    2012-12-01

    This article provides recommendations for the diagnosis and treatment of mania, which characterizes bipolar I disorder (BD I). Failure to detect mania leads to misdiagnosis and suboptimal treatment. To diagnose mania, clinicians should include a detailed mood history within their assessment of patients presenting with depression, agitation, psychosis or insomnia. With regards to treatment, by synthesizing the findings from recent treatment guidelines, and reviewing relevant literature, this paper has distilled recommendations for both acute and long-term management. Antimanic agents including atypical antipsychotics and traditional mood stabilizers are employed to reduce acute manic symptoms, augmented by benzodiazepines if needed, and in refractory or severe cases with behavioural and/or psychotic disturbance, electroconvulsive therapy may occasionally be necessary. Maintenance/prophylaxis therapy aims to reduce recurrences/relapse, for which the combination of psychological interventions with pharmacotherapy is beneficial as it ensures adherence and monitoring of tolerability. PMID:22986995

  3. Diagnosis and treatment of congenital heart defects

    International Nuclear Information System (INIS)

    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.)

  4. 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.)

  5. Belgian consensus on chronic pancreatitis in adults and children: statements on diagnosis and nutritional, medical, and surgical treatment

    OpenAIRE

    Delhaye, Myriam; Van Steenbergen, Werner; Cesmeli, Ercan; Pelckmans, Paul; Putzeys, Virginie; Roeyen, Geert; Berrevoet, Frederik; Scheers, Isabelle; Ausloos, Floriane; GAST, Pierrette; Ysebaert, Dirk; Plat, Laurence; van der Wijst, Edwin; Hans, Guy; Arvanitakis, Marianna

    2014-01-01

    Chronic pancreatitis (CP) is an inflammatory disorder characterized by inflammation and fibrosis, resulting in a progressive and irreversible destruction of exocrine and endocrine pancreatic tissue. Clinicians should attempt to classify patients into one of the six etiologic groups according to the TIGARO classification system. MRI/MRCP, if possible with secretin enhancement, is considered the imaging modality of choice for the diagnosis of early-stage disease. In CP, pain is the most disabli...

  6. 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

    International Nuclear Information System (INIS)

    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.

  7. Osteoidosteoma. From diagnosis to treatment

    International Nuclear Information System (INIS)

    An osteoid osteoma is a benign bone-forming tumor which usually presents in childhood and adolescence and is characterized by extensive nocturnal pain. Computed tomography (CT) is used to reveal the typical radiolucent nidus surrounded by a sclerotic reaction and in magnetic resonance imaging (MRI) a nidal enhancement and perifocal edema can confirm the diagnosis. Having shown excellent success rates radiofrequency ablation has become the treatment of choice which allows minimally invasive and precise destruction of nidal tumor tissue. By using thermal protection techniques and multiple ablation positions successful therapy of perineural tumors and niduses with diameters of more than 2 cm are possible. (orig.)

  8. 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.

  9. 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. PMID:26489772

  10. 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.

  11. Diagnosis and treatment update: cholangiocarcinoma.

    Science.gov (United States)

    Wijaya, Indra; Abdullah, Murdani

    2011-07-01

    Cholangiocarcinoma is a rare and very aggressive neoplasm that arises from the biliary epithelium, constitutes approximately 2% of all reported cancer, and accounts for about 3% of all gastrointestinal malignancies. Up to date, there are many modalities to diagnosis and treat with a range of sensitivity and specificity, and also the advantage and disadvantage of its modality. As a physician, we should be able to assess and choose promptly which modality is best for our patient, even for paliative care. Treatment modalities are surgery and non-surgery like adjuvant chemotherapy, radiation, chemoradiation, radiotherapy, TACE, 5-FU chemoinfusion, intralesion PEI, photodynamic therapy, liver transplantation, and paliative therapy. The choice of treatment varies individually. Radical surgery remains the optimal therapy and offering a potential for cure. Overall prognosis in these patients is poor and survival is limited to a few months. PMID:21979289

  12. Choledochal cysts: diagnosis and treatment.

    Science.gov (United States)

    Popova-Jovanovska, R; Genadieva-Dimitrova, M; Trajkovska, M; Serafimoski, V

    2012-01-01

    The aim of this study is to show the different diagnostic procedures and treatment in patients diagnosed with congenital choledochal cysts. Choledochal cysts are congenital anomalies of the bile ducts and include cystic dilatation of the extrahepatic and intrahepatic biliary ducts or both. The study shows ten patients diagnosed as having choledochal cysts. Diagnosis was established by clinical and radiographic findings including: ultrasound (US), magnetic resonance cholangiopancreatograpy (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC) and cytological examination of the bile juice. In the study choledochal cysts were classified according to the Todani classification. Most common cysts were type I (six cases); type III (one case), type IVa (one case) and two patients were type V cysts (Caroli disease). The most frequent symptoms were abdominal pain, jaundice and cholangitis. US findings were sensitive for the preliminary diagnosis of choledochal cysts in all the patients. MRCP accurately defined the cyst anatomy and the site of the biliary origin in all the cases with extrahepatic cysts. In three cases ERCP clearly demonstrated the cyst and by PTC smaller cysts were well defined. Cytological examination of the bile juice obtained during the PTC procedure showed malignant cells in one case. Therefore pancreaticoduodenectomy was performed and pathological examination showed associated cholangiocarcinoma. Five years after the operation the patient was well and free of the disease. Five patients underwent surgical treatment with a total cyst excision and Roux-en-Y hepaticojejunostomy while the surgical approach in two patients was partial cyst excision and cystojejunostomy. Patients with Caroli disease were conservatively treated and 3 with interventional endoscopic procedures. Despite US evidence suggesting choledochal cyst diagnosis, other supportive radiographic imaging modalities such as MRCP, ERCP and

  13. Turco's injury: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Ana Paula Simões da Silva

    2014-08-01

    Full Text Available 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.

  14. 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. PMID:26229821

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

    Science.gov (United States)

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

  16. 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 ...

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

    Science.gov (United States)

    ... of this 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 both eyes. Often ...

  18. 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.

  19. 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.

  20. 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.

  1. 2D/3D/4D contrast-enhanced voiding urosonography in the diagnosis and monitoring of treatment of vesicoureteral reflux in children – can it replace voiding cystourethrography?

    OpenAIRE

    Woźniak, Magdalena Maria; Pawelec, Agata; Wieczorek, Andrzej Paweł; Zajączkowska, Maria Małgorzata; Borzęcka, Halina; Nachulewicz, Paweł

    2013-01-01

    Introduction Vesicoureteral reflux appears in 20–50% of pediatric patients with recurrent urinary tract infections. The most common method of diagnosing this disease is voiding cystourethrography. However, contemporary pediatric radiology does not favor this method due to exposure to X-radiation. Aim The aim of this study was to assess the usefulness of 2D/3D/4D contrast-enhanced voiding urosonography in the diagnosis and treatment monitoring of vesicoureteral reflux in children and the possi...

  2. 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.

  3. Fetal tachycardia : diagnosis and treatment

    NARCIS (Netherlands)

    Oudijk, Martijn Alexander

    2003-01-01

    Part I: Fetal tachyarrhythmias Diagnosis Fetal tachycardia is a serious condition warranting specialized evaluation. In chapter 2, methods of diagnosis of fetal tachycardia are described, including doppler and M-mode echocardiography and fetal magnetocardiography. The study presented in chapter 3 d

  4. Prediabetes diagnosis and treatment: A review

    Science.gov (United States)

    Bansal, Nidhi

    2015-01-01

    Prediabetes is an intermediate state of hyperglycemia with glycemic parameters above normal but below the diabetes threshold. While, the diagnostic criteria of prediabetes are not uniform across various international professional organizations, it remains a state of high risk for developing diabetes with yearly conversion rate of 5%-10%. Observational evidence suggests as association between prediabetes and complications of diabetes such early nephropathy, small fiber neuropathy, early retinopathy and risk of macrovascular disease. Several studies have shown efficacy of lifestyle interventions with regards to diabetes prevention with a relative risk reduction of 40%-70% in adults with prediabetes. While there is increasing evidence to prove the efficacy of pharmacotherapy in prevention of diabetes in adults with prediabetes, pharmaceutical treatment options other than metformin are associated with adverse effects that limit their use for prediabetes. There are no reports of systematic evaluation of health outcomes related to prediabetes in children. The effects of pharmacotherapy of prediabetes on growth and pubertal development in children remains unknown. Secondary intervention with pharmacotherapy with metformin is advocated for high-risk individuals but criteria for such consideration benefit of early intervention, long term cost effectiveness of such interventions and the end point of therapy remain unclear. Pharmacotherapy must be used with caution in children with prediabetes. Prediabetes is a condition defined as having blood glucose levels above normal but below the defined threshold of diabetes. It is considered to be an at risk state, with high chances of developing diabetes. While, prediabetes is commonly an asymptomatic condition, there is always presence of prediabetes before the onset of diabetes. The elevation of blood sugar is a continuum and hence prediabetes can not be considered an entirely benign condition. This aim of this review is to

  5. Diagnosis and treatment of craniosynostosis

    International Nuclear Information System (INIS)

    Craniosynostoses are cranio-cerebral and cranio-facial dysmorphic states, characterized by early closure of one or more cranial sutures. In this pathology the perpendicular growth of the bone to the involved suture is disturbed (Virchow's theory). Craniosynostoses can be divided into: 1) single-suture synostoses (scaphocephaly, plagiocephaly, trigonocephaly); 2) multiple-suture synostoses (brachycephaly, oxicephaly); 3) cranio-facial dysostoses. From 1970 to 1987, 63 children with craniosynostosis were studied. All patients underwent radiologic and neuroradiologic research with CT scans both before and after surgery; in the past year three-dimensional reconstructions of CT images were also employed. Major advantages of 3DCT have been obtained in cranio-facial malformations. In fact, this technique helps reduce surgical risks and allows the surgeon to evaluate patial results and to make eventual corrections in the last phase. The processing of images is useful to simulate the operation, thus allowing the surgeon to take the best therapeutic choice by computer. This technique is especially useful for postoperative follow-up. In craniosynostoses, early surgical treatment (ehitin the first 6-8 months of life) is necessary in order to obtain excellent functional and cosmetic results

  6. Clinical strategies for the diagnosis and treatment of febrile seizures in children%儿童热性惊厥诊治中的临床对策

    Institute of Scientific and Technical Information of China (English)

    郑君芳

    2014-01-01

    目的:探讨儿童热性惊厥临床诊治对策。方法:2013年3月-2014年3月收治热性惊厥患儿100例,随机将其分为对照组和观察组,对照组给予物理降温、常规药物等治疗,观察组在此基础上联合布洛芬混合液直肠给药治疗,对两组临床治疗效果进行比较。结果:观察组治疗总有效率96%,10 min止惊率54%,再发惊厥率4%;对照组治疗总有效率82%,10 min止惊率54%,再发惊厥率18%,两组比较P<0.05。另外,观察组平均退热时间(24.20±0.65)h,对照组平均退热时间(32.83±1.25)h,两组比较,P<0.05。结论:常规处理基础上联合布洛芬混合液,能快速有效地降低体温,止惊效果良好,安全可靠,值得临床推广。%Objective:To investigate the clinical diagnosis and treatment of febrile convulsion in children.Methods:100 children with febrile seizures were selected from March 2013 to March 2014.They were randomly divided into the observation group and the control group.Patients in the control group were treated with physical cooling,conventional drug and so on.The observation group were given ibuprofen mixed liquid of rectal administration based on the control group.We compared the clinical treatment effect of two groups.Results:The observation group total effective rate was 96%;10 min anti convulsion rate was 54%;the recurrent convulsion rate was 4% .The control group total effective rate was 82% ;10 min anti convulsion rate was 54% ;the recurrent convulsion rate was 18%.The comparison of two groups P<0.05.In addition,the average defervescence time of the observation group was(24.20±0.65)h;the average defervescence time of the control group was(32.83±1.25)h;the comparison of two groups, P<0.05.Conclusion:We plus ibuprofen mixed liquid on the basis of routine treatment.It can effectively lower the body temperature.The anti convulsion effect is good,safe and reliable,so it is worthy of clinical application.

  7. Chronic Pain: Symptoms, Diagnosis, & Treatment

    Science.gov (United States)

    ... in the treatment. Treatment With chronic pain, the goal of treatment is to reduce pain and improve ... some treatments used for chronic pain. Less invasive psychotherapy, relaxation therapies, biofeedback, and behavior modification may also ...

  8. Radiological diagnosis of hip joint abnormalities in children

    Directory of Open Access Journals (Sweden)

    Михаил Михайлович Камоско

    2015-06-01

    Full Text Available Abnormalities of the hip joint in children covers a wide range of diseases, including both congenital and acquired ones. Hip dysplasia, Legg-Calve-Perthes disease and juvenile slipped capital femoral epiphysis account for up to 25 % of all diseases of the musculoskeletal system in pediatric patients. Early diagnosis of these disorders and timely treatment are of paramount importance in the prevention of childhood disability.

  9. Radiological diagnosis of hip joint abnormalities in children

    OpenAIRE

    Mikhail Mikhailovich Kamosko; Mahmoud Stanislavovich Poznovich

    2015-01-01

    Abnormalities of the hip joint in children covers a wide range of diseases, including both congenital and acquired ones. Hip dysplasia, Legg-Calve-Perthes disease and juvenile slipped capital femoral epiphysis account for up to 25 % of all diseases of the musculoskeletal system in pediatric patients. Early diagnosis of these disorders and timely treatment are of paramount importance in the prevention of childhood disability.

  10. 小儿局限性骨化性肌炎的诊断与治疗%Diagnosis and treatment of myositis ossificans circumscripta in children

    Institute of Scientific and Technical Information of China (English)

    唐学阳; 蒋欣; 王道喜; 杨晓东; 刘利君; 刘敏; 彭明惺

    2013-01-01

    Objective To study the clinical features,diagnosis,treatment and prognosis of myositis ossificans circumscripta.Methods Clinical data of 13 children of myositis ossificans circumscripta were retrospectively analyzed.Results Four cases were diagnosed by pathological examination,including 3 cases who had resection of ossified mass because of joint dysfunction or pain.The other 9 cases were diagnosed according to clinical presentations and imaging features.The clinical presentations included redness,swelling,heat and tenderness.One case had no imaging abnormality at the early stage,but subsequently had typical X-ray features in mid and late stages.Two of the 3 cases who had resection recovered completely and one case had only very little impairment of finger flexion.During follow-up,eight of the 9 cases had stable disease,but one patient died of other unrelated cause.Conclusions Myositis ossificans circumscripta is a self-limiting disease,but it is often confused with other soft tissue conditions,such as abscess,osteomyelitis,or tumor at early stage.Clinical presentations may help to make a clinical diagnosis.Biopsy should be considered to avoid erroneous treatment.%目的 探讨小儿局限骨化性肌炎的临床特点、诊断、治疗与预后,以期提高对本病的认识能力.方法 回顾分析13例患儿临床资料及影像学特点,随访其治疗结果及预后情况.结果 13例患儿中,4例经病理活检确诊,包括3例因关节功能障碍或疼痛,作了骨化病灶切除术,其余9例结合临床及影像学的综合资料初步诊断并在随访观察中证实诊断,这9例主要临床特点为早期局部红肿热,后期包块伴局部关节活动受限,早期X线片无特殊发现,中后期可见高密度的由外向内呈带状、片、团状影与附近骨干并不相连;3例切除骨化块后2例完全康复,1例手指屈曲功能轻度受限,但较术前改善,1例39d患儿出院后死于其他病因,其余9例病变静止,

  11. [Surgical treatment of children with hepatic tumours

    DEFF Research Database (Denmark)

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

    2008-01-01

    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 with......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...

  12. Diagnosis and Treatment in 20 Children with Aerophagia%儿童吞气症20例的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    郝理华; 刘志峰

    2012-01-01

    Objective To investigate the diagnosis and treatment of childhood aerophagia. Methods Twenty children with aerophagia, aged 2-13 years old,hospitalized in Nanjing Children's Hospital Affiliated to Nanjing Medical University from Jul. 2005 to Mar. 2009 were selected. All the diagnosis were made according to the medical history, physical examination and laboratory tests, parenchymal diseases were excluded. The clinical data of them were reviewed. Results The diagnostic clinical profiles suggested by Rome IE criteria,all the 20 cases of aerophagia were diagnosed. Of the 20 patients,the chief complaints were abdominal distention in 20 cases(100% ) .visible or audible air swallowing in 20 cases(100%),repetitive belching in 18 cases(90%) .reduced appetite in 18 cases(90% ),constipation in 12 cases(60%), psychological stresses in 8 cases(40% ) .recurrent abdominal pain in 6 cases(30% ) .chronic diarrhea in 2 cases(10% ) and acute abdominal pain in 2 cases(10% ). Physical examination:obvious abdominal distention,soft abdomen.no tenderness or mess,percussion for the sound of drums,auscultation for active bowel sounds. X - ray showed excessive gastrointestinal gas, with no liquid plane. The infection disease,electrolytes disturbance and surgical diseases were excluded by normal blood,urine and stool test,stool cultivation,enterovirus and blood biochemistry detection. Fourteen cases(70% ) were cured by psychological counseling management, diet modification, laxatives,propubives and vitamins. Six several cases were also cured after silicone oils(dimethicone or simethicone) treatment. Conclusions Aerophagia is a kind of functional gastrointestinal disorders in children. Part cases of aerophagia are accompanied with psychiatric disorders, a self - limited course were common observed in the patients without psychiatric disorders. Silicone oils can help to alleviate the clinical symptoms and may shorten the duration of illness.%目的 探讨吞气症的诊断和治疗.方法

  13. Memory and attention problems in children with brain tumors at diagnosis

    OpenAIRE

    Margelisch, Katja; Studer, Martina; Steinlin, Maja; Leibundgut, Kurt; Heinks Maldonado, Theda

    2014-01-01

    Purpose: Results from previous studies indicate that children with brain tumors (BT) might present with cognitive problems at diagnosis and thus before the start of any medical treatment. The question remains whether these problems are due to the underlying tumor itself or due to the high level of emotional and physical stress which is involved at diagnosis of a malignant disorder. All children with a de novo oncological diagnosis not involving the central nervous systems (CNS) are usually ex...

  14. 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

    2012-01-01

    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

  15. 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

  16. Urinary tract infections in infants and children: Diagnosis and management.

    Science.gov (United States)

    Robinson, Joan L; Finlay, Jane C; Lang, Mia Eileen; Bortolussi, Robert

    2014-06-01

    Recent studies have resulted in major changes in the management of urinary tract infections (UTIs) in children. The present statement focuses on the diagnosis and management of infants and children >2 months of age with an acute UTI and no known underlying urinary tract pathology or risk factors for a neurogenic bladder. UTI should be ruled out in preverbal children with unexplained fever and in older children with symptoms suggestive of UTI (dysuria, urinary frequency, hematuria, abdominal pain, back pain or new daytime incontinence). A midstream urine sample should be collected for urinalysis and culture in toilet-trained children; others should have urine collected by catheter or by suprapubic aspirate. UTI is unlikely if the urinalysis is completely normal. A bagged urine sample may be used for urinalysis but should not be used for urine culture. Antibiotic treatment for seven to 10 days is recommended for febrile UTI. Oral antibiotics may be offered as initial treatment when the child is not seriously ill and is likely to receive and tolerate every dose. Children <2 years of age should be investigated after their first febrile UTI with a renal/bladder ultrasound to identify any significant renal abnormalities. A voiding cystourethrogram is not required for children with a first UTI unless the renal/bladder ultrasound reveals findings suggestive of vesicoureteral reflux, selected renal anomalies or obstructive uropathy. PMID:25332662

  17. Diagnosis and emergencv treatment of coma in children%儿童昏迷的诊断与急救处理

    Institute of Scientific and Technical Information of China (English)

    王纪文; 李婧

    2011-01-01

    Coma is one of the most serious type of consciousness disturbances.The causes of coma are complicated and the mortality rate is high.In this review,we discuss the definition,diagnosis and emergency treatment of coma,which is helpful for pediatricians to have a deeper understanding of coma,make correct diagnosis and administer appropriate treatment more quickly.%昏迷是一种严重的意识障碍,病因复杂,病死率高.本文将从定义、诊断及急救处理等方面对昏迷进行论述,从而使临床医师加深对昏迷的认知,有助于及时进行正确的诊断和合理的救治.

  18. Dental caries. Diagnosis and treatment.

    Science.gov (United States)

    Charland, Robert; Voyer, René; Cudzinowski, Lionel; Salvail, Paule; Abelardo, Leonardo

    2002-02-01

    The diagnosis of tooth decay must go beyond the clinical detection of a carious lesion. The practitioner should assess the individual's risk factors as well as the activity of the lesion. Our traditional instrumentation has limitations. Therefore, researchers are urged to find new diagnostic tools to allow earlier detection, to predict disease activity and, finally, to assess the susceptibility of an individual. PMID:11898271

  19. Prostate Cancer: Symptoms, Diagnosis and Treatment

    Science.gov (United States)

    ... this page please turn Javascript on. Feature: Prostate Cancer Prostate Cancer: Symptoms, Diagnosis and Treatment Past Issues / Winter ... Read More "Prostate Cancer" Articles Progress Against Prostate Cancer / Prostate Cancer Research Trial Helps John Spencer Treat His ...

  20. HIV / AIDS: Symptoms, Diagnosis, Prevention and Treatment

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: Symptoms , Diagnosis, Prevention and Treatment Past Issues / ... Most people who have become recently infected with HIV will not have any symptoms. They may, however, ...

  1. HIV / AIDS: Symptoms, Diagnosis, Prevention and Treatment

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: Symptoms , Diagnosis, Prevention and Treatment Past Issues / Summer ... and have resulted in a dramatic decrease in AIDS deaths in the U.S. NIH Research to Results ...

  2. Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

  3. Evaluation and Diagnosis of Back Pain in Children and Adolescents.

    Science.gov (United States)

    Shah, Suken A; Saller, Jeremy

    2016-01-01

    Although traditionally it has been accepted that back pain in young children and adolescents most often has an organic etiology, nonorganic back pain in this population is becoming more common. The most common identifiable clinical entities responsible for such pain are spondylolysis, spondylolisthesis, Scheuermann kyphosis, overuse syndromes, disk herniation, apophyseal ring fracture, spondylodiscitis, vertebral osteomyelitis, and neoplasm. Appropriate clinical workup leads to earlier diagnosis and management of back pain and avoids unnecessary cost. Knowledge of the most common diagnoses associated with back pain in children and adolescents and the use of a systematic method to select the appropriate diagnostic tests can help the clinician to minimize costs and maximize the likelihood of making the correct diagnosis and providing appropriate treatment. PMID:26589458

  4. Radiological diagnosis of pneumonia in children.

    Science.gov (United States)

    Kiekara, O; Korppi, M; Tanska, S; Soimakallio, S

    1996-02-01

    During 12 months in 1981-82, 201 children were hospitalized due to radiologically verified definite or probable pneumonia. In 1985, 194 chest radiographs (anteroposterior views) were re-evaluated jointly by two radiologists, and classified into three categories: alveolar, interstitial and probable pneumonia. In 127 cases definite pneumonia was diagnosed on both occasions, alveolar in 48 cases and interstitial in 79 cases. Variation between the two evaluations 3 years apart was observed in 46 (24%) of the 194 cases; the adjusted kappa (0.47) was in the modest region. Factors contributing to this variation were young age, less than 12 months, and the presence of interstitial infiltration, bronchial obstruction and low C-reactive protein. Factors associated with less marked variation were the presence of alveolar infiltration, auscultatory fine rates and elevated C-reactive protein. The microbial aetiology of infection, assessed by viral and bacterial antigen and antibody assays, showed no association with diagnostic variation. A lateral view of the chest radiograph was obtained from 158 patients; it was positive in 99 (91%) of the 109 cases with definite pneumonia. In only three cases the diagnosis was based on the lateral view alone. Our results show that the radiological diagnosis of pneumonia is difficult in children, especially in young children with interstitial pneumonia. PMID:8932509

  5. 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

  6. Paedophilia; Diagnosis, Treatment & Moral Panic

    OpenAIRE

    Sadat, Sama; Ashraf, Kashifah; Nilsson Smith, Heidi; Chemlali, Hanan; Bosboom, Chiara; Hoff, Rasmus

    2012-01-01

    Paedophilia, briefly explained, is an adult’s sexual and emotional fascination for children. This phenomenon tends to raise a lot of strong feelings of horror, disgust and rage in the general population. The mere description is seen as horrible and directly unacceptable by normative morals and values. The collection of empirical data was done through authors and researchers, who have written reports and made research in this particular field. Additionally we interviewed persons from the ...

  7. Diagnosis and treatment of hypernatremia.

    Science.gov (United States)

    Muhsin, Saif A; Mount, David B

    2016-03-01

    Hypernatremia is defined as a serum sodium level above 145 mmol/L. It is a frequently encountered electrolyte disturbance in the hospital setting, with an unappreciated high mortality. Understanding hypernatremia requires a comprehension of body fluid compartments, as well as concepts of the preservation of normal body water balance. The human body maintains a normal osmolality between 280 and 295 mOsm/kg via Arginine Vasopressin (AVP), thirst, and the renal response to AVP; dysfunction of all three of these factors can cause hypernatremia. We review new developments in the pathophysiology of hypernatremia, in addition to the differential diagnosis and management of this important electrolyte disorder. PMID:27156758

  8. Diagnosis, Epidemiology, and Management of Hypertension in Children.

    Science.gov (United States)

    Rao, Goutham

    2016-08-01

    National guidelines for the diagnosis and management of hypertension in children have been available for nearly 40 years. Unfortunately, knowledge and recognition of the problem by clinicians remain poor. Prevalence estimates are highly variable because of differing standards, populations, and blood pressure (BP) measurement techniques. Estimates in the United States range from 0.3% to 4.5%. Risk factors for primary hypertension include overweight and obesity, male sex, older age, high sodium intake, and African American or Latino ancestry. Data relating hypertension in childhood to later cardiovascular events is currently lacking. It is known that BP in childhood is highly predictive of BP in adulthood. Compelling data about target organ damage is available, including the association of hypertension with left ventricular hypertrophy, carotid-intima media thickness, and microalbuminuria. Guidelines from both the United States and Europe include detailed recommendations for diagnosis and management. Diagnostic standards are based on clinic readings, ambulatory BP monitoring is useful in confirming diagnosis of hypertension and identifying white-coat hypertension, masked hypertension, and secondary hypertension, as well as monitoring response to therapy. Research priorities include the need for reliable prevalence estimates based on diverse populations and data about the long-term impact of childhood hypertension on cardiovascular morbidity and mortality. Priorities to improve clinical practice include more education among clinicians about diagnosis and management, clinical decision support to aid in diagnosis, and routine use of ambulatory BP monitoring to aid in diagnosis and to monitor response to treatment. PMID:27405770

  9. Iliopsoas: Pathology, Diagnosis, and Treatment.

    Science.gov (United States)

    Anderson, Christian N

    2016-07-01

    Disorders of the iliopsoas can be a significant source of groin pain in the athletic population. Commonly described pathologic conditions include iliopsoas bursitis, tendonitis, impingement, and snapping. The first-line treatment for iliopsoas disorders is typically conservative, including activity modification, physical therapy, nonsteroidal anti-inflammatory drugs, and corticosteroid injections. Surgical treatment can be considered if the patient fails conservative measures and typically involves arthroscopic lengthening of the musculotendinous unit and treatment of concomitant intra-articular abnormality. Tendon release has been described: in the central compartment, in the peripheral compartment, and at the lesser trochanter, with similar outcomes observed between the techniques. PMID:27343394

  10. Lyme Disease: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Ivan Maluf Junior

    2010-11-01

    Full Text Available Lyme disease is a multisystem bacterial infection caused by the spirochete Borrelia burgdorferi. It is transmitted by the bite of infected ticks of the genus Ixodes and Amblyomma. The disease is endemic in wooded, brushy areas, which are habitats for wild animals and ticks. It is the disease most commonly transmitted by ticks, but rarely reported in Brazil. Early local Lyme Disease often starts with erythema migrans at the site of the tick bite, followed by flu-like symptoms. In advanced stage the disease may cause symptoms in the joints, eyes, heart and nervous system. Diagnosis is based on clinical symptoms, epidemiology and laboratory tests. Lyme disease is treated with antibiotics according to the stage of the disease.

  11. 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...

  12. Anxiety disorders. Part 1: Diagnosis and treatment.

    OpenAIRE

    Labelle, A.; Lapierre, Y. D.

    1993-01-01

    Anxiety disorders often take second priority in clinical practice because many physicians do not understand them or their treatment. This paper reviews the diagnostic groupings of anxiety disorders according to the American Psychiatric Association's Revised Diagnostic and Statistical Manual of Mental Disorders (DSM 3-R) and discusses differential diagnosis and treatment.

  13. Diagnosis and treatment of myopic traction maculopathy

    OpenAIRE

    2012-01-01

    In recent years, the broad application of optical coherence tomography and vitrectomy, combined with research efforts in maculopathy in high myopia have provided many achievements, such as the new classification of myopic traction maculopathy (MTM). Here, we review the latest developments in the diagnosis and treatment of MTM, including its conception, clinical characteristics, pathogenesis, clinical stages, and the options for surgical treatment.

  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 fibroids].

    Science.gov (United States)

    Török, Péter; Póka, Róbert

    2016-05-22

    Uterine fibroid is the most common tumor in women of reproductive age. Depending on the size and location they can cause variety of symptoms. The clinical presentation may include bleeding disorders, infertility, pelvic pain and dysmenorrhea as well. Detection and precise evaluation of the number, size and location of myomas is possible due to advances in imaging and endoscopic methods. Treatment of fibroids depends on the severity and type of symptoms. There are medical, radiological and surgical options for treatment. Debates on fibroid management are widely published and are in focus recently, related to the "fibroid-scandal" occurred in the United States. PMID:27177787

  16. Current Diagnosis and Treatment of Halitosis

    OpenAIRE

    Mehmet Mustafa Kılıçkaya

    2015-01-01

    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 ...

  17. 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.

  18. 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.

  19. Diagnosis and treatment of central diabetes insipidus

    Directory of Open Access Journals (Sweden)

    Ekaterina Aleksandrovna Pigarova

    2014-11-01

    Full Text Available Diabetes insipidus represents a serious disease that dramatically interferes with the everyday life of patients due to the need to constantly replenish of fluid lost in the urine, which comes amid shortage of synthesis, secretion or action of pituitary hormone vasopressin. The main difficulty is the differential diagnosis of types of diabetes insipidus in patients with the syndrome of polydipsia-polyuria as the correct differential diagnosis of these forms predetermine the safety and efficacy of further treatment. This lecture presents the current concepts of etiology, diagnosis and treatment of central diabetes insipidus (CDI. We give the comparative characteristics of various preparations of desmopressin for the treatment of the central form of the disease. We also consider the features of the management of selected patient populations with CDI: during pregnancy and lactation, pathology of the thirst sensation, after traumatic brain injury and neurosurgery.

  20. MOLLUSCUM CONTAGIOSUM, DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Winda Arista Haeriyoko

    2013-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Molluscum contagiosum is a dermathology disease caused by molluscum contagiosum virus (MCV, pox viral group from Molluscipox viral genus. The incidence of molluscum contagiosum all over the world aprroximately 2% - 8% with prevalence 5% - 18% in HIV patient.Molluscum contagiosum sendemically spread among rural area, bad hygiene, and low-income population. This disease usually suffered by children, sexually active adult, immunodeficiency patient. Diagnose can be done according to physical examination. Evaluation using central content usig crush and Giemsa or histopatologic if needed. Patient wil spontaneously healed, but after a long time, for months even years. The disease will not residive with eradication of all the lessions will /* 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;}

  1. HPV: diagnosis, prevention, and treatment.

    Science.gov (United States)

    Hathaway, Jon K

    2012-09-01

    Human papilloma virus (HPV) is the most common sexually transmitted disease in the world. Almost 80% of the world's population is exposed by the age of 50. HPV can cause oropharyngeal, genital, and anal cancers. It also causes genital warts. There is no cure for HPV but vaccines are available to prevent infection by the most common HPV viruses; unfortunately, usage is low. Most people will clear HPV spontaneously. Those who do not are at high risk for developing malignancy. Treatment mainstays are destruction and excision of the lesions. PMID:22828099

  2. 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...... 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...

  3. 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;}

  4. 小儿肺炎支原体感染临床诊治与分析%Analysis of Clinical Diagnosis and Treatment of Mycoplasma Pneumoniae Infection in Children

    Institute of Scientific and Technical Information of China (English)

    刘艳茹

    2015-01-01

    目的分析观察小儿肺炎支原体感染的临床特点,通过该病患儿的治疗分析与观察,提高诊疗水平。方法对2014年1月~6月于我院就诊的患儿的临床特点和诊治过程进行分析总结。结果23例支原体肺炎(MP)感染患儿经明确诊断并对症治疗后均得以痊愈。结论小儿肺炎支原体感染的临床症状各异,临床需要根据患儿的年龄、症状、体征、实验室检查和医学影像检查结果进行诊断分析,以利于早期治疗。 MP感染临床抗生素治疗首选大环内酯类抗生素,同时注意监测肺外各脏器功能。%Objective To analysis to observe the clinical characteristics of pediatric pneumonia mycoplasma infection,through analysis and observe the treatment of children with the disease,improve the level of diagnosis and treatment.Methods In January 2014-June 2014 in our hospital of children is analyzed to summarize the clinical characteristics and treatment process.Results 23 cases of children with mycoplasma pneumonia (MP)infection after definite diagnosis and symptomatic treatment to recover.Conclusion The clinical symptoms of pediatric pneumonia mycoplasma infection, clinical need according to the patient's age,symptoms,signs,laboratory examination and analysis of medical image diagnosis to check the result,to facilitate early treatment.MP infection clinical antibiotic treatment choice for large ring lactone class antibiotic,at the same time pay at ention to the monitoring of extrapulmonary each viscera function.

  5. Acute withdrawal: diagnosis and treatment.

    Science.gov (United States)

    Brust, John C M

    2014-01-01

    Symptoms of alcohol withdrawal range in severity from mild "hangover" to fatal delirium tremens (DTs). Tremor, hallucinosis, and seizures usually occur within 48 hours of abstinence. Seizures tend to be generalized without focality, occurring singly or in a brief cluster, but status epilepticus is not unusual. DTs usually appears after 48 hours of abstinence and consists of marked inattentiveness, agitation, hallucinations, fluctuating level of alertness, marked tremulousness, and sympathetic overactivity. The mainstay of treatment for alcohol withdrawal is benzodiazepine pharmacotherapy, which can be used to control mild early symptoms, to prevent progression to DTs, or to treat DTs itself. Alternative less evidence-based pharmacotherapies include phenobarbital, anticonvulsants, baclofen, gamma-hydroxybutyric acid, beta-blockers, alpha-2-agonists, and N-methyl-d-aspartate receptor blockers. Treatment of DTs is a medical emergency requiring heavy sedation in an intensive care unit, with close attention to autonomic instability, fever, fluid loss, and electrolyte imbalance. Frequent comorbid disorders include hypoglycemia, liver failure, pancreatitis, sepsis, meningitis, intracranial hemorrhage, and Wernicke-Korsakoff syndrome. PMID:25307572

  6. Clinical diagnosis and treatment of olfactory meningioma

    International Nuclear Information System (INIS)

    Objective: To analyze the clinical diagnosis and treatment of olfactory meningioma. Methods: In this group 17 olfactory meningiomas were operated, and the clinical presentations and the surgery results were obtained. Results: The symptoms of psychiatrical disorder, visual disturbances and eclipse at presentation was higher. In 16 cases the grade of resection was Simpson II, 1 case Simpson III, most of the cases had a good recovery. Conclusion: Attention should be paid to the early symptom at presentation such as psychiatrical disorder to obtain an early diagnosis. Microsurgery is useful in the treatment of olfactory meningioma. (authors)

  7. 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. PMID:20678175

  8. Diagnosis and treatment of Morton's neuroma.

    Science.gov (United States)

    Summers, Anthony

    2010-09-01

    Morton's neuroma is a benign foot condition that occurs more often in women than men, and particularly in those who wear narrow, high-heeled shoes. This article presents a case study of the condition, discusses its symptoms and diagnosis, and provides information about the range of treatments on offer. PMID:20882801

  9. Diagnosis and treatment for chronic migraine.

    Science.gov (United States)

    Moriarty, Maureen; Mallick-Searle, Theresa

    2016-06-19

    Migraine is a debilitating headache disorder that is underdiagnosed and undertreated worldwide, partially attributable to misdiagnosis and expectations of poor treatment outcomes. This article provides a review of chronic migraine, including pathophysiology, burden, diagnosis, and management, with special emphasis on the role of NPs. PMID:27203455

  10. 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…

  11. Diagnosis and treatment of myopic traction maculopathy

    Directory of Open Access Journals (Sweden)

    Ping-Bo Ouyang

    2012-12-01

    Full Text Available In recent years, the broad application of optical coherence tomography and vitrectomy, combined with research efforts in maculopathy in high myopia have provided many achievements, such as the new classification of myopic traction maculopathy (MTM. Here, we review the latest developments in the diagnosis and treatment of MTM, including its conception, clinical characteristics, pathogenesis, clinical stages, and the options for surgical treatment.

  12. Differential diagnosis of infratentorial tumors in children

    International Nuclear Information System (INIS)

    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. (orig.)

  13. Diagnosis and treatment of breast cancer

    International Nuclear Information System (INIS)

    This paper explains the outline of the present diagnosis and treatment of breast cancer essentially based on its therapeutic guideline by the Japan Breast Cancer Society (2005) and on authors' experiences. The diagnosis item contains the medical interview of patients, observatory and palpating examinations, mammography (for this, Japan-Breast Imaging Recording and Data System), ultrasonography (guideline for sonographic diagnosis of mammary gland, 2004), fine needle aspiration (FNA) or aspiration biopsy cytology, bases of triple test (palpation, mammography and FNA) for the cancer diagnosis, core needle biopsy, and mammotome biopsy of non-palpable calcified lesion. The treatment item contains the surgery involving conservation, sentinel lymph node biopsy (for this, lymphoscintigraphy with Tc-phytate is illustrated), radiofrequency ablation, adjuvant chemotherapy essentially using anthracycline and taxane, endocrinological therapy using tamoxifen, LH-RH analogues and aromatase inhibitors, and molecular target therapy with HER2 monoclonal antibody like trastuzumab. Recent progress of systemic therapy with medicals is remarkable, and the educational promotion of experts and medicare circumstances are concluded to be important. (R.T.)

  14. Prospective, longitudinal assessment of quality of life in children from diagnosis to 3 months off treatment for standard risk acute lymphoblastic leukemia: Results of Children's Oncology Group study AALL0331.

    Science.gov (United States)

    Mitchell, Hannah-Rose; Lu, Xiaomin; Myers, Regina M; Sung, Lillian; Balsamo, Lyn M; Carroll, William L; Raetz, Elizabeth; Loh, Mignon L; Mattano, Leonard A; Winick, Naomi J; Devidas, Meenakshi; Hunger, Stephen P; Maloney, Kelly; Kadan-Lottick, Nina S

    2016-01-15

    Standard risk acute lymphoblastic leukemia (SR-ALL) has high cure rates, but requires 2-3 years of therapy. We aimed to (i) prospectively evaluate health-related quality of life (HRQOL) during and after SR-ALL therapy, and (ii) identify associated predictors. Parents of 160 SR-ALL patients enrolled on Children's Oncology Group (COG) therapeutic trial AALL0331 at 31 sites completed the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales (physical, emotional and social functioning) and Family Assessment Device-General Functioning (FAD-GF) at 1, 6 and 12 months after diagnosis, and 3 months post-therapy. Mean PedsQL scores in physical, emotional and social functioning were impaired 1 month after diagnosis but steadily improved. Three months post-therapy, impaired physical and social functioning was observed in 27.8 and 25.8% of patients, respectively. In repeated-measures analysis, problematic family functioning predicted emotional (OR = 1.85, 95% CI 1.03-3.34) and social (OR = 1.99, 95% CI 1.21-3.27) impairment. Larger household size was associated with social impairment (OR = 1.21, 95% CI 1.02-1.45). Adverse neurological event(s) during therapy predicted post-therapy physical (OR = 5.17, 95% CI 1.61-16.63) and social (OR = 8.17, 95% CI 1.19-56.16) impairment. HRQOL 1 month after diagnosis was not predictive of HRQOL 3 months after therapy completion. In conclusion, children with SR-ALL experience considerable impairment in HRQOL at the end of induction, but rapidly improve. However, many still experience physical and social impairment 3 months post-therapy, suggesting a role for continued family and physical functioning support. Longer follow-up is needed to determine if post-therapy deficits change over time. PMID:26235006

  15. Diagnosis of onychomycosis by trypsin treatment method

    Directory of Open Access Journals (Sweden)

    Xess Immaculata

    2007-01-01

    Full Text Available Background: Fungal infection of the nails is a common, difficult to treat problem, prevalent worldwide. A discrepancy in the microscopic examination and culture findings can create problems in the diagnosis of this common infection. Aim: This study was designed to evaluate a new method for accurate diagnosis of onychomycosis. Materials and Methods: Nail samples from 25 patients of suspected onychomycosis were taken. A portion of the samples was treated with 2% trypsin before culturing and the rest was processed by the standard mycological technique. Results: A higher number of culture positive samples were obtained by the trypsin treatment method as compared to the standard technique. Conclusion: Trypsin treatment prior to culture increases the isolation of fungi from nail samples.

