125 research outputs found
Nephrogenic remnants: Occasional ultrasound diagnosis and follow-up
No full textNephrogenic remnants (NRs) are nodular collections of undifferentiated renal blastema cells in the postnatal kidney that are recognized as putative precursor lesions of Wilms tumor (WT). NRs may remain stationary, undergo regression, or proliferate. In the last case, there is a high risk for the development of a WT. During infancy, they are most frequently of microscopic size, to be found only at autopsy in approximately 1% of infant kidneys. Approximately 1 out of 100 microscopic lesions persist and grow developing lesions large enough to be seen by ultrasound in the first months of life. We report on a case of NRs in a six year old child, as incidental finding during abdominal ultrasound performed for other purposes. In consideration of the potential evolution in WT, after a period of close surveillance of 14 months, the lesion was resected. Histological examination revealed the presence of NRs, no neoplastic lesions were found. Currently the patient is 16 years old, in good health, and there have been no signs of recurrence
Lung ultrasound in bronchiolitis: Comparison with chest X-ray
No full textThe diagnosis of bronchiolitis is based mainly on the patient's medical history and physical examination. However, in severe cases, a further evaluation including chest X-ray (CXR) may be necessary. At present, lung ultrasound (LUS) is not included in the diagnostic work-up of bronchiolitis. This study aimed to compare the diagnostic accuracy of LUS and CXR in children with bronchiolitis, and to evaluate the correlation between clinical and ultrasound findings. Only patients with a diagnosis of bronchiolitis, who had undergone a CXR, were enrolled in the study. Fifty-two infants underwent LUS and CXR. LUS was also performed in 52 infants without clinical signs of bronchiolitis. LUS was positive for the diagnosis of bronchiolitis in 47/52 patients, whereas CXR was positive in 38/52. All patients with normal LUS examination had a normal CXR, whereas nine patients with normal CXR had abnormal LUS. In these patients, the clinical course was consistent with bronchiolitis. We found that LUS is a simple and reliable tool for the diagnosis and follow-up of bronchiolitis. It is more reliable than CXR, can be easily repeated at the patient's bedside, and carries no risk of irradiation. In some patients with bronchiolitis, LUS is able to identify lung abnormalities not revealed by CXR. Furthermore, there is a good correlation between clinical and ultrasound findings. Given the short time needed to get a US report, this technique could become the routine imaging modality for patients with bronchiolitis. © 2011 Springer-Verlag
Usefulness of lung ultrasound in a newborn with pulmonary atelectasis
No full textThe use of ultrasound for the evaluation of the lung is relatively recent. We describe the case of a newborn with pulmonary atelectasis and shift of the mediastinum underlining both advantages and limits of lung ultrasound (LUS). The baby, 1 month of age, was admitted to our hospital for tachypnoea, vomiting and poor weight gain. Chest X-ray (CXR) showed displacement of the heart to the right, suggesting the presence of atelectasis of the right lung. LUS confirmed the displacement of the mediastinum to the right and atelectasis of the right lung, clearly visible as a consolidation with the presence of air bronchograms. The computed tomography image showed that the lung parenchyma displayed in the right hemithorax could be attributed to the hyperexpanded left lung. However, once this information was acquired, and compared to the ultrasound picture, we were able to monitor the patient by LUS until normalization, thus avoiding further exposure to ionizing radiation. Our case, in accordance with the recent Literature, indicates that LUS can be adopted as a simple and non-invasive method for evaluating children with lung disease. It is easy to perform at bedside, allows a close follow-up and avoids the use of ionizing radiation
Lung ultrasound characteristics of community-acquired pneumonia in hospitalized children
No full textBackground The diagnosis of community-acquired pneumonia (CAP) is based mainly on the patient's medical history and physical examination. However, in severe cases a further evaluation including chest X-ray (CXR) may be necessary. At present, lung ultrasound (LUS) is not included in the diagnostic work-up of pneumonia. Aim To describe the ultrasonographic appearance of CAP at presentation and during the follow-up. Methods A total of 102 patients with clinical signs and symptoms suggesting pneumonia, who underwent a clinically driven CXR, were evaluated by LUS on the same day. LUS signs of pneumonia included subpleural lung consolidation, B-lines, pleural line abnormalities, and pleural effusion. The diagnostic gold standard was the ex-post diagnosis of pneumonia made by two independent experienced pediatricians on the basis of clinical presentation, CXR and clinical course following British Thoracic Guidelines recommendations. Results A final diagnosis of pneumonia was confirmed in 89/102 patients. LUS was positive for the diagnosis of pneumonia in 88/89 patients, whereas CXR was positive in 81/89. Only one patient with normal LUS examination had an abnormal CXR, whereas 8 patients with normal CXR had an abnormal LUS. LUS was able to detect pleural effusion resulting from complicated pneumonia in 16 cases, whereas CXR detected pleural effusion in 3 cases. Conclusions LUS is a simple and reliable imaging tool, not inferior to CXR in identifying pleuro-pulmonary alterations in children with suspected pneumonia. During the course of the disease, LUS allows a radiation-free follow-up of these abnormalities. Pediatr Pulmonol. 2013; 48:280-287. © 2012 Wiley Periodicals, Inc. Copyright © 2012 Wiley Periodicals, Inc
GREEN: Building an Operational Prototype of Expert System for Planning Control in Urban Environments
No full textDiagnosis and follow-up of congenital intrahepatic portosystemic venous shunt by ultrasounds.
