RESUMEN
Headache in children and adolescent represents one of the most frequent and potentially severe pathological conditions, requiring a paediatric consult. The purpose of the study was to establish the headache prevalence from the total paediatric consultations in ambulatory practice as well as to establish the main etiological causes of the headache. The study, including 400 children and adolescents (M/F ratio=150/250, U/R ratio=290/110) with headache selected from 3100 cases between 2003 and 2004, in two practices (one general paediatric office and one paediatric neuropsychiatry office) from the Outpatient Clinic of the "Sf. Spiridon" Hospital of Iasi, has shown a prevalence of headache of 12.9%, the most affected age group being that of 5-12 years (52.5%). The etiologic study proved a high frequency of trauma 46.25%, ophthalmologic diseases 13.28%, psychogenic headache 10.75%, migraine 10%, general causes (infections, anaemia, hypoglycaemia) 9%, ENT causes 6.25%, intracranial causes 0.75%. The study confirms the necessity of a multidisciplinary approach, most causes being benign and the prognosis favourable in most cases.
Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Cefalea/epidemiología , Cefalea/etiología , Pacientes Ambulatorios/estadística & datos numéricos , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Comunicación Interdisciplinaria , Masculino , Prevalencia , Estudios Retrospectivos , Rumanía/epidemiologíaRESUMEN
Is it possible for the child with Congenital Heart Disease to have an adequate life-style? The life-style of the child mainly depends on the life-style of his/her family. Consecutively, the parents themselves must adopt a healthy life-style to be a good example for their children; on the other side, certain restrictions (hyponatremic regimen, the limitation of the physical activity) must be shared among entire family, the education of the parents being essential. To accomplish this, there must be an interdisciplinary team, including the GP, the cardiologist, the psychotherapist and the physiotherapist. This article discusses the factors influencing the life-style, their dependence on the family social status, on the diagnosis, on the child's age. The psychotherapeutic approach becomes very important at puberty. There is also essential the transition to the adult life, so these children will benefit of maximum of choices in life.
Asunto(s)
Cardiopatías Congénitas , Estilo de Vida , Relaciones Padres-Hijo , Grupo de Atención al Paciente , Adaptación Psicológica , Niño , Preescolar , Humanos , Psicoterapia , PubertadRESUMEN
UNLABELLED: The prediction of diabetes mellitus is mostly based on the existence of plasma markers. The aim of this preliminary study was to determine islet cell antibodies (ICA) and glutamic acid decarboxylase antibodies (GADA) in 28 diabetic children (12 of them having an evolutive disease of 1 year and 16 at the beginning of the diabetes) and to 47 of their first-degree relatives. There have been determined the levels of these two autoantibodies using the ELISA technique. RESULTS: To 17 of the patients with type I diabetes have been found high levels of GADA (60.7%) while 8 cases have positive ICA (28.5%). For the patients whose disease was diagnosed 1 year ago there have been found differences between the patients with and without antibodies regarding the level of the average values of Hb A1c, the daily insulin needs and the remission period. From the tested parents (a total of 25), 7 was GADA positive (28%), 6 had both antibodies present (24%) and one mother was ICA positive (4%). 9 of the brothers and sisters of the diabetic patients had high levels of GADA and 2 had both antibodies present. To the first-degree relatives with autoantibodies must be determined other plasma markers too (IAA, IA-2A) as well as genetic markers (HLA typing). CONCLUSION: The use of plasma markers is recommended as a first step in discovering the relatives with potential risk of developing the disease.
Asunto(s)
Autoanticuerpos/sangre , Diabetes Mellitus Tipo 1/inmunología , Glutamato Descarboxilasa/inmunología , Anticuerpos Insulínicos/sangre , Adolescente , Adulto , Algoritmos , Biomarcadores/sangre , Niño , Preescolar , Diabetes Mellitus Tipo 1/genética , Ensayo de Inmunoadsorción Enzimática , Familia , Femenino , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Candidiasis are conditions caused by fungi from Candida genus. The most frequently involved in humans pathology is Candida albicans, which, even if is in balance with endogenous bacterial flora, became pathogenic in certain conditions. The hereby study aims to evaluate retrospectively on a period of 5 years (1999-2003), an group of 101,000 children aged 14 days-18 years, the prevalence of candidiasis, the clinical aspects determined in pediatric population diagnosed and treated in the paediatric offices of the outpatient clinic of "Sf. Spiridon" Hospital, as well as the risk factors of these diseases. From 3806 positive samples for Candida, 2650 (69%) have presented signs of pathogenicity of a significant intensity of colonization. 65% of samples have been observed in female gender, 35% in male gender, 58% of cases from urban areas, 42% from rural environment. The concordance of the lab results having significant values with the manifest clinical symptoms was 85% for the nasal and pharyngeal exudates; 93% for the examination of the stools and 95% for vaginal secretions. The most frequent clinical aspects were oropharyngeal candidiasis (39%), mycotic esopharyngitis (0.4%), enterocolitis (15%), mycotic colitis (22%), vulvovaginitis (25%). The most frequent risk factors for the appearance of candidiasis have been repeated or prolonged antibiotic treatments (90% of cases), diabetes mellitus (0.3% cases), steroid therapy (0.2% cases), deficient hygiene (5% cases), diet rich in carbohydrates (9%). This study confirm that Candida albicans can become pathogenic producing signs and symptoms of disease in certain conditions, the most important factor being prolonged or repeated antibiotic treatment.