  16. [Diagnosis and Treatment of Diaphragmatic Dysfunction].

    Science.gov (United States)

    Windisch, W; Schönhofer, B; Magnet, F S; Stoelben, E; Kabitz, H-J

    2016-07-01

    There are many reasons for an impairment of the diaphragmatic function potentially affecting all components of the respiratory pump. Particularly, diagnosis and treatment of unilateral and bilateral phrenic nerve paralysis are challenging. Neuromuscular disorders, trauma, iatrogenic conditions, tumor compression, but also infectious and inflammatory conditions in addition to neuralgic amyotrophy and idiopathic phrenic nerve paralysis are reasons for phrenic nerve paralysis. Primarily, diagnostic procedures include the anamnesis, physical examination, blood gas analysis, lung function testing and the diagnosis of the underlying disease. In addition, specific respiratory muscle testing and respiratory imaging are available today. Current established treatment options include respiratory muscle training, long-term non-invasive ventilation and surgical diaphragm plication in selected patients. PMID:27411076

  17. Diagnosis and medical treatment of prolactinomas

    International Nuclear Information System (INIS)

    The first-line treatment of prolactinomas is medical therapy with dopamine receptor agonists. Bromocriptine (BC) has been used over the past 30 years, while cabergoline (CAB) is increasingly used in recent years because of its enhanced efficacy and better tolerability. Cabergoline is highly effective in normalizing elevated prolactin, recovering hypogonadism, and achieving a successful pregnancy in patients with tumoral and non-tumoral hyperprolactinemia. Also, CAB has a greater ability to shrink prolactinomas (PRLomas) than BC and often extinguishes them. Regarding the diagnosis, it requires demonstrating hyperprolactinemia on at least two separate occasions, excluding other causes of hyperprolactinemia than PRLomas, and detecting pituitary tumor on magnetic resonance imaging. Final diagnosis in non-operated cases is made empirically by attaining unequivocal tumor shrinkage or disappearance with CAB treatment. (author)

  18. 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.

  19. Deep vein thrombosis: diagnosis, treatment, and prevention

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, W.P.; Youngswick, F.D.

    Deep vein thrombosis (DVT) is a dangerous complication that may present after elective foot surgery. Because of the frequency with which DVT occurs in the elderly patient, as well as in the podiatric surgical population, the podiatrist should be acquainted with this entity. A review of the diagnosis, treatment, prevention, and the role of podiatry in the management of DVT is discussed in this paper.

  20. Scaphoid fractures: anatomy, diagnosis and treatment

    OpenAIRE

    Buijze, G.A.

    2012-01-01

    This thesis deals with current issues in anatomy, diagnosis and treatment of scaphoid fractures. Anatomical inconsistencies are elucidated by accurate 3D imaging. Sophisticated diagnostic imaging cannot solve the problem of the suspected scaphoid fracture because there is no gold standard for a true fracture, and there likely never will be. Acknowledging that we can only deal in probabilities, the development of clinical prediction rules will help to better define and narrow those probabiliti...

  1. 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.

  2. Scintigraphic diagnosis and development of hepatic amoebiasis in children

    International Nuclear Information System (INIS)

    The authors studied 300 cases of children with diagnosed liver abscess caused by E. histolytica. A scintigraphic diagnosis was made in 99% of the cases. The study confirms the statement that liver scintigraphy is a supporting method of diagnosis which indicates the site, number and size of the liver abscesses. When following the sequence from start to finish of the resolution of the imaged defect it was observed that the time varies according to (a) the size of the abscess and (b) the number of abscesses. Initiation of regeneration was observed most often between the third and fourth week after treatment commenced. The greater the number of lesions and the larger their size, the more time was required to achieve regeneration. In the case of lesions less than 5 cm in size, complete resolution was achieved within the first six months of treatment. No direct relationship was observed between the nutritional level and the resolution time. In cases with complications the time for complete resolution was prolonged. This method is a highly sensitive one that can be very useful in monitoring clinical progress and evaluating the treatment applied. The benefit obtained by the patients studied was greater than the radiobiological risk. (author)

  3. 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.

  4. Diagnosis and treatment of radiation injuries

    International Nuclear Information System (INIS)

    This publication is the translation of IAEA Safety Reports Series No.2 ,Diagnosis and Treatment of Radiation Injuries. This report is directed at medical professionals who may be involved in the management of radiation injuries starting from the first few hours or days after an exposure of undefined severity. The principal aim of this publication is to provide guidelines to enable medical professionals to carry out prompt diagnostic measure and to offer emergency treatment. This report provides information in tabulated form on clinical criteria for dose assesment. Additionally, it discusses the appropriate dose-effect relationship in cases of external radiation involving either total body or local exposures, as well as internal contamination

  5. 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 

  6. 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.

  7. Experience in diagnosis and treatment of asparaginase-associated pancreatitis in children%门冬酰胺酶相关胰腺炎的诊治体会

    Institute of Scientific and Technical Information of China (English)

    陈再生; 李健

    2014-01-01

    Objective To analyze the clinical characteristics and the course of diagnosis and therapy of PEG-asparaginase associated pancreatitis (AAP)in childhood,and to reveal the pathophysiology of AAP,enhance the ability of diagnosis and treament.Method Data of 13 cases with AAP in childhood seen from March 2011 to March 2014 were analyzed with regard to clinical manifestations,laboratory findings,imaging feature and treatment.Result AAP was found in 12 of acute lymphoblastic leukemia (ALL) and 1 of non-Hodgkin's lymphoma (NHL),8 were boys and 5 were girls,with a mean age 6 years.In 12 cases AAP occurred during the induction-remission treatment,in 1 case during the maintenance-intensification phase.AAP occurred after a median of two doses,and 9 d (median) from the latest administration of PEG-asparaginase.The major manifestations of AAP was abdominal pain (11/13).At the time of AAP diagnosis during the first 48 hours the median peak serum amylase and serum lipase levels were 559 U/L (range 118 -1 585,upper normal limit:125) and 934 U/L (range 221-1 673,upper normal limit:300).Three cases with serum amylase and serum lipase levels above 3 times upper normal limit were repeatedly complicated with pancreatic pseudocyst; 11 patients had abnormal CT imaging,8 cases revealed effusion around the pancreas,and 4 cases had pseudocyst.Therapy with ulinastatin,octreotide acetate,glucocorticoid could relieve abdominal pain significantly.Three cases underwent abdominal puncture drainage and 5 cases fulfilled nasojejunal nutrition therapy.Nine of them were cured,4 developed pseudocyst,in 2 AAP vanished gradually and 2 died with pseudocyst.Conclusion The major manifestations of AAP were abdominal pain,but sometimes apparent and sometimes latent.Condition of acute pancreatitis may exacerbate rapidly and easily.Early identification had significance.Pancreatic pseudocyst suggested a poor prognosis.%目的 分析门冬酰胺酶相关胰腺炎(AAP)的临床特征和诊治经过.方法 收集

  8. Diagnosis and treatment of hysterical conversion reactions.

    OpenAIRE

    Leslie, S A

    1988-01-01

    Twenty children with hysterical conversion reactions were reviewed. The ways in which they became ill, the attitudes of their families to their illnesses and their underlying personal problems were noted. Treatment comprised avoiding unnecessary investigations and removing symptoms by using graded exercises given by physiotherapists. Exploration of the underlying psychological problems took place at a pace with which the family could cope because many families were reluctant at first to accep...

  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. Treatment of children with pulmonary hypertension. 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)

    Hansmann, Georg; Apitz, Christian

    2016-05-01

    Treatment of children and adults with pulmonary hypertension (PH) with or without cardiac dysfunction has improved in the last two decades. The so-called pulmonary arterial hypertension (PAH)-specific medications currently approved for therapy of adults with PAH target three major pathways (endothelin, nitric oxide, prostacyclin). Moreover, some PH centres may use off-label drugs for compassionate use. Pulmonary hypertensive vascular disease (PHVD) in children is complex, and selection of appropriate therapies remains difficult. In addition, paediatric PAH/PHVD therapy is vastly based on experience and trial data from adult rather than paediatric studies; however, the first randomised paediatric PAH trials have been conducted recently. We present consensus recommendations for the treatment of children with PH. Class of recommendation and level of evidence were assigned based on paediatric data only or on adult studies that included >10% children. After a systematic literature search and analysis of the published data, we developed treatment strategies and algorithms that can guide goal-oriented PH therapy. We discuss early combination therapy (double, triple) in patients with PAH in functional class II-IV and in those with inadequate response to the initial pharmacotherapy. In those children with progressive, severe PAH and inadequate response, advances in drug development, and interventional and surgical approaches provide promising new strategies to avoid, reverse or ameliorate right heart failure and left ventricular compression. In particular, first follow-up data indicate that Potts shunt (left pulmonary artery to descending aorta anastomosis) may be an alternative destination therapy, or bridge to bilateral lung transplantation, in end-stage paediatric PAH. PMID:27053700

  11. 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...... rapid urease test. Proton pump inhibitor therapy should be stopped at least 1 week prior to Hp testing. All infected patients should be offered Hp eradication therapy. First-line treatment is 7-day triple therapy with a proton pump inhibitor and clarithromycine in combination with metronidazole or...... amoxicilline. Quadruple therapy for 2 weeks with bismuthsubsalicylate, tetracycline, metronidazole and a proton pump inhibitor is recommended in case of treatment failure. Hp testing should be offered to all patients after eradication therapy but is mandatory in patients with ulcer disease, noninvasive gastric...

  12. 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.

  13. [Diagnosis and treatment of ocular hypertension].

    Science.gov (United States)

    Sun, Y Y; Chen, W W; Wang, N L

    2016-07-01

    Ocular hypertension is popular among people, with a prevalence of 3% to 10% in those older than 40 years old. Without proper intervention, over 10% of the patients with ocular hypertension would develop glaucoma in the following 5 to 10 years. Glaucoma has become one of the leading causes of blindness all over the world, which makes it essential for us to pay enough attention to the prevention and treatment of ocular hypertension. However, it is not cost-effective to treat all the patients with ocular hypertension. Certain side effects may also be caused with long-term medical treatment. Therefore, it is of great importance for ophthalmologists to identify the right time and use appropriate therapeutic methods. To introduce the knowledge of ocular hypertension, the definition, epidemiology, diagnosis, risk factors and treatment of ocular hypertension are reviewed in this article. (Chin J Ophthalmol, 2016, 52: 542-546). PMID:27531115

  14. 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

  15. Acute biliary pancreatitis: Diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Hazem Zakaria

    2009-01-01

    Full Text Available Gallstones are the commonest cause of acute pancreatitis (AP, a potentially life-threatening condition, worldwide. The pathogenesis of acute pancreatitis has not been fully understood. Laboratory and radiological investigations are critical for diagnosis as well prognosis prediction. Scoring systems based on radiological findings and serologic inflammatory markers have been proposed as better predictors of disease severity. Early endoscopic retrograde cholangiopancreatography (ERCP is beneficial in a group of patients with gallstone pancreatitis. Laparoscopic cholecystectomy with preoperative endoscopic common bile duct clearance is recommended as a treatment of choice for acute biliary pancreatitis. The timing of cholecystectomy, following ERCP, for biliary pancreatitis can vary markedly depending on the severity of pancreatitis

  16. Chronic candidiasis - pathogenesis, symptoms, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Klajn-Laslo Marija

    2009-01-01

    Full Text Available The yeast named Candida normally colonizes the gut and vagina without causing any sign of its presence. It is a commensal and opportune fungus but in certain conditions it turns to be pathogenic, causing chronic disturbances in any part of the body. The pathogenesis is complex, signs and symptoms are non-specific. The colonisation is difficult to distinguish from invasive disease. The current diagnostic methods do not always allow a definitive diagnosis to be made. Treatment is complex, individual and no protocol can be created. The author tries to give an overview of the Candida related problem.

  17. Mialgias: Approaches to differential diagnosis, treatment

    Directory of Open Access Journals (Sweden)

    Nadezhda Aleksandrovna Shostak

    2013-10-01

    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.

  18. 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.

  19. [Clinical diagnosis and treatment of allergic pharyngitis].

    Science.gov (United States)

    Liu, Jinfeng; Yan, Zhanfeng; Zhang, Mingxia

    2015-08-01

    Although the concept of united airway disease has been widely accepted, most scholars emphasize only the effect of rhino-sinusitis while ignoring the pharyngeal factors to the lower airway, especially to the allergic pharyngitis (AP), which still lacks enough awareness. First of all, absence of unified diagnostic standard leads to the lack of epidemiological data, which, results in doctors' personal experience but no guideline in treatments. In addition, it is still not clear that the role of AP in the allergic airway diseases and its relationship with asthma. However, the number of patients with AP has been increasing obviously in daily clinic practice. Combined with the previous observation, this paper does a systematic review about the clinical problems of AP, expecting to give a hand to the clinical diagnosis and treatment of AP. PMID:26685417

  20. Food allergy: from diagnosis to treatment.

    Science.gov (United States)

    Scarpellini, E; Tack, J

    2012-01-01

    Adverse food reactions, an adverse health effect arising from an immune or nonimmune response that occurs reproducibly on the exposure to a given food, can be divided into toxic and hypersensitivity reactions. When an immunologic mechanism has been shown, hypersensitivity food reactions should be referred to as food allergy that may be IgE- or non-IgE-mediated. Food allergy diagnosis is mainly guided by a correct and accurate history and physical examination, thus leading to prick test and elimination diets. The treatment gold standard is still represented by an elimination diet together with antihistamines and corticosteroid usage in order to reduce the gastrointestinal and potentially life-threatening systemic symptoms. Other treatments are currently under investigation with promising results. PMID:22722444

  1. Dentofacial Asymmetries: Challenging Diagnosis and Treatment Planning.

    Science.gov (United States)

    Agrawal, Manish; Agrawal, Jiwan Asha; Nanjannawar, Lalita; Fulari, Sangamesh; Kagi, Vishwal

    2015-07-01

    Dentofacial asymmetry is quite common and when sufficiently severe can require surgical orthodontic intervention. Asymmetries can be classified according to the structures involved into skeletal, dental and functional. In diagnosing asymmetries, a thorough clinical examination and radiographic survey are essential to determine the extent of soft tissue, skeletal, dental and functional involvement. Dental asymmetries, as well as a variety of functional deviations, can be managed orthodontically, whereas significant structural facial asymmetries require a comprehensive orthodontic and orthognathic management. With less severe dental, skeletal and soft tissue deviations the advisability of treatment should be carefully considered. The following article also contains a case report highlighting the importance of proper diagnosis in treatment plan for management of dentofacial asymmetry. PMID:26229387

  2. Diagnosis, phenomenology and treatment of poststroke depression

    Directory of Open Access Journals (Sweden)

    Starkstein Sergio E

    2002-01-01

    Full Text Available Diagnosing depression in stroke patients is a challenge in neuropsychiatry since depression symptoms may overlap neurological deficit signs. The best approach is to assess the presence of depressive symptoms using semi-structured or structured psychiatric interviews, such as the Present State Exam, the Structured Clinical Interview for DSM-IV or the Schedules for Clinical Assessment in Neuropsychiatry. The diagnosis of a depressive syndrome should be made according to standardized diagnostic criteria for mood disorders due to neurological disease such as in the DSM-IV or ICD-10. Depression rating scales such as the Hamilton Depression Scale and the Center for Epidemiologic Scales for Depression may be used to rate the depression severity and monitor the progression of antidepressant treatment. Most studies have reported the effectiveness of pharmacological treatment in patients with post-stroke depression, and there is preliminary evidence that the degree of impairment in activities of daily living (ADL may improve as well.

  3. Diagnosis and treatment of dentinal hypersensitivity.

    Science.gov (United States)

    Porto, Isabel C C M; Andrade, Ana K M; Montes, Marcos A J R

    2009-09-01

    This bibliographic review provides a general view of the etiology, characteristics and treatment of dentinal hypersensitivity, so that professionals can use this information in the therapeutic management of this clinical condition. For this purpose, the authors have analyzed whole texts of relevant articles on the subject. This study showed that the predisposing factors associated with the causes of dentinal hypersensitivity must be controlled or eliminated, by educating the patient regarding the excessive intake of acidic food, as well as providing guidance on the proper tooth brushing technique and analysis of occlusion. Effective treatment must be preceded by a proper diagnosis, established after the exclusion of any other possible causes of the pain. These cases must be managed efficiently, quickly and permanently. The availability of a wide variety of treatment could be an indicator that there is still no effective desensitizing agent to completely resolve the patient's discomfort, or that it is difficult to treat, irrespective of the available treatment options. Even with the large number of published studies, it has not been possible to reach a consensus about the product that represents the gold standard in the treatment of dentinal hypersensitivity. PMID:19776498

  4. Diagnosis and the treatment of primary amyloidosis

    Directory of Open Access Journals (Sweden)

    Đunić Irena

    2010-01-01

    Full Text Available Backgraund. Primary amyloidosis belongs to a group of monoclonal plasma cell disorders, characterized by extracellular deposition of immunoglobulin light chain fibrils in various tissues and subsequent multiorgan dysfunction. Case report. We present a 51-year-old female with 2-years history of fatigue on exertion, oedema of face, abdomen and legs, bone pain and obstipation. After diagnostic procedures such as electrophoresis and immunoelectrophoresis of serum and urine proteins, immunohistohemical staining of bone marrow biopsy specimens and Congo red staining of rectal biopsy specimens, the patient received misdiagnosis of multiple myeloma and was referred to our hospital for further treatment. We reevaluated and complemented diagnostic procedures (ehocardiosonography and biopsy of subcutaneaus tissue with Congo red staining, and established diagnosis of primary amyloidosis. The therapy had started with intravenous (iv melphalan and dexamethasone (totally eight cycles and continued with peroral melphalan and iv dexamethasone. Stabilization of the disease was achieved after 35 months of the treatment. Conclusion. The case of this rare and often fatal disease emphasizes significance of early diagnosis and, consequently, initiation of specific therapies which are indispensable to improve the disease prognosis.

  5. 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.

  6. Diagnosis, surgical treatment and follow-up of thyroid cancers

    International Nuclear Information System (INIS)

    This paper reports the activities and the results of the research carried out by the Centers participating to the JSP4 project, within the framework of the EU program on the consequences of the Chernobyl disaster. The project was aimed to develop and to control the application of basic principles for the diagnosis, treatment and follow-up of thyroid carcinoma, with special attention to the peculiar requirement of children and adolescents. To this purpose, training in Western European Centers was offered to a number of scientists from Belarus, Ukraine and Russia. Several official meetings were organized to share views and to discuss the progress of the project. A basic protocol for the diagnosis, treatment and follow-up of thyroid carcinoma has been developed and approved by all participating Centers. Hopefully, it will be applied to the new cases and to those already under monitoring. A large part of the protocol is dedicated to the post-surgical treatment with thyroid hormones for the suppression of TSH and with calcitriol for the management of surgical hypoparathyroidism. A detailed protocol to asses iodine deficiency and, eventually, to introduce a program of iodine supplementation has been proposed. The collection of control cases of childhood thyroid carcinoma in non-radiation exposed European countries has been initiated in Italy, France and Germany. This data will be used as control for the post-Chernobyl childhood thyroid carcinomas. Here is reported a preliminary comparison of the clinical and epidemiological features of almost all (n=368) radiation-exposed Belarus children who developed thyroid carcinoma (age at diagnosis < 16 years), with respect to 90 children of the same age group, who, in the past 20 years, have received treatment for thyroid carcinoma in two centers in Italy (Pisa and Rome). Finally, by molecular biology, genetic mutations of the RET proto-oncogene have been found in several samples of thyroid carcinomas provided by the Belarus

  7. Modular playware as a playful diagnosis tool for autistic children

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop

    2009-01-01

    children. Using artificial neural networks for automatic classification of the individual construction practices, we may compare this classification with the diagnosis of the children, and possible obtain a supplementary diagnosis tool which is based on the autistic children's free play with the modular...... robotic tiles. Preliminary experiments with 7 autistic children show that the automatic neural network classification with post-processing can be done with a 100% accuracy for this small sample set, and thereby give some preliminary indications of the potential of the approach.......Based upon user-configurable modular robotics and design principles for modular playware, we developed modular robotic tiles to be used as playful, interactive tools for children with autism. The modular playware can make automatic documentation of the construction play activities by the autistic...

  8. Alzheimer's disease: early diagnosis and treatment.

    Science.gov (United States)

    Chu, L W

    2012-06-01

    With ageing of populations, the worldwide population of persons with dementia will reach over 81 million by 2040, of which the most common cause is Alzheimer's disease. In recent years, there have been major advances in the understanding of its pathogenesis, methods to diagnose it, and treatment. Magnetic resonance brain imaging, cerebrospinal fluid biomarkers, and Pittsburgh compound B and fluorodeoxyglucose positron emission tomography of the brain can facilitate an accurate diagnosis of Alzheimer's disease in its early stage, and diagnose the mild cognitive impairment stage of Alzheimer's disease. At present, only symptomatic but not disease-modifying drug treatments are available. Donepezil, rivastigmine and galantamine are the currently approved cholinesterase inhibitors for the treatment of mild, moderate, and severe Alzheimer's disease. Overall, cholinesterase inhibitors show beneficial effects on cognition, activity of daily living, behaviour, and overall clinical rating. Memantine is another symptomatic treatment for moderate-to-severe Alzheimer's disease patients. It has a small beneficial effect on cognition, activity of daily living, behaviour, and overall clinical rating. Vitamin E has antioxidant properties, and may be used in some Alzheimer's disease patients without vascular risk factors. Concurrent non-pharmacological and psychosocial management of patients and their caregivers have a very important role. Disease-modifying therapies are still under development, whilst immunotherapy may be a viable option in the near future. PMID:22665688

  9. Diagnosis and treatment of Helicobacter pylori infection.

    Science.gov (United States)

    Bytzer, Peter; Dahlerup, Jens Frederik; Eriksen, Jens Ravn; Jarbøl, Dorte Ejg; Rosenstock, Steffen; Wildt, Signe

    2011-04-01

    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 degree relatives to patients with gastric cancer, in NSAID-naive patients, who need long-term NSAID therapy, and in patients presenting with dyspepsia and no alarm symptoms. Non-endoscoped patients can be tested with a urea-breath test or a faecal antigen test. Endoscoped patients can be tested with a rapid urease test. Proton pump inhibitor therapy should be stopped at least 1 week prior to Hp testing. All infected patients should be offered Hp eradication therapy. First-line treatment is 7-day triple therapy with a proton pump inhibitor and clarithromycine in combination with metronidazole or amoxicilline. Quadruple therapy for 2 weeks with bismuthsubsalicylate, tetracycline, metronidazole and a proton pump inhibitor is recommended in case of treatment failure. Hp testing should be offered to all patients after eradication therapy but is mandatory in patients with ulcer disease, noninvasive gastric cancer or MALT lymphoma. Testing after eradication should not be done before 4 weeks after treatment has ended. PMID:21466771

  10. 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.

  11. 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 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. PMID:26479995

  12. 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

    OpenAIRE

    Vandenplas, Yvan; Ashkenazi, A.; Belli, D; Boige, N.; Bouquet, Jan; Cadranel, S; Cezard, J; Cucchiara, S; Dupont, C.; Geboes, K; Gottrand, F; Heymans, Hugo; Jasinski, C.; Kneepkens, Frank; Koletzko, Sybille

    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-oesophageal reflux can be safely treated before performing (expensive and often unnecessary) complementary investigations. However, the latter are mandatory if symptoms persist despite appropriate treatm...

  13. Diagnosis and treatment of vitamin D deficiency.

    Science.gov (United States)

    Cannell, J J; Hollis, B W; Zasloff, M; Heaney, R P

    2008-01-01

    The recent discovery--in a randomised, controlled trial--that daily ingestion of 1100 IU of colecalciferol (vitamin D) over a 4-year period dramatically reduced the incidence of non-skin cancers makes it difficult to overstate the potential medical, social and economic implications of treating vitamin D deficiency. Not only are such deficiencies common, probably the rule, vitamin D deficiency stands implicated in a host of diseases other than cancer. The metabolic product of vitamin D is a potent, pleiotropic, repair and maintenance, secosteroid hormone that targets > 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. A common misconception is that government agencies designed present intake recommendations to prevent or treat vitamin D deficiency. They did not. Instead, they are guidelines to prevent particular metabolic bone diseases. Official recommendations were never designed and are not effective in preventing or treating vitamin D deficiency and in no way limit the freedom of the physician--or responsibility--to do so. At this time, assessing serum 25-hydroxy-vitamin D is the only way to make the diagnosis and to assure that treatment is adequate and safe. The authors believe that treatment should be sufficient to maintain levels found in humans living naturally in a sun-rich environment, that is, > 40 ng/ml, year around. Three treatment modalities exist: sunlight, artificial ultraviolet B radiation or supplementation. All treatment modalities have their potential risks and benefits. Benefits of all treatment modalities outweigh potential risks and greatly outweigh the risk of no treatment. As a prolonged 'vitamin D winter', centred on the winter solstice, occurs at many temperate latitudes, < or = 5000 IU (125 microg) of vitamin D/day may be required in obese, aged and/or dark-skinned patients to maintain adequate levels during the winter, a dose that makes many physicians uncomfortable. PMID

  14. 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

  15. Priapism in children: treatment with embolotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Hurh, Peter; Baskin, Kevin; Cahill, Anne M.; Kaye, Robin [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Carr, Michael; Canning, Douglas; Snyder, Howard [Children' s Hospital of Philadelphia, Department of Urology, Philadelphia, PA (United States); Towbin, Richard

    2007-05-15

    Priapism is defined as involuntary, prolonged penile erection caused by factors other than sexual arousal, and is classified as either low-flow or high-flow. Embolotherapy is an accepted form of therapy in adults with high-flow priapism. Because the differences in etiology, management and outcome are significant, accurate and timely diagnosis is imperative. The purpose of this report is to present our experience with embolotherapy for treatment of high-flow priapism in three children. This was a retrospective study. During an 18-month period, three boys ranging in age from 6 to 15 years presented with priapism. All three children were treated with embolotherapy. All three children were successfully treated with angiography and embolotherapy. One boy had a presentation that initially raised the possibility of low-flow priapism. No complications occurred, and to date all children are able to maintain normal erections. Subselective transcatheter embolization is the procedure of choice for high-flow priapism. In cases where priapism persists despite adequate therapy, angiography might be useful to exclude high-flow disease. In children with high-flow priapism, selective occlusion of the penile arteriovenous fistula led to detumescence and normal erectile function. (orig.)

  16. 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.

  17. [Surgical treatment of myasthenia gravis in children].

    Science.gov (United States)

    Iudin, Ia B; Kogan, O G; Prokopenko, Iu D; Klepikov, I I; Vusik, G V; Fedorov, K K; Ivanov, V V; Diupin, V A; Merzeniuk, O S

    1989-11-01

    The article deals with the treatment of myasthenia in 33 children whose ages ranged from 3 to 15 years. Myasthenia of moderate severity was diagnosed in 14, severe in 15, and extremely severe in 2 children. To make a precise diagnosis, loading, neostigmine methylsulfate, cold, and D-tubocurarine tests were conducted. Thymectomy was performed in 32 patients. The operation was carried out through a T-shaped sternotomy approach. Thymogenic myasthenia was verified in 31 patients and thymomogenic only in one patient. There were no fatal outcomes. The late-term results were studied in 12 patients in follow-up periods of 3 to 6 years. Adaptational activity of the patients, anticholinesterase agents and the results of stimulant electric myography served as the criterion in appraising the late-term results. Modern diagnostic methods and surgical intervention ensure a favourable result in 75% of patients. PMID:2615272

  18. Diagnosis, treatment and management of epidermolysis bullosa.

    Science.gov (United States)

    Watkins, Jean

    Epidermis bullosa is a genetically inherited disease in which painful blistering of the skin or mucous membranes occurs after minor trauma. It is a lifelong problem. The diagnosis should be confirmed by a specialist, preferably at a specialist unit where a treatment plan and follow-up arrangements for professionals and families can be put in place. Nurses will be involved in frequent dressings of wounds, after extra analgesia, and may need to be alert to any need for further specialist referral, especially in the case of complications such as infection, deformities, gastrointestinal strictures and possible skin cancers. Genetic counselling should also be offered to families, especially when considering the possible risks to future pregnancies. PMID:27126750

  19. PRIMIPARA POST PARTUM DEPRESSION DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Esha Pradnyana

    2013-02-01

    Full Text Available Pregnancy and the first child birth is an influential complex event for a mother, which is where everything including phsycal and psyological aspects. This change can make mother psyological disorder, that can lead into depression after childbearing that call post childbearing depression or post partum depression. A wide review at 59 study make a result that 13% among primipara can suffer post partum depression 12 weeks after childbearing. Estabilishmet of this diagnosis, besides from history and symptoms, and can be supported through test Edinburgh Postnatal Depression Scale( EPDS . Patient with post partum depression, given treatment with antidepressant drug. Breastfeeding is not only to reduce stress for the mother, but also reduce the level of stress on a baby when his mother suffered depression

  20. [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. PMID:26821457

  1. 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. PMID:25751444

  2. Urolithiasis: Advances in diagnosis and treatment

    International Nuclear Information System (INIS)

    This course addresses radiologic aspects of diagnosis and treatment of renal calculi. The combined clinical experience from two institutions (UCLA and Mayo Clinic) of over 3,000 extracorporeal shock wave lithotripsy (ESWL) treatments is presented, as is the new developmental designs and socioeconomic impact. ESWL has radically altered the management of renal and ureteral calculi. An underwater shock wave is concentrated on a calculus, which shatters after being subjected to a number of shocks. Small fragments are usually passed spontaneously, making the patient stone free and eliminating the need for surgery. Radiology plays an important role in this patient population. The presence of radiopaque and radiolucent calculi - their size, number, and location; the anatomic appearance of the kidneys, pelvocalyceal system, and ureter; anatomic variants; and pathologic conditions such as horseshoe kidneys, ureteropelvic junction narrowing, polycystic kidney disease, calyceal diverticuli, infundibular stenosis, ureteral obstruction, and medullary sponge kidney are best imaged with excretory urography and occasionally retrograde pyelography and US. Follow-up examinations usually consist of abdominal radiography and US if obstruction is suspected. The percutaneous approach still plays a major albeit obviously diminished role in treatment and may be used for a number of specific indications, which is discussed

  3. 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

  4. 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.

  5. The bronchovalvular mechanism - differential diagnosis in children

    International Nuclear Information System (INIS)

    A differential diagnosis of the bronchovalvular mechanism can usually be made by means of plain radiography of the chest in the inhalation and the exhalation phase. If respiratory distress is due to causes other than foreign body aspiration, there may arise the necessity to apply bronchoradiography or angiography, or to examine the oesophagus. (orig.)

  6. Diagnosis and treatment of hereditary angioedema.

    Science.gov (United States)

    Canonica, G W; Rossi, O

    2012-09-01

    Hereditary angioedema (HAE) is a rare autosomal dominant disorder affecting approximately 1 in 50000 persons. It causes frequent attacks of non-pitting, non-pruritic edema without urticaria, usually of the skin of the extremities, gastrointestinal tract, and upper airways. Gastrointestinal attacks may cause severe pain, and attacks in the laryngeal region may lead to asphyxiation and death. HAE usually begins in childhood or adolescence and persists throughout life. The majority of HAE cases are caused by mutations that result in low levels of functional C1-inhibitor (C1-INH), a serine protease inhibitor that plays regulatory roles in the contact, complement, and fibrinolytic systems. Low C1-INH function results in overproduction of bradykinin, the primary cause of HAE symptoms. Type I HAE is characterized by low levels of functional C1-INH, whereas type II HAE is characterized by normal levels of dysfunctional C1-INH. A third type of HAE has a similar presentation, but is not due to C1-INH deficiency or impairment. Some patients with type III HAE carry mutations in the coagulation factor XII gene that do not alter factor XII plasma levels but markedly increase its activity. HAE is often undiagnosed or misdiagnosed, sometimes leading to inappropriate treatment that may include surgery. HAE should be suspected in any patient who presents with repeated attacks of cutaneous edema without urticaria or recurrent unexplained abdominal pain. Diagnosis requires laboratory testing of complement levels. HAE requires disease-specific treatment with agents that increase functional C1-INH levels and/or reduce the production or activity of bradykinin. These treatments include C1-INH concentrates, icatibant, ecallantide, and attenuated androgens. HAE severely reduces patients' quality of life, which makes supportive care an essential part of the treatment program. PMID:22801442

  7. [Caseous pneumonia: diagnosis, clinical aspects and treatment].

    Science.gov (United States)

    Mishin, V Iu

    2001-01-01

    Fifty-two patients with caseous pneumonia (CP) (whose age ranged from 18 to 60 years) admitted to a specialized tuberculosis facility of the general health care system were followed up. On admission, all the patients had marked intoxication and bronchopulmonary manifestations of the disease. X-study revealed lesions to one lobe in 19.2%, to 2 lobes in 32.7%, to 3 lobes or more in 48.1% of the patients. At the same time, all the patients had destructive changes with large and giants caverns in 57.7% of cases. The sputa of all 52 patients exhibited Mycobacteria tuberculosis (MBT), whose primary drug resistance being established. The nonspecific microflora composed of gram-positive cocci, gram-negative bacilli, fungi of the genus Candida in over 60% of patients was found in the sputa in two thirds of cases. A retrospective analysis indicated that CP had been correctly diagnosed only in 11.5% of patients within the first fortnight, in 65.4% by the end of the first month and by the beginning of the second, and in 23.1% following 2 months. The main reason for untimely diagnosis of CP was no sputum test for MBT. An algorithm of early CP diagnosis at general hospitals was developed, which includes a compulsory test of 3 sputum smears by the Ziehl-Nielsen method in all patients with pneumonia on admission and 2 weeks after treatment with wide-spectrum antibiotics. Chemotherapy in CP patients was long-term and combined 4-5 essential drugs within the first 4 months with obligatory correction after there was evidence for drug resistance. A course of nonspecific antibiotic therapy and a developed complex of symptomatic and pathogenetic treatments were compulsory. By the cessation of bacterial isolation, the efficiency of combined treatment was 82.7%, but a question as to a surgical intervention that is a compulsory component of CP therapy always arose at the final stage. PMID:11508227

  8. Food Allergy: Common Causes, Diagnosis, and Treatment.

    Science.gov (United States)

    Patel, Bhavisha Y; Volcheck, Gerald W

    2015-10-01

    Food allergy is a growing concern, and recognition of symptoms, knowledge of common food allergens, and management of reactions are important for patients and practitioners. Symptoms of a classic IgE-mediated food allergy vary in severity and can include any combination of laryngeal edema, wheezing, nausea, vomiting, diarrhea, urticaria, angioedema, and hypotension. Many foods can induce an allergic reaction, but the most commonly implicated foods include cow's milk, egg, peanut, tree nut, soy, wheat, fish, and shellfish. Milk and egg allergy generally develop and are outgrown in childhood. Peanut and tree nut allergy can occur during childhood or adulthood, are less likely to be outgrown, and tend to cause more fatal reactions. Given the possibility of life-threatening reactions, it is important to recognize the potential for cross-reactivity among food groups. Diagnosis of food allergy includes skin prick testing, specific serum IgE testing, and oral food challenges. Management is centered on avoidance of allergenic and cross-reacting foods and early recognition and immediate treatment of reactions. Treatment protocols to desensitize patients to food are currently under investigation. PMID:26434966

  9. [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, PMID:23815019

  10. [Alpha-1 antitrypsin deficiency: diagnosis and treatment].

    Science.gov (United States)

    Camelier, Aquiles A; Winter, Daniel Hugo; Jardim, José Roberto; Barboza, Carlos Eduardo Galvão; Cukier, Alberto; Miravitlles, Marc

    2008-07-01

    Alpha-1 antitrypsin deficiency is a recently identified genetic disease that occurs almost as frequently as cystic fibrosis. It is caused by various mutations in the SERPINA1 gene, and has numerous clinical implications. Alpha-1 antitrypsin is mainly produced in the liver and acts as an antiprotease. Its principal function is to inactivate neutrophil elastase, preventing tissue damage. The mutation most commonly associated with the clinical disease is the Z allele, which causes polymerization and accumulation within hepatocytes. The accumulation of and the consequent reduction in the serum levels of alpha-1 antitrypsin cause, respectively, liver and lung disease, the latter occurring mainly as early emphysema, predominantly in the lung bases. Diagnosis involves detection of low serum levels of alpha-1 antitrypsin as well as phenotypic confirmation. In addition to the standard treatment of chronic obstructive pulmonary disease, specific therapy consisting of infusion of purified alpha-1 antitrypsin is currently available. The clinical efficacy of this therapy, which appears to be safe, has yet to be definitively established, and its cost-effectiveness is also a controversial issue that is rarely addressed. Despite its importance, in Brazil, there are no epidemiological data on the prevalence of the disease or the frequency of occurrence of deficiency alleles. Underdiagnosis has also been a significant limitation to the study of the disease as well as to appropriate treatment of patients. It is hoped that the creation of the Alpha One International Registry will resolve these and other important issues. PMID:18695797

  11. The Diagnosis and Treatment of Patellar Fracture in Children%儿童髌骨骨折的诊断与处理

    Institute of Scientific and Technical Information of China (English)

    许刚; 张广明; 高立华; 吕学升

    1995-01-01

    The children with patellar fracture were treated.Among them 4 with transverse fracture were treated by internal fixation with tension-bad wire,5 with sleeve shape fracture were repaired by suturing and 1 smashed fracture was reduced manually and fixed in plaster cast.All the 10 cases were followed up 3 to 12 months,9 of them showed that the extensionflexsion of the injuried knees ranged between 0°(=)90°-100°,the other smashed fracture between 0°(=)90°.The sleeve shape fracture is liable to be misdiagnosed and should be differentiated from the ligament tearing.The operation for patellar fracture,same as in children and in adult,depends on the extensivehess and opening of the fracture.If the fracture is intraarticular,it should be reduced anatomically by operation as earlier as posible in order to avoid the function lost of the knee joint.%10例儿童髌骨骨折,其中4例横行骨折行张力带钢丝内固定,5例袖形骨折行缝合修复,1例粉碎性骨折行手法复位管形石膏外固定.随访3个月~1年,9例患儿的患膝伸0°(=)屈90~100°,1例粉碎性患膝达伸0°(=)屈90°范围.儿童髌骨骨折中袖形骨折容易误诊,临床上需同髌韧带撕裂伤进行鉴别.手术指征取决于骨折呈开放或闭合性以及骨折程度.髌骨骨折属关节内骨折,治疗需达到解剖复位,应力求及时、准确的于术治疗,以避免膝关节功能障碍的发生.

  12. Late-stage diagnosis of HIV infection in Brazilian children: evidence from two national cohort studies

    Directory of Open Access Journals (Sweden)

    Alberto Novaes Ramos Jr.

    2013-07-01

    Full Text Available This study analyzed data from two consecutive retrospective cohort samples (1983 to 1998 and 1999 to 2002 of Brazilian children with AIDS (N = 1,758 through mother-to-child-transmission. Late-stage diagnosis (CDC category C was investigated in relation to the following variables: year of birth, year of HIV diagnosis, and time periods related to changes in government treatment guidelines. Late-stage diagnosis occurred in 731 (41.6% of cases and was more prevalent in infants under 12 months of age. The rate of late-stage diagnosis decreased from 48% to 36% between the two periods studied. We also observed a reduction in the proportion of late-stage diagnoses and the time lapse between HIV diagnosis and ART initiation. A significant association was found between timely diagnosis and having been born in recent years (OR = 0.62; p = 0.009 and year of HIV diagnosis (OR = 0.72; p = 0.002/OR = 0.62; p < 0.001. Infants under the age of 12 months were more likely to be diagnosed at a late stage than older children (OR = 1.70; p = 0.004. Despite advances, there is a need to improve the effectiveness of policies and programs focused on improving early diagnosis and management of HIV/AIDS.

  13. 儿童胃食管反流病诊断治疗研究进展%Progress in diagnosis and treatment of gastroesophageal reflux disease in children

    Institute of Scientific and Technical Information of China (English)

    傅宏娜

    2011-01-01

    Gastroesophageal reflux disease(GERD) is a common upper gastrointestinal tract dysfunctional disease in paediatrics, which has specifical clinical manifestations due to reflux. GERD can be diagnosed by clinical symptoms associated with related examinations. The treatment of GERD involves general treatment,medication, surgery. Proton pump inhibitor is the most frequently used drug.%胃食管反流病是由反流引起的具有临床表现的综合征,是儿科常见的上消化道动力障碍性疾病。该病的诊断主要依靠临床症状和相关检查联合判断,治疗分为一般治疗、药物治疗、手术治疗和其他治疗,其中抑酸剂中质子泵抑制剂最为常用。

  14. 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. PMID:27419327

  15. 新诊断标准下儿童弱视的远期疗效分析%Long term efficacy of comprehensive treatment for children with amblyopia in new standard of diagnosis

    Institute of Scientific and Technical Information of China (English)

    杨帆; 郑煜; 林世斌; 公为芬

    2015-01-01

    Objective In new standard of diagnosis, to investigate the long term efficacy of comprehensive treatment for amblyopia in children and the effect factors.Methods According to the expert consensus of amlbyopia diagnosis in 2011, totally 72 cases (116 eyes) were classified by the type of amblyopia, degree of amblyopia, and age, treated with correction of refractive error,occlusion therapy, family fine eyesight training and red light therapy, comprehensive therapeutic apparatus, and followed up 5 years.Results Follow up 5 year,the total effective rate is 90.5% , the total cure rate is 72.4%.Ametropic amblyopia ( 97.8%) was significantly higher than the anisometropic(57.1%), strabismic amblyopia(54.3%) in the cure rate.Mild amblyopia(98%) was significantly higher than the moderate(68.9%) and severe amblyopia(15%) in the cure rate.The younger treatment of amblyopia, the better efficacy.The 4 to 7-year-old group ( 88.2 %) was significantly higher than 8 to 14-year-old group(42.5 %) .Conclusions Amblyopia treatment efficacy is closely related to type of amblyopia, degree of amblyopia, age of starting treatment, the duration of treatment, and it may be influenced by the standard of the diagnosis.%目的:分析新的诊断标准下,综合疗法治疗弱视的远期疗效及相关因素的影响。方法以2011年弱视诊断专家共识,作为研究的入选标准,对72例(116眼)弱视儿童按年龄,弱视类型及程度分类,进行综合疗法治疗,随访5年,对比分析其疗效及其相关因素。结果在72例(116眼)弱视儿童中,5年综合治疗后,总有效率为90.5%,总痊愈率为72.4%。其中屈光不正性弱视的基本痊愈率为97.8%,与屈光参差性弱视(57.1%)和斜视性弱视(54.3%)组间差异有显著性(P<0.05)。轻度弱视的基本痊愈率为98%,与中度弱视(68.9%)和重度弱视(15%)相比,组间差异有显著性(P<0.05)。4~7

  16. 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 ...