No full textPaediatric Cushing’s disease: epidemiology, pathogenesis, clinical management and outcome
No full textCushing’s disease (CD) is rare in paediatric practice but requires prompt investigation, diagnosis and therapy to prevent long-term complications. Key presenting features are a change in facial appearance, weight gain, growth failure, virilization, disturbed puberty and psychological disturbance. Close consultation with an adult endocrinology department is recommended regarding diagnosis and therapy. The incidence of CD, a form of ACTH-dependent Cushing’s syndrome (CS), is equal to approximately 5% of that seen in adults. The majority of ACTH-secreting adenomas are monoclonal and sporadic, although recent studies of pituitary tumours have shown links to several deubiquitination gene defects. Diagnosis requires confirmation of hypercortisolism followed by demonstration of ACTH-dependence. Identification of the corticotroph adenoma by pituitary MRI and/or bilateral inferior petrosal sampling for ACTH may contribute to localisation before pituitary surgery. Transsphenoidal surgery (TSS) with selective microadenomectomy is first-line therapy, followed by external pituitary irradiation if surgery is not curative. Medical therapy to suppress adrenal steroid synthesis is effective in the short-term and bilateral adrenalectomy should be considered in cases unfit for TSS or radiotherapy or when urgent remission is needed after unsuccessful surgery. TSS induces remission of hypercortisolism and improvement of symptoms in 70–100% of cases, particularly when performed by a surgeon with experience in children. Post-TSS complications include pituitary hormone deficiencies, sub-optimal catch-up growth, and persisting excess of BMI. Recurrence of hypercortisolism following remission is recognised but infrequent, being less common than in adult CD patients. With experienced specialist medical and surgical care, the overall prognosis is good. Early referral to an experienced endocrine centre is advised
The Mu2e calorimeter: Quality assurance of production crystals and SiPMs
No full textThe Mu2e calorimeter is composed of two disks each containing 1348 pure CsI crystals, each crystal read out by two arrays of 6x6 mm2 monolithic SiPMs. The experimental requirements have been translated in a series of technical specifications for both crystals and SiPMs. Quality assurance tests, on first crystal and then SiPM production batches, confirm the performances of preproduction samples previously assembled in a calorimeter prototype and tested with an electron beam. The production yield is sufficient to allow the construction of a calorimeter of the required quality in the expected times
A patient with duplication (7)(p22.1pter) characterized by array-CGH
No full textApproximately 40 patients with terminal duplication of the distal short arm of chromosome 7 have been reported, the smallest being dup(7)(p21). We report here on a patient with a smaller duplication, dup(7)(p22.1), detected on G-banding and characterized by array-CGH. We establish phenotype-karyotype correlations with the reported patients with other 7p duplications. © 2006 Wiley-Liss, Inc.Cai T, 1999, AM J MED GENET, V86, P305, DOI 10.1002-(SICI)1096-8628(19991008)86:4305::AID-AJMG13.0.CO;2-B; CAIULO A, 1989, HUM GENET, V84, P51, DOI 10.1007-BF00210670; CARNEVALE A, 1978, CLIN GENET, V14, P202; Kozma C, 2000, AM J MED GENET, V91, P286, DOI 10.1002-(SICI)1096-8628(20000410)91:4286::AID-AJMG93.0.CO;2-2; LURIE IW, 1995, AM J MED GENET, V55, P62, DOI 10.1002-ajmg.1320550117; Megarbane A, 2001, J MED GENET, V38, P178, DOI 10.1136-jmg.38.3.178; MILUNSKY JM, 1989, AM J MED GENET, V33, P364, DOI 10.1002-ajmg.1320330315; ODELL JM, 1987, AM J MED GENET, V27, P687, DOI 10.1002-ajmg.1320270323; Pallotta R, 1996, ANN GENET-PARIS, V39, P152; Redha MA, 1996, ANN GENET-PARIS, V39, P5; Reish O, 1996, AM J MED GENET, V61, P21, DOI 10.1002-(SICI)1096-8628(19960102)61:121::AID-AJMG43.3.CO;2-2; SAINTOMER FB, 1990, PATHOLOGICA, V82, P543; Schinzel A, 2001, CATALOGUE UNBALANCED; Stankiewicz P, 2001, AM J MED GENET, V103, P56, DOI 10.1002-ajmg.1512; ZERRES K, 1989, ANN GENET-PARIS, V32, P22546
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