The aim of this study was to determine the frequency of misdiagnosis of sinus headache in migraine and other primary headache types in the children and adolescents with chronic or recurrent headaches. Children with chronic or recurrent headaches (n = 310) were prospectively evaluated. Data collection for each patient included history of previously diagnosed sinusitis due to headache, and additional sinusitis complaints (such as fever, cough, nasal discharge, postnasal discharge) at the time of sinusitis diagnosis, and improvement of the headache following treatment of sinusitis. If sinus radiographs existed they were recorded. The study included 214 patients with complete data. One hundred and sixteen (54.2%) patients have been diagnosed as sinusitis previously and 25% of them had at least one additional complaint, while 75% of them had none. Sinusitis treatment had no effect on the headaches in 60.3% of the patients. Sinus graphy had been performed in 52.8%, and 50.4% of them were normal. The prevalence of sinus headache concomitant with primary headache, and only sinus headache was detected in 7 and 1%, respectively, in our study. Approximately 40% of the patients with migraine and 60% of the patients with tension-type headache had been misdiagnosed as “sinus headache”. Children with chronic or recurrent headaches are frequently misdiagnosed as sinus headache and receive unnecessary sinusitis treatment and sinus graphy.
Ultrasonography (US) is the main imaging method to assess thyroid nodules. In the pediatric population, thyroid nodules are less prevalently seen than those in adults. However, approximately 25% of the nodules can be malignant. Validation of Thyroid Image Reporting and Data System (TI-RADS) classification has been mostly tested in adults, and information on pediatric cases is limited. In the current study, we aim to define the diagnostic power of the TI-RADS risk stratification method in pediatric thyroid nodules. The study population consists of 68 nodules of 64 patients (20 malignant, 48 benign). We have included patients at least 18 years and with a pathological diagnosis. The researchers evaluated the US images of the patients, if available. If US images cannot be found, US reports of the patients were evaluated to define TI-RADS points and category. Mean age of the population is 15.15 ± 2.66 years. There were 10 (17.7%) male patients and 58 (85.3%) female patients. Median nodule size was 8 mm. Final diagnosis was benign in 48 nodules (70.6%) and malignant in 20 nodules (29.4%). There were 5 follicular carcinoma cases and 15 papillary carcinoma cases. The area under the curve estimate was 0.89 (95% confidence interval, 0.80–0.98), and the area under the curve value confirmed the diagnostic efficacy of TI-RADS categorization in pediatric thyroid nodules. A TI-RADS category of 4 or 5 seemed to be a good cutoff point to predict malignancy. To conclude, TI-RADS categorization can be effectively used to assess pediatric thyroid nodules. Nodules with TI-RADS categories of 4 and 5 have the greatest risk of malignancy, and they should be evaluated pathologically.
Objective Lung ultrasonography (LUS) is a useful method for diagnosis of lung diseases such as respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, and pneumothorax in the neonatal period. LUS has become an important tool in the diagnosis and follow-up of lung diseases. LUS is easy to apply at the bedside and is a practical and low-cost method for diagnosing pneumonia. Study Design This study was conducted in neonatal intensive care unit of Dr. Sami Ulus Obstetrics, Children's Health and Diseases Training and Research Hospital. From September 2019 to April 2020, 50 patients who were diagnosed with viral pneumonia were included in the study. Also, 24 patients with sepsis-related respiratory failure were included in the study as a control group. LUS was performed at the bedside three times, by a single expert, once each before treatment for diagnosis, on discharge, and after discharge in outpatient clinic control. Results Before treatment, LUS findings were lung consolidation with air bronchograms (50/50), pleural line abnormalities (35/50), B-pattern (25/50), disappearance of lung sliding (21/50), lung pulse (5/50), and pleural effusion (9/50). During discharge, we found significant changes: lung consolidation with air bronchograms (6/50), pleural line abnormalities (7/50), B-pattern (12/50), and pleural effusion (1/50) (p < 0.05). Outpatient clinic control LUS findings were lung consolidation with air bronchograms (0/50), pleural line abnormalities (0/50), B-pattern (0/50), disappearance of lung sliding (0/50), and pleural effusion (0/50) (p < 0.05). Also, B-pattern image, disappearance of lung sliding, and pleural line abnormalities were higher in control group (p < 0.05). Conclusion Ultrasound gives no hazard, and the application of bedside ultrasonography is comfortable for the patients. Pneumonia is a serious infection in the neonatal period. Repeated chest radiography may be required depending on the clinical condition of the patient with pneumonia. This study focuses on adequacy of LUS in neonatal pneumonia. Key Points
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