  17. Abfraction lesions: etiology, diagnosis, and treatment options

    Science.gov (United States)

    Nascimento, Marcelle M; Dilbone, Deborah A; Pereira, Patricia NR; Duarte, Wagner R; Geraldeli, Saulo; Delgado, Alex J

    2016-01-01

    Abfraction is a type of noncarious cervical lesion (NCCL) characterized by loss of tooth tissues with different clinical appearances. Evidence supports that abfraction lesions, as any NCCLs, have a multifactorial etiology. Particularly, the cervical wear of abfraction can occur as a result of normal and abnormal tooth function and may also be accompanied by pathological wear, such as abrasion and erosion. The interaction between chemical, biological, and behavioral factors is critical and helps to explain why some individuals exhibit more than one type of cervical wear mechanism than others. In an era of personalized dentistry, patient risk factors for NCCLs must be identified and addressed before any treatment is performed. Marked variations exist in dental practice concerning the diagnosis and management of these lesions. The lack of understanding about the prognosis of these lesions with or without intervention may be a major contributor to variations in dentists’ management decisions. This review focuses on the current knowledge and available treatment strategies for abfraction lesions. By recognizing that progressive changes in the cervical area of the tooth are part of a physiologically dynamic process that occurs with aging, premature and unnecessary intervention can be avoided. In cases of asymptomatic teeth, where tooth vitality and function are not compromised, abfraction lesions should be monitored for at least 6 months before any invasive procedure is planned. In cases of abfraction associated with gingival recession, a combined restorative-surgical approach may be performed. Restorative intervention and occlusal adjustment are not indicated as treatment options to prevent further tooth loss or progression of abfraction. The clinical decision to restore abfraction lesions may be based on the need to replace form and function or to relieve hypersensitivity of severely compromised teeth or for esthetic reasons. PMID:27217799

  18. Update on the Diagnosis and Treatment of Idiopathic Intracranial Hypertension.

    Science.gov (United States)

    Bidot, Samuel; Bruce, Beau B

    2015-10-01

    Idiopathic intracranial hypertension (IIH) is a rare disorder occurring more frequently in obese women of childbearing age, resulting in increased intracranial pressure (ICP) from an unknown cause. Recent advances in epidemiology, imaging, and treatment have provided a better understanding of IIH in recent years, with better identification of visual risk factors and atypical forms of IIH, including fulminant IIH and spontaneous cerebrospinal fluid leaks, and a randomized clinical trial providing the rationale for the use of acetazolamide. In addition, a revised version of the modified Dandy criteria for the diagnosis of IIH was suggested in 2013, with better definition of IIH in adults and children; however, controversy regarding nomenclature has precluded its acceptance among IIH experts. Finally, questions regarding the best surgical strategy, the indications for venous sinus stenting, and the diagnostic role of the radiologic findings commonly seen in IIH have remained unanswered. PMID:26444398

  19. 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.

  20. 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.

  1. Diagnosis and Evaluation of Children Who Are Not Talking.

    Science.gov (United States)

    Downey, Debora; Mraz, Royann; Knott, James; Knutson, Claudia; Holte, Lenore; Van Dyke, Don

    2002-01-01

    This article outlines key components of a medical evaluation of a child who is not talking. Factors to consider during diagnosis and screening are discussed, including the presence of mental retardation, hearing impairments, autism, cerebral palsy, and other disorders. The physiology of speech/language disorders in children is also examined.…

  2. Laboratory Diagnosis of Mycobacterium tuberculosis Infection and Disease in Children.

    Science.gov (United States)

    Dunn, James J; Starke, Jeffrey R; Revell, Paula A

    2016-06-01

    Diagnosis of tuberculosis in children is challenging; even with advanced technologies, the diagnosis is often difficult to confirm microbiologically in part due to the paucibacillary nature of the disease. Clinical diagnosis lacks standardization, and traditional and molecular microbiologic methods lack sensitivity, particularly in children. Immunodiagnostic tests may improve sensitivity, but these tests cannot distinguish tuberculosis disease from latent infection and some lack specificity. While molecular tools like Xpert MTB/RIF have advanced our ability to detect Mycobacterium tuberculosis and to determine antimicrobial resistance, decades old technologies remain the standard in most locales. Today, the battle against this ancient disease still poses one of the primary diagnostic challenges in pediatric laboratory medicine. PMID:26984977

  3. Estado atual do diagnóstico e tratamento da apendicite aguda na criança: avaliação de 300 casos Present status for diagnosis and treatment of acute appendicitis in children: evaluation of 300 cases

    Directory of Open Access Journals (Sweden)

    Pedro Félix Vital Jr

    2005-12-01

    advances in diagnostic methods acute appendicitis still represents a problem in children, resulting in late diagnosis and treatment, and case of greater severity. Our objective is to assess the current state of diagnosis and treatment of acute appendicitis in children treated in two important referral hospitals of São Paulo (Brazil, over a 30 month's period. METHODS: The variables studied were: age, sex, clinical manifestations, time for the diagnosis to be established, the findings from physical examination and laboratory tests, surgical findings and antibiotic protocols, postoperative complications and hospital lenght of stay. RESULTS: In the present sample, of 300 children, 65% were boys and 35% girls, with an initial diagnosis of appendicitis being made in 63% of the cases. The signs and symptoms most frequently encountered were: abdominal pain in the right iliac fossa (85.3% and peritoneal irritation in this region (82%. We identified leukocytosis in 83% of the patients and the urine analysis showed leukocyturia in 39.7% of the patients. Around 92.4% of the simple radiological studies of the abdomen produced images that were not specific to acute appendicitis. Ultrasonography studies diagnosed the disease in 80.1% of the cases. Various antibiotic schemes were used, although there was special attention towards Gram-negative and anaerobic bacteria. The main complication was infection of the surgical wound, and there was no mortality. The average hospital length of stay was 5 days. CONCLUSION: In spite of greater knowledge of acute appendicitis and greater refinement of laboratory and radiological techniques, the diagnosis is still delayed and disease constitutes a cause of great morbidity among pediatric age groups.

  4. 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.

  5. Diagnosis and treatment of pancreatic endocrine tumors

    International Nuclear Information System (INIS)

    The incidence of pancreatic endocrine tumor (PET) accounts for 1-2% of total pancreatic tumors and 0.4-1.5% of autopsy cases, reflecting the recently increasing trend. According to World Health Organization (WHO) criteria (2004), PET is classified by the type of hormone produced by the tumor and its biological behavior. Together with the classical clinical images and hormone markers, 11C-5-HTP-Positron emission tomography, OctreoScan ([111In-DTPA0] octreotide) scintigram, selective arterial calcium injection (SACI)-test and intraoperative ultrasonography (IOUS) are used for diagnosis. Surgery is the treatment of choice, if supposed to be curative and tolerable. In case of a well-differentiated endocrine tumor, with no indication of resection or interventional radiology (IVR), somatostatin analog is another therapy showing stable disease status for a long period. Systemic chemotherapy, including 5-fluorouracil (FU)+streptozotocin, and streptozotocin+doxorubicin, are used in cases of well-differentiated endocrine carcinoma, and cisplatin+etoposide are applied for poorly-differentiated endocrine carcinoma (or small cell carcinoma). Recent studies focus on molecular target therapy including small molecules and monoclonal antibody, such as tyrosine kinase inhibitor, anti-vascular endothelial growth factor (VEGF) antibody and mammalian target of rapamycin (mTOR) inhibitor. (author)

  6. Diagnosis and treatment of cardiac sarcoidosis.

    Science.gov (United States)

    Kusano, Kengo F; Satomi, Kazuhiro

    2016-02-01

    Sarcoidosis is a systemic granulomatous disease of unknown aetiology. The frequency of cardiac involvement (cardiac sarcoidosis (CS)) varies in the different geographical regions, but it has been reported that it is an absolutely important prognostic factor in this disease. Complete atrioventricular block is the most common, and ventricular tachycardia/ventricular fibrillation the second most common arrhythmia in this disease, both of which are associated with cardiac sudden death. Diagnosing CS is sometimes difficult because of the non-specific ECG and echocardiographic findings, and CS is sometimes misdiagnosed as dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy or an idiopathic ventricular aneurysm, and therefore, endomyocardial biopsy is important, but has a low sensitivity. Another problem is the recognition of isolated types of CS. Recently, MRI and (18)F-fluorodeoxyglucose positron emission tomography have been demonstrated to be useful tools for the non-invasive diagnosis of CS as well as therapeutic evaluation tools, but are still unsatisfactory. Treatment of CS is usually done by corticosteroid therapy to control inflammation, prevent fibrosis and protect from any deterioration of the cardiac function, but the long-term outcome is still in debate. Despite the advancement of non-pharmacological approaches for CS (pacing, defibrillators and catheter ablation) to improve the prognosis, there are still many issues remaining to resolve diagnosing and managing CS. Here, we attempt a review of the clinical evidence, with special focus on the current understanding of this disease and showing the current strategies and remaining problems of diagnosing and managing CS. PMID:26643814

  7. Diagnosis and Treatment of Dyssynergic Defecation.

    Science.gov (United States)

    Rao, Satish S C; Patcharatrakul, Tanisa

    2016-07-30

    Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools. A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis. Newer techniques such as high-resolution manometry and magnetic resonance defecography can provide mechanistic insights. Recently, randomized controlled trials have shown that biofeedback therapy is more effective than laxatives and other modalities, both in the short term and long term, without side effects. Also, symptom improvements correlated with changes in underlying pathophysiology. Biofeedback therapy has been recommended as the first-line of treatment for dyssynergic defecation. Here, we provide an overview of the burden of illness and pathophysiology of dyssynergic defecation, and how to diagnose and treat this condition with biofeedback therapy. PMID:27270989

  8. Soft tissue sarcoma - diagnosis and treatment

    International Nuclear Information System (INIS)

    Significant progress in the treatment of soft tissue sarcoma (STS), both primary tumor and local recurrences/metastatic disease, has been achieved in recent years. Surgery is essential modality, but the use of combined treatment (standard combination of surgery with adjuvant radiotherapy, chemotherapy in selected cases and perioperative rehabilitation) in highly-experienced centers increased possibility of cure and limitations of extent of local surgery. Current combined therapy together with the use of reconstructive methods allows for limb-sparing surgery in majority of soft tissue sarcoma patients (amputation in 10% of cases as compared to approximately 50% in the 1960 - 70s). The slow, but constant, increase of rate of soft tissue sarcoma patients with long-term survival has been observed. Contemporary 5-year overall survival rate in patients with extremity soft tissue sarcomas is 55 -78%. In case of diagnosis of metastatic disease the prognosis is still poor (survival of approximately 1 year). Good results of local therapy may be expected only after planned (e.g., after preoperative biopsy - tru - cut or incisional) radical surgical excision of primary tumor with pathologically negative margins (R0 resection). Following appropriate diagnostic check-up, adjuvant radiotherapy is necessary in the majority of patients treated with radical surgery need, as well as long-term rehabilitation and follow-up examinations in treating center are needed for at least 5 years. The progress is due to the introduction of targeted therapy acting on molecular or genetic cellular disturbances detected during studies on etiopathogenetic mechanisms of sarcoma subtypes. In view of rarity of sarcomas and necessity of multidisciplinary therapy, the crucial issue is that management of these tumors should be hold in experienced oncological sarcoma centers. (authors)

  9. SIGNIFICANCE OF GASTROSCOPY AND LAPAROSCOPY IN THE DIAGNOSIS AND TREATMENT OF CHILDREN WITH HETEROTOPIC PANCREAS%胃镜及腹腔镜技术对小儿消化道异位胰腺的诊疗意义

    Institute of Scientific and Technical Information of China (English)

    耿娜; 李索林; 李英超; 时保军; 马亚贞

    2011-01-01

    Objective To investigate the clinical features of children patients with heterotopic pancreas and to discuss the significance of endoscopy in the diagnosis and treatment of heterotopic pancreas as well. Methods The clinical manifestations, diagnostic methods, lesion distribution and treatments of 11 cases heterotopic pancreas from 1998 to 2010 were retrospectively analysed. Results The clinical manifestations of the 11 patients included:abdominal mass 1 case; gastrointestinal bleeding 5cases, umbilical fistula leases, upper abdominal pain 3cases, and one was found by surgical exploration.The distribution of heterotopic pancreas shows that 1 case was found in duodenum,2 cases in stomach,3cases in jejunum,5 cases in ileum,of which one case was complicated with intussusception. Ten of the patients were treated by surgery and the clinical results were satisfied. Conclusion The children patients with heterotopic pancreas mostly show bleeding, abdominal pain or intussusception as the complications, so it is lack of characteristic clinical manifestations and effective means of inspection. The endoscopic technology that widely used in the clinical application raised the rate of diagnosis and treatment.%目的 探讨小儿消化道异位胰腺的临床特点及内镜技术对该疾病的诊断与治疗意义.方法 对1998-2010年收治的11例病理确诊的异位胰腺患儿的临床表现、诊断方法、病变部位分布及治疗措施进行回顾性分析.结果 11例患儿表现为腹部包块1例,消化道出血5例,脐肠瘘1例,上腹痛3例,行其他手术探查发现1例.分布部位,十二指肠1例,胃内2例,空肠3例,回肠5例,其中并发肠套叠1例.其中10例患儿行手术治疗,1例随访观察,临床效果满意.结论 小儿消化道异位胰腺多以消化道出血,腹痛或肠套叠等为主要表现,缺乏特征性的临床表现和有效的检查手段,内镜及腔镜技术在临床的日益广泛应用提高了该病的诊断治疗率.

  10. 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

    2015-01-01

    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…

  11. Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. Fourth Edition

    Science.gov (United States)

    Barkley, Russell A., Ed.

    2014-01-01

    Widely regarded as the standard clinical reference, this volume provides the best current knowledge about attention-deficit/hyperactivity disorder (ADHD) in children, adolescents, and adults. The field's leading authorities address all aspects of assessment, diagnosis, and treatment, including psychological therapies and pharmacotherapy. Core…

  12. Roentogenologic diagnosis of an acute abdomen in children

    Energy Technology Data Exchange (ETDEWEB)

    Oka, Makio; Chiba, Nobuyuki; Miyagi, Tetsuo (Kanagawa Children' s Medical Center, Yokohama (Japan))

    1983-05-01

    An acute abdomen is one of the main topics among emergency practice for children. We have experienced about 300 acute abdomen cases per year at our Children's Hospital since 1970. Radiological technologists provide a 24-hour emergency service using special knowledge and techniques in our radiological investigation. In the noenatal period esophageal atresia should be diagnosed by plain up-right film with a coiled-up rubber tube, and a contrast examination is contraindicated to prevent severe aspiration pneumonia. In the cases with intestinal atresia, the contrast examination is not necessary again, because the findings of plain film such as the distribution of air-filled intestinal loops, dilated bowel with air-fluid level gives us enough information for the diagnosis of these congenital anomalies. On the contrary, barium enema is useful and harmless for the neonatal age group. It is practical for diagnosing Hirschsprung's disease, midgut malrotation with volvulus, ileal and colonic atresia and necrotizing enterocolitis. An imperforate anus should be classified into the high and low type in the neonatal period to define the treatment. Invertogram is an only way for the differentiation of a baby without external fistula, and we have established the technique for this. The level is diagnosed by the relationship between the gas-filled rectal pouch and ischiac bone. In the infant group intussusception is the most common and urgent acute abdomen. We use a special device to fix the bady, dilute the barium with warm saline (to avoid water intoxication), limit the water pressure to within one meter, and avoid abdominal manipulation and longtime exposure. The successful reduction rate that our team has obtained is almost 85%.

  13. 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

  14. 儿童卵巢恶性生殖细胞肿瘤17例临床分析%The diagnosis and treatment of malignant ovarian germ cell tumor in children :a clinical study of 17 patients

    Institute of Scientific and Technical Information of China (English)

    张丹晔; 谭明子; 王慧敏; 李潇; 高一平; 郭瑞江; 林蓓

    2013-01-01

    Objective To investigate the clinical characteristics, treatment experience of malignant ovarian germ cell tumor in children. Methods Seventeen malignant ovarian germ cell tumor (MOGCT) patients under 14 years old, who were diagnosed and treated in Shengjing Hospital Affiliated to China Medical University between June 2003 and June 2012. A retrospective analysis was conducted on the clinical data of them. Results The seventeen children were all got the final diagnosis by operation, histologically, ovarian yolk sac tumors (n = 10) were found most frequently,followed by dysgerminoma ( n = 3 ) , immature ovarian teratomas ( n = 2 ) , embryonal carcinoma ( n = 1) and a special case that yolk sac tumor in one ovary and dysgerminoma in the other. Patients were mostly treated with fertility preservation surgery ( n = 14) ,including 5 in stage I a ( FIGO) , 6 in stage I c ( FIGO) , 1 in stage II ( FIGO) , 1 in stage I ( FIGO) and 1 in stage IV (FIGO). Three children were treated by cytoreductive surgery, including one in stage I ,one in stage IIIc and the other in stage IV- Eleven patients received chemotherapy and one received radiotherapy after operation. During a follow-up of 8 ~ 96 months, there are 2 death cases, 2 lost cases and one case experienced recurrence. The rest children are healthy. Conclusion The operation method of malignant ovarian germ cell tumor in children should take more consideration in fertility preservation. The lesser degrees of surgical staging would be recommended, especially in early stage.%目的 探讨儿童卵巢恶性生殖细胞肿瘤的临床特征及诊断和治疗方法.方法 回顾性分析中国医科大学附属盛京医院2003年6月至2012年6月收治的17例14岁以下(包括14岁)卵巢恶性生殖细胞肿瘤患儿的临床资料.结果 17例患儿均经手术病理确诊,其中内胚窦瘤10例,无性细胞瘤3例,双卵巢分别内胚窦瘤及无性细胞瘤1例,胚胎癌1例,未成熟畸胎瘤2例.14例(Ⅰ a期5

  15. 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.

  16. Advances in diagnosis and treatment of autoimmune hepatitis

    Directory of Open Access Journals (Sweden)

    WANG Qianyi

    2015-02-01

    Full Text Available Autoimmune hepatitis (AIH is a progressive, chronic hepatitis of unknown cause. It is characterized by interface hepatitis, hypergammaglobulinaemia, circulating autoantibodies, and a favorable response to immunosuppression. This article summarizes the epidemiological and clinical characteristics of AIH and reviews recent advances in the diagnosis and treatment of AIH. Early diagnosis and proper treatment can improve the prognosis.

  17. Renal calculi: emergency department diagnosis and treatment.

    Science.gov (United States)

    Carter, Michelle R; Green, Brad R

    2011-07-01

    The acute treatment of kidney stones (urolithiasis) addresses pain management and focuses on the effects of the morbidity associated with an obstructed renal system. Minimal fluid intake, resulting in decreased urine production and a high concentration of stone-forming salts, is a leading factor in renal calculi development. Radio-opaque calcareous stones account for 70% to 75% of renal calculi. Microscopic hematuria in the presence of acute flank pain is suggestive of renal colic, but the absence of red blood cells does not exclude urolithiasis. Furthermore, many inflammatory and infectious conditions cause hematuria, demonstrating the low specificity of urinalysis testing. The diagnostic modality of choice is a noncontrast computed tomography (CT); ultrasonography s preferred in pregnant patients and children. Combining opioids with non-steroidal anti-inflammatory drugs (NSAIDs) is the optimal evidence-based regimen to treat severe symptoms. Rapid intravenous (IV) hydration has not shown a benefit. Potentially life-threatening diagnoses including abdominal aortic aneurysm, ovarian torsion, and appendicitis may mimic renal colic and must be ruled out. PMID:22164398

  18. School Refusal: Clinical Features, Diagnosis and Treatment

    OpenAIRE

    Kayhan Bahali; Aysegul Yolga Tahiroglu

    2010-01-01

    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. Th...

  19. Retinoblastoma: genetics, diagnosis, treatment and sequelae

    International Nuclear Information System (INIS)

    retinoblastoma treatment is cure. It is reasonable to assert that a secondary goal of treatment is preservation of vision in the affected eye. Surgical options for therapy include enucleation, exenteration, photo coagulation, cryotherapy, and radioactive plaque application. External beam radiotherapy has a significant role to play in sight-preserving therapy. There has been a resurgence of interest in the use of systemic cytotoxic chemotherapy, either in addition to conventional surgical and radiotherapy techniques or as an alternative to them. The RB1 gene unequivocally is involved in carcinogenesis. Heritable retinoblastoma has an appreciable rate of second malignant neoplasm development - the cumulative mortality for all second tumors at 40 years of follow-up for bilateral retinoblastoma has been calculated to be 26%. Therapy choice may influence the risk and type of second malignant neoplasms. This refresher course will survey the genetic basis of retinoblastoma, techniques of diagnosis, forms of therapy, and the long-term consequences of cure of this fascinating childhood malignancy

  20. Retinoblastoma: Genetics, diagnosis, treatment and sequelae

    International Nuclear Information System (INIS)

    retinoblastoma treatment is cure. It is reasonable to assert that a secondary goal of treatment is preservation of vision in the affected eye. Surgical options for therapy include enucleation, exenteration, photo coagulation, cryotherapy, and radioactive plaque application. External beam radiotherapy has a significant role to play in sight-preserving therapy. There has been a resurgence of interest in the use of systemic cytotoxic chemotherapy, either in addition to conventional surgical and radiotherapy techniques or as an alternative to them. Several ophthalmic oncology centers have piloted therapy programs designed to avoid enucleation or whole eye external beam irradiation. Such programs rely on vigorous focal therapy plus chemotherapy. The RB1 gene unequivocally is involved in carcinogenesis. Heritable retinoblastoma has an appreciable rate of second malignant neoplasm development - the cumulative mortality for all second tumors at 40 years of follow-up for bilateral retinoblastoma has been calculated to be 26%. Therapy choice may influence the risk and type of second malignant neoplasms. This refresher course will survey the genetic basis of retinoblastoma, techniques of diagnosis, forms of therapy, proposals for protocols emphasizing chemotherapy plus focal therapy, and the long-term consequences of cure of this fascinating childhood malignancy

  1. 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. PMID:25591183

  2. Treatment on leukaemia in children

    Energy Technology Data Exchange (ETDEWEB)

    McCann, S.R. (St. James' s Hospital, Dublin (Ireland))

    1984-06-01

    Since the late 1960s it has become clear that significant numbers of children may achieve long term remissions from acute leukaemia and that substantial numbers are probably cured of their disease. Results in most European countries and North America have failed to demonstrate any improvement on the early ''success'' rates and more than 50% of children will still ultimately die from their diseases. This review will attempt to outline the results of current approaches and treatment, to highlight prognostic factors and to examine the role of bone marrow transplantation in a onetime invariably fatal disease. For the purpose of this review, acute lymphoblastic leukaemia (ALL) only, will be dealt with in detail, as this accounts for 85% of cases of childhood acute leukaemia. 27 refs.

  3. Diagnosis and treatment of Alzheimer's disease

    International Nuclear Information System (INIS)

    Alzheimer's disease is often diagnosed too late. Its etiology is still largely unknown and remains one of the big challenges in neurobiological fundamental research. Optimized early and differential diagnosis can be ensured by a dynamic concept of multidisciplinary diagnosis in cooperation between practitioners specializing in brain disorders, clinical psychogeriatric deprtments, and general practitioners. This, in turn, will enable individualized planning of further living conditions and care of Alzheimer patients and their relations as well as efficient and early pharmacotherapy and psychological intervention. (orig)

  4. Diagnosis and treatment of symptomatic Rathke cleft cysts in 17 children: clinical features and surgical results%儿童症状性Rathke囊肿17例临床分析

    Institute of Scientific and Technical Information of China (English)

    王剑新; 幸兵; 王继存; 姚勇; 连伟; 任祖渊; 苏长保; 王任直

    2013-01-01

    Objective To summarize the cinical features and surgical results of diagnosis and treatments of symptomatic Ratheke cleft cysts(RCCs) in children.Methods The clinical data of 17 cases RCCs of children (younger than 18 years old) selected from 182 cases RCCs admitted into Peking Union Medical College Hospital from 2001 to 2010 were retrospectively analyized.Sixteen patients undertook the transsphenoidal pituitary cyst excision or incision and drainage,1 case by the frontal approach craniotomy.Results Five cases of the 17 children with growth retardation (29.4%),headache in 4 cases (23.5%),decreased visual acuity or visual field defect in 3 cases (17.6%),2 cases of polydipsia,polyuria (11.8%),3 cases of accidental discovery (1 child with benign epilepsy,1 breast development,1 exception injury).The thin cyst wall in 10 surgeries were visible:whole resection of 5 cases,part of wall resection in 3 cases,the only line of drainage in 2 cases; Remaining 7 cases with cyst wall invisble were given drainage only.Five cases with cerebrospinal rhinorrhea during operations were treated by repairing and recconstructing the sellar floor,and 4 cases got good recoveries only by lying spine.One case,suffering from meningitis,was cured by virtue of lumbar subarachnoid drainage,supine,anti-inflammatory treatment.For other 12 cases,the sellar floor was opened and drained directly with no filling.Five cases of children with growth retardation,whose average bone age are lower than the actual age got effective growth hormone therapy after surgery.The symptoms of headache and visual disturbance in 7 patient were relieved after treatment.Two cases with diabetes insipidus were treated at least for two months,maintained with minimal dose of minirin.Three cases accidentally found were cured.The average follow-up time lasted 3.Two years,and no cyst recurrence found in all children.Conclusion Transsphenoidal cyst excision or incision and drainage surgery is the preferred therapeutic

  5. [Pitfalls in the diagnosis of occult elbow fractures in children].

    Science.gov (United States)

    Courvoisier, A; Calvelli, N; Bourgeois, E; Eid, A; Griffet, J

    2016-08-01

    Elbow injuries are frequent but occult fractures are difficult to diagnose on x-rays. However, any delay in the diagnosis may severely impair the prognosis of some fractures. Simple tips may help the clinician read x-rays properly and avoid the classical pitfalls of elbow injuries in children. The chronology of appearance of ossification nuclei around the elbow is important to distinguish normal features from abnormality. Drawing simple geometric constructions on the x-rays may clarify most occult elbow fractures in children. PMID:27345552

  6. CT diagnosis of traumatic bronchial rupture in children

    International Nuclear Information System (INIS)

    Bronchial rupture is a rare and serious complication of blunt chest trauma in children. The diagnosis of this injury is challenging and requires a high degree of clinical suspicion. It is frequently associated with other severe injuries that may draw the focus of attention away from this potentially catastrophic but treatable injury. The radiographic findings of bronchial rupture have been reported in very few series. We report the findings in two children with bronchial rupture diagnosed by CT, in whom CT resulted in a significant change in patient management. (orig.)

  7. Malaria diagnosis and treatment administered by teachers in primary schools in Tanzania

    DEFF Research Database (Denmark)

    Magnussen, P; Ndawi, B; Sheshe, A K;

    2001-01-01

    number of malaria cases (cases/1000 registered school children) diagnosed and treated by school teachers was 159 (67) in 1995, 324 (124) in 1996, 348 (128) in 1997 and 339 (108) in 1998. Children in grades 1-4 (age 7-13) accounted for 64.6% of cases. Symptoms and oral temperature were recorded for 1258.......4% were found positive. Among children who fulfilled the algorithm criteria 75.0% had a positive blood slide. With little training and regular supervision it was feasible for school teachers to make a presumptive diagnosis of malaria. We conclude that teachers can play a major role in school health......A school health programme in Mwera Division, Pangani District included treatment of malaria attacks occurring in children during school time. A combination of symptoms (headache, muscle/joint pains, feeling feverish) and oral temperature > or = 37.5 degrees C was used for the diagnosis of malaria...

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

    International Nuclear Information System (INIS)

    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.)

  9. Alveolar proteinosis: diagnosis and treatment over a 10-year period.

    OpenAIRE

    du Bois, R M; McAllister, W A; Branthwaite, M A

    1983-01-01

    Ten years' experience of using bronchoalveolar lavage in the treatment of 10 patients with alveolar proteinosis is reported. The diagnosis was often missed. The interval between onset of symptoms and diagnosis varied from six weeks to six years (median 2 years), so that the start of treatment was often delayed. Some patients experienced severe progressive disability before they had treatment. Whole-lung lavage proved to be a safe, repeatable procedure which provided symptomatic, physiological...

  10. Risperidone Versus Methylphenidate in Treatment of Preschool Children With Attention-Deficit Hyperactivity Disorder

    OpenAIRE

    Arabgol, Fariba; Panaghi, Leily; Nikzad, Vahid

    2015-01-01

    Background: Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric diagnosis among preschool children. Objectives: The aim of this study was to examine the Risperidone treatment compared to Methylphenidate (MPH) in preschool children with ADHD. Patients and Methods: Thirty three outpatient preschool children, aged 3-6 years, diagnosed with ADHD (The diagnosis of ADHD was established by two child and adolescent psychiatrists according to the DSM-IV-TR criteria), participated i...

  11. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available ... story! Children Procedures and Treatment Is ovarian tissue cryopreservation available to girls under 18? How can a ... priority for my child? How does ovarian tissue cryopreservation differ for children and adults? Why is it ...

  12. Radionuclide cisternography in the diagnosis of hydrocephalus type in tuberculous meningitis in children

    International Nuclear Information System (INIS)

    The radionuclide cisternography permits an accurate diagnosis in hydrocephalus, this is an easy procedure, not traumatic nor expensive. Hydrocephalus is one of the most serious complications of tuberculous meningitis, that, without an opportune treatment, leads to severe sequel and death of the patient. The medical records of thirty patients with diagnosis of tuberculosis meningitis were reviewed, to whom the Neuro-Pediatric Service of the National Institute of Children Health solicited radionuclide cisternography to evaluate hydrocephalus and to determinate type, between january 1990 and october 1992. The hydrocephalus was demonstrated by radionuclide cisternography in 26/30 patients (86,7%) The most frequent age was in children under five years old 21/26 (80,7%) and pre-students in 65,38%. The most common finding was communicating hydrocephalus, pattern type IV in 20/30 patients (66,7%). It is concluded that the radionuclide cisternography is very useful for the diagnosis of hydrocephalus and its type patients with tuberculous meningitis. This exam is recommended for all patients with diagnosis of tuberculous meningitis, with no satisfactory evolution, in order to obtain an early diagnosis of hydrocephalus and its type, and get an opportune medical or surgical treatment. (author). 35 refs., 3 tab., 8 ills

  13. Congenital ectopia lentis : diagnosis and treatment

    OpenAIRE

    Rysä Konradsen, Tiina

    2012-01-01

    Congenital ectopia lentis (EL) is an ocular condition, which typically causes a high grade of refractive errors, mainly myopia and astigmatism. These might be difficult to compensate for, especially in children, who might develop ametropic amblyopia. Surgery on ectopic lenses has previously been controversial, due to the risk of sightthreatening complications. In paper I we studied retrospectively visual outcomes and complications in children, who were operated for congen...

  14. 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.

  15. AD/HD: POSSIBLE DIAGNOSIS AND TREATMENT

    OpenAIRE

    REICHELT Karl; M. NODLAND; K. FOSSE; A.M. KNIVSBERG

    2015-01-01

    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 intervention...

  16. Radiographic caries diagnosis and restorative treatment decision making

    International Nuclear Information System (INIS)

    This thesis is concerned with a single diagnostic technique: the bitewing radiograph, and the way it is used by dentists to decide on patient treatment need for interproximal caries. The variation in caries diagnosis and treatment decisions using bitewing radiographs is described and the radiographic criteria of choice for minimizing over and undertreatment according to a norm are investigated. Three possible diagnostic strategies in interproximal caries diagnosis using a decision analysis approach are described and evaluated, and the effect of the reported diagnostic behaviour and knowledge of practicing Dutch dentists in their use of bitewing radiographs for the diagnosis and treatment of interproximal caries is described and analyzed. (Auth.)

  17. Diagnosis and treatment of venous thromboembolism by consultants in Scotland.

    OpenAIRE

    Prentice, A. G.; Lowe, G D; Forbes, C. D.

    1982-01-01

    A questionnaire was sent to 508 consultants in Scotland likely to encounter deep vein thrombosis and pulmonary embolism to assess their current standard practice in diagnosis and treatment of these disorders. Replies were received from 358 (70.5%). In deep vein thrombosis 47% and in pulmonary embolism 33% of consultants usually depended on clinical observation alone for diagnosis. In deep vein thrombosis 37% used venography to supplement clinical diagnosis and in pulmonary embolism 13% used a...

  18. Autism spectrum disorders: an overview on diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Helena Brentani

    2013-01-01

    Full Text Available Pervasive developmental disorders are now commonly referred to as autism spectrum disorders (ASDs. ASDs present with a range of severity and impairments, and often are a cause of severe disability, representing a major public health concern. The diagnostic criteria require delays or abnormal functioning in social interaction, language, and/or imaginative play within the first 3 years of life, resulting in a deviation from the developmental pattern expected for the age. Because establishing a diagnosis of ASD is possible as early as 18-24 months of age, clinicians should strive to identify and begin intervention in children with ASD as soon as signs are manifest. Increasing efforts are underway to make ASD screening universal in pediatric healthcare. Given the crucial importance of early identification and multiple modalities of treatment for ASD, this review will summarize the diagnostic criteria, key areas for assessment by clinicians, specific scales and instruments for assessment, and discussion of evidence-based treatment programs and the role of specific drug therapies for symptom management.

  19. The diagnosis of gastroesophageal reflux disease in children

    International Nuclear Information System (INIS)

    Gastroesophageal reflux disease is a common disorder affecting children worldwide. The objective of this study is to report our experience on the accuracy of tests used for the diagnosis ofgastroesophageal reflux disease with emphasis on the advantages and disadvantages of each of them. This study took place in the Pediatric Gastroenterology Division, Department of Pediatrics, College of Medicine and King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, during the period of 1994 through to 1999. Results of barium meal, 24-hour esophageal pH monitoring, endoscopy, and gastrointestinal scintigraphy are analyzed and compared in children with and without gastroesophageal reflux disease. One hundred and forty-four children were investigated. The diagnosis was confirmed in 85 and excluded in 59 children, who will be considered as patients without gastroesophageal reflux disease. The results of barium meal, 24 hour pH monitoring, endoscopy, and gastrointestinal scintigraphy were positive in 80%, 78%, 92%, and 70% of the patients with gastroesophageal disease. The same studies were falsely positive in 29%, 9%, 19%, and 0% of those without gastroesophageal reflux disease. Esophageal pH was the most specific diagnostic study (91%), whereas endoscopy was the most sensitive (92%) and had the best positive predictive value (95%). The results of this study are similar to reports from other parts of the world. It is stressed that all procedures have important advantages and disadvantages indicating that the selection of procedures should be individualized and based on the clinical situation. (author)

  20. Acute Biliary Pancreatitis: Diagnosis and Treatment

    OpenAIRE

    Hazem Zakaria

    2009-01-01

    Gallstones are the commonest cause of acute pancreatitis (AP), a potentially life-threatening condition, worldwide. The pathogenesis of acute pancreatitis has not been fully understood. Laboratory and radiological investigations are critical for diagnosis as well prognosis prediction. Scoring systems based on radiological findings and serologic inflammatory markers have been proposed as better predictors of disease severity. Early endoscopic retrograde cholangiopancreatography (ERCP) is benef...

  1. Generalized anxiety disorder: Differential diagnosis and treatment

    OpenAIRE

    Tatyana Gratsiyevna Voznesenskaya

    2013-01-01

    Generalized anxiety disorder (GAD) is poorly diagnosed and inadequately treated by general practitioners. The paper considers the major diagnostic signs of GAD, its differential diagnosis, prevalence, etiology, and pathogenesis. Antidepressants from a group of selective serotonin reuptake inhibitors in combination with psychotherapy are the drugs of first choice.

  2. Diagnosis and management of undifferentiated fever in children.

    Science.gov (United States)

    Long, Sarah S

    2016-07-01

    The incidence and likely causes of fever of unknown origin (FUO) have changed over the last few decades, largely because enhanced capabilities of laboratory testing and imaging have helped confirm earlier diagnoses. History and examination are still of paramount importance for cryptogenic infections. Adolescents who have persisting nonspecific complaints of fatigue sometimes are referred to Pediatric Infectious Diseases consultants for FUO because the problem began with an acute febrile illness or measured temperatures are misidentified as "fevers". A thorough history that reveals myriad symptoms when juxtaposed against normal findings on examination and simple laboratory testing can suggest a diagnosis of "fatigue of deconditioning". "Treatment" is forced return to school, and reconditioning. The management of patients with acute onset of fever without an obvious source or focus of infection is dependent on age. Infants under one month of age are at risk for serious and rapidly progressive bacterial and viral infections, and yet initially can have fever without other observable abnormalities. Urgent investigation and pre-emptive therapies usually are prudent. By two months of age, clinical judgment best guides management. Between one and two months of age, a decision to investigate or not depends on considerations of the height and duration of fever, the patient's observable behavior/interaction, knowledge of concurrent family illnesses, and likelihood of close observation and follow up. Children 6 months-36 months of age with acute onset of fever who appear well and have no observable focus of infection can be evaluated clinically, without laboratory investigation or antibiotic therapy, unless risk factors elevate the likelihood of urinary tract infection. PMID:27209095

  3. 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.

  4. 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. ...

  5. Feature: Post Traumatic Stres Disorder PTSD: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Feature PTSD Symptoms, Diagnosis , Treatment Past Issues / Winter 2009 Table of ... Symptoms As with mild traumatic brain injury (TBI), PTSD symptoms can be very subtle. "For example, some people ...

  6. [Primary obstructive megaureter- diagnosis and treatment].

    Science.gov (United States)

    Aprodu, S G; Savu, B; Goţia, D G; Gavrilescu, S; Nedelcu, D; Apostol, D; Munteanu, V; Vlad, A; Brumaru, O; Munteanu, M

    2001-01-01

    The authors have treated 13 cases of primary obstructive megaureter (POM) in children, presenting without vesicoureteric reflux. The diagnostic possibilities and the surgical approach options are discussed. Both Cohen and Leadbetter--Politano uretero-vesical reimplantation techniques proved to be successful in this series. Ureteric folding was done in 2 cases. Reported final results are good in 10 cases. PMID:12092136

  7. Diagnosis and Treatment of Pancreas Rejection

    OpenAIRE

    Redfield, R. R.; Kaufman, D. B.; Odorico, J. S.

    2015-01-01

    Despite significant improvement in pancreas allograft survival, rejection of the pancreas remains a major clinical problem. In addition to cellular rejection of the pancreas, antibody-mediated rejection of the pancreas is now a well-described entity. The 2011 Banff update established comprehensive guidelines for the diagnosis of acute and chronic AMR. The pancreas biopsy is critical in order to accurately diagnose and treat pancreas rejection. Other modes of monitoring pancreas rejection we f...

  8. 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...

  9. PRIMIPARA POST PARTUM DEPRESSION DIAGNOSIS AND TREATMENT

    OpenAIRE

    Esha Pradnyana; Wayan Westa; Nyoman Ratep

    2013-01-01

    Pregnancy and the first child birth is an influential complex event for a mother, which is where everything including phsycal and psyological aspects. This change can make mother psyological disorder, that can lead into depression after childbearing that call post childbearing depression or post partum depression. A wide review at 59 study make a result that 13% among primipara can suffer post partum depression 12 weeks after childbearing. Estabilishmet of this diagnosis, besides from history...

  10. Tuberculous Meningitis: Diagnosis and Treatment Overview

    OpenAIRE

    Grace E. Marx; Chan, Edward D.

    2011-01-01

    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...

  11. 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...

  12. Diagnosis and Treatment of West Nile Infections

    OpenAIRE

    Kemmerly, Sandra Abadie

    2003-01-01

    West Nile Virus (WNV) should be considered in the differential diagnosis for patients presenting with symptoms of viral meningitis, encephalitis, and flaccid paralysis. The activity for 2003 started with human cases in July and is expected to continue spreading throughout the United States. Only 1 in 150 WNV infections result in severe neurologic illness, which is more common in the elderly population. Testing for the IgM antibody against WNV in both serum and spinal fluid is the diagnostic t...

  13. Short View of Leukemia Diagnosis and Treatment in Iran

    OpenAIRE

    2015-01-01

    Background: Early diagnosis and treatment of leukemia patients remains a fundamental aim in clinical oncology, especially in developing country. Present study highlights the basic requirements of these patients in Iran. Better understanding of these issues may lead to improve the healthcare standards toward leukemia diagnosis and treatment. Methods: This descriptive study included 101 specialists in hematology-oncology and pathology serving in oncology centers. The participants were then aske...

