The Burden of Assessing Ocular Status of Children - Causes and Control.

Pediatric ocular diseases can be detectable through a comprehensive eye examination and most of them are preventable once they are discovered. There is a well known fact that children can have ocular pathology such as cataract, refractive errors, strabismus and amblyopia. In children, low vision can have a negative impact on their growth and development; therefore, any visual impairment must be detected as soon as possible to prevent amblyopia development.

Histopathological and immunohistochemical aspects of bone tissue in aseptic necrosis of the femoral head.

Femoral head osteonecrosis, also known as avascular necrosis, is a disease with a multifactorial etiology, characterized by a profound change of bone architecture, which leads to the diminishing of bone resistance and femoral head collapse. The main causes that lead to femoral head necrosis are represented by the decrease of local blood perfusion and increase of intraosseous pressure, because of an excessive development of adipose tissue in the areolas of the trabecular bone tissue in the femoral head. The histopathological and immunohistochemical (IHC) study performed by us showed that most of bone trabeculae were damaged by necrotic-involutive processes, their sizes being reduced, both regarding their length and their diameter; generally, the spans were thin, fragmented, distanced among them, which led to the occurrence of some large areolar cavities, full of conjunctive tissue, rich in adipocytes. Some of the residual bone spans even presented microfractures. In the structure of the trabecular bone tissue, numerous cavities showed lack of content, which indicates the death of osteocytes inside, while the endosteum appeared very thin, with few osteoprogenitor, flattened, difficult to highlight cells. The IHC study showed a low reaction of the bone reparatory processes and a reduced multiplication capacity of bone cells involved in the remodeling and remake of the diseased bone tissue. Nevertheless, there were identified numerous young conjunctive cells (fibroblasts, myofibroblasts), positive to proliferating cell nuclear antigen (PCNA), cells that have a high capacity of multiplication, participating in the formation of a fibrous conjunctive tissue (sclerous) instead of the damaged bone trabeculae. The formation of fibrous conjunctive tissue causes the reduction of mechanical resistance of the femoral head and its collapse. The IHC study of the microvascularization in the femoral head damaged by aseptic osteonecrosis showed the presence of a very low vascular system, both in the residual bone trabeculae and in the sclerous conjunctive tissue. Of the inflammatory cells present in the spongy bone tissue of the femoral head affected by osteonecrosis, the most numerous ones were the macrophages. Both macrophages and T- and B-lymphocytes had a heterogenous distribution.

The sensitivity of transabdominal ultrasound in the diagnosis of ureterolithiasis.

OBJECTIVES: The ultrasonographic diagnosis of renal lithiasis colic is suggested by the existence of hydronephrosis, but the certainty is given by the direct visualization of the ureteral calculus. The aim of this study is to assess the performance of ultrasound in identifying ureteral calculi compared to other imaging methods (abdominal X-ray, urography and computed tomography). MATERIAL AND METHOD: We performed ultrasonographic examination (one or multiple examinations) in 217 patients with renal colic and ureterolithiasis. The calculus was identified by abdominal radiography, urography, computed tomography or by eliminating the calculus RESULTS: Ureteral calculi were ultrasonographically identified in 159 of the examined patients: 121 in the initial examination, 38 in the additional reexaminations (73.27% sensitivity compared to 48.39% X-ray, 68.37% urography, and 91.11% CT). Hydronephrosis was identified in 193 patients (88.94%). None of the imaging methods managed to identify ureteral calculus in 4 of the patients (1.84%), the diagnosis being retrospective, based on the urinary elimination of the calculus. The calculi were located 12.58% in the pelviureteric junction, 10.69% in the proximal ureter, 6.91% in the mid ureter, 28.93% in the distal ureter, and 40.88% in the pelviureteric junction. CONCLUSIONS: Ultrasound is a sensitive method for detecting UL in renal colic and can be used as the initial imaging method in investigating these patients. The presence or absence of hydronephrosis can not be considered as a discriminatory factor for the diagnosis of ureterolithiasis.