The role of ultrasonography in the evaluation of maxillary sinusitis in pediatrics.

UNLABELLED: Sinusitis in children may sometimes present non-specific signs and symptoms. The imaging techniques used for its diagnosis are computed tomography and magnetic resonance imaging, the standard radiography being used less and less. Ultrasonography is seldom mentioned in literature as a diagnosis method of sinusitis. OBJECTIVE: The purpose of this study is to evaluate the value of ultrasonography compared with the standard X-ray in the diagnosis of maxillary sinusitis in children. METHOD: The study was prospectively conducted. The study group included 76 patients who had an ultrasound of the maxillary sinuses. The including criteria were represented by uncontrolled or partially controlled asthma, symptomatology suggesting rhinosinusitis and age over 4. Patients with radiological anomalies of the maxillary sinuses were excluded from the study as well as the patients who were not examined through X-ray and the ultrasonography on the same day. The ultrasound was performed with a pediatric convex transducer with the patient in a sitting position. The ultrasonographic exam evaluated the presence of fluid collection and mucosal thickening within the maxillary sinuses. Signs evaluated by X-ray exam were: total opacity of the maxillary sinus, air-fluid level and mucosal thickening. The Wilcoxon matched-pairs tests was used in order correlate the results obtained through ultrasonography and radiograph. It was considered statistic significant p<0.05. Using the ROC curve the sensitivity and the specificity of the ultrasound compared with the standard radiograph were determined. RESULTS: Based on the excluding criteria a number of 67 patients (35 male) were selected from the study group. The patient's mean age+/-standard deviation was 9 years 2 months+/-3 years 9 months. 134 maxillary sinuses were analyzed ultrasonographically and radiologically. There was a diagnosis agreement between the two techniques in 112 out of 134 sinuses (83.5%). Compared to the standard X-ray, ultrasonography had a 94.9 % sensitivity and a 98.4 % specificity. The error of the ultrasound exam compared to the standard X-ray evaluated in a divided interpretation was low for the normal aspect (1.58%) and for the fluid collection (5.12%), but the error for the thickening of the mucosa was high, over 50% (59.37%). IN CONCLUSION: Ultrasonography may come to represent, on a larger scale, an accessible imaging alternative to the more invasive investigations used in the present in evaluating fluid collections in the maxillary sinus in pediatrics.

[Relationship between asthma and obesity in school age students]. / Relatia dintre astm si obezitate la copiii de vârsta scolara.

BACKGROUND: Obesity and asthma are both public health problems with an increasing prevalence all over the world. The association between asthma and obesity was studied and proved in some papers, although the pathogenic pathway between them is not exactly known. The aim of this study was to examine the relationship between obesity and asthma by measuring the prevalence of obesity in asthmatic children compared with a control population. METHODS: Two groups of children aged between 7 and 18 years were studied: one group of asthmatic children and a control group, with the same age and sex with the first group. The differences between the two groups regarding the BMI were calculated, obesity being defined as a body mass index greater than the 95th percentile. RESULTS: A number of 200 children with asthma and 200 children in the control group were studied. The mean age was 10.49 years. 61.5% of children were boys. No significant difference was observed in the two groups regarding the percentage of overweight and obese children, except in the group of 7-10 years, where there is a greater percentage of children with overweight in the asthmatic group (23.3% vs 1% in the control group, p = 0.045). CONCLUSION: Obesity does not constitute, therefore, a risk factor for asthma and does not contribute to the severity of the disease.

The long-term evolution of chronic hepatitis B acquired in childhood.

UNLABELLED: The AIM of this study was to assess the long-term evolution of chronic hepatitis B acquired in childhood. METHODS: The study was carried out in 2007 - 2008 on a group of 77 adult patients who were diagnosed with chronic hepatitis B in childhood. The actual assessment included epidemiological, clinical, biological and virological data, ultrasound examination in all patients and liver histology in 3 patients. RESULTS: From the 77 patients, 69 were HBeAg positive and the other 8 patients were anti-HBe positive when the diagnosis was made in their childhood. Thirty-seven patients from the HBeAg positive group and 2 patients from the anti-HBe group had been treated in childhood with IFN-alpha and the other 38 patients remained untreated (32 patients with HBeAg positive and 6 patients anti-HBe positive). Overall, 78.26% seroconverted to anti-HBe (87.50% untreated and 70.27% of patients treated with IFN). After a median follow-up period of 13 years, 36 patients from the HBeAg positive group (48.65% of treated patients and 56.25% of untreated ones) became inactive carriers. Seroconversion to anti-HBs, in the HBeAg positive group, occurred in 10.14% of cases (8.1% in treated patients) without statistical significance. Three patients from the whole group developed cirrhosis but none developed hepatocellular carcinoma. CONCLUSION: The long-term outcome in our patients with CHB acquired in childhood did not differ between treated and untreated patients.