  14. Advances in the Diagnosis and Treatment of Tuberculosis

    OpenAIRE

    Nahid, Payam; Pai, Madhukar; Hopewell, Philip C.

    2006-01-01

    Although truly major advances that would revolutionize tuberculosis (TB) diagnosis and treatment have not been realized, we are beginning to see the innovations that have been prompted by the recognition of the economic potential of the market for new diagnostic tests and treatments for TB and considerably increased public and private funding. Despite the enormous global burden of TB and the overall low rates of case detection worldwide, conventional approaches to diagnosis have, until recent...

  15. Diagnosis and treatment of diabetic foot infections.

    Science.gov (United States)

    Lipsky, Benjamin A; Berendt, Anthony R; Deery, H Gunner; Embil, John M; Joseph, Warren S; Karchmer, Adolf W; LeFrock, Jack L; Lew, Daniel P; Mader, Jon T; Norden, Carl; Tan, James S

    2006-06-01

    -stimulating factors and systemic hyperbaric oxygen therapy may help prevent amputations (B-I). These treatments may be useful for severe infections or for those that have not adequately responded to therapy, despite correcting for all amenable local and systemic adverse factors. 18. Spread of infection to bone (osteitis or osteomyelitis) may be difficult to distinguish from noninfectious osteoarthropathy. Clinical examination and imaging tests may suffice, but bone biopsy is valuable for establishing the diagnosis of osteomyelitis, for defining the pathogenic organism(s), and for determining the antibiotic susceptibilities of such organisms (B-II). 19. Although this field has matured, further research is much needed. The committee especially recommends that adequately powered prospective studies be undertaken to elucidate and validate systems for classifying infection, diagnosing osteomyelitis, defining optimal antibiotic regimens in various situations, and clarifying the role of surgery in treating osteomyelitis (A-III). PMID:16799390

  16. The Diagnosis of HIV Infection in Infants and Children.

    Science.gov (United States)

    Abdollahi, Alireza; Saffar, Hana

    2016-01-01

    It is estimated that the number of HIV infected children globally has increased from 1.6 million in 2001 to 3.3 million in 2012. The number of children below 15 years of age living with HIV has increased worldwide. Published data from recent studies confirmed dramatic survival benefit for infants started anti-retroviral therapy (ART) as early as possible after diagnosis of HI. Early confirmation of HIV diagnosis is required in order to identify infants who need immediate ART. WHO has designed recommendations to improve programs for both early diagnoses of HIV infection and considering ART whenever indicated? It is strongly recommended that HIV virologocal assays for diagnosis of HIV have sensitivity of at least 95% and ideally greater than 98% and specificity of 98% or more under standardized and validated conditions. Timing of virological testing is also important. Infants infected at or around delivery may take short time to have detectable virus. Therefore, sensitivity of virological tests is lower at birth. In utero HIV infection, HIV DNA or RNA can be detected within 48 h of birth and in infants with peripartum acquisition it needs one to two weeks. Finally it is emphasized that all laboratories performing HIV tests should follow available services provided by WHO or CDC for quality assurance programs. Both clinicians and staffs providing laboratory services need regular communications, well-defined SOPs and nationally validated algorithms for optimal use of laboratory tests. Every country should use assays that have been validated by national reference laboratory. PMID:27499768

  17. 儿童粒细胞缺乏性小肠结肠炎的诊断和处理%A single center experience with diagnosis and treatment of neutropenic enterocolitis in children

    Institute of Scientific and Technical Information of China (English)

    李凯; 郑珊; 董岿然; 高怡瑾; 王宏胜; 柳龚堡; 高解春; 肖现民

    2011-01-01

    目的 粒细胞缺乏性小肠结肠炎在临床上以粒细胞缺乏、腹痛和高热为三大主症.本文回顾了粒细胞缺乏性小肠结肠炎患儿17例,对其临床特征、治疗和预后进行分析.方法 总结复旦大学附属儿科医院2004至2009年5年间粒细胞缺乏性盲肠炎息儿的临床资料,并进行文献复习.结果 17例患儿,男11例,女6例,平均年龄7.2岁.2例淋巴瘤,11例白血病,1例再生障碍性贫血,1例神经母细胞瘤,2例单纯性粒细胞缺乏而无明显的基础性疾病证据.所有患儿均有典型的临床表现,4例有弥漫性腹膜炎,中毒性休克,其中3例需要呼吸机辅助通气治疗.体检发现有右下腹压痛和肌紧张.伴有CRP的升高和电解质的紊乱.血培养阳性率47%.CT、B超提示肠壁增厚,盲肠或右侧结肠充气减少,气腹等.13例患儿接受内科保守治疗,4例手术干预.2例死亡.结论 粒细胞缺乏性小肠结肠炎是由粒细胞缺乏所引起的危及生命的消化道并发症,临床及CT表现可明确诊断.早期发现和积极的内科治疗可减少病死率.大多数的患儿可通过保守治疗,避免外科手术而获得良好的预后.%Objective To summarize our experience with disgnosis and treatment of neutropenic enterocolitis in children. Methods From 2004 to 2009, 17 patients were diagnosed with neutropenic enterocolitis, and treated at this center. Their clinical data were retrospectively analyzed to summarize the clinical features, managment experience and evaluate the outcome of neutropenic enterocolitis. Results Among the 17 patients, 11 were males and 6 were females. Their avergae age at diagnosis was 7. 2 years old. The primary diseases that caused neutropenia in these patients were lyphoma in 2 patients, leukemia in 11 patients,aplastic anemia in 1, neuroblastoma in 1, and primary neutropenia in 2. All the patients presented enterocolitis symptoms like fever, vomitting, and diarrhea. Physical examination found lower

  18. MRI appearances and diagnosis of mitochondrial encephalomyopathy in children

    International Nuclear Information System (INIS)

    Objective: To explore the MRI appearances and diagnostic value of mitochondrial encephalomyopathy in children. Methods: MRI manifestations in 16 children patients with mitochondrial encephalomyopathy, confirmed by pathology and laboratory examination from January of 1996 to December of 2002, were retrospectively analyzed. Results: Cerebral foci of mitochondrial encephalomyopathy showed as multiple and symmetrical abnormal slight long T1 and long T2 signals in all 16 cases. Deep grey matter was only invaded in 9 of 16 cases, both cerebral cortex and deep grey matter were involved in 6 cases, and white matter was only invaded in 1 case, respectively. Their main clinical manifestations were progressive declination of the intelligence (n=12) and muscle force (n=10). The biopsy in the skeletal muscle showed ragged red fiber and abnormal mitochondria. Conclusion: Gradual declination of intelligence and muscle force is the common clinical manifestations of mitochondrial encephalomyopathy in children. The main MRI findings were multiple symmetrical abnormal signal intensities in the deep grey matter, and MRI is an important way to show the cerebral lesions and benefit to the diagnosis of mitochondrial encephalomyopathy. But the definite diagnosis of mitochondrial encephalomyopathy depends on skeletal muscle biopsy and gene examination

  19. Hepatocellular Carcinoma: Risk Factors, Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Dafina Janevska

    2015-10-01

    Full Text Available Hepatocellular carcinoma (HCC is the most often primary cancer of the liver and is one if the leading cause of cancer-related death worldwide. The incidence of HCC has geographic distribution with the highest levels in countries with developing economies. Patients with hepatocellular carcinoma have poor prognosis despite the achievements in surgery techniques and other therapeutic procedures and it is a reason why continuous attention should be paid to this issue. This article provides an overview of this disease based on an extensive review of relevant literature. The article summarizes the current risk factors, diagnosis, staging and the management of HCC.

  20. Factors related to under-diagnosis and under-treatment of childhood asthma in metropolitan France

    Directory of Open Access Journals (Sweden)

    Annesi-Maesano Isabella

    2012-08-01

    Full Text Available Abstract Background Under-diagnosis and under-treatment of childhood asthma were investigated in France using data collected during the 6 Cities Study, the French contribution to the International Study of Asthma and Allergies in Childhood. Methods 7,781 schoolchildren aged between 9 and 10 years underwent a medical visit including skin prick tests to common allergens and exercise test for Exercise-Induced Asthma (EIA and their parents filled in a standardized questionnaire on asthma, management, treatment and potential risk factors. Results 903 children reported asthma (11.6%, 377 without a doctor’s diagnosis. Of the 526 participants with a diagnosis of asthma confirmed by a doctor (58.2%, 353 were treated and 76 were not treated during the year preceding the investigation despite their diagnosis. The information on the treatment was missing for the rest of individuals diagnosed with asthma (n = 97. Having a treatment was significantly associated with severe asthma and with the presence of other respiratory and allergic stigmata (atopic eczema, rhinitis, positive skin allergy tests, and EIA. In addition, having a treatment did not correspond to a good control of the disease. Similarly, children with asthma-like symptoms but without doctor-diagnosed asthma had asthma less well controlled than children with diagnosed asthma. They were also more exposed to passive smoking and traffic but had fewer pets. In contrast, diagnosed children reported more frequently a small weight at birth and a preterm birth. Conclusions In France, childhood asthma is still under-diagnosed and under-treated and environmental factors play a role in these phenomena.

  1. [Prevention and treatment strategy for burn wound sepsis in children].

    Science.gov (United States)

    Niu, Xihua; Li, Xiaoling

    2016-02-01

    Wound sepsis is one of the main causes of death in patients with severe burn and trauma. The high incidence of burn wound sepsis in children is attributed to their imperfect immune system function, poor resistance against infection, and the weakened skin barrier function after burn. The key to reduce the mortality of pediatric patients with burn wound sepsis is to enhance the understanding of its etiology, epidemiology, pathogenesis, and diagnostic criteria, in order to improve its early diagnosis and treatment. PMID:26902271

  2. Hepatobiliary scintigraphy in the diagnosis of choledochal cysts in children

    Directory of Open Access Journals (Sweden)

    El Desouki Mahmoud

    1997-01-01

    Full Text Available The objective is to present the usefulness of hepatobiliary scintigraphy in the investigation of children with suspected choledochal cysts through our experience in King Khalid University Hospital at King Saud University, Riyadh. Seven patients aged between I and 10 years (average 4.8 yrs comprising six females and one male were investigated. Laboratory tests, abdominal Ultrasound and/or CT, and cholangiography were performed whenever indicated. Persistent activity in a dilated common bile duct, with or without dilatation of intrahepatic bile ducts, was considered a positive indicator for choledochal cyst disease. Four children with cystic dilatation (type I were diagnosed by hepatobiliary scintigraphy, one saccular (type II, and two cases of Caroli′s disease (type V. The diagnosis of choledochal cyst was proven by surgery with histological confirmation. Visualization of the gallbladder occurred in one case only. The common bile duct was seen in four cases. Late activity in the bowel was noted in two cases.

  3. 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.

  4. Differential diagnosis and treatment of vestibular vertigo

    Directory of Open Access Journals (Sweden)

    Vladimir Anatolyevich Parfenov

    2010-06-01

    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.

  5. 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…

  6. The complexity of ADHD: diagnosis and treatment of the adult patient with comorbidities.

    Science.gov (United States)

    Newcorn, Jeffrey H; Weiss, Margaret; Stein, Mark A

    2007-08-01

    Attention-deficit/hyperactivity disorder (ADHD) is an impairing but usually treatable condition. Popular culture propagates the myth that ADHD recedes with age; this is not the case. Although it is common, problems, and learning disabilities. However, symptoms that result from ADHD, such as mood symptoms or lability, are often mistaken for comorbid disorders. Comorbidity with ADHD impacts treatment compliance, treatment response, and patient insight. Insufficient data on the interaction between ADHD and comorbidities impedes proper diagnosis and treatment. Better clinical tools for assessing these conditions are needed. Food and Drug Administration-approved pharmacologic treatments for adult ADHD include stimulants, dexmethylphenidate, and the nonstimulant atomoxetine. Effect sizes of approved medicines at approved doses are half those seen in children. Adults may also need longer duration of medication effects than children. Short-acting stimulants are likely to result in poorer adherence and have a higher risk for diversion or abuse. Risk of abuse is a major concern; stimulant treatments are controlled substances, and children with ADHD show increased risk of substance abuse. Psychosocial interventions may be beneficial in treating both ADHD and comorbidities.In this expert roundtable supplement, Margaret Weiss, MD, PhD, presents a comprehensive overview of complications surrounding differential diagnosis in adults with ADHD. Next, Mark A. Stein, PhD, reviews evaluation, comorbidity, and development of a treatment plan in this population. Finally, Jeffrey H. Newcorn, MD, provides a discussion on the pharmacologic options available for adults with ADHD, considering dosages specific to adults and common comorbidities. PMID:17667893

  7. Missed opportunities in the diagnosis and management of protein energy malnutrition among children under 5 years in Wakiso district, Uganda

    OpenAIRE

    Akugizibwe, Roselyne; Kasolo, Josephine; Makubuya, Duncan B.; Damani, Ali M.

    2013-01-01

    Protein energy malnutrition (PEM) is one of the leading causes of death among children below 5 years in Uganda. It develops after acute childhood illnesses despite children having received treatment from health facilities. This study assessed knowledge and practices of health workers in the diagnosis and management of PEM, which was used to establish missed opportunities to prevent severe acute malnutrition (SAM) in its management. This was a cross sectional descriptive study that used questi...

  8. Burning mouth syndrome: a review on diagnosis and treatment.

    Science.gov (United States)

    Coculescu, E C; Radu, A; Coculescu, B I

    2014-01-01

    Burning mouth syndrome (BMS) is defined as a chronic pain condition characterized by a burning sensation in the clinically healthy oral mucosa. It is difficult to diagnose BMS because there is a discrepancy between the severity, extensive objective pain felt by the patient and the absence of any clinical changes of the oral mucosa. This review presents some aspects of BMS, including its clinical diagnosis, classification, differential diagnosis, general treatment, evolution and prognosis. PMID:25713611

  9. Ebola in children: epidemiology, clinical features, diagnosis and outcomes.

    Science.gov (United States)

    Olupot-Olupot, Peter

    2015-03-01

    Ebola virus disease is caused by a highly contagious and pathogenic threadlike RNA virus of the Filoviridae family. The index human case is usually a zoonosis that launches human-to-human transmission interface with varying levels of sustainability of the epidemic depending on the level of public health preparedness of the affected country and the Ebola virus strain. The disease affects all age groups in the population. Clinical diagnosis is challenging in index cases especially in the early stages of the disease when the presenting features are usually nonspecific and only similar to a flu-like illness. However, in the agonal stages, hemorrhage frequently occurs in a high proportion of cases. The diagnostic gold standard is by detecting the antigen using reverse transcription-polymerase chain reaction. Mortality rates in the past 28 outbreaks since 1976 have ranged from 30% to 100% in different settings among adults, but lower mortality rates have been documented in children. This review aims to describe Ebola virus infection, clinical presentation, diagnosis and outcomes in children. PMID:25522340

  10. Early Detection, Referral, Investigation, and Diagnosis of Children with Growth Disorders.

    Science.gov (United States)

    Savage, Martin O; Backeljauw, Philippe F; Calzada, Raúl; Cianfarani, Stefano; Dunkel, Leo; Koledova, Ekaterina; Wit, Jan M; Yoo, Han-Wook

    2016-01-01

    Early diagnosis is a key objective in clinical medicine, and early detection of pathological short stature has tangible benefits for growth prognosis and the well-being of the child. Despite late diagnosis being common in growth disorders, programmes of height screening in primary care are not universal in developed countries and may be random or non-existent. A notable exception is automated growth monitoring in Finland, where an algorithm to detect abnormal growth is integrated into children's electronic health records, resulting in increased diagnoses of pathological short stature. Evidence-based anthropometric criteria for referral of short stature to secondary or tertiary care are now published, due largely to excellent studies in the Netherlands. Following referral of the short child, the protocol for laboratory investigations remains somewhat controversial because in healthy children their diagnostic yield can be too low for cost-effectiveness. However, outside of tertiary academic paediatric endocrinology centres, baseline screening tests are considered worthwhile and may speed up diagnosis and treatment. Finally, auxological cut-offs cannot replace good clinical practice, and the understanding that early and effective management depends on commitment to a diagnosis and individualisation of therapy in the short child cannot be overemphasised. PMID:27055026

  11. Diagnosis and treatment of Helicobacter pylori infection

    DEFF Research Database (Denmark)

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

    2011-01-01

    rapid urease test. Proton pump inhibitor therapy should be stopped at least 1 week prior to Hp testing. All infected patients should be offered Hp eradication therapy. First-line treatment is 7-day triple therapy with a proton pump inhibitor and clarithromycine in combination with metronidazole or...... amoxicilline. Quadruple therapy for 2 weeks with bismuthsubsalicylate, tetracycline, metronidazole and a proton pump inhibitor is recommended in case of treatment failure. Hp testing should be offered to all patients after eradication therapy but is mandatory in patients with ulcer disease, noninvasive gastric...... degree relatives to patients with gastric cancer, in NSAID-naive patients, who need long-term NSAID therapy, and in patients presenting with dyspepsia and no alarm symptoms. Non-endoscoped patients can be tested with a urea-breath test or a faecal antigen test. Endoscoped patients can be tested with a...

  12. Depression in Parkinson's disease: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Flavio Henrique de Rezende Costa

    2012-08-01

    Full Text Available The prevalence of non-motor symptoms in Parkinson's disease (PD is high. Depression varies from 20 to 50% of the PD patients, and is associated with increasing disability. The key characteristics of depression are anhedonia and low mood. The recommended scales for screening purposes are: HAM-D, BDI, HADS, MADRS and GDS. As for measurement of severity: HAM-D, MADRS, BDI and SDS. In cases with mild depression, non-pharmacological intervention is the treatment of choice. In moderate depression, antidepressants are required. The choice of an antidepressant should be based mainly on the comorbidities and unique features of the patient. Evidence for antidepressant effectiveness is seen mostly with amitriptyline and nortriptyline, but one should be cautious in elderly patients. Other antidepressants that can be prescribed are: citalopram, escitalopram, sertraline, bupropion, trazodone, venlafaxine, mirtazapine and duloxetin. The dopaminergic agonist pramipexole is a treatment option.

  13. [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). PMID:23091927

  14. Orthopaedic Surgeon Burnout: Diagnosis, Treatment, and Prevention.

    Science.gov (United States)

    Daniels, Alan H; DePasse, J Mason; Kamal, Robin N

    2016-04-01

    Burnout is a syndrome marked by emotional exhaustion, depersonalization, and low job satisfaction. Rates of burnout in orthopaedic surgeons are higher than those in the general population and many other medical subspecialties. Half of all orthopaedic surgeons show symptoms of burnout, with the highest rates reported in residents and orthopaedic department chairpersons. This syndrome is associated with poor outcomes for surgeons, institutions, and patients. Validated instruments exist to objectively diagnose burnout, although family members and colleagues should be aware of early warning signs and risk factors, such as irritability, withdrawal, and failing relationships at work and home. Emerging evidence indicates that mindfulness-based interventions or educational programs combined with meditation may be effective treatment options. Orthopaedic residency programs, departments, and practices should focus on identifying the signs of burnout and implementing prevention and treatment programs that have been shown to mitigate symptoms. PMID:26885712

  15. Diagnosis and treatment of primary spontaneous pneumothorax

    OpenAIRE

    Luh, Shi-ping

    2010-01-01

    Primary spontaneous pneumothorax (PSP) commonly occurs in tall, thin, adolescent men. Though the pathogenesis of PSP has been gradually uncovered, there is still a lack of consensus in the diagnostic approach and treatment strategies for this disorder. Herein, the literature is reviewed concerning mechanisms and personal clinical experience with PSP. The chest computed tomography (CT) has been more commonly used than before to help understand the pathogenesis of PSP and plan further managemen...

  16. Atopic Dermatitis: Natural History, Diagnosis, and Treatment

    OpenAIRE

    Simon Francis Thomsen

    2014-01-01

    Atopic dermatitis is an inflammatory skin disease with early onset and with a lifetime prevalence of approximately 20%. The aetiology of atopic dermatitis is unknown, but the recent discovery of filaggrin mutations holds promise that the progression of atopic dermatitis to asthma in later childhood may be halted. Atopic dermatitis is not always easily manageable and every physician should be familiar with the fundamental aspects of treatment. This paper gives an overview of the natural histor...

  17. Current Diagnosis and Treatment of Anxiety Disorders

    OpenAIRE

    Bystritsky, Alexander; Khalsa, Sahib S.; Cameron, Michael E.; Schiffman, Jason

    2013-01-01

    Anxiety disorders are the most prevalent mental health conditions. Although they are less visible than schizophrenia, depression, and bipolar disorder, they can be just as disabling. The diagnoses of anxiety disorders are being continuously revised. Both dimensional and structural diagnoses have been used in clinical treatment and research, and both methods have been proposed for the new classification in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-5). However, each of t...

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

    OpenAIRE

    Hartman, D.

    1995-01-01

    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...

  19. The role of nanotechnology in cancer treatment and diagnosis

    OpenAIRE

    Teixeira, Vanessa Micaela dos Santos; Silva, Ana Catarina; Lopes, Carla Martins

    2010-01-01

    Cancer treatment is one of the major challenges of modern medicine. Several attempts have been made, in order to find more successful treatments. Nanotechnology can be applied to target drugs to the surface or to the interior of specific cells. In addition, it can also be used in diagnosis and prognosis of diseases. Therefore, nanotechnology opened a new vast exploiting area for cancer treatment. The studies must go on to obtain tailor-made therapies, with low adverse side effe...

  20. Diagnosis and surgical treatment of primary hepatic lymphoma

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To assess the benefi ts and limits of surgery for primary hepatic lymphoma (PHL), and probability of survival after postoperative chemotherapy. METHODS: A retrospective analysis was undertaken to determine the results of surgical treatment of PHL over the past 8 years. Only nine patients underwent such treatment. The detailed data of diagnosis, treatment, and prognosis were carefully studied. RESULTS: All patients were mistaken as having α-fetoprotein-negative hepatic cancer before pathological diagnos...

  1. Toward personalizing treatment for depression: predicting diagnosis and severity

    OpenAIRE

    Huang, Sandy H; LePendu, Paea; Iyer, Srinivasan V.; Tai-Seale, Ming; Carrell, David; Shah, Nigam H

    2014-01-01

    Objective Depression is a prevalent disorder difficult to diagnose and treat. In particular, depressed patients exhibit largely unpredictable responses to treatment. Toward the goal of personalizing treatment for depression, we develop and evaluate computational models that use electronic health record (EHR) data for predicting the diagnosis and severity of depression, and response to treatment. Materials and methods We develop regression-based models for predicting depression, its severity, ...

  2. ATRIAL FLUTTER: CONTEMPORARY POSSIBILITIES OF DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Yu. A. Bunin

    2016-01-01

    Full Text Available Diagnosis and treatment of atrial flutter (AF is an important clinical task. Epidemiological data, electrophysiological mechanisms and updated classification of AF are presented as well as treatment algorithm that is suggested by leading experts. Two strategies of AF therapy are shown: "rhythm control" and "rate control". Author paid attention that ventricular rate reduction in AF is more difficult task than this in atrial fibrillation. Indications for different AF treatments are discussed: pharmacotherapy, pacing and cardioversion as well as surgical methods.

  3. Chylous ascites: diagnosis, causes and treatment.

    Science.gov (United States)

    Laterre, P F; Dugernier, T; Reynaert, M S

    2000-01-01

    Chylous ascites is a rare form of ascites and generally associated with a poor outcome since it is often secondary to neoplasms. Its true incidence is not well established in the general medico-surgical population. Any source of lymph vessels obstruction or leakage can potentially cause chylous effusions in the peritoneal or retroperitoneal cavities. Any type of cancer and lymph node involvement may be associated with this uncommon type of ascites. Traumatic, and mainly surgical, vessels leakage is the second most common source of chylous effusions. Other even more rare underlying conditions have been described as leading to chyloperitoneum. Large fluid volume losses together with proteins, and lymphocytes can induce additional morbidity in a previously debilitated population or severely ill patients. This includes organ dysfunction related to volume and electrolytes losses, but mainly secondary infections due to impaired immunity by antibodies and lymphocytes depletion. Even if a vast majority of chylous effusions shall heal spontaneously, early and full treatment has to be initiated in order to reduce morbidity and mortality associated with this condition. Adapted oral diet is to be introduced to reduce lymph flow. Low lipid, high medium-chain triglycerides alimentation is the first measure to implement. Total parenteral nutrition is to be reserved to failures of oral diet. In addition, paracentesis is indicated to improve patient comfort, reduce intra-adbominal pressure and secondary renal dysfunction. Somatostatin analogues have been demonstrated to be effective in reducing lymphorragia and may be proposed prior to consider the surgical approach. Direct lymph vessels ligation can be indicated for large lymph vessels leakage demonstrated by radiologic techniques and when medical treatment has failed. Peritoneo-venous shunt becomes a less common technique in refractory chylous effusion because of its high morbidity. Herein, the other causes of chylous effusions

  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...

  5. Post-traumatic stress disorder diagnosis in children: challenges and promises

    OpenAIRE

    Cohen, Judith A.; Scheeringa, Michael S.

    2009-01-01

    Children and adolescents experience high rates of potentially traumatic experiences. Many children subsequently develop mental health problems, including post-traumatic stress disorder (PTSD) symptoms. Accurately diagnosing PTSD in children is challenging. This paper reviews the following important issues: (i) the specificity of the PTSD diagnosis; (ii) children who are symptomatic and impaired but do not have enough symptoms for the diagnosis of PTSD; (iii) developmental considerations for p...

  6. Characteristics of Children Who Lost the Diagnosis of Autism: A Sample from Istanbul, Turkey

    OpenAIRE

    Nahit Motavalli Mukaddes; Mustafa Deniz Tutkunkardas; Oktay Sari; Aydan Aydin; Pınar Kozanoglu

    2014-01-01

    Aim. The aim of this study was to describe a group of children who lost a diagnosis of autism following participation in early educational programs. Method. This is a descriptive study reporting the characteristics of children (n: 39) who lost their diagnosis of autism and explaining the educational programs that these children followed. The data were collected by reviewing the participants' files and through examinations. Results. All of the children were placed at regular psychiatric follow...

  7. Treatment of diabetes in children

    OpenAIRE

    GAO, YI-QING; Gao, Min; Xue, Ying

    2016-01-01

    Type 1 diabetes mellitus (T1D) and type 2 diabetes (T2D) mellitus are on the increase in children and adolescents. An increase in T2D is linked to the increasing rates of obesity in children. Usually, in both children and adults, T1D is treated with insulin while T2D is treated with metformin. There are other classes of drugs that are under assessment for their safety and efficacy in relation to pediatric patients. Most of these new drugs, however, have not been studied in children. Thus, the...

  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. Stress ulcers - Cushing ulcers: diagnosis, treatment, prevention

    Directory of Open Access Journals (Sweden)

    R. Şcerbina

    2012-11-01

    Full Text Available BACKGROUND: Cushing ulcers appear at the 3rd to 5th day after stress situations accompanied with hemorrhage in 5-10%, perforations in 4%. METHODS: Between 2007-2011 in the National Scientific and Practical Center for Emergency Medicine Kishinev, 1917 patients with superior gastric hemorrhages were treated, from which 139 in ICU. RESULTS: In 45 cases were diagnosed Cushing ulcers: men – 30, women – 15 with age between 21 years and 87 years. The disease causes were: cerebral vascular diseases 13(28.8%; fractures with hip replacement – 16 (35.5%; chronic renal insufficiency and septic states - 3 (12.32%; severe head trauma – 10 (22.2%. The mortality rate was 22.2% (10 patients. Gastroscopy revealed hemorrhages followed by endoscopic hemostasis. For the prophylaxis of hemorrhage relapse all patients underwent repeated endoscopic hemostasis 2 to 3 times. One patient was operated for a perforated bulbar Cushing ulcer and another one due to Forrest IA hemorrhage that didn’t respond to endoscopic hemostasis – Bilroth I antrum resection. Both patients died due to multiple organ dysfunction syndrome (MODS. Patients with Cushing ulcers received anti-ulcer treatment: PPI, H2 blockers in maximum dosages, hemostatic and repeated blood plasma transfusions. CONCLUSIONS: Gastroscopy is obligatory in all patients with severe head trauma, septic states, chronic renal insufficiency and severe cerebral vascular diseases. Anti-ulcer and hemostatic treatment insures ulcer healing and scarring in most of the cases.

  10. Reactive arthritis: advances in diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    A. Petricca

    2011-09-01

    Full Text Available Reactive Arthritis (ReA is an aseptic synovitis developing after a primary infection distant from the joint, mainly localized in the gastrointestinal (Enteroarthritis or genitourinary tract (Uroarthritis. Because of either the asymmetric joint involvement, the possibility of involvement of the spine and enthesis, and the HLA-B27 association ReA is considered one of the spondylarthropathies. Recently, bacterial components or viable bacteria were found in joints during ReA. For this reason, the limits between ReA itself and infectious arthritis are now less definite. Generally accepted diagnostic and classification criteria are still lacking but the improvement in techniques for detection of bacteria increase the possibility to identify the triggering agents. Several studies have examined the role of antimicrobial drugs in ameliorating the natural course of ReA, with some positive results for Uroarthritis only. However, more conventional treatments based on NSAIDs, Sulfasalazine and steroids are effective in many cases.

  11. 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.

  12. [Depressive syndrome in gastroenterology: diagnosis and treatment].

    Science.gov (United States)

    Tsimmerman, Ia S; Tsimmerman, I Ia

    2007-01-01

    The article presents modern data on depressive syndrome, its prevalence and possible reasons for its growth, the role of psychoemotional stress in the development of anxiety depression (AD), as well as psychosomatic diseases and syndromes and modern views on the mechanisms of their formation. The authors discuss methods of revealing and diagnostic criteria of AD and psychosomatic diseases, including those that develop against the background of masked depression. Associations between depressive syndrome and the development of gastroenterological diseases and psychosomatic syndromes such as peptic ulcer, functional dyspepsia, irritated bowel syndromes, chronic cholecystitis, and chronic duodenal obstruction syndrome are discussed in detail. Special attention is paid to treatment of AD in gastroenterological patients using psycho- and hypnotherapy as well as psychotropic drugs such as antidepressives, anxiolytics, neuroleptics, and nootropic agents. PMID:17665598

  13. Parents’ views on growth hormone treatment for their children: psychosocial issues

    OpenAIRE

    van Dongen, Nadine; Kaptein, Ad A

    2012-01-01

    Background We evaluated the opinions of parents in The Netherlands concerning treatment of their children with growth hormone, and examined beliefs and perceptions about treatment and quality of health care communication and support. Methods An Internet survey was completed by 69 parents who had children prescribed growth hormone and were part of the Patient Intelligence Panel. Acceptance of the diagnosis and treatment was investigated with reference to four topics, ie, search and quality of ...

  14. Influenza diagnosis and treatment: a view from clinical practice.

    Science.gov (United States)

    Fleming, D M

    2001-12-29

    Influenza is a descriptive term for respiratory epidemic disease presenting with cough and fever. Influenza viruses are probably the most important of the pathogens that cause this condition. Clinical influenza occurs almost every winter in England and Wales and the outbreaks last 8-10 weeks. In recent years, influenza B virus outbreaks have occurred in January and February, whereas influenza H3N2 virus outbreaks have generally started long before Christmas. Influenza H3N2 virus outbreaks pressurize health service resources in winter more than influenza B viruses, that do not have the same impact in elderly people. Infections with influenza H1N1 viruses are also usually less severe in their impact than those with influenza H3N2 viruses, but, unlike influenza B viruses, influenza H1N1 viruses have a pandemic potential along with influenza H3N2 viruses. A diagnosis of respiratory infection in primary care is based on the presenting symptoms set within the context of the current pattern of consultations of patients with similar illness. Measurement of temperature, inspection of the throat and examination of the chest or ears add a little to the diagnostic process, but in general these procedures do not help in identifying the organism. However, if it is known that influenza viruses are circulating in the community, the probability of influenza as the cause is greatly increased, as was shown in clinical trials of neuraminidase antivirals. Maximum confusion occurs when respiratory syncytial virus (RSV) and influenza cocirculate. Although RSV infection can occur throughout the winter in young children, it assumes more of an epidemic character just before Christmas in children and possibly in adults just after. During seven of the last 20 winters, influenza has been prevalent around Christmas/New Year. In routine virological surveillance of influenza-like illness in the community during the winters of 1997, 1998 and 1999, ca. 30% of swab specimens yielded influenza

  15. 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.

  16. Diagnosis and treatment of portal hypertension in children (Part II: treatment) Diagnóstico y tratamiento de la hipertensión portal en el niño (Parte II - Tratamiento).

    OpenAIRE

    Ramón Villamil Martínez; Luis Marcano Sanz; Yanet Hidalgo Marrero; Rafael Trinchet Soler

    2005-01-01

    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 meth...

  17. Dental Treatment Needs of Children with Disabilities

    OpenAIRE

    Ajami, Behjat Almolook; Shabzendedar, Mahboobeh; Rezay, Yar Ali; Asgary, Mohammad

    2007-01-01

    Background and aims Children and adolescents with disabilities appear to have poorer oral health than their non-disabled counterparts. The aim of this study was to assess the frequency and severity of oral diseases and treatment needs using world health organization criteria of caries, periodontal disease and malocclusions in a selected population of children with disabilities in Mashhad, Iran. Materials and methods A randomized study on 1621 children aged 5-16 was conducted in 13 special sch...

  18. Integrating treatment strategies for children with autism

    OpenAIRE

    Jobin, Allison Brooke

    2012-01-01

    Treatment studies indicate that substantial gains may be achieved by some children with autism spectrum disorders (ASD) when behavioral treatment is provided at an early age (National Autism Center, 2009; Vismara & Rogers, 2010). However, heterogeneity of treatment response is common to all evidence-based approaches (Delmolino & Harris, 2012; Sherer & Schreibman, 2005). Currently, no treatment completely ameliorates the symptoms of ASD and no specific treatment has emerged as the established ...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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......-tailored one-on-one information. IMPLICATIONS FOR PRACTICE: This article contributes to the knowledge base of support needs of lung cancer patients. Interventions aimed at supportive care during the period between diagnosis and surgical intervention should be researched....

  20. 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.

  1. 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.

  2. [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. PMID:26820213

  3. Iron deficiency: from diagnosis to treatment.

    Science.gov (United States)

    Polin, Vanessa; Coriat, Romain; Perkins, Géraldine; Dhooge, Marion; Abitbol, Vered; Leblanc, Sarah; Prat, Frédéric; Chaussade, Stanislas

    2013-10-01

    Iron deficiency is the most frequent cause of anaemia worldwide. It impairs quality of life, increases asthenia and can lead to clinical worsening of patients. In addition, iron deficiency has a complex mechanism whose pathologic pathway is recently becoming better understood. The discovery of hepcidin has allowed a better clarification of iron metabolism regulation. Furthermore, the ratio of concentration of soluble transferrin receptor to the log of the ferritin level, has been developed as a tool to detect iron deficiency in most situations. The cause of iron deficiency should always be sought because the underlying condition can be serious. This review will summarize the current knowledge regarding diagnostic algorithms for iron deficiency anaemia. The majority of aetiologies occur in the digestive tract, in men and postmenopausal women, and justify morphological examination of the gut. First line investigations are upper gastrointestinal endoscopy and colonoscopy, and when negative, the small bowel should be explored; newer tools such as video capsule endoscopy have also been developed. The treatment of iron deficiency is aetiological if possible and iron supplementation whether in oral or in parenteral form. New parenteral formulations are available and seem to have promising results in terms of efficacy and safety. PMID:23582772

  4. The Diagnosis and Treatment of Joplin's Neuroma.

    Science.gov (United States)

    Melendez, Mark M; Patel, Anup; Dellon, A Lee

    2016-01-01

    Joplin's neuroma is a rare perineurial fibrosis of the medial plantar digital proper nerve arising from various etiologies but most commonly after bunion surgery. Treatment for this painful great toe problem remains controversial. It is our purpose to describe our experience with this chronic pain problem, considering it to be a neuroma requiring resection. A retrospective medical record review of 8 patients with medial hallux pain related to the digital nerve was performed. Each patient had failed to respond to >6 months of nonoperative therapy. At surgery, the medial digital nerve to the hallux was identified distally, the neuroma was resected distally, and the proximal end of the nerve was implanted into the arch of the foot in 7 (87.5%) of the 8 patients. At a mean follow-up of 25 (range 13 to 43) months, 6 results (75%) were excellent, 1 (12.5%) was good, and 1 (12.5%) was fair. The 1 fair result was in the only patient in whom the distal end of the divided nerve was not implanted proximally, according to the patient's request. In conclusion, surgical resection of the medial plantar nerve to the hallux with implantation of the proximal end of the nerve into the arch of the foot, can be expected to result in good to excellent relief of pain in 80% of the patients. PMID:25488599

  5. Diagnosis and surgical treatment of retroperitoneal tumours.

    Science.gov (United States)

    Testini, M; Catalano, G; Macarini, L; Paccione, F

    1996-01-01

    The authors examine the various techniques for diagnosing Retroperitoneal Tumours (RPT) and analyse the results of the surgical treatment performed. Between March 1987 and February 1991, 20 patients with RPT (6 benign and 14 malignant forms) were observed in our Institution. CT and NMR revealed more diagnostic accuracy than other techniques (100%), while NMR had greater accuracy than CT in predictly resectability preoperatively (100% vs. 80.0%, respectively). A total of 26 laparotomies were performed: 20 for primary neoplasms and 6 for recurrent tumours. Exeresis of the mass was performed in 18/20 (90%) patients. Mean follow-up was 57.6 months (84-36). The benign forms had no recurrence. In malignant cases the disease recurred in 58.3% of the cases after an interval varying from 10 to 59 months. Overall mean survival of the 12 patients with malignant tumours subjected to resection was 58.3%. The 1- and 3-year survival rates were 91.7% and 58.3% respectively. Prognosis in malignant RPT is still very poor. PMID:8803715

  6. Childhood opsoclonus-myoclonus syndrome: diagnosis and treatment.

    Science.gov (United States)

    Blaes, Franz; Dharmalingam, Backialakshmi

    2016-06-01

    Opsoclonus-myoclonus syndrome (OMS) is a rare and primarily immune-mediated disease in children and adults. The main symptoms include opsoclonus, myoclonus and ataxia. In children, the symptoms also include irritability, and, over a long-term course, learning and behavioural disturbances. OMS can be idiopathic, parainfectious or occur as a paraneoplastic (tumour-associated) syndrome. Paraneoplastic OMS in children is almost exclusively associated with neuroblastoma, whereas in adults, small cell lung cancer and breast cancer are the main underlying tumours. An autoimmune pathophysiology is suspected because childhood OMS patients have functionally active autoantibodies, proinflammatory changes in the cytokine network and immunotherapy responses. Children appear to respond regularly to immunosuppressive treatment. However, although the neurological symptoms show a good response, most children continue to show neuropsychological disturbances. PMID:27095464

  7. 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 ...

  8. Vitamin D status is insufficient in the majority of children at diagnosis of nephrotic syndrome

    DEFF Research Database (Denmark)

    Nielsen, Cecilie Ane; Jensen, Jens-Erik Bech; Cortes, Dina

    2015-01-01

    time of their diagnosis before treatment with glucocorticoids. The following plasma levels were measured: 25-hydroxy-vitamin-D (25(OH)D), albumin, ionised calcium, phosphate, parathyroid hormone (PTH), alkaline phosphatase and creatinine. The glomerular filtration rate (GFR) was estimated from the...... Schwartz formula, and only patients with normal values were included. RESULTS: A total of 14 children were examined, 13 (93%) had 25(OH)D deficiency including 12 (86%) with moderate or severe vitamin D deficiency. The plasma 25(OH)D was positively associated with plasma albumin (p = 0.031) and negatively...

  9. Sportsman hernia; the review of current diagnosis and treatment modalities.

    Science.gov (United States)

    Paksoy, Melih; Sekmen, Ümit

    2016-01-01

    Groin pain is an important clinical entity that may affect a sportsman's active sports life. Sportsman's hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman's hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman's hernia at our hospital between 2011-2014, in light of current literature. PMID:27436937

  10. Treatment for Constipation in Children

    Science.gov (United States)

    ... using a reward system when children use the bathroom regularly taking a break from potty training until ... Once a child has better eating and bowel habits, the doctor will recommend stopping the laxative. If ...

  11. Urinary Tract Infections in Pregnancy - Diagnosis, Treatment and Prevention

    OpenAIRE

    Figueiredo, A; Gomes, G; Campos, A.

    2012-01-01

    Objectives: Literature review of classification, epidemiology, pathophysiology, microbiology, clinical presentation, diagnosis, complications, treatment and prevention of urinary tract infections (UTI) in pregnancy. Data Sources and Review Methods: Bibliographic research in Medline, through PubMed and Medscape, of systematic reviews, observational studies, clinical guidelines, meta-analyses and randomized controlled trials published between January 1992 and December 2010. Results: Asymp...

