Abdominal mass in a neonate: hepatoblastoma.

A term neonate born to a 37 year old mother was admitted to our Neonatology Unit because of jaundice and abdominal distention. Gastrointestinal examination revealed abdominal distention and a palpable abdominal mass in right upper quadrant. After the initial radiological studies, it was clear that the mass originated from liver. At postnatal 15th day alfa-feto protein was found to be 60.500 ng/ml (normal level (2 week-1 month):9.452+/-12.610 ng/ml). While due to relatively high frequency in infancy and the type of contrast material enhancement in imaging studies suggested an infantile hemangioendothelioma (IHE), heterogenous nature of the lesion and high AFP levels were consistent with a hepatoblastoma (HB). Since accurate diagnosis could not be achieved by radiological studies a liver biopsy is performed. After the pathological examination of the tru-cut liver biopsy specimen, histomorphological and immunohistochemical findings were consistent with the epithelial component of an embryonal type hepatoblastoma.

Impact of obesity on ventilatory function

OBJETIVO: Embora a obesidade tenha sido associada ao comprometimento grave da ventilação, a maior parte da população estudada constitui-se de adultos com obesidade mórbida. Nosso objetivo foi investigar os efeitos da obesidade leve na função ventilatória de pacientes pediátricos. MÉTODOS: Estudo transversal controlado que analisou 80 pacientes (M/F: 35/45) avaliados em nosso ambulatório, com queixa de sobrepeso, sem histórico de asma ou de outras atopias, comparando-os a um grupo controle com 50 crianças de peso normal controladas para a idade e para o sexo. A média de idade dos pacientes foi de 9,7±2,5 anos (7 a 15 anos). Todos os indivíduos foram submetidos a medições antropométricas e à espirometria. A capacidade vital forçada (CVF) e o volume expiratório forçado no primeiro segundo (VEF1) foram usados como medidas da função ventilatória. RESULTADOS: Não houve diferenças significativas nas VEF1 por cento, CVF por cento e VEF1 por cento/CVF por cento por grupo de estudo (p > 0,05). Apenas três pacientes tiveram alterações obstrutivas relatadas em seus testes de função pulmonar (dois tiveram alterações moderadamente graves e um teve alterações obstrutivas leves). Não houve correlação entre os parâmetros da função pulmonar e as medidas antropométricas. CONCLUSÃO: Esses dados mostram que os parâmetros do teste da função pulmonar em crianças com obesidade leve foram semelhantes àqueles das crianças com peso normal. As medidas antropométricas não mostraram nenhum efeito significativo nas medições espirométricas das crianças, como ocorreu nos adultos.

OBJECTIVE: Although obesity was found to be associated with severe impairment of ventilation, most of the study population has been morbidly obese adults. We aimed to explore the effects of mild obesity on ventilatory function in the pediatric age group. METHODS: In a cross-sectional controlled study, 80 patients (M/F: 35/45), who were evaluated in our outpatient clinic with the complaint of excess body weight, with no history of asthma or other atopic diseases were studied and compared to a control group of 50 normal weight children controlled for age and sex. The mean age of patients was 9.7±2.5 years (7 to 15 years). Anthropometric measurements and spirometry were performed in all subjects. Forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were used as measures of ventilatory function. RESULTS: There were no significant differences in FEV1 percent, FVC percent and FEV1 percent/FVC percent by study group (p > 0.05). Only three patients had obstructive abnormalities documented on their pulmonary function tests (two had moderately severe and one had mild obstructive abnormalities). No correlation was observed between pulmonary function parameters and anthropometric measurements. CONCLUSION: These data demonstrate that pulmonary function test parameters of the mildly obese children were similar to those of the normal weight children. Anthropometric measurements had no significant effect on spirometric measurements in children as they did on adults.