Asunto(s)
Atención Ambulatoria , Candidiasis/diagnóstico , Servicio Ambulatorio en Hospital , Adolescente , Candidiasis/epidemiología , Candidiasis Bucal/diagnóstico , Candidiasis Bucal/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Rumanía/epidemiologíaRESUMEN
UNLABELLED: Our study is focused on blood pressure before and after repair of aortic coarctation in childhood. METHODS: A group of 26 children (13 boys, 13 girls, range 1-18 years, of which 12 operated: 9 boys and 3 girls) was studied, blood pressure being followed before and after operation. The recorded blood pressure was compared to normal values for age and height. RESULTS: Before the surgical treatment blood pressure being above normal in all cases, the figures were: "high normal"--6 cases, significant--8 cases and severe hypertension--12 cases. After surgery: 75% normal blood pressure, 25% hypertension (variable degrees). CONCLUSION: Hypertension in aortic coarctation varies from "high normal" to severe. Hypertension got worse during pregnancy in an unoperated girl. In most of children, blood pressure decreased after surgical treatment, being normal in 75% of all cases, in one year after surgery. Persistence of a severe hypertension after surgery signifies presence of an underlying lesion unrecognised yet.
Asunto(s)
Coartación Aórtica/complicaciones , Hipertensión/etiología , Adolescente , Coartación Aórtica/cirugía , Monitoreo Ambulatorio de la Presión Arterial , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/cirugía , Lactante , Masculino , EmbarazoRESUMEN
Microalbuminuria (MA) is a noninvasive marker which has to be effected for all the patients in order to watch the appearance of the kidney disease. The aim of this study was the identification of the MA and of its associated factors within a lot of 110 children and teenagers suffering from type 1 diabetes mellitus. Persistent MA (the incipient diabetic nephropathy) was detected in the case of 10 patients (9%) and the intermittent one at 13 of them (11.8%). In all the cases, a poor glycemic control was associated, the average of the Hb A1c being higher than 10%. The progression of MA was associated with high blood-pressure values in the case of 2 patients and other chronic complications were present at 15 of them. In conclusion, we detected MA in 20.8% of the patients and its prevalence was significantly associated with poor glycemic control.
Asunto(s)
Albuminuria/etiología , Diabetes Mellitus Tipo 1/complicaciones , Nefropatías Diabéticas/diagnóstico , Nefropatías Diabéticas/etiología , Adolescente , Niño , Preescolar , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/epidemiología , Nefropatías Diabéticas/complicaciones , Nefropatías Diabéticas/epidemiología , Progresión de la Enfermedad , Diagnóstico Precoz , Femenino , Humanos , Lactante , Masculino , Prevalencia , Estudios Retrospectivos , Rumanía/epidemiologíaRESUMEN
UNLABELLED: The evolution and prognosis of the atrioventricular canal (AVC) depend very much on the clinical type of the disease and its recovery is sometimes an extremely difficult problem. METHODS: The evolution of the 24 cases with atrioventricular canal (10 boys and 14 girls), registered in the files of pediatric cardiology consulting room from the Outpatient Department of the "Sf. Spiridon" Hospital from Iasi, has been studied. According to the state of the patients and, especially, with the parents' permission, these children were sent to Cardiovascular Surgery, for corrective surgical treatment. Before that, they had received a medical treatment for the cardiac failure (digitals, diuretics) and for the pulmonary hypertension (beta-adrenergic blockers, renin angiotensin inhibitors) and they continued this treatment for 1-2 years after the surgical correction. RESULTS AND DISCUSSIONS: This sample included: 9 cases with AVC-complete type; 1 case with AVC-intermediate type; 14 cases with AVC-partial type (13 cases with atrial septal defect-ostium primum + mitral valve cleft and 1 case with left ventricle to right atrium type IIa communication). Only 7 of the 10 children with AVC partial type were surgically corrected, and in all cases the evolution was positive. Three of the nine cases with AVC complete type were investigated in Cardiovascular Surgery in our country, all of them considered without surgical solution. For one of the cases with AVC--complete type and pulmonary stenosis, considered also without surgical solution, a palliative systemic-to-pulmonary artery shunt was made, for the improvement of the pulmonary circulation. CONCLUSIONS: 1. AVC partial type could be recovered in the best conditions in the clinics of cardiovascular surgery in our country. 2. AVC--complete type didn't have, in our cases, surgical solution, either in our country or abroad. 3. For the special situation of the AVC complete type with pulmonary stenosis, the only treatment possible was palliative, performed to increase the pulmonary artery blood flow.