  12. Depression Screening, Diagnosis, and Treatment Across the Lifespan.

    Science.gov (United States)

    Cozine, Elizabeth W; Wilkinson, John M

    2016-06-01

    This article focuses on six basic components of more effective depression care, emphasizing systems of team-based and collaborative care for diagnosis, monitoring, and follow-up. It also emphasizes the principles of stepped care and proactive and timely intensification of treatment, and discusses various augmentation strategies that all primary care providers could more readily employ. PMID:27262004

  13. Barrett’s esophagus: review of diagnosis and treatment

    OpenAIRE

    Sappati Biyyani, Raja Shekhar; Chak, Amithab

    2013-01-01

    Barrett's esophagus (BE) is an acquired condition characterized by replacement of stratified squamous epithelium by a cancer predisposing metaplastic columnar epithelium. Endoscopy with systemic biopsy protocols plays a vital role in diagnosis. Technological advancements in dysplasia detection improves outcomes in surveillance and treatment of patients with BE and dysplasia. These advances in endoscopic technology radically changed the treatment for dysplastic BE and early cancer from being s...

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. Hepatic adenoma and focal nodular hyperplasia: differential diagnosis and treatment.

    Science.gov (United States)

    Herman, P; Pugliese, V; Machado, M A; Montagnini, A L; Salem, M Z; Bacchella, T; D'Albuquerque, L A; Saad, W A; Machado, M C; Pinotti, H W

    2000-03-01

    The diagnosis of benign hepatic tumors as hepatic adenoma (HA) and focal nodular hyperplasia (FNH) remains a challenge for clinicians and surgeons. The importance of differentiating between these lesions is based on the fact that HA must be surgically resected and FNH can be only observed. A series of 23 female patients with benign liver tumors (13 FNH, 10 HA) were evaluated, and a radiologic diagnostic algorithm was employed with the aim of establishing preoperative criteria for the differential diagnosis. All patients were submitted to surgical biopsy or hepatic resection to confirm the diagnosis. Based only on clinical and laboratory data, distinction was not possible. According to the investigative algorithm, the diagnosis was correct in 82.6% of the cases; but even with the development of imaging methods, which were used in combination, the differentiation was not possible in four patients. For FNH cases scintigraphy presented a sensitivity of 38.4% and specificity of 100%, whereas for HA the sensitivity reached 60% and specificity 85.7%. Magnetic resonance imaging, employed when scintigraphic findings were not typical, presented sensitivities of 71.4% and 80% and specificities of 100% and 100% for FNH and HA, respectively. Preoperative diagnosis of FNH was possible in 10 of 13 (76.9%) patients and was confirmed by histology in all of them. In one case, FNH was misdiagnosed as HA. The diagnosis of HA was possible in 9 of 10 (90%) adenoma cases. Surgical biopsy remains the best method for the differential diagnosis between HA and FNH and must be performed in all doubtful cases. Surgical resection is the treatment of choice for all patients with adenoma and can be performed safely. With the evolution of imaging methods it seems that the preoperative diagnosis of FNH may be considered reliable, thereby avoiding unnecessary surgical resection. PMID:10658075

  20. Diagnosis and treatment of portal hypertension in children (Part II: treatment Diagnóstico y tratamiento de la hipertensión portal en el niño (Parte II - Tratamiento.

    Directory of Open Access Journals (Sweden)

    Ramón Villamil Martínez

    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.
    La hipertensión portal es el síndrome clínico caracterizado por el aumento de la presión en el sistema de drenaje venoso portal del aparato digestivo. Indudablemente las hemorragias digestivas altas debidas a várices esofagogástricas, gastritis erosivas y úlceras pépticas constituyen el reto más difícil y peligroso para médicos y pacientes. Aunque la mayoría de los pacientes son tratados de forma ";conservadora";, el tratamiento quirúrgico realizado correctamente en pacientes escogidos según los protocolos actuales de manejo de la enfermedad es el método más eficaz para disminuir la presión portal definitivamente y puede ser realizado en más del 88 % de los pacientes incluso menores de 2 años con una mortalidad electiva cercana a 0 % en algunos países. Se presenta la segunda parte de la Guía de Buenas Prácticas Clínicas para Hipertensión portal (tratamiento, aprobada por consenso en el 1er Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Cienfuegos, 7 al 9 de marzo del 2002

  1. Method of diagnosis of chronic non-specific diseases of lungs in children

    International Nuclear Information System (INIS)

    Method of diagnosis of chronic nonspecific diseases of lungs in children using bronchography and arteriography is suggested to improve diagnosis accuracy. The method lies in simultaneous contrasting of all bronchial arteries of both lungs. The suggested method of diagnosis enabled to obtain data on pathology of bronchial arteries and bronchial structurs, to reveal additional information about propogation and character of pathologic process

  2. Constraints in the diagnosis and treatment of Lassa Fever and the effect on mortality in hospitalized children and women with obstetric conditions in a rural district hospital in Sierra Leone

    Science.gov (United States)

    Dahmane, A.; van Griensven, J.; Van Herp, M.; Van den Bergh, R.; Nzomukunda, Y.; Prior, J.; Alders, P.; Jambai, A.; Zachariah, R.

    2014-01-01

    Background Lassa fever (LF) is an acute viral haemorrhagic infection, endemic in West Africa. Confirmatory diagnosis and treatment (ribavirin) is difficult, expensive, and restricted to specialised hospitals. Among confirmed and suspected LF cases, we report on clinical and laboratory features, timing and administration of ribavirin and the relationship with case fatality. Methods We conducted an audit of patient files of suspected LF cases admitted to a pediatric and obstetric referral hospital in rural Sierra Leone (April 2011 to February 2012). Results There were 84 suspected LF cases; 36 (43%) were laboratory-confirmed cases, of whom only 20 (56%) received ribavirin after a median duration of eight days (IQR 314 days) of hospital admission. Of 16 patients who did not receive ribavirin, 14 (87%) died before ribavirin treatment could be commenced. Starting ribavirin within six days of admission was associated with a case fatality of 29% (2/7), while starting ribavirin later than six days was associated with a case fatality of 50% (6/12). Among the 48 suspected LF cases without laboratory confirmation, there were 21 (44%) deaths. Conclusions These findings highlight shortcomings in LF management, including diagnostic and treatment delays. More research and development efforts should be devoted to this ‘neglected disease’. PMID:24535150

  3. Infected cardiac-implantable electronic devices: prevention, diagnosis, and treatment.

    Science.gov (United States)

    Nielsen, Jens Cosedis; Gerdes, Jens Christian; Varma, Niraj

    2015-10-01

    Cardiac implantable electronic device (CIED) infection, according to current trends, appears to be an increasing problem. It can be indolent and its diagnosis challenging. Cardiac implantable electronic device infections are potentially lethal, and timely diagnosis and early initiation of correct treatment are of highest importance for patient prognosis. For reducing CIED infections, careful patient selection, preventative measures, and appropriate choice of device are key. The current review presents available data and consensus opinion within the field of CIED infection and identifies important current practice points and aspects for future development. Strategies for reducing CIED infection should be tested in sufficiently powered and well-designed multicentre randomized controlled trials. PMID:25749852

  4. 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.

  5. Prostate Cancer: Symptoms, Diagnosis and Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... this page please turn Javascript on. Feature: Prostate Cancer Prostate Cancer: Symptoms, Diagnosis and Treatment Past Issues / Winter 2010 ... only way to confirm a diagnosis of prostate cancer. Treatment Prostate cancer treatment depends on how serious the cancer ...

  6. Diagnosis and treatment of cervico-omo-brachialgia

    International Nuclear Information System (INIS)

    Described is the importance of exact diagnosis by complaint, physical and imaging findings, and of effective conservative or open surgical treatment in cervico-omo-branchialgia (COB). COB derives from diseases at cervical vertebra, thoracic outlet, upper limb and others. Imaging in the diagnosis involves the flat plate roentgenography, and MRI for lesions in the cervical vertebra, disk, vertebral canal, spinal cord, nerve root tube and muscle to evaluate hernia, tumor, infection, fracture, pressures of nerve root and spinal cord. CT is excellent for bony lesions of the cervical vertebra and ligament. Treatment with nerve block is done usually under X-ray fluoroscopy. Conservative treatment is usual and evaluation is important in its process not to miss the surgical timing. (R.T.)

  7. 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

  8. Implications of Resolving the Diagnosis of PKU for Parents and Children

    OpenAIRE

    Lord, Bruce; Ungerer, Judy; Wastell, Colin

    2008-01-01

    Objective To examine resolution of the diagnosis among parents of children with phenylketonuria (PKU) as a mechanism of adjustment for parents and children. Methods Reaction to diagnosis interviews were conducted with 52 mothers and 47 fathers of 55 children with PKU aged 2–12 years. The parents also completed questionnaires assessing their personal adjustment (stress symptoms), their child's adjustment (behavior problems), and coping variables (personal hopefulness and coping strategies). Re...

  9. [Chemotherapy-induced peripheral neuropathy: characteristics, diagnosis and treatment].

    Science.gov (United States)

    Istenes, Ildikó; Nagy, Zsolt; Demeter, Judit

    2016-06-01

    Longer remissions and better overall survival rates can be achieved with the introduction of new, effective treatments and targeted therapies in the past 1-2 decades, however, the incidence of side effects is also increasing parallelly. Chemotherapy-induced peripheral neuropathy (CIPN) is a common and potentially debilitating side effect due to peripheral somatic or autonomic nerve dysfunction. CIPN becomes increasingly important, as it affects patients' quality of life, and it is very often a dose limiting factor with the potential for reduced treatment efficacy. The pathomechanism, diagnosis, prevention and treatment possibilities are described in this review with special attention to the different groups of drugs. PMID:27275643

  10. Treatment for Sexually Abused Children and Adolescents.

    Science.gov (United States)

    Saywitz, Karen J.; Mannarino, Anthony P.; Berliner, Lucy; Cohen, Judith A.

    2000-01-01

    Reviews research demonstrating the variable effects of childhood sexual abuse, need for intervention, and effectiveness of available treatment. Proposes extending and modifying treatment from mainstream clinical child psychology to sexually abused children. Interventions range from psychoeducation and screening, to short-term, abuse-focused…

  11. 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). PMID:26541535

  12. 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...

  13. 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. PMID:25443793

  14. Diagnosis and treatment of pancreatic cancer. Oncology overview

    International Nuclear Information System (INIS)

    Oncology Overviews are a service of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute, intended to facilitate and promote the exchange of information between cancer scientists by keeping them aware of literature related to their research being published by other laboratories throughout the world. Each Oncology Overview represents a survey of the literature associated with a selected area of cancer research. It contains abstracts of articles which have been selected and organized by researchers associated with the field. Contents: Radiological diagnosis of pancreatic cancer; Biopsy and cytology in the diagnosis of pancreatic cancer; Pathology and morphology of pancreatic cancer; Staging and prognosis of pancreatic cancer; Biological and immunological markers in the diagnosis of pancreatic cancer; Surgical treatment of pancreatic cancer; Drug therapy of pancreatic cancer; Radiation therapy of pancreatic cancer; Selected studies on the epidemiology of pancreatic cancer; Clinical correlates and syndromes associated with pancreatic neoplasia

  15. 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.

  16. EANO guidelines for the diagnosis and treatment of meningiomas.

    Science.gov (United States)

    Goldbrunner, Roland; Minniti, Giuseppe; Preusser, Matthias; Jenkinson, Michael D; Sallabanda, Kita; Houdart, Emmanuel; von Deimling, Andreas; Stavrinou, Pantelis; Lefranc, Florence; Lund-Johansen, Morten; Moyal, Elizabeth Cohen-Jonathan; Brandsma, Dieta; Henriksson, Roger; Soffietti, Riccardo; Weller, Michael

    2016-09-01

    Although meningiomas are the most common intracranial tumours, the level of evidence to provide recommendations for the diagnosis and treatment of meningiomas is low compared with other tumours such as high-grade gliomas. The meningioma task force of the European Association of Neuro-Oncology (EANO) assessed the scientific literature and composed a framework of the best possible evidence-based recommendations for health professionals. The provisional diagnosis of meningioma is mainly made by MRI. Definitive diagnosis, including histological classification, grading, and molecular profiling, requires a surgical procedure to obtain tumour tissue. Therefore, in many elderly patients, observation is the best therapeutic option. If therapy is deemed necessary, the standard treatment is gross total surgical resection including the involved dura. As an alternative, radiosurgery can be done for small tumours, or fractionated radiotherapy in large or previously treated tumours. Treatment concepts combining surgery and radiosurgery or fractionated radiotherapy, which enable treatment of the complete tumour volume with low morbidity, are being developed. Pharmacotherapy for meningiomas has remained largely experimental. However, antiangiogenic drugs, peptide receptor radionuclide therapy, and targeted agents are promising candidates for future pharmacological approaches to treat refractory meningiomas across all WHO grades. PMID:27599143

  17. [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. PMID:25314041

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... test results, but the impact decreased over time. In several but not all studies, CIN appeared to have similar psychological consequences to abnormal smears. No study showed a difference in psychological outcomes between CIN and cervical cancer diagnosis when these were measured some years after......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 of...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    test results, but the impact decreased over time. In several but not all studies, CIN appeared to have similar psychological consequences to abnormal smears. No study showed a difference in psychological outcomes between CIN and cervical cancer diagnosis when these were measured some years after......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...

  20. Incidence, diagnosis and treatment of children's congenital abnormalities of the kidney and urinary tract detected in ultrasound screening%超声筛查26989名儿童中先天性肾脏和尿路畸形的临床分析

    Institute of Scientific and Technical Information of China (English)

    张斌; 王辉; 孙宁; 贾立群; 沈颖

    2011-01-01

    目的 了解泌尿系超声筛查儿童先天性肾脏和尿路畸形(CAKUT)的发生率及其中各种畸形的发病诊疗情况,探讨超声在筛查诊断儿童CAKUT的重要性.方法 对2008年底北京儿童医院超声筛查26 989名儿童发现的489例儿童泌尿系异常病例进行随访,核实是否进一步明确筛查发现的泌尿系异常情况,对于未复查或者仍未确诊者统一者安排到北京儿童医院复查超声,进行总结分析.结果 ①本次筛查中(26 989例)估算CAKUT发生率约为1.67%,绝大部分无临床表现.②489例病例中随访到320例,失访169例,随访组(320例)中明确CAKUT 295例,其中16例确诊结果与超声筛查结果不完全一致.③肾积水137例(0.78%),输尿管膀胱连接部梗阻33例(0.19%),肾发育不良30例(0.17%),肾囊肿26例(0.15%);重复肾24例(0.14%);孤立肾22例(0.12%);输尿管囊肿16例(0.09%);融合肾10例(0.06%);肾发育不全9例(0.05%);异位肾5例(0.03%);多囊肾3例(0.02%);原发膀胱输尿管反流、后尿道瓣膜、肾旋转不良、分支肾盂、肾外型肾盂各1例.④114例畸形病例需手术治疗,占随访组中CAKUT患儿的38.6%(114/295),只有1例肾盂输尿管连接部梗阻病例手术失败.结论 儿童CAKUT的发生率较高,且早期并无明显临床表现而不易发现;超过三分之一的CAKUT需要外科干预;超声检查对发现儿童CAKUT具有明显优势,是筛查的首选方法,可以作为儿童的常规体检项目.%Objective To investigate the proportion of children with congenital abnormalities of the kidney and urinary tract(CAKUT)among those who received screening,analyze the rate, diagnosis and treatment of each abnormality, and evaluate the value of ultrasonogrphy in the CAKUT diagnosis.Method Totally 489 of 26 989 children who received screening for urinary tract abnormalities were found to have CAKUT and were followed up by telephone interviews and were asked whether they had defined diagnosis of CAKUT, had

  1. A Multimodal Approach for Clinical Diagnosis and Treatment

    OpenAIRE

    Ahmed, Mobyen Uddin

    2011-01-01

    A computer-aided Clinical Decision Support System (CDSS) for diagnosis and treatment often plays a vital role and brings essential benefits for clinicians. Such a CDSS could function as an expert for a less experienced clinician or as a second option/opinion of an experienced clinician to their decision making task. Nevertheless, it has been a real challenge to design and develop such a functional system where accuracy of the system performance is an important issue. This research work focuse...

  2. 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...

  3. Advances in Diagnosis and Treatment of Fetal Alcohol Spectrum Disorders

    OpenAIRE

    Murawski, Nathen J.; Moore, Eileen M.; Thomas, Jennifer D.; Riley, Edward P.

    2015-01-01

    Prenatal alcohol exposure can cause a number of physical, behavioral, cognitive, and neural impairments, collectively known as fetal alcohol spectrum disorders (FASD). This article examines basic research that has been or could be translated into practical applications for the diagnosis or treatment of FASD. Diagnosing FASD continues to be a challenge, but advances are being made at both basic science and clinical levels. These include identification of biomarkers, recognition of subtle facia...

  4. The importance of early diagnosis and treatment of developmental dysplasia of the hips.

    Science.gov (United States)

    Dziewulski, M; Dziewulski, W; Barcińska-Wierzejska, I

    2001-01-01

    The primary purpose of this article is to draw closer attention to a particularly important orthopedic problem: the prevention and early treatment of Developemental Displasia of the Hip (DDH) in children, using ultrasonography (USG) as the main diagnostic method. The article presents clinical material collected over a period of several years in the Children's Orthopedic Outpatient Clinic at the County Pediatric Hospital in Toruń. The material covers a period of six years (1994-1999), but the experience of this clinic in the area of DDH dates back many years. The entire system of complex diagnosis, prevention, and treatment of dysplasis hip joints in children will be presented in the light of Polish realities. The authors' intention is to portray the rich potential of USG technology in the diagnosis of DDH, to demonstrate its effectiveness, and to promote the use of this method among orthopedic surgeons and pediatricians, who may have differing opinions concerning its actual value. The problem of the early prevention of DDH is an interdisciplinary one, involving first neonatologists and obstetricians, later pediatricians, orthopedic surgeons, and even primary care physicians whose practice includes infants. This issue has been the subject of many national and international conferences, congresses and symposia. PMID:17984920

  5. Asma em menores de cinco anos: dificuldades no diagnóstico e na prescrição da corticoterapia inalatória Asthma in children under five years of age: problems in diagnosis and in inhaled corticosteroid treatment

    Directory of Open Access Journals (Sweden)

    Maria Jussara Fernandes Fontes

    2005-06-01

    Full Text Available O objetivo deste trabalho foi fazer um levantamento bibliográfico focalizando as dificuldades para se diagnosticar a asma e se estabelecer o início da corticoterapia inalatória em menores de cinco anos. As fontes pesquisadas foram as bases de dados LILACS e MEDLINE, no período de 1991 a 2002, em português, espanhol e inglês. A asma, doença crônica mais comum na infância, apresenta o início dos sintomas nos primeiros anos de vida em grande percentagem dos casos. Na atualidade, não existem meios propedêuticos disponíveis rotineiramente que permitam estabelecer com certeza o diagnóstico em menores de cinco anos. De acordo com as manifestações clínicas, lactentes e pré-escolares podem demandar tratamento semelhante ao da asma desde que precedido por avaliação clínica criteriosa. Conclui-se que o diagnóstico da asma nos primeiros anos de vida é complexo e eminentemente clínico. A corticoterapia inalatória constitui recurso eficaz, mas exige ponderação dos riscos e benefícios.The objective of this study was to review the literature, focusing on difficulties encountered in asthma diagnosis and in the establishment of initial inhaled corticosteroid treatment in children under five years of age. The search was limited to studies published between 1991 and 2002 in Portuguese, Spanish, or English and included in the LILACS and MEDLINE databases. Symptoms of asthma, the most common chronic childhood disease, typically appear in the first years of life. There are currently no diagnosis means of making a certain diagnosis of asthma in children under the age of five. Clinical manifestations, when present in toddlers and preschoolers, may require treatment such as that given for asthma, assuming that it is preceded by a critical evaluation. We can conclude that diagnosis of asthma in the first years of life is complex and predominantly clinical. Inhaled corticosteroid treatment is an effective tool, although its risks and benefits

  6. Early Gastric Cancer: Current Advances of Endoscopic Diagnosis and Treatment.

    Science.gov (United States)

    Zhu, Linlin; Qin, Jinyu; Wang, Jin; Guo, Tianjiao; Wang, Zijing; Yang, Jinlin

    2016-01-01

    Endoscopy is a major method for early gastric cancer screening because of its high detection rate, but its diagnostic accuracy depends heavily on the availability of endoscopic instruments. Many novel endoscopic techniques have been shown to increase the diagnostic yield of early gastric cancer. With the improved detection rate of EGC, the endoscopic treatment has become widespread due to advances in the instruments available and endoscopist's experience. The aim of this review is to summarize frequently-used endoscopic diagnosis and treatment in early gastric cancer (EGC). PMID:26884753

  7. Early Gastric Cancer: Current Advances of Endoscopic Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Linlin Zhu

    2016-01-01

    Full Text Available Endoscopy is a major method for early gastric cancer screening because of its high detection rate, but its diagnostic accuracy depends heavily on the availability of endoscopic instruments. Many novel endoscopic techniques have been shown to increase the diagnostic yield of early gastric cancer. With the improved detection rate of EGC, the endoscopic treatment has become widespread due to advances in the instruments available and endoscopist’s experience. The aim of this review is to summarize frequently-used endoscopic diagnosis and treatment in early gastric cancer (EGC.

  8. 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.

  9. Status Epilepticus in Adults: A Review of Diagnosis and Treatment.

    Science.gov (United States)

    Lawson, Thomas; Yeager, Susan

    2016-04-01

    Status epilepticus is a medical emergency that requires rapid diagnosis and treatment. Nonconvulsive status epilepticus is frequently underdiagnosed and therefore undertreated, which can lead to permanent neuronal damage resulting in disability or death. Despite the frequent occurrence and morbidity associated with status epilepticus, this topic has received little attention within the literature. A systematic approach to treatment should start with management of airway, breathing, and circulation, followed by administration of benzodiazepines and intravenous antiepileptic drugs, and rapid escalation of therapy to prevent morbidity and mortality. Armed with the information in this article, nurses will have a higher-level understanding of what to do when encountering a patient in status epilepticus. PMID:27037340

  10. Advances in Diagnosis and Treatments for Immune Thrombocytopenia

    Science.gov (United States)

    Nomura, Shosaku

    2016-01-01

    Immune thrombocytopenia (ITP) is an acquired hemorrhagic condition characterized by the accelerated clearance of platelets caused by antiplatelet autoantibodies. A platelet count in peripheral blood number of bleeding events. TRAs are usually considered safe, effective treatments for patients with chronic ITP at risk of bleeding after failure of first-line therapies. Due to the high costs of TRAs, however, it is unclear if patients prefer these agents. In addition, some new agents are under development now. This manuscript summarizes the pathophysiology, diagnosis, and treatment of ITP. The goal of all treatment strategies for ITP is to achieve a platelet count that is associated with adequate hemostasis, rather than a normal platelet count. The decision to treat should be based on the bleeding severity, bleeding risk, activity level, likely side effects of treatment, and patient preferences.

  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. 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.

  13. Diagnosis and treatment of radioactive poisoning. Proceedings of the scientific meeting on the diagnosis and treatment of radioactive poisoning

    International Nuclear Information System (INIS)

    The increasing use of atomic energy generated by nuclear fission is necessarily accompanied by the production of large quantities of radioactive isotopes. This, together with the growing use of radioactive materials in many fields, has given added importance to practical considerations of how best to deal with accidents - should they occur - involving radioactive contamination of individuals. Such considerations require knowledge of the metabolic behaviour of various radionuclides in man and of methods of increasing their elimination from the body. Information of this type is limited, and it is therefore essential to make maximum use of those data which, are available. Analyses of earlier accidents are one important source of such data; another is experience gained from the medical administration of radioisotopes for therapeutic or diagnostic purposes. The World Health Organization and the International Atomic Energy Agency jointly sponsored a scientific meeting on the Diagnosis and Treatment of Radioactive Poisoning, in Vienna from 15 to 18 October 1962. The aim of the meeting, which followed an earlier one (The Diagnosis and Treatment of Acute Radiation Injury) sponsored by the two organizations in 1960 on another aspect of radiation protection, was to review the present state of knowledge on the diagnosis, evaluation and treatment of persons who have accidentally incorporated radioactive materials. It brought together three groups of persons: those experienced in various methods of diagnosis and treatment of patients who have been exposed (occupationally or accidentally) to radioactive material; those engaged in the clinical administration of radionuclides and the study of their behaviour in man; and those working on related problems with experimental animals. In view of the great interest of many of the topics discussed at the meeting, it was felt desirable that the information presented in the papers and brought out in the ensuing discussions should be

  14. Stability and change of ODD, CD and ADHD diagnosis in referred preschool children.

    Science.gov (United States)

    Bunte, Tessa L; Schoemaker, Kim; Hessen, David J; van der Heijden, Peter G M; Matthys, Walter

    2014-10-01

    Longitudinal studies have shown that preschool children's diagnosis of Oppositional Defiant Disorder (ODD), Conduct Disorder (CD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are likely to persist into school age. However, limited attention has been paid to instability of diagnosis. The aim of the present study, therefore, was to investigate both stability and change of ODD, CD and ADHD diagnosis in children aged 3.5-5.5 years. For diagnosing these disorders, a semi-structured diagnostic parent interview, i.e., the Kiddie-Disruptive Behavior Disorder Schedule (K-DBDS), was used at the first assessment and at follow-up assessments (9 and 18 months). Five diagnostic stability groups (chronic, partial remission, full remission, new onset, no diagnosis) were compared with regard to impairment and number of symptoms. Participants were referred preschool children with externalizing behavioral problems (N = 193; 83% male) and typically developing (TD) children (N = 58; 71% male). Follow-up assessments allowed to distinguish children belonging to the chronic group of ODD, CD or ADHD from those belonging to one of the remission groups. In addition, there was a substantial number of children with a new onset diagnosis. In conclusion, as a complement to studies showing stability of ODD, CD and ADHD diagnosis into school age, present findings point to changes of diagnosis in the preschool and early school period. Diagnostic reassessments therefore are needed in this age group. PMID:24781411

  15. Diagnosis-prescribing surveys in 2000, 2002 and 2005 in Swedish general practice: consultations, diagnosis, diagnostics and treatment choices.

    Science.gov (United States)

    André, Malin; Vernby, Asa; Odenholt, Inga; Lundborg, Cecilia Stålsby; Axelsson, Inge; Eriksson, Margareta; Runehagen, Arne; Schwan, Ake; Mölstad, Sigvard

    2008-01-01

    The aim of this study is to present diagnostic patterns, diagnostics used and antibiotic treatment in relation to guidelines in 3 repeated diagnosis-prescription studies conducted simultaneously in general practice in 5 Swedish counties, during 1 week in November 2000, 2002 and 2005. General practitioners (GPs) at the participating health centres were asked to complete a form for all patients with symptoms of an infectious disease. During the studied periods a total of 15,371 consultations was registered. Consultations with GPs diagnosed as respiratory tract infection (RTI), especially consultations for sore throat, decreased considerably between y 2000 and 2005. The percentage of patients allocated an RTI diagnosis and prescribed an antibiotic declined significantly from 54% to 49% and the decline was most pronounced among children. Penicillin V remained the dominant antibiotic prescribed throughout the study periods. For lower urinary tract infections there was a significant change in choice of prescribed antibiotics with an increase for pivmecillinam and nitrofurantoin and a decrease for trimethoprim, in accordance with recommendations. The results indicate a quite close adherence to current guidelines, with changes in the pattern of consultations as well as in the management of infectious diseases in general practice in Sweden. PMID:18979603

  16. The Comparison between the Echocardiographic Data to the Cardiac Catheterization Data on the Diagnosis, Treatment, and Follow-Up in Patients Diagnosed as Pulmonary Valve Stenosis

    OpenAIRE

    Kim, Do Hoon; Park, Su-Jin; Jung, Jo Won; Kim, Nam Kyun; Choi, Jae Young

    2013-01-01

    Background Isolated pulmonary valve stenosis (PS) makes up 6-9% of all congenital heart defects among children. The initial gold standard for diagnosis, follow-up of PS is by echocardiography. However, the most accurate diagnosis still remains to be measurement of the pressure gradient through transcatheterization. The purpose of this study is to compare the difference between the echocardiographic data to the cardiac catheterization data on the diagnosis, treatment, and follow-up in patients...

  17. 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.

  18. Definition, assessment and treatment of wheezing disorders in preschool children

    DEFF Research Database (Denmark)

    Brand, P L P; Baraldi, E; Bisgaard, H;

    2008-01-01

    There is poor agreement on definitions of different phenotypes of preschool wheezing disorders. The present Task Force proposes to use the terms episodic (viral) wheeze to describe children who wheeze intermittently and are well between episodes, and multiple-trigger wheeze for children who wheeze...... both during and outside discrete episodes. Investigations are only needed when in doubt about the diagnosis. Based on the limited evidence available, inhaled short-acting beta(2)-agonists by metered-dose inhaler/spacer combination are recommended for symptomatic relief. Educating parents regarding...... preschool child with recurrent wheeze, but should be discontinued if there is no clear clinical benefit. Large well-designed randomised controlled trials with clear descriptions of patients are needed to improve the present recommendations on the treatment of these common syndromes....

  19. 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.

  20. Exploring the Causes, Diagnosis, Symptoms, Risk Factors,Treatments and Prevention of Rheumatic Fever

    Directory of Open Access Journals (Sweden)

    Abdul Razzaq Mughal

    2015-06-01

    Full Text Available The present article aimed at exploring the diagnosis, signs andsymptoms, risk factors treatment and preventing among patients with rheumatic fever. Rheumatic fever is common worldwide and responsible for many cases of damaged heart valves. Acute rheumatic fever primarily affects the heart, joints and central nervous system. This usually happens 2 to 4 weeks after the Streptococcus bacterial infection in child’s body. Rheumatic heart disease is the common acquired heart disease in children between the ages of 6 and 15, with only 20% of first time attacks occurring in adults. However, age over 19 years and a large family size appeared as the protective factors for rheumatic heart disease. The overcrowding and low level of education of mothers increased the risk of rheumatic heart disease among the rheumatic fever patients. Urban residence, peoples living in brick-built house, having three or more siblings and mothers working out of home, further appeared as the significant risk factors. Primary prevention of acute rheumatic fever is accomplished by proper identification and adequate antibiotic treatment of group A β-hemolytic streptococcal tonsillopharyngitis. Diagnosis of streptococcal pharyngitis is best accomplished by combining clinical judgment with diagnostic test results, and the criterion standard of which is the throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin is the treatment of choice, because it is cost-effective, has a narrow spectrum of activity and long-standing proven efficacy, and streptococcal resistant to penicillin has not been documented. For penicillin-allergic individuals, acceptable alternatives include a narrow-spectrum oral cephalosporin, oral clindamycin, or various oral macrolides or azalides. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition oneself. A registered physician should be

  1. 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.

  2. Diagnosis and treatment of small intestinal bacterial overgrowth.

    Science.gov (United States)

    Ponziani, Francesca Romana; Gerardi, Viviana; Gasbarrini, Antonio

    2016-02-01

    A huge number of bacteria are hosted in the gastrointestinal tract, following a gradient increasing towards the colon. Gastric acid secretion and intestinal clearance provide the qualitative and quantitative partitioning of intestinal bacteria; small intestinal bacteria overgrowth (SIBO) occurs when these barrier mechanisms fail. Diagnosis of SIBO is challenging due to the low specificity of symptoms, the frequent association with other diseases of the gastrointestinal tract and the absence of optimal objective diagnostic tests. The therapeutic approach to SIBO is oriented towards resolving predisposing conditions, and is supported by antibiotic treatment to restore the normal small intestinal microflora and by modifications of dietary habits for symptomatic relief. In the near future, metagenomics and metabolomics will help to overcome the uncertainties of SIBO diagnosis and the pitfalls of therapeutic management, allowing the design of a personalized strategy based on the direct insight into the small intestinal microbial community. PMID:26636484

  3. Guidelines for the diagnosis, prevention and treatment of osteoporosis

    Directory of Open Access Journals (Sweden)

    M. Rossini

    2011-06-01

    Full Text Available The guidelines for the osteoporosis management were first drafted by a working group and then critically evaluated by the board of SIOMMMS. The most relevant points are: Definition: Osteoporosis is defined as a quantitative and qualitative deterioration of bone tissue leading to increased risk of fracture. Postmenopausal and senile osteoporosis are defined as primitive. Diagnosis: The cornerstone for the diagnosis of osteoporosis is the measurement of bone mineral density (BMD by DXA (dual-energy X-ray absortiometry at the femoral neck with T-score values -2.5 is usually not justified. Pharmacological intervention: The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk. This is the case only when the risk of fracture is rather high. FRAX™ is recognized as a useful tool for easily estimate the long-term fracture risk. SIOMMMS with these guidelines is committed to validate and further develop this diagnostic tool.

  4. Ultrasound diagnosis of pulmonary hypertension in children with chronic bronchopulmonary diseases

    International Nuclear Information System (INIS)

    Ultrasound criteria of diagnosis of pulmonary hypertension and study this complication frequency in children with chronic bronchopulmonary diseases was determined. As diagnostic criteria of pulmonary hypertension Doppler echocardiographic indices of circulation in the pulmonary arteries are suggested

  5. Children Procedures and Treatment (Fertility Issues)

    Medline Plus

    Full Text Available ... Share my story! Children Procedures and Treatment Is ovarian tissue cryopreservation available to girls under 18? How can a parent approach the subject of fertility preservation with their cancer-stricken child? How is the Oncofertility Consortium addressing ...

  6. 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.

  7. 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

    2014-06-01

    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

  8. The perchlorate discharge test with 123I for the diagnosis of the Pendred syndrome in children

    International Nuclear Information System (INIS)

    The method for the diagnosis of the Pendred Syndrome in children by the Perchlorate discharge test using 123I is described. The older child, who has the Pendred Syndrome and the obligatory hearing deficit, frequently has neither a goitre nor hypothyroidism, but other investigations (bone growth, scars and function tests) can also show changes. However a more certain diagnosis of this disorder in children is possible by the perchlorate discharge test using 123I. (orig.)

  9. Usefulness of the computed tomography and magnetic resonance in evaluation of progress of treatment of the neoplasmatic diseases in children

    OpenAIRE

    Myga-Porosiło, Jolanta; Borowiak, Hanna; Sraga, Wojciech; Jackowska, Zuzanna; Serafin, Magdalena; Kluczewska, Ewa

    2012-01-01

    Summary Background: Neoplastmatic diseases constitute about 1% diseases in children in Poland, what makes about 1200 new incidents during one year. Fast diagnosis in those illnesses is crucial in treatment results. The point of this work was to value usefulness of CT and MRI in diagnostics of neoplasmatic diseases in children. Material/Methods: The retrospective study involved 121 children examined in CT and MRI because of suspicion or during treatment of neoplasmatic disease. Together 184 CT...

  10. Diagnosis and treatment of pancreatic pseudocysts in chronic pancreatitis.

    Science.gov (United States)

    Aghdassi, Ali; Mayerle, Julia; Kraft, Matthias; Sielenkämper, Andreas W; Heidecke, Claus-Dieter; Lerch, Markus M

    2008-03-01

    Pancreatic pseudocysts are a well-known complication of acute or chronic pancreatitis, with a higher incidence in the latter. Diagnosis is accomplished most often by computed tomographic scanning, by endoscopic retrograde cholangiopancreatography, or by ultrasound, and a rapid progress in the improvement of diagnostic tools enables detection with high sensitivity and specificity. Different strategies contribute to the treatment of pancreatic pseudocysts: endoscopic transpapillary or transmural drainage, percutaneous catheter drainage, or open surgery. The feasibility of endoscopic drainage is highly dependent on the anatomy and topography of the pseudocyst, but provides high success and low complication rates. Percutaneous drainage is used for infected pseudocysts. However, its usefulness in chronic pancreatitis-associated pseudocysts is questionable. Internal drainage and pseudocyst resection are frequently used as surgical approaches with a good overall outcome, but a somewhat higher morbidity and mortality compared with endoscopic intervention. We therefore conclude that pseudocyst treatment in chronic pancreatitis can be effectively achieved by both endoscopic and surgical means. This review entails publications referring to the classification of pancreatic pseudocysts, epidemiology, diagnostic tools, and therapeutic options for pancreatic pseudocysts. Only full articles were considered for the review. Based on a search in PubMed, the MeSH terms "pancreatic pseudocysts and classification," "diagnosis," and "endoscopic, percutaneous, and surgical treatment" were used either alone or in combination. PMID:18376299

  11. 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. PMID:27171673

  12. [Current diagnosis and treatment of male genital lichen sclerosus].

    Science.gov (United States)

    Lü, Jun; Huang, Xiao-Dong

    2014-07-01

    Male genital lichen sclerosus (MGLSc) is a chronically relapsing disease characterized by a long course, gradual aggravation, and a tendency towards malignancy. Once called balanitis xerotica obliterans, MGLSc has a distinct predilection for the prepuce and glans, involving the urethra when aggravating, forming scarring tissues, and causing urethral stricture, which may seriously affect the patients'quality of life with such symptoms as urinary stream narrowing, dysuria, and painful penile erection. The etiology and pathogenesis of MGLSc have not yet been adequately explained though it is generally thought to be associated with autoimmune mechanism, genetic factors, infections, local trauma, and chronic urinary irritation. MGLSc can be fairly easily diagnosed according to its clinical manifestations and histopathological results, but can be hardly cured. Early diagnosis and prompt treatment are the most important approaches, which may relieve its symptoms, check its progression, and prevent its long-term sequelae. Ultrapotent topical corticosteroids are the choice for the treatment of MGLSc. For those who fail to respond to expectant medication or have dysuria due to urethral stricture and painful erection, rational surgery may be resorted to, with importance attached to long-term follow-up. This article presents an update of the diagnosis and treatment of MGLSc and MGLSc-induced urethral stricture. PMID:25095613

  13. 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. PMID:17965769

  14. 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.

  15. Intellectual Characteristics of Diabetic Children at Diagnosis and One Year Later.

    Science.gov (United States)

    Rovet, Joanne F.; And Others

    A longitudinal investigation of neurocognitive function was conducted on 63 newly diagnosed pediatric patients with insulin-dependent diabetes mellitus (IDDM) at onset of illness and 1-year post diagnosis. The results at diagnosis, when the children were ages 4 months to 12 years, revealed no differences compared to sibling controls, nor any…

  16. Descriptive characteristics of children with autism at Autism Treatment Center, KSA.

    Science.gov (United States)

    Al Shirian, Sarah; Al Dera, Hussain

    2015-11-01

    Autism characteristics in sixty children (aged from 2 to 8) were assed. Their behavioral symptoms were evaluated using the Autism Treatment Evaluation Checklist (ATEC). ATEC has four main domains of autistic disorders (Speech/Language/Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior) in children with clinical diagnosis by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and Childhood Autism Rating Scale (CARS) of autism spectrum disorder (ASD). Utilizing ATEC checklist, our study describes significant behavioral observations between autistic children which could effectively contribute to better understanding and treatment during their early intervention stage. PMID:26343774

  17. Dentin hypersensitivity: etiology, diagnosis and treatment; a literature review.

    Science.gov (United States)

    Davari, Ar; Ataei, E; Assarzadeh, H

    2013-09-01

    The objective of this review is to inform practitioners about dentin hypersensitivity (DH); to provide a brief overview of the diagnosis, etiology and clinical management of dentin hypersensitivity and to discuss technical approaches to relieve sensitivity. This clinical information is described in the context of the underlying biology. The author used PUBMED to find relevant English-language literature published in the period 1999 to 2010. The author used combinations of the search terms "dentin*", "tooth", "teeth", "hypersensit*", "desensitiz*". Abstracts and also full text articles to identify studies describing etiology, prevalence, clinical features, controlled clinical trials of treatments and relevant laboratory research on mechanisms of action were used. PMID:24724135

  18. 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.

  19. 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.

  20. Sublingual immunotherapy in the treatment of children.

    Science.gov (United States)

    Pham-Thi, N; de Blic, J; Scheinmann, P

    2006-01-01

    Children with controlled intermittent mild-to-moderate asthma, controlled rhinitis and a single sensitivity may be appropriate candidates for sublingual immunotherapy (SLIT). Positive effects of SLIT may depend on initiation in early childhood and a long duration of treatment. To ensure optimum compliance, sociological, economic and familial factors should also be taken in to consideration when prescribing SLIT. Evidence from recent long-term trials indicates that SLIT interfered with the atopic march and the allergic progression from rhinitis to asthma without any severe adverse side effects. Local immune response has been seen to be blunted with SLIT, which suggests that treatment has an immunomodulatory effect. In addition, it may also decrease the risk of new sensitizations. Ongoing developments in SLIT, particularly advances in dosing and new indications, such as food allergies, will increase the use of this treatment modality in children. PMID:16792599

  1. 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...

  2. Can children withhold consent to treatment?

    OpenAIRE

    Devereux, J A; Jones, D P; Dickenson, D L

    1993-01-01

    A dilemma exists when a doctor is faced with a child or young person who refuses medically indicated treatment. The Gillick case has been interpreted by many to mean that a child of sufficient age and intelligence could validly consent or refuse consent to treatment. Recent decisions of the Court of Appeal on a child's refusal of medical treatment have clouded the issue and undermined the spirit of the Gillick decision and the Children Act 1989. It is now the case that a child patient whose c...

  3. Diagnosis and Management of Recurrent Respiratory Tract Infections in Children: A Practical Guide

    Directory of Open Access Journals (Sweden)

    Schaad

    2015-12-01

    Full Text Available Context Respiratory tract infections (RTIs affect children all over the world and are associated with significant morbidity and mortality. RTIs are usually triggered by viruses, though bacterial infections are also common. Results Children are particularly susceptible to RTIs due to the relative immaturity of their immune systems, and genetic factors (such as family history of atopy and/or environmental factors (such as exposure to pollution and pathogens also render certain populations more vulnerable to infection. Furthermore, RTIs tend to be recurrent and can result in multiple infections per year. The management of recurrent RTIs poses a tremendous challenge for physicians, who have a limited armamentarium with which to alleviate patients’ symptoms, treat their disease, and prevent recurrences. Conclusions Though antibiotics are rarely indicated, they are often still used to treat RTIs. The resulting increase in bacterial resistance, the lack of treatment efficacy, and drug-related side effects all underscore the need for alternative strategies to manage recurrent RTIs. This article uses a typical pediatric case study to review central issues in the diagnosis and management of recurrent RTIs in children, with an emphasis on the role of immunomodulation as a preventive strategy.

