ABSTRACT
Background: Juvenile Rheumatoid Arthritis [JRA] is the most common chronic pediat-ric rheumatologic disease. There is a wide range of variation in disease subgroup distribution and evolution according to different populations, environments and genetic predisposition. This study was designed to evaluate epidemiologic characteristics of JRA in Iran
Methods: A cross-sectional studies was performed on children suffering from JRA according to American College of Rheumatology during 10 year [2002-2011]
Patients' data was recorded in hospital questionnaires; Patients' age at the first presentation and time of diagnosis, sex, ethnicity, early clinical and constitutional presentations, joint involvement pattern and presence of associated diseases were evaluated
Results: In this study, 171 children [91 boys and 80 girls] were enrolled. The mean age of patients was 5.2 +/- 3.5 years at the time of presentation and 5.7+/-3.6 years when the diagnosis was confirmed
The most common type of disease was polyarticular arthritis [41.9%]
The prevalence of pauciarticular and systemic onset subtype were 31.6% and 19.3%, respectively
According to ethnicity, the most common incidence was seen in Pars and Turk populations respectively
The most common constitutional presentation was fever
Fever and morning stiffness was significantly higher in polyarticular patients. Extra articular manifestation was seen in 40.4% patients. Among extra-articular manifestations, skin involvement was seen more than others
There was no correlation between sex and type of chronic arthritis. Uveitis was detected in 5.8% of our cases
The mean age was significantly higher in polyarticular group [6.04 year] in comparison to pauciarticular and systemic group [4.4 year in both groups] [P= 0.005]
There was no correlation between sex and type of chronic arthritis
Conclusion: The prevalence of JRA subgroups was different in Iran comparing with western countries and polyarticular disease was the most common subgroup in this study. Uveitis was less common in this study in comparison to studies in other countries. There is no sex predilection in each subgroup of JR
ABSTRACT
Pneumomediastinum is commonly caused by iatrogenic injury such as surgery on the cervical planes and chest or by tracheostomy. It is also well known that emphysema may occur after dental treatments using an air turbine drill, but there have been few cases of emphysema which extended to the mediastinum. A 16-year-old boy is presented with subcutaneous emphysema and pneumomediastinum which developed 24 hours after surgery for extraction of an inferior second molar. We first describe history, clinical presentation and radiologic appearance of our patient and then review the literature about oral surgery causing pneumomediastinum. Surgical procedures in oral cavity can lead to the development of emphysema and pneumomediastinum when air turbine dental drills are used. To avoid these complications, air turbine high speed drills should be used only in necessary cases
Subject(s)
Humans , Male , Subcutaneous Emphysema/diagnosis , Emphysema , Face , Neck , Tooth Extraction/adverse effectsABSTRACT
Air leak syndromes including pneumothorax, pneumomediastinum and pulmonary interstitial emphysema are frequent in neonatal period. Mechanical ventilation with positive pressure is one of the most common causes of these syndromes. The aim of this study was to evaluate predisposing factors and incidence of pneumothorax in newborns under mechanical ventilation. This descriptive cross sectional study was performed in 400 newborns under mechanical ventilation in intensive care unit of a teaching hospital in Iran from April 2004 to December 2008. Predisposing factors leading to ventilation and incidence of air leak syndromes were studied. Sex, gestational age, birth weight, type of delivery, history of surfactant replacement therapy, ventilator settings and mortality rate were recorded. Statistical analysis was done using SPSS software. Univariate analysis and regression analysis were considered. Among 400 patients under mechanical ventilation, 102 neonates developed pneumothorax [26%]. Fifty six [54.9%] of them were boys and 46 [45.1%] girls. 54.9% of newborns with pneumothorax were preterm and 45.1% term. Birth weight less than 2500g was recorded in 59.8%. Fifty two percent of these neonates were born by cesarean section vs. 32% of newborns without pneumothorax. The most common type [62.7%] of ventilation leading to pneumothorax was Inspiratory Positive Pressure Ventilation [IPPV]. Surfactant replacement therapy was recorded in 32.4% of cases with pneumothorax compared to 60.4% of neonates under ventilation without pneumothorax, which was significantly different [P= 0.017]. In newborns surfactant replacement therapy can reduce the risk of pneumothorax caused by mechanical ventilation