Introduction. Infestation with the roundworm Ascaris lumbricoides is one of the most prevalent helminthic diseases belonging to the soil-transmitted helminths class. Infections are especially affecting children in tropical countries and low and middle-income countries but also may occur in developing countries where sanitation and hygiene are poor. We aim to present a case report to sound the alarm on this widespread pathology. Case presentation. We report the case of a 9-year-old boy with Down syndrome and duodenal stenosis admitted to our hospital with recurrent bouts of pancreatitis secondary to ascariasis. Child is living in poor sanitation conditions. The first episode of pancreatitis was at the age of seven. The abdominal ultrasound shows enlargement and heterogeneity of the head and body of the pancreas, and multiple images of "the strip sign" in the duodenum, suggesting the presence of Ascaris lumbricoides. Live worms were expelled several times. During the next two years, this child was admitted for similar episodes suggesting re-infection with the soil-transmitted helminths, repeated courses of albendazole were administered to the patient and to his close relatives contact. Conclusions. Ascaris lumbricoides infection is rarely a direct cause of mortality, but it contributes to overwhelming morbidity. Periodically repeated de-worming treatment and additional preventive measures such as improvements to water, sanitation and hygiene (WASH) could ensure high rates of eradication.
Congenital obstructive Uropathies are a leading cause of Chronic Kidney Disease in children. The gold-standard for renal functional imaging is Diuretic Renal Scintigraphy. Different alternatives to Renal Scintigraphy have been suggested, many of them based on Magnetic Resonance Imaging (MRI). The accurate morphologic details of MRI with its more specific application - MR-Urography are well known. The prospect of adding functional information is very attractive, as it will make the MRU a comprehensive “all in one” examination for obstructive uropathies. We chose to investigate DCE MR urography and DTI as tools for the evaluation of congenital obstructive uropathies. Also, we suggest a different technique that describes the urinary flow in the collecting system – phase contrast imaging of the urinary flow in the renal pelvis. Therefore we performed three different studies, all with different sets of patients.
Objectives. Pediatricians face various challenges in different stages of celiac disease (CD) diagnosis. Whom to test is intensely debated because of CD's heterogenous clinical spectrum. The main purpose of the study was to identify symptoms or symptom associations that should initiate an active strategy of CD early diagnosis in Romanian children. Material and method. We conducted a prospective study in "Grigore Alexandrescu" Emergency Children's Hospital. From March 2013 until February 2014, 249 children with symptoms/signs at risk of CD were included. Results. CD was diagnosed in 11 (1/21 patients evaluated). One in 12.6; 16; 18; 18.5 and 18.5 children respectively with chronic diarrhea, low stature, growth failure, recurrent abdominal pain and constipation had CD. Certain symptom associations increased the risk: classical symptom associations (chronic diarrhea and weight loss), as well as other associations: recurrent abdominal pain and weight loss, constipation and weight loss, constipation and refractory iron deficiency anemia. Conclusion. Active screening among patients with symptoms and especially symptom associations at risk of CD would improve diagnosis rates in pediatric CD.
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