  4. 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.

  5. Recent advances in diagnosis and treatment of primary aldosteronism.

    Science.gov (United States)

    Veglio, F; Morello, F; Rabbia, F; Leotta, G; Mulatero, P

    2003-08-01

    Primary aldosteronism is the most common form of secondary hypertension. The use of aldosterone/plasma renin activity ratio (ARR) as a screening test has elevated its prevalence up to 10% of hypertensive patients. Idiopathic bilateral adrenal hyperplasia and aldosterone-producing adrenal adenoma are the leading causes of primary aldosteronism. Most patients with this conditions are normokalemic and clinically undistinguishable from essential hypertensives. However, they suffer from anticipated and more severe target organ damage than other hypertensives. Thus, being primary aldosteronism a common, specifically treatable and sometimes surgically cured form of hypertension, a prompt diagnosis is necessary and cannot be overlooked. The measurement of ambulatory ARR represents the screening test and should be performed in the majority of hypertensive patients. ARR higher than a set cutoff suggests the need of a confirmatory test for primary aldosteronism, such as intravenous saline load or fludrocortisone suppression test. If inability to suppress aldosterone is demonstrated, the disease is confirmed. The subtype evaluation is based on adrenal imaging (CT scan) and selective adrenal venous sampling. The latter is the gold standard for the diagnosis of a lateralized aldosterone secretion, as typically observed in aldosterone-producing adenomas. Microadenomas are frequently overlooked by adrenal image. If lateralization is confirmed, unilateral adrenalectomy is the reasonable therapeutic option, leading to a significant reduction of blood pressure, if not normotension. If bilateral aldosterone excess is demonstrated, an aldosterone receptor antagonist should be administered. This article reviews and discusses the new data about prevalence, diagnosis and treatment of primary aldosteronism. PMID:14605590

  6. Mitochondrial myopathies: diagnosis, exercise intolerance, and treatment options.

    Science.gov (United States)

    Tarnopolsky, Mark A; Raha, Sandeep

    2005-12-01

    Mitochondrial myopathies are caused by genetic mutations that directly influence the functioning of the electron transport chain (ETC). It is estimated that 1 of 8,000 people have pathology inducing mutations affecting mitochondrial function. Diagnosis often requires a multifaceted approach with measurements of serum lactate and pyruvate, urine organic acids, magnetic resonance spectroscopy (MRS), muscle histology and ultrastructure, enzymology, genetic analysis, and exercise testing. The ubiquitous distribution of the mitochondria in the human body explains the multiple organ involvement. Exercise intolerance is a common but often an overlooked hallmark of mitochondrial myopathies. The muscle consequences of ETC dysfunction include increased reliance on anaerobic metabolism (lactate generation, phosphocreatine degradation), enhanced free radical production, reduced oxygen extraction and electron flux through ETC, and mitochondrial proliferation or biogenesis (see article by Hood in current issue). Treatments have included antioxidants (vitamin E, alpha lipoic acid), electron donors and acceptors (coenzyme Q10, riboflavin), alternative energy sources (creatine monohydrate), lactate reduction strategies (dichloroacetate) and exercise training. Exercise is a particularly important modality in diagnosis as well as therapy (see article by Taivassalo in current issue). Increased awareness of these disorders by exercise physiologists and sports medicine practitioners should lead to more accurate and more rapid diagnosis and the opportunity for therapy and genetic counseling. PMID:16331134

  7. Scintigraphic diagnosis of spiral fracture in young children

    International Nuclear Information System (INIS)

    8 cases of unsuspected bone fracture in children, identified at bone scan are reported. Common features were the children's young age (1 to 3 years), the absence of clinical suspicion, the initially normal X-rays, the fracture type (spiral fracture of the tibia undisplaced), and the uniform appearance of the bone scan. These data confim the value of bone scan in limping children and suggest that spiral fracture of the tibia is a frequent and underdiagnosed condition in children

  8. Scintigraphic diagnosis of spiral fracture in young children

    International Nuclear Information System (INIS)

    The authors report 8 cases of unsuspected bone fracture in children, identified at bone scan. Common features were the children's young age (1 to 3 years), the absence of clinical suspicion, the initially normal X-rays, the fracture type (sprial fracture of the tibia undisplaced), and the uniform of appearance the bone scan. These data confirm the value of the bone scan in limping children and suggest that spiral fracture of the tibia is a frequent and underdiagnosed condition in children

  9. CEREBRAL ARTERIOVENOUS MALFORMATIONS IN CHILDREN. ENDOVASCULAR TREATMENT

    OpenAIRE

    Scheglov, D.; Zagorodniy, V.

    2013-01-01

    The objective — to learn the features of the cerebral arteriovenous malformations (АVМ) endovascular treatment in children. Materials and methods. Totally 39 children with cerebral AVMs were treated at the center from 2005 to 2012. The average age of the patients (12.6 ± 1.2) years. It was found that the most of AVMs were occurred in temporoparietal subcortical area — 46.2 % cases. Results. Small size of AVMs were detected in 15.4 % of patients, the middle — in 33.3 %, the large — in 38.5 %, ...

  10. Minor changes on cranial MRI during treatment in children with acute lymphoblastic leukaemia

    Energy Technology Data Exchange (ETDEWEB)

    Paeaekkoe, E. [Dept. of Diagnostic Radiology, Univ. of Oulu (Finland); Vainionpaeae, L. [Dept. of Paediatrics, Univ. of Oulu (Finland); Pyhtinen, J. [Dept. of Diagnostic Radiology, Univ. of Oulu (Finland); Lanning, M. [Dept. of Paediatrics, Univ. of Oulu (Finland)

    1996-04-01

    Cranial MRI was used to study treatment-related changes in children undergoing therapy for acute lymphoblastic leukaemia (ALL) or lymphoma. Nineteen children (18 with ALL, 1 with lymphoma) underwent MRI at the beginning of treatment and at intervals during it, to a total of 105 imaging studies and a minimum of 3 per case. Nine patients had finished all therapy, all received consolidation treatment. No patient had central nervous system (CNS) leukaemia at diagnosis or developed a CNS relapse. Mild treatment-related white matter changes were observed in only 2 patients after consolidation therapy with three 5 g/m{sup 2} pulses of intravenous methotrexate. Transient enlargement of the ventricles and cortical sulci was observed in 13 patients, always temporally related to steroid treatment. These preliminary data suggest that treatment-related white matter changes are rare and no routine MRI follow-up is needed during treatment in asymptomatic children after a baseline assessment. (orig.)

  11. Minor changes on cranial MRI during treatment in children with acute lymphoblastic leukaemia

    International Nuclear Information System (INIS)

    Cranial MRI was used to study treatment-related changes in children undergoing therapy for acute lymphoblastic leukaemia (ALL) or lymphoma. Nineteen children (18 with ALL, 1 with lymphoma) underwent MRI at the beginning of treatment and at intervals during it, to a total of 105 imaging studies and a minimum of 3 per case. Nine patients had finished all therapy, all received consolidation treatment. No patient had central nervous system (CNS) leukaemia at diagnosis or developed a CNS relapse. Mild treatment-related white matter changes were observed in only 2 patients after consolidation therapy with three 5 g/m2 pulses of intravenous methotrexate. Transient enlargement of the ventricles and cortical sulci was observed in 13 patients, always temporally related to steroid treatment. These preliminary data suggest that treatment-related white matter changes are rare and no routine MRI follow-up is needed during treatment in asymptomatic children after a baseline assessment. (orig.)

  12. 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…

  13. Psychiatric morbidity in children with medically unexplained chronic pain: Diagnosis from the pediatrician's perspective

    NARCIS (Netherlands)

    Konijnenberg, Antoinette Y.; De Graeff-Meeder, Elisabeth R.; Van Der Hoeven, Joost; Kimpen, Jan L. L.; Buitelaar, Jan K.; Uiterwaal, Cuno S.P.M.; Van Dijken, Pieter J.; Dijkman-Neerincx, Regina H.M.; Essink, Alphons H.P.M.; Flapper, Boudien C.T.; Fliers, Ellen A.; Ten Haaf, Jeanette K.; Hofkamp, Marchinus; Van Der Meer, Syb B.; Moens, Marijn; Pelleboer, Rolf A.A.; Van Rhijn, Aart; Russel, Ingrid M.B.; Thunnissen, Bernadien T.M.J.; Vlieger, Arine M.; Wennink, Johanna M.B.; Van Wieringen, Hester; Zwart, Pieter

    2006-01-01

    CONTEXT. There is very little general evidence to support the clinical management, particularly diagnosis, of medically unexplained chronic pain (UCP) in children. OBJECTIVE. We sought to assess in children with UCP if clinical characteristics held important by general pediatricians help to accurate

  14. Late effects of treatment on the intelligence of children with posterior fossa tumors

    International Nuclear Information System (INIS)

    This retrospective pilot study was undertaken to evaluate the late effects of treatment on intelligence in a population of children with posterior fossa tumors. Ten children with posterior fossa tumors treated with radiation and chemotherapy received intellectual evaluations at least one year following diagnosis. Six children had medulloblastomas, one child had a fourth ventricular ependymoma, two children had brainstem gliomas, and one child had a recurrent cerebellar astrocytoma. Children with supratentorial tumors were specifically excluded from the study in order to eliminate the possible influence of the tumor on intellectual functioning. Four children had had intelligence testing in school prior to treatment of their tumor. In each case results following treatment revealed a deterioration of full scale IQ of at least 25 points. Six children did not have prior testing; of these, two had IQ's less than 20. Overall, 50% of the patients had IQ's of less than 80 and 20% had IQ's of greater than 100. Furthermore, four children with normal intelligence (IQ greater than 80) have learning problems requiring special classes. Thus, of the ten children evaluated, all have either dementia, learning disabilities, or evidence of intellectual retardation. This study suggests that aggressive treatment of children with brain tumors may improve survivals but may be associated with significant long-term disabilities

  15. Evaluation of FDG-PET in the diagnosis of neck lymph node swelling on children

    International Nuclear Information System (INIS)

    Usefulness and limitation of fluorodeoxyglucose (FDG)-position emission tomography (PET) examination were evaluated in children with cervical lymph node tumors. Subjects were 14 pediatric patients (3 months to 18FDG concentration/18FDG dose/body wt.), and on other clinical findings involving the process, lymph node biopsy and surgery. For diagnosing the malignant tumor, sensitivity of PET was found to be 100% at SUV=4 or 10, but specificity, 78% at SUV 10 and 22% at 4. Thus the FDG distribution in the tumor was not always an indication of the presence of malignant one; however, it surely indicated the presence of lesion necessary for treatment. Clinical, ultrasonographic, CT and MRI findings together with PET were thought important for precise diagnosis. (R.T.)

  16. Vestibular migraine: diagnosis challenges and need for targeted treatment.

    Science.gov (United States)

    Barbosa, Felipe; Villa, Thaís Rodrigues

    2016-05-01

    Approximately 1% of the general population suffers from vestibular migraine. Despite the recently published diagnostic criteria, it is still underdiagnosed condition. The exact neural mechanisms of vestibular migraine are still unclear, but the variability of symptoms and clinical findings both during and between attacks suggests an important interaction between trigeminal and vestibular systems. Vestibular migraine often begins several years after typical migraine and has a variable clinical presentation. In vestibular migraine patients, the neurological and neurotological examination is mostly normal and the diagnosis will be based in the patient clinical history. Treatment trials that specialize on vestibular migraine are scarce and therapeutic recommendations are based on migraine guidelines. Controlled studies on the efficacy of pharmacologic interventions in the treatment of vestibular migraine should be performed. PMID:27191239

  17. 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.

  18. 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.

  19. 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

  20. [Progress in the diagnosis and treatment of cardiac amyloidosis].

    Science.gov (United States)

    Jurczyszyn, Artur; Engel, Anna; Rajzer, Marek; Czepiel, Jacek; Mazurs, Grzegorz

    2014-01-01

    The heart is an organ often occupied by various forms of amyloidosis; cardiomyopathies are the leading cause of mortality in patients with amyloidosis. Cardiac amyloidosis is often diagnosed late because of nonspecific symptoms and missed early signs in the imaging routine. A method for treating cardiac amyloidosis depends on the type of amyloid protein. In the treatment of amyloidosis associated with immunoglobulins systemic chemotherapy is used without transplant or stem cell transplantation and in the treatment of familial transthyretin amyloidosis liver transplantation is used. There are still clinical studies on the use of siRNA for the treatment of cardiomyopathy associated with transthy retin amyloidosis, and on the use of amyloid protein stabilizers. The prognosis depends on the type of amyloid protein; worse results observed in the case of light chain amyloidosis. Care support is the cornerstone of treatment; it is expected that advances in cardiac imaging and proteomics positive impact on our ability to diagnosis, prognosis and treatment outcomes of amyloidosis of the heart. PMID:25344976

  1. Diagnosis and treatment of radiation-induced burns

    International Nuclear Information System (INIS)

    The utilization of radioactive sources in medicine, industry and research is associated with a probability of accidental overexposures to ionizing radiation, among which localized irradiation are the most frequent events. Moreover, between 5 and 8 % of the patients undergoing therapeutical irradiations could exhibit a higher individual radiosensitivity which could account for severe skin reactions. Localized overexposures may damage not only epidermis and dermis but also deeper connective tissue, vessels, muscles and even bones. Within the framework of a cooperation agreement between the Buenos Aires Burn Hospital and the National Board of Nuclear Regulation, a Radio pathology Committee has been established in 1997 with the purpose of carrying out a collaborative project concerning diagnosis and treatment of radiological burns. The present document particularly considers radiological burns form the point of view of their physiopathology, physical and biological dosimetry, diagnosis prognosis and treatment. It also includes basic concepts of radiation biology and radio pathology. It could be an useful tool for training medical practitioners and also a practical guidance for organizing medical response in accidental overexposures. (author)

  2. Metastases of unknown origin: Principles of diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Petrović Dragana

    2007-01-01

    Full Text Available DEFINITION Cancer of unknown primary (CUP origin refers to patients who present with histologically confirmed metastatic cancer in whom a detailed medical history, complete physical examination, including pelvic and rectal examination, full blood count and biochemistry, urinalysis and stool occult blood testing, histopathological review of biopsy speimens with the use of immunohistochemistry, chest radiography, computed tomography of the abdomen and pelvis, and in certain cases mammography, fail to identify the primary site. EPIDEMIOLOGY of CUP The cancer of unknown primary accounts for 3%-5% of all human cancers. DIAGNOSIS of CUP The standard diagnostic procedure for the majority of patients includes histopathologic review of biopsy specimens with the use of immunohistochemistry, full blood count, routine biochemistry, fecal occult blood testing, urine testing, chest radiography, and computed tomography of the abdomen and pelvis. The four common histologic diagnoses are: adenocarcinoma (70%, poorly differentiated carcinoma (20%, squamous carcinoma (10%, and poorly differentiated neoplasms (5%. PROGNOSIS of CUP The prognosis for most patients with unknown primary tumors is poor, with survival often less than 6 months from diagnosis. THERAPY of CUP Based on clinical and pathologic features, approximately 40% of patients can be categorized within subsets for which specific treatment has been defined. Empiric therapy is an option for the remaining 60% of patients. CONCLUSION Metastatic tumors of unknown origin have a unique clinical presentation due to a specific biology. Insight into the molecular biology of unknown primary tumors will be essential for the development of more effective treatments.

  3. 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.

  4. 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.

  5. Current concepts and controversies in the diagnosis and treatment of attention deficit hyperactivity disorder.

    Science.gov (United States)

    Jensen, P S

    2000-04-01

    Concerns about possible over-diagnosis and over-treatment of attention deficit hyperactivity disorder (ADHD) have been prominent in media reports, as have various competing claims about the safety and efficacy of the various treatments for ADHD. Drawing upon the results of the recent National Institutes of Health Consensus Conference, this paper reviews the evidence concerning these controversial areas. Although there do appear to be pockets of over-prescribing in selected communities, the best available evidence suggests that across the United States substantial underdiagnosis continues to occur, and only 50% of all children with ADHD are being treated with stimulant medications. Among those who are treated with stimulant medications, inadequate treatment is quite common. Substantial evidence suggests that for ADHD symptoms, stimulants are more effective than behavioral therapies in head-to-head comparisons. Combined medication and behavioral treatments do not offer any meaningful advantages over medication treatments alone for ADHD symptoms. For other areas of functioning, however (social skills, academic performance, etc.), combined treatments appear to offer some modest advantages over single treatment approaches. Although research findings show that ADHD can indeed be rigorously and reliably diagnosed under optimal conditions, and that carefully delivered treatments can yield substantial benefits, such best practices do not appear to be taking place in the real world. Thus, although the above controversies are facing some resolution in principal, in practice much remains to be done. PMID:11122941

  6. Video-Assisted Thoracoscopy for the Diagnosis of Mediastinal Masses in Children

    OpenAIRE

    Sandoval, Claudio; Stringel, Gustavo

    1997-01-01

    Background and Objectives: Video-assisted thoracoscopy has been successfully used for several different thoracic procedures in adults. However, its use in children has been limited. The present study evaluated our experience with video-assisted thoracoscopy in the diagnosis of mediastinal masses in children. Methods: Nine children (age range, 3 to 18 years) with undiagnosed mediastinal masses underwent video-assisted thoracoscopy. The operation was performed using general anesthesia, with the...

  7. Contributions of scintigraphy and sonography to the diagnosis of traumatic splenic lesions in children

    International Nuclear Information System (INIS)

    20 children who were sent to the Nuclear Medicine and Sonography services for evaluation of the spleen in the context of a history of abdominal trauma were studied. All but one of the children were treated conservately, the exception having had on emergency renal procedure performed for renal rupture. The working diagnosis, based on the clinical that of splenic trauma in all cases. The result show a sensitivity of 90% (2 false negatives) for scintigraphy, and of 30% (14 false negatives) for sonography for the non-invasive diagnosis of splenic trauma in children

  8. Radioiodine Treatment of Well-Differentiated thyroid cancer in children

    International Nuclear Information System (INIS)

    Full text: Well-differentiated thyroid cancer (DTCA) in children is quite different from the adult- onset disease in that they are more aggressive at the time of diagnosis and with metastases and has a higher risk for recurrence. Some studies claim it to be less lethal and hence treatment protocols may be different from that of the adult. This study was made to analyze the need for RAI therapy as one of the cornerstone of treatment aside from surgery and thyroid hormone suppression as well as to determine the behavior of WDTCA in children. Results: The incidence of DTCA is varied and ranges from 1-10% in several published series. In the Philippines where thyroid cancer in adults ranks 5th in mortality for both sexes, the incidence is likewise very low, around 0.5-1% for ages 18 years and below in a ten year study. It was predominantly a female population (74%) as compared to the males (26%). Fifteen cases were reviewed and included as most were given RAI (87%). Most presented as a solitary nodule and with lymph node metastases. Thirteen cases were papillary in nature and only two cases were follicular. The incidence of nodal metastases was 53% while lung metastases were seen in 20% of cases. Of the 13 cases that underwent RAI therapy, three cases of lung metastases needed repeat therapy. In the cases with lymph node metastases, 2 cases also had recurrence and which necessitated repeat RAI therapy. The two cases that did not get RAI therapy had progressive disease on follow- up after 5 and 7 years respectively from surgery. Discussion: Primary treatment for DTC should consist of surgery, radioiodine ablation and thyroid hormone suppression. We must rely on pediatric outcome studies and the high frequency of multifocal intrathyroidal disease, loco- regional spread and extra cervical metastases often seen as initial presentations of this particular group. The more advanced disease at diagnosis for children, propensity for recurrence as well as the greater radioiodine

  9. Applications of nanotechnology for melanoma treatment, diagnosis, and theranostics

    Directory of Open Access Journals (Sweden)

    Chen J

    2013-07-01

    Full Text Available Jiezhong Chen,1,2 Renfu Shao,3 Xu Dong Zhang,4 Chen Chen1 1School of Biomedical Sciences, University of Queensland, Brisbane, QLD, Australia; 2Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia; 3GeneCology Research Centre, School of Science, Education and Engineering, University of the Sunshine Coast, Maroochydore, QLD, Australia; 4School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia Abstract: Melanoma is the most aggressive type of skin cancer and has very high rates of mortality. An early stage melanoma can be surgically removed, with a survival rate of 99%. However, metastasized melanoma is difficult to cure. The 5-year survival rates for patients with metastasized melanoma are still below 20%. Metastasized melanoma is currently treated by chemotherapy, targeted therapy, immunotherapy and radiotherapy. The outcome of most of the current therapies is far from optimistic. Although melanoma patients with a mutation in the oncogene v-Raf murine sarcoma viral oncogene homolog B1 (BRAF have an initially higher positive response rate to targeted therapy, the majority develop acquired drug resistance after 6 months of the therapy. To increase treatment efficacy, early diagnosis, more potent pharmacological agents, and more effective delivery systems are urgently needed. Nanotechnology has been extensively studied for melanoma treatment and diagnosis, to decrease drug resistance, increase therapeutic efficacy, and reduce side effects. In this review, we summarize the recent progress on the development of various nanoparticles for melanoma treatment and diagnosis. Several common nanoparticles, including liposome, polymersomes, dendrimers, carbon-based nanoparticles, and human albumin, have been used to deliver chemotherapeutic agents, and small interfering ribonucleic acids (siRNAs against signaling molecules have also been tested for the treatment of melanoma. Indeed

  10. Performance of Clinical Signs in the Diagnosis of Dehydration in Children with Acute Gastroenteritis

    OpenAIRE

    Hoxha, Teuta; Xhelili, Luan; Azemi, Mehmedali; Avdiu, Muharrem; Ismaili-Jaha, Vlora; Efendija-Beqa, Urata; Grajcevci-Uka, Violeta

    2015-01-01

    Background: Acute evaluation and treatment of children presenting with dehydration represent one of the most common situation in the pediatric emergency department. To identify dehydration in infants and children before treatment, a number of symptoms and clinical signs have been evaluated. The aim of the study was to describe the performance of clinical signs in detecting dehydration in children. Methods: Two hundred children aged 1 month to 5 year were involved in our prospective study. The...

  11. Sleep-disordered breathing in children with asthma: a systematic review on the impact of treatment

    Science.gov (United States)

    Sánchez, Trinidad; Castro-Rodríguez, José A; Brockmann, Pablo E

    2016-01-01

    Background The objective was to perform a systematic review in order to describe the relationship between asthma and sleep-disordered breathing (SDB) in children, especially regarding the impact of treatment and management. Methods We performed an electronic search in MEDLINE, EMBASE, and LILACS database. Study inclusion criteria were the following: 1) studies that examined the relationship between asthma/wheezing and SDB/obstructive sleep apnea (OSA); and 2) studies conducted in children prevalence of asthma and SDB, the tests used for diagnosis, and the influence of their treatment and management. Results One thousand and twenty studies were identified, among which 32 were selected (n=143,343 children; 51% males; age [mean ± standard deviation] 8.4±2.5 years). Most studies (n=26) diagnosed SDB using questionnaires or clinical history. Nine studies performed a sleep study for diagnosing OSA. The diagnosis of asthma was based on clinical history (n=16), previous medical diagnosis (n=4), questionnaires (n=12), and spirometry (n=5). Children with asthma were more likely to develop habitual snoring and OSA, and children with SDB were more likely to develop asthma. Moreover, asthma was associated with more severe OSA, and the presence of SDB was associated with severe asthma. Treatment of SDB with adenotonsillectomy was associated with significant asthma improvement. Conclusion The relationship between asthma and SDB appears to be bidirectional, and adenotonsillectomy appears to improve asthma control. Future trials on how asthma treatment could impact on SDB are needed.

  12. Considerations regarding the diagnosis and treatment of childhood type 2 diabetes.

    Science.gov (United States)

    Zeitler, Philip

    2010-05-01

    The prevalence of diabetes among children and adolescents has been steadily increasing, making it even more important that diabetes be adequately managed in this patient population. A basic distinction between type 1 and type 2 diabetes has long been understood. Type 1 diabetes results from a primary loss of pancreatic insulin production, usually as a consequence of autoimmune destruction of pancreatic cells; in type 2 diabetes, insulin production continues and may even be exaggerated, but is insufficient to adequately compensate for resistance to insulin action, leading to the loss of glycemic control. Regardless of the type of diabetes, the treatment goal is to control hyperglycemia. However, the optimal treatment strategy depends on the underlying cause of hyperglycemia. It is therefore important to accurately diagnose whether a patient has type 1 or type 2 diabetes. Historically, this has been thought possible based on the different clinical presentations and age of onset of the conditions. More recently, with the increasing prevalence of type 2 diabetes among adolescents and the trend toward a more obese society, the distinction has become less clear. This has led to the need for the differential diagnosis of diabetes to be confirmed using biochemical and immunological testing. In addition, because the prevalence of type 2 diabetes in the pediatric population is a relatively new phenomenon, available treatments for type 2 diabetes have been studied predominantly in adult populations. With type 2 diabetes becoming increasingly common in pediatric centers, there is a need to evaluate the optimal treatments for children and adolescents. PMID:20463418

  13. Treatment of Obesity in Children and Adolescents

    OpenAIRE

    Matson, Kelly L.; Fallon, Renee M.

    2012-01-01

    The prevalence of childhood and adolescent obesity continues to rise in the United States (US). Immediate health consequences are being observed, and long-term risks are mounting within the pediatric population, secondary to obesity. The hallmark of prevention and treatment of obesity in children and adolescents includes lifestyle modification (i.e., dietary modification, increased physical activity, and behavioral modifications). However, when intensive lifestyle modification is insufficient...

  14. Multifocal motor neuropathy: a review of pathogenesis, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    Lawson VH

    2014-04-01

    Full Text Available Victoria H Lawson,1 W David Arnold1,2 1Division of Neuromuscular Disorders, Department of Neurology, 2Department of Physical Medicine and Rehabilitation, Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA Abstract: Multifocal motor neuropathy (MMN is an uncommon, purely motor neuropathy associated with asymmetric deficits with predilection for upper limb involvement. Even in the early descriptions of MMN, the associations of anti-GM1 antibodies and robust response to immunomodulatory treatment were recognized. These features highlight the likelihood of an underlying autoimmune etiology of MMN. The clinical presentation of MMN can closely mimic several neurological conditions including those with more malignant prognoses such as motor neuron disease. Therefore early and rapid recognition of MMN is critical. Serological evidence of anti GM-1 antibodies and electrodiagnostic findings of conduction block are helpful diagnostic clues for MMN. Importantly, these diagnostic features are not universally present, and patients lacking these characteristic findings can demonstrate similar robust response to immunodulatory treatment. In the current review, recent research in the areas of diagnosis, pathogenesis, and treatment of MMN and needs for the future are discussed. The characteristic findings of MMN and treatment implications are reviewed and contrasted with other mimicking disorders. Keywords: autoimmune, conduction block, electrodiagnosis, motor neuron, nerve, inflammatory

  15. Recent advances in the diagnosis and treatment of cancer

    International Nuclear Information System (INIS)

    Incidence and mortality rates of cancer are currently on the top of disease pattern and the number is increasing and increasing worldwide. The impact of screening program for early diagnosis has been proved their important roles in the war against cancer because it helps increase the cure rates, decrease the mortality and morbidity rates, and therefore reduces the economic-social burden. Advances in diagnostic imaging techniques, especially the hybrid imaging (X-ray and Nuclear Medicine) such as PET/CT, SPECT/CT, PET/MRI, is important in accurate staging and these help choose the optimized treatment options to prolong survival while improve the quality of life. The treatment outcomes of cancer has certain remarkable advances based on variety of research to modify, promote and strengthen the traditional treatments (surgery-chemotherapy-radiation) such as laparoscopic surgery, combined chemo-regimens, intensity modulated radiation therapy, volumetric modulated arc therapy, stereotactic radiation therapy, radio surgery, PET/CT simulation, radioactive seeds implant, selective internal radiation therapy, intra-operative radiation therapy, etc. as well as the emerge of new methods such as targeted therapy, immune therapy, radio immunotherapy, proton therapy and heavy ion. Treatment of cancer is now the “individualized treatment” with the advances of biochemistry and histopathology. To achieve the most optimal outcomes, cancer should be approached by a multi professional team including biochemistry, immunology, histopathology, surgical oncology, medical oncology and radiation oncology. (author)

  16. Late diagnosis of a McFarland fracture: imaging and treatment

    International Nuclear Information System (INIS)

    McFarland fractures represent a type of oblique medial malleolar fracture in children that can be challenging to diagnose and treat. A 14-year-old junior league soccer player with a Salter Harris type IV McFarland fracture presented late, as the initial routine two views radiological assessment failed to reveal a clear fracture line. The addition of a mortise ankle view led to the correct diagnosis and subsequent MRI findings guided nonsurgical treatment with an excellent outcome. The debate between obtaining two or three views in closed pediatric ankle injuries according to the so-called Ottawa rules and the usefulness of magnetic resonance imaging (MRI) in the decision making for the choice of treatment of McFarland fractures are discussed in this case report. (orig.)

  17. Late diagnosis of a McFarland fracture: imaging and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Symeonidis, Panagiotis D. [Aristotelian University of Thessaloniki, Thessaloniki (Greece); Konstantinidis, George Ath; Givisis, Panagiotis G. [Aristotelian University of Thessaloniki, Thessaloniki (Greece); Dionellis, Panagiotis S. [Hippocration General Hospital of Thessaloniki, Thessaloniki (Greece); Ousatzopoulos, John [Private Practice Thessaloniki, Thessaloniki (Greece)

    2014-01-15

    McFarland fractures represent a type of oblique medial malleolar fracture in children that can be challenging to diagnose and treat. A 14-year-old junior league soccer player with a Salter Harris type IV McFarland fracture presented late, as the initial routine two views radiological assessment failed to reveal a clear fracture line. The addition of a mortise ankle view led to the correct diagnosis and subsequent MRI findings guided nonsurgical treatment with an excellent outcome. The debate between obtaining two or three views in closed pediatric ankle injuries according to the so-called Ottawa rules and the usefulness of magnetic resonance imaging (MRI) in the decision making for the choice of treatment of McFarland fractures are discussed in this case report. (orig.)

  18. 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.

  19. 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.    

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

    OpenAIRE

    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 diagnosis. Diagnosis Because of the consequences, a correct diagnosis of CMA is pivotal. Open challenges tend to overestimate the number of children with CMA. The only reliable way to diagnose CMA is by do...

  1. Children with schizophrenia: clinical picture and pharmacological treatment.

    Science.gov (United States)

    Masi, Gabriele; Mucci, Maria; Pari, Cinzia

    2006-01-01

    Awareness of childhood-onset schizophrenia is rapidly increasing, with a more precise definition now available of the clinical picture and early signs, the outcome and the treatment strategies. Premorbid developmental impairments, including language, motor and social deficits, are more frequent and more pronounced in earlier- than in later-onset forms of schizophrenia. This 'pan-dysmaturation' is reported from the first months of life in more than half of the children who will develop childhood-onset schizophrenia, and it suggests a more severe and early disruption of brain development compared with the adolescent- and adult-onset disorder. The insidious onset in at least 75% of children, the high rates of premorbid problems and the hesitancy on the part of clinicians to make a diagnosis of schizophrenia in a child usually delay the recognition of the syndrome. Elementary auditory hallucinations are the most frequent positive symptom, while visual and tactile hallucinations are rarer. Delusions are less complex than in adolescents and are usually related to childhood themes. Negative symptoms are largely predominant, namely flat or inappropriate affect. A marked deterioration from the previous level of functioning is present in all these children, and an impaired outcome is reported in approximately 50-60% of them. The main diagnostic challenges are with differentiating childhood-onset schizophrenia from affective disorders (both depression and bipolar disorder) with psychotic symptoms, pervasive developmental disorders and severe personality disorders. Post-traumatic stress disorder and obsessive-compulsive disorder without insight may also be misdiagnosed as schizophrenia. Furthermore, approximately 10% of children from the community report nonpsychotic hallucinations or delusions. Finally, children with atypical psychotic features that do not strictly fit diagnostic criteria for schizophrenia have been described, and new labels have been proposed to categorise

  2. Diagnosis and office-based treatment of urinary incontinence in adults. Part one: diagnosis and testing.

    Science.gov (United States)

    Cameron, Anne P; Heidelbaugh, Joel J; Jimbo, Masahito

    2013-08-01

    Urinary incontinence is a common problem in both men and women. This review article addresses its prevalence, risk factors, cost, the various types of incontinence, as well as how to diagnose them. The US Preventive Services Task Force, the Cochrane Database of Systematic Reviews, and PubMed were reviewed for articles focusing on urinary incontinence. Incontinence is a common problem with a high societal cost. It is frequently underreported by patients so it is appropriate for primary-care providers to screen all women and older men during visits. A thorough history and physical examination combined with easy office-based tests can often yield a clear diagnosis and rule out other transient illnesses contributing to the incontinence. Specialist referral is occasionally needed in specific situations before embarking on a treatment plan. PMID:23904857

  3. Exosomes and Their Significance in Diagnosis and Treatment of Tumors

    Directory of Open Access Journals (Sweden)

    Jian WANG

    2015-12-01

    Full Text Available Abstract 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 defined 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 specific 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.

  4. Determinants of delay in malaria treatment-seeking behaviour for under-five children in south-west Ethiopia: a case control study

    OpenAIRE

    Deribew Amare; Deribe Kebede; Getahun Alemayehu

    2010-01-01

    Abstract Background Prompt diagnosis and timely treatment of malaria within 24 hours after onset of first symptoms can reduce illness progression to severe stages and therefore, decrease mortality. The reason why mothers/caretakers delay in malaria diagnosis and treatment for under-five children is not well studied in Ethiopia. The objective of this study was to assess determinants of malaria treatment delay in under-five children in three districts of south-west Ethiopia. Methods A case cont...

  5. Infantile Pompe disease: Clinical picture, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    N. P. Kotlukova

    2012-01-01

    Full Text Available Pompe disease is a rare inherited disease that belongs to lysosomal accumulation diseases and can be considered as cardiac glycogenosistype II, as well as a severe neuromuscular disease or metabolic myopathy. Physicians of different specialties very rarely identify this pathology, which is due to both its rarity and clinical and genetic polymorphism. Infantile Pompe disease is the severest form. It is characterized by a progressive pattern and a fatal outcome during the first year of life. The possibility of performing enzyme replacement therapy for this disease, which can improve the prognosis and quality of life of patients, makes the early diagnosis of Pompe disease urgent. The paper describes the clinical presentation of infantile Pompe disease and current methods for its diagnosis and treatment. The authors give their experience in diagnosing and treating infantile Pompe disease, by demonstrating 3 cases of the disease. The characteristics of each infant, which confirm the clinical and genetic variety of this pathology, are discussed.

  6. Vulvar cancer: pathogenetic types, diagnosis, treatment, plastic operations

    Directory of Open Access Journals (Sweden)

    V. G. Cherenkov

    2014-08-01

    Full Text Available The morbidity rates and pathogenetic types of vulvar cancer (VC and reasons for its advance were studied in the Novgorod Region. The condylomatous type of VC (that has developed in the presence of vulvar intraepithelial neoplasia was stated in 18% of patients; 48 (75% had a classical pathogenetic type 2 of VC (caused by significant vulvar dystrophy and lichen sclerosus. The tumor process had an intermediate variant in 9.4% of patients with VC. The reason for untimely diagnosis is that obstetricians and gynecologists have no current knowledge of vulvar carcinogenesis, the standards for the diagnosis and treatment of vulvar dystrophies. Tumor cryodevitalization and the application of a radio-wave knife create optimal conditions for implementing the basic principles of ablastics and antiblastics. Reparative surgery using skin and fascial flaps from the posterior surface of the hip to close the organ-tissue defect resulting from vulvectomy, to reduce the risk for postoperative complications, and to form the appearance of the organ is the method of choice in treating VC.

  7. A Review Article: Diagnosis and Treatment of Radial Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Ebrahimzadeh Mohammad Hosein

    2015-04-01

    Full Text Available  Radial tunnel syndrome is a disease which we should consider it in elbow and forearm pains. It is diagnosed with lateral elbow and dorsal forearm pain may radiate to the wrist and dorsum of fingers. The disease is more prevalent in women with the age of 30 to 50 years old. It occurs by intermittent compression on the radial nerve from the radial head to the inferior border of the supinator muscle, without obvious extensor muscle weakness. Compression could happen in five different sites but the arcade of Frose is the most common area that radial nerve is compressed. To diagnosis radial tunnel syndrome, clinical examination is more important than paraclinic tests such as electrodiagnsic test and imaging studies. The exact site of the pain which can more specified by rule of nine test and weakness of the third finger and wrist extension are valuable physical exams to diagnosis. MRI studies my show u muscle edema or atrophy along the distribution of the posterior interosseous nerve. Although non-surgical treatments such as rest, NSAIDs, injections and physiotherapy do not believe to have permanent relief, but it is justify undergoing them before surgery. Surgery could diminish pain and symptoms in 67 to 93 percents of patients completely.

  8. Spinal dural arteriovenous fistulas: Pathogenesis, clinical manifestations, diagnosis, treatment

    Directory of Open Access Journals (Sweden)

    G. Yu. Evzikov

    2015-10-01

    Full Text Available The paper describes spinal dural arteriovenous fistulas (SDAVF, the most common type of spinal cord vascular anomalies. SDAVFs account for 60–80% of the spinal cord vascular anomalies. The causes of SDAVFs, the specific features of their hemodynamics, and their classification remain the subject matter of disputes.SDAVFs form in dura mater tissue, on the dorsal surface of radicular cuffs. The pathogenesis of neurological disorders in SDAVF has determined the name «venous hypertensive myelopathy», a spinal cord injury occurring in their presence. Pain and paresthesias, cacesthesia (more commonly in their distal parts, and motor disorders as flail legs are observed at the onset of SDAVF in typical cases. On average, 12 to 44 months elapse to establish its diagnosis. In addition of motor and sensory disorders, sphincter impairments and sexual dysfunction are detected in the patients at the time of diagnosis. By this time, most patients have already neurological disability.The paper presents the history of studying SDAVF, the existing classifications of arteriovenous malformations and fistulas, the clinical manifestations of venous hypertensive myelopathy in SDAVF, neuroimaging findings, and treatment options.

  9. Initial diagnosis and treatment in first-episode psychosis: can an operationalized diagnostic classification system enhance treating clinicians' diagnosis and the treatment chosen?

    LENUS (Irish Health Repository)

    Coentre, Ricardo

    2011-05-01

    Diagnosis during the initial stages of first-episode psychosis is particularly challenging but crucial in deciding on treatment. This is compounded by important differences in the two major classification systems, International Classification of Diseases, 10th revision (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). We aimed to compare the concordance between an operationalized diagnosis using Operational Criteria Checklist (OPCRIT) and treating clinician-generated diagnosis in first episode psychosis diagnosis and its correlation with treatment prescribed.

