1,720,963 research outputs found
Prolasso rettale recidivante in un lattante: può nascondere una patologia importante
No full textDescriviamo il caso di S.,10 mesi, che giunge in PS per prolasso rettale dopo l’evacuazione; alvo sempre regolare. Non presenti alterazioni mucose all’esplorazione anale. Il prolasso viene ridotto manualmente. A 11 mesi torna per un nuovo episodio di prolasso rettale: l’ecografia addominale risulta a norma, si esegue riduzione manuale e si prova terapia con rammollitori fecali. Gli episodi tuttavia diventano sempre più frequenti. All’età di 15 mesi viene quindi eseguita una rettoscopia che evidenzia, a 18 cm dall’ano, un voluminoso polipo sessile di natura infiammatoria cloacogenica. Poche settimane più tardi, in occasione di una nuova recidiva associata a ematochezia; si esegue colonscopia che rileva polipo del sigma. L’istologia ne documenterà la natura amartomatosa (tipo Peutz-Jeghers). A seguito della rimozione endoscopia del polipo, il piccolo non ha più presentato prolasso rettale né altra sintomatologia addominale. Il follow-up eseguito nei tre anni successivi (endoscopie annuali), ha evidenziato la presenza a livello gastrico di piccoli polipi di mucosa gastrica con iperplasia foveolare e di 2 polipi di tipo amartomatoso. L’indagine genetica ha documentato delezione degli esoni 2 e 3 del gene LKB1, confermando la diagnosi di sindrome di Peutz-Jeghers (PJS).
Data l’età, il piccolo non ha presentato ancora chiazze melaniniche cutanee o mucose.
Sebbene la PJS riconosca un erediterità autosomica dominante, non è presente familiarità per poliposi nella famiglia di S. È tuttavia noto che nel 35% dei casi possono presentarsi mutazioni ex-novo.
Dato la nota predisposizione di questi pazienti a sviluppare neoplasie del tratto gastrointestinale, sarà necessario proseguire il follow-up annuale che, quando l’età del bambino lo consentirà, sarà arricchito dell’ausilio ormai indispensabile della videocapsula
Polyarteritis nodosa of childhood. A review
No full textSystemic vasculitides are uncommon in childhood and
their treatment is based mainly on the use of corticosteroids
and other immunosuppressive drugs. The combined use of cortisone and cyclophosphamide, in particular, induce a remission
rate nearly 90%
Ischemic Stroke in Infants and Children: Practical Management in Emergency
Full text linkStroke is a rare disease in children, with an estimated incidence 13/100000 and a significant impact on morbidity and mortality. Clinical presentation and risk factors, present in almost half of pediatric patients, are not the same as in adults. The diagnosis of stroke in children is often delayed because signs and symptoms can be subtle and nonspecific. History and clinical examination should exclude underlying diseases or predisposing factors. Neuroimaging is crucial in defining diagnosis. Other tests might be necessary, according to the clinical picture. We present here the most recent practical directions on how to diagnose and manage arterial stroke in children, according to different international guidelines on the subject
Clostridium difficile Enterocolitis and Reactive Arthritis: A Case Report and Review of the Literature
Full text linkReactive arthritis is a rare complication of Clostridium difficile enterocolitis, especially in children. We review the 6 pediatric cases published in the English and non-English literature and discuss their clinical presentation, outcome, treatment, and pathophysiology. We also report the seventh case of Clostridium difficile reactive arthritis in a 6-year-old boy who was treated with amoxicillin-clavulanate for 10 days because of an upper respiratory infection. After the antibiotic course, the child developed at the same time diarrhea with positive stool culture for Clostridium difficile and an asymmetric polyarthritis. Nonsteroidal anti-inflammatory drugs and metronidazole completely resolved the pain, joint swelling, and diarrhea. After twelve months of follow-up there has been no recurrence. This report confirms the self-limiting course of Clostridium difficile reactive arthritis. Clostridium difficile testing in children with gastrointestinal symptoms and acute onset of joint pain should be always considered
Una rettocolite "difficile"
No full textViene esposto un caso clinico di rettocolite in età pediatrica, interessante sia per la gravità che per la precosità del quadro clinico (la RCU ha un esordio tipico in età adolescente-adulta; i casi in età pediatric, specialmente nei lattanti e durante la prima infanzia, sono invece rari e in genere a prognosi più severa), sia per l'elevato numero di recidive presentate in un lasso di tempo relativamente breve
Atypical lymphadenitis presenting with positive mantoux and quantiferon: Description of a case
No full textAtypical mycobacterial infections are a common cause of chronic cervicofacial lymphadenitis especially in 1-5 year-old children. Although tuberculous mycobacterial adenitis are less frequent among this age group, it is important to consider them in the differential diagnosis, because of the increasing incidence of tuberculosis even in Developed Countries. Considering the high sensitivity and specificity of Tuberculin skin test and Quantiferon, these tests are normally performed to exclude Tuberculosis. The Authors report and discuss the case of a patient with Atypical Mycobacterial Adenitis of parotid gland, positive Tuberculin skin test and Quantiferon but with definitive diagnosis of Mycobacterium avium lymphadenitis
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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