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At least 613 records · Page 34Linked to original sources

PubMed1981

Radiation induced cancer: a report of 10 cases.

Ionizing radiations have been shown to be carcinogenic to man as well as experimental animals. Malignancies following therapeutic radiation occur rarely. Over the past 10 years the authors recorded 10 cases of tumours in irradiated tissues. 3 occurred in patients irradiated for nasopharyngeal carcinoma, 3 were irradiated for tuberculosis adenitis, 2 for carcinoma of the cervix, 1 for carcinoma of the breast and 1 for basal cell carcinoma. The latent period for tumour induction following the irradiation varied from 5 years to 31 years. All these cases showed no evidence of recurrence or metastases of the original primary lesion; and the histology of the second primary differed from the first. Evidence of radiation damage was seen in all cases except for 2 patients who were treated for tuberculosis adenitis. The doses received varied from 900r to about, 9000r. Among the tumours produced, there were 3 cases of squamous cell carcinoma of the oral & postcricoid region, 2 cases of papillary carcinoma of the thyroid, 2 cases of adenocarcinoma of the rectum, 1 case of adenocarcinoma of the ethmoid, 1 case of osteosarcoma of the mandible and 1 case of extraskeletal osteosarcoma. The clinical features of these cases are discussed and other cases reported in the literature are reviewed.

Adenocarcinoma↗

PubMedDate not supplied

[Evaluation of the efficacy and tolerance of ceftriaxone in childhood].

Between the years 1981 and 1983 we treated with Ceftriaxone (Cx) 34 children--aged 15 days to 13 years--affected with serious infections: 18 infections of lower respiratory tract, 1 sepsis caused by E. Coli, 1 meningitis with cloudy cerebrospinal fluid, 1 submandibular adenitis with otitis, 1 otitis, 12 infections of the urinary tract caused by Proteus mirabilis, E. Coli, Klebsiella oxitocica and Klebsiella pneumoniae. Whenever bacteria were isolated by cultures, sensibility in vitro to Cx was tested. Cx was given i.m. or i.v. at a dose ranging from 50 to 135 mg/Kg/die according to the age and the seriousness of the infections; in 17 children Cx was administered once daily, in the other patients in two divided doses. The following laboratory measurements were obtained before, during and after treatment: complete blood cell count, platelet count, total bilirubin, creatinine, SGOT, SGPT, alkaline phosphatase and urinalysis. Patients were also monitored daily for clinical signs and symptoms such as fever, general conditions, heart rate, respiratory rate, blood pressure. Twenty children showed a good clinical response (1 sepsis, 1 otitis, 1 adenitis, 1 meningitis, 12 infections of the urinary tract, 4 infections of the lower respiratory tract); urine sterilization was achieved after three days of therapy in all patients with infections of the urinary tract. Remarkable clinical and radiological improvement in 9 patients with infections of lower respiratory tract was observed while in only 4 children with bronchopneumonia therapy was ineffective although the dosage of Cx was adeguate; in these patients a further antibiotic treatment was necessary for a complete recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1980

Vascular lesions in tuberculosis.

4 cases of tuberculosis in which the vessels were involved are described: 1 of tuberculous adenitis and arteritis in the region of the carotid artery bifurcation; 1 of tuberculous endometritis associated with aortic pseudoaneurysms and inferior vena cava partial occlusion, and 2 of tuberculous para-aortic adenitis, 1 with complete occlusion of the inferior vena cava, and the other with miliary nodulations of the liver later demonstrated by angiogram. It is suggested that in veiw of the ubiquitous presentations and incidence of tuberculosis in this environment, more vascular studies need be done to demonstrate the frequency and the involvement of the vessels by tuberculosis in cases of tuberculosis. Furthermore, in cases of aortitis and arteritis, tuberculosis must be excluded as an etiological cause.

Adult↗

PubMed1995

[Lymph node tuberculosis in HIV-1 seropositive patients in Central Africa. A characteristic histopathologic picture].