  10. Adult and paediatric GERD: diagnosis, phenotypes and avoidance of excess treatments.

    Science.gov (United States)

    Nikaki, Kornilia; Woodland, Philip; Sifrim, Daniel

    2016-09-01

    Detailed investigations and objective measurements in patients with symptoms of gastro-oesophageal reflux should be performed with the intent of making the correct diagnosis, thus enabling choice of appropriate therapy. Establishing the most effective therapy is particularly important in adults who do not respond to standard treatment and in children. The use of PPIs for suspected GERD has increased substantially over the past decade, providing great relief in patients with acid-related symptoms, but also leading to adverse effects and a considerable economic burden. Adults with functional heartburn do not benefit from PPIs, while prolonged PPI use in patients with extraoesophageal symptoms remains a controversial area. Moreover, PPIs are not indicated in infants with GERD unless symptoms are proven to be acid-related. With regard to antireflux surgery, patients must be carefully selected to avoid the need for ongoing PPI treatment postoperatively. Correct diagnosis and phenotyping of patients with symptoms attributed to gastro-oesophageal reflux through detailed investigations is therefore imperative, leading to improved patient outcomes and rationalized use of available treatment options. In this Review, we outline currently available diagnostic tests and discuss approaches to limit any unnecessary medical or surgical interventions. PMID:27485786

  11. Canine angiostrongylosis: recent advances in diagnosis, prevention, and treatment

    Directory of Open Access Journals (Sweden)

    Di Cesare A

    2014-12-01

    Full Text Available Angela Di Cesare, Donato Traversa Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy Abstract: Angiostrongylus vasorum is a parasitic nematode affecting the heart and pulmonary arteries of wild (eg, foxes and domestic canids. The parasite has an indirect life cycle in which slugs and snails act as intermediate hosts. In the last few years the parasite has spread outside the traditional endemic foci, and there is a rise of documented cases of canine angiostrongylosis across Europe. Angiostrongylus vasorum causes cardiopulmonary disorders and coagulopathies, along with different nonspecific clinical signs. Fatal infections are frequently reported. Given the severity of the infection and the recent geographic spreading of the parasite, this article reviews and discusses the current knowledge of A. vasorum, with a special focus on recent insights on diagnosis, prevention, and treatment of dog angiostrongylosis. Keywords: Angiostrongylus vasorum, dog, epidemiology, diagnostic approaches, control, therapy

  12. Ultrasound-Guided Diagnosis and Treatment of Morton's Neuroma.

    Science.gov (United States)

    Ata, Ayşe Merve; Onat, Şule Şahin; Özçakar, Levent

    2016-02-01

    Morton's neuroma is the fibrous enlargement of the interdigital nerve branches, usually in the second and third interspace between the metatarsal heads where the lateral and medial plantar nerves often join. Specific symptoms are dull or sharp pain, numbness and/or tingling in the third and fourth digits, burning sensation, cramping, and a feeling of "walking on a stone" around the metatarsal heads. Numerous clinical tests for Morton's neuroma have been described, such as thumb index finger squeeze, and Mulder's click and foot squeeze tests. Ultrasound and magnetic resonance imaging can be used for confirmation, especially for differential diagnosis, exact localization, and number of neuromas. Further, performing dynamic imaging during the aforementioned tests is paramount and can readily be carried out with ultrasound. The treatment mainly comprises footwear modifications, radiofrequency ablation, physical therapy, local (corticosteroid and anesthetic) injections into the affected webspace, and surgery. Again the use of real-time ultrasound guidance during such interventions is noteworthy. PMID:26815264

  13. Iron deficiency: new insights into diagnosis and treatment.

    Science.gov (United States)

    Camaschella, Clara

    2015-01-01

    Iron deficiency and iron deficiency anemia are common conditions worldwide affecting especially children and young women. In developing countries, iron deficiency is caused by poor iron intake and/or parasitic infection, whereas vegetarian dietary choices, poor iron absorption, and chronic blood loss are common causes in high-income countries. Erythropoiesis stimulating agents can result in functional iron deficiency for erythropoiesis even when stores are iron-replete. Diagnosis of iron deficiency is straightforward, except when it occurs in the context of inflammatory disorders. Oral iron salts correct absolute iron deficiency in most patients, because low hepcidin levels facilitate iron absorption. Unfortunately frequent side effects limit oral iron efficacy. Intravenous iron is increasingly utilized, because currently available preparations allow rapid normalization of total body iron even with a single infusion and are effective also in functional iron deficiency and in iron deficiency associated with inflammatory disorders. The evidence is accumulating that these preparations are safe and effective. However, long-term safety issues of high doses of iron need to be further explored. PMID:26637694

  14. Thrombosis: Novel nanomedical concepts of diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    Iwona; Cicha

    2015-01-01

    Intravascular thrombosis, a critical pathophysiological feature of many cardiovascular disorders, leads to the formation of life-threatening obstructive blood clots within the vessels. Rapid recanalization of occluded vessels is essential for the patients’ outcome, but the currently available systemic fibrinolytic therapy is associated with low efficacy and tremendous side effects. Additionally, many patients are ineligible for systemic thrombolytic therapy, either due to delayed admission to the hospital after symptom onset, or because of recent surgery, or bleeding. In order to improve the treatment efficacy and to limit the risk of hemorrhagic complications, both precise imaging of the affected vascular regions, and the localized application of fibrinolytic agents, are required. Recent years have brought about considerable advances in nanomedical approaches to thrombosis. Although these thrombustargeting imaging agents and nanotherapies are not yet implemented in humans, substantial amount of successful in vivo applications have been reported, including animal models of stroke, acute arterial thrombosis, and pulmonary embolism. It is evident that the future progress in diagnosis and treatment of thrombosis will be closely bound with the development of novel nanotechnology-based strategies. This Editorial focuses on the recently reported approaches, which hold a great promise for personalized, disease-targeted treatment and reduced side effects in the patients suffering from this life-threatening condition.

  15. Diagnosis and treatment of HIV-associated manifestations in otolaryngology

    Directory of Open Access Journals (Sweden)

    Emily Iacovou

    2012-01-01

    Full Text Available Almost 30 years after its first description, HIV still remains a global pandemic. The present paper aims to review the current knowledge on the ear, nose and throat (ENT manifestations of HIV infection, and present the available diagnostic and treatment options. A literature review was conducted in Medline and other available database sources. Information from related books was also included in the data analysis. It is well acknowledged that up to 80% of HIV-infected patients eventually develop ENT manifestations; among which, oral disease appears to be the most common. Oro-pharyngeal manifestations include candidiasis, periodontal and gingival disease, HSV and HPV infection, oral hairy leucoplakia, Kaposi’s sarcoma, and non- Hodgkin’s lymphoma. ENT manifestations in the neck can present as cervical lymphadenopathy or parotid gland enlargement. Respective nasal manifestations include sinusitis (often due to atypical bacteria, and allergic rhinitis. Finally, otological manifestations include otitis (externa, or media, inner ear involvement (sensorineural hearing loss, disequilibrium, and facial nerve palsy (up to 100 times more frequently compared to the general population. Although ENT symptoms are not diagnostic of the disease, they might be suggestive of HIV infection, or related to its progression and the respective treatment failure. ENT doctors should be aware of the ENT manifestations associated with HIV disease, and the respective diagnosis and treatment. A multi-disciplinary approach may be required to provide the appropriate level of care to HIV patients.

  16. [Diagnosis and treatment of non-triggered single epileptic seizures].

    Science.gov (United States)

    Martinez-Juarez, I E; Moreno, J; Ladino, L D; Castro, N; Hernandez-Vanegas, L; Burneo, J G; Hernandez-Ronquillo, L; Tellez-Zenteno, J F

    2016-08-16

    Epileptic seizures are one of the main reasons for neurological visits in an emergency department. Convulsions represent a traumatic event for the patient and the family, with significant medical and social consequences. Due to their prevalence and impact, the initial management is of vital importance. Although following the first epileptic seizure, early recurrence diminishes after establishing treatment with antiepileptic drugs, the forecast for developing epilepsy and long-term outcomes are not altered by any early intervention. Detailed questioning based on the symptoms of the convulsions, the patient's medical history and a full electroencephalogram and neuroimaging study make it possible to define the risk of recurrence of the seizure and the possible diagnosis of epilepsy. Epileptic abnormalities, the presence of old or new potentially epileptogenic brain lesions, as well as nocturnal seizures, increase the risk of recurrence. Physicians must assess each patient on an individual basis to determine the most suitable treatment, and explain the risk of not being treated versus the risk that exists if treatment with antiepileptic drugs is established. PMID:27439486

  17. Diagnosis and treatment of fungal infection after liver transplantation

    Institute of Scientific and Technical Information of China (English)

    SHI Xian-jie; LU Shao-cheng; HE Lei; L(U) Fang; LIANG Yu-rong; LUO Ying; JI Wen-bin; ZHAO Zhi-ming

    2011-01-01

    Background Liver transplantation is the most effective treatment for end-stage liver diseases;however,infections after transplantation can seriously affect the patient's health. The aim of this research was to investigate the diagnosis and treatment of fungal infection following liver transplantation.Methods Clinical data for 232 liver transplant patients at risk of fungal infection were examined for the presence of fungus in the blood,fluid,sputum,urine and stools of patients and by chest or abdominal CT scans. Patients diagnosed with a fungal infection were treated with Fluconazole or,if this was not effective,Voriconazole or Amphotericin B.Immunosuppressive therapy was also reviewed.Results Thirty-seven of 232 (15.9%) patients were diagnosed with a fungal infection,which occurred 4 to 34 days post-transplantation. Candida infections were diagnosed in 23 cases (62.2%) and Aspergillus infections in 12 cases (32.4%). Twenty-one cases were effectively treated with Fluconazole,11 cases with Voriconazole,and two cases with Amphotericin B;however,three cases were not effectively treated with any of the antifungal agents. Overall,treatment was effective in 91.9% of patients.Conclusions Fungal infection has a significant influence on survival rate after liver transplantation. Imaging studies,and pathogenic and biopsy examinations can diagnose fungal infections,which can be effectively treated with antifungal agents such as Fluconazole,Voriconazole or Amphotericin B.

  18. Metastatic Colorectal Cancer: Review of Diagnosis and Treatment Options

    Directory of Open Access Journals (Sweden)

    Madalina Palaghia

    2015-04-01

    Full Text Available Colorectal cancer (CRC is currently considered the third most common neoplasm in the world according to the World Cancer Research Fund International with 1.4 million cases diagnosed in 2012, and the second malignity as cause of death. Approximately 1/5 of patients present directly with metastatic disease (mCRC, and 30 to 50% develop metastasis after surgical treatment for initially localized disease. The aims of the current study are to review the diagnostic particularities, treatment options and clinical evolution of mCRC. Metastatic process in CRC is long and complex, involving several mechanisms, molecular pathways and cellular types. Advances in medical imaging now allow an early and accurate diagnosis of metastatic lesions no matter their location. The progress of fundamental research in CRC led to understanding the molecular basis of the metastatic process that was further translated into novel chemotherapic and biological agents, thus increasing overall survival and and progression-free survival rates. Resection of liver, lung and brain metastases is crucial for survival when achievable and is more effective when completed by an oncological treatment and rigorous follow-up. All patients with mCRC should be discussed by a multidisciplinary team (surgeon, oncologist, radiologist, and gastroenterologist in order to identify the most appropriate therapeutic management.

  19. Translation research: from accurate diagnosis to appropriate treatment

    Directory of Open Access Journals (Sweden)

    Pass Harvey I

    2004-10-01

    Full Text Available Abstract This review article focuses on the various aspects of translational research, where research on human subjects can ultimately enhance the diagnosis and treatment of future patients. While we will use specific examples relating to the asbestos related cancer mesothelioma, it should be stressed that the general approach outlined throughout this review is readily applicable to other diseases with an underlying molecular basis. Through the integration of molecular-based technologies, systematic tissue procurement and medical informatics, we now have the ability to identify clinically applicable "genotype"-"phenotype" associations across cohorts of patients that can rapidly be translated into useful diagnostic and treatment strategies. This review will touch on the various steps in the translational pipeline, and highlight some of the most essential elements as well as possible roadblocks that can impact success of the program. Critical issues with regard to Institutional Review Board (IRB and Health Insurance Portability and Accountability Act (HIPAA compliance, data standardization, sample procurement, quality control (QC, quality assurance (QA, data analysis, preclinical models and clinical trials are addressed. The various facets of the translational pipeline have been incorporated into a fully integrated computational system, appropriately named Dx2Tx. This system readily allows for the identification of new diagnostic tests, the discovery of biomarkers and drugable targets, and prediction of optimal treatments based upon the underlying molecular basis of the disease.

  20. Fibromyalgia: Up to date aspects of patophysiology, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Tomašević-Todorović Snežana

    2010-01-01

    Full Text Available Introduction. Fibromyalgia (FM is a chronic pain condition with spontaneous, chronic, widespread musculoskeletal pain and tenderness accompanied by a number of nonspecific symptoms. The low prevalence of FM is considered an underestimation and results from insufficient knowledge about FM. In order to increase the general awareness of the unique nature of pain in fibromyalgia and the right of patients to receive specific attention, EFIC (European Federation of the IASP Chapters launched the European campaign against pain in fibromyalgia. Pathophysiological mechanisms. The pathogenesis of fibromyalgia is not yet clear. An altered processing of pain is probably the main contributor to the pathogenesis, arising from a number of neuroendocrine, neurotransmitter and neurosensory disturbances in genetically predisposed patients. According to numerous findings, FM originates in the central nervous system and indicates a state of central sensitization in fibromyalgia. There are many reasons for considering that FM and neuropathic pain share similar mechanisms. Diagnostic criteria and fibromyalgia assessment. The ACR criteria (1990 are currently a “gold standard” applied for FM diagnosing, but a number of scoring systems and scales are valid tools for fibromyalgia assessment, differential diagnosis, treatment evaluation and estimation of patient’s quality of life. Treatment. According to multiple pathophysiological mechanisms, the treatment involves multidisciplinary and multimodal approach, includding a combination of pharmacological and non-pharmacological interventions based on EULAR (European League Against Rheumatism recommendations from 2007. Pharmacological treatment (antidepressants, anticonvulsants and conventional analgesics is directed toward the control of pain and other symptoms, but non-pharmacological management (aerobic exercise, strength training and cognitive behavioural therapy is directed to functional consequences of the

  1. 201Thallium SPECT, accuracy in astrocytoma diagnosis and treatment evaluation

    International Nuclear Information System (INIS)

    The aims of the studies included in this thesis were: - to investigate the reliability of 201Thallium single photon emission computed tomography. Tl SPECT for preoperative diagnosis and histological staging of malignant astrocytomas in comparison with CT; - to develop a method for quantification of cerebral thallium uptake, and to evaluate the quantitative measurement in comparison with CT, for astrocytoma treatment follow-up purposes; - to compare quantitative Tl SPECT and proton magnetic resonance spectroscopy (H-MRS) with conventional MR imaging for astrocytoma monitoring, and to evaluate associations between change of morphological tumour characteristics during treatment and changes of cerebral thallium uptake and metabolic ratios. Results and conclusions: - High TI-index, calculated as a ratio comparing tumour uptake to uptake in the contralateral hemisphere, is an indicator of highly malignant astrocytoma. Differentiation between the high-grade astrocytomas, the low-grade astrocytomas, and infectious lesions is only partial, with an overlap of Tl-indexes between these groups. High-grade astrocytomas that do not show contrast enhancement on CT, and astrocytomas with central necrosis and moderate ring-enhancement, tend to be underestimated when evaluated by Tl-index calculation. Tl SPECT is not a reliable method for non-invasive tumour staging among the group of highly malignant astrocytomas. - Quantification of cerebral TI-uptake, defining the volume of viable tumour tissue, is a new method for astrocytoma chemotherapy monitoring. Results suggest that the method provides prognostic information, and information of treatment efficacy, at an earlier stage than CT. - We did not find a higher accuracy of quantitative Tl SPECT than of MR for monitoring purposes and our results indicated that treatment induced MR changes were interrelated with TI-uptake variations. - Multi-voxel H-MRS was difficult to apply for astrocytoma treatment monitoring, due to the anatomical

  2. Novel electrophysiological approaches to clinical epilepsy. Diagnosis and treatment

    International Nuclear Information System (INIS)

    Seizure onset zone (SOZ) is currently defined by ictal epileptiform discharges, which are most commonly recorded as regional low-voltage fast waves or repetitive spikes. Interictal epileptiform discharges, on the other hand, are not specific enough for SOZ as they are recorded at zones other than the SOZ; they are also recorded from areas that do not generate the ictal pattern and from areas to which ictal discharges propagate. Besides spikes and sharp waves, a novel index of human epileptogenicity has been investigated in association with wide-band electroencephalography (EEG) analysis. We primarily noted the following during clinical neurophysiological analysis for clinical epilepsy. Recent development of digital EEG technology enabled us to record wide-band EEG in a clinical setting. Thus, high frequency (>200 Hz) and low frequency (<1 Hz) components can be reliably recorded using subdural electrodes. Direct current shift, slow shift, ripple, and fast ripple can be well delineated, and they will be potentially useful in the diagnosis and management of epileptic patients. Fiber tractography (morphological parameter) and cortico-cortical-evoked potentials with single cortical stimulation (electrophysiological parameter) elucidated cortico-cortical connections in human brain. The data thus obtained can help us understand the mechanism of seizure propagation and normal cortical functional connectivity. Non-invasive simultaneous recording of EEG and functional magnetic resonance imaging (fMRI) provided information on the roles of deep brain structures associated with scalp-recorded epileptiform discharges. Interventional neurophysiology can shed light on the non-pharmacological treatment of epilepsy. In this report, we discuss these novel electrophysiological approaches to the diagnosis and treatment of clinical epilepsy. (author)

  3. The STAR Program: A Description and Analysis of a Multifaceted Early Intervention for Young Children with a Diagnosis of Attention Deficit Hyperactivity Disorder

    Science.gov (United States)

    Northup, John; Reitman, David; de Back, John

    2009-01-01

    This article describes the first 2 years of a comprehensive early intervention program for young children with a diagnosis of ADHD--the "STAR (Summer Treatment and Research) Program." Following the program rationale and overview, case examples are presented to illustrate the use of various program components and some typical outcomes. In addition…

  4. Characteristics of Children Who Lost the Diagnosis of Autism: A Sample from Istanbul, Turkey

    Directory of Open Access Journals (Sweden)

    Nahit Motavalli Mukaddes

    2014-01-01

    Full Text Available Aim. The aim of this study was to describe a group of children who lost a diagnosis of autism following participation in early educational programs. Method. This is a descriptive study reporting the characteristics of children (n: 39 who lost their diagnosis of autism and explaining the educational programs that these children followed. The data were collected by reviewing the participants’ files and through examinations. Results. All of the children were placed at regular psychiatric follow-ups. The mean age at referral was 2.39±0.75 years, whereas the mean age at the time of optimal outcome reported was 5.11±1.95 years. Two of the children were in early intensive behavioral intervention (EIBI, and the rest were in a comprehensive naturalistic behavioral program. The childhood autism rating scale (CARS total scores at baseline and final were 32.75±3.15 and 18.01±1.76, respectively. The mean IQ of the group at final examination was 116.70±18.88. Conclusion. It could be concluded that a group of children with an autism diagnosis could lose the diagnosis of autism upon early intervention. High IQ and the development of communicative and language skills at an early age could be the most powerful factors contributing to an optimal outcome.

  5. Food Allergies: Symptoms, Diagnosis, Prevention and Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

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

  6. Food Allergies: Symptoms, Diagnosis, Prevention and Treatment | NIH MedlinePlus the Magazine

    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 ...

  7. Improving Treatment Outcome for Oppositional Defiant Disorder in Young Children

    Science.gov (United States)

    MacKenzie, Elizabeth P.

    2007-01-01

    Oppositional Defiant Disorder (ODD) is relatively common among 3-8 year-old children and its presence puts children at risk for more serious and stable behavior problems. Behavioral Parent Training (BPT) as the most empirical support as a treatment for children with ODD as well as for children with clinically significant conduct problems. The…

  8. Category attribution as a device for diagnosis: fitting children to the autism spectrum.

    Science.gov (United States)

    Turowetz, Jason; Maynard, Douglas W

    2016-05-01

    The practice of medicine involves applying abstract diagnostic classifications to individual patients. Patients present with diverse histories and symptoms, and clinicians are tasked with fitting them into generic categories. They must also persuade patients, or family members, that the diagnosis is appropriate and elicit compliance with prescribed treatments. This can be especially challenging with psychiatric disorders such as autism, for which there are no clear biomarkers. In this paper, we explicate a discursive procedure, which we term category attribution. The procedure juxtaposes a narrative about the child with a claim about members of a clinically relevant category, in this case, either children with autism or typically/normally developing children. The attribution procedure carries the implication that the child does or does not belong to that category. We show that category attributions are organised in a recurrent interactional sequence. Further, we argue that category attributions encode normative expectations about child development, such that the child is rendered typical or atypical relative to clinical and social norms. Accordingly, such categorisation devices have a moral dimension as well as a clinical one. PMID:26589878

  9. Diagnosis of gastro-oesophageal reflux in children. Comparison between oesophageal pH and barium examinations

    Energy Technology Data Exchange (ETDEWEB)

    Al-Khawari, Hanaa A. [Department of Radiology, Al-Amiri Hospital, Kuwait University (Kuwait); Sinan, T.S. [Department of Radiology, Mubarak Al-Kabeer Hospital, Kuwait University (Kuwait); Seymour, Helen [Department of Radiology, St George' s Hospital, Blackshaw Road, London SW17 0QT (United Kingdom)

    2002-11-01

    Gastro-oesophageal reflux (GOR) is a common disorder encountered during childhood. Early diagnosis and treatment is essential to prevent serious complications. There are several methods for the diagnosis of GOR, with variable opinions regarding which one is the most sensitive and specific. Objective. This is a retrospective study comparing 24-h oesophageal pH monitoring and barium examinations in the diagnosis of GOR in children. Patients and methods. All children referred with signs and/or symptoms of GOR from January to December 1996 at Great Ormond Street Hospital, London, UK, were included in the study. The recorded results (presence or absence of reflux) of barium examinations and 24-h oesophageal pH monitoring studies performed on 169 children were retrospectively reviewed and compared. Results. One-third of patients were below 1 year of age. In all age groups, oesophageal pH probe studies showed a high detection rate (83%) and low incidence of false-negative results (7%) compared to barium examinations, which showed a lower detection rate (43%) and higher incidence of false-negative results (48%). Most GOR-related anatomical abnormalities diagnosed by barium examinations were identified in infants below 1 year of age. Conclusions. We believe that 24-h oesophageal pH monitoring should be used as the first line of investigation for the diagnosis of GOR in all children regardless of the age group. Barium examinations can be reserved for patients below 1 year of age, those going for surgery and those with negative oesophageal pH monitoring results but strong clinical suspicion of GOR. (orig.)

  10. Diagnosis of gastro-oesophageal reflux in children. Comparison between oesophageal pH and barium examinations

    International Nuclear Information System (INIS)

    Gastro-oesophageal reflux (GOR) is a common disorder encountered during childhood. Early diagnosis and treatment is essential to prevent serious complications. There are several methods for the diagnosis of GOR, with variable opinions regarding which one is the most sensitive and specific. Objective. This is a retrospective study comparing 24-h oesophageal pH monitoring and barium examinations in the diagnosis of GOR in children. Patients and methods. All children referred with signs and/or symptoms of GOR from January to December 1996 at Great Ormond Street Hospital, London, UK, were included in the study. The recorded results (presence or absence of reflux) of barium examinations and 24-h oesophageal pH monitoring studies performed on 169 children were retrospectively reviewed and compared. Results. One-third of patients were below 1 year of age. In all age groups, oesophageal pH probe studies showed a high detection rate (83%) and low incidence of false-negative results (7%) compared to barium examinations, which showed a lower detection rate (43%) and higher incidence of false-negative results (48%). Most GOR-related anatomical abnormalities diagnosed by barium examinations were identified in infants below 1 year of age. Conclusions. We believe that 24-h oesophageal pH monitoring should be used as the first line of investigation for the diagnosis of GOR in all children regardless of the age group. Barium examinations can be reserved for patients below 1 year of age, those going for surgery and those with negative oesophageal pH monitoring results but strong clinical suspicion of GOR. (orig.)

  11. Social anxiety disorder in children and adolescents: assessment, maintaining factors, and treatment

    OpenAIRE

    Cederlund, Rio

    2013-01-01

    The present dissertation consists of three empirical studies on social anxiety disorder (SAD) in a sample of Swedish children and adolescents. Based on findings made in a large behavior treatment study, the thesis contributes to the field of research on childhood SAD by investigating a factor that maintains the disorder, ways to measure and screen for diagnosis, and the treatment of the disorder. Study I investigated whether giving an educational course to the parents of socially anxious chil...

  12. Diagnosis of Peptic Esophagitis in Children; Ultrasound versus Endoscopy

    OpenAIRE

    Mehdizadeh Mehrzad; Farahmand Fatemeh; Jannati Javaad; Mahjoob Fatemeh; Almaasi Alireza

    2003-01-01

    Background/Objectives: To investigate the value of transabdominal sonography for evaluation of esophagitis in children. Materials and Methods: A total of 74 children with the clinical suspicion of esophagitis underwent transabdominal sonography of the gastroesophageal junction. Thicknesses of the anterior and posterior walls of the gastroesophageal junction were measured, as well as the thickness of the mucosa. This was followed by endoscopy and biopsy. Results: In histopathologic examination...

  13. [Circumstances for diagnosis and treatment of intestinal parasitosis in France].

    Science.gov (United States)

    Bouchaud, Olivier

    2013-01-01

    In a compatible context, hypereosinophilia is suggestive of helminthosis. When the count is higher than 1000/mm(3), a primo-invasion syndroma may be considered, especially if allergic signs are present. Below that level, the helminthosis is probably at the adult stage (chronic phase). In a chronic diarrhoea occurring after a journey abroad, "emerging" protozoa (crypto-microsporidia, Isospora, Cyclospora…) are possibly in cause. A presumptive treatment may be considered. A systematic screening for schistosomiasis (serology and stool examination) is recommended in travellers exposed to the risk (contacts with fresh water) and in immigrant from endemic areas (mainly sub-Saharan Africa) since the disease may be asymptomatic. In young children living communally, two courses at 15 days interval against giardiosis or enterobiasis are recommended for both infected and contact persons. In order to avoid disseminated strongyloidiasis, severe and possibly lethal, a systematic course of ivermectine is strongly recommended before any immunosuppressive treatment in patients having stayed in tropical areas even for a short period and even decades ago. Albendazole became the reference drug for intestinal helminthiasis with in addition a good efficacy on giardiasis. Since some intestinal parasites are not pathogenic, a treatment is not necessarily required when a parasite is found in a stool examination. PMID:23266344

  14. INTERVENTIONAI DIAGNOSIS AND TREATMENT OF VASCULOGENEIC PULSATILE TINNITUS

    Institute of Scientific and Technical Information of China (English)

    LI Baomin; CAO Xiangyu; LIU Xinfeng; LI Sheng; WANG Jun; LIANG Yongping; GE Aili; ZHANG Alan; FENG Huimin

    2014-01-01

    Objective To retrospectively study clinical features and diagnostic imaging of vasculogeneic pulsatile tin-nitus, and the feasibility and efficacy of transvascular interventional treatment for this condition. Methods Data from 82 cases of arterial or venous pulsatile tinnitus were reviewed. DSA characteristics and possible pathophysiological mechanisms of pulsatile tinnitus in these cases were studied. Diagnoses in this group in-cluded intracranial arterovenous fistula (AVF) (n=3), spontaneous skull base dural AVF (n=16), traumatic ca-rotid-cavernous sinus fistula (n=5), subclavian artery stenosis (n=2), internal carotid artery stenosis (n=3), in-tracranial arterial stenosis (n=1), kinked and/or elongated vertebrobasilar artery (n=2), venous sinus divertic-ulum (n=2), venous sinus stenosis on the dominant drainage side (n=46) and occipital sinus stenosis (n=2). Treatments included embolization and stenting using coils, NBCA glue, Balt balloons, self-expansion stents and intracranial micro-stents via either the femoral artery or femoral vein. Results Procedures were suc-cessful in all cases with no surgery-related complications. Tinnitus disappeared within 2 days after the pro-cedure in all cases. Follow up duration was 5-36 months. Recurrence occurred in 4 cases of arterial tinnitus within 3 months following the initial procedure, which improved after revision embolization or symptom management. There was no recurrence in venous tinnitus cases following stent plastic or stent-coiling embo-lization treatments. Conclusions Endovascular intervention provides a new approach to the diagnosis and treatment of intractable pulsatile tinnitus. It is also effective in differentiating and studying other types of tinnitus.

  15. Three to four years after diagnosis: cognition and behaviour in children with 'epilepsy only'. A prospective, controlled study.

    Science.gov (United States)

    Oostrom, K J; van Teeseling, H; Smeets-Schouten, A; Peters, A C B; Jennekens-Schinkel, A

    2005-07-01

    A 3.5-year follow-up study of cognition and behaviour in 42 children with newly diagnosed idiopathic or cryptogenic epilepsy ('epilepsy only') attending mainstream education and 30 healthy gender-matched classmate controls was carried out to identify differences between groups, to detect factors that contribute to the difference and its change over time, and to establish the proportion of poorly performing children. The neuropsychological battery covered the major domains of cognition, mental and motor speed and academic language skills. Children were tested at the time of diagnosis (before any anti-epileptic drug treatment started) and 3, 12 and approximately 42 months later. Parents and teachers completed behaviour checklists, for which the scoring was adapted to prevent any influence of epilepsy-related ambiguity. Based on parental interviews at the time of diagnosis, children with epilepsy were categorized as having longstanding behavioural and/or learning problems, as belonging to a troubled family, as being exposed to 'off-balance' parenting starting at the time of epilepsy onset and/or as reacting maladaptively to the changes in relation to the onset of epilepsy. Throughout follow-up, the group of children with epilepsy only performed less well than healthy classmates on measures of learning, memory span for words, attention and behaviour. After controlling for school delay, proactive interference (number of responses to the same images as in the learning trials, but now presented in reordered locations) was the only remaining variable that distinguished the group of children with epilepsy only. Group-wise, no changes in cognitive and behavioural differences over time were found, but instability in individual performances appeared to characterize children with epilepsy only. Rather than intrinsically epilepsy-related variables, such as idiopathic versus cryptogenic aetiology, seizure control or anti-epileptic drug treatment, the child's prediagnostic

  16. Effect of pioglitazone treatment on behavioral symptoms in autistic children

    Directory of Open Access Journals (Sweden)

    Edelson Stephen M

    2007-01-01

    Full Text Available Abstract Introduction Autism is complex neuro-developmental disorder which has a symptomatic diagnosis in patients characterized by disorders in language/communication, behavior, and social interactions. The exact causes for autism are largely unknown, but is has been speculated that immune and inflammatory responses, particularly those of Th2 type, may be involved. Thiazolidinediones (TZDs are agonists of the peroxisome proliferator activated receptor gamma (PPARγ, a nuclear hormone receptor which modulates insulin sensitivity, and have been shown to induce apoptosis in activated T-lymphocytes and exert anti-inflammatory effects in glial cells. The TZD pioglitazone (Actos is an FDA-approved PPARγ agonist used to treat type 2 diabetes, with a good safety profile, currently being tested in clinical trials of other neurological diseases including AD and MS. We therefore tested the safety and therapeutic potential of oral pioglitazone in a small cohort of children with diagnosed autism. Case description The rationale and risks of taking pioglitazone were explained to the parents, consent was obtained, and treatment was initiated at either 30 or 60 mg per day p.o. A total of 25 children (average age 7.9 ± 0.7 year old were enrolled. Safety was assessed by measurements of metabolic profiles and blood pressure; effects on behavioral symptoms were assessed by the Aberrant Behavior Checklist (ABC, which measures hyperactivity, inappropriate speech, irritability, lethargy, and stereotypy, done at baseline and after 3–4 months of treatment. Discussion and evaluation In a small cohort of autistic children, daily treatment with 30 or 60 mg p.o. pioglitazone for 3–4 months induced apparent clinical improvement without adverse events. There were no adverse effects noted and behavioral measurements revealed a significant decrease in 4 out of 5 subcategories (irritability, lethargy, stereotypy, and hyperactivity. Improved behaviors were inversely

  17. Prenatal and postnatal diagnosis in children with urinary tract obstruction

    International Nuclear Information System (INIS)

    The prenatal diagnosis of urinary tract obstruction was made in 10 neonates. These findings were confirmed postnatally by sonography, urography, voiding cystourethrography, and scintigraphy. There were 8 neonates with unilateral obstruction of the ureter, and 2 with urethral valves and reflux. Nephrectomy because of hydronephrosis was necessary in 2 instances. The prenatal diagnosis of a urinary tract obstruction is of great importance, because the neonate may be operated upon without delay. Thus the diseased kidney can be saved. Diuretic radionuclide urography is helpful in differentiating between dilated obstructed and dilated nonobstructed kidneys. (orig.)

  18. [Management of diagnosis and treatment in ulcerative colitis].

    Science.gov (United States)

    Klotz, Caroline; Barret, Maximilien; Dhooge, Marion; Oudjit, Ammar; Chaussade, Stanislas; Coriat, Romain; Abitbol, Vered

    2015-02-01

    Ulcerative colitis (UC) is a chronic inflammatory bowel disease limited to the mucosa and affecting the rectum and the colon continuously. Salicylates are the first line treatment for moderate forms. Corticosteroids are used to induce remission, but are not given as maintenance therapy. Thiopurines are indicated as maintenance therapy in case of failure of salicylates or cortico-dependence. Anti TNF alpha are indicated in cortico-resistant severe flares or if cortico- dependence. Vedolizumab (anti-integrin) is the first non anti-TNF alpha biotherapy available for the treatment of UC. Severe acute colitis is a medical emergency; diagnosis is based on Lichtiger score. An emergency colectomy for severe acute colitis is indicated in cases of surgical complication or resistance to medical therapy. UC patients with extension beyond splenic flexure are at risk of colorectal cancer, increasing with the duration of the disease, severity of mucosal inflammation, family history of colorectal cancer, and the existence of sclerosing cholangitis. Annual surveillance colonoscopy is required in patients with sclerosing cholangitis regardless of the extension of their UC. PMID:25534469

  19. Canine mast cell tumors: diagnosis, treatment, and prognosis

    Directory of Open Access Journals (Sweden)

    Garrett LD

    2014-08-01

    Full Text Available Laura D Garrett Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, IL, USA Abstract: Mast cell tumors (MCTs are the most common malignant skin cancer in dogs, and significant variability exists in their biological behavior. Most MCTs are cured with appropriate local therapy, but a subset shows malignant behavior with the potential to spread to lymph nodes, liver, spleen, and other areas and to thus become a systemic cancer. Because of this variable behavior, it is difficult to predict how any individual tumor is going to behave. The variability thus creates uncertainty in deciding what a particular dog's prognosis is, whether staging tests to assess for metastasis are needed, and even what treatments will be necessary for best outcome. In addition to controversies over the potential for development of systemic disease, or diffuse metastasis, controversies also exist over what treatment is needed to best attain local control of these tumors. This article will briefly discuss the diagnosis of MCTs in dogs and will summarize the literature in regards to the controversial topics surrounding the more aggressive form of this disease, with recommendations made based on published studies. Keywords: mitotic index, mastocytosis, tyrosine kinase inhibitor, histologic grade

  20. Coronary artery ectasia: new insights into pathophysiology, diagnosis, and treatment.

    Science.gov (United States)

    Eitan, Amnon; Roguin, Ariel

    2016-08-01

    Coronary artery ectasia (CAE) is defined as a segment of the coronary artery that has a diameter of more than 1.5 times the normal adjacent segments. It was described many years ago, but many aspects of this phenomenon are still unknown. It can be found in 1.2-2% of patients referred for coronary angiography. Risk factors are similar to atherosclerosis, but not in all patients. Histology shows extensive destruction of the musculoelastic elements, with marked degradation of the medial collagen and elastin fibers with disruption of the internal and external elastic lamina. These patients have abnormal levels of matrix metalloproteinases and other related proteins. Yet, the actual etiology of CAE is still unknown. Advances in new and improved imaging modalities such as CT and magnetic resonance angiography enable easier and more accessible diagnosis and evaluation. Treatment is aimed mostly at common cardiovascular risk factors. In small series, CAE was associated with worse prognosis. Anticoagulation was never examined in large trials. Nitrates worsen the flow and should not be administered. Interventional treatments are also an option, but a challenging one. This review presents an update on the current knowledge on CAE. PMID:27218145

  1. Laboratory testing improves diagnosis and treatment outcomes in primary health care facilities

    OpenAIRE

    Jane Y. Carter; Orgenes E. Lema; Magdaline W. Wangai; Charles G. Munafu; Philip H. Rees; Jackson A. Nyamongo

    2011-01-01

    Objective: To determine if use of basic laboratory tests improves diagnosis and treatment outcomes in outpatients attending rural primary health care facilities.Setting: Six rural health centres in Kenya.Design: Cross-sectional study to observe change in diagnosis and treatment made by clinical officers after laboratory testing in outpatients attending six rural health centres in Kenya.Subject: The diagnosis and treatment of 1134 patients attending outpatient services in six rural health cent...

  2. Disease-related distress in parents of children with cancer at various stages after the time of diagnosis.

    Science.gov (United States)

    Boman, Krister; Lindahl, Annika; Björk, Olle

    2003-01-01

    This study evaluates and describes disease-related distress in parents, with particular focus on the association between the time elapsed since the child's cancer diagnosis and a number of indicators of distress. In a cross-sectional design, 264 mothers and fathers of children with various malignancies completed a multidimensional questionnaire focusing on 11 illness-specific and general indicators of distress. Parents were assessed from 4 weeks to 14 years after the child's diagnosis, and age of children at onset of illness ranged from newly born to 21 years (mean approximately 6 years). The levels of distress related to loss of control, self-esteem, anxiety, depression, sleep disturbances, and psychological and physical distress were lower among parents for whom a longer period of time had elapsed from the time of diagnosis. However, the time elapsed could not explain all of the variation in these stress reactions, or any of the variation in uncertainty, disease-related fear and loneliness. The child's age at diagnosis and treatment situation at assessment were surpassed by time elapsed since diagnosis as predictors of variance in parental distress. The pattern observed indicates the presence of disease-related distress even years after the completion of medical treatment. The findings point to the need for research to identify parents at particular risk of suffering long-term harmful consequences from the prolonged stress of parenting a child with cancer. The necessity of longitudinal studies to evaluate the proportion of acute stress in relation to chronic or cumulative parental stress is emphasized. PMID:12801132

  3. Diagnosis, treatment and long-term outcome in fetal hydrocephalus

    International Nuclear Information System (INIS)

    The objective of this study was to evaluate the method of prenatally estimating an appropriate clinical outcome in fetal hydrocephalus. Retrospective study, single institute (Osaka National Hospital). Hundred and seventeen cases with fetal hydrocephalus treated at Osaka National Hospital from 1992 to 2010 were analysed. Of the 117 cases analysed, 38% are diagnosed as isolated ventriculomegaly (IVM), 51% as other types of malformation (30 cases of myelomeningocele, 4 cases of holoprosencephaly, 4 of Dandy Walker syndrome, 10 of arachnoid cyst and 6 of encephalocele etc.) and 11% as secondary hydrocephalus. They are diagnosed between 17 and 40 weeks of gestation (average 27 weeks), 17% diagnosed between 17 and 21 weeks, 30% between 22 and 27 weeks and 53% after 28 weeks. With the exception of 9 aborted cases and 30 unknown cases too young to be evaluated or lost due to lack of follow-up, final outcome was analyzed in 78 cases. Of these 78 cases, 15% died in utero or after birth, 23% showed severe retardation, 17% moderate retardation, 26% mild retardation, and 19% showed good outcome. Long term consequences were mostly influenced by basic disease and accompanied anomalies. Hydrocephalus associated with arachnoid cyst, atresia of Monro, corpus callosum agenesis and hydrocephalus due to fetal intracranial hemorrhage are categorized in the good outcome group. On the other hand, holoprosencephaly, hydrocephalus associated with encephalocele, syndromic hydrocephalus and hydrocephalus due to fetal virus infection are categorized in the poor outcome group. In order to accurate diagnosis and proper counseling, establishment of diagnosis protocol and treatment policy for fetal hydrocephalus including not only fetal sonography, fetal MRI, toxoplasma, rubella, cytomegalovirus, herpes simplex (TORCH) screening test but also chromosomal and gene testing is required. (author)

  4. Diagnosis and Treatment of Alcoholic Hepatitis: A Systematic Review.

    Science.gov (United States)

    Singal, Ashwani K; Kodali, Sudha; Vucovich, Lee A; Darley-Usmar, Victor; Schiano, Thomas D

    2016-07-01

    Alcoholic hepatitis (AH) occurs in about one-third of individuals reporting long-term heavy alcohol use. It is associated with high short-term mortality, economic burden, and hospital resources utilization. We performed this systematic review to (i) describe clinical characteristics and genomics associated with the risk of AH; (ii) discuss role and limitations of liver biopsy and prognostic scoring systems; (iii) summarize evidence regarding the currently available therapies including liver transplantation; and (iv) outline emerging therapies with areas of unmet need. Literature search was performed for studies published in English language (January 1971 through March 2016). The following search engines were used: PubMed, Elsevier Embase, PsycINFO, and Cochrane Library. For the treatment section, only randomized controlled studies were included for this review. A total of 138 studies (59 randomized, 22 systematic reviews or meta-analyses, 7 surveys or guidelines, 7 population-based, and 43 prospective cohorts) were cited. There are over 325,000 annual admissions with AH contributing to about 0.8% of all hospitalizations in the United States. Liver biopsy may be required in about 25 to 30% cases for uncertain clinical diagnosis. Corticosteroids with or without N-acetylcysteine remains the only available therapy for severe episodes. Data are emerging on the role of liver transplantation as salvage therapy for select patients. Abstinence remains the most important factor impacting long-term prognosis. Results from the ongoing clinical trials within the National Institute on Alcohol Abuse and Alcoholism-funded consortia are awaited for more effective and safer therapies. AH is a potentially lethal condition with a significant short-term mortality. A high index of suspicion is required. There remains an unmet need for noninvasive biomarkers for the diagnosis, and predicting prognosis and response to therapy. PMID:27254289

  5. Radiologic diagnosis and treatment of iatrogenic acquired uterine arteriovenous malformation

    International Nuclear Information System (INIS)

    To analyze gray-scale US, color and duplex Doppler US, and angiographic findings in patients with acquired uterine arteriovenous malformations (AVMs), and to evaluate the usefulness of these modalities in the diagnosis of this disease and the effect of transcatheter arterial embolization in its treatment. During a recent seven-year period, we diagnosed 21 cases of acquired uterine AVM. Nineteen of these patients had a history of causative D and C (between one and seven D and C procedures per patient), one had a history of causative cesarean section, and one had cervical conization. All patients underwent transabdominal and endovaginal gray-scale, color Doppler, and duplex Doppler US and angiography, with therapeutic embolization of bilateral uterine arteries. The majority underwent follow-up Doppler US after embolization. The gray-scale US morphology of uterine AVMs included subtle myometrial inhomogeneity and multiple distinct, small anechoic spaces in the thickened myometrium or endometrium. Color Doppler US showed a tangle of tortuous vessels with multidirectional, high-velocity arterial flow, which was focally or asymmetrically distributed. Duplex Doppler US depicted a waveform of fast arterial flow with low resistance, while angiography demonstrated a complex tangle of vessels supplied by enlarged uterine arteries, in association with early venous drainage during the arterial phase, and staiss of contrast medium within abnormal vasculature. Where AVMs were combined with a pseudoaneurysm, this finding was observed. Transcatheter arterial embolization provided a complete cure, without recurrence. Color and duplex Doppler US in an appropriate modality for the detection and diagnosis of uterine AVMs and for follow-up after embolization. Transcatheter arterial embolization is a safe and effective method of treating this disease

  6. Hepatocellular carcinoma with obstructive jaundice:diagnosis,treatment and prognosis

    Institute of Scientific and Technical Information of China (English)

    Lun-Xiu Qin; Zhao-You Tang

    2003-01-01

    Obstructive jaundice as the main clinical feature is uncommon in patients with hepatocellular carcinoma (HCC). Only 1-12 %of HCC patients manifest obstructive jaundice as the initial complaint. Such cases are clinically classified as "icteric type hepatoma", or "cholestatic type of HCC". Identification of this group of patients is important, because surgical treatment may be beneficial. HCC may involve the biliary tract in several different ways: tumor thrombosis, hemobilia,tumor compression, and diffuse tumor infiltration. Bile duct thrombosis (BDT) is one of the main causes for obstructive jaundice, and the previously reported incidence is 1.2-9 %.BDT might be benign, malignant, or a combination of both.Benign thrombi could be blood clots, pus, or sludge.Malignant thrombi could be primary intrabiliary malignant tumors, HCC with invasion to bile ducts, or metastatic cancer with bile duct invasion. The common clinical features of this type of HCC include: high level of serum AFP; history of cholangitis with dilation of intrahepatic bile duct; aggravating jaundice and rapidly developing into liver dysfunction. It is usually difficult to make diagnosis before operation, because of the low incidence rate, ignorant of this disease, and the difficulty for the imaging diagnosis to find the BDT preoperatively. Despite recent remarkable improvements in the imaging tools for diagnosis of HCC, such cases are still incorrectly diagnosed as cholangiocarcinoma or choledocholithiases. Ultrasonography (US) and CT are helpful in showing hepatic tumors and dilated intrahepatic and/or extrahepatic ducts containing dense material corresponding to tumor debris. Direct cholangiography including percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP)remains the standard procedure to delineate the presence and level of biliary obstruction. Magnetic resonance cholangiopancreatography (MRCP) is superior to ERCP in interpreting the cause and

  7. Intussusception in children: Comparison between ultrasound diagnosis and operation findings in a tropical developing country

    Directory of Open Access Journals (Sweden)

    Usang E Usang

    2013-01-01

    Full Text Available Background: Intussusception is one of the more common causes of intestinal obstruction in children. The diagnosis may be based mainly on clinical features; however, there are no classic signs and symptoms that are common to all cases. This study reports our experience at US diagnosis and operation findings of children with intussusceptions in a tropical developing economy. Materials and Methods: This was an 8 years retrospective review of intussusceptions in children in a tertiary health facility in a tropical developing country from January 2004 to December 2011. Results: Twenty-five out of 41 children (M:F = 2.2:1 admitted with intussusceptions within the period were studied. The median age was 6.0 ± 5.57 months (range 3 months- 7 years. US positively diagnosed intussusceptions in 20 (80% cases. Conclusion: US can increase diagnostic confidence in intussusceptions.

