Oral manifestations leading to the diagnosis of acute lymphoblastic leukemia in a young girl.

BACKGROUND: oral complications may be leukemia's first presentation. AIM: to present a case of a young girl with a swelling on the face that led to the diagnosis of acute lymphoblastic leukemia is reported. RESULTS: a 10-year old anemic girl was referred for evaluation and treatment of a swelling at the left-nasolabial region. Symptoms reported (tiredness, poor appetite, fever, lethargy, and musculoskeletal pain) and clinical findings (enlargement at the presternal region and brownish stain in the lumbar region) led to the suspicion of a hematopoietic malignancy. The diagnosis of lymphoblastic leukemia was attained after specific examination conducted by the pediatric oncologist and hematologist. CONCLUSION: dentists must be able to clearly recognize oral physiological characteristics, and, when identifying changes of normalcy, to fully investigate it requesting additional tests or referring the patient to specialized professionals.

Strength deficit of knee extensor muscles of individuals with Down syndrome from childhood to adolescence.

The isokinetic strength of the knee extensor muscles of both limbs, at the speed of 30 degrees/second, was evaluated in 25 children and adolescents with Down syndrome. Comparison with two control groups of 40 intellectually average individuals and 30 individuals with mental retardation of unknown origin showed that both children and adolescents with Down syndrome were weaker than were the control subjects. Moreover, by the age of 14 years, adolescents with Down syndrome failed to show the muscle strength increase that physiologically occurs by this age. Interlimb comparison of knee extensor muscles showed a strength dominance in the 44% of individuals with Down syndrome, with a prevalence for the left leg. In conclusion, our data suggest the presence of a dysfunction of the neuromuscular system both at the level of the pyramidal system and/or of the neuromuscular junction, possibly as an expression of premature ageing.