Sixty two patients fulfilling the definition established by the Centers for Disease Control in 1982 for persistent lymphadenopathy syndrome, thought to be related to the human immunodeficiency virus (HIV) infection, were selected at the Butare university hospital, in Rwanda, between 1987 and 1988. Forty-five (73%) of them were indeed seropositive. Fifteen patients of sixty two (24%) presented unexpectedly evidence of tuberculous adenitis on biopsy. Three of them, found HIV-1 seronegative, showed a classical follicular adenitis, whereas the twelve other seropositive patients presented unusual histologic features, consisting of more or less immature tuberculoid granulomas with an abundant caseating and often granular necrosis, containing acid fast bacilli. Numerous blood vessels and abundant plasmacytosis were found in non-necrotic areas. Semi-quantitative evaluation of the granulomatous reaction components provided a histological spectrum probably related to the degree of impairment of the cellular immune response, which could be of prognostic significance. In areas where populations are exposed to both HIV and M. tuberculosis, it appears that lymph node biopsy with mycobacterial culture should be recommended in order to detect occult tuberculosis among HIV-seropositive persons, allowing accurate medical care and adequate public health surveillance.

AIDS-Related Opportunistic Infections↗

PubMed1994

[Brachial plexus neuropathy following pyogenic cervical adenophlegmon].

BACKGROUND: Brachial plexopathy is rare in children; it may follow a non-specific respiratory infection or occur after a specific viral disease or immunization. CASE REPORT: An 8 year-old girl was admitted suffering from presuppurative acute cervical adenitis. She was given penicillin V, netilmicin and corticosteroids. The adenitis gradually resolved over a period of ten days. There was no evidence of a specific bacterial infection. The patient suffered from pain localized to her right shoulder 15 days after admission; this pain was resolved within 3-4 days but was followed by paralysis affecting the upper brachial roots without sensory signs. EMG performed 15 days later showed signs of denervation. Amyotrophy set in rapidly but recovery under physiotherapy was complete 5 months later. CONCLUSION: This plexopathy resembling the Parsonage-Turner syndrome could be allergic in pathogenesis although similar cases after bacterial, possibly streptococcal, infection remain to be confirmed.

Brachial Plexus↗

PubMed1993

Sensitization potential and reactogenicity of varying doses of BCG plus killed Mycobacterium leprae: an extended study.

This study is an extension of a previous study on an antileprosy combination vaccine of BCG plus killed Mycobacterium leprae (KML) regarding its sensitization potential and reactogenicity. The study was extended to see if by reducing the dose of BCG in the combination vaccine the incidence of suppurative adenitis could be reduced without a significant reduction in the level of postvaccination skin-test responses. The study included 860 individuals, and three preparations of the combination vaccine [BCG 0.05 mg + 6 x 10(8) KML (I), BCG 0.05 mg + 5 x 10(7) KML (II), BCG 0.01 mg + 5 x 10(7) KML (III)] along with normal saline (i.v.) were used. Each individual received one of these four preparations by random allocation. They were also tested with Rees' M. leprae soluble antigen (MLSA) and lepromin A 12 weeks after vaccination. Reactions to the MLSA were measured after 48 hr; reactions to lepromin A after 48 hr and 3 weeks. The character and size of the local response at the vaccination site were recorded at the third, eighth, and 15th week postvaccination. The results of the study showed that by halving the dose of BCG in the combination vaccine BCG plus 6 x 10(8) KML a) the incidence of suppurative regional adenitis was reduced significantly, b) there was no significant change in the post-vaccination response at 12 weeks as measured by Rees' MLSA and lepromin A, and c) the evolution of the vaccination lesion was somewhat prolonged. This dose was found satisfactory for use in a comparative antileprosy vaccine trial in South India.

Adolescent↗

PubMed1995

[Comparative characteristics of intrathoracic lymph node coniotuberculosis of occupational and non-occupational etiology].

263 patients with coniotuberculosis of the intrathoracic lymph nodes were compared clinically according to whether they were or not at 0ccupational risk of silicosis. Patients exposed to quartz dust had some special morphological picture of affected lymph nodes: periadenitis, dust caseosis and tubercula in the presence anthracosilicosis sclerosis. Silicotuberculous broncho-adenitis in silicosis patients is characterized by solitary lesions of the lymph nodes, bronchi, rare dissemination to the lungs. Coniotuberculous broncho-adenitis in elderly subjects arises in the result of occupation-unrelated accumulation in the lymph nodes of coal and quartz dust and runs chronically. Unless the disease is controlled early and actively, it may generalize and aggravate with perforation in the bronchi, vessels and esophagus. Profuse hemorrhage, caverns, atelectasis are also possible.

Adult↗

PubMed1981

Characterization of the major apolipoproteins secreted by two human hepatoma cell lines.