  8. The challenge of growth hormone deficiency (GHD diagnosis and treatment during the transition from puberty into adulthood

    Directory of Open Access Journals (Sweden)

    Stefano eCianfarani

    2013-03-01

    Full Text Available In children with childhood-onset growth hormone deficiency, replacement GH therapy is effective in normalising height during childhood and achieving adult height within the genetic target range. GH has further beneficial effects on body composition and metabolism through adult life. The transition phase, defined as the period from mid to late teens until 6–7 years after the achievement of final height, represents a crucial time for reassessing children’s GH secretion and deciding whether GH therapy should be continued throughout life. Evidence-based guidelines for diagnosis and treatment of GHD children during transition are lacking. The aim of this review is to critically review the up-to-date evidence on the best management of transition patients in order to ensure the correct definitive diagnosis and establish the appropriate therapeutic regimen.

  9. Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder During Adolescence in the Primary Care Setting: A Concise Review.

    Science.gov (United States)

    Brahmbhatt, Khyati; Hilty, Donald M; Hah, Mina; Han, Jaesu; Angkustsiri, Kathy; Schweitzer, Julie B

    2016-08-01

    Attention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder with a worldwide prevalence of about 5% in school-age children. This review is intended to assist primary care providers (PCPs) in diagnosing and treating ADHD in adolescents. PubMed, PsychInfo, and Science Citation Index databases were searched from March 1990 to 2015 with the keywords: ADHD, primary care/pediatrics, and children/adolescents. Abstracts addressing diagnosis and/or treatment with 105 citations were identified including supplementary treatment guidelines/books. Adolescent ADHD presents with significant disturbances in attention, academic performance, and family relationships with unique issues associated with this developmental period. Diagnostic challenges include the variable symptom presentation during adolescence, complex differential diagnosis, and limited training and time for PCPs to conduct thorough evaluations. The evidence base for treatments in adolescence in comparison to those in children or adults with ADHD is relatively weak. Providers should be cognizant of prevention, early identification, and treatment of conditions associated with ADHD that emerge during adolescence such as substance use disorders. Adolescent ADHD management for the PCP is complex, requires further research, and perhaps new primary care psychiatric models, to assist in determining the optimal care for patients at this critical period. PMID:27209327

  10. Exercise addiction- diagnosis, bio-psychological mechanisms and treatment issues.

    Science.gov (United States)

    Weinstein, Aviv; Weinstein, Yitzhak

    2014-01-01

    Exercise and sports activity are beneficial both physically and psychologically but excessive exercise may have adverse physiological and psychological effects. There are methodological issues in the definition, diagnosis and etiology of exercise addiction. Several questionnaires and diagnostic tools have been developed and validated and they show high validity and reliability. Exercise addiction has been suggested as having an obsessive-compulsive dimension as well as rewarding aspects that may include it among the behavioral addictions. Biological studies show that in rodents, exercise such as wheel running activates the dopamine reward system and thus contributing to stress reduction. Further evidence suggests that running is associated with endorphins and cannabinoids thus explaining the "runners high" or euphoric feelings that may lead to exercise addiction. Genetic studies suggest that genes which control preference for drugs also control the preference for naturally rewarding behaviors such as exercise. Psychological studies also explain exercise addiction in terms of reward, habituation, social support, stress-relief, avoidance of withdrawal and reduction of anxiety. It has been suggested that exercise addiction is a part of a continuum of sportive activity that develops in stages from the recreational exercise to at-risk exercise, problematic exercise and finally into exercise addiction. Assessment and treatment should take into account the various stages of exercise addiction development, its comorbidity with other psychiatric disorders such as eating disorders or substance use and alcohol disorders. Treatment approaches for exercise addiction are based on the cognitive-behavioral approach but little is known about their effectiveness. A single-case study shows promise of pharmacological treatment for exercise addiction and further studies are required. This review summarizes diagnostic and phenomenology of exercise addiction with emphasis on

  11. Treatments for aggressive and antisocial children.

    Science.gov (United States)

    Kazdin, A E

    2000-10-01

    progress in understanding the nature of conduct disorder is likely to have very important implications for improving treatment outcome. Improved triage of patients to treatments that are likely to work will require understanding of characteristics of children, parents, and families that will make them more or less amenable to current treatments. PMID:11005009

  12. Identifying the Barriers to Early Diagnosis and Treatment in Underserved Individuals with Autism Spectrum Disorders (ASD) and Their Families: A Qualitative Study.

    Science.gov (United States)

    Elder, Jennifer Harrison; Brasher, Susan; Alexander, Beverly

    2016-06-01

    Clinical accounts indicate that disparities exist among families of children with Autism Spectrum Disorders (ASD), and that these disparities impede timely diagnosis and intervention. Furthermore, families living in rural areas are more likely to have reduced access to proper care and use alternative, unproven, and potentially harmful treatments. The purpose of this project was to begin addressing these needs by engaging providers and families of children with ASD living in rural and typically underserved areas. The investigators established a Community Advisory Board (CAB) of ASD professionals (e.g., community-based healthcare and service providers, director of a center for disabilities, psychologist, autism researcher, and special education professional). Next, they conducted four focus groups comprised of a total of 35 major stakeholders (e.g., individuals with ASD, parents of individuals with ASD, community-based healthcare and service providers, school teachers) to determine potential resources, barriers to early diagnosis/treatment, and alternative treatment use in children with ASD. Focus group sessions were audio-recorded, transcribed verbatim, and analyzed by three trained independent coders. Community participants identified several barriers to early diagnosis and intervention, as well as a variety of alternative treatments used in children with ASD. Thematic analysis of focus group transcripts showed several overarching themes regarding barriers to early diagnosis and treatment. Findings from this study have implications for practice and future research. PMID:27070190

  13. Families of children with Down syndrome and maternal strategies of coping with stress knowing the diagnosis

    OpenAIRE

    Ojo, Lea

    2013-01-01

    Family has a very important role in children's life, because it influences their development in many ways. Also children themselves influence family members with their developmental and behavioral characteristics and they have an effect on the dynamics of what is happening in the family. The diagnosis of Down syndrome, a chromosomal disorder, which causes characteristic facial features, hypotonic muscles, hyperflexibility of conclusions, sensitive skin, sparse hair and big tongue, touches...

  14. Non-oncology physician visits after diagnosis of cancer in children

    OpenAIRE

    Heins, M.J.; Lorenzi, M.F.; Korevaar, J. C.; McBride, M. L.

    2016-01-01

    Background: Children diagnosed with cancer often require extensive care for medical, psychosocial and educational problems during and after therapy. Part of this care is provided by family physicians and non-cancer specialists, but their involvement in the first years after diagnosis has barely been studied. Studying non-oncology physician visits may provide insight into the roles of different health care providers. Methods: We included 757 children diagnosed with cancer under age 15 between ...

  15. MR and CT diagnosis of carotid pseudoaneurysm in children following surgical resection of craniopharyngioma

    International Nuclear Information System (INIS)

    We report the cases of two children who underwent CT, MR, MRA and angiography in the diagnosis of postoperative aneurysmal dilatation of the supraclinoid carotid arteries following surgical resection of craniopharyngioma. Craniopharyngiomas are relatively common lesions, accounting for 6-7 % of brain tumors in children. They are histologically benign, causing symptoms by their growth within the sella and suprasellar cistern with compression of adjacent structures, especially the pituitary gland, hypothalamus and optic nerves, chiasm, and tracts. (orig.)

  16. Diagnosis and treatment of metal-induced side-effects.

    Science.gov (United States)

    Stejskal, Vera; Hudecek, Romuald; Stejskal, Jenny; Sterzl, Ivan

    2006-12-01

    Environmental factors are recognized as a cause of the increasing frequency of allergic and autoimmune diseases. In addition to external pollutants, metal ions released from dental restorations or from other body implants might trigger inflammation in susceptible subjects. In humans, genes governing metal-induced inflammation and autoimmunity are not yet known. In clinical praxis, metal-sensitive patients will present various symptoms ranging from oral mucosal changes and skin disease to excessive fatigue and autoimmune diseases. Since genetic markers of genetic susceptibility in man are not known, one has to rely on the phenototypic markers. Such biomarkers might be certain detoxification enzymes but also the presence of metal-specific memory cells in the blood. With the increasing use of metal implants in medicine and dentistry, it is important to have a proper tool for the diagnosis of metal allergy in susceptible subjects. After nickel, gold is now the second most common sensitizer. In addition to patch test, an in vitro blood test, an optimized commercially available lymphocyte transformation test (MELISA) is discussed. Both tests were used for the diagnosis of metal allergy in a selected group of 15 patients who suffered from clinical metal sensitivity in addition to other health problems. The concordance of the two tests was good but MELISA detected more metal allergies than patch test. The removal of incompatible dental material (RID) resulted in long-term health improvement in the majority of patients. We postulate that in vivo, metal ions activate T-cells, initiating systemic inflammation, which, through cytokines, affects the brain and hypothalamus-pituitary-adrenal axis. We postulate that in vivo metal ions will activate T-cells starting systemic inflammation which, through cytokines affect the brain and hypothalamus-pituitary-adrenal (HPA) axis. The treatment and rehabilitation of metal sensitive patients is based on a firm understanding and

  17. Endoleakage after endovascular treatment of abdominal aortic aneurysms: diagnosis, significance and treatment

    International Nuclear Information System (INIS)

    Endoleak, also called leakage, leak and Perigraft leak, is a major complication and its persistence represents a failure of endovascular aortic aneurysm repair. Its detection and treatment is therefore of primary importance, since endoleak can be associated with pressurization (increase in pressure) of the sac, resulting in expansion and rupture of the aneurysm. The aim of this paper is to discuss the definition, significance, diagnosis and different options to treat endoleak. (orig.)

  18. Immuno diagnosis of thyroid diseases in children exposed to radiation

    International Nuclear Information System (INIS)

    Immune status has been studied in 200 children with different thyroid diseases. A marked deficiency of immunity T-link, considerable variations, depending on the type of thyroid pathology, on interferon content in blood, tumor necrosis factor and interleukin-1 have been revealed. 1 tab, 14 refs

  19. Trends in antibiotic treatment of acute otitis media and treatment failure in children, 2000-2011.

    Directory of Open Access Journals (Sweden)

    Leah J McGrath

    Full Text Available OBJECTIVES: Guidelines to treat acute otitis media (AOM were published in 2004. Initial declines in prescribing were shown, but it's unknown if they were sustained. We examine trends in antibiotic dispensing patterns to treat AOM among a large population of children. We also document trends in antibiotic failure. STUDY DESIGN: Children aged 3 months to 12 years with an AOM diagnosis, enrolled in a commercial claims database between January 1, 2000-December 31, 2011 were included. Pharmacy claims within 7 days of diagnosis were searched for antibiotic prescriptions. Antibiotic failure was defined as a dispensing of a different antibiotic class within 2-18 days after the first prescription. We analyzed trends in antibiotic use and failure by class of antibiotic and year. RESULTS: We identified over 4 million children under 13 years with AOM. The proportion of antibiotic dispensing decreased from 66.0% in 2005 to 51.9% in 2007, after which the instances of dispensing rebounded to pre-guideline levels. However, levels began decreasing again in 2010 and the antibiotic use rate in 2011 was 57.6%. Cephalosporin prescriptions increased by 41.5% over eleven years. Antibiotic failure decreased slightly, and macrolides had the lowest proportion of failures, while all other classes had failure rates around 10%. CONCLUSIONS: In recent years, antibiotic dispensing to treat AOM remains high. In addition, the use of broad-spectrum antibiotics is increasing despite having a high rate of treatment failure. Overprescribing of antibiotics and use of non-penicillin therapy for AOM treatment could lead to the development of antibiotic-resistant infections.

  20. A diagnosis-based health economic analysis of postural orthostatic tachycardia syndrome in Chinese children

    Institute of Scientific and Technical Information of China (English)

    LI Ya-wen; DENG Wen-jun; ZHANG Feng-wen; DU Jun-bao; JIN Hong-fang

    2011-01-01

    Background Postural orthostatic tachycardia syndrome (POTS) is a common clinical problem in children and adolescents.The previous diagnostic approach to POTS of children and adolescents is based on a series of tests to exclude all other causes,which is time and medical resource consuming.Recently,a new diagnostic approach has been developed.The present study was designed to statistically analyze the results of clinical investigation items and the cost for the diagnosis of POTS in children patients,and evaluate cost changes in the diagnosis of POTS.Methods A total of 315 children patients were divided into two groups according to diagnosis period,including group Ⅰdiagnosed in 2002-2006 (100 cases) and group Ⅱ in 2007-2010 (215 cases) and the diagnostic item-based distribution of the cost was analyzed.The diagnostic costs were compared between two groups using SPSS17.0.Results The per-capita cost of diagnosis in group Ⅰ was (621.95±21.10) Yuan,costs of diagnostic tests (head-up tilt test,standing test,etc) accounted for 8.68% and the exclusive tests for 91.32%.The per-capita cost of diagnosis in group Ⅱwas (542.69±23.14) Yuan,diagnostic tests accounted for 10.50% and exclusive tests for 89.50%.Comparison of the total cost of diagnostic tests between the two groups showed significant differences (P <0.05).Conclusion The cost of POTS diagnosis has been declined in recent years,but the cost of exclusive diagnosis is still its major part.

  1. Advances in diagnosis and treatment of trigeminal neuralgia

    Directory of Open Access Journals (Sweden)

    Montano N

    2015-02-01

    neurostimulation might represent an opportunity in TN refractory to other surgical treatments. The aim of this work was to review the recent literature about the pathogenesis, diagnosis, and medical and surgical treatments, and discuss the significant advances in all these fields. Keywords: microvascular decompression, percutaneous balloon compression, gamma knife radiosurgery, surgical treatment, magnetic resonance imaging, therapy

  2. Development of Scabies During Treatment for Mycosis Fungoides: Dermatoscopic Diagnosis

    OpenAIRE

    Caner Aykol; İnci Mevlitoğlu; Hüseyin Tol; Yeliz Uçar Tavlı

    2012-01-01

    Scabies is a cutaneous infestation caused by Sarcoptes scabiei var. hominis and characterized by severe and generalized pruritus. A clinical diagnosis can be made when a burrow is detected at a typical predilection site and the lesion is severely itching. Scabies which occurs in the elderly and also in patients who are immunosuppressed, the lesions are very variable and clinical diagnosis may be difficult. In such cases, dermatoscopy is a simple and rapid diagnostic tool for the diagnosis of ...

  3. Psychogenic seizures in brain injury: diagnosis, treatment and case study.

    Science.gov (United States)

    Conder, R L; Zasler, N D

    1990-01-01

    Psychogenic seizures are a functional phenomena in which a person experiences a paroxysmal event that may be interpreted as epileptiform in nature. By definition, psychogenic seizures imply a sudden episode of change in behaviour or psychic state that is not associated with an identifiable process, either vasculogenic or neurogenic, and during which there is an absence of characteristic epileptiform changes on the electroencephalogram. Prevalence rates range from 5% to 50% in outpatient populations seen in epilepsy clinics. However, approximately 20% of true seizure patients also have psychogenic seizures. As psychogenic seizures are not a pathophysiological phenomena, pharmacological interventions do not alter their aetiology and can cloud the cognitive skills necessary to ameliorate the psychogenic seizure behaviour. In non-aphasic true seizure patients, as well as psychogenic seizure patients, self-control relaxation paradigms have been successful where pharmacological intervention has failed. This case involved an aphasic brain-injured patient who had both psychogenic and true seizures. For this patient, the self-control paradigm was modified to include use of gesture and prosody to achieve similar psychotherapeutic effects. Additionally, family therapy was instituted to provide a constructive means for the patient's family to participate in the reduction of psychogenic seizures. As seizures are a common sequelae of brain injury, the differential diagnosis of seizures and knowledge of standard and alternative treatment is essential for rehabilitation professionals. PMID:1701326

  4. An update on Acanthamoeba keratitis: diagnosis, pathogenesis and treatment

    Directory of Open Access Journals (Sweden)

    Lorenzo-Morales Jacob

    2015-01-01

    Full Text Available Free-living amoebae of the genus Acanthamoeba are causal agents of a severe sight-threatening infection of the cornea known as Acanthamoeba keratitis. Moreover, the number of reported cases worldwide is increasing year after year, mostly in contact lens wearers, although cases have also been reported in non-contact lens wearers. Interestingly, Acanthamoeba keratitis has remained significant, despite our advances in antimicrobial chemotherapy and supportive care. In part, this is due to an incomplete understanding of the pathogenesis and pathophysiology of the disease, diagnostic delays and problems associated with chemotherapeutic interventions. In view of the devastating nature of this disease, here we present our current understanding of Acanthamoeba keratitis and molecular mechanisms associated with the disease, as well as virulence traits of Acanthamoeba that may be potential targets for improved diagnosis, therapeutic interventions and/or for the development of preventative measures. Novel molecular approaches such as proteomics, RNAi and a consensus in the diagnostic approaches for a suspected case of Acanthamoeba keratitis are proposed and reviewed based on data which have been compiled after years of working on this amoebic organism using many different techniques and listening to many experts in this field at conferences, workshops and international meetings. Altogether, this review may serve as the milestone for developing an effective solution for the prevention, control and treatment of Acanthamoeba infections.

  5. An update on Acanthamoeba keratitis: diagnosis, pathogenesis and treatment

    Science.gov (United States)

    Lorenzo-Morales, Jacob; Khan, Naveed A.; Walochnik, Julia

    2015-01-01

    Free-living amoebae of the genus Acanthamoeba are causal agents of a severe sight-threatening infection of the cornea known as Acanthamoeba keratitis. Moreover, the number of reported cases worldwide is increasing year after year, mostly in contact lens wearers, although cases have also been reported in non-contact lens wearers. Interestingly, Acanthamoeba keratitis has remained significant, despite our advances in antimicrobial chemotherapy and supportive care. In part, this is due to an incomplete understanding of the pathogenesis and pathophysiology of the disease, diagnostic delays and problems associated with chemotherapeutic interventions. In view of the devastating nature of this disease, here we present our current understanding of Acanthamoeba keratitis and molecular mechanisms associated with the disease, as well as virulence traits of Acanthamoeba that may be potential targets for improved diagnosis, therapeutic interventions and/or for the development of preventative measures. Novel molecular approaches such as proteomics, RNAi and a consensus in the diagnostic approaches for a suspected case of Acanthamoeba keratitis are proposed and reviewed based on data which have been compiled after years of working on this amoebic organism using many different techniques and listening to many experts in this field at conferences, workshops and international meetings. Altogether, this review may serve as the milestone for developing an effective solution for the prevention, control and treatment of Acanthamoeba infections. PMID:25687209

  6. Small Intestinal Tumours: An Overview on Classification, Diagnosis, and Treatment

    Directory of Open Access Journals (Sweden)

    Chiara Notaristefano

    2014-12-01

    Full Text Available The small intestinal neoplasia group includes different types of lesions and are a relatively rare event, accounting for only 3-6% of all gastrointestinal (GI neoplasms and 1-3% of all GI malignancies. These lesions can be classified as epithelial and mesenchymal, either benign or malignant. Mesenchymal tumours include stromal tumours (GIST and other neoplasms that might arise from soft tissue throughout the rest of the body (lipomas, leiomyomas and leiomyosarcomas, fibromas, desmoid tumours, and schwannomas. Other lesions occurring in the small bowel are carcinoids, lymphomas, and melanomas. To date, carcinoids and GIST are reported as the most frequent malignant lesions occurring in the small bowel. Factors that predispose to the development of malignant lesions are different, and they may be hereditary (Peutz-Jeghers syndrome, familial adenomatous polyposis, hereditary non-polyposis colorectal cancer, neuroendocrine neoplasia Type 1, von Hippel-Lindau disease, and neurofibromatosis Type 1, acquired (sporadic colorectal cancer and small intestine adenomas, coeliac disease, Crohn’s disease, or environmental (diet, tobacco, and obesity. Small bowel tumours present with different and sometimes nonspecific symptoms, and a prompt diagnosis is not always so easily performed. Diagnostic tools, that may be both radiological and endoscopic, possess specificity and sensitivity, as well as different roles depending on the type of lesion. Treatment of these lesions may be different and, in recent years, new therapies have enabled an improvement in life expectancy.

  7. Challenge in Clinical Diagnosis and Treatment of Leptospirosis

    Directory of Open Access Journals (Sweden)

    Dora I. Ríos

    2015-01-01

    Full Text Available Abstract: Introduction: Leptospirosis is an acute febrile disease caused by the leptospira. It is considered a zoonosis that affects a variety of animals, both wild and domestic (mainly rodents. Humans become infected accidentally by contact with urine or tissues from infected animals. This pathology has variable clinical manifestations, ranging from inapparent infections and aseptic meningitis, to severe forms such as the Weil syndrome. Development: We present the case of a young patient of 22 years old with fever quantified peaks of 40° C, chills, profuse sweating, headache, muscle and joint pain in knees and malleoli, retroorbital and retrosternal pain; and appetite loss. The symptoms occurred after 20 days of having practiced extreme water sports. Conclusion: The late diagnosis of the patient and hospital readmission are the result of several factors; First, the homology with other infectious diseases that present acute febrile illness with similar symptoms as dengue , malaria, influenza , yellow fever , brucellosis; and secondly the lack of expertise and poor contact with patients who present this disease by the medical staff. Correct antibiotic treatment and proper support reduce morbidity and mortality. The objective of this article is to describe a case of human leptospirosis and make a review of the literature in order to analyze the epidemiological characteristics and relevant clinical manifestations.

  8. Diagnosis and treatment of mast cell disorders: practical recommendations.

    Science.gov (United States)

    Sandes, Alex Freire; Medeiros, Raphael Salles Scortegagna; Rizzatti, Edgar Gil

    2013-01-01

    CONTEXT AND OBJECTIVE The term mastocytosis covers a group of rare disorders characterized by neoplastic proliferation and accumulation of clonal mast cells in one or more organs. The aim of this study was to assess the principal elements for diagnosing and treating these disorders. DESIGN AND SETTING Narrative review of the literature conducted at Grupo Fleury, São Paulo, Brazil. METHODS This study reviewed the scientific papers published in the PubMed, Embase (Excerpta Medica Database), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) and Cochrane Library databases that were identified using the search term "mastocytosis." RESULTS The clinical presentation of mastocytosis is remarkably heterogeneous and ranges from skin lesions that may regress spontaneously to aggressive forms associated with organ failure and short survival. Currently, seven subtypes of mastocytosis are recognized through the World Health Organization classification system for hematopoietic tumors. These disorders are diagnosed based on clinical manifestations and on identification of neoplastic mast cells using morphological, immunophenotypic, genetic and molecular methods. Abnormal mast cells display atypical and frequently spindle-shaped morphology, and aberrant expression of the CD25 and CD2 antigens. Elevation of serum tryptase is a common finding in some subtypes, and more than 90% of the patients present the D816V KIT mutation in mast cells. CONCLUSION Here, we described the most common signs and symptoms among patients with mastocytosis and suggested a practical approach for the diagnosis, classification and initial clinical treatment of mastocytosis. PMID:24141298

  9. Importance of MRI in the diagnosis and treatment of rhabdomyolysis

    International Nuclear Information System (INIS)

    Background: Rhabdomyolysis is a common disorder resulting from a large variety of causes. We describe the MRI features and their importance for diagnosis and treatment. Patients and methods: Between 2003 and 2006, four male patients (age range: 25-33 years) with rhabdomyolysis were studied via 1.5 T MRI (GE, Siemens). In all the patients, T1- and T2-weighted sequences with and without fat suppression, short tau inversion recovery (STIR) and gradient-echo sequences were obtained in axial, coronal and sagittal planes. In one patient, contrast material was given. Results: Two patients presented rhabdomyolysis due to drug abuse, one due to intense exercise and the last one due to long unconsciousness with compression of the paravertebral musculature. Two patients had acute kidney failure. The affected muscles showed an increased signal intensity on T2-weighted and STIR sequences and decreased on T1-weighted sequences. In one patient, intramuscular hemorrhage was observed on T1-weighted and gradient-echo sequences. In the patient with kidney failure, a globular swelling of the kidney with alteration of the corticomedullary differentiation on T2-weighted sequences with fat saturation and hypointensity of the renal medulla on T1-weighted contrast enhanced images was found. Discussion: Immediate recognition of rhabdomyolysis is important to prevent late complications. MRI is the method of choice to evaluate the distribution and extension of the affected muscles, especially when fasciotomy is considered for treatment. Even though the MRI findings are non-specific, the sensitivity in the detection of muscle involvement is higher than CT or US

  10. Transnodal Lymphangiography in the Diagnosis and Treatment of Genital Lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Gomez, F. M., E-mail: gomez_fermun@gva.es; Martinez-Rodrigo, J.; Marti-Bonmati, L. [Hospital Universitario y Politecnico La Fe, Servicio de Radiologia (Spain); Santos, E. [University of Pittsburgh, Department of Radiology (United States); Forner, I. [Hospital Universitario y Politecnico La Fe, Servicio de Medicina Fisica y Rehabilitacion (Spain); Lloret, M.; Perez-Enguix, D.; Garcia-Marcos, R. [Hospital Universitario y Politecnico La Fe, Servicio de Radiologia (Spain)

    2012-12-15

    Purpose: To report the success of groin nodal lymphography in the diagnosis and treatment of genital lymphedema. Methods and Materials: We present one female (8 years old [patient no. 1]) and two male (69 and [patient no. 2] 31 years old [patient no. 3], respectively) patients with genital lymphedema in whom conservative treatment failed. The girl also had lymphorrhagia. Genital lymphedema was caused by radical cystectomy (patient no. 2), lymphatic hyperplasia (patient no. 1), and idiopathic lymphangitis (patient no. 3). All of them underwent ultrasound-guided bilateral groin lymph node puncture. Afterward, 4-8 ml Lipiodol Ultra-Fluide (Guerbet) were injected at a rate of 0.2 ml/s. Lipiodol progression was assessed by fluoroscopy. Computed tomography scan of the abdomen and pelvis was performed immediately after and again at 24 h after the procedure to confirm the leak. The follow-up period was 15, 13, and 9 months, respectively. Technical success was considered as bilateral pelvic and abdominal filling of lymphatic vessels. Therapeutic success was considered as improvement or disappearance of genital lymphedema and/or lymphorrhagia. Results: Lipiodol leak to the scrotum was observed in patients no. 2 and 3. Lymphaticopelvic fistula and genital lymphatic hyperplasia were seen in patient no. 1. Genital lymphedema diminished within 1 week and almost disappeared in two cases (patients no. 1 and 3) or significantly improved (patient no. 2). lymphorrhagia also resolved in patient no. 1. No recurrence or worsening was detected during follow-up. Conclusion: Therapeutic lymphangiography by lymph node injection seems to be effective to treat genital lymphedema. Lymph node puncture lymphangiography is feasible and less cumbersome than pedal lymphangiography.

  11. Importance of MRI in the diagnosis and treatment of rhabdomyolysis

    Energy Technology Data Exchange (ETDEWEB)

    Moratalla, Monica Ballesta [Department of Radiology, La Fe Hospital, Avenida Campanar, 21, 46009 Valencia (Spain)], E-mail: monica_ballesta@hotmail.com; Braun, Petra; Fornas, Guillermina Montoliu [Department of Radiology, La Fe Hospital, Avenida Campanar, 21, 46009 Valencia (Spain)

    2008-02-15

    Background: Rhabdomyolysis is a common disorder resulting from a large variety of causes. We describe the MRI features and their importance for diagnosis and treatment. Patients and methods: Between 2003 and 2006, four male patients (age range: 25-33 years) with rhabdomyolysis were studied via 1.5 T MRI (GE, Siemens). In all the patients, T1- and T2-weighted sequences with and without fat suppression, short tau inversion recovery (STIR) and gradient-echo sequences were obtained in axial, coronal and sagittal planes. In one patient, contrast material was given. Results: Two patients presented rhabdomyolysis due to drug abuse, one due to intense exercise and the last one due to long unconsciousness with compression of the paravertebral musculature. Two patients had acute kidney failure. The affected muscles showed an increased signal intensity on T2-weighted and STIR sequences and decreased on T1-weighted sequences. In one patient, intramuscular hemorrhage was observed on T1-weighted and gradient-echo sequences. In the patient with kidney failure, a globular swelling of the kidney with alteration of the corticomedullary differentiation on T2-weighted sequences with fat saturation and hypointensity of the renal medulla on T1-weighted contrast enhanced images was found. Discussion: Immediate recognition of rhabdomyolysis is important to prevent late complications. MRI is the method of choice to evaluate the distribution and extension of the affected muscles, especially when fasciotomy is considered for treatment. Even though the MRI findings are non-specific, the sensitivity in the detection of muscle involvement is higher than CT or US.

  12. Diagnosis, Treatment and Management of Haemonchus contortus in Small Ruminants.

    Science.gov (United States)

    Besier, R B; Kahn, L P; Sargison, N D; Van Wyk, J A

    2016-01-01

    Haemonchus contortus is a highly pathogenic, blood-feeding nematode of small ruminants, and a significant cause of mortalities worldwide. Haemonchosis is a particularly significant threat in tropical, subtropical and warm temperate regions, where warm and moist conditions favour the free-living stages, but periodic outbreaks occur more widely during periods of transient environmental favourability. The clinical diagnosis of haemonchosis is based mostly on the detection of anaemia in association with a characteristic epidemiological picture, and confirmed at postmortem by the finding of large numbers of H. contortus in the abomasum. The detection of impending haemonchosis relies chiefly on periodic monitoring for anaemia, including through the 'FAMACHA' conjunctival-colour index, or through faecal worm egg counts and other laboratory procedures. A range of anthelmintics for use against H. contortus is available, but in most endemic situations anthelmintic resistance significantly limits the available treatment options. Effective preventative programmes vary depending on environments and enterprise types, and according to the scale of the haemonchosis risk and the local epidemiology of infections, but should aim to prevent disease outbreaks while maintaining anthelmintic efficacy. Appropriate strategies include animal management programmes to avoid excessive H. contortus challenge, genetic and nutritional approaches to enhance resistance and resilience to infection, and the monitoring of H. contortus infection on an individual animal or flock basis. Specific strategies to manage anthelmintic resistance centre on the appropriate use of effective anthelmintics, and refugia-based treatment schedules. Alternative approaches, such as biological control, may also prove useful, and vaccination against H. contortus appears to have significant potential in control programmes. PMID:27238006

  13. Diagnosis and medical treatment of neuropathic pain in leprosy 1

    Science.gov (United States)

    Arco, Rogerio Del; Nardi, Susilene Maria Tonelli; Bassi, Thiago Gasperini; Paschoal, Vania Del Arco

    2016-01-01

    ABSTRACT Objective: to identify the difficulties in diagnosing and treating neuropathic pain caused by leprosy and to understand the main characteristics of this situation. Methods: 85 patients were treated in outpatient units with reference to leprosy and the accompanying pain. We used a questionnaire known as the Douleur Neuropathic 4 test and we conducted detailed neurological exams. As a result, 42 patients were excluded from the study for not having proved their pain. Results: Out of the 37 patients that experienced pain, 22 (59.5%) had neuropathic pain (or a mixture of this pain and their existing pain) and of these 90.8% considered this pain to be moderate or severe. 81.8% of the sample suffered with this pain for more than 6 months. Only 12 (54.5%) of the patients had been diagnosed with neuropathic pain and in almost half of these cases, this pain had not been diagnosed. With reference to medical treatment (n=12) for neuropathic pain, 5 (41.6%) responded that they became better. For the other 7 (58.4%) there were no changes in relation to the pain or in some cases the pain worsened in comparison to their previous state. Statistical analysis comparing improvements in relation to the pain amongst the patients that were treated (n=12) and those that were not, showed significant differences (value p=0.020). Conclusion: we noted difficulties in diagnosing neuropathic pain for leprosy in that almost half of the patients that were studied had not had their pain diagnosed. We attributed this to some factors such as the non-adoption of the appropriate protocols which led to inadequate diagnosis and treatment that overlooked the true picture. PMID:27508904

  14. Radionuclide treatment of thyrotoxicosis in children

    International Nuclear Information System (INIS)

    In adult population thyrotoxicosis occurs in 2% of women and about 10% as often in men. Symptoms and signs can vary widely between patients. Diagnosis of thyrotoxicosis is based on the blood level of free thyroxine (T4), thyrotropin (TSH, thyroid-simulating hormone) and the iodine uptake measured with I131. These diseases, including Graves' disease and functioning nodules, require long-term management. Thyrotoxicosis is relatively infrequent in the pediatric population, with a clear differentiation between sex (more frequent in girls) and age (puberty). Most pediatric patients with thyrotoxicosis have Graves' disease. In this case, the TSH receptor is stimulated by antibodies. In Graves' disease the thyroid develops a lymphocytic infiltrate as well as follicular hyperplasia. Activated T cells initiate B cell proliferation and TSH receptor antibody production. Hashimototo's disease may also result in hyperthyroidism, although in this case the excess thyroid hormone is discharged from an inflamed gland and is not the result of TSH receptor stimulation. The goal of treatment of Graves' disease are to efficiently control symptoms and restore euthyroidism. The available treatments are antithyroid drugs, radioiodine and surgery. Opinions vary as to the optimal form of therapy and not always a single treatment results in permanent euthyroidism

  15. Hepatobiliary scintigraphy in the diagnosis of choledochal cysts in children

    OpenAIRE

    El Desouki Mahmoud; Mohamadiyeh Mohamad; Al Rabeaah Abdullah; Othman Saleh; Al Jurayyan Nasir; Asaad Abdullah; Skiff Zafer; Malabarey Tajuddin; Al Samarrai Asel

    1997-01-01

    The objective is to present the usefulness of hepatobiliary scintigraphy in the investigation of children with suspected choledochal cysts through our experience in King Khalid University Hospital at King Saud University, Riyadh. Seven patients aged between I and 10 years (average 4.8 yrs) comprising six females and one male were investigated. Laboratory tests, abdominal Ultrasound and/or CT, and cholangiography were performed whenever indicated. Persistent activity in a dilated common bile d...

  16. Unusual causes of obstructive jaundice in children: diagnosis on CT

    Energy Technology Data Exchange (ETDEWEB)

    Shih, S.L. (Dept. of Radiology, Mackay Memorial Hospital, Taipei (Taiwan, Province of China)); Lin, J.C.T. (Dept. of Radiology, Mackay Memorial Hospital, Taipei (Taiwan, Province of China)); Lee, H.C. (Dept. of Pediatrics, Mackay Hospital, Taipei (Taiwan, Province of China)); Blickman, J.G. (Div. of Pediatric Radiology, Dept. of Radiology, Massachusetts General Hospital, Boston, MA (United States))

    1992-11-01

    Three cases are presented with unusual causes of obstructive jaundice diagnosed on abdominal CT in children under the age of 15 years. All the cases were initially examined by ultrasound which was inconclusive. CT studies were subsequently performed were diagnostic. These cases included hepatocellular carcinoma, a common bile duct web and duodenal hematoma. The first two cases were surgically confirmed, while the third case was proved by clinical follow-up. (orig.)

  17. Regression analysis for solving diagnosis problem of children's health

    Science.gov (United States)

    Cherkashina, Yu A.; Gerget, O. M.

    2016-04-01

    The paper includes results of scientific researches. These researches are devoted to the application of statistical techniques, namely, regression analysis, to assess the health status of children in the neonatal period based on medical data (hemostatic parameters, parameters of blood tests, the gestational age, vascular-endothelial growth factor) measured at 3-5 days of children's life. In this paper a detailed description of the studied medical data is given. A binary logistic regression procedure is discussed in the paper. Basic results of the research are presented. A classification table of predicted values and factual observed values is shown, the overall percentage of correct recognition is determined. Regression equation coefficients are calculated, the general regression equation is written based on them. Based on the results of logistic regression, ROC analysis was performed, sensitivity and specificity of the model are calculated and ROC curves are constructed. These mathematical techniques allow carrying out diagnostics of health of children providing a high quality of recognition. The results make a significant contribution to the development of evidence-based medicine and have a high practical importance in the professional activity of the author.

  18. Neurophysiological Strategies for the Diagnosis of Disorders of the Neuromuscular Junction in Children

    Science.gov (United States)

    Pitt, Matthew

    2008-01-01

    The disorders of the neuromuscular junction seen in children, the congenital myasthenic syndromes and autoimmune myasthenia gravis, are very rare. Their clinical symptoms and signs may be variable, most notably in the neonate and infant. They should enter the differential diagnosis of many different clinical presentations, such as "floppy infant"…

  19. Informing Children about Their Sibling's Diagnosis of Autism Spectrum Disorder: An Initial Investigation into Current Practices

    Science.gov (United States)

    Tanaka, Kyoko; Uchiyama, Tokio; Endo, Fumio

    2011-01-01

    The manner in which typically developing (TD) children were informed about their sibling's diagnosis of autism spectrum disorders (ASDs) was examined in Japan. Seventy-seven parents, each with a child with ASD and a TD child, participated in a questionnaire survey. From the data obtained, it was revealed that parents informed 66.7% (72/108) TD…

  20. Proteomics for the early diagnosis and treatment of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Autor OJS

    2007-02-01

    Full Text Available

    The incidence of primary cancer has been increasing globally and now-a-days it constitutes the 5th most frequent cancer of humans representing around 5% of all cancers worldwide. Chronic HBV infection assumes greater significance because of its reported association with cirrhosis, and more ominously hepatocellular carcinoma or HCC. Hepatitis B infection constitutes a major global problem with nearly 400 million infected individuals. It contributes to a significant degree of morbidity on account of the associated chronicity that develops in 5-10% of infected adults and more than 90% of infected neonates. Globally, around one million people suffering from HBVrelated chronic heptatitis and HCC die per year. Despite the availability of an effective prophylactic vaccine against hepatitis B for over 20 years, effective treatment of the chronic disease and associated HCC remains elusive. Therefore, identification of the cellular mediators and effectors of HCC is an important medical objective for developing new diagnostic tools and therapeutic strategies against it. Molecular biomarkers hold great promise for refining our ability to establish early diagnosis and prognosis for HCC, and to predict response to therapy. Proteomics is a rapidly expanding discipline that is expected to change the way in which disease can be diagnosed, treated and monitored in the near future. The proteomic analysis of serum and tumors should allow accurate prediction of what is happening at the protein level in a cancer cell or a body fluid proteome. It is the hope that, by deciphering the alterations in serum and liver proteome, biomarkers and patterns of biomarkers will be found that should be helpful in improving early detection, diagnosis and treatment monitoring of HCC. In the last few years, HCC has been extensively investigated using different proteomic approaches on HCC cell lines