Introdução: A asma é uma doença heterogénea, com uma prevalência estimada de 9% nos adolescentes. Os adolescentes asmáticos, para além de lidarem com os sintomas físicos, podem também debater-se com problemas sociais e emocionais, devido à incapacidade de acompanhar os seus pares em ambientes onde possam existir fatores desencadeantes da doença. Objetivo: Avaliar a perceção da qualidade de vida (QoL) em adolescentes asmáticos seguidos em consulta de alergologia pediátrica num hospital de nível II. Método: Estudo transversal, englobando doentes asmáticos entre os 10 e os 17 anos, observados em consulta de alergologia pediátrica. Foi feita a caracterização da doença e pesquisados fatores de risco e comorbilidades associadas. Posteriormente aplicou-se o Questionário de Qualidade de Vida na Asma Pediátrica (PAQLQ). Resultados: Foram avaliados 41 adolescentes, 68,3% do sexo masculino, com idade média de 13,1±2,0 anos. Nenhum doente apresentava asma grave e 13 (31,7%) tinham asma moderada. A asma não estava controlada em 11 (26,8%) doentes e 33 (80,5%) apresentavam provas de função respiratória (PFR) normais. Os adolescentes com asma controlada apresentaram maior pontuação em todos os domínios do questionário, sendo a diferença estatisticamente significativa (p<0,05). A gravidade da asma e a presença de alterações na PFR relacionaram-se com pior pontuação total do PAQLQ e nos domínios «sintomas» e «emocional» (p<0,05). Relativamente aos fatores de risco, o valor do FeNO e a obesidade, para o domínio «sintomas», e a ansiedade, para os domínios «emocional» e «sintomas», relacionaram-se com um agravamento estatisticamente significativo (p<0,05) da QoL. Conclusões: A QoL está diretamente relacionada com o nível de controlo e gravidade da asma. O uso de um questionário em português, que permite avaliar a QoL, pode ser uma ferramenta útil, quer no incentivo dos adolescentes ao cumprimento da terapêutica quer na orientação do profissional de saúde sobre o seu trabalho.
Allergen-Specific Immunotherapy (ASI) is being used on the treatment of respiratory allergies for over a century, aiming to reduce individual hypersensitivity to specific allergens, and is proven to be very effective on the long term. Goal Evaluation of the patients followed in the Paediatric Allergology clinic at a level II Hospital treated with ASI.Retrospective and descriptive study of the efficiency of ASI in patients attending our Allergology inpatient clinic between 2016 and 2020.The sample was characterized according to patients' gender, age, initial diagnosis, method of allergy testing (blood IgE or Skin Prick Testing) and the type of ASI used.During the estimated period, a total of 44 patients were treated with ASI.Of these, 27 (61%) are male, with a median age of 11 years old on the first day of treatment (minimum age: 6 years old, maximum age: 17 years old).As to the diagnosis: 34 (77%) have Allergic Rhinitis, 20 (46%) have Allergic Asthma, 9(21%) Allergic Conjuntctivitis, 3 (7%) Urticaria, and 2 (5%) Atopic Dermathitis. The majority of patients have more than one condition identified.All the patients underwent Skin Prick Testing and 60% also did blood tests.Grasses and domestical mites were the agents more frequently identified as inducers of Hypersensitivy, and 36% of the patients received monotherapy.Subcutaneous admnistrations was the prefered method in 2/ 3 of the patients.There were no adverse effects observed until today and the ASI was proven to be effective to reduce allergic symptomatology.ASI is the only treatment modality known to effectively change the natural course of Allergic disease.However, it is essential to thoroughly select the patients that can qualify for the treatment, as to the specific allergen extracts being used, so that we can optimize therapy benefits.
All autosomal variants were filtered for allelic frequency <1% according to the gnomAD database (version 2.1). Among them, 821 variants were found the most common (!10%) in both the control and experimental group. Wherein 280 variants were presented with an alternative allele frequency of more than 10% in the experimental group, but were found with a lower frequency in the control. Interestingly, 10 of these 280 variants were located in the ZNF717 gene. This gene encodes a Kruppel-associated box (KRAB) zinc-finger protein, which belongs to a large group of transcriptional regulators in mammals and play important roles in various cellular functions, including cell proliferation, differentiation and apoptosis. Extended bioinformatics analysis showed that 34 unique variants were found in the experimental group and were absent in the control group, which may indicate both the characteristics of Russian children with BPD and the insufficient representativeness of the control group and, in turn, requires a more in-depth analysis.For the first time in Russia, large-scale studies have been carried out to identify the molecular genetic characteristics of Russian children with BPD using full exome sequencing. Our study indicates ZNF717 gene may be relevant in BPD pathogenesis, but further research is required. These preliminary results may contribute to improving knowledge of the pathogenesis of bronchopulmonary dysplasia and targeting therapeutic interventions.