Two newly described human hepatoma derived cell lines, Hep G2 and Hep 3B [Knowles, B. B., Howe, C. C., & Aden, D. P. (1980) Science (Washington, D.C.) 209, 497-499], synthesize and secrete into the culture medium most of the major plasma apoproteins (apoA-I, apoA-II, apoB, apoC-II, apoC-III, and apoE). The synthesized apoproteins were identified by direct two-dimensional gel analysis of the culture medium or by two-dimensional analysis following purification of the apoproteins by ultracentrifugation or immunoprecipitation. We found that the apoA-I synthesized by both of the hepatoma cell lines consists of two isoproteins designated 2 and 3 which are more basic than the major plasma apoA-I isoproteins designated 4 and 5. The apoE synthesized by both cell lines is composed mainly of an array of isoproteins with increasingly higher molecular weights and lower isoelectric points as compared to those of the major apoE isoproteins found in plasma. These precursors of apoE are converted to the major apoE isoproteins upon treatment with Clostridium perfringens neuraminidase and represent sialo apoE isoproteins. ApoA-II, apoC-II, apoC-III-1, and apoC-III-2 correspond to the protein forms present in plasma. The human hepatoma cell lines (Hep G2 and Hep 3B) provide a unique model for studies of the regulation of human apoprotein and lipoprotein synthesis and catabolism.

Apolipoproteins↗

PubMed2000

Methicillin-resistant Staphylococcus aureus infections in 2 pediatric outpatients.

Methicillin-resistant Staphylococcus aureus (MRSA) infections are an emerging problem in children. The following are 2 case reports of unsuspected MRSA infections: the first is an infant with cervical adenitis and the second is a child with a deep infection of the toe. Both patients failed outpatient therapy with oral cephalosporins and required hospitalization for surgical drainage. Both patients had cultures positive for MRSA at surgery. Neither patient had any risk factors for acquiring MRSA. Thus, outpatients with presumed staphylococcal infections who fail oral therapy with cephalosporins may be infected with MRSA.

Ambulatory Care↗

PubMed1999

Recurrence of a deep neck infection: a clinical indication of an underlying congenital lesion.

OBJECTIVE: To discuss the computed tomographic (CT) and clinical findings of those entities that may present as recurrent deep neck infections. PATIENTS AND METHODS: Twelve patients with recurrent deep neck infections and CT scans were retrospectively identified since 1990. Their CT scans and medical histories were reviewed. The diagnosis was pathologically confirmed in all cases. RESULTS: The CT scans revealed an abscess or a localized infected cyst in the deep soft tissues of the neck, with varying degrees of associated inflammatory change in the adjacent soft tissues. The diagnoses in these cases included 1 first branchial cleft cyst, 3 second branchial cleft cysts, 1 third branchial cleft cyst, 2 fourth branchial cleft cysts, 2 infected lymphangiomas, 2 thyroglossal duct cysts, and 1 cervical thymic cyst. CONCLUSIONS: Most deep neck infections are the result of suppurative adenitis. The location of the primary focus is usually from the mucosa of the upper aerodigestive tract or from an odontogenic source. Less common causes are perforations due to a foreign body, thrombophlebitis of the internal jugular vein, or osteomyelitis of the spine. Recurrences in these situations are unusual. Less commonly, congenital lesions can present as deep neck infections, and recurrences are common. Our cases suggest that the recurrence of a deep neck infection should alert the physician to the possibility of an underlying congenital lesion and that CT is helpful in the early recognition of these lesions.

Adolescent↗

PubMed2000

Fewer symptoms occur in same-serotype recurrent streptococcal tonsillopharyngitis.

BACKGROUND: Most patients with acute rheumatic fever report no antecedent pharyngitis. OBJECTIVE: To determine the clinical and microbiological characteristics of recurrent group A beta-hemolytic streptococcal (GABHS) tonsillopharyngitis. DESIGN: Prospective randomized trial. SUBJECTS: Symptoms were recorded and throat cultures were obtained at 4 to 6, 18 to 21, and 32 to 35 days following the start of treatment. A subset of 60 patients with subsequent GABHS episodes occurring were evaluated for a 0.2-or greater log rise in either antistreptolysin O or anti-deoxyribonuclease B titer to confirm a bona fide recurrence. RESULTS: Sixteen (27%) of 60 patients had recurrent GABHS tonsillopharyngitis of the same serotype that occurred 21 days or longer following the onset of the initial GABHS infection and was associated with a 0.2- or greater log rise in either antistreptolysin O or anti-deoxyribonuclease B titer, indicating bona fide recurrent infection; these recurrences all occurred within 55 days. Fewer patients with recurrent GABHS pharyngitis of the same serotype had headache (P =.02), sore throat (P =.006), fever (P =. 008), pharyngeal erythema (P<.001), pharyngeal edema (P<.001), pharyngeal exudate (P =.04), and adenitis (P =.03) compared with the initial episode. Chills, stomachache, scarlatina, tonsillar enlargement, and palatal petechiae were similar for both episodes. CONCLUSIONS: Fewer symptoms occur during recurrent GABHS pharyngitis of the same serotype compared with the initial infection. These patients may be less likely to seek physician attention, yet their infections put them at risk for sequelae.

