[Fever of Unknown Origin in children and adolescents in Georgia: a review of 52 patients].

The distribution of the disorders causing Fever of Unknown Origin (FUO) may differ according to the geographic area and the socioeconomic status of the country. FUO has not been appropriately investigated in children and adolescents in Georgia and therefore a study was undertaken to determine its causes and clinical characteristics. A total of 52 children fitting the classical FUO criteria seen in our clinic between 2003 and 2005 were investigated retrospectively. 27 (51,9 %) were boys and 25 (48,0%) were girls. 3 children (5,7 %) were less than 3 years old, 4 (7,6%) were 3-9 years old, 14 (26,9 %) were 10-14 years old and 32 (61,5%) were 15-18 years old. The mean age was 15,9 +/-4,8 years (range 1 year-18 years). 25 children (48,0 %) had a prolonged fever that had lasted for 15-30 days, 15 (28.8 %) for 31-60 days, and 12 (23.0 %) had fever lasting for more than 60 days. The most common causes of FUO were sepsis (10/52), tuberculosis (9/52), pneumonia (8/52), pyelonephritis (5/52), collagen tissue disorder (2/52), neoplasm (2/52), and miscellaneous (9/52). In 7 (13,4 %) of the cases the etiology could not be found. Some derivative hematological parameters--leukocytic index of intoxication, organism's allergisation index, ratios lymphocytes/neutrophils and eosinophils/lymphocytes and adaptation reactions can be helpful to distinguish severe infections. Precise evaluation of hematological changes can be useful for differential diagnosis of FUO. The most common cause of FUO in children and adolescents in Georgia remains infection.

[Clinical characteristics of juvenile systemic hypertension in the population of Tbilisi].

The goal of the work was to study a prevalence of juvenile systemic hypertension among 15-16 years old adolescents of Tbilisi, its clinical characteristics and several indices of mental capacity. In the result of an analysis of 378 adolescents' blood pressure records only 6 (1.6%) had high normal values and 32 (8,46%) revealed juvenile systemic hypertension. Four youths from 6 with high normal values refused to participate in a further investigation. For this reason the study was continued only in 32 youths with juvenile systemic hypertension. In the contingent noted 6 (18,75%) had overweight, 9 (28,12%) had hereditary predisposition, 15 (46,9%) revealed excessive use of salt, 3 (9,4%) had moderate consumption of alcohol and 7 (21,9%) noted insufficient physical activity. Juvenile systemic hypertension in youth was predominantly asymptomatic, only 9 (28,12%) had mild headache in the evening, 12 (37,5%) had light fatigue and 5 (15,6%) weak dizziness. Fourteen youths noted diminished work-status and being behind in learning process. In the persons with juvenile systemic hypertension diminution of the attention concentration was observed during a fulfilment of a simple sensor and motor task in condition of monotonous work (increment of answers missed up to 13+/-12%). A psycho-emotional loading test has proved the fact of mental capacity lowering within the persons with juvenile systemic hypertension that is expressed in the increment of errors made up to 12+/-3,1% and answers missed up to 11+/-2,3%. Our investigations confirm the reasonability of blood pressure monitoring among adolescents for the early detection of the juvenile systemic hypertension and the conduction of an opportune preventive measures for avoiding of cardiovascular diseases in a mature age.

[Visceral leishmaniasis: clinical and epidemiological features among children and adolescents in Georgia].

The aim of the study was to describe the clinical and epidemiological features of children and adolescents with visceral leishmaniasis in Georgia. We performed a retrospective analysis of demographic, clinical and laboratory data from children and adolescents under age of 18 (n=200) with visceral leishmaniasis admitted to the referral center -- Tbilisi S. Virsaladze Institute of Parasitology between 2000 and 2005. Diagnosis was based on detection of amastigotes in the bone marrow punctate. Age ranged from 4 months to 15.9 years, the average age was 2.79+/-0.17 years. There were 84 girls and 116 boys. 190 cases came from Eastern Georgia (123 from the capital), 10 cases -- from Western Georgia. The period between manifestation of first clinical signs of the disease and admission to the referral center varied from 1 week to 1 year (6.8+/-0,6 weeks in average). Main clinical and laboratory presentations were splenomegaly and hepatomagaly, anemia, pancytopenia (84.5%). Among associated diseases, the most frequent were bronchitis and pneumonia (7.0%) and jaundice (3.5%). In all patients glucantime was used for treatment. One patient died. Visceral leishmaniasis can be considered as an important etiological agent of the fever of unknown origin in Georgia, particularly in Eastern Georgia and in children under six. Health care workers should be trained for the early recognition and appropriate management of visceral leishmaniasis and its complications.