Case Discussion Though MIS-C is rare, with an incidence of 0.14% among children with SARS CoV-2 infection according to one Systematic Review (Hoang Et al. 2020), it is an important new differential which must be borne in mind in cases of fever with no clear source. Both of these cases had a negative PCR test for SARS CoV-2 and no history of Covid 19 disease. No serological testing for SARS CoV-2 was available in our hospital setting. But in accordance with RCPCH guidelines this does not exclude the diagnosis of MIS-CIn previous studies as many as 71% of cases of MIS-C required PICU admission (Ahmed Et al., 2020), however not all are severely unwell and may be stable enough to be managed on a ward setting as described above.
Aims: Lipschütz ulcer (LU), also known as acute vulvar ulcer, is a rare cause of vulvar ulcerations of nonvenereal origin. Our aim is to alert about this manifestation of the disease and to prevent unnecessary treatment.Case description: we present a 15 years old female, without relevant family and past history, admitted in the emergency room with a painful vulvar ulcer, preceded by five days of fever and sore throat. On physical examination, she had enlarged, and erythematous tonsils and bilateral anterior cervical lymphadenopathy and the genital examination revealed vulvar oedema and a deep ulcer with necrotic plaques in labium minus. The exclusion of transmitted sexual disease led to a diagnosis of Lipschütz ulcer. She started symptomatic treatment, oral antibiotic and corticoid therapy. She was discharged from the hospital after 6 days of admission and returned to a consult one month later when it was observed an almost complete resolution of the lesions. No recurrences occurred until 3 months.Conclusion: LU is a misdiagnosed pathology, probably because doctors, in general, are not familiarized with that, and since the diagnosis is made by exclusion. Infectious, such as Epstein-Barr Virus infections, are proposed etiologies.
14000/mm3 with lymphocytic predominance and numerous atypical lymphocytes in the smear. Her IMN monospot test was positive. Her alanine aminotransferase (ALT) was 370 IU/L. She was discharged home with diagnosis of glandular fever on symptomatic treatment. A week later, she represented with jaundice, pruritus, nausea and anorexia. Her liver functions showed ALT: 1956 IU/L, aspartate aminotransferase (AST): 1007 IU/L, alkaline phosphatase (ALP): 162 IU/L, total bilirubin: 70 mmol/L, direct bilirubin: 47 mmol/L and albumin: 45 g/L. Her renal functions and clotting was normal.Her viral markers (hepatitis B virus surface antigen, antihepatitis C virus, hepatitis A virus immunoglobulin IgM) were negative. Hepatitis E IgG antibody was positive whereas IgM was negative. Antinuclear, anti-mitochondrial and anti-smooth antibody profile was negative. Ultrasound abdomen showed mild splenomegaly (14cm). Her copper level was 35.8 mmol/L (N: 11-22 mmol/L) and ceruloplasmin level was 0.52 g/L (0.16-0.45 g/L). EBV viral capsid antigen IgM and IgG were positive and EBV nuclear antigen IgG was negative. Cytomegalovirus IgM was negative and IgG were positive. Her IgA and IgM antibody levels were mildly elevated 3.36 g/L (N: 0.8-2.8 g/L) and 2.8 g/L (N: 0.5-1.9 g/L) respectively. She was treated with ursodeoxycholic acid and fat soluble vitamins. Her liver functions improved but were still deranged 4 weeks later.Symptomatic hepatitis in IMN is rare, more so in paediatric population compared to elderly. The elevation in aminotransferases levels are usually less than fivefold and hyperbilirubinaemia is seen in up to 5% of patients.In our patient ALT increased more than 30 times and she became clinically jaundiced and symptomatic. Fulminant hepatitis is very rare. Possible mechanisms are lymphocytic infiltration of hepatocytes, cholestasis and auto-immune hepatitis. Treatment is mainly symptomatic and supportive. Conclusion Patients with IMN should be observed for jaundice and subsequently monitored for liver function in case of hepatitis. EBV should be considered in patients presenting with clinical jaundice.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.