Adolescent↗

PubMed2000

Periodic fever and pharyngitis in young children: a new disease for the otolaryngologist?

OBJECTIVE: A clinical entity consisting of periodic fever associated with aphthous stomatitis, pharyngitis and cervical adenitis termed "PFAPA syndrome" in young children (<5 years old) may be unfamiliar to otolaryngologists. We present our 5-year experience of PFAPA syndrome. DESIGN: Case series. SETTING: Tertiary academic. PATIENTS: A 5-year retrospective chart review for children (<5 years old) who have undergone tonsillectomies with and without adenoidectomies was conducted. Medical records from subjects who underwent the procedures for recurrent pharyngitis were reviewed with reference to a history of periodic fever and stomatitis associated with pharyngitis. INTERVENTIONS: Tonsillectomy with and without adenoidectomy. MAIN OUTCOME MEASURE: The objective measure was a comparison of the number of visits to the primary care physician for pharyngitis associated with fever in a 3-month period before and after the surgical intervention. The subjective measure was a telephone interview evaluating preoperative and postoperative symptoms. RESULTS: Of the 117 patients identified, 22 (19%) underwent surgery for recurrent pharyngitis. Five subjects (average age, 2.5 years) were identified as having PFAPA syndrome. The average number of preoperative PFAPA-related complaints was 11.6 compared with 0.2 for the number of postoperative PFAPA-related complaints (P=.03). CONCLUSIONS: Our experience suggests that PFAPA syndrome is an uncommon disease. Most of these children have undergone workup(s) for sepsis performed by their pediatricians because of the associated high fever. The clinical history of this cohort was quite distinctive. This small sample suggests a significant decrease if not cessation of pharyngitis following surgical intervention.

Adenoidectomy↗

PubMed2003

Management of nontuberculous mycobacterial cervical lymphadenitis.

OBJECTIVE: To review the treatment and outcome of patients with nontuberculous mycobacterial (NTM) cervical lymphadenitis. DESIGN: Retrospective chart review. SETTING: Tertiary care children's hospital. PATIENTS: Thirty consecutive immunocompetent patients (median age, 32 months; age range, 11-147 months) diagnosed as having NTM cervical lymphadenitis over a 77-month period. INTERVENTIONS: Primary therapy for 34 foci of NTM cervical lymphadenitis in 30 children consisted of excisional biopsy (n = 8), incision and drainage procedures (n = 14), fine-needle aspiration biopsy (n = 7), observation only (n = 4), and antimycobacterial chemotherapy only (n = 1). MAIN OUTCOME MEASURES: (1) Time to cure, (2) recurrent adenitis, and (3) complications associated with therapy were determined for each therapeutic option. The average duration of follow-up was 32 months (range, 6-78 months). RESULTS: Nearly all patients (97%) were cured of their disease regardless of which therapeutic option was used. Excisional biopsy, while associated with transient marginal mandibular nerve injury in 1 patient, typically resulted in the most rapid resolution of disease. Observation alone did result in eventual cure, although the disease course was protracted. Simple incision and drainage without curettage was associated with prolonged postoperative wound discharge and hypertrophic scarring. CONCLUSIONS: A variety of therapeutic options were used in children with NTM cervical lymphadenitis. Resolution of infection was an eventual outcome regardless of treatment option, although duration of disease, potential for facial nerve injury, and incidence of hypertrophic scarring varied among the different treatments. An individualized management approach is recommended, with excisional biopsy as the preferred option when feasible.

Anti-Bacterial Agents↗

PubMed1985

Cervical mycobacterial lymphadenitis. Medical vs surgical management.

After years in its decrease, cervical mycobacterial adenitis is once again an increasing problem in Los Angeles County. We reviewed 54 cases of cervical lymphadenopathies treated over ten years. Twenty-five (46%) of these patients were found to have mycobacterial cervical lymphadenitis. Medical approaches often failed to conclusively diagnose this disease. In our series, none of the patients with cervical adenopathies (36%) treated only medically regressed, even after an average time of 18 months of antituberculosis drug treatment. The treatment of choice seems to be surgical excision and long-term antituberculosis drugs. Surgery provides a rapid tissue diagnosis and confirms the bacterial type, including atypical mycobacterium. This approach is simple, shortens hospitalization, is cost-effective, and carries a low morbidity.

Adolescent↗

PubMed1989

Kawasaki disease and cervical adenopathy.

Kawasaki disease (KD) is an acute illness of unknown cause that affects infants and children. The diagnosis is confirmed in patients with prolonged fever and four of the following clinical features: (1) nonexudative conjunctivitis; (2) oral cavity changes; (3) rash; (4) extremity changes; and (5) cervical adenopathy. Complications of KD include coronary artery aneurysms, which may lead to myocardial infarction, chronic coronary insufficiency, or death. We describe a series of 83 patients with KD in whom 43 (52%) of 83 developed cervical adenopathy during their acute illness. Eighteen (42%) of these 43 patients were initially misdiagnosed as having cervical adenitis and were treated with antibiotics. The otolaryngologist may see these patients in referral and should consider the diagnosis of KD in patients with cervical adenopathy, prolonged fever, signs of mucosal inflammation, or rash. Early diagnosis and intravenous treatment with high-dose gamma-globulin is effective in reducing the prevalence of coronary artery abnormalities.

Child, Preschool↗

PubMed1990

Inflammatory torticollis in children.

Acute torticollis is commonly seen in the pediatric emergency department. It often results from an inflammatory process that irritates the cervical muscles, nerves, or vertebrae. Posturing of the head occurs with unilateral spasm of the sternocleidomastoid muscle such that the child will position the head with the occiput rotated to the affected side and the chin rotated to the contralateral side. We recently treated 26 children who presented to the emergency department with acute nontraumatic torticollis. The most common causes were upper respiratory infection, sinusitis, otomastoiditis, cervical adenitis, and retropharyngeal abscess or cellulitis. Four patients had subluxation of the atlantoaxial joint as a result of the inflammatory process. Children with acute torticollis need careful evaluation for either overt or occult otolaryngologic infections. Computed tomography and magnetic resonance imaging are helpful in determining the cause of the acute torticollis and in ruling out rotatory subluxation of the atlantoaxial joint.

Atlanto-Axial Joint↗

PubMed1994

Nontuberculous mycobacterial infections of the head and neck.

OBJECTIVE: To review the treatment and outcome of patients with nontuberculous mycobacterial infections of the head and neck. DESIGN: Retrospective examination of the medical records of patients treated by several surgeons during a 5-year period with a minimum 6-month follow-up. SETTING: Large teaching children's hospital. PATIENTS: Twenty-six children hospitalized for treatment of nontuberculous mycobacterial infections of the head and neck. MAIN OUTCOME MEASURES: Resolution of infection, recurrence, and need for additional surgical intervention for cure. RESULTS: Eleven patients initially were treated by incisional biopsy or incision and drainage procedures; eight patients developed recurrence or a draining sinus tract, necessitating a second surgical procedure. In contrast, 15 patients initially underwent complete excision; only one developed a recurrence (P < .01). Thus, eight (31%) of 26 patients required at least two surgical procedures owing to inadequate initial treatment. CONCLUSIONS: Excisional biopsy is both the diagnostic procedure and treatment of choice for nontuberculous mycobacterial adenitis.

Adolescent↗

PubMed1988

Group A beta-hemolytic streptococci as a cause of bacteremia in children.

The clinical manifestations of patients with group A beta-hemolytic streptococcal (GAS) bacteremia presenting to an urban children's hospital were reviewed. Group A beta-hemolytic streptococci were isolated from blood cultures from 17 children over a three-year period. Systemic illnesses that may have predisposed these children to GAS bacteremia were identified in seven patients: preceding varicella infection (four patients) or malignant neoplasm/immunosuppressive therapy (three patients). Possible sources of GAS included compromised integument (seven patients), the oropharynx (six patients), or the lower respiratory tract (two patients). The clinical manifestations of GAS sepsis included the following: fever (15 patients); arthritis or arthralgias (four patients); cellulitis (three patients); maculopapular eruption (one patient); petechial or pustular exanthems (three patients); osteomyelitis (two patients); cervical adenitis (one patient); empyema (one patient); and meningitis with multiple brain abscesses (one patient). Two patients died of apparent overwhelming GAS sepsis while at home. Group A beta-hemolytic streptococcal bacteremia can present with a wide range of clinical manifestations and cause mild to fulminant disease in children.

Child↗